EXHIBIT 4(a)
In this Group Contract, Keyport Life Insurance Company is referred to as "We,"
"Us," "Our," or the "Company."
This Group Contract, as issued to the Group Contract Owner by Us with any riders
or endorsements, alone makes up the agreement under which benefits are paid. The
Group Contract may be inspected at the office of the Group Contract Owner. In
consideration of any application for a Certificate and the payment of any
purchase payments, We agree, subject to the terms and conditions of the Group
Contract, to provide the benefits described in a Certificate to the Certificate
Owner.
If a Certificate is In Force on the Income Date, We will begin making Annuity
Payments to the Annuitant. We will make such payments according to the terms of
the Certificate and Group Contract.
Right to Cancel - A Certificate Owner may return the Certificate to Us (Keyport
Life Insurance Company, ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇) or to the agent from
whom it was purchased for cancellation. The Certificate Owner must mail or
deliver it within 45 days from the Issue Date or 20 days after it is received,
whichever is later. The Certificate will then be treated as if We had never
issued it and We will promptly refund the Initial Premium, and any Subsequent
Premium less the amount of any partial surrenders.
Read This Contract Carefully
GROUP DEFERRED ANNUITY CONTRACT
FLEXIBLE PREMIUM PAYMENT
NON-PARTICIPATING
VALUES GREATER THAN GUARANTEED VALUES ARE DEPENDENT UPON INCREASES AND
DECREASES IN THE INDEX, THE LENGTH OF TIME A CERTIFICATE IS HELD AND THE
DECLARED RATE WHICH IS ESTABLISHED EVERY MONTH AND GUARANTEED FOR THAT MONTH
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KEYPORT LIFE INSURANCE COMPANY
▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
Contract Specifications
Group Contract Owner: Keyport Insurance Trust
Group Contract Number: 9999999
Issue Date: 1/30/1995
Issue State: Rhode Island
Minimum Initial Premium: $5,000
Minimum Subsequent Premium: $1,000
Index
[The Standard & Poor's 500 Composite Stock Price Index. "Standard & Poor's 500"
is a trademark of The ▇▇▇▇▇▇-▇▇▇▇ Companies, Inc. and has been licensed for use
by Keyport Life Insurance Company. This annuity is not sponsored, endorsed,
sold or promoted by Standard & Poor's and Standard & Poor's makes no
representation regarding the advisability of purchasing the annuity.]
Premium Allocation
Currently, Certificate Owners can select among an Interest Sub-Account and
Index Sub-Accounts with Terms of [1-10] years. The minimum initial premium is
[$5,000] and Index Sub-Accounts require a minimum premium, transfer or renewal
of Indexed Value of [$1,000].
Partial Withdrawals
Minimum withdrawal amount: currently [$250].
Minimum Index Sub-Account balance after a partial withdrawal: currently
[$1,000].
Minimum Interest Sub-Account balance after a partial withdrawal: currently [$0]
Minimum Combined Surrender Value of all Sub-Accounts after partial withdrawal:
currently [$4,000]
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Table of Contents
Page
Right to Examine Certificate..................................................1
Contract Specifications.......................................................2
Definitions...................................................................3
General Provisions............................................................5
The Sub-Accounts..............................................................9
The Interest Sub-Account......................................................9
The Index Sub-Account........................................................10
Transfers....................................................................14
Withdrawals and Surrender....................................................15
Death Provisions.............................................................15
Annuity Provisions...........................................................17
Endorsements (if any) are before page........................................22
Definitions
Sub-Account: An Index Sub-Account or Interest Sub-Account.
Sub-Account Anniversary, Sub-Account Year: A continuous twelve-month period
commencing on the date that an Index Sub-Account is opened by allocation or
transfer, and each anniversary thereof including the end of the Term.
Annuitant: The natural person on whose life Annuity Payments are based, and to
whom any Annuity Payments will be made starting on the Income Date.
Annuity Options: Options available for Annuity Payments.
Annuity Payments: The series of payments made to the Annuitant, starting on the
Income Date, under the Annuity Option selected.
Annuity Period: The period after the Income Date during which Annuity Payments
are made.
Beneficiary: The person(s) or entity(ies) who controls the Certificate if any
Certificate Owner dies before the Income Date.
Cap: The maximum percentage by which an Index Sub-Account will be increased for
a Term. The cap may be "none" which means that there is no Cap.
Certificate: The document issued to a Certificate Owner to evidence a
Certificate Owner's participation under the Group Contract. The Certificate
summarizes the benefits and provisions of the Group Contract. All owners must
exercise ownership rights and privileges together, including the signing of
Written Requests.
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Definitions (Continued)
Certificate Anniversary, Certificate Year: A continuous twelve-month period
commencing on the Issue date and each anniversary thereof.
Certificate Owner: The person who owns a Certificate under the Group Contract.
Any Joint Certificate Owners and the Certificate Owner own the Certificate
equally with rights of survivorship.
Declared Rate: The annual effective interest rate that will be credited when
daily interest credits have compounded for a full year. The Declared Rate will
be set on the first of every month and guaranteed for that month. It will never
be less than 3%.
▇▇▇▇▇ ▇▇▇▇▇▇▇: An annuity with a series of payments made during the Annuity
Period which are guaranteed as to dollar amount by Us.
Floor: The minimum percentage by which an Index Sub-Account will be increased
for a Term. The Floor may be "none" or it may be less than 0% in which case the
Floor is the maximum percentage by which an Indexed Value can decrease over a
Term.
