1
SINGLE PREMIUM
MODIFIED GUARANTEED ANNUITY CONTRACT
issued by
XXXXXXX XXXXX LIFE INSURANCE COMPANY
A Stock Life Insurance Company
HOME OFFICE
Little Rock, Arkansas 72201
SERVICE CENTER
P.O. Box 44222
Jacksonville, Florida 32231-4222
0-000-000-0000
Xxxxxxx Xxxxx Life Insurance Company (hereafter referred to as "we" or "us")
agrees to pay annuity benefits as provided in this Contract. Payments will be
made starting on the Annuity Date. The amount of the single premium for this
Contract is shown on the Contract Schedule Page.
A detailed description of this Contract and the Market Value Adjustment has
been filed with the insurance department of the jurisdiction in which this
Contract is delivered.
RIGHT TO EXAMINE CONTRACT
IF FOR ANY REASON YOU ARE NOT SATISFIED WITH THIS CONTRACT, YOU MAY CANCEL IT
BY RETURNING THE CONTRACT TO US OR YOUR FINANCIAL CONSULTANT WITHIN 10 DAYS
AFTER YOU RECEIVE IT. IF YOU DO, WE WILL REFUND THE PREMIUM THAT WAS PAID AND
THE CONTRACT WILL BE VOID.
THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT THAT MAY RESULT IN BOTH UPWARD
AND DOWNWARD ADJUSTMENTS IN CASH SURRENDER BENEFITS AND THE AMOUNT PAID AT
ANNUITIZATION AND THAT MAY RESULT IN AN UPWARD ADJUSTMENT IN DEATH BENEFITS.
NO ADJUSTMENTS ARE MADE AT THE END OF A GUARANTEE PERIOD.
READ YOUR CONTRACT CAREFULLY. THIS IS A LEGAL CONTRACT BETWEEN YOU AND XXXXXXX
XXXXX LIFE INSURANCE COMPANY.
President Secretary
Single Premium Modified Guaranteed Annuity.
Death Benefit Before Annuity Date. Non-Participating.
Account Value Subject to Market Value Adjustment.
ML-MGA-003 SPECIMEN
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TABLE OF CONTENTS
SECTION PAGE
CONTRACT SCHEDULE ...................................................... 3
DEFINITIONS ............................................................ 4
1. GENERAL PROVISIONS ............................................... 6
2. SUB-ACCOUNTS ..................................................... 8
3. CONTRACT VALUES .................................................. 8
4. MARKET VALUE ADJUSTMENT .......................................... 9
5. WITHDRAWALS ..................................................... 10
6. PAYMENT AT DEATH OF OWNER ....................................... 10
7. DEATH OF ANNUITANT WHO IS NOT AN OWNER .......................... 11
8. ANNUITY PROVISIONS .............................................. 11
9. ANNUITY OPTIONS ................................................. 12
10. ANNUITY OPTIONS TABLES .......................................... 14
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ML-MGA-003 SPECIMEN
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CONTRACT SCHEDULE
XXXXXXX XXXXX LIFE INSURANCE COMPANY Contract Number: R970123456
Service Center: Issue Date: August 1, 1997
P.O. Box 44222 Current Date: August 10, 1997
Jacksonville, FL 32231-4222
0-000-000-0000 Financial Consultant:
XXX XXXXXX
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OWNER INFORMATION ANNUITANT INFORMATION
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OWNER NAME: XXXX X. CLIENT ANNUITANT: Xxxx X. Xxxxxx
OWNER AGE: 55 SEX: M OWNER AGE: 53 SEX: F
CO-OWNER NAME: XXXX X. CLIENT ANNUITY DATE: SEPTEMBER 1, 2002
CO-OWNER AGE: 53 SEX: F ANNUITY OPTION:
LIFE WITH 10 YEAR CERTAIN
OWNER ADDRESS: 000 Xxxxx Xxxxxx
Xxxxx 0000
Xxxxxxx, XX 00000-0000
BENEFICIARY: SURVIVING SPOUSE
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CONTRACT INFORMATION
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CONTRACT TYPE: MODIFIED GUARANTEED ANNUITY
PLAN: NON-QUALIFIED
SINGLE PREMIUM: $100,000.00
INITIAL PREMIUM ALLOCATION:
Initial Guaranteed
Guarantee Period Amount Allocated Interest Rate Renewal Date
---------------- ---------------- ------------- ------------
3-Year $35,000.00 7.00% 08/01/2000
5-Year $65,000.00 8.00% 08/01/2002
1-Year Available at Renewal Date only
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WITHDRAWAL CHARGE RATE: 6% for duration of each initial and renewal
