1
SECURITY BENEFIT LIFE INSURANCE COMPANY
A MUTUAL COMPANY/FOUNDED IN 1892/TOPEKA, KS
FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT
THE COMPANY'S PROMISE
In consideration for the Purchase Payments and the attached application,
Security Benefit Life Insurance Company (the "Company") will pay the benefits of
this Contract according to its provisions.
LEGAL CONTRACT
PLEASE READ YOUR CONTRACT CAREFULLY. It is a legal Contract between the Owner
and the Company. The Contract's table of contents is on page 2.
FREE LOOK PERIOD-RIGHT TO CANCEL
IF FOR ANY REASON THE OWNER IS NOT SATISFIED WITH THIS CONTRACT, HE OR SHE MAY
RETURN IT TO THE COMPANY WITHIN 10 DAYS FROM THE DATE OF RECEIPT. IT MAY BE
RETURNED BY DELIVERING OR MAILING IT TO THE COMPANY. IF RETURNED, THIS CONTRACT
SHALL BE DEEMED VOID FROM THE CONTRACT DATE. THE COMPANY WILL REFUND ANY
PURCHASE PAYMENTS MADE AND ALLOCATED TO THE FIXED ACCOUNT AND WILL REFUND
SEPARATE ACCOUNT CONTRACT VALUE AS OF THE DATE THE RETURNED POLICY IS RECEIVED
BY THE COMPANY.
Signed for Security Benefit Life Insurance Company on the Contract Date.
XXXXX X. XXXXX XXXXXX X. XXXXXX
Secretary President
A BRIEF DESCRIPTION OF THIS CONTRACT
This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT.
* Purchase Payments may be made until the earlier of the Annuity Start Date or
termination of the Contract.
* A Death Benefit may be paid prior to the Annuity Start Date according to the
Contract provisions.
* Annuity Payments begin on the Annuity Start Date using the method specified in
this Contract.
* This Contract is Participating.
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN
ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. THERE ARE NO
GUARANTEED MINIMUM PAYMENTS OR CASH VALUES. (SEE "CONTRACT VALUE AND EXPENSE
PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.)
[SBL LOGO]
SECURITY BENEFIT LIFE INSURANCE COMPANY
A Member of The Security Benefit Group of Companies
P.O. Box 750497, Topeka, KS 66675-0497
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0001
0-000-000-0000
Form V6022 (10-94)
2
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TABLE OF CONTENTS
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Page
CONTRACT SPECIFICATIONS................................................ 3
DEFINITIONS............................................................ 4-6
GENERAL PROVISIONS..................................................... 7,8
The Contract...................................................... 7
Compliance........................................................ 7
Misstatement of Age and Sex....................................... 7
Evidence of Survival.............................................. 7
Incontestability.................................................. 7
Assignment........................................................ 7
Transfers...................... .................................. 8
Claims of Creditors............................................... 8
Nonforfeiture Values.............................................. 8
Participation..................................................... 8
Statements........................................................ 8
OWNERSHIP, ANNUITANT AND BENEFICIARY PROVISIONS........................ 9
Ownership......................................................... 9
Joint Ownership................................................... 9
Annuitant......................................................... 9
Primary and Secondary Beneficiaries............................... 9
Ownership and Beneficiary Changes................................. 9
PURCHASE PAYMENT PROVISIONS............................................ 10
Flexible Purchase Payments........................................ 10
Purchase Payment Limitations...................................... 10
Purchase Payment Allocation....................................... 10
Place of Payment.................................................. 10
CONTRACT VALUE AND EXPENSE PROVISIONS.................................. 10-12
Contract Value.................................................... 10
Fixed Account Contract Value...................................... 10
Fixed Account Interest Crediting.................................. 11
Separate Account Contract Value................................... 11
Accumulation Unit Value........................................... 11
Determining Accumulation Units.................................... 11
Mortality and Expense Risk Charge................................. 12
Premium Tax Expense............................................... 12
Administrative Charge............................................. 12
Mutual Fund Expenses.............................................. 12
WITHDRAWAL PROVISIONS.................................................. 12,13
Withdrawals....................................................... 12,13
Withdrawal Value.................................................. 13
Systematic Withdrawals............................................ 13
Date of Request................................................... 13
Payment of Withdrawal Benefits.................................... 13
DEATH BENEFIT PROVISIONS............................................... 14,15
Death Benefit..................................................... 14
Proof of Death.................................................... 14
Distribution Rules................................................ 14,15
ANNUITY PAYMENT PROVISIONS
Annuity Start Date................................................ 15
Change of Annuity Start Date...................................... 15
Annuity Start Amount.............................................. 15
Annuity Tables.................................................... 16
Annuity Payments.................................................. 16
Change of Annuity Option.......................................... 16
Fixed Annuity Payments............................................ 16
Variable Annuity Payments......................................... 16
Annuity Units..................................................... 16,17
Net Investment Factor............................................. 17
Alternate Annuity Option Rates.................................... 17
Annuity Options................................................... 18
ANNUITY TABLES......................................................... 19
AMENDMENTS OR ENDORSEMENTS, if any
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VARIFLEX LS VARIABLE ANNUITY CONTRACT SPECIFICATIONS
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OWNER NAME: Xxxx X. Xxx CONTRACT NUMBER: Specimen
OWNER DATE OF BIRTH: 10-30-1953 CONTRACT DATE: 6-30-1993
JOINT OWNER NAME: Xxxx X. Xxx ISSUE DATE: 6-30-1993
JOINT OWNER DATE OF BIRTH: 7-18-1981 ANNUITY START DATE: 7-1-2025*
ANNUITANT NAME: Xxxxx X. Xxx PLAN: Non-Qualified
ANNUITANT DATE OF BIRTH: 5-13-1987 ASSIGNMENT: This policy may be assigned.
See Assignment Provision of your Policy.
