Exhibit 4(a)
Form of Variable Annuity Contract
[LOGO] PHOENIX
--------------------------------------------------------------------------------
Primary Annuitant: Xxxx Xxx 35 Male :Age and Sex
Contract Number: 13000000 December 12, 1994 :Contract Date
Initial Premium: $10,000.00 July 1, 2029 :Maturity Date
Dear Contract Owner:
Thank You for purchasing this annuity contract from PHL Variable Insurance
Company. We agree to pay the benefits of this contract in accordance with
its provisions.
IT IS IMPORTANT TO US THAT YOU ARE SATISFIED WITH YOUR CONTRACT AND THAT IT
MEETS YOUR FINANCIAL GOALS. IF FOR ANY REASON YOU ARE NOT SATISFIED WITH
THIS CONTRACT, YOU MAY RETURN IT WITHIN 10 DAYS AFTER WE DELIVER IT TO YOU
FOR A REFUND OF THE CONTRACT VALUE, LESS THE VALUE OF ANY BONUS PAYMENTS
MADE UNDER THIS CONTRACT. YOU MAY RETURN IT TO EITHER THE AGENT THROUGH
WHOM IT WAS PURCHASED OR TO US AT THE FOLLOWING ADDRESS:
PHL Variable Insurance Company
Variable Annuity Operations
P.O. Box 8027
Boston, MA 02266-8027
Telephone (000) 000-0000
WE WILL DETERMINE THE CONTRACT VALUE AS OF THE NEAREST VALUATION DATE
FOLLOWING RECEIPT OF THE RETURNED CONTRACT AT OUR VARIABLE ANNUITY
OPERATIONS.
This contract provides for a series of annuity payments. The annuity
payments will be based on the Contract Value on the Maturity Date, the
annuity purchase rates stated herein, and the investment experience of the
Subaccounts during the annuity payout period. The Contract Value will
depend on the rate of interest credited to the Guaranteed Interest Account
and the investment experience of the Subaccounts.
Signed for PHL Variable Insurance Company at its Home Office, Xxx Xxxxxxxx
Xxx, Xxxxxxxx, Xxxxxxxxxxx 06102-5056.
Sincerely yours,
PHL VARIABLE INSURANCE COMPANY
/S/ /S/ Xxxxxx X. Xxxxxxxxx
Secretary Chief Executive Officer
Registrar
FLEXIBLE PREMIUM VARIABLE ACCUMULATION DEFERRED ANNUITY
ALL VALUES AND BENEFITS BASED ON THE INVESTMENT EXPERIENCE OF THE
SUBACCOUNTS OF THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE AND ARE
VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. SEE PART 7 FOR A
DESCRIPTION OF HOW THE CONTRACT VALUES ARE DETERMINED, AND PART 9 FOR A
DESCRIPTION OF HOW THE DEATH BENEFITS ARE DETERMINED.
NOT ELIGIBLE FOR ANNUAL DIVIDENDS
D604
SCHEDULE PAGE
Primary Annuitant: [Xxxx Xxx] [35 Male] :Age and Sex
Contract Number: [13000000] [December 12, 1994] :Contract Date
Initial Premium: [$10,000.00] [July 1, 2029] :Maturity Date
Contingent Annuitant: [None]
Owner: [Xxxx Xxx]
Beneficiaries: [Xxxx Xxx]
Subsequent Premiums: [Flexible]
Payment Intervals: [Flexible]
Death Benefit Option: [1]
Bonus Payment: [5% of each Premium Payment]
SUBACCOUNT FEES
Mortality and Expense Risk Fee: [.00404%(Based on an annual rate of 1.475%)]
Daily Administrative Fee: [.00034%(Based on an annual rate of .125%)]
Daily Tax Fee: [.0000%]
CONTRACT FEES AND CHARGES
Premium Tax: [.000% of each premium paid]
Annual Administrative Charge: [$35]
Transfer Charge: [Currently, there is no charge for transfers. However, we
reserve the right to impose a Transfer Charge after the first two transfers made
in each Contract Year, upon prior Written Notice to the Owner. In no event,
however, will such Transfer Charge exceed $20 per transaction.]
Contingent Deferred Sales Charge: See Part 5 for a Description of How this
Charge Is Determined.
PREMIUM ALLOCATION SCHEDULE
[Money Market #122 100.00%]
D604
SCHEDULE PAGE (CONTINUED)
Annuitant: Xxxx Xxx 13000000 :Contract Number
GUARANTEED The Guaranteed Interest Account is not part of
INTEREST ACCOUNT the Separate Account. It is accounted for as
part of Our General Account. We reserve the
right to limit cumulative premium payments to
the Guaranteed Interest Account during any
one-week period to not more than $250,000. We
will credit interest daily on any amounts held
under the Guaranteed Interest Account at such
rates as We shall determine but in no event will
the effective annual rate of interest be less
than 3%. On the last working day of each
calendar week, We will set the interest rate
that will apply to any premium and Bonus Payment
made to the Guaranteed Interest Account during
the following calendar week. That rate will
remain in effect for such premiums and Bonus
Payments, or their resulting Adjusted Premiums,
for an initial guaranteed period of one full
year. Upon expiry of the initial one-year
guarantee period, and for any premiums, Bonus
Payments or Adjusted Premiums whose guarantee
has just ended, the new rate shall be the same
rate that applies to new premiums made during
the calendar week in which the guarantee period
expired. Such rate shall likewise remain in
effect for such Adjusted Premiums for a
subsequent guarantee period of one full year.
D604
SCHEDULE PAGE (CONTINUED)
Annuitant: Xxxx Xxx 13000000 :Contract Number
GUARANTEED INTEREST ACCOUNTS
GUARANTEED The GIA account with 1-year guarantee is not
INTEREST ACCOUNT part of the Separate Account. It is accounted
WITH 1-YEAR for as part of Our General Account. We reserve
GUARANTEE the right to limit cumulative premium payments
(GIA) to the GIA account during any one-week period to
not more than $250,000. We will credit interest
daily on any amounts held under the GIA account
at such rates as We shall determine but in no
event will the effective annual rate of interest
be less than 3%. On the last working day of each
calendar week, We will set the interest rate
that will apply to any premium and Bonus Payment
made to the GIA account during the following
calendar week. That rate will remain in effect
for such premiums, Bonus Payments or their
resulting Adjusted Premiums, for an initial
guaranteed period of one full year. Upon expiry
of the initial one-year guarantee period, and
for any premiums, Bonus Payments or Adjusted
Premiums whose guarantee has just ended shall be
the same rate that applies to new premiums made
during the calendar week in which the guarantee
period expired. Such rate shall likewise remain
in effect for such Adjusted Premiums for a
subsequent guarantee period of one full year. No
market value adjustment is applied to
withdrawals from the GIA account.
MARKET VALUE The MVA account provides four choices of
ADJUSTED interest rate guarantee periods: 3-year, 5-year,
GUARANTEED 7-year, and 10-year. The MVA account is
INTEREST ACCOUNT accounted for as a non-unitized separate
(MVA) account. We will credit interest daily on any
amounts held under the MVA account at such rates
as We shall determine but in no event will the
effective annual rate of interest be less than
3%. On the last working day of each calendar
week, We will set the interest rate that will
apply to any new premiums and Bonus Payments
made during the following calendar week to each
of these accounts. The applicable rate will
remain in effect until the end of the Guarantee
Period selected by you, the Contract Owner. Upon
expiry of the selected Guarantee Period, unless
you elect to transfer funds to another Guarantee
Period or Subaccount, or elect to withdraw
funds, We will begin another Guarantee Period of
the same duration as the one that just ended,
and will credit interest at the then current
rate for that new Guarantee Period. If your
original Guarantee Period is no longer available
or if you choose a Guarantee Period that is no
longer available We will use the Guarantee
Period with the next longest duration. To the
extent permitted by law, We reserve the right to
discontinue Guarantee Periods and to offer other
Guarantee Periods that differ from those
available at the time your contract was issued.
Any withdrawals or transfers from the MVA will
be subject to a market value adjustment, except
that funds may be withdrawn or transferred from
this account without a market value adjustment
in the 30-day Window Period from 15 days before
to 15 days after the Guarantee Period expiry
date. We reserve the right to limit cumulative
premiums made to any one of these accounts
during any one-week period to not more than
$250,000.
D604
CONTRACT SUMMARY
ABOUT THIS SUMMARY This summary briefly highlights some of the
major contract provisions. Since this is only a
summary, the detailed provisions of the contract
will control. See those provisions for full
information and any limits or restrictions that
apply. A Table of Contents is provided to help
You find specific provisions. Your contract is a
legal contract between You and Us. You should,
therefore, READ YOUR CONTRACT CAREFULLY.
