Exhibit 4.1
Federal Xxxxxx Life Assurance Company [LOGO]
A Stock Life Insurance Company ZURICH
0000 XxXxxxxx Xxxxxxx XXXX
Xxxxxxxxxx, Xxxxxxxx 00000-0000
RIGHT TO CANCEL - FREE LOOK PROVISION - At any time within 10 days of receiving
this contract you may return it to us or to the agent through whom it was
purchased. Immediately upon our receipt, this contract will be voided as if it
had never been in force. All purchase payments allocated to the fixed account
plus the separate account contract value computed at the end of the valuation
period following our receipt of this contract will then be refunded within ten
days.
We agree to pay an annuity to the owner provided this contract is in force on
the annuity date.
We further agree to pay the death benefit prior to the annuity date upon the
death of an owner when a death benefit is payable. Payment will be made upon our
receipt of due proof of death and the return of this contract.
This contract is issued in consideration of the initial purchase payment. The
provisions on this cover and the pages that follow are part of this contract.
Signed for Federal Xxxxxx Life Assurance Company at its home office in
Schaumburg, Illinois.
/s/ Illegible /s/ Illegible
------------- -------------
Secretary President
FIXED AND VARIABLE DEFERRED ANNUITY
NON-PARTICIPATING
ALL BENEFITS, PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED UPON THE
INVESTMENT EXPERIENCE OF THE SUBACCOUNTS, ARE VARIABLE AND ARE NOT GUARANTEED AS
TO DOLLAR AMOUNT. REFER TO THE VARIABLE ACCOUNT AND ANNUITY PERIOD PROVISIONS
FOR A DETERMINATION OF ANY VARIABLE BENEFITS.
This is a legal contract between the owner and Federal Xxxxxx Life Assurance
Company.
READ YOUR CONTRACT CAREFULLY.
S-3253 XXXXXXXXXXXXXXXX
INDEX
Page
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ANNUITY OPTION TABLE 16
ANNUITY PERIOD PROVISIONS 12 - 15
Election of Annuity Option 12
Annuity Options 12 - 13
Transfers During the Annuity Period 14 - 15
APPLICATION Follows Endorsements, if any
CONTRACT SCHEDULE Follows Index
DEATH BENEFIT PROVISIONS 10 - 11
Amount Payable Upon Death 10
Payment of Death Benefits 11
Spousal Continuation 11
DEFINITIONS 1 - 2
ENDORSEMENTS, if any Follows Annuity Option Table
FIXED ACCOUNT PROVISIONS 5 - 6
Fixed Account 5
Fixed Account Contract Value 5 - 6
GENERAL PROVISIONS 2 - 3
The Contract 2
Incontestability 2
Assignment 3
Reports 3
Premium Taxes 3
LOAN PROVISIONS 10
Loans 10
Loan Interest Rate 10
Loan Repayment 10
OWNERSHIP PROVISIONS 3 - 4
Owner of Contract 3
Change of Ownership 3
Beneficiary 4
PURCHASE PAYMENT PROVISIONS 4 - 5
Initial Purchase Payment 4
Purchase Payment Limitations 4 - 5
TRANSFER AND WITHDRAWAL PROVISIONS 7 - 9
Transfers During the Accumulation Period 7 - 8
Withdrawals During the Accumulation Period 8 - 9
Withdrawal Charges 9
Transfer and Withdrawal Procedures 9
VARIABLE ACCOUNT PROVISIONS 6 - 7
Separate Account 6
Liabilities of Separate Account 6
Subaccounts 6
Rights Reserved by the Company 6 - 7
Accumulation Unit Value 7
Contract Schedule
Contract number: XXXXXXXXXX Issue Date: XXXXXXXXXXXXXXX
Initial Purchase Payment: XXXXXXXXXXXXXX Type of contract: XXXXXXXXXXXXXXX
Owner: XXXXXXXXXXXXXXXXXX
Owner date of birth
or trust inception date: XXXXXXXX
Annuitant: XXXXXXXXXXXXXXXXXX
Annuitant gender: XXXXXX
Annuitant date of birth: XXXXXXXX
Joint Owner: XXXXXXXXXXXXXXXXXX
Joint Owner date of birth: XXXXXX
Joint Annuitant: XXXXXXXXXXXXXXXXXX
Joint Annuitant gender: XXXXXX
Joint Annuitant date
of birth: XXXXXXXX
Annuity Date: XXXXXXXXXXXXX
Maximum Annuity Date: Later of the oldest owner's or annuitant's 90th
birthdate
Date of Continuance: XXXXXXXX
Optional Enhanced Death XXXXXXXXXXXXXXXXXXXXXX
Benefit Rider:
Guaranteed Roll-up Death Benefit Interest Rate:
Class 1 Accumulation Options XXXXXX
Class 2 Accumulation Options XXXXXX
Agent: XXXXXXXXXXXXXXXXXXXXXXXXX
Page A
Contract Schedule
Beneficiary Information
Primary beneficiary(ies):
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
Contingent beneficiary(ies):
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXX
We declare a fixed account interest rate for each allocation to the fixed
account for an initial period when the allocation is made and at the start of
each subsequent interest period. This interest rate will never be less than the
minimum guaranteed fixed account interest rate.
The minimum guaranteed fixed account interest rate is:
Contract Years 1 - 10 2.00%
11 + 3.00%
The initial period is: Through the contract year in which the allocation is
made.
Subsequent periods are: Each next contract year.
Maximum Total Purchase Payments: $1,000,000
Maximum Fixed Account Purchase Payments
Per Contract Year: $100,000
Minimum Initial Account Allocation: Subaccount $500
Fixed Account see limits in Contract
Minimum Subsequent Account Allocation: Subaccount $500
Fixed Account see limits in Contract
Page B
Contract Schedule
Withdrawal Charge:
A withdrawal charge applies to each purchase payment. Year one is the
contract year in which the purchase payment is made. Each later year is
measured from the start of the contract year in which the purchase payment
was made.
The Withdrawal
During Year Charge is:
----------- --------------
One 6.00%
Two 5.00%
Three 4.00%
Four 3.00%
Five 2.00%
Six 1.00%
Seven and later 0.00%
Up to 10% of the contract value less debt may be withdrawn as a partial
free withdrawal each contract year. Charges are applied to purchase
payments and all related accumulations for any withdrawal in excess of the
10% partial free withdrawal.