ANNUITANT'S SEX: Female
PRIMARY BENEFICIARY NAME:
Xxxxx X. Xxx
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INITIAL PURCHASE PAYMENT............... $25,000
MINIMUM SUBSEQUENT PURCHASE PAYMENTS... $1,000
MINIMUM SYSTEMATIC WITHDRAWAL.......... $100
MORTALITY AND EXPENSE RISK CHARGE...... 1.25% Annually
ADMINISTRATION CHARGE.................. .15% Annually
GUARANTEED FIXED ACCOUNT RATE.......... 3%
ANNUITY OPTION......................... Life with 10-Year Fixed Period Option*
SUBACCOUNTS:
Money Market Subaccount
High Grade Income Subaccount
High Yield Subaccount
Global Aggressive Subaccount
Growth-Income Subaccount
Equity Income Subaccount
Managed Asset Allocation Subaccount
Specialized Asset Allocation Subaccount
Growth Subaccount
Value Subaccount
Worldwide Equity Subaccount
Social Awareness Subaccount
Emerging Growth Subaccount
Small Cap Subaccount
METHOD FOR DEDUCTIONS:
Deductions for Premium Taxes, and any unallocated partial withdrawals,
including Systematic Withdrawals, will be made sequentially from the Contract
Value in descending order of the Subaccounts listed above. The value of each
account will be depleted before the next is charged. The Fixed Account is the
last Account charged.
* The Owner may select the Annuity Start Date and the Annuity Option. If no
Annuity Start Date or Annuity Option is selected by the Owner, they will be
assigned automatically.
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V6022 A (R5-97)
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DEFINITIONS
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ACCOUNT
An Account is one of the Subaccounts or the Fixed Account.
ACCUMULATION UNIT
The Accumulation Unit is a unit of measure. It is used to compute the
Separate Account Contract Value prior to the Annuity Start Date. It is also
used to compute the Variable Annuity Payments for Annuity Options 5 and 6.
ANNUITANT
The Annuitant is the person named by the Owner on whose life the Annuity
Payments depend for Annuity Options 1 through 4. The Annuitant receives
Annuity Payments under this Contract. Please see "Annuitant" provisions on
page 9.
ANNUITY OPTION
An Annuity Option is a set of provisions that form the basis for making
Annuity Payments. The Annuity Option is set prior to the Annuity Start
Date. Please see "Annuity Options" on page 18.
ANNUITY START DATE
The Annuity Start Date is the date on which Annuity Payments are scheduled
to begin. This date may be changed by the Owner. The Annuity Start Date is
shown on Page 3. Please see "Annuity Start Date" on page 15.
ANNUITY UNIT
The Annuity Unit is a unit of measure used to compute Variable Annuity
Payments for Annuity Options 1 through 4.
AUTOMATIC TRANSFERS
Automatic Transfers are Transfers among the Subaccounts and the Fixed
Account. Such transfers are made automatically on a periodic basis by the
Company at the written request of the Owner. The Company reserves the right
to discontinue, modify or suspend Automatic Transfers.
COMPANY
The Company is Security Benefit Life Insurance Company, P.O. Box 750497,
Topeka, Kansas 66675-0497.
CONTRACT ANNIVERSARY
A Contract Anniversary is a 12-month anniversary of the Contract Date.
CONTRACT DATE
The Contract Date is the date the Contract begins. The Contract Date is
shown on page 3.
CONTRACT YEAR
Contract Years are measured from the Contract Date.
CURRENT INTEREST
The Company may in its discretion pay Current Interest on the Fixed Account
at a rate that exceeds the Guaranteed Rate shown on page 3. The Company
will declare the rate of Current interest, if any, from time to time.
DESIGNATED BENEFICIARY
Upon the death of the Owner or Joint Owner, the Designated Beneficiary will
be the first person on the following list who is alive on the date of
death:
1. Owner;
2. Joint Owner;
3. Primary Beneficiary;
4. Secondary Beneficiary;
5. Annuitant; and
6. the Owner's estate if no one listed above is alive.
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V6022 B (10-94)
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DEFINITIONS (Continued)
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DESIGNATED BENEFICIARY (Continued)
The Designated Beneficiary receives a death benefit upon the death of the
Owner prior to the Annuity Start Date. Please see "Ownership, Annuitant,
and Beneficiary Provisions" on page 9 and "Death Benefit Provisions" on
pages 14 and 15.
FIXED ACCOUNT
The Fixed Account is part of the Company's general account. The Company
manages the general account and guarantees that it will credit interest on
Fixed Account Contract Value at an annual rate at least equal to the
Guaranteed Rate. This Rate is shown on page 3.
GUARANTEE PERIOD
Current interest, if declared, is fixed for rolling periods of one or more
years, referred to as Guarantee Periods. The Company may offer Guarantee
Periods of different durations. The Guarantee Period that applies to any
Fixed Account Contract Value: (1) starts on the date that such Contract
Value is allocated to the Fixed Account pursuant to: (a) a Purchase Payment
Received by the Company; or (b) a Transfer to the Fixed Account; and (2)
ends on the last day of the same month in the year in which the Guarantee
Period expires. When any Guarantee Period expires, a new Guarantee Period
shall start for such Contract Value on the date that follows such
expiration date. Such period shall end on the immediately preceding date in
the year in which the Guarantee Period expires. For example, assuming a
one-year Guarantee Period, Contract Value transferred to the Fixed Account
on June 1 would have a Guarantee Period starting on that date and ending on
June 30 of the following year. A new Guarantee Period for such Contract
Value would start on July 1 of that year and end on June 30 of the
following year.
HOME OFFICE
The address of the Company's Home Office is Security Benefit Life Insurance
Company, P.O. Box 750497, Topeka, Kansas 66675-0497.
ISSUE DATE
The Issue Date is the date the Company uses to determine the date the
Contract becomes incontestable. The Issue Date is shown on Page 3. Please
see "Incontestability" on page 7.
JOINT OWNER
The Joint Owner, if any, shares an undivided interest in the entire
Contract with the Owner. The Joint Owner, if any, is named on page 3.
Please see "Joint Ownership" provisions on page 9.
NONNATURAL PERSON
Any group or entity that is not a living person, such as a trust or
corporation.
OWNER
The Owner is the person who possesses all rights under the Contract. The
Owner is named on page 3. Please see "Ownership" provisions on page 9.
PREMIUM TAX
Any Premium Taxes levied by a state or other governmental entity will be
charged against this Contract. When Premium Tax is assessed after the
Purchase Payment is applied, it will be deducted as described on page 3.
PURCHASE PAYMENT
A Purchase Payment is money Received by the Company and applied to the
Contract.
RECEIVED BY THE COMPANY
The phrase "Received by the Company" means receipt by the Company in good
order at its Home Office, P.O. Box 750497, Topeka, Kansas 66675-0497.
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DEFINITIONS (Continued)
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SEPARATE ACCOUNT
Variable Annuity Account VIII (the "Separate Account") is a separate
account established and maintained by the Company under Kansas law. The
Separate Account is registered with the Securities and Exchange Commission
under the Investment Company Act of 1940 as a Unit Investment Trust. It was
established by the Company to support variable annuity contracts. The
Company owns the assets of the Separate Account and maintains them apart
from the assets of its general account and its other separate accounts. The
assets held in the Separate Account equal to the reserves and other
Contract liabilities with respect to the Separate Account may not be
charged with liabilities arising from any other business the Company may
conduct.
