IDS LIFE INSURANCE COMPANY
OF NEW YORK
00 Xxxxxxx Xxx. Ext.
P.O. Box 5144
Albany, NY 12205
DEFERRED ANNUITY CONTRACT
- FLEXIBLE PURCHASE PAYMENTS.
- OPTIONAL FIXED DOLLAR OR VARIABLE ACCUMULATION VALUES AND ANNUITY PAYMENTS.
- ANNUITY PAYMENTS TO BEGIN ON THE SETTLEMENT DATE.
- THIS CONTRACT IS NONPARTICIPATING. DIVIDENDS ARE NOT PAYABLE.
Annuitant: Xxxx Xxx Contract Date: June 15, 2006
Contract Number: XXXX-XXXXXXXX Settlement Date: June 15, 2061
This is a deferred annuity contract. It is a legal contract between you, as
the owner, and us, IDS Life Insurance Company of New York, a Stock Company.
PLEASE READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the settlement date, upon your request, we will
begin to pay you monthly annuity payments. Any payments made by us are subject
to the terms of this contract.
We issue this contract in consideration of your application and the payment of
the purchase payments.
FIXED ACCOUNT IS AVAILABLE ONLY FOR SPECIAL DOLLAR COST AVERAGING ARRANGEMENTS
AND AS PART OF VARIOUS OPTIONAL RIDERS.
ACCUMULATION VALUES AND ANNUITY PAYMENTS, WHEN BASED ON THE INVESTMENT RESULTS
OF THE VARIABLE SUBACCOUNTS, ARE VARIABLE AND NOT GUARANTEED AS TO FIXED DOLLAR
AMOUNT. SEE THE FIXED AND VARIABLE ACCOUNTS SECTION FOR VARIABLE PROVISIONS. THE
MORTALITY AND EXPENSE RISK CHARGE, CONTRACT ADMINISTRATIVE CHARGE AND CHARGES
FOR ANY OPTIONAL RIDERS ARE SHOWN UNDER CONTRACT DATA.
In order for the dollar amount of variable annuity payments not to decrease, the
assets of the variable acconts must have an annual net rate of investment return
of 5%. This is equal to the gross investment return minus the mortality and
expense risk charge shown under Contract Data.
NOTICE OF YOUR RIGHT TO EXAMINE THIS CONTRACT FOR 10 DAYS.
If for any reason you are not satisfied with this contract, return it to us or
our representative within 10 days after you receive it. We will then cancel this
contract. Upon such cancellation we will refund an amount equal to the sum of
the contract value, any fees paid and any premium tax charges paid. This
contract will then be considered void from its start.
Signed for and issued by IDS Life Insurance Company of New York in Albany,
New York, as of the contract date shown above.
/s/ Xxxxxxx X. Xxxxxxxx
PRESIDENT
/s/ ILLEGIBLE
SECRETARY
139484 (06/2006)
GUIDE TO CONTRACT PROVISIONS
CONTRACT DATA........................................................Pages 2A-2C
Important contract specifications, fund allocations, fees and charges,
surrender charge schedule
DEFINITIONS............................................................Pages 3-4
GENERAL PROVISIONS........................................................Page 5
Entire Contract
Modification of the Contract
Incontestable
Benefits Based on Incorrect Data
State Laws
Federal Laws
Reports to Owner
Evidence of Survival
Protection of Proceeds
Payments by Us
Voting Rights
OWNERSHIP, ANNUITANT AND BENEFICIARY......................................Page 6
Owner's Rights
Change of Ownership
Naming a Beneficiary
Change of Beneficiary
Beneficiary's Rights
Change of Annuitiant or successor annuitant
Assignment
PAYMENTS TO BENEFICIARY................................................Pages 7-8
Death Benefit Before the Settlement Date
Pre-election of an Annuity Payment Plan
Spouse Option to Continue Contract
Death Benefits After Settlement
PURCHASE PAYMENTS.........................................................Page 9
Purchase Payments
Amounts and Intervals
Payment Limits
Allocation of Purchase Payments
CONTRACT VALUE.......................................................Pages 10-11
Variable Account Contract Value
Fixed Account Contract Value
Interest to be Credited
Contract Administrative Charge
Premium Tax Charges
Transfers of Contract Values
Dollar Cost Averaging
FIXED AND VARIABLE ACCOUNTS..........................................Pages 12-13
The Fixed Account
The Variable Account
Investments of the Variable Account
Valuation of Assets
Variable Account Accumulation Units and Values
Net Investment Factor
Mortality and Expense Risk Charge
Annuity Unit Value
SURRENDER PROVISIONS.....................................................Page 14
Surrender of the contract for its surrender value
Rules for Surrender
Surrender Value
Suspension or Delay in Payment of Surrender
ANNUITY PROVISIONS...................................................Pages 15-16
When annuity payments begin
Different ways to receive annuity payments
Determination of payment amounts
TABLES OF SETTLEMENT RATES...........................................Pages 17-18
Tables showing amount of first variable annuity payment and the guaranteed
fixed annuity payments for the various payment plans
139484 Page 2 (06/2006)
CONTRACT DATA
Annuitant: Xxxx Xxx Contract Date: June 15, 2006
Contract Number: XXXX-XXXXXXXX Settlement Date: June 15, 2061
Contract Owner: Xxxx Xxx Age at Issue: 35
Deferred Annuity Contract:
("RIVERSOURCE RETIREMENT ADVISOR ACCESS(SM) VARIABLE ANNUITY")
Federal Tax Status: Non-qualified
Cash Submitted With Application:* $10,000.00
*Exchanges and transfers from other accounts are not reflected and will be
confirmed separately.
Intended Optional Purchase Payments:
Annual Amount: NA
Maximum Purchase Payments Permitted:
1st contract year: $1,000,000
Each contract year thereafter: $100,000
Special DCA Minimum Purchase Payment: $10,000
Upon issuance of this contract your purchase payments have been scheduled to be
paid and applied to the fixed account and variable subaccounts investing in
funds as shown below. You may change the amount, frequency and allocations as
provided in this contract. Refer to the Purchase Payments provision.
Purchase Payments
Funds Allocation Percentage
----- ---------------------
AIM V.I.
Capital Appreciation Fund, Series II Shares 30.0%
Capital Development Fund, Series II Shares 00.0%
Financial Services Fund, Series II Shares 00.0%
Global Health Care Fund, Series II Shares 00.0%
International Growth Fund, Series II Shares 00.0%
ALLIANCEBERNSTEIN VPS
Global Technology Portfolio (Class B) 00.0%
Growth and Income Portfolio (Class B) 00.0%
International Value Portfolio (Class B) 00.0%
Large Cap Growth Portfolio (Class B) 00.0%
AMERICAN CENTURY(R) VP
Mid Cap Value, Class II 00.0%
Ultra, Class II 00.0%
VP Value, Class II 00.0%
COLUMBIA
High Yield Fund, Variable Series, Class B 00.0%
Xxxxxxx Growth 00.0%
Xxxxxxx International Opportunities 00.0%
CREDIT SUISSE TRUST
Commodity Return Strategy 00.0%
DREYFUS VARIABLE INVESTMENT FUND
International Equity Portfolio, Service Class Shares 20.0%
International Value Portfolio, Service Class Shares 00.0%
XXXXX XXXXX VT
Floating-Rate Income Fund 00.0%
EVERGREEN VA
Fundamental Large Cap Fund - Class 2 00.0%
International Equity Fund - Class 2 00.0%
FIDELITY(R) VIP
Contrafund(R) Portfolio Service Class 2 10.0%
Mid Cap Portfolio Service Class 2 00.0%
Overseas Portfolio Service Class 2 00.0%
XXXXXXXX XXXXXXXXX VIP TRUST (FTVIPT)
Franklin Real Estate Securities Fund - Class 2 00.0%
Franklin Small Cap Value Securities Fund-Class 2 00.0%
Mutual Shares Securities Fund - Class 2 00.0%
XXXXXXX XXXXX VIT
StructuredSM U.S. Equity Fund 00.0%
XXXX XXXXX PARTNERS
Variable Small Cap Growth Portfolio, Class II 00.0%
139484 Page 2A (6/2006)
Purchase Payments
Funds Allocation Percentage
----- ---------------------
MFS(R)
Investors Growth Stock Series - Service Class 00.0%
Total Return Series - Service Class 00.0%
Utilities Series - Service Class 00.0%
XXXXXXXXX XXXXXX ADVISERS MGMT TRUST
International Portfolio S Class 00.0%!
