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BMA INDIVIDUAL FLEXIBLE PAYMENT
A member of the Generali Group DEFERRED VARIABLE ANNUITY
NON-PARTICIPATING
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BUSINESS MEN'S ASSURANCE COMPANY OF AMERICA
BMA TOWER, P.O. BOX 419458
KANSAS CITY, MO 64141
CALL (▇▇▇) ▇▇▇-▇▇▇▇ FOR ASSISTANCE OR QUESTIONS.
BUSINESS MEN'S ASSURANCE COMPANY OF AMERICA (referred to in this Contract as us,
we) will make Annuity Payments as set forth in this Contract beginning on the
Annuity Date.
This Contract is issued in consideration of the payment of the initial Purchase
Payment.
FREE LOOK
This Contract may be returned within [10] days after you receive it. It can be
mailed or delivered to either us or the agent who sold it. Return of this
Contract by mail is effective on being postmarked, properly addressed and
postage prepaid. The returned Contract will be treated as if we had never issued
it. We will promptly refund your Contract Value in states where permitted which
may be less than your Purchase Payment. In some states, we may be required to
refund the Purchase Payment. In those states, we will allocate the initial
Purchase Payments to the Money Market Subaccount for [15] days from the Issue
Date. Upon the expiration of the [15] days, the Contract Value in the Money
Market Subaccount will be allocated as you have directed. If we allocate your
Purchase Payment to the Money Market Subaccount, we will refund the greater of
your Purchase Payments, less any withdrawals and related charges, or your
Contract Value.
Executed by us on the Issue Date.
Secretary President
THIS IS A LEGAL CONTRACT, PLEASE READ IT CAREFULLY
ANNUITY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE
INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
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THE VARIABLE PROVISIONS OF THIS CONTRACT ARE ON PAGES __, __.
INDEX
PAGE
CONTRACT SCHEDULE
DEFINITIONS
PURCHASE PAYMENTS PROVISION
PURCHASE PAYMENTS
CHANGE IN PURCHASE PAYMENTS
ALLOCATION OF PURCHASE PAYMENTS
CONTRACT VALUE PROVISION
SEPARATE ACCOUNT PROVISION
THE SEPARATE ACCOUNT
VALUATION OF ASSETS
ACCUMULATION UNITS
ACCUMULATION UNIT VALUE
NET INVESTMENT FACTOR
COVERAGE CHARGE
CONTRACT MAINTENANCE CHARGE PROVISION
TRANSFER PROVISION
WITHDRAWAL PROVISION
WITHDRAWALS
WITHDRAWAL CHARGE
DEATH BENEFIT PROVISION
DEATH OF OWNER DURING THE ACCUMULATION PERIOD
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD
DEATH OF OWNER DURING THE ANNUITY PERIOD
DEATH OF ANNUITANT
PAYMENT OF DEATH BENEFIT
ANNUITY PROVISION
GENERAL
ANNUITY DATE
SELECTION OF AN ANNUITY OPTION
ANNUITY OPTIONS
OPTION 1 - LIFE ANNUITY
OPTION 2 - LIFE ANNUITY WITH 120 OR 240 MONTHLY ANNUITY PAYMENTS
GUARANTEED
OPTION 3 - JOINT AND LAST SURVIVOR ANNUITY
OPTION 4 - JOINT AND LAST SURVIVOR ANNUITY WITH 120 OR 240 MONTHLY
ANNUITY PAYMENTS GUARANTEED
ANNUITY
FIXED ANNUITY
VARIABLE ANNUITY
ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISION
OWNER
JOINT OWNER
ANNUITANT
ASSIGNMENT OF A CONTRACT
BENEFICIARY
BENEFICIARY
CHANGE OF BENEFICIARY
SUSPENSION OF DEFERRAL OF PAYMENTS OR TRANSFERS
FROM THE SEPARATE ACCOUNT
GENERAL PROVISIONS
THE CONTRACT
NON-PARTICIPATING IN SURPLUS
INCONTESTABILITY
MISSTATEMENT OF AGE OR SEX
CONTRACT SETTLEMENT
REPORTS
TAXES
EVIDENCE OF SURVIVAL
PROTECTION OF PROCEEDS
MODIFICATION OF CONTRACT
RESERVES, VALUES AND BENEFITS
CONTRACT SCHEDULE
OWNER: [▇▇▇▇ ▇▇▇] AGE AT ISSUE: [52]
JOINT OWNER: [▇▇▇▇ ▇▇▇] AGE AT ISSUE: [50]
ANNUITANT: [▇▇▇▇ ▇▇▇] AGE AT ISSUE: [52]
CONTRACT NUMBER: [12345] ISSUE DATE: [May 1, 1997]
PLAN TYPE: [Non-qualified] ANNUITY DATE: [2015]
PURCHASE PAYMENTS:
Initial Purchase Payment: [$10,000 Non-Qualified; $2,000 IRA]
Minimum Subsequent Purchase Payment: [$1,000]
Maximum Total Purchase Payments: [$1 million, without our prior
approval]
BENEFICIARY:
As designated by Owner at Issue Date unless changed in accordance with
the Contract provisions.
