Exhibit (4)(e)
Form of Variable Annuity Contract
[LOGO] PHOENIX
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Primary Annuitant: Xxxx Xxx 35 Male :Age and Sex
Contract Number: 13000000 December 12, 1994 :Contract Date
Initial Premium: $10,000.00 July 1, 2029 :Maturity Date
Dear Contract Owner:
Thank You for purchasing this annuity contract from Phoenix Home Life Mutual
Insurance Company. We agree to pay the benefits of this contract in accordance
with its provisions.
IT IS IMPORTANT TO US THAT YOU ARE SATISFIED WITH YOUR CONTRACT AND THAT IT
MEETS YOUR FINANCIAL GOALS. IF FOR ANY REASON YOU ARE NOT SATISFIED WITH THIS
CONTRACT, YOU MAY RETURN IT WITHIN 10 DAYS AFTER WE DELIVER IT TO YOU FOR A
REFUND OF THE CONTRACT VALUE PLUS ANY CHARGES MADE UNDER THIS CONTRACT. YOU MAY
RETURN IT TO EITHER THE AGENT THROUGH WHOM IT WAS PURCHASED OR TO US AT THE
FOLLOWING ADDRESS:
Phoenix Home Life Mutual Insurance Company
Variable Products Mail Operations
P.O. Box 8027
Boston, MA 02266-8027
Telephone (000) 000-0000
WE WILL DETERMINE THE CONTRACT VALUE AS OF THE NEAREST VALUATION DATE
FOLLOWING RECEIPT OF THE RETURNED CONTRACT AT OUR VARIABLE PRODUCTS MAIL
OPERATIONS.
This contract provides for a series of annuity payments. The annuity payments
will be based on the Contract Value on the Maturity Date, the annuity purchase
rates stated herein, and the investment experience of the Subaccounts during the
annuity payout period, and for variable payout options the amount of annuity
income will vary with the investment experience of the Subaccounts within the
Separate Account. The Contract Value will depend on the rate of interest
credited to the Guaranteed Interest Account and the investment experience of the
Subaccounts.
Signed for Phoenix Home Life Mutual Insurance Company at its Home Office, Xxx
Xxxxxxxx Xxx, Xxxxxxxx, Xxxxxxxxxxx 00000-0000.
Sincerely yours,
Phoenix Home Life Mutual INSURANCE COMPANY
/s/Xxxxx Xxxxxxx /s/Xxxxxx X. Xxxxxxxxx
Secretary Chief Executive Officer
Registrar
FLEXIBLE PREMIUM VARIABLE ACCUMULATION DEFERRED ANNUITY
ALL VALUES AND BENEFITS BASED ON THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS OF
THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE AND ARE VARIABLE AND NOT
GUARANTEED AS TO DOLLAR AMOUNT. SEE PART 7 FOR A DESCRIPTION OF HOW THE CONTRACT
VALUES ARE DETERMINED, PART 9 FOR A DESCRIPTION OF HOW THE DEATH BENEFITS ARE
DETERMINED, AND PART 10 FOR A DESCRIPTION OF HOW VARIABLE INCOME PAYMENTS ARE
DETERMINED.
NOT ELIGIBLE FOR ANNUAL DIVIDENDS
D602 NY
SCHEDULE PAGE
Primary Annuitant: [Xxxx Xxx] [35 Male] :Age and Sex
Contract Number: [13000000] [December 12, 1994] :Contract Date
Initial Premium: [$10,000.00] [July 1, 2029] :Maturity Date
Contingent Annuitant: [None]
Owner: [Xxxx Xxx]
Beneficiaries: [Xxxx Xxx]
Subsequent Premiums: [Flexible]
Payment Intervals: [Flexible]
If the annual rate of investment return on the assets of the Separate Account is
at least 5.875%, then the dollar amount of variable annuity payments will not
decrease.
Death Benefit Option: [1]
SUBACCOUNT FEES
Mortality and Expense Risk Fee: [.00226% (Based on an annual rate of .825%)]
Daily Administrative Fee: [.00034% (Based on an annual rate of .125%)]
CONTRACT FEES AND CHARGES
Premium Tax: [.000% of each premium payment]
Annual Administrative Charge: [$35] Any portion of the Annual Administrative
Charge against the Guaranteed Interest Account cannot exceed $30.
Transfer Charge: [Currently there is no charge for transfers. However, we
reserve the right to impose a Transfer Charge after the first two transfers made
in each Contract Year, upon prior Written Notice to the Owner. In no event,
however, will such Transfer Charge exceed $20 per transaction.]
PREMIUM ALLOCATION SCHEDULE
[Money Market #122 100.00%]
D602 NY
SCHEDULE PAGE (CONTINUED)
Annuitant: Xxxx Xxx 13000000 :Contract Number
GUARANTEED The Guaranteed Interest Account is not part
INTEREST ACCOUNT of the Separate Account. It is accounted for
as part of Our General Account. We reserve
the right to limit premium payments to the
Guaranteed Interest Account during any
one-week period to not more than $250,000.
We will credit interest daily on any amounts
held under the Guaranteed Interest Account
at such rates as We shall determine but in
no event will the effective annual rate of
interest be less than 3%. On the last
working day of each calendar week, We will
set the interest rate that will apply to any
premium made to the Guaranteed Interest
Account during the following calendar week.
That rate will remain in effect for such
premiums, or their resulting Adjusted
Premiums, for an initial guaranteed period
of one full year. Upon expiry of the initial
one-year guarantee period, and for any
premiums or Adjusted Premiums whose
guarantee has just ended shall be the same
rate that applies to new premiums made
during the calendar week in which the
guarantee period expired. Such rate shall
likewise remain in effect for such Adjusted
Premiums for a subsequent guarantee period
of one full year.
D602
SCHEDULE PAGE (CONTINUED)
Annuitant: Xxxx Xxx 13000000 :Contract Number
GUARANTEED INTEREST ACCOUNTS
GUARANTEED The GIA account with 1-year guarantee is not
INTEREST ACCOUNT part of the Separate Account. It is
WITH 1-YEAR accounted for as part of Our General
GUARANTEE Account. We reserve the right to limit
(GIA) cumulative premium payments to the GIA
account during any one-week period to not
more than $250,000. We will credit interest
daily on any amounts held under the GIA
account at such rates as We shall determine
but in no event will the effective annual
rate of interest be less than 3%. On the
last working day of each calendar week, We
will set the interest rate that will apply
to any premium made to the GIA account
during the following calendar week. That
rate will remain in effect for such
premiums, or their resulting Adjusted
Premiums, for an initial guaranteed period
of one full year. Upon expiry of the initial
one-year guarantee period, and for any
premiums or Adjusted Premiums whose
guarantee has just ended shall be the same
rate that applies to new premiums made
during the calendar week in which the
guarantee period expired. Such rate shall
likewise remain in effect for such Adjusted
Premiums for a subsequent guarantee period
of one full year. No market value adjustment
is applied to withdrawals from the GIA
account.
MARKET VALUE The MVA account provides four choices of
ADJUSTED interest rate guarantee periods; 3-year,
GUARANTEED 5-year, 7-year, and 10-year. The MVA
INTEREST ACCOUNT account is accounted for as a non-unitized
(MVA) separate account. We will credit interest
daily on any amounts held under the MVA
account at such rates as We shall determine
but in no event will the effective annual
rate of interest be less than 3%. On the
last working day of each calendar week, We
will set the interest rate that will apply
to any new premiums made during the
following calendar week to each of these
accounts. The applicable rate will remain in
effect until the end of the Guarantee Period
selected by you, the Contract Owner. Upon
expiry of the selected Guarantee Period,
unless you elect to transfer funds to
another Guarantee Period or Subaccount, or
elect to withdraw funds, We will begin
another Guarantee Period of the same
duration as the one that just ended, and
will credit interest at the then current
rate for that new Guarantee Period. If your
original Guarantee Period is no longer
available or if you choose a Guarantee
Period that is no longer available We will
use the Guarantee Period with the next
longest duration. To the extent permitted by
law, We reserve the right to discontinue
Guarantee Periods and to offer other
Guarantee Periods that differ from those
available at the time your contract was
issued. Any withdrawals or transfers from
the MVA will be subject to a market value
adjustment, except that funds may be
withdrawn or transferred from this account
without a market value adjustment in the
30-day Window Period from 15 days before to
15 days after the Guarantee Period expiry
date. We reserve the right to limit
cumulative premiums made to any one of these
accounts during any one-week period to not
more than $250,000.
