--------------------------------------------------------------------------------
FORM N-4, Item 24(b)(4.25)
AUL Omni Employer Spnosored TDA Contract
Form GBErTDA.OM-ChuK
--------------------------------------------------------------------------------
CONTRACT NUMBER: [GXX,XXX]
CONTRACTHOLDER: [ABC 501(c)(3)]
DATE OF ISSUE: [JANUARY 2, 2006]
CONTRACT DATE: [JANUARY 1, 2006]
FIRST CONTRACT ANNIVERSARY: [JANUARY 1, 2006]
American United Life Insurance Company (AUL) issues this contract in
consideration of the Contractholder's application and [the Plan Sponsor's]
payment of Contributions to AUL. When used in this contract, "we," "us," or
"our" refer to AUL and "you" or "your" refer to the Contractholder.
All provisions and conditions stated on this and subsequent pages are part of
this contract.
This contract is signed for us at our Home Office in Indianapolis, Indiana. Our
mailing address is X.X. Xxx 000, Xxxxxxxxxxxx, Xxxxxxx 00000-0000. Our street
address is Xxx Xxxxxxxx Xxxxxx, Xxxxxxxxxxxx, Xxxxxxx 00000.
NOTICE OF [TEN DAY] RIGHT TO EXAMINE CONTRACT
Please read this contract carefully. You may return the contract for any reason
within ten days after receiving it. If returned, the contract is void from the
beginning and any Contributions will be refunded.
AMERICAN UNITED LIFE INSURANCE COMPANY(R)
By
/s/ Xxxxxx X. Xxxxxxxxx
[President & Chief Executive Officer]
Attest
/s/ Xxxxxx X. Xxxxx
[Secretary]
AUL American Series
Guaranteed Benefit Employer-Sponsored TDA
Multiple-Fund Group Variable Annuity [(SBR)]
Current Interest Credited
Nonparticipating
ACCUMULATION UNITS IN AN INVESTMENT ACCOUNT UNDER THIS CONTRACT MAY INCREASE OR
DECREASE IN VALUE ACCORDING TO THE INVESTMENT PERFORMANCE OF THE UNDERLYING
INVESTMENTS HELD BY THE INVESTMENT ACCOUNT. THE VALUE OF SUCH ASSETS AND
ACCUMULATION UNITS IS NOT GUARANTEED. SECTION [4] OF THIS CONTRACT EXPLAINS THE
VALUATION OF SUCH ASSETS AND ACCUMULATION UNITS.
If you have questions concerning your contract, or wish to register a complaint,
you may reach us by calling [0-000-000-0000].
GBErTDA.OM-ChuK
[(SBR)]
TABLE OF CONTENTS
SECTION 1 - DEFINITIONS [3]
SECTION 2 - ADMINISTRATION OF PARTICIPANT ACCOUNTS [7]
2.1----- How Contributions Are Handled
2.2----- Transfers from Other Retirement Programs
2.3----- Reallocation of Participant Accounts
2.4----- Excess Contributions
2.5----- Transfers from Other Contracts
SECTION 3 - OPERATION OF FIXED INTEREST ACCOUNT [9]
3.1----- Allocations to Participant Accounts
3.2----- Provision of Guaranteed Rates for Interest Pockets
3.3----- Renewal of Guaranteed Rates
3.4----- Minimum Rate Guarantee
3.5----- Allocation of Withdrawals
3.6----- Limitation on Contributions and Transfers to FIA
SECTION 4 - VALUATION OF INVESTMENT ACCOUNTS [10]
4.1----- Operation of Investment Accounts
4.2----- Valuation of Mutual Funds and Other Entities
4.3----- Accumulation Units
4.4----- Value of Accumulation Units
4.5----- Valuing Participant Accounts
SECTION 5 - BENEFIT PAYMENTS AND TRANSFERS [11]
5.1----- General Withdrawal Provisions
5.2----- Plan Benefit Payments
5.3----- Transfers Between Investment Options
5.4----- Transfers to and from the FIA
SECTION 6 - ANNUITIES [15]
6.1----- Annuity Purchases
6.2----- Annuity Options
6.3----- Determining Annuity Amount
6.4----- Proof of Age and Survival; Minimum Payments
6.5----- Annuity Certificates
SECTION 7 - OTHER CONTRACT CHARGES
[16]
7.1----- Investment Option Charge (IOC)
7.2----- Taxes
7.3----- Reduction or Waiver of Charges
7.4----- Other Charges
[7.5----- Variable Investment Plus (VIP) Credit Factor
GBErTDA.OM-ChuK
[(SBR)] 1
SECTION 8 - CONTRACT MODIFICATIONS [18]
8.1----- Contract Amendment
8.2----- Rates and Section 7 Charges
[8.3----- Conformance with Law]
[8.4----- Addition, Deletion, or Substitution of Investments]
[8.5]----- Our Right to Initiate Changes
[8.6]----- Prohibited Amendments
SECTION 9 - TERMINATION OF PARTICIPATION IN CONTRACT [20]
9.1----- Termination by [the Plan Sponsor]
9.2----- Payment Upon Termination by [the Plan Sponsor]
9.3----- Termination by Us
9.4----- Payment Upon Termination by Us
9.5----- Indemnification Required
9.6----- Effect on Contract Obligations
SECTION 10 - GENERAL PROVISIONS [22]
10.1----- Ownership
10.2----- Entire Contract
10.3----- Benefit Determinations
10.4----- Representations and Warranties
10.5----- Contractholder [or Plan Sponsor] Representative; Misstatement
of Data
10.6----- Form of Request, Notice, Instruction, or Direction
10.7----- [Quarterly] Statement of Account Value
10.8----- Conformity with Law
10.9----- Gender and Number
10.10---- Facility of Payment
10.11---- Voting
10.12---- Acceptance of New Participants or Contributions
10.13---- Our Annual Statement
10.14---- Nonforfeitability and Nontransferability
10.15---- Notice of Annual Meeting of Members
[10.16---- Recordkeeping Services]
[TABLE OF CONTRACT CHARGES]
[25]
[TABLE OF GUARANTEED IMMEDIATE ANNUITIES] [26]
[TABLE OF INVESTMENT ACCOUNTS] [27]
GBErTDA.OM-ChuK
[(SBR)] 2
SECTION 1 - DEFINITIONS
1.1 "Account Value" for a Participant Account as of a date is:
(a) that account's balance of funds in the Fixed Interest Account (FIA),
if any, on that date; plus
(b) the value of that account's Accumulation Units in each Investment
Account on that date.
1.2 "Accumulation Unit" is a valuation device used to measure increases in and
decreases to the value of any Investment Account.
1.3 "Annuity Commencement Date" is the first day of the month an annuity begins
under this contract. This date may not be later than the date a
Participant's periodic benefits are required to commence under the Code.
1.4 "Business Day" is any day both the New York Stock Exchange and our Home
Office are open for the general conduct of business.
1.5 "Code" means the Internal Revenue Code of 1986, as amended, and any
applicable regulations or rulings thereunder.
1.6 The "First Contract Anniversary" is listed on the contract face page.
Subsequent "Contract Anniversaries" are on the same day of each subsequent
year.
1.7 "Contract Quarter" is each of the four successive three-month periods in a
Contract Year.
1.8 The first "Contract Year" starts on the Contract Date and ends on the day
before the First Contract Anniversary. Each subsequent Contract Year starts
on a Contract Anniversary and ends on the day before the next Contract
Anniversary.
1.9 "Contributions" are funds which can be allocated to Participant Accounts
according to instructions and which have been paid to us pursuant to a Plan
or transferred from a prior AUL group annuity contract or a prior funding
medium. Such transferred funds may be listed under categories other than
"Contributions" on annual and quarterly reporting.
1.10 A "Contribution-Source" means each type of Contribution allowed under the
Participant's Plan, including the following:
(a) "Elective Deferrals," which means, with respect to any taxable year,
any Contribution made under a salary reduction agreement. A
Contribution made under a salary reduction agreement is not treated as
an Elective Deferral if, under the salary reduction agreement, such
Contribution is made pursuant to a one-time irrevocable election made
by the Participant at the time of initial eligibility to participate
in the agreement, or is made pursuant to a similar arrangement
involving a one-time irrevocable election specified in Regulations
issued under the Code.
(b) "Employee Mandatory Contributions," which means Contributions made
under a salary reduction agreement pursuant to a one-time irrevocable
election made by the Participant at the time of initial eligibility to
participate in the agreement, or made pursuant to a similar
arrangement involving a one-time irrevocable election specified in
Regulations issued under the Code.
(c) "Employer Contributions," which means Contributions made by the
Participant's employer
GBErTDA.OM-ChuK
[(SBR)] 3
that are not made pursuant to (a) or (b) above.