Check the Schedule Page of this contract to make
sure it reflects the premium payment allocation
requested. Please call Your agent or Us any time
You have questions about Your contract.
THE TYPE OF CONTRACT This contract provides for payment of a variable
life annuity. The amount of each annuity payment
will be based on the Contract Value, the annuity
purchase rates stated herein, and the investment
experience of the Subaccounts during the annuity
payout period. Other Annuity Payment Options are
available.
ALLOCATION OF The values that accumulate under this contract
PREMIUM PAYMENTS prior to the Maturity Date are based on the
premium payments and Bonus Payments made, the
rates of interest credited on any premium
payments and Bonus Payments allocated to the
Guaranteed Interest Account, any expense
charges, and the investment experience of the
Subaccounts within the Separate Account on any
premium payments and Bonus Payments allocated to
the Subaccounts. Except for the Guaranteed
Interest Account which is part of Our General
Account, the Subaccounts are part of PHL
Variable Insurance Company's Variable
Accumulation Separate Account (VA Account) and
have differing investment objectives. Subject to
the terms of this contract, You may transfer the
Contract's Value between and among the various
Subaccounts and Guaranteed Interest Account.
The VA Account is a Separate Account established
by Our company under Connecticut Law and is
registered as a unit investment trust under the
Investment Company Act of 1940. All income,
gains and losses, realized and unrealized, of
the VA Account are credited to or charged
against the amounts placed in the VA Account
without reference to other income, gains and
losses of Our General Account. The assets of the
VA Account are owned solely by Us and We are not
a trustee with respect to such assets. These
assets are not chargeable with liabilities
arising out of any other business that We may
conduct.
D604
We use the assets of the VA Account to buy
shares of the Fund(s) of this contract according
to Your most recent allocation instruction on
file with Us at Our Variable Products
Operations. The Fund(s) are registered under the
1940 Act as an open-end, diversified management
investment company. The Fund(s) have separate
Series that correspond to the Subaccounts of the
VA Account. Assets of each Subaccount are
invested in shares of the corresponding Fund
Series.
This contract also contains a Guaranteed
Interest Account to which premium payments and
Bonus Payments may be allocated. The Guaranteed
Interest Account is not part of the Separate
Account. It is accounted for as part of Our
General Account. We will credit interest on the
amount in the Guaranteed Interest Account at
such rate(s) as provided under the terms of this
contract. We reserve the right to add other
Guaranteed Interest Accounts subject to approval
(as required by some states) by the insurance
supervisory official of states where this
contract is delivered.
WITHDRAWAL PRIVILEGE Before the Maturity Date, You may withdraw all
or part of the Contract Value less any
applicable contingent deferred sales charge.
After the Maturity Date, You may only withdraw
from the remaining value under Variable Payment
Options K or L, less any applicable contingent
deferred sales charge.
OTHER BENEFITS This contract provides for the payment of death
proceeds in the event of the death of either the
Owner or the Annuitant prior to the Maturity
Date. The amount of the death proceeds will
depend upon whether it is the Owner or the
Annuitant whose death has occurred. The amount
of the death proceeds is determined as described
in Part 9 of this Contract.
D604
TABLE OF CONTENTS
PART PAGE
---------------------------------------------------------------
SCHEDULE PAGES
CONTRACT SUMMARY
TABLE OF CONTENTS
1. DEFINITIONS.............................................1
2. ABOUT THIS CONTRACT.....................................5
The Effective Date......................................5
The Contract and Application............................5
Required Proof of Age and Survival......................5
Adjustment for Misstatement of
Age or Sex............................................5
Assignments.............................................5
Statement of Account....................................5
3. RIGHTS OF OWNER...........................................6
Who Is the Owner........................................6
What Are the Rights of the Owner........................6
How to Change the Owner ................................7
Designation of Contingent Annuitant.....................7
4. PREMIUM PAYMENTS AND ALLOCATIONS..........................7
Premium Payments........................................7
Premium Payment Allocation..............................8
Accumulation Units......................................8
Additional Subaccounts..................................8
Substitution of Subaccounts.............................9
5. TRANSFERS, WITHDRAWALS AND LAPSE..........................9
Transfers among Subaccounts and the
Guaranteed Interest Account...........................9
Withdrawals and Full Surrender.........................10
Lapse..................................................11
Rules and Limitations..................................11
Deferral of Payment....................................11
6. EXPENSE CHARGES..........................................12
Premium Tax............................................12
Surrender Charge.......................................13
Transfer Charge........................................13
Annual Administrative Charge...........................13
Mortality and Expense Risk Fee.........................13
Daily Tax Fee..........................................13
Daily Administrative Fee...............................13
7. DETERMINING THE CONTRACT AND
ACCUMULATION UNIT VALUES................................13
Crediting of Subaccount Units and Premiums.............13
Determination of the Contract Value....................14
The Valuation of Subaccounts and
Guaranteed Interest Account..........................14
8. ANNUITY BENEFITS.........................................14
9. DEATH BENEFITS...........................................15
Death Before Maturity Date.............................15
Election of Death Benefit Options......................16
Death Benefit - Option 1...............................16
Death Benefit - Option 2...............................16
Adjusted Partial Withdrawals...........................17
Annual Step-up Amount..................................17
Annual Roll-up Amount..................................16
Distribution at Death Requirements.....................17
Death on or after the Maturity Date....................18
The Beneficiary........................................19
What Are the Rights of the Beneficiary.................19
How to Change the Beneficiary..........................19
10. PAYMENT OPTIONS.........................................20
Calculation of Fixed Annuity Payments..................20
Calculation of Variable Annuity Payments...............20
Option A - Life Annuity with Specified
Period Certain.......................................21
Option B - Non-Refund Life Annuity.....................21
Option D - Joint and Survivorship
Life Annuity.........................................21
Option E - Installment Refund Life Annuity.............21
Option F - Joint and Survivorship Life
Annuity with 10-Year Period Certain..................21
Option G - Payments for a Specified Period.............22
Option H - Payments of a Specified Amount..............22
Option I - Variable Life Annuity with
10-Year Period Certain...............................22
Option J - Joint Survivorship Variable
Life Annuity with 10-Year Period Certain.............22
Option K - Variable Annuity for
Specified Period.....................................22
Option L - Variable Life
Expectancy Annuity...................................22
Option M - Unit Refund Variable
Life Annuity.........................................23
Option N - Variable Non-Refund
Life Annuity.........................................23
Other Options..........................................23
11. TABLES OF PAYMENT OPTION AMOUNTS.....................24-26
D604
PART 1: DEFINITIONS
YOU (YOUR) The Owner of this contract.
WE (OUR, US) PHL Variable Insurance Company
ACCUMULATION UNIT A standard of measurement as described in Part
4, used to determine the value of a Contract and
its interest in the Subaccounts prior to the
Maturity Date and for amounts held under Payment
Option L.
ACCUMULATION UNIT VALUE On the first Valuation Date selected by Us, We
set all Accumulation Unit Values of each
Subaccount of the Separate Account at 1.000000.
The Accumulation Unit Value on any subsequent
Valuation Date is determined by multiplying the
Accumulation Unit Value of the Subaccount on the
immediately preceding Valuation Date by the Net
Investment Factor for that Subaccount for the
Valuation Period just ended.
ADJUSTED PREMIUM Any premium or Bonus Payment to the Guaranteed
Interest Account, as adjusted to include any
interest credited on and any contract charges or
withdrawals deducted from such payments.
ANNUITANT On or prior to the Maturity Date, the term
"Annuitant" as used in this contract refers to
the Primary Annuitant as shown on the Schedule
Page, while such Primary Annuitant is living,
and then the Contingent Annuitant, if any, or as
later changed by You in writing, provided such
Contingent Annuitant is living at the death of
the Primary Annuitant. After the Maturity Date,
the term "Annuitant" shall mean the Annuitant
under this contract determined as of the
Maturity Date.
ANNUITANT'S BENEFICIARY The beneficiary entitled to receive payment of
any amounts payable under this contract upon
death of the Annuitant.
ANNUITY A contract promising a periodic series of
payments.
ANNUITY UNIT A standard of measurement used to determine the
amount of each periodic payment made under the
Variable Payment Options I, J, K, M and N. The
number of Annuity Units in each Subaccount with
assets under the chosen option is equal to the
portion of the first payment provided by that
Subaccount divided by the Annuity Unit Value for
that Subaccount on the first Payment Calculation
Date.
