EXHIBIT 4(ii)
ALLOCATED FIXED AND VARIABLE ANNUITY GROUP CONTRACT
UNITED COMPANIES LIFE INSURANCE COMPANY (the "Company"), Baton Rouge, Louisiana,
agrees with the Contract Owner to provide benefits to the Certificate Holders,
subject to the provisions set forth in this Contract and in consideration of
Purchase Payments received from Certificate Holders.
RIGHT TO EXAMINE CERTIFICATE: Within 10 days of the date of receipt of a
Certificate under this Contract by the Certificate Holder, it may be returned by
delivering or mailing it to the Company at its Annuity Service Center, P. O. Box
365, Haddam, Connecticut 06438-0365. 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 Holder's Account Value computed at the end of the
Valuation Period during which this Certificate is received by the Company at its
Annuity Service Center.
THIS IS A LEGAL CONTRACT BETWEEN THE CONTRACT OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
SECRETARY PRESIDENT
ALLOCATED FIXED AND VARIABLE
GROUP ANNUITY CONTRACT
Nonparticipating
WITHDRAWAL VALUES AND THE DEATH BENEFITS PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
TABLE OF CONTENTS
CONTRACT SCHEDULE
DEFINITIONS
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS
ALLOCATION OF PURCHASE PAYMENTS
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNT
VALUATION OF ASSETS
ACCUMULATION UNITS
ACCUMULATION UNIT VALUE
MORTALITY AND EXPENSE RISK CHARGE
ADMINISTRATIVE CHARGE
DISTRIBUTION EXPENSE CHARGE
MVA ACCOUNT
MVA ACCOUNT
INTEREST TO BE CREDITED
GUARANTEE PERIOD
MULTIPLE GUARANTEE PERIODS
CHANGE IN GUARANTEE PERIOD
MARKET VALUE ADJUSTMENT
MVA ACCOUNT VALUES
FIXED ACCOUNT PROVISIONS
FIXED ACCOUNT VALUES
INTEREST TO BE CREDITED
CERTIFICATE HOLDER'S ACCOUNT VALUE
CERTIFICATE MAINTENANCE CHARGE
DEDUCTION FOR CERTIFICATE MAINTENANCE CHARGE
TRANSFERS
TRANSFERS PRIOR TO THE ANNUITY DATE
WITHDRAWAL PROVISIONS
WITHDRAWALS
CONTINGENT DEFERRED SALES CHARGE
PROCEEDS PAYABLE ON DEATH
DEATH OF CERTIFICATE HOLDER DURING THE ACCUMULATION PERIOD DEATH BENEFIT
AMOUNT DURING THE ACCUMULATION PERIOD DEATH BENEFIT OPTIONS DURING THE
ACCUMULATION PERIOD DEATH OF CERTIFICATE HOLDER DURING THE ANNUITY PERIOD
DEATH OF ANNUITANT PAYMENT OF DEATH BENEFIT BENEFICIARY CHANGE OF
BENEFICIARY SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION
CERTIFICATE HOLDER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
CERTIFICATE HOLDER
JOINT CERTIFICATE HOLDER
CONTRACT OWNER
ANNUITANT
ASSIGNMENT OF A CERTIFICATE
ANNUITY PROVISIONS
GENERAL
ANNUITY DATE
SELECTION OF AN ANNUITY OPTION
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS
ANNUITY OPTIONS
OPTION A. LIFE ANNUITY
OPTION B. LIFE ANNUITY WITH PERIODS CERTAIN
OPTION C. JOINT AND SURVIVOR ANNUITY
FIXED ANNUITY
MORTALITY TABLES
GENERAL PROVISIONS
THE CONTRACT
MISSTATEMENT OF AGE
INCONTESTABILITY
MODIFICATION
NON-PARTICIPATING
EVIDENCE OF SURVIVAL
PROOF OF AGE
PROTECTION OF PROCEEDS
REPORTS
TAXES
REGULATORY REQUIREMENTS
CONTRACT SCHEDULE
United Companies Life Insurance Company
Variable Annuity Processing Center
P. O. Box 354
Haddam, CT 06438-3054
CONTRACT OWNER: [United Variable Trust] CONTRACT DATE: [July 1, 1995]
CONTRACT NUMBER: [12345]
Beneficiary, Certificate Holder and Annuitant: As named by the Certificate
Holder at the Certificate Issue Date, unless changed according to the Contract
provisions.
PURCHASE PAYMENTS:
INITIAL PURCHASE PAYMENT: [$5,000]
MINIMUM SUBSEQUENT PURCHASE PAYMENT: $500 OR $100 for automatic check option.