1.11 ["Death Benefit" is the greater of:
(a) the Participant's Account Value as of the date the Death Benefit is
calculated, or
(b) (1) the Guaranteed Minimum Death Benefit (GMDB) on the Contract
Anniversary immediately preceding the date of the Participant's death,
increased by
(2) any Contributions made for the Participant since the last
Contract Anniversary, reduced proportionately to reflect
(3) any withdrawals by the Participant since the last Contract
Anniversary.]
1.12 "Excess Contributions" are Contributions in excess of the applicable Code
limits.
1.13 "Fixed Interest Account" or "FIA" is an Investment Option described in
Section 3 to which Contributions may be allocated for accumulation at the
Guaranteed Rates. The FIA funds constitute a portion of our general asset
account.
1.14 [The "Guaranteed Minimum Death Benefit" or "GMDB" prior to the first
Contract Anniversary is equal to the Contributions made for a Participant
minus any of his withdrawals or loans. On each Contract Anniversary prior
to, or concurrent with, the Participant's date of death, the GMDB is reset,
based on the age of the Participant on his last birthday, as follows:
(a) For Participants less than 81 years of age, the GMDB is the greater
of:
(1) the Participant's Account Value as of the current Contract
Anniversary, or
(2) (A) the GMDB as of the immediately preceding Contract
Anniversary; increased by
(B) any Contributions made for the Participant since the
immediately preceding Contract Anniversary; and reduced
proportionately to reflect
(C) any withdrawals by the Participant since the immediately
preceding Contract Anniversary.
(b) For Participants 81 years of age or older, the GMDB is equal to:
(1) the GMDB as of the immediately preceding Contract Anniversary,
increased by
(2) any Contributions made for the Participant since the immediately
preceding Contract Anniversary, reduced proportionately to
reflect
(3) any withdrawals by the Participant since the immediately
preceding Contract Anniversary.
As of the Participant's date of death, the GMDB ceases to increase or
decrease in value.]
GBErTDA.OM-ChuK
[(SBR)] 4
1.15 "Guaranteed Rates" are the guaranteed annual effective rates of interest we
credit to each Interest Pocket. We credit interest daily to each Interest
Pocket. A Guaranteed Rate may be modified only as described in Section 3.3.
1.16 "Home Office" is our principal office in Indianapolis, Indiana. For
anything to be "received by AUL," it must be received at our Home Office.
1.17 "Interest Pocket" means a tracking method which associates funds allocated
to the FIA over a specific time period with a specific Guaranteed Rate, as
described in Section 3. After the guaranteed period provided in Section 3.3
has elapsed, we may consolidate two or more Interest Pockets in conjunction
with the announcement of new Guaranteed Rates.
1.18 "Investment Account" means each distinct portfolio established within our
[Variable Account] and identified in the Table of Investment Accounts in
this contract. Amounts allocated to any Investment Account are invested in
the shares of the corresponding Mutual Fund, Portfolio, or other entity
identified in the Table of Investment Accounts. Our "[Variable Account]" is
a separate account we maintain under Indiana law which is called the AUL
American Unit Trust and which is registered under the Investment Company
Act of 1940 as a unit investment trust.
[The following sentence is applicable if the contract is sold as a
non-custodial.]
"Competing Investment Accounts" are those Investment Accounts listed in the
Table of Investment Accounts which are marked with an asterisk (*).
1.19 "Investment Option" is the FIA or any Investment Account.
1.20 "Mutual Fund" means any diversified, open-end, management company made
available by us and listed in the Table of Investment Accounts.
1.21 "Participant" is any person participating in a Plan that has a Participant
Account.
1.22 "Participant Account" is an account under this contract for each
Participant. Each Contribution-Source is tracked separately within the
Participant Account. We credit Contributions to Participant Accounts and
Contribution-Sources as we are directed.
1.23 "Plan" means a Plan Sponsor's plan that is qualified under Code Section
403(b)[(9)] and that invests in this contract.
1.24 "Plan Sponsor" is an employer that sponsors a Plan.
1.25 "Portfolio" is a portfolio established within a particular Mutual Fund, as
described in the Mutual Fund's current prospectus.
1.26 "Valuation Periods" start at the close of each Business Day and end at the
close of the next Business Day.
1.27 The "Withdrawal Charge" is [a percentage of the Account Value withdrawn
under this contract.] The Withdrawal Charge will not apply to Account
Values withdrawn to provide certain benefit payments or an annuity as
described in [Sections 5.2 and 6.1, respectively. The percentage varies by
the Participant Account Year in which the withdrawal is made. The first
Participant Account Year begins on the date we establish the Participant
Account and credit the first Contribution to it, and ends on the day before
the next anniversary of that date. Each Participant Account Year thereafter
begins on such an anniversary date and ends on the day before the next
anniversary
GBErTDA.OM-ChuK
[(SBR)] 5
date.] The Withdrawal Charge percentage is as follows:
[During
Participant Account Years Percentage
1 7
2 6
3 5
4 4
5 3
6 2
7 1
Thereafter 0]
In no event will the cumulative total of all Withdrawal Charges,
including those previously assessed against any amount withdrawn from
a Participant Account, exceed [8.5%] of total Contributions allocated
to that Participant Account.
1.28 "Withdrawal Value" is a Participant's Account Value, less any Withdrawal
Charge.
GBErTDA.OM-ChuK
[(SBR)] 6
SECTION 2 - ADMINISTRATION OF PARTICIPANT ACCOUNTS
2.1 How Contributions Are Handled: Contributions are credited to the
appropriate Contribution-Sources within each Participant Account as we are
directed in allocation instructions. Contributions must be identified as
Elective Deferrals, Employee Mandatory Contributions, or Employer
Contributions. A Participant's initial Contribution is allocated to the
Participant Account [by the second Business Day after] we (1) receive the
initial Contribution or, if later, (2) receive all data necessary to
complete the allocation (including data required to establish the
Participant Account, the amount of the Participant's Contribution, and
Investment Option elections). Subsequent Contributions are allocated to the
Participant Account [on the Business Day] we (1) receive that Contribution
or, if later, (2) receive all data necessary to complete the allocation.
If we receive funds which cannot be allocated to a Participant's Account,
those funds will be returned to [the Plan Sponsor] in their entirety or, at
our option, only the unallocable portion will be returned, [within 5
Business Days.]
[(The following paragraph applicable when issued as custodial.)]
[If we can allocate a Contribution to a Participant's Account, but we have
not received Investment Option elections for that Participant, the
Contribution will be credited to the AUL Money Market Investment Account.
Subsequently received Investment Option elections for that Participant will
be used to allocate future Contributions only. We will transfer amounts
previously allocated for that Participant to the AUL Money Market
Investment Account, plus gains or minus losses thereon, only if we are
directed to make a transfer. This transfer request must be submitted in a
format specifically authorized by us.]
[(The following paragraph applicable when issued as a non-custodial.)]
If we can allocate a Contribution to a Participant's Account, but we have
not received Investment Option elections for that Participant, the
Contribution will be credited to the AUL Money Market Investment Account.
However, such a Contribution will be credited to the FIA (not the AUL Money
Market Investment Account) if the FIA is an available Investment Option and
if you elect the 90-day transfer option outlined in Section 5.4(a)(1).
Subsequently received Investment Option elections for that Participant will
be used to allocate future Contributions only. We will transfer amounts
previously allocated for that Participant to the AUL Money Market
Investment Account (or the FIA), plus gains or minus losses thereon, only
if we are directed to make a transfer. This transfer request must be
submitted in a format specifically authorized by us.]
Participant Account funds may be allocated to Investment Options in any
increments acceptable to us. Investment Option elections remain in effect
until changed by [the Plan Sponsor]. A change in Investment Option
elections is made by giving us new Investment Option elections.
2.2 Transfers from Other Retirement Programs: [If permitted by the Plan and by
applicable state and federal law, we may accept, or may initiate the
transfer of, amounts transferred from other retirement programs. Such
transferred amounts, as identified by the Plan Sponsor, are credited as a
rollover Contribution under the appropriate Participant Account and are
tracked within this contract as required by applicable state and federal
law.]
2.3 Reallocation of Participant Accounts: [The Plan Sponsor] may direct us to
reallocate all or a portion of the Account Value of [any of its Plan
Participants among the Accounts of other of its Plan Participants]. [The
Plan Sponsor] must certify that such reallocation is in accordance with the
Plan.
GBErTDA.OM-ChuK
[(SBR)] 7
2.4 Excess Contributions: Contributions may vary in amount and frequency, as
determined by [the Plan Sponsor's] Plan.
On receipt of instructions from [the Plan Sponsor], we will withdraw Excess
Contributions, plus gains and minus losses, from a Participant Account and
return them to the Participant, or as directed. Such instructions must
state the amount to be returned and certify that such Contributions are
Excess Contributions and that such return is permitted by the Plan and the
Code. A return of Excess Contributions is treated like a Plan benefit
payment, under Section 5.2(a).
