PLEASE READ THIS CONTRACT CAREFULLY
ANNUITY BENEFIT PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNT, MAY INCREASE OR DECREASE
AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. PLEASE REFER TO THE VALUE OF
THE VARIABLE ACCOUNT SECTION FOR ADDITIONAL INFORMATION.
Values removed from a Guarantee Period Account prior to the end of its Guarantee
Period may be subject to a Market Value Adjustment that may increase or decrease
the values. A negative Market Value Adjustment will never be applied to the
Death Benefit. A positive Market Value Adjustment, if applicable, will be added
to the Death Benefit when the benefit paid is the contract's Accumulated Value.
Please refer to the Market Value Adjustment section for additional information.
RIGHT TO EXAMINE CONTRACT
The Owner may cancel this contract by returning it to the Company or one of its
authorized representatives within ten days after receipt. If returned, the
Company will refund an amount equal to the Accumulated Value, after application
of any Market Value Adjustment, plus any fees or other charges imposed. If,
however, the contract is issued as an Individual Retirement Annuity (IRA), the
Company will refund the greater of the above or gross payments.
ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY
Home Office: Dover, Delaware
Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000
This is a legal contract between Allmerica Financial Life Insurance and Annuity
Company (the Company) and the Owner and is issued in consideration of the
Initial Payment shown on the Specifications page. Additional Payments are
permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account
or Guarantee Period Accounts. While this contract is in effect, the Company
agrees to pay annuity benefit payments beginning on the Annuity Date or to pay a
Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date.
/s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx
President Secretary
Flexible Payment Deferred Variable and Fixed Annuity
Annuity Benefit Payments Payable on the Annuity Date
Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date
Non-Participating
Form A3036-01 1 BACS11
TABLE OF CONTENTS
SPECIFICATIONS ............................................................. 3
DEFINITIONS ................................................................ 9
OWNER, ANNUITANT AND BENEFICIARY ........................................... 11
THE ACCUMULATION PHASE
PAYMENTS .......................................................... 13
VALUES ............................................................ 14
TRANSFER .......................................................... 15
XXXXXXXXXX AND SURRENDER .......................................... 16
DEATH BENEFIT ..................................................... 17
THE PAYOUT PHASE
ANNUITY BENEFIT.................................................... 19
TRANSFER .......................................................... 21
WITHDRAWAL ........................................................ 22
PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS ......................... 23
DEATH OF THE ANNUITANT ............................................ 23
ANNUITY BENEFIT PAYMENT OPTIONS ................................... 24
ANNUITY BENEFIT PAYMENT GUARANTEE OPTIONS ......................... 24
ANNUITY OPTION RATE TABLES ........................................ 24
GENERAL PROVISIONS ......................................................... 28
Form A3036-01 2 BACS11
SPECIFICATIONS
(TO BE ISSUED ON THE ISSUE DATE)
Contract Type: [NQ] Contract Number: [xx00000000]
Issue Date: [01/01/2002] Annuity Date: [01/01/2035]
(Must be at least [1] year(s) after the issue date)
Owner: [Xxxx Xxx] Owner Date of Birth: [01/01/1950]
Joint Owner: [Xxxx Xxx] Joint Owner Date of Birth: [01/01/1950]
Annuitant: [Xxxx Xxx] Xxxxxxxxx Date of Birth [01/01/1950]
Joint Annuitant: [Xxxx Xxx] Joint Annuitant Date of Birth [01/01/1950]
Annuitant Sex: [Male] Beneficiary(ies):
Joint Annuitant Sex: [Male] Primary: Surviving Joint Owner, if any
1st Contingent: [Xxxx Xxx]
2nd Contingent: [Xxxx Xxx]
Minimum Fixed Account Minimum Additional Payment
Guaranteed Interest Rate: [2.75%] Amount: [$50.00]
Guarantee Period Account Guarantee Period Account
Minimum Interest Rate: [2.75%] Minimum Allocation Amount: [$1,000.00]
Minimum Withdrawal Minimum Accumulated Value
Amount: [$100.00] After Withdrawal: [$1,000.00]
Minimum Annuity Maximum Alternative Annuity
Benefit Payment: [$100.00] Date: [01/01/2035]
(Must be at least [1] year(s) after the issue date)
Mortality and Expense Risk Charge: [1.30%] on an annual basis of the daily
value of the Sub-Account assets.
Administrative Charge: [.20%] on an annual basis of the daily value of the
Sub-Account assets.
Contract Fee: [$35], if the Accumulated Value is less than $75,000.00
Waived for 401 (k)s.
Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000
[(0-000-000-0000)]
Form A8036-01 3 BACS11
SPECIFICATIONS (CONTINUED)
(TO BE ISSUED ON THE ISSUE DATE)
Owner: [Xxxx Xxx] Contract Number: [zz00000000]
Joint Owner: [Xxxx Xxx]
Initial Payment: [$75,000.00]
Payment Allocation: The Initial Payment is allocated in the following manner:
VARIABLE SUB-ACCOUNTS:
[Fund A
Fund B
Fund C]
FIXED ACCOUNT:
Form A8036-01 4 BACS11
SPECIFICATIONS (CONTINUED)
(TO BE ISSUED ON THE ISSUE DATE)
Owner: [Xxxx Xxx] Contract Number: [zz00000000]
Joint Owner: [Xxxx Xxx]
GUARANTEE PERIOD ACCOUNTS:
GUARANTEE PERIOD INTEREST RATE EXPIRATION DATE
[2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years]
--------------
100% TOTAL OF ALL ACCOUNTS
Form A8036-01 5 BACS11
SPECIFICATIONS (CONTINUED)
(TO BE ISSUED ON THE ISSUE DATE)
Owner: [Xxxx Xxx] Contract Number: [zz00000000]
Joint Owner: [Xxxx Xxx]
RIDER(S) SELECTED:
[Enhanced Death Benefit Rider:
EDB Effective Annual Yield [5%]
EDB Charge:
For amounts allocated to the variable Sub-Accounts: [.25%] on an annual
basis of the daily value of the Sub-Account Assets.
For amounts allocated to the Fixed Account: The credited rate will be
[.25%] lower than if the rider was not selected.
For amounts allocated to the Guarantee Period Accounts: The Guaranteed
Interest Rate will be [.25%] lower than if the rider was not selected.
The EDB charge only applies during the Accumulation Phase.]
