PLEASE READ THIS CONTRACT CAREFULLY
Annuity benefit payments and other values provided by this contract, when based
on the investment performance of the Variable Account, may increase or decrease
and are not guaranteed as to fixed dollar amount. Please refer to the Value of
the Variable Account section for additional information.
Values removed from a Guarantee Period Account prior to the end of its Guarantee
Period may be subject to a Market Value Adjustment that may increase or decrease
the values. A negative Market Value Adjustment will never be applied to the
Death Benefit. A positive Market Value Adjustment, if applicable, will be added
to the Death Benefit when the benefit paid is the contract's Accumulated Value.
Please refer to the Market Value Adjustment section for additional information.
RIGHT TO EXAMINE CONTRACT
The Owner may cancel this contract by returning it to the Company or one of its
authorized representatives within ten days after receipt. The Company will
refund an amount equal to the Accumulated Value, after application of any Market
Value Adjustment, plus any fees and other charges imposed. This amount may be
more or less than gross payment(s) to the contract. If, however, the contract is
issued as an Individual Retirement Annuity (IRA), the Company will refund the
greater of the above or gross payments.
ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY
Home Office: Dover, Delaware
Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000
This is a legal contract between Allmerica Financial Life Insurance and Annuity
Company (the Company) and the Owner and is issued in consideration of the
Initial Payment shown on the Specifications page. Additional Payments are
permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account
or Guarantee Period Accounts.
President Secretary
[ ] [ ]
Flexible Payment Deferred Variable and Fixed Annuity
Annuity Benefit Payments Payable on the Annuity Date
Death Benefit Payable if death occurs prior to Annuity Date
(see Death Benefits section) Non-Participating
1
PLEASE READ THIS CONTRACT CAREFULLY
Annuity benefit payments and other values provided by this contract, when based
on the investment performance of the Variable Account, may increase or decrease
and are not guaranteed as to fixed dollar amount. Please refer to the Value of
the Variable Account section for additional information.
Values removed from a Guarantee Period Account prior to the end of its Guarantee
Period may be subject to a Market Value Adjustment that may increase or decrease
the values. A negative Market Value Adjustment will never be applied to the
Death Benefit. A positive Market Value Adjustment, if applicable, will be added
to the Death Benefit when the benefit paid is the contract's Accumulated Value.
Please refer to the Market Value Adjustment section for additional information.
RIGHT TO EXAMINE CONTRACT
The Owner may cancel this contract by returning it to the Company or one of its
authorized representatives within ten days after receipt. The Company will
refund an amount equal to gross payments less any withdrawals taken.
ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY
Home Office: Dover, Delaware
Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000
This is a legal contract between Allmerica Financial Life Insurance and Annuity
Company (the Company) and the Owner and is issued in consideration of the
Initial Payment shown on the Specifications page. Additional Payments are
permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account
or Guarantee Period Accounts.
President Secretary
[ ] [ ]
Flexible Payment Deferred Variable and Fixed Annuity
Annuity Benefit Payments Payable on the Annuity Date
Death Benefit Payable if death occurs prior to Annuity Date
(see Death Benefit section) Non-Participating
2
TABLE OF CONTENTS
SPECIFICATONS 3
DEFINITIONS 8
OWNER, ANNUITANT AND BENEFICIARY 9
THE ACCUMULATION PHASE
PAYMENTS 11
VALUES 11
TRANSFER 13
XXXXXXXXXX AND SURRENDER 14
DEATH BENEFIT 16
THE PAYOUT PHASE
ANNUITY BENEFIT 18
TRANSFER 20
WITHDRAWAL 20
PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS 22
DEATH OF THE ANNUITANT 22
ANNUITY BENEFIT PAYMENT OPTIONS 22
LIFE ANNUITY GUARANTEE OPTIONS 23
ANNUITY OPTION RATE TABLES 23
GENERAL PROVISIONS 27
3
SPECIFICATIONS
Contract Type: [NQ] Contract Number: [zz00600000]
Issue Date: [01/01/02] Annuity Date: [01/01/2035]
(Must be at least 30 days after issue date)
Owner: [Xxxx Xxx] Owner Date of Birth: [01/01/1950]
Joint Owner: [Xxxx Xxx] Joint Owner Date of Birth: [01/01/1950]
Annuitant: [Xxxx Xxx] Xxxxxxxxx Date of Birth: [01/01/1950]
Joint Annuitant: [Xxxx Xxx] Joint Annuitant Date of Birth: [01/01/1950]
Annuitant Sex: [Male] Beneficiary(ies):
Joint Annuitant Sex: [Male] Primary: Surviving Joint Owner, if any
1st Contingent: [Xxxx Xxx]
2nd Contingent: [Xxx Xxx]
Minimum Fixed Account Minimum Additional Payment
Guaranteed Interest Rate: [3%] Amount: [$50.00]
Guarantee Period Account Guarantee Period Account
Minimum Interest Rate: [3%] Minimum Allocation Amount: [$1,000.00]
Minimum Withdrawal Minimum Accumulated Value
Amount: [$100.00] After Withdrawal: [$1,000.00]
Minimum Annuity Maximum Alternative Annuity Date: [01/01/2035]
Benefit Payment: [$100.00] (Must be at least 30 days after issue date)
Surrender Charge Table:
YEARS FROM SURRENDER CHARGE AS A
DATE OF PAYMENT PERCENT OF THE PAYMENTS
TO DATE OF WITHDRAWAL WITHDRAWN
--------------------------------------------------
Less Than: 1 7 %
2 6 %
3 4 %
Thereafter 0%
Withdrawal Without Surrender Charge Percentage: [10% of Gross Payment Base
(reduced by any prior Withdrawal Without Surrender Charge in the same calendar
year)] Mortality and Expense Risk Charge: [1.60%] on an annual basis of the
daily value of the Sub-Account assets. Administrative Charge: [.15%] on an
annual basis of the daily value of the Sub-Account assets. Contract Fee: [$35,
if the Accumulated Value is less than $75,000.00. Waived for 401(k)s.] Principal
Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 [(0-000-000-0000)]
4
SPECIFICATIONS (CONTINUED)
Owner: [Xxxx Xxx ] Contract Number: [zzz0000000]
Joint Owner: [Xxxx Xxx]
Initial Payment: [$10,000.00]
Payment Allocation: (The Initial Payment is allocated in the following manner:)
VARIABLE SUB-ACCOUNTS:
[ INSERT NAMES OF THE VARIABLE SUB-ACCOUNTS ]
FIXED ACCOUNT
5
SPECIFICATIONS (CONTINUED)
Owner: [Xxxx Xxx] Contract Number: [zzz0000000]
Joint Owner: [Xxxx Xxx]
GUARANTEE PERIOD ACCOUNTS
GUARANTEE INTEREST EXPIRATION
