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[Natiowide LOGO]
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NATIONWIDE LIFE INSURANCE COMPANY (the Company) agrees to make payments to the
person or persons entitled thereto, in accordance with and subject to the terms
of this Contract.
CONTRACT SCHEDULE
Owner of Contract: Contract Number:
Plan: Contract Date:
Jurisdiction: Issue Date:
Termination Date:
This Contract has been issued in consideration of the application and payment of
Purchase Payments as provided herein. This Contract is issued and accepted
subject to all the terms set forth in the following pages, which are a part of
this Contract.
Signed for the Company at its Home Office, Xxx Xxxxxxxxxx Xxxxx, Xxxxxxxx, Xxxx,
to be effective on the Contract Date.
Signature Signature
Secretary President
GROUP FLEXIBLE FUND RETIREMENT CONTRACT
NON-PARTICIPATING
ALL CONTRACTUAL VALUES BASED ON THE INVESTMENT RESULTS OF A SEPARATE ACCOUNT
INCLUDED IN THIS CONTRACT ARE VARIABLE (MAY INCREASE OR DECREASE) AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
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TABLE OF CONTENTS
Page
CONTRACT SUMMARY PAGE .....................................................iii
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ARTICLE I: DEFINITIONS .......................................................1
Accumulation Unit
Actuarial Risk Fee
Beneficiary
Code
Company
Contingent Beneficiary
Contract
Contract Anniversary
Contract Date
Contract Maintenance Charge
Contract Value
Contract Year
Distribution
Distribution Period- Account
Exchange
General Account
Group Fixed Contract
Home Office
Initial Transfer Amount
Optional Retirement Income Forms
Owner
Participant
Participant Account
Participant Account Year
Participant Anniversary
Participant Effective Date
Plan
Purchase Payment
Retirement Commencement Date
Retirement Income Payments
Retired Participant
Sub-Account
Transfer
Underlying Mutual Fund
Valuation Date
Valuation Period
Variable Account
ARTICLE II: CHARGES ...........................................................2
Net Investment Factor
Contract Maintenance Charge
Mortality Risk Charge, Expense Risk and Administration Charge
Premium Taxes
Contingent Deferred Sales Charge
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ARTICLE III: PARTICIPANT ACCOUNTS..............................................4
Purchase Payments
Crediting Accumulation Units
Accumulation Unit Value
Change of Allocation Percentage Between Sub-Account
Exchanges Between Sub-Account and Transfer to Deposit Fund
ARTICLE IV: BENEFITS ..........................................................5
Notice to Distribute
Elections
Death Benefit Before Retirement
Optional Retirement Income Forms
Special Provisions Relating to Options
Method of Calculating Retirement Income Payments
ARTICLE V: SUSPENSION AND TERMINATION .........................................7
Suspension and Termination
Redemption of Participants Accounts
Termination by Company
ARTICLE VI: GENERAL PROVISIONS.................................................8
The Contract
Modification of the Contract
Individual Certificates
Misstatements and Adjustments
Evidence of Survival
Ownership and Assignment
Designation of Beneficiary
Data to be Furnished to the Company
Non-Participating
Relation of this Contract to the Variable Account
Substitution of Fund Shares
ARTICLE VII: PURCHASE RATES, ANNUAL RATES ....................................10
Applicability and Basis of Tables
Adjusted Age
Illustrative Tables for Determining Variable Payments
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CONTRACT SUMMARY PAGE
Actuarial Risk Fee:
The Actuarial Risk Fee, taken
on a daily basis and is
computed at a maximum annual
rate up to 1.50% of the
average Variable Account
value and reflects the
charges made for the Mortality
Risk, the Expense Risk and the
Administration of the Variable
Account.
Administration Charge: The charge will be 1.00%.
Companion Contract(s): The Nationwide Life Insurance
Company's Group Fixed Annuity
Contract(s) or other
investment option(s) as
offered by the Plan and
accepted by the Company
Contingent Deferred Sales Charge:
DEFERRED SALES CHARGE NUMBER OF PARTICIPANT DEFERRED SALES CHARGE NUMBER OF PARTICIPANT ACCOUNT
PERCENTAGE ACCOUNT YEARS PERCENTAGE YEARS
9% 0-16 4% 0-16
8% 0-16 3% 0-16
7% 0-16 2% 0-16
6% 0-16 1% 0-16
5% 0-16 0% 16 and after
This Contingent Deferred Sales Charge will not exceed 9% of the lesser of: (1)
the total of all Purchase Payments received on behalf of the surrendering
Participant or the withdrawing Owner prior to the date of the request for
surrender; or (2) the amount surrendered. The Contingent Deferred Sales Charge
is made by canceling a number of Accumulation Units equal in value to the
applicable Contingent Deferred Sales Charge.
Contract Anniversary: The date 12 months after the
Effective Date of the
Contract, and each 12-month
period thereafter.
Contract Maintenance Charge: $15 at the beginning of each
Participant Account Year for
the preceding Participant
Account Year.
Creditable Percentage: 100%.