No Participant is permitted to have elective deferral contributions (within
the meaning of Code Section 402(g)(3)) made during a calendar year under
this contract, or under any other plans, contracts, or arrangements
maintained by his employer, in excess of the dollar limitation in effect
under Code Section 402(g)(1) and any Regulations issued thereunder for
taxable years beginning in such calendar year.
2.5 Transfers from Other Contracts: We may require amounts transferred to a
Participant Account from other AUL group annuity contracts to be credited
to [the FIA]. We will advise you if this limitation applies before
accepting such a transfer.
GBErTDA.OM-ChuK
[(SBR)] 8
SECTION 3 -- OPERATION OF FIXED INTEREST ACCOUNT
3.1 Allocations to Participant Accounts: We credit each Participant's
Contributions to the FIA based on the information we are provided. We
credit interest daily from the date of the Contribution or transfer to the
FIA to the date of withdrawal or transfer from the FIA to an Investment
Account.
3.2 Provision of Guaranteed Rates for Interest Pockets: At least [10 days] in
advance of each [calendar] [quarter], we will declare a Guaranteed Rate for
the Interest Pocket for that [quarter]. All Contributions or transfers
hereunder which are allocated to the FIA during that [quarter] will earn
interest at that Guaranteed Rate until [that quarterly Interest Pocket
matures on the second January 1 following the quarter in which that pocket
was established.]
3.3 Renewal of Guaranteed Rates: Those [quarterly] Interest Pockets which
mature at the same time will be combined into [an annual renewal Interest
Pocket]. Funds associated with that [annual renewal Interest Pocket] will
earn interest for [a full year] at the Guaranteed Rate declared for that
pocket. A new Guaranteed Rate for each [annual renewal Interest Pocket]
will be declared [at least 30 days prior to January 1 of the year in which
that pocket is established and prior to January 1 of each of the next 4
years which follow the year in which that pocket was established.] An
[annual renewal Interest Pocket] will mature on [the fifth anniversary of
the date of its establishment], when it will be combined into [one annual
portfolio Interest Pocket]. Funds associated with that [annual portfolio
Interest Pocket] will earn interest for [a full year] at the Guaranteed
Rate for that pocket, which will be declared [at least 30 days prior to
every January 1].
3.4 Minimum Rate Guarantee: An Interest Pocket's Guaranteed Rate may not be
less than an annual effective interest rate equal to [the average 5-year
Constant Maturity Treasury Rate reported by the Federal Reserve for the
month of October of the calendar year immediately preceding the calendar
year in which that Interest Pocket's Guaranteed Rate became effective
(rounded to the nearest 0.05%), minus 1.25%. This minimum Guaranteed Rate
shall not be less than 1% nor greater than 3%.
3.5 Allocation of Withdrawals: Withdrawals or transfers from the FIA are on a
first-in/first-out (FIFO) basis. All amounts paid during an installment
payout period are paid from all Investment Options on a pro-rata basis.
3.6 Limitation on Contributions and Transfers to FIA: Except for annuity
purchases as described in Section 6.1, we reserve the right to limit or
disallow allocation of new Contributions and transfers to the FIA upon [30
days] notice to [the Plan Sponsor].
GBErTDA.OM-ChuK
[(SBR)] 9
SECTION 4 - VALUATION OF INVESTMENT ACCOUNTS
4.1 Operation of Investment Accounts: All income, gains, or losses, realized or
unrealized, from assets held in any Investment Account are credited to or
charged against the applicable Investment Account without regard to our
other income, gains, or losses. Investment Account assets are not
chargeable with liabilities arising out of any other business we may
conduct.
4.2 Valuation of Mutual Funds and Other Entities: The current report or
prospectus for each Mutual Fund or other entity listed in the second column
of the Table of Investment Accounts describes how that Mutual Fund's or
other entity's assets are valued.
4.3 Accumulation Units: We credit amounts allocated to an Investment Account in
Accumulation Units. The Accumulation Unit value used is the one for the
Valuation Period when we allocate the amount to the Investment Account.
4.4 Value of Accumulation Units: We establish the initial Accumulation Unit
value for a new Investment Account on the inception date of that Investment
Account. The value of an Accumulation Unit for any later Valuation Period
reflects [the Section 4.1 income, gains, and losses and the Section 7.1
Investment Option Charge (IOC)]. We determine the Accumulation Unit value
before giving effect to any additions, withdrawals, or transfers in the
current Valuation Period.
4.5 Valuing Participant Accounts: We determine the Account Value in an
Investment Account by multiplying the Accumulation Units in a Participant
Account by the Accumulation Unit value. The Accumulation Unit value of an
Investment Account changes only on a Business Day.
GBErTDA.OM-ChuK
[(SBR)] 10
SECTION 5 - BENEFIT PAYMENTS AND TRANSFERS
5.1 General Withdrawal Provisions: Subject to the following provisions of this
Section, and prior to notification of contract termination (but not
thereafter), [the Plan Sponsor] may direct us to withdraw all or a portion
of the Account Value of a Participant [in its Plan] pursuant to Section 5.2
to provide a single-sum payment to [the Plan Sponsor] to pay Plan benefits.
(a) Amounts attributable to amounts held as of December 31, 1988 under
another Code Section 403(b) annuity contract may be withdrawn to
provide such benefits.
(b) Contributions made other than pursuant to a salary reduction agreement
(within the meaning of Code Section 402(g)(3)(C)) may be withdrawn to
provide such benefits.
(c) Contributions made pursuant to a salary reduction agreement (within
the meaning of Code Section 402(g)(3)(C)) may be withdrawn to provide
such benefits, provided that the withdrawal is made to provide a loan
or that any distribution of such amount shall not occur until the
Participant has either attained age 59 1/2, severed employment, died,
become totally disabled (as defined by the Plan), or experienced a
hardship (as defined by the Plan). However, in the case of a hardship
withdrawal, any gain credited to such Contributions may not be
withdrawn.
(d) Withdrawal of any amount from this contract which is transferred
directly by us pursuant to [Plan Sponsor] or Participant instructions
to another Code Section 403(b) tax-deferred annuity funding vehicle
under applicable IRS rules and regulations is not the provision of a
Plan benefit for purposes of Section 5.2, but instead is a Contract
termination as to that amount for that Participant; and any such
withdrawal shall be subject to application of the Withdrawal Charge
pursuant to Section 5.2(a)(3). [The Plan Sponsor] hereby grants to a
Participant the right to direct the withdrawal and direct transfer of
his voluntary Elective Deferrals (as determined by [the Plan Sponsor])
to another Code Section 403(b)[(9)] tax-deferred annuity funding
vehicle, subject to Plan provisions.
(e) If, as provided in Internal Revenue Code Regulation Section
1.403(b)-2T Q&A-2, the distributee of any eligible rollover
distribution elects to have the distribution paid directly to an
eligible retirement plan (as defined in Q&A-1 of that Section) and
specifies the eligible retirement plan to which the distribution is to
be paid, then the distribution shall be paid to that eligible
retirement plan in a direct rollover.
(f) We are not responsible for determining a Participant's compliance with
the requirements above. Any withdrawal request must include
certification as to the purpose of the withdrawal. [The Plan Sponsor]
assumes full responsibility for determining whether any withdrawal is
permitted under applicable law and under the terms of its Plan. We may
rely solely upon [the Plan Sponsor's] representations made in the
withdrawal request.
(g) [Withdrawals from a Participant Account's FIA share may not be made in
an amount less than the smaller of $500 or the Participant Account's
entire FIA share. If a withdrawal reduces the Participant Account's
FIA share to less than $500, such remaining share shall also be
withdrawn.]
(h) A withdrawal request is effective, and the Account Value to be applied
pursuant to Section 5.2 is determined, on the Business Day that we
receive a proper withdrawal request (or due proof of death, if
received later).
GBErTDA.OM-ChuK
[(SBR)] 11
(i) We will pay any cash lump-sum to [the Plan Sponsor or its designee]
within [7 days] from the appropriate Business Day as determined in
Subsection (h) above, except as we may be permitted to defer such
payment of amounts withdrawn from the Variable Account in accordance
with appropriate provisions of the federal securities laws. We reserve
the right to defer the payment of amounts withdrawn from the FIA for a
period of up to [6 months] after we receive the withdrawal request.
5.2 Plan Benefit Payments: [The Plan Sponsor] will advise us of any person for
whom a payment is due under its Plan, including the nature and amount of
such payment, before the date such payment is due or as soon thereafter as
is practicable.
