HomeMy WebLinkAbout921085.tiff RESOLUTION
RE: APPROVE LETTER AGREEMENT WITH GREAT-WEST LIFE AND ANNUITY INSURANCE
COMPANY AND AUTHORIZE 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, the Board has been presented with a Letter Agreement between the
Great-West Life and Annuity Insurance Company and the County of Weld, State of
Colorado, with the terms and conditions being as stated in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said
agreement, a copy of which is attached hereto and incorporated herein by
reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Letter Agreement between the Great-West Life and
Annuity Insurance Company and the County of Weld, State of Colorado be, and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 16th day of November, A.D. , 1992.
I) BOARD OF COUNTY COMMISSIONERS
ATTEST: a t fi ,' ; ° " ' WELD COUNTY, COLORADO
Weld County Clerk to the Board
Geoo e Kenn y, airman
BY: "OC -•,-x-1 /dxco�,::Y� �f�
Deputy Cle to the Board Constance L. Harbert, Pro-Tem
APPROVED AS T FORM:
C. W. Kirby
County Attorney Gordo
;),
W. H. Webster
n 921085
PICnn/ �--
LEI l'ER AGREEMENT
Attached to and Forming Part of
The Group Deferred Compensation Annuity Contract
It is agreed to by the Great-West Life & Annuity Insurance Company (herein
called the "Insurance Company") and the County of Weld, State of Colorado
(herein called the "Group Policyholder") that the following modifications and
clarifications of the group annuity contract, group policy number 88041,
issued by the Insurance Company shall remain in effect for the period of time
noted herein. This Letter Agreement Supersedes and replaces any other
previous Agreement, Rider or representation(s) .
1. For the term of the Group Annuity Contract, the Contingent Deferred
Sales Charge described in Section 9.2 will be modified. The new Section
9.2 of the contract will read as follows:
9.2 Lump Sum Distributions
On any total or partial lump sum distribution of the Participant Annuity
Account at age 70 1/2, separation from service or due to an
unforeseeable emergency, a Contingent Deferred Sales Charge will be
deducted from the amount distributed. The Contingent Deferred Sales
Charge will be equal to a percentage of the amount distributed in excess
of the Contingent Deferred Sales charge Free Amount, if any, based on
the sum of Sections a and b below.
a. The Contingent Deferred Sales Charge applicable to any Lump Sum
Distribution relating to Deposits under this Contract (excluding
any Conversion Deposit, as defined below) will be equal to 6% of
the amount surrendered. This portion of the Contingent Deferred
Sales Charge is limited so that the amount then charged will not
cause the cumulative total of all Contingent Deferred Sales
charges charged under this section to exceed 6% of the Deposits
made to his/her Participant Annuity Account (excluding Conversion
Deposits) with 72 months prior to the effective date of the Lump
Sum Distribution. Notwithstanding the immediately preceding two
sentences, for purposes of this Section 1(a) , if the number of
years of coverage of a Participant under the FutureFunds contract
and this Contract is at least 15 years, there will not be a
contingent Deferred Sales Charge deducted in accordance with the
provisions of this Section 1(a) .
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b. The Contingent Deferred Sales Charge applicable to any Lump Sum
Distribution relating to any Conversion Deposit, if any, will be
an amount which is the result of multiplying the amount of any
Conversion Deposit surrendered by the appropriate percentage as
chosen from the table below. For purposes of this section, a
Conversion Deposit is defined as the amount Deposited into this
Group Annuity Contract from the Great-West Life Assurance Company
Group Deferred Compensation Annuity Contract (the "Previous
Contract") .
Number of Years of
Coverage of Participant
Under Previous Contract,
FutureFunds Contract The Percentage of the
and This Contract Amount Surrendered Shall Be
Less Than 5 Years 6%
At Least 5 Years,
But Less Than 10 Years 5%
At Least 10 Years 4%
2. For the term of the Group Annuity Contract, the Contingent Deferred
Sales Charge "Free Amount" Section of the contract, Section 9.3, will
be modified. The new Section 9.3 of the contract will read as follows:
9.3 Contingent Deferred Sales Charge Free Amount
The Contingent Deferred Sales Charge "Free Amount" applicable to any
total or partial Lump Sum Distribution relating to an unforeseeable
emergency is equal to 10% of the Participant Annuity Account Value at
December 31 of the calendar year prior to the year in which the amount
is distributed.
The Contingent Deferred Sales Charge Free Amount is only applicable to
an unforeseeable emergency, as defined under the terms of the Group
Policyholder's Plan. Only one Contingent Deferred Sales Charge "Free
Amount" is available on behalf of a Participant in each calendar year.
The Contingent Deferred Sales Charge "Free Amount" will be applied on
the first unforeseeable emergency made under the Participant Annuity
Account in that year.
3. Notwithstanding anything in this Agreement to the contrary, this Letter
Agreement shall remain in effect only as long as the Insurance company
is a funding provider for the Group Policyholder Plan.
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Upon termination of this Letter Agreement for any reason, all fees and
charges waived or reduced hereunder may, at the option of the Insurance
Company, again become effective from the date of termination forward.
COUNTY OF WELD, STATE OF COLORADO
By: � November 16, 1992
G orge Ke nedy, Cairman /18/92 (Date)
W Couryty o of ommissioners
ATTEST14 j
By:
e d County �CClerk to B and
By: .(l l �/� grdiL�%'
Deputye k GREATemsST LIFE rANNUITY INSURANCE COMPANY
By:
(Date)
3 pp
Q 03-
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY
HOME OFFICE - ENGLEWOOD, COLORADO
ADMINISTRATIVE OFFICES
ENGLEWOOD, COLORADO
GROUP POLICYHOLDER County of Weld, State of Colorado
GROUP POLICY NUMBER 88041
GROUP ANNUITY CONTRACT DATE
Group Deferred Compensation Annuity, Non-Participating
The provisions on the following pages, together with the Application for this Group Annuity
Contract, are part of this Group Annuity Contract.
For the purposes of this Group Annuity Contract, "Plan" means the plan and adoption agreement
that the Group Policyholder has designated as the County of Weld, State of Colorado.
Signed for the Great-West Life & Annuity Insurance Company on the issuance of the Group
Annuity Contract on the Annuity Contract Date.
Vice President & Secretary President
For the Actuary
This Group Annuity Contract is a legal contract between the Group Policyholder and the Great-
West Life&Annuity Insurance Company. PLEASE READ THIS ANNUITY CONTRACT CAREFULLY.
IT IS A CONTRACT WHICH MAY PROVIDE FOR PAYMENTS OR VALUES WHICH ARE NOT
GUARANTEED AS TO FIXED-DOLLAR AMOUNT BUT MAY INCREASE OR DECREASE
ACCORDING TO THE INVESTMENT EXPERIENCE OF A VARIABLE ANNUITY ACCOUNT.
Group Deferred Compensation Annuity
GDC990FFSII
APPLICATION FOR GROUP DEFERRED COMPENSATION ANNUITY CONTRACT
Exact Name: County of Weld, State of Colorado
(herein called the Group Policyholder) applies to Great-West Life &Annuity Insurance Company
for a Group Deferred Compensation Annuity Contract (herein called the Group Annuity
Contract) in the form of the copy attached to this Application. It is agreed that the Group
Policyholder will accept the Group Annuity Contract when issued.
Specify the effective date of the Group Annuity Contract:
(which is not earlier than the first day of the year in which this Application has been made)
Specify the name of the Deferred Compensation Plan: County of Weld, State of Colorado
Deferred Compensation Plan
This Group Annuity Contract is only available to policyholders whose Deferred Compensation
Plan is an eligible State deferred compensation plan described in Section 457(b) of the Internal
Revenue Code of 1954, as amended.
The Insurance Company requires that a copy of the currently effective plan document accompany
this application, for its information.
PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT MAY INCREASE OR
DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
Group Policyholder's address Weld County Board of Commissioners
915 10th Street; P.O. Box 758, Greeley, Colorado 80632
Dated at Greeley, Colorado, this 16th day of November , 19 92
County of Weld, State of Colorado
Agent/Broker
Name of Group Policyholder
By
Signature 11/1 2
Chairman, Weld County Board of Commissioners
Title
Application
Group Deferred Compensation Annuity
G620
TABLE. OF CONTENTS
SEC 0N CEriNITIONS . Pay?
