ING USA SINGLE PREMIUM IMMEDIATE
ANNUITY AND LIFE FIXED AND VARIABLE ANNUITY
INSURANCE COMPANY GROUP MASTER CONTRACT
ING USA is a stock company domiciled in Iowa
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Offices: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇
CONTRACTHOLDER: Golden Investor Trust, Inc.
GROUP CONTRACT NUMBER: G-000029-OE
ISSUED IN: Delaware CONTRACT ISSUE DATE: August 1, 2004
In this Contract, we, our and us refer to the ING USA Annuity and Life Insurance
Company.
In consideration of application for this Contract and the payment of premiums,
we agree, subject to the terms and conditions of this Contract, to provide the
benefits described in this Contract to the persons eligible (herein called
"Annuitants") under the terms of this Contract.
If this Contract is in force, we will make income payments to the Certificate
Owner, or Payee if different, starting on the First Annuity Payment Date shown
in each Certificate. If the Annuitant dies after income payments have commenced
and there is no surviving Certificate Owner or joint Certificate Owner, we will
pay any remaining Guaranteed Payments ("death proceeds") to the Beneficiary. The
amounts of such benefits are subject to the terms of this Contract.
Any death proceeds due under this Contract will be paid according to the
Beneficiary designation and the provisions of this Contract. Payment of any
death proceeds by us will completely discharge our liability with respect to the
amounts so paid.
All provisions set forth on the following pages are a part of this Contract.
Signed for ING USA Annuity and Life Insurance Company on the Contract Date.
[GRAPHIC OMITTED][GRAPHIC OMITTED]
Secretary:
Customer Service Center
P.O. Box 9271 [GRAPHIC OMITTED][GRAPHIC OMITTED] ▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇
President:
1-800-366-0066
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SINGLE PREMIUM IMMEDIATE FIXED AND VARIABLE ANNUITY GROUP MASTER CONTRACT - NO
DIVIDENDS Non-participating. Investment results reflected in values.
IU-MP-3000 2
CERTIFICATE CONTENTS
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SCHEDULE OF BENEFITS....................................................3
IMPORTANT TERMS.........................................................4
GENERAL PROVISIONS......................................................6
Eligibility
The Certificate Owner
The Beneficiary
Change of Certificate Owner or Beneficiary
Single Premium Payment
Premium Taxes
Market Value Adjustments
DEATH BENEFIT PROVISIONS.................................................8
Death of Certificate Owner Prior to the First Annuity
Payment Date
Spousal Continuation upon Death of Certificate Owner
Death After the First Annuity Payment Date
Death of Annuitant
Death of Certificate Owner
How to Claim Payments to Beneficiary
VARIABLE ANNUITY PROVISIONS..............................................9
The Variable Separate Account
Variable Separate Account Divisions
Changes Within the Variable Separate Account
Variable Annuity Payments
Annuity Unit Value
Net Return Factor
Deductions from the Variable Separate Account Divisions
Mortality and Expense Risk Charges and Administrative
Expenses
Redemption Fees
Certificate Owner's Right to Make Allocation Changes
OTHERIMPORTANT
INFORMATION........................................................12
Entire Contract
Sending Notice to Us
Reports to Certificate Owner
Assignment - Using this Certificate as Collateral Security
Contract Changes - Applicable Tax Law
Misstatement of Age or Sex
Non-Participating
Incontestability
Certificates
Conformity with Law
Facility of Payment
Authority to Make Agreements
Required Note on Our Computations
Payments We May Defer
Surrender/Loan Value
Records
Certificate Owner's Right to Examine the Certificate
Copies of any additional Riders and Endorsements are at the back of
this Certificate.