CONTRACT MAINTENANCE CHARGE:
The Contract Maintenance Charge is currently [$35.00] each Contract
Year. [We reserve the right to increase the Contract Maintenance
Charge, but it will not exceed $60 per Contract Year.] The Contract
Maintenance Charge will be deducted from the Contract Value on each
Contract Anniversary while this Contract is in force. However, during
the Accumulation Period, if your Contract Value on a Contract
Anniversary is at least [$100,000], then no Contract Maintenance Charge
is deducted. If a total withdrawal is made on other than a Contract
Anniversary and your Contract Value for the Business Day during which
the total withdrawal is made is less than [$100,000], the full Contract
Maintenance Charge will be deducted at the time of the total
withdrawal. The Contract Maintenance Charge will be deducted from the
Subaccounts and any Fixed Account Option selected in the same
proportion that the amount of the Contract Value in each Subaccount
and/or Fixed Account bears to the total Contract Value. During the
Annuity Period, the Contract Maintenance Charge will be collected pro
rata from each Annuity Payment. [In the event you own more than one
Contract, we will determine the total Contract Value for all of the
Contracts. If the total Contract Value exceeds [$100,000], we will not
assess the Contract Maintenance Charge.] If the Contract Owner is not a
natural person, we will look to the Annuitant in determining the
foregoing.
COVERAGE CHARGE:
Equal on an annual basis to [1.4%] of the average daily net asset
value of the Separate Account. [We may increase this charge, but it
may not be greater than [1.75%].]
INVESTMENT OPTIONS:
[INVESTORS MARK SERIES FUND, INC.]
[Intermediate Fixed Income Portfolio
Global Fixed Income Portfolio
Balanced Portfolio
Small Cap Equity Portfolio
Mid Cap Equity Portfolio
Large Cap Value Portfolio
Large Cap Growth Portfolio
Growth & Income Portfolio
International Equity Portfolio
Money Market Portfolio]
[THE ▇▇▇▇▇▇ INSTITUTIONAL PRODUCTS TRUST]
[▇▇▇▇▇▇/BIAM IPT - International Fund]
SEPARATE ACCOUNT: [BMA Variable Annuity Account A]
ALLOCATION GUIDELINES:
[1. Currently, you can select as many Subaccounts as you wish.
However, we reserve the right to limit this in the future.
2. Currently, you can also select Fixed Account I or any Guarantee
Period option within Fixed Account II which is available at the time
the Purchase Payment or transfer is made.
3. Any allocation to Fixed Account I or to any Guarantee Period option
of Fixed Account II which is selected must be at least $5,000 and any
allocation to a Subaccount must be at least $1,000.
4. If the Purchase Payment and forms required to issue a Contract are
in good order, the initial Purchase Payment will be credited to your
Contract within two (2) business days after receipt at the BMA Service
Center. Additional Purchase Payments, which are in good order, will be
credited to your Contract as of the Business Day they are received.
5. Allocation percentages must be in whole numbers. Each allocation
must be at least [10%]. Allocations made pursuant to a pre-scheduled
transfer are not subject to these limitations.]
TRANSFERS:
NUMBER OF TRANSFERS PERMITTED: [During the Accumulation Period: Subject
to any transfer fees and any minimum and maximum amounts that may be
transferred, there is no limitation on the number of transfers that can
currently be made between Subaccounts. Currently, you can make
unlimited transfers to any Fixed Account Option, subject to any
transfer fees and any required minimum and maximum amounts that may be
transferred. You can make a transfer from any Guarantee Period of Fixed
Account II, without any limitation or transfer fee, at the end of the
Guarantee Period. We reserve the right to modify the above, but the
Owner will always be allowed at least [12] transfers between
Subaccounts in a Contract Year during the Accumulation Period.
During the Annuity Period: Currently, during a Contract Year you can
make [4] transfers between Subaccounts of the Separate Account, subject
to any minimum and maximum amounts that may be transferred. Currently
you can make [4] transfers each Contract Year from one or more
Subaccounts to the General Account, subject to any minimum and maximum
amounts that may be transferred. You may not make a transfer from the
General Account to the Separate Account.]
NUMBER OF FREE TRANSFERS: [Currently, you are allowed [12] free
transfers each Contract Year during the Accumulation Period and [4]
free transfers each Contract Year during the Annuity Period.]
TRANSFER FEE: [For each transfer in excess of the free transfers
permitted, the Transfer Fee is [$25]. Transfers made pursuant to a
pre- scheduled transfer will not be counted in determining the
application of the transfer fee.]
MINIMUM AND MAXIMUM AMOUNT TO BE TRANSFERRED: [The minimum amount which
can be transferred is $250 or your entire interest in any Subaccount,
Fixed Account I or any Guarantee Period of Fixed Account II, if less.
At the Company's discretion, the maximum amount which can be
transferred from any Fixed Account Option, unless the transfer is from
a Guarantee Period just expiring, may be limited to 25% of the amount
in Fixed Account I or any Guarantee Period of Fixed Account II. This
requirement is waived if the transfer is pursuant to a pre-scheduled
transfer or applied to an Annuity Option.]
MINIMUM AMOUNT WHICH MUST REMAIN IN AN ACCOUNT AFTER A TRANSFER:
[$1,000 in any Subaccount or $5,000 in Fixed Account I or any
Guarantee Period of Fixed Account II.]
PRE-SCHEDULED TRANSFERS: [You can elect the Dollar Cost Averaging
Option, the Asset Allocation Option and the Asset Rebalancing Option.
However, that portion of Contract Value held in any Fixed Account
options is not included in any pre-scheduled transfer option except
you can elect to have Fixed Account I as the source fund for Dollar
Cost Averaging. We reserve the right to limit the availability of any
Account for a Pre-Scheduled Transfer.]
