CONTRACT SCHEDULE
OWNER: [Xxxx Xxx] SEX: [M] AGE AT ISSUE: [35]
JOINT OWNER: [Xxxx Xxx] SEX: [F] AGE AT ISSUE: [35]
ANNUITANT: [Xxxx Xxx ] SEX: [M] AGE AT ISSUE: [35]
CONTRACT NUMBER: [12345678] ISSUE DATE: [February 15, 2005]
PLAN TYPE: [Qualified, IRA, Non-Qualified, MATURITY DATE: [February 15, 2060]
SIMPLE IRA, SEP, XXXX XXX]
PRODUCT CLASS: [Series XTRA, Vintage EXTRA, VAPlus, Pioneer]
PURCHASE PAYMENT: [$100,000.00]
PURCHASE PAYMENTS: [We reserve the right to reject any Purchase
Payment.]
MINIMUM SUBSEQUENT PURCHASE
PAYMENT: [$500.00] [for both Non-Qualified and
Qualified, unless you have elected an automatic
sweep program.] [However, for IRAs, SEPs,
SIMPLE IRAs and Xxxx IRAs, in order to avoid
cancellation of the Contract, we will accept a
Purchase Payment of at least $50 once in every
24 month period. We will also accept subsequent
Purchase Payments as required under applicable
law and federal tax law.]
MAXIMUM TOTAL
PURCHASE PAYMENTS: [$1,000,000.00], without our prior approval.
PURCHASE PAYMENT CREDITS: [[_%] of each Purchase Payment received prior
to the [first Contract Anniversary]].
MINIMUM ACCOUNT VALUE: [$2,000.00]
BENEFICIARY: [As designated by you as of the Issue Date
unless changed in accordance with the Contract
provisions.]
PRODUCT CHARGES:
[SEPARATE ACCOUNT: We assess certain daily charges equal on an
annual basis to the percentages set out below
of the average daily net asset value of each
Subaccount of the Separate Account:
Mortality and Expense Charge: [____% for the
first 9 Contract Years declining to ____%
starting in Contract Year 10]
Administration Charge: [0.25%]
[Death Benefit Rider Charge: [_____%]]
[Additional Death Benefit Rider Charge:
[____%]]
ACCOUNT FEE: The Account Fee is [$30.00] each Contract Year.
During the Accumulation Period, on the Contract
Anniversary the full Account Fee is deducted
from each applicable Subaccount in the ratio
that the Account Value in the Subaccount bears
to the total Account Value in the Separate
Account. On the Annuity Calculation Date, a
pro-rata portion of the Account Fee will be
deducted from the Account Value as described
above. However, if your Account Value on the
last day of the Contract Year or on the Annuity
Calculation Date is at least [$50,000], then no
Account Fee is deducted. If during the
Accumulation Period, a total withdrawal is
made, the full Account Fee will be deducted at
the time of the total withdrawal. During the
Annuity Period the Account Fee will be deducted
regardless of the size of your Contract and it
will be deducted pro-rata from each Annuity
Payment.
SEPARATE ACCOUNT: [MetLife Investors USA Variable Annuity
Account One]
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ALLOCATION REQUIREMENTS:
1. [Currently, you can select from any of the Subaccounts or the Fixed Account
(if a Fixed Annuity Rider has been issued). However, we reserve the right
to limit this in the future.
2. Allocations must be in whole numbers. Each allocation must be at least
[$500]. Allocations made pursuant to Pre-scheduled Transfer programs are
not subject to this limitation. The current approved Pre-scheduled Transfer
programs are Rebalancing program, Asset Allocation program and Dollar Cost
Averaging program.
3. We reserve the right to restrict allocations to the Fixed Account if any of
the following conditions exist: (a) the credited interest rate for the
amount to be allocated is equal to the Minimum Guaranteed Interest Rate for
the Fixed Account; (b) the Account Value in the Fixed Account equals or
exceeds [$500,000]; or (c) a transfer was made out of the Fixed Account
within the previous 180 days.]
TRANSFER REQUIREMENTS:
[NUMBER PERMITTED: The maximum number of transfers per Contract Year shall be
[12] (excluding transfers resulting from our Pre-scheduled Transfer programs).
We reserve the right to waive from time to time this transfer limitation.
Subject to the Allocation Rules and the issuance of a Fixed Annuity Rider,
during the Accumulation Period you may make transfers into the Fixed Account
from the Subaccounts, subject to the maximum number of transfers per Contract
Year as stated above. There are further limitations on transfers from the Fixed
Account to the Separate Account as set forth below. During the Annuity Period,
you cannot make transfers from the General Account to the Subaccounts.
TRANSFER FEE: In the event that [12] transfers are made in a Contract Year,
(excluding those related to our Pre-scheduled Transfer programs) we will deduct
a Transfer Fee of [$25] for each additional transfer in such Contract Year. The
Transfer Fee will be deducted from the Subaccount or Fixed Account from which
the transfer is made. However, if the entire interest in an account is being
transferred, the Transfer Fee will be deducted from the amount which is
transferred. We reserve the right to waive from time to time, the Transfer Fee.
