AIG Life Insurance Company
000 Xxxx Xxxxxx
Xxxxxxxxxx, XX 00000
A capital stock company
---------------------------------------- ---------------------------------------
This Policy is a contract between AIG Life Insurance Company ("We", "Us" or
"Our") and the Policyholder ("You" or "Your") shown on the Policy Schedule.
Subject to the terms of this Policy and the Certificates We issue to each
Certificate Owner, We will provide the benefits described in this Policy. We do
this in return for the application of the Policyholder, and the required
individual applications for the annuities and for the payment of the premiums.
This Policy becomes effective at 12:01 A.M. Standard Time on the Policy
Effective Date at the address of the Policyholder and will continue in force, in
accordance with the applicable provisions, unless terminated in accordance with
its provisions.
This Policy is non-participating and is not entitled to share in Our surplus
earnings.
/s/ Xxxxxxxxx X. Xxxx /s/ Xxxxxx Xxxxxxx
Secretary President
GROUP VARIABLE ANNUITY POLICY
Non-Participating
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INDEX
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Policy Sections Page
Policy Schedule 3
Policy Provisions 4
POLICY SCHEDULE
POLICY NUMBER [00001]
POLICYHOLDER [Direct Consumer's Group Trust Dated December 22, 1995]
POLICY EFFECTIVE DATE [September 1, 1999]
ELIGIBLE PERSONS: [Current And Prospective Customers Of American
International Group, Inc. And Its Affiliates]
POLICY PROVISIONS
Eligible Persons. Persons eligible to become insured under this Policy are those
described as Eligible Persons on the Policy Schedule.
Certificates. We will issue a Certificate to each Certificate Owner describing
the annuity coverage under this Policy. The certificate will describe the
benefits of this Policy, to whom the benefits will be paid, and the limitations
and conditions that apply.
A certificate may be modified by rider or endorsement issued by Us to be
attached to the certificate. The rider or endorsement will set forth the
modifications to the certificate which affect the Insured.
Premiums. All premiums are payable to Us. The initial premium applicable to each
certificate is shown on the certificate Information Page.
Required Data. The Policyholder must give Us all data that We need to administer
this Policy.
Examination Of Records. We have the right to examine all records of the
Policyholder that pertain to the anuities issued under by this Policy.
Continuation Of This Policy. This Policy will continue in force, subject to the
Policy Termination provision.
Entire Contract. The entire contract ("Policy") consists of this Policy, the
certificates, the policyholder's application, each annuity owner's application
for an annuity issued under this Policy, and any attached riders, endorsements
or amendments.
We rely on the Policyholder's application to issue this Policy and the
individual applications, if any, to issue the annuity certificates providing to
each annuity owner. Any certificate issued under this policy is not contestable.
Changing This Policy. This Policy may only be changed, in writing, by one of our
executive officers. No other person, including an agent, has any authority to
change or reinstate this Policy or extend the time for paying a premium.
Conformity With State Statutes. Any provision of this Policy that, on the Policy
Effective Date, conflicts with state laws of the governing jurisdiction is
changed to meet the minimum requirements of those laws.
Policy Termination. This Policy may only be terminated with respect to the
issuance of new certificates. Either We or the Policyholder may terminate this
Policy upon giving at least 31 days written notice to the other. We will not
terminate this Policy prior to the end of the first year following the Policy
Effective Date.
Clerical Error. Clerical error will not void any certificate issued under this
Policy which is otherwise validly in force, nor will it keep in force any
certificate that otherwise would end.
Certificate Provisions Made Part Of This Policy. The remainder of this Policy
consists of provisions that appear in the certificates, riders and endorsements.
A copy of the certificates, riders and endorsements is added to and made a part
of this Policy.
CERTIFICATE SCHEDULE
GROUP CONTRACTHOLDER: [DIRECT CONSUMER'S GROUP TRUST DATED DECEMBER 22, 1995]
GROUP CONTRACT NUMBER: 1234 INITIAL PREMIUM: $50,000
CERTIFICATE NUMBER: 5678 MINIMUM SUBSEQUENT PREMIUM: [$1,000]
CERTIFICATEHOLDER(S): Xxxx Xxx EFFECTIVE DATE: January 3, 2000
ANNUITANT: Xxxx Xxx ANNUITY DATE: January 3, 2030
BENEFICIARY: Xxxx Xxx
ACCIDENTAL DEATH BENEFIT CHARGE: Equal on an annual basis to [.10%] of the
average daily net assets of the Variable Account.
ADMINISTRATIVE CHARGE: Equal on an annual basis to [.15%] of the average daily
net assets of the Variable
Account.
MORTALITY AND EXPENSE RISK CHARGE: Equal on an annual basis to [1.25%] of the
average daily net assets of the Variable Account.
DISTRIBUTION CHARGE: Equal on an annual basis to. [.20%] of the average daily
net assets of the Variable Account.
TRANSFER FEE: [$10.00] However, we will not make a charge for the first [12]
transfers in any policy year.
