Deferred Annuity Contract
(logo) American Centurion
AMERICAN Life Assurance Company
EXPRESS 00 Xxxxxxx Xxx. Ext.
(R) P.O. Box 5555
American Albany, New York 12205
Centurion
Life
This is a deferred annuity contract. It is a legal contract between you, as the
owner, and us, American Centurion Life Assurance Company, a Stock Company.
PLEASE READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the retirement date, upon your request, we will
begin to pay you monthly annuity payments. Any payments made by us are subject
to the terms of this contract.
We issue this contract in consideration of your application and the payment of
the initial purchase payment. This contract is established for the benefit of
the owner/annuitant or his/her beneficiaries.
Signed for and issued by American Centurion Life Assurance Company of Albany,
New York, as of the contract date.
ACCUMULATION VALUES AND ANNUITY PAYMENTS, WHEN BASED ON THE INVESTMENT RESULTS
OF THE VARIABLE SUBACCOUNTS, ARE VARIABLE AND NOT GUARANTEED AS TO FIXED DOLLAR
AMOUNT. See the Fixed And Variable Accounts section for variable provisions. The
Mortality & Expense Risk and Variable Account Administrative Charges are shown
under Contract Data.
In order for the dollar amount of variable annuity payments not to decrease, the
assets of the variable accounts must have an annual net rate of investment
return of 3.5%. This is equal to the gross investment return minus the mortality
and expense risk charge and administrative charge shown under Contract Data.
NOTICE OF YOUR RIGHT TO EXAMINE THIS CONTRACT FOR 10 DAYS
If for any reason you are not satisfied with this contract, return it to us or
our representative within 10 days after you receive it. We will then cancel this
contract and refund all premiums which you have paid. This contract will then be
considered void from its start.
/s/ Xxxx X. Xxxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Secretary President
o Flexible purchase payments.
o Investment experience reflected in benefits.
o Optional fixed dollar or variable accumulation values and annuity payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
IRA
272251 A(12/02)
Guide To Contract Provisions
Definitions Important words and meanings Page 3
General Provisions Entire Contract; Modification of the
Contract; Incontestable; Benefits Based
on Incorrect Data; State Laws; Federal
Laws; Reports to Owner; Evidence of
Survival; Protection of Proceeds;
Payments by Us; Voting Rights Page 5
Ownership and
Beneficiary Owner's Rights; Trust or Custodial
Ownership; Change of Ownership;
Beneficiary; Change of Beneficiary Page 7
Payments to
Beneficiary Describes options and amounts payable
upon death Page 8
Purchase Payments Purchase Payments; Amount and Intervals;
Payment Limits; Allocation of Purchase
Payments; Additional "Credits" for
Purchase Payments Page 9
Contract Value Describes the fixed and variable account
contract values; Interest to be
Credited, Contract Administrative
Charge; Premium Tax Charges, Transfers
of Contract Values; Dollar Cost
Averaging Program Page 11
Fixed and Variable
Accounts Describes the variable subaccounts,
accumulation units and values; Net
Investment Factor; Mortality and Expense
Risk Charge; Annuity Unit Value Page 13
Withdrawal Provisions Withdrawal of the contract for its
withdrawal value; Rules for Withdrawal;
Withdrawal Value; Withdrawal Charge;
Withdrawal Order; Waiver of Withdrawal
Charges; Suspension or Delay in Payment
of Withdrawal Page 15
Annuity Provisions When annuity payments begin; Different
ways to receive annuity payments;
Determination of payment amounts Page 17
Tables of Annuity
Rates Tables showing amount of first variable
annuity payment and the guaranteed fixed
annuity payments for the various payment plans
Page 20
Page 2
Definitions
The following words are often used in this contract. When we use these words,
this is what we mean:
Accumulation Unit
An accumulation unit is an accounting unit of measure. It is used to calculate
the contract value prior to annuitization.
Annuitant
The person or persons on whose life monthly annuity payments depend.
Annuity Unit
An annuity unit is an accounting unit of measure. It is used to calculate the
value of annuity payments from the variable subaccounts on and after the
retirement date.
Annuitization
The application of the contract value of this contract to an Annuity Payment
Plan to provide annuity payments.
Code
The Internal Revenue Code of 1986, as amended, its regulations thereunder and/or
promulgations of the Internal Revenue Service, as applicable.
Contract Anniversary
The same day and month as the contract date each year that the contract remains
in force.
Contract Date
The date from which contract anniversaries, contract years, and contract months
are determined. Your contract date is shown under Contract Data.
Contract Value
The sum of the Fixed Account Contract Value (which receives a declared interest
rate) and the Variable Account Contract Value (which varies with the investment
performance of the elected subaccounts) for this contract.
Fixed Account
The fixed account is made up of all our assets other than those in any separate
account.
Xxxxx Xxxxxxx
A fixed annuity is an annuity with payments which are guaranteed by us as to
dollar amount during the annuity payment period.
Required Beginning Date
If this is a traditional IRA contract, your required beginning date is the first
day of April following the calendar year you reach age 70-1/2.
Required Minimum Distributions
The minimum distributions that Code Section 408(b)(3) requires to be distributed
from an IRA, beginning not later than your required beginning date. If this is a
Xxxx XXX contract, required minimum distributions are not required until after
your death.
Xxxx XXX
An Individual Retirement Annuity as described in Section 408A of the Code.
Retirement Date
The date shown under Contract Data on which annuity payments are scheduled to
begin. This date may be changed as provided in this contract. You will be
notified prior to the retirement date in order to select an appropriate annuity
payment plan.
Special DCA Fixed Account
The Special DCA fixed account is an option within the fixed account whereby
amounts allocated will earn a specified rate of interest provided they are
transferred monthly to the variable subaccounts within specified time periods we
declare.
Traditional IRA
An Individual Retirement Annuity as described in Section 408(b) of the Code.
Page 3
Definitions (Continued)
Valuation Date
A valuation date is each day the New York Stock Exchange is open for trading.
Valuation Period
A valuation period is the interval of time commencing at the close of business
on each valuation date and ending at the close of business on the next valuation
date.
Variable Annuity
A variable annuity is an annuity with payments which: (1) are not predetermined
or guaranteed as to dollar amounts; and (2) vary in amount with the investment
experience of one or more of the variable subaccounts.
Variable Subaccounts
The portfolios of the Variable Account. The subaccounts available on the
contract date are named under Contract Data.
We, Our, Us
American Centurion Life Assurance Company.
Written Request
A request in writing signed by you and delivered to us at our home office.
You, Your
The owner and annuitant of this contract.
Page 4
General Provisions
Entire Contract
This contract form and any endorsements or riders attached to it are the entire
contract between you and us.
