Contract Holder Group Annuity Contract No. E. G. Anybroker Specimen ----------- --------------------------------------------------------------------- Your Name Certificate No. John Doe Specimen ---------------------------------------------...
Exhibit 99-B.4.15
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Aetna Life Insurance and Annuity Company
Home Office: 000 Xxxxxxxxxx Xxxxxx
Xxxxxxxx, Xxxxxxxxxxx 00000
(000) 000-0000
Aetna Life Insurance and Annuity Company, herein
called Aetna, agrees to pay the benefits stated
in the Contract.
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Certificate of Group To the Certificate Holder:
Annuity Coverage
Aetna certifies that coverage is in force for
you under the stated Group Annuity Contract and
Certificate numbers. All data shown here is
taken from Aetna records and is based upon
information furnished by you.
This Certificate is a summary of the Group
Annuity Contract provisions. It replaces any and
all prior certificates, riders, or amendments
issued to you under the stated Contract and
Certificate numbers. This Certificate is for
information only and is not a part of the
Contract.
THE VARIABLE FEATURES OF THE GROUP CONTRACT ARE
DESCRIBED IN PARTS III AND IV.
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Right to Cancel You may cancel the Account evidenced by this
Certificate within 10 days of receiving it, by
returning this Certificate along with a written
notice to Aetna at the above address or to the
agent from whom it was purchased. Within 7 days
after it receives the notice of cancellation
and this Certificate at its Home Office, Aetna
will return the entire consideration paid plus
and increase or minus any decrease in the
current value of any funds allocation to the
Separate Account.
/s/ Xxxx X. Xxxxxxx /s/ Xxxxxx X. Xxxxxxx
Xxxx X. Xxxxxxx Xxxxxx X. Xxxxxxx
President Secretary
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Contract Holder Group Annuity Contract No.
E. G. Anybroker Specimen
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Your Name Certificate No.
Xxxx Xxx Specimen
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Annuitant Name Type of Plan
Xxxx Xxx Jr. Flexible Premium
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ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CERTIFICATE CONTAINS A MARKET VALUE ADJUSTMENT
FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN
INCREASE OR DECREASE IN THE CURRENT
GMCC-IC-(NQ)
VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM
AT THE TIME OF ITS MATURITY.
2
Specifications
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Guaranteed Interest There are guaranteed interest rates for amounts
Rate held in the MG Account (See Certificate Schedule I).
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Deductions from the There will be deductions for mortality and expense
Separate Account risks and administrative fees. (See Certificate
Schedule I and II).
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Deduction from Purchase Payment(s) are subject to a deduction for
Purchase Payment(s) premium taxes, if any. (See 3.01.)
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Surrender Fee There will be a charge deducted upon surrender.
(See Certificate Schedule I).
3
Contract Schedule I
Accumulation Period
Separate Account
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Separate Account: Variable Annuity Account B
Charges to Separate Account: A daily charge is deducted from any portion
of the Current Value allocated to the
Separate Account. The deduction is the daily
equivalent of the annual effective percentage
shown in the following chart:
Administrative Charge 0.15%
Mortality Risk Charge 0.35%
Expense Risk Charge 0.90%
----
Total Separate Account
Charges 1.40%
Marathon Guaranteed Account (MG Account)
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Minimum Guaranteed Interest Rate (effective
annual rate of return): 3.0%
Separate Account and MG Account
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Transfers: An unlimited number of Transfers may be made
during the Accumulation Period. Aetna allows
12 free Transfers in any calendar year.
Thereafter, Aetna reserves the right to
charge $10 for each subsequent Transfer.
Maintenance Fee: The Annual Maintenance Fee is $30. If the
Account's Current Value is $50,000 or more on
the date the Maintenance Fee is to be
deducted, the Maintenance Fee is $0.
Surrender Fee: For each surrender, the Surrender Fee for
each Net Purchase Payment will be determined
as follows:
Surrender Fee
Length of Time from Deposit of Net (as percentage of
Purchase Payment (Years) Net Purchase Payment)
Less than 2 years 7%
2 or more but less than 4 years 6%
4 or more but less than 5 years 5%
5 or more but less than 6 years 4%
6 or more but less than 7 years 3%
7 years or more 0%
4
Contract Schedule I (Continued)
Accumulation Period
Systematic Withdrawal Option The specified payment or specified percentage
(SWO): may not be greater than 10% of the Account's
Current Value at time of election.
See 1 - GENERAL DEFINITIONS for explanations.
5
Contract Schedule II
Annuity Period
Separate Account
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Charges to Separate Account: A daily charge at an annual effective
rate of 1.25% for Annuity mortality
and expense risks. The administrative
charge is established upon election of
an Annuity option. This charge will
not exceed 0.25%.
Variable Annuity Assumed Annual If a Variable Annuity is chosen,
Net Return Rate: an assumed annual net return rate of
5.0% may be elected. If 5.0% is not
elected, Aetna will use an assumed
annual net return rate of 3.5%
The assumed annual net return rate
factor for 3.5% per year is 0.9999058.
The assumed annual net return rate
factor for 5.0% per year is 0.9998663.
If the portion of a Variable Annuity
payment for any Fund is not to
decrease, the Annuity return factor
under the Separate Account for that
Fund must be:
(a) 4.75% on an annual basis plus an
annual return of up to 0.25% to
offset the administrative charge
set at the time Annuity payments
commence if an assumed annual net
return rate of 3.5% is chosen; or
(b) 6.25% on an annual basis plus an
annual return of up to 0.25% to
offset the administrative charge
set at the time Annuity payments
commence, if an assumed annual
net return rate of 5% is chosen.
Fixed Annuity
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Minimum Guaranteed Interest Rate
(effective annual rate of return):
3.0%
See 1. GENERAL DEFINITIONS for explanations.
6
TABLE OF CONTENTS
I. GENERAL DEFINITIONS
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Page
1.01 Account..............................................................9
1.02 Accumulation Period..................................................9
1.03 Adjusted Current Value...............................................9
1.04 Annuitant............................................................9
1.05 Annuity..............................................................9
1.06 Beneficiary..........................................................9
1.07 Certificate Holder...................................................9
1.08 Code.................................................................9
1.09 Contract.............................................................9
1.10 Contract Holder......................................................9
1.11 Current Value.......................................................10
1.12 Deposit Period......................................................10
1.13 Fixed Annuity.......................................................10
1.14 Fund(s).............................................................10
1.15 General Account.....................................................10
1.16 Guaranteed Rates - MG Account.......................................10
1.17 Guaranteed Term.....................................................11
1.18 Guaranteed Term(s) Groups...........................................11
1.19 Maintenance Fee.....................................................11
1.20 Marathon Guaranteed Account (MG Account)............................11
1.21 Market Value Adjustment (MVA).......................................11
1.22 Matured Term Value..................................................11
1.23 Matured Term Value Transfer.........................................11
1.24 Maturity Date.......................................................11
1.25 Net Purchase Payment(s).............................................12
1.26 Nonunitized Separate Account........................................12
1.27 Purchase Payment(s).................................................12
1.28 Reinvestment........................................................12
1.29 Separate Account....................................................12
1.30 Surrender Value.....................................................12
1.31 Transfers...........................................................12
1.32 Valuation Period (Period)...........................................13
1.33 Variable Annuity....................................................13
7
II. GENERAL PROVISIONS
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Page
2.01 Change of Contract...................................................13
2.02 Change of Fund(s)....................................................14
2.03 Nonparticipating Contract............................................14
2.04 Payments and Elections...............................................14
2.05 State Laws...........................................................15
2.06 Control of Contract..................................................15
2.07 Designation of Beneficiary...........................................15
2.08 Misstatements and Adjustments........................................15
2.09 Incontestability.....................................................15
2.10 Grace Period.........................................................15
III. PURCHASE PAYMENT, CURRENT VALUE, AND SURRENDER PROVISIONS
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3.01 Net Purchase Payment.................................................16
3.02 Certificate Holder's Account.........................................16
3.03 Fund(s) Record Units -- Separate Account.............................16
3.04 Net Return Factor(s) -- Separate Account.............................16
3.05 Fund Record Unit Value -- Separate Account...........................17
3.06 Market Value Adjustment..............................................17
3.07 Transfer of Current Value from the Funds or MG Account...............18
3.08 Notice to the Certificate Holder.....................................19
3.09 Loans................................................................19
3.10 Systematic Withdrawal Option (SWO)...................................19
3.11 Death Benefit Amount.................................................21
3.12 Death Benefit Options available to Beneficiary.......................22
3.13 Liquidation of Surrender Value.......................................23
3.14 Surrender Fee........................................................24
3.15 Payment of Surrender Value...........................................25
3.16 Reinstatement........................................................25
3.17 Payment of Adjusted Current Value....................................25
IV. ANNUITY PROVISIONS
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4.01 Choices to be Made...................................................26
4.02 Terms of Annuity Options.............................................26
4.03 Death of Annuitant/Beneficiary.......................................27
4.04 Fund(s) Annuity Units - Separate Account.............................28
4.05 Fund(s) Annuity Unit Value - Separate Account........................29
4.06 Annuity Net Return Factor(s) -- Separate Account.....................29
4.07 Annuity Options......................................................30
8
I. GENERAL DEFINITIONS
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1.01 Account: A record established for each
Certificate Holder to maintain the
value of all Net Purchase Payments
held on his her behalf during the
Accumulation Period.