D604 1
ANNUITY UNIT VALUE On the first Valuation Date selected by Us, We
set all Annuity Unit Values in each Subaccount
of the Separate Account at $1.000000. The
Annuity Unit Value on any subsequent Valuation
Date is equal to the Annuity Unit Value of the
Subaccount on the immediately preceding
Valuation Date multiplied by the Net Investment
Factor for that Subaccount for the Valuation
Period divided by 1.000000 plus the rate of
interest for the number of days in the Valuation
Period based on the Assumed Investment Rate.
ASSIGNS Any person to whom You assign an interest in
this contract if We have Written Notice of the
assignment in accordance with the provisions
stated in Part 2.
ASSUMED INVESTMENT RATE The Assumed Investment Rate is 4.5% per year. We
use this rate to determine the first payment
under Variable Payment Annuity Options I, J, K,
M and N. Future payment amounts under these
options will depend on the relationship between
the Assumed Investment Rate and the actual
investment performance of each Subaccount as
reflected in the Subaccount's Annuity Unit
Value. The Assumed Investment Rate is the annual
investment return that will need to be earned by
each Subaccount of the Separate Account for
there to be no reduction in the amount of the
monthly payments under these options.
BONUS PAYMENT An amount that We will credit to the Contract
Value at the time of each premium payment. The
amount of Bonus Payment is calculated as a
percentage of each premium payment as shown on
the Schedule Page.
CONTRACT ANNIVERSARY The same date each year as the Contract Date.
CONTRACT DATE The Contract Date shown on the Schedule Page. It
is the date from which Contract Years and
anniversaries are measured.
CONTRACT VALUE The sum of the values under a Contract of all
Accumulation Units held in the Subaccounts and
the Adjusted Premium Payments held in the
Guaranteed Interest Account.
CONTRACT YEAR The first Contract Year is the one-year period
from the Contract Date. Following Contract Years
run from one Contract Anniversary to the next.
FIXED PAYMENT ANNUITY An annuity providing payments which do not vary
in amount after the first payment is made.
D604 2
MATURITY DATE The Maturity Date shown on the Schedule Page or
such changed Maturity Date as may result from
death of the Primary Annuitant while a
Contingent Annuitant is living or as We may
later agree. The Maturity Date may not be
earlier than the fifth Contract Anniversary, or
later than the Contract Anniversary nearest the
Annuitant's 95th birthday unless We agree
otherwise. If a Contingent Annuitant becomes the
Annuitant as the result of death of the Primary
Annuitant prior to the Maturity Date, the
Maturity Date will change to the Contract
Anniversary nearest the Contingent Annuitant's
95th birthday unless You and We agree otherwise.
NET INVESTMENT FACTOR The Net Investment Factor for each Subaccount of
the Separate Account is determined by the
investment performance of the assets underlying
the Subaccount for the Valuation Period just
ended. The Net Investment Factor is equal to
1.000000 plus the applicable net investment rate
for the Valuation Period. The net investment
rate is determined by:
a. taking the sum of the accrued net investment
income and capital gains and losses,
realized or unrealized, of the Subaccount
for the Valuation Period. The net investment
income is affected by an investment advisory
expense fee which is deducted from the Funds
in which the assets of the Subaccounts of
the Separate Account are invested; and
b. dividing the result of (a) by the
Subaccount's share of the Separate Account
at the beginning of the Valuation Period;
and
c. for each calendar day in the Valuation
Period subtracting from the result of (a)
divided by (b), an amount equal to the
Mortality and Expense Risk Fee plus the
Daily Administrative Fee and any daily tax
fee.
OWNER/ANNUITANT An individual who is both the Owner and
Annuitant under the contract.
OWNER'S BENEFICIARY The beneficiary entitled to receive payment of
any amounts payable under this contract upon
death of the Owner.
PAYMENT CALCULATION DATE The date We calculate annuity payments under a
Variable Payment Annuity Option. The first
Payment Calculation Date is the Valuation Date
on or next following the Settlement Date unless
We agree otherwise.
D604 3
After the first Payment Calculation Date, We
will calculate payments on the same date each
month. We use the next following Valuation Date
if such date is not a Valuation Date.
PREMIUM PAYMENT DATE The Valuation Date on which a premium payment is
received at Our Variable Products Operations
unless it is received after the close of the New
York Stock Exchange, in which case it will be
the next Valuation Date.
SETTLEMENT DATE The date contract proceeds are applied to an
annuity payment option. Unless We agree
otherwise, for death benefits, the Settlement
Date is the date that We receive a certified
copy of the Annuitant's certificate of death;
for proceeds payable on the Maturity Date, it is
the Maturity Date; and for proceeds payable upon
a surrender, it is the effective date of the
surrender.
SUBACCOUNT(S) The account(s) within Our Separate Account to
which assets under the contract may be
allocated.
SURRENDER VALUE Contract Value less any applicable contingent
deferred sales charge and premium tax.
VALUATION DATE Every day the New York Stock Exchange is open
for trading.
VALUATION PERIOD The period in days beginning with the day
following the last Valuation Date and ending on
the next succeeding Valuation Date.
VARIABLE PAYMENT ANNUITY An annuity where each payment will vary with the
investment experience of the Subaccounts.
VAO Our Variable Annuity Operations division. The
address is shown on the cover page of this
contract.
WRITTEN REQUEST A request We receive in writing at VAO in a form
(AND WRITTEN NOTICE) satisfactory to Us.
D604 4
PART 2: ABOUT THIS CONTRACT
THE EFFECTIVE DATE This contract will begin in effect on the
Contract Date provided the initial premium due
is paid while the Annuitant is alive.
THE CONTRACT This contract and application, if any, which is
AND APPLICATION attached to this contract, is the entire
contract between You and Us. Any change in terms
of this contract, as required to conform to law,
to be in effect, must be signed by one of Our
executive officers and countersigned by Our
registrar or one of Our executive officers. This
contract is issued at Our Home Office in
Hartford, Connecticut. Any benefits payable
under this contract are payable at VAO.
REQUIRED PROOF We may require proof of the Annuitant's age
OF AGE AND SURVIVAL before any annuity payments will begin. We also
have the right to require proof of the identity,
age and survival of any person entitled to any
payment under this contract or upon whose life
any payments depend.
ADJUSTMENT FOR If the age or sex of the Annuitant has been
MISSTATEMENT OF misstated, any benefits payable will be adjusted
AGE OR SEX to the amount that the Contract Value would have
purchased based on the Annuitant's correct age
and sex. Any over payment(s) and under
payment(s) made by Us will be charged or
credited against future payments to be made
under the contract.
ASSIGNMENTS We will not be considered to have notice of any
assignment of an interest in this contract until
We receive the original or copy of the written
assignment at VAO. In no event will We be
responsible for its validity.
STATEMENT OF ACCOUNT We will send You a statement of the Contract
Value of this contract at least annually. We
will also provide You with a statement of the
investments held by each Subaccount. After the
Maturity Date, We will provide You with an
annual Statement of Account if You elect any of
the variable payment options.
D604 5
PART 3: RIGHTS OF OWNER
WHO IS THE OWNER The Owner may be the Annuitant, an employer, a
trust or any other individual or entity. If no
Owner is named, the Annuitant will be the Owner.
Under contracts used with certain tax qualified
plans, the Owner must be the Annuitant. A
husband and wife may be designated as Joint
Owners. If one of such Joint Owners dies, the
other Joint Owner becomes the sole Owner of the
Contract.
WHAT ARE THE RIGHTS You control this contract during the Annuitant's
OF THE OWNER lifetime but not until the Contract Date. Unless
You and We agree otherwise, You may exercise all
rights provided under this contract without the
consent of anyone else. Your rights include the
right to:
a. Receive any amounts payable under this
contract during the Annuitant's lifetime.
b. Change the Owner.
c. Change the premium payment amounts and
intervals. See Part 4.
d. Change the allocation schedule for
premium payments. See Part 4.
e. Transfer Contract Values between and among
the various Subaccounts and the Guaranteed
Interest Account. See Part 5.
f. Make withdrawals from the various
Subaccounts and the Guaranteed Interest
Account or fully surrender the contract for
its Surrender Value. See Part 5.
g. Select a Payment Option for amounts payable
upon a withdrawal or full surrender.
h. Select an alternative Payment Option to
commence on the Maturity Date. See Part 8.
i. Change the Owner's or Annuitant's
Beneficiary.
D604 6
j. Assign, subject to the restrictions stated
in Part 2, release, or surrender any
interest in this contract. See Parts 2 and
5.
k. Change the Contingent Annuitant any
time prior to the death of the Primary
Annuitant.
You may exercise these rights only while the
Annuitant is alive. Your exercise of any rights
will, to the extent thereof, assign, release, or
surrender the interest of the Annuitant and all
beneficiaries and Owners under this contract.
HOW TO CHANGE THE OWNER To change the Owner, you must submit a Written
Request.