No one except one of our home officers (President, Vice President, Secretary or
Assistant Secretary) can change or waive any of our rights or requirements under
this contract. That person must do so in writing. None of our other
representatives or other persons has the authority to change or waive any of our
rights or requirements under this contract.
Modification of the contract
We reserve the right to modify this contract to the extent necessary to qualify
this contract as an annuity contract under Section 72 of the Code and all
related laws and regulations which are in effect during the term of this
contract.
Traditional IRA: If this contract is intended to qualify as an Individual
Retirement Annuity (IRA), we agree to and reserve the right to modify this
contract to the extent necessary to qualify this contract as an Individual
Retirement Annuity, as described in Sections 408(b) and 219 of the Code, as
amended and all related sections and regulations which are in effect during the
term of the contract.
Xxxx XXX: If this contract is intended to qualify as a Xxxx XXX, we agree to and
reserve the right to modify this contract to the extent necessary to qualify
this contract as a Xxxx XXX as described in Section 408A of the Code, as amended
and all related sections and regulations which are in effect during the term of
the contract.
Incontestable
This contract is incontestable from its date of issue.
Benefits Based on Incorrect Data
If the amount of benefits is determined by data as to a person's age or sex that
is incorrect, benefits will be recalculated on the basis of the correct data.
Any underpayments made by us will promptly be paid in a single sum with an
interest credit of 6% per annum. Any overpayments made by us will be subtracted
from the future payments together with an interest charge of 6% per annum.
State Laws
This contract is governed by the laws of the state in which it is delivered. The
values and benefits of this contract are at least equal to those required by
such state.
Federal Laws
This contract is intended to qualify as an annuity contract for Federal income
tax purposes. To that end, the provisions of this contract are to be interpreted
to ensure or maintain such tax qualification, despite any other provisions to
the contrary. We reserve the right to unilaterally amend this contract to
reflect any clarifications that may be needed or are appropriate to maintain
such tax qualification. We will send you a copy of any such amendments.
Reports to Owner
At least once a year we will send you a statement showing the contract value,
the cash withdrawal value and death benefit of this contract as of a date not
more than two months prior to the statement. This statement will be based on any
laws or regulations that apply to contracts of this type. It will be mailed to
your last known post office address.
Evidence of Survival
Where any payments under this contract depend on the recipient or annuitant
being alive on a given date, proof that such condition has been met may be
required by us. Such proof may be required prior to making the payment.
Protection of Proceeds
Payments under this contract are not assignable by any beneficiary prior to the
time they are due.
Payments by Us
All sums payable by us are payable from our home office. Any payment or
withdrawal from a variable annuity is based on the variable contract value.
Page 5
General Provisions (Continued)
Voting Rights
So long as federal law requires, we will give certain voting rights to contract
owners. As contract owner, if you have voting rights we will send a notice to
you telling you the time and place of the shareholder meeting. The notice will
also explain matters to be voted upon and how many votes you have.
Trustee or custodian owners shall cast votes according to instructions received
from appropriate annuitants. All other votes of such trustee or custodian under
the same trust or custodial agreement shall be cast in the same proportion. If
no instructions are received, the votes may be cast at the trustee's or
custodian's discretion.
Page 6
Ownership And Beneficiary
Owner's Rights
As long as you are living and unless otherwise provided in this contract, you
may exercise all rights and privileges provided in this contract or allowed by
us.
Your entire interest is non-forfeitable and non-transferable.
Trust or Custodial Ownership
If you are a tax qualified trust or tax qualified custodial account, then your
trustees or custodian (or other successors) properly named by your trust or
custodial agreement may exercise all rights and privileges provided in this
contract or allowed by us.
Change of Ownership (Restricted)
Your right to change the ownership of this contract is restricted. This contract
may not be sold, assigned, transferred, forfeited, discounted or pledged as
collateral for a loan or as security for performance of an obligation or for any
other purpose to any other person other than as may be required or permitted
under Section 408 of the Code. Your interest in this contract may be transferred
to your former spouse, if any, under a divorce decree or a written instrument
incident to such divorce.
However, if this contract is owned by a trustee of a tax-qualified trust or the
custodian of a tax-qualified custodial account, such trustee or custodian may
transfer ownership of this contract to the annuitant or to a qualified successor
trustee or custodian. Such transfer shall be effective only if received by us at
our home office. When so received, such transfer shall take effect as of the
date of instrument, subject to any payment made or other action taken by us
before such receipt.
Beneficiary
Unless designated otherwise, beneficiaries are those you name, in a form
satisfactory to us, to receive benefits of this contract if you die while this
contract is in force.
Only those beneficiaries who are living when death benefits become payable may
share in the benefits, if any. Benefits will be paid to all primary
beneficiaries surviving the owner, in accordance with your last beneficiary
designation on file. If none survive, proceeds will be paid to all surviving
contingent beneficiaries. If no beneficiary survives, we will pay the benefits
to your estate.
Change of Beneficiary
If the annuitant is still living, you may change the beneficiary anytime while
the annuitant is living by satisfactory written request to us. Once we receive
the change, it will take effect as of the date of your request, subject to any
action taken or payment made by us before the receipt.
Page 7
Payments To Beneficiary
Death Benefit Before the Retirement date
If you die before the retirement date while this contract is in force, we will
pay the beneficiary the greater of:
1. the contract value as of the date we receive proof of death; or
2. the total purchase payments payments and any purchase payment credits made
to the contract minus paid less any "adjusted partial withdrawals."
An "adjusted partial withdrawal" is calculated for each partial withdrawal as
the product of (a) times (b) where:
(a) is the ratio of the amount of the partial withdrawal to the contract value
on the date of (but prior to) the partial withdrawal; and
(b) is the death benefit on the date of (but prior to) the partial withdrawal.
We will determine the contract value on which we base amounts payable or applied
under this section at the next accumulation unit value calculated after we
receive due proof of death at our home office.
Death Benefit Before Required Beginning Date - Payment Options to Beneficiary
If required minimum distributions from your IRA have not begun, your beneficiary
must receive payments under one of the following options:
1. Annuity Payment Plan:
Payments may be made under an Annuity Payment Plan, provided:
a) the beneficiary elects the plan within 60 days after we receive due
proof of death;
b) the plan provides payments over a period which does not exceed the
life or life expectancy of the beneficiary; and
c) payments begin no later than one year after the year your death
occurs, in the case of a non-spouse beneficiary,
d) payments must begin no later than the year you would have attained age
70-1/2 in the case of a spouse beneficiary.
In this event, the reference to "annuitant in the Annuity Provisions shall
apply to the beneficiary who is a natural person.
