EXHIBIT 99.B4(i)
INDIVIDUAL FIXED AND VARIABLE DEFERRED ANNUITY CONTRACT
GREAT AMERICAN RESERVE INSURANCE COMPANY
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(▇▇▇) ▇▇▇-▇▇▇▇
A STOCK COMPANY
GREAT AMERICAN RESERVE INSURANCE COMPANY (the "Company") agrees with the Owner
to provide benefits to the Owner, subject to the provisions set forth in this
Contract and in consideration of Purchase Payments received from the Owner.
RIGHT TO EXAMINE CONTRACT: Within 10 days of the date of receipt of this
Contract by the Owner, it may be returned by delivering or mailing it to the
Company at its Administrative Office. When the Contract is received by the
Company, it will be voided as if it had never been in force. The Company will
refund the Contract Value computed at the end of the Valuation Period during
which the Contract is received by the Company at its Administrative Office.
THIS IS A LEGAL CONTRACT BETWEEN THE OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
SECRETARY PRESIDENT
INDIVIDUAL FIXED AND VARIABLE
ANNUITY CONTRACT
Non-participating
WITHDRAWAL VALUES AND THE DEATH BENEFITS PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE AND ARE
NOT GUARANTEED AS TO DOLLAR AMOUNT. NON FORFEITURE VALUES MAY INCREASE OR
DECREASE BASED ON THE MARKET VALUE ADJUSTMENT SPECIFIED IN THIS CONTRACT.
TABLE OF CONTENTS
CONTRACT SCHEDULE
DEFINITIONS
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS
ALLOCATION OF PURCHASE PAYMENTS
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNTS
VALUATION OF ASSETS
ACCUMULATION UNITS
ACCUMULATION UNIT VALUE
MORTALITY AND EXPENSE RISK CHARGE
ADMINISTRATIVE CHARGE
DISTRIBUTION EXPENSE CHARGE
MVA ACCOUNT PROVISIONS
MVA ACCOUNT
INTEREST TO BE CREDITED
GUARANTEE PERIOD
MULTIPLE GUARANTEE PERIODS
CHANGE IN GUARANTEE PERIOD
MARKET VALUE ADJUSTMENT
MVA ACCOUNT VALUES
FIXED ACCOUNT PROVISIONS
FIXED ACCOUNT VALUES
INTEREST TO BE CREDITED
CONTRACT VALUE
CONTRACT MAINTENANCE CHARGE
DEDUCTION FOR CONTRACT MAINTENANCE CHARGE
TRANSFERS
TRANSFERS DURING THE ACCUMULATION PERIOD
TRANSFERS DURING THE ANNUITY PERIOD
WITHDRAWAL PROVISIONS
WITHDRAWALS
CONTINGENT DEFERRED SALES CHARGE
WITHDRAWAL CHARGE
PROCEEDS PAYABLE ON DEATH
DEATH OF OWNER DURING THE ACCUMULATION PERIOD
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD
DEATH OF OWNER DURING THE ANNUITY PERIOD
DEATH OF ANNUITANT
PAYMENT OF DEATH BENEFIT
BENEFICIARY
CHANGE OF BENEFICIARY
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION
OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
OWNER
JOINT OWNER
ANNUITANT
ASSIGNMENT OF A CONTRACT
ANNUITY PROVISIONS
GENERAL
ANNUITY DATE
SELECTION OF AN ANNUITY OPTION
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS
ANNUITY OPTIONS
OPTION 1. LIFETIME ONLY ANNUITY:
OPTION 2. LIFETIME ANNUITY WITH GUARANTEED PERIODS
OPTION 3. INSTALLMENT REFUND LIFE ANNUITY
OPTION 4. PAYMENT FOR A FIXED PERIOD:
OPTION 5. JOINT AND SURVIVOR ANNUITY
ANNUITY
FIXED ANNUITY
VARIABLE ANNUITY
ANNUITY UNIT
MORTALITY TABLES
GENERAL PROVISIONS
THE CONTRACT
MISSTATEMENT OF AGE
INCONTESTABILITY
MODIFICATION
NON-PARTICIPATING
EVIDENCE OF SURVIVAL
PROOF OF AGE
PROTECTION OF PROCEEDS
REPORTS
TAXES
REGULATORY REQUIREMENTS
CONTRACT SCHEDULE
OWNER: [▇▇▇▇ ▇▇▇]
CONTRACT NUMBER: [12345] CONTRACT ISSUE DATE:[January 3, 1995]
ANNUITY DATE: [January 3, 2000]
PURCHASE PAYMENTS:
INITIAL PURCHASE PAYMENT: [$50,000 Non-Qual; $10,000
IRA - 403(b) rollover]
MINIMUM SUBSEQUENT PURCHASE PAYMENT: [$1,000; or if the automatic premium
check option is elected: $250
monthly]
MAXIMUM TOTAL PURCHASE PAYMENT: [$1,000,000, without prior Company
approval]
ALLOCATION GUIDELINES:
[1. Currently, the Owner can select all investment options, including
Sub-Accounts of the Variable Account and the MVA Account. The Company
reserves the right to change this in the future.
2. If the Purchase Payments and forms required to issue a Contract are in
good order, the initial Net Purchase Payment will be credited to the Contract
within two (2) business days after receipt at the Administrative Office.
Additional Purchase Payments will be credited to the Contract as of the
Valuation Period when they are received.
3. Allocation percentages must be in whole numbers. Each allocation must
be at least 1%.
4. Currently, the minimum amount which must be allocated to a Guarantee
Period in the MVA Account is $2,000. The Company reserves the right to
increase this minimum in the future.]
BENEFICIARY:
[As designated by the Owner at the Contract Issue Date, unless
subsequently changed.]
CONTRACT MAINTENANCE CHARGE:
[The Contract Maintenance Charge is currently $30.00 each Contract Year.
The Company reserves the right to increase the Contract Maintenance Charge but
it will not exceed $60 per Contract Year. However, during the Accumulation
Period if the Contract Value on the Contract Anniversary is at least $25,000,
then no Contract Maintenance Charge is deducted. If a total withdrawal is made
on other than a Contract Anniversary and the Contract Value for the Valuation
Period during which the total withdrawal is made is less than $25,000, the
full Contract Maintenance Charge will be deducted at the time of the total
withdrawal. If the Annuity Date is not the Contract Anniversary and the
Contract Value on the Annuity Date is less than $25,000, then the full
Contract Maintenance Charge will be deducted on the Annuity Date. During the
Annuity Period, no Contract Maintenance Charge will be deducted.]
MORTALITY AND EXPENSE RISK CHARGE:
[Equal, on an annual basis, to 1.15% of the average daily net asset value
of the Variable Account. The Company may increase this charge; however, the
maximum Mortality and Expense Risk Charge will not exceed 1.25% of the average
daily net asset value of the Variable Account. In the event of an increase,
the Company will give Owners 90 days prior notice of the increase.]
