SECURITY BENEFIT LIFE INSURANCE COMPANY
A MUTUAL COMPANY/FOUNDED IN 1892/TOPEKA, KS
FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT
THE COMPANY'S PROMISE
In consideration for the Purchase Payments and the attached application,
Security Benefit Life Insurance Company (the "Company") will pay the benefits of
this Contract according to its provisions.
LEGAL CONTRACT
PLEASE READ YOUR CONTRACT CAREFULLY. It is a legal Contract between the Owner
and the Company. The Contract's table of contents is on page 2.
FREE LOOK PERIOD-RIGHT TO CANCEL
IF FOR ANY REASON THE OWNER IS NOT SATISFIED WITH THIS CONTRACT, HE OR SHE MAY
RETURN IT TO THE COMPANY WITHIN 10 DAYS FROM THE DATE OF RECEIPT. IT MAY BE
RETURNED BY DELIVERING OR MAILING IT TO THE COMPANY. IF RETURNED, THIS CONTRACT
SHALL BE DEEMED VOID FROM THE CONTRACT DATE. THE COMPANY WILL REFUND ANY
PURCHASE PAYMENTS MADE AND ALLOCATED TO THE FIXED ACCOUNT AND WILL REFUND
SEPARATE ACCOUNT CONTRACT VALUE AS OF THE DATE THE RETURNED POLICY IS RECEIVED
BY THE COMPANY.
Signed for Security Benefit Life Insurance Company on the Contract Date.
XXXXX X. XXXXX XXXXXX X. XXXXXX
Secretary President
A BRIEF DESCRIPTION OF THIS CONTRACT
This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT.
* Purchase Payments may be made until the earlier of the Annuity Start Date or
termination of the Contract.
* A Death Benefit may be paid prior to the Annuity Start Date according to the
Contract provisions.
* Annuity Payments begin on the Annuity Start Date using the method specified in
this Contract.
* This Contract is Participating.
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN
ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. THERE ARE NO
GUARANTEED MINIMUM PAYMENTS OR CASH VALUES. (SEE "CONTRACT VALUE AND EXPENSE
PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.)
[SBL LOGO]
SECURITY BENEFIT LIFE INSURANCE COMPANY
A Member of The Security Benefit Group of Companies
P.O. Box 750497, Topeka, KS 66675-0497
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0001
0-000-000-0000
Form V6022 (10-94)
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TABLE OF CONTENTS
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Page
CONTRACT SPECIFICATIONS................................................ 3
DEFINITIONS............................................................ 4-6
GENERAL PROVISIONS..................................................... 7,8
The Contract...................................................... 7
Compliance........................................................ 7
Misstatement of Age and Sex....................................... 7
Evidence of Survival.............................................. 7
Incontestability.................................................. 7
Assignment........................................................ 7
Transfers...................... .................................. 8
Claims of Creditors............................................... 8
Nonforfeiture Values.............................................. 8
Participation..................................................... 8
Statements........................................................ 8
OWNERSHIP, ANNUITANT AND BENEFICIARY PROVISIONS........................ 9
Ownership......................................................... 9
Joint Ownership................................................... 9
Annuitant......................................................... 9
Primary and Secondary Beneficiaries............................... 9
Ownership and Beneficiary Changes................................. 9
PURCHASE PAYMENT PROVISIONS............................................ 10
Flexible Purchase Payments........................................ 10
Purchase Payment Limitations...................................... 10
Purchase Payment Allocation....................................... 10
Place of Payment.................................................. 10
CONTRACT VALUE AND EXPENSE PROVISIONS.................................. 10-12
Contract Value.................................................... 10
Fixed Account Contract Value...................................... 10
Fixed Account Interest Crediting.................................. 11
Separate Account Contract Value................................... 11
Accumulation Unit Value........................................... 11
Determining Accumulation Units.................................... 11
Mortality and Expense Risk Charge................................. 12
Premium Tax Expense............................................... 12
Administrative Charge............................................. 12
Mutual Fund Expenses.............................................. 12
WITHDRAWAL PROVISIONS.................................................. 12,13
Withdrawals....................................................... 12,13
Withdrawal Value.................................................. 13
Systematic Withdrawals............................................ 13
Date of Request................................................... 13
Payment of Withdrawal Benefits.................................... 13
DEATH BENEFIT PROVISIONS............................................... 14,15
Death Benefit..................................................... 14
Proof of Death.................................................... 14
Distribution Rules................................................ 14,15
ANNUITY PAYMENT PROVISIONS
Annuity Start Date................................................ 15
Change of Annuity Start Date...................................... 15
Annuity Start Amount.............................................. 15
Annuity Tables.................................................... 16
Annuity Payments.................................................. 16
Change of Annuity Option.......................................... 16
Fixed Annuity Payments............................................ 16
Variable Annuity Payments......................................... 16
Annuity Units..................................................... 16,17
Net Investment Factor............................................. 17
Alternate Annuity Option Rates.................................... 17
Annuity Options................................................... 18
ANNUITY TABLES......................................................... 19
AMENDMENTS OR ENDORSEMENTS, if any
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VARIFLEX LS VARIABLE ANNUITY CONTRACT SPECIFICATIONS
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OWNER NAME: Xxxx X. Xxx CONTRACT NUMBER: Specimen
OWNER DATE OF BIRTH: 10-30-1953 CONTRACT DATE: 6-30-1993
JOINT OWNER NAME: Xxxx X. Xxx ISSUE DATE: 6-30-1993
JOINT OWNER DATE OF BIRTH: 7-18-1981 ANNUITY START DATE: 7-1-2025*
ANNUITANT NAME: Xxxxx X. Xxx PLAN: Non-Qualified
ANNUITANT DATE OF BIRTH: 5-13-1987 ASSIGNMENT: This policy may be assigned.
See Assignment Provision of your Policy.
