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Aetna Insurance Company of America
Home Office: 000 Xxxxxxxxxx Xxxxxx
Xxxxxxxx, Xxxxxxxxxxx 00000
(000) 000-0000
Individual Variable, Fixed or Combination Annuity Contract (Nonparticipating)
Aetna Insurance Company of America (We or Us) agrees to pay benefits according
to the terms and conditions set forth in this Contract.
Specifications
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Plan
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Type of Plan
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Contract Holder
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Annuitant
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Contract Number
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Effective Date
This Contract is delivered in and is subject to
the laws and regulations of that state.
THE VARIABLE FEATURES OF THE CONTRACT ARE DESCRIBED IN SECTIONS 6 AND 12.
Right to Cancel
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The Contract Holder may cancel this Contract within ten (10) days of receiving
it by returning it to Us at the address above or to the person from whom it was
purchased. Within seven (7) days of the cancellation request, We will return the
Contract Holder's Purchase Payment(s) made plus any increase, or minus any
decrease on the amount allocated to the Separate Account.
Signed at the Home Office on the Effective Date.
/s/ Xxx Xxxxxxx /s/ Xxxxx X. Xxxxxxxxx
President Secretary
ALL PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA.
APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR
DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT
APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
I-CDA-GP2(4/94)
Table of Contents
Page
Right to Cancel.............................................................1
Contract Schedule...........................................................4
Separate Account.....................................................4
AICA Guaranteed Account (AG Account).................................4
Separate Account and AG Account......................................4
Fixed Annuity........................................................6
Section 1. Definitions.....................................................7
Section 2. General Provisions..............................................8
The Contract.........................................................8
Nonparticipating Contract............................................8
Misstatements and Adjustments........................................8
Reports..............................................................9
Premium Taxes........................................................9
Protection of Proceeds...............................................9
Evidence of Survival.................................................9
Proof of Age.........................................................9
Change of Contract...................................................9
Section 3. Ownership.......................................................9
Contract Holder Rights...............................................9
Transfer of Ownership...............................................10
Section 4. Beneficiary Provisions.........................................10
Beneficiary.........................................................10
Change of Beneficiary...............................................10
Death of Beneficiary................................................10
Section 5. Purchase Payments..............................................10
Purchase Payments...................................................10
Allocation of Purchase Payments.....................................10
Section 6. Separate Account...............................................10
General.............................................................11
Investment Allocations to the Separate Account......................11
Valuation of Assets.................................................11
Accumulation Unit...................................................11
Net Return Factor for Each Valuation Period.........................11
Administrative Charge...............................................12
Mortality Risk Charge...............................................12
Expense Risk Charge.................................................12
Mortality and Expense Guarantee.....................................12
Section 7. AG Account.....................................................12
AG Account Guaranteed Interest Rate.................................12
Deposit Period......................................................12
Guaranteed Term.....................................................12
2
Guaranteed Term(s) Groups...........................................12
Maturity Date.......................................................12
Allocation of Net Purchase Payments to the AG Account...............13
AG Account Guaranteed Term Maturity Date and Maturity Value.........13
Transfers from the AG Account.......................................13
Withdrawals from the AG Account.....................................13
Reinvestment........................................................13
AG Account Market Value Adjustment (Factor).........................14
Section 8. Contract Value; Transfers and Withdrawals During the
Accumulation Period Contract Value.............................14
Transfers During the Accumulation Period............................14
Withdrawals During the Accumulation Period..........................15
Deferred Sales Charge...............................................15
Waiver of Deferred Sales Charge.....................................15
Payment of Adjusted Contract Value..................................16
Systematic Withdrawal Option (SWO)..................................16
Section 9. Maintenance Charge.............................................17
Maintenance Charge..................................................17
Section 10. Proceeds Payable on Death.....................................17
Death of the Contract Holder Prior to the Annuity Date..............17
Death Benefit Amount Prior to the Annuity Date......................17
Death Benefit Payment Methods.......................................18
Death of Contract Holder On or After the Annuity Date...............19
Death of the Annuitant..............................................19
Section 11. Delay of Payments.............................................19
Delay of Payments...................................................19
Section 12. Annuity Provisions............................................19
Designation of Annuitant............................................19
Terms of Annuity Options............................................20
Annuity Unit........................................................21
Annuity Unit Value..................................................21
Annuity Net Return Factor...........................................21
Annuity Options.....................................................22
3
Contract Schedule
Separate Account
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Separate Account: Variable Account I
Charges to the A daily charge is deducted from the assets of the
Separate Account: Separate Account. The deduction is the daily
equivalent of the annual effective percentage
shown below:
(a) During the Accumulation Period:
Administrative Charge 0.15%
Mortality Risk Charge 0.35%
Expense Risk Charge 0.90%
TOTAL Separate Account Charges During
Accumulation Period 1.40%
(b) During the Annuity Period
Administrative Charge Not To Exceed 0.25%
Mortality Risk Charge 0.35%
Expense Risk Charge 0.90%
TOTAL Maximum Separate Account Charges
During Annuity Period 1.50%
AICA Guaranteed Account (AG Account)
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Minimum Guaranteed 3.0%
Interest Rate
(effective annual rate
of return):
Separate Account and AG Account
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Minimum Initial $1,500
Purchase Payment:
Minimum Subsequent $500 or $50 per month if paid by an automatic
Purchase Payment: check plan
Maximum Subsequent $500,000 without Home Office approval
Purchase Payment:
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Transfers: We allow an unlimited number of transfers during
the Accumulation Period. Twelve (12) transfers in
any calendar year are free. Thereafter, We reserve
the right to charge a transfer charge up to $10
for each subsequent transfer.
Maintenance Charge: The annual maintenance charge is $30. If the
Contract Value is $50,000 or more on the date the
maintenance charge is to be deducted, the
maintenance charge is $0.
Deferred Sales Charge: For each withdrawal from the Contract, a deferred
sales charge for Charge: each Net Purchase Payment
will be determined as follows:
Years from Receipt of Deferred
Net Purchase Payment Sales Charge
0-1 7%
1-2 6%
2-3 5%
3-4 4%
4-5 3%
5-6 2%
6-7 1%
7+ 0%
Waiver of Deferred Section 8.05 provides for the following:
Sales Charge:
(c) At least 12 months after the date of the
first Purchase Payment in an amount equal
to or less than 15% of the Contract
Value.
(d) For a full withdrawal where the Contract
Value does not exceed $2,500 and no
withdrawals have been taken from the
Contract within the prior 12 months.
Systematic (a) Specified Payment - Maximum Percentage: 10%
Withdrawal Option:
(b) Specified Period - Minimum Period: 10 years
(c) Specified Percentage - Maximum Percentage: 10%
Death Benefit Factor: 4%
Death Benefit There is no maximum death benefit amount.
Maximum Amount:
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Death Benefit 85 years
Maximum Age:
Fund for Allocation Federated Prime Money Fund
of Excess Guaranteed
Death Benefit Value:
Latest Annuity Date: The Contract Holder's 90th birthday.
Fixed Annuity
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Minimum Guaranteed 3.0%
Interest Rate
(effective annual rate
of return):
6
Section 1. Definitions
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1.01 Accumulation Period - The period during which one or more Net Purchase
Payments applied to the Contract accumulate to provide future Annuity
payments.
1.02 Accumulation Unit - A measure of the net investment results for each
variable investment option during the Accumulation Period. The
Accumulation Units for the applicable Funds are used to calculate the
portion of the Contract Value attributable to a Separate Account during
the Accumulation Period.
1.03 Adjusted Contract Value - The Contract Value, plus or minus any
aggregate AG Account Market Value Adjustment.
1.04 Annuitant - The natural person on whose life an Annuity payment is
based.
1.05 Annuity - A series of payments We make for life, a definite period or a
combination of the two.
1.06 Annuity Date - The date on which Annuity payments commence.
1.07 Annuity Options - Annuity payment methods available during the Annuity
Period.
