1
Exhibit 4.(b)
ANCHOR NATIONAL LIFE INSURANCE COMPANY
A STOCK COMPANY LOS ANGELES, CALIFORNIA
CERTIFICATE NUMBER P9999999999
PARTICIPANT XXXX XXX
STATUTORY HOME OFFICE EXECUTIVE OFFICE ANNUITY SERVICE CENTER
0000 XXXXX 00XX XX., XXXXX 000 0 SUNAMERICA CENTER PO BOX 54299
PHOENIX, AZ 85018 LOS ANGELES, CA 90067-6022 LOS ANGELES, CA 90054-0299
ANCHOR NATIONAL LIFE INSURANCE COMPANY ("We", "Us", the "Company", or "Anchor
National") agrees to provide benefits to the Participant under the Group
Contract, in accordance with the provisions set forth in this Certificate and in
consideration of the Participant Enrollment Form and Purchase Payments We
receive.
THIS CERTIFICATE IS EVIDENCE OF COVERAGE UNDER THE GROUP CONTRACT IF A
PARTICIPANT ENROLLMENT FORM IS ATTACHED. THE COVERAGE WILL BEGIN AS OF THE
CERTIFICATE DATE, SHOWN ON THE CERTIFICATE DATA PAGE.
THE VALUE OF AMOUNTS ALLOCATED TO THE SEPARATE ACCOUNT DURING THE ACCUMULATION
AND ANNUITY PERIODS IS NOT GUARANTEED, AND WILL INCREASE OR DECREASE BASED UPON
THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS YOU CHOOSE.
THE CASH SURRENDER BENEFIT OF AMOUNTS ALLOCATED TO ANY FIXED MVA ACCOUNT OPTION
MAY INCREASE OR DECREASE BASED ON THE APPLICATION OF THE MARKET VALUE
ADJUSTMENT. THE UNADJUSTED CASH SURRENDER BENEFIT IS AVAILABLE FOR 30 DAYS AFTER
THE END OF THE GUARANTEE PERIOD. THERE IS NO MARKET VALUE ADJUSTMENT FOR ANY
CASH SURRENDER BENEFIT OF AMOUNTS ALLOCATED TO THE DCA FIXED ACCOUNT OPTIONS.
RIGHT TO EXAMINE - YOU MAY RETURN THIS CERTIFICATE TO OUR ANNUITY SERVICE CENTER
OR TO THE AGENT THROUGH WHOM THE CERTIFICATE WAS PURCHASED WITHIN 10 DAYS AFTER
YOU RECEIVE IT, IF YOU ARE NOT SATISFIED WITH IT. THE COMPANY WILL REFUND THE
CERTIFICATE VALUE ON THE BUSINESS DAY DURING WHICH THE CERTIFICATE IS RECEIVED.
UPON SUCH REFUND, THE CERTIFICATE SHALL BE VOID.
THIS IS A LEGAL DOCUMENT. READ IT CAREFULLY.
/s/ XXXXX X. XXXXXX /s/ XXX XXXXX
------------------------------- ------------------------------
Xxxxx X. Xxxxxx Xxx Xxxxx
Secretary President
ALLOCATED FIXED AND
VARIABLE GROUP ANNUITY CERTIFICATE
Nonparticipating
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TABLE OF CONTENTS
CERTIFICATE DATA PAGE...................................................................PAGE 3
PURCHASE PAYMENT ALLOCATION.............................................................PAGE 4
DEFINITIONS.............................................................................PAGE 5
PURCHASE PAYMENT PROVISIONS.............................................................PAGE 8
Purchase Payments; Deferment of Payments; Suspension of Payments; Substitution of Portfolio
ACCUMULATION PROVISIONS.................................................................PAGE 9
Separate Account Accumulation Value; Number of Accumulation Units; Accumulation Unit Value (AUV);
Fixed Account Accumulation Value; Fixed Account Guarantee Period Options and Interest Crediting ;
Market Value Adjustment(MVA)
CHARGES AND DEDUCTIONS.................................................................PAGE 11
Withdrawal Charge; Mortality Risk Charge; Expense Risk Charge; Distribution Expense Charge
TRANSFER PROVISION.....................................................................PAGE 12
Transfers of Accumulation Units and Annuity Units Between Subaccounts; Transfers of Accumulation
Units To and From the Fixed Account
WITHDRAWAL PROVISIONS..................................................................PAGE 12
Withdrawal Charge; Withdrawal Charge Exemption
GENERAL PROVISIONS.....................................................................PAGE 14
Entire Contract; Change of Annuitant; Death of Annuitant; Misstatement of Age; Proof of Age or
Survival; Conformity With State Laws; Changes in Law; Assignment; Claims of Creditors; Premium
Taxes or Other Taxes; Written Notice; Periodic Reports; Incontestability; Non-Participating
DEATH PROVISIONS.......................................................................PAGE 16
Death of Participant Before the Annuity Date; Due Proof of Death; Amount of Death Benefit; Death
of Participant or Annuitant on or After the Annuity Date; Beneficiary
ANNUITY PROVISIONS.....................................................................PAGE 17
Annuity Date; Payments to Participant; Fixed Annuity Payments; Amount of Fixed Annuity Payments;
Amount of Variable Annuity Payments
ANNUITY PAYMENT OPTIONS ...............................................................PAGE 19
FIXED ANNUITY PAYMENT OPTIONS TABLE....................................................PAGE 20
VARIABLE ANNUITY PAYMENT OPTIONS TABLE.................................................PAGE 22
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CERTIFICATE DATA PAGE
CERTIFICATE NUMBER: ANNUITY SERVICE CENTER:
P9999999999 P. O. BOX 54299
LOS ANGELES, CA 90054-0299
PLAN PLAN ADMINISTRATOR:
[403(b)] Xxxx Xxx Distributors
CONTRACTHOLDER: None
PARTICIPANT: AGE AT ISSUE:
XXXX XXX 35
ANNUITANT: FIRST PURCHASE PAYMENT:
XXXX XXX $10,000.00
ANNUITY DATE: CERTIFICATE DATE:
December 1, 2028 July 1, 1998
LATEST ANNUITY DATE: BENEFICIARY:
December 1, 2038 As stated on the Participant Enrollment
Form or beneficiary designated form
MORTALITY RISK CHARGE: EXPENSE RISK CHARGE:
[0.80%] [0.30%]
DISTRIBUTION EXPENSE CHARGE: FIXED ACCOUNT OPTIONS -
[0.15%] Minimum Guarantee Rate:
3.0%
SEPARATE ACCOUNT:
[Variable Annuity Account Seven]
FOR INQUIRIES
[CALL 0-000-000-0000]
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PURCHASE PAYMENT ALLOCATION
Subaccounts
SUNAMERICA ANCHOR
SERIES TRUST SERIES TRUST
25.00% Cash Management 0.00% Government & Quality Bond
0.00% Corporate Bond 0.00% Growth
0.00% Global Bond 0.00% Capital Appreciation
0.00% High-Yield Bond
0.00% Worldwide High Income
25.00% SunAmerica Balanced
0.00% Asset Allocation
0.00% Equity Income
0.00% Utility
0.00% Equity Index
0.00% Growth-Income
0.00% Federated Value
0.00% Venture Value
0.00% "Dogs" of Wall Street
0.00% Alliance Growth
25.00% Xxxxxx Growth
0.00% Real Estate
0.00% Small Company Value
0.00% Aggressive Growth
0.00% International Growth
and Income
0.00% Global Equities
0.00% International Diversified
Equities
0.00% Emerging Markets
FIXED ACCOUNT OPTIONS
Guarantee Initial
Period Interest Rate
25.00% 1-Year Fixed MVA 3.00%
0.00% 3-Year Fixed MVA
0.00% 5-Year Fixed MVA
DCA Fixed Account Options
0.00% 6 Month DCA Fixed Non-MVA
0.00% 1 Year DCA Fixed Non-MVA
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DEFINITIONS
Defined in this section are some of the words and phrases used in this
Certificate. These terms are capitalized when used in the Certificate. Other
capitalized terms in the Certificate refer to the captioned paragraph explaining
that particular concept in the Certificate.