MAXIMUM TOTAL PURCHASE PAYMENT: For each Certificate Holder, $250,000
without prior company approval.
ALLOCATION GUIDELINES:
The Certificate Holder can select up to 10 investment options, including
Sub-Accounts, the Fixed Account and the Guarantee Periods of the MVA Account.
If the Purchase Payments and forms required to issue a Certificate are in good
order, the initial net purchase payment will be credited to the Certificate
Holder's Account within two (2) business days after receipt by the Annuity
Service Center. Additional purchase payments will be credited to the Certificate
Holder's Account as of the valuation period when they are received.
Allocation percentages must be in whole numbers. Each allocation must be at
least 5%. Allocations made pursuant to a Pre-approved Rebalancing Program are
not subject to such limitations.
CERTIFICATE MAINTENANCE CHARGE:
$30.00 assessed on each Certificate Holder's Anniversary if the total
accumulated value in the Contract on the anniversary is less than $75,000. If
the total accumulated value in the Contract on the date of a full surrender is
less than $75,000, the Certificate Maintenance Charge is assessed in addition to
any applicable Contingent Deferred Sales Charge or Market Value Adjustment.
MORTALITY AND EXPENSE RISK CHARGE: Equal, on an annual basis, to 1.52% of the
average daily net asset value of the Separate Account.
ADMINISTRATION CHARGE: Equal, on an annual basis, to .15% of the average daily
net asset value of the Separate Account.
DISTRIBUTION EXPENSE CHARGE: None
TRANSFERS:
NUMBER OF TRANSFERS PERMITTED: No limit during the Accumulation Period.
TRANSFER FEE: The lesser of $25.00 or 2% of the amount transferred. No transfer
fee on the first 12 transfers in a Certificate Holder's Year. The transfer fee
is deducted from the amount transferred. Transfers made at the end of the Right
to Examine Certificate 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: $250 from any account or the Certificate
Holder's entire interest in any account, if less. This requirement is waived if
the transfer is pursuant to a Pre-approved Dollar Cost Averaging Program or a
Pre-approved Rebalancing Program.
MINIMUM WHICH MUST REMAIN IN EACH ACCOUNT AFTER A TRANSFER: $500 per account or
$0, if the entire amount in any account is transferred.
MAXIMUM AMOUNT WHICH CAN BE TRANSFERRED FROM THE FIXED ACCOUNT TO THE SEPARATE
ACCOUNT DURING THE ACCUMULATION PERIOD: 25% of the Certificate Holder's Fixed
Account Value in any one Certificate Year and then only at the end of a
Guarantee Period. This requirement is waived if the transfer is pursuant to a
Pre-Approved Dollar Cost Averaging Program or a Pre-approved Rebalancing
Program.
WITHDRAWALS: A Contingent Deferred Sales Charge is assessed against purchase
payments withdrawn. The charge is calculated at the time of each withdrawal and
will be deducted from the account value remaining in the Certificate. The
Contingent Deferred Sales Charge is based upon the length of time from receipt
of Purchase Payments to the date of withdrawal. Each Purchase Payment is tracked
as to its date of receipt and withdrawals thereof are determined in accordance
with the following:
NUMBER OF COMPLETE
YEARS SINCE RECEIPT
OF PURCHASE
PAYMENTS CHARGE
--------------------- --------
0 8.5%
1 8.0%
2 7.5%
3 7.5%
4 7.0%
5 6.5%
6 6.0%
7 5.0%
8 4.0%
9 3.0%
10+ 0.0%
FREE WITHDRAWAL: On each Certificate Anniversary, the Free Withdrawal Amount is
equal to the greater of: (a) the earnings in the Certificate Holder's Account or
(b) 10% of Purchase Payments as of the beginning of the current Certificate
Year. On other than Certificate Anniversaries, the Free Withdrawal Amount is
equal to the Free Withdrawal Amount at the beginning of the Certificate Year
less amount withdrawn without deduction of Contingent Deferred Sales Charges
during the current Certificate Year.
MINIMUM PARTIAL WITHDRAWAL: $500. This requirement is waived if the partial
withdrawal is pursuant to a Systematic Withdrawal Option.
MINIMUM CERTIFICATE HOLDER'S ACCOUNT VALUE WHICH MUST REMAIN IN CERTIFICATE
AFTER A PARTIAL WITHDRAWAL: $2,000
MINIMUM CERTIFICATE HOLDER'S ACCOUNT VALUE WHICH MUST REMAIN IN ANY ACCOUNT
AFTER A PARTIAL WITHDRAWAL: $500
WAIVER OF CONTINGENT DEFERRED SALES CHARGE: After the first Certificate Year,
the Contingent Deferred Sales Charge will not apply if: (a) the Certificate
Holder is confined in a skilled nursing facility; (b) a physician certifies that
skilled nursing care is needed; and (c) such confinement continues for 90 days.
