[LOGO] AETNA LIFE INSURANCE AND ANNUITY COMPANY
HOME OFFICE: 000 XXXXXXXXXX XXX.
HARTFORD, CONNECTICUT 06156
0-000-000-0000
Herein called Aetna
Agrees to pay the benefits stated in this Contract.
DETAILS OF VARIABLE FEATURES OF THIS CONTRACT ARE IN THE DEPOSIT,
RESERVE, AND SURRENDER PROVISIONS, AND ANNUITY PROVISIONS.
RIGHT TO CANCEL
The Owner may cancel this Contract within 10 days of receiving it,
by sending a written notice to Aetna at the above address or to the
agent from whom it was purchased. Aetna will return all payments
made for this Contract within 7 days after it receives the notice of
cancellation and this Contract.
This page, and the following pages, and the application, make up the
entire Contract.
Signed at Hartford, Connecticut on the Effective Date.
/s/ Xxxxx X Xxxxxxxxx /s/ Xxx Xxxxxxx
SECRETARY PRESIDENT
GROUP VARIABLE OR FIXED ANNUITY OR COMBINATION CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT.
(39169)
CAT. 2000599000
GLID-CDA-HO PRINTED IN U.S.A.
SPECIFICATIONS
PLAN
OWNER
GROUP CONTRACT NO.
EFFECTIVE DATE
THIS CONTRACT IS DELIVERED IN
AND IS SUBJECT TO THE LAWS OF THAT JURISDICTION
Deduction from Deposit(s)-- The amount of the Net Deposit(s) applied
will be the deposit(s) received minus a deduction for premium taxes,
if any then deducted (see Deposit, Reserve, and Surrender Provisions
of this Contract).
Deductions From The Separate Account And The Funds -- Total deductions
equal 1.5% on an annual basis. Once Annuity payments begin, Aetna
must earn a gross return on the assets of the Separate Account of:
(a) 5% on an annual basis if an assumed net return rate of 3.5% is
chosen; or (b) 6.5% on an annual basis if an assumed net return rate
of 5% is chosen; in order that the dollar amount of the Variable
Annuity payments will not decrease.
GLID-CDA-HO 2
COVER SHEET
This Contract is a legal contract between the Owner and Aetna.
READ THIS CONTRACT CAREFULLY. This cover sheet is only a brief
outline of some of the important features of this Contract. This
cover sheet is not the insurance contract. Only the actual terms of
this Contract will control. This Contract sets forth, in detail, all
of the rights and obligations of both you and Aetna. IT IS THEREFORE
IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY.
TABLE OF CONTENTS
GENERAL DEFINITIONS Page
1. Participant ......................................... 4
2. Annuitant ........................................... 4
3. Xxxxxxx ............................................ 4
4. Fixed Annuity ....................................... 4
5. Variable Annuity .................................... 4
6. General Account ..................................... 4
7. Separate Accounts ................................... 4
8. Fund(s) ............................................. 4
9. Valuation Period .................................... 4
GENERAL PROVISIONS
1. Contract ............................................ 5
2. Incontestability .................................... 5
3. Control of Contract and Individual Accounts ......... 5
4. Change of Contract by Aetna ......................... 5
5. Individual Certificates ............................. 5
6. Designation of Beneficiary .......................... 5
7. Misstatements and Adjustments ....................... 6
8. State Laws .......................................... 6
9. Non-participating Contract .......................... 6
DEPOSIT, RESERVE, AND SURRENDER PROVISIONS
1. Net Deposit ......................................... 6
2. Individual Accounts ................................. 6
3. Guaranteed Interest Rate -- General Account ......... 6
4. Record Units -- Separate Account .................... 7
5. Investment Increment Factors -- Separate Account .... 7
6. Record Unit Value -- Separate Account ............... 7
7. Individual Account Reserve .......................... 7
8. Active Life Fund .................................... 8
9. Experience Credits .................................. 8
10. Transfer of Individual Account Reserves ............ 8
11. Notice to the Owner ................................ 8
12. Sum Payable at Death (Before Annuity Payments Start). 8
13. Surrender Value ..................................... 9
ANNUITY PROVISIONS
1. Choices to be Made ................................... 10
2. Fund(s) Annuity Units -- Separate Account ............ 10
3. Fund(s) Annuity Unit Value -- Separate Account ....... 10
4. Annuity Options ...................................... 11
5. Other Terms of Annuity Options ....................... 19
6. Death of Annuitant/Beneficiary ....................... 19
GLID-CDA-HO 3
GENERAL DEFINITIONS
1. PARTICIPANT -- A person who participates in the Plan and for whom
benefits are being accrued under this Contract.
