|||GOLDEN DEFERRED
||||AMERICAN COMBINATION
|||||LIFE INSURANCE VARIABLE AND
||||COMPANY FIXED ANNUITY
GROUP MASTER
CONTRACT
Golden American is a stock company domiciled in Wilmington, Delaware.
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Offices: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇▇▇ 19380
CONTRACTHOLDER: [Golden Investor Trust, Inc.] GROUP CONTRACT NUMBER:[12345]
ISSUED IN: [Delaware] CONTRACT ISSUE DATE:[January 1, 1996]
In this Contract, we, our and us refer to the Golden American Life
Insurance Company.
In consideration of application for this Contract and the payment of
premiums, we agree, subject to the terms and conditions of this Contract,
to provide the benefits described in this Contract to the persons eligible
(herein called "Annuitant[s]") under the terms of this Contract.
If this Contract is in force, we will make income payments to the
Certificate Owner starting on the Annuity Commencement Date shown in each
Certificate. If the Certificate Owner or the Annuitant (if the Owner is
other than a natural person) dies prior to the Annuity Commencement Date
shown in each Certificate, we will pay a death benefit to the Beneficiary.
The amounts of such benefits are subject to the terms of this Contract.
All death proceeds due under this Contract will be paid according to the
Beneficiary designation and the provisions of this Contract. Payment of
such death proceeds by us will completely discharge our liability with
respect to the amounts so paid.
All provisions set forth on the following pages are a part of this
Contract.
Signed for Golden American Life Insurance Company on the Contract Issue
Date.
President: /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Secretary: /s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇
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DEFERRED COMBINATION VARIABLE AND FIXED ANNUITY GROUP MASTER
CONTRACT - NO DIVIDENDS
Variable Cash Surrender Values while a Certificate Owner is living and
prior to the Annuity Commencement Date. Death benefit subject to
guaranteed minimum. Additional premium payment option. Partial Withdrawal
Option. Non-participating. Investment results reflected in values.
GA-MA-1082 1
TABLE OF CONTENTS
The contents of this Contract appear in the following order:
SCHEDULE...................................................4
Premium Payment and Investment Information
General Account
Contract Facts
Charges
Income Plan Factors
IMPORTANT TERMS............................................9
INTRODUCTION TO THE CONTRACT...............................11
Eligibility
The Certificate Owner
The Annuitant
The Beneficiary
Change of Certificate Owner or Beneficiary
PREMIUM PAYMENTS AND ALLOCATION CHANGES....................12
Initial Premium Payment
Additional Premium Payment Option
Reallocation of Accumulation Value
What Happens if a Variable Separate Account Division is Not Available
Restricted Funds
Thresholds
Dollar Cap
Premium Threshold
Allocation Threshold
Thresholds - Effect on Withdrawals
Threshold Processing
HOW WE MEASURE THE ACCUMULATION VALUE......................15
The Variable Separate Accounts
The General Account
Valuation Period
Accumulation Value
Accumulation Value in Each Division and Fixed Allocation
Fixed Account Guarantee Periods
Market Value Adjustments
Measurement of Investment Experience
Charges Deducted From Accumulation Value for Each Processing Period
THE CERTIFICATE OWNER'S BENEFITS...........................20
Cash Value Benefit
Partial Withdrawal Option
DEATH BENEFIT PROCEEDS.....................................21
Proceeds Payable to the Beneficiary
GA-MA-1082 2
CHOOSING AN INCOME PLAN....................................22
Annuity Benefits
Annuity Commencement Date Selection
Frequency Selection
The Income Plan
The Annuity Options
Payment When Named Person Dies
GENERAL PROVISIONS.........................................24
Entire Contract
Sending Notice to Us
Reports to Certificate Owner
Assignment
Changing the Contract
Contract Changes - Applicable Tax
Law Misstatement of Age or Sex
Non-Participating
Payments We May Defer
Authority to Make Agreements
Computations
Facility of Payment
Incontestability
Certificates
Conformity With Law
Records
Certificate Owner's Right to Examine the Certificate
GA-MA-1082 3
The Schedule
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PREMIUM PAYMENT AND INVESTMENT INFORMATION
Investment
Initial Premium [Minimum $10,000.]
Accumulation Value As shown in each Certificate.
Additional Premium Payment
Minimum payment: Qualified plan $[250]
Non-qualified plan $[500]
Maximum Attained Age of Annuitants and
Certificate Owners [86]
Allocations
Maximum Divisions at any one time [twenty]
Allocation changes per Certificate Year
without charge [Twelve]
Excess allocation charge $[0]
THE VARIABLE SEPARATE ACCOUNT
Divisions Investing in Shares of Mutual Funds
Separate Account B is a unit investment trust separate account, organized
in and governed by the laws of the State of Delaware, our state of
domicile. Separate Account B is divided into Divisions. Each Division
listed below invests in shares of the mutual fund portfolio (the "Series")
designated. Each portfolio is a part of The GCG Trust managed by Directed
Services, Inc.
SERIES ............. SERIES SERIES
-------------------- ----------------------- -------------------
[All Cap ........... Capital Growth Liquid Asset
Equity Income ...... Managed Global Strategic Equity
Fully Managed ...... Asset Allocation Growth Research
Value Equity ....... Diversified Mid-Cap Growth
Small Cap .......... Investors Global Fixed Income
Capital Appreciation Large Cap Value Developing World
Rising Dividends ... Real Estate Equity Income
Mid-Cap Growth ..... Hard Assets Growth and Income
Total Return ....... Limited Maturity Bond Special Situations
The Division listed below invests in shares of the mutual fund portfolio
(the "Portfolio") designated. The portfolio is a part of the ING Variable
Insurance Trust managed by ING Investment Management.
PORTFOLIO
---------
ING Global Brand Names Fund
The Division listed below invests in shares of the mutual fund portfolio
(the "Portfolio") designated. The portfolios are a part of the Prudential
Series Fund, Inc. managed by ▇▇▇▇▇▇▇▇ Associates, LLC.
PORTFOLIO
---------
Prudential ▇▇▇▇▇▇▇▇
The Division listed below invests in shares of the mutual fund portfolio
(the "Portfolio") designated. The portfolio is a part of the Warburg Pincus
Trust managed by Credit Suisse Asset Management, LLC.
PORTFOLIO
---------
International Equity
International Growth
The Division listed below invests in shares of the mutual fund portfolio
(the "Portfolio") designated. The portfolios are a part of the PIMCO Trust
managed by Pacific Investment Management Company.
PORTFOLIO
---------
PIMCO High Yield Bond
PIMCO StocksPlus Growth & Income]
NOTE: PLEASE REFER TO THE PROSPECTUSES FOR THIS CONTRACT AND
THE GCG TRUST FOR MORE DETAILS.
