EXHIBIT 4(a): FORM OF VARIABLE ANNUITY GROUP MASTER CONTRACT GA-MA-1080
[LOGO] GOLDEN GROUP FLEXIBLE PREMIUM
AMERICAN DEFERRED COMBINATION
LIFE INSURANCE VARIABLE AND FIXED
COMPANY ANNUITY MASTER CONTRACT
GOLDEN AMERICAN IS A STOCK COMPANY DOMICILED IN DELAWARE.
Golden American Life Insurance Company, herein called GALIC, agrees to pay the
benefits stated in this Contract.
SPECIFICATIONS
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Plan
[SPECIMEN]
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Type of Plan
[SPECIMEN]
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Contract Holder
[SPECIMEN]
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Contract No.
[SPECIMEN]
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Contract Effective Date
[SPECIMEN]
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This Contract is delivered in Delaware and is subject to the laws of that
jurisdiction.
THE VARIABLE FEATURES OF THE GROUP CONTRACT ARE DESCRIBED IN PARTS III, IV
AND V.
RIGHT TO CANCEL
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The Contract Holder may cancel this Contract within 10 days by returning it to
the agent from whom it was purchased, or to GALIC at the address shown below.
Within seven days of receiving the Contract at its Customer Service Center,
GALIC will return the amount of Certificate Holder Purchase Payment(s) received,
plus any increase, or minus any decrease, on the amount, if any, allocated to
the Separate Account Subaccount(s).
This page and the pages that follow constitute the entire Contract.
Signed at the Customer Service Center on the Contract Effective Date.
Customer Service Center Secretary: /s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇
▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇
▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ President: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇
Group Variable, Fixed, or Combination Annuity Contract
Nonparticipating
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. AMOUNTS ALLOCATED TO THE FIXED ACCOUNT, IF WITHDRAWN BEFORE
THE GUARANTEED TERM MATURITY DATE, MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT.
THE MARKET VALUE ADJUSTMENT MAY RESULT IN AN INCREASE OR A DECREASE IN THE
ACCOUNT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A
GUARANTEED TERM AT THE TIME OF ITS MATURITY.
GA-MA-1080
SPECIFICATIONS
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GUARANTEED There is a minimum guaranteed rate for Purchase Payment(s)
RATE held in the Fixed Account. (SEE SCHEDULE - ACCUMULATION
PERIOD.)
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DEDUCTIONS FROM There will be deductions for mortality and expense risk
THE SEPARATE as well as administrative charges. (SEE SCHEDULE -
ACCOUNT ACCUMULATION PERIOD AND SCHEDULE - ANNUITY PERIOD.)
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DEDUCTION FROM Purchase Payment(s) may be subject to a deduction for
PURCHASE premium taxes. (SEE SECTION III - PURCHASE PAYMENT.)
PAYMENT(S)
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DEFERRED SALES There may be a charge deducted upon withdrawal. (SEE
CHARGE SCHEDULE - ACCUMULATION PERIOD.)
This Contract is a legal contract and constitutes the entire legal relationship
between GALIC and the Contract Holder.
READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the
rights and obligations of both you and GALIC. THEREFORE, IT IS IMPORTANT THAT
YOU READ THIS CONTRACT CAREFULLY.
GA-MA-1080 Page 2
SCHEDULE - ACCUMULATION PERIOD
OPTION PACKAGE
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OPTION PACKAGE SELECTED - A different SCHEDULE - ACCUMULATION PERIOD will apply
to each Account depending upon the Option Package selected. (SEE SECTION IV -
OPTION PACKAGES.)
Option Package III was selected.
SCHEDULE EFFECTIVE DATE
[June 1, 1998]
SEPARATE ACCOUNT
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SEPARATE ACCOUNT
Separate Account B
CHARGES TO SEPARATE ACCOUNT
A daily charge is deducted from any portion of the Account Value
allocated to the Separate Account. The deduction is the daily
equivalent of the annual effective percentage shown in the following
chart:
Administrative Charge [0.15%]
Mortality and Expense Risk Charge [1.25%]
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Total Separate Account Charges [1.40%]
FIXED ACCOUNT
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MINIMUM GUARANTEED RATE
3.0% (effective annual rate of return)
SEPARATE ACCOUNT AND FIXED ACCOUNT
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TRANSFERS
An unlimited number of Transfers are allowed during the Accumulation
Period. GALIC allows 12 free Transfers in any Account Year.
Thereafter, GALIC reserves the right to charge [$10] for each
subsequent Transfer.
MAINTENANCE FEE
The annual Maintenance Fee is [$30.] If the Account Value is $50,000
or more on the date the Maintenance Fee is to be deducted, the
Maintenance Fee is $0.
GA-MA-1080 Page 3
SCHEDULE - ACCUMULATION PERIOD (CONTINUED)
SEPARATE ACCOUNT AND FIXED ACCOUNT
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DEFERRED SALES CHARGE
For each withdrawal, the Deferred Sales Charge will be determined as
follows:
DEFERRED SALES CHARGE
LENGTH OF TIME FROM RECEIPT OF (AS PERCENTAGE OF
PURCHASE PAYMENT (YEARS) PURCHASE PAYMENT)
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[Less than 2 years 7%
More than 2 but less than 4 years 6%
More than 4 but less than 5 years 5%
More than 5 but less than 6 years 4%
More than 6 but less than 7 years 3%
7 years or more 0%]
SEE SECTION I - DEFINITIONS for explanations.
GA-MA-1080 Page 4
SCHEDULE - ANNUITY PERIOD
SEPARATE ACCOUNT - VARIABLE ANNUITY PAYMENT
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CHARGES TO SEPARATE ACCOUNT
A daily charge is deducted at an annual effective rate of [1.25%] for
mortality and expense risks. The administrative charge is established
upon election of an Annuity Payout Option. This charge will not exceed
[0.25%].
ASSUMED INTEREST RATE (AIR)
If a variable Annuity Payment is chosen, an AIR of 5.0% may be
elected. If 5.0% is not elected, GALIC will use an AIR of 3.5%.
The AIR factor for 3.5% per year is 0.9999058.
The AIR factor for 5.0% per year is 0.9998663.
If the portion of a variable Annuity Payment for any Subaccount is not
to decrease, the annuity return factor under the Separate Account for
that Subaccount must be:
(a) 4.75% on an annual basis plus an annual return of up to 0.25% to
offset the administrative charge set at the time Annuity Payments
commence if an AIR of 3.5% is chosen; or
(b) 6.25% on an annual basis plus an annual return of up to 0.25% to
offset the administrative charge set at the time Annuity Payments
commence, if an AIR of 5% is chosen.
TRANSFERS
When a variable Annuity Payment has been elected, four free Transfers
are allowed each Account Year among the Subaccounts available during
the Annuity Period. Thereafter, GALIC reserves the right to charge
[$10] for each subsequent Transfer.
GENERAL ACCOUNT - FIXED ANNUITY PAYMENT
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MINIMUM GUARANTEED INTEREST RATE
3.0% (effective annual rate of return)
SEE SECTION I - DEFINITIONS for explanations.
GA-MA-1080 Page 5
TABLE OF CONTENTS
I. DEFINITIONS PAGE
1.01 Account..................................................... 8
1.02 Account Effective Date...................................... 8
1.03 Account Value............................................... 8
1.04 Account Year................................................ 8
1.05 Accumulation Period......................................... 8
1.06 Adjusted Account Value...................................... 8
1.07 Annuitant................................................... 8
1.08 Annuity Payment............................................. 8
1.09 Annuity Payout Options...................................... 8
1.10 Annuity Period.............................................. 8
1.11 Beneficiary................................................. 9
1.12 Certificate Holder.......................................... 9
1.13 Claim Date.................................................. 9
1.14 Code........................................................ 9
1.15 Contract.................................................... 9
1.16 Contract Holder............................................. 9
1.17 Deferred Sales Charge....................................... 9
1.18 Deposit Period.............................................. 9
1.19 Dollar Cost Averaging....................................... 9
1.20 Fund(s)..................................................... 10
1.21 General Account............................................. 10
1.22 Fixed Account............................................... 10
1.23 Guaranteed Rates - Fixed Account............................ 10
1.24 Guaranteed Term............................................. 10
1.25 Guaranteed Term(s) Groups................................... 10
1.26 Maintenance Fee............................................. 10
1.27 Market Value Adjustment (MVA)............................... 11
1.28 Matured Term Value.......................................... 11
1.29 Maturity Value Transfer..................................... 11
1.30 Maturity Date............................................... 11
1.31 Option Package.............................................. 11
1.32 Purchase Payment(s)......................................... 11
1.33 Reinvestment................................................ 11
1.34 Schedule Effective Date..................................... 11
1.35 Separate Account............................................ 11
1.36 Subaccount(s)............................................... 12
1.37 Systematic Distribution Option.............................. 12
1.38 Transfers................................................... 12
1.39 Withdrawal Value............................................ 12
1.40 Valuation Date.............................................. 12
II. GENERAL PROVISIONS
2.01 Change of Contract.......................................... 12
2.02 Change of Fund(s)........................................... 13
2.03 Nonparticipating Contract................................... 13
2.04 Payments and Elections...................................... 13
2.05 State Laws.................................................. 13
2.06 Control of Contract......................................... 13
2.07 Designation of Beneficiary.................................. 14
2.08 Misstatements and Adjustments............................... 14
2.09 Incontestability............................................ 14
2.10 Grace Period................................................ 14
2.11 Individual Certificates..................................... 14
GA-MA-1080 Page 6
III. PURCHASE PAYMENT, ACCOUNT VALUE, AND WITHDRAWAL PROVISIONS
3.01 Purchase Payment............................................ 14
3.02 Certificate Holder's Account................................ 14
3.03 Accumulation Units - Separate Account....................... 15
3.04 Net Investment Factor(s) - Separate Account................. 15
3.05 Accumulation Unit Value - Separate Account.................. 15
3.06 Market Value Adjustment (MVA)............................... 15
3.07 Transfer of Account Value from the Subaccount(s) or
Fixed Account During the Accumulation Period ............... 16
3.08 Notice to the Certificate Holder............................ 17
3.09 Loans....................................................... 17
3.10 Systematic Distribution Options............................. 17
3.11 Death Benefit Amount........................................ 17
3.12 Death Benefit Options Available to Beneficiary.............. 18
3.13 Liquidation of Withdrawal Value............................. 19
3.14 Deferred Sales Charge....................................... 19
3.15 Payment of Withdrawal Value................................. 19
3.16 Payment of Adjusted Account Value........................... 19
3.17 Reinstatement............................................... 19
IV. OPTION PACKAGES
4.01 Election of Option Packages................................. 20
4.02 Description of Option Package I............................. 20
4.03 Description of Option Package II............................ 21
4.04 Description of Option Package III........................... 23
V. ANNUITY PAYOUT PROVISIONS
5.01 Annuity Payout Options...................................... 25
5.02 Annuity Payment Choices..................................... 26
5.03 Terms of Annuity Payout Options............................. 27
5.04 Death of Annuitant/Beneficiary.............................. 27
5.05 Annuity Units - Separate Account............................ 28
5.06 Annuity Unit Value - Separate Account....................... 28
5.07 Annuity Net Return Factor(s) - Separate Account............. 28
GA-MA-1080 Page 7
I. DEFINITIONS
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1.01 ACCOUNT:
A record that identifies contract values accumulated on each
Certificate Holder's behalf.
1.02 ACCOUNT EFFECTIVE DATE:
The date on which an Account is established on a Certificate Holder's
behalf.
