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Aetna Insurance Company of America
Home Office: ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇
▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
Aetna Insurance Company of America (We or Us) agrees to pay benefits according
to the terms and conditions set forth in this Contract.
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Certificate of Group Annuity Coverage
Aetna certifies that an account is established for you under the Group Annuity
Contract and Certificate numbers shown below.
This certificate describes Group Annuity Contract provisions. It replaces any
and all prior certificates or endorsements issued to you under the stated
Contract and Certificate numbers. This Certificate is for information only and
is not a part of the Contract.
THE VARIABLE FEATURES OF THE GROUP CONTRACT ARE DESCRIBED IN SECTIONS 6 AND 12.
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Right to Cancel
The Certificate Holder may cancel the Certificate within ten (10) days of
receiving it by returning it to Us at the address above or the person from whom
it was purchased. Within seven (7) days of the cancellation request, We will
return the Certificate Holder's Purchase Payment(s) made plus any increase, or
minus any decrease on the amount allocated to the Separate Account.
Signed at the Home Office on the Effective Date.
/s/ ▇▇▇ ▇▇▇▇▇▇▇ /s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇
President Secretary
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Contract Holder Group Annuity Contract Number
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Certificate Holder Certificate Number
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Annuitant Name Type of Plan
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CERTIFICATE CONTAINS A MARKET VALUE ADJUSTMENT
FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN
INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA
DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
GP2CERT(4/94)
Table of Contents
Page
Right to Cancel...........................................................1
Contract Schedule.........................................................4
Separate Account.................................................4
AICA Guaranteed Account (AG Account).............................4
Separate Account and AG Account..................................4
Fixed Annuity....................................................6
Section 1. Definitions....................................................7
Section 2. General Provisions.............................................9
The Contract.....................................................9
Certificates.....................................................9
Nonparticipating Contract........................................9
Misstatements and Adjustments....................................9
Reports..........................................................9
Premium Taxes....................................................9
Protection of Proceeds...........................................9
Evidence of Survival.............................................9
Proof of Age.....................................................9
Change of Contract...............................................9
Section 3. Ownership.....................................................10
Group Contract Holder...........................................10
Certificate Holder Rights.......................................10
Transfer of Ownership...........................................10
Section 4. Beneficiary Provisions........................................11
Beneficiary.....................................................11
Change of Beneficiary...........................................11
Death of Beneficiary............................................11
Section 5. Purchase Payments.............................................11
Purchase Payments...............................................11
Allocation of Purchase Payments.................................11
Section 6. Separate Account..............................................12
General.........................................................12
Investment Allocations to the Separate Account..................12
Valuation of Assets.............................................12
Accumulation Unit...............................................12
Net Return Factor for Each Valuation Period.....................12
Administrative Charge...........................................13
Mortality Risk Charge...........................................13
Expense Risk Charge.............................................13
Mortality and Expense Guarantee.................................13
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Page
Section 7. AG Account....................................................13
AG Account Guaranteed Interest Rate.............................13
Deposit Period..................................................13
Guaranteed Term.................................................13
Guaranteed Term(s) Groups.......................................14
Maturity Date...................................................14
Allocation of Net Purchase Payments to the AG Account...........14
AG Account Guaranteed Term Maturity Date and Maturity Value.....14
Transfers from the AG Account...................................14
Withdrawals from the AG Account.................................14
Reinvestment....................................................14
AG Account Market Value Adjustment (Factor).....................15
Section 8. Certificate Holder's Account Value; Transfers and Withdrawals
During the Accumulation Period ...............................16
Certificate Holder's Account Value..............................16
Transfers During the Accumulation Period........................16
Withdrawals During the Accumulation Period......................16
Deferred Sales Charge...........................................16
Waiver of Deferred Sales Charge.................................17
Payment of Adjusted Certificate Holder Account Value............17
Systematic Withdrawal Option (SWO)..............................17
Section 9. Maintenance Charge............................................18
Maintenance Charge..............................................18
Section 10. Proceeds Payable on Death....................................18
Death of the Certificate Holder Prior to the Annuity Date.......18
Death Benefit Amount Prior to the Annuity Date..................18
Death Benefit Payment Methods...................................20
Death of Certificate Holder On or After the Annuity Date........20
Death of the Annuitant..........................................20
Section 11. Delay of Payments............................................20
Delay of Payments...............................................20
Section 12. Annuity Provisions...........................................21
Designation of Annuitant........................................21
Terms of Annuity Options........................................21
Annuity Unit....................................................22
Annuity Unit Value..............................................23
Annuity Net Return Factor.......................................23
Annuity Options.................................................23
3
Contract Schedule
Separate Account
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Separate Account: Variable Account I
Charges to the Separate A daily charge is deducted from the assets of the
Account: Separate Account. The deduction is the daily
equivalent of the annual effective percentage
shown below:
(a) During the Accumulation Period:
Administrative Charge 0.15%
Mortality Risk Charge 0.35%
Expense Risk Charge 0.90%
TOTAL Separate Account Charges During
Accumulation Period 1.40%
(b) During the Annuity Period
Administrative Charge Not To Exceed 0.25%
Mortality Risk Charge 0.35%
Expense Risk Charge 0.90%
TOTAL Maximum Separate Account Charges
During Annuity Period 1.50%
AICA Guaranteed Account (AG Account)
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Minimum Guaranteed 3.0%
Interest Rate
(effective annual rate of
return):
Separate Account and AG Account
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Minimum Initial $1,500
Purchase Payment:
Minimum Subsequent $500 or $50 per month if paid by an automatic
Purchase Payment: check plan
Maximum Subsequent $500,000 without Home Office approval
Purchase Payment:
Transfers: We allow an unlimited number of transfers during
the Accumulation Period. Twelve (12) transfers
in any calendar year are free. Thereafter, We
reserve the right to charge a transfer charge up to
$10 for each subsequent transfer.
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Maintenance Charge: The annual maintenance charge is $30. If the
Certificate Holder's Account is $50,000 or more on
the date the maintenance charge is to be deducted,
the maintenance charge is $0.
Deferred Sales For each withdrawal from a Certificate Holder's
Charge: Account, a deferred sales charge for each Net
Purchase Payment will be determined as follows:
Years from Receipt of Deferred
Net Purchase Payment Sales Charge
0-1 7%
1-2 6%
2-3 5%
3-4 4%
4-5 3%
5-6 2%
6-7 1%
7+ 0%
Waiver of Deferred Section 8.05 provides for the following:
Sales Charge:
(c) At least 12 months after the date of the first
Purchase Payment in an amount equal to or less
than 15% of the Certificate Holder's Account
Value.
(d) For a full withdrawal where the Certificate
Holder's Account Value does not exceed $2,500
and no withdrawals have been taken from the
Certificate Holder's Account within the prior
12 months.
Systematic (a) Specified Payment - Maximum Percentage: 10%
Withdrawal Option:
(b) Specified Period - Minimum Period: 10 years
(c) Specified Percentage - Maximum Percentage: 10%
Death Benefit Factor: 4%
Death Benefit There is no maximum death benefit amount.
Maximum Amount:
Death Benefit 85 years
Maximum Age:
Fund for Allocation of Federated Prime Money Fund II
Excess Guaranteed Death
Benefit Value:
Latest Annuity Date: The Certificate Holder's 90th birthday.
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Fixed Annuity
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Minimum Guaranteed 3.0%
Interest Rate
(effective annual rate
of return):
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Section 1. Definitions
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1.01 Accumulation Period - The period during which one or more Net
Purchase Payments applied to a Certificate Holder's Account
accumulate to provide future Annuity payments.
1.02 Accumulation Unit - A measure of the net investment results for
each variable investment option during the Accumulation Period.
The Accumulation Units for the applicable Funds are used to
calculate the portion of a Certificate Holder's Account Value
attributable to a Separate Account during the Accumulation
Period.
1.03 Adjusted Certificate Holder Account Value - The Certificate
Holder's Account Value, plus or minus any aggregate AG Account
Market Value Adjustment.
1.04 Annuitant - The natural person on whose life an Annuity payment
is based.
1.05 Annuity - A series of payments We make for life, a definite
period or a combination of the two.
1.06 Annuity Date - The date on which Annuity payments commence.
1.07 Annuity Options - Annuity payment methods available during the
Annuity Period.
1.08 Annuity Period - The period of time during which Annuity payments
are made.
