UNITED LIFE & ANNUITY INSURANCE COMPANY (the "Company"), Baton Rouge, Louisiana,
agrees to provide benefits to the Owner, subject to the provisions set forth in
this Contract and in consideration of Purchase Payments received from the Owner.
RIGHT TO EXAMINE CONTRACT: Within 10 days of the date of receipt of this
Contract by the Owner, it may be returned by delivering or mailing it to United
Life & Annuity Insurance Company, III United Plaza, 0000 Xxxxxx Xxxxx Xxxxxxxxx,
Xxxxx Xxxxx, Xxxxxxxxx 00000-0000. When the contract is received by the Company,
it will be voided as if it had never been in force. The Company will refund the
greater of Purchase Payments, less withdrawals, or the Owner's Contract Value
computed at the end of the Valuation Period during which this Contract is
received by the Company at Baton Rouge, Louisiana. For the 15 days following the
date this Contract was issued, Purchase Payments may be allocated to a Money
Market Sub-Account except for any portion of your Purchase Payment which you
selected to be allocated to the Fixed Account and/or the Interest Adjustment
Account. At the end of 15 days, the Owner's Contract Value will be allocated to
the Sub-Accounts of the Separate Account, the Fixed Account and the IA Account
in accordance with the election made by the Owner.
THIS IS A LEGAL CONTRACT BETWEEN THE CONTRACT OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
SECRETARY PRESIDENT
INDIVIDUAL FIXED AND VARIABLE ANNUITY CONTRACT
Nonparticipating
WITHDRAWAL VALUES AND THE DEATH BENEFITS PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
ULV-AN-6008
UNITED LIFE & ANNUITY INSURANCE COMPANY (the "Company"), Baton Rouge, Louisiana,
agrees to provide benefits to the Owner, subject to the provisions set forth in
this Contract and in consideration of Purchase Payments received from the Owner.
RIGHT TO EXAMINE CONTRACT: Within 20 days of the date of receipt of this
Contract by the Owner, it may be returned by delivering or mailing it to United
Life & Annuity Insurance Company, III United Plaza, 0000 Xxxxxx Xxxxx Xxxxxxxxx,
Xxxxx Xxxxx, Xxxxxxxxx 00000-0000. When the contract is received by the Company,
it will be voided as if it had never been in force. The Company will refund the
greater of Purchase Payments, less withdrawals, or the Owner's Contract Value
computed at the end of the Valuation Period during which this Contract is
received by the Company at Baton Rouge, Louisiana. For the 25 days following the
date this Contract was issued, Purchase Payments may be allocated to a Money
Market Sub-Account except for any portion of your Purchase Payment which you
selected be allocated to the Fixed Account and/or the Interest Adjustment
Account. At the end of 25 days, the Owner's Contract Value will be allocated to
the Sub-Accounts of the Separate Account, the Fixed Account and the IA Account
in accordance with the election made by the Owner.
THIS IS A LEGAL CONTRACT BETWEEN THE CONTRACT OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
SECRETARY PRESIDENT
INDIVIDUAL FIXED AND VARIABLE ANNUITY CONTRACT
Nonparticipating
WITHDRAWAL VALUES AND THE DEATH BENEFITS PROVIDED BY THIS CONTRACT, WHEN BASED
ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
ULV-AN-6008
TABLE OF CONTENTS
CONTRACT SCHEDULE.........................................................4
DEFINITIONS...............................................................9
PURCHASE PAYMENT PROVISIONS..............................................12
PURCHASE PAYMENTS...............................................12
ALLOCATION OF PURCHASE PAYMENTS.................................12
SEPARATE ACCOUNT PROVISIONS..............................................12
THE SEPARATE ACCOUNT............................................12
VALUATION OF ASSETS.............................................12
ACCUMULATION UNITS..............................................12
ACCUMULATION UNIT VALUE.........................................13
MORTALITY AND EXPENSE RISK CHARGE...............................13
ADMINISTRATIVE CHARGE...........................................13
DISTRIBUTION EXPENSE CHARGE.....................................13
IA ACCOUNT...............................................................14
IA ACCOUNT......................................................14
INTEREST TO BE CREDITED.........................................14
GUARANTEE PERIOD................................................14
MULTIPLE GUARANTEE PERIODS......................................14
CHANGE IN GUARANTEE PERIOD......................................14
INTEREST ADJUSTMENT.............................................15
IA ACCOUNT VALUES...............................................15
FIXED ACCOUNT PROVISIONS.................................................15
FIXED ACCOUNT VALUES............................................15
INTEREST TO BE CREDITED.........................................16
CONTRACT VALUE......................................................... 16
CONTRACT MAINTENANCE CHARGE..............................................16
DEDUCTION FOR CONTRACT MAINTENANCE CHARGE.......................16
TRANSFERS................................................................16
TRANSFERS PRIOR TO THE ANNUITY DATE.............................16
WITHDRAWAL PROVISIONS....................................................17
WITHDRAWALS.....................................................17
CONTINGENT DEFERRED SALES CHARGE................................17
PROCEEDS PAYABLE ON DEATH................................................18
DEATH OF OWNER DURING THE ACCUMULATION PERIOD ..................18
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD ............18
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD............18
DEATH OF OWNER DURING THE ANNUITY PERIOD........................19
DEATH OF ANNUITANT..............................................19
PAYMENT OF DEATH BENEFIT........................................19
BENEFICIARY.....................................................19
CHANGE OF BENEFICIARY...........................................20
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION.............................20
OWNER, ANNUITANT, ASSIGNMENT PROVISIONS.................................20
OWNER...........................................................20
JOINT OWNER.....................................................20
ANNUITANT.......................................................20
ASSIGNMENT OF A CONTRACT........................................21
ANNUITY PROVISIONS.......................................................21
GENERAL.........................................................21
ANNUITY DATE....................................................21
SELECTION OF AN ANNUITY OPTION..................................21
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS........................21
ANNUITY OPTIONS.................................................21
OPTION A. LIFE ANNUITY....................................21
OPTION B. LIFE ANNUITY WITH PERIODS CERTAIN...............21
OPTION C. JOINT AND SURVIVOR ANNUITY......................22
FIXED ANNUITY...................................................22
MORTALITY TABLES................................................22
GENERAL PROVISIONS.......................................................22
THE CONTRACT....................................................22
MISSTATEMENT OF AGE.............................................22
INCONTESTABILITY................................................22
MODIFICATION....................................................22
NON-PARTICIPATING...............................................22
EVIDENCE OF SURVIVAL............................................23
PROOF OF AGE....................................................23
PROTECTION OF PROCEEDS..........................................23
REPORTS ........................................................23
TAXES...........................................................23
REGULATORY REQUIREMENTS.........................................23
CONTRACT SCHEDULE
Home Office:
United Life & Annuity Insurance Company
0000 Xxxxxx Xxxxx Xxxx.
P.O. Box 260100
Xxxxx Xxxxx, XX 00000-0000
CONTRACT OWNER: [XXX XXXXXX] CONTRACT DATE: [March 13, 1997]
CONTRACT NUMBER: [8390000002] ANNUITY DATE: [March 13, 2041]
Beneficiary and Annuitant: As named by the Owner at the Issue Date, unless
changes according to the Contract provisions.
PURCHASE PAYMENTS:
INITIAL PURCHASE PAYMENT: [$999,999.00]
MINIMUM SUBSEQUENT PURCHASE PAYMENT: $500 OR $100 for automatic
check option.