A skilled nursing facility is a place which qualifies as a provider of extended
skilled nursing facility services under the Federal Medicare Plan of Title XVIII
of the Social Security Act of 1965, as amended. Certificate of need and proof of
confinement, in writing in a form satisfactory to us, will be required.
ELIGIBLE FUNDS: SUB-ACCOUNTS:
MFS VARIABLE INSURANCE TRUST
MFS Emerging Growth MFS Emerging Growth Sub-Account
MFS Total Return Series MFS Total Return Sub-Account
FEDERATED INSURANCE SERIES
Corporate Bond Fund Federated Corporate Bond Sub-Account
Utility Fund Federated Utility Sub-Account
DREYFUS STOCK INDEX FUND Dreyfus Stock Index Sub-Account
DREYFUS VARIABLE INVESTMENT FUND
Growth and Income Portfolio Dreyfus Growth and Income Sub-Account
XXXXXXX VARIABLE LIFE INVESTMENT FUND
Money Market Portfolio Xxxxxxx Money Market Sub-Account
International Portfolio Xxxxxxx International Sub-Account
XXX XXX INVESTMENT TRUST
Gold and Natural Resources Fund Xxx Xxx Gold and Natural Resources
Sub-Account
ELIGIBLE FUNDS: As selected by the Certificate Holder in the application unless
changed according to the Contract provisions.
SEPARATE ACCOUNT: United Companies Separate Account One
MVA ACCOUNT:
INITIAL CURRENT INTEREST RATE: [4.5%]
INITIAL GUARANTEED PERIOD: [3 Years] [5 Years] [7 Years]
MINIMUM GUARANTEED INTEREST RATE: 3.0%
CURRENT MVA ACCOUNT GUARANTEE PERIOD OPTIONS:
3 Years
5 Years
7 Years
MARKET VALUE ADJUSTMENT FACTOR: The Market Value Adjustment Factor is equal to:
n/12
[ ( 1 + i) / ( 1 + j + .005) ] - 1
where
i = Current interest rate credited to the Certificate Holder's Account
Value allocated to a guarantee period as of the beginning of the
guarantee period.
j = Current Interpolated U.S. Constant Maturity Treasury Rate (CMT) for the
time remaining in the guarantee period plus the difference between I
and the corresponding CMT rate at time of purchase.
n = Number of full months remaining in the guarantee period.
FIXED ACCOUNT:
INITIAL GUARANTEE PERIOD: 1 Year
INITIAL GUARANTEED INTEREST RATE: 3.5%
MINIMUM GUARANTEED INTEREST RATE: 3.0%
RIDERS:
[ENHANCED DEATH BENEFIT ENDORSEMENT]
[IRA ENDORSEMENT]
UNISEX ANNUITY RATES ENDORSEMENT
DEFINITIONS
ACCUMULATION PERIOD: The period prior to the Annuity Date during which Purchase
Payments may be made by a Certificate Holder.
ACCUMULATION UNIT: A unit of measure used to determine the value of a
Certificate Holder's interest in a Sub-Account of the Separate Account during
the Accumulation Period.
AGE: The age of any Certificate Holder or Annuitant on his/her last birthday.
ANNUITANT: The natural person on whose life Annuity Payments to a Certificate
Holder 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 Certificate Schedule.
ANNUITY OPTIONS: Options available for Annuity Payments.
ANNUITY PAYMENTS: The series of payments made to the Certificate Holder 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 SERVICE CENTER: The office indicated on the Contract Schedule of this
Contract to which notices, requests and Purchase Payments must be sent. All sums
payable by the Company under this Contract or any Certificate are payable only
at the Annuity Service Center.
BENEFICIARY: The person(s) or entity(ies) who will receive the death benefit
payable under a Certificate.
CERTIFICATE: The document issued to a Certificate Holder to evidence a
Certificate Holder's Account established under this Group Contract.
CERTIFICATE ANNIVERSARY: The Anniversary of the Certificate Issue Date.
CERTIFICATE ISSUE DATE: The date a Certificate is issued to a Certificate
Holder. The Certificate Issue Date is shown on the Certificate Schedule.
CERTIFICATE HOLDER: A person who has established a Certificate Holder's Account
under this Group Contract.
CERTIFICATE HOLDER'S ACCOUNT: A record established for each Certificate Holder
to maintain values under this Group Contract.
CERTIFICATE HOLDER'S ACCOUNT VALUE: The dollar value as of any Valuation Period
of all amounts accumulated in a Certificate Holder's Account.