PERIOD RATE DATE
------ ---- ----
[ 2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years]
-------
100% TOTAL PAYMENT ALLOCATION
6
SPECIFICATIONS (CONTINUED)
Owner: [Xxxx Xxx] Contract Number: [zzz0000000]
Joint Owner: [Xxxx Xxx]
RIDER(S) SELECTED:
FOR TX ADD RIDER 3311-01
[Annual Step-up with 5% Yield Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[Annual Step-up with 7% Yield Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[10% Breakthrough Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[15% Breakthrough Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[10% Breakthrough with 5% Yield Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[15% Breakthrough with 5% Yield Enhanced Death Benefit Rider:]
[See Rider for Benefit and Charge:]
[Discount Rider:]
[See Rider for details]
[Enhanced Earnings Rider:]
[See Rider for Benefit and Charge:]
7
SPECIFICATIONS (SUPPLEMENT)
Contract Type: [Non-qualified] Contract Number: [zz00600000]
Owner: [Xxxx Xxx] Owner Date of Birth: [01/01/1950]
Joint Owner: [Xxxx Xxx] Joint Owner Date of Birth: [01/01/1950]
Annuitant: [Xxxx Xxx] Xxxxxxxxx Date of Birth: [01/01/1950]
Joint Annuitant: [Xxxx Xxx] Joint Annuitant Date of Birth: [01/01/1950]
Annuitant Sex: [Male] Beneficiary(ies):
Joint Annuitant Sex: [Male] Primary: Surviving Joint Owner, if any
1st Contingent: [Xxxx Xxx]
2nd Contingent: [Xxx Xxx]
Payee: [Xxxx Xxx and Xxxx Xxx]
Payee Address: [000 Xxxx Xxxxxx, Xxxxxxx, Xxxxxxxx 00000 ]
Annuity Date: [01/01/2035]
Annuity Benefit Payment Option: [Joint with 2/3 Survivor Option]
Survivor Annuity Benefit Percentage: [66 2/3%]
Percentage under a Fixed Annuity Option: [30%]
Percentage under a Variable Annuity Option: [70%]
Assumed Investment Return: [7%]
Annuity Benefit Payment Change Frequency: [Annual]
Annuity Benefit Frequency: [Monthly]
Variable Allocation on Annuity Date:
SUB-ACCOUNTS:
[INSERT NAMES OF THE VARIABLE SUB-ACCOUNTS]
3a
SPECIFICATONS (SUPPLEMENT)
[Payment Withdrawal Amount [10] times the previous annuity benefit
payment [but not more than the remaining
guaranteed annuity benefit payments.
"Guaranteed annuity benefit payments"
refers to the non-life contingent annuity
benefit payments.].]
[Present Value Withdrawal Amount: [[75%-100%] of Present Value of remaining
guaranteed annuity benefit payments.
"Guaranteed annuity benefit payments"
refers to the non-life contingent annuity
benefit payments.]
Mortality and Expense Risk Charge: [1.60% ] on an annual basis of the daily
value of the Sub-Account assets.
Administrative Charge: [.15%] on an annual basis of the daily
value of the Sub-Account assets.
Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx,
Xxxxxxxxxxxxx 00000 [(0-000-000-0000)]
4a
DEFINITIONS
Accumulated Value The aggregate value of all accounts in this contract
before the Annuity Date. As long as the Accumulated
Value is greater than zero, the contract will stay in
effect.
Accumulation Unit A measure used to calculate the value of a Sub-Account
before annuity benefit payments begin.
Annuitant On and after the Annuity Date, the person upon whose
continuation of life annuity benefit payments involving
life contingency depend. Joint Annuitants are permitted
and unless otherwise indicated, any reference to
Annuitant shall include Joint Annuitants.
Annuity Date The date annuity benefit payments begin. The Annuity
Date is shown on the Specifications page.
Annuity Unit A measure used to calculate annuity benefit payments
under a variable annuity option.
Beneficiary The person, persons or entity entitled to the Death
Benefit prior to the Annuity Date or any annuity
benefit payments upon the death of the Owner on or
after the Annuity Date.
Company Allmerica Financial Life Insurance and Annuity Company.
Contract Year A one-year period based on the issue date or an
anniversary thereof.
Effective Valuation The Valuation Date on or immediately following the day
Date a payment, request for transfer, withdrawal or
surrender, or Proof of Death is received at the
Principal Office.
Fixed Account The part of the Company's General Account to which all
or a portion of a Payment or transfer may be allocated.
Fund Each separate investment company, investment series or
portfolio eligible for investment by a Sub-Account of
the Variable Account.
General Account All assets of the Company that are not allocated to a
Separate Account.
Gross Payment Base Total gross payments made to the contract reduced by
withdrawals which exceed the Withdrawal Without
Surrender Charge amount.
Guarantee Period The number of years that a Guaranteed Interest Rate
may be credited to a Guarantee Period Account.
Guarantee Period An account which corresponds to a Guaranteed Interest
Account Rate for a specified Guarantee Period and is supported
by assets in a Separate Account. The Owner may only
invest in a Guarantee Period Account prior to the
Annuity Date.
Guaranteed Interest The annual effective rate of interest after daily
Rate compounding credited to a Guarantee Period Account.
7
Market Value A positive or negative adjustment to earnings in a
Adjustment Guarantee Period Account assessed if any portion of a
Guarantee Period Account is withdrawn or transferred
prior to the end of its Guarantee Period.
Owner The person, persons or entity entitled to exercise the
rights and privileges under this contract. Joint Owners
are permitted and unless otherwise indicated, any
reference to Owner shall include joint Owners.
Pro Rata How a Payment or withdrawal may be allocated among the
accounts. A Pro Rata allocation or withdrawal will be
made in the same proportion that the value of each
account bears to the Accumulated Value.
Proof of Death The death certificate and all necessary claim
paperwork, as determined by the Company.
Request A request or notice made by the Owner, in a manner
consistent with the Company's current procedures, which
is received and recorded by the Company.
Separate Account A segregated account established by the Company. The
assets in a Separate Account are not commingled with
the Company's general assets and obligations. The
assets of a Separate Account are not subject to claims
arising out of any other business the Company may
conduct.
State The state or jurisdiction in which the contract is
issued.
Sub-Account A Variable Account subdivision that invests exclusively
in shares of a corresponding Fund.
Surrender Value The amount payable to the Owner on full surrender after
application of any Market Value Adjustment, surrender
charge and Contract Fee.