Form A8036-01 6 BACS11
THIS PAGE INTENTIONALLY LEFT BLANK
Form A8036-01 7 BACS11
THIS PAGE INTENTIONALLY LEFT BLANK
Form A8036-01 8 BACS11
DEFINITIONS
Accumulated Value The aggregate value of all accounts in this
contract before the Annuity Date. As long as the
Accumulated Value is greater than zero, the
contract will stay in effect.
Accumulation Unit A measure used to calculate the value of a
Sub-Account before annuity benefit payments
begin.
Annuitant On and after the Annuity Date, the person upon
whose continuation of life annuity benefit
payments involving life contingency depend. Joint
Annuitants are permitted and unless otherwise
indicated, any reference to Annuitant shall
include Joint Annuitants.
Annuity Date The date annuity benefit payments begin. The
Annuity Date is shown on the Specification page.
Annuity Unit A measure used to calculate annuity benefit
payments under a variable annuity option.
Beneficiary The person, persons or entity entitled to the
Death Benefit prior to the Annuity Date or any
annuity benefit payments upon the death of the
Owner on or after the Annuity Date.
Company Allmerica Financial Life Insurance and Annuity
Company.
Contract Year A one-year period based on the issue date or an
anniversary thereof.
Effective Valuation Date The Valuation Date on or immediately following
the day a payment, request for transfer,
withdrawal, surrender, or Proof of Death is
received at the Principal Office.
Fixed Account The part of the Company's General Account to
which all or a portion of a Payment or
transfer may be allocated.
Fund Each separate investment company, investment
series or portfolio eligible for investment by
a Sub-Account of the Variable Account.
General Account All assets of the Company that are not allocated
to a Separate Account.
Guarantee Period The number of years that a Guaranteed Interest
Rate may be credited to a Guarantee Period
Account.
Guarantee Period Account An account which corresponds to a Guaranteed
Interest Rate for a specified Guarantee Period
and is supported by assets in a Separate Account.
The Owner may only invest in a Guarantee Period
Account prior to the Annuity Date.
Guaranteed Interest Rate The annual effective rate of interest, after
daily compounding, credited to a Guarantee
Period Account.
Market Value Adjustment A positive or negative adjustment to earnings
in a Guarantee Period Account assessed if any
portion of a Guarantee Period Account is
withdrawn or transferred prior to the end of
its Guarantee Period.
Form A3036-01 9 BACS11
Owner The person, persons or entity entitled to
exercise the rights and privileges under this
contract. Joint Owners are permitted and unless
otherwise indicated, any reference to Owner shall
include joint Owners.
Proof of Death The date on which both the death
certificate and all necessary claim paperwork
have been received at the Principal Office.
Pro Rata How a Payment or withdrawal may be allocated
among the accounts. A Pro Rata allocation or
withdrawal will be made in the same proportion
that the value of each account bears to the
Accumulated Value.
Request A request or notice made by the Owner, in a
manner consistent with the Company's current
procedures, which is received and recorded by
the Company.
Qualified Contract For purposes of this contract only, a contract
that is purchased in connection with a
retirement plan which meets the requirements of
Sections 401, 403, 408 and 408A of the Internal
Revenue Code.
Separate Account A segregated account established by the
Company. The assets in a Separate Account are not
commingled with the Company's general assets and
obligations. The assets of a Separate Account are
not subject to claims arising out of any other
business the Company may conduct.
State The state or jurisdiction in which the contract
is issued.
Sub-Account A Variable Account subdivision that invests
exclusively in shares of a corresponding Fund.
Surrender Value The amount payable to the Owner on full
surrender after application of any Market Value
Adjustment and Contract Fee.
Survivor Annuity Benefit The number of Annuity Units (under a variable
Percentage joint life annuitization option) or the dollar
value of the annuity benefit payments (under a
fixed joint life annuitization option) paid
during the surviving Annuitant's life may be
less than or equal to the number of
Annuity Units paid when both individuals are
living, The Survivor Annuity Benefit Percentage
is the percentage of total Annuity Units or
dollars paid in each annuity benefit during the
survivor's life. For example, with a Joint and
Two-thirds Survivor Option, the Survivor Annuity
Benefit Percentage is 66 2/3%. This percentage is
only applicable after the death of the first
Annuitant.
Valuation Date A day the values of all units are determined.
Valuation Dates occur on each day the New
York Stock Exchange is open for trading, or
such other dates when there is sufficient trading
in a Fund's portfolio securities such that the
current unit value may be materially affected.
Valuation Period The interval between two consecutive Valuation
Dates.
Variable Account The Company's Separate Account, consisting of
Sub-Accounts that invest in the underlying Funds.
Form A3036-01 10 BACS11
OWNER, ANNUITANT AND BENEFICIARY
Owner When the contract is issued, the Owner will be as
shown on the Specifications page. The Owner may
be changed in accordance with the terms of this
contract. Upon the death of an Owner prior to the
Annuity Date, a Death Benefit is paid. The
Maximum Alternative Annuity Date is based upon
the age of the Owner.
The Owner may exercise all rights and options
granted in this contract or by the Company,
subject to the consent of any irrevocable
Beneficiary. Where there are joint Owners, the
consent of both is required in order to exercise
any ownership rights.
Assignment Prior to the Annuity Date and prior to the death
of an Owner, the Owner may be changed at any
time. Only the Owner may assign this contract. An
absolute assignment will transfer ownership to
the assignee. This contract may also be
collaterally assigned as security. The
limitations on ownership rights while the
collateral assignment is in effect are stated in
the assignment. Additional limitations may exist
for contracts issued under provisions of the
Internal Revenue Code.
An assignment will take place only when the
Company has actually received a Request in
writing and recorded the change at the Principal
Office. The Company will not be deemed to know of
the assignment until such time. When recorded,
the assignment will take effect as of the date it
was signed. The assignment will be subject to
payments made or actions taken by the Company
before the change was recorded.
The Company will not be responsible for the
validity of any assignment nor the extent of any
assignee's interest. The interests of the
Beneficiary will be subject to any assignment.
Annuitant When the contract is issued, the Annuitant will
be as shown on the Specifications page. The
Annuitant may be changed in accordance with the
terms of this contract. Prior to the Annuity
Date, an Annuitant may be replaced or added
unless the Owner is a non-natural person. At
all times there must be at least one Annuitant.
