Exhibit 4(a)(iii)
METLIFE (R)
METROPOLITAN LIFE INSURANCE COMPANY
A Stock Company
[200 ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇ ▇▇▇▇, ▇▇ ▇▇▇▇▇]
Contractholder
[ABC Company]
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Group Annuity Contract No. Issue Date
[00000] [Month/Day/Year]
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NOTICE: ANY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT THAT ARE BASED ON THE
INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE AND SPECIFIC DOLLAR
AMOUNTS ARE NOT GUARANTEED. THE DOLLAR AMOUNTS OF SUCH PAYMENTS AND VALUES WILL
INCREASE OR DECREASE, AS SET OUT IN THE CERTIFICATE, DEPENDING UPON THE
INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT.
In consideration of the payments made under this Contract, MetLife agrees to
make the payments, purchased under this Contract, in accordance with and subject
to its terms.
Therefore, the Contractholder and MetLife execute this Contract in duplicate to
take effect as of the Issue Date.
[Contractholder Name]
--------------------------------------------------- Metropolitan Life Insurance Company
/s/ ▇▇▇▇▇ ▇. ▇▇▇▇ /s/ C. ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇
--------------------------------------------------- ▇▇▇▇▇ ▇. ▇▇▇▇ C. ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇
Signature Senior Vice-President President and Chief
and Secretary Operating Officer
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Title
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Witness Registrar
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Date Date
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City and State City and State
Group Annuity Contract
Multi-Purchase Deferred Paid-up Income Annuity
Fixed and Variable Payments - Voluntary
Non-Participating
CONTENTS
SECTION PAGE
1 DEFINITIONS..................................................................................... [2]
2 PAYMENTS TO METLIFE ............................................................................ [4]
3 COMMENCEMENT OF INCOME ANNUITY PAYMENTS......................................................... [6]
4 CHANGE IN ANNUITANT STATUS...................................................................... [8]
5 CONTRACT DISCONTINUANCE......................................................................... [9]
6 GENERAL PROVISIONS.............................................................................. [10]
TABLE I ANNUITY PURCHASE RATES...................................................................... [12]
INCOME ANNUITY PAYMENT FORMS..................................................................... EXHIBIT A
SECTION 1 DEFINITIONS
ANNUITANT means a person upon whose life an Income Annuity has
been purchased under this Contract. The Annuitant is the owner
of his or her Income Annuity. As Owner, all rights and
benefits under the Certificate belong to the Annuitant.
ANNUITY PURCHASE RATE means the dollar amount required by Us
to provide a monthly Income Annuity of $1.00 beginning on the
Expected Income Payment Start Date. For a fixed Income
Annuity, the RATE will be the best available purchase rate
MetLife is offering under contracts in the class of business
to which this Contract belongs, and will not be less favorable
than that specified in Table I of this Contract.
For a variable Income Annuity, the rates will be determined
using the "Assumed Investment Return" selected by each
Annuitant and stated in their Certificate. The mortality basis
for variable Income Annuity purchases will not be less
favorable than that specified in Table I of this Contract.
ASSUMED INVESTMENT RETURN means the interest rate used to
determine the Annuity Purchase Rates applicable to variable
Income Annuity amounts. It is also the benchmark rate of
return against which all future variable returns will be
compared. The Assumed Interest Rate is selected by the
Annuitant and stated in the Certificate.
BENEFICIARY means the person or persons named to receive any
death benefit payable after an Annuitant dies.
BUSINESS DAY means each day on which the New York Stock
Exchange is open for business. A Business Day ends as of the
close of regular trading on the New York Stock Exchange.
CERTIFICATE means the form issued by Us to each Annuitant
which provides a description of the benefits, rights and terms
of the Income Annuity purchased under this Contract.
CODE means the Internal Revenue Code of 1986, as amended.
CONTRIBUTION(s) means an amount received in good order by
MetLife to purchase an Income Annuity under this Contract.
DISCONTINUANCE DATE means the date on which either You or We
elect to cease adding Annuitants under this Contract.