Group Contract Owner: The person or entity to which the Group Contract is
issued.
Guaranteed Interest Rate Factors: The Participation Rate, Cap, and Floor, which
are set and guaranteed by Us at the beginning of each Term of an Indexed
Sub-Account and used to calculate Index Increases under a formula set forth in
the Certificate.
Income Date: The date on which Annuity Payments begin. The Income Date is shown
on the Certificate Specifications' page.
Index: The Index (set forth in the Certificate Specifications' page) that is
used to calculate Index Increases. If the publication of the Index is
discontinued, or the calculation of the Index is changed substantially, We will
substitute a suitable index and notify the Certificate Owner.
Index Sub-Account: A Sub-Account for which We calculate values depending on
increases or decreases in the Index.
Interest Sub-Account: A Sub-Account to which We credit the Declared Rate.
In Force: The status of a Certificate before the Income Date so long as it has
not been totally surrendered and there has not been a death of a Certificate
Owner or Joint Certificate Owner that will cause the Certificate to end within
five years of the date of death.
Issue date: The date a Certificate is issued to a Certificate Owner. The Issue
date is shown on the Certificate Specifications' page.
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Office: Our executive office shown on the Certificate Specifications' page.
Participation Rate: The percentage used to calculate the Index change for an
Index Sub-Account for a Term. The Participation Rate determines what percentage
of the Term's change in the Index will be used in calculating the increase or
decrease in the Sub-accounts Indexed Value.
Person: A human being, trust, corporation, or any other legally recognized
entity.
Term: The number of complete years for which an increase or decrease in Indexed
Value is calculated.
We, Us, Our: Keyport Life Insurance Company.
Written Request: A request in writing, in a form satisfactory to Us, and
received by Us at Our Office.
General Provisions
Initial Premium
The Initial Premium is due on the Issue Date of the Certificate . It must be
paid in United States currency and deposited to a bank account of Ours in order
for the Certificate to be valid. The Initial Premium is allocated to the
Sub-Account(s) based on the Certificate Owner s instructions.
Subsequent Premiums
Subsequent premiums, subject to the minimum and maximum stated on page 2, may
be paid at any time during the first Certificate Year. Thereafter, it may be
paid anytime the Certificate is In Force unless the current Certificate Year is
within 10 years of the Income Date. Any Subsequent Premium must be paid in
United States currency and deposited to a bank account of Ours. We will then
apply the premium to the Sub-Account the Certificate Owner requested. Any
Subsequent Premium for an Index Sub-Account will be allocated to a new Index
Sub-Account of a Term requested by the Certificate Owner, subject to the
limitations described in this Certificate . If no instruction is received, We
will add the premium to the Interest Sub-Account. The Company reserves the
right to not allow Subsequent Premium to the Certificate.
The Contract
The Group Contract, including the application, if any, and any attached rider or
endorsement constitute the entire contract between the Group Contract Owner and
Us. All statements made by the Group Contract Owner, any Certificate Owner or
any Annuitant will be deemed representations and not warranties. No such
statement will be used in any contest unless it is contained in the application
signed by the Group Contract Owner or in a Certificate Enrollment Form signed by
the Certificate Owner, a copy of which has been furnished to the Certificate
Owner, the Beneficiary or the Group Contract Owner.
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Only Our President or Secretary may agree to change any of the terms of the
Group Contract or a Certificate. Any changes must be in writing. Any change to
the terms of a Certificate must be with a Certificate Owner's consent, unless
provided otherwise by the Group Contract and the Certificate.
To assure that the Group Contract and the Certificate will maintain their status
as an annuity under the Internal Revenue Code, We reserve the right to change
the Group Contract and any Certificate issued thereunder to comply with future
changes in the Internal Revenue Code, any regulations or rulings issued
thereunder, and any requirements otherwise imposed by the Internal Revenue
Service. The Group Contract Owner and the affected Certificate Owner will be
sent a copy of any such amendment.
Certificate Owner
A Certificate Owner has all rights and may receive all benefits under a
Certificate. A Certificate Owner is the person designated as such on the Issue
date, unless changed. A Certificate Owner may exercise all rights of a
Certificate while it is In Force, subject to the rights of (a) any assignee
under an assignment filed with Us, and (b) any irrevocably named Beneficiary.
Joint Certificate Owner
A Certificate can be owned by Joint Certificate Owners. Upon the death of any
Certificate Owner or Joint Certificate Owner, the surviving owner(s) will be the
primary Beneficiary(ies). Any other beneficiary designation will be treated as a
Contingent Beneficiary unless otherwise indicated in a Written Request filed
with Us.
Annuitant
The Annuitant is the person on whose life Annuity Payments are based. The
Annuitant is the person designated by a Certificate Owner at the Issue date,
unless changed prior to the Income Date. Any change of Annuitant is subject to
Our underwriting rules then in effect. The Annuitant may not be changed in a
Certificate which is owned by a non-natural person. A Certificate Owner may name
a Contingent Annuitant. The Contingent Annuitant becomes the Annuitant if the
Annuitant dies while a Certificate is In Force. If the Annuitant dies and no
Contingent Annuitant has been named, We will allow a Certificate Owner sixty
days to designate someone other than a Certificate Owner as Annuitant. A
Certificate Owner will be the Contingent Annuitant unless a Certificate Owner
names someone else. If the Certificate is owned by a non-natural person, the
death of the Annuitant will be treated as the death of the Certificate Owner and
a new Annuitant may not be designated.
