EXHIBIT 4
ALLSTATE LIFE
INSURANCE COMPANY
A Stock Company
Home Office: Xxxxxxxx Xxxxx, Xxxxxxxxxx, Xxxxxxxx 00000-0000
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FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT
This Contract is issued to the owner in consideration of the initial purchase
payment. Allstate Life Insurance Company will pay the benefits of this
Contract, subject to its terms and conditions.
Throughout this Contract, "you" and "your" refer to the Contract owner(s).
"We", "us" and "our" refer to Allstate Life Insurance Company.
CONTRACT SUMMARY
This flexible premium deferred variable annuity provides a cash withdrawal
benefit and a death benefit during the Accumulation Phase and periodic income
payments beginning on the Payout Start Date during the Payout Phase.
THE DOLLAR AMOUNT OF INCOME PAYMENTS OR OTHER VALUES PROVIDED BY THIS
CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT,
WILL VARY TO REFLECT THE PERFORMANCE OF THE VARIABLE ACCOUNT AND ARE NOT
GUARANTEED AS TO DOLLAR AMOUNT.
This Contract does not pay dividends.
The tax status of this Contract as it applies to the owner should be reviewed
each year.
PLEASE READ YOUR CONTRACT CAREFULLY.
THIS IS A LEGAL CONTRACT BETWEEN THE CONTRACT OWNER AND ALLSTATE LIFE
INSURANCE COMPANY.
RETURN PRIVILEGE
IF YOU ARE NOT SATISFIED WITH THIS CONTRACT FOR ANY REASON, YOU MAY RETURN IT
TO US OR OUR AGENT WITHIN 20 DAYS AFTER YOU RECEIVE IT. WE WILL REFUND ANY
PURCHASE PAYMENTS ALLOCATED TO THE VARIABLE ACCOUNT, ADJUSTED TO REFLECT
INVESTMENT GAIN OR LOSS FROM THE DATE OF ALLOCATION TO THE DATE OF
CANCELLATION, PLUS ANY PURCHASE PAYMENTS ALLOCATED TO THE FIXED ACCOUNT
OPTIONS. (WHERE REQUIRED BY STATE LAW, WE WILL REFUND ANY PURCHASE PAYMENTS.)
IF THIS CONTRACT IS QUALIFIED UNDER SECTION 408 OF THE INTERNAL REVENUE CODE,
WE WILL REFUND THE GREATER OF ANY PURCHASE PAYMENTS OR THE CONTRACT VALUE.
If you have any questions about your Allstate Life variable annuity, please
contact Allstate Life at (000) 000-0000.
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Secretary Chairman and Chief Executive Officer
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TABLE OF CONTENTS
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THE PERSONS INVOLVED....................................................... 3
ACCUMULATION PHASE......................................................... 3
PAYOUT PHASE............................................................... 10
INCOME PAYMENT TABLES...................................................... 12
GENERAL PROVISIONS......................................................... 13
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THE PERSONS INVOLVED
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OWNER The person named at the time of application is the Owner of this
Contract unless subsequently changed. As Owner, you will receive any periodic
income payments, unless you have directed us to pay them to someone else.
You may exercise all rights stated in this Contract, subject to the rights of
any irrevocable Beneficiary.
You may change the Owner or Beneficiary at any time. You may name a new
Annuitant only upon the death of the current Annuitant. You may restrict
income payments to Beneficiaries. Once we have received a satisfactory written
request for a change of Owner or Beneficiary, or restricted payments to any
Beneficiary, the change will take effect as of the date you signed it. We are
not liable for any payment we make or other action we take before receiving
any written request for a change from you. You may not assign an interest in
this Contract as collateral or security for a loan.
If the sole surviving Owner dies prior to the Payout Start Date, the
Beneficiary becomes the new Owner. If the sole surviving Owner dies after the
Payout Start Date, the Beneficiary becomes the new Owner and will receive any
subsequent guaranteed income payments.
If more than one person is designated as Owner:
1. Owner as used in this Contract refers to all persons named as Owners,
unless otherwise indicated;
2. any request to exercise ownership rights must be signed by all Owners;
and
3. on the death of any person who is an Owner, the surviving person(s)
named as Owner will continue as Owner.