EXPECTED INCOME PAYMENT START DATE means the date the
Annuitant attains the expected start age noted on the
Annuitant's application and is the date he or she anticipates
Income Annuity payments will begin. The Annuitant may change
his or her Expected Income Payment Start Date by notifying Our
Administrative Office or calling the toll free number. In no
event may an Annuitant select a date that is earlier than the
date the Annuitant attains age 50 or, if later, the second
2
anniversary of the Certificate effective date, nor later than
the Annuitant's 85th birthday.
INCOME ANNUITY means the fixed and variable annuity amounts
purchased by an Annuitant under this Contract.
INCOME PAYMENT START DATE means the date on which an
Annuitant's Income Annuity payments begin.
PURCHASE DATE means the date on which an Income Annuity is
purchased on behalf of those Annuitants from whom a
Contribution is received.
SEPARATE ACCOUNT means MetLife's Separate Account E, the
commingled investment account accessed under this Contract and
other group annuity contracts, that we maintain separate from
Our other assets, into which those Contributions for variable
Income Annuity amounts are allocated.
WE, US, OUR, AND METLIFE refer to Metropolitan Life Insurance
Company.
YOU AND YOUR refer to the Contractholder named on the cover
page of this Contract.
3
SECTION 2 PAYMENTS TO METLIFE
2.01 PERIODIC AND LUMP SUM CONTRIBUTIONS
An Income Annuity amount will be purchased on behalf of each
Annuitant for whom an application has been received in good
order and a Contribution equal to or exceeding the minimum
amount required (see Section 2.02) has been made. It is
anticipated that Contributions will be made on both a periodic
and lump sum basis. Contributions may be made at any time
prior to an Annuitant's Income Payment Start Date.
Unless otherwise provided in Section 5, no Contributions may
be made on and after the Discontinuance Date
2.02 LIMITATIONS ON PERIODIC AND LUMP SUM CONTRIBUTION AMOUNTS
Each Income Annuity amount purchased on a periodic basis is
subject to a minimum Contribution amount of $[50], per
Annuitant. Lump sum Contributions have a minimum dollar amount
of $[1000], per Annuitant. MetLife reserves the right to limit
the total Contributions received on behalf of any one
Annuitant to $[1,000,000].
MetLife, unless it agrees otherwise, will have no liability
with respect to any Income Annuity purchase until (i) it
accepts the Contribution in good order and (ii) the
Contribution amount received on behalf of an Annuitant equals
or exceeds the minimum required for such purchases.
2.03 CALCULATION OF INCOME ANNUITY AMOUNT
On the Purchase Date MetLife will determine the amount of
Income Annuity to be purchased for each Annuitant by applying
the fixed or variable Annuity Purchase Rate, associated with
the Annuitant's current allocation to the Contribution
received. This calculation will produce a dollar amount of
monthly Income Annuity that is to begin on the Expected Income
Payment Start Date. Each purchase will take into account the
Annuitant's current age [,gender] and the Contribution amount
We received.
Although the form of annuity may be changed at the time Income
Annuity payments are about to begin, the total amount
purchased for an Annuitant will be accrued and reported as
though the benefit form selected is a life annuity.
The amount of Income Annuity purchased can change based on the
investment performance of the Separate Account and any
reallocations made by the Annuitant. Among the details of the
Income Annuity outlined within the Certificate are those
relating to the calculation of Income Annuity payments, any
reallocations, and the Annuitant's commutation right.
The amount of Income Annuity payable will be adjusted if the
Income Annuity payments start on a date other than the
Expected Income Payment Start Date,. The amount of the Income
Annuity will also be adjusted if there is a change
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made in the form of annuity, the Assumed Investment Return
and the frequency of payments.
2.04 ANNUITY CANCELLATION EVENTS
MetLife reserves the right to cancel an Annuitant's Income
Annuity if (i) no Contributions have been received on behalf
of the Annuitant for three (3) consecutive years and (ii) the
Income Annuity amount commencing on the Annuitant's 65th
birthday or attained age, if later, under the life annuity
form is less than [$20] dollars a month, or such other amount
as may be applicable in the Annuitant's state of residence. In
the event MetLife takes such action, We will pay the Annuitant
an amount equal to the commuted value of the Income Annuity as
described in Section 3.04. Upon making such payment MetLife's
liability under this Contract with respect to the Annuitant's
Income Annuity will terminate.
