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Form N-6 JOHN HANCOCK LIFE INSURA

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August 31, 2020 2:18 PM EDT
As filed with the U.S. Securities and Exchange Commission on August 31, 2020
Registration No. 333-000000
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM N-6
SEC File No 811-4834
REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 [X]
REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940
AMENDMENT NO. 100 [X]
John Hancock Life Insurance Company (U.S.A.) Separate Account A
(Exact Name of Registrant)
John Hancock Life Insurance Company (U.S.A.)
(Name of Depositor)
200 Berkeley Street
Boston, MA 02116
(Complete address of depositor’s principal executive offices)
Depositor's Telephone Number: 617-572-6000
JAMES C. HOODLET
John Hancock Life Insurance Company (U.S.A.)
U.S. INSURANCE LAW
200 BERKELEY ST.
BOSTON, MA 02116
(Name and complete address of agent for service)
It is proposed that this filing will become effective as soon as practicable after the effective date of the Registration Statement.
The Registrant hereby amends this Registration Statement on such date or dates as may be necessary to delay its effective date until the Registrant shall file a further amendment that specifically states that this Registration Statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933 or until the Registration Statement shall become effective on such date as the Commission, acting pursuant to said Section 8(a), may determine.
Pursuant to the provisions of Rule 24f-2, Registrant has registered an indefinite amount of the securities under the Securities Act of 1933.

Prospectus dated [ ], 2020
for interests in
John Hancock Life Insurance Company (U.S.A.) Separate Account A
Interests are made available under
Protection Variable Universal Life 2021
a flexible premium variable universal life insurance policy
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
(“John Hancock USA”)
The policy provides a fixed account option with fixed rates of return declared by John Hancock USA and the following variable investment accounts:
500 Index
Active Bond
American Asset Allocation
American Global Growth
American Growth
American Growth-Income
American International
Blue Chip Growth
Capital Appreciation
Capital Appreciation Value
Core Bond
Disciplined Value International
Emerging Markets Value
Equity Income
Financial Industries
Fundamental All Cap Core
Fundamental Large Cap Value
Global
Health Sciences
High Yield
International Equity Index
International Small Company
Investment Quality Bond
Lifestyle Balanced
Lifestyle Conservative
Lifestyle Growth
Lifestyle Moderate
Managed Volatility Aggressive
Managed Volatility Balanced
Managed Volatility Conservative
Managed Volatility Growth
Managed Volatility Moderate
Mid Cap Index
Mid Cap Stock
Mid Value
Money Market
Opportunistic Fixed Income
PIMCO VIT All Asset
Real Estate Securities
Science & Technology
Select Bond
Short Term Government Income
Small Cap Index
Small Cap Opportunities
Small Cap Stock
Small Cap Value
Small Company Value
Strategic Income Opportunities
Total Bond Market
Total Stock Market Index
Ultra Short Term Bond
* * * * * * * * * * * *
Please note that the Securities and Exchange Commission (“SEC”) has not approved or disapproved these securities, or determined if this prospectus is truthful or complete. Any representation to the contrary is a criminal offense.
Beginning on January 1, 2021, as permitted by regulations adopted by the Securities and Exchange Commission, you may no longer receive paper copies of the shareholder reports for the Portfolios offered through your John Hancock life insurance policy unless you specifically request paper copies from John Hancock. Instead, the shareholder reports will be made available on a website, and you will be notified by mail each time reports are posted and be provided with a website link to access those reports. If you have already elected to receive shareholder reports electronically, you will not be affected by this change, and you do not need to take any action.
Alternatively, you may request to receive reports in paper, free of charge, at any time, by calling John Hancock at 800-827-4546. Your election to receive reports in paper will apply to all Portfolios offered within your life insurance policy.

 

GUIDE TO THIS PROSPECTUS
This prospectus provides a description of all the material rights and obligations under your policy. This prospectus is arranged in the following way:
•  Starting on the next page is a Table of Contents for this prospectus.
•  The section after the Table of Contents is called “Summary of Benefits and Risks.” It contains a summary of the benefits available under the policy and of the principal risks of purchasing the policy. You should read this section before reading any other section of this prospectus.
•  Behind the Summary of Benefits and Risks section is a section called “Fee Tables” that describes the fees and expenses you will pay when buying, owning and surrendering the policy.
•  Behind the Fee Tables section is a section called “Detailed Information.” This section gives more details about the policy. It may repeat certain information contained in the Summary of Benefits and Risks section in order to put the more detailed information in proper context.
•  Finally, on the back cover of this prospectus is information concerning the Statement of Additional Information (the “SAI”) and how the SAI, audited financial statements for John Hancock USA and the Separate Account, personalized illustrations and other information can be obtained.
Prior to making any investment decisions, you should carefully review this product prospectus and all applicable supplements. In addition, you will receive the prospectuses for the underlying funds that we make available as investment options under the policies. The funds' prospectuses describe the investment objectives, policies and restrictions of, and the risks relating to, investment in the funds. In the case of any of the portfolios that are operated as feeder funds, the prospectus for the corresponding master fund is also provided. If you need to obtain additional copies of any of these documents, please contact your John Hancock USA representative or contact our Service Office at the address and telephone number on the back page of this product prospectus.
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Table of Contents
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SUMMARY OF BENEFITS AND RISKS
The nature of the policy
The policy's primary purpose is to provide lifetime protection against economic loss due to the death of the insured person. The policy is unsuitable as a short-term savings vehicle because of the substantial policy-level charges. We are obligated to pay all amounts promised under the policy. The value of the amount you have invested under the policy may increase or decrease daily based upon the investment results of the variable investment accounts that you choose. The amount we pay to the policy’s beneficiary on the death of the insured person (we call this the “death benefit”) may be similarly affected. That’s why the policy is referred to as a “variable” life insurance policy. We call the investments you make in the policy “premiums” or “premium payments.” The amount we require as your first premium depends upon the specifics of your policy and the insured person. Except as noted in the “Detailed Information” section of this prospectus, you can make any other premium payments you wish at any time. That’s why the policy is called a “flexible premium” policy.
The policy comes with a Death Benefit Protection feature, which will protect your policy from lapsing so long as the Death Benefit Protection Value minus policy debt is greater than zero (see “Death Benefit Protection”). However, if your policy debt is greater than your policy value, the Death Benefit Protection will not prevent your policy from going into default. Thus, if your goal is to maximize the protection under the Death Benefit Protection feature, you may wish to minimize the amount you borrow from the policy.
You should discuss your priorities for this policy with your registered representative.
Summary of policy benefits
Death benefit
When the insured person dies, we will pay the death benefit minus any policy debt and unpaid fees and charges. There are two ways of calculating the death benefit (Option 1 and Option 2). You choose which one you want in the application. The two death benefit options are:
•  Option 1 - The death benefit will equal the greater of (1) the Face Amount plus any amount payable under a supplementary benefit rider, or (2) the minimum death benefit (as described under “The minimum death benefit” provision in the “Detailed Information” section of this prospectus).
•  Option 2 - The death benefit will equal the greater of (1) the Face Amount plus any amount payable under a supplementary benefit rider, plus the policy value on the date of death, or (2) the minimum death benefit.
Variable investment accounts
The policy offers a number of variable investment accounts, as listed on page 1 of this prospectus. These variable investment accounts are subaccounts of John Hancock Life Insurance Company (U.S.A.) Separate Account A (“Separate Account”), a separate account operated by us under Michigan law. The variable investment accounts cover a broad spectrum of investment styles and strategies. Although the portfolios of the series funds that underlie those variable investment accounts operate like publicly traded mutual funds, there are important differences between the variable investment accounts and publicly traded mutual funds. You can transfer money from one variable investment account to another without tax liability. Moreover, any dividends and capital gains distributed by each underlying portfolio are automatically reinvested and reflected in the portfolio’s value and create no taxable event for you. If and when policy earnings are distributed (generally as a result of a surrender or withdrawal), they will be treated as ordinary income instead of as capital gains. Also, you must keep in mind that you are purchasing an insurance policy and you will be assessed charges at the policy level as well as at the fund level. Such policy level charges, in aggregate, are significant and will reduce the investment performance of your policy.
Surrender of the policy
You may surrender the policy in full at any time. If you do, we will pay you the policy value less any outstanding policy debt and less any surrender charge that then applies. This is called your “net cash surrender value.” You must return your policy when you request a surrender.
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If you have not taken a loan on your policy, the “policy value” of your policy will, on any given date, be equal to:
•  the amount you invested,
•  plus any gain or minus any loss of the investment experience of the variable investment accounts you’ve chosen,
•  plus any amounts credited or applied to your policy value,
•  minus all charges we deduct, and
•  minus all withdrawals you have made.
If you take a loan on your policy, your policy value will be computed somewhat differently (see “Effects of policy loans”).
Withdrawals
After the first policy year, you may make a withdrawal of part of your net cash surrender value. Generally, each withdrawal must be at least $500. Your policy value is automatically reduced by the amount of the withdrawal and any surrender charge that then applies. A withdrawal may also reduce the Face Amount (see “Surrender and withdrawals— Withdrawals”). We reserve the right to refuse any withdrawal that would cause the Face Amount to fall below $50,000. Withdrawals will reduce your Policy Value; this means a withdrawal may reduce the amount of Policy Value Credits or Asset Credits you receive over the long term (see “Policy Value Credit” and “Asset Credit”). Withdrawals will also reduce the Death Benefit Protection Value; this means the Death Benefit Protection feature would be more likely to go into default (see “Death Benefit Protection”).
Policy loans
If your policy is in force and has sufficient policy value, you may borrow from it at any time by completing the appropriate form. Generally, the minimum amount of each loan is $500. The maximum amount you can borrow is determined by a formula as described in your policy. Interest is charged on each loan. You can pay the interest or allow it to become part of the outstanding loan balance. You can repay all or part of a loan at any time. If there is an outstanding loan when the insured person dies, it will be deducted from the death benefit. Policy loans permanently affect the calculation of your policy value, and may also result in adverse tax consequences.
Policy Value Credit and Asset Credit
We will apply a Policy Value Credit to your policy value on each monthly deduction date (see “Policy Value Credit”), and on each monthly deduction date beginning in the Asset Credit Commencement Year, we will apply an Asset Credit. The Asset Credit is equal to the Asset Credit Rate multiplied by the lesser of the Policy Value (excluding the Loan Account) and the Face Amount. The Asset Credit Commencement Year and the Asset Credit Rates are shown in your Policy Specifications. The Policy Value Credit and Asset Credit will be applied to the Fixed Account and Investment Accounts in the same manner as we take Monthly Deductions from these accounts. These credits are designed to help improve the long-term performance of your policy and are affected by the amounts and timing of the premiums that you pay into the policy, how well the investment options you select perform, loans (with respect to the Asset Credit), withdrawals and other changes you make to the policy. You can see the effect that these factors have on the policy value by requesting an illustration at various assumptions.
Optional supplementary benefit riders
When you apply for the policy, you can request any of the optional supplementary benefit riders that we make available. Availability of riders varies from state to state. Charges for most riders will be deducted monthly from the policy value. Some riders may not be available in combination with other riders or benefits (see “Other policy benefits, rights and limitations— Optional supplementary benefit riders you can add”).
Summary of policy risks
Lapse risk
A policy will go into default if on any monthly deduction date the policy’s net cash surrender value would be zero or below after deducting the monthly deductions then due and the Death Benefit Protection feature is in default (i.e. “lapse”).
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This can happen because you haven't paid enough premium, because the investment performance of the variable investment accounts you’ve chosen has been poor, or because of a combination of both factors. You will be given a “grace period” within which to make additional premium payments to keep the policy in force. If lapse occurs, you may be given the opportunity to reinstate the policy by making the required premium payments and satisfying certain other conditions (see “Lapse and reinstatement”).
Since withdrawals reduce your policy value, withdrawals increase the risk of lapse. Policy loans also increase the risk of lapse.
Investment risk
As mentioned above, the investment performance of any variable investment account may be good or bad. Your policy value will rise or fall based on the investment performance of the variable investment accounts you’ve chosen. Some variable investment accounts are riskier than others. These risks (and potential rewards) are discussed in detail in the prospectuses of the underlying portfolios.
Transfer risk
There is a risk that you will not be able to transfer your policy value from one variable investment account to another because of limitations on the dollar amount or frequency of transfers you can make. The limitations on transfers out of the fixed account are more restrictive than those that apply to transfers out of variable investment accounts. If you purchase the Long-Term Care Rider, while benefits are being paid under that rider you will be subject to special transfer restrictions (see “Optional supplementary benefit riders you can add”).
Early surrender risk
There are surrender charges assessed if you surrender your policy in the first ten policy years. Surrender charges may also apply to a Face Amount decrease (see “The death benefit—Requesting a decrease in coverage”). Depending on the policy value at the time you are considering surrender, there may be little or no surrender value payable to you.
Market timing and disruptive trading risks
The policy is not designed for professional market timers or highly active traders, including persons or entities that engage in programmed, large or frequent transfers among the variable investment accounts or between the variable investment accounts and any available fixed account. The policy is also not designed to accommodate trading that result in transfers that are large in relation to the total assets of the underlying portfolio.
To discourage market timing and disruptive trading activity, we impose restrictions (see “Market timing and disruptive trading practices”) on transfers and reserve the right to change, suspend or terminate telephone, facsimile and internet transaction privileges (see “How you communicate with us”).
While we seek to identify and prevent disruptive trading activity, it may not always be possible to do so. Therefore, no assurance can be given that the restrictions we impose will be successful in preventing all disruptive trading and avoiding harm to long term investors.
Tax risks
Life insurance death benefits are ordinarily not subject to income tax. Other Federal and state taxes may apply as further discussed below. In general, you will be taxed on the amount of lifetime distributions that exceed the premiums paid under the policy. Any taxable distribution will be treated as ordinary income (rather than as capital gains) for tax purposes. If you have elected the Long-Term Care Rider, the Healthy Engagement Rider or the Critical Illness Rider, please see the section of the prospectus entitled “Tax considerations” for a description of certain tax risks associated with that rider.
In order for you to receive the tax benefits extended to life insurance under the Internal Revenue Code, your policy must comply with certain requirements of the Code. We will monitor your policy for compliance with these requirements, but a policy might fail to qualify as life insurance in spite of our monitoring. If this were to occur, you would be subject to income tax on the income credited to your policy for the period of disqualification and all subsequent periods. The tax laws also contain a so-called “7 pay limit” that limits the amount of premium that can be paid in relation to the policy’s death benefit. If the limit is violated, the policy will be treated as a “modified endowment contract,” which can have adverse tax consequences. There are also certain Treasury Department rules referred to as the “investor control rules” that determine whether you would
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be treated as the “owner” of the assets underlying your policy. If that were determined to be the case, you would be taxed on any income or gains those assets generate. In other words, you would lose the value of the so-called “inside build-up” that is a major benefit of life insurance.
There is a tax risk associated with policy loans. Although no part of a loan is treated as income to you when the loan is made unless your policy is a “modified endowment contract,” surrender or lapse of the policy with a loan outstanding would result in the loan being treated as a distribution at the time of lapse or surrender. This could result in a considerable tax bill. Under certain circumstances involving large amounts of outstanding loans and an insured person of advanced age, you might find yourself having to choose between high premium requirements to keep your policy from lapsing and a significant tax burden if you allow the lapse to occur.
Tax consequences of ownership or receipt of policy proceeds under Federal, state and local estate, inheritance, gift and other tax laws can vary greatly depending upon the circumstances of each owner or beneficiary. There can also be unfavorable tax consequences on such things as the change of policy ownership or assignment of ownership interests. For these and all the other reasons mentioned above, we recommend you consult with a qualified tax adviser before buying the policy and before exercising certain rights under the policy.
FEE TABLES
This section contains tables that describe all of the fees and expenses that you will pay when buying, owning and surrendering the policy. In the first three tables, certain entries show the maximum charge, the minimum charge and the charge for a representative insured person. Other entries show only the maximum charge we can assess. Except where necessary to show a rate greater than zero, all rates shown in the tables have been rounded to two decimal places as required by prospectus disclosure rules. Consequently, the actual rates charged may be slightly higher or lower than those shown in the tables.
The first table below describes the fees and expenses that you will pay at the time that you pay a premium, surrender the policy, lapse the policy, reduce the Face Amount, or transfer policy value between variable investment accounts. A portion of the premium charge is used to cover premium taxes. Premium taxes vary by jurisdiction and are subject to change. Currently, premium tax levels range from 0% to 5%.
Transaction Fees
Charge When Charge is Deducted Amount Deducted
Premium charge Upon payment of premium 35% of each premium paid in years 1-10
32% of each premium paid in years 11+
Surrender charge(1) Upon surrender, policy lapse or any reduction in Face Amount  
Maximum charge   $70.80 per $1,000 of Face Amount
Minimum charge   $2.28 per $1,000 of Face Amount
Charge for representative insured person   $37.95 per $1,000 of Face Amount
Transfer fee Upon each transfer into or out of a variable investment account beyond an annual limit of not less than twelve $25.00 (2)
    
(1)  A surrender charge is applicable for ten policy years from the Policy Date, and varies based upon the sex, issue age, and risk classification of the insured person. The surrender charge will reduce monthly over the surrender charge period as a percentage of the initial amount stated in the Policy Specifications. The charges shown in the table are the amounts applied in month one in the first year of the surrender charge period. The maximum charge shown is for a 73-year old male superpreferred non-smoker underwriting risk. The minimum charge shown is for a 0-year old female standard non-smoker underwriting risk. The representative insured person rate shown is for a 55-year old male preferred non-smoker underwriting risk. For more information about the surrender charge, see “Deductions from policy value – Surrender charge.” These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(2)  This charge is not currently imposed, but we reserve the right to do so in the policy.
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The next two tables describe the charges and expenses that you will pay periodically during the time you own the policy. These tables do not include fees and expenses paid at the portfolio level. The second table is devoted only to optional supplementary rider benefits.
Periodic Charges Other Than Fund Operating Expenses
Charge When Charge is Deducted Amount Deducted
Cost of insurance charge(1) Monthly  
Maximum charge   $0.08 per $1 of NAR
Minimum charge   $0.0000067 per $1 of NAR
Charge for representative insured person   $0.0002838 per $1 of NAR
Face Amount charge(2) Monthly  
Maximum charge   $14.87 per $1,000 of Face Amount
Minimum charge   $0.08 per $1,000 of Face Amount
Charge for representative insured person   $0.81 per $1,000 of Face Amount
Advance Contribution Charge(3) Monthly  
Maximum charge   $7.38 per $1,000 of excess Cumulative Premiums
Minimum charge   $0.83 per $1,000 of excess Cumulative Premiums
Charge for representative insured person   $1.68 per $1,000 of excess Cumulative Premiums
Administrative charge Monthly $20.00
Asset-based risk charge(4) Monthly 0.02% of policy value
Policy loan interest rate(5) Accrues daily
Payable annually 		3.25%
    
(1)  The cost of insurance charge is determined by multiplying the net amount of insurance for which we are at risk (the net amount at risk or “NAR”) by the applicable cost of insurance rate. The rates vary widely depending upon the length of time the policy has been in effect, the insurance risk characteristics of the insured person and (generally) the gender of the insured person. The maximum rate shown is the rate in policy year 14 for a policy issued to cover a 90-year old male substandard smoker underwriting risk. The minimum rate shown is the rate in the first policy year for a 5-year old female standard non-smoker underwriting risk. The representative insured person rate shown is the rate for a 55-year old male preferred non-smoker underwriting risk with a policy in the first policy year. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(2)  This charge is determined by multiplying the Face Amount at issue by the applicable rate. The rates vary by the sex, issue age, and risk classification at issue of the insured person. The maximum rate shown is for a 90-year old male standard smoker underwriting risk. The minimum rate shown is for a 0-year old male standard non-smoker underwriting risk. The representative insured person rate shown is the rate for a 55- year old male preferred non-smoker underwriting risk. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(3)  This charge is determined by multiplying the Advance Contribution Charge Rate by the excess (if any) of cumulative premiums paid over the Advance Contribution Limit multiplied by the policy year. The Advance Contribution Charge Rate and Advance Contribution Limit vary depending upon the issue age, insurance risk characteristics and gender of the insured person. The Advance Contribution Charge Rate and the Advance Contribution Limit are identified in your Policy Specifications. The maximum rate shown is for a 35-year old male standard plus non-smoker underwriting risk. The minimum rate shown is for a 45-year old male preferred non-smoker underwriting risk. The representative insured person rate shown is the rate for a 55-year old male preferred non-smoker underwriting risk. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(4)  This charge only applies to that portion of policy value held in the variable investment accounts. The charge determined does not apply to any policy value held in a fixed account. We currently do not impose an asset-based risk charge for any policy years, but we reserve the right to do so in the policy.
(5)  The maximum effective annual interest rate we can charge for the loan account is 3.25% for policy years 1-10 and 2.25% for policy years 11 and thereafter. The minimum interest that the loan account will earn is equal to the difference between the maximum annual
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interest rate we charge for the loan minus the Maximum Loan Interest Credited Differential. The Maximum Loan Interest Credited Differential is the difference between the annual interest rate we charge for the loan minus the interest rate we credit for the loan, however, it will never be greater than 2%. For example, if the annual interest rate we charge for a loan is 3%, we cannot credit interest at a rate less than 1% because the difference between the interest rate charged for the loan and the interest rate credited to the loan cannot be more than the Maximum Loan Interest Credited Differential, which is 2%. Policy value in the variable investment accounts and fixed account used as collateral for a loan are transferred to the loan account and credited and charged interest as explained above (see “Policy loans”).
Rider Charges
Charge When Charge is Deducted Amount Deducted
Healthy Engagement Rider Monthly $2
Disability Payment of Specified Premium Rider(1) Monthly  
Maximum charge   $198.67 per $1,000 of Specified Premium
Minimum charge   $16.57 per $1,000 of Specified Premium
Charge for representative insured person   $88.11 per $1,000 of Specified Premium
Long-Term Care Rider(2) Monthly  
Maximum charge   $3.34 per $1,000 of NAR
Minimum charge   $0.01 per $1,000 of NAR
Charge for representative insured person   $0.11 per $1,000 of NAR
Long-Term Care Rider 2018(3) Monthly  
Maximum charge   $3.75 per $1,000 of NAR
Minimum charge   $0.01 per $1,000 of NAR
Charge for representative insured person   $0.10 per $1,000 of NAR
Critical Illness Benefit Rider (4) Monthly  
Maximum charge   $48.43 per $1,000 of Critical Illness Benefit Amount
Minimum charge   $0.20 per $1,000 of Critical Illness Benefit Amount
Charge for representative insured person   $5.10 per $1,000 of Critical Illness Benefit Amount
Return of Premium Death Benefit Rider(5) Monthly  
Maximum charge   $0.08 per $1 of NAR
Minimum charge   $0.0000067 per $1 of NAR
Charge for representative insured person   $0.0002838 per $1 of NAR
Accelerated Benefit Rider (6) At exercise of benefit $150.00
    
(1)  The charge for this rider is determined by multiplying the Specified Premium by the applicable rate. The Specified Premium is stated in the Policy Specifications page of your policy. The rates vary by the sex, issue age and the disability insurance risk characteristics of the insured person. The maximum rate shown is for a 54-year old female substandard smoker underwriting risk. The minimum rate shown is for a 20-year old male standard non-smoker underwriting risk. The representative insured person rate shown is for a 55 year old male preferred non-smoker underwriting risk. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(2)  The charge for this rider is determined by multiplying the net amount of insurance for which we are at risk (the net amount at risk or “NAR”) by the applicable rate. The rates vary by the long-term care insurance risk characteristics of the insured person and the rider benefit level selected. The maximum rate shown is for a 75-year old male substandard smoker underwriting risk with a 4% Monthly Acceleration Percentage. The minimum rate shown is for a 20-year old female super preferred non-smoker underwriting risk with a 1% Monthly Acceleration Percentage, which is a percentage of the death benefit you can accelerate each month. The Monthly Acceleration
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Percentage is stated in the Policy Specifications page of your policy. The representative insured person rate shown is for a 55-year old male preferred non-smoker underwriting risk with a 4% Monthly Acceleration Percentage. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(3)  The charge for this rider is determined by multiplying the net amount of insurance for which we are at risk (the net amount at risk or “NAR”) by the applicable rate. The rates vary by the long-term care insurance risk characteristics of the insured person and the rider benefit level selected. The maximum rate shown is for a 75-year old female substandard smoker underwriting risk with a 4% Monthly Acceleration Percentage. The minimum rate shown is for a 20-year old male super preferred non-smoker underwriting risk with a 1% Monthly Acceleration Percentage. The representative insured person rate shown is for a 55-year old male preferred non-smoker underwriting risk with a 4% Monthly Acceleration Percentage. The Monthly Acceleration Percentage is the percentage of the death benefit you can accelerate each month, and is stated in the Policy Specifications page of your policy. These rates may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(4)  The charge for this rider is determined by multiplying the Critical Illness Benefit Amount by the applicable rate. The rates vary by issue age, duration, gender, and critical illness risk classification of the insured person (e.g., the risk that the insured person will develop a Critical Illness, as defined in the rider). The maximum rate shown is the rate in the sixteenth policy year for a 49-year old male standard smoker underwriting risk. The minimum rate shown is the rate in the second policy year for an 18-year old female standard non-smoker underwriting risk. The rate for the representative insured person is the rate in the first policy year for a 55-year old male standard non-smoker underwriting risk. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(5)  The Return of Premium Death Benefit Rider charge is determined by multiplying the net amount of insurance for which we are at risk (the net amount of risk or “NAR”) by the applicable cost of insurance rate. The rates vary widely depending upon the length of time the policy has been in effect, the insurance risk characteristics of the insured person and (generally) the sex of the insured person. The maximum rate shown is the rate in policy year 14 for a policy issued to cover a 90-year old male substandard smoker underwriting risk. The minimum rate shown is the rate in the first policy year for a 5-year old female standard non-smoker underwriting risk. The representative insured person rate shown is the rate for a 55-year old male preferred non-smoker underwriting risk with a policy in the first policy year. These charges may not be particularly relevant to your current situation. For more information, contact your John Hancock USA representative.
(6)  The charge is not currently imposed, but we reserve the right to do so in the policy.
The next table describes the minimum and maximum portfolio level fees and expenses, as of December 31, 2019, charged by any of the portfolios underlying a variable investment account offered through this prospectus, expressed as a percentage of average net assets (rounded to two decimal places). These expenses are deducted from portfolio assets. For more information, please refer to the prospectus for the underlying portfolio.
Total Annual Portfolio Operating Expenses Minimum Maximum
Range of expenses, including management fees, distribution and/or service (12b-1) fees, and other expenses1 0.41% 2.02%
    
1  Certain of the portfolios’ advisers or subadvisers have contractually agreed to reimburse or waive certain portfolio level expenses. The minimum and maximum expenses shown do not reflect these contractual expense reimbursements or waivers. If such reimbursements or waivers were reflected, the minimum and maximum expenses would be 0.25% and 1.87%, respectively.
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DETAILED INFORMATION
This section of the prospectus provides additional detailed information that is not contained in the Summary of Benefits and Risks section.
Table of Variable Investment Accounts and Investment Subadvisers
When you select a Separate Account variable investment account, we invest your money in shares of a corresponding portfolio of the John Hancock Variable Insurance Trust (the “Trust” or “JHVIT”) or the PIMCO Variable Insurance Trust (the “PIMCO Trust” with respect to the PIMCO VIT All Asset portfolio) and hold the shares in a subaccount of the Separate Account. Fees and expenses of the portfolios are not fixed or specified under the terms of the policies and may vary from year to year. These fees and expenses differ for each portfolio and reduce the investment return of each portfolio. Therefore, they also indirectly reduce the return you will earn on any Separate Account variable investment options you select. For more information, please refer to the prospectus for the underlying portfolio.
The JHVIT and the PIMCO Trust are so-called “series” type mutual funds and each is registered under the Investment Company Act of 1940 (“1940 Act”) as an open-end management investment company. John Hancock Variable Trust Advisers LLC (“JHVTA”) provides investment advisory services to the Trust and receives investment management fees for doing so. JHVTA pays a portion of its investment management fees to other firms that manage the Trust’s portfolios. We are affiliated with JHVTA and may indirectly benefit from any investment management fees JHVTA retains. The PIMCO VIT All Asset portfolio of the PIMCO Trust receives investment advisory services from Pacific Investment Management Company LLC (“PIMCO”) and pays investment management fees to PIMCO.
Each of the American Asset Allocation, American Global Growth, American Growth, American Growth-Income, and American International portfolios invests in Series 1 shares of the corresponding investment portfolio of the Trust. The American Asset Allocation, American Global Growth, American Growth, American Growth-Income and, American International portfolios (“American Portfolios”) operate as “feeder funds,” which means that the portfolios do not buy investment securities directly. Instead, they invest in a “master fund” which in turn purchases investment securities. Each of the American feeder fund portfolios has the same investment objective and limitations as its master fund. The prospectus for the American Fund master fund is included with the prospectuses for the underlying funds. We pay American Funds Distributors, Inc., the principal underwriter for the American Funds Insurance Series, a percentage of some or all of the amounts allocated to the American Portfolios of the Trust for the marketing support services it provides.
The portfolios pay us or certain of our affiliates compensation for some of the distribution, administrative, shareholder support, marketing and other services we or our affiliates provide to the portfolios. Compensation payments may be made by a portfolio’s investment adviser or its affiliates. The compensation payments are based on a percentage of the assets of the portfolios attributable to the variable insurance products that we and our affiliates issue. These percentages may differ from portfolio to portfolio and among classes of shares within a portfolio. In some cases, the compensation is derived from the Rule 12b-1 fees that are deducted from a portfolio’s assets for the services we or our affiliates provide to that portfolio. These compensation payments do not, however, result in any charge to you in addition to what is shown in the prospectus for the portfolio.
The following table provides a general description of the portfolios that underlie the variable investment accounts we make available under the policy. You bear the investment risk of any portfolio you choose as a variable investment account for your policy. You can find a full description of each portfolio, including the investment objectives and strategies, policies, restrictions, and risks, in the prospectus for that portfolio. You should read the portfolio’s prospectus carefully before investing in the corresponding variable investment account.
The variable investment accounts in the Separate Account are not publicly traded mutual funds. The variable investment accounts are only available to you as variable investment accounts in the policies, or in some cases through other variable annuity contracts or variable life insurance policies issued by us or by other life insurance companies. In some cases, the variable investment accounts also may be available through participation in certain qualified pension or retirement plans. The portfolios' investment advisers and managers (i.e. subadvisers) may manage publicly traded mutual funds with similar names and investment objectives. However, the portfolios are not directly related to any publicly traded mutual fund. You should not compare the performance of any variable investment account described in this prospectus with the performance of a publicly traded mutual fund. The performance of any publicly traded mutual fund could differ substantially from that of any of the variable investment accounts of our Separate Account.
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The portfolios available under the policies, the investment subadvisers (engaged by JHVTA or PIMCO) and the investment objective for each portfolio are described in the table below. For additional information regarding these portfolios’ investment objectives and strategies, policies and restrictions of and the risks relating to investment in the portfolios, please refer to the prospectus for the portfolio.
Portfolio Subadviser Investment Objective
500 Index Manulife Investment Management (North America) Limited To approximate the aggregate total return of a broad-based U.S. domestic equity market index.
Active Bond Manulife Investment Management (US) LLC To seek to provide income and capital appreciation.
American Asset Allocation Capital Research and Management Company (Adviser to the American Funds Insurance Series) To seek to provide high total return (including income and capital gains) consistent with preservation of capital over the long-term.
American Global Growth Capital Research and Management Company (Adviser to the American Funds Insurance Series) To seek to provide long-term growth of capital.
American Growth Capital Research and Management Company (Adviser to the American Funds Insurance Series) To seek to provide growth of capital.
American Growth–Income Capital Research and Management Company (Adviser to the American Funds Insurance Series) To seek to provide long term growth of capital and income.
American International Capital Research and Management Company (Adviser to the American Funds Insurance Series) To seek to provide long-term growth of capital.
Blue Chip Growth T. Rowe Price Associates, Inc. To seek to provide long-term growth of capital. Current income is a secondary objective.
Capital Appreciation Jennison Associates LLC To seek to provide long-term growth of capital.
Capital Appreciation Value T. Rowe Price Associates, Inc. To seek to provide long-term capital appreciation.
Core Bond Wells Capital Management, Incorporated To seek to provide total return consisting of income and capital appreciation.
Disciplined Value International Boston Partners Global Investors, Inc. To seek to provide long-term growth of capital.
Emerging Markets Value Dimensional Fund Advisors LP To seek to provide long-term capital appreciation.
Equity Income T. Rowe Price Associates, Inc. To seek to provide substantial dividend income and also long-term growth of capital.
Financial Industries Manulife Investment Management (US) LLC To seek to provide growth of capital.
Fundamental All Cap Core Manulife Investment Management (US) LLC To seek to provide long-term growth of capital.
Fundamental Large Cap Value Manulife Investment Management (US) LLC To seek to provide long-term capital appreciation.
Global Manulife Investment Management (US) LLC To seek to provide long-term capital appreciation.
Health Sciences T. Rowe Price Associates, Inc. To seek to provide long-term capital appreciation.
High Yield Western Asset Management Company, LLC To seek to provide an above-average total return over a market cycle of 3 to 5 years, consistent with reasonable risk.
International Equity Index SSGA Funds Management, Inc. To seek to track the performance of a broad-based equity index of foreign companies primarily in developed countries and, to a lesser extent, in emerging markets.
International Small Company Dimensional Fund Advisors LP To seek to provide long-term capital appreciation.
Investment Quality Bond Wellington Management Company LLP To seek to provide a high level of current income consistent with the maintenance of principal and liquidity.
Lifestyle Balanced Manulife Investment Management (US) LLC To seek to provide a balance between a high level of current income and growth of capital, with a greater emphasis on growth of capital.
Lifestyle Conservative Manulife Investment Management (US) LLC To seek to provide a high level of current income with some consideration given to growth of capital.
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Portfolio Subadviser Investment Objective
Lifestyle Growth Manulife Investment Management (US) LLC To seek to provide long-term growth of capital. Current income is also a consideration.
Lifestyle Moderate Manulife Investment Management (US) LLC To seek to provide a balance between a high level of current income and growth of capital, with a greater emphasis on income.
Managed Volatility Aggressive Manulife Investment Management (US) LLC To seek to provide long-term growth of capital while seeking to both manage the volatility of return and limit the magnitude of portfolio losses.
Managed Volatility Balanced Manulife Investment Management (US) LLC To seek to provide growth of capital and current income while seeking to both manage the volatility of return and limit the magnitude of portfolio losses.
Managed Volatility Conservative Manulife Investment Management (US) LLC To seek to provide current income and growth of capital while seeking to both manage the volatility of return and limit the magnitude of portfolio losses.
Managed Volatility Growth Manulife Investment Management (US) LLC To seek to provide long-term growth of capital while seeking to both manage the volatility of return and limit the magnitude of portfolio losses.
Managed Volatility Moderate Manulife Investment Management (US) LLC To seek to provide current income and growth of capital while seeking to both manage the volatility of return and limit the magnitude of portfolio losses.
Mid Cap Index Manulife Investment Management (North America) Limited To seek to approximate the aggregate total return of a medium-capitalization U.S. domestic equity market index.
Mid Cap Stock Wellington Management Company LLP To seek to provide long-term growth of capital.
Mid Value T. Rowe Price Associates, Inc. To seek to provide long-term capital appreciation.
Money Market Manulife Investment Management (US) LLC To seek to obtain maximum current income consistent with preservation of principal and liquidity. Certain market conditions may cause the return of the portfolio to become low or possibly negative.
Opportunistic Fixed Income Wellington Management Company LLP To seek to provide maximum total return, consistent with preservation of capital and prudent investment management.
PIMCO VIT All Asset (a series of PIMCO Variable Insurance Trust) (only Class M is available) Pacific Investment Management Company LLC To seek to provide maximum real return, consistent with preservation of real capital and prudent investment management.
Real Estate Securities DWS Investment Management Americas, Inc. To seek to provide a combination of long-term capital appreciation and current income.
Science & Technology Allianz Global Investors U.S. LLC; and T. Rowe Price Associates, Inc. To seek to provide long-term growth of capital. Current income is incidental to the portfolio’s objective.
Select Bond Manulife Investment Management (US) LLC To seek to provide income and capital appreciation.
Short Term Government Income Manulife Investment Management (US) LLC To seek to provide a high level of current income consistent with preservation of capital. Maintaining a stable share price is a secondary goal.
Small Cap Index Manulife Investment Management (North America) Limited To seek to approximate the aggregate total return of a small-capitalization U.S. domestic equity market index.
Small Cap Opportunities Dimensional Fund Advisors LP; and GW&K Investment Management, LLC To seek to provide long-term capital appreciation.
Small Cap Stock Wellington Management Company LLP To seek to provide long-term capital appreciation.
Small Cap Value Wellington Management Company LLP To seek to provide long-term capital appreciation.
Small Company Value T. Rowe Price Associates, Inc. To seek to provide long-term growth of capital.
Strategic Income Opportunities Manulife Investment Management (US) LLC To seek to provide a high level of current income.
Total Bond Market Manulife Investment Management (US) LLC To seek to track the performance of the Bloomberg Barclays U.S. Aggregate Bond Index.*
Total Stock Market Index Manulife Investment Management (North America) Limited To seek to approximate the aggregate total return of a broad U.S. domestic equity market index.
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Portfolio Subadviser Investment Objective
Ultra Short Term Bond Manulife Investment Management (US) LLC To seek to provide a high level of current income consistent with the maintenance of liquidity and the preservation of capital.
    