Income and realized and unrealized gains and losses from assets in the
Separate Account are credited to, or charged against, the Separate Account
without regard to the income, gains or losses from the Company's general
account or its other separate accounts. The Separate Account is divided
into Subaccounts shown on page 3. Income and realized and unrealized gains
and losses from assets in each Subaccount are credited to, or charged
against, the Subaccount without regard to income, gains or losses in the
other Subaccounts. The Company has the right to transfer to its general
account any assets of the Separate Account that are in excess of the
reserves and other Contract liabilities with respect to the Separate
Account. The value of the assets in the Separate Account on each Valuation
Date are determined at the end of each Valuation Date.
SUBACCOUNT NET ASSET VALUE
The Subaccount Net Asset Value is equal to: (1) the net asset value of all
shares of the underlying mutual fund held by the Subaccount; plus (2) any
cash or other assets; less (3) all liabilities of the Subaccount.
SUBACCOUNTS
The Separate Account is divided into Subaccounts which invest in shares of
mutual funds. Each Subaccount may invest its assets in a separate class or
series of a designated mutual fund or funds. The Subaccounts are shown on
page 3. Subject to the regulatory requirements then in force, the Company
reserves the right to:
1. change or add designated mutual funds or other investment vehicles;
2. add, remove or combine Subaccounts;
3. add, delete or make substitutions for securities that are held or
purchased by the Separate Account or any Subaccount;
4. operate the Separate Account as a management investment company;
5. combine the assets of the Separate Account with other Separate
Accounts of the Company or an affiliate thereof;
6. restrict or eliminate any voting rights of the Owner with respect to
the Separate Account or other persons who have voting rights as to the
Separate Account; and
7. terminate and liquidate any Subaccount.
If any of these changes result in a material change to the Separate Account
or a Subaccount, the Company will notify the Owner of the change. The
Company will not change the investment policy of any Subaccount in any
material respect without complying with the filing and other procedures of
the insurance regulators of the state of issue.
VALUATION DATE
A Valuation Date is each day the New York Stock Exchange and the Company's
Home Office are open for business.
VALUATION PERIOD
A Valuation Period is the interval of time from one Valuation Date to the
next Valuation Date.
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V6022 C (10-94)
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GENERAL PROVISIONS
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THE CONTRACT
The entire Contract between the Owner and the Company consists of this
Contract, the attached Application, and any Amendments, Endorsements or
Riders to the Contract. All statements made in the Application will, in the
absence of fraud, as ruled by the a court of competent jurisdiction, be
deemed representations and not warranties. The Company will use no
statement made by or on behalf of the Owner or the Annuitant to void this
Contract unless it is in the written Application. Any change in the
Contract can be made only with the written consent of the President, a Vice
President, or the Secretary of the Company.
The Purchase Payment(s) and the Application must be acceptable to the
Company under its rules and practices. If they are not, the Company's
liability shall be limited to a return of the Purchase Payment(s).
COMPLIANCE
The Company reserves the right to make any change to the provisions of this
Contract to comply with or give the Owner the benefit of any federal or
state statute, rule or regulation. This includes, but is not limited to,
requirements for annuity contracts under the Internal Revenue Code or the
laws of any state. The Company will provide the Owner with a copy of any
such change and will also file such a change with the insurance regulatory
officials of the state in which the Contract is delivered.
MISSTATEMENT OF AGE AND SEX
If the age or sex of the Annuitant has been misstated, payments shall be
adjusted, when allowed by law, to the amount which would have been provided
for the correct age or sex. Proof of the age of an Annuitant may be
required at any time, in a form suitable to the Company. If payments have
already commenced and the misstatement has caused an underpayment, the full
amount due will be paid with the next scheduled payment. If the
misstatement has caused an overpayment, the amount due will be deducted
from one or more future payments.
EVIDENCE OF SURVIVAL
When any payments under this Contract depend on the payee being alive on a
given date, proof that the payee is living may be required by the Company.
Such proof must be in a form accepted by the Company, and may be required
prior to making the payments.
INCONTESTABILITY
This Contract will not be contested after it has been in force for two
years from the Issue Date during the life of the Owner.
ASSIGNMENT
Please refer to page 3 to see if the Contract may be assigned. If it may be
assigned, no Assignment under this Contract is binding unless Received by
the Company in writing. The Company assumes no responsibility for the
validity, legality, or tax status of any Assignment. The Assignment will be
subject to any payment made or other action taken by the Company before the
Assignment is Received by the Company. Once filed, the rights of the Owner,
Annuitant and Beneficiary are subject to the Assignment. Any claim is
subject to proof of interest of the assignee.
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GENERAL PROVISIONS (Continued)
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TRANSFERS
The Owner may Transfer Contract Value among the Fixed Account and
Subaccounts subject to the following.
Transfers are not allowed within 30 days of the Annuity Start Date. After
the Annuity Start Date, for Annuity Options 1 through 4, the Owner may
Transfer Contract Value only among Subaccounts.
The Company reserves the right to: (1) limit the amount that may be subject
to Transfer to $1,000,000 per Transfer without Home Office approval; (2)
limit the number of Transfers allowed each Contract Year to 14; and (3)
suspend Transfers. Transfers must be at least $1,000.00 or, if less; (i)
the remaining balance in a Subaccount, or (ii) the amount of Fixed Account
Contract Value the Guarantee Period of which expires in the calendar month
in which the Transfer is effected.
Contract Value may be transferred from the Fixed Account only: (1) during
the calendar month in which the applicable Guarantee Period expires; (2)
pursuant to an Automatic Transfer. Transfers of Fixed Account Contract
Value shall be made: (1) first from Fixed Account Contract Value for which
the Guarantee Period expires during the calendar month in which the
Transfer is effected; (2) then in the order that starts with Fixed Account
Contract Value which has the longest amount of time before its Guarantee
Period expires; and (3) ends with that which has the least amount of time
before its Guarantee Period expires.
The Company will effect a Transfer to or from a Subaccount on the basis of
Accumulation Unit Value (or Annuity Unit Value) determined at the end of
the Valuation Period in which the Transfer is effected. The Company will
effect a Transfer from the Fixed Account on the basis of Fixed Account
Contract Value at the end of the Valuation Period in which the Transfer is
effected.