ANNUITANT The Annuitant is the person named on the Annuity Data Page. The
Annuitant must be a living individual.
BENEFICIARY The Beneficiary is the person(s) named on the Annuity Data Page,
but may be changed by the Owner, as described above. We will determine the
Beneficiary from the most recent written request we have received from you. If
you do not name a Beneficiary or if the Beneficiary named is no longer living,
the Beneficiary will be:
1. your spouse if living; otherwise
2. your children equally if living; otherwise
3. your estate.
The Beneficiary may become the Owner under the circumstances described in the
Owner provision above.
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ACCUMULATION PHASE
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ACCUMULATION PHASE DEFINED The "Accumulation Phase" is the first of two phases
during your Contract. The Accumulation Phase begins on the issue date of the
Contract stated on the Annuity Data Page. This phase will continue until the
Payout Start Date unless the Contract is terminated before that date.
CONTRACT YEAR "Contract Year" is the one year period beginning on the issue
date of the Contract and on each anniversary of the issue date.
INVESTMENT ALTERNATIVES The "Investment Alternatives" are the subaccounts of
the Variable Account and the Fixed Account Options. We reserve the right to
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limit the availability of the Investment Alternatives for new investments.
PURCHASE PAYMENTS The initial payment is shown on the Annuity Data Page. You
may make subsequent purchase payments during the Accumulation Phase. We may
limit the amount of each purchase payment that we will accept to a minimum of
$500 and a maximum of $1,000,000.
We will invest the purchase payments in the Investment Alternatives you
select. You may allocate any portion of your purchase payment in whole
percents from 0% to 100% or in exact dollar amounts to any of the Investment
Alternatives. The total allocation must equal 100%.
The allocation of the initial purchase payment is shown on the Annuity Data
Page. Allocation of each subsequent purchase payment will be the same as the
allocation for the most recent purchase payment unless you change the
allocation. You may change the allocation of subsequent purchase payments at
any time, without charge, simply by giving us written notice. Any change will
be effective at the time we receive the notice.
VARIABLE ACCOUNT The "Variable Account" for this Contract is the Allstate Life
Insurance Company Separate Account A. This account is a separate investment
account to which we allocate assets contributed under this and certain other
contracts. These assets will not be charged with liabilities arising from any
other business we may have.
VARIABLE SUBACCOUNTS The Variable Account is divided into subaccounts. Each
subaccount invests solely in the shares of the mutual fund underlying that
subaccount.
FIXED ACCOUNT OPTIONS The Fixed Account Option is the Standard Fixed Account.
STANDARD FIXED ACCOUNT Money in the Standard Fixed Account will earn interest
at the current rate in effect at the time of allocation or transfer to the
Standard Fixed Account for the guarantee period. We will offer a one year
guarantee period. Other guarantee periods will be offered at our discretion.
Subsequent renewal dates will be on anniversaries of the first renewal date.
After the initial guarantee period, a renewal rate will be declared.
CREDITING INTEREST We credit interest daily to money allocated to the Fixed
Account Option at a rate which compounds over one year to the interest rate we
guaranteed when the money was allocated. We will credit interest to the
initial purchase payment allocated to the Fixed Account Option from the issue
date. We will credit interest to subsequent purchase payments allocated to the
Fixed Account Option from the date we receive them at a rate declared by us.
We will credit interest to transfers to the Standard Fixed Account from the
date the transfer is made. The interest rate for the Fixed Account Option will
never be less than the minimum guaranteed rate shown on the Annuity Data Page.
TRANSFERS Prior to the Payout Start Date, you may transfer amounts among
Investment Alternatives. You may make 12 transfers per Contract Year without
charge. Each transfer after the 12th transfer in any Contract Year may be
assessed a transfer fee of .50% of the amount transferred. Transfers are
subject to the following restrictions:
1. The maximum amount transferable from the Standard Fixed Account during
any Contract Year is the greater of 30% of the Standard Fixed Account
balance as of the last Contract Anniversary or the greatest of any prior
transfer from the Standard Fixed Account. This limitation does not apply
to dollar cost averaging. However, if any interest rate is renewed at a
rate at least one percentage point less than the previous rate, the
Contract Owner may elect to transfer up to 100% of the Funds receiving
that reduced rate within 60 days of the notification of the interest
rate decrease. The Company reserves the right to defer transfers from
the Standard Fixed Account for up to six months from the date of
request.