*  The Barclays U.S. Aggregate Bond Index represents the U.S. investment grade bond market.
Substitutions
If the shares of a portfolio are no longer available for investment or in our judgment investment in a portfolio becomes inappropriate, we may eliminate the shares of a portfolio and substitute shares of another portfolio of the Trust or another open-end registered investment company. Substitution may be made with respect to both existing investments and the investment of future purchase payments. However, we will make no such substitution without first notifying you and obtaining approval of the appropriate insurance regulatory authorities and the SEC (to the extent required by the 1940 Act).
Valuation
We will purchase and redeem series fund shares for the Separate Account at their net asset value without any sales or redemption charges. Shares of a series fund represent an interest in one of the funds of the series fund which corresponds to a subaccount of the Separate Account. Any dividend or capital gains distributions received by the Separate Account will be reinvested in shares of that same fund at their net asset value as of the dates paid.
On each business day, shares of each series fund are purchased or redeemed by us for each subaccount based on, among other things, the amount of net premiums allocated to the subaccount, distributions reinvested, and transfers to, from and among subaccounts, all to be effected as of that date. Such purchases and redemptions are effected at each series fund’s net asset value per share determined for that same date. A “business day” is any date on which the New York Stock Exchange (“NYSE”) is open for trading. We normally compute policy values for each business day as of the close of the NYSE on that day (usually 4:00 p.m. Eastern time). In case of emergency or other disruption resulting in the NYSE closing at a time other than the regularly scheduled close, the close of our business day may be the regularly scheduled close of the NYSE or another time permitted by the Securities and Exchange Commission and applicable regulations.
Voting interest
We will vote shares of the portfolios held in the Separate Account at the shareholder meetings according to voting instructions timely received from persons having the voting interest under the policies. We will determine the number of portfolio shares for which voting instructions may be given not more than 90 days prior to the meeting. Proxy material will be distributed to each person having the voting interest under the policy together with appropriate forms for giving voting instructions. We will vote all portfolio shares that we hold in the Separate Account for policy owners in proportion to the instructions timely received by us from policy owners from all our Separate Accounts that are registered with the SEC under the 1940 Act. We will vote all portfolio shares that we otherwise are entitled to vote (including our own shares) on any matter in proportion to the instructions timely received by us and any affiliated insurance companies with respect to the matter from policy owners in Separate Accounts of these insurance companies that are registered with the SEC under the 1940 Act. The effect of this proportional voting is that a small number of policy owners can determine the outcome of a vote.
We determine the number of a series fund's shares held in a subaccount attributable to each owner by dividing the amount of a policy's variable investment account value held in the subaccount by the net asset value of one share in the series fund. Fractional votes will be counted. We determine the number of shares as to which the owner may give instructions as of the record date for a series fund's meeting. Owners of policies may give instructions regarding the election of the Board of Trustees or Board of Directors of a series fund, ratification of the selection of independent auditors, approval of series fund investment advisory agreements and other matters requiring a shareholder vote. We will furnish owners with information and forms to enable owners to give voting instructions. However, we may, in certain limited circumstances permitted by the SEC's rules, disregard voting instructions. If we do disregard voting instructions, you will receive a summary of that action and the reasons for it in the next semi-annual report to owners.
The voting privileges described above reflect our understanding of applicable Federal securities law requirements. To the extent that applicable law, regulations or interpretations change to eliminate or restrict the need for such voting privileges, we reserve the right to proceed in accordance with any such revised requirements. We also reserve the right, subject to compliance with applicable law, including approval of owners if so required, (1) to transfer assets determined by John Hancock USA to be associated with the class of policies to which your policy belongs from the Separate Account to another separate account or subaccount, (2) to deregister the Separate Account under the 1940 Act, (3) to substitute for the fund
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shares held by a subaccount any other investment permitted by law, and (4) to take any action necessary to comply with or obtain any exemptions from the 1940 Act. Any such change will be made only if, in our judgment, the change would best serve the interests of owners of policies in your policy class or would be appropriate in carrying out the purposes of such policies. We would notify owners of any of the foregoing changes and to the extent legally required, obtain approval of affected owners and any regulatory body prior thereto. Such notice and approval, however, may not be legally required in all cases.
Description of John Hancock (USA)
We are a stock life insurance company incorporated in Maine on August 20, 1955 by a special act of the Maine legislature and redomesticated under the laws of Michigan. We are a licensed life insurance company in the District of Columbia and all states of the United States except New York. Our ultimate parent is Manulife Financial Corporation (“MFC”), a publicly traded company based in Toronto, Canada. MFC is the holding company of John Hancock USA and its subsidiaries. However, neither John Hancock USA nor any of its affiliated companies guarantees the investment performance of the Separate Account. Our executive office is located at 200 Berkeley St., Boston, MA 02116.
We are ranked and rated by independent financial rating services, which may include Moody's, Standard & Poor's, Fitch and A.M. Best. The purpose of these ratings is to reflect the financial strength or claims-paying ability of the company, but they do not specifically relate to its products, the performance (return) of these products, the value of any investment in these products upon withdrawal or to individual securities held in any portfolio. These ratings do not apply to the safety and performance of the Separate Account.
Description of Separate Account A
The variable investment accounts shown on page 1 are in fact subaccounts of the John Hancock Life Insurance Company (U.S.A.) Separate Account A, a separate account operated by us under Michigan law. The Separate Account meets the definition of “separate account” under the Federal securities laws and is registered as a unit investment trust under the 1940 Act. Such registration does not involve supervision by the SEC of the management of the Separate Account or of us.
The Separate Account’s assets are our property. Each policy provides that amounts we hold in the Separate Account pursuant to the policies cannot be reached by any other persons who may have claims against us and can’t be used to pay any indebtedness of John Hancock USA other than those arising out of policies that use the Separate Account. Income, gains and losses credited to, or charged against, the Separate Account reflect the Separate Account's own investment experience and not the investment experience of John Hancock USA's other assets. John Hancock USA is obligated to pay all amounts promised to policy owners under the policies.
New variable investment accounts may be added and made available to policy owners from time to time. Existing variable investment accounts may be modified or deleted at any time.
The fixed account
Our obligations under any fixed account are backed by our general account assets. Our general account consists of assets owned by us other than those in the Separate Account and in other separate accounts that we may establish. Subject to applicable law, we have sole discretion over the investment of assets of the general account and policy owners do not share in the investment experience of, or have any preferential claim on, those assets. Instead, we guarantee that the policy value allocated to any fixed account will accrue interest daily at an effective annual rate that we determine without regard to the actual investment experience of the general account. We currently offer only one fixed account—the standard fixed account. The effective annual rate we declare for the fixed account will never be less than 2%. We reserve the right to offer one or more additional fixed accounts with characteristics that differ from those of the current fixed account, but we are under no obligation to do so.
Because of exemptive and exclusionary provisions, interests in our fixed account have not been and will not be registered under the Securities Act of 1933 (“1933 Act”) and our general account has not been registered as an investment company under the 1940 Act. Accordingly, neither the general account nor any interests therein are subject to the provisions of these acts, and we have been advised that the staff of the SEC has not reviewed the disclosure in this prospectus relating to any fixed account. Disclosure regarding fixed accounts, however, is subject to certain generally-applicable provisions of the Federal securities laws relating to accuracy and completeness of statements made in prospectuses.
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The death benefit
In your application for the policy, you will tell us how much life insurance coverage you want on the life of the insured person. This is called the “Face Amount.”
When the insured person dies, we will pay the death benefit minus any outstanding policy debt and unpaid fees and charges. There are two ways of calculating the death benefit. You must choose which one you want in the application. The two death benefit options are described below.
•  Option 1 - The death benefit will equal the greater of (1) the Face Amount plus any amount payable under a supplementary benefit rider, or (2) the minimum death benefit (as described below).
•  Option 2 - The death benefit will equal the greater of (1) the Face Amount plus any amount payable under a supplementary benefit rider, plus the policy value on the date of death, or (2) the minimum death benefit.
For the same premium payments, the death benefit under Option 2 will tend to be higher than the death benefit under Option 1. On the other hand, the cost of insurance charge will be higher under Option 2 to compensate us for the additional insurance risk. Because of that, the policy value will tend to be higher under Option 1 than under Option 2 for the same premium payments.
Limitations on payment of death benefit
If the insured person commits suicide within certain time periods (generally within two years from the Issue Date of the policy), the amount payable will be equal to the premiums paid, less the amount of any policy debt on the date of death, and less any withdrawals.
Also, if an application misstated the age or sex of the insured person, we will adjust, if necessary, the Face Amount and every other benefit to that which would have been purchased at the correct age or sex by the most recent cost of insurance charge.
The minimum death benefit
In order for a policy to qualify as life insurance under Federal tax law, there has to be a minimum amount of insurance in relation to policy value. The Federal tax law test that will be applied at issue to determine whether your policy qualifies for life insurance is the cash value accumulation test (see “Tax Considerations”).
Under the cash value accumulation test, we compute the minimum death benefit each business day by multiplying the policy value on that date by the death benefit factor applicable on that date. The factor decreases as attained age increases. A table showing the factor for each age will appear in the policy.
To the extent that the calculation of the minimum death benefit under the cash value accumulation test causes the death benefit to exceed our limits, we reserve the right to distribute a portion of the policy value so that the resulting amount of insurance is maintained within our limits. Alternatively, should we consider accepting the additional amount of insurance, we may require additional evidence of insurability.
Requesting an increase in coverage
You may not increase your Face Amount under the policy. However, if you request a change in your death benefit option from Option 2 to Option 1, it may result in an increase of the Face Amount (see “Change of death benefit option”).
Requesting a decrease in coverage
After the first policy year, we may approve a reduction in the Face Amount, but only if:
•  the remaining Face Amount will be at least $50,000, and
•  the remaining Face Amount will at least equal the minimum required by the tax laws to maintain the policy’s life insurance status.
A pro-rata portion of the Surrender Charge will be deducted from the policy value in instances where your requests for Face Amount reductions cumulatively exceed 10% of your Face Amount at issue. An approved decrease will take effect on the monthly deduction date on or following the date we approve the request. We will impose a Surrender Charge on withdrawals you take that reduce your Face Amount (see “Surrender and withdrawals - Withdrawals”).
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Change of death benefit option
Under our current administrative rules, we permit the death benefit option to be changed from Option 2 to Option 1 after the first policy year. If you request in writing, and we approve a change from Option 2 to Option 1, your Face Amount after the change will equal your Face Amount before the change plus the policy value as of the effective date of the change. If you change from Option 2 to Option 1, your death benefit will change from one that may increase over time due to the investment experience of the underlying variable investment accounts to one that is a level death benefit. Changing from Option 2 to Option 1 may increase or decrease the monthly cost of insurance charges because your Net Amount At Risk may increase or decrease depending on the investment experience of the variable investment accounts; all other charges under the policy would remain the same. We reserve the right to limit a request for a change if the change would cause the policy to fail to qualify as life insurance for tax purposes.
Tax consequences of coverage changes
A change in the death benefit option or a reduction in Face Amount may change the policy’s limits under Federal tax laws. To avoid having the policy cease to qualify as life insurance for tax purposes, we reserve the right to refuse or limit a change in the death benefit option or a reduction in Face Amount. Please read “Tax considerations” to learn about possible tax consequences of changing your insurance coverage under the policy.
Changing a payment option
You can change the payment option at any time before the proceeds are payable. If you haven’t made a choice, the payee of the proceeds has a prescribed period in which he or she can make that choice.
There may be tax consequences to you or your beneficiary depending upon which payment option is chosen. You should consult with a qualified tax adviser before making that choice.
Premiums
Planned premiums
The Policy Specifications page of your policy will show the “Planned Premium” for the policy. You choose this amount in the policy application. You will also choose how often to pay premiums—annually, semi-annually or quarterly. You may also choose to pay premiums by monthly electronic funds transfers. The premium reminder notice we send you is based on the amount and period you choose. However, payment of Planned Premiums is not necessarily required. You need only pay enough premium to keep the policy in force (see “Lapse and reinstatement”).
Minimum initial premium
The Minimum Initial Premium is set forth in the Policy Specifications page of your policy. After the payment of the initial premium, premiums may be paid at any time and in any amount until the insured person's attained age 121, subject to the need to pay enough premium to keep the policy in force and to the limitations on maximum premium amount described below.
Maximum premium payments
If our receipt of any premium payment would cause the policy to be treated as a Modified Endowment Contract (“MEC”) under the federal tax laws, we will only process the payment on the first Business Day after we have received from you a completed and executed copy of our MEC Authorization Form. More discussion of these tax law requirements is provided under “Tax considerations.”
Large premium payments may expose us to unanticipated investment risk. In addition, in order to limit our investment risk exposure under certain market conditions, we may refuse to accept additional premium payments. This may be the case, for example, in an environment of decreasing interest rates, where we may not be able to acquire investments for our general account that will sufficiently match the liabilities we are incurring under our fixed account guarantees. Excessive allocations may also interfere with the effective management of our variable investment accounts, if we are unable to make an orderly investment of the additional premium into the variable investment accounts. Also, we may refuse to accept or limit an amount of premium if the amount of the premium would increase our insurance risk exposure, and the insured person doesn't provide us with adequate evidence that he or she continues to meet our requirements for issuing insurance.
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We will notify you in writing of our refusal to accept premium under these provisions within three days following the date that it is received by us, and will promptly thereafter take the necessary steps to return the premium to you. Notwithstanding the foregoing limits on the premium that we will accept, we will not refuse to accept any premium necessary to prevent the policy from terminating.
Processing premium payments
No premiums will be accepted prior to our receipt of a completed application at our Service Office. All premiums received prior to the Issue Date of the policy will be held in the general account and credited with interest from the date of receipt at the rate of return then being earned on amounts allocated to the Money Market variable investment account. After the Issue Date but prior to the Allocation Date, Net Premiums received are allocated to the Money Market variable investment account. The “Allocation Date” of the policy is the tenth day after the Issue Date. The Issue Date is shown on the Policy Specifications page of the policy. On the Allocation Date, the Net Premiums paid plus interest credited, if any, will be allocated among the investment accounts or the fixed account in accordance with the policy owner’s instructions. The “Net Premium” is the premium paid less applicable premium charges we deduct from it.
Any Net Premium received on or after the Allocation Date will be allocated among investment accounts or the Fixed Account as of the Business day on or next following the date the premium is received at the Service Office. Monthly deductions are normally due on the Policy Date and at the beginning of each policy month thereafter. However, if the monthly deductions are due prior to the Contract Completion Date, they will be deducted from policy value on the Contract Completion Date instead of the dates they were due (see “Procedures for issuance of a policy” for the definition of “Contract Completion Date”).
Payment of premiums will not guarantee that the policy will stay in force. Conversely, failure to pay premiums will not necessarily cause the policy to lapse. However, the policy has a Death Benefit Protection feature, which would prevent the policy from lapsing, provided certain criteria are satisfied (see “Death Benefit Protection”).
Ways to pay premiums
If you pay premiums by check or money order, they must be drawn on a U.S. bank in U.S. dollars and made payable to “John Hancock.” We will not accept credit card checks. We will not accept starter or third party checks if they fail to satisfy our administrative requirements. Premiums after the first must be sent to the John Hancock USA Service Office at the appropriate address shown on the back cover of this prospectus.
We will also accept premiums:
•  by wire or by exchange from another insurance company, or
•  via an electronic funds transfer program (any owner interested in making monthly premium payments must use this method).
Lapse and reinstatement
Lapse
A policy will go into default if on any monthly deduction date the policy's net cash surrender value would be zero or below after deducting the monthly deductions then due and the Death Benefit Protection feature is in default. We will notify you of the default and will allow a 61-day grace period in which you may make a premium payment sufficient to bring the policy out of default (the “Default Payment”). The Default Payment will be the lesser of (a) the amount necessary to bring the net cash surrender value to zero, if it is less than zero on the date of default, plus the amount necessary to keep the net cash surrender value above zero for the next three policy months and (b) the Death Benefit Protection Default Payment (see “Death Benefit Protection”). The Default Payment may be insufficient to continue your policy for the next three policy months due to the investment experience of the variable investment accounts that you have chosen. If the Default Payment is not received by the end of the grace period, the policy will terminate (i.e., “lapse”) with no value. A lapse could have adverse tax consequences as described under “Tax considerations.”
Death Benefit Protection
Your policy is issued with the Death Benefit Protection feature that prevents your policy from going into default in certain circumstances, as described below, even if your net cash surrender value falls to zero or below. The Death Benefit
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Protection feature does not provide you with any additional death benefit amount or any increase in your policy value, and it does not provide any type of investment performance guarantee.
The Death Benefit Protection feature prevents your policy from going into default as long as the Death Benefit Protection Value less policy debt is greater than zero and the policy debt does not exceed the policy value. The Death Benefit Protection Value (“DBPV”) is determined in a similar manner to the policy value determination described in this prospectus except that it has a separate set of notional charges and values. On the Issue Date and on each monthly deduction date thereafter, we will calculate your Death Benefit Protection Value (“DBPV”). Your DBPV is the accumulated value of any DBPV net premiums, plus DBPV interest, less the DBPV Administrative Charge, the DBPV Cost of Insurance Charge, and the DBPV Face Amount Charge (the “DBPV Monthly Deductions”). Interest is credited to the DBPV at the Death Benefit Protection Annual Interest Rate, and when the ratio of the DBPV to the Face Amount exceeds the Death Benefit Protection Threshold Rate the interest rate will be increased by the Death Benefit Protection Annual Bonus Rate. The DBPV Monthly Deductions, Death Benefit Protection Threshold Rate and Death Benefit Protection Annual Bonus Rate are shown in your Policy Specifications page. Additionally, each time an amount is deducted from the policy value for any reason other than to take a monthly deduction (e.g., when you take a withdrawal), the DBPV is adjusted. Investment losses or gains, amounts credited to the fixed account, and Policy Value Credits and Asset Credits will not be applied to the Death Benefit Protection Value.
Your DBPV is calculated solely to determine whether your Death Benefit Protection feature is in effect. The DBPV charges and values that determine the DBPV are not charges you pay nor are they values that you receive in your policy value. The Death Benefit Protection Value does not provide any additional death benefit amount or any increase in your policy value.
The Death Benefit Protection feature will go into default at the beginning of any policy month in which the Death Benefit Protection Value less policy debt is less than or equal to zero after we deduct the DBPV Monthly Deductions that are due for that month. If the Death Benefit Protection feature is in default, we will notify you of that fact and allow a 61-day grace period in which you may make a premium payment sufficient to keep the policy from going into default (the “Death Benefit Protection Default Payment”). This required payment, as described in the notification, will be the amount necessary to bring the Death Benefit Protection Value less policy debt to zero, plus the amount necessary to keep the Death Benefit Protection Value less policy debt above zero for the next three policy months. If the Death Benefit Protection Default Payment is not paid by the end of the grace period, then the Death Benefit Protection feature will terminate. This feature cannot be reinstated after it terminates. At least 30 days prior to termination of the feature, we will send a notice to your last known address, specifying the amount you must pay to bring the feature out of default. If we have notice of a policy assignment on file at our Service Office, we will mail a copy of the notice of the amount due to the assignee on record.
The DBPV charge rates and interest rates are set at issue and reflect the age, sex and risk class of the insured person, as well as any additional rating and supplementary benefits, if applicable. The Death Benefit Protection feature may be impacted by certain policy changes because of the effect such policy changes has on the DBPV Monthly Deductions described above. Such changes include, but are not limited to the following: (i) a reduction in Face Amount, (ii) a death benefit option change, (iii) any change in the supplementary benefits added to the policy, (iv) any change in the risk classification of the insured person, or (v) withdrawals. Additionally, withdrawals reduce the DBPV by the amount of the withdrawal. For example, if the DBPV was equal to $2,000 at the time that you take a $3,000 withdrawal, then the DBPV would be reduced by the amount of that withdrawal to an amount that is less than zero, and your Death Benefit Protection Feature would then be in default.
Death during grace period
If the insured person should die during the grace period, the policy value used in the calculation of the death benefit will be the policy value as of the date of default and the death benefit will be reduced by any outstanding monthly deductions due at the time of death.
Reinstatement
By making a written request, you can apply to reinstate a policy that has gone into default and terminated at any time within the three-year period following the date of termination subject to the following conditions:
(a)  You must provide to us evidence of the insured person's insurability that is satisfactory to us; and
(b)  You must pay the Default Payment.
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If the reinstatement is approved, the date of reinstatement will be the later of the date we approve your request or the date the Default Payment is received at our Service Office. In addition, any surrender charges will be reinstated to the amount they were at the date of default. The policy value on the date of reinstatement, prior to the crediting of any Net Premium paid in connection with the reinstatement, will be equal to the policy value on the date the policy terminated. Any policy debt not paid upon termination of a policy will be reinstated if the policy is reinstated.
Generally, the suicide exclusion and incontestability provisions will apply from the effective date of reinstatement. A surrendered policy cannot be reinstated.
The policy value
From each premium payment you make, we deduct the applicable premium charges described under “Deduction from premium payments.” We invest the rest (known as the “Net Premium”) in the variable investment accounts and any fixed account you've elected. Special investment rules apply to premiums processed prior to the Allocation Date (see “Premiums - - Processing premium payments”).
Over time, the amount you’ve invested in any variable investment account will increase or decrease the same as if you had invested the same amount directly in the corresponding underlying portfolio and had reinvested all portfolios' dividends and distributions in additional portfolio shares, except that we will deduct certain additional charges which will reduce your policy value. We describe these charges under “Description of charges at the policy level.”
We normally calculate the unit values for each variable investment account once every business day as of the close of that day, usually 4:00 p.m. Eastern time. Sales and redemptions within any variable investment account will be transacted using the unit value calculated as follows after we receive your request either in writing or other form that we specify: If we receive your request before the close of our business day, we’ll use the unit value calculated as of the end of that business day. If we receive your request at or after the close of our business day, we’ll use the unit value calculated as of the end of the next business day. If a scheduled transaction falls on a day that is not a business day, we’ll process it as of the end of the next business day.
The amount you’ve invested in the fixed account will earn interest at the rates we declare from time to time. For the fixed account, we guarantee that this rate will be at least 2%. If you want to know what the current declared rate is for the fixed account, just call or write to us. The asset-based risk charge only applies to that portion of the policy value held in the variable investment accounts. The charge determined does not apply to the fixed account. Otherwise, the policy level charges applicable to the fixed account are the same as those applicable to the variable investment accounts. We reserve the right to offer one or more additional fixed accounts with characteristics that differ from those of the current fixed account, but we are under no obligation to do so.
Policy Value Credit
We will calculate a Policy Value Credit to be applied to your policy value on each monthly deduction date. The Policy Value Credit, if any, will be allocated automatically to each variable investment account and/or fixed account from which, and in the same proportion as, we are taking your monthly deductions.
The Policy Value Credit on each monthly deduction date is equal to the greater of zero and Policy Value Credit Component A minus Policy Value Credit Component B; however, in no event will the Policy Value Credit exceed the Cost of Insurance Charge for that monthly deduction date. Policy Value Credit Component B is subject to the Policy Value Credit Component B Limit, which restricts the cumulative reduction in Policy Value Credits over the life of the policy. The formulas for these components and their respective rates are shown in your policy.
The value of the Policy Value Credit applied to your policy is affected by the amounts and timing of the premiums that you pay into the policy, how well the variable investment accounts you select perform, the current cost of insurance rate being charged, and withdrawals and other changes you make to the policy. In particular, your Policy Value Credit may be smaller, or possibly you will receive no Policy Value Credit at all, if you minimally fund your policy and/or if the investment accounts you select perform poorly. You can see the effect that these factors have on the policy value by requesting an illustration at various assumptions.
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Asset Credit
We will calculate an Asset Credit to be applied to your policy value on each monthly deduction date. The Asset Credit, if any, will be allocated automatically to each variable investment account and/or fixed account from which, and in the same proportion as, we are taking your monthly deductions. The Asset Credit is designed to help improve the long-term performance of your policy. The Asset Credit is equal to the Asset Credit Rate multiplied by the lesser of the Policy Value (excluding the Loan Account) and the Face Amount. The Asset Credit Commencement Year and the Asset Credit Rates are shown in your Policy Specifications.
The value of the Asset Credit applied to your policy is affected by the amounts and timing of the premiums that you pay into the policy, and how well the variable investment accounts you select perform. Many factors, including withdrawals, and other changes you make to the policy, may impact the amount of Asset Credit, if any, applied to your policy value. You can see the effect that these factors have on the policy value by requesting an illustration at various assumptions.
Allocation of future premium payments
At any time, you may change the variable investment accounts or any fixed account in which future premium payments will be invested. You make the original allocation in the application for the policy. The percentages you select must be in whole numbers and must total 100%.
Transfers of existing policy value
You may also transfer your existing policy value from one variable investment account or any fixed account to another, subject to the limitations discussed below. To do so, you must tell us how much to transfer, either as a whole number percentage or as a specific dollar amount. A confirmation of each transfer will be sent to you. Without our approval, the maximum amount you may transfer to or from any variable investment account or any fixed account in any policy year is $1,000,000.
Market timing and disruptive trading practices
Variable investment accounts in variable life insurance products can be a prime target for abusive transfer activity because these products value their variable investment accounts on a daily basis and allow transfers among variable investment accounts without immediate tax consequences. As a result, some investors may seek to frequently transfer into and out of variable investment accounts or to make large transfers in reaction to market news or to exploit a perceived pricing inefficiency. Whatever the reason, long-term investors in any variable investment account can be harmed by large or frequent transfer activity. For example, such activity may expose the variable investment account's underlying portfolio to increased portfolio transaction costs and/or disrupt the portfolio manager's ability to effectively manage the portfolio's investments in accordance with the portfolio's investment objectives and policies. This could include causing the portfolio to maintain higher levels of cash than would otherwise be the case, or liquidating investments prematurely. Accordingly, frequent or large transfers may result in dilution with respect to interests held for long-term investment and adversely affect policy owners, beneficiaries and the underlying portfolios.
To discourage market timing and disruptive trading activity, we impose restrictions on transfers and reserve the right to change, suspend or terminate telephone, facsimile and internet transaction privileges (see “How you communicate with us”). We also reserve the right to impose a fee of up to $25 for any transfer beyond an annual limit (which will not be less than twelve). No transfer fee will be imposed on any transfer from a variable investment account into any fixed account if the transfer occurs during the following periods:
•  within 18 months after the policy's Issue Date, or
•  within 60 days after the later of the effective date of a material change in the investment objectives of any variable investment account or the date you are notified of the change.
In addition to the actions described above, we also reserve the right to take other actions at any time to restrict trading, including, but not limited to: (i) restricting the number of transfers made during a defined period, (ii) restricting the dollar amount of transfers, (iii) restricting transfers into and out of certain variable investment accounts, (iv) restricting the method used to submit transfers, and (v) deferring a transfer at any time we are unable to purchase or redeem shares of the underlying portfolio.
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We may also impose additional administrative conditions upon, or prohibit a transfer request made by a third party giving instructions on behalf of multiple policies, whether owned by the same owner or different owners. If you engage a third party for asset allocation services, then you may be subject to these transfer restrictions because of the actions of that party in providing those services. We will notify the third party you have engaged if we exercise this right. While we seek to identify and prevent disruptive trading activity, it may not always be possible to do so. Therefore, no assurance can be given that the restrictions we impose will be successful in preventing all disruptive trading and avoiding harm to long-term investors.
Limitations on transfers to or from a variable investment account. Our current practice is to restrict transfers into or out of variable investment accounts to two per calendar month (except with respect to those policies described in the following paragraphs). For purposes of this restriction, and in applying the limitation on the number of free transfers, any transfers made during the period from the opening of a business day (usually 9:00 a.m. Eastern time) to the close of that business day (usually 4:00 p.m. Eastern time) are considered one transfer. You may, however, transfer to the Money Market variable investment account even if the two transfers per month limit has been reached, but only if 100% of the account value in all variable investment accounts is transferred to the Money Market variable investment account. If such a transfer to the Money Market variable investment account is made, then for the 30 calendar day period after such transfer no transfers from the Money Market variable investment account to any other variable investment accounts or any fixed account may be made. If your policy offers a dollar cost averaging or automatic asset allocation rebalancing program, any transfers pursuant to such program are not considered transfers subject to these restrictions on frequent trading. The restrictions described in this paragraph will be applied uniformly to all policy owners subject to the restrictions.
Policies such as yours may be purchased by a corporation or other entity as a means to informally finance the liabilities created by an employee benefit plan, and to this end the entity may aggregately manage the policies purchased to match its liabilities under the plan. Policies sold under these circumstances are subject to special transfer restrictions. In lieu of the two transfers per month restriction, we will allow the policy owner under these circumstances to rebalance the investment options in its policies within the following limits: (i) during the 10 calendar day period after any policy values are transferred from one variable investment account into a second variable investment account, the values can only be transferred out of the second variable investment account if they are transferred into the Money Market variable investment account; and (ii) any policy values that would otherwise not be transferable by application of the 10 day limit described above and that are transferred into the Money Market variable investment account may not be transferred out of the Money Market variable investment account into any other variable investment account or any fixed account for 30 calendar days. The restrictions described in this paragraph will be applied uniformly to all policy owners subject to the restrictions.
Subject to our approval, we may offer policies purchased by a corporation or other entity that has purchased policies to match its liabilities under an employee benefit plan, as described above, the ability to electronically rebalance the variable investment accounts in its policies. Under these circumstances, in lieu of imposing any specific limit upon the number and timing of transfers, we will monitor aggregate trades among the subaccounts for frequency, pattern and size for potentially harmful investment practices. If we detect trading activity that we believe may be harmful to the overall operation of any variable investment account or underlying portfolio, we may impose conditions on policies employing electronic rebalancing to submit trades, including setting limits upon the number and timing of transfers, and revoking privileges to make trades by any means other than written communication submitted via U.S. mail. While we seek to identify and prevent disruptive frequent trading activity, it may not always be possible to do so. Therefore, no assurance can be given that the restrictions we impose will be successful in preventing all disruptive frequent trading and avoiding harm to long-term investors. The restrictions described in these paragraphs will be applied uniformly to all policy holders subject to the restrictions.
Rule 22c-2 under the 1940 Act requires us to provide tax identification numbers and other policy owner transaction information to the Trust or to other investment companies in which the Separate Account invests, at their request. An investment company will use this information to identify any pattern or frequency of variable investment account transfers that may violate their frequent trading policy. An investment company may require us to impose trading restrictions in addition to those described above if violations of their frequent trading policy are discovered.
Limitations on transfers out of the fixed account. Transfers out of the fixed account option in any one policy year are limited to the greater of (i) the fixed account maximum transfer amount of $2,000, (ii) the fixed account maximum transfer percentage of 15% multiplied by the amount of the fixed account on the immediately preceding policy anniversary, or (iii) the amount transferred out of the fixed account during the previous policy year. Any transfer out of the fixed account may not involve a transfer to the Money Market variable investment account.
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We reserve the right to impose a minimum amount limit on transfers out of any fixed account. We also reserve the right to impose different restrictions on any additional fixed account that we may offer in the future.
We may waive the transfer restrictions on the fixed account. Please contact us or your John Hancock USA representative to find out if a waiver is currently in effect.
Dollar cost averaging. We may offer policy owners a dollar cost averaging (“DCA”) program. Under the DCA program, you will designate an amount that will be transferred monthly from one variable investment account into any other variable investment account or a fixed account. If insufficient funds exist to effect a DCA transfer, the transfer will not be effected and you will be so notified. No fee is charged for this program. This program may be used in conjunction with the asset allocation balancer transfer program detailed below.
We reserve the right to cease to offer this program as of 90 days after written notice is sent to you.
Asset allocation balancer transfers. Under the asset allocation balancer program, you will designate an allocation of policy value among the variable investment accounts. We will move amounts among the variable investment accounts at specified intervals you select - annually, semi-annually, quarterly or monthly. A change to your premium allocation instructions will automatically result in a change in asset allocation balancer instructions so that the two are identical unless you either instruct us otherwise or have elected the dollar cost averaging program. No fee is charged for this program. This program may be used in conjunction with the DCA program detailed above.
We reserve the right to cease to offer this program as of 90 days after written notice is sent to you.
Surrender and withdrawals
Surrender
You may surrender your policy in full at any time. If you do, we will pay you the policy value less any policy debt and surrender charge that then applies. This is called your “net cash surrender value.” You must return your policy when you request a surrender. We will process surrenders on the day we receive the surrender request (unless such day is not a business day, in which case we will process surrenders as of the business day next following the date of the receipt).
Withdrawals
After the first policy year, you may make a withdrawal of part of your net cash surrender value once in each policy month. Generally, each withdrawal must be at least $500. If the withdrawal results in a reduction in Face Amount, a charge equal to a pro-rata portion of any surrender charge will be applied during the surrender charge period. We will automatically reduce the policy value of your policy by the amount of the withdrawal. Unless otherwise specified by you, each variable investment account and any fixed account will be reduced in the same proportion as the policy value that is then allocated among them. We will not permit a withdrawal if it would cause your surrender value to fall below three months’ worth of monthly deductions (see “Deductions from policy value”). We reserve the right to refuse any withdrawal that would cause the policy’s Face Amount to fall below $50,000. We also reserve the right to approve reductions in the Face Amount.
Withdrawals will reduce your death benefit under Option 1 or Option 2 (see “The death benefit”). If Option 1 is in effect, withdrawals will reduce the death benefit by reducing the Face Amount. If Option 2 is in effect, withdrawals will reduce the death benefit by reducing the policy value.
If a reduction in Face Amount would cause the policy to fail the Internal Revenue Code’s definition of life insurance, we will not permit the withdrawal. If the withdrawal results in a reduction in Face Amount, a pro-rata portion of the applicable surrender charge will be deducted from the policy value. For example, assume a policy owner that has elected death benefit Option 1 requests a withdrawal of $25,000 on a policy with a Face Amount of $200,000 and a current surrender charge of $10,000. The $25,000 withdrawal would reduce the Face Amount from $200,000 to $175,000. The reduction in Face Amount would trigger a partial surrender charge equal to the surrender charge times the proportionate reduction in Face Amount, in this case equal to $10,000 X (25,000/200,000) or $1,250. The surrender charge after the withdrawal would be equal to $10,000 - $1,250 or $8,750.
Withdrawals may reduce the amount of Policy Value Credit and Asset Credit you receive over the long term (see “Policy Value Credit” and “Asset Credit”). Withdrawals will also reduce the Death Benefit Protection Value; this means the Death Benefit Protection feature would be more likely to go into default (see “Death Benefit Protection”).
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Policy loans
You may borrow from your policy at any time by completing a form satisfactory to us. The maximum amount you can borrow is the Available Loan Value. The Available Loan Value is equal to the net cash surrender value on the date you apply for a loan, minus any monthly deductions or applicable loan interest due from the date you apply for the loan until the end of the policy year, plus any interest payable on your cash surrender value at the Minimum Fixed Account Annual Rate through the end of the year. The Minimum Fixed Account Annual Rate is the minimum annual rate of interest applied to the fixed account as shown in your Policy Specifications page.
In no event, however, will the Available Loan Value be less than 90% of the net cash surrender value. Values will be determined in accordance with Section 28 of your policy and as of the end of the business day on which the loan application is received at our Service Office.
The minimum amount of each loan is $500. The maximum effective annual interest rate we can charge for the loan account is 3.25% for policy years 1-10 and 2.25% for policy years 11 and thereafter. Accrued interest will be added to the loan daily and will bear interest at the same rate as the original loan amount. Unless otherwise specified by you, the amount of the loan is deducted from the variable investment accounts and any fixed account in the same proportion as the policy value is then allocated among them. The amount of the loan is then placed in a special loan account. The minimum interest that the loan account will earn at any time is equal to the difference between the annual interest rate we charge for the loan minus the Maximum Loan Interest Credited Differential. The loan interest credit differential is the difference between the annual interest rate we charge for the loan minus the interest rate we credit for the loan, however, it will never be greater than 2%. For example, if the annual interest rate we charge for a loan is 3%, we cannot credit interest at a rate less than 1% because the difference between the interest rate charged for the loan and the interest rate credited to the loan cannot be more than the Maximum Loan Interest Credited Differential, which is 2%. The tax consequences of a loan interest credited differential of 0% are unclear. You should consult a tax adviser before effecting a loan to evaluate possible tax consequences. If we determine that a loan will be treated as a distribution from your policy because of the differential between the loan interest rate and the rate being credited on the special loan account, we reserve the right to increase the rate charged on the loan to a rate that would, in our reasonable judgment, result in the transaction being treated as a loan under Federal tax law. The right to increase the rate charged on the loan is restricted in some states. Please see your John Hancock USA representative for details. We process policy loans as of the business day on or next following the day we receive the loan request.
Repayment of policy loans
You can repay all or part of a loan at any time. Each repayment will be allocated among the variable investment accounts and any fixed account as set out below.
•  The same proportionate part of the loan as was borrowed from the fixed account will be repaid to that fixed account.
•  The remainder of the repayment will be allocated among the variable investment accounts and any fixed account in the same way a new premium payment would be allocated (unless otherwise specified by you).
If you want a payment to be used as a loan repayment, you must include instructions to that effect. Otherwise, all payments will be assumed to be premium payments. We process loan repayments as of the day we receive the repayment.
Loan repayments received prior to the close of the New York Stock Exchange will be applied on the same day it was received. Loan repayments received after the close of the New York Stock Exchange will be applied as of the next business day.
Effects of policy loans
The policy value, the net cash surrender value, and any death benefit are permanently affected by any loan, whether or not it is repaid in whole or in part. This is because the amount of the loan is deducted from the variable investment accounts or any fixed account and placed in a special loan account. The variable investment accounts, any fixed account, and the special loan account will generally have different rates of investment return.
The amount of the outstanding loan (which includes accrued and unpaid interest) is subtracted from the amount otherwise payable when the policy proceeds become payable.
Taking a loan on the policy increases the risk that the policy may lapse because of the difference between the interest rate charged on the loan and the interest rate credited to the special loan account. When a loan is outstanding, the amount in
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the loan account is not available to help pay for any policy charges. If, after deducting your policy loan, there is not enough net cash surrender value to cover the policy charges, your policy could lapse. Also, whenever the outstanding loan equals or exceeds your policy value after the insured person reaches age 121, the policy will terminate 31 days after we have mailed notice of termination to you (and to any assignee of record at such assignee’s last known address) specifying the amount that must be paid to avoid termination, unless a repayment of at least the amount specified is made within that period. Policy loans may also result in adverse tax consequences under certain circumstances (see “Tax considerations”).
As described above, the amount of the loan is deducted from the variable investment accounts and any fixed account and placed in a special loan account. The special loan account will generally have different rates of investment return than the variable investment accounts and fixed account. This means policy loans may affect the overall investment performance and/or interest you earn that may result in a lower Policy Value Credit (see “Policy Value”) and Asset Credit (see “Asset Credit”). Policy loans will also reduce the Death Benefit Protection Value, which could cause the Death Benefit Protection feature to default (see “Death Benefit Protection”).
Description of charges at the policy level
Deduction from premium payments
•  Premium charge - A charge to help defray our sales costs and related taxes. A premium charge of 35% is deducted from all premiums paid in policy years 1-10. A premium charge of 32% is deducted from all premiums paid in policy years 11 and thereafter. We will stop accepting premium payments at and after the life insured’s age 121 (see “Coverage at and after age 121”).
Deductions from policy value
•  Administrative charge - A monthly charge to help cover our administrative costs. This is a flat dollar charge of $20 per month.
•  Advance Contribution Charge – A monthly charge to help offset reserving and other costs incurred by highly funded policies. To determine the charge, we multiply the Advance Contribution Charge Rate times the excess, if any, of premiums paid to date over the Advance Contribution Limit multiplied by the current Policy Year. The Advance Contribution Charge Rate grades down over the first ten policy years and is zero thereafter.
•  Face Amount charge - A monthly charge to primarily help cover sales costs. To determine the charge, we multiply the amount of Face Amount by a rate which varies by policy year, the insured person's sex, age, and risk classification.
•  Cost of insurance charge - A monthly charge for the cost of insurance. To determine the charge, we multiply the net amount of insurance for which we are then at risk by a cost of insurance rate. The rate is derived from an actuarial table. The table in your policy will show the maximum cost of insurance rates. The cost of insurance rates that we currently apply are generally less than the maximum rates and the current rates will never be more than the maximum rates shown in the policy. Cost of insurance charges will cease at and after the insured person reaches age 121. The cost of insurance rates we use will depend on the age at issue, the insurance risk characteristics and (usually) sex of the insured person, and the length of time the policy has been in effect. Regardless of the table used, cost of insurance rates generally increase each year that you own your policy, as the insured person's age increases. (The insured person's “age” on any date is his or her age on the birthday nearest that date.) For death benefit Option 1, the net amount at risk is equal to the greater of zero, or the result of (a) minus (b) where:
    (a) is the death benefit as of the first day of the Policy Month, divided by 1.0016516; and
    (b) is the policy value as of the first day of the Policy Month after the deduction of all monthly deductions.
Since the net amount at risk for death benefit Option 1 is based on a formula that includes as factors the death benefit and the policy value, the net amount at risk is affected by the investment performance of the variable investment accounts chosen, payment of premiums and charges assessed.
If the minimum death benefit is greater than the Face Amount, the cost of insurance charge will reflect the amount of that additional benefit.
For death benefit Option 2, the net amount at risk is equal to the Face Amount of insurance divided by 1.0016516.
•  Asset-based risk charge - A monthly charge to help cover sales, administrative and other costs. The charge is a percentage of that portion of your policy value allocated to variable investment accounts. This asset-based risk charge
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  does not apply to the fixed account. We do not currently impose this charge, but we reserve the right to do so in the policy. Any charge would cease at and after the insured person reaches age 121.
•  Supplementary benefit rider charges - A charge for any supplementary insurance benefit added to the policy by means of a rider.
•  Loan interest rate - We will charge interest on any amount you borrow from your policy. The interest charged on any loan is an effective annual rate of 3.25% in the first ten policy years and 2.25% thereafter (see “Policy loans”).
•  Transfer fee - We currently do not impose a fee upon transfers of policy value among the variable investment accounts, but reserve the right to impose a fee of up to $25 for any transfer beyond an annual limit (which will not be less than 12) to compensate us for the costs of processing these transfers (see “Market timing and disruptive trading practices”).
•  Surrender charge – During the first ten policy years, we will deduct a surrender charge if you surrender the policy, make a withdrawal that reduces the Face Amount, request Face Amount reductions cumulatively exceeding 10% of your Face Amount at issue, or your policy lapses. We deduct this charge to compensate us for sales expenses that we would otherwise not recover in the event of early lapse, surrender or certain Face Amount reductions. The surrender charge is equal to the Initial Surrender Charge, shown in your Policy Specifications, minus 0.0158 multiplied by the sum of premiums paid in policy year 1, minus the sum of Advance Contribution Charges incurred in policy year 1, with the result multiplied by the applicable percentage as described below.
The table below shows the applicable Maximum Percentage of Surrender Charge at the beginning of each year during the surrender charge period for a male age 55 preferred non-smoker. The Maximum Percentage of Surrender Charge is proportionately reduced each month of the policy year. These percentages may vary depending on your age, gender and insurance risk characteristics.
Year in Surrender Charge Period   Maximum Percentage of Surrender Charge
1
   100.00%
2
   98.76%
3
   97.61%
4
   96.43%
5
   95.24%
6
   87.70%
7
   80.16%
8
   72.62%
9
   65.08%
10
   57.54%
11+
   0%
The following hypothetical example demonstrates how we would calculate a surrender charge for this product. In this example, assume a policy with an Initial Surrender Charge amount of $3,000 is surrendered at the beginning of policy year 4 The policy owner paid $5,000 in premium in policy year 1 and incurred $20 of Advance Contribution Charges. There has not been a reduction in Face Amount on this policy.
Initial Surrender Charge   $3,000.00
minus 0.0158 x sum of year 1 premiums
   $ 79.00
minus sum of year 1 Advance Contribution charges
   $ 20.00
equals
   $2,901.00
multiplied by the applicable percentage of surrender charge for year 4 month 1
   x96.43%
equals the final surrender charge amount
   $2,797.43
A pro-rata portion of the surrender charge will be deducted from the policy value in instances where your requests for Face Amount reductions cumulatively exceed 10% of your Face Amount at issue. An approved decrease will take effect on the monthly deduction date on or following the date we approve the request. We will impose a surrender charge on withdrawals you take that reduce your Face Amount (see “Surrender and withdrawals - Withdrawals”).
Sales expenses and related charges
The premium and Face Amount charges help to compensate us for the cost of selling our policies (see “Description of charges at the policy level”). The amount of the charges in any policy year does not specifically correspond to sales expenses
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for that year. We expect to recover our total sales expenses over the life of the policies. To the extent that the premium and Face Amount charges do not cover total sales expenses, the sales expenses may be recovered from other sources, including the asset-based risk charge and other charges with respect to the policies, or from our general assets. Similarly, administrative expenses not fully recovered by the administrative charge may also be recovered from such other sources.
Method of deduction
Unless we agree otherwise or you do not have sufficient funds in any fixed account or variable investment accounts, we deduct the monthly deductions described in the Fee Tables section from your policy’s fixed account and variable investment accounts in the same proportion to the amount of policy value you have in each of the variable investment accounts and any fixed account.
Special purchase programs for eligible classes
With respect to policies issued to a class of associated individuals or to a trustee, employer or similar entity where we anticipate that the sales to the members of the class will result in lower than normal sales or administrative expenses, lower taxes or lower risks to us, we may offer the policies with reduced charges or with additional or enhanced features or benefits. We will make these programs available in accordance with our established administrative procedures in effect at the time of the application for a policy. The factors we consider in determining the eligibility of a particular group for such a program are: (i) the nature of the association and its organizational framework; (ii) the method by which sales will be made to the members of the class; (iii) the facility with which premiums will be collected from the associated individuals and the association's capabilities with respect to administrative tasks; (iv) the anticipated lapse and surrender rates of the policies; (v) the size of the class of associated individuals and the number of years it has been in existence; (vi) the aggregate amount of premiums paid; and (vii) any other such circumstances which result in a reduction in sales or administrative expenses, lower taxes or lower risks. Any reduction in charges or feature or benefit enhancement will be reasonable and will apply uniformly to all prospective policy purchasers in the class and will not unfairly discriminate against any owner.
The Statement of Additional Information (the “SAI”) contains additional information about any special purchase program we currently make available. For information as to how you may obtain a copy of the SAI, please see the last page of this prospectus.
Other charges we could impose in the future
Except for a portion of the premium charge, we currently make no charge for our Federal income taxes. However, if we incur, or expect to incur, income taxes attributable to any subaccount of the Separate Account or this class of policies in future years, we reserve the right to make a charge for such taxes. Any such charge would reduce what you earn on any affected accounts. However, we expect that no such charge will be necessary.
A portion of the premium charge is used to cover premium taxes. Premium taxes vary by jurisdiction and are subject to change. Currently, premium tax levels range from 0% to 5%.
Under current laws, we may incur state and local taxes (in addition to premium taxes)in several states. At present, these taxes are not significant. If there is a material change in applicable state or local tax laws, we may make charges for such taxes.
Description of charges at the portfolio level
The portfolios must pay investment management fees and other operating expenses. These fees and expenses (shown in the tables of portfolio annual expenses under “Fee Tables”) are different for each portfolio and reduce the investment return of each portfolio. Therefore, they also indirectly reduce the return you will earn on any variable investment accounts you select. Expenses of the portfolios are not fixed or specified under the terms of the policy, and those expenses may vary from year to year.
When the insured person reaches 121
If the policy is still in effect on the policy anniversary nearest the 121st birthday of the insured person, the following things will happen (whether or not there is any net cash surrender value):
•  We will stop any monthly deduction charges
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•  We will stop accepting any premium payments
•  We will no longer process withdrawals
•  We will continue to credit interest to a fixed account
•  We will continue to charge loan interest on outstanding loans and accept loan repayments.
•  The Death Benefit Protection feature will be terminated.
•  We will no longer calculate and apply the Policy Value Credit or the Asset Credit to your policy value
Other policy benefits, rights and limitations
Optional supplementary benefit riders you can add
When you apply for a policy, you can request any of the optional supplementary benefit riders that we then make available. Availability of any rider, the benefits it provides and the charges for it may vary by state. Our rules and procedures will govern eligibility for any rider and, in some cases, the configuration of the actual rider benefits. Each rider contains specific details that you should review before you decide to choose the rider (See “Variations in policy terms” for more details). Charges for most riders will be deducted from the policy value. We may change these charges (or the rates that determine them), but not above any applicable maximum amount stated in the Policy Specifications page of your policy. We may add to, delete from or modify the list of optional supplementary benefit riders.
•  Healthy Engagement Rider - Our Healthy Engagement Rider provides you with the opportunity to add credits (as described below) to your policy value based upon the insured’s ongoing participation in activities that promote a healthy lifestyle. If you elect this rider, the insured person will qualify for one of four healthy engagement status (“Status”) categories each year. The Status categories are based on the longevity benefits of certain healthy activities in which the insured person engages (such as regular checkups, biometric screenings, exercising regularly, participating in health educational programs, and periodically considering and answering certain health-related questions) and other health-related information about the insured person. The insured person’s Status category may change from year to year. (Current information relating to the insured person’s Status and/or the standards for determining Status are available through our Service Office at 1-800-387-2747.)
Beginning in the second policy year, if the insured person has qualified for one of the three highest Status categories, we will contribute a percentage of your policy’s monthly cost of insurance charge in the form of a credit (a “Rider Credit”) to your policy value, subject to the conditions mentioned below. Any Rider Credits will be allocated automatically to each variable investment account and/or any fixed account from which, and in the same proportion as, we are taking your monthly deductions. The Healthy Engagement Rider also provides the insured person with the possibility of other benefits, including discounted wearable devices, gear used to engage in healthy activities, biometric screenings, access to health and fitness information, and other discounts and offers that depend on the insured person having a certain Status. These and any other benefits available pursuant to the rider, are designed to encourage a high level of engagement by the insured person in activities that are correlated with improved longevity.
Under the Healthy Engagement Rider, several considerations are relevant to the percentage, if any, of any month’s cost of insurance charge that we will contribute as a Rider Credit to your policy. One important consideration is the insured person’s Status category for the current year and for prior years. If the insured person has always been in the lowest Status category, no Rider Credits will be paid. The higher the insured person’s Status category, and the more years the insured person qualifies for higher Status categories, the larger your Rider Credits are likely to be.
Also, the Rider Credit that is contributed to your policy in any month will not be more than the factor identified in the rider multiplied by the difference between the maximum amount of cost of insurance charge that your policy permits us to deduct for that month and the amount of cost of insurance charge that we actually deduct for that month. This means that the amount of any Rider Credit will be less the closer we are to charging the maximum cost of insurance rate that the policy permits; and there will not be any Rider Credit if and when we are charging the maximum cost of insurance rate. We will continue to deduct the Healthy Engagement Rider charge in instances where no Rider Credits are being earned and we are charging the maximum cost of insurance rate under the policy. Although our ability to change the cost of insurance rate (subject to the maximum rate) can therefore affect whether and how much Rider Credit you may receive, no Rider Credits that we contributed to your policy value prior to such a change would be affected.
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The amount of the Rider Credits that are contributed to your policy value in any month also will be reduced if the death benefit under your policy then exceeds $20,000,000. In such cases, the reduction in any Rider Credit will be larger as the death benefit at the time of such credit exceeds $20,000,000.
The amount of any Rider Credit for a month in which the policy is in default (as described under “Lapse and reinstatement”) will be applied first to pay any monthly deductions that are then due and unpaid and next to reduce the Default Payment, with any remaining amount then being contributed to your policy value in accordance with the allocation instructions then in effect for premium payments. The same procedure also will apply for any month in which the policy is being continued in force under the Death Benefit Protection feature, except that no amount will be applied to reduce a Default Payment.
We have the right to change at any time the qualification standards for Status categories. Such changes will be based on our expectations of the impact of those standards on future mortality, policy persistency, our expenses, our capital and reserve requirements, and our taxes relating to the policies. Any such changes, however, will be determined prospectively on a basis that does not discriminate unfairly within any class of insured persons. If we change the qualification standards for a Status level, it has an effect on the amount of Rider Credits you may earn for future months, but it will not affect the Rider Credits you have already earned. Also, we may change or terminate any other incentives (such as access to health and fitness information, offers, discounts, tools, or other services designed to encourage the insured to participate in activities that promote a healthy lifestyle) that we may make available from time to time to insured persons under the Healthy Engagement Rider.
If the Healthy Engagement Rider is still in effect on the later of the policy anniversary nearest the insured person’s 80th birthday or the 10th policy anniversary, the rider charge will cease to be deducted, no new Rider Credits will be earned, all previously earned Rider Credits will continue to apply as provided in the rider, and the availability to the insured person of certain benefits under the rider may cease.
You may elect to discontinue the rider at any time by written notice to us. In that case, the rider charge will cease to be deducted, no new Rider Credits will be earned, all previously earned Rider Credits will continue to apply as provided in the rider, and the availability to the insured person of certain benefits under the rider may cease.
If your policy terminates for any reason, the Healthy Engagement Rider also will terminate, although no Rider Credits that we contributed to your policy value prior to the termination will be affected.
Although the standards for determining a Status category may be administered directly by us or through an affiliated or unaffiliated provider that we designate, any termination or change in such third-party provider will not terminate or modify the Healthy Engagement Rider or our obligations thereunder.
There may be costs associated with meeting the standards to qualify for a given Status level that will not be reimbursed by the Company. Examples of such costs include, but are not limited to, health coverage co-pays, health club fees, athletic events, health equipment, health monitoring devices, and athletic attire.
•  Critical Illness Benefit Rider - Our Critical Illness Benefit Rider is designed to pay the policy owner a one-time, lump sum benefit amount if the insured person is diagnosed for the first time with one of seven critical illnesses (as defined in the rider) (“Critical Illness”) while this rider is in force and after the waiting period has been satisfied, subject to all policy and rider provisions. However, if the Insured receives a first time diagnosis for one of the Critical Illnesses before the rider is in force or during the rider's waiting period, then the policy owner will not receive benefits under this rider for that Critical Illness. Benefits under this rider will not begin until we receive proof of the insured person's initial diagnosis of a Critical Illness. Once the Critical Illness Benefit Amount has been paid, this rider will terminate. The Critical Illness Benefit Amount is an amount that is separate from the death benefit and may be used for any purpose. The charge for this rider is deducted each month from the Policy Value. Deductions for the rider charge will impact your cash surrender value under the policy. We will treat the monthly charges for the Critical Illness Rider as distributions from your life insurance policy for Federal tax purposes. In addition, please note that there is a risk that benefits received by certain third-party owners under this rider may have adverse tax consequences (see “Tax considerations”).
The Critical Illness Benefit Amount is determined at issue, shown in the Policy Specifications, and equal to your election of either 10% or 25% of the Face Amount, subject to a $250,000 maximum. Once issued, you cannot change your Critical Illness Benefit Amount. However, any policy change that results in a reduction in the Face Amount will reduce your Critical Illness Benefit Amount proportionally.
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If there is a reduction in the Face Amount, the new Critical Illness Benefit Amount will be equal to the lesser of (a) and (b), where:
(a)  is the Critical Illness Benefit Percent, shown in the Policy Specifications, multiplied by the Face Amount immediately after reduction of the Face Amount; and
(b)  is the Critical Illness Benefit Amount immediately before the reduction in Face Amount.
Any increases to the Face Amount will not result in a recalculation of the Critical Illness Benefit Amount.
Benefits under this rider do not reduce the Maximum Monthly Benefit Amount that is calculated under the Long-Term Care Benefit Rider.
Benefits paid under this rider do not provide or pay for the cost of medical care and are meant to be supplemental to health insurance that does pay for such costs. This rider is not a substitute for health insurance coverage, nor does it provide for supplemental coverage to Medicare. The benefits provided by this rider may not be coordinated with benefits provided by other coverage. Please review the benefits provided by this rider carefully to avoid possible duplication of coverage.
When this rider terminates, no further Rider Charge will be due and no Critical Illness Benefit Amount will be available.
•  Disability Payment of Specified Premium Rider – This rider is designed to pay an amount of premium, referred to as the Specified Premium, into the policy value each month during the life insured’s total disability. The Specified Premium is chosen at issue and shown in the Policy Specifications.
Total disability is a condition resulting from accidental bodily injury or disease which leaves the insured person (1) incapable of performing the duties of employment or (2) with total and irrecoverable loss of sight of both eyes or use of both hands, both feet or one hand and one foot. Before we will pay Specified Premium, we must receive due proof of the insured person’s total disability, which must begin between the policy anniversaries nearest the insured person’s 5th and 65th birthdays and must be continuous for at least six months.
Pursuant to the terms and conditions of this rider, we will continue to pay Specified Premium until (1) the insured person’s total disability has ceased, (2) the insured person has died, (3) we have not received sufficient proof of continued total disability, or (4) the rider has terminated. However, if total disability begins on or after the policy anniversary nearest the insured person’s 60th birthday, we will cease to pay Specified Premium on the earliest of the dates provided above and the day before the policy anniversary nearest the insured person’s 65th birthday.
We will not pay the Specified Premium under this rider if: (1) the total disability results from an intentional, self-inflicted injury or service in the armed forces; or (2) the total disability begins within 2 years after the rider’s Issue Date and results from an injury sustained or a disease contracted before the rider’s issue date.
The Specified Premium may be reduced in the event of a reduction in Face Amount or a change in any rider benefits. We will notify you of any such reduction in the Specified Premium.
This rider will terminate at the earliest of (a) the date your policy terminates, (b) the date you request in writing to terminate this rider, or (c) the date of death of the insured person. However, if total disability begins on or after the policy anniversary nearest the insured person’s 60th birthday, the rider will terminate on the earliest of the dates provided above and the policy anniversary nearest the insured person’s 65th birthday.
The Specified Premium paid under this rider may not be sufficient to maintain the policy in force to Age 121. Therefore, you may be required to pay premiums during the period of continuous total disability in order to maintain the policy in force.
•  Long-Term Care Rider - This rider provides for periodic advance payments to you of a portion of the death benefit if the insured person becomes “chronically ill” so that such person: (1) is unable to perform at least two activities of daily living without substantial human assistance or has a severe cognitive impairment; and (2) is receiving certain qualified services described in the rider. The decision to add this rider must be made at issuance of the policy. If you elect this rider, you will also have an option to apply to have a portion of the policy's death benefit advanced to you in the event of terminal illness. Please note that there is a significant risk that ownership of a policy with this rider by anyone other than the insured will cause adverse tax consequences (see “Tax considerations”).
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  Benefits under the Long-Term Care Rider will not begin until we receive proof that the insured person qualifies and has received “qualified long-term care service,” while the policy was in force. You must continue to submit evidence during the insured person's lifetime of the insured person's eligibility for rider benefits.
There is a maximum amount of death benefit that we will advance for each month of qualification. This amount, called the “Maximum Monthly Benefit Amount,” is equal to the amount of the death benefit that may be accelerated under the rider (as of the day the insured qualifies for benefits) multiplied by the Monthly Acceleration Percentage, which is the percentage of the death benefit you can accelerate each month. The Monthly Acceleration Percentage must be elected when you apply for the policy. The actual amount of any advance is based on the expense incurred by the insured person, up to the Maximum Monthly Benefit Amount, for each day of qualified long-term care service in a calendar month, as described in the rider. We will recalculate the Maximum Monthly Benefit Amount if you make a withdrawal of policy value, and for other events described in the rider. Each advance reduces the remaining death benefit under your policy, and causes a proportionate reduction in your policy value. If you have a policy loan, we will use a pro-rata portion of each death benefit advance to repay indebtedness. For example, if current indebtedness is $10,000, the death benefit is $100,000, and the gross advance is $2,000, then the net advance would be $1,800 = $2,000 X (1 - ($10,000/ $100,000)). As a result of the advance, the indebtedness will be reduced by $200.
We restrict your policy value's exposure to market risk when benefits are paid under the Long-Term Care Rider. We do this in several ways. First, before we begin paying any Monthly Benefit, we will transfer all policy value from the variable investment accounts to the fixed account. (The amount to be transferred will be determined on the business day immediately following the date we approve a request for benefits under the rider.) In addition, you will not be permitted to transfer policy value or allocate any additional premium payment to a variable investment account while rider benefits are paid. Your participation in any of the automatic investment plans will also be suspended during this period.
If the insured person no longer qualifies for rider benefits and your policy remains in force, you will be permitted to invest new premium payments or transfer existing policy value in the variable investment accounts. (The restriction on transfers from the fixed account will continue to apply.) Accelerated benefits under this rider reduce the Death Benefit Protection Value by the same proportion as the Face Amount.
Finally, please note that there is a significant risk that ownership of a policy with this rider by anyone other than the insured person will cause adverse tax consequences. If the owner of the policy is not the insured person, benefit payments may be included in the owner's income, and the death benefit may be part of the estate of the insured person for purposes of Federal estate tax (see “Tax considerations”).
•  Long Term Care Rider 2018 - This rider provides for periodic advance payments to you of a portion of the death benefit if the insured person becomes “chronically ill” so that such person: (1) is unable to perform at least two activities of daily living without substantial human assistance or has a severe cognitive impairment; and (2) is receiving certain Qualified Long-Term Care Services defined in the rider. The decision to add this rider must be made at issuance of the policy.
There is a significant risk that ownership of a policy with this rider by anyone other than the insured person will cause adverse tax consequences. If the owner of the policy is not the insured person, benefit payments may be included in the owner’s income, and the death benefit may be part of the estate of the insured person for purposes of Federal estate tax (see “Tax considerations”).
The maximum amount of death benefit that may be accelerated under this rider is the Accelerated Benefit Pool, which is equal to a percentage of the Face Amount at Issue. You can choose to accelerate between 1% and 100% of your death benefit.
Each advance payment under the rider reduces the remaining death benefit under your policy, and causes a proportionate reduction in your policy value. If you have a policy loan, we will use a pro-rata portion of each death benefit advance to repay indebtedness. For example, if current indebtedness is $10,000, the death benefit is $100,000, and the gross advance is $2,000, then the net advance would be $1,800 = $2,000 X (1 - ($10,000/ $100,000)). As a result of the advance, the indebtedness will be reduced by $200.
When the insured person qualifies for benefits under this rider, we will determine the Maximum Monthly Benefit Amount, which is the portion of the Accelerated Benefit Pool that you can accelerate each month to pay for Qualified Long-Term Care Services. The Maximum Monthly Benefit Amount is equal to the Accelerated Benefit Pool multiplied by the Monthly Acceleration Percentage. You can choose a Monthly Acceleration Percentage which is equal
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to 1%, 2% or 4%. The Monthly Acceleration Percentage must be selected when you apply for the policy and cannot be changed. We will recalculate the Maximum Monthly Benefit Amount and the Accelerated Benefit Pool if you make a withdrawal of policy value, and for other events described in the rider.
Rider benefits may also be used to pay for Stay at Home Services. At the time we receive Receipts for Stay at Home Services, we will determine the Stay at Home Lifetime Benefit Amount, which is the maximum amount that you can accelerate from the Accelerated Benefit Pool over the life of the policy to pay for Stay at Home Services. The Stay at Home Lifetime Benefit Amount is set equal to the Maximum Monthly Benefit Amount (as described above) in effect on the date you submit Receipts for Stay at Home Services. Stay at Home Services and Receipts for Stay at Home Services are defined in the rider.
Once the Accelerated Benefit Pool is exhausted, the rider will terminate and you will no longer receive advance payments pursuant to the rider.
We restrict your policy value’s exposure to market risk when benefits are being paid under this rider. We do this in several ways. First, before we begin paying any benefit under this rider, we will transfer all policy value from the variable investment accounts to the fixed account. (The amount to be transferred will be determined on the business day immediately following the date we approve a request for benefits under the rider.) In addition, you will not be permitted to transfer policy value or allocate any additional premium payment to a variable investment account while rider benefits are being paid. Your participation in any of the automatic investment plans will also be suspended during this period.
If the insured person no longer qualifies to receive periodic advance payments and your policy remains in force, you will be permitted to invest new premium payments in or transfer existing policy value to the variable investment accounts. (The restriction on transfers from the fixed account will continue to apply.)
Finally, benefits paid under this rider do not reduce the Early Lapse Protection requirements that may be necessary for the Early Lapse Protection feature to remain in effect after a termination of rider benefits.
•  Accelerated Benefit Rider - This rider allows you to make a one-time request to accelerate a portion of your death benefit should the insured person become terminally ill and have a life expectancy of one year or less.
Before we can pay the benefit amount under this rider, the following conditions must be met: (1) you must provide us with written evidence satisfactory to us that that the insured person is terminally ill and has a life expectancy of one year or less, (2) we must receive a written consent of any assignee or any irrevocable beneficiary under the policy and (3) you must claim the benefit voluntarily and not as a way to satisfy a creditor’s claim or for government benefits.
If you satisfy the above conditions, we will pay you 50% of the eligible death benefit, up to a maximum of $1,000,000 on the insured person. You will receive your payment in one lump sum. You cannot make another claim under this rider after we have paid the benefit. We will not make a payment if it would be less than $10,000. If more than one policy owner makes a claim, we will pay the benefit in proportion to the amount of eligible death benefit each has on the insured person.
Payment of the benefit amount will reduce your death benefit, cash value or loan value under your policy. You should consult your tax adviser and social service agencies before you decide to receive the benefit under this rider. This rider is only available with policies that are individually owned.
•  Return of Premium Death Benefit Rider - You may elect to have your policy issued with an optional Return of Premium Death Benefit (“ROP”) Rider. The ROP rider provides an additional death benefit payable upon the death of the insured person. The initial value of your ROP is equal to the Percentage of Premium times your initial premium payment. The Percentage of Premium is selected by you at the time of issue, ranges between 1% to 100%, and is shown in your ROP Policy Specifications page.
We will multiply the Percentage of Premium by each subsequent premium and increase the ROP coverage at the time of the subsequent premium payment by that amount, up to the maximum benefit amount. The amount of ROP coverage cannot exceed the maximum benefit amount, which is determined at issue and is stated in the ROP Rider. This rider is only available at issue with Death Benefit Option 1. It may not be used in conjunction with Disability Payment of Specified Premium or the Long-Term Care Rider.
•  Healthy Engagement Core Rider - Our Healthy Engagement Core Rider provides the insured person with the opportunity to participate in the Company’s Healthy Engagement Core program (the “Program”). This Program is
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  designed to help improve the longevity of the insured person by educating and motivating the insured person to develop and maintain a healthy lifestyle.
By participating in this Program, the insured person may receive discounts on certain goods and services, educational resources, tools, or other items that are designed to encourage learning and participation in healthy activities (the “Program Rewards”). The Company reserves the right to amend aspects of the Program from time to time, including the Program Rewards.
The Company will not use any medical or other information about the insured person, after the issue date, under the Program to change a Risk Classification or as the sole basis to deny a request for reinstatement.
The Program may be administered by us or through an affiliated or unaffiliated company designated by us. The Company may designate or replace any such company at any time.
Participation in the Program is voluntary and, while there are no policy level fees associated with this rider, there may be costs associated with participating in the Program that will not be reimbursed by us. Examples of such costs include, but are not limited to, health coverage co-pays, health club fees, athletic event registration fees, health equipment, health monitoring devices, athletic attire and online access fees. Participation in the Program does not provide you with the opportunity to add credits to your policy nor will it affect your policy value.
In order to participate in this Program, the insured person must have attained Age 20. An insured person may not participate in this Program if the Healthy Engagement Rider under the policy has already been elected. An insured person may elect to discontinue participation in the Program at any time by written notice to us. If your policy terminates for any reason, the Program will also terminate. An insured person may obtain current information about the Program by visiting http://www.JohnHancockVitality.com/or by calling 1(800)-387-2747.
Procedures for issuance of a policy
Generally, the policy is available with a minimum Face Amount at issue of $50,000. At the time of issue, the insured person must have an attained age of no more than 90. The insured person must meet certain health and other insurance risk criteria called “underwriting standards.”
Policies issued in Montana or in connection with certain employee plans will not directly reflect the sex of the insured person in either the premium rates or the charges or values under the policy.
Commencement of insurance coverage
After you apply for a policy, it can sometimes take up to several weeks for us to gather and evaluate all the information we need to decide whether to issue a policy to you and, if so, what the insured person's risk classification should be. After we approve an application for a policy and assign an appropriate insurance risk classification, we will prepare the policy for delivery. We will not pay a death benefit under a policy unless the policy is in effect when the insured person dies (except for the circumstances described under “Temporary coverage prior to policy delivery” below).
The policy will take effect only if all of the following conditions are satisfied:
•  The policy is delivered to and received by the applicant.
•  The Minimum Initial Premium is received by us.
•  The insured person is living and there has been no deterioration in the insurability of the insured person since the date of the application.
The date all of the above conditions are satisfied is referred to in this prospectus as the “Contract Completion Date.” If all of the above conditions are satisfied, the policy will take effect on the date shown in the policy as the “Policy Date.” That is the date on which we begin to take monthly deductions. Policy months, policy years and policy anniversaries are all measured from the Policy Date.
Backdating
Under limited circumstances, we may backdate a policy, upon request, by assigning a Policy Date earlier than the date the application is signed. However, in no event will a policy be backdated earlier than the earliest date allowed by state law, which is generally three months to one year prior to the date of application for the policy. The most common reasons for backdating are to preserve a younger age at issue for the insured person or to retain a common monthly deduction date in
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certain corporate-owned life insurance cases involving multiple policies issued over time. If used to preserve age, backdating will result in lower insurance charges. However, monthly deductions will begin earlier than would otherwise be the case. Monthly deductions for the period the Policy Date is backdated will actually be deducted from policy value on the Contract Completion Date.
Temporary coverage prior to policy delivery
If a specified amount of premium is paid with the application for a policy and other conditions are met, we will provide temporary term life insurance coverage on the insured person for a period prior to the time coverage under the policy takes effect. Such temporary term coverage will be subject to the terms and conditions described in the Temporary Life Insurance Agreement and Receipt attached to the application for the policy, including conditions to coverage and limits on amount and duration of coverage.
Monthly deduction dates
Each charge that we deduct monthly is assessed against your policy value at the close of business on the Policy Date and at the close of the first day in each subsequent policy month.
Changes that we can make as to your policy
We reserve the right to make any changes in the policy necessary to ensure the policy is within the definition of life insurance under the Federal tax laws and is in compliance with any changes in Federal or state tax laws.
In our policies, we reserve the right to make certain changes if they would serve the best interests of policy owners or would be appropriate in carrying out the purposes of the policies. These changes include the following:
•  Changes necessary to comply with or obtain or continue exemptions under the Federal securities laws
•  Combining or removing fixed accounts or variable investment accounts
•  Changes in the form of organization of any separate account
Any such changes will be made only to the extent permitted by applicable laws and only in the manner permitted by such laws. When required by law, we will obtain your approval of the changes and the approval of any appropriate regulatory authority.
The owner of the policy
Who owns the policy? That's up to the person who applies for the policy. The owner of the policy is the person who can exercise most of the rights under the policy, such as the right to choose the accounts in which to invest or the right to surrender the policy. In many cases, the person buying the policy is also the person who will be the owner. However, the application for a policy can name another person or entity (such as a trust) as owner. Whenever we've used the term “you” in this prospectus, we've assumed that the reader is the person who has whatever right or privilege is being discussed. There may be tax consequences if the owner and the insured person are different, so you should discuss this issue with your tax adviser.
While the insured person is alive, you will have a number of options under the policy. These options include those listed below:
•  Determine when and how much you invest in the variable investment accounts and any fixed account
•  Borrow or withdraw amounts you have in the variable investment account and any fixed account
•  Change the beneficiary who will receive the death benefit
•  Change the amount of insurance
•  Turn in (i.e., “surrender”) the policy for the full amount of its net cash surrender value
•  Choose the form in which we will pay out the death benefit or other proceeds
It is possible to name so-called “joint owners” of the policy. If more than one person owns a policy, all owners must join in most requests to exercise rights under the policy.
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Your beneficiary
You name your beneficiary when you apply for the policy. The beneficiary is entitled to the proceeds we pay following the insured person's death. Until the death of the insured person you can change your beneficiary by written request. Such a change requires the consent of any named irrevocable beneficiary. A new beneficiary designation will not affect any payments we make before we receive it. If no beneficiary is living when the insured person dies, we will pay the insurance proceeds to the owners or the owner's estate.
Policy cancellation right
You have the right to cancel your policy within ten days after you receive it (the period may be longer in some states). This is often referred to as the “free look” period. During this period, your premiums will be allocated as described under “Processing premium payments” in this prospectus. To cancel your policy, simply deliver or mail the policy to:
•  John Hancock USA at either of the addresses shown on the back cover of this prospectus, or
•  the John Hancock USA representative who delivered the policy to you.
The date of cancellation will be the date of such mailing or delivery. In most states, you will receive a refund of any premiums you’ve paid. In some states, the refund will be your policy value on the date of cancellation. The state in which the policy is issued determines the period and type of refund that applies. A general summary of material state variations is described in “Variations in policy terms.”
Delay to challenge coverage
We may challenge the validity of your insurance policy based on any material misstatements made to us in the application for the policy. We cannot make such a challenge, however, beyond certain time limits that are specified by the laws of the state in which your policy was issued. The longest limit is two years, except in cases of fraud. The longest limit is two years, except in cases of fraud.
Reports that you will receive
At least annually, we will send you a statement setting forth at least the following information as of the end of the most recent reporting period: the amount of the death benefit, the portion of the policy value in the fixed account and in each variable investment account, premiums received and charges deducted from premiums since the last report, any outstanding policy loan (and interest charged for the preceding policy year), and any further information required by law. Moreover, you also will receive confirmations of premium payments, transfers among accounts, policy loans, partial withdrawals and certain other policy transactions.
Semi-annually we will send you a report containing the financial statements of the portfolios, including a list of securities held in each portfolio.
Assigning your policy
You may assign your rights in the policy to someone else as collateral for a loan or for some other reason. Assignments do not require the consent of any revocable beneficiary. A copy of the assignment must be forwarded to us. We are not responsible for any payment we make or any action we take before we receive a copy of the assignment at our Service Office. Nor are we responsible for the validity of the assignment or its efficacy in meeting your objectives. An absolute assignment is a change of ownership. All collateral assignees of record must usually consent to any surrender, withdrawal or loan from the policy.
When we pay policy proceeds
General
We will ordinarily pay any death benefit, withdrawal, surrender value or loan within seven days after we receive the last required form or request (and, with respect to the death benefit, any other documentation that may be required). You may choose to receive proceeds from the policy as a single sum. If we do not have information about the desired manner of payment within seven days after the date we receive documentation of the insured person's death, we will pay the proceeds as a single sum. As permitted by state law and our current administrative procedures, death claim proceeds may be placed into an interest-bearing John Hancock retained asset account in the beneficiary's name. The interest earned in a John Hancock
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retained asset account is normally subject to income tax. You should consult with your tax advisor if you have any questions regarding taxation of the interest earned. We will provide the beneficiary with a checkbook, so checks may be written for all or a part of the proceeds. The retained asset account is part of our general account and is subject to the claims of our creditors. It is not a bank account and it is not insured by the FDIC. We may receive a benefit from managing proceeds held in a retained asset account. Alternatively, you can elect to have proceeds of $1,000 or more applied to any of the other payment options we may offer at the time. You cannot choose an option if the monthly payments under the option would be less than $50. We will issue a supplementary agreement when the proceeds are applied to any alternative payment option. That agreement will spell out terms of the option in full. Please contact our Service Office for more information.
Delay for check clearance
We reserve the right to defer payment of that portion of your policy value that is attributable to a premium payment made by check for a reasonable period of time (not to exceed fifteen days) to allow the check to clear the banking system. We will not delay payment longer than necessary for us to verify a check has cleared the banking system.
Delay of separate account proceeds
We reserve the right to defer payment of any death benefit, loan or other distribution that is derived from a variable investment account if (1) the New York Stock Exchange is closed (other than customary weekend and holiday closings) or trading on the New York Stock Exchange is restricted; (2) an emergency exists, as determined by the SEC, as a result of which disposal of securities is not reasonably practicable or it is not reasonably practicable to fairly determine the policy value; or (3) the SEC by order permits the delay for the protection of owners. Transfers and allocations of policy value among the variable investment accounts may also be postponed under these circumstances. If we need to defer calculation of separate account values for any of the foregoing reasons, all delayed transactions will be processed at the next values that we do compute.
Delay of general account surrender proceeds
State laws allow us to defer payment of any portion of the net cash surrender value derived from the fixed account for up to six months. These laws were enacted many years ago to help insurance companies in the event of a liquidity crisis.
How you communicate with us
General rules
You should mail or express all checks and money orders for premium payments and loan repayments to the John Hancock USA Service Office at the appropriate address shown on the back cover.
Under our current rules, certain requests must be made in writing and be signed and dated by you. Those requests include the following.
•  loans
•  surrenders or withdrawals
•  change of death benefit option
•  increase or decrease in Face Amount
•  change of beneficiary
•  election of payment option for policy proceeds
•  tax withholding elections
•  election of telephone/internet transaction privilege
The following requests may be made either in writing (signed and dated by you) or by telephone or fax or through the Company's secured website, if a special form is completed (see “Telephone, facsimile and internet transactions” below).
•  transfers of policy value among the variable investment accounts and any fixed account
•  change of allocation among the variable investment accounts and any fixed account for new premium payments
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You should mail or express all written requests to our Service Office at the appropriate address shown on the back cover. You should also send notice of the insured person's death and related documentation to our Service Office. We do not consider that we’ve “received” any communication until such time as it has arrived at the proper place and in the proper and complete form.
We have special forms that should be used for a number of the requests mentioned above. You can obtain these forms from our Service Office or your John Hancock USA representative. Each communication to us must include your name, your policy number and the name of the insured person. We cannot process any request that doesn’t include this required information. Any communication that arrives after the close of our business day, or on a day that is not a business day, will be considered “received” by us on the next following business day. Our business day currently closes at 4:00 p.m. Eastern time, but special circumstances (such as suspension of trading on a major exchange) may dictate an earlier closing time.
Telephone, facsimile and internet transactions
If you complete a special authorization form, you can request transfers among the variable investment accounts and any fixed account and changes of allocation among the variable investment accounts and any fixed account simply by telephoning us at 1-800-827-4546 or by faxing us at 1-617-572-1571 or through the Company's secured website. Any fax or internet request should include your name, daytime telephone number, policy number and, in the case of transfers and changes of allocation, the names of the variable investment accounts and any fixed account involved. We will honor telephone and internet instructions from anyone who provides the correct identifying information, so there is a risk of loss to you if this service is used by an unauthorized person. However, you will receive written confirmation of all telephone/internet transactions. There is also a risk that you will be unable to place your request due to equipment malfunction or heavy phone line or internet usage. If this occurs, you should submit your request in writing.
If you authorize telephone or internet transactions, you will be liable for any loss, expense or cost arising out of any unauthorized or fraudulent telephone or internet instructions which we reasonably believe to be genuine, unless such loss, expense or cost is the result of our mistake or negligence. We employ procedures which provide safeguards against the execution of unauthorized transactions which are reasonably designed to confirm that instructions received by telephone or internet are genuine. These procedures include requiring personal identification, the use of a unique password for internet authorization, recording of telephone calls, and providing written confirmation to the owner. If we do not employ reasonable procedures to confirm that instructions communicated by telephone or internet are genuine, we may be liable for any loss due to unauthorized or fraudulent instructions.
As stated earlier in this prospectus, the policies are not designed for professional market timing organizations or other persons or entities that use programmed, large or frequent transfers among investment options. To discourage disruptive trading, we have imposed certain transfer restrictions (see “Transfers of existing policy value”). In addition, we also reserve the right to change our telephone, facsimile and internet transaction privileges outlined in this section at any time, and to suspend or terminate any or all of those privileges with respect to any owners who we feel are abusing the privileges to the detriment of other owners.
Variations in policy terms
Insurance laws and regulations apply to us in every state in which our policies are sold. As a result, terms and conditions of your insurance coverage may vary depending on where you purchase a policy, and certain riders and options may not be available due to state insurance laws or restrictions in the state in which the policy is issued. We disclose all material variations in this prospectus, consistent with disclosure standards under federal securities law. A general summary of material state variations to the statements made in this prospectus is included below. Specific variations from the information appearing in this prospectus which are required due to insurance laws and regulations are contained in your policy, or in riders or endorsements attached to your Policy. You should refer to your policy for these state specific features.
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MATERIAL STATE VARIATIONS
Policy Provisions States with Variation Description of Variations
Free Look Period (amount of refund) AK, AL, AR, AZ, CT, CO, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, VT, WA, WV and WY Return of premium
 
CA, SD 		Policy value at time of return plus charges deducted
Riders States with Variation Description of Variations
Accelerated Benefit Rider MA Not available
 
WA 		Condition of payment is based in part on the life insured person having a life expectancy of two years or less.
Critical Illness Benefit Rider CT, GA, GU, ID, KS, MA, MS, MO, NH, NJ, OH, PA, PR, TN, VA, and WA Not available
Disability Payment of Specified Premium Rider  
IN 		Total disability must begin between policy anniversary nearest the insured person’s 20th and 65th birthdays.
Healthy Engagement Rider ND and PR Not available
Long Term Care 2018 CA, GU, MT, NJ, and PR Not available
ROP GU and PR Not available
We may vary the charges and other terms of our policies where special circumstances result in sales or administrative expenses, mortality risks or other risks that are different from those normally associated with the policies. These include the type of variations discussed under “Special purchase programs for eligible classes.” No variation in any charge will exceed any maximum stated in this prospectus with respect to that charge.
Any variation discussed above will be made only in accordance with uniform rules that we adopt and that we apply fairly to our customers.
Distribution of policies
John Hancock Distributors LLC (“JH Distributors”), a Delaware limited liability company affiliated with us, is the principal distributor and underwriter of the securities offered through this prospectus and of other annuity and life insurance products we and our affiliates offer. JH Distributors also acts as the principal underwriter of the Trust, whose securities are used to fund certain variable investment accounts under the policies and under other annuity and life insurance products we offer.
JH Distributors' principal address 200 Berkeley Street, Boston, Massachusetts 02116. JH Distributors is a broker-dealer registered under the Securities Exchange Act of 1934 (the “1934 Act”) and a member of the Financial Industry Regulatory Authority (“FINRA”).
We offer the policies for sale through individuals who are licensed as insurance agents and who are registered representatives of broker-dealers that have entered into selling agreements with JH Distributors. In addition, we, either directly or through JH Distributors, have entered into agreements with other financial intermediaries that provide marketing, sales support and certain administrative services to help promote the policies (“financial intermediaries”). In a limited number of cases, we have entered into loans, leases or other financial agreements with these broker-dealers or financial intermediaries or their affiliates.
Compensation
The broker-dealers and other financial intermediaries that distribute or support the marketing of our policies may be compensated by means of various compensation and revenue sharing arrangements. A general description of these arrangements is set out below under “Standard compensation” and “Additional compensation and revenue sharing.” These arrangements may differ between firms, and not all broker-dealers or financial intermediaries will receive the same
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compensation and revenue sharing benefits for distributing our policies. Also, a broker-dealer may receive more or less compensation or other benefits for the promotion and sale of our policy than it would expect to receive from another issuer.
Under their own arrangements, broker-dealers determine how much of any amounts received from us is to be paid to their registered representatives.
Policy owners do not pay any compensation or revenue sharing benefits directly. These payments are made from JH Distributors’ and our own revenues, profits or retained earnings, which may be derived from a number of sources, such as fees received from an underlying fund’s distribution plan (“12b-1 fees”), the fees and charges imposed under the policy and other sources.
You should contact your registered representative for more information on compensation arrangements in connection with your purchase of a policy. We provide additional information on special compensation or reimbursement arrangements involving broker-dealers and other financial intermediaries in the SAI, which is available upon request.
Standard compensation. JH Distributors pays compensation to broker-dealers for the promotion and sale of the policies, and for providing ongoing service in relation to policies that have already been purchased. We may also pay a limited number of broker-dealers commissions or overrides to “wholesale” the policies; that is, to provide marketing support and training services to the broker-dealer firms that do the actual selling.
The compensation JH Distributors pays to broker-dealers may vary depending on the selling agreement. The compensation paid is not expected to exceed 145% of target premium paid in the first policy year, and 8% of target premium paid in years 2-10. Compensation paid on any premium in excess of target will not exceed 10% in any year. This compensation schedule is exclusive of additional compensation and revenue sharing and inclusive of overrides and expense allowances paid to broker-dealers for sale of the policies (not including riders).
Additional compensation and revenue sharing. To the extent permitted by SEC and FINRA rules and other applicable laws and regulations, we may enter into special compensation or reimbursement arrangements (“revenue sharing”), either directly or through JH Distributors, with selected broker-dealers and other financial intermediaries. In consideration of these arrangements, a firm may feature our policy in its sales system, give us preferential access to sales staff, or allow JH Distributors or its affiliates to participate in conferences, seminars or other programs attended by the firm’s sales force. We hope to benefit from these revenue sharing and other arrangements through increased sales of our policies.
Selling broker-dealers and other financial intermediaries may receive, directly or indirectly, additional payments in the form of cash, other compensation or reimbursement. These additional compensation or reimbursement arrangements may include, for example, payments in connection with the firm's “due diligence” examination of the policies, payments for providing conferences or seminars, sales or training programs for invited registered representatives and other employees, payment for travel expenses, including lodging, incurred by registered representatives and other employees for such seminars or training programs, seminars for the public or client seminars, advertising and sales campaigns regarding the policies, payments to assist a firm in connection with its systems, operations and marketing expenses and/or other events or activities sponsored by the firms. We may contribute to, as well as sponsor, various educational programs, sales promotions, and/or other contests in which participating firms and their sales persons may receive gifts and prizes such as merchandise, cash or other rewards as may be permitted under FINRA rules and other applicable laws and regulations.
Tax considerations
This description of Federal income tax consequences is only a brief summary and is neither exhaustive nor authoritative. It was written to support the promotion of our products. It does not constitute legal or tax advice, and it is not intended to be used and cannot be used to avoid any penalties that may be imposed on you. Tax consequences will vary based on your own particular circumstances, and for further information you should consult a qualified tax adviser. Federal, state and local tax laws, regulations and interpretations can change from time to time. As a result, the tax consequences to you and the beneficiary may be altered, in some cases retroactively. The policy may be used in various arrangements, including non-qualified deferred compensation or salary continuation plans, split dollar insurance plans, executive bonus plans, retiree medical benefit plans and others. The tax consequences of such plans may vary depending on the particular facts and circumstances of each individual arrangement. Therefore, if the value of using the policy in any such arrangement depends in part on the tax consequences, a qualified tax adviser should be consulted for advice.
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General
We are taxed as a life insurance company. Under current tax law rules, we include the investment income (exclusive of capital gains) of the Separate Account in our taxable income and take deductions for investment income credited to our policy holder reserves. We are also required to capitalize and amortize certain costs instead of deducting those costs when they are incurred. We do not currently charge the Separate Account for any resulting income tax costs, other than a charge we may impose against the Separate Account to compensate us for the cost of a delay in the deductibility of deferred acquisition costs (the “DAC tax” adjustment) pursuant to section 848 of the Internal Revenue Code. We also claim certain tax credits or deductions relating to foreign taxes paid and dividends received by the series funds. These benefits can be material. We do not pass these benefits through to the Separate Account, principally because: (i) the deductions and credits are allowed to us and not the policy owners under applicable tax law; and (ii) the deductions and credits do not represent investment return on the Separate Account assets that is passed through to policy owners.
The policies permit us to deduct a charge for any taxes we incur that are attributable to the operation or existence of the policies or the Separate Account. Currently, we do not anticipate making any specific charge for such taxes other than any DAC tax charge and premium taxes where applicable. If the level of the current taxes increases, however, or is expected to increase in the future, we reserve the right to make a charge in the future.
Death benefit proceeds and other policy distributions
Generally, death benefits paid under policies such as yours are not subject to income tax unless policy ownership has been transferred in exchange for payment. Earnings on your policy value are ordinarily not subject to income tax as long as we don’t pay them out to you. If we do pay out any amount of your policy value upon surrender or partial withdrawal, all or part of that distribution would generally be treated as a return of the premiums you’ve paid and not subjected to income tax. Any portion not treated as a return of your premiums would be includible in your income.
Please note that certain distributions associated with a reduction in death benefit or other policy benefits within the first fifteen years after issuance of the policy are ordinarily taxable in whole or in part. Amounts you borrow are generally not taxable to you.
However, some of the tax rules change if your policy becomes a modified endowment contract. This can happen if you’ve paid premiums in excess of limits prescribed by the tax laws. In that case, additional taxes and penalties may be payable for policy distributions of any kind, including loans. (See “7-pay premium limit and modified endowment contract status” below.)
We expect the policy to receive the same Federal income and estate tax treatment as fixed benefit life insurance policies. Section 7702 of the Internal Revenue Code defines a life insurance contract for Federal tax purposes. For a policy to be treated as a life insurance contract, it must satisfy either the cash value accumulation test or the guideline premium test. These tests limit the amount of premium that you may pay into the policy. We will monitor compliance with these standards. If we determine that a policy does not satisfy section 7702, we may take whatever steps are appropriate and reasonable to bring it into compliance with section 7702.
If the policy complies with section 7702, the death benefit proceeds under the policy ordinarily should be excludible from the beneficiary’s gross income under section 101 of the Internal Revenue Code. (As noted above, a transfer of the policy for valuable consideration may limit the exclusion of death benefits from the beneficiary's income.) In addition, if you have elected a Long-Term Care Rider, or the Long-Term Care Rider 2018, the rider's benefits generally will be excludible from gross income under the Internal Revenue Code. The tax-free nature of these accelerated benefits is contingent on the rider meeting specific requirements under section 101 and/or section 7702B of the Internal Revenue Code. The riders are intended to meet these standards.
If you have elected a Long-Term Care Rider or the Long-Term Care Rider 2018, we caution you that there is a significant risk that ownership by anyone other than the person insured by the policy will cause adverse tax consequences. If the owner of the policy is not the insured person, benefit payments may be included in the owner's income, and the death benefit may be part of the insured person's estate for purposes of the Federal estate tax. A policy with a Long-Term Care Rider or the Long Term Care Rider 2018 should not be purchased by or transferred to a person other than the insured person unless you have carefully reviewed the tax implications with your tax adviser.
Increases in policy value as a result of interest or investment experience will not be subject to Federal income tax unless and until values are received through actual or deemed distributions. In general, unless the policy is a modified endowment
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contract, the owner will be taxed only on the amount of distributions that exceed the premiums paid under the policy. An exception to this general rule occurs in the case of a decrease in the policy's death benefit or any other change that reduces benefits under the policy in the first fifteen years after the policy is issued and that results in a cash distribution to the policy owner. Changes that reduce benefits include partial withdrawals, death benefit option changes, and distributions required to keep the policy in compliance with section 7702. For purposes of this rule any distribution within the two years immediately before a reduction in benefits will also be treated as if it were a result of the reduction. A cash distribution that reduces policy benefits will be taxed in whole or in part (to the extent of any gain in the policy) under rules prescribed in section 7702. The taxable amount is subject to limits prescribed in section 7702(f)(7). Any taxable distribution will be ordinary income to the owner (rather than capital gain).
Distributions for tax purposes include amounts received upon surrender or partial withdrawals. You may also be deemed to have received a distribution for tax purposes if you assign all or part of your policy rights or change your policy’s ownership. If you have elected a Long-Term Care Rider or the Long-Term Care Rider 2018, as described in “Optional supplementary benefit riders you can add,” deductions from policy value to pay the rider charges will reduce your investment in the contract but will not be included in income even if you have recovered all of your investment in the contract.
If you have elected the Critical Illness Benefit Rider, as described in “Optional supplementary benefit riders you can add,” we will treat the monthly charges for the Critical Illness Rider as distributions from your life insurance policy for federal income tax purposes. Therefore, such charges may be includible in your taxable income if your policy is a modified endowment contract or if your investment in the contract has been reduced to zero. We anticipate that benefits paid under the Critical Illness Rider will generally be excludible from gross income under Internal Revenue Code section 104(a)(3). However, the benefits may not qualify for this exclusion with certain third-party ownership arrangements. Nevertheless, you should consult your tax adviser as to the income tax consequences to you.
It is possible that, despite our monitoring, a policy might fail to qualify as a life insurance contract under the Internal Revenue Code. This could happen, for example, if we inadvertently failed to return to you any premium payments that were in excess of amounts permitted under section 7702, or if any of the funds failed to meet certain investment diversification or other requirements of the Internal Revenue Code. If this were to occur, you would be subject to income tax on the income credited to the policy from the date of issue to the date of the disqualification and for subsequent periods.
Tax consequences of ownership or receipt of policy proceeds under Federal, state and local estate, inheritance, gift and other tax laws will depend on the circumstances of each owner or beneficiary. If the person insured by the policy is also its owner, either directly or indirectly through an entity such as a revocable trust, the death benefit will be includible in his or her estate for purposes of the Federal estate tax. If the owner is not the person insured, the value of the policy will be includible in the owner's estate upon his or her death. Even if ownership has been transferred, the death proceeds or the policy value may be includible in the former owner's estate if the transfer occurred less than three years before the former owner's death or if the former owner retained certain kinds of control over the policy. You should consult your tax adviser regarding these possible tax consequences.
Because there may be unfavorable tax consequences (including recognition of taxable income and the loss of income tax-free treatment for any death benefit payable to the beneficiary), you should consult a qualified tax adviser prior to changing the policy’s ownership or making any assignment of ownership interests.
If you have elected a rider that imposes a monthly rider charge, we will treat the monthly charges for the rider as distributions from your life insurance policy for federal income tax purposes. Therefore, such charges may be includible in your taxable income if your policy is a modified endowment contract or if your investment in the contract has been reduced to zero.
The tax treatment of certain aspects of the Healthy Engagement Rider, such as gift cards and other cash equivalents, could be includible in your taxable income. We expect to report to the Internal Revenue Service only those benefits we believe are taxable income, such as gift cards and other cash equivalents. Taxable benefits will be reported to the Internal Revenue Service by us only if the value of such benefits received in a year is $600 or more. This material does not constitute tax or legal advice and neither John Hancock USA nor any of its agents, employees or registered representatives are in the business of offering such advice. We do not expect that we will be required to report any free or discounted services or products that are available to the insured person under the Healthy Engagement Rider or the Healthy Engagement Core Rider to the Internal Revenue Service on Form 1099. Nevertheless, you should consult your tax adviser as to the income tax consequences to you.
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Policy loans
We expect that, except as noted below (see “7-pay premium limit and modified endowment contract status”), loans received under the policy will be treated as indebtedness of an owner and that no part of any loan will constitute income to the owner. However, if the policy terminates for any reason other than the payment of the death benefit, an amount equal to any outstanding loan that was not previously considered income will be treated as if it had been distributed to the owner upon such termination. This could result in a considerable tax bill. Under certain circumstances involving large amounts of outstanding loans, you might find yourself having to choose between high premiums required to keep your policy from lapsing and a significant tax burden if you allow the lapse to occur.
Diversification rules and ownership of the Separate Account
Your policy will not qualify for the tax benefits of a life insurance contract unless the Separate Account follows certain rules requiring diversification of investments underlying the policy. In addition, the rules require that the policy owner not have “investor control” over the underlying assets.
In certain circumstances, the owner of a variable life insurance policy may be considered the owner, for Federal income tax purposes, of the assets of the Separate Account used to support the policy. In those circumstances, income and gains from the Separate Account assets would be includible in the policy owner's gross income. The Internal Revenue Service (“IRS”) has stated in published rulings that a variable policy owner will be considered the owner of Separate Account assets if the policy owner possesses incidents of ownership in those assets, such as the ability to exercise investment control over the assets. A Treasury Decision issued in 1986 (T.D. 8101) stated that guidance would be issued in the form of regulations or rulings on “the extent to which policyholders may direct their investments to particular sub-accounts of a Separate Account without being treated as owners of the underlying assets.” As of the date of this prospectus, no comprehensive guidance on this point has been issued. In Rev. Rul. 2003-91, however, the IRS ruled that a contract holder would not be treated as the owner of assets underlying a variable life insurance or annuity contract despite the owner’s ability to allocate funds among as many as twenty subaccounts.
The ownership rights under your policy are similar to, but different in certain respects from, those described in IRS rulings in which it was determined that policyholders were not owners of Separate Account assets. Since you have greater flexibility in allocating premiums and policy values than was the case in those rulings, it is possible that you would be treated as the owner of your policy’s proportionate share of the assets of the Separate Account.
We do not know what future Treasury Department regulations or other guidance may require. We cannot guarantee that the funds will be able to operate as currently described in the series funds' prospectuses, or that a series fund will not have to change any fund's investment objectives or policies. We have reserved the right to modify your policy if we believe doing so will prevent you from being considered the owner of your policy's proportionate share of the assets of the Separate Account, but we are under no obligation to do so.
7-pay premium limit and modified endowment contract status
At the time of policy issuance, we will determine whether the Planned Premium schedule will exceed the 7-pay limit discussed below. If so, our standard procedures prohibit issuance of the policy unless you sign a form acknowledging that fact.
The 7-pay limit at any time during the first seven contract years is the total of net level premiums that would have been payable at or before that time under a comparable fixed policy that would be fully “paid-up” after the payment of seven equal annual premiums. “Paid-up” means that no further premiums would be required to continue the coverage in force until maturity, based on certain prescribed assumptions. If the total premiums paid at any time during the first seven policy years exceed the 7-pay limit, the policy will be treated as a modified endowment contract, which can have adverse tax consequences.
Policies classified as modified endowment contracts are subject to the following tax rules:
•  First, all withdrawals from such a policy are treated as ordinary income subject to tax up to the amount equal to the excess (if any) of the policy value immediately before the withdrawal over the investment in the policy at such time. If you own any other modified endowment contracts issued to you in the same calendar year by the same insurance company or its affiliates, their values will be combined with the value of the policy from which you take the withdrawal for purposes of determining how much of the withdrawal is taxable as ordinary income.
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•  Second, loans taken from or secured by such a policy and assignments or pledges of any part of its value are treated as partial withdrawals from the policy and taxed accordingly. Past-due loan interest that is added to the loan amount is treated as an additional loan.
•  Third, a 10% additional penalty tax is imposed on the portion of any distribution (including distributions on surrender) from, or loan taken from or secured by, such a policy that is included in income except where the distribution or loan:
•  is made on or after the date on which the policy owner attains age 59½ or
•  is attributable to the policy owner becoming disabled.
These exceptions to the 10% additional tax do not apply in situations where the policy is not owned by an individual.
Furthermore, any time there is a “material change” in a policy, the policy will begin a new 7-pay testing period as if it were a newly-issued policy. The material change rules for determining whether a policy is a modified endowment contract are complex. In general, however, the determination of whether a policy will be a modified endowment contract after a material change depends upon the relationship among the death benefit of the policy at the time of such change, the policy value at the time of the change, and the additional premiums paid into the policy during the seven years starting with the date on which the material change occurs.
Moreover, under a policy insuring a single life, if there is a reduction in benefits (such as a reduction in the death benefit or the reduction or cancellation of certain rider benefits) during a 7-pay testing period, the 7-pay limit will generally be recalculated based on the reduced benefits and the policy will be re-tested from the beginning of the 7-pay testing period using the lower limit. If the premiums paid to date at any point during the 7-pay testing period are greater than the recalculated 7-pay limit, the policy will become a modified endowment contract. If your policy is a survivorship policy, a reduction in benefits under the policy at any time will require re-testing. For such a policy the 7-pay limit will generally be recalculated based on the reduced benefits and the policy will be re-tested, using the lower limit, from the date it was issued. You should consult your tax adviser if you have questions regarding the possible impact of the 7-pay limit on your policy.
If your policy is issued as a result of an exchange subject to section 1035 of the Internal Revenue Code, it may be considered to be a modified endowment contract if the death benefit under the new policy is smaller than the death benefit under the exchanged policy, or if you reduce coverage in your new policy after it is issued. Therefore, if you desire to reduce the face amount as part of a 1035 exchange, a qualified tax adviser should be consulted for advice. A new policy issued in exchange for a modified endowment contract will also be a modified endowment contract regardless of any change in the death benefit.
All modified endowment contracts issued by the same insurer (or its affiliates) to the same owner during any calendar year generally are required to be treated as one contract for the purpose of applying the rules on taxation of withdrawals from modified endowment contracts. You should consult your tax adviser if you have questions regarding the possible impact of the 7-pay limit on your policy.
Corporate and H.R. 10 retirement plans
The policy may be acquired in connection with the funding of retirement plans satisfying the qualification requirements of section 401 of the Internal Revenue Code. If so, the Internal Revenue Code provisions relating to such plans and life insurance benefits thereunder should be carefully scrutinized. We are not responsible for compliance with the terms of any such plan or with the requirements of applicable provisions of the Internal Revenue Code.
Withholding
To the extent that policy distributions to you are taxable, they are generally subject to withholding for your Federal income tax liability. However if you reside in the United States, you can generally choose not to have tax withheld from distributions. Electing to have no withholding will not reduce your tax liability and may expose you to penalties under the rules governing payment of estimated taxes.
Life insurance purchases by residents of Puerto Rico
In Rev. Rul. 2004-75, 2004-31 I.R.B. 109, the Internal Revenue Service ruled that income received by residents of Puerto Rico under a life insurance policy issued by a United States company is U.S.-source income that is subject to United States Federal income tax.
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Life insurance purchases by non-resident aliens
If you are not a U.S. citizen, U.S. resident alien or other U.S. person, you will generally be subject to U.S. Federal withholding tax on taxable distributions from life insurance policies at a 30% rate, unless a lower treaty rate applies. In addition, you may be subject to state and/or municipal taxes and taxes imposed by your country of citizenship or residence. You should consult with a qualified tax adviser before purchasing a policy.
Life insurance owned by citizens or residents living abroad
If you are a U.S. citizen or permanent resident living outside the United States, you are still subject to income taxation by the United States. Since many countries tax on the basis of domicile, you may also be subject to tax in the country or territory in which you are living. The tax-deferred accumulation of gain that a life insurance policy provides under United States tax law may not be available under the tax laws of the country in which you are living. If you are living outside the United States or planning to do so, you should consult with a qualified tax adviser before purchasing or retaining ownership of a policy. If your policy is issued as a result of an exchange of a policy owned or issued outside the United States, the country or territory in which you reside may still tax you on the surrender of the policy replaced through the exchange. You should consult with a qualified tax adviser before exchanging your policy issued outside of the United States for one issued within the United States.
Financial statements reference
The financial statements of John Hancock USA and the Separate Account can be found in the SAI. The financial statements of John Hancock USA should be distinguished from the financial statements of the Separate Account and should be considered only as bearing upon the ability of John Hancock USA to meet its obligations under the policies. Our general account is comprised of securities and other investments, the value of which may decline during periods of adverse market conditions.
Registration statement filed with the SEC
This prospectus omits certain information contained in the Registration Statement which has been filed with the SEC. More details may be obtained from the SEC upon payment of the prescribed fee.
Legal and Regulatory Matters
There are no legal proceedings to which the Depositor, the Separate Account or the principal underwriter is a party or to which the assets of the Separate Account are subject that are likely to have a material adverse effect on the Separate Account or the ability of the principal underwriter to perform its contract with the Separate Account or of the Depositor to meet its obligations under the policy.
Independent registered public accounting firm
The statutory-basis financial statements of John Hancock Life Insurance Company (U.S.A.) at December 31, 2019 and 2018, and for each of the three years in the period ended December 31, 2019, and the financial statements of John Hancock Life Insurance Company (U.S.A.) Separate Account A at December 31, 2019, and for each of the two years in the period ended December 31, 2019, appearing in this Prospectus and Statement of Additional Information of the Registration Statement have been audited by Ernst &Young LLP, independent registered public accounting firm, as set forth in their reports thereon appearing elsewhere herein, and are included in reliance upon such reports given on the authority of such firm as experts in accounting and auditing.
44

