1. (a) Failure of an insurer or agent to comply with any of the requirements contained in Ins 303.04 or Ins 303.05 of this part shall be a violation of the part, subject to the penalties provided in RSA 400-A:15, subject to the requirements therein, in addition to any other penalties provided by the laws of this state.
2. (b) After appropriate notice and hearing, an administrative fine of $2,500 shall be levied for each finding of violation of RSA 400-A:15, III if the penalty of suspension or revocation as specified below is not appropriate.

3. (c) The insurer or agent may request at hearing a reduced fine or no fine imposed under (b) above through successful demonstration that:

   1. (1) There is no or minimal damage or costs to consumers, the State or other insurance entities as a result of the violation; and
   2. (2) The insurer or agent has not committed multiple or repeated violations.

4. (d) Insurers and agents shall be subject to suspension pursuant to RSA 400-A:15,III if one of the following occurs:

   1. (1) The violation is continuing; or
   2. (2) There is a high probability the violation will be repeated, based on findings of record; and
   3. (3) Imposition of a penalty other than suspension, such as a fine, will not be a sufficient deterrent.

5. (e) Insurers and agents shall be subject to revocation pursuant to RSA 400-A:15, III if:

   1. (1) The violative act or omission was intentional or committed in bad faith; or
   2. (2) There was significant damage or cost to consumers, the State or other insurance entities as a result of the violation.

6. (f) Repeated or multiple violations of this part shall constitute separate violations subject to penalty.

   Table 303-1 Disclosure Statement for Policy with an

   Additional First Year Premium

   You are invited to determine if your needs for a life insurance program can be adequately served by the (insert policy description) life policy being proposed. Note that this policy is designed to provide individuals with an incentive to maintain the policy in force for at least 10 full years. Conversely, it may be said that the policy design includes disincentives or penalties for individuals who lapse the policy prior to the 10 anniversary.

   The premium payable in the first year is $ , and the premium payable in years two through ten is $ .

   The difference between these amounts, $ , is the additional first year premium.

   The cash values payable at the end of policy years one through ten under this policy are:

   Policy Year Cash Value

   1 $ _________________

   2 $ _________________

   3 $ _________________

   4 $ _________________

   5 $ _________________

   6 $ _________________

   7 $ _________________

   8 $ _________________

   9 $ _________________

   10 $ _________________

   If you choose to terminate this policy, only the cash value, less any policy loans, will be paid to you.

   *Optional Benefits Included:

   Premium Years Payable

   Waiver of Premium $ _________ __________

   Accidental Death Indemnity $ _________ __________

   $ _________ __________

   $ _________ __________

   $ _________ __________

   Policy options at the end of the 10th policy year are:

7. (a) Continue in 11th year as whole life policy
8. (b) Renew MPWL for second ten years

9. (c) Convert to decreasing term to 100

   If the person insured or policyowner does not elect an option, the terms of the policy designate option no. ______ above as the automatic option.

   The following is a brief outline of each option listed above:

   Option 1. Continue as whole life insurance $ __________ face amount.

   Premiums 11th year and thereafter $ __________

   Cash values

   10th year $ _________

   15th year $ _________

   20th year $ _________

   Age 65 $ _________

   Interest adjusted surrender cost ______%

   10 years _____ 20 years _____

   Disposition of pure endowment _____

   Or tenth year cash value __________

   Option 2. ** Renew MPWL for another 10 year $ __________

   period for face amount.

   * Premiums per year 11th through 20th year $ _________

   ** Additional first year premium 11th year $ _________

   only

   Ten year total premiums $ _________

   Guaranteed cash value after 10 years $ _________

   Interest adjusted surrender cost _________%

   10 years ________ 20 years _________

   Disposition of pure endowment or tenth

   year cash value: $ _________

   *Includes rider benefits

   **Death benefit is increased by additional first year premium

   Option 3. Convert to decreasing term to age $ _________

   100 for face amount.

   * Level premiums $ _________

   Additional 11th year premium $ _________

   Interest adjusted surrender cost %

   10 years _________ 20 years _________

   Disposition of pure endowment or tenth

   year cash value: $ _________

   You will have ten days from the day the (insert policy description) life policy is delivered to you to return it for cancellation. Should you elect to cancel, all premiums paid by you will be returned.

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   (Insert Name)

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   Telephone No.

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   Agent's Signature

   I acknowledge that I received a copy of this disclosure statement for policy with an additional first year premium on the date indicated below.

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   Applicant's Signature

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   Date

Source. #1900, eff 1-1-82; ss by #4287, eff 7-1-87; ss by #5657, eff 7-1-93; ss by #7015, INTERIM, eff 7-1-99, EXPIRED: 10-29-99 New. #7450, eff 2-16-01