Survivor Annuity The number of Annuity Units (under a variable joint
Benefit Percentage life annuitization option) or the dollar value of the
annuity benefit payments (under a fixed joint life
annuitization option) paid during the surviving
Annuitant's life may be less than or equal to the
number of Annuity Units paid when both individuals are
living. The Survivor Annuity Benefit Percentage is the
percentage of total Annuity Units or dollars paid in
each annuity benefit during the survivor's life. For
example, with a Joint and Two-thirds Survivor Option,
the Survivor Annuity Benefit Percentage is 66 2/3 %.
This percentage is only applicable after the death of
the first Annuitant.
Valuation Date A day the values of all units are determined. Valuation
Dates occur on each day the New York Stock Exchange is
open for trading, or such other dates when there is
sufficient trading in a Fund's portfolio securities
such that the current unit value may be materially
affected.
Valuation Period The interval between two consecutive Valuation Dates.
Variable Account The Company's Separate Account, consisting of
Sub-Accounts that invest in the underlying Funds.
8
OWNER, ANNUITANT AND BENEFICIARY
Owner When the contract is issued, the Owner will be as shown
on the Specifications page. The Owner may be changed in
accordance with the terms of this contract. Upon the
death of an Owner prior to the Annuity Date, a Death
Benefit is paid. The Maximum Alternative Annuity Date
is based upon the age of the Owner.
The Owner may exercise all rights and options granted
in this contract or by the Company, subject to the
consent of any irrevocable Beneficiary. Where there
are joint Owners, the consent of both is required in
order to exercise any ownership rights.
Assignment Prior to the Annuity Date and prior to the death of an
Owner, the Owner may be changed at any time. Only the
Owner may assign this contract. An absolute assignment
will transfer ownership to the assignee. This contract
may also be collaterally assigned as security. The
limitations on ownership rights while the collateral
assignment is in effect are stated in the assignment.
Additional limitations may exist for contracts issued
under provisions of the Internal Revenue Code.
An assignment will take place only when the Company has
actually received a Request in writing and recorded the
change at the Principal Office. The Company will not be
deemed to know of the assignment until such time. When
recorded, the assignment will take effect as of the
date it was signed. The assignment will be subject to
payments made or actions taken by the Company before
the change was recorded.
The Company will not be responsible for the validity of
any assignment nor the extent of any assignee's
interest. The interests of the Beneficiary will be
subject to any assignment.
Annuitant When the contract is issued, the Annuitant will be as
shown on the Specifications page. The Annuitant may be
changed in accordance with the terms of this contract.
Prior to the Annuity Date, an Annuitant may be replaced
or added unless the Owner is a non-natural person. At
all times there must be at least one Annuitant. If the
Annuitant dies and a replacement is not named, the
Owner will be considered to be the new Annuitant. Upon
the death of an Annuitant prior to the Annuity Date, a
Death Benefit is not paid unless the Owner is a
non-natural person.
A change of Annuitant will take place only when the
Company has actually received a Request in writing and
recorded the change at the Principal Office. The
Company will not be deemed to know of the change of
Annuitant until such time. When recorded, the change of
Annuitant will take effect as of the date it was
signed. The change of Annuitant will be subject to
payments made or actions taken by the Company before
the change was recorded.
9
Beneficiary The Beneficiary is as named on the Specifications page
unless subsequently changed. The Owner may declare any
Beneficiary to be revocable or irrevocable. A revocable
Beneficiary may be changed at any time prior to the
Annuity Date and before the death of an Owner or after
the Annuity Date and before the death of the Annuitant.
An irrevocable Beneficiary must consent in writing to
any change. Unless otherwise indicated, the Beneficiary
will be revocable.
A Beneficiary change must be made in writing in a form
acceptable to the Company and will be subject to the
rights of any assignee of record. When the Company
receives the form, the change will take place as of the
date it was signed, even if an Owner or the Annuitant
dies after the form is signed but prior to the
Company's receipt of the form. Any rights created by
the change will be subject to payments made or actions
taken by the Company before the change was recorded.
All benefits payable to the Beneficiary under this
contract will be divided equally among the surviving
Beneficiaries of the same class, unless the Owner
directs otherwise. If there is no surviving Beneficiary
in a particular class, then the benefit is divided
equally among the surviving Beneficiaries of the next
class. If there is no surviving Beneficiary, the
deceased Beneficiary's interest will pass to the Owner
or the Owner's estate. At the death of the first joint
Owner prior to the Annuity Date, the surviving joint
Owner is the sole, primary Beneficiary notwithstanding
that the designated Beneficiary may be different.
The Beneficiary can not assign, transfer, commute,
anticipate or encumber the proceeds or payments unless
given that right by the Owner.
Protection of Proceeds To the extent allowed by law, this contract and any
payments made under it will be exempt from the claims
of creditors.
10
THE ACCUMULATION PHASE
PAYMENTS
Payments Each Payment is equal to the gross payment less the
amount of any applicable premium tax. The Company
reserves the right to deduct the amount of the premium
tax from the Accumulated Value at a later date rather
than when the premium tax liability is first incurred
by the Company. In no event will an amount be deducted
for premium taxes before the Company has incurred a tax
liability under applicable State law.
Initial Payment The Initial Payment is shown on the Specifications
page.
Additional Payments Prior to the Annuity Date and before the death of an
Owner, the Owner may make additional Payments of at
least the Minimum Additional Payment Amount (see
Specifications page). Total Payments made may not
exceed [$2,000,000] without the Company's consent.
Payment Allocations The Initial Payment is allocated in accordance with the
Payment Allocation, shown on the Specifications page.
Each subsequent Payment will be allocated in the same
manner unless allocation instructions accompany the
Payment or the Payment Allocation is changed by the
Owner.
The minimum amount that may be allocated to the
Guarantee Period Account is shown on the Specifications
page. If the Owner requests an allocation less than the
minimum amount, the Company reserves the right to apply
that amount to the [money market Sub-Account.]
VALUES
Value of the Variable The value of a Sub-Account on a Valuation Date is
Account determined by multiplying the Accumulation Units in
that Sub-Account by the Accumulation Unit Value as of
the Valuation Date.
Accumulation Units are purchased when an amount is
allocated to a Sub-Account. The number of Accumulation
Units purchased equals that amount divided by the
applicable Accumulation Unit Value as of the Valuation
Date.
Accumulation Unit The value of a Sub-Account Accumulation Unit as of any
Values Valuation Date is determined by multiplying the value
of an Accumulation Unit for the preceding Valuation
Date by the Net Investment Factor for that Valuation
Period.
