GREAT AMERICAN RESERVE INSURANCE COMPANY
00000 X. Xxxxxxxxxxxx Xxxxxx
Xxxxxx, Xxxxxxx 00000-0000
(000) 000-0000
A Stock Company
GREAT AMERICAN RESERVE INSURANCE COMPANY (the "Company") agrees with the Group
Contract Owner to provide benefits to the Certificate Owners, subject to the
provisions set forth in this Contract and in consideration of Purchase Payments
received from the Certificate Owners.
RIGHT TO EXAMINE CONTRACT: Within 10 days of the date of receipt of a
Certificate under this Contract by a Certificate Owner, it may be returned by
delivering or mailing it to the Company at its Administrative Office. When the
Certificate is received by the Company, it will be voided as if it had never
been in force. The Company will refund the Certificate Value computed at the end
of the Valuation Period during which the Certificate is received by the Company
at its Administrative Office.
THIS IS A LEGAL CONTRACT BETWEEN THE OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
SIGNED FOR THE COMPANY AT CARMEL, INDIANA, ON THE CONTRACT DATE.
ABCDEFGH ABCDEFGH
SECRETARY PRESIDENT
ALLOCATED FIXED AND VARIABLE
GROUP ANNUITY CONTRACT
NON-PARTICIPATING
WITHDRAWAL VALUES AND THE DEATH BENEFITS PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT. NON FORFEITURE VALUES MAY INCREASE OR DECREASE
BASED ON THE MARKET VALUE ADJUSTMENT SPECIFIED IN THIS CONTRACT.
TABLE OF CONTENTS
CONTRACT SCHEDULE............................................................4
DEFINITIONS..................................................................7
PURCHASE PAYMENT PROVISIONS..................................................8
PURCHASE PAYMENTS...................................................8
ALLOCATION OF PURCHASE PAYMENTS.....................................9
SEPARATE ACCOUNT PROVISIONS..................................................9
THE SEPARATE ACCOUNTS...............................................9
VARIABLE ACCOUNT....................................................9
VALUATION OF ASSETS.................................................9
ACCUMULATION UNITS..................................................9
ACCUMULATION UNIT VALUE.............................................9
MORTALITY AND EXPENSE RISK CHARGE..................................10
ADMINISTRATIVE CHARGE..............................................10
DISTRIBUTION EXPENSE CHARGE........................................10
MVA ACCOUNT PROVISIONS......................................................10
MVA ACCOUNT........................................................10
INTEREST TO BE CREDITED............................................10
GUARANTEE PERIOD...................................................10
MULTIPLE GUARANTEE PERIODS.........................................10
CHANGE IN GUARANTEE PERIOD.........................................10
MARKET VALUE ADJUSTMENT............................................11
MVA ACCOUNT VALUES.................................................11
FIXED ACCOUNT PROVISIONS....................................................11
FIXED ACCOUNT VALUES...............................................11
INTEREST TO BE CREDITED............................................11
CERTIFICATE VALUE...........................................................11
CERTIFICATE MAINTENANCE CHARGE..............................................12
DEDUCTION FOR CERTIFICATE MAINTENANCE CHARGE.......................12
TRANSFERS...................................................................12
TRANSFERS DURING THE ACCUMULATION PERIOD...........................12
TRANSFERS DURING THE ANNUITY PERIOD................................12
WITHDRAWAL PROVISIONS.......................................................13
WITHDRAWALS........................................................13
CONTINGENT DEFERRED SALES CHARGE...................................13
WITHDRAWAL CHARGE..................................................13
PROCEEDS PAYABLE ON DEATH...................................................13
DEATH OF OWNER DURING THE ACCUMULATION PERIOD......................13
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD................13
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD...............14
DEATH OF OWNER DURING THE ANNUITY PERIOD...........................14
DEATH OF ANNUITANT DURING THE ACCUMULATION PERIOD..................14
DEATH OF THE ANNUITANT DURING THE ANNUITY PERIOD...................14
PAYMENT OF DEATH BENEFIT...........................................14
BENEFICIARY........................................................14
CHANGE OF BENEFICIARY..............................................15
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION................................15
CERTIFICATE OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS..............15
CERTIFICATE OWNER..................................................15
JOINT CERTIFICATE OWNER............................................15
GROUP CONTRACT OWNER...............................................15
ANNUITANT..........................................................15
ASSIGNMENT OF A CERTIFICATE........................................16
ANNUITY PROVISIONS..........................................................16
GENERAL............................................................16
ANNUITY DATE.......................................................16
SELECTION OF AN ANNUITY OPTION.....................................16
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS...........................16
ANNUITY OPTIONS....................................................16
OPTION 1. INCOME FOR SPECIFIED PERIOD
OPTION 2. LIFE INCOME......................................16
OPTION 3. INCOME OF SPECIFIED AMOUNT........................16
OPTION 4. JOINT AND SURVIVOR INCOME.........................16
ANNUITY............................................................17
FIXED ANNUITY......................................................17
VARIABLE ANNUITY...................................................17
ANNUITY UNIT.......................................................17
MORTALITY TABLES...................................................17
GENERAL PROVISION...........................................................17
THE CONTRACT.......................................................17
MISSTATEMENT OF AGE................................................18
INCONTESTABILITY...................................................18
MODIFICATION.......................................................18
NON-PARTICIPATION..................................................18
EVIDENCE OF SURVIVAL...............................................18
PROOF OF AGE`......................................................18
PROTECTION OF PROCEEDS.............................................18
REPORTS............................................................18
PREMIUM TAXES......................................................18
OTHER TAXES........................................................18
REGULATORY REQUIREMENTS............................................18
ANNUITY OPTION TABLES.......................................................19
CONTRACT SCHEDULE
CONTRACT OWNER: [ABC Trust] CONTRACT ISSUE DATE: [November 1, 1997]
CONTRACT NUMBER: [12345] ANNUITY DATE: [November 1, 2032]
PURCHASE PAYMENTS UNDER EACH CERTIFICATE:
INITIAL PURCHASE PAYMENT: [$5,000 Non-Qualified; $2,000 IRA]
MINIMUM SUBSEQUENT PURCHASE PAYMENT: [$500 ($50 for IRAs & EFTs); or $200 monthly for
non qualified contracts if the automatic premium
check option is elected.]
MAXIMUM TOTAL PURCHASE PAYMENT: [$500,000, without prior Company approval]
ALLOCATION GUIDELINES:
[1. The Certificate Owner can select any of the investment options,
including the Sub-Accounts of the Variable Account, the MVA Account
and the Fixed Account Options. However, Certificate Owners are limited
to 15 Sub-Accounts at any one time.
2. If the Purchase Payments and forms required to issue a Certificate
are in good order, the initial Purchase Payment will be credited to
the Certificate Owners Account within two (2) business days after
receipt at the Administrative Office. Additional Purchase Payments
will be credited to the Certificate Owner's Account as of the
Valuation Period when they are received.
3. Allocation percentages must be in whole numbers. Each allocation
must be at least 1%.
4. The minimum amount which must be allocated for any Guarantee Period
in the MVA Account is $2,000. The company reserves the right to change
this minimum in the future.]
BENEFICIARY:
[As designated by the Certificate Owner at the Certificate Issue Date,
unless subsequently changed.]
CERTIFICATE MAINTENANCE CHARGE:
[The Certificate Maintenance Charge is $30 each Certificate Year. The
Company reserves the right to change the Certificate Maintenance
Charge but it will not exceed $60 per Certificate Year. During the
Accumulation Period, if the Certificate Value on the Certificate
Anniversary is at least $50,000, then no Certificate Maintenance
Charge will be deducted. During the Accumulation Period, a total
withdrawal is made on other than a Certificate Anniversary and the
Certificate Value for the Valuation Period during which the total
withdrawal is made is less than $50,000, the full Certificate
Maintenance Charge will be deducted at the time of the total
withdrawal. If at annuitization, the Annuity Date is not the
Certificate Anniversary and the Certificate Value on the Annuity Date
is less than $50,000, then the full Certificate Maintenance Charge
will be deducted on the Annuity Date. During the Annuity Period, no
Certificate Maintenance Charge will be deducted.]