Beneficiary
The Beneficiary is the person who controls the Certificate if any Certificate
Owner dies prior to the Income Date. If the Certificate is owned by Joint
Certificate Owners, upon the death of any Certificate Owner or Joint Certificate
Owner, the surviving owner(s) will become the primary Beneficiary. Any other
beneficiary designation will be treated as a Contingent Beneficiary unless
otherwise indicated in a Written Request filed with Us. If a Certificate Owner
names more than one Person as primary Beneficiary or as Contingent Beneficiary,
and do not state otherwise on the application or in a Written Request to Us, any
non-survivors will
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not receive a benefit. The survivors will receive equal shares. Subject to
the rights of any irrevocable Beneficiary(ies), a Certificate Owner may
change primary or contingent Beneficiary(ies). A change must be made by
Written Request and will be effective as of the date the Written Request is
signed. We will not be liable for any payment We make or action We take
before We receive the Written Request.
Group Contract Owner
The Group Contract Owner has title to the Group Contract. The Group Contract and
any amount accumulated under any Certificate are not subject to the claims of
the Group Contract Owner or any of its creditors. The Group Contract Owner may
transfer ownership of this Group Contract. Any transfer of ownership terminates
the interest of any existing Group Contract Owner. It does not change the rights
of any Certificate Owner.
Change of Certificate Owner, Beneficiary or Contingent Annuitant
While a Certificate is In Force, a Certificate Owner may by Written Request
change the primary Certificate Owner, Joint Certificate Owner, primary
Beneficiary, Contingent Beneficiary, Contingent Annuitant, or in certain
instances, the Annuitant. An irrevocably named Person may be changed only with
the written consent of such Person. The change will be effective, following Our
receipt of the Written Request, as of the date the Written Request is signed.
The change will not affect any payments We make or actions We take prior to the
time We receive the Written Request.
Assignment of the Certificate
A Certificate Owner may assign a Certificate at any time while it is In Force.
The assignment must be in writing and a copy must be filed at Our Office. A
Certificate Owner's rights and those of any revocably named Person will be
subject to the assignment. An assignment will not affect any payments We make or
actions We take before We receive the assignment. We are not responsible for the
validity of any assignment.
Misstatement of Age or Sex
If the age or sex of the Annuitant or any payee has been misstated, We will
compute the amount payable based on the correct age and sex. If Annuity Payments
have begun, any underpayment(s) that have been made will be paid in full with
the next Annuity Payment. Any overpayment, unless repaid to Us in one sum, will
be deducted from future Annuity Payments otherwise due until We are repaid in
full.
Non-Participating
A Certificate does not participate in Our divisible surplus.
Evidence of Death, Age, Sex or Survival
If a Certificate provision relates to the death of a natural Person, we will
require proof of death before We will act under that provision. Proof of death
shall be: (a) a certified death certificate; or (b) a certified decree of a
court of competent jurisdiction as to the finding of death; or (c) a written
statement by a medical doctor who attended the deceased; or (d) any other
document constituting due proof of death under applicable state law.
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If Our action under a Certificate provision is based on the age, sex, or
survival of any Person, We may require evidence of the particular fact before
We act under that provision.
Protection of Proceeds
No Beneficiary or payee may commute or assign any payments under a Certificate
before they are due. To the extent permitted by law, no payments shall be
subject to the debts of any Beneficiary or payee or to any judicial process for
payment of those debts.
Reports
We will send the Certificate Owner a report shortly after the end of each
Certificate Year that shows the following values for each Index Sub-Account that
was open at any time during the Certificate Year: the Surrender Value and
Indexed Value at the beginning of that year and the Indexed Value (as of the
most recent Sub-Account Anniversary); the amount of any surrenders or transfers
during that year; and the Index Increase, Surrender Value and Indexed Value at
the end of that year. For the Interest Sub-Account We will show the Surrender
Value and Accumulated Value at the beginning of the year, the amount of any
surrenders and transfers during the year, interest credits during the year, and
any premium payments allocated to this Sub-Account during the year, and the
Surrender Value and Accumulated Value at the end of the year. Also, at the end
of the term of each Index Sub-Account, We will give a report that shows the
length of the new term and the new term s Participation Rate and Floor and Cap.
We will send any other reports that may be required by law. Also, upon Written
Request, We will provide the Certificate Owner in a timely manner with factual
information about this Certificate's benefits and provisions.
Taxes
Any taxes paid to any governmental entity relating to a Certificate will be
deducted from the Initial Premium and any subsequent premium or the values of
the Sub-Account(s). We may, in Our sole discretion, delay the deduction until a
later date, including the Income Date. By not deducting tax payments at the time
of Our payment, We do not waive any right We may have to deduct amounts at a
later date. We will, in Our sole discretion, determine when taxes relate to a
Certificate. We will deduct from any payment under a Certificate any withholding
taxes required by applicable law.
Regulatory Requirements
All values payable under a Certificate will not be less than the minimum
benefits required by the laws and regulations of the states in which the
Certificate is delivered.
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The Sub-Accounts
The Initial and any Subsequent Premium may be allocated to an Interest and/or
Index Sub-Account(s). We will make the allocation based on a Certificate Owner's
allocation instructions (as stated on the Certificate Specifications' page). If
no instruction is received, all premium will be allocated to the Interest
Sub-Account.