1.02 Accumulation Period: The period during which the Net
Purchase Payment(s) are applied to an
Account to provide future Annuity
payment(s).
1.03 Adjusted Current Value: The Current Value of an Account plus
or minus any aggregate MG Account MVA,
if applicable. (See 1.21)
1.04 Annuitant: The person whose life is measured for
purposes of the guaranteed death
benefit and the duration of Annuity
payments under the Contract.
1.05 Annuity: Payment of an income:
(a) For the life of one or two
persons;
(b) For a stated period; or
(c) For some combination of (a) and
(b).
1.06 Beneficiary: The individual or estate entitled to
receive any payment from the Account
upon the death of the Annuitant.
1.07 Certificate Holder: A person who purchases an interest in
the Contract as evidenced by a
certificate. A Certificate Holder
cannot be a nonnatural person (i.e. a
trustee for a trust, an executor or
administrator for an estate, or an
incorporated or unincorporated
business).
1.08 Code: The Internal Revenue Code of
1986, as it may be amended from time
to time.
1.09 Contract: The agreement between Aetna and the
Contract Holder.
1.10 Contract Holder: The entity to which the Contract is
issued. The Contract is offered to:
(a) National Association of Securities
Dealers, Inc. ("NASD") member
broker-dealers selected by Aetna,
who have a minimum net capital of
$250,000 or more, including
broker-dealer subsidiaries of
banks and savings and loan
associations;
(b) Employers who sponsor nonqualified
benefit plans for their employees
(exempt from ERISA Title I);
(c) Entities that contribute to
annuities on behalf of their
customers; and
9
1.10 Contract Holder (Cont'd): (d) Custodians of custodial accounts
and trustees of trusts that have
been established for Individual
Retirement Accounts under Code
Section 408.
1.11 Current Value: As of the most recent Valuation
Period, the Net Purchase Payment and
any additional amount deposited
pursuant to 3.11 plus any interest
added to the portion allocated to the
MG Account; and plus or minus the
investment experience of the portion
allocated to the Funds since deposit;
less all Maintenance Fees deducted,
any amounts surrendered and any
amounts applied to an Annuity.
1.12 Deposit Period: A calendar week, a calendar month, a
calendar quarter, or any other period
of time specified by Aetna during
which Net Purchase Payment(s),
Transfers and Reinvestments are
accepted into the MG Account for one
or more Guaranteed Terms. Aetna
reserves the right to extend the
Deposit Period.
1.13 Fixed Annuity: An Annuity with payments that do not
vary in amount.
1.14 Fund(s): The open-end management investment
companies (mutual funds) in which the
Separate Account invests.
1.15 General Account: The Account holding the assets of
Aetna, other than those assets held in
Aetna's separate accounts.
1.16 Guaranteed Rates -- MG Aetna will declare the interest
Account: rate(s) applicable to a specific
Guaranteed Term at the start of the
Deposit Period for that Guaranteed
Term. The rate(s) are guaranteed by
Aetna for that Deposit Period and the
ensuing Guaranteed Term. The
Guaranteed Rates are annual effective
yields. That is, interest is credited
daily at a rate that will produce the
Guaranteed Rate over the period of a
year. No Guaranteed Rate will ever be
less than the Minimum Guaranteed Rate
shown on Contract Schedule I.
For Guaranteed Terms of one year or
less, one Guaranteed Rate is credited
for the full Guaranteed Term. For
longer Guaranteed Terms, an initial
Guaranteed Rate is credited from the
date of deposit to the end of a
specified period within the Guaranteed
Term. There may be different
Guaranteed Rate(s) declared for
subsequent specified time intervals
throughout the Guaranteed Term.
1.17 Guaranteed Term: The period of time for which MG
Account Guaranteed Rates are
guaranteed on Net Purchase Payments.
Transfers and Reinvestments made into
a current Deposit Period for the MG
Account. Such period begins on the day
following the close of the Deposit
Period and ends on the designated
Maturity Date. Guaranteed Terms are
offered at Aetna's discretion for
various lengths of time ranging up to
and including ten years.
10
1.17 Guaranteed Term (Cont'd): During a Deposit Period, Aetna may
make available any number of
Guaranteed Terms. The Certificate
Holder may allocate Net Purchase
Payments and Transfers into any or all
of the available Guaranteed Terms.
1.18 Guaranteed Term(s) Groups: All MG Account Guaranteed Term(s) with
the same length of time from the close
of the Deposit Period until the
designated Maturity Date.
1.19 Maintenance Fee: The Maintenance Fee (see Contract
Schedule I) will be deducted during
the Accumulation Period from the
Current Value on each anniversary of
the date the Account is established
and upon surrender of the entire
Account.
1.20 Marathon Guaranteed An accumulation option where Aetna
Account (MG Account): guarantees stipulated rate(s) of
interest for specified period of time.
All assets of Aetna, including amounts
in the Nonunitized Separate Account,
are available to meet the guarantees
under the MG Account.
1.21 Market Value An adjustment to the amount withdrawn
Adjustment (MVA): or transferred from an MG Account
Guaranteed Term prior to the end of
that Guaranteed Term. The adjustments
reflects the change in the value of
the investment due to changes in
interest rates since the date of
deposit and is computed using the
formula given in 3.06. The adjustment
is expressed as a percentage of each
dollar being withdrawn.
1.22 Matured Term Value: The amount payable on an MG Account
Guaranteed Term's Maturity Date.
1.23 Matured Term Value Transfer: During the calendar month following an
MG Account Maturity Date, the
Certificate Holder may notify Aetna's
Home Office in writing to Transfer or
surrender all or part of the Matured
Term Value, plus interest at the new
Guaranteed Rate accrued thereon, from
the MG Account without an MVA. This
provision only applies to the first
such written request received from the
Certificate Holder during this period
for any Matured Term Value.
1.24 Maturity Date: The last day of an MG Account
Guaranteed Term.
1.25 Net Purchase Payment(s): The Purchase Payment less premium
taxes, as applicable.
1.26 Nonunitized Separate A separate account set up by Aetna
Account: under Title 38. Section 38a-433, of
the Connecticut General Statutes, that
holds assets for MG Account Terms.
There are no discrete units for this
Account. The Certificate Holder does
not participate in the investment gain
or loss from the assets held in the
Nonunitized Separate Account. Such
gain or loss is borne entirely by
Aetna. These assets may be chargeable
with liabilities arising out of any
other business of Aetna.
11
1.27 Purchase Payment(s): Payment(s) accepted by Aetna at its
Home Office. Aetna reserves the right
to refuse to accept any Purchase
Payment at any time for any reason. No
advance notice will be given to the
Contract Holder or Certificate Holder.
1.28 Reinvestment: Aetna will mail a notice to the
Certificate Holder at least 18
calendar days before a Guaranteed
Term's Maturity Date. This notice will
contain the current Terms available
during the current Deposit Periods
with their Guaranteed Rate(s), and
projected Matured Term Value. If no
specific direction is given by the
Certificate Holder prior to the
Maturity Date, each Matured Term Value
will be reinvested in the current
Deposit Period for a Guaranteed Term
of the same duration. If a Guaranteed
Term of the same duration is
unavailable, each Matured Term Value
will automatically be reinvested in
the current Deposit Period for the
next shortest Guaranteed Term
available, if no shorter Guaranteed
Term is available, the next longer
Guaranteed Term will be used. Aetna
will mail a confirmation statement to
the Certificate Holder the next
business day after the Maturity Date.
This notice will state the Guaranteed
Term and Guaranteed Rate(s) which will
apply to the reinvested Matured Term
Value.
1.29 Separate Account: A separate account that buys and holds
shares of the Fund(s). Income, gains
or losses, realized or unrealized, are
credited or charged to the Separate
Account without regard to other
income, gains or losses of Aetna.