PREMIUM ENHANCEMENT: [4%]
SURRENDER CHARGE:
Number of Complete Years Percentage of Number of Complete Years Percentage of
Since Premium Payment Premium Since Premium Payment Premium
0 6% 4 4%
1 6% 5 3%
2 5% 6 2%
3 5% 7 and later 0%
SEPARATE ACCOUNT ALLOCATIONS: [Variable Account I]
GENERAL ACCOUNT ALLOCATION:
ONE YEAR GUARANTEE PERIOD: [ %]
ANNUITY SERVICE OFFICE: AIG Life Insurance Company
c/o Delaware Valley Financial Services
000 Xxxxxx Xxxx
P.O. Box 3031
Berwyn, PA 19312-0031
(000) 000-0000
AIG Life Insurance Company
000 Xxxx Xxxxxx
Xxxxxxxxxx, Xxxxxxxx 00000
A capital stock company
This is a legal contract issued in consideration of the payment of the Initial
Premium. We will make annuity payments to the Annuitant as set forth in this
certificate beginning on the Annuity Date.
READ YOUR CERTIFICATE CAREFULLY
RIGHT TO CANCEL THIS CERTIFICATE
This certificate may be returned within 10 days after You receive it. It can be
mailed or delivered to either Us or Our agent. Return of this certificate by
mail is effective as of the date of its postmark, properly addressed and postage
pre-paid. The returned certificate will be treated as if We had never issued it.
We will promptly refund the Certificate Value as of the date of return; this may
be more or less than the Premium paid.
This is a variable annuity certificate. Annuity payments and Certificate Value
may increase or decrease depending on the experience of the Variable Account
identified in the Certificate Schedule.
The assets of the Variable Account must earn a minimum annual rate of 6.6% so
that the dollar amount of the variable annuity payments will not decrease below
the level shown in the Options On A Variable Basis Table on page 15.
Signed by the Company:
/s/ Xxxxxxxxx X. Xxxx /s/ Xxxxxx Xxxxxxx
Secretary President
CERTIFICATE OF COVERAGE
VARIABLE ANNUITY
NONPARTICIPATING
TABLE OF CONTENTS
PAGE
CERTIFICATE SCHEDULE 3
DEFINITIONS 4
GENERAL PROVISIONS 5
OWNERSHIP PROVISIONS 6
BENEFICIARY PROVISIONS 6
PREMIUM PROVISIONS 6
PREMIUM ENHANCEMENT 7
VARIABLE ACCOUNT 7
GUARANTEED ACCOUNT 8
TRANSFERS 8
CERTIFICATE CHARGES 9
ANNUITY PROVISIONS 9
ANNUITY OPTIONS 10
DEATH BENEFIT 12
SURRENDER PROVISIONS 13
DELAY OF PAYMENTS 14
FIXED OPTIONS TABLE 15
VARIABLE OPTIONS TABLE 16
DEFINITIONS
ACCUMULATION UNIT - An accounting unit of measure used to calculate the
Certificate Value prior to the Annuity Date.
ADMINISTRATIVE OFFICE - The Annuity Service Office of the Company as designated
on the Certificate Schedule.
ANNUITANT - The person designated by the Owner upon whose continuation of life
any annuity payment involving life contingencies depends.
ANNUITY DATE - The date on which annuity payments are to commence.
ANNUITY OPTION - An arrangement under which annuity payments are made under this
certificate.
ANNUITY UNIT - An accounting unit of measure used to calculate annuity payments
after the Annuity Date.
CERTIFICATE ANNIVERSARY - An anniversary of the Effective Date of this
certificate.
CERTIFICATE VALUE - The dollar value as of any Valuation Date of all amounts
accumulated under this certificate.
CERTIFICATE YEAR - Each period of twelve (12) months commencing with the
Effective Date.
EFFECTIVE DATE - The date shown on the Certificate Schedule on which the first
Certificate Year begins.
ELIGIBLE INVESTMENT(S) - Those investments available under the certificate.
Eligible Investments, at the time this certificate is issued, are shown in the
application for this certificate .
GUARANTEED ACCOUNT - A part of Our General Account which earns a Guaranteed Rate
of interest.
INJURY - Bodily injury caused by an accident which occurs while coverage under
the Accidental Death Benefit is in force, and resulting directly and
independently from all other causes in death.
OWNER - The Owner is named in the Certificate Schedule as the Certificateholder,
unless changed, and has all rights under this certificate.
PREMIUM - Purchase payments are referred to in this certificate as Premiums.
Premiums do not include any Premium Enhancement.
SUBACCOUNT - A division of the Variable Account established to invest in a
particular portfolio of Eligible Investments.
VALUATION DATE - Each day that the New York Stock Exchange is open for trading.
VALUATION PERIOD - The period between the close of business of the New York
Stock Exchange on any Valuation Date and the close of business for the next
succeeding Valuation Date.
VARIABLE ACCOUNT - The Separate Account designated on the Certificate Schedule.
WE, OUR, US - AIG Life Insurance Company.
YOU, YOUR - The Owner of this certificate.
GENERAL PROVISIONS
THE CERTIFICATE - The entire contract consists of the group contract, this
certificate, and any attached endorsement, rider or application. Nothing in the
group contract invalidates or impairs any right granted to You under this
Certificate. This certificate may be changed or altered only by Our President or
Secretary. Any change, modification or waiver must be made in writing.
NON-PARTICIPATION IN SURPLUS - This certificate does not share in any
distribution of Our profits or surplus.