Guarantee Period shown above
MINIMUM WITHDRAWAL AMOUNT: $500
MINIMUM REMAINING NET SUB-ACCOUNT VALUE: $5,000
MINIMUM REMAINING ACCOUNT VALUE: $15,000
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DEFINITIONS
1. ACCOUNT VALUE: The sum of all Sub-Account Values. See Section 3.2.
2. ANNUITANT: The person whose age determines the latest possible
Annuity Date. Payments under certain annuity options stop when the
Annuitant dies.
3. ANNUITY: A series of predetermined periodic payments. See Section 8.
4. ANNUITY DATE: The date shown on the Contract Schedule on which
annuity payments are to start. The Annuity Date can be no later than
the Annuitant's 85th birthday for non-qualified contracts. See
Section 8.1.
5. BENEFICIARY: The person to whom payment is to be made upon the death
of the Owner.
6. CONTRACT ANNIVERSARY: Each anniversary of the Issue Date.
7. CONTRACT YEAR: A year starting on the Issue Date or Contract
Anniversary and ending with the day just prior to the next Contract
Anniversary.
8. ISSUE DATE: The date shown on the Contract Schedule as the date the
Contract was issued.
9. GUARANTEED INTEREST RATE: The interest rate that we will credit a
Sub-Account for a specified Guarantee Period.
10. GUARANTEE PERIOD: The period for which we guarantee to credit a
specified interest rate for a Sub-Account. See Section 2.2.
11. MARKET VALUE ADJUSTMENT ("MVA"): An adjustment that may be made to a
Sub-Account Value. The adjustment may be either a deduction from or
an addition to the Sub-Account Value. See Sections 4, 5.1, 6.1 and
8.3.
12. MVA INTEREST RATES: The interest rates used in the calculation of the
Market Value Adjustment. See Section 4.2.
13. NET ACCOUNT VALUE: The sum of all Net Sub-Account Values. Upon
annuitization the Net Account Value will reflect deductions for
premium taxes, if any. See Section 8.3.
14. NET SUB-ACCOUNT VALUE: Sub-Account Value as adjusted for any Market
Value Adjustment and Withdrawal Charge applied in connection with a
withdrawal, annuitization, or the payment of death benefits upon the
death of the Owner prior to the Annuity Date.
15. OWNER: The person entitled to exercise all rights under the Contract.
In this Contract, "you" means Owner.
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16. RENEWAL DATE: The Contract Anniversary immediately following the last
day of the Guarantee Period of a Sub-Account.
17. SUB-ACCOUNT: Your single premium will be allocated to one or more
Sub-Accounts as directed by you. Each Sub-Account will correspond to
a specified Guaranteed Interest Rate and Guarantee Period. See
Section 2. The initial allocation of your single premium is shown in
the Contract Schedule.
18. SUB-ACCOUNT VALUE: An amount equal to that part of your single
premium or Account Value allocated or transferred to a Sub-Account
plus credited interest, as adjusted for any prior withdrawals, Market
Value Adjustments and Withdrawal Charges. See Section 3.1.
19. WITHDRAWAL CHARGE: A charge deducted from any Sub-Account from which
a withdrawal is made prior to the end of a Guarantee Period. See
Section 5.2.
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1. GENERAL PROVISIONS
1.1 BENEFICIARY: A Beneficiary is the person designated by you in writing
to receive payment on death under Section 6 or Section 9.
Generally, you may change the Beneficiary while you are alive.
You may also name a Beneficiary irrevocably. You may change an
irrevocable Beneficiary only with such Beneficiary's written consent.