DESIGNATION OF Prior to the death of the Annuitant, You may
CONTINGENT ANNUITANT designate or change the Contingent Annuitant by
sending a Written Request with the name, date of
birth, sex, Social Security Number and address
of the new Contingent Annuitant.
If You are an Owner/Xxxxxxxxx and Your spouse is
Your beneficiary under this Contract, Your
surviving spouse will automatically be the
Contingent Annuitant.
PART 4: PREMIUM PAYMENTS AND ALLOCATION
PREMIUM PAYMENTS The initial premium payment is due on the
Contract Date and must at least equal $10,000
for non-tax qualified plans or $2,000 for
qualified individual retirement annuity plans
unless We agree otherwise. The Annuitant must be
alive when the initial premium payment is made.
Thereafter, the premium payment amount and
intervals are as shown on the Schedule Page
unless later changed as described below. All
premium payments are payable at VAO, except that
the initial premium payment may be given to an
authorized agent for forwarding to VAO. No
benefit associated with any such premium payment
will be provided until it is actually received
by Us at VAO.
You may vary the amount and interval for
subsequent premium payments, and additional
premium payments may be made within the
following limits:
D604 7
a. Each premium payment must at least equal
$500 for non-tax qualified plans or $100 for
qualified individual retirement annuity
plans.
b. No more than $1,000,000 in total premium
payments may be paid on this contract,
unless We agree otherwise.
c. The premium payment intervals may be
unscheduled or changed to monthly,
quarterly, semi-annual, annual, or any other
arrangement agreed to by Us.
d. Additional premium payments may only be made
while an Annuitant is living, prior to the
Maturity Date.
We reserve the right to waive the limits in a &
b above.
PREMIUM The premium payment and Bonus Payment will be
PAYMENT ALLOCATION applied on its Premium Payment Date to the
various Subaccounts and the Guaranteed Interest
Account in accordance with Your instructions for
the allocation of premium payments.
You may change the allocation schedule with
respect to subsequent premium payments by
telephone or written request. We reserve the
right to waive the requirement of written
notice.
ACCUMULATION UNITS The number of Accumulation Units credited to
each Subaccount of the Separate Account will be
determined by dividing the premium payment and
Bonus Payment applied to that Subaccount by the
Accumulation Unit Value of that Subaccount on
the Premium Payment Date. The amount deposited
to the Guaranteed Interest Account will equal
the amount of any premium payment and Bonus
Payment applied on the Premium Payment Date.
ADDITIONAL SUBACCOUNTS We have the right to add Subaccounts of the
Separate Account subject to approval by the
Securities and Exchange Commission and, where
required, other regulatory authority. We further
reserve the right to add other Guaranteed
Interest Accounts.
D604 8
SUBSTITUTION OF If the shares of the Funds of this contract
SUBACCOUNTS should no longer be available for investment by
the Separate Account or if in Our judgment
further investment in such Funds becomes
inappropriate for use with this contract, We
reserve the right to substitute Accumulation
Units of another Subaccount for Accumulation
Units already purchased or to be purchased in
the future by premium payments under this
contract. Any such change will be subject to
approval by the Securities and Exchange
Commission and, where required, by the insurance
supervisory official of the state where this
contract is issued.
PART 5: TRANSFERS, WITHDRAWALS AND LAPSE
TRANSFERS AMONG You may transfer all or a portion of the
SUBACCOUNTS AND THE Contract Value of this contract among one or
GUARANTEED INTEREST ACCOUNT more of the Subaccounts and the Guaranteed
Interest Account. Transfers may be made by
telephone or Written Request. You may make up to
six transfers per Contract Year from the
Subaccounts and only one transfer per Contract
Year from the Guaranteed Interest Account unless
the Systematic Transfer Program is elected.
Under the Systematic Transfer Program, funds may
be transferred automatically among the
Subaccounts on a monthly, quarterly, semiannual
or annual basis. Unless We agree otherwise, the
minimum initial and subsequent transfer amounts
are $25 monthly, $75 quarterly, $150
semi-annually or $300 annually. Except as
otherwise provided under the Systematic Transfer
Program, the amount that may be transferred from
the Guaranteed Interest Account at any one time
cannot exceed the higher of $1000 or 25% of the
value of the Guaranteed Interest Account.
The transfer charge is as shown on the Schedule
Page. Any such charge will be deducted from the
Subaccounts or Guaranteed Interest Account from
which the amounts are to be transferred with
each such Subaccount or Guaranteed Interest
Account bearing a pro rata share of the transfer
charge. The value of each Subaccount will be
determined on the Valuation Date that coincides
with the date of transfer. Any Accumulation
Units held under a Subaccount of the Separate
Account or Adjusted Premiums held under the
Guaranteed Interest Account as the result of any
transfer shall retain its original Premium
Payment Date.
D604 9
WITHDRAWALS AND
FULL SURRENDER
You may withdraw in cash the Contract Value of
this contract, less any applicable deferred
premium tax and contingent deferred sales
charge, in whole or in part any time prior to
the Maturity Date or at any time for amounts
held under Variable Payment Annuity Options K or
L. Such withdrawals must be by Written Request
and must include such tax withholding
information as We may reasonably require. The
portion withdrawn from any Subaccount will be
taken by the surrender and release of such
number of Accumulation Units in such Subaccount
required to make the withdrawal, including any
deferred premium tax and contingent deferred
sales charge applicable to such withdrawal. Any
portion withdrawn from the Guaranteed Interest
Account will be taken by the release of Adjusted
Premiums in the amount needed to make the
withdrawal, including any deferred premium tax
and contingent deferred sales charge applicable
to such withdrawal. If no Contract Value remains
under this contract as the result of a
withdrawal, the contract will be deemed fully
surrendered and have no further value or effect.
The Contract Value will be determined on the
Valuation Date that coincides with the date of
the withdrawal.
During the first Contract Year, an amount up to
10% of the Contract Value at the time of the
first partial withdrawal may be withdrawn free
of any contingent deferred sales charge. After
the first Contract Year and each Contract Year
before the Maturity Date, an amount up to 10% of
the Contract Value as of the end of the prior
Contract Year may be withdrawn free of any
contingent deferred sales charge. Any amount
withdrawn in excess of the 10% will be subject
to the following contingent deferred sales
charge, expressed as a percentage of the amount
withdrawn, up to a maximum of the total premium:
Age in Complete Years from Payment
Date of Unit or Adjusted Premium Contingent Deferred
Released to Effectuate Withdrawal Sales Charge
---------------------------------- ------------
0 8%
1 8%
2 8%
3 7%
4 6%
5 5%
6 4%
7 3%
8 years or more 0%
D604 10
The contingent deferred sales charge is applied
to amounts withdrawn up to the total of all
premium payments less prior withdrawals
including any free withdrawal amounts. In no
event, however, will the total of all contingent
deferred sales charges applied under this
contract exceed 9% of the total premium payments
paid on this contract.
You may elect to apply the amount withdrawn or
surrendered to the various Payment Options
described in Part 10.
LAPSE If on any Valuation Date the Contract Value
becomes zero, the contract will immediately
terminate and lapse without value unless any
Contract Value has been applied under one of the
variable payment options within 30 days after
any such Valuation Date. We will mail a written
notice of lapse to You at Your most recent post
office address on file with Us at VAO.
RULES AND LIMITATIONS The Accumulation Units and Adjusted Premiums
released for transfer or withdrawal will be
determined on a First-In, First-Out (FIFO) basis
based on Premium Payment Date. No withdrawals,
or full surrender may be made after commencement
of an annuity on the Maturity Date except for
any Contract Value remaining under Options K or
L. Also, You may not transfer any assets under
Option M, unless We agree otherwise
DEFERRAL OF PAYMENT With the exception of transfers from the
Guaranteed Interest Account, as described above
under Transfers Among Subaccounts and
withdrawals from such Subaccount as described
below, transfers, withdrawals, or a request for
a full surrender will usually be processed
within 7 days after We receive the written
request at VAO. However, We may postpone the
processing of any such transactions for any of
the following reasons (as provided under the
Investment Company Act of 1940):
a. when the New York Stock Exchange is closed,
other than customary weekend and holiday
closings;
b. when trading on the exchange is restricted
by the Securities and Exchange Commission;
D604 11
c. when the Securities and Exchange Commission
declares that an emergency exists as a
result of which disposal of securities in
the Fund is not reasonably practicable or it
is not reasonably practicable to determine
the value of the Units in the Subaccounts of
the Separate Account; or
d. when a governmental body having jurisdiction
over the VA Account by order permits such
suspension.
Rules and regulations of the Securities and
Exchange Commission, if any, are applicable and
will govern as to whether conditions described
in (b) or (c) or (d) exist.