Aetna owns the assets held in the
Separate Account and is not a trustee
as to such amounts. This Separate
Account generally is not guaranteed
and is held at market value. The
assets of the Separate Account, to the
extent of reserves and other contract
liabilities of the Account, shall not
be charged with other Aetna
liabilities.
1.30 Surrender Value: The amount payable by Aetna upon the
surrender of any portion of an
Account.
1.31 Transfers: The movement of invested amounts among
the available Fund(s) and the MG
Account under the Contract during the
Accumulation Period.
1.32 Valuation Period (Period): The period of time for which a Fund
determines its net asset value,
usually from 4:15 p.m. Eastern time
each day the New York Stock Exchange
is open until 4:15 p.m. the next such
day, or such other day that one or
more of the Funds determines its net
asset value.
1.33 Variable Annuity: An Annuity with payments that vary
with the net investment results of one
or more Funds under the Separate
Account.
12
II. GENERAL PROVISIONS
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2.01 Change of Contract: Only an authorized officer of Aetna
may change the terms of the Contract.
Aetna will notify the Contract Holder
in writing at least 30 days before the
effective date of any change. Any
change will not affect the amount or
terms of any Annuity which begins
before the change.
Aetna reserves the right to refuse to
accept any Purchase Payment at any
time for any reason. This applies to
an initial Purchase Payment to
establish a new Account or to
subsequent Purchase Payments to
existing Accounts under the Contract.
No advance notice will be given to the
Contract Holder or Certificate Holder.
Aetna may make any change that affects
the MG Account Market Value Adjustment
(3.06) with at least 30 days' advance
written notice to the Contract Holder
and the Certificate Holder. Any such
change shall become effective for any
new Term and will apply to all present
and future Accounts.
Aetna reserves the right to change the
terms of the Systematic Withdrawal
Option (3.10) for future elections and
discontinue the availability of this
option after proper notification.
Any change that affects any of the
following under the Contract will not
apply to Accounts in existence before
the effective date of the change:
(a) Net Purchase Payment (1.25)
(b) MG Account Guaranteed Rate (1.16)
(c) Net Return Factor(s) -- Separate
Account (3.04)
(d) Current Value (1.11)
(e) Surrender Value (1.30)
(f) Fund(s) Annuity Unit Value -
Separate Account (4.05)
(g) Annuity options (4.07)
(h) Fixed Annuity Interest Rates
(4.01)
(i) Transfers (1.31).
Any change that affects the Annuity
options and the tables for the options
may be made:
(a) No earlier than 12 months after
the effective date of the
Contract; and
(b) No earlier than 12 months after
the effective date of any prior
change.
13
2.02 Change of Fund(s): Any Account established on or after
the effective date of any change will
be subject to the change. If the
Contract Holder does not agree to any
change under this provision, no new
Accounts may be established under the
Contract. The Contract may also be
changed as deemed necessary by Aetna
to comply with federal or state law.
Aetna, or the Separate Account, may:
(a) Change the Fund(s) which may be
invested in by the Separate
Account; and
(b) Replace the shares of any Fund(s)
held in the Separate Account with
shares of any other Fund(s).
Changes must be:
(a) Approved by a majority vote in the
Separate Account with respect to
the Fund(s) whose shares are to be
replaced; or
(b) Deemed necessary by Aetna under
the Investment Company Act of
1940; or
(c) Deemed necessary by Aetna to
accomplish the purpose of the
Separate Account.
Aetna will notify the Contract Holder
and the Certificate Holder of any
change.
2.03 Nonparticipating Contract: The Contract Holder, Certificate
Holders, or Beneficiaries will not
have a right to share in the earnings
of Aetna.
2.04 Payments and Elections: While the Certificate Holder is
living, Aetna will pay the Certificate
Holder any Annuity payments as and
when due. After the Certificate
Holder's death, any Annuity payments
required to be made will be paid in
accordance with 4.03. Aetna will
determine other payments and/or
elections as of the end of the
Valuation Period in which the request
is received at its Home Office. Such
payments will be made within 7
calendar days of receipt at its Home
Office of a written claim for payment
which is in good order, except as
provided in 3.15.
2.05 State Laws: The Contract and the Certificates
comply with the laws of the state in
which they are delivered. Any
surrender, death, or Annuity payments
are equal to or greater than the
minimum required by such laws. Annuity
tables for legal reserve valuation
shall be as required by state law.
Such tables may be different from
Annuity tables used to determine
Annuity payments.
14
2.06 Control of Contract: The Contract is between the Contract
Holder and Aetna. The Contract Holder
has title to the Contract. Contract
Holder rights are limited to accepting
or rejecting Contract modifications.
The Certificate Holder has all other
rights to amounts held in his or her
Account.
Each Certificate Holder shall own all
amounts held in his or her Account.
Each Certificate Holder may make any
choices allowed by the Contract for
his or her Account. Choices made under
the Contract must be in writing. Until
receipt of such choices at Aetna's
Home Office, Aetna may rely on any
previous choices made.
The Contract is not subject to the
claims of any creditors of the
Contract Holder or the Certificate
Holder, except to the extent permitted
by law.
The Certificate Holder may assign or
transfer his or her rights under the
Contract to one or more natural
persons. Any assignment or transfer
must be submitted to Aetna's Home
Office in writing and will not be
effective until accepted by Aetna.
2.07 Designation of Beneficiary: Each Certificate Holder shall name his
or her Beneficiary. The Beneficiary
may be changed at any time. Changes to
a Beneficiary must be submitted to
Aetna's Home Office in writing and
will not be effective until accepted
by Aetna.
2.08 Misstatements and Adjustments: If Aetna finds the age of any
Annuitant to be misstated, the correct
facts will be used to adjust payments.
2.09 Incontestability: Aetna cannot cancel the Contract
because of any error of fact on the
application. Aetna cannot cancel an
Account because of any error of fact
on the enrollment form.
2.10 Grace Period: The Contract and this Certificate will
remain in effect even if Purchase
Payments are not continued except as
provided in the Payment of Adjusted
Current Value provision (See 3.17).
III. PURCHASE PAYMENT, CURRENT VALUE, AND SURRENDER PROVISIONS
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3.01 Net Purchase Payment: This amount is the actual Purchase
Payment less any premium tax. Aetna
will generally deduct the premium tax
when Annuity benefits are elected (see
Part IV). If Aetna determines that
under applicable state law, it must
pay a premium tax when the Purchase
Payment is received or at any other
time, it will deduct the tax at that
time.
The Net Purchase Payment will be
credited among:
(a) The current Deposit Period(s) for
Guaranteed Terms under the MG
Account; and
15
3.01 Net Purchase Payment (b) The Fund(s) in which the Separate
(Cont'd): Account invests.
For each Net Purchase Payment, the
Certificate Holder shall tell Aetna
the allocation percentage to be
applied to the current Deposit Period
for each of the available Guaranteed
Terms in the MG Account and/or each
Fund. If allocation instructions are
not received along with any subsequent
Net Purchase Payment, the allocation
will be the same as that indicated on
the original enrollment form. If the
same Guaranteed Term is no longer
available, the Net Purchase Payment
will be allocated to the next shortest
Guaranteed Term available in the
current Deposit Period. If no shorter
Guaranteed Term is available, the next
longer Guaranteed Term will be used.
3.02 Certificate Holder's Account: Aetna will maintain an Account for
each Certificate Holder.
Aetna will declare from time to time
the acceptability and the minimum
amount for additional Purchase
Payments. Each Account will be subject
to the Terms and Conditions of the
Contract in effect at the time the
first Purchase Payment for such
Account is applied to the Contract
except for changes made to comply with
federal or state law.
3.03 Fund(s) Record Units -- The portion of the Net Purchase
Separate Account: Payment(s) applied to each Fund under
the Separate Account will determine
the number of Fund record units for
that Fund. This number is equal to the
portion of the Net Purchase Payment(s)
applied to each Fund divided by the
Fund record unit Value (see 3.05) for
the Valuation Period in which the
Purchase Payment is received in good
order at Aetna's Home Office.
3.04 Net Return Factor(s) -- The net return factor(s) are used to
Separate Account: compute all Separate Account record
units for any Fund.
The net return factor(s) for each Fund
is equal to 1.0000000 plus the net
return rate.
