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Home My WebLink About851363.tiff RESOLUTION RE : APPROVAL OF 401K PLAN OFFERED BY BANKERS LIFE AND AUTHORIZATION FOR CHAIRMAN TO SIGN WHEREAS , the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS , on the 26th day of September, 1983 , the Board of County Commissioners established a Deferred Compensation Plan for its employees, WHEREAS , on the 29th day of October, 1984 , the Board approved the 401K plan offered by Bankers Life for Weld County employees, and WHEREAS, the plan documents for the 401K plan offered by Bankers Life for Weld County employees have now been presented to the Board for its approval, and WHEREAS, after study, the Board deems it advisable to approve said plan documents and authorize the Chairman to sign same. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the plan documents for the 401K plan offered by Bankers Life for Weld County employees be , and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is, authorized to sign said plan documents. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 22nd day of April, A.D. , 1985 . �,r/ BOARD OF COUNTY COMMISSIONERS ATTEST 1 �� WELD COUNTY, COLORADO Weld County Clerk and Recorder C≥ and Clerk to the Board cqt line nson, Chairman r I EXCUSED DATE OF SIGNING - AYE FIX: - bY{c rv�� csJ Gene R. Brantner, Pro-Tem puty County C rk , APPROVED AS TO FORM: C.W. Ki Gaf n . Lacy �,�� County Att r ey r�� fi'4121(1,4 Frank Yama a 851363 l APPLICATION FOR GROUP ANNUITY CONTRACT Application is made to BANKERS LIFE COMPANY 711 High Street Des Moines, Iowa 50307 Weld County (Exact name of Applicant e.g_'XVZ Co..Inc.'or if Trusteed;e.g.,"Trustee of ABC Co..Inc.Retirement Plan) Greeley, Colorado (Applicants City d State) The Applicant applies for the following group annuity contract: ❑ Deposit Administration (DA) ❑ Fixed Interest Funds (FIF) [�] Flexible Investment Annuity (FIA) D Flexible Investment Annuity - 1 (FIA) ❑ Group Accumulation Annuity (GAA) ❑ Immediate Participation Guarantee (IPG) ❑ Investment Value Account (IVA) O Investment Value Fund (IVF) O Investment Value Plus (IVP) O Retirement Investment Annuity (RIA) O Single Premium (SP) State of delivery of this contract shall be Colorado Advance payment of $ 250.00 is submitted with this application to be applied under the contract. The effective date of the contract shall be 1/1/85 It is agreed that acceptance of any contract issued shall constitute approval by the applicant of the provisions in such contract as being in accord with this application. A determination letter stating that the applicant's plan (including any pending changes)qualifies under Section 401(a) of the Internal Revenue Code a has been or will be requested. ❑ has been received. ❑ is not intended to be requested. Signed at Greeley, Colorado (City) ;State) this >< 9 day of x mac'— 19 84 0 c�� gent X ' �^" ' de -s-,- Person signing for Applicant X dYt+-t-w-.4..� Title(Trustee, if applicable) GP 19170-1 THE BANKERS LIFE COI BANKERS LIFE COMPANY DES MOINES, IOWA TABLE 1 OPTION 5 -- FIXED PERIOD OPTION Amount of Monthly Annuity Purchased by $1,000 Number Monthly of Years Annuity 5 $17.91 6 15.14 7 13.16 8 11.68 9 10.53 10 9.61 11 8.86 12 8. 24 13 7.71 14 7. 26 15 6.87 16 6.53 17 6.23 18 5.96 19 5. 73 20 5.51 Table 1 Option 5 GP 17323 Fixed Period TABLE 1 OPTION 4--SINGLE LIFE INSTALLMENT REFUND ANNUITY Amount of Monthly Annuity Purchased by $1,000 Age* Monthly Male Female Annuity 45 50 S3.95 46 51 4.01 47 52 4.07 48 53 4.13 49 54 4.20 50 55 4.27 51 56 4. 34 52 57 4.42 53 58 4.50 54 59 4.58 55 60 4.67 56 61 4. 76 57 62 4.85 58 63 4.96 59 64 5.06 60 65 5.18 61 66 5.29 62 67 5.42 63 68 5.54 64 69 5.69 65 70 5.84 66 71 6.00 67 72 6. 16 68 73 6. 34 69 74 6.52 70 75 6. 72 71 76 6.93 7? 77 7.14 73 78 7.37 74 79 7.63 75 80 7.87 *A Member's age for the purpose of this table is age last birth- day on his Annuity Commencement Date. Table 1 Option 4 Cl' 11679 Single Life Installment Refund -- TABLE 1 OPTION 3 - SURVIVORSHIP ANNUITY WITH INSTALLMENT REFUND with 100% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Male Member Age* of 55 60 65 70 75 Contingent Annuitant Age* of Female Member Male Female 60 65 70 75 80 55 $3.98 $4. 10 $4. 19 $4.24 $4.26 56 4. 02 4. 15 4.24 4. 30 4.33 57 4.06 4.20 4. 30 4. 37 4.40 58 4. 10 4.25 4. 37 4.44 4.48 59 4. 14 4.30 4.43 4. 52 4.56 55 60 4. 17 4. 35 4.49 4. 59 4.64 56 61 4.21 4.40 4.56 4.67 4.73 57 62 4.25 4.45 4.63 4. 75 4.82 58 63 4.28 4. 50 4.69 4.83 4.91 59 64 4.32 4.55 4. 76 4. 92 5.01 60 65 4.35 4.60 4.83 5.00 5. 11 61 66 4.38 4. 65 4. 90 5.09 5.22 62 67 4.41 4.70 4.97 5. 18 5.32 63 68 4.44 4. 74 5.03 5.28 5.44 64 69 4.47 4,79 5. 10 5.37 5.55 65 70 4.49 4.83 5. 17 5.46 5.67 66 71 4.52 4.87 5.23 5.56 5. 79 67 72 4.54 4.91 5.29 5.65 5.92 68 73 4.56 4.94 5. 35 5.74 6.04 69 74 4.58 4.97 5.41 5.83 6. 17 70 75 4.59 5.00 5.46 5.92 6.30 71 4.61 5.03 5. 51 6.00 6.43 72 4.62 5.05 5.56 6.08 6.55 73 4.63 5.07 5.60 6. 16 6.67 74 4.64 5.09 5.64 6.23 6.79 75 4.64 5. 11 5.67 6.30 6.91 *A Member's age and a Contingent Annuitant's age for the purpose of this table is age last birthday on the Member's Annuity Commencement Date. CP 17322 Table 1 Option 3 100% Survivorship Installment Refund / . TABLE 1 OPTION 3 - SURVIVORSHIP ANNUITY WITH INSTALLMENT REFUND with 66 2/3% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Male Member Age* of 55 60 65 70 75 Contingent Annuitant Age* of Female Member Male Female 60 65 70 75 80 55 $4.26 $4. 50 $4.76 $5.02 $5.27 56 4. 29 4.54 4.81 5.08 5.34 57 4.31 4.58 4.86 5. 14 5.41 58 4.34 4.62 4.91 5.20 5.48 59 4.37 4.65 4.96 5.27 5.56 55 60 4.39 4.69 5.01 5.33 5.64 56 61 4.42 4. 73 5.06 5.40 5.72 57 62 4.44 4. 76 5. 11 5.46 5.80 58 63 4.47 4.80 5. 16 5.53 5.89 59 64 4.49 4.83 5.21 5.60 5. 98 60 65 4.51 4. 87 5. 26 5.67 6.07 61 66 4.53 4. 90 5. 31 5.74 6. 16 62 67 4.55 4.93 5.36 5.81 6.26 63 68 4.57 4.96 5.41 5.88 6.35 64 69 4.58 4.99 5.45 5. 96 6.45 65 70 4.60 5.02 5.50 6.03 6. 55 66 71 4.61 5.04 5.54 6.09 6.65 67 72 4.62 5.07 5. 58 6. 16 6. 75 68 73 4.64 5.09 5.62 6.22 6.85 69 74 4.64 5. 10 5.66 6.28 6.95 70 75 4.65 5. 12 5.69 6. 35 7.04 71 4.66 5. 14 5. 72 6.40 7. 13 72 4.67 5. 15 5. 74 6.45 7.22 73 4.67 5. 16 5.77 6.50 7.30 74 4.67 5. 17 5. 79 6.54 7.38 75 4.68 5. 18 5.81 6.58 7.46 *A Member's age and a Contingent Annuitant's age for the purpose of this table is age last birthday on the Member's Annuity Commencement Date. GP 17321 Table 1 Option 3 66 2/3% Survivorship Installment Refund TABLE 1 OPTION 3 - SURVIVORSHIP ANNUITY WITH INSTALLMENT REFUND with 50% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Male Member Age* of 55 60 65 70 75 Contingent Annuitant Age* of Female Member Male Female 60 65 70 75 80 55 $4.41 $4.73 $5. 10 $5.52 $5.96 56 4.43 4. 76 5. 14 5.57 6.03 57 4.45 4.79 5. 18 5.62 6.09 58 4.47 4.82 5.22 5.67 6. 16 59 4.49 4.85 5.26 5.73 6.23 55 60 4.51 4.88 5. 30 5.78 6.30 56 61 4.52 4. 90 5. 34 5.84 6.37 57 62 4.54 4.93 5.38 5.89 6.45 58 63 4.56 4.96 5.42 5. 95 6.52 59 64 4. 57 4. 98 5.46 6.01 6.60 60 65 4.59 5.01 5.50 6.06 6.67 61 66 4.60 5.03 5.53 6. 11 6.75 62 67 4.62 5.05 5.57 6. 17 6.83 63 68 4.63 5.07 5.61 6.23 6.91 64 69 4.64 5.09 5.64 6.28 6.99 65 70 4.65 5. 11 5.67 6.33 7.07 66 71 4.66 5. 13 5.70 6.38 7. 15 67 72 4.67 5. 14 5.73 6.43 7.23 68 73 4.67 5. 16 5.76 6.48 7.30 69 74 4.68 5. 17 5.78 6.52 7.37 70 75 4.68 5. 18 5.80 6.57 7.45 71 4.69 5. 19 5.82 6.60 7.52 72 4.69 5.20 5.84 6.64 7.58 73 4.69 5.21 5.86 6.67 7.64 74 4.70 5.21 5.87 6.70 7.69 75 4.70 5.22 5.88 6.72 7.74 *A Member's age and a Contingent Annuitant's age for the purpose of this table is age last birthday on the Member's Annuity Commencement Date. GP 17320 Table 1 Option 3 50% Survivorship Installment Refund . -.- . TAISI.E 1 OPTION 2--CERTAIN AND LIFE; ANNUITY Amount of Monthly Annuity Purchased by $1 ,000 Monthly Annuity Age * _ 5 years 10 years 15 years Male Female curtain certain certain 45 50 $4. 11 $4.08 $4.04 46 51 4. 18 4. 15 4.10 47 52 4.26 4.22 4.17 48 53 4. 33 4. 30 4.23 49 54 4.42 4. 37 4. 30 50 55 4. 50 4.46 4.37 51 5h 4. 59 4.54 4.45 52 57 4.69 4.63 4.52 53 58 4. 79 4. 72 4.60 54 54 4.89 4.82 4.69 55 60 5.01 4.92 4.77 56 61 5. 12 5.02 4.86 57 62 5.25 5. 13 4.95 58 63 5. 38 5.25 5.05 59 64 5. 52 5. 37 5.14 60 65 5.67 5. 50 5.24 61 66 5.82 5.64 5. 35 62 67 5.99 5. 78 5.45 63 68 6. 17 5.93 5.55 64 69 6. 36 6.09 5.66 65 70 6.57 6.25 5. 76 66 71 6. 7Q 6.42 5.86 67 7.! 7.02 6. 59 5.96 68 71 7.27 6. 77 6.06 1,9 /4 7.54 6.96 6.15 70 7 7.82 7.14 6.24 71 /6 8.13 7. 33 6.32 72 /7 8.45 7.52 6.40 73 78 8. 78 7. 70 6.47 74 79 9. 14 7.88 6.53 75 Mu 9.51 8.06 6.59 *A Member's age for the purpose of this table is age last birthday on his Annuity Commencement Date. Table 1 Option 2 LP 11615 Certain and Life / C - TABLE 1 OITION 1--LIFE ANNUITY Amount of Monthly Annuity Purchased by $1,000 Age * Monthly Male Female Annuity 45 50 $ 4. 12 46 51 4.19 47 52 4.27 48 53 4. 35 49 54 4.43 50 55 4.52 51 56 4.61 52 57 4. 71 53 58 4.81 54 59 4.92 55 60 5.03 56 61 5.15 57 62 5.28 58 63 5.42 59 64 5.56 60 65 5. 72 61 66 5.89 62 67 6.06 63 68 6.25 64 69 6.46 65 70 6.68 66 71 6.91 67 72 7.17 68 73 7.44 69 74 7.74 70 75 8.07 71 76 8.42 72 77 8.80 73 78 9.21 74 79 9.65 75 80 10.13 *A Member's age for the purpose of this table is age last birth- day on his Annuity Commencement Date. GP 11674 - Table 1 Option 1 Life r Application for and issuance of this contract constitutes appointment of and acceptance and affirmation by us that (i) we are an Investment Manager as described under the Em- ployee Retirement Income Security Act of 1974 with respect to Plan assets held under this contract, except the right reserved in the preceding paragraph and (ii) we are qualified to accept such appointment and acknowledge that by virtue of such appointment we are a fiduciary of the Plan, within the meaning of the Employee Retirement Income Security Act of 1974 with respect to our responsibilities as Investment Manager. SECTION 18--OWNERSHIP. You are the owner of this contract; provided however that if the Plan is trusteed, the trustee(s) of the Plan is sole owner of all the payments, rights, options, and privileges herein granted or made payable to any Member, benefici- ary, or contingent annuitant under this contract. This includes, without limitation, the right to distribute all or a portion of the Member' s accounts, or ownership of these rights in respect of such accounts, on or after the Member' s Termination of Employment; but this does not include the right to designate a Member' s beneficiary unless such right has been granted to the trustee by the Plan or trust. The trustee(s) of the Plan is entitled to exercise all such rights, options, and privileges and to receive all such payments at the time or times specified in this contract that such payments, rights, options, and privileges are available to a Member. Such exercise by the trustee(s) may be made without the consent or participation of any Member, beneficiary, or contingent annuitant. \ 7--18;FIA;8404 THE BANKERS LIFE 0 BANKERS LIFE COWANV OES MOINES. IOWA / 1 SECTION 11--MODIFICATION IN MODE OF PAYMENT OF ANNUITY. If, at any time on or subse- quent to a Member's Annuity Commencement Date, the monthly amount of the annuity payable under this contract to such Member or to his beneficiary or contingent annuitant would be less than $20, we may, at our option, pay in cash the reserve for the annuity payments in full settlement of all benefits otherwise payable. The reserve will be determined by us on the same mortality and interest basis as the annuity purchase rate which was used to determine the amount of annuity payments. If, after a Member's Termination of Employment has occurred, the total of his Separate Investment Accounts and General Investment Accounts is less than $1 ,750, we, at our op- tion, may pay to such Member the amount of such accounts in a single sum in lieu of any and all other benefits as to such accounts. SECTION 12--COMMUTATION OF PAYMENTS. If any monthly payments are to be commuted, com- muted value of the payments will be determined by us, using the interest rate which was used as a basis for calculating the amount of the monthly payment at the time the annuity was purchased. Neither the Member, the contingent annuitant nor any beneficiary who is a natural per- son taking in his own right, has the right to commute any monthly annuity payments under this contract. SECTION 13--FACILITY OF PAYMENT. If any Member, contingent annuitant or beneficiary is phisically or mentally incapable of giving a valid receipt for any payment due him and no legal representative has been appointed for him, we may, in the absence of written direc- tion to the contrary from you, at our option, make such payment to the person or persons as have, in our opinion, assumed the care and principal support of the Member, contingent annuitant or beneficiary, except that any payment due a minor will be paid at a rate not `I exceeding $100.00 per month. However, in no event will any such payment exceed the maxi- mum amount allowed under applicable law of the state in which this contract is delivered. Any such payment made by us shall fully discharge us to the extent of the payment. SECTION 14--PRONOUNS. Masculine pronouns used in this contract include both masculine and feminine gender unless the context indicates otherwise. SECTION 15--ASSIGNMENT. No benefits payable under this contract to any Member, bene- ficiary or contingent annuitant are assignable, and all such benefits are exempt from the claims of creditors to the maximum extent permitted by law. SECTION 16--BASIS OF ANNUITY PURCHASES. The rates shown in the Table 1 included in this contract on the Contract Date have been computed on the basis of (i) interest at the rate of 3% per annum and (ii) mortality according to the a-1949 Male Annuity Table (Modi- fied Projection C) with 1960 modifications in the rates of mortality, projected 30 years, males set forward one year in age, females set back four years in age. SECTION 17--INVESTMENT MANAGER. As set out in Article II, Sections 3, 8 and 9 , the right to direct the split of Contributions between General Investment Accounts and Sepa- rate Investment Accounts and to direct any transfer between these accounts is reserved to you and/or the Member, all in accordance with provisions of this contract. • \.7--11 ,12, 13,14, 15 ,16,17;FIA;8304 • THE BANKERS LIFE a ERRRERS VIE COMPANY DES MOIRES. IOWA SECTION 9--AMENDMENT. We reserve the right to amend or change this contract as fol- lows, subject to the limitations of item (f) : (a) Any or all of the contract provisions may be changed at any time, including retro- active changes , to the extent necessary to meet the requirements of any law or regulation issued by any governmental agency to which we are subject. (b) As of any date after the Contract Date and subject to the notice provisions of (e) of this Section, we may amend or change the length of the Guarantee Period; the Order of Application; the provisions for transferring values between accounts; and the charge contained in Article VI , Section 1. (c) We may amend or change Table 1 as of any date which is at least 5 years after the later of (i) the Contract Date or (ii) the date of the latest amendment or change under this item (c) . (d) By written agreement between you and us, this contract may be amended or changed at any time as to any of its provisions, including those in regard to coverage , benefits and the participation privileges, without the consent of any Member, beneficiary or contingent annuitant. (e) We will give you written notice of any change made because of item (a) above. Any amendment or change under items (b) or (c) will not become effective unless we give you written notice at least 60 days before the date the amendment or change is to take effect. (f) Any amendment or change under this Section 9 is binding and conclusive on each Member, beneficiary, or contingent annuitant, but is limited by the following: (i) No amendment or change will apply to annuities purchased under Article IVA before the effective date of the amendment or change except to the extent necessary in making changes in accordance with item (a) above. (ii) No amendment or change under (b) above will affect Guaranteed Interest Ac- counts established prior to the date of the amendment or change. (iii) Any change in the general administration expense charge referred to in (b) of Section 1 , Article III, will not take effect as to any General Invest- ment Accounts and Separate Investment Accounts to be transferred to an Alternate Funding Agent, if, prior to the date the amendment or change is to take effect, we receive written request from you for payment of all such General Investment Accounts and Separate Investment Accounts to the Alternate Funding Agent in accordance with Article V, Section 1 , and such request is not revoked. SECTION 10--CONTRIBUTIONS. We reserve the right to limit or refuse further Contribu- tions or Annuity Premiums under this contract. We will give you written notice at least 60 days before the date after which further Contributions or Annuity Premiums will be limited or refused by us. K7--9, 10;FIA;8304 THE BANKERS LIFE f© BANKERS LIFE COMPANY 0E5 MOINES. IOWA C K for the benefit of a natural person and if the payment period is at least 24 months and not more than 60 months, monthly or other periodic payments may be continued to such beneficiary. SECTION 3--DIVIDENDS. Any portion of the divisible surplus that we determine to accrue on this contract shall be determined annually by us and shall be credited to this con- tract on each Yearly Date after the Contract Date. Any such dividend shall be applied as directed by you in accordance with Plan provisions. (NOTE: Because of the direct cred- iting of investment return to both General Investment Accounts and Separate Investment Accounts, it is not anticipated that there will be any surplus accruing on this contract from which dividends may be apportioned to this contract.) SECTION 4--CONTRACT. This contract and your application, a copy of which is attached to and made a part of this contract, are the entire contract between the parties. We are obligated only as provided in this contract and are not a party to nor bound by any trust or plan. t� SECTION 5--PLAN AND PLAN AMENDMENTS. You agree to furnish us with a copy of the Plan in effect on the Contract Date and any subsequent amendments to it. No amendment to the Plan which affects our duties and obligations will be effective under this contract if we notify you in writing that such change is unacceptable to us . We agree to notify you within 60 days after we receive an amendment if it is unacceptable. SECTION 6--WAIVER AND MODIFICATION. Only our officers have authority to change this contract or waive any of its provisions or requirements. SECTION 7--MISSTATEMENTS. If the age or sex of any Member or contingent annuitant is found to have been misstated, i I (a) the amount of annuity payable by us will be that provided by the amount applied to purchase such annuity, determined as of the date of purchase established by the misstated information and on the basis of the correct age and sex. (b) any overpayment by us resulting from any misstatements will be deducted from amounts thereafter payable to the Member, his contingent annuitant or his benefi- ciary. (c) any underpayment by us resulting from any misstatements will be paid in full with the next payment due the Member, his contingent annuitant or his beneficiary. SECTION 8--INFORMATION, PROOFS AND DETERMINATION OF FACTS. You agree to furnish to us evidence of the age of each Member and his contingent annuitant, if any, on or before his earliest Annuity Purchase Date and other records, data, proofs or additional information which, in our opinion, is necessary for the administration of this contract. For the purposes of this contract, the determination by you as to any facts (except age and sex) relating to any employee is, except for fraud or willful misstatement of fact, conclusive. • \7--3,4,5,6,7 ,8;FIA;8304 THE BANKERS LIFE 0 BANKERS LIFE COMPANY DES MOINES IOWA I ARTICLE VII GENERAL PROVISIONS SECTION 1--CERTIFICATES. If a Member contributes under the Plan and the state of issue so requires, we will prepare and send to the Employer, for delivery to each such Member, an individual certificate setting out a statement of the benefits to which that Member is entitled and to whom death benefits are payable. If benefits become payable to a Member under one of the options of Article IVA, we will issue an individual certificate setting forth the amount, form and period of payment of the monthly annuity benefits. SECTION 2--BENEFICIARY. The beneficiary is the person or persons named by the Member to whom benefits (other than any monthly income payable to a contingent annuitant under the provisions of Article IVA, Section 2) are payable under this contract upon the death of the Member, subject to the provisions of Section 12 of this Article. A Member shall F name or change a beneficiary by filing a written beneficiary designation to that effect with us, but the designation will not be effective until we receive it. When we receive the designation, it will be effective as of the date it is executed, but any payments we made before receipt of the designation shall discharge us to the extent of such payments. We reserve the right to require the Member's certificate for endorsement of any change of beneficiary. Unless otherwise specified by the Member with our consent, (a) if any beneficiary dies before the Member, any monthly payment which would have become payable to such beneficiary, if living, will be payable when due to the beneficiary or beneficiaries surviving the Member in the order provided. (b) if any beneficiary survives the Member but dies before receiving all of the month- ly payments which would have become payable to such beneficiary, if living, pay- ment will be paid when due to the surviving beneficiary or beneficiaries in the order provided. (c) if the last survivor of all named beneficiaries dies after the death of the Mem- ber, (and the contingent annuitant, if any) and before all payments due the bene- ficiary have been made, the remaining payments will be commuted and the commuted value paid to the executor or administrator of the last survivor of the benefici- aries. If no named beneficiary survives the Member (and the contingent annuitant, if any) , or no beneficiary has been named, any amount which would have become payable to a benefici- ary will be commuted and the commuted value paid to the executor or administrator of the Member (the executor or administrator of any contingent annuitant, if he survives the Member) . If the beneficiary is not a natural person taking in his own right (e.g. , a trust or an estate) , any monthly or other periodic payments will be commuted and the commuted value paid to the beneficiary in one sum. However, if the beneficiary is a trust established K7--1 ,2;FIA;8304 THE BANKERS LIFE C� RANKERS LIFE COMPANY OES MOINES. IOWA ( transfer from the General Investment Accounts. If this limitation is effective, the first installment will be made one month after the date of request, or on such later date that you specify. Nothing in any of the limitations described above will apply to payments to the benefi- ciary of a Member, or to applications of Annuity Premium. If a deferment is effective under this Section, amounts to be paid or transferred will continue to earn interest at the rate determined pursuant to Article II, Section 5, until the date payment or transfer occurs. Any surrender charges applicable under Section 1 of this Article will be determined as of the date payment or transfer occurs under this Sec- tion. We will notify you in the event of any deferment of more than 30 days under the provisions of this Section. SECTION 3--LIMITATIONS ON TRANSFERS AND PAYMENTS FROM SEPARATE INVESTMENT ACCOUNTS. Any limitation on the payment or transfer from a Separate Investment Account is contained in the rider describing such Separate Investment Account. I � (... 