Exhibit 99-B.4.1
AETNA LIFE INSURANCE AND ANNUITY COMPANY
Customer Relations Department, PFSD
HOME OFFICE: 000 XXXXXXXXXX XXX.
HARTFORD, CONNECTICUT 06156
000-000-0000
Herein called Aetna
Agrees to pay the benefits stated in this Contract.
THE VARIABLE FEATURES OF THIS CONTRACT ARE DESCRIBED IN PARTS III AND IV.
RIGHT TO CANCEL
The Contract Holder may cancel this Contract within 10 days of receiving it
by returning this Contract along with a written notice to Aetna at the above
address or to the agent from whom it was purchased. Within 7 days after it
receives the notice of cancellation and this Contract at its Home Office,
Aetna will return the entire consideration paid plus any increase or minus
any decrease in the cash value of any funds allocated to the Separate
Account.
This page, the following pages, and the application make up the entire
Contract.
Signed at the Home Office on the Effective Date.
/s/ Xxxxxx X. Xxxxxxx /s/ Xxxx X. Xxxxxxx
SECRETARY PRESIDENT
GROUP VARIABLE, FIXED, OR COMBINATION ANNUITY CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT.
39355
CAT. 70123
G-CDA-HF PRINTED IN U.S.A.
SPECIFICATIONS
PLAN
TYPE OF PLAN
CONTRACT HOLDER
GROUP CONTRACT NO.
EFFECTIVE DATE
THIS CONTRACT IS DELIVERED IN
AND IS SUBJECT TO THE LAWS OF THAT JURISDICTION
Guaranteed Interest Rate -- There are guaranteed interest rates for amounts
held in the General Account. (See 3.03(c) and 3.04.)
Surrender Fee -- There will be a charge deducted for early surrender. (See
Part V.)
Deductions from the Separate Account -- There will be deductions for
mortality and expense risks and administrative fees. (See 3.08.)
Deduction from Purchase Payment(s) -- Purchase Payment(s) are subject to a
deduction for premium taxes, if any. (See 3.01.)
This Contract is a legal contract and constitutes the entire legal
relationship between Aetna and the Contract Holder.
READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of
the rights and obligations of both you and Aetna. IT IS, THEREFORE,
IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY.
2
TABLE OF CONTENTS
I. GENERAL DEFINITIONS
PAGE
1.01 Annuitant....................................................... 5
1.02 Annuity......................................................... 5
1.03 Fixed Account................................................... 5
1.04 Fixed Annuity................................................... 5
1.05 Fund(s)......................................................... 5
1.06 General Account................................................. 5
1.07 Guaranteed Accumulation Account................................. 5
1.08 Participant..................................................... 5
1.09 Plan............................................................ 5
1.10 Purchase Payments............................................... 5
1.11 Separate Account................................................ 5
1.12 Valuation Period................................................ 5
1.13 Variable Annuity................................................ 5
II. GENERAL PROVISIONS
2.01 Change of Contract.............................................. 6
2.02 Change of Fund(s)............................................... 6
2.03 Non-participating Contract...................................... 6
2.04 Payments........................................................ 6
2.05 State Laws...................................................... 6
2.06 Control of Contract............................................. 6
2.07 Designation of Beneficiary...................................... 7
2.08 Misstatements and Adjustments................................... 7
2.09 Incontestability................................................ 7
2.10 Grace Period.................................................... 7
2.11 Individual Certificates......................................... 7
III. PURCHASE PAYMENT, CURRENT VALUE, AND SURRENDER PROVISIONS
3.01 Net Purchase Payment(s)......................................... 8
3.02 Individual Accounts............................................. 8
3.03 Guaranteed Accumulation Account (GA Account).................... 8
3.04 Guaranteed Interest Rate -- Fixed Account....................... 9
3.05 Experience Credits.............................................. 9
3.06 Maintenance Fee................................................. 10
3.07 Fund(s) Record Units -- Separate Account........................ 10
3.08 Net Return Factor(s) -- Separate Account........................ 10
3.09 Fund(s) Record Unit Value -- Separate Account................... 10
3.10 Current Value................................................... 10
3.11 Transfer of Current Value from the Funds or GA Account.......... 10
3.12 Transfer of Current Value from the Fixed Account................ 11
3.13 Notice to the Contract Holder................................... 11
3.14 Sum Payable at Death (Before Annuity Payments Start)............ 11
3.15 Surrender Value................................................. 11
3.16 Payment of Surrender Value...................................... 11
3.17 Reinstatement................................................... 11
3
IV. ANNUITY PROVISIONS
4.01 Choices to be Made.............................................. 13
4.02 Terms of Annuity Options........................................ 13
4.03 Death of Annuitant/Beneficiary.................................. 13
4.04 Fund(s) Annuity Units -- Separate Account....................... 14
4.05 Fund(s) Annuity Unit Value -- Separate Account.................. 14
4.06 Annuity Options................................................. 14
V. SPECIAL PROVISIONS
5.01 Deferred Compensation Plan...................................... 23
5.02 Allocated Pension or Profit Sharing Plan........................ 24
5.03 Unallocated Pension or Profit Sharing Plan...................... 25
5.04 Tax Deferred Annuity Plan....................................... 26
5.05 Tax Deferred Annuity Plan (ERISA)............................... 28
VI. FEE SCHEDULE
6.01 Maintenance Fee................................................. 31
6.02 Surrender Fee................................................... 31
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I. GENERAL DEFINITIONS
1.01. ANNUITANT -- A person on whose life an An-nuity has been effected
under this Contract.
1.02. ANNUITY -- Payment of an income:
(a) For the life of one or two persons;
(b) For a stated period; or
(c) For some combination of (a) and (b).
1.03. FIXED ACCOUNT -- An accumulation option with a guaranteed minimum
interest rate. Aetna may credit a higher rate which is not
guaranteed.
1.04. FIXED ANNUITY -- An Annuity with payments which do not vary in amount.
1.05. FUND(S) -- The open-end registered management investment companies
(mutual funds) made available by Aetna under this Contract.
1.06. GENERAL ACCOUNT -- The Account holding the assets of Aetna, other
than those assets held in the Separate Account.
1.07. GUARANTEED ACCUMULATION ACCOUNT -- An accumulation option which
guarantees a stipulated rate of interest for a specified period of
time.
1.08. PARTICIPANT -- A person who participates in the Plan named on the
Specifications page of this Contract.
1.09. PLAN -- The Plan named on the Specifications page. The Plan is not a
part of the Contract. Aetna is not bound by the terms of the Plan.
1.10. PURCHASE PAYMENTS -- Payments made to Aetna.
1.11. SEPARATE ACCOUNT -- An account set up by Aetna under the Connecticut
Insurance Laws which purchase shares of the Fund(s).
1.12. VALUATION PERIOD (PERIOD) -- The period of time from the end of one
business day on the New York Stock Exchange to the end of the next
business day.
1.13. VARIABLE ANNUITY -- An Annuity with payments which vary with the net
investment results of a Separate Account.
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II. GENERAL PROVISIONS
2.01. CHANGE OF CONTRACT: Only an authorized officer of Aetna may change
the terms of this Contract. Aetna will notify the Contract Holder in
writing at least 30 days before the effective date of any change. Any
change will not affect the amount or terms of any Annuity which begins
before the change.