2. In lieu of an annuity payment plan, the beneficiary may: (i) take one or
more distributions so that the entire death benefit is received by December
31 of the calendar year containing the fifth anniversary of your death, or
(ii) take distributions in installments, in the form of partial withdrawals
from this contract, beginning no later than one year after the year your
death occurs, (or no later than the year you would have attained age 70-1/2
in the case of a spouse beneficiary) over the life or life expectancy of
the beneficiary pursuant to Section 401(a) of the Code and the regulations
thereunder.
Death After Required Beginning Date
Under the Code, required minimum distributions are considered to have begun if
you reach your IRA required beginning date.
If required minimum distributions from your IRA have begun (before the
retirement date), Section 401(a)(9) of the Code requires that your beneficiary
receive payments over a period which does not exceed the life or life expectancy
of the beneficiary, beginning no later than one year after the year your death
occurs. In meeting the requirements of Section 401(a) of the Code, your
beneficiary, who is a natural person, may elect either: (i) an annuity payment
plan as described above, or (ii) to take distributions in installments in the
form of partial withdrawals from this contract.
Refer to the "Annuity Provisions" section for information on required minimum
distributions, life expectancy calculations and required beginning date
information.
Spouse Option to Continue Contract Upon Owner's Death
If your death occurs prior to the retirement date, and your spouse is designated
as sole beneficiary, the spouse may elect in writing to forego receipt of the
death benefit and instead continue this contract in force as the owner. This
election by your spouse must be made within 60 days after we receive due proof
of death. Upon such continuation the contract value shall be equal to the death
benefit that would otherwise have been paid. Withdrawal charges under the
continued contract shall only apply to additional purchase payments.
Annuitant's Death After the Retirement Date
If the annuitant dies after the retirement date, the amount payable, if any,
will be as provided in the Annuity Payment Plan then in effect.
Page 8
Purchase Payments
Purchase Payments
Purchase payments are the payments you make for this contract and the benefits
it provides. Purchase payments must be paid or mailed to us at our home office
or to an authorized agent. If requested, we'll give you a receipt for your
purchase payments.
Net purchase payments are that part of your purchase payments applied to the
contract value. A net purchase payment is equal to the purchase payment less any
applicable premium tax charge.
Amount and Intervals
Purchase payments may be paid in a single sum or in installments until the
earlier of: (1) the date this contract terminates by withdrawal or otherwise; or
(2) the date on which the annuity payments begin.
Subject to the Payment Limits Provision you may: (1) stop and/or restart
purchase payments; or (2) increase or decrease the amount of your purchase
payments; or (3) change the interval of your purchase payments.
If this contract is a traditional IRA, no annual purchase payments may be made
with respect to the taxable year in which the annuitant attains age 70-1/2 or
any later year, with the exception of employer purchase payments made in
connection with a Simplified Employee Pension Plan.
If this contract is a Xxxx XXX, purchase payments may be made even after the
annuitant has attained age 70-1/2.
Payment Limits Provision
Maximum Purchase Payments - The maximum purchase payments in the first or later
contract years may not exceed the amounts shown under Contract Data.
Minimum Purchase Payments - Upon issue of this contract, a purchase payment
intended as a Single Purchase Payment must be at least $2,000. If you intend to
make installment purchase payments, the minimum purchase payment is shown under
Contract Data.
All purchase payments must be made in cash. This contract does not require fixed
purchase payments.
In the case of a rollover contribution described in Sections 402(a)(5),
402(a)(7), 403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16) of the Code, there is
no limit on the amount of your purchase payment.
Contributions that are made under a SIMPLE IRA Plan, established by any employer
pursuant to 408(p) of the Code, will not be accepted into a traditional, SEP or
Xxxx XXX contract.
If you die before the entire interest in this contract has been distributed to
you, and your beneficiary is other than your surviving spouse, no additional
purchase payments will be accepted from your beneficiary under this contract.
Traditional IRA: If this contract is a traditional IRA, except as otherwise
provided in this paragraph, the total purchase payments for any taxable year may
not exceed the limit described in section 408(b)(2), and no annual purchase
payments may be made with respect to the taxable year in which the annuitant
attains age 70-1/2 or any later year, with the exception of employer purchase
payments made in connection with a Simplified Employee Pension Plan.
Xxxx XXX: If this contract is a Xxxx XXX, except as otherwise provided in this
paragraph, the total purchase payments for any taxable year may not exceed the
limits described in section 408A(c)(2). In the case of a rollover contribution
or a conversion of an Individual Retirement Annuity (other than a Xxxx XXX) to a
Xxxx XXX as described in Sections 408A(c)(6) and 408A(d)(3)(C) of the Code,
there is no limit on the amount of your purchase payment. All purchase payments
must be made in cash. If this contract is a Xxxx XXX, purchase payments may be
made after the annuitant has attained age 70-1/2.
Page 9
Purchase Payments (Continued)
For all contacts, we reserve the right to cancel this contract if both of the
following conditions exist at the same time: (1) no purchase payments have been
paid for a continuous period of 36 months; and (2) the contract value is less
than $2,000. In this event we will give you 30 days written notice of our intent
to cancel this contract. Upon such cancellation we will pay you the contract
value in one sum. This contract will then terminate.
Allocation of Purchase Payments
You instruct us on how you want your purchase payments allocated among the fixed
account and variable subaccounts. Your choice for each account may be made in
any whole percent from 0% to 100% as long as the total adds up to 100%. Your
allocation instructions as of the contract date are shown under Contract Data.
By written request, or by other method agreed to by us, you may change your
choice of accounts or percentages. The first net purchase payment will be
allocated as of the end of the valuation period during which we make an
affirmative decision to issue this contract. Net purchase payments after the
first will be allocated as of the end of the valuation period during which we
receive the payment at our home office.
Additional "Credits" for Purchase Payments
We may apply an additional purchase payment credit to your contract value for
applicable net purchase payments you make to this contract as indicated under
Contract Data. The purchase payment credit is a percentage of such net purchase
payment which is the purchase payment less the amount of partial withdrawals
that exceed all prior purchase payments. The percentage depends on the amount of
cumulative purchase payments under the contract less partial withdrawals as
shown under Contract Data.
If an additional purchase payment causes the contract as a whole to be eligible
for a greater percentage credit, an additional credit on prior purchase
payments, less any partial withdrawals, will be allocated on the date of the
additional purchase payment. Such additional credit is calculated to bring the
credit percentage on all prior net purchase payments to the current level.
Purchase payment credits will be allocated to the contract value according to
your then-existing purchase payment allocation instructions.
Any partial withdrawal reduces the cumulative net purchase payments used as the
basis of the credits on a last-in, first-out basis.
Credits shall be reversed from the contract value for any purchase payment that
is not honored.
The amount returned to you under the Right to Examine Contract (Free-look)
provision shall not include any Credits applied to your contract.
Page 10
Contract Value
Contract Value
The contract value at any time is the sum of: (1) the Fixed Account Contract
Value; and (2) the Variable Account Contract Value.