Net Investment Factor The Net Investment Factor measures the investment
performance of a Sub-Account from one Valuation Period
to the next. This factor is equal to 1.000000 plus the
result (which may be positive or negative) from
dividing (a) by (b) and subtracting (c) and (d) where:
(a) is the investment income of a Sub-Account
for the Valuation Period, including
realized or unrealized capital gains and
losses during the Valuation Period,
adjusted for provisions made for taxes,
if any;
(b) is the value of that Sub-Account's
assets at the beginning of the
Valuation Period;
11
(c) is the Mortality and Expense Risk Charge
applicable to the current Valuation
Period (see Specifications page) plus any
applicable Rider charges; and
(d) is the Administrative Charge
applicable to the current Valuation
Period (see Specifications page).
The Company assumes the risk that its actual mortality
expense experience may exceed the amounts provided
under the contract. The Company guarantees that the
charge for mortality and expense risks and the
administrative charge will not be increased. Subject to
applicable State and federal laws, these charges may be
decreased or the method used to determine the Net
Investment Factor may be changed.
Value of the Fixed Amounts allocated to the Fixed Account receive interest
Account at rates periodically set by the Company. The Company
guarantees that the initial rate of interest in effect
when an amount is allocated to the Fixed Account will
remain in effect for that amount for one year or until
such amount is transferred out of the Fixed Account,
whichever is sooner. Thereafter, the rate of interest
for that amount will be the Company's current interest
rate, but no less than the Minimum Fixed Account
Guaranteed Interest Rate (see Specifications page).
The value of the Fixed Account on any date is the sum
of amounts allocated to the Fixed Account plus interest
compounded and credited daily at the rates applicable
to those amounts. The value of the Fixed Account will
be at least equal to the minimum required by law in the
State in which this contract is delivered.
Value of the Guarantee Amounts allocated to the same Guarantee Period Account
Period Accounts on the same day will be treated as one Guarantee
Period Account. The interest rate in effect when an
amount is allocated to a Guarantee Period Account is
guaranteed for the duration of the Guarantee Period.
Each time the Guaranteed Interest Rate changes for a
particular Guarantee Period, a new Guarantee Period
Account is established.
The value of a Guarantee Period Account on any date is
the sum of amounts allocated to that Guarantee Period
Account plus interest compounded and credited daily at
the rate applicable to that amount.
Guaranteed Interest The Company will periodically set Guaranteed Interest
Rates Rates for each available Guarantee Period. These rates
will be guaranteed for the duration of the respective
Guarantee Periods. A Guaranteed Interest Rate will
never be less than the Guarantee Period Account Minimum
Interest Rate (see Specifications page).
Renewal Guarantee At least 45 days (but not more than 75 days) prior to
Periods the end of a Guarantee Period, the Company will notify
the Owner in writing of the expiration of that
Guarantee Period. The Owner may transfer amounts to the
Sub-Accounts, the Fixed Account or establish a new
Guarantee Period Account of any duration then offered
by the Company as of the day following the expiration
of the Guarantee Period. The transfer will not be
subject to a Market Value Adjustment; see "Market Value
Adjustment," page [16]. Guaranteed Interest Rates
corresponding to the available Guarantee Periods may be
higher or lower than the previous Guaranteed Interest
Rate. If reallocation instructions are not received at
the Principal Office before the end of a Guarantee
Period, the Guarantee Period Account value will be
automatically applied to a new Guarantee Period Account
with the same Guarantee Period unless:
12
(a) less than the Guarantee Period Account
Minimum Allocation Amount (see
Specifications page) remains in the
Guarantee Period Account on its
expiration date; or
(b) the Guarantee Period would extend beyond
the Annuity Date or is no longer
available.
In such cases, the Guarantee Period Account value will
be transferred to the [money market Sub-Account.]
Contract Fee Prior to the Annuity Date on each contract anniversary
and when the contract is surrendered, the Company will
deduct a Contract Fee (see Specifications page) Pro
Rata.
TRANSFER
Prior to the Annuity Date, the Owner may transfer
amounts among accounts by Request to the Principal
Office. Transfers to a Guarantee Period Account must be
at least equal to the Minimum Guarantee Period Account
Allocation Amount (see Specifications page). If the
Owner requests the transfer of a smaller amount to the
Guarantee Period Account, the Company may transfer that
amount to the [money market Sub-Account.]
Any transfer from a Guarantee Period Account prior to
the end of its Guarantee Period will be subject to a
Market Value Adjustment.
There is no charge for the first twelve transfers per
contract year. A transfer charge of up to $25 may be
imposed on each additional transfer.
The Company reserves the right to limit or refuse
transfers if it determines, in its sole discretion,
that the exercise of that right by an Owner(s), or any
agent or duly authorized representative of such
Owner(s) is, or would be, to the disadvantage of other
Owners. Such transfer limitations could be applied to
transfers to or from some or all of the accounts and
could include but not be limited to:
(a) the requirement of a minimum time
period between each transfer;
(b) not accepting a transfer request of
an agent or duly authorized
representative of such Owner(s)
authorized to act on behalf of such
Owner(s); and
(c) limiting the dollar amount that may
be transferred to or from any of
the accounts by an Owner(s) at any
one time.
Such limitations, individually or in aggregate, may be
applied in any manner reasonably designed to prevent
any use of the transfer right which is considered by
the Company to be to the disadvantage of other Owners.
13
XXXXXXXXXX AND SURRENDER
Prior to the Annuity Date, the Owner may, by Request,
withdraw a part of the Surrender Value or surrender the
contract for its Surrender Value.
Any withdrawal must be at least the Minimum Withdrawal
Amount (see Specifications page). A withdrawal will not
be permitted if the Accumulated Value remaining in the
contract would be less than the Minimum Accumulated
Value After Withdrawal (see Specifications page). The
Request must indicate the dollar amount to be paid and
the accounts from which it is to be withdrawn. A
withdrawal from a Guarantee Period Account will be
subject to a Market Value Adjustment.
When surrendered, this contract terminates and the
Company has no further liability under it. The
Surrender Value will be based on the Accumulated Value
on the Effective Valuation Date.
Amounts taken from the Variable Account will be paid
within 7 days of the date a Request is received. The
Company reserves the right to delay payments subject to
applicable laws, rules and regulations governing
variable annuities.
Amounts taken from the Fixed Account or the Guarantee
Period Accounts will normally be paid within 7 days of
the date a Request is received. The Company may defer
payment for up to six months from the receipt date.
If deferred for 30 days or more, the amount payable
will be credited interest at a rate equal to the
Minimum Fixed Account Guaranteed Interest Rate (see
Specifications Page), or the rate mandated by the
appropriate State.
Withdrawal Without In each calendar year, withdrawals up to the Withdrawal
Surrender Charge Without Surrender Charge Amount (see Specifications
page) as of the Effective Valuation Date may be made.