2. The minimum amount that may be transferred from the Standard Fixed
Account or a Subaccount of the Variable Account is $100; if the total
amount remaining in the Standard Fixed Account or the Subaccount of the
Variable Account after a transfer would be less than $100, the entire
amount may also be transferred.
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3. We reserve the right to limit the number of transfers in any Contract
Year or to refuse any transfer request for an Owner or certain Owners
if, in our sole discretion, we believe that:
a. excessive trading by such Owner or Owners or a specific transfer
request or group of transfer requests may have a detrimental
effect on Unit Values or the share prices of the underlying mutual
funds or would be to the disadvantage of other Contract Owners; or
b. we are informed by one or more of the underlying mutual funds that
the purchase or redemption of shares is to be restricted because
of excessive trading or a specific transfer or group of transfers
is deemed to have a detrimental effect on share prices of affected
underlying mutual funds.
Such restrictions may be applied in any manner which is reasonably
designed to prevent any use of the transfer right which is considered by
us to be to the disadvantage of the other Contract Owners.
We reserve the right to waive the transfer restrictions contained in this
Contract.
CONTRACT VALUE On the issue date of the Contract, the "Contract Value" is
equal to the initial purchase payment. After the issue date, the "Contract
Value" is equal to the sum of:
1. the number of Accumulation Units you hold in each subaccount of the
Variable Account multiplied by the Accumulation Unit Value for that
subaccount on the most recent Valuation Date; plus
2. the total value you have in the Fixed Account Option.
If you withdraw the entire Contract Value, you may receive an amount less than
the Contract Value because a Withdrawal Charge, income tax withholding, and a
premium tax charge may apply.
VALUATION PERIOD AND VALUATION DATE A "Valuation Period" is the time interval
between the closing of the New York Stock Exchange on consecutive Valuation
Dates. A "Valuation Date" is any date the New York Stock Exchange is open for
trading.
ACCUMULATION UNITS AND ACCUMULATION UNIT VALUE Amounts which you allocate to a
subaccount of the Variable Account are used to purchase Accumulation Units in
that subaccount. The Accumulation Unit Value for each subaccount at the end of
any Valuation Period is calculated by multiplying the Accumulation Unit Value
at the end of the immediately preceding Valuation Period by the subaccount's
Net Investment Factor for the Valuation Period. The Accumulation Unit Values
may go up or down. Additions or transfers to a subaccount of the Variable
Account will increase the number of Accumulation Units for that subaccount.
Withdrawals or transfers from a subaccount of the Variable Account will
decrease the number of Accumulation Units for that subaccount.
NET INVESTMENT FACTOR For each Variable Subaccount, the "Net Investment
Factor" for a Valuation Period is equal to:
1. The sum of:
a. the net asset value per share of the mutual fund underlying the
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 mutual fund underlying the subaccount during the
current Valuation Period.
2. Divided by the net asset value per share of the mutual fund underlying
the subaccount determined as of the end of the immediately preceding
Valuation Period.
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3. The result is reduced by the Mortality and Expense Risk Charge
corresponding to the portion of the current calendar year that is in the
current Valuation Period.
CHARGES The charges for this Contract include Mortality and Expense Risk
Charges, transfer charges, and any applicable taxes. If a withdrawal is made,
the Contract may also be subject to a Withdrawal Charge.
MORTALITY AND EXPENSE RISK CHARGE The annualized Mortality and Expense Risk
Charge will never be greater than 1.65%. (See Net Investment Factor for a
description of how this charge is applied.)
Our actual mortality and expense experience will not adversely affect the
dollar amount of variable benefits or other contractual payments or values
under this Contract.
TAXES Any premium tax relating to this Contract may be deducted from purchase
payments or the Contract Value when the tax is incurred or at a later time.
WITHDRAWAL You have the right to withdraw part or all of your Contract Value
at any time during the Accumulation Phase. A withdrawal must be at least $50.
