Exhibit 4(i)
==== GOLDEN
======= AMERICAN GUARANTEED DEATH
=========== LIFE INSURANCE BENEFIT ENDORSEMENT
===== COMPANY
Golden American is a stock company domiciled in Delaware.
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The Contract to which this endorsement is attached is hereby amended
by replacing the applicable provision with the provisions stated
below as of the Contract Date. Where used in this Endorsement the
term Contract shall mean Certificate when this Endorsement is
attached to a Certificate. Where used in this Endorsement, Owner,
shall mean Certificateowner when this Endorsement is attached to a
Certificate.
The provisions of the Contract Schedule dealing with death benefits
are replaced with the following:
DEATH BENEFIT
The Death Benefit is the greatest of (i), (ii), (iii), and (iv)
below, where:
(i) the Accumulation Value less any Credits applied within [12]
months of the date of death;
(ii) the lesser of (a) and (b) less any Credits applied within [12]
months of the date of death
(a) the Guaranteed Death Benefit, and
(b) the Maximum Guaranteed Death Benefit;
(iii) the Cash Surrender Value;
(iv) the sum of premiums paid, reduced by Prorata Partial Withdrawal
Adjustment(s) for Accumulation Value withdrawn.
GUARANTEED DEATH BENEFIT
On the Contract Date, the Guaranteed Death Benefit is the initial
premium plus any Credit, if applicable. On subsequent Valuation
Dates, the guaranteed Death Benefit is calculated as follows:
(1) Start with the Guaranteed Death Benefit on the prior valuation
date;
(2) Calculate interest on (1) for the current valuation period at
the Guaranteed Death Benefit Interest Rate;
(3) Add (1) and (2);
(4) Add to (3) any additional premiums paid (plus any Credit) during
the current valuation period;
(5) Subtract from (4) the amount of any Special Partial Withdrawal
Adjustments and Prorata Partial Withdrawal Adjustments for any
partial withdrawals made during the current valuation period.
Transfer of Accumulation Value to or from Special Funds will apply to
the Guaranteed Death Benefit on a prorata basis.
GUARANTEED DEATH BENEFIT INTEREST RATE
The Guaranteed Death Benefit Interest Rate is [7%] compounded
annually, except:
(a) For any portion of the Guaranteed Death Benefit attributable to
Accumulation Value allocated to Special Funds, the Guaranteed Death
Benefit Interest Rate is the lesser of: (1) [7%] (compounded
annually) and (2) the interest rate, positive or negative, providing
a yield on the Guaranteed Death Benefit for Special Funds equal to
the net return for the current valuation period on the Accumulation
Value allocated to Special Funds; and
(b) For any valuation period ending after the contract anniversary
on which the Owner attains age [80], or after the Maximum Guaranteed
Death Benefit has been reached, the Guaranteed Death Benefit Interest
Rate is [0%].
GA-RA-1044-1
SPECIAL FUNDS
Where used in this Endorsement the Special Funds are [the Liquid
Assets Division, the Limited Maturity Bond Division, the Fixed
Allocations, and the Guaranteed Interest Division]. The Company
reserves the right to classify newly available divisions as
Special Funds from the date of their availability to the Owner.
The Company may reclassify an existing division as a Special Fund
or remove such designation. Such reclassification shall be made
with 30 days notice to contract owners, and will apply to amounts
transferred or otherwise added to such division after the date of
change.
MAXIMUM GUARANTEED DEATH BENEFIT
The Maximum Guaranteed Death Benefit is equal to [three] times
premium paid, plus [three] times any Credits, reduced by the
amount of any Special and Prorata Partial Withdrawal Adjustments.
Any addition due to spousal continuation will not affect the
Maximum Guaranteed Death Benefit or the Guaranteed Death Benefit.
SPECIAL AND PRORATA PARTIAL WITHDRAWAL ADJUSTMENTS
For any partial withdrawal, the Death Benefit components will be
reduced by Prorata or Special Partial Withdrawal Adjustments. A
Prorata Partial Withdrawal Adjustment will be made unless a
Special Partial Withdrawal Adjustment applies to that component
for the withdrawal. Special Partial Withdrawal Adjustments are
made when partial withdrawals in a contract year do not exceed
[7%] of the sum of cumulative premiums, and any Credits, but only
if partial withdrawals in each prior contract year did not exceed
[7%] of the sum of cumulative premiums paid and any Credits prior
to that year. The Special Partial Withdrawal Adjustment is equal
to the amount of Accumulation Value withdrawn. Special Partial
Withdrawal Adjustments are applicable only in the calculation of
the Maximum Guaranteed Death Benefit and the Guaranteed Death
Benefit, and in all other cases withdrawals are treated as
Prorata Partial Withdrawal Adjustment.