ANNUITANT'S SEX: Female
PRIMARY BENEFICIARY NAME:
Xxxxx X. Xxx
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INITIAL PURCHASE PAYMENT............... $25,000
MINIMUM SUBSEQUENT PURCHASE PAYMENTS... $1,000
MINIMUM SYSTEMATIC WITHDRAWAL.......... $100
MORTALITY AND EXPENSE RISK CHARGE...... 1.25% Annually
ADMINISTRATION CHARGE.................. .15% Annually
GUARANTEED FIXED ACCOUNT RATE.......... 3%
ANNUITY OPTION......................... Life with 10-Year Fixed Period Option*
SUBACCOUNTS:
1. Money Market 9. Main Street Growth and Income 17. Mid Cap Growth
2. Diversified Income 10. Equity 18. Global
3. High Yield 11. Large Cap Growth 19. International
4. Global Strategic Income 12. Enhanced Index 20. Technology
5. Managed Asset Allocation 13. Capital Growth 21. Small Cap Value
6. Equity Income 14. Select 25 22. Small Cap Growth
7. Global Total Return 15. Social Awareness
8. Large Cap Value 16. Mid Cap Value
METHOD FOR DEDUCTIONS:
Deductions for Premium Taxes, and any unallocated partial withdrawals,
including Systematic Withdrawals, will be made sequentially from the Contract
Value in descending order of the Subaccounts listed above. The value of each
account will be depleted before the next is charged. The Fixed Account is the
last Account charged.
* The Owner may select the Annuity Start Date and the Annuity Option. If no
Annuity Start Date or Annuity Option is selected by the Owner, they will be
assigned automatically.
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V6022 A (R5-97)
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DEFINITIONS
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ACCOUNT
An Account is one of the Subaccounts or the Fixed Account.
ACCUMULATION UNIT
The Accumulation Unit is a unit of measure. It is used to compute the Separate
Account Contract Value prior to the Annuity Start Date. It is also used to
compute the Variable Annuity Payments for Annuity Options 5 and 6.
ANNUITANT
The Annuitant is the person named by the Owner on whose life the Annuity
Payments depend for Annuity Options 1 through 4. The Annuitant receives Annuity
Payments under this Contract. Please see "Annuitant" provisions on page 9.
ANNUITY OPTION
An Annuity Option is a set of provisions that form the basis for making Annuity
Payments. The Annuity Option is set prior to the Annuity Start Date. Please see
"Annuity Options" on page 18.
ANNUITY START DATE
The Annuity Start Date is the date on which Annuity Payments are scheduled to
begin. This date may be changed by the Owner. The Annuity Start Date is shown on
Page 3. Please see "Annuity Start Date" on page 15.
ANNUITY UNIT
The Annuity Unit is a unit of measure used to compute Variable Annuity Payments
for Annuity Options 1 through 4.
AUTOMATIC TRANSFERS
Automatic Transfers are Transfers among the Subaccounts and the Fixed Account.
Such transfers are made automatically on a periodic basis by the Company at the
written request of the Owner. The Company reserves the right to discontinue,
modify or suspend Automatic Transfers.
COMPANY
The Company is Security Benefit Life Insurance Company, P.O. Box 750497, Topeka,
Kansas 66675-0497.
CONTRACT ANNIVERSARY
A Contract Anniversary is a 12-month anniversary of the Contract Date.
CONTRACT DATE
The Contract Date is the date the Contract begins. The Contract Date is shown on
page 3.
CONTRACT YEAR
Contract Years are measured from the Contract Date.
CURRENT INTEREST
The Company may in its discretion pay Current Interest on the Fixed Account at a
rate that exceeds the Guaranteed Rate shown on page 3. The Company will declare
the rate of Current interest, if any, from time to time.
DESIGNATED BENEFICIARY
Upon the death of the Owner or Joint Owner, the Designated Beneficiary will be
the first person on the following list who is alive on the date of death:
1. Owner;
2. Joint Owner;
3. Primary Beneficiary;
4. Secondary Beneficiary;
5. Annuitant; and
6. the Owner's estate if no one listed above is alive.
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V6022 B (10-94)
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DEFINITIONS (Continued)
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DESIGNATED BENEFICIARY (Continued)
The Designated Beneficiary receives a death benefit upon the death of the Owner
prior to the Annuity Start Date. Please see "Ownership, Annuitant, and
Beneficiary Provisions" on page 9 and "Death Benefit Provisions" on pages 14 and
15.
FIXED ACCOUNT
The Fixed Account is part of the Company's general account. The Company manages
the general account and guarantees that it will credit interest on Fixed Account
Contract Value at an annual rate at least equal to the Guaranteed Rate. This
Rate is shown on page 3.
GUARANTEE PERIOD
Current interest, if declared, is fixed for rolling periods of one or more
years, referred to as Guarantee Periods. The Company may offer Guarantee Periods
of different durations. The Guarantee Period that applies to any Fixed Account
Contract Value: (1) starts on the date that such Contract Value is allocated to
the Fixed Account pursuant to: (a) a Purchase Payment Received by the Company;
or (b) a Transfer to the Fixed Account; and (2) ends on the last day of the same
month in the year in which the Guarantee Period expires. When any Guarantee
Period expires, a new Guarantee Period shall start for such Contract Value on
the date that follows such expiration date. Such period shall end on the
immediately preceding date in the year in which the Guarantee Period expires.
For example, assuming a one-year Guarantee Period, Contract Value transferred to
the Fixed Account on June 1 would have a Guarantee Period starting on that date
and ending on June 30 of the following year. A new Guarantee Period for such
Contract Value would start on July 1 of that year and end on June 30 of the
following year.
HOME OFFICE
The address of the Company's Home Office is Security Benefit Life Insurance
Company, P.O. Box 750497, Topeka, Kansas 66675-0497.
ISSUE DATE
The Issue Date is the date the Company uses to determine the date the Contract
becomes incontestable. The Issue Date is shown on Page 3. Please see
"Incontestability" on page 7.
JOINT OWNER
The Joint Owner, if any, shares an undivided interest in the entire Contract
with the Owner. The Joint Owner, if any, is named on page 3. Please see "Joint
Ownership" provisions on page 9.
NONNATURAL PERSON
Any group or entity that is not a living person, such as a trust or corporation.
OWNER
The Owner is the person who possesses all rights under the Contract. The Owner
is named on page 3. Please see "Ownership" provisions on page 9.
PREMIUM TAX
Any Premium Taxes levied by a state or other governmental entity will be charged
against this Contract. When Premium Tax is assessed after the Purchase Payment
is applied, it will be deducted as described on page 3.
PURCHASE PAYMENT
A Purchase Payment is money Received by the Company and applied to the Contract.
RECEIVED BY THE COMPANY
The phrase "Received by the Company" means receipt by the Company in good order
at its Home Office, P.O. Box 750497, Topeka, Kansas 66675-0497.
