Exhibit 24(b)(4)(a)(i)
(XXXX XXXXXXX(R) LOGO) XXXX XXXXXXX LIFE INSURANCE COMPANY OF NEW YORK
HOME OFFICE: [000 Xxxxxx Xxxx Xxxxx, 0xx Xxxxx
Xxxxxxxx, XX 00000]
THIS IS A LEGAL CONTRACT - READ IT CAREFULLY.
This Contract is issued in consideration of the Payments. Xxxx Xxxxxxx Life
Insurance Company of New York, a stock company, agrees to pay the benefits of
this Contract in accordance with its terms.
VARIABLE ACCOUNT PROVISIONS
ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT WHEN BASED ON THE
INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE, MAY INCREASE OR
DECREASE IN ACCORDANCE WITH THE FLUCTUATIONS IN THE INVESTMENT RESULTS, AS
APPLICABLE AND NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. DETAILS OF THE VARIABLE
ACCOUNT PROVISIONS BEGIN ON PAGE 6.
The smallest annual rate of investment return which is required to be earned on
the assets of the separate account so that the dollar amount of variable annuity
payments will not decrease is [2.73%]. Explicit annual charges against the
assets of the separate account are as follows:
Contract Asset Fee Charge: Not greater than [1.70%]
RIGHT TO REVIEW
You may cancel the Contract by returning it to our Annuities Service Center or
the registered representative who sold it to you at any time within [10] days
after receipt of the Contract. Within 7 days of receipt of the Contract by us,
we will pay the Contract Value computed at the end of the Business Day on which
the Contract is delivered to us plus the sum of all fees and charges deducted
from the gross Payments to the Owner.
When the Contract is issued as an individual retirement annuity, during the
first 7 days of this [10] day period, we will return the greater of (i) Contract
Value computed at the end of the Business Day on which the Contract is delivered
to us plus the sum of all fees and charges deducted from the gross Payments or
(ii) sum of all Payments less any Withdrawals. If you return the Contract to us
after the first 7 days and before the [10]-day period has elapsed, we will
refund an amount determined as described in the paragraph above.
SIGNED FOR THE COMPANY at its Main Administration Office in Boston,
Massachusetts, on the Contract Date.
/s/ Xxxxx X. Xxxxxxxxx /s/ Xxxxxxx Xxxxx
[Xxxxx X. Xxxxxxxxx, President] [Xxxxxxx Xxxxx, Secretary]
INDIVIDUAL FLEXIBLE PAYMENT DEFERRED VARIABLE ANNUITY
Variable Accumulation prior to Annuity Commencement Date
Variable and Fixed Annuity Options
Death Benefit Proceeds Payable prior to Annuity Commencement Date
Withdrawal Charge Waiver Benefit
Non-Participating
DOLLAR COST AVERAGING (DCA) ACCOUNT OPTIONS MAY NOT BE AVAILABLE ON THE ISSUE
DATE. REFER TO THE AVAILABLE INVESTMENT OPTIONS ON THE SPECIFICATIONS PAGES FOR
DETAILS.
ANNUITIES SERVICE CENTER:
[P.O. Box 9506 Portsmouth, NH 03802-9506] [0-000-000-0000] [www.jhannuitiesnew
xxxx.xxx]
OVERNIGHT MAILING ADDRESS:
[000 Xxxxxxxxx Xxxxx Xxxxxxxxxx, XX 00000-0000]
VENTURE-L.11-NY SAMPLE
Table of Contents
Specifications Pages ..................................................... S.1
Part 1 - Definitions ..................................................... 1
Part 2 - Parties to the Contract ......................................... 4
Part 3 - Payments ........................................................ 5
Part 4 - Fees And Deductions ............................................. 6
Part 5 - Variable Account Provisions ..................................... 6
Part 6 - Transfers ....................................................... 8
Part 7 - Withdrawal Provisions ........................................... 9
Part 8 - Death Benefits .................................................. 11
Part 9 - Contract Maturity ............................................... 13
Part 10 - Annuity Payments ............................................... 13
Part 11 - Annuity Options ................................................ 15
Part 12 - General Provisions ............................................. 15
Part 13 - Contract Termination ........................................... 17
INTRODUCTION
This is an individual flexible payment deferred variable annuity contract. This
Contract provides that, prior to the Annuity Commencement Date, the Contract
Value will accumulate on a variable basis. You allocate Payments among one or
more Investment Options. The initial Investment Options are identified on the
Specifications Pages. The Contract Value will vary with the investment
performance of your Investment Account. Subject to the provisions of the
Contract, you may take withdrawals and transfer amounts among the Investment
Options.
After the Annuity Commencement Date, Annuity Payments may be either fixed or
variable, or a combination of fixed and variable. If you select Annuity Payments
on a variable basis, the payment amount will vary with the investment
performance of the Variable Account.
If the Owner (Annuitant if the Owner is not an individual) dies while this
Contract is in effect prior to the Annuity Commencement Date, we will pay a
Death Benefit to the Beneficiary upon receipt of all required claim forms and
proof of death of the Owner at the Annuities Service Center.
VENTURE-L.11-NY SAMPLE
Specifications Page
TYPE OF CONTRACT: [Qualified] CONTRACT DATE: [06/15/2011]
CONTRACT NUMBER: [000000005] ISSUE STATE: NY
OWNER: [Xxxx X. Xxx] OWNER'S AGE & SEX: [55] [Male]
ANNUITANT: [Xxxx X. Xxx] ANNUITANT'S AGE & SEX: [55] [Male]
[CO-OWNER:] [ ] [CO-OWNER'S AGE & SEX:] [ ] [ ]
[CO-ANNUITANT:] [ ] [CO-ANNUITANT'S AGE & SEX:] [ ] [ ]
PLAN [VENTURE 4 Series]
FEES AND CHARGES
CONTRACT ASSET FEE [1.70%]
ANNUAL CONTRACT FEE Electronic-Delivery of Financial
Owner Elects Electronic Delivery of Transaction Confirmations is
Financial Transaction Confirmations Not Elected by Owner
------------------------------------------ ---------------------------------
[$0] [$50]
[RIDER FEE(S) See Optional Riders section on page S.[4]]
PAYMENT LIMITS
PAYMENT LIMITS - Minimum Additional Payment Amount:
[$30]
- Total Additional Payments: [$100,000]
- Maximum Amount: [$1,000,000]
VENTURE-L.11-NY S.1 SAMPLE
LIMITS--TRANSFERS AND AMOUNT OF PARTIAL WITHDRAWALS
TRANSFER CHARGES AND LIMITATIONS-- - Minimum Transfer Amount: $300
BEFORE ANNUITY COMMENCEMENT
DATE - Minimum Investment Account Value:
$100
- Number of Transfers Per Contract
Year: two per month
- Transfer Charge: the lesser of $25 or
2% of the amount of each transfer in
excess of 12 per Contract Year
TRANSFER LIMITATIONS - ON OR AFTER - Number of Transfers Per Contract
ANNUITY COMMENCEMENT DATE Year: 4
LIMITATIONS ON AMOUNT OF - Minimum Amount of Partial Withdrawal:
PARTIAL WITHDRAWALS [$300]
- Minimum Investment Account Balance:
$100
- Minimum Remaining Contract Value:
$1,000
WITHDRAWALS CHARGES
TABLE OF WITHDRAWAL CHARGES Number of Complete Years Withdrawal Charge
Payment has been in Contract Percentage
---------------------------- -----------------
0 8%
1 7%
2 6%
3 5%
4+ 0%
[Withdrawal Charges will be waived for any
contract issued to an employee of the
Company.]
