EX-16 11 ex164g.htm EXHIBIT 16(4)(G) CERTIFICATE GP2CERT (4/94) ex164g.htm - Generated by SEC Publisher for SEC Filing
Exhibit 16(4)(g)
Aetna Insurance Company of America
Home Office: 151 Farmington Avenue
Hartford, Connecticut 06156
(800) 531-4547  
 
Aetna Insurance Company of America (We or Us) agrees to pay benefits according
to the terms and conditions set forth in this Contract.
 
- --------------------------------------------------------------------------------
Certificate of Group Annuity Coverage  
 
Aetna certifies that an account is established for you under the Group Annuity
Contract and Certificate numbers shown below.  
 
This certificate describes Group Annuity Contract provisions. It replaces any
and all prior certificates or endorsements issued to you under the stated
Contract and Certificate numbers. This Certificate is for information only and
is not a part of the Contract.  
 
THE VARIABLE FEATURES OF THE GROUP CONTRACT ARE DESCRIBED IN SECTIONS 6 AND 12.
 
- --------------------------------------------------------------------------------
Right to Cancel  
 
The Certificate Holder may cancel the Certificate within ten (10) days of
receiving it by returning it to Us at the address above or the person from whom
it was purchased. Within seven (7) days of the cancellation request, We will
return the Certificate Holder's Purchase Payment(s) made plus any increase, or
minus any decrease on the amount allocated to the Separate Account.
 
Signed at the Home Office on the Effective Date.
 
/s/ Dan Kearney /s/ Maria F. McKeon
President Secretary
 
- --------------------------------------------------------------------------------
Contract Holder Group Annuity Contract Number
 
- --------------------------------------------------------------------------------
Certificate Holder Certificate Number
 
- --------------------------------------------------------------------------------
Annuitant Name Type of Plan
 
 
ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT. THIS CERTIFICATE CONTAINS A MARKET VALUE ADJUSTMENT
FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN
INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA
DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.
 
GP2CERT(4/94)  
<PAGE>  
 
Table of Contents  
  Page
Right to Cancel 1
 
Contract Schedule 4
 
Separate Account 4
AICA Guaranteed Account (AG Account) 4
Separate Account and AG Account 4
Fixed Annuity 6
 
Section 1. Definitions 7
 
Section 2. General Provisions 9
 
The Contract 9
Certificates 9
Nonparticipating Contract 9
Misstatements and Adjustments 9
Reports 9
Premium Taxes 9
Protection of Proceeds 9
Evidence of Survival 9
Proof of Age 9
Change of Contract 9
 
Section 3. Ownership 10
 
Group Contract Holder 10
Certificate Holder Rights 10
Transfer of Ownership 10
 
Section 4. Beneficiary Provisions 11
 
Beneficiary 11
Change of Beneficiary 11
Death of Beneficiary 11

 


 

Page 2 of 23

Section 5. Purchase Payments 11
 
Purchase Payments 11
Allocation of Purchase Payments 11
 
Section 6. Separate Account 12
 
General 12
Investment Allocations to the Separate Account 12
Valuation of Assets 12
Accumulation Unit 12
Net Return Factor for Each Valuation Period 12
Administrative Charge 13
Mortality Risk Charge 13
Expense Risk Charge 13
Mortality and Expense Guarantee 13
 
 
2  
 
<PAGE>  
 
  Page
 
Section 7. AG Account 13
 
AG Account Guaranteed Interest Rate 13
Deposit Period 13
Guaranteed Term 13
Guaranteed Term(s) Groups 14
Maturity Date 14
Allocation of Net Purchase Payments to the AG Account 14
AG Account Guaranteed Term Maturity Date and Maturity Value 14
Transfers from the AG Account 14
Withdrawals from the AG Account 14
Reinvestment 14
AG Account Market Value Adjustment (Factor) 15

 

Section 8. Certificate Holder's Account Value; Transfers and Withdrawals  
During the Accumulation Period 16
 
Certificate Holder's Account Value 16
Transfers During the Accumulation Period 16
Withdrawals During the Accumulation Period 16
Deferred Sales Charge 16
Waiver of Deferred Sales Charge 17
Payment of Adjusted Certificate Holder Account Value 17
Systematic Withdrawal Option (SWO) 17
 
Section 9. Maintenance Charge 18
 
Maintenance Charge 18
 
Section 10. Proceeds Payable on Death 18
 
Death of the Certificate Holder Prior to the Annuity Date 18
Death Benefit Amount Prior to the Annuity Date 18
Death Benefit Payment Methods 20
Death of Certificate Holder On or After the Annuity Date 20
Death of the Annuitant 20
 
Section 11. Delay of Payments 20
 
Delay of Payments 20
 
Section 12. Annuity Provisions 21
 
Designation of Annuitant 21
Terms of Annuity Options 21
Annuity Unit 22
Annuity Unit Value 23
Annuity Net Return Factor 23
Annuity Options 23
 
 
3  
 
<PAGE>  

 

Contract Schedule

Separate Account

- --------------------------------------------------------------------------------

Separate Account: Variable Account I    
Charges to the Separate A daily charge is deducted from the assets of the  
Account: Separate Account. The deduction is the daily  
  equivalent of the annual effective percentage  
  shown below:    
  (a) During the Accumulation Period:    
  Administrative Charge 0.15%  
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt 03/26/2018

 


 

Page 3 of 23

  Mortality Risk Charge 0.35%
  Expense Risk Charge 0.90%
  TOTAL Separate Account Charges During  
  Accumulation Period 1.40%
 
(b) During the Annuity Period  
 
  Administrative Charge Not To Exceed 0.25%
  Mortality Risk Charge 0.35%
  Expense Risk Charge 0.90%
  TOTAL Maximum Separate Account Charges  
  During Annuity Period 1.50%

 

AICA Guaranteed Account (AG Account)

- --------------------------------------------------------------------------------

Minimum Guaranteed 3.0%
Interest Rate  
(effective annual rate of  
return):  

 

Separate Account and AG Account

- --------------------------------------------------------------------------------

Minimum Initial Purchase Payment:

Minimum Subsequent Purchase Payment:

Maximum Subsequent Purchase Payment:

Transfers:

$1,500

$500 or $50 per month if paid by an automatic check plan

$500,000 without Home Office approval

We allow an unlimited number of transfers during the Accumulation Period. Twelve (12) transfers in any calendar year are free. Thereafter, We reserve the right to charge a transfer charge up to $10 for each subsequent transfer.

 

4

<PAGE>

Maintenance Charge: The annual maintenance charge is $30. If the
  Certificate Holder's Account is $50,000 or more on
  the date the maintenance charge is to be deducted,
  the maintenance charge is $0.  
 
Deferred Sales For each withdrawal from a Certificate Holder's
Charge: Account, a deferred sales charge for each Net
  Purchase Payment will be determined as follows:
 
  Years from Receipt of Deferred
  Net Purchase Payment Sales Charge
 
  0-1 7%
  1-2 6%
  2-3 5%
  3-4 4%
  4-5 3%
  5-6 2%
  6-7 1%
  7+ 0%
 
Waiver of Deferred Section 8.05 provides for the following:
Sales Charge:    

 

(c)     

At least 12 months after the date of the first Purchase Payment in an amount equal to or less than 15% of the Certificate Holder's Account Value.

(d)     

For a full withdrawal where the Certificate Holder's Account Value does not exceed $2,500 and no withdrawals have been taken from the Certificate Holder's Account within the prior 12 months.

Systematic (a) Specified Payment - Maximum Percentage: 10%  
Withdrawal Option:      
  (b) Specified Period - Minimum Period: 10 years  
 
  (c) Specified Percentage - Maximum Percentage: 10%  
 
Death Benefit Factor: 4%    
 
Death Benefit There is no maximum death benefit amount.    
Maximum Amount:      
 
Death Benefit 85 years    
Maximum Age:      
 
Fund for Allocation of Federated Prime Money Fund II    
Excess Guaranteed Death      
Benefit Value:      
 
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt 03/26/2018

 


 

Page 4 of 23

Latest Annuity Date:

The Certificate Holder's 90th birthday.

5

<PAGE>

Fixed Annuity
- --------------------------------------------------------------------------------

 

Minimum Guaranteed 3.0%  
Interest Rate    
(effective annual rate    
of return):    
 
 
      6
<PAGE>      
 
 
 
Section 1. Definitions    

 

  • --------------------------------------------------------------------------------

  • Accumulation Period - The period during which one or more Net

Purchase Payments applied to a Certificate Holder's Account
accumulate to provide future Annuity payments.

1.02     

Accumulation Unit - A measure of the net investment results for each variable investment option during the Accumulation Period.

 

The Accumulation Units for the applicable Funds are used to calculate the portion of a Certificate Holder's Account Value attributable to a Separate Account during the Accumulation Period.

1.03     

Adjusted Certificate Holder Account Value - The Certificate Holder's Account Value, plus or minus any aggregate AG Account Market Value Adjustment.

1.04     

Annuitant - The natural person on whose life an Annuity payment is based.

1.05     

Annuity - A series of payments We make for life, a definite period or a combination of the two.

1.06     

Annuity Date - The date on which Annuity payments commence.

1.07     

Annuity Options - Annuity payment methods available during the Annuity Period.

1.08     

Annuity Period - The period of time during which Annuity payments are made.

1.09     

Annuity Unit - A measure of the net investment results for each variable investment option during the Annuity Period. Annuity Units are used to calculate the amount of each variable Annuity payment.