SECTION 2. OWNERSHIP PROVISIONS
2 1 Ownership of Series Account 9
2.2 Ownersnip of Group Annuity Contract
2.3 Transfer and Assignment 3
SECTION 3. GENERAL PROVISIONS
3.1 The Group Annuity Contract
3.2 Entire Contract
3.3 The Plan 10
3.4 Non-Participating 1,
3.5 Currency and Payment of Deposits 13
3 5 Age 1
3.7 Voting Rights and Reports 41
3.8 Notice and Proof 12
SECTION 4. PURCHASE PROVISIONS
4 1 Commencement and Termination of Coverage "3
4.2 Deposits 13
4 3 Allocation of Deposits 13
SECTION 5. CONTRACT VALUE PROVISIONS
5.1 Variable Contract Value la
5.2 Accumulation Unit 14
5.3 Accumulation Unit Value 14
5.4 Annuity Unit Value 15
5.5 Risk Charge 15
5.6 Net Investment Factor 15
5.7 Guaranteed Contract Value 16
5.8 Guaranteed Sub-Account Riders 16
5.9 Contract Maintenance Charge 17
TABLE CF CONTENTS (Cantnuec
SEC CN 6. 7PANSFEPS
. Q
5 1 Transfers ' 9
6.2 Transfer Terms 6
6 3 intra-Company Transfers 13
6.4 Transfers to Other Companies . 3
6.5 Plan-To-Plan Transfers . 9
6.6 Transfers To The Company .9
6.7 Non-Taxable Distribution
SECTION 7. DISTRIBUTIONS TO A BENEFICIARY
20
7.1 Death of Participant after Annuity Commencement Cate 20
7.2 Death of Participant before Annuity Commencement Cate 21
7 3 Amount Payable On Death Of Participant 21
7,4 Requests for Distributions
SECTION 8. DISTRIBUTIONS TO A PARTICIPANT
22
8.1 Requests for Distributions 22
8.2 Distribution at age 70 1/2. or Separation From Service 22
8.3 Distribution Due to Unforeseeable Emergency 23
8.4 Amount Payable on Distribution 23
8.5 Conditions of Payment 23
8.6 Adequate Proof
SECTION 9. CONTINGENT DEFERRED SALES CHARGE
24
9.1 Transfers 24
9.2 Lump Sum Distributions 24
9.3 Contingent Deferred Sales Charge Free Amount"
SECTION 10. PAYMENT OPTIONS
25
10.1 Selection of Payment Options 25
10.2 How to Elect Payment Options 25
10.3 Variable Dollar Payment Options 26
10.4 Fixed Dollar Payment Options
TABLE CF CCNTENTS (Continued)
_ECTCN 1 t C NTRACT MCCIFICATION
11 1 Contract Modification 31
11 2 Modification of Taoles 31
11 3 Modification of Guaranteed Sub-Account Riders, if Any 31
11.4 Modification of Variable and/or Guaranteed Sub-Account 31
Riders. if Any
SECTION 12. CESSATION OF DEPOSITS
12.1 Cessation of Deposits 32
12.2 Options of Date of Cessation of Deposits 32
33
TABLE A 33
TABLE 8 34
3r
TABLE C
TABLE D 37
6
TABLE E
GUARANTEED SUB-ACCOUNT RIDERS, IF ANY
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921035
SECON ^==:NI—IONS
Accumulation Period - the :enc.; wricr the Par:c,cant is cc._ e:
unbar this Group Annuity Contract to :re
Participant s Annuity
Commencement Cate.
Accumulation Unit - an accounting measure used to deterrr.re :re
Vanacte Contract Vaiue cefore :re
Commencement Cate.
Administrative Offices - 8505 East Orchard Road, Englewood. Ccicradc
80111 .
Annuitant the person upon whose life the payment of an
annuity is cased.
Annuity Commencement Date - the date on which annuity payments commence
under a payment option, which for any Partic,oart
is the date required under the Group Policynoicer s
Plan. Notwithstanding the immediately prececirg
sentence, the Participant's Annuity commencement
Date will never be later than April 1 of the calencar
year following the calendar year in wnicn :ne
Participant attains the later of:
A. Age 70 1/2, or
B. Separation from service.
Annuity Payment Period - the period during which the Participant is covered
under this Group Annuity Contract after the
Participant's Annuity Commencement Cate.
Annuity Unit an accounting measure used to determine the dollar
value of any Variable Dollar Annuity Payment after
the first annuity payment is made.
Company - the Great-West Life & Annuity Insurance Company.
5
SEC .CN 1 .,_F NI''.CNS (continued)
:eccs;t induces ccntr:cutions. transfers and carer ar-c is
deposited into Guaranteed or vanac.e
Suc-Accounts.
:igible Fund • a registered management investment comoany n
which the assets of the Series Account .'ray be
invested.
Group Annuity Contract Date the effective date indicated by the Grouo
Policyholder on the Application for this Grcuo
Annuity Contract, or such otner date wnicn is
acceptable to the Company.
Group Policynolder • the employer of a Participant and the applicant `or
this Group Annuity Contract.
Guaranteed Account - the portion of this Group Annuity Contract providing
Guaranteed Sub-Accounts, each having a
Guaranteed Interest Rate and containing fixed dollar
amounts.
Guaranteed Contract Value - the sum of the values of the Guaranteed
Sub-Accounts credited to the Group Policynolder in
respect of a Participant under a Participant Annuity
Account.
Guaranteed Interest Rate - the minimum interest rate applicable to Guaranteed
Sub-Accounts which on an annual effective basis is
4%.
Guaranteed Sub-Account - a subdivision of the Guaranteed Account having a
Guaranteed Interest Rate. This subdivision is
described in greater detail in the attached
Guaranteed Sub-Account Riders, if any.
Investment Division - a division of the Series Account containing the
shares of a specific portfolio of the Eligible Fund.
There is an Investment Division for each portfolio of
the Eligible Fund.
6
_EC— cN __='V',-CNS iccrt:nueci
intra-Compary Transfer - amounts moved within arc between :re curerr:
offered Varapie and Guaranteed Suc-Acco..r:s
upon eacn Written Reeuest of :ne Gr__c
Poiicjnoicer on oenail of me Participant.
Letter Agreement - a formal written agreement signed by the Ccrpary
and Me Group Policyholder wnicn is used :o c.ar_y
or modify certain provisions of the Contract arc wi I
be attached to and form a part of tms Gruc
Annuity Contract.
Participant - an employee who has met the eiig,cIi ty
recwrements under the Plan and for whom :re
Greco Policyholder has applied for coverage.
Participant Annuity Account - a secarate record in the name of each Participant
wnucn reflects the total of the Guaranteed and
Variacie Contract Values.
Participant Annuity Account Value - the sum of the Variable and Guaranteed Contract
Values :recited to the Group Policyholder in respect
of a Participant under a Participant Annuity Account.
Participant Effective Date the date on which the first Deposit is credited to a
Participant Annuity Account.
Payee - the Group Policyholder or the person. including the
Participant. designated to receive the value of the
Participant Annuity Account.
Plan - the :ndertymg plan document of the Group
Poucmcroer written in accordance with Section 457
of the rternal Revenue Code. Although the
Company may have knowledge of certain provisions
of the a'an. the legal sufficiency of the Plan remains
sorery the responsibility of the Group Policyholder.
Shows any provisions of the Plan and this Contract
be in conflict, the provisions of this Contract snail
prevail
7
924 035
-.,, c,njhi;N !continued!
F -c-Plan Transfer - amounts moved from any Variacie or G..arantees
- an Sub-Account to another eligible deterred
comoensation plan uoon Written Request from ire
Group Policyholder on Denali of a Parttcccant.
Premium Tax - the amount of tax. A any, charged by a state or
other governmental authority on premiums.
the FutureFunds Series II Account, a segregates
Series Account investment account established by Great-Nest Lfe
3 Annuity insurance Company under Colorado Jaw.
Transfer to Other Companies - amounts moved from any Variable or Guaranteed
S,u.c-Account to another company upon eac❑
Written Request from the Group Policyholder on
tenart of the Participant.