2. ANNUITANT -- A Participant or beneficiary on whose life an Annuity
has been effected under this Contract.
3. ANNUITY -- Payment of an income:
(a) for the life of one or two people;
(b) for a stated period;
(c) for some mix of (a) and (b); or
(d) until there are no funds left.
4. FIXED ANNUITY -- An Annuity of a fixed dollar amount paid from the
General Account.
5. VARIABLE ANNUITY -- An Annuity of a varying dollar amount paid from
the Separate Account.
6. GENERAL ACCOUNT -- The Account which holds the assets of Aetna,
other than those assets of Aetna in the Separate Accounts.
Reserves for a Fixed Annuity are held in the General Account.
7. SEPARATE ACCOUNTS -- Accounts set up by Aetna under the Connecticut
Insurance Laws. Assets for this class of variable contracts are
set apart from other assets of Aetna. Reserves for a Variable
Annuity are held in a Separate Account and invested in shares of
Fund(s).
8. FUND(S) -- The open-end management investment companies (mutual
funds) registered under the Investment Company Act of 1940. They
are:
(a) Aetna Variable Fund, Inc. (Variable Fund);
(b) Aetna Variable Encore Fund, Inc. (Encore Fund);
(c) Aetna Income Shares, Inc. (Income Fund); and
(d) Other funds (if any) which Aetna may allow.
9. VALUATION PERIOD -- The period of time from the end of one business
day to the end of the next business day.
GLID-CDA-HO 4
GENERAL PROVISIONS
1. Contract
This Contract may be changed only by an officer of Aetna. Any
change must be made in writing. Any choices under this Contract
by the Owner, Annuitant or beneficiary must be in writing. Until
receipt of such choices in the Home Office of Aetna, Aetna may
rely on any previous choices made.
Aetna will make Annuity payments as and when due. Any other
payments will be made by Aetna within 7 days of receipt of the
written claim for payment, except as otherwise provided in the
Surrender Value provision.
2. Incontestability
Aetna cannot cancel this Contract because of any error of fact on
the application.
3. Control of Contract and Individual Accounts
All of the benefits and rights granted by this Contract, or
allowed by Aetna, belong to the Owner.
4. Change of Contract by Aetna
Aetna may change any of the terms of this Contract. Aetna will
notify the Owner in writing 30 days before the effective date of
any such change. Any such change will not affect the amount or
terms of any Annuity which began prior to such change. Changes
that affect the following provisions of this Contract: (a)
Annuity Options; (b) Net Deposit; (c) Guaranteed Interest Rate;
(d) Individual Account Reserve; and (e) Surrender Value; will only
apply to deposits made on behalf of Participants who become
covered under this Contract on or after the effective date of such
change. If the Owner fails to agree to any such change, no new
Participants may be covered under this Contract. Aetna will
continue to accept contributions for the Participants covered
under this Contract prior to the change. This Contract is subject
to change as required by federal or state law.
5. Individual Certificates
Aetna shall issue certificates for each Participant as required by
the state in which this Contract is delivered. The certificate
will contain a summary of the benefits provided by this Contract.
Certificates are not a part of this Contract.
6. Designation of Beneficiary
The beneficiary for each Participant shall be as named, or later
changed, by the Owner. If no beneficiary is living at the death
of the Participant, payment of any amount due will be made to the
Owner.
GLID-CDA-HO 5
7. Misstatements and Adjustments
If the age or sex of any payee is found to be misstated, the
correct facts will be used to adjust payments.