INCONTESTABILITY - This certificate is not contestable.
MISSTATEMENT OF AGE OR SEX - We will require proof of age and sex of the
Annuitant before making any life annuity payment provided for by this
certificate. If the age or sex of the Annuitant has been misstated, the amount
payable will be the amount that the Certificate Value would have provided at the
true age or sex.
Once annuity payments have begun, any underpayments will be made up in one sum
including interest at the annual rate of 3%, unless a higher interest rate is
required by the law of the jurisdiction where this certificate is delivered,
with the next annuity payment. Overpayments including interest at the annual
rate of 3%, unless a higher interest rate is required by the law of the
jurisdiction where this certificate is delivered, will be deducted from the
future annuity payments until the total is repaid.
CERTIFICATE SETTLEMENT - This certificate must be returned to Us upon settlement
as a death claim. Prior to
any settlement as a death claim, due proof of death must be submitted to Us.
FACILITY OF PAYMENT - If a payee is unable to give a valid receipt for a payment
made under this certificate, We may make payments to the person who, in Our
opinion is caring for that payee until claim is made by his duly appointed
guardian or other legal representative.
REPORTS - We will furnish You with a report showing the Certificate Value, Cash
Surrender Value and Death Benefit at least once each calendar year. We will also
furnish an annual report of the Variable Account. These reports will be sent to
Your last known address.
TAXES - Any taxes paid to any governmental entity will be charged against the
Premiums or the Certificate Value, depending upon the Owner's state of
residence. We may, at Our sole discretion, pay taxes when due and deduct that
amount from the Certificate Value at a later date. Our payment of such taxes at
an earlier date does not waive any right We may have to deduct amounts at a
later date.
EVIDENCE OF SURVIVAL - Where any benefits under this certificate are contingent
upon the recipient being alive on a given date, We will require proof
satisfactory to Us that the condition has been met.
PROTECTION OF PROCEEDS - No Beneficiary or payee may commute, or assign any
payments under this certificate before they are due. To the extent permitted by
law, no payments will be subject to the debts of any Beneficiary or payee nor to
any judicial process for payment of those debts.
MODIFICATION OF CERTIFICATE - This certificate may not be modified by Us,
without Your consent except as may be required by applicable law. If the state
insurance laws or regulations, the federal securities or tax laws or
regulations, or any regulations under which this certificate would qualify as an
annuity change, We may amend this certificate to comply with these changes.
MINIMUM BENEFITS - Any paid-up annuity, cash surrender or death benefit that may
be available under this certificate is not less than the minimum benefits
required by statute in the jurisdiction in which this certificate is delivered.
CONTINUATION OF CERTIFICATE COVERAGE - If the group contract under which this
certificate is issued should terminate, coverage may be continued under this
certificate unless it is surrendered or otherwise ends in accordance with its
terms.
OWNERSHIP PROVISIONS
OWNER The Owner may exercise all the rights of this certificate, subject to the
rights of:
1. any assignee under an assignment filed with Our Administrative Office; and
2. any irrevocably named Beneficiary.
TRANSFER OF OWNERSHIP - You may transfer Ownership of this certificate. A
written request, dated and signed by You, must be sent to and received by Our
Administrative Office. We may require this certificate for endorsement. The
transfer will take effect as of the date the request was received and recorded
at Our Administrative Office.
Transfer of Ownership does not change the Beneficiary, nor transfer the
Beneficiary's interest. Any change or transfer of Ownership is subject to any
payment made by Us before the request is received and recorded at Our
Administrative Office.
ASSIGNMENT - You may assign this certificate. A copy of any assignment must be
filed with Our Administrative Office. We are not responsible for the validity of
any assignment. If You assign this certificate, Your rights and those of any
revocably-named person will be subject to the assignment. An assignment will not
affect any payments We may make or actions We may take before such assignment
has been recorded at Our Administrative Office. A change in ownership or an
assignment may result in adverse tax consequences.
BENEFICARY PROVISIONS
BENEFICIARY - The Beneficiary will receive the death benefit. The Beneficiary is
named in the Certificate Schedule.
DEATH OF BENEFICIARY - If no named beneficiary is living at the time a death
benefit becomes payable we will pay the death benefit to Your estate.
CHANGE OF BENEFICIARY - To change a beneficiary, a written request for a change
of beneficiary, dated and signed by You, must be received at Our Administrative
Office. If the request is received at Our Administrative Office after the death
of the Owner, it will be effective only if no payment has been made. After the
change is recorded, it will take effect as of the date the request was signed.
PREMIUM PROVISIONS
PREMIUM - The Initial Premium is due on or before the Effective Date.
Thereafter, Premium payments may be made at any time prior to the Annuity Date,
in an amount equal to or greater than the Minimum Subsequent Premium amount,
shown on the Certificate Schedule page.
ALLOCATION OF premium PAYMENTS - Premiums may be allocated to one or more of the
Subaccounts of the Variable Account or to the Guaranteed Account. Whole
percentages must be used. The allocation of the Initial Premium is shown on the
Certificate Schedule. You may change the allocation by written request at any
time. Any subsequent Premium received will be allocated in accordance with the
most recently received allocation instructions.