If the Annuitant dies and a replacement is not
named, the Owner will be considered to be the
new Annuitant. Upon the death of an Annuitant
prior to the Annuity Date, a Death Benefit is
not paid unless the Owner is a non-natural
person.
A change of Annuitant will take place only when
the Company has actually received a Request in
writing and recorded the change at the Principal
Office. The Company will not be deemed to
know of the change of Annuitant until such time.
When recorded, the change of Annuitant will
take effect as of the date it was signed. The
change of Annuitant will be subject to payments
made or actions taken by the Company before the
change was recorded.
Beneficiary The Beneficiary is as named on the Specifications
page unless subsequently changed. The Owner may
declare any Beneficiary to be revocable or
irrevocable. A revocable Beneficiary may be
changed at any time prior to the Annuity Date and
before the death of an Owner or after the Annuity
Date and before the death of the Annuitant.
Form A3036-01 11 BACS11
An irrevocable Beneficiary must consent in
writing to any change. Unless otherwise
indicated, the Beneficiary will be revocable.
A Beneficiary change must be made in writing in
a form acceptable to the Company and will be
subject to the rights of any assignee of record.
When the Company receives the form, the change
will take place as of the date it was signed,
even if an Owner or the Annuitant dies after the
form is signed but prior to the Company's receipt
of the form. Any rights created by the change
will be subject to payments made or actions taken
by the Company before the change was recorded.
All benefits payable to the Beneficiary under
this contract will be divided equally among the
surviving Beneficiaries of the same class, unless
the Owner directs otherwise. If there is no
surviving Beneficiary in a particular class (e.g.
1st Contingent Beneficiary, see Specifications
page), the benefit is divided equally among the
surviving Beneficiaries of the next class. If
there is no surviving Beneficiary, the deceased
Beneficiary's interest will pass to the Owner or
the Owner's estate. At the death of the first
joint Owner prior to the Annuity Date, the
surviving joint Owner is the sole, primary
Beneficiary notwithstanding that the designated
Beneficiary may be different.
The Beneficiary can not assign, transfer,
commute, anticipate or encumber the proceeds or
payments unless given that right by the Owner.
Protection of Proceeds To the extent allowed by law, this
contract and any payments made under it will be
exempt from the claims of creditors.
Form A3036-01 12 BACS11
THE ACCUMULATION PHASE
PAYMENTS
Payments Each Payment is equal to the gross payment less
the amount of any applicable premium tax. The
Company reserves the right to deduct the amount
of the premium tax from the Accumulated Value at
a later date rather than when the premium tax
liability is first incurred by the Company. In no
event will an amount be deducted for premium
taxes before the Company has incurred a tax
liability under applicable State law.
Initial Payment The Initial Payment is shown on the
Specifications page.
Additional Payments Prior to the Annuity Date and before the
death of an Owner, the Owner may make additional
Payments of at least the Minimum Additional
Payment Amount (see Specifications page). Total
Payments made may not exceed $5,000,000 without
the Company's consent.
Payment Allocations If the applicable refund amount
(outlined in the Right to Examine Contract
provision, see page 1) provides for a refund of:
(a) gross payments, or
(b) the greater of the Accumulated Value,
after application of any Market Value
Adjustment, plus any fees or other
charges imposed or gross payments,
then the Initial Payment and any subsequent
Payment made during the contract's first fifteen
days, allocated to the Sub-Accounts, will be
allocated to the money market Sub-Account. After
the first fifteen days, such amounts will be
allocated in accordance with the Payment
Allocation, shown on the Specifications page. New
Payments made after the first fifteen days will
be allocated in accordance with the Payment
Allocation shown on the Specifications Page
unless allocation instructions accompany the
Payment or the Payment Allocation is changed by
the Owner.
If the applicable refund amount provides
otherwise, the Initial Payment will be allocated
in accordance with the Payment Allocation, shown
on the Specifications page. Each subsequent
Payment will be allocated in the same manner
unless allocation instructions accompany the
Payment or the Payment Allocation is changed by
the Owner.
The minimum amount that may be allocated to the
Guarantee Period Account is shown on the
Specifications page. If the Owner requests an
allocation less than the minimum amount, the
Company reserves the right to apply that amount
to the money market Sub-Account.
Form A3036-01 13 BACS11
VALUES
Value of the Variable The value of a Sub-Account on a Valuation Date is
Account determined by multiplying the Accumulation Units
in that Sub-Account by the Accumulation Unit
Value as of the Valuation Date.
Accumulation Units are purchased when an amount
is allocated to a Sub-Account. The number of
Accumulation Units purchased equals that amount
divided by the applicable Accumulation Unit Value
as of the Valuation Date.
Accumulation Unit The value of a Sub-Account Accumulation Unit
Values as of any Valuation Date is determined by
multiplying the value of an Accumulation Unit
for the preceding Valuation Date by the Net
Investment Factor for that Valuation Period.
Net Investment Factor The Net Investment Factor measures the investment
performance of a Sub-Account from one Valuation
Period to the next. This factor is equal to
1.000000 plus the result (which may be positive
or negative) from dividing (a) by (b) and
subtracting (c) and (d) where:
(a) is the investment income of a
Sub-Account for the Valuation Period,
including realized or unrealized
capital gains and losses during the
Valuation Period, adjusted for
provisions made for taxes, if any;
(b) is the value of that Sub-Account's
assets at the beginning of the
Valuation Period;
(c) is the Mortality and Expense Risk Charge
applicable to the current Valuation
Period plus any applicable Rider
charges (see Specifications page); and
(d) is the Administrative Charge applicable
to the current Valuation Period (see
Specifications page).
The Company assumes the risk that its actual
mortality expense experience may exceed the
amounts provided under the contract. The Company
guarantees that the charge for mortality and
expense risks and the administrative charge will
not be increased. Subject to applicable State and
federal laws, these charges may be decreased or
the method used to determine the Net Investment
Factor may be changed.
Value of the Fixed Amounts allocated to the Fixed Account receive
Account interest at rates periodically set by the
Company. The Company guarantees that the initial
rate of interest in effect when an amount is
allocated to the Fixed Account will remain in
effect for that amount for one year or until such
amount is transferred out of the Fixed Account,
whichever is sooner. Thereafter, the rate of
interest for that amount will be the Company's
current interest rate, but no less than the
Minimum Fixed Account Guaranteed Interest Rate
(see Specifications page).