1.08 Annuity Period - The period of time during which Annuity payments are
made.
1.09 Annuity Unit - A measure of the net investment results for each
variable investment option during the Annuity Period. Annuity Units are
used to calculate the amount of each variable Annuity payment.
1.10 Beneficiary - The person(s) entitled to receive any death benefit under
the Contract. Upon the death of a joint Contract Holder, the surviving
joint Contract Holder, if any, is treated as the Beneficiary. Any other
Beneficiary designation on record with Us at the time of death is
treated as a contingent Beneficiary.
1.11 Contract Holder - The person who purchases this Contract. We reserve
the right to limit ownership to natural persons. If more than one
Contract Holder owns the Contract, each Contract Holder shall be a
joint Contract Holder. Any joint Contract Holder must be the spouse of
the other joint Contract Holder. Joint Contract Holders have joint
ownership rights and both must authorize any exercising of those
ownership rights unless otherwise allowed by Us.
1.12 Contract Value - The dollar value as of any Valuation Period of all
amounts accumulated in the Contract.
1.13 Contract - This agreement between the Contract Holder and Us.
1.14 Effective Date - The date the Contract is issued to the Contract
Holder.
1.15 Fund - One of the variable investment options which may be selected by
the Contract Holder.
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1.16 General Account - The General Account is made up of all of our general
assets other than those allocated to the separate accounts.
1.17 AICA Guaranteed Account (AG Account) - An investment option where We
guarantee specified rate(s) of interest for specified periods of time.
The AG Account is a separate account established by Us in accordance
with the provisions of the Connecticut General Statutes Section
38a-433. The Contract Holder does not participate in the investment
gain or loss from the assets held in the AG Account. Assets in the AG
Account may be charged with liabilities arising out of any other
business We may conduct.
1.18 Home Office - Our headquarters, located at 000 Xxxxxxxxxx Xxxxxx,
Xxxxxxxx, XX 00000.
1.19 Market Value Adjustment - An adjustment to any withdrawal made from the
AG Account before the end of a guaranteed term as stated in Section
7.11.
1.20 Net Purchase Payment - The Purchase Payment less premium taxes, if
applicable.
1.21 Purchase Payment - The gross payment accepted by Us and allocated to
the Contract. We reserve the right to refuse to accept any Purchase
Payment at any time for any reason.
1.22 Separate Account - A separate account that buys and holds shares of the
Fund(s). Income, gains or losses, realized or unrealized, are credited
or charged to the Separate Account without regard to Our other income,
gains or losses. We own the assets held in the Separate Account and are
not a trustee as to such amounts. The Separate Account generally is not
guaranteed and is held at market value. The name of the Separate
Account is shown on the Contract Schedule. The assets of the Separate
Account, to the extent of reserves and other Contract liabilities of
the Separate Account, will not be charged with Our other liabilities.
1.23 Valuation Period - The period of time for which a Fund determines its
net asset value, usually from 4:15 p.m. Eastern time each day the New
York Stock Exchange is open until 4:15 p.m. the next such business day,
or such other day that one or more of the Funds determines its net
asset value. The assets of the Separate Account are not chargeable with
the liabilities arising out of any other business We may conduct.
1.24 Variable Annuity Contract - An Annuity Contract providing for the
accumulation of value and/or for Annuity payments which vary in amount
based on investment results.
Section 2. General Provisions
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2.01 The Contract - The entire Contract consists of this Contract and any
attached applications or endorsements.
2.02 Nonparticipating Contract - Neither the Contract Holder nor any
Beneficiary have a right to share in our earnings.
2.03 Misstatements and Adjustments - If We learn that the age of any
Annuitant or second Annuitant is misstated, the correct age will be
used to adjust payments. We reserve the right to request
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reimbursement or adjust future payments for any amount overpaid. We
will pay the amount of any underpayment.
2.04 Reports - We furnish the Contract Holder with a report showing the
Contract Value at least once each calendar year. We also furnish an
annual report of the Separate Account.
2.05 Premium Taxes - Any premium taxes paid to any governmental entity are
charged against Purchase Payments or the Contract Value. We may, at our
sole discretion, pay premium taxes when due and deduct that amount from
the Contract at a later date. Payment at an earlier date does not waive
any right We may have to deduct amounts at a later date.
2.06 Protection of Proceeds - To the extent permitted by law, all payments
under this Contract to the Contract Holder or Beneficiary shall be free
from legal process and the claim of any creditor.
2.07 Evidence of Survival - The Company may require satisfactory evidence of
the continued survival of any person(s) on whose life Annuity payments
are based.
2.08 Proof of Age - The Company may require evidence of age of any Annuitant
under Annuity Options 2 and 3 and of the designated second Annuitant
under Annuity Option 3.
2.09 Change of Contract - We reserve the right to change the Contract, but
only if a change is necessary to:
(a) Make the Contract or the Separate Account comply with state or
federal laws or regulations; or
(b) Assure the continued qualified status of the Contract under the
Code or other federal laws or regulations governing annuity
contracts; or
(c) Reflect a change in the operation of the Separate Account or the
Funds; or
(d) Provide additional funds; or
(e) Withdraw Funds
We will notify the Contract Holder in writing 30 days before any change
becomes effective. When appropriate, We will endorse the Contract for
the change.
Section 3. Ownership
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3.01 Contract Holder Rights - The Contract Holder has all interest and right
to amounts held in his or her Contract. The Contract Holder and any
joint Contract Holder are named on the Specifications page. The
Contract Holder and any joint Contract Holder may exercise all the
rights under the Contract, subject to the rights of:
(a) Any assignee under an assignment filed at our Home Office; and
(b) Any irrevocably named Beneficiary.
Upon the death of a Contract Holder prior to the Annuity Date, a
spousal Beneficiary may elect to continue the Contract in his or her
own name and retain all ownership rights and privileges or take
distribution of the death benefit as defined in Section 10.
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3.02 Transfer of Ownership - The Contract Holder may transfer all of his or
her rights under the Contract. A written request, dated and signed by
the Contract Holder and any joint Contract Holder, must be filed at our
Home Office. After the transfer is recorded, it will take effect as of
the date the request was signed. Any such transfer terminates the
interest of the existing Contract Holder. It does not change the
Beneficiary, nor transfer the Beneficiary's interest. A transfer will
not affect any payments We may make or actions We may take before such
transfer has been recorded at our Home Office.
Section 4. Beneficiary Provisions
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4.01 Beneficiary - The Contract Holder may name a Beneficiary and a
contingent Beneficiary. At the death of the Contract Holder prior to
the Annuity Date, the Beneficiary(ies) named in our records will
receive a death benefit as stated in Section 10. Upon the death of a
joint Contract Holder prior to the Annuity Date, the surviving joint
Contract Holder, if any, will be treated as the designated Beneficiary
and any other Beneficiary designation on record with Us at the time of
death is treated as a contingent Beneficiary.
4.02 Change of Beneficiary - The Contract Holder may change the Beneficiary.
A written request, dated and signed by the Contract Holder, must be
filed at our Home Office. If there are joint Contract Holders, both
must sign the request. After the change is recorded, it will take
effect as of the date the request was signed. If the request reaches
our Home Office and is recorded after the Contract Holder dies, but
before any payment is made, the change is valid.
4.03 Death of Beneficiary - If all of the Beneficiaries and contingent
Beneficiaries die prior to the Contract Holder's death, We pay the
death benefit in one sum to the Contract Holder's estate.
Section 5. Purchase Payments
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5.01 Purchase Payments - Subject to the maximum and minimum shown on the
Contract Schedule, the Contract Holder may determine the amount and
frequency of Purchase Payments. We reserve the right not to accept any
Purchase Payment. We will declare from time to time the acceptability
of additional Purchase Payments.
