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
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0000
0-000-000-0000
Form V6025 (1-97)
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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 .......................................... 9, 10
Flexible Purchase Payments ......................................... 9
Purchase Payment Limitations ....................................... 9
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 ................................... 10
Separate Account Contract Value .................................... 11
Accumulation Unit Value ............................................ 11
Net Investment Factor .............................................. 11
Determining Accumulation Units ..................................... 11
Mortality and Expense Risk Charge .................................. 12
Premium Tax Expense ................................................ 12
Administration Charge .............................................. 12
Mutual Fund Expenses ............................................... 12
WITHDRAWAL PROVISIONS ................................................ 12-14
Withdrawals ........................................................ 12
Withdrawal Value ................................................... 12
Withdrawal Charges ................................................. 13
Free Withdrawals ................................................... 13
Systematic Withdrawals ............................................. 13
Free Systematic Withdrawals ........................................ 13
Date of Request .................................................... 13
Payment of Withdrawal Benefits ..................................... 14
DEATH BENEFIT PROVISIONS ............................................. 14, 15
Death Benefit ...................................................... 14, 15
Proof of Death ..................................................... 15
Distribution Rules ................................................. 15
ANNUITY PAYMENT PROVISIONS ........................................... 15-18
Annuity Start Date ................................................. 15
Change of Annuity Start Date ....................................... 16
Annuity Start Amount ............................................... 16
Withdrawal Charges ................................................. 16
Annuity Tables ..................................................... 16
Annuity Payments ................................................... 16
Change of Annuity Option ........................................... 16
Fixed Annuity Payments ............................................. 17
Variable Annuity Payments .......................................... 17
Annuity Units ...................................................... 17
Net Investment Factor .............................................. 17
Alternate Annuity Option Rates ..................................... 17
Annuity Options .................................................... 18
ANNUITY TABLES ....................................................... 19, 20
AMENDMENTS OR ENDORSEMENTS, IF ANY
2
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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: 6-30-1997
JOINT OWNER NAME: Xxxx X Xxx ISSUE DATE: 6-30-1997
JOINT OWNER DATE OF BIRTH: 7-18-1981 ANNUITY STATE DATE: 7-1-2052*
ANNUITANT NAME: Xxxxx X. Xxx PLAN: Non-Qualified
ANNUITANT DATE OF BIRTH: 5-13-1987 ASSIGNMENT: This Policy may be
assigned. See Assignment Provision
ANNUITANT'S SEX: Female of your Policy.
PRIMARY BENEFICIARY NAME: Xxxxx X. Xxx
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INITIAL PURCHASE PAYMENT $25,000
MINIMUM SUBSEQUENT PURCHASE PAYMENTS $500 ($50 pursuant to an automatic
investment program)
MINIMUM SYSTEMATIC WITHDRAWAL $100
MORTALITY AND EXPENSE RISK CHARGE 1.25% Annually (1.2% annually during
Annuity Options 1-4, 7 and 8.)
ADMINISTRATION CHARGE .15% Annually (0% annually during
Annuity Options 1-4, 7 and 8.)
WITHDRAWAL CHARGES:
Contract Year of Withdrawal 1 2 3 4 5 6 7+
Withdrawal Charge 6% 6% 5% 4% 3% 2% 0%
FREE WITHDRAWAL PERCENTAGE 10%
GUARANTEED RATE 3.00%
ANNUITY OPTION Life with 10-Year Fixed Period Option*
SUBACCOUNTS:
Money Market Subaccount
High Grade Income Subaccount
High Yield Subaccount
Global Aggressive Bond Subaccount
Growth-Income Subaccount
Equity Income Subaccount
Managed Asset Allocation Subaccount
Specialized Asset Allocation Subaccount
Growth Subaccount
Value Subaccount
Worldwide Equity Subaccount
Social Awareness Subaccount
Emerging Growth Subaccount
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 Fixed Account
is the last Account charged. The value of each Account will be depleted
before the next is 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.
V6025 A (1-97) 3
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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 and 8. 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, 7 and 8.
AUTOMATIC INVESTMENT PROGRAM
A program pursuant to which Purchase Payments are automatically paid from the
Owner's bank account on a specified day of the month, on a monthly, quarterly,
semiannual or annual basis.
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, 000 XX Xxxxxxxx Xxxxxx,
Xxxxxx, Xxxxxx 00000-0000.
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 alive.
V6025 B (1-97) 4
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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, 000 XX Xxxxxxxx Xxxxxx, Xxxxxx, Xxxxxx 00000-0000.
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, (000) XX Xxxxxxxx Xxxxxx, Xxxxxx, Xxxxxx 00000-0000.
5
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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 fund 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.
V6025 C (1-97) 6
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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 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 this 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.
7
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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, 7 and 8, 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 $500.00 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.
V6025 D (1-97) 8
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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 BENEFICIAIRES
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.
9
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PURCHASE PAYMENT PROVISIONS (Continued)
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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 and applicable Withdrawal Charges 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, 7 and 8; and
5. any Annuity Payments made under Annuity Options 5 and 6.
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.
V6025 E (1-97) 10
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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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). The
Accumulation Unit Value for any subsequent Valuation Date is equal to (1) times
(2) where:
1. is Accumulation Unit Value determined on the immediately preceding
Valuation Date; and
2. is the Net Investment Factor on the Valuation Date with respect to which the
Accumulation Unit Value is being determined.
NET INVESTMENT FACTOR
The Net Investment Factor for any Subaccount as of 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 as of 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 Separate Account or the
Subaccounts; operations of the Company with respect to the Contract; or
the payment of premiums or acquisition costs under the Contract.
2. is the net asset value per share of the Subaccount's underlying mutual fund
as of the end of the prior Valuation Period.
3. is a daily factor representing the Mortality and Expense Risk Charge and
Administration Charge which are 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 to or charged against the Subaccounts without
regard to the gains or losses in the Company or other Subaccounts.
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 as of 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 and any applicable Withdrawal Charges that are deducted from the
Subaccount; and
4. Premium Taxes that are deducted from the Subaccount.
11
--------------------------------------------------------------------------------
CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
--------------------------------------------------------------------------------
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.
--------------------------------------------------------------------------------
WITHDRAWAL PROVISIONS
--------------------------------------------------------------------------------
WITHDRAWALS
A full or partial Withdrawal of Contract Value is allowed at any time while the
Owner is living. This provision is subject to any federal or state Withdrawal
restrictions.
Upon the Owner's request for a full Withdrawal, the Company will pay the
Withdrawal Value in a lump sum, and the Contract will terminate.
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, if any.
2. The Owner must apply: (a) while this Contract is in force; and (b) prior to
the Annuity Start Date.
3. The amount Withdrawn must be at least SCORE ($500.00) except that a
Withdrawal of less than $500.00 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.
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 as of any Valuation Date will be: (1) the Contract Value on
that date; less (2) any Premium Taxes due or paid by the Company; and (3) any
Withdrawal Charges.