WITHDRAWALS:
WITHDRAWAL CHARGE: [A Withdrawal Charge is assessed against each
Purchase Payment withdrawn and will result in a reduction in remaining
Contract Value. The Withdrawal Charge is calculated at the time of each
withdrawal. Each Purchase Payment is tracked from its date of receipt
and the Withdrawal Charges are determined in accordance with the
following:
Number of Complete Years
from Date of Purchase Payment Withdrawal Charge
----------------------------- -----------------
0 7%
1 6%
2 5%
3 4%
4 3%
5 2%
6 1%
7 and thereafter 0%
WAIVER OF WITHDRAWAL CHARGE: [The first 10% of a withdrawal may be
made free from the Withdrawal Charge (unless you have already made
another withdrawal during that same Contract Year) on a non-cumulative
basis as follows:
1. Once each Contract Year after the first Contract Year, as a
single sum payment if the Contract Value prior to the withdrawal
exceeds [$10,000]; or
2. At any time, subject to any conditions and fees we may impose,
as equal periodic installments.]
MINIMUM PARTIAL WITHDRAWAL AMOUNT: [$1,000. Withdrawals made pursuant
to the Automatic Withdrawal Option or the Minimum Distribution Option
are not subject to this minimum.]
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN AN ACCOUNT AFTER A PARTIAL
WITHDRAWAL: [$1,000 in any Subaccount or $5,000 in Fixed Account I or
any Guarantee Period of Fixed Account II.]
MINIMUM CONTRACT VALUE WHICH MUST REMAIN IN THE CONTRACT AFTER A
PARTIAL WITHDRAWAL: [$10,000]
[FIXED ACCOUNT OPTIONS:
FIXED ACCOUNT I:
MINIMUM GUARANTEE INTEREST RATE: [3%]
CURRENT INTEREST RATE AS OF ISSUE DATE [ X%, guaranteed for
any Purchase Payments allocated or transferred to Fixed
Account I during the calendar month in which this Contract is
issued. This rate is guaranteed for 12 months.]
FIXED ACCOUNT II:
MINIMUM GUARANTEE INTEREST RATE: [3%]
CURRENT FIXED ACCOUNT II GUARANTEE PERIODS : [2, 3, 4, 5, 6,
7, 8, 9, 10] CURRENT INTEREST RATES FOR SELECTIVE GUARANTEE
PERIOD(S): Each current interest rate applies only to Purchase
Payments allocated or transferred to Fixed Account II during
the calendar month in which this Contract is issued.
[2 Years - %
3 Years - %
4 Years - %
5 Years - %
6 Years - %
7 Years - %
8 Years - %
9 Years - %
10 Years- %]
INTEREST ADJUSTMENT FACTOR: If a total or partial withdrawal
or transfer is made from Fixed Account II other than at the
end of a Guarantee Period, an Interest Adjustment will be made
to the Contract Value. The Interest Adjustment Factor with
respect to each purchase payment or transfer allocated to
Fixed Account II is:
(.75 x (A-B) x N/12) where:
A = the guaranteed interest rate (expressed as a
decimal) in effect for the specific purchase payment
or transfer.
B = the guaranteed interest rate (expressed as a decimal)
available for new contracts of this type of contract
for the applicable guarantee period, as of the
withdrawal or transfer. If a guaranteed interest
rate is not available for the same type of
contract, a suitable replacement rate will be
determined by us.
N = the number of complete months from the date of the
withdrawal or transfer to the end of the applicable
Guarantee Period as shown on the Contract Schedule.
The amount of the Interest Adjustment with respect to each
Purchase Payment or transfer is equal to the Interest
Adjustment Factor multiplied by the amount of the withdrawal
or transfer.
If the Interest Adjustment is a negative value, the Interest
Adjustment is subtracted from the Contract Value. If the
Interest Adjustment is a positive value, the Interest
Adjustment is added to the Contract Value.
Within each guarantee period of Fixed Account II, withdrawals
and transfers will be determined on a first-in, first-out
(FIFO) basis.
ENDORSEMENTS:
[Individual Retirement Annuity Endorsement]
[Fixed Account I Endorsement]
[Fixed Account II Endorsement]
[Waiver of Withdrawal Charges & Interest Adjustment Rider]
BMA SERVICE CENTER:
[BMA
▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇.
▇▇. ▇▇▇▇▇, ▇▇ ▇▇▇▇▇-1690]
DEFINITIONS
ACCOUNT: Any Subaccount, any available Fixed Account Option or the General
Account.
ACCUMULATION PERIOD: The period prior to the Annuity Date during which you can
make Purchase Payments.
ACCUMULATION UNIT: A unit of measure used to calculate the Contract Value prior
to the Annuity Date.
ADJUSTED CONTRACT VALUE: The Contract Value less any applicable Premium Tax.
This amount is applied to the applicable Annuity Table to determine the initial
Annuity Payment.
AGE: Age last birthday, except when calculating age for the Annuity Date when
it is the actual age to the nearest month.
ANNUITANT: The natural person upon whose continuation of life any Annuity
Payment involving life contingencies depends. You may change the Annuitant at
any time prior to the Annuity Date unless the Contract Owner is not a natural
person. On or after the Annuity Date, any reference to Annuitant shall also
include any Joint Annuitant.
ANNUITY DATE: The date on which Annuity Payments are to begin.
ANNUITY OPTION: An arrangement under which Annuity Payments are made under this
Contract.
ANNUITY PAYMENTS: The series of payments made to you or any named payee after
the Annuity Date under the Annuity Option selected.
ANNUITY PERIOD: The period of time beginning on the Annuity Date during which
Annuity Payments are made.
ANNUITY RESERVE: The assets which support the Annuity Option you have selected
during the Annuity Period.
