MetLife (Registered)
Metropolitan Life Insurance Company
Xxx Xxxxxxx Xxxxxx, Xxx Xxxx, XX 00000-0000
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Contractholder
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Group Annuity Contract No: Issue Date:
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NOTICE: ANY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT THAT ARE BASED ON
THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE AND SPECIFIC
DOLLAR AMOUNTS ARE NOT GUARANTEED. THE DOLLAR AMOUNTS OF SUCH PAYMENTS AND
VALUES WILL INCREASE OR DECREASE, AS SET OUT IN THE CERTIFICATE, DEPENDING
UPON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT.
In consideration of the Contractholder's payments under this Contract,
Metropolitan Life Insurance Company
(herein called "MetLife")
Agrees to make payments, and to pay annuities bought, under this Contract, in
accordance with and subject to its terms.
Therefore, the Contractholder and MetLife execute this Contract in duplicate
to take effect as of the Issue Date.
Metropolitan Life Insurance Company
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------------------------------------- /s/ Xxxxx X. Xxxxxx /s/ Xxxxxx X. Xxxxxxxxx
Signature
Xxxxx X. Xxxxxx Xxxxxx X. Xxxxxxxxx
Vice-President and Secretary President and Chief Operating Officer
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Title
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Witness Registrar
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Date Date
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City and State City and State
Group Annuity Contract - Deferred and Immediate Annuities
Accumulation Value - Non-Participating
CONTENTS
Page
Section 1. Definitions.............................................................2
Section 2. Annuities
2.01 Purchase of Annuities.................................................. 2
2.02 Report of Annuities.................................................... 2
2.03 Purchase Payments...................................................... 3
2.04 Purchase of Annuity.................................................... 3
2.05 Annuity Certificates................................................... 3
2.06 Death of Annuitant Before Annuity Commencement Date.................... 3
2.07 Surrender of Annuity Before Annuity Commencement Date.................. 3
2.08 Proof that Annuitant is Alive on Annuity Commencement Date............. 3
Section 3. General Provisions
3.01 Participation; Dividends............................................... 3
3.02 MetLife's Liability.................................................... 3
3.03 Misstatements.......................................................... 4
3.04 Changes by MetLife..................................................... 4
3.05 Discontinuance of Purchases............................................ 4
3.06 Communications; Payments to MetLife.................................... 4
3.07 Entire Contract........................................................ 4
3.08 Termination of Contract................................................ 5
Table I Annuity Purchase Rates................................................. 6
Section 1. Definitions
1.01 "Annuitant" means a person upon whose life a Certificate has
been issued under this Contract.
1.02 "Annuity" means an annuity payable under this Contract for
which a Certificate has been issued.
1.03 "Annuity Commencement Date" means the date as of which
payment of an Annuity is to commence.
1.04 "Business Day" means a day on which the Home Office of
MetLife in New York, New York is open for business.
1.05 "Certificate" means a certificate issued to the Owner of an
Annuity pursuant to Section 2.05.
1.06 "Discontinuance Date" means the date on and after which no
further Purchase Payments will be made to MetLife under this
Contract.
1.07 "Owner" means the person so reported to MetLife at the date
of purchase of the Certificate.
1.08 "Purchase Date" means the date as of which MetLife receives
the Purchase Payment for an annuity purchased under this
Contract or such other date MetLife agrees to.
1.09 "Purchase Payment" means an amount paid to MetLife to
purchase an Annuity under this Contract.
Section 2. Annuities
2.01 Purchase of Annuities
Annuities may be purchased under this Contract prior to the
Discontinuance Date.
2.02 Report of Annuities
For each Annuity purchased under this Contract the purchaser
will report the following information to MetLife:
(a) The name, sex (if relevant), date of birth, social
security number, and state of residence of the
Annuitant and the name of the beneficiary, if any.
(b) The name, address and social security number of the
Owner.
(c) The Annuity Commencement Date if relevant to the
form of annuity purchased. This must be a date
after MetLife receives the report. If MetLife
receives the report less than thirty one days
before the date reported as the Annuity
Commencement Date, MetLife will have the right to
make the Annuity Commencement Date thirty days from
the date MetLife receives the report.
(d) The form of each annuity to be purchased. Such form
will be any form which MetLife is willing to
provide.
2
Section 2 - Continued
2.03 Purchase Payments
The Purchase Payment for each annuity will accompany each
report made under Section 2.02 unless MetLife agrees
otherwise, MetLife need not accept any Purchase Payment of
less than $5,000.00 for any Annuity or any Purchase Payments
that will cause the total of all Purchase Payments accepted
with respect to any Owner or Annuitant to exceed
$500,000.00. MetLife will have no liability with respect to
any Annuity until it accepts the Purchase Payment unless
MetLife agrees otherwise.
