EXHIBIT 4l
KEYPORT BENEFIT LIFE INSURANCE COMPANY
Read this Contract carefully. This document is a description of the
legal contract between the Group Contract Owner and Us.
A Certificate Owner may return a Certificate to Us within 10 days
after receipt by delivering or mailing it to Our Office. The return of the
Certificate by mail will be effective when the postmark is affixed to a
properly addressed and postage prepaid envelope. This returned Certificate
will be treated as if We never issued it and We will refund the Certificate
Value plus any amount deducted from the purchase payment before it was
allocated to the Variable Account. The Certificate Value will be determined
as of the date of surrender (i.e., for a mailed contract, the postmark
date).
The Group Contract, as issued to the Group Contract Owner by Us with
any riders or endorsements, alone makes up the agreement under which
benefits are paid. The Group Contract may be inspected at the office of
the Group Contract Owner. In consideration of any application for a
Certificate and the payment of purchase payments, We agree, subject to the
terms and conditions of the Group Contract, to provide the benefits
described in the Certificate to the Certificate Owner. If a Certificate is
In Force on the Income Date, We will begin making income payments to the
Annuitant. We will make such payments according to the terms of the
Certificate and Group Contract.
Signed for the Company on the Issue Date at Our Executive Office, 000
Xxxx Xxxxxx, Xxxxxx, Xxxxxxxxxxxxx 00000:
_________________________ _________________________
Secretary President
POLICY DESCRIPTION
This is a GROUP VARIABLE ANNUITY CONTRACT with limited purchase
payment flexibility. This contract is nonparticipating with no dividends.
ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT, WHEN
BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND
ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. VARIABLE ANNUITY PAYMENTS WILL NOT
DECREASE OVER TIME IF THE SEPARATE ACCOUNT (AFTER DEDUCTION OF THE ANNUAL
[1.55%] ASSET CHARGE) HAS AN ANNUALIZED INVESTMENT RETURN OF AT LEAST 5.0%.
SEE PAGES 12-13 AND 19 FOR FURTHER EXPLANATION. CONTRACT ASSETS ALLOCATED
TO THE SEPARATE ACCOUNT INCUR CHARGES OF [1.55%] BEFORE ANNUITY PAYMENTS
BEGIN AND [1.40%] ONCE ANNUITY PAYMENTS BEGIN. INCOME, CAPITAL GAINS,
AND/OR LOSSES WHETHER OR NOT REALIZED, FROM ASSETS ALLOCATED TO THE
SEPARATE ACCOUNT ARE CREDITED TO OR CHARGED AGAINST THE SEPARATE ACCOUNT
WITHOUT REGARD TO INCOME, CAPITAL GAINS, AND/OR LOSSES ARISING OUT OF ANY
OTHER BUSINESS THE COMPANY MAY CONDUCT.
Table of Contents
Page
Right to Examine Certificate 1
Definitions 2
Contract Schedule 3
General Provisions 5
Variable Account Provisions 10
Transfers 13
Partial Withdrawals and Total Surrender 14
Death Provisions 15
Annuity Provisions 16
Endorsements (if any) are before page 22
Definitions
Accumulation Period: The period prior to the Income Date during which
Purchase Payments may be made by a Certificate Owner.
Accumulation Unit: An accounting unit used to calculate a Certificate
Owner's interest in a Sub-account of the Variable Account during the
Accumulation Period.
Adjusted Certificate Value: The Certificate Value less any applicable
taxes relating to a Certificate and Certificate Maintenance Charge. This
amount is applied to the applicable Annuity Tables to determine Annuity
Payments.
Annuitant: The natural person on whose life Annuity Payments are based,
and to whom any Annuity Payments will be made starting on the Income Date.
Annuity Options: Options available for Annuity Payments.
Annuity Payments: The series of payments made to the Annuitant, starting
on the Income Date, under the Annuity Option selected.
Annuity Period: The period after the Income Date during which Annuity
Payments are made.
Annuity Unit: An accounting unit used to calculate Variable Annuity
Payments during the Annuity Period.
Beneficiary: The person(s) or entity(ies) who controls the Certificate if
any Certificate Owner dies before the Income Date.
KEYPORT BENEFIT LIFE INSURANCE COMPANY
000 Xxxxxxxxxxxxxx Xxxx, Xxxxxxxx, Xxx Xxxx 00000
Service Office
000 Xxxx Xxxxxx, 00xx Xxxxx
Xxxxxx, Xxxxxxxxxxxxx 00000
Contract Schedule
GROUP CONTRACT OWNER Keyport Benefit Insurance Trust I
GROUP CONTRACT NUMBER DVA(NY)003
GROUP CONTRACT ISSUE DATE 10/1/97
MINIMUM INITIAL PAYMENT $25,000
MINIMUM ADDITIONAL PAYMENT $250 ($50 for EFT payment)
Charges
Distribution Charge: None.
Administrative Charge: We deduct 0.000411% of the assets in each Variable
Account Sub-Account on a daily basis (equivalent to an annual rate of
0.15%) to compensate Us for a portion of Our administrative costs.
Mortality and Expense Risk Charge: We deduct 0.003403% of the assets in
each Variable Account Sub-account on a daily basis (equivalent to an annual
rate of 1.25%) for Our mortality and expense risks.
Certificate Maintenance Charge: None
Transfer Charge: Currently none, however, We reserve the right to charge
$25 for a transfer if You make more than 12 transfers per Certificate Year.
Surrender Charge: None
Initial Purchase Payment Allocation
Currently, Certificate Owners can select 21 Sub-accounts and the Fixed
Account. We reserve the right to increase or decrease the number of
available Sub-accounts. The minimum You may allocate to any Sub-account or
the Fixed Account is 5% of any Purchase Payment. Your initial Purchase
Payment has been invested as follows:
AIM Capital Appreciation x%
AIM Growth x%
AIM International x%
Alliance Global Bond x%
Alliance Growth and Income x%
Alliance Premier Growth x%
Alliance Real Estate x%
Colonial Growth and Income x%
Colonial High Yield Securities x%
Colonial Small Cap Value x%
Colonial Strategic Income x%
Colonial U.S. Stock x%
Liberty All-Star x%
MFS Bond x%
MFS Emerging Growth x%
MFS Research x%
Xxxxx Xxx Balanced x%
Xxxxx Xxx Global Utilities x%
Xxxxx Xxx Growth Stock x%
Xxxxx Xxx Money Market x%
Xxxxx Xxx Special Venture x%
Fixed Account - 1 Year x%
Transfer Guidelines
Number of Transfers and Transfer Charge: Currently, Certificate Owners are
permitted unlimited transfers per Certificate Year during the Accumulation
Period and unlimited transfers during the Annuity Period. We reserve the
right to change, upon notice, the frequency of transfers You can make. We
also reserve the right to impose a charge for any transfer in excess of 12
per Certificate Year. The transfer charge is shown in the Charges section
of the Schedule.
Minimum amount to be transferred: None.
Minimum amount which must remain in a Sub-account after transfer: None.
Death Benefits
Adjustment of Certificate Value
When We receive due proof of death of the Certificate Owner, or the
Annuitant if the Certificate Owner is a non-natural Person, We will
compare, as of the date of death, the Certificate Value to the Death
Benefit amount defined in this Schedule. If the Certificate Value is less
than the Death Benefit, We will increase the current Certificate Value by
the amount of the difference. Any amount credited will be allocated to the
Variable Account and/or the Fixed Account based on the Purchase Payment
allocation selection that is in effect when We receive due proof of death.
