EXHIBIT 4
WE WILL PAY the benefits of this contract subject to its terms.
Our Home Office is at Xxx Xxxxxxxxx Xxx, Xxxxxxxxxx, Xxxx 00000.
/s/ Xxxxxxx X. XxXxxxxxx /s/ Xxxxx X. X'Xxxxx
SECRETARY PRESIDENT
[RIGHT TO CANCEL: You may return this contract to our Home Office within ten
(10) days after its delivery for a refund. The amount of the refund will equal
the account value with any adjustments required by applicable law or
regulation.]
ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT MAY INCREASE OR
DECREASE ACCORDING TO THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT. BENEFITS
ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED-DOLLAR AMOUNT.
VARIABLE DEFERRED ANNUITY CONTRACT
Flexible Purchase Payments
Nonparticipating
FORM 06-VA-4 PAGE 1
TABLE OF CONTENTS
PAGE
CONTRACT SPECIFICATIONS 3
DEFINITIONS 5
1940 Act 5
Age 5
Annuitant 5
Annuity Payout Date 5
Code 5
IRA 5
Pronouns 5
Proof of Death 6
Subaccount 6
VAA 6
Valuation Period 6
GENERAL PROVISIONS 6
Annuity Payments 6
Beneficiary 6
Claims of Creditors 7
Entire Contract 7
Evidence of Sex, Age, or Survival 7
Governing Law 8
Incontestability 8
Individual Retirement Annuities 8
Misstatement of Age, Sex, or Identity 8
Nonparticipating 8
Notice 8
Ownership 8
Ownership Transferability 9
Reports 9
Separate Account VAA 9
Supplementary Agreement 10
Voting Rights 10
PURCHASE PAYMENTS PROVISIONS 10
Purchase Payments 10
Allocation of Purchase Payments 10
VALUATION PROVISIONS 10
Contract Value 10
Variable Accumulation Account 10
Net Investment Factor 11
Splitting Units 11
Taxes 11
ACCUMULATION PERIOD PROVISIONS 11
Transfers Among Subaccounts 11
Surrender 12
Withdrawals 13
Deferral of Payment on Surrender and Withdrawals 13
Deferred Premium Tax 13
Death Benefit During Accumulation Period 13
Settlement Options 14
Death of the Owner 14
Contract Administration Charge 15
SETTLEMENT PROVISIONS 15
General 15
Elections 15
Pension Plan 15
Determination of Amount To Be Applied 15
Effect of Settlement on Accumulation Units 15
Change of Annuity Payout Date 16
Annuity Payment Amounts 16
Annuity Unit Value 16
Change in Subaccount 16
Limitation on Availability of Options 16
Alternate Annuity Option 17
Death Benefit After the Annuity Payout Date 17
Spendthrift Provision 17
Description of Annuity Options 17
Life Annuity Options 17
Joint and Survivor Life Annuity Options 17
ANNUITY OPTION TABLES 18
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 2
CONTRACT SPECIFICATIONS
Contract Number: [00000000] Contract Date: [05/01/2005] Annuitant's Date of Birth: [05/01/1955]
Annuitant: [Xxxx Xxx]
Owner: [Xxxx Xxx]
Beneficiary: [Xxxx Xxx]
Contingent Beneficiary: [Xxxxx Xxx]
Initial Purchase Payment: [$5,000]
Additional Purchase Payments May Be Made. See PURCHASE PAYMENTS PROVISIONS section.
Annuity Payout Date: First Day of [May, 2026]
Type of Plan: [401(K)]
Riders:
FOR RIDERS, IF ANY, SEE PAGE 4.
Charges:
[Annual Contract Administration Charge: $30 (waived on contract anniversaries where the Contract Value equals
or exceeds $50,000)]
[Transfer Fee: $10.00 per transfer (waived for the first 12 transfers in any contract year)]
[Mortality and Expense Risk Charge: 1.15% Annually (.003133% Daily)]
[Administration Expense Charge: 0.35% Annually (.000957% Daily)]
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 3
CONTRACT SPECIFICATIONS
RIDERS:
[Fixed Accumulation Account Rider:
Charge: 0% Annually
Effective Rate at Issue: 0-25%
Minimum Guaranteed Interest Rate: 1.5%]
[Dollar Cost Averaging Account Rider:
Charge: 0% Annually
Effective Rate at Issue: 0-25%
Minimum Guaranteed Interest Rate: 2%]
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 4
We will pay you an annuity starting on the Annuity Payout Date if the Annuitant
is then living. We will then apply the Contract Value under the SETTLEMENT
PROVISIONS section of this contract.
We will pay the death benefit proceeds to the beneficiary, as defined below, if
the Annuitant dies while this contract is in effect and before the Annuity
Payout Date in accordance with the DEATH BENEFIT DURING ACCUMULATION PERIOD
provision of this contract.
This contract provides accumulation values on a variable basis, and annuity
payments on a variable and/or fixed basis under one or more Annuity Options as
selected by you. The Contract Value and the dollar amount of the variable
annuity payments will vary with the investment results of a separate account
(VAA) that we have established. However, we guarantee that the dollar amount of
annuity payments will not be affected by our mortality experience. We also
guarantee that the expense charges will not be more than the charges provided
for in this contract. The dollar amount of fixed annuity payments are guaranteed
by us.
Any paid-up annuity, surrender value, or death benefit that may be payable under
this contract will not be less than the minimum benefits required by law in the
state in which this contract was issued.
DEFINITIONS
1940 ACT
The Investment Company Act of 1940, as amended, or any similar successor
federal legislation.
AGE
Except as otherwise noted, age shall refer to the person's age as of his or
her last birthday. Age as used in the Annuity Option Tables is age as of
nearest birthday.
ANNUITANT
The person so named in the Contract Specifications on Page 3, or, if after
the Annuity Payout Date, any other natural person or persons whose length
of life or lives measures annuity payments that involve life contingencies.
ANNUITY PAYOUT DATE
The date shown in the Contract Specifications on Page 3, or the date you
later choose under the CHANGE OF ANNUITY PAYOUT DATE provision of this
contract, or any other date on which annuity payments are to start.
CODE
The Internal Revenue Code of 1986, as amended.
IRA
An Individual Retirement Annuity as defined in the Code.
PRONOUNS
"We," "us," and "our" means The Ohio National Life Insurance Company.
"You," "your," or "yours" means the Owner or Owners of this contract.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 5
PROOF OF DEATH
Proof of Death is either:
(1) an original or a certified copy of a death certificate;
(2) an original or a certified copy of a decree of a court of
competent jurisdiction as to the finding of death with reasonable
verification that such decree has become final; or
(3) other written proof satisfactory to us.
SUBACCOUNT
An investment Subaccount established within VAA. We reserve the right to
limit the number of Subaccounts in which you may invest provided that we
will not limit the number of Subaccounts to less than 10.
VAA
A separate account (Ohio National Variable Account A) that consists of
assets we have set aside and kept separate from assets of our general
account.
VALUATION PERIOD
That period of time from one determination of variable accumulation unit
and annuity unit values to their next determination. Such values will be
determined as often as we choose to do so, but will occur at least once
each week or as often as required by the 1940 Act.
GENERAL PROVISIONS
ANNUITY PAYMENTS
All sums to be paid by us under this contract are payable at our Home
Office. We may require you to send us this contract as a condition to any
payment.
BENEFICIARY
The Beneficiary is entitled to receive the Death Benefit if the Annuitant
dies before the Annuity Payout Date, or any remaining annuity payments, in
accordance with the terms and provisions of this contract.
You may name Beneficiaries and Contingent Beneficiaries at the time you
apply for this contract. You may change Beneficiaries or Contingent
Beneficiaries by providing Notice to us. Unless otherwise specified in
writing at the time you apply for this contract or in a later Notice,
beneficiary designations are revocable and you may change them during the
lifetime of the Annuitant. Any new choice of Beneficiary will automatically
revoke any prior choice of Beneficiary. Any new choice of Contingent
Beneficiary will automatically revoke any prior choice of Contingent
Beneficiary. Any irrevocable beneficiary designation may be changed only
with the consent of such Irrevocable Beneficiary. The consent of any
Irrevocable Beneficiary will also be required for any assignment,
surrender, withdrawal, change of Annuity Payout Date or Annuity Option, or
other changes to this contract.
We will not allow a change in Beneficiary or Contingent Beneficiary that,
in our sole opinion, could result in the transfer of any rights or benefits
payable under this contract to a person, entity, or trust that does not
have an insurable interest in the life of the Annuitant at the time of the
requested change of Beneficiary or Contingent Beneficiary.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 6
Subject to the terms and provisions of this contract, we will pay an equal
portion of benefits to each Beneficiary unless you direct otherwise. A
Contingent Beneficiary will only receive benefits payable under this
contract if there is no surviving Beneficiary. Where applicable, a
Secondary Contingent Beneficiary will only receive benefits payable under
this contract if there is no surviving Beneficiary or Contingent
Beneficiary.