ANNUITY UNIT: A unit of measure used to calculate Annuity Payments after the
Annuity Date.
AUTHORIZED REQUEST: A request, in a form satisfactory to us, which is received
by the BMA Service Center.
BMA SERVICE CENTER: The office indicated on the Contract Schedule of the
Contract to which notices, requests and Purchase Payments must be sent. All sums
payable to us under the Contract are payable only at the BMA Service Center.
BENEFICIARY: The person(s) or entity(ies) who will receive any death benefit
payable under this Contract.
BUSINESS DAY: Each day that the New York Stock Exchange is open for trading. The
Separate Account will be valued each Business Day.
COMPANY: Business Men's Assurance Company of America (BMA).
CONTRACT ANNIVERSARY: A calendar year anniversary of the Issue Date of this
Contract.
CONTRACT WITHDRAWAL VALUE: The Contract Value less any applicable Premium Tax,
less any Withdrawal Charge and less any applicable Contract Maintenance Charge.
CONTRACT VALUE: The dollar value as of any Business Day of all amounts
accumulated under this Contract.
CONTRACT YEAR: Any period of twelve (12) months commencing with the Issue Date
and each Contract Anniversary thereafter.
INVESTMENT OPTION(S): Those investments available under the Contract. Current
Investment Option(s) are shown on the Contract Schedule.
GENERAL ACCOUNT: Our general investment account which contains all of our assets
with the exception of the Separate Account and other segregated asset accounts.
ISSUE DATE: The date shown on the Contract Schedule on which the first Contract
Year begins.
JOINT OWNER: If there is more than one Owner, each Owner shall be a Joint Owner
of the Contract. Joint Owners have equal ownership rights and, except for
telephone transfers, must both authorize any exercising of those ownership
rights unless otherwise allowed by us. Any Joint Owner must be the spouse of the
other Joint Owner.
OWNER: The person(s) or entity(ies) entitled to the ownership rights stated in
this Contract. If Joint Owners are named, all references to Owner shall mean the
Joint Owners.
PREMIUM TAX: Any premium taxes owed by us to any governmental entity and
assessed against Purchase Payments or Contract Value.
PURCHASE PAYMENT: A payment you make toward this Contract.
SEPARATE ACCOUNT: A segregated asset account maintained by us in which a portion
of our assets has been allocated for this and certain other contracts. It has
been designated on the Contract Schedule.
SUBACCOUNT: Separate Account assets are divided into Subaccounts. Assets of
each Subaccount will be invested in shares of an Investment Option.
PURCHASE PAYMENTS PROVISION
PURCHASE PAYMENTS: Purchase Payments are payable according to the frequency and
in the amount selected by you. The initial Purchase Payment is due on the Issue
Date. We reserve the right to decline any Purchase Payment. The Minimum
Subsequent Purchase Payment allowed and the Maximum Total Purchase Payments
accepted without our prior permission are shown on the Contract Schedule.
CHANGE IN PURCHASE PAYMENTS: You may elect to increase or decrease or to change
the frequency of Purchase Payments. Unless surrendered, this Contract remains in
force until the Annuity Date and will not be in default if no additional
Purchase Payments are made.
ALLOCATION OF PURCHASE PAYMENTS: Purchase Payments are allocated to one or more
of the Subaccounts of the Separate Account or the available Fixed Account
Options in accordance with your selection. The allocation of the initial
Purchase Payment is made in accordance with your selection made at the Issue
Date. Unless you inform us otherwise, subsequent Purchase Payments are allocated
in the same manner as the Initial Purchase Payment. However, the Company has
reserved the right to allocate the initial Purchase Payment to the Money Market
Subaccount as set forth on the face page of this Contract. All allocations of
Purchase Payments are subject to the Allocation Guidelines shown on the Contract
Schedule.
CONTRACT VALUE PROVISION
The Contract Value for any Business Day is equal to the total dollar value
accumulated under this Contract.
The Contract Value in a Subaccount of the Separate Account is determined by
multiplying the number of Accumulation Units allocated to the Contract Value for
the Subaccount by the Accumulation Unit Value for that Subaccount.
Purchase Payments, withdrawals and transfers from or to a Subaccount will result
in the addition of or the cancellation of Accumulation Units in a Subaccount.
SEPARATE ACCOUNT PROVISION
THE SEPARATE ACCOUNT: The Separate Account is designated on the Contract
Schedule. It consists of assets we have set aside and have kept separate from
the rest of our assets and those of our other separate accounts. The assets of
the Separate Account, equal to reserves and other liabilities of your Contract
and those of other Owners, will not be charged with liabilities arising out of
any other business we may conduct.
The Separate Account assets are divided into Subaccounts. The assets of the
Subaccounts are allocated to the Investment Option(s) shown on the Contract
Schedule. We may add additional Investment Option(s) to those shown. You may be
permitted to transfer your Contract Value or allocate Purchase Payments to the
additional Subaccount(s). However, the right to make such transfers or
allocations will be limited by any terms and conditions we may impose.
Should the shares of any Investment Option(s) become unavailable for investment
by the Separate Account, or our Board of Directors deems further investment in
the shares inappropriate, we may limit further purchase of such shares or
substitute shares of another Investment Option for shares already purchased.
VALUATION OF ASSETS: Assets of Investment Options held within the Subaccounts
will be valued at their net asset value on each Business Day.