1.09 Annuity Unit - A measure of the net investment results for each
variable investment option during the Annuity Period. Annuity
Units are used to calculate the amount of each variable Annuity
payment.
1.10 Beneficiary - The person(s) entitled to receive any death
benefit under the Certificate Holder's Account. Upon the death of
a joint Certificate Holder, the surviving joint Certificate
Holder, if any, is treated as the Beneficiary. Any other
Beneficiary designation on record with Us at the time of death is
treated as a contingent Beneficiary.
1.11 Certificate - The document issued to a Certificate Holder to
evidence a Certificate Holder's Account established under the
group Contract.
1.12 Certificate Holder - A person who has established a Certificate
Holder's Account under a group Contract. We reserve the right to
limit ownership to natural persons. If more than one Certificate
Holder owns an Account, each Certificate Holder shall be a joint
Certificate Holder. Any joint Certificate Holder must be the
spouse of the other joint Certificate Holder. Joint Certificate
Holders have joint ownership rights and both must authorize any
exercising of those ownership rights unless otherwise allowed by
Us.
1.13 Certificate Holder's Account - A record We establish for each
Certificate Holder to maintain values under a group Contract.
1.14 Certificate Holder's Account Value - The dollar value as of any
Valuation Period of all amounts accumulated in a Certificate
Holder's Account.
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1.15 Contract - This agreement between the Group Contract Holder and
Us.
1.16 Effective Date - The date a Certificate is issued to a
Certificate Holder.
1.17 Fund - One of the variable investment options which may be
selected by a Certificate Holder.
1.18 General Account - The General Account is made up of all of our
general assets other than those allocated to the separate
accounts.
1.19 AICA Guaranteed Account (AG Account) - An investment option
where We guarantee specified rate(s) of interest for specified
periods of time. The AG Account is a separate account established
by Us in accordance with the provisions of the Connecticut
General Statutes Section 38a-433. Certificate Holders do not
participate in the investment gain or loss from the assets held
in the AG Account. Assets in the AG Account may be charged with
liabilities arising out of any other business We may conduct.
1.20 Group Contract Holder - The entity to which a group Contract is
issued.
1.21 Home Office - Our headquarters, located at ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇,
▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇.
1.22 Market Value Adjustment - An adjustment to any withdrawal made
from the AG Account before the end of a guaranteed term as stated
in Section 7.11.
1.23 Net Purchase Payment - The Purchase Payment less premium taxes,
if applicable.
1.24 Purchase Payment - The gross payment accepted by Us and
allocated to the Certificate Holder's Account. We reserve the
right to refuse to accept any Purchase Payment at any time for
any reason.
1.25 Separate Account - A separate account that buys and holds shares
of the Fund(s). Income, gains or losses, realized or unrealized,
are credited or charged to the Separate Account without regard to
Our other income, gains or losses. We own the assets held in the
Separate Account and are not a trustee as to such amounts. The
Separate Account generally is not guaranteed and is held at
market value. The name of the Separate Account is shown on the
Contract Schedule. The assets of the Separate Account, to the
extent of reserves and other Contract liabilities of the Separate
Account, will not be charged with Our other liabilities.
1.26 Valuation Period - The period of time for which a Fund determines
its net asset value, usually from 4:15 p.m. Eastern time each day
the New York Stock Exchange is open until 4:15 p.m. the next such
business day, or such other day that one or more of the Funds
determines its net asset value. The assets of the Separate
Account are not chargeable with the liabilities arising out of
any other business We may conduct.
1.27 Variable Annuity Contract - An Annuity Contract providing for the
accumulation of value and/or for Annuity payments which vary in
amount based on investment results.
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Section 2. General Provisions
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2.01 The Contract - The entire Contract consists of this Contract and
any attached applications or endorsements.
2.02 Certificates - A Certificate is issued to each Certificate Holder
whose Purchase Payment(s) is accepted by Us. The Certificate
evidences a Certificate Holder's Account established under the
Contract. Certificates are not part of the Contract.
2.03 Nonparticipating Contract - Neither the Group Contract Holder,
Certificate Holder nor any Beneficiary have a right to share in
our earnings.
2.04 Misstatements and Adjustments - If We learn that the age of any
Annuitant or second Annuitant is misstated, the correct age will
be used to adjust payments. We reserve the right to request
reimbursement or adjust future payments for any amount overpaid.
We will pay the amount of any underpayment.
2.05 Reports - We furnish each Certificate Holder with a report
showing the Certificate Holder's Account Value at least once each
calendar year. We also furnish an annual report of the Separate
Account.
2.06 Premium Taxes - Any premium taxes paid to any governmental
entity are charged against Purchase Payments or a Certificate
Holder's Account. We may, at our sole discretion, pay premium
taxes when due and deduct that amount from the Certificate
Holder's Account at a later date. Payment at an earlier date does
not waive any right We may have to deduct amounts at a later
date.
2.07 Protection of Proceeds - To the extent permitted by law, all
payments under this Contract to a Certificate Holder or
Beneficiary shall be free from legal process and the claim of any
creditor.
2.08 Evidence of Survival - The Company may require satisfactory
evidence of the continued survival of any person(s) on whose life
Annuity payments are based.
2.09 Proof of Age - The Company may require evidence of age of any
Annuitant under Annuity Options 2 and 3 and of the designated
second Annuitant under Annuity Option 3.
2.10 Change of Contract - Only our authorized officers may change the
terms of this Contract. We will notify the Group Contract Holder
in writing at least 30 days before the effective date of any
change. Any change will not affect the amount or terms of any
Annuity which begins before the change.
We may make any change that affects the AG Account Market Value
Adjustment with at least thirty (30) days' advance written notice
to the Group Contract Holder and the Certificate Holder. Any such
change shall become effective for any new guaranteed term and
will apply to all present and future Certificate Holders'
Accounts.
We reserve the right to change the terms of the Systematic
Withdrawal Option for future elections and discontinue the
availability of this option.
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Any change to any of the following provisions under this Contract
will not apply to Certificate Holder's Accounts in existence
before the effective date of the change:
(a) Net Purchase Payment (1.23)
(b) AG Account Guaranteed Interest Rate (7.01)
(c) Net Return Factor (6.05)
(d) Certificate Holder's Account Value (1.14)
(e) Deferred Sales Charge (8.04)
(f) Annuity Unit Value (12.04)
(g) Annuity Options (12.06)
(h) Fixed Annuity Interest Rates (12.01)
(i) Transfers (8.02).
Any change that affects the Annuity Option and the tables for the
Annuity Options may be made:
(a) No earlier than twelve (12) months after the Effective Date;
and
(b) No earlier than twelve (12) months after the effective date
of any prior change.
Any Certificate Holder's Account established on or after the
effective date of any change will be subject to the change. If
the Group Contract Holder does not agree to any change under this
provision, We reserve the right to not allow any new Certificate
Holder's Accounts to be established under this Contract. This
Contract may also be changed as deemed necessary by Us to comply
with federal or state law.
Section 3. Ownership
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3.01 Group Contract Holder - The Group Contract Holder has title to
the Contract. The Contract and any amounts accumulated thereunder
are not subject to the claims of the Group Contract Holder nor
any of its creditors.
3.02 Certificate Holder Rights - The Certificate Holder has all
interest and right to amounts held in his or her Certificate
Holder's Account. The Certificate Holder and any joint
Certificate Holder are named on the Specifications page. The
Certificate Holder and any joint Certificate Holder may exercise
all the rights under the Certificate Holder's Account, subject to
the rights of:
(a) Any assignee under an assignment filed at our Home Office;
and
(b) Any irrevocably named Beneficiary.
Upon the death of a Certificate Holder prior to the Annuity Date,
a spousal Beneficiary may elect to continue the Certificate
Holder's Account in his or her own name and retain all ownership
rights and privileges or take distribution of the death benefit
as defined in Section 10.
3.03 Transfer of Ownership - The Group Contract Holder may transfer
ownership of this Contract. A written request, dated and signed,
must be filed at our Home Office.
Any transfer of ownership terminates the interest of any existing
Group Contract Holder. It does
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not change the rights of any Certificate Holder.
A Certificate Holder may transfer all of his or her rights under
the Contract. A written request, dated and signed by the
Certificate Holder and any joint Certificate Holder, must be
filed at our Home Office. After the transfer is recorded, it will
take effect as of the date the request was signed. Any such
transfer terminates the interest of any existing Certificate
Holder. It does not change the Beneficiary, nor transfer the
Beneficiary's interest. A transfer will not affect any payments
We may make or actions We may take before such transfer has been
recorded at our Home Office.
