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0000892569-04-000882.txt : 20041015
0000892569-04-000882.hdr.sgml : 20041015
20041015171625
ACCESSION NUMBER: 0000892569-04-000882
CONFORMED SUBMISSION TYPE: 485APOS
PUBLIC DOCUMENT COUNT: 16
FILED AS OF DATE: 20041015
DATE AS OF CHANGE: 20041015
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: SEPARATE ACCOUNT A OF PACIFIC LIFE INSURANCE CO
CENTRAL INDEX KEY: 0000935823
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 485APOS
SEC ACT: 1933 Act
SEC FILE NUMBER: 333-93059
FILM NUMBER: 041081712
BUSINESS ADDRESS:
STREET 1: P O BOX 7500
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92658-7500
BUSINESS PHONE: 7146403743
MAIL ADDRESS:
STREET 1: P O BOX 7500
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92658-7500
FORMER COMPANY:
FORMER CONFORMED NAME: SEPARATE ACCOUNT A OF PACIFIC MUTUAL LIFE INS CO
DATE OF NAME CHANGE: 19950119
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: SEPARATE ACCOUNT A OF PACIFIC LIFE INSURANCE CO
CENTRAL INDEX KEY: 0000935823
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 485APOS
SEC ACT: 1940 Act
SEC FILE NUMBER: 811-08946
FILM NUMBER: 041081713
BUSINESS ADDRESS:
STREET 1: P O BOX 7500
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92658-7500
BUSINESS PHONE: 7146403743
MAIL ADDRESS:
STREET 1: P O BOX 7500
CITY: NEWPORT BEACH
STATE: CA
ZIP: 92658-7500
FORMER COMPANY:
FORMER CONFORMED NAME: SEPARATE ACCOUNT A OF PACIFIC MUTUAL LIFE INS CO
DATE OF NAME CHANGE: 19950119
485APOS
1
a02094e485apos.htm
PACIFIC INNOVATIONS AND INNOVATIONS SELECT
e485apos
As filed with the
Securities and Exchange Commission on October 15, 2004.
Registrations Nos.
333-93059
811-08946
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM N-4
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REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
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Pre-Effective
Amendment No. ___
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Post-Effective
Amendment No. 19
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and/or |
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REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940
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Amendment
112
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(Check appropriate box or boxes)
SEPARATE
ACCOUNT A
(Exact Name of Registrant)
PACIFIC
LIFE INSURANCE COMPANY
(Name of Depositor)
700 Newport Center Drive
Newport Beach, California 92660
(Address of Depositors Principal Executive Offices) (Zip Code)
(949) 219-3743
(Depositors Telephone Number, including Area Code)
Diane N. Ledger
Vice President
Pacific Life Insurance Company
700 Newport Center Drive
Newport Beach, California 92660
(Name and address of agent for service)
Copies of all communications to:
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Diane N. Ledger
Pacific Life Insurance Company
P.O. Box 9000
Newport Beach, CA 92658-9030
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Ruth Epstein, Esq.
Dechert LLP
1775 Eye Street, N.W.
Washington, D.C. 20006-2401 |
Approximate Date of Proposed Public Offering
It is proposed that this filing will become effective (check appropriate box)
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immediately upon filing pursuant to paragraph (b) of Rule 485 |
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on pursuant to paragraph (b) of Rule 485 |
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60 days after filing pursuant to paragraph (a) (1) of Rule 485 |
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on _____________ pursuant to paragraph (a)(1) of Rule 485 |
If appropriate, check the following box:
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this post-effective amendment
designates a new effective date
for a previously filed
post-effective amendment. |
Title of Securities Being Registered: Interests in the Separate Account Under
Pacific Innovations and Pacific Innovations Select individual flexible premium
deferred variable annuity contracts.
Filing Fee: None
SEPARATE ACCOUNT A
FORM N-4
CROSS REFERENCE SHEET
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PART A |
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Item No. |
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Prospectus Heading |
1.
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Cover Page
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Cover Page |
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2.
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Definitions
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TERMS USED IN THIS PROSPECTUS |
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3.
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Synopsis
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT |
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4.
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Condensed Financial Information
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YOUR INVESTMENT OPTIONS
Variable Investment Option
Performance; ADDITIONAL
INFORMATION Financial
Statements; FINANCIAL
HIGHLIGHTS |
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5.
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General Description of Registrant,
Depositor and Portfolio Companies
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT; PACIFIC LIFE AND THE
SEPARATE ACCOUNT Pacific
Life, Separate
Account A;
YOUR INVESTMENT OPTIONS
Your Variable Investment
Options; ADDITIONAL
INFORMATION Voting Rights |
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6.
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Deductions
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT; HOW YOUR INVESTMENTS
ARE ALLOCATED Transfers;
CHARGES, FEES AND
DEDUCTIONS; WITHDRAWALS
Optional Withdrawal |
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT; PURCHASING YOUR
CONTRACT How to Apply for
your Contract; HOW YOUR
INVESTMENTS ARE ALLOCATED;
RETIREMENT BENEFITS AND
OTHER PAYOUTS Choosing
Your Annuity Option, Your
Annuity Payments, Death
Benefits; ADDITIONAL
INFORMATION Voting Rights,
Changes to Your Contract,
Changes to ALL Contracts,
Inquiries and Submitting |
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7.
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General Description of Variable
Annuity Contracts
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AN OVERVIEW OF PACIFIC INNOVATIONS;
AN OVERVIEW OF PACIFIC INNOVATIONS SELECT; PURCHASING YOUR
CONTRACT How to Apply for your Contract; HOW YOUR
INVESTMENTS ARE ALLOCATED; RETIREMENT BENEFITS AND OTHER
PAYOUTS Choosing Your Annuity Option, Your
Annuity Payment, Death Benefits; OTHER OPTIONAL RIDERS;
ADDITIONAL INFORMATION Voting Rights, Changes
to Your Contract, Changes to ALL Contracts,
Inquiries and Submitting Forms and Requests, Timing of
Payments and Transactions. |
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8
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Annuity Period
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RETIREMENT BENEFITS AND
OTHER PAYOUTS |
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9.
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Death Benefit
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RETIREMENT BENEFITS AND
OTHER PAYOUTS Death
Benefits |
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10.
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Purchases and Contract Value
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT; PURCHASING YOUR
CONTRACT; HOW YOUR
INVESTMENTS ARE ALLOCATED;
PACIFIC LIFE AND THE
SEPARATE ACCOUNT Pacific
Life; THE GENERAL ACCOUNT
Withdrawals and Transfers |
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11.
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Redemptions
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AN OVERVIEW OF PACIFIC
INNOVATIONS AND AN OVERVIEW
OF PACIFIC INNOVATIONS
SELECT; CHARGES, FEES AND
DEDUCTIONS; WITHDRAWALS;
ADDITIONAL INFORMATION
Timing of Payments and
Transactions; THE GENERAL
ACCOUNT Withdrawals and
Transfers |
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12.
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Taxes
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CHARGES, FEES AND DEDUCTIONS
Premium Taxes; WITHDRAWALS
Optional Withdrawals,
Tax Consequences of
Withdrawals; FEDERAL TAX
STATUS |
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13.
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Legal Proceedings
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Not Applicable |
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14.
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Table of Contents of the Statement
of Additional Information
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CONTENTS OF THE STATEMENT OF
ADDITIONAL INFORMATION |
PART B
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Item No. |
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Statement of Additional Information Heading |
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15.
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Cover Page
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Cover Page |
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16.
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Table of Contents
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TABLE OF CONTENTS |
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17.
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General Information and History
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Not Applicable |
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18.
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Services
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Not Applicable |
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19.
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Purchase of Securities Being Offered
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THE CONTRACTS AND THE
SEPARATE ACCOUNT
Calculating Subaccount Unit
Values, Systematic
Transfer Programs |
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20.
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Underwriters
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DISTRIBUTION OF THE
CONTRACTS Pacific Select
Distributors, Inc. |
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21.
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Calculation of Performance Data
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PERFORMANCE |
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22.
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Annuity Payments
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THE CONTRACTS AND THE
SEPARATE ACCOUNT Variable
Annuity Payment Amounts |
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23.
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Financial Statements
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FINANCIAL STATEMENTS |
PART C
Information required to be included in Part C is set forth under the
appropriate Item, so numbered, in Part C to this Registration Statement.
PROSPECTUS
(included in Registrants Form N-4/B,
File No. 333-93059,
Accession No. 0000892569-04-000565 filed on April 30, 2004,
Accession No. 0000892569-04-000585 filed on May 3, 2004,
Accession No. 0000892569-04-000639 filed on May 6, 2004,
Accession No. 0000892569-04-000764 filed on June 29, 2004,
2nd Accession No. 0000892569-04-000828 filed on July 23, 2004
and incorporated by reference herein.)
STATEMENT OF ADDITIONAL INFORMATION
(included in Registrants Form N-4/B,
File No. 333-93059,
Accession No. 0000892569-04-000565 filed on April 30, 2004,
Accession No. 0000892569-04-000585 filed on May 3, 2004,
Accession No. 0000892569-04-000639 filed on May 6, 2004,
Accession No. 0000892569-04-000764 filed on June 29, 2004,
2nd Accession No. 0000892569-04-000828 filed on July 23, 2004
and incorporated by reference herein.)
Supplement dated December 17, 2004 to the
Prospectus and Statement of Additional Information dated May 1, 2004
for the Pacific Innovations variable annuity contract issued by Pacific Life
Insurance Company
Capitalized terms used in this supplement are defined in the Prospectus
referred to above unless otherwise defined herein. We, us, or our refer
to Pacific Life Insurance Company; you or your refer to the Contract Owner.
This supplement must be preceded or accompanied by the Prospectus dated May 1,
2004. The changes described in this supplement to the Prospectus and Statement
of Additional Information are effective February 1, 2005.
This supplement changes the Prospectus and Statement of Additional Information
(SAI) as follows:
The optional Guaranteed Income Advantage 5 (GIA 5) Rider, where available, is
only available for purchase until the GIA Plus Rider is available in your
state. All references to the GIA 5 Rider in the Prospectus and SAI shall be
subject to this disclosure.
The optional Guaranteed Income Advantage II (GIA II) Rider, where available, is
only available for purchase until the GIA Plus Rider is available in your
state. All references to the GIA II Rider in the Prospectus and SAI shall be
subject to this disclosure.
AN OVERVIEW OF PACIFIC INNOVATIONS is amended by adding the following:
Guaranteed Income Advantage Plus (GIA Plus) Rider
Subject to state availability, the optional GIA Plus Rider offers a guaranteed
income annuity option when an asset allocation program established and
maintained by us for the GIA Plus Rider is used. You may buy the GIA Plus
Rider on the Contract Date or on any Contract Anniversary. The GIA Plus Rider
may not be available. Ask your registered representative about its current
availability.
If you buy the GIA Plus Rider within sixty (60) days after the Contract Date or
within thirty (30) days after a Contract Anniversary, we will make the
Effective Date of the GIA Plus Rider coincide with that Contract Date or
Contract Anniversary.
You should consult a qualified adviser for complete information and advice
before purchasing the GIA Plus Rider.
There may be adverse consequences to taking a loan while this Rider is in
effect. If you have an existing loan on your Contract, you should carefully
consider whether the Rider is appropriate for you.
The GIA Plus Rider is called the Guaranteed Income Annuity (GIA) Rider in the
Contracts Rider.
Income Access Plus Rider
Subject to state availability, the optional Income Access Plus Rider offers you
during the accumulation period, the ability to withdraw up to 5% of a Protected
Payment Base (usually Purchase Payments) and provides an Income Access Credit
of 6% to your Protected Payment Base and Remaining Protected Balance for up to
a five year period (provided you do not take any withdrawals during this
period), when used with an asset allocation program established and maintained
by us. You may buy this Rider on the Contract date or on any Contract
Anniversary.
The Rider also provides for an additional option (the ''Reset) on any Contract
Anniversary beginning with the third (3rd) anniversary of the Rider Effective
Date or most recent Reset Date and may include an increase in the charges (up
to a maximum of 1.20%) associated with the Rider. The Income Access Plus Rider
may not be available. Ask your registered representative about its current
availability.
If you buy the Rider within sixty (60) days after the Contract Date or within
thirty (30) days after a Contract Anniversary, we will make the Effective Date
of the Rider coincide with that Contract Date or Contract Anniversary.
You should consult a qualified advisor for complete information and advice
before purchasing the Income Access Plus Rider or electing the Reset provision
available under the Rider.
There may be adverse consequences to taking a loan while this Rider is in
effect. If you have an existing loan on your Contract, you should carefully
consider whether the Rider is appropriate for you.
The Income Access Plus Rider is called the Guaranteed Withdrawal Benefit Rider
in the Contracts Rider.
The Periodic Expenses section is amended by adding the following:
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Guaranteed Income Advantage Plus (GIA Plus) Rider Charge |
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0.50 |
%13 |
Income Access Plus Rider Charge |
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1.20 |
%14 |
The following Footnotes are added to the Periodic Expenses section:
13 |
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If you buy the GIA Plus Rider (subject to state availability), we deduct
this charge proportionately from your Investment Options on each Contract
Anniversary and when you make a full withdrawal if the Rider is in effect
on that date, or if the Rider is terminated. If the Rider is terminated
on a Contract Anniversary, the full annual Charge will be deducted from
the Contract Value on that Contract Anniversary. If this Rider is
terminated on a day other than a Contract Anniversary the Charge will be
prorated to the date of termination. The prorated Charge will be based on
the greater of the Guaranteed Income Base or the Contract Value as of the
day the Rider terminates. The prorated amount will be deducted from the
Contract Value on the earlier of the day the Contract terminates or the
Contract Anniversary immediately following the day the Rider terminates.
We will waive the annual charge if the Rider terminates as a result of
death of an Owner or sole surviving Annuitant or upon full annuitization
of your Contract. |
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If you buy the Income Access Plus Rider (subject to state availability),
we deduct this charge proportionately from your Investment Options on each
Contract Anniversary following the Effective Date of the Rider during the
term of the Rider and while the Rider is in effect, or if the Rider is
terminated. If the Rider is terminated on a Contract Anniversary, the
full annual Charge will be deducted from the Contract Value on that
Contract Anniversary. If this Rider is terminated on a day other than a
Contract Anniversary the charge will be prorated to the date of
termination. The prorated Charge will be calculated based on the Contract
Value as of the day the Rider terminates. The prorated Charge will be
deducted from the Contract Value on the earlier of the day the Contract
terminates or the Contract Anniversary immediately following the day the
Rider terminates. The 1.20% Charge is the maximum charge allowable under
the terms and conditions of the Rider. Currently, the annual Charge for
the Rider is 0.40%. Under the terms and conditions of the Rider, the
annual Charge will remain the same while the Rider is in effect, unless
you elect the optional Reset provision provided under the Rider. The
Charge if you purchase the Rider will also be shown on the Rider in your
Contract. We will waive the annual Charge if the Rider terminates as a
result of death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract. |
Footnotes 9, 10, 11, 12 and 13 in the Periodic Expenses section are amended by
adding the following:
If the effective date of termination of the Rider or Contract is on a day other
than the Contract Anniversary, any Charge imposed for the Rider will be
prorated based on the effective date of termination.
The Minimum and Maximum expense percentages in the Pacific Select Fund Annual
Operating Expenses table are replaced with the following:
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Minimum |
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Total
Annual Pacific Select Fund Operating Expenses1
Expenses that are deducted from the Funds assets, including
advisory fees, 12b-1 distribution expenses and other expenses |
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0.30 |
% |
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1.29 |
% |
The footnote to the Total Annual Pacific Select Fund Operating Expenses section
is amended by adding the following:
The expense information has been restated to reflect fees that will be
effective on February 1, 2005.
The Examples section is replaced with the following:
The following examples are intended to help you compare the cost of investing
in your Contract with the cost of investing in other variable annuity
contracts. These costs include Contract transaction expenses, the maximum
periodic Contract expenses (including the combination of optional Riders whose
cumulative expenses totaled more than any other combination of optional
Riders), Separate Account annual expenses, and maximum and minimum Portfolio
fees and expenses for the year ended December 31, 2003, and to reflect fees
that will be effective on February 1, 2005. Premium taxes and/or other taxes
may also be applicable.
The examples assume that you invest $10,000 in the Contract for the time
periods indicated. They also assume that your Investment has a 5% return each
year and assumes the maximum and minimum fees and expenses of all of the
Investment
Options available. Although your actual costs may be higher or lower, based on
these assumptions, your maximum and minimum costs would be:
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If you surrendered your Contract: |
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1 Year |
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3 Years |
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5 Years |
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10 Years |
Maximum* |
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1,444 |
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$ |
2,598 |
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$ |
3,088 |
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$ |
5,976 |
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Minimum* |
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$ |
987 |
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$ |
1,269 |
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$ |
944 |
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$ |
2,047 |
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If you annuitized your Contract: |
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1 Year |
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3 Years |
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5 Years |
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10 Years |
Maximum* |
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$ |
1,444 |
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$ |
1,878 |
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$ |
3,088 |
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$ |
5,976 |
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Minimum* |
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$ |
987 |
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$ |
549 |
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$ |
944 |
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$ |
2,047 |
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If you did not surrender or annuitize, but left the money in your Contract: |
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1 Year |
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3 Years |
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5 Years |
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10 Years |
Maximum* |
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$ |
634 |
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$ |
1,878 |
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$ |
3,088 |
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$ |
5,976 |
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Minimum* |
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$ |
177 |
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$ |
549 |
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$ |
944 |
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$ |
2,047 |
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* In calculating the examples above, we used the maximum and minimum total
operating expenses of all of the Portfolios as shown in the Fees And
Expenses Paid By The Fund section of the Funds Prospectus adjusted to
reflect fees that will be effective on February 1, 2005. For more
information on fees and expenses, see CHARGES, FEES AND DEDUCTIONS in this
Prospectus, and see the Funds Prospectus. See the FINANCIAL HIGHLIGHTS
section in the Prospectus for condensed financial information. |
PURCHASING YOUR CONTRACT AND OPTIONAL RIDERS is amended by adding the following:
Purchasing the Guaranteed Income Advantage Plus (GIA Plus) Rider (Optional)
You may purchase the GIA Plus Rider (subject to state availability) on the
Contract Date or on any Contract Anniversary. You may purchase the GIA Plus
Rider only if:
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the age of each Annuitant is eighty (80) years or younger on the date
the Rider is purchased, and |
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the entire Contract Value is invested according to an asset
allocation program established and maintained by us for this Rider. |
Except as otherwise provided below, the GIA Plus Rider will remain in effect
until the earlier of:
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the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for the Rider, |
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the day we receive notification from you to terminate the Rider, |
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the day of the first death of an Owner or the date of death
of the sole surviving Annuitant, |
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the date the Contract is terminated in accordance with the terms of the Contract, or |
Upon your request, the GIA Plus Rider may be terminated at any time. If your
request to terminate the GIA Plus Rider is received at our Service Center
within thirty (30) days after a Contract Anniversary, the GIA Plus Rider will
terminate on that Contract Anniversary. If your request to terminate the GIA
Plus Rider is received at our Service Center more than thirty (30) days after a
Contract Anniversary, the GIA Plus Rider will terminate the day we receive the
request.
If the GIA Plus Rider is terminated, you must wait until a Contract Anniversary
that is at least one (1) year from the Effective Date of the termination before
the GIA Plus Rider may be purchased again (if available). In addition, you
cannot switch from the GIA 5 or GIA II Riders to the GIA Plus Rider on the same
Contract Anniversary. You must wait one (1) year from the Effective Date of
termination of the GIA 5 or GIA II Riders before the GIA Plus Rider may be
purchased.
Continuation of Rider if Surviving Spouse Continues Contract
If the Owner dies while this Rider is in effect and if the surviving spouse of
the deceased Owner elects to continue the Contract in accordance with its
terms, then the provisions of this Rider will continue, unless otherwise
terminated.
Purchasing the Income Access Plus Rider (Optional)
Subject to state availability, you may purchase the optional Income Access Plus
Rider on the Contract Date or on any
Contract Anniversary if:
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the age of each Annuitant is eighty five (85) years or younger on the
date of purchase, and |
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your entire Contract Value is invested in an asset allocation program
established and maintained by us for this Rider during the entire period
that the Rider is in effect. |
You cannot request a termination of the Rider. Except as otherwise provided
below, the Rider will automatically terminate on the earliest of:
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the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for this Rider, |
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the day the Remaining Protected Balance is reduced to zero, |
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the day of the first death of an Owner or the date of death
of the sole surviving Annuitant, except as otherwise provided in the paragraph below, |
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the day the Contract is terminated in accordance with the provisions
of the Contract, except as otherwise provided in the paragraph below, or |
The Contract and the Rider will not terminate on the first death of an Owner or
death of the sole surviving Annuitant, or the day the Contract is terminated in
accordance with the provisions of the Contract if, at the time of those events,
the Contract Value is zero and we are making pre-authorized withdrawals of the
Remaining Protected Balance under the provisions of the Rider. If we are making
pre-authorized withdrawals, the Contract and the Rider will terminate on the
Contract Anniversary immediately following the day the Remaining Protected
Balance is zero.
If this Rider is terminated as a result of having any portion of the Contract
Value no longer invested according to an asset allocation program established
and maintained by us, you must wait until a Contract Anniversary that is at
least one (1) year from the Effective Date of termination before this Rider may
be purchased again (if available). In addition, you cannot switch from the
Income Access Rider to the Income Access Plus Rider on the same Contract
Anniversary. You must wait until a Contract Anniversary that is at least one
(1) year from the Effective Date of termination of the Income Access Rider
before the Income Access Plus Rider may be purchased.
Continuation of Rider if Surviving Spouse Continues Contract
If the Owner dies while this Rider is in effect and if the surviving spouse of
the deceased Owner elects to continue the Contract in accordance with its
terms, then the provisions of this Rider will continue, unless otherwise
terminated.
CHARGES, FEES AND DEDUCTIONS is amended by adding the following:
Guaranteed Income Advantage Plus (GIA Plus) Annual Charge (Optional Rider)
If you purchase the GIA Plus Rider (subject to state availability), we will
deduct a GIA Annual Charge (Charge) for expenses related to the GIA Plus
Rider. The annual Charge is equal to 0.50% multiplied by the greater of the
Guaranteed Income Base or the Contract Value on the Contract Anniversary. The
Charge for a Contract Year will be deducted on the Contract Anniversary
following that Contract Year.
