CONTRACT SCHEDULE
Exhibit 4 Contract Schedule
| CONTRACT NUMBER: [12345678] | ANNUITY DATE: [Max Age = 100] | |||
| ISSUE DATE: [10/01/2003] | CONTRACT SCHEDULE DATE: [10/01/2003] | |||
PRODUCT VERSION: [Evolution]
CONTRACT OWNER: [XXXX XXX]
AGE AND SEX: [35]
JOINT OWNER: [ ]
AGE AND SEX: [Maximum Issue Age 90]
ANNUITANT: [XXXX XXX]
AGE AND SEX: [35]
| BENEFICIARY: | As designated by the Contract Owner at the Issue Date, or as otherwise changed or provided in accordance with the Contract. |
PURCHASE PAYMENTS
Initial Purchase Payment: [$50,000.00]
Minimum Subsequent Purchase Payment: $250, or, if the automatic investment plan option is elected, $100.
Maximum Total Purchase Payments: For a Contract Owner up to Age 75 on the Issue Date, the maximum total Purchase Payments are $1,000,000; for a Contract Owner over Age 75 on the Issue Date, the maximum total Purchase Payments are $500,000. Purchase Payments above these amounts must be pre-approved by the Company. For a Joint Contract Owner, Age refers to the oldest Joint Contract Owner. If the Contract is owned by a non-natural person, then Contract Owner shall mean Annuitant.
Allocation Guidelines:
| 1. | The Contract Owner may have Purchase Payments allocated to the Separate Account(s) subject to the conditions imposed on such allocations by the Company. However, we reserve the right to limit the number of investment choices that you may invest in to a maximum of 18 at any one time. |
| 2. | The Contract Owner may have Purchase Payments allocated to the Fixed Account(s) subject to the conditions imposed on such allocations by the Company. [Currently, the allocation of any Net Purchase Payment to the Fixed Account will be limited to 70% of the total Net Purchase Payment.] The Company reserves the right, upon 30 days advance notice to the Contract Owner, to limit the allocation of any Net Purchase Payment to the Fixed Account. |
| Purchase Payments may not be allocated to the Fixed Account if the Contract Owner is participating in either the Guaranteed Minimum Accumulation Benefit (GMAB) or Guaranteed Minimum Income Benefit (GMIB). However, the Company reserves the right, upon 30 days |
| TMLS-EV.1 | 4A | [9-07] |
Exhibit 4 Contract Schedule
| advance notice to the Contract Owner, to modify permissible allocations to the Fixed Account and/or Sub-Accounts. |
| 3. | If the Purchase Payments and forms required to issue a Contract are in good order, the initial Net Purchase Payment will be credited to the Contract within two (2) business days after receipt at the Annuity Service Center. Additional Purchase Payments will be credited to the Contract as of the Valuation Period when they are received in good order. |
TRANSFERS
Minimum and Maximum Amount to be Transferred: The minimum amount of a transfer is $1,000 per transfer request (from one or multiple Sub-Accounts and the Fixed Account(s) during the Accumulation Period) or the Contract Owner’s entire interest in the Sub-Account or Fixed Account(s), if less. This requirement is waived if the transfer is made in connection with any scheduled transfer program (e.g. dollar cost averaging, rebalancing, asset allocation, interest sweep) offered by the Company.
For any Contract Year, transfers out of the Declared Interest Rate Fixed Account are limited in amount to 30% of the Contract Value allocated to such account at the time of the first transfer in that Contract Year. The entire Contract Value allocated to the Fixed Account may be transferred in the Contract Year following 30% transfers in each of the immediately preceding three Contract Years, provided that Purchase Payments or transfers have not been applied to the Fixed Account(s) from the time the first annual transfer was made.
Transfers out of the Fixed Account(s) are done on a first-in-first-out basis. [Currently, the Company will limit transfers from the Separate Account such that no transfer can cause the Fixed Account to exceed 70% of the Contract Value.] The Company reserves the right, upon 30 days advance notice to the Contract Owner, to limit transfers from the Separate Account to the Fixed Account.