MORTALITY AND EXPENSE RISK CHARGE:
[Equal, on an annual basis, to 1.25% of the average daily net asset
value of the Variable Account.]
ADMINISTRATIVE CHARGE:
[Equal, on an annual basis, to .15% of the average daily net asset
value of the Variable Account. The Company may increase this charge;
however, the maximum Administrative Charge will not exceed .25% of the
average daily net asset value of the Variable Account. In the event of
an increase, the Company will give Certificate Owners 90 days prior
notice of the increase.]
DISTRIBUTION EXPENSE CHARGE:
[NONE]
TRANSFERS:
NUMBER OF TRANSFERS PERMITTED: [There are currently no limits on the
number of transfers that can be made during the Accumulation Period.
Certificate Owners are permitted two transfers per Certificate Year
during the Annuity Period.]
TRANSFER FEE: [The Company does not assess a Transfer Fee on one
transfer in a 30 day period during the Accumulation Period or the two
transfers permitted during the Annuity Period. You can transfer among
the Sub-Accounts at least once every 30 days. If you transfer more
often, you may be assessed a $25 fee. The Company reserves the right
to change the transfer fee. All reallocations made on a given date
count as one transfer. Transfers made at the end of the Right to
Examine Contract period by the Company and any transfers made pursuant
to a pre-approved Dollar Cost Averaging Program or pursuant to a
pre-approved Rebalancing Program will not be counted in determining
the application of the Transfer Fee.]
MINIMUM AMOUNT TO BE TRANSFERRED: [$500 (from any Sub-Account or any
Guarantee Period of the MVA Account), or the Certificate Owner's
entire interest in the Sub-Account or the Guarantee Period, if less.
This requirement is waived if the transfer is pursuant to a
pre-approved Dollar Cost Averaging Program or Rebalancing Program.
Transfers from the Fixed Account are limited to 20% of the Contract
Value every six (6) months.]
MINIMUM AMOUNT WHICH MUST REMAIN IN EACH ACCOUNT AFTER A TRANSFER:
[$500 per Sub-Account or a Guarantee Period in the MVA Account; or $0
if the entire amount in any Sub-Account of the Variable Account or a
Guarantee Period in the MVA Account is transferred.]
MAXIMUM AMOUNT WHICH CAN BE TRANSFERRED FROM THE FIXED ACCOUNT OR MVA
ACCOUNT TO THE VARIABLE ACCOUNT: [NONE]
WITHDRAWALS:
CONTINGENT DEFERRED SALES CHARGE: A Contingent Deferred Sales Charge
is assessed against each Purchase Payment withdrawn [and will result
in a reduction in remaining Contract Value.] The Purchase Payment is
tracked from its date of receipt and the charges are determined in
accordance with the following:
Number of Years from Receipt Contingent Deferred
of Purchase Payment Sales Charge
------------------- ------------
1st Year 7%
2nd Year 7%
3rd Year 6%
4th Year 5%
5th Year 4%
6th Year 3%
7th Year 2%
8th Year and later 0%
Waiver of Contingent Deferred Sales Charge: In every Certificate Year, an amount
equal to the greater of: (i) 10% of the Certificate Value, on a non-cumulative
basis, (ii) the IRS minimum distribution requirement, if the Certificate was
issued as an IRA, or (iii) the total premiums paid that have been in the
Certificate more than seven complete years is available free of Contingent
Deferred Sales Charges.
WITHDRAWAL CHARGE: [NONE]
MINIMUM PARTIAL WITHDRAWAL: [$500 from each Sub-Account of the Variable Account,
each Guarantee Period of the MVA Account and the Fixed Account. This requirement
is waived if the partial withdrawal is pursuant to the Systematic Withdrawal
Program.]
MINIMUM CERTIFICATE VALUE WHICH MUST REMAIN IN CERTIFICATE AFTER A PARTIAL
WITHDRAWAL: [$500]
MINIMUM CERTIFICATE VALUE WHICH MUST REMAIN IN ANY SUB-ACCOUNT OF THE VARIABLE
ACCOUNT AFTER A PARTIAL WITHDRAWAL: [$500]
MAXIMUM AMOUNT WHICH CAN BE WITHDRAWN FROM THE FIXED AND MVA ACCOUNTS: [There is
currently no limitation on the maximum amount which can be withdrawn from the
Fixed Account or the MVA Account.]
SEPARATE ACCOUNTS: Variable Account [Great American Reserve Variable Annuity Account F for the
Variable Annuity portion of the Contract.]
and
MVA Account [Great American Reserve Market Value Adjustment Account for the
portion of the Contract that may be subject to a Market Value
Adjustment.]
MVA ACCOUNT:
Minimum Guaranteed Interest Rate: 3%
Current MVA Account Guarantee Period Options and
Credited Interest Rates:
[1 Year]. [XX%]
[3 Years] [XX%]
[5 Years] [XX%]
MARKET VALUE ADJUSTMENT FACTOR: [The Market Value Adjustment Factor is equal to:
N/365
[(1 + A)/(1 + B)] - 1
where:
A = the U.S. Treasury rate in effect at the beginning of the
Guarantee Period for the length of the guarantee period selected.
B = the current U.S. Treasury rate as of the transaction date plus
.005. Treasury rate period is determined by N/365 rounded to the
next highest year.
N = the number of days remaining in the MVA Guarantee Period.]
If the Treasury rate is not available for the period, the rate will be
arrived at by interpolation. If no Treasury rates are available, an Index
will be selected by the Company and approved by the State Insurance
Commissioner.
[MVA Waiver: For withdrawals from MVA Account Guarantee Period Option,
after the first year in such Guarantee Period option, the Certificate Owner
can make one withdrawal each Certificate Year of up to a total of 10% of
each such Guarantee Period option of the MVA Account without the Market
Value Adjustment.]
FIXED ACCOUNT:
Minimum Guarantee Interest Rate: 3%
Current Interest Rate as of Issue Date: [X%]
RIDERS:
[IRA ENDORSEMENT]
ADMINISTRATIVE OFFICE:
[Great American Reserve Insurance Company Great American Reserve Insurance Company
Administrative Office Administrative Office
P.O. Box 1927..... OR 00000 X. Xxxxxxxxxxxx Xxxxxx
Xxxxxx, XX 00000 Xxxxxx. IN 46032]
(000) 000-0000
(000) 000-0000
DEFINITIONS
ACCOUNT(S): The Fixed Account, the MVA Account and the General Account and/or
one or more of the Sub-Accounts of the Variable Account.
ACCUMULATION PERIOD: The period prior to the Annuity Date during which Purchase
Payments may be made by an Owner.
ACCUMULATION UNIT: A unit of measure used to determine the value of a
Certificate Owner's interest in a Sub-Account of the Variable Account during the
Accumulation Period.
ADJUSTED CERTIFICATE VALUE: The Certificate Value less any applicable Premium
Tax, and Certificate Maintenance Charge and plus the applicable Market Value
Adjustment which may be positive or negative. This amount is applied to the
applicable Annuity Tables to determine Annuity Payments.
AGE: The age of any Certificate Owner or Annuitant on his or her last birthday.
For Joint Certificate Owners, all provisions which are based on age are based on
the Age of the older of the Joint Certificate Owners.
ADMINISTRATIVE OFFICE: The office address indicated on the Contract Schedule of
the Contract to which notices, requests and Purchase Payments must be sent. All
sums payable to the Company under this Contract or any Certificate are payable
at the Administrative Office or an address designated by the Company in writing.
ANNUITANT: The natural person on whose life Annuity Payments are based. On or
after the Annuity Date, the Annuitant shall also include any Joint Annuitant.
ANNUITY DATE: The date on which Annuity Payments begin. The Annuity Date is
shown on the Contract Schedule.
ANNUITY OPTIONS: Options available for Annuity Payments.
ANNUITY PAYMENTS: The series of payments made to the Certificate Owner or any
named payee after the Annuity Date under the Annuity Option selected.
ANNUITY PERIOD: The period of time beginning with the Annuity Date during which
Annuity Payments are made.
ANNUITY UNIT: An accounting unit of measure used to calculate the amount of
Annuity Payments.
AUTHORIZED REQUEST: A request, in a form satisfactory to the Company, which is
received by the Administrative Office.