The Beneficiary has no ownership rights under this Contract.
If a Beneficiary does not survive you, the estate or heirs of such
Beneficiary have no rights under this Contract. However, if a
Beneficiary survives you but dies before the Contract's proceeds are
distributed, the estate or heirs of such Beneficiary are entitled to
that portion of the Contract's proceeds that would otherwise have been
paid to such Beneficiary. If no Beneficiary survives you, payment
will be made to your estate.
1.2 OWNERSHIP OF CONTRACT: Unless another Owner is named by the
purchaser, the purchaser is the Owner. An Owner's age must be less
than 85 years. If the Owner of the Contract is not an individual,
then the Annuitant's age must be less than 85 years.
Upon notice to us you may assign the Contract to a new Owner. The
assignment terminates all prior Beneficiary designations. A new
Owner's age must be less than 85 years.
Only spouses may be co-owners. The Beneficiary of the co-owner's
spouse must be the surviving spouse. The age of the oldest co-owner
must be less than 85 years. Ownership rights must be exercised by the
co-owners jointly. Co-owners are deemed to be joint tenants with
right of survivorship unless they indicate otherwise.
1.3 COLLATERAL ASSIGNMENT: Upon notice to us, you may make a collateral
assignment of your rights under this Contract to a creditor as
security for a debt. The rights of an assignee have priority over the
rights of a Beneficiary.
No amounts payable under this Contract to a payee other than you may
be assigned by that payee, nor will they be subject to the claims of
creditors or to legal process, except to the extent permitted by law.
1.4 NOTICES, CHANGES AND CHOICES: To be effective, all notices, changes
and choices you make under the Contract must be in writing, signed and
received by us at our Service Center, except that the following may be
made by telephone:
a. Notices regarding transfers of Sub-Account Values under
Section 2.4.
b. Specifications of Sub-Accounts for withdrawals under Section
5.1.
c. Change of Annuity Date, unless the Annuitant is over 70 1/2
and the Contract has been issued under an IRA or a qualified
plan.
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We are not responsible for the validity of any notices, changes or
choices. When recorded by us, changes relating to beneficiaries,
ownership and the Annuitant will take effect as of the date signed by
you, unless we have already acted in reliance on the prior status.
Changes relating to Annuity Date will take effect as of the date
received by us unless we have already acted in reliance on the prior
status.
We will mail a notice to you at least 30 days but not more than 60
days prior to the Renewal Date of a Sub-Account. This notice will
inform you that we require notification from you prior to the Renewal
Date if you wish to receive a withdrawal or make a transfer from that
Sub-Account as of the Renewal Date (without a Market Value Adjustment
or Withdrawal Charge). See Sections 4.1 and 5.2.
1.5 MISSTATEMENT OF AGE OR SEX: If the age or sex of the Annuitant is
misstated, annuity payments will be adjusted to reflect the correct
age and sex. Any amount we have overpaid as the result of such
misstatement will be deducted from subsequent payments made by us
under this Contract until recovered. Interest on the overpayment will
be charged at the rate of 4% per year. Any amount we have underpaid
will be paid in full with the next payment made by us under this
Contract. We will pay interest on the underpayment at the rate of 4%
per year.
1.6 PROOF OF AGE, SEX, OR SURVIVAL: We may require satisfactory proof of
age, sex or survival of any person on whose continued life any payment
under this Contract depends.
1.7 INCONTESTABILITY: We will not contest this Contract.
1.8 THE CONTRACT: The Contract and any endorsements or riders are the
entire Contract. It is issued in consideration of the payment of the
single premium. Only our President, a Vice President, Secretary or
Assistant Secretary may change the Contract. Any change must be in
writing.
1.9 NONPARTICIPATING: This Contract is nonparticipating. It does not
share in our surplus.
1.10 PAYMENTS: All sums payable to or by us are payable at our Service
Center. We may require return of this Contract prior to making
payment. We may defer payments of partial or full withdrawals for up
to 6 months.
1.11 REPORTS: Prior to the Annuity Date we will furnish you with a report
at least once each year. It will show your Account Value, Sub-Account
Values and current Sub-Account Guaranteed Interest Rates.