ACCUMULATION UNIT
A unit of measurement used to compute the Certificate Value in a Subaccount
prior to the Annuity Date.
AGE
Age as of last birthday.
ANNUITANT
The natural person whose life is used to determine the annuity benefits under
the Certificate. If the Certificate is in force and the Annuitant is alive on
the Annuity Date, We will begin payments to the Payee.
ANNUITY DATE
The date on which annuity payments to the Payee are to start.
ANNUITY SERVICE CENTER
As specified on the Certificate Data Page.
ANNUITY UNIT
A unit of measurement used to compute annuity payments from the Subaccounts.
BENEFICIARY
The Beneficiary is as designated on the Participant Enrollment Form unless later
changed by the Participant in writing to Us. See Death Provisions, page 16.
CALENDAR YEAR
Calendar Year begins on January 1 and ends on December 31.
CERTIFICATE
This Certificate describes Your interest as a Participant under the group
annuity contract.
CERTIFICATE DATE
The date Your Certificate is issued, as shown on the Certificate Data Page. It
is the date from which Certificate Years and anniversaries are measured.
CERTIFICATE VALUE
The sum of: (1) Your share of the Subaccounts' Accumulation Unit values and (2)
the value of amounts allocated to the Fixed Account Options.
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CERTIFICATE YEAR
A year starting from the Certificate Date in one Calendar Year and ending on the
day preceding the anniversary of such date in the succeeding Calendar Year.
CONTRIBUTION YEAR
A year starting from the date a Purchase Payment is made in one Calendar Year
and ending on the day preceding the anniversary of such date in the succeeding
Calendar Year.
CURRENT INTEREST RATE
The rate(s) of interest declared by Us applicable to allocations of Subsequent
Purchase Payments to the Fixed Account Options. The Current Interest Rate will
not be less than the Minimum Guarantee Rate as shown on the Certificate Data
Page.
DOLLAR COST AVERAGING (DCA)
You may authorize the automatic transfer of amounts, at the interval selected by
You, from the DCA Fixed Account Option(s) to any Subaccount(s). All amounts
allocated to a DCA Fixed Account Option will be transferred out within the
specified DCA Fixed Account period. You may also authorize the automatic
transfer of amounts at regular intervals and specified amounts or percentages
from the 1-Year MVA Fixed Account Option or any of the Subaccounts to any other
Subaccount(s) (other than the source account). The unit values credited and
applied to Your Certificate are determined on the dates of transfer(s). You may
terminate the DCA program at any time. However, upon termination or
annuitization, any amounts remaining in the DCA Fixed Account Options will be
transferred to the 1-Year MVA Fixed Account Option. We reserve the right to
change the terms and conditions of the DCA program at any time.
ERISA PLAN
A Plan subject to the Employee Retirement Income Security Act of 1974, as
amended.
FIXED ACCOUNT OPTIONS
The investment options under this Certificate that are credited with a fixed
rate of interest declared by the Company. All Purchase Payments allocated to the
Fixed Account Options become part of the Company's general asset account. The
term of each Fixed Account Option determines the length of the Guarantee Period.
FIXED ANNUITY
A series of periodic annuity payments of predetermined amounts that do not vary
with investment experience. Such payments are made from the Company's general
asset account.
GUARANTEE PERIOD
The period for which any of the Initial Interest Rate, the Current Interest Rate
or the Renewal Interest Rate is credited to amounts allocated to any Fixed
Account Option. The Guarantee Period for each Initial Interest Rate and Current
Interest Rate of the Fixed Account Options will begin on the date Purchase
Payments are invested in the Fixed Account Option and extend to the end of the
Calendar Year following the end of the term of the Fixed Account Option. The
Guarantee Period for each Renewal Interest Rate will begin at the beginning of a
Calendar Year and extend for the term of the Fixed Account Option.
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INITIAL INTEREST RATE
The rate(s) of interest credited to any portion of the first Purchase Payment
allocated to the Fixed Account Option(s) as described in the Accumulation
Provisions section. The Initial Interest Rate(s) for this Certificate is/are
listed on page 4. The Initial Interest Rate may not be less than the Minimum
Guarantee Rate as shown on the Certificate Data Page.
IRC
The Internal Revenue Code of 1986, as amended, or as it may be amended or
superseded, together with all regulations thereunder.
NYSE
New York Stock Exchange. Generally, the close of any NYSE business day is 4:00
PM, Eastern Time. Financial transactions received after the close of any NYSE
business day will be credited with the next NYSE business day's Accumulation
Unit Value for the selected Subaccount.
PARTICIPANT
The person or entity named in the Certificate who is entitled to exercise all
rights and privileges set forth in the Certificate while living.
PAYEE
The person receiving payment of annuity benefits under this Certificate.
PLAN ADMINISTRATOR
The Plan Administrator is the person or entity as set forth on the Certificate
Data Page.
PORTFOLIOS
The variable investment options available under the Certificate in which the
corresponding Subaccount(s) invest.