If: (1) part or all of the contract value is withdrawn; or (2) charges described
herein are made against the contract value; then a number of accumulation units
from the variable subaccounts and an amount from the fixed account will be
deducted to equal such amount.
For withdrawals, deductions will be made from the fixed or variable subaccounts
that you specify. Otherwise, the number of units from the variable subaccounts
and the amount from the fixed account will be deducted in the same proportion
that your interest in each bears to the total contract value.
Variable Account Contract Value
The variable account contract value at any time will be the sum of the value of
the units in any variable subaccount resulting from: (1) purchase payments and
any purchase payment credit allocated to a subaccount; plus (2) any amounts
transferred to a subaccount from another subaccount or from the fixed account;
less (3) any amounts transferred from a subaccount to another subaccount or to
the fixed account; less; (4) any amounts deducted from a subaccount for charges
or withdrawals.
Fixed Account Contract Value
The fixed account contract value at any time will be: (1) the sum of all
purchase payments and any purchase payment credit allocated to the fixed
account, plus interest credited; plus (2) any amounts transferred to the fixed
account from any variable subaccount, plus interest credited; less (3) any
amounts transferred from the fixed account to any variable subaccount; less (4)
any amounts deducted for charges or withdrawals.
Interest to be Credited
We will credit interest to the fixed account contract value. Interest will begin
to accrue on the date the purchase payments which are received in our home
office become available to us for use. We will pay interest on the portion of
your initial purchase payment allocated to the fixed account at a guaranteed
rate shown under Contract Data.
The first-year interest rate includes an additional first-year bonus that is
also guaranteed for the first contract year. After the first year, interest will
accrue on the fixed account value at rates determined by us and at our
discretion. Theses rates will be based on various factors including, but not
limited to, the interest rate environment, returns earned on investments backing
these annuities, the rates currently in effect for new and existing company
annuities, product design, competition, and the company's revenues and expenses.
However, we guarantee that the rate will not be less than the Guaranteed
Interest Rate shown under Contract Data.
Contract Administrative Charge
We charge a fee for establishing and maintaining our records for this contract.
The charge is shown under Contract Data and is deducted from the contract value
at the end of each contract year or, if earlier, when the contract is fully
withdrawn.
The charge deducted will be prorated among the variable subaccounts and the
fixed account in the same proportion your interest in each bears to the total
contract value. However, any amount deducted from the fixed account contract
value will be limited to: (1) the amount of interest credited in excess of 3%;
plus (2) any amounts allocated or transferred to the fixed account in that year.
In no instance will the charge from the fixed account exceed $30 in any contract
year.
We waive this charge if your contract value, immediately prior to the deduction
of the charge, equals or exceeds $50,000.
If you make a full withdrawal of this contract, we deduct the full contract
administrative charge shown under Contract Data at the time of the full
withdrawal regardless of contract value.
The charge does not apply after annuitization of this contract under an annuity
payment plan.
Premium Tax Charges
We reserve the right to deduct an amount from the value of this contract at the
time that any applicable premium taxes assessed against the Company or otherwise
not previously deducted are payable.
If a tax is payable at the time of your purchase payment and we choose to not
deduct it at that time, we further reserve the right to deduct it at a later
date.
Page 11
Contract Value (Continued)
Transfers of Contract Values
While this contract is in force prior to the retirement date, transfer of
contract values may be made as outlined below:
1. You may transfer all or part of the values held in one or more variable
subaccounts to another one or more of the variable subaccounts. Subject to
item 2, you may also transfer values held in one or more of the variable
subaccounts to the fixed account (other than any Special DCA fixed
account).
2. On or within the 30 days after a contract anniversary you may transfer
values from the fixed account (other than any Special DCA fixed account) to
one or more of the variable subaccounts. Only one such transfer is allowed
during this period each year. If such a transfer is made, no transfers from
a variable subaccount to the fixed account may be made for six months after
such a transfer.
You may make a transfer by written request. Transfer requests may also be made
according to automated transfer procedures that are then currently in effect, if
any. There is no fee or charge for these transfers. However, the minimum
transfer amount is $500, or if less, the entire value in the account from which
the transfer is being made. The minimum automated transfer is $100.
We reserve the right to:
1. limit the number of transfers to 12 per contract year; and
2. require up to a maximum of 10 valuation dates between each transfer; and
3. limit the amount to be transferred on any one valuation date to no more
than $2,000,000; and
4. upon 30 days prior written notice, to only accept transfer instructions
from you (the contract owner), and not from your representative, agent or
person acting under a power of attorney for you.
Dollar Cost Averaging Program
You may elect to participate in any DCA Program we offer by written request on a
form approved by us. Under the program you may allocate purchase payments to the
Special DCA fixed account(s), if the Special DCA program is offered, and
authorize the automatic transfer of amounts on a monthly basis from the Special
DCA fixed account to any of the variable subaccount(s) or the fixed account. All
amounts allocated to the Special DCA fixed account will be transferred out
within the specified Special DCA fixed account time period you elect from the
time periods we make available.
You may also authorize the automatic transfer of amounts, on an annual,
semiannual, quarterly or monthly basis, for specified amounts from the regular
fixed account or any of the variable subaccounts to any other variable
subaccounts other than the source account.
The unit values credited and applied to your contract are determined on each
date of transfer. You may terminate the DCA Program at any time. However, upon
termination or annuitization, any amounts remaining in the Special DCA fixed
account will be transferred to the regular fixed account.
Page 12
Fixed And Variable Accounts
The Fixed Account
The fixed account is our general account. It is made up of all of our assets
other than:
1. those in the variable subaccounts; and
2. those in any other segregated asset account.
The Variable Account
The variable account is a separate investment account of ours. It consists of
several subaccounts, which are named under Contract Data. We have allocated a
part of our assets for this contract to the variable accounts. Such assets
remain our property. However, they may not be charged with the liabilities from
any other business in which we may take part.
Investments of the Variable Account
Purchase payments applied to the variable subaccounts will be allocated as
specified by the owner. Each variable subaccount will buy, at net asset value,
shares of the fund shown for that subaccount under Contract Data or as later
added or changed.
We may change the funds from which the variable subaccounts buy shares if laws
or regulations change, the existing funds become unavailable or in our judgment,
the funds are no longer suitable for the subaccounts. We have the right to
substitute funds for those shown under Contract Data, including funds other than
those shown under Contract Data. We may also: add additional subaccounts
investing in other funds; combine subaccounts; transfer assets to and from the
subaccounts or the variable account; and eliminate or close any subaccounts.
When required, we would first seek approval of the Securities and Exchange
Commission and, the insurance regulator of the state where this contract is
delivered.
Valuation of Assets
Fund shares in the variable subaccounts will be valued at their net asset value.