If any withdrawal reduces the Contract Value to less than $1,000, we will
treat the request as a withdrawal of the entire Contract Value. If you
withdraw the entire Contract Value, the Contract will terminate.
You must specify the Investment Alternative(s) from which you wish to make a
withdrawal. When you make a withdrawal, your Contract Value will be reduced by
the amount paid to you and any applicable Withdrawal Charge and/or taxes. Any
Withdrawal Charge will be waived on withdrawals taken to satisfy IRS minimum
distribution rules. This waiver is permitted only for withdrawals which
satisfy distributions resulting from this Contract.
WITHDRAWAL CHARGE Withdrawals will be subject to a Withdrawal Charge as
follows:
Payment Year: 1 2 3 and Later
Percentage: 2% 1% 0%
To determine the Withdrawal Charge, we assume that purchase payments are
withdrawn first, beginning with the oldest payment. When all purchase payments
have been withdrawn, additional withdrawals will not be assessed a Withdrawal
Charge.
For each purchase payment withdrawal, the "Payment Year" in the table is
measured from the date we received the purchase payment. The Withdrawal Charge
is determined by multiplying the percentage corresponding to the Payment Year
times each purchase payment withdrawal.
DEATH OF OWNER If you die prior to the Payout Start Date, the new Owner will
be the surviving Owner. If there is no surviving Owner, the new Owner will be
the Beneficiary(ies). The new Owner will have the options described below.
1. IF THE SOLE NEW OWNER IS YOUR SPOUSE:
a. Your spouse may elect, within 180 days of the date of your death,
to receive the Death Benefit described below in a lump sum.
b. Your spouse may elect, within 180 days of the date of your death,
to receive an amount equal to the Death Benefit paid out under one
of the Income Plans described in the Payout Phase section. The
Payout Start Date must be within one year of your date of death.
Income Payments must be:
i. over the life of your spouse; or
ii. for a guaranteed number of payments from 5 to 30 years but
not to exceed the life expectancy of your spouse; or
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iii. Over the life of your spouse with a guaranteed number of
payments from 5 to 30 years but not to exceed the life
expectancy of your spouse.
c. If your spouse does not elect one of the options above, then your
spouse may continue the Contract in the Accumulation Phase as if
the death had not occurred. If the Contract is continued in the
Accumulation Phase, the following conditions apply:
i. On the day the Contract is continued, the Contract Value
will be the Death Benefit as determined at the end of the
Valuation Period during which we received due proof of
death.
ii. The surviving spouse may make a single withdrawal of any
amount within one year of the date of death without
incurring a Withdrawal Charge.
iii. Prior to the Payout Start Date, the Death Benefit of the
continued Contract will be the greater of:
1) the sum of all purchase payments less any withdrawals,
as defined in the Death Benefit provision; or
2) the Contract Value on the date we determine the Death
Benefit; or
3) the Maximum Anniversary Value, as defined in the Death
Benefit provision, with the following changes:
A. "Date of Issue" is replaced by the date the
Contract is continued; and
B. "Initial purchase payment" is replaced with the
Death Benefit as determined at the end of the
Valuation Period during which we received due
proof of death.
2. IF THE NEW OWNER IS NOT YOUR SPOUSE BUT IS A NATURAL PERSON, THEN THIS
NEW OWNER HAS THE FOLLOWING OPTIONS:
a. The new Owner may elect, within 180 days of the date of your
death, to receive the Death Benefit described below in a lump sum.
b. The new Owner may elect, within 180 days of the date of your
death, to receive an amount equal to the Death Benefit paid out
under one of the Income Plans described in the Payout Phase
section. The Payout Start Date must be within one year of your
date of death. Income Payments must be:
i. over the life of the new Owner; or
ii. for a guaranteed number of payments from 5 to 30 years but
not to exceed the life expectancy of the new Owner; or
iii. Over the life of the new Owner with a guaranteed number of
payments from 5 to 30 years but not to exceed the life
expectancy of the new Owner.
c. The new Owner may elect to receive the Settlement Value payable in
a lump sum within 5 years of your date of death. The new Owner may
make a single withdrawal of any amount within one year of the date
of death without incurring a Withdrawal Charge.