Death Benefit Amount
Certificate Anniversary Death Benefit
On the Certificate Date, the Death Benefit is the initial Purchase Payment.
On subsequent Valuation Dates, the Death Benefit is calculated as follows:
(1) (a) Start with the Death Benefit from the Certificate Date;
(b) Add to (a) any additional Purchase Payments paid since the
Certificate Date and subtract from (a) any partial
withdrawals (including any associated surrender charge
incurred) made since the Certificate Date;
(2) (a) Determine the Certificate Value for each Certificate
Anniversary (the "Anniversary Value") before the 81st
birthday of the Certificate Owner or, if the Certificate
Owner is a non-natural Person, the Annuitant;
(b) Increase each "Anniversary Value" by any Purchase Payments
made after that Value's Anniversary;
(c) Decrease each "Anniversary Value" by the following amount
calculated at the time of each partial withdrawal made
after that Value's Anniversary: (i) the partial withdrawal
amount (including any associated surrender charge
incurred) divided by the Certificate Value immediately
preceding the withdrawal, (ii) multiplied by the
"Anniversary Value" immediately preceding the withdrawal;
(d) Select the highest "Anniversary Value" after the
adjustments in (b) and (c) above;
(3) Set the Death Benefit equal to the greater of (1) and (2).
If there is a change of Certificate Owner, the new Certificate Owner's age
will be used to determine the amount in (2) above.
The Variable Separate Account
Sub-accounts investing in shares of mutual funds
Variable Account A is a unit investment trust variable separate account,
organized in and governed by the laws of the State of New York, Our state
of domicile. Variable Account A is divided into Sub-accounts. Each Sub-
account listed below invests in shares of the corresponding Portfolio of
the Eligible Fund shown.
Sub-Accounts Investment Objective
AIM Variable Insurance Funds, Inc.
AIM Capital Appreciation Capital appreciation through investments in
Sub-account common stocks, with emphasis on medium-sized
and smaller emerging growth companies
AIM Growth Sub-Account Growth of capital through investments
primarily in common stocks of leading U.S.
companies considered by AIM to have strong
earnings momentum.
AIM International Equity Long-term growth of capital by investing in
Sub-account international equity securities, the issuers
of which are considered by AIM to have strong
earnings momentum.
Alliance Variable Products Series Fund, Inc.
Alliance Global Bond A high level of return from a combination of
Sub-account current income and capital appreciation by
investing in a globally diversified portfolio
of high quality debt securities denominated
in the U.S. Dollar and a range of foreign
currencies.
Alliance Growth and Income Balance the objectives of reasonable current
Sub-account income and reasonable opportunities for
appreciation through investments primarily in
dividend-paying common stocks of good
quality.
Alliance Premier Growth Growth of capital rather than current income.
Sub-account
Alliance Real Estate Total return on its assets through long-term
Sub-account growth of capital and income principally
through investing in a portfolio of equity
securities of issuers that are primarily
engaged in or related to the real estate
industry.
Liberty Variable Investment Trust
Colonial Growth and Income Primarily income and long-term
Sub-Account(formerly named capital growth and, secondarily,
Colonial-Keyport Growth and preservation of capital.
Income Fund)
Colonial High Yield High current income and total return by
Securities Sub-account investing primarily in lower rated corporate
debt securities.
Colonial Small Cap Value Long-term growth by investing in smaller
Sub-account capitalization equity securities.
Colonial Strategic Income A high level of current income, as is
Sub-Account (formerly named consistent with prudent risk and maximizing
Colonial-Keyport Strategic total return, by diversifying investments
Income Fund) primarily in U.S. and foreign government and
high yield, high risk corporate debt
securities.
Colonial U.S. Stock Long-term capital growth by investing
Sub-Account(formerly named primarily in large capitalization
Colonial-Keyport U.S. Stock equity securities.
Fund)
Liberty All-Star Equity Total investment return, comprised of long-
Sub-account term capital appreciation and current income,
through investment primarily in a diversified
portfolio of equity securities.
Xxxxx Xxx Global Utilities Current income and long-term growth
Sub-Account (formerly named of capital and income.
Colonial-Keyport Utilities
Fund)
MFS Variable Insurance Trust
MFS Bond Sub-Account High level of current income as is believed
consistent with prudent investment risk and
secondarily to protect shareholders' capital.
MFS Emerging Growth Long-term growth of capital.
Sub-account
MFS Research Sub-Account Long-term growth of capital and future
income.
SteinRoe Variable Investment Trust
Xxxxx Xxx Balanced High total investment return through
Sub-Account (formerly named investment in a changing mix
Xxxxx Xxx Managed Assets Fund)of securities.
Xxxxx Xxx Growth Stock Long-term growth of capital
Sub-Account(formerly named through investment primarily
SteinRoe Managed Growth in common stocks.
Stock Fund)
Xxxxx Xxx Money Market High current income from short-term
Sub-Account (formerly named money market instruments while
SteinRoe Cash Income Fund) emphasizing preservation of capital and
maintaining excellent liquidity.
Xxxxx Xxx Special Venture Capital growth by investing primarily
Sub-account (formerly named in common stocks, convertible securities
SteinRoe Capital Appreciation and other securities selected for
Fund) prospective capital growth.
Sub-accounts investing directly in securities - None.
The Fixed Account
The Fixed Account is part of Our General Account, which consists of all of
Our assets except the assets of the Variable Account and the assets of
other separate accounts that We maintain. Subject to applicable law, We
have sole discretion over investments of the assets of the Fixed Account.
If You allocate assets to the Fixed Account, Your accumulation values and
annuity payments will have guaranteed minimums.
Before the Income Date, Your interest in the Fixed Account is measured by
the Fixed Account Value. When annuity payments begin, the payee's interest
in the Fixed Account is measured by the amount of each periodic payment.
Benefits from the Fixed Account will not be less than the minimum values
required by any law of the jurisdiction where the Certificate is delivered.
Purchase Payments will be allocated to the Fixed Account in accordance with
Your selection at the Certificate Date. You may change such selection by
Written Request.
The Fixed Account Value at any time is equal to:
(1) all Purchase Payments allocated to the Fixed Account plus the
interest subsequently credited on those payments; plus
(2) any Variable Account value transferred to the Fixed Account
plus the interest subsequently credited on the transferred
value; less
(3) any prior partial withdrawals from the Fixed Account; less
(4) any Fixed Account Value transferred to the Variable Account.
We will credit interest to Purchase Payments allocated to the Fixed Account
at rates declared by Us for Guarantee Periods of one or more years from the
month and day of allocation. The minimum Guaranteed Interest Rate is 3%
per year.
Definitions (continued)
Certificate: The document issued to a Certificate Owner to evidence a
Certificate Owner's participation under the Group Contract. The
Certificate summarizes the benefits and provisions of the Group Contract.
Certificate Anniversary: An anniversary of the Certificate Date.
Certificate Date: The date a Certificate is issued to a Certificate Owner.
The Certificate Date is shown on the Certificate Schedule.
Certificate Owner: The person who owns a Certificate under the Group
Contract. Any Joint Certificate Owners and the Certificate Owner own the
Certificate equally with rights of survivorship. All Owners must exercise
ownership rights and privileges together, including the signing of Written
Requests.
Certificate Value: The sum of the Certificate Owner's interest in the Sub-
accounts of the Variable Account and the Fixed Account during the
Accumulation Period.