(a) Subject to the limitations provided in Section 5.1 (including
application of the Withdrawal Charge to those transfers outlined in
Subsection 5.1(d)) and Subsection (b) below, prior to notification of
contract termination (but not thereafter), [the Plan Sponsor] may
direct us to withdraw all or a portion of the [Account of a
Participant in its Plan] to provide a single-sum payment to [the Plan
Sponsor] to pay:
[(1) Plan benefits for retirement, death, disability, hardships,
loans, required minimum distribution benefits pursuant to Code
Section 401(a)(9), or benefits after age 59 1/2 or as otherwise
allowed by the Code (provided that such benefits after age 59 1/2
or as otherwise allowed by the Code are paid in a taxable
distribution to the Participant). Such a withdrawal is not
subject to a Withdrawal Charge.
(2) Plan benefits for termination of employment. Such a withdrawal is
not subject to a Withdrawal Charge, with the following
exceptions:
(A) Any such payment requested for a Plan Participant who
terminates employment on or after the date the Plan is
terminated is subject to a Withdrawal Charge.
(B) Any such payment requested for a Participant whose
termination of employment is part of a partial Plan
termination under IRS guidelines is subject to a Withdrawal
Charge.
(C) Even if there is no full or partial Plan termination under
Subparagraphs (A) and (B) above, any such termination of
employment payments during the Contract Year (or, at our
option, during the 365-day period preceding our receipt of a
termination of employment benefit payment request) which
exceed 20% of the aggregate Account Value of all Participant
Accounts determined as of the first day of the Contract Year
(or the first day of the 365-day period) are subject to a
Withdrawal Charge.
(D) Any such payment requested for a Participant who terminates
employment on or after the date the Plan Sponsor files for
protection under federal bankruptcy law, is deemed
insolvent, dissolves, closes, or shuts down its business, or
ceases operations is subject to a Withdrawal Charge.
GBErTDA.OM-ChuK
[(SBR)] 12
(3) Plan benefits not otherwise listed in Paragraphs (1) and (2)
above. Such a withdrawal is subject to a Withdrawal Charge.]
(b) Regarding death benefits specifically, notwithstanding the provisions
of Section 9, upon receipt from [the Plan Sponsor] of instructions and
of due proof of the Participant's (and, if applicable, the
beneficiary's) death prior to the date the Participant Account is
closed, we will apply the Account Value of the Participant Account,
minus any charges described in Section 7 that are not included in the
Accumulation Unit value, for the purpose of providing a death benefit
under the Plan. The death benefit will be paid to the Participant's
beneficiary according to the method of payment elected by the
beneficiary (unless such method of payment was previously elected by
the Participant). The Participant's beneficiary may also designate a
beneficiary.
The death benefit will be payable:
(1) in a single sum or other method not provided in (2) below;
provided, however, that the entire Account Value, minus any
charges described in Section 7 that are not included in the
Accumulation Unit value, must be paid to the beneficiary on or
before December 31 of the calendar year which contains the fifth
anniversary of the Participant's death, or
(2) as an annuity in accordance with the Annuity Options shown in
Section 6.2 over a period not to exceed the life or life
expectancy of the beneficiary. If the beneficiary is not the
Participant's surviving spouse, the annuity must begin on or
before December 31 of the calendar year immediately following the
calendar year in which the Participant died. If the beneficiary
is the Participant's surviving spouse, the annuity need not begin
before December 31 of the calendar year in which the Participant
would have attained age 70 1/2.
If a Participant dies on or after his Annuity Commencement Date,
any interest remaining under the Annuity Option selected will be
paid at least as rapidly as prior to the Participant's death.
(c) Under Subsection (a)(2) (A), (B), (C), and (D) and under (a)(3) above,
if the entire Account Value is withdrawn, the amount paid equals the
Withdrawal Value minus any charges described in Section 7 which are
not included in the Accumulation Unit value. If a portion of the
Account Value is withdrawn, the Account Value is reduced by an amount
sufficient to make the payment requested and to cover the Withdrawal
Charge and any charges described in Section 7 which are not included
in the Accumulation Unit value.
5.3 Transfers between Investment Options: [The Plan Sponsor] may direct us to
transfer amounts between Investment Options, or to initiate
Participant-directed transfers between Investment Options. A transfer is
deemed "Participant-directed" only if it reflects the Participant's
investment choice, free of any suggestion or influence by [you,] the Plan
Sponsor, or any fiduciary or other party to the administration or
management of the Plan [(with the exception of any investment advice
rendered by a third-party provider for whom an Investment Advice Provider
Fee is earned under the Table of Contract Charges)]. A transfer that is not
"Participant-directed" is subject to Section 5.4(b). Transfers are
effective on [the Business Day we receive the transfer direction]. Transfer
directions for a Participant Account may be made [daily on any Business
Day]. We will make the transfer as
GBErTDA.OM-ChuK
[(SBR)] 13
requested within [7 days] from the date we receive the request, except as
we may be permitted to defer the transfer of amounts withdrawn from the
Variable Account in accordance with appropriate provisions of the federal
securities laws. We reserve the right to defer a transfer of amounts from
the FIA for a period of up to [6 months] after we receive the transfer
request.
5.4 Transfers to and from the FIA:
[(a) Participant-directed Transfers (as defined in Section 5.3):
[(Subsection (1) and (2)applicable when contract is issued as a custodial)]
(1) if a Participant's FIA Account Value is less than $2,500 as of
the first day of the Contract Year in which we receive the
transfer request, the Participant may transfer any amount from
the FIA.
(2) if a Participant's FIA Account Value is $2,500 or more as of the
first day of the Contract Year in which we receive the transfer
request, no more than 20% of the Participant's FIA Account Value
as of the first day of that Contract Year less amounts previously
transferred by him during that Contract Year may be transferred
by him from the FIA as of the date we receive the transfer
request.
[(Subsection (1) and (2)applicable when contract is issued as a non-custodial)]
(1) If you do not make available to Participants any of the Competing
Investment Accounts identified in the Table of Investment
Accounts, once a Participant transfers funds from the FIA to an
Investment Account, he may transfer funds to the FIA only after
90 days have elapsed since the date of his last transfer from the
FIA.
(2) If you make available to Participants any of the Competing
Investment Accounts identified in the Table of Investment
Accounts, the 90-day transfer restriction discussed in Paragraph
(1) above does not apply. Instead:
(A) if a Participant's FIA Account Value is less than $2,500 as
of the first day of the Contract Year in which we receive
the transfer request, the Participant may transfer any
amount from the FIA.
(B) if a Participant's FIA Account Value is $2,500 or more as of
the first day of the Contract Year in which we receive the
transfer request, no more than 20% of the Participant's FIA
Account Value as of the first day of that Contract Year less
amounts previously transferred by him during that Contract
Year may be transferred by him from the FIA as of the date
we receive the transfer request.
(b) Contractholder-directed Transfers:
(1) Contractholder-directed transfers to the FIA from an Investment
Account are subject to our approval.
(2) We may cease to permit Contractholder-directed transfers upon 30
days notice.]
GBErTDA.OM-ChuK
[(SBR)] 14
SECTION 6 - ANNUITIES
6.1 Annuity Purchases: Prior to notification of contract termination (but not
thereafter), [the Plan Sponsor] may withdraw all or a portion of the
Account Value of a Participant in its Plan to provide an annuity reflecting
Plan benefits. Such a withdrawal is not subject to a Withdrawal Charge. [On
the date we receive an annuity purchase request, we transfer the entire
Participant Account to the FIA if it is an available Investment Option,
otherwise to the AUL Money Market Investment Account. Such amounts remain
in the FIA or the AUL Money Market Investment Account until the full
Account Value (reflecting gains and losses) is applied to purchase the
annuity on the last day of the month preceding the Annuity Commencement
Date. As of that annuity purchase date, such Participant Account funds are
no longer maintained in this contract.]
The annuity purchase request must specify the purpose for the annuity, the
election of an annuity option, Annuity Commencement Date, any contingent
annuitant or beneficiary, and any additional information we require. If the
Participant or any contingent annuitant dies before the Annuity
Commencement Date, the annuity election is cancelled.
The minimum amount which may be applied to purchase an annuity is
[$10,000].
6.2 Annuity Options: [The Plan Sponsor] may elect any optional form of annuity
we offer at the time of purchase. Available annuity options always include:
(a) Life Annuity. A monthly annuity is payable as long as the annuitant
lives.
(b) Survivorship Annuity. A monthly annuity is payable as long as the
annuitant lives. After the annuitant's death, all or a portion of the
monthly annuity is paid to the contingent annuitant as long as the
contingent annuitant lives.
If a certain period annuity is available, the certain period may not
extend beyond the life expectancy of a Participant or the joint life
expectancy of a Participant and any contingent annuitant, as
determined on the Annuity Commencement Date.