The Withdrawal Without Surrender Charge will first be
deducted from cumulative earnings. To the extent that
it exceeds cumulative earnings, the excess will be
considered withdrawn on a last-in, first-out basis from
Payments not previously withdrawn. Amounts withdrawn
from a Guarantee Period Account prior to the end of the
applicable Guarantee Period will be subject to a Market
Value Adjustment.
Withdrawal With Any amounts withdrawn or surrendered in excess of the
Surrender Charge Withdrawal Without Surrender Charge amount may be
subject to a surrender charge.
These amounts will be taken on a first-in, first-out
basis from Payments not previously considered
withdrawn. The Company will compute applicable charges
using the Surrender Charge Table (see Specifications
page).
Waiver of Surrender The surrender charge will be waived if an Owner, or the
Charge Annuitant if the Owner is a non-natural person, is:
(a) admitted to a "medical care facility"
after being named Owner or Annuitant
and remains confined there until the
later of one year after the issue
date or 90 consecutive days;
(b) first diagnosed by a licensed "physician"
as having a "fatal
14
illness" after the issue date and after
being named Owner or Annuitant; or
(c) physically disabled after the issue date
and after being named Owner or Annuitant
and before attaining age 65. The Company
may require proof of continuing
disability, and reserves the right to
obtain an examination by a licensed
"physician" of its choice and at its
expense.
"Medical care facility" means any State licensed
facility providing medically necessary inpatient care
which is prescribed by a licensed "physician" in
writing and based on physical limitations which
prohibit daily living in a non-institutional setting.
"Fatal illness" means a condition diagnosed by a
licensed "physician" which is expected to result in
death within two years of the diagnosis. "Physician"
means a person other than the Owner, the Annuitant or a
member of one of their families who is State licensed
to give medical care or treatment and is acting within
the scope of that license. "Physically disabled" means
the Owner or Annuitant has been unable to engage in an
occupation or to conduct daily activities for a period
of at least 12 consecutive months as a result of
disease or bodily injury.
No additional Payments are permitted after this
provision becomes effective.
Market Value Adjustment A transfer, withdrawal or surrender from a Guarantee
Period Account after the expiration of its Guarantee
Period will not be subject to a Market Value
Adjustment. A Market Value Adjustment will apply to all
other transfers, withdrawals or surrenders from a
Guarantee Period Account. Amounts in a Guarantee Period
Account that are applied under an Annuity Option are
treated as withdrawals when calculating the Market
Value Adjustment. The Market Value Adjustment will be
determined by multiplying the amount taken from each
Guarantee Period Account by the market value factor.
The market value factor for each Guarantee Period
Account is equal to:
n/365
(1+I)
-----
(1+j) -1
where:
i - is the Guaranteed Interest Rate expressed
as a decimal being credited to the current
Guarantee Period;
j - is the new Guaranteed Interest Rate,
expressed as a decimal, for a Guarantee
Period with a duration equal to the
number of years remaining in the current
Guarantee Period, rounded to the next higher
number of whole years. If that rate is not
available, the Company will use a suitable
rate or index allowed by the Department of
Insurance; and
n - is the number of days remaining from the
Effective Valuation Date to the end of the
current Guarantee Period.
If the Guaranteed Interest Rate being credited is lower
than the new Guaranteed Interest Rate, the Market Value
Adjustment will decrease the Guarantee Period Account
value. Similarly, if the Guaranteed Interest Rate being
credited is higher than the new Guaranteed Interest
Rate, the Market Value Adjustment will increase the
Guarantee Period Account value. The Market Value
Adjustment
15
will never result in a change to the value more than
the interest earned in excess of an amount based on the
Guarantee Period Account Minimum Interest Rate (see
Specifications page).
DEATH BENEFIT
At the death of an Owner prior to the Annuity Date, the
Company will pay to the Beneficiary a Death Benefit
upon receipt at the Principal Office of Proof of Death.
If the Owner is a non-natural person, prior to the
Annuity Date, a Death Benefit is paid on the death of
an Annuitant, upon receipt at the Principal Office of
Proof of Death.
Death Benefit The Death Benefit will be the greater of:
(a) the Accumulated Value on the Effective
Valuation Date, increased by any
positive Market Value Adjustment; or
(b) the sum of the gross payments made
under this contract prior to the date of
death, proportionately reduced to
reflect all partial withdrawals.
For each withdrawal, the proportionate
reduction is calculated by multiplying
the Death Benefit under the (b) option,
immediately prior to the withdrawal, by
the following:
Amount of the withdrawal
------------------------
Accumulated Value immediately prior to the withdrawal
Payment of the Death Unless the Owner has specified otherwise, the Death
Benefit Benefit will be paid to the Beneficiary within 7 days
of the Effective Valuation Date. Alternatively, the
Beneficiary may, by a Request in writing, elect to:
(a) defer distribution of the Death Benefit
for a period no more than 5 years from
the date of death; or
(b) receive distributions over his/her life
expectancy (or over a period not
extending beyond such life expectancy).
Distributions must begin within one
year from the date of death.
If distribution of the Death Benefit is deferred under
(a) or (b), any value in Guarantee Period Accounts will
be transferred to the [money market Sub-Account]. The
excess, if any, of the Death Benefit over the
Accumulated Value will also be transferred to the
[money market Sub-Account.] The Beneficiary may, by a
Request, effect transfers and withdrawals, but may not
make additional Payments. If there are multiple
Beneficiaries, the consent of all is required.
If the sole Beneficiary is the deceased Owner's spouse,
the Beneficiary may, by a Request in writing, continue
the contract and become the new Owner and Annuitant
subject to the following:
(a) any value in the Guarantee Period
Accounts will be transferred to the
[money market Sub-Account];
(b) the excess, if any, of the Death Benefit
over the contract's Accumulated Value
will also be transferred to the [money
market Sub-Account];
16
(c) additional Payments may be made;
and
(d) any subsequent spouse of the new
Owner, if named as the Beneficiary,
may not continue the contract.
17
THE PAYOUT PHASE
ANNUITY BENEFIT
Annuity Options Annuity Options are available on a fixed, variable or
combination fixed and variable basis. The Annuity
Options described below or any alternative option
offered by the Company may be chosen. If no option is
chosen, monthly benefit payments will be made under the
Life Annuity with 10 Years Period Certain option.
Fixed annuity options are funded through the General
Account. Variable annuity options may be funded through
one or more of the Sub-Accounts. Not all Sub-Accounts
may be made available.
Selection of Annuity The Owner must select an Annuity Benefit Payment Option
Benefit Payments prior to or after the issue date but before the Annuity
Date. Annuity benefit payments will be paid monthly or
at any other frequency currently offered by the
Company. If the first payment would be less than the
Minimum Annuity Benefit Payment (see Specifications
page), a single payment will be made instead. If a life
annuity option has been elected, satisfactory proof of
the date of birth of the Annuitant must be received at
the Principal Office before any payment is made. Also,
if a life annuity option has been elected, from time to
time the Company may require satisfactory proof that
the Annuitant is alive.