The value of the Fixed Account on any date is the
sum of amounts allocated to the Fixed Account
plus interest compounded and credited daily at
the rates applicable to those amounts. The
value of the Fixed Account will be at least
equal to the minimum required by law in the
State in which this contract is delivered.
Form A3036-01 14 BACS11
Value of the Guarantee Amounts allocated to the same Guarantee Period
Period Accounts Account on the same day will be treated as one
Guarantee Period Account. The interest rate in
effect when an amount is allocated to a Guarantee
Period Account is guaranteed for the duration of
the Guarantee Period. Each time the Guaranteed
Interest Rate changes for a particular Guarantee
Period, a new Guarantee Period Account is
established.
The value of a Guarantee Period Account on any
date is the sum of amounts allocated to that
Guarantee Period Account plus interest compounded
and credited daily at the rate applicable to that
amount.
Guaranteed Interest The Company will periodically set Guaranteed Interest
Rates Rates for each available Guaranteed Period. These
rates will be guaranteed for the duration of the
respective Guarantee Periods. A Guaranteed Interest
Rate will never be less than the Guarantee Period
Account Minimum Interest Rate (see Specifications
page).
Renewal Guarantee At least 45 days (but not more than 75 days) prior
Periods to the end of a Guarantee Period, the Company will
notify the Owner in writing of the expiration of that
Guarantee Period. The Owner may transfer amounts
to the Sub-Accounts, the Fixed Account or establish a
new Guarantee Period Account of any duration then
offered by the Company as of the day following
the expiration of the Guarantee Period. The
transfer will not be subject to a Market Value
Adjustment; see "Market Value Adjustment"
provision. Guaranteed Interest Rates
corresponding to the available Guarantee Periods
may be higher or lower than the previous
Guaranteed Interest Rate. If reallocation
instructions are not received at the Principal
Office before the end of a Guarantee Period, the
Guarantee Period Account value will be
automatically applied to a new Guarantee Period
Account with the same Guarantee Period unless:
(a) the Guarantee Period Account value is
less than the Guarantee Period Account
Minimum Allocation Amount (see
Specifications page) on its expiration
date; or
(b) the Guarantee Period would extend
beyond the Annuity Date or is no
longer available.
In such cases, the Guarantee Period Account value
will be transferred to the money market
Sub-Account.
Contract Fee Prior to the Annuity Date, on each Contract
Anniversary, and when the Contract is surrendered,
the Company will deduct a Contract Fee (see
Specifications page) Pro Rata.
TRANSFER
Prior to the Annuity Date, the Owner may transfer
amounts among accounts by Request to the Principal
Office. Transfers to a Guarantee Period Account
must be at least equal to the Guarantee Period
Account Minimum Allocation Amount (see
Specifications page). If the Owner requests the
transfer of a smaller amount to the Guarantee
Period Account, the Company may transfer that
amount to the money market Sub-Account.
Form A3036-01 15 BACS11
Any transfer from a Guarantee Period Account prior
to the end of its Guarantee Period will be subject
to a Market Value Adjustment.
There is no charge for the first twelve transfers
per contract year. A transfer charge of up to $25
may be imposed on each additional transfer.
The Company reserves the right to limit or refuse
transfers if it determines, in its sole
discretion, that the exercise of that right by an
Owner(s), or any agent or duly authorized
representative of such Owner(s) is, or would be,
to the disadvantage of other Owners. Such transfer
limitations could be applied to transfers to or
from some or all of the accounts and could include
but not be limited to:
(a) the requirement of a minimum time
period between each transfer;
(b) not accepting a transfer request of an
agent or duly authorized representative
of such Owner(s) authorized to act on
behalf of such Owner(s); and
(c) limiting the dollar amount that may be
transferred to or from any of the
accounts by an Owner(s) at any one time.
Such limitations, individually or in aggregate,
may be applied in any manner reasonably designed
to prevent any use of the transfer right which is
considered by the Company to be to the
disadvantage of other Owners.
XXXXXXXXXX AND SURRENDER
Prior to the Annuity Date, the Owner may, by
Request, withdraw a part of the Surrender Value or
surrender the contract for its Surrender Value.
Any withdrawal must be at least the Minimum
Withdrawal Amount (see Specification page). A
withdrawal will not be permitted if the
Accumulated Value remaining in the contract would
be less than the Minimum Accumulated Value After
Withdrawal (see Specifications page). The Request
must indicate the accounts from which it is to be
withdrawn. A withdrawal from a Guarantee Period
Account will be subject to a Market Value
Adjustment.
When surrendered, this contract terminates and the
Company has no further liability under it. The
Surrender Value will be based on the Accumulated
Value on the Effective Valuation Date.
Amounts taken from the Variable Account will be
paid within 7 days of the date a Request is
received. The Company reserves the right to delay
payments subject to applicable laws, rules and
regulations governing variable annuities.
Amounts taken from the Fixed Account or the
Guarantee Period Accounts will normally be paid
within 7 days of the date a Request is received.
The Company may defer payment for up to six months
from the receipt date.
If deferred for 30 days or more, the amount
payable will be credited interest at a rate of at
least 3% or the rate mandated by the State.
Form A3036-01 16 BACS11
Market Value Adjustment A transfer, withdrawal or surrender from a
Guarantee Period Account after the expiration of
its Guarantee Period will not be subject to a
Market Value Adjustment. A Market Value Adjustment
will apply to all other transfers, withdrawals, or
surrenders from a Guarantee Period Account.
Amounts in a Guarantee Period Account that are
applied under an Annuity Option are treated as
withdrawals and a Market Value Adjustment may
apply. The Market Value Adjustment will be
determined by multiplying the amount taken from
each Guarantee Period Account by the market value
factor. The market value factor for each Guarantee
Period Account is equal to:
n/365
[(1 + i)/(1 + j)] - 1
where:
i - is the Guaranteed Interest Rate
expressed as a decimal (for example: 3%
= 0.03) being credited to the current
Guarantee Period;
j - is the new Guaranteed Interest Rate
(as adjusted due to selection of any
rider, if applicable), expressed as a
decimal, for a Guarantee Period with a
duration equal to the number of years
remaining in the current Guarantee
Period, rounded to the next higher
number of whole years. If that rate is
not available, the Company will use a
suitable rate or index allowed by the
Department of Insurance; and
n - is the number of days remaining from
the Effective Valuation Date to the end
of the current Guarantee Period.