Variable Account Accumulation Units
The number of accumulation units for each of the variable subaccounts is found
by adding the number of accumulation units resulting from:
1. purchase payments and any purchase payment credits allocated to the
subaccount; and
2. transfers to the subaccount;
and subtracting the number of accumulation units from:
1. transfers from the subaccount; and
2. withdrawals (including withdrawal charges) from the subaccount; and
3. contract administrative charge or any rider charge deductions from the
subaccount.
The number of accumulation units added or subtracted for each of the above
transactions is found by dividing (1) by (2) where:
(1) is the amount allocated to or deducted from the subaccount; and
(2) is the accumulation unit value for the subaccount for the respective
valuation period during which we receive the purchase payment or transfer
value, or during which we deducted transfers, withdrawals, withdrawal
charges, rider charges or contract administrative charges.
Variable Account Accumulation Unit Value
The value of an accumulation unit for each of the variable subaccounts was
arbitrarily set at $1 when the first fund shares were bought. The value for any
later valuation period is found as follows:
The accumulation unit value for each variable subaccount for the last prior
valuation period is multiplied by the net investment factor for the same
account for the next following valuation period. The result is the
accumulation unit value. The value of an accumulation unit may increase or
decrease from one valuation period to the next.
Page 13
Fixed And Variable Accounts (Continued)
Net Investment Factor
The net investment factor is an index applied to measure the investment
performance of a variable subaccount from one valuation period to the next. The
net investment factor may be greater or less than one; therefore, the value of
an accumulation or annuity unit may increase or decrease.
The net investment factor for any such subaccount for any valuation period is
determined by: dividing (1) by (2) and subtracting (3) and (4) from the result.
This is done where:
(1) is the sum of:
a) the net asset value per share of the fund held in the variable
subaccount determined at the end of the current valuation period; plus
b) the per share amount of any dividend or capital gain distributions
made by the fund held in the variable subaccount, if the "ex-dividend"
date occurs during the current valuation period.
(2) is the net asset value per share of fund held in the variable subaccount,
determined at the end of the last prior valuation period.
(3) is a factor representing the mortality and expense risk charge.
(4) is a factor representing the variable account administrative charge.
Mortality and Expense Risk Charge
In calculating unit values we will deduct a mortality and expense risk charge
from the variable subaccounts equal, on an annual basis, to the percentage shown
under Contract Data of the daily net asset value. This deduction is made to
compensate us for assuming the mortality and expense risks under contracts of
this type. We estimate that approximately 2/3 of this charge is for assumption
of mortality risk and 1/3 is for assumption of expense risk. The deduction will
be: (1) made from each variable subaccount; and (2) computed on a daily basis.
Annuity Unit Value
The value of an Annuity Unit for each variable subaccount was arbitrarily set at
$1 when the first funds were bought. The value for any later valuation period is
found as follows:
1. The annuity unit value for each variable subaccount for the last prior
valuation periods is multiplied by the net investment factor for the
subaccount for the valuation period for which the annuity unit value is
being calculated.
2. The result is multiplied by an interest factor, which on an annualized
basis is equal to .966184. This is done to neutralize the assumed
investment rate which is built into the annuitization tables on under the
Tables of Annuity Rates section.
Page 14
Withdrawal Provisions
Withdrawal
By written request and subject to the rules below you may:
1. fully withdraw this contract for the total withdrawal value; or
2. partially withdraw this contract for a part of the withdrawal value.
Required Minimum Distributions
In lieu of choosing a lump sum or annuity payment option as of your required
beginning date, you may elect to satisfy the required minimum distribution
requirements by requesting partial withdrawals. It is your responsibility to
ensure that your partial withdrawals, if any, satisfy the requirements of
Section 408(b)(3) of the Code.
Rules for Withdrawal
All withdrawals will have the following conditions;
1. You must apply by written request or other method agreed to by us: (a)
while this contract is in force; and (b) prior to the earlier of the
retirement date or the death of the annuitant.
2. Unless we agree otherwise, you must withdraw an amount equal to at least
$500. Each variable subaccount value and the fixed account value after a
partial withdrawal must be either $0 or at least $50.
3. The amount withdrawn, less any charges, will normally be paid to you within
seven days of our receipt of your written withdrawal request and the return
of this contract, if required. For withdrawals from the fixed account, we
have the right to defer payment to you for up to 6 months from the date we
receive the request. If we defer payment more than 10 days, we will pay
annual interest at a rate required by law on the amount deferred.
4. For partial withdrawals, if you do not specify from which accounts the
withdrawal is to be made, the withdrawal will be made from the variable
subaccounts and fixed account in the same proportion as your interest in
each bears to the contract value.
Upon withdrawal for the full withdrawal value this contract will terminate. We
may require that you return the contract to us before we pay the full withdrawal
value.
Amounts withdrawn from a Xxxx XXX: For tax purposes, the amounts withdrawaled
will be treated in accordance with the distribution rules described in Section
408A of the Code.
Withdrawal Value
The withdrawal value at any time will be:
1. the contract value;
2. minus the contract administrative charge;
3. minus any withdrawal charge.
Withdrawal Charge
If you withdraw all or a part of your contract, you may be subject to a
withdrawal charge. A withdrawal charge applies if all or a part of the contract
value you withdraw is from payments received that are still in the withdrawal
charge period indicated under Contract Data. Refer to Waiver of Withdrawal
Charges for situations when withdrawal charges are not deducted.
We determine your withdrawal charge by multiplying each of your payments
withdrawn by the applicable withdrawal charge percentage, and then totalling the
withdrawal charges.
For a partial withdrawal that is subject to a withdrawal charge, the amount we
actually withdraw from your contract value will be the amount you request plus
any applicable withdrawal charge as of the date of withdrawal. The withdrawal
charge is applied to this total amount. We pay you the amount you requested.
The withdrawal charge percentage depends upon the number of years since you made
the payment(s) withdrawn as shown under Contract Data.
The withdrawal charge applies regardless of the contract value at time of
withdrawal. Therefore, the purchase payment amount applied to the withdrawal
charge percentage may be greater or less than the contract value.
Page 15
Withdrawal Provisions (Continued)
Waiver of Withdrawal Charges
Withdrawal charges are waived for all of the following:
1. In each year, amounts withdrawn totaling up to 10% of the contract value as
of the beginning of that contract year,(1) or, if larger, amounts withdrawn
that represent contract earnings;(2) or
(1) Your initial purchase payment and any purchase payment credit applied
is considered the beginning of contract year contract value during the
first contract year.
(2) Contract earnings are defined as the contract value less purchase
payments not previously withdrawn.
2. In the second and later contract years, amounts withdrawn to meet
applicable minimum distribution requirements under the Code to the extent
they exceed amounts waived under item 1 of this provision; and
Note: Amounts withdrawn under this waiver provision are limited to required
minimum distributions for this contract only and to one time per year
unless we agree otherwise.