6--3;FIA;8304 / THE BANKERS LIFE 0 BANNERS LIFE COMPANY DES MOINES, IOWA. ARTICLE VI CHARGES AND LIMITATIONS SECTION 1--CHARGES FOR SURRENDER OF A GUARANTEED INTEREST ACCOUNT. Transfer or with- drawal of a Guaranteed Interest Account during its Guarantee Period as provided in Arti- cle II, Section 8; Article IVB, Section 4; and Article V, Section 1, is a surrender of the portion of the account so transferred or withdrawn. If, however, the transfer under Article V, Section 1 is on account of the death, Termination of Employment, disability, or retirement of a Member and could have been a payment under Article IVB, Section 1 or Section 2, charges under this Section will not be made. If all or a portion of a Guaranteed Interest Account is surrendered, the amount avail- able will be reduced by a surrender charge equal to the following: (a) If the Guaranteed Interest Rate in effect for contracts of this class for the date of surrender is equal to or less than the Composite Guaranteed Rate for such ac- count, there is no charge. (b) If the Guaranteed Interest Rate in effect for contracts of this class for the date of surrender is greater than the Composite Guaranteed Rate for such account, such charge is equal to (1) the difference between such Guaranteed Interest Rate for such date of surren- der and such Composite Guaranteed Rate multiplied by (2) the number of years (including fractional parts of a year) remaining in the Guarantee Period for such Guaranteed Interest Account multiplied by (3) the amount being surrendered. If the entire account is surrendered, such Guaranteed Interest Account will be applied on the date of surrender and the difference between the amount applied and the surrender charge (if any) determined above will be paid or transferred. If a portion of the account is surrendered, the amount applied will be equal to the amount being surrendered plus the surrender charge, if any. SECTION 2--LIMITATIONS ON TRANSFERS AND PAYMENTS FROM GENERAL INVESTMENT ACCOUNTS. In general, payments and transfers from the General Investment Accounts will be made in full within 90 days after the requested date of payment. We may, at our option, delay such payment or transfer for up to an additional 180 days. However, if in the 36-month period which ends on the requested date of payment or transfer all payments or transfers from the General Investment Accounts total $12,000,000 or more, then the portion of the requested payment or transfer in excess of $12,000,000 may be made in substantially equal monthly installments over a period not greater than the following 36 months . For purposes of this limitation, payments and transfers from our general account from any other contracts or policies we issued in connection with the Plan or with any other retirement plan of the Employer will be included as a payment or \ 6--1,2;FIA;8304 1 THE BANKERS LIFE BANKERS LIFE COMPANY DES MOINES. IOWA ( r 1 ARTICLE V TRANSFER TO ALTERNATE FUNDING AGENT; CESSATION SECTION 1--TRANSFER TO ALTERNATE FUNDING AGENT. You may file a written request with us at our home office for payment of the aggregate of all or a portion of the General In- vestment Accounts and Separate Investment Accounts to an Alternate Funding Agent. Sub- ject to the charges provided for in Article VI, Section 1, and the limitations provided in Article VI, Sections 2 and 3, the amount of any General Investment Accounts and Sepa- rate Investment Accounts to be transferred will be determined and transferred within seven business days after the date we receive your request. If you request payment as of some later date, the amounts to be paid out will be determined and paid out as of that later date. If only a portion of the General Investment Accounts or Separate Investment Accounts is to be transferred, we will reduce the account or accounts specified in your written re- quest by the portion requested. If the Guaranteed Interest Account or Accounts to be transferred is not specified, the Order of Application (defined in Article I, Section 2) will apply. Alternate Funding Agent means an insurance company or trustee designated by you and authorized to receive any amount or amounts transferred under this Section as to a Member or Members and to apply such amount or amounts for the exclusive benefit of such Member or Members under a plan which continues to meet the requirements of the Internal Revenue Code, without any obligation on our part as to such application. SECTION 2--CESSATION OF CONTRIBUTIONS. Cessation of Contributions shall be effective as of any of the following dates : (a) On the date you notify us in writing that cessation of Contributions is to occur. (b) On the date the Plan terminates. (c) On the date the Plan fails to meet the requirements of the Internal Revenue Code if we have given you written notice that cessation is to be effective as of such date. (d) On the date no General Investment Accounts or Separate Investment Accounts remain under this contract. Upon cessation of Contributons , no further employees will become Members and no further Contributions will become payable. All provisions of this contract will remain effective as to any General Investment Ac- counts and Separate Investment Accounts which have not been paid or applied in full. Once all General Investment Accounts and Separate Investment Accounts have been paid or applied in full we will have no further obligation in regard to such Accounts. \ S--1 ,2;FIA;8304 THE BANKERS LIFE © BANNERS LIFE COMPANY DES MOINES, IOWA . SECTION 3--OPTIONS FOR BENEFITS PAYABLE AT DEATH. By written direction to us, a Member may have an annuity purchased for his beneficiary under a supplementary contract. Any such purchase must conform to the requirements of our supplementary contract. If no such written direction is on file with us , a beneficiary may choose to make such a purchase, subject to any requirements under the supplementary contract we make avail- able to the beneficiary. Any election under this Section shall be in lieu of any benefits payable under Section 2 of this Article. SECTION 4--WITHDRAWAL BENEFIT. Upon written request from you and a Member, we will pay to that Member any portion of the amounts available to him under this contract, subject to the following: (a) The request must be before the Member' s Termination of Employment, disability or retirement. (b) The plan must allow for such withdrawal. (c) Any amount withdrawn under this Section will be subject to both the delay of pay- ment and limitation provisions of Article VI, Sections 2 and 3, and the charges of Article VI, Section 1. (d) The request must be on a form we either furnish or approve and will be accompanied (at our request) by the Member' s certificate, if any, issued as described in Arti- cle VII, Section 1. We will determine the amount available as of the date we receive the request at our home office, or at some later date specified in the request. The amount available will be that portion of his Separate Investment Account and his General Investment Account in which he is vested under the Plan. If a portion of a Member' s General Investment Account is to be withdrawn, the written request must specify which Guaranteed Interest Account or Accounts are to be applied. If none is specified, the Order of Application (defined in Article I, Section 2) will apply. Any payment under this Section will be an application of the portion requested from the account or accounts involved on the date paid. This payment will be in lieu of any other benefits under this contract for the portions applied. l 4B--3,4;FIA;8304 THE BANKERS LIFE Chi . BANKERS uFE COMPANY 0E5 MOINES TOWN C C ARTICLE IVB SINGLE SUM PAYMENTS SECTION 1--CASH TERMINATION, RETIREMENT OR DISABILITY BENEFITS. All or a portion of the amounts available to a Member under this contract may be paid to him by us in a single sum on or after his Termination of Employment or his retirement under the Plan or his disability under the Plan if (a) the Plan allows such payment, and (b) we receive a written request from you and the Member, using a form we either fur- nish or approve. The amount available will be determined as of the date we receive the request at our home office, or some later date specified in the request. It will consist of that part of the Member' s accounts in which he is vested under the vesting provisions of the Plan. Any amount payable to a Member under this Section is subject to the delay of payment and limitation provisions of Article VI, Sections 2 and 3, but such amount is not subject to the charges contained in Article VI, Section 1. Any payment made because of this Section will be an application equal to the amount of payment from the account or accounts involved on the date paid and it will be in lieu of any other benefits available under this contract for the amounts applied. SECTION 2--BENEFITS PAYABLE AT DEATH. Subsection (1)--Before Annuity Purchase Date. If a Member dies before his Annuity Pur- chase Date, a benefit equal to his vested accounts will be payable to his beneficiary. Upon receipt of due proof of death, we will pay this benefit in accordance with Plan pro- visions. If the Plan does not provide for another method, or if no other method has been chosen, we will pay this benefit to the beneficiary in a single sum. We will determine the value of these accounts as of the date proof of death is received at our home office. There is no charge under Article VI , Section 1 for a payment made under this Section, nor is such payment subject to the delay of payment and limitation provisions of Article VI , Section 2. Subsection (2)--After Annuity Purchase Date. If a Member dies after his Annuity Pur- chase Date, benefits will be paid under the form of annuity in effect for him. Subsection (3)--Proof of Death. We will accept as due proof of death a copy of a cer- tified death certificate, a copy of a certified decree of a court of competent jurisdic- tion as to the finding of death, a written statement by a medical doctor who attended the deceased during his last illness, or any other proof that is satisfactory to us. \ 4B--1,2;FIA;8304 THE BANKERS LIFE 0 BANNERS LIFE COMPANY OES MOINES. IOWA SECTION 3--AMOUNT OF MONTHLY ANNUITY. The amount of monthly Fixed Dollar Annuity pur- chased under Section 1 of this Article and payable to a Member will be determined by us based on (a) the Annuity Premium for such portion, (b) the option chosen, (c) the age and sex of the Member, (d) the Annuity Purchase Date, • (e) the age and sex of the contingent annuitant (if any) , and (f) the annuity purchase rates applicable (for purchases under all contracts of this class issued by us) on the date of purchase. However, the annuity purchase rates used will not be less favorable to the Member than the rates shown in Table 1 . SECTION 4--CANCELLATION OF ANNUITY. If under the provisions of the Plan in effect on a Member's Annuity Purchase Date you determine and report to us that the monthly annuity purchased for a Member is to be reduced, then the fraction you report of Fixed Dollar Annuity purchased for that Member will be cancelled, and the amount of monthly annuity payments paid to the Member, his beneficiary or contingent annuitant will be reduced accordingly. The reserve for any annuity cancelled under this Section will be treated as a forfei- ture under Article II, Section 7. (.- . ' I j f 4A--3,4;FIA;8304 / THE BANKERS LIFE BANKERS LIFE COMPANY OES MOINES. IOWA C . c (b) Whether the remaining payments are to be paid as due to the beneficiary or com- muted and paid in a single sum. (c) The beneficiary named by the Member to whom remaining payments are to be made. Option 3--Survivorship Annuity with Installment Refund. This provides monthly annuity payments to the Member, starting on his Annuity Commencement Date and continuing for his life. If the Member dies after his Annuity Commencement Date, a fraction of the monthly annuity will be continued to the contingent annuitant named by the Member for the lifetime of the contingent annuitant. If both the Member and the contingent annui- tant die after commencement but before his Annuity Premium has been paid out, the rest of his Annuity Premium will be paid to his beneficiary in monthly payments. The monthly payments to the beneficiary will be in the same amount as the last monthly pay- ment made by us before the payment to the beneficiary is due. In choosing this option, the following items must be reported to us: (a) The fraction to be continued (1/2, 2/3, or 1) . (b) The name, date of birth, and sex of the contingent annuitant. (c) The beneficiary to whom any remaining payments are to be made. Option 4--Single Life Installment Refund Annuity. This provides monthly annuity pay- ments to the Member, starting on his Annuity Commencement Date and continuing for his life. If the Member dies after his Annuity Commencement Date and before monthly pay- ments to him total his Annuity Premium, then monthly payments will continue to his beneficiary until the total of monthly payments made equal the Annuity Premium. In choosing this option, the name of the beneficiary to whom remaining payments are to be made must be reported to us. Option 5--Fixed Period Annuity. This provides monthly annuity payments to the Member, starting on his Annuity Commencement Date and continuing for a stated (fixed) period. If the Member dies after his Annuity Commencement Date but before payments as to him have been made for the stated period, any payments remaining for this period will be paid to his beneficiary. In choosing this option, the following items must be reported to us: (a) The number of complete years the period is to run. (b) Whether remaining payments are to be paid as due to the beneficiary or commuted and paid in a single sum. (c) The beneficiary named by the Member to whom remaining payments are to be made. By written agreement with you, we may provide other options permitted by the Plan. \ 4A--2(2) ;FIA;8304 THE BANKERS LIFE a BANKERS LIFE COMRANV DES MOINES. IOWA r K ARTICLE IVA ANNUITY BENEFITS SECTION 1--PURCHASE OF ANNUITY. An annuity will be purchased for a Member, payable under any option of Section 2 of this Article, as long as the purchase conforms to Plan provisions and complies with the following: (a) The amount available to purchase an annuity may be all or a portion of the amount available under the Plan, as reported to us by you. (b) You or the Member, as permitted by the Plan, must make the request to us to pur- chase, using a form we either furnish or approve. (c) If no optional form of income is elected, the Normal Income Form will be pur- chased. (d) The Annuity Premium applied for the Member must be at least $1 ,750. (If the Mem- ber has had other purchases under this contract, this provision does not apply. ) (e) You or the Member, as permitted by the Plan, must specify what portion of the Annuity Premium is to purchase Fixed Dollar Annuity. A transfer between accounts under Article II, Section 8, may be made to purchase the portion of Fixed Dollar Annuity requested. We will apply a Member' s General Investment Accounts to pur- chase Fixed Dollar Annuity. (f) Any other amounts applied, not included in (e) above, will purchase Fixed Dollar Annuity as specified in the request to purchase. (g) The form of annuity and the contingent annuitant named (if any) cannot be changed after Annuity Purchase Date. (h) Annuity Commencement Date will be the Member's Annuity Purchase Date. SECTION 2--OPTIONS. Any of the options described below may be chosen as the form of income to be paid for an annuity purchased under Section 1. Option 1--Life Annuity. This provides monthly annuity payments to the Member, starting on his Annuity Commencement Date and continuing for his life, with no further payments due after the Member's death. Option 2--Life Annuity with Certain Period. This provides monthly annuity payments to the Member, starting on his Annuity Commencement Date and continuing for his life. If the Member dies-after his Annuity Commencement Date, but before payments as to him have been made for a certain period, the payments left for that certain period will be con- tinued to the Member's beneficiary. In choosing this option, the following items must be reported to us: (a) The length of the certain period (5, 10, or 15 years) . \ 4A--1,2;FIA;8304 THE BANKERS LIFE 4 RANKERS LIFE COYVAMY DES MOINES, IOWA C ARTICLE IV BENEFITS SECTION 1--DISTRIBUTION OF BENEFITS. Benefits will be payable to a Member or a bene- ficiary under this contract as an annuity as described in Article IVA or in a single sum payment as described in Article IVB. Benefits may be payable because of a Member's (a) Termination of Employment, (b) retirement (whether early, normal or late) , (c) disability, (d) death, or (e) withdrawal depending upon the Plan provisions. \ 4--1;FIA;8304 THE BANKERS LIFE G� SNNREAS LIFE COMPANY 0E3 MOINES. 'OWA l - r ARTICLE III EXPENSES SECTION 1--EXPENSES. Expense charges will be determined by us periodically, but at least annually, in accordance with the written service agreement we have with you. The amount of such charges will be made up of the following: (a) Compensation paid or payable by us to the soliciting agent named by you on Contri- butions received by us since the last date expenses were paid. (b) A general administration expense charge, as shown in the service agreement, which is calculated for each period based on the average account balances under the con- tract during the period. (We will apply this charge in a uniform manner to all contracts of this class that we issue. ) (c) A recordkeeping expense charge for keeping individual records of the various types of contribution accounts for Members under this contract, and for preparing materials to inform Members about their accounts under this contract. (d) Other charges may be made for services you ask us to do that are not covered by (a) through (c) above, for example, preparing the summary plan description if we do not hold all Plan assets or if the Employer requests unusual material. We will inform you of the charges for such services before we perform them. These expenses may be paid to us directly at our home office in Des Moines, Iowa. We will send you a statement of these charges periodically in accordance with our written service agreement with you. Such charges must be paid within 31 days from the date of the statement. If the expense charges are not paid within 31 days from the date of the statement date, we will deduct them from the Holding Accounts and the Members' General Investment Accounts and Separate Investment Accounts as set out in Section 2 of this Article. If this automatic deduction of expenses occurs twice in any twenty-four (24) month period, we will deduct expenses from the accounts as described in Section 2 of this article thereafter until a new written service agreement is completed with us. SECTION 2--DEDUCTION OF EXPENSES. In your written service agreement with us (or as provided in Section 1 of this Article) , an election may be made to have some or all of the expense charges (described in Section 1 above) deducted from Member accounts instead of having these charges paid separately. These expense charges will be deducted as due from the General Investment Accounts, Separate Investment Accounts, and Holding Accounts and will be an application from each such account when deducted. For General Investment Accounts, such charges will be (i) deducted from the Guaranteed Interest Accounts for the current Deposit Year, if any, or (ii) if no current Deposit Year Guaranteed Interest Account has been established under such General Investment Account (or if it. is insufficient) , such deductions will be made from the Guaranteed Interest Account most recently established under it. \3--1 ,2;FIA;8309 THE-BANKERS LIFE © SANRERS LPFE COMPANY DES MOkNES. JOWA C K (d) Transfer to Alternate Funding Agent. On or before the end of its Guarantee Peri- od, you may make written request to us to transfer all or a part of such account to an Alternate Funding Agent. We will transfer the amount requested from such account within 10 days after its Guarantee Period ends. If no written election has been received by us on the last day of the Guarantee Period, item (a) will be applied by us. SECTION 10--FUNDS. We are sole owner of all funds received under this contract. All General Investment Accounts we receive under this contract are and remain a part of our general account without any duty or requirement of segregation or separate investment on our part. Separate Investment Accounts will be held as stated in the rider or riders describing such Separate Investment Accounts. \ 2--10;FIA;8304 THE BANKERS LIFE ea BARKERS LIFE COMPANY DES MOIRES. IOWA l � and the provisions of Sections 1 and 3 will apply. If the Plan is a pension plan, it is understood that amounts allocated under this Section will be an offset to the earliest Employer Contribution made under the Plan on or after such date. SECTION 8--TRANSFERS BETWEEN ACCOUNTS. In general, all or a portion of a Member' s ac- counts can be transferred to another account or accounts as of any date requested subject to the following: (a) We must receive written direction to transfer from you or the Member, as permitted by the Plan. The written direction will specify, in addition to the amount to be transferred and the accounts involved, the type of Contribution (see Article II, Section 2) being transferred. If a requested transfer from a Member' s General In- vestment Account does not specify the Guaranteed Interest Account or Accounts to be transferred, the Order of Application (as defined in Article I, Section 2) will determine the accounts to be transferred. (b) No transfer will be effective if it is within one month before the Member' s Annu- ity Commencement Date. (c) A transfer