Transfers between Competing Accounts are not allowed except as provided below. The Fixed Account(s) and the money market Sub-Account are considered Competing Accounts. For a period of ninety (90) days following a transfer out of a Competing Account, no transfers may be made into that same account or any other Competing Account. However, transfers may be made from the money market Sub-Account to the Fixed Account(s) without regard to the Competing Accounts restrictions.
Number of Transfers: The Contract Owner may make unlimited transfers during the Accumulation Period and 6 transfers per calendar year during the Annuity Period, subject to the conditions imposed on such transfers by the Company. The Company reserves the right to limit transfers when the transfer privilege is being exercised to the detriment of other Contract Owners. The Company further reserves the right, upon 30 days advance notice to the Contract Owner, to limit the number of transfers in the future.
Unscheduled transfers may not be made if the Contract Owner is participating in either the Guaranteed Minimum Accumulation Benefit (GMAB) or Guaranteed Minimum Income Benefit (GMIB); provided, however, that the Company reserves the right, upon 30 days advance notice to the Contract Owner, to modify permissible transfers to the Fixed Account and/or Sub-Accounts.
Free Transfers: 12 per calendar year during the Accumulation Period; 6 per calendar year during the Annuity Period. All transfers made during a Valuation Period are deemed to be one transfer.
Transfer Fee: The Transfer fee will not exceed $20 for each transfer in excess of the Free Transfers. In addition, this requirement is waived if transfers are made in connection with any scheduled transfer program offered by the Company or through an automatic voice response system or the internet.
| TMLS-EV.1 | 4B | [9-07] |
Exhibit 4 Contract Schedule
Minimum Amount Which Must Remain In a Sub-Account or the Fixed Account(s) After a Transfer: $1,000; or if the entire amount in the Sub-Account or Fixed Account(s) is less than $1,000, the entire amount must be transferred.
WITHDRAWALS
Contingent Deferred Sales Charge (CDSC): A Contingent Deferred Sales Charge is assessed against the amount of the Contract Value withdrawn and may be applied to an Annuity Option. The charge is calculated at the time of each withdrawal or if applicable, at the time of annuitization. For partial withdrawals, the charge is deducted from the remaining Contract Value and is deducted from the Sub-Accounts and Fixed Account(s) in the same proportion that the amount of withdrawal from the Sub-Account or Fixed Account(s) bears to the total of the partial withdrawal.
| Contract Year: |
1 | 2 | 3 | 4 | 5 | 6 | and thereafter | |||||||||||||
| CDSC % of Contract Value: |
7 | % | 6 | % | 6 | % | 4 | % | 3 | % | 0 | % |
Free Withdrawal Amount: During the first Contract Year, the Contract Owner may withdraw up to 10% of the Purchase Payments reduced by any Free Withdrawal Amount(s) previously taken during such Contract Year. Beginning in the second Contract Year, the Contract Owner may withdraw up to 10% of the Contract Value determined as of the end of the previous Contract Year plus 10% of any Purchase Payment received in the current Contract Year reduced by any Free Withdrawal Amount(s) previously taken during the current Contract Year.
Withdrawal Charge: None
Minimum Partial Withdrawal: $250
Minimum Contract Value Which Must Remain in the Contract After a Partial Withdrawal: [Qualified Plan: $2,000; Non-Qualified Plan: $5,000]
Number of Partial Withdrawals Permitted: [Currently, No Limit.] Guaranteed Minimum of one per Contract Year.
