EXHIBIT 4(a)
First Great-West Life & Annuity Insurance Company
A Stock Company
000 Xxxx Xxxx Xxxxxx, XX 00000
FLEXIBLE PREMIUM FIXED DEFERRED GROUP ANNUITY
MASTER CONTRACT
PLEASE READ THIS ANNUITY CONTRACT CAREFULLY.
PAYMENTS AND VALUES BASED ON THE ANNUITY ACCOUNT VALUE MAY BE SUBJECT TO A
MARKET VALUE ADJUSTMENT AND MAY RESULT IN POSITIVE OR NEGATIVE ADJUSTMENTS TO
AMOUNTS PAYABLE DUE TO SURRENDERS, TRANSFERS, AND AMOUNTS APPLIED TO PURCHASE AN
ANNUITY. THE MARKET VALUE ADJUSTMENT IS APPLIED TO THE AMOUNT OF TRANSFER OR
WITHDRAWAL REQUESTED AND A NEGATIVE ADJUSTMENT MAY CAUSE THE AMOUNT TRANSFERRED
OR WITHDRAWN TO BE LESS THAN THE AMOUNT REQUESTED. THE MARKET VALUE ADJUSTMENT
WILL NOT APPLY TO ANY GUARANTEE PERIOD HAVING FEWER THAN 6 MONTHS PRIOR TO THE
GUARANTEE PERIOD MATURITY DATE FOR: 1) TRANSFER TO ANOTHER GUARANTEE PERIOD OR
FIXED SUB-ACCOUNT OFFERED UNDER
THIS CONTRACT; OR
2) SURRENDERS, PARTIAL WITHDRAWALS, ANNUITIZATION OR PERIODIC WITHDRAWALS; OR
3) A SINGLE SUM PAYMENT UPON DEATH OF AN OWNER OR THE ANNUITANT.
A 10% FEDERAL TAX PENALTY MAY APPLY IF A SURRENDER, WITHDRAWAL, OR DISTRIBUTION
IS TAKEN PRIOR TO THE TAXPAYER'S ATTAINMENT OF AGE 59 1/2.
FREE LOOK PERIOD
10 DAY RIGHT TO EXAMINE CONTRACT. IF NOT SATISFIED WITH THE CONTRACT, RETURN IT
TO THE COMPANY WITHIN 10 DAYS OF RECEIVING IT. THE CONTRACT WILL BE VOID FROM
THE START, AND THE COMPANY WILL REFUND THE GREATER OF: 1) CONTRIBUTIONS
RECEIVED; OR 2)THE ANNUITY ACCOUNT VALUE LESS SURRENDERS, WITHDRAWALS, AND
DISTRIBUTIONS.
FLEXIBLE PREMIUM FIXED DEFERRED GROUP ANNUITY.
Contributions may be made until the Payment Commencement Date or until the death
benefit is payable to a Beneficiary. The Owner of each Certificate is as shown
on the Certificate Data Page unless changed as provided for in this Contract.
The Company will pay the Annuitant the first of a series of annuity payments on
the annuity commencement date by applying the Annuity Account Value with a
Market Value Adjustment, if applicable, of the Owner's Annuity Account according
to the Payment Options Provisions. Subsequent payments will be paid on the same
day of each frequency period according to the provisions of this Contract. Any
paid-up annuity, cash surrender value or death benefits that may be available
under this Contract will not be less than the minimum benefits required by any
statute of the state in which this Contract is delivered.
Non-Participating. Not eligible to share in the Company's divisible surplus.
Signed for First Great-West Life & Annuity Insurance Company on the issuance of
this Contract.
[GRAPHIC SIGNATURE OMITTED] [GRAPHIC SIGNATURE OMITTED]
/s/ X.X. Xxxxxx /s/ X.X. XxXxxxxx
X.X. Xxxxxx, X.X. XxXxxxxx,
Secretary President and Chief Executive Officer
CONTRACT DATA PAGE
POLICYHOLDER INFORMATION: Trustees of ABC Trust, Inc.
Master Contract Number: 1234567
Effective Date: March 1, 1996
Address:
Tax ID Number: ###-##-####
CONTRACT INFORMATION
o_CONTRACTUAL GUARANTEE OF A MINIMUM RATE OF INTEREST: 3%
o_CHARGES: Charges at the time we issued this Contract are shown below.
Surrender Charge
Years Completed Percentage of Distribution
1 3%
2 2%
3 1%
4+ 0%
o_PAYMENT COMMENCEMENT DATE: The date on which annuity payments or periodic
withdrawals will start.
CONTRACT DATA PAGE
POLICYHOLDER INFORMATION - Trustees of the First GWL&A Trust for the benefit
of eligible participants.
Master Contract Number: 1234567
Effective Date: September 17, 1996
Address: Boatmen's Bank Iowa
Trust Department
PO Box 1813
Des Moines, IA 50306-1813
Table of Contents
Use this Table of Contents to locate specific topics in this annuity Contract.
DEFINITIONS................................................................................................3
GENERAL PROVISIONS
Entire Contract........................................................................................5
Contract Modification..................................................................................5
Non-Participating......................................................................................5
Misstatement of Age or Sex.............................................................................5
Reports................................................................................................5
Notice and Proof.......................................................................................5
Tax Consequences of Payments...........................................................................6
Currency...............................................................................................6
OWNERSHIP PROVISIONS
Rights of Owner........................................................................................6
Beneficiary............................................................................................6
Designation of Beneficiary.............................................................................6
Change of Beneficiary..................................................................................6
Death of Beneficiary...................................................................................6
Successive Beneficiaries...............................................................................7
Annuitant..............................................................................................7
Contingent Annuitant...................................................................................7
Change of Ownership....................................................................................7
Collateral Assignment..................................................................................7
CONTRIBUTIONS PROVISIONS
Effective Date.........................................................................................7
Contributions..........................................................................................7
Allocation of Contributions............................................................................8
ANNUITY ACCOUNT VALUE AND MARKET VALUE ADJUSTMENT PROVISIONS
Guarantee Period Fund..................................................................................8
Value of Guarantee Period..............................................................................8
Allocation at Guarantee Period Maturity Date...........................................................8
Breaking a Guarantee Period............................................................................9
Market Value Adjustment................................................................................9
TRANSFER PROVISIONS
Transfers.............................................................................................10
DEATH BENEFIT PROVISIONS
Payment of Death Benefit..............................................................................10
Distribution Rules....................................................................................10
Compliance with Code Section 72(s)....................................................................11
Table of Contents (continued)
Use this Table of Contents to locate specific topics in this annuity Contract.
SURRENDERS AND PARTIAL WITHDRAWALS
Surrender Benefit.....................................................................................12
Surrender Value.......................................................................................12
Partial Withdrawals...................................................................................12
Postponement..........................................................................................12
SURRENDER CHARGE
Surrender Charge......................................................................................12
Surrender Charge Amount...............................................................................12
PAYMENT OPTIONS
How to Elect..........................................................................................13
Selection of Payment Options..........................................................................13
Fixed Annuity Payment Options.........................................................................13
Periodic Withdrawal Option............................................................................14
How to Elect Periodic Withdrawals.....................................................................14
Periodic Withdrawal Options Available.................................................................14
Definitions
Accumulation Period - the period between the Effective Date and the Payment
Commencement Date.