A daily equivalent of the following annual charges will be assessed each day on
the subaccounts:
Mortality and expense risk charge: 1.30%
Optional Enhanced Death Benefit rider charge: XXXXXXXXXXXXXXXXX XXXXXXX
The Optional Enhanced Death Benefit rider charge applies to the Class 2
accumulation options. This charge does not apply to the Class 1
accumulation options.
We will assess a records maintenance charge at the end of each calendar quarter
in which you participate in the separate account, upon a full withdrawal, and on
the annuity date. This charge will not be assessed after the annuity date. This
charge will be deducted on a proportional basis from amounts allocated to the
subaccounts. The amount of this charge will depend on the amount of the contract
value on the date the charge is made:
Amount Of Records Maintenance
Contract Value Charge
-------------- -------------------
less than $25,000 $7.50
$25,000 to $49,999.99 $3.75
$50,000 and greater none
Page C
Contract Schedule
Initial Annual Effective Allocation
Initial Allocations: Interest Rate(s) Percentage(s)
-------------------- ------------------------ -------------
XXXXXXXXXXXXXXXXXXXX XXXXXXX XXXXXXX
XXXXXXXXXXXXXXXXXXXX XXXXXXX XXXXXXX
XXXXXXXXXXXXXXXXXXXX XXXXXXX XXXXXXX
Page D
Contract Schedule
Class 1 Accumulation Options:
Fixed Account
Xxxxxxx Money Market subaccount
Class 2 Accumulation Options:
All subaccounts except the Xxxxxxx Money Market subaccount.
Separate Account: FKLA Variable Annuity Separate Account.
FKLA Variable Annuity Separate Account Subaccounts available on the Issue Date:
Xxxxxxx Money Market
Xxxxxxx Government Securities
Xxxxxxx High Yield
Xxxxxxx Total Return
Xxxxxxx Growth
Xxxxxxx International Research
Xxxxxxx Small Cap Growth
Xxxxxxx Investment Grade Bond
Xxxxxxx Small Cap Value
Xxxxxxx Contrarian Value
SVS Focus Value + Growth
Xxxxxxx Technology Growth
Xxxxxxx Bond
Xxxxxxx Capital Growth
Xxxxxxx International
Credit Suisse Warburg Pincus Trust - Emerging Markets
Janus Aspen Balanced
Janus Aspen Growth
Janus Aspen Aggressive Growth
Janus Aspen Worldwide Growth
Pilgrim Emerging Markets Fund, Inc.
Pilgrim Natural Resources Trust
Fidelity VIP II Asset Manager
Fidelity VIP II Index 500
Fidelity VIP II Contrafund
Fidelity VIP Equity-Income
Fidelity VIP Growth
Xxxxx American Growth
Xxxxx American Small Capitalization
Xxxxx American MidCap Growth
American Century VP Income & Growth
American Century VP Value
The Dreyfus Socially Responsible Growth Fund, Inc.
X.X. Xxxxxx Small Company
Page E
DEFINITIONS
Accumulation Period - The period between the
issue date and the annuity date.
Accumulation Unit - An accounting unit of
measure used to calculate the value of each
subaccount.
Age - The attained age.
Annuitant - The person during whose lifetime
the annuity is to be paid. Under a
nonqualified plan when two people are named as
joint annuitants, the term "annuitant" means
the joint annuitants or the survivor.
Annuity - A series of payments paid in
accordance with this contract which begins on
the annuity date.
Annuity Date - The date on which annuity
payments begin. The original annuity date is
stated in the contract schedule.
Annuity Period - This is the period that
starts on the annuity date.
Annuity Unit - An accounting unit of measure
used to calculate the amount of variable
annuity payments after the first annuity
payment.
Annuity Unit Value - The value of an annuity
unit of a subaccount determined for a
valuation period according to the formula
stated in this contract.
Contract Value - The sum of the fixed account
contract value plus the separate account
contract value.
Contract Year - A one year period of time
starting on the issue date and successive
contract anniversaries.
Debt - The principal of any outstanding loan
plus any loan interest due or accrued.
Fixed Account - Our assets other than those
allocated to the separate account or any other
separate account. We guarantee a minimum rate
of interest on purchase payments allocated to
the fixed account.
Fixed Account Contract Value - The fixed
account contract value is the value of the
fixed account of this contract on any
valuation date.
Fixed Annuity - An annuity payment plan that
does not vary as to dollar amount with
investment experience.
Fund - An investment company or separate
series thereof, in which subaccounts of the
separate account invest.
Issue Date - The issue date is stated in the
contract schedule.
Mortality and Expense Risk Charge - This is a
charge deducted in the calculation of the
accumulation unit value and the annuity unit
value. It is for our assumption of mortality
risks and expense guarantees.
Nonqualified - This contract issued other than as
a qualified plan.
Owner - See "You, You, Yours" below.
Purchase Payments - This is the dollar amount
we receive in U.S. currency to buy the
benefits this contract provides.
Qualified Plan - This contract issued under a
retirement plan which qualifies for favorable
income tax treatment under Section 401, 403,
408 or 457 of the Internal Revenue Code as
amended.
Records Maintenance Charge - This is a charge
assessed against your contract as specified in
the contract schedule.
Page 1
Page 2
DEFINITIONS (Continued)
Received By The Company - This means received by
Federal Xxxxxx Life Assurance Company at its home
office in Schaumburg, Illinois.
Separate Account - A unit investment trust
registered with the Securities and Exchange
Commission under the Investment Company Act of
1940 and identified in the contract schedule.
Separate Account Contract Value - This is the sum
of the subaccount values of this contract on the
valuation date.
Subaccounts - The separate account has multiple
subaccounts. The subaccounts available on the
issue date are stated in the contract schedule.
Subaccount Value - We will value each subaccount
separately according to the formula stated in
this contract.
Valuation Date - Each business day that
applicable law requires that we value the assets
of the separate account. Currently this is each
day that the New York Stock Exchange is open for
trading.
Valuation Period - The period that starts at the
close of a valuation date and ends at the close
of the next succeeding valuation date.
Variable Annuity - An annuity payment plan which
varies as to dollar amount because of subaccount
investment experience.
We, Our, Us - Federal Xxxxxx Life Assurance
Company.