3. IF THE NEW OWNER IS A CORPORATION OR OTHER NON-NATURAL PERSON:
a. The non-natural Owner may elect, within 180 days of your death, to
receive the Death Benefit in a lump sum.
b. The non-natural Owner may elect to receive the Settlement Value
payable in a lump sum within 5 years of your date of death.
If any new Owner is a non-natural person, all new Owners will be considered to
be non-natural persons for the above purposes.
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If the new Owner who is not your spouse does not make one of the above
described elections, the Settlement Value must be withdrawn by the new Owner
on or before the mandatory distribution date 5 years after your date of death.
Under any of these options, all ownership rights are available to the new
Owner from the date of your death to the date on which the Death Benefit or
Settlement Value is paid. We reserve the right to extend beyond 180 days the
period when we will pay the Death Benefit.
DEATH OF ANNUITANT If the Annuitant who is not also the Owner dies prior to
the Payout Start Date, the Owner must elect an applicable option listed below.
If the option selected is 1(a) or 1(b)(ii) below, the new Annuitant will be
the youngest Owner, unless the Owner names a different Annuitant.
1. IF THE OWNER IS A NATURAL PERSON:
a. The Owner may choose to continue this Contract as if the death had
not occurred; or
b. If we receive due proof of death within 180 days of the date of
the Annuitant's death, then the Owner may alternatively choose to:
i. Receive the Death Benefit in a lump sum; or
ii. Apply the Death Benefit to an Income Plan which must begin
within one year of the date of death.
2. IF THE OWNER IS A NON-NATURAL PERSON:
a. The non-natural Owner may elect, within 180 days of the
Annuitant's date of death, to receive the Death Benefit in a lump
sum; or
b. The non-natural Owner may elect to receive the Settlement Value
payable in a lump sum within 5 years of the Annuitant's date of
death.
If the non-natural Owner does not make one of the above described elections,
the Settlement Value must be withdrawn by the non-natural Owner on or before
the mandatory distribution date 5 years after the Annuitant's death.
Under any of these options, all ownership rights are available to the Owner
from the date of the Annuitant's death to the date on which the Death Benefit
or Settlement Value is paid. We reserve the right to extend beyond 180 days
the period when we will pay the Death Benefit.
DEATH BENEFIT Except as defined in the Death of Owner provision, when the
surviving spouse continues the Contract, prior to the Payout Start Date, the
Death Benefit is equal to the greatest of the following Death Benefit
alternatives:
1. the sum of all purchase payments less any withdrawals; or
2. the Contract Value on the date we determine the Death Benefit; or
3. the Maximum Anniversary Value.
a. On the date of issue, the Maximum Anniversary Value is equal to
the initial purchase payment.
b. After issue, the Maximum Anniversary Value is recalculated when a
purchase payment or withdrawal is made or on a contract
anniversary as follows:
i. For purchase payments, the Maximum Anniversary Value is
equal to the most recently calculated Maximum Anniversary
Value plus the purchase payment.
ii. For withdrawals, the Maximum Anniversary Value is equal to
the most recently calculated Maximum Anniversary Value
reduced by a withdrawal adjustment, as defined below.
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iii. On each contract anniversary, the Maximum Anniversary Value
is equal to the greater of the Contract Value or the most
recently calculated Maximum Anniversary Value.
In the absence of any withdrawals or purchase payments, the Maximum
Anniversary Value will be the greatest of all anniversary Contract Values on
or prior to the date we calculate the Death Benefit. The Maximum Anniversary
Value will be recalculated until the first Contract anniversary after the 80th
birthday of the oldest Owner or, if no Owner is a living individual, the
Annuitant. After that date, the Maximum Anniversary Value will be recalculated
only for purchase payments and withdrawals. The Maximum Anniversary Value will
never be greater than the maximum death benefit allowed by any non-forfeiture
laws which govern this Contract.
The withdrawal adjustment is equal to (a) divided by (b), with the result
multiplied by (c), where:
(a) = the withdrawal amount.
(b) = the Contract Value immediately prior to the withdrawal.
(c) = the value of the applicable Death Benefit alternative immediately
prior to the withdrawal.