Expense Risk Charge: 0.40%
Mortality Risk Fee: 0.10%
Plan: State ABC Internal Revenue
Code 457 Plan.
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ARTICLE I: DEFINITIONS
ACCUMULATION UNIT- A statistical index measuring the net investment results of
each Sub-Account of the Variable Account. It is the unit of measurement used to
determine Contract Value and each Participant Account Value.
ACTUARIAL RISK FEE A charge made for mortality and expense risk and
administration of the Variable Account. It is computed on a daily basis at a
maximum annual rate of up to 1.50% of the average Variable Account value.
BENEFICIARY- The person named in the enrollment form to receive certain benefits
under the Contract upon the death of the designated annuitant. The Beneficiary
can be changed by the Owner as set forth in the Contract.
CODE- The Internal Revenue Code of 1986, as amended.
COMPANY- Nationwide Life Insurance Company.
CONTINGENT BENEFICIARY- The person named on the enrollment form to be the
alternate Beneficiary if the Beneficiary is not living at the time of the death
of the designated annuitant.
CONTRACT- The group flexible fund retirement contract issued by the Company to
the Owner under which the Company invests Purchase Payments made by the Owner
and assists the Owner in making Retirement Income Payments at specified dates.
CONTRACT ANNIVERSARY- An anniversary of the date of issue of the Contract.
CONTRACT DATE- The date shown as the Contract Date in the Contract.
CONTRACT MAINTENANCE CHARGE- The maximum Contract Maintenance Charge is $15 per
Participant per year to reimburse the Company for certain administrative
expenses relating to the maintenance of individual Participant records and the
mailing of periodic statements to Participants.
CONTRACT VALUE- The sum of the value of all Variable Account Accumulation Units
attributable to the Contract plus any amount held under the Contract in the
General Account.
CONTRACT YEAR- Each period starting with either (1) the Contract Date or (2) a
Contract Anniversary. The Contract Year ends immediately prior to the next
Contract Anniversary.
DISTRIBUTION- Any payment by the Company of part or all of the Contract Value
under the Contract.
DISTRIBUTION PERIOD- The period during which payments are distributed from a
Participant Account.
EXCHANGE- An exchange from a Fund to a Companion Contract described in the
Contract Summary Page, if any or to another Fund.
GENERAL ACCOUNT- An account comprised of all assets of the Company other than
those in any segregated asset account.
GROUP FIXED CONTRACT- The Company's Group Fixed Fund Retirement Contract or
Group Fixed Tax Deferred Annuity Contract.
HOME OFFICE-The main office of the Company located in Columbus, Ohio.
INITIAL TRANSFER AMOUNT- The initial amount transferred by the Owner from
another investment vehicle which is the initial Purchase Payment under the
Contract.
OPTIONAL RETIREMENT INCOME FORMS- The method for making annuity payments.
Several forms are available under the Contract.
OWNER- The employer or other entity to which the Contract is issued.
PARTICIPANT- A Participant is an eligible employee, member or other person who
is entitled to benefits under the Plan. Such persons are determined and reported
to the Company by the Owner.
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PARTICIPANT ACCOUNT- An account established by the Company for each Participant
in which all financial transactions occurring with respect to a Participant,
under this Contract, other than the purchase and payment of an annuity made from
the Company's General Account, are recorded.
PARTICIPANT ACCOUNT YEAR- For each Participant, the Participant Account Year is
each one year period starting with either the Participant Effective Date or a
Participant Anniversary.
PARTICIPANT ANNIVERSARY- An anniversary of the Participant Effective Date.
PARTICIPANT EFFECTIVE DATE- For each Participant, the Participant Effective Date
is the first date Accumulation Units are credited to the Participant Account on
behalf of such Participant under the Contract.
PLAN- A retirement plan which receives favorable tax treatment under the
provisions of the Code. The Plan document is referred to in the Contract as the
Plan.
PURCHASE PAYMENT- A deposit of new value into the Contract. The term "Purchase
Payment" does not include transfers among the Sub-Accounts.
RETIREMENT COMMENCEMENT DATE- The date upon which Retirement Income Payments
commence.
RETIREMENT INCOME PAYMENTS- Periodic Distributions from a Participant Account
made by the Company to the Owner during the Distribution Period.
RETIRED PARTICIPANT- A Participant for whom payments under an Optional
Retirement Income Form are being made.
SUB-ACCOUNT- A separate and distinct division of the Variable Account, to which
specific Underlying Mutual Fund shares are allocated and for which Accumulation
Units are separately maintained.
TRANSFER- A transfer of amounts from this Contract to any other non-Companion
investment option under the Plan, or to another Plan.
UNDERLYING MUTUAL FUND OR FUND- The registered management investment company,
specified in the enrollment form, in which the assets of a Sub-Account of the
Variable Account will be invested.
VALUATION DATE- Each day the New York Stock Exchange and the Company's Home
Office are open for business or any other day during which there is a sufficient
degree of trading of the Variable Account's Underlying Mutual Fund shares that
the current net asset value of its Accumulation Units might be materially
affected.