You, Your, Yours - The party(ies) named as owner
in the contract schedule unless later changed as
provided in this contract. Under a nonqualified
plan when more than one person is named as owner,
the terms "you," "your," "yours," means joint
owners. The owner may be changed during the
lifetime of the owner. The owner, prior to the
death of an owner, has the exclusive right to
exercise every option and right conferred by this
contract.
GENERAL PROVISIONS
The Contract This contract and any attached application,
endorsement(s) and rider(s) constitute the entire
contract between the parties. All statements made
in the application are deemed representations and
not warranties. No statement will void this
contract or be used as a defense of a claim
unless it is contained in the application.
Modification of Contract Only our president, secretary and assistant
secretaries have the power to approve a change or
waive any provisions of this contract. Any such
modifications must be in writing. No agent or
person other than the officers named has the
authority to change or waive the provisions of
this contract.
Upon notice to you, this contract may be modified
by us as is necessary to comply with any law or
regulation issued by a governmental agency to
which we or the separate account is subject or as
is necessary to assure continued qualification of
this contract under the Internal Revenue Code or
other laws relating to retirement plans or
annuities or as otherwise may be in your best
interest. In the event of a modification, we may
make appropriate endorsement to this contract and
we will obtain all required regulatory approvals.
Incontestability We cannot contest this contract after it has been
in force for two years from the issue date.
GENERAL PROVISIONS (Continued)
Change of Annuity Date You may write to us prior to distribution of a
death benefit or the first annuity payment date
and request a change of the annuity date. The new
annuity date must not be later than the maximum
annuity date stated in the contract schedule.
Assignment No assignment of this contract is binding unless
we receive it in writing. We assume no
responsibility for the validity or sufficiency of
any assignment. Once filed, the rights of the
owner, annuitant and beneficiary are subject to
the assignment. Any claim is subject to proof of
interest of the assignee.
Due Proof of Death We must receive written proof of the death of the
owner when a death benefit is payable. The proof
may be a certified death certificate or any other
proof satisfactory to us.
Reserves, Contract Values, All reserves are equal to or greater than those
Annuity and Death Benefits required by statute. Any available contract
value, paid-up annuity benefit and death benefit
are not less than the minimum benefits required
by the statutes of the state in which this
contract is delivered.
Non-Participating This contract does not pay dividends. It will not
share in our surplus or earnings.
Reports At least once each contract year we will send you
a statement showing purchase payments received,
interest credited, investment experience and
charges made since the last report, as well as
any other information required by statute.
Premium Taxes We will make a deduction for state premium taxes
in certain situations. On any contract subject to
premium tax, as provided under applicable law,
the tax will be deducted from: a. the purchase
payments when we receive them; b. the contract
value upon total withdrawal; or c. from the total
contract value applied to an annuity option at
the time annuity payments start.
Qualified Plans If this contract is issued under a qualified plan
additional provisions may apply. The rider or
amendment to this contract used to qualify it
under the applicable section of the Internal
Revenue Code will indicate the extent of change
in the provisions.
OWNERSHIP PROVISIONS
Owner Before the annuity date and prior to the death of
an owner, you have the right to cancel or amend
this contract if we agree. You may exercise every
option and right conferred by this contract
including the right of assignment. The joint
owners must agree to any change if more than one
owner is named.
Change of Ownership You may change the owner by written request
before the annuity date and prior to the death of
an owner. You must furnish information sufficient
to clearly identify the new owner to us. The
change is subject to any existing assignment of
this contract. When we record the effective date
of the change, it will be the date the notice was
signed except for action taken by us prior to
receiving the request. Any change is subject to
the payment of any proceeds. We may require you
to return this contract to us for endorsement of
a change.
Page 3
Page 4
OWNERSHIP PROVISIONS (Continued)
Annuitant Prior to the annuity date, an annuitant may be
replaced or added unless the owner is a
non-natural person. At all times there must be at
least one annuitant. If the annuitant dies, the
youngest owner will become the new annuitant
unless a new annuitant is otherwise named. Upon
the death of an annuitant prior to the annuity
date, a death benefit is not paid unless the
owner is a non-natural person.
Beneficiary Designation and The beneficiary is stated in the contract
Change of Beneficiary schedule. In the case of joint owners, the
surviving joint owner is automatically the
primary beneficiary of any death benefit
resulting from the death of a joint owner. You
may change the beneficiary if you send us a
written change form. Changes are subject to the
following:
1. The change must be filed while you are alive
and prior to the annuity date;
2. This contract must be in force at the time
you file a change;
3. Such change must not be prohibited by the
terms of an existing assignment, beneficiary
designation or other restriction;
4. Such change will take effect when we receive
it;
5. After we receive the change, it will take
effect on the date the change form was
signed. However, action taken by us before
the change form was received will remain in
effect; and
6. The request for change must provide
information sufficient to identify the new
beneficiary.
7. In the case of joint owners, the designation
of a beneficiary other than the joint
surviving owner will be deemed to be a
contingent beneficiary(ies).
We may require you to return this contract for
endorsement of a change.
Death of Beneficiary The interest of a beneficiary who dies before the
distribution of the death benefit will pass to
the other beneficiaries, if any, share and share
alike, unless otherwise provided in the
beneficiary designation. If no beneficiary
survives or is named, the distribution will be
made to your estate when you die. If a
beneficiary dies within ten days of the date of
your death, the death benefit will be paid as if
you had survived the beneficiary. If you and the
beneficiary die simultaneously, we will pay the
death benefit as if you had survived the
beneficiary.
PURCHASE PAYMENT PROVISIONS
Initial Purchase Payment The minimum initial purchase payment is $2,500
for a nonqualified plan and $50 for a qualified
plan.
Purchase Payment Limitations The minimum subsequent purchase payment is $500
for a nonqualified plan and $50 for a qualified
plan. We will accept a subsequent qualified plan
purchase payment of less than $50 when annual
contributions from a payroll deduction or salary
reduction plan equal or exceed $600.
The sum of all purchase payments allocated to the
fixed account in any contract year may not exceed
the maximum fixed account purchase payment shown
on the contract schedule. Purchase payments made
under a systematic investment program that has
been approved by us are not subject to the above
limitation, but we reserve the right to modify or
terminate this provision and to apply the
contract year allocation limitation to such
purchase payments.
The sum of all purchase payments allocated to the
contract may not exceed the maximum total
purchase payments shown on the contract schedule.
We will not accept purchase payments more
frequently than once every other week.