MAXIMUM TOTAL PURCHASE PAYMENT: $500,000
without prior company approval.
ALLOCATION GUIDELINES:
The Owner can select up to 10 investment options, including Sub-Accounts, the
Fixed Account and the Guarantee Periods of the IA Account.
If the Purchase Payments and forms required to issue a Contract are in good
order, the initial Net Purchase Payment will be credited to the Contract Value
within two (2) business days after receipt by the Company. Additional Purchase
Payments will be credited to the Contract Value as of the Valuation Period when
they are received.
Allocation percentages must be in whole numbers. Each allocation must be at
least 5% or $500 (whichever is greater) except for certain plans referenced in
the Purchase Payment definition on page 9. Allocations made pursuant to a
Pre-approved Rebalancing Program are not subject to such limitations.
CONTRACT MAINTENANCE CHARGE:
$30.00 assessed on each Contract Anniversary if the total accumulated value in
the Contract on the anniversary is less than $75,000. If the total accumulated
value in the Contract on the date of a full surrender is less than $75,000, the
Contract Maintenance Charge is assessed in addition to any applicable Contingent
Deferred Sales Charge or Interest Adjustment.
MORTALITY AND EXPENSE RISK CHARGE:
Equal, on an annual basis, to 1.25% of the average daily net asset value of the
Separate Account.
ADMINISTRATION CHARGE:
Equal, on an annual basis, to .15% of the average daily net asset value of the
Separate Account.
DISTRIBUTION EXPENSE CHARGE:
None
TRANSFERS:
NUMBER OF TRANSFERS PERMITTED: No limit during the Accumulation Period.
TRANSFER FEE: The lesser of $25.00 or 2% of the amount transferred. No transfer
fee on the first 12 transfers in a Contract Year. The transfer fee is deducted
from the amount transferred. Transfers made at the end of the Right to Examine
Contract Period by the Company and any transfers made pursuant to a Pre-approved
Dollar Cost Averaging Program or pursuant to a Pre-approved Rebalancing Program
will not be counted in determining the application of the Transfer Fee.
MINIMUM AMOUNT TO BE TRANSFERRED: $250 from any Account or the Owner's entire
interest in any Account, if less. This requirement is waived if the transfer is
pursuant to a Pre-approved Dollar Cost Averaging Program or a Pre-approved
Rebalancing Program.
MINIMUM AMOUNT WHICH MUST REMAIN IN EACH ACCOUNT AFTER A TRANSFER: $500 per
Account or $0, if the entire amount in any Account is transferred.
MAXIMUM AMOUNT WHICH CAN BE TRANSFERRED FROM THE FIXED ACCOUNT TO THE SEPARATE
ACCOUNT DURING THE ACCUMULATION PERIOD: 25% of the Owner's Fixed Account Value
in any one Contract Year and then only at the end of a Guarantee Period. This
requirement is waived if the transfer is pursuant to a Pre-approved Dollar Cost
Averaging Program or a Pre-approved Rebalancing program.
MAXIMUM AMOUNT THAT CAN BE TRANSFERRED FROM ANY GUARANTEE PERIOD IN THE INTEREST
ADJUSTMENT ACCOUNT TO ANY ACCOUNT DURING THE ACCUMULATION PERIOD: 25% of the
Owner's value in the Interest Adjustment Account as of the beginning of the
current Contract Year. If the Effective Date of the Interest Adjustment Account
is after the beginning of the current Contract Year, then the maximum amount
which can be transferred is 25% of the Purchase Payment allocated to the
Interest Adjustment Account.
WITHDRAWALS: A Contingent Deferred Sales Charge is assessed against Purchase
Payments withdrawn. The charge is calculated at the time of each withdrawal and
will be deducted from the Contract Value remaining in the Contract. The
Contingent Deferred Sales Charge is based upon the length of time from receipt
of Purchase Payments to the date of withdrawal. Each Purchase Payment is tracked
as to its date of receipt and withdrawals thereof are determined in accordance
with the following:
NUMBER OF COMPLETE
YEARS SINCE RECEIPT
OF PURCHASE PAYMENTS CHARGE
----------- -------- ------
0 8.5%
1 8.0%
2 7.5%
3 7.0%
4 6.5%
5 6.0%
6 5.0%
7 4.0%
8 3.0%
9 2.0%
10+ 0.0%
FREE WITHDRAWAL: On each Contract Anniversary, the Free Withdrawal Amount is
equal to the greater of: (a) the earnings in the Contract or (b) 10% of
remaining Purchase Payments as of the beginning of the current Contract Year. On
other than Contract Anniversaries, the Free Withdrawal Amount is equal to the
Free Withdrawal Amount at the beginning of the Contract Year less amounts
withdrawn without deduction of Contingent Deferred Sales Charges during the
Contract Year. The Free Withdrawal Amount is not available for a total
surrender.
MINIMUM PARTIAL WITHDRAWAL: $500. This requirement is waived if the partial
withdrawal is pursuant to a Systematic Withdrawal Option.
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN THE CONTRACT AFTER A PARTIAL
WITHDRAWAL: $2000
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN ANY ACCOUNT AFTER A PARTIAL
WITHDRAWAL: $500
WAIVER OF CONTINGENT DEFERRED SALES CHARGE: After the first Contract Year, the
Contingent Deferred Sales Charge will not apply if: (a) the Owner, or the older
Owner if the Contract is jointly owned, becomes confined to a Nursing Home for
at least 90 consecutive days; (b) confinement in a Nursing Home is certified by
a physician and is medically necessary; and (c) the request for a full surrender
or a partial withdrawal and adequate proof of confinement, in writing, are
received by the Company, no later than 90 days after discharge from a Nursing
Home.
ELIGIBLE FUNDS: SUB-ACCOUNTS:
MFS VARIABLE INSURANCE TRUST
MFS Emerging Growth Series MFS Emerging Growth Sub-Account
MFS Total Return Series MFS Total Return Sub-Account
FEDERATED INSURANCE SERIES
Federated High Income Bond Fund II Federated High Income Bond Sub-Account
Federated Utility Fund II Federated Utility Sub-Account
Federated Fund for U.S. Government Federated U.S. Government Securities
Securities II Sub-Account
DREYFUS STOCK INDEX FUND Dreyfus Stock Index Sub-Account
DREYFUS VARIABLE INVESTMENT FUND
Growth and Income Portfolio Dreyfus Growth and Income Sub-Account
XXXXXXX VARIABLE LIFE INVESTMENT FUND
Money Market Portfolio Xxxxxxx Money Market Sub-Account
International Portfolio, Class A Xxxxxxx International Sub-Account
XXXXX AMERICAN FUND
Xxxxx American Growth Portfolio Xxxxx American Growth Sub-Account
XXX XXX WORLDWIDE INSURANCE TRUST
Worldwide Hard Asset Fund Xxx Xxx Worldwide Hard Assets Sub-
Account
ELIGIBLE FUNDS: As selected by the Owner in the application unless changed
according to the Contract provisions.