The Company reserves the right to delay Transfers from the Fixed Account
for up to 6 months as required by most states. The Company will notify you
if there will be a delay.
CLAIMS OF CREDITORS
The Contract Value and other benefits under this Contract are exempt from
the claims of creditors of the Owner to the extent allowed by law.
NONFORFEITURE VALUES
The Death Benefits, Withdrawal Values and Annuity Payout Values will at
least equal the minimum required by law.
PARTICIPATION
The Company is a mutual life insurance company. Therefore, it pays
dividends on some of its contracts. However, the Company does not expect
dividends to become payable on this Contract. At the end of each Contract
Year the Company will determine the Contract's dividend, if any. The Owner
may choose to have it: (1) added to the Contract Value; or (2) paid in
cash. If no choice is made, any dividend will be added to the Contract
Value.
STATEMENTS
At least once each Contract Year the Owner shall be sent a statement
including the current Contract Value and any other information required by
law. The Owner may send a written request for a statement at other
intervals. The Company may charge a reasonable fee for such statements.
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V6022 D (R6-96)
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OWNERSHIP, ANNUITANT AND BENEFICIARY PROVISIONS
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OWNERSHIP
During the Owner's lifetime, all rights and privileges under the Contract
may be exercised only by the Owner. If the purchaser names someone other
than himself or herself as Owner, the purchaser has no rights in the
Contract. No Owner may be older than age 90 on the Contract Date.
JOINT OWNERSHIP
If a Joint Owner is named in the application, then the Owner and Joint
Owner share an undivided interest in the entire Contract as joint tenants
with rights of survivorship. When an Owner and Joint Owner have been named,
the Company will honor only requests for changes and the exercise of other
Ownership rights made by both the Owner and Joint Owner. When a Joint Owner
is named, all references to "Owner" throughout this Contract should be
construed to mean both the Owner and Joint Owner, except for the
"Statements" provision on page 8 and the "Death Benefit Provisions" on
pages 14 and 15.
ANNUITANT
The Annuitant is named on page 3. The Owner may change the Annuitant prior
to the Annuity Start Date. The request for this change must be made in
writing and Received by the Company at least 30 days prior to the Annuity
Start Date. No annuitant may be named who is more than 90 years old on the
Contract Date. When the Annuitant dies prior to the Annuity Start Date, the
Owner must name a new Annuitant within 30 days or, if sooner, by the
Annuity Start Date, except where the Owner is a Nonnatural Person. If a new
Annuitant is not named, the Owner becomes the Annuitant.
PRIMARY AND SECONDARY BENEFICIARIES
The Primary Beneficiary is named on page 3. The Owner may change any
Beneficiary as described in "Ownership and Beneficiary Changes" below. If
the Primary Beneficiary dies prior to the Owner, the Secondary Beneficiary
becomes the Primary Beneficiary. Unless the Owner directs otherwise, when
there are two or more Primary Beneficiaries, they will receive equal
shares.
OWNERSHIP AND BENEFICIARY CHANGES
Subject to the terms of any existing Assignment, the Owner may name a new
Owner, a new Primary Beneficiary or a new Secondary Beneficiary. Any new
choice of Owner, Primary Beneficiary or Secondary Beneficiary will revoke
any prior choice. Any change must be made in writing and recorded at the
Home Office. The change will become effective as of the date the written
request is signed, whether or not the Owner is living at the time the
change is recorded. A new choice of Primary Beneficiary or Secondary
Beneficiary will not apply to any payment made or action taken by the
Company prior to the time it was recorded. The Company may require the
Contract be returned so these changes may be made.
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PURCHASE PAYMENT PROVISIONS
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FLEXIBLE PURCHASE PAYMENTS
The Contract becomes in force when the initial Purchase Payment is applied.
The Owner is not required to continue Purchase Payments in the amount or
frequency originally planned. The Owner may: (1) increase or decrease the
amount of Purchase Payments, subject to any Contract limits; or (2) change
the frequency of Purchase Payments. A change in frequency or amount of
Purchase Payments does not require a written request.
PURCHASE PAYMENT LIMITATIONS
Purchase Payments exceeding $1,000,000 will not be accepted without prior
approval by the Company. The Minimum Subsequent Purchase Payment amount is
shown on page 3.
PURCHASE PAYMENT ALLOCATION
Purchase Payments may be allocated among the Fixed Account and the
Subaccounts. Purchase Payments will be allocated according to the Owner's
instructions in the Application or more recent instructions, if any. Each
allocation to the Fixed Account and the Subaccounts must be at least 1% of
the Purchase Payment. The allocations must be whole percentage amounts and
must total 100%. The Owner may change the allocations by written notice to
the Company.
PLACE OF PAYMENT
All Purchase Payments under this Contract are to be paid to the Company at
its Home Office. Purchase Payments after the initial Purchase Payment are
applied as of the end of the Valuation Period during which they are
Received by the Company.
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CONTRACT VALUE AND EXPENSE PROVISIONS
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CONTRACT VALUE
On any Valuation Date, the Contract Value is the sum of: (1) the Separate
Account Contract Value; and (2) the Fixed Account Contract Value. At any
time after the first Contract Year and before the Annuity Start Date, the
Company reserves the right to pay to the Owner the Contract Value as a lump
sum if it is below $5,000.
FIXED ACCOUNT CONTRACT VALUE
On any Valuation Date, the Fixed Account Contract Value is equal to the
first Purchase Payment allocated under the Contract to the Fixed Account:
PLUS:
1. any other Purchase Payments allocated under the Contract to the Fixed
Account;
2. any Transfers from the Separate Account to the Fixed Account; and
3. any interest credited to the Fixed Account.
LESS:
1. any Withdrawals deducted from the Fixed Account;
2. any Transfers from the Fixed Account to the Separate Account;
3. any applicable Premium Taxes;
4. any Fixed Account Contract Value which is applied to any of Annuity
Options 1 through 4; and
5. any Annuity Payments made under Annuity Options 5 and 6.
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V6022 E (10-94)
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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FIXED ACCOUNT INTEREST CREDITING
The Company shall credit interest on Fixed Account Contract Value at an
annual rate at least equal to the Guaranteed Rate shown on page 3. Also,
the Company may in its sole judgment credit Current Interest at a rate in
excess of the Guaranteed Rate. The rate of Current Interest, if declared,
shall be fixed during the Guarantee Period. Fixed Account Contract Value
shall earn Current Interest during each Guarantee Period at the rate, if
any, declared by the Company on the first day of the Guarantee Period.