1.12 COMPLIANCE WITH STATE AND FEDERAL LAW: We reserve the right to change
the provisions of the Contract to conform to any applicable law,
regulation or ruling issued by a government, agency thereof or court.
1.13 TAX QUALIFICATION: The Contract is intended to qualify as an annuity
contract for federal income tax purposes. To that end, the provisions
of the Contract are to be interpreted to ensure or maintain such tax
qualifications, notwithstanding any other provisions to the contrary.
Distributions under the Contract shall be made in a time and manner
necessary to maintain such qualification under
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ML-MGA-003 SPECIMEN
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the applicable provisions of the Internal Revenue Code including, in
the case of an Owner who is not an individual, the requirement to
distribute the entire interest in the Contract upon any change of the
Annuitant. For this purpose, the entire interest in the Contract is
the Net Account Value.
We reserve the right to amend the Contract to reflect any
clarifications that may be needed or are appropriate to maintain such
qualification or to conform the Contract to any applicable changes in
the tax qualification requirements.
2. SUB-ACCOUNTS
2.1 SUB-ACCOUNT: Your single premium will be allocated to one or more
Sub-Accounts as chosen by you.
2.2 AVAILABLE GUARANTEE PERIODS: Guarantee Periods currently offered by
us are shown on the Contract Schedule. We may at our discretion offer
additional Guarantee Periods not to exceed 10 years.
2.3 TRANSFERS OF SUB-ACCOUNT VALUE PRIOR TO RENEWAL DATE: Sub-Account
Values may not be transferred to another Sub-Account in full or in
part prior to the end of the Guarantee Period.
2.4 TRANSFERS OF SUB-ACCOUNT VALUE AT RENEWAL DATE: Upon notice to us
prior to the end of the current Guarantee Period, the Sub-Account
Value will be transferred at the end of the Guarantee Period to one or
more Sub-Accounts as chosen by you. See Section 1.4. Transfers
cannot be made to a Guarantee Period with a duration that will extend
beyond the Annuity Date or the Annuitant's 85th birthday, if no
Annuity Date has been chosen. If no notice is received from you, the
Sub-Account Value will be automatically transferred to the Sub-Account
for the one-year Guarantee Period.
3. CONTRACT VALUES
3.1 SUB-ACCOUNT VALUE: An amount equal to that part of your single
premium or Account Value allocated or transferred to a Sub-Account
plus credited interest, as adjusted for any prior withdrawals, Market
Value Adjustments and Withdrawal Charges.
3.2 ACCOUNT VALUE: The current Account Value at any time prior to the
Annuity Date is equal to the sum of all Sub-Account Values.
3.3 INTEREST RATES: The daily simple interest rate will be computed by
dividing the applicable Guaranteed Interest Rate for a Sub-Account by
365. This rate will be applied to the last Contract Anniversary
Sub-Account Value with adjustment for subsequent withdrawals to
determine credited interest daily (except on February 29). The
Guaranteed Interest Rate for a Guarantee Period of a specified
duration for a Sub-Account into which Sub-Account Value has been
transferred may not be equal to the Guaranteed Interest Rate available
for a Guarantee Period of the same duration for initial allocation of
a single premium.
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4. MARKET VALUE ADJUSTMENT
4.1 MARKET VALUE ADJUSTMENT: The Market Value Adjustment may be either
negative or positive. It will be deducted from or added to
Sub-Account Value according to the formula shown in Section 4.2 in any
of the following circumstances:
(a) Upon withdrawal of all or part of a Net Sub-Account Value
prior to the end of the Guarantee Period for that Sub-Account.
(b) Upon annuitization at the Annuity Date if the Annuity Date is
prior to the end of the Guarantee Period for that Sub-Account.
(c) Upon payment of a death benefit prior to the Annuity Date (See
Section 6.1.), except that no Market Value Adjustment is
calculated if the combined Market Value Adjustments applicable
to all affected Sub-Accounts would reduce the Account Value.