GA-MA-1082 4
The Schedule (continued)
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GENERAL ACCOUNT
[Guaranteed Interest Division
A Guaranteed Interest Division provides an annual minimum interest rate of
3%. At our sole discretion, we may periodically declare higher interest
rates. Such rates will apply to periods following the date of declaration.
Any declaration will be by class and will be based on our future
expectations.
Limitations on Allocations
We reserve the right to restrict allocations into and out of the General
Account. Such limits may be dollar restrictions on allocations into the
General Account or we may restrict reallocations into the General Account.
Transfers from a Guaranteed Interest Division
We currently require that an amount allocated to a Guarantee Period not be
transferred until the Maturity Date, except pursuant to our published
rules. We reserve the right not to allow amounts previously transferred
from a Guaranteed Interest Division to the Variable Separate Account
Divisions or to a Fixed Allocation to be transferred back to a Guaranteed
Interest Division for a period of at least six months from the date of
transfer.
Systematic Withdrawals
Up to the interest earned in the prior month, quarter or year may be
withdrawn without Surrender Charge adjustment, depending upon whether you
have chosen a monthly, quarterly or annual frequency, respectively.]
GA-MA-1082 5
The Schedule (continued)
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CONTRACT FACTS
Processing Dates As shown in each Certificate.
Specially Designated Division [Liquid Asset Division.]
Annuity Commencement Date As shown in each Certificate.
Required Date of Annuity Commencement As shown in each Certificate.
Death Benefits As shown in each Certificate.
Minimum Annuity Income Payment As shown in each Certificate.
Optional Benefit Riders None.
Partial Withdrawals
The minimum withdrawal amount which may be taken is shown in each
Certificate.The maximum amount that can be taken as a Conventional Partial
Withdrawal each Certificate Year without being considered an Excess Partial
Withdrawal is shown in each ▇▇▇▇▇▇▇▇▇▇▇.▇▇ no event may a Partial
Withdrawal be greater than 90% of the Cash Surrender Value. After a Partial
Withdrawal, the remaining Accumulation Value must be at least $100 to keep
a Certificate in force.
Systematic Partial Withdrawals and Conventional Partial Withdrawals may not
be taken in the same Certificate Year.
Conventional Partial Withdrawals
The minimum withdrawal amount which may be taken is shown in each
Certificate.The maximum amount that can be taken as a Conventional Partial
Withdrawal each Certificate Year without being considered an Excess Partial
Withdrawal is shown in each Certificate.
Any Conventional Partial Withdrawal is subject to a Market Value Adjustment
unless withdrawn from a Fixed Allocation within 30 days prior to the
Maturity Date.
Systematic Partial Withdrawals
Systematic Partial Withdrawals may be elected to commence after 28 days
from the Certificate Issue Date. Systematic Partial Withdrawals may be
taken on a monthly, quarterly or annual basis. The maximum withdrawal
amount which may be taken is shown in each Certificate. Systematic Partial
Withdrawals from Fixed Allocations are not subject to a Market Value
Adjustment. We may collect a Surrender Charge for Excess Partial
Withdrawals.
IRA Partial Withdrawals for Qualified Certificates Only
IRA Partial Withdrawals may be taken on a monthly, quarterly or annual
basis, as long as the minimum of $100 is met.
GA-MA-1082 6
The Schedule (continued)
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Fixed Account
Minimum Fixed Allocation As shown in each Certificate.
Guaranteed Minimum Interest Rate As shown in each Certificate.
Guarantee Periods: We currently offer Guarantee Periods of [1, 3, 5, 7, and
10] years. We reserve the right to offer Guarantee Periods of durations
other than those available on the Contract Issue Date. We also reserve the
right to cease offering a particular Guarantee Period or Periods.
Index Rate
The Index Rate is the average of the Ask Yields for U.S. Treasury Strips as
reported by a national quoting service for the applicable maturity. The
average is based on the period from the 22nd day of the calendar month two
months prior to the calendar month of Index Rate determination to the 21st
day of the calendar month immediately prior to the month of determination.
The applicable maturity date for these U.S. Treasury Strips is on or next
following the last day of the Guarantee Period. If these Ask Yields are no
longer available, the Index Rate will be determined using a suitable
replacement method.
We currently set the Index Rate once each calendar month. However, we
reserve the right to set the Index Rate more frequently than monthly, but
in no event will such Index Rate be based on a period of less than 28 days.
CHARGES
Charge Deduction Division [Liquid Asset Division.]
EXPENSE CHARGES
Deduction from Premium Payments None.
Deductions from Accumulation Value
Initial Administrative Charge None.
Administrative Charge $30 per Certificate
Processing Period. The
charge is incurred at
the beginning of the
Certificate
Processing Period
and deducted on
the Certificate
Processing Date at
the end of each
Certificate
Processing Period.
Excess Allocation Charge $25 - Covers the cost of allocations
in excess of the twelve free
allocation changes allowed per
year. This charge may be imposed
at the time each additional
allocation is processed. The charge,
unless the Certificate Owner
specifies otherwise, will be
deducted in proportion to the
amount being transferred from each
Division and Fixed Allocation.
Surrender Charges As shown in the Certificate.
GA-MA-1082 7
The Schedule (continued)
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Premium Taxes We deduct from the Accumulation Value the amount of
any premium or other state and local taxes levied by
any state or governmental entity when such taxes are
incurred. We reserve the right to change the amount
of the deduction to conform with changes in the law
or if the Certificate Owner changes state of
residence. If the charge for premium taxes is
incurred when premiums are received, we advance the
amount of the charge to the Accumulation Value and
deduct it in equal installments on each Certificate
Processing Date. Currently, we will waive the
deduction of the applicable installment on each
Certificate Processing Date. However, we deduct the
applicable unrecovered portion of the charge for
premium taxes (not including installments which were
waived) when determining the Cash Surrender Value
payable if the Certificate is surrendered.
Deductions from
the Divisions
Mortality and
Expense Risk Charge As shown in each Certificate.
Asset Based
Administrative
Charge As shown in each Certificate.
INCOME PLAN FACTORS
These factors are
shown in each
Certificate.
GA-MA-1082 8
Important Terms
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ACCUMULATION VALUE - The amount that a Certificate provides for investment
at any time. Initially, this amount is equal to the premium paid.
ANNUITANT- The person designated by the Certificate Owner to be the
measuring life in determining annuity payments.
ANNUITY COMMENCEMENT DATE - For each Certificate, the date on which annuity
payments begin.
ANNUITY OPTIONS - Options the Certificate Owner selects that determine the
form and amount of Annuity Payments.