 

In addition to this prospectus, John Hancock USA has filed with the SEC an SAI that contains additional information about John Hancock USA and the Separate Account, including information on our history, services provided to the Separate Account, and the audited financial statements for John Hancock USA and the Separate Account. The SAI and personalized illustrations of death benefits, policy values and surrender values are available, without charge, upon request. You may obtain the personalized illustrations from your John Hancock USA representative. The SAI may be obtained by contacting the John Hancock USA Service Office. You should also contact the John Hancock USA Service Office to request any other information about your policy or to make any inquiries about its operation.
JOHN HANCOCK USA SERVICE OFFICE
Overnight Express Delivery Mail Delivery
Life Post Issue
John Hancock Insurance Company
30 Dan Road, Suite #55979
Canton, MA 02021 		Life Post Issue
John Hancock Life Insurance Company
PO Box 55979
Boston, MA 02205
Phone: Fax:
1-800-827-4546 1-617-572-1571
Information about the Separate Account (including the SAI) can be reviewed and copied at the SEC’s Public Reference Branch, 100 F Street, NE, Room 1580, Washington, DC, 20549. Information on the operation of the Public Reference Room may be obtained by calling the SEC at 202-551-8090. Reports and other information about the Account are available on the SEC’s Internet website at http://www.sec.gov. Copies of such information may be obtained, upon payment of a duplicating fee, by writing the Public Reference Section of the SEC at 100 F Street, NE, Washington, DC 20549-0102.
1940 Act File No. 811-4834—1933 Act File No. 333-000000

Statement of Additional Information
dated [ ], 2020
for interests in
John Hancock Life Insurance Company (U.S.A.) Separate Account A
(Name of Registrant)
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
(“John Hancock USA”)
(Name of Depositor)
This is a Statement of Additional Information (“SAI”). It is not the prospectus. The prospectus, dated the same date as this SAI, may be obtained from a John Hancock USA representative or by contacting our Service Office by mail at Life Post Issue, John Hancock Insurance Company, PO Box 55979, Boston, MA 02205, or telephone at 1-800-827-4546.
TABLE OF CONTENTS

 

Description of the Depositor
Under the Federal securities laws, the entity responsible for organization of the registered separate account underlying the variable life insurance policy is known as the “Depositor.” John Hancock USA (“Depositor”) is a stock life insurance company organized under the laws of Maine on August 20, 1955 by a special act of the Maine legislature and redomesticated under the laws of Michigan. The Depositor is a licensed life insurance company in the District of Columbia and all states of the United States except New York. Until 2004, the Depositor was known as The Manufacturers Life Insurance Company (U.S.A.).
The Depositor's ultimate parent is Manulife Financial Corporation (“MFC”), a publicly traded company based in Toronto, Canada. MFC is the holding company of The Manufacturers Life Insurance Company and its subsidiaries, collectively known as Manulife Financial.
Description of the Registrant
Under the Federal securities laws, the registered separate account underlying the variable life insurance policy is known as the “Registrant.” John Hancock Life Insurance Company (U.S.A.) Separate Account A (the “Registrant” or “Separate Account”), is a separate account established by the Depositor under Michigan law. The variable investment accounts shown on page 1 of the prospectus are subaccounts of the Separate Account. The Separate Account meets the definition of “separate account” under the Federal securities laws and is registered as a unit investment trust under the Investment Company Act of 1940 (“1940 Act”). Such registration does not involve supervision by the Securities and Exchange Commission (“SEC”) of the management of the Separate Account or of the Depositor.
New subaccounts may be added and made available to policy owners from time to time. Existing subaccounts may be modified or deleted at any time.
Services
Administration of policies issued by the Depositor and of registered separate accounts organized by the Depositor may be provided by other affiliates. Neither the Depositor nor the separate accounts are assessed any charges for such services.
Custodianship and depository services for the Registrant are provided by State Street Investment Services (“State Street”). State Street’s address is State Street Financial Center, One Lincoln Street, Boston, Massachusetts, 02111.
Independent registered public accounting firm
The statutory-basis financial statements of John Hancock Life Insurance Company (U.S.A.) at December 31, 2019 and 2018, and for each of the three years in the period ended December 31, 2019, and the financial statements of John Hancock Life Insurance Company (U.S.A.) Separate Account A at December 31, 2019, and for each of the two years in the period ended December 31, 2019, appearing in this Prospectus and Statement of Additional Information of the Registration Statement have been audited by Ernst &Young LLP, independent registered public accounting firm, as set forth in their reports thereon appearing elsewhere herein, and are included in reliance upon such reports given on the authority of such firm as experts in accounting and auditing.
2

 

Principal Underwriter/Distributor
John Hancock Distributors LLC (“JH Distributors”), a Delaware limited liability company affiliated with the Depositor, is the principal distributor and underwriter of the securities offered through the prospectus. JH Distributors acts as the principal distributor of a number of other life insurance and annuity products we and our affiliates offer or maintain. JH Distributors also acts as the principal underwriter of John Hancock Variable Insurance Trust (the “Trust”), whose securities are used to fund certain variable investment options under the policies and under other life insurance and annuity products we offer or maintain.
JH Distributors' principal address is 200 Berkeley Street, Boston, MA 02116. JH Distributors is a broker-dealer registered under the Securities Act of 1934 (the “1934 Act”) and is a member of the Financial Industry Regulatory Authority (“FINRA”).
We offer the policies for sale, on a continuous basis, through individuals who are licensed as insurance agents and who are registered representatives of broker-dealers that have entered into selling agreements with JH Distributors.
The aggregate dollar amount of underwriting commissions paid to JH Distributors by the Depositor and its affiliates in connection with the sale of variable life products in 2019, 2018, and 2017, was $93,867,230, $95,309,756, and $94,706,904, respectively. JH Distributors did not retain any of these amounts during such periods.
The registered representative through whom your policy is sold will be compensated pursuant to the registered representative’s own arrangement with his or her broker-dealer. Compensation to broker-dealers for the promotion and sale of the policies is not paid directly by policy owners but will be recouped through the fees and charges imposed under the policy.
Additional compensation and revenue sharing arrangements may be offered to certain broker-dealer firms and other financial intermediaries. The terms of such arrangements may differ among firms we select based on various factors. In general, the arrangements involve three types of payments or any combination thereof:
•  Fixed dollar payments: The amount of these payments varies widely. JH Distributors may, for example, make one or more payments in connection with a firm’s conferences, seminars or training programs, seminars for the public, advertising and sales campaigns regarding the policies, to assist a firm in connection with its systems, operations and marketing expenses, or for other activities of a selling firm or wholesaler. JH Distributors may make these payments upon the initiation of a relationship with a firm, and at any time thereafter.
•  Payments based upon sales: These payments are based upon a percentage of the total amount of money received, or anticipated to be received, for sales through a firm of some or all of the insurance products that we and/or our affiliates offer. JH Distributors makes these payments on a periodic basis.
•  Payments based upon “assets under management”: These payments are based upon a percentage of the policy value of some or all of our (and/or our affiliates’) insurance products that were sold through the firm. JH Distributors makes these payments on a periodic basis.
Additional Information About Charges
A policy will not be issued until the underwriting process has been completed to our satisfaction. The underwriting process generally includes the obtaining of information concerning the insured person's age, medical history, occupation and other personal information. This information is then used to determine the cost of insurance charge.
3

 

Special purchase programs for eligible classes
The policy may be available for purchase by corporations and other groups or sponsoring organizations. Group or sponsored arrangements may include reduction or elimination of withdrawal charges and deductions for employees, officers, directors, agents and immediate family members of the foregoing. We reserve the right to reduce any of the policy's charges on certain cases where it is expected that the amount or nature of such cases will result in savings of sales, underwriting, administrative, commissions or other costs. Eligibility for these reductions and the amount of reductions will be determined by a number of factors, including the number of lives to be insured, the total premiums expected to be paid, total assets under management for the policyowner, the nature of the relationship among the insured individuals, the purpose for which the policies are being purchased, expected persistency of the individual policies, and any other circumstances which we believe to be relevant to the expected reduction of its expenses. Some of these reductions may be guaranteed and others may be subject to withdrawal or modifications, on a uniform case basis. Reductions in charges will not be unfairly discriminatory to any policyowners. We may modify from time to time, on a uniform basis, both the amounts of reductions and the criteria for qualification.
4

PART C
OTHER INFORMATION
Item 26. Exhibits
The following exhibits are filed as part of this Registration Statement:
(b) Not applicable.

 

(j) Not applicable.
(k) Opinion and consent of counsel regarding the legality of the securities being registered, to be filed via pre-effective amendment.
(l) Not Applicable.
(m) Not Applicable.
(n) Consent of Independent Registered Public Accounting Firm, to be filed via pre-effective amendment.
(n) (1) Opinion of Counsel as to the eligibility of this post-effective amendment to be filed pursuant to Rule 485(b), N/A.
(o) Not Applicable.
(p) Not Applicable.
Powers of Attorney
(i) to be filed via pre-effective amendment.

 

Item 27. Directors and Officers of the Depositor
OFFICERS AND DIRECTORS OF JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
Name and Principal Business Address   Position with Depositor
Marianne Harrison

200 Berkeley Street

Boston, MA 02116
   Chair, President & Chief Executive Officer
Paul M. Connolly

75 Indian Spring Road

Milton, MA 02186
   Director
James D. Gallagher

200 Berkeley Street

Boston, MA 02116
   Director, Executive Vice President
J. Stephanie Nam

1 West 72nd Street, Apt. 35

New York NY 10023
   Director
Ken Ross

200 Berkeley St.

Boston, MA 02116
   Director
Rex Schlaybaugh, Jr.

400 Renaissance Center

Detroit, MI 48243
   Director
Brooks Tingle

200 Berkeley Street

Boston, MA 02116
   Director, Senior Vice President
John G. Vrysen

200 Berkeley Street

Boston, MA 02116
   Director
Linda A. Davis Watters

200 Berkeley Street

Boston, MA 02116
   Director
Henry H. Wong

200 Berkeley Street

Boston, MA 02116
   Director
Executive Vice Presidents
    
Andrew G. Arnott*
    
Christopher Paul Conkey**
    
Scott S. Hartz**
   Chief Investment Officer – U.S. Investments
Naveed Irshad**
   Head of Legacy Business
Halina K. von dem Hagen***
   Treasurer
Shamus Weiland*
   Chief Information Officer
Senior Vice Presidents
    
Emanuel Alves*
   General Counsel
John C.S. Anderson**
    
Michael Biagiotti*
    
Kevin J. Cloherty**
    
Peter DeFrancesco*
   Head of Digital – Direct to Consumer
Barbara Goose*
   Chief Marketing Officer
Linda Levyne*
    
Patrick McGuinness*
    
William McPadden**
    
Joelle Metzman**
    
Patrick M. Murphy*
    
Lee Ann Murray**
    
Sebastian Pariath*
   Head of Operations and Chief Information Officer
Martin Sheerin*
   Chief Financial Officer
Curt Smith*
    

 

Name and Principal Business Address   Position with Depositor
Anthony Teta*
    
Leo Zerilli**
    
Vice Presidents
    
Lynda Abend*
    
John Addeo**
    
Mark Akerson*
    
Kevin Askew**
    
Zahir Bhanji***
   CFO JH Insurance
Stephen J. Blewitt**
    
Alan M. Block**
    
Paul Boyne**
    
Jon Bourgault**
   Senior Counsel
Ian B. Brodie**
    
Randall B. Brown*
    
Ted Bruntrager*
   Chief Risk Officer
Grant Buchanan***
    
Daniel C. Budde**
    
Robert Burrow**
    
Jennifer Toone Campanella**
    
Rick A. Carlson*
    
Patricia Rosch Carrington**
    
Todd J. Cassler*
    
Ken K. Cha*
    
Diana Chan***
   Treasury Operations
Brian Collins*
    
William E. Corson**
    
Kenneth D’Amato*
    
John J. Danello**
    
Robert Donahue*
    
Jeffrey Duckworth*
    
Carolyn Flanagan**
    
Lauren Marx Fleming**
    
Philip J. Fontana**
    
Carl O. Fowler**
    
Scott Francolini*
    
Paul Gallagher**
    
Thomas C. Goggins**
    
Susan Ghalili*
    
Jeffrey N. Given**
    
Howard C. Greene**
    
Christopher Griswold*
    
Erik Gustafson**
    
Richard Harris***
   Appointed Actuary
Ellie Harrison*
   US Human Resources
John Hatch*
    
Michael Hession*
    
John Hibbs*
    
Kevin Hill*
    
James C. Hoodlet*
    
Sesh Iyengar**
    
Daniel S. Janis III**
    
Mitchell Karman**
   CCO & Counsel
Recep C. Kendircioglu**
    
Neal P. Kerins*
    
Frank Knox**
   CCO – Retail Funds
Hung Ko***
   Treasury
Diane R. Landers**
    
Michael Landolfi**
    

 

Name and Principal Business Address   Position with Depositor
Scott Lively**
    
Jeffrey H. Long**
    
Jennifer Lundmark*
    
Edward P. Macdonald**
    
Patrick MacDonnell**
    
Kevin McGuire*
    
Nathaniel I. Margolis**
    
Robert G. Maulden**
    
John B. Maynard**
    
Karen McCafferty**
    
Scott A. McFetridge**
    
Jonathan McGee**
    
Ann McNally*
    
Michael McNamara*
    
Steven E. Medina**
    
Maureen Milet**
   CCO – Investments
Scott Morin*
    
Catherine Murphy*
   Deputy Appointed Actuary
Jeffrey H. Nataupsky**
    
Scott Navin**
    
Sinead O’Connor*
    
Jeffrey Packard**
    
Gary M. Pelletier**
    
David Pemstein**
    
Charlie Philbrook*
    
David Plumb*
    
Tracey Polsgrove*
    
Todd Renneker**
    
Charles A. Rizzo**
    
Robert William Rizzo*
    
Susan Roberts*
    
Keri Rogers**
    
Ian Roke**
    
Josephine M. Rollka*
    
Ronald J. Rovner*
    
Devon Russell*
    
Thomas Samoluk**
    
Emory W. Sanders*
    
Jeffrey R. Santerre**
    
Martin C. Schafer*
    
Dolores (Dee Dee) Schreitmueller*
    
Christopher L. Sechler**
    
Thomas Shea**
    
Gordon Shone**
    
Susan Simi**
    
Darren Smith**
    
Rob Stanley*
    
Paddy Subbaraman**
    
Wilfred Talbot*
    
Gary Tankersley*
    
Nathan Thooft**
    
Tony Todisco*
    
Brian E. Torrisi**
    
Len van Greuning*
    
Simonetta Vendittelli*
   Controller
Peter de Vries*
    
Lisa Ann Welch**
    
Adam Wise**
    

 

Name and Principal Business Address   Position with Depositor
R. Blake Witherington**
    
Sameh Youssef*
    
Ross Zilber*
    
*Principal Business Office is 200 Berkeley Street, Boston, MA 02116
**Principal Business Office is 197 Clarendon Street, Boston, MA 02116
***Principal Business Office is 200 Bloor Street, Toronto, Canada M4W1E5
****Principal Business Office is 250 Bloor Street, Toronto, Canada M4W1E5
Item 28. Persons Controlled by or Under Common Control with the Depositor or the Registrant
The Registrant is a separate account of the Depositor operating as a unit investment trust. The Registrant supports benefits payable under the Depositor's variable life insurance policies by investing assets allocated to various investment options in shares of John Hancock Variable Insurance Trust (formerly, John Hancock Trust) and other mutual funds registered under the Investment Company Act of 1940 as open-end management investment companies of the “series” type.
As of the effective date of the registration statement, the Company and its affiliates are controlled by Manulife Financial Corporation.

 

 

Item 29. Indemnification
The Form of Selling Agreement or Service Agreement between John Hancock Distributors LLC (“JH Distributors”) and various broker-dealers may provide that the selling broker-dealer indemnify and hold harmless JH Distributors and the Company, including their affiliates, officers, directors, employees and agents against losses, claims, liabilities or expenses (including reasonable attorney’s fees), arising out of or based upon a breach of the Selling or Service Agreement, or any applicable law or regulation or any applicable rule of any self-regulatory organization or similar provision consistent with industry practice.
Insofar as indemnification for liability arising under the Securities Act of 1933 may be permitted to directors, officers and controlling persons of the registrant pursuant to the foregoing provisions, or otherwise, the registrant has been advised that in the opinion of the Securities and Exchange Commission such indemnification is against public policy as expressed in the Act and is, therefore, unenforceable. In the event that a claim for indemnification against such liabilities (other than the payment by the registrant of expenses incurred or paid by a director, officer or controlling person of the registrant in the successful defense of any action, suit or proceeding) is asserted by such director, officer or controlling person in connection with the securities being registered, the registrant will, unless in the opinion of its counsel the matter has been settled by controlling precedent, submit to a court of appropriate jurisdiction the question whether such indemnification by it is against public policy as expressed in the Act and will be governed by the final adjudication of such issue.
Item 30. Principal Underwriter
(a) Set forth below is information concerning other investment companies for which JH Distributors, the principal underwriter of the contracts, acts as investment adviser or principal underwriter.
Name of Investment Company   Capacity in Which Acting
John Hancock Variable Life Account S
   Principal Underwriter
John Hancock Variable Life Account U
   Principal Underwriter
John Hancock Variable Life Account V
   Principal Underwriter
John Hancock Variable Life Account UV
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account R
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account T
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account W
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account X
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account Q
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account A
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account N
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account H
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account I
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account J
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account K
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account L
   Principal Underwriter
John Hancock Life Insurance Company (U.S.A.) Separate Account M
   Principal Underwriter
John Hancock Life Insurance Company of New York Separate Account B
   Principal Underwriter
John Hancock Life Insurance Company of New York Separate Account A
   Principal Underwriter

 

(b) John Hancock Life Insurance Company (U.S.A.) is the sole member of JH Distributors and the following comprise the Board of Managers and Officers of JH Distributors.
Name   Title
James C. Hoodlet*
   Director
Gary Tankersley*
   Director, President and Chief Executive Officer
Martin Sheerin*
   Director
Christopher Walker***
   Director, Vice President, Investments
Tracy Lannigan**
   Secretary
Brian Collins**
   Vice President, US Taxation
Jeffrey H. Long**
   Chief Financial Officer and Financial Operations Principal
*Principal Business Office is 200 Berkeley Street, Boston, MA 02116
**Principal Business Office is 197 Clarendon Street, Boston, MA 02116
***Principal Business Office is 200 Bloor Street, Toronto, Canada M4W1E5
(c) John Hancock Distributors LLC
Compensation received, directly or indirectly, from the Registrant by John Hancock Distributors LLC, the sole principal underwriter of the contracts funded by the Separate Account during the last fiscal year:
(1)   (2)   (3)   (4)   (5)
Name of
Principal
Underwriter 		  Net
Underwriting
Discounts and
Commissions 		  Compensation
on Events
Occasioning
the Deduction
of a Deferred
Sales Load 		  Brokerage
Commissions 		  Other
Compensation
John Hancock Distributors LLC   $0   $0   $0   $0
Item 31. Location of Accounts and Records
The following entities prepare, maintain, and preserve the records required by Section 31(a) of the Act for the Registrant through written agreements between the parties to the effect that such services will be provided to the Registrant for such periods prescribed by the Rules and Regulations of the Commission under the Act and such records will be surrendered promptly on request: John Hancock Distributors LLC, 200 Berkeley Street, Boston, Massachusetts 02116, serves as Registrant’s distributor and principal underwriter, and, in such capacities, keeps records regarding shareholders account records, cancelled stock certificates. John Hancock Life Insurance Company (U.S.A.) (at the same address), in its capacity as Registrant’s depositor keeps all other records required by Section 31 (a) of the Act.
Item 32. Management Services
All management services contracts are discussed in Part A or Part B.
Item 33. Fee Representation
Representation of Insurer Pursuant to Section 26 of the Investment Company Act of 1940
John Hancock Life Insurance Company (U.S.A.) hereby represents that the fees and charges deducted under the contracts issued pursuant to this registration statement, in the aggregate, are reasonable in relation to the services rendered, the expenses expected to be incurred, and the risks assumed by the Company.

 

Signatures
Pursuant to the requirements of the Securities Act of 1933 and the Investment Company Act of 1940, the Registrant has caused this Initial Registration Statement to be signed on its behalf in the City of Boston, Commonwealth of Massachusetts, as of the 31st day of August, 2020.
John Hancock Life Insurance Company (U.S.A.) Separate Account A
(Registrant)
By: JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
By: /s/ Marianne Harrison
Marianne Harrison
Principal Executive Officer
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
(Depositor)
By: /s/ Marianne Harrison
Marianne Harrison
Principal Executive Officer

 

Signatures
Pursuant to the requirements of the Securities Act of 1933, this Initial Registration Statement has been signed by the following persons in the capacities indicated as of the 31st day of August, 2020.
Signatures Title
/s/ Simonetta Vendittelli
Simonetta Vendittelli 		Vice President and Controller
/s/ Martin Sheerin
Martin Sheerin 		Senior Vice President and Chief Financial Officer
*
Marianne Harrison 		Chair, President and Chief Executive Officer
*
Paul M. Connolly 		Director
*
James D. Gallagher 		Director
*
J. Stephanie Nam 		Director
*
Ken Ross 		Director
*
Rex Schlaybaugh, Jr. 		Director
*
Brooks Tingle 		Director
*
John G. Vrysen 		Director
*
Linda A. Davis Watters 		Director
*
Henry H. Wong 		Director
/s/James C. Hoodlet
James C. Hoodlet 		 
*Pursuant to Power of Attorney
Title   Business Lines   BD Tax ID#     CRD#     Current Status   Approval Date  

1st Discount Brokerage, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     65-0592899       39164     Approved     5/7/2002  

1st Global Capital Corp.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-2429960       30349     Approved     2/1/1999  

Abacus Investments, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     39-1768558       35127     Approved     12/20/1994  

ABD Retirement Services, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     80-0833114       167641     Approved     2/12/2015  

Access Financial Group, Inc.

  

Annuity; Group Pension; JHVLICO

     13-3696056       33065     Approved     4/10/2002  

Access Investments, Inc.

  

Annuity; Life; Group Pension

     73-1505851       42202     Approved     10/5/2004  

ACE Diversified Capital, Inc.

  

Annuity; Life; Group Pension

     95-4591545       41768     Approved     7/30/2008  

Advanced Advisor Group, LLC

  

529;#Annuity; Life; Group Pension

     35-2261591       140393     Approved     8/31/2007  

Adviser Dealer Services, Inc.

  

Annuity; Life; Group Pension

     31-1391437       36773     Approved     9/7/2007  

Advisory Group Equity Services Ltd.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     04-2830039       15427     Approved     2/28/1996  

Aegis Capital Corp.

       11-2671906       15007     Approved     7/25/2005  

Aegis Investments, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     41-1540307       16033     Approved     1/1/2002  

Alamo Capital

  

Annuity; 529; Life; Group Pension

     68-0134926       26193     Approved     1/1/2002  

Alexander Capital, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     13-3866977       40077     Approved     4/21/2016  

Alexander Investment Services Co.

  

Annuity; 529

     61-0652524       1037     Approved     2/9/2007  

Allegheny Investments, Ltd.

  

Annuity; 529; Life; Group Pension; JHVLICO

     25-1326593       7597     Approved     4/18/1990  

Allegis Investment Services LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     46-2849009       168557     Approved     6/20/2014  

Allen & Company of Florida, Inc.

  

Annuity; 529; Life; Group Pension

     59-0913641       25     Approved     4/17/2002  

Allen C. Ewing & Co. (NEW)

  

Group Pension;#Life;#Annuity (servicing only)

     59-3000850       26102     Approved     2/2/2017  

Allen, Mooney & Barnes Brokerage Services, LLC

  

Group Pension

     74-3070309       142619     Approved     7/9/2007  

Alliance Advisory & Securities, Inc.

  

Annuity; Life; Group Pension

     95-3745191       18835     Approved     12/24/1999  

Alliance Global Partners

  

Group Pension;#Life;#Annuity (servicing only)

     59-2015540       8361     Approved     12/10/2018  

Allied Millennial Partners, LLC

       35-1632778       16569     Approved     1/1/2002  

Allstate Financial Services, LLC

  

Annuity; 529; Life; Group Pension

     47-0826838       18272     Approved     1/12/1994  

Alvarez & Marsal Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     51-0430281       127858     Approved     4/25/2014  

American Capital Partners, LLC

  

Annuity

     01-0564479       119249     Approved     3/3/2010  

American Equity Investment Corporation

  

Annuity; 529; Life; Group Pension

     35-1970410       40199     Approved     10/9/2002  

American Financial Associates, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     23-2654301       29049     Approved     5/10/1993  

American Funds & Trusts Incorporated

  

Group Pension

     87-0238597       1066     Approved     3/9/2010  

American Global Wealth Management

  

Group Pension;#Life;#Annuity (servicing only)

     39-1259164       7388     Approved     10/30/2017  

American Heritage Securities, Inc.

  

Annuity

     34-1695617       29678     Approved     7/15/2009  

American Independent Securities Group, LLC

  

Annuity; 529; Life; Group Pension

     20-2190456       135288     Approved     12/20/2005  

American Investors Company

  

Annuity; 529; Life; Group Pension; JHVLICO

     94-2201424       38     Approved     1/1/2002  

American Investors Group, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     41-1576186       10020     Approved     2/10/1995  

American Municipal Securities, Inc.

  

Annuity; 529; Life; Group Pension

     59-2023127       8365     Approved     1/1/2002  

American Portfolios Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     11-3018002       18487     Approved     1/18/2002  

American Trust Investment Services, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     35-1168112       3001     Approved     8/13/2014  

American Wealth Management, Inc.

  

Annuity; 529; Life; Group Pension

     58-1867326       25536     Approved     1/1/2002  

Ameriprise Financial Services, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     41-0973005       6363     Approved     10/17/2005  

Ameritas Investment Corp

  

Annuity; 529; Life; Group Pension; JHVLICO

     47-0663374       14869     Approved     3/3/2000  

Anchor Bay Securities, LLC

  

Group Pension;#Life;#Annuity

     90-0391569       47360     Approved     6/30/2010  

Andrew Garrett Inc.

  

Annuity; 529; Life; Group Pension

     43-1613019       29931     Approved     8/18/1993  

Aon Securities Inc.

       13-2642812       4138     Approved     8/22/2001  

AOS, Inc. (dba TradingBlock and MoneyBlock)

  

529;#Group Pension;#Life;#Annuity (servicing only)

     36-4535546       128605     Approved     7/30/2004  

APW Capital, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-3526587       43814     Approved     8/24/2001  

Arete Wealth Management, LLC

       39-1918659       44856     Approved     12/4/2008  

Arkadios Capital LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     81-1052458       282710     Approved     12/14/2017  

Arlington Securities, Incorporated

  

Annuity; 529; Life; Group Pension

     38-2711392       19596     Approved     8/31/2000  

Arque Capital, Ltd.

       20-4040914       121192     Approved     5/13/2009  

Arvest Asset Management

  

Annuity; Life; Group Pension; JHVLICO

     71-0794602       42057     Approved     2/27/2003  

Ashton Young, Inc.

  

Group Pension;#Annuity

     38-1617113       2827     Approved     7/25/2003  

Associated Investment Services, Inc.

  

Annuity; 529; Life; Group Pension

     39-0210110       1464     Approved     6/24/2004  

Aurora Securities, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     92-0162178       46147     Approved     9/11/2018  

Ausdal Financial Partners, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     42-1129623       7995     Approved     1/1/2002  

Avalon Investment & Securities Group Inc.

  

529;#Group Pension;#Life;#Annuity

     63-0634741       6281     Approved     4/17/2008  

Aventura Securities, LLC

  

Annuity; 529; Life; Group Pension

     20-5452876       142374     Approved     5/2/2008  

Avisen Securities, Inc.

  

Annuity; 529; Group Pension

     06-1676986       125977     Approved     7/13/2006  

Avondale Partners, LLC

       62-1761948       46838     Approved     7/6/2009  

AXA Advisors, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     06-1555494       6627     Approved     10/8/1993  

B. C. Ziegler And Company

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-0727640       61     Approved     11/5/1998  

B. Riley Wealth Management, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     62-1518255       2543     Approved     1/4/1999  

B.B. Graham & Company, Inc.

  

Annuity; 529; Life; Group Pension

     95-4587418       41533     Approved     4/14/2004  

Ballew Investments, Inc.

  

Group Pension;#Life

     64-0823167       32028     Approved     5/1/1995  

BancWest Investment Services, Inc.

       13-3618472       29357     Approved     9/5/2000  

Bankers Life Securities, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     47-1481527       173962     Approved     12/19/2016  

Bankoh Investment Services, Inc.

  

529;#Annuity; Life; Group Pension

     99-0291948       29280     Approved     6/20/2000  

BB&T Securities LLC

  

Group Pension;#Life;#Annuity (servicing only)

     20-5817590       142785     Approved     3/27/2013  

BBVA Securities, Inc.

  

Annuity; 529; Life; Group Pension

     75-2329230       27060     Approved     4/30/2004  

BCG Securities, Inc.

  

Annuity; 529; Life; Group Pension

     23-1664237       70     Approved     7/2/2003  

BD4RIA, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     82-2712078       290240     Approved     6/12/2018  

Beaconsfield Financial Services, Inc.

  

529;#Annuity

     25-1447238       14634     Approved     3/28/2003  

Bellamah, Neuhauser and Barrett. Inc.

  

Group Pension;#Life;#Annuity

     53-0260880       83     Approved     10/29/2010  

Benchmark Investments, Inc.

  

Group Pension;#Life;#Annuity

     71-0825385       103792     Approved     6/16/2010  

Benefit Funding Services, LLC

  

Annuity; Life; Group Pension

     86-0891039       44079     Approved     10/7/2004  

Benjamin F. Edwards & Company, Inc.

  

Annuity; 529; Life; Group Pension

     26-3199152       146936     Approved     8/24/2009  

Bernard Herold & Co., Inc.

  

Annuity; Life; Group Pension; JHVLICO

     13-2707317       6193     Approved     1/1/2002  

Berthel Fisher & Company Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     42-1029773       13609     Approved     4/29/1993  

BestVest Investments, Ltd.

  

Annuity; Life; Group Pension

     32-3220312       40302     Approved     1/1/2002  

BFT Financial Group, LLC

  

Annuity; 529; Life; Group Pension

     75-2856929       109121     Approved     8/20/2002  

BG Worldwide Securities, Inc.

  

Life; JHVLICO

     30-0039439       121735     Approved     9/3/2003  

BHK Securities, LLC

  

Annuity; Group Pension

     20-2455216       139665     Approved     12/19/2006  

Bill Few Securities, Inc.

  

Annuity; 529; Life; Group Pension

     25-1540905       41917     Approved     1/1/2002  

Black Oak Securities, Inc.

  

Group Pension

     37-1299579       30889     Approved     4/10/2006  

Blakeslee And Blakeslee Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     77-0017182       8149     Approved     1/15/2004  

BMA Securities, LLC

  

529;#Annuity; Life; Group Pension

     95-4815988       108219     Approved     6/20/2008  

BMO Harris Financial Advisors, Inc.

  

529;#Group Pension;#Life;#Annuity

     20-3320712       137115     Approved     5/1/2006  

Bodell Overcash Anderson & Co., Inc.

  

Annuity; JHVLICO

     16-0971911       5148     Approved     5/17/2005  

Boenning & Scattergood, Inc.

  

Group Pension; JHVLICO

     23-1720062       100     Approved     8/6/2008  

BOK Financial Services, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     73-1275307       17530     Approved     4/3/1998  

Bolton Global Capital, Inc.

  

Annuity; 529; Life; Group Pension

     04-2848146       15650     Approved     1/1/2002  

BPU Investment Management Inc.

  

529;#Group Pension;#Life;#Annuity

     25-1503421       17058     Approved     12/21/2007  

Brandon Investments, Inc.

  

Annuity; Life; Group Pension

     62-1142517       16931     Approved     8/26/1993  

Brazos Securities, Inc.

  

Annuity

     75-2199922       21624     Approved     4/27/2009  

Brighton Securities Corp.

  

Group Pension;#Life;#Annuity; 529

     16-0961085       3875     Approved     1/1/2002  

Bristol Financial Services, Inc.

  

Annuity; Life; Group Pension

     20-3156765       137988     Approved     8/21/2007  

BrokerageSelect

  

Group Pension;#Life;#Annuity (servicing only)

     06-1549225       47974     Approved     5/24/2013  

Brokers International Financial Services, LLC

       20-3749442       139627     Approved     9/25/2006  

Bronfman E.L. Rothschild Capital, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     38-3931144       171970     Approved     9/13/2016  

Brooklight Place Securities, Inc.

  

Annuity; 529; Life; Group Pension

     36-3317130       15764     Approved     8/8/2001  

Brown Advisory Securities, LLC

  

Annuity; Life; Group Pension

     75-3015089       120736     Approved     5/29/2003  

Brown Associates, Inc.

  

Annuity; Life; Group Pension

     62-0808843       5049     Approved     2/15/1989  

Brown, Lisle/Cummings, Inc.

  

Group Pension

     05-0310503       1331     Approved     12/17/2010  

Buckman, Buckman & Reid, Inc.

  

Annuity; Life; Group Pension

     22-2926943       23407     Approved     1/1/2002  

Bull & Bear Brokerage Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     59-3698994       113866     Approved     1/1/2002  

Buttonwood Partners, Inc.

  

Annuity; Life; Group Pension

     39-1674219       27108     Approved     1/1/2002  

Cabot Lodge Securities, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     45-3717999       159712     Approved     5/24/2013  

Cadaret, Grant & Co., Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-2361254       10641     Approved     9/9/1992  

Callaway Financial Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     75-2855666       104003     Approved     1/1/2002  

Calton & Associates, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     59-2845944       20999     Approved     4/24/1997  

Cambria Capital, LLC

  

Group Pension;#Life;#Annuity

     02-0727653       133760     Approved     6/23/2011  

Cambridge Investment Research, Inc.

  

BOLI;#Annuity; 529; Life; Group Pension; JHVLICO

     42-1445429       39543     Approved     5/3/1996  

Camden Financial Services

  

Annuity; JHVLICO

     33-0653990       19925     Approved     3/21/2002  

Cammack LaRhette Brokerage, Inc.

  

Annuity; Life; Group Pension

     04-3516344       109906     Approved     5/29/2003  

Cantella & Co., Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     04-3211861       13905     Approved     1/1/2002  

Cape Securities, Inc.

  

Annuity; 529; Life; Group Pension

     56-1128974       7072     Approved     8/11/2008  

CapFinancial Securities, LLC

  

BOLI;#Annuity; 529; Life; Group Pension

     46-4350797       126291     Approved     4/16/2004  

Capital Brokerage Corporation

  

Annuity; Life; Group Pension; JHVLICO

     91-1143830       10465     Approved     1/1/2002  

Capital City Securities, LLC

  

Annuity; 529; Life; Group Pension

     20-2350070       146001     Approved     10/3/2008  

Capital Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-1361519       8408     Approved     11/4/1991  

Capital Investment Brokerage, Inc.

  

Annuity; 529; Life; Group Pension

     56-1958819       40657     Approved     1/1/2002  

Capital Investment Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     56-1394939       14752     Approved     6/27/1996  

Capital Management Securities, Inc.

  

Annuity; Life; Group Pension

     41-1249586       10579     Approved     2/4/1988  

Capital One Investing, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     91-1905424       45744     Approved     2/8/2017  

Capital Portfolio Management, Inc.

       52-1744548       29302     Approved     4/10/2008  

Capital Synergy Partners

  

529;#Group Pension;#Life;#Annuity

     33-0837865       148733     Approved     1/28/2011  

Capitol Securities Management, Inc.

       54-1170635       14169     Approved     7/1/1993  

Cardinal Investments, Inc.

  

529;#Group Pension;#Life;#Annuity

     37-1326529       36838     Approved     1/1/2002  

Carolinas Investment Consulting LLC

  

Annuity; Life; Group Pension

     56-2204761       104379     Approved     1/1/2002  

Carter, Terry & Company, Inc.

  

Annuity; 529; Life; Group Pension

     58-1608676       16365     Approved     1/1/2002  

Carty & Company, Inc.

  

Annuity; 529; Life; Group Pension

     62-0842403       7001     Approved     1/1/2002  

Cary Street Partners LLC

  

529;#Annuity; Life; Group Pension

     32-0007529       128089     Approved     8/23/2007  

Cascade Financial Management, Inc.

  

Annuity; 529; Life; Group Pension

     84-1599435       119030     Approved     5/21/2003  

Cascade Investment Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     84-1245938       35844     Approved     1/17/1995  

CBIZ Financial Solutions, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     52-1396995       16678     Approved     3/13/1996  

CCO Investment Services Corp.

  

529;#Annuity; Life; Group Pension

     05-0487400       39550     Approved     12/22/2005  

Celadon Financial Group LLC

  

Annuity; Life; Group Pension

     59-2657843       36538     Approved     1/1/2002  

Centaurus Financial, Inc.

       33-0530236       30833     Approved     9/15/1993  

Centennial Securities Company, Inc.

  

Group Pension;#Annuity;#Annuity; 529; JHVLICO

     38-2214928       7763     Approved     5/1/2002  

Center Street Securities, Inc.

  

529;#Group Pension;#Life;#Annuity

     72-1159563       26898     Approved     9/3/2009  

Century Securities Associates, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     43-1567959       28218     Approved     5/16/2001  

Ceros Financial Services, Inc.

  

Annuity; 529; Life; Group Pension

     04-3249931       37869     Approved     1/11/2010  

Cetera Advisor Networks, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     95-3845382       13572     Approved     10/31/1988  

Cetera Advisors, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     84-0858799       10299     Approved     7/6/1994  

Cetera Financial Specialists LLC

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     36-3120284       10358     Approved     8/24/2001  

Cetera Investment Services LLC

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     41-1483314       15340     Approved     6/6/2000  

CFD Investments, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#BOLI

     35-1692812       25427     Approved     1/7/1994  

Chalice Capital Partners, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     81-4245023       288898     Approved     6/12/2018  

Chapin, Davis

  

Annuity; 529

     52-1715615       28116     Approved     4/13/2007  

Chauner Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     36-3356325       10075     Approved     5/18/1992  

Chelsea Financial Services

  

Annuity; Life; Group Pension

     11-3489062       47770     Approved     6/11/2009  

CIG Securities

       20-0194097       129864     Approved     1/17/2005  

Citigroup Global Markets Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     11-2418191       7059     Approved     3/20/1992  

Classic, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     45-3356898       159357     Approved     1/17/2013  

Cleary Gull Inc.

  

Annuity; Life; Group Pension

     04-3414501       45309     Approved     1/1/2002  

Client One Securities, LLC

  

529;#Group Pension;#Life;#Annuity

     27-1408998       152974     Approved     1/26/2011  

CliftonLarsonAllen Wealth Advisors, LLC

  

Annuity; Life; Group Pension

     41-1803291       38357     Approved     5/1/2008  

Coastal Equities, Inc.

  

529;#Group Pension;#Life;#Annuity

     56-2456935       23769     Approved     1/1/2002  

Coburn & Meredith, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     06-0634693       164     Approved     1/1/2002  

Coker & Palmer, Inc.

  

Annuity; Life; Group Pension

     64-0802631       29163     Approved     1/8/2003  

Coldstream Securities, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     93-1198599       46835     Approved     1/2/2016  

Colorado Financial Service Corporation

  

529;#Group Pension;#Life;#Annuity

     26-1855173       104343     Approved     3/31/2010  

Comerica Securities, Inc.

       38-2621207       17079     Approved     5/8/2002  

Commerce Brokerage Services, Inc.

  

Annuity; 529; Life; Group Pension

     43-1381067       17140     Approved     1/1/2002  

Commonwealth Financial Group, Inc.

  

Annuity; 529; Life; Group Pension

     22-3217132       32505     Approved     1/28/2004  

Commonwealth Financial Network

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     04-2675571       8032     Approved     9/10/1992  

CommunityAmerica Financial Solutions, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     26-0046643       168203     Approved     6/20/2014  

Compak Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     13-4225974       125472     Approved     9/26/2006  

Compass Securities Corporation

  

Annuity; Life; Group Pension

     04-2844064       16168     Approved     3/30/1992  

Concord Wealth Brokerage, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     41-1644073       24999     Approved     5/22/2013  

Concorde Investment Services, LLC

  

529;#Group Pension;#Life;#Annuity

     27-0498480       151604     Approved     12/13/2010  

Conover Securities Corporation

       91-1260477       17129     Approved     1/1/2002  

Consolidated Financial Investments, Inc.

  

Annuity; Group Pension

     43-1490793       18810     Approved     12/19/2006  

Continental Investors Services, Inc.

  

529;#Group Pension;#Annuity (servicing only)

     91-1543805       29775     Approved     8/18/2008  

Cooper Malone McClain, Inc.

  

Annuity; Life; Group Pension

     48-1024628       18637     Approved     3/15/2002  

Coordinated Capital Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-1468428       14762     Approved     5/27/1993  

CoreCap Investments, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     23-2809463       37068     Approved     11/9/2012  

Cornerstone Financial Services, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     35-1720807       20627     Approved     11/20/2012  

Correll Co. Investment Services Corp.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-3400965       38995     Approved     3/12/1997  

Country Club Financial Services, Inc.

  

Annuity; Life; Group Pension; BOLI

     43-1604510       29807     Approved     3/6/2002  

Courtlandt Securities Corporation

  

Annuity; Life; Group Pension

     20-2966004       137356     Approved     12/18/2006  

CPS Financial & Insurance Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     33-0701950       41243     Approved     2/29/2000  

Cresap Inc.

  

Annuity; JHVLICO

     23-2589413       25899     Approved     12/17/2009  

Crescent Securities Group, Inc.

  

529;#Group Pension;#Life;#Annuity

     75-2947048       114993     Approved     5/4/2010  

Crews & Associates, Inc.

  

Annuity; 529; Life; Group Pension

     71-0522369       8052     Approved     2/9/2004  

Crown Capital Securities, L.P.

  

Annuity; 529; Life; Group Pension; JHVLICO

     33-0837984       6312     Approved     7/16/1999  

Cullen Investment Group, Ltd.

  

Annuity

     72-1088646       18266     Approved     1/1/2002  

CUNA Brokerage Services, Inc.

  

BOLI;#Annuity; 529; Life; Group Pension; JHVLICO

       13941     Approved     1/1/2002  

Curbstone Financial Management Corporation

  

Group Pension

     02-0367417       13348     Approved     8/22/2002  

CUSO Financial Services, L.P.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     33-0731851       42132     Approved     6/12/2001  

Cutter & Company, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-1477566       22449     Approved     1/22/2001  

CV Brokerage Inc.

  

529;#Group Pension;#Life

     38-1786572       462     Approved     8/31/2006  

CW Securities, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     30-0149369       124496     Approved     7/1/2004  

D.A. Davidson & Co.

  

Annuity; 529; Life; Group Pension

     81-0139474       199     Approved     10/20/2000  

D.H. Hill Securities LLP

  

Annuity; 529; Life; Group Pension

     76-0505272       41528     Approved     11/4/2002  

Davenport & Company LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     54-1835842       1588     Approved     4/18/1990  

David A. Noyes & Company

  

529;#Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     36-2957364       205     Approved     1/1/2002  

Davinci Capital Management Inc.

  

529;#Annuity; Life; Group Pension

     01-0522492       46897     Approved     2/3/2005  

Davis Securities LLC

  

Group Pension;#Life;#Annuity (servicing only)

     20-3138121       138829     Approved     5/27/2014  

Dawson James Securities, Inc.

  

Annuity; 529; Life; Group Pension

     20-0161722       130645     Approved     9/21/2007  

Delta Trust Investments, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     71-0823840       47439     Approved     8/11/2005  

Dempsey Financial Network, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     58-2148282       38330     Approved     1/6/1998  

Dempsey Lord Smith, LLC

  

Annuity; 529; Life; Group Pension

     20-4853289       141238     Approved     5/8/2007  

Despain Financial Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     37-1204646       17360     Approved     1/1/2002  

Detalus Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     43-1879713       103260     Approved     1/1/2002  

Deutsche Bank Securities Inc.

  

Annuity; 529; Life; Group Pension

     13-2730828       2525     Approved     3/7/2002  

DFP Equities, Inc.

  

Annuity; Life; Group Pension

     35-1403362       7518     Approved     1/1/2002  

DFPG Investments, Inc.

  

529;#Group Pension;#Life;#Annuity

     27-3648334       155576     Approved     7/12/2011  

Dinosaur Securities, L.L.C.

  

529;#Group Pension;#Life

     1341 23021       104446     Approved     7/23/2010  

Diversified Resources, LLC

  

Annuity; Life; Group Pension

     05-0515637       31346     Approved     8/27/2003  

Diversified Securities, Incorporated

  

Annuity; Life; Group Pension

     95-2409158       222     Approved     9/25/2000  

Dominick & Dominick LLC

  

Annuity; Group Pension

     13-4023549       7344     Approved     5/1/2008  

Dominion Investor Services, Inc.

  

Annuity; 529; Life; Group Pension

     75-2201702       21548     Approved     12/1/1995  

Dorn & Co., Inc.

  

Group Pension

     41-0836886       2950     Approved     10/21/2011  

Dorsey & Company, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     72-0520792       1668     Approved     5/7/2002  

Dougherty & Company LLC

  

529;#Group Pension;#Life;#Annuity

     41-1883794       7477     Approved     1/1/2002  

Duncan-Williams, Inc.

  

Annuity; 529; Life; Group Pension

     62-0804968       6950     Approved     8/4/2009  

Economy Securities, Incorporated

  

Annuity; 529; Life; Group Pension

     35-1513801       10228     Approved     1/1/2002  

Edward Jones

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-0345811       250     Approved     11/9/1999  

EF Legacy Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     47-3919321       269923     Approved     5/17/2016  

EK Riley Investments, LLC

  

529;#Group Pension;#Life;#Annuity

     01-0682863       121003     Approved     7/15/2005  

Elish & Elish Inc.

  

Annuity; 529

     25-1604700       24409     Approved     10/7/2005  

Emerging Growth Equities, Ltd.

  

Group Pension;#Life;#Annuity (servicing only)

     23-2988717       47040     Approved     8/22/2002  

Emerson Equity LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     74-3109983       130032     Approved     5/25/2005  

Empire Asset Management Company

  

Group Pension;#Life;#Annuity (servicing only)

     20-5835358       143007     Approved     9/13/2016  

Equity Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     03-0221141       265     Approved     9/19/1988  

Essex Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-4529342       127549     Approved     11/18/2003  

Essex Securities LLC

  

Annuity; 529; Life; Group Pension

     04-3482688       46605     Approved     9/26/2003  

E-W Investments, Inc.

  

Group Pension

     95-4039061       17463     Approved     7/5/2007  

Executive Services Securities, LLC

  

Annuity; Life; Group Pension; JHVLICO

     58-2466081       25299     Approved     10/31/2008  

Fairport Capital, Inc.

  

Annuity; 529; Life; Group Pension

     06-1103413       15034     Approved     5/19/1993  

Family Investors Company

  

Annuity; Life; Group Pension

     22-1715407       1785     Approved     1/1/2002  

Farmers Financial Solutions, LLC

  

529;#Annuity; Life; Group Pension

     77-0530616       103863     Approved     1/1/2002  

FAS Corp.

  

Annuity; Life; Group Pension; BOLI

     74-2837348       43536     Approved     10/13/1999  

FB Equity Sales Corporation of Michigan

  

Annuity; Life; Group Pension

     38-3237412       39337     Approved     7/5/1999  

FCG Advisors, LLC

  

529;#Group Pension;#Life;#Annuity

     22-3448536       40633     Approved     3/29/2010  

Feltl & Company

       41-1245161       6905     Approved     12/30/2004  

FieldPoint Private Securities, LLC

  

Annuity; 529; Life; Group Pension

     06-1186517       18975     Approved     4/1/1994  

Fifth Third Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     31-0961761       628     Approved     1/1/2002  

Finance 500, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     95-3771060       12981     Approved     1/1/2002  

Financial Security Management, Incorporated

  

Annuity; 529; Life; Group Pension

     54-1832360       43000     Approved     6/4/2001  

Financial Telesis Inc

  

Annuity; 529; Life; Group Pension; BOLI

     68-0279977       31012     Approved     1/1/2002  

FinTrust Brokerage Services, LLC

  

Annuity; Life; Group Pension

     56-1989135       41608     Approved     1/1/2002  

First Allied Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     11-3152836       32444     Approved     5/1/1991  

First Asset Financial Inc.

  

529; Group Pension

     86-1141733       139107     Approved     7/2/2008  

First Bankers’ Banc Securities, Inc

  

Annuity; 529; Life; Group Pension

     43-1326319       15041     Approved     1/1/2002  

First Capital Equities, Ltd.

  

529; Group Pension

     11-2654162       14428     Approved     6/13/2007  

First Citizens Investor Services, Inc.

       56-1854695       44430     Approved     10/5/1998  

First Dallas Securities Incorporated

  

Annuity; Life; Group Pension; JHVLICO

     75-2278917       24549     Approved     4/25/2003  

First Financial Equity Corporation

  

529;#Life;#Annuity; Group Pension

     86-0511639       16507     Approved     11/8/2002  

First Financial Securities Of America, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     74-2132317       13642     Approved     1/1/2002  

First Heartland Capital, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-1635588       32460     Approved     10/11/1993  

First Kentucky Securities Corporation

  

Annuity; Life

     61-0924505       7524     Approved     2/22/2006  

First Liberties Financial

  

529;#Group Pension;#Life;#Annuity

     11-2656907       14432     Approved     7/30/2010  

First National Capital Markets

  

529;#Group Pension;#Life;#Annuity

     47-0844069       115920     Approved     6/16/2010  

First Palladium, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     82-2239026       289822     Approved     7/11/2018  

First Republic Securities Com. LLC dba Grand Eagle Ins. Serv. LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     91-2076555       105108     Approved     4/28/2015  

First Research Financial

  

Annuity; Life; Group Pension

     75-2348060       27915     Approved     1/1/2002  

First State Financial Management, Inc.

  

529;#Annuity; Life; Group Pension

     43-1370873       16590     Approved     1/1/2002  

First Western Advisors

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     87-0393177       13623     Approved     1/1/2002  

First Western Securities, Inc.

  

Annuity; 529; Life

     75-2176921       19537     Approved     2/10/2003  

FMN Capital Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     33-0649400       38105     Approved     12/8/1997  

FMSbonds, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     59-1842344       7793     Approved     4/15/1997  

FNBB Capital Markets, LLC

  

Annuity; Life; Group Pension

     20-0532898       132091     Approved     2/8/2007  

Folger Nolan Fleming Douglas Incorporated

  

Annuity; Life; Group Pension

     53-0068130       319     Approved     12/13/2006  

Forest Securities, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     36-3328512       16255     Approved     9/8/2017  

Fortune Financial Services, Inc.

  

529;#Annuity; Life; Group Pension; JHVLICO

     25-1799740       42150     Approved     1/1/2002  

Fortune Securities, Inc.

  

Annuity; Life; Group Pension

     95-4553711       40821     Approved     8/6/2008  

Founders Financial Securities, LLC

  

Annuity; 529; Life; Group Pension

     20-2052994       137945     Approved     7/20/2006  

Four Points Capital Partners, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     76-0543859       43149     Approved     11/27/2017  

Frost Brokerage Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     74-2404030       17465     Approved     11/1/2004  

FSB Premier Wealth Management, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     93-1084013       15898     Approved     6/24/1993  

FSC Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     58-1288674       7461     Approved     11/17/1998  

FSIC (Financial Services International Corp.)

  

Annuity; Life; Group Pension; JHVLICO

     91-1663231       37813     Approved     6/15/1999  

FTB Advisors, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     62-1254528       17117     Approved     1/1/2002  

G. A. Repple & Company

  

Annuity; 529; Life; Group Pension; JHVLICO

     59-2599605       17486     Approved     5/13/1993  

G.F. Investment Services, LLC

  

Annuity; 529; Life; Group Pension

     20-1419758       132939     Approved     12/1/2005  

G.L.S. & Associates, Inc.

  

Annuity; Life; Group Pension

     63-1009019       47502     Approved     1/1/2002  

G.W. Sherwold Associates, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     33-0619325       42186     Approved     8/12/2014  

Gage-Wiley & Co., Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     04-2946829       344     Approved     5/2/2012  

Garden State Securities, Inc.

  

Annuity; 529; Life; Group Pension

     22-2319866       10083     Approved     12/21/2001  

Gardner Financial Services, Inc.

  

Annuity; 529; Life; Group Pension

     41-1589846       21000     Approved     1/1/2002  

GDC Securities, LLC

  

Annuity; Life; Group Pension; JHVLICO

     06-1390542       38931     Approved     1/1/2002  

Geneos Wealth Management, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     02-0580939       120894     Approved     7/26/2002  

General Securities Corp

  

529;#Annuity; Life; Group Pension

     43-1513490       15062     Approved     1/1/2002  

Gerwin Group, Inc.

  

Annuity

     95-4188440       23199     Approved     10/6/2003  

Glen Eagle Wealth, LLC

       02-0629945       124504     Approved     11/28/2005  

Global Brokerage Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     52-1899822       37505     Approved     1/1/2002  

Globalink Securities, Inc.

  

Annuity; 529; Life; Group Pension

     33-0493552       29721     Approved     4/4/2007  

GLP Investment Services, LLC

  

Annuity; Group Pension

     38-3544062       25450     Approved     10/21/2003  

Gold Coast Securities, Inc.

  

Annuity; 529; Life; Group Pension

     77-0563040       110925     Approved     1/1/2002  

Googins & Anton, Inc.

  

Annuity

     39-1447696       13985     Approved     8/29/2006  

Gradient Securities, LLC

  

529;#Group Pension;#Life;#Annuity

     26-4463739       127701     Approved     6/1/2005  

Grant Williams L.P.

  

Group Pension;#Life;#Annuity (servicing only)

     23-2990197       45961     Approved     2/26/2008  

GRB Financial, LLC

  

Annuity; Life; Group Pension

     90-0115377       130490     Approved     8/11/2008  

Great American Investors, Inc.

  

Annuity; 529; Life; Group Pension

     48-1099886       28489     Approved     3/16/1998  

Great Nation Investment Corporation

  

Group Pension;#Life;#Annuity

     75-2199942       19981     Approved     2/14/2011  

Greenberg Financial Group

  

Annuity; Life; Group Pension

     86-0903680       38747     Approved     1/1/2002  

Greenbrier Diversified, Inc.

  

Annuity; 529

     95-4049440       18203     Approved     6/13/2002  

Gregory J. Schwartz & Co., Inc.

  

529;#Group Pension;#Life;#Annuity

     38-2117812       7294     Approved     4/21/2009  

GWN Securities Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     65-0939556       128929     Approved     3/29/2004  

H. Beck, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     52-1321340       1763     Approved     3/23/1989  

H. C. Denison Co.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     39-0794607       1628     Approved     1/1/2002  

H.D. Vest Investment Services

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-1869963       13686     Approved     5/8/2001  

Halliday Financial, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     46-2850591       31741     Approved     1/1/2002  

Hancock Investment Services, Inc.

  

Annuity; Life; Group Pension

     64-0867168       40637     Approved     9/26/2003  

Hanson McClain Retirement Network, LLC

  

Annuity; Life; Group Pension

     68-0415440       103747     Approved     9/7/2007  

Hantz Financial Services, Inc.

  

Group Pension;#Life;#Annuity

     38-3439679       46047     Approved     1/1/2002  

Harbor Financial Services, LLC

  

Annuity; Life; Group Pension

     20-0629176       25700     Approved     10/6/2004  

Harbor Investment Advisory, LLC

  

529;#Group Pension;#Life;#Annuity

     90-0497525       151085     Approved     1/25/2011  

Harbour Investments, Inc.

       39-1571149       19258     Approved     2/5/1992  

Harger and Company, Inc.

  

Annuity; Life; Group Pension

     72-0903128       10385     Approved     1/20/2009  

Harold Dance Investments

  

Annuity; Life; Group Pension

     87-0265332       1582     Approved     1/1/2002  

Harvest Financial Corporation

  

Annuity; Life; Group Pension; JHVLICO

     25-1395109       8733     Approved     3/13/1996  

Hazard & Siegel, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     16-0954584       2048     Approved     5/7/2004  

Hazlett, Burt & Watson, Inc.

  

Annuity; Life; Group Pension

     55-0538822       396     Approved     8/1/2002  

Hefren-Tillotson, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     25-1121408       53     Approved     6/17/1988  

Heim, Young & Associates, Incorporated

  

Annuity; 529; Life; Group Pension

     43-1717820       38993     Approved     1/1/2002  

Henley & Company LLC

  

Annuity; 529; Life; Group Pension

     02-0723515       131453     Approved     5/9/2006  

Hennion & Walsh, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     22-3005841       25766     Approved     4/1/2015  

Herbert J. Sims & Co. Inc.

  

Group Pension;#Life;#Annuity (servicing only);#Annuity

     13-5213180       3420     Approved     2/3/2004  

Heritage Financial Systems, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     23-2991359       133019     Approved     8/22/2005  

Herndon Plant Oakley, Ltd.

  

Annuity; 529; Group Pension; JHVLICO

     74-2863988       44971     Approved     3/13/2002  

HighTower Securities, LLC

       36-4454225       116681     Approved     10/29/2008  

Hilltop Securities Independent Network Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-1843605       17587     Approved     8/19/1997  

Hilltop Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-1382137       6220     Approved     2/22/1999  

Horan Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     31-1448612       40794     Approved     8/15/1998  

Hornor, Townsend & Kent, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     23-1706189       4031     Approved     8/1/1993  

HSBC Securities (USA) Inc.

       13-2650272       19585     Approved     4/27/2004  

Hub International Investment Services, Inc.

  

Group Pension;#Life

     26-3188716       150252     Approved     8/10/2011  

Huckin Financial Group, Inc.

  

Annuity; Life; JHVLICO

     76-0003061       8593     Approved     5/18/2005  

Hudson Heritage Capital Management, Inc.

  

529;#Annuity; Life; Group Pension

     13-3970289       44357     Approved     1/1/2002  

Hunter Associates, Inc.

  

Annuity; Life; Group Pension

     47-5665331       30177     Approved     2/23/1996  

Huntleigh Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-1106957       7456     Approved     5/1/1998  

IBN Financial Services, Inc.

       16-1493299       42360     Approved     2/27/2007  

IFS Securities, Inc.

  

529;#Group Pension;#JHVLICO;#Life

     25-1717574       40375     Approved     7/6/2009  

Independence Capital Co. Inc.

  

529;#Group Pension;#JHVLICO;#Life;#BOLI;#Annuity

     34-1620295       24723     Approved     12/7/2006  

Independent Financial Group, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     71-0927304       7717     Approved     9/12/2003  

Indiana Securities, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     35-2030457       45115     Approved     3/10/2000  

Infinex Investments, Inc.