1.03 ACCOUNT VALUE:
As of the most recent Valuation Date, the Account Value is equal to
the total of the Purchase Payment(s) made to the Account;
(a) Plus or minus the investment experience for the amount, if any,
allocated to one or more of the Subaccounts
(b) Plus interest added to the amount, if any, allocated to the
Fixed Account;
(c) Plus any additional amount deposited to the Account (SEE
SECTION IV - OPTION PACKAGES);
(d) Less the amount of any Maintenance Fee deducted;
(e) Less any additional fee(s), charges, or taxes, if applicable,
deducted;
(f) Less any amount(s) withdrawn; and
(g) Less any amount(s) applied to an Annuity Payout Option.
1.04 ACCOUNT YEAR:
A period of twelve months measured from the Account Effective Date or
an anniversary of such Account Effective Date.
1.05 ACCUMULATION PERIOD:
The period during which the Purchase Payment(s) are applied to an
Account to provide future Annuity Payment(s).
1.06 ADJUSTED ACCOUNT VALUE:
The Account Value plus or minus the aggregate Market Value Adjustment
(MVA), if applicable, for the amount(s) allocated to the Fixed Account
(SEE SECTION III - MARKET VALUE ADJUSTMENT).
1.07 ANNUITANT:
The person on whose death, during the Accumulation Period, a death
benefit becomes payable and on whose life or life expectancy the
Annuity Payments are based under the Contract.
1.08 ANNUITY PAYMENT:
A series of payments for life, a definite period or a combination of
the two. The Annuity Payments may be variable or fixed in amount or a
combination of both.
1.09 ANNUITY PAYOUT OPTIONS:
The Certificate Holder may choose to receive Annuity Payments under
one of the following options:
(a) For the life of one or two persons;
(b) For a stated period; or
(c) For some combination of (a) and (b).
1.10 ANNUITY PERIOD:
The period during which Annuity Payments are made.
GA-MA-1080 Page 8
1.11 BENEFICIARY:
The individual(s) or entity entitled to receive any death benefit due
under the Contract. Any designated Beneficiary has the right to name
another Beneficiary. If the Account is owned by joint Certificate
Holders, the survivor will be deemed the designated Beneficiary and
any other Beneficiary on record will then be treated as the primary or
contingent Beneficiary, as originally designated, unless and until
changed by the new designated Beneficiary.
1.12 CERTIFICATE HOLDER:
A person who purchases an interest in this Contract as evidenced by a
certificate. GALIC reserves the right to limit ownership to natural
persons. If more than one Certificate Holder owns an Account, each
Certificate Holder will be a joint Certificate Holder. Joint
Certificate Holders have joint ownership rights and both must
authorize exercising any ownership rights unless GALIC allows
otherwise.
1.13 CLAIM DATE:
The date when proof of death and the Beneficiary's entitlement to the
death benefit are received in good order at GALIC's Customer Service
Center. This is also the date that the excess of the death benefit
over the Account Value, if any, is allocated to the money market fund
available through the Separate Account.
1.14 CODE:
The Internal Revenue Code of 1986, as it may be amended from time to
time.
1.15 CONTRACT:
This agreement between GALIC and the Contract Holder.
1.16 CONTRACT HOLDER:
The entity to which the Contract is issued.
1.17 DEFERRED SALES CHARGE:
The charge that is applied to a Purchase Payment(s) upon withdrawal.
This charge may be waived under certain circumstances or after a
certain length of time (SEE SECTION III - DEFERRED SALES CHARGE).
1.18 DEPOSIT PERIOD:
A day, a calendar week, a calendar month, a calendar quarter, or any
other period of time specified by GALIC during which a Purchase
Payment(s), Transfer(s) and/or Reinvestment(s) may be allocated to one
or more Fixed Account Guaranteed Terms. GALIC reserves the right to
shorten or to extend the Deposit Period.
During a Deposit Period, GALIC may offer any number of Guaranteed
Terms and more than one Guaranteed Term of the same duration may be
offered.
1.19 DOLLAR COST AVERAGING:
A program that permits the Certificate Holder to systematically
transfer amounts from one of the available Subaccounts, or an
available Fixed Account Guaranteed Term, to one or more of the
Subaccounts. If the Certificate Holder elects a Fixed Account
Guaranteed Term available for Dollar Cost Averaging, no MVA applies to
amounts transferred under Dollar Cost Averaging. If Dollar Cost
Averaging from a Fixed Account Guaranteed Term is discontinued before
the end of the Dollar Cost Averaging period elected, GALIC will
automatically transfer the balance to a Guaranteed Term of the same
duration and an MVA will apply. The Certificate Holder may initiate a
Transfer to another investment option and an MVA will apply. If a
Guaranteed Term of the same duration is not available, GALIC will
transfer the amount to the Guaranteed Term with the next shortest
duration. If no shorter Guaranteed Term is available, the next longer
Guaranteed Term will be used. GALIC reserves the right to establish
and change terms and conditions governing Dollar Cost Averaging.
GA-MA-1080 Page 9
1.20 FUND(S):
The open-end registered management investment companies whose shares
are purchased by the Separate Account to fund the benefits provided by
the Contract.
The Funds, and the number of Funds, available during the Accumulation
Period may be different from those available during the Annuity
Period. GALIC reserves the right to limit the number of Funds
available at any one time and to limit the number of investment
options the Certificate Holder may select during the Accumulation
Period and/or during the Annuity Period.
1.21 GENERAL ACCOUNT:
The account holding the assets of GALIC, other than those assets held
in GALIC's separate accounts.
1.22 FIXED ACCOUNT:
A nonunitized separate account, established by GALIC under Delaware
Statutes, that holds assets for Guaranteed Terms. There are no
discrete units for this account. The Certificate Holder does not
participate in any gain or loss resulting from the performance of the
investments held in the account. Income, gains or losses realized or
unrealized, are gains or losses of GALIC.
1.23 GUARANTEED RATES - FIXED ACCOUNT:
GALIC will declare the interest rate(s) applicable to a specific
Guaranteed Term at the start of the Deposit Period for that Guaranteed
Term. The rate(s) are guaranteed by GALIC for the period beginning
with the first day of the Deposit Period and ending on the Maturity
Date. Guaranteed Rates are credited beginning with the date of
allocation. The Guaranteed Rates are annual effective yields. That is,
interest is credited daily at a rate that will produce the Guaranteed
Rate over the period of a year. No Guaranteed Rate will ever be less
than the minimum Guaranteed Rate shown on the SCHEDULE - ACCUMULATION
PERIOD.
For Guaranteed Terms of one year or less, one Guaranteed Rate is
credited for the full Guaranteed Term. For longer Guaranteed Terms, an
initial Guaranteed Rate is credited from the date of deposit to the
end of a specified period within the Guaranteed Term. There may be
different Guaranteed Rate(s) declared for subsequent specified time
intervals throughout the Guaranteed Term.
GALIC may offer more than one Guaranteed Term of the same duration and
credit one with a higher rate contingent upon use only with Dollar
Cost Averaging.
1.24 GUARANTEED TERM:
The period of time specified by GALIC for which a specific Guaranteed
Rate(s) is offered on amounts invested during a specific Deposit
Period. Guaranteed Terms are made available subject to GALIC's terms
and conditions, including, but not limited to, GALIC's right to
restrict allocations to new Purchase Payments (such as by prohibiting
Transfers into a particular Guaranteed Term from any other Guaranteed
Term or from any of the Subaccounts, or by prohibiting Reinvestment of
a Matured Term Value to a particular Guaranteed Term). More than one
Guaranteed Term of the same duration may be offered within the
Contract.
1.25 GUARANTEED TERM(S) GROUPS:
All Fixed Account Guaranteed Term(s) of the same duration (from the
close of the Deposit Period until the designated Maturity Date).
1.26 MAINTENANCE FEE:
The Maintenance Fee (SEE SCHEDULE - ACCUMULATION PERIOD) will be
deducted during the Accumulation Period from the Account Value on each
anniversary of the Account Effective Date and upon withdrawal of the
entire Account.
GA-MA-1080 Page 10
1.27 MARKET VALUE ADJUSTMENT (MVA):
An adjustment that may apply to an amount withdrawn or transferred
from a Fixed Account Guaranteed Term prior to the end of that
Guaranteed Term. The adjustment reflects the change in the value of
the investment due to changes in interest rates since the date of
deposit and is computed using the formula given. The adjustment is
expressed as a percentage of each dollar being withdrawn (SEE SECTION
III- MARKET VALUE ADJUSTMENT).
1.28 MATURED TERM VALUE:
The amount due on a Fixed Account Guaranteed Term's Maturity Date.
1.29 MATURITY VALUE TRANSFER:
During the calendar month following a Fixed Account Maturity Date, the
Certificate Holder may notify GALIC's Customer Service Center in
writing to Transfer or withdraw all or part of the Matured Term Value,
plus accrued interest at the new Guaranteed Rate, from the Fixed
Account without an MVA. This provision only applies to the first such
written request received from the Certificate Holder during this
period for any Matured Term Value.
1.30 MATURITY DATE:
The last day of a Fixed Account Guaranteed Term.
1.31 OPTION PACKAGE:
The version of the Contract selected which defines, among other
things, the amount of the mortality and expense risk charge, the
calculation of the death benefit, and the availability of certain
withdrawals without imposition of a Deferred Sales Charge.
1.32 PURCHASE PAYMENT(S):
The Purchase Payment(s) less premium taxes, if applicable, accepted by
GALIC at its Customer Service Center. GALIC reserves the right to
refuse to accept any Purchase Payment at any time for any reason. No
advance notice will be given to the Contract Holder or Certificate
Holder.
1.33 REINVESTMENT:
GALIC will mail a notice to the Certificate Holder at least 18
calendar days before a Guaranteed Term's Maturity Date. This notice
will contain the Terms available during current Deposit Periods with
their Guaranteed Rate(s), and projected Matured Term Value. If no
specific direction is given by the Certificate Holder prior to the
Maturity Date, each Matured Term Value will be reinvested in the
current Deposit Period for a Guaranteed Term of the same duration. If
a Guaranteed Term of the same duration is unavailable, each Matured
Term Value will automatically be reinvested in the current Deposit
Period for the next shortest Guaranteed Term available. If no shorter
Guaranteed Term is available, the next longer Guaranteed Term will be
used. GALIC will mail a confirmation statement to the Certificate
Holder the next business day after the Maturity Date. This notice will
state the Guaranteed Term and Guaranteed Rate(s) which will apply to
the reinvested Matured Term Value.
1.34 SCHEDULE EFFECTIVE DATE:
The date that an Option Package becomes effective. This date is
indicated on the SCHEDULE - ACCUMULATION PERIOD. At initial purchase,
this date is the same as the Account Effective Date.
1.35 SEPARATE ACCOUNT:
A separate account that buys and holds shares of the Fund(s). Income,
gains or losses, realized or unrealized, are credited or charged to
the Separate Account without regard to other income, gains or losses
of GALIC. GALIC owns the assets held in the Separate Account and is
not a trustee as to such amounts. The Separate Account generally is
not guaranteed and is held at market value. The assets of the Separate
Account, to the extent of reserves and other contract liabilities of
the Separate Account, shall not be charged with other GALIC
liabilities.
GA-MA-1080 Page 11
1.36 SUBACCOUNT(S):
The portion of the assets of the Separate Account that is allocated to
a particular Fund. Each Subaccount invests in the shares of only one
corresponding Fund.
1.37 SYSTEMATIC DISTRIBUTION OPTION:
An option elected by the Certificate Holder during the Accumulation
Period which establishes a schedule of withdrawals to be made
automatically from the Certificate Holder's Account.