The Company may credit Current Interest on Contract Value that was
allocated or transferred to the Fixed Account during one period at a
different rate than amounts allocated or transferred to the fixed Account
in another period. Also, the Company may credit Current Interest on Fixed
Account Contract Value at different rates based upon the length of the
Guarantee Period. Therefore, at any time, portions of Fixed Account
Contract Value may be earning Current Interest at different rates based
upon the period during which such portions were allocated or transferred to
the Fixed Account and the length of the Guarantee Period.
SEPARATE ACCOUNT CONTRACT VALUE
On any Valuation Date, the Separate Account Contract Value is the sum of
the then current value of the Accumulation Units allocated to each
Subaccount for this Contract.
ACCUMULATION UNIT VALUE
The initial Accumulation Unit Value for each Subaccount was set at $10.
Other Accumulation Unit Values are found on each Valuation Date by dividing
(1) by (2) where:
1. is the equal to:
a. the Subaccount Net Asset Value determined at the end of the
current Valuation Period; plus
b. any dividends declared by the Subaccount's underlying mutual fund
that are not part of the Subaccount Net Asset Value; less the
accrued Mortality and Expense Risk Charge; and
c. the accrued Mortality and Expense Risk Charge; and
d. the accrued Administration Charge; and
e. any taxes for which the Company has reserved which the Company
deems to have resulted from the operation of the Subaccount.
2. is the number of Accumulation Units at the start of the Valuation
Period.
The Accumulation Unit Value may increase or decrease from one Valuation
Period to the next.
DETERMINING ACCUMULATION UNITS
The number of Accumulation Units allocated to a Subaccount under this
Contract is found by dividing: (1) the amount allocated to the Subaccount;
by (2) the Accumulation Unit Value for the Subaccount at the end of the
Valuation Period during which the amount is applied under the Contract. The
number of Accumulation Units allocated to a Subaccount under the Contract
will not change as a result of investment experience. Events that change
the number of Accumulation Units are:
1. Purchase Payments that are applied to the Subaccount;
2. Contract Value that is Transferred into or out of the Subaccount;
3. Withdrawals that are deducted from the Subaccount; and
4. Premium Taxes that are deducted from the Subaccount.
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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MORTALITY AND EXPENSE RISK CHARGE
The Company will deduct the Mortality and Expense Risk Charge shown on page
3. This charge will be computed and deducted from each Subaccount on each
Valuation Date. This charge is factored into the Accumulation Unit and
Annuity Unit Values on each Valuation Date.
PREMIUM TAX EXPENSE
The Company reserves the right to deduct Premium Tax when due or any time
thereafter. Any applicable Premium Taxes will be allocated as described on
page 3.
ADMINISTRATION CHARGE
The Company will deduct the Administration Charge shown on page 3. This
charge will be computed and deducted from each Subaccount on each Valuation
Date. This charge is factored into the Accumulation Unit Value on each
Valuation Date.
MUTUAL FUND EXPENSES
Each Subaccount invests in shares of a mutual fund. The net asset value per
share of each underlying fund reflects the deduction of any investment
advisory and administration fees and other expenses of the fund. These fees
and expenses are not deducted from the assets of a Subaccount, but are paid
by the underlying funds. The Owner indirectly bears a pro rata share of
such fees and expenses. An underlying fund's fees and expenses are not
specified or fixed under the terms of this Contract.
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WITHDRAWAL PROVISIONS
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WITHDRAWALS
A full Withdrawal of the Contract Value or partial Withdrawal of Separate
Account Contract Value is allowed at any time. Partial Withdrawals of Fixed
Account Contract Value are, however, restricted as described below. This
provision is subject to any federal or state Withdrawal restrictions.
A partial Withdrawal of Fixed Account Contract Value may be made only: (1)
pursuant to Systematic Withdrawals over a period of at least 36 months; (2)
during the calendar month in which the applicable Guarantee Period expires;
and (3) once per Contract Year in an amount up to the greater of $5,000 or
10% of the Contract Value in the Fixed Account at the time of the partial
Withdrawal.
Upon the Owner's request for a full Withdrawal, the Company will pay the
Withdrawal Value in a lump sum.
All Withdrawals must meet the following conditions.
1. The request for Withdrawal must be Received by the Company in writing
or under other methods allowed by the Company.
2. The Owner must apply: (a) while this Contract is in force; and (b)
prior to the Annuity Start Date of Options 1-4.
3. The amount Withdrawn must be at least $1,000.00, except that a
Withdrawal of less than $1,000.00 is allowed: (i) for Systematic
Withdrawals, as discussed on page 13, (ii) for Fixed Account Contract
Value the Guarantee Period of which expires during the calendar month
of the Withdrawal, or (iii) when terminating the Contract.
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V6022 F (10-94)
13
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WITHDRAWAL PROVISIONS (Continued)
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WITHDRAWALS (Continued)
A partial Withdrawal request must state the allocations for deducting the
Withdrawal from each Account. If no allocation is specified, the partial
Withdrawal will be deducted from the Accounts in the order described on
page 3, "Method for Deductions." Withdrawals of Fixed Account Contract
Value shall be made: (1) first from Fixed Account Contract Value for which
the Guarantee Period expires during the calendar month in which the
Withdrawal is effected; (2) then in the order that starts with Fixed
Account Contract Value which has the longest amount of time before its
Guarantee Period expires; and (3) ends with that which has the least amount
of time before its Guarantee Period expires.
WITHDRAWAL VALUE
The Withdrawal Value at any time will be: (1) the Contract Value; less (2)
any Premium Taxes due or paid by the Company.
SYSTEMATIC WITHDRAWALS
Systematic Withdrawals are automatic periodic distributions from the
Contract in substantially equal amounts prior to the Annuity Start Date. In
order to start Systematic Withdrawals, the Owner must make the request in
writing. The Minimum Systematic Withdrawal is shown on page 3. The Owner
must choose the type of payment and its frequency. The Systematic
Withdrawal request must state the allocations for deducting the Withdrawals
from each Account. If no allocation is specified, the Withdrawals will be
deducted from the Accounts in the order described on page 3, "Method for
Deductions." The payment type may be: (1) a percentage of Contract Value;
(2) a specified dollar amount; (3) all earnings in the Contract; (4) over a
fixed period of time; or (5) based upon the life expectancy of the Owner or
the Owner and a Beneficiary. The payment frequency may be: (1) monthly; (2)
quarterly; (3) semiannually; or (4) annually. Systematic Withdrawals of
Fixed Account Contract Value must provide for payments over a period of not
less than 36 months. Systematic Withdrawals may be stopped by the Owner
upon proper written request Received by the Company at least 30 days in
advance. The Company reserves the right to stop, modify, suspend or charge
a fee for Systematic Withdrawals at any time.
