EX-99.4.3
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A AETNA LIFE INSURANCE AND ANNUITY COMPANY
HOME OFFICE: 000 Xxxxxxxxxx Xxx.
Xxxxxxxx, Xxxxxxxxxxx 00000
0-000-000-0000
Herein called Aetna
Agrees to pay the benefits stated in this Contract.
SPECIFICATIONS
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Type of Plan
SPECIMEN
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Annuitant
SPECIMEN
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Contract Holder
SPECIMEN
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Contract No.
SPECIMEN
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Effective Date
SPECIMEN
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THIS CONTRACT IS DELIVERED IN [STATE] AND IS SUBJECT TO THE LAWS OF THAT
JURISDICTION
THIS CONTRACT MAY NOT BE SUITABLE IF ONLY ONE (1) LARGE PURCHASE PAYMENT IS
MADE.
THE VARIABLE FEATURES OF THIS CONTRACT ARE DESCRIBED IN PARTS III AND IV.
RIGHT TO CANCEL
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The Contract Holder may cancel this Contract within 10 days of receiving it,
by returning this Contract along with a written notice to Aetna at the above
address or to the agent from whom it was purchased. Within 7 days after it
receives the notice of cancellation and this Contract at its Home Office,
Aetna will return the entire consideration paid; plus any increase or minus
any decrease in the cash value of any funds allocated to the Separate
Accounts.
This page, the following pages, and the application make up the entire
Contract.
Signed at the Home Office on the Effective Date.
/s/ Xxxxxx X. XxXxxxxxx /s/ Xxxxx Xxxxxxx-Xxxxxxx
President Secretary
INDIVIDUAL VARIABLE, FIXED, OR COMBINATION ANNUITY CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT.
I-CDA-HD (XC) (NU)
SPECIFICATIONS
(CONTINUED)
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GUARANTEED There is a guaranteed interest rate for Purchase Payment(s)
INTEREST RATE held in the General Account. (See 3.02.)
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SURRENDER FEE There will be a charge deducted for early surrender.
(See Part V.)
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DEDUCTIONS FROM There will be deductions for mortality and expense risks and
THE SEPARATE administrative fees. (See 3.05.)
ACCOUNT
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DEDUCTION FROM Purchase Payments(s) are subject to a deduction for premium
PURCHASE taxes, if any. (See 3.01.)
PAYMENT(S)
This Contract is a legal contract and constitutes the entire legal relationship
between Aetna and the Contract Holder.
READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the
rights and obligations of both you and Aetna. IT IS THEREFORE IMPORTANT THAT
YOU READ THIS CONTRACT CAREFULLY.
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TABLE OF CONTENTS
I. GENERAL DEFINITIONS
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PAGE
1.01 Annuitant 5
1.02 Annuity 5
1.03 Fixed Account 5
1.04 Fixed Annuity 5
1.05 Fund(s) 5
1.06 General Account 5
1.07 Purchase Payment(s) 5
1.08 Separate Accounts 5
1.09 Valuation Period 5
1.10 Variable Annuity 5
II. GENERAL PROVISIONS
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2.01 Change of Contract 5
2.02 Change of Fund(s) 6
2.03 Non-Participating Contract 6
2.04 Payments 6
2.05 State Laws 6
2.06 Control of Contract 6
2.07 Designation of Beneficiary 6
2.08 Misstatements and Adjustments 6
2.09 Incontestability 7
2.10 Grace Period 7
III. PURCHASE PAYMENT, CURRENT VALUE, AND SURRENDER PROVISIONS
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3.01 Net Purchase Payment(s) 7
3.02 Guaranteed Interest Rate - Fixed Account 7
3.03 Maintenance Fee 7
3.04 Fund(s) Record Units - Separate Account 7
3.05 Net Return Factor(s) - Separate Account 7
3.06 Fund(s) Record Unit Value - Separate Account 8
3.07 Current Value 8
3.08 Transfer of Current Value from the Funds 8
3.09 Transfer of Current Value from the Fixed Account 8
3.10 Notice to the Contract Holder 8
3.11 Sum Payable at Death (Before Annuity Payments Start) 9
3.12 Surrender Value 9
3.13 Payment of Surrender Value 9
3.14 Reinstatement 9
3.15 Payment of Current Value 9
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IV. ANNUITY PROVISIONS
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4.01 Choices to be Made 9
4.02 Terms of Annuity Options 10
4.03 Death of Annuitant/Beneficiary 10
4.04 Fund(s) Annuity Units - Separate Account 10
4.05 Fund(s) Annuity Unit Value - Separate Account 10
4.06 Annuity Options 11
V. SPECIAL PROVISIONS
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5.01 Deferred Compensation Plan 19
5.02 Pension or Profit Sharing Plan 19
5.03 Individual Retirement Annuity Plan (XXX) 20
5.04 Tax Deferred Annuity Plan 21
5.05 Individual Annuity Plan 22
VI. FEE SCHEDULE
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6.01 Maintenance Fee 23
6.02 Surrender Fee 23
6.03 Table of Values - Fixed Account 23
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I. GENERAL DEFINITIONS
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1.01 ANNUITANT:
A person on whose life an Annuity has been effected under this
Contract.
1.02 ANNUITY:
Payment of an income:
(a) for the life of one or two persons;
(b) for a stated period, or amount; or,
(c) for some mix of (a) and (b).
1.03 FIXED ACCOUNT:
An accumulation option with a guaranteed minimum interest rate. Aetna
may credit a higher rate which is not guaranteed.
1.04 FIXED ANNUITY:
An Annuity with payments which do not vary in amount.
1.05 FUND(S):
The open-end registered management investment companies (mutual funds)
made available by Aetna under this Contract.
1.06 GENERAL ACCOUNT:
The Account holding the assets of Aetna, other than those assets held
in the Separate Accounts.
1.07 PURCHASE PAYMENTS:
Payments made to Aetna.
1.08 SEPARATE ACCOUNTS:
Accounts set up by Aetna under the Connecticut Insurance Laws which
purchase shares of the Fund(s).
1.09 VALUATION PERIOD (PERIOD):
The period of time from the end of one business day on the New York
Stock Exchange to the end of the next business day.
1.10 VARIABLE ANNUITY:
An Annuity with payments which vary with the net investment results of
a Separate Account.
II. GENERAL PROVISIONS
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2.01 CHANGE OF CONTRACT:
Only an authorized officer of Aetna may change the terms of this
Contract. Aetna will notify the Contract Holder in writing at least 30
days before the effective date of any change. Any change will not
affect the amount or terms of any Annuity which begins before the
change.