D602
TABLE OF CONTENTS
PART PAGE
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SCHEDULE PAGES
CONTRACT SUMMARY
TABLE OF CONTENTS
1. DEFINITIONS.............................................1
2. ABOUT THIS CONTRACT.....................................4
The Effective Date......................................4
The Contract and Application............................4
Required Proof of Age and Survival......................5
Adjustment for Misstatement of
Age or Sex............................................5
Assignments.............................................5
Statement of Account....................................5
3. RIGHTS OF OWNER...........................................5
Who Is the Owner........................................5
What Are the Rights of the Owner........................5
How to Change the Owner Designation
Of Contingent Annuitant...............................6
Designation of Contingent Annuitant.....................6
4. ACCUMULATION PROVISIONS...................................7
Premium Payments........................................7
Premium Payment Allocation..............................7
Accumulation Units......................................7
Additional Subaccounts..................................8
Substitution of Subaccounts.............................8
5. TRANSFERS, WITHDRAWALS AND LAPSE..........................8
Transfers among Subaccounts and the
Guaranteed Interest Account...........................8
Xxxxxxxxxxx and Full Surrender..........................9
Lapse...................................................9
Rules and Limitations...................................9
Deferral of Payment.....................................9
6. EXPENSE CHARGES..........................................10
Premium Tax............................................10
Transfer Charge........................................11
Annual Administrative Charge...........................11
Mortality and Expense Risk Fee.........................11
Daily Tax Fee..........................................11
Daily Administrative Fee...............................11
7. DETERMINING THE CONTRACT AND
ACCUMULATION UNIT VALUES.................................11
Crediting of Subaccount Units and
Premiums.............................................11
Determination of the Contract Value....................12
The Valuation of Subaccounts and
Guaranteed Interest Account..........................12
8. ANNUITY BENEFITS.........................................12
9. DEATH BENEFITS...........................................13
Death Before Maturity Date.............................13
Death Benefit..........................................14
Adjusted Partial Withdrawals...........................14
Annual Step-up Amount..................................14
Distribution at Death Requirements.....................15
Death on or after the Maturity Date....................16
The Beneficiary........................................16
What Are the Rights of the Beneficiary.................16
How to Change the Beneficiary..........................16
10. PAYMENT OPTIONS.........................................17
Calculation of Fixed Annuity Payments..................17
Calculation of Variable Annuity Payments...............17
Option A - Life Annuity with Specified
Period Certain.......................................18
Option B - Non-Refund Life Annuity.....................18
Option D - Joint and Survivorship
Life Annuity.........................................18
Option E - Installment Refund Life Annuity.............18
Option F - Joint and Survivorship Life
Annuity with 10-Year Period Certain..................18
Option G - Payments for a Specified Period.............19
Option H - Payments of a Specified Amount..............19
Option I - Variable Life Annuity with
10-Year Period Certain...............................19
Option J - Joint Survivorship Variable
Life Annuity with 10-Year Period Certain.............19
Option K - Variable Annuity for
Specified Period.....................................19
Option L - Variable Life
Expectancy Annuity...................................19
Option M - Unit Refund Variable
Life Annuity.........................................20
Option N - Variable Non-Refund
Life Annuity.........................................20
Other Options..........................................20
11. TABLES OF PAYMENT OPTION AMOUNTS........................20
D602 NY
CONTRACT SUMMARY
ABOUT THIS SUMMARY This summary briefly highlights some of the
major contract provisions. Since this is
only a summary, the detailed provisions of
the contract will control. See those
provisions for full information and any
limits or restrictions that apply. A Table
of Contents is provided to help You find
specific provisions. Your contract is a
legal contract between You and Us. You
should, therefore, READ YOUR CONTRACT
CAREFULLY.
Check the Schedule Page of this contract to
make sure it reflects the premium allocation
requested. Please call Your agent or Us any
time You have questions about Your contract.
THE TYPE OF CONTRACT This contract provides for payment of a
variable life annuity. The amount of each
annuity payment will be based on the
Contract Value on the Maturity Date, the
annuity purchase rates stated herein, and
the investment experience of the Subaccounts
during the annuity payout period. Other
Annuity Payment Options are available.
ALLOCATION OF The values that accumulate under this
PREMIUM PAYMENTS contract prior to the Maturity Date are
based on the premium payments made, the
rates of interest credited on any premium
payments allocated to the Guaranteed
Interest Account, any expense charges, and
the investment experience of the Subaccounts
within the Separate Account on any premium
payments allocated to the Subaccounts.
Except for the Guaranteed Interest Account
which is part of Our General Account, the
Subaccounts are part of PHL Variable
Insurance Company's Variable Accumulation
Separate Account (VA Account) and have
differing investment objectives. Subject to
the terms of this contract, You may transfer
the Contract's Value between and among the
various Subaccounts and Guaranteed Interest
Account.
The VA Account is a Separate Account
established by Our company under Connecticut
Law and is registered as a unit investment
trust under the Investment Company Act of
1940. All income, gains and losses, realized
and unrealized, of the VA Account are
credited to or charged against the amounts
placed in the VA Account without reference
to other income, gains and losses of Our
General Account. The assets of the VA
Account are owned solely by Us and We are
not a trustee with respect to such assets.
These assets are not chargeable with
liabilities arising out of any other
business that We may conduct.
D602
We use the assets of the VA Account to buy
shares of the Fund(s) of this contract
according to Your most recent allocation
instruction on file with Us at Our Variable
Products Operations. The Fund(s) are
registered under the 1940 Act as an
open-end, diversified management investment
company. The Fund(s) have separate Series
that correspond to the Subaccounts of the VA
Account. Assets of each Subaccount are
invested in shares of the corresponding Fund
Series.
This contract also contains a Guaranteed
Interest Account to which premium payments
may be allocated. The Guaranteed Interest
Account is not part of the Separate Account.
It is accounted for as part of Our General
Account. We will credit interest on the
amount in the Guaranteed Interest Account at
such rate(s) as provided under the terms of
this contract. We reserve the right to add
other Guaranteed Interest Accounts subject
to approval (as required by some states) by
the insurance supervisory official of states
where this contract is delivered.
WITHDRAWAL PRIVILEGE Before the Maturity Date, You may withdraw
all or part of the Contract Value. After
the Maturity Date, You may only withdraw
from the remaining value under Variable
Payment Options K or L, less any applicable
contingent deferred sales charge.
OTHER BENEFITS This contract provides for the payment of
death proceeds in the event of the death of
either the Owner or the Annuitant. The
amount of the death proceeds will depend
upon whether it is the Owner or the
Annuitant whose death has occurred. The
amount of the death proceeds is determined
as described in Part 9 of this Contract.
D602 NY
PART 1: DEFINITIONS
YOU (YOUR) The Owner of this contract.
WE (OUR, US) Phoenix Home Life Mutual Insurance Company
ACCUMULATION UNIT A standard of measurement as described in
Part 4, used to determine the value of a
Contract and its interest in the Subaccounts
prior to the Maturity Date and for amounts
held under Payment Option L.
ACCUMULATION UNIT VALUE On the first Valuation Date selected by Us,
We set all Accumulation Unit Values of each
Subaccount of the Separate Account at
1.000000. The Accumulation Unit Value on any
subsequent Valuation Date is determined by
multiplying the Accumulation Unit Value of
the Subaccount on the immediately preceding
Valuation Date by the Net Investment Factor
for that Subaccount for the Valuation Period
just ended.
ADJUSTED PREMIUM Any premium to the Guaranteed Interest
Account, as adjusted to include any interest
credited on and any contract charges or
withdrawals deducted from such premium
payment.
ANNUITANT On or prior to the Maturity Date, the term
"Annuitant" as used in this contract refers
to the Primary Annuitant as shown on the
Schedule Page, while such Primary Annuitant
is living, and then the Contingent
Annuitant, if any, or as later changed by
You in writing, provided such Contingent
Annuitant is living at the death of the
Primary Annuitant. After the Maturity Date,
the term "Annuitant" shall mean the
Annuitant under this contract determined as
of the Maturity Date.
ANNUITANT'S BENEFICIARY The beneficiary entitled to receive payment
of any amounts payable under this contract
upon death of the Annuitant.
ANNUITY A contract promising a periodic series of
payments.
ANNUITY UNIT A standard of measurement used to determine
the amount of each periodic payment made
under the Variable Payment Options I, J, K,
M and N. The number of Annuity Units in each
Subaccount with assets under the chosen
option is equal to the portion of the first
payment provided by that Subaccount divided
by the Annuity Unit Value for that
Subaccount on the first Payment Calculation
Date.
D602 NY 1
ANNUITY UNIT VALUE On the first Valuation Date selected by Us,
We set all Annuity Unit Values in each
Subaccount of the Separate Account at
$1.000000. The Annuity Unit Value on any
subsequent Valuation Date is equal to the
Annuity Unit Value of the Subaccount on the
immediately preceding Valuation Date
multiplied by the Net Investment Factor for
that Subaccount for the Valuation Period
divided by 1.000000 plus the rate of
interest for the number of days in the
Valuation Period based on the Assumed
Investment Rate.
ASSIGNS Any person to whom You assign an interest in
this contract if We have Written Notice of
the assignment in accordance with the
provisions stated in Part 2.