Valuation Date a date on which the net asset value of each
ig cie Fund is determined.
Valuation Period
tre period between successive Valuation Cates.
Variable Contract Value - the sum of the values of the Variable
inSub-Accounts
s
created to the GroupPolicyholder
Participant under a Participant Annuity Account.
Variable Sub-Account - a sub-division of an Investment Division which
separates Deposits received under tax qualified
arrangements from those received under non-tax
h able'as isd arrangements.
nAccumulator Unitrrand Annuity Unit
Value
Written Request ary request in written form, satisfactory to the
Company and received by the Company at its
Administrauve Office, from the Group Policyholder.
the Participant, or their designee as required by any
provision of this Group Annuity Contract. d any, and
at other times as required by the Company. A form
or direction in lieu of the Written Request may be
accepted by the Company in its sole discretion.
8
r *!N=CI-:,p =CV'!CI�VS
2 -
.n^ers ,.( Ser'�s AJ CUr
he Company has absolute ownersnip of the assets of ;re genes Account.
2 2 Cwrersn,c of 3roup Annuity Ccntract
Upon the Group Policyholder's Application for this Group Annuity Contract. the 3rc_c
Policyholder becomes the owner of the Group Annuity Contract. It alone nas au r.;nts
remedies and recourses given in the Group Annuity Contract. and, while tre
Annuity Contract and the Participant Annuity Accounts are held in respect of Participants
there is no contractual relationship between the Company and the Participants. While tre
Group Policyholder may request the opinion of the Participant on matters ara
transactions affecting the Participant Annuity Account, the Group Policyholder may act
according to the dictates of its own judgment and discretion.
Subject to the Plan participation provisions, each employee for whom Deposits have teen
made is a Participant for whom a Participant Annuity Account is kept.
2.3 Transfer and Assianment
The interest of the Group Policyholder in this Group Annuity Contract may not be
transferred, sold, assigned, pledged, charged, encumbered, or in any way alieratad
without the prior written consent of the Company.
9
32:03.5
SEC-70N 3 -N E=A oaCVIS:CNS
�c ��- L
z,r -- GrCUP
ar :tv Ccrr as
The Group Annuity Contract is issued by the Company to the Group Policyrcicer
3.2 E-t re Contract
This Group Annuity Contract. its Application,Tables, Guaranteed Sub-Account Piders arc form the entire contract between the Paiicincicer
an Letter ompany.nA copyif any, the Application is attached to the Group Annuity Contract
and the Company. A PP
when issued to the Group Policyholder.
After issue. modifications to the Group Annuity Contract under the Contract Mcai ication
provisions become part of the Group Annuity Contract.
All statements in the Application, in the absence of fraud, have been accepted as
representations and not as warranties.
Only the President, a Vice-President. or the Secretary of the Company can modify or
waive any provisions of the Group Annuity Contract.
3.3 The Plan •
The terms and provisions of the Plan do not for any purpose form any part of this Group
Annuity Contract and are not binding on the Company.
Notwithstanding the fact that the Company may have knowledge of the terms of the Plan.
the obligations of the Company are measured and determined solely by the terms and
provisions of this Group Annuity Contract.
3.4 Non-Particioatina
This Group Annuity Contract is non-participating, meaning that it is not eligible to share
in the Company's divisible surplus.
3.5 rrencv and Payment of Deposits
All amounts to be paid to or by the Company must be in the currency of the United
States of America. All Deposits to this Group Annuity Contract must be made payable
to the Company or its designated agent.
10
921035
SE:710N 3 _N_ s' L =r0Vlc:'Nc continued)
3 6' '_
If the age of the Participant or Payee has been misstated. the cayments estac Isrec for
ner urger me Particpant Annuity Account will be made on the oasis of hns,her cor•ac
age.
If payments were too large because of misstatement, the difference with interest rcav oa
deducted by the Company from the next payment or payments. ti payments «ere top
small, the difference with interest may be added by the Company to the next payr^ert.
This interest will be not less than 4% per year.
3.7 Voting Rights and Reports
The Company will vote the shares of an Eligible Fund held in a Variable Sub-Account of
the Investment Division of the Series Account. To the extent required by law, the
Company will vote according to the instructions of the Group Policyholder in proportion
to its interest in the Variable Sub-Account. In such event, the Company will send proxy
materials and form(s) to the Group Policyholder for its reply. If no reply is receivedi. the
Company will vote shares of the appropriate Eligible Fund in the same proportion as
snares of the Eligible Fund for which replies have been received.
During the Annuity Payment Period under the Participant Annuity Account. the numcer
of votes will decrease as the assets held to fund annuity payments decrease, the Payee
will be entitled to receive the proxy materials and form(s) otherwise provided to the Goruo
Policyholder, and all other provisions concerning Voting Rights will apply to the Payee of
a Variable Dollar Method of Payment Option.
The Company will furnish the Group Policyholder or the Payee of a Variable Dollar
Method of Payment Option copies of any shareholder reports of the Eligible Funds and
of any other notices, reports or documents required by law to be furnished to either of
them.
Semi-annual reports of the Eligible Funds will be furnished as required by law to the
Group Policyholder, who shall promptly deliver them to each Participant or Payee of a
Variable Dollar Method of Payment Option. The Company will furnish the Group
Policyholder not less frequently than annually a statement of each Participant's Participant
Annuity Account Value, which the Group Policyholder will promptly deliver to the
Participant. The Group Policyholder may direct the Company to deliver these reports and
statements to the Participants.
11
32:035
SECT 'N a. GcNEL oECVISICNS (continued)
`.C 9 arC orcof
Any notice or demand by the Company to or upon the Group Policrnolder or any °avee
may be given by mailing it to that person's last known address as stated in tre
Company s file.
An application, report, request. election, direction. notice or demand by the Group
Policyholder or Payee will be made in a form satisfactory to the Company. When the
Company requires it. the Group Policyholder will obtain the signature of the Participant s
or Payee's spouse on forms provided by the Company.
The Company may require adequate proof of the age and death of any Payee before it
admits a claim for or pays any payment.
Written materials developed by
by the
r Com
pany.
Policyholder cy to describe this Group Annwry
Contract must first be approved
12
92:035
4 =� _.:AC d('V'. 0NS
.. e
n , t aro' —er^- ^olio cifCovera e
The Grouo Policyholder may make application for coverage of any employee f re
Cancan y :s tnen accepting applications for coverage under this Group Annuity Contract
unless a mate of Cessation of Deposits nos been cecared.
An employee for whom an adequate application has been made becomes covered as a
Participant as of the Participant Effective Date. Coverage of a Participant terminates con
the Group Policyholder's total or partial distribution wnich results in a Participant Anrurty
Account Value of $0.
4.2 Deposits
Unless a Oate of Cessation of Deposits has been declared, the Group Policyholder rrav
from time to time pay Deposits in cash in respect of a Participant until the earner cif
hisiher death, Annuity Commencement Date. or the termination of the Participant Annuity
Account.
The amount of Deposits to be paid by the Group Policyholder in respect of any
Participant will be determined by the Group Policyholder.
The Group Policyholder will report the amount paid as Deposits on forms acceptaole to
the Company. The Group Policyholder's report is conclusive and binding on it and any
person or entity claiming an interest under the Group Annuity Contract or any Participant
Annuity Account. When the Group Policyholder's report does not coincide with the
Deposits received, the Company may return them.
4.3 Allocation of Deposits
Atter an adequate application on behalf of a Participant has been made. Deposits. less
Premium Tax, if any, will be allocated in the Participant Annuity Account when received
by the Company at its Administrative Offices.
Deposits on behalf of the Participant will be allocated among any number of currently offerd Variable and Guaranteed s in accordance with the Written Request of the Group Policyholder t
on behalf of the Participants latest recorded
The allocation of Deposits may be changed at any time upon the Company's receipt at
its Administrative Offices of the Written Request of the Group Policyholder on behalf of
the Participant. A change e of allocation
on recording oethe change.9for Deposits which are received
after the Company's receipt and
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92'1.035
CON--AC' VAJ ' 'PCViS 0NS
SEC-:,;N 5. �. �-
1 l�''a-i2 ac. "ail ie
The variable Contract Value for a Panic:pant on any date during the Accumuiat cn °encc
will be the sum of the values of the Variable Sub-Accounts of the Series Account neic for
the Participant.