  

Annuity; 529; Life; Group Pension

     06-1367288       35371     Approved     9/28/2004  

Infinity Securities, Inc. dba Infinity Financial Services

  

529;#Group Pension;#Life;#Annuity

     68-0642587       144302     Approved     6/17/2008  

Inlet Securities, LLC

  

Annuity; Life; Group Pension

     27-0125668       140278     Approved     10/21/2008  

Innovation Partners, LLC

  

Group Pension;#Life;#BOLI

     30-0451254       146344     Approved     10/24/2011  

Insight Securities, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     36-2708269       5611     Approved     1/1/2002  

Institutional Securities Corporation

  

Annuity; 529; Life; Group Pension

     75-2181339       20291     Approved     1/1/2002  

Integral Financial LLC

  

Group Pension;#Life;#Annuity

     02-0565622       120343     Approved     10/14/2010  

Integrated Financial Planning Services

  

529;#Group Pension;#Life;#Annuity (servicing only)

     98-0385606       17935     Approved     10/18/2017  

Integrity Brokerage Services, Inc.

  

Annuity

     75-3023012       117589     Approved     1/21/2005  

Intercarolina Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     56-1563464       19475     Approved     6/28/2000  

Intercontinental Asset Management Group, LTD.

  

Annuity; Group Pension

     74-2619227       22408     Approved     2/11/2008  

International Assets Advisory, LLC

  

Group Pension;#Life;#Annuity; 529

     59-3734291       10645     Approved     4/17/2003  

International Money Management Group, Inc.

       52-1259351       14367     Approved     11/24/1995  

Intervest International Equities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     98-0096287       20289     Approved     11/3/1995  

Inverness Securities, LLC

  

529;#Group Pension;#Life;#Annuity

     01-0791017       129914     Approved     9/14/2004  

Investacorp, Inc.

       59-1790176       7684     Approved     5/24/1993  

Investment Architects, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     94-2953885       17774     Approved     8/17/1992  

Investment Network, Inc.

  

Annuity

     84-1624658       127724     Approved     10/28/2005  

Investment Planners, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     37-1202099       18557     Approved     3/11/1997  

Investment Security Corporation

  

529;#Annuity; Life; Group Pension

     95-4727975       47536     Approved     10/25/2002  

J K R & Company, Inc.

  

Annuity; 529; Life; Group Pension

     95-3420368       8040     Approved     9/1/1998  

J. Alden Associates, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     23-2825319       40002     Approved     1/1/2002  

J. K. Financial Services, Inc.

  

Annuity; 529; Life; Group Pension

     33-0890059       103728     Approved     9/7/2007  

J.J.B. Hilliard, W.L. Lyons, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     61-0734935       453     Approved     9/1/1993  

J.P. Morgan Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     13-4110995       79     Approved     1/1/2002  

J.W. Cole Financial, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     16-1632597       124583     Approved     9/8/2003  

Jack V. Butterfield Investment Company

  

Annuity; 529; Group Pension

     38-1787847       3998     Approved     7/6/2004  

Jacques Financial, LLC

  

Annuity; Life; Group Pension

     52-2217889       104219     Approved     7/25/2002  

James I. Black & Company

  

Annuity; Life; Group Pension

     59-1056275       1249     Approved     9/23/2009  

James T. Borello & Co.

  

Annuity; Life; Group Pension

     36-3688864       16860     Approved     8/2/2006  

Janney Montgomery Scott LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     23-0731260       463     Approved     7/15/1993  

JBS Liberty Securities, Inc.

  

Annuity; Life; Group Pension

     56-1863246       36179     Approved     8/22/2001  

JDL Securities Corporation

  

Group Pension

     33-0446425       28131     Approved     10/13/2009  

John Hancock Distributors LLC

  

529; JHVLICO

     16-1611843       5249     Approved  

Johnson Securities, Inc.

  

Annuity; Life; Group Pension

     23-2305124       15384     Approved     5/12/1987  

JRL Capital Corporation

  

Annuity; Life; Group Pension

     94-2750178       10225     Approved     5/12/1989  

K. W. Chambers & Co.

  

Annuity; Life; Group Pension

     43-0785292       1432     Approved     6/11/1997  

Kalos Capital, Inc.

  

Annuity; 529; Life; Group Pension

     58-2347396       44337     Approved     5/18/2004  

KCD Financial, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     33-1057766       127473     Approved     11/17/2003  

Keel Point Capital, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     42-1607342       6769     Approved     1/17/2013  

Kestra Investment Services, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     74-2794194       42046     Approved     6/13/1997  

Key Investment Services LLC

  

Annuity; 529; Life; Group Pension

     13-4300906       136300     Approved     1/30/2006  

Keybanc Capital Markets Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     34-1391952       566     Approved     4/22/1994  

Keystone Capital Corporation

  

Group Pension;#Life;#Annuity (servicing only)

     95-3744872       10722     Approved     5/24/2013  

Kingsbury Capital, Inc.

  

529;#Group Pension;#JHVLICO

     36-4405388       7638     Approved     2/4/2003  

KMS Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     91-0850651       3866     Approved     6/14/1993  

Kovack Securities Inc.

  

Annuity; 529; Life; Group Pension

     65-0747270       44848     Approved     12/24/1998  

KW Securities Corporation

  

Annuity; 529; Life; Group Pension

     94-2744022       8237     Approved     1/1/2002  

L.M. Kohn & Company

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     31-1311805       27913     Approved     7/18/2000  

L.O. Thomas & Co. Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-3749272       23657     Approved     1/1/2002  

Labrunerie Financial Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     43-1689437       37627     Approved     1/1/2002  

Lamon & Stern, Inc.

  

Group Pension;#JHVLICO

     58-1334773       10839     Approved     9/19/2001  

Landaas & Company

  

Annuity; 529; Life; Group Pension

     39-1628643       47487     Approved     1/1/2002  

Landolt Securities, Inc.

  

Annuity; 529; Group Pension

     39-1662708       28352     Approved     3/7/2008  

Lara, May & Associates, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     26-1142393       145589     Approved     6/6/1993  

Larimer Capital Corporation

  

Annuity; Life; Group Pension; JHVLICO

     84-1028373       18189     Approved     6/15/1988  

Larson Financial Securities, LLC

  

Group Pension;#Life;#Annuity

     27-1372444       152517     Approved     7/28/2010  

LaSalle St Securities, L.L.C.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-2797246       7191     Approved     3/14/1994  

Leerink Swann LLC

  

Annuity; Life; Group Pension

     42-1738148       39011     Approved     5/30/2002  

Legacy Asset Securities, Inc.

  

Group Pension;#Annuity

     76-0600529       47644     Approved     3/31/2009  

Leigh Baldwin & Co., LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-3348632       38751     Approved     6/4/2001  

Leumi Investment Services Inc.

  

Annuity; 529; Life; Group Pension

     13-4132289       105387     Approved     4/29/2004  

Lewis Financial Group, L.C.

  

Annuity; Life; Group Pension; JHVLICO

     72-1269491       36673     Approved     1/1/2002  

Lexington Investment Company, Inc.

  

Annuity; 529; Life; Group Pension

     61-1182641       27393     Approved     7/1/1992  

Liberty Capital Investment Corporation

  

529;#Annuity; Life; Group Pension

     93-1014148       25706     Approved     1/1/2002  

Liberty Group, LLC

  

Annuity; Life; Group Pension; JHVLICO

     94-3322387       106036     Approved     1/1/2002  

Liberty Partners Financial Services, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only);#Annuity; 529; Group Pension

     90-0139675       130390     Approved     8/18/2004  

Lieblong & Associates, Inc.

  

Annuity; 529; Life; Group Pension

     71-0788483       42578     Approved     1/1/2002  

Lifemark Securities Corp.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     16-1238365       16204     Approved     10/25/1994  

Lincoln Douglas Investments, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     27-3459194       155578     Approved     3/13/2014  

Lincoln Financial Advisors Corporation

       35-1151034       3978     Approved     3/30/1993  

Lincoln Financial Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     02-0275490       3870     Approved     12/1/1988  

Lincoln Investment Planning, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     23-1702591       519     Approved     6/1/1992  

Lion Street Financial, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     80-0842559       165828     Approved     12/11/2013  

Lockton Financial Advisors, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     20-3247391       137476     Approved     8/12/2008  

Lombard Securities Incorporated

  

Annuity; 529; Life; Group Pension

     52-1718358       27954     Approved     1/1/2002  

Long Island Financial Group, Inc.

  

Annuity; Life; Group Pension

     11-3136985       31148     Approved     1/1/2002  

Loria Financial Group, LLC

  

Annuity; Life; Group Pension; JHVLICO

     36-4312353       102360     Approved     8/8/2001  

Lowell & Company, Inc.

  

Annuity; Life; Group Pension

     75-2276328       24913     Approved     7/24/2008  

LPL Financial Corporation

       95-2834236       6413     Approved     3/1/1990  

Lucia Securities, LLC

  

Group Pension;#Life;#Annuity

     95-4481399       37179     Approved     9/14/2011  

M Holdings Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     91-1802259       43285     Approved     6/14/2000  

M&T Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     16-1263079       17358     Approved     5/1/2003  

M.E. Allison & Co., Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     74-1037681       1047     Approved     2/5/2013  

M.H. LeBlang, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     13-2553361       2535     Approved     8/20/2018  

M.S. Howells & Co

  

529;#Group Pension;#Life;#Annuity (servicing only)

     86-0988422       104100     Approved     5/3/2016  

Mack Investment Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-3423948       17643     Approved     6/4/1991  

Madison Avenue Securities, Inc.

  

Annuity; 529; Life; Group Pension

     71-0987804       23224     Approved     3/27/2006  

MAFG RIA Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     22-3203853       35690     Approved     12/10/1996  

Maitland Securities, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     20-0091082       130577     Approved     3/4/2013  

Maplewood Investment Advisors, Inc.

  

Annuity; 529; Life; Group Pension

     75-2908461       103723     Approved     1/1/2002  

Marc J. Lane & Company

  

Group Pension

     36-3342755       16188     Approved     3/16/2010  

Mason Securities, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     54-1211119       12967     Approved     1/23/1995  

May Capital Group, L.L.C.

  

Annuity; Life; Group Pension; JHVLICO

     22-3324819       37081     Approved     3/10/2003  

McClurg Capital Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     94-2969239       16798     Approved     8/4/1998  

McDermott Investment Services, LLC

  

Life;#Annuity

     27-3120227       154926     Approved     8/2/2011  

McDonald Partners, LLC

  

529;#Annuity; Life; Group Pension

     20-2714559       135414     Approved     4/25/2006  

MCG Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     30-0722214       163144     Approved     10/31/2014  

McLaughlin Ryder Investments, Inc.

  

Group Pension;#Life;#Annuity

     26-0427041       147529     Approved     6/3/2011  

McNally Financial Services Corporation

  

Annuity; 529; Group Pension; JHVLICO

     43-1957591       121196     Approved     1/9/2004  

Means Wealth Management

  

Group Pension

     01-0377968       2748     Approved     10/29/2007  

MerCap Securities, LLC

  

Group Pension;#Life;#Annuity

     27-4412372       156607     Approved     2/22/2012  

Mercer Allied Company, L.P.

  

Annuity; Life; Group Pension; JHVLICO

     14-1775694       37404     Approved     8/11/1995  

Meridien Financial Group, Inc.

  

Annuity; Life; Group Pension; JHVLICO; TOHI

     05-0390540       10143     Approved     9/7/2006  

Merrill Lynch, Pierce, Fenner & Smith Incorporated

  

529;#Group Pension;#Life;#Annuity

     13-2808480       7691     Approved     12/31/1990  

Mesirow Financial, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-3194849       2764     Approved     6/10/1994  

Michigan Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     38-3488273       101600     Approved     1/1/2002  

Mid Atlantic Capital Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     25-1409618       10674     Approved     4/9/1993  

Mid-Atlantic Securities, Inc.

  

529;#Group Pension;#Life;#BOLI;#Annuity

     56-1548775       18836     Approved     12/19/1990  

Midwestern Securities Trading Company, LLC

  

Annuity; 529; Life; Group Pension

     37-1392167       101080     Approved     1/1/2002  

Milestone Investments, Inc.

  

Annuity; Life; Group Pension

     56-2125552       47090     Approved     4/23/2002  

Mitre Group, LLC

  

Annuity; Life; Group Pension

     20-1998511       140356     Approved     9/14/2007  

MMA Securities LLC

  

Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     22-3570392       44254     Approved     7/2/2003  

MMC Securities Corp.

  

Annuity; Life; Group Pension; JHVLICO; TOHI

     06-1685865       103846     Approved     5/4/2001  

MML Investors Services, LLC

  

529;#Group Pension;#JHVLICO;#Life;#BOLI

     04-1590850       10409     Approved     10/13/1995  

Moloney Securities Co., Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-1714327       38535     Approved     11/23/2000  

Monere Investments, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     36-4401708       105487     Approved     7/22/2015  

Money Concepts Capital Corp

       59-2268067       12963     Approved     8/30/1995  

Montage Securities, LLC

  

529;#Group Pension;#Life;#Annuity

     27-2587292       154327     Approved     10/10/2011  

Moors & Cabot, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     04-2644548       594     Approved     1/1/2002  

Mora WM Securities, LLC

  

Annuity (servicing only)

     45-2581955       158599     Approved     4/15/2016  

Morgan Stanley & Co., Incorporated

  

Annuity; 529; Life; Group Pension; BOLI

     13-2655998       8209     Approved     6/22/1989  

Morris Group, Inc.

  

Annuity; 529; Life; Group Pension

     35-1546402       13181     Approved     1/1/2002  

Moss Adams Securities & Insurance LLC

  

Annuity; Life; Group Pension

     33-0962422       114950     Approved     6/9/2006  

Multiple Financial Services, Inc.

  

Group Pension;#Life;#Annuity

     33-0860466       100100     Approved     7/23/2010  

Mutual Funds Associates Inc.

  

529; JHVLICO

       2856     Approved  

Mutual of Omaha Investor Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     47-0770844       611     Approved     6/3/2008  

Mutual Securities, Inc.

       95-3703162       13092     Approved     1/1/2002  

Mutual Trust Co. of America Securities

  

Annuity; 529; Life; Group Pension

     59-2044132       8494     Approved     3/12/1999  

MWA Financial Services Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-4420471       112630     Approved     2/21/2002  

National Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     91-0519466       7569     Approved     1/1/2002  

Nations Financial Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-1909295       44181     Approved     1/1/2002  

Nationwide Planning Associates Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-3196827       31029     Approved     3/28/2003  

Nationwide Securities, LLC

  

Annuity; 529; Life; Group Pension

     36-2434406       11173     Approved     8/16/2004  

Navy Federal Brokerage Services, LLC

  

Annuity; 529; Life; Group Pension

     04-3826446       138459     Approved     1/30/2007  

NBC Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     63-0923499       17870     Approved     4/14/2001  

Neidiger, Tucker, Bruner, Inc.

       84-0735234       7425     Approved     6/28/2000  

Nelson Ivest Brokerage Services, Inc.

  

Annuity; Group Pension

     59-2106660       3002     Approved     12/4/2002  

Nelson Securities,Inc.

  

Annuity; 529; Life; Group Pension

     91-1219910       14377     Approved     1/1/2002  

Network 1 Financial Securities Inc.

  

Annuity

     74-2454126       13577     Approved     2/6/2003  

Newbridge Securities Corporation

  

Annuity; 529; Life; Group Pension

     54-1879031       104065     Approved     1/25/2002  

Newport Group Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO; BOLI

     59-3099288       29722     Approved     9/3/2003  

Next Financial Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     54-1900002       46214     Approved     1/1/2002  

NGC Financial, LLC

  

Annuity; Life; Group Pension

     22-3871092       145082     Approved     3/6/2008  

Ni Advisors, Inc.

  

529;#Annuity; Life; Group Pension

     20-2100558       134502     Approved     3/14/2007  

Niagara International Capital Limited

  

529;#Group Pension;#Life;#Annuity (servicing only)

     20-2182342       135327     Approved     2/7/2014  

Nicol Investors Corporation

  

Annuity; Group Pension

     68-0515054       123111     Approved     4/20/2004  

North Ridge Securities Corp.

  

Annuity; 529; Life; Group Pension; JHVLICO

     11-3022165       27098     Approved     1/1/2002  

Northern Lights Distributors, LLC

  

Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     77-0625792       126159     Approved     10/22/2004  

Northland Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     41-1819873       40258     Approved     2/4/2003  

Northwestern Mutual Investment Services, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     52-2114207       2881     Approved     1/1/2001  

NPB Financial Group, LLC

  

Annuity; 529; Life; Group Pension

     72-1606466       137743     Approved     6/27/2006  

NYLife Securities LLC

  

529;#Annuity; Life; Group Pension; JHVLICO; BOLI

     27-0145686       5167     Approved     3/12/1996  

Oak Tree Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     68-0095374       18126     Approved     12/1/1994  

Oberweis Securities, Inc.

  

529; JHVLICO

     36-4106772       42060     Approved  

OFG Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     48-0759751       23940     Approved     4/1/1994  

Omega Securities, Inc.

  

Annuity; Life; Group Pension

     75-1480835       7164     Approved     2/24/1994  

Omni Financial Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     31-1330353       29320     Approved     7/16/1996  

OneAmerica Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     35-1159900       4173     Approved     3/22/2000  

Oppenheimer & Co. Inc.

       13-5657518       249     Approved     7/1/1991  

Oriental Financial Services Corp. (NEW)

  

Group Pension;#Life;#Annuity (servicing only)

     66-0480123       29753     Approved     7/28/2016  

P.J. Robb Variable Corporation

  

Annuity; Life; Group Pension; JHVLICO

     62-1592808       38339     Approved     10/1/1997  

Pacific Financial Associates, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     33-0063888       23772     Approved     1/1/2002  

Packerland Brokerage Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-1794957       37031     Approved     8/28/1995  

Painter, Smith and Gorian Inc.

  

Annuity; Life; Group Pension

     95-3679604       10865     Approved     1/1/2002  

Paradigm Equities, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     38-3091434       31990     Approved     5/17/2016  

Pariter Securities, LLC

  

Annuity; Life; Group Pension

     66-0712540       127836     Approved     8/4/2009  

Park Avenue Securities LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     13-4023176       46173     Approved     9/19/1991  

Parkland Securities, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     74-3010408       115368     Approved     2/26/2002  

Parsonex Securities, Inc.

  

Annuity; 529; Life; Group Pension

     20-8580639       144412     Approved     1/30/2009  

Paulson Investment Company, Inc.

  

Annuity; 529; Life; Group Pension

     93-0789804       5670     Approved     10/22/1991  

Peachtree Capital Corporation

  

529;#Group Pension;#Life;#Annuity (servicing only)

     58-1857011       25590     Approved     11/19/2005  

Peak Brokerage Services LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     27-5097314       157045     Approved     9/28/2011  

Pelion Securities Corporation

  

Group Pension

     33-0879829       103941     Approved     6/11/2009  

Penates Group, Inc.

       86-0887730       44266     Approved     3/24/1998  

Pensionmark Securities, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     81-2334025       283952     Approved     9/8/2017  

Pentegra Distributors, Inc.

  

Annuity; Life; Group Pension

     13-3529467       26249     Approved     2/26/2008  

People’s Securities, Inc.

  

Annuity; 529; Life; Group Pension

     06-1082686       13704     Approved     1/1/2002  

Perryman Securities, Inc.

  

Annuity; Life; Group Pension

     75-2945060       116502     Approved     3/6/2002  

Petersen Investments, Inc.

  

529;#Group Pension;#Life;#Annuity

     22-2332595       38537     Approved     6/4/2010  

Phoenix Equity Planning Corporation

  

Annuity; Life; Group Pension; JHVLICO

     23-2795977       38383     Approved     11/20/2000  

Pinnacle Equity Management, Inc.

  

Annuity; Life; Group Pension

     43-1600887       106213     Approved     8/8/2002  

Plan B Investments, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     20-1688448       136162     Approved     6/28/2013  

PlanMember Securities Corporation

  

Annuity; 529; Life; Group Pension

     95-3706234       11869     Approved     9/30/1997  

Plexus Financial Services, LLC

  

Group Pension;#Life;#Annuity

     27-1746834       153132     Approved     4/6/2011  

PNC Investments, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     42-1604685       129052     Approved     4/6/2004  

Portfolio Advisors Alliance, Inc.

  

Group Pension;#Life;#Annuity

     77-0510678       101680     Approved     1/1/2002  

Portfolio Resources Group, Inc.

  

Annuity; 529; Life; Group Pension

     65-0370652       31155     Approved     5/15/2008  

Preferred Client Group, Inc.

  

Annuity

     75-2826360       48008     Approved     9/8/2008  

Presidential Brokerage, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     33-0469265       28784     Approved     1/1/2002  

Principal Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     42-0941553       1137     Approved     9/7/1994  

Principled Advisors, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     59-3782727       131345     Approved     2/18/2005  

Private Client Services, LLC

  

529;#Group Pension;#Life;#Annuity

     61-1383537       120222     Approved     1/20/2010  

Private Placement Insurance Products, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     20-3716885       140139     Approved     8/10/2018  

ProEquities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     63-0879387       15708     Approved     1/1/1994  

Profinancial, Inc.

  

Annuity; Life; Group Pension

     72-1004707       15345     Approved     5/27/1994  

Prospera Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-1832551       10740     Approved     1/1/2002  

PTS Brokerage, LLC

  

Group Pension;#Annuity; 529

     22-3832388       119307     Approved     12/13/2004  

Puplava Securities, Inc.

  

Annuity; Life; Group Pension

     33-0086182       39301     Approved     1/8/1998  

Puritan Brokerage Services, Inc.

  

Group Pension;#Life;#Annuity

     20-8772472       144445     Approved     2/1/2011  

Purshe Kaplan Sterling Investments, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     14-1796925       35747     Approved     1/1/2002  

Queens Road Securities, LLC

  

Annuity; Life; Group Pension

     56-2190824       104277     Approved     1/1/2002  

Quest Capital Strategies, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     95-3859254       16783     Approved     1/1/2002  

Questar Capital Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     38-3342968       43100     Approved     7/5/1999  

R F Lafferty & Co., Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     13-3000887       2498     Approved     4/28/2016  

R. Seelaus & Co., Inc.

  

Annuity; 529; Life; Group Pension

     22-2501042       14974     Approved     3/2/2007  

R.M. Stark & Co., Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     13-3485532       7612     Approved     1/1/2002  

Raymond James & Associates, Inc.

  

529;#Group Pension;#Life;#Annuity

     59-1237041       705     Approved     1/1/2002  

Raymond James Financial Services, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     59-1531281       6694     Approved     4/1/1989  

RBC Capital Markets, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     41-1416330       31194     Approved     11/13/1991  

Red Capital Markets, LLC

  

Annuity; Life; Group Pension

     31-1078499       14840     Approved     1/2/2003  

Regal Securities, Inc.

  

Annuity; 529; Life; Group Pension

     36-2916812       7297     Approved     10/19/2005  

Register Financial Associates, Inc.

  

Group Pension;#Life;#Annuity

     58-2001619       30568     Approved     4/26/2007  

Regulus Advisors, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     26-3975819       150631     Approved     5/29/2014  

Rehmann Financial Network, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     46-0571202       165027     Approved     4/13/2018  

Reid and Associates, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     14-1778902       8060     Approved     10/25/2013  

Rhodes Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     75-2156987       19610     Approved     1/1/2002  

Richard Brothers Securities (dba Allegiance Capital, LLC)

  

Annuity; 529; Life; Group Pension

     01-0538310       105285     Approved     9/23/2009  

Richfield Orion International, Inc.

  

Annuity; Life; Group Pension

     26-1712862       24433     Approved     2/20/2009  

Riedl First Securities Company of Kansas

  

Annuity; 529; Life; Group Pension

     48-1118573       30812     Approved     1/1/2002  

RNR Securities, L.L.C.

  

Group Pension;#Annuity (servicing only);#Annuity; 529

     11-3374561       43689     Approved     10/25/2002  

Robert W. Baird & Co. Incorporated

  

Annuity; 529; Life; Group Pension; JHVLICO

     39-6037917       8158     Approved     2/5/1997  

Rogan & Associates, Inc.

  

Annuity; 529; Life; Group Pension

     65-0718838       42762     Approved     1/1/2002  

Ross, Sinclaire & Associates, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     20-2461737       25440     Approved     4/15/2016  

Rothschild Investment Corporation

  

Annuity; Life; Group Pension

     36-2708660       728     Approved     9/17/2003  

Royal Alliance Associates, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity (servicing only)

     93-0987232       23131     Approved     7/30/1990  

Ryan Financial, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     04-3286588       39617     Approved     3/15/2016  

S.G. Long & Company

  

Annuity; Life; Group Pension

     81-0504511       47511     Approved     1/1/2002  

S.L. Reed & Company

  

Annuity; Life; Group Pension

     95-4569995       40744     Approved     7/7/2009  

SA Stone Wealth Management, Inc.

       75-2975513       18456     Approved     1/1/2002  

Sage, Rutty & Co., Inc.

  

Annuity; 529; Life; Group Pension

     16-0620690       3254     Approved     11/4/2004  

SagePoint Financial, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     20-1741754       133763     Approved     10/31/2005  

Sanders Morris Harris Inc

  

Annuity; 529; Life; Group Pension; JHVLICO

     76-0224835       20580     Approved     1/8/2002  

Santander Securities, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     66-0534068       41791     Approved     3/4/2013  

Saxony Securities, Inc.

  

529;#Group Pension;#Life;#Annuity

     43-1932300       115547     Approved     4/8/2003  

Saybrus Equity Services, LLC

  

Group Pension;#Life

     27-1869321       153319     Approved     9/17/2010  

SCF Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     86-0936511       47275     Approved     1/1/2002  

Scott T. Taylor, Ltd.

  

Annuity; Life; Group Pension

     20-1277948       136414     Approved     10/9/2007  

Scottsdale Capital Advisors Corp

  

Annuity; 529

     86-1032510       118786     Approved     11/8/2002  

Securian Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     14-1486060       15296     Approved     6/1/1992  

Securities America, Inc.

  

BOLI;#Annuity; 529; Life; Group Pension; JHVLICO

     11-2551174       10205     Approved     4/1/1992  

Securities Equity Group

  

529;#Annuity; Life; Group Pension; JHVLICO

     33-0842620       47215     Approved     7/11/2003  

Securities Management & Research, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     59-1145041       759     Approved     12/15/2011  

Securities Service Network, Inc.

       62-1152936       13318     Approved     9/23/1993  

SEI Investments Distribution Co.

  

Annuity; Life; Group Pension

     23-2177800       10690     Approved     10/4/2004  

Selkirk Investments, Inc.

  

Annuity; 529; Life; Group Pension

     91-1189461       13854     Approved     1/1/2002  

Sentinel Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     04-3527574       110942     Approved     10/23/2001  

Sentinus Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     47-3243901       279029     Approved     5/8/2017  

SFA Financial, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     33-1148678       149647     Approved     11/20/2012  

Shareholders Service Group, Inc.

  

Annuity; Life; Group Pension

     71-0707839       125226     Approved     8/9/2005  

Sigma Financial Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     38-2472555       14303     Approved     11/20/1992  

Signal Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-1994786       15916     Approved     12/1/1993  

Signature Securities Group Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     13-4120476       104233     Approved     11/27/2004  

Silver Oak Securities, Incorporated

  

Annuity; 529; Life; Group Pension

     62-1765234       46947     Approved     1/1/2002  

Simmons First Investment Group

  

Group Pension;#Life;#Annuity (servicing only)

     71-0823840       47439     Approved     9/17/2018  

Singer Xenos Securities, Corp.

  

Annuity

     65-1127769       115856     Approved     7/12/2011  

Sisung Securities Corporation

       72-1156248       25752     Approved     6/23/1994  

SKA Securities, Inc.

  

Annuity

     34-1953704       113852     Approved     3/25/2008  

Slavic Investment Corporation

  

Annuity; Life; Group Pension

     65-0065207       22885     Approved     1/1/2002  

Smith, Brown & Groover, Inc.

  

Annuity; 529; Life; Group Pension

     58-0969636       1329     Approved     1/1/2002  

Smith, Moore & Co.

  

Annuity; 529; Life; Group Pension

     43-1244128       3441     Approved     1/1/2002  

SNC Capital Management Corp.

  

Annuity

     36-3343717       15548     Approved     11/4/2002  

Snowden Account Services, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     94-3467207       149794     Approved     3/8/2013  

Somerset Securities, Inc.

  

Annuity; Life; Group Pension

     04-3333156       2493     Approved     3/25/2003  

Sorrento Pacific Financial, LLC

  

Annuity; 529; Life; Group Pension

     04-3746212       127787     Approved     1/17/2006  

Southeast Investments N.C. Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     56-2001267       43035     Approved     1/1/2002  

Southern Trust Securities, Inc.

  

Annuity; 529; Group Pension

     65-0926091       103781     Approved     9/28/2004  

Southern Wealth Securities, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     82-3136934       291005     Approved     7/30/2018  

Sovereign Legacy Securities, Inc.

  

Annuity

     11-1738990       1783     Approved     5/24/2011  

Spearhead Capital, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     20-3339297       145560     Approved     5/3/2018  

Spire Securities, LLC

  

Annuity; 529; Life; Group Pension

     20-8920866       144131     Approved     11/15/2007  

St. Bernard Financial Services, Inc.

       71-0752696       36956     Approved     5/8/2002  

St. Germain Securities, Inc.

  

Group Pension;#Life;#Annuity

     27-3158654       3255     Approved     8/9/2011  

Stanley Laman Group Securities, LLC

  

Annuity; Life; Group Pension; JHVLICO

     33-1027312       126160     Approved     5/5/2004  

Stephen A. Kohn & Associates, Ltd

  

529;#Group Pension;#Life;#Annuity

     84-1345780       41067     Approved     10/31/2011  

Stephens Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     71-0641478       3496     Approved     1/1/2002  

Sterling Monroe Securities, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     75-3049285       122696     Approved     7/24/2007  

Stern Brothers & Co.

  

Annuity; 529

     43-1357568       16325     Approved     3/27/2003  

Stifel, Nicolaus & Company, Incorporated

  

Annuity; 529; Life; Group Pension; JHVLICO

     43-0538770       793     Approved     8/7/1992  

StockCross Financial Services, Inc.

  

529;#Annuity

     04-2523566       6670     Approved     9/23/2009  

Stoever Glass & Company, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     13-2505863       7031     Approved     4/5/2017  

Stonecrest Capital Markets, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     56-1943573       39616     Approved     7/31/2017  

Stonnington Group, LLC

  

Annuity; Life; Group Pension

     20-0572663       131221     Approved     6/21/2006  

Summit Brokerage Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     59-3202578       34643     Approved     1/1/2002  

Sunbelt Securities, Inc.

  

529;#Annuity; Life; Group Pension

     47-9660137       42180     Approved     5/7/2009  

Sunset Financial Services, Inc.

  

Group Pension;#Life;#Annuity (servicing only);#BOLI

     91-0837062       3538     Approved     11/29/1994  

Sunstreet Securities, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     56-2614773       143211     Approved     2/26/2008  

Suntrust Investment Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     58-1648698       17499     Approved     1/1/2002  

SunTrust Robinson Humphrey, Inc.

       62-0871146       6271     Approved     5/8/2002  

Superior Financial Services, Inc.

  

Annuity; 529; Life; Group Pension

     39-1992135       104165     Approved     1/1/2002  

Supreme Alliance LLC

  

Group Pension;#Life;#Annuity (servicing only)

     90-0436170       45348     Approved     4/25/2012  

SWBC Investment Services, LLC

  

Annuity; 529; Life; Group Pension

     20-1484586       133715     Approved     12/13/2006  

Sycamore Financial Group

  

Annuity; Life; Group Pension

     35-1572068       14143     Approved     1/1/2002  

Symphonic Securities LLC

  

529;#Group Pension;#Life;#Annuity

     42-1675559       139512     Approved     3/26/2009  

Syndicated Capital, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     95-4042447       29037     Approved     1/1/2002  

Synovus Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     58-1625031       14023     Approved     7/4/2002  

T.S. Phillips Investments, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     30-0089632       124348     Approved     4/30/2003  

Tandem Securities, Inc.

  

Annuity

     20-4498572       140546     Approved     6/17/2009  

Taylor Capital Management Inc.

  

529;#Group Pension;#Life;#Annuity

     06-1388917       43559     Approved     5/20/2011  

Taylor Securities, Inc.

  

Annuity; Life; Group Pension

     62-1254593       17575     Approved     8/6/1993  

TCFG Wealth Management, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     80-0804654       164153     Approved     7/10/2014  

TD Ameritrade, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     06-0988655       7870     Approved     1/1/2002  

Teckmeyer Financial Services, L.L.C.

  

Annuity; 529; Life; Group Pension

     47-0789382       39000     Approved     8/6/1997  

TFS Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-2825878       20626     Approved     10/20/1997  

The Capital Group Securities, Inc.

  

Group Pension

     05-0406744       104052     Approved     5/20/2010  

The Enterprise Securities Company

  

Annuity; Life; Group Pension; JHVLICO

     38-2932225       26598     Approved     7/1/1999  

The Garbacz Group Inc

  

Annuity; 529; Life; Group Pension

     43-1535339       26104     Approved     1/1/2002  

The GMS Group, LLC

  

Annuity; 529

     77-0606720       8000     Approved     1/1/2002  

The Huntington Investment Company

  

Annuity; 529; Life; Group Pension; JHVLICO

     31-1316299       16986     Approved     1/19/1998  

The Investment Center, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     22-2699900       17839     Approved     1/1/2002  

The Jeffrey Matthews Financial Group, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     22-3470463       41282     Approved     5/29/2014  

The Leaders Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI; TOHI

     84-1275292       37157     Approved     5/15/1996  

The New PenFacs Inc.

  

Annuity; Life; Group Pension

     41-2238941       145584     Approved     4/21/2009  

The O.N. Equity Sales Company

  

Annuity; 529; Life; Group Pension; JHVLICO; BOLI

     31-0742113       2936     Approved     9/14/1990  

The Oak Ridge Financial Services Group, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     41-1868775       42941     Approved     1/1/2002  

The Strategic Financial Alliance, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     03-0510324       126514     Approved     11/11/2003  

The Tavenner Company

  

Annuity; 529; Life; Group Pension

     31-1171911       18004     Approved     2/16/2001  

ThomasLloyd Capital LLC

  

Annuity; Life; Group Pension

     20-5758053       38784     Approved     1/1/2002  

Thompson Davis & Co., Inc.

  

Annuity; 529

     13-3848035       41353     Approved     12/18/2002  

Thoroughbred Financial Services, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     62-1784717       47893     Approved     5/10/2000  

Thrasher & Chambers, Inc.

  

Life;#Annuity

     71-0824595       3586     Approved     5/1/2003  

Thrivent Investment Management Inc.

  

Life; Group Pension; JHVLICO

     39-1559375       18387     Approved     5/19/2004  

Thurston, Springer, Miller, Herd & Titak, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     35-1493200       8478     Approved     4/12/1995  

TIAA-CREF & Institutional Services, LLC

  

Annuity; Life; Group Pension

     55-0856733       20472     Approved     6/25/2007  

TimeCapital Securities Corporation

       11-2339821       6845     Approved     7/18/2002  

Titan Securities

  

529;#Group Pension;#Life;#Annuity (servicing only)

     59-3782400       131392     Approved     2/5/2009  

Titleist Asset Management, Ltd

  

529;#Group Pension;#Life;#Annuity (servicing only)

     72-1546466       126136     Approved     4/18/2012  

Trade-PMR Inc.

  

Annuity

     59-3539169       46350     Approved     10/30/2009  

Transam Securities, Inc.

  

Annuity; 529; Life; Group Pension

     59-2730348       18923     Approved     5/18/1993  

Transamerica Financial Advisors, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     59-2476008       16164     Approved     4/1/1991  

Triad Advisors, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     65-0173164       25803     Approved     1/15/1999  

Trinity Wealth Securities, L.L.C.

  

Annuity; Life; Group Pension

     43-1892336       104348     Approved     7/7/2003  

Trubee, Collins & Co., Inc.

  

Annuity; 529; Life; Group Pension

     16-1406627       3618     Approved     11/1/2005  

TrueNorth, Inc.

  

Annuity; Life; Group Pension

     48-1233289       112091     Approved     5/27/2005  

Trustcore Investments, Inc.

  

529;#Group Pension;#Life

     62-1209295       15423     Approved     7/2/1996  

Trustmont Financial Group, Inc.

  

Annuity; 529; Life; Group Pension

     25-1527294       18312     Approved     1/1/2002  

U.S. Bancorp Investments, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     84-1019337       17868     Approved     4/21/1992  

U.S. Brokerage, Inc.

  

529;#Annuity

     34-1809568       39307     Approved     6/13/2002  

UBS Financial Services Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     13-2638166       8174     Approved     8/24/1988  

Uhlmann Price Securities, LLC

  

529;#Group Pension;#Life;#Annuity

     36-4135497       42854     Approved     10/31/2011  

UMB Financial Services, Inc.

  

Annuity; 529; Life; Group Pension

     43-1381257       17073     Approved     8/12/2003  

Umpqua Investments, Inc.

       93-0125240       1254     Approved     1/1/2002  

Unified Financial Securities, Inc.

  

Annuity; Life; Group Pension

     35-0913071       7868     Approved     4/8/2002  

Union Capital Company

  

Annuity; Life; Group Pension

     86-1004803       110301     Approved     9/25/2006  

UnionBanc Investment Services, LLC

  

Annuity; 529; Life; Group Pension

     95-3883259       14455     Approved     11/18/2003  

United Brokerage Services, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     55-0742331       39062     Approved     1/6/2006  

United Planners’ Financial Services of America A Limited Partner

  

Annuity; 529; Life; Group Pension; JHVLICO

     86-0588303       20804     Approved     5/1/1992  

Universal Financial Services Inc.

  

Group Pension;#Life;#Annuity

     66-0639438       131558     Approved     5/26/2010  

Univest Investments, Inc.

  

Annuity; 529; Life; Group Pension

     23-1699073       1834     Approved     3/20/2008  

USA Financial Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     38-3397033       103857     Approved     11/9/2001  

USCA Securities LLC

  

529;#Group Pension;#Life;#Annuity

     22-3696585       103789     Approved     3/14/2011  

USI Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     06-1493970       43793     Approved     12/14/1998  

VALIC Financial Advisors, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     76-0519992       42803     Approved     4/19/2002  

Valley National Investments, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     23-2352181       16715     Approved     1/1/2002  

Valmark Securities, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#BOLI;#Annuity

     34-1724087       31243     Approved     8/1/1997  

Valor Financial Securities LLC

  

Annuity; 529; Life; Group Pension

     80-0413304       150726     Approved     12/29/2009  

Vanderbilt Securities, LLC

  

Annuity; 529; Life; Group Pension; JHVLICO

     11-3639254       5953     Approved     11/10/2003  

Variable Investment Advisors, Inc.

  

Annuity

     91-1864112       44412     Approved     12/8/2004  

Veritas Independent Partners, LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     46-3578654       169291     Approved     9/11/2014  

Verity Investments, Inc.

  

529;#Group Pension;#Life;#Annuity

     90-0739043       41527     Approved     1/1/2002  

Vestech Securities, Inc.

  

Annuity; Life; Group Pension; JHVLICO

     48-1181578       41409     Approved     1/1/2002  

Vision

       13-4066286       47927     Approved     1/20/2010  

Visun Securities Corporation

  

Group Pension;#Life;#Annuity (servicing only)

     39-1478987       15251     Approved     6/13/1990  

Vorpahl Wing Securities

  

Annuity; Group Pension

     91-1719382       47548     Approved     10/7/2003  

Voya Financial Advisors, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     41-0945505       2882     Approved     12/5/1994  

Voya Financial Partners, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     06-1375177       34815     Approved     8/2/2002  

Waddell & Reed, Inc.

  

529;#Group Pension;#JHVLICO;#Life;#Annuity

     43-1235675       866     Approved     1/1/2002  

Washington Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     54-1913812       46213     Approved     1/1/2002  

Waveland Capital Partners, LLC

  

Group Pension;#Life;#Annuity (servicing only)

     77-0425821       40054     Approved     10/8/2004  

WBB Securities, LLC

  

Annuity; Life; Group Pension; JHVLICO

     33-0984561       118440     Approved     7/3/2002  

Wedbush Morgan Securities Inc.

  

Annuity; 529; Life; Group Pension

     95-2495390       877     Approved     1/1/2002  

Weitzel Financial Services, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     42-0949102       27346     Approved     4/27/2007  

Weller, Anderson & Co., Ltd.

  

Annuity; Life; Group Pension

     76-0147898       23736     Approved     10/19/2005  

Wellington Shields & Co., LLC

  

Group Pension;#Life;#Annuity

     26-3489406       149021     Approved     7/30/2010  

Wells Fargo Advisors Financial Network, LLC

       48-1305000       11025     Approved     1/9/1998  

Wells Fargo Clearing Services, LLC

       34-1542819       19616     Approved     3/8/1993  

Wesbanco Securities, Inc.

  

Annuity; 529; Life; Group Pension

     31-1484891       43276     Approved     3/23/2006  

Wescom Financial Services LLC

  

529;#Group Pension;#Life;#Annuity (servicing only)

     95-4853684       125650     Approved     9/9/2005  

Western Equity Group, Inc.

       76-0749184       130876     Approved     11/9/2004  

Western International Securities, Inc.

  

529;#Group Pension;#Life

     84-1314321       39262     Approved     1/1/2002  

Western Strategic Advisors, LLC

  

Annuity

     75-2911711       118757     Approved     2/2/2010  

Westminster Financial Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     31-1213105       20677     Approved     1/23/1996  

Weston Securities Corporation

  

Annuity; Life; Group Pension; JHVLICO

     04-2836850       15743     Approved     6/26/1995  

Westpark Capital, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     84-1333428       39914     Approved     1/12/2017  

Westport Capital Markets, LLC

  

529;#Group Pension;#Annuity

     06-1459306       41562     Approved     5/16/2008  

Westport Financial Services, L.L.C.

  

Annuity; Life; Group Pension; JHVLICO

     06-1409406       38449     Approved     1/15/1992  

Westport Resources Investment Services, Inc.

  

Annuity; 529; Life; Group Pension

     22-2955076       24535     Approved     1/17/2003  

White Mountain Capital, LLC

  

529;#Annuity; JHVLICO

     13-4077093       104123     Approved     12/5/2002  

Whitehall-Parker Securities, Inc.

  

Annuity; Life; Group Pension

     94-2787310       10608     Approved     9/25/1996  

Wiley Bros.-Aintree Capital, LLC

  

Annuity; 529; Life; Group Pension

     62-1627736       3767     Approved     1/1/2002  

William Blair & Company L.L.C.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     36-2214610       1252     Approved     8/21/2013  

Wilmington Capital Securities, LLC

  

Group Pension

     20-1894227       133839     Approved     5/26/2010  

Winslow, Evans & Crocker, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     04-3144652       29686     Approved     2/4/2003  

Wintrust Investments, LLC

       36-1245570       875     Approved     1/1/2002  

WJ Lynch Investor Services LLC

  

Annuity; Life; Group Pension

     20-4472438       140762     Approved     4/30/2007  

Wood (Arthur W.) Company, Inc.

  

529;#Group Pension;#Life;#Annuity

     04-3023088       3798     Approved     1/1/2002  

Woodbury Financial Services, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     41-0944586       421     Approved     7/11/1991  

Woodlands Securities Corporation

  

Annuity; 529; Life; Group Pension; JHVLICO

     76-0248272       22373     Approved     2/3/1997  

Woodmen Financial Services, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     22-3828171       117365     Approved     10/6/2014  

Woodstock Financial Group, Inc.

  

Annuity; 529; Life; Group Pension

     58-2161804       38095     Approved     11/7/2005  

World Capital Brokerage, Inc.

  

Annuity; 529; Life; Group Pension

     84-0478785       37     Approved     12/13/1991  

World Choice Securities, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     75-2452273       30933     Approved     1/14/2002  

World Equity Group, Inc.

  

Annuity; 529; Life; Group Pension; JHVLICO

     36-3797444       29087     Approved     6/27/2000  

Worth Financial Group, Inc.

  

529;#Group Pension;#Life;#Annuity (servicing only)

     75-1888861       13478     Approved     5/3/2002  

WWK Investments, Inc.

  

Annuity

     47-0727988       25184     Approved     12/17/2009  

YR Securities, Inc.

  

Group Pension;#Life;#Annuity (servicing only)

     47-2516544       174708     Approved     11/24/2015  

Zions Direct, Inc.

  

Annuity; Life; Group Pension

     87-0432248       17776     Approved     11/18/2003  

Ziv Investment Company

  

Annuity; Life; Group Pension

     34-2481379       4316     Approved     1/1/2002  

LOGO

  

John Hancock Life Insurance Company (U.S.A.)

A Stock Company

LIFE INSURED           [John J. Doe]

POLICY NUMBER     [12 345 678]

PLAN NAME              [Protection VUL]

FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE POLICY

ADJUSTABLE DEATH BENEFIT

BENEFIT PAYABLE ON LIFE INSURED’S DEATH

FLEXIBLE PREMIUMS PAYABLE TO AGE 121 DURING THE LIFE INSURED’S LIFETIME

NON-PARTICIPATING (NOT ELIGIBLE FOR DIVIDENDS)

Subject to the conditions and provisions of this policy, if the Life Insured dies while this policy is In Force, John Hancock Life Insurance Company (U.S.A.) (“the Company”) agrees to pay the Insurance Benefit to the beneficiary in a lump sum, which may include placing the Insurance Benefit in an interest-bearing account in the name of the beneficiary that provides immediate access to all of the account, and to provide the other benefits, rights, and privileges, if any, of the policy. If the Company makes other plans of payment available other than a lump sum, then a beneficiary may request payment under such plans in lieu of a lump sum.

The Insurance Benefit is described in Section 4.

Net Premiums are added to the Policy Value. You may allocate them to one or more of the Investment Accounts or the Fixed Account, subject to Section 10 and any other applicable provisions of the policy.

The portion of the Policy Value that is in the Investment Accounts will vary from day to day. The amount is not guaranteed; it may increase or decrease, depending on the investment experience of the Investment Accounts that you have chosen.

The portion of the Policy Value that is in the Fixed Account will accumulate at rates of interest we determine. Such rates will not be less than the Minimum Fixed Account Annual Rate shown in Section 1.

The amount of the Insurance Benefit, or the duration of the insurance coverage, or both, may increase or decrease as described in Section 4.

READ YOUR POLICY CAREFULLY. It is a contract between you and us.

RIGHT TO RETURN POLICY. If for any reason you are not satisfied with your policy, you may return it for cancellation by delivering or mailing it to us or to the agent who sold it. If this policy does not replace another policy, you may return it within TEN days after receiving it, or if it replaces another policy, you may return it within TWENTY days after receiving it. We will refund in full the payment made. The policy will be void from the beginning.

Signed for the Company by:

 

LOGO

President

   

LOGO

Secretary

     Policy Provisions
  

Section

1.   

POLICY SPECIFICATIONS

2.   

TABLE OF RATES

3.   

DEFINITIONS

4.   

INSURANCE BENEFIT

5.   

FACE AMOUNT

6.   

PREMIUMS

7.   

POLICY VALUE

8.   

LOAN ACCOUNT, FIXED ACCOUNT, AND INVESTMENT ACCOUNTS

9.   

SEPARATE ACCOUNT AND SUBACCOUNTS

10.   

ALLOCATIONS AND TRANSFERS

11.   

LOANS

12.   

SURRENDERS AND WITHDRAWALS

13.   

DEATH BENEFIT PROTECTION

14.   

GRACE PERIOD

15.   

POLICY TERMINATION

16.   

REINSTATEMENT

17.   

COVERAGE AT AND AFTER AGE 121

18.   

OWNER AND BENEFICIARY

19.   

ASSIGNMENT

20.   

MISSTATEMENTS

21.   

SUICIDE

22.   

INCONTESTABILITY

23.   

THE CONTRACT

24.   

RIGHT TO POSTPONE PAYMENT OF BENEFITS

25.   

CLAIMS OF CREDITORS

26.   

REPORTS TO OWNER

27.   

HOW VALUES ARE COMPUTED

28.   

QUALIFICATION AS LIFE INSURANCE

29.   

INTEREST ON PROCEEDS

 

2

 

1. POLICY SPECIFICATIONS

 

 

Life Insured   

[JOHN DOE]

      
Plan Name   

[Protection VUL]

    Policy Number   

[12 345 678]

Age at Policy Date   

[35]

    Issue Date   

[February 1, 2020]

[Sex]   

[MALE]

    Policy Date   

[February 1, 2020]

Risk Classification   

[Standard] [Non Smoker]

   
Additional Ratings   

[not applicable]

Owner, Beneficiary   

As designated in the application or subsequently changed

Death Benefit Option at Issue   

[Death Benefit Option 1]

Life Insurance Qualification Test   

Cash Value Accumulation Test

     Face Amount at Issue    $ [50,000]
Governing Law   

Delaware

   

 

3.1

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

PREMIUMS AT ISSUE

 

  Minimum Initial Premium     

$ [94.95]

  Premium Mode     

[Annual]

  Planned Premium     

$ [5,000.00 per year]

Notice: This policy provides life insurance coverage for the lifetime of the Life Insured if sufficient premiums are paid. Premium payments in aFddition to the Planned Premium shown may need to be made to keep this policy and coverage In Force. After the Life Insured reaches Age 121, no further premium payments are payable.

Keeping the policy and coverage In Force will be affected by factors such as: changes in the current Cost of Insurance rates; changes in the Asset-Based Risk Charge; the amount, timing and frequency of premium payments; the interest rate being credited to the Fixed Account and Loan Account; the investment experience of the Investment Accounts; changes to the Death Benefit Option; changes in the Face Amount; loan activity; withdrawals; and deductions for any applicable supplementary benefit riders that are attached to, and made a part of, this policy. Also refer to the Death Benefit Protection, Grace Period, and Policy Termination provisions in Sections 13, 14, and 15.

Pursuant to the Death Benefit Protection provision in Section 13, this policy will provide, at a minimum, coverage until Policy Month [7], Policy Year [51], if all Planned Premiums shown above are paid when they are due, and you do not take any policy loans or withdrawals and there are no other policy changes.

 

3.2

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

OTHER BENEFITS AND SPECIFICATIONS

[Not Applicable]

 

3.3

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

POLICY VALUE CALCULATION

POLICY CHARGES:

Deductions from Premium Payments

 

Premium Charge   

A percentage of each premium payment, the percentages as shown below.

Policy Years    Percentage
1-10    35%
11+    32%

Monthly Deductions

 

Administrative Charge

    $15.00

Face Amount Charge

    A monthly charge that is a rate per $1,000 of Face Amount. The rates are shown below. This charge does not apply to any increase in Face Amount due to a Death Benefit Option change.

 

Policy Years    Rate
1-3    [0.0898]
4-[15]    [0.0898]
[16]+    0.0000

 

Cost of Insurance Charge

    Determined in accordance with Section 7. Maximum Monthly Cost of Insurance Rates are shown in Section 2.
   The Maximum Monthly Cost of Insurance Rates are no greater than those derived from the appropriate gender distinct or unisex tables used as the basis for the minimum cash surrender values, as described below.

Asset-Based Risk Charge

    0.0208% of Investment Accounts assets deducted monthly

Advance Contribution Charge

    Determined in accordance with Section 7. The Advance Contribution Charge Rates are shown below.

 

Policy Years    Advance Contribution
Charge Rate		    Policy Years    Advance Contribution
Charge Rate
1    [0.000750]    7    [0.000300]
2    [0.000675]    8    [0.000225]
3    [0.000600]    9    [0.000150]
4    [0.000525]    10    [0.000075]
5    [0.000450]    11+    0.000000
6    [0.000375]      

 

3.4

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

POLICY VALUE CALCULATION (continued)

Other Charges

 

Surrender Charge

    

This charge is deducted from the Policy Value during the Surrender Charge Period. See Section 12 for
details of when a Surrender Charge applies.

 

The Surrender Charge is equal to (a) minus (b) minus (c), with the result multiplied by the applicable
percentage from the table below, where:

 

(a)   is the Initial Surrender Charge shown in this Section 1; and

 

(b)   is 0.0158 multiplied by the sum of premiums received in the first Policy Year;

 

(c)   is the sum of the total Advance Contribution Charges deducted in the first Policy Year.

 

In no event, however, will the Surrender Charge be less than zero.

 

The Surrender Charge will reduce over the Surrender Charge Period until it becomes zero. The table below
shows the applicable percentage at the beginning of each year during the Surrender Charge Period. The
Percentage of Surrender Charge is proportionately reduced each month of the year.

 

Year in Surrender Charge Period

   

Maximum Percentage of Surrender Charge

1    100.00%
2    [98.25]%
3    [96.64]%
4    [95.00]%
5    [93.34]%
6    [77.78]%
7    [62.22]%
8    [46.66]%
9    [31.10]%
10    [15.55]%
11+    0.00%

 

Supplementary Benefit Rider Charges

   

Charges for applicable riders are shown under Supplementary Benefits of this Section 1.

 

Minimum Cash Surrender Values

    We base Minimum Cash Surrender Values on the 2017 Loaded CSO Smoker Distinct Ultimate (ANB) mortality tables, with substandard ratings as applicable.

 

3.5

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

POLICY VALUE CALCULATION (continued)

OTHER TERMS AND CHARGES:

Refer to your policy provisions for details on the terms and values shown in this table.

 

Minimum Face Amount

    $ 50,000  

Minimum Face Amount Decrease

    $ 50,000  

Minimum Fixed Account Annual Rate

      2.0 % 
Allocation Date      [10th day after the Issue Date  

Loan Interest Charged Annual Rate

   

Policy Years 1-10

      3.25 % 

Policy Years 11+

      2.25 % 

Maximum Loan Interest Credited Differential

      2.0 % 
Asset Credit Commencement Year      Beginning in Policy Year 11  
Asset Credit Rate      Rates are shown in Section 2  

Minimum Loan Amount

    $ 500  

Minimum Withdrawal Amount

    $ 500  

Death Benefit Discount Factor

      1.0016516  

Initial Surrender Charge

    $ [4,085.66 ] 

Partial Surrender Charge Decrease Exemption

      10 % 

Advance Contribution Limit

    $ [3,650.00 ] 

Maximum Transfer Fee

    $ 25  

Fixed Account Maximum Transfer Percentage

      15 % 

Fixed Account Maximum Transfer Amount

    $ 2,000  

Investment Account Maximum Transfer Amount

    $ 1,000,000  

Policy Value Credit Factor A Limit Rate

      0.15  

 

3.6

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

DEATH BENEFIT PROTECTION VALUE CALCULATION

The following terms and values are used in calculating the Death Benefit Protection Value as described in Section 13 of this policy:

 

Death Benefit Protection Premium Charge    A percentage of each premium payment, the percentages as shown below.
Policy Years    Percentage
1    30%
2-10    10%
11+    5%
Death Benefit Protection Administrative Charge    $20.00 per month
Death Benefit Protection Face Amount Charge    A monthly charge that is a rate per $1,000 of Face Amount. The rates are shown in Section 2. This charge does not apply to any increase in Face Amount due to a Death Benefit Option change.
Death Benefit Protection Cost of Insurance Charge    Determined in accordance with Section 13. Monthly Death Benefit Protection Cost of Insurance Rates are shown in Section 2.
Death Benefit Protection Annual Interest Rates    Shown in Section 2
Death Benefit Protection Annual Bonus Rate    [1.00%]
Death Benefit Protection Bonus Threshold Rates    Shown in Section 2

 

3.7

 

2. TABLE OF RATES– Policy [12 345 678]

 

MAXIMUM MONTHLY COST OF INSURANCE RATES AND MINIMUM DEATH BENEFIT FACTORS

The Maximum Monthly Cost of Insurance Rates per dollar of Net Amount at Risk (“Rates”) are shown below for each Age. The Rates have been adjusted for any applicable Additional Ratings that are applied to the Cost of Insurance Rates as shown in Section 1. The Rates apply to the Risk Classification of the Life Insured on the Issue Date.

When the Life Insured reaches Age 121 and above, the Rate is 0.0000000 and the Minimum Death Benefit Factor is 1.0000.

 

Age

   

Rates

   

Minimum Death
Benefit Factors

35    0.0000063    8.1233
36    0.0000238    7.8136
37    0.0000321    7.5224
38    0.0000375    7.2447
39    0.0000427    6.9785
40    0.0001192    6.7231
41    0.0001259    6.4980
42    0.0001343    6.2808
43    0.0001418    6.0715
44    0.0001493    5.8696
45    0.0001526    5.6745
46    0.0001593    5.4853
47    0.0001643    5.3022
48    0.0001710    5.1249
49    0.0001785    4.9533
50    0.0001877    4.7873
51    0.0002019    4.6269
52    0.0002194    4.4725
53    0.0002403    4.3240
54    0.0002620    4.1813
55    0.0002838    4.0444
56    0.0003038    3.9135
57    0.0003231    3.7874
58    0.0003431    3.6658
59    0.0003666    3.5482
60    0.0003959    3.4347
61    0.0004352    3.3256
62    0.0004838    3.2206
63    0.0005383    3.1199
64    0.0005995    3.0234
65    0.0006658    2.9309
66    0.0007371    2.8411
67    0.0008136    2.7550
68    0.0008986    2.6722
69    0.0009946    2.5928
70    0.0011076    2.5165
71    0.0012418    2.4433
72    0.0014024    2.3733
73    0.0015897    2.3065
74    0.0018036    2.2428
75    0.0020428    2.1821
76    0.0023057    2.1242
77    0.0025959    2.0688
78    0.0029180    2.0158

Age

   

Rates

   

Minimum Death
Benefit Factors

79    0.0032871    1.9649
80    0.0037150    1.9160
81    0.0042182    1.8689
82    0.0047848    1.8235
83    0.0054487    1.7795
84    0.0062246    1.7368
85    0.0071351    1.6949
86    0.0082008    1.6534
87    0.0094428    1.6119
88    0.0108684    1.5695
89    0.0124411    1.5251
90    0.0141491    1.4770
91    0.0159380    1.4234
92    0.0177634    1.3686
93    0.0196061    1.3160
94    0.0213714    1.2654
95    0.0229753    1.2167
96    0.0250472    1.1699
97    0.0273075    1.1249
98    0.0298315    1.0817
99    0.0325821    1.0401
100    0.0355207    1.0000
101    0.0383419    1.0000
102    0.0412506    1.0000
103    0.0441953    1.0000
104    0.0471198    1.0000
105    0.0499590    1.0000
106    0.0526466    1.0000
107    0.0566496    1.0000
108    0.0610817    1.0000
109    0.0660194    1.0000
110    0.0715539    1.0000
111    0.0778115    1.0000
112    0.0833330    1.0000
113    0.0833330    1.0000
114    0.0833330    1.0000
115    0.0833330    1.0000
116    0.0833330    1.0000
117    0.0833330    1.0000
118    0.0833330    1.0000
119    0.0833330    1.0000
120    0.0833330    1.0000
121    0.0000000    1.0000
           
           
 

 

4.1

 

 

2. TABLE OF RATES– Policy [12 345 678]

 

ASSET CREDIT RATES

The rates below are used in determining the applicable Asset Credit, as described in Section 7. For Age 121 and above, the Asset Credit Rate is 0.0000%

 

Age

   

Asset Credit Rate

35    0.0000%
36    0.0000%
37    0.0000%
38    0.0000%
39    0.0000%
40    0.0000%
41    0.0000%
42    0.0000%
43    0.0000%
44    0.0000%
45    0.8700%
46    0.8700%
47    0.8600%
48    0.8500%
49    0.8500%
50    0.8400%
51    0.8400%
52    0.8300%
53    0.8300%
54    0.8200%
55    0.8100%
56    0.8100%
57    0.8000%
58    0.8000%
59    0.7900%
60    0.7900%
61    0.7800%
62    0.7800%
63    0.7700%
64    0.7600%
65    0.7600%
66    0.7500%
67    0.7500%
68    0.7400%
69    0.7400%
70    0.7300%
71    0.7300%
72    0.7200%
73    0.7100%
74    0.7100%
75    0.7000%
76    0.7000%
77    0.6900%
78    0.6900%

Age

   

Asset Credit Rate

79    0.6800%
80    0.6700%
81    0.6700%
82    0.6600%
83    0.6600%
84    0.6500%
85    0.6500%
86    0.6400%
87    0.6400%
88    0.6300%
89    0.6200%
90    0.6200%
91    0.6100%
92    0.6100%
93    0.6000%
94    0.6000%
95    0.5900%
96    0.5900%
97    0.5800%
98    0.5700%
99    0.5700%
100    0.5600%
101    0.5600%
102    0.5500%
103    0.5500%
104    0.5400%
105    0.5400%
106    0.5300%
107    0.5200%
108    0.5200%
109    0.5100%
110    0.5100%
111    0.5000%
112    0.5000%
113    0.4900%
114    0.4900%
114    0.4800%
116    0.4800%
117    0.4700%
118    0.4600%
119    0.4600%
120    0.4500%
121    0.0000%
      
 

 

4.2

 

2. TABLE OF RATES– Policy [12 345 678]

 

 

POLICY VALUE CREDIT FACTOR A RATES (“PVC FACTOR A RATES”) AND POLICY VALUE CREDIT FACTOR B RATES (“PVC FACTOR B RATES”)

The PVC Factor A and PVC Factor B Rates have been adjusted for any applicable Additional Ratings shown in Section 1. When the Life Insured reaches Age 121 and above, the PVC Factor A Rate is 0.0000. When the Life Insured reaches Age 100 and above, the PVC Factor B Rate is 0.0000.

 

Age

   

PVC Factor A Rates

   

PVC Factor B Rates

35

    1.0000    787.7087

36

    0.4627    186.9323

37

    0.4092    110.0937

38

    0.4210    83.8650

39

    0.4457    69.7291

40

    0.4341    54.9704

41

    0.4228    44.5572

42

    0.3897    34.9947

43

    0.3688    28.7114

44

    0.3577    24.4510

45

    0.3555    21.3977

46

    0.3449    18.3125

47

    0.3341    15.7853

48

    0.3258    13.7984

49

    0.3179    12.1456

50

    0.3145    10.5694

51

    0.3097    9.2240

52

    0.3078    8.1807

53

    0.3025    7.2192

54

    0.2961    6.3810

55

    0.2811    5.5050

56

    0.2764    4.9406

57

    0.2746    4.4917

58

    0.2742    4.1137

59

    0.2750    3.7917

60

    0.2712    3.4449

61

    0.2748    3.2232

62

    0.2772    3.0102

63

    0.2791    2.8128

64

    0.2813    2.6375

65

    0.3087    2.6950

66

    0.3083    2.5110

67

    0.3085    2.3484

68

    0.3088    2.2008

69

    0.3092    2.0668

70

    0.3089    1.9401

71

    0.3081    1.8222

72

    0.3069    1.7134

73

    0.3054    1.6134

74

    0.3044    1.5254

75

    0.3188    1.5139

76

    0.3170    1.4293

77

    0.3162    1.3562

78

    0.3160    1.2918

Age

   

PVC Factor A Rates

   

PVC Factor B Rates

79    0.3164    1.2350
80    0.3167    1.1827
81    0.3167    1.1342
82    0.3175    1.0927
83    0.3187    1.0565
84    0.3205    1.0258
85    0.3212    0.9956
86    0.3221    0.9702
87    0.3230    0.9493
88    0.3237    0.9328
89    0.3255    0.9249
90    0.3292    0.9282
91    0.3315    0.9351
92    0.3333    0.9508
93    0.3356    0.9821
94    0.3398    1.0401
95    0.3442    1.1332
96    0.3469    1.2920
97    0.3506    1.6273
98    0.3537    2.6236
99    0.3566    10.4000
100    0.3601    0.0000
101    0.3644    0.0000
102    0.3696    0.0000
103    0.3757    0.0000
104    0.3825    0.0000
105    0.3894    0.0000
106    0.3959    0.0000
107    0.4019    0.0000
108    0.4082    0.0000
109    0.4137    0.0000
110    0.4281    0.0000
111    0.4255    0.0000
112    0.4241    0.0000
113    0.4241    0.0000
114    0.4241    0.0000
115    0.4241    0.0000
116    0.4241    0.0000
117    0.4241    0.0000
118    0.4241    0.0000
119    0.4241    0.0000
120    0.4241    0.0000
121    0.0000    0.0000
 

 

4.3

 

2. TABLE OF RATES– Policy [12 345 678]

 

 

POLICY VALUE CREDIT COMPONENT B CUMULATIVE LIMIT

For Age 100 and above, the Policy Value Credit Component B Cumulative Limit is $0.

 

Age

   

Policy Value Credit Component B
Cumulative Limit

35

    $0

36

    $584

37

    $876

38

    $1,184

39

    $1,507

40

    $1,862

41

    $2,237

42

    $2,625

43

    $3,028

44

    $3,449

45

    $3,916

46

    $4,440

47

    $4,989

48

    $5,566

49

    $6,170

50

    $7,014

51

    $7,914

52

    $8,869

53

    $9,877

54

    $10,938

55

    $12,037

56

    $13,187

57

    $14,411

58

    $15,712

59

    $17,096

60

    $18,557

61

    $20,097

62

    $21,707

63

    $23,389

64

    $25,140

65

    $27,000

66

    $28,941

67

    $30,965

68

    $33,074

69

    $35,264

70

    $37,530

Age

   

Policy Value Credit Component B
Cumulative Limit

71    $39,854
72    $42,221
73    $44,617
74    $47,038
75    $49,638
76    $52,280
77    $54,958
78    $57,662
79    $60,389
80    $63,118
81    $65,821
82    $68,492
83    $71,106
84    $73,649
85    $76,049
86    $78,260
87    $80,205
88    $81,802
89    $82,957
90    $83,602
91    $83,602
92    $83,602
93    $83,602
94    $83,602
95    $83,602
96    $83,602
97    $83,602
98    $83,602
99    $83,602
100+    $0
 

 

4.4

 

2. TABLES OF RATES (continued) – Policy [12 345 678]

 

 

MONTHLY DEATH BENEFIT PROTECTION COST OF INSURANCE RATES

The Monthly Death Benefit Protection Cost of Insurance Rates per dollar of Death Benefit Protection Value Net Amount at Risk (“Rates”) are shown below for each Age. The Rates have been adjusted for any applicable Additional Rating applied to the Cost of Insurance Rates as shown in Section 1. For Age 121 and above, the Rate is 0.0000000.