PURCHASE PAYMENTS
Payments in U.S. currency made by or on behalf of the Participant to the Company
for the Certificate.
RENEWAL INTEREST RATE
The rate(s) of interest declared by Us applicable to transfers from the
Subaccounts into the Fixed Account Options and to amounts previously allocated
to one of the Fixed Account Options wherein the Guarantee Period has expired.
The Renewal Interest Rate may not be less than the Minimum Guarantee Rate as
shown on the Certificate Data Page.
SEPARATE ACCOUNT
A segregated asset account named on the Certificate Data Page. The Separate
Account consists of the Subaccounts, each investing in the shares of the
corresponding Portfolio. The assets of the Separate Account are not comingled
with the general assets and liabilities of the Company. Each Subaccount is not
chargeable with liabilities arising out of any other Subaccount. The value of
amounts allocated to the Subaccounts of the Separate Account is not guaranteed.
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SUBACCOUNT
One or more divisions of the Separate Account which invests in shares of the
corresponding Portfolios. The available Subaccounts are shown on page 4.
SUBSEQUENT PURCHASE PAYMENTS
Purchase Payments made after the first Purchase Payment.
VARIABLE ANNUITY
A series of periodic annuity payments which vary in amount according to the
investment experience of one or more Subaccounts, as selected by You.
WE, OUR, US, THE COMPANY
Anchor National Life Insurance Company.
YOU, YOUR
The Participant.
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS
Purchase Payments are flexible. This means that, subject to Company declared
minimums and maximums and the terms of any applicable Plan, as certified by the
Plan Administrator to Us, You or the Plan Administrator may change the amounts,
frequency or timing of Purchase Payments. Purchase Payments will be allocated to
the Fixed Account Option(s) and Subaccount(s) in accordance with instructions
from You. Purchase Payments resulting from salary reductions and/or employer
contributions are not allowed to be allocated to the DCA Fixed Account Options.
We reserve the right to specify the minimum Purchase Payment that may be
allocated to a Subaccount under the Certificate.
DEFERMENT OF PAYMENTS
We may defer making payments from the Fixed Account Options for up to six (6)
months. Interest, subject to state requirements, will be credited during the
deferral period.
SUSPENSION OF PAYMENTS
We may suspend or postpone any payments from the Subaccounts if any of the
following occur:
(a) the NYSE is closed;
(b) trading on the NYSE is restricted;
(c) an emergency exists such that it is not reasonably practical to dispose
of securities in the Portfolios or to determine the value of their
assets; or
(d) the Securities and Exchange Commission, by order, so permits for the
protection of Participants.
Conditions in (b) and (c) will be decided by or in accordance with rules of the
Securities and Exchange Commission.
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SUBSTITUTION OF PORTFOLIO
If: (a) the shares of a Portfolio should no longer be available for investment
by the Separate Account; or (b) in the judgment of the Board of Trustees for the
Trusts, [SunAmerica Series Trust and the Anchor Series Trust], further
investment in the shares of a Portfolio is no longer appropriate in view of the
purpose of the Certificate, then We may substitute shares of another underlying
investment series or Portfolio, for shares already purchased, or to be purchased
in the future by Purchase Payments under the Certificate. No substitution of
securities may take place without prior approval of the Securities and Exchange
Commission and under such requirements as it may impose.
ACCUMULATION PROVISIONS
SEPARATE ACCOUNT ACCUMULATION VALUE
The Separate Account Accumulation Value under the Certificate shall be the sum
of the values of the Accumulation Units held in the Subaccounts for the
Participant.
NUMBER OF ACCUMULATION UNITS
For each Subaccount, the number of Accumulation Units is the sum of each
Purchase Payment and transfer amount allocated to the Subaccount, reduced by
premium taxes, if any:
Divided by
The Accumulation Unit value for that Subaccount for the NYSE business day in
which the Purchase Payment or transfer amount is received.
The number of Accumulation Units will be similarly adjusted for withdrawals,
annuitizations, transfers and charges. Adjustments will be made as of the NYSE
business day in which We receive all requirements for the transaction, as
appropriate.
ACCUMULATION UNIT VALUE (AUV)
The AUV of a Subaccount for any NYSE business day is calculated by subtracting
(2) from (1) and dividing the result by (3) where:
(1) is the total value for the given NYSE business day of the assets
attributable to the Accumulation Units of the Subaccount minus the total
liabilities;
(2) is the cumulative unpaid charge for assumption of Expense Risk,
Distribution Expense and Mortality Risk charges (See CHARGES AND
DEDUCTIONS);
(3) is the number of Accumulation Units outstanding at the end of the given
NYSE business day.
FIXED ACCOUNT ACCUMULATION VALUE
Under the Certificate, the Fixed Account Accumulation Value shall be the sum of
all monies allocated or transferred to the Fixed Account Option(s), reduced by
any applicable premium taxes, plus all interest credited on the Fixed Account
Option(s) during the period that the Certificate has been in effect. This amount
shall be adjusted for withdrawals, annuitizations, transfers and any applicable
Withdrawal Charge. The Fixed Account Accumulation Value shall not be less than
the minimum value required by law in the state where this Certificate is issued.
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FIXED ACCOUNT GUARANTEE PERIOD OPTIONS AND INTEREST CREDITING
Any amounts allocated to the Fixed Account Options from the first Purchase
Payment will earn interest at the Initial Interest Rate for the Fixed Account
Option(s) selected for the duration of the Guarantee Period.
Subsequent Purchase Payments allocated to the Fixed Account Options will earn
interest at the Current Interest Rate for the Fixed Account Option(s) selected
for the duration of the Guarantee Period.
Transfers to the Fixed Account Options from the Subaccounts and amounts renewed
into the Fixed Account Options will earn interest at the Renewal Interest Rate
for the Fixed Account Option(s) selected for the duration of the Guarantee
Period.
For thirty (30) days following the date of expiration of a Guarantee Period, You
may renew for the same or any other Guarantee Period at the Renewal Interest
Rate or You may transfer all or a portion of the amount to the Subaccounts. If
You do not specify a Guarantee Period at the time of renewal, We will select the
same Guarantee Period as has just expired, crediting Your Certificate with the
Renewal Interest Rate in effect on the date of expiration of the Guarantee
Period, so long as such Guarantee Period does not extend beyond the Annuity
Date. If a renewal occurs within one year of the latest Annuity Date, We will
credit interest up to the Annuity Date at the Renewal Interest Rate for the
1-Year MVA Fixed Account Option.