1.10     

Beneficiary - The person(s) entitled to receive any death benefit under the Certificate Holder's Account. Upon the death of a joint Certificate Holder, the surviving joint Certificate Holder, if any, is treated as the Beneficiary. Any other Beneficiary designation on record with Us at the time of death is treated as a contingent Beneficiary.

1.11     

Certificate - The document issued to a Certificate Holder to evidence a Certificate Holder's Account established under the group Contract.

1.12     

Certificate Holder - A person who has established a Certificate

Holder's     

Account under a group Contract. We reserve the right to

limit     

ownership to natural persons. If more than one Certificate

Holder     

owns an Account, each Certificate Holder shall be a joint

Certificate     

Holder. Any joint Certificate Holder must be the

spouse     

of the other joint Certificate Holder. Joint Certificate

Holders     

have joint ownership rights and both must authorize any

exercising     

of those ownership rights unless otherwise allowed by

Us.     

1.13     

Certificate Holder's Account - A record We establish for each

Certificate     

Holder to maintain values under a group Contract.

1.14     

Certificate Holder's Account Value - The dollar value as of any

Valuation     

Period of all amounts accumulated in a Certificate

Holder's     

Account.

7

<PAGE>

1.15     

Contract - This agreement between the Group Contract Holder and Us.

1.16     

Effective Date - The date a Certificate is issued to a Certificate Holder.

1.17     

Fund - One of the variable investment options which may be

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 5 of 23

selected by a Certificate Holder.

1.18     

General Account - The General Account is made up of all of our general assets other than those allocated to the separate accounts.

1.19     

AICA Guaranteed Account (AG Account) - An investment option where We guarantee specified rate(s) of interest for specified periods of time. The AG Account is a separate account established by Us in accordance with the provisions of the Connecticut General Statutes Section 38a-433. Certificate Holders do not participate in the investment gain or loss from the assets held in the AG Account. Assets in the AG Account may be charged with liabilities arising out of any other business We may conduct.

1.20     

Group Contract Holder - The entity to which a group Contract is issued.

1.21     

Home Office - Our headquarters, located at 151 Farmington Avenue, Hartford, CT 06156.

1.22     

Market Value Adjustment - An adjustment to any withdrawal made from the AG Account before the end of a guaranteed term as stated in Section 7.11.

1.23     

Net Purchase Payment - The Purchase Payment less premium taxes, if applicable.

1.24     

Purchase Payment - The gross payment accepted by Us and allocated to the Certificate Holder's Account. We reserve the right to refuse to accept any Purchase Payment at any time for any reason.

1.25     

Separate Account - A separate account that buys and holds shares of the Fund(s). Income, gains or losses, realized or unrealized, are credited or charged to the Separate Account without regard to Our other income, gains or losses. We own the assets held in the Separate Account and are not a trustee as to such amounts. The

Separate     

Account generally is not guaranteed and is held at

market     

value. The name of the Separate Account is shown on the

Contract     

Schedule. The assets of the Separate Account, to the

extent     

of reserves and other Contract liabilities of the Separate

Account,     

will not be charged with Our other liabilities.

1.26     

Valuation Period - The period of time for which a Fund determines

its     

net asset value, usually from 4:15 p.m. Eastern time each day

the     

New York Stock Exchange is open until 4:15 p.m. the next such

business     

day, or such other day that one or more of the Funds

determines     

its net asset value. The assets of the Separate

Account     

are not chargeable with the liabilities arising out of

any     

other business We may conduct.

1.27     

Variable Annuity Contract - An Annuity Contract providing for the

accumulation     

of value and/or for Annuity payments which vary in

amount     

based on investment results.

8

<PAGE>

Section 2.

General Provisions

  • --------------------------------------------------------------------------------

  • The Contract - The entire Contract consists of this Contract and

any attached applications or endorsements.

2.02     

Certificates - A Certificate is issued to each Certificate Holder whose Purchase Payment(s) is accepted by Us. The Certificate evidences a Certificate Holder's Account established under the Contract. Certificates are not part of the Contract.

2.03     

Nonparticipating Contract - Neither the Group Contract Holder, Certificate Holder nor any Beneficiary have a right to share in our earnings.

2.04     

Misstatements and Adjustments - If We learn that the age of any Annuitant or second Annuitant is misstated, the correct age will be used to adjust payments. We reserve the right to request reimbursement or adjust future payments for any amount overpaid.

 

We will pay the amount of any underpayment.

2.05     

Reports - We furnish each Certificate Holder with a report showing the Certificate Holder's Account Value at least once each calendar year. We also furnish an annual report of the Separate Account.

2.06     

Premium Taxes - Any premium taxes paid to any governmental entity are charged against Purchase Payments or a Certificate Holder's Account. We may, at our sole discretion, pay premium taxes when due and deduct that amount from the Certificate Holder's Account at a later date. Payment at an earlier date does not waive any right We may have to deduct amounts at a later date.

2.07     

Protection of Proceeds - To the extent permitted by law, all

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 6 of 23

payments under this Contract to a Certificate Holder or
Beneficiary shall be free from legal process and the claim of any
creditor.

2.08     

Evidence of Survival - The Company may require satisfactory evidence of the continued survival of any person(s) on whose life Annuity payments are based.

2.09     

Proof of Age - The Company may require evidence of age of any Annuitant under Annuity Options 2 and 3 and of the designated second Annuitant under Annuity Option 3.

2.10     

Change of Contract - Only our authorized officers may change the terms of this Contract. We will notify the Group Contract Holder in writing at least 30 days before the effective date of any change. Any change will not affect the amount or terms of any Annuity which begins before the change.

 

We may make any change that affects the AG Account Market Value Adjustment with at least thirty (30) days' advance written notice to the Group Contract Holder and the Certificate Holder. Any such change shall become effective for any new guaranteed term and will apply to all present and future Certificate Holders' Accounts.

 

We reserve the right to change the terms of the Systematic Withdrawal Option for future elections and discontinue the availability of this option.

9

<PAGE>

Any change to any of the following provisions under this Contract
will not apply to Certificate Holder's Accounts in existence
before the effective date of the change:

(a)     

Net Purchase Payment (1.23)

(b)     

AG Account Guaranteed Interest Rate (7.01)

(c)     

Net Return Factor (6.05)

(d)     

Certificate Holder's Account Value (1.14)

(e)     

Deferred Sales Charge (8.04)

(f)     

Annuity Unit Value (12.04)

(g)     

Annuity Options (12.06)

(h)     

Fixed Annuity Interest Rates (12.01)

(i)     

Transfers (8.02).

Any change that affects the Annuity Option and the tables for the
Annuity Options may be made:

(a)     

No earlier than twelve (12) months after the Effective Date; and

(b)     

No earlier than twelve (12) months after the effective date of any prior change.

Any Certificate Holder's Account established on or after the
effective date of any change will be subject to the change. If
the Group Contract Holder does not agree to any change under this
provision, We reserve the right to not allow any new Certificate
Holder's Accounts to be established under this Contract. This
Contract may also be changed as deemed necessary by Us to comply
with federal or state law.

Section 3.

Ownership

  • --------------------------------------------------------------------------------

  • Group Contract Holder - The Group Contract Holder has title to

the Contract. The Contract and any amounts accumulated thereunder
are not subject to the claims of the Group Contract Holder nor
any of its creditors.

3.02     

Certificate Holder Rights - The Certificate Holder has all

  interest     

and right to amounts held in his or her Certificate

  Holder's     

Account. The Certificate Holder and any joint

  Certificate     

Holder are named on the Specifications page. The

  Certificate     

Holder and any joint Certificate Holder may exercise

  all     

the rights under the Certificate Holder's Account, subject to

  the     

rights of:

  (a)     

Any assignee under an assignment filed at our Home Office; and

  (b)     

Any irrevocably named Beneficiary.

  Upon     

the death of a Certificate Holder prior to the Annuity Date,

  a     

spousal Beneficiary may elect to continue the Certificate

  Holder's     

Account in his or her own name and retain all ownership

  rights     

and privileges or take distribution of the death benefit

  as     

defined in Section 10.

3.03     

Transfer of Ownership - The Group Contract Holder may transfer

  ownership     

of this Contract. A written request, dated and signed,

  must     

be filed at our Home Office.

  Any     

transfer of ownership terminates the interest of any existing

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 7 of 23

Group Contract Holder. It does

10

<PAGE>

not change the rights of any Certificate Holder.

A Certificate Holder may transfer all of his or her rights under
the Contract. A written request, dated and signed by the
Certificate Holder and any joint Certificate Holder, must be
filed at our Home Office. After the transfer is recorded, it will
take effect as of the date the request was signed. Any such
transfer terminates the interest of any existing Certificate
Holder. It does not change the Beneficiary, nor transfer the
Beneficiary's interest. A transfer will not affect any payments
We may make or actions We may take before such transfer has been
recorded at our Home Office.

Section 4.

Beneficiary Provisions

  • --------------------------------------------------------------------------------

  • Beneficiary - The Certificate Holder may name a Beneficiary and

a contingent Beneficiary. At the death of the Certificate Holder
prior to the Annuity Date, the Beneficiary(ies) named in our
records will receive a death benefit as stated in Section 10.
Upon the death of either joint Certificate Holder prior to the
Annuity Date, the surviving joint Certificate Holder, if any,
will be treated as the designated Beneficiary and any other
Beneficiary designation on record with Us at the time of death is
treated as a contingent Beneficiary.