Any change that affects the following provisions of this Contract will
not apply to any individual participating under this Contract before
the effective date of change:
(a) Net Purchase Payment(s)
(b) Guaranteed GA Account Interest Rate
(c) Guaranteed Interest Rate -- Fixed Account
(d) Net Return Factor(s) -- Separate Account
(e) Current Value
(f) Surrender Value
(g) Fund(s) Annuity Unit Value -- Separate Account
Any change that affects the Annuity Options and the tables for the
Options can only be made:
(1) No earlier than 12 months after the Effective Date of this
Contract; and
(2) No earlier than 12 months after the effective date of any such
prior change.
New Participants covered under this Contract on or after the effective
date of any change will be subject to the change. If the Contract
Holder does not agree to any change under this provision, no new
Participants will be covered under this Contract. Aetna will continue
to accept Purchase Pay-ments for the Participants covered under this
Contract before the change. This Contract may also be changed as
required by federal or state law.
2.02. CHANGE OF FUND(S): Aetna, or the Separate Account, may:
(a) Change the Fund(s) which may be invested in by the Separate
Account; and
(b) Replace the shares of any Fund(s) held in the Separate Account
with shares of any other Fund(s).
Changes must be:
(1) Approved by a majority vote of persons having an interest in the
Separate Account and the Fund(s);
(2) Deemed necessary by Aetna under the Investment Company Act of
1940; or
(3) Deemed necessary by Aetna to accomplish the purpose of the
Separate Account.
Aetna will notify the Contract Holder of any change.
2.03. NONPARTICIPATING CONTRACT: The Contract Holder, Participants, or
beneficiaries will not have a right to share in the earnings of Aetna.
2.04. PAYMENTS: Aetna will make Annuity payments as and when due. Aetna
will make other payments within 7 days of receipt at its Home Office
of a written claim for payment which is in good order, except as
provided in 3.16.
2.05. STATE LAWS: This Contract complies with the laws of the state in
which it is delivered. Any cash, death, or Annuity payments are equal
to or greater than the minimum required by such laws. Annuity tables
for legal reserve valuation shall be as required by state law. Such
tables may be different from Annuity tables used to determine Annuity
payments.
2.06. CONTROL OF CONTRACT: See Part V.
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2.07. DESIGNATION OF BENEFICIARY: See Part V. The beneficiary may be
changed at any time.
2.08. MISSTATEMENTS AND ADJUSTMENTS: If Aetna finds the age of any payee to
be misstated, the correct facts will be used to adjust payments.
2.09. INCONTESTABILITY: Aetna cannot cancel the Contract because of any
error of fact on the application.
2.10. GRACE PERIOD: This Contract will remain in effect even if Purchase
Payments are not continued.
2.11. INDIVIDUAL CERTIFICATES: Aetna shall issue certificates to the
Contract Holder or Participants as required by the state in which this
Contract is delivered. The certificate will summarize certain
provisions of the Contract. Certificates are for information only and
are not a part of the Contract.
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III. PURCHASE PAYMENT, CURRENT
VALUE, AND SURRENDER PROVISIONS
3.01. NET PURCHASE PAYMENT(S): The actual Purchase Payment less any
premium tax. As a rule, Aetna will deduct the premium tax when
Annuity benefits are purchased (see Part IV). If Aetna determines
that it must pay a premium tax when Purchase Payments are received or
at any other time, it will deduct the tax at that time.
The Net Purchase Payment(s) will be credited among:
(a) The Fixed Account;
(b) The Guaranteed Accumulation Account; and
(c) The Fund(s) in which the Separate Account invests.
Aetna must be told the percentage of the Net Purchase Payment(s) to be
applied to each investment above.
During any calendar year, Aetna may be told to change the investment
mix four times. If additional changes are allowed, each may be subject
to a fee of up to $10.
3.02. INDIVIDUAL ACCOUNTS: See Part V.
3.03. GUARANTEED ACCUMULATION ACCOUNT (GA ACCOUNT): An accumulation option
which guarantees a stipulated rate of interest for a specified period
of time (see (c) below). Amounts withdrawn before the end of the
Guaranteed Term may be subject to a Market Value Adjustment (see (f)
below).
(a) Guaranteed Deposit Period (Deposit Period) -- The period of time,
usually a calendar month during which Net Purchase Payment(s) are
accepted in the GA Account for a Guaranteed Term.
(b) Guaranteed Term (Term) -- A period of time, including the Deposit
Period, for which interest rates are guaranteed on the Net
Purchase Payment made to the GA Account. The Term may vary for
each Purchase Payment and will be from approximately 1 to 5 years
from the date the Deposit Period ends.
(c) Guaranteed GA Account Interest Rates (Guaranteed Rates ) -- An
interest rate will be declared at the start of a Deposit Period
and guaranteed by Aetna for a Term; this interest rate will never
be less than 4%. Aetna will add interest daily. Aetna may
declare higher interim Guaranteed Rates for:
(1) The Deposit Period and 12 months following the close of a
Deposit Period; and
(2) Any subsequent 12-month period until the end of the Term. The
last period of the Term may be from 10-12 months.
(d) Withdrawals -- Amounts withdrawn from the GA Account before the
end of the Term may be subject to a Market Value Adjustment (see
(f) below). Withdrawals will be made from the Term with the oldest
Deposit Period. During the Deposit Period and the 90 days
following the close of the Deposit Period, any amounts applied to
the GA Account during that Deposit Period may not be withdrawn
unless due to:
(1) A surrender; or
(2) To pay a premium for an Annuity Option.
(e) Reinvestment -- At least 18 days before the end of a Term, the
Contract Holder will be mailed a notice of the next available
Guaranteed Rates and Term. Amounts may be withdrawn from the
ending Term on its final day without Market Value Adjustment.
Aetna must receive written notice of such election at its Home
Office at
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least three (3) business days before the end of the Term.
Otherwise, amounts in the ending Term will be added to the new
Term and will be subject to the new Guaranteed Rates. If this
Contract is issued under a Tax Deferred Annuity Plan (see
Specifications page), the above notice will be sent to the
Participant(s).
(f) Market Value Adjustment -- There will be a Market Value Adjustment
for a withdrawal from the GA Account before the end of a Term when
due to:
(1) A transfer;
(2) A surrender; or
(3) A payment of an Annuity premium for Annuity Option 2.
The amount of the withdrawal will be adjusted to a market value amount
as described below. The market value amount will be equal to the
amount withdrawn multiplied by the following ratio:
x
-----
365
(1 + i)
---------------
x
-----
365
(1 + j)
Where:
- i is the Deposit Period Yield;
- j is the Current Yield; and
- x is the number of days from the Wednesday of the week of
withdrawal to the last day of the Term.
The Deposit Period Yield will be determined as follows:
- At the close of the last business day of each week of the
Deposit Period, a yield will be computed as the average of the
yields on that day of U.S. Treasury Notes which mature in the
last quarter of the Term.
- The Deposit Period Yield is then the average of those yields
for the Deposit period. If withdrawal is made prior to the
close of the Deposit Period, it is the average of those yields
on each week preceding withdrawal.
The Current Yield is the average of the yields on the last business
day of the week preceding withdrawal on the same U.S. Treasury Notes
included in the Deposit Period Yield.
In the event that no U.S. Treasury Notes exist which mature in the
last quarter of the Term, Aetna reserves the right to use the next
available U.S. Treasury Notes that mature in the following quarter.