INITIAL ALLOCATION OF NET PAYMENT (See Following Page for All Available
Investment Options)
INITIAL PAYMENT [$100,000.00]
[DCA ACCOUNT OPTIONS:] [INITIAL INTEREST RATE] [INITIAL GUARANTEE PERIOD EXPIRES]
[6 Month DCA Account] [25.00%] [1.00%] [12/15/2011]
[THE INTEREST RATE FOR THE DCA ACCOUNT OPTION ABOVE MAY CONTAIN AN ENHANCEMENT
THAT MAY NOT BE PROVIDED IN SUBSEQUENT GUARANTEE PERIODS.]
VARIABLE INVESTMENT OPTIONS:
[Lifestyle Balanced PS] [75.00%]
TOTAL 100.00%
VENTURE-L.11-NY S.2 SAMPLE
AVAILABLE INVESTMENT OPTIONS
VARIABLE ACCOUNT: XXXX XXXXXXX LIFE INSURANCE COMPANY OF NEW YORK SEPARATE
ACCOUNT A
VARIABLE INVESTMENT OPTIONS:
[Lifestyle Balanced]
[Lifestyle Balanced PS]
[Lifestyle Conservative]
[Lifestyle Conservative PS]
[Lifestyle Growth]
[Lifestyle Growth PS]
[Lifestyle Moderate]
[Lifestyle Moderate PS]
[Ultra Short Term Bond]
DOLLAR COST AVERAGING (DCA) ACCOUNT INVESTMENT OPTIONS:
6 Month DCA Account
[6 Month DCA Not Currently Available] NO6MODCA03
12 Month DCA Account
[12 Month DCA Not Currently Available] NO12MODCA03
VENTURE-L.11-NY S.3 SAMPLE
OPTIONAL RIDERS
[ENHANCED DEATH BENEFIT RIDER: MARKETING NAME]
- [Rider Date:] [06/15/2011]
- [Rider Fee Percentage:] [0.30%]
- [Total Asset Fee Percentage [2.00%]
(Contract Asset Fee from Pg S.1 +
Rider Fee Percentage):]
[GUARANTEED MINIMUM WITHDRAWAL BENEFIT RIDER: MARKETING NAME]
- [Rider Date:] [06/15/2011]
- [Maximum Rider Fee Percentage:] [1.50%]
ANNUITY BENEFITS
MATURITY DATE: [10/25/2046]
ANNUITY OPTION: Life 10-Year Certain
ANNUITY PAYMENTS -- GENERAL The rates for Annuity Payments are
INFORMATION determined based on:
- Mortality Table: Annuity 2000 Table
projected from 2002 to date of
annuitization at Scale G, 100% female
blend
- Fixed Annuity Payment Interest Rate:
1.00% interest per year
- Variable Annuity Payment Assumed
Interest Rate: 1.00%
The amount of each Annuity Payment will
depend upon the age of the Annuitant, the
Co-Annuitant, if any, or other payee.
VENTURE-L.11-NY S.4 SAMPLE
AMOUNT OF FIRST MONTHLY PAYMENT
PER $1000 OF CONTRACT VALUE
FOR AN ANNUITANT BORN IN 1952
OPTION 1: LIFE ANNUITY
Option 1(A): Non-Refund Option 1(B): 10 Year Certain
----------------------- ----------------------------
Age of Age of
Xxxxxxxxx Xxxxxxxxx
--------- ---------
55 N/A 55 N/A
60 3.08 60 3.06
65 3.50 65 3.47
70 4.07 70 3.99
75 4.85 75 4.66
80 5.91 80 5.46
85 7.40 85 6.35
OPTION 2: JOINT AND SURVIVOR LIFE ANNUITY
Option 2(A): Non-Refund
Age of Co-Annuitant
----------------------------------------------
Age of 10 Years 5 Years Same 5 Years 10 Years
Annuitant Younger Younger Age Older Older
--------- -------- ------- ---- ------- --------
55 N/A N/A N/A N/A N/A
60 2.29 2.46 2.62 2.77 2.88
65 2.51 2.72 2.93 3.11 3.26
70 2.78 3.05 3.33 3.57 3.77
75 3.13 3.49 3.86 4.19 4.45
80 3.59 4.08 4.58 5.03 5.38
85 4.22 4.88 5.57 6.17 6.62
Option 2(B): 10 Year Certain
Age of Co-Annuitant
----------------------------------------------
Age of 10 Years 5 Years Same 5 Years 10 Years
Annuitant Younger Younger Age Older Older
--------- -------- ------- ---- ------- --------
55 N/A N/A N/A N/A N/A
60 2.29 2.46 2.62 2.77 2.88
65 2.51 2.72 2.93 3.11 3.26
70 2.78 3.05 3.32 3.57 3.75
75 3.13 3.49 3.85 4.16 4.40
80 3.58 4.06 4.53 4.93 5.20
85 4.18 4.80 5.38 5.83 6.12
Monthly installments for ages not shown and other years of birth will be
furnished on request.
VENTURE-B.11-NY S.5 SAMPLE
BENEFICIARY INFORMATION
[Xxxx Xxx]
DISCLOSURES
PURSUANT TO SECTION 3 OF THE FEDERAL DEFENSE OF MARRIAGE ACT ("DOMA"), SAME
SEX-MARRIAGES, DOMESTIC PARTNERSHIPS AND CIVIL UNIONS CURRENTLY ARE NOT
RECOGNIZED FOR PURPOSES OF FEDERAL LAW. THEREFORE, THE FAVORABLE INCOME-DEFERRAL
OPTIONS AFFORDED BY FEDERAL TAX LAW TO AN OPPOSITE-SEX SPOUSE UNDER INTERNAL
REVENUE CODE SECTIONS 72(S) AND 401(A)(9) ARE CURRENTLY NOT AVAILABLE TO A
SAME-SEX SPOUSE, DOMESTIC PARTNER OR CIVIL UNION PARTNER. SAME-SEX SPOUSES,
DOMESTIC PARTNERS OR CIVIL UNION PARTNERS WHO OWN OR ARE CONSIDERING THE
PURCHASE OF ANNUITY PRODUCTS THAT PROVIDE BENEFITS BASED UPON STATUS AS A SPOUSE
SHOULD CONSULT A TAX ADVISOR. TO THE EXTENT THAT AN ANNUITY CONTRACT ACCORDS TO
SPOUSES OTHER RIGHTS OR BENEFITS THAT ARE NOT AFFECTED BY DOMA, SAME-SEX
SPOUSES, DOMESTIC PARTNERS AND CIVIL UNION PARTNERS RECOGNIZED BY THE ISSUE
STATE REMAIN ENTITLED TO SUCH RIGHTS OR BENEFITS TO THE SAME EXTENT AS ANY
ANNUITY HOLDER'S SPOUSE.
