HOME OFFICE: International Corporate Center at Rye 555 Theodore Fremd Avenue Rye, N.Y. 10580 THIS IS A LEGAL CONTRACT - READ IT CAREFULLY.
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[THE MANUFACTURERS LIFE INSURANCE LETTERHEAD]
HOME OFFICE:
International Corporate Center at Rye
▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇
▇▇▇, ▇.▇. 10580
THIS IS A LEGAL CONTRACT - READ IT
CAREFULLY.
WE AGREE to pay the benefits of this Contract in
accordance with its terms.
THIS CONTRACT is issued in consideration of the
Application and the Payments.
TEN DAY RIGHT TO REVIEW
THE CONTRACT OWNER MAY CANCEL THE CONTRACT BY RETURNING IT TO OUR ANNUITY
SERVICE OFFICE OR AGENT AT ANY TIME WITHIN 10 DAYS AFTER RECEIPT OF THE
CONTRACT. WITHIN 7 DAYS OF RECEIPT OF THE CONTRACT BY US, WE WILL PAY THE
CONTRACT VALUE, COMPUTED AT THE END OF THE VALUATION PERIOD, ON THE DATE OF
SURRENDER, TO THE CONTRACT OWNER.
SIGNED FOR THE COMPANY at its Executive
Office, Rye, New York, on the Contract Date.
DETAILS OF VARIABLE ACCOUNT PROVISIONS ON PAGE 8
DETAILS OF FIXED ACCOUNT PROVISIONS ON PAGE 9
DETAILS OF MARKET VALUE CHARGE PROVISIONS ON PAGES 9, 12, AND 14
s/▇▇▇▇▇▇ ▇▇▇▇▇ s/▇▇▇▇▇ ▇▇▇▇
President Secretary
Flexible Payment Deferred Combination Fixed and Variable Annuity
Non-Participating
ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT WHEN BASED ON
THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE AND
NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT.
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INTRODUCTION
This is a flexible payment deferred combination fixed and variable annuity. This
Contract provides that prior to the Maturity Date, the Contract Value will
accumulate on either a fixed or variable basis or a combination of both. After
the Maturity Date, annuity payments may be either fixed or variable, or a
combination of fixed and variable.
The variable portion of the Contract will vary with the investment performance
of the Variable Account. The fixed portion of the Contract will accumulate based
on interest rates guaranteed by the Company for the period selected.
If you select annuity payments on a variable basis, the payment amount will vary
with the investment performance of the Variable Account.
You must allocate Payments among one or more Investment Options. The Investment
Options are identified on the Contract Specifications Page.
TABLE OF CONTENTS
Contract Specifications Page Page
PART 1 - DEFINITIONS 1
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PART 2 - GENERAL PROVISIONS 2
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PART 3 - OWNERSHIP 4
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PART 4 - BENEFITS 5
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PART 5 - PAYMENTS 7
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PART 6 - VARIABLE ACCOUNT PROVISIONS 8
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PART 7 - FIXED ACCOUNT PROVISIONS 9
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PART 8 - ANNUITY PROVISIONS 10
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PART 9 - TRANSFERS 11
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PART 10 - WITHDRAWAL PROVISIONS 12
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PART 11 - FEES AND DEDUCTIONS 15
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PART 12 - PAYMENT OF CONTRACT BENEFITS 15
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PART 1 DEFINITIONS
WE AND YOU "We", "us" and "our" means The
Manufacturers Life Insurance
Company of New York. "You" or "your"
means the Owner of this Contract.
ACCUMULATION UNIT A unit of measure that is used
to calculate the value of the
variable portion of the Contract
before the Maturity Date.
ANNUITANT Any individual person or persons
whose life is used to determine the
duration of annuity payments
involving life contingencies. The
Annuitant is as designated on the
Contract Specifications Page and
application, unless changed.
ANNUITY OPTION The method selected by you for
annuity payments made by us.
ANNUITY SERVICE OFFICE Any office designated by us for the
receipt of Payments and processing
of Contract Owner requests.
ANNUITY UNIT A unit of measure that is used after
the Maturity Date to calculate
Variable Annuity payments.
BENEFICIARY The person, persons or entity to whom
certain benefits are payable
following the death of an Owner, or
in certain circumstances, an
Annuitant.
CONTINGENT BENEFICIARY The person, persons, or entity who
becomes the Beneficiary if the
Beneficiary is not alive.
CONTRACT ANNIVERSARY The anniversary of the Contract Date.
CONTRACT DATE The date of issue of the Contract as
specified on the Contract
Specifications Page.
CONTRACT VALUE The total of the Investment Account
Values and, if applicable, any
amount in the Loan Account
attributable to the Contract.
CONTRACT YEAR The period of twelve consecutive
months beginning on the Contract Date
or any anniversary thereafter.
DEBT Any amounts in the Loan Account
attributable to the Contract plus any
accrued loan interest. The loan
provision is applicable to certain
Qualified Contracts only.
DESIGNATED BENEFICIARY For purposes of section 72(s) of the
Internal Revenue Code, the
"designated beneficiary" under
the contract shall be the individual
who is entitled to receive the
amounts payable on death of an Owner,
or if any Owner is not an individual,
on any change in, or death of, an
Annuitant.
FIXED ANNUITY An Annuity Option with payments
which are predetermined and
guaranteed as to dollar amount.
GENERAL ACCOUNT All the assets of The Manufacturers
Life Insurance Company of New York
other than assets in separate
accounts.
INTERNAL REVENUE CODE (IRC) The Internal Revenue Code of 1986,
as amended from time to time, and
any successor statute of similar
purposes.
INVESTMENT ACCOUNT An account established by us which
represents your interest in an
Investment Option prior to the
Maturity Date.
INVESTMENT ACCOUNT VALUE The value of your investment in an
Investment Account.
INVESTMENT OPTIONS The Investment Options can be either
fixed or variable. The Investment
Options available under this
Contract are shown on the Contract
Specifications Page and application.
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LOAN ACCOUNT The portion of the General Account
that is used for collateral when a
loan is taken.
MARKET VALUE CHARGE A charge that may be assessed if
amounts are withdrawn or transferred
from the fixed Investment Options
prior to the end of the interest
rate guarantee period.