For withdrawals from the Guaranteed Interest
Account, We may defer payment for up to six
months from the date VAO receives the Written
Request. If payment is delayed 30 days or more,
We will add interest at an annual rate of 4%.
PART 6: EXPENSE CHARGES
Charges to cover expenses incurred by Us in the
distribution and administration of this contract
are made in the manner described below.
PREMIUM TAX A premium tax may be required based on the laws
of the state of issue or the state where the
Owner resides when a premium payment is applied.
The premium tax rate, if any, as of the Contract
Date, is shown on the Schedule Page. This rate
may change for subsequent premium payments in
accordance with applicable state law. We will
pay any premium tax due and will only reimburse
ourselves upon the earlier of partial
withdrawal, surrender of the Contract, payment
of death proceeds or the Maturity Date. At the
time of reimbursement, We will deduct the tax
proportionately from the Subaccounts and
Guaranteed Interest Account based on their
proportionate Contract Value. On partial
withdrawals, We will deduct a pro rata amount of
the tax based upon the ratio of the amount
withdrawn to the Contract Value.
D604 12
SURRENDER CHARGE A charge to cover expenses incurred in the sale
and distribution of this contract is taken in
the form of a contingent deferred sales charge
as described in Part 5 which is applied to any
withdrawals or full surrender made within the
seven-year period following the Premium Payment
Date of the Accumulation Units or Adjusted
Premiums released to make such withdrawal or
surrender.
TRANSFER CHARGE A transfer charge is as shown on the Schedule.
ANNUAL ADMINISTRATIVE A portion of the administrative expense incurred
CHARGE by Us is assessed in the form of an annual
charge as shown on the Schedule Page. We reserve
the right to lower such charge. Such charge will
be deducted at the end of each Contract Year
from the total Contract Value with each
Subaccount and Guaranteed Interest Account
bearing a pro rata share of such expense based
on the proportionate Contract Value of each of
the Subaccounts and Guaranteed Interest Account.
By agreement with Us, You may, instead, elect to
pay this charge in cash.
If You elect Payment Options I, J, K, M or N,
the Annual Administrative Charge after the
Maturity Date will be deducted from each annuity
payment in proportionately equal amounts.
MORTALITY AND The mortality and expense risk fee is taken in
EXPENSE RISK FEE the form of a daily fee against each
Subaccount as shown on the Schedule
Page. We reserve the right to lower such fee.
DAILY TAX FEE A daily tax fee is taken by Us in the form of a
daily fee against each Subaccount as shown on
the Schedule Page.
DAILY ADMINISTRATIVE FEE A portion of the administrative expense incurred
by Us is assessed in the form of a daily fee
against each Subaccount as shown on the Schedule
Page.
PART 7: DETERMINING THE CONTRACT AND
ACCUMULATION UNIT VALUES
CREDITING OF SUBACCOUNT We will apply any premium payments We receive on
UNITS AND PREMIUMS the Premium Payment Date and Bonus Payments to
credit Accumulation Units to one or more
Subaccounts or to credit purchases to the
Guaranteed Interest Account in accordance with
the most recent allocation schedule on file with
Us. The number of Accumulation Units
D604 13
credited to each Subaccount will be determined
by dividing the premium payment and Bonus
Payment applied to that Subaccount by the then
current Accumulation Unit Value of that
Subaccount. The Accumulation Unit Value of each
Subaccount on a Valuation Date is determined at
the end of that day.
DETERMINATION OF THE Prior to the Maturity Date, the value of a
CONTRACT VALUE Subaccount of the Separate Account is determined
by multiplying the total number of Accumulation
Units under this contract for that Subaccount by
the current Accumulation Unit Value of that
Subaccount. The Contract Value for amounts held
under Variable Payment Annuity Option L is
determined in the same manner. The value of the
Guaranteed Interest Account equals the total
value of the Adjusted Premiums. The total
Contract Value under this contract equals the
sum of the values of each of the Subaccounts and
the Adjusted Premiums.
THE VALUATION OF SUB- The values and benefits of the Guaranteed
ACCOUNTS AND GUARANTEED Interest Account are not less than those
INTEREST ACCOUNT required by the laws of the state in which it is
delivered.
The values of the assets in each Subaccount will
be calculated in accordance with applicable law
and accepted procedures.
We guarantee that expense and mortality results
shall not adversely affect the dollar amount of
variable benefits and other contractual payments
and values.
PART 8: ANNUITY BENEFITS
On or before the Maturity Date, You may elect
any one of the Payment Options as described in
Part 10. If you do not select a Payment Option
on or before the Maturity Date, We will apply
the Contract Value less any premium tax due to
provide You a variable life annuity under
Payment Option L as described in Part 10. Any
annuity payments falling due after the
Annuitant's death during the period certain will
be paid to the Annuitant's Beneficiary.
If the amount to be applied on the Maturity Date
is less than $2,000 or would result in monthly
payments of less than $20, We shall have the
right to pay such amount to You in one lump sum
in lieu of providing such annuity. We also have
the right to change the annuity payment
frequency to annual if the monthly annuity
payment would otherwise be less than $20.
D604 14
PART 9: DEATH BENEFITS
The death benefits provided under this contract
are not less than the minimum benefits required
under the laws of the state where this contract
is delivered.
DEATH BEFORE For deaths occurring prior to the Maturity Date,
MATURITY DATE We will pay the death proceed upon receipt of
due proof of death as follows:
1. Death of an Owner/Annuitant:
If an Owner/Xxxxxxxxx dies before the
Maturity Date, We will pay the Annuitant's
Beneficiary the death proceeds provided by
the Death Benefit Option selected by the
Owner at the time of the initial premium
payment.
2. Death of an Owner who is not the Annuitant:
If an Owner who is not the Annuitant dies
before the Maturity Date, we will pay the
Owner's Beneficiary the death proceeds (less
any deferred premium tax) equal to the
greater of:
a. 100% of premium payments (not including
any Bonus Payments) less "Adjusted
Partial Withdrawals" (as defined below);
or
b. the Contract Value next determined
following receipt of a certified copy of
the death certificate at VAO.
3. Death of an Annuitant who is not the Owner:
If an Annuitant who is not the Owner dies
before the Maturity Date, We will pay the
Annuitant's Beneficiary the death proceeds
provided by the Death Benefit Option
selected by the Owner at the time of the
initial premium payment.
In lieu of receiving the death proceeds in
one lump sum, the beneficiary may elect to
apply the death proceeds under any of the
Payment Options described in Part 10 subject
to the following limitations:
D604 15
a. Options D, F and J are not available for
death benefits;
b. Under Options A, E, G, H and K the period
specified must be at least 5 years, but
not beyond the life expectancy of such
beneficiary.
ELECTION OF DEATH The Owner shall elect either Death Benefit
BENEFIT OPTIONS Option 1 or Death Benefit Option 2 at the time
of the Owner's initial premium payment. The
Owner's chosen option is as shown on the
Schedule Page. If no option is elected, Death
Benefit Option 1 shall apply.
DEATH BENEFIT - OPTION 1 Upon the death of the Annuitant or an
Owner/Annuitant, the death proceeds (less any
deferred premium tax) is equal to the greater
of:
a. 100% of premium payments (not including
any Bonus Payments) less "Adjusted
Partial Withdrawals" (as defined below);
or
b. the Contract Value next determined
following receipt of a certified copy of
the death certificate at VAO.
DEATH BENEFIT - OPTION 2 Upon the death of the Annuitant or an
Owner/Xxxxxxxxx who has not yet attained age 80,
the death proceeds (less any deferred premium
tax) is equal to the greater of:
a. 100% of premium payments (not including
any Bonus Payments) less "Adjusted
Partial Withdrawals" (as defined below);
or
b. the "Annual Step-up Amount" (as
defined below); or
c. the Contract Value next determined
following receipt of a certified copy of
the death certificate at VAO.
On and after the Annuitant's attained age 80,
the death proceeds (less any deferred premium
tax) equals the greater of:
a. the death benefit calculated at the end
of the Contract Year prior to the
Annuitant's attained age 80, plus 100% of
the premium payments less "Adjusted
Partial Withdrawals" made since the end
of the Contract Year prior to the
Annuitant's attained age 80; or
b. the Contract Value next determined
following receipt of a certified copy of
the death certificate at VAO.
D604 16
ADJUSTED PARTIAL The sum of all Adjusted Partial Withdrawals when
WITHDRAWALS each is calculated for each partial withdrawal
as the product of (a) times (b) where:
a. is the ratio of the amount of the partial
withdrawal to the Contract Value on the
date of (but prior to) the partial
withdrawal; and
b. is the death benefit on the date of
(but prior to) the partial withdrawal.