PURCHASE PAYMENT PROVISIONS (Continued)
Initial purchase payments of less than $500 may
be allocated to: 1. the fixed account; or 2. a
subaccount; or 3. to the fixed account and one
subaccount.
Subsequent nonqualified purchase payments must
first be applied to the fixed account or any
subaccount whose value is less than $500. After
each initial account has been allocated to at
least $500, purchase payments may be allocated to
a new account.
Subsequent qualified plan contributions from a
payroll deduction or salary reduction program of
$50 or more may be made to the fixed account or
to an additional subaccount.
We will deduct any applicable state premium taxes
from the purchase payments we apply to the
contract.
We reserve the right: (a) not to allow allocation
of any purchase payment to the fixed account if
the fixed account interest rate applicable to
that purchase payment would be less than or equal
to 3%; and, (b) to except purchase payments that
are part of a systematic investment program that
has been approved by us from such allocation
limitation.
We reserve the right to waive or modify these
limits. We also reserve the right not to accept
any purchase payment.
Place of Payment All purchase payments under this contract must be
paid to us at our home office or such other
location as we may select. We will notify you and
any other interested parties in writing of such
other locations. Purchase payments received by an
agent will begin earning interest after we
receive it.
FIXED ACCOUNT PROVISIONS
Fixed Account The guaranteed benefits under this contract are
provided through the fixed account.
Fixed Account Contract Value The fixed account contract value includes: 1.
your purchase payments allocated to the fixed
account; 2. amounts transferred from a subaccount
to the fixed account at your request; and 3. the
interest credited to amounts so allocated or
transferred. Transfers and withdrawals from the
fixed account reduce the fixed account contract
value.
The initial fixed account interest rate credited
to the initial purchase payment is in effect
through the end of the guarantee period and is
shown in the contract schedule. At the beginning
of each subsequent guarantee period shown in the
contract schedule, we will declare the fixed
account interest rate applicable to the initial
purchase payment for each such subsequent
guarantee period. We will declare the fixed
account interest rate with respect to each
subsequent purchase payment received. Any such
purchase payment we receive will be credited that
rate through the end of the guarantee period
shown in the contract schedule. At the beginning
of each subsequent guarantee period, we will
declare the fixed account interest rate
applicable to each subsequent purchase payment
for such guarantee period.
We reserve the right to declare the fixed account
current interest rate(s) based upon: the issue
date; the date we receive a purchase payment; or
the date of account transfer.
We calculate the interest credited to the fixed
account by compounding daily, at daily interest
rates, rates which would produce at the end of a
contract year a result identical to the one
produced by applying an annual interest rate.
Page 5
Page 6
FIXED ACCOUNT PROVISIONS (Continued)
The minimum guaranteed fixed account interest
rate is shown in the contract schedule.
VARIABLE ACCOUNT PROVISIONS
Separate Account The variable benefits under this contract are
provided through the separate account identified
in the contract schedule. The separate account is
registered with the Securities and Exchange
Commission as a unit investment trust under the
Investment Company Act of 1940. It is a separate
investment account maintained by us into which a
portion of the company's assets have been
allocated for this contract and may be allocated
for certain other contracts.
Liabilities of Separate The assets equal to the reserves and other
Account liabilities of the separate account will not be
charged with liabilities arising out of any other
business we may conduct. We will value the assets
of the separate account on each valuation date.
Separate Account Contract On any valuation day the separate account
Value contract value is the sum of its subaccount
values.
Subaccounts The separate account consists of multiple
subaccounts as shown in the contract schedule. We
may, from time to time, combine or remove
subaccounts in the separate account and establish
additional subaccounts of the separate account.
In such event we may permit you to select other
subaccounts under this contract. However, the
right to select any other subaccount is limited
by the terms and conditions we may impose on such
transactions.
Fund Each subaccount of the separate account will buy
shares of a fund or a separate series of a fund.
Each fund is registered under the Investment
Company Act of 1940 as an open-end diversified
management investment company. Each series of a
fund represents a separate investment portfolio
which corresponds to one of the subaccounts of
the Separate Account.
If we establish additional subaccounts each new
subaccount will invest in a new series of a fund
or in shares of another investment company. We
may also substitute other investment companies.
Rights Reserved by the We reserve the right, subject to compliance with
Company the current law or as it may be changed in the
future:
1. To operate the separate account in any form
permitted under the Investment Company Act
of 1940 or in any other form permitted by
law;
2. To take any action necessary to comply with
or obtain and continue any exemptions from
the Investment Company Act of 1940 or to
comply with any other applicable law;
3. To transfer any assets in any subaccount to
another subaccount or to add, combine or
remove subaccounts in the separate account;
4. To delete the shares of any of the
portfolios of a fund or any other open-end
investment company and to substitute, for
the fund shares held in any subaccount, the
shares of another portfolio of a fund or the
shares of another investment company or any
other investment permitted by law; and
5. To change the way we assess charges, but not
to increase the aggregate amount above that
currently charged to the separate account
and the funds in connection with the
contracts.
VARIABLE ACCOUNT PROVISIONS (Continued)
When required by law, we will obtain your
approval of such changes and the approval of any
regulatory authority.
Accumulation Unit Value Each subaccount has an accumulation unit value.
When purchase payments or other amounts are
allocated to a subaccount, a number of units are
purchased based on the accumulation unit value of
the subaccount at the end of the valuation period
during which the allocation is made. When amounts
are transferred out of or deducted from a
subaccount, units are redeemed in a similar
manner.
The accumulation unit value for each subsequent
valuation period is the investment experience
factor for that period multiplied by the
accumulation unit value for the period
immediately preceding. Each valuation period has
a single accumulation unit value that is applied
to each day in the period. The number of
accumulation units will not change as a result of
investment experience.
Investment Experience Factor Each subaccount has its own investment experience
factor. The investment experience of the separate
account is calculated by applying the investment
experience factor to the cash value in each
subaccount during a valuation period.
The investment experience factor of a subaccount
for a valuation period is determined by dividing
1. by 2. and subtracting 3. from the result,
where:
1. is the net result of:
a. the net asset value per share of the
investment held in the subaccount determined
at the end of the current valuation period;
plus
b. the per share amount of any dividend or
capital gain distributions made by the
investments held in the subaccount, if the
"ex-dividend" date occurs during the current
valuation period; plus or minus
c. a charge or credit for any taxes reserved
for the current valuation period which we
determine resulted from the investment
operations of the subaccount;
2. is the net asset value per share of the
investment held in the subaccount,
determined at the end of the last valuation
period;
3. is the factor representing the mortality and
expense risk charge stated in the contract
schedule and any applicable charges for any
optional death benefits for the number of
days in the valuation period.