ANNUITY GUIDELINE PARAMETERS
| 1. | If the amount to be applied under an Annuity Option is less than $2,000 for a full annuitization, the Company reserves the right to pay the amount in a lump sum. If any Annuity Payment is less than $100, the Company reserves the right to change the payment basis to equivalent quarterly, semi-annual or annual payments. The Company reserves the right to limit the number of partial annuitizations to a maximum of one per Contract Year. The minimum amount for a partial annuitization is $10,000. |
| 2. | The Annuity Date must be the 1st through the 28th day of the month. Any full or partial annuitization cannot be earlier than thirty days after the Issue Date. |
| 3. | The latest permitted Annuity Date is the earlier of: |
| (a) | the 100th birthday of the Annuitant or the oldest Joint Annuitant; |
| (b) | the latest date permitted under state law; or |
| (c) | the 100th birthday of the Contract Owner or the oldest Joint Owner. |
| TMLS-EV.1 | 4C | [9-07] |
Exhibit 4 Contract Schedule
CONTRACT CHARGES
| TYPE | DESCRIPTION/ AMOUNT | |
| Mortality And Expense Risk Charge | [The current charge is equal on an annual basis to 1.40% of the average daily net asset value of the Separate Account.] The maximum charge is equal on an annual basis to 1.75% of the average daily net asset value of the Separate Account. | |
| Administrative Charge | [The current charge is equal on an annual basis to 0.15% of the average daily net asset value of the Separate Account.] The maximum Administrative Charge will not exceed 0.25% of the average daily net asset value of the Separate Account. | |
| Annual Contract Maintenance Charge | [Currently, on the last day of each Contract Year an annual fee of $40.00 per Contract Year will be deducted.] If a total withdrawal is made on other than the last day of the Contract Year, the Annual Contract Maintenance Charge will be deducted at the time of the total withdrawal. If the Annuity Date for a full annuitization is not the last day of the Contract Year, then a pro-rata portion of the Annual Contract Maintenance Charge will be deducted on the Annuity Date. The maximum charge will not exceed $60.00 per Contract Year.
This charge will be deducted at the end of each Contract Year from the Sub-Accounts in the same proportion that the amount of the Contract Value in each Sub-Account bears to the total Contract Value.
During the Annuity Period, the Annual Contract Maintenance Charge will be deducted pro-rata from Annuity Payments regardless of Contract size and will result in a reduction of each Annuity Payment. |
| TMLS-EV.1 | 4D | [9-07] |
Exhibit 4 Contract Schedule
CONTRACT CHARGES FOR OPTION(S) SELECTED
| TYPE | DESCRIPTION/ AMOUNT | |
| [Annual Ratchet Death Benefit Charge | [The current charge is equal on an annual basis to 0.40% of the average daily net asset value of the Separate Account.] The maximum charge on an annual basis will not exceed 0.90% of the average daily net asset value of the Separate Account.] | |
| [Guaranteed Minimum Accumulation Benefit Charge (GMAB) | [The current charge is equal on an annual basis to 0.50% of the average daily net asset value of the Separate Account.] The maximum charge on an annual basis will not exceed 1.00% of the average daily net asset value of the Separate Account. If the Contract Owner elects by Written Request to discontinue the GMAB Rider and its associated benefit, the charge will be discontinued upon the Company’s receipt of such request.] | |