We will deduct the Charge from your Investment Options on a proportionate
basis:
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on each Contract Anniversary the GIA Plus Rider remains in effect, and |
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if the GIA Plus Rider is terminated. |
If the GIA Plus Rider is terminated on a Contract Anniversary, the full annual
Charge will be deducted from the Contract Value. If the GIA Plus Rider is
terminated on a day other than a Contract Anniversary, we will prorate the
annual Charge to the date of termination. The prorated Charge amount will be
based on the greater of the Guaranteed Income Base or the Contract Value as of
the day the Rider terminates. The prorated Charge will be deducted from the
Contract Value on the earlier of the day the Contract terminates or the
Contract Anniversary immediately following the day the GIA Plus Rider
terminates. We will waive the annual charge if the GIA Plus Rider terminates
as a result of death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract.
Any portion of the Charge we deduct from any fixed option will not be greater
than the annual interest credited in excess of 3%.
Income Access Plus Annual Charge (Optional Rider)
If you purchase the Income Access Plus Rider (subject to state availability),
we will deduct, annually, an Income Access Plus Charge (Charge) from your
Investment Options on a proportionate basis on each Contract Anniversary that
the Rider remains in effect following the Effective Date of the Rider, and if
you terminate the Rider. The annual Charge is equal to 0.40% multiplied by your
Contract Value on the Contract Anniversary. The annual Charge for a Contract
Year will be deducted on the Contract Anniversary following that Contract Year.
If the Rider terminates on a Contract Anniversary, the full annual Charge will
be deducted from the Contract Value on that Contract Anniversary. If the Rider
terminates on a day other than a Contract Anniversary the Charge will be
prorated to the date of termination. The prorated annual Charge will be
deducted based on the Contract Value as of the day the Rider terminates. The
prorated Charge will be deducted from the Contract Value on the earlier of the
day the Contract terminates or the Contract Anniversary immediately following
the day the Rider terminates. We will waive the annual Charge if the Rider
terminates due to death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract.
The annual Charge percentage may change if you elect the optional Reset provision in the
Rider, but will never be more than the annual Charge percentage being charged
for new issues of this same Rider and will not be more than a maximum annual
Charge percentage of 1.20%. If you do not elect the optional Reset, your annual
Charge percentage will remain the same as it was on the Effective Date of the
Rider.
Any portion of the annual Charge we deduct from a fixed option will not be
greater than the annual interest credited in excess of 3%.
The following sections
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Earnings Enhancement Guarantee (EEG) Annual Charge (Optional Rider)
Guaranteed Protection Advantage 5 (GPA 5) Annual Charge (Optional Rider)
Guaranteed Protection Advantage (GPA) Annual Charge (Optional Rider)
Guaranteed Income Advantage II (GIA II) Annual Charge (Optional Rider)
Guaranteed Income Advantage 5 (GIA 5) Annual Charge (Optional Rider)
Income Access Annual Charge (Optional Rider) |
are amended by adding:
If the effective date of termination of the Rider or Contract is on a day other
than the Contract Anniversary, any Charge imposed for the Rider will be
prorated to the effective date of termination.
WITHDRAWALS Optional Withdrawals is amended by replacing the first paragraph
of the Amount Available for Withdrawal subsection with the following:
The amount available for withdrawal is your Net Contract Value at the end of
the Business Day on which your withdrawal request is effective, less any
applicable optional Rider Charges, withdrawal charge, withdrawal transaction
fee, and any charge for premium taxes and/or other taxes. The amount we send
to you (your withdrawal proceeds) will also reflect any required or requested
federal and state income tax withholding. See the FEDERAL TAX STATUS and THE
GENERAL ACCOUNT Withdrawals and Transfers sections of this Prospectus.
OTHER OPTIONAL RIDERS is amended by adding the following:
GUARANTEED INCOME ADVANTAGE PLUS (GIA PLUS) RIDER
If you purchase the optional GIA Plus Rider (subject to state availability),
you may, prior to the Annuity Date, choose any of the Annuity Options described
in your Contract, or you may choose the GIA Plus Annuity Option provided this
Rider has been in effect for at least ten (10) years from its Effective Date.
If you choose the GIA Plus Annuity Option, you must choose fixed annuity
payments and the entire amount available for annuitization must be annuitized
under this GIA Plus Annuity Option. The guaranteed income purchased per $1,000
of the net amount applied to the annuity payments will be based on an effective
annual interest rate of 2.0% and the 1996 US Annuity 2000 Mortality Table with
the age set back eight (8) years.
On the Annuity Date, the Net Amount applied to the annuity payments under the
GIA Plus Annuity Option will be equal to the greater of the Guaranteed Income
Base on that day or the GIA Plus Step-Up Value on that day, less the following:
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applicable withdrawal charges resulting from the conversion to the
GIA Plus Annuity Option, |
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applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date, and |
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charges for premium taxes and/or other taxes. |
If you elect the GIA Plus Annuity Option, the waiver of withdrawal charges as
described in the Contract will not apply.
Annuity Payments - The annuity payments that may be elected under the GIA Plus
Annuity Option are:
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Life with 10 years or more Period Certain, |
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Joint and Survivor Life, or |
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20 years or more Period Certain. |
The Rider contains annuity tables for each GIA Plus Annuity Option available.
Initial Values - The Guaranteed Income Base, GIA Plus Withdrawal Base, GIA Plus
Withdrawal Amount and GIA Plus Step-Up Value are values used in determining the
Net Amount applied on the Annuity Date to provide payments under the GIA Plus
Annuity Option.
The initial values are determined on the Rider Effective Date as follows:
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if this Rider is effective on the Contract Date, the Guaranteed
Income Base and GIA Plus Withdrawal Base are equal to the initial
Purchase Payment. |
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if this Rider is effective on a Contract Anniversary, the Guaranteed
Income Base and GIA Plus Withdrawal Base are equal to the Contract Value
on that day. |
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the GIA Plus Withdrawal Amount for the Contract Year beginning on the
Rider Effective Date is equal to 5% of the GIA Plus Withdrawal Base. |
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the GIA Plus Step-Up Value is equal to the Contract Value on the
Rider Effective Date. |
The GIA Plus Withdrawal Base and GIA Plus Withdrawal Amount after the Rider
Effective Date are recalculated only on each subsequent Contract Anniversary.
Subsequent Values The Guaranteed Income Base, GIA Plus Withdrawal Base, GIA
Plus Withdrawal Amount and GIA Plus Step-Up Value after the Rider Effective
Date are determined as follows:
Guaranteed Income Base On any day after the Rider Effective Date, the
Guaranteed Income Base is equal to:
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the Guaranteed Income Base on the prior day, multiplied by a daily
factor of 1.000133680 which is equivalent to increasing the Guaranteed
Income Base at an annual growth rate of 5%, plus |
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Purchase Payments received by us on that day, less |
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adjustments for withdrawals made on that day. |
The adjustment for each withdrawal is calculated by multiplying the Guaranteed
Income Base immediately prior to the withdrawal by the percentage decrease in
Contract Value as a result of the withdrawal.
However, on each Contract Anniversary after the Rider Effective Date, if there
is at least one withdrawal during the prior Contract Year and the cumulative
withdrawals for that Contract Year do not exceed the sum of:
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the GIA Plus Withdrawal Amount for that Contract Year, and |
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any remaining dollar amount of the prior Contract Years GIA Plus Withdrawal Amount, |
the Guaranteed Income Base as of that Contract Anniversary will be reset to
equal:
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the Guaranteed Income Base on the Rider Effective Date or prior
Contract Anniversary, whichever is later, increased at an annual growth
rate of 5%, plus |
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the amount of any subsequent Purchase Payments received by us during
the prior Contract Year, each increased at an annual growth rate of 5%
from the effective date of that Purchase Payment, less |
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the amount of cumulative withdrawals during the prior Contract Year. |
The 5% annual growth rate will stop accruing as of the earlier of:
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the Contract Anniversary prior to the youngest
Annuitants 81st birthday, or |
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the day this Rider terminates. |
GIA Plus Withdrawal Base On each Contract Anniversary after the Rider
Effective Date, the GIA Plus Withdrawal Base is equal to:
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the GIA Plus Withdrawal Base determined on the Rider Effective Date,
plus |
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the amount of any subsequent Purchase Payments received by us after
the Rider Effective Date, up through the day immediately prior to that
Contract Anniversary. |
GIA Plus Withdrawal Amount On each Contract Anniversary after the Rider
Effective Date, the GIA Plus Withdrawal Amount for the Contract Year beginning
on that Contract Anniversary is equal to 5% of the GIA Plus Withdrawal Base as
of that Contract Anniversary.
GIA Plus Step-Up Value On any day after the Rider Effective Date, the GIA
Plus Step-Up Value is equal to:
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the GIA Plus Step-Up Value as of the prior day, plus |
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Purchase Payments received by us on that day, less |
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adjustment for withdrawals made on that day. |
The adjustment for each withdrawal is calculated by multiplying the GIA Plus
Step-Up Value immediately prior to the withdrawal by the percentage decrease in
Contract Value as a result of that withdrawal.
On any Contract Anniversary after the Rider Effective Date and prior to the
youngest Annuitants 81st birthday, the GIA Plus Step-Up Value is set equal to
the greater of:
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the Contract Value as of that Contract Anniversary, or |
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the GIA Plus Step-Up Value immediately prior to that Contract Anniversary. |
The GIA Plus Step-Up Value will then be adjusted for any Purchase Payments or
withdrawals on that Contract Anniversary in accordance with the first paragraph
of this subsection.
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The GIA Plus Step-Up Value on each Contract Anniversary on and after the
youngest Annuitants 81st birthday is equal to the GIA Plus Step-Up Value
immediately prior to that Contract Anniversary. |
Partial Conversion of Net Contract Value for Annuity Payments If a portion of
the Net Contract Value is converted to provide payments under an Annuity Option
described in the Contract, the amount converted will be considered a
Withdrawal for purposes of determining withdrawal adjustments to the
Guaranteed Income Base and GIA Plus Step-Up Value.
Limitation on Subsequent Purchase Payments For purposes of this Rider, we
reserve the right to restrict additional Purchase Payments that result in a
total of all Purchase Payments received on or after the first
(1st) Contract
Anniversary to exceed $100,000 without our prior approval. This provision only
applies if the Contract to which this Rider is attached, permits Purchase
Payments after the first (1st) Contract Anniversary, measured from the Contract
Date.
Sample Calculations Hypothetical sample calculations are in the attached
APPENDIX B: GUARANTEED INCOME ADVANTAGE PLUS RIDER SAMPLE CALCULATIONS to the
Prospectus. The examples provided are based on certain hypothetical
assumptions and are for example purposes only. They are not intended to serve
as projections of future investment returns.
INCOME ACCESS PLUS RIDER
If you purchase the Income Access Plus Rider (subject to state availability),
on any day this Rider allows for withdrawals up to the Protected Payment
Amount, regardless of market performance, until the Remaining Protected Balance
is reduced to zero (0). This Rider also provides for an amount (an Income
Access Credit) to be added to the Protected Payment Base and Remaining
Protected Balance.
In addition, on any Contract
Anniversary beginning with the third (3rd)
Contract Anniversary after the Rider Effective Date or the most recent Reset
Date, whichever is later, you may elect to reset the Remaining Protected
Balance to an amount equal to 100% of the Contract Value on that Contract
Anniversary.
For purposes of this Rider, the term withdrawal includes any applicable
withdrawal charges and charges for premium taxes and/or other taxes, if
applicable. Amounts withdrawn under this Rider will reduce the Contract Value
by the amount withdrawn and will be subject to the same conditions,
limitations, restrictions and all other fees, charges and deductions, if
applicable, as withdrawals otherwise made under the provisions of the Contract.
Protected Payment Amount The maximum amount that can be withdrawn under this
Rider without reducing the Protected Payment Base. The Protected Payment Amount
on any day after the Rider Effective Date is equal to the lesser of:
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5% of the Protected Payment Base as of that day, less cumulative withdrawals during that Contract Year, or |
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the Remaining Protected Balance as of that day. |
Protected Payment Base An amount used to determine the Protected Payment
Amount. The Protected Payment Base will remain unchanged except as otherwise
described under the provisions of this Rider.
Remaining Protected Balance The amount available for future withdrawals made
under this Rider.
Income Access Credit An amount added to the Protected Payment Base and
Remaining Protected Balance.
Reset Date Any
Contract Anniversary beginning with the third (3rd) Contract
Anniversary after the Rider Effective Date or the most recent Reset Date,
whichever is later, on which you elect to Reset the remaining Protected Balance
to an amount equal to 100% of the Contract Value, determined as of that
Contract Anniversary.
Initial Values The initial Protected Payment Base and Remaining Protected
Balance amounts are equal to:
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Initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or |
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Contract Value, if the Rider Effective Date is on a Contract Anniversary. |
The initial Protected Payment Amount on the Rider Effective Date is equal to 5%
of the initial Protected Payment Base.
Subsequent Purchase Payments If we receive additional Purchase Payments after
the Rider Effective Date, we will increase the Protected Payment Base and
Remaining Protected Balance by the amount of the Purchase Payments. However,
for purposes of this Rider, we reserve the right to restrict additional
Purchase Payments that result in a total of all Purchase Payments received on
or after the later of the first (1st) Contract Anniversary or most recent Reset
Date to exceed $100,000 without our prior approval. This provision only applies
if the Contract to which this Rider is attached, permits Purchase Payments
after the first (1st) Contract Anniversary, measured from the Contract Date.
Income Access Credit On each Contract Anniversary after the Rider Effective
Date, an Income Access Credit will be added to the Protected Payment Base and
Remaining Protected Balance, as of that Contract Anniversary, if:
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no withdrawals have occurred after the Rider Effective Date or the
most recent Reset Date, whichever is later, and |
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that Contract Anniversary is prior to the sixth (6th) Contract
Anniversary, measured from the Rider Effective Date or the most recent
Reset Date, whichever is later. |
The Income Access Credit is equal to 6% of the total of:
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the Remaining Protected Balance on the Rider Effective Date or the
most recent Reset Date, whichever is later, and |
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the cumulative Purchase Payments received after the Rider Effective
Date or most recent Reset Date, whichever is later, |
as of the Contract Anniversary on which the Income Access Credit is added.
Once a withdrawal has occurred, no Income Access Credit will be added to the
Protected Payment Base and Remaining Protected Balance on any Contract
Anniversary following the withdrawal, unless you elect to reset the Remaining
Protected Balance.
Income Access Credits will not increase your cost basis and when distributed,
may be recognizable as taxable ordinary income.
Withdrawal of Protected Payment Amount While this Rider is in effect, you may
withdraw up to the Protected Payment Amount without reducing the Protected
Payment Base, regardless of market performance, until the Remaining Protected
Balance equals zero.
If a withdrawal does not exceed the Protected Payment Amount immediately prior
to that withdrawal, the Protected Payment Base will remain unchanged. The
Remaining Protected Balance will decrease by the withdrawal amount immediately
following the withdrawal.
If a withdrawal exceeds the Protected Payment Amount immediately prior to that
withdrawal, we will adjust the Protected Payment Base and Remaining Protected
Balance immediately following the withdrawal, to the lesser of:
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the Contract Value immediately after the withdrawal, or |
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the Remaining Protected Balance immediately prior to the withdrawal, less the withdrawal amount. |
A withdrawal may not exceed the amount available for withdrawal under the
Contract if such withdrawal would exceed the Protected Payment Amount.
If a withdrawal does not exceed the Protected Payment Amount and reduces the
Contract Value to zero, the following will apply:
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5% of the Protected Payment Base will be paid each year until the
Remaining Protected Balance is reduced to zero. The payments will be
made under a series of pre-authorized withdrawals under a payment
frequency, as elected by you, but no less frequently than annually, |
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no additional Purchase Payments will be accepted under the Contract, |
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any Remaining Protected Balance will not be available for payment in
a lump sum and may not be applied to provide payments under an Annuity
Option, and |
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the Contract will cease to provide any death benefit. |
If the Owner or sole surviving Annuitant dies and the Contract Value is zero as
of the date of death, any Remaining Protected Balance will be paid to the
Beneficiary under the series of pre-authorized withdrawals and payment
frequency then in effect at the time of the Owners or sole surviving
Annuitants death.
Election to Reset Remaining Protected Balance You may, on any Contract
Anniversary beginning with the third (3rd) Contract Anniversary, measured from
the Rider Effective Date or the most recent Reset Date, whichever is later,
elect to reset the Remaining Protected Balance to an amount equal to 100% of
the Contract Value as of that Contract Anniversary.
The annual Charge percentage may change if you elect to reset the Remaining
Protected Balance. However, the annual Charge percentage will never exceed the
annual Charge percentage then in effect for new issues of this same Rider. If
we are no longer issuing this Rider, any change in the annual Charge percentage
will not result in an annual Charge percentage that exceeds the maximum annual
Charge percentage. (See CHARGES, FEES and DEDUCTIONS Income Access Plus
Rider).
On each Reset Date and after any Income Access Credit is applied, we will set
the Protected Payment Base and Remaining Protected Balance to an amount equal
to 100% of the Contract Value as of the Reset Date.
The election to reset the Remaining Protected Balance must be received, in a
form satisfactory to us, at our Service Center within thirty (30) days after
the Contract Anniversary on which the reset is effective. Your election to
reset the Remaining Protected Balance may result in a reduction in the
Protected Payment Base, Remaining Protected Balance, Protected Payment Amount
and Income Access Credit. We will provide you with written confirmation of
your election.
On and after each Reset Date, the provisions of this Rider shall apply in the
same manner as they applied when the Rider was originally issued. Eligibility
for any Income Access Credits, the limitations and restrictions on Purchase
Payments and withdrawals, the deduction of annual Charges and any future reset
options available on and after the Reset Date, will again apply and will be
measured from that Reset Date.
Sample Calculations Hypothetical sample calculations are in the attached
APPENDIX C: INCOME ACCESS PLUS RIDER SAMPLE CALCULATIONS to the Prospectus.
The examples provided are based on certain hypothetical assumptions and are for
example purposes only. The examples are not intended to serve as projections
of future investment returns.
FEDERAL TAX STATUS Loans is amended as follows:
The third paragraph in the Loan Terms subsection is replaced with the
following:
If you purchase the GPA, GPA5, GIA II, GIA5, GIA Plus, Income Access, or the
Income Access Plus Riders, there may be adverse consequences to taking a loan
while these Riders are in effect. If you have an existing loan on your
Contract, you should carefully consider whether these Riders are appropriate
for you.
APPENDIX B: GUARANTEED INCOME ADVANTAGE PLUS RIDER SAMPLE CALCULATIONS is added:
GUARANTEED INCOME ADVANTAGE PLUS RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by the
Guaranteed Income Advantage Plus (GIA Plus) Rider, and to demonstrate how
Purchase Payments received and withdrawals made from the Contract prior to the
Annuity Date affect the values and benefits under this Rider over an extended
period of time. These examples are not intended to serve as projections of
future investment returns.
Example #1 The initial values on the Rider Effective Date based on an Initial
Purchase Payment of $100,000. The Initial Purchase Payment is assumed to be
the Contract Value if the Rider Effective Date is on a Contract Anniversary.
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Remaining |
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Contract |
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GIA Plus |
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Dollar |
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Purchase |
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Value |
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Guaranteed |
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GIA Plus |
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GIA Plus |
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Withdrawal |
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Amount of |
Contract |
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Payments |
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Withdrawal |
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after |
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Income Base |
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Step-Up |
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Withdrawal |
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Amt. (GWA) |
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Prior Years |
Years
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Received
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Amount
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Activity
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(GIB)
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Value
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Base (GWB)
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(5% of GWB)
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GWA
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Beginning of Year 1 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
5,000 |
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N/A |
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Example #2 Subsequent Purchase Payment received during the first Contract
Year and its effect on the values and balances under this Rider. This example
assumes that no withdrawals have been made.
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GIA Plus |
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Contract |
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GIA |
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Withdrawal |
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Dollar |
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Purchase |
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Value |
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Guaranteed |
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Plus |
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GIA Plus |
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Amt. (GWA) |
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Amount of |
Contract |
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Payments |
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Withdrawal |
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after |
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Income Base |
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Step-Up |
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Withdrawal |
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(5% of |
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Prior Years |
Years
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Received
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Amount
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Activity
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(GIB)
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Value
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Base (GWB)
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GWB)
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GWA
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Beginning of Year 1 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
5,000 |
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N/A |
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Activity |
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$ |
100,000 |
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$ |
200,742 |
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$ |
201,227 |
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$ |
200,000 |
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Beginning of Year 2 |
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$ |
205,242 |
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$ |
208,727 |
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$ |
205,242 |
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$ |
200,000 |
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$ |
10,000 |
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$ |
5,000 |
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In addition to Purchase Payments, the Contract Value is further subject to
increases and/or decreases during a Contract Year as a result of additional
amounts credited, charges, fees and other deductions, and increases and/or
decreases in the investment performance of the Variable Account.
The Guaranteed Income Base prior to receipt of the Purchase Payment is assumed
to have accumulated to $101,227. This amount is derived by multiplying each
days Guaranteed Income Base by the daily factor of 1.000133680. As a result
of the subsequent Purchase Payment, the Guaranteed Income Base is increased to
$201,227 ($101,227 + $100,000). The Guaranteed Income Base will assume to
accumulate to $208,727 at the next Contract Anniversary, by multiplying each
days Guaranteed Income Base immediately after receipt of the subsequent
Purchase Payment by the daily factor of 1.000133680.
The GIA Plus Step-Up Value prior to receipt of the Purchase Payment is
$100,000. As a result of the subsequent Purchase Payment, the GIA Plus Step-Up
Value is increased to $200,000 ($100,000 + $100,000). On the Contract
Anniversary at the beginning of Contract Year 2, the Contract Value ($205,242)
is greater than the GIA Plus Step-Up Value immediately prior to that Contract
Anniversary ($200,000). As a result, the GIA Plus Step-Up Value as of that
Contract Anniversary is equal to the Contract Value on that Contract
Anniversary ($205,242).
The GIA Plus Withdrawal Base on the Contract Anniversary at the beginning of
Contract Year 2 is equal to the GIA Plus Withdrawal Base on the Rider Effective
Date ($100,000) plus cumulative Purchase Payments received after the Rider
Effective Date ($100,000). As a result of the subsequent Purchase Payment, the
GIA Plus Withdrawal Base on the Contract Anniversary at the beginning of
Contract Year 2 is equal to $200,000 ($100,000 + $100,000).