There will be no Market Value Adjustment for withdrawals made to:
- Satisfy the terms of the Sum Payable at Death provision; or
- Pay a premium for Annuity Options 3 or 4.
Aetna may make any change that affects the Market Value Adjustment
with at least 30 days advance written notice to the Contract Holder.
Any such change shall become effective for any new Term and for any
present or future Participant.
3.04. GUARANTEED INTEREST RATE -- FIXED ACCOUNT: On any Net Purchase
Payment(s) made to the Fixed Account, Aetna will add interest daily at
any annual rate no less than 4%. Aetna may add interest daily at any
higher rate determined by its Board of Directors.
3.05. EXPERIENCE CREDITS: Aetna may apply Experience Credits under this
Contract. Any such Credit will be computed as decided by Aetna.
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3.06. MAINTENANCE FEE: See Part V.
3.07. FUND(S) RECORD UNITS -- SEPARATE ACCOUNT: The portion of the Net
Purchase Payment(s) applied to the Separate Account will determine the
number of Fund(s) Record Units. This number is equal to the Net
Purchase Payment applied to the Fund divided by the Fund Record Unit
Value (see 3.09) for the Valuation Period in which the Purchase
Payment is received in good order.
3.08. NET RETURN FACTOR(S) -- SEPARATE ACCOUNT: The Net Return Factors are
used to compute all Separate Account values and payments for any Fund.
The Net Return Factor for each Fund is equal to 1.0000000 plus the Net
Return Rate.
The Net Return Rate is equal to:
(a) The value of the shares of the Fund held by the Separate Account
at the end of a Valuation Period; minus
(b) The value of the shares of the Fund held by the Separate Account
at the start of the Valuation Period; plus or minus
(c) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(d) The total value of the Fund Record Units and Fund Annuity Units of
the Separate Account (see 3.09 and 4.05) at the start of the
Valuation Period; minus
(e) A daily actuarial charge at an annual rate of 1.25% for Annuity
mortality and expense risks and profit and a daily administrative
charge which will not exceed .25% on an annual basis.
A Net Return Rate may be more or less than 0.
The value of a share of the Fund is equal to the net assets of the
Fund divided by the number of shares outstanding.
The administrative charge may be changed annually except for amounts
which have been used to purchase an Annuity. This charge will not
exceed .25%.
3.09. FUND(S) RECORD UNIT VALUE -- SEPARATE ACCOUNT: A Fund(s) Record Unit
Value is computed by multiplying the Net Return Factor for the current
Valuation Period by the Fund(s) Record Unit Value for the previous
Period. The dollar value of a Fund(s) Record Unit, Separate Account
assets, and Variable Annuity payments may go up or down due to
investment gain or loss.
3.10. CURRENT VALUE: The Current Value (See Part V) is equal to:
(a) Any amounts in the Fixed Account, including Fixed Account interest
added by Aetna; plus
(b) Any amounts in the GA Account, including GA Account interest added
by Aetna; plus
(c) The sum of any Separate Account Record Unit value(s); plus
(d) Any amount due to Experience Credits; less
(e) Any Maintenance Fee(s) due.
Current Value does not include amounts used to purchase an Annuity.
3.11. TRANSFER OF CURRENT VALUE FROM THE FUNDS OR GA ACCOUNT: Before an
Annuity Option is elected, all or any portion of the Current Value may
be transferred from any Fund to any other
10
Fund, to the Fixed Account, or to the GA Account's current Deposit
Period. Any portion of the Current Value in the GA Account may be
transferred to any Fund or to the Fixed Account. Transfers from the
GA Account are subject to the Withdrawal and Market Value Adjustment
provisions. (See 3.03)
Four transfers of Current Value (excluding transfers from the GA
Account at the end of a Guaranteed Term) can be made during a calendar
year period. If additional transfers are allowed, each may be subject
to a fee of up to $10.
3.12. TRANSFER OF CURRENT VALUE FROM THE FIXED ACCOUNT: 10% of the Current
Value held in the Fixed Account may be transferred to any Fund(s) or
to the GA Account's current Deposit Period. Such transfer will be:
(a) Without charge;
(b) Allowed once per calendar year; and
(c) Not allowed under an Annuity Option.
Aetna may, on a temporary basis, allow any larger percent to be
transferred.
The Current Value of the Fixed Account, as used above, is the value
when the request is received at the Home Office of Aetna.
3.13. NOTICE TO THE CONTRACT HOLDER: Aetna will notify the Contract Holder
each year of:
(a) The Value of any amounts held in:
(1) The Fixed Account;
(2) The GA Account; and
(3) The Fund(s) for the Separate Ac-count; and
(b) The number of any Fund(s) Record Units; and
(c) The Fund(s) Record Unit Value(s).
Such number or values will be as of a date no more than 60 days before
the date of the notice.
If this Contract is issued for a Tax Deferred Annuity Plan, the above
notice will be sent to each Participant.
3.14. SUM PAYABLE AT DEATH (BEFORE ANNUITY PAYMENTS START): See Part V.
3.15. SURRENDER VALUE: See Part V.
3.16. PAYMENT OF SURRENDER VALUE: Under certain emergency conditions, Aetna
may defer payment;
(a) For a period of up to 6 months (unless not allowed by state law);
or
(b) As provided by federal law.
Aetna may pay any Fixed Account Surrender Value with interest in equal
payments over a period not to exceed 60 months when the amounts held
in the Fixed Account under this Contract exceed $500,000. This will
apply only if the sum of the amounts surrendered within the past 12
months exceeds 20% of such Fixed Account amount.
Interest, as used above, will not be more than two percentage points
below any rate determined prospectively by the Board of Directors for
this class of Contract. In no event, will the interest rate be less
than 4%.
3.17. REINSTATEMENT: All or a portion of the proceeds of a full surrender
of this Contract may be reinvested within 30 days after the surrender
if allowed by law. Any Maintenance Fee and Surrender Fee charged a
the time of surrender on the amount being reinvested will be included
in the reinstate-
11
ment. Any Market Value Adjustment deducted from GA Account surrenders
will not be included in the reinstatement. Amounts will be reinstated
among the Fixed Account, GA Account, and Separate Account in the same
proportion as they were at the time of surrender. Any amounts
reinstated to the GA Account will be credited to the current Deposit
Period. The number of Record Units reinstated will be based on the
Record Unit Value(s) next computed after receipt at Aetna's Home
Office of the reinstatement request and the amount to be reinvested.
Any Maintenance Fee which falls due after the surrender and before the
reinstatement will be deducted from the amount reinstated.
Reinstatement is permitted only once.
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IV. ANNUITY PROVISIONS
4.01. CHOICES TO BE MADE: An Annuity Option may be elected by telling Aetna
to pay all or any portion of the Current Value (minus any premium tax)
as a premium for an Annuity under Option 2, 3, or 4 (see 4.06). The
first Annuity payment must generally be made no later than the first
day of the month following the Annuitant's 75th birthday. Aetna may
be told to make the first Annuity payment during any prior month.
When an Option is chosen, Aetna must also be told if payments are to
be made other than monthly and to pay:
(a) A Fixed Annuity using the General Account;
(b) A Variable Annuity using any of the Fund(s) made available by
Aetna for Annuity purposes; or
(c) A combination of (a) and (b).