ANNUAL STEP-UP AMOUNT In the first Contract Year the Annual Step-up
Amount is equal to the greater of:
a. 100% of premium payments less "Adjusted
Partial Withdrawals"; or
b. the Contract Value.
In the second Contract Year or any subsequent
Contract Year the Annual Step-up Amount is equal
to the greater of:
a. the Annual Step-up Amount at the end of
the previous Contract Year, plus 100% of
premium payments made since the end of
the previous Contract Year, less
"Adjusted Partial Withdrawals" made since
the end of the previous Contract Year; or
b. the Contract Value next determined
following receipt of a certified copy of
the death at VAO.
DISTRIBUTION AT DEATH Death of an Owner/Annuitant
REQUIREMENTS ---------------------------
If the Owner/Annuitant dies before the Maturity
Date, then the Annuitant's Beneficiary must
elect within 60 days of Our receipt of due proof
of death to receive the death proceeds in a lump
sum or elect to apply the death proceeds due
under a Payment Option, provided that the
payments begin within one year of the date of
death of the Annuitant. If the Annuitant's
Beneficiary is the surviving spouse, the
surviving spouse may elect to continue the
Contract as new Owner/Annuitant as if no death
had occurred.
D604 17
Death of an Owner Who Is not the Annuitant
------------------------------------------
If the Owner who is not the Annuitant dies
before the Maturity Date and the Owner's
surviving spouse is not the Joint Owner or the
Owner's Beneficiary, the Owner's entire interest
in this Contract must be distributed within five
years of the date of the Owner's death, provided
that the Owner's Beneficiary may elect to apply
the death proceeds to a Payment Option not
extending beyond the life (or life expectancy)
of the Owner's Beneficiary and the payments
begin within one year after the Owner's death.
If the Owner's surviving spouse is a Joint
Owner, the Contract will continue with the
surviving Joint Owner becoming the sole Owner.
If the Owner's Beneficiary is the surviving
spouse, the surviving spouse may elect to
continue the Contract as the new Owner as if no
death had occurred.
Death of an Annuitant Who Is not the Owner
------------------------------------------
If the Annuitant who is not the Owner dies
before the Maturity Date and there is no
Contingent Annuitant, then the Annuitant's
Beneficiary must elect within 60 days of Our
receipt of due proof of death to receive the
death proceeds in a lump sum or elect to apply
the death proceeds due under a Payment Option,
provided that the payments begin within one year
of the date of death of the Annuitant. If there
is a Contingent Annuitant, the Contract will
continue with the Contingent Annuitant becoming
the new Annuitant.
If the Annuitant dies before the Maturity Date
and the Owner is not an individual, the entire
interest in this contract must be distributed
within five years of the date of the Annuitant's
death. However, the Annuitant's Beneficiary may
elect to apply the death proceeds to a Payment
Option not extending beyond the life (or life
expectancy) of such Annuitant's Beneficiary and
the payments begin within one year after the
Annuitant's death. If the Annuitant's
Beneficiary is the surviving spouse, the
surviving spouse may elect to continue the
Contract as new Annuitant as if no death had
occurred.
We shall have the right to first require return
of the contract to us so that we may amend it to
reflect these changes.
DEATH ON OR AFTER THE If either the Owner/Xxxxxxxxx, Annuitant, or
MATURITY DATE Owner dies on or after the Maturity Date, any
remaining income payments will be continued to
the Annuitant's or Owner's Beneficiary
respectively. Under Payment Option M, the sum of
the number of remaining Annuity Units for each
Subaccount multiplied by the current Annuity
Unit Value for that Subaccount will be paid to
the Annuitant's or Owner's Beneficiary in a lump
sum (see "Option M - Unit Refund Variable Life
Annuity" in Part 10).
D604 18
THE BENEFICIARY The Annuitant's Beneficiary:
---------------------------
Any death proceeds payable to the Annuitant's
Beneficiary will be paid to the Owner or the
Owner's estate if the Annuitant's Beneficiary is
not living when such death proceeds become
payable.
The Owner's Beneficiary:
------------------------
Any death proceeds payable to the Owner's
Beneficiary will be paid to the Owner's estate
if the Owner's Beneficiary is not living when
such death proceeds become payable.
In the case of the death of an Owner/Annuitant
where conflicting Owner and Xxxxxxxxx's
Beneficiaries have been named, any death
proceeds payable will be paid to the Annuitant's
Beneficiary.
The naming of an Owner's or Xxxxxxxxx's
beneficiary by familial relationship (such as
Mother, Father, etc.) shall be understood to be
their relationship to the Owner or Annuitant
making such designation.
WHAT ARE THE RIGHTS The Annuitant's Beneficiary and Owner's
OF THE BENEFICIARY Beneficiary may exercise the following rights
with respect to the death proceeds they are
entitled to receive:
1. Receive the death proceeds payable under
this contract; or
2. Select a Payment Option for the death
proceeds; or
3. Transfer the amount of any deferred death
proceeds between and among the various
Subaccounts. See Part 5.
HOW TO CHANGE THE At any time prior to the death of the last of
BENEFICIARY the Annuitants under this contract, You may
change the Owner's Beneficiary or the
Annuitant's Beneficiary. The change must be made
by Written Notice signed by You. When We receive
it, the change will be effective as of the date
it was signed by You. However, the change will
be subject to any payment made or actions taken
by Us before We received the Written Notice.
D604 19
PART 10: PAYMENT OPTIONS
You must elect a payment option by Written
Request. We reserve the right to require that
the election of a payment option be in the form
of a supplementary contract distributed by Us
reflecting the terms of the payment option
elected. We have the right to require proof of
age and sex of any person on whose life payments
depend, as well as proof of the continued
survival of any such person. After the first
Payment Calculation Date, You may not change the
Payment Option You elected. As regards the
election of a Payment Option by the beneficiary
of any death proceeds payable under this
contract, limited as described in Part 9, the
term "Annuitant" as used below shall refer to
such beneficiary.
CALCULATION OF The guaranteed annuity payment rates under the
FIXED ANNUITY following options will be based on the
PAYMENTS Annuitant's age and sex, and will be no less
favorable than the following:
Under Options A, B, D, E and F rates are based
on the a-49 Annuity Table projected to 1985 with
Projection Scale B. We use an interest rate of
3-3/8% for 5- and 10-year certain periods under
Option A, for the 10-year certain period under
Option F, and for Option E; an interest rate of
3-1/4% for the 20-year certain period under
Options A and F; an interest rate of 3-1/2%
under Options B and D. Under Options G and H the
guaranteed interest rate is 3%.
If Our rates in effect on the Settlement Date
are more favorable, We will use those rates.
CALCULATION OF Under the following options, all payments after
VARIABLE ANNUITY the first payment will vary with the investment
PAYMENTS experience of the Subaccounts. Payments may be
either higher or lower than the first payment.
Under Options I, J, K, M and N, We determine the
first payment by multiplying the amounts held
under the selected option in each Subaccount by
the applicable Payment Option rate. The first
payment equals the total of such amounts
determined for each Subaccount. We determine
future payments under these options by
multiplying the number of Annuity Units in each
Subaccount by the Annuity Unit Value for each
Subaccount on the Payment Calculation Date. The
payment will equal the sum of the amounts
provided by each Subaccount.
D604 20
Under Option L, We determine the amount of the
annual distribution by dividing the amount of
Contract Value held under this option on
December 31 of the previous year by the life
expectancy of the Annuitant or the joint life
expectancy of the Annuitant and Joint Annuitant
at that time.
Under Options I, J, M and N, the applicable
option rate used to determine the first payment
amount will not be less than the rate based on
the 1983 Table A (1983 IAM) projected with
Projection Scale G to the year 2040, and with
continued projection thereafter, and on the
Assumed Investment Rate. Under Option K, the
rate will be based on the number of payments to
be made during the specified period and the
Assumed Investment Rate.
OPTION A - A fixed payout annuity payable monthly while the
LIFE ANNUITY Annuitant is living or, if later, the end of the
WITH SPECIFIED specified period certain. The period certain may
PERIOD CERTAIN be specified as 5, 10, or 20 years. The period
certain must be elected at the time this option
is elected.
OPTION B - A fixed payout annuity payable monthly while the
NON-REFUND Annuitant is living and ending with the last
LIFE ANNUITY Life payment due preceding the date of the
Annuitant's death.
OPTION D - A fixed payout annuity payable monthly while the
JOINT AND SURVIVORSHIP Annuitant and the designated Joint Annuitant are
LIFE ANNUITY living, and continuing thereafter during the
lifetime of the survivor. The amount to be
continued to the survivor is 100% of the joint
annuity payment, as specified at the time this
option is elected. The designated Joint
Annuitant must be designated at the time this
option is elected and must have an adjusted age
of at least 40. The adjusted age is the person's
age on his or her birthday nearest the
Settlement Date.