Certificate Year: The first Certificate Year is the annual period which
begins on the Certificate Date. Subsequent Certificate Years begin on each
Certificate Anniversary.
Eligible Fund: An investment entity shown on the Certificate Schedule.
Fixed Account: The account We establish to support Fixed Allocations. The
Contract Schedule shows whether the Fixed Account is available under the
Certificates.
Fixed Account Value: The value of all Fixed Account amounts accumulated
under a Certificate prior to the Income Date.
Fixed Allocation: An amount allocated to the Fixed Account that is
credited with a Guaranteed Interest Rate for a specified Guarantee Period.
Xxxxx Xxxxxxx: An annuity with a series of payments made during the
Annuity Period which are guaranteed as to dollar amount by Us.
General Account: Our general investment account which contains all of Our
assets except those in the Variable Account and Our other separate
accounts.
Group Contract Owner: The person or entity to which the Group Contract is
issued.
Guaranteed Interest Rate: The effective annual interest rate which We will
credit for a specified Guarantee Period.
Guarantee Period: The period of year(s) a rate of interest is guaranteed
to be credited within the Fixed Account.
Income Date: The date on which Annuity Payments begin. The Income Date is
shown on the Certificate Schedule.
In Force: The status of a Certificate before the Income Date so long as it
has not been totally surrendered and there has not been a death of a
Certificate Owner or Joint Certificate Owner that will cause the
Certificate to end within five years of the date of death.
Office: Our service office shown on the Certificate Schedule.
Person: A human being, trust, corporation, or any other legally recognized
entity.
Portfolio: A series of an Eligible Fund which constitutes a separate and
distinct class of shares.
Purchase Payment: A payment made by or on behalf of a Certificate Owner
with respect to a Certificate.
Sub-account: Variable Account assets are divided into Sub-accounts.
Assets of each Sub-account will be invested in shares of a Portfolio of an
Eligible Fund, or directly in portfolio securities.
Valuation Date: Each day on which We and the New York Stock Exchange
("NYSE") are open for business, or any other day that the Securities and
Exchange Commission requires that mutual funds, unit investment trusts or
other investment portfolios be valued.
Valuation Period: The period of time beginning at the close of business of
the NYSE on each Valuation Date and ending at the close of business on the
next succeeding Valuation Date.
Variable Account: Our Variable Account(s) shown on the Certificate
Schedule.
Variable Annuity: An annuity with payments which vary as to dollar amount
in relation to the investment performance of specified Sub-accounts of the
Variable Account.
We, Us, Our: Keyport Benefit Life Insurance Company.
Written Request: A request in writing, in a form satisfactory to Us, and
received by Us at Our Office.
General Provisions
Purchase Payments
The initial Purchase Payment is due on the Certificate Date. It must be
paid at Our Office in United States currency. Coverage under a Certificate
does not take effect until We have accepted the initial Purchase Payment
during a Certificate Owner's lifetime. Each Purchase Payment after the
Certificate Date must be at least the amount shown on the Certificate
Schedule. Provided the Certificate Value under a Certificate does not go
to zero, a Certificate will stay in force until the Income Date even if a
Certificate Owner make no payments after the initial one. We reserve the
right to reject any subsequent Purchase Payment.
Allocation of Purchase Payments
An initial Purchase Payment is allocated to the Sub-accounts of the
Variable Account, and to the Fixed Account if available, in accordance with
the selections made by a Certificate Owner at the Certificate Date. Unless
otherwise changed by a Certificate Owner, subsequent Purchase Payments are
allocated in the same manner as the initial Purchase Payment. Allocation
of Purchase Payments is subject to the terms and conditions imposed by Us.
We reserve the right to allocate initial Purchase Payments to the Money
Market Sub-account until the expiration of the Right to Examine Certificate
period set forth on the first page of the Group Contract and the
Certificate.
The Contract
The Group Contract, including the application, if any, and any attached
rider or endorsement constitute the entire contract between the Group
Contract Owner and Us. All statements made by the Group Contract Owner,
any Certificate Owner or any Annuitant will be deemed representations and
not warranties. No such statement will be used in any contest unless it is
contained in the application signed by the Group Contract Owner or in a
written instrument signed by the Certificate Owner, a copy of which has
been furnished to the Certificate Owner, the Beneficiary or to the Group
Contract Owner.
Only Our President or Secretary may agree to change any of the terms of the
Group Contract. Any changes must be in writing. Any change to the terms
of a Certificate must be in writing and with Certificate Owner's consent,
unless provided otherwise by the Group Contract and the Certificate.
To assure that the Group Contract and the Certificate will maintain their
status as a variable annuity under the Internal Revenue Code, We reserve
the right to change the Group Contract and any Certificate issued
thereunder to comply with future changes in the Internal Revenue Code, any
regulations or rulings issued thereunder, and any requirements otherwise
imposed by the Internal Revenue Service. The Group Contract Owner and the
affected Certificate Owner will be sent a copy of any such amendment.
We reserve the right, subject to the approval of the New York
Superintendent of Insurance and compliance with U.S. Laws as currently
applicable or subsequently changed, to: (a) operate the Variable Account
in any form permitted under the Investment Company Act of 1940, as
amended, (the "1940 Act"), or in any other form permitted by law; (b) take
any action necessary to comply with or obtain and continue any exemptions
from the 1940 Act, or to comply with any other applicable law; (c) transfer
any assets in any Sub-account to another Sub-account, or to one or more
separate investment accounts, or the General Account; or to add, combine or
remove Sub-accounts in the Variable Account; and (d) change the way We
assess charges, so long as We do not increase the aggregate amount beyond
that currently charged to the Variable Account and the Eligible Funds in
connection with a Certificate. If the shares of any of the Eligible Funds
should become unavailable for investment by the Variable Account or if in
Our judgment further investment in such Portfolio shares should become
inappropriate in view of the purpose of the Certificate, We may add or
substitute shares of another mutual fund for the Portfolio shares already
purchased under the Certificate. No substitution of Portfolio shares in
any Sub-account may take place without prior approval of the Securities and
Exchange Commission and notice to the affected Certificate Owners, to the
extent required by the 1940 Act.
Certificate Owner
A Certificate Owner has all rights and may receive all benefits under a
Certificate. A Certificate Owner is the person designated as such on the
Certificate Date, unless changed. A Certificate Owner may exercise all
rights of a Certificate while it is In Force, subject to the rights of (a)
any assignee under an assignment filed with Us, and (b) any irrevocably
named Beneficiary.
Joint Certificate Owner
A Certificate can be owned by Joint Certificate Owners. Upon the death of
any Certificate Owner or Joint Certificate Owner, the surviving owner(s)
will be the primary Beneficiary(ies). Any other beneficiary designation
will be treated as a Contingent Beneficiary unless otherwise indicated in a
Written Request filed with Us.
Annuitant
The Annuitant is the person on whose life Annuity Payments are based. The
Annuitant is the person designated by a Certificate Owner at the
Certificate Date, unless changed prior to the Income Date. Any change of
Annuitant is subject to Our underwriting rules then in effect. The
Annuitant may not be changed in a Certificate which is owned by a non-
natural person. A Certificate Owner may name a Contingent Annuitant. The
Contingent Annuitant becomes the Annuitant if the Annuitant dies while a
Certificate is In Force. If the Annuitant dies and no Contingent
Annuitant has been named, We will allow a Certificate Owner sixty days to
designate someone other than the Certificate Owner as Annuitant. The
Certificate Owner will be the Contingent Annuitant unless the Certificate
Owner names someone else. If the Certificate is owned by a non-natural
person, the death of the Annuitant will be treated as the death of the
Certificate Owner and a new Annuitant may not be designated.