from a Member' s General Investment Account to a Separate Investment Ac- count can occur only on a Valuation Date of such Separate Investment Account. (d) Except as provided in Section 9 of this Article, all transfers from a General In- vestment Account are subject to the charges contained in Article VI , Section 1. All transfers are subject to the limitations contained in Article VI, Sections 2 and 3. (e) All Separate Investment Account transfers will be made subject to the provisions of the Separate Investment Rider describing such Separate Account. Any transfer under this Section will be an application from the account from which the funds are transferred as of the date of transfer. SECTION 9--DISPOSITION OF A GUARANTEED INTEREST ACCOUNT AT THE END OF ITS GUARANTEE PERIOD. Each Guaranteed Interest Account which has not been paid or applied in full be- fore the end of its Guarantee Period will be applied in full on the date after its Guar- antee Period ends by one or more of the following methods: (a) Transfer to Current Guaranteed Interest Account. On or before the end of its Guarantee Period, you or the Member (as permitted by the Plan) may make written request to us to transfer all or a part of such account to the current Guaranteed Interest Account of the Member for that type of Contribution. (b) Transfer to a Separate Investment Account. On or before the end of its Guarantee Period, you or the Member (as permitted by the Plan) may make written request to us to transfer all or a part of such account to one or more of the Separate In- vestment Accounts of the Member. (c) Purchase of Annuity. On or before the end of its Guarantee Period, you or the Member (as permitted by the Plan) may make written request to apply all or a por- tion of such account as an Annuity Premium for the Member under Article IVA. \ 2--8,9;FIA;8304 THE BANKERS LIFE CD BANKERS LIFE COMP•NV OE5 MOINES. IOWA (- (2) Interest will be credited daily and compounded annually on the last day of the Deposit Year. (3) Interest will be credited at the Composite Guaranteed Rate from the first day of the Deposit Year to the last day of the Deposit Year, or to the date of payment or transfers if earlier. A Guaranteed Interest Account will be paid or applied in full at the end of its Guaran- tee Period as described in Section 9 of this Article. SECTION 6--SEPARATE INVESTMENT ACCOUNT. A Separate Investment Account is established for a Member for each type of Contribution directed to each Separate Account in which this contract participates. The applicable Separate Investment Rider attached to this contract describes each such Separate Investment Account and its investment, accounting, valuation, and transfer provisions. SECTION 7--HOLDING ACCOUNTS. When we are notified that an event has occurred which re- quires a Member's Separate Investment Account (or Accounts) and his General Investment Account be reduced by the provisions of the Plan, we will reduce the account or accounts affected to the amounts specified. The amounts deducted from the Member's accounts will be held in Holding Accounts which correspond to the Member accounts from which they were deducted until they become forfeitures under the Plan or again become part of Member Ac- counts for such Member. If the Member's Holding Accounts become forfeitures , the following will occur: (a) Each Holding Account for the Member for a Separate Investment Account will be added to the Holding Account for forfeitures for such Separate Investment Account. (b) Each Holding Account for the Member for a Guaranteed Interest Account will be added to the Holding Account for forfeitures for all Guaranteed Interest Accounts whose Guarantee Periods end on the same date as such account. (c) Holding Accounts for forfeitures will operate in the same manner as Member Holding Accounts except as follows. If the Guarantee Period for a Guaranteed Interest Ac- count ends while such account is held as a forfeiture, the value of such account shall be transferred to the Holding Account for forfeitures for the Separate In- vestment Account invested in Separate Account LI. If such Separate Investment Account is not available under this contract, the rate of interest credited to forfeitures consisting of Guaranteed Interest Account values after the end of the Guarantee Period for them will be the rate determined • by us for amounts so held under contracts of this class. (d) As forfeitures, Holding Account values will be allocated to those Members entitled to them under the Plan and will be applied on the earliest date which is consis- tent with Plan provisions. Any amounts allocated to a Member because of this Sec- tion will be considered a Contribution for him under Section 1 of this Article, \2--6,7;FIA;8304 THE BANKERS LIFE 1' BANKERS LIFE COMPAN♦ DES 401NES. IOWA / 1 SECTION 4--GENERAL INVESTMENT ACCOUNT. The General Investment Account of a Member for a type of Contribution is the aggregate of all of his Guaranteed Interest Accounts which have not been paid or applied in full. The value of a General Investment Account of a Member on any date will be the sum of the values of the Guaranteed Interest Accounts held under it on such date. SECTION 5--GUARANTEED INTEREST ACCOUNTS. A Guaranteed Interest Account will be estab- lished for a Member for each type of Contribution directed to his General Investment Ac- count for each Deposit Year. All such General Investment Account Contributions and transfers to General Investment Account for a Member will be credited to his Guaranteed Interest Account established for the Deposit Year in which such Contributions or trans- fers occur. No further Contributions or transfers will be credited to a Guaranteed In- terest Account after the close of the Deposit Year in which it was established. The value of each Guaranteed Interest Account of a Member at any time during its Guar- antee Period will be determined as follows: (a) Initial Deposit Year. (1) On any date, the value of such account will be equal to the sum of all Con- tributions and transfers to it plus interest on such Contributions and trans- fers less any payments or applications from such account on or before such date. (2) Interest will be credited to such account daily and compounded annually on the last day of the Deposit Year. (3) Interest will be credited on the Contributions and transfers to such account from the date received or transferred to the last day of such Deposit Year, or to date of payment or transfer, if earlier. (4) The rate of interest credited will be the Composite Guaranteed Rate deter- mined for such account. Composite Guaranteed Rate means, as of any date, the rate we determine for the Member' s account which is based on the Guaranteed Interest Rate in effect for each Contribution or transfer to the account, the amount and timing of each such Contribution or transfer, and the amount of any payment or applica- tion on or before such date. For second and subsequent Deposit years, the Composite Guaranteed Rate will be the rate in effect on the last day of the initial Deposit Year. (b) Second and subsequent Deposit Years. (1) On any date of determination, the value of such account will be equal to the value on the last day of its preceding Deposit Year, plus interest for the number of days since such last day, less any payments or transfers from such account since such last day. \ 2--4,5;FIA;8302 THE BANKERS LIFE ©/ BANKERS LIFE COMPANY DES MOINES, IOWA ARTICLE II CONTRIBUTIONS AND ACCOUNTS SECTION 1--CONTRIBUTIONS. Contributions may be accepted by us under this contract on any date on or after the Contract Date, subject to the limitations of Article VII, Sec- tion 10. A Contribution on behalf of a Member is any amount determined or allowed by the Plan to be paid to us for that Member. Such Contributions may be paid to us at any time on or after the Contract Date and before the Member's Annuity Commencement Date. Contri- butions in excess of those determined or allowed by the Plan for the current Plan year may be paid to us only with our consent. All Contributions are payable directly to us at our home office in Des Moines, Iowa. Contributions will be received by us during our normal business hours Monday through Fri- day. If received during other hours, Saturdays, and legal holidays, they will be deemed to have been received the next following business day. SECTION 2--TYPES OF CONTRIBUTIONS. A Contribution on behalf of a Member may be any of the following types, if permitted by the Plan: (a) Required employee contributions. This includes all contributions from the Member which the Plan requires in order for the Member to participate or which are matched by employer contributions. (b) Voluntary deductible employee contributions. This includes all contributions from the Member which are deductible for federal income tax purposes under Internal Revenue Code Section 219(a) . (c) Other voluntary employee contributions. This includes all contributions from the Member which are allowed by the Plan but not included in (a) or (b) above. (d) Employer contributions . This includes all Employer contributions permitted or re- quired by the Plan. (e) Transfer, rollover, or other contributions. This includes those Contributions not included in (a) , (b) , (c) , or (d) above which are permitted by the Plan and which are permitted or required to be held separately for a Member. SECTION 3--INVESTMENT DIRECTION. Each type of Contribution on behalf of a Member may be directed to the General Investment Account for the Member (see Section 4 below) or to any number of the Separate Investment Accounts (see Section 6 below) or to any combina- tion of such accounts. We must have written direction from you or, if the Plan permits, from the Member, for the portion of each type of Contribution to be held in each account. Contributions will be added to each account in the amount or percentage specified in the written directions on file with us. Future Contributions may be directed to different accounts or the amount directed to an account may be changed by filing a new direction with us. If a Contribution is received for a Member for whom no written direction is on file with us , we will direct that Contribution to his General Investment Account. • • \\„,2--1,2,3;FIA;8302 THE BANKERS LIFE BANEERS LIFE COMP.l. DES MOINES. IOWA Guaranteed Interest Rate means the annual rate of interest we declare from time to time for contracts of this class for Guaranteed Interest Accounts. Each Contribution to a Guaranteed Interest Account will be credited with the Guaranteed Interest Rate in effect for the date the Contribution was received. Member means a person who is a participant under the Plan. Normal Income Form means the form of benefit to be provided under the Plan if the Mem- ber does not elect some other form. Normal Retirement Date means the Member' s normal retirement date under the Plan. If the Plan does not specify, it will be the first day of the month on or after his 65th birthday. Order of Application means the order in which we will apply the Guaranteed Interest Ac- ; counts of a Member when transfer or withdrawal of a portion of his General Investment Ac- count has been requested and no other order of application has been reported to us. Such Order of Application shall be from the current Guaranteed Interest Account first and then from each preceding Guaranteed Interest Account with the oldest Guaranteed Interest Ac- count being last applied. Plan means the Employer' s retirement plan in effect on the date this contract is exe- cuted and as amended from time to time. The name of the Plan is WELD COUNTY 4.01 (k) SAVINGS PLAN Separate Account means a Separate Account established and maintained by us in accord- ance with the laws of Iowa. Each Separate Account in which this contract may participate is described in the Separate Investment Rider or Riders added to this contract. A Separate Account consists of amounts we receive under group contracts or policies which permit deposit in such Separate Account and which amounts are directed to a Sepa- rate Account or Separate Accounts. All income gains and losses (whether or not real- ized) , and expenses from the assets allocated to a Separate Account will be credited to or charged against that Separate Account without regard to any other income, gains or losses, or expenses we might have for our general account or any other Separate Account. The assets of a Separate Account will not be charged with any liabilities arising out of the investment experience of our general account or any other Separate Accounts outside that Separate Account. Separate Investment Account means the account or accounts established for a Member as described in Article II , Section 6. Termination of Employment means a Member's termination of employment with the Employer. Valuation Date means the date as of which we determine the value of a Separate Account. Valuation Dates will occur at intervals we determine, but not less frequently than the last day of a calendar month. A Valuation Date will occur on those days when the net asset value of the investments of the Separate Account is determined. The valuation will occur as of the end of each such day. Valuation Period means the period from the end of one Valuation Date to the end of the next following Valuation Date. Yearly Date means the Contract Date and the same day of each year thereafter. \1--2(2) ;FIA;8309 (66947) THE BANKERS LIFE ©I BANKERS LIFE COMPANY OES MORES. IOWA ARTICLE I DEFINITIONS SECTION 1--PARTIES TO THIS CONTRACT. This contract is between the Contractholder and The Bankers Life. Contractholder means the holder of this contract named on the face page and will be referred to in this contract as y2a or your. The Bankers Life means Bankers Life Company of Des Moines, Iowa, and will be referred to in this contract as we, us, or our. SECTION 2--OTHER DEFINED TERMS. Annuity Commencement Date means the beginning date for annuity payments to a Member. Annuity Premium means the amount applied under this contract to purchase an annuity for a Member. Annuity Purchase Date means the date an Annuity Premium is applied to purchase an annuity for a Member. Contract Date means the date this contract is effective, as shown on the face page. Contract Year means a period beginning on a Yearly Date and ending on the day before the next Yearly Date. Contributions means amounts you pay to us which we have accepted under Article II, Section 1 . Deposit Year means the twelve-month period beginning on each January 1 and ending on each December 31. Employer means the corporation or firm named as employer in the Plan and any successor by change of name, merger, purchase of stock, or purchase of assets. Fixed Dollar Annuity means an annuity payable in guaranteed amounts. General Investment Account means the account established for a Member as described in Article II , Section 4. Guarantee Period means, for each Guaranteed Interest Account, the five-year period be- ginning on the first day of its initial Deposit Year and ending on the last day of the 4th Deposit Year thereafter. Once established for a Guaranteed Interest Account, a Guar- antee Period will not be changed. Guaranteed Interest Account means the account established for a Member for each Deposit Year as described in Article II , Section 5 . \1--1 ,2;FIA;8304( 66947 ) / THE BANKERS LIFE Q BANKERS LIRE COMPANY OES MOINES IOW• ARTICLE VI CHARGES AND LIMITATIONS Section 1 Charges for Surrender of a Guaranteed Interest Account Section 2 Limitations on Transfers and Payments from General Investment Accounts Section 3 Limitations of Transfers and Payments from Separate Investment Accounts ARTICLE VII GENERAL PROVISIONS Section 1 Certificates Section 2 Beneficiary Section 3 Dividends Section 4 Contract Section 5 Plan and Plan Amendments Section 6 Waiver and Modification Section 7 Misstatements Section 8 Information, Proofs and Determination of Facts Section 9 Amendment Section 10 Contributions Section 11 Modification in Mode of Payment of Annuity Section 12 Commutation of Payments Section 13 Facility of Payment Section 14 Pronouns Section 15 Assignment Section 16 Basis of Annuity Purchases Section 17 Investment Manager Section 18 Ownership \ Tc(2) ;FIA;8304 THE BANKERS LIFE © BANKERS LIFE COMPANY DES MOINES, IOWA C C I TABLE OF CONTENTS ARTICLE I DEFINITIONS Section 1 Parties to this Contract Section 2 Other Defined Terms ARTICLE II CONTRIBUTIONS AND ACCOUNTS Section 1 Contributions Section 2 Types of Contributions Section 3 Investment Direction Section 4 General Investment Account Section 5 Guaranteed Interest Accounts Section 6 Separate Investment Account Section 7 Holding Accounts Section 8 Transfers Between Accounts Section 9 Disposition of a Guaranteed Interest Account at the End of its Guarantee Period Section 10 Funds ARTICLE III EXPENSES Section 1 Expenses Section 2 Deduction of Expenses ARTICLE IV BENEFITS Section 1 Distribution of Benefits ARTICLE IVA ANNUITY BENEFITS Section 1 Purchase of Annuity Section 2 Options Section 3 Amount of Monthly Annuity Section 4 Cancellation of Annuity ARTICLE IVB SINGLE SUM PAYMENTS Section 1 Cash Termination, Retirement, or Disability Benefits Section 2 Benefits Payable at Death Section 3 Options for Benefits Payable at Death Section 4 Withdrawal Benefit ARTICLE V TRANSFER TO ALTERNATE FUNDING AGENT; CESSATION Section 1 Transfer to Alternate Funding Agent Section 2 Cessation of Contributions \ Tc;FIA;8304 THE BANKERS LIFE BANKERS LIFE COMRAN♦ DES MOINES. IOWA / 1 Order of Application means the order in which we will apply the Guaranteed Interest Accounts of a Member when transfer or withdrawal of a portion of his General Investment Accounts has been requested and no other order of application has been reported to us. Such Order of Application shall be from the current Guaranteed Interest Account first and then from each preceding Guaranteed Interest Account with the oldest Guaranteed Interest Account being last applied. However, if two or more Guaranteed Interest Accounts are established at the same time, the account nearest the end of its Guarantee Period shall be applied first, with the account furthest from the end of its Guarantee Period being last applied." 2. By adding the following sentence to Article II, Section 3: "If more than one Guarantee Period is available, however. Contributions for a Member for whom no investment direction is on file will be directed to the General Investment Account with the shortest Guarantee Period then available under the contract." 3. By adding the following sentence to Article II, Section 4: "A separate General Investment Account will he established for each Guarantee Period selected for each type of Contribution." 4. By adding the following sentence to Article II, Section 5: "A separate Guaranteed Interest Account will he established for each Deposit Year for each Guarantee Period used to hold each type of Contribution directed to such accounts." 5. By adding the following sentences to the last paragraph of Article II, Section 9: "Unless you or the Member (as permitted by the Plan) tell us otherwise, each matured Guaranteed Interest Account will he transferred to the current Guaranteed Interest Account of the Member with the same Guarantee Period, if available. If the same Guarantee Period is no longer available, the account will be transferred to the Guaranteed Interest Account with the shortest Guarantee Period available under the contract." BANKERS LIFE COMPANY Critilert PRESIDENT AND CHIEF EXECUTIVE OFFICER GP R 23313 — 2 — FULL THE BAN KERS LI FE V BANKERS LIFE COMPANY DES MOINES, IOWA MULTIPLE GUARANTEE PERIODS RIDER This rider is made a part of the Group Annuity Contract issued by Bankers Life Company to which it is attached. All terms defined in the contract and any of its attached riders have the same meaning where used in this rider. The purpose of this rider is to expand the number of Guarantee Periods available under the contract and to permit Guarantee Periods of other than five year durations to be established. The effective date of this rider is the Contract Date unless otherwise stated in the amendment adding it to the contract. However, this rider will have no effect for any Deposit Years (as to Contributions received during such Deposit Years) for which we do not have valid written directions selecting Guarantee Period(s). In such Deposit Year(s) the provisions of the contract with regard to Guarantee Period and Investment Direction will be the provisions as stated in the contract as if this rider were not in effect. In any event, directions received for a Deposit Year after its start will not become effective until the next Deposit Year. This rider modifies the contract as follows: I. By striking the definitions of Guarantee Period. Guaranteed Interest Rate and Order of Application in Article 1, Section 2, and substituting the following definitions in lieu thereof: "Guarantee Period means the period for which a Guaranteed Interest Account exists. The period or periods available may be any we make available to contracts of this class under the same or similar circumstances. We reserve the right, in our sole discretion, to change at any time the Guarantee Periods available for new Contributions and transfers, including transfers from existing Guaranteed Interest Accounts. We reserve the right to limit both the number of Guarantee Periods available under this contract and the number available to each Member. You must give us written directions selecting the Guarantee Periods available under the contract. Your selection will remain in effect until modified by (b) or (c) below. Our rights to change and to limit the Guarantee Periods available are subject to the following: (a) Once established by us, the Guarantee Period for a particular Guaranteed Interest Account may not be changed by us. A different Guarantee Period may apply to amounts maturing from that Guaranteed Interest Account, however. (b) If a particular Guarantee Period is no longer offered. we will notify you at least 60 days before the date the use of such Guarantee Period will no longer be permitted. (c) For each Deposit Year, you have the right to select Guarantee Periods or to change the selection of Guarantee Periods available to Members by filing written directions with us before the beginning of the Deposit Year for which the selection applies. The selections for a Deposit Year cannot be changed after its start. Guaranteed Interest Rate means the annual rates of interest we declare from time to time for contracts of this class for Guaranteed Interest Accounts. Each Contribution or transfer to a Guaranteed Interest Account will be credited with the Guaranteed Interest Rate in effect for the Guarantee Period chosen on the date the Contribution was received or the transfer was made. -GP R 23313 — 1 — FULL THE BANKERS LIFE C� BANKERS LIFE COMPANY DES MOINES, IOWA 7. // \ (ht The Primart Separate Account Unit Value as of the Valuation Date. as determined in Item l of this rider. Contributions or transfers to a Separate Investment Primart Account increase the number of Primart Separate - Account Units credited to it:applications from the account reduce the number of units. This increase or decrease is determined by dividing the amount to he credited to or applied from the account by the Primart Separate Account Unit Value on the Valuation Date on which a Contribution or transfer is credited or an application is made. 4. TRANSFERS AND PAYMENTS FROM A SEPARATE INVESTMENT PRIMART ACCOUNT. We will, upon receipt of written request from you and/or a Member, as the plan perniie., (a) transfer to his General Investment Account or another Separate Investment Account all or any portion of the Member's Separate Investment Primart Account. or (b) transfer to an Alternate Funding Agent all or any portion of his Separate Investment Primart Account, or (c) pay to the member an amount equal to all or any portion of his Separate Investment Primart Account. The amount to he paid or trnnslerred will he determined and paid or transferred within seven business days after i i) the Valuation Date on which we receive the written request or t iii a later Valuation Date specitied in the request. subject to our right to deter a transfer or payment as described in Item 5 of this rider. We are not responsible for the application of amounts transferred to an Alternate Funding Agent. The amount transferred or paid will he deducted from a Separate Investment Primart Account and will be an application from such account as of the date transferred or paid. Each transfer to another Separate investment Account inay occur only on ❑ Valuation Date of such Separate Investment Account. 