An Index Sub-Account Term begins on the date as of which premium is allocated or
an amount is transferred to an Index Sub-Account and ends when the number of
years in the Term elected has elapsed. The last day of the Term is the
expiration date for that Term. Subsequent Terms begin on the first day following
the expiration date of a previous Term.
We will notify a Certificate Owner in writing at least 30 days prior to the
expiration date of any Term. A new Term of the same duration will commence
automatically after the end of a Term unless We receive a Certificate Owner's
Written Request prior to the start of the new Term of a Certificate Owner's
election of a different Term from among those being offered by Us at that time,
or instructions to transfer the expiring Index Sub-Account Value to the Interest
Sub-Account. A new Term cannot be longer than the number of years remaining
until the Income Date or maximum years allowed following the death of a
Certificate Owner or Annuitant if there is a non-natural Certificate Owner.
To the extent permitted by law, We reserve the right at any time to offer Terms
that differ from those available when a Certificate Owner's Certificate was
issued. We also reserve the right, at any time, to stop accepting premium
allocations, transfers or subsequent Term renewals to a particular Term. Since
the specific Terms available may change periodically, please contact Us to
determine the Terms currently being offered.
The Interest Sub-Account
Through the Interest Sub-Account, We offer a Declared Rate that is set on the
first of every calendar month and is guaranteed for the month. The Declared
Rate is an annual effective interest rate that will be credited when daily
interest credits have compounded for a full year. It will never be less than 3%
per year.
The Interest Sub-Account has an Accumulated Value and a Surrender Value.
Accumulated Value
The Accumulated Value at any time is guaranteed to equal:
(a) the portion of the Initial Premium allocated to this Sub-Account; plus
(b) the portion of any Subsequent Premium(s) allocated to this Sub-Account;
plus
(c) any amounts transferred to this Sub-Account; less
(d) any partial surrender amounts from this Sub-Account; less
(e) any amounts transferred from this Sub-Account; plus
(f) interest on the net amount determined by the above items (a) through (e) at
the Declared Rate.
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Surrender Value
The Surrender Value at any time is equal to:
(a) 90% of the portion of the Initial Premium allocated to this Sub-Account;
plus
(b) 90% of the portion of any Subsequent Premium(s) allocated to this
Sub-Account; plus
(c) any Surrender Values transferred to this Sub-Account; plus
(d) any excess interest as defined below; less
(e) any partial surrender amounts taken from this Sub-Account; less
(f) any amounts transferred from this Sub-Account, plus
(g) interest on the net amount determined by the above items (a) through (f) at
the rate of 3% per year.We will credit interest daily. Three percent
represents the effective annual interest rate that will be credited when
daily Interest credits have compounded for a full Certificate year.
Excess interest is the excess, if any, of interest credited to the Accumulated
Value over interest credited to the Surrender Value since the last date of
excess interest credits. Excess interest is added on the first of each calendar
month plus on any date of a transfer or surrender from this Sub-Account.
After the Calculation of excess interest, on each Certificate Anniversary
within 10 years of the Income Date, if the Accumulated Value exceeds the
Surrender Value, then the Surrender Value will be increased by 1% of the
Accumulated Value, but not to an amount greater than the Accumulated Value.
The Death Benefit
The Death Benefit is the Accumulated Value as of the day before the claim is
paid if the surrender occurs within 90 days of death. Thereafter, the Death
Benefit is the Surrender Value as of the day before the claim is paid.
The Index Sub-Account
Through the Index Sub-Account, We offer participation in increases, or
decreases, in a specified Index. The participation is determined based on a
formula utilizing specified Guaranteed Interest Rate Factors (the Participation
Rate, Cap, and Floor) that are available for specified periods of time (Terms)
selected by a Certificate Owner. The rate at which the value of an Index
Sub-Account grows depends on changes in the Index on which it is based, as well
as its Cap, Floor, and Participation Rate. The Participation Rate, Cap, and
Floor may differ among Terms. However, the applicable Participation Rate, Cap,
and Floor do not change during a Term.
Allocations of Initial and Subsequent Premium and transfers of Sub-Account
values to the Index Sub-Accounts may have different applicable Participation
Rates, Caps, and Floors depending on the timing of such allocations or
transfers. We reserve the right to offer a different Participation Rate, Cap,
and Floor to allocations than to transfers.
Index Sub-Accounts have an Indexed Value and a Surrender Value.
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Indexed Value
The Indexed Value at any time is guaranteed to equal:
(a) the Initial Indexed Value; plus
(b) all Index Increases; less
(c) all Index Decreases; plus
(d) any End-Of-Term Adjustments; less
(e) any partial surrender amounts.
If the Sub-Account is started by a premium payment, the Initial Indexed Value is
equal to the premium allocated to the Sub-Account. If the Sub-Account is
started by a transfer, then the Initial Indexed Value is the amount transferred.
The Index Increase and/or Index Decrease is determined on the Sub-Account
Anniversary using the INDEX Value, the Participation Rate, Floor and Cap.
Index Increases and Index Decreases
We will calculate the Index Increase or Index Decreases on each Sub-Account
Anniversary. On the first Sub-Account Anniversary in a Term, the formula used
is:
A x ((C-D)/D) x (E/F) x G
This calculation provides the proportionate credit for any change in the INDEX
from its value at the beginning of the Term to its value on the first
Sub-Account Anniversary.