 

Age

   

Rates

35

    0.0000063

36

    0.0000236

37

    0.0000316

38

    0.0000367

39

    0.0000416

40

    0.0000463

41

    0.0000513

42

    0.0000602

43

    0.0000689

44

    0.0000770

45

    0.0000844

46

    0.0000942

47

    0.0001056

48

    0.0001176

49

    0.0001308

50

    0.0001449

51

    0.0001603

52

    0.0001761

53

    0.0001942

54

    0.0002158

55

    0.0002465

56

    0.0002753

57

    0.0003055

58

    0.0003385

59

    0.0003748

60

    0.0004200

61

    0.0004628

62

    0.0005137

63

    0.0005709

64

    0.0006354

65

    0.0006351

Age

   

Rates

66    0.0007039
67    0.0007809
68    0.0008666
69    0.0009637
70    0.0010746
71    0.0012021
72    0.0013495
73    0.0015172
74    0.0031082
75    0.0034681
76    0.0039069
77    0.0043922
78    0.0049308
79    0.0055453
80    0.0062530
81    0.0070817
82    0.0080131
83    0.0090945
84    0.0103500
85    0.0118239
86    0.0135406
87    0.0155304
88    0.0178087
89    0.0203276
90    0.0230630
91    0.0259464
92    0.0288911
93    0.0318737
94    0.0347464
95    0.0373505
96    0.0406415

Age

   

Rates

97    0.0441968
98    0.0481745
99    0.0525099
100    0.0571049
101    0.0615527
102    0.0660975
103    0.0706502
104    0.0751313
105    0.0794648
106    0.0833330
107    0.0833330
108    0.0833330
109    0.0833330
110    0.0833330
111    0.0833330
112    0.0833330
113    0.0833330
114    0.0833330
115    0.0833330
116    0.0833330
117    0.0833330
118    0.0833330
119    0.0833330
120    0.0833330
121    0.0000000
 

 

4.5

 

2. TABLES OF RATES (continued) – Policy [12 345 678]

 

 

DEATH BENEFIT PROTECTION FACE AMOUNT CHARGE RATES

The Death Benefit Protection Face Amount Charge Rates per $1,000 of Face Amount are shown below for each Age. For Age 121 and above, the Death Benefit Protection Face Amount Rate per $1,000 of Face Amount is 0.0000.

 

Age

   

Rate per $1,000 of FaceAmount

35

    0.1403

36

    1.4600

37

    1.4400

38

    1.4900

39

    1.5400

40

    1.6700

41

    1.7800

42

    1.8900

43

    2.0200

44

    2.1600

45

    3.0800

46

    3.1500

47

    3.1900

48

    3.2200

49

    3.2300

50

    3.2100

51

    3.1900

52

    3.1300

53

    3.0600

54

    2.9400

55

    2.9400

56

    2.9700

57

    2.9900

58

    3.0100

59

    3.0300

60

    3.0600

61

    3.0700

62

    3.1000

63

    3.1200

64

    3.1300

65

    3.1600

66

    3.1800

67

    3.2000

68

    3.2200

69

    3.2500

70

    3.2700

71

    3.2900

72

    2.4100

73

    2.4300

74

    2.3600

75

    2.2800

76

    2.2000

77

    2.1100

78

    2.0000

Age

   

Rate per $1,000 of FaceAmount

79    2.0000
80    2.0000
81    2.0000
82    2.0000
83    2.0000
84    2.0000
85    2.0000
86    2.0000
87    2.0000
88    2.0000
89    2.0000
90    2.0000
91    2.0000
92    2.0000
93    2.0000
94    2.0000
95    2.0000
96    2.0000
97    2.0000
98    2.0000
99    2.0000
100    2.0000
101    2.0000
102    2.0000
103    2.0000
104    2.0000
105    2.0000
106    2.0000
107    2.0000
108    2.0000
109    2.0000
110    2.0000
111    2.0000
112    2.0000
113    2.0000
114    2.0000
115    2.0000
116    2.0000
117    2.0000
118    2.0000
119    2.0000
120    2.0000
121    0.0000
 

 

4.6

 

2. TABLES OF RATES (continued) – Policy [12 345 678]

 

 

DEATH BENEFIT PROTECTION ANNUAL INTEREST RATES

Death Benefit Protection Annual Interest Rates are shown below for each Age. For Age 121 and above, the Death Benefit Protection Annual Interest Rate is 0.00%.

 

Age

   

Rate

35

    1.57%

36

    1.46%

37

    1.44%

38

    1.49%

39

    1.54%

40

    1.67%

41

    1.78%

42

    1.89%

43

    2.02%

44

    2.16%

45

    3.08%

46

    3.15%

47

    3.19%

48

    3.22%

49

    3.23%

50

    3.21%

51

    3.19%

52

    3.13%

53

    3.06%

54

    2.94%

55

    2.94%

56

    2.97%

57

    2.99%

58

    3.01%

59

    3.03%

60

    3.06%

61

    3.07%

62

    3.10%

63

    3.12%

64

    3.13%

65

    3.16%

66

    3.18%

67

    3.20%

68

    3.22%

69

    3.25%

70

    3.27%

71

    3.29%

72

    2.41%

73

    2.43%

74

    2.36%

75

    2.28%

76

    2.20%

77

    2.11%

78

    2.00%

Age

   

Rate

79    2.00%
80    2.00%
81    2.00%
82    2.00%
83    2.00%
84    2.00%
85    2.00%
86    2.00%
87    2.00%
88    2.00%
89    2.00%
90    2.00%
91    2.00%
92    2.00%
93    2.00%
94    2.00%
95    2.00%
96    2.00%
97    2.00%
98    2.00%
99    2.00%
100    2.00%
101    2.00%
102    2.00%
103    2.00%
104    2.00%
105    2.00%
106    2.00%
107    2.00%
108    2.00%
109    2.00%
110    2.00%
111    2.00%
112    2.00%
113    2.00%
114    2.00%
115    2.00%
116    2.00%
117    2.00%
118    2.00%
119    2.00%
120    2.00%
121    0.00%
  
 

 

4.7

 

2. TABLES OF RATES (continued) – Policy [12 345 678]

 

 

DEATH BENEFIT PROTECTION BONUS THRESHOLD RATES

The rates below are used in calculating the Death Benefit Protection Value, as described in Section 13. For Age 121 and above, the Death Benefit Protection Bonus Threshold Rate is 100.00%.

 

Age

   

Threshold Rate

35

    1.57%

36

    1.46%

37

    1.44%

38

    1.49%

39

    1.54%

40

    1.67%

41

    1.78%

42

    1.89%

43

    2.02%

44

    2.16%

45

    3.08%

46

    3.15%

47

    3.19%

48

    3.22%

49

    3.23%

50

    3.21%

51

    3.19%

52

    3.13%

53

    3.06%

54

    2.94%

55

    2.94%

56

    2.97%

57

    2.99%

58

    3.01%

59

    3.03%

60

    3.06%

61

    3.07%

62

    3.10%

63

    3.12%

64

    3.13%

65

    3.16%

66

    3.18%

67

    3.20%

68

    3.22%

69

    3.25%

70

    3.27%

71

    3.29%

72

    2.41%

73

    2.43%

74

    2.36%

75

    2.28%

76

    2.20%

77

    2.11%

78

    2.00%

Age

   

Threshold Rate

79    2.00%
80    2.00%
81    2.00%
82    2.00%
83    2.00%
84    2.00%
85    2.00%
86    2.00%
87    2.00%
88    2.00%
89    2.00%
90    2.00%
91    2.00%
92    2.00%
93    2.00%
94    2.00%
95    2.00%
96    2.00%
97    2.00%
98    2.00%
99    2.00%
100    2.00%
101    2.00%
102    2.00%
103    2.00%
104    2.00%
105    2.00%
106    2.00%
107    2.00%
108    2.00%
109    2.00%
110    2.00%
111    2.00%
112    2.00%
113    2.00%
114    2.00%
115    2.00%
116    2.00%
117    2.00%
118    2.00%
119    2.00%
120    2.00%
121    100.00%
  
 

 

17

 

3. DEFINITIONS

 

Listed below are some terms that have specific meanings in your policy. Please refer to these definitions as you read your policy. Other terms may be defined in the body of your policy.

Additional Rating means an adjustment to the underwriting class that is applied when a Life Insured does not meet, at a minimum, our underwriting requirements for the Standard Risk Classification.

Age means, on any Policy Anniversary, the age of the Life Insured at his or her birthday nearest that date.

Annual Processing Date means every 12th Processing Date following the Policy Date.

Business Day means any day that we are open for business and the New York Stock Exchange is open for trading. The net asset value of the underlying shares of a Subaccount will be determined at the end of each Business Day. We will deem each Business Day to end at the close of regularly scheduled trading of the New York Stock Exchange (currently 4:00 p.m. Eastern Time) on that day.

Cash Surrender Value means the Policy Value less the Surrender Charge.

Evidence of Insurability means evidence satisfactory to us related to the current health, lifestyle, financial and other circumstances that may impact the insurability of the individual.

Fixed Account means that part of the Policy Value reflecting the value you have in our general account.

Fund means each division, with a specific investment objective, of a Series Fund.

In Force means that the policy has not terminated in accordance with Sections 13, 14, or 15, or surrendered in accordance with Section 12.

Investment Account means that part of the Policy Value reflecting the value you have in a Subaccount.

Issue Date means the date shown in Section 1 of this policy from which the Suicide and Incontestability provisions are applied.

Loan Account means that part of the Policy Value that reflects amounts transferred from the Fixed Account or the Investment Accounts as collateral for a policy loan as described in Section 11.

Minimum Initial Premium means the minimum premium needed to put the policy In Force when the Issue Date is on or before the Policy Date as shown in Section 1.

Net Amount at Risk means an amount used for the purpose of calculating the Cost of Insurance charges as described in Section 7.

Net Cash Surrender Value means the Cash Surrender Value less the Policy Debt.

Net Policy Value means the Policy Value less the value in the Loan Account.

Net Premium means the gross premium paid less any Premium Charge.

Partial Surrender Charge Decrease Exemption Amount at any time means the Partial Surrender Charge Decrease Exemption shown in Section 1, multiplied by the Face Amount at Issue, reduced by cumulative decreases in the Face Amount. This amount will never be less than zero.

Planned Premium means the premium that is stated in the application for the policy that is intended to be paid on a regular modal basis. It is shown in Section 1.

Policy Date means the date from which charges for the first Monthly Deductions are calculated. The Policy Date is shown in Section 1. Policy Years, Policy Months, and Policy Anniversaries are determined from the Policy Date.

Policy Debt means as of any date (a) plus (b) plus (c), minus (d), where:

 

  (a)

is the total amount of loans borrowed as of such date;

 

  (b)

is the total amount of any unpaid loan interest charges borrowed against the policy on a Policy Anniversary;

 

  (c)

is any interest charges accrued from the prior Policy Anniversary to the current date; and

 

  (d)

is the total amount of loan repayments as of such date.

Policy Value means the sum of the values in the Loan Account, the Investment Accounts, and the Fixed Account.

 

5

 

3. DEFINITIONS (continued)

 

 

Policy Year means (a) or (b) below, whichever is applicable.

 

  (a)

The first Policy Year is the period beginning on the Policy Date and ending on the day immediately preceding the first Annual Processing Date.

 

  (b)

Each subsequent Policy Year is the period beginning on an Annual Processing Date and ending on the day immediately preceding the next Annual Processing Date.

Processing Date means the first day of a Policy Month. A Policy Month shall begin on the day in each calendar month that corresponds to the day of the calendar month on which the Policy Date occurred. If the Policy Date is the 29th, 30th, or 31st day of a calendar month, then for any calendar month that has fewer days, the first day of the Policy Month will be the last day of such calendar month. The Policy Date is not a Processing Date.

Service Office means the office that we designate to service this policy as shown on the back cover of your policy.

Separate Account means Separate Account A of the John Hancock Life Insurance Company (U.S.A.).

Series Fund means a series type mutual fund registered under the Investment Company Act of 1940 as an open-end diversified management investment company.

Subaccount refers to one of the subaccounts of the Separate Account.

Surrender Charge Period means the number of years during which we will assess Surrender Charges. The Surrender Charge Period is shown in Section 1.

Surrender Date means the end of the Business Day on which we receive at our Service Office your Written Request for full surrender of the policy.

We, us, and our refer only to the Company.

Written Request means a request in a form satisfactory to us that is signed and dated by you, and received at our Service Office; or, if permitted by our administrative practices, an e-mail received by us at the internet address specified by us for such requests.

You and your refer only to the owner of this policy.

 

 

4. INSURANCE BENEFIT

 

If the Life Insured dies while the policy is In Force, we will pay the Insurance Benefit upon receipt of due proof of death of the Life Insured, subject to any applicable provisions of the policy. If the Life Insured dies on or after the Surrender Date, no Insurance Benefit will be paid. Instead, we will pay the amount payable under the Surrenders and Withdrawals provision.

Insurance Benefit

The Insurance Benefit payable is the greater of (a) or (b), where:

 

  (a)

is the Minimum Death Benefit as described below minus any outstanding Policy Debt, both at the date of death of the Life Insured; and

 

  (b)

is an amount equal to (i) plus (ii) minus (iii), where:

 

  (i)

is the Death Benefit as described below;

 

  (ii)

is any amount payable under any supplementary benefit riders as a result of the Life Insured’s death that form part of the policy;

 

  (iii)

is any outstanding Policy Debt at the date of death.

If the Life Insured dies during a Grace Period, the Insurance Benefit will be reduced by any outstanding Monthly Deductions due.

 

6

 

4. INSURANCE BENEFIT (continued)

 

 

Death Benefit

The Death Benefit will depend on whether Death Benefit Option 1 or Death Benefit Option 2 is in effect on the date of the Life Insured’s death.

Death Benefit Options

Under Death Benefit Option 1, the Death Benefit is equal to the Face Amount at the date of death of the Life Insured. Under Death Benefit Option 2, the Death Benefit is equal to the Face Amount at the date of death of the Life Insured plus the Policy Value at the date of death of the Life Insured.

If any withdrawals are made, the Death Benefit will be less than it would have been if no withdrawals were made (regardless of whether Death Benefit Option 1 or Death Benefit Option 2 is in effect). Withdrawals reduce the Death Benefit by reducing:

 

  (a)

the Face Amount if Death Benefit Option 1 is in effect, as described in Section 12; or

 

  (b)

the Policy Value if Death Benefit Option 2 is in effect.

Change of Death Benefit Options

You may request in writing to change your Death Benefit Option from Death Benefit Option 2 to Death Benefit Option 1 at any time after the first Policy Year, while the policy is In Force. The change will be effective on the Processing Date following the date we approve the request, and the Face Amount after the change will be equal to the Face Amount immediately before the change plus the Policy Value as of the effective date of the change. You may not change your Death Benefit Option from Death Benefit Option 1 to Death Benefit Option 2 at any time.

Minimum Death Benefit

If the sum of the Death Benefit as described above and the benefit payable upon the death of the Life Insured under any supplementary benefit riders is less than the Minimum Death Benefit, we will use the Minimum Death Benefit when determining the Insurance Benefit payable. The Minimum Death Benefit on any date is equal to the Minimum Death Benefit Factor for the Age of the Life Insured multiplied by the greater of the Policy Value or the Cash Surrender Value as defined in the federal income tax laws, on the date of death of the Life Insured. The Minimum Death Benefit Factors are shown in Section 2. However, at no time will the Minimum Death Benefit be less than the amount required to maintain qualification of this policy as a life insurance contract for federal income tax purposes. We reserve the right to modify the Minimum Death Benefit Factors shown in Section 2, retroactively if necessary, to maintain qualification of this policy as a life insurance contract for federal income tax purposes, notwithstanding any other provisions of this policy to the contrary.

To the extent that the Net Amount at Risk associated with the Minimum Death Benefit that results from this calculation exceeds our guidelines and limitations that may be in effect, we reserve the right to:

 

  (a)

distribute to you a portion of the Policy Value such that the Net Amount at Risk associated with the resulting Minimum Death Benefit does not exceed our guidelines and limitations in effect; or

 

  (b)

if we should decide to accept the additional Death Benefit, it will be subject to our normal underwriting practices including Evidence of Insurability.

 

 

5. FACE AMOUNT

 

The Face Amount at Issue is shown in Section 1.

Increase in Face Amount

You may not increase the Face Amount under this policy. However, if you request a change in your Death Benefit Option from Death Benefit Option 2 to Death Benefit Option 1, it will result in an increase of the Face Amount. Refer to the Change of Death Benefit Options provision in Section 4.

 

7

 

5. FACE AMOUNT (continued)

 

 

Reduction of Face Amount

You may request a reduction in Face Amount any time after the first Policy Year while this policy is In Force. The Minimum Face Amount Decrease is shown in Section 1. Without our prior approval, the Face Amount cannot be reduced below the Minimum Face Amount shown in Section 1. Any reduction in Face Amount will be effective on the next Processing Date after the date we approve the request for the decrease. Upon completion of your request, you will receive a policy amendment reflecting the requested change.

If you decrease the Face Amount during the Surrender Charge Period, we will deduct a pro-rata Surrender Charge from the Net Policy Value. A requested reduction in Face Amount is only allowed if the pro-rata Surrender Charge for the reduction is less than or equal to the Policy Value.

The pro-rata Surrender Charge deducted will equal (a) multiplied by (b), divided by (c), where:

 

  (a)

is the Surrender Charge that would have applied if the policy had been surrendered on the date the reduction in Face Amount takes effect;

 

  (b)

is the amount of the reduction in Face Amount that exceeds the Partial Surrender Charge Decrease Exemption Amount; and

 

  (c)

is the amount of Face Amount in effect immediately before the reduction, less any applicable Partial Surrender Charge Decrease Exemption Amount.

Each time we deduct the pro-rata Surrender Charge for a Face Amount decrease, we will reduce the remaining Surrender Charge in the same proportion that the Surrender Charge deducted bears to the total Surrender Charge immediately before the Face Amount decrease.

We will also deduct a pro-rata Surrender Charge if a withdrawal, as described in Section 12, results in a reduction in Face Amount. However, for purposes of calculating this Surrender Charge, we will assume the Partial Surrender Charge Decrease Exemption Amount is equal to zero.

 

 

6. PREMIUMS

 

The Minimum Initial Premium is shown in Section 1. No insurance will take effect under this policy until our underwriters approve issuance of this policy and the conditions specified in the application form have been satisfied, including receipt of at least the Minimum Initial Premium at our Service Office.

In the event the Issue Date is later than the Policy Date, the Minimum Initial Premium due will be the Minimum Initial Premium shown in Section 1, plus an additional amount which is equal to the Minimum Initial Premium multiplied by the number of intervening Processing Dates.

Subsequent premiums can be paid on any Business Day at our Service Office, and in any amount subject to the limits described below. We reserve the right to limit the dollar amount of any premiums paid.

If coverage under the policy takes effect in accordance with the provisions of the application, we will process any premium payment as of the end of the Business Day the payment is received at our Service Office, unless one of the following exceptions applies.

 

  (a)

We will process a payment received prior to the Policy Date as if received on the Policy Date.

 

  (b)

We will process the portion of any premium payment for which we require Evidence of Insurability for the Life Insured on the first Business Day after we have received such evidence.

 

  (c)

If our receipt of any premium payment (or portion thereof) would cause the policy to be treated as a Modified Endowment Contract under federal income tax law, we will process the payment (or portion thereof) on the first Business Day after we have received satisfactory written confirmation from you indicating you understand the consequences of the policy being treated as a Modified Endowment Contract.

You may pay premiums until the Life Insured reaches Age 121, at which time Monthly Deductions cease and no further premiums may then be paid.

If any premium payment would result in the Minimum Death Benefit exceeding the Face Amount, we reserve the right to either refund the premium or to require additional underwriting, including Evidence of Insurability, for any excess of the Minimum Death Benefit over the Face Amount.

 

8

 

6. PREMIUMS (continued)

 

 

Continuation of Insurance Upon Discontinuance of Premium Payments

Regardless of whether you continue paying premiums, we will continue taking the Monthly Deductions from the Policy Value until the Life Insured reaches Age 121. Your insurance coverage will continue subject to the Death Benefit Protection, Grace Period, and Policy Termination provisions in Sections 13, 14, and 15.

Returned or Protested Payments

The Company does not accept checks or other instruments unconditionally and therefore, any purported payment(s) submitted to the Company by check or any other instrument including a wire transfer, whether or not credited to the policy by the Company, which is returned or protested does not constitute payment. The Company undertakes no duty to notify any person of a returned or protested payment, except as may be required by applicable law. Any information about the policy, including but not limited to verifications of coverage and policy values provided in any form by the Company on account of such submission(s) is not valid and shall not constitute a waiver or estoppel with respect to any of the terms or conditions of the policy. Such submissions will not prevent or delay a default or termination and do not extend the time for payment or any Grace Period as provided for under the policy.

 

 

7. POLICY VALUE

 

The Policy Value at any time is equal to the sum of the values you have in the Loan Account, the Fixed Account, and the Investment Accounts. Descriptions of the Fixed Account, the Investment Accounts, and the Loan Account can be found in Section 8.

Net Premiums Added

When we receive your premium payments at our Service Office, we deduct a Premium Charge as shown in Section 1, and then allocate the balance remaining (the Net Premium) to the Policy Value. We will do this before we take any other deductions due on that Business Day. We will add any Net Premiums received before the Policy Date to your Policy Value as of the Policy Date.

For any premiums received prior to the Issue Date, we will credit interest at the rate of return then being earned on allocations to the current money market Investment Account but will not deduct a Premium Charge. The interest credited may be taxable. The Premium Charge will be deducted on the Issue Date, and the balance remaining will be the Policy Value from which other deductions will be taken and to which any subsequent Net Premiums will be added.

Allocation of the initial premium payment and any subsequent premium payments will be in accordance with the Premium Allocations provision of Section 10.

Monthly Deductions

A Monthly Deduction is due and will be taken from your Policy Value as of the Policy Date and as of each applicable subsequent Processing Date, including during a Grace Period. Monthly Deductions are calculated from the Policy Date. If, at your request, we set the Policy Date to a date that precedes the date on which we receive the initial premium, Monthly Deductions due for the period prior to receipt of the initial premium will be taken on the later of the date we receive the initial premium and the policy Issue Date.

Unless we agree otherwise, or you do not have sufficient funds in the Fixed Account or the Investment Accounts, we will take Monthly Deductions from the Fixed Account and the Investment Accounts in the same proportion that the Policy Value in each of the accounts bears to the Net Policy Value immediately prior to the deduction.

Monthly Deductions are due until the Policy Anniversary on which the Life Insured reaches Age 121, at which time we will cease to take any further Monthly Deductions as described in Section 17.

 

9

 

7. POLICY VALUE (continued)

 

 

The Monthly Deduction for any Policy Month that will be deducted from the Policy Value consists of charges (a) through (f) listed below, where:

 

  (a)

is the Administrative Charge;

 

  (b)

is the Face Amount Charge, if any;

 

  (c)

is the Asset-Based Risk Charge;

 

  (d)

is the sum of the charges for supplementary benefit riders that do not have a cost of insurance charge;

 

  (e)

is the Cost of Insurance Charge; and

 

  (f)

is the Advance Contribution Charge, if applicable;

Advance Contribution Charge

The Advance Contribution Charge will be equal to the Advance Contribution Charge Rate, shown in Section 1, times the greater of zero, or (a) minus (b), where:

 

  (a)

is the sum of the premiums paid to date; and

 

  (b)

is the Advance Contribution Limit multiplied by the current Policy Year.

Pursuant to the above formula, the Advance Contribution Charge will be equal to zero if the sum of the premiums paid to date is less than or equal to the Advance Contribution Limit times the current Policy Year.

Cost of Insurance Charge

The Cost of Insurance Charge, which includes the current cost of insurance rate for any supplementary benefit rider that has a cost of insurance charge, for a specific Policy Month is equal to the current Cost of Insurance Rate for that month multiplied by the Net Amount at Risk.

We may adjust the Cost of Insurance Rates, including the cost of insurance rates for any supplementary benefit rider that has a cost of insurance charge, at any time based on our expectations of future experience including mortality, persistency, investment earnings, expenses, taxes, reserve and capital requirements, and reinsurance costs. These rates, however, will never exceed the corresponding Maximum Monthly Cost of Insurance Rates shown in Section 2. Each Cost of Insurance Charge is deducted in advance of the applicable insurance coverage for which we are at risk.

Net Amount at Risk

On the Policy Date and on each subsequent Processing Date we will determine a Net Amount at Risk used to calculate the Cost of Insurance Charge. The Net Amount at Risk is the amount determined by subtracting (a) from the greater of (b) or (c), where:

 

  (a)

is the Policy Value;

 

  (b)

is the Face Amount plus the Death Benefit payable under any supplementary benefit riders that have a cost of insurance charge, divided by the Death Benefit Discount Factor shown in Section 1, plus the Policy Value if Death Benefit Option 2 has been elected for this policy; and

 

  (c)

is the Minimum Death Benefit as defined in Section 4.

The values used to calculate the Net Amount at Risk, including the values used to determine the Minimum Death Benefit, are determined on the Processing Date after any Net Premium is applied and Monthly Deductions other than the Cost of Insurance Charge are taken.

Other Deductions

We will deduct a Surrender Charge, as described in Sections 5 and 12, if during the Surrender Charge Period:

 

  (a)

you surrender this policy for its Net Cash Surrender Value;

 

  (b)

you withdraw part of the Net Cash Surrender Value;

 

  (c)

you request a reduction in the Face Amount that exceeds the Partial Surrender Charge Decrease Exemption Amount; or

 

  (d)

you do not pay the Default Payment described in Section 14, and your policy terminates.

 

10

 

7. POLICY VALUE (continued)

 

 

Change of Risk Classification and/or Additional Rating

Written Requests for a rate reconsideration to a more favorable underwriting class from your current Risk Classification and/or Additional Rating may be submitted to us after issue while this policy is In Force. If approved, these rate reconsiderations will become part of your policy. Our procedures for rate reconsiderations require completion of an application and we will apply the underwriting rules that are current at the time of application for the rate reconsideration. If approved, your policy charges, credits, and values will be based on the more favorable rate reclassification. The reclassification will be effective on the Processing Date following the date we approve the request. We recommend that you request and review a current policy illustration upon a change in rate reclassification. For additional details, please contact your agent or our Service Office at the telephone number on the back of this policy. Approval of a more favorable Risk Classification and/or Additional Rating may require adjustments to limits under federal tax laws. We will notify you if premiums are required to be returned to you in order to avoid adverse tax consequences. Please consult a tax advisor before proceeding with the reclassification.

Policy Value Credit

On each Processing Date, we will apply a Policy Value Credit, if any, to the Policy Value. This Policy Value Credit is equal to the greater of zero or Policy Value Credit Component A minus Policy Value Credit Component B, both described below. In no event, however, will the Policy Value Credit exceed the Cost of Insurance Charge.

The values used to calculate the Policy Value Credit are determined on the Processing Date after any Net Premium is applied and Monthly Deductions are taken. The Policy Value Credit will be applied to the Investment Accounts and the Fixed Account proportionately in the same manner as Monthly Deductions are taken.

Policy Value Credit Component A

Policy Value Credit Component A is equal to Policy Value Credit Factor A multiplied by the Face Amount at the time of the calculation. Policy Value Credit Factor A is equal to the lesser of (a) and (b), where:

 

  (a)

is equal to the Policy Value Credit Factor A Rate for the Age of the Life Insured, shown in Section 2, multiplied by the Cost of Insurance Rate for that month; and

 

  (b)

is equal to the Policy Value Credit Factor A Limit Rate, shown in Section 1, multiplied by the Maximum Monthly Cost of Insurance Rate for the Age of the Life Insured, shown in Section 2.

Policy Value Credit Component B

Policy Value Credit Component B is equal to the greater of zero, or Policy Value Credit Component A minus the result of multiplying the Policy Value at the time of the calculation by Policy Value Credit Factor B. In no event, however, will Policy Value Credit Component B be greater than the Policy Value Credit Component B Limit described below. When the Life Insured reaches Age 100 and above, Policy Value Credit Component B is zero.

Policy Value Credit Factor B is equal to the Policy Value Credit Factor B Rate for the Age of the Life Insured, shown in Section 2, multiplied by the Cost of Insurance Rate for that month. The Policy Value Credit Component B Limit is equal to the greater of zero, or the Policy Value Credit Component B Cumulative Limit for the Age of the Life Insured, shown in Section 2, minus the sum of the Policy Value Credit Component B amounts used in the calculation of the Policy Value Credit in all prior Policy Months.

Asset Credit

On each Processing Date beginning in the Asset Credit Commencement Year, we will apply an Asset Credit to the Fixed Account and Investment Accounts proportionately in the same manner as Monthly Deductions are taken. .

The Asset Credit is equal to (a) multiplied by (b), where:

 

  (a)

is the Asset Credit Rate for the Age of the Life Insured;

 

  (b)

is the lesser of the Net Policy Value and the Face Amount.

For purposes of calculating the Asset Credit, the Net Policy Value is determined on the Processing Date before any Monthly Deductions are taken.

The Asset Credit Commencement Year is shown in Section 1. The Asset Credit Rates are shown in Section 2.

 

11

 

8. LOAN ACCOUNT, FIXED ACCOUNT, AND INVESTMENT ACCOUNTS

 

The Policy Value equals the sum of the values in the Loan Account, the Fixed Account, and the Investment Accounts, as described below.

Loan Account Value

The Loan Account reflects amounts transferred from the Fixed Account or the Investment Accounts as collateral for a portion of the Policy Debt as described in Section 8.

The amount you have in the Loan Account at any time equals:

 

  (a)

amounts transferred to it from the Fixed Account or an Investment Account for loans or borrowed loan interest; plus

 

  (b)

interest credited to it; less

 

  (c)

amounts transferred from it to the Fixed Account or an Investment Account for loan repayments.

For details regarding loan processing, see Section 11.

Fixed Account Value

The Fixed Account is that part of the Policy Value, not in the Investment Accounts or the Loan Account, that receives a declared rate of interest.

The portion of the Policy Value in the Fixed Account at any time equals:

 

  (a)

the portion of Net Premiums allocated to it; plus

 

  (b)

amounts transferred to it from the Loan Account; plus

 

  (c)

amounts transferred to it from an Investment Account; plus

 

  (d)

interest credited to it; plus

 

  (e)

the portion of any Policy Value Credit allocated to it; plus

 

  (f)

the portion of any Asset Credit allocated to it; less

 

  (g)

the portion of Monthly Deductions deducted from it; less

 

  (h)

amounts transferred from it to the Loan Account; less

 

  (i)

the portion of withdrawals, including any applicable charges taken from it; less

 

  (j)

amounts transferred from it to an Investment Account.

Interest

We may adjust the rate or rates of interest we credit to the Fixed Account at any time based on our expectations for future experience including investment earnings, persistency, mortality, expenses, taxes, reserve and capital requirements, and reinsurance costs. However, in no event will we credit interest to the Fixed Account at a rate that is less than the Minimum Fixed Account Annual Rate shown in Section 1.

Any interest to be credited to the Fixed Account will be credited no less frequently than annually. Any interest credited to the Fixed Account in excess of the Minimum Fixed Account Annual Rate is nonforfeitable, except indirectly due to surrender charges.

 

12

 

8. LOAN ACCOUNT, FIXED ACCOUNT, AND INVESTMENT ACCOUNTS (continued)

 

 

Investment Account Value

The amount you have in an Investment Account at any time equals the number of units in that Investment Account multiplied by the unit value of the corresponding Subaccount at that time.

The number of units in an Investment Account at any time equals (a) minus (b), where:

 

  (a)

is the number of units credited to the Investment Account because of:

 

  (i)

Net Premiums allocated to it; and

 

  (ii)

amounts transferred to it from the Loan Account, the Fixed Account, or another Investment Account; and

 

  (iii)

the portion of any Policy Value Credit applied to it; and

 

  (iv)

the portion of any Asset Credit applied to it; and

 

  (b)

is the number of units canceled from the Investment Account because of:

 

  (i)

the portion of Monthly Deductions subtracted from it;

 

  (ii)

the portion of withdrawals deducted from it; and

 

  (iii)

amounts transferred from it to the Loan Account, the Fixed Account, or another Investment Account.

The number of units credited or canceled for a given transaction is equal to the dollar amount of the transaction, divided by the unit value on the Business Day of the transaction. See the Unit Value Calculation provision in Section 9 for details on how unit values are determined.

 

 

9. SEPARATE ACCOUNT AND SUBACCOUNTS

 

Each Subaccount of the Separate Account purchases shares of a corresponding Fund of a Series Fund. The assets of the Separate Account are the property of the Company. They are used to support the Policy Values of variable life insurance policies. Income, gains, and losses of the Separate Account are credited to, or charged against, the Separate Account without regard to other income, gains, and losses. The part of the assets that is equal to the Investment Account values in respect of all variable life insurance policies will not be charged with liabilities from any other business we conduct. We can transfer to our general account the Separate Account assets in excess of the liabilities of the Separate Account arising under the variable life insurance policies supported by the Separate Account.

Right to Make Changes

We reserve the right to make certain changes if, in our judgment, they would best serve the interests of the owners of policies such as this or would be appropriate in carrying out the purposes of such policies. Any changes will be made only to the extent and in the manner permitted by applicable laws. Also, when required by law, we will obtain your approval of the changes and approval from any appropriate regulatory authority.

Examples of the changes we may make include the following:

 

  (a)

To operate a Separate Account in any form permitted under the Investment Company Act of 1940, or in any other form permitted by law.

 

  (b)

To take any action necessary to comply with or obtain and continue any exemptions from the Investment Company Act of 1940.

 

  (c)

To create new separate accounts, or to combine any two or more separate accounts including the Separate Account, or to de-register the Separate Account under the Investment Company Act of 1940, or to transfer assets between the Separate Account and other separate accounts.

 

  (d)

To transfer any assets in a Subaccount to another Subaccount, or to add, combine or remove

 

  Subaccounts.

 

  (e)

To substitute, for the investment company shares held in any Subaccount, another class of shares of the investment company or the shares of another investment company or any other investment permitted by law.

 

  (f)

To make any other necessary technical changes in this policy in order to conform with any action this provision permits us to take.

 

13

 

9. SEPARATE ACCOUNT AND SUBACCOUNTS (continued)

 

 

The investment policy of a Subaccount within the Separate Account shall not be materially changed unless a statement of the change is first filed with any jurisdiction requiring such a filing. In the event of such a change in investment policy, and while this policy is In Force, you may elect a transfer to the Fixed Account as described in Section 10.

Unit Value Calculation

We will determine the unit values for each Subaccount as of the end of each Business Day.

For any Business Day, the unit value for a Subaccount is determined by multiplying the unit value for the immediately preceding Business Day by the net investment factor.

The net investment factor for a Subaccount on any Business Day is equal to (a) divided by (b) where:

 

  (a)

is the net asset value of the underlying Fund shares held by that Subaccount as of the end of such Business Day before any policy transactions are made on that day; and

 

  (b)

is the net asset value of the underlying Fund shares held by that Subaccount as of the end of the immediately preceding Business Day after all policy transactions were made for that day.

We reserve the right to adjust the above formula for any taxes determined by us to be attributable to the operations of the Subaccount.

 

 

10. ALLOCATIONS AND TRANSFERS

 

Allocation Instructions

Allocation instructions are your instructions for how amounts should be allocated among the Fixed Account and the Investment Accounts.

Net Premium allocation instructions are initially elected on your application for this policy and take effect on the Allocation Date shown in Section 1. We reserve the right to limit the dollar amount and to set minimum and maximum percentages that may be allocated to the Fixed Account or any Investment Account.

You may elect to change your allocation instructions for future premium payments at any time by Written Request. A change will be effective as of the end of the Business Day on which we receive such Written Request. Any change you request to premium allocation instructions will affect the allocation of future premiums, but will not change the allocation of any previous premium payments made. We reserve the right to impose a limit on the number and frequency of such changes.

Premium Allocations

We process Net Premiums as described in Section 6. Any Net Premium credited to the Policy Value prior to the Allocation Date will automatically be invested in the current money market Investment Account. On the Allocation Date (or on the date such Net Premium is received, if later), we will reallocate the amount in the current money market Investment Account attributable to any such Net Premium in accordance with the allocation instructions then in effect. We will allocate all subsequent Net Premiums to the Fixed Account and any Investment Accounts in accordance with the allocation instructions then in effect.

Transfers

In the same way as described above in the Premium Allocations provision, instructions may be given to us at any time while the policy is In Force to transfer portions of the Policy Value among the Investment Accounts and the Fixed Account. Transfers are subject to the restrictions described below.

General Restrictions on Transfers

You can make up to two transfers per calendar month. You can transfer 100% of the Policy Value to the current money market Investment Account after this limit has been reached. If such transfer to the current money market Investment Account is made, no subsequent transfers from the current money market Investment Account to another Investment Account may be made within 30 days.

 

14

 

10. ALLOCATIONS AND TRANSFERS (continued)

 

 

There is no charge for the first 12 transfers in any Policy Year. If you make more than 12 transfers in any Policy Year, a transfer fee not to exceed the Maximum Transfer Fee shown in Section 1 will apply to each subsequent transfer in the Policy Year. We will consider all transfer requests made on the same Business Day as one transfer. Transfers made pursuant to the Asset Allocation Balancer or Dollar Cost Averaging options described below are not subject to the foregoing general restrictions. Without our approval, the maximum amount that may be transferred to or from an Investment Account in any Policy Year may not exceed the Investment Account Maximum Transfer Amount shown in Section 1.

We reserve the right to impose additional restrictions to restrict short-term trading. Additional restrictions that may be imposed regarding transfers include, but are not limited to restricting:

 

  (a)

the number of transfers made during a defined period;

 

  (b)

the dollar amount of transfers;

 

  (c)

the method used to submit transfers; and

 

  (d)

transfers into and out of certain Investment Accounts.

We or a Series Fund in which the Separate Account invests may impose limits on transfer amounts or impose additional restrictions to limit or terminate transfer privileges, at any time.

Restrictions on Transfers to the Fixed Account

You may transfer the Policy Value from any of the Investment Accounts to the Fixed Account without incurring any transfer charges, regardless of the number of transfers previously made, provided such transfers:

 

  (a)

occur within 18 months after the Issue Date, as shown in Section 1; or

 

  (b)

occur within the later of (i) or (ii) where (i) is 60 days from the effective date of a material change in the investment objectives of the Subaccount, from which the Policy Value will be transferred, and (ii) is 60 days from the notification date of such change.

Restrictions on Transfers out of the Fixed Account

The maximum amount that you can transfer out of the Fixed Account in any one Policy Year is limited to the greater of:

 

  (a)

the Fixed Account Maximum Transfer Percentage shown in Section 1 multiplied by the value in the Fixed Account at the previous Annual Processing Date;

 

  (b)

the Fixed Account Maximum Transfer Amount shown in Section 1; and

 

  (c)

the amount transferred out of the Fixed Account during the previous Policy Year.

Any transfer out of the Fixed Account may not involve a transfer to the current money market Investment Account.

If any transfer out of the Fixed Account would reduce the amount you have in your Fixed Account below $500, we will transfer out the entire value of the Fixed Account.

We reserve the right, in our sole discretion, to waive the transfer restrictions on the Fixed Account. Please contact us or your registered representative to determine if a waiver is currently in effect.

Asset Allocation Balancer Transfers

If you elect this option, we will automatically transfer amounts among your specified Investment Accounts in order to maintain your designated percentage in each account. We will effect the transfers at specified intervals you select which may be either annually, semi-annually, quarterly, or monthly. When you change your premium allocation instructions, your Asset Allocation Balancer will change so the two are

identical. This change will automatically occur unless you instruct us otherwise, or a Dollar Cost Averaging request is in effect. We reserve the right to cease to offer this option as of 90 days after we send you written notice.

Dollar Cost Averaging Transfers

If you elect this option, we will automatically transfer amounts each month from an Investment Account you select to your choice of one or more of the other Investment Accounts or the Fixed Account. You must select the amount to be transferred. If the value in the Investment Account from which the transfer is being made is insufficient to cover the transfer amount, we will not effect the transfer and we will notify you. We reserve the right to cease to offer this option as of 90 days after we send you written notice.

 

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11. LOANS

 

At any time while this policy is In Force and there is Available Loan Value, you can apply for a loan by Written Request. Each loan must be at least equal to the Minimum Loan Amount shown in Section 1. The Policy Value serves as the only security for a loan, and, as such, we may require a signed loan document to formalize this agreement. We may defer loans as provided in Section 24. Loans may not be made if the policy is in the Grace Period as described in Section 14.

Available Loan Value

The Available Loan Value is a projection of the Net Cash Surrender Value we make at the time you apply for a loan. The Available Loan Value on any date will be an amount equal to the Cash Surrender Value as adjusted by the following:

 

  (i)

projecting the Available Loan Value at the Minimum Fixed Account Annual Rate from the date of the loan to the following Policy Anniversary assuming no premiums and no withdrawals; and

 

  (ii)

the Available Loan Value is reduced by the Policy Debt;

 

  (iii)

the Available Loan Value is reduced by loan interest in advance to the end of the current Policy Year.

In no event, however, will the Available Loan Value be less than 90% of the Net Cash Surrender Value. Values will be determined, subject to Section 27, as of the end of the Business Day on which the loan application is received at our Service Office.

Loan Interest Charged

Interest will accrue daily on Policy Debt at an effective rate equal to the Loan Interest Charged Annual Rate, as shown in Section 1. This rate will apply to the portion of debt that is collateralized by the Loan Account.

We will increase the Loan Interest Charged Annual Rate at any time it is determined that the rate being charged would cause a loan to be taxable under any applicable ruling, regulation, or court decision. In such case, we will increase the Loan Interest Charged Annual Rate to an amount that would result in the transaction being treated as a loan under federal tax law.

Loan interest is charged in arrears and is due on each Annual Processing Date and on any date you make a loan repayment. Accrued interest may be paid at any time. In the event that you do not pay the Loan Interest Charged when it is due, the loan interest will be borrowed against the policy (capitalized) and added to the Policy Debt on the Annual Processing Date. We will allocate the amount borrowed for interest payment as described in the Loan Account provision below.

Loan interest will continue to be charged, as described in Section 17, when Monthly Deductions and premium payments cease when the Life Insured has reached Age 121.

Loan Account Interest Credited

Loan interest is credited to the Loan Account and accrues daily. The annual effective rate of interest credited to the Loan Account is equal to the Loan Interest Charged Annual Rate minus the Loan Interest Credited Differential. We may adjust the Loan Interest Credited Differential at any time based on our expectations for future experience including investment earnings, persistency, mortality, expenses, taxes, reserve and capital requirements, and reinsurance costs. The Loan Interest Credited Differential will not exceed the Maximum Loan Interest Credited Differential shown in Section 1.

Loan Account

When you take a loan, or when accrued interest is capitalized, we will transfer amounts from the Fixed Account and the Investment Accounts to the Loan Account in the same proportion that the Policy Value in each of these accounts bears to the Net Policy Value. When we transfer an amount from an Investment Account to the Loan Account, we will redeem units of that Investment Account that are equal to the amount transferred. These transfers do not count as a transfer for the purposes of the Transfer provisions described in Section 10. If you take a loan, the transfer amount will be equal to the amount of the loan. If accrued interest is capitalized, the transfer amount will be equal to the amount of capitalized interest minus the cumulative amount of Loan Account Interest Credited since the date loan interest was last capitalized, or the Policy Date if none.

 

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11. LOANS (continued)

 

 

Loan Repayment

You may repay the Policy Debt in whole or in part at any time prior to the death of the Life Insured and while the policy is In Force.

When you make a loan repayment, we will first capitalize the loan interest. The loan repayment will be applied to the Policy Value by transferring amounts from the Loan Account as follows:

 

  (a)

we will transfer to the Fixed Account an amount that is equal to the remaining loan repayment multiplied by the ratio of the amount borrowed from the Fixed Account over the sum of the amounts borrowed from the Fixed Account and the Investment Accounts; then

 

  (b)

we will apply any remaining loan repayment in excess of the amount determined in (a), above, in accordance with the allocation instructions then in effect unless our then-current rules allow you to designate a different allocation with your repayment and you in fact do so.

Subject to any supplementary benefit rider, endorsement, or other provisions, while a loan exists, we will treat any amounts you pay as premiums, unless you submit to us a Written Request that they be treated as loan repayments. However, when a portion of the Loan Account Value was transferred from the Fixed Account, we reserve the right, where permitted by state law, to require that premium payments be applied as loan repayments.

 

 

12. SURRENDERS AND WITHDRAWALS

 

Surrender of the Policy

You may surrender this policy upon Written Request for its Net Cash Surrender Value at any date prior to the death of the Life Insured. We will determine the Net Cash Surrender Value on the Surrender Date. We will process the request and pay the Net Cash Surrender Value only if we have not received due proof that the Life Insured died prior to the Surrender Date. After the Surrender Date, no insurance will be In Force. If you surrender the policy during the Surrender Charge Period, we will deduct a Surrender Charge from the Policy Value in calculating the Net Cash Surrender Value. The Surrender Charge and Surrender Charge Period are shown in Section 1.

Withdrawals

Once per Policy Month after the first Policy Year, you may request a withdrawal of part of the Net Cash Surrender Value if available. Withdrawals are subject to the following conditions:

 

  (a)

without our approval, each withdrawal must be for at least the Minimum Withdrawal Amount shown in Section 1;

 

  (b)

after the withdrawal, the remaining Net Cash Surrender Value must be at least equal to three times the Monthly Deductions at the time of the withdrawal;

 

  (c)

we will process the withdrawal, thereby reducing the Policy Value, as of the end of the Business Day on which we receive your Written Request;

 

  (d)

we will deduct a pro-rata Surrender Charge if the withdrawal reduces the Face Amount during the Surrender Charge Period;

 

  (e)

we will reduce the amount of the requested withdrawal if it would otherwise cause the Face Amount to fall below the Minimum Face Amount shown in Section 1;

 

  (f)

we will reduce the amount of the withdrawal if the amount in all accounts is not sufficient to pay the withdrawal and any pro-rata Surrender Charge; and

 

  (g)

you may specify which Investment Accounts as well as the Fixed Account from which we should make the withdrawal. If we do not receive such instructions, we will allocate the deduction of the withdrawal and any pro-rata Surrender Charge in the same proportion that the value in the Fixed Account and the Investment Accounts bears to the Net Policy Value.

If Death Benefit Option 1 is in effect at the time of the withdrawal, the Face Amount plus any amount payable under a supplementary benefit rider as a result of the Life Insured’s death will be reduced.

 

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12. SURRENDERS AND WITHDRAWALS (continued)

 

 

The reduction is equal to the amount of the withdrawal, if at the time of the withdrawal, the Face Amount plus any amount payable under a supplementary benefit rider as a result of the Life Insured’s death is greater than or equal to the Minimum Death Benefit as described in Section 4; otherwise the reduction is equal to the amount (if any) by which the withdrawal exceeds (a) minus (b) with the result divided by (c), where:

 

  (a)

is the Minimum Death Benefit;

 

  (b)

is the Face Amount plus any amount payable under a supplementary benefit rider as a result of the Life Insured’s death; and

 

  (c)

is the applicable Minimum Death Benefit Factor for the Life Insured’s Age as shown in the Table of Rates in Section 2.

The reduction described above will first reduce any amount payable under a supplementary benefit rider as a result of the Life Insured’s death. If any death benefit payable under a supplementary benefit rider is exhausted by the reduction, then we will reduce the Face Amount by any remaining reduction.

If Death Benefit Option 2 is in effect at the time of the withdrawal, the Face Amount will not be reduced.

Your Death Benefit will continue to be determined in accordance with Section 4, subject to this provision.

 

 

13. DEATH BENEFIT PROTECTION

 

Your policy includes a Death Benefit Protection feature for a maximum coverage period of up to the Life Insured’s Age 121.

This feature prevents your policy from going into default provided that the Net Death Benefit Protection Value is greater than zero. However, this feature will not prevent your policy from going into default if the Policy Debt is greater than zero and exceeds the Policy Value. While the Death Benefit Protection feature keeps the policy In Force, we will continue to take Monthly Deductions but only to the extent that such deductions after the application of any credits do not reduce Policy Value to a value that is less than zero.

Net Death Benefit Protection Value

This is an amount equal to the Death Benefit Protection Value, as described below, less Policy Debt.

Death Benefit Protection Value

This is a reference value only. It is determined in the same way that the Policy Value is determined, as described in Section 7, except that:

 

  (a)

the Premium Charge applied to premiums paid will be the Death Benefit Protection Premium Charge shown in Section 1;

 

  (b)

the Administrative Charge and Face Amount Charge deducted monthly from the Death Benefit Protection Value will be the Death Benefit Protection Administrative Charge and Death Benefit Protection Face Amount Charge, respectively, shown in Section 1;

 

  (c)

the Net Premium, after any deductions due are taken, is applied to the Death Benefit Protection Value retroactive to the beginning of the Policy Month in which the premium is received and is credited with interest at the Death Benefit Annual Protection Interest Rates shown in Section 2. If the Death Benefit Protection Value divided by the Face Amount exceeds the applicable Death Benefit Protection Bonus Threshold Rate shown in Section 2, the rate of interest will be increased by the Death Benefit Protection Annual Bonus Rate;

 

  (d)

the rates used in calculating the Death Benefit Protection Cost of Insurance Charge are the Monthly Death Benefit Protection Cost of Insurance Rates shown in Section 2;

 

  (e)

the Policy Value Credit is not applied to the Death Benefit Protection Value;

 

  (f)

the Asset Credit is not applied to the Death Benefit Protection Value;

 

  (g)

no Advance Contribution Charge is deducted from the Death Benefit Protection Value;

 

  (h)

no Asset-Based Risk Charge is deducted from the Death Benefit Protection Value;

 

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13. DEATH BENEFIT PROTECTION (continued)

 

 

  (i)

the Net Amount at Risk used in calculating the Death Benefit Protection Cost of Insurance Charge is equal to the greater of zero or the result of subtracting (ii) from (i), where:

 

  (i)

is the sum of the Face Amount and the Death Benefit payable under any supplementary benefit riders that have a cost of insurance charge, divided by the Death Benefit Discount Factor shown in Section 1; and

 

  (ii)

is the Death Benefit Protection Value (if Death Benefit Option 1 has been elected) at the end of the immediately preceding Business Day less all Monthly Deductions, as modified by this provision, due on the Policy Date or subsequent Processing Date.

The Death Benefit Protection Value is not used in determining the actual Policy Value, Minimum Death Benefit, Cash Surrender Value, or Insurance Benefit provided by this policy.

Default of the Death Benefit Protection Feature

This feature will go into default at the beginning of any Policy Month in which the Net Death Benefit Protection Value is less than or equal to zero after we deduct the Monthly Deductions, as modified by the Death Benefit Protection Value provision, that are due for that month.

Death Benefit Protection Feature Grace Period

We will allow 61 days from the date this feature goes into default for you to pay the Death Benefit Protection Default Payment described below to bring the feature out of default. At least 30 days prior to termination of the feature, we will send a notice to your last known address, specifying the amount you must pay to bring the feature out of default. If we have notice of a policy assignment on file at our Service Office, we will mail a copy of the notice of the amount due to the assignee on record.

Death Benefit Protection Default Payment

The amount required to bring this feature out of default, referred to as the Death Benefit Protection Default Payment, is an amount equal to (a) plus (b) where:

 

  (a)

is the amount necessary to bring the Net Death Benefit Protection Value to zero, if it is less than zero, at the date of default; and

 

  (b)

is the amount necessary to keep the Net Death Benefit Protection Value above zero for the next three Policy Months.

If the Death Benefit Protection Default Payment is not paid by the end of the Death Benefit Protection Feature Grace Period, then this feature will terminate.

Termination of the Death Benefit Protection Feature

This feature terminates at the earliest of:

 

  (a)

the end of the Death Benefit Protection Feature Grace Period for which you have not paid the Death Benefit Protection Default Payment;

 

  (b)

the date your policy terminates;

 

  (c)

at the Life Insured’s Age 121.

This feature cannot be reinstated after it terminates.

 

 

14. GRACE PERIOD

 

If the Death Benefit Protection Feature is in default, has terminated, or the Policy Debt is greater than zero and exceeds the Policy Value, the policy and any supplementary benefit riders will go into default if at the beginning of any Policy Month the Net Cash Surrender Value is less than or equal to zero after we take the Monthly Deductions that are due for that month.

We will allow 61 days from the date the policy goes into default for you to pay the Default Payment described below to bring the policy out of default. This is known as the Grace Period. Any payment sent to us must be received by us within the Grace Period. At least 30 days prior to termination of coverage, we will send notice to your last known address, specifying the amount you must pay to bring the policy out of default. If we have notice of a policy assignment on file at our Service Office, we will also mail a copy of the notice of the amount due to the assignee on record.

 

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14. GRACE PERIOD (continued)

 

 

Default Payment

The amount required to bring the policy out of default, referred to as the Default Payment, is the lesser of (a) or (b) where:

 

  (a)

is an amount equal to (i) plus (ii) where:

 

  (i)

is the amount necessary to bring the Net Cash Surrender Value to zero, if it is less than zero, at the date of default; and

 

  (ii)

is the amount necessary to keep the Net Cash Surrender Value above zero for the next three Policy Months;

 

  (b)

is the Death Benefit Protection Default Payment as described in Section 13.

When payment is received, any Monthly Deductions that are past due and unpaid will be immediately deducted from the Net Premium and the remaining amount will be applied to the Policy Value.

If the Default Payment has not been paid by the end of the Grace Period, the policy will terminate. Upon termination of the policy, the remaining Net Cash Surrender Value, if any, will be paid to the owner. If the Life Insured dies during the Grace Period, we will deduct from the Insurance Benefit all Monthly Deductions due and unpaid as of the date of the Life Insured’s death. No Insurance Benefit under the policy or any supplementary benefit riders will be in effect after the policy terminates.

 

 

15. POLICY TERMINATION

 

This policy terminates on the earliest of the following events:

 

  (a)

the end of the Grace Period for which we have not received the amount necessary to bring the policy out of default;

 

  (b)

surrender of the policy for its Net Cash Surrender Value; or

 

  (c)

the death of the Life Insured.

 

 

16. REINSTATEMENT

 

If the policy terminates at the end of a Grace Period in which you did not make the Default Payment, you may apply for reinstatement within three years from the date of default. The policy cannot be reinstated if it has been surrendered for its Net Cash Surrender Value.

The requirements for reinstatement are as follows:

 

  (a)

we must receive Written Request for reinstatement; and

 

  (b)

reinstatement is subject to our normal underwriting practices, including Evidence of Insurability for the Life Insured, and for any insureds covered under any supplementary benefit rider that you wish to reinstate.

If we approve your request,

 

  (a)

we must receive at our Service Office, within 60 days from the date of approval, a premium equal to the amount that was required to bring the policy out of default immediately prior to termination, plus the amount needed to keep the policy In Force for at least the next three Policy Months;

 

  (b)

the reinstatement date will be the date we receive the required payment referenced in (a) above at our Service Office, until which time no coverage will be In Force;

 

  (c)

the Face Amount will be reinstated to the same amounts they were on the date the policy terminated;

 

  (d)

any Surrender Charge will be reinstated to the amount it was at the date of default;

 

  (e)

the remaining Surrender Charge Period, if any, will be the same as on the date of default;

 

  (f)

the Policy Value on the date of reinstatement, prior to the crediting of any Net Premium paid on the reinstatement, will be equal to the Policy Value on the date the policy terminated;

 

  (g)

at reinstatement, your Policy Value as well as the Net Premium received will be allocated to the Fixed Account and the Investment Accounts according to your current premium allocation instructions; and

 

  (h)

the outstanding Policy Debt on the date of reinstatement will be equal to the Policy Debt on the date the policy terminated. You have the right at time of reinstatement to repay or reinstate any outstanding Policy Debt.

 

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16. REINSTATEMENT (continued)

 

 

The Suicide and Incontestability provisions will apply from the reinstatement date. If the policy has been In Force for two years during the lifetime of the Life Insured, it will be contestable only as to statements made in the reinstatement application.

 

 

17. COVERAGE AT AND AFTER AGE 121

 

Provided the policy is In Force at the Life Insured’s Age 121 we will continue the policy In Force thereafter subject to the stipulations stated below.

Death Benefit

The Death Benefit will be determined in the same manner as specified in Section 4.

Premiums and Monthly Deductions

We will not accept any further premium payments. We will cease to take Monthly Deductions for charges listed in Section 1.

Credited Interest

We will continue to credit interest to the Policy Value. The portion of the Policy Value that is in an Investment Account will continue to vary from day to day.

Asset Credit

The Asset Credit will no longer be credited to the Policy Value.

Policy Debt and Default

Loans will continue to be allowed as described in Section 11. Loan interest will continue to be charged if there is an outstanding loan. Loan repayments will be accepted as well as any amounts required to keep this policy In Force. The policy will go into default at any time the Policy Debt exceeds the Policy Value, as described in Section 11 and Section 14.

Withdrawals

Withdrawals will not be allowed.

 

 

18. OWNER AND BENEFICIARY

 

Until the Life Insured’s death, you can receive any amount payable under the policy and exercise all rights and privileges granted by the policy.

Change of Owner

Until the Life Insured’s death, you can change the ownership of the policy by Written Request. Unless specified by you, the change will take effect as of the date you signed the Written Request. It will not apply to any payments we made or any action we may have taken before we received your Written Request at our Service Office.

Trustee Owner

Should the owner be a trustee, payment to the trustee(s) of any amount to which the trustee(s) is (are) entitled under the policy, either by death or otherwise, will fully discharge us from all liability under the policy to the extent of the amount so paid.

Joint Ownership

Two or more owners will own the policy as joint tenants with right of survivorship, unless otherwise requested on the application or in any subsequent assignment of the policy. On death of any of the owners, the deceased owner’s interest in the policy passes to the surviving owner(s).

Successor Owner

If an owner dies prior to the death of the Life Insured, a named successor owner will, if then living, have all the owner’s rights and interest in the policy. The owner can designate, cancel, or change the designation of successor owner prior to the death of the Life Insured by written agreement provided to us.

The following four provisions will apply unless there is a beneficiary designation In Force that provides otherwise.

 

21

 

18. OWNER AND BENEFICIARY (continued)

 

 

Beneficiary Classification

You can appoint beneficiaries for the Insurance Benefit in three classes: primary, secondary, and final. Beneficiaries in the same class will share equally in the Insurance Benefit payable to them.

Payment To Beneficiaries

We will pay the Insurance Benefit:

 

  (a)

to any primary beneficiaries who are alive when the Life Insured dies; or

 

  (b)

if no primary beneficiary is then alive, to any secondary beneficiaries who are then alive; or

 

  (c)

if no primary or secondary beneficiary is then alive, to any final beneficiaries who are then alive.

Change Of Beneficiary

Until the Life Insured’s death, you can change the beneficiary by Written Request unless you have made an irrevocable beneficiary designation. If an irrevocable beneficiary is named, such beneficiary cannot be changed without the written consent of the irrevocable beneficiary. We are not responsible if the change does not achieve your purpose. Unless otherwise specified by you, the change will take effect as of the date you signed such request. It will not apply to any payments we made or any action we may have taken before we received your Written Request.

Death Of Beneficiary

If no beneficiary is alive when the Life Insured dies, the Insurance Benefit will be payable to you; or if you are the Life Insured, to your estate. Unless otherwise provided, if a beneficiary dies before the seventh day after the death of the Life Insured, we will pay the Insurance Benefit as if the beneficiary had died before the Life Insured.

 

 

19. ASSIGNMENT

 

Your interest in this policy may be assigned with the written consent of any irrevocable beneficiary. Your interest, any interest of the Life Insured and of any revocable beneficiary shall be subject to the terms of the assignment, but such assignment shall not affect the interest of any irrevocable beneficiary. Unless otherwise specified by you, any assignment will take effect on the date the notice of assignment is signed by you, subject to any payments made or actions taken by us prior to receipt of notice.

We will not be on notice of any assignment unless it is in writing, nor will we be on notice until a duplicate of the original assignment has been received at our Service Office. We assume no responsibility for the validity or sufficiency of any assignment.

 

 

20. MISSTATEMENTS

 

If the sex (if issued on a sex distinct basis) or age of the Life Insured was misstated in the application, we will, if necessary, change the Face Amount and every other benefit to that which would have been purchased at the correct sex (if issued on a sex distinct basis) or age by the most recent Cost of Insurance Charge.

 

 

21. SUICIDE

 

If the Life Insured commits suicide, while sane or insane, within two years from the Issue Date, the policy will terminate on the date of such suicide and we will pay (in place of all other benefits, if any) an amount equal to the premiums paid less the amount of any Policy Debt on the date of death and less any withdrawals.

If the Life Insured commits suicide, while sane or insane, after two years from the Issue Date and within two years from the effective date of any increase in the Insurance Benefit requiring Evidence of Insurability, the benefits payable under the policy will not include the amount of such Insurance Benefit increase but will include the amount of premium that pertains to the increase.

We reserve the right under this provision to obtain evidence of the manner and cause of death of the Life Insured.

 

22

 

22. INCONTESTABILITY

 

Except for non-payment of premium and fraud in the procurement of this policy to the extent permitted by applicable state law, this policy shall be incontestable after it has been In Force for two years from the Issue Date during the lifetime of the Life Insured.

In the case of reinstatement or any policy change requiring Evidence of Insurability, the original contestable period will continue to apply. In addition, a new two-year contestable period will apply from the effective date of such reinstatement or policy change during the lifetime of the Life Insured. Any contest will be based only on statements made in the application for reinstatement or policy change, unless the original contestability period is not yet expired.

Any premium payment that we accept subject to Evidence of Insurability, and any increase in Insurance Benefit resulting from such payment, shall be considered a policy change for purposes of this Section.

We reserve the right under this provision to obtain evidence of the manner and cause of death of the Life Insured.

 

 

23. THE CONTRACT

 

The written application for the policy is attached at issue. The entire contract between the applicant and us consists of the policy, such application, and any riders and endorsements. However, additional Written Requests or applications for policy changes or acceptance of excess payment may be submitted to us after issue and such additional requests may become part of the policy.

All statements made in any application shall, in the absence of fraud, be deemed representations and not warranties. We will use no statement made by or on behalf of the Life Insured to defend a claim under the policy unless it is in a written application.

An exchange of this policy for a new policy on a different plan may be made by agreement between you and us in accordance with our published rules in effect at that time.

We reserve the right to make any changes necessary in order to keep this policy in compliance with any changes in federal or state tax laws. Other changes in this policy may be made by agreement between you and us. Only the President, Vice President, the Secretary, or an Assistant Secretary of the Company has authority to waive or agree to change in any respect any of the conditions or provisions of the policy, or to extend credit or to make an agreement for us.

Addition of Post-Issue Riders

You may add any applicable supplementary benefit rider to your policy that we currently make available for addition after issue, provided you meet our then-current eligibility requirements for the issuance of the applicable supplementary benefit rider.

 

 

24. RIGHT TO POSTPONE PAYMENT OF BENEFITS

 

We reserve the right to postpone the payment of Net Cash Surrender Values, withdrawals, and policy loans for up to six months after we receive such Written Request, except when required to make a premium payment.

 

 

25. CLAIMS OF CREDITORS

 

The proceeds and any income payments under the policy will be exempt from the claims of creditors to the extent permitted by law. These proceeds and payments may not be assigned or withdrawn before becoming payable without our agreement.

 

23

 

26. REPORTS TO OWNER

 

Within 30 days after each Policy Anniversary, we will send you a report at no charge showing:

 

  (a)

the beginning and end dates of the current report;

 

  (b)

the Death Benefit at the end of the current report period;

 

  (c)

the amounts credited or debited to the Policy Value during the current period, identified by type;

 

  (d)

the current allocation in the Fixed Account, the Loan Account, and each of the Investment Accounts at the end of the current report period;

 

  (e)

the Loan Account balance, if any, at the end of the current report period;

 

  (f)

the Cash Surrender Value, if any, at the end of the current report period;

 

  (g)

the Policy Value, if any, at the beginning and at the end of the current report period;

 

  (h)

if applicable, a notice stating that unless premium payments are made, assuming guaranteed mortality and expense charges and a 0% crediting rate of interest, the Net Cash Surrender Value will not be sufficient to maintain the policy In Force until the end of the next reporting period; and

 

  (i)

any further information required by law.

Upon request, we will provide you with a report of projected future values. We will provide one report annually without charge. For additional reports you request, we reserve the right to charge a reasonable fee, not to exceed $50.

 

 

27. HOW VALUES ARE COMPUTED

 

We provide Cash Surrender Values that are at least equal to those required by law.

We base minimum Cash Surrender Values on the Commissioners Standard Ordinary Mortality Tables, as described in Section 1.

A detailed statement of the method of computing the values of this policy has been filed with the insurance department of the state shown in Section 1.

 

 

28. QUALIFICATION AS LIFE INSURANCE

 

It is intended that this policy comply with the definition of a “life insurance contract” set forth in the federal income tax laws so that, notwithstanding any other provisions of the policy to the contrary, it will be considered as life insurance for federal income tax purposes. We reserve the right to make any reasonable adjustments to the terms or conditions of this policy if it becomes necessary to allow it to qualify as life insurance. This provision should not be construed to guarantee that this policy will receive tax treatment as life insurance or that the tax treatment of life insurance will never be changed by the future actions of any tax authority. This policy uses the Cash Value Accumulation Test as its life insurance qualification test. Under this test, the Minimum Death Benefit, as described in Section 4, must be maintained.

Effect on Life Insurance Qualification Tests

A change in Death Benefit Option, Face Amount, Risk Classification, Additional Rating, or certain other policy changes, will often change the policy’s limits under federal income tax law.

 

24

 

29. INTEREST ON PROCEEDS

 

We will pay interest on the Insurance Benefit proceeds as follows:

 

  (a)

interest shall accrue and be payable from the date of the Life Insured’s death;

 

  (b)

interest shall accrue at the rate or rates applicable to the policy for funds left on deposit or, if we have not established a rate for funds left on deposit, at the Two Year Treasury Constant Maturity Rate as published by the Federal Reserve. In determining these rates, we will use the rate in effect on the date of death;

 

  (c)

interest shall accrue at the effective annual rate determined in item (b) above, plus additional interest at a rate of 10% annually beginning with the date that is 31 calendar days from the latest of items (i), (ii), and (iii) to the date the claim is paid, where it is:

 

  (i)

the date that due proof of death is received by us;

 

  (ii)

the date we receive sufficient information to determine its liability, the extent of the liability, and the appropriate payee legally entitled to the proceeds; and

 

  (iii)

the date that legal impediments to payment of proceeds that depend on the action of parties other than the Company are resolved and sufficient evidence of the same is provided to the Company. Legal impediments to payment include, but are not limited to: (a) the establishment of guardianships and conservatorships; (b) the appointment and qualification of trustees, executors, and administrators; and (c) the submission of information required to satisfy state and federal reporting requirements.

 

25

Communications about this policy may be sent to the Company’s Service Office, which is currently at [200 Berkeley Street, Boston, Massachusetts 02116-5023]. Our toll-free number is [1-800-387-2747].

Flexible Premium Variable Universal Life Insurance policy

Adjustable Death Benefit

Benefit payable on Life Insured’s death

Flexible premiums payable to Age 121 during the Life Insured’s lifetime

Non-Participating (Not eligible for dividends)

LOGO   

 

Life Insurance Company (U.S.A.)

 

A Stock Company

 

 

SUPPLEMENTARY BENEFIT

RETURN OF PREMIUM DEATH BENEFIT

 

This rider is part of the policy to which it is attached. It takes effect at the same time as your policy, provided that Death Benefit Option 1 is in effect under the policy on that date. Should any provisions in the policy conflict with this rider, the provisions of this rider will prevail.