The following provisions of this Contract will not be changed:
(a) Net Purchase Payment(s);
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(b) Guaranteed Interest Rate - Fixed Account;
(c) Net Return Factor(s) - Separate Account;
(d) Current Value;
(e) Surrender Value;
(f) Funds(s) Annuity Unit Value - Separate Account;
(g) Annuity Options;
(h) Fixed Annuity minimum interest rate;
(i) Maximum transfer, maintenance or surrender fees.
This Contract may also be changed as required by federal or state law.
2.02 CHANGE OF FUND(S):
Aetna, or the Separate Account and the Fund(s), may:
(a) change the Fund(s) which may be invested in by the Separate
Account; and
(b) replace the shares of any Fund(s) held in the Separate Account
with shares of any other Fund(s).
Changes must be:
(1) approved by a majority vote of persons having an interest in the
Separate Account and the Fund(s); or
(2) deemed necessary by Aetna under the Investment Company Act of
1940; or
(3) deemed necessary by Aetna to accomplish the purpose of the
Separate Account.
Aetna will notify the Contract Holder of any change.
2.03 NON-PARTICIPATING CONTRACT:
The Contract Holder, Annuitant, or beneficiaries will not have a right
to share in the earnings of Aetna.
2.04 PAYMENTS:
Aetna will make Annuity payments as and when due. Aetna will make
other payments within 7 days of receipt at its Home Office of a
written claim for payment which is in good order, except as provided
in 3.13.
2.05 STATE LAWS:
This Contract complies with the laws of the state in which it is
delivered. Any cash, death or Annuity payments are equal to or greater
than the minimum required by such laws. Annuity tables for legal
reserve valuation shall be as required by state law. Such tables may
be different from annuity tables used to determine Annuity payments.
2.06 CONTROL OF CONTRACT:
See Part V.
2.07 DESIGNATION OF BENEFICIARY:
See Part V. The beneficiary may be changed at any time.
2.08 MISSTATEMENTS AND ADJUSTMENTS:
If Aetna finds the age, or any other relevant facts to be misstated,
the correct facts will be used to adjust payments.
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2.09 INCONTESTABILITY:
Aetna cannot cancel this Contract because of any error of fact on the
application.
2.10 GRACE PERIOD:
This Contract will remain in effect even if Purchase Payments are not
continued.
III. PURCHASE PAYMENT, CURRENT VALUE AND SURRENDER PROVISIONS
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3.01 NET PURCHASE PAYMENT(S):
The actual Purchase Payment less any premium tax. As a rule, Aetna
will deduct the premium tax when Annuity benefits are purchased (see
Part IV). If Aetna determines that it must pay a premium tax when
Purchase Payments are received or at any other time, it will deduct
the tax at that time.
The Net Purchase Payment(s) will be credited to:
(a) the Fixed Account;
(b) the Fund(s) in which the Separate Account invests.
Aetna must be told the percentage of the Net Purchase Payment(s) to be
applied to each investment above.
During any calendar year, Aetna may be told to change the investment
mix four times if more than one Purchase Payment is made. If
additional changes are allowed, each may be subject to a fee of up to
$10.
3.02 GUARANTEED INTEREST RATE - FIXED ACCOUNT:
On any Purchase Payment(s) made to the Fixed Account, Aetna will add
interest daily at any annual rate no less than 4%. Aetna may add
interest daily at any higher rate determined by its Board of
Directors.
3.03 MAINTENANCE FEE:
See Part V.
3.04 FUND(S) RECORD UNITS - SEPARATE ACCOUNT:
The portion of the Net Purchase Payment(s) applied to the Separate
Account will determine the number of Fund(s) Record Units. This number
is equal to a Net Purchase Payment divided by the Fund(s) Record Unit
Value (see 3.06) for the Valuation Period in which the Purchase
Payment is received in good order.
3.05 NET RETURN FACTOR(S) - SEPARATE ACCOUNT:
The Net Return Factors are used to compute all Separate Account values
and payments for any Fund.
The Net Return Factor for each Fund is equal to 1.0000000 plus the Net
Return Rate.
The Net Return Rate is equal to:
(a) The value of the shares of the Fund held by the Separate Account
at the end of a Valuation Period; minus
(b) the value of the shares of the Fund held by the Separate Account
at the start of the Valuation Period; plus or minus
(c) taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(d) the total value of the Fund Record Units and Fund Annuity Units
of the Separate Account (see 3.06 and 4.05) at the start of the
Valuation Period; minus
(e) a daily actuarial charge at an annual rate of 1.25% for annuity
mortality and expense risks and profit; and a daily
administrative charge which will not exceed .25% on an annual
basis.
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A Net Return Rate may be more or less than 0.
The value of a share of the Fund is equal to the net assets of the
Fund divided by the number of shares outstanding.
The administrative charge may be changed annually except for amounts
which have been used to purchase an annuity. This charge will not
exceed .25%.
3.06 FUND(S) RECORD UNIT VALUE - SEPARATE ACCOUNT:
The Fund(s) Record Unit Value is computed by multiplying the Net
Return Factor for the current Valuation Period by the Fund(s) Record
Unit Value for the previous Period. The dollar value of a Fund(s)
Record Units, Separate Account assets, and Variable Annuity payments
may go up or down due to investment gain or loss.
3.07 CURRENT VALUE:
The current Value (of this Contract) is equal to:
(a) Any amounts in the Fixed Account, including Fixed Account
interest added by Aetna; plus
(b) The sum of any Separate Account Record Unit value(s); less
(c) Any Maintenance Fee(s) due.
Current Value does not include amounts used to purchase an Annuity.
3.08 TRANSFER OF CURRENT VALUE FROM THE FUNDS:
Before an Annuity option is elected, all or any portion of the Current
Value may be transferred from any Fund to any other Fund or to the
Fixed Account.
Four transfers of Current Value can be made during a calendar year
period. If additional transfers are allowed, each may be subject to a
fee of up to $10.
3.09 TRANSFER OF CURRENT VALUE FROM THE FIXED ACCOUNT:
10% of the Current Value held in the Fixed Account may be transferred
to any Fund(s). Such transfer will be:
(a) without charge;
(b) allowed once per calendar year;
(c) not allowed under an annuity option.
Aetna may, on a temporary basis, allow any larger percent to be
transferred.
The Current Value of the Fixed Account, as used above, is the value
when the request is received at the Home Office of Aetna.
3.10 NOTICE TO THE CONTRACT HOLDER:
Aetna will notify the Contract Holder each year of:
(a) The value of any amounts held in:
(1) the Fixed Account; and
(2) the Fund(s) for the Separate Account; and
(b) the number of any Fund(s) Record Units; and
(c) the Fund(s) Record Unit Value(s); and
(d) the Surrender Value of these amounts.
