1
EXHIBIT 4
WE WILL PAY the benefits of this contract subject to its terms.
Our home office is at ▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇ ▇▇▇▇▇.
▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇. ▇'▇▇▇▇▇
------------------ ------------------
Secretary President
WITHIN 10 DAYS OF THE DAY YOU RECEIVE THIS CONTRACT, YOU MAY RETURN IT TO OUR
HOME OFFICE OR TO YOUR REGISTERED REPRESENTATIVE. WE WILL THEN VOID THE CONTRACT
AND REFUND THE CONTRACT VALUE.
ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT MAY INCREASE OR
DECREASE ACCORDING TO THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT. BENEFITS
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED-DOLLAR AMOUNT.
VARIABLE DEFERRED ANNUITY CONTRACT
(Variable-Fixed)
Multiple Funding
Flexible Purchase Payments
Nonparticipating
Benefits Nontransferable
ANNUITANT ▇▇▇▇ ▇▇▇ CONTRACT NUMBER 00000000
OWNER ▇▇▇▇ ▇▇▇ CONTRACT DATE
ANNUITY PAYOUT DATE First Day of
FORM 98-VA-2 PAGE 1
2
POLICY CONTENTS
PAGE
DEFINITIONS 3
1940 Act 3
Annuitant 3
Annuity Payout Date 3
Beneficiary 3
Code 3
IRA 3
Subaccount 3
VAA 3
Valuation Period 3
We and You 3
GENERAL PROVISIONS 4
Contract 4
Misstatement of Age or Sex 4
Ownership 4
Nontransferability 4
Beneficiary 4
Change of Beneficiary 4
General Account and VAA 4
Investments of VAA 5
Nonparticipating 5
Evidence of Sex, Age or Survival 5
Incontestability 5
Contract Payments 5
Supplementary Agreement 5
Voting Rights 5
Reports 5
Notice 5
Individual Retirement Annuities 5
PURCHASE PROVISIONS 6
Purchase Payments 6
Allocation of Purchase Payments 6
VALUATION PROVISIONS 6
Contract Value 6
Fixed Accumulation Account 6
Variable Accumulation Account 6
Net Investment Factor 7
Splitting Units 7
Taxes 7
ACCUMULATION PERIOD PROVISIONS 7
Transfers Among Subaccounts and
General Account 7
Surrender 8
Partial Withdrawal 8
Contingent Deferred Sales Charge 8
Death Benefit During Accumulation
Period 9
Contract Administration Charge 9
SETTLEMENT PROVISIONS 10
General 10
Elections 10
Pension Plan 10
IRA Restrictions 10
Determination of Amount To Be Applied 10
Effect of Settlement on Accumulation
Units 10
Change of Annuity Payout Date 10
Annuity Payment Amounts 11
Variable Annuities 11
Fixed Annuities 11
Annuity Unit Value 11
Change in Subaccount 11
Limitation on Availability of Options 11
Alternate Annuity Option 11
Death Benefit After the Annuity Payout
Date 12
Spendthrift Provision 12
Description of Annuity Options 12
Life Annuity 12
Joint and Survivor Life Annuity 12
ANNUITY OPTION TABLES 14
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 2
3
We will pay an annuity starting on the annuity payout date if the Annuitant is
then living. We will then apply the contract value under the SETTLEMENT
PROVISIONS of this contract.
We will pay this contract's death benefit to the Beneficiary if the Annuitant
dies while this contract is in effect and before the annuity payout date.
This contract provides accumulation values and annuity payments on a variable
and/or fixed basis under one or more options as selected by you. The dollar
amount of the variable annuity payments and the variable part of the contract
value will vary with the investment results of a separate account (VAA) which we
have established. However, we guarantee that the dollar amount of annuity
payments will not be affected by mortality experience. We also guarantee that
the expense charges will not be more than the charges provided for in this
contract. The dollar amount of fixed annuity payments and the fixed part of the
contract value are also guaranteed.
Any paid-up annuity, cash surrender, or death benefit that may be payable under
this contract are not less than the minimum benefits required by law in the
state in which this contract was delivered.
DEFINITIONS
1940 ACT
The Investment Company Act of 1940, as amended, or any similar successor federal
legislation.
ANNUITANT
The person so named in the application or any other natural person whose length
of life measures annuity payments that involve life contingencies.
ANNUITY PAYOUT DATE
The date shown on Page 1 or the date you later choose but under the provisions
of this contract for Change of Annuity Payout Date; or any other date on which
annuity payments are to start.
BENEFICIARY
The person entitled to receive the Contract Value of this contract if the
Annuitant dies before the annuity payout date.
CODE
The Internal Revenue Code as in effect on the Contract Date.
IRA
An Individual Retirement Annuity as defined in the Code.
SUBACCOUNT
The Bond Subaccount, Equity Subaccount, Money Market Subaccount, Omni
Subaccount, International Subaccount, Capital Appreciation Subaccount, Small Cap
Subaccount, Global Contrarian Subaccount, S & P 500 Index Subaccount, Aggressive
Growth Subaccount, Social Awareness Subaccount, Core Growth Subaccount, Growth
Subaccount, Equity Income Subaccount, High Income Bond Subaccount, Growth &
Income Subaccount, Emerging Markets Subaccount, or such other subaccounts as may
be established within VAA.
VAA
An account (Ohio National Variable Account A) that consists of assets we have
set aside so that their investment results are kept separate from those of our
general assets.
VALUATION PERIOD
That period of time from one determination of accumulation unit and annuity unit
values to their next determination. Such values will be determined as often as
we choose to do so. This will occur at least once each week or as often as
require` by the 1940 Act.
WE AND YOU
"We", "us" and "our" means The Ohio National Life Insurance Company. "You" means
the Owner of this contract.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 3
4
GENERAL PROVISIONS
CONTRACT
Your purchase payment(s) and any application, are the consideration for this
contract. A copy of any application is attached. The contract, any riders or
endorsements, if applicable, and any application are the entire agreement.
We are not a party to, nor are we bound by, any plan or trust in conjunction
with this contract. This contract is intended to qualify under the Code for tax
favored status. Any reference in this contract to tax laws or rules is for your
information and instruction and is not subject to approval or disapproval by the
state in which the contract is issued for delivery. Your qualifying status, and
not the contract, controls whether or not your funds will have tax favored
status. You should ask your tax advisor if you have any questions as to whether
or not you qualify.
This contract cannot be changed nor our rights waived except in a writing signed
by our president, vice president or secretary and attached to the contract. READ
YOUR CONTRACT CAREFULLY.
We reserve the right to amend this contract as needed to maintain its status as
an annuity under the Internal Revenue Code. If this contract is so amended we
will send you a copy of the amendment, together with the applicable regulation,
ruling or other requirement imposed by the Internal Revenue Service which
requires such amendment.
We will send you a copy of the amendment, together with applicable regulation,
ruling or other requirement imposed by the Internal Revenue Service which
requires such amendment.
MISSTATEMENT OF AGE OR SEX
If the Annuitant's birth date or sex has been misstated, the benefits shall be
such as would have been provided based on the correct birth date and sex. The
amount of any over payments shall be charged against benefits to be paid after
we learn of a misstatement. The amount of any under payments accumulated at an
annual effective interest rate of 6% shall be added to benefits to be paid after
we learn of a misstatement.
OWNERSHIP
During the Annuitant's lifetime and prior to the annuity payout date, the Owner
of this contract shall be the person so named in the application or the heirs,
successors or transferees of such person. On and after the annuity payout date,
the Annuitant is the Owner.
After the Annuitant's death, the Beneficiary is the Owner. If this contract is
an IRA, the Annuitant shall be the Owner while living. The Annuitant's interest
may not then be forfeited. The contract, if an IRA, is for the sole benefit of
the Annuitant and Beneficiaries.
You have the sole right, without the consent of the Beneficiary or any other
person, to exercise all contract rights. You can transfer ownership to a
successor Owner only if such successor Owner is (1) the Annuitant, (2) a trustee
or successor trustee of a pension or profit-sharing trust which is qualified
under Section 401 of the Code, or (3) the employer of the Annuitant provided
that the contract after transfer is maintained under the terms of a retirement
plan qualified under Section 403(a) of the Code for the benefit of the
Annuitant. Exercise of any ownership rights under this contract shall not take
effect until we receive notice.
NONTRANSFERABILITY
You may not sell, assign, discount or pledge this contract as collateral for a
loan or to secure the performance of any obligation or for any purpose to any
person other than to us, to the Annuitant, or to a trustee or other person
exercising ownership rights solely by reason of the terms of a pension or
profit-sharing plan or trust qualified under the Code. You may not transfer this
contract if it is an IRA.