MATURITY DATE The date on which annuity benefits
commence. It is the date specified
on the Contract Specifications Page,
unless changed.
NET PAYMENT The Payment less the amount of
premium tax, if any, deducted from
the Payment.
NON-QUALIFIED CONTRACTS Contracts which are not issued under
Qualified Plans.
OWNER OR CONTRACT OWNER The person, persons, or entity
entitled to the ownership rights
under this Contract. The Owner is as
designated on the Contract
Specifications Page and application,
unless changed.
PORTFOLIO OR TRUST A separate portfolio of
PORTFOLIO Manufacturers Investment Trust, a
mutual fund in which the Variable
Account invests, or any successor
mutual fund.
PAYMENT An amount paid to us by you as
consideration for the benefits
provided by the Contract.
QUALIFIED CONTRACTS Contracts issued under Qualified
Plans.
QUALIFIED PLANS Retirement plans which receive
favorable tax treatment under
section 401, 403, 408 or 457, of the
Internal Revenue Code of 1986, as
amended.
SEPARATE ACCOUNT A segregated account of The
Manufacturers Life Insurance Company
of New York that is not commingled
with our general assets and
obligations.
SUB-ACCOUNT(S) One or more of the Sub-Accounts of
the Variable Account. Each
Sub-Account is invested in shares of
a different Trust Portfolio.
VALUATION DATE Any date on which the New York Stock
Exchange is open for business and
the net asset value of a Trust
Portfolio is determined.
VALUATION PERIOD Any period from one Valuation Date
to the next, measured from the time
on each such date that the net asset
value of each Portfolio is
determined.
VARIABLE ACCOUNT The Manufacturers Life Insurance
Company of New York Separate Account
A, which is a separate account of
The Manufacturers Life Insurance
Company of New York.
VARIABLE ANNUITY An Annuity Option with payments
which: (1) are not predetermined or
guaranteed as to dollar amount, and
(2) vary in relation to the
investment experience of one or more
specified variable Sub-Accounts.
PART 2 GENERAL PROVISIONS
ENTIRE CONTRACT The entire contract consists of this
Contract, any Contract endorsements,
and a copy of the application. Only
our President, Vice-President or
Secretary may agree to change or
waive any provisions of this
Contract. The change or waiver must
be in writing.
We will not change or modify this
Contract without your consent except
as may be required to make it
conform to any applicable law or
regulation or any ruling issued by a
government agency.
The benefits and values available
under this Contract are not less
than the minimum required by the
State of New York. We have filed a
detailed statement of the method
used to calculate the benefits and
values with the Department of
Insurance in the
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state in which this Contract is
delivered, if required by law.
BENEFICIARY The Beneficiary is as designated in
the Contract Specifications Page and
application, unless changed.
However, if there is a surviving
Owner, that person will be treated
as the Beneficiary. If no such
Beneficiary is living, the
Beneficiary is the "Contingent
Beneficiary". If no Beneficiary or
Contingent Beneficiary is living,
the Beneficiary is the estate of the
deceased Owner.
CHANGE OF MATURITY DATE Prior to the Maturity Date, you may
request in writing a change of the
Maturity Date. Any extension of the
Maturity Date will be subject to our
prior approval.
ASSIGNMENT You may assign this Contract at any
time prior to the Maturity Date. No
assignment will be binding on us
unless it is written in a form
acceptable to us and received at our
Annuity Service Office. We will not
be liable for any payments made or
actions we take before the
assignment is accepted by us. An
absolute assignment will revoke the
interest of any revocable
Beneficiary. We will not be
responsible for the validity of any
assignment.
CLAIMS OF CREDITORS To the extent permitted by law, no
benefits payable under this Contract
will be subject to the claims of
your, the Beneficiary's or the
Annuitant's creditors.
MISSTATEMENT AND PROOF We may require proof of age, sex or
OF AGE, SEX OR SURVIVAL survival of any person upon whose
age, sex or survival any payments
depend. If the age or sex of the
Annuitant has been misstated, the
benefits will be those which the
Payments would have provided for the
correct age and sex. If we have made
incorrect annuity payments, the
amount of any underpayment, adjusted
with interest at 3% per annum, will
be paid immediately. The amount of
any overpayment will be deducted
from future annuity payments.
ADDITION, DELETION OR We reserve the right, subject to
SUBSTITUTION OF prior approval of the New York
INVESTMENT OPTIONS Superintendent of Insurance and
compliance with applicable law, to
make additions to, deletions from,
or substitutions for the Portfolio
shares that are held by the Variable
Account or that the Variable Account
may purchase. We reserve the right
to eliminate the shares of any of
the eligible Portfolios and to
substitute shares of another
Portfolio of the Trust, or of
another open-end registered
investment company, if the shares of
any eligible Portfolio are no longer
available for investment, or if in
our judgment further investment in
any eligible Portfolio should become
inappropriate in view of the
purposes of the Variable Account. We
will not substitute any shares
attributable to your interest in a
Sub-Account without notice to you
and prior approval of the Securities
and Exchange Commission to the
extent required by the Investment
Company Act of 1940. Nothing
contained herein shall prevent the
Variable Account from purchasing
other securities for other series or
classes of contracts, or from
effecting a conversion between
shares of another open-end
investment company.
We also reserve the right, subject
to prior approval of the New York
Superintendent of Insurance and
compliance with applicable law, to
establish additional Sub-Accounts
which would invest in shares of a
new Portfolio of the Trust or in
shares of another open-end
investment company. We also reserve
the right, subject to prior approval
of the New York Superintendent of
Insurance and compliance with
applicable law, to eliminate
existing Sub-Accounts, to combine
Sub-Accounts or to transfer assets
in a Sub-Account to another Separate
Account established by us or an
affiliated company. In the event of
any such substitutions or changes,
we may, by appropriate endorsement,
make such changes in this and other
Contracts as may be necessary or
appropriate to reflect such
substitutions or changes. If deemed
by us to be in the best interests of
persons having voting rights under
the Contracts, the Variable Account
may be operated as a management
company under the Investment Company
Act of 1940 or it may be
deregistered under such Act in the
event such registration is no longer
required.