8. State Laws
This Contract follows the laws of the state in which it is
delivered. Any cash, death or Annuity payments are equal to or
greater than the minimum required by such laws.
9. Grace Period
This Contract will remain in effect even if deposits are not continued.
10. Non-Participating Contract
The Owner will have no right to share in the earnings of Aetna.
DEPOSIT, RESERVE, AND SURRENDER PROVISIONS
1. Net Deposit
The Net Deposit is the actual deposit minus a charge to pay
premium taxes, if any. As a rule, Aetna will take this charge out
of an Individual Account Reserve (see below) when annuity payments
are to start. But, if Aetna determines that it must pay any
imposed premium tax at any other time, it may take out the charge
at any time.
2. Individual Accounts
Aetna will maintain Individual Accounts for each Participant. On
the basis of information supplied by the Owner, Aetna will credit
the Net Deposit(s) to such Accounts in either:
(a) the General Account;
(b) the Separate Account where they are invested in Fund(s)
as directed by the Owner; or
(c) a mix of (a) and (b).
3. Guaranteed Interest Rate -- General Account
On the Net Deposit(s) made to the General Account, Aetna will add
interest daily at an annual rate no less than:
(a) 4% except under the Annuity Provisions; and
(b) 3.5% under the Annuity Provisions.
Aetna may add interest daily at any higher rate.
GLID-CDA-HO 6
4. Record Units -- Separate Account
The portion of the Net Deposit applied to the Separate Account
Fund(s) will determine the number of Record Units. This number is
equal to the Net Deposit(s) divided by the Record Unit Value (see
below) for the Valuation Period when the Net Deposit is received.
5. Investment Increment Factors -- Separate Account
Investment Increment Factors are those items used to determine a
Fund's net return factor for each Valuation Period. The net
return factor(s) are then used to compute all Separate Account
values and payments.
The gross return is equal to:
(a) investment income; PLUS
(b) realized and unrealized capital gains; MINUS
(c) realized and unrealized capital losses; MINUS
(d) certain investment expenses; and MINUS
(e) a daily charge at an annual rate of .25% for investment
management expense and profit.
The gross return is divided by the net assets of the Fund at the
start of the Valuation Period to compute the gross return rate. A
gross return rate may be more or less than 0. The net return rate
is equal to:
(a) the gross return rate; PLUS or MINUS
(b) taxes (or charges to a tax reserve) on the Separate Account;
and MINUS
(c) a daily charge at an annual rate of 1.25% for annuity mortality
and expense risks and profit.
A net return rate may be more or less than 0.
The net return factor for each Fund is equal to the net return
rate plus 1.000000.
6. Record Unit Value -- Separate Account
The Record Unit Value for each Separate Account Fund is computed
by multiplying the net return factor for the current Valuation
Period by the Record Unit Value for the previous Period. The
dollar value of Record Units, Separate Account Reserves, and
Variable Annuity payments may go up or down due to investment gain
or loss.
7. Individual Account Reserve
The Individual Account Reserve for each Participant is equal to:
(a) Net Deposit(s) credited to the General Account (if any); PLUS
(b) General Account interest added by Aetna; PLUS
GLID-CDA-HO 7
(c) the value of Separate Account Record Units (if any); PLUS
(d) any amount due to Experience Credits (see below); MINUS
(e) a charge of $15 on each anniversary of each Individual
Account effective date; and MINUS
(f) any amounts previously surrendered.
8. Active Life Fund
The Active Life Fund is equal to the combined Reserves of all
Individual Accounts, except those Accounts applied to the payment
of Annuities.
9. Experience Credits
Aetna may apply Experience Credits to Individual Accounts in the
Active Life Fund under this Contract. Any such credit will be
computed as decided by Aetna.
10. Transfer of Individual Account Reserves
The Owner may transfer any portion of the Individual Account
Reserves from any Fund to any other Fund or to the General
Account. Reserves cannot be transferred from the General
Account to any of the Funds. A transfer of Reserves cannot be
made within 90 days of a previous transfer.