The net return rate is equal to:
(a) The value of the Shares of the
Fund held by the Separate Account
at the end of the Valuation
Period; minus
(b) The value of the shares of the
Fund held by the Separate Account
at the start of the Valuation
Period; plus or minus
(c) Taxes (or reserves for taxes) on
the Separate Account (if any);
divided by
(d) The total value of the Fund(s)
record units and Fund(s) annuity
units of the Separate Account at
the start of the Valuation Period;
minus
(e) A daily Separate Account charge at
an annual rate as shown on
Contract Schedule I for mortality
and expense risks, which may
include profit; and a daily
administrative charge.
16
3.04 Net Return Factor(s) -- A net return rate may be more or less
Separate Account (Cont'd): than 0%. The value of a share of the
Fund is equal to the net assets of the
Fund divided by the number of shares
outstanding.
3.05 Fund Record Unit Value -- A Fund record unit value is computed
Separate Account: by multiplying the net return factors
for the current Valuation Period by
the Fund record unit value for the
previous Period. The dollar value of
Fund record units, Separate Account
assets, and Variable Annuity payments
may go up or down due to investment
gain or loss.
3.06 Market Value Adjustment: There will be an MVA for a withdrawal
from the MG Account before the end of
a Guaranteed Term when the withdrawal
is due to:
(a) A Transfer; except as specified in
MG Account Matured Term Value
Transfer;
(b) A full or partial surrender,
including a 10% free withdrawal
under 3.14; or
(c)An election of Annuity option 2
(see 4.07).
Full and partial surrenders and
Transfers made within six months after
the date of the Annuitant's death will
be the greater of:
(a) The aggregate MVA amount which is
the sum of all market value
adjusted amounts calculated due to
a withdrawal of amounts. This
total may be greater or less than
the Current Value of those
amounts; or
(b) The applicable portion of the
Current Value in the MG Account.
After the six-month period, the
surrender or Transfer will be the
aggregate MVA amount, which may be
greater or less than the Current Value
of those amounts.
The greater of the aggregate MVA
amount or the applicable portion of
the Current Value applies to amounts
withdrawn from the MG Account on
account of an election of Annuity
options 3 or 4 (see 4.07).
Market value adjusted amounts will be
equal to the amount withdrawn
multiplied by the following ratio:
X
---
365
(1 + i)
---------------
X
---
365
(1 + j)
17
3.06 Market Value Adjustment Where:
(Cont'd): i is the Deposit Period Yield
j is the Current Yield
x is the number of days
remaining, (computed from
Wednesday of the week of
withdrawal) in the Guaranteed
Term.
The Deposit Period Yield will be
determined as follows:
(a) At the close of the last
business day of each week of the
Deposit Period, a yield will be
computed as the average of the
yields on that day of U.S.
Treasury Notes which mature in
the last three months of the
Guaranteed Term.
(b) The Deposit Period Yield is the
average of those yields for the
Deposit Period. If withdrawal is
made before the close of the
Deposit Period, it is the average
of those yields on each week
preceding withdrawal.
The Current Yield is the average of
the yields on the last business day of
the week preceding withdrawal on the
same U.S. Treasury Notes included in
the Deposit Period Yield.
In the event that no U.S. Treasury
Notes which mature in the last three
months of the Guaranteed Term exist,
Aetna reserves the right to use the
U.S. Treasury Notes that mature in the
following quarter.
3.07 Transfer of Current Value Before an Annuity option is elected,
from the Funds or MG Account: all or any portion of the Adjusted
Current Value of the Certificate
Holder's Account may be transferred
from any Fund or Guaranteed Term of
the MG Account:
(a) To any other Fund; or
(b) To any Guaranteed Term of the MG
Account available in the current
Deposit Period.
Transfer requests can be submitted as
a percentage or as a dollar amount.
Aetna may establish a minimum transfer
amount. Within a Guaranteed Term
Group, the amount to be surrendered or
transferred will be withdrawn first
from the oldest Deposit Period, then
from the next oldest, and so on until
the amount requested is satisfied.
The Certificate Holder may make an
unlimited number of Transfers during
the Accumulation Period. The number of
free Transfers allowed by Aetna is
shown on Contract Schedule I.
Additional Transfers may be subject to
a Transfer fee as shown on Contract
Schedule I.
18
3.07 Transfer of Current Value Transfers from the MG Account of a
from the Funds or Matured Term Value on or within one
MG Account (Cont'd): calendar month of a Term's Maturity
Date do not count against the annual
Transfer limit.
Amounts applied to Guaranteed Terms of
the MG Account may not be transferred
to the Funds or to another Guaranteed
Term during the Deposit Period or for
90 days after the close of the Deposit
Period except for Matured Term
Value(s) during the calendar month
following the Term's Maturity Date.
Transfers from Guaranteed Terms of the
MG Account are subject to the MVA
provisions of 3.06.
3.08 Notice to the Certificate The Certificate Holder will receive
Holder: quarterly statements from Aetna of:
(a) The value of any amounts held in:
(1)The MG Account; and
(2)The Fund(s) under the
Separate Account.
(b) The number of any Fund(s) record
units; and
(c) the Fund(s) record unit value.
Such number of values will be as of a
specific date no more than 60 days
before the date of the notice.
3.09 Loans: Loans are not available under this
certificate.
3.10 Systematic Withdrawal Option A distribution option under which a
(SWO): portion of the Account's Current Value
will automatically be surrendered and
distributed each year. SWO payments
will be calculated on the Account's
full Current Value. The distributed
amount is withdrawn pro rata from each
investment option under the Account. A
Surrender Fee will not be deducted
from any portion of the Adjusted
Current Value which is paid as a
distribution under SWO. Certificate
Holders should consult their tax
adviser prior to requesting this
distribution option. Aetna will not be
responsible for any adverse tax
consequences due to receiving SWO
payments.
(a) Amount of Distribution: The
Certificate Holder may elect one
of the three payment methods
described below.
(1) Specified Payment: Payments
of a designated dollar
amount. The annual amount
may not be greater than the
percentage of the Current
Value at time of election as
shown on Contract Schedule I.
This annual dollar amount
will remain constant. At its
discretion, Aetna may require
a minimum initial payment
amount;
19
3.10 Systematic Withdrawal Option (2) Specified Period: Payments
(SWO) (Cont'd): which are made over a period
of time which must be at
least 10 years. The annual
amount paid each year is
calculated by dividing the
Current Value as of December
31 of the prior year by the
number of payment years
remaining; or
(3) Specified Percentage:
Payment of a designated
percentage which cannot be
greater than the percentage
of the Current Value at the
time of election as shown
on Contract Schedule I. The
percentage may be changed
by written request. Aetna
reserves the right to limit
the number of times the
percentage may be changed.
The annual amount is
calculated by multiplying
the Current Value as of
December 31 of the year
prior to the payment by the
designated percentage.
Payments upon the Certificate Holder's
or Annuitant's death will be made to
the Beneficiary in the manner
described in 3.12.
(b) Minimum Initial Current Value: At
its discretion, Aetna may require
a minimum initial Current Value
for election of this option. If
after election of this option the
Current Value is insufficient to
make a scheduled SWO payment,
Aetna will distribute the entire
Account balance.
(c) Date of Distribution: The
Certificate Holder shall specify
the initial distribution date. The
earliest date for distribution is
the date on which the Certificate
Holder attains age 59 1/2. As
elected by the Certificate Holder,
SWO payments will be made on a
monthly, quarterly, semi-annual or
annual basis. If SWO payments are
made more frequently than
annually, the designated annual
amount is divided by the number of
payments due each calendar year.
Subsequent distributions will be
made on the 15th of any month or
such other date Aetna may
designate or allow.
(d) Election and Revocation: SWO may
be elected by the Certificate
Holder by submitting a completed
and signed election form to
Aetna's Home Office. Once elected,
this option may be revoked by the
Certificate Holder or spousal
Beneficiary, if elected after the
Certificate Holder's death, by
submitting a written request to
Aetna at its Home Office. Any
revocation will apply only to
amounts not yet paid. SWO may be
elected only once by the
Certificate Holder or by the
spouse Beneficiary.
20
3.11 Death Benefit Amount: If the Certificate Holder or Annuitant
dies before Annuity payments start,
the Beneficiary is entitled to a death
benefit under the Account. The claim
date is the date when proof of death
and the Beneficiary's claim are
received in good order at Aetna's Home
Office. The amount of the death
benefit is determined as follows:
(a) Death of Annuitant less than 75
years of age: The guaranteed death
benefit is the greatest of:
(1) The gross sum of all
Purchase Payment(s) made to
the Account (as of the date
of death) minus the sum of
all amounts surrendered,
applied to an Annuity, or
deducted from the Account;
(2) The step up value as of the
date of death plus all Net
Purchase Payments made to the
Account, minus the total of
all partial surrenders,
amounts applied to an Annuity
and deductions made from the
Account since determination
of the step up value. The
step up value is the Current
Value on the most recent
seventh year anniversary of
the date the first Net
Purchase Payment is applied
to the Account;
(3) The Account's Current Value
as of the date of death. The
excess, if any, of the
guaranteed death benefit
value over the Account's
Current Value is determined
as of the date of death. Any
excess amount will be
deposited to the Account and
allocated to Aetna Variable
Encore Fund as the claim
date. The Current Value on
the claim date plus any
excess amount deposited
becomes the Account's Current
Value.