The GIA Plus Withdrawal Amount for Contract Year 2 is determined on the
Contract Anniversary at the beginning of Contract Year 2, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result of the subsequent Purchase Payment, the GIA Plus Withdrawal Amount for
Contract Year 2 is equal to $10,000.
Since no withdrawals were made during Contract Year 1, the GIA Plus Withdrawal
Amount for Contract Year 1 ($5,000) becomes the remaining dollar amount of the
prior Contract Years GIA Plus Withdrawal Amount for Contract Year 2.
Example #3 Cumulative withdrawals during Contract Year 2 exceeding the sum
of: (a) the GIA Plus Withdrawal Amount for Contract Year 2; and (b) the
remaining dollar amount of the prior Contract Years GIA Plus Withdrawal Amount
for Contract Year 2. The withdrawal is assumed to result in a 10% reduction in
the Contract Value.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Remaining |
|
|
|
|
|
|
|
|
|
|
Contract |
|
|
|
|
|
GIA |
|
|
|
|
|
GIA Plus |
|
Dollar |
|
|
Purchase |
|
|
|
|
|
Value |
|
Guaranteed |
|
Plus |
|
GIA Plus |
|
Withdrawal |
|
Amount of |
Contract |
|
Payments |
|
Withdrawal |
|
after |
|
Income Base |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Prior Years |
Years
|
|
Received
|
|
Amount
|
|
Activity
|
|
(GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
GWA
|
Beginning of Year 1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
Activity |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
200,742 |
|
|
$ |
201,227 |
|
|
$ |
200,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning of Year 2 |
|
|
|
|
|
|
|
|
|
$ |
205,242 |
|
|
$ |
208,727 |
|
|
$ |
205,242 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
5,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Activity |
|
|
|
|
|
$ |
20,830 |
|
|
$ |
187,468 |
|
|
$ |
192,493 |
|
|
$ |
184,717 |
|
|
|
|
|
|
-$ |
15,830 = $0 |
|
|
-$ |
5,000 = $0 |
|
Beginning of Year 3 |
|
|
|
|
|
|
|
|
|
$ |
190,259 |
|
|
$ |
197,247 |
|
|
$ |
190,259 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
0 |
|
Since the $20,830 withdrawal exceeded the sum of: (a) the GIA Plus Withdrawal
Amount for Contract Year 2; and (b) the remaining dollar amount of the prior
Contracts Years GIA Plus Withdrawal Amount for Contract Year 2, the remaining
dollar amount of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3 is zero. Withdrawals are first applied to the remaining dollar
amount of the prior Contract Years GIA Plus Withdrawal Amount, if any, until
exhausted, then to the GIA Plus Withdrawal Amount for the current Contract
Year, until exhausted.
The GIA Plus Withdrawal Amount for Contract Year 3 is determined on the
Contract Anniversary at the beginning of Contract Year 3, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result, the GIA Plus Withdrawal Amount for Contract Year 3 is equal to
$10,000. The GIA Plus Withdrawal Amount for any Contract Year will not be less
than zero.
Immediately after the withdrawal, the Guaranteed Income Base and the GIA Plus
Step-Up Value are reduced by the percentage decrease (10%) in Contract Value as
a result of the withdrawal.
Since no subsequent Purchase Payments were received during Contract Year 2, the
GIA Plus Withdrawal Base at the beginning of Contract Year 3 remains unchanged.
Example #4 Cumulative withdrawals during Contract Year 3 not exceeding the
sum of: (a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the
remaining dollar value of the prior Contract Years GIA Plus Withdrawal Amount
for Contract Year 3.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Remaining |
|
|
|
|
|
|
|
|
|
|
Contract |
|
|
|
|
|
GIA |
|
|
|
|
|
GIA Plus |
|
Dollar |
|
|
Purchase |
|
|
|
|
|
Value |
|
Guaranteed |
|
Plus |
|
GIA Plus |
|
Withdrawal |
|
Amount of |
Contract |
|
Payments |
|
Withdrawal |
|
after |
|
Income Base |
|
Step-Up |
|
Withdrawal |
|
Amt (GWA) |
|
Prior Years |
Years
|
|
Received
|
|
Amount
|
|
Activity
|
|
(GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
GWA
|
Beginning of Year 1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
Activity |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
200,742 |
|
|
$ |
201,227 |
|
|
$ |
200,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning of Year 2 |
|
|
|
|
|
|
|
|
|
$ |
205,242 |
|
|
$ |
208,727 |
|
|
$ |
205,242 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
5,000 |
|
Activity |
|
|
|
|
|
$ |
20,830 |
|
|
$ |
187,468 |
|
|
$ |
192,493 |
|
|
$ |
184,717 |
|
|
|
|
|
|
-$ |
15,830 -$0 |
|
|
-$ |
5,000 -$0 |
|
Beginning of Year 3 |
|
|
|
|
|
|
|
|
|
$ |
190,259 |
|
|
$ |
197,247 |
|
|
$ |
190,259 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
0 |
|
Activity |
|
|
|
|
|
$ |
8,000 |
|
|
$ |
185,092 |
|
|
$ |
193,744 |
|
|
$ |
182,376 |
|
|
|
|
|
|
-$ |
8,000 -$2,000 |
|
|
-$ |
0 -$0 |
|
Beginning of Year 4 |
|
|
|
|
|
|
|
|
|
$ |
187,848 |
|
|
$ |
199,109 |
|
|
$ |
187,848 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
2,000 |
|
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the remaining
dollar amount of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3, the Guaranteed Income Base on the Contract Anniversary at the
beginning of Contract Year 4 is calculated as follows:
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 3: |
|
$ |
197,247 |
|
Increased at an annual rate of 5% to the Contract Anniversary at the beginning of Contract Year 4: |
|
+ $ |
9,862 |
|
Reduced by the amount equal to the amount withdrawn in Contract Year 3: |
|
- $ |
8,000 |
|
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 4: |
|
$ |
199,109 |
|
Since no subsequent Purchase Payments were received during Contract Year 3, the
GIA Plus Withdrawal Base at the beginning of Contract Year 4 remains unchanged.
The GIA Plus Withdrawal Amount for Contract Year 4 is determined on the
Contract Anniversary at the beginning of Contract Year 4, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result, the GIA Plus Withdrawal Amount for Contract Year 4 is equal to
$10,000.
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the remaining
dollar value of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3; the dollar amount of the GIA Plus Withdrawal Amount for
Contact Year 3 remaining ($2,000) becomes the remaining dollar amount of the
prior Contract Years GIA Plus Withdrawal Amount for Contract Year 4.
Example #5 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and no withdrawals are
taken during the first ten (10) Contract Years after the Rider Effective Date.
The Initial Purchase Payment is assumed to be the Contract Value if the Rider
is effective on a Contract Anniversary.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GIA Plus |
|
|
Beginning |
|
|
|
|
|
|
|
|
|
GIA Plus |
|
GIA Plus |
|
Withdrawal |
|
Remaining Dollar |
of Contract |
|
Contract Value |
|
Guaranteed |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Amount of |
Year
|
|
after Activity
|
|
Income Base (GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
Prior Years GWA
|
|
1 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
|
2 |
|
|
$ |
103,000 |
|
|
$ |
105,000 |
|
|
$ |
103,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
3 |
|
|
$ |
106,090 |
|
|
$ |
110,250 |
|
|
$ |
106,090 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
4 |
|
|
$ |
109,273 |
|
|
$ |
115,763 |
|
|
$ |
109,273 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
5 |
|
|
$ |
112,551 |
|
|
$ |
121,551 |
|
|
$ |
112,551 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
6 |
|
|
$ |
115,927 |
|
|
$ |
127,628 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
7 |
|
|
$ |
112,450 |
|
|
$ |
134,010 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
8 |
|
|
$ |
109,076 |
|
|
$ |
140,710 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
9 |
|
|
$ |
105,804 |
|
|
$ |
147,746 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
10 |
|
|
$ |
102,630 |
|
|
$ |
155,133 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
11 |
|
|
$ |
99,551 |
|
|
$ |
162,889 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
Example #6 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and withdrawals of
$5,000 are taken each Contract Year for the first ten (10) Contract Years after
the Rider Effective Date. The Initial Purchase Payment is assumed to be the
Contract Value if the Rider is effective on a Contract Anniversary.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GIA Plus |
|
|
Beginning |
|
|
|
|
|
|
|
|
|
GIA Plus |
|
GIA Plus |
|
Withdrawal |
|
Remaining Dollar |
of Contract |
|
Contract Value |
|
Guaranteed |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Amount of |
Year
|
|
after Activity
|
|
Income Base (GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
Prior Years GWA
|
|
1 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
|
2 |
|
|
$ |
97,926 |
|
|
$ |
100,000 |
|
|
$ |
97,926 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
3 |
|
|
$ |
95,789 |
|
|
$ |
100,000 |
|
|
$ |
95,789 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
4 |
|
|
$ |
93,588 |
|
|
$ |
100,000 |
|
|
$ |
93,588 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
5 |
|
|
$ |
91,321 |
|
|
$ |
100,000 |
|
|
$ |
91,321 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
6 |
|
|
$ |
88,986 |
|
|
$ |
100,000 |
|
|
$ |
88,986 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
7 |
|
|
$ |
81,392 |
|
|
$ |
100,000 |
|
|
$ |
83,910 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
8 |
|
|
$ |
74,026 |
|
|
$ |
100,000 |
|
|
$ |
78,676 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
9 |
|
|
$ |
66,881 |
|
|
$ |
100,000 |
|
|
$ |
73,280 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
10 |
|
|
$ |
59,950 |
|
|
$ |
100,000 |
|
|
$ |
67,718 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
|
11 |
|
|
$ |
53,227 |
|
|
$ |
100,000 |
|
|
$ |
61,983 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
0 |
|
Should the Contract annuitize immediately after the Rider has been in effect
for at least ten (10) years and the GIA Plus Annuity Option has been elected to
provide such payments, the net amount applied on the Annuity Date as a single
premium to provide the payments is equal to the greater of:
(a) |
|
the Guaranteed Income Base; or |
|
(b) |
|
the GIA Plus Step-Up Value; less any: |
|
(c) |
|
applicable withdrawal charges resulting from the conversion to the
GIA Plus Annuity Option; |
|
(d) |
|
applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date; and |
|
(e) |
|
charges for premium taxes and/or other taxes. |
Under Example #5, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($162,889), as it is greater than the GIA Plus Step-Up Value
($115,927) as of the Annuity Date, less the amounts in (c), (d) and (e) above,
if any.
Under Example #6, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($100,000), as it is greater than the GIA Plus Step-Up Value
($61,983) as of the Annuity Date, less the amounts in (c), (d) and (e) above,
if any.
APPENDIX C: INCOME ACCESS PLUS RIDER SAMPLE CALCULATIONS is added:
INCOME ACCESS PLUS RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by
this Rider and to demonstrate how Purchase Payments received and withdrawals
made from the Contract prior to the Annuity Date affect the values and benefits
under this Rider over an extended period of time. These examples are not
intended to serve as projections of future investment returns.
Example #1 Income Access Credit; No Subsequent Purchase Payments; No
Withdrawals; No Reset in Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
No withdrawals taken. |
|
|
|
No reset of the Remaining Protected Balance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
|
1 |
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
|
2 |
|
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
|
3 |
|
|
|
|
|
|
|
|
|
|
$ |
106,090 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
|
4 |
|
|
|
|
|
|
|
|
|
|
$ |
109,273 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
|
5 |
|
|
|
|
|
|
|
|
|
|
$ |
112,551 |
|
|
$ |
6,000 |
|
|
$ |
124,000 |
|
|
$ |
6,200 |
|
|
$ |
124,000 |
|
|
6 |
|
|
|
|
|
|
|
|
|
|
$ |
115,927 |
|
|
$ |
6,000 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
|
7 |
|
|
|
|
|
|
|
|
|
|
$ |
119,405 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
|
8 |
|
|
|
|
|
|
|
|
|
|
$ |
122,987 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
|
9 |
|
|
|
|
|
|
|
|
|
|
$ |
126,677 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
|
10 |
|
|
|
|
|
|
|
|
|
|
$ |
130,477 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
|
11 |
|
|
|
|
|
|
|
|
|
|
$ |
134,392 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 6, an Income Access Credit of $6,000 (6% of initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on each Contract Anniversary up to the Contract Anniversary
at the beginning of Contract Year 6. As a result, on the Contract Anniversary
at the beginning of Contract Year 6, the Protected Payment Base and Remaining
Protected Balance are equal to $130,000 and the Protected Payment Amount is
equal to $6,500 (5% of $130,000).
No Income Access Credit will be added to the Protected Payment Base and
Remaining Protected Balance on any Contract Anniversary after the Contract
Anniversary at the beginning of Contract Year 6, as no reset in the Remaining
Protected Balance was assumed.
In addition to the Initial Purchase Payment, the Contract Value is further
subject to increases and/or decreases during each Contract Year as a result of
additional amounts credited, charges, fees and other deductions, and increases
and/or decreases in the investment performance of the Variable Account.
Example #2 Subsequent Purchase Payment.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
A subsequent Purchase Payment of $50,000 is received during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
$ |
50,000 |
|
|
|
|
|
|
$ |
154,534 |
|
|
|
|
|
|
$ |
156,000 |
|
|
$ |
7,800 |
|
|
$ |
156,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
156,834 |
|
|
$ |
9,000 |
|
|
$ |
165,000 |
|
|
$ |
8,250 |
|
|
$ |
165,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Immediately after the $50,000 subsequent Purchase Payment during Contract Year
2, the Protected Payment Base and Remaining Protected Balance are increased by
the Purchase Payment amount to $156,000 ($106,000 + $50,000). The Protected
Payment Amount after the Purchase Payment is equal to $7,800 (5% of the
Protected Payment Base after the Purchase Payment since there are no
withdrawals during that Contract Year).
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 3, an Income Access Credit of $9,000 (6% of Initial Remaining
Protected Balance plus 6% of the $50,000 subsequent Purchase Payment) is added
to the Protected Payment Base and Remaining Protected Balance on that Contract
Anniversary, increasing both to $165,000. As a result, the Protected Payment
Amount on that Contract Anniversary is equal to $8,250 (5% of the Protected
Payment Base on that Contract Anniversary).
Example #3 Withdrawal Not Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
A withdrawal of $5,000 is taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
101,016 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
104,046 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount ($5,300):
(a) |
|
the Protected Payment Base remains unchanged; |
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Since a withdrawal occurred during Contract Year 2, no Income Access Credit
will be added to the Protected Payment Base and Remaining Protected Balance on
any Contract Anniversary following the withdrawal.
Example #4 Withdrawals Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
Two separate withdrawals of $5,000 and $3,000 are taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
Activity |
|
|
|
|
|
$ |
3,000 |
|
|
$ |
97,272 |
|
|
|
|
|
|
$ |
97,272 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
97,993 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
100,933 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount ($5,300):
(a) |
|
the Protected Payment Base remains unchanged; |
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Because the $3,000 withdrawal during Contract Year 2 exceeds the Protected
Payment Amount immediately prior to the withdrawal ($3,000 > $300), the
Protected Payment Base and Remaining Protected Balance immediately after the
withdrawal are adjusted to the lesser of:
(a) |
|
the Contract Value immediately after the withdrawal ($97,272); or |
|
(b) |
|
the Remaining Protected Balance immediately prior to the withdrawal,
less the withdrawal amount ($101,000 $3,000 = $98,000). |
The Protected Payment Amount immediately after the withdrawal is equal to $0
(5% of the Protected Payment Base after the withdrawal (5% of $97,272 =
$4,864), less cumulative withdrawals during that Contract Year ($8,000), but
not less than zero).
Since a withdrawal occurred during Contract Year 2, no Income Access Credit
will be added to the Protected Payment Base and Remaining Protected Balance on
any Contract Anniversary following the withdrawal.
Example #5 Reset in Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
Reset in the Remaining Protected Balance at the Beginning of Contract Year 4. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
110,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
121,000 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
4
(Prior to Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
4
(After Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,655 |
|
|
$ |
133,100 |
|
5 |
|
|
|
|
|
|
|
|
|
$ |
146,410 |
|
|
$ |
7,986 |
|
|
$ |
141,086 |
|
|
$ |
7,054 |
|
|
$ |
141,086 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
On the Contract Anniversary at the beginning of Contract Year 4, the Contract
Value ($133,100) is greater than the Remaining Protected Balance ($118,000).
With the reset in Remaining Protected Balance, the Protected Payment Base and
Remaining Protected Balance are set equal to the Contract Value on that
Contract Anniversary. As a result, the Protected Payment Amount is equal to
$6,655 after the reset.
After the reset in Remaining Protected Balance, eligibility for any Income
Access Credit will be based on the most recent Reset Date. That is, an Income
Access Credit may be added to the Protected Payment Base and Remaining
Protected Balance on up to five additional Contract Anniversaries if certain
conditions are met.
The reset in Remaining Protected Balance may result in an increase in the
annual Income Access Charge percentage.
The reset in Remaining Protected Balance may also result in a lower Protected
Payment Base, Remaining Protected Balance, Protected Payment Amount and Income
Access Credit.
STATEMENT OF ADDITIONAL INFORMATION is amended by adding the following:
All references to the optional Riders, including but not limited to, EEG, GPA
5, GPA, GIA II, GIA 5, or Income Access, in the PERFORMANCE and THE CONTRACTS
AND THE SEPARATE ACCOUNT sections, shall include the Guaranteed Income
Advantage Plus (GIA Plus) and Income Access Plus Riders.
Supplement dated December 17, 2004 to the Prospectus and Statement of Additional Information dated May 1, 2004
for the Pacific Innovations Select variable annuity contract issued by Pacific Life Insurance Company
Capitalized terms used in this supplement are defined in the Prospectus
referred to above unless otherwise defined herein. We, us, or our refer
to Pacific Life Insurance Company; you or your refer to the Contract Owner.
This supplement must be preceded or accompanied by the Prospectus dated May 1,
2004. The changes described in this supplement to the Prospectus and Statement
of Additional Information are effective February 1, 2005.
This supplement changes the Prospectus and Statement of Additional Information
(SAI) as follows:
The optional Guaranteed Income Advantage 5 (GIA 5) Rider, where available, is
only available for purchase until the GIA Plus Rider is available in your
state. All references to the GIA 5 Rider in the Prospectus and SAI shall be
subject to this disclosure.
The optional Guaranteed Income Advantage II (GIA II) Rider, where available, is
only available for purchase until the GIA Plus Rider is available in your
state. All references to the GIA II Rider in the Prospectus and SAI shall be
subject to this disclosure.
The optional Guaranteed Income Advantage (GIA) Rider is only available for
purchase until the GIA 5, GIA II, or GIA Plus Riders are available in your
state. All references to the GIA Rider in the Prospectus and SAI shall be
subject to this disclosure.
AN OVERVIEW OF PACIFIC INNOVATIONS SELECT is amended by adding the following:
Guaranteed Income Advantage Plus (GIA Plus) Rider
Subject to state availability, the optional GIA Plus Rider offers a guaranteed
income annuity option when an asset allocation program established and
maintained by us for the GIA Plus Rider is used. If you use our DCA Plus
Program in conjunction with such an asset allocation program, you also will be
considered to have met this requirement. You may buy the GIA Plus Rider on the
Contract Date or on any Contract Anniversary. The GIA Plus Rider may not be
available. Ask your registered representative about its current availability.
If you buy the GIA Plus Rider within sixty (60) days after the Contract Date or
within thirty (30) days after a Contract Anniversary, we will make the
Effective Date of the GIA Plus Rider coincide with that Contract Date or
Contract Anniversary.
You should consult a qualified adviser for complete information and advice
before purchasing the GIA Plus Rider.
There may be adverse consequences to taking a loan while this Rider is in
effect. If you have an existing loan on your Contract, you should carefully
consider whether the Rider is appropriate for you.
The GIA Plus Rider is called the Guaranteed Income Annuity (GIA) Rider in the
Contracts Rider.
Income Access Plus Rider
Subject to state availability, the optional Income Access Plus Rider offers you
during the accumulation period, the ability to withdraw up to 5% of a Protected
Payment Base (usually Purchase Payments) and provides an Income Access Credit
of 6% to your Protected Payment Base and Remaining Protected Balance for up to
a five year period (provided you do not take any withdrawals during this
period), when used with an asset allocation program established and maintained
by us. If you use our DCA Plus program in conjunction with such an asset
allocation program, you also will be considered to have met this requirement.
You may buy this Rider on the Contract date or on any Contract Anniversary.
The Rider also provides for an additional option (the ''Reset) on any Contract
Anniversary beginning with the third (3rd) anniversary of the Rider Effective
Date or most recent Reset Date and may include an increase in the charges (up
to a maximum of 1.20%) associated with the Rider. The Income Access Plus Rider
may not be available. Ask your registered representative about its current
availability.
If you buy the Rider within sixty (60) days after the Contract Date or within
thirty (30) days after a Contract Anniversary, we will make the Effective Date
of the Rider coincide with that Contract Date or Contract Anniversary.
You should consult a qualified advisor for complete information and advice
before purchasing the Income Access Plus Rider or electing the Reset provision
available under the Rider.
There may be adverse consequences to taking a loan while this Rider is in
effect. If you have an existing loan on your Contract, you should carefully
consider whether the Rider is appropriate for you.
The Income Access Plus Rider is called the Guaranteed Withdrawal Benefit Rider
in the Contracts Rider.
The Periodic Expenses section is amended by adding the following:
|
|
Guaranteed Income Advantage Plus (GIA Plus) Rider Charge 0.50% 13 |
|
|
|
Income Access Plus Rider Charge 1.20% 14 |
The following Footnotes are added to the Periodic Expenses section:
|
|
|
13
|
|
If you buy the GIA Plus Rider (subject to state availability), we deduct
this charge proportionately from your Investment Options on each Contract
Anniversary and when you make a full withdrawal if the Rider is in effect
on that date, or if the Rider is terminated. If the Rider is terminated
on a Contract Anniversary, the full annual Charge will be deducted from
the Contract Value on that Contract Anniversary. If this Rider is
terminated on a day other than a Contract Anniversary the Charge will be
prorated to the date of termination. The prorated Charge will be based on
the greater of the Guaranteed Income Base or the Contract Value as of the
day the Rider terminates. The prorated amount will be deducted from the
Contract Value on the earlier of the day the Contract terminates or the
Contract Anniversary immediately following the day the Rider terminates.