Such number or values will be as of a date no more than 60 days before
the date of the notice.
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3.11 SUM PAYABLE AT DEATH (BEFORE ANNUITY PAYMENTS START):
See Part V.
3.12 SURRENDER VALUE:
See Part V.
3.13 PAYMENT OF SURRENDER VALUE:
Under certain emergency conditions, Aetna may defer payment:
(a) for a period of up to 6 months (unless not allowed by state law);
and
(b) as provided by federal law.
3.14 REINSTATEMENT:
All or a portion of the proceeds of a full surrender of this Contract
may be reinvested within 30 days after the surrender if allowed by
law. Any Maintenance Fee and Surrender Fee charged at the time of
surrender on the amount being reinvested will be included in the
reinstatement. Amounts will be reinstated among the Fixed Account and
Separate Account in the same proportion as they were at the time of
surrender. The number of Record Units reinstated will be based on the
Record Unit Value(s) next computed after receipt at Aetna's Home
Office of the reinstatement request and the amount to be reinvested.
Any Maintenance Fee which falls due after the surrender and before the
reinstatement will be deducted from the amount reinstated.
Reinstatement is permitted only once.
3.15 PAYMENT OF CURRENT VALUE:
Aetna may pay in a lump sum any Current Value if Purchase Payment(s)
have not been received for three full years and the Current Value is
less than $2,000. Such Current Value paid may not be reinstated.
IV. ANNUITY PROVISIONS
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4.01 CHOICES TO BE MADE:
Aetna will pay the Current Value (minus any premium tax) as a premium
for an Annuity under Option 4 with no guaranteed period. Any other
Annuity Option may be elected by telling Aetna to pay all or any
portion of the Current Value (minus any premium tax) as a premium for
an Annuity under Option 2, 3, 4 or 5 (see 4.06). The first Annuity
payment must generally be made no later than the first day of the
month following the Annuitant's 75th birthday. If this Contract is
issued under an XXX (see Specifications page), the first Annuity
payment must be made not later than December 31 of the year the
Annuitant attains age 70 1/2. Aetna may be told to make the first
Annuity payment during any prior month.
When an Option is chosen, Aetna must also be told whether payments are
to be made other than monthly and (except for Option 2) to pay:
(a) a Fixed Annuity using the General Account; or
(b) a Variable Annuity using any of the Funds(s) made available by
Aetna for Annuity purposes; or
(c) a mix of (a) and (b).
If a Fixed Annuity is chosen, Aetna will add interest daily at an
annual rate no less than 3.5%. Aetna may add interest daily at any
higher rate.
If a Variable Annuity is chosen, an Assumed Annual Net Return Rate of
5% may be chosen. If not chosen, Aetna will use an Assumed Annual Net
Return Rate of 3.5%.
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4.02 TERMS OF ANNUITY OPTIONS:
(a) When payments start, the age of the Annuitant plus the number of
years for which payments are guaranteed must not exceed 95.
(b) The present value of the expected payments to the Annuitant when
payments start shall be more than 50% of the present value of the
total expected payments to be made; this restriction does not
apply if Option 5 is chosen and the second Annuitant is the
spouse of the Annuitant.
(c) No choice of any Annuity Option may be made if the first payment
would be less than $20 or if the total payments in a year would
be less than $100.
(d) If a Fixed Annuity under Option 3, 4 or 5 is chosen and a larger
payment would result from applying the surrender value to a
single premium immediate annuity currently offered by Aetna to
the same class of Annuitants, Aetna will make the larger payment.
(e) Age, where used in the following tables, means age on the
birthday closest to the date of the first payment.
(f) Assumed Annual Net Return Rate is the interest rate used to
determine the amount of the first annuity payment under a
Variable Annuity. The Separate Account must earn this rate plus
enough to cover the mortality and expense risk and administrative
fee charges if future Variable Annuity payments are to remain
level.
4.03 DEATH OF ANNUITANT/BENEFICIARY:
When an Annuitant dies any remaining payments will be continued to the
beneficiary. If the beneficiary is not a person or persons, the
present value of any remaining payments will be paid in one sum. If no
beneficiary exists, the present value of any remaining payments will
be paid in one sum to the estate of the Annuitant.
If a beneficiary dies while under Option 1; or while receiving Annuity
payments, the present value of any remaining payments will be paid in
one sum to the estate of the beneficiary. The interest rate used to
determine the first payment will be used to calculate the present
value.
4.04 FUND(S) ANNUITY UNITS - SEPARATE ACCOUNT:
The number of Fund(s) Annuity Units is based on the amount of the
first Variable Annuity payment which is equal to:
(a) the portion of the Current Value (minus any premium tax) applied
to pay a Variable Annuity; divided by
(b) 1,000; times
(c) the payment rate for the Option chosen.
Such amount, or portion, of the variable payment will be divided by
the Fund(s) Annuity Unit Value (see 4.05) on the tenth Valuation
Period before the due date of the first payment to determine the
number of Fund(s) Annuity Units. The number of Fund(s) Annuity Units
remains fixed. Each future payment is equal to this number times the
Fund(s) Annuity Unit Value on the tenth Valuation Period prior to the
due date of the payment.
4.05 FUND(S) ANNUITY UNIT VALUE - SEPARATE ACCOUNT:
For any Valuation Period the Fund(s) Annuity Unit Value is equal to:
(a) the Value for the previous Period; times
(b) the Net Return Factor(s) (see 3.05) for the Period; times
(c) a factor to reflect the Assumed Annual Net Return Rate.
The factor for 3.5% per year is .9999058; for 5% per year it is
.9998663.
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The dollar value of the Fund(s) Annuity Unit Values and payments may
go up or down due to investment gain or loss.
If Variable Annuity payments are not to decrease, Aetna must earn a
gross return on the assets of the Separate Account of:
4.75% on an annual basis, plus an annual return of up to .25%
needed to offset the administrative charge set at the time
Annuity payments commenced, if an Assumed Annual Net Return Rate
of 3.5% is chosen; or,
6.25% on an annual basis, plus an annual return of up to .25%
needed to offset the administrative charge set at the time
Annuity payments commence, if an Assumed Annual Net Return Rate
of 5% is chosen.
Payments shall not be changed due to changes in the mortality or
expense results or administrative charges.
4.06 ANNUITY OPTIONS:
Option 1 - Payment of Interest on Sum Left with Aetna - This Option
may be used only by the beneficiary when the Annuitant dies before
Aetna has started paying an Annuity. A portion or all of the sum paid
upon death may be held under this Option and will be held in the
General Account of Aetna at interest (see 4.01). The beneficiary may
later tell Aetna to:
(a) pay a portion, or all, of the sum held by Aetna; or
(b) apply a portion, or all, of the sum held by Aetna to any Annuity
Option below.