IU-MP-3000 2
SCHEDULE OF BENEFITS
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PREMIUM PAYMENT AND INVESTMENT INFORMATION
Investment
Minimum Single Premium Payment $10,000
Variable Annuity Assumed Interest As shown in each Certificate
Fixed Annuity Contract Rate As shown in each Certificate
Guaranteed Payments cannot extend beyond: Qualified: earlier of (a) age 100 and
(b) life expectancy
Non-Qualified: age 100
Allocations - Variable Separate Account Divisions
Maximum Divisions at any one time: Twenty
Maximum allocation changes per Certificate Year without Charge: 12
Index Rate
The Index Rate is the average of the Ask Yields for the U.S. Treasury Strips as
reported by a national quoting service for the applicable maturity. The average
is based on the period from the 22nd day of the calendar month two months prior
to the calendar month of Index Rate determination to the 21st day of the
calendar month immediately prior to the month of determination. The applicable
maturity date for these U.S. Treasury Strips is derived from the length of the
Period Certain ("certain period"). If the Ask Yields are no longer available,
the Index Rate will be determined using a suitable replacement method subject to
any required regulatory approval. We currently set the Index Rate once each
calendar month. However, we reserve the right to set the Index Rate more
frequently than monthly, but in no event will such Index Rate be based on a
period less than 28 days.
CONTRACT FACTS
Certificate Date: As shown in each Certificate
Annuity Option As shown in each Certificate
First Annuity Payment Date: As shown in each Certificate
Death Benefits: As shown in each Certificate
Right to Withdraw Option As shown in each Certificate
Flexible Period Option As shown in each Certificate
Option Riders: As shown in each Certificate
CHARGES
Initial Administrative Charge: None
Excess Allocation Charge: $25 Covers the cost of allocations in excess
of the 12 free allocations changes allowed
per Certificate Year. Deducted from the
Annuity Payment next following any
allocation change(s)
Surrender Charges As shown in each Certificate
Deductions from the Divisions:
Mortality & Expense Risk Charge As shown in each Certificate
Asset Based Administrative Charge As shown in each Certificate
Redemption Fees As shown in each Certificate
IU-MP-3000 3
IMPORTANT TERMS
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ANNUITANT - The person designated by the Certificate Owner to be the measuring
life in determining Annuity Payments and whose death may result in payment
of any death proceeds. The Annuitant must be a natural person.
ANNUITY - a periodic payment to begin at a specified or contingent date and to
continue for a fixed period (the Period Certain) and/or for the duration of
a designated life or lives.
ANNUITY OPTIONS - Options the Certificate Owner selects that determine the form
and amount of Annuity Payments.
ANNUITY PAYMENT - The periodic payment the Certificate Owner, or Payee if
different, receives on either a variable basis or fixed basis, or a
combination thereof.
ANNUITY UNIT - the measure for valuing a Variable Annuity on and after the First
Annuity Payment Date. The dollar value of each unit fluctuates with the
experience of the Variable Separate Account Divisions available for
investment under the Certificate.
ASSUMED INTEREST RATE - The rate selected by the Certificate Owner which is used
to calculate the Variable Annuity Payments under the Certificate and to
determine withdrawal values, as appropriate. The Assumed Interest Rate is
shown in the Certificate Schedule.
BENEFICIARY - The person designated by the Certificate Owner to receive death
proceeds in the case of the Annuitant's death (or joint Annuitant's death
if applicable) if there is no surviving Certificate Owner or joint
Certificate Owner.
BUSINESS DAY - Any day the New York Stock Exchange ("NYSE") is open for trading,
or any day on which the Securities and Exchange Commission ("SEC") requires
that mutual funds, unit investment trusts or other investment portfolios be
valued, excluding federal holidays,
CERTIFICATE - A summary of the benefits and provisions provided under this
Contract.
CERTIFICATE ANNIVERSARY - The anniversary of the Certificate Date.
CERTIFICATE DATE - The date we received the Premium and upon which we begin
determining the Certificate values. This date is used to determine
Certificate months, processing dates, years, and anniversaries.
CONTRACT ISSUE DATE - The date this Contract is issued at our Customer Service
Center.
CERTIFICATE OWNER - The individual who owns the Certificate and is entitled to
exercise all rights under the Certificate.
CERTIFICATE YEAR - The period between Certificate Anniversaries.
CONTRACTHOLDER - The entity to whom this contract is issued.
ESTIMATED VARIABLE ANNUITY PAYMENT - The estimated periodic payments a
Certificate Owner, or Payee if different, receives under a Variable Annuity
which, when based on the experience of a separate account, are not
guaranteed and will fluctuate according to the investment experience of the
Variable Separate Account Divisions. The estimated Variable Annuity
Payment, if any, is shown in the Certificate Schedule.