6.3 Determining Annuity Amount: We compute the annuity amount using the factors
reflected in the Table of Guaranteed Immediate Annuities attached to this
contract. However, if our current single premium, nonparticipating,
immediate annuity rates for this class of group annuity contract produce a
higher monthly annuity than the Table of Guaranteed Immediate Annuities,
then that more favorable annuity rate is applied.
6.4 Proof of Age and Survival; Minimum Payments: We may require proof of any
annuitant's or contingent annuitant's date of birth before commencing
payments under any annuity. We may also require proof that an annuitant or
contingent annuitant is living before making any annuity payment. If a
monthly annuity is less than our current established minimum payment, we
may make payments on a less-frequent basis.
6.5 Annuity Certificates: We issue to each person for whom an annuity is
purchased a certificate setting forth the annuity's amount and terms.
GBErTDA.OM-ChuK
[(SBR)] 15
SECTION 7 - OTHER CONTRACT CHARGES
7.1 [Investment Option Charge (IOC): Under Section 4.4, the Accumulation Unit
values of all Investment Accounts reflect the daily equivalent of an IOC
expressed as an annual percentage.
The IOC for an Investment Account is applied directly against the
Investment Account and is equal to the sum of "x" + "y" where:
"x" = a current charge for the investment advisory fees and for the
operational, organizational, and other expenses of the
corresponding Mutual Fund, Portfolio, or other entity in which
the Investment Account invests. Periodically, for a given
Investment Account, "x" will change to reflect changes in the
related expenses and other factors. Any change in "x" for an
Investment Account will be effective without prior written
notice. Copies of the prospectuses or reports of the Mutual Fund,
Portfolio, or other entity are available for review.
"y" = current charge of 1.25% for our professional services,
administrative services (including systems recordkeeping and
Investment Account accounting), case acquisition costs,
compliance support, sales office expenses, overhead, sales
commissions, annuity purchase rate guarantees, reasonable profit,
and other related costs.
Taxes: We may deduct charges equal to any premium tax we incur which is
directly related to amounts received for the Participant from the balance
applied to purchase an annuity, or at such other time as premium taxes are
incurred by us. We may also deduct from Investment Accounts reasonable
charges for federal, state, or local income taxes we incur that are
attributable to such Investment Accounts.
7.3 Reduction or Waiver of Charges: We may reduce or waive the Withdrawal
Charge or the charges discussed above if the appropriate expenses
associated with the sale or administration of any contract are reduced.
7.4 Other Charges:
[We apply those charges listed in the Table of Contract Charges.]
[Charges due AUL for which the Plan is responsible, and which the Plan
Sponsor has otherwise agreed to in writing, which are unpaid 60 days after
the payment due date, will be deducted from Participant Accounts on a
pro-rata basis. Charges for which the Plan Sponsor (not the Plan) is
responsible, and which the Plan Sponsor has otherwise agreed to in writing,
must be paid by the Plan Sponsor.]
[7.5 Variable Investment Plus (VIP) Credit Factor: We determine a VIP credit
factor each month by multiplying the portions of the aggregate month-end
Account Value in all Investment Accounts by the monthly equivalent of the
corresponding annual VIP credit factors in the table below. The sum of
these products is divided by the aggregate month-end Account Value in all
Investment Accounts. We multiply the resulting percentage by each
Participant's month-end Account Value in each Investment Account, and add
the resulting amount to the Participant's Account Value for that Investment
Account.
Aggregate Month-End Account Value
GBErTDA.OM-ChuK
[(SBR)] 16
allocated to Investment Accounts Annual VIP Credit Factors
First $ 750,000 0.10%
Next $ 750,000 0.30%
Next $ 1,000,000 0.45%
Next $ 2,500,000 0.75%
Next $ 5,000,000 0.85%
Over $10,000,000 0.95%
The VIP Credit Factor may be reduced by an annual charge percentage equal
to the current fixed dollar charge for expenses you have selected and
agreed to in your AUL administrative services agreement divided by the
aggregate period-end Account Value in all Investment Accounts. Period-end
will be month-end. Alternatively, at our option and upon 30 days notice to
you prior to the beginning of the next calendar quarter, we may use the
aggregate calendar quarter-end Account Value in all Investment Accounts to
calculate this charge. We also reserve the right to revert to a month-end
calculation upon 30 days notice to you prior to the beginning of the month
in which the change is to be effective. Such charge percentage may not
reduce the VIP Credit Factor below 0%.]
GBErTDA.OM-ChuK
[(SBR)] 17
SECTION 8 - CONTRACT MODIFICATIONS
8.1 Contract Amendment: You and we may agree to any change or amendment to this
Contract without the consent of any other person or entity. This contract
cannot be modified or amended, nor can any provision or condition be
waived, except by written authorization of a corporate officer of AUL.
8.2 Rates and Section 7 Charges: We may announce new Guaranteed Rates, as
described in Sections 3.2 and 3.3 (including the consolidation of existing
Interest Pockets). However, as provided in Sections 3.2 and 3.3, we may not
change the declared Guaranteed Rate applicable to an established Interest
Pocket during the guaranteed period. We may also modify the charge levels
in Section 7 (but may not exceed the maximum charge levels listed in the
Table of Contract Charges) using the procedures of Section 8.5.
[8.3 Conformance with Law: We may amend this contract at any time, without your
consent, or that of any other person or entity, if the amendment is
reasonably needed to comply with, or give you, the Plan Sponsor, or
Participants the benefit of, any provisions of federal or state laws. Any
such amendment will be delivered to you prior to its effective date.]
[8.4 Addition, Deletion, or Substitution of Investments:
(a) We reserve the right, subject to compliance with applicable law, to
make additions to, deletions from, substitution for, or combinations
of, the securities that are held by any Investment Account or that any
Investment Account may purchase. We reserve the right to eliminate the
shares of any of the eligible Mutual Funds, Portfolios, or other
entities and to substitute shares of, or interests in, another Mutual
Fund, Portfolio, or another investment vehicle, for shares already
purchased or to be purchased in the future under the contract, if the
shares of any or all eligible Mutual Funds, Portfolios, or other
entities are no longer available for investment or if further
investment in any or all eligible Mutual Funds, Portfolios, or other
entities becomes inappropriate in view of the purposes of the
contract. Where required under applicable law, we will not substitute
any shares in any Investment Account without notice, your approval,
Plan Sponsor approval, or Participant approval, or prior approval of
the Securities and Exchange Commission or a state insurance
commissioner, and without following the filing or other procedures
established by applicable state insurance regulators. Nothing
contained herein will prevent the Variable Account from purchasing
other securities for other series or classes of contracts, or from
effecting a conversion between series or classes of contracts on the
basis of requests made by a majority of other contractholders or as
permitted by federal law.
(b) We reserve the right to establish additional Investment Accounts, each
of which would invest in the corresponding Mutual Fund, Portfolio, or
other entity, or in other securities or investment vehicles. We
reserve the right to eliminate or combine existing Investment Accounts
if marketing, tax, or investment conditions warrant. We reserve the
right to provide other Investment Options under this contract at any
time. Subject to any required regulatory approvals, we reserve the
right to transfer assets from any Investment Account to another
separate account of AUL or Investment Account.
(c) In the event of any such substitution or change, we may, by
appropriate amendment, make such changes in this contract as may be
necessary or appropriate to reflect such substitution or change. Any
transfer request or Investment Option election received on
GBErTDA.OM-ChuK
[(SBR)] 18
or after the effective date of such substitution or change which
reflects the previous Investment Option which has been substituted or
changed will be transacted using the new substituted or changed
Investment Option. If deemed by us to be in the best interests of
persons or entities having voting rights under this contract, the
Variable Account may be operated as a management investment company
under the Investment Company Act of 1940 or any other form permitted
by law, it may be deregistered in the event such registration is no
longer required under the Investment Company Act of 1940, or it may be
combined with other separate accounts of AUL or an affiliate thereof.
We may take such action as is necessary to comply with, or to obtain,
exemptions from the Securities and Exchange Commission with regard to
the Variable Account. Subject to compliance with applicable law, we
also may combine one or more Investment Accounts and may establish a
committee, board, or other group to manage one or more aspects of the
Investment Accounts.]
[8.5] Our Right to Initiate Changes: In addition to those amendments permitted
by Sections 8.2, 8.3, and 8.4, we may initiate an additional provision or
modification of any other provision of this contract (except for those
prohibited amendments listed in Section 8.6) by giving you [60 days] notice
of such modification. Any such modification is effective without your
affirmative assent.
[8.6] Prohibited Amendments:
(a) Notwithstanding our right to initiate changes under Section 8.5, we
may not initiate changes to the minimum rate guarantee provision
specified in Section 3.4, our obligation to set Guaranteed Rates for
the period of time specified in Sections 3.2 and 3.3, the payment
provisions upon contract termination specified in Section 9.2, the
maximum charge levels listed in the Table of Contract Charges, or the
Table of Guaranteed Immediate Annuities.