5.02 Allocation of Purchase Payments - The Contract Holder may elect to have
each Net Purchase Payment accumulate:
(a) On a variable basis invested in shares of one or more Funds in
which the Separate Account invests;
(b) For guaranteed terms offered in the current deposit period(s) under
the AG Account; or
(c) In a combination of any of the available investment options.
Net Purchase Payments must be allocated in whole percentages. For
subsequent Purchase Payments, if no allocation instructions are
received with the Purchase Payment, the allocation will be as indicated
in the most recent directive from the Contract Holder. If the same
guaranteed term(s) are not available, the next shortest will be used.
If no shorter guaranteed term is available, the next longer guaranteed
term will be used.
Section 6. Separate Account
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6.01 General - The assets of the Separate Account, equal to the reserves
and other Contract liabilities that depend on the investment
performance of the Separate Account are not chargeable with liabilities
arising out of any other business We may conduct. Income, gains or
losses of the Separate Account, realized or unrealized, are credited to
or charged against the assets of the Separate Account without regard to
Our other income, gains or losses.
6.02 Investment Allocations to the Separate Account - The assets of the
Separate Account are segregated by Fund. If the shares of any Fund are
no longer available for investment by the Separate Account or if in our
judgment, further investment in such shares should become inappropriate
in view of the purpose of the Contract, We may cease to make such Fund
shares available for investment under the Contract prospectively, or We
may substitute shares of another Fund for shares already acquired. We
may also, from time to time, add additional Funds. Any elimination,
substitution or addition of Funds will be done in accordance with
applicable state and federal securities laws. We reserve the right to
substitute shares of another Fund for shares already acquired without a
proxy vote.
6.03 Valuation of Assets - The shares of the Funds will be valued at their
net asset value at the end of each Valuation Period.
6.04 Accumulation Unit - A Net Purchase Payment that is allocated to one or
more Funds is credited to the Contract as Accumulation Units. The
number of Accumulation Units credited is determined by dividing the
applicable portion of the Net Purchase Payment by the Accumulation Unit
value for the appropriate Fund. The Accumulation Unit value used is
that which is computed for the next Valuation Period after which the
Purchase Payment is received at our Home Office. Accumulation Units
attributable to the initial Purchase Payments will be credited within
two business days of acceptance.
Accumulation Unit values may increase or decrease from Valuation Period
to Valuation Period.
6.05 Net Return Factor for Each Valuation Period - The value of an
Accumulation Unit for any Valuation Period is calculated by multiplying
the Accumulation Unit value for the immediately preceding Valuation
Period by the net return factor of the appropriate Fund for the current
period.
The net return factor for each Fund is equal to 1.0000000 plus the net
return rate.
The net return rate equals:
(a) The value of the shares of the Fund held by the Separate Account
at the end of a Valuation Period; minus
(b) The value of the shares of the Fund held by the Separate Account
at the start of the Valuation Period; plus or minus
(c) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(d) The total value of the Funds(s) Accumulation Units and Fund(s)
Annuity Units of the Separate Account at the start of the
Valuation Period; minus
(e) A daily actuarial charge as shown on the Contract Schedule for
Annuity mortality and expense risks and profit and a daily
administrative charge.
The net return rate may be more or less than zero (0) percent.
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The value of a share of the Fund is equal to the net assets of the Fund
divided by the number of shares outstanding.
6.06 Administrative Charge - We deduct an administrative charge equal, on
an annual basis, to the amount shown on the Contract Schedule.
6.07 Mortality Risk Charge - We deduct a mortality risk charge equal, on an
annual basis, to the amount shown on the Contract Schedule.
6.08 Expense Risk Charge - We deduct an expense risk charge equal, on an
annual basis, to the amount shown on the Contract Schedule.
6.09 Mortality and Expense Guarantee - We guarantee that the dollar amount
of each Annuity payment after the first will not be affected by
variations in mortality or expense experience.
Section 7. AG Account
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7.01 AG Account Guaranteed Interest Rate - All amounts allocated to the AG
Account earn a rate of interest that is guaranteed for a specified
period of time. The rate will be credited daily and will never be less
than the minimum guaranteed interest rate shown on the Contract
Schedule. We determine the rate and it is not based on investment
experience.
For guaranteed terms of one year or less, one guaranteed interest rate
is credited for the full guaranteed term. For longer guaranteed terms,
an initial guaranteed interest rate is credited from the date of
deposit to the end of a specified period within the guaranteed term.
There may be different guaranteed interest rate(s) declared for
subsequent specified time intervals throughout the guaranteed term.
7.02 Deposit Period - A calendar week, a calendar month, a calendar quarter,
or any other period of time We specify during which Net Purchase
Payment(s), transfers and reinvestments are accepted into the AG
Account for one or more guaranteed terms. We reserve the right to
extend the deposit period.
7.03 Guaranteed Term - The period of time for which AG Account guaranteed
interest rates are guaranteed on Net Purchase Payments. Transfers and
reinvestments are made into a current deposit period for the AG
Account. Such period begins on the day following the close of the
deposit period and ends on the designated Maturity Date. Guaranteed
terms, if any, are offered at our discretion for various lengths of
time ranging up to and including ten years.
During a deposit period, We may make available any number of guaranteed
terms. The Contract Holder may allocate Net Purchase Payments and
transfers into any or all of the available guaranteed terms.
7.04 Guaranteed Term(s) Groups - All AG Account guaranteed term(s) with the
same length of time from the close of the deposit period until the
designated Maturity Date.
7.05 Maturity Date - The last day of a guaranteed term.
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7.06 Allocation of Net Purchase Payments to the AG Account - When the
Contract Holder wishes to allocate all or any portion of a Net Purchase
Payment to the Guaranteed Account, he or she must tell Us the
percentage to apply to one or more of the AG Account guaranteed term(s)
available during the current deposit period. If no allocation
instructions are received, a Net Purchase Payment is allocated as
indicated in the most recent directive from the Contract Holder. If the
same guaranteed term is not available for any amount allocated to the
AG Account, We will allocate the amount to the next shortest guaranteed
term available. If no shorter guaranteed term is available, We will
allocate it to the next longest guaranteed term.
7.07 AG Account Guaranteed Term Maturity Date and Maturity Value - On the
maturity date, the value of the total of all amounts allocated to that
guaranteed term is called the maturity value.
When the Contract Holder has assets in the AG Account, at least
eighteen (18) days before a maturity date, We notify the Contract
Holder of the:
(a) Projected maturity value; and
(b) Guaranteed terms and the applicable guaranteed interest rates
available during the current deposit period.
When no allocation instructions are received and the assets in a
guaranteed term have been reinvested by Us in another guaranteed term
on the maturity date, the Contract Holder may transfer or withdraw,
during the month following the maturity date, the reinvested amount
with interest earned (as of the date the request is received at our
Home Office) without incurring a Market Value Adjustment. This
transaction is allowed only once for each maturity date, regardless of
whether the transfer or withdrawal is partial or full.
7.08 Transfers from the AG Account - The Contract Holder may transfer any
portion, or all, of an amount in the AG Account to one or more of the
Funds or to another available guaranteed term. The amount withdrawn for
any reason before the maturity date is subject to a Market Value
Adjustment.
7.09 Withdrawals from the AG Account - When the Contract Holder requests a
withdrawal from the AG Account, if instructions are not provided by the
Contract Holder, amounts are withdrawn on a pro rata basis from the
guaranteed term(s) groups in which the Contract Value is currently
invested. Within a guaranteed term group, the amount to be withdrawn
will be withdrawn first from the oldest deposit period. Except on the
maturity date, withdrawals from the AG Account will be subject to a
Market Value Adjustment.