VALUATION PERIOD- The period of time commencing at the close of business of the
New York Stock Exchange and ending at the close of business for the next
succeeding Valuation Date.
VARIABLE ACCOUNT- Nationwide DCVA-II, a segregated investment account
established by the Company in which amounts equivalent to the Company's
obligations under the Contract are held for all Participants, and for those
Participants during retirement who have annuitized.
ARTICLE II: CHARGES
NET INVESTMENT FACTOR
The Net investment factor for any Valuation Period is determined by
dividing (a) by (b) and subtracting (c) from the result where:(a) is
the net of(1) the net asset value per share of the Underlying Mutual
Fund held in the Sub-Account determined at the end of the current
Valuation Period, plus (2) the per share amount of any dividend or
capital gain distributions made by the Underlying Mutual Fund held in
the Sub-Account if the "ex-dividend" date occurs during the current
Valuation Period, plus or minus (3) a per share charge or credit for
any taxes reserved for, which is determined by the Company to have
resulted from the investment operations of the Sub-Account. (b) is the
net of: (1) the net asset value per share of the Underlying Mutual Fund
held in the Sub-Account determined as of the end of the immediately
preceding Valuation Period, plus or minus (2) the per share charge or
credit, if any, for any taxes reserved for in the immediately preceding
Valuation Period. (c) is a factor representing the daily Actuarial Risk
Fee deducted from the Variable Account. Such factor will not exceed the
maximum annual rate, as reflected on the Contract Summary Page, times
the average Variable Account value.
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CONTRACT MAINTENANCE CHARGE
The Company will maintain individual records with respect to each
Participant and will make a charge for expenses attributable to
maintaining such records. The Company will effect such charge by
cancelling a number of Accumulation Units on each Participant
Anniversary during both the accumulation and annuity periods, equal in
value to the applicable Contract Maintenance Charge. If a Participant
Account includes more than one Sub-Account, the deduction will be
allocated amoung Sub-Accounts on the basis of relative values at the
time the deduction is made.
The Company will assess a Contract Maintenance Charge on the date
(other than a Participant Anniversary) that amounts held in respect of
a Participant are fully withdrawn from the Variable Account. In such
case, the amount of the Contract Maintenance Charge will be one-twelfth
of the applicable Contract Maintenance Charge, multiplied by the number
of whole or partial calendar months which have elapsed between the
Participant Anniversary (or the Participant Effective Date during the
first Participant Account Year) and the date of full withdrawal.
For those Plans which provide this contract and certain other
investment options (such as the Company's Group Fixed Fund Retirement
Contract), the Contract Maintenance Charge under this Contract may be
reduced so that the total of the Contract Maintenance Charge and any
similar administrative charges imposed under other investment options
available under the Plan shall not exceed the Contract Maintenance
Charge assessed under this Contract. Such charge will be allocated
amoung Sub-Accounts of the Variable Account and amounts held in such
other investment options available under the Plan on the basis of the
relative values of the Participant`s Account at the time the deduction
is made.
MORTALITY RISK CHARGE, EXPENSE RISK AND ADMINISTRATION CHARGE
The mortality risk portion of the Actuarial Risk Fee is to compensate
the Company for its guarantee to provide Retirement Income Payments
pursuant to the terms of this Contract, regardless of the duration of
the Participant's life, as well as for the Company's guarantee to
provide the death benefit in the event a Participant should die prior
to the Retirement Commencement Date.
The Administration and the Expense Risk portions of the Actuarial Risk
Fee are to compensate the Company for the administration and other
expenses associated with this Contract.
PREMIUM TAXES
To the extent that any taxes are assessed against the Company for
Purchase Payments or the Contract Value the amount of any premium taxes
levied by a state or any other governemental entity upon annuity
considerations received by the Company, the Company may deduct such
taxes from the Contract Owner's Contract Value either : (1) at the time
the Contract is surrendered, (2) at Annuitization, or (3) at such
earlier date as the Company may become subject to such taxes. The
method used to recoup premium tax reserves will be determined by the
Company at its sole discretion and in compliance with applicable state
law.
CONTINGENT DEFERRED SALES CHARGE
In the event that a Contingent Deferred Sales Charge is due, as set
forth on the Contract Summary Page, the charge will be applied to the
following:
A Transfer made in accordance with Article III; or
The Contract Value in the event of termination of this
Contract in accordance with Article V.
Upon a Transfer or Contract termination, the applicable Contingent
Deferred Sales Charge will be applied to reduce the amount withdrawn,
in accordance with the schedule on the Contract Summary Page.
The Contingent Deferred Sales Charge will be assessed against amounts
withdrawn from this Contract if the deposits attributable to the amount
withdrawn were previously assessed a sales charge by the Company.
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No Contingent Deferred Sales Charge will be imposed on Contract Value
that is paid under:
a. any life income payment option;
b. Designated Period payment options of 5 or more years for a
Participant who has a minimum of 5 Participant Account Years
prior to the time the benefit payments are to commence
c. a one-sum or periodic payment payable because of a
Participant's death.