ACCUMULATION UNITS: Accumulation Units shall be used to account for all amounts
allocated to or withdrawn from the Subaccounts of the Separate Account as a
result of Purchase Payments, withdrawals, transfers, or fees and charges. We
will determine the number of Accumulation Units of a Subaccount purchased or
canceled. This will be done by dividing the amount allocated to (or the amount
withdrawn from) the Subaccount by the dollar value of one Accumulation Unit of
the Subaccount as of the end of the Business Day during which the request for
the transaction is received at the BMA Service Center.
ACCUMULATION UNIT VALUE: The Accumulation Unit Value for each Subaccount was
arbitrarily set initially at $10. Subsequent Accumulation Unit Values for each
Subaccount are determined by multiplying the Accumulation Unit Value for the
immediately preceding Business Day by the Net Investment Factor for the
Subaccount for the current Business Day.
The Accumulation Unit Value may increase or decrease from Business Day to
Business Day.
NET INVESTMENT FACTOR: The Net Investment Factor for each Subaccount is
determined by dividing A by B and multiplying by (1 - C) where:
A is (i) the net asset value per share of the Investment Option
held by the Subaccount at the end of the current Business Day;
plus
(ii) any dividend or capital gains per share declared on
behalf of such Investment Option that has an ex-dividend date
within the current Business Day.
B is the net asset value per share of the Investment Option held
by the Subaccount for the immediately preceding Business Day.
C is (i) the Business Day equivalent of the Coverage Charge, which
is shown on the Contract Schedule; plus
(ii) a charge factor, if any, for any taxes or any tax reserve
we have established as a result of the operation or
maintenance of the Subaccount.
COVERAGE CHARGE: Each Business Day, we deduct a Coverage Charge from the
Subaccounts of the Separate Account which is equal, on an annual basis, to the
amount shown on the Contract Schedule.
CONTRACT MAINTENANCE CHARGE PROVISION
We deduct an annual Contract Maintenance Charge shown on the Contract Schedule.
TRANSFER PROVISION
A transfer is subject to the following:
1. the maximum number of transfers and the number of transfers which
may be made which are not subject to a Transfer Fee are shown on the
Contract Schedule;
2. a Transfer Fee is deducted if a transfer exceeds the maximum number
of free transfers. The Transfer Fee is shown on the Contract Schedule.
The Transfer Fee is deducted from the amount which is transferred.
3. you may not make a transfer until after the end of the Free Look
period.
4. the minimum and maximum amounts which may be transferred are shown
on the Contract Schedule.
5. a transfer will be effected as of the end of the Business Day when
we receive an acceptable transfer request containing all required
information.
6. neither us nor our BMA Service Center are liable for a transfer
made in accordance with your instructions.
7. we reserve the right to restrict the number of transfers per year
and to restrict transfers from being made on consecutive Business
Days.
8. your right to make transfers is subject to modification if we
determine, in our sole opinion, that the exercise of the right by one
or more Owners is, or would be, to the disadvantage of other Owners.
Restrictions may be applied in any manner reasonably designed to
prevent any use of the transfer right which is considered by us to be
the disadvantage of other Owners. A modification could be applied to
transfers to or from one or more of the Subaccounts and could include,
but not be limited to:
a. the requirement of a minimum time period between each
transfer;
b. not accepting transfer requests of an agent acting under a
power of attorney on behalf of more than one Owner; or
c. limiting the dollar amount that may be transferred by an Owner
at any one time.
9. In addition to the above, transfers made during the Annuity Period
are subject to the following:
the amount transferred to the General Account from a
Subaccount of the Separate Account will be equal to the
Annuity Reserve which was transferred from the payee's
interest in that Subaccount. The Annuity Reserve is the
product of "(a)" multiplied by "(b)" multiplied by "(c)",
where (a) is the number of Annuity Units representing the
Owner's interest in the Subaccount per Annuity Payment; (b) is
the Annuity Unit Value for the Subaccount; and (c) is the
present value of $1.00 per payment period based on the Age of
the Annuitant at time of transfer for the Annuity Option,
determined using the 1983 Individual Annuity Mortality Tables,
with mortality projected to the year 2000 and with an annual
effective interest rate of 3 1/2%. ▇▇▇▇▇▇▇ transferred to the
General Account will be applied under the Annuity Option
elected at the Age of the Annuitant at the time of the
transfer. All amounts and Annuity Unit Values will be
determined as of the end of the Business Day preceding the
effective date of the transfer.
If you elect to use your transfer privilege, neither us nor our BMA Service
Center will be liable for transfers made in accordance with your instructions.
If there are Joint Owners, we will accept telephone transfer instructions from
either Owner.
WITHDRAWAL PROVISION
WITHDRAWALS: During the Accumulation Period, you may, upon Authorized Request,
make a total or partial withdrawal of the Contract Withdrawal Value. Withdrawals
will result in the cancellation of Accumulation Units from each Subaccount in
the ratio that the value of each Subaccount bears to the total Contract Value.
You must specify, by Authorized Request, which Accumulation Units are to be
canceled if other than the above mentioned method of cancellation is desired. We
will pay the amount of any withdrawal within seven (7) days of receipt, in good
order, of a request unless the "Suspension or Deferral of Payment or Transfers
from the Separate Account Provision" is in effect.
Each partial withdrawal must be for an amount which is not less than the amount
shown on the Contract Schedule. The minimum Contract Value which must remain in
an Account and in the Contract after a partial withdrawal is shown on the
Contract Schedule.
WITHDRAWAL CHARGE: Upon a total or partial withdrawal of Contract Value a
Withdrawal Charge as set forth on the Contract Schedule may be assessed. Under
certain circumstances, we allow withdrawals without the Withdrawal Charge.