If the Guaranteed Interest Rate being credited is
lower than the new Guaranteed Interest Rate, the
Market Value Adjustment will decrease the
Guarantee Period Account value. Similarly, if the
Guaranteed Interest Rate being credited is higher
than the new Guaranteed Interest Rate, the Market
Value Adjustment will increase the Guarantee
Period Account value. The Market Value Adjustment
will never result in a change to the value more
than the interest earned in excess of an amount
based on the Guarantee Period Account Minimum
Interest Rate (see Specifications page).
DEATH BENEFIT
At the death of an Owner prior to the Annuity
Date, the Company will pay to the Beneficiary a
Death Benefit upon receipt at the Principal Office
of Proof of Death. If the Owner is a non-natural
person, prior to the Annuity Date a Death Benefit
is paid on the death of an Annuitant, upon receipt
at the Principal Office of Proof of Death.
Death Benefit The Death Benefit will be the greater of:
(a) the Accumulated Value on the
Effective Valuation Date,
increased by any positive
Market Value Adjustment; or
(b) the sum of the gross payments
made under this contract prior
to the date of death,
proportionately reduced to
reflect all partial
withdrawals.
For each withdrawal, the proportionate
reduction is calculated by multiplying
the Death Benefit under (b), immediately
prior to the withdrawal, by the
following:
Amount of the withdrawal
------------------------
Accumulated Value immediately prior
to the withdrawal
Form A3036-01 17 BACS11
Payment of the Unless the Owner has specified otherwise, the
Death Benefit Death Benefit will be paid to the Beneficiary
within 7 days of the Effective Valuation Date.
Alternatively, the Beneficiary may, by a
Request in writing, elect to:
(a) defer distribution of the Death
Benefit for a period no more than
5 years from the date of death; or
(b) receive distributions over his/her
life expectancy (or over a period not
extending beyond such life
expectancy). Distributions must begin
within one year from the date of
death.
If distribution of the Death Benefit is deferred
under (a) or (b), any value in the Guarantee
Period Accounts will be transferred to the money
market Sub-Account. The excess, if any, of the
Death Benefit over the Accumulated Value will
also be transferred to the money market
Sub-Account. The Beneficiary may, by Request,
effect transfers and withdrawals, but may not
make additional Payments. If there are multiple
Beneficiaries, the consent of all is required.
If the sole Beneficiary is the deceased Owner's
spouse, the Beneficiary may, by a Request in
writing, continue the contract and become the new
Owner and Annuitant subject to the following:
(a) any value in the Guarantee
Period Accounts will be
transferred to the money
market Sub-Account;
(b) the excess, if any, of the
Death Benefit over the
contract's Accumulated Value
will also be transferred to
the money market Sub-Account;
(c) additional Payments may be
made; and
(d) any subsequent spouse of the
new Owner, if named as the
Beneficiary, may not continue
the contract.
Form A3036-01 18 BACS11
THE PAYOUT PHASE
ANNUITY BENEFIT
Annuity Options Annuity Options are available on a fixed,
variable or combination fixed and variable basis.
The Annuity Options described below or any
alternative option offered by the Company may be
chosen. If no option is chosen, monthly benefit
payments will be made under the Life Annuity with
Cash Back option.
The Owner may also elect to have the Death
Benefit applied under any Annuity Option not
extending beyond the Beneficiary's life
expectancy. Such an election may not be altered
by the Beneficiary.
Fixed annuity options are funded through the
General Account. Variable annuity options may be
funded through one or more of the Sub-Accounts.
Not all Sub-Accounts may be available.
Selection of Annuity The Owner must select an Annuity Benefit Payment
Benefit Payments Option. Annuity benefit payments will be paid
monthly or at any other frequency currently
offered by the Company. If the first payment
would be less than the Minimum Annuity Benefit
Payment (see Specifications page), a single
payment will be made instead. If a life annuity
option has been elected, satisfactory proof of
the date of birth of the Annuitant must be
received at the Principal Office before any
payment is made. Also, if a life annuity option
has been elected, the Company may require from
time to time satisfactory proof that the
Annuitant is alive.
Annuity Benefit In the case of a variable annuity option, the
Payment Change Owner must select an Annuity Benefit Payment
Frequency Change Frequency. This is the frequency of
change in the dollar value of the variable
portion of the annuity benefit payments. For
example, if an annual Annuity Benefit Payment
Change Frequency is chosen, the dollar value
of variable annuity benefit payments will
remain constant within each one-year period.
The Owner must also select the date of the
first change.
Assumed Investment In the case of a variable annuity option, the
Return Owner must select an Assumed Investment Return
("AIR"), from the options currently made
available by the Company. This rate is used to
determine the initial variable annuity benefit
payment and how the payment will change over
time in response to the performance
of the selected Sub-Accounts. If the actual
performance of any selected Sub-Account (as
measured by the Net Investment Factor) is equal
to the AIR, the annuity benefit payment
attributable to that Sub-Account will be
constant. If the actual performance is greater
than the AIR, the annuity benefit payment will
increase. If the actual performance is less than
the AIR, the annuity benefit payment will
decrease.
Reversal of Decision The Owner may reverse the decision to annuitize
To Annuitize by a Request in writing within 90 days after
the Annuity Date. Upon receipt of such notice,
the Company will place the contract back to the
Accumulation Phase subject to the following:
(a) The funds applied under a variable
annuity option during this period will
be treated as if they had been
invested in the Accumulation Phase of
the contract, with the same
allocations that were in effect since
the Annuity Date.
Form A3036-01 19 BACS11
(b) The funds applied under a fixed
annuity option during this period will
be treated as if they had been
invested in the Accumulation Phase of
the contract in the Fixed Account,
since the Annuity Date.
(c) Any annuity benefit payment paid or
withdrawal taken during this period
will be treated as a withdrawal of the
Surrender Value as of the date of the
payment or withdrawal. Fixed annuity
benefit payments will be treated as
withdrawals from the Fixed Account.
Variable annuity benefit payments will
be treated as withdrawals from the
variable Sub-Accounts.
(d) If the Company learns of the Owner's
decision to reverse after the Maximum
Alternate Annuity Date (see
Specifications page). The Owner must
immediately select another Annuity
Benefit Payment Option.