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NON-PARTICIPATING Your Contract is non-participating
and will not share in our profits or
surplus earnings. We will pay no
dividends on your Contract.
REPORTS At least once each year we will send
you a report containing information
required by the Investment Company
Act of 1940 and the laws of the
state of New York.
INSULATION The portion of the assets of the
Variable Account equal to the
reserves and other contract
liabilities with respect to such
account are not chargeable with
liabilities arising out of any other
business we may conduct. Moreover,
the income, gains and losses,
realized or unrealized, from assets
allocated to the Variable Account
shall be credited to or charged
against such account without regard
to our other income, gains or
losses.
CURRENCY AND PLACE All payments made to or by us shall
OF PAYMENTS be made in the lawful currency of
the United States of America at the
Annuity Service Office or elsewhere
if we consent.
NOTICES AND ELECTIONS To be effective, all notices and
elections you make under this
Contract must be in writing, signed
by you and received by us at our
Annuity Service Office. Unless
otherwise provided in this Contract,
all notices, requests and elections
will be effective when received by
us, complete with all necessary
information and your signature, at
our Annuity Service Office.
GOVERNING LAW This Contract will be governed by
the laws of the state of New York.
SECTION 72(s) The provisions of this Contract
shall be interpreted so as to comply
with the requirements of Section
72(s) of the Internal Revenue Code.
PART 3 OWNERSHIP
GENERAL Before the Maturity Date, the Owner
of this Contract shall be the
person, persons or entity so named
on the Contract Specifications Page
and application, or the latest
change filed with us. On the
Maturity Date, the Annuitant becomes
the Owner of the Contract. If
amounts become payable to the
Beneficiary under the Contract, the
Beneficiary becomes the Owner of the
Contract.
CHANGE OF OWNER, Subject to the rights of an
ANNUITANT, BENEFICIARY irrevocable Beneficiary, you may
change the Owner, Annuitant, or
Beneficiary by written request in a
form acceptable to us and which is
received at our Annuity Service
Office. The Annuitant may not be
changed after the Maturity Date. You
need not send us the Contract unless
we request it. Any change must be
approved by us. If approved, any
change in Beneficiary will take
effect on the date you signed the
request. If approved, any change of
Owner or Annuitant will take effect
on the date we received the request
at the Annuity Service Office. We
will not be liable for any payments
or actions we take before the change
is approved.
The substitution or addition of any
Owner may result in the resetting of
the Death Benefit to an amount equal
to the Contract Value as of the date
of such change. For purposes of
subsequent calculations of the Death
Benefit, described in Part 4,
Benefits, Death Benefit Before
Maturity Date, the Contract Value on
the date of the change will be
treated as a Payment made on that
date. In addition, all Payments made
and all amounts deducted in
connection with partial withdrawals
prior to the date of change of Owner
will not be considered in the
determination of the Death Benefit.
Furthermore, the Death Benefit on
the last day of the previous
Contract Year shall be set to zero
as of the date of the Owner change.
This paragraph will not apply if (a)
the individual whose death will
cause the Death Benefit to be paid
is the same after the change of
Owner, or (b) if Ownership is
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transferred to your spouse.
If any Annuitant is changed and any
Owner is not an individual, the
entire interest in the Contract must
be distributed to the Owner within
five years of the change.
PART 4 BENEFITS
ANNUITY BENEFITS We will pay a monthly income to the
Annuitant, if living, on the
Maturity Date. Payments can be fixed
or variable, or a combination of
fixed and variable. Annuity benefits
will commence on the Maturity Date
and continue for the period of time
provided for under the Annuity
Option selected.
We may pay the Contract Value, less
Debt, on the Maturity Date in one
lump sum if the monthly income is
less than $20.
On or before the Maturity Date you
must select how the Contract Value
will be used to provide the monthly
income. You may select a Fixed or
Variable Annuity. Unless you
indicate otherwise, we will provide
either variable or fixed, or a
combination variable and fixed
annuity payments in proportion to
the Investment Account Value of each
Investment Option at the Maturity
Date. Annuity payments will continue
for 10 years or the life of the
Annuitant, if longer.
If a Variable Annuity is used, the
amount of the first monthly annuity
payment will be obtained from the
appropriate option table under the
"Payment of Contract Benefits"
Section. Subsequent monthly annuity
payments will vary based on the
investment experience of the
Sub-Account(s) used to effect the
annuity. The method used to
calculate the amount of the initial
and subsequent payments is described
under the "Variable Annuity
Payments" Section of Part 8 of this
Contract.
If a Fixed Annuity is used, the
portion of the Contract Value used
to effect a Fixed Annuity will be
applied to the appropriate table
contained in this Contract. If the
table in use by us on the Maturity
date is more favorable to you, we
will use that table. We guarantee
the dollar amount of fixed
annuity payments.
DEATH BENEFIT BEFORE A Death Benefit will be determined
MATURITY DATE as of the date on which written
notice and proof of death, and all
required claim forms are received at
the Company's Annuity Service Office
as follows:
1. If any Owner dies on
or prior to their 85th birthday
and the oldest Owner had an
attained age of less than 81
years on the Contract Date, the
Death Benefit will be
determined as follows:
(a) During the first Contract
Year, the Death Benefit will
be the greater of:
(i) the Contract Value, or
(ii) the sum of all Payments
made, less any amount
deducted in connection
with partial
withdrawals.
(b) During any subsequent
Contract Year period, the
Death Benefit will be the
greater of:
(i) the Contract Value, or
(ii) the Death Benefit on
the last day of the
previous Contract Year
period plus any
Payments made and less
any amounts deducted in
connection with partial
withdrawals, since
then.
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2. If any Owner dies after their
85th birthday and the oldest
Owner had an attained age of
less then 81 years on the
Contract Date, the Death Benefit
will be determined as the
greater of:
(a) the Contract Value, or
(b) the excess of (i) over (ii)
where:
(i) equals the sum of all
Payments,
(ii) equals the sum of any
amounts deducted in
connection with partial
withdrawals.