CERTIFICATE HOLDER'S ADJUSTED ACCOUNT VALUE: A Certificate Holder's Account
Value less any applicable Premium Tax and Certificate Maintenance Charge. This
amount is applied to the applicable Annuity Tables to determine Annuity
Payments.
CERTIFICATE WITHDRAWAL VALUE: The Certificate Holder's Account Value less any
applicable Premium Tax, less any Contingent Deferred Sales Charge, less any
applicable Certificate Maintenance Charge and plus or minus any Market Value
Adjustment.
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: United Companies Life Insurance Company.
CONTRACT OWNER: The person or entity to which this Group Contract is issued.
CURRENT INTEREST RATE: The interest rate credited to a Certificate Holder's
Account Value by the Company for any given Guarantee Period in the MVA Account
or the Fixed Account. The Initial Current Interest Rates for the selected
Guarantee Periods and for the Fixed Account and the MVA Account are shown on the
Certificate Schedule.
EFFECTIVE DATE: The Effective Date of a Guarantee Period with a Current Interest
Rate. ELIGIBLE FUND: An investment entity shown on the Contract Schedule.
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 with the exception of the Separate Account and other
segregated asset accounts.
GUARANTEE PERIOD: The period for which the Current Interest Rate is credited in
either the MVA Account or the Fixed Account. The Initial Guarantee Periods
selected by the Certificate Holder are shown on the Certificate Schedule.
MARKET VALUE ADJUSTMENT: An adjustment to the amount withdrawn or transferred
from a 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: An investment option where the Company guarantees the rate of
interest for a specified Period and where withdrawals or transfers may be
subject to a Market Value Adjustment.
NET PURCHASE PAYMENT: A Purchase Payment less any applicable Premium Tax.
PORTFOLIO: A segment of an Eligible Fund which constitutes a separate and
distinct class of shares. Portfolios which are available for investment by the
Sub-Accounts under this Contract are shown on the Contract Schedule.
PREMIUM TAX: Any premium taxes incurred to any governmental entity and assessed
against Purchase Payments or a Certificate Holder's Account Value.
PURCHASE PAYMENT: A payment made by a Certificate Holder with respect to this
Contract.
SEPARATE ACCOUNT: The Company's Separate Account designated on the Contract
Schedule.
SUB-ACCOUNT: Separate Account assets are divided into Sub-Accounts which are
listed on the Contract Schedule. 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 Company and the New York Stock Exchange
("NYSE") are 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.
WRITTEN REQUEST: A request in writing, in a form satisfactory to the Company,
which is received by the Annuity Service Center.
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS: The initial Purchase Payment for a Certificate Holder is due
on the Certificate Issue Date. Subject to the maximum and minimum shown on the
Contract Schedule, the Certificate Holder 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: Net Purchase Payments are allocated to one or
more of the Fixed Account or the MVA Account Guarantee Period options and/or to
one or more Sub-Accounts of the Separate Account in accordance with the
selections made by the Certificate Holder. The allocation of the initial Net
Purchase Payment for a Certificate Holder is made in accordance with the
selection made by the Certificate Holder at the Issue Date. Unless otherwise
changed by the Certificate Holder, subsequent Net Purchase Payments are
allocated in the same manner as the initial Net Purchase Payment. Allocation of
the Net Purchase Payments is subject to the Allocation Guidelines shown on the
Certificate Schedule. The Company has reserved the right to allocate initial Net
Purchase Payments to a Money Market Sub-Account until the expiration of the
Right to Examine period.
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNT: The Separate Account is designated on the Contract
Schedule and consists of assets set aside by the Company, which are kept
separate from that of the general assets and all other separate account assets
of the Company. The assets of the Separate Account equal to reserves and other
liabilities will not be charged with liabilities arising out of any other
business the Company may conduct.
The Separate Account assets are divided into Sub-Accounts. The Sub-Accounts
which are available under this Contract are listed on the Contract Schedule. The
assets of the Sub-Accounts are allocated to the Eligible Funds(s) and the
Portfolio(s), if any, within an Eligible Fund, shown on the Contract Schedule.
The Company may, from time to time, add additional Eligible Fund (s) or
Portfolio(s) to those shown on the Contract Schedule. The Certificate Holder may
be permitted to transfer Certificate Holder's Account Values or allocate Net
Purchase Payments to the additional Sub-Account(s) within the Separate Account.
However, the right to make such transfers or allocations will be limited by the
terms and conditions imposed by the Company.
Should the shares of any such Eligible Fund(s) or any Portfolio(s) within an
Eligible Fund become unavailable for investment by the Separate 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 Separate Account 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 Separate Account as a
result of Net Purchase Payments, withdrawals, transfers, or fees and charges.