[THIS PLAN IS INTENDED TO QUALIFY UNDER THE INTERNAL REVENUE CODE FOR
TAX-FAVORED STATUS. LANGUAGE CONTAINED IN THIS CONTRACT REFERRING TO FEDERAL TAX
STATUS OR RULES IS INFORMATIONAL AND INSTRUCTIONAL. PLEASE SEEK THE ADVICE OF
YOUR OWN TAX ADVISOR REGARDING YOUR INDIVIDUAL TAX TREATMENT.]
VENTURE-L.11-NY S.6 SAMPLE
PART 1 DEFINITIONS
WE AND YOU "We", "us" and "our" means the Company. "You" or "your"
means the Owner of this Contract.
ACCUMULATION UNIT A unit of measure that is used to calculate the value of
the Variable Account of this Contract before the Annuity
Commencement Date.
ANNUITANT Any individual person or persons whose life is used to
determine the duration of Xxxxxxx Payments involving life
contingencies. The Annuitant is as designated on the
Specifications Pages, unless changed.
ANNUITIES SERVICE CENTER Any office designated by us for the receipt of Payments
and processing of Owner requests.
ANNUITY COMMENCEMENT DATE The date Annuity Payments begin. This date may not be
earlier than six months following the Contract Date or
later than the Maturity Date. Annuity Payments may not be
scheduled under the Contract to begin earlier than 12
months from the Contract Date.
ANNUITY OPTION The method selected by you for Annuity Payments made by
us.
ANNUITY PAYMENT(S) Payment(s) by us to you, in accordance with the Annuity
Option elected under the terms of this Contract.
ANNUITY UNIT A unit of measure that is used after the Annuity
Commencement Date to calculate Variable Annuity payments.
BENEFICIARY The person, persons or entity to whom certain benefits are
payable following the death of an Owner, or in certain
circumstances, an Annuitant. For purposes of section 72(s)
of the Internal Revenue code, the "designated beneficiary"
under the Contract shall be the individual who is entitled
to receive the amounts payable on death of an Owner, or if
any Owner is not an individual, on any change in, or death
of, of an Annuitant
BUSINESS DAY Any date on which the New York Stock Exchange is open for
business and the net asset value of a Portfolio is
determined.
COMPANY The insurance company named on the first page of this
Contract (or any successor insurance company named by
endorsement to this Contract) that will pay benefits in
accordance with this Contract.
CONTRACT ANNIVERSARY The annual anniversary of the Contract beginning twelve
months from the Contract Date and each year thereafter.
CONTRACT DATE The date of issue of this Contract as designated on the
Specifications Pages.
CONTRACT VALUE The total of your Investment Account Values.
CONTRACT YEAR The period of time measured twelve consecutive months from
the Contract Date or any Contract Anniversary thereafter.
CONTINGENT BENEFICIARY The person, persons or entity who becomes entitled to
receive the Contract proceeds if all Beneficiaries die
before the Owner dies.
VENTURE-L.11-NY 1 SAMPLE
ENDORSEMENT An Endorsement modifies the contract to which it is
attached. Endorsements must be signed by an officer of the
Company in order to be effective.
FIXED ANNUITY An Annuity Option with payments which are predetermined
and guaranteed as to dollar amount.
GOOD ORDER The standard we apply when we determine whether an
instruction is satisfactory. An instruction will be
considered in Good Order if it is received at our
Annuities Service Center: (a) in a manner that is
satisfactory to us such that it is sufficiently complete
and clear that we do not need to exercise any discretion
to follow such instruction and complies with all relevant
laws and regulations and Company requirements; (b) on
specific forms, or by other means we then permit (such as
via telephone or electronic submission); and/or (c) with
any signatures and dates we may require. We will notify
you if an instruction is not in Good Order.
INTERNAL REVENUE CODE (IRC) The Internal Revenue Code of 1986, as amended from time to
time, and any successor statute of similar purpose.
INVESTMENT ACCOUNT An account established by us which represents your
interest in an Investment Option prior to the Annuity
Commencement Date.
INVESTMENT ACCOUNT VALUE The value of your investment in an Investment Account.
INVESTMENT OPTIONS The Subaccount(s) of the Variable Account. The Investment
Options available under this Contract at issue are shown
on the Specifications Pages.
MATURITY DATE The latest date on which annuity benefits may commence. It
is the date listed on the Specifications Pages, unless
changed. Any extension of the maximum Maturity Date beyond
age 90 of the oldest Annuitant or the 10th Conract Year
will be subject to the laws and regulations then in effect
and our prior approval.
NET PAYMENT The Payment less the amount of premium tax, if any,
deducted from the Payment.
NET SURRENDER VALUE The Surrender Value less any amount withheld by us for
income taxes.
NON-QUALIFIED CONTRACTS Contracts which are not issued under Qualified Plans.
OWNER The person, persons or entity entitled to the ownership
rights under this Contract. The Owner is as designated on
the Specifications Pages, unless changed.
PORTFOLIO The investment choices available to the Variable Account.
PAYMENT An amount paid to us by you as consideration for the
benefits provided by this Contract.
QUALIFIED CONTRACTS Contracts issued under Qualified Plans.
QUALIFIED PLANS Retirement plans which receive favorable tax treatment
under sections 401, 403, 408 or 457, of the Internal
Revenue Code of 1986, as amended.
RIDER A rider provides an optional benefit, which may result in
an additional charge to the Contract. A rider supplements
the contract to which it is attached. Riders must be
signed by an officer of the Company in order to be
effective.
VENTURE-L.11-NY 2 SAMPLE
SEPARATE ACCOUNT A segregated account of the Company that is not commingled
with our general assets and obligations.
SUBACCOUNT(S) A division of the Variable Account. Each Subaccount is
invested in shares of a different Portfolio.
SURRENDER VALUE The Contract Value on any Valuation Date, less, if
applicable, any contract fees, any rider charges, any
deduction for premium taxes or similar taxes, and any
Withdrawal Charge.