If a Fixed Annuity is chosen, Aetna will add interest daily at an
annual rate no less than 3.5%. Aetna may add interest daily at any
higher rate.
If a Variable Annuity is chosen, an Assumed Annual Net Return Rate of
5% may be chosen. If not chosen, Aetna will use an Assumed Annual Net
Return Rate of 3.5%.
4.02. TERMS OF ANNUITY OPTIONS:
(a) When payments start, the age of the Annuitant plus the number of
years for which payments are guaranteed must not exceed 95.
(b) The present value of the expected payments to the Annuitant when
payments start shall be more than 50% of the present value of the
total expected payments to be made; this restriction does not
apply if Option 4 is chosen and the second Annuitant is the spouse
of the Annuitant.
(c) No choice of any Annuity Option may be made if the first payment
would be less than $20 or if the total payments in a year would be
less than $100.
(d) If a Fixed Annuity under Option 2, 3 or 4 is chosen and a larger
payment would result from applying the Surrender Value to a
current Aetna single premium immediate annuity, Aetna will make
the larger payment.
(e) Age, where used in the following tables, means age on the birthday
closest to the date of the first payment.
The Annuity rates for Options 3 and 4 are based on mortality from
1983 Table a. The Annuity rates do not differ by sex.
(f) Assumed Annual Net Return Rate is the interest rate used to
determine the amount of the first Annuity payment under a Variable
Annuity. The Separate Account must earn this rate plus enough to
cover the mortality and expense risk and administrative fee
charges if future Variable Annuity payments are to remain level.
4.03. DEATH OF ANNUITANT/BENEFICIARY: When an Annuitant dies under Options 2
and 3, the present value of any remaining guaranteed payments will be
paid in one sum to the beneficiary, or upon election by the
beneficiary, any remaining payments will continue to the beneficiary.
If no beneficiary exists, the present value of any remaining
guaranteed payments will be paid in one sum to the estate of the
Annuitant.
If a beneficiary dies while under Option 1 or while receiving Annuity
payments, the present value of any remaining payments will be paid in
one sum to the estate of the beneficiary. The interest rate used to
determine the first payment will be used to calculate the present
value.
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4.04. FUND(S) ANNUITY UNITS -- SEPARATE ACCOUNT: The number of Fund(s)
Annuity Units is based on the amount of the first Variable Annuity
payment which is equal to:
(a) The portion of the Current Value (minus any premium tax) applied
to pay a Variable Annuity; divided by
(b) 1,000; multiplied by
(c) The payment rate for the Option chosen.
Such amount, or portion, of the Variable Payment will be divided by
the appropriate Fund(s) Annuity Unit Value (see 4.05) on the tenth
Valuation Period before the due date of the first payment to determine
the number of each Fund Annuity Units. The number of each Fund
Annuity Units remains fixed. Each future payment is equal to the sum
of the products of each Fund Annuity Unit Value multiplied by the
appropriate number of Units. The Fund Annuity Unit Value on the tenth
Valuation Period prior to the due date of the payment is used.
4.05. FUND(S) ANNUITY UNIT VALUE -- SEPARATE ACCOUNT: For any Valuation
Period, a Fund(s) Annuity Unit Value is equal to:
(a) The Value for the previous Period; multiplied by
(b) The Net Return Factor(s) (see 3.08) for the Period; multiplied by
(c) A factor to reflect the Assumed Annual Net Return Rate.
The factor for 3.5% per year is .9999058; for 5% per year it is
.9998663.
The dollar value of a Fund(s) Annuity Unit Values and payments may go
up or down due to investment gain or loss.
If Variable Annuity payments are not to decrease, Aetna must earn a
gross return on the assets of the Separate Account of:
- 4.75% on an annual basis plus an annual return of up to .25%
needed to offset the administrative charge set at the time
Annuity payments commence if an Assumed Annual Net Return Rate
of 3.5% is chosen; or
- 6.25% on an annual basis plus an annual return of up to .25%
needed to offset the administrative charge set at the time
Annuity payments commence if an Assumed Annual Net Return Rate
of 5% is chosen.
Payments shall not be changed due to changes in the mortality or
expense results or administrative charges.
4.06. ANNUITY OPTIONS:
Option 1 -- Payment of Interest on Sum Left with Aetna -- This Option
may be used only by the beneficiary when the Participant dies before
Aetna has started paying an Annuity. A portion or all of the sum paid
upon death may be held under this Option and will be held in the
General Account of Aetna at interest (see 4.01). The beneficiary may
later tell Aetna to:
(a) Pay a portion or all of the sum held by Aetna; or
(b) Apply a portion or all of the sum held by Aetna to any Annuity
Option below.
Option 2 -- Payments for a Stated Period of Time -- An Annuity will be
paid for the number of years chosen. The number of years must be at
least 3 and not more than 30. This Option can only be elected on a
fixed basis.
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Option 3 -- Life Income -- An Annuity will be paid for the life of the
Annuitant. If also chosen, Aetna will guarantee payments for 60, 120,
180, or 240 months.
Option 4 -- Life Income for Two Payees -- An Annuity will be paid
during the lives of the Annuitant and a second Annuitant. At the
death of either, payments will continue to the survivor. When this
Option is chosen, a choice must be made of:
(a) 100% of the payment to continue to the survivor;
(b) 66 2/3% of the payment to continue to the survivor;
(c) 50% of the payment to continue to the survivor; or
(d) Payments for a minimum of 120 months with 100% of the payment to
continue to the survivor.
Other Options -- Aetna may make other options available as allowed by
the laws of the state in which this Contract is delivered.