3. If any Owner dies and the oldest
Owner had an attained age of 81
or greater on the Contract
Date, the Death Benefit will be
the Contract Value less any
applicable Withdrawal Charges at
the time of payment of the
benefits.
If there is any Debt, the Death
Benefit equals the amount
described above less the Debt
under the Contract.
DEATH OF ANNUITANT: On the death of
the last surviving Annuitant, the
Owner becomes the new Annuitant,
if the Owner is an individual. If
any Owner is not an individual the
death of any Annuitant is treated
as the death of an Owner and the
Death Benefit will be determined by
substituting the Annuitant for the
Owner as described below.
DEATH OF OWNER: We will pay the
Death Benefit to the Beneficiary if
any Owner dies prior to the
Maturity Date. The Death Benefit
may be taken in one sum
immediately, in which case the
Contract will terminate. If the
Death Benefit is not taken in one
sum immediately, the Contract will
continue subject to the following
provisions:
(a) The Beneficiary becomes the
Contract Owner.
(b) The excess, if any, of the
Death Benefit over the
Contract Value will be
allocated to and among the
Investment Accounts in
proportion to their values as
of the date on which the Death
Benefit is determined.
(c) No additional Payments may be
applied to the Contract.
(d) If the Beneficiary is not the
deceased Owner's spouse, the
entire interest in the
Contract must be distributed
under one of the following
options:
(i) The entire interest in the
Contract must be
distributed over the life
of the Beneficiary, or
over a period not
extending beyond the
life expectancy of the
Beneficiary, with
distributions beginning
within one year of the
Owner's death; or
(ii) the entire interest in the
Contract must be
distributed within 5 years
of the Owner's Death.
If the Beneficiary dies
before the distributions
required by (i) or (ii)
are complete, the entire
remaining Contract Value
must be distributed in a
lump sum immediately.
(e) If the Beneficiary is the
deceased Owner's spouse, the
Contract will continue with
the surviving spouse as the
new Owner. The surviving
spouse may name a new
Beneficiary (and, if no
Beneficiary is so named, the
surviving spouse's estate will
be the Beneficiary). Upon the
death of the surviving spouse,
the Death Benefit will equal
the Contract Value at the time
of the surviving spouse's
death, and the entire interest
in the Contract must be
distributed to the new
Beneficiary in accordance with
the provisions of (d) (i) or
(d) (ii) above.
(f) Withdrawal Charges will be
waived on any withdrawals,
unless the Death Benefit
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payable upon the Owner's death
was defined under provision
3., Death Benefit Before
Maturity Date above. If the
Death Benefit was so defined,
Withdrawal Charges will be
assessed at the time a
withdrawal occurs.
If there is more than one
Beneficiary, the foregoing
provisions will independently
apply to each Beneficiary.
DEATH BENEFIT ON OR If annuity payments have been
AFTER MATURITY DATE selected based on an Annuity
Option providing for payments
for a guaranteed period, and the
Annuitant dies on or after the
Maturity Date, we will make the
remaining guaranteed payments to
the Beneficiary. Any remaining
payments will be made as rapidly
as under the method of
distribution being used as of
the date of the Annuitant's
death. If no Beneficiary is
living, we will commute any
unpaid guaranteed payments to a
single sum (on the basis of the
interest rate used in
determining the payments) and
pay that single sum to the
estate of the last to die of the
Annuitant and the Beneficiary.
PROOF OF DEATH Proof of death is required upon
the death of the Annuitant or
the Owner. Proof of death is one
of the following received at the
Annuity Service Office:
(a) A certified copy of a death
certificate.
(b) A certified copy of a
decree of a court of
competent jurisdiction as
to the finding of death.
(c) Any other proof satisfactory to us.
PART 5 PAYMENTS
GENERAL All Payments under this Contract are payable
at our Annuity Service Office or such other
place as we may designate.
The minimum Payment will be $30. However at
least $300 must be paid during the first
Contract Year. Payments may be made at any
time. If a Payment would cause the Contract
Value to exceed $1,000,000, or the Contract
Value already exceeds $1,000,000, no
additional Payments will be accepted without
our prior approval.
NONPAYMENT OF PAYMENTS FOR If, prior to the Maturity Date, no Payments
THREE YEARS are made for three consecutive Contract
Years, and if both:
(a) the total Payments made, less any
partial withdrawals, are less than
$2,000; and
(b) the Contract Value at the end of such
three year period is less than $2,000;
We may cancel the Contract and pay you the
Contract Value (measured as of the Valuation
Period during which the cancellation
occurs), less any Debt and Annual
Administration Fee. We will provide you with
31 days prior written notice before
cancelling the contract.
ALLOCATION OF NET PAYMENTS When we receive Payments, the Net
Payments will be allocated among Investment
Options in accordance with the allocation
percentages shown on the Contract
Specifications Page. You may change the
allocation of subsequent Net Payments at any
time, without charge, by giving us written
notice.
PART 6 VARIABLE ACCOUNT PROVISIONS
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INVESTMENT ACCOUNT We will establish a separate Investment
Account for you for each variable Investment
Option to which you allocate amounts. The
Investment Account represents the number of
your Accumulation Units in an Investment
Option.
INVESTMENT ACCOUNT VALUE The Investment Account Value of an
Investment Account is determined by
(a) times (b) where:
(a) equals the number of Accumulation
Units credited to the Investment
Account, and
(b) equals the value of the appropriate
Accumulation Unit.
ACCUMULATION UNITS We will credit Net Payments to your
Investment Accounts in the form of
Accumulation Units. The number of
Accumulation Units to be credited to each
Investment Account of the Contract will be
determined by dividing the Net Payment
allocated to that Investment Account by the
Accumulation Unit value for that Investment
Account.
Accumulation Units will be adjusted
for any transfers and will be canceled on
payment of a Death Benefit, withdrawal,
maturity or assessment of certain charges
based on their value for the Valuation
Period in which such transaction occurs.
VALUE OF ACCUMULATION UNIT The Accumulation Unit value for any
Valuation Period is determined by
multiplying the Accumulation Unit value for
the immediately preceding Valuation Period
by the "net investment factor" for the
Investment Account for the Valuation Period
for which the value is being determined. The
value of an Accumulation Unit may increase,
decrease or remain the same from one
Valuation Period to the next.