Socially Responsive Portfolio S Class 00.0%
XXXXXXXXXXX
Global Securities Fund/VA, Service Shares 00.0%
Main Street Small Cap Fund/VA, Service Shares 00.0%
Strategic Bond Fund/VA, Service Shares 00.0%
Value Fund/VA, Service Shares 00.0%
PIMCO VIT
All Asset Portfolio, Advisor Share Class 00.0%
RIVERSOURCE(SM) VARIABLE PORTFOLIO
Balanced Fund 00.0%
Cash Management Fund 00.0%
Core Bond Fund 00.0%
Diversified Bond Fund 00.0%
Diversified Equity Income Fund 00.0%
Emerging Markets Fund 00.0%
Fundamental Value Fund 00.0%
Global Bond Fund 00.0%
Global Inflation Protected Securities Fund 00.0%
Growth Fund 00.0%
High Yield Bond Fund 00.0%
Income Opportunities Fund 00.0%
International Opportunity Fund 00.0%
Large Cap Equity Fund 00.0%
Large Cap Value Fund 00.0%
Mid Cap Growth Fund 00.0%
Mid Cap Value Fund 00.0%
S&P 500 Index Fund 00.0%
Select Value Fund 00.0%
Short Duration U.S. Government Fund 20.0%
Small Cap Advantage Fund 00.0%
Small Cap Value Fund 00.0%
XXX XXXXXX
LIT Xxxxxxxx Portfolio, Class II Shares 00.0%
UIF Global Real Estate Portfolio, Class II Shares 00.0%
UIF Mid Cap Growth Portfolio, Class II Shares 00.0%
XXXXXX
International Small Cap 00.0%!
U.S. Smaller Companies 00.0%
XXXXX FARGO
Advantage Opportunity Fund 00.0%
Advantage Small Cap Growth Fund 00.0%
Fixed Account
FIX IDS Life of New York Regular Fixed Account 20.00%
DCA IDS Life of New York Special DCA Fixed Account 00.0%
Fixed Account Minimum Interest Rate: 3.00% annual effective rate
As of the date this contract was issued, any purchase payments allocated
to the Regular Fixed Account will earn interest, for the first year, at
the annual effective rate of 4.50%. New rates may be declared from time
to time.
As of the date this contract was issued, any purchase payments allocated
to the Special DCA Fixed Account will earn interest at the annual
effective rate of 4.50%. New rates may be declared from time to time.
Page 2B
Page 2C
Fees and Charges:
-----------------
Contract Administrative Charge:
Initial Annual Charge $30
We reserve the right to adjust this charge after the first
contract anniversary, but the charge will never exceed $50.
Initial Annual Charge if contract value, or
purchase payments less purchase payments
surrendered, equals or exceeds $50,000 $0
We reserve the right to charge up to $20 after the first
contract anniversary. See Contract Administrative
Charge provision.
Mortality and Expense Risk Charge: 1.40%
Return of Purchase Payment Death Benefit Rider Effective 6-15-2006
Initial Annual Charge* .25%
Maximum Anniversary Value Death Benefit Rider Effective 6-15-2006
Initial Annual Charge* .25%
Maximum Five-Year Anniversary Value Death Benefit Rider Effective 6-15-2006
Initial Annual Charge* .25%
*We reserve the right to adjust rider charges after the tenth rider
anniversary by a maximum of .10% for any rider.
DEFINITIONS
The following words are often used in this contract. When we use these words,
this is what we mean:
ACCUMULATION UNIT
An accumulation unit is an accounting unit of measure. It is used to calculate
the variable account contract value prior to settlement.
ANNUITANT
The person or persons on whose life monthly annuity payments depend. The
annuitant may be changed as provided in this contract.
ANNUITY UNIT
An annuity unit is an accounting unit of measure. It is used to calculate the
value of annuity payments from the variable subaccounts on and after the
settlement date.
CODE
The Internal Revenue Code of 1986, as amended, its regulations thereunder and/or
promulgations of the Internal Revenue Service, as applicable.
CONTRACT ANNIVERSARY
The same day and month as the contract date each year that the contract remains
in force.
CONTRACT DATE
The date from which contract anniversaries, contract years, and contract months
are determined. Your contract date is shown under Contract Data.
CONTRACT VALUE
The sum of the Fixed Account Contract Value (which receives a declared interest
rate) and the Variable Account Contract Value (which varies with the investment
performance of the elected subaccounts) for this contract.
FIXED ACCOUNT
The fixed account is made up of all our assets other than those in any separate
account.
FIXED ANNUITY
A fixed annuity is an annuity with payments which are guaranteed by us as to
dollar amount during the annuity payment period.
NONQUALIFIED CONTRACT
A contract used primarily for retirement purposes that is not intended to
qualify under 401(a), 403 or 408 of the Code.
REGULAR FIXED ACCOUNT
The Regular Fixed Account is an option available within various optional riders.
Purchase payments allocated to the Regular Fixed Account will earn a specified
rate of interest.
SETTLEMENT
The application of the contract value of this contract to an Annuity Payment
Plan to provide annuity payments.
SETTLEMENT DATE
The date shown under Contract Data on which annuity payments are scheduled to
begin. This date may be changed as provided in this contract. You will be
notified prior to the settlement date, and you will provide instructions to us
to select an annuity payment plan.
SPECIAL DCA FIXED ACCOUNT
The Special DCA fixed account is an option available within the fixed account
whereby new purchase payments allocated will earn a specified rate of interest
if they are transferred monthly to the variable subaccounts within specified
time periods we declare.
SUCCESSOR ANNUITANT
The person who becomes the annuitant when the current annuitant dies prior to
settlement.
VALUATION DATE
Any normal business day, Monday through Friday, on which the New York Stock
Exchange is open, up to the close of business. At the close of business, the
next valuation date begins.
VALUATION PERIOD
A valuation period is the interval of time commencing at the close of business
on each valuation date and ending at the close of business on the next valuation
date.
VARIABLE ANNUITY
A variable annuity is an annuity with payments which: (1) are not predetermined
or guaranteed as to dollar amounts; and (2) vary in amount with the investment
experience of one or more of the variable subaccounts.
139484 Page 3 (06/2006)
DEFINITIONS (CONTINUED)
VARIABLE SUBACCOUNTS
The portfolios of the Variable Account. The subaccounts available on the
contract date are named under Contract Data.