ANNUITY PAYMENT - The periodic payment a Certificate Owner receives. It
may be either a fixed or a variable amount based on the annuity
option chosen.
ATTAINED AGE - The issue age of the annuitant or certificate Owner plus the
number of full years elapsed since the certificate date.
BENEFICIARY - The person designated to receive benefits in the case of the
death of the Certificate Owner.
BUSINESS DAY - Any day the New York Stock Exchange ("NYSE") is open for
trading exclusive of federal holidays, or any day on which the
Securities and Exchange Commission ("SEC") requires that mutual
funds, unit investment trusts or other investment portfolios be
valued.
CASH SURRENDER VALUE - The amount the Certificate Owner receives upon
surrender of the Certificate.
CERTIFICATE - This is a summary of the benefits and provisions provided by
this Contract.
CERTIFICATE ANNIVERSARY - The anniversary of the certificate date.
CERTIFICATE DATE - The date we receive the Initial Premium upon which we
begin determining the Certificate values. It may or may not be the
same as the certificate issue date. This date is used to determine
Certificate months, processing dates, years, and anniversaries.
CERTIFICATE ISSUE DATE - The date the Certificate is issued at our Customer
Service Center.
CERTIFICATE PROCESSING DATES - The days when we deduct certain charges from
the accumulation value. If the Certificate Processing Date is not
a Valuation Date, it will be on the next succeeding Valuation
Date. The Certificate Processing Date will be on the Certificate
Anniversary of each year.
CERTIFICATE PROCESSING PERIOD - The period between successive certificate
processing dates unless it is the first certificate processing
period. In that case, it is the period from the certificate date
to the first certificate processing date.
CERTIFICATE YEAR - The period between certificate anniversaries.
CERTIFICATE OWNER - The person who owns a Certificate and is entitled to
exercise all rights of the Certificate. This person's death also
initiates payment of the death benefit.
CHARGE DEDUCTION DIVISION - The Division from which all charges are
deducted if so designated on the enrollment form or later elected
by the Certificate Owner.
CONTINGENT ANNUITANT - The person designated by the certificate Owner who,
upon the annuitant's death prior to the annuity commencement date,
becomes the annuitant.
GA-MA-1082 9
Important Terms (continued)
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CONTRACT ISSUE DATE - The date this Contract is issued at our Customer
Service Center.
CONTRACTHOLDER - The entity to whom this Contract is issued.
EXPERIENCE FACTOR - The factor which reflects the investment experience of
the portfolio in which a Variable Separate Account Division
invests and also reflects the charges assessed against the
Division for a valuation period.
FIXED ACCOUNT - This is the Separate Account established to support Fixed
Allocations.
FIXED ALLOCATION - An amount allocated to the Fixed Account that is
credited with a Guaranteed Interest Rate for a specified Guarantee
Period.
GENERAL ACCOUNT - The account which contains all of our assets other than
those held in our separate accounts.
GUARANTEEPERIOD - The period of years a rate of interest is guaranteed to
be credited to a fixed allocation or allocations to a Guaranteed
Interest Division.
GUARANTEED INTEREST DIVISION - An investment option available in the
General Account.
GUARANTEED INTEREST RATE - The effective annual interest rate which we will
credit for a specified Guarantee Period.
GUARANTEED MINIMUM INTEREST RATE - The minimum interest rate which can be
declared by us for Fixed Allocations or allocations to a
Guaranteed Interest Division.
INDEX OF INVESTMENT EXPERIENCE - The index that measures the performance
of a Variable Separate Account Division.
INITIAL PREMIUM - The payment amount required to put each Certificate in
effect.
ISSUE AGE - The annuitant's or Certificate Owner's age on the last birthday
on or before the certificate date.
MARKET VALUE ADJUSTMENT - A positive or negative adjustment to Fixed
Allocation. It may apply if all or part of a Fixed Allocation is
withdrawn, transferred, or applied to an Annuity Option prior to
the end of the Guarantee Period.
MATURITY DATE - The date on which a Guarantee Period matures.
RIDERS - Riders add provisions or change the terms of the Certificate.
SPECIALLYDESIGNATED DIVISION - Distributions from a portfolio underlying a
Division in which reinvestment is not available will be allocated
to this Division unless the Certificate Owner specifies otherwise.
VALUATION DATE - The day at the end of a valuation period when each
Division is valued.
VALUATION PERIOD - Each business day together with any non-Business Days
before it.
VARIABLE SEPARATE ACCOUNT DIVISION - An investment option available in the
Variable Separate Account shown in the Certificate Schedule.
GA-MA-1082 10
Introduction to the Contract
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ELIGIBILITY
Eligible persons as stated in the application for this Contract and who
have enrolled and for whom the Initial Premium has been paid are eligible
to receive the benefits under this Contract.
THE CERTIFICATE OWNER
The Certificate Owner is also the Annuitant unless another Annuitant
has been named and is shown in the Certificate. The Certificate Owner has
the rights and options described in this Contract.
One or more people may own a Certificate. If there are multiple
Certificate Owners named, the age of the oldest Certificate Owner will be
used to determine the applicable death benefit. In the case of a sole
certificate Owner who dies prior to the annuity commencement date, we will
pay the Beneficiary the death benefit then due. If the sole certificate
Owner is not an individual, we will treat the annuitant as the certificate
Owner for purposes of determining when the certificate Owner dies under the
death benefit provision (if there is no Contingent Annuitant), and the
Annuitant's Issue Age will determine the applicable death benefit payable
to the Beneficiary. The sole certificate Owner's estate will be the
beneficiary if no beneficiary designation is in effect, or if the sole
designated beneficiary has predeceased the certificate Owner. In the case
of a joint certificate Owner dying prior to the annuity commencement date,
the surviving certificate Owner(s) will be deemed the beneficiary(ies).
THE ANNUITANT
The Annuitant is the measuring life of the annuity benefits provided under
a Certificate. The annuitant may not be changed during the annuitant's
lifetime. The Certificate Owner may name a contingent annuitant. The
contingent annuitant becomes the annuitant if the annuitant dies while a
Certificate is in effect prior to the Annuity Commencement Date. The
Certificate Owner will be the contingent annuitant unless the Certificate
Owner names someone else. The annuitant must be a natural person. If the
annuitant dies and no contingent annuitant has been named, we will allow
the Certificate Owner sixty days to designate someone else as annuitant. If
all Certificate Owners are not individuals and, through operation of this
provision, a Certificate Owner becomes the Annuitant, we will pay the death
benefit proceeds to the Beneficiary. If there are joint Certificate Owners,
we will treat the youngest of the Certificate Owners as the Contingent
Annuitant designated, unless elected otherwise.