11. Notice to the Owner
Aetna will notify the Owner each year of:
(a) the investments held in the Fund(s) for the Separate Account;
and
(b) the number of record units; or
(c) the number of annuity units; and
(d) the value of a unit.
Such number or values will be as of a date no more than 60
days before the date of the notice.
12. Sum Payable at Death (Before Annuity Payments Start)
Aetna will pay to the beneficiary the Individual Account Reserve
if:
(a) the participant dies before Annuity payments start; and
(b) the notice of death is received by Aetna.
The sum paid will be the Reserve on the date when the notice is
received. The beneficiary may choose to apply any sum under
Annuity Options (see Annuity Provisions).
GLID-CDA-HO 8
13. Surrender Value
The amount paid by Aetna upon the surrender of all or any portion
of the Active Life Fund or Individual Account(s) shall be reduced
by a surrender fee. The surrender fee will be a percentage of the
amount surrendered and will vary according to the number of
Deposit Cycles completed for the Individual Account(s) being
surrendered. The number of deposits to be made in a year is
chosen by the Owner. A Deposit Cycle is completed when this
number of deposits has been made. For each surrender from an
Individual Account, the Fee will be as follows:
NUMBER OF DEPOSIT CYCLES COMPLETED FEE
Less than 5 5%
5 or more but less than 7 4%
7 or more but less than 9 3%
9 or more but less than 19 2%
19 or more 0%
In no event, however, will the Fee on a total surrender of an
Individual Account exceed 9% of the actual deposits made to that
Account.
If the Active Life Fund invested in the General Account exceeds
$500,000, Aetna reserves the right to pay out any surrender in
equal installments over a period not to exceed 60 months.
Under certain emergency conditions, Aetna has the right to defer
payment of any surrender value as provided by federal or state
law.
ANNUITY PROVISIONS
1. Choices to be Made
The Owner may tell Aetna to pay the Individual Account Reserve
(minus any charges for premium taxes) as a premium for an Annuity
under Options 2, 3, 4, and 5 (see below). The first Annuity
payment must generally be made no later than the first day of the
month following the Annuitant's 75th birthday. The Owner may tell
Aetna to make the first Annuity payment on the first day of any
prior month.
When any option is chosen, the Owner or beneficiary choosing the
option must tell Aetna if payments are to be made other than
monthly. They must also tell Aetna to pay:
(a) a Fixed Annuity;
(b) a Variable Annuity using Variable Fund;
(c) a Variable Annuity using Income Fund; or
(d) any mix of these.
When choosing a Variable Annuity, an assumed net return rate of 5%
per year may be chosen. If not chosen, Aetna will use an assumed
net return rate of 3.5% per year.
GLID-CDA-HO 9
2. Fund(s) Annuity Units -- Separate Account
The amount of the first Variable Annuity payment will be equal to:
(a) the portion of the Individual Account Reserve (minus any
charges for premium taxes) to be used to pay a Variable Annuity
using the Fund(s); TIMES
(b) the rate for each $1,000 for the Option chosen.
Such amount, or portion, of the payment using a Fund will be
divided by the Fund(s) Annuity Unit Value (see below) on the due
date of the first payment to determine the number of the Fund(s)
Annuity Units.
Such number of Fund(s) Annuity Units remain fixed. Each future
payment is equal to such number times the Fund(s) Annuity Unit
Value on the due date of each payment.
3. Fund(s) Annuity Unit Value -- Separate Account
For any Valuation Period the Fund(s) Annuity Unit Value is equal
to:
(a) the Value for the next previous Period; TIMES
(b) the net return factor(s) (see Investment Increment -- Factors
Separate Account provisions) for the tenth previous Period;
TIMES
(c) a factor to reflect the assumed net return rate.
The factor for 3.5% per year is .9999058; for 5% per year it is
.9998663.
The dollar amount of Annuity Units, values, and payments may go up
or down due to investment gain or loss.
Payments shall not be changed due to mortality or expense results.