3. Death Benefit payments made in the event of the death of the owner or
annuitant; and
4. Contracts settled under an Annuity Payment Plan.
Withdrawal Order
We use this order to determine withdrawal charges.
1. First, withdrawals up to 10% of your prior contract anniversary contract
value not previously withdrawn during this contract year. (No withdrawal
charge.)
2. Next, withdrawals are from amounts representing contract earnings - if any
- in excess of the annual 10% free withdrawal amount. (No withdrawal
charge.)
3. Next, withdrawals are from purchase payments not previously withdrawn and
which had been paid more than the number of years in the withdrawal charge
period shown in the Contract Data prior to withdrawal. (No withdrawal
charge.)
4. Last, withdrawals are from purchase payments received that are still within
the withdrawal charge period shown in the schedule under Contract Data. We
withdraw these payments on a "first-in, first-out" (FIFO) basis. There is a
withdrawal charge on these payments.
Suspension or Delay in Payment of Withdrawal
We have the right to suspend or delay the date of any withdrawal payment from
the variable subaccounts for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists as a result of which: (a) disposal of securities
held in the variable subaccounts is not reasonably practicable; or (b) it
is not reasonably practicable to fairly determine the value of the net
assets of the variable subaccounts; or
4. during any other period when the Securities and Exchange Commission, by
order, so permits for the protection of security holders; or
5. if and to the extend permitted or required under the Federal Investment
Company Act of 1940, as amended, and any other applicable federal or state
law.
Rules and regulations of the Securities and Exchange Commission will govern as
to whether the conditions set forth in 2 and 3 exist.
Page 16
Annuity Provisions
Annuitization
When annuitization occurs, the contract value will be applied to make annuity
payments. The first payment will be made as of the retirement date. This date is
shown under Contract Data. Before payments begin we will require satisfactory
proof that the annuitant is alive. We may also require that you exchange this
contract for a supplemental contract, which provides for the annuity payments.
Change of Retirement Date
Traditional IRA: You may change the retirement date shown for this contract.
Tell us the new date by written request. The retirement date may not be earlier
than 13 months from the contract date. The maximum retirement date is the later
of:
1. April 1 following the calendar year in which the annuitant attains age
70-1/2; or
2. such other date which satisfies the minimum distribution requirements under
the Code; or
3. such other date as agreed upon by us, but in no event later than the
annuitant's 90th birthday.
Also, if you select a new retirement date, it must be at least 30 days after we
receive your written request at our home office.
Xxxx XXX: You may change the retirement date shown for this contract. Tell us
the new date by written request. The retirement date may not be earlier than 13
months from the contract date. However, the retirement date may not be later
than the annuitant's 90th birthday.
Also, if you select a new retirement date, it must be at least 30 days after we
receive your written request at our home office.
Annuity Payment Plans
Subject to the terms of this contract, annuity payments may be made on a fixed
dollar basis, a variable basis, or a combination of both. You can schedule
receipt of annuity payments according to one of the Plans A through E below or
another plan agreed to by us provided:
1. The Plan selected provides for payments over the life of the annuitant or
over the life of the annuitant and a joint annuitant; or
2. the Plan selected provides for payments over a period which does not exceed
the life expectancy of the annuitant, or the life expectancy of the
annuitant and a joint annuitant; and
3. the Plan selected meets the minimum death distribution requirements under
Section 401(a)(9)(B) of the Code and related regulations which are in
effect and applicable to IRAs during the term of the contract.
With respect to applicable IRA distributions including distributions described
in the "Payments to Beneficiary" section and under these Annuity Provisions,
payment amounts, durations and life expectancy calculations must comply with
Code Section 401(a)(9) of the code and the regulations thereunder.
Life expectancy and joint and last survivor expectancy shall be determined by
use of the expected return multiples in Table V and VI of Treasury Regulation
Section 1.72-9 in accordance with Code Section 408(b)(3) and the regulations
thereunder.
The life expectancy of you and your beneficiary will be initially determined on
the basis of your attained ages in the year you reach 70-1/2. Unless you (or
your spouse) elect otherwise prior to the time distributions are required to
commence, your life expectancy and, if applicable, your spouse's life expectancy
will be recalculated annually based on your attained ages in the year for which
the required distribution is being determined. The life expectancy of a
non-spouse beneficiary will not be recalculated. Instead, life expectancy will
be calculated using the attained age of such beneficiary during the calendar
year in which the individual attains age 70-1/2, and payments for subsequent
years shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated. If your death occurs prior to the retirement date, life
expectancy will be initially determined on the basis of your beneficiary's
attained age in the year distributions are required to commence.
IRA annuity payments must be non-increasing, or may increase only for a variable
life annuity as provided in Treasury Regulation Section 1.401(a)(9)-1, Q&A F-3.
Page 17
Annuity Provisions (Continued)
An appropriate annuity payment plan is intended to satisfy the following
requirements that otherwise apply: the annual distribution required to be made
by your IRA required beginning date is for the calendar year in which you
reached age 70-1/2; annual payments for subsequent years, including the year in
which your IRA required beginning date occurs, must be made by December 31 of
that year.
You or your beneficiary, as applicable, shall have the sole responsibility for
requesting a distribution or annuity payment plan that complies with this
Contract and applicable law.
Plan A - Life Income Non-Refund.
Monthly annuity payments will be paid during the lifetime of the annuitant.
No payments will be made after the annuitant dies.
Plan B - Life Income with Guaranteed Period.
Monthly annuity payments will be paid during the lifetime of the annuitant
with a guarantee that payments will be made for a period of at least five,
ten or fifteen years whether or not the annuitant is living. You must select
the guaranteed period.
Plan C - Life Income with Installment Refund.
Monthly annuity payments will be paid during the lifetime of the annuitant
with a guarantee that payments will be made for a certain number of months
whether or not the annuitant is living. The number of months is determined
by dividing the contract value applied under this plan by the amount of the
monthly payment.
Plan D - Joint and Survivor Life Income.
Monthly payments will be paid during the lifetime of the annuitant and a
joint annuitant. When either the annuitant or the joint annuitant dies, we
will continue to make monthly payments for the lifetime of the survivor. No
payments will be paid after the death of both the annuitant and joint
annuitant.
Plan E - Term Certain Installment.
Monthly annuity payments will be paid for a specified period of years. The
period of years may be no less than 10 nor more than 30.
By written request to us at least 30 days before the retirement date, you may
select the plan or change to another plan. If at least 30 days before the
retirement date we have not received at our home office your written request to
select a plan, we will make fixed dollar annuity payments according to Plan B
with payments guaranteed for ten years.