We will waive the annual charge if the Rider terminates as a result of
death of an Owner or sole surviving Annuitant or upon full annuitization
of your Contract. |
|
|
|
14
|
|
If you buy the Income Access Plus Rider (subject to state availability),
we deduct this charge proportionately from your Investment Options on each
Contract Anniversary following the Effective Date of the Rider during the
term of the Rider and while the Rider is in effect, or if the Rider is
terminated. If the Rider is terminated on a Contract Anniversary, the
full annual Charge will be deducted from the Contract Value on that
Contract Anniversary. If this Rider is terminated on a day other than a
Contract Anniversary the charge will be prorated to the date of
termination. The prorated Charge will be calculated based on the Contract
Value as of the day the Rider terminates. The prorated Charge will be
deducted from the Contract Value on the earlier of the day the Contract
terminates or the Contract Anniversary immediately following the day the
Rider terminates. The 1.20% Charge is the maximum charge allowable under
the terms and conditions of the Rider. Currently, the annual Charge for
the Rider is 0.40%. Under the terms and conditions of the Rider, the
annual Charge will remain the same while the Rider is in effect, unless
you elect the optional Reset provision provided under the Rider. The
Charge if you purchase the Rider will also be shown on the Rider in your
Contract. We will waive the annual Charge if the Rider terminates as a
result of death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract. |
Footnotes 9, 10, 11, 12 and 13 in the Periodic Expenses section are amended by
adding the following:
If the effective date of termination of the Rider or Contract is on a day other
than the Contract Anniversary, any Charge imposed for the Rider will be
prorated based on the effective date of termination.
The Minimum and Maximum expense percentages in the Pacific Select Fund Annual
Operating Expenses table are replaced with the following:
|
|
|
|
|
Total Annual Pacific Select Fund Operating Expenses 1
|
|
Minimum
|
|
Maximum |
Expenses that are deducted from the Funds assets, including
advisory fees, 12b-1 distribution expenses and other expenses
|
|
0.30%
|
|
1.29% |
The footnote to the Total Annual Pacific Select Fund Operating Expenses section
is amended by adding the following:
The expense information has been restated to reflect fees that will be
effective on February 1, 2005.
The Examples section is replaced with the following:
The following examples are intended to help you compare the cost of investing
in your Contract with the cost of investing in other variable annuity
contracts. These costs include Contract transaction expenses, the maximum
periodic Contract expenses (including the combination of optional Riders whose
cumulative expenses totaled more than any other combination
of optional Riders), Separate Account annual expenses, and maximum and minimum
Portfolio fees and expenses for the year ended December 31, 2003, and to
reflect fees that will be effective on February 1, 2005. Premium taxes and/or
other taxes may also be applicable.
The examples assume that you invest $10,000 in the Contract for the time
periods indicated. They also assume that your Investment has a 5% return each
year and assumes the maximum and minimum fees and expenses of all of the
Investment Options available. Although your actual costs may be higher or
lower, based on these assumptions, your maximum and minimum costs would be:
|
|
If you surrendered your Contract: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 Year |
|
3 Years |
|
5 Years |
|
10 Years |
Maximum* |
|
$ |
1,289 |
|
|
$ |
2,305 |
|
|
$ |
3,192 |
|
|
$ |
6,139 |
|
Minimum* |
|
$ |
832 |
|
|
$ |
985 |
|
|
$ |
1,073 |
|
|
$ |
2,312 |
|
|
|
If you annuitized your Contract: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 Year |
|
3 Years |
|
5 Years |
|
10 Years |
Maximum* |
|
$ |
1,289 |
|
|
$ |
1,945 |
|
|
$ |
3,192 |
|
|
$ |
6,139 |
|
Minimum* |
|
$ |
832 |
|
|
$ |
625 |
|
|
$ |
1,073 |
|
|
$ |
2,312 |
|
|
|
If you did not surrender or annuitize, but left the money in your Contract: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 Year |
|
3 Years |
|
5 Years |
|
10 Years |
Maximum* |
|
$ |
659 |
|
|
$ |
1,945 |
|
|
$ |
3,192 |
|
|
$ |
6,139 |
|
Minimum* |
|
$ |
202 |
|
|
$ |
625 |
|
|
$ |
1,073 |
|
|
$ |
2,312 |
|
* |
|
In calculating the examples above, we used the maximum and minimum total
operating expenses of all of the Portfolios as shown in the Fees And
Expenses Paid By The Fund section of the Funds Prospectus adjusted to
reflect fees that will be effective on February 1, 2005. For more
information on fees and expenses, see CHARGES, FEES AND DEDUCTIONS in this
Prospectus, and see the Funds Prospectus. See the FINANCIAL HIGHLIGHTS
section in the Prospectus for condensed financial information. |
PURCHASING YOUR CONTRACT AND OPTIONAL RIDERS is amended by adding the following:
Purchasing the Guaranteed Income Advantage Plus (GIA Plus) Rider (Optional)
You may purchase the GIA Plus Rider (subject to state availability) on the
Contract Date or on any Contract Anniversary. You may purchase the GIA Plus
Rider only if:
|
|
the age of each Annuitant is eighty (80) years or younger on the date
the Rider is purchased, and |
|
|
the entire Contract Value is invested according to an asset
allocation program established and maintained by us for this Rider. If
you use our DCA Plus program in conjunction with such an asset
allocation program, you will be considered to have met this requirement. |
Except as otherwise provided below, the GIA Plus Rider will remain in effect
until the earlier of:
|
|
the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for the Rider, |
|
|
the day we receive notification from you to terminate the Rider, |
|
|
the day of the first death of an Owner or the date of death
of the sole surviving Annuitant, |
|
|
the date the Contract is terminated in accordance with the terms of the Contract, or |
Upon your request, the GIA Plus Rider may be terminated at any time. If your
request to terminate the GIA Plus Rider is received at our Service Center
within thirty (30) days after a Contract Anniversary, the GIA Plus Rider will
terminate on that Contract Anniversary. If your request to terminate the GIA
Plus Rider is received at our Service Center more than thirty (30) days after a
Contract Anniversary, the GIA Plus Rider will terminate the day we receive the
request.
If the GIA Plus Rider is terminated, you must wait until a Contract Anniversary
that is at least one (1) year from the Effective Date of the termination before
the GIA Plus Rider may be purchased again (if available). In addition, you
cannot switch from the GIA, GIA 5 or GIA II Riders to the GIA Plus Rider on the
same Contract Anniversary. You must wait one (1) year from the Effective Date
of termination of the GIA, GIA 5 or GIA II Riders before the GIA Plus Rider may
be purchased.
Continuation of Rider if Surviving Spouse Continues Contract
If the Owner dies while this Rider is in effect and if the surviving spouse of
the deceased Owner elects to continue the Contract in accordance with its
terms, then the provisions of this Rider will continue, unless otherwise
terminated.
Purchasing the Income Access Plus Rider (Optional)
Subject to state availability, you may purchase the optional Income Access Plus
Rider on the Contract Date or on any
Contract Anniversary if:
|
|
the age of each Annuitant is eighty five (85) years or younger on the
date of purchase, and |
|
|
your entire Contract Value is invested in an asset allocation program
established and maintained by us for this Rider during the entire period
that the Rider is in effect. If you use our DCA Plus program in
conjunction with such an asset allocation program, you will be
considered to have met this requirement. |
You cannot request a termination of the Rider. Except as otherwise provided
below, the Rider will automatically terminate on the earliest of:
|
|
the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for this Rider, |
|
|
the day the Remaining Protected Balance is reduced to zero, |
|
|
the day of the first death of an Owner or the date of death
of the sole surviving Annuitant, except as otherwise provided in the paragraph below, |
|
|
the day the Contract is terminated in accordance with the provisions
of the Contract, except as otherwise provided in the paragraph below, or |
The Contract and the Rider will not terminate on the first death of an Owner or
death of the sole surviving Annuitant, or the day the Contract is terminated in
accordance with the provisions of the Contract if, at the time of those events,
the Contract Value is zero and we are making pre-authorized withdrawals of the
Remaining Protected Balance under the provisions of the Rider. If we are making
pre-authorized withdrawals, the Contract and the Rider will terminate on the
Contract Anniversary immediately following the day the Remaining Protected
Balance is zero.
If this Rider is terminated as a result of having any portion of the Contract
Value no longer invested according to an asset allocation program established
and maintained by us, you must wait until a Contract Anniversary that is at
least one (1) year from the Effective Date of termination before this Rider may
be purchased again (if available). In addition, you cannot switch from the
Income Access Rider to the Income Access Plus Rider on the same Contract
Anniversary. You must wait until a Contract Anniversary that is at least one
(1) year from the Effective Date of termination of the Income Access Rider
before the Income Access Plus Rider may be purchased.
Continuation of Rider if Surviving Spouse Continues Contract
If the Owner dies while this Rider is in effect and if the surviving spouse of
the deceased Owner elects to continue the Contract in accordance with its
terms, then the provisions of this Rider will continue, unless otherwise
terminated.
CHARGES, FEES AND DEDUCTIONS is amended by adding the following:
Guaranteed Income Advantage Plus (GIA Plus) Annual Charge (Optional Rider)
If you purchase the GIA Plus Rider (subject to state availability), we will
deduct a GIA Annual Charge (Charge) for expenses related to the GIA Plus
Rider. The annual Charge is equal to 0.50% multiplied by the greater of the
Guaranteed Income Base or the Contract Value on the Contract Anniversary. The
Charge for a Contract Year will be deducted on the Contract Anniversary
following that Contract Year.
We will deduct the Charge from your Investment Options on a proportionate
basis:
|
|
on each Contract Anniversary the GIA Plus Rider remains in effect, and |
|
|
if the GIA Plus Rider is terminated. |
If the GIA Plus Rider is terminated on a Contract Anniversary, the full annual
Charge will be deducted from the Contract Value. If the GIA Plus Rider is
terminated on a day other than a Contract Anniversary, we will prorate the
annual Charge to the date of termination. The prorated Charge amount will be
based on the greater of the Guaranteed Income Base or the Contract Value as of
the day the Rider terminates. The prorated Charge will be deducted from the
Contract Value on the earlier of the day the Contract terminates or the
Contract Anniversary immediately following the day the GIA Plus Rider
terminates. We will waive the annual charge if the GIA Plus Rider terminates
as a result of death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract.
Any portion of the Charge we deduct from any fixed option will not be greater
than the annual interest credited in excess of 3%.
Income Access Plus Annual Charge (Optional Rider)
If you purchase the Income Access Plus Rider (subject to state availability),
we will deduct, annually, an Income Access Plus Charge (Charge) from your
Investment Options on a proportionate basis on each Contract Anniversary that
the Rider remains in effect following the Effective Date of the Rider, and if
you terminate the Rider. The annual Charge is equal to 0.40% multiplied by your
Contract Value on the Contract Anniversary. The annual Charge for a Contract
Year will be deducted on the Contract Anniversary following that Contract Year.
If the Rider terminates on a Contract Anniversary, the full annual Charge will
be deducted from the Contract Value on that Contract Anniversary. If the Rider
terminates on a day other than a Contract Anniversary the Charge will be
prorated to the date of termination. The prorated annual Charge will be
deducted based on the Contract Value as of the day the Rider terminates. The
prorated Charge will be deducted from the Contract Value on the earlier of the
day the Contract terminates or the Contract Anniversary immediately following
the day the Rider terminates. We will waive the annual Charge if the Rider
terminates due to death of an Owner or sole surviving Annuitant or upon full
annuitization of your Contract.
The annual Charge percentage may change if you elect the optional Reset provision in the
Rider, but will never be more than the annual Charge percentage being charged
for new issues of this same Rider and will not be more than a maximum annual
Charge percentage of 1.20%. If you do not elect the optional Reset, your annual
Charge percentage will remain the same as it was on the Effective Date of the
Rider.
Any portion of the annual Charge we deduct from a fixed option will not be
greater than the annual interest credited in excess of 3%.
The following sections
|
|
Earnings Enhancement Guarantee (EEG) Annual Charge (Optional Rider)
Guaranteed Protection Advantage 5 (GPA 5) Annual Charge (Optional Rider)
Guaranteed Protection Advantage (GPA) Annual Charge (Optional Rider)
Guaranteed Income Advantage II (GIA II) Annual Charge (Optional Rider)
Guaranteed Income Advantage 5 (GIA 5) Annual Charge (Optional Rider)
Guaranteed Income Advantage (GIA) Annual Charge (Optional Rider), and
Income Access Annual Charge (Optional Rider)
|
are amended by adding:
If the effective date of termination of the Rider or Contract is on a day other
than the Contract Anniversary, any Charge imposed for the Rider will be
prorated to the effective date of termination.
WITHDRAWALS Optional Withdrawals is amended by replacing the first paragraph of the Amount Available for
Withdrawal subsection with the following:
The amount available for withdrawal is your Net Contract Value at the end of
the Business Day on which your withdrawal request is effective, less any
applicable optional Rider Charges, withdrawal charge, withdrawal transaction
fee, and any charge for premium taxes and/or other taxes. The amount we send
to you (your withdrawal proceeds) will also reflect any required or requested
federal and state income tax withholding. See the FEDERAL TAX STATUS and THE
GENERAL ACCOUNT Withdrawals and Transfers sections of this Prospectus.
OTHER OPTIONAL RIDERS is amended by adding the following:
GUARANTEED INCOME ADVANTAGE PLUS (GIA PLUS) RIDER
If you purchase the optional GIA Plus Rider (subject to state availability),
you may, prior to the Annuity Date, choose any of the Annuity Options described
in your Contract, or you may choose the GIA Plus Annuity Option provided this
Rider has been in effect for at least ten (10) years from its Effective Date.
If you choose the GIA Plus Annuity Option, you must choose fixed annuity
payments and the entire amount available for annuitization must be annuitized
under this GIA Plus Annuity Option. The guaranteed income purchased per $1,000
of the net amount applied to the annuity payments will be based on an effective
annual interest rate of 2.0% and the 1996 US Annuity 2000 Mortality Table with
the age set back eight (8) years.
On the Annuity Date, the Net Amount applied to the annuity payments under the
GIA Plus Annuity Option will be equal to the greater of the Guaranteed Income
Base on that day or the GIA Plus Step-Up Value on that day, less the following:
|
|
applicable withdrawal charges resulting from the conversion to the
GIA Plus Annuity Option, |
|
|
applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date, and |
|
|
charges for premium taxes and/or other taxes. |
If you elect the GIA Plus Annuity Option, the waiver of withdrawal charges as
described in the Contract will not apply.
Annuity Payments - The annuity payments that may be elected under the GIA Plus
Annuity Option are:
|
|
Life with 10 years or more Period Certain, |
|
|
Joint and Survivor Life, or |
|
|
20 years or more Period Certain. |
The Rider contains annuity tables for each GIA Plus Annuity Option available.
Initial Values - The Guaranteed Income Base, GIA Plus Withdrawal Base, GIA Plus
Withdrawal Amount and GIA Plus Step-Up Value are values used in determining the
Net Amount applied on the Annuity Date to provide payments under the GIA Plus
Annuity Option.
The initial values are determined on the Rider Effective Date as follows:
|
|
if this Rider is effective on the Contract Date, the Guaranteed
Income Base and GIA Plus Withdrawal Base are equal to the initial
Purchase Payment. |
|
|
if this Rider is effective on a Contract Anniversary, the Guaranteed
Income Base and GIA Plus Withdrawal Base are equal to the Contract Value
on that day. |
|
|
the GIA Plus Withdrawal Amount for the Contract Year beginning on the
Rider Effective Date is equal to 5% of the GIA Plus Withdrawal Base. |
|
|
the GIA Plus Step-Up Value is equal to the Contract Value on the
Rider Effective Date. |
The GIA Plus Withdrawal Base and GIA Plus Withdrawal Amount after the Rider
Effective Date are recalculated only on each subsequent Contract Anniversary.
Subsequent Values The Guaranteed Income Base, GIA Plus Withdrawal Base, GIA
Plus Withdrawal Amount and GIA Plus Step-Up Value after the Rider Effective
Date are determined as follows:
Guaranteed Income Base On any day after the Rider Effective Date, the
Guaranteed Income Base is equal to:
|
|
the Guaranteed Income Base on the prior day, multiplied by a daily
factor of 1.000133680 which is equivalent to increasing the Guaranteed
Income Base at an annual growth rate of 5%, plus |
|
|
Purchase Payments received by us on that day, less |
|
|
adjustments for withdrawals made on that day. |
The adjustment for each withdrawal is calculated by multiplying the Guaranteed
Income Base immediately prior to the withdrawal by the percentage decrease in
Contract Value as a result of the withdrawal.
However, on each Contract Anniversary after the Rider Effective Date, if there
is at least one withdrawal during the prior Contract Year and the cumulative
withdrawals for that Contract Year do not exceed the sum of:
|
|
the GIA Plus Withdrawal Amount for that Contract Year, and |
|
|
any remaining dollar amount of the prior Contract Years GIA Plus Withdrawal Amount, |
the Guaranteed Income Base as of that Contract Anniversary will be reset to
equal:
|
|
the Guaranteed Income Base on the Rider Effective Date or prior
Contract Anniversary, whichever is later, increased at an annual growth
rate of 5%, plus |
|
|
the amount of any subsequent Purchase Payments received by us during
the prior Contract Year, each increased at an annual growth rate of 5%
from the effective date of that Purchase Payment, less |
|
|
the amount of cumulative withdrawals during the prior Contract Year. |
The 5% annual growth rate will stop accruing as of the earlier of:
|
|
the Contract Anniversary prior to the youngest
Annuitants 81st birthday, or |
|
|
the day this Rider terminates. |
GIA Plus Withdrawal Base On each Contract Anniversary after the Rider
Effective Date, the GIA Plus Withdrawal Base is equal to:
|
|
the GIA Plus Withdrawal Base determined on the Rider Effective Date,
plus |
|
|
the amount of any subsequent Purchase Payments received by us after
the Rider Effective Date, up through the day immediately prior to that
Contract Anniversary. |
GIA Plus Withdrawal Amount On each Contract Anniversary after the Rider
Effective Date, the GIA Plus Withdrawal Amount for the Contract Year beginning
on that Contract Anniversary is equal to 5% of the GIA Plus Withdrawal Base as
of that Contract Anniversary.
GIA Plus Step-Up Value On any day after the Rider Effective Date, the GIA
Plus Step-Up Value is equal to:
|
|
the GIA Plus Step-Up Value as of the prior day, plus |
|
|
Purchase Payments received by us on that day, less |
|
|
adjustment for withdrawals made on that day. |
The adjustment for each withdrawal is calculated by multiplying the GIA Plus
Step-Up Value immediately prior to the withdrawal by the percentage decrease in
Contract Value as a result of that withdrawal.
On any Contract Anniversary after the Rider Effective Date and prior to the
youngest Annuitants 81st birthday, the GIA Plus Step-Up Value is set equal to
the greater of:
|
|
the Contract Value as of that Contract Anniversary, or |
|
|
the GIA Plus Step-Up Value immediately prior to that Contract Anniversary. |
The GIA Plus Step-Up Value will then be adjusted for any Purchase Payments or
withdrawals on that Contract Anniversary in accordance with the first paragraph
of this subsection.
|
|
The GIA Plus Step-Up Value on each Contract Anniversary on and after the
youngest Annuitants 81st birthday is equal to the GIA Plus Step-Up Value
immediately prior to that Contract Anniversary. |
Partial Conversion of Net Contract Value for Annuity Payments If a portion of
the Net Contract Value is converted to provide payments under an Annuity Option
described in the Contract, the amount converted will be considered a
Withdrawal for purposes of determining withdrawal adjustments to the
Guaranteed Income Base and GIA Plus Step-Up Value.
Limitation on Subsequent Purchase Payments For purposes of this Rider, we
reserve the right to restrict additional Purchase Payments that result in a
total of all Purchase Payments received on or after the first (1st) Contract
Anniversary to exceed $100,000 without our prior approval. This provision only
applies if the Contract to which this Rider is attached, permits Purchase
Payments after the first (1st) Contract Anniversary, measured from the Contract
Date.
Sample Calculations Hypothetical sample calculations are in the attached
APPENDIX B: GUARANTEED INCOME ADVANTAGE PLUS RIDER SAMPLE CALCULATIONS to the
Prospectus. The examples provided are based on certain hypothetical
assumptions and are for example purposes only. They are not intended to serve
as projections of future investment returns.
INCOME ACCESS PLUS RIDER
If you purchase the Income Access Plus Rider (subject to state availability),
on any day this Rider allows for withdrawals up to the Protected Payment
Amount, regardless of market performance, until the Remaining Protected Balance
is reduced to zero (0). This Rider also provides for an amount (an Income
Access Credit) to be added to the Protected Payment Base and Remaining
Protected Balance.
In addition, on any Contract Anniversary beginning with the third (3rd)
Contract Anniversary after the Rider Effective Date or the most recent Reset
Date, whichever is later, you may elect to reset the Remaining Protected
Balance to an amount equal to 100% of the Contract Value on that Contract
Anniversary.
For purposes of this Rider, the term withdrawal includes any applicable
withdrawal charges and charges for premium taxes and/or other taxes, if
applicable. Amounts withdrawn under this Rider will reduce the Contract Value
by the amount withdrawn and will be subject to the same conditions,
limitations, restrictions and all other fees, charges and deductions, if
applicable, as withdrawals otherwise made under the provisions of the Contract.
Protected Payment Amount The maximum amount that can be withdrawn under this
Rider without reducing the Protected Payment Base. The Protected Payment Amount
on any day after the Rider Effective Date is equal to the lesser of:
|
|
5% of the Protected Payment Base as of that day, less cumulative withdrawals during that Contract Year, or |
|
|
the Remaining Protected Balance as of that day. |
Protected Payment Base An amount used to determine the Protected Payment
Amount. The Protected Payment Base will remain unchanged except as otherwise
described under the provisions of this Rider.
Remaining Protected Balance The amount available for future withdrawals made
under this Rider.
Income Access Credit An amount added to the Protected Payment Base and
Remaining Protected Balance.
Reset Date Any Contract Anniversary beginning with the third (3rd) Contract
Anniversary after the Rider Effective Date or the most recent Reset Date,
whichever is later, on which you elect to Reset the remaining Protected Balance
to an amount equal to 100% of the Contract Value, determined as of that
Contract Anniversary.
Initial Values The initial Protected Payment Base and Remaining Protected
Balance amounts are equal to:
|
|
Initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or |
|
|
Contract Value, if the Rider Effective Date is on a Contract Anniversary. |
The initial Protected Payment Amount on the Rider Effective Date is equal to 5%
of the initial Protected Payment Base.