SEPARATE ACCOUNT: United Life & Annuity Separate Account One
FIXED ACCOUNT:
INITIAL GUARANTEE PERIOD: 1 Year
INITIAL CURRENT INTEREST RATE: 4.25%
MINIMUM GUARANTEED INTEREST RATE: 3%
CURRENT IA ACCOUNT GUARANTEE PERIOD OPTIONS:
MINIMUM GUARANTEED INTEREST RATE: 3%
3 Years
5 Years
7 Years
IA ACCOUNT:
None
INTEREST ADJUSTMENT FACTOR: The Interest Adjustment Factor is equal to:
[ ( 1 + i ) / ( 1 + j + .004) ] n/12 - 1
Where i = Current Interest Rate credited to the Owner's Contract
Value allocated to a Guarantee Period as of the beginning of
the Guarantee Period.
j = Current Interest Rate then being offered for new Guarantee
Periods with durations equal to the number of years in the
current Guarantee Period.
n = Number of full months remaining in the Guarantee Period.
RIDERS:
DEFINITIONS
ACCOUNT: The Fixed Account, each Guaranteed Period of the IA Account and each
Sub-Account.
ACCUMULATION PERIOD: The period prior to the Annuity Date during which Purchase
Payments may be made by the Owner.
ACCUMULATION UNIT: A unit of measure used to determine the value of the Owner's
interest in a Sub-Account of the Separate Account during the Accumulation
Period.
ADJUSTED CONTRACT VALUE: The Contract Value less any applicable Premium Tax and
Contract Maintenance Charge. This amount is applied to the applicable Annuity
Tables to determine Annuity Payments.
AGE: The age of any Owner or Annuitant on his/her last birthday.
ANNUITANT: The natural person on whose life Annuity Payments to the Owner are
based. On or after the Annuity Date, the Annuitant shall also include any Joint
Annuitant.
ANNUITY DATE: The date on which Annuity Payments begin. The Annuity Date is
shown on the Contract Schedule.
ANNUITY OPTIONS: Options available for Annuity Payments.
ANNUITY PAYMENTS: The series of payments made to the Owner or any named payee
after the Annuity Date under the Annuity Option selected.
ANNUITY PERIOD: The period of time beginning with the Annuity Date during which
Annuity Payments are made.
BENEFICIARY: The person(s) or entity(ies) who will receive the death benefit
payable under a Contract.
COMPANY: United Life & Annuity Insurance Company. The office indicated on the
Contract Schedule to which notices, requests, and Purchase Payments must be
sent. All sums payable to the Company and payable by the Company are payable the
Company's Home Office.
CONTRACT ANNIVERSARY: The anniversary of the Issue Date.
CONTRACT VALUE: The dollar value as of any Valuation Period of all amounts
accumulated in a Contract.
CONTRACT WITHDRAWAL VALUE: The Contract Value less any applicable Premium Tax,
less any Contingent Deferred Sales Charge, less any applicable Contract
Maintenance Charge and plus or minus any Interest Adjustment.
CONTRACT YEAR: The first Contract Year is the annual period which begins on the
Issue Date. Subsequent Contract Years begin on each anniversary of the Issue
Date.
CURRENT INTEREST RATE: The interest rate credited to the Contract Value by the
Company for any given Guarantee Period in the IA Account or Fixed Account. The
Initial Current Interest Rates for the selected Guarantee Periods and for the
Fixed Account and the IA Account are shown on the Contract Schedule.
EFFECTIVE DATE: The Effective Date of a Guarantee Period with a Current Interest
Rate.
ELIGIBLE FUND: An investment entity shown on the Contract Schedule.
FIXED ACCOUNT: An investment option within the General Account.
FIXED ANNUITY: A series of payments made during the Annuity Period which are
guaranteed as to dollar amount by the Company.
GENERAL ACCOUNT: The Company's general investment account which contains all the
assets of the Company with the exception of the Separate Account and other
segregated asset accounts.
GUARANTEE PERIOD: The period for which the Current Interest Rate is credited in
either the IA Account or the Fixed Account. The initial Guarantee Periods
selected by the Owner are shown on the Contract Schedule.
ISSUE DATE: The date a Contract is issued to the Owner(s). The Issue Date is
shown on the Contract Schedule.
INTEREST ADJUSTMENT: An adjustment to the amount withdrawn, transferred or
annuitized from a IA Account prior to the end of the applicable Guarantee
Period. The adjustment reflects the change in the value of the funds withdrawn
or transferred due to the change in the interest rates since the beginning of
the Guarantee Period.
IA ACCOUNT: An investment option where the Company guarantees the rate of
interest for a specified Period and where withdrawals or transfers may be
subject to an Interest Adjustment.
NET PURCHASE PAYMENT: A Purchase Payment less any applicable Premium Tax.
OWNER: The person(s) who owns the Contract.
PORTFOLIO: A segment of an Eligible Fund which constitutes a separate and
distinct class of shares. Portfolios which are available for investment by the
Sub-Accounts under this Contract are shown on the Contract Schedule.
PREMIUM TAX: Any premium taxes incurred to any governmental entity and assessed
against Purchase Payments or the Contract Value.
PURCHASE PAYMENT: A payment made by the Owner with respect to this Contract. The
minimum initial Purchase Payment for Qualified Contracts is $2,000 (except for
IRA's, 403(b)'s and some automatic premium payment plans). The minimum initial
Purchase Payment for Non-Qualified Contracts is $5,000.
SEPARATE ACCOUNT: The Company's Separate Account designated on the Contract
Schedule.
SUB-ACCOUNT: Separate Account assets are divided into Sub-Accounts which are
listed on the Contract Schedule. Assets of each Sub-Account will be invested in
shares of an Eligible Fund or a Portfolio of an Eligible Fund.
VALUATION DATE: Each day on which the Company and the New York Stock Exchange
("NYSE") are open for business.
VALUATION PERIOD: The period of time beginning at the close of business of the
NYSE on each Valuation Date and ending at the close of business for the next
succeeding Valuation Date.
WRITTEN REQUEST: A request in writing, in a form satisfactory to the Company,
which is received by the Company.
PURCHASE PAYMENT PROVISIONS
PURCHASE PAYMENTS: The initial Purchase Payment due on the Issue Date. Subject
to the maximum and minimum shown on the Contract Schedule, the Owner may make
subsequent Purchase Payments and may increase or decrease or change the
frequency of such payments. The Company reserves the right to reject any
Application or Purchase Payment.
ALLOCATION OF PURCHASE PAYMENTS: Net Purchase Payments are allocated to one or
more of the Fixed Account or the IA Account Guarantee Period options and/or to
one or more Sub-Accounts of the Separate Account in accordance with the
selections made by the Owner. The allocation of the initial Net Purchase Payment
for the Owner is made in accordance with the selection made by the Owner at the
Issue Date. Unless otherwise changed by the Owner, subsequent Net Purchase
Payments are allocated in the same manner as the initial Net Purchase Payment.
Allocation of the Net Purchase Payments is subject to the Allocation Guidelines
shown on the Contract Schedule. The Company has reserved the right to allocate
initial Net Purchase Payments to a Money Market Sub-Account until the expiration
of the Right to Examine Contract period.
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNT: The Separate Account is designated on the Contract
Schedule and consists of assets set aside by the Company, which are kept
separate from that of the general assets and all other separate account assets
of the Company. The assets of the Separate Account equal to reserves and other
liabilities will not be charged with liabilities arising out of any other
business the Company may conduct.
The Separate Account assets are divided into Sub-Accounts. The Sub-Accounts
which are available under this Contract are listed on the Contract Schedule. The
assets of the Sub-Accounts are allocated to the Eligible Fund(s) and the
Portfolio(s), if any, within an Eligible Fund, shown on the Contract Schedule.