The value of a Participant's interest in a Variable Sub-Account will be determined ty
multiplying the number of Accumulation Units held for the Participant for that Variab'ie
Sub-Account by the Accumulation Unit Value for that Variable Sub-Account.
5.2 Accumulation Unit
Deposits received at the Aar inistrative Offices of the Company before the close of a
Valuation Period will be allocated as requested and applied as of that date based upon
the Accumulation Unit Value for that Variable Sub-Account as of the Valuation Date
immediately preceding receipt of the funds, to provide Accumulation Units of the selected
Variable Sub-Accounts of the Series Account.
The number of Accumulation Units credited for each Participant to a Variable
Sub-Account will be determined by dividing the amount of the Deposits then applied to
such Variable Sub-Account by the on the Valuation Date on which hecDeposits
owee madeVariable and allocated.it Value for that aSub-Account
The number of Accumulation Units will not change because of a later change in the
Accumulation Unit Value, but the Accumulation Unit Value will vary to reflect the
investment experience of the Variable Sub-Account.
•
5.3 Accumulation Unit Value
The Accumulation Unit Value of a Variable Sub-Account on any Valuation Date is ecuat
to the Accumulation Unit Value of that Variable Sub-Account as of the immediately
preceding Valuation Date multiplied by the net investment factor (as explained in Section
5.6) for the Valuation Period ending on the Valuation Date on which the Accumulation
Unit Value is being determined.
The Accumulation Unit Value may increase, decrease, or remain unchanged as a result
of the value of the net investment factor.
14
92A-.0 35
SECT'CN 5 CON`-AC" VALUE ocCV'S'CNS
5 Annuity Unit Value
The 1nitiai Annuity Unit Value of each Vanaoie Sub-Account was estaciisned at 3 cr :ne
Cate a :eoost was first mate under a Variable Annuity Method of Payment to :^.e
Variable Sub-Account(s).
The Annuity Unit Value of any Variable Sub-Account on any suosequent Vaivaticr Cate
is equal to the Annuity Unit Value for the immediately preceding Valuation Gate mu,toned
by the net investment factor for that Variable Sub-Account for the Valuation Pence enc.r,
on the Valuation Date on which the Annuity Unit Value is being determined. are
multiplying the result by a factor of .999905 to neutralize the assumed investment -ate of
3.5% per year used in the applicable Table for Variable Dollar Method of Payment Cptcns
1, 2, 3, and a.
The Annuity Unit Value may increase, decrease or remain unchanged as a result of the
value of the net investment factor.
5.5 Risk Charge
The Company will deduct the risk charge for expense and mortality guarantees in the
calculation of the net investment o
of the daily net asset value of each Variable Sub-Account.
1.25%
Account This deduction is mace easy.
5.6 Net Investment Factor
The net investment factor for any Variable Sub-Account for any Valuation Period is
determined by dividing (A) by (8), and subtracting (C) from the result where:
(A) is the net result of:
(1)
the net asset value per share of the Variable Sub-AccountEligible Fund shares held
determined as of the end of the curre nt Valuation
Period, plus
(2) the per share amount of any dividend (or, if applicable, capital gain
distributions) made by the Eligible Fund on shares held in the Variable
Sub-Account if the 'ex-dividends date (the date four days before the record
date which determines if the Group Policyholder is eligible to receive a
dividend) occurs during the current Valuation Period, minus or plus
(3) a per unit charge or credit for any taxes incurred by or reserved for in the
Variable Sub-Account. whicn is determined by the Company to resulted have
from the investment vestmen operations of the Variable Sub-Account.
15
SEC7CN 5. ^ ��aq�- VALUE �cCVISICNS (continued)
7.7
Net "irveStme'! F3c:Cr (continued)
(31 is the net result of:
(1) the net asset value per share of the Eligible Fund shares he+C ir :re
Variable Sub-Account determined as of the end of the .mmeciate:V
preceding Valuation Period, minus or plus.
(2) the per unit charge or credit for any taxes incurred by or
Valuation Period.
iec !or in
the Variable Sub-Account for the immediately p 9
(C) is a factor representing the risk charge.
The net investment factor may be greater than. less than. or equal to cre.
Therefore. the Accumulation Unit Value and the Annuity Unit Value may increase.
decrease or remain uncnanged.
The per share amount of any dividend referred to in paragraph (A)(2) includes a
deduction for an investment advisory fee. This fee compensates the investment
adviser for services provided to the Eligible Fund. The fee may differ between
Eligible Funds and may be renegotiated each year, but wilassets l ver the Eld an
igible
b n
annual rate of 1.00% of the aggregate average daily
Fund.
5.7 Guaranteed Contract Value
The Guaranteed Contract Value of a Participant Annuity Account on any date during the
Accumulation Period will be the sum of the values of the Guaranteed Sub-Accounts
credited to such Participant Annuity Account.
The Company may offer one or more Guaranteed Sub-Accounts into which Deposits will
be made at the Written Request of the Group Policyholder on behalf of the Participant.
5.8 Guaranteed Sub-Account Riders
The computation of the value of a Guaranteed Sub-Account is described in greater detail
in the attached Guaranteed Sub-Account Riders, if any.
16
9 Ly 33.E
•
SEC-ION 5 CON- rtACT VALUE °OCVISiCNS !continued)
3 C: tract Ma!rterance Charge
On the first day of each calendar year a contract maintenance charge of not more cyan
360 annually will be declared by the Company and decuctec from the Par,rcart yrr_,y
Account. If a Participant Annuity Account is estaohshed for a Participant after :rat tate.
the contract maintenance charge will be deducted on the first day of the next quarter arc
will be pro-rated for the year remaining. No refund of this charge will be mace.
The deduction will be pro-rated among the Variable and Guaranteed Sub-Accounts based
upon their Variable and Guaranteed Contract Values on the date of deduction. Whenever
a deduction for a contract maintenance charge is to be made from a Variacie
Sub-Account, the Company will cancel Accumulation Units having a total value equal to
the amount of the deduction. The Group Policyholder may elect to pay such excesses
to the Company separately. If such an election has been made. then no charge will ce
made against the Variable and Guaranteed Sub-Accounts unless payment is not received
within 30 days.
•
17
32 .035
SECTION 5TRANSFER'S
5.! T'af sfers
The Group Policyholder may make mitre-Company Transfers, Plan-to-Plan Transfers or
Transfers to Other Companies by Written Request on benalf of Me Participant.
6.2 Transfer Terms
a. A transfer will take effect on the later of the date elected or the date the Written
Request is received at the Administrative Offices of the Company. if such Written
Request is received atter 4:00 p.m. ES T,EDT, the transfer will take effect on tre
later of the date elected or the date following the date the Written Request .s
received and a unit value is calculated.
b. A telephone transfer, if permitted. wail take effect on the later of the date elected
or the date the telephone can is received at the Administrative Office. if sucn call
is received after 4:00 p.m. EST,EDT. the transfer will take effect on Me later of me
date elected or the date following me date the call is received and a unit value is
calculated. the c. When the Company provided
rt. Me
metoup Company pholder on as necessary fftof the Participant
requested
will execute forms provided by
transfer.
d. No transfers are permitted after the Annuity Commencement Date.
e. No transfers from the Guaranteed Certificate Fund may be made prior to the
Certificate Maturity Date, as defined n me Guaranteed Certificate Fund Rider, if
any. The amount available 'or transfer is the value of that Certificate on its tten Request to transfer v ytt The GfOparry warm days after s the Certificate Maturity Date. be
received by the Company
6.3 Intra•Comoanv Transfers
a. At any time prior to the Annuity Commencement Date, the Group Policyholder on
behalf of the Participant may by r nen Request transfer all or a portion of the
Participant Annuity Account 'satue wrthln and between the Variable and
Guaranteed Sub-Accounts currertry offered by the Plan.