In the event that an Owner, who is a natural person, survives the
Annuitant, such Owner will be deemed the Beneficiary. Under such
circumstances, the designated Beneficiary will be deemed the Contingent
Beneficiary and the designated Contingent Beneficiary will be deemed the
Secondary Contingent Beneficiary.
The rights of a non-surviving beneficiary will pass to surviving
beneficiaries of the same class unless otherwise specified in writing at
the time you apply for this contract or in a later Notice.
If a beneficiary is a trustee, we will neither be responsible for verifying
a trustee's right to receive any benefits payable under this contract, nor
for how the trustee disposes of any benefits. If before payment of any
benefits, we receive Notice that the trust has been revoked or is not in
effect, then the trustee will be deemed a non-surviving beneficiary.
If there is no surviving Beneficiary, Contingent Beneficiary, or, where
applicable, Secondary Contingent Beneficiary, benefits will be paid to the
last surviving Owner's estate.
CLAIMS OF CREDITORS
The Contract Value and other benefits under this contract are exempt from
the claims of creditors to the extent permitted by law.
ENTIRE CONTRACT
The Entire Contract is this contract, any application, and any riders,
amendments, and endorsements attached to this contract. The Entire Contract
is the legal agreement between you and us. The application, if any, and
purchase payments are your consideration for the Entire Contract. Any
changes or waiver in the terms or provisions of the Entire Contract, as
permitted by Governing Law, must be approved in a writing signed by our
President, Vice President, or Secretary. No agent, representative, or other
officer, employee or person has the authority to make changes to any terms
or provisions of the Entire Contract. We may change the Entire Contract in
order to maintain compliance with applicable state and federal law.
We are not party to, nor are we bound by, any plan or trust in conjunction
with this contract. This contract is intended to qualify under the Code for
tax-favored status. Any reference in this contract to tax laws or
regulations is for your information and instruction only and such reference
to tax laws or regulations is not subject to approval or disapproval by the
state in which this contract was issued. We make no representations or
warranty concerning whether this contract will qualify for tax-favored
status, or concerning whether, if it does qualify for such tax-favored
status, you will derive any tax benefit therefrom. You should ask your tax
adviser if you have any questions as to whether this contract qualifies for
tax-favored status and whether, if it does, you derive any benefit
therefrom that would not otherwise be available to you.
We reserve the right to endorse this contract as needed to maintain its
status as an annuity under the Code. If this contract is so endorsed we
will send you a copy of the endorsement.
EVIDENCE OF SEX, AGE, OR SURVIVAL
Where any payment under this contract depends on the Annuitant's or any
payee's sex, age, or survival on a given date, we may require proof
thereof, satisfactory to us, prior to making such payment.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 7
GOVERNING LAW
Unless otherwise stated herein, this contract, and its terms and
provisions, are governed by the applicable laws and regulations of the
state in which this contract was issued.
INCONTESTABILITY
We will not contest the validity of this contract for misstatements made at
the time you applied for this contract, other than for misstatement of age,
sex, or identity, after two years from the Contract Date.
INDIVIDUAL RETIREMENT ANNUITIES
The Internal Revenue Service has approved the form of this contract, when
accompanied by an IRA Endorsement, as meeting the Code requirements for an
IRA. If this contract is an IRA, we can change this contract in its
approved form so as to keep its approval under the Code or to comply with
any change in the Code or rules under the Code. Any such change shall be in
writing, signed by us, and mailed to you at your address of record in our
files. Any terms that relate to this contract as an IRA shall be of no
further effect if this contract is no longer kept as a qualified IRA under
the Code.
MISSTATEMENT OF AGE, SEX, OR IDENTITY
If the Annuitant's birth date, sex, or identity has been misstated, the
benefits shall be such as would have been provided based on the correct
birth date, sex, and identity. The amount of any over payments shall be
charged against benefits to be paid after we verify a misstatement. The
amount of any under payments shall be made up immediately after we verify a
misstatement.
NONPARTICIPATING
This contract is nonparticipating. It will not share in our divisible
surplus.
NOTICE
Any Notice required from you in this contract must be in written form
acceptable to us, signed by you and received at our Home Office. Unless
otherwise stated herein, the Notice becomes effective as of the date that
all requirements are received, subject to any payment made or action taken
by us prior to our acting upon the Notice, and provided that the action
requested or taken in the Notice is permitted under the terms or provisions
of this contract.
OWNERSHIP
The Owner of this contract shall be the person(s) so named in the Contract
Specifications on Page 3 of this contract. The Owner maintains all rights
and interests in this contract, subject to the rights and interests of any
assignee of record or any Irrevocable Beneficiary.
All Owners possess an undivided interest in this contract with right of
survivorship. The exercise of any ownership right in this contract
(including, but not limited to, the rights to assign this contract,
surrender this contract, to make withdrawals from this contract, or to
change the Owner, the Beneficiary or the Contingent Beneficiary, the
Annuity Payout Date or the Annuity Option) shall require Notice signed by
all Owners.
If this contract is an IRA, the Annuitant shall be the Owner while living.
The Annuitant's interest may not then be forfeited. This contract, if an
IRA, is for the sole benefit of the Annuitant and Beneficiaries.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 8
If this is a tax-qualified contract other than an IRA, you can transfer
ownership to a successor Owner only if such successor Owner is (1) the
Annuitant, (2) a trustee or successor trustee of a pension or
profit-sharing trust that is qualified under Section 401 of the Code, or
(3) the employer of the Annuitant provided that this contract after
transfer is maintained under the terms of a retirement plan qualified under
Section 403(a) of the Code for the benefit of the Annuitant.
OWNERSHIP TRANSFERABILITY
If this is a tax-qualified contract, you may not sell, assign, discount or
pledge this contract as collateral for a loan or to secure the performance
of any obligation or for any purpose to any person other than to us, to the
Annuitant, or to a trustee or other person exercising ownership rights
solely by reason of the terms of a pension or profit-sharing plan or trust
qualified under the Code.
You may not transfer this contract if it is an IRA, except to your spouse
incident to a divorce.
We will not allow a change of ownership or an assignment that, in our sole
opinion, could result in the transfer of any rights or benefits payable
under this contract to a person, entity, or trust that does not have an
insurable interest in the life of the Annuitant at the time of the
requested change of ownership or assignment.
REPORTS
At least once each year after the first contract year and before the
Annuity Payout Date, we shall send you a statement reporting your Contract
Values as of a date not more than four months prior to the date of the
mailing.
You have the duty to review any confirmations or statements we send you and
to report promptly any discrepancy. We will not be responsible for any
losses or damages attributable to a discrepancy that is reflected on such
confirmations or statements unless you report the discrepancy in writing to
us within 30 days of the date of the confirmation or statement.
SEPARATE ACCOUNT VAA
The separate account to which the variable accumulation units of your
Contract Value and variable annuity units and payments under this contract
relate is VAA, which we have established under Ohio law to provide variable
benefits. We shall have sole and complete ownership and control of all
assets in VAA.
A portion of the assets in VAA, equal to the contract reserves for such
account, shall not be chargeable with liabilities arising out of any other
business we may conduct.
All amounts credited to VAA will be used to purchase shares at net asset
value of open-end investment companies registered under the 1940 Act. The
available investment companies are referred to as "Portfolios" and shares
of any are referred to as "Portfolio Shares." Any and all distributions
made by a Portfolio, in respect to Portfolio Shares held by VAA, will be
reinvested to purchase more Portfolio Shares in the same Subaccount at net
asset value. Deductions and withdrawals from VAA may be made by redeeming a
number of Portfolio Shares, at net asset value, equal in total value to the
amount to be deducted or withdrawn. If deemed by us to be in the best
interest of all contract owners, VAA may be operated as a management
company under the 1940 Act or it may be deregistered under the 1940 Act, if
such registration is no longer required.
If there is a substitution of Portfolio Shares or change in operation of
VAA, we will issue an endorsement for this contract and take such other
action as may be necessary and appropriate to make the substitution or
change.
You will be liable for any loss we suffer if we purchase Portfolio Shares
at your direction and, thereafter, we are forced to liquidate such
Portfolio Shares because the check or draft issued by you as a purchase
payment is dishonored by the bank on which it was drawn.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 9
SUPPLEMENTARY AGREEMENT
As of the Annuity Payout Date, we may issue a supplementary agreement that
sets forth the terms of your Annuity Option.
VOTING RIGHTS
We will seek instructions for the voting of Portfolio Shares held on
account of your Contract Value held in VAA or that represent the actuarial
liability for variable annuity payments being made. From time to time, we
will send you reports on the Portfolio, prospectuses, proxy material and a
form with which you may instruct us how to vote Portfolio Shares.
After this contract has been in effect for one year, you may also vote at
our annual meeting of policyholders as provided in our Code of Regulations
and under Ohio law.