Section 4. Beneficiary Provisions
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4.01 Beneficiary - The Certificate Holder may name a Beneficiary and
a contingent Beneficiary. At the death of the Certificate Holder
prior to the Annuity Date, the Beneficiary(ies) named in our
records will receive a death benefit as stated in Section 10.
Upon the death of either joint Certificate Holder prior to the
Annuity Date, the surviving joint Certificate Holder, if any,
will be treated as the designated Beneficiary and any other
Beneficiary designation on record with Us at the time of death is
treated as a contingent Beneficiary.
4.02 Change of Beneficiary - The Certificate Holder may change the
Beneficiary. A written request, dated and signed by the
Certificate Holder, must be filed at our Home Office. If there
are joint Certificate Holders, both must sign the request. After
the change is recorded, it will take effect as of the date the
request was signed. If the request reaches our Home Office and is
recorded after the Certificate Holder dies, but before any
payment is made, the change is valid.
4.03 Death of Beneficiary - If all of the Beneficiaries and contingent
Beneficiaries die prior to the Certificate Holder's death, We pay
the death benefit in one sum to the Certificate Holder's estate.
Section 5. Purchase Payments
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5.01 Purchase Payments - Subject to the maximum and minimum shown on
the Contract Schedule, the Certificate Holder may determine the
amount and frequency of Purchase Payments. We reserve the right
not to accept any Purchase Payment. We will declare from time to
time the acceptability of additional Purchase Payments.
5.02 Allocation of Purchase Payments - The Certificate Holder may
elect to have each Net Purchase Payment accumulate:
(a) On a variable basis invested in shares of one or more Funds
in which the Separate Account invests;
(b) For guaranteed terms offered in the current deposit period(s)
under the AG Account; or
(c) In a combination of any of the available investment options.
Net Purchase Payments must be allocated in whole percentages. For
subsequent Purchase Payments, if no allocation instructions are
received with the Purchase Payment, the allocation will be as
indicated in the most recent directive from the Certificate
Holder. If the same
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guaranteed term(s) are not available, the next shortest will be
used. If no shorter guaranteed term is available, the next longer
guaranteed term will be used.
Section 6. Separate Account
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6.01 General - The assets of the Separate Account, equal to the
reserves and other Contract liabilities that depend on the
investment performance of the Separate Account are not chargeable
with liabilities arising out of any other business We may
conduct. Income, gains or losses of the Separate Account,
realized or unrealized, are credited to or charged against the
assets of the Separate Account without regard to Our other
income, gains or losses.
6.02 Investment Allocations to the Separate Account - The assets of
the Separate Account are segregated by Fund. If the shares of any
Fund are no longer available for investment by the Separate
Account or if in our judgment, further investment in such shares
should become inappropriate in view of the purpose of the
Contract, We may cease to make such Fund shares available for
investment under the Contract prospectively, or We may substitute
shares of another Fund for shares already acquired. We may also,
from time to time, add additional Funds. Any elimination,
substitution or addition of Funds will be done in accordance with
applicable state and federal securities laws. We reserve the
right to substitute shares of another Fund for shares already
acquired without a proxy vote.
6.03 Valuation of Assets - The shares of the Funds will be valued at
their net asset value at the end of each Valuation Period.
6.04 Accumulation Unit - A Net Purchase Payment that is allocated to
one or more Funds is credited to the Certificate Holder's Account
as Accumulation Units. The number of Accumulation Units credited
is determined by dividing the applicable portion of the Net
Purchase Payment by the Accumulation Unit value for the
appropriate Fund. The Accumulation Unit value used is that which
is computed for the next Valuation Period after which the
Purchase Payment is received at our Home Office. Accumulation
Units attributable to the initial Purchase Payments will be
credited within two business days of acceptance.
Accumulation Unit values may increase or decrease from Valuation
Period to Valuation Period.
6.05 Net Return Factor for Each Valuation Period - The value of an
Accumulation Unit for any Valuation Period is calculated by
multiplying the Accumulation Unit value for the immediately
preceding Valuation Period by the net return factor of the
appropriate Fund for the current period.
The net return factor for each Fund is equal to 1.0000000 plus
the net return rate.
The net return rate equals:
(a) The value of the shares of the Fund held by the Separate
Account at the end of a Valuation Period; minus
(b) The value of the shares of the Fund held by the Separate
Account at the start of the Valuation Period; plus or minus
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(c) Taxes (or reserves for taxes) on the Separate Account (if
any); divided by
(d) The total value of the Funds(s) Accumulation Units and
Fund(s) Annuity Units of the Separate Account at the start
of the Valuation Period; minus
(e) A daily actuarial charge as shown on the Contract Schedule
for Annuity mortality and expense risks and profit and a
daily administrative charge.
The net return rate may be more or less than zero (0) percent.
The value of a share of the Fund is equal to the net assets of
the Fund divided by the number of shares outstanding.
6.06 Administrative Charge - We deduct an administrative charge equal,
on an annual basis, to the amount shown on the Contract Schedule.
6.07 Mortality Risk Charge - We deduct a mortality risk charge equal,
on an annual basis, to the amount shown on the Contract Schedule.
6.08 Expense Risk Charge - We deduct an expense risk charge equal, on
an annual basis, to the amount shown on the Contract Schedule.
6.09 Mortality and Expense Guarantee - We guarantee that the dollar
amount of each Annuity payment after the first will not be
affected by variations in mortality or expense experience.
Section 7. AG Account
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7.01 AG Account Guaranteed Interest Rate - All amounts allocated to
the AG Account earn a rate of interest that is guaranteed for a
specified period of time. The rate will be credited daily and
will never be less than the minimum guaranteed interest rate
shown on the Contract Schedule. We determine the rate and it is
not based on investment experience.
For guaranteed terms of one year or less, one guaranteed interest
rate is credited for the full guaranteed term. For longer
guaranteed terms, an initial guaranteed interest rate is credited
from the date of deposit to the end of a specified period within
the guaranteed term. There may be different guaranteed interest
rate(s) declared for subsequent specified time intervals
throughout the guaranteed term.
7.02 Deposit Period - A calendar week, a calendar month, a calendar
quarter, or any other period of time We specify during which Net
Purchase Payment(s), transfers and reinvestments are accepted
into the AG Account for one or more guaranteed terms. We reserve
the right to extend the deposit period.
7.03 Guaranteed Term - The period of time for which AG Account
guaranteed interest rates are guaranteed on Net Purchase
Payments. Transfers and reinvestments are made into a current
deposit period for the AG Account. Such period begins on the day
following the close of the deposit period and ends on the
designated Maturity Date. Guaranteed terms, if any, are offered
at our discretion for various lengths of time ranging up to and
including ten years.
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During a deposit period, We may make available any number of
guaranteed terms. The Certificate Holder may allocate Net
Purchase Payments and transfers into any or all of the available
guaranteed terms.
7.04 Guaranteed Term(s) Groups - All AG Account guaranteed term(s)
with the same length of time from the close of the deposit period
until the designated Maturity Date.
7.05 Majority Date - The last day of a guaranteed term.
7.06 Allocation of Net Purchase Payments to the AG Account - When the
Certificate Holder wishes to allocate all or any portion of a Net
Purchase Payment to the AG Account, he or she must tell Us the
percentage to apply to one or more of the AG Account guaranteed
term(s) available during the current deposit period. If no
allocation instructions are received, a Net Purchase Payment is
allocated as indicated in the most recent directive from the
Certificate Holder. If the same guaranteed term is not available
for any amount allocated to the AG Account, We will allocate the
amount to the next shortest guaranteed term available. If no
shorter guaranteed term is available, We will allocate it to the
next longest guaranteed term.
7.07 AG Account Guaranteed Term Maturity Date and Maturity Value - On
the maturity date, the value of the total of all amounts
allocated to that guaranteed term is called the maturity value.
When Certificate Holders have assets in the AG Account, at least
eighteen (18) days before a maturity date, We notify them of the:
(a) Projected maturity value; and
(b) Guaranteed terms and the applicable guaranteed interest
rates available during the current deposit period.