WE, OUR, US
IDS Life Insurance Company of New York
WRITTEN REQUEST
A request in writing, on a form acceptable to us, signed by you and delivered to
us at our corporate office.
YOU, YOUR
The owner or owners of this contract. The owner may be a natural, living person
or a non-natural entity (e.g., a trust or corporation). If this is a
nonqualified contract or an investment in a Qualified Plan under section 401(a)
of the Code, the owner may be someone other than the annuitant. The owner may be
changed as provided in this contract.
139484 Page 4 (06/2006)
GENERAL PROVISIONS
ENTIRE CONTRACT
This contract form and any endorsements or riders attached to it are the entire
contract between you and us.
No one except one of our corporate officers (President, Vice President,
Secretary or Assistant Secretary) can change or waive any of our rights or
requirements under this contract. That person must do so in writing. None of our
other representatives or other persons has the authority to change or waive any
of our rights or requirements under this contract.
MODIFICATION OF THE CONTRACT
This contract may be modified at any time by written agreement between you and
us. The modification must be signed by one of our corporate officers (President,
Vice President, Secretary or Assistant Secretary).
INCONTESTABLE
This contract is incontestable from its date of issue.
BENEFITS BASED ON INCORRECT DATA
If the amount of benefits is determined by data as to a person's age or sex that
is incorrect, benefits will be recalculated on the basis of the correct data.
Any underpayments made by us will promptly be paid in a single sum with an
interest credit of 6% per annum. Any overpayments made by us will be subtracted
from the future payments together with an interest charge of 6% per annum.
STATE LAWS
This contract is governed by the laws of the state in which it is delivered. The
values and benefits of this contract are at least equal to those required by
such state.
FEDERAL LAWS
This contract is intended to qualify as an annuity contract under Section 72 of
the Internal Revenue Code for Federal income tax purposes. To that end, the
provisions of this contract are to be interpreted to ensure or maintain such tax
qualification, despite any other provisions to the contrary. We reserve the
right to unilaterally amend this contract to reflect any clarifications that may
be needed or are appropriate to maintain such tax qualification. We will send
you a copy of any such amendments.
REPORTS TO OWNER
At least once a year we will send you a statement showing the contract value,
the surrender value and death benefit of this contract as of a date not more
than two months prior to the statement. This statement will be based on any laws
or regulations that apply to contracts of this type. It will be mailed to your
last known post office address.
EVIDENCE OF SURVIVAL
Where any payments under this contract depend on the recipient or annuitant
being alive on a given date, proof that such condition has been met may be
required by us. Such proof may be required prior to making the payment.
PROTECTION OF PROCEEDS
Payments under this contract are not assignable by any beneficiary prior to the
time they are due.
PAYMENTS BY US
All sums payable by us are payable from our corporate office. Any payment or
surrender from a variable annuity is based on the variable account contract
value.
VOTING RIGHTS
So long as federal law requires, we will give certain voting rights to contract
owners. As contract owner, if you have voting rights we will send a notice to
you telling you the time and place of the shareholder meeting. The notice will
also explain matters to be voted upon and how many votes you have.
139484 Page 5 (06/2006)
OWNERSHIP, ANNUITANT AND BENEFICIARY
OWNER'S RIGHTS
Unless otherwise stated in this contract, you may exercise all rights and
privileges provided in this contract or allowed by us.
CHANGE OF OWNERSHIP
You can change the ownership of this contract by written request. The change
must be made while the annuitant is living. Once we receive the change, it will
take effect as of the date of your request, subject to any action taken or
payment made by us before receipt.
NAMING A BENEFICIARY
Except as otherwise provided in the contract, beneficiaries are those you
designate to receive benefits of this contract if you die while this contract is
in force. We will not be bound by any such designation unless made by written
request and recorded by us. Any changes take effect as of the date such written
request was signed. However, we are not liable for any payment made by us before
we record such written request.
For joint spousal ownership with right of survivorship, the surviving spouse is
deemed the sole beneficiary superseding any other beneficiary designation. This
permits the surviving spouse to use the spousal continuation at death option
described in the "Payments to Beneficiary" section of the contract. (The deemed
surviving spouse sole beneficiary designation may only be overridden if
specifically requested in writing and signed by both joint spousal owners.)
CHANGE OF BENEFICIARY
If the annuitant is still living, you may change the beneficiary anytime by
satisfactory written request to us. Once we receive the change, it will take
effect as of the date of your request, subject to any action taken or payment
made by us before the receipt.
BENEFICIARY'S RIGHTS
If the death benefit under this contract becomes payable to a beneficiary
(payee) under an Annuity Payment Plan, that payee shall have the right to name a
beneficiary by written request.
CHANGE OF ANNUITANT OR SUCCESSOR ANNUITANT
If this is a nonqualified contract and you are a natural person, you may change
the annuitant or successor annuitant if the request is made before annuity
payments begin and while the existing annuitant is living. Once we receive a
satisfactory written request and we record the change, it will take effect as of
the date of your request, subject to any action taken or payment made by us
before the receipt.
In the case of joint spousal ownership, one owner must be named as successor
annuitant.
PRE-ELECTION OF AN ANNUITY PAYMENT PLAN
If this is a nonqualified contract, you may elect how the death benefit
described herein is to be paid under the contract in the event of death before
the settlement date by written request. In this event the death benefit shall be
payable as so elected by you, rather than as requested by the beneficiary. If
for any reason such election does not satisfy Section 72 of the Code or related
distribution requirements, the election will be void and the beneficiary will
then be permitted to elect payment pursuant to the provisions of the contract.
ASSIGNMENT
If this is a nonqualified contract, you can assign this contract or any interest
in it. Your interest and the interest of any beneficiary are subject to the
interest of the assignee. An assignment is not a change of ownership and an
assignee is not an owner as these terms are used in this contract. Any amounts
payable to the assignee will be paid in a single sum.
A copy of any new assignment must be submitted to us at our corporate office.
Any assignment is subject to any action taken or payment made by us before the
assignment was received at our corporate office. We are not responsible for the
validity or effect, tax or otherwise, of any assignment.
139484 Page 6 (06/2006)
PAYMENTS TO BENEFICIARY
Only those beneficiaries who are living when death benefits become payable may
share in the benefits, if any. Benefits will be paid to all primary
beneficiaries surviving you, in accordance with your last beneficiary
designation on file. If none survive, proceeds will be paid to all surviving
contingent beneficiaries. If there is no valid beneficiary designation or no
beneficiary survives, we will pay the benefits as follows:
- if the owner is other than a natural person, we will pay the owner,
otherwise;
- to your spouse, if living;
- if no spouse is living, to your lawful children per stirpes;
- if you have no spouse or direct descendents, to your parents equally
or the survivor, if living, otherwise to your estate.
If the annuity is jointly owned by non-spousal owners, then the death benefit
will be paid to the beneficiary at the death of the first joint owner.
If the owner is other than a natural person (e.g., a trust or corporation), and
-------------------------------------------
the annuitant dies before settlement, death benefits are payable to the
beneficiary. The annuitant's age will be used to determine the death benefit.
If the annuitant and the owner are not the same person and the annuitant dies
-----------------------------------------------------------------------------
before the contract is settled, the owner becomes the annuitant unless a
successor annuitant has been previously selected.