| [Guaranteed Minimum Income Benefit Charge (GMIB) | [The current charge is equal to [0.65%] of the Guaranteed Minimum Income Benefit and will be assessed up to and including the date on which the GMIB Rider is annuitized. The charge will be deducted [on a quarterly basis] from the Contract Value during each applicable Contract Year.] The maximum charge will not exceed 1.50% of the Guaranteed Minimum Income Benefit. If the Contract Owner elects by Written Request to discontinue the GMIB Rider and its associated benefit, the charge will be discontinued upon the Company’s receipt of such request.] |
| TMLS-EV.1 | 4E | [9-07] |
Exhibit 4 Contract Schedule
CONTRACT CREDITS
| TYPE | DESCRIPTION/ AMOUNT | |
| Electronic Document Delivery Credit | For any Contract Year prior to [2008], in which the Contract Owner is participating in any electronic document delivery program offered by the Company for this product on a Contract Anniversary Date, a [$24] credit will be applied on such Contract Anniversary proportionately to the Sub-Accounts of the Separate Account that the Contract Owner is invested in as of the date of the calculation. The Company reserves the right to continue, modify or discontinue this benefit for any Contract Year after [2007]. |
| TMLS-EV.1 | 4F | [9-07] |
Exhibit 4 Contract Schedule
| RIDERS
|
RIDER EFFECTIVE DATE
| |
| [Basic Death Benefit Rider] | [10/01/2003] | |
| [Death Benefit Rider with Annual Ratchet Feature] | [10/01/2003] | |
| [Fixed Account with Declared Interest Rate Rider] | [10/01/2003] | |
| [Fixed Account for Dollar Cost Averaging Rider] | [10/01/2003] | |
| [Guaranteed Minimum Accumulation Benefit Rider] | [10/01/2003] | |
| [Guaranteed Minimum Income Benefit Rider] | [10/01/2003] | |
| [Nursing Home Benefit Rider] | [10/01/2003] | |
| [Individual Retirement Annuity Rider] | [10/01/2003] | |
| [Xxxx Individual Retirement Annuity Rider] | [10/01/2003] | |
| [SIMPLE XXX Xxxxx] | [10/01/2003] | |
| [Qualified Plan Rider] | [10/01/2003] | |
| [Unisex Annuity Rates Rider] | [10/01/2003] |
ANNUITY SERVICE CENTER:
Massachusetts Mutual Life Insurance Company
[Annuity Service Center
P.O. Box 9067
Springfield, MA 01102-9067]
| TMLS-EV.1 | 4G | [9-07] |
Exhibit 4 Contract Schedule
FIXED ACCOUNT(S)
FIXED ACCOUNT(S):
The Minimum Guaranteed Interest Rate is [2.00% years 1-10; 3.00% thereafter].
SEPARATE ACCOUNT(S):
[Massachusetts Mutual Variable Annuity Separate Account 4].
| Eligible Investments, Series: | Sub-Accounts: | |
| [AIM Variable Insurance Funds |
||
| AIM V.I. Financial Services Fund (Series I Shares) |
AIM V.I. Financial Services | |
| AIM V.I. Global Health Care Fund (Series I Shares) |
AIM V.I. Global Health Care | |
| AIM V.I. Technology Fund (Series I Shares) |
AIM V.I. Technology | |
| Fidelity® Variable Insurance Products Fund |
||
| Fidelity® VIP Contrafund® Portfolio (Initial Class) |
Fidelity® VIP Contrafund® | |
| ING Investments |
||
| ING VP Real Estate Portfolio |
ING VP Real Estate Portfolio | |
| MML Series Investment Fund |
||
| MML Asset Allocation Fund |
MML Capital Guardian Asset Allocation | |
| MML Blue Chip Growth Fund |
MML X. Xxxx Price Blue Chip Growth | |
| MML Concentrated Growth Fund Class I |
MML Xxxx Xxxxx Concentrated Growth | |
| MML Emerging Growth Fund |
MML Emerging Growth | |
| MML Equity Income Fund |
MML X. Xxxx Price Equity Income | |
| MML Equity Index Fund Class I |
MML Equity Index | |
| MML Foreign Fund |
MML Xxxxxxxxx Foreign | |
| MML Global Fund Class I |
MML Xxxxxxxxx Xxxxxx Global | |
| MML Growth & Income Fund |