PURCHASE PAYMENTS PROVISIONS
PURCHASE PAYMENTS
Purchase payments are payable to us at our Home Office or at any other
location we may designate from time to time or, with respect only to the
first purchase payment, to your registered representative in exchange for a
receipt signed by such registered representative.
The initial purchase payment is due on the Contract Date. You may make
subsequent purchase payments at any time before the Annuity Payout Date.
Each subsequent purchase payment must be at least $500. We reserve the
right to restrict subsequent purchase payments after the total amount of
all purchase payments exceeds $1,000,000. If this is an IRA, purchase
payments may not be more than the maximum amount allowed by law for an IRA.
ALLOCATION OF PURCHASE PAYMENTS
Each purchase payment, less an amount for any applicable premium tax or
similar state or local tax (Net Purchase Payment), will be allocated to
Subaccounts within VAA. We reserve the right to limit the number of
Subaccounts to which you may allocate. If you change your allocations, such
change shall take effect as of the end of the Valuation Period within which
Notice becomes effective.
VALUATION PROVISIONS
CONTRACT VALUE
The Contract Value for any Valuation Period equals the Variable
Accumulation Account value for the Valuation Period.
VARIABLE ACCUMULATION ACCOUNT
We will credit this contract's Variable Accumulation Account with variable
accumulation units in relation to the amount of each Net Purchase Payment
allocated to each Subaccount. To find the number of variable accumulation
units credited to each Subaccount, divide the amount allocated to that
Subaccount by the variable accumulation unit value of that Subaccount for
the Valuation Period during which the purchase payment is received at our
Home Office or at any other location we may designate from time to time.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 10
The value of each variable accumulation unit was set when the first Net
Purchase Payment was allocated to each Subaccount. The value of a variable
accumulation unit for each Subaccount varies for each later Valuation
Period. Such value is found by multiplying the value of a variable
accumulation unit of that Subaccount for the immediately preceding
Valuation Period by the Net Investment Factor for the Subaccount for the
Valuation Period for which the variable accumulation unit value is being
determined. The value of a variable accumulation unit for any Valuation
Period is determined as of the end of such Valuation Period.
The Variable Accumulation Account value for a Valuation Period equals the
number of variable accumulation units credited to the Variable Accumulation
Account multiplied by the value of each such unit for that Valuation
Period.
NET INVESTMENT FACTOR
The Net Investment Factor for a Subaccount is found by dividing (a) by (b),
then subtracting (c) from the result, where
(a) is
(1) the net asset value of a Portfolio Share in that Subaccount
determined as of the end of a Valuation Period, plus
(2) the per share amount of any dividends or other distribution
declared by the Portfolio (as of the ex-dividend date, i.e.,
the date as of which dividends on Portfolio Shares have been
paid out to owners of record) during the Valuation Period,
adjusted by
(3) a per share charge or credit with respect to any taxes
reserved for or paid, which we determine to be attributable
to the maintenance or operation of the Subaccount;
(b) is the net asset value of a Portfolio Share in that Subaccount,
adjusted by a per share credit or charge for any taxes reserved
for or paid, determined as of the end of the prior Valuation
Period; and
(c) is
(1) the Daily Mortality and Expense Risk Charge as shown in the
Contract Specifications on Page 3 for the number of days in
such Valuation Period, plus
(2) the Daily Administration Expense Charge as shown in the
Contract Specifications on Page 3 for the number of days in
such Valuation Period.
The total charges for mortality and expense risks and administration
expenses are shown in the Contract Specifications on Page 3. We guarantee
that these charges will not be adversely affected by our expense results
and/or mortality experience.
SPLITTING UNITS
We reserve the right to split (or reverse split) the value of the variable
accumulation units or the annuity units. In any such split of unit values,
strict equity will be preserved. Such a split will have no material effect
on the benefits or other terms or provisions of this contract. A split may
either increase or decrease the number of such units.
TAXES
Any taxes that pertain to this contract or VAA may be charged against the
Contract Value when incurred or reserved for by us.
ACCUMULATION PERIOD PROVISIONS
TRANSFERS AMONG SUBACCOUNTS
By Notice to us, you may transfer the value of any number of variable
accumulation units from one set of Subaccounts to another set of
Subaccounts. The dollar amount transferred from any Subaccount must be at
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 11
least $300, but the entire value of a Subaccount may be transferred if less
than $300. Such transfers shall be made as of the end of the Valuation
Period within which Notice becomes effective or at the end of any later
Valuation Period that you may request. A fee of not more than $10 may be
charged for each transfer. The first 12 transfers in any contract year will
not be assessed a transfer fee.
In addition to our other rights to limit the number, frequency, method, or
amount of transfers, transfers from any Subaccount on any one day may be
limited to one percent of the previous day's total net assets of that
Portfolio if we or the Portfolio, in the discretion of either or both,
believe that the Portfolio might otherwise be damaged.
If and when transfers must be so limited, some transfer requests will not
be granted. In determining which requests will be granted, scheduled
transfers will be made first, followed by mailed written requests in the
order postmarked and lastly, telephone, Internet and facsimile requests in
the order received. Owners whose requested transfers are not made will be
so notified. Currently, the rules of the U.S. Securities and Exchange
Commission (SEC) preclude us from processing at a later date those
requested transfers that were not made. Accordingly, a new transfer request
must be submitted in order to make a transfer that was not made because of
these limitations.
The right to make transfers between Subaccounts is subject to modification,
if we determine, in our sole opinion, that exercising that right by one or
more owners of annuities issued by us with investments in such Subaccounts
is, or would be, to the disadvantage of other owners. Any modification
could be applied to transfers to, or from, some or all of the Subaccounts
and could include, but not be limited to:
(1) the requirement of a minimum time period between each transfer;
(2) not accepting transfer requests of an agent or representative
acting under a power of attorney or on behalf of more than one
owner;
(3) limiting the dollar amount that may be transferred between the
Subaccounts by an owner at any one time; or
(4) assessing a redemption fee.
Such restrictions may be applied in any manner reasonably designed to
prevent any use of the transfer right that is considered by us to be to the
disadvantage of other owners.
SURRENDER
You may surrender this contract and receive its surrender value upon Notice
any time prior to the earlier of: (1) the Annuity Payout Date; or (2) the
death of the Annuitant. The surrender value is the Contract Value less: (1)
a charge for any applicable premium tax or similar state or local tax not
previously deducted; (2) the Contract Administration Charge, if any; (3)
any charges due as the result of riders affecting this contract. (See also
DEFERRED PREMIUM TAX provision.) For this purpose, except as noted below,
the Contract Value will be for the Valuation Period when we receive the
surrender request in good order at our Home Office. At that time, all
variable accumulation units will be cancelled. The surrender value from VAA
will be paid within seven days of the surrender request in good order (or
later if allowed by law). We reserve the right to establish reasonable
requirements for what constitutes good order for purposes of a surrender
request. After we act upon your Notice to surrender this contract and paid
its surrender value, this contract, including any riders, will terminate,
and any benefit under this contract will be discontinued.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 12
WITHDRAWALS
A withdrawal cannot be less than $500 and cannot be greater than the amount
that would cause the Contract Value to fall below $5,000. Withdrawals will
reduce the Contract Value by the amount withdrawn. (See also DEFERRED
PREMIUM TAX provision.)
You may tell us how much to deduct from each Subaccount. If you do not, the
withdrawal will be deducted from each Subaccount in the same proportion
that the Subaccount's value bears to the total Contract Value on the date
we receive your request in good order in our Home Office.
The amount so withdrawn shall be paid within seven days of receipt of your
Notice (or later if allowed by law). We will cancel the number of variable
accumulation units from the appropriate Subaccount that, when multiplied by
the corresponding variable accumulation unit values as of the end of the
Valuation Period within which Notice becomes effective, equals that portion
of the dollar amount of the withdrawal.
We reserve the right to impose a $15 fee on each withdrawal in excess of 14
each contract year.
DEFERRAL OF PAYMENT ON SURRENDER AND WITHDRAWALS
We may defer the calculation and payment of variable accumulation unit
values or benefits if: (1) the New York Stock Exchange is closed or trading
on the New York Stock Exchange is restricted as determined by the SEC; (2)
the SEC by order permits postponement for the protection of contract
owners; or (3) an emergency exists, as determined by the SEC, as a result
of which disposal of securities is not reasonably practicable or it is not
reasonably practicable to determine the net asset values of VAA.
We have the right to defer payment of any surrender or withdrawal that is
derived from any amount recently paid to us by check or draft until we are
satisfied that the check or draft has been paid by the bank on which it was
drawn.
DEFERRED PREMIUM TAX
If we paid a tax on a purchase payment and did not previously deduct the
tax, then we may deduct it at the time of surrender or withdrawal, or on
the Annuity Payout Date.
DEATH BENEFIT DURING ACCUMULATION PERIOD
If the Annuitant dies prior to the Annuity Payout Date, while this contract
is in force, the Death Benefit will be calculated in accordance with the
Guaranteed Minimum Death Benefit Amount and the Death Benefit Adjustment
provisions below.