DEATH BENEFIT BEFORE THE SETTLEMENT DATE
If you die before the settlement date while this contract is in force, and if
you are age 75 or younger on the Contract Date, we will pay the beneficiary the
greater of:
1. the contract value as of the date we receive due proof of death; or
2. the total purchase payments minus any "adjusted partial surrenders."
An "adjusted partial surrender" is calculated for each partial surrender as the
product of (a) times (b) where:
(a) is the ratio of the amount of the partial surrender to the contract
value on the date of (but prior to) the partial surrender; and
(b) is the death benefit on the date of (but prior to) the partial
surrender.
If you are age 76 or older on the Contract Date, we will pay the beneficiary the
contract value as of the date we receive due proof of death.
The death benefit will be payable in a lump sum on the valuation date we receive
due proof of death of the owner. Due proof of death includes all documents
needed to complete any beneficiary's claim. The beneficiary may elect to receive
payment anytime within 5 years after the date of death.
In lieu of a lump sum, payment may be made under an Annuity Payment Plan,
provided:
1. the beneficiary elects the plan within 60 days after we receive due
proof of death; and
2. payments begin no later than one year after the date of death; and
3. the plan provides payments over a period which does not exceed the
life or the life expectancy of the beneficiary.
In this event, the reference to "annuitant" in the Annuity Provisions shall
apply to the beneficiary.
We will determine the contract value on which we base amounts payable or applied
under this section on the next accumulation unit value calculated after we
receive due proof of death at our corporate office.
SPOUSE OPTION TO CONTINUE CONTRACT UPON OWNER'S DEATH
If the owner's death occurs prior to the settlement date, a spouse who is
designated as sole primary beneficiary, or as a joint tenant with right of
survivorship, may elect by written request to forego receipt of the death
benefit and instead continue this contract as owner, including any associated
riders in force, subject to rider continuation rules in effect. If the owner was
also the annuitant, then the spouse becomes the annuitant as well. The election
by the spouse must be made at the time we receive due proof of death.
139484 Page 7 (06/2006)
PAYMENTS TO BENEFICIARY (CONTINUED)
DEATH BENEFITS AFTER SETTLEMENT
The death of the annuitant triggers a death benefit after the settlement date.
The amount payable, if any, will depend on the annuity payment plan then in
effect.
If the owner is the annuitant and dies after the settlement date, payments cease
--------------------------------------
for life-contingency only plans. Payments continue to beneficiaries for the
remainder of any guarantee period or for the lifetime of a surviving joint
annuitant, if any.
If the annuitant is other than the owner and the annuitant dies after the
---------------------------------------------------------------
settlement date, payments cease for life-contingency only plans. Payments
continue to the owner for the remainder of any guarantee period or for the
lifetime of a surviving joint annuitant, if any.
If the annuitant is other than the owner and the owner dies after the settlement
-----------------------------------------------------------
date, payments continue to the beneficiary according to the payment plan in
effect.
139484 Page 8 (06/2006)
PURCHASE PAYMENTS
PURCHASE PAYMENTS
Purchase payments are the payments you make for this contract and the benefits
it provides. Purchase payments must be paid or mailed to us at our corporate
office or to an authorized agent. If requested, we'll give you a receipt for
your purchase payments.
Net purchase payments are that part of your purchase payments applied to the
contract value. A net purchase payment is equal to the purchase payment less any
applicable premium tax charge.
AMOUNT AND INTERVALS
Purchase payments may be paid in a single sum or in installments until the
earlier of: (1) the date this contract terminates by surrender or otherwise; or
(2) the date on which the annuity payments begin.
Subject to the Payment Limits Provision you may: (1) stop and/or restart
purchase payments; or (2) increase or decrease the amount of your purchase
payments; or (3) change the interval of your purchase payments.
PAYMENT LIMITS PROVISION
Maximum Purchase Payments - The maximum purchase payments in the first or later
contract years may not exceed the amounts shown under Contract Data.
Minimum Purchase Payments - If you intend to make installment purchase payments
such payments, on an annualized basis, must be at least equal to $600.
Additional payments must be at least $50.
We reserve the right to cancel this contract if both of the following conditions
exist at the same time: (1) no purchase payments have been paid for a continuous
period of 36 months; and (2) the contract value is less than $2000. In this
event we will give you 30 days written notice of our intent to cancel this
contract. Upon such cancellation we will pay you the contract value in one sum.
This contract will then terminate.
ALLOCATION OF PURCHASE PAYMENTS
You instruct us on how you want your purchase payments allocated among the
Special DCA fixed account and variable subaccounts. Purchase payment allocations
to the Regular Fixed Account are only allowed for various optional rider
programs. Your choice for each account may be made in any whole percent from 0%
to 100% as long as the total adds up to 100%. Your allocation instructions as of
the contract date are shown under Contract Data. By written request, or by other
method agreed to by us, you may change your choice of accounts or percentages.
The first net purchase payment will be allocated as of the end of the valuation
period during which we make an affirmative decision to issue this contract. Net
purchase payments after the first will be allocated as of the end of the
valuation period during which we receive the payment at our corporate office.
139484 Page 9 (06/2006)
CONTRACT VALUE
CONTRACT VALUE
The contract value at any time is the sum of: (1) the Fixed Account Contract
Value; and (2) the Variable Account Contract Value.
If: (1) part or all of the contract value is surrendered; or (2) charges
described herein are made against the contract value; then a number of
accumulation units from the variable subaccounts and an amount from the Regular
Fixed Account, if applicable, will be deducted to equal such amount. Such
charges may be deducted from any Special DCA fixed account but only if
insufficient amounts are available from any Regular Fixed Account and variable
subaccounts. For surrenders, deductions will be made from the fixed account or
variable subaccounts that you specify. Otherwise, the number of units from the
variable subaccounts and the amount from any Regular Fixed Account will be
deducted in the same proportion that your interest in each bears to the total
contract value less any Special DCA fixed account.
VARIABLE ACCOUNT CONTRACT VALUE
Your variable account contract value at any time will be the sum of the value of
the units in any variable subaccount resulting from: (1) purchase payments
allocated to a subaccount; plus (2) any amounts transferred to a subaccount from
another subaccount or from the fixed account; less (3) any amounts transferred
from a subaccount to another subaccount or to the fixed account; less (4) any
amounts deducted from a subaccount for surrenders, contract administrative
charges or any rider charges.
FIXED ACCOUNT CONTRACT VALUE
Your fixed account contract value at any time will be: (1) the sum of all
purchase payments allocated to any Regular Fixed Account for various optional
rider programs, plus interest credited; plus (2) the sum of all purchase
payments allocated to any Special DCA fixed account, plus interest credited;
plus (3) any amounts transferred to any Regular Fixed Account from any variable
subaccount, plus interest credited; less (4) any amounts transferred from the
Regular Fixed Account and Special DCA fixed account to any variable subaccount;
less (5) any amounts deducted for surrenders, contract administrative charges or
any rider charges.
INTEREST TO BE CREDITED
We will credit interest to the fixed account contract value. Interest will begin
to accrue at our current crediting rate on the date the purchase payments which
are received in our corporate office become available to us for use. After the
first year, interest will accrue on the fixed account value at rates determined
by us and at our discretion. These rates will be based on various factors
including, but not limited to, the interest rate environment, returns earned on
investments backing these annuities, the rates currently in effect for new and
existing company annuities, product design, competition, and the company's
revenues and expenses. However, our current crediting rate will never be less
than the Fixed Account Minimum Interest Rate shown under Contract Data.