Subsequent Purchase Payments If we receive additional Purchase Payments after
the Rider Effective Date, we will increase the Protected Payment Base and
Remaining Protected Balance by the amount of the Purchase Payments. However,
for purposes of this Rider, we reserve the right to restrict additional
Purchase Payments that result in a total of all Purchase Payments received on
or after the later of the first (1st) Contract Anniversary or most recent Reset
Date to exceed $100,000
without our prior approval. This provision only applies if the Contract to
which this Rider is attached, permits Purchase Payments after the first (1st)
Contract Anniversary, measured from the Contract Date.
Income Access Credit On each Contract Anniversary after the Rider Effective
Date, an Income Access Credit will be added to the Protected Payment Base and
Remaining Protected Balance, as of that Contract Anniversary, if:
|
|
no withdrawals have occurred after the Rider Effective Date or the
most recent Reset Date, whichever is later, and |
|
|
that Contract Anniversary is prior to the sixth (6th) Contract
Anniversary, measured from the Rider Effective Date or the most recent
Reset Date, whichever is later. |
The Income Access Credit is equal to 6% of the total of:
|
|
the Remaining Protected Balance on the Rider Effective Date or the
most recent Reset Date, whichever is later, and |
|
|
the cumulative Purchase Payments received after the Rider Effective
Date or most recent Reset Date, whichever is later, |
as of the Contract Anniversary on which the Income Access Credit is added.
Once a withdrawal has occurred, no Income Access Credit will be added to the
Protected Payment Base and Remaining Protected Balance on any Contract
Anniversary following the withdrawal, unless you elect to reset the Remaining
Protected Balance.
Income Access Credits will not increase your cost basis and when distributed,
may be recognizable as taxable ordinary income.
Withdrawal of Protected Payment Amount While this Rider is in effect, you may
withdraw up to the Protected Payment Amount without reducing the Protected
Payment Base, regardless of market performance, until the Remaining Protected
Balance equals zero.
If a withdrawal does not exceed the Protected Payment Amount immediately prior
to that withdrawal, the Protected Payment Base will remain unchanged. The
Remaining Protected Balance will decrease by the withdrawal amount immediately
following the withdrawal.
If a withdrawal exceeds the Protected Payment Amount immediately prior to that
withdrawal, we will adjust the Protected Payment Base and Remaining Protected
Balance immediately following the withdrawal, to the lesser of:
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the Contract Value immediately after the withdrawal, or |
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|
the Remaining Protected Balance immediately prior to the withdrawal, less the withdrawal amount. |
A withdrawal may not exceed the amount available for withdrawal under the
Contract if such withdrawal would exceed the Protected Payment Amount.
If a withdrawal does not exceed the Protected Payment Amount and reduces the
Contract Value to zero, the following will apply:
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|
5% of the Protected Payment Base will be paid each year until the
Remaining Protected Balance is reduced to zero. The payments will be
made under a series of pre-authorized withdrawals under a payment
frequency, as elected by you, but no less frequently than annually, |
|
|
no additional Purchase Payments will be accepted under the Contract, |
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any Remaining Protected Balance will not be available for payment in
a lump sum and may not be applied to provide payments under an Annuity
Option, and |
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the Contract will cease to provide any death benefit. |
If the Owner or sole surviving Annuitant dies and the Contract Value is zero as
of the date of death, any Remaining Protected Balance will be paid to the
Beneficiary under the series of pre-authorized withdrawals and payment
frequency then in effect at the time of the Owners or sole surviving
Annuitants death.
Election to Reset Remaining Protected Balance You may, on any Contract
Anniversary beginning with the third (3rd) Contract Anniversary, measured from
the Rider Effective Date or the most recent Reset Date, whichever is later,
elect to reset the Remaining Protected Balance to an amount equal to 100% of
the Contract Value as of that Contract Anniversary.
The annual Charge percentage may change if you elect to reset the Remaining
Protected Balance. However, the annual Charge percentage will never exceed the
annual Charge percentage then in effect for new issues of this same Rider. If
we are no longer issuing this Rider, any change in the annual Charge percentage
will not result in an annual Charge percentage that exceeds the maximum annual
Charge percentage. (See CHARGES, FEES and DEDUCTIONS Income Access Plus
Rider).
On each Reset Date and after any Income Access Credit is applied, we will set
the Protected Payment Base and Remaining Protected Balance to an amount equal
to 100% of the Contract Value as of the Reset Date.
The election to reset the Remaining Protected Balance must be received, in a
form satisfactory to us, at our Service Center within thirty (30) days after
the Contract Anniversary on which the reset is effective. Your election to
reset the Remaining Protected Balance may result in a reduction in the
Protected Payment Base, Remaining Protected Balance, Protected Payment Amount
and Income Access Credit. We will provide you with written confirmation of
your election.
On and after each Reset Date, the provisions of this Rider shall apply in the
same manner as they applied when the Rider was originally issued. Eligibility
for any Income Access Credits, the limitations and restrictions on Purchase
Payments and withdrawals, the deduction of annual Charges and any future reset
options available on and after the Reset Date, will again apply and will be
measured from that Reset Date.
Sample Calculations Hypothetical sample calculations are in the attached
APPENDIX C: INCOME ACCESS PLUS RIDER SAMPLE CALCULATIONS to the Prospectus.
The examples provided are based on certain hypothetical assumptions and are for
example purposes only. The examples are not intended to serve as projections
of future investment returns.
FEDERAL TAX STATUS Loans is amended as follows:
The third paragraph in the Loan Terms subsection is replaced with the
following:
If you purchase the GPA, GPA 5, GIA II, GIA 5, GIA Plus, Income Access, or the
Income Access Plus Riders, there may be adverse consequences to taking a loan
while these Riders are in effect. If you have an existing loan on your
Contract, you should carefully consider whether these Riders are appropriate
for you.
APPENDIX B: GUARANTEED INCOME ADVANTAGE PLUS RIDER SAMPLE CALCULATIONS is added:
GUARANTEED INCOME ADVANTAGE PLUS RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by the
Guaranteed Income Advantage Plus (GIA Plus) Rider, and to demonstrate how
Purchase Payments received and withdrawals made from the Contract prior to the
Annuity Date affect the values and benefits under this Rider over an extended
period of time. These examples are not intended to serve as projections of
future investment returns.
Example #1 The initial values on the Rider Effective Date based on an Initial
Purchase Payment of $100,000. The Initial Purchase Payment is assumed to be
the Contract Value if the Rider Effective Date is on a Contract Anniversary.
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Remaining |
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Contract |
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GIA Plus |
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Dollar |
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Purchase |
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Value |
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Guaranteed |
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GIA plus |
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GIA Plus |
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Withdrawal |
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Amount of |
Contract |
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Payments |
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Withdrawal |
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after |
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Income Base |
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Step-Up |
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Withdrawal |
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Amt. (GWA) |
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Prior Years |
Years
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Received
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Amount
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Activity
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(GIB)
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Value
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Base (GWB)
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(5% of GWB)
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GWA
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Beginning of Year 1 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
5,000 |
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N/A |
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Example #2 - Subsequent Purchase Payment received during the first Contract
Year and its effect on the values and balances under this Rider. This example
assumes that no withdrawals have been made.
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Remaining |
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Contract |
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GIA Plus |
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Dollar |
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Purchase |
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Value |
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Guaranteed |
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GIA plus |
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GIA Plus |
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Withdrawal |
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Amount of |
Contract |
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Payments |
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Withdrawal |
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after |
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Income Base |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Prior Years |
Years
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Received
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Amount
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Activity
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(GIB)
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Value
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Base (GWB)
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(5% of GWB)
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GWA
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Beginning of Year 1 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
5,000 |
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N/A |
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Activity |
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$ |
100,000 |
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$ |
200,742 |
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$ |
201,227 |
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$ |
200,000 |
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Beginning of Year 2 |
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$ |
205,242 |
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$ |
208,727 |
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$ |
205,242 |
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200,000 |
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$ |
10,000 |
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$ |
5,000 |
|
In addition to Purchase Payments, the Contract Value is further subject to
increases and/or decreases during a Contract Year as a result of additional
amounts credited, charges, fees and other deductions, and increases and/or
decreases in the investment performance of the Variable Account.
The Guaranteed Income Base prior to receipt of the Purchase Payment is assumed
to have accumulated to $101,227. This amount is derived by multiplying each
days Guaranteed Income Base by the daily factor of 1.000133680. As a result
of the subsequent Purchase Payment, the Guaranteed Income Base is increased to
$201,227 ($101,227 + $100,000). The Guaranteed Income Base will assume to
accumulate to $208,727 at the next Contract Anniversary, by multiplying each
days Guaranteed Income Base immediately after receipt of the subsequent
Purchase Payment by the daily factor of 1.000133680.
The GIA Plus Step-Up Value prior to receipt of the Purchase Payment is
$100,000. As a result of the subsequent Purchase Payment, the GIA Plus Step-Up
Value is increased to $200,000 ($100,000 + $100,000). On the Contract
Anniversary at the beginning of Contract Year 2, the Contract Value ($205,242)
is greater than the GIA Plus Step-Up Value immediately prior to that Contract
Anniversary ($200,000). As a result, the GIA Plus Step-Up Value as of that
Contract Anniversary is equal to the Contract Value on that Contract
Anniversary ($205,242).
The GIA Plus Withdrawal Base on the Contract Anniversary at the beginning of
Contract Year 2 is equal to the GIA Plus Withdrawal Base on the Rider Effective
Date ($100,000) plus cumulative Purchase Payments received after the Rider
Effective Date ($100,000). As a result of the subsequent Purchase Payment, the
GIA Plus Withdrawal Base on the Contract Anniversary at the beginning of
Contract Year 2 is equal to $200,000 ($100,000 + $100,000).
The GIA Plus Withdrawal Amount for Contract Year 2 is determined on the
Contract Anniversary at the beginning of Contract Year 2, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result of the subsequent Purchase Payment, the GIA Plus Withdrawal Amount for
Contract Year 2 is equal to $10,000.
Since no withdrawals were made during Contract Year 1, the GIA Plus Withdrawal
Amount for Contract Year 1 ($5,000) becomes the remaining dollar amount of the
prior Contract Years GIA Plus Withdrawal Amount for Contract Year 2.
Example #3 Cumulative withdrawals during Contract Year 2 exceeding the sum
of: (a) the GIA Plus Withdrawal Amount for Contract Year 2; and (b) the
remaining dollar amount of the prior Contract Years GIA Plus Withdrawal Amount
for Contract Year 2. The withdrawal is assumed to result in a 10% reduction in
the Contract Value.
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Remaining |
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Contract |
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GIA Plus |
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Dollar |
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Purchase |
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Value |
|
Guaranteed |
|
GIA plus |
|
GIA Plus |
|
Withdrawal |
|
Amount of |
Contract |
|
Payments |
|
Withdrawal |
|
after |
|
Income Base |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Prior Years |
Years
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Received
|
|
Amount
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Activity
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(GIB)
|
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Value
|
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Base (GWB)
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(5% of GWB)
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GWA
|
Beginning of Year 1 |
|
$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
100,000 |
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$ |
5,000 |
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N/A |
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Activity |
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$ |
100,000 |
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$ |
200,742 |
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$ |
201,227 |
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$ |
200,000 |
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Beginning of Year 2 |
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$ |
205,242 |
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$ |
208,727 |
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$ |
205,242 |
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$ |
200,000 |
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$ |
10,000 |
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$ |
5,000 |
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Activity |
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$ |
20,830 |
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$ |
187,468 |
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$ |
192,493 |
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$ |
184,717 |
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-$ |
15,830 |
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-$ |
5,000 |
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= $ |
0 |
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= $ |
0 |
|
Beginning of Year 3 |
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$ |
190,259 |
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$ |
197,247 |
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$ |
190,259 |
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$ |
200,000 |
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$ |
10,000 |
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$ |
0 |
|
Since the $20,830 withdrawal exceeded the sum of: (a) the GIA Plus Withdrawal
Amount for Contract Year 2; and (b) the remaining dollar amount of the prior
Contracts Years GIA Plus Withdrawal Amount for Contract Year 2, the remaining
dollar amount of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3 is zero. Withdrawals are first applied to the remaining dollar
amount of the prior Contract Years GIA Plus Withdrawal Amount, if any, until
exhausted, then to the GIA Plus Withdrawal Amount for the current Contract
Year, until exhausted.
The GIA Plus Withdrawal Amount for Contract Year 3 is determined on the
Contract Anniversary at the beginning of Contract Year 3, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result, the GIA Plus Withdrawal Amount for Contract Year 3 is equal to
$10,000. The GIA Plus Withdrawal Amount for any Contract Year will not be less
than zero.
Immediately after the withdrawal, the Guaranteed Income Base and the GIA Plus Step-Up Value are reduced by the percentage decrease (10%) in Contract Value as a result of the withdrawal.
Since no subsequent Purchase Payments were received during Contract Year 2, the GIA Plus Withdrawal Base at the beginning of Contract Year 3 remains unchanged.
Example #4 - Cumulative withdrawals during Contract Year 3 not exceeding the
sum of: (a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the
remaining dollar value of the prior Contract Years GIA Plus Withdrawal Amount
for Contract Year 3.
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Remaining |
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Contract |
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|
GIA |
|
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|
GIA Plus |
|
Dollar |
|
|
Purchase |
|
|
|
|
|
Value |
|
Guaranteed |
|
Plus |
|
GIA Plus |
|
Withdrawal |
|
Amount of |
Contract |
|
Payments |
|
Withdrawal |
|
after |
|
Income Base |
|
Step-Up |
|
Withdrawal |
|
Amt (GWA) |
|
Prior Years |
Years
|
|
Received
|
|
Amount
|
|
Activity
|
|
(GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
GWA
|
Beginning of Year 1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
Activity |
|
$ |
100,000 |
|
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|
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|
|
$ |
200,742 |
|
|
$ |
201,227 |
|
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$ |
200,000 |
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|
Beginning of Year 2 |
|
|
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|
$ |
205,242 |
|
|
$ |
208,727 |
|
|
$ |
205,242 |
|
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$ |
200,000 |
|
|
$ |
10,000 |
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$ |
5,000 |
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|
|
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|
|
|
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|
-$ |
15,830 |
|
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-$ |
5,000 |
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Activity |
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|
$ |
20,830 |
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$ |
187,468 |
|
|
$ |
192,493 |
|
|
$ |
184,717 |
|
|
|
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|
|
=$ |
0 |
|
|
=$ |
0 |
|
Beginning of Year 3 |
|
|
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|
|
$ |
190,259 |
|
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$ |
197,247 |
|
|
$ |
190,259 |
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$ |
200,000 |
|
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$ |
10,000 |
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$ |
0 |
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-$ |
8,000 |
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-$ |
0 |
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Activity |
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|
$ |
8,000 |
|
|
$ |
185,092 |
|
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$ |
193,744 |
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$ |
182,376 |
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|
$ |
2,000 |
|
|
= $ |
0 |
|
Beginning of Year 4 |
|
|
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|
|
|
|
|
|
$ |
187,848 |
|
|
$ |
199,109 |
|
|
$ |
187,848 |
|
|
$ |
200,000 |
|
|
$ |
10,000 |
|
|
$ |
2,000 |
|
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the remaining
dollar amount of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3, the Guaranteed Income Base on the Contract Anniversary at the
beginning of Contract Year 4 is calculated as follows:
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 3: |
|
$ |
197,247 |
|
Increased at an annual rate of 5% to the Contract Anniversary at the beginning of Contract Year 4: |
|
+$ |
9,862 |
|
Reduced by the amount equal to the amount withdrawn in Contract Year 3: |
|
-$ |
8,000 |
|
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 4: |
|
$ |
199,109 |
|
Since no subsequent Purchase Payments were received during Contract Year 3, the
GIA Plus Withdrawal Base at the beginning of Contract Year 4 remains unchanged.
The GIA Plus Withdrawal Amount for Contract Year 4 is determined on the
Contract Anniversary at the beginning of Contract Year 4, and is equal to 5% of
the GIA Plus Withdrawal Base on that Contract Anniversary (5% of $200,000). As
a result, the GIA Plus Withdrawal Amount for Contract Year 4 is equal to
$10,000.
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Plus Withdrawal Amount for Contract Year 3; and (b) the remaining
dollar value of the prior Contract Years GIA Plus Withdrawal Amount for
Contract Year 3; the dollar amount of the GIA Plus Withdrawal Amount for
Contact Year 3 remaining ($2,000) becomes the remaining dollar amount of the
prior Contract Years GIA Plus Withdrawal Amount for Contract Year 4.
Example #5 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and no withdrawals are
taken during the first ten (10) Contract Years after the Rider Effective Date.
The Initial Purchase Payment is assumed to be the Contract Value if the Rider
is effective on a Contract Anniversary.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GIA Plus |
|
|
Beginning |
|
|
|
|
|
|
|
|
|
GIA Plus |
|
GIA Plus |
|
Withdrawal |
|
Remaining Dollar |
of Contract |
|
Contract Value |
|
Guaranteed |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Amount of |
Year
|
|
after Activity
|
|
Income Base (GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
Prior Year's GWA
|
1 |
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
2 |
|
$ |
103,000 |
|
|
$ |
105,000 |
|
|
$ |
103,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
3 |
|
$ |
106,090 |
|
|
$ |
110,250 |
|
|
$ |
106,090 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
4 |
|
$ |
109,273 |
|
|
$ |
115,763 |
|
|
$ |
109,273 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
5 |
|
$ |
112,551 |
|
|
$ |
121,551 |
|
|
$ |
112,551 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
6 |
|
$ |
115,927 |
|
|
$ |
127,628 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
7 |
|
$ |
112,450 |
|
|
$ |
134,010 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
8 |
|
$ |
109,076 |
|
|
$ |
140,710 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GIA Plus |
|
|
Beginning |
|
|
|
|
|
|
|
|
|
GIA Plus |
|
GIA Plus |
|
Withdrawal |
|
Remaining Dollar |
of Contract |
|
Contract Value |
|
Guaranteed |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Amount of |
Year
|
|
after Activity
|
|
Income Base (GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
Prior Years GWA
|
9 |
|
$ |
105,804 |
|
|
$ |
147,746 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
10 |
|
$ |
102,630 |
|
|
$ |
155,133 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
11 |
|
$ |
99,551 |
|
|
$ |
162,889 |
|
|
$ |
115,927 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
5,000 |
|
Example #6 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and withdrawals of
$5,000 are taken each Contract Year for the first ten (10) Contract Years after
the Rider Effective Date. The Initial Purchase Payment is assumed to be the
Contract Value if the Rider is effective on a Contract Anniversary.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GIA Plus |
|
|
Beginning |
|
|
|
|
|
|
|
|
|
GIA Plus |
|
GIA Plus |
|
Withdrawal |
|
Remaining Dollar |
of Contract |
|
Contract Value |
|
Guaranteed |
|
Step-Up |
|
Withdrawal |
|
Amt. (GWA) |
|
Amount of |
Year
|
|
after Activity
|
|
Income Base (GIB)
|
|
Value
|
|
Base (GWB)
|
|
(5% of GWB)
|
|
Prior Years GWA
|
1 |
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
N/A |
|
2 |
|
$ |
97,926 |
|
|
$ |
100,000 |
|
|
$ |
97,926 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
3 |
|
$ |
95,789 |
|
|
$ |
100,000 |
|
|
$ |
95,789 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
4 |
|
$ |
93,588 |
|
|
$ |
100,000 |
|
|
$ |
93,588 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
5 |
|
$ |
91,321 |
|
|
$ |
100,000 |
|
|
$ |
91,321 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
6 |
|
$ |
88,986 |
|
|
$ |
100,000 |
|
|
$ |
88,986 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
7 |
|
$ |
81,392 |
|
|
$ |
100,000 |
|
|
$ |
83,910 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
8 |
|
$ |
74,026 |
|
|
$ |
100,000 |
|
|
$ |
78,676 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
9 |
|
$ |
66,881 |
|
|
$ |
100,000 |
|
|
$ |
73,280 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
10 |
|
$ |
59,950 |
|
|
$ |
100,000 |
|
|
$ |
67,718 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
11 |
|
$ |
53,227 |
|
|
$ |
100,000 |
|
|
$ |
61,983 |
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
|
$0 |
|
Should the Contract annuitize immediately after the Rider has been in effect
for at least ten (10) years and the GIA Plus Annuity Option has been elected to
provide such payments, the net amount applied on the Annuity Date as a single
premium to provide the payments is equal to the greater of:
(a) |
|
the Guaranteed Income Base; or |
|
(b) |
|
the GIA Plus Step-Up Value; less any: |
|
(c) |
|
applicable withdrawal charges resulting from the conversion to the
GIA Plus Annuity Option; |
|
(d) |
|
applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date; and |
|
(e) |
|
charges for premium taxes and/or other taxes. |
Under Example #5, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($162,889), as it is greater than the GIA Plus Step-Up Value
($115,927) as of the Annuity Date, less the amounts in (c), (d) and (e) above,
if any.
Under Example #6, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($100,000), as it is greater than the GIA Plus Step-Up Value
($61,983) as of the Annuity Date, less the amounts in (c), (d) and (e) above,
if any.
APPENDIX C: INCOME ACCESS PLUS RIDER SAMPLE CALCULATIONS is added:
INCOME ACCESS PLUS RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by
this Rider and to demonstrate how Purchase Payments received and withdrawals
made from the Contract prior to the Annuity Date affect the values and benefits
under this Rider over an extended period of time. These examples are not
intended to serve as projections of future investment returns.
Example #1 Income Access Credit; No Subsequent Purchase Payments; No
Withdrawals; No Reset in Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
|
Rider Effective Date = Contract Date |
|
|
|
No subsequent Purchase Payments are received. |
|
|
|
No withdrawals taken. |
|
|
|
No reset of the Remaining Protected Balance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
|
|
|
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Purchase Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
106,090 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
109,273 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
5 |
|
|
|
|
|
|
|
|
|
$ |
112,551 |
|
|
$ |
6,000 |
|
|
$ |
124,000 |
|
|
$ |
6,200 |
|
|
$ |
124,000 |
|
6 |
|
|
|
|
|
|
|
|
|
$ |
115,927 |
|
|
$ |
6,000 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
7 |
|
|
|
|
|
|
|
|
|
$ |
119,405 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
8 |
|
|
|
|
|
|
|
|
|
$ |
122,987 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
9 |
|
|
|
|
|
|
|
|
|
$ |
126,677 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
10 |
|
|
|
|
|
|
|
|
|
$ |
130,477 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
11 |
|
|
|
|
|
|
|
|
|
$ |
134,392 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 6, an Income Access Credit of $6,000 (6% of initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on each Contract Anniversary up to the Contract Anniversary
at the beginning of Contract Year 6. As a result, on the Contract Anniversary
at the beginning of Contract Year 6, the Protected Payment Base and Remaining
Protected Balance are equal to $130,000 and the Protected Payment Amount is
equal to $6,500 (5% of $130,000).