For every Sub-Account Anniversary after the first in a Term, the calculation of
any Index Increase, or Index Decrease, to be credited on the Sub-Account
Anniversary , is the sum total of two parts.
Part 1 represents the proportionate credit for any increase in the INDEX Value
from its prior highest Sub-Account Anniversary value to its value on the current
Sub-Account Anniversary. The formula for Part 1 is:
A x ((C-B)/D) x (E/F) x G
Part 2 represents the proportionate credit for any change in the INDEX Value
occurring on a prior Sub-Account Anniversary(ies). The formula for Part 2 is:
A x ((B-D)/D) x (1/F) x G
A is the Participation Rate for the Term
B is the highest INDEX Value on all Sub-Account Anniversaries but excluding
the INDEX Value on the date the Sub-Account is opened and the current
Sub-Account Anniversary. The value of B can never be less than the Minimum
INDEX Value nor greater than the Maximum INDEX Value. The
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Minimum INDEX and the Maximum INDEX Value are defined below.
C is the INDEX Value on the current Sub-Account Anniversary, not less than B
or greater than the Maximum INDEX Value for the Term.
D is the INDEX Value at the beginning of the Term
E is the number of completed Sub-Account Years in the Term
F is the total number of Sub-Account Years in the Term
G is the smaller of the Indexed Value at the beginning of the Term and the
Indexed Value (prior to the crediting of any Index Increases [or Index
Decreases]) on any Sub-Account Anniversary in the Term, including the
current Sub-Account Anniversary
The Minimum INDEX Value and the Maximum INDEX Value are defined as follows:
Minimum INDEX Value = [(Floor/Participation Rate for Term)+1] x Beginning of
Term INDEX Value
and
Maximum INDEX Value = [(Cap/Participation Rate for Term)+1] x Beginning of Term
INDEX Value
End-of-Term Adjustment in the Indexed Value
At the end of the Term (after the Index Increase or Index Decrease), if the
Surrender Value exceeds the Indexed Value, the Indexed Value will be increased
to equal the Surrender Value.
INDEX, Participation Rate, Floor and Cap, Term
The INDEX shown on the Certificate Specifications' page is used to calculate
Index Increases. If the INDEX is discontinued or its calculation is changed
substantially, We will substitute a suitable index and notify the Certificate
Owner. The INDEX Value for a particular day is the value calculated at the end
of that day. If there is no INDEX Value calculated that day, then the value
calculated for the first preceding day shall apply.
We will declare for each new Term of a Sub-Account the Participation Rate, the
Floor and the Cap on a basis which does not discriminate unfairly within any
class of Certificates.
Before the end of each Term of each Sub-Account, We will declare the length(s)
available for the next Term on a basis which does not discriminate unfairly
within a class of Certificates. The Certificate Owner may choose a Term by
Written Request but may not choose a Term that goes beyond the Income Date or in
the case of a "designated beneficiary", a Term that goes beyond the date allowed
by the Death Provision section. If the Certificate Owner does not choose, the
new Term ("Default Term") will be the same length as the prior Term although the
Participation Rate, Cap and Floor may be different as described above. If the
Default Term would go beyond the Income Date or the date allowed by the Death
Provision section, the Sub-Account values will be transferred to the Interest
Sub-Account.
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Surrender Value
The Surrender Value at any time is equal to:
(a) the Initial Surrender Value; plus
(b) any Sub-Account Anniversary Adjustments (see below): less
(c) any partial surrender amounts; plus
(d) interest on the net amount determined by above items (a) through (c) at
the rate of 3% per year.
We will credit interest daily. 3% represents the effective annual interest rate
that will be credited when daily interest credits have compounded for a full
year.
If the Sub-Account is started by a premium payment, the Initial Surrender Value
is equal to 90% of the premium allocated to this Sub-Account.
If the Sub-Account is started by an transfer, the Initial Surrender Value is the
Surrender Value transferred.
Sub-Account Anniversary Adjustment in Surrender Value
The Indexed Value and the Surrender Value are compared on each Sub-Account
Anniversary. If (a) the Indexed Value exceeds the Surrender Value and (b) the
total to date of all Index Increases or Index Decreases during the Term exceed
"all increases in the Surrender Value during the Term", then the Surrender
Value will be increased by the difference between the two amounts in (b). "All
increases in the Surrender Value during the Term" equal the total to date during
the Term of all prior Sub-Account Anniversary adjustments to the Surrender Value
and all interest credited to the Surrender Value (the interest for each
Sub-Account year equals: the Surrender Value at the end of the Sub-Account year
plus the amount of any partial surrender(s) during the Sub-Account year, less
the Surrender Value at the start of the Sub-Account year).
After the above adjustment, on each Sub-Account Anniversary within 10 years of
the Income Date, if the Indexed Value exceeds the Surrender Value, then the
Surrender Value will be increased by the lesser of (a) and (b), where:
(a) is 1% of the Indexed Value multiplied by the number of elapsed
Sub-Account Anniversaries within the 10 year period less any prior increases
made pursuant to this provision; and
(b) is the difference between the Indexed Value and the Surrender Value.
The Death Benefit
If the Floor is greater than 0%, the Death Benefit is the greater of the Indexed
Value as of the date of death less any subsequent partial surrenders, and the
Surrender Value on the date of the payment.
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If death occurs in the last Year of a Term and the surrender occurs after the
end of the Term, the Death Benefit is the greater of the Indexed Value at the
end of the Term, less any partial surrenders, and the Surrender Value on the
date of the payment.