Group Policyholder on
b. At any Par time prior to the Annuity Commencement tten Request make anelntra-Company Plan-to-
Plan of the Participant may oy Ar
Plan Transfer.
aza 035
t8
•
SECT ON ANS:t` IContlnuccl
_ 3 73--d bare 'arsfers .CCnr,^uec)
rf an Intra-Comcany T'ansfer s mace within 30 days of the Ar
Commencement Cate, the Company may delay the Annuity Commencement Cate
by 30 days.
d. if a Participant dies prior to the Annuity Commencement Cate, one intra-Comcary
Transfer may be made after the death of the Participant by the Group Policy-cigar
on behalf of the Payee to effect the election of a Payment Option.
e. No Contingent Deferred Sales Charge will apply to Intra-Company Transfers.
6.4 Transfers to Other Companies
a. At any time prior to the Annuity Commencement Date. the Group Policyholder or
behalf of the Participant may by Written Request transfer all or a portion of the
Participant Annuity Account Value to an account currently offered by another
company under the terms of the Plan.
b. At any time prior to the Annuity Commencement Date, the Group Policyholder on
behalf of the Participant may by Written Request transfer the entire Particcant
Annuity Account Value to an account offered by another company under another
eligible deferred compensation plan.
c. The Contingent Deferred Sales Charge described in Section 9 shall apply to any
and ail Transfers to Other Companies.
6.5 Plan-to-Plan Transfers
a. Plan-to-Plan Transfers where the amounts remain with the Company under a new
eligible deferred compensation plan shall be treated as Intra-Company Transfers.
b. Plan-to-Plan Transfers where the amounts are transferred to other companies
under a new eligible deferred compensation plan shall be treated as Transfers to
Other Companies.
6.6 Transfers To The Company
Amounts transferred to the Company shall be treated as Deposits under Section 4 of this
Contract.
6.7 Non-Taxable Distribution
No amount transferred pursuant to these provisions will be treated as a taxable
distribution to the Participant.
19
:IC-7ANC --, 4 acNjEElAPY
7 t :eat of 2artic:^ant after Annui Commencement Date.
!f the aarticpant dies after the Annuity Commencement Date and before his,`'er entree
interest has teen distributed. payments will continue to the Beneficiary under the Payment
Option appiicaole to the Participant on the Participants date of death. Notwitnstarc,rg
the preceding sentence. rf the Plan allows the Beneficiary to change the method of
distribution, a new Payment Option may be elected by Written Request mace y the Grouo
to the
Policyholder on behatf of the Beneficiary only so long as payments
Beneficiary not less rapidly than under the Payment Option effective on the Partmo:cant s
date of death. The Contingent Deferred Sales Charge will not apply.
7.2 Death of Partici ant before Annui Commencement Date.
a. 5-Year Rule. If the Participant dies before the Annuity Commencement Date. the
entire interest of the Participant must be distributed within five years after the
death of the Participant. This Rule will always apply to non-individual entities
b. 1-Year Rule. If the Plan provides that any portion of the Participant's interest s
payable to a designated Beneficiary, such portion may be distributed over the
lesser of (1) the life of the designated Beneficiary, or (2) over a period not
extending beyond the life expectancy of the designated Beneficiary or 131 15
years. Such distributions to a designated Beneficiary must begin not later tan
December 31 of the year following the date of the Participant's death. The Grouo
Policyholder on behalf of the designated Beneficiary may elect by Written Request
to take distributions either under the 5-Year Rule or under this 1-Year Rule. If no
election is received by the Company by November 1 of the year following the year
of the Participant's death, distributions will be made pursuant to the 5-Year Rue
described in subsection a. of Section 7.2.
For purposes of this section, a designated Beneficiary is any individual named as
a Beneficiary by the Participant.
c. Soecia a for Survivine Souse. if the designated Beneficiary is the surviving
spouse of the Participant, the date on which the distributions are required to begin
shall not be earlier than the date on wnich the Participant would have attained age
Section 10 of this
70 Distributions in any event mustlected at any time pursuant commence on or before the aer of (1) D cemoer
31Contract but in any
of the year immediately
of the calendar year in wh ch the Participant would have attained(2)age 70 1/2.
December 31
20
SEC ON 7 SIST^IEU'bONS —C A BENEFICIARY
7 2 17=atr of °ariccart before Arruity Cor^-ercemert Date. (continued)
d. Any payments made over a period greater than one year can only be -..ace
sucstantially non-increasing amounts pate not less frequently than annually.
e. The Contingent Deferred Sales Charge will not apply.
7.3 Amount Payable on Death of Participant
If the Participant dies before the Annuity Commencement Date the Amount Payaoie on
Death will be:
(a) Where death occurs before the Participant's 70th birthday, the greater of:
(i) the Participant Annuity Account Value, less Premium Tax, if any. and
(ii) the sum of Deposits paid to, less any Partial Distributions made from, the
Participant Annuity Account, less Premium Tax, if any.
(b) Where death occurs on or after the Participant's 70th birthday, the Participant
Annuity Account Value, less Premium Tax, if any.
7.4 Requests For Distributions
Subject to the 5-Year rule, the 1-Year rule or the Special Rule for Surviving Spouse. as
applicable, set forth in Section 7.2, an election to receive the amount described in Section
7.3 must be made pursuant to Section 10 of this Contract.
21
SEC7CN 3 ^'e'o'nir CNS ?C A oART1CIPANT
3 ae^uests 'or ^ stnbutions
On the Company's receipt of the
Policyholder Written Request
behalf at
least
30 days
before pant may:
the wri
Commencement Date. the Group
a. Elect or change a Payment Option. ent te to any future Cate
b, Elect which change the Participant's
1 of the calendar yearfollowing athe calendar..year in
which is not later than April
which the Participant attains the later of age 70 1/2 or separation from service.
If any Annuity Commencement Date would be less than 30 days from the date ire
Written Request is received, the Company may delay the Annuity Commence --ant
Date elected by 30 days.
c. tf the Group Policyholder on behalf of the Participant has failed to elect a Pa . ant
Option within 30 days of the Annuity Commencement Date, the Company will pay
the Group Policyholder on behalf of the Participant a Variable Lite Annuity wrth 10
Wwith 10 Period(earartGuarranteed Period rom the Variable Contract Value and a from the Guaranteed Contract FValue.ixed Life
Annuity
8.2 istribution t a 70 1 or Se oration From Service
Except as provided in Section 8.3, no distributions will be allowed prior to the Participant's
attainment of age 70 1/2, or separation from service, as determined by the Group
Policyholder. The distribution must be elected pursuant to Section 10 of this Contract
and will take effect on the later of the date elected and the date the Written Request is
received at the Administrative Offices of the Company.
8.3 Distribution Due to Unforeseeable Emergency
if the Participant incurs an unforeseeable emergency aPolicyholderdetermined
et m on behalf the
of uc
Policyholder under the terms of the Plan, then the Group
e
Participant may by Written Request take a total or partial distribution from the Participant
Annuity Account. The distribution will take effect on the later of the date elected and the
date the Written Request is received at the Administrative Offices of the Company.
22
9av'n
SEC7CN 8. :'LST= 91_'e.NS TO A :4PTIC;P4NT (Continued)
3 4 Amount Pavacie on Cistnbut,cn
if a total distribution is requested. the amount payable wail be paid uncer the Payment
Option provisions of Section 10 designated by the Group Policynolder on benalf of tre
Partiaoant. If a partial distribution is requested. the amount payable will be in ore sum
In either event, the amount will be equal to:
(a) The amount of the distribution requested as of the effective date of :re
distribution, less
(b) the Contingent Deferred Sales Charge, if any, less
(c) Premium Tax, if any.
8.5 Conditions of Payment
Payment will only be made if then available to the Payee under the terms and provisions
of the Plat:as determined by the Grouo Policyholder, and will only be made to the Group
Policyholder or to the order of the person designated in Written Request by the Group
Policyholder to receive payment.
8.6 Adequate Proof
The Company may require adequate proof of age, separation from service or
unforeseeable emergency to establish that a benefit has become payable under the
provisions of the Plan prior to making any payment under this Group Annuity Contract.
23
92..033
r CALcc ruAPr==
91 ^ansfers
On any total or partial transfer of the Participant Annuity Account to another company :re
Contingent Deferred Sales Charge will be deducted from the amount transferrer. The
Contingent Deferred Sales Charge will be equal to a percentage of the amount trarsferrer
based on the table in 9.2 below.