5. LIMITATIONS ON TRANSFERS AND I'AY\IEN'IS FROM A SEPARATE INVESTMENT PRIMART ACCOUNT. In general. transfers and payments trout a Separate Investment Primart Account normally will he made within seven business days alter the Valuation Date specified in Item 4. However. we reserve the right to defer such transfers or payments for a period not to exceed 270 days. This limitation will not apply to payments to the hencliciary of a Member. If we defer any transferor payment under this Item 5. we will determine the amount to be transferred or paid as of the date transfer or payment occurs. We will notify you in the event of any deferment of more than 30 days under the provisions of this Item 5. BANKERS LIFE COMPANY t SIDENCi; PRET (9 • 2 _ \ GP R 21132-1 FIA THE BANKERS LIFE 0 BANNERS LIFE COMPANY DES MOINES. IOWA SEPARATE INVESTMENT RIDER PRIMART SEPARATE ACCOUNT This rider is added to the Group Annuity Contract issued by us of which it is a part. All terms defined in the contract and any of its attached riders have the same meaning where used in this rider. The purpose of this rider is to allow this contract to participate in our primary bond and mortgage investment account called Primart Separate Account. The effective date of this rider is the Contract Date unless otherwise stated in the amendment adding it to the contract. Pursuant to Articic II, Section 6. the following is added to this contract: I. PRIMART SEPARATE ACCOUNT. Primart Separate Account is a pooled Separate Account for use by our retirement plan customers. It is invested by us primarily in bond and mortgage type investments similar to our general account. We will invest or reinvest Priman Separate Account in accordance with applicable law without regard to any investment requirements of our general account assets or any other of our Separate Accounts. The investment management charge under Priman Separate Account is based on the value of its assets. The pro- rata charge for investment management will be deducted from Primart Separate Account on each Valuation Date for the number of calendar days within the Valuation Period ending on such Valuation Date. The annual investment management charge under Priman Separate Account shall not at any time exceed I.00%of the value of its assets. Currently. the annual charge is 0.36%. We reserve the right to change the amount of the current charge for investment management up to the 1.00% limit at any time by giving you written notice at least 30 days before the date the change is to take effect. 2. DETERMINING PRIMART SEPARATE ACCOUNT VALUE: UNIT VALUES. The value of Primart Separate Account is its market value. or where there is no readily available market, the fair value of the assets included in it. determined by our rules and in accordance with generally accepted accounting practices and applicable law and regulations. We will furnish you with a copy of our rules upon request. The value of Primart Separate Account shall he expressed in units. The Unit Value for Primart Separate Account is the dollar value of one unit of that Separate Account and is determined on each Valuation Date. The initial Unit Value of one unit of Primart Separate Account at its inception was$100.00. The Unit Value for Contributions or transfers added to the Separate Account after its date of inception shall be the Unit Value of Primart Separate Account on the Valuation Date the Contribution or transfer is received at our home office. If a Contribution or transfer is received on any date other than a Valuation Date, the Unit Value for such Contribution shall he determined on the next following Valuation Date. On any Valuation Date occurring after its date of inception, the Unit Value of Priman Separate Account shall be equal to the value of Primart Separate Account on such date divided by the number of units in Primart Separate Account before any adjustments for Contributions or transfers to and applications from Primart Separate Account on such date. 3. SEPARATE INVESTMENT PRIMART ACCOUNT. A Separate Investment Primart Account is established for each Member for each type of Contribution he directs to Primart Separate Account. The value of a Separate Investment Priman Account is its proportionate share of the value of Priman Separate Account. This value will be determined by multiplying (a) by IN: pal The number of Primart Separate Account Units in the Separate Investment Primart Account as of the Valuation Date. GP R 21132-1 FIA THE BANKERS LIFE C� BANKERS LIFE COMPANY DES MOINES. IOWA / 1 The amount to he paid or transferred will be determined and paid or transferred within seven business days after I t) the Valuation Date on which we receive your written request or Iii) a later Valuation Date specified in your request. subject to our right to defer a transfer or payment as described in Item 7 of this rider. We are not responsible for the application of amounts transferred to an Alternate Funding Agent. The amount transferred or paid will he deducted from the Separate Investment Real Estate Account and will be an application from such account as of the date transferred or paid. Each transfer to another Separate Investment Account may occur only on a Valuation Date of such Separate Investment Account. 7. LIMITATIONS ON TRANSFERS FROM A SEPARATE INVESTMENT REAL ESTATE ACCOUNT. In general. transfers and payments from a Separate Investment Real Estate Account normally will be made within seven business days after the Valuation Date specified in Item 6. However. because of the illiquid nature of the assets in which Real Estate Separate Account is invested, we reserve the right to deter transfers or payments from a Separate Investment Real Estate Account if a transfer or payment would exceed the amount of cash and other liquid assets held in Real Estate Separate Account, reduced by amounts committed to purchase properties or needed fir operating expenses. Real Estate Separate Account may he illiquid for indefinite periods of time because we do not intend to sell properties to meet requests fir transler or payment. Real Estate Separate Account will not he mana ecd to provide a liquidity pool for expected. but not yet received. requests for transfer or payment. If requests or transfer or payment Front Real Estate Separate Account are deferred. then the deterred transfers or payments. when made, will he made in the billowing order: (al Any death benefits payable under a defined contribution plan. On All other requests fir transfer or payment. All death benefit payments Irorn defined contribution plans will he made before any other requests for transfer or payment. Once these death benefits have been paid. other requests will be paid in order of the dates we received the requests. Deterred transfers or payments. when paid. will he made as tit a Valuation Date and will be based on the Real Estate Separate Account Cot Value as of the date paid. BANKERS LIFE COMPANY laXecK de e/PRESIDEN(9 \ GP R 20391-1 3 FIA / THE BANKERS LIFE 0 BANKERS LIFE COMPANY DES MOINES. IOWA (hl The Real Estate Separate Account Unit Value as of the Valuation Date, determined as described in Item 2 of this rider. Contributions or transfers to a Separate Investment Real Estate Account increase the number of Real Estate Separate Account Units credited to it: applications from the account reduce the number of units. This increase or decrease is determined by dividing the amount to he credited to or applied from the Separate Investment Real Estate Account by the Real Estate Separate Account Unit Value on the Valuation Date on which a Contribution or transfer is deposited or an application is made. 4. DEPOSITS. We reserve the right to defer placing Contributions and transfers in Real Estate Separate Account. Placement in the Account will he based on the current real estate investment opportunities available to it and the amount of funds needed to acquire additional property or to maintain existing property. Any Contributions or transfers directed to Real Estate Separate Account which are deferred will instead be held in our short term account. Separate Account LI. until a Valuation Date when transfer to Real Estate Separate • Account may he made. 5. ORDER OF ENTRY. Since Real Estate Separate Account may not he open on any given Valuation Date to accept all funds directed by our customers to it. we have established the following order of entry: (a) All amounts held in Separate Account LI waiting for transfer to Real Estate Separate Account. (h) Any amounts held in any other Separate Account or in our general account which are to be transferred to Real Estate Separate Account. Within each of the above two categories. funds will be transferred one customer at a time, in order from the oldest waiting request to the newest request. All amounts held in Separate Account LI which are directed to Real Estate Separate Account will he transferred before any funds are transferred under Item Ib). Normally, either all or no part of an intended transfer under this rider to Real Estate Separate Account will he made. If the amount GI the intended transfer is greater than the amount open for acceptance by Real Estate Separate Account. the entire amount of the transfer will continue to he held in Separate Account LI until the Valuation Date complete transfer my he made. However. we and the Member may mutually agree to transfer only a portion of the intended amount to Real Estate Separate Account. We will notify you and the Member when funds have been transferred to Real Estate Separate Account. A Member may revoke his request for transfer of funds to Real Estate Separate Account by giving us•written notice prior to the date transfer is made. The notice must also include new investment directions for the intended transfer. 6. TRANSFERS AND PAYMENTS FROM THE SEPARATE INVESTMENT REAL ESTATE FUND. We will. upon receipt of written request Gam you and/or the Member. as permitted by the Plan. tat transfer to its General hotsunent Account or another Separate Investment Account all or any portion of his Separate Investment Real Estate Account. or Ih) transfer to an Alternate Funding Agent all or any portion of his Separate Investment Real Estate Account.or (c) pay to the Member an ;unount equal to all or any portion of his Separate Investment Real Estate Account. GP R 20391-1 2 HA 11-1E BANKERS LIFE G� BANKERS LIFE COMPANY DES MOINES, IOWA SEPARATE INVESTMENT RIDER REAL ESTATE SEPARATE ACCOUNT This rider is added to the Group Annuity Contract issued by us of which it is a part. All terms defined in the contract and any of its attached riders have the same meaning where used in this rider. The purpose of this rider is to allow the contract to participate in our Real Estate Separate Account. The effective dale of this rider is the Contract Date unless otherwise stated in the amendment adding it to the contract. Pursuant to Article II, Section 6, the following is added to this contract: I. REAL ESTATE SEPARATE ACCOUNT. Real Estate Separate Account is a pooled Separate Account for use by our retirement plan customers. It is invested by us primarily in real estate such as office buildings. industrial buildings. shopping centers, retail stores. and similar property which meets the investment objectives of this Account. Funds not currently committed to acquire new property or needed to maintain existing property will he invested in short term money market instruments, cash or cash equivalents. We will invest or reinvest the assets held in Real Estate Separate Account in accordance with applicable law without regard to any investment requirements of our general account assets or any of our other Separate Accounts. 2. DETERMINING REAL ESTATE SEPARATE ACCOUNT VALUE: UNIT VALUES. We will determine the value of Real Estate Separate Account on each Valuation Date. The value of the properties held in the Account is their appraised market value. The value of the Account takes into account the market value of any other assets held in the Account and is reduced by any liabilities of the Account. including operating expenses of the Account and a pro-rata portion of our Investment Management Charge. If there is no readily available market, the value of the Account is the fair value of its assets. as determined by us using generally accepted accounting practices and applicable law. The value of Real Estate Separate Account shall he expressed in units. The Unit Value ti r Real Estate Separate Account at its inception was )I(NI. Contributions or transfers deposited in Real Estate Separate Account shall be converted to units using the Unit Value on the Valuation Date the Contribution or transfer is deposited in the Account. On any Valuation Date occurring after its date of inception. the Unit Value of Real Estate Separate Account shall he equal to the then-current dollar value of the Account on such date divided by the number of units in Real Estate Separate Account, before any adjustments for Contributions or transfers to and applications from the Account on such date. Operating expenses arc the external expenses we incur in the operation of Real Estate Separate Account, including any local property management fees. Investment Management Charge is as annual charge to cover internal investment management expenses based on the value of the assets of Real Estate Separate Account. This annual charge is currently-0.96% We reserve the right to chance the amount of charge by giving you written notice at least 30 days before the change is to take effect. 3. SEPARATE INVESTMENT RE.Al. ESTATE A('('OUN'I'. A Separate Investment Real Estate Account is established for each member for each type of contribution be directs to Real Estate Separate Account. The value of a Separate Investment Real Estate Account is its proportionate share of the value of Real Estate Separate Account. This value will he determined on each Valuation Date by multiplying tan by (hl: la) the number of Real Estate Separate Account Units in the Separate Investment Real Estate Account as of the Valuation Date. GP R 20391-1 FIA THE BANKERS LIFE U� BANKERS LIFE COMPANY DES MOINES, IOWA C • i I 3. SEPARATE INVESTMENT 1-I ACCOUNT. A Separate Investment LI Account is established for each Member for each Iv pc of Contribution he directs to Separate Account I.I.The value of aSeparate Investment LI Account is its proportionate share of the value of Separate Account LI. This value will he determined on each Valuation Date by multiplying la) by I hl: (a) The number of Separate Account LI Units in the Separate Investment LI Account as of the Valuation Date. (hl The Separate Account 1.1 Unit Value as of the Valuation Date, as determined in Item 2 of this rider. Contributions or transfers to a Separate Investment I.1 Account increase the number of Separate Account LI Units credited to it: applications from the account reduce the number of units. This increase or decrease is determined by dividing the amount to he credited to or applied from the account by the Separate Account LI Unit Value on the Valuation Date on which a Contribution or transfer was credited or an application was made. 4. TRANSFERS AND PAYMENTS FROM A SEPARATE INVESTMENT LI ACCOUNT. We will. upon receipt of written request from you and/or a Member, as the Plan permits. (a) transfer o his General Investment Account or another Separate Investment Account all or any portion of his Separate Investment LI Account. or (hl transfer to an Alternate Funding Agent all or any portion of his Separate Investment LI Account, or (et pay to the Member an :mount equal to all or any portion of his Separate Investment LI Account. The amount to he paid or tr:mslerred will he determined and paid ortransterred within seven business days after lit the Valuation Date tin which we receive your written request or Iiii a later Valuation Date specified in your request, subject to our right to deter a transi cr or payment as described in Item 5 of this rider. We are not responsible tort the application of ;mounts translerrcd to an Alternate Funding Agent. The amount transferred or paid will he deducted Iron a Separate Investment LI Account and will be an application trout that account as of the date Iranstcrred or paid. Each transler to another Separate Investment Account may occur only on a Valuation Date tit that Separate Investment Account. S. LIMITATIONS ON TRANSFERS AND PAYMENT'S FROM A SEPARATE INVESTMENT LI ACCOUNT. In general. 'musters and payments from a Separate Investment LI Account normally will he made within seven business days alter the Valuation Date specified in Item 4. I lowever. we reserve the right to delay transler or payment for a period not to exceed in) days. This limitation will not apply to payments to the beneficiary of a Member. 'If we deter any transler or payment under this Item e, we will determine the amount to he transferred or paid as of the date transfer or payment occurs. We will notify you in the event of any delerment of more than 30 days under the provisions of this Item S. BANKERS LIFE COMPANY PRESIDENTC(9 '� 1 \ GP R 19542-1 FIA / THE BANKERS LIFE © • BANKERS LIFE COMPANY DES MOINES, IOWA SEPARATE INVESTMENT RIDER SEPARATE ACCOUNT LI This rider is added to the Group Annuity Contract issued by us of which it is a part. All terms defined in the contract and any of its attached riders have the same meaning where used in this rider. The purpose of this rider is to allow this contract to participate in our short term investment account called Separate Account L1. The effective date of this rider is the Contract Date unless otherwise stated in the amendment adding it to the contract. Pursuant to Article II. Section b. the billowing is added to this contract: I. SEPARATE ACCOUNT I.I. Separate Account iLI is.a pooled Separate Account liar use by our retirement plan customers. It is invested by us primarily in money market instruments such as the obligations of the United States government and its agencies. commercial paper. hank certificates of deposit and similar such instru- ments. We will invest or reinvest Separate Account LI in accordance with applicable law without regard to any investment requirements of our general account assets or any ol our other Separate Accounts. The investment management charge under Separate Account LI is based on the value of its assets. The pro-rata charge for investment management will he deducted bout Separate Account LI U❑each Valuation Date for the number of calendar days within the Valuation Period ending on such Valuation Date. The annual investment management charge for Separate Account LI shall not at any time exceed 1.00% of the value ol its assets. Currently. this charge is 0.36'/r. We reserve the right to change the amount of charge fir investment management up to the I ant'; limit at any time by giving you written notice at least +0 days before the date the change is no take eft ecl. 2. DETERMINING SEPARATE ACCOUNT 1.1 VALUE: UNIT VALUES.The value or Separate Account LI is its market value. II there is no readily available market, its value is the fair value of the assets held in each Separate Account. as determined by us using generally accepted accounting practices and applicable law. We will determine the value of Separate Account 1.1 on each Valuation Date. The value of Separate Account LI shall be expressed in units. A Unit Value for Separate Account LI is the dollar value of one unit held in Separate Account 1.1. We will determine the value of Separate Account LI on each Valuation Date. This t[nit Value is equal to the market value of Separate Account LI divided by the total number of Separate Account I.I Innis on such date. The initial Unit Value of one unit ol Separate Account I.I at its inception was S10.00. The Unit Value for ('ontrahuuons or transfers added to Separate Account LI after its date oI inception shall he the Unit Value of Separate Account 1.1 on the Valuation Date the Contrabunon or transfer is received at our home office. If a Contribution or trasler is received on any date other than a Valuation Date. the Unit Value for such Contribution or transfer shall be determined in the next following Valuation Date. On any Valuation Date occurring after its dale of inception,the Unit Value of Separate Account LI shall he equal to the market value of Separate Account I.1 on such date divided by the number of units in Separate Account LI before any adjustments for Contributions or taunters to and applications Itom Separate Account LI on such date. • GP R 19542-1 FIA THE BANKERS LIFE e BANNERS LIFE COMPANY DES MOINES. IOWA C 3. SEPARA'T'E INVESTMENT A ACCOUNT. A Separate Investment A Account is established for each Member • Tor each type of Contribution he directs to Separate Account A. The value of a Separate Investment A Account is its proportionate share of the value of Separate Account A. This value will be determined on each Valuation Date by multiplying (a) by lb)) (a) The number of Separate Account A Units in the Separate Investment A Account as of the Valuation Date. (b) The Separate Account A Unit Value as of the Valuation Date. as determined in Item 2 of this rider. Contributions or transfers to a Separate Investment A Account increase the number of Separate Account A Units credited to it:applications from the account reduce the number of units. This increase or decrease is determined by dividing the amount to he credited to or applied from the account by the Separate Account A Unit Value on the Valuation Date on which a Contribution or transfer was credited or an application was made. 4. TRANSFERS AND PAYMENTS FROM A SEPARATE INVESTMENT A ACCOUNT. We will. upon receipt of written request from you andior a member, as the Plan permits. (al transfer to his General Investment Account or another Separate Investment Account all or anv portion of his Separate Investment A Account, or (b) transfer to an Alternate Funding Agent all or any portion of his Separate Investment A Account, or (c) pay to the Member an amount equal to all or any portion of his Separate Investment A Account. The amount to he paid or transferred will he determined and paid or transferred within seven business days after tit the Valuation Date on which we receive the written request or I ii) a later Valuation Date specified in the request. subject to our right to defer a transfer or payment as described in Item 5 of this rider. We are not responsible for the application of amounts transferred to an Alternate Funding Agent. The amount transferred or paid will be deducted from a Separate Investment A Account and will he an application from such account as of the date transferred or paid. Each transfer to another Separate Investment Account may occur only on a Valuation Date of such Separate Investment Account. 