Annuitant - the person named in the application and in the Contract Data Page
upon whose life the payment of an annuity is based and who will receive annuity
payments. If a Contingent Annuitant is named, then the Annuitant will be
considered the Primary Annuitant.
Annuity Account - an account that reflects the total value of the Owner's Fixed
Sub-Accounts.
Annuity Account Value - the sum of the values of the Fixed Sub-Accounts credited
to the Owner under the Annuity Account.
Annuity Payment Period - the period beginning on the Payment Commencement Date
and continuing until all annuity payments have been made under this Contract.
Automatic Contribution Plan - a plan provided to the Owner to allow for
automatic payment of Contributions. The Contribution amount will be withdrawn
from a pre-authorized account and automatically credited to the Annuity Account.
Beneficiary - the person(s) designated by the Owner to receive death proceeds
which may become payable upon the death of an Owner or the Annuitant. If the
surviving spouse of an Owner is the surviving Joint Owner, the surviving spouse
will be deemed to be the Beneficiary upon such Owner's death and may take the
death benefit or elect to continue this Contract in force. The Beneficiary is
shown on the Contract Data Page unless later changed by the Owner.
Certificate - the document issued to the Owner which specifies the rights and
obligations of the Owner.
Company - First Great-West Life & Annuity Insurance Company, the underwriter for
this annuity, located at 000 Xxxx Xxxx, Xxxxxx, Xxx Xxxx 00000.
Contingent Annuitant - the person named in the application who will become the
Annuitant upon the death of the Primary Annuitant. The Contingent Annuitant is
the person named in the Contract Data Page, unless later changed by Request
while the Primary Annuitant is alive and before annuity payments have commenced.
Contract - the document issued to the Policyholder which specifies the rights
and obligations of the Policyholder.
Contractual Guarantee of a Minimum Rate of Interest - the minimum interest rate
applicable to each Fixed Sub-Account in effect at the time the Contribution is
made. The Contractual Guarantee of a Minimum Rate of Interest is 3%.
Contributions - purchase amounts received and allocated to the Fixed
Sub-Account(s) prior to any Premium Tax or other deductions.
Effective Date - the date on which the first Contribution is credited to the
Annuity Account.
Fixed Sub-Accounts - the sub-division(s) of the Annuity Account described in the
Contract and in the attached Fixed Sub-Account Riders, if any.
Guarantee Period - one of the time intervals of the Guarantee Period Fund
available under this Contract. The Company will specify the Guarantee Period
time intervals that are available and the predetermined rate of interest that
will apply to each of the Guarantee Period time intervals. This rate of interest
will be equal to the annual effective rate in effect at the time the
Contribution is made and as reflected in written confirmation of the
Contribution. The Company may stop offering any time interval at any time for
new Contributions. Amounts allocated to one or more Guarantee Periods may be
subject to a Market Value Adjustment.
Guarantee Period Fund - A type of Fixed Sub-Account.
Guarantee Period Maturity Date - the last day of any Guarantee Period.
Individual Retirement Annuity (IRA) - an annuity Contract used for a retirement
savings program that is intended to satisfy the requirements of Section 408 of
the Internal Revenue Code of 1986, as amended.
Market Value Adjustment - an adjustment which may be made to amounts paid out
before the Guarantee Period Maturity Date due to surrenders, partial
withdrawals, Transfers, amounts applied to a periodic withdrawal or to purchase
an annuity. The Market Value Adjustment may increase or decrease the amount
payable on one of the above described distributions. A negative adjustment may
result in an effective interest rate lower than the Contractual Guarantee of a
Minimum Rate of Interest applicable to your Contract and the value of the
Contribution(s) allocated to the Guarantee Period being less than the
contributions(s) made.
Definitions (continued)
Non-qualified Annuity Contract - an annuity Contract which is not intended to be
a part of a qualified retirement plan and is not intended to satisfy the
requirements of Section 408 of the Internal Revenue Code of 1986, as amended.
Owner (Joint Owners) - the person or persons, named in the Contract Data Page.
The Owner is entitled to exercise all rights and privileges under the Contract,
while the Annuitant is living. Joint Owners must be husband and wife as of the
Effective Date. The Annuitant will be the Owner unless otherwise indicated in
the application. If a Contract is purchased as an Individual Retirement Annuity
under Section 408 of the Code, the Annuitant must be the sole Owner; no Joint
Owner may be named.
Payment Commencement Date - the date on which annuity payments or periodic
withdrawals commence under a payment option. The Payment Commencement Date must
be at least one year after this Contract's Effective Date. If a Payment
Commencement Date is not shown on the Contract Data Page, annuity payments will
begin on the first day of the month of the Annuitant's 90th birthday. The
Payment Commencement Date may be changed by the Owner prior to commencement of
annuity payments or it may be changed by the Beneficiary upon the death of an
Owner. If this is an IRA Contract, payments which satisfy the minimum
distribution requirements of the Code must begin no later than the
Owner/Xxxxxxxxx's attainment of age 70 1/2.
Premium Tax - the amount of tax, if any, charged by a state or other
governmental authority.
Request - any instruction in a form satisfactory to the Company and received at
the Schwab Annuity Service Center (or other annuity service center subsequently
named) from the Owner or the Owner's designee (as specified in a form acceptable
to the Company) or the Beneficiary, (as applicable) as required by any provision
of this Contract or as required by the Company. The Request is subject to any
action taken or payment made by the Company before it was processed.
Schwab Annuity Service Center - Post Office Box 7806, San Francisco, California
94120-7806. The toll-free telephone number is 0-000-000-0000.
Simplified Employee Pension (SEP) - an Individual Retirement Annuity (IRA) which
may accept Contributions from one or more employers under a retirement savings
program intended to satisfy the requirements of Section 408(k) of the Internal
Revenue Code of 1986, as amended.
Surrender Charge - will be equal to a percentage of the amount surrendered based
on the table shown in the Surrender Charge Amount provision.
Surrender Value - will be equal to:
(a) Annuity Account Value with a Market Value
Adjustment, if applicable, on the effective date
of the surrender; less
(b) a Surrender Charge, if applicable, less
(c) Premium Tax, if any.
Transaction Date - the date on which any Contribution or Request from the Owner
will be processed by the Company at the Schwab Annuity Service Center.
Contributions and Requests received after 4:00 p.m. EST/EDT will be deemed to
have been received on the next business day. Requests will be processed on each
date that the New York Stock Exchange is open for trading.
Transfer - the moving of money from one sub-account to one or more
sub-account(s).
General Provisions
What is your agreement with us?