9.2 Lump Sum Distributions
On any total or partial lump sum distribution of the Participant Annuity Account at age 70
1/2. separation from service or due to an unforeseeable emergency, a Contingent
Deferred Sales Charge will be deducted from the amount distributed. The Contingent
Deferred Sales Charge will be equal to a percentage of the amount distributed in excess
of the Contingent Deferred Sales Charge Free Amount, if any, based on the table below.
Contingent Deferred Sales Charge Table
Completed Years From
Participant Effective Date % of Amount Transferred or
Under this Contract Distributed
5%
5 . 9 4%
10 - 14 3%
10 -
15 or more 0%
Notwithstanding anything in this 3roup Annuity Contract to the contrary, in no event shall
the Contingent Deferred Sales Charge at any point in time exceed 8.5% of Deposits
contributed by the Participant into this Group Annuity Contract.
9.3 Contin ent Deferred Sales Char a "Free Amount"
The Contingent Deferred Sales Charge "Free Amount applicable to any
Account or
partial
sum distributions is equal to 10% of the Participant Annuity
December 31 of the calendar year prior to the year in which the amount is distributed.
Only one Contingent Deferred Sales Charge "Free Amount' is available on behalf of a
Participant in each calendar year. The Contingent Deferred Sales Charge 'Free Amount"
n that
will be applied on the first distribution made under the Participant Annuity Account
year.
24
SEC IICN 13. vgYMENT CP"CNS
C_1 Se!ecticn of Payment Coders
;a) A total or partial lump sum or one of the variable or fixed dollar payment cct,crs
or a comoination of them may be elected.
(b) if the Group Policyholder on behalf of the Payee elects to aopiv any or au of tre
Guaranteed Contract Value to a variable dollar method of payment option. or any
or all of the Variable Contract Value to a fixed dollar method of payment :ctior
an Intra-Company Transfer must be made prior to the Annuity Commencement
Cate pursuant to Section 6.
(c) If a lump sum option is elected. the amount to be distributed is the amount
requested as a lump sum less the Contingent Deferred Sales Charge, if any, and
Premium Tax, if any, as of the date the amount is distributed.
(d) If a variable dollar payment option is elected, the amount to be applied is the
Variable Contract Value, less Premium Tax, if any, as of the date the amount of
the first month'y payment is determined.
(d) If a fixed dollar method of payment option is elected, the amount to be applied is
the Guaranteed Contract Value, less Premium Tax, if any, as' of the Annuity
Commencement Oats.
10.2 How to Elect Payment Options
The Written Request of the Group Policyholder on behalf of the Participant or Payee is
required to elect, or change the election of, a Payment Option and must be received by
the Company at least 30 days prior to the Annuity Commencement Date, or, if the
Participant dies prior to the Annuity Commencement Date, within 60 days of the date the
Company receives adequate proof of the Participant's death.
The Company will rely on the Group Policyholder's determination with respect to the
timing and amount of any benefit-payable to the Participant or Payee under this Contract.
Nothing contained herein shall be construed to be tax or legal advice and the Company
assumes no responsibility or liability for any costs, including but not limited to taxes,
penalties or interest incurred by the Plan. the Group Policyholder, the Participant or any
Payee arising out of such determination.
25
3211.035
SEC-1ON 10. PavafEN� � ONS ;continued)
' C 2 Vjzmole -)cila °' re^t Oct Otis
The following variable dollar payment options are available:
(a) Option 1 : Variable Life Annuity with Guaranteed Period
The Company will pay a monthly payment for the guaranteed Annuity Payment
Period elected. Payments will continue for the lifetime of the Payee. T he
guaranteed Annuity Payment Period elected may be 5. 10, 15. or 20 years. Ucon
death of the Payee, any amounts remaining payable under this payment option
will be paid to the Group Policyholder or other Payee designated by the Group
Policyholder under Section 7 of this Group Annuity Contract.
(b) Option 2: Variable Life Annuity
The Company will pay a monthly payment during the Payee's lifetime. Table A is
applicable to this Payment Option.
(c) Option 3: Joint and One-Hall Survivor Variable Annuity
A joint and one-half survivor variable annuity provides a variable monthly payment
to an Annuitant for hisiher lifetime; thereafter, and upon receipt by the Company
ment
of adequate proof of the Annuitants death, one-half of the variable pay
amount continues to a designated Payee, if living, and terminates upon Mister
death. Table B is applicable to this Option.
(d) Option 4: Any Other Form
The Company will pay any other form of Variable Annuity which is acceotable to
it. Upon death of the Payee. any amounts remaining under this Payment Option
will be paid to the Group Policyholder or other Payee designated by the Group
Policyholder under Section 7 of this Group Annuity Contract.
(e) These variable dollar payment pptions are subject to the following provisions.
c•rst Monthly(1) Amou� Pavment. The first monthly payment under a
variable dollar payment option will be based on the Variable Contract
Value credited onbehalf °hthe num Commencement Date.nt Annuity Account on It willbe
Valuation t Date preceding rate horn the applicable Table to
determined by applying the appropriate
the amount applied under the payment option. Thee first monthly
each ar mete
ayment
will be the sum of the variable dollar annuity payments
Y
Sub-Account.
26
10 ;AvMENff CP' CNS (continued)
Jaracie Dear cavr^ert Cptcrs (continued)
2) Annuity Units. The number of Annuity Units for each Variable Sub-Account
to be created in respect of the Participant Annuity Account Ivi t ce
determined by dividing the portion of the first monthly payment to ce taKen
from such Sub-Account by the Sub-Account's Annuity Unrt Value on tre
5th Valuation Date preceding the date the first payment is due for rvn cn
the number of Annuity Units is being computed. The number of Annuity
Units for a Variable Sub-Account remains fixed during the Annuity Payment
Period.
(3) Amount of Monthly Payments after the First. Monthly payments after the
first will vary in amount from time to time depending upon the investment
experience of the Variable Sub-Accounts of the Series Account. The dollar
amount of each Variable Dollar Annuity payment to the Participant or
Payee after the first for each Variable Sub-Account is determined by
multiplying (a) the wumber of Sub-Account Annuity Units credited to the
Participant Annuity Account by (b) the Sub-Account Annuity Unit Value on
the 5th Valuation Date preceding the date the annuity payment is due.
The total dollar amount of each variable dollar annuity payment will be the
sum of the variable dollar annuity payments for each Varacie Sub-
Account. The Company guarantees that the dollar amount of each
payment atter the first will not be affected by variations in expenses or
mortality experience.
(f) If any payment to be made under the elected payment option will be less than
$50, the Company may make the payments in the most frequent interval when
produces a payment of at least $50. The minimum amount that may be applied
under the elected payment option is $2.000. if the amount is less than $2.000. the
Company may pay it in one sum. The maximum amount that may be applied
under any elected payment option is $1,000,000. For the application of any
greater amount, the Company's consent is required.
10.4 Fixed Dollar Payment Options
The following fixed dollar payment options are available:
27
37_.93,
SRC—ON ' 0. '4` yFNT CrICNS con: nuedl
='23c ^Iar oavr^e^t Options ccortinuec)
ia) Cption 1 Income of Specified Amount
The Company will pay an income at 12-. 6-, 3-. or 1-month intervals. of an amount
elected by the Payee for an Annuity Payment Period of not less tnan 36 montns
nor more than 240 months. Uoon death of the Payee. any amounts remaining
payable under this payment ootion will oe paid to the Grouo Policyholder or otner
Payee designated by the Group Policyholder under Section 7 of this Group
Annuity Contract.
(b) Option 2: Income for a Specified Period
The Company will pay an income at 12-. 6-, 3-, or 1-month intervals, for the
number of years elected by the Payee for an Annuity Payment Period of not less
than 36 months nor more tnan 240 months. Upon death of the Payee. any
amounts remaining payable under this payment option will be paid to the Group
Policyholder or other Payee designated by the Group Policyholder under Section
7 of this Group Annuity Contract. Taoie C is applicable to this Option.