DATE OF REQUEST
The Company will effect a Withdrawal of Separate Account Contract Value on
the basis of Accumulation Unit Value determined at the end of the Valuation
Period in which all the required information is Received by the Company.
PAYMENT OF WITHDRAWAL BENEFITS
The Company reserves the right to suspend a Transfer or delay payment of a
Withdrawal from the Separate Account for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists as a result of which: (a) disposal of
securities held in the Separate Account is not reasonably practicable;
or (b) it is not reasonably practicable to fairly value the net assets
of the Separate Account; or
4. during any other period when the Securities and Exchange Commission,
by order, so permits to protect owners of securities.
Rules and regulations of the Securities and Exchange Commission will govern
as to whether the conditions set forth above exist.
The Company further reserves the right to delay payment of a Withdrawal
from the Fixed Account for up to six months as required by most states. The
Company will notify you if there will be a delay.
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14
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DEATH BENEFIT PROVISIONS
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DEATH BENEFIT
If any Owner dies prior to the Annuity Start Date, a Death Benefit will be
paid to the Designated Beneficiary when due Proof of Death and instructions
regarding payment are Received by the Company. If an Owner is a Nonnatural
Person, then the Death Benefit will be paid in the event of the death of
the Annuitant or any joint Owner that is a natural person prior to the
Annuity Start Date. Further, if an Owner is a Nonnatural Person, the amount
of the death benefit is based on the age of the Annuitant or any joint
Owner that is a natural person on the Issue Date.
If the age of each Owner was 75 or younger on the Issue Date, the Death
Benefit will be the greatest of: (1) the sum of all Purchase Payments, less
any Premium Taxes due or paid by the Company and less the sum of all
partial Withdrawals; (2) the Contract Value on the date due Proof of Death
and instructions regarding payment are Received by the Company, less any
Premium Taxes due or paid by the Company; or (3) the Stepped-Up Death
Benefit described below.
The Stepped-Up Death Benefit is:
1. the largest Death Benefit on any Contract Anniversary that is both an
exact multiple of five and occurs prior to the oldest Owner reaching
age 76; plus
2. any Purchase Payments received since the applicable fifth Contract
Anniversary; less
3. any reductions caused by Withdrawals since the applicable fifth
Contract Anniversary; less
4. any Premium Taxes due or paid by the Company.
If the age of any Owner on the Issue Date was 76 or older, or if due proof
of death (regardless of the age of any Owner on the Issue Date) and
instructions regarding payment are not Received by the Company within six
months of the date of the Owner's death, the Death Benefit will be: (1) the
Contract Value on the date due Proof of Death and instructions regarding
payment are Received by the Company; less (2) any Premium Taxes due or paid
by the Company.
If a lump sum payment is requested, the payment will be made in accordance
with any laws and regulations that govern the payment of Death Benefits.
PROOF OF DEATH
Any of the following will serve as Proof of Death:
1. certified copy of the death certificate;
2. certified decree of a court of competent jurisdiction as to the
finding of death;
3. written statement by a medical doctor who attended the deceased Owner;
or
4. any proof accepted by the Company.
DISTRIBUTION RULES
The entire Death Benefit with any interest shall be paid within 5 years
after the death of any Owner, except as provided below. In the event that
the Designated Beneficiary elects an Annuity Option, the length of time for
the payment period may be longer than 5 years if: (1) the Designated
Beneficiary is a natural person; (2) the Death Benefit is paid out under
Annuity Options 1 through 6; (3) payments are made over a period that does
not exceed the life or life expectancy of the Designated Beneficiary; and
(4) Annuity Payments begin within one year of the death of the Owner. If
the deceased Owner's spouse is the sole Designated Beneficiary, the spouse
shall become the sole Owner of the Contract. He or she may elect to: (1)
keep the Contract in force until the sooner of the spouse's death or the
Annuity Start Date; or (2) receive the Death Benefit.
-14-
V6022 G (R6-96)
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DEATH BENEFIT PROVISIONS (Continued)
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DISTRIBUTION RULES (Continued)
If any Owner dies after the Annuity Start Date, Annuity Payments shall
continue to be paid at least as rapidly as under the method of payment
being used as of the date of the Owner's death.
If the Owner is a Nonnatural Person, the distribution rules set forth above
apply in the event of the death of, or a change in, the Annuitant. This
Contract is deemed to incorporate any provision of Section 72(s) of the
Internal Revenue Code of 1986, as amended (the "Code"), or any successor
provision. This Contract is also deemed to incorporate any other provision
of the Code deemed necessary by the Company, in its sole judgment, to
qualify this Contract as an annuity. The application of the distribution
rules will be made in accordance with Code section 72(s), or any successor
provision, as interpreted by the Company in its sole judgment.
The foregoing distribution rules do not apply to a Contract which is: (1)
provided under a plan described in Code Section 401(a); (2) described in
Code section 403(b); (3) an individual retirement annuity or provided under
an individual retirement account or annuity; or (4) otherwise exempt from
the Code section 72(s) distribution rules.
--------------------------------------------------------------------------------
ANNUITY PAYMENT PROVISIONS
--------------------------------------------------------------------------------
ANNUITY START DATE
The Owner may choose the Annuity Start Date at the time of application. If
no Annuity Start Date is chosen, the Company will use the later of: (1) the
oldest Annuitant's seventieth birthday; or (2) the tenth Contract
Anniversary. The Annuity Start Date must be prior to the oldest Annuitant's
ninety-fifth birthday.
The Annuity Start Date is the date the first payment will be made to the
Annuitant under any of the Annuity Options.
CHANGE OF ANNUITY START DATE
The Owner may change the Annuity Start Date. A request for the change must
be made in writing. The written request must be Received by the Company at
least 30 days prior to the new Annuity Start Date as well as 30 days prior
to the previous Annuity Start Date.
ANNUITY START AMOUNT
The Annuity Start Amount is applied to one or more of the Annuity Options
listed on page 18. The Annuity Start Amount is: (1) the Contract Value on
the Annuity Start Date; less (2) any Premium Taxes due or paid by the
Company. Unless otherwise directed by the Owner, Annuity Start Amount
derived from Fixed Account Contract Value will be applied to purchase a
Fixed Annuity Option; that derived from Separate Account Contract Value
will be applied to purchase a Variable Annuity Option.