PREMIUM ENHANCEMENT
PREMIUM ENHANCEMENT - On the Effective Date, the Initial Premium will be
increased by a credit equal to the amount shown in the Certificate Schedule. The
Premium Enhancement will be allocated to the subaccounts or to the Guaranteed
Account in the same manner as the Initial Premium. Any subsequent Premium
Enhancement may be granted at Our sole discretion.
EFFECT OF A SURRENDER OR DEATH OF THE OWNER ON THE PREMIUM ENHANCEMENT - If You
die or surrender all or a portion of this certificate, during the first
twenty-four (24) months following receipt of a Premium Enhancement and prior to
the Annuity Date, a proportionate part of that Premium Enhancement will be
deducted from the Certificate Value. The Proportionate part of the Premium
Enhancement to be deducted will not exceed the proportionate reduction in the
Certificate Value which results from Your death or from the surrender.
Any part of a Premium Enhancement deducted from the Certificate Value will be
withdrawn from the value in each Subaccount and the Guaranteed Account in the
ratio that the value of each Subaccount and the Guaranteed Account bears to the
total Certificate Value.
VARIABLE ACCOUNT
GENERAL DESCRIPTION - The name of the Variable Account is shown in the
Certificate Schedule. The assets of the Variable Account and each Subaccount are
Our property but are not chargeable with the liabilities arising out of any
other business We may conduct, except to the extent that Variable Account assets
exceed Variable Account liabilities arising under the contracts or certificates
supported by the Variable Account. The Variable Account and each Subaccount is
separate from the Our General Account and any other separate account or
Subaccount We may have.
INVESTMENT ALLOCATIONS TO THE VARIABLE ACCOUNT - The Variable Account consists
of Subaccounts and each Subaccount may invest its assets in a separate class of
shares of a designated investment company or companies.
We have the right to change, add or delete designated investment companies. We
have the right to add or remove Subaccounts. We also have the right to combine
any two or more Subaccounts.
VALUATION OF ASSETS - Assets within each Subaccount will be valued at their net
asset value on each Valuation Date.
CERTIFICATE VALUE - Premiums are allocated among the various Subaccounts within
the Variable Account. For each Subaccount, the Premiums are converted into
Accumulation Units. The number of Accumulation Units credited to the certificate
is determined by dividing the Premiums allocated to the Subaccount by the value
of the Accumulation Unit for the Subaccount. Surrenders will result in the
cancellation of Accumulation Units. The value of the certificate is the sum of
the values for the certificate within each Subaccount and the Guaranteed
Account. The value of each Subaccount is determined by multiplying the number of
Accumulation Units attributable to the Subaccount by the Accumulation Unit value
for the Subaccount, independent of the value of any other Subaccount.
ACCUMULATION UNIT VALUES - The value of an Accumulation Unit will vary in
accordance with the investment experience of the underlying portfolio in which
the Subaccount invests. The value of Accumulation Units in each Subaccount will
change daily to reflect the investment experience of the corresponding
underlying portfolio as well as the daily deduction of the Certificate Charges.
The value of an Accumulation Unit for a Subaccount is determined as shown below,
by subtracting item 2. from item 1. and dividing the result by item 3, where
1. is the net result of:
a) the assets of the Subaccount attributable to the Accumulation Units; plus
or minus
b) the cumulative charge or credit for taxes reserved which is determined by
Us to have resulted from the operation of the Subaccount;
2. is the cumulative unpaid charge for the Mortality and Expense Risk Charge,
the Administrative Charge and for the Distribution Charge, which are shown
in the Certificate Schedule; and
3. is the number of Accumulation Units outstanding at the end of the Valuation
Period.
The value of Accumulation Units is expected to increase or decrease from
Valuation Period to Valuation Period. The number of Accumulation Units credited
to a certificate will not change as a result of any fluctuations in the value of
an Accumulation Unit.
GUARANTEED ACCOUNT
GENERAL DESCRIPTION - The Guaranteed Account is a part of Our General Account.
The amount You have in the Guaranteed Account at any time is a result of
Premiums You have allocated to it or any part of Your Certificate Value you have
transferred to it.
GUARANTEE PERIOD - The portion of Your Certificate Value within the Guaranteed
Account is credited with interest at rates guaranteed by Us for the Guarantee
Period of one year. Interest is credited on a daily basis at the then applicable
effective guaranteed interest rate for the applicable Guarantee Period. You may
select from one or more Guarantee Periods which We offer at any particular time.
We reserve the right at any time to add or delete Guarantee Periods. If You have
allocated any part of Your Initial Premium to a Guaranteed Period, the amount
allocated as well as the duration of the Guarantee Period is shown on the
Certificate Schedule.
The guaranteed interest rate applicable to an allocation of Premium or transfer
of Certificate Value to a Guarantee Period is the rate in effect for that
Guarantee Period at the time of the allocation or transfer. If You have
allocated or transferred amounts at different times to the Guaranteed Account,
each allocation or transfer may have a unique effective guaranteed interest rate
associated with that amount. We guarantee that the effective annual rate of
interest for the Guaranteed Account, including any of the Guaranteed Periods,
will not be less than 3%.