No Income Access Credit will be added to the Protected Payment Base and
Remaining Protected Balance on any Contract Anniversary after the Contract
Anniversary at the beginning of Contract Year 6, as no reset in the Remaining
Protected Balance was assumed.
In addition to the Initial Purchase Payment, the Contract Value is further
subject to increases and/or decreases during each Contract Year as a result of
additional amounts credited, charges, fees and other deductions, and increases
and/or decreases in the investment performance of the Variable Account.
Example
#2 Subsequent Purchase Payment.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
|
Rider Effective Date = Contract Date |
|
|
|
A subsequent Purchase Payment of $50,000 is received during Contract Year 2. |
|
|
|
No withdrawals taken. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
|
|
|
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Purchase Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
$ |
50,000 |
|
|
|
|
|
|
$ |
154,534 |
|
|
|
|
|
|
$ |
156,000 |
|
|
$ |
7,800 |
|
|
$ |
156,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
156,834 |
|
|
$ |
9,000 |
|
|
$ |
165,000 |
|
|
$ |
8,250 |
|
|
$ |
165,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Immediately after the $50,000 subsequent Purchase Payment during Contract Year
2, the Protected Payment Base and Remaining Protected Balance are increased by
the Purchase Payment amount to $156,000 ($106,000 + $50,000). The Protected
Payment Amount after the Purchase Payment is equal to $7,800 (5% of the
Protected Payment Base after the Purchase Payment since there are no
withdrawals during that Contract Year).
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 3, an Income Access Credit of $9,000 (6% of Initial Remaining
Protected Balance plus 6% of the $50,000 subsequent Purchase Payment) is added
to the Protected Payment Base and Remaining Protected Balance on that Contract
Anniversary, increasing both to $165,000. As a result, the Protected Payment
Amount on that Contract Anniversary is equal to $8,250 (5% of the Protected
Payment Base on that Contract Anniversary).
Example #3 Withdrawal Not Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
A withdrawal of $5,000 is taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
101,016 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
104,046 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount ($5,300):
(a) |
|
the Protected Payment Base remains unchanged; |
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Since a withdrawal occurred during Contract Year 2, no Income Access Credit
will be added to the Protected Payment Base and Remaining Protected Balance on
any Contract Anniversary following the withdrawal.
Example #4 Withdrawals Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
Two separate withdrawals of $5,000 and $3,000 are taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
Activity |
|
|
|
|
|
$ |
3,000 |
|
|
$ |
97,272 |
|
|
|
|
|
|
$ |
97,272 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
97,993 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
100,933 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an Income Access Credit of $6,000 (6% of Initial Remaining
Protected Balance) is added to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount ($5,300):
(a) |
|
the Protected Payment Base remains unchanged; |
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Because the $3,000 withdrawal during Contract Year 2 exceeds the Protected
Payment Amount immediately prior to the withdrawal ($3,000 > $300), the
Protected Payment Base and Remaining Protected Balance immediately after the
withdrawal are adjusted to the lesser of:
(a) |
|
the Contract Value immediately after the withdrawal ($97,272); or |
|
(b) |
|
the Remaining Protected Balance immediately prior to the withdrawal,
less the withdrawal amount ($101,000 $3,000 = $98,000). |
The Protected Payment Amount immediately after the withdrawal is equal to $0
(5% of the Protected Payment Base after the withdrawal (5% of $97,272 =
$4,864), less cumulative withdrawals during that Contract Year ($8,000), but
not less than zero).
Since a withdrawal occurred during Contract Year 2, no Income Access Credit
will be added to the Protected Payment Base and Remaining Protected Balance on
any Contract Anniversary following the withdrawal.
Example #5 Reset in Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
Initial Purchase Payment = $100,000 |
|
|
Rider Effective Date = Contract Date |
|
|
No subsequent Purchase Payments are received. |
|
|
Reset in the Remaining Protected Balance at the Beginning of Contract Year 4. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
110,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Beginning |
|
|
|
|
|
|
|
|
|
|
|
|
|
Income |
|
Protected |
|
Protected |
|
Remaining |
of Contract |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Access |
|
Payment |
|
Payment |
|
Protected |
Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
3 |
|
|
|
|
|
|
|
|
|
$ |
121,000 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
4
(Prior to Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
4
(After Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,655 |
|
|
$ |
133,100 |
|
5 |
|
|
|
|
|
|
|
|
|
$ |
146,410 |
|
|
$ |
7,986 |
|
|
$ |
141,086 |
|
|
$ |
7,054 |
|
|
$ |
141,086 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
On the Contract Anniversary at the beginning of Contract Year 4, the Contract
Value ($133,100) is greater than the Remaining Protected Balance ($118,000).
With the reset in Remaining Protected Balance, the Protected Payment Base and
Remaining Protected Balance are set equal to the Contract Value on that
Contract Anniversary. As a result, the Protected Payment Amount is equal to
$6,655 after the reset.
After the reset in Remaining Protected Balance, eligibility for any Income
Access Credit will be based on the most recent Reset Date. That is, an Income
Access Credit may be added to the Protected Payment Base and Remaining
Protected Balance on up to five additional Contract Anniversaries if certain
conditions are met.
The reset in Remaining Protected Balance may result in an increase in the
annual Income Access Charge percentage.
The reset in Remaining Protected Balance may also result in a lower Protected
Payment Base, Remaining Protected Balance, Protected Payment Amount and Income
Access Credit.
STATEMENT OF ADDITIONAL INFORMATION is amended by adding the following:
All references to the optional Riders, including but not limited to, EEG, GPA
5, GPA, GIA II, GIA 5, GIA or Income Access, in the PERFORMANCE and THE
CONTRACTS AND THE SEPARATE ACCOUNT sections, shall include the Guaranteed
Income Advantage Plus (GIA Plus) and Income Access Plus Riders.
PART II
Part C: OTHER INFORMATION
Item 24. Financial Statements and Exhibits
|
(a) |
|
Financial Statements |
|
|
|
|
Part A: None |
|
|
|
|
Part B: |
|
(1) |
|
Registrants Financial Statements |
Audited Financial Statements dated as of December 31,
2003 which are incorporated by reference from the 2003
Annual Report include the following for Separate Account
A:
Statements of Assets and Liabilities
Statements of Operations
Statements of Changes in Net Assets
Notes to Financial Statements
|
(2) |
|
Depositors Financial Statements |
Audited Consolidated Financial Statements dated as of
December 31, 2003 and 2002, and for the three year
period ended December 31, 2003, included in Part B
include the following for Pacific Life:
Independent Auditors Report
Consolidated Statements of Financial Condition
Consolidated Statements of Operations
Consolidated Statements of Stockholders Equity
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements
|
|
|
|
|
|
|
|
|
|
|
|
1. |
|
|
(a)
|
|
Resolution of the Board of Directors of the
Depositor authorizing establishment of Separate
Account A and Memorandum establishing Separate
Account A.1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(b)
|
|
Memorandum Establishing Two New Variable
AccountsAggressive Equity and Emerging Markets
Portfolios.1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(c)
|
|
Resolution of the Board of Directors of Pacific
Life Insurance Company authorizing conformity to
the terms of the current Bylaws.1 |
II-1
|
|
|
|
|
|
|
|
|
|
|
|
3. |
|
|
(a)
|
|
Distribution Agreement between Pacific Mutual Life and Pacific Select Distributors, Inc (PSD)1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(b)
|
|
Form of Selling Agreement between Pacific Mutual Life, PSD and Various Broker-Dealers1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4. |
|
|
(a)
|
|
|
(1 |
) |
|
Pacific InnovationsForm of Individual Flexible
Premium Deferred Variable Annuity Contract (Form
No. 10-12600)1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2 |
) |
|
Pacific Innovations SelectForm of Individual
Flexible Premium Deferred Variable Annuity
Contract (Form No. 10-10300)11 |
|
(b) |
|
Qualified Pension Plan Rider (Form No. R90-PEN-V)1 |
|
|
(c) |
|
403(b) Tax-Sheltered Annuity Rider10 |
|
|
(d) |
|
Section 457 Plan Rider (Form No. 24-123799)1 |
|
|
(e) |
|
Individual Retirement Annuity Rider (Form No. 20-18900)11 |
|
|
(f) |
|
Roth Individual Retirement Annuity Rider (Form No. 20-19000)11 |
|
|
(g) |
|
SIMPLE Individual Retirement Annuity Rider (Form No. 20-19100)11 |
|
|
(h) |
|
Qualified Retirement Plan Rider10 |
|
|
|
|
|
|
|
|
|
|
|
(i)
|
|
|
(1 |
) |
|
Pacific InnovationsStepped-Up Death Benefit
Rider (Form No. 20-12601)1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2 |
) |
|
Pacific Innovations SelectStepped-Up Death
Benefit Rider (Form No. 20-13500)5 |
|
|
|
|
|
|
|
|
|
|
|
(j)
|
|
|
(1 |
) |
|
Premier Death Benefit Rider (Form No. 20-12602)1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2 |
) |
|
Premier Death Benefit Rider (Form No. 20-18000)11 |
|
(k) |
|
Guaranteed Earnings Enhancement (EEG) Rider (Form No. 20-14900)6 |
|
|
(l) |
|
Guaranteed Income Advantage (GIA) Rider (Form No. 20-15100)8 |
|
|
(m) |
|
Form of Guaranteed Protection Advantage (GPA) Rider (Form No. 20-16200)9 |
|
|
(n) |
|
Form of Guaranteed Protection Advantage 5 Rider
(Form No. 20-19500)14 |
|
|
|
|
|
|
|
|
|
|
|
(o)
|
|
|
(1 |
) |
|
Income Access Rider (Form No. 20-19800)12 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2 |
) |
|
Form of Income Access Rider
(Form No. 20-1104)15 |
|
(p) |
|
Pacific Innovations SelectDCA Plus Fixed Option Rider (Form No. 20-1103)14 |
|
|
(q) |
|
Form of Guaranteed Income Advantage II Rider (Form No. 20-1109)15 |
|
|
(r) |
|
Form of Guaranteed Income Advantage 5 Rider
(Form No. 20-1102)15 |
|
|
|
(s) |
|
Guaranteed Income Annuity Rider (Form No. 20-1118) |
|
|
|
|
(t) |
|
Guaranteed Withdrawal Benefit Rider (Form No. 20-1119); also
Known as Income Access Plus Rider |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5. |
|
|
(a)
|
|
|
(1 |
) |
|
Pacific InnovationsVariable Annuity Application
(Form No. 25-12610)4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2 |
) |
|
Pacific Innovations SelectVariable Annuity
Application (Form No. 25-10300)11 |
|
(b) |
|
Variable Annuity PAC APP1 |
|
|
(c) |
|
Application/Confirmation Form2 |
|
|
(d) |
|
Guaranteed Income Advantage (GIA) Rider Request (Form No. 1209-1A)9 |
|
|
(e) |
|
Form of Guaranteed Earnings Enhancement (EEG) Rider Request Application6 |
|
|
(f) |
|
Form of Guaranteed Protection Advantage (GPA) Rider Request (Form No. 55-16600)9 |
|
|
(g) |
|
Form of Guaranteed Protection Advantage 5 Rider Request Form (Form No. 2311-BA)12 |
|
|
(h) |
|
Form of Income Access Rider Request Form (Form No. 2315-3A)12 |
|
|
|
(i) |
|
Form of Portfolio Optimization Rider Request Form (Form No.
2311-5A) |
|
|
|
|
|
|
|
|
|
|
|
|
|
6. |
|
|
(a)
|
|
Pacific Lifes Articles of Incorporation1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(b)
|
|
By-laws of Pacific Life1 |
|
|
|
|
|
|
|
|
|
|
|
|
8. |
|
|
(a)
|
|
Fund Participation Agreement7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(b)
|
|
Addendum to the Fund Participation Agreement (to add the Strategic Value and Focused
30 Portfolios)7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(c)
|
|
Addendum to the Fund Participation Agreement (to add nine new Portfolios)7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(d)
|
|
Addendum to the Fund Participation Agreement (to add the Equity Income and Research
Portfolios)10 |
|
9 |
|
Opinion and Consent of legal officer of Pacific Life as to the legality of Contracts being registered.1 |
II-2
|
10. |
|
Independent Auditors Consent 16 |
|
|
11. |
|
Not applicable |
|
|
12. |
|
Not applicable |
|
|
13. |
|
Not applicable |
|
|
14. |
|
Not applicable |
|
|
15. |
|
Powers of Attorney10 |
|
|
16. |
|
Not applicable |
1 |
|
Included in Registrants Form N-4, File No. 333-93059, Accession No. 0000912057-99-009849 filed
on December 17, 1999 and incorporated by reference herein. |
|
2 |
|
Included in Registrants Form N-4, File No. 333-93059, Accession No. 0000912057-00-015739 filed
on March 31, 2000 and incorporated by reference herein. |
|
3 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No. 0000912057-00-018010 filed
on April 14, 2000 and incorporated by reference herein. |
|
4 |
|
Included in Registrants Form N-4/B, File No. 333-93059, Accession No. 0000912057-00-052614 filed
on December 7, 2000 and incorporated by reference herein. |
|
5 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No. 0000912057-00-055027 filed
on December 28, 2000 and incorporated by reference herein. |
|
6 |
|
Included in Registrants Form N-4/A, File No. 333-93059 Accession No. 0000912057-01-007165 filed
on March 2, 2001 and incorporated by reference herein. |
|
7 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No. 0000912057-01-510459 filed
on April 25, 2001 and incorporated by reference herein. |
|
8 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No. 0001017062-01-500247 filed
on May 10, 2001 and incorporated by reference herein. |
|
9 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No. 0000898430-01-503115 filed
on October 25, 2001 and incorporated by reference herein. |
|
10 |
|
Included in Registrants Form N-4/B, File No. 333-93059, Accession No.
0001017062-02-000788 filed on April 30, 2002 and incorporated by reference herein. |
|
11 |
|
Included in Registrants Form N-4/B, File No. 333-93059, Accession No.
0001017062-02-002149 filed on December 19, 2002 and incorporated by reference herein. |
|
12 |
|
Included in Registrants Form N-4/B, File No. 333-93059, Accession No.
0001017062-03-000460 filed on March 18, 2003 and incorporated by reference herein. |
|
13 |
|
Included in Registrants Form N-4/B, File No. 333-93059, Accession No.
0001017062-03-000934 filed on April 25, 2003 and incorporated by reference herein. |
|
14 |
|
Included in Registrants Form N-4/A, File No. 333-93059, Accession No.
0001193125-03-099264 filed on December 24, 2003 and incorporated by reference herein. |
|
15 |
|
Included in Registrants Form N-4/B, File
No. 333-93059, Accession No. 0001193125-04-031276 filed on February 27, 2004. |
16 |
|
Included in Registrants Form N-4/B, File
No. 333-93059, Accession No. 0001193125-04-031276 filed on February 27, 2004. |
Item 25. Directors and Officers of Pacific Life
|
|
|
|
|
Positions and Offices |
Name and Address |
|
with Pacific Life |
Thomas C. Sutton
|
|
Director, Chairman of the Board, and Chief Executive
Officer |
|
|
|
Glenn S. Schafer
|
|
Director and President |
|
|
|
Khanh T. Tran
|
|
Director, Executive Vice President and Chief Financial
Officer |
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David R. Carmichael
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Director, Senior Vice President and General Counsel |
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Audrey L. Milfs
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Director, Vice President and Corporate Secretary |
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Edward R. Byrd
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Vice President, Controller, and
Chief Accounting Officer |
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Brian D. Klemens
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Vice President and Treasurer |
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Gerald W. Robinson
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Executive Vice President |
The address for each of the persons listed above is as follows:
700 Newport Center Drive
Newport Beach, California 92660
II-3
Item 26. Persons Controlled by or Under Common Control with Pacific Life or Separate Account A
The following is an explanation of the organization chart of Pacific Lifes subsidiaries:
PACIFIC LIFE, SUBSIDIARIES & AFFILIATED ENTERPRISES
LEGAL STRUCTURE
Pacific Life is a California Stock Life Insurance Company wholly-owned by
Pacific LifeCorp (a Delaware Stock Holding Company) which is, in turn, 98%
owned by Pacific Mutual Holding Company (a California Mutual Holding Company).
Other subsidiaries of Pacific LifeCorp are: a 91% ownership of Aviation Capital
Group Holding Corp. (a Delaware Corporation); College Savings Bank (a New
Jersey Chartered Capital Stock Savings Bank) and its subsidiary College Savings
Trust (a Montana Chartered Uninsured Trust Company); M.L. Stern & Co., LLC (a
Delaware Limited Liability Company) and its subsidiary Tower Asset Management,
LLC (a Delaware Limited Liability Company); Pacific Asset Funding, LLC (a
Delaware Limited Liability Company) and its subsidiaries PL Trading Company,
LLC (a Delaware Limited Liability Company) and Pacific Life Trade Services,
Limited (a Hong Kong Limited Corporation); and Pacific Life & Annuity Services,
Inc. (a Colorado Corporation). A Subsidiary of Aviation Capital Group Holding
Corp., is Aviation Capital Group Corp. (a Delaware Corporation), which in turn,
is the parent of: ACG Acquisition V Corporation (a Delaware Corporation), and
ACG Trust II Holding LLC, and has a 50% ownership of ACG Acquisition VI LLC (a
Nevada Limited Liability Company); and a 33% ownership of ACG Acquisition IX
LLC. ACG Trust II Holding LLC owns Aviation Capital Group Trust II (a Delaware
statutory trust), which in turn owns ACG Acquisition XXV LLC, ACG Acquisition
XXVI LLC, and ACG Acquisition XXIX LLC. Subsidiaries of ACG Acquisition XXV LLC
are ACG Acquisition 37-38 LLCS and ACG Acquisition Ireland II, Limited (an
Irish Corporation); ACG Acquisition XXVI LLC; and ACG Acquisition XXVII LLC.
Subsidiaries of ACG Acquisition VI LLC are: a 34% ownership of ACG Acquisition
VIII LLC; a 20% ownership of ACG Acquisition XIV LLC; and a 20% ownership of
ACG Acquisition XIX LLC, which in turn owns ACG Acquisition XIX Holding LLC,
which owns Aviation Capital Group Trust (a Delaware statutory trust).
Subsidiaries of Aviation Capital Group Trust are: ACG Acquisition XV LLC; ACG
Acquisition XX LLC and its subsidiary ACG Acquisition Ireland, Limited (an
Irish Corporation); and ACG Acquisition XXI, LLC and ACG Acquisition XXIX LLC.
Subsidiaries of ACG Acquisition XXIX LLC are: ACG Acquisition XXX LLCs; ACG
Acquisition 35 LLC; ACG Acquisition 32-34, 36 and 39 LLCs; and ACGFS LLC.
Pacific Life is the parent company of: Pacific Life & Annuity Company (an
Arizona Stock Life Insurance Company); Pacific Select Distributors, Inc.;
Pacific Asset Management LLC (a Delaware Limited Liability Company);
Confederation Life Insurance and Annuity Company (a Georgia Company); a 9%
ownership of Scottish Re Group Limited [(a Cayman Islands Holding Company)
abbreviated structure]; a 95% ownership of Grayhawk Golf Holdings, LLC (a
Delaware Limited Liability Company), and its subsidiary Grayhawk Golf L.L.C.
(an Arizona Limited Liability Company); a 67% ownership of Pacific Mezzanine
Associates, L.L.C. (a Delaware Limited Liability Company) and its subsidiary
Pacific Mezzanine Investors, L.L.C., (a Delaware Limited Liability Company) who
is the sole general partner of the PMI Mezzanine Fund, L.P. (a Delaware Limited
Partnership); Las Vegas Golf I, LLC (a Delaware Limited Liability Company); Las
Vegas Golf II, LLC (a Delaware Limited Liability Company); and North Carolina
Property, LLC (a Delaware Limited Liability Company). Subsidiaries of Pacific
Asset Management LLC are: a 21% ownership of Carson-Pacific LLC (a Delaware
Limited Liability Company); PMRealty Advisors Inc.; a non-managing membership
interest in Allianz-PacLife Partners LLC (a Delaware Limited Liability
Company); and Pacific Financial Products Inc. (a Delaware Corporation).
Allianz-PacLife Partners LLC and Pacific Financial Products, Inc., own the
Class E units of Allianz Dresdner Asset Management of America L.P. (a Delaware
Limited Partnership). Subsidiaries of Pacific Select Distributors, Inc.,
include: Associated Financial Group, Inc., Mutual Service Corporation (a
Michigan Corporation), United Planners Group, Inc. (an Arizona Corporation),
and a 62% ownership of Waterstone Financial Group, Inc. (an Illinois
Corporation). Subsidiaries of Associated Financial Group, Inc., are Associated
Planners Investment Advisory, Inc., Associated Securities Corp., West Coast
Realty Management, Inc., Associated Planners Securities Corporation of Nevada,
Inc. (a Nevada Corporation), and West Coast Realty Advisors, Inc. Subsidiaries
of Mutual Service Corporation are Advisors Mutual Service Center, Inc. (a
Michigan Corporation) and Contemporary Financial Solutions,
Inc. (a Delaware Corporation). United Planners Group, Inc. is the general
partner and holds an approximate 45% general partnership interest in United
Planners Financial Services of America (an Arizona Limited Partnership).
Subsidiaries of United Planners Financial Services of America are UPFSA
Insurance Agency of Arizona, Inc. (an Arizona Corporation), UPFSA Insurance
Agency of California, Inc., United Planners Insurance Agency of Massachusetts,
Inc. (a Massachusetts Corporation). All corporations are 100% owned unless
otherwise indicated. All entities are California corporations unless otherwise
indicated.