BENEFICIARY
The Beneficiary and any Contingent Beneficiary are named in the application,
unless changed. If the Beneficiary dies prior the Annuitant, the Contingent
Beneficiary becomes the Beneficiary. Unless you have provided otherwise, if
there are two or more Beneficiaries, they will receive equal shares. If there is
no named Beneficiary or Contingent Beneficiary when the Annuitant has died, you
will be deemed to be the Beneficiary.
CHANGE OF BENEFICIARY
Subject to the terms of any assignment, you may name a new Beneficiary or a new
Contingent Beneficiary by notice to us at any time during the lifetime of the
Annuitant. Any new choice of Beneficiary or Contingent Beneficiary will
automatically revoke any prior choice of Beneficiary or Contingent Beneficiary.
GENERAL ACCOUNT AND VAA
The General Account consists of all our assets other than those we allocate to
separate accounts.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 4
5
The separate account to which the variable part of contract values and variable
annuity payments under this contract relate is VAA, which we have established
under Ohio law to provide variable benefits. We shall have sole and complete
ownership and control of all assets in VAA.
A portion of the assets in the VAA equal to the contract reserves for such
account shall not be chargeable with liabilities arising out of any other
business the company may conduct.
INVESTMENTS OF VAA
All amounts credited to VAA will be used to purchase shares at net asset value
of Ohio National Fund, Inc., an open-end investment company registered under the
1940 Act, or substitute shares of another investment company. Ohio National
Fund, Inc. and such other investment companies are referred to as the "Fund" and
shares of either are referred to as "Fund shares". Any and all distributions
made by the Fund in respect to Fund shares held by VAA will be reinvested to
purchase more Fund shares in the same subaccount at net asset value. Deductions
and redemptions from VAA may be made by redeeming a number of Fund Shares, at
net asset value, equal in total value to the amount to be deducted or redeemed.
If deemed by us to be in the best interest of all contract owners, VAA may be
operated as a management company under the 1940 Act or it may be deregistered
under the 1940 Act if such registration is no longer required.
If there is such a substitution of Fund shares or change in operation of VAA, we
may issue such endorsement for the contract and take such other action as may be
necessary and appropriate to make the substitution or change.
NONPARTICIPATING
This contract is nonparticipating. It will not share in our divisible surplus.
EVIDENCE OF SEX, AGE OR SURVIVAL
Where any payment under this contract depends on the payee's sex, age or
survival on a given date, we may require proof thereof prior to making such
payment.
INCONTESTABILITY
After two years, we will not contest this contract.
CONTRACT PAYMENTS
All sums to be paid by us under this contract are payable at our home office. We
may require you to send us this contract as a condition to any payment.
SUPPLEMENTARY AGREEMENT
As of the annuity payout date, we may issue a supplementary agreement that sets
forth the terms of your annuity option.
VOTING RIGHTS
We will seek instructions for the voting of Fund shares held on account of the
variable part of your contract value or held in VAA which represent the
actuarial liability for variable annuity payments being made. From time to time,
we will send you reports on the Fund, proxy material and a form with which you
may instruct us how to vote Fund shares.
After this contract has been effect for one year, you may also vote at our
annual meeting of policyholders as provided in our code of regulations and Ohio
law.
REPORTS
At least once each year after the first we shall send you a statement reporting
the investments hold in the separate account. At least once each year after the
first contract year and before the annuity payout date, we shall send you a
report of your contract values as of a date not more than four months prior to
the date of the mailing.
NOTICE
A notice required by this contract must be in writing signed by you. The notice
will take effect when signed, subject to any payment made or action taken by us
before we receive the notice at our home office.
INDIVIDUAL RETIREMENT ANNUITIES
The Internal Revenue Service has approved the form of this contract as meeting
the Code requirements for an IRA. If this contract is an IRA, we can change the
contract in its approved form so as to keep its approval under the Code or to
comply with any change in the Code or rules under the Code. Any such change
shall be in writing, signed by us and mailed to you at
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 5
6
your address of record in our files. Any terms that relate to this contract as
an IRA shall be of no further effect if the contract is no longer kept as a
qualified IRA under the Code.
PURCHASE PROVISIONS
PURCHASE PAYMENTS
Purchase payments are payable to us at our home office or, with respect only to
the first purchase payment, to one of our authorized agents in exchange for a
receipt signed by such agent.
The initial purchase payment is due on the contract date. You may make
subsequent purchase payments at any time before the date that is ten years
preceding the annuity payout date. Each subsequent purchase payment must be at
least $500. We reserve the right to restrict the amount subsequent purchase
payments. If this is an IRA, purchase payments may not be more than the lesser
of $2,000 or 100% of your compensation in any calendar year. But, this limit
does not apply to "rollover" or employer contributions as defined in the Code.
ALLOCATION OF PURCHASE PAYMENTS
Each purchase payment, less an amount for any applicable premium or similar tax
(net purchase payment), will be allocated to up to ten subaccounts within the
separate account and/or the fixed accumulation and dollar cost averaging
accounts within the General Account in accordance with the allocation percentage
specified by you or as later changed by you.
Such change shall take effect with the first purchase payment received after the
date you ask such change to take effect or, if later, as of the end of the
valuation period during which we receive such change request at our home office.
VALUATION PROVISIONS
CONTRACT VALUE
The contract value for any valuation period equals the sum of the fixed
accumulation account and dollar cost averaging account values as of the end of
the valuation period and the variable accumulation account value for the
valuation period.
FIXED ACCUMULATION ACCOUNT
The fixed accumulation account is established within the General Account. Prior
to the annuity payout date, the fixed accumulation account value will be
(1) The net purchase payments allocated to the fixed accumulation
account; plus
(2) any amounts, net of fees, transferred from VAA to the fixed
accumulation account; plus
(3) accumulated interest; less
(4) any amounts withdrawn from the fixed accumulation account (along
with any applicable contingent deferred sales charge) to pay
benefits, contract administration charge and any applicable charges
for riders to this contract; less
(5) any amounts, plus any associated fees, transferred from the fixed
accumulation account to the variable accumulation account; less
(6) any amounts applied to affect an annuity option under the SETTLEMENT
PROVISIONS.
We will declare annual effective interest rates to be applied to purchase
payments and transfers to the fixed accumulation account. No annual effective
interest rate declared by us will be less than 3.00%. Once established, an
interest rate shall remain in effect for a guarantee period which shall not be
less than one year. After a guarantee period expires we will decline an interest
rate for a subsequent guarantee period.
VARIABLE ACCUMULATION ACCOUNT
We will credit this contract's variable accumulation account with variable
accumulation units in relation to the amount of each net purchase payment
allocated to each subaccount. To find the number of variable accumulation units
credited to each subaccount, divide the amount allocated to that subaccount by
the variable accumulation unit value of that subaccount for the valuation period
during which the purchase payment is received at our home office.
The value of each variable accumulation unit was set when the first purchase
payment was allocated to each subaccount. The value of a variable accumulation
unit for each subaccount varies for each later valuation period. Such value is
found by multiplying the value of a variable accumulation unit of that
subaccount for the immediately preceding valuation period by the net investment
factor for the subaccount for the valuation period for which the variable
accumulation unit value is being determined. The value of a variable
accumulation unit for any valuation period is determined as of the end of such
valuation period.
The variable accumulation account value for a valuation period equals number of
variable accumulation units credited to the variable accumulation account
multiplied by the value of each such accumulation unit for that valuation
period.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 6
7
NET INVESTMENT FACTOR
The net investment factor for a subaccount is found by dividing (a) by (b), then
subtracting (c) from the result, where
(a) is
(1) the net asset value of a Fund share in that subaccount
determined as of the end of a valuation period, plus
(2) the per share amount of any dividends or other distribution
declared by the Fund (as of the ex-dividend date) during the
valuation period, adjusted by
(3) a per share charge or credit with respect to any taxes paid or
reserved for, which we determine to be attributable to the
maintenance or operation of the subaccount;
(b) is the net asset value of a Fund share in that subaccount, adjusted
by a per share credit or charge for any taxes reserved for or paid,
determined as of the end of the prior valuation period; and
(c) is
(1) a charge for mortality and expenses risk assumptions at an
effective rate of 1.15% per year, plus
(2) an administration expense charge of 0.25% per year for the
number of days in such valuation period.