4.02     

Change of Beneficiary - The Certificate Holder may change the Beneficiary. A written request, dated and signed by the Certificate Holder, must be filed at our Home Office. If there are joint Certificate Holders, both must sign the request. After the change is recorded, it will take effect as of the date the request was signed. If the request reaches our Home Office and is recorded after the Certificate Holder dies, but before any payment is made, the change is valid.

4.03     

Death of Beneficiary - If all of the Beneficiaries and contingent Beneficiaries die prior to the Certificate Holder's death, We pay the death benefit in one sum to the Certificate Holder's estate.

Section 5.

Purchase Payments

  • --------------------------------------------------------------------------------

  • Purchase Payments - Subject to the maximum and minimum shown on

the Contract Schedule, the Certificate Holder may determine the
amount and frequency of Purchase Payments. We reserve the right
not to accept any Purchase Payment. We will declare from time to
time the acceptability of additional Purchase Payments.

5.02     

Allocation of Purchase Payments - The Certificate Holder may

  elect     

to have each Net Purchase Payment accumulate:

  (a)     

On a variable basis invested in shares of one or more Funds in which the Separate Account invests;

  (b)     

For guaranteed terms offered in the current deposit period(s) under the AG Account; or

  (c)     

In a combination of any of the available investment options.

  Net     

Purchase Payments must be allocated in whole percentages. For

  subsequent     

Purchase Payments, if no allocation instructions are

  received     

with the Purchase Payment, the allocation will be as

  indicated     

in the most recent directive from the Certificate

  Holder.     

If the same

11

<PAGE>

guaranteed term(s) are not available, the next shortest will be
used. If no shorter guaranteed term is available, the next longer
guaranteed term will be used.

Section 6.

Separate Account

  • --------------------------------------------------------------------------------

  • General - The assets of the Separate Account, equal to the

reserves and other Contract liabilities that depend on the
investment performance of the Separate Account are not chargeable
with liabilities arising out of any other business We may
conduct. Income, gains or losses of the Separate Account,
realized or unrealized, are credited to or charged against the
assets of the Separate Account without regard to Our other
income, gains or losses.

6.02     

Investment Allocations to the Separate Account - The assets of the Separate Account are segregated by Fund. If the shares of any Fund are no longer available for investment by the Separate

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 8 of 23

Account or if in our judgment, further investment in such shares
should become inappropriate in view of the purpose of the
Contract, We may cease to make such Fund shares available for
investment under the Contract prospectively, or We may substitute
shares of another Fund for shares already acquired. We may also,
from time to time, add additional Funds. Any elimination,
substitution or addition of Funds will be done in accordance with
applicable state and federal securities laws. We reserve the
right to substitute shares of another Fund for shares already
acquired without a proxy vote.

6.03     

Valuation of Assets - The shares of the Funds will be valued at

  their     

net asset value at the end of each Valuation Period.

6.04     

Accumulation Unit - A Net Purchase Payment that is allocated to

  one     

or more Funds is credited to the Certificate Holder's Account

  as     

Accumulation Units. The number of Accumulation Units credited

  is     

determined by dividing the applicable portion of the Net

  Purchase     

Payment by the Accumulation Unit value for the

  appropriate     

Fund. The Accumulation Unit value used is that which

  is     

computed for the next Valuation Period after which the

  Purchase     

Payment is received at our Home Office. Accumulation

  Units     

attributable to the initial Purchase Payments will be

  credited     

within two business days of acceptance.

  Accumulation     

Unit values may increase or decrease from Valuation

  Period     

to Valuation Period.

6.05     

Net Return Factor for Each Valuation Period - The value of an

  Accumulation     

Unit for any Valuation Period is calculated by

  multiplying     

the Accumulation Unit value for the immediately

  preceding     

Valuation Period by the net return factor of the

  appropriate     

Fund for the current period.

  The     

net return factor for each Fund is equal to 1.0000000 plus

  the     

net return rate.

  The     

net return rate equals:

  (a)     

The value of the shares of the Fund held by the Separate Account at the end of a Valuation Period; minus

  (b)     

The value of the shares of the Fund held by the Separate Account at the start of the Valuation Period; plus or minus

12

<PAGE>

(c)     

Taxes (or reserves for taxes) on the Separate Account (if any); divided by

(d)     

The total value of the Funds(s) Accumulation Units and Fund(s) Annuity Units of the Separate Account at the start of the Valuation Period; minus

(e)     

A daily actuarial charge as shown on the Contract Schedule for Annuity mortality and expense risks and profit and a daily administrative charge.

The net return rate may be more or less than zero (0) percent.

The value of a share of the Fund is equal to the net assets of
the Fund divided by the number of shares outstanding.

6.06     

Administrative Charge - We deduct an administrative charge equal, on an annual basis, to the amount shown on the Contract Schedule.

6.07     

Mortality Risk Charge - We deduct a mortality risk charge equal, on an annual basis, to the amount shown on the Contract Schedule.

6.08     

Expense Risk Charge - We deduct an expense risk charge equal, on an annual basis, to the amount shown on the Contract Schedule.

6.09     

Mortality and Expense Guarantee - We guarantee that the dollar amount of each Annuity payment after the first will not be affected by variations in mortality or expense experience.

Section 7.

AG Account

  • --------------------------------------------------------------------------------

  • AG Account Guaranteed Interest Rate - All amounts allocated to

the AG Account earn a rate of interest that is guaranteed for a
specified period of time. The rate will be credited daily and
will never be less than the minimum guaranteed interest rate
shown on the Contract Schedule. We determine the rate and it is
not based on investment experience.

  For guaranteed terms of one year or less, one guaranteed interest  
  rate is credited for the full guaranteed term. For longer  
  guaranteed terms, an initial guaranteed interest rate is credited  
  from the date of deposit to the end of a specified period within  
  the guaranteed term. There may be different guaranteed interest  
  rate(s) declared for subsequent specified time intervals  
  throughout the guaranteed term.  
 
7.02 Deposit Period - A calendar week, a calendar month, a calendar  
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt 03/26/2018

 


 

Page 9 of 23

quarter, or any other period of time We specify during which Net
Purchase Payment(s), transfers and reinvestments are accepted
into the AG Account for one or more guaranteed terms. We reserve
the right to extend the deposit period.

7.03     

Guaranteed Term - The period of time for which AG Account guaranteed interest rates are guaranteed on Net Purchase Payments. Transfers and reinvestments are made into a current deposit period for the AG Account. Such period begins on the day following the close of the deposit period and ends on the designated Maturity Date. Guaranteed terms, if any, are offered at our discretion for various lengths of time ranging up to and including ten years.

13

<PAGE>

During a deposit period, We may make available any number of
guaranteed terms. The Certificate Holder may allocate Net
Purchase Payments and transfers into any or all of the available
guaranteed terms.

7.04     

Guaranteed Term(s) Groups - All AG Account guaranteed term(s)

  with     

the same length of time from the close of the deposit period

  until     

the designated Maturity Date.

7.05     

Majority Date - The last day of a guaranteed term.

7.06     

Allocation of Net Purchase Payments to the AG Account - When the

  Certificate     

Holder wishes to allocate all or any portion of a Net

  Purchase     

Payment to the AG Account, he or she must tell Us the

  percentage     

to apply to one or more of the AG Account guaranteed

  term(s)     

available during the current deposit period. If no

  allocation     

instructions are received, a Net Purchase Payment is

  allocated     

as indicated in the most recent directive from the

  Certificate     

Holder. If the same guaranteed term is not available

  for     

any amount allocated to the AG Account, We will allocate the

  amount     

to the next shortest guaranteed term available. If no

  shorter     

guaranteed term is available, We will allocate it to the

  next     

longest guaranteed term.

7.07     

AG Account Guaranteed Term Maturity Date and Maturity Value - On

  the     

maturity date, the value of the total of all amounts

  allocated     

to that guaranteed term is called the maturity value.

  When     

Certificate Holders have assets in the AG Account, at least

  eighteen     

(18) days before a maturity date, We notify them of the:

  (a)     

Projected maturity value; and

  (b)     

Guaranteed terms and the applicable guaranteed interest rates available during the current deposit period.

  When     

no allocation instructions are received and the assets in a

  guaranteed     

term have been reinvested by Us in another guaranteed

  term     

on the maturity date, the Certificate Holder may transfer or

  withdraw,     

during the month following the maturity date, the

  reinvested     

amount with interest earned (as of the date the

  request     

is received at our Home Office) without incurring a

  Market     

Value Adjustment. This transaction is allowed only once

  for     

each maturity date, regardless of whether the transfer or

  withdrawal     

is partial or full.

7.08     

Transfers from the AG Account - A Certificate Holder may transfer

  any     

portion, or all, of an amount in the AG Account to one or

  more     

of the Funds or to another available guaranteed term. The

  amount     

withdrawn for any reason before the maturity date is

  subject     

to a Market Value Adjustment.

7.09     

Withdrawals from the AG Account - When the Certificate Holder

  requests     

a withdrawal from the AG Account, if instructions are

  not     

provided by the Certificate Holder, amounts are withdrawn on

  a     

pro rata basis from the guaranteed term(s) groups in which the

  Certificate     

Holder's Account is currently invested. Within a

  guaranteed     

term group, the amount to be withdrawn will be

  withdrawn     

first from the oldest deposit period. Except on the

  maturity     

date, withdrawals from the AG Account will be subject to

  a     

Market Value Adjustment.