ARTICLE III: PARTICIPANT ACCOUNTS
PURCHASE PAYMENTS
The Company shall receive such Purchase Payments from the Owner as are
made in accordance with the requirements of the Plan. Net Purchase
Payments for each Participant must be at least $20 per Participant per
month. Purchase Payments must be no less frequent than monthly, unless
agreed to by the Company.
Under specific conditions, when authorized by state insurance law, the
Company may credit up to 8% of the Initial Transfer Amount into the
Contract. This credit will reimburse for any exit penalty associated
with the other investment vehicle provider. The Company will recover
said credit by reducing servicing agent or broker compensation and
through increased Administration Charges.
CREDITING ACCUMULATION UNITS
When a Purchase Payment is received by the Company the net Purchase
Payment for each Sub-Account is applied separately to provide
Accumulation Units which are credited to a Participant Account in
accordance with the instructions of the Owner. The number of
Accumulation Units credited to each Participant Account for each
Sub-Account is determined by dividing the net Purchase Payment
allocated to that Sub-Account for that Participant by the value of the
accumulation unit for that Sub-Account next computed following receipt
of the Purchase Payment by the Company. The net Purchase Payment for
each Participant is the total Purchase Payment for that Participant
less any taxes then payable.
ACCUMULATION UNIT VALUE
The value of the accumulation unit for each Variable Account
Sub-Account was established at $1.00 as of the date Underlying Mutual
Fund shares were first purchased for that Sub-Account. The value of
Accumulation Units for any Variable Account Sub-Account for any
subsequent Business day is determined by multiplying the value for the
preceding Business day by the Variable Account net investment factor
for that Sub-Account for the period since that day.
CHANGE OF ALLOCATION PERCENTAGE BETWEEN SUB-ACCOUNT
The Company will permit the Owner, or the Participant if the Plan so
provides, to change the allocation percentages between Sub-Accounts for
subsequent Purchase Payments, provided that no change may be made which
would result in an amount less than 1% of the payment being allocated
to any Sub-Account for any Participant. The Company will permit such
allocation changes as frequently as permitted by the Plan. A change in
allocation percentages will not affect Accumulation Units of any
Sub-Account resulting from Purchase Payments made before the change.
EXCHANGES BETWEEN SUB-ACCOUNT AND TRANSFER TO DEPOSIT FUND
The Company will permit the Owner, or the Participant if the Plan so
provides, to exchange amounts among the Sub-Accounts as frequently as
permitted by the Plan, subject to the limits and rules set by each
Underlying Mutual Fund. For those Plans which provide this contract and
the Company's Group Fixed Fund Retirement Contract, the Owner, or the
Participant if the Plan so provides, may exchange Accumulation Units
between any Sub-Account of the Variable Account and the Group Fixed
Fund Retirement Contract. However, exchanges from the deposit fund to
any Sub-Account of the Variable Account will be subject to the
limitations set forth in the Group Fixed Fund Retirement Contract.
Exchanges will be effected when received in good order by the Company
at its Home Office.
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ARTICLE IV: BENEFITS
NOTICE TO DISTRIBUTE
At least one month prior to the date a Participant is eligible for
Retirement Income Payments in accordance with the Plan, the Owner shall
notify the Company to commence a Distribution from the Participant
Account and shall make the elections required. The Company shall then
determine the first monthly retirement income payment to be payable for
that Retired Participant in accordance with the terms of the Plan, with
Accumulation Units of each Sub-Account being applied to provide
Retirement Income Payments from that Sub-Account. All such payments
will be made by the Company to the Owner. The Company may, however, by
agreement with and on behalf of the Owner, make such payments directly
to the Retired Participant.
To the extent the Plan provides that a Participant may exercise any of
the rights provided the Owner by this Article, the Owner shall mean
Participant in this Article.
ELECTIONS
Retirement Income Form and Date--At least one month prior to a
Participant's Retirement Commencement Date, the Owner may by written
election to the Company at its home office, elect any one of the
retirement income options described below on behalf of a Participant.
Alternate Assumed Investment Rates--If not prohibited by the laws and
regulations of the state in which this Contract is issued, the Owner
may elect on the Contract Date to have all variable benefits payable
for all Participants determined on an assumed investment rate of 5% per
annum.
In addition, if at any time the amount held in respect of the person
entitled to receive such annuity is less than $3,500, the Company shall
have the right to make a lump sum Distribution to such person.
Other Forms and Benefit Payments--With the consent of the Company, the
amount due on Distribution may be applied on any other mutually
agreeable basis.
DEATH BENEFIT BEFORE RETIREMENT
In the event a Participant dies before his or her retirement income
commences, a death benefit equal to the value of the Participant
Account will be paid as provided by the Plan upon (1) the Company's
receipt of verification of proof of death; and (2) the Company's
verification of Beneficiary designations. If the Plan so provides, a
Beneficiary may elect either to receive the value in a lump sum or to
apply it under any of the Optional Retirement Income Forms contained in
this Contract, subject to the minimums applicable to such optional
forms. Monthly payments due under such options may be fixed, variable,
or a combination of fixed and variable.