If You are participating in the DCA program, interest will be credited from the
date a Purchase Payment is deposited in the selected DCA Fixed Account Option or
the 1-Year MVA Fixed Account Option until the end of the selected DCA Fixed
Account period or the 1-Year MVA Fixed Account Option period. Upon termination
of the DCA program, any amounts remaining in the DCA Fixed Account Option(s)
will be automatically transferred to the 1-Year MVA Fixed Account Option. Such
amounts will earn interest at the Renewal Interest Rate for the 1-Year MVA Fixed
Account Option.
MARKET VALUE ADJUSTMENT (MVA)
Any payments and values based on the 1, 3 or 5 year MVA Fixed Account Options
may be subject to an MVA, the operation of which may result in upward or
downward adjustments in the Certificate Value, if withdrawn, transferred or
annuitized prior to the end of the respective Guarantee Period.
The MVA is applied only if the absolute difference between the Guarantee Period
Interest Rate in effect for the Guarantee Period and the Current Interest Rate
for a new Purchase Payment is greater than 50 basis points. If the MVA is
negative, it may not reduce the Certificate Value below the sum of Purchase
Payments made less withdrawals, accumulated at an effective annual rate of 3%
from the date of receipt or withdrawal to the date of surrender. If the MVA is
positive, the amount added to the Certificate Value may not exceed the amount
that if negative, could be deducted. The MVA will be calculated by multiplying
the amount withdrawn or transferred by the following formula:
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(n-t)
(---)
( (1+I) )( 12)
(------------) - 1
((1+J+0.0050))
I = The Guarantee Period interest rate in effect for the Guarantee Period on the
Certificate
J = The Current Interest Rate available for the same Guarantee Period
n = The original term in number of months rounded up to the nearest integer for
the Guarantee Period to the end of the Calendar Year.
t = Time expired in months rounded up to the nearest integer for the Guarantee
Period to the end of the Calendar Year.
(n-t) = The number of months remaining in the Guarantee Period to the end of the
Calendar Year.
There will be no MVA on withdrawals or transfers from the Fixed Account Options
in the following situations: (1) withdrawals under a Withdrawal Charge
Exemption; (2) if the absolute difference between the Guarantee Period Interest
Rate in effect for the Guarantee Period and the Current Interest Rate for a new
Purchase Payment is less than 0.50%; (3) on amounts withdrawn to pay fees or
charges; (4) on amounts withdrawn or transferred from the Fixed Account Options
within thirty (30) days after the end of the Guarantee Period; (5) on
annuitizations; (6) on amounts transferred from a DCA Fixed Account Option; (7)
on amounts transferred under the DCA program from the 1-Year MVA Fixed Account
Option.
CHARGES AND DEDUCTIONS
We will deduct the following charges from the Certificate:
WITHDRAWAL CHARGE
This charge may be deducted upon withdrawal of any portion of the Certificate
Value. See WITHDRAWAL PROVISIONS.
MORTALITY RISK CHARGE
On an annual basis this charge, as shown on the Certificate Data Page, equals a
percentage of the average daily total net asset value of the Subaccounts to
which Your Purchase Payments are allocated. This charge is to compensate Us for
assuming the mortality risks under the Certificate.
EXPENSE RISK CHARGE
On an annual basis this charge, as shown on the Certificate Data Page, equals a
percentage of the average daily total net asset value of the Subaccounts to
which Your Purchase Payments are allocated. This charge is to compensate Us for
assuming the expense risks under the Certificate.
DISTRIBUTION EXPENSE CHARGE
On an annual basis this charge, as shown on the Certificate Data Page, equals a
percentage of the average daily total net asset value of the Subaccounts to
which Your Purchase Payments are allocated. This charge is to compensate Us for
all distribution expenses associated with the Certificate.
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TRANSFER PROVISIONS
Prior to the Annuity Date, You may transfer all or part of Your Certificate
Value to any of the Subaccounts or the Fixed Account Options subject to certain
restrictions. We reserve the right to charge a fee for transfers if the number
of transfers exceeds the limit specified by Us. The minimum amount that can be
transferred and the amount that can remain in a Subaccount or a Fixed Account
Option are subject to Company limits. If this Certificate is issued in
connection with an ERISA Plan, the availability of certain Subaccounts or Fixed
Account Options may be limited by the provisions of the ERISA Plan as certified
by the Plan Administrator to Us.
TRANSFERS OF ACCUMULATION AND ANNUITY UNITS BETWEEN SUBACCOUNTS
Prior to the Annuity Date, You may transfer all or a portion of Your Certificate
Value between Subaccounts. A transfer will result in the purchase of
Accumulation Units in a Subaccount and the redemption of Accumulation Units in
the other Subaccount. Transfers will be effected at the next computed
Accumulation Unit Value following Our receipt of Your request for transfer.
Accumulation Unit Values are calculated at the close of each NYSE business day.
After the Annuity Date, You may transfer all or a portion of Your Certificate
Value from one Subaccount to another Subaccount. A transfer will result in the
purchase of Annuity Units in a Subaccount and the redemption of Annuity Units in
the other Subaccount. Transfers will be effected for the last NYSE business day
of the month in which We receive Your request for the transfer.
TRANSFERS OF ACCUMULATION UNITS TO AND FROM THE FIXED ACCOUNT OPTION(S)
Prior to the Annuity Date, You may transfer all or any part of Your Certificate
Value from the Subaccount(s) to any Fixed Account Option(s) other than the DCA
Fixed Account Options or from the Fixed Account Option(s) to the Subaccount(s)
of the Certificate.
After the Annuity Date, transfers into or out of the Fixed Account Option(s) are
not allowed.
WITHDRAWAL PROVISIONS
On or before the Annuity Date and while the Participant is living, You may
withdraw all or part of Your Certificate Value under this Certificate by
informing Us at Our Annuity Service Center. For a full withdrawal, this
Certificate must be returned to Our Annuity Service Center. The minimum amount
that can be withdrawn and the amount remaining after withdrawal are subject to
Company limits.
Without a written notice to the contrary, withdrawals will be deducted from the
Certificate Value in proportion to their allocation among the Fixed Account
Options and the Subaccounts. Withdrawals will be based on values for the NYSE
business day in which the request for withdrawal and the Certificate (in the
case of a full withdrawal), are received at Our Annuity Service Center. Unless
the SUSPENSION OF PAYMENTS or DEFERMENT OF PAYMENTS sections are in effect,
payment of withdrawals will be made within seven calendar days.
