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Exhibit 4(d)(i)
ADDITIONAL INCOME OPTION ENDORSEMENT
ENDORSEMENT
SECTION 1. GENERAL INFORMATION
1.1 WHAT IS OUR Our agreement with you includes this
AGREEMENT WITH YOU? endorsement as a part of the contract to
which it is attached. The provisions of the
contract apply to this endorsement unless
changed by this endorsement.
ENDORSEMENT
SECTION 2. BENEFIT
2.1 WHAT IS THE BENEFIT This endorsement provides 6 additional
PROVIDED BY THIS income payout options, as described below.
ENDORSEMENT? The term "annuitant", when used in the
income payout options below, includes any
beneficiary who elects to apply death
benefit proceeds under an income payout
option as allowed under the contract.
We reserve the right to discontinue offering
the additional options provided by this
endorsement if the U.S. Treasury no longer
issues new Treasury Inflation-Protection
Securities.
ENDORSEMENT
SECTION 3. ADDITIONAL OPTIONS
3.1 WHAT ADDITIONAL OPTION 5A - SINGLE LIFE INCOME - PAYMENTS
INCOME PAYOUT ADJUSTED FOR INFLATION - GUARANTEE PERIOD
OPTIONS ARE CERTAIN (FIXED INCOME PAYMENTS ONLY). We
AVAILABLE? will pay monthly income payments to the
payee for as long as the annuitant lives. If
the original payee dies before all of the
income payments have been made for the
guaranteed period certain: (a) income
payments will be continued during the
remainder of the guaranteed period certain
to the successor payee; or (b) the present
value of the remaining income payments,
calculated on the same basis used to create
Option 5A rates, will be paid to the
successor payee or to the last surviving
payee's estate, if there is no successor
payee.
The guaranteed period certain choices are:
a.) 5 years;
b.) 10 years;
c.) 15 years; or
d.) 20 years.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid.
OPTION 5B - SINGLE LIFE INCOME - PAYMENTS
ADJUSTED FOR INFLATION - LIFETIME PAYOUT
(FIXED INCOME PAYMENTS ONLY). We will pay
monthly income payments to the payee for as
long as the annuitant lives.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid.
2004-VAIO
OPTION 6A - JOINT LIFE INCOME - PAYMENTS
ADJUSTED FOR INFLATION - GUARANTEE PERIOD
CERTAIN (FIXED INCOME PAYMENTS ONLY). We
will pay monthly income payments to the
payee for as long as either of the
co-annuitants is living. If at the death of
the second surviving annuitant, income
payments have been made for less than the
guaranteed period certain: (a) income
payments will be continued during the
remainder of the guaranteed period certain
to the successor payee; or (b) the present
value of the remaining income payments,
calculated on the same basis used to create
Option 6A rates, will be paid to the
successor payee or to the last surviving
payee's estate, if there is no successor
payee.
The guaranteed period certain choices are:
a.) 5 years;
b.) 10 years;
c.) 15 years; or
d.) 20 years.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid.
OPTION 6B - JOINT LIFE INCOME - PAYMENTS
ADJUSTED FOR INFLATION - LIFETIME PAYOUT
(FIXED INCOME PAYMENTS ONLY). We will pay
monthly income payments to the payee for as
long as either of the co-annuitants is
living.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid.
OPTION 7 - SINGLE LIFE INCOME - PAYMENTS
ADJUSTED FOR INFLATION - LIFETIME PAYOUT
WITH CASH REFUND (FIXED INCOME PAYMENTS
ONLY). We will pay monthly income payments
to the payee for as long as the annuitant
lives. The total amount paid under this
option will be at least equal to the
contract value applied. If the original
payee dies and the total of all income
payments paid is less than the adjusted net
contract value applied to this income payout
option, the difference will be payable to
the successor payee in a single sum. If
there is no successor payee, it will be
payable to the payee's estate.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid
OPTION 8 - JOINT LIFE INCOME - PAYMENTS
ADJUSTED FOR INFLATION - LIFETIME PAYOUT
WITH CASH REFUND (FIXED INCOME PAYMENTS
ONLY). We will pay monthly income payments
to the payee for as long as either of the
co-annuitants is living. The total amount
paid under this option will be at least
equal to the contract value applied. If at
the death of the second surviving annuitant,
the total of all income payments paid is
less than the adjusted net contract value
applied to this income payout option, the
difference will be payable to the successor
payee in a single sum. If there is no
successor payee, it will be payable to the
last surviving payee's estate.