Although we cannot identify that part of the current risk charge that applies to
each of the risks involved, we estimate that a reasonable allocation would be
0.65% for the mortality risk, and .50% for the expense risk. The total charge
for risks and administration expenses is now at the effective rate of 1.40%.
SPLITTING UNITS
We reserve the right to split the value of the variable accumulation units or
the annuity units. In any such split of unit values, strict equity will be
preserved. Such a split will have no material effect on the benefits or other
terms of this contract. A split may either increase or decrease the number of
such units.
TAXES
Any taxes that pertain to this contract or VAA will be charged against the
contract value when incurred or reserved for by us.
ACCUMULATION PERIOD PROVISIONS
TRANSFERS AMONG SUBACCOUNTS AND GENERAL ACCOUNT
By notice to us, you may transfer the value of any number of accumulation units
from one set of subaccounts to another set of subaccounts or to the General
Account at any time. The dollar amount transferred from any subaccount must be
at least $300, but the entire value of a subaccount or the General Account may
be transferred if less than $300. No transfer of variable accumulation units may
be made after the date we receive notice of the Annuitant's death. Such
transfers shall be made as of the end of the valuation period during which we
receive the request at our home office or at the end of any later valuation
period as you may request. A fee of not more than $10 will be charged for each
transfer. The first transfer of any month will not be assessed a transfer fee.
We reserve the right to limit the number, frequency, method or amount of
transfers. Transfers from any portfolio of Ohio National Fund ("the Fund")
on any one day may be limited to 1% of the previous day's total net assets
of that portfolio if we or the Fund, in the discretion of either or both,
believes that the portfolio might otherwise be damaged.
If and when transfers must be so limited, some transfer requests will not
be granted. In determining which requests will be granted, scheduled
transfers (that is, those pursuant to a pre-existing dollar cost averaging
program) will be made first, followed by mailed written requests in the
order postmarked and lastly, telephone and facsimile requests in the order
received. Contractowners whose requested transfers are not made will be so
notified. Current SEC rules preclude us from processing at a later date
those requested transfers that were not made. Accordingly, a new transfer
request would have to be submitted in order to make a transfer that was
not made because of these limitations.
TRANSFERS FROM THE FIXED ACCUMULATION ACCOUNT TO VAA
You may transfer account value amounts between the Fixed Accumulation Account
and the Separate Account. Transfers will be effective on the date we receive
your request at our Home Office. With respect to transfers between the Fixed
Accumulation Account and the Separate Account, we reserve the right to impose
the following restrictions:
- For each allocation to the Fixed Accumulation Account,
transfers to the Separate Account may be made only during the
30-day period following the end of that allocation's interest
rate guarantee period. We may limit the amount that you can
transfer during that time, but the limit will not be less than
20% of the value of the Fixed Accumulation Account as of the
beginning of the contract year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 7
8
- No transfers from the Separate Account to the Fixed
Accumulation Account may be made during the six month period
following the transfer of any amount from the Fixed
Accumulation Account to the Separate Account.
In all other respects, the rules and charges applicable to transfers between the
subaccounts of the Separate Account will apply to transfers involving the Fixed
Accumulation Account.
SURRENDER
You may surrender this contract and receive its surrender value upon notice
received by us at any time at or prior to the annuity payout date. The surrender
value is the contract value less: (1) a charge for any applicable premium taxes
not previously deducted, (2) the contract administration charge, (3) any charges
due as the result of riders affecting this contract and (4) the contingent
deferred sales charge, if any. See Deferred Premium Tax. For this purpose, the
contract value will be that for the valuation period during which the surrender
request is received at our home office. The surrender value from the Separate
Account shall be paid within 7 days of receipt of your notice (or later if
allowed by law). We reserve the right to defer payment of any surrender proceeds
from the fixed accumulation account for up to six months. We will not defer
payment if we are required by law to pay earlier, or if the amount payable is
used to pay premiums on policies with us. After this contract is surrendered,
all variable accumulation units will be cancelled.
PARTIAL SURRENDER
You can take up to 14 partial surrenders within a contract year. The withdrawn
amount cannot be less than $500 and cannot be greater than the amount that would
cause the contract value to fall below $5,000. We will pay to you the amount of
a partial withdrawal less the appropriate contingent deferred sales charge.
Partial withdrawals will reduce the contract value by the amount withdrawn
including any applicable contingent deferred sales charges.
You may tell us how much to deduct from the subaccount and the fixed
accumulation account. If you do not, the partial surrender will be deducted from
each subaccount in the same proportion that the subaccount's value bears to the
total Contract Value on the date we receive your request in our Home Office. See
Deferred Premium tax.
Surrenders from the fixed accumulation account will be taken on a
"first-in-first-out" basis. That is, partial surrenders will be taken first from
any remaining portion of the total contract value resulting from the earliest
purchase payment. Once the value resulting from any purchase payment has been
reduced to zero, remaining amounts withdrawn shall reduce the value resulting
from the earliest of the remaining purchase payments. This process shall
continue until the withdrawal is completed. The amount so withdrawn shall be
paid within 7 days of receipt of your notice (or later if allowed by law). For
amounts withdrawn from VAA, we will cancel the number of variable accumulation
units from the appropriate subaccount which, when multiplied by the
corresponding variable accumulation unit values for the valuation period during
which the notice was received by us, equals that portion of the dollar amount of
the partial surrender, plus any applicable contingent deferred sales charge
taken from that deposit
DEFERRED PREMIUM TAX
If we paid a tax on a purchase payment and did not previously deduct the tax,
then we may deduct it at the time of surrender or on the annuity payout date.
CONTINGENT DEFERRED SALES CHARGE
We can make a contingent deferred sales charge if this contract is surrendered
or a partial surrender is made. Surrenders in a contract year that do not exceed
the free out amount are not subject to a charge. The free out amount is 10% of
the contract value as of the first surrender of the contract year less all
amounts previously surrendered during the contract year that were not subject to
a charge. Surrenders within a contract year in excess of the free out amount may
be subject to a charge. The amount subject to a charge is the lesser of (a) or
(b), where:
(a) is the amount withdrawn; and
(b) is the total purchase payments, less the total of all surrender
amounts previously allocated to purchase payments, but not less than
zero.
The contingent deferred sales charge will be the applicable percentage(s) of the
amount subject to a charge. For purposes of determining the applicable
percentage(s), surrender amounts will be allocated to remaining purchase
payments in the order that the purchase payments were received. Remaining
purchase payments are the original purchase payments less the amount of any
surrender previously allocated to them. The applicable percentages for each
purchase payment is found on the contract data pages in the Table of Contingent
Deferred Sales Charges next to the number denoting the duration of the purchase
payment at the time of surrender.
Year of Percentage of
Purchase Payment resulting value charged
1st 6%
2nd 6%
3rd 5%
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 8
9
4th 4%
5th 2%
6th 1%
7th and later 0%
WAIVER OF CONTINGENT DEFERRED SALES CHARGE
We will waive the Contingent Deferred Sales Charge charges otherwise applicable
to a full surrender or one or more partial surrenders occurring before income
payments begin if: The Annuitant is, or has been confined to a state licensed or
legally operated hospital or inpatient nursing facility for at least 30
consecutive days; and
Such confinement begins at least one year after the policy date; and
The Annuitant was age 80 or younger on the policy date; and
The request for the full or partial surrender, together with proof of such
confinement, is received in the Home Office while the Annuitant is confined or
within 90 days after discharge from the facility.
DEATH BENEFIT DURING ACCUMULATION PERIOD
If the Annuitant dies before the annuity payout date, we will pay a death
benefit to the Beneficiary in one sum or by such other settlement method to
which we may agree. The single sum payment will be made within 7 days after we
receive proof of the Annuitant's death (or later if allowed by law). Any
variable accumulation units will then be cancelled. The death benefit payable to
the Beneficiary shall be the greater of:
(a) The contract value as of the date of death;
(b) the total of all net purchase payments made to, less withdrawals
(including any contingent deferred sales charges) taken from the
contract; and
(c) the Stepped-up Death Benefit Amount defined as follows.
The Stepped-up Death Benefit Amount during the first three contract years shall
be the total of all net purchase payments made to the contract and adjusted for
withdrawals (including contingent deferred sales charges) taken from the
contract on a pro rata basis. That is, the Stepped-up Death Benefit will be
reduced by the same percentage reduction to the Contract Value that resulted
from the partial surrender. On the third anniversary, the Stepped-up Death
Benefit Amount shall be increased to the contract value at that time if it is
greater and if the Annuitant has not yet attained age 90.