5
SECTION 3 COMMENCEMENT OF INCOME ANNUITY PAYMENTS
3.01 INCOME PAYMENT START DATES AND ANNUITY FORMS
Income Annuity payments are anticipated to begin on the
Annuitant's Expected Income Payment Start Date. In addition to
the life annuity form, other annuity forms are available to
the Annuitant. The annuity forms available are specified in
Exhibit A.
Although an Annuitant has identified an Expected Income
Payment Start Date, the Annuitant may choose to begin Income
Annuity payments on any date coincident with or prior to his
or her [85th] birthday. In no event may an Annuitant select a
date that is earlier than the date the Annuitant attains age
50 or, if later, the second anniversary of the Certificate
effective date.
If the Annuitant notifies Us to begin payments on a date
earlier than the Expected Income Payment Start Date, MetLife
must receive the notice at least [30] days in advance of the
revised Income Payment Start Date. MetLife reserves the right
to make the Income Payment Start Date a date that is [30] days
from the date the notice is received.
At least [90] days before the Annuitant's Expected Income
Payment Start Date, We will send the Annuitant information
regarding the available forms of annuity with the necessary
information needed in order to begin Income Annuity payments.
Information can also be requested illustrating how the Income
Annuity payments would differ under any of the other forms of
annuity or at different Income Payment Start Dates.
Prior to the Annuitant's [85th]. birthday We will
automatically send information about the available forms of
annuity and how to begin his or her Income Annuity if we have
not been notified of the Annuitant's decision to begin
payments before that date. If, after releasing this
information, the Annuitant does not contact Us, his or her
Income Annuity will be scheduled to commence within a month of
the annuitant's [85th] birthday. The Income Annuity payable
will, in lieu of the life annuity form, be in the form of a
term certain and life annuity with payments guaranteed for a
period of ten years beginning on the Income Payment Start
date].
Once Income Annuity payments start, the Annuitant will not be
able to change the form of annuity.
3.02 PROOF THAT AN ANNUITANT IS ALIVE ON INCOME PAYMENT START DATE
If requested by MetLife, satisfactory proof must be furnished
to MetLife that an Annuitant is alive on the Income Payment
Start Date. On any subsequent date that an Income Annuity
payment is due, MetLife may also request proof that the
Annuitant is alive. Such requests will be made as a part of
Our normal auditing procedures, or if we have reason to
believe that the recipient is not alive or is not receiving
the payments to which he or she is entitled. If proof is
requested, we need not make any further payments on behalf of
the Annuitant until such proof is received.
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3.03 ANNUITY CERTIFICATES
Upon the initial purchase of an Income Annuity amount, MetLife
will issue and deliver to the Annuitant a Certificate
describing the Income Annuity provided under this Contract. At
the time Income Annuity payments begin, the Annuitant will
receive an additional certificate that specifies and describes
the form of annuity elected, the initial amount the Annuitant
will receive, how often the Annuitant will receive payments,
and how long the payments will be made.
3.04 ANNUITY COMMUTATION
At anytime before Income Annuity payments begin, an Annuitant
may elect to withdraw all or a portion of the commuted value
of his or her variable Income Annuity. The commuted value of
the variable Income Annuity amount on any Business Day is the
market value of the Contributions held in the Separate
Account. The Annuitant may not commute the fixed portion, if
any, of his or her Income Annuity prior to beginning Income
Annuity payments.
After Income Annuity payments begin, and within [60] days of
his or her Income Payment Start Date an Annuitant may elect to
withdraw all or a portion of the Commuted Value of his or her
Income Annuity. Such election must be received by MetLife no
later than the end of the [60] day period following the
Annuitant's Income Payment Start Date. The Annuitant is
limited to one such election.