1.38 TRANSFERS:
The movement of invested amounts among the available Subaccount(s)
and/or any Fixed Account Guaranteed Term made available, subject to
terms and conditions established by GALIC, during the Accumulation
Period or the Annuity Period.
1.39 WITHDRAWAL VALUE:
The amount payable by GALIC upon the withdrawal of any portion of an
Account.
1.40 VALUATION DATE:
The date and time for which a Subaccount calculates its net asset
value, usually from 4:00 p.m. Eastern time each day the New York Stock
Exchange is open, to 4:00 p.m. the next such business day.
II. GENERAL PROVISIONS
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2.01 CHANGE OF CONTRACT:
Only an authorized officer of GALIC may change the terms of this
Contract. GALIC will notify the Contract Holder in writing at least 30
days before the effective date of any change. Any change will not
affect the amount or terms of any Annuity Payout Option which begins
before the change.
GALIC may make any change that affects the Market Value Adjustment
(SEE SECTION III- MARKET VALUE ADJUSTMENT) with at least 30 days
advance written notice to the Contract Holder and the Certificate
Holder. Any such change shall become effective for any new Guaranteed
Term and will apply to all present and future Accounts.
Any change that affects any of the following under this Contract will
not apply to Accounts in existence before the effective date of the
change:
The following will not be changed:
(a) Account Value
(b) Guaranteed Rates - Fixed Account
(c) Purchase Payment
(d) Withdrawal Value
(e) Transfers
(f) Net Investment Factor(s) - Separate Account (SEE SECTION III)
(g) Minimum Guaranteed Interest Rates (SEE SECTION V)
(h) Annuity Unit Value - Separate Account (SEE SECTION V)
(i) Annuity Payout Options (SEE SECTION V).
Any change that affects the Annuity Payout Options and the tables for
the Annuity Payout Options may be made:
(a) No earlier than 12 months after the Account Effective Date; and
(b) No earlier than 12 months after the effective date of any prior
change.
GA-MA-1080 Page 12
2.01 CHANGE OF CONTRACT (CONT'D):
Any Account established on or after the effective date of any change
will be subject to the change. If the Contract Holder does not agree
to any change under this provision, no new Accounts may be established
under the Contract. The Contract may also be changed as deemed
necessary by GALIC to comply with federal or state law.
2.02 CHANGE OF FUND(S):
The assets of the Separate Account are segregated by Fund. If the
shares of any Fund are no longer available for investment by the
Separate Account or if, in our judgment, further investment in such
shares should become inappropriate in view of the purpose of the
Contract, GALIC may cease to make such Fund shares available for
investment under the Contract prospectively, or GALIC may substitute
shares of another Fund for shares already acquired. GALIC may also,
from time to time, add additional Funds. Any elimination, substitution
or addition of Funds will be done in accordance with applicable state
and federal securities laws. GALIC reserves the right to substitute
shares of another Fund for shares already acquired without a proxy
vote.
2.03 NONPARTICIPATING CONTRACT:
The Contract Holder, Certificate Holders or Beneficiaries will not
have a right to share in the earnings of GALIC.
2.04 PAYMENTS AND ELECTIONS:
While the Certificate Holder is living, GALIC will pay the Certificate
Holder any Annuity Payments as and when due. After the Certificate
Holder's death, or at the death of the first Certificate Holder if the
Account is owned jointly, any Annuity Payments required to be made
will be paid in accordance with SECTION V - DEATH OF
ANNUITANT/BENEFICIARY. GALIC will determine other payments and/or
elections as of the end of the Valuation Date in which the request is
received at its Customer Service Center. Such payments will be made
within seven calendar days of receipt at its Customer Service Center
of a written claim for payment which is in good order, except as
provided in SECTION III - PAYMENT OF WITHDRAWAL VALUE.
2.05 STATE LAWS:
The Contract and Certificate comply with the laws of the state in
which they are delivered. Any withdrawal, death benefit amount, or
Annuity Payments are equal to or greater than the minimum required by
such laws. Annuity tables for legal reserve valuation shall be as
required by state law. Such tables may be different from annuity
tables used to determine Annuity Payments.
2.06 CONTROL OF CONTRACT:
This is a Contract between the Contract Holder and GALIC. The Contract
Holder has title to the Contract. Contract Holder rights are limited
to accepting or rejecting Contract modifications. The Certificate
Holder has all other rights to amounts held in his or her Account.
Each Certificate Holder shall own all amounts held in his or her
Account. Each Certificate Holder may make any choices allowed by this
Contract for his or her Account. Choices made under this Contract must
be in writing. If the Account is owned jointly, both joint Certificate
Holders must authorize any Certificate Holder change in writing. Until
receipt of such choices at GALIC's Customer Service Center, GALIC may
rely on any previous choices made.
The Contract is not subject to the claims of any creditors of the
Contract Holder or the Certificate Holder, except to the extent
permitted by law.
The Certificate Holder may assign or transfer his or her rights under
the Contract. GALIC reserves the right not to accept assignment or
transfer to a nonnatural person. Any assignment or transfer made under
the Contract must be submitted to GALIC's Customer Service Center in
writing and will not be effective until accepted by GALIC.
GA-MA-1080 Page 13
2.07 DESIGNATION OF BENEFICIARY:
Each Certificate Holder shall name his or her Beneficiary and when
designating the Beneficiary may elect to specify in writing the form
of payment to the Beneficiary. GALIC will honor the specified form of
payment to the extent permitted under section 72(s) of the Code. If
the Account is owned jointly, both joint Certificate Holders must
agree in writing to the Beneficiary designated. The Beneficiary may be
changed at any time. Changes to a Beneficiary must be submitted to
GALIC's Customer Service Center in writing and will not be effective
until accepted by GALIC. If the Account is owned jointly, at the death
of one joint Certificate Holder, the survivor will be deemed the
designated Beneficiary; any other Beneficiary on record will then be
treated as a primary or a contingent Beneficiary, as originally
designated unless and until changed by the new designated Beneficiary.
If a designated Beneficiary defers taking payment of a death benefit,
the designated Beneficiary has the right to name another Beneficiary.
2.08 MISSTATEMENTS AND ADJUSTMENTS:
If GALIC finds the age of any Annuitant to be misstated, the correct
facts will be used to adjust payments.
2.09 INCONTESTABILITY:
After two years, the Contract will be incontestable.
2.10 GRACE PERIOD:
The Contract will remain in effect even if Purchase Payments are not
continued except as provided in the Payment of Adjusted Account Value
provision (SEE SECTION III - PAYMENT OF ADJUSTED ACCOUNT VALUE).
2.11 INDIVIDUAL CERTIFICATES:
GALIC shall issue a certificate to each Certificate Holder. The
certificate will summarize certain provisions of the Contract.
Certificates are for information only and are not a part of the
Contract.
III. PURCHASE PAYMENT, ACCOUNT VALUE, AND WITHDRAWAL PROVISIONS
--------------------------------------------------------------------------------
3.01 PURCHASE PAYMENT:
This amount is the actual Purchase Payment. GALIC reserves the right
to pay premium taxes when due and deduct the amount from the Account
Value when we pay the tax or at a later date.
Each Purchase Payment will be allocated, as directed by the
Certificate Holder, among:
(a) Fixed Account Guaranteed Terms made available, subject to terms
and conditions established by GALIC; and/or
(b) The Subaccount(s) offered through the Separate Account.
For each Purchase Payment, the Certificate Holder shall tell GALIC the
percentage of each Purchase Payment to allocate to any available Fixed
Account Guaranteed Term and/or each Subaccount. Unless different
allocation instructions are received for any additional Purchase
Payment, the allocation will be the same as for the initial Purchase
Payment. If the same Guaranteed Term is no longer available, the
Purchase Payment will be allocated to the next shortest Guaranteed
Term available in the current Deposit Period. If no shorter Guaranteed
Term is available, the next longer Guaranteed Term will be used.
3.02 CERTIFICATE HOLDER'S ACCOUNT:
GALIC will maintain an Account for each Certificate Holder.
GALIC will declare from time to time the acceptability and the minimum
amount for initial and additional Purchase Payments.
GA-MA-1080 Page 14
3.03 ACCUMULATION UNITS - SEPARATE ACCOUNT:
The portion of the Purchase Payment(s) applied to each Subaccount
under the Separate Account will determine the number of accumulation
units for that Subaccount. This number is equal to the portion of the
Purchase Payment(s) applied to each Subaccount divided by the
accumulation unit value (SEE SECTION III - ACCUMULATION UNIT VALUE -
SEPARATE ACCOUNT) for the Valuation Date in which the Purchase Payment
is received in good order at GALIC's Customer Service Center.
3.04 NET INVESTMENT FACTOR(S) - SEPARATE ACCOUNT:
The net investment factor is used to measure the investment
performance of a Subaccount from one Valuation Date to the next. The
net investment factor for a Subaccount for any Valuation Date is equal
to the sum of 1.0000 plus the net investment rate. The net investment
rate equals:
(a) The net assets of the Subaccount on the current Valuation Date,
minus
(b) The net assets of the Subaccount on the preceding Valuation
Date, plus or minus
(c) Taxes or provisions for taxes, if any, attributable to the
operation of the Subaccount;
(d) Divided by the total value of the Subaccount's accumulation and
annuity units on the preceding Valuation Date;
(e) Minus a daily charge at the annual effective rate for mortality
and expense risks as stated in the SCHEDULE - ACCUMULATION
PERIOD and SCHEDULE - ANNUITY PERIOD, and an administrative
charge of 0.15% (unless reduced or eliminated) during the
Accumulation Period and up to 0.25% during the Annuity Period
(currently 0% during the Annuity Period).
The net investment rate may be either positive or negative.
3.05 ACCUMULATION UNIT VALUE - SEPARATE ACCOUNT:
An accumulation unit value is computed by multiplying the net
investment factor for the current Valuation Date by the accumulation
unit value for the previous Valuation Date. The dollar value of
accumulation units, Separate Account assets, and variable Annuity
Payments may go up or down due to investment gain or loss.
3.06 MARKET VALUE ADJUSTMENT (MVA):
An MVA will apply to any withdrawal from the Fixed Account before the
end of a Guaranteed Term when the withdrawal is:
(a) A Transfer (including a Transfer from a Fixed Account Guaranteed
Term if Dollar Cost Averaging is discontinued); except for
Transfers under Dollar Cost Averaging, or as specified in
SECTION I - MATURITY VALUE TRANSFER;
(b) A full or partial withdrawal (including a free withdrawal, SEE
SECTION III - DEFERRED SALES CHARGE), except for a payment made:
(1) Under a Systematic Distribution Option, or (2) Under a
qualified Contract, when the amount withdrawn is equal to the
required minimum distribution for the Account calculated using a
method permitted under the Code and agreed to by GALIC; or
(c) Due to an election of Annuity Payout Option 1. Only a positive
MVA will apply upon election of Annuity Payout Option 2 or 3
(SEE SECTION V - ANNUITY PAYOUT OPTIONS).
Full and partial withdrawals and Transfers made within six months
after the date of the Annuitant's death will be the greater of:
(a) The aggregate MVA amount which is the sum of all market value
adjusted amounts resulting from a withdrawal(s). This total may
be greater or less than the Account Value of those amounts; or
(b) The applicable portion of the Account Value in the Fixed
Account.
After the six-month period, the withdrawal or Transfer will be the
aggregate MVA amount, which may be greater or less than the Account
Value of those amounts.
GA-MA-1080 Page 15
3.06 MARKET VALUE ADJUSTMENT (MVA) (CONT'D):
Market value adjusted amounts will be equal to the amount withdrawn
multiplied by the following ratio:
x
-------
365
(1 + i)
-----------------------
x
-------
365
(1 + j)
Where:
i is the Deposit Period yield
j is the current yield
x is the number of days remaining in the Guaranteed Term,
computed from Wednesday of the week of withdrawal.