MML Capital Guardian Growth & Income | |
| MML Growth Equity Fund |
MML GMO Growth Equity | |
| MML Income & Growth Fund |
MML American Century Income & Growth | |
| MML Large Cap Growth Fund |
MML AllianceBernstein Large Cap Growth | |
| MML Large Cap Value Fund |
MML Xxxxx Large Cap Value | |
| MML Mid Cap Growth Fund |
MML X. Xxxx Price Mid Cap Growth | |
| MML Mid Cap Value Fund |
MML American Century Mid Cap Value | |
| MML OTC 100 Fund |
MML OTC 100 | |
| MML Small Cap Growth Equity Fund |
MML W&R/Wellington Small Cap Growth Equity | |
| MML Small Cap Index Fund |
MML Small Cap Index | |
| MML Small Cap Value Fund |
MML Xxxxxxx Xxxxx Small Cap Value | |
| MML Series Investment Fund II |
||
| MML Blend Fund |
MML Babson Blend | |
| MML Enhanced Index Core Equity Fund |
MML Babson Enhanced Index Core Equity | |
| MML Equity Fund |
MML Xxxxxxxxxxx/Xxxxxxxxx Equity | |
| MML Inflation Protected Bond Fund |
MML Babson Inflation Protected Bond | |
| MML Managed Bond Fund |
MML Babson Managed Bond | |
| MML Small Cap Equity Fund |
MML Xxxxxxxxxxx Small Cap Equity | |
| MML Small Company Opportunities Fund |
MML Xxxxxxxxxxx Small Company Opportunities] | |
| TMLS-EV.1 | 4H | [9-07] |
Exhibit 4 Contract Schedule
| [Xxxxxxxxxxx Variable Account Funds |
||
| Xxxxxxxxxxx Balanced Fund/VA |
Xxxxxxxxxxx Balanced | |
| Xxxxxxxxxxx Capital Appreciation Fund/VA |
Xxxxxxxxxxx Capital Appreciation | |
| Xxxxxxxxxxx Global Securities Fund/VA |
Xxxxxxxxxxx Global Securities | |
| Xxxxxxxxxxx High Income Fund/VA |
Xxxxxxxxxxx High Income | |
| Xxxxxxxxxxx Main Street Fund®/VA |
Xxxxxxxxxxx Main Street | |
| Xxxxxxxxxxx XxxXxx Fund/VA |
Xxxxxxxxxxx XxxXxx | |
| Xxxxxxxxxxx Money Fund/VA |
Xxxxxxxxxxx Money | |
| Xxxxxxxxxxx Strategic Bond Fund/VA |
Xxxxxxxxxxx Strategic Bond | |
| PIMCO |
||
| PIMCO CommodityRealReturn Strategy Portfolio |
PIMCO CommodityRealReturn Strategy Portfolio | |
| Panorama Series Fund, Inc. |
||
| Xxxxxxxxxxx International Growth Fund/VA |
Xxxxxxxxxxx International Growth] | |
| TMLS-EV.1 | 4I | [9-07] |
Exhibit 4
GMIB Rider
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY
Springfield, MA 01111-0001
GUARANTEED MINIMUM INCOME BENEFIT RIDER
This rider modifies the Contract to which it is attached. The effective date of this rider is the Rider Effective Date shown on the Contract Schedule. This rider is not available for selection on or after Age [76]. In the case of a conflict with any provision in the Contract, the provisions of this rider will control.
The Contract is modified as follows:
The Guaranteed Minimum Income Benefit is established for the sole purpose of determining a minimum amount for the Contract Owner to annuitize the Contract. The Guaranteed Minimum Income Benefit will initially be equal to the Purchase Payments made within the first two Contract Years increased at the beginning of each Contract Year by an annual interest rate of [5% or 6%] adjusted for withdrawals as provided in the Adjustment for Withdrawals section below. The Guaranteed Minimum Income Benefit is available upon annuitization of the Contract. Partial annuitizations are considered withdrawals for the purposes of this rider. Any Purchase Payments made after the second Contract Year following the Rider Effective Date may reduce the value of the benefit under this rider.
Additional Purchase Payments made within the first two Contract Years are added to the Guaranteed Minimum Income Benefit, increased on a pro-rated basis from the date of receipt by the annual interest rate of [5% or 6%].