ENTIRE CONTRACT
This Contract, Contract Data Page, riders and amendments, if any, form the
Entire Contract between the Owner and the Company. This Entire Contract
supersedes all prior representations, statements, warranties, promises and
agreements of any kind, whether oral or written, relating to the subject matter
of this Contract. All statements in the application made by an Owner or the
Annuitant will be considered representations and not warranties.
How can this Contract be modified?
CONTRACT MODIFICATION
This Contract may be modified only by written agreement between the Company and
the Owner, except that upon 30 days notice to the Owner, the Company may at any
time and without the consent of the Owner or any other person, modify this
Contract as needed to conform to changes in tax or other law. Such modifications
will become part of this Contract. Nothing in this Contract invalidates or
impairs any right granted to the Certificate Owner by New York Statutes
Insurance Law Section 3219 or the Certificate.
If this Contract is purchased as an IRA, the Company reserves the right to
modify this Contract to the extent necessary to qualify it as an Individual
Retirement Annuity as described in Section 408 of the Internal Revenue Code of
1986, as amended, and all related sections and regulations which are in effect
during the term of this Contract.
The Company may terminate certain Fixed Sub-Accounts. In that event, the Owner,
by Request, may change the allocation of the Contributions and maturing
Guarantee Periods. If no Request is made by the date the sub-account is
terminated, future Contributions and maturing Guarantee Periods will be
allocated to the closest shorter term. Any modification will not affect the
terms of any unmatured Guarantee Period or other Fixed Sub-Account, except as
may be described in the attached Fixed Sub-Account riders, if any.
The Company may cease offering existing fixed annuity payment options.
ONLY THE PRESIDENT, A VICE-PRESIDENT, OR THE SECRETARY OF THE COMPANY CAN MODIFY
OR WAIVE ANY PROVISION OF THIS CONTRACT.
NON-PARTICIPATING
This Contract is non-participating. It is not eligible to share in the Company's
divisible surplus.
What if the Annuitant's age or sex is
misstated?
MISSTATEMENT OF AGE OR SEX
If the age or sex of the Annuitant has been misstated, the annuity payments
established will be made on the basis of the correct age. If payments were too
large because of misstatement, the difference with interest may be deducted by
the Company from the next payment or payments. If payments were too small, the
difference with interest may be added by the Company to the next payment.
The interest rate will be 3%.
How will the Contract values be reported?
REPORTS
The Company will furnish the Owner, at least annually, a statement of the
Annuity Account Value and the Surrender Value. The Company will furnish the
Owner copies of any other notices, reports or documents required by law.
What are the notice and proof
requirements?
NOTICE AND PROOF
Any notice or demand by the Company to or upon the Owner, or any other person
may be given by mailing it to that person's last known address as stated in the
Company's file. In the event of the death of an Owner or the Annuitant, the
Company will require proof of death.
Any application, report, Request, election, direction, notice or demand by the
Owner, or any other person, must be made in a form satisfactory to the Company.
General Provisions (continued)
What are the tax consequences?
TAX CONSEQUENCES OF PAYMENTS
The Owner or Beneficiary, as the case may be, must determine the timing and
amount of any benefit payable. Payments elected by the Owner in the form of
periodic withdrawals, surrenders or partial withdrawals will be tax reported to
the Owner. Annuity payments are payable to the Annuitant and will be tax
reported to the Annuitant. Payments made to a Beneficiary will be tax reported
to the Beneficiary.
It is recommended that a competent tax adviser be consulted prior to obtaining
any distribution from, or changing the ownership of, this Contract. A 10%
federal tax penalty may apply if a surrender, withdrawal, or distribution is
taken prior to the taxpayer's attainment of age 59 1/2. Nothing contained herein
will be construed to be tax or legal advice. The Company assumes any
responsibility or liability for any damages or costs, including but not limited
to taxes, penalties, interest or attorney's fees incurred by the Owner, the
Annuitant, the Beneficiary, or any other person arising out of any such
determination.
CURRENCY
All Contributions and all transactions will be in the currency of the United
States of America.
Ownership Provisions
What are the Owner's rights?
RIGHTS OF OWNER
While the Annuitant is living, the Owner has the sole and absolute power to
exercise all rights and privileges in this Contract. Upon the death of an Owner
or the Annuitant, the Death Benefit Provisions section will
apply.
How is the Beneficiary determined?
BENEFICIARY
The Owner may, while the Annuitant is living, designate or change a Beneficiary
by Request from time to time as provided below. If an Owner dies and the
surviving Joint Owner is the surviving spouse of the deceased Owner, such
surviving spouse will become the Beneficiary and may take the death benefit or
elect to continue this Contract in force.
DESIGNATION OF BENEFICIARY
Unless changed as provided below, or as otherwise required by law, the
Beneficiary will be as shown on the Contract Data Page. Unless otherwise
indicated, if more than one Beneficiary is designated, then each such
Beneficiary so designated will share equally in any benefits and or rights
granted by the Contract to such Beneficiary or allowed by the Company. If the
Beneficiary is a partnership, any benefits will be paid to the partnership as it
existed at the time of an Owner's or the Annuitant's death. The Company may rely
on an affidavit by any responsible person to identify a Beneficiary or verify
the non-existence of a Beneficiary not identified by name. CHANGE OF BENEFICIARY
The Owner may, while the Annuitant is living, change the Beneficiary by Request.
The Company shall not be bound by any change of Beneficiary unless it is made in
writing and recorded at the Schwab Annuity Service Center. A change of
Beneficiary will take effect as of the date the Request is processed at the
Schwab Annuity Service Center, unless a certain date is specified by the Owner.
If an Owner dies before the date the Request was processed, the change will take
effect as of the date of the Request, unless the Company has already made a
payment or has otherwise taken action on a designation or change before receipt
or processing of such Request. A Beneficiary designated irrevocably may not be
changed without the written consent of that Beneficiary, except to the extent
required by law.
DEATH OF BENEFICIARY
The interest of any Beneficiary who dies before an Owner or the Annuitant will
terminate at the death of such Beneficiary. The interest of any Beneficiary who
dies at the time of, or within 30 days after, the death of an Owner or the
Annuitant will also terminate if no benefits have been paid to such Beneficiary,
unless the Owner has indicated otherwise by Request. The benefits will then be
paid as though the Beneficiary had died before the deceased Owner or Annuitant.
Ownership Provisions (continued)
SUCCESSIVE BENEFICIARIES
If an Owner dies, and the surviving Joint Owner is the surviving spouse of the
deceased Owner, the surviving spouse will become the Beneficiary and may take
the death benefit or elect to continue this Contract in force. If there is no
surviving Joint Owner, and no named Beneficiary is alive at the time of an
Owner's death, any benefits payable will be paid to the Owner's estate.
ANNUITANT
While the Annuitant is living and at least 30 days prior to the annuity
commencement date, the Owner may, by Request, change the Annuitant. A change of
Annuitant will take effect as of the date the Request is processed at the Schwab
Annuity Service Center.
How is the Contingent Annuitant determined?
