|||GOLDEN
|||||AMERICAN SIMPLE RETIREMENT ACCOUNT
|||||||LIFE INSURANCE RIDER
||||COMPANY
Golden American is a stock company domiciled in Delaware.
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The following language amends the Contract to which it is attached in order that
such Contract may be treated as a Simple Individual Retirement Annuity under
Section 408(b) of the Internal Revenue Code, as amended from time to time. The
effective date of this Rider is the later of January 1, 2002, or the Contract
Date.
In the event of any conflict between the provisions of this Rider and the
Contract to which it is attached, the provisions of this Rider shall control.
This SIMPLE XXX cannot be used by a trustee, custodian, or issuer that is a
designated financial institution within the meaning of IRC Section 408(p)(7).
1. ALL REFERENCES IN THIS RIDER TO:
(a) "IRC" means the Internal Revenue Code of 1986, as amended from time to
time.
(b) "Contract" means the Contract or Certificate to which this Rider is
attached.
(c) "Owner" means the Owner of the Contract to which this Rider is
attached.
(d) "Designated Beneficiary" means the beneficiary named by the Owner in
the Contract.
(e) "We", "our", and "us" means Golden American Life Insurance Company.
2. NONFORFEITABILITY AND NONTRANSFERABILITY.
This Contract shall be for the exclusive benefit of the Owner or his or
her beneficiary. The Owner's rights under this Contract shall be
nonforfeitable.
This Contract is nontransferable. Other than to us, it may not be sold,
assigned, discounted or pledged as collateral for a loan or as a
security for the performance of an obligation or for any other purpose.
3. CONTRIBUTIONS.
This SIMPLE XXX will accept only:
(a) a cash contribution made by an employer on behalf of the Owner
under a SIMPLE XXX plan that meets the requirements of Section
408 (p) of the Internal Revenue Code, and
(b) a rollover contribution or a transfer of assets from another
SIMPLE XXX of the Owner.
No other contributions will be accepted. Any refund of premiums (other
than those attributable to excess contributions) will be applied,
before the close of the calendar year following the year of the refund,
toward the payment of future premiums or the purchase of additional
benefits.
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4. DISTRIBUTIONS BEFORE DEATH MUST COMMENCE NO LATER THAN AGE 70 1/2.
(a) Notwithstanding any provision of this SIMPLE XXX to the contrary, the
distribution of the Owner's interest in the SIMPLE XXX shall be made
in accordance with the requirements of Code Section 408(b)(3) and the
regulations there under, the provisions of which are herein
incorporated by reference. If distributions are not made in the form
of an annuity on an irrevocable basis (except for acceleration), then
distribution of the interest in the SIMPLE XXX (as determined under
Section 4(c) below), must satisfy the requirements of Code Section
408(a)(6) and the regulations there under, rather than paragraphs (b),
(c) and (d) below, and Section 5 of this Rider.
(b) The entire interest of the Owner will commence to be distributed no
later than the first day of April following the calendar year in which
the Owner attains age 70 1/2(the "required beginning date") over: (1)
the life of the Owner or the lives of such Owners and his or her
Designated Beneficiary; or (2) a period certain not extending beyond
the life expectancy of the Owner, or the joint Owner and last survivor
expectancy of the Owner and his or her beneficiary. Payments must be
made in periodic payments at intervals of no longer than 1 year and
must be either non-increasing or they may increase only as provided in
Q&As-1 and -4 of Section 1.401(a)(9)-6T of the Temporary Income Tax
Regulations (or as provided in such Final Regulations as may be
subsequently published). In addition, any distribution must satisfy
the incidental benefit requirements specified in Q&A-2 of Section
1.401(a)(9)-6T.
(c) The distribution periods described in paragraph (b) above cannot
exceed the periods specified in Section 1.401(a)(9)-6T of the
Temporary Income Tax Regulations (or as provided in such Final
Regulations as may be subsequently published).
(d) The first required payment can be made as late as April 1 of the year
following the year the Owner attains age 70 1/2 and must be the
payment that is required for one payment interval. The second payment
need not be made until the end of the next payment interval.
5. DISTRIBUTION UPON DEATH.
(a) Death on or After Required Distributions Commence. If the Owner dies
on or after required distributions commence, the remaining portion of
his or her interest will continue to be distributed under the contract
option chosen.
(b) Death Before Required Distributions Commence. If the Owner dies before
required distributions commence, his or her entire interest will be
distributed at least as rapidly as follows:
1. If the designed beneficiary is someone other than the Owner's
surviving spouse, the entire interest will be distributed,
starting by the end of the calendar year following the calendar
year of the Owner's death, over the remaining life expectancy of
the Designated Beneficiary, with such life expectancy determined
using the age of the beneficiary as of his or her birthday in the
year following the year of the Owner's death, or if elected, in
accordance with paragraph (b)(3) below.