Selection or Change The Owner must select an Annuity Date when selecting an
Of Annuity Date Annuity Benefit Payment Option. Prior to such Annuity
Date, the Owner may change the Annuity Date by Request.
The Request must be received at the Principal Office at
least one month before the new Annuity Date. To the
extent permitted by applicable laws, rules and
regulations governing variable annuities, the new
Annuity Date must be no later than the Maximum
Alternative Annuity Date shown on the Specifications
page.
Annuity Benefit Payment In the case of a variable annuity option, the Owner
Change Frequency must select an Annuity Benefit Payment Change
Frequency. This is the frequency of change in the
dollar value of the variable annuity benefit payments.
For example, if an annual Annuity Benefit Payment
Change Frequency is chosen, the dollar value of
variable annuity benefit payments will remain constant
within each one-year period. The Owner must also select
the date of the first change.
Assumed Investment In the case of a variable annuity option, the Owner
Return must select an Assumed Investment Return ("AIR").
This rate is used to determine the initial variable
annuity benefit payment and how the payment will change
over time in response to the performance of the
selected Sub-Accounts. If the actual performance of any
selected Sub-Account (as measured by the Net Investment
Factor) is equal to the AIR, the annuity benefit
payment attributable to that Sub-Account will be
constant. If the actual performance is greater than the
AIR, the annuity benefit payment will increase. If the
actual performance is less than the AIR, the annuity
benefit payment will decrease.
18
Annuity Value The Annuity Value will be the Accumulated Value, after
application of any applicable Market Value Adjustment
less any applicable premium tax. For a Death Benefit
annuity, the Annuity Value will be the amount of the
Death Benefit, less any applicable premium tax. The
Annuity Value applied under a variable Annuity Option
is based on the Accumulation Unit Value on a Valuation
Date not more than four weeks, uniformly applied,
before the Annuity Date.
The amount of the first annuity benefit payment under
all available options except period certain options
will depend on the age and/or sex of the Annuitant on
the Annuity Date and the Annuity Value applied. Period
certain options are based only on the duration of
payments and the Annuity Value.
Annuity Unit Values A Sub-Account Annuity Unit Value on any Valuation Date
is equal to its value on the preceding Valuation Date
multiplied by the product of:
(a) a discount factor equivalent to the
Assumed Investment Return; and
(b) the Net Investment Factor of the
Sub-Account funding the annuity
benefit payments for the applicable
Valuation Period.
The value of an Annuity Unit as of any date other than
a Valuation Date is equal to its value as of the
preceding Valuation Date.
Each variable annuity benefit payment is equal to the
number of Annuity Units multiplied by the applicable
value of an Annuity Unit, except that under a Joint and
Survivor Option, after the first death, the number of
units in each payment is equal to the total number of
units multiplied by the Survivor Annuity Benefit
Percentage.
Variable annuity benefit payments will increase or
decrease with the value of the Annuity Units as of the
date of the first payment of each Annuity Benefit
Payment Change Frequency. The Company guarantees that
the amount of each variable annuity benefit payment
will not be affected by changes in mortality and
expense experience.
Number of Annuity For each Sub-Account the number of Annuity Units
Units determining the benefit payable is equal to the amount
of the first annuity benefit payment divided by the
value of the Annuity Unit as of the Valuation Date used
to calculate the amount of the first payment. Once
annuity benefit payments begin, the number of Annuity
Units will not change unless a split, a withdrawal or a
transfer is made.
Payment of Annuity Annuity Benefit Payments are paid to the Owner. By
Benefit Payments Request in writing, the Owner may direct that payments
are made to another person, persons or entity. If an
Owner, who is not also an Annuitant, dies on or after
the Annuity Date, the following occurs:
(a) If the deceased Owner was the sole Owner,
then the remaining annuity benefit
payments will be payable to the
Beneficiary in accordance with the terms
of the Annuity Option selected. Upon
the death of a sole Owner, the
Beneficiary becomes the Owner of the
contract.
(b) If the contract has joint Owners, then
the remaining annuity
19
benefit payments will be payable to the
surviving joint Owner in accordance with
the terms of the Annuity Option
selected. Upon the death of the
surviving joint Owner, the
Beneficiary becomes the Owner of the
contract.
TRANSFER
After the Annuity Date and prior to the death of the
Annuitant, the Owner may transfer among Sub-accounts by
Request to the Principal Office.
Transfers may increase or decrease the number of
Annuity Units in each subsequent payment.
There is no charge for the first twelve transfers per
contract year. A transfer charge of up to $25 may be
imposed on each additional transfer.
The Company reserves the right to limit or refuse
transfers if it determines, in its sole discretion,
that the exercise of that right by an Owner(s), or any
agent or duly authorized representative of such
Owner(s) is, or would be, to the disadvantage of other
Owners. Such transfer limitations could be applied to
transfers to or from some or all of the accounts and
could include but not be limited to:
(a) the requirement of a minimum time period
between each transfer;
(b) not accepting a transfer request of an
agent or duly authorized representative
of such Owner(s) authorized to act on
behalf of such Owner(s); and
(c) limiting the dollar amount that may
be transferred to or from any of
the accounts by an Owner(s) at any
one time.
Such limitations, individually or in aggregate, may be
applied in any manner reasonably designed to prevent
any use of the transfer right which is considered by
the Company to be to the disadvantage of other Owners.
WITHDRAWAL
After the Annuity Date and prior to the death of the
Annuitant, the Owner may have the right, based on the
Annuity Option selected, to make withdrawals. If the
Death Benefit is applied under an Annuity Option the
Beneficiary may also make withdrawals in accordance
with this provision.
Amounts withdrawn that were applied under a variable
Annuity Option will be paid within 7 days of the date a
Request is received. The Company reserves the right to
delay payments subject to applicable laws, rules and
regulations governing variable annuities.
Amounts withdrawn that were applied under a fixed
Annuity Option will normally be paid within 7 days of
the date a Request is received. The Company may defer
payment for up to six months from the date a Request is
received. If deferred for 30 days or more, the amount
payable will be credited interest at a rate of at least
3% or the appropriate rate mandated by the State.
Only one Request for withdrawal under each provision
may be made each calendar year, unless a period certain
option is chosen.
20
Payment Withdrawal Each calendar year, the Owner can request up to an
Amount Option amount equal to the Payment Withdrawal Amount
(see Specifications page).