(c) Option 3: Fixed Life Annuity with Guaranteed Period
The Company will pay a montny payment for the guaranteed Annuity Payment
Period elected. Payments will continue for the lifetime of the Payee.opt on be n del t
h
of the Payee, any amounts remaining payable under this payment
paid to the Group Policrnolder or other Payee designated by the Grouo
Policyholder under Section 7 of this Group Annuity Contract. Table 0 is
applicable to this option.
The guaranteed Annuity Payment Period elected may be 5, 10. 15 or 20 years. or
may be a d o as t Refund°. Under the d
period, paymentsewillebetmadensntill nea n
total of the payments made equals me
amount applied. •
(d) Option 4: Fixed Life Annuity
The Company will pay a montriy payment during the Payee's lifetime. Table 0 is
applicable to this option.
28
921035
SE:7CN ' : oavylcNT O?tCNS (continued)
4 : xed Ccilar °avr"ent Cpt,crs )continued)
ie) Option 5. Joint and One-Harf Survivor Fixed Annuity
A joint and one-half survivor fixed annuity provides a fixed monthly payr^ent to an
Annuitant for his/her lifetime; thereafter, and upon receipt by the Company
adequate proof of the Annuitant's death, one-hail of the fixed payment am.c..nt
continues to a designated Payee, if living, and terminates upon nisiher ceatr
Table E is applicable to this option.
(f) Option 6: Systematic Withdrawal Option
The Company will pay a monthly, quarterly, semi-annual or annual payment to the
Payee as elected by Written Request by the Group Policyholder on bereft of the
Payee. The amount, timing and method of payment will be as elected by the
Group Policyholder on behalf of the Payee and agreed to by the Company. The
details and provisions of the Systematic Withdrawal Option are described in
greater detail in the attached Systematic Withdrawal Option Rider, which is hereby
made a part of this Group Annuity Contract.
(g) Option 7: Any Other Form
The Company will pay any other form of Fixed Annuity which is acceptable to rt.
Upon death of the Payee, any amounts remaining payable under this payment
option will be paid to the Group Policyholder or other Payee designated by tare
Group Policyholder under Section 7 of this Group Annuity Contract.
(h) These fixed dollar payment options are subject to the following provisions:ayment on are d y the
(1) PaymCompany
as der a fixed dollar todollar amount throughout the t Annuity Payment Period.
Company
The amount of the payment under any fixed dollar payment option will be
determined by applying the Company's then current non-participating
group single premium rates for this class of group annuity contracts to the
amount applied under the option. Those current rates will not be less than
the rate obtained from the Table which is applicable to the elected option.
29
SECTION '0 apvMEN1' CPTCNS (continued)
C a ' zec 0c ar cavment Cpt'4rs (continued)
(2) f any payment to be made under the elected payment
option )i be f be less
than $50, the Company may make the payments
nt
interval which produces a payment of at least $50. The minimum amount
that may be applied under the elected payment option is $2,000. rf the
amount is less than $2.000, the Company may pay it in one sum. The
maximum amount that may be applied under any elected payment option
is $1 ,000,000. For the application of any greater amount, the Company
consent is required.
30
3 .03
SECTiCN 11 CONTACT rv1CC'='CA''CN
11 1 Contract Mco fcaticn
This Group Annuity Contract may be modified at any time by written agreement oettweer
:re Company and the Group Policyholder. No such modification will. without :re wnr.en
consent of the Group Policynolder, affect the terms. provisions. or coroiticrs of ms
Group Annuity Contract wnich are or may be applicable to Deposits paid in respect of
Participants prior to the oats of sucn modification.
However, the Company may at any time and without the consent of the Group
Policyholder or any Participant or other person, but upon 30 days' written notice to :ne
Group Policyholder, modify this Group Annuity Contract in any respect to conform it to
changes in tax or other law, including applicable regulations or rulings.
11.2 Modification of Tables
The Company may at any time and without the consent of the Group Policyholder or any
Participant or other person, but upon 30 days' written notice to the Group Policyholder,
modify Tables A, B, C. 0, and E. or any of them. However, no such modification wiil
affect the terms, provisions or conditions of the Group Annuity contract which are or may
be applicable to Deposits paid in respect of Participants prior to the date of sucn
modification.
11.3 Modification of Guaranteed Sub-Account Riders. if Any
Any Guaranteed Sub-Account Rider may be modified at any time by written agreement
between the Company and the Group Policyholder. No such modification will, without
the written consent of the Group Policyholder, affect the terms, provisions, or conditions
of the Rider which are or may be applicable to Deposits paid in respect of Participants
prior to the date of such modification.
11.4 Modification of Variable and/or Guaranteed Sub-Account Riders. if Any
Notwithstanding the other contract modification provisions, the Company may offer new
or cease offering existing Variable or Guaranteed Sub-Accounts. No such modification
shall affect the terms. provisions, or conditions which are or may be applicable to
Deposits previously paid to any Variable or Guaranteed Sub-Account which is no longer
offered by the Company. The Company will periodically notify the Group Policyholder on
behalf of the Participants of the current offering of Variable or Guaranteed Sub-Accounts.
31
37^.03r-
Sr.. ON ? 2. CESS ' CN OF C PCSi 5
12.1 cessation of Zeocs,ts
Loon 50 days' written notice to ire other. the Group Policyholder or the Comoany may
declare that. as from the date stated in the notice (that sate oeing called a Date of
Cessation of Deposits), no further Deposits will be made to certain or an Guarantees
Sup-Accounts of the Group Annuity Contract.
if a Date of Cessation of Deposits has been declared for certain Sub-Accounts. the Group
Policyholder in respect of the Participant may by Written Request make a change of
allocation of his/her new Deposits. When no change of allocations is received. the
Company may return all new Deposits affected by the declaration of the Date of
Cessation of Deposits, or allocate such new Deposits to a currently offered Guaranteed
Sub-Account.
Atter the Oate of Cessation of Deposits declared in respect of all Sub-Accounts. no new
Participant Annuity Account will be established.
12.2 Options on Date of Cessation of Deposits
Upon the Cate of Cessation of Deposits for all Sub-Accounts, the Group Policyholder may
by Written Request elect one of the following cessation options. If the Group Policyholder
has not elected a cessation option within 30 days of the Date of Cessation, the Company
will make the election in its sole discretion. Such election shall be binding on the Group
Policyholder.
a. Cessation Option (1) Maintenance of Each Participant Annuity Account Value:
The Company will maintain each Participant Annuity Account Value until it is
applied to a Payment Option or paid under the Group Annuity Contract.
b. Cessation Option (2) Installment Settlement of Contract Values:
Upon receipt of a Written Request from the Group Policyholder and subject to the
provisions relating to Transfers to Other Companies. the Company will pay the
sum of the Variable Contract Values in respect of Participants as of the Date of
Cessation of Deposits to the successor insurer of the Plan or to the Group
Policyholder within 7 days of the date the cessation option is elected.
Upon receipt of a Written Request from the Group Policyholder, the Company will
pay the sum of the Guaranteed Contract Values in respect of the Participants as
of the Date of Cessation of Deposits to the successor insurer of the Plan or to the
Group Policyholder in 20 equal quarterly installments. The amount of the
installments will be the amount determined by the Company on the date of the
first such payment, but not less than $514.80 for each $10,000 of Guaranteec
Contract Values. The first payment will be made 30 days after the date the
cessation option is elected.
32
'ABLE A - Vanacie Life Annuity
Monthly Payment for Each 51 .000
of Participant Annuity Account Value
Age of Without With Guaranteed Period
Payee Guaranteed Period 5 Years 10 Years 15 Years 20 years
50 3.99 3.99 3.98 3.96 3.94
55 4.31 4.30 4.27 4.24 4.19
60 4.71 4.70 4.67 4.60 4.49
65 5.28 5.25 5.18 5.05 4.34
70 6.07 6.02 5.85 5.56 5.15
75 7.22 7.09 6.68 6.07 5.41
If payments commence on any other date than the exact age of the Payee as shown above. the
amount of the monthly payment shall be determined by the Company on the actuarial basis used
by it in determining the above amounts.