15
OPTION 2
PAYMENTS FOR A STATED PERIOD OF TIME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
YEARS OF AMOUNT OF YEARS OF AMOUNT OF YEARS OF AMOUNT OF
PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS
-------- --------- -------- ---------- --------- ---------
3 $29.19 13 $7.94 22 $5.39
4 22.27 14 7.49 23 5.24
5 18.12 15 7.10 24 5.09
6 15.35 16 6.76 25 4.96
7 13.38 17 6.47 26 4.84
8 11.90 18 6.20 27 4.73
9 10.75 19 5.97 28 4.63
10 9.83 20 5.75 29 4.53
11 9.09 21 5.56 30 4.45
12 8.46
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
YEARS OF AMOUNT OF YEARS OF AMOUNT OF YEARS OF AMOUNT OF
PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS
-------- --------- -------- ---------- --------- ---------
3 $29.80 13 $8.64 22 $6.17
4 22.89 14 8.20 23 6.02
5 18.74 15 7.82 24 5.88
6 15.99 16 7.49 25 5.76
7 14.02 17 7.20 26 5.65
8 12.56 18 6.94 27 5.54
9 11.42 19 6.71 28 5.45
10 10.51 20 6.51 29 5.36
11 9.77 21 6.33 30 5.28
12 9.16
16
OPTION 3
LIFE INCOME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
-------------------------------------------------
AGE OF
ANNUITANT NONE 60 120 180 240
--------- ---- ---- ----- ----- -----
50 $4.34 $4.34 $4.31 $4.27 $4.22
51 4.41 4.40 4.38 4.33 4.27
52 4.48 4.47 4.45 4.40 4.32
53 4.56 4.55 4.52 4.46 4.38
54 4.64 4.63 4.59 4.53 4.44
55 4.72 4.71 4.67 4.60 4.50
56 4.81 4.80 4.75 4.67 4.56
57 4.91 4.89 4.84 4.75 4.62
58 5.01 4.99 4.93 4.83 4.69
59 5.12 5.10 5.03 4.92 4.75
60 5.23 5.21 5.13 5.00 4.82
61 5.36 5.33 5.24 5.09 4.88
62 5.49 5.45 5.35 5.19 4.95
63 5.63 5.59 5.47 5.28 5.02
64 5.78 5.73 5.60 5.38 5.08
65 5.94 5.89 5.73 5.48 5.15
66 6.11 6.05 5.87 5.58 5.21
67 6.29 6.22 6.02 5.69 5.27
68 6.49 6.41 6.17 5.79 5.33
69 6.70 6.60 6.33 5.90 5.38
70 6.92 6.81 6.49 6.00 5.43
71 7.17 7.04 6.66 6.10 5.48
72 7.43 7.27 6.84 6.20 5.52
73 7.71 7.53 7.02 6.30 5.55
74 8.02 7.80 7.20 6.39 5.59
75 8.35 8.08 7.38 6.48 5.62
Rate for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
17
OPTION 3
LIFE INCOME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
-------------------------------------------------
AGE OF
ANNUITANT NONE 60 120 180 240
--------- ---- ---- ----- ----- -----
50 $5.26 $5.25 $5.22 $5.17 $5.11
51 5.33 5.32 5.28 5.23 5.15
52 5.40 5.38 5.34 5.29 5.20
53 5.47 5.45 5.41 5.35 5.26
54 5.54 5.53 5.48 5.41 5.31
55 5.63 5.61 5.56 5.47 5.36
56 5.71 5.69 5.63 5.54 5.42
57 5.80 5.78 5.72 5.61 5.47
58 5.90 5.88 5.81 5.69 5.53
59 6.01 5.98 5.90 5.77 5.59
60 6.12 6.09 6.00 5.85 5.65
61 6.24 6.21 6.10 5.93 5.71
62 6.37 6.33 6.21 6.02 5.77
63 6.51 6.46 6.33 6.11 5.83
64 6.66 6.60 6.45 6.20 5.89
65 6.82 6.75 6.57 6.30 5.95
66 6.99 6.91 6.71 6.39 6.01
67 7.17 7.08 6.85 6.49 6.06
68 7.36 7.27 6.99 6.59 6.12
69 7.57 7.46 7.15 6.69 6.17
70 7.80 7.67 7.30 6.78 6.21
71 8.05 7.89 7.47 6.88 6.25
72 8.31 8.13 7.64 6.97 6.29
73 8.59 8.38 7.81 7.06 6.33
74 8.90 8.64 7.99 7.15 6.36
75 9.23 8.93 8.16 7.23 6.38
Rate for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
18
OPTION 4
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $3.69 $3.75 $3.81 $3.84 $3.87 $3.90 $3.91 $3.92 $3.92
50 3.75 3.89 3.97 4.04 4.09 4.13 4.15 4.17 4.18
55 3.81 3.97 4.16 4.27 4.35 4.42 4.47 4.50 4.51
60 3.84 4.04 4.27 4.51 4.66 4.78 4.86 4.92 4.95
65 3.87 4.09 4.35 4.66 4.99 5.19 5.35 5.46 5.53
70 3.90 4.13 4.42 4.78 5.19 5.67 5.95 6.17 6.31
75 3.91 4.15 4.47 4.86 5.35 5.95 6.64 7.04 7.34
80 3.92 4.17 4.50 4.92 5.46 6.17 7.04 8.04 8.63
85 3.92 4.18 4.51 4.95 5.53 6.31 7.34 8.63 10.05
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $4.63 $4.68 $4.73 $4.77 $4.80 $4.82 $4.84 $4.85 $4.86
50 4.68 4.80 4.88 4.95 5.00 5.04 5.06 5.08 5.10
55 4.73 4.88 5.04 5.15 5.24 5.30 5.35 5.39 5.41
60 4.77 4.95 5.15 5.37 5.52 5.63 5.72 5.79 5.83
65 4.80 5.00 5.24 5.52 5.83 6.04 6.20 6.31 6.39
70 4.82 5.04 5.30 5.63 6.04 6.49 6.77 6.99 7.15
75 4.84 5.06 5.35 5.72 6.20 6.77 7.45 7.86 8.16
80 4.85 5.08 5.39 5.79 6.31 6.99 7.86 8.84 9.43
85 4.86 5.10 5.41 5.83 6.39 7.15 8.16 9.43 10.86
19
OPTION 4
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
66 2/3% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $3.94 $4.05 $4.18 $4.32 $4.48 $4.66 $4.84 $5.02 $5.19
50 4.05 4.20 4.35 4.51 4.69 4.89 5.09 5.30 5.49
55 4.18 4.35 4.54 4.73 4.95 5.18 5.42 5.65 5.87
60 4.32 4.51 4.73 4.99 5.25 5.53 5.82 6.11 6.37
65 4.48 4.69 4.95 5.25 5.61 5.97 6.33 6.69 7.02
70 4.66 4.89 5.18 5.53 5.97 6.49 6.96 7.43 7.88
75 4.84 5.09 5.42 5.82 6.33 6.96 7.73 8.39 9.02
80 5.02 5.30 5.65 6.11 6.69 7.43 8.39 9.54 10.46
85 5.19 5.49 5.87 6.37 7.02 7.88 9.02 10.46 12.15
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $4.87 $4.99 $5.12 $5.27 $5.44 $5.64 $5.86 $6.09 $6.30
50 4.99 5.12 5.26 5.43 5.63 5.85 6.09 6.33 6.57
55 5.12 5.26 5.44 5.63 5.85 6.11 6.38 6.65 6.92
60 5.27 5.43 5.63 5.87 6.14 6.44 6.75 7.07 7.38
65 5.44 5.63 5.85 6.14 6.49 6.84 7.23 7.62 8.00
70 5.64 5.85 6.11 6.44 6.84 7.35 7.84 8.34 8.83
75 5.86 6.09 6.38 6.75 7.23 7.84 8.60 9.28 9.93
80 6.09 6.33 6.65 7.07 7.62 8.34 9.28 10.42 11.35
85 6.30 6.57 6.92 7.38 8.00 8.83 9.93 11.35 13.04
20
OPTION 4
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
50% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $4.07 $4.22 $4.40 $4.61 $4.87 $5.17 $5.49 $5.84 $6.18
50 4.22 4.37 4.56 4.79 5.06 5.39 5.75 6.13 6.51
55 4.40 4.56 4.76 5.00 5.31 5.66 6.06 6.49 6.91
60 4.61 4.79 5.00 5.27 5.61 6.01 6.46 6.95 7.43
65 4.87 5.06 5.31 5.61 5.99 6.44 6.96 7.54 8.11
70 5.17 5.39 5.66 6.01 6.44 6.99 7.61 8.29 9.00
75 5.49 5.75 6.06 6.46 6.96 7.61 8.43 9.29 10.17
80 5.84 6.13 6.49 6.95 7.54 8.29 9.29 10.54 11.71
85 6.18 6.51 6.91 7.43 8.11 9.00 10.17 11.71 13.57
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $5.01 $5.15 $5.33 $5.56 $5.83 $6.17 $6.55 $6.98 $7.40
50 5.15 5.29 5.48 5.71 6.01 6.36 6.78 7.23 7.68
55 5.33 5.48 5.66 5.91 6.23 6.61 7.05 7.54 8.05
60 5.56 5.71 5.91 6.16 6.51 6.93 7.42 7.96 8.53
65 5.83 6.01 6.23 6.51 6.87 7.34 7.89 8.51 9.16
70 6.17 6.36 6.61 6.93 7.34 7.87 8.51 9.23 10.00
75 6.55 6.78 7.05 7.42 7.89 8.51 9.33 10.20 11.14
80 6.98 7.23 7.54 7.96 8.51 9.23 10.20 11.44 12.64
85 7.40 7.68 8.05 8.53 9.16 10.00 11.14 12.64 14.51
21
OPTION 4
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
120 MONTHS MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5% and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $3.69 $3.75 $3.80 $3.84 $3.87 $3.89 $3.91 $3.91 $3.92