TRANSFERS
During the Accumulation Period, or after the Annuity Date, provided a variable
Annuity Option was selected, You may transfer all or part of Your interest, in a
Subaccount, or allocated to a Guarantee Period of the Guaranteed Account, to
another Subaccount or Guarantee Period of the Guaranteed Account. However, after
the Annuity Date no transfers may be made between a Subaccount and the
Guaranteed Account. The Transfer Fee is shown on the Certificate Schedule.
Transfers from one Guarantee Period to another may also be subject to a Market
Value Adjustment.
All transfers are subject to the following:
1. The deduction of any Transfer Fee that may be imposed is shown in the
Certificate Schedule. The Transfer Fee will be deducted from the amount
which is transferred. However, no Transfer Fee will be imposed on transfers
resulting from the expiration of a Guarantee Period.
2. If We have not received transfer instructions prior to the end of a
Guarantee Period in which You have Certificate Value, We will automatically
transfer it to a new Guarantee Period and under the same restrictions as if
You had requested such transfer.
3. The minimum amount which may be transferred is the lesser of (A) $1,000 or
(B) Your entire interest in the Subaccount or in the amount allocated to
the Guarantee Period of the Guaranteed Account.
4. No partial transfer will be made if, as a result of such transfer, Your
remaining Certificate Value in the Subaccount or in the amount allocated to
the Guarantee Period of the Guaranteed Account would be less than $1,000.
5. Transfers will be effected during the Valuation Period next following
receipt by Us of a written transfer request containing all required
information. However, no transfer may be made effective within seven
calendar days of the date on which any annuity payment is due.
6. Any transfer request must clearly specify:
a. the amount which is to be transferred; and
b. the Subaccounts or Guarantee Periods of the Guaranteed Account which are to
be affected.
7. After the Annuity Date, transfers may not take place between a fixed
Annuity Option and a variable Annuity Option.
CERTIFICATE CHARGES
MORTALITY AND EXPENSE RISK CHARGE - We deduct a Mortality and Expense Risk
Charge equal, on an annual basis, to the amount shown on the Certificate
Schedule. We guarantee that the dollar amount of each annuity payment after the
first will not be affected by variations in mortality or expense experience.
ADMINISTRATIVE EXPENSE CHARGE - We deduct an Administrative Expense Charge
equal, on an annual basis, to the amount shown on the Certificate Schedule. The
Administrative Expense Charge compensates Us for some of the costs associated
with the administration of this certificate and the Variable Account.
DISTRIBUTION CHARGE - Prior to the Annuity Date, We deduct a Distribution Charge
equal, on an annual basis, to the amount shown on the Certificate Schedule.
ACCIDENTAL DEATH BENEFIT CHARGE - If you have elected the Accidental Death
Benefit described in this Certificate, an Accidental Death Benefit Charge will
be included on the Certificate Schedule.
ANNUITY PROVISIONS
CHANGE IN ANNUITY DATE - You may, upon at least thirty (30)days prior written
notice to Us, at any time prior to the Annuity Date, change the Annuity Date
shown on the Certificate Schedule. The Annuity Date must always be the first day
of a calendar month.
Unless We approve otherwise, the new Annuity Date must be at least one year
after the Effective Date. The latest Annuity Date is the first day of the first
calendar month following the Annuitant's 90th birthday or such earlier date as
may be set by applicable law.
ANNUITY OPTIONS
SELECTION OF ANNUITY OPTION - If the Annuitant is alive on the Annuity Date, We
will apply the Certificate Value to provide an income on the basis of a life
income with 10 years guaranteed, unless another annuity option has been
selected. You may however, upon at least thirty (30) days prior written notice
to Us, at any time prior to the Annuity Date, select and/or change the Annuity
Option.
The Annuity Option you select may be on a fixed or variable basis, or a
combination thereof. If, at the time of election of an Annuity Option, We are
using more favorable rates, they will be used in lieu of those here guaranteed.
We may also make available other options.
OPTION 1 - LIFE INCOME. Monthly annuity payments are paid during the life of an
Annuitant ceasing with the last Annuity Payment due prior to the Annuitant's
death.
OPTION 2 - LIFE INCOME WITH 10 YEAR GUARANTEE. Monthly annuity payments are paid
during the life of an Annuitant, but at least for a 10 year minimum period.
OPTION 3 - JOINT AND LAST SURVIVOR ANNUITY. Monthly annuity payments are paid
during the joint lifetime of the Annuitant and a designated second person and
are paid thereafter during the remaining lifetime of the survivor ceasing with
the last annuity payment due prior to the survivor's death.
FIXED OPTIONS
The amount of each fixed annuity payment is determined by multiplying the
available Certificate Value (after the deduction of any premium taxes not
previously deducted) by the factor in the Fixed Option Table for the option
chosen, using the age and sex of the Annuitant and Joint Annuitant, if any,
divided by 1,000. If, when annuity payments are elected, We are using tables of
annuity rates for these contracts which result in larger annuity payments, We
will use those tables instead. The annuity payments, determined at the time of
their election, will not be less than payments that would be provided by the
application of the Certificate Value to an immediate annuity then offered by Us
at the time of election, for the same class of annuitants.