VALUATION PERIOD Any period from one Business Day to the next, measured
from the time on each such day that the net asset value of
each Portfolio is determined.
VARIABLE ACCOUNT The Company's Separate Account as shown on the
Specifications Pages.
VARIABLE ANNUITY An Annuity Option with payments which: (1) are not
predetermined or guaranteed as to dollar amount; and (2)
vary in relation to the investment experience of one or
more specified variable Subaccounts.
WITHDRAWAL AMOUNT The amount deducted from the Contract Value when you take
a withdrawal. This amount is the total of the amount paid
to you plus the following, if applicable: any contract
fees, any rider charges, any deduction for premium taxes
or similar taxes, any amount for income taxes resulting
from the withdrawal, and any Withdrawal Charges. The
Withdrawal Amount may not exceed the Contract Value.
WRITTEN REQUEST A notice provided in a form acceptable to Us based on the
type of request and received in Good Order at our
Annuities Service Center.
VENTURE-L.11-NY 3 SAMPLE
PART 2 PARTIES TO THE CONTRACT
OWNER Before the Annuity Commencement Date, the Owner of this
Contract shall be the person, persons or entity designated
on the Specifications Pages or the latest change filed
with us. A co-Owner is not permitted under this Contract
if any Owner is an entity. On the Annuity Commencement
Date the Annuitant will become the Owner of this Contract,
unless the Owner is a trust or custodian. If amounts
become payable to the Beneficiary under this Contract, the
Beneficiary becomes the Owner of this Contract. Unless
indicated otherwise, references to the Owner will also
include the co-Owner.
ANNUITANT The Annuitant is the person designated as such on the
Specifications Pages or the latest change filed with us.
If you name more than one Xxxxxxxxx, the second Annuitant
is referred to as the co-Annuitant. Unless indicated
otherwise, references to the Annuitant will also include
the co-Annuitant.
BENEFICIARY The Beneficiary is as designated on the Specifications
Pages, unless changed. However, if there is a surviving
Owner, that person will be treated as the Beneficiary. If
no such Beneficiary is living, the Beneficiary is the
Contingent Beneficiary. If no Beneficiary or Contingent
Beneficiary is living, the Beneficiary is the estate of
the deceased Owner.
CHANGE OF OWNER, ANNUITANT, Subject to the rights of an irrevocable Beneficiary, you
BENEFICIARY may change the Owner, Annuitant, or Beneficiary by Written
Request. Any change will take effect on the date the
request is signed. Any change of Owner or Annuitant is
subject to our issue age limitations based on age at the
date of the change. The Annuitant may not be changed after
the Annuity Commencement Date. You need not send us the
Contract unless we request it. We will not be liable for
any payments or actions we take before the Written Request
is received.
The addition of any Owner may result in the resetting of
the Guaranteed Minimum Death Benefit to an amount equal
to the Contract Value as of the date of such change. For
purposes of subsequent calculations of the Guaranteed
Minimum Death Benefit, we will treat the Contract Value
on the date of the change as a Payment made on that date.
In addition, all anniversary values, all Payments made
and all amounts deducted in connection with partial
withdrawals prior to the date of the addition of the
Owner will not be considered in the determination of the
Guaranteed Minimum Death Benefit.
If any Annuitant is changed and any Owner is not an
individual, the entire interest in the Contract must be
distributed to the Owner within five years of the change.
ASSIGNMENT You may assign this Contract, except as otherwise
provided, at any time prior to the Annuity Commencement
Date. No assignment will be binding on us unless it is in
the form of a Written Request. We will not be liable for
any payments made or actions we take before the assignment
is received by us. An absolute assignment will revoke the
interest of any revocable Beneficiary. We will not be
responsible for the validity of any assignment.
If this Contract is issued in a Qualified Plan, this
Contract is subject to assignment restrictions for Federal
Income Tax purposes. In such event, this Contract shall
not be sold, assigned, discounted, or pledged as
collateral for a loan or as security for the performance
of an obligation or for any other purpose, to any person
other than us.
VENTURE-L.11-NY 4 SAMPLE
PART 3 PAYMENTS
GENERAL The Contract is not effective until the Initial Payment is
received by us at our Annuities Service Center or such
other place designated by us. All Payments under this
Contract are payable at our Annuities Service Center or
such other place as we may designate.
PAYMENT LIMITS The Initial Payment is shown on the Specifications Pages.
Each additional Payment must be at least equal to the
Minimum Additional Payment Amount shown on the
Specifications Pages. No additional payment will be
accepted, without our prior approval, after the first
Contract Year that causes the total of all additional
Payments received after the first Contract Year to exceed
the Total Additional Payments amount shown on the
Specifications Pages. If a Payment would cause the
Contract Value on the date of such Payment to exceed the
Maximum Amount shown on the Specifications Pages, or the
Contract Value on the date of such Payment already exceeds
the Maximum Amount, no additional Payments will be
accepted without our prior approval.
ALLOCATION OF NET PAYMENTS When we receive Payments, the Net Payments will be
allocated among Investment Options in accordance with the
allocation percentages shown on the Specifications Pages.
You may change the allocation of subsequent Net Payments
at any time, without charge, by Written Request.
VENTURE-L.11-NY 5 SAMPLE
PART 4 FEES AND DEDUCTIONS
CONTRACT ASSET FEE To compensate us for assuming mortality and expense risks,
and administration expenses, we deduct from each variable
Investment Option a fee each Valuation Period at an annual
rate set forth on the Specifications Pages. A portion of
this Asset Fee may also be used to reimburse us for
distribution expenses. This fee is reflected in the Net
Investment Factor used to determine the value of
Accumulation Units and Annuity Units of the Contract.
ANNUAL CONTRACT FEE To compensate us for assuming administration expenses, we
charge an Annual Contract Fee as set forth on the
Specifications Pages. Prior to the Annuity Commencement
Date, the Annual Contract Fee is deducted on each Contract
Anniversary. We withdraw the Annual Contract Fee from each
Investment Option in the same proportion that the value of
the Investment Accounts of each Investment Option bears to
the Contract Value. If the Contract Value is totally
withdrawn on any date other than the Contract Anniversary,
we will deduct the total amount of the Annual Contract Fee
from the amount paid. After the Annuity Commencement Date,
we deduct the Annual Contract Fee on a pro rata basis from
each Annuity Payment.
TAXES We reserve the right to charge certain taxes against your
Payments (either at the time of payment or liquidation due
to withdrawals, annuitization or death benefit), or
against the Contract Value, Death Benefit proceeds, or
Annuity Payments, as appropriate. Such taxes may include
premium taxes or other taxes levied by any government
entity which we, in our sole discretion, determine have
resulted from the establishment or maintenance of the
Variable Account, or from the receipt by us of Payments,
or from the issuance of this Contract, or from the
commencement or continuance of Annuity Payments under this
Contract.