ADMINISTRATIVE CHARGE:
[Equal, on an annual basis, to .15% of the average daily net asset value
of the Variable Account. The Company may increase this charge; however, the
maximum Administrative Charge will not exceed .25% of the average daily net
asset value of the Variable Account. In the event of an increase, the Company
will give Owners 90 days prior notice of the increase.]
DISTRIBUTION EXPENSE CHARGE: [NONE]
TRANSFERS:
NUMBER OF TRANSFERS PERMITTED: [There are currently no limits on the
number of transfers that can be made during the Accumulation Period.
Currently, Owners are permitted four transfers per Contract Year during the
Annuity Period.]
TRANSFER FEE: [For each transfer, the Transfer Fee is the lesser of
$25.00 or 2% of the amount transferred. Currently, the Company does not
assess a Transfer Fee on one transfer in a 30-day period during the
Accumulation Period or the four transfers permitted during the Annuity Period.
All reallocations made on a given date count as one transfer. Transfers made
at the end of the Right to Examine Contract period by the Company and any
transfers made pursuant to a pre-approved Dollar Cost Averaging Program or
pursuant to a pre-approved Rebalancing Program will not be counted in
determining the application of the Transfer Fee.]
MINIMUM AMOUNT TO BE TRANSFERRED: [$500 (from any Sub-Account or any
Guarantee Period of the MVA Account), or the Owner's entire interest in the
Sub-Account or the Guarantee Period, if less. This requirement is waived if
the transfer is pursuant to a pre-approved Dollar Cost Averaging Program or
Rebalancing Program.]
MINIMUM AMOUNT WHICH MUST REMAIN IN EACH ACCOUNT AFTER A TRANSFER: [$500
per Sub-Account or a Guarantee Period in the MVA Account; or $0 if the entire
amount in any Sub-Account of the Variable Account or a Guarantee Period in the
MVA Account is transferred.]
MAXIMUM AMOUNT WHICH CAN BE TRANSFERRED FROM THE FIXED ACCOUNT OR MVA
ACCOUNT TO THE VARIABLE ACCOUNT: [NONE]
WITHDRAWALS:
CONTINGENT DEFERRED SALES CHARGE: [NONE]
WITHDRAWAL CHARGE: [NONE]
MINIMUM PARTIAL WITHDRAWAL: [$500 from each Sub-Account of the Variable
Account and each Guarantee Period of the MVA Account. This requirement is
waived if the partial withdrawal is pursuant to the Systematic Withdrawal
Program.]
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN CONTRACT AFTER A PARTIAL
WITHDRAWAL: [$500. The Company reserves the right to increase this amount.]
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN ANY SUB-ACCOUNT OF THE
VARIABLE ACCOUNT AFTER A PARTIAL WITHDRAWAL: [$500]
MAXIMUM AMOUNT WHICH CAN BE WITHDRAWN FROM THE FIXED AND MVA ACCOUNTS:
[The Fixed Account is not currently available. There is currently no
limitation on the maximum amount which can be withdrawn from the MVA Account.]
SEPARATE ACCOUNTS: Variable Account: [Great American Reserve Variable Annuity
Account G for the Variable Annuity
portion of the Contract.]
and
MVA Account:
[Great American Reserve Market Value
Adjustment Account for the portion of
the Contract that may be subject to a
Market Value Adjustment.]
ELIGIBLE FUNDS, SERIES & SUB-ACCOUNTS:
[The Conseco Series Trust]
[Conseco - Asset Allocation Portfolio] [Conseco - Asset Allocation Sub-
Account]
[Conseco - Common Stock Portfolio] [Conseco - Common Stock
Sub-Account]
[Conseco - Corporate Bond Portfolio] [Conseco - Corporate Bond Sub-
Account]
[Conseco - Government Securities [Conseco - Government Securities
Portfolio] Sub-Account]
[Conseco - Money Market Portfolio] [Conseco - Money Market
Sub-Account]
[Evergreen Variable Investment Trust]
[Evergreen VA Fund] [Evergreen VA Sub-Account]
[Evergreen VA Foundation Fund] [Evergreen VA Foundation Sub-
Account]
[Evergreen VA Growth and Income Fund] [Evergreen VA Growth and Income
Sub-Account]
[Insurance Management Series]
[International Stock Fund] [International Stock Sub-Account]
[The ▇▇▇▇▇ American Fund]
[▇▇▇▇▇ American Growth Portfolio] [▇▇▇▇▇ American Growth
Sub-Account]
[▇▇▇▇▇ American Leveraged AllCap [▇▇▇▇▇ American Leveraged Allcap
Portfolio] Sub-Account]
[▇▇▇▇▇ American MidCap Growth Portfolio] [▇▇▇▇▇ American MidCap Growth Sub-
Account]
[▇▇▇▇▇ American Small Capitalization [▇▇▇▇▇ American Small Capitali-
Portfolio] zation Sub-Account]
[INVESCO Variable Investment Funds, Inc.]
[INVESCO VIF - High Yield Portfolio] [INVESCO VIF - High Yield Sub-
Account]
[INVESCO VIF - Industrial Income [INVESCO VIF - Industrial Income
Portfolio] Sub-Account]
[Lord ▇▇▇▇▇▇ Series Fund, Inc.]
[Growth & Income Portfolio] [Lord ▇▇▇▇▇▇ - Growth & Income
Sub-Account]
[The OFFITBANK Variable Insurance Fund, Inc.]
[OFFITBANK VIF - Investment Grade [OFFITBANK VIF - Investment Grade
Global Debt Fund] Global Debt Sub-Account]
[OFFITBANK VIF - Total Return Fund] [OFFITBANK VIF - Total Return
Sub-Account]
[▇▇▇ ▇▇▇ Worldwide Insurance Trust]
[Worldwide Emerging Markets Fund] [▇▇▇ ▇▇▇ - Worldwide Emerging
Markets Sub-Account]
[Gold and Natural Resources Fund] [▇▇▇ ▇▇▇ - Gold and Natural
Resources Sub-Account]
[Worldwide Hard Assets Fund] [▇▇▇ ▇▇▇ - Worldwide Hard Assets
Sub-Account]
[Tomorrow Funds Retirement Trust]
[Core Large-Cap Stock Fund] [Tomorrow Funds - Core Large-Cap
Stock Sub-Account]
[Core Small-Cap Stock Fund] [Tomorrow Funds - Core Small-Cap
Stock Sub-Account]
MVA ACCOUNT:
MINIMUM GUARANTEED INTEREST RATE: [3%]
CURRENT MVA ACCOUNT GUARANTEE PERIOD OPTIONS AND
CREDITED INTEREST RATES:
[1 Year] [XX%]
[3 Years] [XX%]
[5 Years] [XX%]
[7 Years] [XX%]
[10 Years] [XX%]
MARKET VALUE ADJUSTMENT FACTOR: [The Market Value Adjustment Factor is equal
to:
N/365
[ ( 1 + A )]
____________ - 1
[ ( 1 + B )]
where: A = the U.S. Treasury rate in effect at the beginning of
the Guarantee Period for the length of the guarantee
period selected.