CONTINGENT ANNUITANT
While the Annuitant is alive, the Owner may, by Request, designate or change a
Contingent Annuitant from time to time. A change of Contingent Annuitant will
take effect as of the date the Request is processed at the Schwab Annuity
Service Center, unless a certain date is specified by the Owner.
Can the ownership of this Contract be changed?
CHANGE OF OWNERSHIP
If this is an IRA Contract, the Owner's right to change the ownership is
restricted. An IRA Contract may not be sold, assigned, transferred, discounted
or pledged as collateral for a loan or as security for the performance of an
obligation or for any other purpose to any person other than as may be required
or permitted under Section 408 of the Internal Revenue Code of 1986, or under
any other applicable section of the Code, as amended. If this is a non-qualified
Contract, the Owner may change the ownership while the Annuitant is living. Any
change of ownership must be made by Request on a form satisfactory to the
Company. The change will take effect as of the date the Request is processed at
the Schwab Annuity Service Center, unless a certain date is specified by the
Owner, and is subject to any action taken or payment made by the Company before
it was processed.
Can this Contract be assigned?
COLLATERAL ASSIGNMENT
If this is an IRA Contract, the Owner may not assign this Contract as
collateral.
If this is a non-qualified Contract, the Owner can assign this Contract as
collateral while the Annuitant is living. The interest of the assignee has
priority over the interest of the Owner and the interest of any Beneficiary. Any
amounts payable to the assignee will be paid in a single sum.
A copy of any assignment must be submitted to the Company at the Schwab Annuity
Service Center. Any assignment is subject to any action taken or payment made by
the Company before the assignment was processed. The Company is not responsible
for the validity of any assignment. An assignment, pledge or agreement to assign
or pledge any portion of the Annuity Account Value generally will be treated as
a distribution. It is recommended that a competent tax adviser be consulted
prior to making such a change to this Contract.
Contributions Provisions
What is the Effective Date ?
The Effective Date, shown on the Contract Data Page, is the date the initial
Contribution is credited to the Annuity Account.
How may Contributions be made?
CONTRIBUTIONS
Contributions should be payable to First Great-West Life & Annuity Insurance
Company (the Company) at the Schwab Annuity Service Center at any time during
the Accumulation Period. All Contributions must be paid in a form acceptable to
the Company, during the
lifetime of the Annuitant and before the Payment
Commencement Date. Coverage will begin on the
Effective Date.
At any time after the Effective Date, the Owner may make additional
Contributions. The minimum amount accepted after the initial Contribution is
$500 except subsequent payments made via an Automatic Contribution Plan have a
minimum of $100 per month. Total Contributions while this Contract is in force
may exceed $1,000,000 with prior approval from the Company. The Company may
modify these limitations.
Contributions Provisions (continued)
How are Contributions allocated?
ALLOCATION OF CONTRIBUTIONS
During the Free Look Period, all Contributions will be allocated to one or more
of the Fixed Sub-Accounts as directed, effective upon the Transaction Date.
Allocation will not be delayed until the end of the Free Look Period. If the
Contract is returned during the Free Look Period, it will be void from the
start, and the Company will refund the greater of: 1) Contributions received; or
2) the Annuity Account Value less surrenders, withdrawals, and distributions.
After the Free Look Period, subsequent Contributions will be allocated in the
Annuity Account as Requested by the Owner. If there are no accompanying
instructions, then allocations will be made in accordance with standing
instructions. Allocations will be effective upon the Transaction Date.
Annuity Account Value and Market Value Adjustment
Provisions
ANNUITY ACCOUNT PROVISIONS
How is the Annuity Account Value determined?
GUARANTEE PERIOD FUND
The Guarantee Period Fund is a type of Fixed Sub-Account. The Owner, by Request,
may allocate all or a portion of a Contribution to any of the several Guarantee
Periods then offered by the Company. The sum of the values of the Owner's
Guarantee Periods is the value of the Owner's interest in the Guarantee Period
Fund.
What is the value of each Guarantee Period?
VALUE OF GUARANTEE PERIOD
All Contributions allocated to a Guarantee Period will earn an annual effective
rate of interest equal to the rate stated by the Company for the applicable
Guarantee Period from the Transaction Date to the end of the Guarantee Period.
The account will be credited daily with interest earned.
If the Owner does not break a Guarantee Period, the annual effective rate will
be at least the Contractual Guarantee of a Minimum Rate of Interest. If the
Owner breaks a Guarantee Period, a Market Value Adjustment may apply. The Market
Value Adjustment is applied to the amount of Transfer or withdrawal Requested
and a negative adjustment may cause the amount Transferred or withdrawn to be
less than the amount Requested.
Each Guarantee Period has its own value, which is calculated as follows:
the Owner's Contributions; less Premium Tax, if any,
in that Guarantee Period; plus
interest earned; less
amounts Transferred, distributed, surrendered (in
whole or in part), or applied to an annuitization
option; less
the Surrender Charge, if applicable; less
1 periodic withdrawals.
ALLOCATION AT GUARANTEE PERIOD
MATURITY DATE
At any time prior to the Guarantee Period Maturity Date, the Owner may Request
to allocate the maturity value of that Guarantee Period among any of the Fixed
Sub-Accounts then offered by the Company under this Contract. The election is
effective on its Guarantee Period Maturity Date.
If the election is not received at the Schwab Annuity Service Center prior to
the Guarantee Period Maturity Date, the value of the matured Guarantee Period
will be allocated to a new Guarantee Period with the same Guarantee Period as
the matured Guarantee Period.
If the new Guarantee Period would mature later than the Payment Commencement
Date, the value will be allocated to the Guarantee Period that matures closest
to the Payment Commencement Date.
If the Company is not then offering the same Guarantee Period under the
Contract, the value of the matured Guarantee Period will be allocated to a new
Guarantee Period with the closest shorter Guarantee Period then available.
If held to maturity, amounts from a matured Guarantee Period allocated to a new
Guarantee Period or other Fixed Sub-Account will earn the annual effective rate
applicable to that Guarantee Period or Fixed Sub-Account. This annual effective
rate may differ from the annual effective rate applicable to the matured
Guarantee Period.
Annuity Account Value and Market Value Adjustment
Provisions (continued)
What if the Guarantee Period is broken prior to
maturity?
BREAKING A GUARANTEE PERIOD
Any Transfer, surrender (in whole or in part), distribution due to death, or the
selection of an annuity option prior to the Guarantee Period Maturity Date will
be known as breaking a Guarantee Period. When a Request to break a Guarantee
Period is received, the Guarantee Period that is closest to the Guarantee Period
Maturity Date will be broken first.
If a Guarantee Period is broken, a Market Value Adjustment may be assessed. The
Market Value Adjustment may increase or decrease the value of the amount being
Transferred or withdrawn from the Guarantee Period. The Market Value Adjustment
is described below.
MARKET VALUE ADJUSTMENT
Distributions from the amounts allocated to a Guarantee Period due to a full
surrender or partial withdrawal, Transfer, application of amounts to the
Periodic Withdrawal Option or to purchase an annuity prior to a Guarantee Period
Maturity Date will be subject to a Market Value Adjustment ("MVA"). An MVA may
increase or decrease the amount payable on one of the above described
distributions.