GUARANTEED MINIMUM DEATH BENEFIT AMOUNT
The Guaranteed Minimum Death Benefit Amount will be used for
calculating the Death Benefit Adjustment, unless a rider accompanying
this contract results in a higher Death Benefit Adjustment.
The Guaranteed Minimum Death Benefit Amount during all contract years
shall be the total of all Net Purchase Payments made to this contract
and adjusted, on a pro rata basis, for any withdrawals taken from this
contract. Under the pro rata adjustment, the Guaranteed Minimum Death
Benefit Amount will be reduced by the same percentage reduction to the
Contract Value that resulted from the withdrawal.
DEATH BENEFIT ADJUSTMENT
If the Annuitant dies prior to the Annuity Payout Date, while this
contract is in force, we will make a Death Benefit Adjustment, if any,
when we receive Proof of Death. The Death Benefit Adjustment will be
equal to the excess, if any, of: (1) the highest guaranteed death
benefit under this contract or any applicable rider as of the
Annuitant's death over (2) the Contract Value as of the Valuation
Period immediately following the Annuitant's death.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 13
As of the end of the Valuation Period when we receive Proof of Death
of the Annuitant, we will add the amount of the Death Benefit
Adjustment to the Contract Value. In order to do so, we will purchase
units in the Money Market Portfolio with the amount of the Death
Benefit Adjustment, where it will remain until we receive different
investment instructions from the payee. If the Contract Value on the
actual date of the Annuitant's death exceeds the highest guaranteed
death benefit under this contract or any applicable rider, then there
is no Death Benefit Adjustment.
After we have made the Death Benefit Adjustment, we will not have any
further liability for any guaranteed death benefit under this contract
or any applicable rider, except that, if the Beneficiary is the spouse
of the sole Owner and the Annuitant and he or she elects Settlement
Option (3) described below and, as a result, continues this contract
as the Owner and the Annuitant, this contract will be eligible for
another Death Benefit Adjustment upon that spouse's death.
SETTLEMENT OPTIONS
Unless otherwise designated by the Owner before the Annuitant's date of
death, the Beneficiary may, by Notice, elect to:
(1) surrender this contract within five years of the Annuitant's
death; or
(2) settle this contract within 12 months of the Annuitant's death,
for annuity payments over the life of the Beneficiary or over a
period not exceeding the Beneficiary's life expectancy; or
(3) continue this contract as the Owner and the Annuitant, if the
only Beneficiary is the surviving spouse of the Owner and
Annuitant and there is either no surviving Owner or the surviving
spouse is also the sole surviving Owner; or
(4) make any other settlement to which we may agree.
In the event that the Beneficiary fails to elect any of the above-described
options within five years of the Annuitant's death, we will pay the
Contract Value under Settlement Option (1) above.
Where there is more than one Beneficiary, all of the Beneficiaries must
agree on the same Settlement Option. If we do not receive an election of a
Settlement Option approved by all the Beneficiaries before the earlier of:
(1) 121 days after the Annuitant's death; or (2) 61 days after we receive
the Proof of Death, this contract will automatically be surrendered for its
surrender value at that time or upon our receipt of Proof of Death, if
later.
Contract riders and any charges therefor terminate upon the Annuitant's
death, except where the only Beneficiary is the surviving spouse of the
Owner and Xxxxxxxxx and there is either no surviving Owner or the surviving
spouse is also the sole surviving Owner, and such surviving spouse elects
to continue this contract as the Owner and the Annuitant.
DEATH OF THE OWNER
If any Owner dies prior to the Annuity Payout Date, either:
(1) the entire interest in this contract must be distributed within
five years of the date of such Owner's death; or
(2) within 12 months of the date of death, the Contract Value must be
annuitized over the life expectancy of the person who becomes the
new Owner of this contract or over a period not extending beyond
the life expectancy of such person; or
(3) if the Owner's surviving spouse becomes the Owner of this
contract, this contract may be continued in the name of the
spouse as the contract Owner.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 14
If any Owner predeceases the Annuitant, ownership will pass in the
following order: (1) any other surviving Owner(s); (2) any surviving
Beneficiary; (3) any surviving Contingent Beneficiary; (4) any surviving
Secondary Contingent Beneficiary, where applicable; and (5) if there are no
such survivors, to the last surviving Owner's estate.
CONTRACT ADMINISTRATION CHARGE
Prior to the Annuity Payout Date, on each contract anniversary and upon
surrender, we will deduct from the Contract Value an annual Contract
Administration Charge of $30 to defray our administrative expenses for this
contract if the Contract Value at that time is less than $50,000. If, on a
contract anniversary, the Contract Value equals or exceeds $50,000, we will
waive the Contract Administration Charge.
We will cancel the number of variable accumulation units from the
appropriate Subaccounts that, when multiplied by the corresponding variable
accumulation unit values for the Valuation Period in which the charge is
taken, equals that portion of the charge taken from VAA.
SETTLEMENT PROVISIONS
GENERAL
On the Annuity Payout Date, the Contract Value shall be applied under one
or more of the Annuity Options shown below or under such other option to
which we may agree.
ELECTIONS
You must give us Notice in order to elect an Annuity Option or revoke or
change such an election. If no such election is in effect on the Annuity
Payout Date, and if the Annuitant is then living, the Contract Value will
be applied under Life Annuity Option (3). The annuity will be variable
unless you elect otherwise. Unless this contract is issued pursuant to a
tax-qualified pension or profit-sharing plan or trust, any remaining
period-certain installments to be paid after the Annuitant's death will
pass in the following order: (1) any surviving Owner(s); (2) any surviving
Beneficiary; (3) any surviving Contingent Beneficiary; (4) any surviving
Secondary Contingent Beneficiary, where applicable; and (5) if there are no
such survivors, to the last surviving Owner's estate.
PENSION PLAN
If: (a) this contract is issued pursuant to a tax-qualified pension or
profit-sharing plan or trust; (b) no Annuity Option election is in effect
on the Annuity Payout Date; and (c) the Annuitant is living on the Annuity
Payout Date, then the Contract Value will be applied as follows:
(1) If the Annuitant is married as of the Annuity Payout Date, the
Contract Value will be applied to provide equal payments under
Joint and Survivor Life Annuity Option (2) with the Annuitant's
spouse as the Joint Annuitant.
(2) If the Annuitant is not married as of the Annuity Payout Date,
the Contract Value will be applied under Life Annuity Option (3)
and paid to the Annuitant with the Beneficiary as payee for any
period-certain payments to be made after the Annuitant's death.
DETERMINATION OF AMOUNT TO BE APPLIED
The Contract Value to be applied to provide an annuity shall be determined
at the end of a Valuation Period, selected by us and uniformly applied,
which is not more than 10 Valuation Periods before the Annuity Payout Date.
Any applicable premium tax or similar state or local tax will be deducted
at that time, if it was not deducted earlier.
EFFECT OF SETTLEMENT ON ACCUMULATION UNITS
When this contract is settled, its variable accumulation units will be
cancelled.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 15
CHANGE OF ANNUITY PAYOUT DATE
You may change the Annuity Payout Date at any time prior to the earlier of
(1) the Annuitant's death; or (2) the Annuity Payout Date by Notice to us.
But, unless we agree, the Annuity Payout Date may not be later than the
first day of the month following the Annuitant's 90th birthday. In any
event, the Annuity Payout Date must be the first day of a month and must be
at least 30 days after the date we receive Notice.
ANNUITY PAYMENT AMOUNTS
VARIABLE ANNUITIES
The dollar amount of the first periodic variable annuity payment shall
be derived from the Annuity Option Tables in this contract or any
other option table to which both we and you agree for the sex(es) and
age(s) of the Annuitant and Joint Annuitant, if any, on the Annuity
Payout Date. The dollar amount of each variable annuity payment after
the first will be measured by variable annuity units. The number of
variable annuity units of each Subaccount to be credited to this
contract is determined by dividing that part of the first variable
annuity payment apportioned to each Subaccount by the variable annuity
unit value of that Subaccount for the Valuation Period used to
determine the Contract Value for settlement of this contract under
this SETTLEMENT PROVISIONS section. The dollar amount of each variable
annuity payment after the first is equal to the number of variable
annuity units credited to this contract multiplied by the variable
annuity unit value of the applicable Subaccount for the Valuation
Period, selected by us and uniformly applied, which is not more than
10 Valuation Periods before the due date of each such payment.
FIXED ANNUITIES
The dollar amount of each periodic fixed annuity payment shall be
derived from the Annuity Option Tables for the sex(es) and age(s) of
the Annuitant and Joint Annuitant, if any, on the Annuity Payout Date.