If this Contract is issued under an XXX and the beneficiary elects
that the full sum paid upon death is to be held under this Option, the
beneficiary, if a spouse, must elect (a) or (b) above within 5 years
after the death of the Annuitant. If the beneficiary is not a spouse,
the beneficiary must tell Aetna to pay the full sum within 5 years
after the death of the Annuitant.
Option 2 - Payments of a Stated Dollar Amount - This Option may only
be elected as a Fixed Annuity. An Annuity of a chosen amount will be
paid until no funds are left. The payments to be made in a year must
be greater than $65 for each $1,000 applied to this Option, but cannot
exceed an amount which would deplete the funds in less than 3 years.
During any year, Aetna reserves the right to make as a minimum payment
an amount equal to 105% of the interest for that year.
Option 3 - Payments for a Stated Period of Time - An Annuity will be
paid for the number of years chosen. The number of years must be at
least 3 and not more than 30.
If payments for this Option are made under a Variable Annuity, the
present value of any remaining payments may be withdrawn at any time.
If a withdrawal is requested within 3 years after the start of
payments, it will be treated as a surrender (see Part V).
Option 4 - Life Income - An Annuity will be paid for the life of the
Annuitant. If also chosen, Aetna will guarantee payments for 60, 120,
180, or 240 months.
Option 5 - Life Income for Two Payees - An Annuity will be paid during
the lives of the Annuitant and a second Annuitant. At the death of
either, payments will continue to the survivor. When this Option is
chosen, a choice must be made of:
(a) 100% of the payment to continue to the survivor;
(b) 66 2/3% of the payment to continue to the survivor;
(c) 50% of the payment to continue to the survivor; or
(d) Payments for a minimum of 120 months, with 100% of the payment to
continue to the survivor.
Other Options - Aetna may make other options available as allowed by
the laws of the state in which this Contract is delivered.
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OPTION 3
PAYMENTS FOR A STATED PERIOD OF TIME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
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YEARS OF AMOUNT OF YEARS OF AMOUNT OF YEARS OF AMOUNT OF
PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS
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3 $29.19 13 $7.94 22 $5.39
4 22.27 14 7.49 23 5.24
5 18.12 15 7.10 24 5.09
6 15.35 16 6.76 25 4.96
7 13.38 17 6.47 26 4.84
8 11.90 18 6.20 27 4.73
9 10.75 19 5.97 28 4.63
10 9.83 20 5.75 29 4.53
11 9.09 21 5.56 30 4.45
12 8.46
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Rates for a Variable Annuity with Assumed Net Return Rate of 5%
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YEARS OF AMOUNT OF YEARS OF AMOUNT OF YEARS OF AMOUNT OF
PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS PAYMENTS
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3 $29.80 13 $8.64 22 $6.17
4 22.89 14 8.20 23 6.02
5 18.74 15 7.82 24 5.88
6 15.99 16 7.49 25 5.76
7 14.02 17 7.20 26 5.65
8 12.56 18 6.94 27 5.54
9 11.42 19 6.71 28 5.45
10 10.51 20 6.51 29 5.36
11 9.77 21 6.33 30 5.28
12 9.16
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OPTION 4
LIFE INCOME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
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AGE OF NONE 60 120 180 240
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ANNUITANT MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE
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50 $ 4.56 $ 4.20 $ 4.55 $ 4.19 $ 4.51 $ 4.18 $ 4.45 $ 4.15 $ 4.36 $ 4.11
51 4.64 4.26 4.62 4.25 4.58 4.24 4.51 4.21 4.42 4.16
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.48 4.21
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.32 4.53 4.27
54 4.89 4.46 4.87 4.46 4.82 4.43 4.73 4.39 4.59 4.32
55 4.99 4.54 4.97 4.53 4.91 4.50 4.80 4.46 4.65 4.38
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.72 4.44
57 5.20 4.71 5.17 4.70 5.10 4.66 4.96 4.60 4.78 4.50
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.84 4.57
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 4.91 4.63
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 4.97 4.70
61 5.71 5.11 5.67 5.09 5.54 5.03 5.32 4.93 5.03 4.77
62 5.86 5.23 5.81 5.21 5.66 5.14 5.42 5.02 5.09 4.84
63 6.02 5.36 5.97 5.33 5.79 5.25 5.51 5.11 5.16 4.91
64 6.20 5.49 6.13 5.46 5.93 5.37 5.61 5.21 5.21 4.98
65 6.38 5.64 6.31 5.60 6.07 5.49 5.71 5.31 5.27 5.05
66 6.58 5.79 6.49 5.75 6.22 5.63 5.81 5.41 5.32 5.12
67 6.79 5.95 6.69 5.91 6.38 5.76 5.91 5.52 5.38 5.18
68 7.02 6.13 6.89 6.08 6.53 5.91 6.01 5.63 5.42 5.25
69 7.26 6.32 7.11 6.26 6.70 6.06 6.11 5.74 5.47 5.31
70 7.52 6.53 7.35 6.45 6.86 6.23 6.20 5.85 5.51 5.37
71 7.80 6.75 7.59 6.66 7.03 6.39 6.29 5.96 5.54 5.42
72 8.09 6.99 7.85 6.89 7.21 6.57 6.38 6.07 5.57 5.47
73 8.41 7.26 8.12 7.13 7.38 6.75 6.46 6.17 5.60 5.51
74 8.75 7.54 8.41 7.39 7.55 6.94 6.53 6.28 5.63 5.55
75 9.12 7.85 8.71 7.66 7.73 7.13 6.61 6.38 5.65 5.59
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Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
13
OPTION 4
LIFE INCOME
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
PAYMENTS GUARANTEED FOR A STATED PERIOD OF MONTHS
---------------------------------------------------------------------------------------------------------------------------
AGE OF NONE 60 120 180 240
--------------------------------------------------------------------------------------------------------
ANNUITANT MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE
---------------------------------------------------------------------------------------------------------------------------
50 $ 5.48 $ 5.12 $ 5.46 $ 5.11 $ 5.41 $ 5.09 $ 5.34 $ 5.06 $ 5.24 $ 5.01
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.29 5.05
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.34 5.10
53 5.71 5.30 5.69 5.29 5.62 5.26 5.53 5.22 5.40 5.15
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.27 5.45 5.20
55 5.89 5.44 5.86 5.43 5.79 5.39 5.67 5.34 5.51 5.25
56 5.99 5.52 5.96 5.51 5.87 5.47 5.74 5.40 5.56 5.31
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.62 5.37
58 6.21 5.69 6.17 5.67 6.06 5.62 5.90 5.54 5.68 5.42
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.61 5.74 5.48
60 6.46 5.89 6.41 5.87 6.28 5.80 6.06 5.69 5.79 5.55
61 6.60 6.00 6.55 5.97 6.39 5.90 6.15 5.77 5.85 5.61
62 6.75 6.11 6.69 6.08 6.51 6.00 6.24 5.86 5.91 5.67
63 6.91 6.23 6.84 6.20 6.64 6.10 6.33 5.95 5.96 5.73
64 7.09 6.37 7.00 6.33 6.77 6.22 6.42 6.04 6.02 5.80
65 7.27 6.51 7.18 6.46 6.91 6.34 6.52 6.13 6.07 5.86
66 7.47 6.66 7.36 6.61 7.05 6.46 6.61 6.23 6.12 5.92
67 7.68 6.82 7.55 6.76 7.20 6.60 6.70 6.33 6.16 5.99
68 7.91 7.00 7.76 6.93 7.35 6.74 6.80 6.43 6.21 6.04
69 8.15 7.19 7.98 7.11 7.51 6.89 6.89 6.54 6.25 6.10
70 8.41 7.39 8.21 7.30 7.67 7.04 6.97 6.64 6.28 6.15
71 8.69 7.62 8.45 7.51 7.83 7.21 7.06 6.74 6.32 6.20
72 8.99 7.86 8.70 7.73 8.00 7.38 7.14 6.85 6.35 6.25
73 9.31 8.12 8.97 7.97 8.16 7.55 7.21 6.95 6.37 6.29
74 9.65 8.41 9.26 8.23 8.33 7.73 7.29 7.04 6.39 6.33
75 10.02 8.72 9.55 8.50 8.50 7.92 7.35 7.14 6.41 6.36
----------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
14
OPTION 5
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF FEMALE ANNUITANT
-----------------------
-----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
-----------------------------------------------------------------------------------------------------------------------------------
45 $3.69 $3.80 $3.90 $3.98 $4.05 $4.11 $4.15 $4.18 $4.20
50 3.75 3.89 4.03 4.16 4.27 4.36 4.43 4.48 4.52
55 3.81 3.97 4.16 4.34 4.51 4.66 4.78 4.86 4.92
60 3.84 4.04 4.27 4.51 4.76 4.99 5.18 5.33 5.43
65 3.87 4.09 4.35 4.66 4.99 5.34 5.66 5.92 6.11
70 3.90 4.13 4.42 4.78 5.19 5.67 6.16 6.61 6.95
75 3.91 4.15 4.47 4.86 5.35 5.95 6.64 7.33 7.95
80 3.92 4.17 4.50 4.92 5.46 6.17 7.04 8.04 9.03
85 3.92 4.18 4.51 4.95 5.53 6.31 7.34 8.63 10.05
-----------------------------------------------------------------------------------------------------------------------------------
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF FEMALE ANNUITANT
-----------------------
-----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
-----------------------------------------------------------------------------------------------------------------------------------
45 $4.63 $4.72 $4.81 $4.89 $4.96 $5.02 $5.07 $5.10 $5.12
50 4.68 4.80 4.93 5.05 5.16 5.25 5.33 5.38 5.42
55 4.73 4.88 5.04 5.21 5.38 5.52 5.65 5.74 5.80
60 4.77 4.95 5.15 5.37 5.61 5.83 6.04 6.19 6.30
65 4.80 5.00 5.24 5.52 5.83 6.17 6.49 6.76 6.96
70 4.82 5.04 5.30 5.63 6.04 6.49 6.97 7.42 7.79
75 4.84 5.06 5.35 5.72 6.20 6.77 7.45 8.14 8.76
80 4.85 5.08 5.39 5.79 6.31 6.99 7.86 8.84 9.83
85 4.86 5.10 5.41 5.83 6.39 7.15 8.16 9.43 10.86
-----------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
15
OPTION 5
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
66 2/3% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF FEMALE ANNUITANT
-----------------------
-------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
-------------------------------------------------------------------------------------------------------------------------------
45 $3.94 $4.06 $4.20 $4.36 $4.54 $4.74 $4.96 $5.19 $5.42
50 4.05 4.20 4.36 4.55 4.76 4.99 5.24 5.51 5.78
55 4.18 4.35 4.54 4.76 5.00 5.28 5.58 5.90 6.22
60 4.32 4.51 4.73 4.99 5.29 5.63 6.00 6.40 6.79
65 4.48 4.69 4.95 5.25 5.61 6.03 6.51 7.02 7.52
70 4.66 4.89 5.18 5.53 5.97 6.49 7.10 7.77 8.45
75 4.84 5.09 5.42 5.82 6.33 6.96 7.73 8.62 9.56
80 5.02 5.30 5.65 6.11 6.69 7.43 8.39 9.54 10.82
85 5.19 5.49 5.87 6.37 7.02 7.88 9.02 10.46 12.15
-------------------------------------------------------------------------------------------------------------------------------
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF FEMALE ANNUITANT
-----------------------
-------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
-------------------------------------------------------------------------------------------------------------------------------
45 $4.87 $4.99 $5.12 $5.28 $5.46 $5.68 $5.93 $6.21 $6.49
50 4.99 5.12 5.27 5.45 5.66 5.90 6.18 6.50 6.82
55 5.12 5.26 5.44 5.65 5.89 6.17 6.50 6.86 7.23
60 5.27 5.43 5.63 5.87 6.16 6.50 6.89 7.32 7.76
65 5.44 5.63 5.85 6.14 6.49 6.90 7.38 7.92 8.47
70 5.64 5.85 6.11 6.44 6.84 7.35 7.96 8.64 9.36
75 5.86 6.09 6.38 6.75 7.23 7.84 8.60 9.49 10.46
80 6.09 6.33 6.65 7.07 7.62 8.34 9.28 10.42 11.71
85 6.30 6.57 6.92 7.38 8.00 8.83 9.93 11.35 13.04
-------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
16
OPTION 5
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
50% TO THE SURVIVOR
NO MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF FEMALE ANNUITANT
-----------------------
----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
----------------------------------------------------------------------------------------------------------------------------------
45 $4.07 $4.21 $4.38 $4.58 $4.83 $5.13 $5.49 $ 5.91 $6.35
50 4.22 4.37 4.55 4.77 5.04 5.37 5.77 6.23 6.72
55 4.40 4.56 4.76 5.00 5.29 5.66 6.10 6.62 7.18
60 4.61 4.79 5.00 5.27 5.60 6.01 6.51 7.11 7.76
65 4.87 5.06 5.31 5.61 5.99 6.46 7.04 7.74 8.52
70 5.17 5.39 5.66 6.01 6.44 6.99 7.68 8.52 9.47
75 5.49 5.75 6.06 6.46 6.96 7.61 8.43 9.45 10.64