NET INVESTMENT FACTOR The net investment factor for a variable
Investment Account is an index that measures
the investment performance of a Sub-Account
from one Valuation Period to the next. The
net investment factor for any Valuation
Period is determined by dividing (a) by (b)
and subtracting (c) from the result where:
(a) is the net result of:
1) the net asset value per share of a
Portfolio share held in the Sub-Account
determined as of the end of the current
Valuation Period, plus
2) the per share amount of any dividend
or capital gain distributions made by
the Portfolio on shares held in the
Sub-Account if the "ex-dividend" date
occurs during the current Valuation
Period, and
(b) is the net asset value per share of a
Portfolio share held in the Sub-Account
determined as of the end of the
immediately preceding Valuation Period,
and
(c) is the Asset Fee as defined in Part
11, Fees and Deductions. The net
investment factor may be greater or
less than, or equal to, one.
PART 7 FIXED ACCOUNT PROVISIONS
INVESTMENT ACCOUNT We will establish a separate Investment
Account for you each time you allocate
amounts to a fixed Investment Option. Any
amounts you allocate to the same fixed
Investment Option on the same day will
establish a new Investment Account. Amounts
invested in these Investment Accounts will
earn interest at the guaranteed rate in
effect on the date the amounts are allocated
for the duration of the guarantee period.
We will determine the guaranteed rate from
time to time for new allocations, but in no
event will the minimum guaranteed rate under
a fixed Investment Account be less than 3%.
GUARANTEE PERIODS For any amounts allocated to the fixed
Investment Options, you have the choice of
the guarantee periods available. The amount
can be allocated into any combination
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of the fixed Investment Options offered
under this Contract.
Separate Investment Accounts will be
established for each guarantee period. The
guarantee period will be the duration of the
fixed Investment Option selected, measured
from the date the amount is allocated to the
Investment Account. Amounts cannot be
allocated to a fixed Investment option that
would extend the guarantee period beyond the
Maturity Date.
RENEWALS The renewal amount is the Investment Account
Value at the end of the particular guarantee
period. The renewal amount will be
automatically renewed in the same Investment
Option at the end of the guarantee period,
unless you specify otherwise. If renewal in
a particular Investment Option would result
in the guarantee period for that Investment
Account extending beyond the Maturity Date,
the renewal amount may not be renewed in
that Investment Option. The renewal amount
will be applied to the longest guarantee
period of a fixed Investment Option such
that the guarantee period does not extend
beyond the Maturity Date.
INVESTMENT ACCOUNT VALUE The amount in the Investment Accounts will
accumulate at a rate of interest determined
by us and in effect on the date the amount
is allocated to the Investment Account. The
Investment Account Value is the accumulated
value of the amount invested in the
Investment Account reduced by any
withdrawals, loans, transfers or charges
taken from the Investment Account.
MARKET VALUE CHARGE Any amounts withdrawn from a fixed
Investment Account, prior to the end of the
guarantee period, may be subject to a Market
Value Charge. The Market Value Charge will
only apply to amounts withdrawn from a fixed
Investment Account pursuant to a partial
withdrawal, total withdrawal, transfer or a
loan. A Market Value Charge will not be
assessed on amounts withdrawn from the
1-year fixed Investment Account.
MARKET VALUE CHARGE A Market Value Charge will be calculated
FACTOR separately for each fixed Investment Account
affected. The Market Value Charge for a
particular Investment Account will be
calculated by multiplying the amount
withdrawn, loaned or transferred from the
Investment Account by the adjustment factor
described below.
The adjustment factor for a particular
Investment Account is determined by the
following formula: 0.75 x (B-A) x C/12
Where A, B and C are defined as follows:
A- The guaranteed interest rate on the
Investment Account.
B- The guaranteed interest rate available,
on the date the request is processed,
for amounts allocated to a new Investment
Account with the same length of
guarantee period as the Investment
Account from which amounts are being
withdrawn.
C- The number of complete months remaining
to the end of the guarantee period.
For purposes of this calculation, the
maximum difference between "B" and "A"
will be 3%. Furthermore, the adjustment
factor will never be less than zero. The
amount of Market Value Charge, if any,
upon transfer, or loan is specified in
Part 9, Transfer Provisions, and upon
withdrawal as specified in Part 10,
Withdrawal Provisions.
PART 8 ANNUITY PROVISIONS
VARIABLE ANNUITY PAYMENTS The amount of the first variable annuity
payment is determined by applying the
portion of the Contract Value used to effect
a Variable Annuity, measured as of a date
not more than 10 business days prior to the
Maturity Date (minus any applicable premium
taxes), to the appropriate tables(s)
contained in this Contract. If the table in
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12
use by us on the Maturity Date is
more favorable to you, we will use
that table. Subsequent payments will
be based on the investment
performance of one or more
Sub-Accounts as you select. The
amount of such payments is determined
by the number of Annuity Units
credited for each Sub-Account. Such
number is determined by dividing the
portion of the first payment
allocated to that Sub-Account by the
Annuity Unit value for that
Sub-Account determined as of the same
date that the Contract Value to
effect annuity payments was
determined. This number of Annuity
Units for each Sub-Account is then
multiplied by the appropriate Annuity
Unit value for each subsequent
determination date, which is a
uniformly applied date not more than
10 business days before the payment
is due.
MORTALITY AND EXPENSE We guarantee that the dollar amount
GUARANTEE of each variable annuity payment will
not be affected by changes
in mortality and expense experience.
ANNUITY UNIT VALUE The value of an Annuity Unit for each
Sub-Account for any Valuation Period
is determined as follows:
(a) The net investment factor for
the Sub-Account for the
Valuation Period for which
the Annuity Unit value is
being calculated is
multiplied by the value of
the Annuity Unit for the
preceding Valuation Period;
and
(b) The result is adjusted to
compensate for the interest
rate assumed in the tables
used to determine the first
variable annuity payment.
The dollar value of Annuity Units may
increase, decrease or remain the same
from one Valuation Period to the
next.