In all other situations, the Death Benefit is the greater of (a) minus (b) and
the Surrender Value on the date of the payment, where:
(a) is the Indexed Value at the start of the Sub-Account year in which
death occurs, with the applicable Index Increase (described on page 13)
recalculated as follows: "E" is equal to "F" and "(B -D)" is multiplied by
the sum of 1.0 plus the number of Sub-Account years from the start of such
year to the end of the Term; and
(b) is the sum of any partial surrenders since the start of such year.
If death occurs in the last year of a Term and the surrender occurs after the
end of the Term, the Indexed Value at the end of such Term will be substituted
for (a).
Transfers
Transfers can be made at any time from the Interest Sub-Account to a new
Index Sub-Account. Transfers can also be made from an Index Sub-Account to
the Interest Sub-Account at certain times. We will make a transfer when We
receive a Written Request to do so from the Certificate Owner that meets the
restrictions set forth below.
Transfers from the Interest Sub-Account to an Index Sub-Account
The Certificate Owner may transfer all or part of the Interest Sub-Account to a
new Index Sub-Account at any time. The amount requested from the Accumulated
Value will be transferred to a new Index Sub-Account and will be the Initial
Indexed Value of the new Sub-Account . The Initial Surrender Value of the new
Index Sub-Account will be equal to the ratio of the Accumulated Value
transferred to the total Accumulated Value of the Interest Sub-Account prior to
the transfer times the Surrender Value of the Interest Sub-Account prior to the
transfer.
The remaining Accumulated Value and Surrender Value of the Interest Sub-Account
will be the values prior to the transfer less the amount transferred.
The minimum amount of any transfer from the Interest Sub-Account to a new Index
Sub-Account must be $1,000.
Transfers from an Index Sub-Account to the Interest Sub-Account
The Certificate Owner may transfer the entire Indexed Value of an Index
Sub-Account to the Interest Sub-Account at the end of the Term of an Index
Sub-Account. The Indexed Value of the Index Sub-Account will be transferred to
the Accumulated Value of the Interest Sub-Account. The Surrender Value of the
Index Sub-Account will be transferred to the Surrender Value of the Interest
Sub-Account.
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Withdrawals and Surrender
A Certificate Owner may make a surrender or withdrawal (partial
surrender) of either the Indexed Value or Surrender Value from the Index
Sub-Account(s) and either the Accumulation Value or Surrender Value from the
Interest Sub-Account. The timing of the surrender or withdrawal determines
which values are available.
The Indexed Value is available only during three time periods. First, as a
surrender payable if a Sub-Account is surrendered within 45 days after the end
of its term. Second, as a Death Benefit that is payable if the Certificate is
surrendered within 90 days after the date of certain deaths or at the required
distribution date. Third, as an amount applied on the Income Date to determine
the amount of annuity payments. At all other times, the Surrender Value is
available while the Certificate is In Force.
The Accumulated Value is available only during three time periods. First, as a
surrender payable if all or part of the Interest Sub-Account is surrendered
within the first 5 days of any calendar month. Second, as a Death Benefit that
is payable if the Certificate is surrendered within 90 days after the date of
certain deaths. Third, as a value applied on the Income Date to determine the
amount of annuity payments. At all other times, the Surrender Value is
available while the Certificate is In Force.
Death Provisions
Death of Primary Certificate Owner, Joint Certificate Owner, or Certain
Non-Certificate Owner Annuitant
This section applies if, before the Income Date while the Certificate is In
Force, the Primary Certificate Owner or any Joint Certificate Owner dies
(whether or not the decedent is also the Annuitant) or the Annuitant dies under
a Certificate with a non-natural owner such as a trust. The "designated
beneficiary" will control the Certificate after such a death. This "designated
beneficiary" will be the first person among the following who is alive on the
date of death: Primary Certificate Owner; Joint Certificate Owner; primary
beneficiary; contingent beneficiary; and if no one is alive, the Primary
Certificate Owner s estate.
If the decedent s surviving spouse (if any) is the sole "designated
beneficiary", the surviving spouse will automatically become the new Primary
Certificate Owner as of the date of death. If the Annuitant is the decedent,
the new Annuitant will be any living contingent annuitant, otherwise the
surviving spouse. The surviving spouse can continue the Certificate until the
Income Date. If the surviving spouse surrenders the Certificate , see the
"Death Benefit" section below for the conditions under which the Death Benefit
value will be paid rather than the Surrender Value. If the surviving spouse
continues the Certificate and another death occurs before the Income Date, the
Certificate can continue for up to five years from the date of this second
death. All of this "Death Provisions" section, except for this paragraph, will
apply to that second death. The exception in the prior sentence means that the
first four sentences of this paragraph can apply only once; they cannot apply a
second time if the surviving spouse continues the Certificate , remarries, and
then dies.
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In all other cases, the Certificate can continue for up to five years from the
date of death. During this period, the "designated beneficiary" may exercise
all ownership rights, including the right to make partial surrenders or the
right to totally surrender the Certificate for its Surrender Value. If the
"designated beneficiary" surrenders the Certificate , see the "Death Benefit"
section below for the conditions under which the Death Benefit value will be
paid rather than the Surrender Value. If this Certificate is continued until
the end of the five-year period, We will automatically end it then by paying the
Indexed Value for any Index Sub-Account and the Accumulated Value for the
Interest Sub-Account to the "designated beneficiary". If the "designated
beneficiary" is not alive then, We will pay any person(s) named by the
"designated beneficiary" in a Written Request; otherwise the "designated
beneficiary's" estate.