The Deposit Period yield will be determined as follows:
(a) At the close of the last business day of each week of the
Deposit Period, a yield will be computed as the average of the
yields on that day of U.S. Treasury Notes which mature in the
last three months of the Guaranteed Term.
(b) The Deposit Period yield is the average of those yields for the
Deposit Period. If withdrawal is made before the close of the
Deposit Period, it is the average of those yields on each week
preceding withdrawal.
The current yield is the average of the yields on the last business
day of the week preceding withdrawal on the same U.S. Treasury Notes
included in the Deposit Period yield.
In the event that no U.S. Treasury Notes which mature in the last
three months of the Guaranteed Term exist, GALIC reserves the right to
use the U.S. Treasury Notes that mature in the following quarter.
3.07 TRANSFER OF ACCOUNT VALUE FROM THE SUBACCOUNT(S) OR FIXED ACCOUNT DURING
THE ACCUMULATION PERIOD:
Before an Annuity Payout Option is elected, all or any portion of the
Adjusted Account Value of the Certificate Holder's Account may be
transferred from any Subaccount or Guaranteed Term of the Fixed
Account:
(a) To any other Subaccount; or
(b) To any Guaranteed Term of the Fixed Account made available in
the current Deposit Period, subject to terms and conditions
specified by GALIC.
Transfer requests can be submitted as a percentage or as a dollar
amount. GALIC may establish a minimum transfer amount. Within a
Guaranteed Term Group, the amount to be withdrawn or transferred will
be withdrawn first from the oldest Deposit Period, then from the next
oldest, and so on until the amount requested is satisfied.
The Certificate Holder may make an unlimited number of Transfers
during the Accumulation Period. The number of free Transfers allowed
by GALIC is shown on the SCHEDULE - ACCUMULATION PERIOD. Additional
Transfers may be subject to a Transfer fee as shown on the SCHEDULE -
ACCUMULATION PERIOD.
GA-MA-1080 Page 16
3.07 TRANSFER OF ACCOUNT VALUE FROM THE SUBACCOUNT(S) OR FIXED ACCOUNT DURING
THE ACCUMULATION PERIOD (CONT'D):
Amounts transferred from the Fixed Account under the Dollar Cost
Averaging program, or amounts transferred as a Matured Term Value on
or within one calendar month of a Maturity Date do not count against
the annual Transfer limit.
Amounts allocated to Fixed Account Guaranteed Terms may not be
transferred to the Subaccounts or to another Guaranteed Term during a
Deposit Period or for 90 days after the close of a Deposit Period
except for:
(a) Matured Term Value(s) during the calendar month following the
Maturity Date;
(b) Amounts applied to an Annuity Payout Option;
(c) Amounts transferred under the Dollar Cost Averaging program;
(d) Amounts distributed under a Systematic Distribution Option; and
(e) Amounts transferred by GALIC if Dollar Cost Averaging is
discontinued.
3.08 NOTICE TO THE CERTIFICATE HOLDER:
The Certificate Holder will receive quarterly statements from GALIC
of:
(a) The value of any amounts held in:
(1) The Fixed Account; and
(2) The Subaccount(s) under the Separate Account;
(b) The number of any accumulation units; and
(c) The accumulation unit value.
Such number or values will be as of a specific date no more than 60
days before the date of the notice.
3.09 LOANS:
Loans are not available under this Contract.
3.10 SYSTEMATIC DISTRIBUTION OPTIONS:
GALIC may, from time to time, make one or more Systematic Distribution
Options available during the Accumulation Period. When a Systematic
Distribution Option is elected, GALIC will make automatic payments
from the Certificate Holder's Account. No Deferred Sales Charge or MVA
will apply to the automatic payments made under a Systematic
Distribution Option.
Any Systematic Distribution Option will be subject to the following
criteria:
(a) Any Systematic Distribution Option will be made available on the
basis of objective criteria consistently applied;
(b) The availability of any Systematic Distribution Option may be
limited by terms and conditions applicable to the election of
such Systematic Distribution Option; and
(c) GALIC may discontinue the availability of a Systematic
Distribution Option at any time. Except to the extent required
to comply with applicable law, discontinuance of a Systematic
Distribution Option will apply only to future elections and will
not affect Systematic Distribution Options in effect at the time
an option is discontinued.
3.11 DEATH BENEFIT AMOUNT:
The amount of the death benefit is described in SECTION IV - OPTION
PACKAGES.
GA-MA-1080 Page 17
3.12 DEATH BENEFIT OPTIONS AVAILABLE TO BENEFICIARY:
Prior to any election, or until amounts must be otherwise distributed
under this section, the Account Value will be retained in the Account.
The Beneficiary has the right to allocate or reallocate any amount to
any of the available investment options (subject to an MVA, if
applicable). If the Certificate Holder has specified the form of
payment to the Beneficiary, the death benefit will be paid as elected
by the Certificate Holder in the Beneficiary designation, to the
extent permitted by section 72(s) of the Code. If the Certificate
Holder has not specified a form of payment, the Beneficiary may elect
one of the following options.
(a) When the Certificate Holder is the Annuitant or when the
Certificate Holder is a nonnatural person, and the Annuitant
dies:
(1) If the Beneficiary is the surviving spouse, the spousal
Beneficiary will be the successor Certificate Holder and
may exercise all Certificate Holder rights under the
Contract and continue in the Accumulation Period, or may
elect (i) or (ii) below. Under the Code, distributions
from the Account are not required until the spousal
Beneficiary's death. The spousal Beneficiary may elect to:
(i) Apply some or all of the Adjusted Account Value to
an Annuity Payout Option (SEE SECTION V); or
(ii) Receive, at any time, a lump sum payment equal to
the Adjusted Account Value.
(2) If the Beneficiary is other than the surviving spouse,
then options (i) or (ii) above apply. Any portion of the
Adjusted Account Value not applied to an Annuity Payout
Option within one year of the death must be distributed
within five years of the date of death.
(3) If no Beneficiary exists, a lump sum payment equal to the
Adjusted Account Value must be made to the Annuitant's
estate within five years of the date of death.
(4) If the Beneficiary is an entity, a lump sum payment equal
to the Adjusted Account Value must be made within five
years of the date of death, unless otherwise permitted by
IRS regulation or ruling.
(b) When the Certificate Holder is not the Annuitant and the
Certificate Holder dies:
(1) If the Beneficiary is the Certificate Holder's surviving
spouse, the spousal Beneficiary will be the successor
Certificate Holder and may exercise all Certificate Holder
rights under the Contract and continue in the Accumulation
Period, or may elect (i) or (ii) below. Under the Code,
distributions from the Account are not required until the
spousal Beneficiary's death. The spousal Beneficiary may
elect to:
(i) Apply some or all of the Adjusted Account Value to
an Annuity Payout Option (SEE SECTION V); or
(ii) Receive, at any time, a lump sum payment equal to
the Withdrawal Value.
(2) If the Beneficiary is other than the Certificate Holder's
surviving spouse, then options (i) or (ii) under (1) above
apply. Any portion of the death benefit not applied to an
Annuity Payout Option within one year of the Certificate
Holder's death must be distributed within five years of
the date of death.
(3) If no Beneficiary exists, a lump sum payment equal to the
Withdrawal Value must be made to the Certificate Holder's
estate within five years of the date of death.
(4) If the Beneficiary is an entity, a lump sum payment equal
to the Withdrawal Value must be made within five years of
the date of death, unless otherwise permitted by IRS
regulation or ruling.
(c) When the Certificate Holder is a natural person and not the
Annuitant and the Annuitant dies, the Beneficiary (or the
Certificate Holder if no Beneficiary exists) may elect to:
(1) Apply all or some of the Adjusted Account Value to an
Annuity Payout Option within 60 days of the date of death;
or
(2) Receive a lump sum payment equal to the Adjusted Account
Value.
GA-MA-1080 Page 18
3.13 LIQUIDATION OF WITHDRAWAL VALUE:
All or any portion of the Account Value may be withdrawn at any time.
Withdrawal requests may be submitted as a percentage of the Account
Value or as a specific dollar amount. Purchase Payment amounts are
withdrawn first, and then the excess value, if any. Partial withdrawal
amounts are withdrawn on a pro rata basis from the Subaccount(s)
and/or the Guaranteed Term(s) Groups of the Fixed Account in which the
Account Value is invested. Within a Guaranteed Term Group, the amount
to be withdrawn or transferred will be withdrawn first from the oldest
Deposit Period, then from the next oldest, and so on until the amount
requested is satisfied.
After deduction of the Maintenance Fee, if applicable, the withdrawn
amount shall be reduced by a Deferred Sales Charge, if applicable. An
MVA may apply to amounts withdrawn from the Fixed Account.
3.14 DEFERRED SALES CHARGE:
The Deferred Sales Charge only applies to the Purchase Payment(s)
portion withdrawn and varies according to the elapsed time since
deposit (SEE SCHEDULE - ACCUMULATION PERIOD). Purchase Payment amounts
are withdrawn in the same order they were applied.
No Deferred Sales Charge is deducted from any portion of the Purchase
Payment which is paid:
(a) To a Beneficiary due to the Annuitant's death before Annuity
Payments start, up to a maximum of the aggregate Purchase
Payment(s) minus the total of all partial surrenders, amounts
applied to an Annuity Payout Option and deductions made prior to
the Annuitant's date of death;
(b) For an Annuity Payout Option (SEE SECTION V);
(c) As a distribution under a Systematic Distribution Option;
(d) For a full withdrawal of the Account where the Account Value is
$2,500 or less and no withdrawals have been taken from the
Account within the prior 12 months;
(e) By GALIC under SECTION III - PAYMENT OF ADJUSTED ACCOUNT VALUE;
(f) Under a qualified Contract when the amount withdrawn is equal to
the minimum distribution required by the Code for the Account,
calculated using a method permitted under the Code and agreed to
by GALIC;
(g) As a free withdrawal as described in SECTION IV - OPTION
PACKAGES; or
(h) Under the Nursing Home Waiver, if available, and as described in
SECTION IV - OPTION PACKAGES.
3.15 PAYMENT OF WITHDRAWAL VALUE:
Under certain emergency conditions, GALIC may defer payment:
(a) For a period of up to six months (unless not allowed by state
law); or
(b) As provided by federal law.
3.16 PAYMENT OF ADJUSTED ACCOUNT VALUE:
Upon 90 days written notice to the Certificate Holder, GALIC will
terminate any Account if the Account Value becomes less than $2,500
immediately following any partial withdrawal. GALIC does not intend to
exercise this right in cases where an Account is reduced to $2,500 or
less solely due to investment performance. A Deferred Sales Charge
will not be deducted from the Adjusted Account Value.
3.17 REINSTATEMENT:
The Certificate Holder may reinstate the proceeds of a full
withdrawal, subject to terms and conditions established by GALIC.
GA-MA-1080 Page 19
IV. OPTION PACKAGES
--------------------------------------------------------------------------------
The Contract offers three Option Packages regarding calculation of the death
benefit and the ability to withdraw money free of Deferred Sales Charge. The
Option Package selected is reflected in the SCHEDULE-ACCUMULATION PERIOD
attached to the Certificate. At initial purchase, the Schedule Effective Date is
the same as the Account Effective Date. If, at a later date, the Certificate
Holder wishes to replace the current Option Package with another available
Option Package, the Certificate Holder may do so upon any anniversary of the
Account Effective Date.
A different SCHEDULE-ACCUMULATION PERIOD may apply to each Certificate Holder
depending upon the Option Package selected.