OPTIONAL RETIREMENT INCOME FORMS
Option A1--Payments for a Designated Period. Payments will be made
monthly for any specified number of years not to exceed 30. The amount
of each variable payment will be determined by multiplying (a) by (b)
where (a) is the Accumulation Unit Value for the date the payment is
made and (b) is the number of Accumulation Units applied under this
option divided by the number of payments selected.
Option A2--Payments of a Designated Amount. Payments will be made
monthly in equal installments until the amount applied, adjusted each
Valuation Date for investment results, in exhausted. The final
installment will be the sum remaining with the Company.
Option B1--Life Income with Payment Certain. Payments will be made
monthly during the lifetime of a Participant. A period certain of 60,
120, 180, 240, 300, or 360 months may be chosen. If the Participant
dies prior to the end of such period certain, payments will continue to
the designated Beneficiary for the remainder of the selected period
certain.
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Option B2--Joint and Last Survivor Life Income. Payments will be made
monthly during the joint lifetime of a Participant and a designated
Beneficiary. Upon the Participants death, periodic payments will be
made in percentages of 50%, 66 2/3%, 75%, or 100% (as elected by the
Participant) of the periodic payments payable to the Participant, and
will be continued to the designated Beneficiary, if living. Payments
will continue to be made as long as either is living. Payments will
stop with the last payment made prior to the death of the designated
Beneficiary. In the event that any payments are made thereafter, such
payments must be reimbursed to Nationwide. If the designated
Beneficiary predeceases the Participant, the payments will continue at
100% to the Participant. These payments will stop with the last payment
made prior to the death of the Participant. In the event that any
payments are made thereafter, such payments must be reimbursed to
Nationwide.
Other Forms and Benefit Payments - With the consent of the Company, the
amount due on Distribution may be applied on any other mutually
agreeable basis.
SPECIAL PROVISIONS RELATING TO OPTIONS
Death of Retired Participant--If any Retired Participant dies while
receiving payments, any benefit payable will be determined in
accordance with the retirement income form elected. Calculation of the
present value of any remaining payments certain for purposes of making
a lump sum payment will be based on the same assumed investment rate
used by the Company in determining the payments certain prior to the
death of the Retired Participant.
Withdrawal--At any time, any amount remaining under Option A1 or A2 may
be withdrawn or if that amount is at least $5,000, it may be applied
under either Option B1 or B2. Unless prohibited by the Plan, a
Beneficiary receiving payments certain under Option B1 after the death
of the Retired Participant may elect at any time to receive the present
value at the current dollar amount of the remaining number of payments
certain in a single payment, calculated on the basis of the assumed
investment rate used in computing the amount of the previous payments.
Frequency of Payment--At the election of the Retired Participant, and
with the consent of the Owner, payments made under any option may be
made annually, semi-annually or quarterly in lieu of monthly. Any
change in frequency of payments must be on the anniversary of the
commencement of Retirement Income Payments.
METHOD OF CALCULATING RETIREMENT INCOME PAYMENTS
Determination of Payments Under Option A1 and A2--Monthly payments
under Option A1 and A2 will be determined in the manner set forth in
the description of those options. As each payment is made under either
of these options, a number of Accumulation Units equal in value to the
payment will be cancelled.
Determination of Payments Under Options B1 and B2--Variable monthly
payments under Option B1 and B2 will be determined annually and will
remain level throughout the year. Each year as of the anniversary of
the commencement of Retirement Income Payments, a new variable monthly
payment will be determined and that new payment will remain level for
that year. An adjusted age is used to determine the amount of monthly
payments for each year. Such adjusted age may not be the same as the
actual age of the Retired Participant.
Determination of Amount of Variable Monthly Payments For First Year--In
determining the amount of Retirement Income Payments under Option B1 or
B2, the value held on behalf of a Participant is determined by
multiplying the number of Accumulation Units in each Sub-Account for
that account by the Accumulation Unit value for that Sub-Account on the
last business day of the second calendar week immediately preceding the
date on which the first payment is due. The first year variable monthly
payment for each Sub-Account is determined by dividing the value of the
Accumulation Units of that Sub-Account in a Participant Account by the
amount required to provide $1 per month (see illustrative purchase
rates shown in Article VII.)
Once the first year's variable monthly payment amount has been
determined for a Participant, the Company will deduct the annual
premium from the Participant Account (see illustrative annual premium
rates shown in Article VII). This deduction is made by cancelling a
number of Accumulation Units in the Participant Account equal in value
to the annual premium. The allocation of the annual premium
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between Sub-Accounts will be in such relationship as the monthly
payments from each Sub-Account have to each other.
Determination of the Amount of Variable Monthly Payments for the Second
and Subsequent Years--As of the first anniversary of the commencement
of Retirement Income Payments, the second year variable monthly
payments will be determined in exactly the same manner as for the first
year, using the purchase rate shown in Article VII for the Retired
Participant age as then determined under the terms of Article VII. As
in the first year, an annual premium will be deducted and transferred
to the General Account from which account the Company will make the
Retirement Income Payments. Subsequent annual determinations will be
made in the same manner.