V6025 F (1-97) 12
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WITHDRAWAL PROVISIONS (Continued)
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WITHDRAWAL CHARGES
If part or all of the Contract Value is Withdrawn, Withdrawal Charges may be
applied at the time of Withdrawal. The Withdrawal Charge is applied to Purchase
Payments withdrawn. The amount of the charge is based on the Contract Year in
which the Withdrawal is made. See the Withdrawal Charges shown on page 3. For
the purpose of determining the Withdrawal Charges, Purchase Payments are
withdrawn before Earnings. The Withdrawal Charge will not be assessed against:
1. any Free Withdrawal amounts;
2. any Free Systematic Withdrawal amounts;
3. any amounts remaining after all Purchase Payments are withdrawn;
4. any Death Benefit;
5. payments under Annuity Options 1 through 4, 7 and 8; or
6. payments under Annuity Options 5 and 6 provided that Annuity Payments are
made for at least 5 years.
The Withdrawal Charge will be assessed against Contract Value allocated to the
Subaccounts and the Fixed Account in the same proportion as the Withdrawal is
allocated.
FREE WITHDRAWALS
A Free Withdrawal is a Withdrawal amount that is not subject to Withdrawal
Charges. The amount of Free Withdrawal available in a Contract Year is
determined as follows. In the first Contract Year, it is equal to: (1)cumulative
Purchase Payments made under the Contract; times (2) the Free Withdrawal
Percentage set forth on page 3; less (3) any Free Withdrawals, including any
Free Systematic Withdrawals, made during the Contract Year. The amount of Free
Withdrawal available in subsequent Contract Years is equal to (1) Contract Value
as of the first day of the current Contract Year; times (2) the Free Withdrawal
Percentage; less (3) any Free Withdrawals, including any Free Systematic
Withdrawals, made during the Contract Year. Unused Free Withdrawal amounts are
not carried from one Contract Year to the next.
SYSTEMATIC WITHDRAWALS
Systematic Withdrawals are automatic periodic Withdrawals from the Contract in
substantially equal amounts made while the Owner is living prior to the Annuity
Start Date. In order to start Systematic Withdrawals, the Owner must make the
request in writing. Systematic Withdrawals are subject to any applicable
Withdrawal Charges, except as discussed under "Free Systematic Withdrawals"
below. 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 may be stopped or changed by the Owner upon proper
written request Received by the Company at least 30 days in advance of the
requested date of termination or change. The Company reserves the right to stop,
modify, suspend or charge a fee for Systematic Withdrawals at any time.
FREE SYSTEMATIC WITHDRAWALS
Free Systematic Withdrawals are not subject to a Withdrawal Charge. The amount
of Free Systematic Withdrawals available in a Contract Year is determined as
follows: the amount of Systematic Withdrawals that, when combined with any Free
Withdrawals in the current Contract Year, does not exceed the Free Withdrawal
amount available in that Contract Year.
DATE OF REQUEST
The Company will effect a Withdrawal of Separate Account Contract Value on the
basis of Accumulation Unit Value determined as of the end of the Valuation
Period in which all the required information is Received by the Company. The
Company will effect Systematic Withdrawals of Separate Account Contract Value on
the basis of Accumulation Unit Value determined as of the end of the Valuation
Period in which such Withdrawal is scheduled.
13
--------------------------------------------------------------------------------
WITHDRAWAL PROVISIONS (continued)
--------------------------------------------------------------------------------
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 emrgency 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 Securitie 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.
--------------------------------------------------------------------------------
DEATH BENEFIT PROVISIONS
--------------------------------------------------------------------------------
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 four and occurs prior to the oldest Owner reaching age 76; plus
2. any Purchase Payments received since the applicable fourth Contract
Anniversary; less
3. any reductions caused by Withdrawals since the applicable fourth 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 as of
the end of the Valuation Period during which due Proof of Death and instructions
regarding payment are Received by the Company; less (2) any Premium Taxes due or
paid by the Company.
V6025 G (1-97) 14
--------------------------------------------------------------------------------
DEATH BENEFIT PROVISIONS (Continued)
--------------------------------------------------------------------------------
DEATH BENEFIT (continued)
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. The
Designated Beneficiary may elect to receive the Death Benefit in the form of
annuity payments under one of the Annuity Options, subject to any requirements
under applicable law.
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 8; (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.
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.
--------------------------------------------------------------------------------
ANNUITY PAYMENT PROVISIONS
--------------------------------------------------------------------------------
ANNUITY START DATE
The Owner may choose the Annuity Start Date at the time of application. The
Annuity Start Date may not be prior to the third Contract Anniversary. 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 one of the Annuity Options.
15
--------------------------------------------------------------------------------
ANNUITY PAYMENT PROVISIONS (Continued)
--------------------------------------------------------------------------------
CHANGE OF ANNUITY START DATE
The Owner may change the Annuity Start Date subject to approval by the Company.
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 and
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; and (3)
Withdrawal Charges, if applicable. 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.
WITHDRAWAL CHARGES
Withdrawal Charges are not applied to: (1) Annuity payments made under Annuity
Options 1-4, 7 and 8; or (2) those made under Annuity Options 5 and 6 that
provide for payments over a period of at least 5 years. Withdrawal Charges are
applied to annuity payments under Annuity Options 5 and 6 that provide for
payments over a period of less than 5 years. Any Withdrawal Charges are applied
on the Annuity Start Date to that portion of Contract Value that represents
Purchase Payments. See "Withdrawal Provisions" on pages 12-14.
ANNUITY TABLES
Annuity Tables A through C show the guaranteed minimum amount of monthly Annuity
Payment per $1,000 of Annuity Start Amount for Annuity Options 1 through 4, 7
and 8 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 and 8 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 Tables
A and 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 through 7, annuity rates based on age and sex are not used
to calculate annuity payments. Annuity Payments for Options 5 and 6 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.
V6025 H (1-97) 16
--------------------------------------------------------------------------------
ANNUITY PAYMENT PROVISIONS (Continued)
--------------------------------------------------------------------------------
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, 7
and 8.
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, 7 and 8. 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.
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 Valuation Date;
(c) is a daily 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 as of 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 as of 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 Separate Account or the
Subaccounts; the operations of the Company with respect to the Contract;
or the payment of premium or acquisition costs under the Contract.
2. is the net asset value per share of the Subaccount's underlying mutual fund
as of the end of the prior Valuation Period.
3. is a daily 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, 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.
OPTION 7
PERIOD CERTAIN OPTION: This option provides payments for a fixed period of 5,
10, 15 or 20 years. Payments will be made until the end of this period. If the
Annuitant dies prior to the end of the period, the remaining payments will be
made to the Designated Beneficiary. Table C shows some of the guaranteed rates
for this option.
OPTION 8
JOINT AND CONTINGENT SURVIVOR OPTION: This option provides payments for the life
of the primary Annuitant. Payments will be made to the primary Annuitant as long
as he or she is living. Upon the death of the primary Annuitant, payments will
be made to the contingent Annuitant as long as he or she is living. If the
contingent Annuitant is not living upon the death of the primary Annuitant, no
payments will be made to the contingent Annuitant. Table B shows some of the
guaranteed rates for this option.