50 3.75 3.89 3.97 4.04 4.09 4.13 4.15 4.16 4.17
55 3.80 3.97 4.15 4.26 4.35 4.41 4.46 4.48 4.49
60 3.84 4.04 4.26 4.50 4.65 4.76 4.84 4.89 4.91
65 3.87 4.09 4.35 4.65 4.98 5.17 5.31 5.41 5.46
70 3.89 4.13 4.41 4.76 5.17 5.62 5.87 6.05 6.15
75 3.91 4.15 4.46 4.84 5.31 5.87 6.48 6.79 6.98
80 3.91 4.16 4.48 4.89 5.41 6.05 6.79 7.50 7.83
85 3.92 4.17 4.49 4.91 5.46 6.15 6.98 7.83 8.50
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF SECOND ANNUITANT
-----------------------
AGE OF
ANNUITANT 45 50 55 60 65 70 75 80 85
--------- ----- ---- ---- ---- ---- ---- ---- ---- ----
45 $4.63 $4.68 $4.73 $4.77 $4.80 $4.82 $4.84 $4.85 $4.85
50 4.68 4.80 4.88 4.94 4.99 5.03 5.06 5.07 5.08
55 4.73 4.88 5.04 5.14 5.23 5.29 5.34 5.37 5.38
60 4.77 4.94 5.14 5.37 5.51 5.62 5.70 5.75 5.78
65 4.80 4.99 5.23 5.51 5.82 6.00 6.15 6.24 6.30
70 4.82 5.03 5.29 5.62 6.00 6.44 6.68 6.86 6.96
75 4.84 5.06 5.34 5.70 6.15 6.68 7.27 7.57 7.76
80 4.85 5.07 5.37 5.75 6.24 6.86 7.57 8.26 8.58
85 4.85 5.08 5.38 5.78 6.30 6.96 7.76 8.58 9.23
22
V. SPECIAL PROVISIONS
The Special Provisions section which applies to this Contract is shown
on the Specifications page under Type of Plan. The other sections
under Special Provisions do not apply.
5.01. DEFERRED COMPENSATION PLAN
(a) Control of Contract: All rights in this Contract rest with the
Contract Holder, who is entitled to all amounts held under this
Contract. The Contract Holder, or authorized designee of the
Contract Holder (as allowed by law), may make any choices allowed
by this Contract with respect to Individual Accounts. Any choices
made under this Contract must be in writing. Until receipt of such
choices in its Home Office, Aetna may rely on any prior choices
made. This Contract and any Individual Accounts are not subject
to the claims of any creditors of Participants except to the
extent permitted by law.
(b) Designation of Beneficiary: The beneficiary shall be the
Contract Holder.
(c) Individual Accounts: Aetna will maintain Individual Account(s) as
instructed by the Contract Xxxxxx. In addition to any Purchase
Payments stated to be made under this Contract, a lump-sum
Purchase Payment(s), of not less than a minimum amount stated by
Aetna, may be made on behalf of one or more Participants. Aetna
may maintain an Individual Account for each lump-sum payment.
(d) Maintenance Fee: The Maintenance Fee (see 6.01) will be deducted
from the Current Value on the anniversary of the Individual
Account Effective Date and on surrender of the entire Individual
Account.
(e) Current Value: The Current alue as determined in 3.10 of an
Individual Ac-count at the end of a Valuation Period.
(f) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay the Current Value as directed by the Con-tract Holder if:
(1) The Participant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the notice is
received at Aetna's Home Office. The amount paid from the Fixed
Account will not be less than the Net Purchase Payments allocated
for the Participant (less any prior transfers (see 3.12),
surrenders, Maintenance Fees, or amounts used to purchase Annuity
Options). The beneficiary may choose to apply all or any part of
the proceeds to an Annuity Option (see Part IV).
(g) Surrender Value: After deduction of the Maintenance Fee (if any),
Aetna will reduce the amount payable upon sur-render of any
portion of the Individual Account(s) by a Surrender Fee. The
Surrender Fee will be in accordance with the Surrender Fee table
in 6.02.
The Fee on a total surrender of an Individual Account will not
exceed 8.5% of the Purchase Payments made to that Account.
(h) The following sections 5.02, 5.03, 5.04 and 5.05 of the Special
Provisions do not apply to this Contract.
23
5.02. ALLOCATED PENSION OR PROFIT SHARING PLAN
(a) The preceding section 5.01 of the Special Provisions does not
apply to this Contract.
(b) Control of Contract: All rights in this Contract rest with the
Contract Holder. The Contract Holder owns all amounts held under
this Contract. The Contract Holder, or authorized designee of the
Contract Holder (as allowed by law), may make any choices allowed
by this Contract with respect to Individual Accounts. Any choices
under this Contract must be in writing. Until receipt of such
choices in its Home Office, Aetna may rely on any prior choices
made. This Contract and any Individual Accounts are not subject
to the claims of any creditors except to the extent per-mitted by
law.
Any payment(s) made under this Contract to other than the Contract
Holder must be in compliance with the provisions of the Retirement
Equity Act of 1984 (Act). At the time payment is requested or an
Annuity Option is elected by the Contract Holder, Aetna will
require the Contract Holder to certify the payment option is
elected in compliance with the Act. In the absence of such
certification, payment will be made to the Contract Holder.
(c) Designation of Beneficiary: The beneficiary shall be the Contract
Holder.
(d) Individual Accounts: If instructed by the Contract Holder, Aetna
will maintain two Individual Accounts for each Participant; these
will be a Participant's In-dividual Account for crediting employee
Net Purchase Payments and a Plan Individual Account for crediting
employer Net Purchase Payments.
(e) Maintenance Fee: The Maintenance Fee (see 6.01) will be deducted
from the Current Value on each anniversary of the Individual
Account Effective Date and upon surrender of the entire Individual
Account.
(f) Current Value: The Current Value as determined in 3.10 of an
Individual Account at the end of a Valuation Period.
(g) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay the Current Value to the beneficiary if:
(1) The Participant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value of the Participant's
Individual Account on the date when the notice is received at
Aetna's Home Office. The amount paid from the Fixed Account will
not be less than the Net Purchase Payments allocated to the Fixed
Account under the Participant's Individual Account (less any prior
transfers (see 3.12), surrenders, Maintenance Fees, or amounts
used to purchase Annuity Options). The beneficiary may choose to
apply all or part of the payment to an Annuity Option (see Part
IV).