The Company will determine the number of Accumulation Units of a Sub-Account
purchased or cancelled. 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 for the transaction is received at the Annuity Service
Center.
ACCUMULATION UNIT VALUE: The Accumulation Unit Value for each Sub-Account was
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 for 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 or minus
(iii)the cumulative per share charge or credit for taxes reserved which is
determined by the Company to have resulted from 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; plus or minus the cumulative per share charge or credit for
taxes reserved for the immediately preceding Valuation Date.
C is the factor representing the cumulative unpaid charge for the
Mortality and Expense Risk Charge, for the Administrative Charge, and
for the Distribution Charge, if any, which are shown on the Contract
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 Separate Account which is equal, on
an annual basis, to the amount shown on the Contract Schedule. The Mortality and
Expense Risk Charge compensates the Company for assuming the mortality and
expense risks under this Contract.
ADMINISTRATIVE CHARGE: Each Valuation Period, the Company deducts an
Administrative Charge from the Separate 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 the Separate Account.
DISTRIBUTION EXPENSE CHARGE: Each Valuation Period, the Company deducts a
Distribution Expense Charge from the Separate 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
MVA ACCOUNT: Net 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 Contract Schedule. In addition, during the Accumulation Period, Certificate
Holder's Account Values can be transferred from the Separate Account and/or the
Fixed Account to one or more of the MVA Account Guarantee Period options on the
next Certificate Anniversary.
INTEREST TO BE CREDITED: The Initial Current Interest Rate for the Initial
Guarantee Period of the MVA Account is shown on the Certificate Schedule. After
the Initial Guarantee Period, the Current Interest Rate for any subsequent
Guarantee Period of the MVA Account may change. All interest payable under a
Certificate is compounded daily at the stated effective annual interest rate. In
no event will the Current Interest Rate be less than the Minimum Guarantee
Interest Rate, prior to the application of the Market Value Adjustment,
specified on the Contract Schedule.
GUARANTEE PERIOD: The Initial Current Guarantee Period is shown on the
Certificate Schedule. During the thirty (30) days prior to the end of a current
Guarantee Period, the Certificate Holder may renew for the same or any other
Guarantee Period at the then Current Interest Rate or may elect to transfer all
or a portion of the amount to the Fixed Account or to the Separate Account. Any
transfer elected will be made as of the last Valuation Date of a current
Guarantee Period and will not be subject to the Market Value Adjustment.
If the Certificate Holder does not specify a Guarantee Period at the time of
renewal, the Company will select 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 Holder. If such Guarantee Period does
extend beyond the latest Annuity Date, the Company will choose the longest
period that will not extend beyond such date. If a renewal occurs within one
year of the latest Annuity Date, the Company will choose the 1-year Fixed
Account option and will credit interest up to the Annuity Date at the Current
Interest Rate for the 1-year Guarantee Period as of the renewal rate.
MULTIPLE GUARANTEE PERIODS: The Certificate Holder 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 Current
Interest Rates to the Certificate Holder's Account Value attributable:
1. to different Guarantee Periods; and
2. to Guarantee Periods of the same duration with different Effective
Dates.
CHANGE IN GUARANTEE PERIOD: The Certificate Holder, may upon Written Request,
change to any Guarantee Period then being offered by the Company with respect to
contracts and certificates 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: Except on the latest Annuity Date, any amount
withdrawn, transferred or annuitized prior to the end of that 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 a Certificate; (2)
amounts withdrawn to pay fees or charges; and (3) amounts withdrawn or
transferred from the MVA Account at the end of the Guarantee Period.
MVA ACCOUNT VALUES: The MVA Account value of a Certificate Holder's Account at
any time is equal to:
1. the Net Purchase Payments allocated to the MVA Account: plus
2. the Certificate Holder's Account Value transferred to the MVA Account:
plus
3. interest credited to the Certificate Xxxxxx's interest in the MVA
Account; less
4. any prior withdrawals of a Certificate Holder's Account Value in the
MVA Account and any Contingent Deferred Sales Charge: less
5. any Certificate Holder's Account Value transferred from the MVA
Account; less
6. Certificate Maintenance Charges or Transfer Fees.
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 Value of a Certificate Holder's Account
at any time is equal to:
1. the Net Purchase Payments allocated to the Fixed Account; plus
2. the Certificate Holder's Account Value transferred to the Fixed
Account; plus
3. interest credited to the Certificate Holder's Account in the Fixed
Account; less
4. any prior withdrawals of a Certificate Holder's Account in the Fixed
Account and any Contingent Deferred Sales Charge; less
5. any Certificate Holder's Account Value transferred from the Fixed
Account; less
6 Certificate Maintenance Charges or transfer fees.
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 HOLDER'S ACCOUNT VALUE
The Certificate Holder's Account Value for any Valuation Period is the sum of
the Certificate Holder's Account Value in each of the Sub-Accounts of the
Separate Account, the Certificate Holder's Account Value in the MVA Account and
the Certificate Holder's Account Value in the Fixed Account.