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DEFINITIONS (Continued)
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SEPARATE ACCOUNT
Variable Annuity Account VIII (the "Separate Account") is a separate account
established and maintained by the Company under Kansas law. The Separate Account
is registered with the Securities and Exchange Commission under the Investment
Company Act of 1940 as a Unit Investment Trust. It was established by the
Company to support variable annuity contracts. The Company owns the assets of
the Separate Account and maintains them apart from the assets of its general
account and its other separate accounts. The assets held in the Separate Account
equal to the reserves and other Contract liabilities with respect to the
Separate Account may not be charged with liabilities arising from any other
business the Company may conduct.
Income and realized and unrealized gains and losses from assets in the Separate
Account are credited to, or charged against, the Separate Account without regard
to the income, gains or losses from the Company's general account or its other
separate accounts. The Separate Account is divided into Subaccounts shown on
page 3. Income and realized and unrealized gains and losses from assets in each
Subaccount are credited to, or charged against, the Subaccount without regard to
income, gains or losses in the other Subaccounts. The Company has the right to
transfer to its general account any assets of the Separate Account that are in
excess of the reserves and other Contract liabilities with respect to the
Separate Account. The value of the assets in the Separate Account on each
Valuation Date are determined at the end of each Valuation Date.
SUBACCOUNT NET ASSET VALUE
The Subaccount Net Asset Value is equal to: (1) the net asset value of all
shares of the underlying mutual fund held by the Subaccount; plus (2) any cash
or other assets; less (3) all liabilities of the Subaccount.
SUBACCOUNTS
The Separate Account is divided into Subaccounts which invest in shares of
mutual funds. Each Subaccount may invest its assets in a separate class or
series of a designated mutual fund or funds. The Subaccounts are shown on page
3. Subject to the regulatory requirements then in force, the Company reserves
the right to:
1. change or add designated mutual funds or other investment vehicles;
2. add, remove or combine Subaccounts;
3. add, delete or make substitutions for securities that are held or purchased
by the Separate Account or any Subaccount;
4. operate the Separate Account as a management investment company;
5. combine the assets of the Separate Account with other Separate Accounts of
the Company or an affiliate thereof;
6. restrict or eliminate any voting rights of the Owner with respect to the
Separate Account or other persons who have voting rights as to the Separate
Account; and
7. terminate and liquidate any Subaccount.
If any of these changes result in a material change to the Separate Account or a
Subaccount, the Company will notify the Owner of the change. The Company will
not change the investment policy of any Subaccount in any material respect
without complying with the filing and other procedures of the insurance
regulators of the state of issue.
VALUATION DATE
A Valuation Date is each day the New York Stock Exchange and the Company's Home
Office are open for business.
VALUATION PERIOD
A Valuation Period is the interval of time from one Valuation Date to the next
Valuation Date.
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V6022 C (10-94)
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GENERAL PROVISIONS
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THE CONTRACT
The entire Contract between the Owner and the Company consists of this Contract,
the attached Application, and any Amendments, Endorsements or Riders to the
Contract. All statements made in the Application will, in the absence of fraud,
as ruled by the a court of competent jurisdiction, be deemed representations and
not warranties. The Company will use no statement made by or on behalf of the
Owner or the Annuitant to void this Contract unless it is in the written
Application. Any change in the Contract can be made only with the written
consent of the President, a Vice President, or the Secretary of the Company.
The Purchase Payment(s) and the Application must be acceptable to the Company
under its rules and practices. If they are not, the Company's liability shall be
limited to a return of the Purchase Payment(s).
COMPLIANCE
The Company reserves the right to make any change to the provisions of this
Contract to comply with or give the Owner the benefit of any federal or state
statute, rule or regulation. This includes, but is not limited to, requirements
for annuity contracts under the Internal Revenue Code or the laws of any state.
The Company will provide the Owner with a copy of any such change and will also
file such a change with the insurance regulatory officials of the state in which
the Contract is delivered.
MISSTATEMENT OF AGE AND SEX
If the age or sex of the Annuitant has been misstated, payments shall be
adjusted, when allowed by law, to the amount which would have been provided for
the correct age or sex. Proof of the age of an Annuitant may be required at any
time, in a form suitable to the Company. If payments have already commenced and
the misstatement has caused an underpayment, the full amount due will be paid
with the next scheduled payment. If the misstatement has caused an overpayment,
the amount due will be deducted from one or more future payments.
EVIDENCE OF SURVIVAL
When any payments under this Contract depend on the payee being alive on a given
date, proof that the payee is living may be required by the Company. Such proof
must be in a form accepted by the Company, and may be required prior to making
the payments.
INCONTESTABILITY
This Contract will not be contested after it has been in force for two years
from the Issue Date during the life of the Owner.
ASSIGNMENT
Please refer to page 3 to see if the Contract may be assigned. If it may be
assigned, no Assignment under this Contract is binding unless Received by the
Company in writing. The Company assumes no responsibility for the validity,
legality, or tax status of any Assignment. The Assignment will be subject to any
payment made or other action taken by the Company before the Assignment is
Received by the Company. Once filed, the rights of the Owner, Annuitant and
Beneficiary are subject to the Assignment. Any claim is subject to proof of
interest of the assignee.
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GENERAL PROVISIONS (Continued)
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TRANSFERS
The Owner may Transfer Contract Value among the Fixed Account and Subaccounts
subject to the following.
Transfers are not allowed within 30 days of the Annuity Start Date. After the
Annuity Start Date, for Annuity Options 1 through 4, the Owner may Transfer
Contract Value only among Subaccounts.
The Company reserves the right to: (1) limit the amount that may be subject to
Transfer to $1,000,000 per Transfer without Home Office approval; (2) limit the
number of Transfers allowed each Contract Year to 14; and (3) suspend Transfers.
Transfers must be at least $1,000.00 or, if less; (i) the remaining balance in a
Subaccount, or (ii) the amount of Fixed Account Contract Value the Guarantee
Period of which expires in the calendar month in which the Transfer is effected.
Contract Value may be transferred from the Fixed Account only: (1) during the
calendar month in which the applicable Guarantee Period expires; (2) pursuant to
an Automatic Transfer. Transfers of Fixed Account Contract Value shall be made:
(1) first from Fixed Account Contract Value for which the Guarantee Period
expires during the calendar month in which the Transfer is effected; (2) then in
the order that starts with Fixed Account Contract Value which has the longest
amount of time before its Guarantee Period expires; and (3) ends with that which
has the least amount of time before its Guarantee Period expires.
The Company will effect a Transfer to or from a Subaccount on the basis of
Accumulation Unit Value (or Annuity Unit Value) determined at the end of the
Valuation Period in which the Transfer is effected. The Company will effect a
Transfer from the Fixed Account on the basis of Fixed Account Contract Value at
the end of the Valuation Period in which the Transfer is effected.