80 5.84 6.13 6.49 6.95 7.54 8.29 9.29 10.54 12.03
85 6.18 6.51 6.91 7.43 8.11 9.00 10.17 11.71 13.57
----------------------------------------------------------------------------------------------------------------------------------
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF FEMALE ANNUITANT
-----------------------
----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
----------------------------------------------------------------------------------------------------------------------------------
45 $5.01 $5.14 $5.30 $5.50 $5.75 $6.08 $6.48 $ 6.96 $ 7.49
50 5.15 5.29 5.46 5.68 5.95 6.29 6.73 7.25 7.82
55 5.33 5.48 5.66 5.89 6.18 6.56 7.03 7.60 8.24
60 5.56 5.71 5.91 6.16 6.49 6.90 7.42 8.06 8.78
65 5.83 6.01 6.23 6.51 6.87 7.33 7.93 8.67 9.50
70 6.17 6.36 6.61 6.93 7.34 7.87 8.56 9.43 10.43
75 6.55 6.78 7.05 7.42 7.89 8.51 9.33 10.35 11.57
80 6.98 7.23 7.54 7.96 8.51 9.23 10.20 11.44 12.95
85 7.40 7.68 8.05 8.53 9.16 10.00 11.14 12.64 14.51
----------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
17
OPTION 5
LIFE INCOME FOR TWO PAYEES
JOINT AND LAST SURVIVOR ANNUITY
100% TO THE SURVIVOR
120 MONTHS MINIMUM PERIOD
AMOUNT OF FIRST MONTHLY PAYMENT FOR EACH $1,000
AFTER DEDUCTION OF ANY CHARGE FOR PREMIUM TAXES
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.5%; and
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
AGE OF FEMALE ANNUITANT
-----------------------
----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
----------------------------------------------------------------------------------------------------------------------------------
45 $3.69 $3.79 $3.89 $3.98 $4.05 $4.11 $4.15 $4.17 $4.19
50 3.75 3.89 4.03 4.16 4.27 4.36 4.42 4.47 4.49
55 3.80 3.97 4.15 4.34 4.51 4.65 4.76 4.83 4.88
60 3.84 4.04 4.26 4.50 4.75 4.97 5.16 5.29 5.36
65 3.87 4.09 4.35 4.65 4.98 5.31 5.61 5.83 5.97
70 3.89 4.13 4.41 4.76 5.17 5.62 6.07 6.43 6.67
75 3.91 4.15 4.46 4.84 5.31 5.87 6.48 7.02 7.40
80 3.91 4.16 4.48 4.89 5.41 6.05 6.79 7.50 8.04
85 3.92 4.17 4.49 4.91 5.46 6.15 6.98 7.83 8.50
----------------------------------------------------------------------------------------------------------------------------------
Rates for a Variable Annuity with Assumed Net Return Rate of 5%
AGE OF FEMALE ANNUITANT
-----------------------
----------------------------------------------------------------------------------------------------------------------------------
AGE OF MALE
ANNUITANT 45 50 55 60 65 70 75 80 85
----------------------------------------------------------------------------------------------------------------------------------
45 $4.63 $4.72 $4.81 $4.89 $4.96 $5.02 $5.06 $5.09 $5.11
50 4.68 4.80 4.93 5.05 5.15 5.25 5.32 5.36 5.39
55 4.73 4.88 5.04 5.21 5.37 5.51 5.63 5.71 5.75
60 4.77 4.94 5.14 5.37 5.60 5.82 6.00 6.14 6.22
65 4.80 4.99 5.23 5.51 5.82 6.13 6.43 6.66 6.80
70 4.82 5.03 5.29 5.62 6.00 6.44 6.87 7.23 7.47
75 4.84 5.06 5.34 5.70 6.15 6.68 7.27 7.80 8.17
80 4.85 5.07 5.37 5.75 6.24 6.86 7.57 8.26 8.79
85 4.85 5.08 5.38 5.78 6.30 6.96 7.76 8.58 9.23
----------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
18
V. SPECIAL PROVISIONS
-------------------------------------------------------------------------------
The Special Provisions section which applies to this Contract is shown
on the Specifications page under Type of a Plan. The other sections
under Special Provision do not apply.
5.01 DEFERRED COMPENSATION PLAN:
(a) Control of Contract: All rights in this Contract rest with the
Contract Holder, who is entitled to all amounts held under this
Contract. The Contract Holder, or authorized designee of the
Contract Holder (as allowed by law), may make any choices allowed
by this Contract. Any choices made under this Contract must be in
writing. Until receipt of such choices in its Home Office, Aetna
may rely on any prior choices made. This Contract is not subject
to the claims of any creditors of the Annuitant except to the
extent permitted by law.
(b) Designation of Beneficiary: The beneficiary shall be the Contract
Holder.
(c) Maintenance Fee: The Maintenance Fee, if any, (see 6.01) will be
deducted from the Current Value on the anniversary of the
Contract effective date and on surrender of the entire Contract.
Any portion of any Maintenance Fee deducted from the Fixed
Account will not exceed the interest in excess of 4% and any Net
Purchase Payment credited to the Fixed Account during the 12
months prior to the deduction.
(d) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay to the beneficiary the Current Value if:
(1) The Annuitant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the notice is
received at Aetna's Home Office. The amount paid from the Fixed
Account will not be less than the Net Purchase Payment(s)
allocated to the Fixed Account for the Annuitant (less any prior
transfers (see 3.09) or surrenders). The beneficiary may choose
to apply all or any part of the proceeds to an Annuity Option
(see Part IV).
(e) Surrender Value: After deduction of the Maintenance Fee, if any,
Aetna will reduce the amount payable upon surrender of any
portion of the Current Value by a Surrender Fee. The Surrender
Fee will be in accordance with the Surrender Fee table in 6.02.
The total deductions made on surrender of the entire Contract
will not exceed 7% of the Current Value as of the date of
surrender and the Surrender Fee will not exceed 8.5% of the
Purchase Payment(s) made to the Contract.
(f) The following sections 5.02, 5.03, 5.04 and 5.05 of the Special
Provisions do not apply to this Contract.
5.02 PENSION OR PROFIT SHARING PLAN:
(a) The preceding section 5.01 of the Special Provisions does not
apply to this Contract.