ANNUITY UNIT VALUE
The value of a variable annuity unit for each Subaccount was set when the
first annuity payment was made from each Subaccount for this class of
contracts. To determine the variable annuity unit value for each later
Valuation Period, (a) multiply the variable annuity unit value for that
Subaccount for the immediately prior Valuation Period by the Net Investment
Factor for that Subaccount for such later Valuation Period, and then (b)
multiply the product by a factor to neutralize the annual interest rate
assumed in the Annuity Option Tables used. For an assumed interest rate of
3 percent, the factor for a one-day Valuation Period is .9999190.
CHANGE IN SUBACCOUNT
After variable annuity payments have been made for at least 12 months, the
payee(s) may, no more than once each 12 months, change all or part of the
investment upon which variable annuity payments are based from one
Subaccount to another. To do this, we will convert the number of annuity
units being changed to the number of annuity units of the Subaccount to
which the payee(s) are changing so as to result in the next variable
annuity payment being of the same amount that it would have been without
the change. After that, variable annuity payments will reflect changes in
the values of the new annuity units. The payee(s) must give us Notice at
least 30 days before the due date of the first variable annuity payment to
which the change will apply.
LIMITATION ON AVAILABILITY OF OPTIONS
If the amount to be applied under any Annuity Option is less than $5,000,
such Annuity Option shall not be available. Settlement shall then be in a
single sum. If an annuity payment to a payee would be less than $100, we
may pay less often so that such payment will be at least $100.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 16
ALTERNATE ANNUITY OPTION
Instead of the variable Annuity Options provided under this contract, you
may choose an alternate amount and type of periodic installments for fixed
annuity payments. Such alternate Annuity Options shall be based on the
rates for fixed-dollar single premium immediate annuities being issued by
us on the Annuity Payout Date. They may only be elected within 30 days
before the Annuity Payout Date.
DEATH BENEFIT AFTER THE ANNUITY PAYOUT DATE
If the Annuitant dies after the Annuity Payout Date, any death benefit
payable will be in accordance with the Annuity Option chosen.
SPENDTHRIFT PROVISION
Except as otherwise provided in this contract (or in any supplementary
contract issued in exchange for it), neither an Owner nor the Beneficiary
may commute, anticipate, assign or otherwise encumber any amounts to be
paid in settlement of this contract. To the extent allowed by law, no such
amount shall be subject to any legal process in payment of any claim
against an Owner or any Beneficiary.
DESCRIPTION OF ANNUITY OPTIONS
All of these options may be on a fixed or variable annuity basis or both.
LIFE ANNUITY OPTIONS
(1) NONREFUND. We will make annuity payments during the lifetime of
the Annuitant. No payments are due after the death of the
Annuitant.
(2) 5-YEARS CERTAIN. We will make annuity payments for five years and
after that during the lifetime of the Annuitant. No payments are
due after the death of the Annuitant or, if later, the end of the
5-year period certain.
(3) 10-YEARS CERTAIN. We will make annuity payments for 10 years and
after that during the lifetime of the Annuitant. No payments are
due after the death of the Annuitant or, if later, the end of the
10-year period certain.
(4) INSTALLMENT REFUND. We will make annuity payments for a period
certain and after that during the lifetime of the Annuitant. No
payments are due after the death of the Annuitant or, if later,
the end of the period certain. The number of period-certain
payments is equal to the amount applied under this installment
refund option divided by the amount of the first annuity payment;
provided, however, that the amount of the final period-certain
payment shall be multiplied by that part of the preceding
quotient that is not an integer.
JOINT AND SURVIVOR LIFE ANNUITY OPTIONS
(1) JOINT AND SURVIVOR NONREFUND. We will make annuity payments
during the joint lifetime of the Annuitant and Joint
Annuitant. Payments will then continue during the remaining
lifetime of the survivor of them. No payments are due after
the death of the last survivor of the Annuitant and Joint
Annuitant.
(2) JOINT AND SURVIVOR WITH 10-YEARS CERTAIN. We will make
annuity payments for 10 years and after that during the
joint lifetime of the Annuitant and Joint Annuitant.
Payments will then continue during the remaining lifetime of
the survivor of them. No payments are due after the death of
the survivor of the Annuitant and Joint Annuitant or, if
later, the end of the 10-year period certain.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 17
ANNUITY OPTION TABLES
Date of Birth
(1939 and Before)
Installments shown are for a monthly payment for each $1,000 of Contract Value
applied under an Annuity Option. Age, as used in these tables, is age as of
nearest birthday. Rates of monthly payments for ages and periods certain not
shown, if allowed by us, will be based on an actuarially equivalent basis. To
determine annual, semi-annual, or quarterly installments, multiply the amounts
shown by 11.64, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5-YEARS 10-YEARS INSTALLMENT ------------ NON- 5-YEARS 10-YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
------------ ------ ------- -------- ----------- ------------ ------ ------- -------- -----------
51 $ 4.12 $ 4.11 $ 4.08 $ 3.96 51 $ 3.86 $ 3.85 $ 3.84 $ 3.77
52 4.19 4.18 4.15 4.02 52 3.92 3.91 3.90 3.82
53 4.26 4.25 4.22 4.08 53 3.98 3.98 3.96 3.88
54 4.34 4.33 4.30 4.15 54 4.05 4.04 4.03 3.93
55 4.43 4.41 4.38 4.22 55 4.12 4.12 4.10 3.99
56 4.51 4.50 4.46 4.29 56 4.20 4.19 4.17 4.06
57 4.61 4.59 4.55 4.36 57 4.28 4.27 4.24 4.12
58 4.71 4.69 4.64 4.44 58 4.36 4.35 4.32 4.19
59 4.81 4.80 4.73 4.52 59 4.45 4.44 4.41 4.27
60 4.93 4.91 4.84 4.61 60 4.54 4.53 4.50 4.34
61 5.05 5.02 4.94 4.70 61 4.65 4.63 4.59 4.43
62 5.18 5.15 5.06 4.79 62 4.75 4.74 4.69 4.51
63 5.32 5.28 5.18 4.89 63 4.87 4.85 4.79 4.60
64 5.46 5.42 5.30 4.99 64 4.99 4.97 4.91 4.70