ASSUMED INVESTMENT RATE The Assumed Investment Rate is 4.5% per
year. We use this rate to determine the
first payment under Variable Payment Annuity
Options I, J, K, M and N. Future payment
amounts under these options will depend on
the relationship between the Assumed
Investment Rate and the actual investment
performance of each Subaccount as reflected
in the Subaccount's Annuity Unit Value. The
Assumed Investment Rate is the net annual
investment return that will need to be
earned by each Subaccount of the Separate
Account for there to be no reduction in the
amount of the monthly payments under these
options.
CONTRACT ANNIVERSARY The same date each year as the Contract
Date.
CONTRACT DATE The Contract Date shown on the Schedule
Page. It is the date from which Contract
Years and anniversaries are measured.
CONTRACT VALUE The sum of the values under a Contract of
all Accumulation Units held in the
Subaccounts and the Adjusted Premium
Payments held in the Guaranteed Interest
Account.
CONTRACT YEAR The first Contract Year is the one-year
period from the Contract Date. Following
Contract Years run from one Contract
Anniversary to the next.
FIXED PAYMENT ANNUITY An annuity providing payments which do not
vary in amount after the first payment is
made.
MATURITY DATE The Maturity Date shown on the Schedule Page
or such changed Maturity Date as may result
from death of the Primary Annuitant while a
Contingent Annuitant is living or as We may
later agree. The Maturity Date may not be
earlier than the fifth Contract Anniversary,
or later than the Contract Anniversary
nearest the Annuitant's 90th
D602 NY 2
birthday unless We agree otherwise. If a
Contingent Annuitant becomes the Annuitant
as the result of death of the Primary
Annuitant prior to the Maturity Date, the
Maturity Date will change to the Contract
Anniversary nearest the Contingent
Annuitant's 90th birthday unless You and We
agree otherwise.
NET INVESTMENT FACTOR The Net Investment Factor for each
Subaccount of the Separate Account is
determined by the investment performance of
the assets underlying the Subaccount for the
Valuation Period just ended. The Net
Investment Factor is equal to 1.000000 plus
the applicable net investment rate for the
Valuation Period. The net investment rate is
determined by:
a. taking the sum of the accrued net
investment income and capital gains
and losses, realized or unrealized, of
the Subaccount for the Valuation
Period. The net investment income is
affected by an investment advisory
expense fee which is deducted from the
Funds in which the assets of the
Subaccounts of the Separate Account
are invested; and
b. dividing the result of (a) by the
value of the Subaccount at the
beginning of the Valuation Period; and
c. for each calendar day in the Valuation
Period subtracting from the result of
(a) divided by (b), an amount equal to
the Mortality and Expense Risk Fee
and any daily tax fee.
OWNER/ANNUITANT An individual who is both the Owner and
Annuitant under the contract.
OWNER'S BENEFICIARY The beneficiary entitled to receive payment
of any amounts payable under this contract
upon death of the Owner.
PAYMENT CALCULATION DATE The date We calculate annuity payments under
a Variable Payment Annuity Option. The first
Payment Calculation Date is the Valuation
Date on or next following the Settlement
Date unless We agree otherwise.
After the first Payment Calculation Date, We
will calculate payments on the same date
each month. We use the next following
Valuation Date if such date is not a
Valuation Date.
D602 NY 3
PREMIUM PAYMENT DATE The Valuation Date on which a premium
payment is received at Our Variable Products
Operations unless it is received after the
close of the New York Stock Exchange, in
which case it will be the next Valuation
Date.
SETTLEMENT DATE The date contract proceeds are applied to an
annuity payment option. Unless We agree
otherwise, for death benefits, the
Settlement Date is the date that We receive
a certified copy of the Annuitant's
certificate of death; for proceeds payable
on the Maturity Date, it is the Maturity
Date; and for proceeds payable upon a
surrender, it is the effective date of the
surrender.
SUBACCOUNT(S) The account(s) within Our Separate Account
to which assets under the contract may be
allocated.
SURRENDER VALUE Contract Value less any applicable contigent
deferred sales charge and premium tax.
VALUATION DATE Every day the New York Stock Exchange is
open for trading and PHL Variable Insurance
Company is opened for business.
VALUATION PERIOD The period in days beginning with the day
following the last Valuation Date and ending
on the next succeeding Valuation Date.
VARIABLE PAYMENT ANNUITY An annuity where each payment will vary with
the investment experience of the
Subaccounts.
VPMO Our Variable Products Mail Operations
division. The address is shown on the cover
page of this contract.
WRITTEN REQUEST A request We receive in writing at VPMO in a
(AND WRITTEN NOTICE) form satisfactory to Us.
PART 2: ABOUT THIS CONTRACT
THE EFFECTIVE DATE This contract will begin in effect on the
Contract Date provided the initial premium
due is paid while the Annuitant is alive.
THE CONTRACT This contract and application, if any, which
AND APPLICATION is attached to this contract, is the entire
contract between You and Us. Any change in
terms of this contract, as required to
conform to law, to be in effect, must be
signed by one of Our executive officers and
countersigned by Our registrar or one of Our
executive officers. This contract is issued
at Our Home Office in Hartford, Connecticut.
Any benefits payable under this contract are
payable at VPMO.
D602 NY 4
REQUIRED PROOF We may require proof of the Annuitant's age
OF AGE AND SURVIVAL before any annuity payments will begin. We
also have the right to require proof of the
identity, age and survival of any person
entitled to any payment under this contract
or upon whose life any payments depend.
ADJUSTMENT FOR If the age or sex of the Annuitant has been
MISSTATEMENT OF misstated, any benefits payable will be
AGE OR SEX adjusted to the amount that the Contract
Value would have purchased based on the
Annuitant's correct age and sex. Any over
payment(s) and under payment(s) made by Us
will be charged or credited against future
payments to be made under the contract. We
will charge interest on overpayments and
credit interest on any underpayments at an
effective annual rate of 6%.
ASSIGNMENTS We will not be considered to have notice of
any assignment of an interest in this
contract until We receive the original or
copy of the written assignment at VPMO. In
no event will We be responsible for its
validity.
STATEMENT OF ACCOUNT We will send You a statement of the Contract
Value, Surrender Value and Death Benefit at
least annually. We will also provide You
with a statement of the investments held by
each Subaccount. After the Maturity Date, We
will provide You with an annual Statement of
Account if You elect any of the variable
payment options.
PART 3: RIGHTS OF OWNER
WHO IS THE OWNER The Owner may be the Annuitant, an employer,
a trust or any other individual or entity.
If no Owner is named, the Annuitant will be
the Owner. Under contracts used with certain
tax qualified plans, the Owner must be the
Annuitant.
WHAT ARE THE RIGHTS You control this contract during the
OF THE OWNER Annuitant's lifetime but not until the
Contract Date. Unless You and We agree
otherwise, You may exercise all rights
provided under this contract without the
consent of anyone else. Your rights include
the right to:
a. Receive any amounts payable under this
contract during the Annuitant's
lifetime.
b. Change the Owner.
D602 NY 5
c. Change the premium payment amounts and
intervals. See Part 4.
d. Change the allocation schedule for
premium payments. See Part 4.
e. Transfer Contract Values between and
among the various Subaccounts and the
Guaranteed Interest Account. See Part
5.
f. Make withdrawals from the various
Subaccounts and the Guaranteed
Interest Account or fully surrender
the contract for its Surrender Value.
See Part 5.
g. Select a Payment Option for amounts
payable upon a withdrawal or full
surrender.
h. Select an alternative Payment Option
to commence on the Maturity Date. See
Part 8.
i. Change the Owner's or Annuitant's
Beneficiary.
j. Assign, subject to the restrictions
stated in Part 2, release, or
surrender any interest in this
contract. See Parts 2 and 5.
k. Change the Contingent Annuitant any
time prior to the death of the Primary
Annuitant.
You may exercise these rights only while the
Annuitant is alive. Your exercise of any
rights will, to the extent thereof, assign,
release, or surrender the interest of the
Annuitant and all beneficiaries and Owners
under this contract.
HOW TO CHANGE THE OWNER To change the Owner, you must submit a
Written Request.
DESIGNATION OF Prior to the death of the Annuitant, You may
CONTINGENT ANNUITANT designate or change the Contingent Annuitant
by sending a Written Request with the name,
date of birth, sex, Social Security Number
and address of the new Contingent Annuitant.
If You are an Owner/Xxxxxxxxx and Your
spouse is Your beneficiary under this
Contract, Your surviving spouse will
automatically be the Contingent Annuitant.
D602 6
PART 4: PREMIUM PAYMENTS AND ALLOCATION
PREMIUM PAYMENTS The initial premium payment is due on the
Contract Date and must at least equal
$1,000 unless We agree otherwise. The
Annuitant must be alive when the initial
premium payment is made. Thereafter, the
premium payment amount and intervals are as
shown on the Schedule Page unless later
changed as described below. All premium
payments are payable at VPMO, except that
the initial premium payment may be given to
an authorized agent for forwarding to VPMO.