B = the current U.S. Treasury rate as of the transaction
date plus .005. Treasury rate period is determined
by N/365 rounded to the next highest year.
N = Number of days remaining in the MVA Guarantee
Period.]
If the Treasury rate is not available for the period, the rate will be arrived
at by interpolation. If no Treasury Rates are available, an Index will be
selected by the Company and approved by the State Insurance Commissioner.]
[MVA Waiver: For withdrawals from MVA Account Guarantee Period Option, after
the first year in such Guarantee Period option, the Owner can make one
withdrawal each Contract Year of up to a total of 10% of each such Guarantee
Period option without the Market Value Adjustment.]
FIXED ACCOUNT:
Not Available
RIDERS:
[IRA ENDORSEMENT]
[TSA ENDORSEMENT]
ADMINISTRATIVE OFFICE:
[Great American Reserve Insurance Great American Reserve Insurance
Company Company
Administrative Office or Administrative Office
P.O. Box 1927 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇
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(317) 817-3700CONTRACT SCHEDULE
DEFINITIONS
ACCOUNT(S): The Fixed Account, the MVA Account and the General Account and/or
one or more of the Sub-Accounts of the Variable Account.
ACCUMULATION PERIOD: The period prior to the Annuity Date during which
Purchase Payments may be made by an Owner.
ACCUMULATION UNIT: A unit of measure used to determine the value of an
Owner's interest in a Sub-Account of the Variable Account during the
Accumulation Period.
ADJUSTED CONTRACT VALUE: The Contract Value less any applicable Premium Tax,
and Contract Maintenance Charge and plus the applicable Market Value
Adjustment which may be positive or negative. This amount is applied to the
applicable Annuity Tables to determine Annuity Payments.
AGE: The age of any Owner or Annuitant on his/her last birthday. For Joint
Owners, all provisions which are based on age are based on the Age of the
older of the Joint Owners.
ADMINISTRATIVE OFFICE: The office indicated on the Contract Schedule of this
Contract to which notices, requests and Purchase Payments must be sent. All
sums payable to the Company under this Contract are payable at the
Administrative Office or an address designated by the Company.
ANNUITANT: The natural person on whose life Annuity Payments are based. On or
after the Annuity Date, the Annuitant shall also include any Joint Annuitant.
ANNUITY DATE: The date on which Annuity Payments begin. The Annuity Date is
shown on the Contract Schedule.
ANNUITY OPTIONS: Options available for Annuity Payments.
ANNUITY PAYMENTS: The series of payments made to the Owner or any named payee
after the Annuity Date under the Annuity Option selected.
ANNUITY PERIOD: The period of time beginning with the Annuity Date during
which Annuity Payments are made.
ANNUITY UNIT: An accounting unit of measure used to calculate the amount of
Annuity Payments.
AUTHORIZED REQUEST: A request, in a form satisfactory to the Company, which is
received by the Administrative Office.
BENEFICIARY: The person(s) or entity(ies) who will receive the death benefit
payable under this Contract.
COMPANY: Great American Reserve Insurance Company.
CONTRACT ANNIVERSARY: An Anniversary of the Contract Issue Date.
CONTRACT ISSUE DATE: The later of the date on the cover of the Contract or
the date Purchase Payments are received. The Contract Issue Date is shown on
the Contract Schedule.
CONTRACT VALUE: The dollar value as of any Valuation Period of all amounts in
the Contract.
CONTRACT WITHDRAWAL VALUE: The Contract Value less any applicable Premium
Tax, less any Contingent Deferred Sales Charge, less any applicable Contract
Maintenance Charge and plus any Market Value Adjustment which may be positive
or negative.
CONTRACT YEAR: The first Contract Year is the annual period which begins on
the Contract Issue Date. Subsequent Contract Years begin on each anniversary
of the Contract Issue Date.
CREDITED INTEREST RATE: The interest rate credited to the Contract by the
Company for any given Guarantee Period in the MVA Account or the Fixed
Account. The Credited Interest Rates for the available Guarantee Periods for
the Fixed Account and the MVA Account are shown on the Contract Schedule.
EFFECTIVE DATE: The Effective Date of a Guarantee Period with a Credited
Interest Rate.
ELIGIBLE FUND: An investment entity shown on the Contract Schedule.
FIXED ACCOUNT: An investment option within the General Account.
FIXED ANNUITY: A series of payments made during the Annuity Period which are
guaranteed as to dollar amount by the Company.
GENERAL ACCOUNT: The Company's general investment account which contains all
the assets of the Company with the exception of the Variable Account and other
segregated asset accounts.
GUARANTEE PERIOD: The period for which the Credited Interest Rate is credited
in either the MVA Account or the Fixed Account. Each deposit or transfer to
the MVA Account creates one or more new Guarantee Period(s). The Guarantee
Periods selected by the Owner are shown on the Contract Schedule.
MARKET VALUE ADJUSTMENT: An adjustment to the amount withdrawn or transferred
from an MVA Account prior to the end of the applicable Guarantee Period. The
adjustment reflects the change in the value of the funds withdrawn or
transferred due to the change in the interest rates since the beginning of the
Guarantee Period.
MVA ACCOUNT: A separate account which provides investment options where the
Company guarantees the rate of interest for a specified Guarantee Period and
where withdrawals or transfers may be subject to a Market Value Adjustment.
NET PURCHASE PAYMENT: A Purchase Payment less any applicable Premium Tax.
OWNER: The person(s) who owns the Contract.
PORTFOLIO: A segment of an Eligible Fund which constitutes a separate and
distinct class of shares. Portfolios which are available for investment by
the Sub-Accounts of the Variable Account under this Contract are shown on the
Contract Schedule.
PREMIUM TAX: Any premium taxes incurred to any governmental entity and
assessed against Purchase Payments or Contract Value.
PURCHASE PAYMENT: A payment made by or for an Owner with respect to this
Contract.
SUB-ACCOUNT: Variable Account assets are divided into Sub-Accounts which are
listed on the Contract Schedule. Assets of each Sub-Account will be invested
in shares of an Eligible Fund or a Portfolio of an Eligible Fund.
VALUATION DATE: Each day on which the New York Stock Exchange ("NYSE") is
open for business.
VALUATION PERIOD: The period of time beginning at the close of business of
the NYSE on each Valuation Date and ending at the close of business for the
next succeeding Valuation Date.