5. LIMITATIONS ON TRANSFERS AND PAYMENTS FROM A SEPARATE INVESTMENT A ACCOUNT. In general. transfers and payments from a Separate Investment A Account normally will he made within seven business days alter the Valuation Date specified in Item 4. However, we reserve the right to deter such transfers or payments for a period not to exceed 270 days. However, if in the 36-month period which ends on the requested date of transfer all transfers and payments from the total of all Separate Investment A Accounts total 520,000,000 or more. then we reserve the right to make the portion of the requested transfer or payment in excess of 520.0110.000 in substantially equal installments over a period not to exceed 36 months. For purposes of this limitation. transfers and payments from any other separate investment accounts or finds included in Separate Account A from any other contracts or policies issued in connection with the Plan or with any other retirement plan of the Employer will be included as a transfer or payment from a Separate Investment A Account. If this limitation is imposed by us, the first installment will be made one month after the date of request. or on such later date that you specify. These limitations will not apply to the payments to the beneficiary of a Member. If we deter any transfer or payment under this hem 5. we will determine the amount to he transferred or paid on the date transfer or payment occurs. We will nutity you in the event of any deferment of more than 30 days under the provisions of This Item 5. BANKERS LIFEiKCOOMPPPAA'NY 9 12 GP R 19541-1 SIDENCT' FIA J THE BANKERS Ll FE C BANKERS LIFE COMPANY DE9 MOINEB, IOWA • I SEPARATE INVESTMENT RIDER SEPARATE ACCOUNT A This rider is added to the Group Annuity Contract issued by us of which it is a part. All terms defined in the contract and any of its attached riders have the same meaning where used in this rider. The purpose of this rider is to allow this contract to participate in our common stock investment account called Separate Account A. The effective date of this rider is the Contract Date. unless otherwise stated in the amendment adding it to the contract. Pursuant to Article II. Section 6. the following is added to this contract: I. SEPARATE ACCOUNT A. Separate Account A is a pooled Separate Account for use by our retirement plan customers. It is invested by us primarily in common stocks. other equity securities, or other convertible securities that may he converted to common stocks. We may also. at our option. occasionally invest in short term money market instruments, cash or cash equivalents. We will invest or reinvest the assets held in Separate Account A in accordance with applicable law. without regard to any investment requirements of our general account assets or any other of our Separate Accounts. The investment management charge under Separate Account A is based on the value of its assets. The pro-rata charge for investment management will he deducted from Separate Account A on each Valuation Date for the number of calendar days within the Valuation Period ending on such Valuation Date. The annual investment management charge for Separate Account A shall not at any time exceed 1.00% of the value of its assets. Currently. the annual charge is t1.30ct. We reserve the right to change the amount of charge for investment management up to the I.t)tPJ limit at any nine by giving you written notice at least 30 days before the date the change is to take effect. 2. DETERMINING SEPARATE ACCOUNT A VALUE: UNIT VALUES. The value of Separate Account A is its market value. If there is no readily available market. its value is the fair value of the assets held in such Separate Account as determined by us using generally accepted accounting practices and applicable law. We will determine the value of Separate Account A on each Valuation Date. The value of Separate Account A may he expressed in units. A Unit Value is the dollar value of one unit held in Separate Account A. We will determine the Unit Value of Separate Account A on each Valuation Date. This Unit Value is equal to the market value of Separate Account A divided by the total number of Separate Account A Units on such date. The initial Unit Value of one unit of Separate Account A at its inception was $10.00. The Unit Value for Contributions or transters added to separate Account A after its date of inception shall he the Unit Value of Separate Account A on the Valuation Date the Contribution or transfer is received at our home office. If a Contribution or transfer is received on any date other then a Valuation Date. the Unit Value for such Contribution or transfer shall he determined on the next following Valuation Date. On any Valuation Date occurring after its date of inception, the Unit Value of Separate Account A shall he qual to the market value of Separate Account A on such date divided by the number of Separate Account A Units before any adjustments for Contributions or transfers to and applications Irian Separate Account ,\ on such date. GP R 19541-1 HA THE BANKERS LIFE V BANKERS LIFE COMPANY DES MOINES, IOWA TABLE 1A OPTION 5-FIXED PERIOD ANNUITY Amount of Monthly Annuity Purchased by $1,000 Number Monthly of Years Annuity 5 $17.91 6 15.14 7 13.16 8 11.68 9 10.53 10 9.61 11 8.86 12 8.24 13 7.71 14 7.26 15 6.87 • GP 11680-FS Table 1 Option 5 GP R 21992 Fixed Period TABLE lA OPTION 4--SINGLE LIFE INSTALLMENT REFUND ANNUITY Amount of Monthly Annuity Purchased by $1,000 Monthly Awe* Annuity 50 $3.95 51 4.01 52 4.07 53 4.13 54 4.20 55 4.27 56 4.34 57 4.42 58 4.50 59 4.58 60 4.67 61 4. 76 62 4.85 63 4.96 64 5.06 65 5.18 66 5.29 67 5.42 68 5.54 69 5.69 70 5.84 71 6.00 72 6.16 73 6.34 74 6.52 75 6.72 76 6.93 77 7.14 78 7. 37 79 7.62 80 7.87 *Age for the purpose of this table is age last birthday on Annuity Commencement Date. GP 11679-FS Table 1 Option 4 Single Life Installment Refund GP R 21992 C C TABLE 1A OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 100% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 74 75 76 77 78 79 80 55 $4.23 $4.24 $4.24 $4.25 $4.25 $4.26 $4.26 56 4.29 4.30 4.31 4. 32 4.32 4. 33 4.33 57 4. 36 4.37 4. 38 4.39 4.39 4.40 4.40 58 4.43 4.44 4.45 4.46 4.47 4.47 4.48 59 4.50 4.52 4.53 4.54 4.55 4.55 4.56 60 4.58 4.59 4.61 4.62 4.63 4.64 4.64 61 4.65 4.67 4.69 4.70 4. 71 4.72 4.73 62 4. 73 4. 75 4.77 4.78 4.80 4.81 4.82 63 4.81 4.83 4.85 4.87 4.89 4.90 4.91 64 4.89 4.92 4.94 4.96 4.98 5.00 5.01 65 4.97 5.00 5.03 5.05 5.07 5.09 5.11 66 5.06 5.09 5.12 5.15 5.18 5.20 5.22 67 5. 15 5.18 5.22 5.25 5.28 5.30 5. 32 68 5.23 5.28 5.31 5.35 5. 38 5.41 5.44 69 5. 32 5. 37 5.41 5.45 5.49 5.52 5.55 70 5.41 5.46 5.51 5.56 5.60 5.64 5.67 71 5.50 5.56 5.61 5.66 5.71 5.75 5. 79 72 5.58 5.65 5.71 5. 77 5.82 5.87 5.92 73 5.67 5. 74 5.81 5.87 5.94 5.99 6.04 74 5. 75 5.83 5.91 5.98 6.05 6.11 6.17 75 5.33 5.92 6.00 6.08 6.16 6.23 6.30 *Age for the purpose of this table is age last birthday on the Participant's or Member's Annuity Commencement Date. Table 1 Option 3 GP 11679-FS -3- Joint Life 100% Installment Refund GP R 21992 TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 100% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 67 68 69 70 71 72 73 55 $4. 14 $4.16 $4.17 S4.19 $4.20 $4.21 $4.22 56 4.19 4.21 4.23 4.24 4.26 4.27 4.28 57 4.25 4.27 4.29 4.30 4.32 4.34 4.35 58 4.30 4. 32 4. 35 4.37 4.39 4.40 4.42 59 4.36 4. 38 4.41 4.43 4.45 4.47 4.49 60 4.41 4.44 4 .47 4.49 4.52 4.54 4.56 61 4.47 4.50 4.53 4.56 4.59 4.61 4.63 62 4.53 4.56 4.59 4.63 4.65 4. 68 4.71 63 4.58 4.62 4.66 4.69 4.73 4.76 4.78 64 4.64 4.68 4. 72 4.76 4.80 4.83 4.86 65 4. 70 4.74 4. 79 4.83 4.87 4.91 4.94 66 4. 75 4.80 4.85 4.90 4.94 4.98 5.02 67 4. 81 4.86 4.92 4.97 5.01 5 .06 5.10 68 4.86 4.92 4.98 5.03 5.09 5.14 5. 19 69 4.92 4.98 5.04 5. 10 5.16 5.22 5. 27 70 4.97 5.03 5. 10 5.17 5.23 5.29 5.35 71 5.01 5.09 5. 16 5.23 5.30 5.37 5.43 72 5.06 5. 14 5. 22 5.29 5.37 5.44 5.51 73 5. 10 5.19 5.27 5.35 5.43 5.51 5.59 74 5.15 5.23 5. 32 5.41 5.50 5.58 5.67 75 5.18 5. 28 5.37 5.46 5.56 5.65 5. 74 *Age for the purpose of this table is age last birthday on the Participant's or Member' s Annuity Commencement Date. Table 1 Option 3 GP 11678-FS -2- Joint Life 100% Installment Refund GP R 21992 TABLE 1A OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 100% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 60 61 62 63 64 65 66 55 $3.98 $4.01 $4.03 $4.06 $4.08 $4. 10 $4.12 56 4.02 4.05 4.07 4.10 4.13 4. 15 4.17 57 4.06 4.09 4. 12 4.15 4.17 4.20 4.22 58 4.10 4.13 4.16 4.19 4.22 4.25 4.28 59 4. 14 4.17 4.20 4.24 4.27 4.30 4.33 60 4. 17 4.21 4.25 4.28 4.32 4. 35 4.38 61 4. 21 4.25 4.29 4.33 4.36 4.40 4.44 62 4.25 4.29 4.33 4.37 4.41 4.45 4.49 63 4.28 4.33 4.37 4.42 4.46 4.50 4.54 64 4.32 4.36 4.41 4.46 4.50 4.55 4.60 65 4. 35 4.40 4.45 4.50 4.55 4.60 4.65 66 4. 38 4.44 4.49 4.54 4.60 4.65 4.70 67 4.41 4.47 4.53 4.58 4.64 4. 70 4.75 68 4.44 4.50 4.56 4.62 4.68 4.74 4.80 69 4.47 4.53 4.59 4.66 4. 72 4. 79 4.85 70 4.49 4.56 4.63 4.69 4. 76 4.83 4.90 71 4.52 4.59 4.65 4.73 4.80 4.87 4.94 72 4.54 4.61 4.68 4. 76 4.83 4.91 4.98 73 4.56 4.63 4. 71 4. 78 4.86 4.94 5.02 74 4.58 4.65 4. 73 4.81 4.89 4.97 5.06 75 4.59 4.67 4. 75 4.83 4.92 5.00 5.09 *Age for the purpose of this table is age last birthday on the Participant's or Member's Annuity Commencement Date. Table 1 Option 3 G? 11578-?S -1_ Joint Life 100% Installment Refund GP R 21992 / r C. TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 66 2/3% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 74 75 76 77 78 79 80 55 $4.97 $5.02 $5.07 $5.12 $5. 17 $5.22 $5.27 56 5.02 5.08 5. 13 5.18 5.24 5.29 5.34 J7 5.08 5. 14 5.19 5.25 5. 30 5.36 5.41 58 5.14 5.20 5.26 5.32 5. 37 5.43 5.48 59 5.20 5.27 5. 33 5.38 5.44 5.50 5.56 60 5. 27 5. 33 5. 39 5.46 5.52 5.58 5.64 61 5. 33 5.40 5.46 5.53 5.59 5.66 5. 72 62 5. 39 5.46 5.53 56.0 5.67 5. 74 5.80 63 5.46 5.53 5.61 5.68 5.75 5.82 5.89 64 5.52 5. 60 5.68 5.75 5.83 5.91 5.98 65 5.59 5.67 5.75 5.83 5.91 5.99 6.07 66 5. 66 5. 74 5.83 5.92 6.00 6.08 6.16 67 5. 72 5.81 5.90 6.00 6.08 6.17 6.26 68 5.79 5.88 5.98 6.07 6. 17 6.26 6.35 69 5.85 5.96 6.06 6. 16 6.26 6.36 6.45 70 5.92 6.03 6. 13 6.24 6.34 6.45 6.55 71 5.98 6.09 6.21 6.32 6.43 6.54 6.65 72 6.04 6.16 6.28 6.40 6.51 6.63 6.75 73 6. 10 6.22 6.35 6.47 6.60 6. 72 6.85 74 6. 15 6.28 6.42 6.55 6.68 6.81 6.95 75 6.21 6. 35 6.48 6.62 6.76 6.90 7.04 *Age for the purpose of this table is age last birthday on the Participant's or Member's Annuity Commencement Date. Table 1 Option 3 GP 11577-FS Joint Life 66 2/3% Installment Refund GP R 21992 (-- TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 66 2/3% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 67 68 69 70 71 72 73 55 $4.61 $4.66 $4.71 $4.76 $4.81 $4.86 $4.91 56 4.65 4.70 4. 75 4.81 4.86 4.92 4.97 57 4.69 4.74 4.80 4.86 4.91 4.97 5.03 58 4. 73 4.79 4.85 4.91 4.96 5.02 5.08 59 4. 77 4.83 4.90 4.96 5.02 5.08 5.14 60 4.82 4.88 4.94 5.01 5.07 5.14 5.20 61 4.86 4.92 4.99 5.06 5.13 5.19 5.26 62 4.90 4.97 5.04 5.11 5.18 5.25 5.32 63 4.94 5.01 5.09 5.16 5.23 5.31 5.38 64 4.98 5.06 5.13 5.21 5.29 5.37 5.44 65 5.02 5.10 5.18 5.26 5.34 5.42 5.51 66 5.06 5.14 5.23 5. 31 5.40 5.48 5.57 67 5.10 5.18 5.27 5.36 5.45 5.54 5.63 68 5.14 5.23 5. 32 5.41 5.50 5.60 5.69 69 5. 17 5.26 5.36 5.45 5.55 5.65 5. 75 70 5.20 5. 30 5.40 5.50 5.60 5.71 5.81 71 5.23 5. 33 5.44 5.54 5.65 5.76 5.87 72 5.26 5.37 5.47 5.58 5.69 5.81 5.92 73 5.29 5.40 5.51 5.62 5. 74 5.86 5.98 74 5. 31 5.42 5.54 5.66 5.78 5.90 6.03 75 5. 34 5.45 5.57 5.69 5.81 5.94 6.07 *Age for the purpose of this table is age last birthday on the Participant's or Member's Annuity Commencement Date. Table 1 Option 3 GP !16T7-?S Joint Life 66 2/3% -2- Installment Refund GP R 21992 C TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 66 2/3% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 60 61 62 63 64 65 66 55 $4.26 $4. 31 $4.36 $4.40 $4.45 $4.50 $4.55 56 4.29 4.34 4. 39 4.44 4.49 4.54 4.59 57 4. 31 4.37 4.42 4.47 4.52 4.58 4.63 58 4. 34 4. 39 4.45 4.50 4.56 4.62 4.67 59 4. 37 4.42 4.48 4.54 4.59 4.65 4. 71 60 4. 39 4.45 4. 51 4.57 4.63 4.69 4. 75 61 4.42 4.48 4.54 4.60 4.66 4. 73 4.79 62 4.44 4.50 4.57 4.63 4.70 4.76 4.83 63 4.47 4.53 4. 60 4.66 4.73 4.80 4.87 64 4.49 4.55 4.62 4.69 4.76 4.83 4.91 65 4.51 4.58 4.65 4. 72 4. 79 4.87 4.94 66 4.53 4.60 4.67 4. 75 4.82 4.90 4.98 67 4. 55 4.62 4. 70 4. 77 4.85 4.93 5.01 68 4. 57 4.64 4. 72 4.80 4.88 4.96 5.05 69 4.58 4.66 4. 74 4.82 4.91 4.99 5.08 70 4.60 4.68 4. 76 4.84 4.93 5.02 5.11 71 4.61 4.69 4. 78 4.86 4.95 5.04 5.14 72 4.62 4. 71 4. 79 4.88 4.97 5.07 5.16 73 4.64 4. 72 4.81 4.90 4.99 5.09 5.19 74 4. 64 4.73 4.82 4.91 5.01 5.10 5.21 75 4.65 4.74 4.83 4.92 5.02 5.12 5.23 *Age for the purpose of this table is age last birthday on the Participant's or Member' s Annuity Commencement Date. Table 1 Option 3 OP 11577-PS -1- Joint Life 66 2/3% Installment Refund GP R 21992 TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 50% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 74 75 76 77 78 79 80 55 $5.43 $5.52 $5.60 $5.69 55. 78 $5.87 $5.96 56 5.48 5.57 5.66 5.75 5.84 5.93 6.03 57 5.53 5.62 5. 71 5.81 5.90 6.00 6.09 58 5.58 5.67 5. 77 5.87 5.96 6.06 6.16 59 5.63 5. 73 5.83 5.92 6.03 6.13 6.23 60 5.68 5. 78 5.88 5.99 6.09 6.19 6.30 61 5. 73 5.84 5.94 6.05 6.15 6.26 6. 37 62 5. 78 5.89 6.00 6.11 6.22 6.33 6.45 63 5.84 5.95 6.06 6.17 6.29 6.41 6.52 64 5.89 6.01 6.12 6.24 6. 36 6.48 6.60 65 5.94 6.06 6.18 6. 30 6.43 6.55 6.67 66 5.99 6. 11 6.24 6.37 6.49 6.62 6.75 67 6.05 6.17 6. 30 6.43 6.56 6. 70 6.83 68 6.09 6.23 6. 36 6.49 6.63 6.77 6.91 69 6.14 6.28 6.42 6.56 6.70 6.85 6.99 70 6.19 6. 33 6.48 6.62 6. 77 6.92 7.07 71 6.24 6. 38 6.53 6.68 6.84 6.99 7.15 72 6.28 6.43 6.58 6.74 6.90 7.06 7.23 73 6. 33 6.48 6.64 6.80 6.97 7.13 7.30 74 6. 37 6.52 6.69 6.86 7.03 7.20 7.37 75 6.40 6.57 6. 73 6.91 7.08 7.26 7.45 *Age for the purpose of this table is age last birthday on the Participant's or Member' s Annuity Commencement Date. Table 1 Option 3 GP 11676-Fs Joint Life 50% Installment Refund GP R 21992 .-- \\ TABLE lA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 50% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 67 68 69 70 71 72 73 55 $4.87 $4.95 $5.02 55.10 $5.18 $5.26 $5.34 56 4.91 4.98 5.06 5.14 5.22 5.31 5.39 57 4.94 5.02 5. 10 5.18 5.26 5.35 5.44 58 4.97 5.05 5. 14 5.22 5.31 5.40 5.49 59 5.01 5.09 5. 17 5.26 5.35 5.44 5.53 60 5.04 5.12 5.21 5.30 5.39 5.49 5.58 61 5.07 5.16 5.25 5.34 5.43 5.53 5.63 62 5.10 5.19 5.28 5.38 5.48 5.58 5.68 63 5.13 5.23 5. 32 5.42 5.52 5.62 5.73 64 5.16 5.26 5.36 5.46 5.56 5.67 5.78 65 5.19 5.29 5.39 5.50 5.60 5.71 5.83 66 5.22 5. 32 5.43 5.53 5.64 5. 76 5.87 67 5.25 5. 35 5.46 5.57 5. 68 5.80 5.92 68 5.27 5. 38 5. 39 5.61 5. 72 5.84 5.97 69 5.30 5.41 5.52 5.64 5. 76 5.88 6.01 70 5.32 5.44 5.55 5.67 5.80 5.93 6.06 71 5.34 5.46 5.58 5.70 5.83 5.96 6.10 72 5.37 5.48 5.60 5.73 5.86 6.00 6.14 73 5.38 5.50 5.63 5.76 5.89 6.03. 6.18 74 5.40 5.52 5.65 5.78 5.92 6.06 6.21 75 5.41 5.54 5.67. 5.80 5.95 6.09 6.24 *Age for the purpose of this table is age last birthday on the Participant's or Member' s Annuity Commencement Date. Table 1 Option 3 GP 11676-FS Joint Life 507. Installment Refund GP R 21992 C (-- TABLE IA OPTION 3--JOINT LIFE INSTALLMENT REFUND ANNUITY with 50% Continued to the Contingent Annuitant Amount of Monthly Annuity Purchased by $1,000 Age* of Contingent Age* of Participant or Member Annuitant 60 61 62 63 64 65 66 55 $4.41 $4.47 $4.53 $4.60 $4.66 $4.73 $4.80 56 4.43 4.49 4.56 4.62 4.69 4.76 4.83 57 4.45 4.51 4.58 4.65 4. 72 4.79 4.86 58 4.47 4.53 4.60 4.67 4. 74 4.82 4.89 59 4.49 4.56 4. 63 4.70 4. 77 4.85 4.93 60 4.51 4. 58 4.65 4.72 4. 80 4.88 4.95 61 4.52 4.60 4.67 4. 74 4.82 4.90 4.99 62 4.54 4.61 4.69 4. 77 4.85 4.93 5.01 63 4.56 4.63 4.71 4.79 4.87 4.96 5.04 64 4.57 4.65 4. 73 4.81 4.89 4.98 5.07 65 4.59 4.67 4. 75 4.83 4.92 5.01 5.10 66 4.60 4. 68 4. 76 4.85 4.94 5.03 5.12 67 4. 62 4. 70 4.78 4.87 4.96 5.05 5.15 68 4.63 4. 71 4.80 4.89 4.98 5.07 5.17 69 4.64 4. 72 4.81 4.90 5.00 5.09 5.20 70 4.65 4. 73 4.82 4.92 5.01 5.11 5.22 71 4.66 4. 75 4.84 4.93 5.03 5.13 5.24 72 4.67 4. 75 4.85 4.94 5.04 5.14 5.25 73 4.67 4. 76 4.86 4.95 5.05 5. 16 5.27 74 4.68 4. 77 4.86 4.96 5.06 5.17 5.28 75 4.68 4. 78 4.87 4.97 5.07 5.18 5.30 *Age for the purpose of this table is age last birthday on the Participant's or Member's Annuity Commencement Date. Table 1 Option 3 OF 1176-Fs Joint Life 50% -1- Installment Refund GP R 21992 TABLE lA OPTION 2--CERTAIN AND LIFE ANNUITY Amount of Monthly Annuity Purchased by $1,000 Monthly Annuity 5 years 10 years 15 years Age * certain certain certain 50 $4.11 $4.08 $4.04 51 4.18 4.15 4.10 52 4.26 4.22 4.17 53 4. 33 4.30 4.23 54 4.42 4.37 4.30 55 4.50 4.46 4.37 56 4.59 4.54 4.45 57 4.69 4.63 4.52 58 4.79 4.72 4.60 59 4.89 4.82 4.69 60 5.01 4.92 4.77 61 5.12 5.02 4.86 62 5.25 5.13 4.95 63 5.38 5.25 5.05 64 5.52 5.37 5.14 65 5.67 5.50 5.24 66 5.82 5.64 5.35 67 5.99 5.78 5.45 68 6.17 5.93 5.55 69 6.36 6.09 5.66 70 6.57 6.25 5.76 71 6.79 6.42 5.86 72 7.02 6.59 5.96 73 7.27 6. 77 6.06 74 7.54 6.96 6.15 75 7.82 7.14 6.24 76 8.13 7.33 6.32 77 8.45 7.52 6.40 78 8.78 7. 70 6.47 79 9.14 7.88 6.53 80 9.51 8.06 6.59 *Age for the purpose of this table is age last birthday on Annuity Commencement Date. CP 1_675-F3 Table 1 Option 2 Certain and Life GP R 21992 TABLE lA OPTION 1--LIFE ANNUITY Amount of Monthly Annuity Purchased by $1,000 Monthly ASe* Annuity 50 S 4.12 51 4.19 52 4.27 53 4.35 54 4.43 55 4.52 56 4.61 57 4.71 58 4.81 59 4.92 60 5.03 61 5.15 62 5.28 63 5.42 64 5.56 65 5.72 66 5.89 67 6.06 68 6.25 69 6.46 70 6.68 71 6.91 72 7.17 73 7.44 74 7.74 75 8.07 76 8.42 77 8.80 78 9.21 79 9.65 80 10.13 *Age for the purpose of this table is age last birthday on Annuity Commencement Date. GP :1674-FS Table 1 Option 1 Life GP R 21992 • MODIFICATION OF BASIS FOR DETERMINING MONTHLY ANNUITY BENEFITS RIDER This rider is made a part of the Group Annuity Contract issued by us to which it is attached.All terms defined in the contract have the same meaning where used in this rider. The effective date of this rider is the Contract Date unless otherwise stated in the amendment adding this rider to the contract. This rider modifies the contract as follows: • 1. If you report to us that all or a part of the monthly annuity income to be provided to Members or Participants under this contract should be determined without regard to the sex of the individual or individuals for whom the income is to be provided, then: (a) Sex will not be a factor used in the determination of such amount of monthy annuity income, and (b) the annuity purchase rates applicable for such amount will be the rates available under contracts of this class for purchases on a sex neutral basis on the date such purchase is made. Such rates will not be less favorable to the Member or Participant than the rates shown in Table 1A. 2. To the extent Item 1 of this rider is applicable to a Member or Participant under this contract.Table 1 A replaces Table 1 as to such Member or Participant. 3. The attached Table 1A is added. BANKERS�LIFE COMPANY PRESIOEE14 U • IN THIS RIDER We, Us. and Our means Bankers Life Company of Des Moines. Iowa. i You. Your means the Contractholoer. • GP R 21992 THE BANKERS LIFE El BANKERS LIE! COMPANY DES MOINES. IOWA i GROUP ANNUITY CONTRACT BANKERS LIFE COMPANY 711 High Street Des Moines, Iowa 50307 in consideration of the application for this contract made by WELD COUNTY (the Contractholder) and payment of all Contributions and Annuity Premiums provided for in this contract,agrees to make payments to the person or persons entitled to them subject to the provisions of this contract. This contract is delivered in Colorado 7ontributicns directed into a Separate Account are no: ^uaranteed as to fixed dollar amount out i increase or cecrense in coiiar amount. depenuing on the investment performance of such Separate Account, as set out in this contract. This contract is issued and accepted subject to all the terms set forth in it. This contract is executed by Bankers Life Company at its Home Office to take effect as of the 1st day of January , 19 85 , which is the Contract Date. 77M. A/Vaialt.