Payment will be made on the Business Day following the Income
Payment Start Date, or if later, our receipt of the
Annuitant's election. On the date of the calculation, the
commuted value for the fixed Income Annuity amount will be
equal to the present value of future Income Annuity payments.
We will determine this value using the mortality and interest
rate assumptions then being used by Us to purchase Income
Annuity amounts under contracts in the class of business to
which this Contract belongs.
The payment of the entire commuted value amount will result in
the cancellation of the Income Annuity and MetLife will make
no further payments. A partial payment of the commuted value
amount will result in a pro-rata reduction of the Income
Annuity payments. The pro-rata reduction will be applied
separately to the fixed and variable Income Annuity amounts
and will be a percentage equal to the actual amount paid
divided by the entire commuted value of the fixed and variable
Income Annuity amounts, respectively, at the time of payment.
If after the election the monthly Income Annuity amount would
be less than [$100] payable as a life annuity at age 65, or
his or her attained age, if later, then the entire commuted
value will be paid, and We will make no further payments to
the Annuitant. The commuted value of any portion of an Income
Annuity may be less than the amount of Contributions received
on behalf of the Annuitant.
7
SECTION 4 CHANGE IN ANNUITANT STATUS
4.01 TERMINATION OF EMPLOYMENT
The Annuitant whose employment with You is terminated may
continue to make Contributions and purchase additional Income
Annuity amounts. The Annuitant can choose to make periodic
Contributions by arranging with Us to set up a systematic
withdrawal plan, if available, from his or her savings or
checking account or by sending lump sum Contributions to
MetLife at our designated office via first class mail. Any
such Contributions will be subject to the minimum amounts
specified in Section 2.02.
4.02 DEATH OF AN ANNUITANT
If the Annuitant dies before Income Annuity payments begin, We
will determine and pay to the Beneficiary an amount equal to
the Income Annuity death benefit described in the Certificate.
Such payment will be made following receipt of satisfactory
proof of the Annuitant's death and will be payable in a lump
sum or any other settlement option offered by Us which the
Beneficiary selects. All settlement options must satisfy
Section 72(s) of the Code.
If the Annuitant dies after Income Annuity payments begin, the
form of annuity elected by the Annuitant will determine if
there is any death benefit to be paid. All Income Annuity
forms of annuity purchased under this Contract must satisfy
Section 72(s) of the Code.
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SECTION 5 CONTRACT DISCONTINUANCE
You or We may discontinue this Contract at any time by
providing the other party with [30] days advance notice. The
Discontinuance Date will be the date specified in the notice,
or, if later, the date which is [30] days from the date the
notice is received. Although Contributions will continue to be
accepted by MetLife to purchase additional Income Annuity, no
new Annuitant applications will be accepted after the
Discontinuance Date.
With the exception of the annuity cancellation events noted in
Section 2.04, any decision to terminate this Contract will not
affect any rights and guarantees Annuitants have with respect
to the Income Annuity amounts purchased on their behalf.
MetLife's obligations to those Annuitants will continue and
will have the full force and affect as if the Discontinuance
Date had not occurred.
At any time following the Discontinuance Date MetLife reserves
the right to discontinue accepting additional Contributions
and allowing any further Income Annuity purchases. Annuitants
will receive notification [60] days in advance should MetLife
decide to discontinue accepting additional Contributions.
Annuitants may continue to make purchases during the [60] day
notification period.
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SECTION 6 GENERAL PROVISIONS
6.01 REQUIRED REPORTS
Before an Annuitant's Income Payment Start Date, We will
periodically (not less frequently than once each calendar
quarter) send the Annuitant a statement with details on
account of [the Contributions we have received, the annuity
amounts purchased, and the death benefit payable].
6.02 PARTICIPATION; DIVIDENDS
This Contract is non-participating with no provisions for
dividends to be paid.
6.03 METLIFE'S LIABILITY
MetLife's only liability with respect to the payment of Income
Annuity under this Contract is to make the payments provided
in the Certificates issued hereunder. The liability to make
such payments is that of MetLife and not of the
Contractholder.