THE BENEFICIARY
The beneficiary is the person to whom we pay death proceeds if the
certificate Owner dies prior to the annuity commencement date. See Death
Benefit Proceeds for more information. We pay death proceeds to the primary
beneficiary (unless there are joint Certificate Owners in which case the
death benefit proceeds are payable to the surviving Certificate Owners). If
the primary beneficiary dies before the certificate Owner, the death
proceeds are paid to the contingent beneficiary, if any. If there is no
surviving beneficiary, we pay the death proceeds to the certificate Owner's
estate.
One or more persons may be named as primary beneficiary or contingent
Beneficiary. In the case of more than one beneficiary, we will assume any
death proceeds are to be paid in equal shares to the surviving
beneficiaries. Other than equal shares may be specified by the Certificate
Owner.
The Certificate Owner has the right to change beneficiaries during the
Certificate Owner's lifetime, unless the primary beneficiary is designated
irrevocable. When an irrevocable Beneficiary has been designated, the
Certificate Owner and the irrevocable Beneficiary may have to act together
to exercise the rights and options under a Certificate.
CHANGE OF CERTIFICATE OWNER OR BENEFICIARY
During the Certificate Owner's lifetime and while a Certificate is in
effect under this Contract, the Certificate Owner can transfer ownership of
a Certificate or change the beneficiary. To make any of these changes, we
require written notice of the change in a form satisfactory to us. The
change will take effect as of the day the notice is signed. The change will
not affect any payment made or action taken by us before recording the
change at our Customer Service Center. A change of certificate Owner may
affect the amount of death benefit payable under the Certificate. See
Proceeds Payable to Beneficiary.
GA-MA-1082 11
Premium Payments and Allocation Changes
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INITIAL PREMIUM PAYMENT
The Initial Premium payment is required to put a Certificate in effect. The
amount and allocation of the Initial Premium payment is shown in each
Certificate.
ADDITIONAL PREMIUM PAYMENT OPTION
Additional premium payments may be made after the Right to Examine period
ends. Satisfactory notice to us must be given for additional premium
payments. Restrictions on additional premium payments, such as the attained
age of the annuitant or certificate Owner and the timing and amount of each
payment, are shown in each Certificate. We reserve the right to defer
acceptance of or to return any additional premium payments.
As of the date we receive and accept the Certificate Owner's additional
premium payment:
(1) The accumulation value will increase by the amount of
the premium payment less any premium deductions as
shown in each Certificate.
(2) The increase in the accumulation value will be
allocated among the Divisions and the Fixed Allocations
in accordance with the Certificate Owner's
instructions. If the Certificate Owner does not provide
such instructions, allocation will be among the
Divisions and in proportion to the amount of
accumulation value in each Division as of the date we
receive and accept the additional premium payment.
Allocations to the Fixed Account will be made only upon
specific written request.
Where to Make Payments
Additional premium payments are to be sent to our Customer Service Center.
On request, a receipt signed by one of our officers will be provided.
REALLOCATION OF ACCUMULATION VALUE
The accumulation value may be reallocated among the Divisions, and the
Fixed Allocations prior to the Annuity Commencement Date. The number of
free allocation changes each certificate year that we will allow is shown
in each Certificate. To make an allocation change, we must receive
satisfactory notice at our Customer Service Center. The change will take
effect when we receive the notice. Restrictions for reallocation into and
out of the Divisions are shown in each Certificate. Some Divisions may have
restrictions on allocations. An allocation from the Fixed Allocation may be
subject to a Market Value Adjustment. See Market Value Adjustment.
WHAT HAPPENS IF A VARIABLE SEPARATE ACCOUNT DIVISION IS NOT AVAILABLE
When a distribution is made from an investment portfolio supporting a unit
investment trust Division of the Separate Account in which reinvestment is
not available, we will allocate the distribution to the Specially
Designated Division shown in each Certificate unless the Certificate Owner
specifies otherwise.
Such a distribution may occur when an investment portfolio or Division
matures, when distribution from a portfolio or Division cannot be
reinvested in the portfolio or Division due to the unavailability of
securities, or for other reasons. When this occurs because of maturity, we
will send written notice 30 days in advance of such date. To elect an
allocation to other than the Specially Designated Division shown in each
Certificate, we must receive satisfactory notice at least seven days prior
to the date the investment matures. Such allocations will not be counted as
an allocation change of the accumulation value for purposes of the number
of free allocations permitted.
GA-MA-1082 12
Premium Payments and Allocation Changes (continued)
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RESTRICTED FUNDS
Restricted Funds are subject to limits as to amounts which may be invested or
transferred into such divisions. The designation of a division as a Restricted
Fund may be changed upon 30 days notice to the Owner with regard to future
transfers and premium payments into such division. When a new division is made
available it may be designated as a Restricted Fund. If so designated, the rules
regarding its restrictions will be sent to the Owner. Also listed below are the
total Contract limits for Restricted Funds. Listed on the Schedule Page are the
total Contract limits for Restricted Funds.
THRESHOLDS
Each Restricted Fund has one or more thresholds at which point no further
amounts may be allocated to that division. Compliance with a threshold is
verified whenever there is a transaction initiated which is subject to such
threshold (premium payments, transfers, withdrawals). A threshold is applied to
the total Accumulation Value of each Restricted Fund. Thresholds may be changed
by the Company for new premiums, transfers or withdrawals by Restricted Fund
upon 30 day notice.
DOLLAR CAP
The Dollar Cap is the dollar amount at which no further Accumulation Value may
be added to Restricted Funds.
PREMIUM THRESHOLD
The threshold for premium by Restricted Fund limits the amount of any premium
which may be allocated to that division. Should a request for allocation to a
Restricted Fund exceed the limit in effect for that division or for the
Contract, any excess over that amount shall be allocated prorata to any
non-Restricted Fund(s) in which the Contract is then invested. Should the
Contract not be invested in other non-Restricted Funds, the excess will be
invested in the Specially Designated Division unless we receive written
instructions to do otherwise. Premium allocations must also satisfy the
Allocation Threshold.
ALLOCATION THRESHOLD
Allocations into a Restricted Fund are limited to that amount such that the
Accumulation Value in that Restricted Fund after such allocation does not exceed
the threshold for that division and does not cause the Contract's total limit on
allocation to Restricted Funds to be exceeded. If the amount of an allocation
would cause either limit to be exceeded, the allocation will only be executed to
the extent the lower limit would allow.
Allocations from a Restricted Fund will be allowed even if the amount remaining
in the Restricted Fund after an allocation exceeds the Allocation Threshold. If
a program of allocations over time is authorized by us, verification of the
threshold will be performed at the initiation of such program. If such program
is modified at a later date, a testing of thresholds will be done at that time.