Annuity Value The Annuity Value will be the Accumulated Value,
after application of any Market Value Adjustment,
less any applicable premium tax. For a Death
Benefit annuity, the Annuity Value will be the
amount of the Death Benefit, less any applicable
premium tax. The Annuity Value applied under a
variable Annuity Option is based on the
Accumulation Unit Value on a Valuation Date not
more than four weeks, uniformly applied,
before the Annuity Date.
The amount of the first annuity benefit payment
under all available options, except the payments
guaranteed for a specified number of years
option, will depend on the age and/or sex of the
Annuitant on the Annuity Date and the Annuity
Value applied. The payments guaranteed for a
specified number of years option is based only on
the duration of payments and the Annuity Value.
Annuity Unit Values A Sub-Account Annuity Unit Value on any
Valuation Date is equal to its value on the
preceding Valuation Date multiplied by the
product of:
(a) a discount factor equivalent to the
Assumed Investment Return; and
(b) the Net Investment Factor of the
Sub-Account funding the annuity
benefit payments for the applicable
Valuation Period.
The value of an Annuity Unit as of any date other
than a Valuation Date is equal to its value as of
the preceding Valuation Date.
Each variable annuity benefit payment is equal to
the number of Annuity Units multiplied by the
applicable value of an Annuity Unit, except that
under a Joint and Survivor Option, after the
first death, the number of units in each payment
is equal to the total number of units multiplied
by the Survivor Annuity Benefit Percentage.
Variable annuity benefit payments will increase
or decrease with the value of the Annuity Units
as of the date of the first payment of each
Annuity Benefit Payment Change Frequency. The
Company guarantees that the amount of each
variable annuity benefit payment will not be
affected by changes in mortality and expense
experience.
Form A3036-01 20 BACS11
Number of Annuity For each Sub-Account the number of Annuity Units
Units determining the benefit payable is equal to
the amount of the first annuity benefit payment
divided by the value of the Annuity Unit as of
the Valuation Date used to calculate the amount
of the first payment. Once annuity benefit
payments begin, the number of Annuity Units will
not change unless a split, a withdrawal or a
transfer is made.
Payment of Annuity Annuity Benefit Payments are paid to the Owner.
Benefit Payments By Request in writing, the Owner may direct
that payments are made to another person,
persons or entity. If an Owner, who is not
also an Annuitant, dies on or after the Annuity
Date, the following occurs:
(a) If the deceased Owner was the sole
Owner, then the remaining annuity
benefit payments will be payable to
the Beneficiary in accordance with the
terms of the Annuity Option selected.
Upon the death of a sole Owner, the
Beneficiary becomes the Owner of the
contract.
(b) If the contract has joint Owners, then
the remaining annuity benefit payments
will be payable to the surviving joint
Owner in accordance with the terms of
the Annuity Option selected. Upon the
death of the surviving joint Owner,
the Beneficiary becomes the Owner of
the contract.
TRANSFER
After the Annuity Date and prior to the death of
the Annuitant, the Owner may transfer among
Sub-accounts by Request to the Principal Office.
Transfers may increase or decrease the number of
Annuity Units in each subsequent payment.
There is no charge for the first twelve transfers
per contract year. A transfer charge of up to $25
may be imposed on each additional transfer.
The Company reserves the right to limit or refuse
transfers if it determines, in its sole
discretion, that the exercise of that right by an
Owner(s), or any agent or duly authorized
representative of such Owner(s) is, or would be,
to the disadvantage of other Owners. Such
transfer limitations could be applied to
transfers to or from some or all of the accounts
and could include but not be limited to:
(a) the requirement of a minimum time
period between each transfer;
(b) not accepting a transfer request of
an agent or duly authorized
representative of such Owner(s)
authorized to act on behalf of such
Owner(s); and
(c) limiting the dollar amount that may
be transferred to or from any of the
accounts by an Owner(s) at any
one time.
Such limitations, individually or in aggregate,
may be applied in any manner reasonably designed
to prevent any use of the transfer right which
is considered by the Company to be to the
disadvantage of other Owners.
Form A3036-01 21 BACS11
WITHDRAWAL
After the Annuity Date and prior to the death of
the Annuitant, the Owner may have the right,
based on the Annuity Option selected, to make
withdrawals. If the Death Benefit is applied
under an Annuity Option the Beneficiary may also
make withdrawals in accordance with this
provision.
Amounts withdrawn that were applied under a
variable Annuity Option will be paid within 7
days of the date a Request is received. The
Company reserves the right to delay payments
subject to applicable laws, rules and regulations
governing variable annuities.
Amounts withdrawn that were applied under a fixed
Annuity Option will normally be paid within 7
days of the date a Request is received. The
Company may defer payment for up to six months
from the date a Request is received. If deferred
for 30 days or more, the amount payable will be
credited interest at a rate of at least 3% or the
appropriate rate mandated by the State.
Only one Request for withdrawal under each
provision may be made each calendar year, unless
a payments guaranteed for a specified number of
years option is chosen.
Payment Withdrawal Each calendar year, the Owner can request up to
Amount Option an amount equal to the Payment Withdrawal Amount
(see Specifications page) multiplied by the
previous monthly annuity benefit payment.
For fixed Annuity Options, each withdrawal
proportionately reduces the dollar amount of each
future annuity benefit payment. The proportionate
reduction is calculated by multiplying the dollar
amount of each future annuity benefit payment by
the following:
Amount of the withdrawal
------------------------
Present Value of all remaining fixed annuity
benefit payments immediately prior the
withdrawal.
For variable Annuity Options, each withdrawal
proportionately reduces the number of Annuity
Units in each future annuity benefit payment. The
proportionate reduction is calculated by
multiplying the number of Annuity Units in each
future annuity benefit payment by the following:
Amount of the withdrawal
------------------------
Present Value of all remaining variable
annuity benefit payments immediately prior
to the withdrawal.
Present Value Over the life of the contract, for payments
Withdrawal Option guaranteed for a specified number of years,
life with payments guaranteed for a specified
number of years and life with cash back
Annuity Options when there are remaining
guaranteed payments, the Owner may request
withdrawals which represent a percentage of the
Present Value of those remaining guaranteed
annuity benefit payments. Each year a withdrawal
is taken under this provision, the Company
records the percentage withdrawn. Each withdrawal
proportionately reduces future annuity benefit
payments. (See
Form A3036-01 22 BACS11
proportionate reduction calculation below.) The
total percentage withdrawn over the life of the
contract cannot exceed the Present Value
Withdrawal Amount (see Specifications page).