FIXED ANNUITY - An Annuity with benefit payments which are fixed and will not
fluctuate during the payment period.
FIXEDANNUITY PAYMENT - The fixed periodic payment a Certificate owner receives
under a Fixed Annuity. Such payments, if any, are supported by the General
Account and are shown in the Certificate Schedule.
FIXEDANNUITY PAYMENT RATE - The rate used to calculate the Fixed Annuity
Payments, if any, under the Certificate and to determine withdrawal values,
as appropriate.
GENERAL ACCOUNT - An account which contains all of our other assets other than
those held in our Separate Account. It is used to support Fixed Annuity
Payments.
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IMPORTANT TERMS (continued)
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GUARANTEED PAYMENT - A periodic payment that is due whether or not the
Annuitant, or joint Annuitant if applicable, is living on date the
Guaranteed Payment is due.
FIRST ANNUITY PAYMENT DATE - the date on which the first annuity periodic
payment is paid under the Certificate.
ISSUEAGE -The age of the Certificate Owner, or that of the Annuitant if
different, on his or her birthday nearest a Certificate Date.
JOINTLIFE INCOME ANNUITY - An Annuity issued on the lives of two individuals
for which payments are based on whether or not at least one of the
Annuitants is living on the date the Annuity Payment is due. Payments cease
at the death of both Annuitants.
JOINTLIFE INCOME WITH PERIOD CERTAIN ANNUITY - An Annuity issued on the lives
of two individuals with Guaranteed Payments that continue for a specified
period of time without being dependent upon the survival of the Annuitant
or joint Annuitant and continue thereafter in whole or in part as long as
at least one of the Annuitants is living.
LIFE INCOME ANNUITY - An Annuity for which payments are based soley on whether
or not the Annuitant is living on the date the Annuity Payment is due.
Payments cease at the Annuitant's death.
LIFE INCOME WITH PERIOD CERTAIN ANNUITY - An Annuity with Guaranteed Payments
that continue for a specified period of time and continue thereafter as
long as the Annuitant is living.
MARKET VALUE ADJUSTMENT - A positive or negative adjustment applied (a) to any
portion of Fixed Annuity Guaranteed Payments withdrawn; or (b) to determine
the withdrawal value under Flexible Period Option, if applicable.
NET RATE OF RETURN - The Net Rate of Return is equal to:
(1) The value of the shares of the Division at the end of a Valuation
Date; minus
(2) The value of shares of the Division at the start of the Valuation
Date; plus or minus
(3) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(4) The value of shares of the Division at the start of the Valuation
Date; minus
(5) The daily Asset Based Administrative Charges and Mortality and Expense
Risk Charges described in the Schedule for each day in the Valuation
Period.
A Net Rate of Return may be more or less than 0%. The value of a share in a
Division is equal to the net assets of the Division divided by the number
of shares outstanding. Refer to the Variable Annuity Provisions of this
Certificate for additional information.
PAYEE- The person designated by the Certificate Owner to receive the Annuity
Payments under the Certificate. The Certificate Owner is the Payee, unless
someone else is named. If the Payee dies before all payments have been made
under the Certificate, the contingent Payee will become the Payee. If there
no contingent Payee, the Certificate Owner will become the Payee.
PERIOD CERTAIN ANNUITY - An Annuity with Guaranteed Payments that continue for a
specified period of time without being dependent upon the survival of the
Annuitant.
VALUATION DATE - The day at the end of a Valuation Period when each Division is
valued.
VALUATION PERIOD - Each business day together with any non-business days before
it.
VARIABLE ANNUITY - an Annuity with payments that fluctuate based on the net
investment experience of the divisions of the Variable Separate Account.
VARIABLE SEPARATE ACCOUNT DIVISION - Under a Variable Annuity, an investment
option available in the Variable Separate Account. Any Variable Separate
Account Divisions elected by the Certificate Owner for the allocation of
some or all of the Premium Payment are shown in each Certificate.
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GENERAL PROVISIONS
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ELIGIBILITY
Eligible persons as stated in the application for this Contract and who have
enrolled and for whom the Initial Premium has been paid are eligible to receive
the benefits under this Contract.