BENEFICIARY: The person(s) or entity(ies) who will receive the death benefit
payable under this Contract.
CERTIFICATE: The document issued to a Certificate Owner to evidence a
Certificate Owner's Account established under this Group Contract.
CERTIFICATE ANNIVERSARY: An Anniversary of the Certificate Issue Date.
CERTIFICATE ISSUE DATE: The later of the date on the cover of the Contract or
the date Purchase Payments are received. The Certificate Issue Date is shown on
the Certificate Schedule.
CERTIFICATE OWNER: A person who has established a Certificate Owner's Account
under this Group Contract.
CERTIFICATE OWNER'S ACCOUNT: A record established for each Certificate to
maintain values under this Group Contract.
CERTIFICATE VALUE: The dollar value as of any Valuation Period of all amounts in
a Certificate Owner's Account.
CERTIFICATE WITHDRAWAL VALUE: The Certificate Value less any applicable Premium
Tax, less any Contingent Deferred Sales Charge, less any applicable Certificate
Maintenance Charge and plus any Market Value Adjustment which may be positive or
negative.
CERTIFICATE YEAR: The first Certificate Year is the annual period which begins
on the Certificate Issue Date. Subsequent Certificate Years begin on each
anniversary of the Certificate Issue Date.
COMPANY: Great American Reserve Insurance Company
CREDITED INTEREST RATE: The interest rate credited to the Certificate Owner's
Account by the Company for any given Guarantee Period in the MVA Account or the
Fixed Account. The Credited Interest Rates for the available Guarantee Periods
for the MVA Account and the Fixed Account are shown on the Certificate Schedule.
EFFECTIVE DATE: The beginning date of a Guarantee Period with a Credited
Interest Rate.
ELIGIBLE FUND: An investment entity that is made available for this Contract.
FIXED ACCOUNT: An investment option within the General Account.
FIXED ANNUITY: A series of payments made during the Annuity Period which are
guaranteed as to dollar amount by the Company.
GENERAL ACCOUNT: The Company's general investment account which contains all the
assets of the company except for the Variable Account and any other segregated
asset accounts.
GROUP CONTRACT OWNER: The person on entity to which this Group Contract is
issued.
GUARANTEE PERIOD: The period for which the Credited Interest Rate is credited in
the MVA Account. Each deposit or transfer to the MVA Account creates one or more
new Guarantee Period(s). The Guarantee Periods selected by the Certificate Owner
are shown on the Certificate Schedule.
MARKET VALUE ADJUSTMENT: An adjustment to the amount withdrawn or transferred
from an MVA Account prior to the end of the applicable Guarantee Period. The
adjustment reflects the change in the value of the funds withdrawn or
transferred due to the change in the interest rates since the beginning of the
Guarantee Period.
MVA ACCOUNT: A separate account which provides investment options where the
Company guarantees the rate of interest for a specified Guarantee Period and
where withdrawals or transfers may be subject to a Market Value Adjustment.
OWNER: The person(s) who owns the Contract.
PORTFOLIO: A segment of an Eligible Fund which constitutes a separate and
distinct class of shares.
PREMIUM TAX: Any premium taxes payable to any government entity and assessed
against Purchase Payments or Contract Value.
PURCHASE PAYMENT: A payment made by or for a Certificate Owner with respect to
this Contract. All payments must be made payable to the Company.
SUB-ACCOUNT: Variable Account assets are divided into Sub-Accounts. Assets of
each Sub-Account will be invested in shares of an Eligible Fund or a Portfolio
of an Eligible Fund.
VALUATION DATE: Each day on which the New York Stock Exchange ("NYSE") is open
for business.
VALUATION PERIOD: The period of time beginning at the close of business of the
NYSE on each Valuation Date and ending at the close of business for the next
succeeding Valuation Date.
VARIABLE ACCOUNT: A separate account which provides investment options where the
benefits are variable and are not guaranteed as to dollar amount,
WRITTEN REQUEST: A request in writing, in a form satisfactory to the Company,
which is received by the Administrative Office.
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS: The initial Purchase Payment for an Owner is due on the
Certificate Issue Date. Subject to the maximum and minimum amounts shown on the
Certificate Schedule, the Owner may make subsequent Purchase Payments and may
increase or decrease or change the frequency of such payments. The Company
reserves the right to reject any Application or Purchase Payment.
ALLOCATION OF PURCHASE PAYMENTS: Purchase Payments are allocated to the Fixed
Account and/or to one or more of the MVA Account Guarantee Period options and/or
to one or more Sub-Accounts of the Variable Account in accordance with the
selections made by the Owner. The allocation of the initial Purchase Payment for
an Owner is made in accordance with the selection made by the Owner at the
Certificate Issue Date. Unless otherwise changed by the Owner, subsequent
Purchase Payments are allocated in the same manner as the initial Purchase
Payment. Allocation of the Purchase Payments is subject to the Allocation
Guidelines shown on the Certificate Schedule. The Company reserves the right to
allocate initial Purchase Payment to the Money Market Sub-Account (except for
any amounts allocated to the Fixed Account and/or MVA Account) until the
expiration of the Right to Examine Period.
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNTS: The Separate Account consist of assets set aside by the
Company, which are kept separate from that of the general assets and any other
separate account assets of the Company.
VARIABLE ACCOUNT: The assets of the Variable Account will not be charged with
liabilities arising out of any other business the Company may conduct.
The Variable Account assets are divided into Sub-Accounts. The assets of the
Sub-Accounts are allocated to the Eligible Fund(s) and the Portfolio(s), if any,
within an Eligible Fund. Should the shares of any such Eligible Fund(s) or any
Portfolio(s) within an eligible Fund become unavailable for investment by the
Variable Account, or the Company's Board of Directors deems further investment
in these shares inappropriate, the Company may limit further purchase of such
shares or substitute shares of another Eligible Fund or Portfolio for shares
already purchased under a Certificate.
VALUATION OF ASSETS: The assets of the Accounts are valued at their fair market
value in accordance with procedures of the Company.
ACCUMULATION UNITS: Accumulation Units shall be used to account for all amounts
allocated to or withdrawn from the Sub-Accounts of the Variable Account as a
result of Purchase Payments, withdrawals, transfers, or fees and charges. The
Company will determine the number of Accumulation Units of a Sub-Account
purchased or canceled. This will be done by dividing the amount allocated to (or
the amount withdrawn from) the Sub-Account by the dollar value of one
Accumulation Unit of the Sub-Account as of the end of the Valuation Period
during which the request of the transaction is received at the Administrative
Office.
ACCUMULATION UNIT VALUE: The Accumulation Unit Value for each Sub-Account is
arbitrarily set initially at $10. Subsequent Accumulation Unit Values for each
Sub-Account are determined by multiplying the Accumulation Unit Value for the
immediately preceding Valuation Period by the Net Investment Factor for the
Sub-Account for the current period.
The Net Investment Factor for each Sub-Account is determined by dividing A by B
and subtracting C where:
A is (i) the net asset value per share of the Eligible Fund or Portfolio
of an Eligible Fund held by the Sub-Account at the end of the current
Valuation Period; plus
(ii) any dividend or capital gains per share declared on behalf of
such Eligible Fund or Portfolio that has an ex-dividend date within
the current Valuation Period; plus
(iii) a charge factor, if any, for any taxes or any tax reserve
established by the Company as a result of the operation or maintenance
of the Sub-Account.
B is the net asset value per share of the Eligible Fund or Portfolio
held by the Sub-Account for the immediately preceding Valuation
Period.
C is the Valuation Period equivalent of the per month Mortality and
Expense Risk Charge, for the Administrative Charge and for the
Distribution Charge, if any, which are shown on the Certificate
Schedule.
The Accumulation Unit Value may increase or decrease from Valuation Period to
Valuation Period.
MORTALITY AND EXPENSE RISK CHARGE: Each Valuation Period, the Company deducts a
Mortality and Expense Risk Charge from the Variable Account which is equal, on
an annual basis, to the amount shown on the Certificate Schedule. The Mortality
and Expense Risk charge compensates the Company for assuming the mortality and
expense risks under this Contract and each Certificate issued hereunder.