V6025 I (1-97) 18
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 Life with Fixed Period 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.
19
ANNUITY TABLES (Continued)
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TABLE B
SETTLEMENT OPTIONS FOUR AND EIGHT
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.
--------------------------------------------------------------------------------
TABLE C
SETTLEMENT OPTION SEVEN
MINIMUM INITIAL MONTHLY INSTALLMENT PER $1,000 OF AMOUNT APPLIED
PERIOD CERTAIN
5 YEARS 10 YEARS 15 YEARS 20 YEARS
--------------------------------------------------------------------------------
18.11 9.83 7.1 5.75
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.
20
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
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0000
0-000-000-0000
TAX-SHELTERED ANNUITY
ENDORSEMENT
TAX-SHELTERED ANNUITY ENDORSEMENT
This Contract is established as a Tax-Sheltered Annuity ("TSA") under Section
403(b) of the Internal Revenue Code of 1986, as amended (the "Code") or any
successor provision, pursuant to the Owner's request in the application.
Accordingly, this Endorsement is attached to and made part of the Contract as of
its issue date or, if later, the date shown below. If this is a group contract,
references to the "Owner" and to the "Contract" shall, respectively, be deemed
to include the Participant and the Participant's Certificate where appropriate.
TAX-SHELTERED ANNUITY PROVISIONS
To ensure treatment as a TSA, this Contract will be subject to the requirements
of Code Section 403(b), which are briefly summarized below:
CONTRIBUTION LIMITATIONS
(a) Purchase Payments made on behalf of the Owner pursuant to a salary reduction
agreement when added to "elective deferral" contributions under all other
plans, contracts or arrangements in which the Owner participates, may not
exceed the annual limitation on such contributions as provided in Code
Section 401(a)(30).
(b) Purchase Payments applied to the Contract on behalf of the Owner which
exceed the applicable "exclusion allowance" (within the meaning of Code
Section 403(b)(2)) or the limitations contained in Code Section 415 shall
not be excludable from gross income.
(c) Purchase Payments that exceed any of the foregoing limitations may be
returned, distributed or otherwise corrected using any method permissable
under the Code.
NONDISCRIMINATION REQUIREMENTS
(a) Except if this Contract is purchased by a "church" (within the meaning of
Code Section 3121(w)), the Plan must satisfy the nondiscrimination
requirements of Code Section 403(b)(12).
(b) Purchase Payments not made pursuant to a salary reduction agreement will
satisfy the nondiscrimination requirements of Code Section 403(b)(12)
provided they satisfy the requirements of Code Section 401(a)(4)
(nondiscrimination in contributions), Code Section 401(a)(5) (permitted
disparity), Code Section 401(a)(17)(annual limit on compensation), Code
Section 401(m) (average contribution percentage test) and Code Section
410(b) (coverage).
(c) Purchase Payments made pursuant to a salary reduction agreement will satisfy
the nondiscrimination requirements of Code Section 403(b)(12) provided that
every employee of the Employer sponsoring the Plan, may elect to make
Purchase Payments of more than $200 pursuant to a salary reduction
agreement.
DISTRIBUTION RESTRICTIONS AND REQUIREMENTS
(a) Distributions attributable to Purchase Payments made pursuant to a salary
reduction agreement may be made only when the Owner attains age 59 1/2,
separates from service, dies, becomes "disabled" (within the meaning of Code
Section 403(b)(11)) or incurs a hardship. A distribution made due to a
hardship may not include income attributable to such Purchase Payments.
6832 A (R9-96) 1
(b) Distributions from this Contract must comply with the minimum distribution
and incidental death benefit requirements of Code Section 403(b)(10).
Accordingly, an Owner's entire interest under the Contract generally must be
distributed (or begin to be distributed) by April 1 of the calendar year
following the later of (i) the calendar year in which the Owner attains age
70 1/2, or (ii) the calendar year in which the Owner retires (the "Required
Beginning Date").
Distributions commencing not later than the Required Beginning Date may be
made over the life of the Owner or over the lives of the Owner and his or
her Designated Beneficiary (or over a period not extending beyond the life
expectancy of the Owner or the life expectancy of the Owner and his or her
Designated Beneficiary).
(c) If the Owner dies before distribution of his or her interest in the Contract
has begun in accordance with paragraph (b) above, the Owner's entire
interest must be distributed within five years, unless: (i) such interest is
distributed to a Designated Beneficiary over his or her life (or over a
period not extending beyond such Designated Beneficiary's life expectancy);
and (ii) such distribution begins not later than one year after the Owner's
surviving spouse, the date on which the distributions are required to begin
shall not be earlier thatn the date on which the Owner would have attained
age 70 1/2.
(d) If the Owner dies after distribution of his or her interest in this Contract
has begun in accordance with paragraph (b) above but before his or her
entire interest has been distributed, the remaining interest must be
distributed at least as rapidly as under the method of distribution being
used prior to the Owner's death.
(e) All distributions must comply with a method of distribution offered by the
Company under this Contract.
(f) If the Owner receives a distribution from this Contract that qualifies as an
"eligible rollover distribution" (within the meaning of Code Section
402(f)(2)(A)) and elects to have such distribution paid directly to an
"eligible retirement plan" (within the meaning of Code Section 402(c)), such
distribution shall be made in the form of a direct transfer to the eligible
retirement plan. The Company may establish reasonable administrative rules
applicable to such direct transfers.
NONFORFEITABILITY
(a) The Owner's rights under this Contract shall be nonforfeitable except for
failure to pay future Premiums.
(b) This Contract may not be transferred, sold, assigned or pledged as
collateral for a loan or as security for the performance fo an obligation or
for any other purposes to any person other than the Company.
MULTIPLE CONTRACTS
(a) If for any taxable year an Owner is covered by this Contract and any other
TSA, all such contracts shall be treated as a single contract.
2
PLAN PROVISIONS
The Plan, including certain Plan provisions required by the Employee Retirement
Income Security Act of 1974 or other applicable law, may limit the Owner's
rights under this Contract. The Plan provisions may:
(a) Limit the Owner's right to make Purchase Payments;
(b) Restrict the time when the Owner may elect to receive payments under this
Contract;
(c) Require the consent of the Owner's spouse before the Owner may elect to
receive payments under this Contract;
(d) Require that all distributions be made in the form of a joint and survivor
annuity for the Owner and the Owner's spouse unless both consent to a
different form of distribution;
(e) Require that the Owner's spouse be the Designated Beneficiary;
(f) Require that the Owner remain employed by the Employer sponsoring the Plan
for a specified period of time before the Owner's rights under this Contract
become fully vested; or
(g) Otherwise restrict the Owner's exercise of rights under the Contract or give
the Employer sponsoring the Plan (or a Plan representative) the right to
exercise certain rights on the Owner's behalf.