THE CERTIFICATE OWNER
The Certificate Owner is also the Annuitant unless another Annuitant has been
named and is shown in the Certificate. The Certificate Owner has the rights and
options described in this Contract. One or more people may own a Certificate.
The sole certificate Owner's estate will be the beneficiary if no beneficiary
designation is in effect, or if the sole designated beneficiary has predeceased
the certificate Owner. In the case of a joint certificate Owner dying prior to
the First Annuity Payment Date, the surviving Owner(s) will be deemed to be the
Beneficiary(ies) and any other Beneficiary(ies) of record will be treated as the
contingent Beneficiary(ies).
THE BENEFICIARY
The Beneficiary will receive any remaining Guaranteed Payments due under this
Certificate at the death of the Annuitant, and joint Annuitant if applicable, if
there is no surviving Certificate Owner or joint Certificate Owner. We pay any
remaining Guaranteed Payments to the primary Beneficiary. If the primary
Beneficiary dies before the Annuitant, any remaining Guaranteed Payments are
paid to the contingent Beneficiary, if any. If there is no contingent
Beneficiary, we pay any remaining Guaranteed Payments to the Certificate Owner,
if living, otherwise to the Certificate Owner's estate or legal successors. One
or more persons may be named as primary Beneficiary or contingent Beneficiary.
In the case of more than one Beneficiary, we will assume any remaining
Guaranteed Payments are to be paid in equal shares to the surviving
Beneficiaries. The Certificate Owner may specify other than equal shares. See
Death Benefit Provisions for more information.
CHANGE OF CERTIFICATE OWNER OR BENEFICIARY
During the Annuitant's lifetime and while the Certificate is in effect under
this Contract, the Certificate Owner can transfer ownership of the Certificate
or change the Beneficiaries, unless the primary Beneficiary has been designated
as irrevocable. To make any of these changes, we require written notice of the
change in a form satisfactory to us. If there are joint Certificate Owners, both
must agree to the change. The change will take effect as of the day the notice
is signed. The change will not affect any payment made or action taken by us
before recording the change at our Customer Service Center.
SINGLE PREMIUM PAYMENT
This is a single premium annuity. However, the single premium may be paid in one
lump sum or in installments anytime prior to the First Annuity Payment Date
shown in the Schedule of each Certificate. Any such planned installments must be
identified at the time a Certificate is issued and be received by us at our
Customer Service Center prior to such First Annuity Payment Date. The
Certificate Holder may allocate Premium Payment to Fixed Annuity Payments,
Variable Annuity Payments, or a combination thereof. The amount of the premium
applied to a Certificate will be the initial premium received as shown in the
Certificate Schedule, minus a deduction for Premium Taxes, if any. If any
subsequent payments are received after a Certificate Date, but before the First
Annuity Payment Date, the initial calculation of Fixed Annuity Payments under a
Certificate will be considered an estimate until the First Annuity Payment Date.
We may defer acceptance of or return any subsequent Premium Payments received
before the First Annuity Payment Date.
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GENERAL PROVISIONS(continued)
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PREMIUM TAXES
We deduct the amount of any premium or other state and local taxes levied by any
state or governmental entity when such taxes are incurred.
MARKET VALUE ADJUSTMENTS
A Market Value Adjustment will be applied to any portion of a Fixed Annuity
Payment withdrawn to determine the withdrawal value under the Certificate. The
Market Value Adjustment is determined by multiplying the amount withdrawn by the
following factor:
1 + I N/365
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1 + J + .0050 - 1
The applicable maturity for Index Rate I is the certain period divided by 2
rounded up to the nearest whole number and the applicable maturity for Index
Rate J is the remaining certain period divided by 2 rounded up to the nearest
whole number. The calendar month of Index Rate determination for Index Rate I is
the month the Certificate was issued or the month of the most recent change (if
any) under the Flexible Period Option. The calendar month of Index Rate
determination for Index Rate J is the month the transaction is effective. N is
equal to the number of days remaining in the certain period, divided by 2.