When no allocation instructions are received and the assets in a
guaranteed term have been reinvested by Us in another guaranteed
term on the maturity date, the Certificate Holder may transfer or
withdraw, during the month following the maturity date, the
reinvested amount with interest earned (as of the date the
request is received at our Home Office) without incurring a
Market Value Adjustment. This transaction is allowed only once
for each maturity date, regardless of whether the transfer or
withdrawal is partial or full.
7.08 Transfers from the AG Account - A Certificate Holder may transfer
any portion, or all, of an amount in the AG Account to one or
more of the Funds or to another available guaranteed term. The
amount withdrawn for any reason before the maturity date is
subject to a Market Value Adjustment.
7.09 Withdrawals from the AG Account - When the Certificate Holder
requests a withdrawal from the AG Account, if instructions are
not provided by the Certificate Holder, amounts are withdrawn on
a pro rata basis from the guaranteed term(s) groups in which the
Certificate Holder's Account is currently invested. Within a
guaranteed term group, the amount to be withdrawn will be
withdrawn first from the oldest deposit period. Except on the
maturity date, withdrawals from the AG Account will be subject to
a Market Value Adjustment.
7.10 Reinvestment - We will mail a notice to the Certificate Holder
before a guaranteed term's
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maturity date. This notice will contain the guaranteed terms
available during the current deposit periods with their
guaranteed interest rate(s) and projected maturity value. If no
specific direction is given by the Certificate Holder prior to
the maturity date, each maturity value will be reinvested in the
current deposit period for a guaranteed term of the same
duration. If a guaranteed term of the same duration is
unavailable, each matured term value will automatically be
reinvested in the current deposit period for the next shortest
guaranteed term available. If no shorter guaranteed term is
available, the next longer guaranteed term will be used. We will
mail a confirmation statement to the Certificate Holder after the
maturity date. This notice will state the guaranteed term and
guaranteed interest rate(s) which will apply to the reinvested
matured term value.
7.11 AG Account Market Value Adjustment (Factor) - The Market Value
Adjustment factor (MVA factor) reflects any change in interest
rates from the time assets are allocated to the AG Account to the
time they are transferred or withdrawn. An MVA factor is applied
to any amount withdrawn or transferred from the AG Account before
the end of a guaranteed term, including amounts paid in a lump
sum death benefit or applied to an Annuity Option.
The amount withdrawn from the AG Account is multiplied by the MVA
factor which is calculated as follows:
x
---
365
(1 + i)
--------------------
x
---
365
(1 + j)
Where:
i is the Deposit Period Yield
j is the Current Yield
x is the number of days remaining, (computed from
Wednesday of the week of withdrawal) in the
guaranteed Term.
Determination of MVA factor parameters:
A yield is computed at the close of the last business day of each
week of the deposit period. The yield will equal the average of
the yields on U.S. Treasury Notes which matured during the last
three months of the applicable guaranteed term.
The deposit period yield is the average of those yields for the
deposit period. If withdrawal is made prior to the close of the
deposit period, it is the average of those yields on each week
preceding withdrawal.
The current yield is the average of the yields on the last
business day of the week preceding withdrawal on the same U.S.
Treasury Notes included in the deposit period yield.
If no U.S. Treasury Notes matured during the last three months of
the guaranteed term, We reserve the right to use the average of
the yields on U.S. Treasury Notes that mature during a
15
following quarter.
Section 8. Certificate Holder's Account Value; Transfers and Withdrawals
During the Accumulation Period
--------------------------------------------------------------------------------
8.01 Certificate Holder's Account Value - The value of a Certificate
Holder's Account is determined by adding the value of the total
of Accumulation Units attributed to the selected Fund(s) to the
value of any amounts attributed to the AG Account.
8.02 Transfers During the Accumulation Period - Before the Annuity
Date, the Certificate Holder may transfer from any Fund or
guaranteed term of the AG Account to:
(a) Any other Fund; or
(b) Any guaranteed term of the AG Account available in the
current deposit period.
Transfer requests can be submitted as a percentage or as a dollar
amount. We may establish a minimum transfer amount. Within a
guaranteed term group, the amount transferred is withdrawn first
from the oldest deposit period, then from the next oldest, and so
on until the amount requested is satisfied.
The Certificate Holder may make an unlimited number of transfers
during the Accumulation Period. The number of free transfers
allowed is shown on the Contract Schedule. Transfers in excess of
that number may be subject to the transfer charge shown on the
Contract Schedule. Transfers of a matured term value from the AG
Account on or within one calendar month after a guaranteed term's
maturity date do not count against the annual transfer limit.
Amounts applied to guaranteed terms of the AG Account may not be
transferred to the Funds or to another guaranteed term during the
deposit period or for 90 days after the close of the deposit
period except for matured term value(s) during the calendar month
following the guaranteed term's maturity date.
Transfers from guaranteed terms of the AG Account are subject to
a Market Value Adjustment.
8.03 Withdrawals During the Accumulation Period - The Certificate
Holder may withdraw all or a portion of the Certificate Holder's
Account Value during the Accumulation Period by properly
completing a withdrawal request form. Withdrawal requests can be
submitted as a percentage or as a specific dollar amount. Net
Purchase Payment amounts are withdrawn first, and then the excess
value, if any. For any partial withdrawal, if instructions are
not provided by the Certificate Holder, amounts are withdrawn on
a pro rata basis from the Fund(s), and/or the guaranteed term(s)
groups in which the Certificate Holder's Account is currently
invested. Within a guaranteed term group, the amount to be
withdrawn will be withdrawn first from the oldest deposit period,
then from the next oldest, and so on until the amount requested
is satisfied.
After deduction of the maintenance charge, if applicable, the
withdrawn amount shall be reduced by the applicable deferred
sales charge and any applicable premium taxes.
8.04 Deferred Sales Charge - The deferred sales charge only applies to
the portion of the amount
16
withdrawn attributable to Net Purchase Payment(s) and varies
according to the elapsed time since receipt of the Purchase
Payment. The deferred sales charge is shown on the Contract
Schedule.
8.05 Waiver of Deferred Sales Charge - No deferred sales charge is
deducted when a Certificate Holder's Account Value is paid:
(a) To a Beneficiary as a death benefit, except for Purchase
Payments made by a surviving joint Certificate Holder as
described in Section 10.02(b);
(b) As a premium for an Annuity Option;
(c) At least the number of months, as shown on the Contract
Schedule, after the date of the first Purchase Payment and
in an amount equal to or less than the percentage of the
Certificate Holder's Account Value as shown on the Contract
Schedule. This applies to the first withdrawal request,
partial or full, in a calendar year. The Certificate
Holder's Account Value is calculated as of the date the
withdrawal request is received in good order at our Home
Office. This waiver is not available to the Certificate
Holder while a SWO is in effect;
(d) For a full withdrawal where the Certificate Holder's
Account Value does not exceed the amount shown on the
Contract Schedule and no withdrawals have been taken from
the Certificate Holder's Account within the prior 12 months;
(e) For a distribution made by Us under Section 8.06; or (f)
For a distribution which is part of a SWO under Section
8.07.
We reserve the right to allow the proceeds of a total withdrawal
to be reinstated under the terms and conditions as established by
Us from time to time.
8.06 Payment of Adjusted Certificate Holder Account Value - Upon 90
day's written notice to the Certificate Holder, We will terminate
any Certificate Holder's Account if the Certificate Holder's
Account Value becomes less than $1,500 immediately following any
partial withdrawal. We do not intend to exercise this right in
cases where the Certificate Holder's Account Value is reduced to
$1,500 or less solely due to investment performance. When We make
a distribution pursuant to this provision, the deferred sales
charge will not be deducted.
8.07 Systematic Withdrawal Option (SWO) - We will allow the
Certificate Holder to establish a schedule of withdrawals to be
made automatically from the Certificate Holder's Account Value.
All distributed amounts will be withdrawn on a pro rata basis
from the Fund(s) and/or the guaranteed term(s) groups of the AG
Account in which the Certificate Holder's Account is invested.
The Certificate Holder must elect one of the following SWO
methods:
(a) Specified Payment: Payments of a designated dollar amount.