The Certificate Holder's Account Value in a Sub-Account of the Separate Account
is determined by multiplying the number of Accumulation Units allocated to the
Certificate Holder'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 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 deducts a Certificate Maintenance
Charge from the Certificate Holder's Account Value by reducing the Certificate
Holder's Account Values in the Fixed Account and/or the MVA Account and by
cancelling Accumulation Units from each applicable Sub-Account to reimburse it
for expenses relating to maintenance of the Certificate. The Certificate
Maintenance Charge will be deducted from the Fixed Account and/or the MVA
Account and the Sub-Accounts in the Separate Account in the same proportion that
the amount of Certificate Holder's Account Value in the Fixed Account and/or the
MVA Account and each Sub-Account bears to the total Certificate Holder's Account
Value. The Certificate Maintenance Charge is shown on the Contract Schedule.
During the Accumulation Period, the Certificate Maintenance Charge will be
deducted from the Certificate Holder's Account Value on each Certificate
Anniversary while the Certificate is in force. If a total withdrawal is made on
other than a Certificate Anniversary, the Certificate Maintenance Charge will be
deducted at the time of withdrawal.
TRANSFERS
TRANSFERS PRIOR TO THE ANNUITY DATE: Subject to any limitation imposed by the
Company on the number of transfers during the Accumulation Period shown on the
Contract Schedule, the Certificate Holder may, after the expiration of any Right
to Examine Period, transfer all or part of the Certificate Holder's Account
Value in the Fixed Account, the MVA Account or a Sub-Account by Written 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 will be deducted from
the amount which is transferred.
2. 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 is shown on the Contract Schedule. The maximum amount
which can be transferred from the Fixed Account to the Separate
Account or the MVA Account is 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 the Certificate Holder elects to use this transfer privilege, the Company
will not be liable for transfers made in accordance with the Certificate
Holder's instructions. 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 Annuity Service Center.
WITHDRAWAL PROVISIONS
WITHDRAWALS: During the Accumulation Period, the Certificate Holder may, upon
Written Request, make a total or partial withdrawal of the Certificate
Withdrawal Value.
Unless the Certificate Holder instructs the Company otherwise, a partial
withdrawal will be made from the Separate Account. A partial withdrawal from the
Separate Account will result in the cancellation of Accumulation Units from each
applicable Sub-Account in the ratio that the Certificate Holder's interest in
the Sub-Account bears to the total Certificate Holder's Account Value in all
Sub-Accounts. The Certificate Holder must specify by Written Request in advance
which Sub-Account Accumulation Units are to be cancelled if other than the above
method is desired.
A partial withdrawal from the Fixed Account or the MVA Account is made for a
Certificate with Multiple Guarantee Periods by a withdrawal first from the
1-year Fixed Account and next from the Guarantee Period of the shortest
remaining duration and then from the Guarantee Period with the earliest
Effective Date where the Guarantee Periods are of the same duration. A partial
withdrawal is taken first from the Certificate Withdrawal Value for which the
Free Withdrawal Provision applies and then from the Withdrawal Value for which
there is no waiver. A withdrawal from the MVA Account may be subject to a Market
Value Adjustment.
The Company will pay the amount of any withdrawal within seven (7) days of
receipt of a request in good order unless the Suspension or Deferral of Payments
Provision is in effect.
Each partial withdrawal must be for an amount which is not less than the amount
shown on the Contract Schedule. The minimum Certificate Holder's Account Value
which must remain in a Sub-Account after a partial withdrawal is shown on the
Contract Schedule.
CONTINGENT DEFERRED SALES CHARGE: Upon a withdrawal of a Certificate Holder's
Withdrawal Value a Contingent Deferred Sales Charge as set forth on the Contract
Schedule may be assessed. The Contingent Deferred Sales Charge may be waived as
set forth on the Contract Schedule under "Free Withdrawal".
PROCEEDS PAYABLE ON DEATH
DEATH OF CERTIFICATE HOLDER DURING THE ACCUMULATION PERIOD: Upon the death of
the Certificate Holder or Joint Certificate Holder, prior to the Annuity Date,
the death benefit will be paid to the Beneficiary(ies) designated by the
Certificate Holder. Upon the death of a Joint Certificate Holder, the surviving
Joint Certificate Holder, 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
Holder, he or she may elect to continue the Certificate at the then current
Certificate Holder's Account Value in his or her own name and exercise all the
Certificate Holder's rights under the Certificate.