VARIABLE ACCOUNT: A separate account designated on the Contract Schedule which
provides investment options where the benefits are variable and are not
guaranteed as to dollar amount.
WRITTEN REQUEST: A request in writing, in a form satisfactory to the Company,
which is received by the Administrative Office.
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS : The initial Purchase Payment for an Owner is due on the
Contract Issue Date. Subject to the maximum and minimum amounts shown on the
Contract Schedule, the Owner may make subsequent Purchase Payments and may
increase or decrease or change the frequency of such payments. The Company
reserves the right to reject any Application or Purchase Payment.
ALLOCATION OF PURCHASE PAYMENTS : Net Purchase Payments are allocated to one
or more of the Fixed Account and/or the MVA Account Guarantee Period options
and/or to one or more Sub-Accounts of the Variable Account in accordance with
the selections made by the Owner. The allocation of the initial Net Purchase
Payment for an Owner is made in accordance with the selection made by the
Owner at the Contract Issue Date. Unless otherwise changed by the Owner,
subsequent Net Purchase Payments are allocated in the same manner as the
initial Net Purchase Payment. Allocation of the Net Purchase Payments is
subject to the Allocation Guidelines shown on the Contract Schedule. The
Company has reserved the right to allocate initial Net Purchase Payments to
the Money Market Sub-Account (except for any amounts allocated to the Fixed
Account and/or MVA Account) until the expiration of the Right to Examine
period.
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNTS : The Separate Accounts are designated on the Contract
Schedule and consists of assets set aside by the Company, which are kept
separate from that of the general assets and all other separate account assets
of the Company.
The assets of the Variable Account equal to reserves and other liabilities will
not be charged with liabilities arising out of any other business
the Company may conduct.
The Variable Account assets are divided into Sub-Accounts. The Sub-Accounts
which are available under this Contract are listed on the Contract Schedule.
The assets of the Sub-Accounts are allocated to the Eligible Funds(s) and the
Portfolio(s), if any, within an Eligible Fund, shown on the Contract Schedule.
The Company may, from time to time, add additional Eligible Fund (s) or
Portfolio(s) to those shown on the Contract Schedule. The Owner may be
permitted to transfer Contract Values or allocate Net Purchase Payments to the
additional Sub-Account(s) within the Variable Account. However, the right to
make such transfers or allocations will be limited by the terms and conditions
imposed by the Company.
Should the shares of any such Eligible Fund(s) or any Portfolio(s) within an
Eligible Fund become unavailable for investment by the Variable Account, or
the Company's Board of Directors deems further investment in these shares
inappropriate, the Company may limit further purchase of such shares or
substitute shares of another Eligible Fund or Portfolio for shares already
purchased under a Contract.
VALUATION OF ASSETS : The assets of the Accounts are valued at their fair
market value in accordance with procedures of the Company.
ACCUMULATION UNITS : Accumulation Units shall be used to account for all
amounts allocated to or withdrawn from the Sub-Accounts of the Variable
Account as a result of Net Purchase Payments, withdrawals, transfers, or fees
and charges. The Company will determine the number of Accumulation Units of a
Sub-Account purchased or canceled. This will be done by dividing the amount
allocated to (or the amount withdrawn from) the Sub-Account by the dollar
value of one Accumulation Unit of the Sub-Account as of the end of the
Valuation Period during which the request for the transaction is received at
the Administrative Office.
ACCUMULATION UNIT VALUE : The Accumulation Unit Value for each Sub-Account
was arbitrarily set initially at $10. Subsequent Accumulation Unit Values for
each Sub-Account are determined by multiplying the Accumulation Unit Value for
the immediately preceding Valuation Period by the Net Investment Factor for
the Sub-Account for the current period.
The Net Investment Factor for each Sub-Account is determined by dividing A by
B and subtracting C where:
A is (i) the net asset value per share of the Eligible Fund or
Portfolio of an Eligible Fund held by the Sub-Account at the end
of the current Valuation Period; plus
(ii) any dividend or capital gains per share declared on behalf
of such Eligible Fund or Portfolio that has an ex-dividend date
within the current Valuation Period; plus
(iii) a charge factor, if any, for any taxes or any tax reserve
established by the Company as a result of the operation or
maintenance of the Sub-Account.
B is the net asset value per share of the Eligible Fund or Portfolio
held by the Sub-Account for the immediately preceding Valuation
Period.
C is the Valuation Period equivalent of the per month Mortality and
Expense Risk Charge, for the Administrative Charge and for the
Distribution Charge, if any, which are shown on the Contract
Schedule.
The Accumulation Unit Value may increase or decrease from Valuation Period to
Valuation Period.
MORTALITY AND EXPENSE RISK CHARGE : Each Valuation Period, the Company
deducts a Mortality and Expense Risk Charge from the Variable Account which is
equal, on an annual basis, to the amount shown on the Contract Schedule. The
Mortality and Expense Risk Charge compensates the Company for assuming the
mortality and expense risks under this Contract.
ADMINISTRATIVE CHARGE : Each Valuation Period, the Company deducts an
Administrative Charge from the Variable Account which is equal, on an annual
basis, to the amount shown on the Contract Schedule. The Administrative
Charge compensates the Company for the costs associated with the
administration of this Contract and the Variable Account.
DISTRIBUTION EXPENSE CHARGE : Each Valuation Period, the Company deducts a
Distribution Expense Charge from the Variable Account which is equal, on an
annual basis, to the amount shown on the Contract Schedule. The Distribution
Charge compensates the Company for the costs associated with the distribution
of the Contracts.
MVA ACCOUNT PROVISIONS
MVA ACCOUNT : The assets of the MVA Account equal to the reserves and other
liabilities will not be charged with liabilities arising out of any other
business the Company may conduct.
Net Purchase Payments may be allocated to one or more of the MVA
Account Guarantee Period options which are available at the time the Purchase
Payment is made. The initial MVA Account Guarantee Period options are shown
on the Contract Schedule. In addition, during the Accumulation Period,
Contract Values can be transferred from the Variable Account and/or the Fixed
Account to one or more of the MVA Account Guarantee Period options.
INTEREST TO BE CREDITED : The Credited Interest Rate for the Guarantee
Period(s) of the MVA Account is shown on the Contract Schedule. After the
initial Guarantee Period, the Credited Interest Rate for any subsequent
Guarantee Period of the MVA Account may change. All interest payable under a
Contract is compounded daily at the stated effective annual interest rate. In
no event will the Credited Interest Rate be less than the Minimum Guaranteed
Interest Rate, prior to the application of the Market Value Adjustment,
specified on the Contract Schedule.