Beneficiary
The Beneficiary is the person who controls the Certificate if any
Certificate Owner dies prior to the Income Date. If the Certificate is
owned by Joint Certificate Owners, upon the death of any Certificate Owner
or Joint Certificate Owner, the surviving owner(s) will become the primary
Beneficiary. Any other beneficiary designation will be treated as a
Contingent Beneficiary unless otherwise indicated in a Written Request
filed with Us. If a Certificate Owner names more than one Person as
Primary Beneficiary or as Contingent Beneficiary, and does not state
otherwise on an application or in a Written Request to Us, any non-
survivors will not receive a benefit. The survivors will receive equal
shares. Subject to the rights of any irrevocable Beneficiary(ies), a
Certificate Owner may change primary or contingent Beneficiary(ies). A
change must be made by Written Request and will be effective as of the date
the Written Request is signed. We will not be liable for any payment We
make or action We take before We receive the Written Request.
Group Contract Owner
The Group Contract Owner has title to the Group Contract. The Group
Contract and any amount accumulated under any Certificate are not subject
to the claims of the Group Contract Owner or any of its creditors. The
Group Contract Owner may transfer ownership of this Group Contract. Any
transfer of ownership terminates the interest of any existing Group
Contract Owner. It does not change the rights of any Certificate Owner.
Nothing in the Group Contract shall invalidate or impair any rights granted
to the Certificate Owner by the Certificate or New York law.
Change of Certificate Owner, Beneficiary or Contingent Annuitant
While a Certificate is In Force, a Certificate Owner may by Written Request
change the primary Certificate Owner, Joint Certificate Owner, primary
Beneficiary, Contingent Beneficiary, Contingent Annuitant, or in certain
instances, the Annuitant. An irrevocably named Person may be changed only
with the written consent of such Person. The change will be effective,
following Our receipt of the Written Request, as of the date the Written
Request is signed. The change will not affect any payments We make or
actions We take prior to the time We receive the Written Request.
Assignment of the Certificate
A Certificate Owner may assign a Certificate at any time while it is In
Force. The assignment must be in writing and a copy must be filed at Our
Office. A Certificate Owner's rights and those of any revocably named
Person will be subject to the assignment. An assignment will not affect
any payments We make or actions We take before We receive the assignment.
We are not responsible for the validity of any assignment.
Misstatement of Age or Sex
If the age or sex of the Annuitant or any payee has been misstated, We will
compute the amount payable based on the correct age and sex. If Annuity
Payments have begun, any underpayment(s) that have been made plus interest
at a rate of 5% per year will be paid in full with the next Annuity
Payment. Any overpayment plus interest at a rate of 5% per year, unless
repaid to Us in one sum, will be deducted from future Annuity Payments
otherwise due until We are repaid in full.
Non-Participating
A Certificate does not participate in Our divisible surplus.
Evidence of Death, Age, Sex or Survival
If a Certificate provision relates to the death of a natural Person, We
will require proof of death before We will act under that provision. Proof
of death shall be: (a) a certified death certificate; or (b) a certified
decree of a court of competent jurisdiction as to the finding of death; or
(c) a written statement by a medical doctor who attended the deceased; or
(d) any other document constituting due proof of death under applicable
state law. If Our action under a Certificate provision is based on the
age, sex, or survival of any Person, We may require evidence of the
particular fact before We act under that provision.
Protection of Proceeds
No Beneficiary or payee may commute or assign any payments under a
Certificate before they are due. To the extent permitted by law, no
payments shall be subject to the debts of any Beneficiary or payee or to
any judicial process for payment of those debts.
Reports
We will send Certificate Owners a report that shows the Certificate Value
at least once each Certificate Year. We will send any other reports that
may be required by law.
Taxes
Any taxes paid to any governmental entity relating to a Certificate will be
deducted from the Purchase Payments or Certificate Value. We may, in Our
sole discretion, delay the deduction until a later date. By not deducting
tax payments at the time of Our payment, We do not waive any right We may
have to deduct amounts at a later date. We will, in Our sole discretion,
determine when taxes relate to a Certificate or to the operation of the
Variable Account. We reserve the right to establish a provision for
federal income taxes if We determine, in Our sole discretion, that We will
incur a tax as a result of the operation of the Variable Account. Such a
provision will be reflected in the Accumulation and Annuity Unit Values.
We will deduct for any income taxes incurred by Us as a result of the
operation of the Variable Account whether or not there was a provision for
taxes and whether or not it was sufficient. We will deduct from any
payment under a Certificate any withholding taxes required by applicable
law.
Regulatory Requirements
All values payable under a Certificate will not be less than the minimum
benefits required by the laws and regulations of the states in which the
Certificate is delivered.
Suspension or Deferral of Payments
We reserve the right to suspend or postpone payments for a withdrawal,
transfer, surrender or death benefit for any period when:
(1) the New York Stock Exchange is closed (other than customary
weekend and holiday closings); or
(2) trading on the New York Stock Exchange is restricted; or
(3) an emergency exists as a result of which valuation or disposal
of the assets and securities of the Variable Account is not
reasonably practicable; or
(4) the Securities and Exchange Commission, by order or
pronouncement, so permits for the protection of Certificate
Owners;
provided that applicable rules and regulations of the Securities and
Exchange Commission govern as to whether the conditions described in (2)
and (3) above exist.
We reserve the right to delay payment of amounts allocated to the Fixed
Account for up to six months.
Variable Account Provisions
The Variable Account
The Variable Account(s) is designated on the Certificate Schedule and
consists of assets set aside by Us, which are kept separate from Our
general assets and all other variable account assets We maintain. We own
the assets of the Variable Account. Variable Account assets equal to
reserves and other contract liabilities will not be chargeable with
liabilities arising out of any other business We may conduct. We may
transfer to Our General Account assets which exceed the reserves and other
liabilities of the Variable Account. Xxxxxx and realized and unrealized
gains or losses from assets in the Variable Account are credited to or
charged against the account without regard to other income, gains or losses
in Our other investment accounts.
The Variable Account assets are divided into Sub-accounts. The Sub-
accounts which are available under the Certificate are shown on the
Certificate Schedule. The assets of the Sub-accounts of the unit
investment trust variable separate account are allocated to the Eligible
Fund(s) and the Portfolio(s), if applicable, within an Eligible Fund shown
on the Certificate Schedule. The assets of the Sub-accounts of the
investment company variable separate account, if applicable, are invested
in portfolios of securities designed to meet the objectives of the Sub-
Account shown on the Certificate Schedule. We may, from time to time, add
additional Sub-accounts, Eligible Funds or Portfolios to those shown on the
Certificate Schedule. A Certificate Owner may be permitted to transfer
Certificate Values or allocate Purchase Payments to the additional Sub-
Accounts, Eligible Funds or Portfolios. However, the right to make such
transfers or allocations will be limited by the terms and conditions
imposed by Us.
We also have the right to eliminate Sub-accounts from the Variable Account,
to combine two or more Sub-accounts or to substitute a new Portfolio for
the Portfolio in which a Sub-account invests. A substitution may become
necessary if, in Our discretion, a Portfolio or Sub-account no longer suits
the purposes of the Group Contract. This may happen: due to a change in
laws or regulations or a change in a Portfolio's investment objectives or
restrictions; because the Portfolio or Sub-account is no longer available
for investment; or for some other reason. We will obtain any prior
approvals that may be required from the insurance department of Our state
of domicile, the New York Superintendent of Insurance and from the SEC or
any other governmental entity before making such a substitution.