(b) No modification to this contract may change the terms of a previously
purchased annuity or reduce any interest guarantee applicable to
Participant Account balances held in the FIA on the modification's
effective date.
GBErTDA.OM-ChuK
[(SBR)] 19
SECTION 9 - TERMINATION OF PARTICIPATION IN CONTRACT
9.1 Termination by [the Plan Sponsor]: [The Plan Sponsor] may terminate its
participation in this contract by giving us notice and electing a form of
payment described in Section 9.2. Such termination is effective on [the
Business Day that we receive such notice.]
9.2 Payment Upon Termination by [the Plan Sponsor]: If [the Plan Sponsor]
terminates its participation in the contract, [the Plan Sponsor] may elect
the following options:
(a) (1) Payment of Investment Accounts in Lump-Sum: The aggregate
Investment Account Withdrawal Value of all Participant Accounts
[of the Plan Sponsor shall be paid to the Plan Sponsor] in a
lump-sum.
(2) Payment of FIA in Lump-Sum: If "j" is greater than or equal to
"i" on the calculation date, the aggregate FIA Withdrawal Value
of all Participant Accounts [of the Plan Sponsor] shall be paid
to [the Plan Sponsor] in a lump-sum. For this purpose, "i" equals
the Guaranteed Rate we credit to new Contributions and "j" equals
the dollar-weighted average rate of interest we credit to amounts
to be withdrawn from the FIA under this Section [for the Plan
Sponsor]. Such Withdrawal Value shall be determined on the
effective date of termination of contract participation and paid
within [7 days] from that termination effective date, except as
we may be permitted to defer payment in accordance with
appropriate provisions of the federal securities laws.
(3) Payment of FIA in Installments: If "i" is greater than "j" (as
"i" and "j" are defined in Paragraph (2) above) on the
calculation date, the aggregate FIA Withdrawal Value of all
Participant Accounts [of the Plan Sponsor] shall be paid to [the
Plan Sponsor] in [6]equal annual installments. The initial FIA
installment is calculated on the termination of participation
effective date and paid within [7 days] from the effective date
of termination of contract participation. Subsequent installments
are paid on the anniversary of that termination effective date.
During the installment payment period, interest is credited to
amounts in the FIA at a rate equal to the current average
Guaranteed Rate (as determined on the first installment payment
date) of all of the [Plan Sponsor's] Interest Pockets, less [1%].
The minimum rate guarantee provided in Section 3.4 applies to the
interest credited under this Section. Interest is paid with each
installment.
(b) Transfer to Another Contract: [The Plan Sponsor may transfer the
aggregate Account Value of all of its Participant Accounts, or it may
permit a Participant to transfer his Account Value, to any group
annuity contract which has a withdrawal charge which we may make
available. The Plan Sponsor may transfer the aggregate Withdrawal
Value of all of its Participant Accounts, or it may permit a
Participant to transfer his Withdrawal Value, to any group annuity
contract which does not have a withdrawal charge which we may make
available. Any such amounts are transferred on the effective date of
termination of participation in the contract.]
9.3 Termination by Us: We have the right, subject to applicable state law, to
terminate any Participant Account established under this contract at any
time during the Contract Year if the Account Value of the Participant
Account is less than [$200] for the first Contract Year in which a
Contribution is made
GBErTDA.OM-ChuK
[(SBR)] 20
for the Participant, and [$400] for any subsequent Contract Year, and at
least [6 months] have elapsed since the last previous Contribution to the
contract. If we elect to terminate a Participant Account, the termination
will be effective on the date [6 months] following the date we give notice
to [the Plan Sponsor] and the Participant that the Participant Account is
to be terminated, provided that any Contributions made during the [6-month
period] are insufficient to raise the Account Value up to the minimum
level.
9.4 Payment Upon Termination by Us: As of the effective date of termination of
a Participant Account by us, we may elect to have a single sum equal to the
Account Value of the Participant Account on the effective date of
termination paid to [the Plan Sponsor] within [7 days] from that date. Any
such payment is in full settlement of the Participant Account under this
contract and in lieu of any other payment under its terms.
9.5 Indemnification Required: Payments or transfers under Section 9.2 are in
full settlement of our obligations [to the Plan Sponsor and its
Participants] under this contract. Prior to making such payments or
transfers under Section 9.2, we may require [you and the] Plan Sponsor to
indemnify and hold us harmless from any and all losses, claims, or demands
that may later be asserted against us in connection with the making of such
payment or transfer.
9.6 Effect on Contract Obligations: Any annuities purchased prior to
notification of termination of participation in the contract are unaffected
by a termination. We may refuse further Contributions at any time after a
termination notice has been given. This contract terminates automatically
if no amounts remain in either the FIA or any Investment Account.
[If we have been providing recordkeeping services, such services stop on
the termination effective date. If we cease to provide Plan recordkeeping
for any reason, any administrative services agreement between the Plan
Sponsor and us regarding its Plan and/or this contract is thereby
terminated.]
GBErTDA.OM-ChuK
[(SBR)] 21
SECTION 10 - GENERAL PROVISIONS
10.1 Ownership: You own this contract. No other person or entity has any right,
title, or interest in this contract or to amounts received or credited
under it until such amounts are made available to them. All amounts
received or credited under this contract become our property. We are
obligated to make only the payments or distributions specified in this
contract.
10.2 Entire Contract: This contract and your application constitute the entire
agreement between you and us. We are not a party to, nor bound by, a Plan
or trust, or any amendment or modification to any of the same. We are not a
fiduciary under this contract or under any such Plan or trust.
10.3 Benefit Determinations: [The Plan Sponsor] will furnish us whatever
information is necessary to establish the eligibility for and amount of
annuity or other benefit due. We rely solely on [the Plan Sponsor's]
instructions and certifications with respect to Participant benefits. [The
Plan Sponsor] is fully responsible for determining:
(a) whether benefit payments are permitted under applicable law and its
Plan and
(b) the existence or amount of Excess Contributions (plus gains or minus
losses thereon), or that returns of Excess Contributions are permitted
by its Plan and the Code.
We may rely on [the Plan Sponsor's or its designee's] statements or
representations in honoring any benefit payment request.
[We require that a Participant execute and submit to us an affidavit
which we prepare in order that we may process that Participant's
benefit payable under this contract if you, the Plan Sponsor, the Plan
Trustee, and the Plan Administrator are no longer in existence at the
time we receive that Participant's benefit payment request.]
10.4 Representations and Warranties: You and we mutually represent and warrant,
each to the other, that each is fully authorized to enter into this
contract and that this contract is a valid and binding obligation and that
the execution of this contract does not violate any law, regulation,
judgment, or order by which the representing party is bound. In addition,
[the Plan Sponsor] represents and warrants to us that:
(a) the Plan meets the requirements of Code Section 403(b)[(9)];
(b) the execution of this contract has been authorized by the Plan
fiduciary responsible for Plan investment decisions; and
(c) the execution or performance of this contract does not violate any
Plan provision or any law, regulation, judgment, or order by which the
Plan is bound.
We do not make any representation or warranty regarding the federal,
state, or local tax status of this contract, any Participant Account,
or any transaction involving this contract.
10.5 Contractholder [or Plan Sponsor] Representative; Misstatement of Data: [You
or the Plan Sponsor] may designate a representative to act on [your or its]
behalf under Sections 2 or 3 or to receive any payment under Sections 5 or
9. We may rely on any information you furnish or your designee, [the Plan
Sponsor, its designee,] or a Participant furnishes. We need not inquire as
to the accuracy or
GBErTDA.OM-ChuK
[(SBR)] 22
completeness of such information. If any essential data pertaining to any
person has been omitted or misstated, including, but not limited to, a
misstatement of an annuitant's or contingent annuitant's age, we will make
an equitable adjustment to provide the annuity or other benefit determined
using correct data.
10.6 Form of Request, Notice, Instruction, or Direction: When reference is made
to you, your designee, [the Plan Sponsor, its designee,] or a Participant
making a request or giving notice, instruction, or direction, such request,
notice, instruction, or direction must be in writing, or in a form
otherwise acceptable to us, and is effective when we receive it.
10.7 [Quarterly] Statement of Account Value: Reasonably promptly after the end
of each [Contract Quarter], we will prepare a statement of the Account
Value for each Participant Account that is maintained under this contract.
10.8 Conformity with Law: Any benefit payable under this contract shall not be
less than the minimum benefit required by the insurance laws of the state
in which the contract is delivered. Language in this contract referring to
state or federal tax, securities, or other statutes or rules do not
incorporate within this contract any such statutes or rules.
10.9 Gender and Number: Whenever the context so requires, the plural includes
the singular, the singular the plural, and the masculine the feminine.