<410,C. VICE-PRESIDENT, COUNSEL AND CORPORATE SECRETARY PRESIDENT • Registrar Date GROUP CONTRACT NO. GA 66947 Flexible Investment Annuity Group Contract With Full Crediting Rates and Pooled Separate Accounts GP A 5913-1 THE BANKERS LIFE BANKERS LIFE COMPANY DES MOINES, IOWA By executing this Plan, the Primary Employer acknowledges having counseled to the extent necessary with selected legal and tax advisors regarding the Plan's legal and tax implications. Executed this 22nd day of April , 19,85 . WELD COUNTY By: Chairman, Board of Weld County Commissioners Title • • • • PLAN EXECUTION 39 (66947) Your plan is an important legal document. This sample plan has been prepared based on our understanding of the desired provisions. It may not fit your situation. You should consult with your lawyer on the plan's legal and tax implications. Neither Bankers Life Company nor its agents can be responsible for the legal or tax aspects of the plan nor its appropriateness for your situation. If you wish to change the provisions of this sample plan, you may ask us to prepare new sample wording for you and your lawyer to review. WELD COUNTY 401(k) SAVINGS PLAN Defined Contribution Plan Effective January 1, 1985 • TABLE OF CONTENTS • INTRODUCTION ARTICLE I FORMAT AND DEFINITIONS Section 1.01 Format Section 1.02 Definitions ARTICLE II PARTICIPATION Section 2.01 Active Participant Section 2.02 Inactive Participant Section 2.03 Cessation of Participation ARTICLE III CONTRIBUTIONS Section 3.01 Employer Contributions Section 3.O1A Voluntary Contributions by Participants Section 3.02 Allocation Section 3.03 Contribution Limitation Section 3.04 Salary Deferral Limitation ARTICLE IV INVESTMENT OF CONTRIBUTIONS Section 4.01 Investment of Contributions ARTICLE V BENEFITS Section 5.01 Retirement Benefits Section 5.02 Death Benefits Section 5.03 Vested Benefits Section 5.04 When Benefits Start Section 5.05 Withdrawal Privileges • ARTICLE VI DISTRIBUTION OF BENEFITS Section 6.01 Automatic Forms of Distribution Section 6.02 Optional Forms of Distribution Section 6.03 Election Procedures ARTICLE VII TERMINATION OF PLAN TABLE OF CONTENTS 2 (66947) I ARTICLE VIII ADMINISTRATION OF PLAN Section 8.01 Administration Section 8.02 Records Section 8.03 Information Available Section 8.04 Unclaimed Vested Account Procedure ARTICLE IX GENERAL PROVISIONS Section 9.01 Amendments Section 9.02 Provisions Relating to the Insurer Section 9.03 Employment Status Section 9.04 Rights to Plan Assets Section 9.05 Beneficiary Section 9.06 Nonalienation of Benefits Section 9.07 Facility of Payment Section 9.08 Construction Section 9.09 Legal Actions Section 9.10 Modification in Mode of Payment Section 9.11 Word Usage Section 9.12 Qualification of Plan PLAN EXECUTION TABLE OF CONTENTS 3 (66947) (- INTRODUCTION The Primary Employer is establishing a defined contribution savings plan for the exclusive benefit of certain of its employees. It is intended that the savings plan qualify under the Internal Revenue Code of 1954, including any later amendments to the Code. The Employer agrees to operate the plan according to the terms, provisions and conditions set forth in this document. • INTRODUCTION 4 (66947) ARTICLE I FORMAT AND DEFINITIONS SECTION 1.01--FORMAT. Words and phrases defined in the DEFINITIONS SECTION of Article I shall have that defined meaning when used in this Plan, unless the context clearly indicates otherwise. These words and phrases have an initial capital letter to aid in identifying them as defined terms. SECTION 1.02--DEFINITIONS. ACCOUNT means a Participant's share of the Investment Fund. Separate accounting records are kept for those parts of his Account that result from: (a) Nondeductible Participant Contributions. (b) Deductible Participant Contributions. (c) Salary Deferral Contributions. A Participant's Account shall be reduced by any distribution of his Vested Account. A Participant's Account will participate in the earnings credited, expenses charged and any appreciation or depreciation of the Investment Fund. His Account is subject to any minimum guarantees applicable under the Group Contract. ACTIVE PARTICIPANT means an Eligible Employee who is actively participating in the Plan according to the provisions in the ACTIVE PARTICIPANT SECTION of Article II. BENEFICIARY means the person or persons named by a Participant to receive any benefits under this Plan upon the Participant' s death. See the BENEFICIARY SECTION of Article IX. CODE means the Internal Revenue Code of 1954, as amended. COMPENSATION means the total earnings paid or made available to an Employee by the Employer. "Earnings" in this definition means the kind of compensation that is subject to tax for Social Security benefits without regard to the dollar limitation on such compensation subject to FICA taxes. ARTICLE I 5 (66947) Compensation means, for an Employee who is a Leased Employee, the Employee's Compensation for the services he performs for the Employer, determined in the same manner as the Compensation of Employees who are not Leased Employees, regardless of whether such Compensation would be received directly from the Employer or from the leasing organization. CONTINGENT ANNUITANT means an individual named by the Participant to receive a lifetime benefit after the Participant's death in accordance with a survivorship life annuity. CONTRIBUTIONS means Salary Deferral Contributions as set out in Article III. DISABLED means that a Participant is disabled to the extent he is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or be of long-continued and indefinite duration for purposes of the WHEN BENEFITS START SECTION of Article V or which has lasted or can be expected to last for a continuous period of not less than twelve months for purposes of the CONTRIBUTION LIMITATION SECTION of Article III. Proof of the existence of the disability will be in such form and manner as the Secretary of the Treasury may require. ELIGIBILITY SERVICE means an Employee' s Period of Service. If he has more than one Period of Service, or if all or a part of a Period of Service is not counted, his Eligibility Service shall be determined by adjusting his Employment Commencement Date so that he has one continuous period of Eligibility Service equal to the aggregate of all his countable Periods of Service. An Employee's Eligibility Service shall be determined on the basis that thirty days equal one month and 365 days equal one year. However, Eligibility Service is modified as follows: Period of Military Duty included: A Period of Military Duty shall be included as service with the Employer to the extent it has not already been credited. Period of Severance included (service spanning rule): A Period of Severance shall be deemed to be a Period of Service under either of the following conditions: (a) The Period of Severance immediately follows a period during which an Employee is not absent from work and ends within twelve months. ARTICLE I 6 (66947) 7- (b) The Period of Severance immediately follows a period during which an Employee is absent from work for any reason other than quitting, being discharged or retiring (such as a leave of absence or layoff) and ends within twelve months of the date he was first absent. ELIGIBLE EMPLOYEE means any Employee of the Employer. EMPLOYEE means an individual who is employed by the Employer. A Leased Employee shall be deemed to be an Employee unless he is a participant in a money purchase plan of the leasing organization which provides an employer contribution rate of at least 7.5% of pay, immediate participation and full and immediate vesting. EMPLOYER means the Primary Employer. which shall, by written agreement, assume the obligations of this Plan. EMPLOYER CONTRIBUTIONS means contributions made by the Employer to fund this Plan. See the EMPLOYER CONTRIBUTIONS SECTION of Article III. EMPLOYMENT COMMENCEMENT DATE means the date an Employee first performs an Hour-of-Service. ENTRY DATE means the date an Employee first enters the Plan as an Active Participant. See the ACTIVE PARTICIPANT SECTION of Article II. FISCAL YEAR means the Primary Employer's accounting year. The last day of the Fiscal Year is December 31. GROUP CONTRACT means the group annuity contract or contracts into which the Primary Employer enters with the Insurer for the purpose of payment of benefits provided under this Plan and for the purpose of investment of all of the Contributions made under the Plan. The term Group Contract as it is used in this Plan is deemed to include the plural unless the context clearly indicates the singular is meant. HOUR-OF-SERVICE means, for an Employee, each hour for which he is paid, or entitled to payment, for performing duties for the Employer. Hours-of-Service shall include service as a Leased Employee. INACTIVE PARTICIPANT means a former Active Participant who is or may become entitled to benefits under the Plan. See the INACTIVE PARTICIPANT SECTION of Article II. INSURER means Bankers Life Company of Des Moines, Iowa, and any other insurance company or companies named by the Primary Employer. ARTICLE I 7 (66947) C INVESTMENT FUND means the total funds held under the Group Contract for the purpose of providing benefits for Participants. These funds result from Contributions made under the Plan. The Investment Fund shall be valued at current fair market value as of the last day of the last calendar month ending in the Plan Year and, at the discretion of the Insurer, may be valued more frequently. The valuation shall take into consideration investment earnings credited, expenses charged, payments made and changes in the value of the assets held in the fund. The Investment Fund shall be allocated at all times to the Participants. Each Participant's share shall be based on the Contributions credited to such Participant' s Account. LATE RETIREMENT DATE means for a Participant who continues working for the Employer after his Normal Retirement Date, the first day of the month after a Participant ceases to be an Employee (the date he ceases to be an Employee, if he ceases to be an Employee on the first day of the month) . If he has not ceased to be an Employee on his Normal Retirement Date, his Late Retirement Date shall be the date his retirement benefit begins. LEASED EMPLOYEE means an individual who is not an Employee of the Employer and who provides services to the Employer if (a) the services are provided pursuant to an agreement between the Employer and another person (the leasing organization) , (b) such individual has performed services for the Employer on a substantially full-time basis for a period of one year, and (c) such services are of a type historically performed, in the Employer's field of business, by employees. Once the one-year period requirement in (b) above is met, all of such individual's period of service for the Employer shall be considered in determining eligibility. NORMAL FORM means a life annuity with installment refund. NORMAL RETIREMENT AGE means the age at which the Participant's normal retirement benefit becomes nonforfeitable. A Participant's Normal Retirement Age is 65. NORMAL RETIREMENT DATE means the earliest first day of the month on or after the date the Participant reaches his Normal Retirement Age. His Normal Retirement Date shall be the date his retirement benefit begins if he has ceased to be an Employee on such date. ARTICLE I 8 (66947) I • PARTICIPANT means either an Active Participant or an Inactive Participant. PARTICIPANT CONTRIBUTIONS means Voluntary Contributions as set out in Article III. PERIOD OF MILITARY DUTY means, for an Employee (a) who served as a member of the armed forces of the United States, and (b) who was reemployed by the Employer at a time when the Employee had a right to reemployment at the Employee's former position or a substantially similar position upon separation from such military duty in accordance with seniority rights as protected under Section 2021 through 2026 of Title 38 of the U. S. Code, the period of time from the date the Employee was first absent from active work for the Employer because of such military duty to the date the Employee was reemployed. PERIOD OF SERVICE means a period of time beginning on an Employee's Employment Commencement Date or Reemployment Commencement Date (whichever applies) and ending on his Severance from Service Date. PERIOD OF SEVERANCE means a period of time beginning on an Employee's Severance from Service Date and ending on the date he again performs an Hour-of-Service. A one-year Period of Severance means a Period of Severance of twelve consecutive months. PLAN means the savings plan of the Employer set forth in this document, including any later amendments to it. PLAN ADMINISTRATOR means the person or persons who administer the Plan. The Plan Administrator is the Employer. PLAN YEAR means a period beginning on a Yearly Date and ending on the day before the next Yearly Date. PRIMARY EMPLOYER means WELD COUNTY. QUALIFIED JOINT AND SURVIVOR FORM means a survivorship life annuity with installment refund, where the survivorship percentage is 100% and the Contingent Annuitant is the Participant's spouse. ARTICLE I 9 (66947) This Qualified Joint and Survivor Form shall be the actuarial equivalent of a single life annuity for the Participant provided by his Vested Account. QUALIFIED PRERETIREMENT SURVIVOR ANNUITY means a life annuity with installment refund payable to the surviving spouse of a Participant who dies before retirement benefits begin. REEMPLOYMENT COMMENCEMENT DATE means the date an Employee first performs an Hour-of-Service following a Period of Severance. REENTRY DATE means the date a former Active Participant reenters the Plan. See the ACTIVE PARTICIPANT SECTION of Article II. RETIREMENT DATE means the date a retirement benefit will begin and is a Participant's Normal or Late Retirement Date, as the case may be. SALARY DEFERRAL CONTRIBUTIONS means Contributions made by the Employer to fund this Plan in accordance with salary deferral agreements between the Employer and Eligible Employees. See the EMPLOYER CONTRIBUTIONS SECTION of Article III. SEVERANCE FROM SERVICE DATE means the earlier of (a) the date on which an Employee quits, retires, dies or is discharged, or (b) the first anniversary of the date an Employee begins a one-year absence from service (with or without pay) . This absence may be the result of any combination of vacation, holiday, sickness, disability, leave of absence or layoff. TEFRA means the Tax Equity and Fiscal Responsibility Act of 1982. TEFRA COMPLIANCE DATE means the date a plan is to comply with the provisions of TEFRA. The TEFRA Compliance Date as used in this Plan is, (a) for purposes of determining the Maximum Permissible Amount and contribution limitations of the CONTRIBUTION LIMITATION SECTION of Article III, January 1, 1983. (b) for all other purposes, the first Yearly Date after December 31, 1983. TOTALLY AND PERMANENTLY DISABLED means that a Participant is disabled, as a result of sickness or injury, to the extent that he is prevented ARTICLE I 10 (66947) ( • from engaging in any substantial gainful activity, and is eligible for and receives a disability benefit under Title II of the Federal Social Security Act. VESTED ACCOUNT means the vested part of a Participant' s Account. The Participant's Vested Account is equal to his Account. VOLUNTARY CONTRIBUTIONS means contributions by a Participant that are not required as a condition of employment or participation or for obtaining additional benefits from the Employer Contributions. See the VOLUNTARY CONTRIBUTIONS BY PARTICIPANTS SECTION of Article III. YEARLY DATE means January 1, 1985, and the same day of each following year. • • ARTICLE I 11 (66947) C C ARTICLE II PARTICIPATION SECTION 2.01--ACTIVE PARTICIPANT. (a) An Employee shall first become an Active Participant (begin active participation in the Plan) on the earliest date on or after January 1, 1985, on which he is an Eligible Employee and has met the eligibility requirement set forth below. This date is his Entry Date. (1) He has completed 6 months of Eligibility Service before his Entry Date. The service requirement above is waived on January 1, 1985. This date shall be an Entry Date if the Employee is an Eligible Employee. (b) An Inactive Participant shall again become an Active Participant (resume active participation in the Plan) on the date he again performs an Hour-of-Service as an Eligible Employee. This date is his Reentry Date. Upon again becoming an Active Participant, he shall cease to be an Inactive Participant. (c) A former Participant shall again become an Active Participant (resume active participation in the Plan) on the date he again performs an Hour-of-Service as an Eligible Employee. This date is his Reentry Date. There shall be no duplication of benefits for a Participant under this Plan because of more than one period as an Active Participant. SECTION 2.02--INACTIVE PARTICIPANT. An Active Participant shall become an Inactive Participant (stop accruing benefits under the Plan) on the earlier of the following: (a) The date on which he ceases to be an Eligible Employee (on his Retirement Date if the date he ceases to be an Eligible Employee occurs within one month of his Retirement Date) . (b) The effective date of complete termination of the Plan. ARTICLE II 12 (66947) 7 SECTION 2.03--CESSATION OF PARTICIPATION. A Participant shall cease to be a Participant on the date he is no longer an Eligible Employee and his Account is zero. • ARTICLE II 13 (66947) C C ARTICLE III CONTRIBUTIONS SECTION 3.01--EMPLOYER CONTRIBUTIONS. Employer Contributions for Plan Years which end on or after January 1, 1985, shall be made from excess revenues (excess of receipts over expenditures) of the Employer. Employer Contributions are conditioned on initial qualification of the Plan and qualification of the Plan as amended. The amount of Employer Contributions for any Plan Year will be equal to the Employer Contributions as described below: (a) The amount of each Salary Deferral Contribution for a Participant shall be equal to any percentage (not to exceed 12.5%) of his Compensation for the pay period as elected in his salary deferral agreement. In no event will his Salary Deferral Contribution be less than $25.00 per month. This agreement must be in writing and completed before the date Salary Deferral Contributions are to begin. Salary Deferral Contributions are fully (100%) vested and nonforfeitable. A portion of the Plan assets resulting from Employer Contributions (but not more than the original amount of those Contributions) may be returned if the Employer Contributions are made because of a mistake of fact. The amount involved must be returned to the Employer within one year after the date the Employer Contributions are made by mistake of fact. Except as provided under this paragraph and Articles VII and IX, the assets of the Plan shall never be used for the benefit of the Employer and are held for the exclusive purpose of providing benefits to Participants and their Beneficiaries and for defraying reasonable expenses of administering the Plan. SECTION 3.01A--VOLUNTARY CONTRIBUTIONS BY PARTICIPANTS. An Active Participant may make Voluntary Contributions. These may include Voluntary Contributions which the Participant may deduct from his gross income for Federal income tax purposes. An Active Participant may make Voluntary Contributions at any time before his Retirement Date. No deductible Voluntary Contributions may be made for the Participant's taxable year in which he attains age 70 1/2 or in any following taxable year nor for a taxable year in which he is not an Employee. Voluntary Contributions shall be made in accordance with procedures and limitations set up by the Plan Administrator. ARTICLE III 14 (66947) ( A Participant' s participation in the Plan is not affected by stopping or changing Voluntary Contributions. An Active Participant's request to start, change or stop his Voluntary Contributions must be in writing on a form furnished for that purpose. The form must be delivered to the Plan Administrator before the date the Participant is to start, change or stop his Voluntary Contributions. All of a Participant's Voluntary Contributions shall be treated as deductible Voluntary Contributions until he has contributed the maximum amount which may be deducted. A Participant may make a written election to have all or part of his Voluntary Contributions designated or redesignated as nondeductible Voluntary Contributions. A Participant may change his election. Such election or change in election must be made before the deadline for filing the Participant's Federal income tax return, without regard to extensions. A Participant's deductible Voluntary Contributions shall be cash contributions. Deductible Voluntary Contributions for any taxable year of the Participant may not be more than the lesser of $2,000 or his pay which is includable in gross income for the taxable year for which the deductible Voluntary Contributions are made. For purposes of this paragraph, pay does not include amounts derived from or received as earnings or profits from property or amounts received as a pension or annuity or as deferred compensation. This limitation applies to all deductible voluntary contributions made to all of the Employer's qualified retirement plans for a taxable year. Deductible Voluntary Contributions over the limitation above shall be redesignated as nondeductible Voluntary Contributions. A Participant' s nondeductible Voluntary Contributions, including any such voluntary contributions he has made under any other qualified plan of the Employer or of a predecessor of the Employer, shall not, in the aggregate, exceed ten percent of his total earnings from the Employer (and from the predecessor) for the period of time he has actively participated under this Plan and such other plan(s) . Voluntary Contributions shall be forwarded to the Insurer not more than three months after they are made and shall be credited to the Participant's Account. The part of the Participant's Account resulting from Voluntary Contributions is fully (100%) vested and nonforfeitable at all times. SECTION 3.02--ALLOCATION. • Salary Deferral Contributions for each Plan Year shall be allocated to Participants for whom such Contributions were made under the EMPLOYER CONTRIBUTIONS SECTION of Article III. ARTICLE III 15 (66947) In determining the amount of Employer Contributions to be allocated to a Participant who is a Leased Employee, contributions and benefits provided by the leasing organization which are attributable to services such Leased Employee performs for the Employer shall be treated as provided by the Employer and there shall be no duplication of those contributions or benefits under this Plan. SECTION 3.03--CONTRIBUTION LIMITATION. (a) For the purpose of determining the contribution limitation set forth in this section, the following terms are defined: Aggregate Annual Addition means, for a Participant with respect to any Limitation Year, the sum of his Annual Additions under all defined contribution plans of the Employer for such Limitation Year. The nondeductible participant contributions which the Participant makes and Employer Contributions made for him for a Plan Year beginning on or after March 31, 1984 to an individual medical benefit account, as defined in Code Section 415(1) (1) , under a defined benefit plan of the Employer shall be treated as Annual Additions to a defined contribution plan. Annual Addition means the amount added to a Participant's account for any Limitation Year which may not exceed the Maximum Permissible Amount. The Annual Addition under any plan for a Participant with respect to any Limitation Year, shall be equal to the sum of (1) and (2) below: (1) Employer contributions and forfeitures credited to his account for the Limitation Year. (2) The lesser of (i) 1/2 of his nondeductible participant contributions made for the Limitation Year, or (ii) the amount, if any, of his nondeductible participant contributions made for the Limitation Year which is in • excess of six percent of his Compensation, as defined in this section, for such Limitation Year. Compensation means a Participant's earned income, wages, salaries, fees for professional service, and other amounts received for personal