When permitted by law, We reserve the right to:
(1) Deregister a Variable Account under the 1940 Act;
(2) Operate a Variable Account as a management company under the 1940
Act, if it is operating as a unit investment trust;
(3) Operate a Variable Account as a unit investment trust under the 1940
Act, if it is operating as a management company;
(4) Restrict or eliminate any voting rights as to the account;
(5) Combine the Variable Account with any other variable account.
Valuation of Assets
The assets of the Variable Account are valued at their fair market value in
accordance with Our procedures.
Accumulation Units
A Certificate Owner's Variable Account value will fluctuate in accordance
with the investment results of the Sub-accounts to which the Certificate
Owner has allocated his or her Purchase Payments or Certificate Value. In
order to determine how these fluctuations affect a Certificate Owner's
Certificate Value, We use an Accumulation Unit value. Accumulation Units
are used to account for all amounts allocated to or withdrawn from the Sub-
accounts of the Variable Account as a result of Purchase Payments, partial
withdrawals, transfers, or charges deducted from the Certificate Value.
We determine the number of Accumulation Units of a Sub-account purchased or
canceled by dividing the amount allocated to, or withdrawn from, the Sub-
account by the dollar value of one Accumulation Unit of the Sub-account as
of the end of the Valuation Period during which We receive the request for
the transaction.
Accumulation Unit Value
The Accumulation Unit Value for each Sub-account was initially set at $10.
Subsequent Accumulation Unit Values for each Sub-account are determined by
multiplying the Accumulation Unit Value for the immediately preceding
Valuation Period by a net investment factor for the Sub-account for the
current period. This factor may be greater or less than 1.0; therefore,
the Accumulation Unit Value may increase or decrease from Valuation Period
to Valuation Period.
We calculate the net investment factor for each Sub-account investing in
shares of mutual funds by dividing (a) by (b) and then subtracting (c)
where:
(a) is equal to:
(i) the net asset value per share of the Portfolio in which the Sub-
account invests at the end of the Valuation Period; plus
(ii) any dividend per share declared for the Portfolio that has an ex-
dividend date within the current Valuation Period.
(b) is the net asset value per share of the Portfolio at the end of the
preceding Valuation Period.
(c) is equal to:
(i) the sum of each Valuation Period equivalent of the annual rate for
the Mortality and Expense Risk Charge, for the Administrative
Charge,
and for the Distribution Charge, if any, which are shown on the
Certificate Schedule; plus
(ii) a charge factor, if any, for any tax provision established by Us a
result of the operation of the Sub-account.
We calculate the net investment factor for each Sub-account investing
directly in securities with the same formula, except:
(a) is equal to:
(i) the value of the assets in the Sub-account at the end of the
preceding Valuation Period; plus
(ii) any investment income and capital gains, realized or
unrealized, credited to the assets during the current
Valuation Period; less
(iii) any capital losses, realized or unrealized, charged against
the assets during the current Valuation Period; less
(iv) all operating and investment expenses relating to the assets
that are incurred during the current Valuation Period.
(b) is the value of the assets in the Sub-account at the end of the
preceding Valuation Period.
Mortality and Expense Risk Charge
Each Valuation Period We deduct a Mortality and Expense Risk Charge from
each Sub-account of the Variable Account which is equal, on an annual
basis, to the amount shown on the Certificate Schedule. The Mortality and
Expense Risk Charge compensates Us for assuming the mortality and expense
risks with respect to the Certificates We issue. We guarantee the dollar
amount of each Annuity Payment after the first Annuity Payment will not be
affected by variations in mortality or expense experience.
Administrative Charge
Each Valuation Period We deduct an Administrative Charge from the Variable
Account which is equal, on an annual basis, to the amount shown on the
Certificate Schedule. The Administrative Charge compensates Us for the
costs associated with administration of the Variable Account and the
Certificates We issue.
Distribution Charge
Each Valuation Period We deduct a Distribution Charge from the Variable
Account which is equal, on an annual basis, to the amount shown on the
Certificate Schedule. The Distribution Charge compensates Us for the costs
associated with the distribution of the Certificates We issue.
Certificate Maintenance Charge
We deduct a Certificate Maintenance Charge from the Certificate Value by
canceling Accumulation Units from each applicable Sub-account to reimburse
Us for expenses relating to the maintenance of the Certificate. We will
deduct the Certificate Maintenance Charge from the Sub-accounts of the
Variable Account in the same proportion that the amount of Certificate
Value in each Sub-account bears to the Certificate Value. The Certificate
Maintenance Charge is shown on the Certificate Schedule. The Certificate
Maintenance Charge will be deducted from the Certificate Value on each
Certificate Anniversary during the Accumulation Period.
If a total surrender is made on a date other than a Certificate
Anniversary, the Certificate Maintenance Charge will be deducted at the
time of surrender.
During the Annuity Period, the Certificate Maintenance Charge will be
deducted on a pro-rata basis from each Annuity Payment.
Transfers
Transfers: Subject to any limitation We impose on the number of
transfers permitted in a Certificate Year, a Certificate Owner may transfer
all or part of Certificate Owner's Certificate Value among the Sub-accounts
and the Fixed Account, if any, by Written Request or by telephone without
the imposition of any fees or charges. Transfers among the Sub-accounts
and the Fixed Account are permitted only during the Accumulation Period.
The number of permitted transfers, and the charge for transfers in excess
of that number, are shown on the Certificate Schedule. All transfers are
subject to the following:
(1) If more than the number of free transfers, shown on the
Certificate Schedule, are made in a Certificate Year, We will deduct a
transfer charge, shown on the Certificate Schedule, for each subsequent
transfer. The transfer fee will be deducted from the Sub-account from
which the transfer is made. However, if Certificate Owner transfers his or
her entire interest in a Sub-account, the transfer fee will be deducted
from the amount transferred. If a Certificate Owner makes a transfer from
more than one Sub-account, any transfer fee will be allocated pro-rata
among such Sub-accounts in proportion to the amount transferred from each.
The deduction of any fees We impose on such transfers will not exceed the
maximum listed on page 3.
(2) During the Annuity Period, transfers of values between Sub-
accounts will be made by converting the number of Annuity Units being
transferred to the number of Annuity Units in the Sub-account to which a
transfer is made, so that the next Annuity Payment, if it were made at that
time, would be the same amount that it would have been without the
transfer. Thereafter, Annuity Payments will reflect changes in the value
of the new Annuity Units.
(3) The minimum amount which can be transferred is shown on the
Certificate Schedule. The minimum amount which must remain in a Sub-
account after a transfer is shown on the Certificate Schedule.
(4) If 100% of the value of any Sub-account is transferred and the
current allocation for Purchase Payments includes that Sub-account, the
allocation for future Purchase Payments will change to reflect a
Certificate Owner's allocation of Certificate Value following the transfer.
(5) We reserve the right, at any time and without prior notice to
any party, to terminate, suspend or modify the transfer privileges
described above.
We will not be liable for transfers made in accordance with a Certificate
Owner's instructions. All amounts and Accumulation Units will be
determined as of the end of the Valuation Period in which We receive the
request for transfer.