OPTION E - A fixed payout annuity payable monthly while the
INSTALLMENT REFUND Annuitant is living or, if later, the date the
LIFE ANNUITY annuity payments made under this option total an
amount which refunds the entire amount applied
under this option. If the Annuitant is not
living when the final payment falls due, that
payment will be limited to the amount which
needs to be added to the payments already made
to equal the entire amount applied under this
option.
OPTION F - A fixed payout annuity payable monthly while
JOINT AND SURVIVORSHIP either the Annuitant or designated Joint
LIFE ANNUITY WITH Annuitant is living, or if later, the end of 10
10-YEAR PERIOD CERTAIN years. The designated Joint Annuitant must be
designated at the time this option is elected
and must have an adjusted age of at least 40
years. The adjusted age is the person's age on
his or her birthday nearest the settlement date.
D604 21
OPTION G - Equal income installments for a specified period
PAYMENTS FOR A of years are paid whether the payee lives or
SPECIFIED PERIOD dies. The period certain specified must be in
whole numbers of years from 5 to 30.
OPTION H - Equal income installments of a specified amount
PAYMENTS OF A are paid until the principal sum remaining under
SPECIFIED AMOUNT this option from the amount applied is less than
the amount of the installment. When that
happens, the principal sum remaining will be
paid as a final payment. The amount specified
must provide for payments for a period of at
least 5 years.
OPTION I - This option provides variable monthly payments
VARIABLE LIFE ANNUITY that will continue during the lifetime of the
WITH 10-YEAR Annuitant or for ten years, if longer. If the
PERIOD CERTAIN beneficiary of any death benefits payable under
this contract elects this payment option, the
term "Annuitant" as used in the preceding
paragraph shall refer to such beneficiary and
the period certain will equal 10 years, or the
life expectancy of such beneficiary, if shorter.
OPTION J - This option provides variable monthly payments
JOINT SURVIVORSHIP VARIABLE while the Annuitant and the designated Joint
LIFE ANNUITY WITH Annuitant are living. Payments will continue
10-YEAR PERIOD CERTAIN during the life of the survivor or until the end
of 10 years if later. You must designate the
Joint Annuitant at the time You elect this
option. The designated Joint Annuitant must be
at least age 40 on the birthday nearest the
first Payment Calculation Date. This option is
not available for the payment of any death
benefit under this contract.
OPTION K - This option provides variable monthly payments
VARIABLE ANNUITY through the release of a fixed number of Annuity
FOR SPECIFIED PERIOD Units over a specified period of time. Payment
continues whether the Annuitant lives or dies.
The specified period must be in whole numbers of
years from 5 to 30. However, the period selected
by the beneficiary may not extend beyond the
life expectancy of such beneficiary. This option
also provides for unscheduled withdrawals. An
unscheduled withdrawal will reduce the number of
remaining annuity units. Thus, the specified
period will be reduced to the period that the
remaining annuity units can provide.
OPTION L - This option provides a variable income which is
VARIABLE LIFE payable over the Annuitant's annually
EXPECTANCY ANNUITY recalculated life expectancy or the annually
recalculated life expectancy of the Annuitant
and Joint Annuitant. This option also provides
for unscheduled withdrawals. An unscheduled
withdrawal will reduce the Contract Value. This
will thus affect the amount of future payments.
Upon the death of the Annuitant (and Joint
Annuitant, if there is a Joint Annuitant) the
remaining Contract Value will be paid in a lump
sum to the Annuitant's Beneficiary.
D604 22
OPTION M - This option provides variable monthly payments
UNIT REFUND as long as the Annuitant lives. In the event of
VARIABLE LIFE ANNUITY the death of the Annuitant, the income will stop
and the Annuitant's Beneficiary will receive in
a lump sum the value of the remaining Annuity
Units. This value is equal to the sum of the
number of remaining Annuity Units for each
Subaccount multiplied by the current Annuity
Unit Value for that Subaccount. The number of
remaining Annuity Units for each Subaccount will
be calculated as follows:
(1) the net amount in the Subaccount
applied under this option on the first
Payment Calculation Date divided by the
corresponding Annuity Unit Value on
that date minus
(2) the sum of the Annuity Units released
from the Subaccount to make the
payments under this option.
OPTION N - This option provides a variable monthly income
VARIABLE NON- for the lifetime of the Annuitant. No income is
REFUND LIFE ANNUITY payable after the death of the Annuitant.
OTHER OPTIONS We may offer other payment options or
alternative versions of the options listed
above.
PART 11: TABLES OF PAYMENT OPTION AMOUNTS
The tables that follow show the guaranteed
minimum monthly payments for Options A-G, and
the minimum initial payment for the Variable
Payment Options I, J, K, M and N for each $1,000
applied. If Our rates in effect at the
Settlement Date are more favorable, We will use
those rates. Subsequent monthly payments for the
Variable Payment Options will vary and may be
higher or lower than the first payment. Amounts
for payment frequencies, periods or ages not
shown will be furnished upon request.
The term "age" as used in the tables refers to
the adjusted age. The adjusted age is defined as
the age of the Annuitant on the Annuitant's
birthday nearest the effective date of the
payment option elected.
D604 23
OPTIONS A & E -- LIFE ANNUITY WITH SPECIFIED PERIOD CERTAIN; INSTALLMENT
REFUND LIFE ANNUITY
------------ --------------------------- -------------------------- -------------------------
INSTALLMENT REFUND 10 YEARS CERTAIN 20 YEARS CERTAIN
AGE OF --------------------------------------------------------------------------------
PAYEE MALE FEMALE MALE FEMALE MALE FEMALE
------------ ------------- ------------- ------------ ------------- ------------ ------------
40 $3.80 $3.64 $3.86 $3.60 $3.74 $3.54
------------ ------------- ------------- ------------ ------------- ------------ ------------
45 4.05 3.85 4.14 .82 3.99 3.74
------------ ------------- ------------- ------------ ------------- ------------ ------------
50 4.36 4.12 4.50 4.10 4.28 3.99
------------ ------------- ------------- ------------ ------------- ------------ ------------
55 4.76 4.47 4.95 4.47 4.61 4.31
------------ ------------- ------------- ------------ ------------- ------------ ------------
60 5.28 4.93 5.54 4.96 4.97 4.67
------------ ------------- ------------- ------------ ------------- ------------ ------------
65 5.97 5.54 6.30 5.63 5.29 5.06
------------ ------------- ------------- ------------ ------------- ------------ ------------
70 6.91 6.39 7.24 6.50 5.43 5.31
------------ ------------- ------------- ------------ ------------- ------------ ------------
75 8.21 7.57 8.26 7.56 5.44 5.40
------------ ------------- ------------- ------------ ------------- ------------ ------------
80 10.04 9.26 10.12 8.60 5.46 5.46
------------ ------------- ------------- ------------ ------------- ------------ ------------
85 12.61 11.68 12.60 9.31 5.46 5.46
------------ ------------- ------------- ------------ ------------- ------------ ------------
OPTION B -- NON-REFUND LIFE ANNUITY
--------------- ------------ ------------
AGE OF
PAYEE MALE FEMALE
--------------- ------------ ------------
40 $ 3.95 $ 3.75
--------------- ------------ ------------
45 4.24 3.98
--------------- ------------ ------------
50 4.62 4.28
--------------- ------------ ------------
55 5.12 4.68
--------------- ------------ ------------
60 5.79 5.24
--------------- ------------ ------------
65 6.75 6.04
--------------- ------------ ------------
70 8.15 7.22
--------------- ------------ ------------
75 10.26 9.03
--------------- ------------ ------------
80 13.54 11.88
--------------- ------------ ------------
85 18.72 16.54
--------------- ------------ ------------
OPTION D -- JOINT AND SURVIVORSHIP LIFE ANNUITY
--------------------------------------------------------------------------------------------------
FEMALE MALE
AGE ---------------------------------------------------------------------------------------
40 45 50 55 60 65 70 75
------------------------------------------------------------------------------------------------
40 $3.49 $3.55 $3.59 $3.62 $3.64 $3.65 $3.66 $3.67
------------------------------------------------------------------------------------------------
45 3.58 3.67 3.74 3.80 3.83 3.86 3.88 3.89
------------------------------------------------------------------------------------------------
50 3.65 3.79 3.90 4.00 4.07 4.12 4.16 4.18
------------------------------------------------------------------------------------------------
55 3.72 3.89 4.06 4.22 4.35 4.44 4.51 4.56
------------------------------------------------------------------------------------------------
60 3.77 3.97 4.20 4.43 4.65 4.83 4.96 5.05
------------------------------------------------------------------------------------------------