No such Plan provision shall limit an Owner's rights under this Contract, unless
the Employer sponsoring the Plan has provided the Company with written
notification of such provision. In no event shall any such Plan provision
enlarge the Company's obligations under this Contract.
TAX CONSEQUENCES
(a) The Company will not incur any liability or be responsible for the timing,
purpose or prorpriety of any contribution or distribution; any tax or
penalty imposed on account of any such contribution or distribution; or any
other failure, in whole or in part, by the Owner or the Employer to comply
with the provisions set forth in the Code or any other law.
ADMINISTRATION
The Company does not act as the Administrator of the Plan. Accordingly, the
Company will not incur any liability or be responsible for interpreting the Plan
or deciding any questions arising thereunder.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
6832 A (R9-96) 3
NOTICE: CONSULT YOUR TAX ADVISOR PRIOR TO REQUESTING THIS BENEFIT. RECEIPT OF
BENEFITS UNDER THIS ENDORSEMENT MAY BE SUBJECT TO AN IRS 10% PENALTY TAX IN
ADDITION TO ANY INCOME TAX THAT MAY BE DUE.
WITHDRAWAL CHARGE WAIVER
ENDORSEMENT
ENDORSEMENT
This Endorsement is attached to and made part of this Contract/Policy (the
"Policy") as of: (1) its Issue Date; or (2) if later, the date shown below. The
Policy is changed by adding the following:
WAIVER OF WITHDRAWAL CHARGES
Security Benefit Life Insurance Company ("SBL") will waive the Withdrawal Charge
on any full or partial Withdrawal of Contract Value/Policy Value if: (1) the
Owner has been confined to a "Hospital" or "Qualified Skilled Nursing Facility"
for at least 90 consecutive days immediately prior to the date of such
Withdrawal and is so confined when the request to withdraw is received by SBL;
(2) such confinement began after the Issue Date; and (3) the request to withdraw
is received along with: (a) a properly completed claim form; and (b) a written
statement by a licensed physician that certifies such confinement is a medical
necessity and is due to illness or infirmity. Such written statement must be
approved by SBL.
SBL reserves the right to have the Owner examined by a physician of SBL's choice
and at SBL's expense to determine if the Owner is eligible for the Withdrawal
Charge Waiver. SBL reserves the right to require the claim form and written
statement described in 3(a) and (b) above with each request to withdraw.
DEFINITIONS
A "Hospital" is: (1) an institution that is licensed as such by the Joint
Commission of Accreditation of Hospitals; or (2) any lawfully operated
institution that provides: (a) in-patient treatment of sick and injured persons
through medical, diagnostic and surgical facilities directed by a staff of
physicians; and (b) 24 hour nursing services. A "Qualified Skilled Nursing
Facility" must be licensed by the state to provide, on a daily basis,
convalescent or chronic care for in-patients who, by reason of illness or
infirmity, are not able to care for themselves.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
V6051 (3-96)
NOTICE: CONSULT YOUR TAX ADVISOR PRIOR TO REQUESTING THIS BENEFIT. RECEIPT OF
BENEFITS UNDER THIS ENDORSEMENT MAY BE SUBJECT TO AN IRS 10% PENALTY TAX IN
ADDITION TO ANY INCOME TAX THAT MAY BE DUE.
WAIVER OF WITHDRAWAL CHARGE FOR TERMINAL ILLNESS
ENDORSEMENT
ENDORSEMENT
This Endorsement is attached to and made part of this Contract/Policy (the
"Policy") as of: (1) its Issue Date; or (2) if later, the date shown below. The
Policy is changed by adding the following:
WAIVER OF WITHDRAWAL CHARGES
Security Benefit Life Insurance Company ("SBL") will waive the Withdrawal Charge
on any full or partial Withdrawal of Contract Value/Policy Value if: (1) the
Owner has been diagnosed with a "terminal illness" by a licensed physician; (2)
such illness was first diagnosed after the Issue Date of this Policy; and (3)
the request to withdraw is received along with (a) a properly completed claim
form acceptable to SBL; and (b) a written statement by a licensed physician
certifying that the Owner has been diagnosed with a terminal illness and the
date that such diagnosis was first made.
SBL reserves the right to have the Owner examined by a physician of SBL's choice
and at SBL's expense to determine if the Owner is eligible for waiver of the
Withdrawal Charge. SBL reserves the right to require the claim form and written
statement described in 3(a) and (b) above with each request to withdraw.
DEFINITIONS
A "terminal illness" is an incurable condition that with a reasonable degree of
medical certainty will result in death within one year from the date of the
physician's statement. A "licensed physician" is a medical doctor licensed in
the United States who is: (1) practicing within the scope of that license; and
(2) is not the Owner, Annuitant or a person related thereto.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
V6051 TI (2-97)
ENDORSEMENT
--------------------------------------------------------------------------------
ANNUITY LOAN PROVISIONS
--------------------------------------------------------------------------------
LOAN ENDORSEMENT
This endorsement is attached to and made part of your Contract as of its Issue
Date or, if later, the date shown below. Notwithstanding any other provision of
the Contract to the contrary, the following provisions shall apply.
GENERAL PROVISIONS
Prior to the start of retirement annuity installments (the "maturity date"), the
Company shall lend an amount applied for to the Owner subject to the
limitations, interest rates, and repayment procedures set forth herein and in
the loan agreement between the Owner and the Company. Any loan applied for must
be for a minimum of $1,000. Only two loans shall be permitted per contract year.
All loans must be repaid as specified herein before the maturity date. Except
for loans that qualify under the Code for a longer repayment period, as
determined by the Company, all loans must be repaid within five years of
approval. All loan repayments must be scheduled to be paid in equal amounts on
the same day of each month or quarter. For monthly repayments the first
scheduled repayment may not be later than 30 days after the date of approval of
the loan application by the Company. For quarterly repayments the first
scheduled repayment may not be later than 90 days after the date of approval of
the loan application by the Company. Before a loan is permitted a written
application and loan agreement on a form acceptable to the Company must be
Received by the Company. The Company may postpone final approval or disapproval
of a loan for up to six months after the application for a loan is received.
TAX CONSEQUENCES
The Company makes no representations or guarantees as to the tax consequences of
a loan to the Owner. The Owner should consult his or her tax counsel for
specific advice.
MAXIMUM LOAN AMOUNT
The maximum loan amount for all contracts combined, is generally equal to the
lesser of: (1) $50,000 reduced by the excess of: (a) the highest outstanding
loan balance within the preceding 12-month period ending on the day before the
date the loan is made; over (b) the outstanding loan balance on the date the
loan is made; or (2) 50% of your account value or $10,000, whichever is greater.
However, in no case can you borrow more than your account value.
LOAN ACCOUNT, AND INTEREST EARNED ON LOAN ACCOUNT
When your loan is approved, the Company will transfer to an account within the
Fixed Amount, referred to as the Loan Account, an amount equal to the loan
amount. Amounts allocated to the Loan Account earn the Maximum Guaranteed
Interest Rate specified in the Contract.