Partial Withdrawals and Total Surrender
Partial Withdrawals
During the Accumulation Period while the Certificate is In Force, a
Certificate Owner may, upon Written Request, make a partial withdrawal,
subject to the provisions and limitations shown on the Certificate
Schedule. For purposes of determining whether a Surrender Charge is
applicable to a partial withdrawal:
(1) A partial withdrawal will first be taken from the portion of a
Certificate Owner's Certificate Value which is in excess of
Purchase Payments, and then from Purchase Payments; and
(2) We will allocate partial withdrawals to Purchase Payments in the
order in which the Purchase Payments were made, starting with
the
first.
A withdrawal will result in the cancellation of Accumulation Units from
each applicable Sub-account in the ratio that a Certificate Owner's
interest in the Sub-account bears to his or her Certificate Value in all
the Sub-accounts. A Certificate Owner must specify by Written Request in
advance if he or she wants Accumulation Units to be canceled in a manner
other than the method described above. If there is no value or
insufficient value in the Variable Account, then the amount withdrawn, or
the insufficient portion, will be deducted from the Fixed Account. If a
Certificate Owner has multiple Guarantee Periods, We will deduct such
amount from each Guarantee Period's values in the ratio that each Period's
values bears to the total Fixed Account Value. A Certificate Owner must
specify by Written Request in advance if he or she wants multiple Guarantee
Periods to be reduced in a manner other than the method described above.
Any amount deducted from the fixed account value may be subject to a market
value adjustment, if applicable.
Each partial withdrawal must be for an amount not less than the amount
shown on the Certificate Schedule. The Certificate Value which must remain
in a Certificate is shown on the Certificate Schedule. The Certificate
Schedule also shows any charge.
Total Surrender
During the Accumulation Period while the Certificate is In Force, a
Certificate Owner may, upon Written Request, make a total surrender of the
Certificate Withdrawal Value. The Certificate Withdrawal Value is:
(1) the Certificate Value as of the end of the Valuation Period
during which We receive a Written Request for a withdrawal or
surrender; less
(2) any applicable taxes not previously deducted; less
(3) any Surrender Charge; less
(4) any Certificate Maintenance Charge.
The Fixed Account Value, which is a component of the Certificate Value, may
be subject to a market value adjustment, if applicable.
We will pay the amount of any withdrawal or surrender within seven days
unless the Suspension or Deferral of Payments Provision is in effect.
Death Provisions
Death of Certificate Owner
These provisions apply if, during the Accumulation Period while the
Certificate is In Force, the Certificate Owner or any Joint Certificate
Owner dies (whether or not the decedent is also the Annuitant) or the
Annuitant dies under a Certificate owned by a non-natural Person. The
"designated beneficiary" will control the Certificate after such a death.
This "designated beneficiary" will be the first Person among the following
who is alive on the date of death: Certificate Owner; Joint Certificate
Owner; primary Beneficiary; Contingent Beneficiary; and Certificate Owner's
estate. If the Certificate Owner and Joint Certificate Owner are both
alive, they shall be the "designated beneficiary" together.
If the decedent's surviving spouse (if any) is the sole "designated
beneficiary", the surviving spouse will automatically become the new sole
Certificate Owner as of the date of the death. And, if the Annuitant is
the decedent, the new Annuitant will be any living Contingent Annuitant,
otherwise the surviving spouse. The Certificate may stay in force until
another death occurs (i.e., until the death of the Certificate Owner or
Joint Certificate Owner). Except for this paragraph, all of "Death
Provisions" will apply to that subsequent death.
In all other cases, the Certificate may stay in force up to five years from
the date of death. During this period, the "designated beneficiary" may
exercise all ownership rights, including the right to make transfers or
partial withdrawals or the right to surrender the Certificate for its
Certificate Withdrawal Value. If this Certificate is still in force at the
end of the five-year period, We will automatically end it then by paying to
the "designated beneficiary" the Certificate Withdrawal Value without the
deduction of any applicable Surrender Charges. If the "designated
beneficiary" is not alive then, We will pay any Person(s) named by the
"designated beneficiary" in a Written Request; otherwise the "designated
beneficiary's" estate.
Death of Annuitant
These provisions apply if during the Accumulation Period while the
Certificate is In Force, (a) the Annuitant dies, (b) the Annuitant is not
an Owner, and (c) the Owner is a natural person. The Certificate will
continue In Force after the Annuitant's death. The new Annuitant will be
any living Contingent Annuitant, otherwise the Certificate Owner.
Payment of Benefits
Instead of receiving a lump sum, a Certificate Owner or any "designated
beneficiary" may by Written Request direct that We pay any benefit of
$2,000 or more under an Annuity Option that meets the following: (a) the
first payment to the "designated beneficiary" must be made no later than
one year after the date of death; (b) payments must be made over the life
of the "designated beneficiary" or over a period not extending beyond that
person's life expectancy; and (c) any Annuity Option that provides for
payments to continue after the death of the "designated beneficiary" will
not allow the successor payee to extend the period of time over which the
remaining payments are to be made.
Annuity Provisions
General
If the Certificate is In Force on the Income Date, the Adjusted Certificate
Value will be applied under the Annuity Option selected by a Certificate
Owner. Annuity Payments may be made on a fixed or variable basis or both.
Income Date
The Income Date may be selected by a Certificate Owner. It is shown on the
Certificate Schedule. The Income Date can be any time after the
Certificate Date for variable payments and any time after the first
Certificate Anniversary for fixed payments. The Income Date may not be
later than the earlier of when the Annuitant reaches attained age 90 or
that required under state law. If no Income Date is selected, it will be
the earlier of when the Annuitant reaches attained age 90 or the maximum
date permitted under state law, if any.
Prior to the Income Date, a Certificate Owner may change the Income Date by
Written Request. Any change must be requested at least 30 days prior to
the new Income Date.
Selection of an Annuity Option
An Annuity Option may be selected by a Certificate Owner. If no Annuity
Option is selected, Option B will automatically be applied. Prior to the
Income Date, a Certificate Owner can change the Annuity Option selected by
Written Request. Any change must be requested at least 30 days prior to
the Income Date.
Frequency and Amount of Annuity Payments
Annuity Payments are paid in monthly installments unless quarterly, semi-
annual or annual payments are chosen. The Adjusted Certificate Value is
applied to the Annuity Table for the Annuity Option selected. If the
Adjusted Certificate Value to be applied under an Annuity Option is less
than $2,000, We reserve the right to make a lump sum payment in lieu of
Annuity Payments. If the Annuity Payment would be or becomes less than
$100, We will reduce the frequency of payments to a longer interval which
will result in each payment being at least $100.
Annuity Options
The following Annuity Options or any other Annuity Option acceptable to Us
may be selected:
OPTION A. ANNUITY FOR A FIXED NUMBER OF YEARS: Annuity Payments for a
chosen number of years, not less than 5. If the payee dies during the
payment period and the Beneficiary does not desire payments to continue for
the remainder of the period, he/she may elect to have the present value of
the remaining payments commuted and paid in a lump sum. During the payment
period of a Variable Annuity, the payee may elect by Written Request to
receive the following amount: (a) the present value of the remaining
payments commuted; less (b) any Surrender Charge that may be due by
treating the value defined in (a) as a surrender. Instead of receiving a
lump sum, the payee may elect another Annuity Option. The amount applied
to that Option would not be reduced by the charge defined in (b).