7.10 Reinvestment - We will mail a notice to the Contract Holder before a
guaranteed term's maturity date. This notice will contain the
guaranteed terms available during the current deposit periods with
their guaranteed interest rate(s) and projected maturity value. If no
specific direction is given by the Contract Holder prior to the
maturity date, each maturity value will be reinvested in the current
deposit period for a guaranteed term of the same duration. If a
guaranteed term of the same duration is unavailable, each matured term
value will automatically be reinvested in the current deposit period
for the next shortest guaranteed term available. If no shorter
guaranteed term is available, the next longer guaranteed term will be
used. We will mail a confirmation statement to the Contract Holder
after the maturity date. This notice will state the guaranteed term and
guaranteed interest rate(s) which will apply to the reinvested matured
term value.
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7.11 AG Account Market Value Adjustment (Factor) - The Market Value
Adjustment factor (MVA factor) reflects any change in interest rates
from the time assets are allocated to the AG Account to the time they
are transferred or withdrawn. An MVA factor is applied to any amount
withdrawn or transferred from the AG Account before the end of a
guaranteed term, including amounts paid in a lump sum death benefit or
applied to an Annuity Option.
The amount withdrawn from the AG Account is multiplied by the MVA
factor which is calculated as follows:
x
---
365
(1 + i)
----------------
x
---
365
(1 + j)
Where:
i is the Deposit Period Yield
j is the Current Yield
x is the number of days remaining, (computed from Wednesday of
the week of withdrawal) in the guaranteed Term.
Determination of MVA factor parameters:
A yield is computed at the close of the last business day of each week
of the deposit period. The yield will equal the average of the yields
on U.S. Treasury Notes which matured during the last three months of
the applicable guaranteed term.
The deposit period yield is the average of those yields for the deposit
period. If withdrawal is made prior to the close of the deposit period,
it is the average of those yields on each week preceding withdrawal.
The current yield is the average of the yields on the last business day
of the week preceding withdrawal on the same U.S. Treasury Notes
included in the deposit period yield.
If no U.S. Treasury Notes matured during the last three months of the
guaranteed term, We reserve the right to use the average of the yields
on U.S. Treasury Notes that mature during a following quarter.
Section 8. Contract Value; Transfers and Withdrawals During the Accumulation
Period
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8.01 Contract Value - The value of the Contract is determined by adding the
value of the total of Accumulation Units attributed to the selected
Fund(s) to the value of any amounts attributed to the AG Account.
8.02 Transfers During the Accumulation Period - Before the Annuity Date,
the Contract Holder may transfer from any Fund or guaranteed term of
the AG Account to:
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(a) Any other Fund; or
(b) Any guaranteed term of the AG Account available in the current
deposit period.
Transfer requests can be submitted as a percentage or as a dollar
amount. We may establish a minimum transfer amount. Within a guaranteed
term group, the amount transferred is withdrawn first from the oldest
deposit period, then from the next oldest, and so on until the amount
requested is satisfied.
The Contract Holder may make an unlimited number of transfers during
the Accumulation Period. The number of free transfers allowed is shown
on the Contract Schedule. Transfers in excess of that number may be
subject to the transfer charge shown on the Contract Schedule.
Transfers of a matured term value from the AG Account on or within one
calendar month after a guaranteed term's maturity date do not count
against the annual transfer limit.
Amounts applied to guaranteed terms of the AG Account may not be
transferred to the Funds or to another guaranteed term during the
deposit period or for 90 days after the close of the deposit period
except for matured term value(s) during the calendar month following
the guaranteed term's maturity date.
Transfers from guaranteed terms of the AG Account are subject to a
Market Value Adjustment.
8.03 Withdrawals During the Accumulation Period - The Contract Holder may
withdraw all or a portion of the Contract Value during the Accumulation
Period by properly completing a withdrawal request form. Withdrawal
requests ran be submitted as a percentage or as a specific dollar
amount. Net Purchase Payment amounts are withdrawn first, and then the
excess value, if any. For any partial withdrawal, if instructions are
not provided by the Contract Holder, amounts are withdrawn on a pro
rata basis from the Fund(s), and/or the guaranteed term(s) groups in
which the Contract is currently invested. Within a guaranteed term
group, the amount to be withdrawn will be withdrawn first from the
oldest deposit period, then from the next oldest, and so on until the
amount requested is satisfied.
After deduction of the maintenance charge, if applicable, the withdrawn
amount shall be reduced by the applicable deferred sales charge and any
applicable premium taxes.
8.04 Deferred Sales Charge - The deferred sales charge only applies to the
portion of the amount withdrawn attributable to Net Purchase Payment(s)
and varies according to the elapsed time since receipt of the Purchase
Payment. The deferred sales charge is shown on the Contract Schedule.
8.05 Waiver of Deferred Sales Charge - No deferred sales charge is deducted
when the Contract Value is paid:
(a) To a Beneficiary as a death benefit, except for Purchase Payments
made by a surviving joint Contract Holder as described in Section
10.02(b);
(b) As a premium for an Annuity Option;
(c) At least the number of months, as shown on the Contract Schedule,
after the date of the first Purchase Payment and in an amount equal
to or less than the percentage of the Contract Value as shown on
the Contract Schedule. This applies to the first withdrawal
request, partial or full, in a calendar year. The Contract Value is
calculated as of the date the withdrawal request is
15
received in good order at our Home Office. This waiver is not
available to the Contract Holder while a SWO is in effect;
(d) For a full withdrawal where the Contract Value does not exceed
the amount shown on the Contract Schedule and no withdrawals have
been taken from the Contract within the prior 12 months;
(e) For a distribution made by Us under Section 8.06; or
(f) For a distribution which is part of a SWO under Section 8.07.
We reserve the right to allow the proceeds of a total withdrawal to be
reinstated under the terms and conditions as established by Us from
time to time.
8.06 Payment of Adjusted Contract Value - Upon 90 day's written notice to
the Contract Holder, We will terminate the Contract if the Contract
Value becomes less than $1,500 immediately following any partial
withdrawal. We do not intend to exercise this right in cases where the
Contract Value is reduced to $1,500 or less solely due to investment
performance. When We make a distribution pursuant to this provision,
the deferred sales charge will not be deducted.
8.07 Systematic Withdrawal Option (SWO) - We will allow the Contract Holder
to establish a schedule of withdrawals to be made automatically from
the Contract Value. All distributed amounts will be withdrawn on a pro
rata basis from the Fund(s) and/or the guaranteed term(s) groups of the
AG Account in which the Contract Value is invested.
The Contract Holder must elect one of the following SWO methods:
(a) Specified Payment: Payments of a designated dollar amount. The
annual amount may not be greater than the percentage of the
Contract Value at time of the election as shown on the Contract
Schedule. This annual dollar amount will remain constant. At our
discretion, We may require a minimum payment amount; or
(b) Specified Period: Payments which are made over a period of time
which must be at least the minimum period as shown on the Contract
Schedule. The annual amount paid each year is calculated by
dividing the Contract Value as of December 31 of the prior year by
the number of payment years remaining; or
(c) Specified Percentage: Payment of a designated percentage which
cannot be greater than the percentage of the Contract Value at the
time of election as shown on the Contract Schedule. The percentage
may be changed by written request. We reserve the right to limit
the number of times the percentage may be changed. The annual
amount is calculated by multiplying the Contract Value as of
December 31 of the year prior to the payment by the designated
percentage.
In our discretion, We may require a minimum initial Contract Value for
election of this option. SWO may be elected by submitting a completed
and signed election form to Us. Once elected, this option may be
revoked by submitting a written request to Us. SWO may be elected only
once by the Contract Holder or by a spousal Beneficiary.
The Contract Holder should consult his/her tax adviser prior to
requesting this distribution option. We are not responsible for any
adverse tax consequences due to a Contract Holder's receiving SWO
16
payments. A ten (10) percent penalty tax may apply to distributions to
a Contract Holder who has not reached age 59-1/2. Upon death of the
Contract Holder, any payments will be made under the terms of Section
10.
Section 9. Maintenance Charge
--------------------------------------------------------------------------------
9.01 Maintenance Charge - We will deduct an annual maintenance charge as
shown in the Contract Schedule from the Contract Value during the
Accumulation Period. We will deduct the maintenance charge on the
anniversary of the Effective Date of the Contract. This maintenance
charge is also deducted upon withdrawal of the entire Adjusted Contract
Value. The maintenance charge is deducted proportionately from each
investment option used.