6.04 MISSTATEMENTS
If the age [or gender} relating to any Annuitant is found to
be misstated, MetLife will not pay a greater amount of Income
Annuity than that provided by the actual Contribution using
the correct information. Any Income Annuity overpayment will,
together with interest, be deducted from future annuity
payments. Any adjustment due to an Income Annuity underpayment
will, together with interest, be paid upon our receipt of the
corrected information. The interest rate will be [5%]
compounded annually.
6.05 CHANGES BY METLIFE
MetLife reserves the right to change any of the following
items one year from the Contract Issue Date and at any time
thereafter for all Annuitants* applicable to purchases made on
and after the change:
(a) The Annuity Purchase Rates in effect under this Contract
set forth in Table I.
(b) The amount of the minimum or maximum Contributions
specified in Section 2.02.
* (a) will not be applicable to those who became
Annuitants prior to the effective date of the
change.
MetLife will give You notice of any such change not less than
[90] days before its effective date. No such change in any of
the foregoing items will be made effective earlier than one
year after the effective date of any such previous change in
that item. In addition no such change will impact any Income
Annuity purchased prior to the date of such change.
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All Certificates issued under this Contract are intended to
comply with Section 72(s) of the Code. We reserve the right to
interpret the provisions of this Contract and the Certificates
thereunder accordingly; and to amend the Contract and
Certificates as necessary in order to comply with federal tax
rules applicable to such annuity contracts. We will notify You
of any amendments, and when required by law, We will obtain
Your approval and the approval of the appropriate regulatory
authorities.
6.06 DISCONTINUANCE OF PURCHASES
Once an Annuitant begins receiving Income Annuity payments,
MetLife will not accept Contributions from You or the
Annuitant to purchase any additional Income Annuity amounts on
behalf of that Annuitant.
6.07 COMMUNICATIONS; PAYMENTS TO METLIFE
All communications provided for in this Contract will be in
writing unless MetLife otherwise agrees in writing. For this
purpose, MetLife's address is [MetLife Retirement and Savings,
Metropolitan Life Insurance Company, ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ -
▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇. 30004,] and Your address will be
that which You designate to MetLife.
All payments to MetLife in accordance with this Contract are
payable to MetLife at the office specified above or such other
office or offices which MetLife may designate.
Any communication that may be made by You may instead be made
by a party or parties designated by You for such purpose.
6.08 ENTIRE CONTRACT
This Contract, including any amendments and endorsements, is
the entire Contract between the parties. Any Contractholder
statements will be deemed representations and not warranties.
No agent, broker or other person, except an authorized officer
of MetLife, may make or change any contract or certificates on
behalf of MetLife. Any amendment, modification or waiver of
any provision of this Contract will be in writing and may be
made effective on behalf of MetLife only by an authorized
officer of MetLife.
6.09 TERMINATION OF CONTRACT
This Contract will terminate upon MetLife's and Your
fulfillment of all the duties and obligations arising under
this Contract.
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TABLE I ANNUITY PURCHASE RATES
[Deferred Fixed Income Annuity - Life Annuity
Under this form income payments are payable monthly from the
Income Payment Start Date, if the Annuitant is then living, to
the date of the last payment before the Annuitant's death.
Integral Years from
Purchase Date to Income Cost to Purchase $1.00 of Monthly Income Annuity if the
Payment Income Payment Start Date is the
Start Date Annuitant's 65th Birthday
----------------------- -------------------------------------------------------
5 $213.47
10 $184.14
15 $158.85
20 $137.02
25 $118.20
30 $101.96
Unisex
The actuarial basis for the rates shown above is:
o Blended Annuity 2000 Mortality Table C (60% male), with
age set back 7 years
o 3% interest rate
o 14% expense load
On request MetLife will furnish fixed Income Annuity purchase
payments for other forms of annuity and for ages or durations
not shown above.]