65 5.62 5.58 5.43 5.10 65 5.12 5.10 5.02 4.80
66 5.79 5.74 5.57 5.22 66 5.26 5.23 5.15 4.90
67 5.97 5.91 5.71 5.34 67 5.41 5.38 5.28 5.02
68 6.16 6.08 5.86 5.47 68 5.57 5.53 5.42 5.13
69 6.36 6.27 6.01 5.60 69 5.74 5.70 5.56 5.26
70 6.58 6.48 6.17 5.74 70 5.93 5.88 5.71 5.39
71 6.81 6.69 6.33 5.89 71 6.13 6.07 5.88 5.53
72 7.06 6.91 6.49 6.05 72 6.35 6.27 6.04 5.68
73 7.32 7.15 6.66 6.21 73 6.58 6.49 6.22 5.84
74 7.60 7.39 6.83 6.38 74 6.83 6.73 6.40 6.01
75 7.90 7.66 7.01 6.56 75 7.11 6.98 6.59 6.18
76 8.22 7.93 7.18 6.75 76 7.40 7.25 6.78 6.37
77 8.56 8.22 7.36 6.95 77 7.72 7.54 6.98 6.57
78 8.92 8.53 7.54 7.16 78 8.07 7.84 7.18 6.78
79 9.31 8.84 7.71 7.38 79 8.44 8.16 7.38 7.01
80 9.73 9.17 7.88 7.61 80 8.85 8.51 7.58 7.24
81 10.18 9.52 8.05 7.85 81 9.29 8.87 7.78 7.49
82 10.66 9.87 8.21 8.11 82 9.76 9.25 7.97 7.75
83 11.17 10.24 8.36 8.38 83 10.28 9.65 8.15 8.03
84 11.71 10.62 8.50 8.65 84 10.84 10.07 8.33 8.32
85 12.29 11.00 8.64 8.95 85 11.44 10.49 8.49 8.63
86 12.91 11.40 8.77 9.27 86 12.09 10.93 8.64 8.95
87 13.57 11.79 8.88 9.59 87 12.79 11.37 8.78 9.29
88 14.28 12.19 8.99 9.93 88 13.53 11.81 8.90 9.64
89 15.02 12.59 9.09 10.30 89 14.32 12.25 9.02 10.01
90 15.82 12.98 9.18 10.67 90 15.15 12.68 9.12 10.40
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 18
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.59 $ 3.75 $ 3.91 $ 4.05 $ 4.17 $ 4.26 $ 4.33 $ 4.37 $ 4.40
60 3.65 3.86 4.07 4.28 4.47 4.63 4.75 4.83 4.87
65 3.70 3.94 4.21 4.50 4.79 5.05 5.26 5.41 5.50
70 3.74 4.01 4.33 4.70 5.10 5.50 5.86 6.14 6.32
75 3.76 4.05 4.41 4.85 5.36 5.94 6.51 6.99 7.35
80 3.78 4.08 4.46 4.95 5.57 6.32 7.14 7.93 8.57
85 3.79 4.10 4.50 5.02 5.71 6.61 7.69 8.86 9.92
90 3.79 4.11 4.52 5.06 5.81 6.81 8.12 9.67 11.27
(b) With 10-Years Certain
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.59 $ 3.75 $ 3.91 $ 4.05 $ 4.17 $ 4.26 $ 4.32 $ 4.35 $ 4.37
60 3.65 3.86 4.07 4.28 4.47 4.62 4.73 4.79 4.82
65 3.70 3.94 4.21 4.50 4.78 5.03 5.22 5.34 5.40
70 3.74 4.00 4.32 4.68 5.08 5.46 5.77 5.98 6.10
75 3.76 4.04 4.40 4.83 5.32 5.85 6.33 6.68 6.88
80 3.77 4.07 4.45 4.92 5.50 6.17 6.83 7.35 7.66
85 3.78 4.08 4.47 4.98 5.62 6.39 7.20 7.88 8.32
90 3.78 4.09 4.49 5.01 5.68 6.51 7.43 8.23 8.77
Actuarial Basis - Installments shown in these tables are based on the Annuity
2000 Mortality Table Projected to 2003 under Scale G with compound interest at
the effective rate of 3 percent per year.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 19
ANNUITY OPTION TABLES
(1940-1959)
Installments shown are for a monthly payment for each $1,000 of Contract Value
applied under an Annuity Option. Age, as used in these tables, is age as of
nearest birthday. Rates of monthly payments for ages and periods certain not
shown, if allowed by us, will be based on an actuarially equivalent basis. To
determine annual, semi-annual, or quarterly installments, multiply the amounts
shown by 11.64, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5-YEARS 10-YEARS INSTALLMENT ------------ NON- 5-YEARS 10-YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
------------ ------ ------- -------- ----------- ------------ ------ ------- -------- -----------
51 $ 4.05 $ 4.04 $ 4.02 $ 3.91 51 $ 3.80 $ 3.80 $ 3.79 $ 3.72
52 4.12 4.11 4.08 3.96 52 3.86 3.85 3.84 3.77
53 4.19 4.18 4.15 4.02 53 3.92 3.91 3.90 3.82
54 4.26 4.25 4.22 4.08 54 3.98 3.98 3.96 3.88
55 4.34 4.33 4.30 4.15 55 4.05 4.04 4.03 3.93
56 4.43 4.41 4.38 4.22 56 4.12 4.12 4.10 3.99
57 4.51 4.50 4.46 4.29 57 4.20 4.19 4.17 4.06
58 4.61 4.59 4.55 4.36 58 4.28 4.27 4.24 4.12
59 4.71 4.69 4.64 4.44 59 4.36 4.35 4.32 4.19
60 4.81 4.80 4.73 4.52 60 4.45 4.44 4.41 4.27
61 4.93 4.91 4.84 4.61 61 4.54 4.53 4.50 4.34
62 5.05 5.02 4.94 4.70 62 4.65 4.63 4.59 4.43
63 5.18 5.15 5.06 4.79 63 4.75 4.74 4.69 4.51
64 5.32 5.28 5.18 4.89 64 4.87 4.85 4.79 4.60
65 5.46 5.42 5.30 4.99 65 4.99 4.97 4.91 4.70
66 5.62 5.58 5.43 5.10 66 5.12 5.10 5.02 4.80
67 5.79 5.74 5.57 5.22 67 5.26 5.23 5.15 4.90
68 5.97 5.91 5.71 5.34 68 5.41 5.38 5.28 5.02
69 6.16 6.08 5.86 5.47 69 5.57 5.53 5.42 5.13
70 6.36 6.27 6.01 5.60 70 5.74 5.70 5.56 5.26
71 6.58 6.48 6.17 5.74 71 5.93 5.88 5.71 5.39
72 6.81 6.69 6.33 5.89 72 6.13 5.07 5.88 5.53
73 7.06 6.91 6.49 6.05 73 6.35 6.27 6.04 5.68
74 7.32 7.15 6.66 6.21 74 6.58 6.49 6.22 5.84
75 7.60 7.39 6.83 6.38 75 6.83 6.73 6.40 6.01
76 7.90 7.66 7.01 6.56 76 7.11 6.98 6.59 6.18
77 8.22 7.93 7.18 6.75 77 7.40 7.25 6.78 6.37
78 8.56 8.22 7.36 6.95 78 7.72 7.54 6.98 6.57
79 8.92 8.53 7.54 7.16 79 8.07 7.84 7.18 6.78
80 9.31 8.84 7.71 7.38 80 8.44 8.16 7.38 7.01
81 9.73 9.17 7.88 7.61 81 8.85 8.51 7.58 7.24
82 10.18 9.52 8.05 7.85 82 9.29 8.87 7.78 7.49
83 10.66 9.87 8.21 8.11 83 9.76 9.25 7.97 7.75
84 11.17 10.24 8.36 8.38 84 10.28 9.65 8.15 8.03
85 11.71 10.62 8.50 8.65 85 10.84 10.07 8.33 8.32
86 12.29 11.00 8.64 8.95 86 11.14 10.49 8.49 8.63
87 12.91 11.40 8.77 9.27 87 12.09 10.93 8.64 8.95
88 13.57 11.79 8.88 9.59 88 12.79 11.37 8.78 9.29
89 14.28 12.19 8.99 9.93 89 13.53 11.81 8.90 9.64
90 15.02 12.59 9.09 10.30 90 14.32 12.25 9.02 10.01
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 20
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.54 $ 3.70 $ 3.85 $ 3.98 $ 4.10 $ 4.18 $ 4.25 $ 4.29 $ 4.31
60 3.61 3.80 4.00 4.20 4.38 4.53 4.64 4.71 4.76
65 3.65 3.88 4.13 4.41 4.68 4.92 5.12 5.26 5.35
70 3.69 3.94 4.24 4.59 4.96 5.34 5.68 5.94 6.12
75 3.71 3.98 4.32 4.73 5.21 5.75 6.28 6.74 7.08
80 3.72 4.01 4.37 4.83 5.40 6.10 6.86 7.60 8.22
85 3.73 4.03 4.40 4.90 5.54 6.37 7.37 8.46 9.47
90 3.74 4.04 4.42 4.94 5.63 6.56 7.77 9.22 10.72
(b) With 10-Years Certain
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.54 $ 3.70 $ 3.85 $ 3.98 $ 4.09 $ 4.18 $ 4.24 $ 4.27 $ 4.29
60 3.60 3.80 4.00 4.20 4.37 4.52 4.62 4.68 4.72
65 3.65 3.88 4.13 4.40 4.67 4.90 5.08 5.20 5.26
70 3.68 3.94 4.24 4.58 4.95 5.30 5.61 5.82 5.93
75 3.71 3.98 4.31 4.71 5.18 5.68 6.14 6.49 6.69
80 3.72 4.00 4.36 4.80 5.35 5.98 6.62 7.14 7.47
85 3.73 4.02 4.38 4.86 5.46 6.20 6.99 7.68 8.14
90 3.73 4.02 4.40 4.89 5.52 6.32 7.22 8.04 8.62
Actuarial Basis - Installments shown in these tables are based on the Annuity
2000 Mortality Table Projected to 2003 under Scale G (set back one year) with
compound interest at the effective rate of 3 percent per year.