2.04 Purchase of Annuity
On the Purchase Date MetLife will determine the monthly rate
of the Annuity (if relevant) by applying the annuity
purchase rates in Table I. However, if on the Purchase Date
MetLife has in effect more favorable rates for the purchase
of annuities under contracts in the class to which this
Contract belongs, then such more favorable rates will be
applicable.
2.05 Annuity Certificates
MetLife will issue to the Owner of an Annuity purchased
under this Contract a Certificate describing the benefits
provided thereunder.
2.06 Death of Annuitant Before Annuity Commencement Date
If the Annuitant dies before the Annuity Commencement Date
MetLife will have no further liability except as may be
provided by the form of the Annuity purchased or as may be
agreed by MetLife when the Annuity is purchased.
2.07 Surrender of Annuity Before Annuity Commencement Date
No annuity will have any cash surrender value before the
Annuity Commencement Date except as may be provided by the
form of Annuity purchased or as may be agreed by MetLife
when the Annuity is purchased.
2.08 Proof that Annuitant is Alive on Annuity Commencement Date
If requested by MetLife, satisfactory proof must be
furnished to MetLife that an Annuitant was alive on the
Annuity Commencement Date or his or her death before the
Annuity Commencement Date will be conclusively presumed.
Section 3. General Provisions
3.01 Participation; Dividends
No dividends will be payable under this Contract.
3.02 MetLife's Liability
MetLife's only liability with respect to the payment of
benefits under this Contract is to make the payments
provided in the Certificates issued hereunder. The liability
to make such payments is that of MetLife and not of the
Contractholder.
3
Section 3 - Continued
3.03 Misstatements
If the age or sex (if relevant) or any other relevant fact
relating to any individual is found to be misstated, MetLife
will not pay a greater amount of annuity than that provided
by the actual Purchase Payment and the correct information.
Any overpayment of annuity will, together with interest, be
deducted from future annuity payments. Any adjustment due to
an underpayment of an annuity will, together with interest,
be paid immediately upon receipt of the corrected
information. The interest rate will be that used to
determine the monthly rate of annuity.
3.04 Changes by MetLife
MetLife reserves the right to change any of the following
items one year from the Issue Date and at any time
thereafter:
(a) The annuity purchase rates in effect under this Contract
set forth in Table I.
(b) The amount of the minimum or maximum Purchase Payments.
MetLife will give the Contractholder notice of any such
change not less than 90 days before its effective date. No
such change in any of the foregoing items will be made
effective earlier than one year after the effective date of
any such previous change in that item.
No such change will affect Certificates purchased before the
effective date of such change.
3.05 Discontinuance of Purchases
MetLife has the right at any time to notify the
Contractholder that no further purchases may be made under
this Contract on or after the date specified in the notice.
That date will be at least 90 days after the date the notice
is given.
3.06 Communications; Payments to MetLife
All communications provided for in this Contract will be in
writing unless MetLife otherwise agrees in writing. For this
purpose, MetLife's address is its Home Office at Xxx Xxxxxxx
Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000, and the Contractholder's
address will be that which it designates to MetLife.
All payments to MetLife in accordance with this Contract are
payable to MetLife at its Home Office or such other office
or offices which MetLife may designate.
Any communication that may be made by the Contractholder may
instead be made by a party or parties designated by the
Contractholder for such purpose.
3.07 Entire Contract
This Contract is the entire contract between the parties.
Any Contractholder statements will be deemed representations
and not warranties. No agent, broker or other person, except
an authorized officer of MetLife, may make or change any
contract or certificates on behalf of MetLife. Any
amendment, modification or waiver of any provision of this
Contract will be in writing and may be made effective on
behalf of MetLife only by an authorized officer of MetLife.
3.08 Termination of Contract
This Contract will terminate upon MetLife and the
Contractholder's fulfillment of all their duties and
obligations arising under this Contract.
4
Table I. Annuity Purchase Rates
Deferred Xxxxx Xxxxxxx - Xxxx Xxxxxxx and Life Annuity
Under this form annuity payments are payable monthly from the Annuity
Commencement Date, if the Annuitant is then living, to the date of the last
payment before the later of (i) the Annuitant's death and (ii) the expiration
of the term certain period that commences on the Annuity Commencement Date.
Annuity payments payable during the Annuitant's lifetime are payable to the
Annuitant unless the Owner directs MetLife otherwise; any annuity payments
payable after the Annuitant's death are payable to the designated beneficiary.
Integral Years Purchase Payments per $1.00 of Monthly Annuity Payment
from Purchase if the Annuity Commencement Date is the Annuitant's 65
to Commencement Birthday and if the Term Certain Period is:
5 Years 10 Years 20 Years
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15 $102.36 $105.83 $120.60
10 119.98 124.34 142.57
5 140.53 145.99 168.48
Edition B
(Unisex)
On request MetLife will furnish Purchase Payments for other forms of annuity,
for annuities that provide benefits in event of the Annuitant's death and/or
surrender values before the Annuity Commencement Date, and for ages or
durations not shown above.
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