DEATH BENEFIT PROVISION
DEATH OF OWNER DURING THE ACCUMULATION PERIOD: Upon the death of the Owner
during the Accumulation Period, the death benefit will be paid to the
Beneficiary(ies) designated by the Owner. Upon the death of a Joint Owner during
the Accumulation Period, the surviving Joint Owner will become the primary
Beneficiary to whom the death benefit will be paid. Any other Beneficiary
designation on record at the time of such death will be treated as a contingent
Beneficiary.
DEATH BENEFIT AMOUNT DURING THE ACCUMULATION PERIOD: The death benefit will be
the greater of (a) the Purchase Payment, less any withdrawals and related
Withdrawal Charges; or (b) the Contract Value determined as of the end of the
Business Day during which we receive both due proof of death and an election for
the payment method.
DEATH BENEFIT OPTIONS DURING THE ACCUMULATION PERIOD: A Beneficiary must request
that the death benefit be paid under one of the Death Benefit Options below. In
addition, if the Beneficiary is the spouse of the Owner, he or she may elect to
continue the Contract in his or her own name and exercise all the Owner's rights
under the Contract.
Option 1 - lump sum payment of the death benefit; or
Option 2 - the payment of the entire death benefit within 5 years of
the date of the death of the Owner or any Joint Owner; or
Option 3 - payment of the death benefit under an Annuity Option over
the lifetime of the Beneficiary or over a period not extending beyond
the life expectancy of the Beneficiary with distribution beginning
within one year of the date of death of the Owner or any Joint Owner.
Any portion of the death benefit not applied under Option 3 within one year of
the date of the Owners' death, must be distributed within five years of the date
of death.
If a lump sum payment is requested, the amount will be paid within seven (7)
days of receipt of proof of death and the election, unless the "Suspension or
Deferral of Payment or Transfers from the Separate Account Provision" is in
effect.
Payment to the Beneficiary, other than in a single sum, may only be elected
during the sixty-day period beginning with the date of receipt of proof of
death.
DEATH OF OWNER DURING THE ANNUITY PERIOD: If you, or any Joint Owner, dies
during the Annuity Period and you are not an Annuitant, any remaining payments
under the Annuity Option elected will continue at least as rapidly as under the
method of distribution in effect at such Owner's death. Upon your death during
the Annuity Period, the Beneficiary becomes the Owner.
DEATH OF ANNUITANT: Upon the death of an ▇▇▇▇▇▇▇▇▇, who is not the Owner, during
the Accumulation Period, you may designate a new Annuitant, subject to our
underwriting rules then in effect. If no designation is made within 30 days of
the death of the Annuitant, you will become the Annuitant. If the Owner is a
non-natural person, the death of the Annuitant will be treated as the death of
the Owner and a new Annuitant may not be designated.
Upon the death of the Annuitant during the Annuity Period, the death benefit, if
any, will be as specified in the Annuity Option elected. Death benefits will be
paid at least as rapidly as under the method of distribution in effect at the
Annuitant's death.
PAYMENT OF DEATH BENEFIT: We will require due proof of death before any death
benefit is paid. Due proof of death will be:
1. a certified death certificate; or
2. a certified decree of a court of competent jurisdiction as to the
finding of death; or
3. any other proof satisfactory to us.
All death benefits will be paid in accordance with applicable law or regulations
governing death benefit payments.
ANNUITY PROVISION
GENERAL: On the Annuity Date, the Adjusted Contract Value will be applied under
the Annuity Option you have selected. You may elect to have the Adjusted
Contract Value applied to provide a Fixed Annuity, a Variable Annuity or a
combination Fixed and Variable Annuity. If a combination is elected, you must
specify what part of the Adjusted Contract Value is to be applied to the Fixed
and Variable Options.
ANNUITY DATE: You select an Annuity Date at the time of issue. The earliest
Annuity Date you can select is one year after the Issue Date. The latest Annuity
Date you can select is the later of the first day of the first calender month
following the Annuitant's 95th birthday or 10 years from the Issue Date, or the
maximum date permitted under state law. You may, at any time prior to the
Annuity Date, change the Annuity Date by Authorized Request 30 days in advance.
SELECTION OF AN ANNUITY OPTION: You can select an Annuity Option by Authorized
Request. If no Annuity Option is selected, Option 2, with 120 Monthly Payments
Guaranteed, will automatically be applied. You may, at any time prior to the
Annuity Date, by an Authorized Request made 30 days in advance, select and/or
change the Annuity Option.
ANNUITY OPTIONS: This Contract provides for Annuity Payments under one of the
Annuity Options described below. Any other Annuity Option acceptable to us may
be selected.
OPTION 1 - LIFE ANNUITY. We will make monthly Annuity Payments during the life
of the Annuitant and ceasing with the last Annuity Payment due prior to the
Annuitant's death.
OPTION 2 - LIFE ANNUITY WITH 120 OR 240 MONTHLY ANNUITY PAYMENTS GUARANTEED. We
will make monthly Annuity Payments during the life of the Annuitant with a
guarantee that if at the Annuitant's death there have been less than 120 or 240
monthly Annuity Payments made as selected, monthly Annuity Payments will
continue for the remainder of the guaranteed period. You may elect to have the
present value of the guaranteed monthly Annuity Payments remaining, as of the
date notice of the Annuitant's death is received at the BMA Service Center,
commuted at the Assumed Investment Return selected for a Variable Annuity or for
a Fixed Annuity the Statutory Calendar Year Interest Rate based on the NAIC
Standard Valuation Law for Single Premium Immediate Annuities corresponding to
the Annuity Date. We will require the return of this Contract and proof of death
prior to the payment of any commuted values.