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2. If the Owner's sole Designated Beneficiary is the Owner's
surviving spouse, the entire interest will be distributed,
starting by the end of the calendar year following the calendar
year of the Owner's death (or by the end of the calendar year in
which the Owner would have attained age 70 1/2, if later), over
such spouse's life, or if elected, in accordance with paragraph
(b)(3) below. If the surviving spouse dies before required
distributions commence to him or her, the remaining interest will
be distributed, starting by the end of the calendar year
following the calendar year of the spouse's death, over the
spouse's Designated Beneficiary's remaining life expectancy
determined using such beneficiary's age as of his or her birthday
in the year following the death of the spouse, or if elected,
will be distributed in accordance with paragraph (b)(3) below. If
the surviving spouse dies after the required distributions
commence to him or her, any remaining interest will continue to
be distributed under the contract option chosen.
3. If there is no Designated Beneficiary, or if applicable by
operation of paragraph (b)(1) or (b)(2) above, the entire
interest will be distributed by the end of the calendar year
containing the fifth anniversary of the Owner's death (or of the
spouse's death in the case of the surviving spouse's death before
distributions are required to begin under paragraph (b)(2)
above).
4. Life expectancy is determined using the Single Life Table in
Q&A-1 of Section 1.401(a)(9)-9 of the Income Tax Regulations. If
distributions are being made to a surviving spouse as the sole
Designated Beneficiary, such spouse's remaining life expectancy
for a year is the number in the Single Life Table corresponding
to such spouse's age in the year. In all other cases, remaining
life expectancy for a year is the number in the Single Life Table
corresponding to the beneficiary's age in the year specified in
paragraph (b)(1) or (2) above and reduced by 1 for each
subsequent year.
(c) The "interest" in the SIMPLE XXX includes the amount of any
outstanding rollover, transfer, and recharacterization under Q&As-7
and -8 of Section 1.408-8 of the Income Tax Regulations and the
actuarial value of any other benefits provided under the SIMPLE XXX,
such as guaranteed death benefits.
(d) For purposes of paragraphs (a) and (b) above, required distributions
are considered to commence on the Owner's required beginning date or,
if applicable, on the date distributions are required to begin to the
surviving spouse under paragraph (b)(2) above. However, if
distributions start prior to the applicable date in the preceding
sentence, on an irrevocable basis (except for acceleration) under an
annuity contract meeting the requirements of Section 1.401(a)(9)-6T of
the Temporary Income Tax Regulations (or as provided in such Final
Regulations as may be subsequently published), then required
distributions are considered to commence on the annuity starting date.
GA-RA-1026-12/02 3
(e) If the sole Designated Beneficiary is the Owner's surviving spouse,
the spouse may elect to treat the SIMPLE XXX as his or her own SIMPLE
XXX. This election will be deemed to have been made if such surviving
spouse makes a contribution to the SIMPLE XXX (permitted under the
contribution rules for SIMPLE IRAs as if the surviving spouse were the
Owner) or fails to take required distributions as a beneficiary.
6. RESTRICTIONS ON ROLLOVERS AND TRANSFERS. Prior to the expiration of the
2-year period beginning on the date the Owner first participated in any
SIMPLE XXX plan maintained by the Owner's employer, any rollover or
transfer by the Owner of funds from this SIMPLE XXX must be made to another
SIMPLE XXX of the Owner. Any distribution of funds to the Owner during this
2-year period may be subject to a 25-percent additional tax if the Owner
does not roll over the amount distributed into a SIMPLE XXX. After the
expiration of this 2-year period, the Owner may roll over or transfer funds
to any SIMPLE XXX of the Owner that is qualified under Code Section 408(a),
(b) or (p), or to another eligible retirement plan described in Code
Section 402(c)(8)(B).
7. AMENDMENTS. We reserve the right to amend or administer this Contract and
Rider as necessary to comply with the provisions of the IRC, Internal
Revenue Service Regulations or published Internal Revenue Service Rulings.
We will send a copy of such amendment to the Owner. It will be mailed to
the last post office address known to us. Any such changes will apply
uniformly to all Contracts that are affected and the Owner will have the
right to accept or reject such changes.
8. PERIODIC REPORTS. We will send the Owner an annual report that shows the
status of the Contract as of the end of each calendar year and such
information concerning required minimum distributions as is prescribed by
the Commissioner of Internal Revenue.
If contributions made on behalf of the Owner under a SIMPLE XXX plan maintained
by the Owner's employer are received directly by us from the employer, we will
provide the employer with the summary description required by Code Section
408(1)(2)(B).
All other provisions of the Contract to which this Rider is attached remain
unchanged.
SIGNED FOR GOLDEN AMERICAN LIFE INSURANCE COMPANY:
President /s/Xxxxx Xxxxxx
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