RIDER FEE(S) We charge an additional fee to compensate us for the
additional benefits provided by any optional benefit
riders elected by you. The Rider Fee for each rider you
elect is shown on the Specifications Pages or in the
Rider. Rider Fees are deducted as described in the
applicable benefit Rider issued by us.
PART 5 VARIABLE ACCOUNT PROVISIONS
INVESTMENT ACCOUNT We will establish a separate Investment Account for you
for each variable Investment Option to which you allocate
amounts. The Investment Account represents the number of
your Accumulation Units in an Investment Option.
INVESTMENT ACCOUNT VALUE The Investment Account Value of an Investment Account is
determined by (a) times (b) where:
(a) equals the number of Accumulation Units credited to
the Investment Account; and;
(b) equals the value of the appropriate Accumulation
Unit.
ACCUMULATION UNITS We will credit Net Payments to your Investment Accounts in
the form of Accumulation Units. The number of Accumulation
Units we will credit to each Investment Account of the
Contract will be determined by dividing the Net Payment
allocated to that Investment Account by the Accumulation
Unit value for that Investment Account.
VENTURE-L.11-NY 6 SAMPLE
Accumulation Units will be adjusted for any transfers and
will be canceled on payment of a death benefit,
withdrawal, maturity or assessment of certain charges
based on their value for the Business Day on which such
transaction occurs.
VALUE OF ACCUMULATION UNIT We will determine the Accumulation Unit value for a
particular Investment Account for any Business Day by
multiplying the Accumulation Unit value for the
immediately preceding Business Day by the net investment
factor for the Valuation Period for which the value is
being determined. The value of an Accumulation Unit may
increase, decrease or remain the same from one Business
Day to the next.
NET INVESTMENT FACTOR The net investment factor is an index that measures the
investment performance of a Subaccount from one Business
Day to the next (" the Valuation Period"). The net
investment factor for any Valuation Period is determined
by dividing (a) by (b) and subtracting (c) from the result
where:
(a) is the net result of:
(i) the net asset value per share of a Portfolio
share held in the Subaccount determined as of
the end of the current Valuation Period, plus
(ii) the per share amount of any dividend or capital
gain distributions made by the Portfolio on
shares held in the Subaccount and received
during the current Valuation Period; and
(b) is the net asset value per share of a Portfolio share
held in the Subaccount determined as of the end of
the immediately preceding Valuation Period; and
(c) is the Contract Asset Fee shown on the Specifications
Pages divided by 365 and multiplied by the number of
calendar days in the Valuation Period.
The net investment factor may be greater or less than, or
equal to, one.
ADDITION, DELETION, SUBSTITUTION We reserve the right, subject to prior approval of the New
OR RESTRICTION OF INVESTMENT York Superintendent of Insurance and in compliance with
OPTIONS applicable law, to make additions to, deletions from, or
substitutions for the Portfolio shares that are held by
the Variable Account or that the Variable Account may
purchase. We reserve the right to eliminate the shares of
any of the eligible Portfolios and to substitute shares of
another Portfolio. We will not substitute any shares
attributable to your interest in a Subaccount without
notice to you and prior approval of the Securities and
Exchange Commission to the extent required by the
Investment Company Act of 1940. Nothing contained herein
shall prevent the Variable Account from purchasing other
securities for other series or classes of contracts, or
from effecting a conversion between shares of another
open-end investment company.
We reserve the right, subject to prior approval of the New
York Superintendent of Insurance and in compliance with
applicable law, to establish additional Subaccounts which
would invest in shares of a new Portfolio. We also reserve
the right to eliminate existing Subaccounts, to restrict
or prohibit additional allocations to a Subaccount, to
combine Subaccounts or to transfer assets in a Subaccount
to another Separate Account established by us or an
affiliated company. In the event of any such substitution
or change, we may, by appropriate endorsement, make such
changes in this and other Contracts as may be necessary or
appropriate to reflect such substitutions or change. If
deemed by us to be in the best interests of persons having
voting rights under the Contracts, the Variable Account
may be operated as a management company under the
Investment Company Act of 1940 or it may be de-registered
under such Act in the event such registration is no longer
required.
VENTURE-L.11-NY 7 SAMPLE
INSULATION The portion of the assets of the Variable Account equal to
the reserves and other contract liabilities with respect
to such account shall not be charged with liabilities
arising out of any other business we may conduct.
Moreover, the income, gains and losses, realized or
unrealized, from assets allocated to the Variable Account
shall be credited to or charged against such account
without regard to our other income, gains or losses.
SEPARATE ACCOUNT ASSETS We will maintain, in the Separate Account, assets with a
value at least equal to the amounts accumulated in
accordance with the terms of the applicable agreements
with respect to the Separate Account and the reserves for
annuities, in the course of payment that vary with the
investment experience of the Separate Account.
PART 6 TRANSFERS
TRANSFERS BEFORE ANNUITY While this Contract is in effect prior to the Annuity
COMMENCEMENT DATE Commencement Date, you may transfer amounts among the
Investment Accounts of the Contract, subject to the
limitations below. Amounts will be canceled from the
Investment Accounts from which amounts are transferred and
credited to the Investment Account to which amounts are
transferred. We will effect such transfers so that the
Contract Value on the date of transfer will not be
affected by the transfer.
You must transfer at least the Minimum Transfer Amount
shown on the Specifications Pages or, if less, the entire
amount in the Investment Account each time you make a
transfer. If, after the transfer, the amount remaining in
the Investment Account from which the transfer is made is
less than Minimum Investment Account Value shown on the
Specifications Pages, then we will transfer the entire
amount instead of the requested amount.
We limit the number of transfers you may make each
Contract Year among each Variable Investment Option as
shown in the Transfers Before Annuity Commencement Date
section on the Specifications Pages.
We do not impose a charge for the first 12 transfers in a
Contract Year. For each additional transfer during a
Contract Year, the Transfer Charge is shown on the
Specifications Pages.
TRANSFERS ON OR AFTER ANNUITY Once variable Annuity Payments have begun, you may
COMMENCEMENT DATE transfer all or part of the investment upon which your
variable Annuity Payments are based from one Subaccount to
another. To do this, we will convert the number of
variable Annuity Units you hold in the Subaccount from
which you are transferring to a number of variable Annuity
Units of the Subaccount to which you are transferring 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. After the transfer, the variable
Annuity Payments will reflect changes in the values of
your new variable Annuity Units. You must give us notice
at least 30 days before the due date of the first variable
Annuity Payment to which the transfer will apply.
We reserve the right, upon notice, to limit the number of
transfers that can be made after variable annuity
payments have begun. If such a limit is imposed, the
number of transfers per Contract Year will be no less
than the Minimum Number of Transfers Per Contract Year
shown in the Transfers On Or After Annuity Commencement
Date section on the Specifications Pages.