LOAN INTEREST RATE
The Owner must pay interest on the outstanding loan balance. Interest shall
accrue on the loan balance from the effective date of any loan. The loan
interest rate shall be the Minimum Guaranteed Interest Rate plus 2.5%.
LOAN PAYMENTS
Each loan payment must be labeled as such. If not labeled as a loan payment,
amounts received by the Company will be treated as Purchase Payments. Each loan
payment will reduce the Loan Account by the amount the payment reduces the
outstanding loan balance. Amounts which are no longer needed in the Loan Account
will be transferred to the Fixed Account and/or the Subaccounts in accordance
with current allocation instructions for purchase payments. The loan may be
repaid in full at any time, in which event, the Loan Account shall be reduced to
$0.
V6846 (R1-97) NON-ERISA
--------------------------------------------------------------------------------
ANNUITY LOAN PROVISIONS (Continued)
--------------------------------------------------------------------------------
FAILURE TO MAKE PAYMENTS
If any required loan payment is not paid, within 30 days of the due date for
loans with a monthly repayment schedule or within 90 days of the due date for
loans with a quarterly repayment schedule, the TOTAL OUTSTANDING LOAN BALANCE
will be deemed to be in default. The entire loan balance, with any accrued
interest, will be reported to the Internal Revenue Service ("IRS") on Form
1099-R for the year the default occurred. Once a loan has gone into default,
regularly scheduled payments will not be accepted. However, the principal plus
accrued interest may be paid in full at any time. Notwithstanding any other
provision of the Contract or this endorsement to the contrary, no new loans will
be allowed when there is a loan in default.
Interest will continue to accrue on a loan in default. You may pay accrued
interest each year when notified by SBL. If such interest is not paid by
December 31st of each year, it will be added to the outstanding balance of the
loan and will be reported to the IRS on Form 1099-R. Account value equal to the
amount of the accrued interest will be transferred to the Loan Account. If a
loan continues to be in default when you attain age 59 1/2, the total
outstanding balance will be deducted from your account value. The Contract will
be automatically terminated if the outstanding loan balance on a loan in default
equals or exceeds the amount for which the Contract may be surrendered. The
proceeds from the Contract will be used to repay the debt.
WITHDRAWAL VALUE, ANNUITY PAYOUT AMOUNT, AND DEATH BENEFIT
If the Contract is surrendered, or if a death benefit becomes payable, the
amount otherwise receivable will be reduced by the amount of the outstanding
loan, plus any accrued interest. In addition, no partial withdrawal request will
be processed which would result in the withdrawal of account value from the Loan
Account.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
ENDORSEMENT
--------------------------------------------------------------------------------
SIMPLE INDIVIDUAL RETIREMENT ANNUITY PROVISIONS
--------------------------------------------------------------------------------
SIMPLE INDIVIDUAL RETIREMENT ANNUITY ENDORSEMENT
This Contract is established as a Savings Incentive Match Plan for Employees of
Small Employers Individual Retirement Annuity ("SIMPLE IRA") as defined in
Section 408 of the Internal Revenue Code of 1986, as amended (the "Code") or any
successor provision pursuant to the Owner's request in the Application.
Accordingly, this endorsement is attached to and made part of the Contract as of
its Issue Date or, if later, the date shown below. Notwithstanding any other
provisions of the Contract to the contrary, the following provisions shall
apply.
RESTRICTIONS ON SIMPLE INDIVIDUAL RETIREMENT ANNUITY
To ensure treatment as a SIMPLE IRA, this Contract will be subject to the
applicable requirements of Code Section 408, which are briefly summarized below:
1. The Contract is established for the exclusive benefit of the Owner or his or
her beneficiaries. The Owner shall be the Annuitant.
2. The Contract shall be nontransferable and the entire interest of the Owner
in the Contract is nonforfeitable.
3. Notwithstanding any provision of the Contract to the contrary, the
distribution of the Owner's interest shall be made in accordance with the
minimum distribution requirements of Section 401(a)(9) of the Internal
Revenue Code and the regulations thereunder, including the incidental death
benefit provisions of Section 1.401(a)(9)-2 of the proposed regulations, all
of which are herein incorporated by reference.
The Owner's entire interest in the Contract must be distributed, or begin to
be distributed, by the Owner's required beginning date, which is the April 1
following the calendar year in which the Owner reaches age 70 1/2. For each
succeeding year, a distribution must be made on or before December 31. By
the required beginning date, the Owner may elect to have the balance in the
account distributed in one of the following forms:
1) A single lump sum payment;
2) Equal or substantially equal monthly, quarterly, or annual payments over
the life of the Owner or over the joint and last survivor lives of the
Owner and his or her Designated Beneficiary; or
3) Equal or substantially equal annual payments over a specified period
that may not be longer than the Owner's life expectancy or the joint and
last survivor life expectancy of the Owner and his or her Designated
Beneficiary.
An Annuity Option may not be elected with a Fixed Period that will guarantee
Annuity Payments beyond the life expectancy of the Annuitant and Beneficiary
and Annuity Payments must be made at least annually and in equal amounts.
4) If the Owner dies before his or her interest is distributed, the entire
remaining interest will be distributed as follows:
a. If the Owner dies on or after distributions have begun under Section
3, the entire remaining interest must be distributed at least as
rapidly as provided under Section 3.
4453C-5S (2-97)
--------------------------------------------------------------------------------
SIMPLE INDIVIDUAL RETIREMENT ANNUITY PROVISIONS (Continued)
--------------------------------------------------------------------------------
RESTRICTIONS ON SIMPLE INDIVIDUAL RETIREMENT ANNUITY (Continued)
b. If the Owner dies before distributions have begun under Section 3,
the entire remaining interest must be distributed as elected by the
Owner or, if the Owner has not so elected, as elected by the
Designated Beneficiary or Beneficiaries as follows:
1) By December 31 of the year containing the fifth anniversary of
the Owner's death; or
2) In equal or substantially equal payments over the life or life
expectancy of the Designated Beneficiary or Beneficiaries
starting by December 31 of the year following the year of the
Owner's death. If however, the Designated Beneficiary is the
Owner's surviving spouse, then this Distribution is not required
to begin until December 31 of the later of: (1) the calendar
year immediately following the calendar year in which the Owner
died; or (2) the calendar year in which the Owner would have
attained age 70 1/2.
5. An individual may satisfy the minimum distribution requirements under
Section 401(a)(9) of the Code by receiving a distribution from one IRA that
is equal to the amount required to satisfy the minimum distribution
requirements for two or more IRAs. For this purpose, the Owner of two or
more IRAs may use the "alternative method" described in Notice 88-38, 1988-1
C.B. 524, to satisfy the minimum distribution requirements described above.
6. 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.
7. The annual premium shall not exceed amounts allowable under the terms of the
SIMPLE plan described in Section 408(p) of the Code or any successor
provision in which the Owner is a participant.
8. Transfers and rollovers from other SIMPLE IRAs are permitted and are
excluded from the limit set forth in Section 7.