(b) Death of Annuitant age 75 or
greater: The death benefit amount
is the Account Current Value on
the claim date.
(c) Death of the Certificate Holder if
the Certificate Holder is not the
Annuitant: The death benefit
amount is the Account Adjusted
Current Value on the claim date. A
Surrender Fee may apply to any
full or partial surrender (see
3.14 and Contract Schedule I).
3.12 Death Benefit Options Prior to any election, or until
available to Beneficiary: amounts must be otherwise distributed
under this section, the Current Value
of the Account will be retained in the
Account. The Beneficiary has the right
under the Account to allocate or
reallocate any amount to any of the
available investment options (subject
to an MVA, as applicable). The
following options are available to the
Beneficiary:
(a) When the Certificate Holder is the
Annuitant: If the Certificate
Holder/Annuitant dies, and:
21
3.12 Death Benefit Options (1) If the Beneficiary is the
available to Beneficiary Certificate Holder's
(Cont'd): surviving spouse, the
Beneficiary will be the
successor Certificate Holder
of the Account on Aetna's
records. Such successor
Certificate Holder may
exercise all Certificate
Holder rights under the
Contract and continue in the
Accumulation Period, or may
elect (i), (ii), or (iii)
below. Under the Code,
distributions from the
Account are not required
until the successor
Certificate Holder's death.
The Beneficiary may elect to:
(i) Apply some or all of
the Adjusted Current
Value of the Account to
Annuity option 2, 3 or
4 (see 4.07);
(ii) Apply some or all of
the Adjusted Current
Value of the Account to
Annuity option 1 (see
4.07); or
(iii) Receive, at any time, a
lump sum payment equal
to the Adjusted Current
Value of the Account.
(2) If the Beneficiary is other
than the Certificate
Holder's surviving spouse,
then options (i), (ii), or
(iii) under (1) above
apply. Any portion of the
Adjusted Current Value of
the Account not applied to
Annuity option 2, 3 or 4
within one year of the
Certificate Holder's death,
must be distributed within
five years of the date of
death.
(3) If no Beneficiary exists, a
lump sum payment equal to the
Adjusted Current Value will
be made to the Certificate
Holder's estate.
(b) When the Certificate Holder is not
the Annuitant and the Certificate
Holder dies, and:
(1) If the Beneficiary is the
Certificate Holder's
surviving spouse, the
Beneficiary will be the
successor Certificate
Holder of the Account on
Aetna's records. Such
successor Certificate
Holder may exercise all
Certificate Holder rights
under the Contract and
continue in the
Accumulation Period, or may
elect (i), (ii), or (iii)
below. Under the Code,
distributions from the
Account are not required
until the successor
Certificate Holder's death.
The Beneficiary may elect
to:
(i) Apply some or all of
the Adjusted Current
Value of the Account to
Annuity option 2, 3 or
4 (see 4.07);
(ii) Apply some or all of
the Surrender Value of
the Account to Annuity
option 1 (see 4.07); or
22
3.12 Death Benefit Options (iii) Receive, at any time,
available to Beneficiary a lump sum payment
(Cont'd): equal to the Surrender
Value of the Account.
(2) If the Beneficiary is other
than the Certificate
Holder's surviving spouse,
then options (i), (ii), or
(iii) under (1) above
apply. Any portion of the
Adjusted Current Value of
the Account not applied to
Annuity option 2, 3 or 4
within one year of the
Certificate Holder's death
will be subject to a
Surrender Fee, if
applicable, and must be
distributed within five
years of the date of death.
(3) If no Beneficiary exists, a
lump sum payment equal to the
Surrender Value will be made
to the Certificate Holder's
estate.
(c) When the Certificate Holder is not
the Annuitant and the Annuitant
dies: The Beneficiary must elect
Annuity option 2, 3 or 4 within 60
days of the date of death or the
gain, if any, will be includable
in the Beneficiary's income in the
tax year in which the Annuitant
dies.
3.13 Liquidation of All or any portion of the Account's
Surrender Value: Adjusted Current Value may be
surrendered at any time. Surrender
requests can be submitted as a
percentage of the Account value or as
a specific dollar amount. Net
Purchase Payment amounts are withdrawn
first, and then the excess value, if
any. For any partial surrender,
amounts are withdrawn on a pro rata
basis from the Fund(s) and/or the
Guaranteed Term(s) Groups of the MG
Account in which the Current Value is
invested. Within a Guaranteed Term
Group, the amount to be surrendered
or transferred will be withdrawn first
from the oldest Deposit Period, then
from the next oldest, and so on until
the amount requested is satisfied.
After deduction of the Maintenance
Fee, if applicable, the surrendered
amount shall be reduced by a Surrender
Fee; if applicable.
3.14 Surrender Fee: The Surrender Fee only applies to the
Net Purchase Payment(s) portion
surrendered and varies according to
the elapsed time since deposit (see
Contract Schedule I). Net Purchase
Payment amounts are withdrawn in the
same order they were applied.
No Surrender Fee is deducted from any
portion of the Current Value which is
paid:
(a) To a Beneficiary due to the
Annuitant's death before Annuity
payments start, up to a maximum of
the aggregate Net Purchase
Payment(s) minus the total of all
partial surrenders, amounts
applied to an Annuity and
deductions made prior to the
Annuitant's date of death;
23
3.14 Surrender Fee (Cont'd): (b) As a premium for an Annuity option
2, 3 or 4 under this Contract (see
4.07);
(c) As a distribution under the SWO
provision (see 3.10);
(d) At least 12 months after the date
of the first Purchase Payment to
the Account, in an amount equal to
or less than 10% of the Current
Value. This applies to the first
surrender request, partial or
full, in a calendar year. The
Current Value is calculated as of
the date the surrender request is
received in good order at Aetna's
Home Office. This waiver is not
available to the Certificate
Holder while SWO is in effect.
(e) For a full surrender of the
Account where the Current Value of
the Account is $2,500 or less and
no surrenders have been taken from
the Account within the prior 12
months;
(f) By Aetna under 3.17; or
(g) If the Annuitant has spent at
least 45 consecutive days in a
licensed nursing care facility and
each of the following conditions
are met:
(1) more than one calendar year
has elapsed since the date
the certificate was issued;
and
(2) the surrender is requested
within 3 years of admission
to a licensed nursing care
facility.
This waiver does not apply if the
Annuitant was in a nursing care
facility at the time this
certificate was issued.
3.15 Payment of Surrender Under certain emergency conditions,
Value: Aetna may defer payment:
(a) For a period of up to 6 months
(unless not allowed by state law);
or
(b) As provided by federal law.
3.16 Reinstatement: All or a portion of the proceeds of a
full surrender of an Account may be
reinvested within 30 days after the
surrender. Any Maintenance Fee and
Surrender Fee charged at the time of
surrender on the amount being
reinvested will be included in the
reinvestment. Any Market Value
Adjustment(s) deducted from surrenders
will not be included in the
reinstatement.
24
3.16 Reinstatement (Cont'd): Amounts will be reinstated among the
MG Account and the Funds in the
Separate Account in the same
proportion as they were at the time
of surrender. Any amounts
reinstated to the MG Account will be
credited to the Guaranteed Terms
available during the current Deposit
Period in the same proportion as they
were at the time of surrender. In the
event that a Guaranteed Term of the
same duration is unavailable, amounts
will be reinvested in the next
shortest Guaranteed Term available
in the current Deposit Period. If no
shorter Guaranteed Term is available,
the next longer Guaranteed Term will
be used. The number of Fund(s)
Record Units reinstated will be based
on the Record Unit Value(s) next
computed after receipt at Aetna's Home
Office of the reinstatement request
and the amount to be reinstated.
Any Maintenance Fee which falls due
after the surrender and before the
reinstatement will be deducted from
the amount reinstated.
Any Account(s) surrendered because the
Current Value was less than $2,500
immediately following any partial
surrender may not be reinstated (see
3.17).
Reinstatement of an Account is
permitted only once.
