Life Insurance


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Life Policy Form Numbers

Level Term

Version Product Form Number
Guranteed policies**
Standard   ICC11 FGCLT02-01
Arizona   FGCLT02-01
Arkansas   FGCLT02-01
California   FGCLT02-01
Connecticut   FGCLT02-01
Delaware   FGCLT02-01
District of Columbia   FGCLT02-01
Florida   FGCLT02-01
Montana   FGCLT02-01
New York 10 Year Plan FGCLT10-03 NY
  15 Year Plan FGCLT15-03 NY
  20 Year Plan FGCLT20-03 NY
  25 Year Plan FGCLT25-03 NY
  30 Year Plan FGCLT30-03 NY
North Dakota   FGCLT02-01
South Dakota   FGCLT02-01
Non-Guaranteed policies***
Standard   ICC11 CLT02-01
Arizona   CLT02-01
Arkansas   CLT02-01
California   CLT02-01
Connecticut   CLT02-01
Delaware   CLT02-01
District of Columbia   CLT02-01
Florida   CLT02-01
Montana   CLT02-01
New York 25 Year Plan CLT25-03 NY
  30 Year Plan CLT30-03 NY
North Dakota   CLT02-01
South Dakota   CLT02-01

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Annual Renewable Term

Version Product Name Form Number
Standard   ICC09 ART01-01
Alabama   ART01-01 (09/2009)
Arizona   ART01-01 (09/2009)
Arkansas   ART01-01 (09/2009)
California   ART01-01 (09/2009)
Connecticut   ART01-01 (09/2009)
Delaware   ART01-01 (09/2009)
District of Columbia   ART01-01 (09/2009)
Florida   ART01-01 (09/2009)
Illinois   ART01-01 (09/2009)
Montana   ART01-01 (09/2009)
Nevada   ART01-01 (09/2009)
New Jersey   ART01-01 (09/2009)
New York   ART01-01 (09/2009)
North Dakota   ART01-01 (09/2009)
Oregon   ART01-01 (09/2009)
South Dakota   ART01-01 (09/2009)

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Simplified Life

Version Product Form Number
Standard   ICC10 SILT01-01
Alabama   SILT01-01
Arizona   SILT01-01
Arkansas   SILT01-01
California   SILT01-01
Connecticut   SILT01-01
Delaware   SILT01-01
District of Columbia   SILT01-01
Florida   SILT01-01
Montana   SILT01-01
New York 10 Year Plan SILT10-01 NY
  15 Year Plan SILT15-01 NY
  20 Year Plan SILT20-01 NY
Nevada   SILT01-01
North Dakota   SILT01-01
Oregon   SILT01-01
South Dakota   SILT01-01

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Simplified Whole Life

Version Product Name Form Number
Standard   ICC11 SIWL01-01
Arizona   SIWL01-02
Arkansas   SIWL01-02
District of Columbia   SIWL01-02
Florida   SIWL01-02
South Dakota   SIWL01-02

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Whole Life

Version Product Name Form Number
Standard   WL2006-01
New York   WL2006-01 NY
Oklahoma   WL2006-01 OK

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Flexible Premium Deferred Annuity - IRA

Version Product Name Form Number
Standard   FPDA-IRA01-01

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Flexible Premium Deferred Annuity - Roth IRA

Version Product Name Form Number
Standard   FPDA-RothIRA01-01

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Flexible Premium Deferred Annuity - Non-Qualified

Version Product Name Form Number
Standard   FPDA-NQA01-01

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Single Premium Deferred Annuity - IRA

Version Product Name Form Number
Standard   SPDA-IRA01-01

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Single Premium Deferred Annuity - Roth IRA

Version Product Name Form Number
Standard   SPDA-ROTHIRA01-01

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Single Premium Deferred Annuity - Non-Qualified

Version Product Name Form Number
Standard   SPDA-NQA01-01

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*Policy name may vary by state

**Guaranteed Period: The period of time during which premiums are guaranteed to remain level.

***Term Period: The period of time during which premiums are intended to remain level.

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