FIXED ANNUITY PAYMENTS The amount of each fixed annuity
payment is determined by applying the
portion of the Contract Value used to
effect a Fixed Annuity measured as of
a date not more than 10 business days
prior to the Maturity Date (minus any
applicable premium taxes) to the
appropriate table contained in this
Contract. If the table in use by us
on the Maturity Date is more
favorable to you, we will use that
table. In addition, at the time of
their commencement, fixed annuity
payments will not be less than those
provided by an amount applied to
purchase a single consideration
immediate annuity to the same class
of annuitants at that time. This
amount will be the greater of:
(a) the Contract Value less
applicable Withdrawal
Charges.
(b) 95% of the Contract Value.
We guarantee the dollar amount of
fixed annuity payments.
PART 9 TRANSFER PROVISIONS
TRANSFERS Before the Maturity Date you may
transfer amounts among Investment
Accounts of the Contract. There is no
transaction charge for transfers,
however, amounts transferred from a
fixed Investment Account prior to the
end of the guarantee period may be
subject to a Market Value Charge.
Amounts will be canceled from the
Investment Accounts from which
amounts are transferred and credited
to the Investment Account to which
amounts are transferred. We will
effect such transfers so that the
Contract Value on the date of
transfer will not be affected by the
transfer, except for the Market Value
Charge, if applicable. We reserve the
right to limit, upon notice, the
maximum number of transfers you may
make per Contract Year to one per
month or six at any time within a
Contract Year.
You must transfer at least $300 or,
if less, the entire amount in the
Investment Account each time you make
a transfer. If, after the transfer,
the amount remaining in the
Investment Account of the Contract
from which the transfer is made is
less than $100, then we will transfer
the entire amount instead of the
requested amount.
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We reserve the right to defer the
transfer privilege at any time that
we are unable to purchase or redeem
shares of the Trust Portfolios. In
addition, in accordance with
applicable law, the Company reserves
the right to modify or terminate the
transfer privilege at any time.
Amounts may not be transferred from a
fixed Investment Account unless those
amounts have been in the fixed
Investment Account for at least one
year. The Market Value Charge, if
applicable, will be deducted from the
amount transferred.
Once variable annuity payments have
begun, you may transfer all or part
of the investment upon which your
variable annuity payments are based
from one Sub-Account to another. To
do this, we will convert the number
of variable Annuity Units you hold in
the Sub-Account from which you are
transferring to a number of variable
Annuity Units of the Sub-Account to
which you are transferring so that
the amount of a variable annuity
payment, if it were made at that
time, would not be affected by the
transfer. After that, your variable
annuity payments will reflect changes
in the values of your new variable
Annuity Units. You must give us
notice at least 30 days before the
due date of the first variable
annuity payment to which the transfer
will apply. We reserve the right to
limit, upon notice, the maximum
number of transfers you may make per
Contract Year after variable annuity
payments have begun to four.
After the Maturity Date, transfers
will not be allowed from a fixed to a
variable Annuity Option, or from a
variable to a fixed Annuity Option.
TRANSFER MARKET VALUE Amounts transferred from a fixed
CHARGE Investment Account may be subject to
a Market Value Charge. For Transfers,
including transfers to the Loan
Account pursuant to a loan request,
the Market Value Charge, if
applicable, will be calculated by
multiplying the amount transferred
from each fixed Investment Account by
the Market Value Charge Factor and
deducted from the amount transferred.
If there are multiple Investment
Accounts under a fixed Investment
Option, the requested amount from
that Investment Option must be
transferred from those Investment
Accounts on a first-in-first-out
basis.
The Market Value Charge may not
exceed the earnings in excess of 3%
per annum attributable to the amount
transferred.
In no event will the Market Value
Charge be greater than 10% of the
amount transferred.
In no event will the Market Value
Charge reduce the amount transferred
below the amount required under the
non-forfeiture laws of the state that
has jurisdiction over this contract.
PART 10 WITHDRAWAL PROVISIONS
CONTRACT VALUE Your Contract Value is equal to
the total of the Investment Account
Values and, if applicable, any amount
in the Loan Account attributable to
the Contract.
PAYMENTS OF WITHDRAWALS You may withdraw part or all of the
Contract Value, less any Debt, at any
time before the earlier of your death
or the Maturity Date, by sending us a
written request. We will pay all
withdrawals within seven days of
receipt at the Annuity Service Office
subject to postponement in certain
circumstances, as specified below.
SUSPENSION OF PAYMENTS We may defer the right of withdrawal,
or postpone the date of payment, from
the variable Investment Accounts for
any period when: (1) the New York
Stock Exchange is closed (other than
customary weekend and holiday
closings); (2) trading on the
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New York Stock Exchange is
restricted; (3) an emergency exists
as a result of which disposal of
securities held in the Variable
Account is not reasonably practicable
or it is not reasonably practicable
to determine the value of the
Variable Account's net assets; or (4)
the Securities and Exchange
Commission, by order, so permits for
the protection of security holders;
provided that applicable rules and
regulations of the Securities and
Exchange Commission shall govern as
to whether the conditions described
in (2) and (3) exist.
We may defer the right of withdrawal
from the fixed Investment Accounts
for not more than six months from the
day we receive written request and
the Contract, if required. If such
payments are deferred 10 days or
more, the amount deferred will earn
interest at a rate not less than 3%
per year.
TOTAL WITHDRAWAL Upon receipt of your request to
withdraw all of your Contract Value,
we will terminate the Contract and
pay you the Contract Value, less any
applicable Debt, Withdrawal Charges,
Market Value Charges and the Annual
Administration Fee.
PARTIAL WITHDRAWAL If you are withdrawing part of the
Contract Value, you should specify
the amount that should be withdrawn
from each Investment Option of the
Contract. If there are multiple
Investment Accounts under a fixed
Investment Option, the requested
amount from that Investment Option
must be withdrawn from those
Investment Accounts on a
first-in-first-out basis. If you do
not specify, the requested amount
will be withdrawn in the following
order:
a) Variable Investment Accounts, on
a pro rata basis,
b) Fixed Investment Options
beginning with the shortest
guarantee period first and the
longest guarantee period last.