Dividends, if any, will be payable as
determined by us. We do not anticipate any
dividends will be paid.
3.2 HOW WILL FIXED The dollar amount of the initial income
INCOME PAYMENT payment will be determined by dividing the
VALUES BE DETERMINED adjusted net contract value applied by
FOR THESE ADDITIONAL $1,000, and multiplying the result by the
INCOME PAYOUT applicable option rate shown in Endorsement
OPTIONS? Section 4. Higher current option rates may
be available on the payout date and are
available upon your request to our home
office.
Income payments for the remainder of the
calendar year in which your payout date
occurs will be equal to your initial income
payment.
The dollar amount of income payments for
subsequent calendar years, adjusted for
inflation, will be calculated annually and
will be effective for the duration of the
calendar year. The adjustment for inflation
is based on the percentage increase in the
Consumer Price Index (defined below) for the
12 month period ending September 30th of the
prior calendar year. If the percentage
change in the Consumer Price Index is zero
or less, your income payments for the
upcoming calendar year will remain
unchanged.
Income payments will never decrease due to
an adjustment for inflation under these
options.
Consumer Price Index means the Consumer
Price Index Urban Wage Earners and Clerical
Workers (Current Series). If the Consumer
Price Index is discontinued, a substitute
index published by the U.S. Department of
Labor or successor agency will be used. Such
substitute index may be subject to approval
by your state insurance department, if
required by state law.
ENDORSEMENT
SECTION 4. ADDITIONAL OPTION TABLES
4.1 WHAT RATES WILL BE The rates shown in the following tables are
USED TO DETERMINE used to determine the minimum payment values
PAYMENT VALUES FOR for monthly income payments. Higher current
THESE ADDITIONAL rates may be available on the payout date,
INCOME PAYOUT and are available upon your request to our
OPTIONS? home office.
The additional options provided by this
endorsement are based on the Annuity 2000
Table and with compound interest at the
effective rate of 3.50% per year and an
assumed annual payment increase of 4.50%.
Rates for ages not shown will be calculated
on an actuarially equivalent basis and will
be available upon request.
The Type A life income rates for these
additional options are based on the
annuitant's age and gender; or the
beneficiary's age and gender if the
beneficiary elects to apply death benefit
proceeds under an income payout option. The
Type B life income rates are based on the
annuitant's age; or the beneficiary's age if
the beneficiary elects to apply death
benefit proceeds under an income payout
option. The life income rates type for this
contract is shown on the contract data page.