ANNUITY OPTIONS (Continued)
VARIABLE OPTIONS
The amount of the first variable annuity payment depends on the Annuity Option
elected and the age and sex of the Annuitant. This certificate contains a
Variable Options Table indicating the dollar amount of the first monthly payment
under each optional annuity form for each $1,000 of value applied. If, when
annuity payments are elected, We are using tables of annuity rates for these
contracts which result in larger annuity payments, We will use those tables
instead.
The 5% interest rate assumed in the annuity tables would produce level annuity
payments if the net investment rate remained constant at 5% per year. Subsequent
payments will be less than, equal to, or greater than the first payment
depending upon whether the actual net investment rate is less than, equal to, or
greater than 5%.
The dollar amount of the first variable annuity payment is determined by
applying the available Certificate Value (after deduction of any premium taxes
not previously deducted) to the table using the age and sex of the Annuitant and
any joint Annuitant. The number of Annuity Units is then determined by dividing
this dollar amount by the then current Annuity Unit value. Thereafter, the
number of Annuity Units remains unchanged during the period of annuity payments.
This determination is made separately for each Subaccount of the Variable
Account. The number of Annuity Units is determined for each Subaccount and is
based upon the available value in each Subaccount as of the date annuity
payments are to begin. The dollar amount determined for each Subaccount will
then be aggregated for purposes of making payments. The dollar amount of the
second and later variable annuity payments is equal to the number of Annuity
Units determined for each Subaccount times the Annuity Unit value for that
Subaccount as of the due date of the payment. This amount may increase or
decrease from month to month. The value of an Annuity Unit for a Subaccount is
determined as shown below, by subtracting item 2. from item 1. and dividing the
result by item 3. and multiplying the result by a factor to neutralize the
assumed net investment rate, discussed above, of 5% per annum (which is built
into the annuity rate tables below and which is not applicable because the
actual net investment rate is credited instead) where:
1. is the net result of:
a) the assets of the Subaccount attributable to the Annuity Units; plus or
minus
b) the cumulative charge or credit for taxes reserved which is determined by
Us to have resulted from the operation of the Subaccount;
2. is the cumulative unpaid charge for the Mortality and Expense Risk Charge
the Administrative Charge and for the Distribution Charge, which are shown
in the Certificate Schedule; and
3. is the number of Annuity Units outstanding at the end of the Valuation
Period.
The value of an Annuity Unit may increase or decrease from Valuation Period to
Valuation Period.
DEATH BENEFIT
DEATH OF THE OWNER - In the event of Your death prior to the Annuity Date, a
death benefit is payable to the Beneficiary. The value of the death benefit will
be determined as of the date We receive proof of death in a form acceptable to
Us. If there has been a change of Owner from one natural person to another
natural person, the death benefit will be the Certificate Value unless the
change of ownership results from the election, made by a surviving spouse as
designated Beneficiary to continue the certificate. Otherwise, We will pay the
death benefit equal to the greatest of:
1. The total of all Premiums paid, less an adjustment for each surrender. The
adjustment will be a proportionate reduction made to each Premium paid
prior to the surrender in the same proportion that the Certificate Value
was reduced on the date of a surrender; or
2. The Certificate Value; or
3. The greatest Certificate Value on any seventh Certificate Anniversary
reduced proportionally by any surrenders subsequent to that Certificate
Anniversary in the same proportion that the Certificate Value was reduced
on the date of a surrender, plus any Premium paid subsequent to that
Certificate Anniversary.
The amount of the reduction in the death benefit under items 1 and 3 above would
be determined as "A" multiplied by the result of "B" divided by "C" where:
"A" is the death benefit prior to the surrender,
"B" is the amount by which the Certificate Value is reduced as a result of a
surrender, and
"C" is the Certificate Value prior to the surrender.
The Beneficiary may elect the death benefit to be paid as follows:
1. payment of the entire death benefit within 5 years of the date of the
Owner's death; or
2. payment over a period not extending beyond the life expectancy of such
designated Beneficiary based on Tables V and VI of section 1.72-9 of the
Income Tax Regulation with distribution beginning within 1 year of the date
of death of the Owner; or
3. if the designated Beneficiary is Your spouse, he/she can continue the
certificate in his/her own name.
If no payment option is elected within 60 days of Our receipt of proof of the
Owner's death, a single sum settlement will be made at the end of the sixty (60)
day period following such receipt. Upon payment of the death benefit, this
certificate will end.
If the Owner is a person other than the Annuitant, and if the Owner's death
occurs on or after the Annuity Date, no death benefit will be payable under this
certificate. Any guaranteed payments remaining unpaid will continue to be paid
to the Annuitant pursuant to the Annuity Option in force at the date of the
Owner's death. If the Owner is not an individual, the Annuitant shall be treated
as the Owner and any change of such first named Annuitant, will be treated as if
the Owner died.
DEATH OF THE ANNUITANT - If the Annuitant is a person other than the Owner, and
if the Annuitant dies before the Annuity Date, a new Annuitant may be named by
the Owner. If no new Annuitant is named within sixty (60) days of Our receipt of
proof of death, the Owner will be the new Annuitant. If the Annuitant dies after
the Annuity Date, the remaining payments, if any, will be as specified in the
Annuity Option elected. We will require proof of the Annuitant's death. Death
benefits, if any, will be paid to the designated Beneficiary at least as rapidly
as under the method of distribution in effect at the Annuitant's death.
