Ex. 4(e)
XXXXXXXXX XXXXXXXX LIFE
INSURANCE COMPANY OF AMERICA
[00000 Xxxxxxxx Xxxxx, Xxxxxxxxxx Xxxxx, Xxxxxxxx 00000]
Qualified Plan Rider
This Rider is part of the Contract. This Contract is issued to or purchased by
the trustee of a pension or profit-sharing plan intended to qualify under
section 401(a) of the Internal Revenue Code of 1986, as amended (the "Code").
The following provisions apply and replace any contrary Contract provisions:
(1) Except as allowed by the qualified pension or profit-sharing plan of
which this Contract is a part, the Contract may not be transferred,
sold, assigned, discounted or pledged, either as collateral for a
loan or as security for the performance of an obligation or for any
other purpose, to any person other than the Company.
(2) This Contract shall be subject to the provisions, terms and
conditions of the qualified pension or profit-sharing plan of which
the Contract is a part. Any payment, distribution or transfer under
this Contract shall comply with the provisions, terms and conditions
of such plan as determined by the plan administrator, trustee or
other designated plan fiduciary. The Company shall be under no
obligation either (a) to determine whether any such payment,
distribution or transfer complies with the provisions, terms and
conditions of such plan or with applicable law, or (b) to administer
such plan, including, without limitation, any provisions required by
the Retirement Equity Act of 1984.
(3) Notwithstanding any provision to the contrary in this Contract or
the qualified pension or profit-sharing plan of which this Contract
is a part, the Company reserves the right to amend or modify this
Contract or Rider to the extent necessary to comply with any law,
regulation, ruling or other requirement deemed by the Company to be
necessary to establish or maintain the qualified status of such
pension or profit-sharing plan.
Except as otherwise set forth above, this Rider is subject to the exclusions,
definition, and provisions of the contract.
President Secretary
20161