A Market Value Adjustment will not be applied upon withdrawal or
annuitization at the end of the Guarantee Period from a Sub-Account if
we receive written notice from you requesting such withdrawal prior to
the end of the Guarantee Period, or if the Annuity Date is at the end
of the Guarantee Period.
4.2 FORMULA: The Market Value Adjustment is determined by the following
formula:
n/365
(1+B)
Ax [1 - ----- ]
(1+C)
Where:
"n" = The remaining number of days in the Guarantee Period.
"A" = The amount withdrawn from the Net Sub-Account Value in the
case of a partial withdrawal; or the Net Sub-Account Value in
the case of a full withdrawal, annuitization or death benefit
paid prior to annuitization.
"B" = The MVA Interest Rate in effect at the time the Market Value
Adjustment is being applied for a Sub-Account with a Guarantee
Period for a duration of years represented by "n/365", whether
or not those durations are currently offered under the
Contract. When n/365 is not a whole number, we determine B by
straight-line interpolation. If n/365 is less than 1, we will
assume B is equal to the MVA Interest Rate for a one-year
Guarantee Period.
"C" = The MVA Interest Rate in effect for the Sub-Account on the
Issue Date or the last Renewal Date.
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5. WITHDRAWALS
5.1 WITHDRAWALS: You may withdraw all or part of the Net Account Value
upon notice to us received prior to the earlier of the Annuity Date or
the death of the Owner. See Section 1.4. For full withdrawal this
Contract must be surrendered at our Service Center.
For partial withdrawals, you must specify the Sub-Accounts from which
the withdrawal is to be made. If you do not specify, then the
withdrawal will be made from the Sub-Account with the shortest period
of time remaining in its Guarantee Period until that Sub-Account has
been depleted. The minimum amount of a withdrawal, the minimum amount
remaining in a Sub-Account (unless the full amount in a Sub-Account is
withdrawn) after adjustment for any current Market Value Adjustment
and Withdrawal Charge and the minimum remaining Account Value are
shown on the Contract Schedule. See Section 1.4.
5.2 WITHDRAWAL CHARGE: A Withdrawal Charge will be deducted from the
Sub-Account from which a withdrawal is made prior to the end of a
Guarantee Period. For partial withdrawals from a Sub-Account,
Withdrawal Charges are determined by multiplying the amount of the
withdrawal being taken from a Sub-Account by the Withdrawal Charge
Rate applicable to the Guarantee Period for that Sub-Account as shown
on the Contract Schedule. For a full withdrawal of a Sub-Account, the
amount received is the Net Sub-Account Value, which reflects
adjustments for the Withdrawal Charge and any Market Value Adjustment.
The Withdrawal Charge equals the Net Sub-Account Value multiplied by
the Withdrawal Charge Rate for the applicable Guarantee Period shown
on the Contract Schedule.
Withdrawal Charges apply when a full withdrawal occurs on an Annuity
Date which does not correspond to the Renewal Date of a Guarantee
Period.
Withdrawal Charges do not apply to:
(a) Death payments under Section 6,
(b) Annuity payments under Section 8, or
(c) Withdrawal at the end of the Guarantee Period from a
Sub-Account if we receive written notice from you requesting
such withdrawal prior to the end of the Guarantee Period. See
Section 1.4.
6. PAYMENT AT DEATH OF OWNER
6.1 DEATH PRIOR TO ANNUITY DATE: On the death of any Owner prior to the
Annuity Date, we will pay your Beneficiary an amount equal to the
Account Value plus any positive Market Value Adjustment as of the date
of payment. See Section 4.l(c). Subject to Section 6.2 and 6.3 such
payments will be made in a lump sum unless an annuity option is
chosen.
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6.2 CONTRACT CONTINUATION OPTION: If the surviving spouse of the deceased
Owner is the Beneficiary, such spouse may choose to continue this
Contract in force on the same terms as before such Owner's death, and
the spouse shall thereafter become the "new" Owner and the Beneficiary
until a new Beneficiary is named.