MINIMUM AND MAXIMUM AMOUNT TO BE TRANSFERRED: The minimum amount that may be
transferred from a Subaccount is [$500], or your entire interest in the
Subaccount, if less (excluding transfers resulting from our Pre-scheduled
Transfer programs. The minimum amount that may be transferred from the Fixed
Account during the Accumulation Period is [$500], or your entire interest in the
Fixed Account. Transfers out of the Fixed Account during the Accumulation Period
shall be limited to the greater of (a) 25% of the Fixed Account Value at the
beginning of the Contract Year, or (b) the amount transferred out of the Fixed
Account in the prior Contract Year.]
WITHDRAWALS:
WITHDRAWAL CHARGE: [A Withdrawal Charge is assessed against Purchase Payments
withdrawn. The Withdrawal Charge is calculated at the time of each withdrawal.
Each Purchase Payment is tracked from the date of its receipt. Amounts will be
withdrawn from your Contract in the following order:
1. Earnings in the Contract (Earnings are equal to your Account Value less
Purchase Payments not withdrawn); and then
2. The Free Withdrawal Amount described below, if any; then
3. Purchase Payments not previously withdrawn, in the order such Purchase
Payments were made: the oldest Purchase Payment first, the next Purchase
Payment second, etc. until all Purchase Payments have been withdrawn
(First-in-First-out (FIFO) basis).
Withdrawal Charges are determined in accordance with the following
schedule:
WITHDRAWAL CHARGES
NUMBER OF COMPLETE YEARS
FROM RECEIPT OF PURCHASE PAYMENT % CHARGE
-------------------------------- --------
[0 8
1 8
2 7
3 6
4 5
5 4
6 3
7 2
8 1
9 and thereafter 0]]
[FREE WITHDRAWAL AMOUNT: Each Contract Year after the first, you can make a
withdrawal of a portion of your Account Value free from any Withdrawal Charge.
The Free Withdrawal Amount each Contract Year is equal to [10%] of total
Purchase Payments, less the total Free Withdrawal Amount previously withdrawn in
the same Contract Year. This right is non-cumulative.]
MINIMUM PARTIAL WITHDRAWAL: [$500], or your entire interest in the Fixed Account
or Subaccount]
8028-6 (2/08)-XXC
MINIMUM WITHDRAWAL VALUE WHICH MUST REMAIN IN THE CONTRACT AFTER A PARTIAL
WITHDRAWAL: [$2,000]
ANNUITY REQUIREMENTS:
1. [The Annuity Date cannot be earlier than 12 months following the Issue
Date. Unless otherwise designated by you, the Annuity Date will be no later
than the Maturity Date. The Maturity Date is the later of the first day of
the calendar month following the Annuitant's 90th birthday or ten (10)
years from the Issue Date.
2. For Variable Annuity Payments, the Variable Annuity Tables are based on the
Annuity 2000 Mortality Table with 7-year age setback and an Assumed
Investment Return (AIR) of 3.00%.
3. For Fixed Annuity Payments, the Fixed Annuity Tables are based on the
Annuity 2000 Mortality Table with 7-year age setback with interest at [3%]]
[FIXED ACCOUNT:
INITIAL GUARANTEE PERIOD: [Through the end of the current calendar year]
RENEWAL GUARANTEE PERIOD: [A calendar year]
INITIAL CURRENT INTEREST RATE: [4.60%][Allocations to the Fixed Account not
currently available]
MINIMUM GUARANTEED INTEREST RATE: [3.00%] annually]
[INITIAL EDCA PERIOD: 24 months EDCA rate applicable to deposits made at the
beginning of the Initial EDCA period: [4.00%]
INITIAL EDCA PERIOD: 12 months EDCA rate applicable to deposits made at the
beginning of the Initial EDCA period: [4.00%]
INITIAL EDCA PERIOD: 6 months EDCA rate applicable to deposits made at the
beginning of the Initial EDCA period: [8.00%]
INITIAL EDCA PERIOD: 3 months EDCA rate applicable to deposits made at the
beginning of the Initial EDCA period: [9.00%]]
ANNUITY SERVICE OFFICE:
MetLife Investors USA Insurance Company
[P.O. Box 10366
Des Moines, Iowa 50306-0366
(000) 000-0000]
ENDORSEMENTS AND RIDERS ATTACHED TO THIS CONTRACT:
[Fixed Account Rider for Variable Annuity
Enhanced Dollar Cost Averaging Rider
Three Month Market Entry Rider
Death Benefit Rider (Principal Protection)
Death Benefit Rider (Annual Step-up)
Death Benefit Rider (Compounded Plus)
Guaranteed Minimum Income Benefit Rider - Living Benefit
Guaranteed Withdrawal Benefit Rider
Lifetime Guaranteed Withdrawal Benefit Rider
Guaranteed Minimum Accumulation Benefit Rider
Additional Death Benefit Rider - Earnings Preservation Benefit
Purchase Payment Credit Rider
Waiver of Withdrawal Charge for Nursing Home or Hospital Confinement Rider - TO
BE ATTACHED AT ISSUE IF LESS THAN AGE 80
Waiver of Withdrawal Charge for Terminal Illness Rider - TO BE ATTACHED AT ISSUE
IF LESS THAN AGE 80
Individual Retirement Annuity Endorsement
Xxxx Individual Retirement Annuity Endorsement
SIMPLE Individual Retirement Annuity Endorsement
401 Plan Endorsement
Tax Sheltered Annuity Endorsement
Unisex Annuity Rates Endorsement
Designated Beneficiary Non-Qualified Annuity Endorsement
Non-Qualified Annuity Endorsement]
8028-6 (2/08)-XXC