Premium Taxes- Retirement income payments calculated in accordance with
this Section may be reduced or accumulation units cancelled in order to
provide premium taxes assessed as described in Article II.
Death of Retired Participant--Upon the death of any Retired
Participant, the Participant Account will be reduced by the number of
Accumulation Units not required to provide further payments during the
remainder of a period certain, if any, or to a contingent Retired
Participant. Any Accumulation Units so cancelled will either remain in
the Variable Account or be transferred to the General Account,
depending on the Company's obligation.
ARTICLE V: SUSPENSION AND TERMINATION
SUSPENSION AND TERMINATION
The Company may suspend the Contract at its option at any time by
giving written notice to the Owner if:
(a) The Owner has failed to remit to the Company any
Purchase Payment specified in the Plan; or
(b) If the Company does not accept an amendment to the
Plan, filed with the Company by the Owner, which in
the Company's opinion would adversely affect its
administrative procedures or financial experience, or
both, with respect to the Contract.
The Owner may suspend the Contract by giving ninety (90) days written
notice to the Company. Suspension of the Contract will become effective
as of the ninety-first (91st) day following receipt of written notice
by the Company. Suspension of the Contract shall mean that no further
Purchase Payments will be accepted by the Company, except by mutual
consent. All other terms of the Contract shall continue to apply. After
suspension of the Contract has become effective, the Owner may, upon 30
days written notice, terminate the Contract. Upon termination of the
Contract, the Company will pay to the Owner the value of the Contract,
subject to applicable charges, in accordance with the terms of the
Contract. Upon such termination by the Owner, payment of Contract
Values will be subject to any applicable Contigent Deferred Sales
Charge.
REDEMPTION OF PARTICIPANT ACCOUNTS
The Owner's right to redeem Participant Accounts, either fully or
partially, will be governed by the terms of the Plan. To the extent
permitted by the Plan a Participant Account may be redeemed fully or
partially at any time prior to the date Retirement Income Payments
commence for the Participant under either Option B1 or B2. All such
payments will be made by the Company to the Owner. The Company may,
however, by agreement with and on behalf of the Owner, make such
payments directly to the Participant. No partial redemption will
directly affect either future requirements to make Purchase Payments
for that Participant or the retirement date of that Participant.
A request for a partial redemption of a Participant Account containing
more than one Sub-Account of Accumulation Units must specify the
allocation of the partial redemption amoung the Sub-Account of
Accumulation Units. However, if no such direction is contained in the
request for a redemption, the Company may pro-rate the redemption among
the applicable Sub-Accounts of Accumulation Units. Upon receipt at the
Company's home office of a written request for a full or partial
redemption of a Participant Account, the Company will determine the
value of the number of Accumulation Units redeemed, less any applicable
Contingent Deferred Sales Charge, at the Accumulation Unit Value next
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computed following receipt of such written request by the Company.
Payment of any such amount will be made to the Owner within seven days
of the date the request is received by the Company. Payment of
redemption values may be suspended when redemption of the Underlying
Mutual Fund shares is suspended (i) during any period in which the New
York Stock Exchange is closed (other than customary holiday or weekend
closing), or (ii) in the event that the Securities and Exchange
Commission may by order direct for the protection of Owners or
Participants. In lieu of a lump sum Distribution of a full or partial
redemption, the Owner, or Participant if permitted by the Plan, may
elect to have that amount paid out in installments under Option A1 or
A2 of this Contract subject to the minimums applicable to these
options.
TERMINATION BY COMPANY
This Contract will terminate at the close of business on the date upon
which the performance and fulfillment by the Company of all its duties
and obligations hereunder have been completed.
ARTICLE VI: GENERAL PROVISIONS
THE CONTRACT
This Contract consists of the Contract, any endorsements or signed
amendments,and the application of the Owner, and constitutes the entire
Contract between the Company and Owner. All statements made in the
application will be deemed representations and not warranties. Only an
officer of the Company has authority, and then only in writing, to
modify the Contract or waive any of the Company's rights or
requirements.
MODIFICATION OF THE CONTRACT
Contract provisions with respect to the deductions made from Purchase
Payments, Participant Accounts, Contigent Deferred Sales Charge, if
applicable, Contract Maintenance Charge and Acturial Risk Fees may be
decreased upon notice to the Owner.
The Company may modify the Contract at any time without consent of the
Owner or Participants, if such modification is considered necessary to
obtain the benefit of federal or state statutes or regulations or to
maintain qualification of the Plan.
INDIVIDUAL CERTIFICATES
The Company will issue a descriptive certificate to the Owner for
delivery to each Retired Participant or other person for whom an
Optional Retirement Income Form is purchased under this Contract, as of
the date of the first payment under such Optional Retirement Income
Form. Each such descriptive certificate will set forth in substance the
benefits to which such Retired Participant is entitled under such form.