The Amount Available for a full surrender or partial withdrawal is the Amount
Requested plus the MVA less any applicable Surrender Charge.
Amount Available = (Amount Requested + MVA) X
(1 - Surrender Charge Percentage of Distribution)
The Amount Available for a Transfer is the Amount Requested plus the MVA.
Amount Available = Amount Requested + MVA
The MVA is calculated by multiplying the amount Requested by the Market Value
Adjustment Factor ("MVAF"). The formula used to determine the MVA
is:
MVA = (Amount Requested) X (MVAF)
The Market Value Adjustment Factor (MVAF) is:
| 1+i | N/12
| _______________ | -1
| 1+j |
where: i is the U.S. Treasury Strip ask side yield as
published in The Wall Street Journal on the last
business day of the week prior to the date the stated
rate of interest was established for the Guarantee
Period. The term of i is measured in years and equals the term of the
Guarantee Period; andj is the U.S. Treasury Strip ask side yield as
published in The Wall Street Journal on the last business day of the week
prior to the week the Guarantee Period is broken. The term of j equals
the remaining term to maturity of the Guarantee Period, rounded up to the
higher number of years; and
N is the number of complete months remaining until maturity.
The Market Value Adjustment will equal 0 if N is less than 6.
If The Wall Street Journal ceases to publish the U.S. Treasury Strip ask side
yield, an alternate source for the same index will be used. If the Treasury
Strip ask side yield is not published anywhere, an appropriate substitute index
of publicly traded obligations will be chosen.
The Market Value Adjustment will apply to any Guarantee Period broken six or
more months prior to the Guarantee Period Maturity Date in each of the following
situations:
Transfers to another Guarantee Period or Fixed
Sub-Account offered under this Contract; or
Surrenders, partial withdrawals.
The Market Value Adjustment will not apply to any Guarantee Period having fewer
than 6 months prior to the Guarantee Period Maturity Date in each of the
following situations:
Transfer to another Guarantee Period or Fixed Sub-
Account offered under this Contract; or
Surrenders, partial withdrawals, annuitization or Periodic Withdrawals.
Transfer Provisions
Can Transfers be made between the Fixed Sub-
Accounts?
TRANSFERS
The Owner may make Transfers by Request. The
following provisions apply:
(a) At any time prior to the date annuity payments begin, the Owner, by
Request, may Transfer all or a portion of the Annuity Account Value among
the Fixed Sub-Accounts currently offered by the Company. No Transfers are
permitted after the election of a fixed annuity payment option.
(b) A Transfer will be effective upon the Transaction Date.
(c) A Transfer from Fixed Sub-Accounts will be
subject to the terms of the Annuity Account
Provisions and the attached Fixed Sub-Account
Rider(s), if any. The Annuity Account Value may
be Transferred prior to the Guarantee Period
Maturity Date. The Market Value Adjustment
will be assessed except in the situations described
in the Market Value Adjustment Provision.
(d) There is no administrative charge for the first twelve Transfers made in
a calendar year. There is a $10 administrative fee for each subsequent
Transfer. All Transfers made on a single Transaction Date will be
aggregated to count as only one Transfer toward the twelve free
Transfers.
Death Benefit Provisions
How is the death benefit paid?
PAYMENT OF DEATH BENEFIT
Upon the death of an Owner or the Annuitant, the death benefit will become
payable in accordance with these death benefit provisions following the
Company's receipt of a Request, while this Contract is in force.
The amount of the death benefit will be as follows:
If the Owner or Annuitant dies after the date annuity payments commence and
before the entire interest has been distributed, the remaining annuity payments,
if any, will be paid to the Beneficiary under the payment option applicable on
the date of death. The Beneficiary will not be allowed to change the method of
distribution in effect on the date of the Owner's or Annuitant's death or to
elect a new payment option; or
If the Owner or Annuitant dies before the date annuity payments commence, the
Company will pay proceeds to the Beneficiary the greater of:
o the Annuity Account Value as of the date Request
for payment is received, less Premium Tax, if any; or
o the sum of Contributions paid, less partial surrenders
and Periodic Withdrawals, less Premium Tax, if any.
When an Owner or the Annuitant dies before the annuity commencement date and a
death benefit is payable to a Beneficiary, the death benefit proceeds will
remain invested in accordance with the allocation instructions given by the
Owner until new allocation instructions are Requested by the Beneficiary or
until the death benefit is actually paid to the Beneficiary. The death benefit
will be determined as of the date payments commence. Distribution of the death
benefit may be Requested to be made as follows (subject to the distribution
rules set forth below): Proceeds from the Fixed Sub-Account(s)
o payment in a single sum; or
o payment under any of the annuity options provided
under this Contract.
DISTRIBUTION RULES
If Annuitant Dies Before Annuity Commencement Date
Upon the death of the Annuitant while the Owner is living, and before the
annuity commencement date, the death benefit provided under the Contract will be
paid to the Beneficiary unless there is a surviving Contingent Annuitant.
If a Contingent Annuitant was named by the Owner prior to the Annuitant's death,
and the Annuitant dies before the annuity commencement date, while the Owner and
Contingent Annuitant are living, no death benefit will be payable by reason of
the Annuitant's death and the Contingent Annuitant will become the Annuitant.
If a corporation or other non-individual is an Owner, or if the deceased
Annuitant is an Owner, the death of the Annuitant will be treated as the death
of an Owner and the Contract will be subject to the death of an Owner provisions
described below.
Death Benefit Provisions (continued)
If an Owner Dies Before Annuity Commencement Date If an Owner dies before the
annuity commencement date, and such Owner was the Annuitant, the following
provisions shall apply:
(1) If there is a Joint Owner (who is the surviving spouse of the deceased
Owner) and a Contingent Annuitant, the Joint Owner will become the Owner and
the Beneficiary, the Contingent Annuitant will become the Annuitant, and the
Contract will continue in force;
(2) If there is a Joint Owner who is the surviving spouse of the deceased
Owner but no Contingent Annuitant, the Joint Owner will become the Owner,
the Annuitant and the Beneficiary, and may take the death benefit or elect
to continue this Contract in force;
(3) In all other cases, the Company will pay the death benefit to the
Beneficiary even if a former spouse Joint Owner, the Annuitant and/or the
Contingent Annuitant are alive at the time of an Owner's death, unless the
sole Beneficiary is the deceased Owner's surviving spouse and the
Beneficiary Requests to become the Owner and the Annuitant, and to continue
the Contract in force.
If an Owner dies before the annuity commencement date, and such Owner was not
the Annuitant, the following provisions shall apply:
(1) If there is a Joint Owner who is the surviving spouse of the deceased
Owner, the Joint Owner will become the Owner and Beneficiary and may take
the death benefit or elect to continue this Contract in force.