The Company reserves the right to delay Transfers from the Fixed Account for up
to 6 months as required by most states. The Company will notify you if there
will be a delay.
CLAIMS OF CREDITORS
The Contract Value and other benefits under this Contract are exempt from the
claims of creditors of the Owner to the extent allowed by law.
NONFORFEITURE VALUES
The Death Benefits, Withdrawal Values and Annuity Payout Values will at least
equal the minimum required by law.
PARTICIPATION
The Company is a mutual life insurance company. Therefore, it pays dividends on
some of its contracts. However, the Company does not expect dividends to become
payable on this Contract. At the end of each Contract Year the Company will
determine the Contract's dividend, if any. The Owner may choose to have it: (1)
added to the Contract Value; or (2) paid in cash. If no choice is made, any
dividend will be added to the Contract Value.
STATEMENTS
At least once each Contract Year the Owner shall be sent a statement including
the current Contract Value and any other information required by law. The Owner
may send a written request for a statement at other intervals. The Company may
charge a reasonable fee for such statements.
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V6022 D (R6-96)
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OWNERSHIP, ANNUITANT AND BENEFICIARY PROVISIONS
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OWNERSHIP
During the Owner's lifetime, all rights and privileges under the Contract may be
exercised only by the Owner. If the purchaser names someone other than himself
or herself as Owner, the purchaser has no rights in the Contract. No Owner may
be older than age 90 on the Contract Date.
JOINT OWNERSHIP
If a Joint Owner is named in the application, then the Owner and Joint Owner
share an undivided interest in the entire Contract as joint tenants with rights
of survivorship. When an Owner and Joint Owner have been named, the Company will
honor only requests for changes and the exercise of other Ownership rights made
by both the Owner and Joint Owner. When a Joint Owner is named, all references
to "Owner" throughout this Contract should be construed to mean both the Owner
and Joint Owner, except for the "Statements" provision on page 8 and the "Death
Benefit Provisions" on pages 14 and 15.
ANNUITANT
The Annuitant is named on page 3. The Owner may change the Annuitant prior to
the Annuity Start Date. The request for this change must be made in writing and
Received by the Company at least 30 days prior to the Annuity Start Date. No
annuitant may be named who is more than 90 years old on the Contract Date. When
the Annuitant dies prior to the Annuity Start Date, the Owner must name a new
Annuitant within 30 days or, if sooner, by the Annuity Start Date, except where
the Owner is a Nonnatural Person. If a new Annuitant is not named, the Owner
becomes the Annuitant.
PRIMARY AND SECONDARY BENEFICIARIES
The Primary Beneficiary is named on page 3. The Owner may change any Beneficiary
as described in "Ownership and Beneficiary Changes" below. If the Primary
Beneficiary dies prior to the Owner, the Secondary Beneficiary becomes the
Primary Beneficiary. Unless the Owner directs otherwise, when there are two or
more Primary Beneficiaries, they will receive equal shares.
OWNERSHIP AND BENEFICIARY CHANGES
Subject to the terms of any existing Assignment, the Owner may name a new Owner,
a new Primary Beneficiary or a new Secondary Beneficiary. Any new choice of
Owner, Primary Beneficiary or Secondary Beneficiary will revoke any prior
choice. Any change must be made in writing and recorded at the Home Office. The
change will become effective as of the date the written request is signed,
whether or not the Owner is living at the time the change is recorded. A new
choice of Primary Beneficiary or Secondary Beneficiary will not apply to any
payment made or action taken by the Company prior to the time it was recorded.
The Company may require the Contract be returned so these changes may be made.
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PURCHASE PAYMENT PROVISIONS
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FLEXIBLE PURCHASE PAYMENTS
The Contract becomes in force when the initial Purchase Payment is applied. The
Owner is not required to continue Purchase Payments in the amount or frequency
originally planned. The Owner may: (1) increase or decrease the amount of
Purchase Payments, subject to any Contract limits; or (2) change the frequency
of Purchase Payments. A change in frequency or amount of Purchase Payments does
not require a written request.
PURCHASE PAYMENT LIMITATIONS
Purchase Payments exceeding $1,000,000 will not be accepted without prior
approval by the Company. The Minimum Subsequent Purchase Payment amount is shown
on page 3.
PURCHASE PAYMENT ALLOCATION
Purchase Payments may be allocated among the Fixed Account and the Subaccounts.
Purchase Payments will be allocated according to the Owner's instructions in the
Application or more recent instructions, if any. Each allocation to the Fixed
Account and the Subaccounts must be at least 1% of the Purchase Payment. The
allocations must be whole percentage amounts and must total 100%. The Owner may
change the allocations by written notice to the Company.
PLACE OF PAYMENT
All Purchase Payments under this Contract are to be paid to the Company at its
Home Office. Purchase Payments after the initial Purchase Payment are applied as
of the end of the Valuation Period during which they are Received by the
Company.
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CONTRACT VALUE AND EXPENSE PROVISIONS
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CONTRACT VALUE
On any Valuation Date, the Contract Value is the sum of: (1) the Separate
Account Contract Value; and (2) the Fixed Account Contract Value. At any time
after the first Contract Year and before the Annuity Start Date, the Company
reserves the right to pay to the Owner the Contract Value as a lump sum if it is
below $5,000.
FIXED ACCOUNT CONTRACT VALUE
On any Valuation Date, the Fixed Account Contract Value is equal to the first
Purchase Payment allocated under the Contract to the Fixed Account:
PLUS:
1. any other Purchase Payments allocated under the Contract to the Fixed
Account;
2. any Transfers from the Separate Account to the Fixed Account; and
3. any interest credited to the Fixed Account.
LESS:
1. any Withdrawals deducted from the Fixed Account;
2. any Transfers from the Fixed Account to the Separate Account;
3. any applicable Premium Taxes;
4. any Fixed Account Contract Value which is applied to any of Annuity Options
1 through 4; and
5. any Annuity Payments made under Annuity Options 5 and 6.
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V6022 E (10-94)
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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FIXED ACCOUNT INTEREST CREDITING
The Company shall credit interest on Fixed Account Contract Value at an annual
rate at least equal to the Guaranteed Rate shown on page 3. Also, the Company
may in its sole judgment credit Current Interest at a rate in excess of the
Guaranteed Rate. The rate of Current Interest, if declared, shall be fixed
during the Guarantee Period. Fixed Account Contract Value shall earn Current
Interest during each Guarantee Period at the rate, if any, declared by the
Company on the first day of the Guarantee Period.