7.10     

Reinvestment - We will mail a notice to the Certificate Holder

  before     

a guaranteed term's

14

<PAGE>

maturity date. This notice will contain the guaranteed terms
available during the current deposit periods with their
guaranteed interest rate(s) and projected maturity value. If no
specific direction is given by the Certificate Holder prior to
the maturity date, each maturity value will be reinvested in the
current deposit period for a guaranteed term of the same
duration. If a guaranteed term of the same duration is
unavailable, each matured term value will automatically be
reinvested in the current deposit period for the next shortest
guaranteed term available. If no shorter guaranteed term is
available, the next longer guaranteed term will be used. We will

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 10 of 23

mail a confirmation statement to the Certificate Holder after the
maturity date. This notice will state the guaranteed term and
guaranteed interest rate(s) which will apply to the reinvested
matured term value.

7.11     

AG Account Market Value Adjustment (Factor) - The Market Value Adjustment factor (MVA factor) reflects any change in interest rates from the time assets are allocated to the AG Account to the time they are transferred or withdrawn. An MVA factor is applied to any amount withdrawn or transferred from the AG Account before the end of a guaranteed term, including amounts paid in a lump sum death benefit or applied to an Annuity Option.

 

The amount withdrawn from the AG Account is multiplied by the MVA factor which is calculated as follows:

x
---
365

(1 + i)
--------------------
x
---
365
(1 + j)

Where:

i is the Deposit Period Yield
j is the Current Yield
x is the number of days remaining, (computed from
Wednesday of the week of withdrawal) in the
guaranteed Term.

Determination of MVA factor parameters:

A yield is computed at the close of the last business day of each
week of the deposit period. The yield will equal the average of
the yields on U.S. Treasury Notes which matured during the last
three months of the applicable guaranteed term.

The deposit period yield is the average of those yields for the
deposit period. If withdrawal is made prior to the close of the
deposit period, it is the average of those yields on each week
preceding withdrawal.

The current yield is the average of the yields on the last
business day of the week preceding withdrawal on the same U.S.
Treasury Notes included in the deposit period yield.

If no U.S. Treasury Notes matured during the last three months of
the guaranteed term, We reserve the right to use the average of
the yields on U.S. Treasury Notes that mature during a

15

<PAGE>

following quarter.

Section 8.

Certificate Holder's Account Value; Transfers and Withdrawals During the Accumulation Period

 

  • --------------------------------------------------------------------------------

  • Certificate Holder's Account Value - The value of a Certificate

Holder's Account is determined by adding the value of the total
of Accumulation Units attributed to the selected Fund(s) to the
value of any amounts attributed to the AG Account.

8.02     

Transfers During the Accumulation Period - Before the Annuity

  Date,     

the Certificate Holder may transfer from any Fund or

  guaranteed     

term of the AG Account to:

  (a)     

Any other Fund; or

  (b)     

Any guaranteed term of the AG Account available in the current deposit period.

  Transfer     

requests can be submitted as a percentage or as a dollar

  amount.     

We may establish a minimum transfer amount. Within a

  guaranteed     

term group, the amount transferred is withdrawn first

  from     

the oldest deposit period, then from the next oldest, and so

  on     

until the amount requested is satisfied.

  The     

Certificate Holder may make an unlimited number of transfers

  during     

the Accumulation Period. The number of free transfers

  allowed     

is shown on the Contract Schedule. Transfers in excess of

  that     

number may be subject to the transfer charge shown on the

  Contract     

Schedule. Transfers of a matured term value from the AG

  Account     

on or within one calendar month after a guaranteed term's

  maturity     

date do not count against the annual transfer limit.

  Amounts     

applied to guaranteed terms of the AG Account may not be

  transferred     

to the Funds or to another guaranteed term during the

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 11 of 23

deposit period or for 90 days after the close of the deposit
period except for matured term value(s) during the calendar month
following the guaranteed term's maturity date.

Transfers from guaranteed terms of the AG Account are subject to
a Market Value Adjustment.

8.03     

Withdrawals During the Accumulation Period - The Certificate Holder may withdraw all or a portion of the Certificate Holder's Account Value during the Accumulation Period by properly completing a withdrawal request form. Withdrawal requests can be submitted as a percentage or as a specific dollar amount. Net Purchase Payment amounts are withdrawn first, and then the excess value, if any. For any partial withdrawal, if instructions are not provided by the Certificate Holder, amounts are withdrawn on a pro rata basis from the Fund(s), and/or the guaranteed term(s) groups in which the Certificate Holder's Account is currently invested. Within a guaranteed term group, the amount to be withdrawn will be withdrawn first from the oldest deposit period, then from the next oldest, and so on until the amount requested is satisfied.

 

After deduction of the maintenance charge, if applicable, the withdrawn amount shall be reduced by the applicable deferred sales charge and any applicable premium taxes.

8.04     

Deferred Sales Charge - The deferred sales charge only applies to the portion of the amount

16

<PAGE>

withdrawn attributable to Net Purchase Payment(s) and varies
according to the elapsed time since receipt of the Purchase
Payment. The deferred sales charge is shown on the Contract
Schedule.

8.05     

Waiver of Deferred Sales Charge - No deferred sales charge is

  deducted     

when a Certificate Holder's Account Value is paid:

  (a)     

To a Beneficiary as a death benefit, except for Purchase

   Payments     

made by a surviving joint Certificate Holder as

   described     

in Section 10.02(b);

  (b)     

As a premium for an Annuity Option;

  (c)     

At least the number of months, as shown on the Contract

   Schedule,     

after the date of the first Purchase Payment and

   in     

an amount equal to or less than the percentage of the

   Certificate     

Holder's Account Value as shown on the Contract

   Schedule.     

This applies to the first withdrawal request,

   partial     

or full, in a calendar year. The Certificate

   Holder's     

Account Value is calculated as of the date the

   withdrawal     

request is received in good order at our Home

   Office.     

This waiver is not available to the Certificate

   Holder     

while a SWO is in effect;

  (d)     

For a full withdrawal where the Certificate Holder's

   Account     

Value does not exceed the amount shown on the

   Contract     

Schedule and no withdrawals have been taken from

   the     

Certificate Holder's Account within the prior 12 months;

   (e)     

For a distribution made by Us under Section 8.06; or (f)

   For     

a distribution which is part of a SWO under Section

   8.07.     

  We     

reserve the right to allow the proceeds of a total withdrawal

  to     

be reinstated under the terms and conditions as established by

  Us     

from time to time.

8.06     

Payment of Adjusted Certificate Holder Account Value - Upon 90

  day's     

written notice to the Certificate Holder, We will terminate

  any     

Certificate Holder's Account if the Certificate Holder's

  Account     

Value becomes less than $1,500 immediately following any

  partial     

withdrawal. We do not intend to exercise this right in

  cases     

where the Certificate Holder's Account Value is reduced to

  $1,500     

or less solely due to investment performance. When We make

  a     

distribution pursuant to this provision, the deferred sales

  charge     

will not be deducted.

8.07     

Systematic Withdrawal Option (SWO) - We will allow the

  Certificate     

Holder to establish a schedule of withdrawals to be

  made     

automatically from the Certificate Holder's Account Value.

  All     

distributed amounts will be withdrawn on a pro rata basis

  from     

the Fund(s) and/or the guaranteed term(s) groups of the AG

  Account     

in which the Certificate Holder's Account is invested.

  The     

Certificate Holder must elect one of the following SWO

  methods:     

  (a)     

Specified Payment: Payments of a designated dollar amount.

   The     

annual amount may not be greater than the percentage of

   the     

Certificate Holder's Account Value at time of the

   election     

as shown on the Contract Schedule. This annual

   dollar     

amount will remain constant. At our discretion, We

   may     

require a minimum payment amount; or

  (b)     

Specified Period: Payments which are made over a period of

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 12 of 23

time which must be at least the minimum period as shown on
the Contract Schedule. The annual amount paid each

17

<PAGE>

year is calculated by dividing the Certificate Holder's
Account Value as of December 31 of the prior year by the
number of payment years remaining; or

(c)     

Specified Percentage: Payment of a designated percentage which cannot be greater than the percentage of the Certificate Holder's Account Value at the time of election as shown on the Contract Schedule. The percentage may be changed by written request. We reserve the right to limit the number of times the percentage may be changed. The annual amount is calculated by multiplying the Certificate Holder's Account Value as of December 31 of the year prior to the payment by the designated percentage.

In our discretion, We may require a minimum initial Certificate
Holder's Account Value for election of this option. SWO may be
elected by submitting a completed and signed election form to Us.
Once elected, this option may be revoked by submitting a written
request to Us. SWO may be elected only once by the Certificate
Holder or by a spousal Beneficiary.

Certificate Holders should consult their tax adviser prior to
requesting this distribution option. We are not responsible for
any adverse tax consequences due to a Certificate Holder's
receiving SWO payments. A ten (10) percent penalty tax may apply
to distributions to a Certificate Holder who has not reached age
59-1/2. Upon death of the Certificate Holder, any payments will
be made under the terms of Section 10.

Section 9.

Maintenance Charge

  • --------------------------------------------------------------------------------

  • Maintenance Charge - We will deduct an annual maintenance charge

as shown in the Contract Schedule from the Certificate Holder's
Account during the Accumulation Period. We will deduct the
maintenance charge on the anniversary of the Effective Date of
the Certificate for the Certificate Holder's Account. This
maintenance charge is also deducted upon withdrawal of the entire
Adjusted Certificate Holder's Account. The maintenance charge is
deducted proportionately from each investment option used.

Section 10.