We will determine the value of the Death Benefit as of the end of the
Valuation Period during which we receive a complete request for payment of the
Death Benefit. A complete request includes due proof of death.
SETTLEMENT VALUE The Settlement Value is the same amount that would be paid in
the event of a full withdrawal of the Contract Value. We will calculate the
Settlement Value at the end of the Valuation Period coinciding with the
requested distribution date for payment or on the mandatory distribution date
of 5 years after the date of death, whichever is earlier.
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PAYOUT PHASE
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PAYOUT PHASE DEFINED The "Payout Phase" is the second of the two phases during
your Contract. During this phase the Contract Value less any applicable taxes
is applied to the Income Plan you choose and is paid out as provided in that
plan.
The Payout Phase begins on the Payout Start Date. It continues until we make
the last payment as provided by the Income Plan chosen.
PAYOUT START DATE The "Payout Start Date" is the date the Contract Value less
any applicable taxes is applied to an Income Plan. The anticipated Payout
Start Date is shown on the Annuity Data Page. You may change the Payout Start
Date by writing to us at least 30 days prior to this date.
The Payout Start Date must be on or before the later of:
1. the Annuitant's 90th birthday; or
2. the 10th anniversary of the Contract's issue date.
INCOME PLANS An "Income Plan" is a series of payments on a scheduled basis to
you or to another person designated by you. The Contract Value on the Payout
Start Date less any applicable taxes, will be applied to your Income Plan
choice from the following list:
1. LIFE INCOME WITH GUARANTEED PAYMENTS. We will make payments for as long
as the Annuitant lives. If the Annuitant dies before the selected number
of guaranteed payments have been made, we will continue to pay the
remainder of the guaranteed payments.
2. JOINT AND SURVIVOR LIFE INCOME WITH GUARANTEED PAYMENTS. We will make
payments for as long as either the Annuitant or joint Annuitant, named
at the time of Income Plan selection, lives. If both the Annuitant and
the joint Annuitant die before the selected number of guaranteed
payments have been made, we will continue to pay the remainder of the
guaranteed payments.
3. GUARANTEED NUMBER OF PAYMENTS. We will make payments for a specified
number of months beginning on the Payout Start Date. These payments do
not depend on the Annuitant's life. The number of months guaranteed may
be from 60 to 360. Income payments for less than 120 months may be
subject to a Withdrawal Charge.
We reserve the right to make available other Income Plans.
INCOME PAYMENTS Income payment amounts may be Variable Amount Income Payments,
Fixed Amount Income Payments, or both. The method of calculating the initial
payment is different for the two types of payments.
VARIABLE AMOUNT INCOME PAYMENTS Variable Amount Income Payments will vary to
reflect the performance of the Variable Account. The portion of the initial
income payment based upon a particular Variable subaccount is determined by
applying the amount of the Contract Value in that subaccount on the Payout
Start Date, less any applicable premium tax, to the appropriate value from the
Income Payment Table. This portion of the initial income payment is divided by
the Annuity Unit Value on the Payout Start Date for that Variable subaccount
to determine the number of Annuity Units from that subaccount which will be
used to determine subsequent income payments. Unless transfers are made
between subaccounts, each subsequent income payment from that subaccount will
be that number of Annuity Units times the Annuity Unit Value for the
subaccount for the Valuation Date on which the income payment is made.
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ANNUITY UNIT VALUE The Annuity Unit Value for each subaccount of the Variable
Account at the end of any Valuation Period is calculated by:
1. multiplying the Annuity Unit Value at the end of the immediately
preceding Valuation Period by the subaccount's Net Investment Factor
during the period; and then
2. dividing the result by 1.000 plus the assumed investment rate for the
period. The assumed investment rate is an effective annual rate of 3%.
We reserve the right to offer an assumed investment rate greater than
3%.
FIXED AMOUNT INCOME PAYMENTS The income payment amount derived from any monies
allocated to the Fixed Account option during the Accumulation Phase is fixed
for the duration of the Income Plan. The Fixed Amount Income Payment is
calculated by applying the portion of the Contract Value in the Fixed Account
Option on the Payout Start Date, less any applicable premium tax, to the
greater of the appropriate value from the Income Payment Table selected or
such other value as we are offering at that time.