If the Plan selected has a payment amount that is the same as another Plan
having a longer guarantee period, then the Plan with the longer guarantee period
will be deemed to have been chosen.
If the amount to be applied to a plan is not at least $2,000 and produces a
monthly payment of less than $20, or if payments are to be made to other than a
natural person, we have the right to make a lump sum payment of the contract
value.
Allocation of Contract Values at Annuitization
At the time of annuitization under an Annuity Payment Plan you may reallocate
your contract value to the Fixed Account to provide fixed dollar payments and/or
among the variable subaccounts to provide variable annuity payments. Unless we
agree otherwise, you may use a maximum of five variable subaccounts at any one
time during annuitization.
Xxxxx Xxxxxxx
A fixed annuity is an annuity with payments that are guaranteed by us as to
dollar amount. Fixed annuity payments after the first will never be less than
the amount of the first payment. At annuitization, the fixed account contract
value will be applied to the applicable Annuity Rates Table. This will be done
in accordance with the Payment Plan chosen. The amount payable for each $1,000
so applied is shown in Table B under the Tables of Annuity Rates section.
Variable Annuity
A variable annuity is an annuity with payments which: (1) are not predetermined
or guaranteed as to dollar amount: and (2) vary in amount with the investment
experience of the variable subaccounts.
Page 18
Annuity Provisions (Continued)
Determination of First Variable Annuity Payment
At annuitization, the variable account contract value will be applied to the
applicable Annuity Rates Table. This will be done: (1) on the valuation date on
or next preceding the 7th calendar day before the retirement date; and (2) in
accordance with the Payment Plan chosen. The amount payable for the first
payment for each $1,000 so applied is shown in Table A under the Tables of
Annuity Rates section.
Variable Annuity Payments After the First Payment
Variable annuity payments after the first vary in amount. The amount changes
with the investment performance of the variable subaccounts. The dollar amount
of variable annuity payments after the first is not fixed. It may change from
month to month. The dollar amount of such payments is determined as follows:
1. The dollar amount of the first annuity payment is divided by the value of
an annuity unit as of the valuation date on or next preceding the 7th
calendar day before the retirement date. This result establishes the fixed
number of annuity units for each monthly annuity payment after the first.
This number of annuity units remains fixed during the annuity payment
period.
2. The fixed number of annuity units is multiplied by the annuity unit value
as of the valuation date on or next preceding the 7th calendar day before
the date the payment is due. The result establishes the dollar amount of
the payment.
We guarantee that the dollar amount of each payment after the first will not be
affected by variation in expenses or mortality experience.
Exchange of Annuity Units
After annuity payments begin, annuity units of any variable subaccount may be
exchanged for units of any of the other variable subaccounts. This may be done
no more than once a year. Unless we agree otherwise you may use a maximum of
five variable subaccounts at any one time. Once annuity payments start, no
exchanges may be made to or from any fixed annuity.
Page 19
Tables Of Annuity Rates
Table A below shows the amount of the first monthly variable annuity payment,
based on a 3.5% assumed investment return, for each $1,000 of value applied
under any payment plan. The amount of the first and all subsequent monthly fixed
dollar annuity payments for each $1,000 of value applied under any payment plan
will be based on our fixed dollar Table of Annuity Rates in effect at
annuitization. Such rates are guaranteed to be not less than those shown in
Table B. The amount of such annuity payments under Plans A, B and C will depend
upon the sex and age of the annuitant at annuitization. The amount of such
annuity payments under Plan D will depend upon the sex and the age of the
annuitant and the joint annuitant at annuitization.
Table A - Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
------------ -------- ----------------- --- ----------- ----------------- --- ------------- --------------- ------------------
Plan A Plan B Plan C Plan D
------------ -------- ----------------- --- ----------- ----------------- --- ------------- --------------- ------------------
Age Life Income Life Income Joint & Survivor
at Beginning Life Income Five Years with Ten Years Fifteen Years Installment Non-Refund
Annuit- In Non-Refund Certain Certain Certain Refund Male & Female
ization Year Male Female Male Female Male Female Male Female Male Female Same Age
------------ -------- -------- -------- -------- ------ -------- -------- -------- -------- ------ -------- ------------------
Age 65 2005 5.61 4.98 5.57 4.96 5.44 4.91 5.23 4.82 5.17 4.75 4.49
2010 5.52 4.91 5.48 4.89 5.36 4.85 5.17 4.76 5.11 4.70 4.44
2015 5.43 4.84 5.40 4.83 5.29 4.79 5.11 4.71 5.05 4.65 4.39
2020 5.35 4.78 5.32 4.77 5.22 4.73 5.06 4.66 4.99 4.60 4.35
2025 5.27 4.72 5.24 4.71 5.15 4.68 5.00 4.62 4.93 4.56 4.31
2030 5.19 4.67 5.17 4.66 5.09 4.63 4.95 4.57 4.88 4.52 4.27
------------ -------- -------- -------- -------- ------ -------- -------- -------- -------- ------ -------- ------------------
Age 70 2005 6.53 5.69 6.43 5.65 6.16 5.53 5.75 5.33 5.81 5.30 5.02
2010 6.40 5.59 6.32 5.56 6.06 5.45 5.69 5.27 5.72 5.23 4.95
2015 6.28 5.50 6.20 5.47 5.97 5.37 5.62 5.21 5.64 5.16 4.89
2020 6.17 5.41 6.09 5.38 5.88 5.30 5.56 5.15 5.57 5.10 4.83
2025 6.06 5.33 5.99 5.31 5.80 5.23 5.50 5.09 5.49 5.04 4.77
2030 5.95 5.25 5.90 5.23 5.72 5.17 5.45 5.04 5.42 4.99 4.72
------------ -------- -------- -------- -------- ------ -------- -------- -------- -------- ------ -------- ------------------
Age 75 2005 7.80 6.73 7.58 6.64 7.00 6.36 6.26 5.92 6.63 6.03 5.79
2010 7.62 6.59 7.42 6.51 6.89 6.25 6.20 5.85 6.52 5.94 5.69
2015 7.45 6.46 7.27 6.38 6.79 6.15 6.15 5.79 6.41 5.85 5.59
2020 7.29 6.33 7.13 6.27 6.69 6.06 6.09 5.73 6.31 5.77 5.51
2025 7.14 6.22 6.99 6.16 6.59 5.97 6.03 5.67 6.22 5.69 5.43
2030 6.99 6.11 6.86 6.05 6.49 5.89 5.98 5.61 6.13 5.62 5.35
------------ -------- -------- -------- -------- ------ -------- -------- -------- -------- ------ -------- ------------------
Age 85 2005 12.15 10.61 10.95 9.92 8.76 8.38 6.97 6.88 9.13 8.41 8.54
2010 11.79 10.29 10.72 9.68 8.68 8.28 6.95 6.85 8.95 8.24 8.33
2015 11.46 10.00 10.49 9.46 8.59 8.18 6.93 6.83 8.79 8.09 8.14
2020 11.14 9.72 10.27 9.25 8.51 8.08 6.92 6.81 8.64 7.95 7.96
2025 10.85 9.47 10.06 9.05 8.43 7.98 6.90 6.78 8.49 7.82 7.79
2030 10.57 9.24 9.87 8.86 8.35 7.89 6.88 6.75 8.36 7.70 7.64
------------ -------- -------- -------- -------- ------ -------- -------- -------- -------- ------ -------- ------------------
Table A above is based on the "1983 Individual Annuitant Mortality Table A" with
100% Projection Scale G and a 3.5% assumed investment return. Annuity rates for
any year, age, or any combination of year, age and sex not shown above, will be
calculated on the same basis as those rates shown in the Table above. Such rates
will be furnished by us upon request. Amounts shown in the Table below are based
on a 3.5% assumed investment return.