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WITHDRAWAL CHARGE
Withdrawals of all or a portion of the Certificate Value may be subject to a
Withdrawal Charge as shown in the chart below. The Withdrawal Charge applied to
any withdrawal will depend on how long each Purchase Payment to which the
withdrawal is attributed has been in the Certificate. No Withdrawal Charge is
made on an amount withdrawn which is certified to be a Withdrawal Charge
Exemption.
For the purpose of determining the Withdrawal Charge, a withdrawal will be
attributed to amounts in the following order: (1) Purchase Payments which are
both no longer subject to the Withdrawal Charge and are not yet withdrawn; and
(2) Purchase Payments subject to a Withdrawal Charge. Purchase Payments, when
withdrawn, are assumed to be withdrawn on a first-in-first-out (FIFO) basis.
The Withdrawal Charge will be assessed against the Subaccounts and the Fixed
Account Options in the same proportion as the remaining Certificate Value is
allocated unless You request that the withdrawal come from a particular Fixed
Account Option or Subaccount. If the remaining Certificate Value is insufficient
to cover the Withdrawal Charge, any remaining balance will be deducted from the
withdrawal amount requested.
On the Certificate Date, if You are not retired or separated from service as
explained under the Withdrawal Charge Exemption provision, the following
Withdrawal Charge table applies for the first ten Certificate Years. Withdrawal
Charges do not apply after the tenth Certificate Year.
------------------------------------- -----------------------
Number of Years Elapsed Withdrawal Charge as a
Between Purchase Payment Contribution Percentage of Withdrawn
and Date of Withdrawal Purchase Payment
------------------------------------- -----------------------
0 6%
------------------------------------- -----------------------
1 6%
------------------------------------- -----------------------
2 5%
------------------------------------- -----------------------
3 5%
------------------------------------- -----------------------
4 4%
------------------------------------- -----------------------
5 4%
------------------------------------- -----------------------
6+ 0%
------------------------------------- -----------------------
On the Certificate Date, if You are retired or separated from service as
explained under the Withdrawal Charge Exemption provision, the following
Withdrawal Charge table applies for the first ten Certificate Years. In
addition, You may withdraw up to an amount equal to 15% of Your Purchase
Payments without Withdrawal Charges each Certificate Year. You will not receive
the benefit of this free withdrawal in a full surrender and free withdrawals do
not reduce future Withdrawal Charge amounts. Withdrawal Charges do not apply
after the tenth Certificate Year.
------------------------------------- -----------------------
Number of Years Elapsed Withdrawal Charge as a
Between Purchase Payment Contribution Percentage of Withdrawn
and Date of Withdrawal Purchase Payment
------------------------------------- -----------------------
0 6%
----------------------------------- -----------------------
1 6%
----------------------------------- -----------------------
2 5%
----------------------------------- -----------------------
3 5%
----------------------------------- -----------------------
4 4%
----------------------------------- -----------------------
5+ 0%
----------------------------------- -----------------------
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WITHDRAWAL CHARGE EXEMPTION
A withdrawal will not be subject to Withdrawal Charges, if the Plan
Administrator (or the Participant if there is no Plan Administrator) certifies
such withdrawal is made to provide Plan benefits to You or Your Beneficiary due
to any of the following events occurring subsequent to the issuance of this
Certificate: (1) death; (2) disability as defined by the Plan but in no event
unless the Participant satisfies the requirements of IRC 72(m)(7); (3) hardship,
as defined by the Plan; (4) normal retirement at or after age 65; or (5)
separation from service for reasons other than retirement.
Separation from service for purposes of the Withdrawal Charge Exemption does not
include (without limiting other events as being or not being a Separation from
Service): (a) any termination of employment in connection with a sale or other
transfer of the assets or business of the employee's then employer while the
employee is thereafter employed by such acquirer or an entity controlling,
controlled by or under common control with such acquirer, (b) any transfer or
other action resulting in employee being employed by any other entity which is
controlling, controlled by or under common control with the same "employer" as
his then employer, (c) any temporary absence or (d) any termination of the
employment relationship resulting from a merger, reorganization, sale,
disposition, or liquidation of all or any part of his then employer's business.
GENERAL PROVISIONS
ENTIRE CONTRACT
The entire contract between You and Us consists of the group annuity contract,
the application, the Participant Enrollment Form as completed by You at the time
of purchase, this Certificate and any attached endorsement(s). An agent cannot
change the terms or conditions of this contract. Any change must be in writing
and approved by Us. Only Our President, Secretary, or one of Our Vice-Presidents
can give Our approval.
MISSTATEMENT OF AGE
If the Age of any Annuitant has been misstated, future annuity payments will be
adjusted using the correct Age, according to Our rates in effect on the date
that annuity payments were determined. Any overpayment from the Fixed Account
Options, plus interest at the rate of 4% per year, will be deducted from the
next payment(s) due. Any underpayment from the Fixed Account Options, plus
interest at the rate of 4% per year, will be paid in full with the next payment
due. Any overpayment from the Subaccounts will be deducted from the next
payment(s) due. Any underpayment from the Subaccounts will be paid in full with
the next payment due.
PROOF OF AGE OR SURVIVAL
The Company may require satisfactory proof of correct Age at any time. If any
payment under this Certificate depends on the Annuitant being alive, the Company
may require satisfactory proof of survival.
15
CONFORMITY WITH STATE LAWS
The provisions of this Certificate will be interpreted by the laws of the state
in which the Participant Enrollment form was signed or such other state as is
required by law. Any provision which, on the Certificate Date, is in conflict
with the law of such state is amended to conform to the minimum requirements of
such law.
CHANGES IN LAW
If the laws governing this Certificate or the taxation of benefits under the
Certificate change, We reserve the right to amend this Certificate to comply
with these changes.
ASSIGNMENT
You may assign this Certificate before the Annuity Date, but We will not be
bound by an assignment unless it is received by Us in writing. Your rights and
those of any other person referred to in this Certificate will be subject to the
assignment. Certain assignments may be taxable. We do not assume any
responsibility for the validity or tax consequences of any assignment.
CLAIMS OF CREDITORS
To the extent permitted by law, no right or proceeds payable under this
Certificate will be subject to claims of creditors or legal process.
PREMIUM TAXES OR OTHER TAXES
The Company may deduct from Your Certificate Value any premium tax or other
taxes payable to a state or other government entity, if applicable. Should We
advance any amount so due, We are not waiving any right to collect such amount
at a later date. The Company will deduct any withholding taxes required by
applicable law.
WRITTEN NOTICE
Any notice We send to You will be sent to Your address shown in the Participant
Enrollment Form unless You request otherwise. Any written request or notice to
Us must be sent to Our Annuity Service Center, as specified on the Certificate
Data Page.