3.17 Payment of Adjusted Upon 90 days' written notice to the
CurrentValue: Certificate Holder, Aetna will
terminate any Account if the Current
Value becomes less than $2,500
immediately following any partial
surrender. Aetna does not intend to
exercise this right in cases where an
Account Current Value is reduced to
$2,500 or less solely due to
investment performance. A surrender
fee will not be deduced from the
Adjusted Current Value. This
terminated Adjusted Current Value of
an Account may not be reinstated.
IV. ANNUITY PROVISIONS
--------------------------------------------------------------------------------
4.01 Choices to be Made: The Certificate Holder may tell Aetna
to apply any portion of the Adjusted
Current Value (minus any premium tax)
for an Annuity under option 2, 3, or 4
(see 4.07). The first Annuity payment
may not be earlier than one calendar
year after the initial Purchase
Payment nor later than the later of:
(a) the first day of the month
following the Annuitant's 85th
birthday or
(b) the tenth anniversary of the last
Purchase Payment. In lieu of the
election of an Annuity, the
Certificate Holder may tell Aetna
to make a lump sum payment.
When an Annuity Option is chosen,
Aetna must also be told if payments
are to be made other than monthly and
whether to pay:
25
4.01 Choices to be Made (Cont'd): (a) A Fixed Annuity using the General
Account;
(b) A Variable Annuity using any of
the Fund(s) available under this
Contract for Annuity purposes; or
(c) A combination of (a) and (b).
If a Fixed Annuity is chosen, the
Annuity purchase rate for the option
chosen reflects the Minimum Guaranteed
Interest Rate (see Contract Schedule
II), but may reflect higher interest
rates. If a Variable Annuity is
chosen, the initial Annuity payment
for the option chosen reflects the
assumed annual return rate elected.
(see Contract Schedule II).
4.02 Terms of Annuity (a) When payments start, the age of
Options the Annuitant plus the number of
years for which payments are
guaranteed must not exceed 95.
(b) An Annuity option may not be
elected if the first payment would
be less than $50 or if the total
payments in a year would be less
than $250 (less if required by
state law). Aetna reserves the
right to increase the minimum
first Annuity payment amount and
the annual minimum Annuity payment
amount based upon increases
reflected in the Consumer Price
Index-Urban, (CPI-U) since July 1,
1983.
(c) If a Fixed Annuity under option 2,
3 or 4 is chosen and a larger
payment would result from applying
the Surrender Value to a current
Aetna single premium immediate
Annuity, Aetna will make the
larger payment.
(d) For purposes of calculating the
guaranteed first payment of a
Variable Annuity or the payments
for a Fixed Annuity, the
Annuitant's and second Annuitant's
adjusted age will be used. The
Annuitant's and second Annuitant's
adjusted age is his or her age as
of the birthday closest to the
Annuity commencement date reduced
by one year for Annuity
commencement dates occurring
during the period of time from
July 1, 1993 through December 31,
1999. The Annuitant's and second
Annuitant's age will be reduced by
two years for Annuity commencement
dates occurring during the period
of time from January 1, 2000
through December 31, 2009. The
Annuitant's and second Annuitant's
age will be reduced by one
additional year for Annuity
commencement dates occurring in
each succeeding decade.
The Annuity purchase rates for
options 3 and 4 are based on
mortality from 1983 Table a.
26
4.02 Terms of Annuity (e) Assumed Annual Net Return Rate is
Options (Cont'd): the interest rate used to
determine the amount of the first
Annuity payment under Variable
Annuity as shown on Contract
Schedule II. The Separate Account
must earn this rate plus enough to
cover the mortality and expense
risks charges (which may include
profit) and administrative charges
if future Variable Annuity
Payments are to remain level. (see
Annuity return factor under
Variable Annuity Assumed Annual
Net Return Rate on Contract
Schedule II).
(f) Once elected, Annuity payments
cannot be commuted to a lump sum
except for Variable Annuity
payments under option 2 (see
4.07). The life expectancy of the
Annuitant and second Annuitant
shall be irrevocable upon the
election of an Annuity option.
4.03 Death of Annuitant/ (a) Certificate Holder is Annuitant:
Beneficiary: When the Certificate Holder is the
Annuitant and the Annuitant dies
under option 2 or 3, or both the
Annuitant and the second Annuitant
die under option 4(d), the present
value of any remaining guaranteed
payments will be paid in one sum
to the Beneficiary, or upon
election by the Beneficiary, any
remaining payments will continue
to the Beneficiary. If option 4
has been elected and the
Certificate Holder dies, the
remaining payments will continue
to the successor payee. If no
successor payee has been
designated, the Beneficiary will
be treated as the successor payee.
(b) Certificate Holder is Not
Annuitant: When the Certificate
Holder is not the Annuitant and
the Certificate Holder dies, the
remaining payments under options
2, 3 or 4 will continue to the
successor payee. If no successor
payee has been designated, the
Beneficiary will be treated as the
successor payee.
If the Annuitant dies under option
2 or 3, or if both the Annuitant
and the second Annuitant die under
option 4(d), the present value of
any remaining guaranteed payments
will be paid in one sum to the
Beneficiary, or upon the election
by the Beneficiary any remaining
payments will continue to the
Beneficiary. If option 4 has been
elected, and the Annuitant dies,
the remaining payments will
continue to the Certificate
Holder.
(c) No Beneficiary Named/Surviving: If
there is no Beneficiary under
option 2, 3 or 4, the present
value of any remaining payments
will be paid in one sum to the
Certificate Holder, or if the
Certificate Holder is not living,
then to the Certificate Holder's
estate.
27
4.03 Death of Annuitant/ (d) If the Beneficiary designated
Beneficiary (Cont'd): under option 1 dies, the amount
held plus accrued interest will be
paid in one sum to a successor
Beneficiary, if any, named by the
designated Beneficiary. If there
is no successor Beneficiary, the
lump sum will be paid to the
designated Beneficiary's estate.
(e) If the Beneficiary or the
successor payee dies while
receiving Annuity payments, the
present value of any remaining
guaranteed payments will be paid
in one sum to the successor
Beneficiary/payee, or upon
election by the successor
Beneficiary/payee, any remaining
payments will continue to the
successor Beneficiary/payee. If no
successor Beneficiary/payee has
been designated, the present value
of any remaining guaranteed
payments will be paid in one sum
to the Beneficiary's/payee's
estate.
(f) The present value will be
determined as of the Valuation
Period in which proof of death
acceptable to Aetna and a request
for payment is received at Aetna's
Home Office. The interest rate
used to determine the first
payment will be used to calculate
the present value.
4.04 Fund(s) Annuity Units - The number of each Fund's Annuity
Separate Account: units is based on the amount of the
first Variable Annuity payment which
is equal to:
(a) The portion of the Current Value
applied to pay a Variable Annuity
(minus any premium tax); divided
by
(b) 1,000; multiplied by (c) The
payment rate for the option
chosen.
Such amount, or portion, of the
variable payment will be divided by
the appropriate Fund Annuity unit
value (see 4.05) on the tenth
Valuation Period before the due date
of the first payment to determine the
number of each Fund Annuity units. The
number of each Fund Annuity units
remains fixed. Each future payment is
equal to the sum of the products of
each Fund Annuity unit value
multiplied by the appropriate number
of units. The Fund(s) Annuity unit
value on the tenth Valuation Period
prior to the due date of the payment
is used.
4.05 Fund(s) Annuity Unit For any Valuation Period, a Fund
Value - Separate Annuity Unit Value is equal to:
Account: (a) The value for the previous Period;
multiplied by
(b) The Annuity net return factor(s)
(see 4.06 below) for the Period
multiplied by
(c) A factor to reflect the assumed
annual net return rate (see
Contract Schedule II).
28
4.05 Fund(s) Annuity Unit The dollar value of a Fund Annuity
Value - Separate unit values and Annuity payments may
Account (Cont'd): go up or down due to investment gain
or loss.
4.06 Annuity Net Return The Annuity net return factor(s) are
Factor(s) -- Separate used to compute all Separate Account
Account Annuity Payments for any Fund.
The Annuity net return factor(s) for
each Fund is equal to 1.0000000 plus
the net return rate.
The net return rate is equal to:
(a) The value of the shares of the
Fund held by the Separate Account
at the end of a Valuation Period;
minus
(b) The value of the shares of the
Fund held by the Separate Account
at the start of the Valuation
Period; plus or minus
(c) Taxes (or reserves for taxes) on
the Separate Account (if any);
divided by
(d) The total value of the Fund(s)
record units and Fund(s) Annuity
units of the Separate Account at
the start of the Valuation Period;
minus
(e) A daily charge for Annuity
mortality and expense risks, which
may include profit, and a daily
administrative charge (at the
annual rate as shown on Contract
Schedule II).