Section 10. Proceeds Payable on Death
--------------------------------------------------------------------------------
10.01 Death of the Contract Holder Prior to the Annuity Date - In the event
of the death of the Contract Holder or a joint Contract Holder prior to
the Annuity Date, a death benefit is payable to the Beneficiary(ies)
designated by the Contract Holder. Upon the death of a joint Contract
Holder, the surviving joint Contract Holder, if any, will be treated as
the designated Beneficiary. Any other Beneficiary designation on record
with Us at the time of death will be treated as a contingent
Beneficiary.
A Beneficiary may request We pay the death benefit under one of the
options described in Section 10.03. If the Beneficiary is the spouse of
the Contract Holder, he or she may elect to continue the Contract in
his or her own name and exercise all the Contract Holder's rights under
the Contract.
10.02 Death Benefit Amount Prior to the Annuity Date -
(a) Except as set forth in Section 10.02(b), the amount of the
guaranteed death benefit value is equal to the greater of:
(i) The Contract Value at the end of the Valuation Period during
which We receive at our Home Office due proof of death and
election of the type of payment to be made; or
(ii) The death benefit determined as of the Valuation Period
corresponding to the date of death.
Until the first Effective Date anniversary, the death benefit
is equal to the Purchase Payments made by the Contract Holder
prior to the Effective Date anniversary less any withdrawals
and any amounts applied to an Annuity Option.
For each Contract year thereafter, the death benefit during
the Contract year equals the death benefit at the beginning of
the Contract year plus Purchase Payments made during the year
less any withdrawals and any amounts applied to an Annuity
Option.
On each Effective Date anniversary, the death benefit is
determined as follows:
(A) The death benefit on the previous Effective Date
anniversary increased by the death benefit factor shown
on the Contract Schedule; plus
17
(B) Purchase Payments made by the Contract Holder during the
Contract year increased by the death benefit factor shown
on the Contract Schedule for the portion of the year since
the Purchase Payment was made; less
(C) Any withdrawals or amounts applied to an Annuity Option
during the Contract year increased by the death benefit
factor shown on the Contract Schedule for the portion of
the Contract year since the withdrawal or election of
Annuity option; or
(iii) The Contract Value on the most recent seventh year anniversary
of the Effective Date plus any Purchase Payments made after
such Effective Date anniversary less any withdrawals and any
amounts applied to an Annuity Option.
Notwithstanding the foregoing, the death benefit under (ii) or
(iii) will not exceed the death benefit maximum amount shown on the
Contract Schedule.
The death benefit calculation described in (ii) and (iii) above,
applies until the Contract Holder reaches the death benefit maximum
age shown on the Contract Schedule. Thereafter, the death benefit
is only adjusted for Purchase Payments, withdrawals and amounts
applied to Annuity Options. If the Contract Holder reaches the
death benefit maximum age shown on the Contract Schedule prior to
the seventh anniversary of the Effective Date, the death benefit
will be the greater of (i) or (ii) above.
The excess, if any, of the guaranteed death benefit value over the
Contract Value is determined when We receive at our Home Office due
proof of death and allocated to the Fund shown on the Contract
Schedule. The Contract Value plus any excess amount deposited
becomes the Contract Value.
(b) In the case of a Beneficiary of a surviving joint Contract
Holder who continued the Contract in his or her own name, the death
benefit shall be equal to (a)(i) above less any applicable deferred
sales charge on any Purchase Payment made after We have received at
our Home Office due proof of death of the first joint Contract
Holder.
10.03 Death Benefit Payment Methods - A non-spousal Beneficiary must elect
the death benefit to be paid under one of the following methods in the
event of the death of the Contract Holder prior to the Annuity Date:
Method 1 - Lump sum payment of the death benefit; or
Method 2 - The payment of the entire death benefit within (5) years of
the date of the Contract Holder's death; or
Method 3 - Payment of the death benefit over the lifetime of the
designated Beneficiary or over a period not extending beyond the life
expectancy of the designated Beneficiary with distribution beginning
within one year of the date of death of the Contract Holder.
Any portion of the death benefit not applied under Option 3 within one
year of the date of Contract Holder's death, must be distributed within
five (5) years of the date of death. A Market Value Adjustment will
apply at the time the death benefit is paid.
18
A spousal Beneficiary may elect to continue the Contract in his or her
name, elect a lump sum payment of the death benefit or apply the
Adjusted Contract Value to an Annuity Option.
10.04 Death of Contract Holder On or After the Annuity Date - If the Contract
Holder, who is not the Annuitant, dies on or after the Annuity Date,
the remaining payments under the Annuity Option elected will be made to
the Beneficiary at least as rapidly as under the method of distribution
in effect at the Contract Holder's death.
10.05 Death of the Annuitant - If the Annuitant, who is not the Contract
Holder, dies on or before the Annuity Date, a new Annuitant may be
named. If no Annuitant is named, the Contract Holder will be the
Annuitant. If the Annuitant dies after the Annuity Date, the death
benefit, if any, will be payable to the Beneficiary as specified in the
Annuity Option elected. We will require proof of the Annuitant's death.
Death benefits will be paid at least as rapidly as under the method of
distribution in effect at the Annuitant's death.
Section 11. Delay of Payments
--------------------------------------------------------------------------------
11.01 Delay of Payments - We will make any payments under this Contract
within seven days after a request is received in good order. We reserve
the right to suspend or postpone any type of payment from the Separate
Account for any period when:
(a) The New York Stock Exchange is closed for other than customary
weekend and holiday closings;
(b) Trading on the Exchange is restricted;
(c) An emergency exists as a result of which it is not reasonably
practicable to dispose of securities held in the Separate Account
or determine their value; or
(d) The Securities and Exchange Commission so permits delay for the
protection of security holders.
The applicable rules of the Securities and Exchange Commission will
govern as to whether the conditions in (b) or (c) exist.
We also reserve the right to delay any type of payment from the AG
Account for up to six (6) months.
Section 12. Annuity Provisions
--------------------------------------------------------------------------------
12.01 Designation of Annuitant - The Contract Holder and the Annuitant need
not be the same person. The Contract Holder names the Annuitant and
during the Accumulation Period, may change the designated Annuitant. We
change the Annuitant when We receive a written request in good order at
our Home Office. We will not change the Annuitant when Annuity payments
have commenced.
The Contract Holder elects an Annuity Option by telling us to use all
or any portion of the Contract Value (minus any applicable premium
taxes if not previously deducted) to purchase Annuity payments under an
Annuity Option.
When an Annuity Option is chosen the Contract Holder must designate a:
(a) Fixed Annuity using the General Account;
19
(b) Variable Annuity using any of the Funds available during the
Annuity Period; or
(c) Combination of (a) and (b).
If a fixed Annuity is chosen, We will calculate the amount using an
interest assumption no less than the percentage specified on the
Contract Schedule. We may calculate the amount using a higher interest
rate.
If a variable Annuity is chosen, an Assumed Annual Net Return Rate of
5% may be chosen. If not chosen, We will use an Assumed Annual Net
Return Rate of 3.5%.
Payments are made on a monthly basis to the Contract Holder unless the
Contract Holder requests a different mode of payment.
Once elected, an Annuity Option may not be revoked, except for Option 1
when elected on a variable basis.
12.02 Terms of Annuity Options - The minimum first payment amount must be at
least $50 per month and at least $250 per year.
If the Contract Holder elects a fixed Annuity and We determine that the
Contract Holder would receive larger payments by applying the Contract
Value, reduced by the deferred sales charge, to a single premium
immediate Annuity currently offered by Us, We will make the larger
payments.