The annual amount may not be greater than the percentage of
the Certificate Holder's Account Value at time of the
election as shown on the Contract Schedule. This annual
dollar amount will remain constant. At our discretion, We
may require a minimum payment amount; or
(b) Specified Period: Payments which are made over a period of
time which must be at least the minimum period as shown on
the Contract Schedule. The annual amount paid each
17
year is calculated by dividing the Certificate Holder's
Account Value as of December 31 of the prior year by the
number of payment years remaining; or
(c) Specified Percentage: Payment of a designated percentage
which cannot be greater than the percentage of the
Certificate Holder's Account Value at the time of election
as shown on the Contract Schedule. The percentage may be
changed by written request. We reserve the right to limit
the number of times the percentage may be changed. The
annual amount is calculated by multiplying the Certificate
Holder's Account Value as of December 31 of the year prior
to the payment by the designated percentage.
In our discretion, We may require a minimum initial Certificate
Holder's Account Value for election of this option. SWO may be
elected by submitting a completed and signed election form to Us.
Once elected, this option may be revoked by submitting a written
request to Us. SWO may be elected only once by the Certificate
Holder or by a spousal Beneficiary.
Certificate Holders should consult their tax adviser prior to
requesting this distribution option. We are not responsible for
any adverse tax consequences due to a Certificate Holder's
receiving SWO payments. A ten (10) percent penalty tax may apply
to distributions to a Certificate Holder who has not reached age
59-1/2. Upon death of the Certificate Holder, any payments will
be made under the terms of Section 10.
Section 9. Maintenance Charge
--------------------------------------------------------------------------------
9.01 Maintenance Charge - We will deduct an annual maintenance charge
as shown in the Contract Schedule from the Certificate Holder's
Account during the Accumulation Period. We will deduct the
maintenance charge on the anniversary of the Effective Date of
the Certificate for the Certificate Holder's Account. This
maintenance charge is also deducted upon withdrawal of the entire
Adjusted Certificate Holder's Account. The maintenance charge is
deducted proportionately from each investment option used.
Section 10. Proceeds Payable on Death
--------------------------------------------------------------------------------
10.01 Death of the Certificate Holder Prior to the Annuity Date - In
the event of the death of the Certificate Holder or a joint
Certificate Holder prior to the Annuity Date, a death benefit is
payable to the Beneficiary(ies) designated by the Certificate
Holder. Upon the death of a joint Certificate Holder, the
surviving joint Certificate Holder, if any, will be treated as
the designated Beneficiary. Any other Beneficiary designation on
record with Us at the time of death will be treated as a
contingent Beneficiary.
A Beneficiary may request We pay the death benefit under one of
the options described in Section 10.03. If the Beneficiary is the
spouse of the Certificate Holder, he or she may elect to continue
the Certificate Holder's Account in his or her own name and
exercise all the Certificate Holder's rights under the Contract.
10.02 Death Benefit Amount Prior to the Annuity Date -
18
(a) Except as set forth in Section 10.02(b), the amount of the
guaranteed death benefit value is equal to the greater of:
(i) The Certificate Holder's Account Value at the end of
the Valuation Period during which We receive at our
Home Office due proof of death and election of the type
of payment to be made; or
(ii) The death benefit determined as of the Valuation
Period corresponding to the date of death.
Until the first Effective Date anniversary, the death
benefit is equal to the Purchase Payments made by the
Certificate Holder prior to the Effective Date
anniversary less any withdrawals and any amounts
applied to an Annuity Option.
For each Certificate year thereafter, the death benefit
during the Certificate year equals the death benefit at
the beginning of the Certificate year plus Purchase
Payments made during the year less any withdrawals and
any amounts applied to an Annuity Option.
On each Effective Date anniversary, the death benefit
is determined as follows:
(A) The death benefit on the previous Effective Date
anniversary increased by the death benefit factor
shown on the Contract Schedule; plus
(B) Purchase Payments made by the Certificate Holder
during the Certificate year increased by the death
benefit factor shown on the Contract Schedule for
the portion of the year since the Purchase Payment
was made; less
(C) Any withdrawals or amounts applied to an Annuity
Option during the Certificate year increased by
the death benefit factor shown on the Contract
Schedule for the portion of the Certificate year
since the withdrawal or election of Annuity
option; or
(iii) The Certificate Holder's Account Value on the most
recent seventh year anniversary of the Effective Date
plus any Purchase Payments made after such Effective
Date anniversary less any withdrawals and any amounts
applied to an Annuity Option.
Notwithstanding the foregoing, the death benefit under (ii)
or (iii) will not exceed the death benefit maximum amount
shown on the Contract Schedule.
The death benefit calculation described in (ii) and (iii)
above, applies until the Certificate Holder reaches the
death benefit maximum age shown on the Contract Schedule.
Thereafter, the death benefit is only adjusted for Purchase
Payments, withdrawals and amounts applied to Annuity
Options. If the Certificate Holder reaches the death benefit
maximum age shown on the Contract Schedule prior to the
seventh anniversary of the Effective Date, the death benefit
will be the greater of (i) or (ii) above.
The excess, if any, of the guaranteed death benefit value
over the Certificate Holder's Account Value is determined
when we receive at our Home Office due proof of death and
allocated to the Fund shown on the Contract Schedule. The
Certificate Holder's Account
19
Value plus any excess amount deposited becomes the
Certificate Holder's Account Value.
(b) In the case of a Beneficiary of a surviving joint
Certificate Holder who continued the Certificate Holder's
Account in his or her own name, the death benefit shall be
equal to (a)(i) above less any applicable deferred sales
charge on any Purchase Payment made after We have received
at our Home Office due proof of death of the first joint
Certificate Holder.
10.03 Death Benefit Payment Methods - A non-spousal Beneficiary must
elect the death benefit to be paid under one of the following
methods in the event of the death of the Certificate Holder prior
to the Annuity Date:
Method 1 - Lump sum payment of the death benefit; or
Method 2 - The payment of the entire death benefit within (5)
years of the date of the Certificate Holder's death; or
Method 3 - Payment of the death benefit over the lifetime of the
designated Beneficiary or over a period not extending beyond the
life expectancy of the designated Beneficiary with distribution
beginning within one year of the date of death of the Certificate
Holder.
Any portion of the death benefit not applied under Option 3
within one year of the date of Certificate Holder's death, must
be distributed within five (5) years of the date of death. A
Market Value Adjustment will apply at the time the death benefit
is paid.
A spousal Beneficiary may elect to continue the Certificate
Holder's Account in his or her name, elect a lump sum payment of
the death benefit or apply the Adjusted Certificate Holder's
Account Value to an Annuity Option.
10.04 Death of Certificate Holder On or After the Annuity Date - If the
Certificate Holder who is not the Annuitant, dies on or after the
Annuity Date, the remaining payments under the Annuity Option
elected will be made to the Beneficiary at least as rapidly as
under the method of distribution in effect at the Certificate
Holder's death.
10.05 Death of the Annuitant - If the Annuitant, who is not a
Certificate Holder, dies on or before the Annuity Date, a new
Annuitant may be named. If no Annuitant is named, the Certificate
Holder will be the Annuitant. If the Annuitant dies after the
Annuity Date, the death benefit, if any, will be payable to the
Beneficiary as specified in the Annuity Option elected. We will
require proof of the Annuitant's death. Death benefits will be
paid at least as rapidly as under the method of distribution in
effect at the Annuitant's death.
Section 11. Delay of Payments
--------------------------------------------------------------------------------
11.01 Delay of Payments - We will make any payments under this Contract
within seven days after a request is received in good order. We
reserve the right to suspend or postpone any type of payment from
the Separate Account for any period when:
20
(a) The New York Stock Exchange is closed for other than
customary weekend and holiday closings;
(b) Trading on the Exchange is restricted;
(c) An emergency exists as a result of which it is not
reasonably practicable to dispose of securities held in the
Separate Account or determine their value; or
(d) The Securities and Exchange Commission so permits delay for
the protection of security holders.
The applicable rules of the Securities and Exchange Commission
will govern as to whether the conditions in (b) or (c) exist.
We also reserve the right to delay any type of payment from the
AG Account for up to six (6) months.
Section 12. Annuity Provisions
--------------------------------------------------------------------------------
12.01 Designation of Annuitant - The Certificate Holder and the
Annuitant need not be the same person. The Certificate Holder
names the Annuitant and during the Accumulation Period, may
change the designated Annuitant. We change the Annuitant when We
receive a written request in good order at our Home Office. We
will not change the Annuitant when Annuity payments have
commenced.
The Certificate Holder elects an Annuity Option by telling Us to
use all or any portion of the Certificate Holder's Adjusted
Account Value (minus any applicable premium taxes if not
previously deducted) to purchase Annuity payments under an
Annuity Option.