No benefit associated with any such premium
payment will be provided until it is
actually received by Us at VPMO.
You may vary the amount and interval for
subsequent premium payments, and additional
premium payments may be made within the
following limits:
a. Each premium payment must at least
equal $25.
b. No more than $1,000,000 in total
premium payments may be paid on this
contract, unless We agree otherwise.
c. The premium payment intervals may be
unscheduled or changed to monthly,
quarterly, semi-annual, annual, or any
other arrangement agreed to by Us.
d. Additional premium payments may only
be made while an Annuitant is living,
prior to the Maturity Date.
We reserve the right to waive the limits in
a & b above.
PREMIUM The premium payment will be applied on its
PAYMENT ALLOCATION Premium Payment Date to the various
Subaccounts and the Guaranteed Interest
Account in accordance with Your instructions
for the allocation of premium payments.
You may change the allocation schedule with
respect to subsequent premium payments by
written request. We reserve the right to
waive the requirement of written notice.
D602 NY 7
ACCUMULATION UNITS The number of Accumulation Units credited to
each Subaccount of the Separate Account will
be determined by dividing the premium
payment applied to that Subaccount by the
Accumulation Unit Value of that Subaccount
on the Premium Payment Date. The amount
deposited to the Guaranteed Interest Account
will equal the amount of any premium payment
applied on the Premium Payment Date.
ADDITIONAL SUBACCOUNTS We have the right to add Subaccounts of the
Separate Account subject to approval by the
Securities and Exchange Commission and,
where required, other regulatory authority.
We further reserve the right to add other
Guaranteed Interest Accounts.
SUBSTITUTION OF SUBACCOUNTS If the shares of the Funds of this contract
should no longer be available for investment
by the Separate Account or if in Our
judgment further investment in such Funds
becomes inappropriate for use with this
contract, We reserve the right to substitute
Accumulation Units of another Subaccount for
Accumulation Units already purchased or to
be purchased in the future by premium
payments under this contract. Any such
change will be subject to approval by the
Securities and Exchange Commission and,
where required, by the insurance supervisory
official of the state where this contract is
issued.
PART 5: TRANSFERS, WITHDRAWALS AND LAPSE
TRANSFERS AMONG You may transfer all or a portion of the
SUBACCOUNTS AND THE Contract Value of this contract among one
GUARANTEED INTEREST ACCOUNT or more of the Subaccounts and the
Guaranteed Interest Account. Transfers may
be made by telephone or Written Request. You
can make up to 12 transfers per Contract
Year from the Subaccounts and only one
transfer per Contract Year from the
Guaranteed Interest Account unless the
Systematic Transfer Program is elected.
Under the Systematic Transfer Program, funds
may be transferred automatically among the
Subaccounts on a monthly, quarterly,
semi-annual or annual basis. Unless We agree
otherwise, the minimum initial and
subsequent transfer amounts are $25 monthly,
$75 quarterly, $150 semi-annually or $300
annually. Except as otherwise provided under
the Systematic Transfer Program, the amount
that may be transferred from the Guaranteed
Interest Account at any one time cannot
exceed the higher of $1000 or 25% of the
value of the Guaranteed Interest Account.
A Contract Owner must have an initial value
of $2,000 in the GIA or the Subaccount that
funds will be transferred from. Funds may be
transferred from only one sending Subaccount
or the GIA but may be allocated to multiple
receiving Subaccounts. Under the Systematic
Transfer Program, Contract Owners may
transfer approximately equal amounts from
the GIA over a minimum 18-month period.
D602 NY 8
The transfer charge is as shown on the
Schedule Page. Any such charge will be
deducted from the Subaccounts or Guaranteed
Interest Account from which the amounts are
to be transferred with each such Subaccount
or Guaranteed Interest Account bearing a
pro rata share of the transfer charge. The
value of each Subaccount will be determined
on the Valuation Date that coincides with
the date of transfer. Any Accumulation Units
held under a Subaccount of the Separate
Account or Adjusted Premiums held under the
Guaranteed Interest Account as the result of
any transfer shall retain its original
Premium Payment Date.
WITHDRAWALS AND FULL You may withdraw in cash the Contract Value
SURRENDER of this contract, less any applicable
deferred premium tax or contingent deferred
sales charge, in whole or in part any time
prior to the Maturity Date or at any time
for amounts held under Variable Payment
Annuity Options K or L. Such withdrawals
must be by Written Request and must include
such tax withholding information as We may
reasonably require. The portion withdrawn
from any Subaccount will be taken by the
surrender and release of such number of
Accumulation Units in such Subaccount
required to make the withdrawal, including
any deferred premium tax or contingent
deferred sales charge applicable to such
withdrawal. Any portion withdrawn from the
Guaranteed Interest Account will be taken by
the release of Adjusted Premiums in the
amount needed to make the withdrawal,
including any deferred premium tax or
contingent deferred sales charge applicable
to such withdrawal. If no Contract Value
remains under this contract as the result of
a withdrawal, the contract will be deemed
fully surrendered and have no further value
or effect. The Contract Value will be
determined on the Valuation Date that
coincides with the date of the withdrawal.
During the first Contract Year, an amount up
to 10% of the Contract Value at the time of
the first partial withdrawal may be
withdrawn free of any contingent deferred
sales charge. After the first Contract Year
and each Contract Year before the Maturity
Date, and amount up to 10% of the Contract
Value as of the end of the prior Contract
Year may be withdrawn free of any contingent
deferred sales charge. Any amount withdrawn
in excess of the 10% will be subject to the
following contingent deferred sales charge,
expressed as a percentage of the amount
withdrawn up to a maximum of the total
premium.
D602 NY 9
AGE IN COMPLETE YEARS FROM PAYMENT
----------------------------------
DATE OF UNIT OR ADJUSTED PREMIUM CONTINGENT DEFERRED
-------------------------------- -------------------
RELEASED TO EFFECTUATE WITHDRAWAL SALES CHARGE
--------------------------------- ------------
0 7%
1 7%
2 6%
3 6%
4 5%
5 4%
6 3%
7 and over 0%
In no event, however, will the total of all
contingent deferred sales charges applied
under this contract exceed 9% of the total
premium payments paid on this contract.
You may elect to apply the amount withdrawn
or surrendered to the various Payment
Options described in Part 10.
LAPSE If on any Valuation Date the Contract Value
becomes zero, the contract will immediately
terminate and lapse without value unless any
Contract Value has been applied under one of
the variable payment options within 30 days
after any such Valuation Date. We will mail
a written notice of lapse to You at Your
most recent post office address on file with
Us at VPMO.
RULES AND LIMITATIONS The Accumulation Units and Adjusted Premiums
released for transfer or withdrawal will be
determined on a First-In, First-Out (FIFO)
basis based on Premium Payment Date. No
withdrawals, or full surrender may be made
after commencement of an annuity on the
Maturity Date except for any Contract Value
remaining under Options K or L. Also, You
may not transfer any assets under Option M,
unless We agree otherwise.
DEFERRAL OF PAYMENT With the exception of transfers from the
Guaranteed Interest Account, as described
above under Transfers Among Subaccounts and
withdrawals from such Subaccount as
described below, transfers, withdrawals, or
a request for a full surrender will usually
be processed within 7 days after We receive
the written request at VPMO. However, We may
postpone the processing of any such
transactions for any of the following
reasons (as provided under the Investment
Company Act of 1940):
a. when the New York Stock Exchange is
closed, other than customary weekend
and holiday closings;
D602 10
b. when trading on the exchange is
restricted by the Securities and
Exchange Commission;
c. when the Securities and Exchange
Commission declares that an emergency
exists as a result of which disposal
of securities in the Fund is not
reasonably practicable or it is not
reasonably practicable to determine
the value of the Units in the
Subaccounts of the Separate Account;
or
d. when a governmental body having
jurisdiction over the VA Account by
order permits such suspension.
Rules and regulations of the Securities and
Exchange Commission, if any, are applicable
and will govern as to whether conditions
described in (b) or (c) or (d) exist.
For withdrawals from the Guaranteed Interest
Account, We may defer payment for up to six
months from the date VPMO receives the
Written Request. If payment is delayed 10
working days or more, We will add interest
at an annual rate equal to that paid under
settlement options G and H.
PART 6: EXPENSE CHARGES
Charges to cover expenses incurred by Us in
the distribution and administration of this
contract are made in the manner described
below.
PREMIUM TAX A premium tax may be required based on the
laws of the state of issue or the state
where the Owner resides when a premium
payment is applied. The premium tax rate, if
any, as of the Contract Date, is shown on
the Schedule Page. This rate may change for
subsequent premium payments in accordance
with applicable state law. We will pay any
premium tax due and will only reimburse
ourselves upon the earlier of partial
withdrawal, surrender of the Contract,
payment of death proceeds or the Maturity
Date. At the time of reimbursement, We will
deduct the tax proportionately from the
Subaccounts and Guaranteed Interest Account
based on their proportionate Contract Value.
