GENWORTH LIFE INSURANCE COMPANY OF NEW YORK
ANNUAL STEP-UP DEATH BENEFIT RIDER
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This rider is added to the Contract. It provides for an optional death benefit.
Annual Step-Up Death Benefit
While this rider is in effect, we will pay a death benefit equal to the
greatest of (a), (b), and (c), as of the first Valuation Day we receive due
proof of death of an Annuitant and all required forms at our Home Office, where:
(a) is the Death Benefit provided for under the Death Provisions section
in the Contract;
(b) is the Annual Step-Up Death Benefit described below; and
(c) is a death benefit provided by an optional rider.
The Annual Step-Up Death Benefit on the Contract Date is the initial Purchase
Payment. We will reset the Annual Step-Up Death Benefit on each Contract
anniversary up to and including the later of (i) the [fifth] Contract
anniversary and (ii) the first Contract anniversary on or after the [80/th/]
birthday of the oldest Annuitant. We will also reset the Annual Step-Up Death
Benefit on the first Valuation Day we receive due proof of death and all
required forms at our Service Center. At each reset date, the Annual Step-Up
Death Benefit equals the greater of (a) and (b), where:
(a) is the Contract Value; and
(b) is the Annual Step-Up Death Benefit on the last reset date plus
Purchase Payments made since the last reset date, adjusted for any
withdrawals since the last reset date.
The Annual Step-Up Death Benefit will not reset after the first Contract
Anniversary on or after the [80/th/] birthday of the oldest Annuitant.
Interest will be paid on the Annual Step-Up Death Benefit from the date of
death to the date of payment as required in New York.
Annual Step-Up Death Benefit adjustment for withdrawals:
Withdrawals reduce the Annual Step-Up Death Benefit proportionally by the same
percentage that the withdrawal, including all surrender charges and premium
taxes paid, reduces the Contract Value.
The following example shows how the Annual Step-Up Death Benefit rider works
based on hypothetical values. It is not intended to depict investment
performance of the Contract. The example assumes that an Owner purchases a
Contract with an Annuitant age 75 at the time of issue. In addition, the
example assumes that:
(1) The Owner purchases the Contract for $100,000;
(2) The Owner makes no additional Purchase Payments; and
(3) The Owner takes no partial withdrawals; then
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End of Year Xxxxxxxxx's Age Contract Value Death Benefit Amount
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1 76 $103,000 $103,000
2 77 112,000 112,000
3 78 90,000 112,000
4 79 135,000 135,000
5 80 130,000 135,000
6 81 150,000 135,000
7 82 125,000 135,000
8 83 145,000 135,000
Partial withdrawals will reduce the Annual Step-Up Death Benefit by the
proportion that the partial withdrawal (including any surrender charge and any
premium tax assessed) reduces your Contract Value.
Rider Charge
There will be a charge made for this rider, as shown on the Contract Data
Pages, while it is in effect. The charge will be calculated and deducted in
arrears. The charge is calculated [quarterly] as a percentage of the value of
the Annual Step-Up Death Benefit on the last reset date, plus Purchase Payments
made since the last reset date adjusted for any withdrawals since the last
reset date, and deducted [quarterly] from the Contract Value. If a spouse is
added as a Joint Annuitant after the Contract is issued, a new charge for the
rider may apply. This new charge may be higher than the charge previously
applied for this rider. On the day the rider and/or the Contract terminates,
the charge for this rider will be calculated, prorata, and deducted.
The charge for this rider will be deducted from the Contract Value
proportionately across the Subaccounts and Guarantee Account in which you are
invested. We will waive any portion of the charge that would cause the net rate
credited to any Guarantee Account to be less than required by New York statutes
or regulations.
When this Rider is Effective
The effective date of this rider is the Contract Date unless another effective
date is shown on the Contract Data Pages. This rider may not be terminated
prior to the Annuity Commencement Date. When Income Payments begin, this rider
and its corresponding charge will terminate. If the Contract is surrendered or
otherwise terminated, this rider will terminate. If the Contract is terminated
and later reinstated, this rider cannot be reinstated without our approval.
Resets of the Annual Step-Up Death Benefit will end on the first Valuation Day
the Contract Value equals zero. On this day, if your Contract has not
terminated, your Annual Step-Up Death Benefit will be the Annual Step-Up Death
Benefit on the last reset date plus Purchase Payments made since the last reset
date, adjusted for any withdrawals since the last reset date. The Annual
Step-Up Death Benefit will not reset after this day.
If a Joint Annuitant is added to the Contract after the date this rider is
issued, the calculation of benefits provided pursuant to this rider will be
determined based on the age of the Annuitant(s) on the date the Joint Annuitant
is added to the Contract.
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Change of Ownership
You may assign the benefits provided under this rider. The Annuitant(s) will
not change if you assign benefits. We must be notified in writing if you assign
the benefits of this rider.
Issue Age
This rider is only available if all Annuitants are age [75 or younger] on the
Contract Date.
Spousal Continuation
Upon the death of any Annuitant, if the designated beneficiary is a surviving
spouse who is an Annuitant and elects to continue the Contract, this rider will
continue.
Upon the death of any Annuitant, if the designated beneficiary is a surviving
spouse who is not an Annuitant, elects to continue the Contract and is age [75
or younger] on the date of the Annuitant's death, this rider will continue. The
charge for this rider may change. The charge for this rider and the calculation
of benefits provided pursuant to this rider when continued will be determined
based on the age of the surviving spouse on the date of the Annuitant's death.
In the event of conflicting provisions between this form and the base contract,
the provisions of this rider will apply.
For Genworth Life Insurance Company of New York,
/s/ Xxxxx X. Xxxxxx
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[Xxxxx X. Xxxxxx]
President
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