PERIODIC REPORTS
During each Certificate Year, We will send You quarterly statements of the
account activity of the Certificate as well as confirmation reports after each
financial transaction. The statement will include all transactions which have
occurred during the quarterly accounting period shown on the statement.
NONPARTICIPATING
This Certificate does not share in Our surplus.
16
DEATH PROVISIONS
DEATH OF PARTICIPANT BEFORE THE ANNUITY DATE. We will pay a death benefit to the
Beneficiary upon Our receiving all required documentation including: (a) due
proof that any Participant died before the Annuity Date; and (b) an election
form selecting the payment option from the options listed below. If no election
is received within 60 days of our receipt of due proof of death, the death
benefit will be paid in accordance with option 1 below. The Beneficiary must
select one of the following options:
1. Immediately collect the death benefit in a lump sum
payment. If a lump sum payment is elected, payment will be
in accordance with any applicable laws and regulations
governing payments and death; or
2. Collect the death benefit in the form of one of the
Annuity Payment Options. The payments must be over the
life of the Beneficiary or over a period not extending
beyond the life expectancy of the Beneficiary. Payments
under this option must commence within one year after the
Participant's death, otherwise, the death benefit will be
paid in accordance with option 1 above; or
3. If the Beneficiary is the Participant's spouse, the
Beneficiary may elect to become the Participant and
continue the Certificate in force. If this option is
elected, no death benefit is paid. Upon the new
Participant's subsequent death, the entire interest must
be distributed immediately under option 1 or 2 above.
In any event, the entire interest in the Certificate will be distributed within
five years from the date of death of the Participant.
DUE PROOF OF DEATH
Due Proof of Death means:
1. a certified copy of a death certificate; or
2. a certified copy of a decree of a court of competent
jurisdiction as to the finding of death; or
3. a written statement by a medical doctor who attended the
deceased Participant at the time of death; or
4. any other proof satisfactory to Us.
AMOUNT OF DEATH BENEFIT
The amount of the death benefit is the greater of:
1. the Certificate Value at the end of the NYSE business day during which
We receive, at Our Annuity Service Center, due proof of the
Participant's death and an election of the type of payment to be made;
Or
2. Purchase Payments less any previous withdrawals including all fees and
charges applicable to such withdrawals of the Certificate Value.
17
DEATH OF PARTICIPANT OR ANNUITANT ON OR AFTER THE ANNUITY DATE. If any
Participant or Annuitant dies on or after the Annuity Date and before the entire
interest in the Certificate has been distributed, We will pay the remaining
portion of the interest of the Certificate under the annuity payment option
being used on the date of death. For further information pertaining to death of
the Annuitant, see ANNUITY PAYMENT OPTIONS.
BENEFICIARY
The Beneficiary is as designated on the Participant Enrollment Form unless later
changed by the Participant. While: (a) the Participant is living; and (b) before
the Annuity Date, the Participant may change the Beneficiary by written notice
in a form satisfactory to Us. The change will take effect on the date We record
the proper notice subject to any payments We have made. If two or more persons
are named: (a) those surviving the Participant will share equally unless
otherwise stated; and (b) the Beneficiaries must elect to receive their
respective portions of the death benefit according to the options listed under
DEATH OF PARTICIPANT BEFORE THE ANNUITY DATE. If the Annuitant survives the
Participant, and there are no surviving Beneficiaries, the Annuitant will be
deemed the Beneficiary.
If the Participant is also the Annuitant and there are no surviving
Beneficiaries at the death of the Participant, the death benefit will be paid to
the estate of the Participant in accordance with option 1, under DEATH OF
PARTICIPANT BEFORE THE ANNUITY DATE.
ANNUITY PROVISIONS
ANNUITY DATE
The Participant selects an Annuity Date (the date on which annuity payments are
to begin) at the time of application. The Participant may change the Annuity
Date at any time, at least seven days prior to the Annuity Date, by written
notice to the Company at its Annuity Service Center. The Annuity Date must
always be the first day of the calendar month and must be at least two years
after the Certificate Date, but not beyond the Participant's 75th birthday,
except as otherwise permitted by law. We reserve the right to waive the two year
waiting period. If no Annuity Date is selected, the Annuity Date will be the
latest Annuity Date, as set by the Company.
PAYMENTS TO PARTICIPANT
Unless You request otherwise, We will make annuity payments to You. If You want
the annuity payments to be made to some other Payee, We will make such payments
subject to receipt of a written request filed at the Annuity Service Center no
later than thirty (30) days before the due date of the first annuity payment.
FIXED ANNUITY PAYMENTS
If a Fixed Annuity payment option has been elected, the proceeds payable under
this Certificate less any applicable premium taxes, shall be applied to the
payment of the Fixed Annuity payment option elected at rates which are at least
equal to the annuity rates based upon the applicable tables in the Certificate.
In no event will the Fixed Annuity payments be changed once they begin.
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AMOUNT OF FIXED ANNUITY PAYMENTS
The amount of each Fixed Annuity payment will be determined by applying the
portion of the Certificate Value allocated to Fixed Annuity payments less any
applicable premium taxes to the annuity table applicable to the Fixed Annuity
payment option chosen.
AMOUNT OF VARIABLE ANNUITY PAYMENTS
(a) FIRST VARIABLE ANNUITY PAYMENT: The dollar amount of the first Variable
Annuity payment will be determined by applying the portion of the
Certificate Value allocated to the Subaccount, less any applicable
premium taxes, to rates which are at least equal to the annuity rates
based upon the annuity table applicable to the Variable Annuity payment
option chosen. If the Certificate Value is allocated to more than one
Subaccount, the value of Your interest in each Subaccount is applied
separately to the Variable Annuity payment option table to determine the
amount of the first annuity payment attributable to each Subaccount.
(b) NUMBER OF VARIABLE ANNUITY UNITS: The number of Annuity Units for each
applicable Subaccount is the amount of the first annuity payment
attributable to that Subaccount divided by the value of the applicable
Annuity Unit for that Subaccount as of the Annuity Date. The number will
not change as a result of investment experience.
(c) VALUE OF EACH VARIABLE ANNUITY UNIT: The value of an Annuity Unit may
increase or decrease from one month to the next. For any month, the
value of an Annuity Unit of a particular Subaccount is the value of that
Annuity Unit as of the last NYSE business day of the preceding month,
multiplied by the Net Investment Factor for that Subaccount for the last
NYSE business day of the current month.