9. Notwithdstanding any Contract provisions to the contrary, no amount may be
borrowed under the Contract and no portion may be used as security for a
loan.
10. Annuity payments may not begin before the Annuitant attains the age of 59
1/2 without incurring a penalty tax except in the situations described in
Section 72(t) of the Code.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
ENDORSEMENT
--------------------------------------------------------------------------------
INDIVIDUAL RETIREMENT ANNUITY PROVISIONS
--------------------------------------------------------------------------------
INDIVIDUAL RETIREMENT ANNUITY ENDORSEMENT
This Contract is established as an Individual Retirement Annuity ("IRA") as
defined in Section 408 of the Internal Revenue Code of 1986, as amended (the
"Code") or any successor provision pursuant to the Owner's request in the
Application. Accordingly, this endorsement is attached to and made part of the
Contract as of its Issue Date or, if later, the date shown below.
Notwithstanding any other provisions of the Contract to the contrary, the
following provisions shall apply.
RESTRICTIONS ON INDIVIDUAL RETIREMENT ANNUITY
To ensure treatment as an IRA, this Contract will be subject to the requirements
of Code Section 408, which are briefly summarized below:
1. The Contract is established for the exclusive benefit of the Owner or his or
her beneficiaries. The Owner shall be the Annuitant.
2. The Contract shall be nontransferable and the entire interest of the Owner
in the Contract is nonforfeitable.
3. Notwithstanding any provision of the Contract to the contrary, the
distribution of the Owner's interest shall be made in accordance with the
minimum distribution requirements of Section 401(a)(9) of the Internal
Revenue Code and the regulations thereunder, including the incidental death
benefit provisions of Section 1.401(a)(9)-2 of the proposed regulations, all
of which are herein incorporated by reference.
The Owner's entire interest in the Contract must be distributed, or begin to
be distributed, by the Owner's required beginning date, which is the April 1
following the calendar year in which the Owner reaches age 70 1/2. For each
succeeding year, a distribution must be made on or before December 31. By
the required beginning date, the Owner may elect to have the balance in the
account distributed in one of the following forms:
1) A single lump sum payment;
2) Equal or substantially equal monthly, quarterly, or annual payments over
the life of the Owner or over the joint and last survivor lives of the
Owner and his or her Designated Beneficiary; or
3) Equal or substantially equal annual payments over a specified period
that may not be longer than the Owner's life expectancy or the joint and
last survivor life expectancy of the Owner and his or her Designated
Beneficiary.
An Annuity Option may not be elected with a Fixed Period that will guarantee
Annuity Payments beyond the life expectancy of the Annuitant and Beneficiary
and Annuity Payments must be made at least annually and in equal amounts.
4) If the Owner dies before his or her entire interest is distributed, the
entire remaining interest will be distributed as follows:
a. If the Owner dies on or after distributions have begun under Section
3, the entire remaining interest must be distributed at least as
rapidly as provided under Section 3.
V6842 A (1-97)
--------------------------------------------------------------------------------
INDIVIDUAL RETIREMENT ANNUITY PROVISIONS (Continued)
--------------------------------------------------------------------------------
RESTRICTIONS ON INDIVIDUAL RETIREMENT ANNUITY (Continued)
b. If the Owner dies before distributions have begun under Section 3,
the entire remaining interest must be distributed as elected by the
Owner or, if the Owner has not so elected, as elected by the
Designated Beneficiary or Beneficiaries as follows:
1) by December 31 of the year containing the fifth anniversary of
the Owner's death; or
2) in equal or substantially equal payments over the life or life
expectancy of the Designated Beneficiary or Beneficiaries
starting by December 31 of the year following the year of the
Owner's death. If however, the Designated Beneficiary is the
Owner's surviving spouse, then this Distribution is not required
to begin until December 31 of the later of: (1) the calendar
year immediately following the calendar year in which the Owner
died; or (2) the calendar year in which the Owner would have
attained age 70 1/2.
5. An individual may satisfy the minimum distribution requirements under
Section 401(a)(9) of the Code by receiving a distribution from one IRA that
is equal to the amount required to satisfy the minimum distribution
requirements for two or more IRAs. For this purpose, the Owner of two or
more IRAs may use the "alternative method" described in Notice 88-38, 1988-1
C.B. 524, to satisfy the minimum distribution requirements described above.
6. 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.
7. The annual premium shall not exceed the lesser of $2,000 or 100 percent of
compensation ($4,000 or 100 percent of compensation for Spousal IRAs
however, no more than $2,000 can be contributed to either spouse's IRA),
except for plans defined in Section 408(k) of the Code, for which annual
premiums shall not exceed $30,000.
8. Rollover contributions from other qualified plans permitted by the Internal
Revenue Code Sections 402(c), 403(a)(4), 403(b)(8) and 408(d)(3), are
excluded from the limit set forth in Section 8.
9. Notwithdstanding any Contract provisions to the contrary, no amount may be
borrowed under the Contract and no portion may be used as security for a
loan.
10. Annuity payments may not begin before the Annuitant attains the age of 59
1/2 without incurring a penalty tax except in the situations described in
Section 72(t) of the Code.
SECURITY BENEFIT LIFE INSURANCE COMPANY
XXXXX X. XXXXX
SECRETARY
________________________________________
Endorsement Effective Date
(If Other Than Issue Date)
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, THE OWNER 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 GROUP UNALLOCATED VARIABLE ANNUITY CONTRACT.
*Purchase Payments may be made until termination of the 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
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0000
0-000-000-0000
Form V6320 (2-97)
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TABLE OF CONTENTS
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Page
CONTRACT SPECIFICATIONS ................................................ 3
DEFINITIONS ............................................................ 4-7
GENERAL PROVISIONS ..................................................... 7,8
The Contract ......................................................... 7
Compliance ........................................................... 7
Incontestability ..................................................... 7
Assignment ........................................................... 7
Transfers ............................................................ 7,8
Claims of Creditors .................................................. 8
Nonforfeiture Values ................................................. 8
Participation ........................................................ 8
Statements ........................................................... 8
OWNERSHIP PROVISIONS ................................................... 8,9
Ownership ............................................................ 8
Joint Ownership ...................................................... 9
Ownership Changes .................................................... 9
PURCHASE PAYMENT PROVISIONS ............................................ 9
Flexible Purchase Payments ........................................... 9
Purchase Payment Limitations ......................................... 9
Purchase Payment Allocation .......................................... 9
Place of Payment ..................................................... 9
CONTRACT VALUE AND EXPENSE PROVISIONS .................................. 10,11
Contract Value ....................................................... 10
Fixed Account Contract Value ......................................... 10
Fixed Account Interest Crediting ..................................... 10
Separate Account Contract Value ...................................... 10
Accumulation Unit Value .............................................. 10
Net Investment Factor ................................................ 11
Determining Accumulation Units ....................................... 11
Mortality and Expense Risk Charge .................................... 11
Premium Tax Expense .................................................. 11
Administration Charge ................................................ 11
Mutual Fund Expenses ................................................. 11
WITHDRAWAL PROVISIONS .................................................. 12,13
Withdrawals .......................................................... 12
Withdrawal Value ..................................................... 12
Withdrawal Charges ................................................... 12
Free Withdrawals ..................................................... 12
Systematic Withdrawals ............................................... 13
Free Systematic Withdrawals .......................................... 13
Date of Request ...................................................... 13
Payment of Withdrawal Benefits ....................................... 13
ANNUITY BENEFIT PROVISIONS ............................................. 14,15
Purchase of Annuity Benefit Provisions ............................... 14
Annuity Tables ....................................................... 14
Fixed Annuity Payments ............................................... 14
Variable Annuity Payments ............................................ 14
Alternate Annuity Option Rates ....................................... 14
Annuity Options ...................................................... 15
ANNUITY TABLES ......................................................... 16,17
AMENDMENTS OR ENDORSEMENTS, IF ANY
2
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VARIABLE ANNUITY CONTRACT SPECIFICATIONS
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OWNER NAME: Xxxx X Xxx CONTRACT NUMBER: Specimen
JOINT OWNER NAME: Xxxx X. Xxx CONTRACT DATE: 6-30-1997
PLAN: Qualified ISSUE DATE: 6-30-1997
ASSIGNEMENT: This policy may not be assigned.