OPTION B. LIFE ANNUITY WITH PERIOD CERTAIN OF 10 YEARS: Annuity
Payments during the lifetime of the payee and in any event for 10 years
certain. If the payee dies during the guaranteed payment period and the
Beneficiary does not desire payments to continue for the remainder of the
guaranteed period, he/she may elect to have the present value of the
guaranteed payments remaining commuted and paid in a lump sum.
OPTION C. JOINT AND SURVIVOR ANNUITY: Annuity Payments payable during
the joint lifetime of the payee and a designated second natural person and
then during the lifetime of the survivor.
Unless the Annuity Option provides for commutation by the payee, a payee
may not withdraw or otherwise end an Annuity Option after it begins.
Payments will end upon the payee's death unless the Annuity Option provides
for payments continuing to a successor payee. No successor payee may
extend the period of time over which the remaining payments are to be made.
Annuity
If a Certificate Owner selects a Fixed Annuity, the Adjusted Certificate
Value is allocated to the General Account and the Annuity is paid as a
Fixed Annuity. If the Certificate Owner selects a Variable Annuity, the
Adjusted Certificate Value will be allocated to the Sub-accounts of the
Separate Account in accordance with the selection he or she makes, and the
Annuity will be paid as a Variable Annuity. A Certificate Owner can also
select a combination of a Fixed and Variable Annuity and the Adjusted
Certificate Value will be allocated accordingly. If a Certificate Owner
does not select between a Fixed Annuity and a Variable Annuity, any
Adjusted Certificate Value in the Variable Account will be applied to a
Variable Annuity and any Adjusted Certificate Value in the Fixed Account
will be applied to a Fixed Annuity.
The Adjusted Certificate Value will be applied to the applicable Annuity
Table contained in the Certificate based upon the Annuity Option a
Certificate Owner selects. If, as of the Income Date, the current Annuity
Option rates applicable to the class of Certificates issued under the Group
Contract provide an initial Annuity Payment greater than the initial
Annuity Payment guaranteed under the applicable Annuity Table in the
Certificate, the greater payment will be made.
Xxxxx Xxxxxxx
The minimum dollar amount of each Fixed Annuity Payment for each $1,000 of
Adjusted Certificate Value is shown in the Annuity Tables. After the
initial Fixed Annuity payment, the payments will not change regardless of
investment, mortality or expense experience.
Variable Annuity
Variable Annuity Payments reflect the investment performance of the
Variable Account in accordance with the allocation of the Adjusted
Certificate Value to the Sub-accounts during the Annuity Period. Variable
Annuity payments are not guaranteed as to dollar amount.
The dollar amount of the first Variable Annuity payment for each $1,000 of
Adjusted Certificate Value is shown in the Annuity Tables. The dollar
amount of Variable Annuity payments for each applicable Sub-account after
the first Variable Annuity Payment is determined as follows:
(1) the dollar amount of the first Variable Annuity payment is
divided
by the value of an Annuity Unit for each applicable Sub-account
as
of the Income Date. This sets the number of Annuity Units for
each monthly payment for the applicable Sub-account. The number
of Annuity Units for each applicable Sub-account remains fixed
during the Annuity Period;
(2) the fixed number of Annuity Units per payment in each Sub-account
is multiplied by the Annuity Unit Value for that Sub-account for
the Valuation Period for which the payment is due. This result
is
the dollar amount of the payment for each applicable Sub-account.
The total dollar amount of each Variable Annuity payment is the sum of all
Sub-account Variable Annuity payments reduced by the applicable portion of
the Certificate Maintenance Charge.
Annuity Unit
The value of any Annuity Unit for each Sub-Account of the Separate Account
was initially set at $10.
The Sub-account Annuity Unit Value at the end of any subsequent Valuation
Period is determined as follows:
(1) the net investment factor calculated as set forth on pages 11-12
(but without the Distribution Charge, if any) for the current
Valuation Period is multiplied by the value of the Annuity Unit
for the Sub-account for the immediately preceding Valuation
Period.
(2) the result in (1) is then divided by the Assumed Investment Rate
Factor which equals 1.00 plus the Valuation Period equivalent of
the Assumed Investment Rate for the number of days in the current
Valuation Period. The Assumed Investment Rate is equal to 6% per
year.
The value of an Annuity Unit may increase or decrease from Valuation Period
to Valuation Period.
Using the Tables
Tables 2, 3, 5, and 6 are age-dependent. The amount of the first annuity
payment will be based on an age a specified number of years younger than
the person's then-attained age (i.e., age last birthday). This age setback
is as follows:
Date of First Payment Age Setback
1996-1999 1 year
2000-2009 2 years
2010-2019 4 years
2020-2029 5 years
2030 or later 6 years
We will calculate the amount for a payment frequency other than monthly and
for any ages not shown in Tables 2, 3, 5, and 6 in accordance with the next
section. Upon request, We will tell a Certificate Owner any such amount.
Basis of Calculation
Tables 1 and 4 are based on interest at 5% and 3%, respectively. Tables 2,
3, 5, and 6 are based on the 1983 Individual Annuity Valuation Tables (sex