DEATH BENEFIT (Continued)
ACCIDENTAL DEATH BENEFIT - If an Accidental Death Benefit Charge is included on
the Certificate Schedule, an Accidental Death Benefit may be payable which is
equal to the lesser of the Certificate Value as of the date the death benefit is
determined or $250,000. The Accidental Death Benefit is payable if the death of
the primary Owner (i.e., the first owner listed on the Certificate Schedule)
occurs prior to the Certificate Anniversary next following his 75th birthday and
is the result of an injury incurred while he was the primary Owner. The death
must also occur before the Annuity Date and within 365 days of the date of the
accident which caused the injury.
The Accidental Death Benefit will not be paid for any death caused by or
resulting (in whole or in part) from the following:
1. suicide or attempted suicide while xxxx or insane;
2. intentionally self-inflicted injuries;
3. sickness disease or bacterial infection of any kind, except pyogenic
infections which occur as a result of an injury, or bacterial infections
which result from the accidental ingestion of contaminated substances;
4. hernia;
5. injury sustained as a consequence of riding in, including boarding or
alighting from, any vehicle or device used for aerial navigation except if
the primary Owner is a passenger on any aircraft licensed for the
transportation of passengers;
6. declared or undeclared war or any act thereof; or
7. service in the military, naval or air service of any country.
SURRENDER PROVISIONS
SURRENDER - While this certificate is in force and before the Annuity Date, We
will, upon written request, allow the surrender of all or a portion of this
certificate for its Surrender Value. Surrenders will result in the cancellation
of Accumulation Units from each applicable Subaccount and the Guaranteed Account
in the ratio that the value of each bears to the total Certificate Value. You
must specify in writing in advance which units are to be canceled if other than
the above mentioned method of cancellation is desired. We will pay the amount of
any surrender within seven (7) days of receipt of a request unless the "Delay of
Payments" provision is in effect.
The Surrender Value will be the Certificate Value as of the date of Our receipt
of Your written surrender request, reduced by the sum of:
1. any applicable premium taxes not previously deducted; plus
2. any applicable Surrender Charge.
CALCULATION OF SURRENDER CHARGE - If all or a portion of the Surrender Value is
surrendered, a Surrender Charge will be calculated at the time of each surrender
and will be deducted from the Certificate Value. In calculating the Surrender
Charge, Premiums will be allocated at the time of surrender on a first-in,
first-out basis.
The amount of the Surrender Charge is calculated by:
1. reducing the amount to be surrendered by the greater of:
a) the accumulated earnings of this certificate (i.e., the Certificate Value
minus Premiums which have not been allocated to amounts previously
surrendered); or
b) 10% of all remaining unsurrendered Premiums, decreased by any surrender
made since the last Certificate Anniversary; then
2. allocating Premiums to the remaining amount to be surrendered; and
3. multiplying each such allocated Premium by the applicable Percentage of
Premium shown in the Certificate Schedule for the period since such Premium
was paid; and
4. adding the products of each multiplication in (3) above.
For a partial surrender, the Surrender Charge will be deducted from the
remaining Certificate Value, if sufficient; otherwise it will be deducted from
the amount surrendered. Partial surrenders will be considered in calculating any
death benefit payable under this certificate.
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DELAY OF PAYMENTS
We will make any payments under this certificate within 7 days (or any shorter
period, if required by law) of a request received in good order. We reserve the
right to suspend or postpone any type of payment from the Variable Account for
any period when:
1. the New York Stock Exchange is closed for other than customary weekend and
holiday closings:
2. trading on the Exchange is restricted;
3. an emergency exists as a result of which it is not reasonably practicable
to dispose of securities held in the Variable Account or determine their
value; or
4. the Securities and Exchange Commission so permits delay for the protection
of security holders.
The applicable rules of the Securities and Exchange Commission will govern as to
whether the conditions in 2. or 3. exist.
We reserve the right to delay any type of payment from the General Account for
up to six (6) months from the date we receive the request for payment.