Index Rate
The Index Rate is the average of the Ask Yields for the U.S. Treasury Strips as
reported by a national quoting service for the applicable maturity. The average
is based on the period from the 22nd day of the calendar month two months prior
to the calendar month of Index Rate determination to the 21st day of the
calendar month immediately prior to the month of determination. The applicable
maturity date for these U.S. Treasury Strips is derived from the length of the
Period Certain ("certain period"). If the Ask Yields are no longer available,
the Index Rate will be determined using a suitable replacement method subject to
any required regulatory approval. We currently set the Index Rate once each
calendar month. However, we reserve the right to set the Index Rate more
frequently than monthly, but in no event will such Index Rate be based on a
period less than 28 days.
Market Value Adjustments will be applied as follows:
(1) The Market Value Adjustment will be applied to the amount withdrawn
before deduction of any applicable Surrender Charge.
(2) The Market Value Adjustment will be calculated on the total amount
that must be withdrawn in order to provide the amount requested
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DEATH BENEFIT PROVISIONS
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DEATH OF CERTIFICATE OWNER PRIOR TO THE FIRST ANNUITY PAYMENT DATE
If a Certificate Owner dies prior to the First Annuity Payment Date, the entire
interest in the Certificate must be distributed within five years of the date of
death, or payments may be made over a period not extending beyond the life
expectancy of the Beneficiary, provided such payments begin not later than one
year after the date of death. The "entire interest" means the Premium Paid plus
any increase or minus any decrease in the value of amounts allocated to the
Separate Account as of the date we receive due proof of death.
Spousal Continuation upon Death of Certificate Owner
If, at the death of the Certificate Owner (who is not also the Annuitant), the
surviving spouse of the deceased Certificate Owner is the Beneficiary, then such
surviving spouse may elect to continue the Certificate as their own pursuant to
Internal Revenue Code Section 72(s) or the equivalent provisions of the U.S.
Treasury Department rules for qualified plans. However, on the death of the
surviving spouse, this provision may not be used again.
DEATH AFTER THE FIRST ANNUITY PAYMENT DATE
Death of Annuitant
If the Annuitant, and Joint Annuitant if applicable, dies and there is no
surviving Certificate Owner or joint Certificate Owner, any remaining Guaranteed
Payments will be paid to the Beneficiary in the form specified in the Schedule
upon receipt of due proof of the Annuitant's death at our Customer Service
Center. Such payments will be paid at least as rapidly as under the method of
distribution then in effect. In all events, distributions under the Certificate
must be made as required by applicable law.
If this Certificate is issued as a Life with Period Certain Annuity, within six
months of such death, the Beneficiary may elect to receive the withdrawal value
of any remaining Guaranteed Payments in a lump sum. If the Certificate is issued
as a Period Certain Annuity or if there are rights to make withdrawals under the
Certificate as shown in the Certificate Schedule, the Beneficiary may elect to
receive the withdrawal value of any remaining Guaranteed Payments in a lump sum
at any time. The withdrawal value under this provision is equal to:
(a) Under the Fixed Annuity portion of the Certificate, if applicable, the
present value of any remaining Fixed Annuity Guaranteed Payments
determined by using the Fixed Annuity Payment Rate as of the Valuation
Date immediately following the date we receive due proof of the
Annuitant's death, adjusted by any Market Value Adjustment; and
(b) Under the Variable Annuity portion of the Certificate, if applicable,
the present value of any remaining Variable Annuity Guaranteed
Payments determined by using the Assumed Interest Rate as of the
Valuation Date immediately following the date we receive due proof of
the Annuitant's death.
No Surrender Charges will apply in calculating the withdrawal value under this
provision. To take the withdrawal value of any remaining Variable and/or Fixed
Annuity Guaranteed Payments, as applicable, we must receive a written request
satisfactory to us at our Customer Service Center.
Death of Certificate Owner
If a Certificate Owner, who is not also the Annuitant, dies, payments will
continue to the Payee in the form specified in the Schedule. If no Payee
designated by the Certificate Owner survives the Certificate Owner, payments
will be made to the Certificate Owner's estate. Such payments will be paid at
least as rapidly as under the method of distribution then in effect.