VENTURE-L.11-NY 8 SAMPLE
After the Annuity Commencement Date, transfers will not be
allowed from a fixed to a variable Annuity Option, or from
a variable to a fixed Annuity Option.
DEFERRAL, MODIFICATION OR We reserve the right to defer, modify or terminate the
TERMINATION OF TRANSFER PRIVILEGE transfer privilege at any time that we are unable to
purchase or redeem shares of the Portfolios. Transfer
charges and limitations are identified above and in the
Suspension of Payments provision in the Withdrawals
Provisions section.
PART 7 WITHDRAWAL PROVISIONS
PAYMENTS OF WITHDRAWALS You may withdraw part or all of the Surrender Value, at
any time before the earlier of the death of an Owner, the
Annuity Commencement Date or the Maturity Date, by sending
us a Written Request. We will pay all withdrawals within
seven days of receipt at the Annuities Service Center
subject to postponement in certain circumstances, as
specified below.
TOTAL WITHDRAWAL Upon receipt of your request to withdraw the entire
Contract Value, we will terminate the Contract and pay you
the Net Surrender Value.
PARTIAL WITHDRAWAL If you request to withdraw an amount less than the
Surrender Value, we will pay you the amount requested and
deduct the Withdrawal Amount from the Contract Value.
Unless you specify the amount to be withdrawn from each
Investment Option, the Withdrawal Amount will be withdrawn
from each Investment Option on a pro rata basis.
Partial withdrawals will reduce the Death Benefit, as
described in the Death Benefit section.
FREQUENCY AND AMOUNT OF PARTIAL You may make as many partial withdrawals as you wish.
WITHDRAWALS Limitations on the amount of partial withdrawals are as
follows.
(a) Any withdrawal from an Investment Account must be at
least equal to the Minimum Amount of Partial
Withdrawal shown on the Specifications Pages or the
entire balance in the Investment Account, if less.
(b) If after the withdrawal, the amount remaining in the
Investment Account is less than the Minimum
Investment Account Balance shown on the
Specifications Pages, then we will consider the
withdrawal request to be a request for withdrawal of
the entire amount held in the Investment Account.
(c) If a partial withdrawal reduces the Contract Value to
less than the Minimum Remaining Contract Value shown
on the Specifications Pages, or if the amount
requested is greater than or equal to the amount
available as a total withdrawal, then we will treat
the partial withdrawal as a total withdrawal of the
Contract Value.
SUSPENSION OF PAYMENTS We may defer the right of withdrawal from, or postpone the
date of payments from, the variable Investment Accounts
for any period when: (1) the New York Stock Exchange is
closed (other than customary weekend and holiday
closings); (2) trading on the New York Stock Exchange is
restricted; (3) an emergency exists as a result of which
disposal of securities held in the Variable Account is not
reasonably practicable or it is not reasonably practicable
to determine the value of the Variable Account's net
assets; or (4) the Securities and Exchange Commission, by
order, so permits for the protection of security holders;
provided that applicable rules and regulations of the
Securities and Exchange Commission
VENTURE-L.11-NY 9 SAMPLE
shall govern as to whether the conditions described in (2)
and (3) exist.
WITHDRAWAL CHARGE If a withdrawal is made from the Contract we may assess a
Withdrawal Charge against Payments. The amount of the
Withdrawal Charge and when it is assessed is discussed
below.
(a) A Free Withdrawal Amount may be withdrawn free of a
Withdrawal Charge. The Free Withdrawal Amount is the
greater of:
(i) Earnings, which for purposes of these Withdrawal
Charge provisions, means the excess of the
Contract Value on the date of withdrawal over
the unliquidated Payments; or
(ii) the excess of a. over b. where
a. equals 10% times the total Payments;
and
b. equals 100% of all prior partial
withdrawals in that Contract Year.
(b) Amounts will be withdrawn from the Contract in the
following order for purposes of calculating the
Withdrawal Charge:
(i) Earnings; then
(ii) any Free Withdrawal Amount in excess of
Earnings; then
(iii) Payments not previously liquidated, in the
order such Payments were received.
(c) Payments are liquidated when the Withdrawal Amount
exceeds Earnings. The amount of Payments liquidated
equals
(i) the lesser of the Withdrawal Amount or the total
unliquidated Payments; minus
(ii) Earnings.
(d) A total withdrawal will liquidate all unliquidated
Payments. Any Payments liquidated may be subject to a
Withdrawal Charge based on the length of time the
Payment has been in the Contract. The Withdrawal
Charge is determined by multiplying the amount of the
Payment being liquidated by the applicable Withdrawal
Charge percentage obtained from the table shown on
the Specifications Pages.
(e) The total Withdrawal Charge will be the sum of the
Withdrawal Charges for the Payments being liquidated.
WAIVER OF WITHDRAWAL CHARGE A Withdrawal Charge is not applied if the withdrawal is:
(a) payment of the Death Benefit; or
(b) due to the application of the Contract Value to an
Annuity Option; or
(c) taken at the Maturity Date of the Contract; or
(d) a distribution required to satisfy Federal Income Tax
minimum distribution requirements that apply to this
Contract; or
(e) a withdrawal guaranteed under certain riders attached
to the Contract, as specified in the rider.
VENTURE-L.11-NY 10 SAMPLE
PART 8 DEATH BENEFITS
DEATH BENEFIT BEFORE ANNUITY Prior to the Maturity Date or Annuity Commencement Date,
COMMENCEMENT DATE if earlier, we will determine the Death Benefit as of the
date on which written notice and proof of death and all
required claim forms are received in Good Order at the
Company's Annuities Service Center as follows:
The Death Benefit will be determined as the greater of the
Contract Value or the Guaranteed Minimum Death Benefit.
The Guaranteed Minimum Death Benefit is the sum of all
Payments made, less any amount deducted in connection with
partial withdrawals. For purposes of calculating the
Guaranteed Minimum Death Benefit, the amount deducted in
connection with partial withdrawals will be equal to (i)
times (ii), where (i) is equal to the Guaranteed Minimum
Death Benefit prior to the withdrawal, and (ii) is equal
to the amount of the partial withdrawal divided by the
Contract Value prior to the partial withdrawal.
We will permit the Owner to limit the Death Benefit
option(s) to be offered any named Beneficiary, if the
Owner provides written notice to the Company prior to
death and the desired option(s) is one provided for in
this Contract.
Death benefit distributions prior to the Annuity
Commencement Date are governed by Internal Revenue Code
Section 72(s). Pursuant to Section 72(s) any reference in
this provision to "spouse" means a spouse as defined in
federal law.
DEATH OF ANNUITANT: On the death of the last surviving
Annuitant, the Owner becomes the new Annuitant, if the
Owner is an individual. If the Owner is not an individual
the death of any Annuitant is treated as the death of an
Owner and the Death Benefit will be determined by
substituting the Annuitant for the Owner as described
below.