Purchase Payments made at any time by or on behalf of any Participant
must be at least $20 per month. In addition, if any applicable law so
requires, the Company will issue a descriptive certificate to the Owner
for delivery to each Participant for whom an Optional Retirement Income
Form has not been purchased under this Contract. Each such descriptive
certificate will set forth in substance the benefits to which such
Participant is entitled. Such descriptive certificates will not be
considered a part of this Contract.
MISSTATEMENTS AND ADJUSTMENTS
If the age, or any other relevant fact relating to any person is found
to be misstated, the amount of retirement income payable by the Company
will be adjusted without changing the date of the first payment of such
retirement income, unless some other adjustment, satisfactory to the
Owner and the Company, is made with respect to such misstatement. Any
adjustment made under the terms of this Section shall be conclusive on
any person affected by such adjustment. The dollar amount of any
underpayment made by the Company will be paid in full with the next
payment due. The dollar amount of any overpayment by the Company due to
any misstatement will be deducted from the amounts otherwise payable
thereafter.
8
13
EVIDENCE OF SURVIVAL
If the Company is making payments conditioned upon the survival of any
person, the Company will have the right to require proof that such
person is living on each date when such payment is due.
OWNERSHIP AND ASSIGNMENT
This Contract shall belong to the Owner, provided however that under
Code Section 457 Plans, the owner must hold the Contract for the
exclusive benefit of the Plan's Participants and Beneficiaries All
contractual rights and privileges may be exercised by the Owner,
subject to any rights specifically reserved in the Plan for
Participants as a group or as individuals. The Contract may not be
assigned.
DESIGNATION OF BENEFICIARY
The Participant Beneficiary shall be specified by the Owner, who may
receive instructions from the Participant in this regard. The Owner, or
the Participant where permitted by the Plan, may change such
Beneficiary designation from time to time. Such change must be made by
written notice filed with the Company. However, an irrevocably
designated Beneficiary can be changed only with such Beneficiary's
written consent. Any new designation will not be effective until such
notice is recorded by the Company. When so recorded, the change will
take effect as of the date the notice was signed, whether or not the
Participant is then living. Any change of Beneficiary will be subject
to any payments made or any other action taken by the Company prior to
such recording.
Unless otherwise provided in the Beneficiary designation, if at a
Participant death there is more than one Beneficiary entitled to the
proceeds then accruing, each will receive equal shares of such
proceeds. If any of two or more beneficiaries die prior to the death of
the Participant, the share of such proceeds which would have been
payable to that Beneficiary will be payable to the surviving
Beneficiary or beneficiaries. If no designated Beneficiary is living at
the Participant death, the proceeds will be payable to the Participant
estate. If any Beneficiary dies simultaneously with the Participant or
within 15 days after the Participant death and before due proof of the
Participant death has been received by the Company; then, rights to the
proceeds will be determined as though such Beneficiary had died prior
to the Participant.
DATA TO BE FURNISHED TO THE COMPANY
The Owner or Participant, as applicable, will furnish all information
which the Company may reasonably require for the administration of the
Contract. The Company will not be liable for the fulfillment of any
obligations which in any way depend on such information, until it
receives such information in a form satisfactory to it.
NON-PARTICIPATING
This Contract is non-participating. It will not share in the surplus of
the Company.
RELATION OF THIS CONTRACT TO THE VARIABLE ACCOUNT
The Company shall have exclusive and absolute control of the assets of
the Variable Account. As long as the Variable Account continues to be
registered under the Investment Company Act of 1940 and the Variable
Account is invested in shares of one or more Funds, the Company will
vote Fund shares held in the Variable Account in accordance with the
instructions received from Owners of Contracts of this class which
provide variable benefits. Each such Owner will receive periodic
reports and proxy material of the applicable Funds and a form with
which to give voting instructions.
9
14
SUBSTITUTION OF FUND SHARES
If the shares of any Underlying Mutual Fund should no longer be
available for investment by the Variable Account or, if in the judgment
of the Company's management, further investment in such Underlying
Mutual Fund shares should become inappropriate in view of the purposes
of the Contract, the Company may substitute shares of another
Underlying Mutual Fund for Underlying Mutual Fund shares already
purchased or to be purchased in the future by Purchase Payments under
the Contract. No substitution of securities in any Sub-Accounts may
take place without prior approval of the Securities and Exchange
Commission, and under such requirements as it may impose.
ARTICLE VII: PURCHASE RATES, ANNUAL RATES
APPLICABILITY AND BASIS OF TABLES
The tables in this Article will be used to determine the monthly
Retirement Income Payments for the first and subsequent years for
Options B1 and B2. Under Option B1, the amount of monthly payment for
each payment year will depend on the Retired Participant adjusted age
at the time the first payment is due (for each payment year for
variable payments). Under Option B2, the amount of monthly payment for
each payment year will depend on the adjusted age of each Retired
Participant at the time the first monthly payment is due (for each
payment year for variable payments).
The Retirement Income Tables show for various adjusted ages the amount
of the first monthly payment per $1,000 in each Sub-Account in a
Participant Account.