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD: The death benefit will be
the greater of (i) the Purchase Payments, less any withdrawals and related
Contingent Deferred Sales Charges; or (ii) the Certificate Holder's Account
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.
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 Holder during the Accumulation Period:
Option 1 - lump sum payment of the death benefit; or
Option 2 - the payment of the entire death benefit within five (5) years of
the date of the Certificate Holder; 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 Holder or any Joint Certificate Holder.
Any portion of the death benefit not applied under Option 3 within one (1) year
of the date of the Certificate Holder's death, must be distributed within five
(5) 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 Holder's Account 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 is in effect. Payment to the Beneficiary, other
than in a single sum, may only be elected during the 60-day period beginning
with the date of receipt of proof of death.
DEATH OF CERTIFICATE HOLDER DURING THE ANNUITY PERIOD: If the Certificate Holder
or a Joint Certificate Holder, 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 Holder's death. Upon the death of the Certificate Holder during the
Annuity Period, the Beneficiary becomes the Certificate Holder.
DEATH OF ANNUITANT: Upon the death of an Annuitant, who is not the Certificate
Holder, during the Accumulation Period, the Certificate Holder 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 Holder will become the Annuitant. If the Certificate Holder is a
non-natural person, the death of the Annuitant will be treated as the death of
the Certificate Holder and a new Annuitant may not be designated.
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;
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 Holder.
Unless the Certificate Holder 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 Holder's
and/or the Annuitant's death, as applicable; or if there are none
2. to the Contingent Beneficiary(ies) who survive the Certificate
Xxxxxx's and/or the Annuitant's death, as applicable; or if there are
none
3. to the estate of the Certificate Holder.
CHANGE OF BENEFICIARY: Subject to the rights of any irrevocable
Beneficiary(ies), the Certificate Holder 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 Separate
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);
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 Separate Account is not reasonably practicable or it is not
reasonably practicable to determine the value of the Separate
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 Holders;
provided that applicable rules and regulations of the Securities and Exchange
Commission will govern as to whether the conditions described in (2) and (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 HOLDER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
CERTIFICATE HOLDER: The Certificate Holder has all interest and right to amounts
held in his or her Certificate Holder's Account. The Certificate Holder is the
person designated as such on the Certificate Issue Date, unless changed. The
Certificate Holder may change holders of the Certificate at any time prior to
the Annuity Date by Written Request. A change of Certificate Holder will
automatically revoke any prior designation of Certificate Holder. The change
will become effective as of the date the Written Request is signed. A new
designation of Certificate Holder will not apply to any payment made or action
taken by the Company prior to the time it was received.
JOINT CERTIFICATE HOLDER: A Certificate may be owned by Joint Certificate
Holders. If Joint Certificate Holders are named, any Joint Certificate Holder
must be the spouse of the other Certificate Holder. Upon the death of either
Certificate Holder, 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.
CONTRACT OWNER: The Contract Owner has title to the Contract. The Contract and
any amount accumulated thereunder are not subject to the claims of the Contract
Owner nor any of its creditors. The Contract Owner may transfer ownership of
this Group Contract. Any transfer of ownership terminates the interest of any
existing Contract Owner. It does not change the rights of any Certificate
Holder.
ANNUITANT: The Annuitant is the person on whose life Annuity Payments are based.
The Annuitant is the person designated by the Certificate Holder at the
Certificate Issue Date, unless changed prior to the Annuity Date. The Annuitant
may not be changed after the annuity date nor in a Certificate which is owned by
a non-natural person. Any change of Annuitant is subject to the Company's
underwriting rules then in effect.
ASSIGNMENT OF A CERTIFICATE: A Written Request specifying the terms of an
assignment of a Certificate must be provided to the Annuity Service Center.
Until the Written Request is received, the Company will not be required to take
notice of or be responsible for any transfer of interest in the Certificate by
assignment, agreement, or otherwise.
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 Holder's rights may only be
exercised with the consent of the assignee of record.
ANNUITY PROVISIONS
GENERAL: On the Annuity Date, the Adjusted Certificate Holder's Account Value
will be applied under the Annuity Option selected by the Certificate Holder.
Annuity Payments will be made on a fixed basis only.
ANNUITY DATE: The Annuity Date is selected by the Certificate Holder at the
Certificate Issue Date. The Annuity Date must be at least three years after the
Certificate Issue Date. The Annuity Date may not be later than when the
Annuitant reaches attained age 85 or 10 years after the Certificate Issue Date
for issue ages after age 75.