The Life Insured for this benefit is the same person who is the Life Insured under your policy. If this rider is attached to a survivorship policy, the Lives Insured for this benefit will be the same persons who are the Lives Insured under your policy. The name of the Life Insured or, if applicable, the names of the Lives Insured, are shown in Policy Specifications, Section 1.

BENEFIT

This benefit provides an additional insurance amount, payable on the death of the Life Insured (or the death of the Surviving Life Insured if this rider is attached to a survivorship policy). On receiving due proof that the Life Insured (or Surviving Life Insured) died while the benefit is in force, we will pay the benefit amount to the same beneficiary and in the same manner as the proceeds payable under the policy.

BENEFIT AMOUNT

The benefit is equal to the amount of the Return of Premium Death Benefit coverage as described below. The Maximum Benefit Amount is shown in the Policy Specifications page for this rider.

RETURN OF PREMIUM DEATH BENEFIT COVERAGE

The amount of the Return of Premium Death Benefit coverage is determined as follows:

 

  (a)

it has an initial value equal to the Percentage of Premium of your initial premium payment. The Percentage of Premium is as elected and shown on the Policy Specifications page for this rider. This percentage is set at issue and cannot be changed;

 

  (b)

the Percentage of Premium will be applied to each subsequent premium and increase the coverage at the time of premium payment by that amount;

 

  (c)

on each Processing Date, before we take any Monthly Deductions due, we will increase the coverage by the monthly equivalent of the annual Return of Premium Death Benefit Increase Rate;

 

  (d)

each withdrawal of part of the Net Cash Surrender Value taken under the policy will reduce the coverage at the time of withdrawal by an amount equal to the withdrawal, except that the coverage will not reduce to less than zero; and

 

  (e)

each request for a decrease in the benefit amount will reduce the coverage on the effective date of the decrease by the amount of the decrease requested, except that the coverage will not be decreased to less than zero.

The initial annual Return of Premium Death Benefit Increase Rate is shown in the Policy Specifications page for this rider. You may make a written request to change this rate, subject to the following:

 

  (a)

a decrease in the rate will take effect on the Annual Processing Date coincident with or next following the date we receive the request; and

 

07MROPR    Page 1

  (b)

an increase in the rate will be subject to the Company’s normal underwriting practices, including evidence of insurability and to our approval of the increase. The increase will take effect on the Annual Processing Date coincident with or next following the date of our approval.

The amount of the Return of Premium Death Benefit coverage will not exceed the Maximum Benefit Amount shown in the Policy Specifications page for this rider.

LAPSE PROTECTION SECONDARY GUARANTEE

Any lapse protection secondary guarantee included in the policy and applicable to this rider is shown in the Policy Specifications page for this rider.

CESSATION OF INCREASES

Increases in the Return of Premium Death Benefit coverage will cease at the earliest of:

 

  (a)

the Processing Date coincident with or next following the date we receive your written request for cessation of any further increases;

 

  (b)

the Processing Date coincident with or next following the date we approve your written request for a change to policy Death Benefit Option 2 if the policy allows for such a change to be made;

 

  (c)

the date on which the amount of the Return of Premium Death Benefit coverage becomes equal to the Maximum Benefit Amount shown in the Policy Specifications page for this rider;

 

  (d)

the date the Life Insured reaches Age 100 (or if this rider is attached to a survivorship policy, the date the younger Life Insured reaches Age 100 or would have reached Age 100 if living); or

 

  (e)

the Processing Date coincident with or next following the date we receive your written request to reduce the amount of the Return of Premium Death Benefit coverage or the Supplemental Face Amount or Base Face Amount of insurance under the policy.

After increases cease, we will not take into account any more premiums paid or apply the Return of Premium Death Benefit Increase Rate in determining the amount of the Return of Premium Death Benefit coverage.

DECREASE IN BENEFIT AMOUNT

You may make a written request to decrease the benefit amount. The decrease will take effect on the Processing Date coincident with or next following the date we approve the request. The Return of Premium Death Benefit coverage will be reduced by the amount of the requested decrease. Decreases in the benefit amount are not subject to any applicable pro-rata Surrender Charges.

PARTIAL NET CASH SURRENDER VALUE WITHDRAWALS

If you make a written request for a withdrawal of part of the Net Cash Surrender Value under the policy while this benefit is in force, we will process the withdrawal, so that the withdrawal:

 

  (a)

first reduces the amount of the Return of Premium Death Benefit coverage; then

 

  (b)

any applicable Supplemental Face Amount under the policy will then be reduced by the amount, if any, by which the net withdrawal exceeds the amount of the Return of Premium Death Benefit coverage; then

 

  (c)

the Base Face Amount under the policy will be reduced by the amount, if any, by which the net withdrawal exceeds the sum of the Return of Premium Death Benefit coverage and any applicable Supplemental Face Amount.

As described above, we will generally process the withdrawal so it reduces the Supplemental Face Amount before it reduces the Base Face Amount but we reserve the right to allow a reduction in Base Face Amount prior to fully reducing the Supplemental Face Amount.

 

07MROPR    Page 2

COST OF INSURANCE

The cost of insurance for this benefit is charged monthly as part of the Monthly Deductions under the policy, and ceases when Monthly Deductions cease under the policy. The monthly cost of insurance rates will always be less than or equal to the Maximum Monthly Rates shown in the Table of Rates, Section 2 of the policy.

INCONTESTABILITY

This benefit shall be incontestable after it has been in force during the Life Insured’s lifetime (or during the lifetime of the Lives Insured if this rider is attached to a survivorship policy) for two years from the Issue Date shown in the Specifications section of the policy.

For any increase which requires evidence of insurability satisfactory to us, the contestable period will start on the effective date of the increase.

SUICIDE EXCLUSION

If the Life Insured (or either of the Lives Insured when this rider is attached to a survivorship policy) dies by suicide, while sane or insane, within two years of the Issue Date shown in the Specifications section of the policy, this benefit will terminate and we will pay only the amount of Monthly Deductions charged for the benefit.

If the Life Insured (or either of the Lives Insured when this rider is attached to a survivorship policy) dies by suicide, while sane or insane, within two years after the effective date of an increase which required evidence of insurability satisfactory to us, for that increase we will pay only the Monthly Deductions charged for the increase.

BENEFIT DEFAULT

This rider will go into default at any time the policy goes into default, and will be subject to the same conditions for bringing the policy out of default.

TERMINATION

This rider terminates at the same time as the policy.

This rider may be reinstated with the policy, subject to the same conditions that apply for reinstating the policy. Upon reinstatement, the amount of the Return of Premium Death Benefit coverage will be equal to the amount at termination, plus the value equal to the Percentage of Premium of your premiums paid for reinstatement.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)

LOGO

 

07MROPR    Page 3

 

1. POLICY SPECIFICATIONS (CONTINUED) – [POLICY 12 345 678]

 

SUPPLEMENTARY BENEFITS

 

BENEFIT    RETURN OF PREMIUM DEATH BENEFIT
LIFE INSURED    LIFE INSURED’S NAME [LIVES INSURED NAMES], AGE, SEX,
[LIVES INSURED] DETAILS    RISK CLASSIFICATION AND ADDITIONAL RATING
   (IF APPLICABLE) ARE SHOWN IN THE POLICY
   SPECIFICATIONS
BENEFICIARY    AS DESIGNATED IN THE APPLICATION OR
   SUBSEQUENTLY CHANGED
BENEFIT AMOUNT    AS DETERMINED BY THE RETURN OF PREMIUM DEATH BENEFIT
   COVERAGE PROVISION
MAXIMUM BENEFIT    $[ 500,000 ]
AMOUNT   
RETURN OF PREMIUM    INITIAL RATE [ 5 ]%
DEATH BENEFIT   
INCREASE RATE   
PERCENTAGE OF PREMIUM    [ 100 ]%
LAPSE PROTECTION    [As Stated in the Policy]
SECONDARY GUARANTEE   
LOGO   

 

John Hancock Life Insurance Company (U.S.A.)

 

A Stock Company

 

 

SUPPLEMENTARY BENEFIT

ACCELERATION OF DEATH BENEFIT FOR QUALIFIED LONG-TERM CARE

SERVICES

 

 

 

LONG-TERM CARE COVERAGE

 

THIS IS AN INDIVIDUAL LONG-TERM CARE INSURANCE RIDER THAT COVERS CARE PROVIDED IN A NURSING HOME OR AN ASSISTED LIVING FACILITY, HOME HEALTH CARE, ADULT DAY CARE, AND HOSPICE CARE. A PORTION OF THE DEATH BENEFIT MAY BE ACCELERATED UNDER THIS RIDER IN ORDER TO REIMBURSE EXPENSES INCURRED FOR THE RECEIPT OF QUALIFIED LONG-TERM CARE SERVICES.

 

 

THIRTY-DAY FREE LOOK

 

If you are not completely satisfied with this rider for any reason, you may return it within 30 days from the date it was delivered to you. To return this rider, mail or deliver it to: the agent who sold it to you, our Service Office, or the agency office through which it was delivered. We will then reverse any charges applicable to this rider and this rider will be treated as if it had never been issued.

 

 

NOTICE TO BUYER

 

This rider may not cover all of the costs associated with long-term care that the Insured incurs during the period of coverage. You are advised to carefully review all benefit limitations. THIS IS NOT A MEDICARE SUPPLEMENT POLICY.

 

 

CAUTION

 

The issuance of this rider is based upon our issuance of the policy and the responses to the questions on the application for this rider and the policy. A copy of the application for the policy and this rider is attached to the policy. If the answers are incomplete, untrue, or not correctly recorded, we have the right to deny benefits or rescind this rider subject to the provisions of this rider and the policy. The best time to clear up any questions is now, before a claim arises! Contact the Company by writing to us: [Customer Service Center R02, 1 John Hancock Way, Suite 1350, Boston, Massachusetts, 02217-1099], or calling us: [1-800-387-2747].

 

 

FEDERAL INCOME TAX TREATMENT OF THIS RIDER

 

This rider is intended to be a qualified long-term care insurance contract under Internal Revenue Code (“Code”) section 7702B(b). The benefits provided by this rider are designed to be excludable from gross income under federal tax law; however, there might be situations in which the benefits or charges for this rider are taxable. If, in the future, it is determined that this rider does not meet the requirements of Code section 7702B, we will make reasonable efforts to amend this rider, if we are required to do so, to maintain this rider’s tax status. We will offer you an opportunity to receive these amendments. If you choose to reject these amendments, this rider may no longer be a qualified long-term care insurance contract under section 7702B(b). If you have any questions concerning the tax implications of this rider, you should consult with an attorney or a qualified tax advisor.

 

 

NONCANCELLABLE

 

You have the right to continue this rider for as long as the Insured lives, or until this rider is terminated in accordance with the Termination provision as set forth herein. The rates used for determining the charges for this rider are guaranteed not to change.

 

14LTCR    1

 

QUALIFYING FOR ACCELERATED BENEFITS

 

Eligibility for Payment of Accelerated Benefits. You are eligible for Accelerated Benefits under this rider if:

 

  (a)

the Insured is Chronically Ill;

 

  (b)

the Insured has satisfied the Elimination Period; and

 

  (c)

we have approved your claim. See Claims.

Once you are eligible, we will determine the Monthly Maximum Benefit Amount. See Accelerated Benefits.

Conditions for Maintaining Eligibility. In order to maintain eligibility:

 

  (a)

the Insured must continue to be Chronically Ill;

 

  (b)

the Insured must be alive;

 

  (c)

the rider must be In Force; and

 

  (d)

you must submit Proof of Loss documentation.

You must also provide us with Written Certification that is renewed every 12 months. Each Written Certification must be submitted to us promptly upon issuance by the Licensed Health Care Practitioner.

If any of these requirements are not met, you will not be eligible for payment of Accelerated Benefits. In that instance, we will terminate your claim. If you wish to initiate a new claim, you must submit a request for Accelerated Benefits.

You are required to assist us in determining ongoing eligibility for Accelerated Benefits under this rider. You must provide us with the Insured’s current Plan of Care. The Plan of Care must be updated as the Insured’s Qualified Long-Term Care needs change. No more than one Plan of Care may be in effect at any one time.

We reserve the right to request periodic assessments or updates regarding the Insured’s Plan of Care and eligibility status. Without such information, we will not be able to determine ongoing eligibility and your claim may be terminated. We reserve the right to obtain clinical information regarding the insured. This includes, but is not limited to conducting a telephone interview with the Insured, consulting with the Insured’s Physician and care providers, performing an in-person nursing or functional/cognitive assessment or evaluation of the Insured, or requiring that the Insured undergo a physical exam, when and as often as we may reasonably require.

Limitations on Eligibility for Payment of Accelerated Benefits. We will only pay benefits under this rider for those Qualified Long-Term Care Services specified in the Plan of Care. The amount of benefits we will pay for any Qualified Long-Term Care Services shall not exceed normal charges for similar care or services in the locality where they are received by the Insured.

Charges Not Covered. We will not pay for any of the following charges incurred by the Insured: Physician’s charges; private duty nurse when the Insured is inpatient confined in a Nursing Home or Assisted Living Facility; hospital and laboratory charges; prescription or non-prescription medication; medical supplies; home modifications and durable medical equipment; shipping charges; any transportation or mileage charge; items and services furnished for beautification, comfort, convenience, or entertainment; room and board charges for independent living quarters in a continuing care retirement community, rest home, or similar entity; any type of residential upkeep, construction, renovation, or home maintenance (such as painting or plumbing); lawn/yard care; snow removal; vehicle or equipment upkeep; charges for Home Health Care provided outside the Home; hotel, cruise ship, or similar charges incurred by the Insured, an Immediate Family member or care provider; and charges for care or services which are not included in and/or are inconsistent with the Insured’s Plan of Care.

 

14LTCR    2

 

QUALIFYING FOR ACCELERATED BENEFITS (CONTINUED)

 

Exceptions. This rider does not pay benefits for care or treatment:

 

  (a)

due to intentionally self-inflicted injury;

 

  (b)

due to suicide or attempted suicide while sane or insane;

 

  (c)

required as a result of alcohol abuse, alcoholism, or drug addiction;

 

  (d)

due to war (declared or undeclared) or any act of war, or service in any of the armed forces or auxiliary units;

 

  (e)

due to participation in a felony, riot, or insurrection;

 

  (f)

normally not provided or made in the absence of insurance;

 

  (g)

received outside of the 50 United States and the District of Columbia;

 

  (h)

provided by a Nursing Home, Assisted Living Facility, Home Health Care Agency, or Adult Day Care Center that is owned and operated by a member of your or the Insured’s Immediate Family; or

 

  (i)

provided by a member of your or the Insured’s Immediate Family.

Non-Duplication of Benefits. This rider will only reimburse charges for Qualified Long-Term Care Services in excess of charges paid, reimbursed, or considered deductibles or coinsurance under any of the following:

 

  (a)

Medicare, including amounts not reimbursable by Medicare such as Medicare deductible or coinsurance amounts;

 

  (b)

any other governmental program (except Medicaid); or

 

  (c)

any workers’ compensation law, employer’s liability or occupational disease law, or any motor vehicle no-fault law.

Payment of Accelerated Benefits. Accelerated Benefits will be paid to you or to an alternative payee designated by you or your legal representative. Any remaining Death Benefit will be included in the Insurance Benefit and paid under the terms of the policy.

Any Accelerated Benefits paid under this rider prior to our receipt of notice of the Insured’s death will reduce the Insurance Benefit paid under the terms of the policy. We will not pay any Accelerated Benefit under this rider after the Insurance Benefit is paid to the beneficiary under the policy.

In the event we receive a claim for the payment of the Accelerated Benefit under this rider and a claim for the payment of the Insurance Benefit under the policy, we will pay first whichever claim we receive Proof of Loss or proof of death that is acceptable to us. Once we pay the Insurance Benefit, the rider is terminated and we will no longer pay Accelerated Benefits under the rider.

We will pay Accelerated Benefits on a monthly basis after: the Insured has received Qualified Long-Term Care Services; charges have been incurred for such services; and we have determined that you are eligible for Accelerated Benefits.

Prompt Payment. If we take more than 30 days to send an Accelerated Benefits payment, we will pay interest on the amount that should have been paid, beginning 31 days after receiving all required information, until such payment is made. We will pay interest at the rate of 1% per month or at a higher rate if required by state law or regulation.

Alternative Payee. At our option, any payment of Accelerated Benefits of $1,000 or less may be paid to an alternative payee, if such benefit is payable to any person who is a minor or otherwise not competent to give a valid release. The alternative payee must be a person who is deemed by us to be justly entitled to the benefit.

 

14LTCR    3

 

QUALIFYING FOR ACCELERATED BENEFITS (CONTINUED)

 

We will be fully discharged and released from all liability to you and to any alternative payee, any assignee, and any beneficiary under the policy to the extent of any payment made in good faith under this rider.

Additional Consent. Before we pay Accelerated Benefits, we must receive a signed consent form from all irrevocable beneficiaries and all assignees. We also reserve the right to require a consent form from any person if we determine that such person’s consent is necessary to protect our interest. Any such consent will be in effect for the length of the current claim.

 

 

EXTENSION OF BENEFITS

 

Benefit Continuation. If the policy lapses for any reason while the Insured is confined in a Nursing Home and we are paying uninterrupted Accelerated Benefits for such Nursing Home confinement, we will continue paying the Accelerated Benefits. We will stop paying Accelerated Benefits at the earliest of the following:

 

  (a)

the date the Insured is discharged from the Nursing Home;

 

  (b)

the date the Accelerated Benefit Pool is exhausted;

 

  (c)

the date you fail to comply with the requirements under Qualifying for Accelerated Benefits; or

 

  (d)

the date the Insured dies.

If the benefits under this rider are continued under this Benefit Continuation provision, we will calculate the Accelerated Benefit Pool and Accelerated Benefit Balance as if the policy had remained In Force. Benefit Continuation will be subject to all the provisions of the policy and this rider. No Insurance Benefit will be payable to the beneficiary under the policy because your policy has terminated.

 

 

CLAIMS

 

Filing a Claim. In order to file a claim for Accelerated Benefits, you must provide us with notice of your intent to file a claim. This notice must include:

 

  (a)

your name;

 

  (b)

the Insured’s name;

 

  (c)

your policy number; and

 

  (d)

the Qualified Long-Term Care Services the Insured is receiving or plans to receive.

You can provide us with notice by: mailing it to our Service Office or by calling us. The mailing address for our Service Office is: [Customer Service Center R02, 1 John Hancock Way, Suite 1350, Boston, Massachusetts, 02217-1099] and our telephone number is: [1-800-387-2747]. We must receive your notice within 45 days of the start of services or as soon as reasonably possible.

Claim Forms. We will provide you with written acknowledgement of your notification of intent to file a claim, instructions, and the necessary forms for filing a claim. Such information will be provided within 15 days of our receiving your notice of intent to file a claim. If 15 days have elapsed and we have not provided you with the necessary claim forms, you can provide written proof that satisfies the Proof of Loss requirements.

Proof of Loss. You must file Proof of Loss with our Service Office before your claim can be approved. The Proof of Loss must include detailed written documentation acceptable to us describing and confirming the Insured’s status as Chronically Ill and the Qualified Long-Term Care Services that the Insured is receiving. You may provide us with Proof of Loss by mailing or faxing originals or copies of the required documentation.

 

14LTCR    4

 

CLAIMS (CONTINUED)

 

The Proof of Loss documentation must include:

 

  (a)

a completed claim form, if applicable;

 

  (b)

Written Certification;

 

  (c)

a functional and cognitive assessment;

 

  (d)

Receipts;

 

  (e)

the current Plan of Care; and

 

  (f)

confirmation that the Insured’s care provider meets licensure/certification standards as required by the jurisdiction in which it is located or care is rendered (or in the event that licensing/certification is not required, confirmation that your care provider meets the applicable definition found in this rider).

No form of barter or trade for care/services is acceptable as Proof of Loss.

We reserve the right to require copies of:

 

  (a)

the Insured’s medical records;

 

  (b)

facility residency agreements;

 

  (c)

the Insured’s service plans;

 

  (d)

an explanation of benefits related to Medicare coverage or any other government program (except Medicaid) applicable to your claim; and

 

  (e)

providers’ daily notes of care.

During the process of reviewing your claim, we may consult with the Insured’s primary care Physician and/or other care providers.

In order for us to process your claim, you must: provide your assistance as described in this form; comply with all applicable rider provisions; and provide us with any additional information we may request. If you refuse to provide the requested information, or if the Insured refuses to undergo any requested assessment, interview, or exam, your claim will be denied. In such case, we will not be liable to pay Accelerated Benefits under this rider.

At your own expense, you must obtain and submit all required documentation in English.

Deadline for Proof of Loss Submission. We must receive Proof of Loss during the Insured’s lifetime and within 90 days of the first Date of Service or as soon as reasonably possible. Your claim for Accelerated Benefits will be denied for failure to provide Proof of Loss unless it is provided to us within one year from the first Date of Service. We will waive this limitation if you provide us with satisfactory proof that you are legally incapacitated or otherwise incapable of providing us with Proof of Loss.

Initial and Ongoing Evaluation Process. We will work with you, the Insured, the Insured’s Physician, the Insured’s care providers, and anyone acting on the Insured’s behalf to obtain information about the Insured’s health and the Qualified Long-Term Care Services the Insured is receiving. We will then make an objective review of all the information we receive. We will provide you with notification as to whether your claim has been approved, denied, or denied in part.

If the Insured has not already selected a care provider at time of claim, you may request information on providers in your area. We do not endorse, sponsor or guarantee the quality of any provider or the care or services provided by such provider. It is your responsibility to choose a provider who will best meet the Insured’s long-term care and service needs.

Examinations and Assessments. We reserve the right to: do a telephone interview with the Insured; to perform an in-person nursing or functional/cognitive assessment or evaluation of the Insured; or to require that the Insured undergo a physical exam. Such evaluations will be made when and as often as we may reasonably require at any time during the claim. Any interview, assessment, evaluation, or exam must be made during the time when the chronic nature of the Insured’s condition can be determined. We will pay for any interview, assessment, evaluation, or examination that we request.

 

14LTCR    5

 

CLAIMS (CONTINUED)

 

Appeals. We will notify you in writing if we do not approve your request for Accelerated Benefits. Such notification will include a written explanation of the reasons for the denial. You will then have the right to appeal our claims decision. You may request that we make all information directly related to such denial available to you. We will provide you with such requested information within 60 days from the date we receive your Written Request. You must request the appeal within one year from the date we provide you with notice of the denial of your claim.

You must send your appeal and/or request for information to: [Customer Service Center R02, 1 John Hancock Way, Suite 1350, Boston, Massachusetts, 02217-1099]. Your appeal should: state why you disagree with our determination; include any other factors you feel that we should take into consideration; and provide any additional information regarding the Insured’s care that you wish to be considered. You are responsible for the expense of securing such additional information.

You may authorize someone else to act for you in this appeals process.

During our review of your appeal, we may request that you provide additional information. If you do not provide this additional information, your appeal will be denied. We will inform you of our decision regarding your appeal. Such decision may be that all or a portion of your claim denial was upheld or overturned. If your claim denial was overturned, we will pay you any Accelerated Benefits due.

Independent Third Party Review. You have the right to request an Independent Third Party Review if we upheld our denial of all or any portion of your claim based upon a determination that the Insured is not Chronically Ill.

We will provide you with written instructions of your right to request an Independent Third Party Review when we notify you of our decision on your appeal. You must make a Written Request for Independent Third Party Review no later than 120 days after we inform you of the outcome of our appeals review. The Independent Third Party will review the relevant material related to the denial of your claim that we provide. The Insured will not be required to undergo an additional exam or assessment. You may provide us with additional information that you wish to be included in the Independent Third Party Review.

The Independent Third Party will provide you, the State Insurance Department (if required), and us with written notice of its final decision within 60 calendar days from its receipt of your request for an Independent Third Party Review. If the Independent Third Party overturns the denial of your claim, the Independent Third Party shall:

 

  (a)

establish the precise date within the specific period of time under review that the Insured is Chronically Ill;

 

  (b)

specify the specific period of time for which we declined eligibility, but the Independent Third Party determined that the Insured is Chronically Ill; and

 

  (c)

provide a certification from a Licensed Health Care Practitioner that the Insured is Chronically Ill.

The decision of the Independent Third Party is final and binding on us. We will pay the Independent Third Party for their time spent reviewing the information and arriving to a decision.

The Independent Third Party must be state approved or certified to conduct such reviews, if the state requires such approvals or certifications. The Independent Third Party must be mutually agreed upon by you and us.

In addition, an Independent Third Party must:

 

  (a)

be, or have on staff or contract with, a Licensed Health Care Practitioner in an appropriate field that can determine if the Insured is Chronically Ill;

 

  (b)

not be affiliated with nor in any manner related to an entity or individual that previously provided care or services to the Insured;

 

  (c)

not employ a licensed health care professional who is associated with us or related to the Insured in any manner; and

 

  (d)

not be compensated in any manner that is dependent upon the outcome of the review.

 

14LTCR    6

 

CLAIMS (CONTINUED)

 

In the event that any part of this Independent Third Party Review provision is in conflict with the applicable long-term care insurance Independent Third Party Review law and/or regulation of the state where the policy is issued, the Independent Third Party Review process will be administered in accordance with such applicable state law or regulation.

Legal Action. Your right to bring suit against us to recover on this rider begins 60 days after you have provided us with the required Proof of Loss and ends 4 years from the date the Proof of Loss was given to us. In the event that any part of this provision is in conflict with the applicable law and/or regulation of the state where the policy is issued, this provision shall be administered in accordance with such applicable state law or regulation.

 

 

ACCELERATED BENEFITS

 

Accelerated Benefit Pool

The Accelerated Benefit Pool is the amount of Death Benefit that may be accelerated under this rider. At issue, the Accelerated Benefit Pool is the Accelerated Benefit Percentage, shown in the Policy Specifications, multiplied by the Face Amount. The Accelerated Benefit Pool can never increase, but will be reduced by Policy Changes. See Effect of Policy Changes on the Accelerated Benefit Pool.

Accelerated Benefits

For each calendar month you are eligible to receive Accelerated Benefits, we will pay an amount equal to the least of: (i) the total shown to be paid by Receipts received for the calendar month; (ii) the Maximum Monthly Benefit Amount; (iii) the amount you request; or (iv) the remaining Accelerated Benefit Balance.

If your claim has been terminated, we will stop paying the Accelerated Benefits.

If the Insured is in a Nursing Home or an Assisted Living Facility and the Insured’s stay in such facility has been interrupted for any reason, we will continue to pay an Accelerated Benefit. Such continued payment will be available for up to 21 days in any calendar year. Any benefit paid under this provision will accelerate the Death Benefit as if the Insured’s stay in a Nursing Home or an Assisted Living Facility had not been interrupted.

This rider will pay benefits for Qualified Long-Term Care Services obtained in a state other than the policy’s state of issue if Accelerated Benefits for such Qualified Long-Term Care Services would have been paid in the policy’s state of issue.

Accelerated Benefit Balance

The amount that is available as Accelerated Benefits under this rider is reduced by the amount received under this rider or a terminal illness rider. The amount of remaining Accelerated Benefits available under this rider is the Accelerated Benefit Balance. The Accelerated Benefit Balance is equal to the Accelerated Benefit Pool minus the sum total of all Accelerated Benefits paid under this rider and a terminal illness rider.

Maximum Monthly Benefit Amount

The Maximum Monthly Benefit Amount is determined for each claim when you first become eligible to receive Accelerated Benefits. The Maximum Monthly Benefit Amount is equal to the Accelerated Benefit Pool on the date you first become eligible to receive Accelerated Benefits multiplied by the Monthly Acceleration Percentage.

Each Accelerated Benefit is based upon a calendar month time period. The Maximum Monthly Benefit Amount for any calendar month is reduced proportionately for the number of days in the calendar month for which no Accelerated Benefits are payable.

Recalculation of Maximum Monthly Benefit Amount

If your claim is terminated and a subsequent Accelerated Benefits claim is approved, we will recalculate the Maximum Monthly Benefit Amount prior to paying Accelerated Benefits for the subsequent claim.

 

14LTCR    7

 

ACCELERATED BENEFITS (CONTINUED)

 

The new Maximum Monthly Benefit Amount is (a) multiplied by (b) divided by (c), where:

 

  (a)

is the Maximum Monthly Benefit Amount as of the date your previous claim was terminated;

 

  (b)

is the Accelerated Benefit Pool as of the date you become eligible for Accelerated Benefits under a subsequent claim; and

 

  (c)

is the Accelerated Benefit Pool as of the date your previous claim was terminated.

Effect of Policy Changes on the Accelerated Benefit Pool

The Accelerated Benefit Pool will be reduced on the date a Policy Change becomes effective. The payment of Accelerated Benefits under this rider or a terminal illness rider is not a Policy Change. Any withdrawal or reduction in Face Amount (whether requested, due to coverage lapse or Misstatements) is considered a Policy Change and will result in a recalculation of the Accelerated Benefit Pool.

The new Accelerated Benefit Pool is (a) minus the result of (b) multiplied by (c), where:

 

  (a)

is the Accelerated Benefit Pool immediately before the withdrawal or reduction;

 

  (b)

is the Accelerated Benefit Percentage; and

 

  (c)

is the Death Benefit immediately before the withdrawal or reduction minus the Death Benefit immediately after the withdrawal or reduction.

If the Policy Change is a reduction in the Accelerated Benefit Percentage, the new Accelerated Benefit Pool is (a) multiplied by (b) divided by (c), where:

 

  (a)

is the Accelerated Benefit Pool immediately before the reduction in the Accelerated Benefit Percentage;

 

  (b)

is the new Accelerated Benefit Percentage; and

 

  (c)

is the old Accelerated Benefit Percentage.

Increases to the Accelerated Benefit Percentage are not allowed.

Effect of Policy Changes on the Maximum Monthly Benefit Amount

Policy Changes also reduce the Maximum Monthly Benefit Amount, effective as of the date of the Policy Change. The recalculated Maximum Monthly Benefit Amount is (a) multiplied by (b), where:

 

  (a)

is the Monthly Acceleration Percentage; and

 

  (b)

is the new Accelerated Benefit Pool after the Policy Change.

Loans

If there is a Policy Loan, a portion of the Accelerated Benefit will be deemed a loan repayment and will reduce the Accelerated Benefit otherwise payable to you. The amount deemed as a loan repayment will also reduce outstanding Policy Loans.

The amount deemed to be a loan repayment is (a) times (b), where:

 

  (a)

is the amount of Policy Debt immediately prior to the payment of the Accelerated Benefit; and

 

  (b)

is 1 minus the ratio of the new Face Amount divided by the Face Amount immediately before the payment of the Accelerated Benefit.

 

 

EFFECT OF ACCELERATED BENEFITS ON YOUR POLICY

 

Face Amount

Each payment of an Accelerated Benefit amount reduces the Face Amount then in effect, resulting in a new Face Amount.

 

14LTCR    8

 

EFFECT OF ACCELERATED BENEFITS ON YOUR POLICY (CONTINUED)

 

The new Face Amount is equal to (a) minus the result of (b) multiplied by (c), where:

 

  (a)

is the Face Amount immediately before the payment of the Accelerated Benefit;

 

  (b)

is the Accelerated Benefit amount; and

 

  (c)

is the Face Amount immediately before the payment of the Accelerated Benefit divided by the Life Insurance Death Benefit immediately before the payment of the Accelerated Benefit.

A reduction in Face Amount resulting solely from a payment of Accelerated Benefits will not reduce the Accelerated Benefit Pool or the Maximum Monthly Benefit Amount, but it will reduce the Accelerated Benefit Balance. Face Amount reductions resulting solely from the payment of Accelerated Benefits will not be subject to any charges normally imposed by the policy for a reduction in Face Amount.

Supplemental Face Amount

If the Face Amount of the policy is made up of the Base Face Amount and Supplemental Face Amount, the payment of Accelerated Benefits will exhaust the Supplemental Face Amount before reducing the Base Face Amount.

Policy Value

Each Accelerated Benefit amount we pay reduces the Policy Value then in effect, resulting in a new Policy Value. The new Policy Value is (a) times (b) divided by (c), where:

 

  (a)

is the Policy Value immediately before the payment of the Accelerated Benefit;

 

  (b)

is the new Face Amount; and

 

  (c)

is the Face Amount immediately before the payment of the Accelerated Benefit.

Restrictions on Transfers and Premium Payments

If this rider is attached to a variable universal life insurance policy, we will transfer any Policy Value in an Investment Account to the Fixed Account at the end of the Business Day when we process your payment of Accelerated Benefits. After that date while you are eligible to receive Accelerated Benefits under this rider, allocations of Premium or transfers of Policy Value to an Investment Account are not allowed.

If this rider is attached to an indexed universal life insurance policy, we will transfer any Segment Proceeds in the Indexed Appreciation Account to the Guaranteed Interest Account on the Segment Maturity Date following the date we process your payment of Accelerated Benefits. After that date while you are eligible to receive Accelerated Benefits under this rider, allocations of Premium or transfers of Policy Value to the Indexed Appreciation Account are not allowed.

If your claim is terminated, the portion of the Policy Value not in the Loan Account will remain in the Fixed Account or in the Guaranteed Interest Account unless we receive your Written Request to reallocate such assets to an Investment Account or Indexed Appreciation Account. The amount that may be transferred and the frequency of transfers will be subject to any restrictions imposed under the terms of the policy.

 

 

GENERAL PROVISIONS

 

Grace Period

The Grace Period provision of the policy shall also apply to this rider. During the Grace Period, this rider will stay in effect. Notice that the policy is in the Grace Period will be provided to you and to the person or persons you designate. The designation(s) may be changed at any time. We will provide you with a reminder of the right to change this written designation every 2 years.

Termination

When this rider terminates, no further charges will be payable for this rider and no further benefits will be paid. See Extension of Benefits and Additional Protection Against Lapse. This rider will terminate at the earliest of the following events:

 

  (a)

the exchange or termination of the policy;

 

14LTCR    9

 

GENERAL PROVISIONS (CONTINUED)

 

 

  (b)

you request to discontinue this rider;

 

  (c)

the exhaustion of the Accelerated Benefit Pool;

 

  (d)

we approve your request for an increase in the Base Face Amount or Supplemental Face Amount, if applicable; or

 

  (e)

the Insured dies.

However, an increase in the Face Amount due to a change from Death Benefit Option 2 to Death Benefit Option 1 will not terminate this rider.

Reinstatement

The reinstated rider will not provide Accelerated Benefits during the period from the end of the Grace Period through the date of reinstatement. This rider may be reinstated according to the reinstatement provisions of the policy, including satisfaction of our underwriting requirements. A reinstated rider will only cover loss due to an injury sustained after the date of reinstatement, or a physical or mental condition that begins after the date of reinstatement. A physical or mental condition will be considered to have begun when treatment is recommended by or received from a Physician.

Additional Protection Against Lapse

Your policy and this rider may be reinstated in accordance with the reinstatement provision of the policy.

In addition to the reinstatement provision of your policy, the benefits of your policy and this rider up to the limit of the Accelerated Benefit Balance at the time that your policy terminated may be reinstated if the following conditions are met:

 

  (a)

you provide us with a Written Request to reinstate within 5 months of the end of the Grace Period;

 

  (b)

you provide us with proof that is satisfactory to us that you were cognitively impaired or otherwise legally incapacitated at the end of the Grace Period; and

 

  (c)

you provide us with payment of all overdue premiums and charges for this rider and your policy as described in the policy’s reinstatement provision.

Changes to this Rider

No change to this rider will be valid until approved by our President or Secretary. No agent may change this rider or waive any of its provisions.

Right to Recovery

If we pay Accelerated Benefits in excess of the Accelerated Benefits payable under the provisions of this rider, we will have the right to recover such excess. Any such excess will be recovered from persons to, or for whom, such payments were made or any organization that received such payments. Any unrecovered excess payments will reduce the Insurance Benefit otherwise payable.

Incontestability

If this rider has been in effect for less than 6 months, we may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that is material to the acceptance of the application for this rider.

If this rider has been in effect for at least 6 months but less than 2 years, we may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that is both:

 

  (a)

material to the acceptance of the application; and

 

  (b)

pertains to the condition for which the claim is made.

After this rider has been in effect for 2 years, it is incontestable except for relevant facts relating to the Insured’s health that were knowingly and intentionally misrepresented.

 

14LTCR    10

 

GENERAL PROVISIONS (CONTINUED)

 

In the event this rider is rescinded after we have paid Accelerated Benefits, we may not recover the payments already made.

Rider Charge

There is a monthly charge for this rider. See Policy Specifications. The charge will cease at the Insured’s Age 100. The charge for the rider is the Monthly Rider Rate times the Rider Net Amount at Risk divided by 1,000.

The Rider Net Amount at Risk is (a) multiplied by (b) where:

 

  (a)

is the Accelerated Benefit Balance; and

 

  (b)

is 1 minus the ratio of the Policy Value divided by the Life Insurance Death Benefit, both determined immediately after the deduction of all other charges due on that date.

The Contract

This rider is made a part of the policy to which it is attached and issued. The rates used for determining the charges for this rider are shown in the policy. If the policy contains a rider that waives the Monthly Deductions on the policy in accordance with that rider, we will waive the charges for this rider as well. This rider takes effect at the same time as the policy, subject to the terms, conditions, and limitations provided herein.

 

 

DEFINITIONS

 

Listed below are some terms that have specific meanings in this rider. Terms not listed below may be defined in the body of this rider or in the policy to which this rider is attached.

Accelerated Benefit(s). The amount of Death Benefit that is accelerated to reimburse expenses arising from the Insured’s receipt of Qualified Long-Term Care Services.

Activities of Daily Living. The 6 activities listed below:

 

  (a)

Bathing: washing oneself by sponge bath, in a tub or a shower, including the task of getting in or out of the tub or shower;

 

  (b)

Continence: the ability to maintain control of bowel and bladder function, or, when unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene (including caring for a catheter or colostomy bag);

 

  (c)

Dressing: putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs;

 

  (d)

Eating: feeding oneself by getting food into the body from a receptacle (such as a plate, cup, or table) or being fed by a feeding tube or intravenously;

 

  (e)

Toileting: getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene;

 

  (f)

Transferring: moving into or out of a bed, chair, or wheelchair. Transferring does not include the task of getting into or out of the tub or shower or mobility outside the Insured’s place of residence.

Not all essential activities are considered Activities of Daily Living. For example, food preparation, use of the telephone, and medication management are not Activities of Daily Living.

Adult Day Care. Social and health-related services provided during the day in a community or group setting of 6 or more persons (or a fewer number of persons as required by applicable state law or regulation). The purpose of the services is to support frail or impaired elderly, or other disabled adults, who can benefit from care in a group setting outside of the home.

 

14LTCR    11

 

DEFINITIONS (CONTINUED)

 

Adult Day Care Center. An Adult Day Care Center is a place that provides the Insured with Adult Day Care for only part of a day while the Insured is residing at Home and is licensed by the jurisdiction in which the services are provided. If licensing is not required, an Adult Day Care Center is a place:

 

  (a)

that provides Adult Day Care;

 

  (b)

has enough full-time staff to maintain no more than an 8-to-1 client-staff ratio; and

 

  (c)

has established procedures for obtaining appropriate aid in the event of a medical emergency.

Assisted Living Facility. A facility, or a distinctly separate part of a facility, that is engaged primarily in providing 24-hour, 7-days a week Custodial Care and:

 

  (a)

is licensed to provide primarily Custodial Care according to the laws of the jurisdiction in which it is located; or

 

  (b)

if licensing is not required, meets all of the following:

 

  (i)

has a 24-hour on-site awake and trained staff to provide Custodial Care;

 

  (ii)

provides Custodial Care services by its employees for a charge, including room and board;

 

  (iii)

has established procedures for obtaining appropriate aid in the event of a medical emergency;

 

  (iv)

provides 3 meals a day and can accommodate special dietary needs;

 

  (v)

provides, at a minimum, assistance with Bathing and Dressing;

 

  (vi)

provides Custodial Care services by its employees to 10 or more persons; and

 

  (vii)

maintains daily notes of the inpatient care and services provided.

Examples of such facilities may include Alzheimer’s facilities or Assisted Living Facilities, which may be either freestanding or part of a life-care community.

The following are not Assisted Living Facilities:

 

  (a)

a hospital or clinic;

 

  (b)

a rehabilitation hospital or clinic;

 

  (c)

a rest home (a home for the aged or a retirement home) which does not, as its primary function, provide Custodial Care;

 

  (d)

your or the Insured’s Home or the home of your or one of the Insured’s Immediate Family members;

 

  (e)

a facility for the treatment of alcoholism, alcohol abuse, drug addiction, or mental illness; and

 

  (f)

an independent living unit.

Chronically Ill. The condition of having been certified by a Licensed Health Care Practitioner that:

 

  (a)

Substantial Assistance is required from an individual who is physically present with the Insured to perform at least 2 Activities of Daily Living, due to the loss of functional capacity, for a period expected to last at least 90 days; or

 

  (b)

Substantial Supervision is required to protect against threats to health and safety due to a Severe Cognitive Impairment.

Custodial Care. Non-skilled long-term care services included in the Plan of Care because the Insured is Chronically Ill.

Date of Service. A day on which the Insured incurs costs for Qualified Long-Term Care Services. For Home Health Care, a Date of Service requires the Insured to have received at least 2 hours of Qualified Long-Term Care Services on that date. Such services cannot be primarily Incidental Homemaker Services.

 

14LTCR    12

 

DEFINITIONS (CONTINUED)

 

Elimination Period (waiting period). The number of Dates of Service that would otherwise be covered by this rider, for which we will not pay Accelerated Benefits. See Policy Specifications.

Only one complete Elimination Period needs to be satisfied while this rider is In Force. No Date of Service may be counted as more than one day towards the satisfaction of the Elimination Period. The Dates of Service used to satisfy the Elimination Period do not need to be consecutive and may be accumulated under separate approved claims.

Face Amount. Face Amount or Total Face Amount, depending on which term is used in your policy.

Home. The Insured’s primary residence, including independent living quarters in a continuing care retirement community, a rest home, or similar entity. The following are never Homes: a Nursing Home, an Assisted Living Facility, an Adult Day Care Center, a hospital or rehabilitation facility/hospital, a hotel, or a facility for the treatment of alcoholism, alcohol abuse, drug addiction, or mental illness.

Home Health Care. Medical and non-medical professional or personal care services provided by a Home Health Care Agency to the Insured in the Insured’s Home and included in the Plan of Care.

Examples of such services include:

 

  (a)

skilled nursing or social work services;

 

  (b)

physical, occupational, dietary, respiratory, or speech therapy;

 

  (c)

Substantial Assistance with 2 of the 6 Activities of Daily Living;

 

  (d)

Substantial Supervision needed because the Insured has a Severe Cognitive Impairment; or

 

  (e)

Incidental Homemaker Services.

Home Health Care cannot be provided by:

 

  (a)

a member of your or the Insured’s Immediate Family;

 

  (b)

an individual who normally resides in your or the Insured’s Home;

 

  (c)

your or the Insured’s legal representative;

 

  (d)

an individual that has been authorized as your or the Insured’s Power of Attorney; or

 

  (e)

your insurance agent/producer or their immediate family.

Incidental Homemaker Services. Non-medical services received by the Insured that are incidental to services associated with the Substantial Assistance with the Activities of Daily Living or Substantial Supervision with a Severe Cognitive Impairment provided to the Insured. Incidental Homemaker Services must be included in the Plan of Care and must be necessary in order for the Insured to remain in the Home. These services must be provided during the same visit and by the same individual providing Substantial Assistance or Substantial Supervision to the Insured. The services must include one or more of the following: meal preparation; laundry; or light housekeeping.

Home Health Care Agency. An entity that is regularly engaged in providing Home Health Care for compensation and employs staff, qualified by training or experience, to provide such care. The entity must meet one of the following requirements:

 

  (a)

it is licensed as a Home Health Care Agency by the jurisdiction in which the Home Health Care is provided;

 

  (b)

it possesses one of the following certifications in the jurisdiction in which the Home Health Care is provided: Medicare Certification, Joint Commission of Accreditation of Health Care Organizations (JCAHO) Certification, or Community Health Accreditation Program (CHAP) Certification;

 

14LTCR    13

 

DEFINITIONS (CONTINUED)

 

 

  (c)

it provides Home Health Care through 7 or more employees of an organization that is in the business of providing Home Health Care according to the laws of the jurisdiction in which the care is provided; or

 

  (d)

it is a state-licensed or a Medicare-certified provider for Hospice Care.

A Home Health Care Agency must also have a Licensed Health Care Practitioner on staff, and must maintain a written record for each recipient of care, the Plan of Care, any assessments, and written notes of care for each Date of Service to document all services delivered.

We may require that any Home Health Care Agency be monitored at least every 30 days by a Licensed Health Care Practitioner.

Hospice. A facility, unit of a facility, public or private agency, or unit of a public or private agency that meets federal certification requirements as a Hospice or is licensed, certified, or registered to provide Hospice Care under the law of the jurisdiction in which it is located.

Hospice Care. A program for meeting the Insured’s palliative care needs if he or she is terminally ill. Terminally ill means there is no reasonable prospect of cure and the Insured has a life expectancy, as estimated by a Physician, of 6 months or less. Hospice Care must be provided or supervised by a Hospice. Hospice Care is limited to those services received by the Insured. Hospice Care may be provided in the Insured’s Home or in a Hospice facility.

Immediate Family. The spouse or Partner of you or the Insured; or the following relatives of you or the Insured (and their respective spouses or Partners): parents, grandparents, siblings, children, grandchildren, aunts/uncles; nieces/nephews; or cousins. Immediate Family also includes adopted, in-law, and step relatives.

A person is a Partner if such person is an adult who is either:

 

  (a)

named, along with you or the Insured, in a valid certificate or license of civil union or domestic partnership as recognized by the state in which the policy is issued; or

 

  (b)

has been living with you or the Insured for the past 12 months in a committed relationship as your or the Insured’s partner or as a member of your or the Insured’s family, as the case may be; and

 

  (i)

is committed to sharing basic living expenses with you or the Insured;

 

  (ii)

is not married to you or the Insured or to anyone else; and

 

  (iii)

if related to you or the Insured, belongs to the same familial generation as you or the Insured (i.e., brother, sister, cousin).

Licensed Health Care Practitioner. A Physician, a registered nurse (R.N.), a licensed social worker, or any other individual who meets the requirements as may be prescribed by the U.S. Secretary of the Treasury.

Life Insurance Death Benefit. The greater of the Face Amount (plus Policy Value if Death Benefit Option 2 is in effect) or the Minimum Death Benefit, as described in the policy.

Maximum Monthly Benefit Amount. The maximum amount of Accelerated Benefits we will pay in any one calendar month.

Medicaid. The reimbursement system under Title XIX of the Federal Social Security Act, as amended.

Medicare. The reimbursement system under Title XVIII of the Federal Social Security Act, as amended.

Nursing Care. Skilled care provided by one or more of the following health care professionals: registered nurse, licensed vocational nurse, licensed practical nurse, physical therapist, occupational therapist, speech therapist, respiratory therapist, medical social worker, or registered dietician.

 

14LTCR    14

 

DEFINITIONS (CONTINUED)

 

Nursing Home. A facility that:

 

  (a)

is licensed and operates to provide Nursing Care for a charge (including room and board), according to the laws of the jurisdiction in which it is located; and

 

  (b)

has services performed by or under the ongoing, direct and immediate supervision of a registered nurse, licensed practical nurse, or licensed vocational nurse, on-site 24-hours a day.

A Nursing Home may be a freestanding facility or it may be a distinct part of a facility, including a ward or wing of a hospital or other facility. The following are examples of facilities that are not Nursing Homes:

 

  (a)

a hospital or clinic;

 

  (b)

a rehabilitation hospital or facility;

 

  (c)

an Assisted Living Facility;

 

  (d)

a rest home (or home for the aged or a retirement home) which does not, as its primary function, provide Custodial Care;

 

  (e)

your or the Insured’s Home or the home of one or more members of your or the Insured’s Immediate Family; or

 

  (f)

a facility for the treatment of alcoholism, alcohol abuse, drug addiction, or mental illness.

Physician. Any person licensed in the United States of America as a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) practicing within the scope of his or her license issued by the jurisdiction in which the services are rendered.

Plan of Care. A written plan for Qualified Long-Term Care Services developed by a Licensed Health Care Practitioner for the Insured. This Plan of Care must specify the type, cost, frequency, expected duration of care, hours of care per day, and type of providers of all services required to meet the Insured’s needs. Services must be in accordance with accepted relevant standards of practice and care for individuals who are Chronically Ill and appropriate to meet the Insured’s care requirements.

Qualified Long-Term Care Services. The following care or services eligible for payment of Accelerated Benefits under this rider and provided for in the Plan of Care:

 

  (a)

24-hour confinement in a Nursing Home or Assisted Living Facility for room, board, and care services (such care services being Nursing Care, Custodial Care, and Hospice Care);

 

  (b)

Home Health Care provided by a Home Health Care Agency;

 

  (c)

Hospice Care; or

 

  (d)

attendance at an Adult Day Care Center providing Adult Day Care.

Qualified Long-Term Care Services are intended to constitute qualified long-term care services as defined under Section 7702B(c) of the Internal Revenue Code.

Receipts. Itemized bills, paid invoices, and cancelled checks or other verifiable proof of payment of expenses for Qualified Long-Term Care Services (including name and type of provider, dates of care or services, and cost per hour of service) provided to the Insured or copies of same.

Severe Cognitive Impairment. A deficiency in the Insured’s short-term or long-term memory; orientation as to person, place, and time; deductive or abstract reasoning; or judgment as it relates to safety awareness. Severe Cognitive Impairment must be established and reliably measured by clinical evidence and standardized tests.

Substantial Assistance. Hands-On or Standby Assistance required more than 50% of the time the Insured performs an Activity of Daily Living during a calendar week. If able to perform an Activity of Daily Living by using an assistive device or equipment, the Insured does not require Substantial Assistance to perform that Activity of Daily Living.

 

14LTCR    15

 

DEFINITIONS (CONTINUED)

 

Hands-On Assistance. The physical assistance of another person without which the Insured would be unable to perform that Activity of Daily Living.

Standby Assistance. The necessary presence of another person within arm’s reach of the Insured to prevent, by physical intervention, injury to the Insured while performing an Activity of Daily Living.

Substantial Supervision. Ongoing, uninterrupted monitoring for 24-hours of each day by another person who is in the Insured’s presence due to the Insured’s Severe Cognitive Impairment. Substantial Supervision (which may include cueing by verbal prompting, gestures, or other demonstration) is necessary to protect the Insured from threats to health or safety (such as may result from wandering).

Written Certification. Written evidence from a Licensed Health Care Practitioner establishing that the Insured is Chronically Ill. This written evidence must relate the Insured’s condition. The Certification must be renewed every 12 months and each renewed Certification must be submitted to us promptly upon issuance by the Licensed Health Care Practitioner.

Signed for the Company by:

 

LOGO

 

14LTCR    16
LOGO   

 

John Hancock Life Insurance Company (U.S.A.)

 

A Stock Company

 

 

SUPPLEMENTARY BENEFIT

[Healthy Engagement Rider]

 

This rider is made a part of your policy to which it is attached and is effective on the date we attach it to your policy. The Rider Charge is the fee payable for this rider. The Effective Date of the rider and the Rider Charge are shown in the Policy Specifications.

Beginning on the first Policy Anniversary following the Effective Date, this rider provides the opportunity to add a Rider Credit to your Policy Value based upon the Status of the Life Insured.

 

 

STATUS

 

The Status of the Life Insured on each Annual Processing Date determines the Rider Credit to be applied to your Policy Value, as described in the Policy Specifications and the Rider Credit provision of this rider. There are four levels of Status under this rider. The achievement of a Status beyond the first level is dependent upon the Life Insured meeting certain Status Qualification Requirements in each year.

Status Qualification Requirements

The Status Qualification Requirements are the criteria used as the basis for determining the Status of the Life Insured.

We reserve the right to amend the Status Qualification Requirements from time to time, as described in the Administration of this Rider provision. The Life Insured can obtain current information relating to his or her Status and/or the Status Qualification Requirements by visiting [http://www.JohnHancockVitality.com/] or by contacting our Service Office at [1-800-387-2747].

 

 

RIDER CREDIT

 

On each Processing Date beginning on the first Policy Anniversary following this rider’s Effective Date, we will apply any Rider Credit to your Policy Value.

Calculation of Rider Credit

The Rider Credit is equal to the Rider Benefit Factor multiplied by the lesser of (a) and (b), where:

 

  (a)

is the Rider Credit Limit described below; and

 

  (b)

is an amount equal to (i) multiplied by (ii) where:

 

  (i)

is the Cost of Insurance Charge for that Processing Date;

 

  (ii)

is the Rider Credit Multiplier for that Policy Year, as shown in the Policy Specifications.

The Rider Benefit Factor equals the lesser of (a) and (b), where:

 

  (a)

is 1; and

 

  (b)

is the Rider Benefit Base shown in the Policy Specifications divided by the Total Death Benefit.

The Total Death Benefit equals the Insurance Benefit as described in your policy plus any outstanding Policy Debt.

 

20HER    1

 

RIDER CREDIT (continued)

 

The Rider Credit Limit in any given Policy Month equals (a) times (b), where:

 

  (a)

is the Rider Credit Limit Multiplier shown in the Policy Specifications times the Net Amount at Risk; and

 

  (b)

is the Maximum Monthly Cost of Insurance Rate shown in the Table of Rates minus the current monthly Cost of Insurance Rate.

In the event that the current Cost of Insurance Rates ever equal the corresponding Maximum Monthly Cost of Insurance Rates for a given month, the Rider Credit Limit and resulting Rider Credit will equal zero on that Processing Date.

 

 

EFFECT OF RIDER ON FLEXIBLE PREMIUM UNIVERSAL LIFE INSURANCE POLICIES

 

Policy Value

While this rider is in effect, your Policy Value will be calculated in the same manner as described in your policy except that we will add any Rider Credit to your Policy Value, as described below, at the same time that Monthly Deductions are taken. In addition, the Policy Value used in the determination of the Net Amount at Risk does not include any Rider Credit applied on the Processing Date. Rider Credits are nonforfeitable after crediting except indirectly due to any applicable surrender charges.

The Rider Credit for a month in which the policy is in default (as described in the Grace Period provision of your policy) will be applied first to pay any Monthly Deductions that are past due and unpaid and next to reduce the Default Payment; any Rider Credit that remains will be applied to your Guaranteed Interest Account. The same process will apply for any month in which the policy is being continued In Force under its No-Lapse Guarantee, or Death Benefit Protection provision, as applicable under your policy, except that there is no Default Payment to be reduced.

Rider Credits are not applied to amounts in the Loan Account.

No-Lapse Guarantee or Death Benefit Protection Value

Rider Credits and the Rider Charge do not apply to the Cumulative Premium Test under the No-Lapse Guarantee feature, or to the calculation of the Death Benefit Protection Value, as applicable under your policy.

Persistency Measure (if applicable)

If your policy contains a Persistency Credit provision, the following will apply:

While this rider is in effect, we will add a Persistency Measure Rider Credit to the Persistency Measure. The Persistency Measure Rider Credit is determined in the same manner as the Rider Credit described above except that:

 

  (a)

the Cost of Insurance Charge is calculated using the Persistency Measure Cost of Insurance Rates;

 

  (b)

the current and Maximum Monthly Cost of Insurance Rates are replaced by the current and Maximum Monthly Persistency Measure Cost of Insurance Rates, respectively; and

 

  (c)

the Net Amount at Risk used in the calculation is replaced by the Persistency Measure Net Amount at Risk.

In addition, the Persistency Measure used in the determination of the Persistency Measure Net Amount at Risk does not include any Persistency Measure Rider Credit applied on the Processing Date.

 

20HER    2

 

EFFECT OF RIDER ON FLEXIBLE PREMIUM INDEXED UNIVERSAL LIFE INSURANCE POLICIES

 

Policy Value

While this rider is in effect, your Policy Value will be calculated in the same manner as described in your policy except that we will add any Rider Credit to your Policy Value, as described below, at the same time that Monthly Deductions are taken. In addition, the Policy Value used in the determination of the Net Amount at Risk does not include any Rider Credit applied on the Processing Date. Rider Credits are nonforfeitable after crediting except indirectly due to any applicable surrender charges.

The Rider Credit is applied to the Guaranteed Interest Account and each Indexed Account (except for the Loaned Indexed Account) in the same proportion that the Policy Value in each of the accounts bears to the total Policy Value net of the Loan Account and the Loaned Indexed Account immediately prior to applying any Rider Credit.

For the portion of the Rider Credit that is applied to an Indexed Account, we will apply that portion of the Rider Credit to each Segment of that Indexed Account and to the Holding Segment in the same proportion that the Segment Balance and the amount in the Holding Segment bear to the total portion of the Policy Value in the Indexed Account immediately prior to applying any Rider Credit.

The Rider Credit for a month in which the policy is in default (as described in the Grace Period provision of your policy) will be applied first to pay any Monthly Deductions that are past due and unpaid and next to reduce the Default Payment; any Rider Credit that remains will be applied to your Policy Value in accordance with the Net Premium allocation instructions then in effect. The same process will apply for any month in which the policy is being continued In Force under the No-Lapse Guarantee or Death Benefit Protection provision, as applicable under your policy, except that there is no Default Payment to be reduced.

Rider Credits are not applied to amounts in the Loan Account or the Loaned Indexed Account.

Adjusted Segment Crediting Balance

While this rider is in effect, your Adjusted Segment Crediting Balance will be calculated in the same manner as described in your policy except we will include any Rider Credit in the calculation. For purposes of this calculation, each Rider Credit is first multiplied by the ratio of the number of months remaining in the Segment Term after the date the Rider Credit is applied, divided by the number of months in the entire Segment Term.

Initial Segment Balance

The Initial Segment Balance includes any Rider Credits applied to a Holding Segment after the Lock In Date.

Segment Balance

The Segment Balance at any time includes any Rider Credits applied to it.

No-Lapse Guarantee or Death Benefit Protection Value

Rider Credits and the Rider Charge do not apply to the Cumulative Premium Test under the No-Lapse Guarantee feature, or to the calculation of the Death Benefit Protection Value, as applicable under your policy.

Cumulative Guarantee

The Cumulative Guarantee provision of your policy describes an alternative method of calculating the Policy Value. Under this method, Rider Credits and Rider Charges are included in the calculation of the Policy Value. Rider Credits will be calculated in the same manner as described in the Rider Credit provision of this rider except that the Cost of Insurance Charge and the Net Amount at Risk are replaced with the Cost of Insurance Charge and the Net Amount at Risk used in the alternative method. The Rider Credits will be applied to the Policy Value under the Cumulative Guarantee at the same time that Monthly Deductions are taken.

 

20HER    3

 

EFFECT OF RIDER ON FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE POLICIES

 

Policy Value

While this rider is in effect, your Policy Value will be calculated in the same manner as described in your policy except that we will add any Rider Credit to your Policy Value, as described below, at the same time that Monthly Deductions are taken. In addition, the Policy Value used in the determination of the Net Amount at Risk does not include any Rider Credit applied on the Processing Date. Rider Credits are nonforfeitable after crediting except indirectly due to any applicable surrender charges.

The Rider Credit is applied to the Fixed Account, each Investment Account, and each Indexed Account (if applicable) in the same proportion that the Monthly Deductions are taken from those same accounts.

For the portion of the Rider Credit that is applied to an Indexed Account, we will apply that portion of the Rider Credit to each Segment of that Indexed Account and to the Holding Segment in the same proportions that the Segment Balance and the amount in the Holding Segment bear to the total portion of the Policy Value in the Indexed Account immediately prior to applying any Rider Credit.

The Rider Credit for a month in which the policy is in default (as described in the Grace Period provision of your policy) will be applied first to pay any Monthly Deductions that are past due and unpaid and next to reduce the Default Payment; any Rider Credit that remains will be applied to your Policy Value in accordance with the allocation instructions then in effect for premium payments. The same process will apply for any month in which the policy is being continued In Force under its No-Lapse Guarantee or Death Benefit Protection provision, as applicable under your policy, except that there is no Default Payment to be reduced.

Rider Credits are not applied to amounts in the Loan Account.

Adjusted Segment Crediting Balance for Indexed Accounts

While this rider is in effect, your Adjusted Segment Crediting Balance will be calculated in the same manner as described in your policy except we will include any Rider Credit in the calculation. For purposes of this calculation, each Rider Credit is first multiplied by the ratio of the number of months remaining in the Segment Term after the date the Rider Credit is applied, divided by the number of months in the entire Segment Term.

Initial Segment Balance for Indexed Accounts

The Initial Segment Balance includes any Rider Credits applied to a Holding Segment after the Lock In Date.

Segment Balance for Indexed Accounts

The Segment Balance at any time includes any Rider Credits applied to it.

No-Lapse Guarantee or Death Benefit Protection Value

Rider Credits and the Rider Charge do not apply to the Cumulative Premium Test under the No-Lapse Guarantee feature, or to the calculation of the Death Benefit Protection Value, as applicable under your policy.

Persistency Measure (if applicable)

If your policy contains a Persistency Credit provision, the following will apply:

While this rider is in effect, we will add a Persistency Measure Rider Credit to the Persistency Measure. The Persistency Measure Rider Credit is determined in the same manner as the Rider Credit described above except that:

 

  (a)

the Cost of Insurance Charge is calculated using the Persistency Measure Cost of Insurance Rates;

 

  (b)

the current and Maximum Monthly Cost of Insurance Rates are replaced by the current and Maximum Monthly Persistency Measure Cost of Insurance Rates, respectively; and

 

  (c)

the Net Amount at Risk used in the calculation is replaced by the Persistency Measure Net Amount at Risk.

In addition, the Persistency Measure used in the determination of the Persistency Measure Net Amount at Risk does not include any Persistency Measure Rider Credit applied on the Processing Date.

 

20HER    4

 

GENERAL PROVISIONS

 

The Contract

This rider, along with the written application for the policy and this rider, is attached to and made part of your policy and constitutes the entire contract between you and us. Should any provisions in the policy conflict with this rider, the provisions of this rider will prevail.

No change in the policy or this rider will be effective until approved by our President or Secretary. This approval must be noted on or attached to the policy. No agent may change the policy or this rider or waive any of the provisions.

Administration of this Rider

The Status Qualification Requirements may be administered directly by us or through an affiliated or unaffiliated company designated by us. We reserve the right to designate or replace any such company at any time.

We may amend the Status Qualification Requirements from time to time based on our expectations of the impact such requirements may have upon future mortality, persistency, expenses, capital and reserve requirements, and taxes under the policy. Such amendments could affect the Life Insured’s ability to achieve a Status level. Any change to the Status Qualification Requirements will be determined prospectively on a basis that does not discriminate unfairly within any class of life insureds. The Life Insured can obtain current information relating to his or her Status and/or the Status Qualification Requirements by visiting [http://www.JohnHancockVitality.com/] or by contacting our Service Office at [1-800-387-2747].

In addition, we or an affiliated or unaffiliated company designated by us may offer incentives to the Life Insured. These incentives may change from time to time and may include offers, discounts, online resources, and other tools designed to encourage the Life Insured to participate in activities to help meet the Status Qualification Requirements. Certain incentives may not be available to the Life Insured after the Rider Charge ceases. There may be costs associated with fulfilling a Status Qualification Requirement that may not be reimbursed by the Company. Examples of such costs include, but are not limited to, health coverage co-pays, health club fees, athletic event registration fees, health equipment, health monitoring devices, athletic attire, and online access fees.

If you are not satisfied with any of the changes we make, you may discontinue this rider at any time, as described below.

In no event will the Company use the Status or any medical or other information about the Life Insured provided after the Issue Date in order to meet Status Qualification Requirements:

 

  (a)

to change the Life Insured’s Risk Classification shown in the Policy Specifications; or

 

  (b)

as the sole basis to deny a request to reinstate coverage.

Discontinuation of this Rider

You may make a Written Request to discontinue this rider at any time. Upon discontinuation, the Rider Charge will cease and no new Rider Credit Factors will be earned. As long as your policy remains In Force, Rider Credits will continue to be applied based on all previously-earned Rider Credit Factors and Rider Credit Grading Factors subject to the Rider Credit Limit. Access to incentives for the Life Insured will cease.

This rider cannot be reinstated after discontinuation.

Termination of this Rider upon Policy Termination

This rider will terminate at the same time as your policy. Please see the Policy Termination provision of your policy. No Rider Credit Factors will be earned and no Rider Credits will be applied once the policy to which this rider is attached is terminated.

 

20HER    5

 

GENERAL PROVISIONS (continued)

 

Reinstatement of this Rider

If your policy and this rider terminate at the end of a Grace Period in which you did not make the Default Payment, you may apply for reinstatement of your policy and this rider in accordance with the Reinstatement provisions of your policy.

For purposes of calculating new Rider Credits following the date of reinstatement, we will determine the Rider Credit Multiplier and the Rider Credit Factors using the Status of the Life Insured on the next Annual Processing Date following the date of reinstatement. The Rider Credit Multiplier and the Rider Credit Factors are described in the Policy Specifications.

For purposes of applying Rider Credits earned in prior Policy Years following the date of reinstatement, the number of Elapsed Years in determining the Rider Credit Grading Factors will be measured from the Policy Year in which the applicable Rider Credit was first earned. The Rider Credit Grading Factors are shown in the Policy Specifications.

Each Annual Processing Date that would have occurred had your policy been In Force will be included in the calculation of the number of Annual Processing Dates for the purpose of calculating the Rider Credit Multiplier and the Rider Credit Factors.

No Rider Credit Factors will be earned and no Rider Credits will be applied once the policy to which this rider is attached is terminated. Any Rider Credit earned in prior Policy Years, that would have applied if the policy were still In Force, will not be applied to the Policy Value upon reinstatement.

Signed for the Company by:

 

LOGO
President

 

20HER    6

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

SUPPLEMENTARY BENEFITS

 

Benefit    Healthy Engagement Rider      
Effective Date    [January 1, 2020]      
 
IMPORTANT NOTICE: Until the Life Insured earns a Status beyond the first level, no Rider Credit Factors will be earned and no new Rider Credits will be applied to your Policy Value. The achievement of a Status beyond the first level is dependent upon the Life Insured meeting certain Status Qualification Requirements in each year.
Rider Credit Multiplier    On each of the first [45] Annual Processing Dates, if this rider is in effect, we determine the Rider Credit Multiplier to be applied in the current Policy Year as the sum of all Rider Credit Factors earned in the current and prior Policy Years.
Rider Credit Factors   

On each of the first [45] Annual Processing Dates, if this rider is in effect, based on the Status of the Life Insured as of that date, you earn a schedule of Rider Credit Factors that will be applied in the current and subsequent Policy Years.

 

The Rider Credit Factor earned in a Policy Year, that is scheduled to be applied in the current or a subsequent Policy Year, is equal to (a) multiplied by (b), where:

 

(a)   is the Rider Credit Rate from the Rider Credit Rates Table corresponding to the Policy Year and Status when earned; and

 

(b)   is the Rider Credit Grading Factor corresponding to the number of years elapsed between the Policy Year when earned and the Policy Year in which it is applied.