Adjustment For Withdrawals. For withdrawals, the Guaranteed Minimum Income Benefit is equal to the most recently calculated Guaranteed Minimum Income Benefit reduced by the withdrawal amount, provided such amount does not exceed the interest credited during the Contract Year. If the withdrawal amount is in excess of the interest credited, the Guaranteed Minimum Income Benefit will be further reduced by an adjustment for additional withdrawals. The adjustment is equal to A divided by B, with the result multiplied by C, where:
A = the withdrawal amount in excess of the interest credited during the Contract Year;
B = the Contract Value immediately prior to the withdrawal; and
C = the most recently calculated Guaranteed Minimum Income Benefit.
The benefit waiting period is [ten years] after the later of the Rider Effective Date or the last reset date.
The Guaranteed Minimum Income Benefit is subject to the following conditions:
| 1. | The Contract Owner may only use the Guaranteed Minimum Income Benefit by annuitizing the Contract on any Contract Anniversary after the expiration of the benefit waiting period provided the Annuitant is at least Age [60] but not older than Age [85]. The Guaranteed Minimum Income Benefit ends upon the Contract Anniversary following the Annuitant’s Age [85], and no further charges for this benefit will be assessed. |
| • | If there has not been a reset of the Guaranteed Minimum Income Benefit, the portion of the Contract Value applied towards annuitizing the Guaranteed Minimum Income Benefit will be in the same proportion as the Purchase Payments received in the first two Contract Years bears to the total Purchase Payments received. The remaining portion of the Contract Value not applied will be available for use outside the Guaranteed Minimum Income Benefit. |
| GMIB.2 | 1 | [5% or 6%-09-07] |
Exhibit 4
GMIB Rider
| • | If there has been a reset of the Guaranteed Minimum Income Benefit, the portion of the Contract Value applied toward annuitizing the GMIB will be equal to A divided by B, where |
A = the last reset amount; and
B = the last reset amount plus Purchase Payments applied since the last reset.
The Company must receive Written Request to annuitize the Contract within 30 calendar days prior to the Contract Anniversary on which annuity payments will commence.
| 2. | The benefit is capped at [200% or 250%] of the Purchase Payments made within the first two Contract Years adjusted for withdrawals as provided in the Adjustment For Withdrawals section of this rider. |
| 3. | The method of annuitization chosen may be a Variable Annuity, a Fixed Annuity, or a combination Fixed and Variable Annuity. If a combination is elected, the Contract Owner must specify what part of the Guaranteed Minimum Income Benefit is to be applied to the Fixed and Variable options. Annuity Options available include Life and Joint and Survivor Life which may have a period certain feature. A Period Certain Annuity is also available; provided, however, that the period certain must be at least [twenty (20)] years. |
| • | Fixed Annuity payments will be determined in accordance with the Contract provisions with the following exception: if the Guaranteed Minimum Income Benefit applied to the Annuity Purchase Rates set forth in the Fixed Annuity Rate Tables produces a higher payment, the Annuitant will receive the higher Fixed Annuity payment. |
| • | Variable Annuity payments will be determined in accordance with the Contract provisions with the following exception: if the Guaranteed Minimum Income Benefit applied to the Annuity Purchase Rates set forth in the Fixed Annuity Rate Tables based on an assumed effective annual interest rate of [4%] produces a higher initial payment, the Annuitant will receive the higher initial Variable Annuity payment. |
Reset Option
On each Contract Anniversary, beginning with the second Contract Anniversary, the Contract Owner may elect to reset the Guaranteed Minimum Income Benefit to the Contract Value as of the Contract Anniversary.
This reset will begin a new [ten-year] benefit waiting period. The Contract Owner must elect the reset by Written Request, within 30 calendar days prior to the Contract Anniversary.
If the Contract Value is less than the Guaranteed Minimum Income Benefit, the reset will not take place and the existing Guaranteed Minimum Income Benefit and benefit waiting period will remain in place.
If the Contract Value (that is, the Contract Value as of the reset, adjusted for subsequent withdrawals and investment experience) exceeds the Guaranteed Minimum Income Benefit, the Company will increase the Guaranteed Minimum Income Benefit to equal the Contract Value. The reset option is only available up to and including Age [75].