A Net Return Rate may be more or less
than 0%.
The value of a share of the Fund is
equal to the net assets of the Fund
divided by the number of shares
outstanding.
Payments shall not be changed due to
changes in the mortality or expense
results or administrative charges.
4.07 Annuity Options: Option 1 -- Payment of Interest on Sum
Left with Aetna -- This option may be
used only by the Beneficiary when the
Certificate Holder dies before Aetna
has started paying an Annuity. A
portion or all of the sum paid upon
death may be held under this option
and will be held in the General
Account of Aetna at interest
(see 4.01). The Beneficiary may later
tell Aetna to:
(a) Pay a portion or all of the sum
held by Aetna; or
(b) Apply a portion or all of the sum
held by Aetna to any Annuity
option below.
29
4.07 Annuity Options If the nonspouse Beneficiary elects
(Cont'd): this option, the Beneficiary must tell
Aetna to pay the full sum held under
this option within 5 years of the date
of death.
Option 2 - Payments for a Stated
Period of Time -- An Annuity will be
paid for the number of years chosen.
The number of years must be at least 5
and not more than 30.
If payments for this option are made
under a Variable Annuity, the present
value of any remaining payments may be
withdrawn at any time. If a
withdrawal is requested within 3
years after the start of payments, it
will be treated as a surrender and any
applicable Surrender Fee will be
applied (see 3.14).
If a nonspouse Beneficiary elects this
option at the death of the Certificate
Holder, the period selected may not
extend beyond the Beneficiary's life
expectancy.
Option 3 -- Life Income -- An Annuity
will be paid for the life of the
Annuitant. If also chosen, Aetna will
guarantee payments for 60, 120, 180,
or 240 months.
Option 4 -- Life Income Based upon the
Lives of Two Annuitants -- An Annuity
will be paid during the lives of the
Annuitant and a second Annuitant.
Payments will continue until both
Annuitants have died. When this option
is chosen, a choice must be made of:
(a) 100% of the payment to continue
after the first death;
(b) 66-2/3% of the payment to continue
after the first death;
(c) 50% of the payment to continue
after the first death;
(d) Payments for a minimum of 120
months with 100% of the payment to
continue after the first death; or
(e) 100% of the payment to continue at
the death of the second Annuitant
and 50% of the payment to continue
at the death of the first
Annuitant.
Other Options -- Aetna may make other
options available as allowed by the
laws of the state in which the
Contract and this Certificate is
delivered.
30
OPTION 2
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
---------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
---------------------------------------------------------------------
3 3.00% $28.99 $86.76 $172.88 $343.23
4 3.00% 22.06 66.02 131.56 261.19
5 3.00% 17.91 53.59 106.78 211.99
6 3.00% 15.14 45.30 90.27 179.22
7 3.00% 13.16 39.39 78.49 155.83
8 3.00% 11.68 34.96 69.66 138.31
9 3.00% 10.53 31.52 62.81 124.69
10 3.00% 9.61 28.77 57.33 113.82
11 3.00% 8.86 26.52 52.85 104.93
12 3.00% 8.24 24.65 49.13 97.54
13 3.00% 7.71 23.08 45.98 91.29
14 3.00% 7.26 21.73 43.29 85.95
15 3.00% 6.87 20.56 40.96 81.33
16 3.00% 6.53 19.54 38.93 77.29
17 3.00% 6.23 18.64 37.14 73.74
18 3.00% 5.96 17.84 35.56 70.59
19 3.00% 5.73 17.13 34.14 67.78
20 3.00% 5.51 16.50 32.87 65.26
21 3.00% 5.32 15.92 31.72 62.98
22 3.00% 5.15 15.40 30.68 60.92
23 3.00% 4.99 14.92 29.74 59.04
24 3.00% 4.84 14.49 28.88 57.33
25 3.00% 4.71 14.09 28.08 55.76
26 3.00% 4.59 13.73 27.36 54.31
27 3.00% 4.47 13.39 26.68 52.97
28 3.00% 4.37 13.08 26.06 51.74
29 3.00% 4.27 12.79 25.49 50.60
30 3.00% 4.18 12.52 24.95 49.53
---------------------------------------------------------------------
31
OPTION 3
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge For Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
Payments Guaranteed for a Stated Period of Months
-----------------------------------------------------------------
Adjusted
Age of
Annuitant None 60 120 180 240
-----------------------------------------------------------------
50 $ 4.05 $ 4.05 $ 4.03 $ 3.99 $ 3.93
51 4.12 4.11 4.09 4.05 3.99
52 4.19 4.19 4.16 4.11 4.04
53 4.27 4.26 4.23 4.18 4.10
54 4.35 4.34 4.31 4.25 4.16
55 4.44 4.42 4.39 4.32 4.22
56 4.53 4.51 4.47 4.40 4.29
57 4.62 4.61 4.56 4.48 4.35
58 4.72 4.71 4.65 4.56 4.42
59 4.83 4.81 4.75 4.64 4.49
60 4.95 4.93 4.86 4.73 4.55
61 5.07 5.05 4.97 4.83 4.62
62 5.20 5.17 5.08 4.92 4.69
63 5.34 5.31 5.20 5.02 4.76
64 5.49 5.45 5.33 5.12 4.83
65 5.65 5.61 5.47 5.22 4.89
66 5.82 5.77 5.61 5.33 4.96
67 6.01 5.94 5.75 5.44 5.02
68 6.20 6.13 5.91 5.54 5.08
69 6.41 6.33 6.07 5.65 5.14
70 6.64 6.54 6.23 5.76 5.19
71 6.88 6.76 6.41 5.86 5.24
72 7.14 7.00 6.59 5.97 5.28
73 7.43 7.26 6.77 6.06 5.32
74 7.73 7.53 6.96 6.16 5.35
75 8.06 7.82 7.14 6.25 5.38
-----------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
32
OPTION 4
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%
--------------------------------------------------------------------------------
Adjusted Ages
--------------------
Second
Annuitant Annuitant Option 4a Option 4b Option 4c Option 4d Option 4e
--------------------------------------------------------------------------------
55 50 $ 3.69 $ 4.05 $ 4.27 $ 3.69 $ 4.03
55 55 3.88 4.25 4.47 3.87 4.14
55 60 3.99 4.44 4.71 3.98 4.42
60 55 3.99 4.44 4.71 3.98 4.42
60 60 4.24 4.71 4.99 4.23 4.57
60 65 4.38 4.97 5.32 4.38 4.93
65 60 4.38 4.97 5.32 4.38 4.93
65 65 4.72 5.33 5.70 4.71 5.14
65 70 4.93 5.68 6.15 4.91 5.66
70 65 4.93 5.68 6.15 4.91 5.66
70 70 5.40 6.21 6.70 5.36 5.96
70 75 5.69 6.68 7.32 5.62 6.67
75 70 5.69 6.68 7.32 5.62 6.67
75 75 6.37 7.45 8.15 6.23 7.12
75 80 6.78 8.11 8.99 6.54 8.13
--------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
33
OPTION 2
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
--------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
--------------------------------------------------------------------------
3 3.50% $ 29.19 $ 87.33 $ 173.91 $ 344.86
4 3.50% 22.27 66.61 132.65 263.04
5 3.50% 18.12 54.19 107.92 213.99
6 3.50% 15.35 45.92 91.44 181.32
7 3.50% 13.38 40.01 79.69 158.01
8 3.50% 11.90 35.59 70.88 140.56
9 3.50% 10.75 32.16 64.05 127.00
10 3.50% 9.83 29.42 58.59 116.18
11 3.50% 9.09 27.18 54.13 107.34
12 3.50% 8.46 25.32 50.42 99.98
13 3.50% 7.94 23.75 47.29 93.78
14 3.50% 7.49 22.40 44.62 88.47
15 3.50% 7.10 21.24 42.31 83.89
16 3.50% 6.76 20.23 40.29 79.89
17 3.50% 6.47 19.34 38.51 76.37
18 3.50% 6.20 18.55 36.94 73.25
19 3.50% 5.97 17.85 35.54 70.47
20 3.50% 5.75 17.22 34.28 67.98