How to Claim Payments to Beneficiary
We must receive proof of the Annuitant's death (and joint Annuitant's death if
applicable) at our Customer Service Center before we will make any remaining
payments to the Beneficiary. We will calculate any proceeds payable as of the
date we receive due proof of death. The Beneficiary should contact our Customer
Service Center for instructions
IU-MP-3000 8
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VARIABLE ANNUITY PROVISIONS
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THE VARIABLE SEPARATE ACCOUNT
The Variable Annuity Payments under this Certificate, if any, are provided
through investments which may be made in our Separate Account (the "Account"), a
unit investment trust Separate Account, organized in and governed by the laws of
the State of Iowa, our state of Domicile. The Account is divided into Divisions,
each of which is available for investment under this Certificate. The Account is
kept separate from our General Account and any other Separate Accounts we may
have. It is used to support Variable Annuity Certificates and may be used for
other purposes permitted by applicable laws and regulations. We own the assets
in the Separate Account. Assets equal to the reserves and other liabilities of
the account will not be charged with liabilities that arise from any other
business we conduct; but, we may transfer to our General Account assets which
exceed the reserves and other liabilities of the Variable Separate Account.
Income and realized and unrealized gains or losses from assets in the Variable
Separate Account are credited to or charged against the Account without regard
to other income, gains or losses in our other investment accounts.
The Variable Separate Account will invest in mutual funds, unit investment
trusts and other investment portfolios which we determine to be suitable for
this Certificate's purposes. The Variable Separate Account is treated as a unit
investment trust under Federal securities laws. It is registered with the
Securities and Exchange Commission ("SEC") under the Investment Company Act of
1940. The Variable Separate Account is also governed by state law as described
above.
Variable Separate Account Divisions
A unit investment trust Separate Account is divided into Divisions, each
investing in a designated investment portfolio. The Divisions and the investment
portfolios designated may be managed by a separate investment adviser. Such
adviser may be registered under the Investment Advisers Act of 1940.
Changes within the Variable Separate Account
We may, from time to time, make additional Variable Separate Account Divisions
available to Certificate Owners. These Divisions will invest in investment
portfolios we find suitable for the group contract. We also have the right to
eliminate Divisions from a Variable Separate Account, to combine two or more
Divisions or to substitute a new portfolio for the portfolio in which a Division
invests. A substitution may become necessary if, in our judgment, a portfolio or
Division no longer suits the purpose of the group contract. This may happen due
to a change in laws or regulations, a change in a portfolio's investment
objectives or restrictions, because the portfolio or Division is no longer
available for investment, or for some other reason. We will obtain any required
regulatory approvals before making such a substitution
Subject to any required regulatory approvals, we reserve the right to transfer
assets of the Variable Separate Account which we determine to be associated with
the class of contracts to which the group contract belongs, to another Variable
Separate Account or Division.
When permitted by law, we reserve the right to:
(1) deregister a Variable Separate Account under the Investment Company Act
of 1940;
(2) operate a Variable Separate Account as a management company under the
Investment Company Act of 1940, if it is operating as a unit investment
trust;
(3) operate a Variable Separate Account as a unit investment trust under
the Investment Company Act of 1940, if it is operating as a managed
Variable Separate Account;
(4) restrict or eliminate any voting rights of Certificate Owners, or other
persons who have voting rights to a Variable Separate Account; and
(5) combine a Variable Separate Account with other Variable Separate
Accounts.
IU-MP-3000 9
VARIABLE ANNUITY PROVISIONS (Continued)
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VARIABLE ANNUITY PAYMENTS
If Variable Annuity Payments are chosen, the initial payment for the option
chosen reflects the Variable Annuity Assumed Interest Rate shown in the
Certificate Schedule. Thereafter, the Divisions of the Variable Separate Account
must earn the Assumed Interest Rate shown in the Schedule plus enough to cover
any deductions stated in the Certificate if future Annuity Payments are to
remain level. If earnings exceed this amount, Variable Annuity Payments will
increase; if earnings are less than this amount, Variable Annuity Payments will
decrease.
Annuity Units
The Number of Annuity Units is equal to the portion of the first Estimated
Variable Annuity Payment allocated to each Division divided by the appropriate
Annuity Unit Value on the Valuation Date. Thereafter, the number of Annuity
Units remains unchanged except when an allocation change is made. Each Variable
Annuity Payment is equal to the sum of the products of each Annuity Unit Value
on the Valuation Date for that payment multiplied by the appropriate number of
Annuity Units for each Division.