DEATH OF OWNER: We will pay the Death Benefit to the
Beneficiary if any Owner dies prior to the Maturity Date
or Annuity Commencement Date, if earlier. The Death
Benefit may be taken in one sum immediately, in which case
the Contract will terminate. If the Death Benefit is not
taken in one sum immediately, the Contract will continue
subject to the following provisions:
(a) The Beneficiary becomes the Owner.
(b) The excess, if any, of the Death Benefit over the
Contract Value will be allocated to and among the
Investment Accounts in proportion to their values as
of the date on which the Death Benefit is determined.
(c) No additional Payments may be applied to the
Contract.
(d) If the Beneficiary is not the deceased Owner's
spouse, the entire interest in the Contract must be
distributed under one of the following options:
(i) The entire interest in the Contract must be
distributed over the life of the Beneficiary, or
over a period not extending beyond the life
expectancy of the Beneficiary, with
distributions beginning within one year of the
Owner's death; or
VENTURE-L.11-NY 11 SAMPLE
(ii) the entire interest in the Contract must be
distributed within 5 years of the Owner's Death,
or
(iii) as Annuity Payments under one of the options
described in the Annuity Options section.
If the Beneficiary dies before the distributions
required by (i) or (ii) are complete, the entire
remaining Contract Value must be distributed in a
lump sum immediately.
(e) If the Beneficiary is the deceased Owner's spouse,
the Contract will continue with the surviving spouse
as the new Owner, subject to the provisions of
Internal Revenue Code Section 72(s). The surviving
spouse may name a new Beneficiary (and, if no
Beneficiary is so named, the surviving spouse's
estate will be the Beneficiary).
The spouse may also elect distributions under one of
the following options:
(i) the entire interest in the Contract may be
distributed over the life of the Beneficiary, or
over a period not extending beyond the life
expectancy of the Beneficiary, with
distributions beginning within one year of the
Owner's death; or
(ii) as Annuity Payments under one of the options
described in the Annuity Options section.
(f) We will waive Withdrawal Charges on any withdrawals.
If there is more than one Beneficiary, the foregoing
provisions will independently apply to each Beneficiary,
to the extent of that Beneficiary's share.
DEATH BENEFIT ON OR AFTER ANNUITY If Annuity Payments have been selected based on an Annuity
COMMENCEMENT DATE Option providing for payments for a guaranteed period, and
the Annuitant dies on or after the Annuity Commencement
Date, we will make the remaining guaranteed payments to
the Beneficiary. Any remaining payments will be made at
least as rapidly as under the method of distribution being
used as of the date of the Annuitant's death. If no
Beneficiary is living, we will commute any unpaid
guaranteed payments to a single sum (on the basis of the
interest rate used in determining the payments) and pay
that single sum to the estate of the last to die of the
Annuitant and the Beneficiary.
PROOF OF DEATH We will require Proof of death upon the death of the
Annuitant or the Owner. Proof of death is one of the
following received at the Annuities Service Center:
(a) A certified copy of a death certificate;
(b) A certified copy of a decree of a court of competent
jurisdiction as to the finding of death; or
(c) Any other proof satisfactory to us.
VENTURE-L.11-NY 12 SAMPLE
PART 9 CONTRACT MATURITY
CHANGE IN MATURITY DATE Prior to the Maturity Date, an Owner may make a Written
Request to change the Maturity Date. Any extension of the
Maturity Date will be subject to our prior approval and
any applicable law or regulation then in effect.
OPTIONS AT MATURITY DATE We will send You information about Your available options
prior to the Maturity Date. If by the Maturity Date, you
do not choose an Annuity Option, make a total withdrawal
of the Surrender Value, or ask us to change the Maturity
Date, we will automatically pay you Annuity Payments under
the Annuity Option shown on the Specifications Pages and
the Annuity Commencement Date is considered to be the
Maturity Date.
We will provide variable Annuity Payments unless
otherwise elected. You can change the Annuity Option at
any time before the Annuity Commencement Date.
PART 10 ANNUITY PAYMENTS
GENERAL The entire Contract Value or the entire amount of the
Beneficiary's portion of the Death Benefit may be applied
in accordance with one or more of the Annuity Options
described below, subject to any restrictions of Internal
Revenue Code section 72(s). Once Annuity Payments
commence, the Annuity Option may not be changed. The "Life
10-Year Certain" Annuity Option described under Part 11,
Option 1 is the default Annuity Option unless you request
another option on or prior to the Maturity Date or unless
otherwise required by the Internal Revenue Code.
You may select a Fixed or Variable Annuity. We will
provide variable Annuity Payments unless otherwise
elected. Once Annuity Payments commence, the Annuity
Option may not be changed.
The method used to calculate the amount of the initial and
subsequent Annuity Payments is described below.
We may pay the Contract Value or Death Benefit, on the
Annuity Commencement Date in one lump sum if the
corresponding monthly income is less than $20.
VARIABLE ANNUITY PAYMENTS We will determine the amount of the first Variable Annuity
Payment by applying the portion of the Contract Value used
to effect a Variable Annuity (minus any applicable premium
taxes) to the Annuity Option elected based on the
mortality table and assumed interest rate shown in the
Specifications Pages. We will provide a table of the
annuity factors upon Written Request. If the current rates
in use by us on the Annuity Commencement Date are more
favorable to you, we will use the current rates. The
portion of the Contract Value used to effect a Variable
Annuity will be measured as of a date not more than 10
business days prior to the Annuity Commencement Date.
VENTURE-L.11-NY 13 SAMPLE
Subsequent payments will be based on the investment
performance of one or more Subaccounts as you select. The
amount of such payments is determined by the number of
Annuity Units credited for each Subaccount. Such number is
determined by dividing the portion of the first payment
allocated to that Subaccount by the Annuity Unit value for
that Subaccount determined as of the same date that the
Contract Value used to effect Annuity Payments was
determined. We then multiply this number of Annuity Units
for each Subaccount by the appropriate Annuity Unit value
for each subsequent determination date, which is a
uniformly applied date not more than 10 business days
before the payment is due.
Variable Annuity payments, at the time of their
commencement, will not be less than those that would be
provided by the application of the amount described below
to purchase a single premium immediate annuity then
offered to the same class of annuitants by us or a company
affiliated with us. Since no such annuity currently
exists, we will apply rates that are reasonable in
relation to the market single premium immediate annuity
rates. The amount applied would be equal to the greater
of;
(a) the Contract Value less applicable Withdrawal
Charges; or
(b) 95% of the Contract Value.
MORTALITY AND EXPENSE GUARANTEE We guarantee that the dollar amount of each Variable
Annuity payment will not be affected by changes in
mortality and expense experience.