6.3 ANNUITY OPTION: If the Beneficiary is the surviving spouse of the
deceased Owner, he or she may choose to receive payments under any of
the annuity options of this Contract. For any other Beneficiary, the
only options available are those that provide for full payment of such
Owner's interest in the Contract:
(a) Within five years of the date of such Owner's death;
(b) Over the lifetime of such Beneficiary of this Contract; or
(c) Over a period that does not exceed the life expectancy of such
Beneficiary of this Contract as defined by Internal Revenue
Service regulations.
Subparagraphs (b) and (c) apply only to individuals, and such payments
must start within one year of the date of such Owner's death. For
IRAs, any annuity option chosen must meet the requirements of the
Internal Revenue Code.
6.4 OWNER NOT AN INDIVIDUAL: If the Owner is not an individual, the
Annuitant will be treated as Owner for the purposes of Section 6, and
the death of the Annuitant will be treated as the death of the Owner.
6.5 MULTIPLE OWNERS: Where the Contract names more than one Owner, the
date of death of the Owner will be deemed to be the date of the first
Owner to die.
6.6 DEATH AFTER ANNUITY DATE: See Section 9.8
7. DEATH OF ANNUITANT WHO IS NOT AN OWNER
7.1 If the Annuitant dies prior to the Annuity Date and the Owner is not
the Annuitant, the Owner may designate a new Annuitant. If one is not
designated, the Owner will be the Annuitant, provided that the Owner
is an individual. If the Owner is not an individual, the death of the
Annuitant will be treated as the death of the Owner. See Section 6.
8. ANNUITY PROVISIONS
8.1 ANNUITY DATE: The Annuity Date may not be later than the Annuitant's
85th birthday. If you have not chosen an Annuity Date, it will be the
date of the Annuitant's 85th birthday. The Annuitant may be changed
prior to the Annuity Date unless the Contract Owner is not an
individual. If the Contract has been issued under a qualified plan,
and you have not chosen an Annuity Date, it will be the date the
Annuitant reaches age 70 1/2. You may change the Annuity Date at any
time prior to the Annuity Date.
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8.2 ANNUITY OPTIONS: If you have not chosen an annuity option described
in Section 9, Option 4 (Life Annuity with Payments Guaranteed for 10
years) will apply. You may change options at any time prior to the
Annuity Date. An option not set forth in the Contract may be chosen
if acceptable to us.
8.3 AMOUNT OF ANNUITY PAYMENTS: Charges made by us for any premium taxes
will be deducted from your Net Account Value as of the Annuity Date.
A Market Value Adjustment will not be applied if the Annuity Date
corresponds to the Renewal Date of a Guarantee Period. The remaining
Net Account Value will be applied to the annuity option chosen at our
current annuity rates, which will be furnished on request. The rates
will assume interest of not less than 3%. They will not be less
favorable than those shown in the annuity tables in this Contract. If
on the Annuity Date we then have a more favorable annuity purchase
rate, we will use that rate. The annuity purchase rate we use shall
be at least as favorable to you as that available in any single
premium annuity contract then offered by us to the same class of
annuitants.
The tables show the minimum guaranteed amount of each monthly payment
for each $1,000 so applied, according to age and sex at the Annuity
Date. The tables are based on the 1983 Table "a" projected forward to
1995 for Individual Annuity Valuation, set back one year, with
interest at 3%. See Section 10.
8.4 MINIMUM ANNUITY PAYMENT: If the Net Account Value to be applied at
the Annuity Date is less than $5,000, we may pay such amount in a lump
sum. If any payment would be less than $50, we may change the
frequency so payments are at least $50 each.
9. ANNUITY OPTIONS
9.1 OPTION 1 - PAYMENTS OF A FIXED AMOUNT: Equal payments in the amount
chosen will be made until the Net Account Value applied under this
option, adjusted for interest credits and prior annuity payments is
exhausted. Interest will be credited at the rate at which we offer
this option. The term over which such payments are made must be at
least 5 years.
9.2 OPTION 2 - PAYMENTS FOR A FIXED PERIOD: Payments will be made for the
period chosen. The period must be at least 5 years.
9.3 OPTION 3 - LIFE ANNUITY: Payments will be made for the life of the
Annuitant. Payments will cease with the last payment due prior to the
Annuitant's death.