(2) In all other cases, the Company will pay the death benefit to the
Beneficiary even if a former spouse Joint Owner, the Annuitant and/or the
Contingent Annuitant are alive at the time of the Owner's death, unless the
sole Beneficiary is the deceased Owner's surviving spouse and such
Beneficiary Requests to become the Owner and the Annuitant and to continue
the Contract in force.
To whom and when is the death benefit payable? Any death benefit payable to the
Beneficiary upon an Owner's death will be distributed as follows:
(1) If the Owner's surviving spouse is the person entitled to receive
benefits upon the Owner's death, the surviving spouse will be treated as the
Owner and will be allowed to take the death benefit or continue the Contract
in force.
(2) If a non-spouse individual is the person entitled to receive
benefits upon the Owner's death, such individual may elect, not later
than one year after the Owner's date of death, to receive the death
benefit in either a single sum or payment under any of the variable
or fixed annuity options available under the Contract, provided that:
(a) such annuity is distributed in substantially equal installments
over the life or life expectancy of such Beneficiary; and (b) such
distributions begin not later than one year after the Owner's date of
death. If no election is received by the Company from an individual
non-spouse Beneficiary such that substantially equal installments
have begun no later than one year after the Owner's date of death,
then the entire amount must be distributed within five years of the
Owner's date of death; or
(3) If a corporation or other non-individual entity is entitled to
receive benefits upon the Owner's death, the death benefit must be
completely distributed within five years of the Owner's date of death.
The death benefit will be determined as of the date the payments commence.
If Xxxxxxxxx Dies After Annuity Commencement Date Upon the death of the
Annuitant (or any Owner/Annuitant) after the annuity commencement date, any
benefit payable must be distributed to the Beneficiary in accordance with and at
least as rapidly as under the annuity option then in effect.
If an Owner Dies After Annuity Commencement Date and While the Annuitant is
Living Upon the death of an Owner after the annuity commencement date and while
the Annuitant is living, any benefit payable will continue to be distributed to
the Annuitant at least as rapidly as under the annuity option then in effect.
All of the Owner's rights granted under the Contract or allowed by the Company
will pass to any surviving Joint Owner and, if none, to the Annuitant.
COMPLIANCE WITH CODE SECTION 72(s)
In any event, no payment of benefits provided under the Contract will be allowed
that does not satisfy the requirements of Code Section 72(s), as amended from
time to time, and any other applicable federal or state law, rules or
regulations. These death benefit provisions will be interpreted and administered
in accordance with such requirements.
Payment Options
How are annuity payment options and the Periodic
Withdrawal Option elected?
HOW TO ELECT
The Request of the Owner is required to elect, or change the election of, a
payment option and must be received by the Company at least 30 days prior to the
Payment Commencement Date.
At any time prior to the Payment Commencement Date, the Owner may Transfer
between Fixed Sub-Account options, subject to the Transfer provisions of this
Contract.
On the Payment Commencement Date the Annuity Account Value may be applied only
to any of the fixed annuity payment options available.
If an option has not been elected within 30 days of the Payment Commencement
Date, the Annuity Account Value will be applied under Fixed Annuity Payment
Option 3 to provide payments for life with a guaranteed
period of 20 years.
What guidelines apply to annuity payment options?
SELECTION OF PAYMENT OPTIONS
(a) A single sum payment may be elected. If so, the amount to be paid is the
Surrender Value.
(b) If a fixed annuity payment option is elected, the amount to be applied is
the Annuity Account Value, as of the Payment Commencement Date, plus a
Market Value Adjustment, if applicable, less
Premium Tax, if any.
(c) The minimum amount that may be withdrawn
from the Annuity Account Value to purchase an
annuity payment option is $2,000. If the amount is
less than $2,000, the Company may pay the
amount in a single sum subject to the Partial
Withdrawal provision. Payments may be elected to
be received on any of the following frequency
periods: monthly, quarterly, semi-annually, or
annually.
(d) Payments to be made under the annuity payment option selected must be at
least $50. The Company reserves the right to make the payments using the
most frequent payment interval which produces a payment of not less than
$50.
(e) The maximum amount that may be applied under any annuity payment option
is $1,000,000, unless prior approval is obtained from the Company.
(f) For information on electing periodic withdrawals, refer to the Periodic
Withdrawal Option section on the following page.
What fixed annuity payment options are available? FIXED ANNUITY PAYMENT OPTIONS
The guaranteed annuity table is based on mortality from the 1983 Table (a) for
Individual Annuity Valuation and a guaranteed interest rate of 2 1/2% per year.
The Company may offer a better rate than the guaranteed rate shown. The rate
offered will result in annuity benefits at the time of commencement that will
not be less than those available to new single premium annuity applicants of the
same class at the time.
The following fixed annuity payment options are
available:
(a) Option 1: Income of Specified Amount
An annuity payment at 12-, 6-, 3-, or 1-month
intervals, of an amount elected by the Owner for an Annuity Payment
Period of not more than 240 months. Upon death of the Annuitant, the
Beneficiary will begin to receive the remaining payments at the same
interval that was elected by the Owner. See Table B.
(b)Option 2: Income for a Specified Period An annuity payment at 12-, 6-, 3-,
or 1-month
intervals, for the number of months elected, for an Annuity Payment
Period of not more than 240 months. Upon death of the Annuitant, the
Beneficiary will begin to receive the remaining payments at the same
interval that was elected by the Owner. See Table B.
(c) Option 3: Fixed Life Annuity with Guaranteed
Period
Payments for the guaranteed Annuity Payment Period elected which may be 5,
10, 15, or 20 years or the lifetime of the Annuitant whichever is longer.
Upon death of the Annuitant, any amounts remaining payable under this
payment option will be paid to the Beneficiary. See Table A.
(d) Option 4: Fixed Life Annuity
Monthly payments for the Annuitant's lifetime,
without a guaranteed period. See Table A. Upon
death of the Annuitant, all payments cease and no
amounts are payable to the Beneficiary.
(e) Option 5: Any Other Form Any other form of annuity which is acceptable to
the Company.
Surrenders And Partial Withdrawals
Can withdrawals be made from this Contract?
SURRENDER BENEFIT
At any time prior to the date annuity payments commence and subject to the
provisions of this Contract, the Owner may surrender this Contract for the
Surrender Value which will be computed as of the Transaction Date. The Company
will make the distribution, paid in a single sum, as soon as practical after
receipt of the Request.
SURRENDER VALUE
The Surrender Value is:
(a) the Annuity Account Value as of the effective date of
the surrender; less
(b) a Market Value Adjustment, if applicable; less
(c) any Surrender Charge on this transaction.
PARTIAL WITHDRAWALS
The Owner may make a partial withdrawal from the Annuity Account Value at any
time, by Request, prior to the date annuity payments commence and subject to the
terms of this Contract. A Market Value Adjustment and a Surrender Charge may
apply. The minimum partial withdrawal amount is $500. After any partial
withdrawal, if the remaining Annuity Account Value is less than $2,000, then a
full surrender may be required.