OPTION 3 - JOINT AND LAST SURVIVOR ANNUITY. We will make monthly Annuity
Payments during the joint lifetime of the Annuitant and the Joint Annuitant.
Upon the death of the Annuitant, if the Joint Annuitant is then living, Annuity
Payments will continue to be paid during the remaining lifetime of the Joint
Annuitant at a level of 100%, 75% or 50% of the previous level, as selected.
Monthly Annuity Payments cease with the final Annuity Payment due prior to the
last survivor's death.
OPTION 4 - JOINT AND LAST SURVIVOR ANNUITY WITH 120 OR 240 MONTHLY ANNUITY
PAYMENTS GUARANTEED. We will make monthly Annuity Payments during the joint
lifetime of the Annuitant and the Joint Annuitant. Monthly Annuity Payments will
continue to be paid during the remaining lifetime of the Joint Annuitant at 100%
of the previous level, as selected. If at the last death of the Annuitant and
the Joint Annuitant, there have been less than 120 or 240 monthly Annuity
Payments made as selected, monthly Annuity Payments will continue to be made for
the remainder of the guaranteed period. You may elect to have the present value
of the guaranteed monthly Annuity Payments remaining, as of the date notice of
the last Annuitant's death is received by us, commuted at the Assumed Investment
Return selected for a Variable Annuity or for a Fixed Annuity the Statutory
Calendar Year Interest Rate based on the NAIC Standard Valuation Law for Single
Premium Immediate Annuities corresponding to the Annuity Date. We will require
the return of this Contract and proof of death prior to the payment of any
commuted values.
ANNUITY: If you select a Fixed Annuity, the Adjusted Contract Value is allocated
to the General Account and the Annuity is paid as a Fixed Annuity. If you select
a Variable Annuity, the Adjusted Contract Value will be allocated to the
Subaccounts of the Separate Account in accordance with your selection, and the
Annuity will be paid as a Variable Annuity. You may also select a combination of
a Fixed Annuity and a Variable Annuity in which case your Annuity Payment would
be the sum of the Fixed Annuity and the Variable Annuity. Unless you designate
another payee, you will be the payee of the Annuity Payments. If when Annuity
Payments begin we are using tables of annuity rates for these Contracts which
result in larger Annuity Payments, we will use those tables instead. Where
permitted, Annuity Payments will depend on the Age and sex of the Annuitant.
The first annuity payment will be due one month (or one modal period if other
than a monthly Annuity Payment frequency is elected) following the later of the
Annuity Date or the date of receipt of all required forms.
BMA may elect to determine the amount of each Annuity Payment up to 10 business
days prior to the elected payment date.
FIXED ANNUITY: You may elect to have the Adjusted Contact Value applied to
provide a Fixed Annuity. The dollar amount of each Fixed Annuity Payment shall
be determined in accordance with Annuity Tables contained in this Contract which
are based on the 1983 Individual Annuity Mortality Table with mortality
projected to the year 2000 by projection scale G and with an annual effective
interest rate of 3 1/2%.
VARIABLE ANNUITY: You may elect to have the Adjusted Contract Value applied to
provide a Variable Annuity. Variable Annuity Payments reflect the investment
performance of the Separate Account in accordance with the allocation of the
Adjusted Contract Value to the Subaccounts during the Annuity Period. Variable
Annuity Payments are not guaranteed as to dollar amount.
On the Annuity Date a fixed number of Annuity Units will be purchased as
follows:
For each Subaccount the fixed number of Annuity Units is equal to the Adjusted
Contract Value for all Subaccounts, divided first by $1000, then multiplied by
the appropriate Annuity Payment amount from the Annuity Table contained in this
Contract for each $1000 of value for the Annuity Option selected, and then
divided by the Annuity Unit value for that Subaccount on the Annuity Date.
Thereafter, the number of Annuity Units in each Subaccount remains unchanged
unless you elect to transfer between Subaccounts. All calculations will
appropriately reflect the Annuity Payment frequency selected.
On each Annuity Payment date, the total Variable Annuity Payment is the sum of
the Annuity Payments for each Subaccount. The Variable Annuity Payment in each
Subaccount is determined by multiplying the number of Annuity Units then
allocated to such Subaccount by the Annuity Unit value for that Subaccount.
On each subsequent Business Day, the value of an Annuity Unit is determined in
the following way:
First: The Net Investment Factor is determined as described under "Separate
Account Provision - Net Investment Factor" above.
Second: The value of an Annuity Unit for a Business Day is equal to:
a. the value of the Annuity Unit for the immediately preceding Business
Day;
b. multiplied by the Net Investment Factor for the current Business Day;
c. divided by the Assumed Net Investment Factor (see below) for the
Business Day.
The Assumed Net Investment Factor is equal to one plus the Assumed Investment
Return which is used in determining the basis for the purchase of an Annuity,
adjusted to reflect the particular Business Day. The Assumed Investment Return
that we will use is [3 1/2%]. However, we may agree with you to use a different
value.
MORTALITY AND EXPENSE GUARANTEE: We guarantee that the dollar amount of each
Annuity Payment after the first will not be affected by variations in mortality
or expense experience.
ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISION
OWNER: As the Owner you have all the interest and rights under this Contract.
The Owner is the person designated as such on the Issue Date, unless changed.
Any change of Owner is subject to our underwriting rules then in effect.
You may change Owners of the Contract at any time by Authorized Request. A
change of Owner will automatically revoke any prior designation of Owner. The
change will become effective as of the date the Authorized Request is signed. We
will not be liable for any payment made or action taken before we record the
change.