CONTRACT ADMINISTRATIVE CHARGE
We charge a fee for establishing and maintaining our records for this contract.
The charge is shown under Contract Data and is deducted from the contract value
at the end of each contract year or, if earlier, when the contract is fully
surrendered. The charge deducted will be prorated among the variable subaccounts
and any Regular Fixed Account in the same proportion your interest in each bears
to the total contract value less any Special DCA fixed account. Such charges
will only be deducted from any Special DCA fixed account if insufficient amounts
are available from any Regular Fixed Account and variable subaccounts.
We reserve the right to adjust this charge after the first contract anniversary
but the charge will never exceed the amount shown under Contract Data. We waive
or reduce this charge if your contract value, or your total purchase payments,
less any purchase payments surrendered, equals or exceeds the amount shown under
Contract Data.
If you make a full surrender of this contract, we deduct the full contract
administrative charge at the time of the full surrender regardless of purchase
payments made or contract value.
The charge does not apply after settlement of this contract under an annuity
payment plan.
PREMIUM TAX CHARGES
We reserve the right to deduct an amount from the value of this contract at the
time that any applicable premium taxes assessed against the Company or otherwise
not previously deducted are payable.
If a tax is payable at the time of your purchase payment and we choose to not
deduct it at that time, we further reserve the right to deduct it at a later
date.
139484 Page 10 (06/2006)
CONTRACT VALUE (CONTINUED)
TRANSFERS OF CONTRACT VALUES
While this contract is in force prior to the settlement date, you may transfer
all or part of the values held in one or more variable subaccounts to another
one or more of the variable subaccounts unless contract values are required to
be allocated to certain accounts or subaccounts under the terms of certain
optional benefit riders, if any, attached to this contract.
You may make a transfer by written request. Transfer requests may also be made
according to telephone procedures or automated transfer procedures that are then
currently in effect, if any. There is no fee or charge for these transfers.
However, the minimum transfer amount is $250, or if less, the entire value in
the account from which the transfer is being made. Smaller minimums may apply to
automated transfer procedures.
These transfer privileges may be suspended or modified by us at any time. The
right to transfer contract values among the subaccounts is also subject to
modification if we determine, at our sole discretion, that the exercise of that
right by one or more contract owners is, or would be, to the disadvantage of
other contract owners. Any modification could be applied to transfers to or from
some or all of the subaccounts. These modifications could include, but not be
limited to, the requirements of a minimum time period between each transfer, not
accepting transfer requests of an agent acting under a power of attorney on
behalf of more than one contract owner, limiting the dollar amount that may be
transferred between the subaccounts by a contract owner at any one time. We may
apply these modifications or restrictions in any manner reasonably designed to
prevent any use of the transfer right we consider to be to the disadvantage of
other contract owners.
Transfers into the Regular Fixed Account are not allowed except as part of
various optional riders. A money market subaccount will be substituted for any
Regular Fixed Account allocations if termination of such riders does not include
purchase payment allocation instructions.
DOLLAR COST AVERAGING (DCA)
You may authorize the automatic transfer of specified amounts from any of the
variable subaccounts to any other variable subaccounts other than the source
account.
The unit values credited and applied to your contract are determined on each
date of transfer. You may terminate the DCA program at any time.
SPECIAL DCA PROGRAM: You may elect to participate in the Special DCA Program by
written request. Under the program you may allocate new purchase payments to the
Special DCA fixed account and authorize the automatic transfer of amounts on a
monthly basis from the Special DCA fixed account to any of the variable
subaccount(s) or any asset allocation models under certain optional benefit
riders. The minimum purchase payment into the Special DCA fixed account is shown
under Contract Data. All amounts allocated to the Special DCA fixed account will
be transferred out within the specified Special DCA fixed account time period
you elect from the time periods we make available.
We credit interest to each Special DCA fixed account at our current crediting
rate for the Special DCA fixed account. We may change the interest rate for any
Special DCA fixed account from time to time at our discretion however, the rate
will never be less than the Fixed Account Minimum Interest Rate shown under
Contract Data.
You may terminate the Special DCA Program at any time. However, upon termination
or annuitization, any amounts remaining in the Special DCA fixed account will be
transferred according to purchase payment allocation instructions then in
effect.
139484 Page 11 (06/2006)
FIXED AND VARIABLE ACCOUNTS
THE FIXED ACCOUNT
The fixed account is our general account. It is made up of all of our assets
other than:
1. those in the variable subaccounts; and
2. those in any other segregated asset account.
THE VARIABLE ACCOUNT
The variable account is a separate investment account of ours. It consists of
several subaccounts, which are named under Contract Data. We have allocated a
part of our assets for this contract to the variable accounts. Such assets
remain our property. However, they may not be charged with the liabilities from
any other business in which we may take part.
INVESTMENTS OF THE VARIABLE ACCOUNT
Purchase payments applied to the variable subaccounts will be allocated as
specified by the owner. Each variable subaccount will buy, at net asset value,
shares of the fund shown for that subaccount under Contract Data or as later
added or changed.
We may change the funds from which the variable subaccounts buy shares if laws
or regulations change, the existing funds become unavailable or in our judgment,
the funds are no longer suitable for the subaccounts. We have the right to
substitute funds for those shown under Contract Data, including funds other than
those shown under Contract Data. We may also: add additional subaccounts
investing in other funds; combine subaccounts; transfer assets to and from the
subaccounts or the variable account; and eliminate or close any subaccounts.
When required, we would first seek approval of the Securities and Exchange
Commission and, the insurance regulator of the state where this contract is
delivered.
VALUATION OF ASSETS
Fund shares in the variable subaccounts will be valued at their net asset value.
VARIABLE ACCOUNT ACCUMULATION UNITS
The number of accumulation units for each of the variable subaccounts is found
by adding the number of accumulation units resulting from:
1. purchase payments allocated to the subaccount; and
2. transfers to the subaccount;
and subtracting the number of accumulation units from:
1. transfers from the subaccount; and
2. surrenders from the subaccount; and
3. contract administrative charge or any rider charge deductions from the
subaccount.
The number of accumulation units added or subtracted for each of the above
transactions is found by dividing (1) by (2) where:
(1) is the amount allocated to or deducted from the subaccount; and
(2) is the accumulation unit value for the subaccount for the respective
valuation period during which we receive the purchase payment or transfer
value, or during which we deducted transfers, surrenders, rider charges or
contract administrative charges.
VARIABLE ACCOUNT ACCUMULATION UNIT VALUE
The value of an accumulation unit for each of the variable subaccounts was
arbitrarily set at $1 when the first fund shares were bought. The value for any
later valuation period is found as follows:
The accumulation unit value for each variable subaccount for the last
prior valuation period is multiplied by the net investment factor for the
same account for the next following valuation period. The result is the
accumulation unit value. The value of an accumulation unit may increase or
decrease from one valuation period to the next.
139484 Page 12 (06/2006)
FIXED AND VARIABLE ACCOUNTS (CONTINUED)
NET INVESTMENT FACTOR
The net investment factor is an index applied to measure the investment
performance of a variable subaccount from one valuation period to the next. The
net investment factor may be greater or less than one; therefore, the value of
an accumulation or annuity unit may increase or decrease.