Annuity Unit Value
On any Valuation Date, an Annuity Unit Value is equal to: (1) The Annuity Unit
Value on the previous Valuation Day; multiplied by (2) The Annuity Net Return
Factor(s) for the Valuation Date; multiplied by (3) A Factor to reflect the
Assumed Interest Rate shown in the Schedule
The Annuity Unit Value and Annuity Payment amount may go up or down due to
investment gain or loss.
Net Return Factor
The Net Return Factor(s) is(are) used to compute all Variable Annuity Payments
for any Division in the Variable Separate Account. The Net Return Factor for
each Division is equal to 1.0000 plus the Net Rate of Return.
The Net Rate of Return is equal to:
(1) The value of the shares of the Division at the end of a Valuation
Date; minus
(2) The value of shares of the Division at the start of the Valuation
Date; plus or minus
(3) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(4) The value of shares of the Division at the start of the Valuation
Date; minus
(6) The daily Asset Based Administrative Charges and Mortality and Expense
Risk Charges described in the Schedule for each day in the Valuation
Period.
A Net Rate of Return may be more or less than 0%. The value of a share in a
Division is equal to the net assets of the Division divided by the number of
shares outstanding.
Annuity Payments shall not be changed due to mortality or expense results.
DEDUCTIONS FROM THE VARIABLE SEPARATE ACCOUNT DIVISIONS
Mortality and Expense Risk Charges and Administrative Expenses
We deduct a charge from the Net Rate of Return on a daily basis for mortality
and expense risks and to compensate us for a portion of our ongoing
administrative expenses. The maximum charges for these expenses as of a
Certificate Date are shown in each Certificate Schedule, but we may charge less
than the maximum.
IU-MP-3000 10
VARIABLE ANNUITY PROVISIONS (Continued)
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REDEMPTION FEES
We may deduct the amount of any redemption fees imposed by a mutual fund or
other investment company in which the Separate Account Divisions invest as a
result of any full or partial withdrawals, reallocations or other transactions
directed by the Certificate Owner.
THE CERTIFICATE OWNER'S RIGHT TO MAKE ALLOCATION CHANGES
The Certificate Owner may make allocation changes among the available Divisions
of the Variable Separate Account after the end of the Right to Examine period.
Allocation changes in excess of twelve in any Certificate Year are subject to an
Excess Allocation Charge as shown in the Schedule. Any charge will be deducted
from the Annuity Payment next following the date of any excess allocation
change(s). To make an allocation change, we must receive satisfactory notice at
our Customer Service Center. The change will take effect when we receive the
notice.
We will monitor transfer activity and will restrict transfers that constitute
Frequent Trading. Our current definition of Frequent Trading is more than one
purchase and sale of the same underlying fund within a 30-day period. We may
modify our general standard, or the standard as it may apply to a particular
fund, at any time without prior notice, if required by the underlying fund(s) in
which Separate Account Divisions invest and/or by state or federal regulatory
requirements, or based on our business judgement. We will notify each
Certificate Owner in writing within 30 days of such modification.
IU-MP-3000 11
OTHER IMPORTANT INFORMATION
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ENTIRE CONTRACT
This Contract, including any attached Riders, endorsements, amendments and the
application of the Contractholder, constitute the entire contract between the
Contractholder and us. All statements made by the Contractholder, any
Certificate Owner or any Annuitant will be deemed representations and not
warranties.
SENDING NOTICE TO US
Whenever written notice is required, send it to our Customer Service Center.
REPORTS TO CERTIFICATE OWNERS
We will send to each Certificate Owner a report at least once during each
Certificate Year. The report will show the Annuity Unit values as of the end of
a Certificate Year. The report will also show the allocation of the Annuity Unit
values as of such date and the amounts, if any, deducted from or added to the
Annuity Unit value since the last report. The report will also include any
information that may be currently required by the insurance supervisory official
of the jurisdiction in which a Certificate is delivered. We will also send
copies of any shareholder reports of the portfolios in which the Divisions of
the Variable Separate Account invest, as well as any other reports, notices or
documents required by law to be furnished to Certificate Owners.