Below is a description of the ability to elect other Option Packages and the
contractual provisions of each Option Package.
4.01 ELECTION OF OPTION PACKAGES:
Any Certificate Holder, who meets the applicable minimum Account Value
required by GALIC, may elect to replace the Option Package in effect
with one of the other available Option Packages. The eligible
Certificate Holder may make the election during the sixty day period
prior to and including any anniversary of the Account Effective Date.
Such election must be made in writing and received in good order at
GALIC's Customer Service Center during the election period.
The effective date of the newly elected Option Package is the
anniversary of the Account Effective Date at the end of the sixty day
election period. GALIC will issue another Schedule reflecting the new
Option Package chosen. The new Schedule will reflect the revisions to
the Certificate Holder's benefits during the Accumulation Period,
namely:
The new Schedule Effective Date,
The revised Charges to Separate Account,
The calculation of the death benefit, and
The revised ability to withdraw money free of Deferred Sales
Charge
All other Contract features remain in effect from the Account
Effective Date.
4.02 DESCRIPTION OF OPTION PACKAGE I:
DEFERRED SALES CHARGE:
In addition to the events described in Section III - Deferred Sales
Charge, the total amount that may be withdrawn each Account Year
without a Deferred Sales Charge cannot exceed 10% of the Account Value
less:
(1) Any amount(s) withdrawn and/or requested for withdrawal under a
Systematic Distribution Option, or
(2) Any amount(s) taken as a minimum required distribution as
described in SECTION III - DEFERRED SALES CHARGE.
DEATH BENEFIT CALCULATION DURING THE ACCUMULATION PERIOD:
If the Certificate Holder or Annuitant dies before an Annuity Payout
Option starts, the Beneficiary is entitled to a death benefit. If the
Account is owned jointly, the death benefit applies at the death of
the first joint Certificate Holder to die. The amount of the death
benefit is determined as follows:
(a) DEATH OF THE ANNUITANT.
The death benefit is the greater of:
(1) The sum of all Purchase Payment(s) made, adjusted for
amount(s) withdrawn or applied to an Annuity Payout Option
as of the Claim Date; or
(2) The Account Value on the Claim Date.
GA-MA-1080 Page 20
4.02 DESCRIPTION OF OPTION PACKAGE I (CONT'D):
On the Claim Date, if the amount of the death benefit is greater than
the Account Value, the amount by which the death benefit exceeds the
Account Value will be deposited and allocated to the money market fund
available through the Separate Account.
The amount paid to the Beneficiary will equal the Adjusted Account
Value on the date the payment request is processed. This amount may be
greater or less than the amount of the death benefit on the Claim
Date. The Beneficiary may elect a death benefit payment option as
permitted in SECTION III - DEATH BENEFIT OPTIONS AVAILABLE TO
BENEFICIARY.
(b) DEATH OF THE CERTIFICATE HOLDER IF THE CERTIFICATE HOLDER IS NOT
THE ANNUITANT.
On the Claim Date, the amount of the death benefit equals the Account
Value.
The amount paid to the Beneficiary will equal the Adjusted Account
Value on the date the payment request is processed. A Deferred Sales
Charge may apply to any full or partial payment of the death benefit.
The Beneficiary may elect a death benefit payment option as permitted
in SECTION III - DEATH BENEFIT OPTIONS AVAILABLE TO BENEFICIARY.
(c) DEATH OF A SPOUSE WHO IS THE BENEFICIARY OF A CERTIFICATE
HOLDER/ANNUITANT AND WHO BECOMES A SUCCESSOR CERTIFICATE
HOLDER/ ANNUITANT.
The amount of the death benefit paid to the Beneficiary at the death
of a successor Certificate Holder/Annuitant is the greater of the
values as described in (a) above except that in calculating (a)(1),
the Account Value on the Claim Date for the prior Certificate Holder's
death is treated as the initial Purchase Payment.
CHARGES TO SEPARATE ACCOUNT:
SEE SCHEDULE-ACCUMULATION PERIOD.
4.03 DESCRIPTION OF OPTION PACKAGE II:
DEFERRED SALES CHARGE:
In addition to the events described in SECTION III - DEFERRED SALES
CHARGE, the total amount that may be withdrawn each Account Year
without a Deferred Sales Charge cannot exceed 10% of the Account Value
less:
(1) Any amount(s) withdrawn and/or requested for withdrawal under a
Systematic Distribution Option, or
(2) Any amount(s) taken as a minimum required distribution as
described in SECTION III - DEFERRED SALES CHARGE.
No Deferred Sales Charge is deducted from any portion of the Purchase
Payment(s) which is withdrawn:
If the Annuitant has spent at least 45 consecutive days in a
licensed nursing care facility and each of the following
conditions are met:
(1) More than one Account Year has elapsed since the Schedule
Effective Date; and
(2) The withdrawal is requested within three years of
admission to a licensed nursing care facility.
This waiver does not apply if the Annuitant was in a licensed
nursing care facility for at least one day during the two week
period immediately preceding or following the Schedule Effective
Date.
GA-MA-1080 Page 21
4.03 DESCRIPTION OF OPTION PACKAGE II (CONT'D):
DEATH BENEFIT CALCULATION DURING THE ACCUMULATION PERIOD:
If the Certificate Holder or Annuitant dies before an Annuity Payout
Option starts, the Beneficiary is entitled to a death benefit. If the
Account is owned jointly, the death benefit applies at the death of
the first joint Certificate Holder to die. The amount of the death
benefit is determined as follows:
(a) DEATH OF THE ANNUITANT.
The death benefit is the greatest of:
(1) The sum of all Purchase Payment(s) made, adjusted for
amount(s) withdrawn or applied to an Annuity Payout Option
as of the Claim Date; or
(2) The Account Value on the Claim Date; or
(3) The "Step-up Value" on the Claim Date.
On the Schedule Effective Date, the Step-up Value is the greater
of:
(1) The Account Value; or
(2) The Step-up Value, if any, calculated on the anniversary
prior to the Schedule Effective Date, adjusted for
Purchase Payments(s) made and amount(s) withdrawn or
applied to an Annuity Payout Option during the prior
Account Year.
Thereafter, on each anniversary of the Schedule Effective
Date until the anniversary immediately preceding the
Annuitant's 85th birthday or death, whichever is earlier,
the Step-up Value is equal to the greater of:
(a) The Step-up Value most recently calculated, adjusted
for Purchase Payment(s) made and amount(s) withdrawn
or applied to an Annuity Payout Option during the
prior Account Year; or
(b) The Account Value on that anniversary of the
Schedule Effective Date.
On the Claim Date, the Step-up Value shall equal the
Step-up Value calculated prior to death. It is
adjusted for Purchase Payment(s) made and amount(s)
withdrawn or applied to an Annuity Payout Option
since the anniversary on which the Step-up Value was
calculated.
On the Claim Date, if the amount of the death benefit is greater than
the Account Value, the amount by which the death benefit exceeds the
Account Value will be deposited and allocated to the money market fund
available through the Separate Account.
The amount paid to the Beneficiary will equal the Adjusted Account
Value on the date the payment request is processed. This amount may be
greater or less than the amount of the death benefit on the Claim
Date. The Beneficiary may elect a death benefit payment option as
permitted in SECTION III - DEATH BENEFIT OPTIONS AVAILABLE TO THE
BENEFICIARY.
(b) DEATH OF THE CERTIFICATE HOLDER IF THE CERTIFICATE HOLDER IS NOT
THE ANNUITANT.
On the Claim Date, the amount of the death benefit equals the
Account Value.
The amount paid to the Beneficiary will equal the Adjusted
Account Value on the date the payment request is processed. A
Deferred Sales Charge may apply to any full or partial payment
of the death benefit. The Beneficiary may elect a death benefit
payment option as permitted in SECTION III - DEATH BENEFIT
OPTIONS AVAILABLE TO THE BENEFICIARY.
GA-MA-1080 Page 22
4.03 DESCRIPTION OF OPTION PACKAGE II (CONT'D):
(c) DEATH OF A SPOUSE WHO IS THE BENEFICIARY OF A CERTIFICATE
HOLDER/ANNUITANT AND WHO BECOMES A SUCCESSOR CERTIFICATE
HOLDER/ ANNUITANT.
The amount of the death benefit paid to the Beneficiary at the
death of a successor Certificate Holder/Annuitant is the greater
of the values as described in (a) above except that:
(1) In calculating (a)(1), the Account Value on the Claim Date
for the prior Certificate Holder's death is treated as the
initial Purchase Payment; and
(2) In calculating (a)(3), the Step-up Value on the Claim Date
for the prior Certificate Holder's death is the initial
Step-up Value.
CHARGES TO SEPARATE ACCOUNT:
SEE SCHEDULE-ACCUMULATION PERIOD.
4.04 DESCRIPTION OF OPTION PACKAGE III:
DEFERRED SALES CHARGE:
In addition to the events described in SECTION III - DEFERRED SALES
CHARGE, the total amount that may be withdrawn each Account Year
without a Deferred Sales Charge cannot exceed 10% of the Account Value
less:
(1) Any amount(s) withdrawn and/or requested for withdrawal under a
Systematic Distribution Option, or
(2) Any amount(s) taken as a minimum required distribution as
described in SECTION III - DEFERRED SALES CHARGE.
If the entire 10% of Account Value free of Deferred Sales Charge is
not taken in any Account Year, the Certificate Holder may accumulate
in successive Account Years the percentage not taken. The amount
eligible each Account Year for withdrawal without a Deferred Sales
Charge cannot exceed 30% of the Account Value less any amount(s)
withdrawn and/or requested for withdrawal under a Systematic
Distribution Option, or taken as a minimum required distribution as
described in SECTION III - DEFERRED SALES CHARGE, during the Account
Year.
No Deferred Sales Charge is deducted from any portion of the Purchase
Payment(s) which is withdrawn:
If the Annuitant has spent at least 45 consecutive days in a
licensed nursing care facility and each of the following
conditions are met:
(1) More than one Account Year has elapsed since the Schedule
Effective Date; and
(2) The withdrawal is requested within three years of
admission to a licensed nursing care facility.
This waiver does not apply if the Annuitant was in a licensed
nursing care facility for at least one day during the two week
period immediately preceding or following the Schedule Effective
Date.
GA-MA-1080 Page 23
4.04 DESCRIPTION OF OPTION PACKAGE III (CONT'D):
DEATH BENEFIT CALCULATION DURING THE ACCUMULATION PERIOD:
If the Certificate Holder or Annuitant dies before an Annuity Payout
Option starts, the Beneficiary is entitled to a death benefit. If the
Account is owned jointly, the death benefit applies at the death of
the first joint Certificate Holder to die. The amount of the death
benefit is determined as follows:
(a) DEATH OF THE ANNUITANT.
The death benefit is the greatest of:
(1) The sum of all Purchase Payment(s) made, adjusted for
amount(s) withdrawn or applied to an Annuity Payout Option
as of the Claim Date; or
(2) The Account Value on the Claim Date; or
(3) The Step-up Value on the Claim Date; or
(4) The "Roll-up Value" on the Claim Date.
On the Schedule Effective Date, the Step-up Value is the greater of:
(1) The Account Value; or
(2) The Step-up Value, if any, calculated on the anniversary prior
to the Schedule Effective Date, adjusted for Purchase
Payments(s) made and amount(s) withdrawn or applied to an
Annuity Payout Option during the prior Account Year.