(b) Control of Contract: All rights in this Contract rest with the
Contract Holder. The Contract Holder owns all amounts held under
this Contract. The Contract Holder (or authorized designee,) may
make any choices allowed by this Contract. Any choices under this
Contract must be in writing. Until receipt of such choices in its
Home Office, Aetna may rely on any prior choices made. This
Contract is not subject to the claims of any creditors except to
the extent permitted by law.
(c) Designation of Beneficiary: The Contract Holder shall name the
beneficiary.
(d) Maintenance Fee: The Maintenance Fee, if any, (see 6.01) will be
deducted from the Current Value on each anniversary of the
Contract effective date and upon surrender of the entire
Contract.
Any portion of any Maintenance Fee deducted from the Fixed
Account will not exceed the interest in excess of 4% and any Net
Purchase Payment credited to the Fixed Account during the 12
months prior to the deduction.
19
(e) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay the Current Value to the beneficiary if:
(1) the Annuitant dies before Annuity payments start; and
(2) the notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date when the
notice is received at Aetna's Home Office. The amount paid from
the Fixed Account will not be less than the Net Purchase
Payment(s) allocated to the Fixed Account (less any prior
transfers (see 3.09) or surrenders). The Contract Holder will
determine if any additional amounts are payable to the
beneficiary. The beneficiary may choose to apply all or part of
the payment to an Annuity Option (see Part IV). If no beneficiary
exists, the payment will be made to the estate of the Annuitant.
(f) Surrender Value: After deduction of the Maintenance Fee, if any,
Aetna will reduce the amount payable upon surrender of any
portion of the Current Value by a Surrender Fee. The Surrender
Fee will be in accordance with the Surrender Fee table in 6.02.
The total deductions made on surrender of an entire Contract will
not exceed 7% of the Current Value as of the date of surrender.
(g) The following Section 5.03, 5.04 and 5.05 of the Special
Provisions do not apply to this Contract.
5.03 INDIVIDUAL RETIREMENT ANNUITY PLAN (XXX):
(a) The preceding Sections 5.01 and 5.02 of the Special Provisions do
not apply to this Contract.
(b) Control of Contract: All rights in this Contract rest with the
Contract Holder. The Contract Holder owns all amounts held under
this Contract. The Contract Holder may make any choices allowed
by this Contract. Any choices under this Contract must be in
writing. Until receipt of such choices in its Home Office, Aetna
may rely on any prior choices made. The Contract may not be
transferred. The Contract may not be assigned except to the
Company.
(c) Designation of Beneficiary: The Contract Holder shall name the
beneficiary.
(d) Maintenance Fee: The Maintenance Fee, if any, (see 6.01) will be
deducted from the Current Value on each anniversary of the
Contract effective date and upon surrender of the entire
Contract.
Any portion of any Maintenance Fee deducted from the Fixed
Account will not exceed the interest in excess of 4% and any Net
Purchase Payment credited to the Fixed Account during the 12
months prior to the deduction.
(e) Purchase Payments: The total deductible annual Purchase Payments
made on behalf of any individual under this Contract cannot
exceed $2,000.
(f) Sum Payable at Death (Before Annuity Payments Start): Aetna will
pay the current value to the beneficiary if:
(1) The Annuitant dies before Annuity payments start; and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the notice is
received at Aetna's Home Office. The amount paid from the Fixed
Account will not be less than the Net Purchase Payment(s)
allocated to the Fixed Account (less any prior transfers (see
3.09) or surrenders). The beneficiary, if a spouse, may choose to
apply all or any portion of the payment to any Annuity Option. If
the beneficiary is not a spouse, all or a portion of the payment
may be applied only to Annuity Options 1, 2 or 3, providing the
full sum is paid to the beneficiary within 5 years of the death
of the Annuitant. (See Part IV.) If no beneficiary exists, the
payment will be made to the estate of the Annuitant.
20
(g) Annuity Payments: In no event may any payments to the
Annuitant or beneficiary under any Annuity Option extend
beyond:
(1) The life of the Annuitant; or
(2) The lives of the Annuitant and spouse; or
(3) Any certain period greater than the Annuitant's life
expectancy; or
(4) Any certain period greater than the life expectancies
of the Annuitant and spouse.
(h) Surrender Value: After deduction of the Maintenance Fee (if
any), the amount paid by Aetna upon the surrender of any
portion of the Current Value shall be reduced by a Surrender
Fee. The Surrender Fee will be in accordance with the
Surrender Fee table in 6.02.
The total deductions made on surrender of an entire Contract
will not exceed 7% of the Current Value as of the date of
surrender and the Surrender Fee will not exceed 8.5% of the
actual Purchase Payment(s) made to the Contract.
(i) The following Sections 5.04 and 5.05 of the Special
Provisions do not apply to this Contract.
5.04 TAX DEFERRED ANNUITY PLAN:
(a) The preceding Sections 5.01, 5.02, and 5.03 of the Special
Provisions do not apply to this Contract.
(b) Control of Contract: The Contract Holder shall own all
amounts held under this Contract and may make any choices
allowed by this Contract. Choices made under this Contract
must be in writing. Until receipt of such choices in its
Home Office, Aetna may rely on any previous choices made.
This Contract shall not be subject to the claims of any
creditors. This Contract is non-assignable and
non-transferable.
(c) Designation of Beneficiary: The Contract Holder shall name
the beneficiary.
(d) Maintenance Fee: The Maintenance Fee, if any, (see 6.01)
will be deducted from the Current Value on each anniversary
of the Contract effective date and upon surrender of the
entire Contract.
Any portion of any Maintenance Fee deducted from the Fixed
Account will not exceed the interest in excess of 4% and any
Net Purchase Payment credited to the Fixed Account during
the 12 months prior to the deduction.
(e) Sum Payable at Death (Before Annuity Payments Start): Aetna
will pay the Current Value to the beneficiary if:
(1) The Contract Holder dies before Annuity payments start;
and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the
notice is received at Aetna's Home Office. The amount paid
from the Fixed Account will not be less than the Net
Purchase Payment(s) allocated to the Fixed Account (less any
prior transfers (see 3.09) surrenders). The beneficiary may
choose to apply all or any portion of the payment to an
Annuity Option (see Part IV). If no beneficiary exists, the
payment will be made to the estate of the Contract Holder.
(f) Surrender Value: After deduction of the Maintenance Fee (if
any), Aetna will reduce the amount payable upon surrender of
any portion of the Current Value by a Surrender Fee. The
Surrender Fee will be in accordance with the Surrender Fee
table in 6.02.