10.10 Facility of Payment: If any Participant, contingent annuitant, or
beneficiary is legally incapable of giving a valid receipt for any payment,
if no guardian has been appointed, and if we receive a valid power of
attorney for such Participant, contingent annuitant, or beneficiary, we may
pay the person or persons named in such power of attorney. We may also pay
[the Plan Sponsor] directly or as [the Plan Sponsor] otherwise instructs.
Any such payment fully discharges us to the extent of such payment.
10.11 Voting: We own all shares of a Mutual Fund, Portfolio, or other entity
held in an Investment Account. We exercise the voting rights of such shares
at all shareholder meetings on all matters requiring shareholder voting
under the Investment Company Act of 1940 or other applicable laws. [Our
vote reflects instructions received from persons having the voting interest
in the shares, as follows:
(a) You have the voting interest under this contract. Unless otherwise
required by applicable law, the number of shares of a Mutual Fund,
Portfolio, or other entity for which you may give voting instructions
is determined by dividing the aggregate Account Values in the affected
Investment Account by the net asset value of the shares of the Mutual
Fund, Portfolio, or other entity. Fractional votes are counted. Our
determination is made as of the date used by the Mutual Fund,
Portfolio, or other entity to determine shareholders eligible to vote.
(b) We vote shares proportionally, to reflect the voting instructions we
receive in a timely manner from you and from all other
contractholders. If no timely voting instructions are received from
you, we vote shares proportionally, to reflect the voting instructions
we received in a timely manner for all other contracts.]
To the extent permitted by applicable law, we may vote shares in our
own right or may modify the above procedures to reflect changes in the
law or its interpretation.
GBErTDA.OM-ChuK
[(SBR)] 23
We will provide prospectuses and other reports as required by
applicable federal law.
[10.12 Acceptance of New Participants or Contributions: We may refuse to accept
new Participants or new Contributions at any time.]
10.13 Our Annual Statement: No provision of this contract controls, determines,
or modifies any annual statement made by us to any insurance department,
contractholder, regulatory body, or other person. Nor does anything in such
annual statement control, determine, or modify the provisions of this
contract.
10.14 Nonforfeitability and Nontransferability: The entire Withdrawal Value of
the vested portion (as determined pursuant to the Plan) of a Participant
Account under this contract is nonforfeitable at all times. No sum payable
under this contract with respect to a Participant may be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person or
entity other than us. In addition, to the extent permitted by law, no such
sum shall in any way be subject to legal process requiring the payment of
any claim against the payee.
10.15 Notice of Annual Meeting of Members: By-law, Art II, Sec. 2: the regular
annual meeting of the members of American United Mutual Insurance Holding
Company shall be held at its principal place of business on [the third
Thursday in February each year at ten o'clock A.M.] local time or at such
other location, place, or time as may be designated by the Board of
Directors. The election of directors shall be held at the annual meeting.
[10.16 Recordkeeping Services: We generally provide Plan recordkeeping services
when all of a Plan's funds are held under this contract. We decline to
provide Plan recordkeeping services if the Plan Sponsor elects to allocate
its Plan funds to investments other than this contract, or if its Plan's
recordkeeping practices, in our judgment, impose an administrative or
financial burden on us. If we cease to provide Plan recordkeeping for any
reason, any administrative services agreement between us and the Plan
Sponsor regarding its Plan and/or this contract is thereby terminated.]
GBErTDA.OM-ChuK
[(SBR)] 24
[TABLE OF CONTRACT CHARGES
(1) Participant Account Charge: We deduct a Participant Account Charge per
Contract Quarter equal to the lesser of $7.50 and 0.5% of the Participant's
Account Value on the last day of each Contract Quarter from each
Participant Account in existence on such day for as long as the Participant
Account is in effect. This charge is to be prorated among each
Contribution-Source utilized under this contract by that Participant
Account. If the entire balance of a Participant Account is applied or
withdrawn before the last day of the Contract Quarter pursuant to the
contract, the Participant Account Charge attributable to the period of time
which has elapsed since the first day of the Contract Quarter in which such
application or withdrawal of funds is made will not be deducted from the
amount applied or withdrawn.
There is no such charge for a Participant for any Contract Quarter in which
the Participant's Account Value on the last day of that quarter is greater
than $25,000.
(2) Charge for Non-Electronic Transfers: We charge a service fee of up to $5
for non-electronic transfers between Investment Options, which will be
deducted from the applicable Participant Account.
(3) Distribution Fee: We assess a Distribution Fee of up to $40 against a
Participant's Account when the entire Account is distributed in a lump-sum.
(4) Individual Participant Check Fee Upon Termination of Participation in the
Contract: We assess a fee of up to $100 against the Account of each
Participant for whom an individual check is prepared upon a Plan Sponsor's
termination of participation in the contract.]
[(5) Investment Advice Provider Fee: We xxxx you for an Investment Advice
Provider Fee in an amount separately agreed upon by you and the third-party
investment advice provider. Alternatively, we may assess this Investment
Advice Provider Fee against the Account of each Participant who utilizes
the investment advice provider's services if permitted under applicable
law, regulations, and rulings. The entire fee collected by us will be
forwarded to the investment advice provider. No portion of this fee will be
retained by us.]
GBErTDA.OM-ChuK
[(SBR)] 25
[TABLE OF GUARANTEED IMMEDIATE ANNUITIES
MONTHLY INCOME PER $1,000 OF ACCOUNT VALUE
10-YEAR CERTAIN
ADJUSTED AGE LIFE ANNUITY AND LIFE ANNUITY
45 2.7498 2.7455
46 2.7986 2.7938
47 2.8498 2.8444
48 2.9036 2.8975
49 2.9602 2.9532
50 3.0197 3.0116
51 3.0823 3.0730
52 3.1483 3.1375
53 3.2178 3.2052
54 3.2913 3.2763
55 3.3690 3.3512
56 3.4511 3.4299
57 3.5381 3.5126
58 3.6301 3.5995
59 3.7273 3.6906
60 3.8300 3.7862
61 3.9387 3.8865
62 4.0536 3.9919
63 4.1751 4.1024
64 4.3037 4.2184
65 4.4397 4.3400
66 4.5837 4.4676
67 4.7365 4.6014
68 4.8992 4.7419
69 5.0735 4.8895
70 5.2610 5.0448
71 5.4635 5.2077
72 5.6823 5.3783
73 5.9180 5.5559
74 6.1718 5.7400
75 6.4456 5.9301
Adjusted Age = Actual Age at Settlement (in years and completed months)
less the following number of months: [0.6 times (Birth Year - 1915)]
rounded to the nearest integer.
Guaranteed purchase rates are 100% of the net single premium for the
benefit provided based on 85% of the unprojected 1994 Group Annuity
Reserving Table for females with interest at 1.5%.]
GBErTDA.OM-ChuK
[(SBR)] 26
TABLE OF INVESTMENT ACCOUNTS
[(Use this paragraph for custodial)]
The following Investment Accounts are made available to you under this contract.
By completing a form we require, [the Plan Sponsor] may restrict the Investment
Accounts made available to [its] Participants. Amounts allocated to any
Investment Account identified below are invested in the shares of the
corresponding Mutual Fund, Portfolio, or other entity listed below.
[(Use this paragraph for non-custodial)]
The following Investment Accounts are made available to you under this contract.
By completing a form we require, you may restrict the Investment Accounts you
make available to your Participants. Amounts allocated to any Investment Account
identified below are invested in the shares of the corresponding Mutual Fund,
Portfolio, or other entity listed below. [The Competing Investment Accounts
marked with an asterisk (*) are not available if your Plan uses the FIA and if
you do not want the FIA 20% annual transfer restriction applicable to
Participant-directed transfers provided in Section 5.4(a)(2) to apply.]
