GOLDEN AMERICAN MINIMUM GURANTEED
LIFE INSURANCE COMPANY INCOME BENEFIT RIDER
Golden American is a stock company domiciled in Delaware.
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GOLDEN AMERICAN LIFE INSURANCE COMPANY
(HEREINAFTER CALLED WE, US AND OUR)
The Contract to which this Rider is attached is hereby modified by the
provisions of this Rider. This Rider's provisions control when there is a
conflict between this Rider and the Contract.
Where used in this Rider the term Contract shall mean Certificate when this
Rider is attached to a Certificate. This Rider becomes effective as of the
Contract Date unless a different date, the Rider Date, is stated below. The term
Credit is as defined in the Contract. If not defined in the Contract to which
this Rider is attached, the Credit shall be zero.
MINIMUM GUARANTEED INCOME BENEFIT
This Rider provides an option to take the Minimum Guaranteed Income Benefit
("MGIB") instead of the annuity benefits payable under the Contract. This option
may only be exercised at specified times, Exercise Dates, as described below and
on the Schedule Page. This Rider has no cash surrender value.
MGIB provides a minimum periodic income. MGIB will be paid monthly, unless you
elect to receive it less frequently. You can elect to receive MGIB on a monthly,
quarterly, semi-annual, or annual basis. Payments may be subject to company
minimums.
To elect to receive the MGIB, you must provide us a written election. Such
election must be received by us within the 30 days prior to an Exercise Date.
Your election will become effective as of the Exercise Date following receipt of
your request. Exercise Dates are shown on the Schedule Page. On the Exercise
Date that you elect to begin receiving the MGIB, the Contract terminates, and no
other benefits under the Contract are payable. If the Contract terminates for
any other reason, this Rider terminates and provides no benefits.
MGIB is determined as follows:
1) The MGIB Benefit Base on the Exercise Date less any surrender charges and
premium tax and after any market value adjustments, is multiplied by;
2) The applicable MGIB Income Factor on the Exercise Date.
The MGIB Benefit Base for determining the MGIB on the Exercise Date equals the
sum of (1) the Accumulation Value in Special Funds and (2) the MGIB Base for
non-Special Funds.
MGIB BASE
If this Rider is effective as of the Contract Date, the initial MGIB Base is
equal to the initial premium paid for the Contract plus any credits. If this
Rider is added to a Contract after the Contract Date, the initial MGIB Base
shall be equal to the Accumulation Value on the Rider Date. Thereafter, the MGIB
Base is increased by Eligible Premiums, and Credits thereon reduced by any
Prorata Partial Withdrawal Adjustments and accumulated for the calculation
period at the MGIB Rate. Eligible Premiums are defined in the Schedule Page. The
MGIB Base is calculated separately for Special Funds and non-Special Funds.
MGIB RATE
The MGIB Rate is equal to the rate stated on the Schedule Page for this Rider.
On the earlier of: (1) the Contract Anniversary on which the Owner's attained
age equals the MGIB maximum age stated in the Schedule, or (2) the date the MGIB
Base is equal to or would exceed the Maximum MGIB Base, the MGIB Rate will be
set to [zero.]
SPECIAL FUNDS
Where used in this Rider the Special Funds, if any, are listed on the Schedule
Page. We reserve the right to classify newly available divisions as Special
Funds from the date of availability to the Owner. We may also reclassify an
existing division as Special Funds or remove such designation. Such
reclassification shall be made with 30 days notice to Contract Owners, and will
apply to amounts transferred or otherwise added to such division after the date
of change.
PRORATA PARTIAL WITHDRAWAL ADJUSTMENT
The MGIB Base will be reduced by a Prorata Partial Withdrawal Adjustment each
time a partial withdrawal is made. The Prorata Partial Withdrawal Adjustment is
equal to (1) divided by (2), multiplied by (3), where: (1) is the Accumulation
Value withdrawn; (2) is the Accumulation Value immediately prior to withdrawal;
and (3) is the amount of MGIB Base immediately prior to the withdrawal. Separate
adjustments will apply to Special and non-Special Funds.
TRANSFERS
Net transfers from Special to non-Special Funds will reduce the MGIB Base
allocated to Special Funds on a pro-rata basis. There will be a corresponding
increase in the MGIB Base for non-Special Funds. The amount of such increase
will equal the lesser of the reduction in MGIB Base allocated to Special Funds
and the net Accumulation Value transferred.