GA-MA-1082 13
Premium Payments and Allocation Changes (continued)
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THRESHOLDS - EFFECT ON WITHDRAWALS
If a withdrawal is requested while any Accumulation Value is allocated to
Restricted Funds and the Allocation Threshold percentage is currently
exceeded, the percentage for funds invested in Restricted Funds for the
total Contract, after taking into account the withdrawal, may not be higher
than prior to the withdrawal. Should the calculated effect of a withdrawal
result in the total Contract threshold being exceeded, the excess portion
of the withdrawal will be processed prorata from all variable divisions.
Systematic withdrawals, while the Contract has investments in Restricted
Funds, if not withdrawn prorata from all divisions, shall be monitored
annually to assure threshold compliance. Should the effect of such
withdrawals cause a Restricted Fund to exceed its threshold, the divisions
from which the withdrawals are processed may be adjusted to assure that the
percentage of Accumulation Value in the Restricted Funds does not increase.
THRESHOLD PROCESSING
For the purpose of calculating any thresholds, the values for the divisions
will be determined using the prior day's closing index of investment
experience.
GA-MA-1082 14
How We Measure the Accumulation Value
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THE VARIABLE SEPARATE ACCOUNTS
These accounts, which are designated in each Certificate, are kept separate
from our General Account and any other separate accounts we may have. They
are used to support variable annuity contracts and may be used for other
purposes permitted by applicable laws and regulations. We own the assets in
the Separate Accounts. Assets equal to the reserves and other liabilities
of the accounts will not be charged with liabilities that arise from any
other business we conduct; but, we may transfer to our General Account
assets which exceed the reserves and other liabilities of the Variable
Separate Accounts. ▇▇▇▇▇▇ and realized and unrealized gains or losses from
assets in these separate accounts are credited to or charged against the
account without regard to other income, gains or losses in our other
investment accounts.
The Variable Separate Account will invest in mutual funds, unit investment
trusts and other investment portfolios which we determine to be suitable
for this Contract's purposes. This Variable Separate Account is treated as
a unit investment trust under Federal securities laws. It is registered
with the SEC under the Investment Company Act of 1940. This Variable
Separate Account is also governed by state laws as designated in each
Certificate. The trusts may offer unregistered series.
Divisions of the Variable Separate Account
A unit investment trust Variable Separate Account includes Divisions, each
investing in a designated investment portfolio. The Divisions and the
investment portfolios in which they invest, if applicable, are specified in
each Certificate. Some of the portfolios designated may be managed by a
separate investment adviser. Such adviser will be registered under the
Investment Advisers Act of 1940 if required.
Changes Within the Variable Separate Accounts
We may, from time to time, make additional Variable Separate Account
Divisions available. These Divisions will invest in investment portfolios
we find suitable for this Contract. We also have the right to eliminate
Divisions from a separate account, to combine two or more Divisions or to
substitute a new portfolio for the portfolio in which a Division invests. A
substitution may become necessary if, in our judgment, a portfolio or
Division no longer suits the purposes of this Contract. This may happen due
to a change in laws or regulations, or a change in a portfolio's investment
objectives or restrictions, or because the portfolio or Division is no
longer available for investment, or for some other reason. We may get prior
approval from the insurance department of our state of domicile before
making such a substitution. We will also get any required approval from the
SEC and any other required approvals before making such a substitution.
Subject to any required regulatory approvals, we reserve the right to
transfer assets of the Divisions of the Variable Separate Account, which we
determine to be associated with the class of Contracts to which this
Contract belongs, to another Variable Separate Account or Division.
When permitted by law, we reserve the right to:
(1) Deregister a Variable Separate Account under the
Investment Company Act of 1940;
(2) Operate a Variable Separate Account as a management
company under the Investment Company Act of 1940,
if it is operating as a unit investment trust;
(3) Operate a Variable Separate Account as a unit investment
trust under theInvestment Company Act of 1940, if it is
operating as a managed Variable Separate Account;
(4) Restrict or eliminate any voting rights of Certificate
Owners, or other persons who have voting rights as to a
Variable Separate Account; and
(5) Combine a Variable Separate Account with other Variable
Separate Accounts.
GA-MA-1082 15
How We Measure the Accumulation Value (continued)
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THE GENERAL ACCOUNT
The General Account contains all assets of the Company other than those in
the Separate Accounts we establish. The Guaranteed Interest Divisions
available for investment are shown in the Schedule. We may, from time to
time, offer other Divisions where assets are held in the General Account.
VALUATION PERIOD
Each Division and Fixed Allocation will be valued at the end of each
valuation period on a valuation date. A valuation period is each business
day together with any non-Business Days before it. A business day is any
day the NYSE is open for trading, and the SEC requires mutual funds, unit
investment trusts, or other investment portfolios to value their
securities.
ACCUMULATION VALUE
The accumulation value of a Certificate is equal to the sum of the amounts
in each Division of the Variable Separate Account and General Account and
allocations to the Fixed Account. The Certificate Owner selects how the
accumulation value is allocated. The maximum number of Divisions and Fixed
Allocations to which the Accumulation Value may be allocated at any one
time is shown in each Certificate.
ACCUMULATION VALUE IN EACH DIVISION AND FIXED ALLOCATION
On the Certificate Date
On the certificate date, the accumulation value is allocated to each
Division and the Fixed Allocations as shown in each Certificate. We reserve
the right to allocate premium to the Specially Designated Division during
any Right to Examine period. After such time, allocation will be made
proportionately in accordance with the initial allocation(s) as elected by
the Certificate Owner.
On each Valuation Date
At the end of each subsequent valuation period, the amount of accumulation
value in each Division and fixed allocation will be calculated as follows:
(1) We take the accumulation value in the Division or Fixed
Allocation at the end of the preceding Valuation
Period.
(2) We multiply (1) by the Variable Separate Account
Division's net rate of return for the current valuation
period, or we calculate the interest to be credited to
a Fixed Allocation or Guaranteed Interest Division for
the current Valuation Period.
(3) We add (1) and (2).
(4) We add to (3) any additional premium payments (less any
premium deductions as shown in each Certificate)
allocated to the Division or Fixed Allocation during
the current valuation period.
(5) We add or subtract allocations to or from that Division
or Fixed Allocation during the current valuation
period.
(6) We subtract from (5) any partial withdrawals which are
allocated to the Division or Fixed Allocation during
the current valuation period.
(7) We subtract from (6) the amounts allocated to that
Division or Fixed Allocation for:
(a) any charges due for optional benefit riders as shown in
each Certificate;
(b) any deductions from Accumulation Value as shown in each
Certificate.
All amounts in (7) are allocated to each Division or Fixed Allocation as
shown in each Certificate.