The Stepped-up Death Benefit Amount in subsequent three year periods shall equal
the Stepped-up Death Benefit Amount as of the end of the previous three year
period plus any net purchase payments made to the contract, and adjusted for any
withdrawals (including contingent deferred sales charges) taken from the
contract during the three year period on a pro rata basis. The Stepped-up Death
Benefit Amount shall be increased at the end of each three year period to the
contract value if it is greater and if the Annuitant has not yet attained age
90.
If your surviving spouse becomes the owner and annuitant of the contract, the
Stepped-up Death Benefit Amount will continue, unreduced.
CONTRACT ADMINISTRATION CHARGE
Prior to the annuity payout date, on each contract anniversary and upon
surrender, we will deduct from the contract value an annual contract
administration charge of $30 to defray our administrative expenses for this
contract if the contract value at that time is less than $50,000. If, on the
anniversary, the contract value equals or exceeds $50,000, we will not deduct
the contract administration charge.
The contract administration charge will be deducted from the variable
accumulation account and the fixed accumulation account in proportion to the
total contract value in the VAA and General Account, respectively. The amount of
the charge deducted from the fixed accumulation account of each account will be
made on a "first-in-first-out" basis.
We will cancel the number of variable accumulation units from the appropriate
subaccounts which, when multiplied by the corresponding variable accumulation
unit values for the valuation period in which the charge is taken, equals that
portion of the charge taken from VAA.
If any portion of the annual contract administration charge is made from the
fixed accumulation account, such portion shall not exceed the sum of (a) and
(b), where
(a) is the total amount of net purchase payments made to the fixed
accumulation account during the contract year; and
(b) is the interest credited to the fixed accumulation account during
the contract year that exceeds the minimum guaranteed interest.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 9
10
SETTLEMENT PROVISIONS
GENERAL
On the annuity payout date, the contract value shall be applied under one or
more of the annuity options shown below or under such other option to which we
may agree. Unless otherwise specified, the first annuity payment will be
apportioned to the General Account and each subaccount in the same proportions
that each bears to the total contract value as of the day we credit your annuity
units.
ELECTIONS
You must give us notice in order to elect an annuity option or revoke or change
such an election. If no such election is in effect on the annuity payout date,
and if the Annuitant is then living, the contract value will be applied under
Option 1(c) as an annuity payable to the Annuitant. The variable part of the
contract value will be used to provide a variable annuity and the fixed part
will provide a fixed annuity unless you elect otherwise. The Beneficiary will be
the payee for any remaining period certain installments to be paid after the
Annuitant's death unless this contract is issued pursuant to a tax qualified
pension plan.
PENSION PLAN
If: (a) this contract is issued pursuant to a tax qualified pension plan; (b) no
election is in effect on the annuity payout date; and (c) the Annuitant is
living on the annuity payout date, then the contract value will be applied as
follows:
(1) If the Annuitant is married as of the annuity payout date, the
contract value will be applied to provide equal payments under
Options 1 (a) and 2 (a) with the Annuitant's spouse as the
contingent annuitant.
(2) If the Annuitant is not married as of the annuity payout date, the
contract value will be applied under Option 1 (c) and paid to the
Annuitant with the Beneficiary as payee for any period certain
payments to be made after the Annuitant's death.
IRA RESTRICTIONS
If this contract is an IRA, the Annuitant's entire interest will be paid to him
or her (a) not later than the close of the tax year in which the Annuitant
attains age seventy and one half years, or (b) in installments that are equal
except for any increment due to operation of the contract. Such installments
will be made (a) for the life of the Annuitant or the lives of the Annuitant and
his or her spouse, or (b) for a term certain period that does not last past the
life expectancy of the Annuitant or the life expectancy of the Annuitant and his
or her spouse. If the Annuitant's entire interest is to be distributed in
installments beginning in the year the Annuitant attains age seventy and one
half years, then the annual payments must be at least the lesser of: (a) the
balance of the Annuitant's interest, or (b) an amount determined by dividing (i)
the Annuitant's entire interest at the beginning of each year (including amounts
not in the IRA at the beginning of the year because they have been withdrawn so
as to make a rollover contribution to another IRA) by (ii) the life expectancy
of the Annuitant (or of the Annuitant and his or her spouse, if applicable) as
of the date the Annuitant attains age seventy, such expectancy being reduced by
the number of whole years that have elapsed since the Annuitant attained age
seventy and one half years.
If the Annuitant dies before the entire interest has been paid, or if payments
have begun to the Annuitant's surviving spouse and such spouse dies before the
entire interest has been paid, the entire interest (or any such interest that is
left if payments have begun) will, within 5 years after the Annuitant's death
(or the death of the surviving spouse), be paid or be applied to purchase an
immediate annuity for the Beneficiary or Beneficiaries. Such an immediate
annuity will be payable for the life of the Beneficiary or Beneficiaries (or for
a term that does not last beyond their life expectancy). This paragraph does not
apply if term certain payments began before the Annuitant's death and the term
certain is for a period allowed in the prior paragraph.
DETERMINATION OF AMOUNT TO BE APPLIED
The contract value to be applied to provide an annuity shall be determined at
the end of a valuation period, selected by us and uniformly applied, which is
not more than 10 valuation periods before the annuity payout date. The fixed
part of the contract value used to provide a fixed annuity will be determined as
of the annuity payout date. Any applicable premium tax will be deducted at this
time, if it was not deducted earlier.
EFFECT OF SETTLEMENT ON ACCUMULATION UNITS
When this contract is settled, its Variable Accumulation Units will be
cancelled.
CHANGE OF ANNUITY PAYOUT DATE
You may change the annuity payout date to any date at least ten years after the
date of the last purchase payment. This can be done at any time prior to the
Annuitant's death by notice to us. But, unless we agree, the annuity payout date
may not be later than the first of the month following the Annuitant's 90th
birthday. In any event, the annuity payout date must be the first day of a month
and must be at least 30 days after the date we receive notice of a change of
date.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 10
11
ANNUITY PAYMENT AMOUNTS
VARIABLE ANNUITIES
The dollar amount of the first periodic variable annuity payment shall be
derived from the annuity option tables for the sex(es) and age(s) of the
Annuitant and contingent annuitant, if any, on the annuity payout date.
The dollar amount of each variable annuity payment after the first will be
measured by annuity units. The number of annuity units of each subaccount
to be credited to this contract is determined by dividing that part of the
first variable annuity payment apportioned to each subaccount by the
annuity unit value of that subaccount for the valuation period used to
determine the contract value for settlement of this contract under these
SETTLEMENT PROVISIONS. The dollar amount of each variable annuity payment
after the first is equal to the number of annuity units credited to this
contract multiplied by the annuity unit value of the applicable subaccount
for the valuation period, selected by us and uniformly applied, which is
not more than 10 valuation periods before the due date of each such
payment.
FIXED ANNUITIES
The dollar amount of the each periodic fixed annuity payment shall be
derived from the annuity option tables for the sex(es) and age(s) of the
Annuitant and contingent annuitant, if any, on the annuity payout date.
ANNUITY UNIT VALUE
The value of an Annuity Unit for each subaccount was set when the first annuity
payment was made from each subaccount for this class of contracts. To determine
the Annuity Unit value for each later valuation period, (a) multiply the Annuity
Unit value for that subaccount for the immediately prior valuation period by the
Net Investment Factor for that subaccount for such later valuation period, and
then (b) multiply the product by a factor to neutralize the interest rate of 3%
per year assumed in the annuity option tables. Such factor is 0.9999190 for a
one-day valuation period.
CHANGE IN SUBACCOUNT
After variable annuity payments have been made for at least 12 months, you may,
no more than once each 12 months, change all or part of the investment upon
which your variable annuity payments are based from one subaccount to another.
To do this, we will convert the number of Annuity Units being changed to the
number of Annuity Units of the Subaccount to which you are changing so as to
result in the next variable annuity payment being of the same amount that it
would have been without the change. After that, variable annuity payments will
reflect changes in the values of your new Annuity Units. You must give us notice
at least 30 days before the due date of the first variable annuity payment to
which the change will apply.
LIMITATION ON AVAILABILITY OF OPTIONS
If the contingent annuitant is not related to the Annuitant, you may not elect
Option 2 unless we consent and then only if, based upon life expectancies, less
than 50% of the amount so applied would accrue to the contingent annuitant.
If the amount to be applied under any annuity option is less than $5,000, such
option shall not be available. Settlement shall than be in a single sum. If the
first periodic payment to a payee would be less than $25, we may pay less often
so that such payment will be at least $25.