distinct), with interest at 5% (Tables 2 and 3) and 3% (Tables 5 and 6),
projected dynamically with Projection Scale G.
TABLE 1: FIRST MONTHLY PAYMENT PAYABLE UNDER VARIABLE OPTION 1 FOR EACH
$1,000 APPLIED
Years Payment Years Payment Years Payment Years
Payment
5 $18.74 12 $9.16 19 $6.71 25 $5.76
6 15.99 13 8.64 20 6.51 26 5.65
7 14.02 14 8.20 21 6.33 27 5.54
8 12.56 15 7.82 22 6.17 28 5.45
9 11.42 16 7.49 23 6.02 29 5.36
10 10.51 17 7.20 24 5.88 30 5.28
11 9.77 18 6.94
TABLE 2: FIRST MONTHLY PAYMENT PAYABLE UNDER VARIABLE OPTION B FOR EACH
$1,000 APPLIED
Age Male Female Age Male Female Age Male Female Age Male Female
30 $4.45 $4.34 47 $5.05 $4.78 64 $6.54 $5.98 80 $9.14 $8.67
31 4.47 4.35 48 5.11 4.82 65 6.68 6.10 81 9.29 8.86
32 4.50 4.37 49 5.17 4.87 66 6.82 6.22 82 9.44 9.05
33 4.52 4.39 50 5.23 4.92 67 6.97 6.35 83 9.57 9.23
34 4.55 4.41 51 5.29 4.97 68 7.12 6.49 84 9.69 9.40
35 4.57 4.43 52 5.36 5.02 69 7.28 6.63 85 9.81 9.55
36 4.60 4.45 53 5.43 5.08 70 7.44 6.79 86 9.91 9.69
37 4.63 4.47 54 5.50 5.13 71 7.61 6.95 87 10.01 9.82
38 4.67 4.49 55 5.58 5.20 72 7.78 7.12 88 10.10 9.94
39 4.70 4.52 56 5.67 5.27 73 7.95 7.30 89 10.17 10.04
40 4.74 4.55 57 5.76 5.34 74 8.12 7.48 90 10.24 10.13
41 4.78 4.57 58 5.85 5.41 75 8.30 7.67 91 10.30 10.21
42 4.82 4.60 59 5.95 5.49 76 8.47 7.87 92 10.35 10.27
43 4.86 4.64 60 6.06 5.58 77 8.65 8.07 93 10.39 10.33
44 4.91 4.67 61 6.17 5.67 78 8.82 8.27 94 10.43 10.37
45 4.95 4.70 62 6.29 5.77 79 8.98 8.47 96 10.45 10.41
46 5.00 4.74 63 6.41 5.87
TABLE 3: FIRST MONTHLY PAYMENT PAYABLE UNDER VARIABLE OPTION 3 FOR EACH
$1,000 APPLIED
COMBINATION OF AGES
FEMALE AGE
30 35 40 45 50 55 60 65 70 75 80 85 90 95
30$4.24$4.28$4.31$4.34$4.36$4.38$4.40$4.42$4.43$4.44$4.45 $4.45 $4.45 $4.46
35 4.26 4.30 4.35 4.39 4.43 4.47 4.50 4.52 4.54 4.56 4.57 4.57 4.58 4.58
40 4.28 4.33 4.39 4.45 4.51 4.56 4.61 4.65 4.68 4.71 4.73 4.74 4.75 4.75
M45 4.29 4.35 4.42 4.50 4.58 4.66 4.74 4.80 4.86 4.90 4.93 4.96 4.97 4.98
A50 4.30 4.37 4.46 4.55 4.66 4.77 4.88 4.98 5.07 5.14 5.20 5.23 5.25 5.27
L55 4.31 4.39 4.48 4.59 4.73 4.87 5.03 5.18 5.32 5.44 5.53 5.59 5.63 5.65
E60 4.32 4.40 4.50 4.63 4.78 4.97 5.18 5.40 5.61 5.80 5.96 6.07 6.13 6.17
65 4.33 4.41 4.52 4.65 4.83 5.05 5.31 5.61 5.92 6.23 6.50 6.70 6.83 6.90
A70 4.33 4.42 4.53 4.68 4.87 5.11 5.42 5.80 6.23 6.70 7.14 7.50 7.75 7.90
G75 4.34 4.42 4.54 4.69 4.89 5.16 5.50 5.95 6.50 7.15 7.83 8.45 8.92 9.23
E80 4.34 4.43 4.54 4.70 4.91 5.19 5.56 6.06 6.71 7.55 8.52 9.50 10.34 10.93
85 4.34 4.43 4.55 4.71 4.92 5.21 5.60 6.13 6.86 7.85 9.10 10.52 11.87 12.93
90 4.34 4.43 4.55 4.71 4.93 5.22 5.62 6.18 6.96 8.06 9.55 11.39 13.34 15.05
95 4.34 4.43 4.55 4.71 4.93 5.23 5.64 6.21 7.02 8.20 9.86 12.09 14.69 17.20
TABLE 4: MINIMUM MONTHLY PAYMENT PAYABLE UNDER FIXED OPTION A FOR EACH
$1,000 APPLIED
Years Payment Years Payment Years Payment Years Payment
5 $17.91 12 $8.24 19 $5.73 25 $4.71
6 15.14 13 7.71 20 5.51 26 4.59
7 13.16 14 7.26 21 5.32 27 4.47
8 11.68 15 6.87 22 5.15 28 4.37
9 10.53 16 6.53 23 4.99 29 4.27
10 9.61 17 6.23 24 4.84 30 4.18
11 8.86 18 5.96
TABLE 5: MINIMUM MONTHLY PAYMENT PAYABLE UNDER FIXED OPTION B FOR EACH
$1,000 APPLIED
Age Male Female Age Male Female Age Male Female Age Male Female
30 $3.12 $2.99 47 $3.82 $3.53 64 $5.40 $4.83 80 $8.15 $7.66
31 3.15 3.01 48 3.88 3.58 65 5.55 4.96 81 8.32 7.86
32 3.18 3.03 49 3.94 3.63 66 5.69 5.08 82 8.47 8.06
33 3.21 3.06 50 4.01 3.68 67 5.85 5.22 83 8.61 8.25
34 3.24 3.08 51 4.08 3.74 68 6.01 5.37 84 8.75 8.43
35 3.27 3.11 52 4.15 3.80 69 6.18 5.52 85 8.87 8.60
36 3.31 3.13 53 4.23 3.86 70 6.35 5.68 86 8.98 8.75
37 3.34 3.16 54 4.31 3.93 71 6.52 5.85 87 9.08 8.88
38 3.38 3.19 55 4.39 4.00 72 6.70 6.03 88 9.18 9.01
39 3.42 3.22 56 4.48 4.07 73 6.89 6.21 89 9.26 9.12
40 3.46 3.25 57 4.58 4.15 74 7.07 6.41 90 9.33 9.21
41 3.51 3.29 58 4.68 4.23 75 7.26 6.61 91 9.40 9.30
42 3.55 3.32 59 4.78 4.32 76 7.44 6.81 92 9.45 9.37
43 3.60 3.36 60 4.89 4.41 77 7.63 7.02 93 9.49 9.43
44 3.65 3.40 61 5.01 4.50 78 7.81 7.23 94 9.53 9.47
45 3.71 3.44 62 5.14 4.61 79 7.98 7.45 95 9.55 9.51
46 3.76 3.49 63 5.27 4.72
TABLE 6: MINIMUM MONTHLY PAYMENT PAYABLE UNDER FIXED OPTION C FOR EACH
$1,000 APPLIED
COMBINATION OF AGES
FEMALE AGE
30 35 40 45 50 55 60 65 70 75 80 85 90 95
30$2.88$2.93$2.97$3.01$3.04$3.07$3.08$3.10$3.11$3.12$3.12 $3.12 $3.13 $3.13
35 2.91 2.97 3.03 3.09 3.14 3.18 3.21 3.23 3.25 3.26 3.27 3.27 3.28 3.28
40 2.93 3.01 3.09 3.17 3.24 3.30 3.35 3.39 3.42 3.44 3.46 3.46 3.47 3.47
45 2.95 3.04 3.14 3.24 3.34 3.43 3.51 3.58 3.63 3.66 3.69 3.71 3.72 3.72
M50 2.96 3.06 3.17 3.30 3.43 3.56 3.68 3.79 3.87 3.94 3.98 4.01 4.03 4.03
A55 2.97 3.07 3.20 3.34 3.50 3.68 3.85 4.02 4.16 4.27 4.34 4.39 4.42 4.44
L60 2.98 3.09 3.22 3.38 3.56 3.78 4.01 4.25 4.47 4.66 4.80 4.89 4.95 4.98
E65 2.98 3.09 3.23 3.40 3.61 3.86 4.15 4.48 4.81 5.12 5.37 5.55 5.66 5.72
70 2.99 3.10 3.24 3.42 3.64 3.92 4.26 4.67 5.13 5.60 6.04 6.38 6.60 6.73
A75 2.99 3.10 3.25 3.43 3.66 3.96 4.34 4.81 5.39 6.06 6.75 7.35 7.79 8.07
G80 2.99 3.11 3.25 3.44 3.68 3.99 4.39 4.92 5.60 6.45 7.44 8.42 9.23 9.79
E85 2.99 3.11 3.26 3.44 3.69 4.00 4.42 4.98 5.73 6.74 8.01 9.44 10.77 11.81
90 2.99 3.11 3.26 3.45 3.69 4.01 4.44 5.02 5.82 6.93 8.43 10.29 12.25 13.95
95 2.99 3.11 3.26 3.45 3.70 4.02 4.45 5.04 5.87 7.05 8.73 10.97 13.58 16.11
Endorsements
To be inserted only by Xx
XXXXXX DESCRIPTION
This is a GROUP VARIABLE ANNUITY CONTRACT with limited purchase payment
flexibility. This Contract is non participating with no dividends.