For fixed Annuity Options, each withdrawal
proportionately reduces the dollar amount of each
future annuity benefit payment. The proportionate
reduction is calculated by multiplying the dollar
amount of each future annuity benefit payment by the
following:
Amount of the withdrawal
------------------------
Present Value of all remaining fixed annuity
benefit payments immediately prior the withdrawal.
For variable Annuity Options, each withdrawal
proportionately reduces the number of Annuity Units in
each future annuity benefit payment. The proportionate
reduction is calculated by multiplying the number of
Annuity Units in each future annuity benefit payment by
the following:
Amount of the withdrawal
------------------------
Present Value of all remaining variable annuity
benefit payments immediately prior to the withdrawal.
Present Value Over the life of the contract, for period certain and
Withdrawal Option life with period certain Annuity Options when there
are remaining guaranteed annuity benefit payments, the
Owner may request withdrawals which represent a
percentage of the Present Value of those remaining
guaranteed annuity benefit payments. "Guaranteed
annuity benefit payments" refers to the non-life
contingent annuity benefit payments. Each year a
withdrawal is taken under this provision, the Company
records the percentage withdrawn. Each withdrawal
proportionately reduces future annuity benefit
payments. (See proportionate reduction calculation
below.) The total percentage withdrawn over the life of
the contract cannot exceed the Present Value Withdrawal
Amount (see Specifications page).
For fixed Annuity Options, each withdrawal
proportionately reduces the dollar amount of each
future annuity benefit payment. The proportionate
reduction is calculated by multiplying the dollar
amount of each future annuity benefit payment by the
following:
Amount of the withdrawal
------------------------
Present Value of all remaining fixed guaranteed annuity
benefit payments immediately prior to the withdrawal
For variable Annuity Options, each withdrawal
proportionately reduces any remaining guaranteed
payments. The proportionate reduction is calculated by
multiplying the number of Annuity Units in each future
annuity benefit payment by the following:
Amount of the withdrawal
------------------------
Present Value of all remaining variable guaranteed
annuity benefit payments immediately prior to the
withdrawal
If an Annuitant is still living after there are no
remaining guaranteed payments under a life with period
certain payout:
21
(a) for variable Annuity Options, the number
of Annuity Units will increase to the
number of Annuity Units payable prior
to any withdrawals, adjusted for
transfers.
(b) for fixed Annuity Options, the
dollar amount of the annuity
benefit payments will increase to
the amount payable prior to any
withdrawals, adjusted for
transfers.
PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS
For a variety of purposes, it is at times necessary to
determine the Present Value of either all future
annuity benefit payments or of future guaranteed
annuity benefit payments. Present Values are calculated
based on the Annuity 2000 Mortality Table, male, female
or unisex rates as appropriate, and the interest rate
or AIR used to determine the annuity benefit payments
increased by the following adjustments:
Adjustment
Death of the Annuitant 0.00%
Withdrawals
3 or more years after the issue date 0.00%
Within 3 years of the issue date:
15 or more years of annuity benefit payments being valued 1.00%
10-14 years of annuity benefit payments being valued 1.50%
Less than 10 years of annuity benefit payments being valued 2.00%
DEATH OF THE ANNUITANT
Unless otherwise indicated by the Owner, upon the death
of the Annuitant, the Present Value of the remaining
guaranteed annuity benefit payments may be paid to the
Owner.
ANNUITY BENEFIT PAYMENT OPTIONS
PERIOD CERTAIN ANNUITY:
Periodic annuity benefit payments for a chosen number
of years. The number of years selected may be from 10
to 30, or any other period currently made available by
the Company.
LIFE ANNUITY:
(a) Single Life - Periodic annuity benefit
payments during the Annuitant's life.
The annuity benefit payments do not
continue after the death of the
Annuitant.
(b) Joint and Survivor - Periodic
annuity benefit payments during the
joint lifetime of the Joint
Annuitants. For variable options,
after the first death, the number
of units in each payment during the
lifetime of the survivor is equal
to the total number of units
multiplied by the Survivor Annuity
Benefit Percentage. For fixed
options, after the first death, the
dollar amount of each payment
during the lifetime of the survivor
is equal to the dollar value of
each payment paid prior to such
death multiplied by the Survivor
Annuity Benefit Percentage.
22
LIFE ANNUITY GUARANTEE OPTIONS
If a life Annuity Option has been elected, the Owner
may also select one of the following guarantees:
PERIOD CERTAIN
Periodic guaranteed payments for a period of 10 to 30
years, or any other period currently made available by
the Company.
CASH BACK
Upon notification of the Annuitant's death, any excess
of the Annuity Value applied over the total amount of
the annuity benefit payments will be paid to the Owner
or Beneficiary, whichever is applicable.
ANNUITY OPTION RATE TABLES
The first variable annuity benefit payment will be
based on the Annuity Option Rates made available by the
Company on the rate basis available at the time the
Annuity Option is selected. The fixed annuity benefit
payments will be based on the greater of the guaranteed
Annuity Option Rates shown in the tables on the
following pages or the Company's non-guaranteed current
Annuity Option Rates applicable to this class of
contracts. The Company guarantees that once an Annuity
Option is selected, the annuity benefit payments will
not be affected by changes in mortality and expense
experience.