The Company may, from time to time, add additional Eligible Fund(s) or
Portfolio(s) to those shown on the Contract Schedule. The Owner may be permitted
to transfer Contract Values or allocate Net Purchase Payments to the additional
Sub-Account(s) within the Separate Account. However, the right to make such
transfers or allocations will be limited by the terms and conditions imposed by
the Company.
Should the shares of any such Eligible Fund(s) or any Portfolio(s) within an
Eligible Fund become unavailable for investment by the Separate Account, or the
Company's Board of Directors deems further investment in these shares
inappropriate, the Company may limit further purchase of such shares or
substitute shares of another Eligible Fund or Portfolio for shares already
purchased under this Contract.
VALUATION OF ASSETS: The assets of the Separate Account are valued at their fair
market value in accordance with procedures of the Company.
ACCUMULATION UNITS: Accumulation Units shall be used to account for all amounts
allocated to or withdrawn from the Sub-Accounts of the Separate Account as a
result of Net Purchase Payments, withdrawals, transfers, or fees and charges.
The Company will determine the number of Accumulation Units of a Sub-Account
purchased or canceled. This will be done by dividing the amount allocated to (or
the amount withdrawn from) the Sub-Account by the dollar value of one
Accumulation Unit of the Sub-Account as of the end of the Valuation Period
during which the request for the transaction is received at the Company.
ACCUMULATION UNIT VALUE: The Accumulation Unit Value for each Sub-Account was
arbitrarily set initially at $10. Subsequent Accumulation Unit Values for each
Sub-Account are determined by multiplying the Accumulation Unit Value for the
immediately preceding Valuation Period by the Net Investment Factor for the
Sub-Account for the current period.
The Net Investment Factor for each Sub-Account is determined by dividing A by B
and subtracting C where:
A is (i) the net asset value per share of the Eligible Fund or
Portfolios of an Eligible Fund held by the Sub-Account for the
current Valuation Period; plus
(ii) any dividend or capital gains per share declared on
behalf of such Eligible Fund or Portfolio that has an
ex-dividend date within the current Valuation Period; plus or
minus
(iii) the cumulative per share charge or credit for taxes
reserved which is determined by the Company to have resulted
from the operation or maintenance of the Sub-Account.
B is the net asset value per share of the Eligible Fund or
Portfolio held by the Sub-Account for the immediately
preceding Valuation Period; plus or minus the cumulative per
share charge or credit for taxes reserved for the immediately
preceding Valuation Date.
C is the factor representing the cumulative unpaid charge for
the Mortality and Expense Risk Charge, for the Administrative
Charge, and for the Distribution Expense Charge, if any, which
are shown on the Contract Schedule.
The Accumulation Unit Value may increase or decrease from Valuation Period to
Valuation Period.
MORTALITY AND EXPENSE RISK CHARGE: Each Valuation Period, the Company deducts a
Mortality and Expense Risk Charge from the Separate Account which is equal, on
an annual basis, to the amount shown on the Contract Schedule. The Mortality and
Expense Risk Charge compensates the Company for assuming the mortality and
expense risks under this Contract.
ADMINISTRATIVE CHARGE: Each Valuation Period, the Company deducts an
Administrative Charge from the Separate Account which is equal, on an annual
basis, to the amount shown on the Contract Schedule. The Administrative Charge
compensates the Company for the costs associated with the administration of this
Contract and the Separate Account.
DISTRIBUTION EXPENSE CHARGE: Each Valuation Period, the Company deducts a
Distribution Expense Charge from the Separate Account which is equal, on an
annual basis, to the amount shown on the Contract Schedule. The Distribution
Charge compensates the Company for the costs associated with the distribution of
the Contracts.
IA ACCOUNT
IA ACCOUNT: Net Purchase Payments may be allocated to one or more of the IA
Account Guarantee Period options which are available at the time the Purchase
Payment is made. The initial IA Account Guarantee Period options are shown on
the Contract Schedule. In addition, during the Accumulation Period, Contract
Values can be transferred from the Separate Account and/or the Fixed Account to
one or more of the IA Account Guarantee Period options on the next Contract
Anniversary.
INTEREST TO BE CREDITED: The initial Current Interest Rate for the initial
Guarantee Period of the IA Account is shown on the Contract Schedule. After the
initial Guarantee Period, the Current Interest Rate for any subsequent Guarantee
Period of the IA Account may change. All interest payable under a Contract is
compounded daily at the stated effective annual interest rate. In no event will
the Current Interest Rate be less than the Minimum Guaranteed Interest Rate
specified on the Contract Schedule.
GUARANTEE PERIOD: The initial Guarantee Period is shown on the Contract
Schedule. During the thirty (30) days prior to the end of a Guarantee Period,
the Owner may renew for the same or any other Guarantee Period at the then
Current Interest Rate or may elect to transfer all or a portion of the amount to
the Fixed Account or to the Separate Account. Any transfer elected will be made
as of the last Valuation Date of a current Guarantee Period and will not be
subject to the Interest Adjustment.
If the Owner does not specify a Guarantee Period at the time of renewal, the
Company will select the same Guarantee Period as has just expired, so long as
such Guarantee Period does not extend beyond the latest Annuity Date that can be
selected by the Owner. If such Guarantee Period does extend beyond the latest
Annuity Date, the Company will choose the longest period that will not extend
beyond such date. If a renewal occurs within one year of the latest Annuity
Date, the Company will choose the 1-year Fixed Account option and will credit
interest up to the Annuity Date at the Current Interest Rate for the one year
Guarantee Period as of the renewal date.
MULTIPLE GUARANTEE PERIODS: The Owner may elect one or more Guarantee Periods
subject to the Company's underwriting rules. Multiple Guarantee Periods are
treated separately for purposes of applying the Interest Adjustment. The Company
reserves the right to credit different Current Interest Rates to the Contact
Value attributable:
1. to different Guarantee Periods; and
2. to Guarantee Periods of the same duration with different Effective
Dates.
CHANGE IN GUARANTEE PERIOD: The Owner may upon Written Request change to any
Guarantee Period then being offered by the Company with respect to contracts of
this type and class. The Interest Adjustment will apply to a change made at any
time other than at the end of a Guarantee Period. The Interest Adjustment will
not apply to a change made at the end of a Guarantee Period if written request
is received by the Company within thirty (30) days prior to the end of the
Guarantee Period.
INTEREST ADJUSTMENT: Except on the latest Annuity Date, any amount withdrawn,
transferred or annuitized prior to the end of that Guarantee Period may be
subject to an Interest Adjustment. The Interest Adjustment will be calculated
using the formula which provides you with the larger value. The formulas are
calculated by: (a) multiplying the amount withdrawn, transferred or annuitized
by the Interest Adjustment Factor shown below or by (b) accumulating the amount
of Purchase Payment withdrawn, transferred or annuitized at an effective annual
interest rate of three percent (3%). Both (a) and (b) will be adjusted for any
applicable Contingent Deferred Sales Charge and any prior deductions for
withdrawals or taxes.
There will be no Interest Adjustment on withdrawals from the IA Account in the
following situations: (1) death benefit paid under the Contract; (2) amounts
withdrawn to pay fees or charges; (3) amounts withdrawn or transferred from the
IA Account at the end of the Guarantee Period; and (4) amounts withdrawn
pursuant to the Free Withdrawal Provision.