Proceeds Payable on Death

  • --------------------------------------------------------------------------------

  • Death of the Certificate Holder Prior to the Annuity Date - In

the event of the death of the Certificate Holder or a joint
Certificate Holder prior to the Annuity Date, a death benefit is
payable to the Beneficiary(ies) designated by the Certificate
Holder. Upon the death of a joint Certificate Holder, the
surviving joint Certificate Holder, if any, will be treated as
the designated Beneficiary. Any other Beneficiary designation on
record with Us at the time of death will be treated as a
contingent Beneficiary.

A Beneficiary may request We pay the death benefit under one of
the options described in Section 10.03. If the Beneficiary is the
spouse of the Certificate Holder, he or she may elect to continue
the Certificate Holder's Account in his or her own name and
exercise all the Certificate Holder's rights under the Contract.

10.02 Death Benefit Amount Prior to the Annuity Date -

18

<PAGE>

(a) Except as set forth in Section 10.02(b), the amount of the
guaranteed death benefit value is equal to the greater of:

(i)     

The Certificate Holder's Account Value at the end of the Valuation Period during which We receive at our Home Office due proof of death and election of the type of payment to be made; or

(ii)     

The death benefit determined as of the Valuation Period corresponding to the date of death.

 

Until the first Effective Date anniversary, the death benefit is equal to the Purchase Payments made by the Certificate Holder prior to the Effective Date anniversary less any withdrawals and any amounts applied to an Annuity Option.

 

For each Certificate year thereafter, the death benefit during the Certificate year equals the death benefit at the beginning of the Certificate year plus Purchase

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 13 of 23

Payments made during the year less any withdrawals and
any amounts applied to an Annuity Option.

On each Effective Date anniversary, the death benefit
is determined as follows:

(A)     

The death benefit on the previous Effective Date anniversary increased by the death benefit factor shown on the Contract Schedule; plus

(B)     

Purchase Payments made by the Certificate Holder during the Certificate year increased by the death benefit factor shown on the Contract Schedule for the portion of the year since the Purchase Payment was made; less

(C)     

Any withdrawals or amounts applied to an Annuity Option during the Certificate year increased by the death benefit factor shown on the Contract Schedule for the portion of the Certificate year since the withdrawal or election of Annuity option; or

(iii)     

The Certificate Holder's Account Value on the most recent seventh year anniversary of the Effective Date plus any Purchase Payments made after such Effective Date anniversary less any withdrawals and any amounts applied to an Annuity Option.

Notwithstanding the foregoing, the death benefit under (ii)
or (iii) will not exceed the death benefit maximum amount
shown on the Contract Schedule.

The death benefit calculation described in (ii) and (iii)
above, applies until the Certificate Holder reaches the
death benefit maximum age shown on the Contract Schedule.
Thereafter, the death benefit is only adjusted for Purchase
Payments, withdrawals and amounts applied to Annuity
Options. If the Certificate Holder reaches the death benefit
maximum age shown on the Contract Schedule prior to the
seventh anniversary of the Effective Date, the death benefit
will be the greater of (i) or (ii) above.

The excess, if any, of the guaranteed death benefit value
over the Certificate Holder's Account Value is determined
when we receive at our Home Office due proof of death and
allocated to the Fund shown on the Contract Schedule. The
Certificate Holder's Account

19

<PAGE>

Value plus any excess amount deposited becomes the
Certificate Holder's Account Value.

(b)     

In the case of a Beneficiary of a surviving joint Certificate Holder who continued the Certificate Holder's Account in his or her own name, the death benefit shall be equal to (a)(i) above less any applicable deferred sales charge on any Purchase Payment made after We have received at our Home Office due proof of death of the first joint Certificate Holder.

10.03     

Death Benefit Payment Methods - A non-spousal Beneficiary must elect the death benefit to be paid under one of the following methods in the event of the death of the Certificate Holder prior to the Annuity Date:

 

Method 1 - Lump sum payment of the death benefit; or

 

Method 2 - The payment of the entire death benefit within (5) years of the date of the Certificate Holder's death; or

 

Method 3 - Payment of the death benefit over the lifetime of the designated Beneficiary or over a period not extending beyond the life expectancy of the designated Beneficiary with distribution beginning within one year of the date of death of the Certificate Holder.

 

Any portion of the death benefit not applied under Option 3 within one year of the date of Certificate Holder's death, must be distributed within five (5) years of the date of death. A Market Value Adjustment will apply at the time the death benefit is paid.

 

A spousal Beneficiary may elect to continue the Certificate Holder's Account in his or her name, elect a lump sum payment of the death benefit or apply the Adjusted Certificate Holder's Account Value to an Annuity Option.

10.04     

Death of Certificate Holder On or After the Annuity Date - If the Certificate Holder who is not the Annuitant, dies on or after the

Annuity     

Date, the remaining payments under the Annuity Option

elected     

will be made to the Beneficiary at least as rapidly as

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 14 of 23

under the method of distribution in effect at the Certificate
Holder's death.

10.05     

Death of the Annuitant - If the Annuitant, who is not a Certificate Holder, dies on or before the Annuity Date, a new Annuitant may be named. If no Annuitant is named, the Certificate Holder will be the Annuitant. If the Annuitant dies after the Annuity Date, the death benefit, if any, will be payable to the Beneficiary as specified in the Annuity Option elected. We will require proof of the Annuitant's death. Death benefits will be paid at least as rapidly as under the method of distribution in effect at the Annuitant's death.

Section 11.

Delay of Payments

  • --------------------------------------------------------------------------------

  • Delay of Payments - We will make any payments under this Contract

within seven days after a request is received in good order. We
reserve the right to suspend or postpone any type of payment from
the Separate Account for any period when:

20

<PAGE>

(a)     

The New York Stock Exchange is closed for other than customary weekend and holiday closings;

(b)     

Trading on the Exchange is restricted;

(c)     

An emergency exists as a result of which it is not reasonably practicable to dispose of securities held in the Separate Account or determine their value; or

(d)     

The Securities and Exchange Commission so permits delay for the protection of security holders.

The applicable rules of the Securities and Exchange Commission
will govern as to whether the conditions in (b) or (c) exist.

We also reserve the right to delay any type of payment from the
AG Account for up to six (6) months.

Section 12.

Annuity Provisions

  • --------------------------------------------------------------------------------

  • Designation of Annuitant - The Certificate Holder and the

Annuitant need not be the same person. The Certificate Holder
names the Annuitant and during the Accumulation Period, may
change the designated Annuitant. We change the Annuitant when We
receive a written request in good order at our Home Office. We
will not change the Annuitant when Annuity payments have
commenced.

The Certificate Holder elects an Annuity Option by telling Us to
use all or any portion of the Certificate Holder's Adjusted
Account Value (minus any applicable premium taxes if not
previously deducted) to purchase Annuity payments under an
Annuity Option.

When an Annuity Option is chosen the Certificate Holder must
designate a:

(a)     

Fixed Annuity using the General Account;

(b)     

Variable Annuity using any of the Funds available during the Annuity Period; or

(c)     

Combination of (a) and (b).

If a fixed Annuity is chosen, We will calculate the amount using
an interest assumption no less than the percentage specified on
the Contract Schedule. We may calculate the amount using a higher
interest rate.

If a variable Annuity is chosen, an Assumed Annual Net Return
Rate of 5% may be chosen. If not chosen, We will use an Assumed
Annual Net Return Rate of 3.5%.

Payments are made on a monthly basis to the Certificate Holder
unless the Certificate Holder requests a different mode of
payment.

Once elected, an Annuity Option may not be revoked, except for
Option 1 when elected on a variable basis.

12.02     

Terms of Annuity Options - The minimum first payment amount must be at least $50 per month and at least $250 per year.

21

<PAGE>

If the Certificate Holder elects a fixed Annuity and We determine
that the Certificate Holder would receive larger payments by
applying the Certificate Holder's Account Value, reduced by the
deferred sales charge, to a single premium immediate Annuity
currently offered by Us, We will make the larger payments.

We determine the first payment of a variable Annuity, or the

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 15 of 23

payment amount of a fixed Annuity, using the Annuitant's (and
second Annuitant's if applicable) adjusted age which We calculate
as follows:

(a)     

If Annuity payments begin any time between July 1, 1992 and December 31, 1999, the adjusted age is the Annuitant's age as of the birthday closest in time to the Annuity Date reduced by one (1) year.

(b)     

If the Annuity begins any time between January 1, 2000 and December 31, 2009, the adjusted age is the Annuitant's age as of the birthday closest in time to the Annuity Date reduced by two (2) years.

(c)     

For each succeeding decade, the adjusted age is the Annuitant's age as determined in (b), reduced by one additional year.

The Annuity rates for Options 2 and 3 are based on mortality from
1983 Table A.

Assumed Annual Net Return Rate is the interest rate used to
determine the amount of the first Annuity payment under a
variable Annuity. The Separate Account must earn this rate plus
enough to cover the mortality and expense risks charges (which
may include profit) and administrative charges if future variable
Annuity payments are to remain level.

The Certificate Holder must give written notice to Us at least 30
days before the Annuity payments begin, electing or changing:

(a)     

The date on which Annuity payments are to begin;

(b)     

The Annuity Option;

(c)     

Whether the payments are to be made monthly, quarterly, semiannually or annually; (d) The investment options used to provide Annuity payments.

The first Annuity payment may not be earlier than one (1)
calendar year after the initial Purchase Payment, nor later than
the later of the:

(a)     

First day of the month following the Annuitant's birthday shown on the Contract Schedule; or

(b)     

Tenth anniversary of the last Purchase Payment. In lieu of the election of an Annuity, the Certificate Holder may request a lump sum payment.