(h) Surrender Value: After deduction of the Maintenance Fee (if any),
Aetna will reduce the amount payable upon surrender of any portion
of the Individual Account(s) by a Surrender Fee. The Surrender Fee
will be in accordance with the Surrender Fee table in 6.02.
(i) The following sections 5.03, 5.04 and 5.05 of the Special
Provisions do not apply to this Contract.
24
5.03. UNALLOCATED PENSION OR PROFIT SHARING PLAN
(a) The preceding Sections 5.01 and 5.02 of the Special Provisions do
not apply to this Contract.
(b) Control of Contract: All rights in this Contract rest with the
Contract Holder. The Contract Holder owns all amounts held under
this Contract. The Contract Holder, or authorized designee of the
Contract Holder (as allowed by law), may make any choices allowed
by this Contract. Any choices under this Contract must be in
writing. Until receipt of such choices in its Home Office, Aetna
may rely on any prior choices made. This Contract is not subject
to the claims of any creditor except to the extent permitted by
law.
Any payment(s) made under this Contract to other than the Contract
Holder must be in compliance with the provisions of the Retirement
Equity Act of 1984 (Act). At the time payment is requested or an
Annuity Option is elected by the Contract Holder, Aetna will
require the Contract Holder to certify the payment option is
elected in compliance with the Act. In the absence of such
certification, payment will be made to the Contract Holder.
(c) Designation of Beneficiary: The beneficiary shall be the Contract
Holder.
(d) Individual Accounts: There are no Individual Accounts under this
Contract. Aetna will maintain one unallocated Plan Account in the
name of the Contract Holder to which Net Purchase Payment(s) will
be credited.
(e) Maintenance Fee: The Maintenance Fee (see 6.01) will be deducted
from the Plan Account Current Value on each anniversary of the
Plan Account effective date and on surrender of the entire Plan
Account.
(f) Current Value: The Current Value as determined in 3.10 of the
Plan Account at the end of a Valuation Period.
(g) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay to the beneficiary any portion of the Plan Account if:
(1) The Participant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The beneficiary may choose to apply all or any part of the payment
to an Annuity Option (see Part IV).
(h) Surrender Value: After deduction of the Maintenance Fee (if any),
the amount paid by Aetna upon surrender of any portion of the Plan
Account will be reduced by a Surrender Fee. The Surrender Fee will
be in accordance with the Surrender Fee table in 6.02.
(i) The following Sections 5.04 and 5.05 of the Special Provisions do
not apply to this Contract.
25
5.04. TAX DEFERRED ANNUITY PLAN
(a) The preceding Sections 5.01, 5.02, and 5.03 of the Special
Provisions do not apply to this Contract.
(b) Control of Contract: This is a Contract between the Contract
Holder and Aetna only to satisfy the "purchase" requirements of
Section 403(b)(1) of the Internal Revenue Code of 1954, as
amended. The Contract Holder has no right, title, or interest in
the amounts held under the Contract either by reason of remitting
Purchase Payments or applying for this Contract.
Each Participant shall own all amounts held in his or her
Individual Account. Each Participant may make any choices allowed
by this Contract for his or her Individual Account. Choices made
under this Contract must be in writing. Until receipt of such
choices in its Home Office, Aetna may rely on any previous choices
made. This Contract and any Individual Accounts shall not e
subject to the claims of any creditors. This Contract and any
Individual Accounts are nonassignable, except to Aetna in the
event of a loan, and non-transferable. In the event a loan
against an Individual Account is requested, however, the Current
Value of the Individual Account necessary to cover the loan amount
plus interest must be assigned to Aetna.
(c) Designation of Beneficiary: Each Participant shall name a
beneficiary.
(d) Individual Accounts: Aetna will maintain an Individual Account
for each Participant. In addition to any Purchase Payments stated
to be made to this Contract, a lump-sum Purchase Payment(s), of
not less than a minimum amount stated by Aetna, may be made on
behalf of one or more Participants. Aetna may maintain an
Individual Account for each lump-sum payment.
(e) Maintenance Fee: The Maintenance Fee (see 6.01) will be deducted
from the Current Value on each anniversary of the Individual
Account Effective Date and upon surrender of the entire Individual
Account.
(f) Current Value: The Current Value as determined in 3.10 of a
Participant's In-dividual Account at the end of a Valuation
Period.
(g) Loan Value: During the Accumulation Period, a Participant may
request a loan from his or her Individual Account Value in place
of a partial withdrawal by submitting a loan request form to
Aetna's Home Office. A loan may not be requested within 12 months
of any prior loan request If the loan meets the requirements
described below, it will not be taxable:
(1) The loan amount must be at least $5,000. The loan amount when
added to the outstanding balance of all previous loans may not
exceed the lesser of:
- One-half of the Individual Account Current Value plus the
outstanding balance of all previous loans under the Plan
Account; or
- $50,000.
Loans can only be made from those Individual Account Values
held in the Fund(s) and the Fixed Account. Loans may not be
made against amounts held in the GA Account although such
values are included in the determination of Individual Account
Value. If a Participant intends to request a loan against any
portion of the GA Ac-count, that portion must be transferred
to any Fund(s) or to the Fixed Account. The transferred
amount will be subject to the Withdrawal and Market Value
Adjustment provisions.
26
When a loan is made, the number of Accumulation Units equal to
the loan amount will be withdrawn from the Individual Account.
Accumulation Units taken from an Individual Account to provide
a loan do not participate in the investment experience of the
related investment media. Unless instructed otherwise, the
amount withdrawn will be allocated on a pro rata basis among
the Fixed Account and the Fund(s).
(2) Loan interest will accrue on a daily basis at the rate of 3%
annually and must be paid in full each year. The interest
must be paid directly to Aetna by the Participant. If
interest is not paid when due, the entire loan amount plus
interest will be treated as a taxable surrender under the
terms of the Contract.
(3) Repayment of a loan can be made at any time within 5 years
from the date the loan was first made. Any unpaid portion of
a loan must be repaid at the end of 5 years, upon election of
an Annuity Option or upon full surrender of the Individual
Account, whichever occurs first. Aetna may require all
outstanding loans be paid if the Individual Account Value
falls below an amount equal to 25% of total loans outstanding.
Any loan and accrued interest not repaid when due will be
considered a taxable surrender with appropriate deferred sales
charges deducted from the Individual Account Value.
(h) Sum Payable at Death (Before Annuity Payments Start): The Current
Value payable under the terms of this section will be reduced by
the amount of the accrued interest on any outstanding loan. Aetna
will pay the Current Value to the beneficiary if:
(1) The Participant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the notice is
received at Aetna's Home Office. The amount paid from the Fixed
Account will not be less than the Net Purchase Payment(s)
allocated to the Fixed Account under the Participant's Individual
Account (less any prior transfers (see 3.12), surrenders,
Maintenance Fees, or amounts used to purchase Annuity Options).
The beneficiary, if a spouse, may choose to apply all or any
portion of the payment to an Annuity Option. If the beneficiary
is not a spouse, all of the payment must either be applied only to
Annuity Option 1 or 2 within one year of the Participant's death
or be paid to the beneficiary within 5 years of the death of the
Participant (see Part IV). If no beneficiary exists, the payment
will be made to the estate of the Participant.