ALTERNATE ANNUITY OPTION
Instead of the variable annuities provided under this contract, you may choose
an alternate amount and type of periodic installments for fixed annuity
payments. Such alternate annuity options shall be based on the rates for fixed
dollar single premium immediate annuities being issued by us on the annuity
payout date. They may only be elected within 30 days before that date.
Any withdrawal of part or all of the contract value for settlement under an
alternate annuity option will be exempt from any otherwise applicable contingent
deferred sales charge if at least one of the following conditions is met:
(a) If withdrawal is before the end of the second contract year, the
annuity income must be payable for the lifetime of the annuitant and
contingent annuitant, if any.
(b) If withdrawal is during the third through fifth contract years, the
annuity income must be payable over a period of not less than ten
years or payable over the lifetime of the annuitant and contingent
annuitant, if any.
(c) If withdrawal is after the fifth contract year, the annuity income
must be payable over a period of not less than five years or payable
over the lifetime of the annuitant and contingent annuitant, if any.
DEATH BENEFIT AFTER THE ANNUITY PAYOUT DATE
If the Annuitant dies after the annuity payout date, any death benefit payable
will be in accordance with the annuity option chosen.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 11
12
SPENDTHRIFT PROVISION
Except as otherwise provided in this contract (or in any supplementary contract
issued in exchange for it), an Annuitant or Beneficiary may not commute,
anticipate, assign or otherwise encumber any amounts to be paid in settlement of
this contract. To the extent allowed by law, no such amount shall be subject to
any legal process in payment of any claim against an Annuitant or Beneficiary.
DESCRIPTION OF ANNUITY OPTIONS
All of these options may be on a fixed or variable annuity basis or both.
LIFE ANNUITY
OPTION 1
(a) NONREFUND. We will make payments during the lifetime of the
Annuitant. No payments are due after the death of the Annuitant.
(b) 5-YEARS CERTAIN. We will make payments for 5 years and after that
during the lifetime of the Annuitant. No payments are due after the
death of the Annuitant or, if later, the end of the 5-year period
certain.
(c) 10-YEARS CERTAIN. We will make payments for 10 years and after that
during the lifetime of the Annuitant. No payments are due after the
death of the Annuitant or, if later, the end of the 10-year period
certain.
(d) INSTALLMENT REFUND. We will make payments for a period certain and
after that during the lifetime of the Annuitant. No payments are due
after the death of the Annuitant or, if later, the end of the period
certain. The number of period certain payments is equal to the
amount applied under this installment refund option divided by the
amount of the first annuity payment; provided, however, that the
amount of the final period certain payment shall be multiplied by
that part of the preceding quotient which is not an integer.
JOINT AND SURVIVOR LIFE ANNUITY
OPTION 2
(a) JOINT AND SURVIVOR NONREFUND. We will make payments during the joint
lifetime of the Annuitant and contingent annuitant. Payments will
then continue during the remaining lifetime of the survivor of them.
No payments are due after the death of the last survivor of the
Annuitant and contingent annuitant.
(b) JOINT AND SURVIVOR WITH 10-YEARS CERTAIN. We will make payments for
10 years and after that during the joint lifetime of the Annuitant
and contingent annuitant. Payments will then continue during the
remaining lifetime of the survivor of them. No payments are due
after the death of the survivor of the Annuitant and contingent
annuitant or, if later, the end of the 10-year period certain.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 12
13
ANNUITY OPTION TABLES
Date of Birth
(1939 and Before)
Installments shown are for a monthly payment for each $1,000 of contract value
applied under an option. Age, as used in these tables, is age as of nearest
birthday. Rates of monthly payments for ages and periods certain not shown, if
allowed by us, will be based on an actuarially equivalent basis. To determine
annual, semi-annual, or quarterly installments, multiply the amounts shown by
11.65, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
---------------------------------------------------------------------------------------------------------------------------
AGE AND SEX AGE AND SEX
OF ANNUITANT NON- 5 YEARS 10 YEARS INSTALLMENT OF ANNUITANT NON- 5 YEARS 10 YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
---------------------------------------------------------------------------------------------------------------------------
51 $ 4.14 $ 4.13 $4.10 $3.97 51 $3.80 $3.79 $3.78 $3.71
52 4.21 4.20 4.17 4.03 52 3.86 3.85 3.84 3.76
53 4.29 4.28 4.24 4.09 53 3.92 3.91 3.90 3.81
54 4.37 4.36 4.32 4.16 54 3.98 3.98 3.96 3.87
55 4.46 4.45 4.40 4.23 55 4.05 4.05 4.03 3.93
56 4.55 4.54 4.49 4.30 56 4.13 4.12 4.10 3.99
57 4.65 4.63 4.58 4.37 57 4.20 4.20 4.17 4.05
58 4.75 4.73 4.67 4.45 58 4.29 4.28 4.25 4.12
59 4.86 4.84 4.77 4.53 59 4.37 4.36 4.33 4.19
60 4.98 4.96 4.88 4.62 60 4.47 4.46 4.42 4.27
61 5.11 5.08 4.99 4.71 61 4.57 4.55 4.51 4.35
62 5.24 5.21 5.11 4.81 62 4.67 4.66 4.61 4.43
63 5.39 5.35 5.23 4.92 63 4.78 4.77 4.71 4.52
64 5.54 5.50 5.36 5.02 64 4.90 4.88 4.82 4.61
65 5.71 5.66 5.49 5.14 65 5.03 5.01 4.94 4.70
66 5.88 5.82 5.63 5.25 66 5.17 5.14 5.06 4.81
67 6.07 6.00 5.78 5.37 67 5.31 5.28 5.18 4.92
68 6.27 6.19 5.93 5.51 68 5.47 5.43 5.32 5.03
69 6.49 6.39 6.08 5.64 69 5.63 5.59 5.46 5.15
70 6.72 6.60 6.24 5.79 70 5.82 5.77 5.61 5.28
71 6.96 6.82 6.41 5.93 71 6.01 5.96 5.77 5.41
72 7.22 7.05 6.58 6.10 72 6.22 6.16 5.93 5.56
73 7.50 7.30 6.75 6.27 73 6.45 6.37 6.11 5.71
74 7.79 7.56 6.92 6.43 74 6.70 6.60 6.29 5.87
75 8.11 7.83 7.09 6.62 75 6.97 6.85 6.47 6.05
76 8.45 8.12 7.27 6.83 76 7.26 7.11 6.66 6.23
77 8.82 8.42 7.44 7.03 77 7.57 7.39 6.86 6.41
78 9.21 8.74 7.61 7.24 78 7.90 7.69 7.05 6.62
79 9.62 9.07 7.78 7.46 79 8.27 8.00 7.25 6.83
80 10.07 9.41 7.95 7.66 80 8.66 8.34 7.45 7.05
81 10.55 9.77 8.11 7.94 81 9.09 8.69 7.64 7.29
82 11.06 10.13 8.26 8.19 82 9.55 9.06 7.83 7.55
83 11.60 10.50 8.40 8.43 83 10.06 9.45 8.02 7.78
84 12.18 10.89 8.53 8.76 84 10.60 9.86 8.19 8.07
85 12.80 11.27 8.66 9.07 85 11.19 10.28 8.35 8.38
86 13.45 11.66 8.77 9.40 86 11.82 10.72 8.50 8.65
87 14.14 12.06 8.88 9.70 87 12.50 11.15 8.64 9.00
88 14.89 12.45 8.97 10.07 88 13.24 11.59 8.76 9.29