On partial withdrawals, We will deduct a
pro rata amount of the tax based upon the
ratio of the amount withdrawn to the
Contract Value.
D602 NY 11
SURRENDER CHARGE A charge to cover expenses incurred in the
sale and distribution of this contract is
taken in the form of a contingent deferred
sales charge as described in Part 5 which is
applied to any withdrawals or full surrender
made within the seven-year period following
the Premium Payment Date of the Accumulation
Units or Adjusted Premiums released to make
such withdrawal or surrender.
TRANSFER CHARGE A transfer charge is as shown on the
Schedule.
ANNUAL ADMINISTRATIVE A portion of the administrative expense
CHARGE incurred by Us is assessed in the form of an
annual charge as shown on the Schedule Page.
We reserve the right to lower such charge.
Such charge will be deducted at the end of
each Contract Year from the total Contract
Value with each Subaccount and Guaranteed
Interest Account bearing a pro rata share of
such expense based on the proportionate
Contract Value of each of the Subaccounts
and Guaranteed Interest Account. By
agreement with Us, You may, instead, elect
to pay this charge in cash.
MORTALITY AND The mortality and expense risk charge is
EXPENSE RISK FEE taken in the form of a daily fee against
each Subaccount as shown on the Schedule
Page. We reserve the right to lower such
fee.
DAILY ADMINISTRATIVE FEE A portion of the administrative expense
incurred by Us is assessed in the form of a
daily fee against each Subaccount shown on
the Schedule Page.
PART 7: DETERMINING THE CONTRACT AND
ACCUMULATION UNIT VALUES
CREDITING OF SUBACCOUNT We will apply any premium payments We
UNITS AND PREMIUMS receive on the Premium Payment Date to
credit Accumulation Units to one or more
Subaccounts or to credit purchases to the
Guaranteed Interest Account in accordance
with the most recent allocation schedule on
file with Us. The number of Accumulation
Units credited to each
D602 NY 12
Subaccount will be determined by dividing
the premium payment,applied to that
Subaccount by the then current Accumulation
Unit Value of that Subaccount. The
Accumulation Unit Value of each Subaccount
on a Valuation Date is determined at the end
of that day.
DETERMINATION OF THE Prior to the Maturity Date, the value of a
CONTRACT VALUE Subaccount of the Separate Account is
determined by multiplying the total number
of Accumulation Units under this contract
for that Subaccount by the current
Accumulation Unit Value of that Subaccount.
The Contract Value for amounts held under
Variable Payment Annuity Option L is
determined in the same manner. The value of
the Guaranteed Interest Account equals the
total value of the Adjusted Premiums. The
total Contract Value under this contract
equals the sum of the values of each of the
Subaccounts and the Adjusted Premiums.
THE VALUATION OF SUB- The values and benefits of the Guaranteed
ACCOUNTS AND GUARANTEED Interest Account are not less than those
INTEREST ACCOUNT required by the laws of the state in which
it is delivered.
The values of the assets in each Subaccount
will be calculated in accordance with
applicable law and accepted procedures.
We guarantee that expense and mortality
results shall not adversely affect the
dollar amount of variable benefits and other
contractual payments and values.
PART 8: ANNUITY BENEFITS
On or before the Maturity Date, You may
elect any one of the Payment Options as
described in Part 10. If you do not select a
Payment Option on or before the Maturity
Date, We will apply the Contract Value less
any premium tax due to provide You a
variable life annuity under Payment Option L
as described in Part 10. Any annuity
payments falling due after the Annuitant's
death during the period certain will be paid
to the Annuitant's Beneficiary.
If the amount to be applied on the Maturity
Date is less than $2,000 or would result in
monthly payments of less than $20, We shall
have the right to pay such amount to You in
one lump sum in lieu of providing such
annuity. We also have the right to change
the annuity payment frequency to annual if
the monthly annuity payment would otherwise
be less than $20.
D602 13
PART 9: DEATH BENEFITS
The death benefits provided under this
contract are not less than the minimum
benefits required under the laws of the
state where this contract is delivered.
DEATH BEFORE For deaths occurring prior to the Maturity
MATURITY DATE Date, We will pay the death proceeds upon
receipt of due proof of death as follows:
1. Death of an Owner/Annuitant:
If an Owner/Xxxxxxxxx dies before the
Maturity Date, We will pay the
Annuitant's Beneficiary the death
proceeds provided by the Death Benefit
Option selected by the Owner at the
time of the initial premium payment.
2. Death of an Owner who is not the
Annuitant:
If an Owner who is not the Annuitant
dies before the Maturity Date, we will
pay the Owner's Beneficiary the death
proceeds (less any deferred premium
tax) equal to the greater of:
a. 100% of premium payments less
"Adjusted Partial Withdrawals"
(as defined below); or
b. the Contract Value next
determined following receipt of a
certified copy of the death
certificate at VPMO.
3. Death of an Annuitant who is not the
Owner:
If an Annuitant who is not the Owner
dies before the Maturity Date, We will
pay the Annuitant's Beneficiary the
death proceeds provided by the Death
Benefit Option selected by the Owner
at the time of the initial premium
payment.
In lieu of receiving the death proceeds in
one lump sum, the beneficiary may elect to
apply the death proceeds under any of the
Payment Options described in Part 10 subject
to the following limitations:
a. Options D, F and J are not
available for death benefits;
b. Under Options A, E, G, H and K
the period specified must be at
least 5 years, but not beyond the
life expectancy of such
beneficiary.
D602 14
ELECTION OF DEATH In addition to Death Benefit Option 1,
BENEFIT OPTIONS We may make available Death Benefit
Option 2 and or Death Benefit Option 3.
The Owner shall elect any one of these
Death Benefit Options that We make
available at the time of the Owner's
initial premium payment. The Owner's
chosen option is as shown on the
Schedule Page. If no option is elected,
Death Benefit Option 1 shall apply.
DEATH BENEFIT - OPTION 1 Upon the death of the Annuitant or an
Owner/Xxxxxxxxx who has not yet attained age
80, the death proceeds (less any deferred
premium tax) is equal to the greater of:
a. 100% of premium payments less
"Adjusted Partial Withdrawals"
(as defined below); or
b. the Contract Value next
determined following receipt of
a certified copy of the death
certificate at VPMO.
On and after the Annuitant's attained age
80, the death proceeds (less any deferred
premium tax) equals the Contract Value (no
surrender charge is imposed) next determined
following receipt of a certified copy of the
death certificate at VPMO.
DEATH BENEFIT - OPTION 2 Upon the death of the Annuitant or an
Owner/Xxxxxxxxx who has not yet attained age
80, the death proceeds (less any deferred
premium tax) is equal to the greater of:
a. 100% of premium payments less
"Adjusted Partial Withdrawals"
(as defined below); or
b. the "Annual Step-up Amount"
(as defined below); or
c. the Contract Value next
determined following receipt of a
certified copy of the death
certificate at VPMO.
On and after the Annuitant's attained age
80, the death proceeds (less any deferred
premium tax) equals the Contract Value (no
surrender charge is imposed) next determined
following receipt of a certified copy of the
death certificate at VPMO.
DEATH BENEFIT - OPTION 3 Upon the death of the Annuitant or an
Owner/Xxxxxxxxx who has not yet attained age
80, the death proceeds (less any deferred
premium tax) is equal to the greater of:
a. 100% of premium payments less
"Adjusted Partial Withdrawals"
(as defined below); or
D602 15
b. the "Annual Step-up Amount" (as
defined below); or
c. the "Annual Roll-up Amount" (as
defined below); or
d. the Contract Value next
determined following receipt of a
certified copy of the death
certificate at VPMO.
On and after the Annuitant's attained age
80, the death benefit (less any deferred
premium tax) equals the Contract Value (no
surrender charge is imposed) next determined
following receipt of a certified copy of the
death certificate at VPMO.
ADJUSTED PARTIAL WITHDRAWALS The sum of all Adjusted Partial Withdrawals
when each is calculated for each partial
withdrawal as the product of (a) times (b)
where:
a. is the ratio of the amount of
the partial withdrawal to the
Contract Value on the date of
(but prior to) the partial
withdrawal; and
b. is the death benefit on the date
of (but prior to) the partial
withdrawal.
ANNUAL STEP-UP AMOUNT In the first Contract Year the Annual
Step-up Amount is equal to the greater of:
a. 100% of premium payments less
"Adjusted Partial Withdrawals";
or
b. the Contract Value.