GUARANTEE PERIOD : The Current MVA Account Guarantee Period is shown on the
Contract Schedule. During the thirty (30) days prior to the end of a current
Guarantee Period, the Owner may renew for the same or any other Guarantee
Period then available at the then Credited Interest Rate or may elect to
transfer all or a portion of the amount to a Fixed Account option, if
available, or to the Variable Account. Any transfer elected during the thirty
(30) days prior to the end of a current Guarantee Period will be made as of
the date the request is received by the Company and will not be subject to the
Market Value Adjustment.
If the Owner does not specify a Guarantee Period at the time of renewal, the
Company will select and transfer to the same Guarantee Period as has just
expired, so long as such Guarantee Period does not extend beyond the latest
Annuity Date that can be selected by an Owner. If such Guarantee Period does
extend beyond the latest Annuity Date, the Company will choose the one year
period. If there is no Guarantee Period for the same period available, the
one year period will be selected. If the one year period is no longer
available, the next longest period available will be selected.
MULTIPLE GUARANTEE PERIODS : The Owner may elect one or more Guarantee Periods
subject to the Company's underwriting rules. Multiple Guarantee Periods are
treated separately for purposes of applying the Market Value Adjustment. The
Company reserves the right to credit different Credited Interest Rates to the
Contract Value attributable:
1. to different Guarantee Periods; and
2. to Guarantee Periods of the same duration with different Effective
Dates.
CHANGE IN GUARANTEE PERIOD : The Owner may upon Written Request change to any
Guarantee Period then being offered by the Company with respect to contracts
of this type and class. The Market Value Adjustment will apply to a change
made at any time other than at the end of a Guarantee Period. The Market
Value Adjustment will not apply to a change made at the end of a Guarantee
Period if Written Request is received by the Company within thirty (30) days
prior to the end of the Guarantee Period.
MARKET VALUE ADJUSTMENT : Any amount withdrawn, transferred or annuitized
prior to the end of that Guarantee Period may be subject to a Market Value
Adjustment. The Market Value Adjustment will be calculated by multiplying the
amount withdrawn, transferred or annuitized by the formula shown on the
Contract Schedule.
There will be no Market Value Adjustment on withdrawals from the MVA Account
in the following situations: (1) death benefit paid under a Contract; (2)
amounts withdrawn to pay fees or charges; (3) amounts withdrawn or transferred
from the MVA Account during the 30 days prior to the end of the Guarantee
Period; (4) an Owner annuitizes his/her Contract under an Annuity Option
providing for at least 60 monthly Annuity Payments; and (5) any withdrawal
subject to the MVA Waiver shown on the Contract Schedule.
MVA ACCOUNT VALUES : The MVA Account portion of a Contract at any time is
equal to:
1. the Net Purchase Payments allocated to the MVA Account on behalf of
an Owner; plus
2. the Contract Value transferred to the MVA Account; plus
3. interest credited to the Contract Value in the MVA Account; less
4. any prior withdrawals of Contract Value in the MVA Account and any
Contingent Deferred Sales Charge; less
5. any Contract Value transferred from the MVA Account; less
6. Contract Maintenance Charges or Transfer Fees deducted from the
Contract Value allocated to the MVA Account.
Any subsequent Purchase Payments and transfers to the MVA Account will be
allocated to a new Guarantee Period with a new Effective Date.
FIXED ACCOUNT PROVISIONS
FIXED ACCOUNT VALUES : The Fixed Account portion of a Contract at any time is
equal to:
1. the Net Purchase Payments allocated to the Fixed Account on behalf of
an Owner; plus
2. the Contract Value transferred to the Fixed Account; plus
3. interest credited to the Contract Value in the Fixed Account; less
4. any prior withdrawals of Contract Value in the Fixed Account and any
Contingent Deferred Sales Charge; less
5. any Contract Value transferred from the Fixed Account; less
6. Contract Maintenance Charges or Transfer Fees deducted from the
Contract Value allocated to the Fixed Account.
INTEREST TO BE CREDITED : The Company guarantees that the interest to be
credited to the Fixed Account will not be less than the Minimum Guaranteed
Interest Rate shown on the Contract Schedule. The Company may credit
additional interest at its sole discretion for any Fixed Account option. The
Fixed Account Option and the Initial Current Interest Rate are shown on the
Contract Schedule.
CONTRACT VALUE
The Contract Value for any Valuation Period is the sum of the Contract Value
in each of the Sub-Accounts of the Variable Account, the Contract Value in the
MVA Account and the Contract Value in the Fixed Account.
The Contract Value in a Sub-Account of the Variable Account is determined by
multiplying the number of Accumulation Units allocated to the Owner's Account
for the Sub-Account by the Accumulation Unit Value.
Withdrawals will result in the cancellation of Accumulation Units in a
Sub-Account or a reduction in the Contract Value in the Fixed Account or the
MVA Account, as applicable.
CONTRACT MAINTENANCE CHARGE
DEDUCTION FOR CONTRACT MAINTENANCE CHARGE : During the Accumulation Period, on
each Contract Anniversary the Company deducts a Contract Maintenance Charge
from the Contract Value by reducing the Contract Value in the Fixed Account
and/or the MVA Account and by canceling Accumulation Units from each
applicable Sub-Account to reimburse it for expenses relating to maintenance of
the Contract. The Contract Maintenance Charge will be deducted first from the
Fixed Account and if there is insufficient value in the Fixed Account, then
the Contract Maintenance Charge will be deducted from the MVA Account or the
Sub-Account of the Variable Account with the largest balance. The Contract
Maintenance Charge is shown on the Contract Schedule.
TRANSFERS
TRANSFERS DURING THE ACCUMULATION PERIOD : Subject to any limitation imposed
by the Company on the number of transfers during the Accumulation Period shown
on the Contract Schedule, an Owner may transfer all or part of his or her
Contract Value in the Fixed Account, the MVA Account or a Sub-Account by
Authorized Request without the imposition of any Transfer Fee if there have
been no more than the number of free transfers shown on the Contract Schedule
for the Contract Year. All transfers are subject to the following:
1. If more than the number of free transfers, shown on the Contract
Schedule, have been made in a Contract Year, the Company will deduct a
Transfer Fee, shown on the Contract Schedule, for each subsequent transfer
permitted. The Transfer Fee is deducted from the Account which is the source
of the transfer. However, if the Owner's entire interest in an Account is
being transferred, the Transfer Fee will be deducted from the amount which is
transferred. If there are multiple source Accounts, the Transfer Fee will be
allocated first to the Fixed Account and then to the Sub-Account or the MVA
Account with the largest balance involved in a transfer transaction.
2. The minimum amount which can be transferred from a Sub-Account is
shown on the Contract Schedule. The minimum amount which must remain in a
Sub-Account, the Fixed and the MVA Account is shown on the Contract Schedule.
The maximum amount which can be transferred from the Fixed Account or the MVA
Account to the Variable Account is shown on the Contract Schedule.