(i) Annuity Payments to Beneficiary: In no event may any payments to
the beneficiary under an Annuity Option extend beyond:
(1) The life of the beneficiary; or
(2) Any certain period greater than the beneficiary's life
expectancy.
(j) Surrender Value: After deduction of the Maintenance Fee (if any),
the amount payable by Aetna upon the surrender of any portion of
the Individual Account(s) shall be reduced by a Surrender Fee.
The Surrender Fee will be in accordance with the Surrender Fee
table in 6.02.
The Fee on a total surrender of an Individual Account will not
exceed 8.5% of the actual Purchase Payments made to that Account.
(k) The following Section 5.05 of the Special Provisions does not
apply to this Contract.
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5.05. TAX DEFERRED ANNUITY PLAN (ERISA)
(a) The preceding Sections 5.01, 5.02, 5.03 and 5.04 of the Special
Provisions do not apply to this Contract.
(b) Control of Contract: This is a Contract between the Contract
Holder and Aetna only to satisfy the "purchase" requirements of
Section 403(b)(1) of the Internal Revenue Code of 1954, as
amended. The Contract Holder has no right, title, or interest in
the amounts held under the Contract either by reason of remitting
Purchase Payments or applying for this Contract.
The Contract Holder shall notify Aetna in writing of the
applicability of Title 1 of the Employee Retirement Income
Security Act of 1974 as amended by subsequent law including the
Retirement Equity Act of 1984 (Act) to the Plan. Aetna shall rely
on the Contract Holder's determination and representation of
applicability.
Each Participant shall own all amounts held in his or her
Individual Account. Each Participant may make any choices allowed
by this Contract for his or her Individual Account. Choices made
under this Contract must be in writing. Until receipt of such
choices in its Home Office, Aetna may rely on any previous choices
made. This Contract and any Individual Accounts shall not be
subject to the claims of any creditors. This Contract and any
Individual Accounts are nonassignable, except to Aetna in the
event of a loan or pursuant to a "qualified domestic relations
order" as set forth under the Act, and nontransferable. In the
event a loan against an Individual Account is requested, however,
the Current Value of the Individual Account necessary to cover the
loan amount plus interest must be assigned to Aetna.
(c) Designation of Beneficiary: Each Participant shall name a
beneficiary. However, if the participant is married, Aetna shall
disregard the named beneficiary and shall treat the current spouse
as sole beneficiary if, upon the Participant's death:
(1) The participant had not reached age 35; or
(2) The appropriate preretirement survivor benefit waiver and
spousal consent form have not been submitted to Aetna.
(d) Individual Accounts: Aetna will maintain an Individual Account
for each Participant. In addition to any Purchase Payments stated
to be made to this Contract, a lump-sum Purchase Payment(s), of
not less than a minimum amount stated by Aetna, may be made on
behalf of one or more Participants. Aetna may maintain an
Individual Account for each lump-sum payment.
(e) Maintenance Fee: The Maintenance Fee (see 6.01) will be deducted
from the Current Value on each anniversary of the Individual
Account Effective Date and upon surrender of the entire Individual
Account.
(f) Current Value: The Current Value as determined in 3.10 of a
Participant's Individual Account at the end of a Valuation Period.
(g) Loan Value: During the Accumulation Period, a Participant may
request a loan from his or her Individual Account Value in place
of a partial withdrawal by submitting a loan request form
accompanied by the appropriate waiver and spousal consent forms to
Aetna's Home Office. A loan may not be requested within 12
months of any prior loan request. If the loan meets the
requirements described below, it will not be taxable:
(1) The loan amount must be at least $5,000. The loan amount when
added to the outstanding balance of
28
all previous loans may not exceed the lesser of:
- One-half of the total Individual Account Current Value plus
the outstanding balance of all previous loans under the Plan
Account; or
- $50,000.
Loans can only be made from those Individual Account Values
held in the Fund(s) and the Fixed Account. Loans may not be
made against amounts held in the GA Account although such
values are included in the determination of Individual Account
Value. If a Participant intends to request a loan against any
portion of the GA Ac-count, that portion must be transferred
to any Fund(s) or to the Fixed Account. The transferred
amount will be subject to the Withdrawal and Market Value
Adjustment provisions.
When a loan is made, the number of Accumulation Units equal to
the loan amount will be withdrawn from the Individual Account.
Accumulation Units taken from an Individual Account to provide
a loan do not participate in the investment experience of the
related investment media. Unless instructed otherwise, the
amount withdrawn will be allocated on a pro rata basis among
the Fixed Account and the Fund(s).
(2) Loan interest will accrue on a daily basis at the rate of 3%
annually and must be paid in full each year. The interest
must be paid directly to Aetna by the Participant. If
interest is not paid when due, the entire loan amount plus
interest will be treated as a taxable surrender under the
terms of the Contract.
(3) Repayment of a loan can be made at any time within 5 years
from the date the loan was first made. Any unpaid portion of a
loan must be repaid at the end of 5 years, upon election of an
Annuity Option or upon full surrender of the Individual
Account, whichever occurs first. Aetna may require all
outstanding loans be paid if the Individual Account Value
falls below an amount equal to 25% of total loans outstanding.
Any loan and accrued interest not repaid when due will be
considered a taxable surrender with appropriate deferred sales
charges deducted from the Individual Account Value.
(h) Sum Payable at Death (Before Annuity Payments Start): The Current
Value payable under the terms of this section will be reduced by
the amount of the accrued interest on any outstanding loan. Aetna
will pay the Current Value to the beneficiary if:
(1) The Participant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the notice is
received at Aetna's Home Office. The amount paid from the Fixed
Account will not be less than the Net Purchase Payment(s)
allocated to the Fixed Account under the Participant's Individual
Account (less any prior transfers (see 3.12), surrenders,
Maintenance Fees, or amounts used to purchase Annuity Options).
The beneficiary, if a spouse, may choose to apply all or any
portion of the payment to an Annuity Option. If the beneficiary
is not a spouse, all of the payment must either be applied only to
Annuity Option 1 or 2 within one year of the Participant's death,
or be paid to the beneficiary within 5 years of the death of the
Participant. (see Part IV). If no beneficiary exists, the payment
will be made to the estate of the Participant.
(i) Annuity Payments to Beneficiary: In no event may any payments to
the beneficiary under an Annuity Option extend beyond:
29
(1) The life of the beneficiary; or
(2) Any certain period greater than the beneficiary's life
expectancy.
(j) Surrender Value: After deduction of the Maintenance Fee (if any),
the amount payable by Aetna upon the surrender of any portion of
the Individual Account(s) shall be reduced by a Surrender Fee.
The Surrender Fee will be in accordance with the Surrender Fee
table in 6.02.
The Fee on a total surrender of an Individual Account will not
exceed 8.5% of the actual Purchase Payments made to that Account.
Aetna may defer payment of the surrender value until appropriate
waiver and spousal consent forms are received.
(k) Annuity Option: Any election of an Annuity Option other than
Option 4 must be accompanied by the appropriate waiver and spousal
consent forms.
30
[Aetna Logo] AETNA LIFE INSURANCE AND ANNUITY COMPANY
Customer Relations Department, PFSD
HOME OFFICE: 000 XXXXXXXXXX, XXX.
HARTFORD, CONNECTICUT 06156
(000) 000-0000
GROUP VARIABLE, FIXED, OR COMBINATION CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT
39355
G-CDA-HF PRINTED IN U.S.A.