89 15.69 12.85 9.06 10.34 89 14.02 12.03 8.87 9.69
90 16.56 13.24 9.14 10.83 90 14.86 12.45 8.97 10.07
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 13
14
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
-------------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE -------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
-------------------------------------------------------------------------------------------
55 $ 3.55 $ 3.72 $ 3.89 $ 4.04 $ 4.17 $ 4.27 $ 4.35 $ 4.40 $ 4.42
60 3.61 3.82 4.04 4.26 4.47 4.64 4.77 4.86 4.92
65 3.65 3.90 4.17 4.47 4.78 5.06 5.30 5.46 5.57
70 3.69 3.95 4.27 4.65 5.07 5.51 5.90 6.21 6.42
75 3.71 3.99 4.35 4.79 5.32 5.92 6.53 7.07 7.47
80 3.72 4.02 4.40 4.88 5.51 6.27 7.13 7.99 8.71
85 3.73 4.03 4.43 4.95 5.63 6.54 7.64 8.88 10.04
90 3.73 4.04 4.44 4.98 5.71 6.72 8.03 9.63 11.33
-------------------------------------------------------------------------------------------
(b) With 10 Years Certain
------------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
------------------------------------------------------------------------------------------
55 $3.55 $3.72 $3.88 $4.04 $4.17 $4.27 $4.33 $4.37 $4.39
60 3.61 3.82 4.04 4.26 4.46 4.63 4.75 4.82 4.86
65 3.65 3.89 4.17 4.47 4.77 5.04 5.25 5.38 5.45
70 3.68 3.95 4.27 4.64 5.05 5.45 5.80 6.03 6.16
75 3.70 3.99 4.34 4.77 5.28 5.83 6.34 6.72 6.94
80 3.72 4.01 4.38 4.85 5.44 6.12 6.80 7.36 7.70
85 3.72 4.02 4.40 4.90 5.53 6.31 7.14 7.85 8.31
90 3.72 4.03 4.41 4.92 5.58 6.41 7.33 8.15 8.70
------------------------------------------------------------------------------------------
Actuarial Basis - Installments shown in these tables are based on the 1983(a)
Mortality Table Projected to 1996 under Scale G with compound interest at the
effective rate of 3% per year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 14
15
ANNUITY OPTION TABLES
(1940-1959)
Installments shown are for a monthly payment for each $1,000 of contract value
applied under an option. Age, as used in these tables, is age as of nearest
birthday. Rates of monthly payments for ages and periods certain not shown, if
allowed by us, will be based on an actuarially equivalent basis. To determine
annual, semi-annual, or quarterly installments, multiply the amounts shown by
11.65, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
---------------------------------------------------------------------------------------------------------------------------
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5 YEARS 10 YEARS INSTALLMENT ------------ NON- 5 YEARS 10 YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
---------------------------------------------------------------------------------------------------------------------------
51 $ 4.07 $ 4.06 $ 4.03 $ 3.91 51 $ 3.74 $ 3.74 $ 3.73 $ 3.66
52 4.14 4.13 4.10 3.97 52 3.80 3.79 3.78 3.71
53 4.21 4.20 4.17 4.03 53 3.86 3.85 3.84 3.76
54 4.29 4.28 4.24 4.09 54 3.92 3.91 3.90 3.81
55 4.37 4.36 4.32 4.16 55 3.98 3.98 3.96 3.87
56 4.46 4.45 4.40 4.23 56 4.05 4.05 4.03 3.93
57 4.55 4.54 4.49 4.30 57 4.13 4.12 4.10 3.99
58 4.65 4.63 4.58 4.37 58 4.20 4.20 4.17 4.05
59 4.75 4.73 4.67 4.45 59 4.29 4.28 4.25 4.12
60 4.86 4.84 4.77 4.53 60 4.37 4.36 4.33 4.19
61 4.98 4.96 4.88 4.62 61 4.47 4.46 4.42 4.27
62 5.11 5.08 4.99 4.71 62 4.57 4.55 4.51 4.35
63 5.24 5.21 5.11 4.81 63 4.67 4.66 4.61 4.43
64 5.39 5.35 5.23 4.92 64 4.78 4.77 4.71 4.52
65 5.54 5.50 5.36 5.02 65 4.90 4.88 4.82 4.61
66 5.71 5.66 5.49 5.14 66 5.03 5.01 4.94 4.70
67 5.88 5.82 5.63 5.25 67 5.17 5.14 5.06 4.81
68 6.07 6.00 5.78 5.37 68 5.31 5.28 5.18 4.92
69 6.27 6.19 5.93 5.51 69 5.47 5.43 5.32 5.03
70 6.49 6.39 6.08 5.64 70 5.63 5.59 5.46 5.15
71 6.72 6.60 6.24 5.79 71 5.82 5.77 5.61 5.28
72 6.96 6.82 6.41 5.93 72 6.01 5.96 5.77 5.41
73 7.22 7.05 6.58 6.10 73 6.22 6.16 5.93 5.56
74 7.50 7.30 6.75 6.27 74 6.45 6.37 6.11 5.71
75 7.79 7.56 6.92 6.43 75 6.70 6.60 6.29 5.87
76 8.11 7.83 7.09 6.62 76 6.97 6.85 6.47 6.05
77 8.45 8.12 7.27 6.83 77 7.26 7.11 6.66 6.23
78 8.82 8.42 7.44 7.03 78 7.57 7.39 6.86 6.41
79 9.21 8.74 7.61 7.24 79 7.90 7.69 7.05 6.62
80 9.62 9.07 7.78 7.46 80 8.27 8.00 7.25 6.83
81 10.07 9.41 7.95 7.66 81 8.66 8.34 7.45 7.05
82 10.55 9.77 8.11 7.94 82 9.09 8.69 7.64 7.29
83 11.06 10.13 8.26 8.19 83 9.55 9.06 7.83 7.35
84 11.60 10.50 8.40 8.43 84 10.06 9.45 8.02 7.78
85 12.18 10.89 8.53 8.76 85 10.60 9.86 8.19 8.07
86 12.80 11.27 8.66 9.07 86 11.19 10.28 8.35 8.38
87 13.45 11.66 8.77 9.40 87 11.82 10.72 8.50 8.65
88 14.14 12.06 8.88 9.70 88 12.50 11.15 8.64 9.00
89 14.89 12.45 8.97 10.07 89 13.24 11.59 8.76 9.29
90 15.69 12.85 9.06 10.34 90 14.02 12.03 8.87 9.69
---------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
16
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
-----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ----------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
-----------------------------------------------------------------------------------------
55 $ 3.66 $ 3.82 $ 3.97 $ 4.09 $ 4.19 $ 4.26 $ 4.31 $ 4.34
60 3.76 3.97 4.18 4.37 4.54 4.66 4.75 4.80
65 3.83 4.09 4.38 4.66 4.93 5.15 5.31 5.41
70 3.89 4.19 4.54 4.94 5.34 5.71 6.00 6.20
75 3.92 4.26 4.67 5.17 5.73 6.29 6.80 7.18
80 3.95 4.30 4.76 5.34 6.05 6.85 7.66 8.34
85 3.96 4.33 4.82 5.46 6.30 7.33 8.48 9.58
90 3.97 4.35 4.86 5.54 6.46 7.68 9.17 10.77
-----------------------------------------------------------------------------------------
(b) With 10 Years Certain
----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ---------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
----------------------------------------------------------------------------------------
55 $3.66 $ 3.82 $ 3.97 $ 4.09 $ 4.18 $ 4.25 $ 4.29 $ 4.31
60 3.76 3.97 4.18 4.37 4.53 4.64 4.71 4.75
65 3.83 4.09 4.37 4.65 4.91 5.11 5.24 5.31
70 3.88 4.18 4.53 4.92 5.30 5.63 5.86 5.99
75 3.92 4.25 4.66 5.13 5.65 6.15 6.53 6.75
80 3.94 4.29 4.74 5.29 5.93 6.60 7.15 7.51
85 3.95 4.31 4.78 5.38 6.12 6.92 7.65 8.13
90 3.96 4.33 4.81 5.43 6.22 7.12 7.96 8.55
----------------------------------------------------------------------------------------
Actuarial Basis - Installments shown in these tables are based on the 1983(a)
Mortality Table Projected to 1996 under Scale G (set back one year) with
compound interest at the effective rate of 3% per year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 16
17
ANNUITY OPTION TABLES
(1960-1979)
Installments shown are for a monthly payment for each $1,000 of contract value
applied under an option. Age, as used in these tables, is age as of nearest
birthday. Rates of monthly payments for ages and periods certain not shown, if