We will deduct the Withdrawal Charge
and the Market Value Charge, if
applicable, from the Contract Value
remaining after payment of the
requested amount.
WITHDRAWAL CHARGE If a withdrawal is made from the
Contract before the Maturity Date, a
Withdrawal Charge (contingent
deferred sales charge) may be
assessed against Payments that have
been in your Contract for less than 7
years. No Withdrawal Charge will
apply to Payments being withdrawn
that have been in the Contract for 7
or more years. The amount of the
Withdrawal Charge and when it is
assessed is discussed below:
1. An amount can be withdrawn
without Withdrawal Charges. This
amount is defined as the greater
of:
a) the excess of the Contract Value
on the date of withdrawal over
the unliquidated Payments, or
b) the excess of (i) over (ii): (i)
equals 10% of total Payments (ii)
equals 100% of all prior partial
withdrawals, in that Contract
Year. The amount withdrawn
without Withdrawal Charges will
be applied to your requested
withdrawal in the following
order:
a) withdrawals from the variable
Investment Accounts,
b) withdrawals from fixed Investment
Options beginning with the
shortest guarantee period first
and the longest guarantee period
last.
2. Withdrawals in excess of the
amount available without
Withdrawal Charges as defined in
(1) above, may be subject to
Withdrawal Charges. A Withdrawal
Charge will be assessed against
Payments liquidated that have
been in the Contract for less
than 7 years. Payments will be
liquidated on a
first-in-first-out basis. We will
liquidate Payments in the order
such Payments were made: the
oldest unliquidated Payment
first, the next Payment second,
etc...until all Payments have
been liquidated.
3. A Withdrawal Charge will be
assessed against Payments
liquidated that have been in the
Contract for less than 7 years.
4. Any Payments liquidated are
subject to a Withdrawal Charge
based on the length of time the
Payment has been in this
Contract. The Withdrawal Charge
is determined by multiplying the
amount of the Payment being
liquidated by the applicable
Withdrawal Charge Percentage
obtained from the table below.
Number of Complete Years Payment has Withdrawal Charge
4
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been in Contract Percentage
---------------- ----------
0 6%
1 6
2 5
3 5
4 4
5 3
6 2
7+ 0
The total Withdrawal Charge will
be the sum of the Withdrawal
Charges for the Payments being
liquidated.
5. The Withdrawal Charge is
deducted from the Contract
Value remaining after you are
paid the amount requested,
except in the case of a
complete withdrawal when it is
deducted from the amount
otherwise payable. In the case
of a partial withdrawal, the
amount requested from an
Investment Account may not
exceed the value of that
Investment Account less any
applicable Withdrawal Charge
and/or Market Value Charge, if
applicable.
6. In no event will the aggregate
Withdrawal Charge be greater
than 6% of the total Payments
made.
WITHDRAWAL MARKET VALUE
CHARGE Amounts withdrawn from a fixed
Investment Account may be subject
to a Market Value Charge. The
total Market Value Charge will be
the sum of the Market Value
Charges for each Investment
Account being withdrawn. For full
withdrawals, the Market Value
Charge will be calculated on the
total amount of each Investment
Account, and the total Market
Value Charge will be deducted from
the amount otherwise payable. For
partial withdrawals, the Market
Value Charge will be calculated
based on the withdrawal amount
requested from each Investment
Account and the Market Value
Charge, if applicable, will be
deducted from the remaining
Investment Account Value.
There will be no Market Value
Charge on withdrawals from the
fixed Investment Accounts in the
following situations: (a)
withdrawal from a 1-year fixed
Investment Account, (b) death of
the Owner, (c) amounts withdrawn
to pay any fees or charges, (d)
amounts applied at the Maturity
Date to purchase an annuity at the
guaranteed rates in the Annuity
Option tables, and (e) amounts
withdrawn from fixed Investment
Accounts within 30 days prior to
the end of the guarantee period. A
written notice of renewal will be
provided at least 15 days, but not
more than 45 days prior to the
beginning of the above 30 day
period.
An amount equal to 10% of total
Payments less all prior
withdrawals in that Contract Year
may be withdrawn without the
imposition of a Market Value
Charge.
The Market Value Charge may not
exceed the earnings in excess of
3% per annum attributable to the
amount withdrawn.
In no event will the Market Value
Charge plus any Withdrawal Charges
for an Investment Account be
greater than 10% of the amount
withdrawn.
In no event will the Market Value
Charge reduce the amount payable
on withdrawal below the amount
required under the non-forfeiture
laws of the state that has
jurisdiction over this Contract.
FREQUENCY AND AMOUNT OF
PARTIAL WITHDRAWLS You may make as many partial
withdrawals as you wish. Any
withdrawal from an Investment
Account of the Contract must be at
least $300 or the entire balance
of the Investment Account, if
less. If after the withdrawal, the
amount remaining in the Investment
Account is less than $100, then we
will consider the withdrawal
request to be a request for
withdrawal of the entire amount
held in the Investment Account. If
a partial withdrawal would reduce
the Contract Value to less than
$300, then we will treat the
partial withdrawal request as a
total withdrawal of the Contract
Value.
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PART 11 FEES AND DEDUCTIONS
--------------------------------------------------------------------------------
ASSET FEE To compensate us for assuming
mortality and expense risks, and
certain administration expenses, we
deduct from each variable Investment
Option a fee each Valuation Period at
an annual rate of 1.40%. A portion of
this Asset Fee may also be used to
reimburse us for distribution
expenses. This fee is reflected in
the Net Investment Factor used to
determine the value of Accumulation
Units and Annuity Units of the
Contract.
ANNUAL ADMINISTRATION FEE To compensate us for assuming
certain administrative expenses,
we charge an Annual Administration
Fee equal to $30 per year. Prior
to the Maturity Date, the $30
Annual Administration Fee is
deducted on each Contract
Anniversary. It is withdrawn from
each Investment Option in the same
proportion that the value of the
Investment Accounts of each
Investment Option bears to the
Contract Value. If the Contract
Value is totally withdrawn on any
date other than the Contract
Anniversary, we will deduct the
total amount of the $30 Annual
Administration Fee from the amount
paid. During the annuity period,
the $30 Annual Administration Fee
is deducted on a pro rata basis
from each annuity payment.