65 3.80 4.04 4.31 4.62 4.94 5.25 5.51 5.71
------------------------------------------------------------------------------------------------
70 3.83 4.08 4.34 4.77 5.20 5.67 6.13 6.52
------------------------------------------------------------------------------------------------
75 3.85 4.12 4.46 4.88 5.40 6.04 6.75 7.46
------------------------------------------------------------------------------------------------
OPTION F -- JOINT AND SURVIVORSHIP LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
--------------------------------------------------------------------------------------------------
MALE
FEMALE -------------------------------------------------------------------------------------------
AGE 40 45 50 55 60 65 70 75
--------------------------------------------------------------------------------------------------
40 $3.49 $3.55 $3.59 $3.62 $3.64 $3.65 $3.66 $3.67
------------------------------------------------------------------------------------------------
45 3.58 3.67 3.74 3.80 3.83 3.86 3.88 3.89
------------------------------------------------------------------------------------------------
50 3.65 3.78 3.90 4.00 4.07 4.12 4.15 4.17
------------------------------------------------------------------------------------------------
55 3.72 3.89 4.06 4.22 4.34 4.44 4.50 4.54
------------------------------------------------------------------------------------------------
60 3.77 3.97 4.19 4.43 4.64 4.82 4.95 5.03
------------------------------------------------------------------------------------------------
65 3.80 4.03 4.31 4.61 4.93 5.23 5.45 5.65
------------------------------------------------------------------------------------------------
70 3.83 4.08 4.39 4.75 5.18 5.63 6.07 6.41
------------------------------------------------------------------------------------------------
75 3.85 4.11 4.45 4.86 5.36 5.96 6.62 7.21
------------------------------------------------------------------------------------------------
D604 24
OPTION G -- PAYMENTS FOR A SPECIFIED PERIOD
-------------------- ----------------- ------------------
NUMBER OF ANNUAL MONTHLY
YEARS INSTALLMENT INSTALLMENT
-------------------- ----------------- ------------------
5 $211.99 $17.91
-------------------- ----------------- ------------------
6 179.22 15.14
-------------------- ----------------- ------------------
7 155.83 13.16
-------------------- ----------------- ------------------
8 138.31 11.68
-------------------- ----------------- ------------------
9 124.69 10.53
-------------------- ----------------- ------------------
10 113.82 9.61
-------------------- ----------------- ------------------
11 104.93 8.86
-------------------- ----------------- ------------------
12 97.54 8.24
-------------------- ----------------- ------------------
13 91.29 7.71
-------------------- ----------------- ------------------
14 85.95 7.26
-------------------- ----------------- ------------------
15 81.33 6.87
-------------------- ----------------- ------------------
16 77.29 6.53
-------------------- ----------------- ------------------
17 73.74 6.23
-------------------- ----------------- ------------------
18 70.59 5.96
-------------------- ----------------- ------------------
19 67.78 5.73
-------------------- ----------------- ------------------
20 65.26 5.51
-------------------- ----------------- ------------------
25 55.76 4.71
-------------------- ----------------- ------------------
30 49.53 4.18
-------------------- ----------------- ------------------
OPTION I -- VARIABLE LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
--------------- ------------ ------------
AGE OF
PAYEE MALE FEMALE
--------------- ------------ ------------
40 $4.15 $4.02
--------------- ------------ ------------
45 4.29 4.12
--------------- ------------ ------------
50 4.40 4.27
--------------- ------------ ------------
55 4.73 4.46
--------------- ------------ ------------
60 5.06 4.71
--------------- ------------ ------------
65 5.51 5.05
--------------- ------------ ------------
70 6.08 5.52
--------------- ------------ ------------
75 6.79 6.17
--------------- ------------ ------------
80 7.65 6.99
--------------- ------------ ------------
85 8.57 7.98
--------------- ------------ ------------
OPTION J -- JOINT SURVIVORSHIP VARIABLE LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
-------------------------------------------------------------------------------------------------
MALE
FEMALE -------------------------------------------------------------------------------------
AGE 40 45 50 55 60 65 70 75
-----------------------------------------------------------------------------------------------
40 $3.92 $3.94 $3.96 $3.98 $3.99 $4.00 $4.00 $4.01
-----------------------------------------------------------------------------------------------
45 3.96 4.00 4.03 4.06 4.08 4.09 4.10 4.11
-----------------------------------------------------------------------------------------------
50 4.00 4.05 4.10 4.15 4.18 4.21 4.23 4.24
-----------------------------------------------------------------------------------------------
55 4.03 4.10 4.18 4.24 4.30 4.35 4.39 4.41
-----------------------------------------------------------------------------------------------
60 4.06 4.15 4.25 4.34 4.43 4.52 4.58 4.63
-----------------------------------------------------------------------------------------------
65 4.09 4.19 4.31 4.44 4.57 4.70 4.81 4.90
-----------------------------------------------------------------------------------------------
70 4.11 4.22 4.36 4.53 4.70 4.89 5.07 5.22
-----------------------------------------------------------------------------------------------
75 4.12 4.75 4.41 4.60 4.82 5.07 5.34 5.59
-----------------------------------------------------------------------------------------------
D604 25
OPTION K -- VARIABLE ANNUITY FOR SPECIFIED PERIOD
-------------------- ----------------- ------------------
NUMBER OF ANNUAL MONTHLY
YEARS INSTALLMENT INSTALLMENT
-------------------- ----------------- ------------------
5 $217.98 $18.53
-------------------- ----------------- ------------------
6 185.53 15.77
-------------------- ----------------- ------------------
7 162.39 13.81
-------------------- ----------------- ------------------
8 145.08 12.34
-------------------- ----------------- ------------------
9 131.65 11.19
-------------------- ----------------- ------------------
10 120.94 10.28
-------------------- ----------------- ------------------
11 112.20 9.54
-------------------- ----------------- ------------------
12 104.94 8.92
-------------------- ----------------- ------------------
13 98.83 8.40
-------------------- ----------------- ------------------
14 93.61 7.96
-------------------- ----------------- ------------------
15 89.10 7.58
-------------------- ----------------- ------------------
16 85.18 7.24
-------------------- ----------------- ------------------
17 81.74 6.95
-------------------- ----------------- ------------------
18 78.70 6.69
-------------------- ----------------- ------------------
19 75.99 6.46
-------------------- ----------------- ------------------
20 73.57 6.25
-------------------- ----------------- ------------------
25 64.53 5.49
-------------------- ----------------- ------------------
30 58.75 5.00
-------------------- ----------------- ------------------
OPTION M - UNIT REFUND VARIABLE LIFE ANNUITY
--------------- ------------ ------------
AGE OF
PAYEE MALE FEMALE
--------------- ------------ ------------
40 $4.12 $4.01
--------------- ------------ ------------
45 4.25 4.11
--------------- ------------ ------------
50 4.42 4.24
--------------- ------------ ------------
55 4.64 4.41
--------------- ------------ ------------
60 4.92 4.64
--------------- ------------ ------------
65 5.28 4.94
--------------- ------------ ------------
70 5.74 5.33
--------------- ------------ ------------
75 6.32 5.86
--------------- ------------ ------------
80 7.07 6.55
--------------- ------------ ------------
85 8.01 7.43
--------------- ------------ ------------
OPTION N -- VARIABLE NON-REFUND LIFE ANNUITY
--------------- ------------ ------------
AGE OF
PAYEE MALE FEMALE
--------------- ------------ ------------
40 $4.15 $4.02
--------------- ------------ ------------
45 4.30 4.13
--------------- ------------ ------------
50 4.50 4.27
--------------- ------------ ------------
55 4.76 4.47
--------------- ------------ ------------
60 5.11 4.73
--------------- ------------ ------------
65 5.60 5.09
--------------- ------------ ------------
70 6.29 5.60
--------------- ------------ ------------
75 7.20 6.34
--------------- ------------ ------------
80 8.49 7.41
--------------- ------------ ------------
85 10.30 8.98
--------------- ------------ ------------
D604 26
[LOGO] PHOENIX
FLEXIBLE PREMIUM VARIABLE ACCUMULATION DEFERRED ANNUITY
ALL VALUES AND BENEFITS BASED ON THE INVESTMENT EXPERIENCE OF THE
SUBACCOUNTS OF THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE AND ARE
VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. SEE PART 7 FOR A
DESCRIPTION OF HOW THE CONTRACT VALUES ARE DETERMINED, AND PART 9 FOR A
DESCRIPTION OF HOW THE DEATH BENEFITS ARE DETERMINED.
NOT ELIGIBLE FOR ANNUAL DIVIDENDS
D604