For fixed Annuity Options, each withdrawal
proportionately reduces the dollar amount of each
future guaranteed annuity benefit payment. The
proportionate reduction is calculated by
multiplying the dollar amount of each future
guaranteed annuity benefit payment by the
following:
Amount of the withdrawal
------------------------
Present Value of all remaining fixed
guaranteed annuity benefit payments
immediately prior to the withdrawal.
For variable Annuity Options, each withdrawal
proportionately reduces any remaining guaranteed
payments. The proportionate reduction is
calculated by multiplying the number of Annuity
Units in each future guaranteed annuity benefit
payment by the following:
Amount of the withdrawal
------------------------
Present Value of all remaining variable
guaranteed annuity benefit payments
immediately prior to the withdrawal.
If an Annuitant is still living after there are
no remaining guaranteed payments under a life
with payments guaranteed for a specified number
of years or life with cash back Annuity Option:
(a) for variable Annuity Options, the
number of Annuity Units will increase
to the number of Annuity Units payable
prior to any withdrawals, adjusted for
transfers.
(b) for fixed Annuity Options, the dollar
amount of the annuity benefit payments
will increase to the amount payable
prior to any withdrawals, adjusted for
transfers.
PRESENT VALUE OF ANNUITY BENEFIT PAYMENTS
For a variety of purposes, it is at times
necessary to determine the Present Value of
either all future annuity benefit payments or of
future guaranteed annuity benefit payments.
Present Values are calculated based on the
Annuity 2000 Mortality Table, male, female or
unisex rates as appropriate, and the interest
rate or AIR used to determine the annuity benefit
payments.
DEATH OF THE ANNUITANT
Unless otherwise indicated by the Owner, upon the
death of the Annuitant, the Present Value of the
remaining guaranteed annuity benefit payments may
be paid to the Owner.
Form A3036-01 23 BACS11
ANNUITY BENEFIT PAYMENT OPTIONS
PAYMENTS GUARANTEED FOR A SPECIFIED NUMBER OF
YEARS:
Periodic annuity benefit payments for a chosen
number of years. The number of years selected may
be from 5 to 30, or any other period currently
made available by the Company.
LIFE ANNUITY:
(a) Single Life - Periodic annuity benefit
payments during the Annuitant's life.
The annuity benefit payments do not
continue after the death of the
Annuitant.
(b) Joint and Survivor - Periodic annuity
benefit payments during the joint
lifetime of the Joint Annuitants.
For variable options, after the first
death, the number of units in
each payment during the lifetime of
the survivor is equal to the total
number of units multiplied by the
Survivor Annuity Benefit Percentage.
For fixed options, after the first
death, the dollar amount of each
payment during the lifetime of
the survivor is equal to the dollar
value of each payment paid prior to such
death multiplied by the Survivor
Annuity Benefit Percentage.
ANNUITY BENEFIT PAYMENT GUARANTEE OPTIONS
If a life Annuity Option has been elected, the
Owner may also select one of the following
guarantees:
PAYMENTS GUARANTEED FOR A SPECIFIED NUMBER OF
YEARS
Periodic guaranteed payments for a period of 5 to
30 years, or any other period currently made
available by the Company.
CASH BACK:
Upon notification of the Annuitant's death, any
excess of the Annuity Value applied over the
total amount of the annuity benefit payments will
be paid to the Owner or Beneficiary, whichever is
applicable.
ANNUITY OPTION RATE TABLES
The first variable annuity benefit payments will
be based on the Annuity Option Rates made
available by the Company on the rate basis
available at the time the Annuity Option is
selected. The fixed annuity benefit payments will
be based on the greater of the guaranteed Annuity
Option Rates shown in the tables on the following
pages or the Company's non-guaranteed current
Annuity Option Rates applicable to this class of
contracts. The Company guarantees that once an
Annuity Option is selected, the annuity benefit
payments will not be affected by changes in
mortality and expense experience.
Form A3036-01 24 BACS11
ANNUITY OPTION TABLES
MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Age Life Annuity with Life Life Annuity
Nearest Payments Guaranteed Annuity With Cashback
Payment For 10 Years
Male Female Unisex Male Female Unisex Male Female Unisex
50 4.05 3.81 3.91 4.08 3.83 3.93 3.90 3.72 3.79
51 4.11 3.87 3.97 4.15 3.89 3.99 3.96 3.77 3.85
52 4.18 3.93 4.03 4.22 3.95 4.06 4.01 3.82 3.90
53 4.25 3.99 4.10 4.30 4.01 4.13 4.07 3.88 3.96
54 4.33 4.06 4.17 4.38 4.08 4.20 4.14 3.94 4.02
55 4.41 4.13 4.24 4.46 4.15 4.28 4.20 3.99 4.07
56 4.49 4.20 4.32 4.55 4.23 4.36 4.27 4.06 4.14
57 4.58 4.28 4.40 4.65 4.31 4.45 4.34 4.12 4.21
58 4.68 4.36 4.49 4.75 4.40 4.54 4.42 4.19 4.28
59 4.78 4.45 4.58 4.86 4.49 4.64 4.50 4.26 4.36
60 4.88 4.54 4.67 4.98 4.59 4.74 4.58 4.34 4.44
61 4.99 4.63 4.77 5.10 4.69 4.85 4.67 4.42 4.52
62 5.10 4.73 4.88 5.23 4.80 4.97 4.76 4.50 4.60
63 5.23 4.84 4.99 5.37 4.92 5.10 4.85 4.59 4.69
64 5.35 4.95 5.11 5.52 5.04 5.24 4.95 4.68 4.79
65 5.48 5.07 5.24 5.69 5.18 5.38 5.06 4.78 4.89
66 5.62 5.20 5.37 5.86 5.32 5.54 5.17 4.89 5.00
67 5.77 5.33 5.51 6.04 5.47 5.70 5.28 4.99 5.11
68 5.92 5.47 5.65 6.24 5.64 5.88 5.40 5.11 5.23
69 6.07 5.62 5.80 6.45 5.82 6.07 5.52 5.23 5.35
70 6.23 5.78 5.96 6.67 6.01 6.27 5.66 5.36 5.48
71 6.39 5.94 6.12 6.90 6.21 6.49 5.79 5.49 5.61
72 6.56 6.11 6.29 7.16 6.44 6.72 5.94 5.63 5.75
73 6.73 6.29 6.47 7.43 6.68 6.98 6.09 5.78 5.90
74 6.90 6.48 6.65 7.71 6.94 7.25 6.24 5.94 6.06
75 7.08 6.67 6.83 8.02 7.22 7.54 6.41 6.11 6.23
These tables are based on an annual interest rate of 3%
and the Annuity 2000 Mortality Table
Form A3036-01 25 BACS11
ANNUITY OPTION TABLES (CONTINUED)
MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Joint and Survivor Life Annuity
Older Age
50 55 60 65 70 75 80
Y 50 3.53 3.61 3.68 3.73 3.76 3.79 3.80
O 55 3.77 3.88 3.97 4.04 4.08 4.11
U 60 4.10 4.25 4.36 4.45 4.50
N 65 4.55 4.74 4.90 5.01
G 70 5.16 5.43 5.64
E 75 6.02 6.41
R 80 7.25
A