9.4 OPTION 4 - LIFE ANNUITY WITH PAYMENTS GUARANTEED FOR 10 OR 20 YEARS:
Payments will be made for the guaranteed period chosen (10 or 20
years) and as long thereafter as the Annuitant lives.
9.5 OPTION 5 - LIFE ANNUITY WITH GUARANTEED RETURN OF NET ACCOUNT VALUE:
Payments will be made until the sum of the annuity payments equals the
Net Account Value applied under this option, and as long thereafter as
the Annuitant lives.
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9.6 OPTION 6 - JOINT AND SURVIVOR LIFE ANNUITY: Payments will be made
during the lifetimes of the Annuitant and a designated second person.
Upon death of one, payments will continue in the same amount for the
life of the other person.
9.7 OPTION 7 - QUALIFIED PLAN OPTION: Annuity payments may be based on
(a) your life expectancy, (b) the joint life expectancy of you and
your spouse, or (c) the life expectancy of your surviving spouse if
you die before the Annuity Date. Payments will be made annually.
Each annual payment will be equal to the Net Account Value on the
first day of that calendar year divided by the applicable current life
expectancy, as defined by Internal Revenue Service regulations. Each
subsequent payment will be made on the anniversary of the Annuity
Date. Interest will be credited at our current rate for this option.
The rate will not be less than 3%. On death of the measuring life or
lives prior to full distribution of the Net Account Value, the
remaining Net Account Value will be paid to the Beneficiary in a lump
sum.
9.8 DEATH AFTER ANNUITY DATE: On the death of the Annuitant while
guaranteed amounts remain unpaid under Option 1, 2, 4, or 5, the Owner
may choose either:
(a) To have payments continue for the amount or period guaranteed,
or
(b) To receive the present value of the remaining guaranteed
payments in a lump sum.
If an Owner dies while guaranteed amounts remain unpaid, the present
value may be paid in a lump sum to the Beneficiary, if the Beneficiary
so elects.
Present values will be computed at the interest rate that was used to
compute the amount of the initial annuity payment.
9.9 PAYMENT: Except for Option 7 (Qualified Plan Option), payments will
be made monthly beginning on the Annuity Date, but prior to the
Annuity Date you may choose a less frequent payment interval instead.
The amount of each payment on an annual, semiannual or quarterly basis
will be not less than the monthly payment computed from the annuity
tables in the Contract multiplied by the appropriate factor:
Annual Semiannual Quarterly
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11.839 5.963 2.993
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10. ANNUITY OPTION TABLES
MINIMUM GUARANTEED MONTHLY ANNUITY PAYMENT FOR EACH $1,000 APPLIED UNDER
OPTION
OPTION 2 (Payments for a Fixed Period)
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Years Each Years Each Years Each Years Each
Payable Payment Payable Payment Payable Payment Payable Payment
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5 17.91 9 10.53 13 7.71 17 6.23
6 15.14 10 9.61 14 7.26 18 5.96
7 13.16 11 8.86 15 6.87 19 5.73
8 11.68 12 8.24 16 6.53 20 5.51
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OPTION 3 (Life Annuity), OPTION 4 (Life Annuity with 10 or 20 Years Guranteed)