ADMINISTRATIVE CHARGE: Each Valuation Period, the Company deducts an
Administrative Charge from the Variable Account which is equal, on an annual
basis, to the amount shown on the Contract Schedule. The Administrative Charge
compensates the Company for the costs associated with the administration of this
Contract and each Certificate issued hereunder and the Variable Account.
DISTRIBUTION EXPENSE CHARGE: Each Valuation Period, the Company deducts a
Distribution Expense Charge from the Variable Account which is equal, on an
annual basis, to the amount shown on the Contract Schedule. The Distribution
charge compensates the Company for the costs associated with the distribution of
Contracts and Certificates.
MVA ACCOUNT PROVISIONS
MVA ACCOUNT: The assets of the MVA Account will not be charged with liabilities
arising out of any other business the Company may conduct.
Purchase Payments may be allocated to one or more of the MVA Account Guarantee
Period options which are available at the time the Purchase Payment is made. The
initial MVA Account Guarantee Period options are shown on the Certificate
Schedule. In addition, during the Accumulation Period, Certificate Values can be
transferred from the Variable Account and/or the Fixed Account to one or more of
the MVA Account Guarantee Period options.
INTEREST TO BE CREDITED: The Credited Interest Rate for the Guarantee Period(s)
of the MVA Account is shown on the Certificate Schedule. After the initial
Guarantee Period, the Credited Interest Rate for any subsequent Guarantee Period
of the MVA Account may change. All interest payable under this Certificate is
compounded daily at the stated effective annual interest rate. In no event will
the Credited Interest Rate be less than the Minimum Guaranteed Interest Rate,
prior to the application of the Market Value Adjustment, specified on the
Contract Schedule.
GUARANTEE PERIOD: The Current MVA Account Guarantee Period is shown on the
Contract Schedule. During the thirty (30) days prior to the end of a current
Guarantee Period, the Certificate Owner may renew for the same or any other
Guarantee Period then available at the then Credited Interest Rate or may elect
to transfer all or a portion of the amount to a Fixed Account option, if
available, or to the Variable Account. Any transfer elected during the thirty
(30) days prior to the end of a current Guarantee Period will be made as of the
date the request is received by the Company and will not be subject to any
Market Value Adjustment.
If the Certificate Owner does not specify a Guarantee Period at the time of
renewal, the Company will select and transfer to the same Guarantee Period as
has just expired, so long as such Guarantee Period does not extend beyond the
latest Annuity Date that can be selected by a Certificate Owner. If such
Guarantee Period does extend beyond the latest Annuity Date, the Company will
choose the one year period. If there is no Guarantee Period for the same period
available, the one year period will be selected. If the one year period is no
longer available, the next longest period available will be selected.
MULTIPLE GUARANTEE PERIODS: The Certificate Owner may elect one or more
Guarantee Periods subject to the Company's underwriting rules. Multiple
Guarantee Periods are treated separately for purposes of applying the Market
Value Adjustment. The Company reserves the right to credit different Credited
Interest Rates to the Certificate Value attributable:
1. to different Guarantee Periods; and
2. to Guarantee Periods of the same duration with different Effective
Dates.
CHANGES IN GUARANTEE PERIOD: The Certificate Owner may, upon Written Request,
change to any Guarantee Period then being offered by the Company with respect to
contracts of this type and class. The Market Value Adjustment will apply to a
change made at any time other than at the end of a Guarantee Period. The Market
Value Adjustment will not apply to a change made at the end of a Guarantee
Period if Written Request is received by the Company within thirty (30) days
prior to the end of the Guarantee Period.
MARKET VALUE ADJUSTMENT: Any amount withdrawn, transferred or annuitized prior
to the end of a Guarantee Period may be subject to a Market Value Adjustment.
The Market Value Adjustment will be calculated by multiplying the amount
withdrawn, transferred or annuitized by the formula shown on the Contract
Schedule.
There will be no Market Value Adjustment on withdrawals from the MVA Account in
the following situations: (1) death benefit paid under this Certificate; (2)
amounts withdrawn to pay fees or charges; (3) amounts withdrawn or transferred
from the MVA Account during the thirty (30) days prior to the end of the
Guarantee Period; (4) a Certificate Owner annuitizes this Certificate under an
Annuity Option providing for at least sixty (60) monthly Annuity Payments; and
(5) any withdrawal subject to the MVA Waiver shown on the Contract Schedule.
MVA ACCOUNT VALUES: The MVA Account portion of a Certificate at any time is
equal to:
1. The Purchase Payments allocated to the MVA Account on behalf of a
Certificate Owner; plus
2. the Certificate Value transferred to the MVA Account; plus
3. interest credited to the Certificate Value in the MVA Account; less
4. any prior withdrawals of Certificate Value in the MVA Account and any
Contingent Deferred Sales Charge; less
5. any Certificate Value transferred from the MVA Account; less
6. Certificate Maintenance Charges or Transfer Fees deducted from the
Certificate Value allocated to the MVA Account.
Any subsequent Purchase Payments and transfers to the MVA Account will be
allocated to a new Guarantee Period with a new Effective Date.
FIXED ACCOUNT PROVISIONS
FIXED ACCOUNT VALUES: The Fixed Account portion of a Certificate at any time is
equal to:
1. the Purchase Payments allocated to the Fixed Account on behalf of a
Certificate Owner; plus
2. the Certificate Value transferred to the Fixed Account; plus
3. interest credited to the Certificate Value in the Fixed Account; less
4. any prior withdrawals of Certificate Value in the Fixed Account and
any Contingent Deferred Sales Charge; less
5. any Certificate Value transferred from the Fixed Account; less
6. Certificate Maintenance Charges or Transfer Fees deducted from the
Certificate Value allocated to the Fixed Account.
INTEREST TO BE CREDITED: The Company guarantees that the interest to be credited
to the Fixed Account will not be less than the Minimum Guaranteed Interest Rate
shown on the Contract Schedule. The Company may credit additional interest at
its sole discretion for any Fixed Account option. The Fixed Account option and
the Initial Current Interest Rate are shown on the Contract Schedule.
CERTIFICATE VALUE
The Certificate Value for any Valuation Period is the sum of the Certificate
Value in each of the Sub-Accounts of the Variable Account, the Certificate Value
in the MVA Account and the Certificate Value in the Fixed Account.
The Certificate Value in a Sub-Account of the Variable Account is determined by
multiplying the number of Accumulation Units allocated to the Certificate
Owner's Account for the Sub-Account by the Accumulation Unit Value.
Withdrawals will result in the cancellation of Accumulation Units in a
Sub-Account or a reduction in the Certificate Value in the Fixed Account or the
MVA Account, as applicable.
CERTIFICATE MAINTENANCE CHARGE
DEDUCTION FOR CERTIFICATE MAINTENANCE CHARGE: During the Accumulation Period, on
each Certificate Anniversary the Company will deduct a Certificate Maintenance
Charge from the Certificate Value by reducing the Certificate Value in the Fixed
Account and/or the MVA Account and by canceling Accumulation Units from each
applicable Sub-Account to reimburse it for expenses relating to maintenance of a
Certificate issued under this Contract. The Certificate Maintenance Charge will
be deducted first from the Fixed Account and if there is insufficient value in
the Fixed Account, then the Certificate Maintenance Charge will be deducted from
the MVA Account or the Sub-Account of the Variable Account with the largest
balance. The Certificate Maintenance Charge is shown on the Contract Schedule.
TRANSFERS
TRANSFERS DURING THE ACCUMULATION PERIOD: Subject to any limitation imposed by
the Company on the number of transfers during the Accumulation Period shown on
the Contract Schedule, a Certificate Owner may transfer all or part of this
Certificate Value in the Fixed Account, the MVA Account or a Sub-Account by
Authorized Request without the imposition of any Transfer Fee if there have been
no more than the number of free transfers shown on the Contract Schedule for the
Certificate Year. All transfers are subject to the following:
1. If more than the number of free transfers, shown on the Contract
Schedule, have been made in a Certificate Year, the Company will deduct
a Transfer Fee, shown on the Contract Schedule, for each subsequent
transfer permitted. The Transfer Fee is deducted from the Account which
is the source of the transfer. However, if the Certificate Owner's
entire interest in an Account is being transferred, the Transfer Fee
will be deducted from the amount which is transferred. If there are
multiple source Accounts, the Transfer Fee will be allocated first to
the Fixed Account and then to the Sub-Account or the MVA Account with
the largest balance involved in a transfer transaction.