TRANSFER AND WITHDRAWAL PROVISIONS
Transfers During the Once each fifteen days all or part of the
Accumulation Period separate account contract value may be
transferred to another subaccount. Transfers may
also be made at that time to the fixed account
subject to the conditions stated in paragraph 7
below. We will allow the first transfer fifteen
days after the issue date.
Transfers will be subject to the following
conditions:
1. The minimum amount which may be transferred,
subject to paragraph 6 below, is $500 or, if
smaller, the remaining value in the fixed
account or a subaccount;
2. No partial transfer will be made if the
remaining contract value of the fixed
account or any subaccount will be less than
$500 unless the transfer will eliminate your
interest in such account;
Page 7
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TRANSFERS AND WITHDRAWAL PROVISIONS (Continued)
3. No transfer may be made within seven
calendar days of the date on which the first
annuity payment is due;
4. You may request an additional transfer from
the fixed account, subject to paragraph 6
below, to one or more subaccounts during the
thirty day period before the date on which
the first annuity payment is due. Such
transfer must become effective no later than
the seventh calendar day before such due
date;
5. When you request a transfer from the fixed
account contract value to a subaccount, we
will limit the amount that can be
transferred, subject to paragraph 6 below,
to the amount which exceeds debt and the
withdrawal charge, if any, applicable to the
total fixed account contract value for the
contract year during which the total
transfer is made.
6. Total transfers out of the fixed account in
any contract year may not excceed 25% of the
value of the fixed account as of: (a) the
prior contract anniversary; or (b) the issue
date for transfers made prior to the first
contract anniversary. Transfers made under a
systematic investment program that has been
approved by us are not subject to the above
limitation, but we reserve the right to
modify or terminate this provision and to
apply the above limitation to such
transfers.
7. Total transfers into the fixed account in
any contract year, that would be credited a
current interest rate of 3% or less, may not
exceed 25% of the contract value as of: (a)
the prior contract anniversary; or (b) the
issue date for transfers made prior to the
first contract anniversary. Transfers made
under a systematic investment program that
has been approved by us are not subject to
the above limitation, but we reserve the
right to modify or terminate this provision
and to apply the above limitation to such
transfers.
8. We reserve the right: (a) not to allow any
transfer into the fixed account if the fixed
account interest rate with respect to that
transfer would be less than or equal to 3%;
and, (b) to except from such transfer
limitation transfers made under an approved
systematic investment program.
We will transfer amounts bought by purchase
payments and all related accumulations received
in a given contract year, in the chronological
order we received them.
Any transfer request must clearly specify: 1. the
amount which is to be transferred; and 2. the
names of the accounts which are affected. We will
only honor a telephone transfer request if a
properly executed telephone transfer
authorization is on file with us. Such request
for a transfer must comply with the conditions of
the authorization.
We reserve the right at any time and without
notice to any party, to terminate, suspend, or
modify these transfer rights.
Withdrawals During the During the accumulation period, you may withdraw
Accumulation Period all or part of the contract value that remains
after we subtract any withdrawal charge, debt and
applicable premium taxes. We must receive a
written request that indicates the amount of the
withdrawal from the fixed account and each
subaccount. You must return the contract to us if
you elect a total withdrawal.
TRANSFER AND WITHDRAWAL PROVISIONS (Continued)
Withdrawals are subject to the conditions that
follow.
1. Each withdrawal must be at least $500 or the
value that remains in the fixed account or a
subaccount if smaller;
2. A minimum of $500 must remain in the account
after you make a withdrawal unless the
account is eliminated by such withdrawal;
3. The maximum you may withdraw from any
account is the value of the fixed account or
a subaccount less the amount of any
withdrawal charge;
4. Any withdrawal amount you request will be
increased by the withdrawal charge;
5. We will limit a withdrawal from the fixed
account to an amount which equals the fixed
account contract value less debt and
interest on any such loan to the end of the
contract year.
Withdrawal Charges 1. All purchase payments in a given contract
year and all related accumulations are
totaled by account and each total is used
separately in computing the withdrawal
charge as stated in the withdrawal charge
table shown in the contract schedule.
2. All amounts to be withdrawn and any
applicable withdrawal charges will be
charged first against purchase payments and
all related accumulations in the
chronological order we received such
purchase payments by contract year.
3. Any amount withdrawn which is not subject to
a withdrawal charge will be considered a
"partial free withdrawal."
4. In the event of a partial withdrawal, a
"partial free withdrawal" is applied against
purchase payments and all related
accumulations in the chronological order we
received such purchase payments by contract
year even though the purchase payments and
related accumulations are no longer subject
to a withdrawal charge.
Transfer and Withdrawal We will withdraw or transfer from the fixed
Procedures account as of the valuation date that follows the
date we receive your written or telephone
transfer request. To process a withdrawal, the
request must contain all required information.
We will redeem the necessary number of
accumulation units to achieve the dollar amount
when the withdrawal or transfer is made from a
subaccount. We will reduce the number of
accumulation units credited in each subaccount by
the number of accumulation units redeemed. The
reduction in the number of accumulation units is
determined on the basis of the accumulation unit
value at the end of the valuation period when we
receive the request, provided the request
contains all required information. We will pay
the amount within seven calendar days after the
date we receive the request, except as provided
below.
Deferment of Withdrawal If the withdrawal or transfer is to be made from
or Transfer a subaccount, we may suspend the right of
withdrawal or transfer or delay payment more than
seven calendar days: 1. during any period when
the New York Stock Exchange is closed other than
customary weekend and holiday closings; 2. when
trading in the markets normally utilized is
restricted, or an emergency exists as determined
by the Securities and Exchange Commission, so
that disposal of investments or determination of
the accumulation unit value is not practical; or
3. for such other periods as the Securities and
Exchange Commission by order may permit for
protection of owners.
We may defer the payment of a withdrawal or
transfer from the fixed account, for the period
permitted by law. This can never be more than six
months after you send us a written request.
During the period of deferral, we will continue
to credit interest, at the then current interest
rate(s), to the fixed account contract value.
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LOAN PROVISIONS
Loans You may request a loan any time before the
annuity date. You must assign this contract to us
as security for a loan.