The Prorata Partial Withdrawal Adjustment to a death benefit
component is equal to (1) divided by (2), multiplied by (3),
where: (1) is the Accumulation Value withdrawn, (2) is the
Accumulation Value immediately prior to withdrawal, and (3) is
the amount of the applicable death benefit component immediately
prior to the withdrawal.
GA-RA-1044-1
CHANGE OF OWNER
A change of Owner from a sole owner to a sole owner (where there
have never been multiple owners designated) will result in
recalculation of the Death Benefit, the Guaranteed Death Benefit,
and the Maximum Guaranteed Death Benefit. If the new owner's
attained age at the time of the change is less than [80], the
Guaranteed Death Benefit and the Maximum Guaranteed Death Benefit
in effect prior to the change will remain in effect and the Death
Benefit provision shall apply. If the new owner's attained age
at the time of the change is [80] or greater, but not greater
than [85]:
(a) the Guaranteed Death Benefit and the Maximum Guaranteed
Death Benefit following the change will be zero; and
(b) the Death Benefit will then be the greatest of:
1) the cash surrender value;
2) the accumulation value, less any Credits applied within [12]
months prior to the date of death; and
3) the sum of the premiums paid, reduced by Prorata Partial
Withdrawal Adjustments for any Accumulation Value Withdrawn.
If ownership changes result in multiple owners of a contract or
if there has ever been multiple owners, the Guaranteed Death
Benefit and the Maximum Guaranteed Death Benefit shall be set to
zero. If the oldest owner is age [85] or younger at the time of
the change, the Death Benefit will then be the greatest of: (b)
1, (b) 2 or (b) 3 above.
If any owner's or oldest multiple owners' attained age is [86] or
greater at the time of the change, the Guaranteed Death Benefit
and the Maximum Guaranteed Death Benefit will be zero, and the
Death Benefit will then be the cash surrender value.
When a change of owner reduces the Guaranteed Death Benefit and
the Maximum Guaranteed Death Benefit to zero, there will be a
reduction in the mortality and expense risk charge.
SPOUSAL CONTINUATION UPON DEATH OF OWNER
If at the Owner's death, the surviving spouse of the deceased
Owner is the beneficiary and such surviving spouse elects to
continue the contract as their own pursuant to Internal Revenue
Code Section 72(s) or the equivalent provisions of U.S. Treasury
Department rules for qualified plans, the following will apply:
(a) If the lesser of 1) the Guaranteed Death Benefit and 2) the
Maximum Guaranteed Death Benefit, as of the date we receive due
proof of death of the Owner, minus the Accumulation Value, also
as of that date, is greater than zero we will add such difference
to the Accumulation Value. Such addition will be allocated to
the divisions of the Separate Account in proportion to the
Accumulation Value in the Separate Account. If there is no
Accumulation Value in the Separate Account, the addition will be
allocated to the Liquid Assets division, or its successor.
(b) The Guaranteed Death Benefit and the Maximum Guaranteed
Death Benefit will continue to apply, with all age criteria using
the surviving spouse's age as the determining age. The
Guaranteed Death Benefit shall be reallocated to the Special and
other funds in proportion to the Accumulation Value.
(c) At subsequent surrender, any surrender charge applicable to
premiums paid prior to the date we receive due proof of death of
the Owner will be waived. Any premiums paid later will be
subject to any applicable surrender charge.
This addition to Accumulation Value is available only to the
spouse of the owner as of the date of death of the owner if such
spouse under the provisions of this contract elects to continue
the contract as their own.
GA-RA-1044-1
DEDUCTIONS FROM THE DIVISIONS
Mortality and Expense Risk Charge - We deduct a charge from the
assets in each separate account division on a daily basis at a
rate of [0.004976%] (equivalent to an annual rate of [1.80%]) for
mortality and expense risks. The charge is not deducted from the
fixed account or general account accumulation values.
All other provisions of the Contract to which this Endorsement is
attached remain unchanged.
/s/Xxxxxxx Xxxxxxx
Signed: --------------------
Xxxxxxx Xxxxxxx
XX-XX-0000-0