By Request, the Owner must elect the Fixed Sub-Account(s), or a combination of
them, from which a partial withdrawal is to be made and the amount to be
withdrawn from each sub-account. The Annuity Account Value will be reduced by
the partial withdrawal amount and the Surrender Charge. The partial withdrawal
proceeds may be greater than or less than the amount requested, depending on the
effect of the Market Value Adjustment.
The following terms apply:
(a) No partial withdrawals are permitted after the date annuity payments
commence.
(b) If a partial withdrawal is made within 30 days of the date annuity
payments are scheduled to commence, the Company may delay the Payment
Commencement Date by 30 days.
(c) A partial withdrawal will be effective upon the Transaction Date.
(d) A partial withdrawal from a Fixed Sub-Account may be subject to the Market
Value Adjustment Provisions, the Annuity Account Provisions of this
Contract, and the terms of the attached Fixed Sub-
Account Rider(s), if any.
POSTPONEMENT
In accordance with state law, if the Company receives a Request for surrender or
partial withdrawal, the Company may postpone any cash payment for no more than 6
months (30 days in West Virginia).
During the postponement period, the Fixed Sub-Account(s) will continue to earn
interest at the annual effective rate applicable to the Guarantee Period (or at
the rate applicable to the attached Fixed Sub-Account Riders, if any) that was
in effect at the time the Request for surrender or partial withdrawal was made.
Surrender Charge
SURRENDER CHARGE
On any surrender, partial withdrawal, periodic withdrawal, or single sum payment
from the Annuity Account, the applicable Surrender Charge will be deducted,
except when the Owner elects:
an annuitization option other than single sum
payment; or
1 a Periodic Withdrawal Option lasting a minimum
of 36 months.
SURRENDER CHARGE AMOUNT
The Surrender Charge will be equal to a percentage of the amount distributed
based on the table shown below:
Years Completed Percentage of
Distribution
1 3%
2 2%
3 1%
4+ 0%
In addition to the Surrender Charge, a Market Value Adjustment, as described in
the Annuity Account Provisions, may be applicable to the certificates broken
prior to the Certificate Maturity Date. If a Market Value Adjustment is
applicable, it will be made prior to the Surrender Charge being deducted.
Payment Options (continued)
What guidelines apply to Periodic Withdrawals?
PERIODIC WITHDRAWAL OPTION
The Owner must Request that all or part of the Annuity Account Value be applied
to a Periodic Withdrawal Option. Premium Tax, if applicable, will be deducted
before applying the amount Requested. While Periodic Withdrawals are being
received:
a Market Value Adjustment applies to Periodic Withdrawals from Guarantee
Periods 6 or more months prior to maturity;
1 the Owner may keep the same Fixed Sub-Accounts as were in force before
Periodic Withdrawals began;
Charges and fees under this Contract continue to
apply;
o the Owner may continue to exercise all contractual rights that are
available prior to electing a payment option, except that no Contributions
may be made;
o if a partial withdrawal is made from a Fixed Sub-Account, the Market Value
Adjustment, if applicable, will be applied;
Guarantee Periods renew into the shortest Guarantee Period then available.
HOW TO ELECT PERIODIC
WITHDRAWALS
The Request of the Owner is required to elect, or change
the election of, the Periodic Withdrawal Option. The
Owner must Request:
o the withdrawal frequency of either 12-, 6-, 3-, or 1-
month intervals;
o a withdrawal amount; a minimum of $100 is
required;
o the calendar month, day, and year on which
withdrawals are to begin;
o one Periodic Withdrawal Option; and
o the allocation of withdrawals from the Fixed Sub-
Account(s) as follows:
1) Prorate the amount to be paid across all Fixed
Sub-Accounts in proportion to the assets in
each sub-account; or
2) Select the Fixed Sub-Account(s) from which withdrawals will be made.
The Owner may elect to change the withdrawal option and/or frequency once each
calendar year. Periodic Withdrawals will cease on the earlier of the date: the
amount elected to be paid under the option
selected has been reduced to zero; the Annuity Account Value is zero; 1
the Owner Requests that withdrawals stop; 1 the Owner purchases an annuity
option; or 1 of death of an Owner or the Annuitant.
PERIODIC WITHDRAWAL OPTIONS
AVAILABLE
The Owner must elect one of these 5 withdrawal options:
1) Income for a Specified Period for at least thirty-six
(36) months - The Owner elects the duration over which withdrawals will
be made. The amount paid will vary based on the duration; or
2) Income of a Specified Amount for at least thirty-six (36) months - The
Owner elects the dollar amount of the withdrawals. Based on the amount
elected, the duration may vary; or
3) Interest Only - The withdrawals will be based on the amount of interest
credited to the Fixed Sub-Account(s) between each withdrawal. Available
only if 100% of the account value is invested in the Fixed Sub-Account;
or
4) Minimum Distribution - If this is an IRA Contract, the Owner may Request
minimum distributions as specified under Internal Revenue Code 401(a)(9);
or
5) Any Other Form for a period of at least thirty-six (36) months - Any
other form of periodic withdrawal which is acceptable to the Company.
TABLE A - Life Annuity
FEMALE
Monthly Payment for Each $1,000
of Annuity Account Value
Without With Guaranteed Period
Age of Guaranteed 5 10 15 20
Annuitant Period Years Years Years Years
20 2.61 2.61 2.61 2.61 2.61
21 2.63 2.63 2.63 2.63 2.63
22 2.65 2.65 2.65 2.64 2.64
23 2.67 2.67 2.66 2.66 2.66
24 2.69 2.69 2.68 2.68 2.68
25 2.71 2.71 2.70 2.70 2.70
26 2.73 2.73 2.72 2.72 2.72
27 2.75 2.75 2.75 2.74 2.74
28 2.77 2.77 2.77 2.77 2.76
29 2.79 2.79 2.79 2.79 2.79
30 2.82 2.82 2.82 2.81 2.81
31 2.84 2.84 2.84 2.84 2.83
32 2.87 2.87 2.87 2.86 2.86
33 2.90 2.90 2.89 2.89 2.89
34 2.93 2.93 2.92 2.92 2.91
35 2.96 2.96 2.95 2.95 2.94
36 2.99 2.96 2.98 2.98 2.97
37 3.02 3.02 3.02 3.01 3.00
38 3.05 3.05 3.05 3.04 3.04
39 3.09 3.09 3.09 3.08 3.07
40 3.13 3.13 3.12 3.12 3.10
41 3.17 3.16 3.16 3.15 3.14
42 3.21 3.21 3.20 3.19 3.18
43 3.25 3.25 3.24 3.23 3.22
44 3.30 3.29 3.29 3.28 3.26
45 3.34 3.34 3.33 3.32 3.30
46 3.39 3.39 3.38 3.37 3.35
47 3.44 3.44 3.43 3.42 3.39
48 3.50 3.50 3.49 3.47 3.44
49 3.56 3.55 3.54 3.52 3.49
50 3.62 3.61 3.60 3.58 3.54
Without With Guaranteed Period
Age of Guaranteed 5 10 15 20
Annuitant Period Years Years Years Years
51 3.68 3.68 3.66 3.64 3.59
52 3.75 3.74 3.73 3.70 3.65
53 3.82 3.81 3.79 3.76 3.71
54 3.89 3.88 3.86 3.83 3.77
55 3.97 3.96 3.94 3.90 3.83
56 4.05 4.04 4.02 3.97 3.89
57 4.14 4.13 4.10 4.05 3.96
58 4.23 4.22 4.19 4.13 4.03
59 4.33 4.32 4.28 4.21 4.10
60 4.44 4.42 4.38 4.30 4.17
61 4.55 4.53 4.48 4.39 4.24
62 4.67 4.65 4.59 4.48 4.31
63 4.79 4.77 4.70 4.58 4.39
64 4.93 4.90 4.82 4.68 4.46
65 5.07 5.04 4.95 4.78 4.53
66 5.23 5.19 5.09 4.89 4.61
67 5.39 5.35 5.23 5.00 4.68
68 5.57 5.52 5.38 5.11 4.74
69 5.76 5.71 5.53 5.23 4.81
70 5.96 5.90 5.70 5.34 4.87
71 6.19 6.11 5.87 5.46 4.93
72 6.43 6.34 6.05 5.57 4.98
73 6.69 6.58 6.24 5.68 5.03
74 6.97 6.84 6.43 5.79 5.07
75 7.28 7.12 6.63 5.90 5.11
76 7.61 7.41 6.83 5.99 5.14
77 7.97 7.73 7.04 6.09 5.17
78 8.36 8.06 7.24 6.17 5.19
79 8.78 8.42 7.44 6.24 5.21
80 9.24 8.79 7.64 6.31 5.22
If payments commence on any other date than the exact age of the Annuitant as
shown above, the amount of the monthly payment shall be determined by the
Company on the actuarial basis used in determining the above amounts.