service actually rendered in the course of employment with the Employer. Such compensation may be actually paid or made available to the Participant or may be accrued compensation as elected by the Employer. Compensation includes, but is not limited to, commissions paid to salesmen, compensation for ARTICLE III 16 (66947) services on the basis of a percentage of profits, commissions on insurance premiums, tips, and bonuses. Compensation excludes the following: (1) Contributions made by the Employer to a plan of deferred compensation to the extent contributions are not included in the gross income of the Employee for the taxable year in which contributed, or on behalf of the Employee to a simplified employee pension plan to the extent such contributions are deductible by the Employee, and any distributions from a plan of deferred compensation whether or not includable in the gross income of the Employee when distributed. (2) Amounts realized from the exercise of a non-qualified stock option, or when restricted stock (or property) held by an Employee becomes freely transferable or is no longer subject to a substantial risk of forfeiture. (3) Amounts realized from the sale, exchange or other disposition of stock acquired under a qualified stock option. (4) Other amounts which receive special tax benefits, or contri- butions made by the Employer (whether or not under a salary reduction agreement) towards the purchase of a 403(b) annuity contract (whether or not the contributions are excludable from the gross income of the Employee) . Compensation for a Disabled Participant, who is a participant under any profit sharing or stock bonus plan(s) maintained by the Employer, shall include the compensation he would have received during the Limitation Year had he continued to be paid at the same rate as he was immediately before he became Disabled. The imputed compensation may be taken into account only if the employer so elects, the Participant is not an officer, owner or highly paid employee of the electing employer, and contributions made for a Disabled Participant are nonforfeitable when made. Defined Benefit Plan Fraction means, with respect to a Limitation Year for a Participant who is or has been a participant in a defined benefit plan ever maintained by the Employer, the quotient, expressed as a decimal, of (1) the Participant' s Projected Annual Benefit under all such plans as of the close of such Limitation Year, divided by ARTICLE III 17 (66947) (2) on and after the TEFRA Compliance Date, the lesser of (i) or (ii) below: (i) 1.25 multiplied by $90,000 (adjusted each January 1 for changes in the cost of living when permitted under the Code and as prescribed by the Secretary of the Treasury or his delegate) or (ii) 1.4 multiplied by the Participant's highest average compensation as defined in the defined benefit plan(s) . Before the TEFRA Compliance Date, this denominator is the Participant' s Projected Annual Benefit as of the close of the Limitation Year if the plan(s) provided the maximum benefit allowable. The Defined Benefit Plan Fraction shall be modified as follows: If the Participant was a participant in one or more defined benefit plans maintained by the Employer which were in existence on July 1, 1982, the denominator of this fraction will not be less than 125 percent of the sum of the annual benefits under such plans which the Participant had accrued as of the end of the last Limitation Year beginning before January 1, 1983. The preceding sentence applies only if the defined benefit plans individually and in the aggregate satisfied the requirements of Code Section 415 as in effect at the end of the last Limitation Year beginning before January 1, 1983. For purposes of this paragraph, a prototype plan with an opinion letter issued by the National Office of the Internal Revenue Service before January 1, 1983, which was adopted by the Employer on or before September 30, 1983, is treated as a plan in existence on July 1, 1982. Defined Contribution Plan Fraction means, for a Participant with respect to a Limitation Year, the quotient, expressed as a decimal, of (1) the Participant's Aggregate Annual Additions for such Limitation Year and all prior Limitation Years, under all defined contribution plans (including the Aggregate Annual Additions attributable to nondeductible accounts under defined benefit plans and attributable to all welfare benefit funds, as defined in Code Section 419(e)) ever maintained by the Employer, divided by (2) on and after the TEFRA Compliance Date, the sum of the amount determined for the Limitation Year under (i) or (ii) below, whichever is less, and the amounts determined in the same ARTICLE III 18 (66947) manner for all prior Limitation Years during which he has been an Employee or an employee of a predecessor employer. (i) 1.25 multiplied by the maximum permissible dollar amount for each such Limitation Year, or (ii) 1.4 multiplied by the maximum permissible percentage of the Participant's Compensation, as defined in this section, for each such Limitation Year. Before the TEFRA Compliance Date, this denominator is the sum of the maximum allowable amount of Annual Addition to his account(s) under all the plan(s) of the Employer for each such Limitation Year. The Defined Contribution Plan Fraction shall be modified as follows: If the Participant was a participant in one or more defined contribution plans maintained by the Employer which were in existence on July 1, 1982, the numerator of this fraction shall be adjusted if the sum of the Defined Contribution and Defined Benefit Plan Fractions would otherwise exceed 1.0 under the terms of this Plan. Under the adjustment, the dollar amount determined below shall be permanently subtracted from the numerator of this fraction. The dollar amount is equal to the excess of the sum of the two fractions, before adjustment, over 1.0 multiplied by the denominator of his Defined Contribution Plan Fraction. The adjustment is calculated using his Defined Contribution and Defined Benefit Plan Fractions as they would be computed as of the end of the last Limitation Year beginning before January 1, 1983. This adjustment also shall be made if, at the end of the last Limitation Year beginning before January 1, 1984, the sum of the fractions exceeds 1.0 because of accruals or additions that were made before the limitations of this section became effective to any plans of the Employer which were in existence on July 1, 1982. For purposes of this paragraph, a prototype plan with an opinion letter issued by the National Office of the Internal Revenue Service before January 1, 1983, which was adopted by the Employer on or before September 30, 1983, is treated as a plan in existence on July 1, 1982. For a plan that was in existence on July 1, 1982, for purposes of determining the Defined Contribution Plan Fraction for any Limitation Year ending after December 31, 1982, the Plan Administrator may elect, in accordance with the provisions of Code Section 415, that the denominator for each Participant for all Limitation Years ending before January 1, 1983 will be equal to ARTICLE III 19 (66947) C C • (1) the Defined Contribution Plan Fraction denominator which would apply for the last Limitation Year ending in 1982 if an election under this paragraph were not made, multiplied by (2) a fraction, equal to (i) over (ii) below: (i) the lesser of (A) $51,875, or (B) 1.4, multiplied by 25% of the Participant's Compensation, as defined in this section, for the Limitation Year ending in 1981; (ii) the lesser of (A) $41,500, or (B) 25% of the Participant's Compensation, as defined in this section, for the Limitation Year ending in 1981. The election described above is applicable only if the plan administrators under all defined contribution plans of the Employer also elect to use the modified fraction. Limitation Period means a period which begins on the first day of the Limitation Year in which a change of Limitation Year occurs and ends on the day before the first day of the new Limitation Year. Limitation Year means the consecutive twelve-month period within which it is determined whether or not the limitations of Code Section 415 are exceeded. Limitation Year means each one-year period ending on the last day of each Plan Year, including corresponding one-year periods before January 1, 1985. If the Limitation Year is other than the calendar year, execution of this Plan (or any amendment to this Plan changing the Limitation Year) constitutes the Employer' s adoption of a written resolution electing the Limitation Year. If the Limitation Year is changed, the new Limitation Year shall begin within the current Limitation Year. Maximum Permissible Amount means, for a Participant with respect to any Limitation Year, the lesser of (1) or (2) below: (1) $30,000. (Before the TEFRA Compliance Date, $25,000 multiplied by the cost of living adjustment factor permitted by Federal regulations.) (2) 25% of his Compensation, as defined in this section, for such Limitation Year. The amount under (1) above shall be adjusted each January 1 for changes in the cost of living when permitted under the Code and as prescribed by the Secretary of the Treasury or his delegate. No ARTICLE III 20 (66947) adjustment shall be made before January 1, 1988. An adjustment as of January 1 of any calendar year shall apply to Limitation Years ending with or within such calendar year. Projected Annual Benefit means a Participant's expected annual benefit under all defined benefit plan(s) ever maintained by the Employer. The Projected Annual Benefit shall be determined assuming that the Participant will continue employment until the later of current age or normal retirement age under such plan(s) , and that the Participant's compensation for the current Limitation Year and all other relevant factors used to determine benefits under such plan(s) will remain constant for all future Limitation Years. Such expected annual benefit shall be adjusted to the actuarial equivalent of a straight life annuity if expressed in a form other than a straight life or qualified joint and survivor annuity. (b) The Annual Addition under this Plan for a Participant during a Limitation Year shall not be more than the Maximum Permissible Amount. (c) Contributions which would otherwise be credited to the Participant' s Account shall be limited or reallocated to the extent necessary to meet the restrictions of subparagraph (b) above for any Limitation Year. Nondeductible Voluntary Contributions shall be limited first. Next, Salary Deferral Contributions shall be limited. If, due to (i) an error in estimating a Participant's Compensation as defined in this section, or (ii) other limited facts and circumstances, a Participant's Annual Addition is greater than the amount permitted in (b) above, such excess amount shall be applied as follows. If the Participant is an Active Participant as of the end of the Limitation Year, the excess amount shall be used to offset Employer Contributions for him in the next Limitation Year. If he is not an Active Participant as of the end of the Limitation Year, the excess amount will be held in a suspense account which will be used to offset Employer Contributions for all Participants in the next Limitation Year. No Employer Contributions or Participant Contributions that would be included in the next Limitation Year's Annual Addition may be made before the total suspense account has been used or reallocated. (d) A Participant's Aggregate Annual Addition for a Limitation Year shall not exceed the Maximum Permissible Amount. If, for the Limitation Year, the Participant has an Annual Addition under more than one defined contribution plan or a welfare benefit fund, as defined in Code Section 419(e) , ARTICLE III 21 (66947) (— maintained by the Employer and such plans and welfare benefit funds do not limit the Aggregate Annual Addition to the Maximum Permissible Amount, any reduction necessary shall be made first to the profit sharing plans, then to all other such plans and welfare benefit funds and, if necessary, by reducing first those that were most recently established. Welfare benefit funds shall be deemed to be established first. If some of the Employer's defined contribution plans were not in existence on July 1, 1982 and some were in existence on that date, the Maximum Permissible Amount which is based on a dollar amount may differ for a Limitation Year. The Aggregate Annual Addition for the Limitation Year in which the dollar limit differs shall not exceed the lesser of (1) 25% of Compensation as defined in this section, (2) $45,475, or (3) the greater of $30,000 or the sum of the Annual Additions for such Limitation Year under all the plan(s) to which the $45,475 amount applies. (e) If Limitation Period applies, an adjusted Maximum Permissible Amount shall apply to the Limitation Period. The adjustment shall be made by multiplying the otherwise allowable Maximum Permissible Amount which is based on a dollar amount by the ratio of the number of whole months and fractional parts of a month in the Limitation Period to twelve. The amount of Compensation, as defined in this section, taken into account shall be the Participant's Compensation for the Limitation Period. (f) If a Participant is or has been a participant in both defined benefit and defined contribution plans (including a welfare benefit fund) ever maintained by the Employer, the sum of the Defined Benefit and Defined Contribution Plan Fractions for any Limitation Year shall not exceed 1.0 (1.4 before the TEFRA Compliance Date) . After all other limitations set out in the plans and funds have been applied, the following limitations shall apply so that the sum of the Participant' s Defined Benefit and Defined Contribution Plan Fractions shall not exceed 1.0 (1.4 before the TEFRA Compliance Date) . The Projected Annual Benefit shall be limited first. If the Participant's annual benefit(s) equal his Projected Annual Benefit, as limited, then Annual Additions to the defined contribution plan(s) shall be limited to the extent needed to reduce the sum to 1.0 (1.4) . First, the voluntary contributions the Participant may make for the Limitation Year shall be limited. Next, in the case of a profit sharing plan, any forfeitures allocated to the Participant shall be reallocated to remaining participants to the extent necessary to reduce the decimal to 1.0 (1.4) . Last, to the extent necessary, employer contributions for the Limitation Year shall be reallocated or limited, and any ARTICLE III 22 (66947) 7 7- required and optional employee contributions to which such employer contributions were geared shall be reduced in proportion. If, for the Limitation Year, the Participant has an Annual Addition under more than one defined contribution plan or welfare benefit fund maintained by the Employer, any reduction above shall be made first to the profit sharing plans, then to all other such plans and, if necessary, by reducing first those that were most recently established. The annual addition to the welfare benefit fund shall be limited last. SECTION 3.04--SALARY DEFERRAL LIMITATION. (a) For the purpose of determining the salary deferral limits set forth in this section, the following terms are defined: Actual Deferral Percentage means, for a group of Active Participants with respect to a Plan Year, the average of the Deferral Ratios of each of the Active Participants within such group. Deferral Ratio means, for an Active Participant with respect to a Plan Year, the amount of Salary Deferral Contributions divided by his Compensation taken into account for that Plan Year. Only Employer Contributions that satisfy the nonforfeitability and withdrawal limitations of Code Section 401(k) may be used in computing the Deferral Ratio. Highly Compensated Employee means any Active Participant who receives, with respect to the Compensation taken into account for that Plan Year, more Compensation than two-thirds of all Active Participants. (b) As of the end of any Plan Year, one of the following tests must be met: (1) 150% test. The Actual Deferral Percentage for the group of Highly Compensated Employees is not more than the Actual Deferral Per- centage for all other Active Participants multiplied by 1.5. (2) 250%-3% difference test. The Actual Deferral Percentage for the group of Highly Compensated Employees is not more than the Actual Deferral Percentage for all other Active Participants multiplied by 2.5 and the difference between the Actual Deferral Percentages is not more than 3. If one of the above tests is not met for any Plan Year, Contributions for Highly Compensated Employees shall be limited on a nondiscriminatory basis until one of the tests is met. Unless such Employee elects to receive these Contributions in a single sum, they will be considered Voluntary Contributions according to the provisions in the VOLUNTARY CONTRIBUTIONS SECTION of Article III. However, if such limited Contributions and ARTICLE III 23 (66947) C C Voluntary Contributions in combination would be more than the amount of Voluntary Contributions permitted under this Plan, the excess limited Contributions shall be returned to such Employee in a single sum. • ARTICLE III 24 (66947) I ARTICLE IV INVESTMENT OF CONTRIBUTIONS SECTION 4.01--INVESTMENT OF CONTRIBUTIONS. All Contributions are forwarded by the Employer to the Insurer to be deposited under the Group Contract. Investment of Contributions is governed by the provisions of the Group Contract. Unless restricted by the Group Contract, the parties named below shall direct the Contributions to any of the accounts available under the Group Contract and may request the transfer of assets resulting from those Contributions between such accounts. To the extent that a Participant does not direct the investment of his Account, such Account shall be invested ratably in the accounts available under the Group Contract in the same manner as the undirected Accounts of all other Participants. The Vested Accounts of all Inactive Participants may be segregated and invested separately from the Accounts of all other Participants. (a) Salary Deferral Contributions: The Participant, with the consent of the Primary Employer, shall direct the investment of Salary Deferral Contributions and transfer of assets resulting from those Contributions. ARTICLE IV 25 (66947) C ARTICLE V BENEFITS SECTION 5.01--RETIREMENT BENEFITS. On a Participant' s Retirement Date, his Vested Account shall be distributed to him according to the provisions of Article VI. SECTION 5.02--DEATH BENEFITS. If a Participant dies before his Retirement Date, his Vested Account shall be distributed according to the provisions of Article VI. SECTION 5.03--VESTED BENEFITS. An Inactive Participant's Vested Account shall be held for him until the earlier of his Retirement Date or death and shall then be applied as described in the preceding sections of Article V. However, the Participant may receive an earlier distribution under this section. Unless the Plan Administrator directs otherwise, if after a Participant ceases to be an Employee and before again becoming an Employee, his Account resulting from Employer Contributions is not more than $3,500, his Vested Account will be paid to him in a single sum. An Inactive Participant may elect to receive a distribution of his . Vested Account after he ceases to be an Employee. A distribution under this paragraph will be a retirement benefit and shall be distributed to the Participant according to the provisions of Article VI. A Participant must elect and receive any distribution of his Vested Account before he again becomes an Employee. Some or all of an Inactive Participant's Vested Account may be trans- ferred directly to the trustee, named fiduciary or insurer under the retire- ment plan of the Inactive Participant's current employer if the following requirements are met: the Inactive Participant would be eligible to receive a distribution of the amount transferred at the time the transfer is to occur; the amount transferred, if distributed to the Participant, would qualify as a rollover contribution which the Code permits to be transferred to a plan that meets the requirements of Code Section 401(a) ; the current employer's plan meets the requirements of Code Section 401(a) . The Participant must request the transfer in writing, and the trustee, named fiduciary or insurer under the plan must be willing to accept such a transfer. Such transferred amount shall be treated as a distribution under this Plan. ARTICLE V 26 (66947) SECTION 5.04--WHEN BENEFITS START. Benefits under the Plan shall begin on a Participant's Retirement Date, his death, or cessation of his active participation in the Plan, whichever applies, as provided in the preceding sections of this article. Benefits which begin before Normal Retirement Date for a Participant who became Totally and Permanently Disabled when he was an Employee shall be deemed to begin because he is Totally and Permanently Disabled. Benefits shall begin by the April 1 following the calendar year in which the Participant attains age 70 1/2 or in which he ceases to be an Employee, if later. If, before attaining age 59 1/2 or, if earlier, before becoming Disabled, a Participant receives a distribution (including a withdrawal) of any part of his Vested Account which results from deductible Voluntary Contributions, the Participant may be subject to a Federal tax penalty. The penalty will not apply to the amount of the distribution resulting from deductible Voluntary Contributions which are rolled over to a qualified plan or individual retirement plan within sixty days of the date of distribution. SECTION 5.05--WITHDRAWAL PRIVILEGES. Before he ceases to be an Employee, a Participant may withdraw that part of his Vested Account resulting from his Voluntary Contributions in accordance with the procedures and limitations set up by the Plan Administrator. Before he ceases to be an Employee, a Participant may withdraw all or any portion of his Vested Account which results from Salary Deferral Contributions in the event of undue financial hardship. The Participant' s request for a withdrawal shall include his statement that such a hardship exists and explain its nature. To qualify as a financial hardship withdrawal it must be determined that the withdrawal is to meet an immediate and heavy financial need of the Participant and the amount of the withdrawal is not reasonably available from other resources of the Participant. Examples of heavy financial need may include but not be limited to those financial needs arising on account of a college education, purchase of a principal residence and major medical expenses. The Plan Administrator will establish uniform, nondiscriminatory guidelines to use in determining if such a condition of undue financial hardship exists. The Plan Administrator's determination shall be final. The Participant has no legal or equitable right to