We determine the first payment of a variable Annuity, or the payment
amount of a fixed Annuity, using the Annuitant's (and second
Annuitant's if applicable) adjusted age which We calculate as follows:
(a) If Annuity payments begin any time between July 1, 1992 and
December 31, 1999, the adjusted age is the Annuitant's age as of
the birthday closest in time to the Annuity Date reduced by one
(1) year.
(b) If the Annuity begins any time between January 1, 2000 and December
31, 2009, the adjusted age is the Annuitant's age as of the
birthday closest in time to the Annuity Date reduced by two (2)
years.
(c) For each succeeding decade, the adjusted age is the Annuitant's
age as determined in (b), reduced by one additional year.
The Annuity rates for Options 2 and 3 are based on mortality from 1983
Table A.
Assumed Annual Net Return Rate is the interest rate used to determine
the amount of the first Annuity payment under a variable Annuity. The
Separate Account must earn this rate plus enough to cover the mortality
and expense risks charges (which may include profit) and administrative
charges if future variable Annuity payments are to remain level.
The Contract Holder must give written notice to Us at least 30 days
before the Annuity payments begin, electing or changing:
(a) The date on which Annuity payments are to begin;
(b) The Annuity Option;
20
(c) Whether the payments are to be made monthly, quarterly,
semiannually or annually;
(d) The investment options used to provide Annuity payments.
The first Annuity payment may not be earlier than one (1) calendar year
after the initial Purchase Payment, not later than the later of the:
(a) First day of the month following the Annuitant's birthday shown on
the Contract Schedule; or
(b) Tenth anniversary of the last Purchase Payment. In lieu of the
election of an Annuity, the Contract Holder may request a lump sum
payment.
12.03 Annuity Unit - The number of Annuity Units per Fund is based on the
amount of the first variable Annuity payment which is equal to:
(a) The portion of the Contract Value (minus any premium taxes) applied
to pay a variable Annuity; divided by,
(b) 1000; multiplied by,
(c) The payment rate for the Annuity Option chosen.
Such amount, or portion, of the variable Annuity payment will be
divided by the Annuity Unit value for the appropriate Fund on the tenth
Valuation Period before the due date of the first payment to determine
the number of each Fund's Annuity Units. The number of each Fund's
Annuity Unit remains fixed. Each future payment is equal to the sum of
the products of each Fund's Annuity Unit value multiplied by the
appropriate number of units. The Fund's Annuity Unit value on the tenth
Valuation Period prior to the due date of the payment is used.
12.04 Annuity Unit Value - For any Valuation Period, a Fund's Annuity Unit
value is equal to:
(a) The value for the previous Valuation Period; multiplied by,
(b) The Annuity Net Return Factor for the Valuation Period; multiplied
by,
(c) A daily factor to reflect the Assumed Annual Net Return Rate (the
factor for 3.5% per year is .9999058; for 5% per year it is
.9998663).
The dollar value of a Fund(s) Annuity Unit values and payments may go
up or down due to investment gain or loss.
12.05 Annuity Net Return Factor - The Annuity net return factor is used to
compute all Separate Account Annuity payments for any Fund.
The Annuity net return factor(s) for each Fund is equal to 1.0000000
plus the net return rate. The net return rate is equal to:
(a) The value of the shares of the Fund held by the Separate Account at
the end of a Valuation Period; minus,
(b) The value of the shares of the Fund held by the Separate Account at
the start of the Valuation Period; plus or minus,
(c) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(d) The total value of the Fund(s) Accumulation Units and Fund(s)
Annuity Units of the Separate Account at the start of the Valuation
Period; minus,
21
(e) A daily actuarial charge as shown of the Contract Schedule for
Annuity mortality and expense risks and profit and a daily
administrative charge which will not exceed the administrative
charge as shown on the Contract Schedule.
The net return rate may be more or less than zero (0) percent.
The value of a share of the Fund is equal to the net assets of the Fund
divided by the number of shares outstanding.
12.06 Annuity Options
Option 1 - Payments for a Stated Period of Time - An Annuity will be
paid for the number of years chosen. The number of years must be at
least 5 and not more than 30.
If payments for this Annuity Option are made under a variable Annuity,
the present value of any remaining payments may be withdrawn at any
time.
Option 2 - Life Income - An Annuity will be paid for the life of the
Annuitant. If also chosen, We will guarantee payments for 60, 120, 180,
or 240 months.
Option 3 - Life Income Based upon the Lives of Two Annuitants - An
Annuity will be paid during the lives of the Annuitant and a second
Annuitant. Payments will continue until both Annuitants have died. When
this Annuity Option is chosen, a choice must be made of:
(a) 100% of the payment to continue after the first death;
(b) 66-2/3% of the payment to continue after the first death;
(c) 50% of the payment to continue after the first death;
(d) Payments for a minimum of 120 months with 100% of the payment to
continue after the first death; or
(e) 100% of the payment to continue at the death of the second
Annuitant and 50% of the payment to continue at the death of the
Annuitant.
We may make other options available as allowed by law.
22
OPTION 1
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
--------------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
--------------------------------------------------------------------------------
5 3.00% 17.91 53.59 106.78 211.99
6 3.00% 15.14 45.30 90.27 179.22
7 3.00% 13.16 39.39 78.49 155.83
8 3.00% 11.68 34.96 69.66 138.31
9 3.00% 10.53 31.52 62.81 124.69
10 3.00% 9.61 28.77 57.33 113.82
11 3.00% 8.86 26.52 52.85 104.93
12 3.00% 8.24 24.65 49.13 97.54
13 3.00% 7.71 23.08 45.98 91.29
14 3.00% 7.26 21.73 43.29 85.95
15 3.00% 6.87 20.56 40.96 81.33
16 3.00% 6.53 19.54 38.93 77.29
17 3.00% 6.23 18.64 37.14 73.74
18 3.00% 5.96 17.84 35.56 70.59
19 3.00% 5.73 17.13 34.14 67.78
20 3.00% 5.51 16.50 32.87 65.26
21 3.00% 5.32 15.92 31.72 62.98
22 3.00% 5.15 15.40 30.68 60.92
23 3.00% 4.99 14.92 29.74 59.04
24 3.00% 4.84 14.49 28.88 57.33
25 3.00% 4.71 14.09 28.08 55.76
26 3.00% 4.59 13.73 27.36 54.31
27 3.00% 4.47 13.39 26.68 52.97
28 3.00% 4.37 13.08 26.06 51.74
29 3.00% 4.27 12.79 25.49 50.60
30 3.00% 4.18 12.52 24.95 49.53
-------------------------------------------------------------------------------
23
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
Payments Guaranteed for a Stated Period of Months
------------------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
------------------------------------------------------------------------------------------------------------------------------
Age of
Annuitant Male Female Male Female Male Female Male Female Male Female