OPTION 5A - SINGLE LIFE INCOME RATES - PAYMENTS ADJUSTED FOR INFLATION -
GUARANTEE PERIOD CERTAIN - FIRST PAYMENT DUE AT BEGINNING OF PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
AGE - MALE
----------------------------------------------------------------------------
YEARS 60 61 62 63 64 65 66 67 68 69 70 71 72
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 2.98 3.10 3.22 3.36 3.50 3.65 3.81 3.98 4.16 4.35 4.55 4.76 4.99
10 2.95 3.06 3.17 3.30 3.43 3.56 3.71 3.85 4.01 4.17 4.34 4.51 4.69
15 2.87 2.97 3.07 3.17 3.28 3.39 3.50 3.61 3.73 3.84 3.95 4.07 4.18
20 2.73 2.81 2.88 2.96 3.04 3.11 3.18 3.25 3.32 3.38 3.44 3.50 3.55
AGE - MALE
----------------------------------------------------------------------------
YEARS 73 74 75 76 77 78 79 80 81 82 83 84 85
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 5.23 5.48 5.75 6.04 6.34 6.65 6.98 7.33 7.69 8.07 8.45 8.85 9.26
10 4.87 5.06 5.25 5.44 5.64 5.83 6.02 6.21 6.40 6.57 6.74 6.90 7.06
15 4.29 4.39 4.49 4.58 4.67 4.76 4.83 4.90 4.96 5.01 5.06 5.10 5.14
20 3.60 3.64 3.68 3.71 3.74 3.76 3.78 3.80 3.81 3.83 3.83 3.84 3.85
AGE - FEMALE
----------------------------------------------------------------------------
YEARS 60 61 62 63 64 65 66 67 68 69 70 71 72
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 2.65 2.75 2.86 2.97 3.09 3.22 3.36 3.51 3.66 3.83 4.01 4.20 4.41
10 2.63 2.73 2.83 2.94 3.06 3.18 3.31 3.45 3.59 3.74 3.90 4.07 4.25
15 2.59 2.68 2.78 2.88 2.98 3.09 3.20 3.31 3.43 3.55 3.68 3.80 3.93
20 2.52 2.60 2.68 2.76 2.84 2.92 3.00 3.09 3.16 3.24 3.32 3.39 3.45
AGE - FEMALE
----------------------------------------------------------------------------
YEARS 73 74 75 76 77 78 79 80 81 82 83 84 85
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 4.63 4.87 5.13 5.40 5.69 6.00 6.34 6.69 7.07 7.46 7.88 8.32 8.77
10 4.44 4.63 4.83 5.04 5.26 5.47 5.69 5.91 6.12 6.33 6.54 6.73 6.90
15 4.06 4.18 4.30 4.42 4.53 4.63 4.72 4.81 4.89 4.95 5.01 5.06 5.11
20 3.51 3.57 3.62 3.66 3.70 3.73 3.76 3.78 3.80 3.82 3.83 3.84 3.84
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
AGE - UNISEX
----------------------------------------------------------------------------
YEARS 60 61 62 63 64 65 66 67 68 69 70 71 72
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 2.72 2.82 2.93 3.05 3.17 3.31 3.45 3.60 3.76 3.93 4.12 4.31 4.52
10 2.70 2.80 2.90 3.01 3.13 3.26 3.39 3.53 3.67 3.83 3.99 4.16 4.34
15 2.65 2.74 2.84 2.94 3.04 3.15 3.26 3.38 3.49 3.61 3.74 3.86 3.98
20 2.56 2.64 2.72 2.80 2.88 2.96 3.04 3.12 3.20 3.27 3.34 3.41 3.48
AGE - UNISEX
----------------------------------------------------------------------------
YEARS 73 74 75 76 77 78 79 80 81 82 83 84 85
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
5 4.75 4.99 5.25 5.52 5.82 6.13 6.47 6.82 7.19 7.58 8.00 8.42 8.86
10 4.53 4.72 4.92 5.12 5.33 5.55 5.76 5.97 6.18 6.38 6.58 6.76 6.94
15 4.10 4.22 4.34 4.45 4.56 4.66 4.75 4.83 4.90 4.97 5.02 5.07 5.11
20 3.53 3.59 3.63 3.67 3.71 3.74 3.76 3.79 3.80 3.82 3.83 3.84 3.84