2. The minimum amount which can be transferred from a Sub-Account is
shown on the Contract Schedule. The minimum amounts which must remain
in a Sub-Account, the Fixed and the MVA Account are shown on the
Contract Schedule. The maximum amounts which can be transferred from
the Fixed Account or the MVA Account to the Variable Account are shown
on the Contract Schedule.
3. The Company reserves the right, at any time and without prior notice
to any party, to terminate, suspend or modify the transfer privilege
described above.
If a Certificate Owner elects to use this transfer privilege, the Company will
not be liable for transfers made in accordance with the instructions received
from the Certificate Owner or other authorized persons. All amounts and
Accumulation Units will be determined as of the end of the Valuation Period
during which the request for transfer is received at the Administrative Office.
TRANSFERS DURING THE ANNUITY PERIOD: Subject to any limitations imposed by the
Company on the number of transfers during the Annuity Period shown on the
Contract Schedule, the Certificate Owner may transfer Annuity Units in
accordance with the following::
1. Transfers may be made upon written notice to the Company at least
thirty (30) days before the due date of the first Annuity Payment for
which the change will apply. Transfers will be made by converting the
number of Annuity Units being transferred to the number of Annuity
Units of the Sub-Account to which the transfer is made, so that the
next Annuity Payment, if it were made at that time would be the same
amount that it would have been without the transfer. Thereafter,
Annuity Payments will reflect changes in the value of the new Annuity
Units.
2. If more than the number of free transfers, shown on the Contract
Schedule, have been made in a Certificate Year, the Company will
deduct a Transfer Fee, shown on the Contract Schedule, for each
subsequent transfer. The Transfer Fee is deducted from the Account
which is the source of the transfer. However, if the Certificate
Owner's entire interest in an Account is being transferred, the
Transfer Fee will be deducted from the amount which is transferred. If
there are multiple source Accounts, the Transfer Fee will be allocated
first to the Fixed Account and then to the Sub-Account or the MVA
Account with the largest balance involved in the transfer transaction.
3. The minimum amount which can be transferred from a Sub-Account is
shown on the Contract Schedule. The minimum amount which must remain
in a Sub-Account after a transfer is shown on the Contract Schedule.
4. No transfers can be made between the General Account and the
Variable Account.
5. The Company reserves the right, at any time and without prior
notice, to terminate, suspend or modify the transfer privilege
described above.
If a Certificate Owner elects to use this transfer privilege, the Company will
not be liable for transfers made in accordance with instructions received from
the Certificate Owner or other authorized persons. All amounts and Annuity Units
will be determined as of the end of the Valuation Period during which the
request for transfer is received at the Administrative Office.
WITHDRAWAL PROVISIONS
WITHDRAWALS: During the Accumulation Period, the Certificate Owner may, upon
Written Request, make a total or partial withdrawal of the Certificate
Withdrawal Value.
The Certificate Owner must specify by Written Request which Sub-Account or
Guarantee Period of the MVA Account or Fixed Account, as applicable, is the
source of the partial withdrawal.
A withdrawal from the MVA Account may be subject to a Market Value Adjustment.
The Company will pay the amount of any withdrawal from the Variable Account
within seven (7) days of receipt of a request in good order unless the
Suspension or Deferral of Payment Provision is in effect.
Each partial withdrawal must be for an amount which is not less than the minimum
amount shown on the Contract Schedule. The minimum Certificate Value which must
remain in a Sub-Account after a partial withdrawal is shown on the Contract
Schedule. The maximum amounts which can be withdrawn from the Fixed Account
and/or the MVA Account are shown on the Certificate Schedule.
CONTINGENT DEFERRED SALES CHARGE: Upon a withdrawal of Certificate Value, a
Contingent Deferred Sales Charge, as set forth on the Contract Schedule, may be
assessed.
WITHDRAWAL CHARGE: Upon a withdrawal of Certificate Value, a Withdrawal Charge,
as set forth on the Contract Schedule, may be assessed.
PROCEEDS PAYABLE ON DEATH
DEATH OF CERTIFICATE OWNER:
DURING THE ACCUMULATION PERIOD: Upon the death of the Certificate Owner, or any
Joint Certificate Owner, during the Accumulation Period, the death benefit will
be paid to the Beneficiary(ies) designated by the Certificate Owner. Upon the
death of any Joint Certificate Owner, the surviving Joint Certificate Owner, if
any, will be treated as the Primary Beneficiary. Any other Beneficiary
designation on record at the time of death will be treated as a contingent
Beneficiary.
A Beneficiary may request that the death benefit be paid under one of the Death
Benefit Options below. If the Beneficiary is the spouse of the Certificate
Owner, he or she may elect to continue the Certificate at the then current
Certificate Value in his or her own name and exercise all the Certificate
Owner's right under the Certificate.
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD: If death occurs prior to
age 90, the death benefit will be the greater of:
1. the total Purchase Payments, less any prior Adjusted Partial
Withdrawals, accumulated at 5% per year up to the date of death .
Adjusted Partial Withdrawals are equal to: the Partial Withdrawal
multiplied by the Death Benefit just before the Partial Withdrawal,
divided by the Certificate Value just before Partial Withdrawal; or
2. the Certificate Value determined as of the end of the Valuation Period
during which the Company receives both due proof of death and an
election for the payment method.
If death occurs at age 90 or later, the death benefit will be the Certificate
Value determined as of the end of the Valuation Period during which the Company
received both due proof of death and an election for the payment method.
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD: A non-spousal Beneficiary
must elect the death benefit to be paid under one of the following options in
the event of the death of the Certificate Owner or any Joint Certificate Owner
during the Accumulation Period:
Option 1 - lump sum payment of the death benefit; or
Option 2 - the payment of the entire death benefit within 5 years of
the date of the death of the Certificate Owner or any Joint Certificate
Owner; or
Option 3 - payment of the death benefit under an Annuity Option over
the lifetime of the Beneficiary or over a period not extending beyond
the life expectancy of the Beneficiary with distribution beginning
within one year of the date of death of the Certificate Owner or any
Joint Certificate Owner.
Any portion of the death benefit not applied under Option 3 within one year of
the date of the Certificate Owner's death, must be distributed within five years
of the date of death.
A spousal Beneficiary may elect to continue the Certificate in his or her own
name at the then current Certificate Value, elect a lump sum payment of the
death benefit or apply the death benefit to an Annuity Option.
If a lump sum payment is requested, the amount will be paid within seven (7)
days of receipt of proof of death and the election, unless the Suspension or
Deferral of Payments Provision, as set forth on page 15 of this Certificate, is
in effect.
Payment to the Beneficiary, other than in a lump sum, may only be elected during
the sixty-day period beginning with the date of receipt of proof of death.
DURING THE ANNUITY PERIOD: If the Certificate Owner, or any Joint Certificate
Owner, who is not the Annuitant, dies during the Annuity Period, any remaining
payments under the Annuity Option elected will continue at least as rapidly as
under the method of distribution in effect at such Certificate Owner's or Joint
Certificate Owner's death. Upon the death of any Certificate Owner during the
Annuity Period, the Beneficiary becomes the Certificate Owner. Upon the death of
any Joint Certificate Owner during the Annuity Period, the surviving Joint
Certificate Owner, if any, will be treated as the Primary Beneficiary. Any other
Beneficiary designation on record at the time of death will be treated as a
Contingent Beneficiary.
DEATH OF ANNUITANT:
DURING THE ACCUMULATION PERIOD: Upon the death of an Annuitant, who is not the
Owner, during the Accumulation Period, the Certificate Owner may designate a new
Annuitant, subject to the Company's underwriting rules then in effect. If no
designation is made within thirty (30) days of the death of the Annuitant, the
Certificate Owner will become the Annuitant effective as of the death of the
Annuitant. If the Certificate Owner is a non-natural person, the death of the
Annuitant will be treated as the death of the Certificate Owner and a new
Annuitant may not be designated.