------------------------------------------------------------------------------------------------------------------------------
50 $ 4.27 $ 3.90 $ 4.26 $ 3.90 $ 4.22 $ 3.89 $ 4.17 $ 3.86 $ 4.08 $ 3.82
51 4.34 3.97 4.33 3.96 4.30 3.95 4.23 3.92 4.14 3.88
52 4.43 4.03 4.41 4.03 4.37 4.01 4.30 3.98 4.20 3.93
53 4.51 4.10 4.50 4.10 4.45 4.08 4.37 4.04 4.26 3.99
54 4.60 4.18 4.59 4.17 4.54 4.15 4.45 4.11 4.32 4.04
55 4.70 4.25 4.68 4.25 4.62 4.22 4.53 4.18 4.39 4.11
56 4.80 4.34 4.78 4.33 4.72 4.30 4.61 4.25 4.45 4.17
57 4.91 4.42 4.89 4.41 4.82 4.38 4.69 4.32 4.51 4.23
58 5.03 4.52 5.00 4.51 4.92 4.47 4.78 4.40 4.58 4.30
59 5.15 4.61 5.12 4.60 5.03 4.56 4.87 4.48 4.65 4.37
60 5.28 4.72 5.25 4.70 5.14 4.66 4.96 4.57 4.71 4.44
61 5.43 4.83 5.39 4.81 5.27 4.76 5.06 4.66 4.78 4.51
62 5.58 4.95 5.53 4.93 5.39 4.87 5.16 4.75 4.84 4.58
63 5.74 5.08 5.69 5.05 5.53 4.99 5.26 4.85 4.90 4.65
64 5.91 5.21 5.85 5.18 5.66 5.10 5.36 4.95 4.96 4.72
65 6.10 5.36 6.03 5.32 5.81 5.22 5.46 5.05 5.02 4.79
66 6.30 5.51 6.21 5.47 5.96 5.36 5.56 5.16 5.08 4.86
67 6.51 5.67 6.41 5.63 6.12 5.50 5.66 5.26 5.13 4.93
68 6.73 5.85 6.62 5.80 6.28 5.65 5.77 5.37 5.18 5.00
69 6.97 6.04 6.84 5.98 6.44 5.80 5.86 5.49 5.23 5.06
70 7.23 6.25 7.07 6.18 6.61 5.97 5.96 5.60 5.27 5.12
71 7.51 6.47 7.32 6.39 6.79 6.14 6.05 5.71 5.31 5.18
72 7.80 6.71 7.58 6.62 6.96 6.32 6.14 5.83 5.34 5.23
73 8.12 6.98 7.85 6.86 7.14 6.50 6.23 5.94 5.37 5.28
74 8.46 7.26 8.14 7.12 7.32 6.69 6.31 6.04 5.40 5.32
75 8.82 7.57 8.45 7.40 7.50 6.89 6.38 6.14 5.42 5.35
------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
24
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Male and Second Annuitant is Female)
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
-----------------------------------------------------------------------------------------------
Adjusted Ages
----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
-----------------------------------------------------------------------------------------------
55 50 $ 3.69 $ 4.05 $ 4.27 $ 3.69 $ 4.13
55 55 3.88 4.25 4.47 3.87 4.25
55 60 3.06 4.47 4.71 4.06 4.36
60 55 3.99 4.44 4.71 3.98 4.55
60 60 4.24 4.71 4.99 4.23 4.70
60 65 4.49 5.01 5.32 4.48 4.85
65 60 4.38 4.97 5.32 4.38 5.10
65 65 4.72 5.33 5.70 4.71 5.32
65 70 5.07 5.75 6.17 5.05 5.54
70 65 4.93 5.68 6.15 4.91 5.86
70 70 5.40 6.21 6.70 5.36 6.18
70 75 5.89 6.82 7.40 5.81 6.49
75 70 5.69 6.68 7.32 5.62 6.92
75 75 6.37 7.45 8.15 6.23 7.40
75 80 7.07 8.34 9.16 6.78 7.85
-----------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
25
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Female and Second Annuitant is Male)
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
--------------------------------------------------------------------------------------------
Adjusted Ages
-----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
--------------------------------------------------------------------------------------------
55 50 $ 3.75 $ 4.07 $ 4.26 $ 3.75 $ 3.98
55 55 3.88 4.25 4.47 3.87 4.06
55 60 3.99 4.44 4.71 3.98 4.12
60 55 4.06 4.47 4.71 4.06 4.37
60 60 4.24 4.71 4.99 4.23 4.47
60 65 4.38 4.97 5.32 4.38 4.54
65 60 4.49 5.01 5.32 4.48 4.89
65 65 4.72 5.33 5.70 4.71 5.02
65 70 4.93 5.68 6.15 4.91 5.14
70 65 5.07 5.75 6.17 5.05 5.60
70 70 5.40 6.21 6.70 5.36 5.79
70 75 5.69 6.68 7.32 5.62 5.96
75 70 5.89 6.83 7.40 5.81 6.63
75 75 6.37 7.45 8.15 6.23 6.92
75 80 6.78 8.11 8.99 6.54 7.15
--------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
26
OPTION 1
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
--------------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
--------------------------------------------------------------------------------
5 3.50% 18.12 54.19 107.92 213.99
6 3.50% 15.35 45.92 91.44 181.32
7 3.50% 13.38 40.01 79.69 158.01
8 3.50% 11.90 35.59 70.88 140.56
9 3.50% 10.75 32.16 64.05 127.00
10 3.50% 9.83 29.42 58.59 116.18
11 3.50% 9.09 27.18 54.13 107.34
12 3.50% 8.46 25.32 50.42 99.98
13 3.50% 7.94 23.75 47.29 93.78
14 3.50% 7.49 22.40 44.62 88.47
15 3.50% 7.10 21.24 42.31 83.89
16 3.50% 6.76 20.23 40.29 79.89
17 3.50% 6.47 19.34 38.51 76.37
18 3.50% 6.20 18.55 36.94 73.25
19 3.50% 5.97 17.85 35.54 70.47
20 3.50% 5.75 17.22 34.28 67.98
21 3.50% 5.56 16.65 33.15 65.74
22 3.50% 5.39 16.13 32.13 63.70
23 3.50% 5.24 15.66 31.19 61.85
24 3.50% 5.09 15.24 30.34 60.17
25 3.50% 4.96 14.85 29.56 58.62
26 3.50% 4.84 14.49 28.85 57.20
27 3.50% 4.73 14.15 28.19 55.90
28 3.50% 4.63 13.85 27.58 54.69
29 3.50% 4.53 13.57 27.02 53.57
30 3.50% 4.45 13.30 26.49 52.53
--------------------------------------------------------------------------------
27
OPTION 1
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
-------------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
-------------------------------------------------------------------------------
5 5.00% 18.74 56.00 111.33 219.98
6 5.00% 15.99 47.77 94.96 187.64
7 5.00% 14.02 41.90 83.30 164.59
8 5.00% 12.56 37.52 74.58 147.35
9 5.00% 11.42 34.11 67.81 133.99
10 5.00% 10.51 31.40 62.42 123.34
11 5.00% 9.77 29.19 58.03 114.66
12 5.00% 9.16 27.36 54.38 107.45
13 5.00% 8.64 25.81 51.31 101.39
14 5.00% 8.20 24.50 48.69 96.21
15 5.00% 7.82 23.36 46.44 91.75
16 5.00% 7.49 22.37 44.47 87.88
17 5.00% 7.20 21.51 42.75 84.48
18 5.00% 6.94 20.74 41.23 81.47
19 5.00% 6.71 20.06 39.88 78.80
20 5.00% 6.51 19.46 38.68 76.42
21 5.00% 6.33 18.91 37.59 74.28
22 5.00% 6.17 18.42 36.62 72.35
23 5.00% 6.02 17.98 35.73 70.61
24 5.00% 5.88 17.57 34.93 69.02
25 5.00% 5.76 17.20 34.20 67.57
26 5.00% 5.65 16.87 33.53 66.25
27 5.00% 5.54 16.56 32.92 65.04
28 5.00% 5.45 16.28 32.35 63.93
29 5.00% 5.36 16.01 31.83 62.90
30 5.00% 5.28 15.77 31.35 61.95
-------------------------------------------------------------------------------
28
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
Payments Guaranteed for a Stated Period of Months
-----------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
Age of -----------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female
-----------------------------------------------------------------------------------------------------------------------
50 $ 4.56 $ 4.20 $ 4.55 $ 4.19 $ 4.51 $ 4.18 $ 4.45 $ 4.15 $ 4.36 $ 4.11
51 4.64 4.26 4.62 4.25 4.58 4.24 4.51 4.21 4.42 4.16
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.48 4.21
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.32 4.53 4.27
54 4.89 4.46 4.87 4.46 4.82 4.43 4.73 4.39 4.59 4.32
55 4.99 4.54 4.97 4.53 4.91 4.50 4.80 4.46 4.65 4.38
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.72 4.44
57 5.20 4.71 5.17 4.70 5.10 4.66 4.96 4.60 4.78 4.50
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.84 4.57
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 4.91 4.63
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 4.97 4.70
61 5.71 5.11 5.67 5.09 5.54 5.03 5.32 4.93 5.03 4.77
62 5.96 5.23 5.81 5.21 5.66 5.14 5.42 5.02 5.09 4.84
63 6.02 5.36 5.97 5.33 5.79 5.25 5.51 5.11 5.16 4.91
64 6.20 5.49 6.13 5.46 5.93 5.37 5.61 5.21 5.21 4.98
65 6.38 5.64 6.31 5.60 6.07 5.49 5.71 5.31 5.27 5.05