The following GMIB Reset Option Examples provide an illustration of how the reset option feature will work when the Guaranteed Minimum Income Benefit is less than the Contract Value (Example 1) and when the Guaranteed Minimum Income Benefit is more than the Contract Value (Example 2).
| GMIB.2 | 2 | [5% or 6%-09-07] |
Exhibit 4
GMIB Rider
GMIB Reset Option Examples: (The examples assume an initial Purchase Payment of $100,000 only.)
| Example 1: | Example 2: | |
| [Contract issue 09/01/2007 with GMIB Rider | Contract issue 09/01/2007 GMIB Rider | |
| Purchase Payments in first two years: $100,000 | Purchase Payments in first two years: $100,000 | |
| No further payments or withdrawals | No further payments or withdrawals | |
| GMIB: $110,250 as of 08/31/2009 (benefit waiting period ends 08/31/2017) |
GMIB: $110,250 as of 08/31/2009 (benefit waiting period ends 08/31/2017) | |
| Contract Value at end of year 2: $120,000 | Contract Value at end of year 2: $90,000 | |
| Reset chosen as of 2nd Contract Anniversary (09/01/2009) |
Reset chosen as of 2nd Contract Anniversary (09/01/2009) | |
| New GMIB: $126,000 ($120,000 x 5% credited New benefit waiting period now ends 08/31/2020 |
No Reset, since Contract Value is less than GMIB - GMIB will be $115,763 ($110,250 x 5% credited interest) | |
| Benefit waiting period still ends 08/31/2017 | ||
| $6,000 available during Contract Year as dollar- for-dollar withdrawal |
$5,513 available during Contract Year as dollar- for-dollar withdrawal] | |
Withdrawal Benefit for Annuity Options with Period Certain Payment Feature
If a Variable Annuity Option with a Period Certain Payment feature has been chosen, the Contract Owner may, upon Written Request, withdraw a portion of the Commuted Value of any remaining Period Certain Payments, subject to the following conditions:
| 1. | A partial or full withdrawal may be made from a Contract. |
| • | Partial withdrawals are limited to [1] per Contract Year and must be a minimum amount of [$5000]. |
| • | The remaining payment after a partial withdrawal must be at least [$100]. |
| 2. | Any request for a withdrawal will be taken proportionately from the Sub-Accounts of the Separate Account that the Contract Owner is invested in as of the date of the withdrawal. |
| 3. | The amount of any withdrawal will be paid by the Company within seven (7) calendar days of the Written Request unless the Suspension or Deferral of Payments Provision is in effect. |
| 4. | Life Contingent payments cannot be withdrawn. |
Commuted Value
The Commuted Value of the remaining Period Certain Annuity Payments is calculated using the Commuted Value Formula specified herein. All Commuted Values will be determined upon the Company’s receipt of a Written Request. Upon receipt of such Written Request, the Contract Owner will be provided with a notice of the amount payable, how the amount was determined and the impact on remaining Annuity Payments, if applicable.
| GMIB.2 | 3 | [5% or 6%-09-07] |
Exhibit 4
GMIB Rider
Once a withdrawal is made, the remaining Period Certain Annuity Payments will be reduced proportionally. Withdrawals will not affect Annuity Payments that are to be made after the Period Certain is over, if any.
Commuted Value Formula
The Commuted Value is the actuarial present value of remaining Annuity Payments that are being withdrawn, in accordance with the terms and conditions of the Contract. The present value is determined using an assumed effective annual interest rate of [4%] [plus 1%] as of the date of the withdrawal.
This rider will be discontinued upon the Company’s receipt of a Written Request from the Contract Owner to terminate this rider.
The annuity rates attributable to this rider are subject to the rates shown in the Contract without referring to Note 1 of the Fixed Annuity Rates of the Contract.
Signed for Massachusetts Mutual Life Insurance Company by:
| [ABCDE] | [ABC] | |
| [SECRETARY] | [PRESIDENT] |
| GMIB.2 | 4 | [5% or 6%-09-07] |