The net investment factor for any such subaccount for any one valuation period
is determined by: dividing (1) by (2) and subtracting (3) from the result. This
is done where:
(1) is the sum of:
a) the net asset value per share of the fund held in the variable
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 fund held in the variable subaccount, if the
"ex-dividend" date occurs during the current valuation period.
(2) is the net asset value per share of fund held in the variable subaccount,
determined at the end of the last prior valuation period.
(3) is a factor representing the mortality and expense risk charge.
MORTALITY AND EXPENSE RISK CHARGE
In calculating unit values we will deduct a mortality and expense risk charge
from the variable subaccounts which is equal, on an annual basis, to a
percentage of the daily net asset value. The annual percentage charge is shown
under Contract Data. This deduction is made to compensate us for assuming the
mortality and expense risks under contracts of this type. We estimate that
approximately 2/3 of this charge is for assumption of mortality risk and 1/3 is
for assumption of expense risk. The deduction will be: (1) made from each
variable subaccount; and (2) computed on a daily basis.
ANNUITY UNIT VALUE
The value of an Annuity Unit for each variable subaccount was arbitrarily set at
$1 when the first funds were bought. The value for any later valuation period is
found as follows:
1. The annuity unit value for each variable subaccount for the last prior
valuation periods is multiplied by the net investment factor for the
subaccount for the valuation period for which the annuity unit value is
being calculated.
2. The result is multiplied by an interest factor, which on an annualized
basis is equal to .952381. This is done to neutralize the assumed
investment rate which is built into Table A under the Tables of Settlement
Rates section.
139484 Page 13 (06/2006)
SURRENDER PROVISIONS
SURRENDER
By written request and subject to the rules below you may:
1. surrender this contract for the total surrender value; or
2. partially surrender this contract for a part of the surrender value.
RULES FOR SURRENDER
All surrenders will have the following conditions;
1. You must apply by written request or other method agreed to by us: (a)
while this contract is in force; and (b) prior to the earlier of the
settlement date or the death of the owner.
2. Unless we agree otherwise, you must surrender an amount equal to at least
$250 or the entire contract value, if less.
3. The amount surrendered, less any charges, will normally be paid to you
within seven days of our receipt of your written request and the return of
this contract, if required. For surrenders from the fixed account and
following any required regulatory approval, we have the right to defer
payment to you for up to 6 months from the date we receive the request. If
we defer payment more than 10 days, we will pay annual interest at a rate
required by law on the amount deferred.
4. For partial surrenders, if you do not specify from which accounts the
surrender is to be made, the surrender will be made from the variable
subaccounts and Regular Fixed Account in the same proportion as your
interest in each bears to the contract value less any Special DCA fixed
account. Amounts will only be surrendered from any Special DCA fixed
account if insufficient amounts are available in the variable subaccounts
and Regular Fixed Account.
5. If the owner dies following a surrender request, payment will be made to
the owner's estate.
Upon surrender for the full surrender value this contract will terminate. We may
require that you return the contract to us before we pay the full surrender
value.
SURRENDER VALUE
The surrender value at any time will be:
1. the contract value;
2. minus the contract administrative charge and any applicable rider charges.
SUSPENSION OR DELAY IN PAYMENT OF SURRENDER
We have the right to suspend or delay the date of any surrender payment from the
variable subaccounts for any period:
1. when the New York Stock Exchange is closed; or
2. when trading on the New York Stock Exchange is restricted; or
3. when an emergency exists as a result of which: (a) disposal of securities
held in the variable subaccounts is not reasonably practicable; or (b) it
is not reasonably practicable to fairly determine the value of the net
assets of the variable subaccounts; or
4. during any other period when the Securities and Exchange Commission, by
order, so permits for the protection of security holders; or
5. if and to the extent permitted or required under the Federal Investment
Company Act of 1940, as amended, and any other applicable federal or state
law.
Rules and regulations of the Securities and Exchange Commission will govern as
to whether the conditions set forth in 2 and 3 exist.
139484 Page 14 (06/2006)
ANNUITY PROVISIONS
SETTLEMENT
When settlement occurs, the contract value will be applied to make annuity
payments. The first payment will be made as of the settlement date. This date is
shown under Contract Data. Before payments begin we will require satisfactory
proof that the annuitant is alive. We may also require that you exchange this
contract for a supplemental contract, which provides for the annuity payments.
CHANGE OF SETTLEMENT DATE
You may change the settlement date shown for this contract. Tell us the new date
by written request. The settlement date may not be earlier than 13 months from
the contract date. However the settlement date may not be later than the later
of: (1) the annuitant's 90th birthday; or (2) the tenth contract anniversary; or
(3) such other date as agreed upon by us. Also, if you select a new date, it
must be at least 30 days after we receive your written request at our corporate
office.
ANNUITY PAYMENT PLANS
Subject to the terms of this contract, annuity payments may be made on a fixed
dollar basis, a variable basis, or a combination of both. You can schedule
receipt of annuity payments according to one of the Plans A through E below or
another plan agreed to by us.
PLAN A - LIFE INCOME NON-REFUND.
Monthly annuity payments will be paid during the lifetime of the annuitant.
No payments will be made after the annuitant dies.
PLAN B - LIFE INCOME WITH GUARANTEED PERIOD.
Monthly annuity payments will be paid during the lifetime of the annuitant
with a guarantee that payments will be made for a period certain of at least
five, ten, fifteen or twenty years whether or not the annuitant is living.
You must select the guaranteed period.
PLAN C - LIFE INCOME WITH INSTALLMENT REFUND.
Monthly annuity payments will be paid during the lifetime of the annuitant
with a guarantee that payments will be made for a certain number of months
whether or not the annuitant is living. The number of months is determined
by dividing the contract value applied under this plan by the amount of the
first monthly payment.
PLAN D - JOINT AND SURVIVOR LIFE INCOME NON-REFUND.
Monthly payments will be paid during the lifetime of the annuitant and a
joint annuitant. When either the annuitant or the joint annuitant dies, we
will continue to make monthly payments for the lifetime of the survivor. No
payments will be paid after the death of both the annuitant and joint
annuitant.
PLAN E - TERM CERTAIN INSTALLMENT.
Monthly annuity payments will be paid for a specified period of years. The
period of years may be no less than 10 nor more than 30.
By written request to us at least 30 days before the settlement date, you may
select the Plan or change to another plan. The default annuity option is Plan B
with payments guaranteed for ten years.
If the Plan selected has a payment amount that is the same as another Plan
having a longer guarantee period, then the Plan with the longer guarantee period
will be deemed to have been chosen.
If the amount applied to a Plan is less than $2,000 or would not provide an
initial monthly payment of at least $20, or if payments are to be made to other
than a natural person, we have the right to make a lump sum payment of the
contract value.
ALLOCATION OF CONTRACT VALUES AT SETTLEMENT
At the time of settlement under an Annuity Payment Plan, you may allocate your
contract value to provide fixed dollar payments and/or allocate your contract
value in whole percentages among the variable subaccounts to provide variable
annuity payments. Unless we agree otherwise, you may use a maximum of five
variable subaccounts at any one time during settlement.
139484 Page 15 (06/2006)
ANNUITY PROVISIONS (CONTINUED)
FIXED ANNUITY
A fixed annuity is an annuity with payments that are guaranteed by us as to
dollar amount. Fixed annuity payments remain the same. At settlement contract
value amounts you allocate will be applied to the applicable Settlement Table.