3. The Company reserves the right, at any time and without prior notice
to any party, to terminate, suspend or modify the transfer privilege described
above.
If an Owner elects to use this transfer privilege, the Company will not be
liable for transfers made in accordance with the instructions received from
the Owner or other authorized persons. All amounts and Accumulation Units will
be determined as of the end of the Valuation Period during which the request
for transfer is received at the Administrative Office.
TRANSFERS DURING THE ANNUITY PERIOD : Subject to any limitations imposed by
the Company on the number of transfers during the Annuity Period shown on the
Contract Schedule, the Owner may transfer Annuity Units in accordance with the
following:
1. Transfers may be made upon written notice to the Company at least
thirty (30) days before the due date of the first Annuity Payment for which
the change will apply. Transfers will be made by converting the number of
Annuity Units being transferred to the number of Annuity Units of the
Sub-Account to which the transfer is made, so that the next Annuity Payment,
if it were made at that time would be the same amount that it would have been
without the transfer. Thereafter, Annuity Payments will reflect changes in
the value of the new Annuity Units.
2. If more than the number of free transfers, shown on the Contract
Schedule, have been made in a Contract Year, the Company will deduct a
Transfer Fee, shown on the Contract Schedule, for each subsequent transfer
permitted. The Transfer Fee is deducted from the Account which is the source
of the transfer. However, if the Owner's entire interest in an Account is
being transferred, the Transfer Fee will be deducted from the amount which is
transferred. If there are multiple source Accounts, the Transfer Fee will be
allocated first to the Fixed Account and then the Sub-Account or the MVA
Account with the largest balance involved in a transfer transaction.
3. The minimum amount which can be transferred from a Sub-Account is
shown on the Contract Schedule. The minimum amount which must remain in a
Sub-Account after a transfer is shown on the Contract Schedule.
4. No transfers can be made between the General Account and the Variable
Account.
5. The Company reserves the right, at any time and without prior notice
to any party, to terminate, suspend or modify the transfer privilege described
above.
If an Owner elects to use this transfer privilege, the Company will not be
liable for transfers made in accordance with instructions received from the
Owner or other authorized persons. All amounts and Annuity Units will be
determined as of the end of the Valuation Period during which the request for
transfer is received at the Administrative Office.
WITHDRAWAL PROVISIONS
WITHDRAWALS : During the Accumulation Period, the Owner may, upon Written
Request, make a total or partial withdrawal of the Contract Withdrawal Value.
The Owner must specify by Written Request which Sub-Account or Guarantee
Period of the MVA Account or Fixed Account, as applicable, is the source of
the partial withdrawal.
A withdrawal from the MVA Account may be subject to a Market Value Adjustment.
The Company will pay the amount of any withdrawal from the Variable Account
within seven (7) days of receipt of a request in good order unless the
Suspension or Deferral of Payments Provision is in effect.
Each partial withdrawal must be for an amount which is not less than the
amount shown on the Contract Schedule. The minimum Contract Value which must
remain in a Sub-Account after a partial withdrawal is shown on the Contract
Schedule. The maximum amounts which can be withdrawn from the Fixed Account
and/or the MVA Account are shown on the Contract Schedule.
CONTINGENT DEFERRED SALES CHARGE : Upon a withdrawal of Contract Value, a
Contingent Deferred Sales Charge as set forth on the Contract Schedule may be
assessed.
WITHDRAWAL CHARGE : Upon a withdrawal of Contract Value, a Withdrawal Charge
as set forth on the Contract Schedule may be assessed.
PROCEEDS PAYABLE ON DEATH
DEATH OF OWNER DURING THE ACCUMULATION PERIOD : Upon the death of the Owner,
or any Joint Owner, during the Accumulation Period, the death benefit will be
paid to the Beneficiary(ies) designated by the Owner. Upon the death of any
Joint Owner, the surviving Joint Owner, if any, will be treated as the Primary
Beneficiary. Any other Beneficiary designation on record at the time of death
will be treated as a contingent Beneficiary.
A Beneficiary may request that the death benefit be paid under one of the
Death Benefit Options below. If the Beneficiary is the spouse of the Owner,
he or she may elect to continue the Contract at the then current Contract
Value in his or her own name and exercise all the Owner's rights under the
Contract.
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD : Prior to the Owner
attaining Age 80, the death benefit will be the greater of: (i) the Purchase
Payments, less any withdrawals; or (ii) the Contract Value determined as of
the end of the Valuation Period during which the Company receives both due
proof of death and an election for the payment method. If the death occurs
after Age 80, the death benefit will be the Value determined as of the end of
the Valuation Period during which the Company receives both due proof of death
and an election for the payment method.
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD : A non-spousal
Beneficiary must elect the death benefit to be paid under one of the following
options in the event of the death of the Owner or any Joint Owner during the
Accumulation Period:
OPTION 1 - lump sum payment of the death benefit; or
OPTION 2 - the payment of the entire death benefit within 5 years of
the date of the death of the Owner or any Joint Owner; or
OPTION 3 - payment of the death benefit under an Annuity Option over
the lifetime of the Beneficiary or over a period not extending beyond the life
expectancy of the Beneficiary with distribution beginning within one year of
the date of death of the Owner or any Joint Owner.
Any portion of the death benefit not applied under Option 3 within one year of
the date of the Owner's death, must be distributed within five years of the
date of death.
A spousal Beneficiary may elect to continue the Contract in his or her own
name at the then current Contract Value, elect a lump sum payment of the death
benefit or apply the death benefit to an Annuity Option.
If a lump sum payment is requested, the amount will be paid within seven (7)
days of receipt of proof of death and the election, unless the Suspension or
Deferral of Payments Provision is in ▇▇▇▇▇▇.▇▇ the Beneficiary, other than in
a lump sum, may only be elected during the sixty-day period beginning with the
date of receipt of proof of death.
DEATH OF OWNER DURING THE ANNUITY PERIOD : If the Owner, or any Joint Owner,
who is not the Annuitant, dies during the Annuity Period, any remaining
payments under the Annuity Option elected will continue at least as rapidly as
under the method of distribution in effect at such Owner's or Joint Owner's
death. Upon the death of any Owner during the Annuity Period, the Beneficiary
becomes the Owner. Upon the death of any Joint Owner during the Annuity
Period, the surviving Joint Owner, if any, will be treated as the Primary
Beneficiary. Any other Beneficiary designation on record at the time of death
will be treated as a Contingent Beneficiary.
DEATH OF ANNUITANT : Upon the death of an ▇▇▇▇▇▇▇▇▇, who is not the Owner,
during the Accumulation Period, the Owner may designate a new Annuitant,
subject to the Company's underwriting rules then in effect. If no designation
is made within 30 days of the death of the Annuitant, the Owner will become
the Annuitant. If the Owner is a non-natural person, the death of the
Annuitant will be treated as the death of the Owner and a new Annuitant may
not be designated.