4. Annuity Options
Option 1 -- Payment of Interest on Sum Left With Aetna This option
may be used only by the beneficiary when the death of the
Participant is before Aetna has started paying an Annuity. A
portion or all of the sum due may be held in the General Account
of Aetna at interest (see Guaranteed Interest Rate -- General
Account provision). The beneficiary may later tell Aetna to:
(a) pay a portion, or all, of the sum held by Aetna; or
(b) apply a portion, or all, of the sum held by Aetna under any of
the Annuity Options below.
Option 2 -- Payments of a Stated Dollar Amount -- An Annuity of a
chosen amount will be paid until there are no funds left. The
payments to be made in a year must be no less than $60 for each
$1,000 applied to this Option, but cannot exceed an amount which
would deplete the funds in less than 3 years.
GLID-CDA-HO 10
Where there is a right under Federal Securities Law to forgo
future payments and receive the present value of the Annuity under
this Option in a lump sum, the exercise of that right within a 3
year period after the start of payments shall be treated as a
surrender (see Surrender Value under Deposit, Reserve and
Surrender Provisions).
Option 3 -- Payments for a State Period of Time -- An Annuity will
be paid for the number of years chosen. The number of years must
be no less than 3 and no more than 30.
Where there is a right under Federal Securities Law to forgo
future payments and receive the present value of the Annuity under
this Option in a lump sum, the exercise of that right within a 3
year period after the start of payments shall be treated as a
surrender (see Surrender Value under Deposit, Reserve and
Surrender Provisions).
GLID-CDA-HO 11
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
PAYMENTS FOR A STATED PERIOD
YEARS YEARS YEARS
OF PAY- AMOUNT OF OF PAY- AMOUNT OF OF PAY- AMOUNT OF
MENTS PAYMENTS MENTS PAYMENTS MENTS PAYMENTS
------- --------- ------- --------- ------- ----------
3 $29.19 13 $7.94 22 $5.39
4 22.27 14 7.49 23 5.24
5 18.12 15 7.10 24 5.09
6 15.35 16 6.76 25 4.96
7 13.38 17 6.47 26 4.84
8 11.90 18 6.20 27 4.73
9 10.75 19 5.97 28 4.63
10 9.83 20 5.75 29 4.53
11 9.09 21 5.56 30 4.45
12 8.46
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
PAYMENTS FOR A STATED PERIOD
YEARS YEARS YEARS
OF PAY- AMOUNT OF OF PAY- AMOUNT OF OF PAY- AMOUNT OF
MENTS PAYMENTS MENTS PAYMENTS MENTS PAYMENTS
------- ---------- ------- --------- ------- ----------
3 $29.80 13 $8.64 22 $6.17
4 22.89 14 8.20 23 6.02
5 18.74 15 7.82 24 5.88
6 15.99 16 7.49 25 5.76
7 14.02 17 7.20 26 5.65
8 12.56 18 6.94 27 5.54
9 11.42 19 6.71 28 5.45
10 10.51 20 6.51 29 5.36
11 9.77 21 6.33 30 5.28
12 9.16
GLID-CDA-HO 12
Option 4 -- Life Income -- An Annuity will be paid for life. Payments
may be made for a minimum stated period, if chosen, of 60, 120,
180 or 240 months. If the Annuitant dies before the end of such
stated period, payments will be made to the beneficiary for the
rest of the stated period.