-15-
16
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ANNUITY PAYMENT PROVISIONS (Continued)
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ANNUITY TABLES
Annuity Tables A and B show the guaranteed minimum amount of monthly
Annuity Payment per $1,000 of Annuity Start Amount for annuity options 1
through 4 that applies to the first Variable Annuity Payment and to each
payment for Fixed Annuity Payments. The amount of each Annuity Payment for
Annuity Options 1 through 4 will depend on the Annuitant's sex and age on
the Annuity Start Date.
Tables A and B assume 1900 as the year of birth of the annuitant. To use
Table A and B for an Annuitant born after 1900, the actual age is reduced
by 0.1 (one-tenth) of a year for each year the year of birth exceeds 1900.
For an annuitant with a birth year prior to 1900, the actual age is
increased in a like manner. The actual age (in completed months) reduced or
increased becomes the "adjusted age of the Annuitant". The guaranteed
payout rate is then found by interpolating the Annuitant's adjusted age
between the ages shown in Tables A and B. Tables A and B are based on the
1983 Table "A" mortality table and an interest rate of 3.5% per year. On
request the Company will furnish the amount of monthly Annuity Payment per
$1,000 applied for any ages not shown.
For Annuity Options 5 and 6, annuity rates based on age and sex are not
used to calculate annuity payments. Annuity Payments for these options are
computed without reference to the Annuity Tables.
ANNUITY PAYMENTS
The Annuity Option is shown on page 3. The Owner may choose any form of
Annuity Option that is allowed by the Company. The Owner may choose an
Annuity Option by written request. This request must be Received by the
Company at least 30 days prior to the Annuity Start Date. Several Annuity
Options are listed on page 18. No Annuity Option can be selected that
requires the Company to make periodic payments of less than $100.00. If no
Annuity Option is chosen prior to the Annuity Start Date, the Company will
use Life with 10-Year Fixed Period Option. Each Annuity Option allows for
making Annuity Payments annually, semiannually, quarterly or monthly.
CHANGE OF ANNUITY OPTION
Prior to the Annuity Start Date, the Owner may change the Annuity Option
chosen. The Owner must request the change in writing. This request must be
Received by the Company at least 30 days prior to the Annuity Start Date.
FIXED ANNUITY PAYMENTS
With respect to Fixed Annuity Payments, the amounts shown on the Tables are
the guaranteed minimum for each Annuity Payment for Annuity Options 1
through 4.
VARIABLE ANNUITY PAYMENTS
With respect to Variable Annuity Payments, the amount shown on the Tables
is the guaranteed minimum first Annuity Payment, based on the assumed
interest rate of 3.5% for Annuity Options 1 through 4. The amount of each
Annuity Payment after the first for these options is computed by means of
Annuity Units.
ANNUITY UNITS
The number of Annuity Units is found by dividing the first Annuity Payment
by the Annuity Unit Value for the selected Subaccount on the Annuity Start
Date. The number of Annuity Units for the Subaccount then remains constant,
unless a Transfer of Annuity Units is made. After the first Annuity
Payment, the dollar amount of each subsequent Annuity Payment is equal to
the number of Annuity Units times the Annuity Unit Value for the Subaccount
on the due date of the Annuity Payment.
-16-
V6022 H (10-94)
17
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ANNUITY PAYMENT PROVISIONS (Continued)
--------------------------------------------------------------------------------
ANNUITY UNITS (Continued)
The Annuity Unit Value for each Subaccount was first set at $1.00. The
Annuity Unit Value for any subsequent Valuation Date is equal to (a) times
(b) times (c), where:
(a) is the Annuity Unit Value on the immediately preceding Valuation Date;
(b) is the Net Investment Factor for the day;
(c) is a factor used to adjust for an assumed interest rate of 3.5% per
year used to determine the Annuity Payment amounts. The assumed
interest rate is reflected in the Annuity Tables.
NET INVESTMENT FACTOR
The Net Investment Factor for any Subaccount at the end of any Valuation
Period is determined by dividing (1) by (2) and subtracting (3) from the
result, where:
1. is equal to:
a. the net asset value per share of the mutual fund held in the
Subaccount, found at the end of the current Valuation Period;
plus
b. the per share amount of any dividend or capital gain
distributions paid by the Subaccount's underlying mutual fund
that is not included in the net asset value per share; plus or
minus
c. a per share charge or credit for any taxes reserved for, which
the Company deems to have resulted from the operation of the
Subaccount.
2. is the net asset value per share of the Subaccount's underlying mutual
fund as found at the end of the prior Valuation Period.
3. is a factor representing the Mortality and Expense Risk Charge which
is deducted from the Separate Account.
Underlying mutual funds may declare dividends on a daily basis and pay such
dividends once a month. The Net Investment Factor allows for the monthly
reinvestment of these daily dividends. As described above, the gains and
losses from each Subaccount are credited or charged against the Subaccount
without regard to the gains or losses in the Company or other Subaccounts.
ALTERNATE ANNUITY OPTION RATES
The Company may, at the time of election of an Annuity Option, offer more
favorable rates in lieu of the guaranteed rates shown in the Annuity
Tables.
-17-
18
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ANNUITY PAYMENT PROVISIONS (Continued)
--------------------------------------------------------------------------------
ANNUITY OPTIONS
OPTION 1
LIFE OPTION: This option provides payments for the life of the
Annuitant. Table A shows some of the guaranteed rates for this option.
OPTION 2
LIFE WITH FIXED PERIOD OPTION: This option provides payments for the
life of the Annuitant. A fixed period of 5, 10, 15 or 20 years may be
chosen. Payments will be made to the end of this period even if the
Annuitant dies prior to the end of the period. If the Annuitant dies
before receiving all the payments during the fixed period. If the
Annuitant dies before receiving all the payments during the fixed
period, the remaining payments will be made to the Designated
Beneficiary. Table A shows some of the guaranteed rates for this
option.
OPTION 3
LIFE WITH INSTALLMENT OR UNIT REFUND OPTION: This option provides
payments for the life of the Annuitant, with a period certain
determined by dividing the Annuity Start Amount by the amount of the
first payment. A fixed number of payments will be made even if the
Annuitant dies. If the Annuitant dies before receiving the fixed
number of payments, any remaining payments will be made to the
Designated Beneficiary. Table A shows some of the guaranteed rates for
this option.