ANNUITY TRANSFERS After the Payout Start Date, you may transfer among the
variable subaccounts. You may make up to 12 transfers per Contract year. No
transfers may be made from the Fixed Amount Income Payment. Transfers from the
Variable Amount Income Payment to the Fixed Amount Income Payment may be made
only if Income Plan 3 has been chosen, and may not be made for six months
after the Payout Start Date.
PAYOUT TERMS AND CONDITIONS The income payments are subject to the following
terms and conditions:
1. If no purchase payments have been received for two years and the
Contract Value is less than $2,000, or not enough to provide an initial
payment of at least $20, we reserve the right to:
a. change the payment frequency to make the payment at least $20; or
b. terminate the Contract and pay you the Contract Value less any
applicable taxes in a lump sum.
2. If we do not receive a written choice of an Income Plan from you at
least 30 days before the Payout Start Date, the Income Plan will be Life
Income with Guaranteed Payments for 120 months.
3. If you choose an Income Plan which depends on any person's life, we may
require:
a. proof of age and sex before income payments begin; and
b. proof that the Annuitant or joint Annuitant is still alive before
we make each payment.
4. After the Payout Start Date, the Income Plan cannot be changed and
withdrawals cannot be made unless income payments are being made under
Income Plan 3. You may terminate the income payments being made under
Income Plan 3 at any time and withdraw their value, subject to
Withdrawal Charges.
5. If any Owner dies during the Payout Phase, the remaining income payments
will be paid to the successor Owner as scheduled.
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INCOME PAYMENT TABLES
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The initial income payment will be at least the amount based on the adjusted
age of the Annuitant(s) and the tables below, less any federal income taxes
which are withheld. The adjusted age is the actual age on the Payout Start
Date reduced by one year for each six full years between January 1, 1983 and
the Payout Start Date. Income payments for ages and guaranteed payment periods
not shown below will be determined on a basis consistent with that used to
determine those that are shown. The Income Payment Tables are based on 3.0%
interest and the 1983a Annuity Mortality Tables.
INCOME PLAN 1 - LIFE INCOME WITH GUARANTEED PAYMENTS FOR 120 MONTHS
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Monthly Income Payment for each $1,000 Applied to this Income Plan
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Annuitant's Annuitant's Annuitant's
Adjusted Male Female Adjusted Male Female Adjusted Male Female
Age Age Age
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35 $3.43 $3.25 49 $4.15 $3.82 63 $5.52 $4.97
36 3.47 3.28 50 4.22 3.88 64 5.66 5.09
37 3.51 3.31 51 4.29 3.94 65 5.80 5.22
38 3.55 3.34 52 4.37 4.01 66 5.95 5.35
39 3.60 3.38 53 4.45 4.07 67 6.11 5.49
40 3.64 3.41 54 4.53 4.14 68 6.27 5.64
41 3.69 3.45 55 4.62 4.22 69 6.44 5.80
42 3.74 3.49 56 4.71 4.29 70 6.61 5.96
43 3.79 3.53 57 4.81 4.38 71 6.78 6.13
44 3.84 3.58 58 4.92 4.46 72 6.96 6.31
45 3.90 3.62 59 5.02 4.55 73 7.13 6.50
46 3.96 3.67 60 5.14 4.65 74 7.31 6.69
47 4.02 3.72 61 5.26 4.75 75 7.49 6.88
48 4.08 3.77 62 5.39 4.86
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INCOME PLAN 2 - JOINT AND SURVIVOR LIFE INCOME WITH GUARANTEED PAYMENTS FOR 120 MONTHS
===========================================================================================================================
Monthly Income Payment for each $1,000 Applied to this Income Plan
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Female Annuitant's Adjusted Age
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Male
Annuitant's 35 40 45 50 55 60 65 70 75
Adjusted
Age
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35 $3.09 $3.16 $3.23 $3.28 $3.32 $3.36 $3.39 $3.40 $3.42
40 3.13 3.22 3.31 3.39 3.46 3.51 3.56 3.59 3.61
45 3.17 3.28 3.39 3.50 3.60 3.69 3.76 3.81 3.85
50 3.19 3.32 3.45 3.60 3.74 3.87 3.98 4.07 4.14
55 3.21 3.35 3.51 3.68 3.87 4.06 4.23 4.37 4.48
60 3.23 3.37 3.55 3.75 3.98 4.23 4.47 4.70 4.88
65 3.24 3.39 3.57 3.80 4.07 4.37 4.71 5.04 5.34
70 3.24 3.40 3.59 3.83 4.13 4.48 4.90 5.36 5.81
75 3.25 3.41 3.61 3.86 4.17 4.56 5.04 5.61 6.22
===========================================================================================================================
INCOME PLAN 3 - GUARANTEED NUMBER OF PAYMENTS
=============================================================================
Monthly Income Payment for each
Specified Period $1,000 Applied to this Income Plan
-----------------------------------------------------------------------------
10 Years $9.61
11 Years 8.86
12 Years 8.24
13 Years 7.71
14 Years 7.26
15 Years 6.87
16 Years 6.53
17 Years 6.23
18 Years 5.96
19 Years 5.73
20 Years 5.51
=============================================================================
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GENERAL PROVISIONS
-----------------------------------------------------------------------------
THE ENTIRE CONTRACT The entire contract consists of this Contract, any written
application, and any Contract endorsements and riders.
