EX-99.(H)(33)(III) 4 tm242291d1_ex99-xhx33xiii.htm EXHIBIT 99.(H)(33)(III)
Exhibit (h)(33)(iii)
 
Amendment to Participation Agreement
 
THIS AMENDMENT TO PARTICPATION AGREEMENT is made as of October 5, 2020, by and among Empower Annuity Insurance Company of America (formerly, Great-West Life and Annuity Insurance Company) (“GWL&A”); Empower Life & Annuity Insurance Company of New York (formerly, Great-West Life & Annuity Insurance Company of New York) (“GWL&ANY”); BNY Mellon Variable Investment Fund (formerly, Dreyfus Variable Investment Fund), BNY Mellon Investment Portfolios (formerly, Dreyfus Investment Portfolios), BNY Mellon Sustainable U.S. Equity Portfolio, Inc. (formerly, The Dreyfus Sustainable U.S. Equity Portfolio, Inc.), BNY Mellon Stock Index Fund, Inc. (formerly, Dreyfus Stock Index Fund) (each, a “Fund”); and BNY Mellon Investment Adviser, Inc.  (formerly, The Dreyfus Corporation) (“Adviser”) (collectively, the “Parties”). Capitalized terms not otherwise defined herein shall have the meaning ascribed to them in the Agreement (defined below).
 
WHEREAS, the Parties executed a Fund Participation Agreement dated as of December 31, 1998, as amended (the “Agreement”);
 
WHEREAS, the Parties desire to update the Contracts listed in Schedule A and the Designated Portfolios listed in Schedule B of the Agreement; and
 
WHEREAS, the Parties desire to update all references to Separate Accounts to include additional Separate Accounts of GWL&A and GWL&ANY.
 
NOW, THEREFORE, in consideration of the mutual covenants herein contained, which consideration is full and complete, the Parties hereby agree as follows:
 
1.
Schedule A of the Agreement is deleted and replaced in its entirety with the Schedule A attached hereto.
 
2.
Schedule B of the Agreement is deleted and replaced in its entirety with the Schedule B attached hereto.
 
3.
The preamble and all additional references to Separate Accounts will now refer to the following Separate Accounts:
 
Maxim Series Account
COLI VUL Series Account 2
COLI VUL Series Account 4
COLI VUL Series Account 7
COLI VUL-2 NY Series Account
COLI VUL-1 Series Account
COLI VUL Series Account 8
COLI VUL Series Account 9
COLI VUL Series Account 10
COLI VUL Series Account 11
COLI VUL Series Account 14
 
 
4.
All other terms and provisions of the Agreement not amended herein shall remain in full force and effect.
 
5.
This Amendment may be executed in any number of counterparts, each of which shall be deemed to be an original.
 
 
[Signature Page Follows]
 
 
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IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed as of the Effective Date.
 
 
 
PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANY, as administrator on behalf of EMPOWER LIFE & ANNUITY INSURANCE COMPANY OF NEW YORK
 
By: _/s/ Steve Cramer________________________________
 
Name: _Steve Cramer______________________________
 
Title: __Chief Product Officer – Retirement Division______________________________
 
 
PROTECTIVE LIFE INSURANCE COMPANY, as administrator on behalf of EMPOWER ANNUITY INSURANCE COMPANY OF AMERICA
 
By: _/s/ Steve Cramer________________________________
 
Name: _Steve Cramer______________________________
 
Title: __Chief Product Officer – Retirement Division______________________________
 
 
ON BEHALF OF EACH OF THE BNY MELLON FAMILY OF FUNDS LISTED ABOVE AS PARTIES TO THE AGREEMENT
 
By: __/s/ James Bitetto_______________________________
 
Name: _James Bitetto______________________________
 
Title: __Vice President and Secretary______________________________
 
 
BNY MELLON INVESTMENT ADVISER, INC.  
 
By: __/s/ James Bitetto_______________________________
 
Name: _James Bitetto______________________________
 
Title: _Secretary_______________________________
 
 
 
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Schedule A
 
 
Contracts
 
AICPA Variable Annuity
Private Placement VUL (PPVUL)
Private Placement VUL NY (PPVUL NY)
Executive Benefit VUL
Executive Benefit VUL II
Executive Benefit Registered VUL NY
 
Separate Accounts
 
Maxim Series Account
COLI VUL Series Account 2
COLI VUL Series Account 4
COLI VUL Series Account 7
COLI VUL Series Account 8
COLI VUL Series Account 9
COLI VUL Series Account 10
COLI VUL Series Account 11
COLI VUL Series Account 14
COLI VUL-2 NY Series Account
COLI VUL-1 Series Account (GWLANY)
 
 
 
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Schedule B
 
LIST OF PARTICIPATING FUNDS
The provisions of this Agreement apply exclusively to the dealer code and branch codes specified in this Schedule B.  Insurance Company is solely responsible for providing the correct dealer and branch codes on each account.
Dealer Code: 007368 Branch Code: GW01 or GW02
 
 
F und Name
 
 
Share Class
 
BNY Mellon Investment Portfolios:
MidCap Stock Portfolio
Initial and Service
Small Cap Stock Index Portfolio
Service
Technology Growth Portfolio
 
Initial and Service
BNY Mellon Stock Index Fund, Inc.
 
Initial and Service
BNY Mellon Sustainable U.S. Equity Portfolio, Inc.
 
Initial and Service
BNY Mellon Variable Investment Fund
Appreciation Portfolio
Initial and Service
Growth and Income Portfolio
Initial and Service
Government Money Market Portfolio
-
Opportunistic Small Cap Portfolio
 
Initial and Service
 
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