Thereafter, on each anniversary of the Schedule Effective Date until
the anniversary immediately preceding the Annuitant's 85th birthday or
death, whichever is earlier, the Step-up Value is equal to the greater
of:
(a) The Step-up Value most recently calculated, adjusted for
Purchase Payment(s) made and amount(s) withdrawn or applied to
an Annuity Payout Option during the prior Account Year; or
(b) The Account Value on that anniversary of the Schedule Effective
Date.
On the Claim Date, the Step-up Value shall equal the Step-up Value
calculated prior to death. It is adjusted for Purchase Payment(s) made
and amount(s) withdrawn or applied to an Annuity Payout Option since
the anniversary on which the Step-up Value was calculated.
On the Schedule Effective Date, the Roll-up Value is equal to the
Account Value.
Thereafter, on each anniversary of the Schedule Effective Date until
the anniversary immediately preceding the Annuitant's 76th birthday or
death, whichever is earlier, the Roll-up Value is equal to the Roll-up
Value most recently calculated, multiplied by a factor of 1.05,
adjusted for Purchase Payment(s) made, and amount(s) withdrawn or
applied to an Annuity Payout Option during the prior Account Year. The
Roll-up Value may not exceed 200% of the Account Value on the Schedule
Effective Date, adjusted for additional Purchase Payments made, and
amount(s) withdrawn or applied to an Annuity Payout Option.
On the Claim Date, the Roll-up Value shall equal the Roll-up Value
calculated prior to death. It is adjusted for additional Purchase
Payment(s) made and amount(s) withdrawn or applied to an Annuity
Payout Option since the anniversary on which the Roll-up Value was
calculated.
On the Claim Date, if the amount of the death benefit is greater than
the Account Value, the amount by which the death benefit exceeds the
Account Value will be deposited and allocated to the money market fund
available through the Separate Account.
The amount paid to the Beneficiary will equal the Adjusted Account
Value on the date the payment request is processed. This amount may be
greater or less than the amount of the death benefit on the Claim
Date. The Beneficiary may elect a death benefit payment option as
permitted in SECTION III - DEATH BENEFIT OPTIONS AVAILABLE TO THE
BENEFICIARY.
GA-MA-1080 Page 24
4.04 DESCRIPTION OF OPTION PACKAGE III (CONT'D):
(b) DEATH OF THE CERTIFICATE HOLDER IF THE CERTIFICATE HOLDER IS NOT
THE ANNUITANT.
On the Claim Date, the amount of the death benefit equals the
Account Value.
The amount paid to the Beneficiary will equal the Adjusted
Account Value on the date the payment request is processed. A
Deferred Sales Charge may apply to any full or partial payment
of the death benefit. The Beneficiary may elect a death benefit
payment option as permitted in SECTION III - DEATH BENEFIT
OPTIONS AVAILABLE TO THE BENEFICIARY.
(c) DEATH OF A SPOUSE WHO IS THE BENEFICIARY OF A CERTIFICATE
HOLDER/ANNUITANT AND WHO BECOMES A SUCCESSOR CERTIFICATE
HOLDER/ ANNUITANT.
The amount of the death benefit paid to the Beneficiary at the
death of a successor Certificate Holder/Annuitant is the greater
of the values as described in (a) above except that:
(1) In calculating (a)(1), the Account Value on the Claim Date
for the prior Certificate Holder's death is treated as the
initial Purchase Payment; and
(2) In calculating (a)(3), the Step-up Value on the Claim Date
for the prior Certificate Holder's death is the initial
Step-up Value; and
(3) In calculating (a)(4), the Roll-up Value on the Claim Date
for the prior Certificate Holder's death is the initial
Roll-Up Value.
CHARGES TO SEPARATE ACCOUNT:
SEE SCHEDULE-ACCUMULATION PERIOD.
V. ANNUITY PAYOUT PROVISIONS
--------------------------------------------------------------------------------
5.01 ANNUITY PAYOUT OPTIONS:
ANNUITY PAYOUT OPTION 1 - PAYMENTS FOR A SPECIFIED PERIOD:
Payments are made for the number of years specified by the
Certificate Holder. The number of years must be at least five
and not more than 30.
ANNUITY PAYOUT OPTION 2 - LIFE INCOME BASED ON THE LIFE OF ONE
ANNUITANT:
When this option is elected, the Certificate Holder must choose
one of the following:
(a) Payments cease at the death of the Annuitant;
(b) Payments are guaranteed for a specified period from five
to 30 years;
(c) Cash refund: when the Annuitant dies, the Beneficiary will
receive a lump sum payment equal to the amount applied to
the Annuity Payout Option (less any premium tax, if
applicable) less the total amount of Annuity Payments made
prior to such death. This cash refund feature is only
available if the total amount applied to the Annuity
Payout Option is allocated to a fixed Annuity Payment.
GA-MA-1080 Page 25
5.01 ANNUITY PAYOUT OPTIONS (CONT'D):
ANNUITY PAYOUT OPTION 3 - LIFE INCOME BASED ON THE LIVES OF TWO
ANNUITANTS:
Payments are made for the lives of two Annuitants, one of whom
is designated the primary Annuitant and the other the secondary
Annuitant, and cease when both Annuitants have died. When this
option is elected, the Certificate Holder must also choose one
of the following:
(a) 100% of the payment to continue after the first death;
(b) 66 2/3% of the payment to continue after the first death;
(c) 50% of the payment to continue after the first death;
(d) 100% of the payment to continue after the first death and
payments are guaranteed for a period of five to 30 years;
(e) 100% of the payment to continue at the death of the
secondary Annuitant and 50% of the payment to continue at
the death of the primary Annuitant; or
(f) 100% of the payment continues after the first death with
a cash refund feature. When the primary Annuitant and
secondary Annuitant die, the Beneficiary will receive a
lump sum payment equal to the amount applied to the
Annuity Payout Option (less any premium tax) less the
total amount of Annuity Payments paid prior to such
death. This cash refund feature is only available if the
total amount applied to the Annuity Payout Option is
allocated to a fixed Annuity Payment.
If a fixed Annuity Payment is chosen under Annuity Payout Option
1, 2 (a) or (b), or 3 (a) or (d), the Certificate Holder may
elect, at the time the Annuity Payout Option is selected, an
annual increase of one, two or three percent compounded
annually.
As allowed under applicable state law, GALIC reserves the right
to offer additional Annuity Payout Options.
5.02 ANNUITY PAYMENT CHOICES:
The Certificate Holder may tell GALIC to apply any portion of
the Adjusted Account Value (minus any premium tax, if
applicable,) to any Annuity Payout Option . The first Annuity
Payment may not be earlier than one calendar year after the
initial Purchase Payment nor later than the later of:
(a) The first day of the month following the Annuitant's 85th
birthday; or
(b) The tenth anniversary of the last Purchase Payment. In
lieu of the election of an Annuity Payout Option, the
Certificate Holder may tell GALIC to make a lump sum
payment.
When an Annuity Payout Option is chosen, GALIC must also be told
if payments are to be made other than monthly and whether to
pay:
(a) A fixed Annuity Payment using the General Account;
(b) A variable Annuity Payment using any of the Subaccount(s)
available under this Contract for the Annuity Period; or
(c) A combination of (a) and (b).
If a fixed Annuity Payment is chosen, the payment rate for the
option chosen, shown on the tables immediately following,
reflects at least the minimum guaranteed interest rate (SEE
SCHEDULE - ANNUITY PERIOD), but may reflect a higher interest
rate.
If a variable Annuity Payment is chosen, the initial Annuity
Payment for the option elected reflects the Assumed Interest
Rate (AIR) elected (SEE SCHEDULE - ANNUITY PERIOD). The
Certificate Holder must allocate specified amounts among the
Subaccounts available during the Annuity Period. GALIC reserves
the right to limit the number of Subaccounts available at one
time and to limit the number of Subaccounts the Certificate
Holder may select during the Annuity Period. Subject to terms
and conditions established by GALIC, the Certificate Holder may
transfer all or any portion of the amount allocated to a
Subaccount to another Subaccount. The number of Transfers
allowed without charge each year is shown on SCHEDULE - ANNUITY
PERIOD.
Transfer requests must be submitted as a percentage of the
allocation among the Subaccounts. GALIC reserves the right to
establish a minimum transfer amount. Transfers will be effective
as of the Valuation Date in which GALIC receives a transfer
request in good order at its Customer Service Center.
GA-MA-1080 Page 26
5.03 TERMS OF ANNUITY PAYOUT OPTIONS:
(a) When payments start, the age of the Annuitant plus the number of
years for which payments are guaranteed must not exceed 95.
(b) An Annuity Payout Option may not be elected if the first payment
would be less than $50 or if the total payments in a year would
be less than $250 (less if required by state law). GALIC
reserves the right to increase the minimum first Annuity Payment
amount and the minimum annual Annuity payment amount based upon
increases reflected in the Consumer Price Index-Urban, (CPI-U)
since July 1, 1993.
(c) If a fixed Annuity Payment is chosen GALIC will use the
applicable current rate if it will provide higher fixed Annuity
Payments.
(d) For purposes of calculating the guaranteed first payment of a
variable or fixed Annuity Payment, the primary Annuitant's and
secondary Annuitant's adjusted age will be used. The primary
Annuitant's and secondary Annuitant's adjusted age is his or her
age as of the birthday closest to the Annuity Payment
commencement date reduced by one year for commencement dates
occurring during the period of time from July 1, 1993 through
December 31, 1999. The primary Annuitant's and secondary
Annuitant's age will be reduced by two years for commencement
dates occurring during the period of time from January 1, 2000
through December 31, 2009. The primary Annuitant's and
secondary Annuitant's age will be reduced by one additional year
for Annuity commencement dates occurring in each succeeding
decade.
The attached payment rates for Annuity Payout Options 2 and 3
are based on mortality from 1983 Table a.
(e) Assumed Interest Rate (AIR) is the interest rate used to
determine the amount of the first Annuity Payment under a
variable Annuity Payment as shown on SCHEDULE - ANNUITY PERIOD.
The Separate Account must earn this rate plus enough to cover
the mortality and expense risks charges (which may include
profit) and administrative charges if future variable Annuity
Payments are to remain level, (SEE SCHEDULE - ANNUITY PERIOD).
(f) Once elected, Annuity Payments cannot be commuted to a lump sum
except for variable Annuity Payments under Annuity Payout
Option 1.
5.04 DEATH OF ANNUITANT/BENEFICIARY:
(a) CERTIFICATE HOLDER IS THE ANNUITANT: When the Certificate Holder
is the Annuitant and the Annuitant dies under Annuity Payout
Option 1 or 2(b), or both the primary Annuitant and the
secondary Annuitant die under Annuity Payout Option 3(d), any
remaining payments will continue to the Beneficiary, or if
elected by the Beneficiary and not prohibited by the Certificate
Holder in the Beneficiary designation, the present value of any
remaining payments will be paid in one sum to the Beneficiary.
If Annuity Payout Option 3 has been elected and the Certificate
Holder dies, the remaining payments will continue to the
successor payee. If no successor payee has been designated, the
Beneficiary will be treated as the successor payee. If the
Account has joint Certificate Holders, the surviving joint
Certificate Holder will be deemed the successor payee.
(b) CERTIFICATE HOLDER IS NOT THE ANNUITANT: When the Certificate
Holder is not the Annuitant and the Certificate Holder dies, any
remaining payments will continue to the successor payee. If no
successor payee has been designated, the Beneficiary will be
treated as the successor payee. If the Account has joint
Certificate Holders, the surviving joint Certificate Holder will
be deemed the successor payee.