In the second Contract Year or any
subsequent Contract Year the Annual Step-up
Amount is equal to the greater of:
a. the Annual Step-up Amount at the
end of the previous Contract
Year, plus 100% of premium
payments made since the end of
the previous Contract Year, less
"Adjusted Partial Withdrawals"
made since the end of the
previous Contract Year; or
b. the Contract Value next
determined following receipt of a
certified copy of the death at
VPMO.
ANNUAL ROLL-UP AMOUNT In the first Contract Year the Annual
Roll-up Amount is equal to the initial
premium payment.
D602 16
At the beginning of the second Contract Year
or any subsequent Contract Year the Annual
Roll-up Amount is equal to the Roll-up
Amount at the end of the previous Contract
Year multiplied by a factor of 1.05, plus
100% of premium payments, less "Adjusted
Partial Withdrawals" made since the end of
the previous Contract Year. The Roll-up
Amount may not exceed 200% of total premium
payments less "Adjusted Partial
Withdrawals".
DISTRIBUTION AT DEATH If the Owner/Annuitant dies before the
REQUIREMENTS Maturity Date, then the Annuitant's
Beneficiary must elect within 60 days of
Our receipt of due proof of death to
receive the death proceeds in a lump sum or
elect to apply the death proceeds due under
a Payment Option, provided that the payments
begin within one year of the date of death
of the Annuitant. If the Annuitant's
Beneficiary is the surviving spouse, the
surviving spouse may elect to continue the
Contract as new Owner/Annuitant as if no
death had occurred.
If the Owner who is not the Annuitant dies
before the Maturity Date and the Owner's
surviving spouse is not the Joint Owner or
the Owner's Beneficiary, the Owner's entire
interest in this Contract must be
distributed within five years of the date of
the Owner's death, provided that the Owner's
Beneficiary may elect to apply the death
proceeds to a Payment Option not extending
beyond the life (or life expectancy) of the
Owner's Beneficiary and the payments begin
within one year after the Owner's death. If
the Owner's surviving spouse is a Joint
Owner, the Contract will continue with the
surviving Joint Owner becoming the sole
Owner. If the Owner's Beneficiary is the
surviving spouse, the surviving spouse may
elect to continue the Contract as the new
Owner as if no death had occurred.
If the Annuitant who is not the Owner dies
before the Maturity Date and there is no
Contingent Annuitant, then the Annuitant's
Beneficiary must elect within 60 days of Our
receipt of due proof of death to receive the
death proceeds in a lump sum or elect to
apply the death proceeds due under a Payment
Option, provided that the payments begin
within one year of the date of death of the
Annuitant. If there is a Contingent
Annuitant, the Contract will continue with
the Contingent Annuitant becoming the new
Annuitant.
If the Annuitant dies before the Maturity
Date and the Owner is not an individual, the
entire interest in this contract must be
distributed within five years of the date of
the Annuitant's death. However, the
Annuitant's Beneficiary may elect to apply
the death proceeds to
D602 17
a Payment Option not extending beyond the
life (or life expectancy) of such
Xxxxxxxxx's Beneficiary and the payments
begin within one year after the Annuitant's
death. If the Annuitant's Beneficiary is the
surviving spouse, the surviving spouse may
elect to continue the Contract as new
Annuitant as if no death had occurred.
We shall have the right to first require
return of the contract to us so that we may
amend it to reflect these changes.
DEATH ON OR AFTER THE If either the Owner/Xxxxxxxxx, Annuitant, or
MATURITY DATE Owner dies on or after the Maturity Date,
any remaining income payments will be
continued to the Annuitant's or Owner's
Beneficiary respectively. Under Payment
Option M, the sum of the number of remaining
Annuity Units for each Subaccount multiplied
by the current Annuity Unit Value for that
Subaccount will be paid to the Annuitant's
or Owner's Beneficiary in a lump sum, (see
"Option M - Unit Refund Variable Life
Annuity" in Part 10).
THE BENEFICIARY The Annuitant's Beneficiary:
----------------------------
Any death proceeds payable to the
Annuitant's Beneficiary will be paid
to the Owner or the Owner's estate if
the Annuitant's Beneficiary is not
living when such death proceeds become
payable.
The Owner's Beneficiary:
------------------------
Any death proceeds payable to the
Owner's Beneficiary will be paid to
the Owner's estate if the Owner's
Beneficiary is not living when such
death proceeds become payable.
In the case of the death of an
Owner/Annuitant where conflicting Owner and
Xxxxxxxxx's Beneficiaries have been named,
any death proceeds payable will be paid to
the Annuitant's Beneficiary.
The naming of an Owner's or Xxxxxxxxx's
beneficiary by familial relationship (such
as Mother, Father, etc.) shall be understood
to be their relationship to the Owner or
Annuitant making such designation.
WHAT ARE THE RIGHTS The Annuitant's Beneficiary and Owner's
OF THE BENEFICIARY Beneficiary may exercise the following
rights with respect to the death proceeds
they are entitled to receive:
1. Receive the death proceeds payable
under this contract; or
2. Select a Payment Option for the death
proceeds; or
D602 18
3. Transfer the amount of any deferred
death proceeds between and among the
various Subaccounts. See Part 5.
HOW TO CHANGE THE At any time prior to the death of the last
BENEFICIARY Annuitants under this contract, you may
change the Owner's Beneficiary or the
Annuitant's Beneficiary. The change must be
made by Written Notice signed by You. When
we receive it, the change will be effective
as of the date it was signed by you.
However, the change will be subject to any
payment made or actions taken by us before
we received the Written Notice.
PART 10: PAYMENT OPTIONS
You must elect a payment option by Written
Request. We reserve the right to require
that the election of a payment option be in
the form of a supplementary contract
distributed by Us reflecting the terms of
the payment option elected. We have the
right to require proof of age and sex of any
person on whose life payments depend, as
well as proof of the continued survival of
any such person. After the first Payment
Calculation Date, You may not change the
Payment Option You elected. As regards the
election of a Payment Option by the
beneficiary of any death proceeds payable
under this contract, limited as described in
Part 9, the term "Annuitant" as used below
shall refer to such beneficiary.
CALCULATION OF The guaranteed annuity payment rates under
FIXED ANNUITY the following options will be based on the
PAYMENTS Annuitant's age and sex, and will be no
less favorable than the following:
Under Options A, B, D, E and F rates are
based on the a-49 Annuity Table projected to
1985 with Projection Scale B. We use an
interest rate of 3-3/8% for 5- and 10-year
certain periods under Option A, for the
10-year certain period under Option F, and
for Option E; an interest rate of 3-1/4% for
the 20-year certain period under Options A
and F; an interest rate of 3-1/2% under
Options B and D. Under Options G and H the
guaranteed interest rate is 3%.
CALCULATION OF Under the following options, all payments
VARIABLE ANNUITY after the first payment will vary with
PAYMENTS the investment experience of the
Subaccounts. Payments may be either higher
or lower than the first payment.
D602 NY 19
Under Options I, J, K, M and N, We determine
the first payment by multiplying the amounts
held under the selected option in each
Subaccount by the applicable Payment Option
rate. The first payment equals the total of
such amounts determined for each Subaccount.
We determine future payments under these
options by multiplying the number of Annuity
Units in each Subaccount by the Annuity Unit
Value for each Subaccount on the Payment
Calculation Date. The payment will equal the
sum of the amounts provided by each
Subaccount.
Under Option L, We determine the amount of
the annual distribution by dividing the
amount of Contract Value held under this
option on December 31 of the previous year
by the life expectancy of the Annuitant or
the joint life expectancy of the Annuitant
and Joint Annuitant at that time.
Under Options I, J, M and N, the applicable
option rate used to determine the first
payment amount will not be less than the
rate based on the 1983 Table A (1983 IAM)
projected with Projection Scale G to the
year 2040, and with continued projection
thereafter, and on the Assumed Investment
Rate. Under Option K, the rate will be based
on the number of payments to be made during
the specified period and the Assumed
Investment Rate.
We quarantee that neither expenses actually
incurred, other than taxes on investment
return, nor mortality actually experienced,
shall adversely affect the dollar amount of
variable annuity payments.
OPTION A - A fixed payout annuity payable monthly
LIFE ANNUITY while the Annuitant is living or, if later,
WITH SPECIFIED the end of the specified period certain.
PERIOD CERTAIN The period certain may be specified as
5, 10, or 20 years. The period certain must
be elected at the time this option is
elected.
OPTION B - A fixed payout annuity payable monthly while
LIFE ANNUITY the Annuitant is living and ending with the
NON-REFUND last Life payment due preceding the date of
the Annuitant's death.
OPTION D - A fixed payout annuity payable monthly
JOINT AND SURVIVORSHIP while the Annuitant and the designated
LIFE ANNUITY Joint Annuitant are living, and continuing
thereafter during the lifetime of the
survivor. The amount to be continued to the
survivor is 100% of the joint annuity
payment, as specified at the time this
option is elected. The designated Joint
Annuitant must be designated at the time
this option is elected and must have an
adjusted age of at least 40. The adjusted
age is the person's age on his or her
birthday nearest the Settlement Date.