DURING THE ANNUITY PERIOD: Upon the death of the Annuitant during the Annuity
Period, the death benefit, if any, will be as specified in the Annuity Option
elected. Death benefits will be paid at least as rapidly as under the method of
distribution in effect at the Annuitant's death.
PAYMENT OF DEATH BENEFIT: The Company will require due proof of death before any
death benefit is paid. Due proof of death will be:
1. a certified death certificate; or
2. a certified decree of a court of competent jurisdiction as to the
finding of death; or
3. any other proof satisfactory to the Company.
All death benefits will be paid in accordance with applicable law or regulations
governing death benefit payments.
BENEFICIARY: The Beneficiary designation in effect on the Certificate Issue Date
will remain in effect until changed. The Beneficiary is entitled to receive the
benefits to be paid at the death of the Certificate Owner.
Unless the Certificate Owner provides otherwise, the death benefit will be paid
in equal shares to the survivor(s) as follows:
1. to the Primary Beneficiary(ies) who survive the Certificate Owner's
and/or the Annuitant's death, as applicable; or if there are none
2. to the Contingent Beneficiary(ies) who survive the Certificate Owner's
and/or the Annuitant's death, as applicable; or if there are none
3. to the estate of the Certificate Owner.
CHANGE OF BENEFICIARY: Subject to the rights of any irrevocable
Beneficiary(ies), the Certificate Owner may change the Primary Beneficiary(ies)
or Contingent Beneficiary(ies). A change may be made by Written Request. The
change will take effect as of the date the Written Request is signed. The
Company will not be liable for any payment made or action taken before it
records the change.
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION
The Company reserves the right to suspend or postpone payments from the Variable
Account for a withdrawal or transfer for any period when:
1. the New York Stock Exchange is closed (other than customary weekend
and holiday closings);or
2. trading on the New York Stock Exchange is restricted;
3. an emergency exists as a result of which disposal of securities held
in the Variable Account is not reasonably practicable or it is not
reasonably practicable to determine the value of the Variable
Account's net assets; or
4. during any other period when the Securities and Exchange Commission,
by order, so permits for the protection of Certificate Owners;
providing that applicable rules and regulations of the Securities and Exchange
Commission will govern as to whether the conditions described in (2) or (3)
exist.
The Company further reserves the right to postpone payments from the Fixed
Account and the MVA Account for a period of up to six (6) months.
CERTIFICATE OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
CERTIFICATE OWNER: The Certificate Owner has all interest and right to amounts
held in this Certificate. The Certificate Owner is the person designated as such
on the Certificate Issue Date, unless changed.
The Certificate Owner may change owners of the Certificate at any time by
Written Request. A change of Certificate Owner will automatically revoke any
prior designation of Certificate Owner. The change will become effective as of
the date the Written Request is signed. The Company will not be liable for any
payment made or action taken before it records the change..
JOINT CERTIFICATE OWNER: A Certificate may be owned by Joint Certificate Owners.
If Joint Certificate Owners are named, any Joint Certificate Owner must be the
spouse of the other Certificate Owner. Upon the death the either Joint
Certificate Owner, the surviving spouse will be the Primary Beneficiary. Any
other Beneficiary designation will be treated as a Contingent Beneficiary unless
otherwise indicated in a Written Request.
GROUP CONTRACT OWNER: The Group Contract Owner has title to the Contract. The
Contract and any amounts accumulated thereunder are not subject to the claims of
the Group Contract Owner nor any of its creditors. The Group Contract Owner may
transfer ownership of this Group Contract. Any transfer of ownership terminates
the interest of any existing Group Contract Owner. It does not change the right
of any Certificate Owner.
ANNUITANT: The Annuitant is the person on whose life Annuity Payments are based.
The Annuitant is the person designated by the Certificate Owner at the
Certificate Issue Date, unless changed prior to the Annuity Date. In the event
that the Annuitant dies prior to the Annuity Date, the Certificate Owner must
designate a new Annuitant. If no new Annuitant is designated by the Certificate
Owner within 30 days of the death of the Annuitant, effective as of the death of
the Annuitant, the Certificate Owner becomes the Annuitant. The Annuitant may
not be changed in a Certificate which is owned by a non-natural person. Any
change of Annuitant is subject to the Company's underwriting rules in effect at
the time the request is recorded by the Company.
ASSIGNMENT OF A CERTIFICATE: A Written Request specifying the terms of an
assignment of a Certificate must be provided to the Administrative Office. The
Company will not be liable for any payment made or action taken before it
records the assignment. The Company will not be responsible for the validity or
tax consequences of any assignment. Any assignment made after the death benefit
has become payable will be valid only with Company consent.If the Certificate is
assigned, the Certificate Owner's rights may only be exercised with the consent
of the assignee of record.
ANNUITY PROVISIONS
GENERAL: On the Annuity Date, the Certificate Withdrawal Value will be applied
under the Annuity Option selected by the Owner. The Certificate Owner may elect
to have the Certificate Withdrawal Value applied to provide a Fixed Annuity, a
Variable Annuity or a combination Fixed and Variable Annuity. The Certificate
Value may be applied under the Annuity Option selected if the annuitization is
after the 4th policy year and the option is life contingent or for a minimum of
5 years. If a combination is elected, the Certificate Owner must specify what
part of the Certificate Withdrawal Value is to be applied to the Fixed and
Variable Options.
ANNUITY DATE: The Annuity Date is selected by the Certificate Owner at the
Certificate Issue Date, The Annuity Date must be the first day of a calendar
month and must be at least ninety (90) days after the Certificate Issue Date.
The Annuity Date may not be later than the earlier of when the Annuitant reaches
attained age 90 or the maximum date permitted under the law of the state in
which the Certificate is delivered.
Prior to the Annuity Date, the Certificate Owner, subject to the above, may
change the Annuity Date by Written Request. Any change must be requested at
least thirty (30) days prior to the new Annuity Date.
SELECTION OF AN ANNUITY OPTION: An Annuity Option may be selected by Written
Request of the Certificate Owner. If no Annuity Option is selected, Option 2
with 120 monthly payments guaranteed will automatically be applied. Unless
specified otherwise, that portion of the Certificate Withdrawal Value allocated
to the Variable Account shall be used to provide a Variable Annuity and that
portion of the Certificate Withdrawal Value allocated to the Fixed Account and
the MVA Account will be used to provide a Fixed Annuity. Prior to the Annuity
Date, the Owner can change the Annuity Option selected by Written Request. Any
change must be requested at least thirty (30) days prior to the Annuity Date.
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS: Annuity Payments are paid in monthly
installments. The Certificate Withdrawal Value is applied to the Annuity Table
for the Annuity Option selected. If the Certificate Withdrawal Value to be
applied under an Annuity Option is less than $5,000, the Company reserves the
right to make a lump sum payment in lieu of Annuity Payments. If the Annuity
Payment would be or become less than $40, the Company reserves the right to
reduce the frequency of payments to an interval which will result in each
payment being at least $50.
ANNUITY OPTIONS: The following Annuity Options or any other annuity option
acceptable to the Company may be selected:
OPTION 1. INCOME FOR SPECIFIED PERIOD: We will pay an income for a specific
number of years in equal installments. We guarantee these payments to be at
least those shown in Table 1.
OPTION 2. LIFE INCOME: We will pay equal monthly payments for a specified
period certain and then for life. We guarantee these payments will be at
least those shown in Table 2.
OPTION 3. INCOME OF SPECIFIED AMOUNT: We will pay income of the specified
amount until the principal and interest are exhausted.
OPTION 4. JOINT AND SURVIVOR INCOME: We will pay equal monthly payments
during the joint lifetime of the Annuitant and the named Beneficiary/Payee.
We will determine the payment by the sex and Age of each person from Table
4. The Annuitant must be at least 50 years old, and the Beneficiary/Payee
must be at least 45 years old, at the time of the first monthly payment.