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF LIFE INCOME WITH
ANNUITANT PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
MALE FEMALE NONE 60 120 180 240
----- ------ ----- -- --- --- ----
50 55 $4.98 $4.96 $4.89 $4.77 $4.62
51 56 5.08 5.05 4.98 4.85 4.68
52 57 5.18 5.16 5.07 4.93 4.74
53 58 5.30 5.26 5.17 5.01 4.80
54 59 5.41 5.38 5.27 5.09 4.86
55 60 5.54 5.49 5.37 5.17 4.92
56 61 5.67 5.62 5.48 5.26 4.98
57 62 5.80 5.75 5.59 5.35 5.04
58 63 5.95 5.89 5.71 5.44 5.10
59 64 6.10 6.03 5.83 5.53 5.16
60 65 6.27 6.19 5.96 5.62 5.22
61 66 6.44 6.35 6.09 5.72 5.27
62 67 6.63 6.52 6.23 5.81 5.33
63 68 6.82 6.71 6.38 5.91 5.38
64 69 7.04 6.90 6.53 6.00 5.43
65 70 7.26 7.11 6.68 6.10 5.47
66 71 7.50 7.33 6.84 6.19 5.52
67 72 7.76 7.56 7.01 6.28 5.55
68 73 8.04 7.80 7.18 6.37 5.59
69 74 8.34 8.07 7.35 6.46 5.62
70 75 8.67 8.34 7.52 6.54 5.65
71 9.01 8.63 7.70 6.62 5.67
72 9.39 8.94 7.88 6.69 5.69
73 9.79 9.26 8.05 6.76 5.71
74 10.22 9.61 8.22 6.81 5.72
75 10.69 9.96 8.39 6.87 5.73
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
GLID-CDA-HO 13
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF LIFE INCOME WITH
ANNUITANT PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
MALE FEMALE NONE 60 120 180 240
----- ------ ----- -- --- --- ----
50 55 $5.89 $5.86 $5.78 $5.65 $5.48
51 56 5.99 5.96 5.86 5.71 5.53
52 57 6.09 6.06 5.95 5.79 5.59
53 58 6.20 6.16 6.04 5.86 5.64
54 59 6.32 6.27 6.14 5.94 5.70
55 60 6.44 6.39 6.24 6.02 5.75
56 61 6.57 6.51 6.34 6.10 5.80
57 62 6.71 6.64 6.45 6.18 5.86
58 63 6.85 6.77 6.56 6.26 5.91
59 64 7.00 6.92 6.68 6.35 5.97
60 65 7.16 7.07 6.80 6.43 6.02
61 66 7.34 7.23 6.93 6.52 6.07
62 67 7.52 7.40 7.06 6.61 6.12
63 68 7.72 7.58 7.20 6.70 6.17
64 69 7.93 7.77 7.35 6.79 6.21
65 70 8.16 7.97 7.50 6.88 6.25
66 71 8.40 8.19 7.65 6.97 6.29
67 72 8.66 8.42 7.81 7.05 6.33
68 73 8.94 8.66 7.97 7.14 6.36
69 74 9.24 8.92 8.13 7.22 6.39
70 75 9.56 9.19 8.30 7.29 6.41
71 9.91 9.48 8.47 7.36 6.43
72 10.29 9.78 8.64 7.43 6.45
73 10.69 10.10 8.80 7.49 6.47
74 11.13 10.43 8.97 7.55 6.48
75 11.60 10.79 9.13 7.60 6.49
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
Option 5 -- Life Income for Two Payees -- An Annuity will be paid
during the lives of the Annuitant and a second annuitant. At the
death of either, payments will continue to the survivor. When
this option is chosen, a choice must be made of:
(a) 100% of the payment to continue to the survivor;
(b) 66 2/3% of the payment to continue to the survivor;
(c) 50% of the payment to continue to the survivor; or
(d) payments for a minimum of 120 months, with 100% of the payment
to continue to the survivor.