Upon the death of the Annuitant during the Annuity Period, the death benefit,
if any, will be as specified in the Annuity Option elected. Death benefits
will be paid at least as rapidly as under the method of distribution in effect
at the Annuitant's death.
PAYMENT OF DEATH BENEFIT : The Company will require due proof of death before
any death benefit is paid. Due proof of death will be:
1. a certified death certificate; or
2. a certified decree of a court of competent jurisdiction as to the
finding of death; or
3. any other proof satisfactory to the Company.
All death benefits will be paid in accordance with applicable law or
regulations governing death benefit payments.
BENEFICIARY : The Beneficiary designation in effect on the Contract Issue
Date will remain in effect until changed. The Beneficiary is entitled to
receive the benefits to be paid at the death of the Owner.
Unless the Owner provides otherwise, the death benefit will be paid in equal
shares to the survivor(s) as follows:
1. to the Primary Beneficiary(ies) who survive the Owner's and/or the
Annuitant's death, as applicable; or if there are none
2. to the Contingent Beneficiary(ies) who survive the Owner's and/or the
Annuitant's death, as applicable; or if there are none
3. to the estate of the Owner.
CHANGE OF BENEFICIARY : Subject to the rights of any irrevocable
Beneficiary(ies), the Owner may change the Primary Beneficiary(ies) or
Contingent Beneficiary(ies). A change may be made by Written Request. The
change will take effect as of the date the Written Request is signed. The
Company will not be liable for any payment made or action taken before it
records the change.
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION
The Company reserves the right to suspend or postpone payments from the
Variable Account for a withdrawal or transfer for any period when:
1. the New York Stock Exchange is closed (other than customary weekend
and holiday closings);
2. trading on the New York Stock Exchange is restricted;
3. an emergency exists as a result of which disposal of securities held
in the Variable Account is not reasonably practicable or it is not reasonably
practicable to determine the value of the Variable Account's net assets; or
4. during any other period when the Securities and Exchange Commission,
by order, so permits for the protection of Owners;
provided that applicable rules and regulations of the Securities and Exchange
Commission will govern as to whether the conditions described in (2) and (3)
exist.
The Company further reserves the right to postpone payments from the Fixed
Account and the MVA Account for a period of up to six months.
OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
OWNER : The Owner has all interest and right to amounts held in his or her
Contract. The Owner is the person designated as such on the Contract Issue
Date, unless changed.
The Owner may change owners of the Contract at any time by Written Request. A
change of Owner will automatically revoke any prior designation of Owner. The
change will become effective as of the date the Written Request is signed.
The Company will not be liable for any payment made or action taken before it
records the change.
JOINT OWNER : A Contract may be owned by Joint Owners. If Joint Owners are
named, any Joint Owner must be the spouse of the other Owner. Upon the death
of either Owner, the surviving spouse will be the Primary Beneficiary. Any
other Beneficiary designation will be treated as a Contingent Beneficiary
unless otherwise indicated in a Written Request.
ANNUITANT : The Annuitant is the person on whose life Annuity Payments are
based. The Annuitant is the person designated by the Owner at the Contract
Issue Date, unless changed prior to the Annuity Date. The Owner may not change
the Annuitant except in the event that the Annuitant dies prior to the Annuity
Date. If no new Annuitant is designated by the Owner within 30 days of the
death of the Annuitant, the Owner becomes the Annuitant. The Annuitant may
not be changed in a Contract which is owned by a non-natural person. Any
change of Annuitant is subject to the Company's underwriting rules then in
effect.
ASSIGNMENT OF A CONTRACT : A Written Request specifying the terms of an
assignment of a Contract must be provided to the Administrative Office. The
Company will not be liable for any payment made or action taken before it
records the assignment.
The Company will not be responsible for the validity or tax consequences of
any assignment. Any assignment made after the death benefit has become payable
will be valid only with Company consent.
If the Contract is assigned, the Owner's rights may only be exercised with
the consent of the assignee of record.
ANNUITY PROVISIONS
GENERAL : On the Annuity Date, the Adjusted Contract Value will be applied
under the Annuity Option selected by the Owner. The Owner may elect to have
the Contract Value applied to provide a Fixed Annuity, a Variable Annuity or a
combination Fixed and Variable Annuity. If a combination is elected, the
Owner must specify what part of the Contract Value is to be applied to the
Fixed and Variable Options.
ANNUITY DATE : The Annuity Date is selected by the Owner at the Contract
Issue Date. The Annuity Date must be the first day of a calendar month and
must be at least 90 days after the Contract Issue Date. The Annuity Date may
not be later than the earlier of when the Annuitant reaches attained age 90
or the maximum date permitted under state law.
Prior to the Annuity Date, the Owner subject to the above, may change the
Annuity Date by Written Request. Any change must be requested at least thirty
(30) days prior to the new Annuity Date.
SELECTION OF AN ANNUITY OPTION : An Annuity Option may be selected by Written
Request of the Owner. If no Annuity Option is selected, Option B with 120
monthly payments guaranteed will automatically be applied. Unless specified
otherwise, that portion of the Adjusted Contract Value allocated to the
Variable Account shall be used to provide a Variable Annuity and that portion
of the Adjusted Contract Value allocated to the Fixed Account and the MVA
Account will be used to provide a Fixed Annuity. Prior to the Annuity Date,
the Owner can change the Annuity Option selected by Written Request. Any
change must be requested at least thirty (30) days prior to the Annuity Date.
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS : Annuity Payments are paid in
monthly installments. The Adjusted Contract Value is applied to the Annuity
Table for the Annuity Option selected. If the Adjusted Contract Value to be
applied under an Annuity Option is less than $5,000, the Company reserves the
right to make a lump sum payment in lieu of Annuity Payments. If the Annuity
Payment would be or become less than $50, the Company reserves the right to
reduce the frequency of payments to an interval which will result in each
payment being at least $50.
ANNUITY OPTIONS : The following Annuity Options or any other annuity option
acceptable to the Company may be selected:
OPTION 1. LIFETIME ONLY ANNUITY: The Company will make monthly payments
during the life of the Annuitant. If this option is elected, it is understood
and agreed that payments shall cease immediately upon the death of the
Annuitant and the annuity will terminate without further value.
OPTION 2. LIFETIME ANNUITY WITH GUARANTEED PERIODS : The Company will
make monthly payments for the guaranteed period selected and thereafter for
the life of the Annuitant. If this option is elected, it is understood and
agreed that upon the death of the Annuitant, any amounts remaining under the
guaranteed period selected will be distributed to the Beneficiary at least as
rapidly as under the method of distribution being used as of the date of the
Annuitant's death. The guaranteed period may be five (5) years, ten (10)
years or twenty (20) years.