GA-MA-1082 16
How We Measure the Accumulation Value (continued)
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FIXED ACCOUNT
The Fixed Account is a Separate Account under state law and is not
required to be registered with the Securities and Exchange Commission under
the Investment Company Act of 1940. The Fixed Account includes various
Fixed Allocations which we credit with fixed rates of interest for the
Guarantee Period (or Periods) the Certificate Owner selects. We reset the
interest rates for new Fixed Allocations periodically, based on our sole
discretion.
Guarantee Periods
Each Fixed Allocation is guaranteed an interest rate or rates for a
period, a Guarantee Period. The Guaranteed Interest Rates for a fixed
allocation are effective for the entire period. The Maturity Date of a
Guarantee Period will be the last day of a calendar month in which the
Guarantee Period ends. Withdrawals and transfers made during a Guarantee
Period may be subject to a Market Value Adjustment unless made thirty days
or less prior to the Maturity Date.
Upon the expiry of a Guarantee Period, we will transfer the
Accumulation Value of the expiring Fixed Allocation to a Fixed Allocation
with a Guarantee Period equal in length to the expiring Guarantee Period,
unless the Certificate Owner selects another period prior to a Maturity
Date. We will notify the Certificate Owner at least thirty days prior to a
Maturity Date of options for renewal. If the period remaining from the
expiry of the previous guarantee period to the annuity commencement date is
less than the period elected or the period expiring, the next shortest
period then available that will not extend beyond the Annuity Commencement
Date will be offered. If a period is not available, the Accumulation Value
will be transferred to the Specially Designated Division.
We will declare guaranteed interest rates for the then available Fixed
Allocation Guarantee Periods. These interest rates are based solely on our
expectation as to our future earnings. Declared guaranteed interest rates
are subject to change at any time prior to application to specific fixed
allocations, although in no event will the rates be less than the Minimum
Guaranteed Interest Rate shown in the Certificate.
Market Value Adjustments
A Market Value Adjustment will be applied to a Fixed Allocation upon
withdrawal, transfer or application to an Income Plan if made more than
thirty days prior to such Fixed Allocation's Maturity Date, except on
Systematic Partial Withdrawals and IRA Partial Withdrawals. The Market
Value Adjustment is applied to each Fixed Allocation separately.
The Market Value Adjustment is determined by multiplying the amount of
Accumulation Value withdrawn, transferred or applied to an Income Plan by
the following factor:
1 + I N/365
--------------------
(1 + J + .0050) - 1
Where I is the Index Rate for a Fixed Allocation on the first day of
the applicable Guarantee Period; J is the Index Rate for new Fixed
Allocations with Guarantee Periods equal to the number of years (fractional
years rounded up to the next full year) remaining in the Guarantee Period
at the time of calculation; and N is the remaining number of days in the
Guarantee Period at the time of calculation. (The Index Rate is described
in each Certificate.)
Market Value Adjustments will be applied as follows:
(1) The Market Value Adjustment will be applied to the
amount withdrawn before deduction of any applicable
Surrender Charge.
(2) For a partial withdrawal, partial transfer or in the
case where a portion of a Fixed Allocation is applied
to an Income Plan, the Market Value Adjustment will be
calculated on the total amount that must be withdrawn,
transferred or applied to an Income Plan in order to
provide the amount requested.
(3) If the Market Value Adjustment is negative, it will be
assessed first against any remaining Accumulation Value
in a particular Fixed Allocation. Any remaining Market
Value Adjustment will be applied against the amount
withdrawn, transferred or applied to an Income Plan.
GA-MA-1082 17
How We Measure the Accumulation Value (continued)
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(4) If the Market Value Adjustment is positive, it will be
credited to the Accumulation Value of a particular
Fixed Allocation. If a cash surrender, or full
transfer, or application to an Income Plan has been
requested, the Market Value Adjustment is added to the
amount being withdrawn, transferred or applied to an
Income Plan.
MEASUREMENT OF INVESTMENT EXPERIENCE
Index of Investment Experience
The investment experience of a Division is determined on each valuation
date. We use an index to measure changes in each Division's experience
during a valuation period. We set the index at $10 when the first
investments in a Division are made. The index for a current valuation
period equals the index for the preceding valuation period multiplied by
the Experience Factor for the current valuation period.
How We Determine the Experience Factor
For Divisions of a unit investment trust separate account the Experience
Factor reflects the investment experience of the portfolio in which the
Division invests as well as the charges assessed against the Division for a
valuation period. The factor is calculated as follows:
(1) We take the net asset value of the portfolio in which
the Division invests at the end of the current
valuation period.
(2) We add to (1) the amount of any dividend or capital
gains distribution declared for the investment
portfolio and reinvested in such portfolio during the
current valuation period. We subtract from that amount
a charge for our taxes, if any.
(3) We divide (2) by the net asset value of the portfolio
at the end of the preceding valuation period.
(4) We subtract the daily mortality and expense risk charge
for each Division shown in each Certificate for each
day in the valuation period. This charge is to cover
expense and mortality risks that we are assuming.
(5) We subtract the daily asset based administrative charge
shown in each Certificate for each day in the Valuation
Period.
Calculations for Divisions investing in unit investment trusts are on a per
unit basis.
Net Rate of Return for a Variable Separate Account Division
The net rate of return for a Division during a valuation period is the
Experience Factor for that valuation period minus one.
Interest Credited to a Guaranteed Interest Division
Accumulation Value allocated to a Guaranteed Interest Division will be
credited with the Guaranteed Interest Rate for the Guarantee Period in
effect on the date the premium or reallocation is applied. Once applied,
such rate will be guaranteed until the Maturity Date of that Guarantee
Period. Interest will be credited daily at a rate to yield the declared
annual Guaranteed Interest Rate. No Guaranteed Interest Rate will be less
than the Minimum Interest Rate shown in the Schedule.
GA-MA-1082 18
How We Measure the Accumulation Value (continued)
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Interest Credited to a Fixed Allocation
A Fixed Allocation will be credited with the Guaranteed Interest Rate for
the Guarantee Period in effect on the date the premium or reallocation is
applied. Once applied, such rate will be guaranteed until that Fixed
Allocation's Maturity Date. Interest will be credited daily at a rate to
yield the declared annual Guaranteed Interest Rate.
We periodically declare Guaranteed Interest Rates for then available
Guarantee Periods. No Guaranteed Interest Rate will be less than the
Minimum Guaranteed Interest Rate shown in each Certificate.
CHARGES DEDUCTED FROM ACCUMULATION VALUE FOR EACH PROCESSING PERIOD
All charges and fees are shown in each Certificate.