See Assignment Provision of Your
Policy.
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INITIAL PURCHASE PAYMENT $25,000
MINIMUM SUBSEQUENT PURCHASE PAYMENTS $500 ($50 pursuant to an automatic
investment program)
MINIMUM SYSTEMATIC WITHDRAWAL $100
MORTALITY AND EXPENSE RISK CHARGE 1.25% Annually
ADMINISTRATION CHARGE .15% Annually
WITHDRAWAL CHARGES:
Contract Year of Withdrawal 1 2 3 4 5 6 7+
Withdrawal Charge 6% 6% 5% 4% 3% 2% 0%
FREE WITHDRAWAL PERCENTAGE 10%
GUARANTEED RATE 3.00%
SUBACCOUNTS:
Money Market Subaccount
High Grade Income Subaccount
High Yield Subaccount
Global Aggressive Bond Subaccount
Growth-Income Subaccount
Equity Income Subaccount
Managed Asset Allocation Subaccount
Specialized Asset Allocation Subaccount
Growth Subaccount
Value Subaccount
Worldwide Equity Subaccount
Social Awareness Subaccount
Emerging Growth Subaccount
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 Fixed Account is the last
Account charged. The value of each Account will be depleted before the next is
charged.
V6320 A (2-97) 3
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DEFINITIONS
--------------------------------------------------------------------------------
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.
ANNUITANT
When Contract Value is distributed to a Participant and used to purchase an
annuity, the Annuitant is the person named by the Participant on whose life the
Annuity Payments depend for Annuity Options 1 through 4 and 8. The Annuitant
receives Annuity Payments under the Participant's Contract. Please see "Annuity
Benefit Provisions" on page 14.
ANNUITY OPTION
An Annuity Option is a set of provisions that form the basis for making Annuity
Payments. Please see "Annuity Options" on page 15.
AUTOMATIC INVESTMENT PROGRAM
A program pursuant to which Purchase Payments are automatically paid from the
Owner's bank account on a specified day of the month, on a monthly, quarterly,
semiannual or annual basis.
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, 000 XX Xxxxxxxx Xxxxxx,
Xxxxxx, Xxxxxx 00000-0000.
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.
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.
V6320 B (2-97) 4
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DEFINITIONS (Continued)
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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, 000 XX Xxxxxxxx Xxxxxx, Xxxxxx, Xxxxxx 00000-0000.
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, group or entity that possesses all rights under the
Contract. The Owner is named on page 3. Please see "Ownership" provisions on
page 9.
PARTICIPANT
A Participant under the Plan.
PARTICIPANT'S CONTRACT
A Contract purchased with a Participant's distribution from the Plan.
PLAN
The employer-sponsored retirement plan, annuity purchase arrangement or deferred
compensation program for which the Contract is issued.
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, 000 XX Xxxxxxxx Xxxxxx, Xxxxxx, Xxxxxx 00000-0000.
5
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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 is 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.
V6320 C (2-97) 6
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DEFINITIONS (Continued)
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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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GENERAL PROVISIONS
--------------------------------------------------------------------------------
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 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
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.
INCONTESTABILITY
This Contract will not be contested after it has been in force for two years
from the Issue Date.
ASSIGNMENT
Please refer to page 3 to see if this 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 are subject to the
Assignment. Any claim is subject to proof of interest of the assignee.
TRANSFERS
The Owner may Transfer Contract Value among the Fixed Account and Subaccounts
subject to the following.
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 $500.00 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.
7
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GENERAL PROVISIONS (Continued)
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TRANSFERS (Continued)
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 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 as of 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 Withdrawal 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.
--------------------------------------------------------------------------------
OWNERSHIP PROVISIONS
--------------------------------------------------------------------------------
OWNERSHIP
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.
V6320 D (2-97) 8
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OWNERSHIP PROVISIONS (Continued)
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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.
OWNERSHIP CHANGES
Subject to the terms of any existing Assignment, the Owner may name a new Owner.
Any new choice of Owner 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. The Company may require the Contract be
returned so these changes may be made.
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PURCHASE PAYMENT PROVISIONS
--------------------------------------------------------------------------------
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.
9
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CONTRACT VALUE AND EXPENSE PROVISIONS
--------------------------------------------------------------------------------
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, 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 and applicable Withdrawal Charges deducted from the Fixed
Account;
2. any Transfers from the Fixed Account to the Separate Account; and
3. any applicable Premium Taxes.
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. The
Accumulation Unit Value for any subsequent Valuation Date is equal to (1) times
(2) where:
1. is Accumulation Unit Value determined on the immediately preceding Valuation
Date; and
2. is the Net Investment Factor on the Valuation Date with respect to which
Accumulation Unit Value is being determined;
V6320 E (2-97) 10
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CONTRACT VALUE AND EXPENSE PROVISIONS (Continued)
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NET INVESTMENT FACTOR
The Net Investment Factor for any Subaccount as of 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 as of 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 Separate Account or the
Subaccounts; operations of the Company with respect to the Contract; or
the payment of premiums or acquisition costs under the Contract.
2. is the net asset value per share of the Subaccount's underlying mutual fund
as of the end of the prior Valuation Period.
3. is a daily factor representing the Mortality and Expense Risk Charge and
Administration Charge which are 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 to or charged against the Subaccounts without
regard to the gains or losses in the Company or other Subaccounts.
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 as of 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 and any applicable Withdrawal Charges that are deducted from the
Subaccount; and
4. Premium Taxes that are deducted from the Subaccount.
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 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.
11
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WITHDRAWAL PROVISIONS
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WITHDRAWALS
A full or partial Withdrawal of Contract Value is allowed at any time. This
provision is subject to any federal or state Withdrawal restrictions.
Upon the Owner's request for a full Withdrawal, the Company will pay the
Withdrawal Value in a lump sum, and the Contract will terminate.