Plan E - Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
Years Payable Monthly Payment Years Payable Monthly Payment Years Payable Monthly Payment
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
10 9.83 17 6.47 24 5.09
11 9.09 18 6.20 25 4.96
12 8.46 19 5.97 26 4.84
13 7.94 20 5.75 27 4.73
14 7.49 21 5.56 28 4.63
15 7.10 22 5.39 29 4.53
16 6.76 23 5.24 30 4.45
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
Page 20
Fixed Dollar annuity payments will not be less than those shown in Table B. In
addition, the amount of payments under any annuity payment plan will not be less
than that which would be provided if:
1. a single premium immediate annuity contract were to be offered by us to
annuitants in the same class and
2. the annuity were to be purchased with the greater of: (1) withdrawal value
of the contract; or (2) 95% of the contract value of this contract.
Table B- Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
---------------------------------------------------------------------------------------------------------------------------------
Plan A Plan B Plan C Plan D
---------------------------------------------------------------------------------------------------------------------------------
Age Life Income Life Income Joint & Survivor
at Beginning Life Income Five Years with Ten Years Fifteen Years Installment Non-Refund
Annuit- In Non-Refund Certain Certain Certain Refund Male & Female
ization Year Male Female Male Female Male Female Male Female Male Female Same Age
---------------------------------------------------------------------------------------------------------------------------------
Age 65 2005 5.32 4.69 5.28 4.68 5.16 4.63 4.96 4.54 4.85 4.44 4.21
2010 5.23 4.62 5.19 4.61 5.08 4.57 4.90 4.49 4.79 4.39 4.16
2015 5.14 4.56 5.11 4.55 5.01 4.51 4.84 4.43 4.73 4.34 4.12
2020 5.06 4.50 5.03 4.49 4.94 4.45 4.78 4.39 4.67 4.30 4.07
2025 4.98 4.44 4.95 4.43 4.87 4.40 4.73 4.34 4.61 4.26 4.03
2030 4.90 4.38 4.88 4.38 4.81 4.35 4.68 4.30 4.56 4.22 4.00
---------------------------------------------------------------------------------------------------------------------------------
Age 70 2005 6.24 5.40 6.15 5.37 5.88 5.26 5.49 5.07 5.47 4.98 4.75
2010 6.11 5.31 6.03 5.28 5.79 5.18 5.42 5.00 5.38 4.91 4.68
2015 5.99 5.21 5.92 5.19 5.70 5.10 5.36 4.94 5.31 4.85 4.62
2020 5.87 5.13 5.81 5.10 5.61 5.03 5.30 4.88 5.23 4.79 4.56
2025 5.77 5.05 5.71 5.03 5.53 4.96 5.24 4.83 5.16 4.73 4.50
2030 5.66 4.97 5.61 4.95 5.45 4.89 5.18 4.77 5.10 4.68 4.45
---------------------------------------------------------------------------------------------------------------------------------
Age 75 2005 7.51 6.45 7.30 6.36 6.74 6.09 6.01 5.67 6.27 5.70 5.52
2010 7.33 6.31 7.14 6.23 6.63 5.99 5.95 5.60 6.16 5.61 5.42
2015 7.15 6.17 6.99 6.10 6.52 5.89 5.90 5.54 6.06 5.53 5.33
2020 6.99 6.05 6.84 5.99 6.42 5.79 5.84 5.47 5.97 5.45 5.24
2025 6.84 5.93 6.71 5.88 6.32 5.71 5.78 5.41 5.88 5.38 5.16
2030 6.70 5.83 6.58 5.78 6.23 5.62 5.73 5.35 5.79 5.31 5.09
---------------------------------------------------------------------------------------------------------------------------------
Age 85 2005 11.85 10.31 10.68 9.65 8.52 8.14 6.73 6.64 8.69 8.00 8.28
2010 11.49 10.00 10.45 9.41 8.44 8.04 6.72 6.62 8.53 7.85 8.07
2015 11.15 9.70 10.22 9.19 8.36 7.93 6.70 6.59 8.38 7.70 7.88
2020 10.84 9.43 10.00 8.98 8.27 7.83 6.68 6.57 8.23 7.57 7.70
2025 10.55 9.18 9.79 8.78 8.19 7.74 6.67 6.54 8.09 7.45 7.53
2030 10.28 8.95 9.60 8.59 8.11 7.64 6.65 6.52 7.96 7.33 7.38
---------------------------------------------------------------------------------------------------------------------------------
Table B above is based on the "1983 Individual Annuitant Mortality Table A" at
3.00% with 100% Projection Scale G. Annuity rates for any year, age, or any
combination of year, age and sex not shown above, will be calculated on the same
basis as those rates shown in the Table above. Such rates will be furnished by
us upon request. Amounts shown in the Table below are based on a 3% annual
effective interest rate.
Plan E - Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
Years Payable Monthly Payment Years Payable Monthly Payment Years Payable Monthly Payment
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
10 9.61 17 6.23 24 4.84
11 8.86 18 5.96 25 4.71
12 8.24 19 5.73 26 4.59
13 7.71 20 5.51 27 4.47
14 7.26 21 5.32 28 4.37
15 6.87 22 5.15 29 4.27
16 6.53 23 4.99 30 4.18
--------------------- ------------------ ------------------- ------------------ ------------------- ------------------
Page 21
(logo) American Centurion
AMERICAN Life Assurance Company
EXPRESS 00 Xxxxxxx Xxx. Ext.
(R) P.O. Box 5555
American Albany, New York 12205
Centurion
Life
Deferred Annuity Contract
o Flexible purchase payments.
o Investment experience reflected in benefits.
o Optional fixed dollar or variable accumulation values and annuity payments.
o Annuity payments to begin on the retirement date.
o This contract is nonparticipating. Dividends are not payable.
*recycled paper with a minimum of 10% post-consumer waste