The Net Investment Factor for any Subaccount for a certain month is
determined by dividing (1) by (2) where:
(1) is the Accumulation Unit Value of the Subaccount
determined as of the last business day at the end of that
month, and
(2) is the Accumulation Unit Value of the Subaccount
determined as of the last business day at the end of the
preceding month.
The result is then multiplied by a factor that neutralizes the assumed
investment rate of 3.5%.
(d) SUBSEQUENT VARIABLE ANNUITY PAYMENTS: After the first Variable
Annuity payment, payments will vary in amount according to the
investment performance of the applicable Subaccount(s) to which Your
Purchase Payments are allocated. The amount may change from month to
month. The amount of each subsequent payment for each Subaccount is :
The number of Annuity Units for each Subaccount as determined for the first
annuity payment
Multiplied by
The value of an Annuity Unit for that Subaccount at the end of the month
immediately preceding the month in which payment is due.
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We guarantee that the amount of each Variable Annuity payment will not be
affected by variations in expenses or mortality experience.
ANNUITY PAYMENT OPTIONS
During the Annuitant's life, upon written election and the return of this
Certificate to the Company at its Annuity Service Center, the Certificate Value
may be applied to provide one of the following options or any annuity payment
option that is mutually agreeable. After two years from the Certificate Date,
and prior to the Annuity Date, You can choose one of the options described
below. If no option has been selected by the Annuity Date, You will
automatically receive option 4, below, with 120 monthly payments guaranteed.
OPTIONS 1 & 1v - LIFE ANNUITY, LIFETIME PAYMENTS GUARANTEED
Payments payable to the Payee during the lifetime of the Annuitant. No further
payments are payable after the death of the Annuitant.
OPTIONS 2 & 2v - JOINT AND SURVIVOR LIFE ANNUITY
Payments payable to the Payee during the lifetime of the Annuitant and during
the lifetime of a designated second person. No further payments are payable
after the deaths of both the Annuitant and the designated second person.
OPTIONS 3 & 3v - JOINT AND SURVIVOR LIFE ANNUITY WITH PAYMENTS GUARANTEED FOR
120 MONTHS
Payments are payable to the Payee during the lifetime of the
Annuitant and during the lifetime of a designated second person. If, at the
death of the survivor, payments have been made for less than 120 months, the
remaining guaranteed annuity payments will be continued to the Beneficiary.
OPTIONS 4 & 4v - LIFE ANNUITY WITH PAYMENTS GUARANTEED FOR 120, 180 OR 240
MONTHS
Payments payable to the Payee during the lifetime of the Annuitant. If,
at the death of the Annuitant, payments have been made for less than the 120,
180 or 240 months, as selected at the time of annuitization, the remaining
guaranteed annuity payments will be continued to the Beneficiary.
OPTIONS 5 & 5v - FIXED PAYMENTS FOR A SPECIFIED PERIOD CERTAIN
Payments payable to the Payee for any specified period of time for five (5)
years or more, but not exceeding thirty (30) years, as selected at the time of
annuitization. The selection must be made for full twelve month periods. In the
event of death of the Annuitant, any remaining annuity payments will be
continued to the Beneficiary.
20
FIXED ANNUITY PAYMENT OPTIONS TABLE
BASIS OF COMPUTATION
The actuarial basis for the Table of Annuity Rates is the 1983a Annuity
Mortality Table, with equal mortality distribution between male and female, with
projection and a guaranteed interest rate of 3%. The mortality table is
projected using Projection Scale G factors, assuming annuitization in the year
2000. The Fixed Annuity Payment Options Table does not reflect any applicable
premium tax.
OPTIONS 1 & 4 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(Monthly installments for ages not shown will be furnished upon request.)
OPTION 1 OPTION 4 OPTION 4 OPTION 4
LIFE ANNUITY LIFE ANNUITY LIFE ANNUITY
AGE OF (W/120 PAYMENTS (W/180 PAYMENTS (W/240 PAYMENTS
ANNUITANT LIFE ANNUITY GUARANTEED) GUARANTEED GUARANTEED)
55 4.04 4.00 3.96 3.90
56 4.11 4.08 4.03 3.96
57 4.19 4.15 4.10 4.02
58 4.28 4.23 4.17 4.09
59 4.37 4.32 4.25 4.15
60 4.47 4.41 4.33 4.22
61 4.57 4.50 4.42 4.29
62 4.68 4.61 4.50 4.36
63 4.80 4.71 4.59 4.43
64 4.93 4.82 4.69 4.50
65 5.07 4.94 4.79 4.57
66 5.21 5.07 4.89 4.64
67 5.37 5.20 4.99 4.72
68 5.53 5.34 5.10 4.79
69 5.71 5.48 5.20 4.86
70 5.90 5.63 5.31 4.92
71 6.11 5.79 5.43 4.99
72 6.33 5.95 5.54 5.05
73 6.57 6.13 5.65 5.11
74 6.82 6.30 5.76 5.16
75 7.10 6.48 5.87 5.21
76 7.39 6.67 5.97 5.26
77 7.71 6.86 6.07 5.30
78 8.05 7.05 6.17 5.34
79 8.42 7.24 6.26 5.37
80 8.81 7.44 6.34 5.40
81 9.24 7.63 6.42 5.42
82 9.70 7.82 6.48 5.44
83 10.19 8.00 6.55 5.46
84 10.72 8.17 6.60 5.47
85 11.29 8.34 6.65 5.49
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OPTION 2 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(MONTHLY INSTALLMENTS FOR AGES NOT SHOWN WILL BE FURNISHED UPON REQUEST.)
JOINT & 100% SURVIVOR LIFE ANNUITY
AGE OF
ANNUITANT AGE OF ANNUITANT
--------- ----------------
55 60 65 70 75 80 85
55 3.54 3.66 3.77 3.85 3.92 3.97 4.00
60 3.66 3.83 3.99 4.14 4.25 4.34 4.39
65 3.77 3.99 4.23 4.45 4.65 4.80 4.91
70 3.85 4.14 4.45 4.78 5.10 5.37 5.57
75 3.92 4.25 4.65 5.10 5.57 6.02 6.40
80 3.97 4.34 4.80 5.37 6.02 6.70 7.35
85 4.00 4.39 4.91 5.57 6.40 7.35 8.35
OPTION 3 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(MONTHLY INSTALLMENTS FOR AGES NOT SHOWN WILL BE FURNISHED UPON REQUEST.)