Rider Credit Grading    Elapsed Years    Rider Credit    Elapsed    Rider Credit
Factors       Grading Factor    Years    Grading Factor
   0    100%    11    45%
   1    95%    12    40%
   2    90%    13    35%
   3    85%    14    30%
   4    80%    15    25%
   5    75%    16    20%
   6    70%    17    15%
   7    65%    18    10%
   8    60%    19    5%
   9    55%    20+    0%
   10    50%      

 

20HER(20PVUL)    3.x

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

Rider Credit Limit

Multiplier

    Policy Years   Rider Credit Limit Multiplier
   1-3   5.00
   4+   5.00
Rider Benefit Base    $ [20,000,000]
Rider Charge    $ 2.00 per month for Policy Years 1 – [45]

Death Benefit

Protection Cost of

Insurance

Adjustment

    While this rider is in effect, the Monthly Death Benefit Protection Cost of Insurance Rate will be multiplied by the applicable Death Benefit Protection Cost of Insurance Adjustment Factor shown in Section 2, determined based on the Status of the Life Insured as of the most recent Annual Processing Date, before being applied to the Death Benefit Protection Value Net Amount at Risk.

 

20HER(20PVUL)    3.x

 

2. TABLE OF RATES (continued)—Policy [12 345 678]

 

 

     RIDER CREDIT RATES TABLE    
POLICY    [BRONZE   [SILVER   [GOLD   [PLATINUM
YEAR    (LEVEL 1)]   (LEVEL 2)]   (LEVEL 3)]   (LEVEL 4)]
     STATUS   STATUS   STATUS   STATUS
1    0.00%   0.00%   0.00%   0.00%
2    0.00%   0.78%   3.37%   4.22%
3    0.00%   0.69%   2.96%   3.70%
4    0.00%   0.61%   2.62%   3.27%
5    0.00%   0.55%   2.33%   2.90%
6    0.00%   0.49%   2.08%   2.58%
7    0.00%   0.91%   3.83%   4.75%
8    0.00%   1.25%   5.23%   6.47%
9    0.00%   1.55%   6.40%   7.86%
10    0.00%   1.83%   7.39%   9.02%
11    0.00%   1.74%   6.87%   8.32%
12    0.00%   1.66%   6.38%   7.67%
13    0.00%   1.58%   5.94%   7.09%
14    0.00%   1.51%   5.55%   6.58%
15    0.00%   1.44%   5.19%   6.11%
16    0.00%   1.38%   4.86%   5.69%
17    0.00%   1.32%   4.55%   5.29%
18    0.00%   1.26%   4.26%   4.92%
19    0.00%   1.20%   3.99%   4.58%
20    0.00%   1.14%   3.73%   4.26%
21    0.00%   1.09%   3.49%   3.97%
22    0.00%   1.04%   3.28%   3.70%
23    0.00%   0.99%   3.08%   3.46%
24    0.00%   0.95%   2.89%   3.24%
25    0.00%   0.91%   2.72%   3.03%
26    0.00%   0.87%   2.56%   2.83%
27    0.00%   0.83%   2.41%   2.66%
28    0.00%   0.79%   2.26%   2.49%
29    0.00%   0.76%   2.13%   2.34%
30    0.00%   0.72%   2.01%   2.19%
31    0.00%   0.69%   1.90%   2.06%
32    0.00%   0.66%   1.77%   1.92%
33    0.00%   0.62%   1.66%   1.79%
34    0.00%   0.59%   1.55%   1.67%
35    0.00%   0.56%   1.45%   1.55%
36    0.00%   0.53%   1.35%   1.45%
37    0.00%   0.50%   1.27%   1.35%
38    0.00%   0.47%   1.19%   1.26%
39    0.00%   0.45%   1.11%   1.18%
40    0.00%   0.43%   1.05%   1.11%
41    0.00%   0.41%   0.99%   1.04%
42    0.00%   0.39%   0.93%   0.98%
43    0.00%   0.37%   0.87%   0.92%
44    0.00%   0.35%   0.82%   0.86%
45    0.00%   0.33%   0.77%   0.81%
46    0.00%   0.32%   0.73%   0.76%
47+    0.00%   0.00%   0.00%   0.00%

 

20HER(20PVUL)    4.x

 

2.TABLE OF RATES (continued)—Policy [12 345 678]

 

DEATH BENEFIT PROTECTION COST OF INSURANCE ADJUSTMENT FACTORS

 

     [BRONZE   [SILVER   [GOLD   [PLATINUM
Age    (LEVEL 1)]   (LEVEL 2)]   (LEVEL 3)]   (LEVEL 4)]
     STATUS   STATUS   STATUS   STATUS
35    100.0000%   100.0000%   100.0000%   100.0000%
36    100.0000%   99.5838%   98.2014%   97.7476%
37    100.0000%   99.2393%   96.7234%   95.9002%
38    100.0000%   98.9574%   95.5124%   94.3889%
39    100.0000%   98.7245%   94.5283%   93.1652%
40    100.0000%   98.8071%   94.4854%   92.8820%
41    100.0000%   98.4536%   92.8365%   90.7779%
42    100.0000%   97.8786%   90.2682%   87.5417%
43    100.0000%   97.1901%   87.2354%   83.7503%
44    100.0000%   96.4165%   83.9120%   79.6259%
45    100.0000%   95.7694%   81.2149%   76.3185%
46    100.0000%   95.1378%   78.7446%   73.3504%
47    100.0000%   94.5687%   76.6452%   70.8774%
48    100.0000%   94.0833%   74.9713%   68.9540%
49    100.0000%   93.6677%   73.6514%   67.4858%
50    100.0000%   93.3609%   72.7227%   66.5185%
51    100.0000%   93.1062%   72.2353%   66.0994%
52    100.0000%   92.9475%   72.1261%   66.1391%
53    100.0000%   92.8164%   72.1474%   66.3431%
54    100.0000%   92.7350%   72.3694%   66.7870%
55    100.0000%   92.6144%   72.4934%   67.1233%
56    100.0000%   92.6660%   73.2149%   68.1629%
57    100.0000%   92.7848%   74.1406%   69.4247%
58    100.0000%   92.9500%   75.2003%   70.8754%
59    100.0000%   93.1593%   76.3660%   72.3935%
60    100.0000%   93.3521%   77.4369%   73.8214%
61    100.0000%   93.6535%   78.8345%   75.5981%
62    100.0000%   93.9597%   80.2066%   77.3338%
63    100.0000%   94.2627%   81.5391%   78.9581%
64    100.0000%   94.5669%   82.8205%   80.5257%
65    100.0000%   95.0759%   84.6848%   82.7310%
66    100.0000%   95.3217%   85.6986%   83.9530%
67    100.0000%   95.5669%   86.6630%   85.1075%
68    100.0000%   95.8031%   87.5732%   86.1863%
69    100.0000%   96.0314%   88.4309%   87.1988%
70    100.0000%   96.2465%   89.2256%   88.1252%
71    100.0000%   96.4511%   89.9593%   88.9805%
72    100.0000%   96.6468%   90.6408%   89.7796%
73    100.0000%   96.8302%   91.2776%   90.5010%
74    100.0000%   97.0077%   91.8795%   91.1886%
75    100.0000%   97.2728%   92.6964%   92.1045%
76    100.0000%   97.4284%   93.2048%   92.6780%
77    100.0000%   97.5833%   93.6990%   93.2296%
78    100.0000%   97.7356%   94.1700%   93.7549%
79    100.0000%   97.8853%   94.6204%   94.2524%
80    100.0000%   98.0246%   95.0384%   94.7150%
81    100.0000%   98.2797%   95.7066%   95.4338%

 

20HER(20PVUL)    4.x

82    100.0000%   98.5149%   96.3166%   96.0883%
83    100.0000%   98.7287%   96.8661%   96.6766%
84    100.0000%   98.9225%   97.3600%   97.2039%
85    100.0000%   99.0916%   97.7875%   97.6597%
86    100.0000%   99.2418%   98.1640%   98.0603%
87    100.0000%   99.3736%   98.4919%   98.4085%
88    100.0000%   99.4879%   98.7741%   98.7077%
89    100.0000%   99.5884%   99.0204%   98.9683%
90    100.0000%   99.6767%   99.2353%   99.1955%
91    100.0000%   99.7493%   99.4107%   99.3805%
92    100.0000%   99.8092%   99.5547%   99.5322%
93    100.0000%   99.8591%   99.6734%   99.6572%
94    100.0000%   99.9006%   99.7714%   99.7603%
95    100.0000%   99.9334%   99.8485%   99.8412%
96    100.0000%   99.9581%   99.9057%   99.9013%
97    100.0000%   99.9764%   99.9478%   99.9455%
98    100.0000%   99.9889%   99.9760%   99.9750%
99    100.0000%   99.9965%   99.9927%   99.9925%
100+    100.0000%   100.0000%   100.0000%   100.0000%

 

20HER(20PVUL)    4.x

RIDER

ACCELERATED BENEFIT

In this rider Accelerated Benefit refers to an acceleration of your life insurance benefits.

The death benefit and, if applicable, any cash values and loan values under your life insurance policy will be reduced if the Accelerated Benefit is paid.

Receipt of the Accelerated Benefit is intended to qualify for favorable tax treatment under section 101(g)(1)(A) of the Internal Revenue Code of 1986 as amended by Public Law 104-191. However, receipt of the benefit may affect eligibility for Medicaid and certain other public assistance programs. You should consult with your personal tax advisor and social service agencies before you decide to receive the benefit under this rider.

 

This rider has been added to and forms part of your policy. Unless this rider states otherwise, the provisions set out in your policy will apply to the rider.

 

Effective Date. This rider is effective on the date we attach it to your policy.

 

Benefit. If you meet the Conditions of Payment, we will pay you 50% of the eligible death benefit, up to a maximum of $1,000,000 on the life insured.

 

If more than one policy owner make a claim, we will pay the benefit in proportion to the amount of eligible death benefit each has on the life insured.

 

You will receive your payment in one lump sum. You cannot make another claim under this rider after we have paid the benefit. We will not make a payment if it would be less than $10,000.

 

Eligible Death Benefit. The eligible death benefit

is equal to (a) plus (b), minus (c), where

 

(a)   is the death benefit of your qualifying policies, including any paid-up additional insurance;

 

(b)   is the death benefit of any qualifying riders and supplementary benefits attached to your qualifying policies; and

 

(c)   is any outstanding loan amount.

   

Your qualifying policies are your inforce permanent or term life insurance policies issued by us, covering only one life insured. Your qualifying riders and qualifying supplementary benefits are part of your qualifying policies. They insure the same person and provide a death benefit other than accidental death coverage. Each policy, rider and supplementary benefit must have at least one year remaining in the benefit period. In this rider, “policy” refers to a qualifying policy, rider and supplementary benefit.

 

Conditions of Payment. You must meet the following conditions before we pay the benefit.

 

(a)   You must provide written evidence satisfactory to us that the life insured is terminally ill and has a life expectancy of one year or less. Part of the evidence must be a written statement from a licensed medical doctor stating the prognosis for the illness.

 

(b)   We must have the signed consent of any irrevocable beneficiary and any assignee.

 

(c)   You must claim the benefit voluntarily. We will not pay the benefit if you are claiming it to satisfy creditors, or for government benefits.

 

(continued)

 

S134-1ak    Page 1

ACCELERATED BENEFIT

 

Premium. There is no premium for this rider, and it has no effect on the premium due for your policy.

 

Administrative Expense Charge. The administrative expense charge for this benefit will not exceed $150.

 

Death Benefit Reduction. We will reduce the death benefit of your policy by the benefit amount, plus one year’s interest, plus any administrative expense charge. The interest rate charged for this benefit is the variable loan interest rate on our currently issued policies. In no event will the interest rate exceed your policy’s loan interest rate, if your policy includes a loan interest provision.

 

If your benefit calculation includes more than one policy, we will reduce the most recently issued first. If necessary, we will reduce the next most recently issued policy until we reach the desired amount.

 

If your policy permits a decrease in the face amount of insurance, we will not apply the policy restrictions on the amount, timing and number of decreases to the death benefit reduction.

 

Cash Value Reduction. Payment of the benefit will reduce any cash value in your policy. The reduced cash value will be equal to the original cash value multiplied by (a), divided by (b), where

 

(a)   is the death benefit after the payment of the accelerated benefit, and

   

(b)   is the death benefit before the payment of the accelerated benefit.

 

If your policy is a variable life insurance policy, you may tell us how to allocate the reduction of your policy. If you do not tell us, we will base the reduction on the proportion that each account bears to your Net Policy Value.

 

Effect On Policy Debt. If any qualifying policy has a loan against it, we will reduce the policy loan by the same proportion as the cash value.

 

Effect On Accidental Death Benefit Provision. Payment of the accelerated benefit will not affect any accidental death insurance coverage.

 

Termination. This rider will terminate on the earliest of the following dates:

 

(a)   the date we receive your written request for termination,

 

(b)   the date any premium for your policy is in default beyond the end of its grace period,

 

(c)   one year before the expiry or termination date of your policy, or

 

(d)   the date you surrender your policy.

THE MANUFACTURERS LIFE INSURANCE COMPANY (U.S.A.)

 

   LOGO
   President

 

S134-1ak    Page 2

 

LOGO

  

 

John Hancock Life Insurance Company (U.S.A.)

 

A Stock Company

 

 

Rider

[Healthy Engagement Core Rider]

 

This rider is made a part of your policy to which it is attached and is effective on the date we attach it to your policy or, if later, the date a Life Insured attains Age 20. This rider is only in effect in the absence of any other Healthy Engagement feature that is attached to or included with a policy issued by the Company. This rider terminates at the earlier of the date your policy terminates or, if attached to a Term Life Insurance policy, the end of the Select Period or Level Premium Period (whichever is applicable).

There is no charge for this rider.

 

 

HEALTHY ENGAGEMENT CORE PROGRAM

 

Under this rider, Life Insureds may participate in the Company’s Healthy Engagement Core program. The Healthy Engagement Core program is designed to help improve longevity of a Life Insured by educating and motivating him or her to develop and maintain a healthy lifestyle.

Through participation in the Healthy Engagement Core program, a Life Insured may receive discounts on goods and services, educational resources, tools, or other items designed to encourage a Life Insured to learn about and to participate in healthy activities. The availability of such items a Life Insured may receive under the Healthy Engagement Core program may change over time.

The decision to participate in the Healthy Engagement Core program is voluntary. We reserve the right to amend elements of the Healthy Engagement Core program from time to time. A Life Insured can obtain current information about the Healthy Engagement Core program by visiting [http://www.JohnHancockVitality.com/] or by contacting our Service Office at [1-800-387-2747].

In no event will the Company use any medical or other information about a Life Insured provided after the Issue Date under the Healthy Engagement Core program:

 

  (a)

to change a Life Insured’s Risk Classification shown in the Policy Specifications; or

 

  (b)

as the sole basis to deny a request to reinstate coverage.

 

 

ADMINISTRATION

 

The Healthy Engagement Core program may be administered by us or through an affiliated or unaffiliated company designated by us. We reserve the right to designate or replace any such company at any time.

There may be costs associated with participating in the Healthy Engagement Core program that may not be reimbursed by the Company. Examples of such costs include, but are not limited to, health coverage co-pays, health club fees, athletic event registration fees, health equipment, health monitoring devices, athletic attire, and online access fees.

Signed for the Company by:

 

LOGO
  President

 

18VCR   

 

SUPPLEMENTARY BENEFIT

DISABILITY BENEFIT RIDER

PAYMENT OF SPECIFIED PREMIUM IN EVENT OF LIFE INSURED’S

TOTAL DISABILITY AS DEFINED AND LIMITED

 

We agree, subject to the terms and conditions of this rider and the policy, to pay the Specified Premium (as defined below), during the period of continuous total disability of the life insured subject to the following conditions:

 

  (a)

we have received at our Service Office due proof of the life insured’s total disability as defined and limited herein;

 

  (b)

the total disability began between the Policy Anniversaries nearest the life insured’s 5th and 65th birthdays;

 

  (c)

the policy and this rider were in full force when the total disability began; and

 

  (d)

the total disability of the life insured has been continuous for at least 6 months.

This rider is made a part of the policy to which it is attached. If this rider is issued subsequent to delivery of the policy, the consideration for issuance of the rider is:

 

  (a)

the application for this rider, a copy of which is attached to and made a part of this policy; and

 

  (b)

deduction of the applicable Monthly Benefit Cost from the Policy Value, as described in the Policy Specifications section of the rider.

This rider is effective on the Effective Date shown in the Policy Specifications section for this rider.

The Issue Date of this rider is as provided in the Specifications section for this rider.

 

 

SPECIFIED PREMIUM DEFINED

 

The Specified Premium payable under this rider is the amount shown in the Policy Specifications section for this rider for the life insured whose total disability has met the terms and conditions of this rider.

We reserve the right to limit the amount of such Specified Premium to the amount necessary to ensure or maintain qualification of this rider as a Qualified Additional Benefit under Internal Revenue Code Section 7702. The Specified Premium may be reduced in the event of a reduction in Face Amount or a change in any rider benefits. We will notify you of any such reduction in the Specified Premium.

The Specified Premium paid under this rider may not be sufficient to maintain the policy in force to Age 121. You may be required to pay premiums during the continuous period of total disability to maintain the policy in force.

 

J142-lus    Page 1

 

TOTAL DISABILITY DEFINED

 

Total disability means such incapacity of the life insured as a result of bodily injury or disease that:

 

  (a)

For the first 24 months: the life insured is able to perform none of the duties of his or her occupation or employment for pay or profit; and

 

  (b)

After the first 24 months: the life insured is able to perform none of the duties of any occupation or employment for pay or profit for which the life insured is reasonably fitted by education, training or experience.

We will deem as total disability the total and irrecoverable loss by the life insured of:

 

  (a)

the sight of both eyes; or

 

  (b)

the use of both hands or both feet or of one hand and one foot.

 

 

PERIOD OF CONTINUOUS TOTAL DISABILITY

 

Subject to the conditions of this rider, the Specified Premium will be paid each month for the period of continuous total disability.

Beginning of Period of Continuous Total Disability. The period of continuous total disability begins on the first Policy Month after the later of:

 

  (a)

the date total disability began; and

 

  (b)

the date 1 year before written notice of claim is received.

End of Period of Continuous Total Disability. The period of continuous total disability ends on the earliest of:

 

  (a)

the date of the life insured’s death;

 

  (b)

the date the total disability ends;

 

  (c)

the date proof of continuous total disability is not given when required;

 

  (d)

the date the life insured fails to be examined when required.

If, however, the total disability starts on or after the Policy Anniversary nearest the life insured’s 60th birthday, then the period of continuous total disability ends on the earliest of the dates above and the day before the anniversary nearest the life insured’s 65th birthday.

Any premiums received during the period of continuous total disability will be applied in accordance with the terms of the policy.

 

J142-lus    Page 2

Provided we have received written notice not later than the first Policy Month following the date the total disability began, and subject to the other conditions of this rider, the first payment made under this rider will occur after all conditions have been met, including proof that total disability was continuous for at least 6 months, and will include all amounts that would have been paid from the Beginning of Period of Continuous Total Disability. Subsequent payments of the Specified Premium will be paid on each Policy Month that the Life Insured continues to be totally disabled, until the End of Period of Continuous Total Disability.

 

 

EXCEPTIONS AND EXCLUSIONS

 

No payment of the Specified Premium will be made:

 

  (a)

if the total disability begins within 2 years after the rider’s Issue Date and results from an injury sustained or a disease contracted before such rider’s Issue Date ;

 

  (b)

if the total disability has ceased or the life insured has died prior to receipt of due proof of total disability;

 

  (c)

if the total disability results wholly or partially from:

 

  (i)

willfully and intentionally self-inflicted injury; or

 

  (ii)

service in an armed force of an international body, or a country or group of countries at war whether declared or undeclared;

 

  (d)

if the due proof is not received before this rider terminates. However, failure to give due proof in the time required will not void or reduce a claim if:

 

  (i)

it was not reasonably possible to give proof in the time required;

 

  (ii)

due proof is given as soon as reasonably possible; and

 

  (iii)

due proof is given no later than 1 year after the date is otherwise required, except in the absence of legal capacity.

We reserve the right to pay an amount less than the Specified Premium if such lower payment is necessary to maintain the rider’s tax qualification.

 

 

WRITTEN NOTICE OF CLAIM

 

Written notice of claim may be filed with us to determine the beginning of the period for which benefits are provided, but no benefit will start until we receive the required due proof.

In any case in which written notice is filed more than 1 year after the disability began, benefits will start as if notice had been filed within 1 year. It must be shown, however, that notice was furnished as soon as was reasonably possible.

 

 

PROOF OF CONTINUANCE OF TOTAL DISABILITY

 

We shall have the right to require proof of continued total disability at reasonable intervals after receipt of due proof. After the Policy Anniversary nearest the life insured’s 65th birthday, no proof will be required if the period of total disability began before and has been continuous since the Policy Anniversary nearest the life insured’s 60th birthday.

As part of any proof, the life insured may be required to be examined by a medical examiner named by us at our expense.

 

J142-lus    Page 3

 

INCONTESTABILITY

 

This rider shall be incontestable after it has been in force during the lifetime of the life insured and without the occurrence of the total disability of the life insured, for 2 years from the Issue Date except for nonpayment of premium.

 

 

DISCONTINUANCE ON REQUEST

 

This rider may be discontinued as of any Policy Month on receipt of written notice and presentation of the policy for adjustment to us at our Service Office before the Policy Month and before the life insured’s death.

 

 

TERMINATION

 

This rider will terminate on the earliest of:

 

  (a)

the exchange or termination of the policy;

 

  (b)

the date this rider is discontinued on request;

 

  (c)

the date the death benefit of the policy becomes payable;

 

  (d)

the Policy Anniversary nearest the life insured’s 65th birthday except for benefits for total disability which began before the Policy Anniversary nearest the life insured’s 60th birthday.

This rider cannot be reinstated.

 

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
LOGO
President

 

J142-lus    Page 4

 

1. POLICY SPECIFICATIONS (CONTINUED)—POLICY 12 345 674

 

SUPPLEMENTARY BENEFITS

 

BENEFIT    

DISABILITY BENEFIT RIDER—PAYMENT OF

   

SPECIFIED PREMIUM IN EVENT OF LIFE INSURED’S

   

TOTAL DISABILITY AS DEFINED AND LIMITED

LIFE INSURED    

[JOHN J. DOE]

AGE AT    
EFFECTIVE DATE    

[35]

RISK CLASSIFICATION    

[NON-SMOKER, STANDARD CLASS]

EFFECTIVE DATE    

[SEPTEMBER 1, 2004]

ISSUE DATE    

[SEPTEMBER 2, 2004]

SPECIFIED PREMIUM    

[$100.00]

MONTHLY BENEFIT COST    

[30.9600] PER $1000 OF THE SPECIFIED

   

PREMIUM*

ADDITIONAL RATING    

[NOT APPLICABLE]

*ANY ADDITIONAL RATING IS INCLUDED IN THE MONTHLY BENEFIT COST

 

J142-lus    Page 5
LOGO   

 

John Hancock Life Insurance (U.S.A.)

 

A Stock Company

 

 

SUPPLEMENTARY BENEFIT

CRITICAL ILLNESS BENEFIT RIDER

 

THIS IS A LIMITED BENEFIT RIDER – PLEASE READ IT CAREFULLY.

This is an individual critical illness benefit insurance rider that provides for a one-time lump sum benefit amount if the Life Insured is Initially Diagnosed with a Critical Illness while this Rider is In Force, subject to all Policy and Rider provisions.

This Rider is part of your Policy to which it is attached. This Rider is subject to all the provisions of your Policy. The Rider Effective Date, the Rider Expiration Date and the Rider Charge for this Rider are shown in the Policy Specifications. This Rider has no cash value.

 

 

THIRTY-DAY FREE LOOK

 

If you are not completely satisfied with this Rider for any reason, you may return it within 30 days from the date you receive it. To return this Rider, mail or deliver it to: the agent who sold it to you, our Service Office, or the agency office through which it was delivered. We will then reverse any charges applicable to this Rider and this Rider will be treated as if it had never been issued.

 

 

NOTICE TO BUYER

 

 

  •  

THIS CRITICAL ILLNESS BENEFIT RIDER PROVIDES LIMITED BENEFITS. BENEFITS PROVIDED UNDER THIS RIDER DO NOT PROVIDE OR PAY FOR THE COST OF MEDICAL CARE AND ARE SUPPLEMENTAL TO HEALTH INSURANCE WHICH DOES PAY FOR SUCH COSTS. THIS RIDER IS NOT A SUBSTITUTE FOR HEALTH INSURANCE COVERAGE.

 

  •  

The benefits provided by this Rider cannot be coordinated with benefits provided by other coverage. Please review the benefits provided by this Rider carefully to avoid duplication of coverage.

 

  •  

Please read this Rider carefully along with the outline of coverage. We suggest you carefully review all benefit limitations. THIS IS NOT MEDICARE SUPPLEMENT COVERAGE.

 

 

CAUTION

 

The issuance of this Rider is based upon our issuance of the Policy and the responses to the questions on the application for this Rider and the Policy. A copy of the application and any supplemental application(s) for the Policy and this Rider are attached to the Policy. If the answers are incomplete, untrue, or not correctly recorded, we have the right to deny benefits or rescind this Rider subject to the provisions of this Rider and the Policy. The best time to clear up any questions is now, before a claim arises. Contact the Company by writing to us: [John Hancock Life Insurance Company (U.S.A.), 197 Clarendon Street, Boston MA 02116-5010, or calling us: 1-800-387-2747.]

 

 

IMPORTANT NOTICE REGARDING FEDERAL INCOME TAX LAW AND THE CRITICAL ILLNESS BENEFIT

 

Please refer to the Policy for the Federal Income Tax implications of the life insurance benefits found in the Policy. Monthly Rider Charges, when deducted from the Policy Value, constitute distributions from the Policy Value and are subject to the same income tax rules that apply to any other distribution. The purchase of and/or payment of any Critical Illness Benefit may have Federal Income Tax implications for you or the Life Insured. You are advised to consult with a qualified tax professional or attorney to determine any such tax impact.

 

17CIBR    1

 

GUARANTEED RENEWABLE

 

This Rider is guaranteed renewable. This means that as long as the Policy and Rider remain In Force subject to the Grace Period provision found in the Policy, the Rider will continue until the earliest of the dates described in the provision Termination of this Rider found in GENERAL PROVISIONS. The Rider Charge is not guaranteed to remain unchanged. We have a limited right to increase the Rider Charge. However, in no event will the Current Monthly Rider Charge Rate ever exceed the Maximum Monthly Rider Charge Rate shown in the Policy Specifications. Any change to the Current Monthly Rider Charge Rate: must apply to all similar critical illness benefit riders issued in the Jurisdiction of Issue to individuals in the same class on this rider form; and be accepted by the insurance department of the Jurisdiction of Issue. This means we cannot single the Life Insured out for an increase because: of their advancing age, declining health, claim status; or for any other reason related solely to the Life Insured. We will not change the Current Monthly Rider Charge Rate more frequently than once in any 12-month period. We cannot change the provisions of this Rider without your consent. To continue this Rider, the Rider Charge must be paid when due.

 

 

CRITICAL ILLNESS BENEFIT

 

We will pay the Critical Illness Benefit Amount if all of the following conditions are met:

 

  •  

the Life Insured is Initially Diagnosed with a Critical Illness after;

 

  ○   

the Rider Effective Date; and

 

  ○   

the Waiting Period has been satisfied;

 

  •  

the Initial Diagnosis of the Critical Illness is made by an appropriate Physician except as noted in the definition of Critical Illness below where the Initial Diagnosis is required by the named specialist relevant to the Critical Illness condition; and

 

  •  

we are provided with due Proof of Loss.

No benefits are payable for conditions other than the specified Critical Illnesses defined in this Rider. This Rider will not cover any Critical Illness Initially Diagnosed prior to the Rider Effective Date.

The Critical Illness Benefit Amount is shown in the Policy Specifications. The Critical Illness Benefit Amount may be reduced after issue if your Total Face Amount is reduced as described in the provision captioned Impact of Face Amount Changes on the Critical Illness Benefit Amount. In addition, the Critical Illness Benefit Amount will never exceed the Critical Illness Benefit Cap shown in the Policy Specifications. The Critical Illness Benefit Amount will be paid in a lump sum on a one-time basis to you. Once the Critical Illness Benefit has been paid, this Rider will terminate.

 

 

WAITING PERIOD

 

The Waiting Period is the 30-calendar day period that needs to be satisfied prior to the Initial Diagnosis of a Critical Illness. The Waiting Period begins on the Rider Effective Date and ends after 30-calendar days.

No Critical Illness Benefit Amount will be paid if the Life Insured is Initially Diagnosed with a Critical Illness during the Waiting Period. In such event, you may elect to terminate this Rider.

 

  •  

If you elect to terminate this Rider you must provide us with written notification of such request. The Rider Charge will be reversed as of the Rider Effective Date.

 

  •  

If you elect to keep this Rider In Force, the Rider Charge must continue to be paid. In addition, please note that:

 

  •  

the Critical Illness Benefit Amount will never be payable for the Life Insured’s Critical Illness Initially Diagnosed during the Waiting Period; however,

 

  •  

the Critical Illness Benefit Amount will be available in the event the Life Insured is Initially Diagnosed with one of the remaining specified Critical Illnesses defined in this Rider and all applicable Policy and Rider conditions are met.

In the event this Rider is reinstated, a new Waiting Period will be established. In such instance, the Waiting Period will begin on the date of reinstatement and end 30-calendar days after the date of such reinstatement.

 

17CIBR    2

 

DEFINITIONS

 

Listed below are terms that have specific meanings for this Rider. Terms not listed below may be defined in the body of this Rider or in the Policy to which this Rider is attached.

Critical Illness means one of the seven illnesses or conditions listed below for which an Initial Diagnosis is made by a Physician or a specialist expert in the medical field diagnosing the specific Critical Illness described below.

 

  •  

Cancer means a definite Initial Diagnosis of a tumor characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. Types of cancer include: carcinoma; melanoma; leukemia; lymphoma; and sarcoma. The Initial Diagnosis of Cancer must be made by a Physician who is a board-certified oncologist. Such Initial Diagnosis must be made pursuant to a Pathological or Clinical Diagnosis.

 

  •  

A Pathological Diagnosis must be based on a microscopic study of fixed tissue or preparations from the hemic (blood) system. This type of diagnosis must be done by a certified pathologist, whose diagnosis of malignancy is in keeping with the standards set up by the American Board of Pathology.

 

  •  

A Clinical Diagnosis of Cancer must be based on the study of symptoms and medical evidence which supports the Initial Diagnosis of Cancer.

The following are not deemed to be within the meaning of “Cancer” for purposes of this Rider:

 

  •  

lesions described as benign, pre-malignant, uncertain, borderline, non-invasive, carcinoma in-situ (Tis), or tumors classified as Ta (noninvasive tumors of the bladder);

 

  •  

malignant melanoma skin cancer that is less than or equal to 1.0 mm in thickness, unless it is ulcerated or is accompanied by lymph node or distant metastasis;

 

  •  

any non-melanoma skin cancer, without lymph node or distant metastasis;

 

  •  

prostate cancer classified as T1a or T1b, without lymph node or distant metastasis; or

 

  •  

papillary thyroid cancer or follicular thyroid cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis.

 

  •  

Coronary Artery Bypass Grafting means heart surgery determined to be Medically Necessary by a Physician who is a board-certified cardiologist to correct narrowing or blockage of one or more coronary arteries with bypass graft(s). For purposes of Coronary Artery Bypass Grafting, Initial Diagnosis/Initially Diagnosed means the date this surgery is performed.

The following are not deemed to be within the meaning of Coronary Artery Bypass Grafting for purposes of this Rider: angioplasty; intra-arterial procedures; percutaneous trans-catheter procedures; or non-surgical procedures.

 

  •  

Heart Attack means a definite Initial Diagnosis of the death of heart muscle due to obstruction of blood flow to the coronary arteries, that results in a rise and fall of biochemical cardiac markers to levels considered diagnostic of myocardial infarction, with at least one of the following:

 

  •  

new electrocardiogram (ECG) changes consistent with a heart attack; or

 

  •  

development of new Q waves during or immediately following an intra-arterial cardiac procedure including, but not limited to, coronary angiography and coronary angioplasty.

The Initial Diagnosis of Heart Attack must be made by a Physician who is a board-certified cardiologist.

The following are not deemed to be within the meaning of Heart Attack for purposes of this Rider:

 

  •  

elevated biochemical cardiac markers as a result of an intra-arterial cardiac procedure including, but not limited to, coronary angiography and coronary angioplasty, in the absence of new Q waves;

 

  •  

ECG changes suggesting a prior myocardial infarction, which do not meet the definition of Heart Attack described above; or

 

  •  

elevated biochemical cardiac markers are a result of coronary angioplasty and there are no associated findings of new Q waves.

 

17CIBR    3

 

DEFINITIONS (continued)

 

 

  •  

Kidney Failure means a definite Initial Diagnosis of chronic irreversible failure of both kidneys to function, as a result of which regular hemodialysis, peritoneal dialysis or renal transplantation is initiated. The Initial Diagnosis of Kidney Failure must be made by a Physician.

 

  •  

Major Organ Failure means a definite Initial Diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow, and transplantation must be Medically Necessary. To qualify as Major Organ Failure (on transplant waiting list), the Life Insured must become enrolled as the recipient in a recognized transplant center in the United States that performs the required form of transplant surgery. The Initial Diagnosis of the Major Organ Failure must be made by a Physician.

 

  •  

Paralysis means a definite Initial Diagnosis of the total loss of muscle function of two or more limbs as a result of injury or disease to the nerve supply of those limbs, for a period of at least 90 days following the precipitating event. The Initial Diagnosis of Paralysis must be made by a Physician who is a board-certified neurologist.

 

  •  

Stroke means a definite Initial Diagnosis of an acute cerebrovascular event caused by intracranial thrombosis or hemorrhage, or embolism from an extra-cranial source, with:

 

  •  

acute onset of new neurological symptoms; and

 

  •  

new objective neurological deficits on clinical examination, persisting for more than 30 days following the date of Initial Diagnosis.

These new symptoms and deficits must be confirmed by diagnostic imaging testing consistent with an acute stroke. The Initial Diagnosis of Stroke must be made by a Physician who is a board-certified neurologist.

The following are not deemed to be within the meaning of Stroke for purposes of this Rider:

 

  •  

transient ischemic attacks / transient global amnesia;

 

  •  

intracerebral vascular events due to trauma;

 

  •  

chronic cerebrovascular insufficiency;

 

  •  

reversible ischemic neurological deficits; or

 

  •  

lacunar infarcts which do not meet the definition of stroke as described above.

Initial Diagnosis/Initially Diagnosed means a first time ever positive diagnosis of a Critical Illness of the Life Insured during the Life Insured’s lifetime.

Medically Necessary means health care services, treatment or procedures that a Physician, exercising prudent clinical judgment, would provide to a patient for the purpose of evaluating, diagnosing or treating an illness, injury, disease or its symptoms, and that are:

 

  •  

in accordance with the generally accepted standards of medical practice;

 

  •  

clinically appropriate, in terms of type, frequency, extent, site and duration, and considered effective for the patient’s illness, injury or disease; and

 

  •  

not primarily for the convenience of the patient or Physician, or another Physician.

For these purposes, “generally accepted standards of medical practice” means:

 

  •  

standards that are based on credible scientific evidence published in peer-reviewed, medical literature generally recognized by the relevant medical community;

 

  •  

Physician Specialty Society recommendations;

 

  •  

the views of Physicians practicing in the relevant clinical area; and

 

  •  

any other relevant factors.

 

17CIBR    4

 

DEFINITIONS (continued)

 

Physician. Any person licensed in the United States of America as a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) practicing within the scope of his or her license issued by the jurisdiction in which the Initial Diagnosis is rendered.

A Physician cannot be: the Owner; the Life Insured: anyone related to the Owner and/or Life Insured by blood or marriage; a business or professional partner of the Owner and/or Life Insured; or any person who has a financial affiliation or a business interest with the Owner and/or Life Insured.

 

 

EXCEPTIONS AND LIMITATIONS

 

We will not pay the Critical Illness Benefit Amount if the Life Insured’s Initially Diagnosed Critical Illness is caused by, results from, or occurs during:

 

  •  

intentionally self-inflicted injuries;

 

  •  

suicide, or any attempt at suicide, while sane or insane;

 

  •  

war (declared or undeclared) or any act of war, or service in any of the armed forces or auxiliary units;

 

  •  

participation in the commission or attempted commission of a felony, riot, or insurrection;

 

  •  

intoxication or being under the influence of alcohol, drugs or any narcotic (including overdose) unless administered on, and taken in accordance with, the instructions of a Physician; or

 

  •  

alcohol abuse, alcoholism or drug addiction.

The Critical Illness Benefit Amount will not be available or payable for any Critical Illness of the Life Insured Initially Diagnosed outside the 50 United States and the District of Columbia, unless: the Initial Diagnosis is confirmed in the United States, in which case the Critical Illness will be deemed to occur on the date the Initial Diagnosis is made outside the United States; and all of the applicable Policy and Rider conditions are met.

 

 

IMPACT OF FACE AMOUNT CHANGES ON THE CRITICAL ILLNESS BENEFIT AMOUNT

 

Any reduction in Total Face Amount regardless of the cause will result in a recalculation of Critical Illness Benefit Amount. If there is a reduction in the Total Face Amount, the new Critical Illness Benefit Amount is equal to the lesser of (a) and (b), where:

 

  (a)

is the Critical Illness Benefit Percent shown in the Policy Specifications multiplied by the Total Face Amount immediately after reduction in the Total Face Amount; and

 

  (b)

is the Critical Illness Benefit Amount immediately before the reduction in Total Face Amount.

Decreases in the Critical Illness Benefit Amount, without changes to the Total Face Amount, are not available.

The lapse of the Supplemental Face Amount if applicable is considered a reduction in the Total Face Amount for purposes of this Rider. The payment of any Accelerated Benefit is not considered a reduction in the Total Face Amount for the purposes of this Rider.

Any increases to the Total Face Amount will not result in a recalculation of the Critical Illness Benefit Amount.

Increases to the Critical Illness Benefit Amount are not available.

 

 

LOANS AND WITHDRAWALS

 

Loans and/or withdrawals on the Critical Illness Benefit Amount are not allowed.

 

17CIBR    5

 

CLAIMS

 

Notice of Claim

Written notice of a claim for the Critical Illness Benefit must be given to us. You can provide us with notice by mailing it to our Service Office or by calling us. The mailing address for our Service Office is: [John Hancock Life Insurance Company (U.S.A.), Life Post Issue – Claims, John Hancock, PO BOX 55979, Boston MA 02205] and our telephone number is: [1-800-387-2747]. The notice must be received by us within 45 days of the date the Life Insured’s Critical Illness is Initially Diagnosed.

Claim Forms

We will provide you with written acknowledgement of your notification of intent to file a claim, instructions, and the necessary forms for filing a claim. Such information will be provided within 15 days of our receiving your notice of intent to file a claim. If 15 days have elapsed and we have not provided you with the necessary claim forms, you can provide written proof that satisfies the Proof of Loss requirements. You must file your Proof of Loss with our Service Office.

Proof of Loss

Proof of Loss means detailed written documentation acceptable to us which describes and confirms the Life Insured’s Initial Diagnosis of a Critical Illness. Proof of Loss includes: a completed claim form, if applicable, and documentation furnished by a Physician or the Initially Diagnosing specialist relevant to the applicable Critical Illness and supported by one or more of the following: clinical, radiological, histological, pathological and/or laboratory evidence of the specified Critical Illness.

Written Proof of Loss must be filed within 6 months of the Initial Diagnosis of the Life Insured’s Critical Illness or as soon thereafter as is reasonably possible. Your claim for the Critical Illness Benefit will be denied for failure to provide Proof of Loss unless it is provided to us within one year from the date the Life Insured is Initially Diagnosed with a Critical Illness. We will waive this limitation if you provide us with satisfactory proof that you are legally incapacitated or otherwise incapable of providing us with Proof of Loss.

We have the right to require additional written proof to verify the Initial Diagnosis. During the process of reviewing your claim, we may consult with the Life Insured’s primary care Physician and/or other medical professional.

At your own expense, you must obtain and submit all required documentation in English.

You may provide us with Proof of Loss by mailing or faxing originals or copies of the required documentation.

Time of Payment of Claim

We will make an objective review of all the information we receive. We will send claim payment no later than 30 days after we receive notice of claim and satisfactory Proof of Loss, provided that all Rider and Policy requirements have been satisfied.

As a reminder, in order for us to process your claim, we will need your assistance. You have a responsibility to comply with all applicable Rider and Policy provisions, provide us with requested information and comply with our requests in a timely manner. If you refuse to provide requested information or if the Life Insured refuses to undergo any requested assessment, interview or exam, we will be unable to process your claim and therefore, we will not be liable for the payment of the Critical Illness Benefit Amount under this Rider.

Payment of Claim

All benefits payable under this Rider are payable to you, subject to the ownership provisions on the Policy at the time of claim. We will be fully discharged of our obligations to the extent any payment under this Rider is made in good faith.

 

17CIBR    6

 

CLAIMS (continued)

 

Good Health and Wellness Programs Access

From time to time, we may provide you and/or the Life Insured (directly or through a vendor) access to information, offers, discounts, services or programs which are designed to promote good health and/or help maintain wellness. Information may be provided to you and/or the Life Insured through written, website or other mediums. The decision to access any information or service or participate in any program is completely voluntary. In addition, the decision to access any information or program will not reduce any Policy or Rider benefits.

There may be an additional cost associated with accessing certain services or programs. Any such cost is yours or the Life Insured’s responsibility and is not covered or payable under the Policy or this Rider. Also, please note that any discounted fees charged by a program or provider may not be the least expensive fees available. We do not endorse, sponsor or guarantee the quality of a program or provider, or the care or services provided by such provider. It is yours or the Life Insured’s responsibility to choose a program or provider who will best meet your respective needs.

Our Right to Require Medical Exams and Reports

We have the right to:

 

  •  

require a medical assessment, evaluation and/or exam of the Life Insured as often as it may be reasonably required while a claim is pending; and

 

  •  

request an autopsy report if necessary to adjudicate a claim where allowable by law.

We will pay for any assessment, evaluation, or exam that we request.

 

 

GENERAL PROVISIONS

 

Rider Charge

There is a monthly Rider Charge for this Rider which is deducted from the Policy Value. If your Policy contains a Death Benefit Protection provision or a Persistency Credit provision, the Rider Charge is also deducted from the Death Benefit Protection Value and the Persistency Measure, as applicable. If your Policy contains a Cumulative Guarantee provision, the Rider Charge is also deducted from the Policy Value under this provision. The Rider Charge is shown in Policy Specifications. In no event, will the Rider Charge ever exceed the Maximum Monthly Rider Charge Rate shown in the Policy Specifications.

Grace Period

The Grace Period provision of the Policy shall also apply to this Rider. During the Grace Period, this Rider will stay in effect.

Reinstatement of this Rider

If your Policy and this Rider terminate at the end of a Grace Period in which you did not make the Default Payment, you may apply for reinstatement of your Policy and this Rider in accordance with the Reinstatement provisions of your Policy. Reinstatement will be subject to the satisfaction of our underwriting requirements (including but not limited to any applicable age restrictions for the Life Insured), and payment of any required premium. A reinstated Rider will only pay the Critical Illness Benefit Amount if after the date of reinstatement and the reinstated Waiting Period has been satisfied: the Life Insured is Initially Diagnosed with a Critical Illness; and all of the conditions in the Critical Illness Benefit provision are met. Please note that the Policy may be reinstated while reinstatement of the Rider may be declined. If the Rider is reinstated, the reinstated Rider will not provide a Critical Illness Benefit during the period from the end of the Grace Period through the date of reinstatement. In addition, a new Waiting Period will be established as of the effective date of the Rider’s reinstatement and will continue for 30 days after such date. This Waiting Period must be satisfied prior to any Initial Diagnosis of a Critical Illness.

 

17CIBR    7

 

GENERAL PROVISIONS (continued)

 

Incontestability

After this Rider has been in effect for two years, it is incontestable except for relevant facts relating to the Life Insured’s health that were knowingly and intentionally misrepresented. The contestability period for this Rider begins on the Rider Effective Date. In the case of reinstatement of this Rider requiring Evidence of Insurability, the contestable period shall be two years and begins on the effective date of such reinstatement of this Rider.

Any Initial Diagnosis of a Critical Illness which occurs within two years of the Rider Effective Date or within two years of the reinstatement date of this Rider will fall within the contestable period even if reported after the expiration of the contestable period.

Legal Action

Your right to bring suit against us to recover on this Rider begins 60 days after you have provided us with the required Proof of Loss and ends 4 years from the date the Proof of Loss was given to us. If any part of this provision is in conflict with the applicable law and/or regulation of the state where the Policy is issued, this provision shall be administered in accordance with such applicable state law or regulation.

Discontinuation of this Rider

You may make a Written Request to discontinue this Rider at any time. The Rider coverage and Rider Charge will cease on the Processing Date following the date we approve the request for Rider discontinuation. This Rider cannot be reinstated after discontinuation.

Termination of this Rider

When this Rider terminates, no further Rider Charge will be due and no Critical Illness Benefit will be available. This Rider will terminate on the earlier of the following events:

 

  •  

the exchange or termination of the Policy;

 

  •  

your request to discontinue this Rider;

 

  •  

the payment of the Critical Illness Benefit Amount;

 

  •  

the Rider Expiration Date shown in the Policy Specifications; or

 

  •  

the Life Insured dies.

The Contract

This Rider, along with the written application and any supplemental applications for the Policy and this Rider, are attached to and made part of your Policy, along with any other riders and endorsements and constitutes the entire contract between you and us. Should any provisions in the Policy conflict with this Rider, the provisions of this Rider will prevail.

No change in the Policy or this Rider will be effective until approved by our President or Secretary. This approval must be noted on or attached to the Policy. No agent may change the Policy or this Rider or waive any of the provisions.

Signed for the Company by:

LOGO

President

 

17CIBR    8

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

SUPPLEMENTARY BENEFITS

 

Benefit      CRITICAL ILLNESS BENEFIT RIDER
Life Insured      [John J. Doe]
Rider Effective Date      [Jun 2, 2020]
Rider Expiration Date      [Jun 1, 2050]
Rider Charge Date     

Sep 2, 2020

 

Your Rider Charge will take effect on this date when your rider is added after the Policy Issue Date.

Rider Risk Classification      [Standard Non-Smoker]
Additional Rating      [Not Applicable]
Critical Illness Benefit Percent      [10]%

Critical Illness Benefit Amount

(CIBA)

     

$[100,000.00] on the Rider Effective Date

 

After the Rider Effective Date, reductions in the Total Face Amount may decrease the CIBA.

Critical Illness Benefit Cap      $[250,000]
Rider Charge     

The Rider Charge deducted monthly from the Policy Value is the result of (a) multiplied by (b) multiplied by (c), where:

 

(a)   is the CIBA divided by 1,000;

 

(b)   is the Current Monthly Rider Charge Rate under Section 2. Table of Rates; and

 

(c)   is the minimum of one and the result of (i) minus (ii) divided by (i), where:

 

(i) is the Current Monthly Cost of Insurance Rate for the current Policy Year assuming no additional ratings apply; and

 

(ii)  is the Policy Value Credit Factor A for the current Policy Year.

Death Benefit Protection Rider Charge      The Rider Charge deducted monthly from the Death Benefit Protection Value is equal to the CIBA divided by 1,000 multiplied by the Death Benefit Protection Monthly Rider Charge Rate. Please see Death Benefit Protection Monthly Rider Charge Rate under Section 2. Table of Rates .

 

17CIBR(PIVUL)    3.X    [(PVC)]

 

2. TABLE OF RATES (continued) – Policy [12 345 678]

 

CURRENT AND MAXIMUM MONTHLY RIDER CHARGE RATES

 

Age   

Current Monthly Rider

Charge Rate per

$1,000 of CIBA

   

Maximum Monthly

Rider Charge Rate

per $1,000 of CIBA

   

Death Benefit

Protection Monthly

Rider Charge Rate

per $1,000 of CIBA

35

    0.1984    0.9922    0.1984

36

    0.1320    0.6599    0.1320

37

    0.1781    0.8904    0.1781

38

    0.2226    1.1130    0.2226

39

    0.2512    1.2561    0.2512

40

    0.2767    1.3833    0.2767

41

    0.3021    1.5106    0.3021

42

    0.3307    1.6537    0.3307

43

    0.3864    1.9319    0.3864

44

    0.4611    2.3056    0.4611

45

    0.5486    2.7428    0.5486

46

    0.6360    3.1801    0.6360

47

    0.7346    3.6730    0.7346

48

    0.8300    4.1500    0.8300

49

    0.9620    4.8099    0.9620

50

    1.0876    5.4380    1.0876

51

    1.1989    5.9945    1.1989

52

    1.3118    6.5590    1.3118

53

    1.4438    7.2189    1.4438

54

    1.5948    7.9741    1.5948

55

    1.7459    8.7294    1.7459

56

    1.8890    9.4449    1.8890

57

    2.0257    10.1287    2.0257

58

    2.1768    10.8839    2.1768

59

    2.3453    11.7267    2.3453

60

    2.5059    12.5296    2.5059

61

    2.6633    13.3167    2.6633

62

    2.8160    14.0800    2.8160

63

    3.0354    15.1771    3.0354

64

    3.3216    16.6081    3.3216

65

    0.0000    0.0000    0.0000

Monthly Rider Charge Rates have been adjusted for any applicable Additional Ratings. The rates shown above apply to the Risk Classification of the Life Insured and any applicable Additional Ratings on the Rider Effective Date.

 

17CIBR(PIVUL)    4.X    [(PVC)]
LOGO   

 

John Hancock Life Insurance Company (U.S.A.)

 

A Stock Company

 

 

SUPPLEMENTARY BENEFIT

ACCELERATION OF DEATH BENEFIT FOR QUALIFIED LONG-TERM CARE SERVICES RIDER

 

 

 

LONG-TERM CARE COVERAGE

 

THIS IS AN INDIVIDUAL LONG-TERM CARE INSURANCE RIDER THAT COVERS CARE PROVIDED IN A NURSING HOME OR AN ASSISTED LIVING FACILITY, HOME HEALTH CARE, ADULT DAY CARE, AND HOSPICE CARE. A PORTION OF THE DEATH BENEFIT MAY BE ACCELERATED UNDER THIS RIDER IN ORDER TO REIMBURSE EXPENSES INCURRED FOR THE RECEIPT OF QUALIFIED LONG-TERM CARE SERVICES.

 

 

THIRTY-DAY FREE LOOK

 

If you are not completely satisfied with this rider for any reason, you may return it within 30 days from the date it was delivered to you. To return this rider, mail or deliver it to: the agent who sold it to you, our Service Office, or the agency office through which it was delivered. We will then reverse any charges applicable to this rider and this rider will be treated as if it had never been issued.

 

 

NONCANCELLABLE

 

You have the right to continue this rider for as long as the Insured lives, or until this rider is terminated in accordance with the Termination provision as set forth herein. The rates used for determining the charges for this rider are guaranteed not to change.

 

 

CAUTION

 

The issuance of this rider is based upon our issuance of the policy and the responses to the questions on the application for this rider and the policy. A copy of the application for the policy and this rider are attached to the policy. If the answers are incomplete, untrue, or not correctly recorded, we have the right to deny benefits or rescind this rider subject to the provisions of this rider and the policy. The best time to clear up any questions is now, before a claim arises. Contact the Company by writing to us: [Life Post Issue, John Hancock Life Insurance Company (U.S.A.), 30 Dan Road Suite #55979, Canton, MA 02021], or calling us: [1-800-387-2747].

NOTICE: This rider provides only the following price protection and no more. The rates used for determining the charges for this rider are guaranteed not to change.

 

 

NOTICE TO BUYER

 

This rider may not cover all the costs associated with long-term care that the Insured incurs during the period of coverage. You are advised to carefully review all benefit limitations. THIS IS NOT A MEDICARE SUPPLEMENT POLICY.

 

 

FEDERAL INCOME TAX TREATMENT OF THIS RIDER

 

This rider is intended to be a qualified long-term care insurance contract under Internal Revenue Code (“Code”) section 7702B(b). The benefits provided by this rider are designed to be excludable from gross income under federal tax law; however, there might be situations in which the benefits or charges for this rider are taxable. If, in the future, it is determined that this rider does not meet the requirements of Code section 7702B, we will make reasonable efforts to amend this rider, if we are required to do so, to maintain this rider’s tax status. We will offer you an opportunity to receive these amendments. If you choose to reject these amendments, this rider may no longer be a qualified long-term care insurance contract under section 7702B(b). If you have any questions concerning the tax implications of this rider, you should consult with an attorney or a qualified tax advisor.

 

18LTCR    1    DE

 

TABLE OF CONTENTS

 

 

Rider Provisions    Section  

Definitions

      3  

Accelerated Benefits

      8  

Eligibility for Accelerated Benefits

      10  

Exclusions

      12  

Claims

      12  

Effect of Accelerated Benefits on Your Policy

      16  

General Provisions

      17  

 

18LTCR    2    DE

 

1. DEFINITIONS

 

Listed below are some terms that have specific meanings in this rider. Defined terms are presented with the first letter in the defined terms capitalized to help you easily identify them. Other terms may be defined in the section of the rider in which they are most frequently discussed or in the policy to which this rider is attached.

Accelerated Benefit(s) means the amount of Death Benefit that is accelerated to reimburse expenses arising from the Insured’s receipt of Qualified Long-Term Care Services.

Activities of Daily Living means the 6 activities listed below:

 

  (i)

Bathing which means washing oneself by sponge bath, in a tub or a shower, including the task of getting in or out of the tub or shower.

 

  (ii)

Continence which means the ability to maintain control of bowel and bladder function, and, when unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene (including caring for a catheter or a colostomy bag).

 

  (iii)

Dressing which means putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs.

 

  (iv)

Eating which means feeding oneself by getting food into the body from a receptacle (such as a plate, cup, or table) or being fed by a feeding tube or intravenously. Eating does not include preparing a meal.

 

  (v)

Toileting which means getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.

 

  (vi)

Transferring which means moving into or out of a bed, chair, or wheelchair. Transferring does not include the task of getting into or out of the tub or shower or mobility outside the Insured’s place of residence.

Medication management, the management of financial affairs, assistance with the telephone and clinical interventions (such as but not limited to blood and/or glucose monitoring, or assistance in putting on and/or taking off compression stockings) are not Activities of Daily Living.

Adult Day Care means social and health-related services provided during the day in a community or group setting of 6 or more persons (or a fewer number of persons as required by applicable state law or regulation). The purpose of the services is to support frail or impaired elderly, or other disabled adults, who can benefit from care in a group setting outside of the home.

Adult Day Care Center means a place that provides the Insured with Adult Day Care for only part of a day while the Insured is residing at Home and is licensed by the jurisdiction in which the services are provided. If licensing is not required, an Adult Day Care Center is a place:

 

  (a)

that provides Adult Day Care;

 

  (b)

has enough full-time staff to maintain no more than an 8-to-1 client-staff ratio; and

 

  (c)

has established procedures for obtaining appropriate aid in the event of a medical emergency.

Assisted Living Facility means a facility or a distinctly separate part of a facility, that is engaged primarily in providing 24-hour, 7-days a week Custodial Care and:

 

  (a)

is licensed to provide primarily Custodial Care according to the laws of the jurisdiction in which it is located; or

 

  (b)

if licensing is not required, meets all of the following:

 

  (i)

has a 24-hour on-site awake and trained staff to provide Custodial Care;

 

  (ii)

provides Custodial Care services by its employees for a charge, including room and board;

 

  (iii)

has established procedures for obtaining appropriate aid in the event of a medical emergency;

 

  (iv)

provides 3 meals a day and can accommodate special dietary needs;

 

  (v)

provides, at a minimum, assistance with Bathing and Dressing;

 

  (vi)

provides Custodial Care services by its employees to 10 or more persons; and

 

  (vii)

maintains daily notes of the inpatient care and services provided.

 

18LTCR    3    DE

 

1. DEFINITIONS (CONTINUED)

 

Examples of such facilities may include Alzheimer’s facilities or Assisted Living Facilities, which may be either freestanding or part of a life-care community.

The following are not Assisted Living Facilities:

 

  (a)

a hospital or clinic;

 

  (b)

a rehabilitation hospital or clinic;

 

  (c)

a rest home (a home for the aged or a retirement home) which does not, as its primary function, provide Custodial Care;

 

  (d)

your or the Insured’s Home or the home of your or one of the Insured’s Immediate Family members;

 

  (e)

a facility for the treatment of alcoholism; alcohol abuse, drug addiction, or mental illness; and (f) an independent living unit.

Bed Hold Benefit means that we will continue to pay Accelerated Benefits and reserve the Insured’s bed, for up to 21 days in any calendar year, if the Insured is in a Nursing Home or an Assisted Living Facility and the Insured’s stay in such facility has been interrupted for any reason. Any benefit paid under this provision will continue to be paid from the Accelerated Benefit Balance as if the Insured’s stay in a Nursing Home or an Assisted Living Facility had not been interrupted.

Chronically Ill Individual means an Insured who has provided Written Certification that he or she requires:

 

  (a)

Substantial Assistance from an individual to perform at least 2 Activities of Daily Living, due to the loss of functional capacity, for a period expected to last at least 90 days; or

 

  (b)

Substantial Supervision to protect against threats to health and safety due to a Severe Cognitive Impairment.

Custodial Care means non-skilled long-term care services included in the Plan of Care because the Insured is a Chronically Ill Individual.

Date of Service means a day on which the Insured incurs costs for Qualified Long-Term Care Services while this rider is In Force. For Home Health Care, a Date of Service requires the Insured to have received at least 2 hours of Qualified Long-Term Care Services on that date. Such services cannot be primarily Incidental Homemaker Services.

Elimination Period (waiting period) means the number of Dates of Service that would otherwise be covered by this rider, for which we will not pay Accelerated Benefits. The Elimination Period is shown in the Policy Specifications.

Only one complete Elimination Period needs to be satisfied while this rider is In Force. No Date of Service may be counted more than once towards the satisfaction of the Elimination Period. The Dates of Service used to satisfy the Elimination Period do not need to be consecutive and may be accumulated under separate approved claims.

Face Amount means Face Amount or Total Face Amount, depending on which term is used in your policy.

Home means the Insured’s primary residence, including independent living quarters in a continuing care retirement community, a rest home, or similar entity. The following are never Homes: a Nursing Home, an Assisted Living Facility, an Adult Day Care Center, a hospital or rehabilitation facility/hospital, a hotel, or a facility for the treatment of alcoholism, alcohol abuse, drug addiction, or mental illness.

Home Health Care means medical and non-medical professional care services or personal care services provided by a Home Health Care Agency to the Insured in the Insured’s Home and included in the Plan of Care.

Examples of such services include:

 

  (a)

skilled nursing or social work services;

 

  (b)

physical, occupational, dietary, respiratory, or speech therapy;

 

18LTCR    4    DE

 

1. DEFINITIONS (CONTINUED)

 

(c) Substantial Assistance with 2 of the Activities of Daily Living;

(d) Substantial Supervision needed because the Insured has a Severe Cognitive Impairment; or (e) Incidental Homemaker Services.

Important Note – Home Health Care must be provided by a Home Health Care Agency.

Home Health Care cannot be provided by:

 

  (a)

a member of your or the Insured’s Immediate Family;

 

  (b)

an individual who normally resides in your or the Insured’s Home; (c) your or the Insured’s legal representative;

 

  (d)

an individual that has been authorized as your or the Insured’s Power of Attorney; or (e) your insurance agent/producer or their immediate family.

Home Health Care Agency means an entity that is regularly engaged in providing Home Health Care for compensation and employs staff, qualified by training or experience, to provide such care. The entity must meet one of the following requirements:

 

  (a)

it is licensed as a Home Health Care Agency by the jurisdiction in which the Home Health Care is provided;

 

  (b)

it possesses one of the following certifications in the jurisdiction in which the Home Health Care is provided: Medicare Certification, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Certification, or Community Health Accreditation Program (CHAP) Certification;

 

  (c)

it provides Home Health Care through an organization with 7 or more employees that is in the business of providing Home Health Care according to the laws of the jurisdiction in which the care is provided;

 

  (d)

in the event there are no laws and/or regulations which regulate a Home Health Care Agency in the jurisdiction in which the care is provided, it provides Home Health Care through an organization with 7 or more employees that is in the business of providing Home Health Care; or

 

  (e)

it is a state-licensed or a Medicare-certified provider for Hospice Care.

A Home Health Care Agency must maintain a written record for each recipient of care, the Plan of Care, any assessments, and written notes of care for each Date of Service to document all services delivered.

We may require that any Home Health Care Agency be monitored at least every 30 days by a Licensed Health Care Practitioner.

Hospice means a facility, unit of a facility, public or private agency, or unit of a public or private agency that meets federal certification requirements as a Hospice or is licensed, certified, or registered to provide Hospice Care under the law of the jurisdiction in which it is located.

Hospice Care means a program for meeting the Insured’s palliative care needs if he or she is terminally ill. Terminally ill means there is no reasonable prospect of cure and the Insured has a life expectancy, as estimated by a Physician, of 6 months or less. Hospice Care must be provided or supervised by a Hospice. Hospice Care is limited to those services received by the Insured. Hospice Care may be provided in the Insured’s Home or in a Hospice facility.

Immediate Family means the spouse or Partner of you or the Insured; or the following relatives of you or the Insured (and their respective spouses or Partners): parents, grandparents, siblings, children, grandchildren, aunts/uncles; nieces/nephews; or cousins. Immediate Family also includes adopted, in-law, and step relatives.

A person is a Partner if such person is an adult who is either:

 

  (a)

named, along with you or the Insured, in a valid certificate or license of civil union or domestic partnership as recognized by the state in which the policy is issued; or

 

5

 

1. DEFINITIONS (CONTINUED)

 

 

  (b)

has been living with you or the Insured for the past 12 months in a committed relationship as your or the Insured’s partner or as a member of your or the Insured’s family, as the case may be; and

 

  (i)

is committed to sharing basic living expenses with you or the Insured;

 

  (ii)

is not married to you or the Insured or to anyone else; and

 

  (iii)

if related to you or the Insured, belongs to the same familial generation as you or the Insured (i.e., brother, sister, cousin).

Incidental Homemaker Services means non-medical services received by the Insured that are incidental to services associated with the Substantial Assistance with the Activities of Daily Living or Substantial Supervision with a Severe Cognitive Impairment provided to the Insured. Incidental Homemaker Services must be included in the Plan of Care and must be necessary in order for the Insured to remain in the Home. These services must be provided during the same visit and by the same individual providing Substantial Assistance or Substantial Supervision to the Insured. The services must include one or more of the following: meal preparation; laundry; or light housekeeping.

Licensed Health Care Practitioner means a Physician, a registered nurse (R.N.), a licensed social worker, or any other individual who meets the requirements as may be prescribed by the U.S. Secretary of the Treasury.

Life Insurance Death Benefit means the greater of the Face Amount (plus Policy Value, if Death Benefit Option 2 is in effect) or the Minimum Death Benefit, as described in the policy.

Maximum Monthly Benefit Amount means the maximum amount of Accelerated Benefits we will pay in any one calendar month, excluding the Stay at Home Lifetime Benefit Amount.

Medicaid means the reimbursement system under Title XIX of the Federal Social Security Act, as amended.

Medicare means the reimbursement system under Title XVIII of the Federal Social Security Act, as amended.

Nursing Care means skilled care provided by one or more of the following health care professionals: registered nurse, licensed vocational nurse, licensed practical nurse, physical therapist, occupational therapist, speech therapist, respiratory therapist, medical social worker, or registered dietician.

Nursing Home means a facility that:

 

  (a)

is licensed and operates to provide Nursing Care for a charge (including room and board), according to the laws of the jurisdiction in which it is located; and

 

  (b)

has services performed by or under the ongoing, direct and immediate supervision of a registered nurse, licensed practical nurse, or licensed vocational nurse, on-site 24-hours a day.

A Nursing Home may be a freestanding facility or it may be a distinct part of a facility, including a ward or wing of a hospital or other facility. The following are examples of facilities that are not Nursing Homes:

 

  (a)

a hospital or clinic;

 

  (b)

a rehabilitation hospital or facility;

 

  (c)

an Assisted Living Facility;

 

  (d)

a rest home (or home for the aged or a retirement home) which does not, as its primary function, provide Custodial Care;

 

  (e)

your or the Insured’s Home or the home of one or more members of your or the Insured’s Immediate Family; or

 

  (f)

a facility for the treatment of alcoholism, alcohol abuse, drug addiction, or mental illness.

 

18LTCR    6    DE

 

1. DEFINITIONS (CONTINUED)

 

Physician means any person licensed in the United States of America as a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) practicing within the scope of his or her license issued by the jurisdiction in which the services are rendered.

Plan of Care means a written plan for Qualified Long-Term Care Services developed by a Licensed Health Care Practitioner for the Insured. This Plan of Care must specify the type, cost, frequency, expected duration of care, hours of care per day, and type of providers of all services required to meet the Insured’s needs. Services must be in accordance with accepted relevant standards of practice and care for a Chronically Ill Individual and appropriate to meet the Insured’s care requirements.

Qualified Long-Term Care Services means the following care or services eligible for payment of Accelerated Benefits under this rider and provided for in the Plan of Care:

 

  (a)

24-hour confinement in a Nursing Home or Assisted Living Facility for room, board, and care services (such care services being Nursing Care, Custodial Care, and Hospice Care);

 

  (b)

Home Health Care provided by a Home Health Care Agency;

 

  (c)

Hospice Care;

 

  (d)

Stay at Home Services; or

 

  (e)

attendance at an Adult Day Care Center providing Adult Day Care.

Qualified Long-Term Care Services are intended to constitute qualified long-term care services as defined under Section 7702B(c) of the Internal Revenue Code.

Receipts means itemized bills, paid invoices, and cancelled checks or other verifiable proof of payment of expenses for Qualified Long-Term Care Services (excluding Stay at Home Services) provided to the Insured. Receipts must include the name and type of provider, dates of care or services, and cost per hour of service.

Receipts for Stay at Home Services means itemized bills, paid invoices, and cancelled checks or other verifiable proof of payment of expenses for Stay at Home Services provided to the Insured. Receipts for Stay at Home Services must include dates of purchase or services.

Severe Cognitive Impairment means a deficiency in the Insured’s short-term or long-term memory; orientation as to person, place, and time; deductive or abstract reasoning; or judgment as it relates to safety awareness. Severe Cognitive Impairment must be established and reliably measured by clinical evidence and standardized tests.