IA ACCOUNT VALUES: The IA Account Value of the Contract at any time is equal to:
1. the Net Purchase Payments allocated to the IA Account; plus
2. the Contract Value transferred to the IA Account; plus
3. interest credited to the Owner's interest in the IA Account; less
4. any prior withdrawals of the Contract Value in the IA Account and any
Contingent Deferred Sales Charge; less
5. any Contract Value transferred from the IA Account; less
6. Contract Maintenance Charges or Transfer Fees.
Any subsequent Purchase Payments and transfers to the IA Account will be
allocated to a new Guarantee Period with a new Effective Date.
FIXED ACCOUNT PROVISIONS
FIXED ACCOUNT VALUES: The Fixed Account Value of the Contract at any time is
equal to:
1. the Net Purchase Payments allocated to the Fixed Account; plus
2. the Contract Value transferred to the Fixed Account; plus
3. interest credited to the Owner's interest in the Fixed Account; less
4. any prior withdrawals of the Contract Value in the Fixed Account and
any Contingent Deferred Sales Charge; less
5. any Contract Value transferred from the Fixed Account; less
6. Contract Maintenance Charges or Transfer Fees.
INTEREST TO BE CREDITED: The Company guarantees that the interest to be credited
to the Fixed Account will not be less than the Minimum Guaranteed Interest Rate
shown on the Contract Schedule. The Company may credit additional interest, at
its sole discretion, for any Fixed Account option. The Fixed Account option and
the Initial Current Interest Rate are shown on the Contract Schedule.
CONTRACT VALUE
The Contract Value for any Valuation Period is the sum of the Contract Value in
each of the Sub-Accounts of the Separate Account, the Contract Value in the IA
Account and the Contract Value in the Fixed Account.
The Contract Value in a Sub-Account of the Separate Account is determined by
multiplying the number of Accumulation Units allocated to the Contract for the
Sub-Account by the Accumulation Unit Value.
Withdrawals will result in the cancellation of Accumulation Units in a
Sub-Account or a reduction in the Fixed Account or the IA Account, as
applicable.
CONTRACT MAINTENANCE CHARGE
DEDUCTION FOR CONTRACT MAINTENANCE CHARGE: During the Accumulation Period, on
each Contract Anniversary the Company deducts a Contract Maintenance Charge from
the Contract Value by reducing the Contract Values in the Fixed Account and/or
the IA Account and by canceling Accumulation Units from each applicable
Sub-Account to reimburse it for expenses relating to maintenance of the
Contract. The Contract Maintenance Charge will be deducted from the Fixed
Account and/or the IA Account and the Sub-Accounts in the Separate Account in
the same proportion that the amount of Contract Value in the Fixed Account
and/or the IA Account and each Sub-Account bears to the total Contract Value.
The Contract Maintenance Charge is shown on the Contract Schedule. During the
Accumulation Period, the Contract Maintenance Charge will be deducted from the
Contract Value on each Contract Anniversary while the Contract is in force. If a
total withdrawal is made on other than a Contract Anniversary, the Contract
Maintenance Charge will be deducted at the time of withdrawal.
TRANSFERS
TRANSFERS PRIOR TO THE ANNUITY DATE: Subject to any limitation imposed by the
Company on the number of transfers during the Accumulation Period shown on the
Contract Schedule, the Owner may, after the expiration of any Right to Examine
Contract Period, transfer all or part of the Contract Value in the Fixed
Account, the IA Account or a Sub-Account by Written Request without the
imposition of any Transfer Fee if there have been no more than the number of
free transfers as shown on the Contract Schedule for the Contract Year. All
transfers are subject to the following:
1. If more than the number of free transfers, shown on the Contract
Schedule, have been made in a Contract Year, the Company will deduct a
Transfer Fee, shown on the Contract Schedule, for each subsequent
transfer permitted. The Transfer Fee will be deducted from the amount
which is transferred.
2. The minimum amount which can be transferred from a Sub-Account is
shown on the Contract Schedule. The minimum amount which must remain
in a Sub-Account is shown on the Contract Schedule. The maximum amount
which can be transferred from the Fixed Account to the Separate
Account or the IA Account is shown on the Contract Schedule. The
maximum amount that can be transferred from an IA Account Guarantee
Period to another Account is shown on the Contract Schedule.
3. The Company reserves the right, at any time and without prior notice
to any party, to terminate, suspend or modify the transfer privilege
described above.
If the Owner elects to use this transfer privilege, the Company will not be
liable for transfers made in accordance with the Owner's instructions. All
amounts and Accumulation Units will be determined as of the end of the Valuation
Period during which the request for transfer is received at the Company.
WITHDRAWAL PROVISIONS
WITHDRAWALS: During the Accumulation Period, the Owner may, upon Written
Request, make a total or partial withdrawal of the Contract Withdrawal Value.
Unless the Owner instructs the Company otherwise, a partial withdrawal will be
made from the Separate Account. A partial withdrawal from the Separate Account
will result in the cancellation of Accumulation Units from each applicable
Sub-Account in the ratio that the Owner's interest in the Sub-Account bears to
the total Contract Value in all Sub-Accounts. The Owner must specify by Written
Request in advance which Sub-Account Accumulation Units are to be canceled if
other than the above method is desired.
A partial withdrawal from the Fixed Account or the IA Account is made when there
are multiple Guarantee Periods by a withdrawal first from the one year Fixed
Account and next from the Guarantee Period of the shortest remaining duration
and then from the Guarantee Period with the earliest Effective Date where the
Guarantee Periods are of the same duration. A partial withdrawal is taken first
from the Contract Withdrawal Value for which the Free Withdrawal Provision
applies and then from the Contract Withdrawal Value for which there is no
waiver. A withdrawal from the IA Account may be subject to an Interest
Adjustment.
The Company will pay the amount of any withdrawal within seven (7) days of
receipt of a request in good order unless the Suspension or Deferral of Payments
Provision is in effect.
Each partial withdrawal must be for an amount which is not less than the amount
shown on the Contract Schedule. The minimum Contract Value which must remain in
the Contract after a partial withdrawal is shown on the Contract Schedule. The
minimum Contract Value which must remain in an Account after a partial
withdrawal is shown on the Contract Schedule.
CONTINGENT DEFERRED SALES CHARGE: Upon a withdrawal of the Contract Withdrawal
Value, a Contingent Deferred Sales Charge as set forth on the Contract Schedule
may be assessed. The Contingent Deferred Sales Charge may be waived as set forth
on the Contract Schedule under "Free Withdrawal" and "Waiver of Contingent
Deferred Sales Charge."
PROCEEDS PAYABLE ON DEATH
DEATH OF OWNER DURING THE ACCUMULATION PERIOD: Upon the death of the Owner, or
Joint Owner, prior to the Annuity Date, the death benefit will be paid to the
Beneficiary(ies) designated by the Owner. Upon the death of a Joint Owner, the
surviving Joint Owner, if any, will be treated as the Primary Beneficiary. Any
other Beneficiary designation on record at the time of death will be treated as
a Contingent Beneficiary.
A Beneficiary may request that the death benefit be paid under one of the Death
Benefit Options below. If the Beneficiary is the spouse of the Owner, he or she
may elect to continue the Contract at the then current Contract Value in his or
her own name and exercise all the Owner's rights under the Contract.
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD: The death benefit will be:
the greater of (i) the Purchase Payments, less any withdrawals and related
Contingent Deferred Sales Charges; or (ii) the Contract Value determined as of
the end of the Valuation Period during which the Company receives both due proof
of death and an election for the payment method.