G
E
Joint and Two-Thirds Survivor Life Annuity
Older Age
50 55 60 65 70 75 80
Y 50 3.80 3.93 4.09 4.25 4.43 4.61 4.80
O 55 4.11 4.29 4.49 4.70 4.91 5.13
U 60 4.53 4.77 5.02 5.29 5.55
N 65 5.09 5.42 5.75 6.07
G 70 5.88 6.31 6.75
E 75 6.99 7.59
R 80 8.58
These tables are based on an annual interest rate of 3%
and the Annuity 2000 Mortality Table
Form A3036-01 26 BACS11
ANNUITY OPTION TABLES (CONTINUED)
MONTHLY ANNUITY BENEFIT PAYMENT
FOR EACH $1,000 OF ANNUITY VALUE APPLIED
Number of Payments Guaranteed for a Specified
Years Number of Years
5 17.91
10 9.61
15 6.87
20 5.51
25 4.71
30 4.18
These tables are based on an annual interest rate of 3%
and the Annuity 2000 Mortality Table
Form A3036-01 27 BACS11
GENERAL PROVISIONS
Entire Contract The entire contract consists of this contract,
any application attached at issue, riders,
Specifications pages and endorsements.
Misstatement of Age If the age or sex of an individual is misstated,
or Sex the Company will adjust all benefits payable
to that which would be available at the correct
age or sex. Any underpayments already made by
the Company will be paid immediately. Any
overpayments will be deducted from future annuity
benefit payments.
Failure to Notify After the Annuity Date and once notified of the
Company of Annuitant's death, the Company reserves the right
Annuitant Death to recover any overpaid annuity benefit payments.
Modifications Only the President or Vice President of the
Company may modify or waive any provisions of
this contract. Agents or Brokers are not
authorized to do so.
Incontestability The Company cannot challenge the validity of this
contract after it has been in force for more than
two years from the date of issue.
Change of Annuity Date The Owner may change the Annuity Date by Request
at any time after the issue date. The
request must be received by the Principal
Office at least one month before the new Annuity
Date. To the extent permitted by applicable laws,
rules and regulations governing variable
annuities, the new Annuity Date must be no later
than the Maximum Alternative Annuity Date shown
on the Specifications page.
Minimums All values and benefits available under this
contract equal or exceed those required by the
State in which the contract is delivered.
Annual Report The Company will furnish an annual report
to the Owner containing a statement of the number
and value of Accumulation Units credited to the
Sub-Accounts, the value of the Fixed Account and
the Guarantee Period Accounts and any other
information required by applicable law, rules and
regulations.
Addition, Deletion, or The Company reserves the right, subject to
Substitution of compliance with applicable law, to add to,
Investments delete from, or substitute for the shares of a
Fund that are held by the Sub-Accounts or
that the Sub-Accounts may purchase. The Company
also reserves the right to eliminate the shares
of any Fund no longer available for investment
or if the Company believes further investment
in the Fund is no longer appropriate for the
purposes of the Sub-Accounts. The Company
will not substitute shares attributable to
any interest in a Sub-Account without notice
to the Owner and prior approval of the Securities
and Exchange Commission as required by the
Investment Company Act of 1940. This will not
prevent the Variable Account from purchasing
other securities for other series or classes of
contracts, or from permitting a conversion
between series or classes of contracts on the
basis of requests made by Owners.
In addition, the Company reserves the right,
subject to compliance with applicable laws, to
establish additional Separate Accounts, Guarantee
Period Accounts and Sub-Accounts and to make them
available to any class or series of contracts as
the Company considers appropriate. Each new
Separate Account or Sub-Account will
Form A3036-01 28 BACS11
invest in a new investment company, or in shares
of another open-end investment company, or such
other investments as may be permitted under
applicable law. The Company also reserves the
right to eliminate or combine existing
Sub-Accounts and to transfer the assets of any
Sub-Accounts to any other Sub-Accounts. In the
event of any substitution or change, the Company
may, by appropriate notice, make such changes in
this and other contracts as may be necessary or
appropriate to reflect the substitution or
change. If the Company considers it to be in the
best interest of the owners, the Variable Account
or any Sub-Account may be operated as a
management company under the Investment Company
Act of 1940 or in any other form permitted by
law, or may be de-registered under the Act in the
event registration is no longer required, or may
be combined with other accounts of the Company.
Changes in Law The Company reserves the right to make any
changes to provisions of the contract to comply
with, or give Owners the benefit of, any federal
or State statute, rule, or regulations.
Change of Name Subject to compliance with applicable law,
the Company reserves the right to change the
names of the Variable Account or the
Sub-Accounts.
Federal Tax The Variable Account is not currently subject
Considerations to tax, but the Company reserves the right
to assess a charge for taxes if the Variable
Account becomes subject to tax.
Splitting of Units The Company reserves the right to split
the value of a unit, either to increase or to
decrease the number of units. Any splitting of
units will have no material effect on the
benefits, provisions or investment return of this
contract or upon the Owner, the Annuitant, any
Beneficiary, or the Company.
Insulation of Separate The investment performance of Separate Account
Account assets is determined separately from the other
assets of the Company. The assets of a Separate
Account equal to the reserves and liabilities
from any other business that the Company may
conduct.
Form A3036-01 29 BACS11
Flexible Payment Deferred Variable and Fixed Annuity
Annuity Benefit Payments Payable on the Annuity Date
Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date
Non-Participating
Form A3036-01 30 BACS11