When an Annuity Option is chosen the Certificate Holder must
designate a:
(a) Fixed Annuity using the General Account;
(b) Variable Annuity using any of the Funds available during the
Annuity Period; or
(c) Combination of (a) and (b).
If a fixed Annuity is chosen, We will calculate the amount using
an interest assumption no less than the percentage specified on
the Contract Schedule. We may calculate the amount using a higher
interest rate.
If a variable Annuity is chosen, an Assumed Annual Net Return
Rate of 5% may be chosen. If not chosen, We will use an Assumed
Annual Net Return Rate of 3.5%.
Payments are made on a monthly basis to the Certificate Holder
unless the Certificate Holder requests a different mode of
payment.
Once elected, an Annuity Option may not be revoked, except for
Option 1 when elected on a variable basis.
12.02 Terms of Annuity Options - The minimum first payment amount must
be at least $50 per month and at least $250 per year.
21
If the Certificate Holder elects a fixed Annuity and We determine
that the Certificate Holder would receive larger payments by
applying the Certificate Holder's Account Value, reduced by the
deferred sales charge, to a single premium immediate Annuity
currently offered by Us, We will make the larger payments.
We determine the first payment of a variable Annuity, or the
payment amount of a fixed Annuity, using the Annuitant's (and
second Annuitant's if applicable) adjusted age which We calculate
as follows:
(a) If Annuity payments begin any time between July 1, 1992 and
December 31, 1999, the adjusted age is the Annuitant's age
as of the birthday closest in time to the Annuity Date
reduced by one (1) year.
(b) If the Annuity begins any time between January 1, 2000 and
December 31, 2009, the adjusted age is the Annuitant's age
as of the birthday closest in time to the Annuity Date
reduced by two (2) years.
(c) For each succeeding decade, the adjusted age is the
Annuitant's age as determined in (b), reduced by one
additional year.
The Annuity rates for Options 2 and 3 are based on mortality from
1983 Table A.
Assumed Annual Net Return Rate is the interest rate used to
determine the amount of the first Annuity payment under a
variable Annuity. The Separate Account must earn this rate plus
enough to cover the mortality and expense risks charges (which
may include profit) and administrative charges if future variable
Annuity payments are to remain level.
The Certificate Holder must give written notice to Us at least 30
days before the Annuity payments begin, electing or changing:
(a) The date on which Annuity payments are to begin;
(b) The Annuity Option;
(c) Whether the payments are to be made monthly, quarterly,
semiannually or annually; (d) The investment options used to
provide Annuity payments.
The first Annuity payment may not be earlier than one (1)
calendar year after the initial Purchase Payment, nor later than
the later of the:
(a) First day of the month following the Annuitant's birthday
shown on the Contract Schedule; or
(b) Tenth anniversary of the last Purchase Payment. In lieu of
the election of an Annuity, the Certificate Holder may
request a lump sum payment.
12.03 Annuity Unit - The number of Annuity Units per Fund is based on
the amount of the first variable Annuity payment which is equal
to:
(a) The portion of the Certificate Holder's Account Value (minus
any premium taxes) applied to pay a variable Annuity;
divided by,
22
(b) 1000; multiplied by,
(c) The payment rate for the Annuity Option chosen.
Such amount, or portion, of the variable Annuity payment will be
divided by the Annuity Unit value for the appropriate Fund on the
tenth Valuation Period before the due date of the first payment
to determine the number of each Fund's Annuity Units. The number
of each Fund's Annuity Unit remains fixed. Each future payment is
equal to the sum of the products of each Fund's Annuity Unit
value multiplied by the appropriate number of units. The Fund's
Annuity Unit value on the tenth Valuation Period prior to the due
date of the payment is used.
12.04 Annuity Unit Value - For any Valuation Period, a Fund's Annuity
Unit value is equal to:
(a) The value for the previous Valuation Period; multiplied by,
(b) The Annuity Net Return Factor for the Valuation Period;
multiplied by,
(c) A daily factor to reflect the Assumed Annual Net Return
Rate (the factor for 3.5% per year is .9999058; for 5%
per year it is .9998663).
The dollar value of a Fund(s) Annuity Unit values and payments
may go up or down due to investment gain or loss.
12.05 Annuity Net Return Factor - The Annuity net return factor is
used to compute all Separate Account Annuity payments for any
Fund.
The Annuity net return factor(s) for each Fund is equal to
1.0000000 plus the net return rate. The net return rate is equal
to:
(a) The value of the shares of the Fund held by the Separate
Account at the end of a Valuation Period; minus,
(b) The value of the shares of the Fund held by the Separate
Account at the start of the Valuation Period; plus or minus,
(c) Taxes (or reserves for taxes) on the Separate Account (if
any); divided by
(d) The total value of the Fund(s) Accumulation Units and
Fund(s) Annuity Units of the Separate Account at the start
of the Valuation Period; minus,
(e) A daily actuarial charge as shown on the Contract Schedule
for Annuity mortality and expense risks and profit and a
daily administrative charge which will not exceed the
administrative charge as shown on the Contract Schedule.
The net return rate may be more or less than zero (o) percent.
The value of a share of the Fund is equal to the net assets of
the Fund divided by the number of shares outstanding.
12.06 Annuity Options
Option 1 - Payments for a Stated Period of Time - An Annuity will
be paid for the number of years chosen. The number of years must
be at least 5 and not more than 30.
23
If payments for this Annuity Option are made under a variable
Annuity, the present value of any remaining payments may be
withdrawn at any time.
Option 2 - Life Income - An Annuity will be paid for the life of
the Annuitant. If also chosen, We will guarantee payments for 60,
120, 180, or 240 months.
Option 3 - Life Income Based upon the Lives of Two Annuitants -
An Annuity will be paid during the lives of the Annuitant and a
second Annuitant. Payments will continue until both Annuitants
have died. When this Annuity Option is chosen, a choice must be
made of:
(a) 100% of the payment to continue after the first death;
(b) 66-2/3% of the payment to continue after the first death;
(c) 50% of the payment to continue after the first death;
(d) Payments for a minimum of 120 months with 100% of the
payment to continue after the first death; or
(e) 100% of the payment to continue at the death of the second
Annuitant and 50% of the payment to continue at the death of
the Annuitant.
We may make other options available as allowed by law.