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD: A non-spousal Beneficiary
must elect the death benefit to be paid under one of the following options in
the event of the death of the Owner during the Accumulation Period:
Option 1 - lump sum payment of the death benefit; or
Option 2 - the payment of the entire death benefit within five (5) years of
the date of death of the Owner; or
Option 3 - payment of the death benefit under an Annuity Option over the
lifetime of the Beneficiary or over a period not extending beyond the life
expectancy of the Beneficiary with distribution beginning within one year
of the date of death of the Owner or any Joint Owner.
Any portion of the death benefit not applied under Option 3 within one (1) year
of the date of the Owner's death must be distributed within five (5) years of
the date of death.
A spousal Beneficiary may elect to continue the Contract in his or her own name
at the then current Contract Value, elect a lump sum payment of the death
benefit, or apply the death benefit to the Annuity Option.
If a lump sum payment is requested, the amount will be paid within seven (7)
days of receipt of proof of death and the election, unless the Suspension or
Deferral of Payments Provision is in effect.
Payment to the Beneficiary, other than in a single sum, may only be elected
during the (60) day period beginning with the date of receipt of proof of death.
DEATH OF OWNER DURING THE ANNUITY PERIOD: If the Owner, or a Joint Owner, who is
not the Annuitant, dies during the Annuity Period, any remaining payments under
the Annuity Option elected will continue at least as rapidly as under the method
of distribution in effect at such Owner's death. Upon the death of the Owner
during the Annuity Period, the Beneficiary becomes the Owner.
DEATH OF ANNUITANT: Upon the death of an Annuitant, who is not the Owner, during
the Accumulation Period, the Owner may designate a new Annuitant, subject to the
Company's underwriting rules then in effect. If no designation is made within
thirty (30) days of the death of the Annuitant, the Owner will become the
Annuitant. If the Owner is a non-natural person, the death of the Annuitant will
be treated as the death of the Owner and a new Annuitant may not be designated.
Upon the death of the Annuitant during the Annuity Period, the death benefit, if
any, will be as specified in the Annuity Option elected. Death benefits will be
paid at least as rapidly as under the method of distribution in effect at the
Annuitant's death.
PAYMENT OF DEATH BENEFIT: The Company will require due proof of death before any
death benefit is paid. Due proof of death will be:
1. a certified death certificate;
2. a certified decree of a court of competent jurisdiction as to the finding
of death; or
3. any other proof satisfactory to the Company.
All death benefits will be paid in accordance with applicable law or regulations
governing death benefit payments.
BENEFICIARY: The Beneficiary designation in effect on the Issue Date will remain
in effect until changed. The Beneficiary is entitled to receive the benefits to
be paid at the death of the Owner.
Unless the Owner provides otherwise, the death benefit will be paid in equal
shares to the survivor(s) as follows:
1. to the Primary Beneficiary(ies) who survive the Owner's and/or the
Annuitant's death, as applicable; or if there are none
2. to the Contingent Beneficiary(ies) who survive the Owner's and/or the
Annuitant's death, as applicable; or if there are none
3. to the estate of the Owner.
CHANGE OF BENEFICIARY: Subject to the rights of any irrevocable
Beneficiary(ies), the Owner may change the Primary Beneficiary(ies) or
Contingent Beneficiary(ies). A change may be made by Written Request. The
change will take effect as of the date the Written Request is signed. The
Company will not be liable for any payment made or action taken before it
records the change.
SUSPENSION OR DEFERRAL OF PAYMENTS PROVISION
The Company reserves the right to suspend or postpone payments from the Separate
Account for a withdrawal or transfer for any period when:
1. the New York Stock Exchange is closed (other than customary weekend and
holiday closings);
2. trading on the New York Stock Exchange is restricted;
3. an emergency exists as a result of which disposal of securities held in the
Separate Account is not reasonably practicable or if it is not reasonably
practicable to determine the value of the Separate Account's net assets; or
4. during any other period when the Securities and Exchange Commission, by
order, so permits for the protection of Owners;
provided that applicable rules and regulations of the Securities and Exchange
Commission will govern as to whether the conditions described in (2) and (3)
exist.
The Company further reserves the right to postpone payments from the Fixed
Account and the IA Account for the a period permitted by law but not more than
of up to six (6) months.
OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
OWNER: The Owner has all interest and right to amounts held in his or her
Contract. The Owner is the person designated as such on the Issue Date, unless
changed.
The Owner may change Owners of the Contract at any time prior to the Annuity
Date by Written Request. A change of Owner will automatically revoke any prior
designation of Owner. The change will become effective as of the date the
Written Request is signed. A new designation of Owner will not apply to any
payment made or action taken by the Company prior to the time it was received.
JOINT OWNER: A Contract may be owned by Joint Owners. If Joint Owners are named,
any Joint Owner must be the spouse of the other Owner. Upon the death of either
Owner, the surviving spouse will be the Primary Beneficiary. Any other
Beneficiary designation will be treated as a Contingent Beneficiary unless
otherwise indicated in a Written Request.
ANNUITANT: The Annuitant is the person on whose life Annuity Payments are based.
The Annuitant is the person designated by the Owner at the Issue Date, unless
changed prior to the Annuity Date. The Annuitant may not be changed after the
Annuity Date nor in a Contract which is owned by a non-natural person. Any
change of Annuitant is subject to the Company's underwriting rules then in
effect.
ASSIGNMENT OF A CONTRACT: A Written Request specifying the terms of an
assignment of a Contract must be provided to the Company. Until the Written
Request is received, the Company will not be required to take notice of or be
responsible for any transfer of interest in the Contract by assignment,
agreement, or otherwise.
The Company will not be responsible for the validity or tax consequences of any
assignment. Any assignment made after the death benefit has become payable will
be valid only with Company consent.
If the Contract is assigned, the Owner's rights may only be exercised with the
consent of the assignee of record.
ANNUITY PROVISIONS
GENERAL: On the Annuity Date, the Adjusted Contract Value will be applied under
the Annuity Option selected by the Owner. Annuity Payments will be made on a
fixed basis only.
ANNUITY DATE: The Annuity Date is selected by the Owner at the Issue Date. The
Annuity Date must be at least three (3) years after the Issue Date. The Annuity
Date may not be later than when the Annuitant reaches attained age 85 or 10
years after the Issue Date for issue ages after age 75.
Prior to the Annuity Date, the Owner, subject to the above, may change the
Annuity Date by Written Request. Any change must be requested at least thirty
(30) days prior to the new Annuity Date.
SELECTION OF AN ANNUITY OPTION: An Annuity Option may be selected by Written
Request of the Owner. If no Annuity Option is selected, Option B with 120
monthly payments guaranteed will automatically be applied. Prior to the Annuity
Date, the Owner can change the Annuity Option selected by Written Request. Any
change must be requested at least thirty (30) days prior to the Annuity Date.
FREQUENCY AND AMOUNT OF ANNUITY PAYMENTS: Annuity Payments are paid in monthly
installments. The Adjusted Contract Value is applied to the Annuity Table for
the Annuity Option selected. If the Adjusted Contract Value to be applied under
an Annuity Option is less than $2,000, the Company reserves the right to make a
lump sum payment in lieu of Annuity Payments. If the Annuity Payment would be or
become less than $200, the Company reserves the right to reduce the frequency of
payments to an interval which will result in each payment being at least $200.
ANNUITY OPTIONS: The following Annuity Options or any other annuity option
acceptable to the Company may be selected:
OPTION A. LIFE ANNUITY: Monthly Annuity Payments during the life of the
Annuitant.