The maximum loan available is the fixed account
contract value minus: 1. any withdrawal charge
that applies to the total fixed account contract
value in the year in which you make the loan; and
2. interest on the loan paid to the end of the
contract year in which you make the loan.
We may defer granting a loan for six months from
the date we receive the written loan request.
Loan Interest The loan interest is 5.50% per year compounded
daily at the daily equivalent of a 5.50% annual
rate. Interest is due at the end of each contract
year. If you do not pay interest when it is due,
we will add it to the loan and it will bear
interest at the same rate as the loan. We will
charge interest on a daily basis.
Loan Payment You may repay a debt in full or in part at any
time prior to the annuity date. If the debt
equals or exceeds the fixed account contract
value, less any withdrawal charge that applies to
the total withdrawal of the fixed account, your
interest in the fixed account will terminate. The
termination occurs thirty-one days after we mail
notice of termination to your last known address
and that of any assignee of record.
We will apply any repayment of debt: first to
reduce that part of the debt that can be
attributed to interest; and second to that part
of the debt that can be attributed to purchase
payments.
Effects of Loans on Interest While there is a loan, the portion of the fixed
Rates account contract value that equals the debt will
earn interest at 3.00% per year, compounded daily
at the daily equivalent of a 3.00% annual rate,
instead of the current interest rate.
DEATH BENEFIT PROVISIONS
Amount Payable Upon Death We compute the death benefit at the end of the
valuation period following: our receipt of due
proof of death; such other information we may
require to process the death benefit, and the
return of this contract.
If death occurs prior to the oldest owner
attaining age 75, we will pay the greater of: a.
the contract value less debt; or b. the total
amount of purchase payments, less debt and the
aggregate dollar amount of all adjustments for
withdrawals. We will pay the contract value less
debt if death occurs on or after the oldest
owner's 75th birthday.
Adjustments for Withdrawals The adjustment for withdrawals described above is
a dollar amount determined for each withdrawal
which is equal to (1) divided by (2), with the
result multiplied by (3), where:
1. is the withdrawal and withdrawal charge
amount;
2. is the contract value immediately prior to
the withdrawal; and
3. is the value of the death benefit immediatly
prior to the withdrawal.
DEATH BENEFIT PROVISIONS (Continued)
Payment of Death Benefits We will pay a death benefit before the annuity
date if the owner or a joint owner dies. If the
owner is a non-natural person, a death benefit
will be paid upon the death of an annuitant
before the annuity date.
When we pay the death benefit we will then have
no further obligation under this contract.
When you die, we will pay the death benefit in a
lump sum. This sum may be deferred for up to five
years from the date of your death.
Instead of a lump sum payment the beneficiary may
elect to have the death benefit distributed as
stated in Option 1 for a period not to exceed the
beneficiary's life expectancy; or Options 2, or 3
based upon the life expectancy of the beneficiary
as prescribed by federal regulations. The
beneficiary must make this choice within sixty
days of the time we receive due proof of death.
If the beneficiary is not a natural person, the
beneficiary must elect that the entire death
benefit be distributed within five years of your
death. Distribution of the death benefit must
start within one year after your death. It may
start later if prescribed by federal regulations.
Spousal Continuation If this contract was issued as a nonqualified
plan or an Individual Retirement Annuity ("IRA")
and your spouse is the primary beneficiary when
you die, the surviving spouse may elect to be the
successor owner of this contract. This is known
as a spousal continuation. In such case, no death
benefit will be payable upon your death.
Upon your death, your surviving spouse may
continue this contract thereby waiving claim to
the death benefit otherwise payable. Electing to
continue this contract under the spousal
continuation provision of this contract will
affect how the charges and benefits under this
contract and applicable endorsements and riders
are calculated or determined.
If a spousal continuation is elected, the
contract value will be adjusted to equal the
amount otherwise payable as a death benefit under
this contract subject to the following:
1. The contract value will be adjusted to equal
the amount of the death benefit. If the
death benefit otherwise payable exceeds the
contract value one day prior to the date of
continuance, such excess will be credited to
the money market subaccount listed in the
contract schedule. This amount may
subsequently be transferred from the money
market subaccount to other options under
this contract.
2. Upon the death of your surviving spouse
before the annuity date, the amount of the
death benefit payable will be determined as
if: (a) the contract was issued on the date
of continuance; and (b) the contract value
applied on the date of continuance resulted
from our receipt of an intial purchase
payment.
3. Withdrawal charges will not apply to
withdrawals made from contract value
credited on the date of continuance.
Withdrawal charges will apply to purchase
payments made after the date of continuance.
4. This contract may not be continued under a
subsequent spousal continuation.
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ANNUITY PERIOD PROVISIONS
Election of Annuity Option We must receive an election of an annuity option
in writing. You may make an election before the
annuity date. The beneficiary may make an
election when we pay the death benefit.
An election will be revoked by: 1. a subsequent
change of beneficiary; or 2. an assignment of
this contract unless the assignment provides
otherwise.
Subject to the terms of the death benefit
provision, the beneficiary may elect to have the
death benefit remain with us under one of the
annuity options.
If an annuity option is not elected by the
annuity date, an annuity will be paid under
Option 3 if there is one annuitant on the annuity
date or under Option 5 if there are joint
annuitants on the annuity date.
If the total contract value is applied under one
of the annuity options, this contract must be
surrendered to us.
An option can not be changed after the first
annuity payment is made.
If, on the seventh calendar day before the first
annuity payment due date, all the contract value
is allocated to the fixed account, the annuity
will be paid as a fixed annuity. If all of the
contract value on such date is allocated to the
separate account, the annuity will be paid as a
variable annuity. If the contract value on such
date is allocated to both the fixed account and a
subaccount, then the annuity will be paid as a
combination of a fixed and variable annuity. A
fixed and variable annuity payment will reflect
the investment performance of the subaccounts in
accordance with the allocation of the contract
values existing on such date. Allocations will
not be changed thereafter, except as provided in
the Transfers During The Annuity Period provision
of this contract.
Payments for all options are derived from the
applicable tables. Current annuity rates will be
used if they produce greater payments than those
quoted in the contract. The age in the tables is
the age of the annuitant on the last birthday
before the first payment is due.
The option selected must result in a payment that
is at least equal to our minimum payment,
according to our rules, at the time the annuity
option is chosen. If at any time the payments are
less than the minimum payment, we have the right
to increase the period between payments to
quarterly, semi-annual or annual so that the
payment is at least equal to the minimum payment
or to make payment in one lump sum.