24
OPTION 1
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
---------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
---------------------------------------------------------------------------
5 3.00% 17.91 53.59 106.78 211.99
6 3.00% 15.14 45.30 90.27 179.22
7 3.00% 13.16 39.39 78.49 155.83
8 3.00% 11.68 34.96 69.66 138.31
9 3.00% 10.53 31.52 62.81 124.69
10 3.00% 9.61 28.77 57.33 113.82
11 3.00% 8.86 26.52 52.85 104.93
12 3.00% 8.24 24.65 49.13 97.54
13 3.00% 7.71 23.08 45.98 91.29
14 3.00% 7.26 21.73 43.29 85.95
15 3.00% 6.87 20.56 40.96 81.33
16 3.00% 6.53 19.54 38.93 77.29
17 3.00% 6.23 18.64 37.14 73.74
18 3.00% 5.96 17.84 35.56 70.59
19 3.00% 5.73 17.13 34.14 67.78
20 3.00% 5.51 16.50 32.87 65.26
21 3.00% 5.32 15.92 31.72 62.98
22 3.00% 5.15 15.40 30.68 60.92
23 3.00% 4.99 14.92 29.74 59.04
24 3.00% 4.84 14.49 28.88 57.33
25 3.00% 4.71 14.09 28.08 55.76
26 3.00% 4.59 13.73 27.36 54.31
27 3.00% 4.47 13.39 26.68 52.97
28 3.00% 4.37 13.08 26.06 51.74
29 3.00% 4.27 12.79 25.49 50.60
30 3.00% 4.18 12.52 24.95 49.53
---------------------------------------------------------------------------
25
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
Payments Guaranteed for a Stated Period of Months
-----------------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
Age of -------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female
-----------------------------------------------------------------------------------------------------------------------------
50 $ 4.27 $ 3.90 $ 4.26 $ 3.90 $ 4.22 $ 3.89 $ 4.17 $ 3.86 $ 4.08 $ 3.82
51 4.34 3.97 4.33 3.96 4.30 3.95 4.23 3.92 4.14 3.88
52 4.43 4.03 4.41 4.03 4.37 4.01 4.30 3.98 4.20 3.93
53 4.51 4.10 4.50 4.10 4.45 4.08 4.37 4.04 4.26 3.99
54 4.60 4.18 4.59 4.17 4.54 4.15 4.45 4.11 4.32 4.04
55 4.70 4.25 4.68 4.25 4.62 4.22 4.53 4.18 4.39 4.11
56 4.80 4.34 4.78 4.33 4.72 4.30 4.61 4.25 4.45 4.17
57 4.91 4.42 4.89 4.41 4.82 4.38 4.69 4.32 4.51 4.23
58 5.03 4.52 5.00 4.51 4.92 4.47 4.78 4.40 4.58 4.30
59 5.15 4.61 5.12 4.60 5.03 4.56 4.87 4.48 4.65 4.37
60 5.28 4.72 5.25 4.70 5.14 4.66 4.96 4.57 4.71 4.44
61 5.43 4.83 5.39 4.81 5.27 4.76 5.06 4.66 4.78 4.51
62 5.58 4.95 5.53 4.93 5.39 4.87 5.16 4.75 4.84 4.58
63 5.74 5.08 5.69 5.05 5.53 4.99 5.26 4.85 4.90 4.65
64 5.91 5.21 5.85 5.18 5.66 5.10 5.36 4.95 4.96 4.72
65 6.10 5.36 6.03 5.32 5.81 5.22 5.46 5.05 5.02 4.79
66 6.30 5.51 6.21 5.47 5.96 5.36 5.56 5.16 5.08 4.86
67 6.51 5.67 6.41 5.63 6.12 5.50 5.66 5.26 5.13 4.93
68 6.73 5.85 6.62 5.80 6.28 5.65 5.77 5.37 5.18 5.00
69 6.97 6.04 6.84 5.98 6.44 5.80 5.86 5.49 5.23 5.06
70 7.23 6.25 7.07 6.18 6.61 5.97 5.96 5.60 5.27 5.12
71 7.51 6.47 7.32 6.39 6.79 6.14 6.05 5.71 5.31 5.18
72 7.80 6.71 7.58 6.62 6.96 6.32 6.14 5.83 5.34 5.23
73 8.12 6.98 7.85 6.86 7.14 6.50 6.23 5.94 5.37 5.28
74 8.46 7.26 8.14 7.12 7.32 6.69 6.31 6.04 5.40 5.32
75 8.82 7.57 8.45 7.40 7.50 6.89 6.38 6.14 5.42 5.35
-----------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
26
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Male and Second Annuitant is Female)
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
-----------------------------------------------------------------------------------------------
Adjusted Ages
---------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
-----------------------------------------------------------------------------------------------
55 50 $ 3.69 $ 4.05 $ 4.27 $ 3.69 $ 4.13
55 55 3.88 4.25 4.47 3.87 4.25
55 60 3.06 4.47 4.71 4.06 4.36
60 55 3.99 4.44 4.71 3.98 4.55
60 60 4.24 4.71 4.99 4.23 4.70
60 65 4.49 5.01 5.32 4.48 4.85
65 60 4.38 4.97 5.32 4.38 5.10
65 65 4.72 5.33 5.70 4.71 5.32
65 70 5.07 5.75 6.17 5.05 5.54
70 65 4.93 5.68 6.15 4.91 5.86
70 70 5.40 6.21 6.70 5.36 6.18
70 75 5.89 6.82 7.40 5.81 6.49
75 70 5.69 6.68 7.32 5.62 6.92
75 75 6.37 7.45 8.15 6.23 7.40
75 80 7.07 8.34 9.16 6.78 7.85
-----------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
27
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Female and Second Annuitant is Male)
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
--------------------------------------------------------------------------------------
Adjusted Ages
----------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
--------------------------------------------------------------------------------------
55 50 $ 3.75 $ 4.07 $ 4.26 $ 3.75 $ 3.98
55 55 3.88 4.25 4.47 3.87 4.06
55 60 3.99 4.44 4.71 3.98 4.12
60 55 4.06 4.47 4.71 4.06 4.37
60 60 4.24 4.71 4.99 4.23 4.47
60 65 4.38 4.97 5.32 4.38 4.54
65 60 4.49 5.01 5.32 4.48 4.89
65 65 4.72 5.33 5.70 4.71 5.02
65 70 4.93 5.68 6.15 4.91 5.14
70 65 5.07 5.75 6.17 5.05 5.60
70 70 5.40 6.21 6.70 5.36 5.79
70 75 5.69 6.68 7.32 5.62 5.96
75 70 5.89 6.83 7.40 5.81 6.63
75 75 6.37 7.45 8.15 6.23 6.92
75 80 6.78 8.11 8.99 6.54 7.15
---------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
28
OPTION I
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
-----------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
-----------------------------------------------------------------------
5 3.50% 18.12 54.19 107.92 213.99
6 3.50% 15.35 45.92 91.44 181.32
7 3.50% 13.38 40.01 79.69 158.01
8 3.50% 11.90 35.59 70.88 140.56
9 3.50% 10.75 32.16 64.05 127.00
10 3.50% 9.83 29.42 58.59 116.18
11 3.50% 9.09 27.18 54.13 107.34
12 3.50% 8.46 25.32 50.42 99.98
13 3.50% 7.94 23.75 47.29 93.78
14 3.50% 7.49 22.40 44.62 88.47
15 3.50% 7.10 21.24 42.31 83.89
16 3.50% 6.76 20.23 40.29 79.89
17 3.50% 6.47 19.34 38.51 76.37
18 3.50% 6.20 18.55 36.94 73.25
19 3.50% 5.97 17.85 35.54 70.47
20 3.50% 5.75 17.22 34.28 67.98
21 3.50% 5.56 16.65 33.15 65.74
22 3.50% 5.39 16.13 32.13 63.70
23 3.50% 5.24 15.66 31.19 61.85
24 3.50% 5.09 15.24 30.34 60.17
25 3.50% 4.96 14.85 29.56 58.62
26 3.50% 4.84 14.49 28.85 57.20
27 3.50% 4.73 14.15 28.19 55.90
28 3.50% 4.63 13.85 27.58 54.69
29 3.50% 4.53 13.57 27.02 53.57
30 3.50% 4.45 13.30 26.49 52.53
-----------------------------------------------------------------------
29
OPTION 1
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
-------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
-------------------------------------------------------------------------
5 5.00% 18.74 56.00 111.33 219.98
6 5.00% 15.99 47.77 94.96 187.64
7 5.00% 14.02 41.90 83.30 164.59
8 5.00% 12.56 37.52 74.58 147.35
9 5.00% 11.42 34.11 67.81 133.99
10 5.00% 10.51 31.40 62.42 123.34
11 5.00% 9.77 29.19 58.03 114.66
12 5.00% 9.16 27.36 54.38 107.45
13 5.00% 8.64 25.81 51.31 101.39
14 5.00% 8.20 24.50 48.69 96.21
15 5.00% 7.82 23.36 46.44 91.75
16 5.00% 7.49 22.37 44.47 87.88
17 5.00% 7.20 21.51 42.75 84.48
18 5.00% 6.94 20.74 41.23 81.47
19 5.00% 6.71 20.06 39.88 78.80
20 5.00% 6.51 19.46 38.68 76.42
21 5.00% 6.33 18.91 37.59 74.28
22 5.00% 6.17 18.42 36.62 72.35
23 5.00% 6.02 17.98 35.73 70.61
24 5.00% 5.88 17.57 34.93 69.02
25 5.00% 5.76 17.20 34.20 67.57
26 5.00% 5.65 16.87 33.53 66.25
27 5.00% 5.54 16.56 32.92 65.04
28 5.00% 5.45 16.28 32.35 63.93
29 5.00% 5.36 16.01 31.83 62.90
30 5.00% 5.28 15.77 31.35 61.95
-------------------------------------------------------------------------
30
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
Payments Guaranteed for a Stated Period of Months
----------------------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
Age of ------------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female
----------------------------------------------------------------------------------------------------------------------------------
50 $ 4.56 $ 4.20 $ 4.55 $ 4.19 $ 4.51 $ 4.18 $ 4.45 $ 4.15 $ 4.36 $ 4.11
51 4.64 4.26 4.62 4.25 4.58 4.24 4.51 4.21 4.42 4.16
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.48 4.21
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.32 4.53 4.27
54 4.89 4.46 4.87 4.46 4.82 4.43 4.73 4.39 4.59 4.32
55 4.99 4.54 4.97 4.53 4.91 4.50 4.80 4.46 4.65 4.38
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.72 4.44
57 5.20 4.71 5.17 4.70 5.10 4.66 4.96 4.60 4.78 4.50
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.84 4.57