All statements made in a written application are representations and not
warranties. No statement will be used by us in defense of a claim or to void
the Contract unless it is included in a written application.
We may not modify this Contract without your consent, except to make it comply
with any changes in the Internal Revenue Code or as required by any other
applicable law. Only our officers may change this Contract. No other
individual may do this.
INCONTESTABILITY We will not contest the validity of this Contract after the
issue date.
MISSTATEMENT OF AGE OR SEX If any age or sex has been misstated, we will pay
the amounts which would have been paid at the correct age and sex.
If we find the misstatement of age or sex after the income payments begin, we
will:
1. pay all amounts underpaid including interest calculated at an effective
annual rate of 6%; or
2. stop payments until the total payments are equal to the corrected
amount.
ANNUAL STATEMENT At least once a year, prior to the Payout Start Date, we will
send you a statement containing Contract Value information. The effective date
of the information in the annual statement will not be more than two months
before date of mailing. We will provide you with Contract Value information at
any time upon request. The information presented will comply with any
applicable law.
SETTLEMENTS We may require that this Contract be returned to us prior to any
settlement. We must receive due proof of death of the Owner or Annuitant prior
to settlement of a death claim.
Any full withdrawal or Death Benefit under this Contract will not be less than
the minimum benefits required by any statute of the state in which the
Contract is delivered.
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DEFERMENT OF PAYMENTS We will pay any amounts due from the Variable Account
under this Contract within seven days, unless:
1. the New York Stock Exchange is closed for other than usual weekends or
holidays, or trading on such Exchange is restricted;
2. an emergency exists as defined by the Securities and Exchange
Commission; or
3. the Securities and Exchange Commission permits delay for the protection
of Contract holders.
We reserve the right to postpone payments or transfers from the Fixed Account
options for up to six months. If we elect to postpone payments from the Fixed
Account for 30 days or more, we will pay interest as required by applicable
law. Any interest would be payable from the date the withdrawal request is
received by us to the date the payment is made.
VARIABLE ACCOUNT MODIFICATIONS We reserve the right, subject to applicable
law, to make additions to, deletions from, or substitutions for the mutual
fund shares underlying the subaccounts of the Variable Account. We will not
substitute any shares attributable to your interest in a subaccount of the
Variable Account without notice to you and prior approval of the Securities
and Exchange Commission, to the extent required by the Investment Company Act
of 1940, as amended.
We reserve the right to establish additional subaccounts of the Variable
Account, each of which would invest in shares of a mutual fund. You may then
instruct us to allocate purchase payments or transfers to such subaccounts,
subject to any terms set by us or the mutual fund.
In the event of any such substitution or change, we may by endorsement, make
such changes as may be necessary or appropriate to reflect such substitution
or change.
If we deem it to be in the best interests of persons having voting rights
under the contracts, the Variable Account may be operated as a management
company under the Investment Company Act of 1940, as amended, or it may be
deregistered under such Act in the event such registration is no longer
required.
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