VALUES AND BENEFITS. All reserves are greater than, or equal to, those required by statute. Any values and death benefits that may be available under this Contract are not less than the minimum benefits required by any law of the state in which this Contract is delivered. FIXED ANNUITY TABLES AND VARIABLE ANNUITY TABLES AMOUNT OF FIRST MONTHLY PAYMENT PER $1000 OF CONTRACT VALUE Annuitant Only
VALUES AND BENEFITS. Any cash values, paid up annuities and death benefits that may be available under this Contract are not less than the minimum benefits required by the law of any state in which this Contract is delivered.
VALUES AND BENEFITS. All reserves are greater to or equal to those required by statute. Any values and death benefits that may be available under this Contract are not less than the minimum benefits required by any statute of the state in which this Contract is delivered.
VALUES AND BENEFITS. Any values and death benefits that may be available under this Contract are not less than the minimum benefits required by the law of any state in which this Contract is delivered. ANNUITY OPTION PAYMENT TABLES
VALUES AND BENEFITS. NOTICE OF RIGHT TO EXAMINE CONTRACT YOU MAY RETURN THIS CONTRACT TO THE SELLING PRODUCER OR THE COMPANY NO LATER THAN 10 DAYS AFTER YOU RECEIVE IT (30 DAYS AFTER YOU RECEIVE IT IF YOU PURCHASED THE CONTRACT AS A REPLACEMENT CONTRACT). [IF THIS CONTRACT WAS PURCHASED AS A REPLACEMENT FOR A XXXXXXX NATIONAL LIFE INSURANCE COMPANY CONTRACT, YOU MAY RETURN IT NO LATER THAN 45 DAYS AFTER YOU RECEIVE IT.] THE COMPANY WILL REFUND THE FULL PREMIUM ALLOCATED TO THE FIXED ACCOUNTS LESS ANY WITHDRAWALS FROM THE FIXED ACCOUNT, PLUS THE SEPARATE ACCOUNT CONTRACT VALUE, WITHOUT DEDUCTION FOR ANY FEES AND CHARGES, CALCULATED ON THE BUSINESS DAY ON WHICH THE COMPANY RECEIVES THE CONTRACT AT ITS SERVICE CENTER. RETURNED CONTRACTS ARE VOID. Please Note: The Company reserves the right to allocate all Premium received during the "Notice of Right to Examine Contract" period to a money market Investment Division or the Fixed Account. After the "Notice of Right to Examine Contract" period expires, the Company will allocate the Contract Value to the Contract Options You have specified. The Telephone Number for the [Issue State] Department of Insurance is [Insurance Department telephone number]. INDIVIDUAL DEFERRED VARIABLE AND FIXED ANNUITY CONTRACT WITH MARKET VALUE ADJUSTMENT. (FLEXIBLE PREMIUM).