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 4.91 4.63
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 4.97 4.70
61 5.71 5.11 5.67 5.09 5.54 5.03 5.32 4.93 5.03 4.77
62 5.86 5.23 5.81 5.21 5.66 5.14 5.42 5.02 5.09 4.84
63 6.02 5.36 5.97 5.33 5.79 5.25 5.51 5.11 5.16 4.91
64 6.20 5.49 6.13 5.46 5.93 5.37 5.61 5.21 5.21 4.98
65 6.38 5.64 6.31 5.60 6.07 5.49 5.71 5.31 5.27 5.05
66 6.58 5.79 6.49 5.75 6.22 5.63 5.81 5.41 5.32 5.12
67 6.79 5.95 6.69 5.91 6.38 5.76 5.91 5.52 5.38 5.18
68 7.02 6.13 6.89 6.08 6.53 5.91 6.01 5.63 5.42 5.25
69 7.26 6.32 7.11 6.26 6.70 6.06 6.11 5.74 5.47 5.31
70 7.52 6.53 7.35 6.45 6.86 6.23 6.20 5.85 5.51 5.37
71 7.80 6.75 7.59 6.66 7.03 6.39 6.29 5.96 5.54 5.42
72 8.09 6.99 7.85 6.89 7.21 6.57 6.38 6.07 5.57 5.47
73 8.41 7.26 8.12 7.13 7.38 6.75 6.46 6.17 5.60 5.51
74 8.75 7.54 8.41 7.39 7.55 6.94 6.53 6.28 5.63 5.55
75 9.12 7.85 8.71 7.66 7.73 7.13 6.61 6.38 5.65 5.59
----------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
31
OPTION 2
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
Payments Guaranteed for a Stated Period of Months
-------------------------------------------------------------------------------------------------------------------------------
Adjusted None 60 120 180 240
Age of ---------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female
-------------------------------------------------------------------------------------------------------------------------------
50 $ 5.48 $ 5.12 $ 5.46 $ 5.11 $ 5.41 $ 5.09 $ 5.34 $ 5.06 $ 5.24 $ 5.01
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.29 5.05
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.34 5.10
53 5.71 5.30 5.69 5.29 5.62 5.26 5.53 5.22 5.40 5.15
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.27 5.45 5.20
55 5.89 5.44 5.86 5.43 5.79 5.39 5.67 5.34 5.51 5.25
56 5.99 5.52 5.96 5.51 5.87 5.47 5.74 5.40 5.56 5.31
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.62 5.37
58 6.21 5.69 6.17 5.67 6.06 5.62 5.90 5.54 5.68 5.42
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.61 5.74 5.48
60 6.46 5.89 6.41 5.87 6.28 5.80 6.06 5.69 5.79 5.55
61 6.60 6.00 6.55 6.97 6.39 5.90 6.15 5.77 5.85 5.61
62 6.75 6.11 6.69 6.08 6.51 6.00 6.24 5.86 5.91 5.67
63 6.91 6.23 6.84 6.20 6.64 6.10 6.33 5.95 5.96 5.73
64 7.09 6.37 7.00 6.33 6.77 6.22 6.42 6.04 6.02 5.80
65 7.27 6.51 7.18 6.46 6.91 6.34 6.52 6.13 6.07 5.86
66 7.47 6.66 7.36 6.61 7.05 6.46 6.61 6.23 6.12 5.92
67 7.68 6.82 7.55 6.76 7.20 6.60 6.70 6.33 6.16 5.99
68 7.91 7.00 7.76 6.93 7.35 6.74 6.80 6.43 6.21 6.04
69 8.15 7.19 7.98 7.11 7.51 6.89 6.89 6.54 6.25 6.10
70 8.41 7.39 8.21 7.30 7.67 7.04 6.97 6.64 6.28 6.15
71 8.69 7.62 8.45 7.51 7.83 7.21 7.06 6.74 6.32 6.20
72 8.99 7.86 8.70 7.73 8.00 7.38 7.14 6.85 6.35 6.25
73 9.31 8.12 8.97 7.97 8.16 7.55 7.21 6.95 6.37 6.29
74 9.65 8.41 9.26 8.23 8.33 7.73 7.29 7.04 6.39 6.33
75 10.02 8.72 9.55 8.50 8.50 7.92 7.35 7.14 6.41 6.36
-------------------------------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
32
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Male and Second Annuitant is Female)
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
-------------------------------------------------------------------------------------------------------
Adjusted Ages
------------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
-------------------------------------------------------------------------------------------------------
55 50 $ 3.97 $ 4.35 $ 4.56 $ 3.97 $ 4.42
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.34 4.76 5.00 4.34 4.64
60 55 4.27 4.73 5.00 4.26 4.83
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.76 5.29 5.60 4.75 5.13
65 60 4.66 5.25 5.61 4.65 5.39
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.34 6.03 6.46 5.31 5.81
70 65 5.19 5.97 6.44 5.17 6.14
70 70 5.67 6.49 6.99 5.62 6.47
70 75 6.16 7.10 7.68 6.07 6.77
75 70 5.95 6.96 7.61 5.87 7.20
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.33 8.62 9.45 7.02 8.13
-------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
33
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant Is Female and Second Annuitant Is Male)
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
--------------------------------------------------------------------------------------------------------
Adjusted Ages
-------------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
--------------------------------------------------------------------------------------------------------
55 50 $ 4.03 $ 4.36 $ 4.55 $ 4.03 $ 4.41
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.27 4.73 5.00 4.26 4.83
60 55 4.34 4.76 5.00 4.34 4.64
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.66 5.25 5.61 4.65 5.39
65 60 4.76 5.29 5.60 4.75 5.13
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.19 5.97 6.44 5.17 6.14
70 65 5.34 6.03 6.46 5.31 5.81
70 70 5.67 6.49 6.99 5.62 6.47
70 75 5.95 6.96 7.61 5.87 7.20
75 70 6.16 7.10 7.68 6.07 6.77
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.04 8.39 9.29 6.79 8.70
--------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
34
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant Is Male and Second Annuitant Is Female)
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
-------------------------------------------------------------------------------------------------------
Adjusted Ages
-------------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
-------------------------------------------------------------------------------------------------------
55 50 $ 4.88 $ 5.26 $ 5.48 $ 4.88 $ 5.34
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.21 5.65 5.89 5.21 5.53
60 55 5.15 5.63 5.91 5.14 5.73
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.61 6.16 6.49 5.60 6.01
65 60 5.52 6.14 6.51 5.51 6.28
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.17 6.90 7.33 6.13 6.67
70 65 6.04 6.84 7.34 6.00 7.03
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.97 7.96 8.56 6.87 7.62
75 70 6.77 7.84 8.51 6.68 8.08
75 75 7.45 8.60 9.33 7.27 8.55
75 80 8.14 9.49 10.35 7.80 8.98
-------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Male and the Second Annuitant is Female.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
35
OPTION 3
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
(Annuitant is Female and the Second Annuitant is Male)
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
---------------------------------------------------------------------------------------------------------
Adjusted Ages
-------------------------
Second
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e
---------------------------------------------------------------------------------------------------------
55 50 $ 4.93 $ 5.27 $ 5.46 $ 4.93 $ 5.19
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.15 5.63 5.91 5.14 5.73
60 55 5.21 5.65 5.89 5.21 5.53
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.52 6.14 6.51 5.51 6.28
65 60 5.61 6.16 6.49 5.60 6.01
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.04 6.84 7.34 6.00 7.03
70 65 6.17 6.90 7.33 6.13 6.67
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.77 7.84 8.51 6.68 8.08
75 70 6.97 7.96 8.56 6.87 7.62
75 75 7.45 8.60 9.33 7.27 8.55
75 80 7.86 9.28 10.20 7.57 9.59
---------------------------------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a.
The rates assume the Annuitant is Female and the Second Annuitant is Male.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
36
--------------------------------------------------------------------------------
Aetna Insurance Company of America
Home Office: ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇
▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
(▇▇▇) ▇▇▇-▇▇▇▇
Certificate of Group Annuity Coverage
--------------------------------------------------------------------------------
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA.
APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR
DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT
APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
GP2CERT(4/94)