Death Benefit
This section applies only if the "covered person" dies and the Certificate is
surrendered within 90 days of the date of death. The Primary Certificate Owner
shall be the "covered person" or, if there is a non-natural owner such as a
trust, the Annuitant shall be the "covered person". If the "covered person"
dies, the "designated beneficiary" may surrender this Certificate within 90
days of the date of death for the Death Benefit. For a surrender after 90 days
and for a surrender at any time after the death of a non-covered person, the
Surrender Value is payable. The total Death Benefit is the sum of the Death
Benefit of each Sub-Account in the Certificate.
Payment of Benefits
The prior two sections allow the "designated beneficiary" to surrender the
Certificate. If the Certificate Owner wants that person to receive annuity
payments rather than a lump sum, the Certificate Owner may choose by Written
Request an annuity payment option that meets the following three conditions.
First, the first payment to a non-spouse "designated beneficiary" must be made
no later than one year after the date of death. Second, payments must be made
over the life of the non-spouse "designated beneficiary" or over a period not
exceeding that person s life expectancy. Third, any payment option that
provides for payments to continue after the death of the "designated
beneficiary" will not allow the successor payee to extend the period of time
over which the remaining payments are to be made. If the Certificate Owner does
not direct Us to make annuity payments, the "designated beneficiary" can choose
between a lump sum and an annuity payment option meeting the above three
conditions.
Death of Certain Non-Certificate Owner Annuitant
This section applies if, before the Income Date while the Certificate is In
Force, (a) the Annuitant dies, (b) the Annuitant is not a Certificate Owner, and
(c) the Certificate Owner is a natural person. The Certificate will continue
in force after the Annuitant s death. The new annuitant will be any living
contingent annuitant, otherwise the Primary Certificate Owner.
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Annuity Provisions
Annuity Benefits
If this Certificate is In Force and the Annuitant is alive on the Income Date,
payments to the Annuitant will begin under the payment option chosen. The
Certificate Owner may choose or change a payment option by making a Written
Request at least 30 days before the Income Date. Unless the Certificate Owner
chooses otherwise, Option 3 with 10 years guaranteed will become automatically
effective. The amount of the payments will be determined by applying the total
Income Value (defined as the sum of the Indexed Value for the Index
Sub-Accounts and the Accumulated Value for the Interest Sub-Account, less any
applicable premium taxes or other taxes) on the Income Date in accordance with
the "Payment Options" section.
Income Date
The Income Date for the Annuitant is the date shown on the Certificate
Specifications' page. If the Annuitant's death results in someone becoming the
new Annuitant, the Income Date will be based on the new Annuitant's date of
birth only if the new Annuitant is younger than the decedent.
Payment Options
The Certificate Owner may choose any of the four payment options described
below. The Certificate Owner may also arrange other payment options with Us.
The payee is the person who will receive the sum payable under a payment
option. If the amount available to apply under any option is less than $5,000
($2,000 if the issue state shown on page 2 is Massachusetts), We reserve the
right to pay such amount in one sum to the payee in lieu of the payment
otherwise provided for.
Payments will be made monthly unless quarterly, semi-annual, or annual payments
are chosen by Written Request. However, if any payment provided for would be or
becomes less than $100, We have the right to reduce the frequency of payments to
an interval that will result in each payment being at least $100.
The payment amount under each option will be equal to the greater of the amount
shown in the applicable table or the amount currently offered by Us at the time
of the first payment. Under Options 2, 3 and 4 and any other life income
option, the payment amount will be based on the age of the payee(s). The
current amount may also be based on the sex of the payee(s) (except if this is
prohibited by law or if the issue state shown on page 2 is Massachusetts or
Montana).
A payee may not surrender or otherwise end a payment option after it begins.
Payments will end upon the payees death unless the option provides for payments
continuing to a successor payee.
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Option 1: Income For a Fixed Number of Years
We will pay an annuity for a chosen number of years, not fewer than 5 nor more
than 30. If the payee dies before the last payment is made, We will continue to
make the remaining payments to the successor payee. Upon Written Request of the
successor payee, We will make a lump sum payment of the present value of the
remaining payments, commuted at a rate of 3% per year or at such greater rate as
was used to compute the payments.
Option 2: Life Income
We will pay an annuity for as long as the payee lives.
Option 3: Life Income with 5 or 10 Years Guaranteed
We will pay an annuity for as long as the payee lives. Payments are guaranteed
for at least the number of years chosen even if the payee dies before then. If
the payee dies before the last payment is made, We will continue to make the
remaining guaranteed payments to the successor payee. Upon Written Request of
the successor payee, We will make a lump sum payment of the present value of the
remaining guaranteed payments, commuted at a rate of 3% per year or at such
greater rate as was used to compute the payments.
Option 4: Joint and Last Survivor Income
We will pay an annuity for as long as the payee lives. Upon the payee s death,
We will continue payments to the successor payee for as long as the successor
payee lives.
Misstatement of Age or Sex
If We learn on or after the Income Date that the age or sex of the Annuitant or
any other payee is incorrect, We will compute the amount payable based on the
correct age and sex (however, if the issue state shown on page 2 is
Massachusetts or Montana, We will only correct an age). If income payments have
begun, any underpayment that may have been made will be paid in full with the
next annuity payment. Any overpayments, unless repaid to Us in one sum, will be
deducted from future annuity payments otherwise due until We are repaid in full.