Options On A Fixed Basis
Option 1: Life Income *
Monthly Income per $1,000
Year of 2010 2020 2030 2040
Annuitization
Age Male Female Male Female Male Female Male Female
30 3.16 3.06 3.12 3.03 3.09 3.00 3.06 2.97
35 3.30 3.18 3.25 3.14 3.21 3.10 3.18 3.07
40 3.48 3.32 3.42 3.28 3.37 3.23 3.32 3.20
45 3.70 3.51 3.63 3.45 3.57 3.40 3.51 3.35
50 3.98 3.74 3.89 3.67 3.82 3.60 3.74 3.54
55 4.34 4.05 4.23 3.95 4.13 3.87 4.04 3.79
60 4.82 4.45 4.68 4.33 4.55 4.22 4.43 4.12
65 5.48 4.99 5.29 4.83 5.12 4.68 4.96 4.55
70 6.38 5.75 6.13 5.53 5.89 5.33 5.69 5.16
75 7.62 6.86 7.26 6.54 6.95 6.26 6.66 6.02
80 9.35 8.48 8.85 8.02 8.41 7.61 8.02 7.26
85 11.76 10.89 11.08 10.21 10.48 9.62 9.96 9.11
Option 2: Life Income with 10 years payments Guaranteed *
Monthly Income per $1,000
Year of 2010 2020 2030 2040
Annuitization
Age Male Female Male Female Male Female Male Female
30 3.16 3.06 3.12 3.03 3.09 3.00 3.06 2.97
35 3.30 3.17 3.25 3.14 3.21 3.10 3.17 3.07
40 3.47 3.32 3.42 3.27 3.37 3.23 3.32 3.19
45 3.69 3.50 3.62 3.44 3.56 3.39 3.50 3.35
50 3.96 3.73 3.87 3.66 3.80 3.60 3.73 3.54
55 4.30 4.03 4.20 3.94 4.10 3.86 4.02 3.78
60 4.74 4.41 4.61 4.29 4.50 4.19 4.39 4.10
65 5.31 4.91 5.15 4.76 5.01 4.63 4.87 4.51
70 6.02 5.57 5.83 5.39 5.65 5.22 5.48 5.07
75 6.85 6.42 6.63 6.19 6.42 5.98 6.23 5.79
80 7.73 7.40 7.51 7.16 7.30 6.92 7.10 6.70
85 8.52 8.34 8.35 8.13 8.18 7.93 8.02 7.73
Option 3: Joint (Male and Female) and Last Survivor *
Monthly Income per $1,000
Year of 2020 2040
Annuitization
Female Age 45 55 65 75 45 55 65 75
Male Age
45 3.25 3.41 3.52 3.59 3.18 3.32 3.42 3.47
55 3.35 3.63 3.90 4.09 3.26 3.52 3.76 3.92
65 3.40 3.80 4.30 4.78 3.31 3.67 4.10 4.52
75 3.43 3.89 4.59 5.54 3.34 3.74 4.36 5.18
* Values are based on the Annuity 2000 Table projected with Scale G to the
year of annuitization, with interest at 3.00%.
The values shown have not been adjusted for the annual certificate
maintenance charge described on pages 3 and 9.
Values not shown are available from Our Administrative Office on request.
OPTIONS ON A VARIABLE BASIS
Option 1: Life Income *
Monthly Income per $1,000
Year of 2010 2020 2030 2040
Annuitization
Age Male Female Male Female Male Female Male Female
30 4.47 4.38 4.44 4.36 4.41 4.34 4.39 4.32
35 4.58 4.47 4.55 4.44 4.51 4.41 4.48 4.39
40 4.74 4.60 4.69 4.55 4.64 4.52 4.60 4.49
45 4.94 4.75 4.88 4.70 4.82 4.65 4.76 4.61
50 5.20 4.96 5.12 4.90 5.04 4.83 4.97 4.78
55 5.54 5.24 5.43 5.15 5.34 5.07 5.25 5.00
60 6.00 5.62 5.86 5.50 5.74 5.40 5.62 5.30
65 6.65 6.15 6.46 5.99 6.29 5.84 6.14 5.72
70 7.56 6.90 7.30 6.68 7.07 6.48 6.86 6.30
75 8.81 8.01 8.45 7.69 8.12 7.41 7.83 7.16
80 10.55 9.65 10.05 9.18 9.59 8.76 9.19 8.40
85 12.99 12.09 12.30 11.39 11.68 10.79 11.14 10.26
Option 2: Life Income with 10 years payments Guaranteed *
Monthly Income per $1,000
Year of 2010 2020 2030 2040
Annuitization
Age Male Female Male Female Male Female Male Female
30 4.47 4.38 4.44 4.36 4.41 4.34 4.39 4.32
35 4.58 4.47 4.54 4.44 4.51 4.41 4.48 4.39
40 4.73 4.59 4.68 4.55 4.64 4.51 4.60 4.48
45 4.92 4.74 4.86 4.69 4.80 4.65 4.75 4.61
50 5.16 4.95 5.09 4.88 5.02 4.82 4.95 4.77
55 5.48 5.21 5.38 5.13 5.30 5.05 5.22 4.99
60 5.90 5.57 5.77 5.46 5.66 5.36 5.56 5.27
65 6.44 6.04 6.29 5.90 6.15 5.77 6.02 5.66
70 7.12 6.67 6.93 6.49 6.76 6.33 6.60 6.18
75 7.90 7.49 7.69 7.27 7.49 7.06 7.31 6.88
80 8.73 8.42 8.53 8.18 8.32 7.96 8.13 7.75
85 9.48 9.31 9.32 9.11 9.16 8.91 9.00 8.72
Option 3: Joint (Male and Female) and Last Survivor *
Monthly Income per $1,000
Year of 2020 2040
Annuitization
Female Age 45 55 65 75 45 55 65 75
Male Age
45 4.50 4.64 4.74 4.81 4.45 4.56 4.66 4.71
55 4.59 4.83 5.07 5.26 4.52 4.73 4.94 5.10
65 4.65 4.98 5.43 5.90 4.57 4.86 5.25 5.65
75 4.68 5.08 5.72 6.62 4.59 4.94 5.49 6.27
* Values are based on the Annuity 2000Table projected with Scale G to the
year of annuitization, with interest at 5.00%.
The values shown have not been adjusted for the annual certificate
maintenance charge described on pages 3 and 9.
Values not shown are available from Our Administrative Office on request.