II-4
Item 27. Number of Contractholders
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(1) Pacific Innovations Approximately
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Qualified |
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Non Qualified |
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(2) Pacific Innovations Select Approximately
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Qualified |
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Non Qualified |
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Item 28. Indemnification
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(a) |
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The Distribution Agreement between Pacific Life and Pacific Select
Distributors, Inc. (PSD) provides substantially as follows: |
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Pacific Life hereby agrees to indemnify and hold harmless PSD and its
officers and directors, and employees for any expenses (including
legal expenses), losses, claims, damages, or liabilities incurred by
reason of any untrue statement or representation of a material fact or
any omission or alleged omission to state a material fact required to
be stated to make other statements not misleading, if made in reliance
on any prospectus, registration statement, post-effective amendment
thereof, or sales materials supplied or approved by Pacific Life or
the Separate Account. Pacific Life shall reimburse each such person
for any legal or other expenses reasonably incurred in connection with
investigating or defending any such loss, liability, damage, or claim.
However, in no case shall Pacific Life be required to indemnify for
any expenses, losses, claims, damages, or liabilities which have
resulted from the willful misfeasance, bad faith, negligence,
misconduct, or wrongful act of PSD. |
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PSD hereby agrees to indemnify and hold harmless Pacific Life, its
officers, directors, and employees, and the Separate Account for any
expenses, losses, claims, damages, or liabilities arising out of or
based upon any of the following in connection with the offer or sale
of the contracts: (1) except for such statements made in reliance on
any prospectus, registration statement or sales material supplied or
approved by Pacific Life or the Separate Account, any untrue or
alleged untrue statement or representation is made; (2) any failure to
deliver a currently effective prospectus; (3) the use of any
unauthorized sales literature by any officer, employee or agent of PSD
or Broker; (4) any willful misfeasance, bad faith, negligence,
misconduct or wrongful act. PSD shall reimburse each such person for
any legal or other expenses reasonably incurred in connection with
investigating or defending any such loss, liability, damage, or claim. |
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(b) |
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The Form of Selling Agreement between Pacific Life, Pacific Select
Distributors, Inc. (PSD) and Various Broker-Dealers provides
substantially as follows: |
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Pacific Life and PSD agree to indemnify and hold harmless Selling
Broker-Dealer and General Agent, their officers, directors, agents and
employees, against any and all losses, claims, damages or liabilities
to which they may become subject under the 1933 Act, the 1934 Act, or
other federal or state statutory law or regulation, at common law or
otherwise, insofar as such losses, claims, damages or liabilities (or
actions in respect thereof) arise |
II-5
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out of or are based upon any untrue statement or alleged untrue
statement of a material fact or any omission or alleged omission to
state a material fact required to be stated or necessary to make the
statements made not misleading in the registration statement for the
Contracts or for the shares of Pacific Select Fund (the Fund) filed
pursuant to the 1933 Act, or any prospectus included as a part
thereof, as from time to time amended and supplemented, or in any
advertisement or sales literature approved in writing by Pacific Life
and PSD pursuant to Section IV.E. of this Agreement. |
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Selling Broker-Dealer and General Agent agree to indemnify and hold
harmless Pacific Life, the Fund and PSD, their officers, directors,
agents and employees, against any and all losses, claims, damages or
liabilities to which they may become subject under the 1933 Act, the
1934 Act or other federal or state statutory law or regulation, at
common law or otherwise, insofar as such losses, claims, damages or
liabilities (or actions in respect thereof) arise out of or are based
upon: (a) any oral or written misrepresentation by Selling
Broker-Dealer or General Agent or their officers, directors, employees
or agents unless such misrepresentation is contained in the
registration statement for the Contracts or Fund shares, any
prospectus included as a part thereof, as from time to time amended
and supplemented, or any advertisement or sales literature approved in
writing by Pacific Life and PSD pursuant to Section IV.E. of this
Agreement, (b) the failure of Selling Broker-Dealer or General Agent
or their officers, directors, employees or agents to comply with any
applicable provisions of this Agreement or (c) claims by Sub-agents or
employees of General Agent or Selling Broker-Dealer and General Agent
will reimburse Pacific Life or PSD or any director, officer, agent or
employee of either entity for any legal or other expenses reasonably
incurred by Pacific Life, PSD, or such officer, director, agent or
employee in connection with investigating or defending any such loss,
claims, damages, liability or action. This indemnity agreement will be
in addition to any liability which Broker-Dealer may otherwise have. |
II-6
Item 29. Principal Underwriters
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(a) |
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PSD also acts as principal underwriter for Pacific Select Variable Annuity
Separate Account, Separate Account B, Pacific Corinthian Variable Separate
Account, Pacific Select Separate Account, Pacific Select Exec Separate Account,
COLI Separate Account, COLI II Separate Account, COLI III Separate Account,
Separate Account A of Pacific Life & Annuity Company, Pacific Select Exec
Separate Account of Pacific Life & Annuity Company, |
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(b) |
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For information regarding PSD, reference is made to Form B-D, SEC File No.
8-15264, which is herein incorporated by reference. |
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(c) |
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PSD retains no compensation or net discounts or commissions from the Registrant. |
Item 30. Location of Accounts and Records
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The accounts, books and other documents required to be maintained by
Registrant pursuant to Section 31(a) of the Investment Company Act of
1940 and the rules under that section will be maintained by Pacific
Life at 700 Newport Center Drive, Newport Beach, California 92660. |
Item 31. Management Services
Item 32. Undertakings
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The registrant hereby undertakes: |
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(a) |
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to file a post-effective amendment to this registration statement as
frequently as is necessary to ensure that the audited financial
statements in this registration statement are never more than 16
months old for so long as payments under the variable annuity
contracts may be accepted, unless otherwise permitted. |
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(b) |
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to include either (1) as a part of any application to purchase a
contract offered by the prospectus, a space that an applicant can
check to request a Statement of Additional Information, or (2) a post
card or similar written communication affixed to or included in the
prospectus that the applicant can remove to send for a Statement of
Additional Information, or (3) to deliver a Statement of Additional
Information with the Prospectus. |
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(c) |
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to deliver any Statement of Additional Information and any financial
statements required to be made available under this Form promptly upon
written or oral request. |
II-7
Additional Representations
(a) The Registrant and its Depositor are relying upon American Council of
Life Insurance, SEC No-Action Letter, SEC Ref. No. 1P-6-88 (November 28, 1988)
with respect to annuity contracts offered as funding vehicles for retirement
plans meeting the requirements of Section 403(b) of the Internal Revenue Code,
and the provisions of paragraphs (1)-(4) of this letter have been complied
with.
(b) The Registrant and its Depositor are relying upon Rule 6c-7 of the
Investment Company Act of 1940 with respect to annuity contracts offered as
funding vehicles to participants in the Texas Optional Retirement Program, and
the provisions of Paragraphs (a)-(d) of the Rule have been complied with.
(c) REPRESENTATION PURSUANT TO SECTION 26(f) OF THE INVESTMENT COMPANY
ACT OF 1940: Pacific Life Insurance Company and Registrant represent that the
fees and charges to be deducted under the Variable Annuity Contract
(Contract) described in the prospectus contained in this registration
statement are, in the aggregate, reasonable in relation to the services
rendered, the expenses expected to be incurred, and the risks assumed in
connection with the Contract.
II-8
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933 and the
Investment Company Act of 1940, the Registrant certifies that it meets the
requirements of Securities Act Rule 485(a) for effectiveness of this
Registration Statement and has caused this Post-Effective Amendment
No. 19 to
the Registration Statement on Form N-4 to be signed on its behalf by the
undersigned thereunto duly authorized in the City of Newport Beach, and the
State of California on this 15th day of October, 2004.
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SEPARATE ACCOUNT A |
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(Registrant) |
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By:
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PACIFIC LIFE INSURANCE COMPANY |
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By: |
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Thomas C. Sutton* |
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Chairman and Chief Executive Officer |
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By:
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PACIFIC LIFE INSURANCE |
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COMPANY |
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(Depositor) |
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By: |
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Thomas C. Sutton* |
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Chairman and Chief Executive Officer |
Pursuant to the requirements of the Securities Act of 1933, this
Post-Effective Amendment No. 19 to the Registration Statement has been signed
below by the following persons in the capacities and on the dates indicated:
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Signature
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Title
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Date
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Thomas C. Sutton* |
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Director, Chairman of the
Board and Chief Executive
Officer
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October 15, 2004 |
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Glenn S. Schafer* |
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Director and President
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October 15, 2004 |
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Khanh T. Tran* |
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Director, Executive Vice President and Chief Financial Officer |
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October 15, 2004 |
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David R. Carmichael* |
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Director, Senior Vice President
and General Counsel |
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October 15, 2004 |
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Audrey L. Milfs* |
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Director, Vice President and
Corporate Secretary
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October 15, 2004 |
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Edward R. Byrd* |
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Vice President, Controller, and
Chief Accounting Officer
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October 15, 2004 |
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Brian D. Klemens* |
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Vice President and Treasurer
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October 15, 2004 |
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Gerald W. Robinson* |
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Executive Vice President
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October 15, 2004 |
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*By: /s/ DAVID R. CARMICHAEL
David R. Carmichael
as attorney-in-fact |
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October 15, 2004 |
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(Powers of Attorney are contained in Post-Effective Amendment No. 9 of the
Registration Statement filed on Form N-4/B for Separate Account A, File No.
333-93059, Accession No. 0001017062-02-000788 filed on April 30, 2002, as
Exhibit 15.)
II-9
EX-99.4(S)
2
a02094exv99w4xsy.htm
EXHIBIT 4(S)
exv99w4xsy
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Pacific Life Insurance Company
700 Newport Center Drive
Newport Beach, CA 92660
A Stock Company |
GUARANTEED INCOME ANNUITY (GIA) RIDER
Pacific Life Insurance Company has issued this Rider as a part of the annuity
Contract to which it is attached. Please read it carefully.
All provisions of the Contract that do not conflict with this Rider apply to
this Rider. In the event of any conflict between the provisions of this Rider
and the provisions of the Contract, the provisions of this Rider shall prevail
over the provisions of the Contract.
The provisions of this Rider relate only to the GIA Annuity Option, and do not
impact any of the other Annuity Options described in the Contract.
The numeric examples provided in this Rider are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by
this Rider and to demonstrate how Purchase Payments received and withdrawals
made from the Contract prior to the Annuity Date affect the values and benefits
under this Rider over an extended period of time.
TABLE OF CONTENTS
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Page |
Definition of Terms |
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1 |
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Guaranteed Income Annuity (GIA) |
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2 |
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GIA Annual Charge |
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2 |
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GIA Annuity Option |
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2 |
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Application of Net Amount |
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3 |
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Initial Values |
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3 |
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Subsequent Values |
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4 |
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Limitation on Subsequent Purchase Payments |
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5 |
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Partial Annuitization of Net Contract Value |
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5 |
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Applicability of Rates |
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5 |
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Basis of Computations |
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5 |
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Rates Not Shown |
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5 |
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Continuation of Rider if Surviving Spouse Continues Contract |
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5 |
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Termination of Rider |
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5 |
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Rider Effective Date |
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5 |
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GIA Annuity Option Tables |
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6 |
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Sample Calculations |
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8 |
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Definition of Terms Unless redefined in this Rider, the terms defined in the
Contract will have the same meaning when used in this Rider.
1
Guaranteed Income Annuity (GIA) You have purchased a Guaranteed Income
Annuity (GIA) Rider. Subject to the terms and conditions described herein, this
Rider adds an Annuity Option to the Contract called the GIA Annuity Option.
This Rider may be purchased on the Contract Date or on any subsequent Contract
Anniversary, provided:
(a) |
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the age of each Annuitant is 80 years or younger on the date of
purchase; and |
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(b) |
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the entire Contract Value is invested according to an asset
allocation program established and maintained by us for this Rider. |
The date of purchase is the Rider Effective Date as shown on Page 5.
GIA Annual Charge An annual charge for expenses related to this Rider will be
deducted from the Investment Options on a proportionate basis relative to the
Account Value in each such option.
The annual charge is deducted, in arrears, on each Contract Anniversary that
this Rider remains in effect. The annual charge is equal to
[0.50%] multiplied
by the greater of the Guaranteed Income Base or the Contract Value on the day
the charge is deducted.
If this Rider terminates on a Contract Anniversary, the entire annual charge
for the prior Contract Year will be deducted from the Contract Value on that
Contract Anniversary.
If the Rider terminates prior to a Contract Anniversary, we will prorate the
annual charge. The prorated amount will be based on the greater of the
Guaranteed Income Base or the Contract Value as of the day the Rider
terminates. Such prorated amount will be deducted from the Contract Value on
the earlier of the day the Contract terminates or the Contract Anniversary
immediately following the day the Rider terminates.
We will waive the annual charge if the Rider terminates as a result of the
death of an Owner or sole surviving Annuitant, or upon full annuitization of
the Contract.
Any portion of the annual charge we deduct from any of our fixed-rate General
Account options (if available under the Contract) will not be greater than the
annual interest credited in excess of that options minimum guaranteed interest
rate.
GIA Annuity Option While this Rider is in effect and in lieu of the Annuity
Options described in the Contract, you may, prior to the Annuity Date, elect to
have annuity payments made under the GIA Annuity Option, provided this Rider
has been in effect for at least ten (10) years from the Rider Effective Date.
If you elect this option, any withdrawal charge (if applicable) that would
otherwise be waived in connection with a conversion to an Annuity Option as
described in the Contract will apply.
Annuity payments under this option will be paid in fixed dollar amounts under
any one of the payment methods described below:
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Life Only Periodic payments are made to the designated payee during
the Annuitants lifetime. Payments stop when the Annuitant dies. |
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Life with Period Certain Periodic payments are made to the
designated payee during the Annuitants lifetime, with payments
guaranteed for a period certain, as selected by you prior to the Annuity
Date, of ten (10) years or more. If the Annuitant dies before the
guaranteed payments are completed, we will pay the remainder of the
guaranteed payments to the first among the following who is (1) living;
or (2) an entity or corporation entitled to receive the remainder of the
guaranteed payments: |
(a) |
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the Owner; |
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(b) |
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the Joint Owner; |
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(c) |
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the Contingent Owner; |
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(d) |
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the Beneficiary; or |
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(e) |
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the Contingent Beneficiary. |
2
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If none are living (or if there is no entity or corporation entitled to
receive the remainder of the guaranteed payments), we will pay the
remainder of the guaranteed payments to the Owners estate. |
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If the Annuitant dies after all of the payments under the period certain
have been paid, payments will stop when the Annuitant dies. |
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Joint and Survivor Life Periodic payments are made to the
designated payee during the lifetime of the Primary Annuitant. After
the death of the Primary Annuitant, periodic payments are based on the
life of the secondary Annuitant named in the election if, and so long
as, such secondary Annuitant lives. Payments made based on the life of
the secondary Annuitant may be in installments equal to 50%, 66-2/3% or
100% (as specified in the election) of the original payment amount
payable during the lifetime of the Primary Annuitant. If you elect a
reduced payment based on the life of the secondary Annuitant, annuity
payments will be equal to 50% or 66-2/3% of the original payment payable
during the lifetime of the Primary Annuitant. Payments stop when both
Annuitants have died. |
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Period Certain Only Periodic payments are made to the designated
payee, with payments guaranteed for a period certain, as selected by you
prior to the Annuity Date, of twenty (20) years or more. If the
Annuitant dies before the guaranteed payments are completed, we will pay
the remainder of the guaranteed payments to the first among the
following who is (1) living; or (2) an entity or corporation entitled to
receive the remainder of the guaranteed payments: |
(a) |
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the Owner; |
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(b) |
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the Joint Owner; |
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(c) |
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the Contingent Owner; |
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(d) |
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the Beneficiary; or |
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(e) |
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the Contingent Beneficiary. |
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If none are living (or if there is no entity or corporation entitled to
receive the remainder of the guaranteed payments), we will pay the
remainder of the guaranteed payments to the Owners estate. |
Application of Net Amount On the Annuity Date, we will apply the net amount
as a single premium, based on the payment method chosen under the GIA Annuity
Option provision, and the age and sex of each Annuitant, under the appropriate
annuity rates contained in this Rider.
The net amount applied as a single premium on the Annuity Date is equal to the
greater of: (a) the Guaranteed Income Base on that day; or (b) the GIA Step-Up
Value on that day; less any:
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applicable withdrawal charges resulting from the conversion to the
GIA Annuity Option; |
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applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date; and |
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charges for premium taxes and/or other taxes. |
The net amount applied will be held in our General Account.
Initial Values The Guaranteed Income Base, GIA Withdrawal Base, GIA
Withdrawal Amount and GIA Step-Up Value are values used in determining the net
amount applied on the Annuity Date to provide payments under the GIA Annuity
Option.
These initial values are determined on the Rider Effective Date as follows:
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If this Rider is effective on the Contract Date, the Guaranteed
Income Base and GIA Withdrawal Base are equal to the Initial Purchase
Payment. |
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If this Rider is effective on a Contract Anniversary, the Guaranteed
Income Base and GIA Withdrawal Base are equal to the Contract Value on
that day. |
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The GIA Withdrawal Amount for the Contract Year beginning on the
Rider Effective Date is equal to 5% of the GIA Withdrawal Base. |
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The GIA Step-Up Value is equal to the Contract Value on the Rider
Effective Date. |
3
The GIA Withdrawal Base and GIA Withdrawal Amount after the Rider Effective
Date are recalculated only on each subsequent Contract Anniversary.
Subsequent Values The Guaranteed Income Base, GIA Withdrawal Base, GIA
Withdrawal Amount and GIA Step-Up Value after the Rider Effective Date are
determined as follows:
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Guaranteed Income Base On any day after the Rider Effective Date, the
Guaranteed Income Base is equal to: |
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the Guaranteed Income Base on the prior day, multiplied by a
daily factor of 1.000133680, which is equivalent to increasing the
Guaranteed Income Base at an annual growth rate of 5%; plus |
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Purchase Payments received by us on that day; less |
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adjustments for withdrawals made on that day. |
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The adjustment for each withdrawal is calculated by multiplying the
Guaranteed Income Base immediately prior to the withdrawal by the percentage
decrease in Contract Value as a result of the withdrawal. |
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However, on each Contract Anniversary after the Rider Effective Date, if
there is at least one withdrawal during the prior Contract Year and the
cumulative withdrawals for that Contract Year do not exceed the sum of: |
(a) |
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the GIA Withdrawal Amount for that Contract Year, and |
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(b) |
|
any remaining dollar amount of the prior Contract Years GIA
Withdrawal Amount; |
|
|
the Guaranteed Income Base as of that Contract Anniversary will be reset to
equal: |
|
|
the Guaranteed Income Base on the Rider Effective Date or prior
Contract Anniversary, whichever is later, increased at an annual
growth rate of 5%; plus |
|
|
the amount of any subsequent Purchase Payments received by us
during the prior Contract Year, each increased at an annual growth
rate of 5% from the effective date of that Purchase Payment; less |
|
|
the amount of cumulative withdrawals during the prior Contract Year. |
|
|
The 5% annual growth rate will stop accruing as of the earlier of: |
|
|
the Contract Anniversary prior to the youngest Annuitants 81st birthday; or |
|
|
the day this Rider terminates. |
|
|
GIA Withdrawal Base On each Contract Anniversary after the Rider Effective
Date, the GIA Withdrawal Base is equal to: |
|
|
the GIA Withdrawal Base determined on the Rider Effective Date;
plus |
|
|
the amount of any subsequent Purchase Payments received by us
after the Rider Effective Date, up through the day immediately prior
to that Contract Anniversary. |
|
|
GIA Withdrawal Amount On each Contract Anniversary after the Rider
Effective Date, the GIA Withdrawal Amount for the Contract Year beginning on
that Contract Anniversary is equal to 5% of the GIA Withdrawal Base as of
that Contract Anniversary. |
|
|
GIA Step-Up Value On any day after the Rider Effective Date, the GIA
Step-Up Value is equal to: |
|
|
the GIA Step-Up Value as of the prior day, plus |
|
|
Purchase Payments received by us on that day, less |
|
|
adjustment for withdrawals made on that day. |
|
|
The adjustment for each withdrawal is calculated by multiplying the GIA
Step-Up Value immediately prior to the withdrawal by the percentage decrease
in Contract Value as a result of the withdrawal. |
4
|
|
On any Contract Anniversary after the Rider Effective Date and prior to the
youngest Annuitants 81st birthday, the GIA Step-Up Value is set equal to the
greater of: |
(a) |
|
the Contract Value as of that Contract Anniversary; or |
|
(b) |
|
the GIA Step-Up Value immediately prior to that Contract
Anniversary. |
|
|
The GIA Step-Up Value on each Contract Anniversary on and after the youngest
Annuitants 81st birthday is equal to the GIA Step-Up Value immediately prior
to that Contract Anniversary. |
Limitation on Subsequent Purchase Payments For purposes of this Rider, in no
event may any Purchase Payment received on and after the first
(1st) Contract
Anniversary, measured from the Rider Effective Date, result in the total of all
Purchase Payments received after that Contract Anniversary to exceed $100,000,
without our prior approval.
This provision only applies if the Contract permits Purchase Payments after the
first (1st) Contract Anniversary, measured from the Contract Date.
Partial Annuitization of Net Contract Value Any portion of the Net Contract
Value converted to provide payments under any one of the Annuity Options
described in the Contract, will be considered a withdrawal for purposes of
determining withdrawal adjustments to the Guaranteed Income Base and GIA
Step-Up Value.
Applicability of Rates The annuity rates contained in this Rider will be used
to provide a guaranteed monthly income for each $1,000 of net amount applied.
For some Qualified Plans and in some states, the use of sex-distinct income
factors are prohibited. For those Qualified Plans, we use blended unisex income
factors for life payment options for both male and female Annuitants.
Basis of Computations The actuarial basis for the annuity rates contained in
this Rider is the 1996 US Annuity 2000 Mortality Table, age set back eight (8)
years with interest at an effective annual rate of 2.0%.
Rates Not Shown Any rates and/or ages not shown in the tables contained in
this Rider will be provided by the Company upon request.
Continuation of Rider if Surviving Spouse Continues Contract If the Owner
dies while this Rider is in effect and if the surviving spouse of the deceased
Owner elects to continue the Contract in accordance with its terms, then the
provisions of this Rider will continue, unless otherwise terminated.
Termination of Rider Except as otherwise provided under the Continuation of
Rider if Surviving Spouse Continues Contract provision of this Rider, this
Rider will automatically terminate upon the earliest to occur of one of the
following events:
(a) |
|
the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for this Rider; |
|
(b) |
|
the day we receive notification from you to terminate this Rider; |
|
(c) |
|
the day of the first death of an Owner or the date of death of the
sole surviving Annuitant; |
|
(d) |
|
the day the Contract is terminated in accordance with the provisions
of the Contract; or |
|
(e) |
|
the Annuity Date. |
Rider Effective Date This Rider is effective as of the Contract Date, unless
a later date is shown below.
|
|
Rider Effective Date: [Date] |
All other terms and conditions of the Contract remain unchanged by this Rider.