GLID-CDA-HO 14
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $4.10 $4.27 $4.43 $4.57 $4.69 $4.79 $4.86
55 60 4.21 4.43 4.65 4.86 5.04 5.20 5.32
60 65 4.30 4.57 4.86 5.15 5.43 5.68 5.88
65 70 4.38 4.69 5.04 5.43 5.83 6.21 6.56
70 75 4.44 4.79 5.20 5.68 6.21 6.78 7.33
75 80 4.48 4.86 5.32 5.88 6.56 7.33 8.16
80 85 -- 4.91 5.41 6.03 6.82 7.80 8.95
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $5.00 $5.16 $5.31 $5.44 $5.57 $5.67 $5.75
55 60 5.11 5.31 5.51 5.71 5.90 6.06 6.19
60 65 5.20 5.44 5.71 5.99 6.26 6.52 6.73
65 70 5.28 5.57 5.90 6.26 6.65 7.04 7.38
70 75 5.34 5.67 6.06 6.52 7.04 7.59 8.14
75 80 5.38 5.75 6.19 6.73 7.38 8.14 8.96
80 85 -- 5.81 6.29 6.90 7.66 8.62 9.76
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
GLID-CDA-HO 15
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
JOINT AND LAST SURVIVOR ANNUITY
66 2/3% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $4.51 $4.72 $4.94 $5.18 $5.44 $5.71 $6.00
55 60 4.70 4.94 5.20 5.49 5.81 6.14 6.49
60 65 4.90 5.18 5.49 5.84 6.23 6.65 7.09
65 70 5.11 5.44 5.81 6.23 6.71 7.25 7.82
70 75 5.34 5.71 6.14 6.65 7.25 7.93 8.69
75 80 5.58 6.00 6.49 7.09 7.82 8.69 9.69
80 85 -- 6.28 6.84 7.53 8.39 9.47 10.77
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
JOINT AND LAST SURVIVOR ANNUITY
66 2/3% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $5.43 $5.62 $5.84 $6.08 $6.36 $6.65 $6.98
55 60 5.62 5.84 6.10 6.38 6.70 7.06 7.44
60 65 5.82 6.08 6.38 6.72 7.11 7.54 8.01
65 70 6.06 6.36 6.70 7.11 7.58 8.12 8.71
70 75 6.31 6.65 7.06 7.54 8.12 8.80 9.56
75 80 6.59 6.98 7.44 8.01 8.71 9.56 10.56
80 85 -- 7.31 7.84 8.49 9.33 10.38 11.66
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
GLID-CDA-HO 16
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
JOINT AND LAST SURVIVOR ANNUITY
50% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $4.75 $4.98 $5.24 $5.55 $5.91 $6.32 $6.79
55 60 4.99 5.24 5.54 5.88 6.28 6.76 7.30
60 65 5.26 5.55 5.88 6.27 6.73 7.27 7.90
65 70 5.59 5.91 6.28 6.73 7.26 7.90 8.65
70 75 5.96 6.32 6.76 7.27 7.90 8.67 9.57
75 80 6.37 6.79 7.30 7.90 8.65 9.57 10.69
80 85 -- 7.30 7.88 8.59 9.49 10.61 12.00
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
JOINT AND LAST SURVIVOR ANNUITY
50% TO THE SURVIVOR
NO MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $5.67 $5.89 $6.15 $6.47 $6.84 $7.29 $7.81
55 60 5.91 6.15 6.44 6.78 7.20 7.70 8.28
60 65 6.20 6.47 6.78 7.16 7.63 8.19 8.86
65 70 6.54 6.84 7.20 7.63 8.16 8.80 9.58
70 75 6.95 7.29 7.70 8.19 8.80 9.56 10.48
75 80 7.42 7.81 8.28 8.86 9.58 10.48 11.60
80 85 -- 8.39 8.94 9.61 10.46 11.56 12.92
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
GLID-CDA-HO 17
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
120 MONTHS MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $4.10 $4.27 $4.42 $4.56 $4.68 $4.77 $4.83
55 60 4.21 4.42 4.64 4.84 5.02 5.16 5.26
60 65 4.30 4.56 4.84 5.12 5.38 5.61 5.78
65 70 4.37 4.68 5.02 5.38 5.76 6.10 6.37
70 75 4.42 4.77 5.16 5.61 6.10 6.58 7.00
75 80 4.46 4.83 5.26 5.78 6.37 7.00 7.58
80 85 -- 4.86 5.33 5.88 6.55 7.29 8.02
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
120 MONTHS MINIMUM PERIOD
AGE OF AGE OF ANNUITANT
SECOND
ANNUITANT MALE 45 MALE 50 MALE 55 MALE 60 MALE 65 MALE 70
MALE FEMALE FEMALE 50 FEMALE 55 FEMALE 60 FEMALE 65 FEMALE 70 FEMALE 75 MALE 75
---- ------ -------- --------- --------- --------- -------- --------- -------
50 55 $5.00 $5.15 $5.30 $5.43 $5.55 $5.64 $5.71
55 60 5.10 5.30 5.50 5.69 5.87 6.01 6.12
60 65 5.19 5.43 5.69 5.96 6.21 6.44 6.61
65 70 5.27 5.55 5.87 6.21 6.57 6.90 7.17
70 75 5.32 5.64 6.01 6.44 6.90 7.37 7.78
75 80 5.36 5.71 6.12 6.61 7.17 7.78 8.34
80 85 -- 5.75 6.19 6.72 7.35 8.06 8.76
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
GLID-CDA-HO 18
5. Other Terms of Annuity Options
No choice of any Annuity Option may be made if the first payment
would be less than $20 or if the total payments in a year would be
less than $100.