Stay at Home Services means any of the following services: Home Modification, Emergency Medical Response System, Durable Medical Equipment, Caregiver Training, Home Safety Check, and Provider Care Check. The Stay at Home Services are described in more detail below.

 

  •  

Home Modification means modifications to the Home that are primarily being made to improve the Insured’s ability to perform the Activities of Daily Living and allow the Insured to live safely and independently in the Home.Examples of Home Modification include: installation of ramps for wheelchair access; installation of shower bars; widening doorways; and other similar accessibility modifications. Home Modifications do not include: hot tubs, swimming pools, home repair or maintenance; or other modifications that may, other than incidentally, increase the value of the Home. The costs associated with any building permit or inspection are also not examples of Home Modification.

 

  •  

Emergency Medical Response System means a communication system that is installed in the Home and used to call for assistance in the event of a medical emergency. It does not mean a home security system.

 

  •  

Durable Medical Equipment means rented or purchased equipment designed to be used in the Home to assist the Insured in performing the Activities of Daily Living. Examples of Durable Medical Equipment include: walkers, hospital-style beds, crutches, and wheelchairs. Durable Medical Equipment does not include: prescription drugs, athletic equipment, exercise or massage equipment, equipment placed in the Insured’s body, or items commonly found in a household.

 

18LTCR    7    DE

 

1. DEFINITIONS (CONTINUED)

 

 

  •  

Caregiver Training means training which provides instruction to uncompensated caregivers in basic caregiving techniques that are consistent with the Plan of Care and allow the Insured to remain in the Home. Caregiver Training may be provided to a relative or a person chosen by you. However, in no instance, does Caregiver Training mean training provided to anyone who is compensated for caring for the Insured’s long-term care needs.

 

  •  

Home Safety Check means a written evaluation of the Home by a Home Health Care Agency or other qualified professional agency or individual acceptable to us, in order to evaluate the safety of the Home environment. Examples of items in the Home that may be evaluated include: cabinet and appliance height, furniture arrangement, doorway and hallway width, and the need for safety bars in the bathroom.

 

  •  

Provider Care Check means a written evaluation by an independent Home Health Care Agency or other qualified professional agency or individual acceptable to us about the care the Insured is receiving in the Home, in order to confirm consistent delivery of care being provided to the Insured, as defined in the Plan of Care.

Stay at Home Services are intended to constitute qualified long-term care services as defined under Section 7702B(c) of the Internal Revenue Code.

Substantial Assistance means Hands-On or Standby Assistance required by the Insured more than 50% of the time the Insured performs each Activity of Daily Living during a calendar week. If able to perform an Activity of Daily Living by using an assistive device or equipment, the Insured does not require Substantial Assistance to perform that Activity of Daily Living.

 

  •  

Hands-On Assistance means the physical assistance of another person without which the Insured would be unable to perform that Activity of Daily Living.

 

  •  

Standby Assistance means the necessary presence of another person within arm’s reach of the Insured to prevent, by physical intervention, injury to the Insured while performing an Activity of Daily Living.

Substantial Supervision means ongoing, uninterrupted monitoring for 24-hours of each day by another person who is in the Insured’s presence due to the Insured’s Severe Cognitive Impairment. Substantial Supervision (which may include cueing by verbal prompting, gestures, or other demonstration) is necessary to protect the Insured from threats to health or safety (i.e., harm that results from wandering).

Written Certification means written evidence from a Licensed Health Care Practitioner establishing that the Insured is a Chronically Ill Individual. Written Certification must be received by us promptly upon issuance by the Licensed Health Care Practitioner, in a form satisfactory to us.

 

 

2. ACCELERATED BENEFITS

 

Under this rider, you have the opportunity to accelerate your Death Benefit to pay for Qualified Long-Term Care Expenses.

Accelerated Benefit Pool

The Accelerated Benefit Pool is the amount of Death Benefit that may be accelerated under this rider and any terminal illness rider. On the Rider Effective Date, the Accelerated Benefit Pool is the Accelerated Benefit Percentage, multiplied by the Face Amount. The Rider Effective Date, the Accelerated Benefit Pool and the Accelerated Benefit Percentage are shown in the Policy Specifications. The Accelerated Benefit Pool can never increase, but will be reduced by certain Policy Changes, as described in the “Effect of Policy Changes on the Accelerated Benefit Pool” provision.

 

18LTCR    8    DE

 

2. ACCELERATED BENEFITS (CONTINUED)

 

Your Accelerated Benefit Pool may be used to pay for expenses incurred for Qualified Long-Term Care Services (including Stay at Home Services) while this rider is In Force, up to the limits specified in this rider.

Accelerated Benefits

For each calendar month you are eligible to receive Accelerated Benefits, we will pay an amount equal to the least of (a), (b) or (c), where:

 

  (a)

is the sum of (i) and (ii), where:

 

  (i)

is the lesser of total shown to be paid by Receipts received for the calendar month (excluding Receipts for Stay at Home Services) and the Maximum Monthly Benefit Amount; and

 

  (ii)

is the lesser of total shown to be paid by Receipts for Stay at Home Services received for the calendar month and any unused portion of the Stay at Home Lifetime Benefit Amount;

 

  (b)

is the amount you request; or

 

  (c)

is the remaining Accelerated Benefit Balance.

Accelerated Benefit Balance

Accelerated Benefits are paid from the Accelerated Benefit Balance. The Accelerated Benefit Balance is equal to the Accelerated Benefit Pool minus the sum total of all Accelerated Benefits paid under this rider and under any terminal illness rider.

Maximum Monthly Benefit Amount

The maximum we will pay for Accelerated Benefits in any one calendar month for Qualified Long-Term Care Services, excluding the Stay at Home Services, is the Maximum Monthly Benefit Amount. When you become eligible to receive Accelerated Benefits, we will determine the Maximum Monthly Benefit Amount. The Maximum Monthly Benefit Amount is equal to the Accelerated Benefit Pool on the date you first become eligible to receive Accelerated Benefits multiplied by the Monthly Acceleration Percentage.

Your claim to receive Accelerated Benefits will remain in effect until it is terminated. If a claim is terminated and you later become eligible to receive Accelerated Benefits, we will recalculate your Maximum Monthly Benefit Amount using the Accelerated Benefit Pool then in effect.No more than one claim may be in effect at any one time.

If there is a Policy Change while you are on claim, the Maximum Monthly Benefit Amount will be recalculated as described in the Effect of Policy Changes on the Maximum Monthly Benefit Amount provision. The Maximum Monthly Benefit Amount for any calendar month is reduced proportionately for the number of days in the calendar month for which you are not eligible to receive Accelerated Benefits.

Stay at Home Lifetime Benefit Amount

The Stay at Home Lifetime Benefit Amount is the maximum amount we will pay for Stay at Home Services during the Insured’s lifetime. On the date we first receive Receipts for Stay at Home Services the Stay at Home Lifetime Benefit Amount is equal to the Maximum Monthly Benefit Amount in effect on that date. Thereafter, the Stay at Home Lifetime Benefit Amount will be recalculated if the Maximum Monthly Benefit Amount is recalculated.

As long as the Accelerated Benefit Balance is not exhausted and the total amount we pay for Stay at Home Services does not exceed the Stay at Home Lifetime Benefit Amount, we will pay charges incurred for Stay at Home Services, provided that these charges do not exceed normal charges for similar care, services or other items in the locality where they are received.

Effect of Policy Changes on the Accelerated Benefit Pool

The Accelerated Benefit Pool will be reduced on the date a Policy Change becomes effective. For purposes of this rider, any withdrawal or reduction in Face Amount (whether requested, due to coverage lapse or Misstatements) is considered a Policy Change and will result in a recalculation of the Accelerated Benefit Pool. The payment of Accelerated Benefits under this rider or a terminal illness rider is not a Policy Change.

 

18LTCR    9    DE

 

2. ACCELERATED BENEFITS (CONTINUED)

 

The new Accelerated Benefit Pool is (a) multiplied by (b) divided by (c), where:

 

  (a)

is the Accelerated Benefit Pool immediately before the withdrawal or reduction in Face Amount;

 

  (b)

is the Death Benefit immediately after the withdrawal or reduction in Face Amount; and

 

  (c)

is the Death Benefit immediately before the withdrawal or reduction in Face Amount.

If the Policy Change is a reduction in the Accelerated Benefit Percentage, the new Accelerated Benefit Pool is (a) multiplied by (b) divided by (c), where:

 

  (a)

is the Accelerated Benefit Pool immediately before the reduction in the Accelerated Benefit Percentage;

 

  (b)

is the new Accelerated Benefit Percentage; and

 

  (c)

is the old Accelerated Benefit Percentage.

Increases to the Accelerated Benefit Percentage are not allowed.

Effect of Policy Changes on the Maximum Monthly Benefit Amount

Policy Changes also reduce the Maximum Monthly Benefit Amount, effective as of the date of the Policy Change. The recalculated Maximum Monthly Benefit Amount is (a) multiplied by (b), where:

 

  (a)

is the Monthly Acceleration Percentage; and

 

  (b)

is the new Accelerated Benefit Pool after the Policy Change.

Effect of Policy Loans on Accelerated Benefits

If there is a Policy Loan, a portion of the Accelerated Benefit will be deemed a loan repayment and will reduce the Accelerated Benefit otherwise payable to you. The amount deemed as a loan repayment will also reduce outstanding Policy Debt.

The amount deemed to be a loan repayment is (a) times (b), where:

 

  (a)

is the amount of Policy Debt immediately prior to the payment of the Accelerated Benefit; and

 

  (b)

is 1 minus the ratio of the new Face Amount divided by the Face Amount immediately before the payment of the Accelerated Benefit.

 

 

3. ELIGIBILITY FOR ACCELERATED BENEFITS

 

This section describes when you are eligible to receive Accelerated Benefits under this rider.

Eligibility for Accelerated Benefits

The following conditions must be satisfied in order for you to be eligible to receive Accelerated Benefits:

 

  (a)

the rider must be In Force;

 

  (b)

you provide us with Written Certification that the Insured is a Chronically Ill Individual;

 

  (c)

the Insured has satisfied the Elimination Period;

 

  (d)

we receive a current Plan of Care and written Proof of Loss, as described in Claims; and

 

  (e)

the Insured was alive and received Qualified Long-Term Care Services that are consistent with and specified in the Insured’s Plan of Care while this rider is In Force.

Conditions for Maintaining Eligibility

In order to maintain eligibility:

 

  a)

you must provide Written Certification, at least once every 12 months, that the Insured is a Chronically Ill Individual;

 

  b)

the Insured must be alive;

 

18LTCR    10    DE

 

3. ELIGIBILITY FOR ACCELERATED BENEFITS (CONTINUED)

 

 

  c)

the rider must be In Force; and

 

  d)

we must receive Proof of Loss for each payment of Accelerated Benefits.

If any of these requirements are not met, you will not be eligible for payment of Accelerated Benefits. In that instance, we will terminate your claim. If you wish to initiate a new claim, you must submit a new request for Accelerated Benefits.

Once you are eligible, we will determine the Maximum Monthly Benefit Amount, which is described under the Accelerated Benefits section of this rider. See the Claims section of this rider for details on what you must provide to us to assist in our evaluation of your claim.

Limitations on Eligibility for Payment of Accelerated Benefits

We will only pay benefits under this rider for those Qualified Long-Term Care Services specified in the Plan of Care. The amount of benefits we will pay for any Qualified Long-Term Care Services shall not exceed normal charges for similar care or services in the locality where they are received by the Insured.

Payment of Accelerated Benefits

Accelerated Benefits will be paid to you or to an alternative payee designated by you or your legal representative. Any remaining Death Benefit will be included in the Insurance Benefit and paid under the terms of the policy.

Any Accelerated Benefits paid under this rider prior to our receipt of notice of the Insured’s death will reduce the Insurance Benefit paid under the terms of the policy. We will not pay any Accelerated Benefit under this rider after the Insurance Benefit is paid to the beneficiary under the policy.

In the event we receive a claim for the payment of the Accelerated Benefit under this rider and a claim for the payment of the Insurance Benefit under the policy, we will pay the claim for which we receive acceptable Proof of Loss or due proof of death first. Once we pay the Insurance Benefit, the rider is terminated and we will no longer pay Accelerated Benefits.

This rider will pay benefits for Qualified Long-Term Care Services obtained in a state other than the policy’s state of issue if Accelerated Benefits for such Qualified Long-Term Care Services would have been paid in the policy’s state of issue.

Prompt Payment

If we take more than 30 days to send an Accelerated Benefits payment, we will pay interest on the amount that should have been paid, beginning 31 days after receiving all required information, until such payment is made. We will pay interest at the rate of 1% per month or at a higher rate if required by state law or regulation.

Alternative Payee

At our option, any payment of Accelerated Benefits of $1,000 or less may be paid to an alternative payee, if such benefit is payable to any person who is a minor or otherwise not competent to give a valid release. The alternative payee must be a person who is deemed by us to be justly entitled to the benefit.

We will be fully discharged and released from all liability to you and to any alternative payee, any assignee, and any beneficiary under the policy to the extent of any payment made in good faith under this rider.

Additional Consent

Before we pay Accelerated Benefits, we must receive a signed consent form from all irrevocable beneficiaries and all assignees. We also reserve the right to require a consent form from any person if we determine that such person’s consent is necessary to protect our interest. Any such consent will be in effect for the length of the current claim.

 

18LTCR    11    DE

 

4. EXCLUSIONS

 

This section describes care, treatment or services that will be excluded under the rider.

Exceptions

This rider does not pay Accelerated Benefits for care or treatment:

 

  (a)

due to intentionally self-inflicted injury;

 

  (b)

due to suicide or attempted suicide, while sane or insane;

 

  (c)

required as a result of alcohol abuse, alcoholism, or drug addiction;

 

  (d)

due to war (declared or undeclared) or any act of war, or service in any of the armed forces or auxiliary units;

 

  (e)

due to participation in a felony, riot, or insurrection;

 

  (f)

normally not provided or made in the absence of insurance;

 

  (g)

received outside of the 50 United States and the District of Columbia;

 

  (h)

provided by a Nursing Home, Assisted Living Facility, Home Health Care Agency, or Adult Day Care Center that is owned or operated by a member of your or the Insured’s Immediate Family; or

 

  (i)

provided by a member of your or the Insured’s Immediate Family.

Non-Duplication of Benefits

This rider will only reimburse charges for Qualified Long-Term Care Services in excess of charges paid, reimbursed, or considered deductibles or coinsurance under any of the following:

 

  (a)

Medicare, including amounts not reimbursable by Medicare such as Medicare deductible or coinsurance amounts;

 

  (b)

any other governmental program (except Medicaid); or

 

  (c)

any workers’ compensation law, employer’s liability or occupational disease law, or any motor vehicle no-fault law.

Charges Not Covered

We will not pay for any of the following charges incurred by the Insured: Physician’s charges; private duty nurse when the Insured is inpatient confined in a Nursing Home or Assisted Living Facility; hospital and laboratory charges; prescription or non-prescription medication; medical supplies; home modifications and durable medical equipment (except as described in the definition of Stay at Home Services); shipping charges; any transportation or mileage charge; items and services furnished for beautification, comfort, convenience, or entertainment; room and board charges or entrance fee for independent living quarters in a continuing care retirement community, rest home, or similar entity; any type of residential upkeep, construction, renovation, or home maintenance (such as painting or plumbing); lawn/yard care; snow removal; vehicle or equipment upkeep; charges for Home Health Care provided outside the Home; hotel, cruise ship, or similar charges incurred by the Insured, an Immediate Family member or care provider; and charges for care or services which are not included in and/or are inconsistent with the Insured’s Plan of Care.

 

 

5. CLAIMS

 

This section explains when to file a claim for Accelerated Benefits under this rider; the information we need to review, process and pay the claim for Accelerated Benefits; and your and our rights and responsibilities during the claims process.

Filing a Claim

In order to file a claim for Accelerated Benefits, you must provide us with notice of your intent to file a claim. This notice must include:

 

  (a)

your name;

 

  (b)

the Insured’s name;

 

18LTCR    12    DE

 

5. CLAIMS (CONTINUED)

 

 

  (c)

your policy number; and

 

  (d)

the Qualified Long-Term Care Services the Insured is receiving or plans to receive, and an explanation as to why such services are required.

You can provide us with notice by: mailing it to our Service Office or by calling us. The mailing address for our Service Office is: [Life Post Issue, John Hancock Life Insurance Company (U.S.A.), 30 Dan Road Suite #55979, Canton, MA 02021] and our telephone number is: [1-800-387-2747]. We must receive your notice within 45 days of the start of services or as soon as reasonably possible.

Claim Forms

We will provide you with written acknowledgement of your notification of intent to file a claim, instructions, and the necessary forms for filing a claim. Such information will be provided within 15 days of our receiving your notice of intent to file a claim. If 15 days have elapsed and we have not provided you with the necessary claim forms, you can provide written proof that satisfies the Proof of Loss requirements.

Proof of Loss

You must file Proof of Loss with our Service Office before your claim can be approved. The Proof of Loss must include detailed written documentation acceptable to us describing and confirming the Insured’s status as Chronically Ill and the Qualified Long-Term Care Services that the Insured is receiving. You may provide us with Proof of Loss by mailing or faxing originals or copies of the required documentation.

The Proof of Loss documentation must include:

 

  (a)

a completed claim form, if applicable;

 

  (b)

Written Certification;

 

  (c)

a functional and cognitive assessment;

 

  (d)

Receipts and/or Receipts for Stay at Home Services;

 

  (e)

the current Plan of Care; and

 

  (f)

confirmation that the Insured’s care provider meets licensure/certification standards as required by the jurisdiction in which it is located or care is rendered (or in the event that licensing/certification is not required, confirmation that your care provider meets the applicable definition found in this rider).

No form of barter or trade for care/services is acceptable as Proof of Loss. We reserve the right to require copies of:

 

  (a)

the Insured’s medical records;

 

  (b)

facility residency agreements;

 

  (c)

the Insured’s service plans;

 

  (d)

an explanation of benefits related to Medicare coverage or any other government program (except Medicaid) applicable to your claim; and

 

  (e)

providers’ daily notes of care.

During the process of reviewing your claim, we may consult with the Insured’s primary care Physician and/or other care providers.

In order for us to process your claim, you must: provide your assistance as described in this form; comply with all applicable rider provisions; and provide us with any additional information we may request. If you refuse to provide the requested information, or if the Insured refuses to undergo any requested assessment, interview, or exam, your claim will be denied. In such case, we will not be liable to pay Accelerated Benefits under this rider.

At your own expense, you must obtain and submit all required documentation in English.

 

18LTCR    13    DE

 

5. CLAIMS (CONTINUED)

 

Deadline for Proof of Loss Submission

We must receive Proof of Loss within 90 days of the first Date of Service or as soon as reasonably possible. Your claim for Accelerated Benefits will be denied for failure to provide Proof of Loss unless it is provided to us within one year from the first Date of Service. We will waive this limitation if you provide us with satisfactory proof that you are legally incapacitated or otherwise incapable of providing us with Proof of Loss.

Initial and Ongoing Evaluation Process

We will work with you, the Insured, the Insured’s Physician, the Insured’s care providers, and anyone acting on the Insured’s behalf to obtain information about the Insured’s health and the Qualified Long-Term Care Services the Insured is receiving. We will then make an objective review of all the information we receive. We will provide you with notification as to whether your claim has been approved, denied, or denied in part.

In order for us to process your claim, you must: provide assistance as described in this form; comply with all applicable rider provisions; and provide us with any additional information we may request. If you cannot provide or refuse to provide the requested information, or if the Insured refuses to undergo any requested assessment, interview, or exam, your claim will be denied. In such case, we will not be liable to pay Accelerated Benefits under this rider.

You or your responsible designee are required to assist us in determining ongoing eligibility for Accelerated Benefits under this rider. You must provide us with the Insured’s current Plan of Care. The Plan of Care must be updated as the Insured’s Qualified Long-Term Care needs change. No more than one Plan of Care may be in effect at any one time.

We reserve the right to request periodic assessments or updates regarding the Insured’s Plan of Care and eligibility status. Without such information, we will not be able to determine ongoing eligibility and your claim may be terminated. If your claim has been terminated, we will stop paying the Accelerated Benefits.

Bed Hold Benefit: As long as the Accelerated Benefit Balance is not exhausted, if the Insured is in a Nursing Home or an Assisted Living Facility and the Insured’s stay in such facility has been interrupted for any reason, we will continue to pay Accelerated Benefit and reserve the Insured’s bed for up to 21 days in any calendar year. Any amount paid will continue to be paid from the Accelerated Benefit Balance as if the Insured’s stay in a Nursing Home or an Assisted Living Facility had not been interrupted.

We reserve the right to obtain clinical information regarding the insured. This includes, but is not limited to conducting a telephone interview with the Insured, consulting with the Insured’s Physician and care providers, performing an in-person nursing or functional/cognitive assessment or evaluation of the Insured, or requiring that the Insured undergo a physical exam, when and as often as we may reasonably require.

Examinations and Assessments

We reserve the right to conduct a telephone interview with the Insured; to perform an in-person nursing or functional/cognitive assessment or evaluation of the Insured; or to require that the Insured undergo a physical exam. Such evaluations will be made when and as often as we may reasonably require at any time during the claim. We will pay for any interview, assessment, evaluation, or examination that we request.

Appeals

We will notify you in writing if we do not approve your request for Accelerated Benefits. Such notification will include a written explanation of the reasons for the denial. You will then have the right to appeal our claims decision. You may request that we make all information directly related to such denial available to you. We will provide you with such requested information within 60 days from the date we receive your Written Request. You must request the appeal within one year from the date we provide you with notice of the denial of your claim.

 

18LTCR    14    DE

 

5. CLAIMS (CONTINUED)

 

You must send your appeal and/or request for information to: [Life Post Issue, John Hancock Life Insurance Company (U.S.A.), 30 Dan Road Suite #55979, Canton, MA 02021]. Your appeal should: state why you disagree with our determination; include any other factors you feel that we should take into consideration; and provide any additional information regarding the Insured’s condition that you wish to be considered. You are responsible for the expense of securing such additional information.

You may authorize someone else to act for you in this appeals process.

During our review of your appeal, we may request that you provide additional information. If you do not provide this additional information, your appeal will be denied. We will inform you of our decision regarding your appeal. Such decision may be that all or a portion of your claim denial was upheld or overturned. If your claim denial was overturned, we will pay you any Accelerated Benefits due.

Independent Third Party Review

You have the right to request an Independent Third Party Review if we upheld our denial of all or any portion of your claim based upon a determination that the Insured is not a Chronically Ill Individual.

We will provide you with written instructions of your right to request an Independent Third Party Review when we notify you of our decision on your appeal. You must make a Written Request for Independent Third Party Review no later than 120 days after we inform you of the outcome of our appeals review. The Independent Third Party will review the relevant material related to the denial of your claim that we provide. The Insured will not be required to undergo an additional exam or assessment. You may provide us with additional information that you wish to be included in the Independent Third Party Review.

The Independent Third Party will provide you, the State Insurance Department (if required), and us with written notice of its final decision within 60 calendar days from its receipt of your request for an Independent Third Party Review. If the Independent Third Party overturns the denial of your claim, the Independent Third Party shall:

 

  (a)

establish the precise date within the specific period of time under review that the Insured is a Chronically Ill Individual;

 

  (b)

specify the specific period of time for which we declined eligibility, but the Independent Third Party determined that the Insured is a Chronically Ill Individual; and

 

  (c)

provide a certification from a Licensed Health Care Practitioner that the Insured is a Chronically Ill Individual.

The decision of the Independent Third Party is final and binding on us. We will pay the Independent Third Party for their time spent reviewing the information and arriving to a decision.

The Independent Third Party must be state approved or certified to conduct such reviews, if the state requires such approvals or certifications. The Independent Third Party must be mutually agreed upon by you and us.

In addition, an Independent Third Party must:

 

  (a)

be, or have on staff or contract, a Licensed Health Care Practitioner in an appropriate field that can determine if the Insured is a Chronically Ill Individual;

 

  (b)

not be affiliated with nor in any manner related to an entity or individual that previously provided care or services to the Insured;

 

  (c)

not employ a licensed health care professional who is associated with us or related to the Insured in any manner; and

 

  (d)

not be compensated in any manner that is dependent upon the outcome of the review.

In the event that any part of this Independent Third Party Review provision is in conflict with the applicable long-term care insurance Independent Third Party Review law and/or regulation of the state where the policy is issued, the Independent Third Party Review process will be administered in accordance with such applicable state law or regulation.

 

18LTCR    15    DE

 

5. CLAIMS (CONTINUED)

 

Legal Action

Your right to bring suit against us to recover on this rider begins 60 days after you have provided us with the required Proof of Loss and ends 4 years from the date the Proof of Loss was given to us. In the event that any part of this provision is in conflict with the applicable law and/or regulation of the state where the policy is issued, this provision shall be administered in accordance with such applicable state law or regulation.

Administrative Error

Administrative error shall not prejudice the rights of the Company, except as otherwise provided in this rider. In the event of such administrative error, this rider will be administered in accordance with rider provisions as if there had been no such error.

 

 

6. EFFECT OF ACCELERATED BENEFITS ON YOUR POLICY

 

This section describes the effect on your policy when you accelerate your Death Benefit under this rider.

Face Amount

Each payment of an Accelerated Benefit reduces the Face Amount then in effect, resulting in a new Face Amount.

The new Face Amount is equal to (a) minus the result of (b) multiplied by (c), where:

 

  (a)

is the Face Amount immediately before the payment of the Accelerated Benefit;

 

  (b)

is the Accelerated Benefit paid; and

 

  (c)

is the Face Amount immediately before the payment of the Accelerated Benefit divided by the Life Insurance Death Benefit immediately before the payment of the Accelerated Benefit.

Face Amount reductions resulting solely from the payment of Accelerated Benefits will not be subject to any charges normally imposed by the policy for a reduction in Face Amount.

Supplemental Face Amount

If the Face Amount of the policy is made up of the Base Face Amount and Supplemental Face Amount, the payment of Accelerated Benefits will exhaust the Supplemental Face Amount before reducing the Base Face Amount.

Policy Value

Each Accelerated Benefit we pay reduces the Policy Value then in effect, resulting in a new Policy Value. The new Policy Value is (a) times (b) divided by (c), where: (a) is the Policy Value immediately before the payment of the Accelerated Benefit; (b) is the Face Amount immediately after the payment of the Accelerated Benefit; and (c) is the Face Amount immediately before the payment of the Accelerated Benefit.

If your policy contains the Death Benefit Protection provision, Persistency Credit provision, or Cumulative Guarantee provision, each Accelerated Benefit we pay reduces the Death Benefit Protection Value, Persistency Measure, and the Cumulative Guarantee Policy Value by the same proportion by which the Policy Value is reduced.

Restrictions on Transfers and Premium Payments

If this rider is attached to a variable universal life insurance policy, we will transfer any Policy Value in an Investment Account to the Fixed Account at the end of the Business Day when we process your payment of Accelerated Benefits. After that date while you are eligible to receive Accelerated Benefits under this rider, allocations of Premium or transfers of Policy Value to an Investment Account are not allowed.

If this rider is attached to an indexed universal life insurance policy, we will transfer any Segment Proceeds in the Indexed Appreciation Account to the Guaranteed Interest Account on the Segment Maturity Date following the date we process your payment of Accelerated Benefits. After that date while you are eligible to receive Accelerated Benefits under this rider, allocations of Premium or transfers of Policy Value to the Indexed Appreciation Account are not allowed.

 

18LTCR    16    DE

 

6. EFFECT OF ACCELERATED BENEFITS ON YOUR POLICY (CONTINUED)

 

If your claim is terminated, the portion of the Policy Value not in the Loan Account will remain in the Fixed Account or in the Guaranteed Interest Account unless we receive your Written Request to reallocate such assets to an Investment Account or Indexed Appreciation Account. The amount that may be transferred and the frequency of transfers will be subject to any restrictions imposed under the terms of the policy.

Extension of Benefits (benefit continuation)

If the policy lapses for any reason while the Insured is continuously confined in a Nursing Home, we will pay Accelerated Benefits under this rider for such confinement. We will stop paying Accelerated Benefits at the earliest of the following:

 

  (a)

the date the Insured is discharged from the Nursing Home;

 

  (b)

the date the Accelerated Benefit Balance is exhausted;

 

  (c)

the date you fail to comply with the requirements under Eligibility for Accelerated Benefits section of this rider; or

 

  (d)

the date the Insured dies.

If the benefits under this rider are continued under this Extension of Benefits provision, we will calculate the Accelerated Benefit Pool and Accelerated Benefit Balance as if the policy had remained In Force. Extension of Benefits will be subject to all the provisions of the policy and this rider. No Insurance Benefit will be payable to the beneficiary under the policy because your policy has terminated.

 

 

7. GENERAL PROVISIONS

 

This section explains the charge for this rider, and what happens when your policy goes into default. It also explains some of the important provisions that affect your and our rights under this rider.

Rider Charge

There is a monthly charge for this rider, as shown in the Policy Specifications. The charge will cease at the Insured’s Age 100. The charge for the rider is the Monthly Rider Rate multiplied by the greater of $0.00 and the Rider Net Amount at Risk divided by 1,000.

The Rider Net Amount at Risk is (a) multiplied by (b) multiplied by (c), where:

 

  (a)

is the Accelerated Benefit Balance; and

 

  (b)

is (i) minus (ii), where:

 

  (i)

is 1 divided by the Death Benefit Discount Factor; and

 

  (ii)

is the ratio of the Policy Value divided by the Life Insurance Death Benefit, both determined immediately after the deduction of all other charges due on that date;

 

  (c)

is the Rider Charge Adjustment Factor as shown in the Policy Specifications.

If your policy contains a Death Benefit Protection provision, the Rider Charge deducted from the Death Benefit Protection Value is calculated in the same manner as described above except that the Rider Charge Adjustment Factor is equal to 1 and the Death Benefit Protection Value is used instead of the Policy Value in the Rider Net Amount at Risk calculation.

Grace Period

The Grace Period provision of the policy shall also apply to this rider. During the Grace Period, this rider will stay in effect. Notice that the policy is in the Grace Period will be provided to you and to the person or persons you designate. The designation(s) may be changed at any time. We will provide you with a reminder of the right to change this written designation every 2 years.

 

18LTCR    17    DE

 

7. GENERAL PROVISIONS (CONTINUED)

 

Reinstatement of this Rider

The reinstated rider will not provide Accelerated Benefits during the period from the end of the Grace Period through the date of reinstatement. This rider may be reinstated according to the reinstatement provisions of the policy, including satisfaction of our underwriting requirements. A reinstated rider will only cover loss due to an injury sustained after the date of reinstatement, or a physical or mental condition that begins after the date of reinstatement. A physical or mental condition will be considered to have begun when treatment is recommended by or received from a Physician.

Protection Against Unintended Lapse

Your policy and this rider may be reinstated in accordance with the reinstatement provision of the policy.

In addition to the reinstatement provision of your policy, the benefits of your policy and this rider up to the limit of the Accelerated Benefit Balance in effect at the time that your policy terminated, may be reinstated if the following conditions are met:

 

  (a)

you provide us with a Written Request to reinstate within 5 months of the end of the Grace Period;

 

  (b)

you provide us with proof that is satisfactory to us that you were cognitively impaired or otherwise legally incapacitated at the end of the Grace Period; and

 

  (c)

you provide us with payment of all overdue premiums and charges for this rider and your policy as described in the policy’s Reinstatement section.

The Contract

This rider is made a part of the policy to which it is attached and is effective on the Rider Effective Date shown in the Policy Specifications. This rider is subject to the terms, conditions and limitations provided herein. The rates used for determining the charges for this rider are shown in the policy. If the policy contains a rider that waives the Monthly Deductions on the policy in accordance with that rider, we will waive the charges for this rider as well.

Changes to this Rider

No change to this rider will be valid until approved by our President or Secretary. No agent may change this rider or waive any of its provisions.

Right to Recovery

If we pay Accelerated Benefits in excess of the Accelerated Benefits payable under the provisions of this rider, we will have the right to recover such excess. Any such excess will be recovered from persons to, or for whom, such payments were made or any organization that received such payments. Any unrecovered excess payments will reduce the Insurance Benefit otherwise payable.

Incontestability

If this rider has been In Force for less than 6 months, we may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that is material to the acceptance of the application for this rider.

If this rider has been In Force for at least 6 months but less than 2 years, we may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that is both:

 

  (a)

material to the acceptance of the application; and

 

  (b)

pertains to the condition for which the claim is made.

After this rider has been In Force for 2 years, it is incontestable except for relevant facts relating to the Insured’s health that were knowingly and intentionally misrepresented.

In the event this rider is rescinded after we have paid Accelerated Benefits, we may not recover the payments already made.

 

18LTCR    18    DE

 

7. GENERAL PROVISIONS (CONTINUED)

 

Termination

When this rider terminates, no further charges will be payable for this rider and no further Accelerated Benefits will be paid. This rider will terminate at the earliest of the following events:

 

  (a)

the exchange or termination of the policy;

 

  (b)

you request to discontinue this rider;

 

  (c)

the exhaustion of the Accelerated Benefit Balance;

 

  (d)

we approve your request for an increase in the Base Face Amount or Supplemental Face Amount, if applicable; or

 

  (e)

the Insured dies.

However, an increase in the Face Amount due to a change from Death Benefit Option 2 to Death Benefit Option 1 will not terminate this rider.

Additional Support Services

From time to time, we may provide you (directly or through a vendor) access to information, offers, discounts, services or programs which are designed to promote good health and/or help you maintain cognitive wellness. Information may be provided to you through written, website or other mediums. Additional information regarding available long-term care resources may also be included. Your decision to access any information or service or participate in any program is completely voluntary. In addition, your decision to access any information or program will not reduce any of your policy benefits.

There may be an additional cost associated with accessing certain services or programs. Any such cost is your responsibility and is not covered or payable under the policy. Also, please note that any discounted fees charged by a program or provider may not be the least expensive fees available. We do not endorse, sponsor or guarantee the quality of a program or provider, or the care or services provided by such provider. It is your responsibility to choose a program or provider who will best meet your needs.

If the Insured has not already selected a care provider at time of claim, you may request information on providers in your area. We do not endorse, sponsor or guarantee the quality of any provider or the care or services provided by such provider. It is your responsibility to choose a provider who will best meet the Insured’s long-term care and service needs.

Important Note: Good health and cognitive wellness programs may be provided only to the extent permitted under a federally tax qualified long-term care insurance contract under Section 7702B(c) of the Internal Revenue Code.

Signed for the Company by:

LOGO

President

 

18LTCR    19    DE

 

1. POLICY SPECIFICATIONS (continued) – Policy [12 345 678]

 

 

   SUPPLEMENTARY BENEFITS
Benefit    Acceleration of Death Benefit for Qualified Long-Term Care Services Rider
Life Insured    [John J. Doe]
Rider Effective Date    [May 1, 2018]
Risk Classification    [Standard Nonsmoker]
Additional Rating    [Not Applicable]
Accelerated Benefit Percentage    [50.00%]
Monthly Acceleration Percentage    [2%]
Maximum Monthly Benefit Amount    As determined by the Maximum Monthly Benefit Amount provision
Stay at Home Lifetime Benefit    As determined by the Stay at Home Lifetime Benefit Amount provision
Amount   
Monthly Rider Rate    $[0.02046] per $1,000 of Rider Net Amount at Risk*
Rider Charge Adjustment Factor    0.70
Elimination Period    100 Dates of Service

* The Monthly Rider Rate includes any applicable rating.

 

18LTCR(PIUL/MAJPIUL)    3.X   
LOGO            Service Office:    Application For Individual Life Insurance
 

Life New Business

30 Dan Rd, Suite 55765

    JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.)
  Canton, MA 02021-2809    (hereinafter referred to as The Company)
          

 

If applying for Survivorship Coverage, please also complete Survivorship Supplement for Second Life [ICC16 NB6001]

Print and use black ink. Any changes must be initialed by the Proposed Insured and the Policy Owner.

 

IMPORTANT NOTICE: Your application is a critical source of information for consideration of your request for insurance coverage.

Therefore:

 

  •  

We strongly urge you to be complete and accurate in your responses so that we may provide you with the best coverage we can.

 

  •  

If we determine that your answers on this application are incorrect, incomplete, or untrue, it will delay your application, and The Company may have the right to deny benefits or terminate coverage.

 

 

      SECTION A: Proposed Insured

 

1. Name         FIRST                                              MIDDLE                                  LAST                     

 

                      JOHN                 M.                    DOE

  

2. Sex

 

    ☒ Male     ☐ Female

 

 

3. Date of Birth

 

        MONTH         DAY          YEAR

 

     LOGO

  

 

4. Place of Birth            STATE/COUNTRY

 

        ANYTOWN                     USA

   

 

5. Social Security Number

 

 

     LOGO

6. Driver’s License Number/State                     

 

    1234567890                             AS

   

7. Citizenship

    ☒ US    ☐ Non US - Country of  Citizenship                                                                                                                                

    Type of Green Card/VISA                                                                                                                                                               

 

8. Primary Residence         STREET ADDRESS                             CITY                         STATE                                 ZIP CODE

 

                                             1999 MARCH STREET                    ANYTOWN,            ANYSTATE                         12345

 

9. Telephone Numbers                                                           

    PERSONAL                              BUSINESS                        

        905  123-4567                         905  234-5678

 

   

10. Email Address                 LOGO

 

      [email protected]

    Your email is required so we may communicate with you about your policy online

11. Occupation

 

      ☒ Job/Duties                      COMPANY PRESIDENT                            Employed  by   ABC COMPANY                                                                                                        

 

      ☐ Student     ☐ Homemaker     ☐  Unemployed     ☒ Retired     ☐ Other                                                                                                                                                             

 

12. Are you currently a member of the armed forces, including the reserves?

      ☒ Yes    ☐ No      LOGO   If Yes, complete Military Personnel Financial Services Disclosure Regarding Insurance Products NB5109

 

13. Gross Annual Household Income

 

      Salary $     300,000              Other $        100,00                

 

   

14. Household Net Worth

 

        $  2.6 M                                                                                                                                                    

 

15. In the last 5 years, has the Proposed Insured or any business of which he/she is a partner/owner/executive been bankrupt, had any liens, or judgements?

      ☐ Yes    ☒ No - If  Yes, provide details                                                                                                                                                                                                                   

 

 

ICC19 NB6000 (01/2019)   1 of 11   VERSION (01/2019)

 

      SECTION B: Policy Owner

      • Complete if Policy Owner is someone other than the Proposed Insured

      • List additional Policy Owners and details in SECTION K: ADDITIONAL INFORMATION

 

   
16.a. Policy Owner Type    b. Policy Owner Relationship
         ☒ Individual   ☐ Business  ☐ Existing Trust  ☐ Trust to be Established         ☒ Spouse    ☐ Child     ☐ Trust
            LOGO If Trust Owner, complete the Trust Certification PS5101         ☐ Business Partner        ☐ Employer
            LOGO If Partnership Owner, complete the Partnership Statement PS7800US         ☐ Other

         ☐ Other                                                                                                        

 

 

   

                                                                    

 

    c. Name or Entity/Trust Name             FIRST   MIDDLE    LAST
   JAMES                        M.                   DOE   
    d. Date of Birth or Trust Date (if applicable)    e. Social Security OR Tax ID
                                MONTH         DAY         YEAR        ☒ SSN LOGO
        ☒ DOB LOGO
                                             MONTH         DAY         YEAR   

    ☐ Tax ID LOGO

 

        ☐ Trust Date LOGO

    f. Address                 STREET ADDRESS                             CITY                         STATE                             ZIP CODE

 

                                       1999 MARCH STREET                    ANYTOWN,            ANYSTATE                     12345

 

 

    g. Telephone Number

 

  

 

h. Email Address     LOGO

 

   

 

Your email is required so we may communicate with you about your policy online

 

          905    123-4567       [email protected]
17. Multiple Policy Owners - Type of Ownership       ☒ Joint with right of survivorship    ☐ Tenants in common

18. Is the Policy Owner a Non US Person or a Non Resident Alien?

      ☒ Yes    ☐ No  LOGO  If Yes, Complete IRS Form W-8BEN for individuals

 

      SECTION C: Beneficiary Information

      • This section is to be completed by Policy Owner

      • Beneficiary listed in question 19 is always assigned as Primary

      • List additional beneficiaries in SECTION K: ADDITIONAL INFORMATION

 

 

19. a. Name or Entity/Trust Name            FIRST                         MIDDLE                         LAST

 

          JUDY                                 M.                                         DOE

    b. Percentage

 

        100         %

      c. Relationship to Proposed Insured    d. Date of Birth or Trust Date (if applicable)
          ☐ Spouse    ☒ Child    ☐ Trust    ☐ Business Partner                            MONTH            DAY             YEAR
          ☐ Employer   ☐ Other                                                          ☒ DOB LOGO
                                              MONTH            DAY            YEAR
       ☐ Trust Date LOGO

      e. Social Security OR Tax ID

 

          ☒ SSN         LOGO

 

          ☐ Tax ID     LOGO

 

    f. Telephone Number    905    123-4567
  

g. Email Address    [email protected]

 

      h. Address             STREET ADDRESS                         CITY                             STATE                             ZIP CODE

 

                                       1999 MARCH STREET                ANYTOWN,            ANYSTATE                       12345

 

20. a. Name or Entity/Trust Name            FIRST                             MIDDLE                             LAST    b. Percentage    

 

                         %

      c.    d. Relationship to Proposed Insured    e. Date of Birth or Trust Date (if applicable)
      ☐ Primary        ☐ Spouse    ☐ Child    ☐ Trust    ☐ Business Partner   

 

        MONTH            DAY             YEAR

    ☐ DOB LOGO

      ☐ Secondary          ☐ Employer    ☐ Other                                                                                            MONTH             DAY            YEAR
          ☐ Trust Date LOGO
      f. Social Security OR Tax ID   

 

g. Telephone Number

          ☐ SSN LOGO     
          ☐ Tax ID LOGO   

 

h. Email Address

 

      i. Address             STREET ADDRESS                             CITY                             STATE                             ZIP CODE

 

ICC19  NB6000  (01/2019)   2 of 11                    (US)   VERSION (01/2019)

 

      SECTION D: Coverage Details

      • This section is to be completed by Policy Owner

      • Refer to your illustration for riders and benefits selected

 

 

21.   Product Name (see Policy Illustration Summary Page)    JH UNIVERSAL LIFE                                                                               

 

22.  

Flexible Premium Products

 

☒ Universal Life LOGO If applying for Indexed UL, complete Premium Allocation Instructions [ICC16 NB6017]

☐ Variable Universal Life LOGO Complete Fund Allocation [ICC16 NB6016]

 

 

a. ☒ Single Life

☐ Survivorship LOGO Complete Survivorship Supplement for Second Life [ICC16 NB6001]

 

  b. ☒ Base Face Amount $ 250,000                                                 
 

☐ Supplemental Face Amount $                                                        (not available with all products)

 

☐ Level     ☐ Increasing by             % for                  Years

 

☐ Customized Increasing Schedule LOGO Complete Customized Schedule NB5064

 

  c. Death Benefit Option ☒ Option 1 (Death Benefit = Face Amount)     ☐ Option 2 (Death Benefit = Face Amount + Policy Value)

 

  d. Life Insurance Qualification Test ☒ Guideline Premium Test (GPT) ☐ Cash Value Accumulation (CVAT)

 

 

e. Riders and Benefits (Refer to instruction page for riders and benefits available per product)

☐ Accelerated Death Benefit (for terminal illness) LOGO Complete Summary and Disclosure Statement for Accelerated Benefit NB1237

☐ Long-Term Care Rider LOGO Complete Application Supplement (Long-Term Care Rider) [ICC13 NB5018]

☒ Critical Illness Benefit Rider LOGO Complete Application Supplement: Individual Insurance Critical Illness Benefit Rider NB5230

☐ Cash Value Enhancement Rider                                                    ☐ Estate Preservation Rider     ☐ Overloan Protection Rider

☐ Healthy Engagement (Vitality) Rider                                            ☐ Policy Split Option Rider

☐ Disability Payment of Specified Premium Rider                          ☐ Return of Premium Rider (Death Benefit Option 1 only)

 

MonthlySpecified Amount $                                                               Percentage of premiums to be returned at death

 

☐ Disability Waiver of Monthly Deductions Rider                              (Whole numbers only. Maximum 100%)                 %

☐ Extended No-Lapse Guarantee Rider                                             ☐ Preliminary Funding Account

 

LOGO Not all fund investment options are available with this rider ☐ Other                                              

 

23.  

Term Products (choose at least one product and duration)

☒ Protection Term:     ☒ 10 Years     ☐ 15 Years     ☐ 20 Years     ☐ 30 Years     ☐ Other                                             

OR

  ☐ Vitality Term:     ☐ 10 Years     ☐ 15 Years     ☐ 20 Years     ☐ 30 Years     ☐ Other                                                   
 

 

LOGO This product automatically includes the Vitality Program, which provides premium savings and rewards for the everyday things you do to stay healthy. Your premiums may decrease, stay level, or increase based on insured’s participation in the program. The Vitality Program cannot be dropped at a later date, as it is a built-in feature of this product.

 

  a. Face Amount $                                                                                              

 

 

b. Riders and Benefits (if applicable)

☐ Total Disability Waiver

☐ Accelerated Death Benefit (for terminal illness)

 

LOGO Complete Summary and Disclosure Statement for Accelerated Benefit NB1237

☐ Unemployment Protection Rider

☐ Healthy Engagement (Vitality) Rider

 

LOGO When you select this rider, the Vitality Program will be included with your Protection Term Life insurance policy. Your premiums may stay level or decrease (but never increase) based on insured’s participation in the program. The Healthy Engagement Rider can be dropped at any time. The rider is not available on the Vitality Term product.

☐ Other                                                                                                                                                                                             

 

24.  

If an additional or optional policy is being applied for by the Policy Owner in a separate application, state plan and face amount.

Plan Name                                                                                            Face Amount $                                                                         

 

ICC19 NB6000 (01/2019)   3 of 11   VERSION (01/2019)

      SECTION E: Purpose and Funding Information

      • This section is to be completed by the Policy Owner

      • List additional information in SECTION K: ADDITIONAL INFORMATION

      • All Premium Notices and Correspondence are sent to the Policy Owner at the address provided in Section B

25. a. Billing Method

 

 ☐ Pre-Authorized Payment Plan LOGO Complete Request for Pre-Authorized Payment Plan NB5087

 

 ☒ Direct Bill (not available for monthly billing)

 

 

b. Please select billing frequency

 

            ☒ Annual         ☐ Semi-Annual         ☐ Quarterly        ☐ Monthly (Pre-Authorized Payment Plan only)

 

 

26. Existing Life Insurance

 

a. Does the Policy Owner have any existing life insurance and/or annuities with this or any other company?

 

    ☒ Yes LOGO If Yes, refer to the Instructions for Application for Individual Life Insurance regarding additional required

         Replacement forms

 

    ☐ No

 

 

b. Will this insurance replace any existing life insurance policies and/or annuities, or are you, the Policy Owner, considering using funds from existing policies or annuities to pay premiums on the new policy?

 

    ☒ Yes LOGO If Yes, refer to the Instructions for Application for Individual Life Insurance regarding additional required

         Replacement forms

 

    ☐ No

 

 

27. Purpose of Insurance

 

☒ Income Replacement      ☐ Estate Planning

 

☐ Business Insurance LOGO Complete Financial Supplement for Business Insurance[ICC16 NB6014]

 

☐ Other - give details                                                                                                                                                                                      

 

 

28. Lapse Notification Handling

 

Secondary Addressee: In addition to the Policy Owner, The Company will mail lapse notices for overdue premiums to any Secondary Addressee you designate. If you want this option, provide the following information for the Secondary Addressee:

 

a. Name        FIRST                         MIDDLE                        LAST                     

                    JUDY                         M.                                 DOE

   

b. Date of Birth

        MONTH        DAY         YEAR        

LOGO

c. Address       STREET ADDRESS                                CITY                             STATE                         ZIP CODE

                         1999 MARCH STREET                    ANYTOWN,                     ANYSTATE                12345

 

29. a.  Other than the Policy Owner, Proposed Insured(s) and beneficiaries specified herein, does or will any person or entity have any right, title or interest in any policy issued as a result of this application?

 

  ☐ Yes    ☒ No - If Yes,  give details                                                                                                                                                            

 

 

b. Have you been offered money or other consideration by any person or entity in connection with this application?

 

  ☐ Yes    ☒ No - If Yes,  give details                                                                                                                                                            

 

 

30. Premium (Payment) Source

 

☒ Income

 

☐ Liquidated Assets - give details                                                                                                                                                             

 

 

☐ Proceeds from Sold or Viaticated policy - give details                                                                                                                               

 

☐ Loan LOGO If you checked Loan, complete Question 31 a, b, and c on next page

 

☐ Other - give details                                                                                                                                                                                         

 

 

 

SECTION E: Purpose And Funding Information continues on next page  

 

ICC19 NB6000 (01/2019)   4 of 11   VERSION (01/2019)

      SECTION E: Purpose And Funding Information (continued)

 

      Only complete question 31, a, b and c if ‘Loan’ was selected in question 30

 

31. a. Name all lenders involved                            

b.  What amount and type of collateral is required to secure the loan and/or loans?

 

       Amount $                                              Type of  collateral                                              

      c. In addition to repayment of principal and interest, are there other fees, charges or other consideration to be paid?

          ☐ Yes    ☐ No  - If Yes, give details                                                                                                                                                            

      SECTION F: Existing, Replacement, And Pending Insurance Information

      • This section is to be completed by Proposed Insured

      • List additional policies in SECTION K: ADDITIONAL INFORMATION

32. a.  Is the Proposed Insured under this application also an insured on any other existing life insurance policy, including any policy that has been sold, assigned, transferred or settled?

          ☐ Yes    ☒ No LOGO If you checked Yes, complete Question 32b

      b. If Yes, provide details for each existing Life Insurance policy on the Proposed Insured with all companies

     INSURANCE PURPOSE  

YEAR

ISSUED

   SURVIVORSHIP  

TO BE

REPLACED

  

1035

EXCHANGE

   SOLD, ASSIGNED
TRANSFERRED
OR SETTLED		   FACE AMOUNT
INCLUDING
RIDERS
INSURANCE COMPANY   PERSONAL   BUSINESS   YES   NO   YES   NO   YES   NO   YES   YEAR     
    ☐   ☐       ☐   ☐   ☐   ☐   ☐   ☐   ☐       $        
    ☐   ☐       ☐   ☐   ☐   ☐   ☐   ☐   ☐       $        

33. a.  If life insurance coverage is being applied for on the Proposed Insured with any other company, provide the face amount of all applications and name of the life insurance company. Do not include informal inquiries.

       If “None” check this box  ☒

          INSURANCE COMPANY    FACE AMOUNT INCLUDING RIDERS
     $
     $

b.  What is the total amount of new Life Insurance coverage that you plan to accept with all companies including this application? $                                                              

 

ICC19 NB6000 (01/2019)   5 of 11                    (US)   VERSION (01/2019)

 

      SECTION G: Personal Information

      • This section is to be completed by the Proposed Insured as it pertains to his or her own personal history

 

 

34.

The information you provide in this application is critical to our consideration of your request for insurance coverage. You are strongly urged to answer all questions completely and accurately so that we may provide you with the best coverage we can. We will seek information from other sources to assist us with evaluating your application, potentially including your health care provider. If your answers are incorrect, incomplete or untrue, it will delay your application, and The Company may have the right to deny benefits or terminate coverage. Please know that your personal information, including health information, is protected by The Company and only used by The Company to do business with you, and as permitted or required by law.

X        Initial here to acknowledge that you have carefully reviewed and fully understand the above statement.

 

 

35. a. Primary Physician Name     FIRST                                         LAST

        ARTHUR                         H.                    SMITH

  

 

☐  Check if Proposed Insured does not have a physician

 

 

b. Address     STREET ADDRESS         CITY                 STATE                     ZIP CODE    

 

    123 MAIN STREET                    ANYTOWN,             ANYSTATE                    12347

  

 

c.   Telephone Number

 

        905 123-4567

 

     

 

d. Date of last visit

        MONTH         DAY         YEAR

LOGO

 

 

e. Reason for last visit, outcome and treatment prescribed

 

        ANNUAL CHECK-UP - NONE

36. a. Name of Medical Group/Health Care Provider (if applicable)

 

b. Name of Health Insurance Provider (if applicable)

 

37.  Provide name, address, and phone number of any other specialists or member of the medical profession consulted in the past 24 months.

 

•  If you need more space, continue listing in SECTION K: ADDITIONAL INFORMATION.

 

                                                                                                                                                                                                                 

 

                                                                                                                                                                                                                 

 

38.  Describe your complete tobacco/nicotine products usage history, including but not limited to:

cigarettes, e-cigarettes, cigars, pipe, chewing tobacco, snuff, hookah, nicotine patch, nicotine gum.

Note: Tobacco use does not automatically nor necessarily result in denial of coverage.

 

 

•  If products used exceed the allotted space below, list the remainder in SECTION K: ADDITIONAL INFORMATION

 

TYPE OF PRODUCT  

QUANTITY AND UNIT

(Ex. Packs, cigarettes, patches, etc.)

   FREQUENCY  

DATE LAST USED

(MONTH/YEAR)

       
   

#              Unit Type                      

 

  

☐ Day    ☐ Month    ☐ Year

 

    
       
   

#              Unit Type                      

 

  

☐ Day    ☐ Month    ☐ Year

 

    

 

☒ I have never used nicotine/tobacco products

 

 

SECTION G: Personal Information continues on next page

 

ICC19 NB6000 (01/2019)   6 of 11                    (US)   VERSION (01/2019)

      SECTION G: Personal Information (continued)

 

39. Describe your marijuana use in the past 5 years.

       NOTE: Marijuana use does not automatically nor necessarily result in denial of coverage

       PURPOSE

       ☐ Recreational/Social

       ☐ Medicinal – Provide Prescription Card ID                                                           

 

   

Date Last Used

        MONTH            YEAR

LOGO

 

       FREQUENCY

 

                times per ☐ Day    ☐ Month     ☐ Year

 

   

DELIVERY METHOD

 

☐ Ingested     ☐ Vaporized     ☐ Inhaled

 

      ☒ I have not used marijuana in the past 5 years

 

 

      SECTION H: Lifestyle Information

      • This section is to be completed by Proposed Insured as it pertains to his or her own lifestyle history

 

40. Describe your exercise routine, such as walking, running, treadmill, swimming, aerobics, strength training, cycling, sports or yoga.

       • If exercises exceed the allotted space below, list the remainder in SECTION K: ADDITIONAL INFORMATION

 

        TYPE OF EXERCISE   FREQUENCY   TIME SPENT PER SESSION
    ☐ Daily     ☐ 1-3 x/week     ☐ 4-6 x/week            hours                 minutes
    ☐ Daily     ☐ 1-3 x/week     ☐ 4-6 x/week            hours                  minutes

      ☒ I do not participate in an exercise routine

 

41. Have you ever had an application for life insurance declined, postponed, rated substandard, modified, requiring extra premium, or offered less than applied for by any company?

      ☐ Yes    ☒ No

      If Yes, give details of decision type,  reason and date                                                                                                                                

 

                                                                                                                                                                                                                             

 

42. In the past 12 months, have you missed more than 10 consecutive days of work, school, or your daily/regular activities because of illness, injury, or medical treatment?

      ☐ Yes     ☒ No

      If Yes, provide details                                                                                                                                                                                   

 

                                                                                                                                                                                                                             

 

SECTION H: Lifestyle Information continues on next page

 

ICC19 NB6000 (01/2019)   7 of 11                    (US)   VERSION (01/2019)

 

SECTION H: Lifestyle Information (continued)

 

 

43.  Do you expect to travel outside the U.S. or Canada, or change your country of residence in the next 2 years?

 

☐ Yes    ☒ No

 

If Yes, give details of location (city/country), purpose, frequency and duration                                                                                    

 

                                                                                                                                                                                                                    

 

44.  Have you ever flown or intend to fly in the next 2 years as a student pilot, licensed pilot, or crew member in any aircraft, including ultralight planes?

 

☐ Yes    ☒ No LOGO If Yes, complete Aviation Questionnaire[ICC16 NB6009]

 

 

45.  Please indicate any of the following activities you participate in or have participated in, within the last 2 years:

 

☐ Motorcycle racing                 ☐ Scuba diving        ☐ Power boat racing             ☐ Skydiving/Parachuting

 

☐ Mountain climbing                ☐ Ballooning           ☐ Hang-gliding                     ☐ Backcountry skiing/snowmobiling

 

☐ Bungee/base jumping            ☐ Heli skiing           ☒ Motor vehicle racing         ☐ I do not participate in any of these activities

 

LOGO If any activities selected, complete Avocation Questionnaire[ICC16 NB6010]

 

 

46.  Please indicate which of the following apply to your driving history:

 

☐ Convicted of 1 or more moving violations in the past 2 years    ☐ Convicted of driving while intoxicated or otherwise impaired

 

☐ License is currently revoked or suspended                                ☒ None of these apply to me

 

 

47.  Have you ever been convicted of, plead guilty for, or are you currently awaiting trial for any infraction, misdemeanor or felony?

 

☐ Yes    ☒ No

 

If Yes, give details of type, date, city/state of felony and/or crime and if currently on probation or parole

 

                                                                                                                                                                                                                    

 

                                                                                                                                                                                                                    

 

 

      SECTION I: Juvenile Insurance

 

      • Complete only if Proposed Insured is under age 18

 

 

48. a. Are all siblings equally insured?

 

☐ Yes    ☐ No

 

If No, give details                                                                                                                                                                                           

 

                                                                                                                                                                                                                        

 

 

b. Amount of life insurance currently in force or pending for:

 

 

    Mother    $                                      If none, provide reason:                                                                                                                   

    Father     $                                      If none, provide reason:                                                                                                                     

    Guardian $                                      If none, provide reason:                                                                                                                     

 

 

 

 

ICC19 NB6000 (01/2019)   8 of 11   VERSION (01/2019)

   

   

   

   

   

 

      

  

SECTION J: Temporary Life Insurance Agreement Application

•  You may be eligible for Temporary Life Insurance Coverage. Please speak with your Agent/Representative for details on the amount and benefit period. This section is to be completed only if you are applying for Temporary Life Insurance.

Instructions for Agent/Representative

•  Money may only be collected with this application and the Temporary Life Insurance Receipt and Agreement [ICC16 NB6004] may only be issued if:

1. questions 49, 50 and 51 are answered “No”

2. the Proposed Insured is age 20 to 70

3. the amount applied for under this application is not greater than $10,000,000 (single life) or $15,000,000

(survivorship)

Note: Temporary Life Insurance questions must be answered by both insureds if Survivorship coverage is being applied for. See Survivorship Supplement for Second Life [ICC16 NB6001].

 

     

49. Within the last 24 months, has the Proposed Insured under this application:

    PROPOSED INSURED    

a.  consulted a member of the medical profession for, been diagnosed with or been treated for any heart problem, stroke or cancer?

    ☐ Yes    ☒ No

b. received a recommendation (excluding HIV) from a member of the medical profession for any consultation, testing, investigation or surgery that has not yet been completed?

    ☐ Yes    ☒ No

c.  been declined for life insurance?

    ☐ Yes    ☒ No

50. Other than planned routine check-ups, in the last 24 months have there been any pending medical tests or follow-up for medical concerns or symptoms (excluding HIV) for which a medical professional should be consulted?

    ☐ Yes    ☒ No

51. Does the Proposed Insured reside outside the United States more than 6 months per year?

    ☐ Yes    ☒ No
  

        

  

SECTION K: Additional Information

•  This is an additional section if more space is required for any of the previous sections, e.g. listing additional beneficiaries from SECTION C, listing additional policies from SECTION F, listing additional tobacco products from SECTION G, etc.

        SECTION        

   

        QUESTION        

NUMBER

    DETAILS
     
       
     
       
     
       
     
           
     
        

SECTION L: Special Instructions

             
              
             
             

 

ICC19 NB6000 (01/2019)   9 of 11   VERSION (01/2019)

 

Read the following carefully and sign next page

 

 

 

DECLARATIONS

The Proposed Insured (or Parent or Guardian) and Policy Owner declare that the statements and answers in this application and any form that is made part of this application are complete and true to the best of their knowledge and belief. All such statements and answers are representations, not warranties.

In addition, I/we understand and agree that:

 

 

1.

Policy Application: The statements and answers in this application, which include any supplemental form relating to health, aviation practices or lifestyle of the Proposed Insured, will become part of the insurance policy issued as a result of this application. No information about me will be considered to have been given to The Company unless it is stated in the application or any form that is made part hereof.

 

2.

Policy Effective Date:

 

  a)

Any life insurance policy issued as a result of this application will be effective on the later of the date the first premium has been paid in full and the date the policy has been delivered to the Policy Owner, provided that the Proposed Insured is still living and nothing has occurred that would require a change in any statement or answer in any part of the application, including any supplemental forms, in order to make the statement or answer true and complete as of the date this policy becomes effective. If there has been such an occurrence: (i) if there is no Temporary Life Insurance Agreement (TIA) coverage, the policy will not be put into effect, and (ii) if there is TIA coverage and the TIA has not ended, the policy will be put into effect but only to the limit of the TIA coverage amount.

 

  b)

If premiums are paid prior to delivery of the policy and the terms and conditions of the TIA are satisfied, insurance prior to the effective date shall be provided under the TIA and according to its terms.

 

  c)

Only an officer of The Company may make, modify, or discharge any insurance contract on its behalf. No agent has the authority to: (i) accept risks; (ii) determine insurability; (iii) make or modify any contractual provision; or (iv) waive any of The Company’s rights or requirements.

 

3.

Employer Owned Policies: The Proposed Insured confirms that they have received, prior to issue, written notice that indicates: (i) the employer’s intent to insure the Proposed Insured, (ii) the maximum amount of the insurance to be issued on the life of the Proposed Insured and (iii) that the employer will be the beneficiary of the new policy. The Proposed Insured also confirms that they have provided written consent to being insured and that such coverage may continue after employment terminates.

 

4.

Fraud Warning: Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law.

 

5.

Variable Policies: I/We acknowledge that the policy values that are based on the separate account assets are not guaranteed and will decrease or increase with investment experience. I/We acknowledge receipt of the current prospectuses and supplements that describe the variable life insurance policy applied for and the sub-accounts of the separate account that are available under this policy. I/We have reviewed the prospectuses and supplements and believe that the variable life policy is consistent with my/our insurance needs, investment objectives and investment risk tolerance.

 

6.

Flexible Premium Policies: I/We understand that I/we may need to pay additional premiums in addition to the Planned Premium if the current policy charges or actual interest rate credited/investment performance are different from the assumptions used in the illustration (assuming the requirements of any applicable guaranteed death benefit feature have not been satisfied).

 

7.

Temporary Insurance Coverage: If coverage under a TIA is applied for, I have received, read and understand the terms and conditions of the Temporary Life Insurance Receipt and Agreement [ICC16 NB6004.]

 

8.

Healthy Engagement Benefit: If a policy is issued with the Healthy Engagement rider or benefit (the Benefit), the Proposed Insured will receive a membership in a healthy engagement program offered by a third party program provider. By applying for the Benefit, the Proposed Insured authorizes The Company to share his/her personal information, including certain health information, with the provider in connection with the registration for the program and administration of the Benefit. The Proposed Insured understands and agrees that (i) his/her program membership will be subject to the provider’s privacy policy and terms and conditions of membership, which the Proposed Insured should read prior to joining the program, and (ii) he/she will be asked to authorize the provider to share his/her health, lifestyle, medical or other personal information with The Company. The Proposed Insured will not be eligible to participate in the program if the terms and conditions of membership are not accepted. Upon termination of the policy or rider, as applicable, the program membership will terminate and access to further benefits and incentives, if any, will cease as provided in the terms and conditions. The Company is not responsible or liable for any damage, loss or injury arising out of the Proposed Insured’s participation in any third party healthy engagement programs or receipt of any products or services provided through such programs.

 

ICC19 NB6000 (01/2019)   10 of 11   VERSION (01/2019)

 

         Read carefully and sign below

 

I, THE PROPOSED INSURED, AUTHORIZE:

 

1. The Company to obtain consumer reports including but not limited to motor vehicle records and investigative consumer reports on me.

2. Any medical professional, medical care provider, hospital, clinic, laboratory, pharmacy or pharmacy benefit manager, electronic health record provider, insurance company, the MIB, Inc. (“MIB”) or any other similar person or organization to disclose health information about me or any minor child who is to be insured. Health information includes: (i) my entire medical record and medical history, prescription history, and other health information; (ii) confidential information related to Human Immunodeficiency Virus (HIV), other communicable diseases and mental illness (excluding psychotherapy notes) and (iii) genetic information and genetic test results, to the extent permitted by law.

3. Any financial professional, CPA, attorney personal banker or any other similar person or organization to disclose financial/net worth information about me.

Such disclosure of my information may be made to The Company, its affiliated companies, agents, service providers, reinsurers, MIB or any person or entity entitled to receive such information by law or as I may further consent.

Information collected under this authorization will be used to evaluate my application for insurance, identify any misrepresentation in the information provided by me in this application, administer coverage, evaluate a claim for benefits, for reinsurance or other insurance purposes, or to conduct other legally permissible activities. I authorize The Company, or its reinsurers, to make a brief report of my health information to MIB.

This authorization is valid for 24 months from the date shown below or for the time limit, if any, permitted by applicable law in the state where the policy is delivered or issued for delivery, whichever period is shorter. A photocopy of this authorization will be as valid as the original. I am entitled, or my authorized representative is entitled, to a copy of this authorization.

I understand that I can revoke this permission to collect information at any time by providing written notification to John Hancock Life Insurance Company (U.S.A.) at the Service Office address (page 1) Attention: Chief Underwriter, but any revocation will not affect such information that has already been collected and relied on by The Company.

I acknowledge receipt of the Notice of Disclosure of Information relating to the underwriting process, investigative consumer reports and the MIB.

 

 

SIGNATURES – If Proposed Insured is under age 15, Parent or Guardian must sign on the Proposed Insured Signature Line and include relationship

 

X  

                                                                                                   

  SIGNATURE OF POLICY OWNER (PROVIDE TITLE OR CORPORATE SEAL, IF SIGNING OFFICER)
                                                                                                    
  POLICY OWNER- SIGNED AT                  CITY                  STATE                  THIS                  DAY OF                              YEAR
X  

                                                                                   

  SIGNATURE OF PROPOSED INSURED IF OTHER THAN POLICY OWNER(PARENT OR GUARDIAN IF UNDER AGE 15)

 

AGENT SIGNATURE

 

I certify that all the information supplied by the Proposed Insured and Owner(s) has truly and accurately been recorded on the application.

 

X  

                     

   

                     

  SIGNATURE OF AGENT/REPRESENTATIVE     DATE

 

ICC19 NB6000 (01/2019)   11 of 11   (US)                        VERSION  (01/2019)

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