ANNUITY: If the Certificate Owner selects a Fixed Annuity, the Certificate
Withdrawal Value is allocated to the General Account and the Annuity is paid as
a Fixed Annuity. If the Certificate Owner selects a Variable Annuity, the
Certificate Withdrawal Value will be allocated to the Sub-Accounts of the
Variable Account in accordance with the selection made by the Certificate Owner,
and the Annuity will be paid as a Variable Annuity. If no selection is made, the
Certificate Withdrawal Value will be applied in the same proportions to the same
Sub-Accounts as the allocations are at the time of election. Unless the
Certificate Owner specifies otherwise, the payee of the Annuity Payments shall
be the Certificate Owner. The Certificate Withdrawal Value will be applied to
the applicable Annuity Table contained in the Certificate based upon the Annuity
Option selected by the Certificate Owner. The amount of the first payment for
each $1,000 of Certificate Withdrawal Value is shown in the Annuity Tables.
FIXED ANNUITY: The Certificate Owner may elect to have the Certificate
Withdrawal Value applied to provide a Fixed Annuity.
The dollar amount of each Fixed Annuity Payment shall be determined in
accordance with Annuity Tables contained in this Contract which are based on the
minimum guaranteed interest rate of 3% per year.
VARIABLE ANNUITY: The Certificate Owner may elect to have the Certificate
Withdrawal Value applied to provide a Variable Annuity. Variable Annuity
Payments reflect the investment performance of the Variable Account in
accordance with the allocation of the Certificate Withdrawal Value to the
Sub-Accounts during the Annuity Period. Variable Annuity Payments are not
guaranteed as to the dollar amount.
The dollar amount of the first Variable Annuity Payment is determined in
accordance with the description above. The dollar amount of the Variable Annuity
Payment for each applicable Sub-Account after the first Variable Annuity Payment
is determined as follows:
1. The dollar amount of the first Variable Annuity Payment is divided
by the value of an Annuity Unit for each applicable Sub-Account as of
the Annuity Date. This sets the number of Annuity Units for each
monthly payment for the applicable Sub-Accounts.
2. The fixed number of Annuity Units per payment in each Sub-Account is
multiplied by the Annuity Unit Value for that Sub-Account for the last
Valuation Period of the month preceding the month for which the payment
is due. This result is the dollar amount of the payment for each
applicable Sub-Account.
The total dollar amount of each Variable Annuity Payment is the sum of all
Sub-Account Variable Annuity Payments reduced by the applicable portion of the
Certificate Maintenance Charge.
ANNUITY UNIT: The value of any Annuity Unit for each Sub-Account of the Variable
Account was set initially at $10.
The Sub-Account Annuity Unit Value at the end of any subsequent Valuation Period
is determined as follows:
1. the Net Investment Factor for the current Valuation Period is
multiplied by the value of the Annuity Unit for the Sub-Account for the
immediately preceding Valuation Period.
2. The result in (1) is then divided by the Assumed Investment Rate
Factor which equals 1.00 plus the Assumed Investment Rate for the
number of days since the preceding Valuation Date. The Certificate
Owner can choose either a 5% or a 3% Assumed Investment Rate.
MORTALITY TABLES: The mortality table used in establishing the Annuity Table is
the Annuity 2000 Mortality Table.
The dollar amount of an Annuity Payment for any Age or combination of Ages not
shown in the Tables or for any other form of Annuity Option agreed to by the
Company will be provided by the Company upon request.
GENERAL PROVISIONS
THE CONTRACT: The entire contract consists of this Contract, the Application and
any riders or endorsements attached to this Contract. This Contract may be
changed or altered only by the President or Senior Vice President and the
Secretary of the Company. A change or alteration must be made in writing.
MISSTATEMENT OF AGE: If the Age of any Annuitant has been misstated, any Annuity
benefits payable will be the Annuity benefits provided by the correct Age. After
Annuity Payments have begun, any underpayments will be made up in one sum with
the next Annuity Payment. Any overpayment will be deducted from future Annuity
Payments until the total is repaid.
INCONTESTABILITY: This Certificate will not be contestable from the date of
issue.
MODIFICATION: This Contract and any Certificate issued hereunder may be modified
in order to maintain compliance with applicable state and/or federal law.
NON-PARTICIPATING: This Contract and any Certificate issued hereunder will not
share in any distribution of dividends, profits or income of the Company.
EVIDENCE OF SURVIVAL: The Company may require satisfactory evidence of the
continued survival of any person(s) on whose life Annuity Payments are based.
PROOF OF AGE: The Company may require evidence of Age of any Annuitant and any
Certificate Owner.
PROTECTION OF PROCEEDS: To the extent permitted by law, death benefits and
Annuity Payments shall be free from legal process and the claim of any creditor
other than the person entitled to them under any Certificate. No payment and no
amount under this Certificate can be taken or assigned in advance of its payment
date unless the Company receives the Certificate Owner's written consent.
REPORTS: At least once each calendar year, the Company will furnish each Owner
with a report showing the Certificate Value and any other information as may be
required by law. The Company will also furnish an annual report of the Variable
Account.
PREMIUM TAXES: Any taxes paid to any governmental entity relating to the
Certificate will be deducted from the Purchase Payment or Certificate Value. The
Company may, in its sole discretion, pay taxes when due and deduct that amount
from the Contract Value at a later date. Payment at an earlier date does not
waive any right the Company may have to deduct amounts at a later date.
OTHER TAXES: The Company reserves the right to establish a provision for federal
income taxes if it determines, in its sole discretion, that it will incur a tax
as a result of the operation of the Separate Account. The Company will deduct
for any income taxes incurred by it as a result of the operation of the Separate
Account whether or not there was a provision for taxes and whether or not is was
sufficient. The Company will deduct any withholding taxes required by applicable
law.
REGULATORY REQUIREMENTS: All values payable under any Certificate will not be
less than the minimum benefits required by the laws and regulations of the
states in which the Certificate is delivered.
TABLE 1
INCOME FOR SPECIFIED PERIOD FACTORS
Installments shown are for each $1,000 of net Proceeds applied. Interest is 3%,
and is subject to change as described in the Interest On Settlement Options
Section.
------------------- --------------------- -------------------- -------------------- --------------------
Annual Semi
Years Annual Annual Quarterly Monthly *
------------------- --------------------- -------------------- -------------------- --------------------
1 N/A N/A N/A N/A
2 N/A N/A N/A N/A
3 N/A N/A N/A N/A
4 N/A N/A N/A N/A
5 $211.99 $106.78 $53.59 $17.91
6 179.22 90.27 45.30 15.14
7 155.83 78.49 39.39 13.16
8 138.31 69.66 34.96 11.68
9 124.69 62.81 31.52 10.53
10 113.82 57.33 28.77 9.61
11 104.93 52.85 26.52 8.86
12 97.54 49.13 24.65 8.24
13 91.29 45.98 23.08 7.71
14 85.95 43.29 21.73 7.26
15 81.33 40.96 20.56 6.87
16 77.29 38.93 19.54 6.53
17 73.74 37.14 18.64 6.23
18 70.59 35.56 17.84 5.96
19 67.78 34.14 17.13 5.73
20 65.26 32.87 16.50 5.51
------------------- --------------------- -------------------- -------------------- --------------------
* Equal monthly payment for the number of years elected, not to exceed 25 years.
Payments will begin on the option date.
TABLE 2
MONTHLY INCOME FOR LIFE WITH GUARANTEED PERIOD OF:
Equal monthly payments for a guaranteed period of 10, 15 or 20 years as elected
and for life thereafter as shown in the table below. Amount of each monthly
installment per $1,000 net proceeds. Amounts based on Annuity 2000 Mortality
Tables and 3% interest.