OPTION E - A fixed payout annuity payable monthly
INSTALLMENT REFUND while the Annuitant is living or, if later,
LIFE ANNUITY the date the annuity payments made under
this option total an amount which refunds
the entire amount applied under this
D602 NY 20
option. If the Annuitant is not living when
the final payment falls due, that payment
will be limited to the amount which needs to
be added to the payments already made to
equal the entire amount applied under this
option.
OPTION F - A fixed payout annuity payable monthly
JOINT AND SURVIVORSHIP while either the Annuitant or designated
LIFE ANNUITY WITH Joint Annuitant is living, or if later, the
10-YEAR PERIOD CERTAIN end of 10 years. The designated Joint
Annuitant must be designated at the time
this option is elected and must have an
adjusted age of at least 40 years. The
adjusted age is the person's age on his or
her birthday nearest the settlement date.
OPTION G - Equal income installments for a specified
PAYMENTS FOR A period of years are paid whether the payee
SPECIFIED PERIOD lives or dies. The period certain specified
must be in whole numbers of years from 5
to 30.
OPTION H - Equal income installments of a specified
PAYMENTS OF A amount are paid until the principal sum
SPECIFIED AMOUNT remaining under this option from the amount
applied is less than the amount of the
installment. When that happens, the
principal sum remaining will be paid as a
final payment. The amount specified must
provide for payments for a period of at
least 5 years.
OPTION I - This option provides variable monthly
VARIABLE LIFE ANNUITY payments that will continue during the
WITH 10-YEAR lifetime of the Annuitant or for ten
PERIOD CERTAIN years, if longer. If the beneficiary of
any death benefits payable under this
contract elects this payment option, the
term "Annuitant" as used in the preceding
paragraph shall refer to such beneficiary
and the period certain will equal 10 years,
or the life expectancy of such beneficiary,
if shorter.
OPTION J - This option provides variable monthly
JOINT SURVIVORSHIP VARIABLE payments while the Annuitant and the
LIFE ANNUITY WITH designated Joint Annuitant are living.
10-YEAR PERIOD CERTAIN Payments will continue during the life of
the survivor or until the end of 10 years if
later. You must designate the Joint
Annuitant at the time You elect this option.
The designated Joint Annuitant must be at
least age 40 on the birthday nearest the
first Payment Calculation Date. This option
is not available for the payment of any
death benefit under this contract.
OPTION K - This option provides variable monthly
VARIABLE ANNUITY payments through the release of a fixed
FOR SPECIFIED PERIOD number of Annuity Units over a specified
period of time. Payment continues whether
the Annuitant lives or dies. The specified
period must be in whole numbers of years
from 5 to 30. However, the period selected
by the beneficiary may not extend beyond the
life expectancy of such beneficiary. This
option also
D602 21
provides for unscheduled withdrawals. An
unscheduled withdrawal will reduce the
number of remaining annuity units. Thus, the
specified period will be reduced to the
period that the remaining annuity units can
provide.
OPTION L - This option provides a variable income
VARIABLE LIFE which is payable over the Annuitant's
EXPECTANCY ANNUITY annually recalculated life expectancy or
the annually recalculated life expectancy of
the Annuitant and Joint Annuitant. This
option also provides for unscheduled
withdrawals. An unscheduled withdrawal will
reduce the Contract Value. This will thus
affect the amount of future payments. Upon
the death of the Annuitant (and Joint
Annuitant, if there is a Joint Annuitant)
the remaining Contract Value will be paid in
a lump sum to the Annuitant's Beneficiary.
OPTION M - This option provides variable monthly
UNIT REFUND payments as long as the Annuitant lives.
VARIABLE LIFE ANNUITY In the event of the death of the Annuitant,
the income will stop and the Annuitant's
Beneficiary will receive in a lump sum the
value of the remaining Annuity Units. This
value is equal to the sum of the number of
remaining Annuity Units for each Subaccount
multiplied by the current Annuity Unit Value
for that Subaccount. The number of remaining
Annuity Units for each Subaccount will be
calculated as follows:
(1) the net amount in the Subaccount
applied under this option on the first
Payment Calculation Date divided by
the corresponding Annuity Unit Value
on that date minus
(2) the sum of the Annuity Units released
from the Subaccount to make the
payments under this option.
OPTION N - This option provides a variable monthly
VARIABLE NON- income for the lifetime of the Annuitant.
REFUND LIFE ANNUITY No income is payable after the death of
the Annuitant.
OTHER OPTIONS We may offer other payment options or
alternative versions of the options listed
above.
PART 11: TABLES OF PAYMENT
OPTION AMOUNTS
The tables that follow show the guaranteed
minimum monthly payments for Options A-G,
and the minimum initial payment for the
Variable Payment Options I, J, K, M and N
each $1,000 applied. If Our rates in effect
for at the Settlement Date are more
favorable, We
D602 22
will use those rates. Subsequent monthly
payments for the Variable Payment Options
will vary and may be higher or lower than
the first payment. Amounts for payment
frequencies, periods or ages not shown will
be furnished upon request.
The term "age" as used in the tables refers
to the adjusted age. The adjusted age is
defined as the age of the Annuitant on the
Annuitant's birthday nearest the effective
date of the payment option elected.
D602 23
OPTIONS A & E -- LIFE ANNUITY WITH SPECIFIED PERIOD CERTAIN; INSTALLMENT REFUND LIFE ANNUITY
------------ --------------------------- ------------------------- --------------------------
AGE OF INSTALLMENT REFUND 10 YEARS CERTAIN 20 YEARS CERTAIN
PAYEE ------------- ------------- ------------ ------------ ------------- ------------
MALE FEMALE MALE FEMALE MALE FEMALE
------------ ------------- ------------- ------------ ------------ ------------- ------------
40 $3.80 $3.64 $3.86 $3.60 $3.74 $3.54
------------ ------------- ------------- ------------ ------------ ------------- ------------
45 4.05 3.85 4.14 3.82 3.99 3.74
------------ ------------- ------------- ------------ ------------ ------------- ------------
50 4.36 4.12 4.50 4.10 4.28 3.99
------------ ------------- ------------- ------------ ------------ ------------- ------------
55 4.76 4.47 4.95 4.47 4.61 4.31
------------ ------------- ------------- ------------ ------------ ------------- ------------
60 5.28 4.93 5.54 4.96 4.97 4.67
------------ ------------- ------------- ------------ ------------ ------------- ------------
65 5.97 5.54 6.30 5.63 5.29 5.06
------------ ------------- ------------- ------------ ------------ ------------- ------------
70 6.91 6.39 7.24 6.50 5.43 5.31
------------ ------------- ------------- ------------ ------------ ------------- ------------
75 8.21 7.57 8.26 7.56 5.44 5.40
------------ ------------- ------------- ------------ ------------ ------------- ------------
80 10.04 9.26 10.12 8.60 5.46 5.46
------------ ------------- ------------- ------------ ------------ ------------- ------------
85 12.61 11.68 12.60 9.31 5.46 5.46
------------ ------------- ------------- ------------ ------------ ------------- ------------
OPTION B -- NON-REFUND LIFE ANNUITY
--------------- ------------ ------------
AGE OF PAYEE MALE FEMALE
--------------- ------------ ------------
40 $ 3.95 $ 3.75
--------------- ------------ ------------
45 4.24 3.98
--------------- ------------ ------------
50 4.62 4.28
--------------- ------------ ------------
55 5.12 4.68
--------------- ------------ ------------
60 5.79 5.24
--------------- ------------ ------------
65 6.75 6.04
--------------- ------------ ------------
70 8.15 7.22
--------------- ------------ ------------
75 10.26 9.03
--------------- ------------ ------------
80 13.54 11.88
--------------- ------------ ------------
85 18.72 16.54
--------------- ------------ ------------
OPTION D -- JOINT AND SURVIVORSHIP LIFE ANNUITY
-------------------------------------------------------------------------------------------------
FEMALE MALE
--------------------------------------------------------------------------------------
AGE 40 45 50 55 60 65 70 75
-------------------------------------------------------------------------------------------------
40 $3.49 $ 3.55 $ 3.59 $ 3.62 $ 3.64 $ 3.65 $ 3.66 $ 3.67
-------------------------------------------------------------------------------------------------
45 3.58 3.67 3.74 3.80 3.83 3.86 3.88 3.89
-------------------------------------------------------------------------------------------------
50 3.65 3.79 3.90 4.00 4.07 4.12 4.16 4.18
-------------------------------------------------------------------------------------------------
55 3.72 3.89 4.06 4.22 4.35 4.44 4.51 4.56
-------------------------------------------------------------------------------------------------
60 3.77 3.97 4.20 4.43 4.65 4.83 4.96 5.05
-------------------------------------------------------------------------------------------------