OPTION 3. INSTALLMENT REFUND LIFE ANNUITY : The Company will make monthly
payments for the installment refund period (the time required for the sum of
the payments to equal the amount applied), and thereafter for the life of the
Annuitant. If this option is elected, it is understood and agreed that upon
the death of the Annuitant, any amounts remaining under the installment refund
period will be distributed to the Beneficiary at least as rapidly as under the
method of distribution being used at the time of the Annuitant's death.
OPTION 4. PAYMENT FOR A FIXED PERIOD: The Company will make monthly
payments for a fixed period of 3 to 20 years.
OPTION 5. JOINT AND SURVIVOR ANNUITY : The Company will make monthly
payments during the joint life time of the Annuitant and a Joint Annuitant.
Payments will continue during the lifetime of the surviving Annuitant and will
be computed on the basis of 100%, 50% or 66% of the Annuity Payment (or
limits) in effect during the joint life time.
ANNUITY : If the Owner selects a Fixed Annuity, the Adjusted Contract Value
is allocated to the General Account and the Annuity is paid as a Fixed
Annuity. If the Owner selects a Variable Annuity, the Adjusted Contract Value
will be allocated to the Sub-Accounts of the Variable Account in accordance
with the selection made by the Owner, and the Annuity will be paid as a
Variable Annuity. If no selection is made, the Adjusted Contract Value will
be applied in the same proportions to the same Sub-Accounts as the allocations
are at the time of election. Unless the Owner specifies otherwise, the payee
of the Annuity Payments shall be the Owner. The Adjusted Contract Value will
be applied to the applicable Annuity Table contained in the Contract based
upon the Annuity Option selected by the Owner. The amount of the first
payment for each $1,000 of Adjusted Contract Value is shown in the Annuity
Tables.
FIXED ANNUITY : The Owner may elect to have the Adjusted Contract Value
applied to provide a Fixed Annuity.
The dollar amount of each Fixed Annuity Payment shall be determined in
accordance with Annuity Tables contained in this Contract which are based on
the minimum guaranteed interest rate of 3% per year.
VARIABLE ANNUITY : The Owner may elect to have the Adjusted Contract Value
applied to provide a Variable Annuity. Variable Annuity Payments reflect the
investment performance of the Variable Account in accordance with the
allocation of the Adjusted Contract Value to the Sub-Accounts during the
Annuity Period. Variable Annuity Payments are not guaranteed as to dollar
amount.
The dollar amount of the first Variable Annuity Payment is determined in
accordance with the description above. The dollar amount of the Variable
Annuity Payments for each applicable Sub-Account after the first Variable
Annuity Payment is determined as follows:
1. The dollar amount of the first Variable Annuity Payment is divided by
the value of an Annuity Unit for each applicable Sub-Account as of the Annuity
Date. This sets the number of Annuity Units for each monthly payment for the
applicable Sub-Account.
2. The fixed number of Annuity Units per payment in each Sub-Account is
multiplied by the Annuity Unit Value for that Sub-Account for the last
Valuation Period of the month preceding the month for which the payment is
due. This result is the dollar amount of the payment for each applicable
Sub-Account.
The total dollar amount of each Variable Annuity Payment is the sum of all
Sub-Account Variable Annuity Payments reduced by the applicable portion of the
Contract Maintenance Charge.
ANNUITY UNIT : The value of any Annuity Unit for each Sub-Account of the
Variable Account was arbitrarily set initially at $10.
The Sub-Account Annuity Unit Value at the end of any subsequent Valuation
Period is determined as follows:
1. The Net Investment Factor for the current Valuation Period is
multiplied by the value of the Annuity Unit for the Sub-Account for the
immediately preceding Valuation Period.
2. The result in (1) is then divided by the Assumed Investment Rate
Factor which equals 1.00 plus the Assumed Investment Rate for the number of
days since the preceding Valuation Date. The Owner can choose either a 5% or
a 3% Assumed Investment Rate.
MORTALITY TABLES : The mortality table used in establishing the Annuity Table
is 1983 Individual Annuity Mortality, (IAM) Table, Unisex.
The dollar amount of an Annuity Payment for any Age or combination of Ages not
shown in the Tables or for any other form of Annuity Option agreed to by the
Company will be provided by the Company upon request.
GENERAL PROVISIONS
THE CONTRACT : The entire Contract consists of this Contract, the
Application, if any, and any riders or endorsements attached to this Contract.
This Contract may be changed or altered only by the President or Vice
President and the Secretary of the Company. A change or alteration must be
made in writing.
MISSTATEMENT OF AGE : If the Age of any Annuitant has been misstated, any
Annuity benefits payable will be the Annuity benefits provided by the correct
Age. After Annuity Payments have begun, any underpayments will be made up in
one sum with the next Annuity Payment. Any overpayments will be deducted from
future Annuity Payments until the total is repaid.
INCONTESTABILITY : This Contract will not be contestable from the date of
issue.
MODIFICATION : This Contract may be modified in order to maintain compliance
with applicable state and federal law.
NON-PARTICIPATING : This Contract will not share in any distribution of
dividends.
EVIDENCE OF SURVIVAL : The Company may require satisfactory evidence of the
continued survival of any person(s) on whose life Annuity Payments are based.
PROOF OF AGE : The Company may require evidence of Age of any Annuitant and
any Owner.
PROTECTION OF PROCEEDS : To the extent permitted by law, death benefits and
Annuity Payments shall be free from legal process and the claim of any
creditor other than the person entitled to them under any Contract. No
payment and no amount under this Contract can be taken or assigned in advance
of its payment date unless the Company receives the Owner's written consent.
REPORTS : At least once each calendar year, the Company will furnish each
Owner with a report showing the Contract Value and any other information as
may be required by law. The Company will also furnish an annual report of the
Variable Account.
TAXES : Any taxes paid to any governmental entity relating to any Contract
will be deducted from the Purchase Payment or Contract Value when incurred.
The Company will, in its sole discretion, determine when taxes have resulted
from: the investment experience of the Variable Account; receipt by the
Company of the Purchase Payments; or commencement of Annuity Payments. The
Company may, in its sole discretion, pay taxes when due and deduct that amount
from the Contract Value at a later date. Payment at an earlier date does not
waive any right the Company may have to deduct amounts at a later date. The
Company reserves the right to establish a provision for federal income taxes
if it determines, in its sole discretion, that it will incur a tax as a result
of the operation of the Variable Account. The Company will deduct for any
income taxes incurred by it as a result of the operation of the Variable
Account whether or not there was a provision for taxes and whether or not it
was sufficient. The Company will deduct any withholding taxes required by
applicable law.
REGULATORY REQUIREMENTS : All values payable under any Contract will not be
less than the minimum benefits required by the laws and regulations of the
states in which the Contract is delivered.