OPTION B. LIFE ANNUITY WITH PERIODS CERTAIN OF 60, 120, 180 OR 240 MONTHS:
Monthly Annuity Payments during the lifetime of the Annuitant and in any event
for sixty (60), one hundred twenty (120), one hundred eighty (180) or two
hundred forty (240) months certain as selected.
OPTION C. JOINT AND SURVIVOR ANNUITY: Monthly Annuity Payments payable during
the joint lifetime of the Annuitant and a Joint Annuitant and then during the
lifetime of the survivor.
FIXED ANNUITY: The Adjusted Contract Account Value is allocated to the General
Account and the Annuity is paid as a Fixed Annuity. Unless the Owner specifies
otherwise, the payee of the Annuity Payments shall be the Owner.
The Adjusted Contract Account Value will be applied to the applicable Annuity
Table contained in the Contract based upon the Annuity Option selected by the
Owner. The amount of the first payment for each $1,000 of Adjusted Contract
Value is shown in the Annuity Tables. If, as of the Annuity Date, the current
Annuity Option rates applicable to this class of contracts provide an initial
Annuity Payment greater than that guaranteed under the same Annuity Option under
this Contract, the greater payment will be made. The dollar amount of each Fixed
Annuity Payment shall be determined in accordance with Annuity Tables contained
in this Contract which are based on the minimum guaranteed interest rate of 3%
per year.
MORTALITY TABLES: The Annuity Tables contained in the Contract utilize a minimum
guaranteed rate of 3% per year for the determination of the monthly Fixed
Annuity Payment.
The mortality table used in determining the Annuity Purchase Rates for Option A,
B, and C is the 1983 Individual Annuity Mortality Table A with Projection Scale
G.
The dollar amount of an Annuity Payment for any Age or combination of Ages not
shown in the Tables or for any other form of Annuity Option agreed to by the
Company will be provided by the Company upon request.
GENERAL PROVISIONS
THE CONTRACT: The entire Contract consists of this Contract, the Application, if
any, and any riders or endorsements attached to this Contract.
This Contract may be changed or altered only by the President or Vice President
and the Secretary of the Company. A change or alteration must be made in
writing.
MISSTATEMENT OF AGE: If the Age of any Annuitant has been misstated, any Annuity
benefits payable will be the Annuity benefits provided by the correct Age. After
Annuity Payments have begun, any underpayments will be made up in one sum with
the next Annuity Payment. Any overpayments will be deducted from future Annuity
Payments until the total is repaid.
INCONTESTABILITY: A Contract will not be contestable after it has been in force
for a period of two (2) years from the Issue Date.
MODIFICATION: This Contract may be modified in order to maintain compliance with
applicable state and federal law.
NON-PARTICIPATING: This Contract will not share in any distribution of
dividends.
EVIDENCE OF SURVIVAL: The Company may require satisfactory evidence of the
continued survival of any person(s) on whose life Annuity Payments are based.
PROOF OF AGE: The Company may require evidence of Age of any Annuitant or Owner.
PROTECTION OF PROCEEDS: To the extent permitted by law, death benefits and
Annuity Payments shall be free from legal process and the claim of any creditor
if the person is entitled to them under any Contract. No payment and no amount
under any Contract can be taken or assigned in advance of its payment date
unless the Company receives the Owner's written consent.
REPORTS: At least once each calendar year, the Company will furnish the Owner
with a report showing the Contract Value and any other information as may be
required by law. Reports will be sent to the last known address of the Owner.
TAXES: Any taxes paid to any governmental entity relating to any Contract will
be deducted from the Purchase Payment or Contract Value when incurred. The
Company will, in its sole discretion, determine when taxes have resulted from
the investment experience of the Separate Account, receipt by the Company of the
Purchase Payments, or commencement of Annuity Payments. The Company may, in its
sole discretion, pay taxes when due and deduct that amount from the Contract
Value at a later date. Payment at an earlier date does not waive any right the
Company may have to deduct amounts at a later date. The Company reserves the
right to establish a provision for federal income taxes if it determines, in its
sole discretion, that it will incur a tax as a result of the operation of the
Separate Account. The Company will deduct for any income taxes incurred by it as
a result of the operation of the Separate Account whether or not there was a
provision for taxes and whether or not it was sufficient. The Company will
deduct any withholding taxes required by applicable law.
REGULATORY REQUIREMENTS: All values payable under the Contract will not be less
than the minimum benefits required by the laws and regulations of the states in
which the Contract is delivered.
ANNUITY TABLES
--------------------------------------------------------------------------------------------------------------------------
Life Annuity
--------------------------------------------------------------------------------------------------------------------------
--------------------------------- -------------------------------------------------------------------- -------------------
Without Period Period Certain Installment
Certain 10 years 15 Refund
years 20 years
--------------------------------- -------------------------------------------------------------------- -------------------
---------- ----------- ---------- ----------- ---------- ---------- ----------- ---------- ----------- ---------- --------
Age Male Female Male Female Male Female Male Female Male Female
---------- ----------- ---------- ----------- ---------- ---------- ----------- ---------- ----------- --------- -------