The total deductions made on surrender of an entire Contract
will not exceed 7% of the Current Value as of the date of
surrender and the Surrender Fee will not exceed 8.5% of the
actual Purchase Payment(s) made to the Contract.
(g) The following Section 5.05 of the Special Provisions does
not apply to this Contract.
21
5.05 INDIVIDUAL ANNUITY PLAN:
(a) The preceding Sections 5.01, 5.02, 5.03 and 5.04 of the
Special Provisions do not apply to this Contract.
(b) Control of Contract: All rights in this Contract rest with
the Contract Holder. The Contract Holder owns all amounts
held under this Contract. The Contract Holder may make any
choices allowed by this Contract. Choices made under this
Contract must be in writing. Until receipt of such choices
at its Home Office, Aetna may rely on any previous choices
made.
(c) Designation of Beneficiary: The Contract Holder shall name
the beneficiary.
(d) Maintenance Fee: The Maintenance Fee, if any, (see 6.01)
will be deducted from the Current Value on each anniversary
of the Contract effective date and on surrender of the
entire Contract.
Any portion of any Maintenance Fee deducted from the Fixed
Account will not exceed the interest in excess of 4% and any
Net Purchase Payment credited to the Fixed Account during
the 12 months prior to the deduction.
(e) Sum Payable at Death (Before Annuity Payments Start): Aetna
will pay the Current Value to the beneficiary if:
(1) The Contract Holder dies before Annuity payments start;
and
(2) The notice of death is received in good order by Aetna.
The sum paid will be the Current Value on the date the
notice is received at Aetna's Home Office. The amount paid
from the Fixed Account will not be less than the Net
Purchase Payment(s) allocated to the Fixed Account (less any
prior transfers (see 3.09) surrenders). The beneficiary may
choose to apply all or any portion of the payment to an
Annuity Option (see Part IV). If no beneficiary exists, the
payment will be made to the estate of the Contract Holder.
(f) Surrender Value: After deduction of the Maintenance Fee, if
any, Aetna will reduce the amount payable upon surrender of
any portion of the Current Value by a Surrender Fee. The
Surrender Fee will be in accordance with the Surrender Fee
table in 6.02.
The total deductions made on surrender of an entire Contract
will not exceed 7% of the Current Value as of the date of
surrender and the Surrender Fee will not exceed 8.5% of the
actual Purchase Payment(s) made to the Contract.
22
VI. FEE SCHEDULE
INDIVIDUAL ANNUITY PLAN
6.01 MAINTENANCE FEE:
The Maintenance Fee will be $20.
6.02 SURRENDER FEE:
For each surrender, the Surrender Fee will vary according to the
number of Purchase Payment Cycles completed. The number and
amount of Purchase Payments to be made in a year is chosen by the
Contract Holder. A Purchase Payment Cycle is completed when this
number and amount of Purchase Payments have been made. The number
of Purchase Payment Cycles completed may not be greater than the
number of whole years since the Contract was issued. For each
surrender, the Fee will be as follows:
NUMBER OF PURCHASE PAYMENT CYCLES COMPLETED SURRENDER FEE
Less than 5 5%
5 or more but less than 7 4%
7 or more but less than 9 3%
9 or more 2%
No Surrender Fee is deducted from any portion of the Current
Value which is paid:
(a) At the death of the Contract Holder before Annuity payments
start; or
(b) As a premium for an Annuity under this Contract; or
(c) After the Contract Holder has reached age 59 1/2 and 9 or
more Purchase Payment Cycles have been completed.
6.03 TABLE OF VALUES - FIXED ACCOUNT:
The values in the following table only apply to annual Purchase
Payments of exactly $1,000.
The Paid-Up Annuity Benefit assumes the Current Value has
accumulated in the Fixed Account at the Guaranteed Interest Rate
until age 65 and is applied to Option 4 with a stated period of
120 months.
The Surrender Value assumes the Purchase Payments are credited to
the Fixed Account at the Guaranteed Interest Rate at the
beginning of each Contract year. The Maintenance Fee and
applicable Surrender Fee are deducted.
The values would be different for other Purchase Payment amounts,
if Purchase Payments are not made when due, if partial surrenders
are made, or if Aetna adds interest at a rate greater than the
Guaranteed Interest Rate-Fixed Account.
23
TABLE OF VALUES
FOR A $10,000 SINGLE DEPOSIT
APPLIED AT THE GUARANTEED INTEREST RATE
Sex: FEMALE
Age of Issue: 21
END OF PAID-UP ANNUITY
CONTRACT BENEFIT AT AGE 65 SURRENDER
YEAR (MONTHLY INCOME) VALUE
----------------------------------------------------------------------------------------------------------------
1 308.35 9880.
2 308.35 10275.
3 308.35 10686.
4 308.35 11114.
5 308.35 11558.
6 308.35 12147.
7 308.35 12765.
8 308.35 13412.
9 308.35 14091.
10 308.35 14802.
11 308.35 15395.
12 308.35 16010.
13 308.35 16651.
14 308.35 17317.
15 308.35 18009.
16 308.35 18730.
17 308.35 19479.
18 308.35 20258.
19 308.35 21068.
20 308.35 21911.
25 308.35 26658.
30 308.35 32434.
35 308.35 39461.
40 308.35 48010.
44 308.35 56165.
TABLE OF VALUES
FOR A $10,000 SINGLE DEPOSIT
APPLIED AT THE GUARANTEED INTEREST RATE
Sex: MALE
Age of Issue: 21
END OF PAID-UP ANNUITY
CONTRACT BENEFIT AT AGE 65 SURRENDER
YEAR (MONTHLY INCOME) VALUE
----------------------------------------------------------------------------------------------------------------
1 340.92 9880.
2 340.92 10275.
3 340.92 10686.
4 340.92 11114.
5 340.92 11558.
6 340.92 12147.
7 340.92 12765.
8 340.92 13412.
9 340.92 14091.
10 340.92 14802.
11 340.92 15395.
12 340.92 16010.
13 340.92 16651.
14 340.92 17317.
15 340.92 18009.
16 340.92 18730.
17 340.92 19479.
18 340.92 20258.
19 340.92 21068.
20 340.92 21911.
25 340.92 26658.
30 340.92 32434.
35 340.92 39461.
40 340.92 48010.
44 340.92 56165.
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A
AETNA LIFE INSURANCE AND ANNUITY COMPANY
HOME OFFICE: 000 Xxxxxxxxxx Xxx.
Xxxxxxxx, Xxxxxxxxxxx 00000
0-000-000-0000
INDIVIDUAL VARIABLE, FIXED, OR COMBINATION CONTRACT
NON-PARTICIPATING
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT,
WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT,
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT.
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