21 3.50% 5.56 16.65 33.15 65.74
22 3.50% 5.39 16.13 32.13 63.70
23 3.50% 5.24 15.66 31.19 61.85
24 3.50% 5.09 15.24 30.34 60.17
25 3.50% 4.96 14.85 29.56 58.62
26 3.50% 4.84 14.49 28.85 57.20
27 3.50% 4.73 14.15 28.19 55.90
28 3.50% 4.63 13.85 27.58 54.69
29 3.50% 4.53 13.57 27.02 53.57
30 3.50% 4.45 13.30 26.49 52.53
--------------------------------------------------------------------------
34
OPTION 2
Payments for a Stated Period of Time
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
---------------------------------------------------------------------------
Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment
---------------------------------------------------------------------------
3 5.00% $ 29.80 $ 89.04 $ 176.99 $ 349.72
4 5.00% 22.89 68.38 135.93 268.58
5 5.00% 18.74 56.00 111.33 219.98
6 5.00% 15.99 47.77 94.96 187.64
7 5.00% 14.02 41.90 83.30 164.59
8 5.00% 12.56 37.52 74.58 147.35
9 5.00% 11.42 34.11 67.81 133.99
10 5.00% 10.51 31.40 62.42 123.34
11 5.00% 9.77 29.19 58.03 114.66
12 5.00% 9.16 27.36 54.38 107.45
13 5.00% 8.64 25.81 51.31 101.39
14 5.00% 8.20 24.50 48.69 96.21
15 5.00% 7.82 23.36 46.44 91.75
16 5.00% 7.49 22.37 44.47 87.88
17 5.00% 7.20 21.51 42.75 84.48
18 5.00% 6.94 20.74 41.23 81.47
19 5.00% 6.71 20.06 39.88 78.80
20 5.00% 6.51 19.46 38.68 76.42
21 5.00% 6.33 18.91 37.59 74.28
22 5.00% 6.17 18.42 36.62 72.35
23 5.00% 6.02 17.98 35.73 70.61
24 5.00% 5.88 17.57 34.93 69.02
25 5.00% 5.76 17.20 34.20 67.57
26 5.00% 5.65 16.87 33.53 66.25
27 5.00% 5.54 16.56 32.92 65.04
28 5.00% 5.45 16.28 32.35 63.93
29 5.00% 5.36 16.01 31.83 62.90
30 5.00% 5.28 15.77 31.35 61.95
---------------------------------------------------------------------------
35
OPTION 3
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
Payments Guaranteed for a Stated Period of Months
-----------------------------------------------------------------------
Adjusted
Age of
Annuitant None 60 120 180 240
-----------------------------------------------------------------------
50 $ 4.34 $ 4.34 $ 4.31 $ 4.27 $ 4.22
51 4.41 4.40 4.38 4.33 4.27
52 4.48 4.47 4.45 4.40 4.32
53 4.56 4.55 4.52 4.46 4.38
54 4.64 4.63 4.59 4.53 4.44
55 4.72 4.71 4.67 4.60 4.50
56 4.81 4.80 4.75 4.67 4.56
57 4.91 4.89 4.84 4.75 4.62
58 5.01 4.99 4.93 4.83 4.69
59 5.12 5.10 5.03 4.92 4.75
60 5.23 5.21 5.13 5.00 4.82
61 5.36 5.33 5.24 5.09 4.88
62 5.49 5.45 5.35 5.19 4.95
63 5.63 5.59 5.47 5.28 5.02
64 5.78 5.73 5.60 5.38 5.08
65 5.94 5.89 5.73 5.48 5.15
66 6.11 6.05 5.87 5.58 5.21
67 6.29 6.22 6.02 5.69 5.27
68 6.49 6.41 6.17 5.79 5.33
69 6.70 6.60 6.33 5.90 5.38
70 6.92 6.81 6.49 6.00 5.43
71 7.17 7.04 6.66 6.10 5.48
72 7.43 7.27 6.84 6.20 5.52
73 7.71 7.53 7.02 6.30 5.55
74 8.02 7.80 7.20 6.39 5.59
75 8.35 8.08 7.38 6.48 5.62
-----------------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
36
OPTION 3
Life Income
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
Payments Guaranteed for a Stated Period of Months
---------------------------------------------------------------------------
Adjusted
Age of
Annuitant None 60 120 180 240
---------------------------------------------------------------------------
50 $ 5.26 $ 5.25 $ 5.22 $ 5.17 $ 5.11
51 5.33 5.32 5.28 5.23 5.15
52 5.40 5.38 5.34 5.29 5.20
53 5.47 5.45 5.41 5.35 5.26
54 5.54 5.53 5.48 5.41 5.31
55 5.63 5.61 5.56 5.47 5.36
56 5.71 5.69 5.63 5.54 5.42
57 5.80 5.78 5.72 5.61 5.47
58 5.90 5.88 5.81 5.69 5.53
59 6.01 5.98 5.90 5.77 5.59
60 6.12 6.09 6.00 5.85 5.65
61 6.24 6.21 6.10 6.93 5.71
62 6.37 6.33 6.21 6.02 5.77
63 6.51 6.46 6.33 6.11 5.83
64 6.66 6.60 6.45 6.20 5.89
65 6.82 6.75 6.57 6.30 5.95
66 6.99 6.91 6.71 6.39 6.01
67 7.17 7.08 6.85 6.49 6.06
68 7.36 7.27 6.99 6.59 6.12
69 7.57 7.46 7.15 6.69 6.17
70 7.80 7.67 7.30 6.78 6.21
71 8.05 7.89 7.47 6.88 6.25
72 8.31 8.13 7.64 6.97 6.29
73 8.59 8.38 7.81 7.06 6.33
74 8.90 8.64 7.99 7.15 6.36
75 9.23 8.93 8.16 7.23 6.38
---------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
37
OPTION 4
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%
--------------------------------------------------------------------------------
Adjusted Ages
-----------------------
Second
Annuitant Annuitant Option 4a Option 4b Option 4c Option 4d Option 4e
------------------------------------------------------------------------------
55 50 $ 3.97 $ 4.35 $ 4.56 $ 3.97 $ 4.31
55 55 4.16 4.54 4.76 4.15 4.42
55 60 4.27 4.73 5.00 4.26 4.48
60 55 4.27 4.73 5.00 4.26 4.70
60 60 4.51 4.99 5.27 4.50 4.84
60 65 4.66 5.25 5.61 4.65 4.93
65 60 4.66 5.25 5.61 4.65 5.22
65 65 4.99 5.61 5.99 4.98 5.42
65 70 5.19 5.97 6.44 5.17 5.54
70 65 5.19 5.97 6.44 5.17 5.93
70 70 5.67 6.49 6.99 5.62 6.23
70 75 5.95 6.96 7.61 5.87 6.40
75 70 5.95 6.96 7.61 5.87 6.95
75 75 6.64 7.73 8.43 6.48 7.40
75 80 7.04 8.39 9.29 6.79 7.64
------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
38
OPTION 4
Life Income for Two Payees
Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes
Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%
--------------------------------------------------------------------------------
Adjusted Ages
--------------------------------
Second
Annuitant Annuitant Option 4a Option 4b Option 4c Option 4d Option 4e
--------------------------------------------------------------------------------
55 50 $ 4.88 $ 5.26 $ 5.48 $ 4.88 $ 5.23
55 55 5.04 5.44 5.66 5.04 5.32
55 60 5.15 5.63 5.91 5.14 5.38
60 55 5.15 5.63 5.91 5.14 5.59
60 60 5.37 5.87 6.16 5.37 5.72
60 65 5.52 6.14 6.51 5.51 5.80
65 60 5.52 6.14 6.51 5.51 6.10
65 65 5.83 6.49 6.87 5.82 6.29
65 70 6.04 6.84 7.34 6.00 6.41
70 65 6.04 6.84 7.34 6.00 6.81
70 70 6.49 7.35 7.87 6.44 7.08
70 75 6.77 7.84 8.51 6.68 7.25
75 70 6.77 7.84 8.51 6.68 7.81
75 75 7.45 8.60 9.33 7.27 8.25
75 80 7.86 9.28 10.20 7.57 8.49
--------------------------------------------------------------------------------
Rates are based on mortality from 1983 Table a. The rates do not differ by sex.
Rates for ages not shown will be provided on request and will be computed
on a basis consistent with the rates in the above tables.
39
--------------------------------------------------------------------------------
Aetna Life Insurance and Annuity Company
Home Office: 000 Xxxxxxxxxx Xxxxxx
Xxxxxxxx, Xxxxxxxxxxx 00000
(000) 000-0000
Certificate of Group Annuity Coverage
--------------------------------------------------------------------------------
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CERTIFICATE CONTAINS A MARKET VALUE ADJUSTMENT
FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN
INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA
DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