OPTION 5B - SINGLE LIFE INCOME RATES - PAYMENTS ADJUSTED FOR INFLATION -
LIFETIME PAYOUT - FIRST PAYMENT DUE AT BEGINNING OF PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
AGE
----------------------------------------------------------------------------
YEARS 60 61 62 63 64 65 66 67 68 69 70 71 72
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
MALE 2.99 3.11 3.24 3.37 3.52 3.67 3.84 4.01 4.20 4.40 4.61 4.84 5.08
FEMALE 2.66 2.76 2.87 2.98 3.10 3.23 3.37 3.52 3.68 3.85 4.04 4.24 4.45
AGE
----------------------------------------------------------------------------
YEARS 73 74 75 76 77 78 79 80 81 82 83 84 85
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- -----
MALE 5.34 5.61 5.91 6.23 6.57 6.93 7.32 7.74 8.19 8.67 9.18 9.73 10.31
FEMALE 4.68 4.93 5.21 5.50 5.82 6.16 6.53 6.94 7.38 7.85 8.37 8.93 9.53
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
AGE
----------------------------------------------------------------------------
YEARS 60 61 62 63 64 65 66 67 68 69 70 71 72
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
UNISEX 2.72 2.83 2.94 3.06 3.18 3.32 3.46 3.62 3.78 3.96 4.15 4.35 4.57
AGE
----------------------------------------------------------------------------
YEARS 73 74 75 76 77 78 79 80 81 82 83 84 85
----- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ---- ----
UNISEX 4.81 5.07 5.34 5.64 5.96 6.31 6.69 7.09 7.53 8.01 8.53 9.08 9.69
OPTION 6A - JOINT AND SURVIVOR LIFE INCOME RATES - PAYMENTS ADJUSTED FOR
INFLATION - GUARANTEE PERIOD CERTAIN - FIRST PAYMENT DUE AT BEGINNING OF PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
5 YEAR GUARANTEE PERIOD
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.26 2.48 2.66 2.79 2.88 2.93
65 2.40 2.71 3.00 3.25 3.42 3.54
70 2.50 2.90 3.32 3.72 4.06 4.29
75 2.57 3.04 3.58 4.17 4.73 5.17
80 2.61 3.12 3.77 4.54 5.37 6.12
85 2.63 3.17 3.88 4.80 5.89 7.02
10 YEAR GUARANTEE PERIOD
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.26 2.48 2.66 2.79 2.87 2.92
65 2.40 2.71 3.00 3.23 3.40 3.49
70 2.50 2.89 3.31 3.69 4.00 4.19
75 2.57 3.03 3.56 4.11 4.61 4.95
80 2.60 3.11 3.73 4.44 5.15 5.69
85 2.62 3.15 3.83 4.65 5.53 6.27
15 YEAR GUARANTEE PERIOD
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.26 2.47 2.64 2.76 2.83 2.86
65 2.39 2.69 2.96 3.17 3.30 3.36
70 2.49 2.87 3.25 3.58 3.79 3.90
75 2.55 2.98 3.46 3.91 4.23 4.40
80 2.58 3.05 3.59 4.13 4.55 4.78
85 2.59 3.08 3.65 4.24 4.72 4.99
20 YEAR GUARANTEE PERIOD
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.24 2.44 2.59 2.68 2.72 2.73
65 2.37 2.64 2.87 3.01 3.08 3.11
70 2.45 2.79 3.09 3.30 3.40 3.44
75 2.50 2.87 3.22 3.48 3.62 3.67
80 2.51 2.91 3.29 3.58 3.73 3.79
85 2.52 2.92 3.31 3.61 3.77 3.83
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
5 YEAR GUARANTEE PERIOD
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.21 2.38 2.52 2.60 2.66 2.69
65 2.38 2.65 2.88 3.05 3.17 3.24
70 2.52 2.88 3.24 3.56 3.80 3.95
75 2.60 3.05 3.56 4.07 4.52 4.85