JOINT & 100% SURVIVOR LIFE ANNUITY (W/120 PAYMENTS GUARANTEED)
AGE OF
ANNUITANT AGE OF ANNUITANT
--------- ----------------
55 60 65 70 75 80 85
55 3.54 3.66 3.76 3.85 3.91 3.96 3.98
60 3.66 3.83 3.99 4.13 4.24 4.32 4.37
65 3.76 3.99 4.22 4.44 4.63 4.77 4.86
70 3.85 4.13 4.44 4.76 5.06 5.31 5.47
75 3.91 4.24 4.63 5.06 5.50 5.89 6.18
80 3.96 4.32 4.77 5.31 5.89 6.46 6.92
85 3.98 4.37 4.86 5.47 6.18 6.92 7.55
OPTION 5 - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
FIXED PAYMENT FOR SPECIFIED PERIOD
NUMBER MONTHLY NUMBER MONTHLY NUMBER MONTHLY NUMBER MONTHLY
OF YEARS PAYMENT OF YEARS PAYMENT OF YEARS PAYMENT OF YEARS PAYMENT
-------- ------- -------- ------- -------- ------- -------- -------
10 9.61 17 6.23 24 4.84
11 8.86 18 5.96 25 4.71
5 17.91 12 8.24 19 5.73 26 4.59
6 15.14 13 7.71 20 5.51 27 4.47
7 13.16 14 7.26 21 5.32 28 4.37
8 11.68 15 6.87 22 5.15 29 4.27
9 10.53 16 6.53 23 4.99 30 4.18
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VARIABLE ANNUITY PAYMENT OPTIONS TABLE
BASIS OF COMPUTATION
The actuarial basis for the Table of Annuity Rates is the 1983a Annuity
Mortality Table, with equal mortality distribution between male and female, with
projection and a guaranteed interest rate of 3.5%. The mortality table is
projected using Projection Scale G factors, assuming annuitization in the year
2000. The Variable Annuity Payment Options Table does not reflect any applicable
premium tax.
OPTIONS 1v & 4v - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(Monthly installments for ages not shown will be furnished upon request.)
OPTION 1v OPTION 4v OPTION 4v OPTION 4v
LIFE ANNUITY LIFE ANNUITY LIFE ANNUITY
AGE OF (W/120 PAYMENTS (W/180 PAYMENTS (W/240 PAYMENTS
ANNUITANT LIFE ANNUITY GUARANTEED) GUARANTEED) GUARANTEED)
55 4.33 4.30 4.25 4.19
56 4.41 4.37 4.32 4.25
57 4.49 4.44 4.39 4.31
58 4.57 4.52 4.46 4.37
59 4.66 4.61 4.53 4.43
60 4.76 4.70 4.61 4.50
61 4.86 4.79 4.70 4.56
62 4.98 4.89 4.78 4.63
63 5.09 5.00 4.87 4.70
64 5.22 5.11 4.96 4.77
65 5.36 5.22 5.06 4.84
66 5.50 5.35 5.16 4.91
67 5.66 5.48 5.26 4.98
68 5.83 5.61 5.36 5.05
69 6.00 5.76 5.47 5.12
70 6.20 5.91 5.58 5.18
71 6.40 6.06 5.69 5.25
72 6.62 6.23 5.80 5.31
73 6.86 6.39 5.90 5.36
74 7.12 6.57 6.01 5.42
75 7.39 6.75 6.12 5.46
76 7.69 6.93 6.22 5.51
77 8.01 7.12 6.32 5.55
78 8.35 7.31 6.41 5.58
79 8.72 7.50 6.50 5.62
80 9.11 7.69 6.58 5.64
81 9.54 7.88 6.66 5.67
82 10.00 8.07 6.72 5.69
83 10.50 8.24 6.79 5.70
84 11.03 8.42 6.84 5.72
85 11.60 8.58 6.89 5.73
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OPTION 2v - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(MONTHLY INSTALLMENTS FOR AGES NOT SHOWN WILL BE FURNISHED UPON REQUEST.)
JOINT & 100% SURVIVOR LIFE ANNUITY
AGE OF
ANNUITANT AGE OF ANNUITANT
--------- ----------------
55 60 65 70 75 80 85
55 3.83 3.95 4.05 4.14 4.21 4.26 4.29
60 3.95 4.11 4.27 4.42 4.53 4.62 4.68
65 4.05 4.27 4.50 4.73 4.92 5.08 5.19
70 4.14 4.42 4.73 5.05 5.37 5.64 5.85
75 4.21 4.53 4.92 5.37 5.84 6.29 6.67
80 4.26 4.62 5.08 5.64 6.29 6.97 7.62
85 4.29 4.68 5.19 5.85 6.67 7.62 8.61
OPTION 3v - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
(MONTHLY INSTALLMENTS FOR AGES NOT SHOWN WILL BE FURNISHED UPON REQUEST.)
JOINT & 100% SURVIVOR LIFE ANNUITY (W/120 PAYMENTS GUARANTEED)
AGE OF
ANNUITANT AGE OF ANNUITANT
--------- ----------------
55 60 65 70 75 80 85
55 3.83 3.95 4.05 4.14 4.20 4.25 4.27
60 3.95 4.11 4.27 4.41 4.52 4.60 4.65
65 4.05 4.27 4.50 4.72 4.91 5.05 5.14
70 4.14 4.41 4.72 5.03 5.33 5.58 5.75
75 4.20 4.52 4.91 5.33 5.77 6.16 6.45
80 4.25 4.60 5.05 5.58 6.16 6.72 7.17
85 4.27 4.65 5.14 5.75 6.45 7.17 7.80
OPTION 5v - TABLE OF MONTHLY INSTALLMENTS PER $1,000.
PAYMENT FOR SPECIFIED PERIOD
NUMBER MONTHLY NUMBER MONTHLY NUMBER MONTHLY NUMBER MONTHLY
OF YEARS PAYMENT OF YEARS PAYMENT OF YEARS PAYMENT OF YEARS PAYMENT
-------- ------- -------- ------- -------- ------- -------- -------
10 9.83 17 6.47 24 5.09
11 9.09 18 6.20 25 4.96
5 18.12 12 8.46 19 5.97 26 4.84
6 15.35 13 7.94 20 5.75 27 4.73
7 13.38 14 7.49 21 5.56 28 4.63
8 11.90 15 7.10 22 5.39 29 4.53
9 10.75 16 6.76 23 5.24 30 4.45
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ANCHOR NATIONAL LIFE INSURANCE COMPANY
A STOCK COMPANY LOS ANGELES, CALIFORNIA
ALLOCATED FIXED AND
VARIABLE GROUP ANNUITY CERTIFICATE
Nonparticipating