66 6.58 5.79 6.49 5.75 6.22 5.63 5.81 5.41 5.32 5.12
67 6.79 5.95 6.69 5.91 6.38 5.76 5.91 5.52 5.38 5.18
68 7.02 6.13 6.89 6.08 6.53 5.91 6.01 5.63 5.42 5.25
69 7.26 6.32 7.11 6.26 6.70 6.06 6.11 5.74 5.47 5.31
70 7.52 6.53 7.35 6.45 6.86 6.23 6.20 5.85 5.51 5.37
71 7.80 6.75 7.59 6.66 7.03 6.39 6.29 5.96 5.54 5.42
72 8.09 6.99 7.85 6.89 7.21 6.57 6.38 6.07 5.57 5.47
73 8.41 7.26 8.12 7.13 7.38 6.75 6.46 6.17 5.60 5.51
74 8.75 7.54 8.41 7.39 7.55 6.94 6.53 6.28 5.63 5.55
75 9.12 7.85 8.71 7.66 7.73 7.13 6.61 6.38 5.65 5.59
-----------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
29
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
Payments Guaranteed for a Stated Period of Months
-----------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
Age of ------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female
-----------------------------------------------------------------------------------------------------------------------
50 $ 5.48 $ 5.12 $ 5.46 $ 5.11 $ 5.41 $ 5.09 $ 5.34 $ 5.06 $ 5.24 $ 5.01
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.29 5.05
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.34 5.10
53 5.71 5.30 5.69 5.29 5.62 5.26 5.53 5.22 5.40 5.15
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.27 5.45 5.20
55 5.89 5.44 5.86 5.43 5.79 5.39 5.67 5.34 5.51 5.25
56 5.99 5.52 5.96 5.51 5.87 5.47 5.74 5.40 5.56 5.31
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.62 5.37
58 6.21 5.69 6.17 5.67 6.06 5.62 5.90 5.54 5.68 5.42
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.61 5.74 5.48
60 6.46 5.89 6.41 5.87 6.28 5.80 6.06 5.69 5.79 5.55
61 6.60 6.00 6.55 6.97 6.39 5.90 6.15 5.77 5.85 5.61
62 6.75 6.11 6.69 6.08 6.51 6.00 6.24 5.86 5.91 5.67
63 6.91 6.23 6.84 6.20 6.64 6.10 6.33 5.95 5.96 5.73
64 7.09 6.37 7.00 6.33 6.77 6.22 6.42 6.04 6.02 5.80
65 7.27 6.51 7.18 6.46 6.91 6.34 6.52 6.13 6.07 5.86
66 7.47 6.66 7.36 6.61 7.05 6.46 6.61 6.23 6.12 5.92
67 7.68 6.82 7.55 6.76 7.20 6.60 6.70 6.33 6.16 5.99
68 7.91 7.00 7.76 6.93 7.35 6.74 6.80 6.43 6.21 6.04
69 8.15 7.19 7.98 7.11 7.51 6.89 6.89 6.54 6.25 6.10
70 8.41 7.39 8.21 7.30 7.67 7.04 6.97 6.64 6.28 6.15
71 8.69 7.62 8.45 7.51 7.83 7.21 7.06 6.74 6.32 6.20
72 8.99 7.86 8.70 7.73 8.00 7.38 7.14 6.85 6.35 6.25
73 9.31 8.12 8.97 7.97 8.16 7.55 7.21 6.95 6.37 6.29
74 9.65 8.41 9.26 8.23 8.33 7.73 7.29 7.04 6.39 6.33
75 10.02 8.72 9.55 8.50 8.50 7.92 7.35 7.14 6.41 6.36
-----------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
30
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Male and Second Annuitant is Female)
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
--------------------------------------------------------------------------------------------
Adjusted Ages
-----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
--------------------------------------------------------------------------------------------
55 50 $ 3.97 $ 4.35 $ 4.56 $ 3.97 $ 4.42
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.34 4.76 5.00 4.34 4.64
60 55 4.27 4.73 5.00 4.26 4.83
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.76 5.29 5.60 4.75 5.13
65 60 4.66 5.25 5.61 4.65 5.39
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.34 6.03 6.46 5.31 5.81
70 65 5.19 5.97 6.44 5.17 6.14
70 70 5.67 6.49 6.99 5.62 6.47
70 75 6.16 7.10 7.68 6.07 6.77
75 70 5.95 6.96 7.61 5.87 7.20
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.33 8.62 9.45 7.02 8.13
--------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
31
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Female and Second Annuitant is Male)
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
------------------------------------------------------------------------------------------------------
Adjusted Ages
----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
---------------------------------------------------------------------------------------------------
55 50 $ 4.03 $ 4.36 $ 4.55 $ 4.03 $ 4.41
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.27 4.73 5.00 4.26 4.83
60 55 4.34 4.76 5.00 4.34 4.64
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.66 5.25 5.61 4.65 5.39
65 60 4.76 5.29 5.60 4.75 5.13
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.19 5.97 6.44 5.17 6.14
70 65 5.34 6.03 6.46 5.31 5.81
70 70 5.67 6.49 6.99 5.62 6.47
70 75 5.95 6.96 7.61 5.87 7.20
75 70 6.16 7.10 7.68 6.07 6.77
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.04 8.39 9.29 6.79 8.70
---------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
32
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Male and Second Annuitant is Female)
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
-----------------------------------------------------------------------------------------
Adjusted Ages
-----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
-----------------------------------------------------------------------------------------
55 50 $ 4.88 $ 5.26 $ 5.48 $ 4.88 $ 5.34
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.21 5.65 5.89 5.21 5.53
60 55 5.15 5.63 5.91 5.14 5.73
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.61 6.16 6.49 5.60 6.01
65 60 5.52 6.14 6.51 5.51 6.28
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.17 6.90 7.33 6.13 6.67
70 65 6.04 6.84 7.34 6.00 7.03
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.97 7.96 8.56 6.87 7.62
75 70 6.77 7.84 8.51 6.68 8.08
75 75 7.45 8.60 9.33 7.27 8.55
75 80 8.14 9.49 10.35 7.80 8.98
-----------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
33
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Female and the Second Annuitant is Male)
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
------------------------------------------------------------------------------------------
Adjusted Ages
----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
------------------------------------------------------------------------------------------
55 50 $ 4.93 $ 5.27 $ 5.46 $ 4.93 $ 5.19
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.15 5.63 5.91 5.14 5.73
60 55 5.21 5.65 5.89 5.21 5.53
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.52 6.14 6.51 5.51 6.28
65 60 5.61 6.16 6.49 5.60 6.01
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.04 6.84 7.34 6.00 7.03
70 65 6.17 6.90 7.33 6.13 6.67
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.77 7.84 8.51 6.68 8.08
75 70 6.97 7.96 8.56 6.87 7.62
75 75 7.45 8.60 9.33 7.27 8.55
75 80 7.86 9.28 10.20 7.57 9.59
------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
34
--------------------------------------------------------------------------------
Aetna Insurance Company of America
Home Office: 000 Xxxxxxxxxx Xxxxxx
Xxxxxxxx, Xxxxxxxxxxx 00000
(000) 000-0000
Individual Variable, Fixed, or Combination Annuity Contract
Nonparticipating
--------------------------------------------------------------------------------
ALL PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA.
APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR
DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT
APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
I-CDA-GP2(4/94)