*5 2.79 2.73 2.79 2.73 2.79 2.73 2.79 2.73 2.78 2.73
6 2.80 2.74 2.80 2.74 2.80 2.74 2.80 2.74 2.79 2.73
7 2.81 2.75 2.81 2.75 2.81 2.75 2.81 2.75 2.80 2.74
8 2.82 2.76 2.82 2.76 2.82 2.76 2.82 2.75 2.81 2.75
9 2.83 2.77 2.83 2.77 2.83 2.76 2.83 2.76 2.82 2.76
10 2.85 2.78 2.84 2.77 2.84 2.77 2.84 2.77 2.84 2.77
11 2.86 2.79 2.86 2.79 2.86 2.78 2.85 2.78 2.85 2.78
12 2.87 2.80 2.87 2.80 2.87 2.79 2.86 2.79 2.86 2.79
13 2.88 2.81 2.88 2.81 2.88 2.81 2.88 2.80 2.87 2.80
14 2.90 2.82 2.90 2.82 2.89 2.82 2.89 2.82 2.88 2.81
15 2.91 2.83 2.91 2.83 2.91 2.83 2.91 2.83 2.90 2.82
16 2.93 2.84 2.92 2.84 2.92 2.84 2.92 2.84 2.91 2.84
17 2.94 2.85 2.94 2.85 2.94 2.85 2.93 2.85 2.93 2.85
18 2.96 2.87 2.96 2.87 2.95 2.87 2.95 2.86 2.94 2.86
19 2.97 2.88 2.97 2.88 2.97 2.88 2.97 2.88 2.96 2.87
20 2.99 2.90 2.99 2.89 2.99 2.89 2.98 2.89 2.98 2.89
21 3.01 2.91 3.01 2.91 3.00 2.91 3.00 2.91 2.99 2.90
22 3.03 2.93 3.03 2.92 3.02 2.92 3.02 2.92 3.01 2.92
23 3.05 2.94 3.04 2.94 3.04 2.94 3.04 2.94 3.03 2.93
24 3.07 2.96 3.06 2.96 3.06 2.95 3.06 2.95 3.05 2.95
25 3.09 2.97 3.08 2.97 3.08 2.97 3.08 2.97 3.07 2.96
26 3.11 2.99 3.11 2.99 3.10 2.99 3.10 2.99 3.09 2.98
27 3.13 3.01 3.13 3.01 3.13 3.01 3.12 3.00 3.11 3.00
28 3.16 3.03 3.15 3.03 3.15 3.03 3.14 3.02 3.13 3.02
29 3.18 3.05 3.18 3.05 3.17 3.05 3.17 3.04 3.16 3.04
30 3.21 3.07 3.20 3.07 3.20 3.07 3.19 3.06 3.18 3.06
31 3.23 3.09 3.23 3.09 3.22 3.09 3.22 3.08 3.20 3.08
32 3.26 3.11 3.26 3.11 3.25 3.11 3.24 3.11 3.23 3.10
33 3.29 3.14 3.29 3.14 3.28 3.13 3.27 3.13 3.25 3.12
34 3.32 3.16 3.32 3.16 3.31 3.16 3.30 3.15 3.29 3.14
35 3.35 3.19 3.35 3.19 3.34 3.18 3.33 3.18 3.31 3.17
36 3.39 3.21 3.38 3.21 3.38 3.21 3.36 3.20 3.34 3.19
37 3.42 3.24 3.42 3.24 3.41 3.24 3.40 3.23 3.37 3.22
38 3.46 3.27 3.46 3.27 3.45 3.27 3.43 3.26 3.41 3.25
39 3.50 3.30 3.49 3.30 3.48 3.30 3.47 3.29 3.45 3.28
40 3.54 3.34 3.54 3.33 3.52 3.33 3.50 3.32 3.48 3.31
41 3.59 3.37 3.58 3.37 3.56 3.36 3.54 3.35 3.52 3.34
42 3.63 3.41 3.62 3.40 3.61 3.40 3.58 3.38 3.56 3.37
43 3.68 3.44 3.67 3.44 .3.65 3.43 3.62 3.42 3.60 3.41
44 3.73 3.48 3.72 3.48 3.70 3.47 3.66 3.46 3.64 3.44
45 3.78 3.52 3.77 3.52 3.74 3.51 3.71 3.49 3.68 3.48
46 3.84 3.57 3.82 3.56 3.79 3.55 3.75 3.53 3.73 3.51
47 3.90 3.61 3.87 3.60 3.84 3.59 3.80 3.57 3.78 3.56
48 3.96 3.66 3.93 3.65 3.90 3.64 3.85 3.62 3.83 3.60
49 4.02 3.71 3.99 3.70 3.96 3.68 3.90 3.66 3.89 3.64
50 4.08 3.76 4.05 3.75 4.01 3.73 3.96 3.71 3.94 3.69
51 4.15 3.82 4.12 3.80 4.08 3.79 4.01 3.76 3.99 3.74
52 4.23 3.88 4.19 3.86 4.14 3.84 4.07 3.81 4.06 3.79
53 4.30 3.94 4.26 3.92 4.21 3.90 4.12 3.86 4.11 3.84
54 4.39 4.00 4.34 3.98 4.28 3.96 4.18 3.91 4.18 3.90
55 4.47 4.07 4.42 4.05 4.35 4.02 4.24 3.97 4.25 3.96
56 4.56 4.14 4.50 4.12 4.42 4.08 4.31 4.03 4.32 4.01
57 4.66 4.22 4.59 4.19 4.50 4.15 4.37 4.09 4.40 4.08
58 4.76 4.30 4.68 4.27 4.58 4.22 4.43 4.15 4.48 4.15
59 4.87 4.39 4.78 4.35 4.67 4.30 4.50 4.22 4.56 4.22
60 4.98 4.48 4.89 4.44 4.76 4.38 4.56 4.28 4.65 4.29
61 5.11 4.57 5.00 4.53 4.85 4.46 4.63 4.35 4.74 4.38
62 5.24 4.68 5.11 4.62 4.94 4.54 4.70 4.42 4.84 4.46
63 5.38 4.79 5.23 4.72 5.04 4.63 4.76 4.49 4.94 4.54
64 5.53 4.90 5.36 4.83 5.13 4.73 4.83 4.56 5.05 4.64
65 5.69 5.03 5.49 4.94 5.23 4.82 4.89 4.64 5.16 4.74
66 5.87 5.16 5.63 5.06 5.33 4.92 4.95 4.71 5.27 4.84
67 6.05 5.31 5.78 5.19 5.44 5.03 5.01 4.78 5.41 4.95
68 6.25 5.46 5.93 5.32 5.54 5.13 5.07 4.85 5.53 5.06
69 6.46 5.62 6.08 5.46 5.64 5.24 5.12 4.92 5.67 5.18
70 6.68 5.80 6.24 5.61 5.74 5.35 5.17 4.99 5.81 5.31
71 6.92 5.99 6.40 5.77 5.84 5.47 5.22 5.06 5.96 5.45
72 7.17 6.20 6.57 5.93 5.94 5.58 5.26 5.12 6.12 5.59
73 7.44 6.42 6.74 6.11 6.03 5.70 5.30 5.17 6.29 5.74
74 7.73 6.66 6.92 6.28 6.12 5.81 5.34 5.23 6.47 5.91
75 8.04 6.93 7.09 6.47 6.21 5.92 5.37 5.27 6.65 6.07
76 8.37 7.21 7.27 6.66 6.29 6.03 5.40 5.32 6.85 6.26
77 8.72 7.51 7.45 6.86 6.37 6.13 5.42 5.36 7.05 6.45
78 9.10 7.84 7.62 7.06 6.44 6.23 5.44 5.39 7.27 6.65
79 9.51 8.19 7.80 7.26 6.51 6.32 5.46 5.42 7.50 6.88
*80 9.94 8.58 7.97 7.46 6.56 6.40 5.48 5.44 7.58 7.11
---------- ----------- ---------- ----------- ---------- ---------- ----------- ---------- ----------- ---------- --------
* For ages below 5 and over 80, rates will be furnished on request.
Annuity Tables (continued)
--------------------------------------------------------------------------------------------------------------------------
Joint & Survivor Annuity
--------------------------------------------------------------------------------------------------------------------------
Full Payment Continued to Survivor
--------------------------------------------------------------------------------------------------------------------------
----------------- ----------------- --------------------------------------------------------------------------------------
Age of Female
---------------------------------------------------------------------------------------------------------------------------
----------------- ------------------ ----------------- ----------------- --------------------------------------------------
3 3
Age of Years Same Years
Male Younger Age Older
----------------- ----------------- ----------------- ------------------ ----------------- ----------------- -------------
55 3.49 3.58 3.67
56 3.53 3.63 3.72
57 3.58 3.68 3.78
58 3.63 3.74 3.84
59 3.69 3.80 3.91
60 3.74 3.86 3.98
61 3.80 3.93 4.06
62 3.87 4.00 4.14
63 3.94 4.08 4.22
64 4.01 4.16 4.31
65 4.09 4.25 4.41
66 4.17 4.34 4.52
67 4.26 4.44 4.63
68 4.35 4.55 4.75
69 4.45 4.67 4.88
70 4.56 4.79 5.02
71 4.68 4.92 5.17
72 4.80 5.06 5.33
73 4.93 5.21 5.50
74 5.07 5.38 5.68
75 5.23 5.55 5.88
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FOR FURTHER INFORMATION, OR SHOULD YOU WISH TO DISCUSS A PROBLEM OR COMPLAINT
PLEASE CALL US AT 0-000-000-0000
[GRAPHIC OMITTED]
Baton Rouge, Louisiana
Individual Fixed and Variable Annuity Contract
Non-participating