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FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 21
ANNUITY OPTION TABLES
(1960-1979)
Installments shown are for a monthly payment for each $1,000 of Contract Value
applied under an Annuity Option. Age, as used in these tables, is age as of
nearest birthday. Rates of monthly payments for ages and periods certain not
shown, if allowed by us, will be based on an actuarially equivalent basis. To
determine annual, semi-annual, or quarterly installments, multiply the amounts
shown by 11.64, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5-YEARS 10-YEARS INSTALLMENT ------------ NON- 5-YEARS 10-YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
------------ ------ ------- -------- ----------- ------------ ------ ------- -------- -----------
51 $ 3.98 $ 3.98 $ 3.96 $ 3.85 51 $ 3.75 $ 3.74 $ 3.73 $ 3.67
52 4.05 4.04 4.02 3.91 52 3.80 3.80 3.79 3.72
53 4.12 4.11 4.08 3.96 53 3.86 3.85 3.84 3.77
54 4.19 4.18 4.15 4.02 54 3.92 3.91 3.90 3.82
55 4.26 4.25 4.22 4.08 55 3.98 3.98 3.96 3.88
56 4.34 4.33 4.30 4.15 56 4.05 4.04 4.03 3.93
57 4.43 4.41 4.38 4.22 57 4.12 4.12 4.10 3.99
58 4.51 4.50 4.46 4.29 58 4.20 4.19 4.17 4.06
59 4.61 4.59 4.55 4.36 59 4.28 4.27 4.24 4.12
60 4.71 4.69 4.64 4.44 60 4.35 4.35 4.32 4.19
61 4.81 4.80 4.73 4.52 61 4.45 4.44 4.41 4.27
62 4.93 4.91 4.84 4.61 62 4.54 4.53 4.50 4.34
63 5.05 5.02 4.94 4.70 63 4.65 4.63 4.59 4.43
64 5.18 5.15 5.06 4.79 64 4.75 4.74 4.69 4.51
65 5.32 5.28 5.18 4.89 65 4.87 4.85 4.79 4.60
66 5.46 5.42 5.30 4.99 66 4.99 4.97 4.91 4.70
67 5.62 5.58 5.43 5.10 67 5.12 5.10 5.02 4.80
68 5.79 5.74 5.57 5.22 68 5.26 5.23 5.15 4.90
69 5.97 5.91 5.71 5.34 69 5.41 5.38 5.28 5.02
70 6.16 6.08 5.86 5.47 70 5.57 5.53 5.42 5.13
71 6.36 6.27 6.01 5.60 71 5.74 5.70 5.56 5.26
72 6.58 6.48 6.17 5.74 72 5.93 5.88 5.71 5.39
73 6.81 6.69 6.33 5.89 73 6.13 6.07 5.88 5.53
74 7.06 6.91 6.49 6.05 74 6.35 6.27 6.04 5.68
75 7.32 7.15 6.66 6.21 75 6.58 6.49 6.22 5.84
76 7.60 7.39 6.83 6.38 76 6.83 6.73 6.40 6.01
77 7.90 7.66 7.01 6.56 77 7.11 6.98 6.59 6.18
78 8.22 7.93 7.18 6.75 78 7.40 7.25 6.78 6.37
79 8.56 8.22 7.36 6.95 79 7.72 7.54 6.98 6.57
80 8.92 8.53 7.54 7.16 80 8.07 7.84 7.18 6.78
81 9.31 8.84 7.71 7.38 81 8.44 8.16 7.38 7.01
82 9.73 9.17 7.88 7.61 82 8.85 8.51 7.58 7.24
83 10.18 9.52 8.05 7.85 83 9.29 8.87 7.78 7.49
84 10.66 9.87 8.21 8.11 84 9.75 9.25 7.97 7.75
85 11.17 10.24 8.36 8.38 85 10.28 9.65 8.15 8.03
86 11.71 10.62 8.50 8.65 86 10.84 10.07 8.33 8.32
87 12.29 11.00 8.64 8.95 87 11.44 10.49 8.49 8.63
88 12.91 11.40 8.77 9.27 88 12.09 10.93 8.64 8.95
89 13.57 11.79 8.88 9.59 89 12.79 11.37 8.78 9.29
90 14.28 12.19 8.99 9.93 90 13.53 11.81 8.90 9.64
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 22
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.50 $ 3.65 $ 3.79 $ 3.92 $ 4.02 $ 4.11 $ 4.17 $ 4.21 $ 4.23
60 3.56 3.74 3.93 4.12 4.29 4.43 4.54 4.61 4.65
65 3.60 3.82 4.06 4.32 4.57 4.80 4.99 5.12 5.21
70 3.64 3.88 4.16 4.48 4.84 5.19 5.51 5.75 5.92
75 3.66 3.91 4.23 4.62 5.07 5.57 6.06 6.50 6.82
80 3.67 3.94 4.28 4.71 5.25 5.89 6.61 7.30 7.88
85 3.68 3.96 4.31 4.78 5.38 6.15 7.08 8.10 9.05
90 3.69 3.97 4.33 4.82 5.46 6.32 7.44 8.79 10.21
(b) With 10-Years Certain
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.50 $ 3.65 $ 3.79 $ 3.92 $ 4.02 $ 4.10 $ 4.16 $ 4.19 $ 4.21
60 3.56 3.74 3.93 4.12 4.29 4.42 4.52 4.58 4.62
65 3.60 3.82 4.06 4.31 4.56 4.78 4.96 5.07 5.14
70 3.63 3.87 4.16 4.48 4.82 5.16 5.45 5.66 5.77
75 3.66 3.91 4.23 4.61 5.04 5.51 5.96 6.30 6.51
80 3.67 3.94 4.27 4.69 5.21 5.81 6.42 6.93 7.27
85 3.68 3.95 4.30 4.75 5.32 6.01 6.77 7.47 7.95
90 3.68 3.96 4.31 4.78 5.37 6.13 7.00 7.84 8.45
Actuarial Basis - Installments shown in these tables are based on the Annuity
2000 Mortality Table Projected to 2003 under Scale G (set back two years) with
compound interest at the effective rate of 3 percent per year.
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 23
ANNUITY OPTION TABLES
(1980-1999)
Installments shown are for a monthly payment for each $1,000 of Contract Value
applied under an Annuity Option. Age, as used in these tables, is age as of
nearest birthday. Rates of monthly payments for ages and periods certain not
shown, if allowed by us, will be based on an actuarially equivalent basis. To
determine annual, semi-annual, or quarterly installments, multiply the amounts
shown by 11.64, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5-YEARS 10-YEARS INSTALLMENT ------------ NON- 5-YEARS 10-YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
------------ ------ ------- -------- ----------- ------------ ------ ------- -------- -----------
51 $ 3.92 $ 3.92 $ 3.90 $ 3.80 51 $ 3.69 $ 3.69 $ 3.68 $ 3.63
52 3.98 3.98 3.96 3.85 52 3.75 3.74 3.73 3.67
53 4.05 4.04 4.02 3.91 53 3.80 3.80 3.79 3.72
54 4.12 4.11 4.08 3.96 54 3.86 3.85 3.84 3.77
55 4.19 4.18 4.15 4.02 55 3.92 3.91 3.90 3.82
56 4.26 4.25 4.22 4.08 56 3.98 3.98 3.96 3.88
57 4.34 4.33 4.30 4.15 57 4.05 4.04 4.03 3.93
58 4.43 4.41 4.38 4.22 58 4.12 4.12 4.10 3.99
59 4.51 4.50 4.46 4.29 59 4.20 4.19 4.17 4.06
60 4.61 4.59 4.55 4.36 60 4.28 4.27 4.24 4.12
61 4.71 4.69 4.64 4.44 61 4.36 4.35 4.32 4.19
62 4.81 4.80 4.73 4.52 62 4.45 4.44 4.41 4.27
63 4.93 4.91 4.84 4.61 63 4.54 4.53 4.50 4.34
64 5.05 5.02 4.94 4.70 64 4.65 4.63 4.59 4.43
65 5.18 5.15 5.06 4.79 65 4.75 4.74 4.69 4.51
66 5.32 5.28 5.18 4.89 66 4.87 4.85 4.79 4.60
67 5.46 5.42 5.30 4.99 67 4.99 4.97 4.91 4.70
68 5.62 5.58 5.43 5.10 68 5.12 5.10 5.02 4.80
69 5.79 5.74 5.57 5.22 69 5.26 5.23 5.15 4.90
70 5.97 5.91 5.71 5.34 70 5.41 5.38 5.28 5.02
71 6.16 6.08 5.86 5.47 71 5.57 5.53 5.42 5.13
72 6.36 6.27 6.01 5.60 72 5.74 5.70 5.56 5.26
73 6.58 6.48 6.17 5.74 73 5.93 5.88 5.71 5.39
74 6.81 6.69 6.33 5.89 74 6.13 6.07 5.88 5.53
75 7.06 6.91 6.49 6.05 75 6.35 6.27 6.04 5.68
76 7.32 7.15 6.66 6.21 76 6.58 6.49 6.22 5.84
77 7.60 7.39 6.83 6.38 77 6.83 6.73 6.40 6.01
78 7.90 7.66 7.01 6.56 78 7.11 6.98 6.59 6.18
79 8.22 7.93 7.18 6.75 79 7.40 7.25 6.78 6.37
80 8.56 8.22 7.36 6.95 80 7.72 7.54 6.98 6.57
81 8.92 8.53 7.54 7.16 81 8.07 7.84 7.18 6.78
82 9.31 8.84 7.71 7.38 82 8.44 8.16 7.38 7.01
83 9.73 9.17 7.88 7.61 83 8.85 8.51 7.58 7.24
84 10.18 9.52 8.05 7.85 84 9.29 8.87 7.78 7.49
85 10.66 9.87 8.21 8.11 85 9.76 9.25 7.97 7.75
86 11.17 10.24 8.36 8.38 86 10.28 9.65 8.15 8.03
87 11.71 10.62 8.50 8.65 87 10.84 10.07 8.33 8.32
88 12.29 11.00 8.64 8.95 88 11.44 10.49 8.49 8.63
89 12.91 11.40 8.77 9.27 89 12.09 10.93 8.64 8.95
90 13.57 11.79 8.88 9.59 90 12.79 11.37 8.78 9.29
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 24
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.46 $ 3.60 $ 3.73 $ 3.85 $ 3.96 $ 4.04 $ 4.09 $ 4.13 $ 4.16
60 3.51 3.69 3.87 4.05 4.21 4.34 4.44 4.51 4.55
65 3.56 3.76 3.99 4.23 4.47 4.68 4.86 4.99 5.07
70 3.59 3.81 4.08 4.39 4.72 5.05 5.35 5.58 5.74
75 3.61 3.85 4.15 4.51 4.94 5.40 5.86 6.27 6.58
80 3.62 3.88 4.20 4.60 5.11 5.70 6.37 7.02 7.56
85 3.63 3.89 4.23 4.66 5.23 5.94 6.81 7.75 8.65
90 3.64 3.90 4.25 4.70 5.30 6.10 7.14 8.40 9.73
(b) With 10-Years Certain
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.46 $ 3.60 $ 3.73 $ 3.85 $ 3.95 $ 4.03 $ 4.09 $ 4.12 $ 4.14
60 3.51 3.69 3.87 4.04 4.20 4.33 4.43 4.49 4.52
65 3.56 3.76 3.99 4.23 4.46 4.67 4.84 4.95 5.01
70 3.59 3.81 4.08 4.38 4.71 5.03 5.30 5.50 5.62
75 3.61 3.85 4.15 4.50 4.92 5.36 5.78 6.12 6.33
80 3.62 3.87 4.19 4.59 5.07 5.64 6.22 6.73 7.07
85 3.63 3.89 4.22 4.64 5.18 5.83 6.57 7.25 7.76
90 3.63 3.90 4.23 4.67 5.24 5.95 6.79 7.63 8.27
Actuarial Basis - Installments shown in these tables are based on the Annuity
2000 Mortality Table Projected to 2003 under Scale G (set back three years) with
compound interest at the effective rate of 3 percent per year.