and OPTION 5 (Return of Contract Value Guaranteed)
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*Adjusted Life 10 Years 20 Years Return of *Adjusted Life 10 Years 20 Years Return of
Male Age Annuity Guaranteed Guaranteed Net Contract Female Age Annuity Guaranteed Guaranteed Net Contract
Value Value
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56 4.62 4.56 4.34 4.37 56 4.19 4.16 4.06 4.05
57 4.72 4.65 4.41 4.45 57 4.27 4.24 4.12 4.12
58 4.83 4.75 4.47 4.53 58 4.35 4.32 4.19 4.19
59 4.94 4.85 4.54 4.61 59 4.44 4.40 4.25 4.26
60 5.06 4.95 4.60 4.70 60 4.54 4.49 4.32 4.34
61 5.19 5.07 4.67 4.80 61 4.64 4.58 4.39 4.42
62 5.33 5.19 4.73 4.90 62 4.74 4.68 4.46 4.50
63 5.47 5.31 4.80 5.00 63 4.86 4.79 4.53 4.59
64 5.63 5.44 4.86 5.11 64 4.98 4.90 4.60 4.69
65 5.80 5.58 4.92 5.23 65 5.11 5.01 4.67 4.79
66 5.98 5.72 4.98 5.35 66 5.25 5.14 4.74 4.89
67 6.17 5.86 5.04 5.48 67 5.40 5.27 4.82 5.00
68 6.37 6.02 5.10 5.61 68 5.55 5.40 4.89 5.12
69 6.59 6.18 5.15 5.75 69 5.72 5.55 4.95 5.25
70 6.82 6.34 5.20 5.90 70 5.91 5.70 5.02 5.38
71 7.07 6.50 5.24 6.06 71 6.11 5.86 5.08 5.52
72 7.34 6.67 5.28 6.22 72 6.32 6.03 5.14 5.66
73 7.62 6.85 5.32 6.39 73 6.56 6.20 5.19 5.82
74 7.92 7.02 5.35 6.57 74 6.81 6.38 5.24 5.99
75 8.24 7.20 5.38 6.76 75 7.08 6.57 5.29 6.16
76 8.58 7.38 5.40 6.97 76 7.37 6.76 5.33 6.35
77 8.95 7.55 5.42 7.17 77 7.69 6.96 5.36 6.55
78 9.35 7.72 5.44 7.39 78 8.03 7.16 5.39 6.75
79 9.77 7.89 5.46 7.63 79 8.40 7.36 5.41 6.98
80 10.22 8.06 5.47 7.87 80 8.80 7.56 5.44 7.21
81 10.71 8.22 5.48 8.13 81 9.23 7.75 5.45 7.45
82 11.22 8.37 5.49 8.40 82 9.70 7.94 5.47 7.71
83 11.77 8.51 5.50 8.68 83 10.21 8.13 5.48 7.98
84 12.35 8.65 5.50 8.97 84 10.76 8.30 5.49 8.27
85 12.97 8.77 5.50 9.29 85 11.35 8.46 5.50 8.57
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ML-MGA-003 SPECIMEN
15
OPTION 6 (Joint and Survivor Life Annuity)
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*Adjusted *Adjusted Male Age *Adjusted
Female Age -------------------------------------------------------------------------------------------- Female Age
50 55 60 65 70 75 80 85
------------------------------------------------------------------------------------------------------------------
50 3.52 3.60 3.66 3.71 3.74 3.76 3.78 3.78 50
55 3.65 3.77 3.87 3.95 4.01 4.05 4.08 4.09 55
60 3.78 3.94 4.10 4.23 4.34 4.41 4.46 4.49 60
65 3.88 4.10 4.33 4.54 4.72 4.86 4.96 5.02 65
70 3.96 4.23 4.54 4.85 5.15 5.40 5.59 5.72 70
75 4.02 4.34 4.72 5.14 5.59 6.01 6.37 6.64 75
80 4.06 4.41 4.85 5.38 5.99 6.63 7.24 7.76 80
85 4.09 4.46 4.94 5.55 6.30 7.17 8.11 9.01 85
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Information for ages not shown will be furnished on request.
*"Adjusted Age" means attained age at last birthday adjusted as follows:
ANNUITY DATE ADJUSTED AGE
------------ ------------
Before 2000 Actual Age
2000-2009 Subtract 1 year from actual age
2010-2019 Subtract 2 years from actual age
2020-2029 Subtract 3 years from actual age
2030 and after Subtract 4 years from actual age
- 15 -
ML-MGA-003 SPECIMEN
16
XXXXXXX XXXXX LIFE INSURANCE COMPANY
SINGLE PREMIUM MODIFED GUARANTEED ANNUITY.
DEATH BENEFIT BEFORE ANNUITY DATE. NON-PARTICIPATING.
ACCOUNT VALUE SUBJECT TO MARKET VALUE ADJUSTMENT.
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ML-MGA-003 SPECIMEN