allowed by us, will be based on an actuarially equivalent basis. To determine
annual, semi-annual, or quarterly installments, multiply the amounts shown by
11.65, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
-----------------------------------------------------------------------------------------------------------------------------
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5 YEARS 10 YEARS INSTALLMENT ------------ NON- 5 YEARS 10 YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
-----------------------------------------------------------------------------------------------------------------------------
52 $ 4.07 $ 4.06 $ 4.03 $ 3.91 52 $ 3.74 $ 3.74 $ 3.73 $ 3.66
53 4.14 4.13 4.10 3.97 53 3.80 3.79 3.78 3.71
54 4.21 4.20 4.17 4.03 54 3.86 3.85 3.84 3.76
55 4.29 4.28 4.24 4.09 55 3.92 3.91 3.90 3.81
56 4.37 4.36 4.32 4.16 56 3.98 3.98 3.96 3.87
57 4.46 4.45 4.40 4.23 57 4.05 4.05 4.03 3.93
58 4.55 4.54 4.49 4.30 58 4.13 4.12 4.10 3.99
59 4.65 4.63 4.58 4.37 59 4.20 4.20 4.17 4.05
60 4.75 4.73 4.67 4.45 60 4.29 4.28 4.25 4.12
61 4.86 4.84 4.77 4.53 61 4.37 4.36 4.33 4.19
62 4.98 4.96 4.88 4.62 62 4.47 4.46 4.42 4.27
63 5.11 5.08 4.99 4.71 63 4.57 4.55 4.51 4.35
64 5.24 5.21 5.11 4.81 64 4.67 4.66 4.61 4.43
65 5.39 5.35 5.23 4.92 65 4.78 4.77 4.71 4.52
66 5.54 5.50 5.36 5.02 66 4.90 4.88 4.82 4.61
67 5.71 5.66 5.49 5.14 67 5.03 5.01 4.94 4.70
68 5.88 5.82 5.63 5.25 68 5.17 5.14 5.06 4.81
69 6.07 6.00 5.78 5.37 69 5.31 5.28 5.18 4.92
70 6.27 6.19 5.93 5.51 70 5.47 5.43 5.32 5.03
71 6.49 6.39 6.08 5.64 71 5.63 5.59 5.46 5.15
72 6.72 6.60 6.24 5.79 72 5.82 5.77 5.61 5.28
73 6.96 6.82 6.41 5.93 73 6.01 5.96 5.77 5.41
74 7.22 7.05 6.58 6.10 74 6.22 6.16 5.93 5.56
75 7.50 7.30 6.75 6.27 75 6.45 6.37 6.11 5.71
76 7.79 7.56 6.92 6.43 76 6.70 6.60 6.29 5.87
77 8.11 7.83 7.09 6.62 77 6.97 6.85 6.47 6.05
78 8.45 8.12 7.27 6.83 78 7.26 7.11 6.66 6.23
79 8.82 8.42 7.44 7.03 79 7.57 7.39 6.86 6.41
80 9.21 8.74 7.61 7.24 80 7.90 7.69 7.05 6.62
81 9.62 9.07 7.78 7.46 81 8.27 8.00 7.25 6.83
82 10.07 9.41 7.95 7.66 82 8.66 8.34 7.45 7.05
83 10.55 9.77 8.11 7.94 83 9.09 8.69 7.64 7.29
84 11.06 10.13 8.26 8.19 84 9.55 9.06 7.83 7.55
85 11.60 10.50 8.40 8.43 85 10.06 9.45 8.02 7.78
86 12.18 10.89 8.53 8.76 86 10.60 9.86 8.19 8.07
87 12.80 11.27 8.66 9.07 87 11.19 10.28 8.35 8.38
88 13.45 11.66 8.77 9.40 88 11.82 10.72 8.50 8.65
89 14.14 12.06 8.88 9.70 89 12.50 11.15 8.64 9.00
90 14.89 12.45 8.97 10.07 90 13.24 11.59 8.76 9.29
-----------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
18
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ---------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
----------------------------------------------------------------------------------------
55 $3.61 $ 3.76 $ 3.90 $ 4.02 $ 4.11 $ 4.18 $ 4.23 $ 4.25
60 3.70 3.90 4.10 4.28 4.44 4.56 4.64 4.69
65 3.77 4.02 4.28 4.55 4.80 5.01 5.16 5.26
70 3.82 4.11 4.44 4.81 5.19 5.53 5.81 6.00
75 3.86 4.18 4.56 5.02 5.55 6.08 6.55 6.91
80 3.88 4.22 4.65 5.19 5.85 6.59 7.34 7.99
85 3.90 4.25 4.70 5.30 6.08 7.03 8.10 9.14
90 3.91 4.26 4.74 5.37 6.23 7.36 8.75 10.25
----------------------------------------------------------------------------------------
(b) With 10 Years Certain
-----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ----------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
-----------------------------------------------------------------------------------------
55 $ 3.61 $ 3.76 $ 3.90 $ 4.02 $ 4.11 $ 4.17 $ 4.21 $ 4.23
60 3.70 3.90 4.10 4.28 4.43 4.54 4.61 4.65
65 3.77 4.01 4.28 4.54 4.79 4.98 5.11 5.18
70 3.82 4.10 4.43 4.79 5.15 5.47 5.70 5.83
75 3.85 4.17 4.55 5.00 5.49 5.96 6.34 6.57
80 3.88 4.21 4.63 5.15 5.76 6.39 6.95 7.31
85 3.89 4.23 4.67 5.24 5.94 6.71 7.44 7.95
90 3.89 4.24 4.70 5.29 6.04 6.91 7.76 8.39
-----------------------------------------------------------------------------------------
Actuarial Basis - Installments shown in these tables are based on the 1983(a)
Mortality Table Projected to 1996 under Scale G (set back two years) with
compound interest at the effective rate of 3% per year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 16
19
ANNUITY OPTION TABLES
(1980-1999)
Installments shown are for a monthly payment for each $1,000 of contract value
applied under an option. Age, as used in these tables, is age as of nearest
birthday. Rates of monthly payments for ages and periods certain not shown, if
allowed by us, will be based on an actuarially equivalent basis. To determine
annual, semi-annual, or quarterly installments, multiply the amounts shown by
11.65, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
-----------------------------------------------------------------------------------------------------------------------------
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5 YEARS 10 YEARS INSTALLMENT ------------ NON- 5 YEARS 10 YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
-----------------------------------------------------------------------------------------------------------------------------
53 $ 4.07 $ 4.06 $ 4.03 $ 3.91 53 $ 3.74 $ 3.74 $ 3.73 $ 3.66
54 4.14 4.13 4.10 3.97 54 3.80 3.79 3.78 3.71
55 4.21 4.20 4.17 4.03 55 3.86 3.85 3.84 3.76
56 4.29 4.28 4.24 4.09 56 3.92 3.91 3.90 3.81
57 4.37 4.36 4.32 4.16 57 3.98 3.98 3.96 3.87
58 4.46 4.45 4.40 4.23 58 4.05 4.05 4.03 3.93
59 4.55 4.54 4.49 4.30 59 4.13 4.12 4.10 3.99
60 4.65 4.63 4.58 4.37 60 4.20 4.20 4.17 4.05
61 4.75 4.73 4.67 4.45 61 4.29 4.28 4.25 4.12
62 4.86 4.84 4.77 4.53 62 4.37 4.36 4.33 4.19
63 4.98 4.96 4.88 4.62 63 4.47 4.46 4.42 4.27
64 5.11 5.08 4.99 4.71 64 4.57 4.55 4.51 4.35
65 5.24 5.21 5.11 4.81 65 4.67 4.66 4.61 4.43
66 5.39 5.35 5.23 4.92 66 4.78 4.77 4.71 4.52
67 5.54 5.50 5.36 5.02 67 4.90 4.88 4.82 4.61
68 5.71 5.66 5.49 5.14 68 5.03 5.01 4.94 4.70
69 5.88 5.82 5.63 5.25 69 5.17 5.14 5.06 4.81
70 6.07 6.00 5.78 5.37 70 5.31 5.28 5.18 4.92
71 6.27 6.19 5.93 5.51 71 5.47 5.43 5.32 5.03
72 6.49 6.39 6.08 5.64 72 5.63 5.59 5.46 5.15
73 6.72 6.60 6.24 5.79 73 5.82 5.77 5.61 5.28
74 6.96 6.82 6.41 5.93 74 6.01 5.96 5.77 5.41
75 7.22 7.05 6.58 6.10 75 6.22 6.16 5.93 5.56
76 7.50 7.30 6.75 6.27 76 6.45 6.37 6.11 5.71
77 7.79 7.56 6.92 6.43 77 6.70 6.60 6.29 5.87
78 8.11 7.83 7.09 6.62 78 6.97 6.85 6.47 6.05
79 8.45 8.12 7.27 6.83 79 7.26 7.11 6.66 6.23
80 8.82 8.42 7.44 7.03 80 7.57 7.39 6.86 6.41
81 9.21 8.74 7.61 7.24 81 7.90 7.69 7.05 6.62
82 9.62 9.07 7.78 7.46 82 8.27 8.00 7.25 6.83
83 10.07 9.41 7.95 7.66 83 8.66 8.34 7.45 7.05
84 10.55 9.77 8.11 7.94 84 9.09 8.69 7.64 7.29