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 25
ANNUITY OPTION TABLES
(2000 +)
Installments shown are for a monthly payment for each $1,000 of Contract Value
applied under an Annuity Option. Age, as used in these tables, is age as of
nearest birthday. Rates of monthly payments for ages and periods certain not
shown, if allowed by us, will be based on an actuarially equivalent basis. To
determine annual, semi-annual, or quarterly installments, multiply the amounts
shown by 11.64, 5.92 or 2.98; respectively.
OPTION 1: LIFE INCOME
AGE AND SEX AGE AND SEX
OF ANNUITANT OF ANNUITANT
------------ NON- 5-YEARS 10-YEARS INSTALLMENT ------------ NON- 5-YEARS 10-YEARS INSTALLMENT
MALE REFUND CERTAIN CERTAIN REFUND FEMALE REFUND CERTAIN CERTAIN REFUND
------------ ------ ------- -------- ----------- ------------ ------ ------- -------- -----------
51 $ 3.86 $ 3.86 $ 3.84 $ 3.75 51 $ 3.64 $ 3.64 $ 3.64 $ 3.58
52 3.92 3.92 3.90 3.80 52 3.69 3.69 3.68 3.63
53 3.98 3.98 3.96 3.85 53 3.75 3.74 3.73 3.67
54 4.05 4.04 4.02 3.91 54 3.80 3.80 3.79 3.72
55 4.12 4.11 4.08 3.96 55 3.86 3.85 3.84 3.77
56 4.19 4.18 4.15 4.02 56 3.92 3.91 3.90 3.82
57 4.26 4.25 4.22 4.08 57 3.98 3.98 3.96 3.88
58 4.34 4.33 4.30 4.15 58 4.05 4.04 4.03 3.93
59 4.43 4.41 4.38 4.22 59 4.12 4.12 4.10 3.99
60 4.51 4.50 4.46 4.29 60 4.20 4.19 4.17 4.06
61 4.61 4.59 4.55 4.36 61 4.28 4.27 4.24 4.12
62 4.71 4.69 4.64 4.44 62 4.36 4.35 4.32 4.19
63 4.81 4.80 4.73 4.52 63 4.45 4.44 4.41 4.27
64 4.93 4.91 4.84 4.61 64 4.54 4.53 4.50 4.34
65 5.05 5.02 4.94 4.70 65 4.65 4.63 4.59 4.43
66 5.18 5.15 5.06 4.79 66 4.75 4.74 4.69 4.51
67 5.32 5.28 5.18 4.89 67 4.87 4.85 4.79 4.60
68 5.46 5.42 5.30 4.99 68 4.99 4.97 4.91 4.70
69 5.62 5.58 5.43 5.10 69 5.12 5.10 5.02 4.80
70 5.79 5.74 5.57 5.22 70 5.26 5.23 5.15 4.90
71 5.97 5.91 5.71 5.34 71 5.41 5.38 5.28 5.02
72 6.16 6.08 5.86 5.47 72 5.57 5.53 5.42 5.13
73 6.36 6.27 6.01 5.60 73 5.74 5.70 5.56 5.26
74 6.58 6.48 6.17 5.74 74 5.93 5.88 5.71 5.39
75 6.81 6.69 6.33 5.89 75 6.13 6.07 5.88 5.53
76 7.06 6.91 6.49 6.05 76 6.35 6.27 6.04 5.68
77 7.32 7.15 6.66 6.21 77 6.58 6.49 6.22 5.84
78 7.60 7.39 6.83 6.38 78 6.83 6.73 6.40 6.01
79 7.90 7.66 7.01 6.56 79 7.11 6.98 6.59 6.18
80 8.22 7.93 7.18 6.75 80 7.40 7.25 6.78 6.37
81 8.56 8.22 7.36 6.95 81 7.72 7.54 6.98 6.57
82 8.92 8.53 7.54 7.16 82 8.07 7.84 7.18 6.78
83 9.31 8.84 7.71 7.38 83 8.44 8.16 7.38 7.01
84 9.73 9.17 7.88 7.61 84 8.85 8.51 7.58 7.24
85 10.18 9.52 8.05 7.85 85 9.29 8.87 7.78 7.49
86 10.66 9.87 8.21 8.11 86 9.76 9.25 7.97 7.75
87 11.17 10.24 8.36 8.38 87 10.28 9.65 8.15 8.03
88 11.71 10.62 8.50 8.65 88 10.84 10.07 8.33 8.32
89 12.29 11.00 8.64 8.95 89 11.44 10.49 8.49 8.63
90 12.91 11.40 8.77 9.27 90 12.09 10.93 8.64 8.95
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 26
OPTION 2: JOINT & SURVIVOR LIFE INCOME
(a) Nonrefund
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.42 $ 3.55 $ 3.68 $ 3.80 $ 3.89 $ 3.97 $ 4.02 $ 4.06 $ 4.09
60 3.47 3.64 3.81 3.98 4.13 4.25 4.35 4.42 4.46
65 3.51 3.71 3.92 4.15 4.37 4.58 4.74 4.86 4.94
70 3.54 3.76 4.01 4.30 4.61 4.92 5.19 5.42 5.57
75 3.56 3.79 4.08 4.42 4.81 5.24 5.68 6.06 6.35
80 3.58 3.82 4.12 4.50 4.97 5.53 6.15 6.75 7.27
85 3.59 3.83 4.15 4.56 5.08 5.75 6.55 7.43 8.28
90 3.59 3.84 4.17 4.60 5.16 5.90 6.87 8.03 9.28
(b) With 10-Years Certain
AGE OF
AGE FEMALE JOINT ANNUITANT
OF MALE ------------------------------------------------------------------------------
ANNUITANT 50 55 60 65 70 75 80 85 90
--------- ------ ------ ------ ------ ------ ------ ------ ------ ------
55 $ 3.42 $ 3.55 $ 3.68 $ 3.79 $ 3.89 $ 3.97 $ 4.02 $ 4.05 $ 4.07
60 3.47 3.64 3.81 3.97 4.12 4.25 4.34 4.40 4.43
65 3.51 3.71 3.92 4.15 4.37 4.57 4.73 4.84 4.90
70 3.54 3.76 4.01 4.29 4.60 4.90 5.16 5.36 5.48
75 3.56 3.79 4.07 4.41 4.80 5.21 5.61 5.94 6.15
80 3.57 3.82 4.12 4.49 4.95 5.48 6.03 6.53 6.88
85 3.58 3.83 4.14 4.54 5.05 5.66 6.36 7.04 7.55
90 3.59 3.84 4.16 4.57 5.10 5.78 6.59 7.42 8.08
Actuarial Basis - Installments shown in these tables are based on the Annuity
2000 Mortality Table Projected to 2003 under Scale G (set back four years) with
compound interest at the effective rate of 3 percent per year.
--------------------------------------------------------------------------------
FORM 06-VA-4 THE OHIO NATIONAL LIFE INSURANCE COMPANY PAGE 27
THE OHIO NATIONAL
LIFE INSURANCE COMPANY
Ohio National Financial Services
--------------------------------
VARIABLE DEFERRED ANNUITY CONTRACT
Flexible Purchase Payments
Nonparticipating
FORM 06-VA-4 PAGE 28