OPTION 4
JOINT AND LAST SURVIVOR OPTION: This option provides payments for the
life of the Annuitant and Joint Annuitant. Payments will be made as
long as either is living. Table B shows some of the guaranteed rates
for this option.
OPTION 5
FIXED PERIOD OPTION: This option provides payments for a fixed number
of years between 5 and 20. If the Contract Value is held in the Fixed
Account, then the amount of the payments will vary as a result of the
interest rate (as adjusted periodically) credited on the Fixed
Account. This rate is guaranteed to be no less than the Guaranteed
Rate shown on page 3. If the Contract Value is held in the Separate
Account, then the amount of the payments will vary as a result of the
investment performance of the Subaccounts chosen. If all the
Annuitants die before receiving the fixed number of payments, any
remaining payments will be made to the Designated Beneficiary.
OPTION 6
FIXED PAYMENT OPTION: This option provides a fixed payment amount.
This amount is paid until the amount applied, including daily interest
adjustments, is paid. If the Contract Value is held in the Fixed
Account, then the number of payments will vary as a result of the
interest rate (as adjusted periodically) credited on the Fixed
Account. This rate is guaranteed to be no less than the Guaranteed
Rate shown on page 3. If the Contract Value is held in the Separate
Account, then the number of payments will vary as a result of the
investment performance of the Subaccounts chosen. If all the
Annuitants die before receiving all the payments, any remaining
payments will be made to the Designated Beneficiary.
-18-
V6022 I (10-94)
19
ANNUITY TABLES
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TABLE A
SETTLEMENT OPTIONS ONE, TWO, AND THREE
MINIMUM INITIAL MONTHLY INSTALLMENTS PER $1,000 OF AMOUNT APPLIED
Option Two
Adjusted Option One Year Fixed Period Ends Option Three
Age Life 5 10 15 20 Unit
of Annuitant Only Years Years Years Years Refund
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MALE
55 4.99 4.97 4.91 4.80 4.66 4.73
56 5.09 5.07 5.00 4.88 4.72 4.81
57 5.20 5.17 5.10 4.97 4.78 4.90
58 5.32 5.29 5.20 5.05 4.85 4.99
59 5.44 5.41 5.31 5.14 4.91 5.08
60 5.57 5.53 5.42 5.23 4.97 5.18
61 5.71 5.67 5.54 5.33 5.04 5.29
62 5.86 5.81 5.67 5.42 5.10 5.40
63 6.02 5.97 5.80 5.52 5.16 5.51
64 6.20 6.13 5.94 5.62 5.22 5.63
65 6.38 6.31 6.08 5.72 5.28 5.76
66 6.58 6.49 6.23 5.82 5.33 5.90
67 6.79 6.69 6.38 5.92 5.38 6.04
68 7.02 6.90 6.54 6.02 5.43 6.19
69 7.26 7.12 6.71 6.12 5.48 6.35
70 7.52 7.35 6.87 6.21 5.52 6.52
71 7.80 7.60 7.05 6.30 5.55 6.69
72 8.09 7.86 7.22 6.39 5.59 6.88
73 8.41 8.13 7.40 6.47 5.62 7.07
74 8.75 8.42 7.57 6.55 5.64 7.27
75 9.12 8.72 7.75 6.62 5.66 7.49
FEMALE
55 4.54 4.53 4.51 4.46 4.38 4.40
56 4.62 4.61 4.58 4.53 4.44 4.47
57 4.71 4.70 4.66 4.60 4.51 4.54
58 4.80 4.79 4.75 4.68 4.57 4.62
59 4.90 4.88 4.84 4.76 4.64 4.70
60 5.00 4.99 4.93 4.84 4.70 4.78
61 5.11 5.09 5.03 4.93 4.77 4.87
62 5.23 5.21 5.14 5.02 4.84 4.96
63 5.36 5.33 5.25 5.12 4.91 5.06
64 5.49 5.46 5.37 5.21 4.98 5.17
65 5.64 5.60 5.50 5.31 5.05 5.28
66 5.79 5.75 5.63 5.42 5.12 5.39
67 5.95 5.91 5.77 5.53 5.19 5.52
68 6.13 6.08 5.91 5.63 5.25 5.65
69 6.32 6.26 6.07 5.74 5.32 5.79
70 6.53 6.46 6.23 5.86 5.37 5.94
71 6.75 6.67 6.40 5.97 5.43 6.09
72 6.99 6.89 6.58 6.08 5.48 6.26
73 7.26 7.13 6.76 6.18 5.52 6.44
74 7.54 7.39 6.95 6.29 5.57 6.63
75 7.85 7.67 7.14 6.39 5.60 6.83
Values not shown will be provided upon request. Annual, semiannual, or
quarterly installments can be determined by multiplying the monthly installments
by 11.812853, 5.9572227, and 2.9914196 respectively.
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TABLE B
SETTLEMENT OPTION FOUR
MINIMUM INITIAL MONTHLY INSTALLMENT PER $1,000 OF AMOUNT APPLIED
Adjusted Age of Adjusted Age of Male Annuitant
Female Annuitant 55 60 62 65 70 75
--------------------------------------------------------------------------------
55 4.16 4.27 4.30 4.35 4.42 4.47
60 4.34 4.51 4.57 4.66 4.78 4.86
62 4.41 4.61 4.68 4.79 4.94 5.04
65 4.51 4.76 4.85 4.99 5.20 5.35
70 4.66 4.99 5.13 5.34 5.67 5.95
75 4.78 5.19 5.37 5.66 6.16 6.63
Values not shown will be provided upon request. Annual, semiannual, or
quarterly installments can be determined by multiplying the monthly installments
by 11.812853, 5.9572227, and 2.9914196 respectively.
-19-
20
A BRIEF DESCRIPTION OF THIS CONTRACT
This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT.
* Purchase Payments may be made until the earlier of the Annuity Start Date
or termination of the Contract.
* A Death Benefit may be paid prior to the Annuity Start Date according to
the Contract provisions.
* Annuity Payments begin on the Annuity Start Date using the method as
specified in this Contract.
* This Contract is Participating.
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN
ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. THERE ARE NO
GUARANTEED MINIMUM PAYMENTS OR CASH VALUES. (SEE "CONTRACT VALUE AND EXPENSE
PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.)
[SBL LOGO]
SECURITY BENEFIT LIFE INSURANCE COMPANY
A Member of The Security Benefit Group of Companies
P.O. Box 750497, Topeka, KS 66675-0497
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0001
0-000-000-0000