Deferred Variable Income Annuity
The actuarial basis for the rates applicable to variable
deferred income annuity purchases is:
o Blended Annuity 2000 Mortality Table C (60% male), with
age set back 7 years
o Interest rate equal to the applicable selected Assumed
Investment Return
On request MetLife will furnish illustrative variable Income
Annuity purchase payments for the requested age, duration,
Assumed Investment Return and form of annuity.]
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EXHIBIT A INCOME ANNUITY PAYMENT FORMS
FORMS OF ANNUITY AVAILABLE
[LIFE ANNUITY: Under this annuity form Income Annuity payments are payable to
the Annuitant monthly from the Income Payment Start Date, if the Annuitant is
then living, to and including the date of the last payment payable on or before
the Annuitant's date of death.
TERM CERTAIN AND LIFE ANNUITY: Under this annuity form Income Annuity payments
are payable monthly from the Income Payment Start Date, if the Annuitant is then
living, to and including the date of the last payment payable on or before the
Annuitant's date of death, or, if later, the Term Certain Expiration Date. The
Term Certain Expiration Date is a date that will be any anniversary date between
5 and 30 years after the Income Payment Start Date in accordance with the
Annuitant's election. Annuity payments payable during the Annuitant's lifetime
are payable to the Annuitant. Any annuity payments payable after the Annuitant's
death are payable to the Annuitant's Beneficiary, except that if the beneficiary
is not a natural person, then in lieu of the payment of monthly annuity payments
to the beneficiary the commuted value of such annuity payments, as determined by
Us, will be paid to the Beneficiary. If the Beneficiary is a natural person, and
if neither the Annuitant nor the Annuitant's Beneficiary is living at the time
an Income Annuity payment is payable, the commuted value of the Income Annuity
payments will be paid to (i) the Annuitant's executors or administrators when
the Annuitant dies after the Beneficiary, or (ii) the Beneficiary's executors or
administrators when the Beneficiary dies after the Annuitant.
JOINT AND SURVIVOR LIFE ANNUITY: Under this annuity form Income Annuity payments
are payable monthly from the Income Payment Start Date, if both the Annuitant
and the survivor Annuitant are then living, to and including the date of the
last payment payable on or before the date of death of the second to die of the
Annuitant and the survivor Annuitant. Income Annuity payments made during the
Annuitant's lifetime are payable to the Annuitant. Any Income Annuity payments
made after the Annuitant's death are payable to the survivor Annuitant. Income
Annuity payments made to the survivor Annuitant are a specified percentage, not
greater than 100% as elected by the Annuitant, of the Income Annuity payments
payable to the Annuitant.
TERM CERTAIN JOINT AND SURVIVOR LIFE ANNUITY: Under this annuity form Income
Annuity payments are payable monthly from the Income Payment Start Date, if both
the Annuitant and the survivor Annuitant are then living, to and including the
date of the last payment payable on or before the date of death of the second to
die of the Annuitant and the survivor Annuitant, or, if later, the Term Certain
Expiration Date. The Term Certain Expiration Date is a date that will be any
anniversary date between 5 and 30 years after the Income Payment Start Date in
accordance with the Annuitant's election. Income Annuity payments payable during
the Annuitant's lifetime are payable to the Annuitant.
EXHIBIT A PAGE (2)
Any Income Annuity payments payable after the Annuitant's death are payable to
the survivor Annuitant, if living, otherwise to the Annuitant's Beneficiary. If
the Beneficiary is not a natural person, then in lieu of the payment of monthly
annuity payments the commuted value of the remaining Income Annuity payments, as
determined by Us, will be paid. Income Annuity payments payable to the survivor
Annuitant, or to the Beneficiary, before the Term Certain Expiration Date are
100% of the monthly Income Annuity payments payable to the Annuitant. Income
Annuity payments payable to the survivor Annuitant after the Term Certain
Expiration Date are a specified percentage, not greater than 100% as elected by
the Annuitant, of the Income Annuity payments payable to the Annuitant. If the
Beneficiary is a natural person and if such Beneficiary is not living at the
time an Income Annuity payment is payable, the commuted value of such payments
will be paid to the Beneficiary's executors or administrators.]