Personalized Supplemental Disability Insurance Policy Description for NetBank, Inc. Executive Officer
This document outlines the details of a supplemental disability insurance plan provided to a NetBank, Inc. executive officer. It describes two insurance policies, each offering a monthly benefit ($3,000 and $2,000) payable until age 65, with a 180-day elimination period and a 2-year minimum non-disability aggregate (MNDA) period. The policies are effective from March 1, 2003, and are designed to provide income protection in the event of disability. The annual premium amounts are not specified in this form.
Exhibit 10.12
[Form of Personalized Policy Description Under
Supplemental Disability Insurance Plan]
Personalized Policy Description for:
[Name of Executive Officer]
NetBank, Inc.
| Policy I | | |
| | | |
| Policy Number: |
|
|
| Policy Form: |
| 601 Income III Choice, GR |
| Monthly Benefit Amount: |
| $3,000.00 |
| MNDA: |
| 2 Year Aggregate |
| Residual: |
| To Age 65 Residual |
| Elimination Period: |
| 180 Days |
| Benefit Period: |
| To age 65 |
| Issue Date: |
| 03/01/03 |
| Annual Premium: |
| $ |
| Policy II | | |
| | | |
| Policy Number: |
|
|
| Policy Form: |
| 601 Income III Choice, GR |
| Monthly Benefit Amount: | | $2,000.00 |
| MNDA: |
| 2 Year Aggregate |
| Residual: |
| To Age 65 Residual |
| Elimination Period: |
| 180 Days |
| Benefit Period: |
| To age 65 |
| Issue Date: |
| 03/01/03 |
| Annual Premium: |
| $ |