Prior to the Maturity Date, when
the Annual Administration Fee is
to be assessed, if the sum of all
Investment Accounts exceeds
$100,000.00, the $30 Annual
Administration Fee will be waived.
TAXES We reserve the right to charge
certain taxes against your Payments
(either at the time of payment or
liquidation), Contract Value,
payment of Death Benefit or annuity
payments, as appropriate. Such taxes
may include any premium taxes or
other taxes levied by any government
entity which we, in our sole
discretion, determine have resulted
from the establishment or
maintenance of the Variable Account,
or from the receipt by us of
Payments, or from the issuance of
this Contract, or from the
commencement or continuance of
annuity payments under this
Contract.
PART 12 PAYMENT OF CONTRACT BENEFITS
--------------------------------------------------------------------------------
GENERAL Benefits payable under this Contract
may be applied in accordance with one
or more of the Annuity Options
described below, subject to any
restrictions of Internal Revenue Code
section 72(s).
ALTERNATE ANNUITY OPTIONS Instead of settlement
in accordance with the Annuity
Options described below, you may
choose an alternate form of
settlement acceptable to us.
DESCRIPTION OF ANNUITY Option 1: Life Annuity
OPTIONS
(a) Life Non-Refund. We will make
payments during the lifetime of
the Annuitant. No payments are
due after the death of the
Annuitant.
(b) Life 10-Year Certain. We will
make 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.
Option 2: Joint and Survivor Life
Annuity
The second Annuitant named shall be
referred to as the Co-Annuitant.
(a)Joint and Survivor Non-Refund. We
will make payments during the
joint lifetime of the Annuitant
and Co-Annuitant.
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Payments will then continue
during the remaining lifetime of
the survivor. No payments are due
after the death of the last
survivor of the Annuitant and
Co-Annuitant. (b) Joint and
Survivor with 10-Year Certain. We
will make payments for 10 years
and after that during the joint
lifetime of the Annuitant and
Co-Annuitant. Payments will then
continue during the remaining
lifetime of the survivor. No
payments are due after the death
of the survivor of the Annuitant
and Co-Annuitant or, if later,
the end of the 10-year period
certain.
ANNUITY PAYMENT RATES The annuity payment rates on the
attached tables show, that for
each $1,000 applied, the dollar
amount of both (a) the first
monthly variable annuity payment
based on the assumed interest
rate of 3% and (b) the monthly
fixed annuity payment, when this
payment is based on the minimum
guaranteed interest rate of 3%
per year. The annuity payment
rates for payments made on a less
frequent basis (quarterly,
semiannual or annual) will be
quoted by us upon request.
The annuity payment rates are
based on the 1983 Table A
projected at Scale G with
interest at the rate of 3% per
annum and assume births in year
1942. The amount of each annuity
payment will depend upon the sex
and adjusted age of the
Annuitant, the Co-Annuitant, if
any, or other payee. The adjusted
age is determined from the actual
age nearest birthday at the time
the first monthly annuity payment
is due, as follows:
Calendar Year of Birth Adjustment to Actual Age
---------------------- ------------------------
1899 - 1905 +6
1906 - 1911 +5
1912 - 1918 +4
1919 - 1925 +3
1926 - 1932 +2
1933 - 1938 +1
1939 - 1945 0
1946 - 1951 -1
1952 - 1958 -2
1959 - 1965 -3
1966 - 1972 -4
1973 - 1979 -5
1980 - 1986 -6
1987 + -7
The dollar amount of annuity
payment for any age or
combination of ages not shown
following or for any other form
of Annuity Option agreed to by us
will be quoted on request.
18
AMOUNT OF FIRST MONTHLY PAYMENT
PER $1000 OF CONTRACT VALUE
OPTION 1: LIFE ANNUITY
Option 1(A): Non-Refund Option 1(B): 10-Year Certain
-------------------------------------- -----------------------------------
Adjusted Age of Adjusted Age of
Annuitant Male Female Annuitant Male Female
-------------------------------------- -----------------------------------
55 4.23 3.83 55 4.19 3.82
60 4.64 4.15 60 4.57 4.12
65 5.20 4.57 65 5.05 4.51
70 5.94 5.13 70 5.65 5.02
75 6.91 5.91 75 6.35 5.67
80 8.21 6.98 80 7.13 6.45
85 9.94 8.47 85 7.90 7.29
OPTION 2: JOINT AND SURVIVOR LIFE ANNUITY
Option 2(A): Non-Refund
Age of Co-Annuitant
------------------------------------------------------------
Adjusted
Age of Male 10 Years 5 Years Same 5 Years 10 Years
Annuitant Younger Younger Age Older Older
------------------------------------------------------------
55 3.24 3.38 3.53 3.69 3.83
60 3.40 3.58 3.78 3.98 4.16
65 3.61 3.85 4.10 4.36 4.61
70 3.88 4.19 4.53 4.88 5.20
75 4.23 4.64 5.10 5.57 6.00
80 4.70 5.26 5.88 6.51 7.06
85 5.34 6.09 6.94 7.76 8.43
Option 2(B): 10 Year Certain
Age of Co-Annuitant
------------------------------------------------------------
Adjusted
Age of Male 10 Years 5 Years Same 5 Years 10 Years
Annuitant Younger Younger Age Older Older
------------------------------------------------------------
55 3.24 3.38 3.53 3.69 3.83
60 3.40 3.58 3.78 3.98 4.16
65 3.61 3.85 4.10 4.36 4.59
70 3.88 4.18 4.52 4.86 5.16
75 4.23 4.63 5.07 5.50 5.86
80 4.68 5.21 5.78 6.30 6.69
85 5.27 5.95 6.62 7.18 7.56
------------------------------------------------------------
Monthly installments for ages not shown will be furnished on request.
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--------------------------------------------------------------------------------
THE MANUFACTURERS LIFE INSURANCE
COMPANY OF NEW YORK
--------------------------------------------------------------------------------
Manulife Financial and the block design are registered marks of The
Manufacturers Life Insurance Company and are used by it and its subsidiaries.
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