VALUES AND BENEFITS. Any cash values, paid up annuities and death benefits that may be available under this Contract are not less than the minimum benefits required by the law of any state in which this Contract is delivered. ANNUITY SETTLEMENT TABLES Tables 1 and 2 below are applied to the Adjusted Contract Value to compute the minimum amount of the annuity payment. Table 1 is used to compute the minimum annuity payment under Option 1 (Fixed Period Annuity Option). Table 2 is used to compute the minimum annuity payment under Option 2 (Life Income Annuity Option). The rates in Tables 1 and 2 are applied per $1000 of Adjusted Contract Value. The annuity payments in Table 2 are based on the Annuitant's Adjusted Age and sex. The Adjusted Age is the Annuitant's age last birthday prior to the date on which the first Annuity payment is due, adjusted as shown in the "Translation of Adjusted Age" Table. When we computed the amounts shown in Table 2, we adjusted the Annuity 2000 Mortality Table to an age last birthday basis, less two years, with projected mortality improvements (modified Scale G), and an interest rate of 3% per year. We will calculate annuities for other certain periods using the same interest and mortality assumptions as in Table 2. ------------------------------- Table 1 ------------------------------- Number Monthly of Years Payment ------------------------------- 10 9.61 11 8.86 12 8.24 13 7.71 14 7.26 15 6.87 16 6.53 17 6.23 18 5.96 19 5.73 20 5.51 21 5.32 22 5.15 23 4.99 24 4.84 25 4.71 ------------------------------- Multiply the monthly amount by 2.993 for quarterly, 5.963 for semi-annual or 11.839 for annual ------------------------------- -------------------------------------- Table 2 -------------------------------------- Adjusted Age Male Female -------------------------------------- 41 $3.40 $3.25 42 3.44 3.29 43 3.48 3.32 44 3.53 3.35 45 3.57 3.39 46 3.62 3.43 47 3.67 3.47 48 3.72 3.51 49 3.77 3.56 50 3.83 3.61 51 3.88 3.66 52 3.95 3.71 53 4.01 3.76 54 4.08 3.82 55 4.15 3.88 56 4.22 3.94 57 4.30 4.01 58 4.38 4.08 59 4.47 4.16 60 4.56 4.24 61 4.66 4.32 62 4.76 4.41 63 4.87 4.50 64 4.98 4.60 65 5.10 4.71 66 5.23 4.82 67 5.36 4.94 68 5.49 5.06 69 5.64 5.19 70 5.78 5.33 71 5.94 5.48 72 6.10 5.63 73 6.26 5.79 74 6.43 5.96 75 6.60 6.14 76 6.78 6.33 77 6.95 6.52 78 7.13 6.71 79 7.31 6.92 80 7.49 7.12 -------------------------------------- TRANSLATION OF ADJUSTED AGE Calendar Year in Which First Payment is Due Adjusted Age -------------------- ------------ Prior ...
VALUES AND BENEFITS. All reserves are greater than or equal to those required by statute. Any values and death benefits that may be available under this Contract are not less than the minimum benefits required by any law of the state in which this Contract is delivered. [Fixed] [Variable] ANNUITY TABLE OPTION 1 [Minimum Guaranteed Interest Rate for a Fixed Annuity Option: 3%] [Assumed Investment Rate for a Variable Annuity Option: 3%] Monthly Annuity Payments for Life Annuity For Each $1,000 Of Adjusted Contract Value Applied Male Female