12.03     

Annuity Unit - The number of Annuity Units per Fund is based on

  the     

amount of the first variable Annuity payment which is equal

  to:     

  (a)     

The portion of the Certificate Holder's Account Value (minus any premium taxes) applied to pay a variable Annuity; divided by,

22

<PAGE>

(b)     

1000; multiplied by,

(c)     

The payment rate for the Annuity Option chosen.

Such amount, or portion, of the variable Annuity payment will be
divided by the Annuity Unit value for the appropriate Fund on the
tenth Valuation Period before the due date of the first payment
to determine the number of each Fund's Annuity Units. The number
of each Fund's Annuity Unit remains fixed. Each future payment is
equal to the sum of the products of each Fund's Annuity Unit
value multiplied by the appropriate number of units. The Fund's
Annuity Unit value on the tenth Valuation Period prior to the due
date of the payment is used.

12.04     

Annuity Unit Value - For any Valuation Period, a Fund's Annuity

  Unit     

value is equal to:

  (a)     

The value for the previous Valuation Period; multiplied by,

  (b)     

The Annuity Net Return Factor for the Valuation Period; multiplied by,

  (c)     

A daily factor to reflect the Assumed Annual Net Return Rate (the factor for 3.5% per year is .9999058; for 5% per year it is .9998663).

  The     

dollar value of a Fund(s) Annuity Unit values and payments

  may     

go up or down due to investment gain or loss.

12.05     

Annuity Net Return Factor - The Annuity net return factor is

  used     

to compute all Separate Account Annuity payments for any

  Fund.     

  The     

Annuity net return factor(s) for each Fund is equal to

  1.0000000     

plus the net return rate. The net return rate is equal

  to:     

  (a)     

The value of the shares of the Fund held by the Separate Account at the end of a Valuation Period; minus,

  (b)     

The value of the shares of the Fund held by the Separate Account at the start of the Valuation Period; plus or minus,

  (c)     

Taxes (or reserves for taxes) on the Separate Account (if

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 16 of 23

any); divided by

(d)     

The total value of the Fund(s) Accumulation Units and Fund(s) Annuity Units of the Separate Account at the start of the Valuation Period; minus,

(e)     

A daily actuarial charge as shown on the Contract Schedule for Annuity mortality and expense risks and profit and a daily administrative charge which will not exceed the administrative charge as shown on the Contract Schedule.

The net return rate may be more or less than zero (o) percent.

The value of a share of the Fund is equal to the net assets of
the Fund divided by the number of shares outstanding.

12.06     

Annuity Options

Option 1 - Payments for a Stated Period of Time - An Annuity will
be paid for the number of years chosen. The number of years must
be at least 5 and not more than 30.

23

<PAGE>

If payments for this Annuity Option are made under a variable
Annuity, the present value of any remaining payments may be
withdrawn at any time.

Option 2 - Life Income - An Annuity will be paid for the life of
the Annuitant. If also chosen, We will guarantee payments for 60,
120, 180, or 240 months.

Option 3 - Life Income Based upon the Lives of Two Annuitants -
An Annuity will be paid during the lives of the Annuitant and a
second Annuitant. Payments will continue until both Annuitants
have died. When this Annuity Option is chosen, a choice must be
made of:

(a)     

100% of the payment to continue after the first death;

(b)     

66-2/3% of the payment to continue after the first death;

(c)     

50% of the payment to continue after the first death;

(d)     

Payments for a minimum of 120 months with 100% of the payment to continue after the first death; or

(e)     

100% of the payment to continue at the death of the second Annuitant and 50% of the payment to continue at the death of the Annuitant.

We may make other options available as allowed by law.

24

<PAGE>

OPTION 1

Payments for a Stated Period of Time

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%

- ---------------------------------------------------------------------------

  Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment

 

- ---------------------------------------------------------------------------

5 3.00% 17.91 53.59 106.78 211.99
6 3.00% 15.14 45.30 90.27 179.22
7 3.00% 13.16 39.39 78.49 155.83
8 3.00% 11.68 34.96 69.66 138.31
9 3.00% 10.53 31.52 62.81 124.69
10 3.00% 9.61 28.77 57.33 113.82
11 3.00% 8.86 26.52 52.85 104.93
12 3.00% 8.24 24.65 49.13 97.54
13 3.00% 7.71 23.08 45.98 91.29
14 3.00% 7.26 21.73 43.29 85.95
15 3.00% 6.87 20.56 40.96 81.33
16 3.00% 6.53 19.54 38.93 77.29
17 3.00% 6.23 18.64 37.14 73.74
18 3.00% 5.96 17.84 35.56 70.59
19 3.00% 5.73 17.13 34.14 67.78
20 3.00% 5.51 16.50 32.87 65.26
21 3.00% 5.32 15.92 31.72 62.98
22 3.00% 5.15 15.40 30.68 60.92
23 3.00% 4.99 14.92 29.74 59.04
24 3.00% 4.84 14.49 28.88 57.33
25 3.00% 4.71 14.09 28.08 55.76
26 3.00% 4.59 13.73 27.36 54.31
27 3.00% 4.47 13.39 26.68 52.97
28 3.00% 4.37 13.08 26.06 51.74
29 3.00% 4.27 12.79 25.49 50.60
30 3.00% 4.18 12.52 24.95 49.53

 

- ---------------------------------------------------------------------------

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 17 of 23

     25 <PAGE>

OPTION 2

Life Income

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%

Payments Guaranteed for a Stated Period of Months

<TABLE> <CAPTION>

- -----------------------------------------------------------------------------------------------------------------------------

Adjusted   None   60   120   180   240
Age of -------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female

 

- -----------------------------------------------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
50 $ 4.27 $ 3.90 $ 4.26 $ 3.90 $ 4.22 $ 3.89 $ 4.17 $ 3.86 $ 4.08 $ 3.82
51 4.34 3.97 4.33 3.96 4.30 3.95 4.23 3.92 4.14 3.88
52 4.43 4.03 4.41 4.03 4.37 4.01 4.30 3.98 4.20 3.93
53 4.51 4.10 4.50 4.10 4.45 4.08 4.37 4.04 4.26 3.99
54 4.60 4.18 4.59 4.17 4.54 4.15 4.45 4.11 4.32 4.04
 
55 4.70 4.25 4.68 4.25 4.62 4.22 4.53 4.18 4.39 4.11
56 4.80 4.34 4.78 4.33 4.72 4.30 4.61 4.25 4.45 4.17
57 4.91 4.42 4.89 4.41 4.82 4.38 4.69 4.32 4.51 4.23
58 5.03 4.52 5.00 4.51 4.92 4.47 4.78 4.40 4.58 4.30
59 5.15 4.61 5.12 4.60 5.03 4.56 4.87 4.48 4.65 4.37
 
60 5.28 4.72 5.25 4.70 5.14 4.66 4.96 4.57 4.71 4.44
61 5.43 4.83 5.39 4.81 5.27 4.76 5.06 4.66 4.78 4.51
62 5.58 4.95 5.53 4.93 5.39 4.87 5.16 4.75 4.84 4.58
63 5.74 5.08 5.69 5.05 5.53 4.99 5.26 4.85 4.90 4.65
64 5.91 5.21 5.85 5.18 5.66 5.10 5.36 4.95 4.96 4.72
 
65 6.10 5.36 6.03 5.32 5.81 5.22 5.46 5.05 5.02 4.79
66 6.30 5.51 6.21 5.47 5.96 5.36 5.56 5.16 5.08 4.86
67 6.51 5.67 6.41 5.63 6.12 5.50 5.66 5.26 5.13 4.93
68 6.73 5.85 6.62 5.80 6.28 5.65 5.77 5.37 5.18 5.00
69 6.97 6.04 6.84 5.98 6.44 5.80 5.86 5.49 5.23 5.06
 
70 7.23 6.25 7.07 6.18 6.61 5.97 5.96 5.60 5.27 5.12
71 7.51 6.47 7.32 6.39 6.79 6.14 6.05 5.71 5.31 5.18
72 7.80 6.71 7.58 6.62 6.96 6.32 6.14 5.83 5.34 5.23
73 8.12 6.98 7.85 6.86 7.14 6.50 6.23 5.94 5.37 5.28
74 8.46 7.26 8.14 7.12 7.32 6.69 6.31 6.04 5.40 5.32
 
75 8.82 7.57 8.45 7.40 7.50 6.89 6.38 6.14 5.42 5.35

 

- -----------------------------------------------------------------------------------------------------------------------------</TABLE>

Rates are based on mortality from 1983 Table a.

Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

26

<PAGE>

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes

(Annuitant is Male and Second Annuitant is Female)

Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%

<TABLE>              
<CAPTION>              
- -----------------------------------------------------------------------------------------------  
Adjusted Ages            
- ---------------------            
  Second            
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e  
- -----------------------------------------------------------------------------------------------  
<S> <C> <C> <C> <C> <C> <C>  
55 50 $ 3.69 $ 4.05 $ 4.27 $ 3.69 $ 4.13  
55 55 3.88 4.25 4.47 3.87 4.25  
55 60 3.06 4.47 4.71 4.06 4.36  
 
60 55 3.99 4.44 4.71 3.98 4.55  
60 60 4.24 4.71 4.99 4.23 4.70  
60 65 4.49 5.01 5.32 4.48 4.85  
 
65 60 4.38 4.97 5.32 4.38 5.10  
65 65 4.72 5.33 5.70 4.71 5.32  
65 70 5.07 5.75 6.17 5.05 5.54  
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt 03/26/2018

 


 

Page 18 of 23

70 65 4.93 5.68 6.15 4.91 5.86
70 70 5.40 6.21 6.70 5.36 6.18
70 75 5.89 6.82 7.40 5.81 6.49
 
75 70 5.69 6.68 7.32 5.62 6.92
75 75 6.37 7.45 8.15 6.23 7.40
75 80 7.07 8.34 9.16 6.78 7.85

 

- -----------------------------------------------------------------------------------------------
</TABLE>

 

Rates are based on mortality from 1983 Table a.