ASSIGNMENT - USING THIS CERTIFICATE AS COLLATERAL SECURITY
Benefits under a Certificate may be assigned as collateral security for a loan
or other obligation. This does not change the ownership. The Certificate Owner's
rights and any Beneficiary's right are subject to the terms of the assignment.
The Beneficiary's rights may be subordinate to those of an assignee unless the
Beneficiary was designated as an irrevocable Beneficiary prior to the
assignment. To make or release an assignment, we must receive written notice
satisfactory to us, at our Customer Service Center. We are not responsible for
the validity of any assignment.
CONTRACT CHANGES - APPLICABLE TAX LAW
We reserve the right to make changes in this Contract or its Riders to the
extent necessary to continue to qualify this Contract as an annuity. Any such
changes will apply uniformly to all Certificates that are affected. The
Contractholder and Certificate Owner will be given advance written notice of
such changes.
MISSTATEMENT OF AGE OR SEX
If an age or sex has been misstated, the amounts payable or benefits provided by
the Contract will be those that the Premium Payment made would have bought at
the correct age or sex.
NON-PARTICIPATING
This Contract does not participate in our divisible surplus.
INCONTESTABILITY
The benefits under this Contract will not be contested, except for nonpayment of
premiums, after it has been in effect during the annuitant's lifetime for two
years from the certificate date.
CERTIFICATES
Certificates will be furnished by us.
CONFORMITY WITH LAW
If any provision of this Contract is contrary to any law to which it is subject,
such provision is considered amended to conform to such law.
IU-MP-3000 12
OTHER IMPORTANT INFORMATION (Continued)
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FACILITY OF PAYMENT
If no beneficiary is named, we reserve the right to pay an amount not to exceed
$2,000 to any person we determine to be entitled to such amount by reason of
incurred expenses incident to the last illness or death of a Certificate Owner.
AUTHORITY TO MAKE AGREEMENTS
All agreements made by us must be signed by one of our officers. No other
person, including an insurance agent or broker, has the authority to: (1) change
any of this Contract's terms; (2) extend the time for Premium Payments; or (3)
make any agreement binding on us.
REQUIRED NOTE ON OUR COMPUTATIONS
We have filed a detailed statement of our computations with the insurance
supervisory official in the appropriate jurisdictions where each Certificate is
delivered. The values are not less than those required by the law of that state
or jurisdiction. Any benefit provided by an attached optional benefit rider will
not increase these values unless otherwise stated in that rider.
PAYMENTS WE MAY DEFER
We may not be able to determine the value of the assets in the Variable
Separate Account because:
(1) The NYSE is closed for trading;
(2) the SEC determines that a state of emergency exists;
(3) an order or pronouncement of the SEC permits a delay for the
protection of Certificate Owners; or
(4) the check used to pay the premium has not cleared through the
banking system. This may take up to 15 days.
During such times, as to amounts allocated to the Variable Separate
Account, we may delay:
(1) determination and payment of any death benefit if death occurs
before the First Annuity Payment Date;
(2) allocation changes among the available Divisions of the Variable
Separate Account; or
(3) making a Variable Annuity Payment.
SURRENDER/LOAN VALUE
Except as provided in the Right to Examine provision, this Contract has no loan
or surrender value.
RECORDS
The Contractholder will furnish us information relative to this Contract as we
may require to administer this Contract. Such records, which in our opinion have
a bearing on this Contract, will be open to us for inspection at all reasonable
times.
CERTIFICATE OWNER'S RIGHT TO EXAMINE THE CERTIFICATE
A Certificate Owner may return a Certificate to us or the agent through whom it
was purchased within 10 days of receipt. If so returned, we will treat the
Certificate as though it were never issued. Upon receipt we will promptly refund
the Accumulation Value plus any charges we have deducted as of the date the
returned Certificate is received by us.
IU-MP-3000 13
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SINGLE PREMIUM IMMEDIATE FIXED AND VARIABLE ANNUITY GROUP MASTER CONTRACT - NO
DIVIDENDS
Non-participating. Investment results reflected in Variable Annuity Payments.