Age, where used in the above tables, means age nearest birthday on
the date of the first payment. The tables for Options 4 and 5 use
the Annuity table for 1949 with:
(a) a 1 year age reduction for males; and
(b) a 6 year age reduction for females.
If Fixed Annuity Options 3, 4, or 5 are chosen and Aetna's current
applicable rates at that time are larger than the rates above, the
larger payment will be made.
6. Death of Annuitant/Beneficiary
When an Annuitant dies while payments are being made under an
Annuity Option, payments will be continued to the beneficiary as
provided by the option. If no beneficiary is living, the present
value of any remaining payments will be paid in one sum to the
Owner. The present value will assume the same interest rate that
was used when the first payment was made.
When a beneficiary dies while a sum is held at interest, the
amount held will be paid in one sum to the estate of the
beneficiary. When a beneficiary dies while payments are being
made under an Annuity Option, the present value of any remaining
payments will be paid in one sum to the estate of the beneficiary.
The present value will assume the same interest rate that was used
when the first payment was made.
GLID-CDA-HO 19
[LOGO] AETNA LIFE INSURANCE AND ANNUITY COMPANY
HOME OFFICE: 000 XXXXXXXXXX XXX.
HARTFORD, CONNECTICUT 06156
0-000-000-0000
GROUP VARIABLE OR FIXED ANNUITY OR COMBINATION CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT
(39169)
CAT. 2000599000
GLID-CDA-HO PRINTED IN U.S.A.
AETNA LIFE INSURANCE AND ANNUITY COMPANY
ENDORSEMENT
The Contract is hereby endorsed as follows:
Delete the paragraph entitled DEDUCTIONS FROM THE SEPARATE ACCOUNT AND
THE FUNDS on the SPECIFICATIONS page and replace it with the following:
Deductions From The Separate Account and The Funds - Total deductions
equal 1% on an annual basis. Once Annuity payments begin, Aetna must
earn a gross return on the assets of the Separate Account of: (a) 4.5%
on an annual basis if an assumed net return rate of 3.5% is chosen; or
(b) 6% on an annual basis if an assumed net return rate of 5% is chosen;
in order that the dollar amount of the Variable Annuity payments will not
decrease.
Delete the following paragraph from the section entitled INVESTMENT
INCREMENT FACTORS - SEPARATE ACCOUNT:
(c) a daily charge at an annual rate of 1.25% for annuity mortality
and expense risks and profit.
and replace it with the folowing:
(c) a daily charge at an annual rate of .75% for annuity and expense
risks and profit.
Delete paragraphs (e) and (f) in the section entitled INDIVIDUAL ACCOUNT
RESERVE under DEPOSIT, RESERVE, AND SURRENDER PROVISIONS and replace with
the following:
(e) a charge of $0 on each anniversary of each Individual Account
effective date; and MINUS
(f) any amounts previously surrendered.
Add the following to the end of the section entitled SURRENDER VALUE under
DEPOSIT, RESERVE, AND SURRENDER PROVISIONS:
The amount paid by Aetna upon the surrender of all or any portion of the
Active Life Fund or Individual Account(s) shall not be reduced by a
surrender fee when the surrender is due to separation from service.
Endorsed and made a part of the Contract on the effective date of the
Contract.
/s/ Xxx Xxxxxx
PRESIDENT
AETNA LIFE INSURANCE AND ANNUITY COMPANY
E2ACB95