The Company may credit Current Interest on Contract Value that was allocated or
transferred to the Fixed Account during one period at a different rate than
amounts allocated or transferred to the fixed Account in another period. Also,
the Company may credit Current Interest on Fixed Account Contract Value at
different rates based upon the length of the Guarantee Period. Therefore, at any
time, portions of Fixed Account Contract Value may be earning Current Interest
at different rates based upon the period during which such portions were
allocated or transferred to the Fixed Account and the length of the Guarantee
Period.
SEPARATE ACCOUNT CONTRACT VALUE
On any Valuation Date, the Separate Account Contract Value is the sum of the
then current value of the Accumulation Units allocated to each Subaccount for
this Contract.
ACCUMULATION UNIT VALUE
The initial Accumulation Unit Value for each Subaccount was set at $10. Other
Accumulation Unit Values are found on each Valuation Date by dividing (1) by (2)
where:
1. is the equal to:
a. the Subaccount Net Asset Value determined at the end of the current
Valuation Period; plus
b. any dividends declared by the Subaccount's underlying mutual fund that
are not part of the Subaccount Net Asset Value; less the accrued
Mortality and Expense Risk Charge; and
c. the accrued Mortality and Expense Risk Charge; and
d. the accrued Administration Charge; and
e. any taxes for which the Company has reserved which the Company deems to
have resulted from the operation of the Subaccount.
2. is the number of Accumulation Units at the start of the Valuation Period.
The Accumulation Unit Value may increase or decrease from one Valuation Period
to the next.
DETERMINING ACCUMULATION UNITS
The number of Accumulation Units allocated to a Subaccount under this Contract
is found by dividing: (1) the amount allocated to the Subaccount; by (2) the
Accumulation Unit Value for the Subaccount at the end of the Valuation Period
during which the amount is applied under the Contract. The number of
Accumulation Units allocated to a Subaccount under the Contract will not change
as a result of investment experience. Events that change the number of
Accumulation Units are:
1. Purchase Payments that are applied to the Subaccount;
2. Contract Value that is Transferred into or out of the Subaccount;
3. Withdrawals that are deducted from the Subaccount; and
4. Premium Taxes that are deducted from the Subaccount.
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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MORTALITY AND EXPENSE RISK CHARGE
The Company will deduct the Mortality and Expense Risk Charge shown on page 3.
This charge will be computed and deducted from each Subaccount on each Valuation
Date. This charge is factored into the Accumulation Unit and Annuity Unit Values
on each Valuation Date.
PREMIUM TAX EXPENSE
The Company reserves the right to deduct Premium Tax when due or any time
thereafter. Any applicable Premium Taxes will be allocated as described on page
3.
ADMINISTRATION CHARGE
The Company will deduct the Administration Charge shown on page 3. This charge
will be computed and deducted from each Subaccount on each Valuation Date. This
charge is factored into the Accumulation Unit Value on each Valuation Date.
MUTUAL FUND EXPENSES
Each Subaccount invests in shares of a mutual fund. The net asset value per
share of each underlying fund reflects the deduction of any investment advisory
and administration fees and other expenses of the fund. These fees and expenses
are not deducted from the assets of a Subaccount, but are paid by the underlying
funds. The Owner indirectly bears a pro rata share of such fees and expenses. An
underlying fund's fees and expenses are not specified or fixed under the terms
of this Contract.
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WITHDRAWAL PROVISIONS
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WITHDRAWALS
A full Withdrawal of the Contract Value or partial Withdrawal of Separate
Account Contract Value is allowed at any time. Partial Withdrawals of Fixed
Account Contract Value are, however, restricted as described below. This
provision is subject to any federal or state Withdrawal restrictions.
A partial Withdrawal of Fixed Account Contract Value may be made only: (1)
pursuant to Systematic Withdrawals over a period of at least 36 months; (2)
during the calendar month in which the applicable Guarantee Period expires; and
(3) once per Contract Year in an amount up to the greater of $5,000 or 10% of
the Contract Value in the Fixed Account at the time of the partial Withdrawal.
Upon the Owner's request for a full Withdrawal, the Company will pay the
Withdrawal Value in a lump sum.
All Withdrawals must meet the following conditions.
1. The request for Withdrawal must be Received by the Company in writing or
under other methods allowed by the Company.
2. The Owner must apply: (a) while this Contract is in force; and (b) prior to
the Annuity Start Date of Options 1-4.
3. The amount Withdrawn must be at least $1,000.00, except that a Withdrawal of
less than $1,000.00 is allowed: (i) for Systematic Withdrawals, as discussed
on page 13, (ii) for Fixed Account Contract Value the Guarantee Period of
which expires during the calendar month of the Withdrawal, or (iii) when
terminating the Contract.
-12-
V6022 F (10-94)
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WITHDRAWAL PROVISIONS (Continued)
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WITHDRAWALS (Continued)
A partial Withdrawal request must state the allocations for deducting the
Withdrawal from each Account. If no allocation is specified, the partial
Withdrawal will be deducted from the Accounts in the order described on page 3,
"Method for Deductions." Withdrawals of Fixed Account Contract Value shall be
made: (1) first from Fixed Account Contract Value for which the Guarantee Period
expires during the calendar month in which the Withdrawal is effected; (2) then
in the order that starts with Fixed Account Contract Value which has the longest
amount of time before its Guarantee Period expires; and (3) ends with that which
has the least amount of time before its Guarantee Period expires.
WITHDRAWAL VALUE
The Withdrawal Value at any time will be: (1) the Contract Value; less (2) any
Premium Taxes due or paid by the Company.
SYSTEMATIC WITHDRAWALS
Systematic Withdrawals are automatic periodic distributions from the Contract in
substantially equal amounts prior to the Annuity Start Date. In order to start
Systematic Withdrawals, the Owner must make the request in writing. The Minimum
Systematic Withdrawal is shown on page 3. The Owner must choose the type of
payment and its frequency. The Systematic Withdrawal request must state the
allocations for deducting the Withdrawals from each Account. If no allocation is
specified, the Withdrawals will be deducted from the Accounts in the order
described on page 3, "Method for Deductions." The payment type may be: (1) a
percentage of Contract Value; (2) a specified dollar amount; (3) all earnings in
the Contract; (4) over a fixed period of time; or (5) based upon the life
expectancy of the Owner or the Owner and a Beneficiary. The payment frequency
may be: (1) monthly; (2) quarterly; (3) semiannually; or (4) annually.