33
—IL= 3 - :clrt and One•-4alf Sur/Ivor Variaole Annuity
Montnly Payment for Eacn 31 .000
of Participant Annuity Account Value
Age of •
if Designated Payee Is Me
Annuitant 50 55 50 65 70 75
50 3.88 3.91 3.94 3.96 3.97 3.98
55 4.09 4.15 4.19 4.23 4.25 4.27
60 4.34 4.43 4.51 4.58 4.63 466
65 4.64 4.77 4.90 5.01 5.10 5.16
70 4.99 5.17 5.36 5.55 5.70 5.83
75 5.40 5.65 5.91 6.19 6.46 6.69
If payments commence on any other date than the exact age of the Annuitant or designated
Payee as shown above, the amount of the monthly payment shall be determined by the
Company on the actuarial basis used by it in determining the above amounts.
34
921.'035
TABLE C - Income of Specified Amount
- nccme of a Specified Period
Monthly Payment for Each 51 ,000
of Participant Annuity Account Value
Years Payment
3 28.61
4 21.82
5 17.75
6 15.04
7 13.10
8 11.66
9 10.54
10 9.63
11 8.90
12 8.30
13 7.78
14 7.34
15 6.96
16 6.63
17 6.34
18 6.08
19 5.85
20 5.64
To determine the payment for other frequencies of payment, multiply the above monthly payment
by the following factors:
Factor
Quarterty payment 2.99
Semi-annual payment 5.96
Annual payment 11.81
tf payments are for an amount or duration different than that outlined above, the Company will
determine the proper amount or duration using the actuarial basis used to determine the above
Table.
35
317' .035
TABLE .7 • F,xed Life Annuity
Monthly Payment for Each $1 .000
of Participant Annuity Account Value
Age of Without With Guaranteed Period
Paves Guaranteed Period 5 Years 10 Years 15 Years 20 years
3.96 3.94
50
3.99 3.99 3.98 4.24 4.19
t 9
4.30 4.27
6 4.71 4.70 4.67 4.60 4.49
60 4.71 2 5.18 5.05 4.84
65 5.28 5.25 6.02 5.85 5•5b 5.15
70 7.07 7.09 6.68 6.07 5.41
75 7.22
If payments commence on any other date than the exact age of the Payee as shown above. the
amount of the monthly payment shall be determined by the Company on the actuarial basis used
by it in determining the above amounts.
36
92:033
—Agi c o - Jcirt art One--4alf Survivor r' xet AnrurN
Monthly Payment for Eacn 51 .000
of Participant Annuity Account Value
Age of If Designated Payee Is Ace
Annuitant 50
55 50 55 70 75
50 3.88 3.91 3.94 3.96 3.97 3.98
4.09 4.15 4.19 4.23 4.25 4 27
55 4 51 4.58 4.63 466
60 4.34 4.43
65 4.64 4.77 490 5.01 5.10 5.16
70 4.99 5.17 536 5.55 5.70 5.83
75 5.40 5.65 5 91 6.19 6.46 6.69
If payments commence on any other date than the exact age of the Annuitant or designated Payee
as shown above, the amount of the monthly payment snail be determined by the Company on the
actuarial basis used by it in determining the aoove amounts.
37
w
DAILY INTE?EST GUARANTEE FUND
GUARANTEED SUB-ACCOUNT RIDER
ATTACHED TO AND FORMING PART OF THE GROUP ANNUITY CONTRACT
The Daily Interest Guarantee Fund is a Guaranteed Sub-Account. Deposits may be made Fnto
the Daily Interest Guarantee Fund at any time. Interest will be earned on the Daily Interest
Guarantee Fund value and compounded daily. The interest rate credited may chance on a
calendar quarter basis, but on an annual effective basis will not be less than the Guaranteed
Interest Rate.
The value of the Daily Interest Guarantee Fund in respect of the Participant will be determined
by adding his/her Daily Interest Guarantee Fund Sub-Account's Deposits and interest and
subtracting distributions to a Beneficiary, amounts distributed or applied under a payment option,
transfers, Contract Maintenance Charge, and Premium Tax.
This Rider, unless and until modified, forms part of the Group Annuity Contract.
Daily Interest Guarantee Fund Rider • 1
GUARANTEED CERTIFICATE FUND
GUARANTEED SUB-ACCOUNT RIDER
ATTACHED TC AND FORMING PART CF THE GROUP ANNUITY CONTRACT
The Guaranteed Certificate Fund is a Guaranteed Sue-Account. whereby Credited Interest Rates
not ess tan the Guaranteed Interest Rate, are credited to Deposits Held for varying Interest
Guarantee Periods. The Company may offer Certificates to the Group Policynolder who may oy
Written Request allocate any Deposit in respect of the Participant to any one Certificate. The
Group Poiicynoider in respect of the Participant may allocate Deposits only to those Certificates
currently being offered by the Company.
If the Group Policyholder in respect of the Participant allocates Deposits to Certificates not
currently offered by the Company, the Company may return such Deposits, allocate sucn
Deposits to a currently offered Certificate, or allocate such Deposits to another currently offered
Guaranteed Sub-Account.
DEFINITIONS
Certificate • represents the amount deposited into the Guaranteed Fund
under each Interest Guarantee Period. Each Certificate has
its own interest rate and Term.
Term the duration of the Certificate which begins on the first day
of the calendar quarter following the date of the Deposit
and ends on the date specified by the Company. The
duration of Terms available may be limited by the
Company.
Certificate Maturity Date - the last day of the Term.
Interest Guarantee Period - the period from the date of the Deposit to the Certificate
Maturity Date.
Interest Creditina and Selection of Payment Option
The Credited Interest Rate on an annual effective basis will not be less than the Guaranteed
Interest Rate and will be compounded daily. A Deposit to the Guaranteed Certificate Fund whicn
remains in the Guaranteed Certificate Fund until the Certificate Maturity Date will earn a Credited
Interest Rate for the Certificate's Interest Guarantee Period.
If the Participant dies, separates from service or has an unforeseeable emergency as determined
by the Group Policyholder, amounts deposited into the Guaranteed Certificate Fund may be
applied to a payment option prior to the Certificate Maturity Date. Amounts applied to a payment
option pursuant to Section 10 of the Group Annuity Contract prior to the Certificate Maturity Date
will receive the Credited Interest Rate from the date of deposit to the date the amount is applied
to the elected payment option. •
Guaranteed Certificate Fund Rider - 1
vUAc:1ti =__ -_�
�'=wCATc ; ND SUS-ACCOUNT RIDE? iccnuncedI
are Seiect:cn of l'ev'"?nt Cct!on icontinuedl
If me Participant has not died. separated from service or excerienced an unforeseeac e
emergency as determined by the Group Policyholder, amounts oeposite0 into the Guaranteed
Certificate Fund must remain in me Certificate until the Certificate Maturity Date. Thus. ^c
payment action may oe elected, and no distributions or transfers will be permitted prior to :re
Maturity Date of each respective Certificate.
Cert'ficate Maturity
Prior to the Certificate Maturity Date, the Company will offer a Guaranteed Sub-Account nto
whicn the ue of the be deposited on its Maturity ate. The Guaranteed
Sub-Accounts Certificate
so offered may be either willCertificate the Guaranteed FundD or another Guaranteed
Sub-Account.
If the Guaranteed Certificate Fund is offered, the value of the Certificate on its Maturity Date wul
establish a new Certificate which has its own Credited
rm. The Credited
Interest Rate of this new Certificate may be higher or lower than the Credited Inn erest Rate of any
other Certificate or Deposit.
tf another Guaranteed Sub-Account is offered. the value of the Certificate on its Maturity Date will be nterest be higher or
into lower
rthan the Crediitedub-Account. The Credited Interest Rate of any otherlDeposrt ate of this Deposit may
Transfers •
The terms of Section 6 of the Group Annuity Contract will apply to any transfer to or
from the Guaranteed Certificate Fund.
Value of Guaranteed Certificate Fund
The value of the Guaranteed Certificate Fund in respect of the Participant will be determined by
adding his/her Guaranteed Certificate Fund Sub-Account's Deposits and interest, and subtracting
ing ciary, amounts underra paymentptionttransfers, Contract Maintenanctotal or partial disributions, distributions to a e Charge, and Premium Tax.
Thd isapp
This Rider, unless and until modified. forms part of the Group Annuity Contract.
Guaranteed Certificate Fund Rider - 2
3,7-#.933
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