Variable Retirement Income Payments would remain level each year if the
investment results of the Variable Account were exactly equal to the
investment rate assumed in the tables. Since each year's variable
monthly payments are based on the actual value of the Participant
Account at the time such payments are determined, those monthly
payments will vary from year to year.
The table illustrates for retirement ages 62 and 65 the purchase rates
and annual premium rates applicable to variable payments at the time
payments are determined for a payment year, and the amount transferred
to the General Account to provide variable payments for any year will
be determined by multiplying the applicable annual premium rate by the
value of the Participant Account at that time.
The tables in this Article are based on the Progressive Annuity Table
assuming births in the year 1925 and an investment rate of 31/2% per
year. Any rates or factors for any ages not shown will be furnished by
the Company upon request.
ADJUSTED AGE
The actual age of a Retired Participant as used in determining his
adjusted age for any payment year shall mean the age of the payee on his
last birthday preceding the date the first payment is due for that
payment date plus 0.25 for each completed three months between the last
birthday and the due date of that first payment.
Adjusted age for any payment year is determined as follows:
CALENDAR YEAR ADJUSTMENT TO CALENDAR YEAR ADJUSTMENT TO
OF BIRTH ACTUAL AGE OF BIRTH ACTUAL AGE
Prior to 1916 1941 to 1945 -1.50
1916 to 1920 -.26 1946 to 1950 -1.75
1921 to 1925 -.50 1951 to 1955 -2.00
1926 to 1930 -.75 1956 to 1960 -2.25
1931 to 1935 -1.00 1961 to 1965 -2.50
1936 to 1940 -1.25 1966 to 1970 -2.75
1971 to 1975 -3.00
10
15
ILLUSTRATIVE TABLE OF CALCULATION OF VARIABLE PAYMENTS
----------------------------------------------------------------------------------------------------------------------------
RETIREMENT INCOME PAYMENTS ON A LIFE INCOME WITH
10 YEARS CERTAIN UNISEX RATES
----------------------------------------------------------------------------------------------------------------------------
Adjusted Age 62 Column 2 Adjusted Age 65 Column 2
Beginning Of Column 1 Annual Column 1 Annual
Payment Year Purchase Rate Premium Rate Purchase Rate Premium Rate
------------ ------------- ------------ ------------- ------------
1 176.73 63.08 164.37 67.26
2 171.38 64.43 158.68 68.83
3 165.95 65.72 152.93 70.46
4 160.47 67.11 147.13 72.04
5 154.94 68.36 141.31 73.54
6 149.40 69.58 135.50 74.96
7 143.87 70.62 129.73 76.04
8 138.39 71.38 124.06 76.73
9 133.01 71.73 118.55 76.85
10 127.79 71.62 113.77 76.04
11 122.79 72.06 108.32 76.19
12 117.93 73.31 103.57 77.48
13 113.11 74.73 98.89 78.96
14 108.32 76.19 94.27 80.45
15 103.57 77.48 89.72 81.85
16 98.89 78.96 85.26 83.34
17 94.27 80.45 80.89 84.82
18 89.72 81.85 76.62 86.27
19 85.26 83.34 72.46 87.82
20 80.89 84.82 68.41 89.32
21 76.62 86.27 64.48 90.76
22 72.46 87.82 60.68 92.25
23 68.41 89.32 57.01 93.64
24 64.48 90.76 53.48 95.24
25 60.68 92.25 50.08 96.52
----------------------------------------------------------------------------------------------------------------------------
Column 1 is the amount required to provide $1 per month to the Retired
Participant.
Column 2 is the amount per $1,000 to be transferred to the General Account to
provide payments for the payment year.
16
[NATIONWIDE LIFE INSURANCE COMPANY LOGO]
NATIONWIDE LIFE INSURANCE COMPANY
Home Office Columbus, Ohio
(Hereinafter Called the Company)
................................................................................
APPLICATION FOR GROUP FLEXIBLE FUND RETIREMENT CONTRACT, NON-PARTICIPATING
MADE TO
NATIONWIDE LIFE INSURANCE COMPANY
(Called Nationwide)
ONE NATIONWIDE PLAZA
COLUMBUS, OHIO 43215
[Applicant]
--------------------------------------------------------------------------------
(Exact Name of Applicant)
The Applicant applies for Group Flexible Fund Retirement annuity form DC-3008.
The Applicant approves and accepts the terms of the Contract.
The Applicant certifies that to the best of his or her knowledge the Applicant
has authority to enter into the Contract.
If Nationwide fails to accept this Application, the amounts received will be
refunded without interest or charge.
[May 1, 1997] [Xxxx Xxx]
------------------------------------------------------ ----------------------------------------------------
Date Agent Signature
[May 1, 1997] [Xxxx Xxx]
------------------------------------------------------ ----------------------------------------------------
Date Person Signing for Applicant
[May 1, 1997] [Officer]
------------------------------------------------------ ----------------------------------------------------
Date of Issue Title
Any person who, with intent to defraud or knowing that he is facilitating a
fraud against an insurer, submits an application or files a claim containing a
false or deceptive statement is guilty of insurance fraud.
DC-3008-1(OH) (4/97)