Systematic Withdrawals of Fixed Account Contract Value must provide for payments
over a period of not less than 36 months. Systematic Withdrawals may be stopped
by the Owner upon proper written request Received by the Company at least 30
days in advance. The Company reserves the right to stop, modify, suspend or
charge a fee for Systematic Withdrawals at any time.
DATE OF REQUEST
The Company will effect a Withdrawal of Separate Account Contract Value on the
basis of Accumulation Unit Value determined at the end of the Valuation Period
in which all the required information is Received by the Company.
PAYMENT OF WITHDRAWAL BENEFITS
The Company reserves the right to suspend a Transfer or delay payment of a
Withdrawal from the Separate Account for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists as a result of which: (a) disposal of securities
held in the Separate Account is not reasonably practicable; or (b) it is not
reasonably practicable to fairly value the net assets of the Separate
Account; or
4. during any other period when the Securities and Exchange Commission, by
order, so permits to protect owners of securities.
Rules and regulations of the Securities and Exchange Commission will govern as
to whether the conditions set forth above exist.
The Company further reserves the right to delay payment of a Withdrawal from the
Fixed Account for up to six months as required by most states. The Company will
notify you if there will be a delay.
-13-
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DEATH BENEFIT PROVISIONS
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DEATH BENEFIT
If any Owner dies prior to the Annuity Start Date, a Death Benefit will be paid
to the Designated Beneficiary when due Proof of Death and instructions regarding
payment are Received by the Company. If an Owner is a Nonnatural Person, then
the Death Benefit will be paid in the event of the death of the Annuitant or any
joint Owner that is a natural person prior to the Annuity Start Date. Further,
if an Owner is a Nonnatural Person, the amount of the death benefit is based on
the age of the Annuitant or any joint Owner that is a natural person on the
Issue Date.
If the age of each Owner was 75 or younger on the Issue Date, the Death Benefit
will be the greatest of: (1) the sum of all Purchase Payments, less any Premium
Taxes due or paid by the Company and less the sum of all partial Withdrawals;
(2) the Contract Value on the date due Proof of Death and instructions regarding
payment are Received by the Company, less any Premium Taxes due or paid by the
Company; or (3) the Stepped-Up Death Benefit described below.
The Stepped-Up Death Benefit is:
1. the largest Death Benefit on any Contract Anniversary that is both an exact
multiple of five and occurs prior to the oldest Owner reaching age 76; plus
2. any Purchase Payments received since the applicable fifth Contract
Anniversary; less
3. any reductions caused by Withdrawals since the applicable fifth Contract
Anniversary; less
4. any Premium Taxes due or paid by the Company.
If the age of any Owner on the Issue Date was 76 or older, or if due proof of
death (regardless of the age of any Owner on the Issue Date) and instructions
regarding payment are not Received by the Company within six months of the date
of the Owner's death, the Death Benefit will be: (1) the Contract Value on the
date due Proof of Death and instructions regarding payment are Received by the
Company; less (2) any Premium Taxes due or paid by the Company.
If a lump sum payment is requested, the payment will be made in accordance with
any laws and regulations that govern the payment of Death Benefits.
PROOF OF DEATH
Any of the following will serve as Proof of Death:
1. certified copy of the death certificate;
2. certified decree of a court of competent jurisdiction as to the finding of
death;
3. written statement by a medical doctor who attended the deceased Owner; or
4. any proof accepted by the Company.
DISTRIBUTION RULES
The entire Death Benefit with any interest shall be paid within 5 years after
the death of any Owner, except as provided below. In the event that the
Designated Beneficiary elects an Annuity Option, the length of time for the
payment period may be longer than 5 years if: (1) the Designated Beneficiary is
a natural person; (2) the Death Benefit is paid out under Annuity Options 1
through 6; (3) payments are made over a period that does not exceed the life or
life expectancy of the Designated Beneficiary; and (4) Annuity Payments begin
within one year of the death of the Owner. If the deceased Owner's spouse is the
sole Designated Beneficiary, the spouse shall become the sole Owner of the
Contract. He or she may elect to: (1) keep the Contract in force until the
sooner of the spouse's death or the Annuity Start Date; or (2) receive the Death
Benefit.
-14-
V6022 G (R6-96)
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DEATH BENEFIT PROVISIONS (Continued)
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DISTRIBUTION RULES (Continued)
If any Owner dies after the Annuity Start Date, Annuity Payments shall continue
to be paid at least as rapidly as under the method of payment being used as of
the date of the Owner's death.
If the Owner is a Nonnatural Person, the distribution rules set forth above
apply in the event of the death of, or a change in, the Annuitant. This Contract
is deemed to incorporate any provision of Section 72(s) of the Internal Revenue
Code of 1986, as amended (the "Code"), or any successor provision. This Contract
is also deemed to incorporate any other provision of the Code deemed necessary
by the Company, in its sole judgment, to qualify this Contract as an annuity.
The application of the distribution rules will be made in accordance with Code
section 72(s), or any successor provision, as interpreted by the Company in its
sole judgment.
The foregoing distribution rules do not apply to a Contract which is: (1)
provided under a plan described in Code Section 401(a); (2) described in Code
section 403(b); (3) an individual retirement annuity or provided under an
individual retirement account or annuity; or (4) otherwise exempt from the Code
section 72(s) distribution rules.
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ANNUITY PAYMENT PROVISIONS
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ANNUITY START DATE
The Owner may choose the Annuity Start Date at the time of application. If no
Annuity Start Date is chosen, the Company will use the later of: (1) the oldest
Annuitant's seventieth birthday; or (2) the tenth Contract Anniversary. The
Annuity Start Date must be prior to the oldest Annuitant's ninety-fifth
birthday.
The Annuity Start Date is the date the first payment will be made to the
Annuitant under any of the Annuity Options.
CHANGE OF ANNUITY START DATE
The Owner may change the Annuity Start Date. A request for the change must be
made in writing. The written request must be Received by the Company at least 30
days prior to the new Annuity Start Date as well as 30 days prior to the
previous Annuity Start Date.
ANNUITY START AMOUNT
The Annuity Start Amount is applied to one or more of the Annuity Options listed
on page 18. The Annuity Start Amount is: (1) the Contract Value on the Annuity
Start Date; less (2) any Premium Taxes due or paid by the Company. Unless
otherwise directed by the Owner, Annuity Start Amount derived from Fixed Account
Contract Value will be applied to purchase a Fixed Annuity Option; that derived
from Separate Account Contract Value will be applied to purchase a Variable
Annuity Option.