Male Female Male Female Adjusted Monthly Monthly Adjusted Monthly Monthly Adjusted Monthly Monthly Age Payment Payment Age Payment Payment Age Payment Payment --- ------- ------- --- ------- ------- --- ------- ------- 5 2.82 2.75 32 3.35 3.18 59 5.17 4.63 6 2.83 2.76 33 3.38 3.21 60 5.31 4.74 7 2.84 2.77 34 3.41 3.24 61 5.45 4.85 8 2.85 2.78 35 3.45 3.26 62 5.60 4.97 9 2.86 2.79 36 3.49 3.29 63 5.77 5.10 10 2.88 2.80 37 3.53 3.33 64 5.94 5.23 11 2.89 2.81 38 3.57 3.36 65 6.13 5.38 12 2.91 2.83 39 3.62 3.40 66 6.33 5.53 13 2.92 2.84 40 3.67 3.43 67 6.54 5.70 14 2.94 2.85 41 3.72 3.47 68 6.77 5.88 15 2.95 2.86 42 3.77 3.51 69 7.02 6.07 16 2.97 2.88 43 3.82 3.55 70 7.28 6.28 17 2.98 2.89 44 3.88 3.60 71 7.56 6.51 18 3.00 2.90 45 3.94 3.64 72 7.86 6.75 19 3.02 2.92 46 4.00 3.69 73 8.18 7.02 20 3.04 2.94 47 4.07 3.74 74 8.53 7.31 21 3.06 2.95 48 4.13 3.80 75 8.89 7.62 22 3.08 2.97 49 4.21 3.86 76 9.29 7.96 23 3.10 2.99 50 4.28 3.92 77 9.72 8.32 24 3.13 3.00 51 4.36 3.98 78 10.17 8.72 25 3.15 3.02 52 4.44 4.04 79 10.66 9.15 26 3.17 3.04 53 4.53 4.12 80 11.19 9.62 27 3.20 3.06 54 4.62 4.19 81 11.75 10.13 28 3.23 3.09 55 4.72 4.27 82 12.34 10.68 29 3.25 3.11 56 4.82 4.35 83 12.98 11.28 30 3.28 3.13 57 4.93 4.44 84 13.65 11.93 31 3.31 3.16 58 5.05 4.53 85+ 14.37 12.64 [Fixed] [Variable] ANNUITY TABLE OPTION 2 [Minimum Guaranteed Interest Rate for a Fixed Annuity Option: 3%] [Assumed Investment Rate for a Variable Annuity Option: 3%] Monthly Annuity Payments for Life Annuity with 5, 10 or 20 Years Guaranteed For Each $1,000 Of Adjusted Contract Value Applied Female's Female's Adjusted 5 Years 10 Years 20 Years Adjusted 5 Years 10 Years 20 Years Age Guaranteed Guaranteed Guaranteed Age Guaranteed Guaranteed Guaranteed --- ---------- ---------- ---------- --- ---------- ---------- ---------- 5 2.75 2.75 2.75 46 3.69 3.68 3.64 6 2.76 2.76 2.76 47 3.74 3.73 3.69 7 2.77 2.77 2.77 48 3.80 3.78 3.73 8 2.78 2.78 2.78 49 3.85 3.84 3.78 9 2.79 2.79 2.79 50 3.91 ...
VALUES AND BENEFITS. Any values and death benefits that may be available under this Contract are not less than the minimum benefits required by Section 7B of the Model Variable Annuity Regulation, model #250. 6-200-1 (11/14) FIXED ANNUITY TABLES AMOUNT OF MONTHLY PAYMENT PER $1,000 OF ADJUSTED ACCOUNT VALUE OPTION 2 - LIFE ANNUITY WITH 10 OPTION 3 - OPTION 1 - YEARS OF ANNUITY LIFE ANNUITY WITH LIFE ANNUITY PAYMENTS GUARANTEED CASH REFUND AGE MALE FEMALE MALE FEMALE MALE FEMALE 60 $ 3.21 $ 2.94 $3.18 $2.93 $2.83 $2.69 61 $ 3.29 $ 3.01 $3.26 $2.99 $2.88 $2.75 62 $ 3.38 $ 3.08 $3.34 $3.07 $2.94 $2.80 63 $ 3.47 $ 3.16 $3.43 $3.14 $3.00 $2.85 64 $ 3.56 $ 3.24 $3.52 $3.22 $3.06 $2.91 65 $ 3.66 $ 3.33 $3.61 $3.30 $3.12 $2.97 66 $ 3.77 $ 3.42 $3.71 $3.39 $3.19 $3.04 67 $ 3.89 $ 3.52 $3.82 $3.49 $3.26 $3.10 68 $ 4.01 $ 3.62 $3.93 $3.58 $3.33 $3.17 69 $ 4.14 $ 3.74 $4.05 $3.69 $3.41 $3.24 70 $ 4.28 $ 3.85 $4.17 $3.80 $3.48 $3.32 71 $ 4.43 $ 3.98 $4.30 $3.91 $3.57 $3.40 72 $ 4.59 $ 4.11 $4.44 $4.03 $3.65 $3.48 73 $ 4.75 $ 4.25 $4.58 $4.16 $3.74 $3.56 74 $ 4.93 $ 4.40 $4.72 $4.30 $3.83 $3.65 75 $ 5.13 $ 4.57 $4.88 $4.44 $3.93 $3.75 76 $ 5.33 $ 4.74 $5.03 $4.59 $4.03 $3.85 77 $ 5.55 $ 4.93 $5.20 $4.75 $4.13 $3.95 78 $ 5.78 $ 5.13 $5.37 $4.92 $4.24 $4.06 79 $ 6.03 $ 5.35 $5.54 $5.10 $4.36 $4.17 80 $ 6.29 $ 5.59 $5.72 $5.28 $4.48 $4.29 81 $ 6.57 $ 5.85 $5.90 $5.47 $4.60 $4.42 82 $ 6.87 $ 6.12 $6.08 $5.67 $4.74 $4.55 83 $ 7.20 $ 6.42 $6.26 $5.87 $4.87 $4.69 84 $ 7.54 $ 6.74 $6.45 $6.07 $5.02 $4.84 85 $ 7.91 $ 7.09 $6.63 $6.28 $5.17 $4.99 86 $ 8.31 $ 7.47 $6.81 $6.49 $5.33 $5.15 87 $ 8.73 $ 7.88 $6.99 $6.70 $5.49 $5.32 88 $ 9.18 $ 8.33 $7.16 $6.90 $5.66 $5.49 89 $ 9.67 $ 8.81 $7.33 $7.10 $5.84 $5.68 90 $10.18 $ 9.34 $7.49 $7.29 $6.03 $5.87 91 $10.73 $ 9.90 $7.64 $7.47 $6.23 $6.07 92 $11.32 $10.51 $7.78 $7.64 $6.44 $6.28 93 $11.95 $11.17 $7.91 $7.79 $6.66 $6.50 94 $12.62 $11.88 $8.03 $7.93 $6.89 $6.73 95 $13.33 $12.63 $8.14 $8.05 $7.13 $6.97 6-200-1 (11/14) OPTION 4 - JOINT AND SURVIVOR ANNUITY MALE Annuitant FEMALE Annuitant Age Age 60 65 70 75 80 85 90 95 60 $2.62 $2.77 $2.91 $3.01 $3.09 $3.14 $3.17 $3.19 65 $2.72 $2.93 $3.13 $3.30 $3.43 $3.53 $3.59 $3.62 70 $2.80 $3.06 $3.33 $3.60 $3.83 $4.00 $4.12 $4.19 75 $2.85 $3.16 $3.51 $3.88 $4.24 $4.55 $4.78 $4.93 80 $2.89 $3.23 $3.64 $4.11 $4.63 $5.13 $5.55 $5.86 85 $2.91 $3.27 $3.73 $4.29 $4.96 $5.69 $6.39 $6.96 90 $2.92 $3.30 $3.78 $4.41 $5.20 $6.17 $7.21 $8.17 95 $2.93 $3.31 $3.81 $4.48 $5.37 $6.52 $7.91 $9.36 OPTION 5 - JOINT AND SURVIVOR ANNUIT...
VALUES AND BENEFITS. Any cash values, paid up annuities and death benefits that may be available under this Contract are not less than the minimum benefits required by the laws of the state of New York. MVA-2002 NY
VALUES AND BENEFITS. Any cash values, paid up annuities and death benefits that may be available under this Contract are not less than the minimum benefits required by the law of any state in which this Contract is delivered. ANNUITY SETTLEMENT TABLES Tables 1 and 2 below are applied to the Adjusted Contract Value to compute the minimum amount of the annuity payment. Table 1 is used to compute the minimum annuity payment under Option 1 (Fixed Period Annuity Option). Table 2 is used to compute the minimum annuity payment under Option 2 (Life Income Annuity Option). The rates in Tables 1 and 2 are applied per $1000 of Adjusted Contract Value. The annuity payments in Table 2 are based on the Annuitant's Adjusted Age and sex. The Adjusted Age is the Annuitant's age last birthday prior to the date on which the first Annuity payment is due, adjusted as shown in the "Translation of Adjusted Age" Table. When we computed the amounts shown in Table 2, we adjusted the Annuity 2000 Mortality Table to an age last birthday basis, less two years, with projected mortality improvements (modified Scale G), and an interest rate of 3% per year. We will calculate annuities for other certain periods using the same interest and mortality assumptions as in Table 2. INDIVIDUAL FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT. NON-PARTICIPATING. ANNUITY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