This will be done in accordance with the Payment Plan chosen. The minimum amount
payable for each $1,000 so applied is shown in Table B under the Tables of
Settlement Rates section.
VARIABLE ANNUITY
A variable annuity is an annuity with payments which: (1) are not predetermined
or guaranteed as to dollar amount: and (2) vary in amount with the investment
experience of the variable subaccounts.
DETERMINATION OF FIRST VARIABLE ANNUITY PAYMENT
At settlement, the variable account contract value will be applied to the
applicable Settlement Table. This will be done: (1) on the valuation date on or
next preceding the 7th calendar day before the settlement date; and (2) in
accordance with the Payment Plan chosen. The amount payable for the first
payment for each $1,000 so applied is shown in Table A under the Tables of
Settlement Rates section.
VARIABLE ANNUITY PAYMENTS AFTER THE FIRST PAYMENT
Variable annuity payments after the first vary in amount. The amount changes
with the investment performance of the variable subaccounts. The dollar amount
of variable annuity payments after the first is not fixed. It may change from
month to month. The dollar amount of such payments is determined as follows:
1. The dollar amount of the first annuity payment is divided by the value of
an annuity unit as of the valuation date on or next preceding the 7th
calendar day before the settlement date. This result establishes the fixed
number of annuity units for each monthly annuity payment after the first.
This number of annuity units remains fixed during the annuity payment
period.
2. The fixed number of annuity units is multiplied by the annuity unit value
as of the valuation date on or next preceding the 7th calendar day before
the date the payment is due. The result establishes the dollar amount of
the payment.
We guarantee that the dollar amount of each payment after the first will not be
affected by variation in expenses or mortality experience.
EXCHANGE OF ANNUITY UNITS
After annuity payments begin, annuity units of any variable subaccount may be
exchanged for units of any of the other variable subaccounts. This may be done
no more than once a year. Unless we agree otherwise you may use a maximum of
five variable subaccounts at any one time. Once annuity payments start, no
exchanges may be made to or from any fixed annuity.
139484 Page 16 (06/2006)
TABLES OF SETTLEMENT RATES
Table A below shows the amount of the first monthly variable annuity payment,
based on a 5% assumed investment return, for each $1,000 of value applied under
any payment plan. The amount of the first and all subsequent monthly fixed
dollar annuity payments for each $1,000 of value applied under any payment plan
will be based on our fixed dollar Table of Settlement Rates in effect at
settlement. Such rates are guaranteed to be not less than those shown in Table
B. The amount of such annuity payments under Plans A, B and C will depend upon
the sex and age of the annuitant at settlement. The amount of such annuity
payments under Plan D will depend upon the sex and the age of the annuitant and
the joint annuitant at settlement.
TABLE A - DOLLAR AMOUNT OF FIRST MONTHLY VARIABLE ANNUITY PAYMENT PER $1,000 APPLIED
------------------------------------------------------------------------------------------------------------------------------
PLAN A PLAN B PLAN C PLAN D
------------------------------------------------------------------------------------------------------------------------------
Age Life Income with Life Income Joint & Survivor
at Beginning Life Income Five Years Ten Years Fifteen Years Installment Non-Refund
Annuit- In Non-Refund Certain Certain Certain Refund Male & Female
ization Year Male Female Male Female Male Female Male Female Male Female Same Age
------------------------------------------------------------------------------------------------------------------------------
Age 65 2010 6.42 5.92 6.37 5.89 6.23 5.82 6.01 5.71 6.07 5.72 5.35
2015 6.33 5.84 6.28 5.82 6.15 5.76 5.95 5.65 6.00 5.66 5.30
2020 6.24 5.77 6.20 5.75 6.09 5.70 5.90 5.60 5.94 5.61 5.26
2025 6.16 5.71 6.13 5.69 6.02 5.64 5.85 5.55 5.88 5.55 5.21
2030 6.09 5.65 6.05 5.63 5.96 5.59 5.80 5.51 5.82 5.51 5.18
2035 6.01 5.59 5.99 5.58 5.90 5.54 5.75 5.47 5.77 5.46 5.14
------------------------------------------------------------------------------------------------------------------------------
Age 70 2010 7.29 6.64 7.19 6.58 6.90 6.44 6.49 6.20 6.71 6.29 5.86
2015 7.17 6.53 7.07 6.49 6.81 6.35 6.43 6.13 6.62 6.21 5.79
2020 7.05 6.43 6.97 6.39 6.72 6.27 6.37 6.07 6.54 6.14 5.72
2025 6.94 6.34 6.86 6.31 6.64 6.20 6.32 6.02 6.46 6.07 5.66
2030 6.84 6.25 6.77 6.22 6.56 6.13 6.26 5.96 6.38 6.00 5.61
2035 6.74 6.17 6.67 6.15 6.48 6.06 6.21 5.91 6.31 5.94 5.56
------------------------------------------------------------------------------------------------------------------------------
Age 75 2010 8.51 7.71 8.28 7.59 7.69 7.24 6.97 6.75 7.54 7.08 6.60
2015 8.34 7.56 8.13 7.45 7.59 7.14 6.91 6.68 7.43 6.97 6.50
2020 8.17 7.41 7.98 7.32 7.49 7.04 6.86 6.62 7.32 6.87 6.40
2025 8.02 7.28 7.84 7.19 7.39 6.94 6.81 6.56 7.22 6.78 6.32
2030 7.87 7.16 7.71 7.08 7.30 6.85 6.75 6.50 7.12 6.69 6.24
2035 7.73 7.04 7.59 6.97 7.21 6.76 6.70 6.45 7.03 6.61 6.16
------------------------------------------------------------------------------------------------------------------------------
Age 85 2010 12.67 11.74 11.49 10.89 9.37 9.17 7.65 7.61 10.10 9.65 9.30
2015 12.33 11.39 11.26 10.65 9.29 9.06 7.64 7.58 9.91 9.45 9.09
2020 12.00 11.07 11.04 10.41 9.21 8.96 7.62 7.56 9.74 9.28 8.89
2025 11.70 10.77 10.83 10.19 9.13 8.87 7.60 7.53 9.57 9.11 8.70
2030 11.42 10.50 10.63 9.98 9.04 8.77 7.58 7.51 9.42 8.95 8.53
2035 11.15 10.24 10.44 9.78 8.96 8.67 7.56 7.48 9.28 8.80 8.37
------------------------------------------------------------------------------------------------------------------------------
Age 90 2010 16.12 15.30 13.50 13.10 10.00 9.91 7.79 7.77 12.01 11.61 11.64
2015 15.68 14.81 13.29 12.84 9.96 9.86 7.78 7.77 11.80 11.38 11.35
2020 15.27 14.37 13.08 12.60 9.92 9.81 7.78 7.77 11.60 11.16 11.09
2025 14.88 13.95 12.88 12.36 9.88 9.76 7.78 7.76 11.42 10.96 10.84
2030 14.52 13.57 12.68 12.14 9.84 9.70 7.77 7.76 11.25 10.78 10.61
2035 14.17 13.21 12.49 11.92 9.80 9.65 7.77 7.75 11.08 10.61 10.41
------------------------------------------------------------------------------------------------------------------------------
Table A above is based on the "Annuity 2000 Mortality Table" with 100%
Projection Scale G and a 5.0% assumed investment return. Settlement rates for
any year, age, or any combination of year, age and sex not shown above, will be
calculated on the same basis as those rates shown in the Table above. Such rates
will be furnished by us upon request. Amounts shown in the Table below are based
on a 5.0% assumed investment return.
