[LOGO] The Consultant
VARIABLE ANNUITY SUPPLEMENT
TO DEALER SALES AGREEMENT
--------------------------------------------------------------------------------
1. THE CONTRACTS
The variable annuity contracts offered by Fortis Investors under this Supplement
are issued by Fortis Benefits Insurance Company. See the current variable
annuity Prospectuses for contract features.
2. APPOINTMENT AND AUTHORITY
The Dealer, when appointed by Fortis Benefits Insurance Company (herein called
the "Insurance Company"), is authorized to take applications for variable
annuity contracts offered by Fortis Investors and issued by the Insurance
Company, to collect and send initial premiums to the Insurance Company, and to
deliver and service policies. These duties shall be performed only in states in
which the dealer is properly licensed and the Insurance Company is qualified to
do business.
The Dealer is also authorized by Investors to recruit and nominate others,
hereafter Representatives, who, when duly licensed in any state where they will
be soliciting, will be appointed by the Insurance Company. It is understood and
agreed that such Representatives will be Representatives of the Dealer and that
the Dealer shall be solely responsible for their conduct. Representatives may
accept applications for variable annuity contracts once properly appointed.
Investors and the Insurance Company reserves the right to refuse to appoint any
nominated Representative or, once appointed, to terminate any appointment.
The Dealer or Representative will not make, alter or discharge any contract of
insurance, nor waive any of the provisions of any such contract.
3. RESPONSIBILITIES
The Dealer agrees to comply with all applicable insurance securities laws and
regulations relating to the business of insurance and with all rules and
regulations of the Insurance Company.
4. COMPENSATION
The Dealer will be paid a sale commission on sales of The Consultant Variable
Annuity in accordance with Option A below. However, if the Dealer so elects,
using the election procedures established by Fortis Benefits Insurance Company,
the Dealer may add commission Options B and/or C and/or D as options for the
payment of commissions. If the Dealer makes such an election, the Dealer will
be paid a sales commission in accordance with the commission option as set forth
below which the Dealer's sales representative shall elect, using the election
procedures established by Fortis Benefits, upon submission of the product
application to Fortis Benefits. Should the sales representative fail to make an
election upon submission of the product application, or should the Dealer not
have elected the designated option or should the election not be available
because of the conditions set forth below, the sales commission paid will be
based upon Option A.
OWNER'S COMMISSION (AS A % OF PREMIUM)
AGE ------------------------------
WHEN PREMIUM PAID OPTION A OPTION B OPTION C* OPTION D
----------------- -------- -------- --------- --------
0-80 6.25 3.50 1.00 4.75
81 - 85 3.25 2.00 .85 2.50
86 - 90 1.75 1.00 0.00 1.50
Gross Trail Commission 0% 0.50% 0.85% 0.25%
(yrs. 1-7)
0.40%
(yrs. 8+)
Start of Gross Trail N/A 1st 13th 1st
Commission Month Month Month
* The premium payments must total $40,000 or more within the first three
months of the policy for this Option C to be available. Sales commissions
will only be paid on premiums received within the first three months from
the date of issue.
The Trail Commission will be paid on a monthly basis and will be equal to
one-twelfth of the above-specified percentage of the policy value at the end of
the month. It will start to be paid for policy values for the policy months set
forth above. In order to qualify for entitlement to payment of Trail
Commissions, the Dealer must be the dealer of record on Fortis Benefits variable
annuity policies having an aggregate policy value of $1 million or more.
Commissions will be paid twice monthly. Irrespective of the above, if the Dealer
becomes entitled to commissions on an annuity contract as a result of a change
of dealer on such contract, the Dealer will receive commissions on such contract
in accordance with the commission option in effect for such contract prior to
the transfer.
GENERAL
Investors reserves the right to revise the compensation payable herein from time
to time, but any such revision will apply only to
purchase payments received after the effective date of such revision.
If an annuity contract is issued as a replacement of another contract, the
commission payable may be other than the commission otherwise provided herein in
accordance with Fortis Investors' policies regarding replacement then in effect.
If the premium on any policy is refunded by the Insurance Company for any
reason, or if the Insurance Company cancels or reduces the amount of a policy
for any cause, either before or after termination of the Agreement, the Dealer
agrees to repay on demand any compensation received on that premium.
Investors will furnish the Dealer with a statement of account, no less
frequently than twice monthly. The compensation payable under this Supplement
will be paid twice monthly as long as this
agreement remains in effect. In the event of termination of this agreement all
compensation payable under this Supplement shall terminate.
5. GENERAL PROVISIONS
A. FEES, SUPPLIES, SOFTWARE AND RECORDS
The Dealer will pay fees in accordance with published rules and regulations. All
ratebooks, printed material, computer software and other supplies furnished by
the Insurance Company, and all documents and records of any and every
description relating to the Insurance Company's business or the names and
addresses of policyholders and description of their coverages are confidential
information and will not be used by or otherwise disclosed to another party for
any purpose whatsoever and will be delivered to Investors upon demand. Upon any
termination of this Agreement all such confidential information will be returned
to Investors.
B. ASSIGNMENT
No assignment of this Agreement or of any compensation due the Dealer will be
valid unless authorized in advance in writing by an officer of Investors. Any
such assignment will be subject to, and subordinate to, any and all indebtedness
of the Dealer to Investors.
C. AMENDMENT
No modification of the Agreement or Schedule will bind Investors unless it is
made in writing and executed by an officer of Investors.
6. ORDERS
Applications to purchase a variable annuity contract, together with a
remittance for the full amount of the order (made payable to "Fortis Benefits
Insurance Company"), should be sent to CM #9747, Xxxx Xxxxxx Xxx 00000, Xx.
Xxxx, XX 00000-0000. No telephonic orders will be accepted.
DAP846.dlr