such a withdrawal. A request for withdrawal shall be in writing on a form furnished for that purpose and delivered to the Plan Administrator before the withdrawal is to occur. ARTICLE V 27 (66947) C ARTICLE VI DISTRIBUTION OF BENEFITS SECTION 6.01--AUTOMATIC FORMS OF DISTRIBUTION. Unless a qualified election of an optional form of benefit has been made within the election period (see the ELECTION PROCEDURES SECTION of Article VI) , the automatic form of benefit payable to or on behalf of a Participant is determined as follows: (a) The automatic form of retirement benefit shall be: (1) The Normal Form for a Participant who does not have a spouse on his Retirement Date. (2) The Qualified Joint and Survivor Form for a Participant who does have a spouse on his Retirement Date. (b) The automatic form of death benefit shall be: (1) A single sum payment to the Participant' s Beneficiary for a Participant who does not have a spouse on the date of his death. (2) A Qualified Preretirement Survivor Annuity for a Participant who does have a spouse on the date of his death. The spouse may elect to start receiving the death benefit on any first day of the month on or after the Participant dies and before the date the Participant would have been age 70 1/2. If the spouse dies before benefits start, the Participant's Vested Account, determined as of the date of the spouse's death, shall be paid to the spouse's Beneficiary. SECTION 6.02--OPTIONAL FORMS OF DISTRIBUTION. The optional forms of retirement benefit may include single life annuities to the Participant, survivorship life annuities to the Participant and his Contingent Annuitant and fixed period annuities to the Participant. Unless the Plan Administrator otherwise specifies in writing, the optional annuity forms are those set out in the Group Contract or mutually agreed to in writing by the Insurer and contractholder. The Plan Administrator may not eliminate an optional form. • ARTICLE VI 28 (66947) • The Participant may also elect to receive his Vested Account in a single sum payment. This single sum payment is available only with the Plan Administrator's consent. A single sum payment shall not be made before the Participant's Normal Retirement Age if the Participant is an Employee. Any form of distribution for a retirement benefit must meet the following limitations: (a) The Contingent Annuitant shall be the Participant's spouse or, on the date benefit payments are to begin, the present value of the amount to be paid to the Participant while living shall be greater than fifty percent of the total benefit to be paid to the Participant and the Beneficiary or, if applicable, the Contingent Annuitant. (b) An interest only optional form is not available. (c) The entire interest of the Participant shall be distributed either (1) over the life of the Participant or over the lives of the Participant and an individual named as his Beneficiary or Contingent Annuitant or (2) over a period not extending beyond the life expectancy of the Participant or the life expectancies of the Participant and such named Beneficiary. If the Qualified Joint and Survivor Form is in effect according to the provisions of the AUTOMATIC FORMS OF DISTRIBUTION SECTION of Article VI, the Participant's spouse is deemed to be his named Contingent Annuitant. (d) If the Participant dies after benefit payments begin and before his entire interest has been distributed, the form of distribution in effect before his death may continue unchanged. If the form of distribution is changed, the Participant' s remaining interest shall be distributed at least as rapidly as under the form of distribution in effect before the Participant died. The optional forms of death benefit are a single sum payment and any annuity that is an optional form of retirement benefit. If the Participant dies before beginning to receive a distribution of his retirement benefits, any form of distribution for a death benefit must meet the following limitations: (e) If the Participant did not name an individual as his Beneficiary to receive any death benefit payable under the DEATH BENEFITS SECTION of Article V, such death benefit shall be distributed within five years of the Participant's death. (f) If the Participant named an individual as Beneficiary to receive any death benefit payable under the DEATH BENEFITS SECTION of ARTICLE VI 29 (66947) (— Article V, such death benefit may be distributed over the life (or over a period not extending beyond the life expectancy) of such individual. Payment to the Beneficiary must begin within one year of the Participant's death. If such individual is the Participant's surviving spouse, payments need not begin until the date the Participant would have been 70 1/2. If the Participant's surviving spouse dies before such payments begin, then the provisions of (e) and (f) shall be applied to the spouse's Beneficiary as if the spouse were the Participant. Payments to a child shall be treated as though made to the surviving spouse if the payments will be made to the spouse when the child reaches the age of majority. If a death benefit in the form of a Qualified Preretirement Survivor Annuity is payable, the Participant's spouse is deemed to be his named Beneficiary. Any annuity contract distributed shall be nontransferable. A form of distribution for retirement or death benefits shall be available to a Participant or Beneficiary only if the annual distribution under such form is at least equal to the quotient of the Participant's Vested Account as of the date distribution is to begin, divided by the life expectancy of the Participant, Beneficiary or joint and last survivor expectancy of the Participant and Beneficiary, as appropriate. If distribu- tion is in a form other than a life annuity, the life expectancy of the Participant (and/or Beneficiary, if the spouse is the Beneficiary) may be recalculated after distribution begins, but no more frequently than annually. The life expectancy or joint and last survivor expectancy shall be computed by use of the return multiples contained in Section 1.72-9 of the regulations under the Code. The limitations described in subsections (c) through (f) above shall not apply before the first Yearly Date in 1985. SECTION 6.03--ELECTION PROCEDURES. The Participant, Beneficiary, or spouse shall make any election under this section in writing. The Plan Administrator may require such individual to complete and sign any necessary documents as to the provisions to be made. Any election shall be subject to the following provisions of this section. (a) Retirement Benefits. A Participant may elect his Beneficiary or Contingent Annuitant and may elect to have retirement benefits distributed at any time under any of the optional forms of retirement benefit described in the OPTIONAL FORMS OF DISTRIBUTION SECTION of Article VI. The Participant's election period is the ninety-day period ending on the date benefits begin. ARTICLE VI 30 (66947) (b) Death Benefits. A Participant may elect his Beneficary and may elect at any time to have death benefits distributed under any of the optional forms of death benefit described in the OPTIONAL FORMS OF DISTRIBUTION SECTION of Article VI. A Participant who does not have a spouse may make an election at any time. If the Participant has not elected an optional form of distribution for the death benefit payable to his Beneficiary, the Beneficiary may, for his own benefit, elect the form of distribution, in like manner as a Participant. The Beneficiary's electio❑ period begins on the date the Participant dies and ends on the date benefits begin. The spouse may, for his own benefit, elect to have the death benefit distributed under any of the optional forms of death benefit described in the OPTIONAL FORMS OF DISTRIBUTION SECTION of Article VI. The spouse's election period begins on the date the Participant dies and ends on the date benefits begin. (c) Qualified Election. The Participant, Beneficiary or spouse may make an election at any time. The Participant, Beneficiary, or spouse may revoke the election made (or make a new election) at any time before benefits begin. ARTICLE VI 31 (66947) I ARTICLE VII TERMINATION OF PLAN The Employer expects to continue the Plan indefinitely but reserves the right to terminate the Plan in whole or in part at any time upon given written notice to all parties concerned. Complete discontinuance of Contributions under the Plan constitutes complete termination of Plan. The Account of each Participant shall be fully (100%) vested and nonforfeitable as of the effective date of complete termination of Plan. The Account of each Participant who becomes an Inactive Participant because he is no longer an Eligible Employee due to partial termination of the Plan shall be fully (100%) vested and nonforfeitable as of the effective date of the partial Plan termination. The Inactive Participant's Account shall continue to participate in the earnings credited, expenses charged and any appreciation or depreciation of the Investment Fund until the Vested Account is distributed. It may be distributed to the Participant after the effective date of the complete or partial Plan termination. Upon complete termination of Plan, no more Employees shall become Participants and no more Contributions shall be made. The assets of this Plan shall not be paid to the Employer at any time, except that, after the satisfactio❑ of all liabilities under the Plan, any assets remaining may be paid to the Employer. The payment may not be made if it would contravene any provision of law. ARTICLE VII 32 (66947) ARTICLE VIII ADMINISTRATION OF PLAN SECTION 8.01--ADMINISTRATION. Subject to the provisions of this article, the Plan Administrator has complete control of the administration of the Plan. The Plan Administrator has all the powers necessary for it to properly carry out its administrative duties. Not in limitation, but in amplification of the foregoing, the Plan Administrator has the power to construe the Plan and to determine all questions that may arise under the Plan, including all questions relating to the eligibility of Employees to participate in the Plan and the amount of benefit to which any Participant, Beneficiary, spouse or Contingent Annuitant may become entitled. The Plan Administrator' s decisions upon all matters within the scope of its authority shall be final. Unless otherwise set out in the Plan or Group Contract, the Plan Administrator may delegate recordkeeping and other duties which are necessary to assist it with the administration of the Plan to any person or firm which agrees to accept such duties. The Plan Administrator shall be entitled to rely upon all tables, valuations, certificates and reports furnished by the consultant or actuary appointed by the Plan Administrator and upon all opinions given by any counsel selected or approved by the Plan Administrator. The Plan Administrator shall receive all claims for benefits by Participants, former Participants, Beneficiaries, spouses, and Contingent Annuitants. The Plan Administrator shall determine all facts necessary to establish the right of any claim to benefits and the amount of those benefits under the provisions of the Plan. The Plan Administrator may establish rules and procedures to be followed in filing claims for benefits, in furnishing and verifying proofs necessary to determine age, and in any other matters required to administer the Plan. SECTION 8.02--RECORDS. All acts and determinations of the Plan Administrator shall be duly recorded. All these records, together with other documents necessary for the administration of the Plan, shall be preserved in the Plan Administrator's custody. Writing (handwriting, typing, printing) photostating, photographing, microfilming, magnetic impulse, mechanical or electrical recording or other forms of data compilation shall be acceptable means of keeping records. ARTICLE VIII 33 (66947) SECTION 8.03--INFORMATION AVAILABLE. Any Participant in the Plan or any Beneficiary may examine copies of the Plan description, latest annual report, any bargaining agreement, this Plan, the Group Contract or any other instrument under which the Plan was established or is operated. The Plan Administrator shall maintain all of the items listed in this section in its office, or in such other place or places as it may designate in order to comply with governmental regulations. These items may be examined during reasonable business hours. Upon the written request of a Participant or Beneficiary receiving benefits under the Plan, the Plan Administrator will furnish him with a copy of any of these items. The Plan Administrator may make a reasonable charge to the requesting person for the copy. SECTION 8.04--UNCLAIMED VESTED ACCOUNT PROCEDURE. If a Participant, his spouse or his Beneficiary fails to claim the Participant's Vested Account, the Vested Account may be forfeited and applied according to the forfeiture provisions of Article III. If Article III contains no forfeiture provisions, such amount will be applied to reduce the earliest Employer Contributions due after the forfeiture arises. A forfeiture of an unclaimed Vested Account shall not occur until the date six months after the date the Participant, spouse or Beneficiary is notified, by certified or registered mail addressed to his last known address, that he is entitled to a benefit. If within six months after the date the notice is mailed, the Participant, spouse or Beneficiary has not claimed the Vested Account or made his whereabouts known in writing, the Plan Administrator may treat the Vested Account as a forfeiture under this section. If a Participant's Vested Account is forfeited according to the provisions of the above paragraph and the Participant, his spouse or his Beneficiary at any time make a claim for benefits, the forfeited Vested Account shall be reinstated, unadjusted for any gains or losses occurring after the date it was forfeited. The reinstated Vested Account shall then be distributed to the Participant, spouse or Beneficiary according to the preceding provisions of the Plan. ARTICLE VIII 34 (66947) C (- ARTICLE IX GENERAL PROVISIONS SECTION 9.01--AMENDMENTS. The Employer may amend this Plan at any time, including any remedial retroactive changes (within the specified period of time as may be determined by Internal Revenue Service regulations) to comply with the requirements of any law or regulation issued by any governmental agency to which the Employer is subject. No amendment shall decrease a Participant's Account or eliminate an optional form of distribution or diminish or adversely affect any accrued interest or benefit of Participants or their Beneficiaries nor allow reversion or diversion of Plan assets to the Employer at any time, except as may be necessary to comply with the requirements of any law or regulation issued by any governmental agency to which the Employer is subject. SECTION 9.02--PROVISIONS RELATING TO THE INSURER. The obligations of the Insurer shall be governed solely by the provisions of the Group Contract. The Insurer shall not be required to perform any act not provided in or contrary to the provisions of the Group Contract. The Insurer is not a party to the Plan, nor bound in any way by the Plan provisions. It shall not be required to look to the terms of this Plan, nor to determine whether the Employer or the Plan Administrator have the authority to act in any particular manner or to make any contract or agreement. Until notice of any amendment or termination of this Plan has been received by the Insurer at its home office, the Insurer is and shall be fully protected in assuming that the Plan has not been amended or terminated according to the latest information which it has received at its home office. SECTION 9.03--EMPLOYMENT STATUS. Nothing contained in this Plan gives an Employee the right to be retained in the Employer's employ or to interfere with the Employer' s right to discharge any Employee. ARTICLE IX 35 (66947) C SECTION 9.04--RIGHTS TO PLAN ASSETS. No Employee shall have any right to or interest in any assets of the Plan upon termination of his employment or otherwise except as specifically provided under this Plan, and then only to the extent of the benefits payable to such Employee in accordance with Plan provisions. Any final payment or distribution to a Participant or his legal representative or to any Beneficiaries, spouse or Contingent Annuitant of such Participant under the Plan provisions shall be in full satisfaction of all claims against the Plan, the Plan Administrator, the Insurer, and the Employer arising under or by virtue of the Plan. SECTION 9.05--BENEFICIARY. Each Participant may name a Beneficiary to receive any death benefit (other than any income payable to a Contingent Annuitant) that may arise out of his participation in the Plan. The Participant's Beneficiary designation shall be subject to the ELECTION PROCEDURES SECTION of Article VI. He may change his Beneficiary from time to time without the Beneficiary's consent. It is the responsibility of the Participant to give written notice to the Insurer of the name of his Beneficiary on a form furnished for that purpose. With the Employer's consent, the Plan Administrator may maintain records of Beneficiary designations for Participants before their Retirement Dates. In that event, the written designations made by Participants shall be filed with the Plan Administrator. If a Participant dies before his Retirement Date, the Plan Administrator shall certify to the Insurer the Beneficiary designation on its records for the Participant. If, at the death of a Participant, there is no Beneficiary named or surviving, any death benefit under the Group Contract shall be paid under the applicable provisions of the Group Contract. SECTION 9.06--NONALIENATION OF BENEFITS. Benefits payable under the Plan are not subject to the claims of any creditor of any Participant, Beneficiary, spouse or Contingent Annuitant. A Participant, Beneficiary, spouse or Contingent Annuitant does not have any rights to alienate, anticipate, commute, pledge, encumber or assign any of such benefits. The preceding sentences shall also apply to the creation, assignment, or recognition of a right to any benefit payable with respect to a Participant according to a domestic relations order, unless such order is determined by the Plan Administrator to be a qualified domestic relations order, as defined in Code Section 414(p) , or any domestic relations order entered before January 1 , 1985. ARTICLE IX 36 (66947) SECTION 9.07--FACILITY OF PAYMENT. If any Participant, Beneficiary, spouse or Contingent Annuitant is physically or mentally incapable of giving a valid receipt for any payment due him and no legal representative has been appointed for such person, the Plan Administrator may direct the Insurer to make such payment to any person or institution maintaining such Participant, Beneficiary, spouse or Contingent Annuitant. The payment to such person or institution shall be a valid and complete discharge of any liability for the making of such payment under the provisions of the Plan. SECTION 9.08--CONSTRUCTION. The validity of the Plan or any of its provisions is determined under and construed according to Federal law and, to the extent permissible, according to the laws of the state in which the Employer has its principal office. In case any provision of this Plan is held illegal or invalid for any reason, such determination shall not affect the remaining provisions of this Plan, and the Plan shall be construed and enforced as if the illegal or invalid provision had never been included. In the event of any conflict between the provisions of the Plan and the terms of any contract or policy issued hereunder, the provisions of the Plan control. SECTION 9.09--LEGAL ACTIONS. The Plan and the Plan Administrator are the necessary parties to any action or proceeding involving the assets held with respect to the Plan or administration of the Plan. No person employed by the Employer, no Participant, former Participant or their Beneficiaries or any other person having or claiming to have an interest in the Plan is entitled to any notice of process. A final judgment entered in any such action or proceeding shall be binding and conclusive on all persons having or claiming to have an interest in the Plan. SECTION 9.10--MODIFICATION IN MODE OF PAYMENT. Unless the Plan Administrator elects otherwise, if the Participant' s Vested Account is not more than $3,500 on his Retirement Date (the date a distribution of his entire Vested Account is made under the VESTED BENEFITS SECTION of Article V, if earlier) , it shall be paid to him in a single sum in full settlement of all benefits otherwise payable. If benefits become payable to a Beneficiary or Contingent Annuitant due to a Participant' s death after his Retirement Date, and the present value of such benefit on the date such benefit becomes payable is not more than $3•,500, such present value shall be paid to the Beneficiary or Contingent Annuitant in a single sum in full settlement of all benefits otherwise payable. Such present value shall be determined under the provisions of the Group Contract. ARTICLE IX 37 (66947) (7 SECTION 9.11--WORD USAGE. The masculine gender, where used in this Plan, shall include the feminine gender and the singular words as used in this Plan may include the plural, unless the context indicates otherwise. SECTION 9.12--QUALIFICATION OF PLAN. The Employer intends to apply for an advance determination letter from the Internal Revenue Service for the initial qualification of the Plan. If this Plan is denied initial qualification, it will terminate. The Employer shall give written notice to the Insurer of the denial in sufficient time so the assets resulting from Contributions which were conditioned on initial qualification of the Plan may be returned within one year after the date of denial. The Employer shall notify the Insurer that the Group Contract is to be terminated. The Plan assets which result from Employer Contributions and Participant Contributions shall be returned to the Employer and Participants, respectively. The Plan Administrator and the Named Fiduciary shall then be discharged from all obligations under the Plan and the Insurer shall be discharged from all obligations under the Group Contract. Employer Contributions are conditioned upon qualification of the Plan as amended. The portion of the Plan assets resulting from those Contributions (but not more than the original amount of those Contributions) may be returned to the Employer if the Plan as amended fails to qualify under the Code. The Contributions must be returned to the Employer within one year after the date the Plan's requalification is denied, provided the amendment to the Plan is submitted to the Internal Revenue Service for qualification within one year after the date the amendment is adopted. / ARTICLE IX 38 (66947) J Hello