If the Annuitant dies under Annuity Payout Option 1 or 2(b), or
both the primary Annuitant and secondary Annuitant die under
Annuity Payout Option 3(d), any remaining payments will continue
to the Beneficiary, or if elected by the Beneficiary and not
prohibited by the Certificate Holder in the Beneficiary
designation, the present value of any remaining payments will be
paid in one sum to the Beneficiary. If Annuity Payout Option 3
has been elected and the Annuitant dies, the remaining payments
will continue to the Certificate Holder.
GA-MA-1080 Page 27
5.04 DEATH OF ANNUITANT/BENEFICIARY (CONT'D):
(c) No Beneficiary Named/Surviving: If there is no Beneficiary, the
present value of any remaining payments will be paid in one sum
to the Certificate Holder, or if the Certificate Holder is not
living, then to the Certificate Holder's estate.
(d) If the Beneficiary or the successor payee dies while receiving
Annuity Payments, any remaining payments will continue to the
successor Beneficiary/payee or upon election by the successor
Beneficiary/payee, the present value of any remaining payments
will be paid in one sum to the successor Beneficiary/payee. If
no successor Beneficiary/payee has been designated, the present
value of any remaining payments will be paid in one sum to the
Beneficiary's/payee's estate.
(e) The present value will be determined as of the Valuation Date in
which proof of death acceptable to GALIC and a request for
payment is received at GALIC's Customer Service Center.
5.05 ANNUITY UNITS - SEPARATE ACCOUNT:
The number of annuity units is based on the amount of the first
variable Annuity Payment which is equal to:
(a) The portion of the Account Value applied to pay a variable
Annuity Payment (minus any applicable premium tax); divided by
(b) 1,000; multiplied by
(c) The payment rate on the tables immediately following, for the
option chosen.
Such amount, or portion, of the variable Annuity Payment will be
divided by the appropriate annuity unit value (SEE SECTION V - ANNUITY
UNIT VALUE - SEPARATE ACCOUNT) on the tenth Valuation Date before the
due date of the first payment to determine the number of annuity
units. The number of annuity units remains fixed. Each future payment
is equal to the sum of the products of each annuity unit value
multiplied by the appropriate number of annuity units. The annuity
unit value on the tenth Valuation Date prior to the due date of the
payment is used.
5.06 ANNUITY UNIT VALUE - SEPARATE:
For any Valuation Date, an annuity unit value is equal to:
(a) The value for the previous Valuation Date; multiplied by
(b) The annuity net return factor(s) (SEE SECTION V - NET RETURN
FACTOR(S) - SEPARATE ACCOUNT) for the Valuation Date; multiplied
by
(c) A factor to reflect the AIR (SEE SCHEDULE - ANNUITY PERIOD).
The annuity unit value and Annuity Payment amount may go up or down
due to investment gain or loss.
5.07 NET RETURN FACTOR(S) - SEPARATE ACCOUNT:
The net return factor(s) are used to compute all variable Annuity
Payments for any Subaccount.
The net return factor for each Subaccount is equal to 1.▇▇▇▇▇▇▇ plus
the net return rate.
The net return rate is equal to:
(a) The value of the shares of the Subaccount at the end of a
Valuation Date; minus
(b) The value of the shares of the Subaccount at the start of the
Valuation Date; plus or minus
(c) Taxes (or reserves for taxes) on the Separate Account (if any);
divided by
(d) The total value of the annuity units at the start of the
Valuation Date; minus
GA-MA-1080 Page 28
5.07 NET RETURN FACTOR(S) - SEPARATE ACCOUNT (CONT'D):
(e) A daily charge for mortality and expense risks, which may
include profit, and a daily administrative charge at the annual
rate as shown on SCHEDULE - ANNUITY PERIOD.
A net return rate may be more or less than 0%.
The value of a share of the Subaccount is equal to the net assets of
the Subaccount divided by the number of shares outstanding.
Annuity Payments shall not be changed due to changes in the mortality
or expense results or administrative charges.
GA-MA-1080 Page 29
OPTION 1: PAYMENTS FOR A SPECIFIED PERIOD
---------------------------------------------------------------------------------------
Monthly Amount for Each $1,000*
Rates for a Fixed Annuity with a 3% Guaranteed Interest Rate
---------------------------------------------------------------------------------------
Years Payment Years Payment
---------------------------------------------------------------------------------------
5 $17.91 18 $5.96
6 15.14 19 5.73
7 13.16 20 5.51
8 11.68 21 5.32
9 10.53 22 5.15
10 9.61 23 4.99
11 8.86 24 4.84
12 8.24 25 4.71
13 7.71 26 4.59
14 7.26 27 4.47
15 6.87 28 4.37
16 6.53 29 4.27
17 6.23 30 4.18
---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------
First Monthly Amount for Each $1,000*
Rates for a Variable Annuity with a 3.5% AIR
---------------------------------------------------------------------------------------
Years Payment Years Payment
---------------------------------------------------------------------------------------
5 $18.12 18 $6.20
6 15.35 19 5.97
7 13.38 20 5.75
8 11.90 21 5.56
9 10.75 22 5.39
10 9.83 23 5.24
11 9.09 24 5.09
12 8.46 25 4.96
13 7.94 26 4.84
14 7.49 27 4.73
15 7.10 28 4.63
16 6.76 29 4.53
17 6.47 30 4.45
---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------
First Monthly Amount for Each $1,000*
Rates for a Variable Annuity with a 5% AIR
---------------------------------------------------------------------------------------
Years Payment Years Payment
---------------------------------------------------------------------------------------
5 $18.74 18 $6.94
6 15.99 19 6.71
7 14.02 20 6.51
8 12.56 21 6.33
9 11.42 22 6.17
10 10.51 23 6.02
11 9.77 24 5.88
12 9.16 25 5.76
13 8.64 26 5.65
14 8.20 27 5.54
15 7.82 28 5.45
16 7.49 29 5.36
17 7.20 30 5.28
---------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 30
OPTION 2: LIFE INCOME BASED ON THE LIFE OF ONE ANNUITANT
------------------------------------------------------------------------------------------------------------------------------------
Monthly Payment Amount for Each $1,000*
Rates for a Fixed Annuity with 3% Guaranteed Interest Rate
------------------------------------------------------------------------------------------------------------------------------------
Option 2(a): Option 2(b): Option 2(b): Option 2(b): Option 2(b): Option 2(c):
payments for payments payments payments payments Cash Refund
Adjusted life guaranteed guaranteed guaranteed guaranteed
Age of 5 years 10 years 15 years 20 years
Annuitant ------------------------------------------------------------------------------------------------------------------------
Male Female Male Female Male Female Male Female Male Female Male Female
------------------------------------------------------------------------------------------------------------------------------------
50 $4.27 $3.90 $4.26 $3.90 $4.22 $3.89 $4.17 $3.86 $4.08 $3.82 $4.04 $3.78
51 4.34 3.97 4.33 3.96 4.30 3.95 4.23 3.92 4.14 3.88 4.10 3.84
52 4.43 4.03 4.41 4.03 4.37 4.01 4.30 3.98 4.20 3.93 4.16 3.89
53 4.51 4.10 4.50 4.10 4.45 4.08 4.37 4.04 4.26 3.99 4.23 3.95
54 4.60 4.18 4.59 4.17 4.54 4.15 4.45 4.11 4.32 4.04 4.29 4.01
55 4.70 4.25 4.68 4.25 4.62 4.22 4.53 4.18 4.39 4.11 4.37 4.07
56 4.80 4.34 4.78 4.33 4.72 4.30 4.61 4.25 4.45 4.17 4.44 4.13
57 4.91 4.42 4.89 4.41 4.82 4.38 4.69 4.32 4.51 4.23 4.52 4.20
58 5.03 4.52 5.00 4.51 4.92 4.47 4.78 4.40 4.58 4.30 4.61 4.28
59 5.15 4.61 5.12 4.60 5.03 4.56 4.87 4.48 4.65 4.37 4.69 4.35
60 5.28 4.72 5.25 4.70 5.14 4.66 4.96 4.57 4.71 4.44 4.78 4.43
61 5.43 4.83 5.39 4.81 5.27 4.76 5.06 4.66 4.78 4.51 4.88 4.52
62 5.58 4.95 5.53 4.93 5.39 4.87 5.16 4.75 4.84 4.58 4.98 4.60
63 5.74 5.08 5.69 5.05 5.53 4.98 5.26 4.85 4.90 4.65 5.09 4.70
64 5.91 5.21 5.85 5.18 5.66 5.10 5.36 4.95 4.96 4.72 5.20 4.80
65 6.10 5.36 6.03 5.32 5.81 5.22 5.46 5.05 5.02 4.79 5.31 4.90
66 6.30 5.51 6.21 5.47 5.96 5.36 5.56 5.16 5.08 4.86 5.44 5.01
67 6.51 5.67 6.41 5.63 6.12 5.50 5.66 5.26 5.13 4.93 5.56 5.12
68 6.73 5.85 6.62 5.80 6.28 5.65 5.77 5.37 5.18 5.00 5.70 5.24
69 6.97 6.04 6.84 5.98 6.44 5.80 5.86 5.49 5.23 5.06 5.84 5.37
70 7.23 6.25 7.07 6.18 6.61 5.97 5.96 5.60 5.27 5.12 5.98 5.51
71 7.51 6.47 7.32 6.39 6.79 6.14 6.05 5.71 5.31 5.18 6.14 5.65
72 7.80 6.71 7.58 6.62 6.96 6.32 6.14 5.83 5.34 5.23 6.30 5.80
73 8.12 6.98 7.85 6.86 7.14 6.50 6.23 5.94 5.37 5.28 6.47 5.96
74 8.46 7.26 8.14 7.12 7.32 6.69 6.31 6.04 5.40 5.32 6.65 6.13
75 8.82 7.57 8.45 7.40 7.50 6.89 6.38 6.14 5.42 5.35 6.83 6.31
------------------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 31
OPTION 2: LIFE INCOME BASED ON THE LIFE OF ONE ANNUITANT
-------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 3.5% AIR
-------------------------------------------------------------------------------------------------------------------
Option 2(a): Option 2(b): Option 2(b): Option 2(b): Option 2(b):
payments for payments payments payments payments
Adjusted life guaranteed guaranteed guaranteed guaranteed
Age of 5 years 10 years 15 years 20 years
Annuitant ----------------------------------------------------------------------------------------------------
Male Female Male Female Male Female Male Female Male Female
-------------------------------------------------------------------------------------------------------------------
50 $4.56 $4.20 $4.55 $4.19 $4.51 $4.18 $4.45 $4.15 $4.36 $4.11
51 4.64 4.26 4.62 4.25 4.58 4.24 4.51 4.21 4.42 4.16
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.48 4.21
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.32 4.53 4.27
54 4.89 4.46 4.87 4.46 4.82 4.43 4.73 4.39 4.59 4.32
55 4.99 4.54 4.97 4.53 4.91 4.50 4.80 4.46 4.65 4.38
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.72 4.44
57 5.20 4.71 5.17 4.70 5.10 4.66 4.96 4.60 4.78 4.50
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.84 4.57
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 4.91 4.63
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 4.97 4.70
61 5.71 5.11 5.67 5.09 5.54 5.03 5.32 4.93 5.03 4.77
62 5.86 5.23 5.81 5.21 5.66 5.14 5.42 5.02 5.09 4.84
63 6.02 5.36 5.97 5.33 5.79 5.25 5.51 5.11 5.16 4.91
64 6.20 5.49 6.13 5.46 5.93 5.37 5.61 5.21 5.21 4.98
65 6.38 5.64 6.31 5.60 6.07 5.49 5.71 5.31 5.27 5.05
66 6.58 5.79 6.49 5.75 6.22 5.63 5.81 5.41 5.32 5.12
67 6.79 5.95 6.69 5.91 6.38 5.76 5.91 5.52 5.38 5.18