Prior to the Annuity Date, the Certificate Holder 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 Holder. If no Annuity Option is selected, Option B
with 120-month guarantee will automatically be applied. Prior to the Annuity
Date, the Certificate Holder 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 Holder's Adjusted Account Value is applied to the
Annuity Table for the Annuity Options selected. If the Certificate Holder's
Adjusted Account Value to be applied under an Annuity Option is less than
$2,000, 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 $200, the
Company reserves the right to reduce the frequency of payments to an interval
which will result in each payment being at least $200.
ANNUITY OPTIONS: The following Annuity Options or any other annuity option
acceptable to the Company may be selected:
OPTION A. LIFE ANNUITY: Monthly Annuity Payments during the life of the
Annuitant.
OPTION B. LIFE ANNUITY WITH PERIODS CERTAIN OF 60, 120, 180 OR 240 MONTHS:
Monthly Annuity Payments during the lifetime of the Annuitant and in any
event for sixty (60), one hundred twenty (120), one hundred eighty (180) or
two hundred forty (240) months certain as selected.
OPTION C. JOINT AND SURVIVOR ANNUITY: Monthly Annuity Payments payable
during the joint lifetime of the Annuitant and a Joint Annuitant and then
during the lifetime of the survivor.
FIXED ANNUITY: The Adjusted Certificate Holder's Account Value is allocated to
the General Account and the Annuity is paid as a Fixed Annuity. Unless the
Certificate Holder specifies otherwise, the payee of the Annuity Payments shall
be the Certificate Holder.
The Adjusted Certificate Holder Account Value will be applied to the applicable
Annuity Table contained in the Certificate based upon the Annuity Option
selected by the Certificate Holder. The amount of the first payment for each
$1,000 of Adjusted Certificate Holder's Account Value is shown in the Annuity
Tables. If, as of the Annuity Date, the current Annuity Option rates applicable
to this class of contracts provide an initial Annuity Payment greater than that
guaranteed under the same Annuity Option under a Certificate, the greater
payment will be made.
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.
MORTALITY TABLES: The Annuity Tables contained in the Certificate utilize a
minimum guaranteed rate of 3% per year for the determination of the monthly
Fixed Annuity Payment.
The mortality table used in determining the Annuity Purchase Rates for Option A,
B, and C is the 1983 Individual Annuity Mortality Table A with Projection Scale
G.
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 consist of this Contract, the Application, if
any, and any riders or endorsements attached to this Contract.
This Contract may be changed or altered only by the President or 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 overpayments will be deducted from future Annuity
Payments until the total is repaid.
INCONTESTABILITY: A Certificate will not be contestable after it has been in
force for a period of two years from the Certificate Issue Date.
MODIFICATION: This Contract and any Certificate issued thereunder may be
modified in order to maintain compliance with applicable state and federal law.
NON-PARTICIPATING: This Contract and any Certificate issued thereunder will not
share in any distribution of dividends.
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 or
Certificate Holder.
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
if the person is entitled to them under any Certificate. No payment and no
amount under any Certificate can be taken or assigned in advance of its payment
date unless the Company receives the Certificate Holder's written consent.
REPORTS: At least once each calendar year, the Company will furnish the
Certificate Holder with a report showing the Certificate Holder's Account Value
and any other information as may be required by law. The Company will also
furnish an annual report of the Separate Account. Reports will be sent to the
last known address of the Certificate Holder.
TAXES: Any taxes paid to any governmental entity relating to any Certificate
will be deducted from the Purchase Payment or Certificate Holder's Account Value
when incurred. The Company will, in its sole discretion, determine when taxes
have resulted from the investment experience of the Separate Account; receipt by
the Company of the Purchase Payments; or commencement of Annuity Payments. The
Company may, in its sole discretion, pay taxes when due and deduct that amount
from the Certificate Holder's Account 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. 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 it 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.
[back page of contract is split in half vertically with a graphic line. To the
right of the page is the following text:]
FOR FURTHER INFORMATION OR
TO DISCUSS A PROBLEM OR COMPLAINT,
PLEASE CALL US AT
0-000-000-0000
[United Companies logo- a capitalized "U" lying flat with the ends of the "U"
pointing toward the right side of the page with a capitalized "C" looped through
the bend in the "U". The ends of the "C" point toward the left of the page. To
the right of the "C is printed the company name.]
UNITED COMPANIES LIFE COMPANY
Baton Rouge, Louisiana
Flexible Premium Deferred Annuity Contract
Monthly Annuity Income Payable
on Maturity Date
Non-Participating