Charge Deduction Division Option
We will deduct all charges against the accumulation value of a Certificate
from the Charge Deduction Division if the Certificate Owner elected this
option. If this option was not elected or if the charges are greater than
the amount in the Charge Deduction Division, the charges against the
Accumulation Value will be deducted as follows:
(1) If these charges are less than the accumulation value
in the Variable Separate Account Divisions, they will
be deducted proportionately from all Divisions.
(2) If these charges exceed the Accumulation Value in the
Variable Separate Account Divisions, any excess over
such value will be deducted proportionately from any
Fixed Account and Guaranteed Interest Divisions.
Any charges deducted from the Fixed Account or the General Account will be
taken from the Fixed Allocations or the Guaranteed Interest Divisions,
starting with the Guarantee Period nearest its Maturity Date until such
charges have been paid.
The Certificate Owner may at any time while the Certificate is in effect
change the election of this option. To do so, the Certificate Owner must
send a written request to our Customer Service Center. Any change will take
effect within seven days of the date we receive the request.
GA-MA-1082 19
The Certificate Owner's Benefits
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While a Certificate is in effect, the Certificate Owner has important
rights and benefits available. We discuss these rights and benefits in this
section.
CASH VALUE BENEFIT
Cash Surrender Value
The cash surrender value before the annuity commencement date, is
determined as follows:
(1) We take a Certificate's accumulation value;
(2) We adjust for any applicable Market Value Adjustment;
(3) We deduct any Surrender Charges; and
(4) We deduct any charges as shown in each Certificate that have been
incurred but not yet deducted, including:
(a) any administrative charge that has not yet been deducted;
(b) the prorata part of any charges for optional benefit riders; and
(c) any applicable premium or other tax.
Cancelling to Receive the Cash Surrender Value
The Certificate Owner may, at any time before the annuity commencement
date, surrender a Certificate to us. To do this, the Certificate Owner must
return the Certificate with a signed request for cancellation to our
Customer Service Center.
The cash surrender value will vary daily. We will determine the cash
surrender value as of the date we receive the Certificate and the signed
request in our Customer Service Center. All benefits under the Certificate
will then end.
We will usually pay the cash surrender value within seven days; but, we may
delay payment as described in the Payments We May Defer provision.
PARTIAL WITHDRAWAL OPTION
After the certificate Date, the Certificate Owner may make partial
withdrawals. Partial Withdrawals may be subject to a Partial Withdrawal
Charge. The minimum amount that may be withdrawn is shown in each
Certificate. The maximum amount that may be withdrawn is shown in each
Certificate. To take a partial withdrawal, satisfactory notice must be sent
to our Customer Service Center.
GA-MA-1082 20
Death Benefit Proceeds
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PROCEEDS PAYABLE TO THE BENEFICIARY
Prior to the Annuity Commencement Date
If the sole certificate Owner dies prior to the annuity commencement date,
we will pay the beneficiary the death benefit. If there are joint
Certificate Owners and any Certificate Owner dies, we will pay the
surviving Certificate Owners the death benefit. We will pay the amount on
receipt of due proof of the certificate Owner's death at our Customer
Service Center. Such amount may be received in a single lump sum or applied
to any of the Annuity Options (see Choosing an Income Plan). When the
Certificate Owner (or all Certificate Owners where there are joint
Certificate Owners) is not an individual, the proceeds become payable on
the death of the annuitant prior to the Annuity Commencement Date (unless a
contingent annuitant survived the annuitant). Only one death benefit is
payable under a Certificate. In all events, distributions under the
Certificate must be made as required by applicable law.
How to Claim Payments to Beneficiary
We must receive proof of the certificate Owner's (or annuitant's) death
before we will make any payments to the beneficiary. We will calculate the
death benefit as of the date we receive due proof of death. The beneficiary
should contact our Customer Service Center for instructions.
GA-MA-1082 21
Choosing an Income Plan
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ANNUITY BENEFITS
If the annuitant and certificate Owner are living on the annuity
commencement date, we will begin making payments to the certificate Owner.
We will make these payments under the annuity option (or options) as chosen
initially or as subsequently selected. An annuity option may be chosen or
changed by making a written request at least 30 days prior to the annuity
commencement date. Unless chosen otherwise, Option 2 on a 10-year period
certain basis will become effective. The amount of the payments will be
determined by applying the accumulation value on the annuity commencement
date in accordance with the Annuity Options section below (See Payments We
May Defer). See each Certificate for certain restrictions which may apply.
Before we pay any annuity benefits, we require the return of the
Certificate. If a Certificate has been lost, we require the applicable lost
Certificate form.
ANNUITY COMMENCEMENT DATE SELECTION
The Certificate Owner selects the Annuity Commencement Date. Any date may
be elected following the fifth certificate anniversary but before the
required date of annuity commencement as shown in each Certificate. If a
date is not selected, the annuity commencement date will be in the month
following the required date of annuity commencement.
FREQUENCY SELECTION
The Certificate Owner chooses the frequency of the Annuity Payments. They
may be monthly, quarterly, semi-annually, or annually. If we do not receive
written notice, the payments will be made monthly.
THE INCOME PLAN
While a Certificate is in effect and before the annuity commencement date,
the Certificate Owner may choose one or more annuity options to which death
benefit proceeds may be applied. If, at the time of the certificate Owner's
death, no option has been chosen for paying death benefit proceeds, the
beneficiary may choose an option within one year. An annuity option on
surrender of the Certificate for its cash surrender value may also be
elected. For each option we will issue a separate written agreement putting
the option into effect.
Our approval is needed for any option where:
(1) The person named to receive payment is other than the certificate
Owner or beneficiary; or
(2) The person named is not a natural person, such as a corporation; or
(3) Any income payment would be less than the minimum annuity income
payment shown in each Certificate.
THE ANNUITY OPTIONS
There are four options to choose from. They are:
Option 1. Income for a Fixed Period
Payment is made in equal installments for a fixed number of years. We
guarantee each monthly payment will be at least the Income For Fixed Period
amount shown in each Certificate. Values for annual, semiannual or
quarterly payments are available on request.
Option 2. Income for Life
Payment is made to the person named in equal monthly installments and
guaranteed for at least a period certain. The period certain can be 10 or
20 years. Other periods certain are available on request. A refund certain
may be chosen instead. Under this arrangement, income is guaranteed until
payments equal the amount applied. If the person named lives beyond the
guaranteed period, payments continue until his or her death.
GA-MA-1082 22
Choosing an Income Plan (continued)
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We guarantee each payment will be at least the amount shown in the Income
for Life Table in each Certificate. By age we mean the named person's age
on his or her last birthday before the option's effective date. Amounts for
ages not shown are available on request.