85 11.06 10.13 8.26 8.19 85 9.55 9.06 7.83 7.55
86 11.60 10.50 8.40 8.43 86 10.06 9.45 8.02 7.78
87 12.18 10.89 8.53 8.76 87 10.60 9.86 8.19 8.07
88 12.80 11.27 8.66 9.07 88 11.19 10.28 8.35 8.38
89 13.45 11.66 8.77 9.40 89 11.89 10.72 8.50 8.65
90 14.14 12.06 8.88 9.70 90 12.50 11.15 8.64 9.00
-----------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
20
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
-------------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ----------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
-------------------------------------------------------------------------------------------
55 $ 3.56 $ 3.71 $ 3.84 $ 3.95 $ 4.04 $ 4.10 $ 4.15 $ 4.18
60 3.65 3.84 4.02 4.20 4.34 4.46 4.54 4.59
65 3.71 3.95 4.20 4.45 4.68 4.88 5.02 5.12
70 3.76 4.03 4.35 4.69 5.04 5.36 5.62 5.81
75 3.80 4.10 4.46 4.89 5.38 5.87 6.32 6.66
80 3.82 4.14 4.54 5.05 5.66 6.35 7.05 7.66
85 3.83 4.17 4.59 5.15 5.87 6.76 7.76 8.73
90 3.84 4.18 4.63 5.22 6.02 7.07 8.35 9.76
-------------------------------------------------------------------------------------------
(b) With 10 Years Certain
-----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ----------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
-----------------------------------------------------------------------------------------
55 $ 3.56 $ 3.71 $ 3.84 $ 3.95 $ 4.03 $ 4.10 $ 4.14 $ 4.16
60 3.65 3.83 4.02 4.19 4.34 4.44 4.51 4.55
65 3.71 3.94 4.19 4.44 4.67 4.86 4.98 5.05
70 3.76 4.03 4.34 4.68 5.02 5.32 5.54 5.67
75 3.79 4.09 4.45 4.87 5.33 5.78 6.15 6.39
80 3.82 4.13 4.53 5.01 5.59 6.20 6.74 7.12
85 3.83 4.15 4.57 5.10 5.76 6.51 7.23 7.76
90 3.83 4.16 4.59 5.15 5.86 6.71 7.56 8.22
-----------------------------------------------------------------------------------------
Actuarial Basis - Installments shown in these tables are based on the 1983(a)
Mortality Table Projected to 1996 under Scale G (set back three years) with
compound interest at the effective rate of 3% per year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 16
21
ANNUITY OPTION TABLES
(2000 +)
Installments shown are for a monthly payment for each $1,000 of contract value
applied under an option. Age, as used in these tables, is age as of nearest
birthday. Rates of monthly payments for ages and periods certain not shown, if
allowed by us, will be based on an actuarially equivalent basis. To determine
annual, semi-annual, or quarterly installments, multiply the amounts shown by
11.65, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
----------------------------------------------------------------------------------------------------------------------------
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5 YEARS 10 YEARS INSTALLMENT ------------ NON- 5 YEARS 10 YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
----------------------------------------------------------------------------------------------------------------------------
54 $ 4.07 $ 4.06 $ 4.03 $ 3.91 54 $ 3.74 $ 3.74 $ 3.73 $ 3.66
55 4.14 4.13 4.10 3.97 55 3.80 3.79 3.78 3.71
56 4.21 4.20 4.17 4.03 56 3.86 3.85 3.84 3.76
57 4.29 4.28 4.24 4.09 57 3.92 3.91 3.90 3.81
58 4.37 4.36 4.32 4.16 58 3.98 3.98 3.96 3.87
59 4.46 4.45 4.40 4.23 59 4.05 4.05 4.03 3.93
60 4.55 4.54 4.49 4.30 60 4.13 4.12 4.10 3.99
61 4.65 4.63 4.58 4.37 61 4.20 4.20 4.17 4.05
62 4.75 4.73 4.67 4.45 62 4.29 4.28 4.25 4.12
63 4.86 4.84 4.77 4.53 63 4.37 4.36 4.33 4.19
64 4.98 4.96 4.88 4.62 64 4.47 4.46 4.42 4.27
65 5.11 5.08 4.99 4.71 65 4.57 4.55 4.51 4.35
66 5.24 5.21 5.11 4.81 66 4.67 4.66 4.61 4.43
67 5.39 5.35 5.23 4.92 67 4.78 4.77 4.71 4.52
68 5.54 5.50 5.36 5.02 68 4.90 4.88 4.82 4.61
69 5.71 5.66 5.49 5.14 69 5.03 5.01 4.94 4.70
70 5.88 5.82 5.63 5.25 70 5.17 5.14 5.06 4.81
71 6.07 6.00 5.78 5.37 71 5.31 5.28 5.18 4.92
72 6.27 6.19 5.93 5.51 72 5.47 5.43 5.32 5.03
73 6.49 6.39 6.08 5.64 73 5.63 5.59 5.46 5.15
74 6.72 6.60 6.24 5.79 74 5.82 5.77 5.61 5.28
75 6.96 6.82 6.41 5.93 75 6.01 5.96 5.77 5.41
76 7.22 7.05 6.58 6.10 76 6.22 6.16 5.93 5.56
77 7.50 7.30 6.75 6.27 77 6.45 6.37 6.11 5.71
78 7.79 7.56 6.92 6.43 78 6.70 6.60 6.29 5.87
79 8.11 7.83 7.09 6.62 79 6.97 6.85 6.47 6.05
80 8.45 8.12 7.27 6.83 80 7.26 7.11 6.66 6.23
81 8.82 8.42 7.44 7.03 81 7.57 7.39 6.86 6.41
82 9.21 8.74 7.61 7.24 82 7.90 7.69 7.05 6.62
83 9.62 9.07 7.78 7.46 83 8.27 8.00 7.25 6.83
84 10.07 9.41 7.95 7.66 84 8.66 8.34 7.45 7.05
85 10.55 9.77 8.11 7.94 85 9.09 8.69 7.64 7.29
86 11.06 10.13 8.26 8.19 86 9.55 9.06 7.83 7.55
87 11.60 10.50 8.40 8.43 87 10.06 9.45 8.02 7.78
88 12.18 10.89 8.53 8.76 88 10.60 9.86 8.19 8.07
89 12.80 11.27 8.66 9.07 89 11.19 10.28 8.35 8.38
90 13.45 11.66 8.77 9.40 90 11.82 10.72 8.50 8.65
----------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
22
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
---------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE --------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
---------------------------------------------------------------------------------
55 $3.52 $3.65 $3.78 $3.88 $3.97 $4.03 $4.07 $4.10
60 3.60 3.78 3.95 4.12 4.25 4.36 4.44 4.49
65 3.66 3.88 4.12 4.35 4.57 4.76 4.90 4.99
70 3.71 3.96 4.26 4.58 4.91 5.21 5.46 5.63
75 3.74 4.02 4.36 4.77 5.22 5.68 6.10 6.43
80 3.76 4.06 4.44 4.91 5.48 6.13 6.78 7.35
85 3.78 4.09 4.49 5.01 5.68 6.51 7.43 8.35
90 3.78 4.10 4.52 5.08 5.82 6.79 7.99 9.30
---------------------------------------------------------------------------------
(b) With 10 Years Certain
-----------------------------------------------------------------------------------------
AGE OF
AGE FEMALE CONTINGENT ANNUITANT
OF MALE ----------------------------------------------------------------------------
ANNUITANT 55 60 65 70 75 80 85 90
-----------------------------------------------------------------------------------------
55 $ 3.52 $ 3.65 $ 3.78 $ 3.88 $ 3.96 $ 4.03 $ 4.06 $ 4.09
60 3.60 3.77 3.95 4.11 4.25 4.35 4.42 4.46
65 3.66 3.88 4.11 4.35 4.56 4.74 4.86 4.93
70 3.71 3.96 4.25 4.57 4.89 5.17 5.39 5.52
75 3.74 4.02 4.36 4.75 5.19 5.61 5.97 6.21
80 3.76 4.06 4.43 4.89 5.43 6.01 6.54 6.92
85 3.77 4.08 4.47 4.97 5.60 6.31 7.02 7.56
90 3.78 4.09 4.50 5.02 5.69 6.50 7.35 8.04
-----------------------------------------------------------------------------------------
Actuarial Basis - Installments shown in these tables are based on the 1983(a)
Mortality Table Projected to 1996 under Scale G (set back four years) with
compound interest at the effective rate of 3% per year.
--------------------------------------------------------------------------------
FORM 98-VA-2 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