ANNUITY UNIT VALUE The value of an Annuity Unit for each Subaccount for any
Business Day is determined as follows:
(a) The net investment factor for the Subaccount for the
Valuation Period ending on the Business Day for which
the Annuity Unit value is being calculated is
multiplied by the value of the Annuity Unit for the
preceding Business Day; and
(b) The result is adjusted to compensate for the interest
rate used to determine the first Variable Annuity
payment.
The dollar value of Annuity Units may increase, decrease
or remain the same from one Valuation Period to the next.
FIXED ANNUITY PAYMENTS We will determine the amount of each Fixed Annuity payment
by applying the portion of the Contract Value used to
effect a Fixed Annuity measured as of a date not more than
10 business days prior to the Annuity Commencement Date
(minus any applicable premium taxes) to the Annuity Option
elected based on the mortality table and interest rate
shown on the Specifications Pages. The Fixed Annuity
payment will not be less than that available by applying
the amount described below to purchase a single premium
immediate annuity then offered to the same class of
annuitants by us or a company affiliated with us. Such an
amount would be equal to the greater of:
(c) the Contract Value less applicable Withdrawal
Charges; or
(d) 95% of the Contract Value.
We guarantee the dollar amount of Fixed Annuity payments.
VENTURE-L.11-NY 14 SAMPLE
PART 11 ANNUITY OPTIONS
DESCRIPTION OF ANNUITY OPTIONS Option 1: Life Annuity
a) Life Non-Refund. We will make Annuity Payments during
the lifetime of the Annuitant. No payments are due
after the death of the Annuitant.
b) Life with 10-Year Certain. We will make Annuity
Payments for 10 years and after that during the
lifetime of the Annuitant. No payments are due after
the death of the Annuitant or, if later, the end of
the 10-year period.
Option 2: Joint and Survivor Life Annuity
The second Annuitant named shall be referred to as the
Co-Annuitant.
a) Joint and Survivor Non-Refund. We will make Annuity
Payments during the joint lifetime of the Annuitant
and Co-Annuitant. Payments will then continue during
the remaining lifetime of the survivor. No payments
are due after the death of the last survivor of the
Annuitant and Co-Annuitant.
b) Joint and Survivor with 10-Year Certain. We will make
Annuity Payments for 10 years and after that during
the joint lifetime of the Annuitant and Co-Annuitant.
Payments will then continue during the remaining
lifetime of the survivor. No payments are due after
the death of the survivor of the Annuitant and
Co-Annuitant or, if later, the end of the 10-year
period.
ALTERNATE ANNUITY OPTIONS Instead of settlement in accordance with the Annuity
Options described above, you may choose an alternate form
of settlement acceptable to us. Once Annuity Payments
commence, the form of settlement may not be changed.
PART 12 GENERAL PROVISIONS
ENTIRE CONTRACT The entire Contract consists of this Contract,
Endorsements and Riders, if any, and the application, if
one is attached to this Contract.
BENEFITS AND VALUES The benefits and values available under this Contract are
not less than the minimum required by any statute of the
state in which this Contract is delivered. We have filed a
detailed statement of the method used to calculate the
benefits and values with the Department of Insurance in
the state in which this Contract is delivered, if required
by law.
MODIFICATION Only the President, a Vice President, or the Secretary of
the Company has authority to agree on our behalf to any
alteration of the Contract or to any waiver of our rights
or requirements. The change or waiver must be in writing.
We will not change or modify this Contract without prior
approval of the New York Superintendent of Insurance. No
change that reduces benefits will be made without your
written consent.
VENTURE-L.11-NY 15 SAMPLE
CLAIMS OF CREDITORS All benefits and payments under this Contract shall be
exempt from the claims of creditors to the extent
permitted by law.
MISSTATEMENT AND PROOF OF AGE We may require proof of age or survival of any person upon
OR SURVIVAL whose age or survival any Annuity Payments or other
benefits provided by this Contract or any Rider attached
thereof depend. If the age of the Annuitant has been
misstated, the benefits will be those which would have
been provided for the correct age. If we have made
incorrect benefit payments, we will immediately pay the
amount of any underpayment adjusted with interest at 3%
per annum. We will deduct the amount of any overpayment
from future benefit payments without adjustment for
interest.
INCONTESTABILITY This Contract is not contestable.
NON-PARTICIPATING Your Contract is non-participating and will not share in
our profits or surplus earnings. We will pay no dividends
on your Contract.
REPORTS We provide periodic reports no less frequently than
annually without charge, containing the Investment Account
Value, the Contract Value and Death Benefit. The report
will include the number of Accumulation Units credited to
the Variable Account, the Accumulation Unit value and the
dollar value of the Accumulation Unit of the Variable
Account no more than 4 months prior to the date of the
delivery of the report. We will provide annual calendar
year reports concerning the status of the Contract and
such information concerning required minimum distributions
as is prescribed by the Commissioner of Internal Revenue.
We will provide additional status reports upon request for
a charge not to exceed $25 per request.
CURRENCY AND PLACE OF PAYMENTS All payments made to or by us shall be made in the lawful
currency of the United States of America at the Annuities
Service Center or elsewhere if we consent.
NOTICES AND ELECTIONS To be effective, all notices and elections you make under
this Contract must be in the form of a Written Request.
All notices, requests and elections will be effective when
signed. We will not be liable for any payments made or
actions taken before the Written Request is received by
us.
GOVERNING LAW This Contract will be governed by the laws of the
jurisdiction indicated on the Specifications Pages.
SECTION 72(S) The provisions of this Contract shall be interpreted so as
to comply with the requirements of Section 72(s) of the
Internal Revenue Code.
VENTURE-L.11-NY 16 SAMPLE
PART 13 CONTRACT TERMINATION
CANCELLATION FOR NONPAYMENT & If, prior to the Annuity Commencement Date, no Payments
MINIMUM ACCOUNT VALUE have been made for two consecutive Contract Years, and if
both:
(a) the total Payments made, less any partial
withdrawals, are less then $2,000; and
(b) the Contract Value at the end of such two year period
is less than $2,000;
we may cancel this Contract and pay you the Contract
Value (measured as of the Valuation Period during which
the cancellation occurs), less the Annual Contract Fee.
OTHER This Contract will terminate on the earliest of:
(a) receipt of your request to withdraw the entire
Contract Value;
(b) the date a Death Benefit is payable and the
Beneficiary takes the Death Benefit as a lump sum; or
(c) the date the Contract Value reduces to zero, subject
to the provisions of any benefit rider attached to
this Contract.
VENTURE-L.11-NY 17 SAMPLE
XXXX XXXXXXX LIFE INSURANCE COMPANY OF NEW YORK (XXXX XXXXXXX(R) LOGO)
HOME OFFICE: Valhalla, New York
VENTURE-L.11-NY SAMPLE