80 2.66 3.17 3.80 4.52 5.25 5.88
85 2.69 3.24 3.95 4.85 5.88 6.91
10 YEAR GUARANTEE PERIOD
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.21 2.38 2.51 2.60 2.65 2.68
65 2.38 2.65 2.87 3.05 3.16 3.22
70 2.51 2.87 3.23 3.54 3.76 3.89
75 2.60 3.05 3.54 4.03 4.43 4.70
80 2.65 3.16 3.76 4.43 5.06 5.53
85 2.68 3.22 3.89 4.70 5.53 6.22
15 YEAR GUARANTEE PERIOD
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.21 2.38 2.50 2.58 2.62 2.64
65 2.38 2.63 2.85 3.00 3.09 3.13
70 2.50 2.85 3.18 3.45 3.62 3.70
75 2.58 3.00 3.45 3.85 4.13 4.27
80 2.62 3.09 3.62 4.13 4.51 4.72
85 2.64 3.13 3.70 4.27 4.72 4.98
20 YEAR GUARANTEE PERIOD
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.20 2.36 2.47 2.53 2.55 2.56
65 2.36 2.59 2.78 2.89 2.94 2.96
70 2.47 2.78 3.04 3.22 3.31 3.34
75 2.53 2.89 3.22 3.46 3.58 3.62
80 2.55 2.94 3.31 3.58 3.72 3.77
85 2.56 2.96 3.34 3.62 3.77 3.83
OPTION 6B - JOINT AND SURVIVOR LIFE INCOME RATES - PAYMENTS ADJUSTED FOR
INFLATION - LIFETIME PAYOUT - FIRST PAYMENT DUE AT BEGINNING OF PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.26 2.48 2.66 2.80 2.88 2.94
65 2.40 2.71 3.00 3.25 3.43 3.54
70 2.50 2.90 3.32 3.73 4.06 4.30
75 2.57 3.04 3.58 4.18 4.74 5.20
80 2.61 3.12 3.77 4.55 5.39 6.18
85 2.63 3.17 3.89 4.82 5.94 7.14
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.21 2.38 2.52 2.60 2.66 2.69
65 2.38 2.65 2.88 3.06 3.17 3.24
70 2.52 2.88 3.24 3.56 3.80 3.96
75 2.60 3.06 3.56 4.08 4.53 4.87
80 2.66 3.17 3.80 4.53 5.27 5.93
85 2.69 3.24 3.96 4.87 5.93 7.01
OPTION 7 - SINGLE LIFE INCOME RATES - PAYMENTS ADJUSTED FOR INFLATION - LIFETIME
PAYOUT WITH CASH REFUND - FIRST PAYMENT DUE AT BEGINNING OF PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
AGE 60 65 70 75 80 85
--- ---- ---- ---- ---- ---- ----
MALE 2.69 3.18 3.81 4.62 5.67 7.08
FEMALE 2.47 2.93 3.52 4.31 5.36 6.78
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
AGE 60 65 70 75 80 85
--- ---- ---- ---- ---- ---- ----
UNISEX 2.51 2.98 3.58 4.37 5.42 6.84
OPTION 8 - JOINT AND SURVIVOR LIFE INCOME RATES - PAYMENTS ADJUSTED FOR
INFLATION - LIFETIME PAYOUT WITH CASH REFUND - FIRST PAYMENT DUE AT BEGINNING OF
PERIOD.
TYPE A LIFE INCOME RATES
PER $1,000 APPLIED
AGE - FEMALE
---------------------------------------
AGE MALE 60 65 70 75 80 85
-------- ---- ---- ---- ---- ---- ----
60 2.22 2.42 2.57 2.66 2.69 2.70
65 2.34 2.63 2.88 3.06 3.16 3.19
70 2.42 2.78 3.15 3.47 3.68 3.78
75 2.46 2.88 3.35 3.83 4.22 4.47
80 2.47 2.92 3.47 4.09 4.70 5.18
85 2.47 2.93 3.51 4.23 5.05 5.82
TYPE B LIFE INCOME RATES
PER $1,000 APPLIED
AGE - UNISEX
---------------------------------------
AGE UNISEX 60 65 70 75 80 85
---------- ---- ---- ---- ---- ---- ----
60 2.18 2.33 2.44 2.50 2.52 2.52
65 2.33 2.58 2.77 2.90 2.97 2.98
70 2.44 2.77 3.09 3.35 3.50 3.57
75 2.50 2.90 3.35 3.77 4.09 4.27
80 2.52 2.97 3.50 4.09 4.64 5.05
85 2.52 2.98 3.57 4.27 5.05 5.76
CUNA Mutual Insurance Society
A Mutual Insurance Company
/s/ Xxxx Xxxx
President