JOINT OWNER: A Contract may be owned by Joint Owners. If Joint Owners are named,
any Joint Owner must be the spouse of the other Owner. Upon the death of either
Owner, the surviving spouse will be the Primary Beneficiary. Any other
Beneficiary designation will be treated as a Contingent Beneficiary unless
otherwise indicated in an Authorized Request.
ANNUITANT: The Annuitant is the person on whose life Annuity Payments are based.
The Annuitant is the person designated by you at the Issue Date, unless changed
prior to the Annuity Date. The Annuitant may not be changed in a Contract which
is owned by a non-natural person. Any change of Annuitant is subject to our
underwriting rules then in effect.
ASSIGNMENT OF A CONTRACT: An Authorized Request specifying the terms of an
assignment of a Contract must be provided to the BMA Service Center. We will not
be liable for any payment made or action taken before we record the assignment.
We will not be responsible for the validity or tax consequences of any
assignment. Any assignment made after the death benefit has become payable will
be valid only with our consent.
If the Contract is assigned, your rights may only be exercised with the consent
of the assignee of record.
BENEFICIARY
BENEFICIARY: The Beneficiary designation in effect on the Issue Date will remain
in effect until changed. The Beneficiary is entitled to receive the benefits to
be paid at your death.
Unless you provide otherwise, the death benefit will be paid in equal shares to
the survivor(s) as follows:
1. to the primary Beneficiary(ies) who survive you and/or the
Annuitant's death, as applicable; or if there are none
2. to the contingent Beneficiary(ies) who survive you and/or the
Annuitant's death, as applicable; or if there are none
3. to your estate.
CHANGE OF BENEFICIARY: Subject to the rights of any irrevocable
Beneficiary(ies), you may change the Primary Beneficiary(ies) or Contingent
Beneficiary(ies). A change may be made by Authorized Request. The change will
take effect as of the date the Authorized Request is signed. The Company will
not be liable for any payment made or action taken before it records the change.
SUSPENSION OF DEFERRAL OF PAYMENTS OR TRANSFERS
FROM THE SEPARATE ACCOUNT
The Company reserves the right to suspend or postpone payments from the Separate
Account for a withdrawal or transfer for any period when:
1. the New York Stock Exchange is closed (other than customary
weekend and holiday closings);
2. trading on the New York Stock Exchange is restricted;
3. an emergency exists as a result of which disposal of
securities held in the Separate Account is not reasonably
practicable or it is not reasonably practicable to determine the
value of the Separate Account's net assets; or
4. during any other period when the Securities and Exchange
Commission, by order, so permits for the protection of Owners;
provided that applicable rules and regulations of the Securities and Exchange
Commission will govern as to whether the conditions described in (2) and (3)
exist.
GENERAL PROVISIONS
THE CONTRACT: The entire Contract consists of this Contract, and any attached
application, endorsements or riders. This Contract may be changed or altered
only by our President or Secretary. Any change, modification or waiver must be
made in writing.
NON-PARTICIPATING IN SURPLUS: This Contract does not share in any distribution
of our profits or surplus.
INCONTESTABILITY: We will not contest this Contract from its Issue Date.
MISSTATEMENT OF AGE OR SEX: We may require proof of Age of the Annuitant before
making any life contingent Annuity Payment provided for by this Contract. If the
Age or sex of the Annuitant has been misstated the amount payable will be the
amount that the Contract Value would have provided at the true Age or sex.
Once Annuity Payments have begun, any underpayments will be made up in one sum
with the next Annuity Payment, and overpayments will be deducted from the future
Annuity Payments until the total is repaid.
CONTRACT SETTLEMENT: This Contract must be returned to us upon any settlement.
Prior to any settlement as a death claim, due proof of death must be submitted
to us. Any paid-up annuity, withdrawal or death benefits that may be available
are not less than the minimum benefits required by statute.
REPORTS: We will furnish you with a report showing the Contract Value at least
once each calender year. We will also furnish an annual report of the Separate
Account. These reports will be sent to your last known address.
TAXES: Any taxes paid to any governmental entity will be charged against the
Contract Value. We will, in our sole discretion, determine when taxes have
resulted from: the investment experience of the Separate Account; receipt by us
of the Purchase Payment(s); or commencement of Annuity Payments. We may, at our
discretion, pay taxes when due and deduct that amount from the Contract Value at
a later date. Payment at an earlier date does not waive any right we may have to
deduct amounts at a later date. We reserve the right to establish a provision
for federal income taxes if we determine, in our sole discretion, that we will
incur a tax as a result of the operation of the Separate Account. We will deduct
for any income taxes incurred by it as a result of the operation of the Separate
Account whether or not there was a provision for taxes and whether or not it was
sufficient. We will deduct any withholding taxes required by applicable law.
EVIDENCE OF SURVIVAL: Where any benefits under this Contract are contingent upon
the recipient being alive on a given date, we may require proof satisfactory to
us that the condition has been met.
PROTECTION OF PROCEEDS: No Beneficiary may commute, encumber, alienate or assign
any payments under this Contract before they are due. To the extent permitted by
law, no payments will be subject to the debts, contracts or engagements of any
Beneficiary or to any judicial process to levy upon or attach the same for
payment thereof.
MODIFICATION OF CONTRACT: This Contract may not be modified by us without your
consent except as may be required by applicable law.
RESERVES, VALUES AND BENEFITS
All reserves are greater to or equal to those required by statute. Any values
and death benefits that may be available under this Contract are not less than
the minimum benefits required by any law in the state in which this Contract is
delivered.
TABLES
