Every policy summary shall include at least the following information:

1. A. The prominently placed title “Statement Of Policy Cost And Benefit Information.”
2. B. The name and address of the insurance agent or, if no agent is involved, a statement of the procedure to be followed in order to receive responses to inquiries regarding the policy summary.
3. C. The full name and home office or administrative office address of the company in which the life insurance policy is to be or has been written.
4. D. The generic name of the basic policy and each rider.

5. E. The following amounts, where applicable, for the first five (5) policy years and representative policy years thereafter sufficient to clearly illustrate the premium and benefit patterns; including, but not necessarily limited to, the years for which cost comparison indexes are displayed and the earlier of at least one age from sixty (60) through sixty-five (65) and policy maturity:

   (1) the annual premium for the basic policy;

   (2) the annual premium for each optional rider;

   (3) the amount payable upon death at the beginning of the policy year regardless of the cause of death, other than suicide or other specifically enumerated exclusions, which is provided by the basic policy and each optional rider; with benefits provided under the basic policy and each rider shown separately;

   (4) the total guaranteed cash surrender values at the end of the year with values shown separately for the basic policy and each rider; and

   (5) any endowment amounts payable under the policy which are not included under cash surrender values above.

6. F. The effective policy loan annual percentage interest rate, if the policy contains this provision, specifying whether this rate is applied in advance or in arrears. If the policy loan interest rate is adjustable, the policy summary shall also indicate that the annual percentage rate will be determined by the company in accordance with the provisions of the policy and the applicable law.
7. G. The date on which the policy summary is prepared.

[13.9.5.8 NMAC - Rp 13 NMAC 9.5.13, 1-1-04]