Option 1 We will make monthly payments for 10 years.
Fixed Instalment Annuity
Option 2 We will make monthly payments while the annuitant
Life Annuity is alive.
Option 3 We will make monthly payments for a 10 year
Life Annuity With certain period and thereafter while the annuitant
Instalments Guaranteed is alive.
ANNUITY PERIOD PROVISIONS (Continued)
Option 4 We will pay the full monthly income while both
Joint and Survivor Annuity annuitants are alive. Upon the death of either
annuitant, we will continue to pay the a
percentage of the original monthly payment. The
percentage payable during the life of the
surviving annuitant must be selected at the time
the annuity option is chosen. The percentages
available are 50%, 66 2/3%, 75% and 100%.
Option 5 We will make monthly payments for a 10 year
Joint and Survivor Annuity certain period and thereafter while the
with Installments Guaranteed annuitants are alive.
Other Options We may make other annuity options available.
Payments are also available on a quarterly,
semi-annual or annual basis.
Fixed Annuity The fixed account contract value on the first day
preceding the date on which the first annuity
payment is due, is first reduced by any debt and
premium taxes that apply. The value that remains
will be used to determine the fixed annuity
monthly payment in accordance with the annuity
option selected.
Variable Annuity The separate account contract value, at the end
of the valuation period preceding the valuation
period that includes the date on which the first
annuity payment is due, is first reduced by any
premium taxes that may apply. The value that
remains is used to determine the first monthly
annuity payment. The first monthly annuity
payment is based upon the guaranteed annuity
option shown in the Annuity Option Table. You may
elect any option available.
The dollar amount of subsequent payments may
increase or decrease depending on the investment
experience of each subaccount. The number of
annuity units per payment will remain fixed for
each subaccount unless a transfer is made. If a
transfer is made, the number of annuity units per
payment will change.
The number of annuity units for each subaccount
is calculated by dividing a. by b. where:
a. is the amount of the monthly payment that
can be attributed to that subaccount; and
b. is the annuity unit value for that
subaccount at the end of the valuation
period. The valuation period includes the
date on which the payment is made.
Monthly annuity payments, after the first
payment, are calculated by summing up, for each
subaccount, the product of a. times b. where:
a. is the number of annuity units per payment
in each subaccount; and
b. is the annuity unit value for that
subaccount at the end of the valuation
period. The valuation period includes the
date on which the payment is made.
After the first payment, we guarantee that the
dollar amount of each annuity payment, will not
be affected adversely by actual expenses or
changes in mortality experience from the expense
and mortality assumptions on which we based the
first payment.
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ANNUITY PERIOD PROVISIONS (Continued)
Annuity Unit Value The value of an annuity unit, for each
subaccount, at the end of any subsequent
valuation period is determined by multiplying the
result of a. times b. by c. where:
a. is the annuity unit value for the
immediately preceding valuation period; and
b. is the net investment factor for the
valuation period for which the annuity unit
value is being calculated; and
c. is the interest factor of .99993235 per
calendar day of such subsequent valuation
period to offset the effect of the assumed
rate of 2.50% per year used in the Annuity
Option Table.
The net investment factor for each subaccount for
any valuation period is determined by dividing a.
by b. where:
a. is the value of an accumulation unit of the
applicable subaccount as of the end of the
current valuation period plus or minus the
per share charge or credit for taxes
reserved; and
b. is the value of an accumulation unit of the
applicable subaccount as of the end of the
immediately preceding valuation period, plus
or minus the per share charge or credit for
taxes reserved.
Transfer During the Annuity You may not convert fixed annuity payments to
Period variable annuity payments. However, during the
annuity period, you, by sending us a written
notice in a form satisfactory to us, may: convert
variable annuity payments to fixed annuity
payments; or have variable annuity payments
reflect the investment experience of other
subaccounts. A transfer may be made subject to
the following:
1. Transfer from a subaccount to the fixed
account can be effective only on an
anniversary of the first annuity payment
date. We must receive notice of such
transfer at least thirty days prior to the
effective date of the transfer;
2. Transfers from one subaccount to another
subaccount will be effective during the
valuation period next succeeding the date
the notice is received by us. However, no
transfers may be made during the seven days
immediately preceding an annuity payment
date. No transfer to a subaccount may be
made during the first year of the annuity
period. In subsequent years all transfers
between subaccounts will be made on the same
day in a given year and are limited to one
transfer each year;
3. You may not have more than three subaccounts
after any transfer; and
4. Your entire interest in a subaccount must be
transferred.
The number of annuity units per payment
attributable to a subaccount to which transfer is
made is equal to, in the case of a transfer
between subaccounts, the number of annuity units
per payment in the subaccount from which transfer
is being made multiplied by the annuity unit
value for that subaccount, such amount being
divided by the annuity unit value for the
subaccount to which transfer is being made.
The amount of money allocated to the fixed
account in the event of a transfer from
subaccount equals the annuity reserve for the
owner's interest in such subaccount. The annuity
reserve is the product of a. multiplied by b.
multiplied by c. where: a. is the number of
annuity units representing the owner's interest
in such subaccount per annuity payment; b. is the
annuity unit value for such subaccount; and c. is
the present value of $1.00 per payment period
using the attained age(s) of the annuitant(s) and
any remaining guaranteed payments that may be due
at the time of the transfer. The guaranteed
monthly payments are based on an interest rate of
2.50% per year and, where mortality is involved,
the "Annuity 2000 Table" developed by the Society
of Actuaries projected using Scale G to the year
2015. Money allocated to the fixed account upon
such transfer will be applied under the same
annuity option as originally elected. Any
guaranteed period payments will be adjusted to
reflect the number of guaranteed payments already
made. If all guaranteed payments have already
been made, no further payments will be
guaranteed.
ANNUITY PERIOD PROVISIONS (Continued)
All amounts and annuity unit values are
determined as of the end of the annuity valuation
period which precedes the effective date of the
transfer.
We reserve the right at any time and without
notice to any party to terminate, suspend or
modify the transfer privileges.
Supplementary Agreement A supplementary agreement will be issued to
reflect payments that will be made under a
settlement option. If payment is made as a death
benefit distribution, the effective date will be
the date of death. Otherwise the effective date
will be the date chosen by the owner.