The rates assume the Annuitant is Male and the Second Annuitant is Female. Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

27

<PAGE>

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes

(Annuitant is Female and Second Annuitant is Male)

Rates for a Fixed Annuity with Guaranteed Interest Rate of 3.0%

<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------

 

     Adjusted Ages - ----------------------Second

Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e - --------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C>
55 50 $ 3.75 $ 4.07 $ 4.26 $ 3.75 $ 3.98
55 55 3.88 4.25 4.47 3.87 4.06
55 60 3.99 4.44 4.71 3.98 4.12
 
60 55 4.06 4.47 4.71 4.06 4.37
60 60 4.24 4.71 4.99 4.23 4.47
60 65 4.38 4.97 5.32 4.38 4.54
 
65 60 4.49 5.01 5.32 4.48 4.89
65 65 4.72 5.33 5.70 4.71 5.02
65 70 4.93 5.68 6.15 4.91 5.14
 
70 65 5.07 5.75 6.17 5.05 5.60
70 70 5.40 6.21 6.70 5.36 5.79
70 75 5.69 6.68 7.32 5.62 5.96
 
75 70 5.89 6.83 7.40 5.81 6.63
75 75 6.37 7.45 8.15 6.23 6.92
75 80 6.78 8.11 8.99 6.54 7.15

 

- ---------------------------------------------------------------------------------------
</TABLE>

 

Rates are based on mortality from 1983 Table a.

The rates assume the Annuitant is Female and the Second Annuitant is Male. Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

28

<PAGE>

OPTION I

Payments for a Stated Period of Time

Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes

Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%

- -----------------------------------------------------------------------  
  Guaranteed Monthly Quarterly Semi-Annual Annual  
Years Rate Payment Payment Payment Payment  
- -----------------------------------------------------------------------  
 
5 3.50% 18.12 54.19 107.92 213.99  
6 3.50% 15.35 45.92 91.44 181.32  
7 3.50% 13.38 40.01 79.69 158.01  
8 3.50% 11.90 35.59 70.88 140.56  
9 3.50% 10.75 32.16 64.05 127.00  
10 3.50% 9.83 29.42 58.59 116.18  
11 3.50% 9.09 27.18 54.13 107.34  
12 3.50% 8.46 25.32 50.42 99.98  
13 3.50% 7.94 23.75 47.29 93.78  
14 3.50% 7.49 22.40 44.62 88.47  
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt 03/26/2018

 


 

Page 19 of 23

15 3.50% 7.10 21.24 42.31 83.89
16 3.50% 6.76 20.23 40.29 79.89
17 3.50% 6.47 19.34 38.51 76.37
18 3.50% 6.20 18.55 36.94 73.25
19 3.50% 5.97 17.85 35.54 70.47
20 3.50% 5.75 17.22 34.28 67.98
21 3.50% 5.56 16.65 33.15 65.74
22 3.50% 5.39 16.13 32.13 63.70
23 3.50% 5.24 15.66 31.19 61.85
24 3.50% 5.09 15.24 30.34 60.17
25 3.50% 4.96 14.85 29.56 58.62
26 3.50% 4.84 14.49 28.85 57.20
27 3.50% 4.73 14.15 28.19 55.90
28 3.50% 4.63 13.85 27.58 54.69
29 3.50% 4.53 13.57 27.02 53.57
30 3.50% 4.45 13.30 26.49 52.53

 

- -----------------------------------------------------------------------

29

<PAGE>

OPTION 1

Payments for a Stated Period of Time

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%

- -------------------------------------------------------------------------

  Guaranteed Monthly Quarterly Semi-Annual Annual
Years Rate Payment Payment Payment Payment

 

- -------------------------------------------------------------------------

5 5.00% 18.74 56.00 111.33 219.98
6 5.00% 15.99 47.77 94.96 187.64
7 5.00% 14.02 41.90 83.30 164.59
8 5.00% 12.56 37.52 74.58 147.35
9 5.00% 11.42 34.11 67.81 133.99
10 5.00% 10.51 31.40 62.42 123.34
11 5.00% 9.77 29.19 58.03 114.66
12 5.00% 9.16 27.36 54.38 107.45
13 5.00% 8.64 25.81 51.31 101.39
14 5.00% 8.20 24.50 48.69 96.21
15 5.00% 7.82 23.36 46.44 91.75
16 5.00% 7.49 22.37 44.47 87.88
17 5.00% 7.20 21.51 42.75 84.48
18 5.00% 6.94 20.74 41.23 81.47
19 5.00% 6.71 20.06 39.88 78.80
20 5.00% 6.51 19.46 38.68 76.42
21 5.00% 6.33 18.91 37.59 74.28
22 5.00% 6.17 18.42 36.62 72.35
23 5.00% 6.02 17.98 35.73 70.61
24 5.00% 5.88 17.57 34.93 69.02
25 5.00% 5.76 17.20 34.20 67.57
26 5.00% 5.65 16.87 33.53 66.25
27 5.00% 5.54 16.56 32.92 65.04
28 5.00% 5.45 16.28 32.35 63.93
29 5.00% 5.36 16.01 31.83 62.90
30 5.00% 5.28 15.77 31.35 61.95

 

- -------------------------------------------------------------------------

30

<PAGE>

OPTION 2

Life Income

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%

Payments Guaranteed for a Stated Period of Months

<TABLE> <CAPTION>

- ----------------------------------------------------------------------------------------------------------------------------------

Adjusted   None 60     120   180   240
Age of ------------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female

 

- ----------------------------------------------------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
50 $ 4.56 $ 4.20 $ 4.55 $ 4.19 $ 4.51 $ 4.18 $ 4.45 $ 4.15 $ 4.36 $ 4.11
51 4.64 4.26 4.62 4.25 4.58 4.24 4.51 4.21 4.42 4.16
52 4.72 4.32 4.70 4.32 4.66 4.30 4.58 4.26 4.48 4.21
53 4.80 4.39 4.79 4.38 4.74 4.36 4.65 4.32 4.53 4.27
54 4.89 4.46 4.87 4.46 4.82 4.43 4.73 4.39 4.59 4.32
 
55 4.99 4.54 4.97 4.53 4.91 4.50 4.80 4.46 4.65 4.38
56 5.09 4.62 5.07 4.61 5.00 4.58 4.88 4.53 4.72 4.44
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt     03/26/2018

 


 

                    Page 20 of 23
 
 
 
 
57 5.20 4.71 5.17 4.70 5.10 4.66 4.96 4.60 4.78 4.50
58 5.32 4.80 5.29 4.79 5.20 4.75 5.05 4.68 4.84 4.57
59 5.44 4.90 5.41 4.88 5.31 4.84 5.14 4.76 4.91 4.63
 
60 5.57 5.00 5.53 4.99 5.42 4.93 5.23 4.84 4.97 4.70
61 5.71 5.11 5.67 5.09 5.54 5.03 5.32 4.93 5.03 4.77
62 5.86 5.23 5.81 5.21 5.66 5.14 5.42 5.02 5.09 4.84
63 6.02 5.36 5.97 5.33 5.79 5.25 5.51 5.11 5.16 4.91
64 6.20 5.49 6.13 5.46 5.93 5.37 5.61 5.21 5.21 4.98
 
65 6.38 5.64 6.31 5.60 6.07 5.49 5.71 5.31 5.27 5.05
66 6.58 5.79 6.49 5.75 6.22 5.63 5.81 5.41 5.32 5.12
67 6.79 5.95 6.69 5.91 6.38 5.76 5.91 5.52 5.38 5.18
68 7.02 6.13 6.89 6.08 6.53 5.91 6.01 5.63 5.42 5.25
69 7.26 6.32 7.11 6.26 6.70 6.06 6.11 5.74 5.47 5.31
 
70 7.52 6.53 7.35 6.45 6.86 6.23 6.20 5.85 5.51 5.37
71 7.80 6.75 7.59 6.66 7.03 6.39 6.29 5.96 5.54 5.42
72 8.09 6.99 7.85 6.89 7.21 6.57 6.38 6.07 5.57 5.47
73 8.41 7.26 8.12 7.13 7.38 6.75 6.46 6.17 5.60 5.51
74 8.75 7.54 8.41 7.39 7.55 6.94 6.53 6.28 5.63 5.55
 
75 9.12 7.85 8.71 7.66 7.73 7.13 6.61 6.38 5.65 5.59

 

- ----------------------------------------------------------------------------------------------------------------------------------</TABLE>

Rates are based on mortality from 1983 Table a.

Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

31

<PAGE>

OPTION 2

Life Income

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%

Payments Guaranteed for a Stated Period of Months

<TABLE> <CAPTION>

- -------------------------------------------------------------------------------------------------------------------------------

Adjusted   None   60   120   180   240
Age of ---------------------------------------------------------------------------------------------------------------
Annuitant Male Female Male Female Male Female Male Female Male Female

 

- -------------------------------------------------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
50 $ 5.48 $ 5.12 $ 5.46 $ 5.11 $ 5.41 $ 5.09 $ 5.34 $ 5.06 $ 5.24 $ 5.01
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.29 5.05
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.34 5.10
53 5.71 5.30 5.69 5.29 5.62 5.26 5.53 5.22 5.40 5.15
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.27 5.45 5.20
 
55 5.89 5.44 5.86 5.43 5.79 5.39 5.67 5.34 5.51 5.25
56 5.99 5.52 5.96 5.51 5.87 5.47 5.74 5.40 5.56 5.31
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.62 5.37
58 6.21 5.69 6.17 5.67 6.06 5.62 5.90 5.54 5.68 5.42
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.61 5.74 5.48
 
60 6.46 5.89 6.41 5.87 6.28 5.80 6.06 5.69 5.79 5.55
61 6.60 6.00 6.55 6.97 6.39 5.90 6.15 5.77 5.85 5.61
62 6.75 6.11 6.69 6.08 6.51 6.00 6.24 5.86 5.91 5.67
63 6.91 6.23 6.84 6.20 6.64 6.10 6.33 5.95 5.96 5.73
64 7.09 6.37 7.00 6.33 6.77 6.22 6.42 6.04 6.02 5.80
 
65 7.27 6.51 7.18 6.46 6.91 6.34 6.52 6.13 6.07 5.86
66 7.47 6.66 7.36 6.61 7.05 6.46 6.61 6.23 6.12 5.92
67 7.68 6.82 7.55 6.76 7.20 6.60 6.70 6.33 6.16 5.99
68 7.91 7.00 7.76 6.93 7.35 6.74 6.80 6.43 6.21 6.04
69 8.15 7.19 7.98 7.11 7.51 6.89 6.89 6.54 6.25 6.10
 
70 8.41 7.39 8.21 7.30 7.67 7.04 6.97 6.64 6.28 6.15
71 8.69 7.62 8.45 7.51 7.83 7.21 7.06 6.74 6.32 6.20
72 8.99 7.86 8.70 7.73 8.00 7.38 7.14 6.85 6.35 6.25
73 9.31 8.12 8.97 7.97 8.16 7.55 7.21 6.95 6.37 6.29
74 9.65 8.41 9.26 8.23 8.33 7.73 7.29 7.04 6.39 6.33
 
75 10.02 8.72 9.55 8.50 8.50 7.92 7.35 7.14 6.41 6.36

 

- -------------------------------------------------------------------------------------------------------------------------------</TABLE>

Rates are based on mortality from 1983 Table a.

Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

32

<PAGE>

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018


 

Page 21 of 23

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

(Annuitant is Male and Second Annuitant is Female)

Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%

<TABLE> <CAPTION>

- -------------------------------------------------------------------------------------------------------Adjusted Ages - ------------------------Second Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e - -------------------------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C>
55 50 $ 3.97 $ 4.35 $ 4.56 $ 3.97 $ 4.42
55 55 4.16 4.54 4.76 4.15 4.54
55 60 4.34 4.76 5.00 4.34 4.64
 
60 55 4.27 4.73 5.00 4.26 4.83
60 60 4.51 4.99 5.27 4.50 4.98
60 65 4.76 5.29 5.60 4.75 5.13
 
65 60 4.66 5.25 5.61 4.65 5.39
65 65 4.99 5.61 5.99 4.98 5.60
65 70 5.34 6.03 6.46 5.31 5.81
 
70 65 5.19 5.97 6.44 5.17 6.14
70 70 5.67 6.49 6.99 5.62 6.47
70 75 6.16 7.10 7.68 6.07 6.77
 
75 70 5.95 6.96 7.61 5.87 7.20
75 75 6.64 7.73 8.43 6.48 7.68
75 80 7.33 8.62 9.45 7.02 8.13

 

- -------------------------------------------------------------------------------------------------------</TABLE>

Rates are based on mortality from 1983 Table a.

The rates assume the Annuitant is Male and the Second Annuitant is Female. Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

33

<PAGE>

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes

(Annuitant Is Female and Second Annuitant Is Male)

Rates for a Variable Annuity with Assumed Net Return Rate of 3.5%

<TABLE>              
<CAPTION>              
- --------------------------------------------------------------------------------------------------------  
Adjusted Ages            
- -------------------------            
  Second            
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e  
- --------------------------------------------------------------------------------------------------------  
<S> <C> <C> <C> <C> <C> <C>  
55 50 $ 4.03 $ 4.36 $ 4.55 $ 4.03 $ 4.41  
55 55 4.16 4.54 4.76 4.15 4.54  
55 60 4.27 4.73 5.00 4.26 4.83  
 
60 55 4.34 4.76 5.00 4.34 4.64  
60 60 4.51 4.99 5.27 4.50 4.98  
60 65 4.66 5.25 5.61 4.65 5.39  
 
65 60 4.76 5.29 5.60 4.75 5.13  
65 65 4.99 5.61 5.99 4.98 5.60  
65 70 5.19 5.97 6.44 5.17 6.14  
 
70 65 5.34 6.03 6.46 5.31 5.81  
70 70 5.67 6.49 6.99 5.62 6.47  
70 75 5.95 6.96 7.61 5.87 7.20  
 
75 70 6.16 7.10 7.68 6.07 6.77  
75 75 6.64 7.73 8.43 6.48 7.68  
75 80 7.04 8.39 9.29 6.79 8.70  
- --------------------------------------------------------------------------------------------------------  
</TABLE>              
 
  Rates are based on mortality from 1983 Table a.      
The rates assume the Annuitant is Female and the Second Annuitant is Male.      
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt   03/26/2018

 


 

Page 22 of 23

Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

     34 <PAGE>

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000 After Deduction of any Charge for Premium Taxes

(Annuitant Is Male and Second Annuitant Is Female)

Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%

<TABLE> <CAPTION>

- -------------------------------------------------------------------------------------------------------Adjusted Ages - -------------------------Second Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e - -------------------------------------------------------------------------------------------------------

<S> <C> <C> <C> <C> <C> <C>
55 50 $ 4.88 $ 5.26 $ 5.48 $ 4.88 $ 5.34
55 55 5.04 5.44 5.66 5.04 5.43
55 60 5.21 5.65 5.89 5.21 5.53
 
60 55 5.15 5.63 5.91 5.14 5.73
60 60 5.37 5.87 6.16 5.37 5.86
60 65 5.61 6.16 6.49 5.60 6.01
 
65 60 5.52 6.14 6.51 5.51 6.28
65 65 5.83 6.49 6.87 5.82 6.47
65 70 6.17 6.90 7.33 6.13 6.67
 
70 65 6.04 6.84 7.34 6.00 7.03
70 70 6.49 7.35 7.87 6.44 7.33
70 75 6.97 7.96 8.56 6.87 7.62
 
75 70 6.77 7.84 8.51 6.68 8.08
75 75 7.45 8.60 9.33 7.27 8.55
75 80 8.14 9.49 10.35 7.80 8.98

 

- -------------------------------------------------------------------------------------------------------</TABLE>

Rates are based on mortality from 1983 Table a.

The rates assume the Annuitant is Male and the Second Annuitant is Female. Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

35

<PAGE>

OPTION 3

Life Income for Two Payees

Amount of First Monthly Payment for Each $1,000
After Deduction of any Charge for Premium Taxes

(Annuitant is Female and the Second Annuitant is Male)

Rates for a Variable Annuity with Assumed Net Return Rate of 5.0%

<TABLE>              
<CAPTION>              
- ---------------------------------------------------------------------------------------------------------  
Adjusted Ages            
- -------------------------            
  Second            
Annuitant Annuitant Option 3a Option 3b Option 3c Option 3d Option 3e  
- ---------------------------------------------------------------------------------------------------------  
<S> <C> <C> <C> <C> <C> <C>  
55 50 $ 4.93 $ 5.27 $ 5.46 $ 4.93 $ 5.19  
55 55 5.04 5.44 5.66 5.04 5.43  
55 60 5.15 5.63 5.91 5.14 5.73  
 
60 55 5.21 5.65 5.89 5.21 5.53  
60 60 5.37 5.87 6.16 5.37 5.86  
60 65 5.52 6.14 6.51 5.51 6.28  
 
65 60 5.61 6.16 6.49 5.60 6.01  
65 65 5.83 6.49 6.87 5.82 6.47  
65 70 6.04 6.84 7.34 6.00 7.03  
 
70 65 6.17 6.90 7.33 6.13 6.67  
70 70 6.49 7.35 7.87 6.44 7.33  
70 75 6.77 7.84 8.51 6.68 8.08  
 
75 70 6.97 7.96 8.56 6.87 7.62  
 
 
 
https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt   03/26/2018

 


 

Page 23 of 23

75 75 7.45 8.60 9.33 7.27 8.55
75 80 7.86 9.28 10.20 7.57 9.59

 

- ---------------------------------------------------------------------------------------------------------
</TABLE>

 

Rates are based on mortality from 1983 Table a.

The rates assume the Annuitant is Female and the Second Annuitant is Male. Rates for ages not shown will be provided on request and will be computed on a basis consistent with the rates in the above tables.

36

<PAGE>

- --------------------------------------------------------------------------------

Aetna Insurance Company of America
Home Office: 151 Farmington Avenue
Hartford, Connecticut 06156
(800) 531-4547

Certificate of Group Annuity Coverage

- --------------------------------------------------------------------------------

ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY.

GP2CERT(4/94)

https://www.sec.gov/Archives/edgar/data/925981/0000950146-98-000663.txt

03/26/2018