MALE
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
AGE OF PAYEE 10 15 20 AGE OF PAYEE 10 15 20
YEARS YEARS YEARS YEARS YEARS YEARS
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
25 $3.08 $3.08 3.07 53 $4.25 $4.20 $4.12
26 3.10 3.10 3.09 54 4.33 4.27 4.18
27 3.12 3.12 3.11 55 4.41 4.34 4.24
28 3.15 3.14 3.14 56 4.49 4.42 4.30
29 3.17 3.17 3.16 57 4.58 4.49 4.36
30 3.20 3.19 3.19 58 4.68 4.58 4.43
31 3.22 3.22 3.21 59 4.78 4.66 4.49
32 3.25 3.25 3.24 60 4.88 4.75 4.56
33 3.28 3.28 3.27 61 4.99 4.84 4.62
34 3.31 3.31 3.30 62 5.10 4.93 4.69
35 3.34 3.34 3.33 63 5.23 5.03 4.75
36 3.38 3.37 3.36 64 5.35 5.13 4.82
37 3.41 3.40 3.39 65 5.48 5.22 4.88
38 3.45 3.44 3.42 66 5.62 5.33 4.94
39 3.49 3.48 3.46 67 5.77 5.43 5.00
40 3.53 3.52 3.50 68 5.92 5.53 5.06
41 3.57 3.56 3.53 69 6.07 5.63 5.11
42 3.62 3.60 3.57 70 6.23 5.73 5.16
43 3.66 3.64 3.62 71 6.39 5.83 5.21
44 3.71 3.69 3.66 72 6.56 5.93 5.25
45 3.76 3.74 3.70 73 6.73 6.02 5.29
46 3.81 3.79 3.75 74 6.90 6.11 5.33
47 3.87 3.84 3.80 75 7.08 6.20 5.36
48 3.92 3.89 3.85 76 7.25 6.28 5.39
49 3.98 3.95 3.90 77 7.43 6.35 5.41
50 4.05 4.01 3.95 78 7.61 6.42 5.43
51 4.11 4.07 4.00 79 7.78 6.49 5.45
52 4.18 4.13 4.06 80 7.95 6.55 5.46
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
TABLE 2
MONTHLY INCOME FOR LIFE WITH A GUARANTEED PERIOD OF:
Equal monthly payments for a guaranteed period of 10, 15 or 20 years as elected
and for life thereafter as shown in the table below. Amount of each monthly
installment per $1,000 net proceeds. Amounts based on Annuity 2000 Mortality
Tables and 3% interest.
FEMALE
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
AGE OF PAYEE 10 15 20 AGE OF PAYEE 10 15 20
YEARS YEARS YEARS YEARS YEARS YEARS
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
25 $2.99 $2.99 $2.99 53 $3.99 $3.96 $3.92
26 3.01 3.01 3.00 54 4.06 4.02 3.97
27 3.03 3.03 3.02 55 4.13 4.09 4.03
28 3.05 3.05 3.04 56 4.20 4.16 4.09
29 3.07 3.07 3.06 57 4.28 4.23 4.15
30 3.09 3.09 3.09 58 4.36 4.30 4.22
31 3.11 3.11 3.11 59 4.45 4.38 4.28
32 3.14 3.14 3.13 60 4.54 4.46 4.35
33 3.16 3.16 3.15 61 4.63 4.55 4.42
34 3.19 3.19 3.18 62 4.73 4.64 4.49
35 3.22 3.21 3.21 63 4.84 4.73 4.57
36 3.24 3.24 3.23 64 4.95 4.83 4.64
37 3.27 3.27 3.26 65 5.07 4.93 4.71
38 3.30 3.30 3.29 66 5.20 5.03 4.78
39 3.34 3.33 3.32 67 5.33 5.14 4.85
40 3.37 3.36 3.35 68 5.47 5.25 4.92
41 3.41 3.40 3.39 69 5.62 5.36 4.99
42 3.44 3.44 3.42 70 5.78 5.47 5.05
43 3.48 3.47 3.46 71 5.94 5.58 5.11
44 3.52 3.51 3.50 72 6.11 5.70 5.17
45 3.57 3.55 3.54 73 6.29 5.81 5.22
46 3.61 3.60 3.58 74 6.48 5.92 5.27
47 3.66 3.64 3.62 75 6.67 6.03 5.31
48 3.71 3.69 3.66 76 6.86 6.13 5.35
49 3.76 3.74 3.71 77 7.06 6.22 5.38
50 3.81 3.79 3.76 78 7.26 6.31 5.40
51 3.87 3.85 3.81 79 7.46 6.39 5.43
52 3.93 3.90 3.86 80 7.66 6.47 5.45
--------------- --------------- -------------- -------------- -------------- -------------- --------------- --------------
TABLE 3
EQUAL PAYMENTS OF A SPECIFIED AMOUNT
Equal monthly payments of at least $4.71 per month for each $1,000 of
proceeds. Payments will begin on the option date and will continue until the
proceeds and interest at the rate of 3.00% compounded annually are
exhausted.
TABLE 4
JOINT AND SURVIVOR INCOME FACTORS
We will furnish values for age or sex combinations not shown in the table on
request.
Male Age
_____________________________________________________________________________________________
Female Age 45 50 55 60 65 70
45 $3.34 $3.41 $3.46 $3.50 $3.54 $3.58
50 3.44 3.54 3.62 3.69 3.74 3.79
55 3.53 3.66 3.79 3.90 3.99 4.06
60 3.60 3.78 3.95 4.12 4.27 4.38
65 3.66 3.87 4.10 4.34 4.57 4.77
70 3.71 3.95 4.22 4.54 4.87 5.19
Installments shown are monthly and are for each $1,000 of net Proceeds applied.
Based on Annuity 2000 Tables and 3% interest: Amounts are subject to change as
described in the Interest On Settlement Options Section.
GREAT AMERICAN RESERVE INSURANCE COMPANY
FIXED FUND
ACCUMULATION TABLE FOR FLEXIBLE PREMIUM DEFERRED ANNUITY
$1,000 FOR FIRST FIVE YEARS
GUARANTEED SURRENDER VALUE*
---------------------------- ------------------------- -------------------------- --------------------------
End of Accumulated
Policy Value Accumulated Surrender
Year Increase Value Value
---------------------------- ------------------------- -------------------------- --------------------------
1 1,030.00 1,030.00 967.21
2 1,060.90 2,090.90 1,965.54
3 1,092.73 3,183.63 3,002.73
4 1,125.51 4,309.14 4,080.68
5 1,159.27 5,468.41 5,200.28
---------------------------- ------------------------- -------------------------- --------------------------
6 164.05 5,632.46 5,399.36
7 168.97 5,801.44 5,613.04
8 174.04 5,975.48 5,835.48
9 179.26 6,154.74 6,064.74
10 184.64 6,339.39 6,289.39
---------------------------- ------------------------- -------------------------- --------------------------
11 190.18 6,529.57 6,509.57
12 195.89 6,725.45 6,725.45
13 201.76 6,927.22 6,927.22
14 207.82 7,135.03 7,135.03
15 214.05 7,349.09 7,349.09
---------------------------- ------------------------- -------------------------- --------------------------
16 220.47 7,569.56 7,569.56
17 227.09 7,796.64 7,796.64
18 233.90 8,030.54 8,030.54
19 240.92 8,271.46 8,271.46
20 248.14 8,519.60 8,519.60
---------------------------- ------------------------- -------------------------- --------------------------
21 255.59 8,775.19 8,775.19
22 263.26 9,038.45 9,038.45
23 271.15 9,309.60 9,309.60
24 279.29 9,588.89 9,588.89
25 287.67 9,876.56 9,876.56
---------------------------- ------------------------- -------------------------- --------------------------
26 296.30 10,172.85 10,172.85
27 305.19 10,478.04 10,478.04
28 314.34 10,792.38 10,792.38
29 323.77 11,116.15 11,116.15
30 333.48 11,449.64 11,449.64
---------------------------- ------------------------- -------------------------- --------------------------
31 343.49 11,793.13 11,793.13
32 353.79 12,146.92 12,146.92
33 364.41 12,511.33 12,511.33
34 375.34 12,886.67 12,886.67
35 386.60 13,273.27 13,273.27
---------------------------- ------------------------- -------------------------- --------------------------
36 398.20 13,671.46 13,671.46
37 410.14 14,081.61 14,081.61
38 422.45 14,504.06 14,504.06
39 435.12 14,939.18 14,939.18
40 448.18 15,387.35 15,387.35
---------------------------- ------------------------- -------------------------- --------------------------
*Values Shown are Based on an Interest Rate of 3% for All Years.
GREAT AMERICAN RESERVE INSURANCE COMPANY
00000 X. XXXXXXXXXXXX XXXXXX
XXXXXX, XXXXXXX 00000-0000
(000) 000-0000
INDIVIDUAL FIXED AND VARIABLE
ANNUITY CONTRACT
NON-PARTICIPATING
32-4008M