23
ANNUITY OPTION TABLES
FIRST MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Age Life Annuity with Life Life Annuity
Nearest 10 Years Period Certain Annuity With Cashback
Payment
Male Female Unisex Male Female Unisex Male Female Unisex
[50 4.05 3.81 3.91 4.08 3.83 3.93 3.90 3.72 3.79
51 4.11 3.87 3.97 4.15 3.89 3.99 3.96 3.77 3.85
52 4.18 3.93 4.03 4.22 3.95 4.06 4.01 3.82 3.90
53 4.25 3.99 4.10 4.30 4.01 4.13 4.07 3.88 3.96
54 4.33 4.06 4.17 4.38 4.08 4.20 4.14 3.94 4.02
55 4.41 4.13 4.24 4.46 4.15 4.28 4.20 3.99 4.07
56 4.49 4.20 4.32 4.55 4.23 4.36 4.27 4.06 4.14
57 4.58 4.28 4.40 4.65 4.31 4.45 4.34 4.12 4.21
58 4.68 4.36 4.49 4.75 4.40 4.54 4.42 4.19 4.28
59 4.78 4.45 4.58 4.86 4.49 4.64 4.50 4.26 4.36
60 4.88 4.54 4.67 4.98 4.59 4.74 4.58 4.34 4.44
61 4.99 4.63 4.77 5.10 4.69 4.85 4.67 4.42 4.52
62 5.10 4.73 4.88 5.23 4.80 4.97 4.76 4.50 4.60
63 5.23 4.84 4.99 5.37 4.92 5.10 4.85 4.59 4.69
64 5.35 4.95 5.11 5.52 5.04 5.24 4.95 4.68 4.79
65 5.48 5.07 5.24 5.69 5.18 5.38 5.06 4.78 4.89
66 5.62 5.20 5.37 5.86 5.32 5.54 5.17 4.89 5.00
67 5.77 5.33 5.51 6.04 5.47 5.70 5.28 4.99 5.11
68 5.92 5.47 5.65 6.24 5.64 5.88 5.40 5.11 5.23
69 6.07 5.62 5.80 6.45 5.82 6.07 5.52 5.23 5.35
70 6.23 5.78 5.96 6.67 6.01 6.27 5.66 5.36 5.48
71 6.39 5.94 6.12 6.90 6.21 6.49 5.79 5.49 5.61
72 6.56 6.11 6.29 7.16 6.44 6.72 5.94 5.63 5.75
73 6.73 6.29 6.47 7.43 6.68 6.98 6.09 5.78 5.90
74 6.90 6.48 6.65 7.71 6.94 7.25 6.24 5.94 6.06
75 7.08 6.67 6.83 8.02 7.22 7.54 6.41 6.11 6.23]
These tables are based on an annual interest rate of [3%]
and the Annuity 2000 Mortality Table
24
ANNUITY OPTION TABLES (CONTINUED)
FIRST MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Joint and Survivor Life Annuity
Older Age
50 55 60 65 70 75 80
Y 50 [3.53 3.61 3.68 3.73 3.76 3.79 3.80
O 55 3.77 3.88 3.97 4.04 4.08 4.11
U 60 4.10 4.25 4.36 4.45 4.50
N 65 4.55 4.74 4.90 5.01
G 70 5.16 5.43 5.64
E 75 6.02 6.41
R 80 7.25]
A
G
E
Joint and Two-Thirds Survivor Life Annuity
Older Age
50 55 60 65 70 75 80
Y 50 [3.80 3.93 4.09 4.25 4.43 4.61 4.80
O 55 4.11 4.29 4.49 4.70 .491 5.13
U 60 4.53 4.77 5.02 5.29 5.55
N 65 5.09 5.42 5.75 6.07
G 70 5.88 6.31 6.75
E 75 6.99 7.59
R 80 8.58]
A
G
E
These tables are based on an annual interest rate of [3 %]
and the Annuity 2000 Mortality Table
25
ANNUITY OPTION TABLES (CONTINUED)
FIRST MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Number of Variable or Xxxxx Xxxxxxx for a
Years Certain Period
[ 10 9.61
15 6.87
20 5.51
25 4.71
30 4.18]
These tables are based on an annual interest rate of [3%]
And the Annuity 2000 Mortality Tables.
26
GENERAL PROVISIONS
Entire Contract The entire contract consists of this contract, any
application attached at issue, riders, Specifications
pages and endorsements.
Misstatement of Age If the age or sex of an individual is misstated, the
or Sex Company will adjust all benefits payable to that
which would be available at the correct age or sex. Any
underpayments already made by the Company will be paid
immediately. Any overpayments will be deducted from
future annuity benefit payments. Failure to Notify
Company of Annuitant Death After the Annuity Date and
once notified of the Annuitant's death, the Company
reserves the right to recover any overpaid annuity
benefit payments.
Failure to Notify After the Annuity Date and once notified of the
Company of Annuitant Xxxxxxxxx's death, the Company reserves the right to
Death recover any overpaid annuity benefit payments.
Modifications Only the President or Vice President of the Company may
modify or waive any provisions of this contract. Agents
or Brokers are not authorized to do so.
Incontestability The Company cannot challenge the validity of this
contract after it has been in force for more than two
years from the date of issue.
Minimums All values and benefits available under this contract
equal or exceed those required by the State in which
the contract is delivered.
Annual Report The Company will furnish an annual report to the Owner
containing a statement of the number and value of
Accumulation Units credited to the Sub-Accounts, the
value of the Fixed Account and the Guarantee Period
Accounts and any other information required by
applicable law, rules and regulations.
Addition, Deletion, or The Company reserves the right, subject to compliance
Substitution of with applicable law, to add to, delete from, or
Investments substitute for the shares of a Fund that are held by
the Sub-Accounts or that the Sub-Accounts may purchase.
The Company also reserves the right to eliminate the
shares of any Fund no longer available for investment
or if the Company believes further investment in the
Fund is no longer appropriate for the purposes of the
Sub-Accounts.
The Company will not substitute shares attributable to
any interest in a Sub-Account without notice to the
Owner and prior approval of the Securities and Exchange
Commission as required by the Investment Company Act of
1940. This will not prevent the Variable Account from
purchasing other securities for other series or classes
of contracts, or from permitting a conversion between
series or classes of contracts on the basis of requests
made by Owners.
The Company reserves the right, subject to compliance
with applicable laws, to establish additional Separate
Accounts, Guarantee Period Accounts and Sub-Accounts
and to make them available to any class or series of
contracts as the Company considers appropriate. Each
new Separate Account or Sub-Account will invest in a
new investment company, or in shares of another
open-end investment company, or such other investments
as may be permitted under applicable law. The Company
also reserves the right to eliminate or combine
existing Sub-Accounts and to transfer the assets of any
Sub-Accounts to any other Sub-Accounts. In the event of
any substitution or change, the Company may, by
appropriate notice, make such changes in this and other
contracts as may be necessary or appropriate to reflect
the substitution or change. If the Company considers it
to be in the best interests of the owners, the Variable
Account or any Sub-Account may be operated as a
management company under
27
the Investment Company Act of 1940 or in any other form
permitted by law, or may be de-registered under the Act
in the event registration is no longer required, or may
be combined with other accounts of the Company.
Changes in Law The Company reserves the right to make any changes to
provisions of the contract to comply with, or give
Owners the benefit of, any federal or State statute,
rule, or regulation.
Change of Name Subject to compliance with applicable law, the Company
reserves the right to change the names of the Variable
Account or the Sub-Accounts.
Federal Tax The Variable Account is not currently subject to tax,
Considerations but the Company reserves the right to assess a charge
for taxes if the Variable Account becomes subject to
tax.
Splitting of Units The Company reserves the right to split the value of a
unit, either to increase or decrease the number of
units. Any splitting of units will have no material
effect on the benefits, provisions or investment return
of this contract or upon the Owner, the Annuitant, any
Beneficiary, or the Company.
Insulation of Separate The investment performance of Separate Account assets
Account is determined separately from the other assets of the
Company. The assets of a Separate Account equal to the
reserves and liabilities of the contracts supported by
the account will not be charged with liabilities from
any other business that the Company may conduct.
28
Flexible Payment Deferred Variable and Fixed Annuity
Annuity Benefit Payments Payable on the Annuity Date
Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date
Non-Participating
29