Date of First Payment Interest, under an option, will start to accrue
on the effective date of the supplementary
agreement.
Evidence of Age, Sex and We may require satisfactory evidence of the age,
Survival sex and the continued survival of any person on
whose life the income is based.
Misstatement of Age or Sex If the age or sex of the annuitant(s) has been
misstated, the amount payable under this contract
will be such as the purchase payments sent to us
would have purchased at the correct age or sex.
Interest not to exceed 6% compounded each year
will be charged to any overpayment or credited to
any underpayment against future payments we may
make under this contract.
Basis of Annuity Options The guaranteed monthly payments are based on an
interest rate of 2.50% per year and, where
mortality is involved, the "Annuity 2000 Table"
developed by the Society of Actuaries projected
using Scale G to the year 2015.
Disbursement of Funds Upon When the annuitant dies, the value of any unpaid
Death of Annuitant Under installments will be paid, in one sum, to the
Options 1, 3 or 5 owner. The commuted value based upon a minimum
interest rate of not less than 2.50% will be
paid. The commuted value of any variable
installments will be determined by applying the
annuity unit value next determined following our
receipt of due proof of death.
Payment of Death Benefits If an owner, who is not also an annuitant, dies
During the Annuity Period after the annuity date, the following provisions
Upon Death of an Owner apply:
1. If the owner was the sole owner, the
remaining annuity payments will be payable
to the beneficiary in accordance with the
annuity option in effect. The beneficiary
will become the owner.
2. If this contract has joint owners, the
annuity payments will be payable to the
surviving joint owner in accordance with the
terms of the annuity option in effect. Upon
the death of the surviving joint owner, the
beneficiary becomes the owner.
Protection of Benefits Unless otherwise provided in the supplementary
agreement, the owner may not commute, anticipate,
assign, alienate or otherwise hinder the receipt
of any payment.
Creditors The proceeds of this contract and any payment
under an annuity option will be exempt from the
claim of creditors and from legal process to the
extent permitted by law.
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ANNUITY OPTION TABLE
AMOUNT OF MONTHLY PAYMENT FOR EACH $1,000 OF VALUE APPLIED
Option One - Fixed Installment Annuity
Number
of years Monthly
selected Payment
-------- -------
10 9.39
Options Two and Three - Life Annuity With Installments Guaranteed
Age of Monthly Payments Guaranteed Age of Monthly Payments Guaranteed
Male --------------------------- Female ---------------------------
Annuitant None 120 Annuitant None 120
--------- ----- ---- --------- ----- ----
55 4.00 3.96 55 3.71 3.70
56 4.08 4.04 56 3.78 3.76
57 4.17 4.12 57 3.86 3.83
58 4.26 4.21 58 3.93 3.91
59 4.36 4.30 59 4.02 3.99
60 4.46 4.40 60 4.10 4.07
61 4.57 4.50 61 4.20 4.16
62 4.69 4.60 62 4.29 4.25
63 4.81 4.71 63 4.40 4.35
64 4.95 4.83 64 4.51 4.45
65 5.09 4.95 65 4.63 4.56
66 5.24 5.08 66 4.75 4.68
67 5.41 5.22 67 4.89 4.80
68 5.58 5.36 68 5.03 4.93
69 5.76 5.50 69 5.19 5.06
70 5.96 5.65 70 5.36 5.21
71 6.17 5.81 71 5.54 5.36
72 6.39 5.97 72 5.73 5.52
73 6.62 6.13 73 5.94 5.69
74 6.88 6.30 74 6.17 5.86
75 7.14 6.47 75 6.41 6.04
76 7.43 6.65 76 6.68 6.23
77 7.73 6.83 77 6.96 6.42
78 8.06 7.01 78 7.26 6.62
79 8.41 7.18 79 7.59 6.82
80 8.79 7.36 80 7.95 7.02
81 9.19 7.54 81 8.34 7.23
82 9.62 7.71 82 8.76 7.43
83 10.08 7.88 83 9.21 7.62
84 10.57 8.04 84 9.71 7.81
85 11.10 8.20 85 10.24 8.00
Option Four - Joint and 100% Survivor Annuity
Age of Age of Female Annuitant
Male ----------------------------------------------------
Annuitant 55 60 65 70 75 80 85
--------- ---- ---- ---- ---- ---- ---- ----
55 3.38 3.53 3.67 3.77 3.86 3.91 3.95
60 3.48 3.68 3.88 4.06 4.20 4.30 4.37
65 3.56 3.81 4.08 4.35 4.59 4.77 4.91
70 3.62 3.92 4.26 4.63 4.99 5.32 5.57
75 3.65 3.99 4.39 4.87 5.39 5.90 6.34
80 3.68 4.03 4.49 5.05 5.73 6.46 7.18
85 3.69 4.06 4.55 5.18 5.99 6.96 8.01
Option Five - Joint Life Annuity with Installments Guaranteed
Age of Age of Female Annuitant
Male ----------------------------------------------------
Annuitant 55 60 65 70 75 80 85
--------- ---- ---- ---- ---- ---- ---- ----
55 3.38 3.53 3.66 3.77 3.85 3.91 3.94
60 3.48 3.68 3.88 4.05 4.19 4.29 4.35
65 3.56 3.81 4.08 4.34 4.57 4.74 4.86
70 3.61 3.91 4.25 4.61 4.96 5.26 5.46
75 3.65 3.98 4.38 4.84 5.33 5.78 6.13
80 3.67 4.03 4.47 5.01 5.63 6.26 6.78
85 3.69 4.05 4.52 5.12 5.84 6.63 7.34
Rates for ages not shown here will be provided upon request.
FIXED AND VARIABLE DEFERRED ANNUITY
NON-PARTICIPATING
ALL BENEFITS, PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED UPON THE
INVESTMENT EXPERIENCE OF THE SUBACCOUNTS, ARE VARIABLE AND ARE NOT GUARANTEED AS
TO DOLLAR AMOUNT. REFER TO THE VARIABLE ACCOUNT AND ANNUITY PERIOD PROVISIONS
FOR A DETERMINATION OF ANY VARIABLE BENEFITS.
This is a legal contract between the owner and Federal Xxxxxx Life Assurance
Company.
READ YOUR CONTRACT CAREFULLY
Federal Xxxxxx Life Assurance Company
0000 XxXxxxxx Xxxxxxx, Xxxxxxxxxx, Xxxxxxxx 00000-0000