-15-
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ANNUITY PAYMENT PROVISIONS (Continued)
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ANNUITY TABLES
Annuity Tables A and B show the guaranteed minimum amount of monthly Annuity
Payment per $1,000 of Annuity Start Amount for annuity options 1 through 4 that
applies to the first Variable Annuity Payment and to each payment for Fixed
Annuity Payments. The amount of each Annuity Payment for Annuity Options 1
through 4 will depend on the Annuitant's sex and age on the Annuity Start Date.
Tables A and B assume 1900 as the year of birth of the annuitant. To use Table A
and B for an Annuitant born after 1900, the actual age is reduced by 0.1
(one-tenth) of a year for each year the year of birth exceeds 1900. For an
annuitant with a birth year prior to 1900, the actual age is increased in a like
manner. The actual age (in completed months) reduced or increased becomes the
"adjusted age of the Annuitant". The guaranteed payout rate is then found by
interpolating the Annuitant's adjusted age between the ages shown in Tables A
and B. Tables A and B are based on the 1983 Table "A" mortality table and an
interest rate of 3.5% per year. On request the Company will furnish the amount
of monthly Annuity Payment per $1,000 applied for any ages not shown.
For Annuity Options 5 and 6, annuity rates based on age and sex are not used to
calculate annuity payments. Annuity Payments for these options are computed
without reference to the Annuity Tables.
ANNUITY PAYMENTS
The Annuity Option is shown on page 3. The Owner may choose any form of Annuity
Option that is allowed by the Company. The Owner may choose an Annuity Option by
written request. This request must be Received by the Company at least 30 days
prior to the Annuity Start Date. Several Annuity Options are listed on page 18.
No Annuity Option can be selected that requires the Company to make periodic
payments of less than $100.00. If no Annuity Option is chosen prior to the
Annuity Start Date, the Company will use Life with 10-Year Fixed Period Option.
Each Annuity Option allows for making Annuity Payments annually, semiannually,
quarterly or monthly.
CHANGE OF ANNUITY OPTION
Prior to the Annuity Start Date, the Owner may change the Annuity Option chosen.
The Owner must request the change in writing. This request must be Received by
the Company at least 30 days prior to the Annuity Start Date.
FIXED ANNUITY PAYMENTS
With respect to Fixed Annuity Payments, the amounts shown on the Tables are the
guaranteed minimum for each Annuity Payment for Annuity Options 1 through 4.
VARIABLE ANNUITY PAYMENTS
With respect to Variable Annuity Payments, the amount shown on the Tables is the
guaranteed minimum first Annuity Payment, based on the assumed interest rate of
3.5% for Annuity Options 1 through 4. The amount of each Annuity Payment after
the first for these options is computed by means of Annuity Units.
ANNUITY UNITS
The number of Annuity Units is found by dividing the first Annuity Payment by
the Annuity Unit Value for the selected Subaccount on the Annuity Start Date.
The number of Annuity Units for the Subaccount then remains constant, unless a
Transfer of Annuity Units is made. After the first Annuity Payment, the dollar
amount of each subsequent Annuity Payment is equal to the number of Annuity
Units times the Annuity Unit Value for the Subaccount on the due date of the
Annuity Payment.
-16-
V6022 H (10-94)
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ANNUITY PAYMENT PROVISIONS (Continued)
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ANNUITY UNITS (Continued)
The Annuity Unit Value for each Subaccount was first set at $1.00. The Annuity
Unit Value for any subsequent Valuation Date is equal to (a) times (b) times
(c), where:
(a) is the Annuity Unit Value on the immediately preceding Valuation Date;
(b) is the Net Investment Factor for the day;
(c) is a factor used to adjust for an assumed interest rate of 3.5% per year
used to determine the Annuity Payment amounts. The assumed interest rate is
reflected in the Annuity Tables.
NET INVESTMENT FACTOR
The Net Investment Factor for any Subaccount at the end of any Valuation Period
is determined by dividing (1) by (2) and subtracting (3) from the result, where:
1. is equal to:
a. the net asset value per share of the mutual fund held in the Subaccount,
found at the end of the current Valuation Period; plus
b. the per share amount of any dividend or capital gain distributions paid
by the Subaccount's underlying mutual fund that is not included in the
net asset value per share; plus or minus
c. a per share charge or credit for any taxes reserved for, which the
Company deems to have resulted from the operation of the Subaccount.
2. is the net asset value per share of the Subaccount's underlying mutual fund
as found at the end of the prior Valuation Period.
3. is a factor representing the Mortality and Expense Risk Charge which is
deducted from the Separate Account.
Underlying mutual funds may declare dividends on a daily basis and pay such
dividends once a month. The Net Investment Factor allows for the monthly
reinvestment of these daily dividends. As described above, the gains and losses
from each Subaccount are credited or charged against the Subaccount without
regard to the gains or losses in the Company or other Subaccounts.
ALTERNATE ANNUITY OPTION RATES
The Company may, at the time of election of an Annuity Option, offer more
favorable rates in lieu of the guaranteed rates shown in the Annuity Tables.
-17-
--------------------------------------------------------------------------------
ANNUITY PAYMENT PROVISIONS (Continued)
--------------------------------------------------------------------------------
ANNUITY OPTIONS
OPTION 1
LIFE OPTION: This option provides payments for the life of the Annuitant. Table
A shows some of the guaranteed rates for this option.
OPTION 2
LIFE WITH FIXED PERIOD OPTION: This option provides payments for the life of the
Annuitant. A fixed period of 5, 10, 15 or 20 years may be chosen. Payments will
be made to the end of this period even if the Annuitant dies prior to the end of
the period. If the Annuitant dies before receiving all the payments during the
fixed period. If the Annuitant dies before receiving all the payments during the
fixed period, the remaining payments will be made to the Designated Beneficiary.
Table A shows some of the guaranteed rates for this option.
OPTION 3
LIFE WITH INSTALLMENT OR UNIT REFUND OPTION: This option provides payments for
the life of the Annuitant, with a period certain determined by dividing the
Annuity Start Amount by the amount of the first payment. A fixed number of
payments will be made even if the Annuitant dies. If the Annuitant dies before
receiving the fixed number of payments, any remaining payments will be made to
the Designated Beneficiary. Table A shows some of the guaranteed rates for this
option.