65 3.80 4.04 4.31 4.62 4.94 5.25 5.51 5.71
-------------------------------------------------------------------------------------------------
70 3.83 4.08 4.34 4.77 5.20 5.67 6.13 6.52
-------------------------------------------------------------------------------------------------
75 3.85 4.12 4.46 4.88 5.40 6.04 6.75 7.46
-------------------------------------------------------------------------------------------------
OPTION F -- JOINT AND SURVIVORSHIP LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
-------------------------------------------------------------------------------------------------
FEMALE MALE
--------------------------------------------------------------------------------------
AGE 40 45 50 55 60 65 70 75
-------------------------------------------------------------------------------------------------
40 $ 3.49 $ 3.55 $ 3.59 $ 3.62 $ 3.64 $ 3.65 $ 3.66 $ 3.67
-------------------------------------------------------------------------------------------------
45 3.58 3.67 3.74 3.80 3.83 3.86 3.88 3.89
-------------------------------------------------------------------------------------------------
50 3.65 3.78 3.90 4.00 4.07 4.12 4.15 4.17
-------------------------------------------------------------------------------------------------
55 3.72 3.89 4.06 4.22 4.34 4.44 4.50 4.54
-------------------------------------------------------------------------------------------------
60 3.77 3.97 4.19 4.43 4.64 4.82 4.95 5.03
-------------------------------------------------------------------------------------------------
65 3.80 4.03 4.31 4.61 4.93 5.23 5.45 5.65
-------------------------------------------------------------------------------------------------
70 3.83 4.08 4.39 4.75 5.18 5.63 6.07 6.41
-------------------------------------------------------------------------------------------------
75 3.85 4.11 4.45 4.86 5.36 5.96 6.62 7.21
-------------------------------------------------------------------------------------------------
D602 24
OPTION G -- PAYMENTS FOR A SPECIFIED PERIOD
-------------------- ----------------- ------------------
ANNUAL MONTHLY
NUMBER OF YEARS INSTALLMENT INSTALLMENT
-------------------- ----------------- ------------------
5 $ 211.99 $ 17.91
-------------------- ----------------- ------------------
6 179.22 15.14
-------------------- ----------------- ------------------
7 155.83 13.16
-------------------- ----------------- ------------------
8 138.31 11.68
-------------------- ----------------- ------------------
9 124.69 10.53
-------------------- ----------------- ------------------
10 113.82 9.61
-------------------- ----------------- ------------------
11 104.93 8.86
-------------------- ----------------- ------------------
12 97.54 8.24
-------------------- ----------------- ------------------
13 91.29 7.71
-------------------- ----------------- ------------------
14 85.95 7.26
-------------------- ----------------- ------------------
15 81.33 6.87
-------------------- ----------------- ------------------
16 77.29 6.53
-------------------- ----------------- ------------------
17 73.74 6.23
-------------------- ----------------- ------------------
18 70.59 5.96
-------------------- ----------------- ------------------
19 67.78 5.73
-------------------- ----------------- ------------------
20 65.26 5.51
-------------------- ----------------- ------------------
25 55.76 4.71
-------------------- ----------------- ------------------
30 49.53 4.18
-------------------- ----------------- ------------------
OPTION I -- VARIABLE PAYMENT LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
--------------- ------------ ------------
AGE OF PAYEE MALE FEMALE
--------------- ------------ ------------
40 $ 4.15 $ 4.02
--------------- ------------ ------------
45 4.29 4.12
--------------- ------------ ------------
50 4.40 4.27
--------------- ------------ ------------
55 4.73 4.46
--------------- ------------ ------------
60 5.06 4.71
--------------- ------------ ------------
65 5.51 5.05
--------------- ------------ ------------
70 6.08 5.52
--------------- ------------ ------------
75 6.79 6.17
--------------- ------------ ------------
80 7.65 6.99
--------------- ------------ ------------
85 8.57 7.98
--------------- ------------ ------------
OPTION J -- JOINT SURVIVOR VARIABLE PAYMENT LIFE ANNUITY WITH 10-YEAR PERIOD CERTAIN
-----------------------------------------------------------------------------------------------
FEMALE MALE
------------------------------------------------------------------------------------
AGE 40 45 50 55 60 65 70 75
-----------------------------------------------------------------------------------------------
40 $ 3.92 $ 3.94 $ 3.96 $ 3.98 $ 3.99 $ 4.00 $ 4.00 $ 4.01
-----------------------------------------------------------------------------------------------
45 3.96 4.00 4.03 4.06 4.08 4.09 4.10 4.11
-----------------------------------------------------------------------------------------------
50 4.00 4.05 4.10 4.15 4.18 4.21 4.23 4.24
-----------------------------------------------------------------------------------------------
55 4.03 4.10 4.18 4.24 4.30 4.35 4.39 4.41
-----------------------------------------------------------------------------------------------
60 4.06 4.15 4.25 4.34 4.43 4.52 4.58 4.63
-----------------------------------------------------------------------------------------------
65 4.09 4.19 4.31 4.44 4.57 4.70 4.81 4.90
-----------------------------------------------------------------------------------------------
70 4.11 4.22 4.36 4.53 4.70 4.89 5.07 5.22
-----------------------------------------------------------------------------------------------
75 4.12 4.75 4.41 4.60 4.82 5.07 5.34 5.59
-----------------------------------------------------------------------------------------------
D602 25
OPTION K -- VARIABLE PAYMENT ANNUITY FOR A SPECIFIED PERIOD
-------------------- ----------------- ------------------
ANNUAL MONTHLY
NUMBER OF YEARS INSTALLMENT INSTALLMENT
-------------------- ----------------- ------------------
5 $217.98 $18.53
-------------------- ----------------- ------------------
6 185.53 15.77
-------------------- ----------------- ------------------
7 162.39 13.81
-------------------- ----------------- ------------------
8 145.08 12.34
-------------------- ----------------- ------------------
9 131.65 11.19
-------------------- ----------------- ------------------
10 120.94 10.28
-------------------- ----------------- ------------------
11 112.20 9.54
-------------------- ----------------- ------------------
12 104.94 8.92
-------------------- ----------------- ------------------
13 98.83 8.40
-------------------- ----------------- ------------------
14 93.61 7.96
-------------------- ----------------- ------------------
15 89.10 7.58
-------------------- ----------------- ------------------
16 85.18 7.24
-------------------- ----------------- ------------------
17 81.74 6.95
-------------------- ----------------- ------------------
18 78.70 6.69
-------------------- ----------------- ------------------
19 75.99 6.46
-------------------- ----------------- ------------------
20 73.57 6.25
-------------------- ----------------- ------------------
25 64.53 5.49
-------------------- ----------------- ------------------
30 58.75 5.00
-------------------- ----------------- ------------------
OPTION M -- VARIABLE PAYMENT LIFE ANNUITY WITH UNIT REFUND
--------------- ------------ ------------
AGE OF PAYEE MALE FEMALE
--------------- ------------ ------------
40 $ 4.12 $ 4.01
--------------- ------------ ------------
45 4.25 4.11
--------------- ------------ ------------
50 4.42 4.24
--------------- ------------ ------------
55 4.64 4.41
--------------- ------------ ------------
60 4.92 4.64
--------------- ------------ ------------
65 5.28 4.94
--------------- ------------ ------------
70 5.74 5.33
--------------- ------------ ------------
75 6.32 5.86
--------------- ------------ ------------
80 7.07 6.55
--------------- ------------ ------------
85 8.01 7.43
--------------- ------------ ------------
OPTION N -- VARIABLE PAYMENT LIFE ANNUITY
--------------- ------------ ------------
AGE OF PAYEE MALE FEMALE
--------------- ------------ ------------
40 $ 4.15 $ 4.02
--------------- ------------ ------------
45 4.30 4.13
--------------- ------------ ------------
50 4.50 4.27
--------------- ------------ ------------
55 4.76 4.47
--------------- ------------ ------------
60 5.11 4.73
--------------- ------------ ------------
65 5.60 5.09
--------------- ------------ ------------
70 6.29 5.60
--------------- ------------ ------------
75 7.20 6.34
--------------- ------------ ------------
80 8.49 7.41
--------------- ------------ ------------
85 10.30 8.98
--------------- ------------ ------------
D602 26
[LOGO] PHOENIX
FLEXIBLE PREMIUM VARIABLE ACCUMULATION DEFERRED ANNUITY
ALL VALUES AND BENEFITS BASED ON THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS OF
THE SEPARATE ACCOUNT MAY INCREASE OR DECREASE AND ARE VARIABLE AND NOT
GUARANTEED AS TO DOLLAR AMOUNT. SEE PART 7 FOR A DESCRIPTION OF HOW THE CONTRACT
VALUES ARE DETERMINED, AND PART 9 FOR A DESCRIPTION OF HOW THE DEATH BENEFITS
ARE DETERMINED.
NOT ELIGIBLE FOR ANNUAL DIVIDENDS
D602 NY