PLAN E - DOLLAR AMOUNT OF FIRST MONTHLY VARIABLE ANNUITY PAYMENT PER $1,000 APPLIED
----------------------------------------------------------------------------------------------------------------------
YEARS PAYABLE MONTHLY PAYMENT YEARS PAYABLE MONTHLY PAYMENT YEARS PAYABLE MONTHLY PAYMENT
----------------------------------------------------------------------------------------------------------------------
10 10.51 17 7.20 24 5.88
11 9.77 18 6.94 25 5.76
12 9.16 19 6.71 26 5.65
13 8.64 20 6.51 27 5.54
14 8.20 21 6.33 28 5.45
15 7.82 22 6.17 29 5.36
16 7.49 23 6.02 30 5.28
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139484 Page 17 (06/2006)
Fixed Dollar annuity payments will not be less than those shown in Table B. In
addition, the amount of payments under any annuity payment plan will not be less
than that which would be provided if a single premium immediate annuity contract
then offered by us to annuitants in the same class and were to be purchased with
the greater of:
(1) surrender value of the contract; or
(2) 95% of the contract value of this contract.
TABLE B- DOLLAR AMOUNTS OF EACH MONTHLY FIXED DOLLAR ANNUITY PAYMENT PER $1,000 APPLIED
------------------------------------------------------------------------------------------------------------------------------
PLAN A PLAN B PLAN C PLAN D
------------------------------------------------------------------------------------------------------------------------------
Age Life Income with Life Income Joint & Survivor
at Beginning Life Income Five Years Ten Years Fifteen Years Installment Non-Refund
Annuit- In Non-Refund Certain Certain Certain Refund Male & Female
ization Year Male Female Male Female Male Female Male Female Male Female Same Age
------------------------------------------------------------------------------------------------------------------------------
Age 65 2010 4.65 4.19 4.63 4.18 4.53 4.13 4.37 4.05 4.12 3.86 3.68
2015 4.57 4.12 4.54 4.10 4.46 4.06 4.31 3.99 4.07 3.81 3.63
2020 4.48 4.05 4.46 4.04 4.39 4.00 4.25 3.93 4.01 3.77 3.58
2025 4.41 3.98 4.39 3.97 4.32 3.94 4.19 3.88 3.96 3.72 3.54
2030 4.33 3.92 4.31 3.92 4.25 3.89 4.14 3.83 3.92 3.68 3.50
2035 4.26 3.87 4.25 3.86 4.19 3.84 4.08 3.79 3.87 3.64 3.46
------------------------------------------------------------------------------------------------------------------------------
Age 70 2010 5.53 4.92 5.46 4.89 5.25 4.78 4.91 4.59 4.68 4.38 4.22
2015 5.41 4.82 5.34 4.79 5.15 4.70 4.84 4.53 4.61 4.31 4.15
2020 5.29 4.72 5.24 4.70 5.06 4.62 4.78 4.46 4.54 4.25 4.09
2025 5.19 4.63 5.14 4.61 4.98 4.54 4.72 4.40 4.48 4.20 4.03
2030 5.08 4.55 5.04 4.53 4.90 4.47 4.66 4.34 4.42 4.14 3.97
2035 4.99 4.47 4.95 4.46 4.82 4.40 4.60 4.28 4.36 4.09 3.92
------------------------------------------------------------------------------------------------------------------------------
Age 75 2010 6.73 5.98 6.56 5.90 6.10 5.64 5.45 5.21 5.39 5.06 4.99
2015 6.56 5.84 6.41 5.77 5.99 5.53 5.39 5.14 5.30 4.98 4.89
2020 6.40 5.70 6.27 5.64 5.89 5.43 5.33 5.07 5.22 4.90 4.80
2025 6.25 5.57 6.13 5.52 5.78 5.33 5.27 5.01 5.13 4.82 4.71
2030 6.11 5.45 6.00 5.40 5.69 5.24 5.22 4.94 5.06 4.75 4.63
2035 5.98 5.34 5.88 5.30 5.59 5.15 5.16 4.88 4.99 4.69 4.56
------------------------------------------------------------------------------------------------------------------------------
Age 85 2010 10.82 9.93 9.86 9.26 7.94 7.72 6.23 6.18 7.54 7.20 7.71
2015 10.49 9.60 9.63 9.02 7.85 7.61 6.22 6.16 7.39 7.05 7.50
2020 10.18 9.30 9.41 8.78 7.76 7.50 6.20 6.13 7.26 6.92 7.31
2025 9.89 9.01 9.20 8.56 7.68 7.40 6.18 6.10 7.14 6.80 7.13
2030 9.62 8.75 9.00 8.35 7.59 7.30 6.16 6.08 7.03 6.68 6.97
2035 9.36 8.51 8.81 8.16 7.50 7.20 6.14 6.05 6.93 6.58 6.82
------------------------------------------------------------------------------------------------------------------------------
Age 90 2010 14.23 13.43 11.97 11.56 8.63 8.54 6.38 6.37 9.17 8.85 10.04
2015 13.80 12.97 11.75 11.30 8.59 8.48 6.38 6.36 9.02 8.69 9.77
2020 13.41 12.54 11.54 11.05 8.55 8.42 6.37 6.36 8.88 8.54 9.51
2025 13.04 12.14 11.33 10.81 8.51 8.37 6.37 6.35 8.75 8.41 9.28
2030 12.69 11.78 11.14 10.58 8.46 8.31 6.37 6.35 8.63 8.28 9.06
2035 12.36 11.44 10.94 10.37 8.42 8.26 6.36 6.35 8.52 8.17 8.86
------------------------------------------------------------------------------------------------------------------------------
Table B above is based on the "Annuity 2000 Mortality Table" at 2.0% annual
effective interest rate with 100% Projection Scale G. Settlement rates for any
year, age, or any combination of year, age and sex not shown above, will be
calculated on the same basis as those rates shown in the Table above. Such rates
will be furnished by us upon request. Amounts shown in the Table below are based
on a 2.0% annual effective interest rate.
PLAN E - DOLLAR AMOUNT OF EACH MONTHLY FIXED DOLLAR ANNUITY PAYMENT PER $1,000 APPLIED
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YEARS PAYABLE MONTHLY PAYMENT YEARS PAYABLE MONTHLY PAYMENT YEARS PAYABLE MONTHLY PAYMENT
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10 9.18 17 5.77 24 4.36
11 8.42 18 5.50 25 4.22
12 7.80 19 5.26 26 4.10
13 7.26 20 5.04 27 3.98
14 6.81 21 4.85 28 3.87
15 6.42 22 4.67 29 3.77
16 6.07 23 4.51 30 3.68
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139484 Page 18 (06/2006)
DEFERRED ANNUITY CONTRACT
- FLEXIBLE PURCHASE PAYMENTS.
- OPTIONAL FIXED DOLLAR OR VARIABLE ACCUMULATION VALUES AND ANNUITY PAYMENTS.
- ANNUITY PAYMENTS TO BEGIN ON THE SETTLEMENT DATE.
- THIS CONTRACT IS NONPARTICIPATING. DIVIDENDS ARE NOT PAYABLE.
IDS LIFE INSURANCE COMPANY
OF NEW YORK
00 Xxxxxxx Xxx. Ext.
P.O. Box 5144
Albany, NY 12205