68 7.02 6.13 6.89 6.08 6.53 5.91 6.01 5.63 5.42 5.25
69 7.26 6.32 7.11 6.26 6.70 6.06 6.11 5.74 5.47 5.31
70 7.52 6.53 7.35 6.45 6.86 6.23 6.20 5.85 5.51 5.37
71 7.80 6.75 7.59 6.66 7.03 6.39 6.29 5.96 5.54 5.42
72 8.09 6.99 7.85 6.89 7.21 6.57 6.38 6.07 5.57 5.47
73 8.41 7.26 8.12 7.13 7.38 6.75 6.46 6.17 5.60 5.51
74 8.75 7.54 8.41 7.39 7.55 6.94 6.53 6.28 5.63 5.55
75 9.12 7.85 8.71 7.66 7.73 7.13 6.61 6.38 5.65 5.59
-------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 32
OPTION 2: LIFE INCOME BASED ON THE LIFE OF ONE ANNUITANT
-------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 5% AIR
-------------------------------------------------------------------------------------------------------------------
Option 2(a): Option 2(b): Option 2(b): Option 2(b): Option 2(b):
payments for payments payments payments payments
Adjusted life guaranteed guaranteed guaranteed guaranteed
Age of 5 years 10 years 15 years 20 years
Annuitant ----------------------------------------------------------------------------------------------------
Male Female Male Female Male Female Male Female Male Female
-------------------------------------------------------------------------------------------------------------------
50 $5.48 $5.12 $5.46 $5.11 $5.41 $5.09 $5.34 $5.06 $5.24 $5.01
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.29 5.05
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.34 5.10
53 5.71 5.30 5.69 5.29 5.62 5.26 5.53 5.22 5.40 5.15
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.27 5.45 5.20
55 5.89 5.44 5.86 5.43 5.79 5.39 5.67 5.34 5.51 5.25
56 5.99 5.52 5.96 5.51 5.87 5.47 5.74 5.40 5.56 5.31
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.62 5.37
58 6.21 5.69 6.17 5.67 6.06 5.62 5.90 5.54 5.68 5.42
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.61 5.74 5.48
60 6.46 5.89 6.41 5.87 6.28 5.80 6.06 5.69 5.79 5.55
61 6.60 6.00 6.55 5.97 6.39 5.90 6.15 5.77 5.85 5.61
62 6.75 6.11 6.69 6.08 6.51 6.00 6.24 5.86 5.91 5.67
63 6.91 6.23 6.84 6.20 6.64 6.10 6.33 5.95 5.96 5.73
64 7.09 6.37 7.00 6.33 6.77 6.22 6.42 6.04 6.02 5.80
65 7.27 6.51 7.18 6.46 6.91 6.34 6.52 6.13 6.07 5.86
66 7.47 6.66 7.36 6.61 7.05 6.46 6.61 6.23 6.12 5.92
67 7.68 6.82 7.55 6.76 7.20 6.60 6.70 6.33 6.16 5.99
68 7.91 7.00 7.76 6.93 7.35 6.74 6.80 6.43 6.21 6.04
69 8.15 7.19 7.98 7.11 7.51 6.89 6.89 6.54 6.25 6.10
70 8.41 7.39 8.21 7.30 7.67 7.04 6.97 6.64 6.28 6.15
71 8.69 7.62 8.45 7.51 7.83 7.21 7.06 6.74 6.32 6.20
72 8.99 7.86 8.70 7.73 8.00 7.38 7.14 6.85 6.35 6.25
73 9.31 8.12 8.97 7.97 8.16 7.55 7.21 6.95 6.37 6.29
74 9.65 8.41 9.26 8.23 8.33 7.73 7.29 7.04 6.39 6.33
75 10.02 8.72 9.55 8.50 8.50 7.92 7.35 7.14 6.41 6.36
-------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 33
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
------------------------------------------------------------------------------------------------------------------------------------
Monthly Payment Amount for Each $1,000*
Rates for a Fixed Annuity with 3% Guaranteed Interest Rate
Primary Annuitant is Female and Secondary Annuitant is Male
------------------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
------------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e) Option 3(f)
------------------------------------------------------------------------------------------------------------------------------------
55 50 $3.75 $4.07 $4.26 $3.75 $3.98 $3.72
55 55 3.88 4.25 4.47 3.87 4.06 3.85
55 60 3.99 4.44 4.71 3.98 4.12 3.94
60 55 4.06 4.47 4.71 4.06 4.37 4.02
60 60 4.24 4.71 4.99 4.23 4.47 4.17
60 65 4.38 4.97 5.32 4.38 4.54 4.29
65 60 4.49 5.01 5.32 4.48 4.89 4.39
65 65 4.72 5.33 5.70 4.71 5.02 4.59
65 70 4.93 5.68 6.15 4.91 5.14 4.74
70 65 5.07 5.75 6.17 5.05 5.60 4.87
70 70 5.40 6.21 6.70 5.36 5.79 5.13
70 75 5.69 6.68 7.32 5.62 5.96 5.29
75 70 5.89 6.82 7.40 5.81 6.63 5.48
75 75 6.37 7.45 8.15 6.23 6.92 5.78
75 80 6.78 8.11 8.99 6.54 7.15 5.93
------------------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 34
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
--------------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 3.5% AIR
Primary Annuitant Is Female and Secondary Annuitant Is Male
--------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
----------------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e)
--------------------------------------------------------------------------------------------------------------------------
55 50 $4.03 $4.36 $4.55 $4.03 $4.27
55 55 4.16 4.54 4.76 4.15 4.34
55 60 4.27 4.73 5.00 4.26 4.40
60 55 4.34 4.76 5.00 4.34 4.65
60 60 4.51 4.99 5.27 4.50 4.74
60 65 4.66 5.25 5.61 4.65 4.82
65 60 4.76 5.29 5.60 4.75 5.16
65 65 4.99 5.61 5.99 4.98 5.30
65 70 5.19 5.97 6.44 5.17 5.41
70 65 5.34 6.03 6.46 5.31 5.88
70 70 5.67 6.49 6.99 5.62 6.07
70 75 5.95 6.96 7.61 5.87 6.23
75 70 6.16 7.10 7.68 6.07 6.90
75 75 6.64 7.73 8.43 6.48 7.19
75 80 7.04 8.39 9.29 6.79 7.42
--------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 35
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
--------------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 5% AIR
Primary Annuitant is Female and Secondary Annuitant is Male
--------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
----------------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e)
--------------------------------------------------------------------------------------------------------------------------
55 50 $4.93 $5.27 $5.46 $4.93 $5.17
55 55 5.04 5.44 5.66 5.04 5.23
55 60 5.15 5.63 5.91 5.14 5.29
60 55 5.21 5.65 5.89 5.21 5.53
60 60 5.37 5.87 6.16 5.37 5.62
60 65 5.52 6.14 6.51 5.51 5.70
65 60 5.61 6.16 6.49 5.60 6.03
65 65 5.83 6.49 6.87 5.82 6.15
65 70 6.04 6.84 7.34 6.00 6.27
70 65 6.17 6.90 7.33 6.13 6.73
70 70 6.49 7.35 7.87 6.44 6.91
70 75 6.77 7.84 8.51 6.68 7.07
75 70 6.97 7.96 8.56 6.87 7.75
75 75 7.45 8.60 9.33 7.27 8.04
75 80 7.86 9.28 10.20 7.57 8.27
--------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 36
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
--------------------------------------------------------------------------------------------------------------------------------
Monthly Payment Amount for Each $1,000*
Rates for a Fixed Annuity with 3% Guaranteed Interest Rate
Primary Annuitant is Male and Secondary Annuitant is Female
--------------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
-----------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e) Option 3(f)
--------------------------------------------------------------------------------------------------------------------------------
55 50 $3.69 $4.05 $4.27 $3.69 $4.13 $3.67
55 55 3.88 4.25 4.47 3.87 4.25 3.85
55 60 4.06 4.47 4.71 4.06 4.36 4.02
60 55 3.99 4.44 4.71 3.98 4.55 3.94
60 60 4.24 4.71 4.99 4.23 4.70 4.17
60 65 4.49 5.01 5.32 4.48 4.85 4.39
65 60 4.38 4.97 5.32 4.38 5.10 4.29
65 65 4.72 5.33 5.70 4.71 5.32 4.59
65 70 5.07 5.75 6.17 5.05 5.54 4.87
70 65 4.93 5.68 6.15 4.91 5.86 4.74
70 70 5.40 6.21 6.70 5.36 6.18 5.13
70 75 5.89 6.82 7.40 5.81 6.49 5.48
75 70 5.69 6.68 7.32 5.62 6.92 5.29
75 75 6.37 7.45 8.15 6.23 7.40 5.78
75 80 7.07 8.34 9.16 6.78 7.85 6.17
--------------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 37
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
--------------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 3.5% AIR
Primary Annuitant is Male and Secondary Annuitant is Female
--------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
----------------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e)
--------------------------------------------------------------------------------------------------------------------------
55 50 $3.97 $4.35 $4.56 $3.97 $4.42
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.34 4.76 5.00 4.34 4.64
60 55 4.27 4.73 5.00 4.26 4.83
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.76 5.29 5.60 4.75 5.13
65 60 4.66 5.25 5.61 4.65 5.39
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.34 6.03 6.46 5.31 5.81
70 65 5.19 5.97 6.44 5.17 6.14
70 70 5.67 6.49 6.99 5.62 6.47
70 75 6.16 7.10 7.68 6.07 6.77
75 70 5.95 6.96 7.61 5.87 7.20
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.33 8.62 9.45 7.02 8.13
--------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 38
OPTION 3: LIFE INCOME BASED ON THE LIVES OF TWO ANNUITANTS
--------------------------------------------------------------------------------------------------------------------------
First Monthly Payment Amount for Each $1,000*
Rates for a Variable Annuity with 5% AIR
Primary Annuitant Is Male and Secondary Annuitant is Female
--------------------------------------------------------------------------------------------------------------------------
Adjusted Ages
----------------------------------
payments
guaranteed
Primary Secondary 10 years
Annuitant Annuitant Option 3(a) Option 3(b) Option 3(c) Option 3(d) Option 3(e)
--------------------------------------------------------------------------------------------------------------------------
55 50 $4.88 $5.26 $5.48 $4.88 $5.34
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.21 5.65 5.89 5.21 5.53
60 55 5.15 5.63 5.91 5.14 5.73
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.61 6.16 6.49 5.60 6.01
65 60 5.52 6.14 6.51 5.51 6.28
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.17 6.90 7.33 6.13 6.67
70 65 6.04 6.84 7.34 6.00 7.03
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.97 7.96 8.56 6.87 7.62
75 70 6.77 7.84 8.51 6.68 8.08
75 75 7.45 8.60 9.33 7.27 8.55
75 80 8.14 9.49 10.35 7.80 8.98
--------------------------------------------------------------------------------------------------------------------------
* Net of any applicable premium tax deduction
GA-MA-1080 Page 39
--------------------------------------------------------------------------------
GROUP FLEXIBLE PREMIUM DEFERRED COMBINATION VARIABLE
AND FIXED ANNUITY MASTER CONTRACT
NONPARTICIPATING
--------------------------------------------------------------------------------
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. AMOUNTS ALLOCATED TO THE FIXED ACCOUNT, IF WITHDRAWN BEFORE
THE GUARANTEED TERM MATURITY DATE, MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT.
THE MARKET VALUE ADJUSTMENT MAY RESULT IN AN INCREASE OR A DECREASE IN THE
ACCOUNT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A
GUARANTEED TERM AT THE TIME OF ITS MATURITY.
GA-MA-1080