Net transfers from non-Special Funds will reduce the MGIB Base allocated to the
non-Special Funds on a prorata basis. There will be a corresponding increase in
the MGIB Base for Special Funds. The resulting increase in the MGIB Base
allocated to Special Funds will equal the reduction in the MGIB Base allocated
to non-Special Funds.
MAXIMUM MGIB BASE
The Maximum MGIB Base is shown or defined on the Schedule Page. Any addition to
the Accumulation Value due to spousal continuation will have no effect on the
MGIB Base or the Maximum MGIB Base. The Maximum MGIB Base is calculated
separately for Special Funds and non-Special Funds. Transfers between Special
Funds and non-Special Funds will affect the Maximum MGIB Base on a prorata
basis.
MGIB CHARGES
Charges for this Rider will be deducted from the Contract's Accumulation Value.
The rate and frequency of deduction of charges are stated on the Schedule Page.
Deduction dates are measured from the Contract Date. The charge is a percentage
of the total MGIB Base as of the deduction date. It is deducted in arrears from
the portion of Accumulation Value allocated to the Variable Separate Account in
proportion to the Accumulation Value in each division. If there is insufficient
Accumulation Value in the separate account, charges will be deducted from the
Fixed Division nearest maturity. An MVA adjustment may be applied to charges
deducted from the Fixed Division. We may charge less than the maximum. The
maximum charge is stated on the Schedule Page.
If the Contract to which the Rider is attached is terminated by surrender,
cancellation or application of the Contract's value to an Income Benefit, the
Rider charge for the current period will be deducted from the Accumulation Value
prior to termination of the Contract. Charges will be calculated using the MGIB
Charge Base immediately prior to termination.
RIDER TERMINATION
This Rider will terminate immediately under any of the following circumstances:
1. If the Contract to which this Rider is attached terminates;
2. If you die, unless the Contract is continued on the life of your spouse, in
which case the Rider will continue with your surviving spouse as Owner; or,
3. If the Owner is not a natural person and the Annuitant dies.
4. If the Ownership of this Contract changes and the new Owner is other than
the spouse of the previous Owner.
5. If the Accumulation Value is insufficient to pay the MGIB Charge deduction.
PREMIUM TAX
Any premium taxes paid by us relating to premiums for the Contract will be
deducted from the MGIB Benefit Base prior to determining the amount of MGIB
payable.
NOTIFICATION
The Company will notify the Owner 30 days prior to an Exercise Date of the
Owner's options on that Exercise Date.
MGIB INCOME FACTORS
MGIB Income Factors are calculated using interest at a rate of [2.5%] per annum
and, where applicable, the [Annuity 2000] Mortality Table [with improvements
based on Projection Scale G]. The following are the MGIB Income Options
available:
1) Income for Life (Single Life or Joint with 100% Survivor) with 10-30 Years
Certain;
2) Years Certain Income for 20-30 Years Certain.
3) Any other Income Plan offered by the Company in connection with the Rider
on the Exercise Date.
Monthly Income Factors for certain ages are shown below. Factors shown are per
$1000 of Rider proceeds applied to the Income Option. Income Factors for other
ages and/or payment frequencies are available upon request.
Income Payments made under Option 1 will be paid for a minimum period (Certain
period) and for the life of the payee after the Certain period. If the payee
dies during the Certain period, payments will continue until the end of the
Certain period, but will be paid to the Beneficiary.
Income Factors for Option 1 vary by sex and attained Age of the payee on the
Exercise Date that MGIB begins.
TABLE OF INCOME FOR LIFE
YEARS
MALE/FEMALE MALE/FEMALE CERTAIN
AGE 10 YEAR CERTAIN 20 YEAR CERTAIN YEARS INCOME
[50 3.56/3.33 3.49/3.29 20 5.27
55 3.91/3.63 3.78/3.56 21 5.08
60 4.37/4.02 4.12/3.89 22 4.90
65 4.96/4.54 4.47/4.27 23 4/74
70 5.71/5.24 4.81/4.66 24 4.60
75 6.59/6.13 5.06/4.98 25 4.46
80 7.52/7.18 5.21/5.18 26 4.34
85 8.35/8.17 5.26/5.26 27 4.22
90 8.94/8.87 5.27/5.27 28 4.12
29 4.02
30 3.93]
This Rider has no surrender value or other non-forfeiture benefits upon
termination. This Rider may not be cancelled unless the Contract is terminated.
Rider Date: _________________________
(if other than Contract Date)
Signed: /s/Xxxxxxx Xxxxxxx
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Xxxxxxx Xxxxxxx