Option 3. Joint Life Income
This option is available if there are two persons named to receive
payments. At least one of the persons named must be either the certificate
Owner or beneficiary of the Certificate. Monthly payments are guaranteed
and are made as long as at least one of the named persons is living. The
monthly payment amounts are available upon request. Such amounts are
guaranteed and will be calculated on the same basis as the Table for Income
for Life, however, the amount will be based on two lives.
Option 4. Annuity Plan
An amount can be used to buy any single premium immediate annuity we offer
on the option's effective date.
The minimum rates for Option 1 are based on 3% interest, compounded
annually. The minimum rates for Options 2 and 3 are based on 3% interest,
compounded annually, and the Annuity 2000 Mortality Table. We may pay a
higher rate at our discretion.
PAYMENT WHEN NAMED PERSON DIES
When the person named to receive payment dies, we will pay any amounts
still due as provided by the option agreement. The amounts still due are
determined as follows:
(1) For Option 1 or for any remaining guaranteed payments
under Option 2, payments will be continued.
(2) For Option 3, no amounts are payable after both named
persons have died.
(3) For Option 4, the annuity agreement
will state the amount due, if any.
GA-MA-1082 23
General Provisions
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ENTIRE CONTRACT
This Contract, including any attached Rider, Endorsement, amendment and the
application of the contractholder, constitute the entire Contract between
the contractholder and us. All statements made by the contractholder, any
certificate Owner or any annuitant will be deemed representations and not
warranties. No such statement will be used in any contest unless it is
contained in the application signed by the contractholder or in a written
instrument signed by the certificate Owner, a copy of which has been
furnished to the certificate Owner, the beneficiary or to the
contractholder.
SENDING NOTICE TO US
Any written notices or requests should be sent to our Customer Service
Center.
REPORTS TO CERTIFICATE OWNER
We will send the Certificate Owner a report, at least once during each
Certificate year, showing the accumulation value and the cash surrender
value of each Certificate as of the end of the certificate processing
period. The report will also show the allocation of the accumulation value
as of such date and the amounts deducted from or added to the accumulation
value since the last report. The report will also include any other
information that may be currently required by the insurance supervisory
official of the jurisdiction in which the Certificate is delivered.
We will also send copies of any shareholder reports of the portfolios in
which the Divisions of the Variable Separate Accounts invest, as well as
any other reports, notices or documents required by law to be furnished to
certificate Owners.
ASSIGNMENT
Benefits under a Certificate may be assigned as collateral security for a
loan or other obligation. This does not change the Certificate ownership.
The Certificate Owner's rights and any Beneficiary's rights are subject to
the terms of the assignment. To make or release an assignment, we must
receive written notice satisfactory to us, at our Customer Service Center.
We are not responsible for the validity of any assignment.
CHANGING THE CONTRACT
This Contract or any additional benefit riders may be changed to another
annuity plan according to our rules at the time of the change.
CONTRACT CHANGES - APPLICABLE TAX LAW
We reserve the right to make changes in this Contract or its riders to the
extent we deem it necessary to continue to qualify this Contract as an
annuity. Any such changes will apply uniformly to all Certificates that are
affected. The Contractholder and the Certificate Owner will be given
advance written notice of such changes.
MISSTATEMENT OF AGE OR SEX
If an age or sex has been misstated, the amounts payable or benefits
provided under the Contract, as described in each Certificate, will be
those that the premium payment made would have bought at the correct age or
sex.
NON-PARTICIPATING
Neither this Contract, nor its Certificates, participates in the divisible
surplus of Golden American Life Insurance Company.
GA-MA-1082 24
General Provisions (continued)
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PAYMENTS WE MAY DEFER
We may not be able to determine the value of the assets of the Variable
Separate Account Divisions because:
(1) The NYSE is closed for trading;
(2) The SEC determines that a state of emergency exists; or
(3) An order or pronouncement of the SEC permits a delay for the
protection of certificate Owners.
(4) The check used to pay the premium has not cleared through the banking
system. This may take up to 15 days.
During such times, as to amounts allocated to the Variable Separate Account
Divisions, we may delay:
(1) Determination and payment of the cash surrender value;
(2) Determination and payment of any death benefit if death occurs
before the annuity commencement date;
(3) Allocation changes of the accumulation value; or
(4) Application of the accumulation value under an income plan.
As to the amounts allocated to a Guaranteed Interest Division in the General
Account and as to amounts allocated to Fixed Allocations of the Fixed Account,
we may, at any time, defer payment of the Cash Surrender Value for up to six
months after we receive a request for it. We will allow interest of at least
3.00% a year on any Cash Surrender Value payment derived from a Fixed Allocation
or Guaranteed Interest Division that we defer for 30 days or more.
AUTHORITY TO MAKE AGREEMENTS
All agreements made by us must be signed by one of our officers. No other
person, including an insurance agent or broker, can:
(1) Change any of the Contract's terms; or
(2) Make any agreement binding on us.
COMPUTATIONS
We have filed a detailed statement of our computations with the insurance
supervisory official in appropriate jurisdictions. The values are not less
than those required by the law of that state or jurisdiction. Any benefit
provided by an attached optional benefit rider will not increase these
values unless otherwise stated in that rider.
FACILITY OF PAYMENT
If no beneficiary is named, we reserve the right to pay an amount not to
exceed $2,000 to any person we determine to be entitled to such amount by
reason of incurred expenses incident to the last illness or death of a
Certificate Owner.
INCONTESTABILITY
The benefits under this Contract will not be contested, except for
nonpayment of premiums, after it has been in effect during the annuitant's
lifetime for two years from the certificate date.
CERTIFICATES
Certificates will be furnished by us.
CONFORMITY WITH LAW
If any provision of this Contract is contrary to any law to which it is
subject, such provision is considered amended to conform to such law.
GA-MA-1082 25
General Provisions (continued)
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RECORDS
The Contractholder will furnish us information relative to this Contract as
we may require to administer this Contract. Such records, which in our
opinion have a bearing on this Contract, will be open to us for inspection
at all reasonable times.
CERTIFICATE OWNER'S RIGHT TO EXAMINE THE CERTIFICATE
A Certificate Owner may return a Certificate to us or the agent through
whom it was purchased within 10 days of receipt. If so returned, we will
treat the Certificate as though it were never issued. Upon receipt we will
promptly refund the Accumulation Value plus any charges we have deducted as
of the date the returned Certificate is received by us.
GA-MA-1082 26
DEFERRED COMBINATION VARIABLE AND FIXED ANNUITY GROUP MASTER
CONTRACT - NO DIVIDENDS
Variable Cash Surrender Values while a Certificate Owner is living and
prior to the Annuity Commencement Date. Death benefit subject to
guaranteed minimum. Additional premium payment option. Partial
withdrawal option. Non-participating. Investment results reflected
in values.
GA-MA-1082