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, if any.
2. The Owner must apply while this Contract is in force.
3. The amount Withdrawn must be at least $500.00 except that a Withdrawal of
less than $500.00 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.
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 as of any Valuation Date will be: (1) the Contract Value on
that date; less (2) any Premium Taxes due or paid by the Company; and (3) any
Withdrawal Charges.
WITHDRAWAL CHARGES
If part or all of the Contract Value is Withdrawn, Withdrawal Charges may be
applied at the time of Withdrawal. The Withdrawal Charge is applied to Purchase
Payments withdrawn. The amount of the charge is based on the Contract Year in
which the Withdrawal is made. See the Withdrawal Charges shown on page 3. For
the purpose of determining the Withdrawal Charges, Purchase Payments are
withdrawn before Earnings. The Withdrawal Charge will not be assessed against:
1. any Free Withdrawal amounts;
2. any Free Systematic Withdrawal amounts;
3. any amounts remaining after all Purchase Payments are withdrawn;
The Withdrawal Charge will be assessed against Contract Value allocated to the
Subaccounts and the Fixed Account in the same proportion as the Withdrawal is
allocated.
FREE WITHDRAWALS
A Free Withdrawal is a Withdrawal amount that is not subject to Withdrawal
Charges. The amount of Free Withdrawal available in a Contract Year is
determined as follows. In the first Contract Year, it is equal to: (1)cumulative
Purchase Payments made under the Contract; times (2) the Free Withdrawal
Percentage set forth on page 3; less (3) any Free Withdrawals, including any
Free Systematic Withdrawals, made during the Contract Year. The amount of Free
Withdrawal available in subsequent Contract Years is equal to (1) Contract Value
as of the first day of the current Contract Year; times (2) the Free Withdrawal
Percentage; less (3) any Free Withdrawals, including any Free Systematic
Withdrawals, made during the Contract Year. Unused Free Withdrawal amounts are
not carried from one Contract Year to the next.
V6320 F (2-97) 12
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WITHDRAWAL PROVISIONS (Continued)
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SYSTEMATIC WITHDRAWALS
Systematic Withdrawals are automatic periodic Withdrawals from the Contract in
substantially equal amounts. In order to start Systematic Withdrawals, the Owner
must make the request in writing. Systematic Withdrawals are subject to any
applicable Withdrawal Charges, except as discussed under "Free Systematic
Withdrawals" below. 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. The
payment frequency may be: (1) monthly; (2) quarterly; (3) semiannually; or (4)
annually. Systematic Withdrawals may be stopped or changed by the Owner upon
proper written request Received by the Company at least 30 days in advance of
the requested date of termination or change. The Company reserves the right to
stop, modify, suspend or charge a fee for Systematic Withdrawals at any time.
FREE SYSTEMATIC WITHDRAWALS
Free Systematic Withdrawals are not subject to a Withdrawal Charge. The amount
of Free Systematic Withdrawals available in a Contract Year is determined as
follows. The amount of Systematic Withdrawals that, when combined with any Free
Withdrawals in the current Contract Year, does not exceed the Free Withdrawal
amount available in that Contract Year.
DATE OF REQUEST
The Company will effect a Withdrawal of Separate Account Contract Value on the
basis of Accumulation Unit Value determined as of the end of the Valuation
Period in which all the required information is Received by the Company. The
Company will effect Systematic Withdrawals of Separate Account Contract Value on
the basis of Accumulation Unit Value determined as of the end of the Valuation
Period in which such Withdrawal is scheduled.
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 Exchang 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 Securitie 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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ANNUITY BENEFIT PROVISIONS
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PURCHASE OF ANNUITY BENEFIT PROVISIONS
The Company agrees to make available to any Participant under the Owner's Plan
who receives an eligible rollover distribution (or in the case of a Plan
described in Section 457 of the Internal Revenue Code, any distribution) from
the Plan, an annuity contract for purchase with such distribution. The Annuity
Contract will offer the annuity options and rates set forth below. A
Participant's purchase payment and application for such annuity contract must be
acceptable to the Company under its rules and practices and the provisions of
the contract applied for.
ANNUITY TABLES
Annuity Tables A through C show the guaranteed minimum amount of monthly Annuity
Payment per $1,000 applied, which for Annuity Options 1 through 4, 7 and 8
determine the amount of the first Variable Annuity Payment and the amount of
each Fixed Annuity Payment. The amount of each Annuity Payment for Annuity
Options 1 through 4, and 8 will depend on the Annuitant's sex and age.
Tables A through B assume 1900 as the year of birth of the Annuitant. To use
Tables A through 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
through B. Tables A through 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 through 7, annuity rates based on age and sex are not used
to calculate annuity payments. Annuity Payments for Options 5 and 6 are computed
without reference to the Annuity Tables.
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, 7
and 8.
VARIABLE ANNUITY PAYMENTS
With respect to Variable Annuity Payments, the amounts shown on the Tables are
the guaranteed minimum first Annuity Payment, based on the assumed interest rate
of 3.5% for Annuity Options 1 through 4, 7 and 8. The amount of each Annuity
Payment after the first for these options is computed by means of Annuity Units.
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.
V6320 G (2-97) 14
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ANNUITY PAYMENT PROVISIONS (Continued)
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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, 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.
OPTION 7
PERIOD CERTAIN OPTION: This option provides payments for a fixed period of 5,
10, 15 or 20 years. Payments will be made until the end of this period. If the
Annuitant dies prior to the end of the period, the remaining payments will be
made to the Designated Beneficiary. Table C shows some of the guaranteed rates
for this option.
OPTION 8
JOINT AND CONTINGENT SURVIVOR OPTION: This option provides payments for the life
of the primary Annuitant. Payments will be made to the primary Annuitant as long
as he or she is living. Upon the death of the primary Annuitant, payments will
be made to the contingent Annuitant as long as he or she is living. If the
contingent Annuitant is not living upon the death of the primary Annuitant, no
payments will be made to the contingent Annuitant. Table B shows some of the
guaranteed rates for this option.
15
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 Life with Fixed Period Option Three
Age Life 5 10 15 20 Unit
of Annuitant Only Years Years Years Years Refund
--------------------------------------------------------------------------------
UNISEX
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.
V6320 H (2-97) 16
ANNUITY TABLES (Continued)
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TABLE B
SETTLEMENT OPTIONS FOUR AND EIGHT
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
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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.
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TABLE C
SETTLEMENT OPTION SEVEN
MINIMUM INITIAL MONTHLY INSTALLMENT PER $1,000 OF AMOUNT APPLIED
PERIOD CERTAIN
5 YEARS 10 YEARS 15 YEARS 20 YEARS
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18.11 9.83 7.1 5.75
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.
17
A BRIEF DESCRIPTION OF THIS CONTRACT
This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT.
* Purchase Payments may be made until termination of the 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
000 XX Xxxxxxxx Xxxxxx, Xxxxxx, XX 00000-0000
0-000-000-0000