OPTION 4
JOINT AND LAST SURVIVOR OPTION: This option provides payments for the life of
the Annuitant and Joint Annuitant. Payments will be made as long as either is
living. Table B shows some of the guaranteed rates for this option.
OPTION 5
FIXED PERIOD OPTION: This option provides payments for a fixed number of years
between 5 and 20. If the Contract Value is held in the Fixed Account, then the
amount of the payments will vary as a result of the interest rate (as adjusted
periodically) credited on the Fixed Account. This rate is guaranteed to be no
less than the Guaranteed Rate shown on page 3. If the Contract Value is held in
the Separate Account, then the amount of the payments will vary as a result of
the investment performance of the Subaccounts chosen. If all the Annuitants die
before receiving the fixed number of payments, any remaining payments will be
made to the Designated Beneficiary.
OPTION 6
FIXED PAYMENT OPTION: This option provides a fixed payment amount. This amount
is paid until the amount applied, including daily interest adjustments, is paid.
If the Contract Value is held in the Fixed Account, then the number of payments
will vary as a result of the interest rate (as adjusted periodically) credited
on the Fixed Account. This rate is guaranteed to be no less than the Guaranteed
Rate shown on page 3. If the Contract Value is held in the Separate Account,
then the number of payments will vary as a result of the investment performance
of the Subaccounts chosen. If all the Annuitants die before receiving all the
payments, any remaining payments will be made to the Designated Beneficiary.
-18-
V6022 I (10-94)
ANNUITY TABLES
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TABLE A
SETTLEMENT OPTIONS ONE, TWO, AND THREE
MINIMUM INITIAL MONTHLY INSTALLMENTS PER $1,000 OF AMOUNT APPLIED
Option Two
Adjusted Option One Year Fixed Period Ends Option Three
Age Life 5 10 15 20 Unit
of Annuitant Only Years Years Years Years Refund
--------------------------------------------------------------------------------
MALE
55 4.99 4.97 4.91 4.80 4.66 4.73
56 5.09 5.07 5.00 4.88 4.72 4.81
57 5.20 5.17 5.10 4.97 4.78 4.90
58 5.32 5.29 5.20 5.05 4.85 4.99
59 5.44 5.41 5.31 5.14 4.91 5.08
60 5.57 5.53 5.42 5.23 4.97 5.18
61 5.71 5.67 5.54 5.33 5.04 5.29
62 5.86 5.81 5.67 5.42 5.10 5.40
63 6.02 5.97 5.80 5.52 5.16 5.51
64 6.20 6.13 5.94 5.62 5.22 5.63
65 6.38 6.31 6.08 5.72 5.28 5.76
66 6.58 6.49 6.23 5.82 5.33 5.90
67 6.79 6.69 6.38 5.92 5.38 6.04
68 7.02 6.90 6.54 6.02 5.43 6.19
69 7.26 7.12 6.71 6.12 5.48 6.35
70 7.52 7.35 6.87 6.21 5.52 6.52
71 7.80 7.60 7.05 6.30 5.55 6.69
72 8.09 7.86 7.22 6.39 5.59 6.88
73 8.41 8.13 7.40 6.47 5.62 7.07
74 8.75 8.42 7.57 6.55 5.64 7.27
75 9.12 8.72 7.75 6.62 5.66 7.49
FEMALE
55 4.54 4.53 4.51 4.46 4.38 4.40
56 4.62 4.61 4.58 4.53 4.44 4.47
57 4.71 4.70 4.66 4.60 4.51 4.54
58 4.80 4.79 4.75 4.68 4.57 4.62
59 4.90 4.88 4.84 4.76 4.64 4.70
60 5.00 4.99 4.93 4.84 4.70 4.78
61 5.11 5.09 5.03 4.93 4.77 4.87
62 5.23 5.21 5.14 5.02 4.84 4.96
63 5.36 5.33 5.25 5.12 4.91 5.06
64 5.49 5.46 5.37 5.21 4.98 5.17
65 5.64 5.60 5.50 5.31 5.05 5.28
66 5.79 5.75 5.63 5.42 5.12 5.39
67 5.95 5.91 5.77 5.53 5.19 5.52
68 6.13 6.08 5.91 5.63 5.25 5.65
69 6.32 6.26 6.07 5.74 5.32 5.79
70 6.53 6.46 6.23 5.86 5.37 5.94
71 6.75 6.67 6.40 5.97 5.43 6.09
72 6.99 6.89 6.58 6.08 5.48 6.26
73 7.26 7.13 6.76 6.18 5.52 6.44
74 7.54 7.39 6.95 6.29 5.57 6.63
75 7.85 7.67 7.14 6.39 5.60 6.83
Values not shown will be provided upon request. Annual, semiannual, or
quarterly installments can be determined by multiplying the monthly installments
by 11.812853, 5.9572227, and 2.9914196 respectively.
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TABLE B
SETTLEMENT OPTION FOUR
MINIMUM INITIAL MONTHLY INSTALLMENT PER $1,000 OF AMOUNT APPLIED
Adjusted Age of Adjusted Age of Male Annuitant
Female Annuitant 55 60 62 65 70 75
--------------------------------------------------------------------------------
55 4.16 4.27 4.30 4.35 4.42 4.47
60 4.34 4.51 4.57 4.66 4.78 4.86
62 4.41 4.61 4.68 4.79 4.94 5.04
65 4.51 4.76 4.85 4.99 5.20 5.35
70 4.66 4.99 5.13 5.34 5.67 5.95
75 4.78 5.19 5.37 5.66 6.16 6.63
Values not shown will be provided upon request. Annual, semiannual, or
quarterly installments can be determined by multiplying the monthly installments
by 11.812853, 5.9572227, and 2.9914196 respectively.
-19-
A BRIEF DESCRIPTION OF THIS CONTRACT
This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT.
* Purchase Payments may be made until the earlier of the Annuity Start Date
or termination of the Contract.
* A Death Benefit may be paid prior to the Annuity Start Date according to
the Contract provisions.
* Annuity Payments begin on the Annuity Start Date using the method as
specified in this Contract.
* This Contract is Participating.
ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN
ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. THERE ARE NO
GUARANTEED MINIMUM PAYMENTS OR CASH VALUES. (SEE "CONTRACT VALUE AND EXPENSE
PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.)
[SBL LOGO]
SECURITY BENEFIT LIFE INSURANCE COMPANY
A Member of The Security Benefit Group of Companies
P.O. Box 750497, Topeka, KS 66675-0497
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0001
0-000-000-0000