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J401 Page 16
TABLE A - Life Annuity
MALE
Monthly Payment for Each $1,000
of Annuity Account Value
Without With Guaranteed Period
Age of Guaranteed 5 10 15 20
Annuitant Period Years Years Years Years
20 2.72 2.72 2.72 2.72 2.71
21 2.74 2.74 2.74 2.74 2.73
22 2.76 2.76 2.76 2.76 2.75
23 2.79 2.78 2.78 2.78 2.78
24 2.81 2.81 2.81 2.80 2.80
25 2.83 2.83 2.83 2.83 2.82
26 2.86 2.86 2.86 2.85 2.85
27 2.89 2.88 2.88 2.88 2.87
28 2.91 2.91 2.91 2.91 2.90
29 2.94 2.94 2.94 2.93 2.93
30 2.97 2.97 2.97 2.96 2.95
31 3.00 3.00 3.00 2.99 2.98
32 3.04 3.03 3.03 3.03 3.01
33 3.07 3.07 3.07 3.06 3.05
34 3.11 3.10 3.10 3.09 3.08
35 3.14 3.14 3.14 3.13 3.11
36 3.18 3.18 3.18 3.17 3.15
37 3.22 3.22 3.22 3.21 3.19
38 3.27 3.28 3.26 3.25 3.23
39 3.31 3.31 3.30 3.29 3.27
40 3.36 3.36 3.35 3.33 3.31
41 3.41 3.41 3.40 3.38 3.35
42 3.46 3.46 3.45 3.43 3.39
43 3.52 3.51 3.50 3.48 3.44
44 3.57 3.57 3.56 3.53 3.49
45 3.63 3.63 3.61 3.58 3.54
46 3.70 3.69 3.67 3.64 3.59
47 3.76 3.75 3.73 3.69 3.64
48 3.83 3.82 3.80 3.76 3.69
49 3.90 3.89 3.87 3.82 3.75
50 3.98 3.97 3.94 3.88 3.81
Without With Guaranteed Period
Age of Guaranteed 5 10 15 20
Annuitant Period Years Years Years Years
51 4.05 4.04 4.01 3.95 3.86
52 4.14 4.12 4.09 4.02 3.93
53 4.22 4.21 4.17 4.10 3.99
54 4.32 4.30 4.25 4.17 4.05
55 4.41 4.39 4.34 4.25 4.11
56 4.51 4.50 4.44 4.33 4.18
57 4.62 4.60 4.54 4.42 4.25
58 4.74 4.72 4.64 4.51 4.31
59 4.86 4.84 4.75 4.60 4.38
60 5.00 4.96 4.87 4.69 4.45
61 5.14 5.10 4.99 4.79 4.51
62 5.29 5.25 5.12 4.89 4.58
63 5.45 5.40 5.25 4.99 4.65
64 5.62 5.57 5.39 5.09 4.71
65 5.81 5.74 5.54 5.20 4.77
66 6.00 5.93 5.69 5.30 4.83
67 6.21 6.12 5.85 5.41 4.88
68 6.44 6.33 6.01 5.51 4.93
69 6.68 6.55 6.18 5.61 4.98
70 6.94 6.79 6.35 5.71 5.02
71 7.21 7.03 6.52 5.80 5.06
72 7.51 7.29 6.70 5.90 5.09
73 7.82 7.57 6.88 5.98 5.12
74 8.16 7.86 7.06 6.08 5.15
75 8.52 8.16 7.24 6.14 5.17
76 8.90 8.48 7.42 6.21 5.19
77 9.32 8.81 7.59 6.27 5.21
78 9.77 9.16 7.76 6.33 5.22
79 10.24 9.52 7.93 6.38 5.24
80 10.75 9.90 8.09 6.43 5.24
If payments commence on any other date than the exact age of the Annuitant as
shown above, the amount of the monthly payment shall be determined by the
Company on the actuarial basis used in determining the above amounts.
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J401 Page 17
TABLE B - Income of Specified Amount
- Income for a Specified Period
Payment for Each $1,000
of Annuity Account Value
Years Monthly Quarterly Semi-Annually Annually
1 84.28 252.32 503.09 1,000.00
2 42.66 127.72 254.65 506.17
3 28.79 86.19 171.85 341.60
4 21.86 65.44 130.47 259.33
5 17.70 52.99 105.65 210.00
6 14.93 44.69 89.11 177.12
7 12.95 38.77 77.30 153.65
8 11.47 34.33 68.45 136.07
9 10.32 30.88 61.58 122.40
10 9.39 28.13 56.08 111.47
11 8.64 25.87 51.59 102.54
12 8.02 24.00 47.85 95.11
13 7.49 22.41 44.69 88.83
14 7.03 21.06 41.98 83.45
15 6.64 19.88 39.64 78.80
16 6.30 18.86 37.60 74.73
17 6.00 17.95 35.79 71.15
18 5.73 17.15 34.20 67.97
19 5.49 16.43 32.77 65.13
20 5.27 15.79 31.48 62.58
If payments are for an amount or duration different than that
outlined above, the Company will determine the proper amount or
duration using the actuarial basis used to determine the above
amounts.
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