Investment Account Mutual Fund, Portfolio, or Other Entity
AIM Basic Value AIM Basic Value Fund (A Class)
AIM Energy AIM Energy Fund (K Class)
AIM Financial Services AIM Financial Services Fund (K Class)
AIM Global Health Care AIM Global Health Care Fund (K Class)
AIM Global Equity AIM Global Equity Fund (A Class)
AIM Leisure AIM Leisure Fund (K Class)
AIM Mid Cap Core Equity AIM Mid Cap Core Equity Fund (R Class)
AIM Small Cap Growth AIM Small Cap Growth Fund (R Class)
AIM Technology AIM Technology Fund (K Class)
AllianceBernstein Focused Growth & Income AllianceBernstein Focused Growth & Income Fund (R Class)
AllianceBernstein Global Value AllianceBernstein Global Value Fund (R Class)
AllianceBernstein International Value AllianceBernstein International Value Fund (R Class)
AllianceBernstein Mid-Cap Growth AllianceBernstein Mid-Cap Growth Fund (R Class)
AllianceBernstein Small/Mid Cap Value AllianceBernstein Small/Mid Cap Value Fund (R Class)
AllianceBernstein Small-Cap Growth AllianceBernstein Small - Cap Growth Fund (R Class)
AllianceBernstein Value AllianceBernstein Value Fund (R Class)
AllianceBernstein International Growth AllianceBernstein International Growth Fund (R Class)
Allianz CCM Capital Appreciation Allianz CCM Capital Apprecitaion Fund (R Class)
Allianz NFJ Small-Cap Value Fund Allianz NFJ Small-Cap Value Fund (R Class)
Allianz OpCap Renaissance Fund Allianz OpCap Renaissance Fund (R Class)
Allianz OpCap Value Allianz OpCap Value Fund (R Class)
American Century(R) Equity Growth American Century(R) Equity Growth Fund (Advisor Class)
American Century(R) Equity Income American Century(R) Equity Income Fund (Advisor Class)
American Century(R) Xxxxxx Mae American Century(R) Xxxxxx Xxx Fund (Advisor Class)
American Century(R) Growth American Century(R) Growth Fund (Advisor Class)
American Century(R) Heritage American Century(R) Heritage Fund (Advisor Class)
American Century(R) Inflation-Adjusted Bond American Century(R) Inflation-Adjusted Bond Fund (Advisor Class)
American Century(R) International Growth American Century(R) International Growth Fund (Advisor Class)
American Century(R) New Opportunities II American Century(R) New Opportunities II Fund (A Class)
American Century(R) Large Company Value American Century(R) Large Company Value Fund (Advisor Class)
American Century(R) Real Estate American Century(R) Real Estate (Advisor Class)
American Century(R) Select American Century(R) Select Fund (Advisor Class)
American Century(R) Strategic Allocation: Aggressive American Century(R) Strategic Allocation: Aggressive Fund (Advisor Class)
American Century(R) Strategic Allocation: Conservative American Century(R) Strategic Allocation: Conservative Fund (Advisor Class)
American Century(R) Strategic Allocation: Moderate American Century(R) Strategic Allocation: Moderate Fund (Advisor Class)
American Century(R) Ultra American Century(R) Ultra Fund (Advisor Class)
American Century(R) Vista Fund American Century(R) Vista Fund (Advisor Class)
Dreyfus Premier Future Leaders Dreyfus Premier Future Leaders Fund (T Class)
Dreyfus Premier New Leaders Dreyfus Premier New Leaders Fund (T Class)
GBErTDA.OM-ChuK
[(SBR)] 27
Dreyfus Premier Small Cap Value Dreyfus Premier Small Cap Value Fund (T Class)
Dreyfus Premier Structured MidCap Dreyfus Premier Structured MidCap Fund (T Class)
Dreyfus Premier Third Century Dreyfus Premier Third Century Fund (T Class)
Dreyfus Premier Worldwide Growth Dreyfus Premier Worldwide Growth Fund (T Class)
Fidelity(R) Advisor Dividend Growth Fidelity(R) Advisor Dividend Growth Fund (T Class)
Fidelity(R) Advisor Dynamic Capital Appreciation Fidelity(R) Advisor Dynamic Capital Appreciation Fund (T Class)
Fidelity(R) Advisor Equity Growth Fidelity(R) Advisor Equity Growth Fund (T Class)
Fidelity(R) Advisor Equity Income Fidelity(R) Advisor Equity Income Fund (T Class)
Fidelity(R) Advisor Growth & Income Fidelity(R) Advisor Growth & Income Fund (T Class)
Fidelity(R) Advisor Growth Opportunities Fidelity(R) Advisor Growth Opportunities Fund (T Class)
Fidelity(R) Advisor New Insights Fidelity(R) Advisor New Insights Fund (T Class)
Fidelity(R) Advisor Small Cap Fidelity(R) Advisor Small Cap (T Class)
Fifth Third Mid Cap Growth Fifth Third Mid Cap Growth Fund (Advisor Class)
Fifth Third Multi Cap Value Fifth Third Multi Cap Value Fund (Advisor Class)
Fifth Third Quality Growth Fifth Third Quality Growth Fund (Advisor Class)
Fifth Third Strategic Income Fifth Third Strategic Income Fund (Advisor Class)
Fifth Third Technology Fifth Third Technology Fund (Advisor Class)
Franklin Capital Growth Franklin Capital Growth Fund (R Class)
Franklin Flex Cap Growth Franklin Flex Cap Growth Fund (R Class)
Franklin Small Mid Cap Growth Franklin Small Mid Cap Growth Fund (R Class)
Franklin Strategic Income Franklin Strategic Income Fund (R Class)
Janus Adviser Risk-Managed Growth Janus Adviser Risk-Managed Growth Fund (I Class)
Janus Adviser Small Company Value Janus Adviser Small Company Value Fund (I Class)
Lord Xxxxxx Developing Growth Lord Xxxxxx Developing Growth Fund (P Class)
Lord Xxxxxx Growth Opportunities Lord Xxxxxx Growth Opportunities Fund (P Class)
Lord Xxxxxx Small-Cap Blend Lord Xxxxxx Small-Cap Blend Fund (P Class)
Xxxxxxxxx Xxxxxx Xxxxxxxx Xxxxxxxxx Xxxxxx Xxxxxxxx Fund (Advisor Class)
Xxxxxxxxx Xxxxxx Focus Xxxxxxxxx Xxxxxx Focus Fund (Advisor Class)
Xxxxxxxxx Xxxxxx Millennium Xxxxxxxxx Xxxxxx Millennium Fund (Advisor Class)
Xxxxxxxxx Xxxxxx Partners Xxxxxxxxx Xxxxxx Partners Fund (Advisor Class)
OneAmerica(R) Asset Director OneAmerica(R) Asset Director Portfolio (Advisor Class)
OneAmerica(R) Investment Grade Bond OneAmerica(R) Investment Grade Bond Portfolio (Advisor Class)
OneAmerica(R) Money Market* OneAmerica(R) Money Market Portfolio (Advisor Class)
OneAmerica(R) Value OneAmerica(R) Value Portfolio (Advisor Class)
Xxxxxxxxxxx Developing Markets Xxxxxxxxxxx Developing Markets Fund (N Class)
Xxxxxxxxxxx Global Xxxxxxxxxxx Global Fund (N Class)
Xxxxxxxxxxx International Bond Xxxxxxxxxxx International Bond Fund (N Class)
Xxxxxxxxxxx International Small Company Xxxxxxxxxxx International Small Company Fund (N Class)
Xxxxxxxxxxx Main Street Opportunity Xxxxxxxxxxx Main Street Opportunity Fund (N Class)
Xxxxxxxxxxx Small Cap Value Xxxxxxxxxxx Small Cap Value Fund (N Class)
PIMCO High Yield PIMCO High Yield Fund (R Class)
PIMCO Total Return PIMCO Total Return Fund (R Class)
Xxxxxxx LifePoints Aggressive Xxxxxxx LifePoints Aggressive Strategy Fund (D Class)
Xxxxxxx LifePoints Balanced Xxxxxxx LifePoints Balanced Strategy Fund (D Class)
Xxxxxxx LifePoints Conservative Xxxxxxx LifePoints Conservative Strategy Fund (D Class)
Xxxxxxx LifePoints Equity Aggressive Xxxxxxx LifePoints Equity Aggressive Strategy Fund (D Class)
Xxxxxxx LifePoints Moderate Xxxxxxx LifePoints Moderate Strategy Fund (D Class)
State Street Equity 500 Index State Street Equity 500 Index
X. Xxxx Price Blue Chip Growth X. Xxxx Price Blue Chip Growth Fund (R Class)
X. Xxxx Price Equity Income X. Xxxx Price Equity Income Portfolio (R Class)
X. Xxxx Price Growth Stock X. Xxxx Price Growth Stock Fund (R Class)
X. Xxxx Price International Growth & Income X. Xxxx Price International Growth & Income Fund (R Class)
X. Xxxx Price International Stock X. Xxxx Price International Stock Fund (R Class)
Xxxxxxxxx Foreign Xxxxxxxxx Foreign Fund (R Class)
Xxxxxxxxx Growth Xxxxxxxxx Growth Fund (R Class)
Xxxxxxxxx Core Growth Xxxxxxxxx Core Growth Fund (R Class)
GBErTDA.OM-ChuK
[(SBR)] 28
Xxxxxxxxx International Value Xxxxxxxxx International Value Fund (R Class)
Xxxxxxxxx Limited-Term Income Xxxxxxxxx Limited-Term Income Fund (R Class)
Xxxxxxxxx Limited-Term US Govt Xxxxxxxxx Limited-Term US Govt Fund (R Class)
Xxxxxxxxx Value Xxxxxxxxx Value Fund (R Class)
GBErTDA.OM-ChuK
[(SBR)] 29