Basis of Calculation
The minimum annuity payments are based on the 1983 Individual Annuity Valuation
Tables, weighted 40% male and 60% female, with interest at 3% per year. We will
similarly calculate the amount for a payment frequency other than monthly and
the amount for any age not shown in a table. Upon request, We will tell the
Certificate Owner any such amount.
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Payment Option Tables
OPTION 1: MINIMUM MONTHLY PAYMENT PAYABLE FOR EACH $1,000 APPLIED VALUE
Years Payment Years Payment Years Payment
----- ------- ----- ------- ----- -------
5 $17.91 14 $7.26 23 $4.99
6 15.14 15 6.87 24 4.84
7 13.16 16 6.53 25 4.71
8 11.68 17 6.23 26 4.59
9 10.53 18 5.96 27 4.47
10 9.61 19 5.73 28 4.37
11 8.86 20 5.51 29 4.27
12 8.24 21 5.32 30 4.18
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OPTIONS 2 AND 3: MINIMUM MONTHLY PAYMENT PAYABLE FOR EACH $1,000 APPLIED VALUE
Option 3- Option 3- Option 3- Option 3-
Age Option 2 5 Years 10 Years Age Option 2 5 Years 10 Years
--- -------- -------- -------- --- -------- --------- ---------
30 $3.19 $3.19 $3.19 63 $5.34 $5.31 $5.20
31 3.22 3.22 3.21 64 5.49 5.45 5.33
32 3.24 3.24 3.24 65 5.65 5.61 5.47
33 3.27 3.27 3.27 66 5.82 5.77 5.61
34 3.30 3.30 3.30 67 6.01 5.94 5.75
35 3.34 3.33 3.33 68 6.20 6.13 5.91
36 3.37 3.37 3.36 69 6.41 6.33 6.07
37 3.40 3.40 3.40 70 6.64 6.54 6.23
38 3.44 3.44 3.44 71 6.88 6.76 6.41
39 3.48 3.48 3.47 72 7.14 7.00 6.59
40 3.52 3.52 3.51 73 7.43 7.26 6.77
41 3.56 3.56 3.55 74 7.73 7.53 6.96
42 3.61 3.61 3.60 75 8.06 7.82 7.14
43 3.65 3.65 3.64 76 8.42 8.12 7.34
44 3.70 3.70 3.69 77 8.80 8.45 7.53
45 3.76 3.75 3.74 78 9.21 8.79 7.71
46 3.81 3.81 3.79 79 9.66 9.14 7.90
47 3.87 3.86 3.85 80 10.14 9.52 8.06
48 3.93 3.92 3.90 81 10.65 9.91 8.25
49 3.99 3.98 3.96 82 11.21 10.31 8.41
50 4.05 4.05 4.03 83 11.81 10.72 8.57
51 4.12 4.11 4.09 84 12.46 11.15 8.71
52 4.19 4.19 4.16 85 13.14 11.58 8.84
53 4.27 4.26 4.23 86 13.88 12.01 8.96
54 4.35 4.34 4.31 87 14.67 12.44 9.06
55 4.44 4.42 4.39 88 15.50 12.86 9.15
56 4.53 4.51 4.47 89 16.39 13.28 9.23
57 4.62 4.61 4.56 90 17.32 13.68 9.31
58 4.72 4.71 4.65 91 18.31 14.07 9.37
59 4.83 4.81 4.75 92 19.35 14.45 9.42
60 4.95 4.93 4.86 93 20.45 14.81 9.47
61 5.07 5.05 4.97 94 21.61 15.15 9.50
62 5.20 5.17 5.08 95 22.84 15.48 9.53
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OPTION 4: MINIMUM MONTHLY PAYMENT PAYABLE FOR EACH $1,000 APPLIED VALUE
Combination of Ages
30 35 40 45 50 55 60 65 70 75 80 85 90 95
30 $2.99 $3.04 $3.07 $3.10 $3.13 $3.15 $3.16 $3.17 $3.18 $3.18 $3.18 $3.19 $3.19 $3.19
40 3.10 3.15 3.20 3.24 3.27 3.29 3.30 3.32 3.32 3.33 3.33 3.33 3.33
45 3.23 3.30 3.35 3.40 3.44 3.47 3.49 3.50 3.51 3.51 3.52 3.52
50 3.39 3.48 3.55 3.61 3.66 3.69 3.72 3.73 3.74 3.75 3.75
55 3.60 3.71 3.81 3.89 3.94 3.99 4.01 4.03 4.04 4.05
60 3.87 4.02 4.14 4.24 4.32 4.36 4.40 4.41 4.42
65 4.23 4.43 4.59 4.72 4.81 4.87 4.91 4.92
70 4.71 4.98 5.21 5.38 5.59 5.56 5.60
75 5.39 5.77 6.08 6.30 6.45 6.53
80 6.35 6.89 7.32 7.62 7.81
85 7.73 8.50 9.10 9.51
90 9.72 10.80 11.63
95 12.49 13.95
16.20
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Endorsements
To be inserted only by Us
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Keyport
Life Insurance Company
Providence, Rhode Island
GROUP DEFERRED ANNUITY CONTRACT
FLEXIBLE PREMIUM PAYMENT
NON-PARTICIPATING
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