PACIFIC LIFE INSURANCE COMPANY
|
|
|
|
|
 |
Chairman and Chief Executive Officer
|
|
Secretary |
5
GIA ANNUITY OPTION TABLES
LIFE ONLY OR
LIFE WITH PERIOD CERTAIN OF 10 AND 20 YEARS
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male
|
|
Female
|
|
Unisex
|
|
|
|
|
|
|
Life with |
|
|
|
|
|
Life with |
|
|
|
|
|
Life with |
|
|
Life |
|
Period Certain |
|
Life |
|
Period Certain |
|
Life |
|
Period Certain |
Age
|
|
Only
|
|
10 Yr.
|
|
20 Yr.
|
|
Only
|
|
10 Yr.
|
|
20 Yr.
|
|
Only
|
|
10 Yr.
|
|
20 Yr.
|
30 |
|
|
2.41 |
|
|
|
2.41 |
|
|
|
2.40 |
|
|
|
2.32 |
|
|
|
2.32 |
|
|
|
2.32 |
|
|
|
2.37 |
|
|
|
2.36 |
|
|
|
2.36 |
|
35 |
|
|
2.52 |
|
|
|
2.52 |
|
|
|
2.51 |
|
|
|
2.42 |
|
|
|
2.42 |
|
|
|
2.42 |
|
|
|
2.47 |
|
|
|
2.47 |
|
|
|
2.47 |
|
40 |
|
|
2.66 |
|
|
|
2.66 |
|
|
|
2.65 |
|
|
|
2.54 |
|
|
|
2.54 |
|
|
|
2.54 |
|
|
|
2.60 |
|
|
|
2.60 |
|
|
|
2.59 |
|
45 |
|
|
2.83 |
|
|
|
2.83 |
|
|
|
2.81 |
|
|
|
2.69 |
|
|
|
2.69 |
|
|
|
2.68 |
|
|
|
2.76 |
|
|
|
2.76 |
|
|
|
2.75 |
|
50 |
|
|
3.05 |
|
|
|
3.04 |
|
|
|
3.01 |
|
|
|
2.87 |
|
|
|
2.87 |
|
|
|
2.85 |
|
|
|
2.96 |
|
|
|
2.95 |
|
|
|
2.93 |
|
55 |
|
|
3.32 |
|
|
|
3.30 |
|
|
|
3.24 |
|
|
|
3.10 |
|
|
|
3.09 |
|
|
|
3.06 |
|
|
|
3.21 |
|
|
|
3.20 |
|
|
|
3.15 |
|
60 |
|
|
3.65 |
|
|
|
3.62 |
|
|
|
3.51 |
|
|
|
3.38 |
|
|
|
3.37 |
|
|
|
3.31 |
|
|
|
3.52 |
|
|
|
3.50 |
|
|
|
3.42 |
|
65 |
|
|
4.09 |
|
|
|
4.03 |
|
|
|
3.83 |
|
|
|
3.76 |
|
|
|
3.73 |
|
|
|
3.62 |
|
|
|
3.92 |
|
|
|
3.88 |
|
|
|
3.73 |
|
70 |
|
|
4.67 |
|
|
|
4.56 |
|
|
|
4.17 |
|
|
|
4.25 |
|
|
|
4.19 |
|
|
|
3.97 |
|
|
|
4.46 |
|
|
|
4.38 |
|
|
|
4.08 |
|
75 |
|
|
5.47 |
|
|
|
5.23 |
|
|
|
4.50 |
|
|
|
4.92 |
|
|
|
4.80 |
|
|
|
4.35 |
|
|
|
5.19 |
|
|
|
5.02 |
|
|
|
4.43 |
|
80 |
|
|
6.58 |
|
|
|
6.04 |
|
|
|
4.77 |
|
|
|
5.88 |
|
|
|
5.59 |
|
|
|
4.68 |
|
|
|
6.22 |
|
|
|
5.82 |
|
|
|
4.73 |
|
85 |
|
|
8.11 |
|
|
|
6.93 |
|
|
|
4.93 |
|
|
|
7.28 |
|
|
|
6.55 |
|
|
|
4.90 |
|
|
|
7.69 |
|
|
|
6.75 |
|
|
|
4.91 |
|
90 |
|
|
10.25 |
|
|
|
7.79 |
|
|
|
5.01 |
|
|
|
9.37 |
|
|
|
7.56 |
|
|
|
5.00 |
|
|
|
9.80 |
|
|
|
7.68 |
|
|
|
5.00 |
|
95 |
|
|
13.21 |
|
|
|
8.46 |
|
|
|
5.03 |
|
|
|
12.46 |
|
|
|
8.37 |
|
|
|
5.03 |
|
|
|
12.83 |
|
|
|
8.42 |
|
|
|
5.03 |
|
JOINT LIFE WITH 100% SURVIVOR LIFE
Primary Annuitant
Male Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Female Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.07 |
|
|
|
3.16 |
|
|
|
3.24 |
|
|
|
3.29 |
|
|
|
3.33 |
|
|
|
3.35 |
|
65 |
|
|
3.21 |
|
|
|
3.35 |
|
|
|
3.48 |
|
|
|
3.57 |
|
|
|
3.64 |
|
|
|
3.69 |
|
70 |
|
|
3.34 |
|
|
|
3.54 |
|
|
|
3.73 |
|
|
|
3.90 |
|
|
|
4.02 |
|
|
|
4.11 |
|
75 |
|
|
3.44 |
|
|
|
3.70 |
|
|
|
3.98 |
|
|
|
4.24 |
|
|
|
4.46 |
|
|
|
4.63 |
|
80 |
|
|
3.52 |
|
|
|
3.84 |
|
|
|
4.20 |
|
|
|
4.58 |
|
|
|
4.94 |
|
|
|
5.26 |
|
85 |
|
|
3.57 |
|
|
|
3.93 |
|
|
|
4.37 |
|
|
|
4.88 |
|
|
|
5.42 |
|
|
|
5.94 |
|
Primary Annuitant
Unisex Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Unisex Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.08 |
|
|
|
3.19 |
|
|
|
3.29 |
|
|
|
3.37 |
|
|
|
3.43 |
|
|
|
3.46 |
|
65 |
|
|
3.19 |
|
|
|
3.37 |
|
|
|
3.52 |
|
|
|
3.65 |
|
|
|
3.75 |
|
|
|
3.82 |
|
70 |
|
|
3.29 |
|
|
|
3.52 |
|
|
|
3.75 |
|
|
|
3.95 |
|
|
|
4.12 |
|
|
|
4.25 |
|
75 |
|
|
3.37 |
|
|
|
3.65 |
|
|
|
3.95 |
|
|
|
4.26 |
|
|
|
4.54 |
|
|
|
4.77 |
|
80 |
|
|
3.43 |
|
|
|
3.75 |
|
|
|
4.12 |
|
|
|
4.54 |
|
|
|
4.96 |
|
|
|
5.36 |
|
85 |
|
|
3.46 |
|
|
|
3.82 |
|
|
|
4.25 |
|
|
|
4.77 |
|
|
|
5.36 |
|
|
|
5.96 |
|
6
GIA ANNUITY OPTION TABLES
JOINT LIFE WITH 66 2/3% SURVIVOR LIFE
Primary Annuitant
Male Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Female Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.24 |
|
|
|
3.42 |
|
|
|
3.60 |
|
|
|
3.79 |
|
|
|
3.98 |
|
|
|
4.17 |
|
65 |
|
|
3.34 |
|
|
|
3.57 |
|
|
|
3.80 |
|
|
|
4.04 |
|
|
|
4.28 |
|
|
|
4.51 |
|
70 |
|
|
3.43 |
|
|
|
3.70 |
|
|
|
4.00 |
|
|
|
4.31 |
|
|
|
4.62 |
|
|
|
4.92 |
|
75 |
|
|
3.51 |
|
|
|
3.82 |
|
|
|
4.18 |
|
|
|
4.58 |
|
|
|
5.00 |
|
|
|
5.41 |
|
80 |
|
|
3.56 |
|
|
|
3.92 |
|
|
|
4.34 |
|
|
|
4.84 |
|
|
|
5.39 |
|
|
|
5.95 |
|
85 |
|
|
3.60 |
|
|
|
3.98 |
|
|
|
4.47 |
|
|
|
5.06 |
|
|
|
5.76 |
|
|
|
6.52 |
|
Primary Annuitant
Unisex Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Unisex Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.21 |
|
|
|
3.41 |
|
|
|
3.61 |
|
|
|
3.82 |
|
|
|
4.03 |
|
|
|
4.24 |
|
65 |
|
|
3.30 |
|
|
|
3.53 |
|
|
|
3.79 |
|
|
|
4.05 |
|
|
|
4.32 |
|
|
|
4.59 |
|
70 |
|
|
3.37 |
|
|
|
3.64 |
|
|
|
3.96 |
|
|
|
4.29 |
|
|
|
4.65 |
|
|
|
5.00 |
|
75 |
|
|
3.42 |
|
|
|
3.74 |
|
|
|
4.11 |
|
|
|
4.53 |
|
|
|
4.99 |
|
|
|
5.46 |
|
80 |
|
|
3.46 |
|
|
|
3.80 |
|
|
|
4.23 |
|
|
|
4.74 |
|
|
|
5.32 |
|
|
|
5.96 |
|
85 |
|
|
3.48 |
|
|
|
3.85 |
|
|
|
4.32 |
|
|
|
4.90 |
|
|
|
5.62 |
|
|
|
6.44 |
|
JOINT LIFE WITH 50% SURVIVOR LIFE
Primary Annuitant
Male Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Female Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.33 |
|
|
|
3.56 |
|
|
|
3.82 |
|
|
|
4.11 |
|
|
|
4.42 |
|
|
|
4.74 |
|
65 |
|
|
3.42 |
|
|
|
3.68 |
|
|
|
3.99 |
|
|
|
4.32 |
|
|
|
4.69 |
|
|
|
5.07 |
|
70 |
|
|
3.49 |
|
|
|
3.79 |
|
|
|
4.15 |
|
|
|
4.55 |
|
|
|
4.99 |
|
|
|
5.46 |
|
75 |
|
|
3.54 |
|
|
|
3.89 |
|
|
|
4.30 |
|
|
|
4.78 |
|
|
|
5.32 |
|
|
|
5.90 |
|
80 |
|
|
3.58 |
|
|
|
3.96 |
|
|
|
4.42 |
|
|
|
4.99 |
|
|
|
5.65 |
|
|
|
6.38 |
|
85 |
|
|
3.61 |
|
|
|
4.01 |
|
|
|
4.52 |
|
|
|
5.16 |
|
|
|
5.94 |
|
|
|
6.86 |
|
Primary Annuitant
Unisex Age
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Unisex Age
|
|
60
|
|
65
|
|
70
|
|
75
|
|
80
|
|
85
|
60 |
|
|
3.28 |
|
|
|
3.52 |
|
|
|
3.79 |
|
|
|
4.09 |
|
|
|
4.42 |
|
|
|
4.78 |
|
65 |
|
|
3.35 |
|
|
|
3.62 |
|
|
|
3.93 |
|
|
|
4.29 |
|
|
|
4.68 |
|
|
|
5.10 |
|
70 |
|
|
3.40 |
|
|
|
3.71 |
|
|
|
4.07 |
|
|
|
4.49 |
|
|
|
4.96 |
|
|
|
5.48 |
|
75 |
|
|
3.44 |
|
|
|
3.78 |
|
|
|
4.19 |
|
|
|
4.68 |
|
|
|
5.25 |
|
|
|
5.89 |
|
80 |
|
|
3.47 |
|
|
|
3.83 |
|
|
|
4.28 |
|
|
|
4.85 |
|
|
|
5.52 |
|
|
|
6.31 |
|
85 |
|
|
3.49 |
|
|
|
3.87 |
|
|
|
4.35 |
|
|
|
4.97 |
|
|
|
5.76 |
|
|
|
6.71 |
|
PERIOD CERTAIN ONLY
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Years
|
|
|
|
|
|
Years
|
|
|
|
|
|
Years
|
|
|
|
|
|
Years
|
|
|
|
|
20 |
|
|
5.04 |
|
|
|
26 |
|
|
|
4.09 |
|
|
|
32 |
|
|
|
3.51 |
|
|
|
38 |
|
|
|
3.11 |
|
21 |
|
|
4.84 |
|
|
|
27 |
|
|
|
3.98 |
|
|
|
33 |
|
|
|
3.43 |
|
|
|
39 |
|
|
|
3.06 |
|
22 |
|
|
4.66 |
|
|
|
28 |
|
|
|
3.87 |
|
|
|
34 |
|
|
|
3.36 |
|
|
|
40 |
|
|
|
3.01 |
|
23 |
|
|
4.50 |
|
|
|
29 |
|
|
|
3.77 |
|
|
|
35 |
|
|
|
3.29 |
|
|
|
|
|
|
|
|
|
24 |
|
|
4.35 |
|
|
|
30 |
|
|
|
3.68 |
|
|
|
36 |
|
|
|
3.23 |
|
|
|
|
|
|
|
|
|
25 |
|
|
4.22 |
|
|
|
31 |
|
|
|
3.59 |
|
|
|
37 |
|
|
|
3.17 |
|
|
|
|
|
|
|
|
|
7
GUARANTEED INCOME ANNUITY (GIA) RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by
this Rider and to demonstrate how Purchase Payments received and withdrawals
made from the Contract prior to the Annuity Date affect the values and benefits
under this Rider over an extended period of time. These examples are not
intended to serve as projections of future investment returns.
Example #1 The initial values on the Rider Effective Date based on an Initial
Purchase Payment of $100,000. The Initial Purchase Payment is assumed to be
the Contract Value if the Rider Effective Date is on a Contract Anniversary.
Example #2 - Subsequent Purchase Payment received during the first Contract
Year and its effect on the values and balances under this Rider. This example
assumes that no withdrawals have been made.
In addition to Purchase Payments, the Contract Value is further subject to
increases and/or decreases during a Contract Year as a result of additional
amounts credited, charges, fees and other deductions, and increases and/or
decreases in the investment performance of the Variable Account.
The Guaranteed Income Base prior to receipt of the Purchase Payment is assumed
to have accumulated to $101,227. This amount is derived by multiplying each
days Guaranteed Income Base by the daily factor of 1.000133680. As a result
of the subsequent Purchase Payment, the Guaranteed Income Base is increased to
$201,227 ($101,227 + $100,000). The Guaranteed Income Base will assume to
accumulate to $208,727 at the next Contract Anniversary, by multiplying each
days Guaranteed Income Base immediately after receipt of the subsequent
Purchase Payment by the daily factor of 1.000133680.
The GIA Step-Up Value prior to receipt of the Purchase Payment is $100,000. As
a result of the subsequent Purchase Payment, the GIA Step-Up Value is increased
to $200,000 ($100,000 + $100,000). On the Contract Anniversary at the
beginning of Contract Year 2, the Contract Value ($205,242) is greater than the
GIA Step-Up Value immediately prior to that Contract Anniversary ($200,000).
As a result, the GIA Step-Up Value as of that Contract Anniversary is equal to
the Contract Value on that Contract Anniversary ($205,242).
The GIA Withdrawal Base on the Contract Anniversary at the beginning of
Contract Year 2 is equal to the GIA Withdrawal Base on the Rider Effective Date
($100,000) plus cumulative Purchase Payments received after the Rider Effective
Date ($100,000). As a result of the subsequent Purchase Payment, the GIA
Withdrawal Base on the Contract Anniversary at the beginning of Contract Year 2
is equal to $200,000 ($100,000 + $100,000).
The GIA Withdrawal Amount for Contract Year 2 is determined on the Contract
Anniversary at the beginning of Contract Year 2, and is equal to 5% of the GIA
Withdrawal Base on that Contract Anniversary (5% of $200,000). As a result of
the subsequent Purchase Payment, the GIA Withdrawal Amount for Contract Year 2
is equal to $10,000.
Since no withdrawals were made during Contract Year 1, the GIA Withdrawal
Amount for Contract Year 1 ($5,000) becomes the remaining dollar amount of the
prior Contract Years GIA Withdrawal Amount for Contract Year 2.
8
GUARANTEED INCOME ANNUITY (GIA) RIDER
SAMPLE CALCULATIONS
Example #3 - Cumulative withdrawals during Contract Year 2 exceeding the sum
of: (a) the GIA Withdrawal Amount for Contract Year 2; and (b) the remaining
dollar amount of the prior Contract Years GIA Withdrawal Amount for Contract
Year 2. The withdrawal is assumed to result in a 10% reduction in the Contract
Value.
Since the $20,830 withdrawal exceeded the sum of: (a) the GIA Withdrawal Amount
for Contract Year 2; and (b) the remaining dollar amount of the prior
Contracts Years GIA Withdrawal Amount for Contract Year 2, the remaining
dollar amount of the prior Contract Years GIA Withdrawal Amount for Contract
Year 3 is zero. Withdrawals are first applied to the remaining dollar amount
of the prior Contract Years GIA Withdrawal Amount, if any, until exhausted,
then to the GIA Withdrawal Amount for the current Contract Year, until
exhausted.
The GIA Withdrawal Amount for Contract Year 3 is determined on the Contract
Anniversary at the beginning of Contract Year 3, and is equal to 5% of the GIA
Withdrawal Base on that Contract Anniversary (5% of $200,000). As a result,
the GIA Withdrawal Amount for Contract Year 3 is equal to $10,000. The GIA
Withdrawal Amount for any Contract Year will not be less than zero.
Immediately after the withdrawal, the Guaranteed Income Base and the GIA
Step-Up Value are reduced by the percentage decrease (10%) in Contract Value as
a result of the withdrawal.
Since no subsequent Purchase Payments were received during Contract Year 2, the
GIA Withdrawal Base at the beginning of Contract Year 3 remains unchanged.
9
GUARANTEED INCOME ANNUITY (GIA) RIDER
SAMPLE CALCULATIONS
Example #4 - Cumulative withdrawals during Contract Year 3 not exceeding the
sum of: (a) the GIA Withdrawal Amount for Contract Year 3; and (b) the
remaining dollar value of the prior Contract Years GIA Withdrawal Amount for
Contract Year 3.
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Withdrawal Amount for Contract Year 3; and (b) the remaining dollar
amount of the prior Contract Years GIA Withdrawal Amount for Contract Year 3,
the Guaranteed Income Base on the Contract Anniversary at the beginning of
Contract Year 4 is calculated as follows:
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 3:
|
|
$ |
197,247 |
|
Increased at an annual rate of 5% to the Contract Anniversary at the beginning of Contract Year 4:
|
|
+ |
$9,862 |
|
Reduced by the amount equal to the amount withdrawn in Contract Year 3:
|
|
- |
$8,000 |
|
|
|
|
|
Guaranteed Income Base on the Contract Anniversary at the beginning of Contract Year 4:
|
|
$ |
199,109 |
|
Since no subsequent Purchase Payments were received during Contract Year 3, the
GIA Withdrawal Base at the beginning of Contract Year 4 remains unchanged.
The GIA Withdrawal Amount for Contract Year 4 is determined on the Contract
Anniversary at the beginning of Contract Year 4, and is equal to 5% of the GIA
Withdrawal Base on that Contract Anniversary (5% of $200,000). As a result,
the GIA Withdrawal Amount for Contract Year 4 is equal to $10,000.
Because cumulative withdrawals for Contract Year 3 did not exceed the sum of:
(a) the GIA Withdrawal Amount for Contract Year 3; and (b) the remaining dollar
value of the prior Contract Years GIA Withdrawal Amount for Contract Year 3;
the dollar amount of the GIA Withdrawal Amount for Contact Year 3 remaining
($2,000) becomes the remaining dollar amount of the prior Contract Years GIA
Withdrawal Amount for Contract Year 4.
10
GUARANTEED INCOME ANNUITY (GIA) RIDER
SAMPLE CALCULATIONS
Example #5 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and no withdrawals are
taken during the first ten (10) Contract Years after the Rider Effective Date.
The Initial Purchase Payment is assumed to be the Contract Value if the Rider
is effective on a Contract Anniversary.
Example #6 Rider values on each Contract Anniversary based on an Initial
Purchase Payment of $100,000 paid on the Contract Date. The values further
assume that no subsequent Purchase Payments are received and withdrawals of
$5,000 are taken each Contract Year for the first ten (10) Contract Years after
the Rider Effective Date. The Initial Purchase Payment is assumed to be the
Contract Value if the Rider is effective on a Contract Anniversary.
Should the Contract annuitize immediately after the Rider has been in effect
for at least ten (10) years and the GIA Annuity Option has been elected to
provide such payments, the net amount applied on the Annuity Date as a single
premium to provide the payments is equal to the greater of:
(a) |
|
the Guaranteed Income Base; or |
|
(b) |
|
the GIA Step-Up Value; less any: |
|
(c) |
|
applicable withdrawal charges resulting from the conversion to the
GIA Annuity Option; |
|
(d) |
|
applicable annual charges for expenses related to other optional
benefit riders attached to the Contract that are in effect as of the
Annuity Date; and |
|
(e) |
|
charges for premium taxes and/or other taxes. |
Under Example #5, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($162,889), as it is greater than the GIA Step-Up Value ($115,927)
as of the Annuity Date, less the amounts in (c), (d) and (e) above, if any.
Under Example #6, the net amount applied on the Annuity Date (the Contract
Anniversary at the beginning of Contract Year 11) is equal to the Guaranteed
Income Base ($100,000), as it is greater than the GIA Step-Up Value ($61,983)
as of the Annuity Date, less the amounts in (c), (d) and (e) above, if any.
11
EX-99.4(T)
3
a02094exv99w4xty.htm
EXHIBIT 4(T)
exv99w4xty
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Pacific Life Insurance Company |
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700 Newport Center Drive |
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Newport Beach, CA 92660 |
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A Stock Company |
GUARANTEED WITHDRAWAL BENEFIT RIDER
Pacific Life Insurance Company has issued this Rider as a part of the annuity
Contract to which it is attached.
All provisions of the Contract that do not conflict with this Rider apply to
this Rider. In the event of any conflict between the provisions of this Rider
and the provisions of the Contract, the provisions of this Rider shall prevail
over the provisions of the Contract.
The examples provided in this Rider are based on certain assumptions. They have
been provided to assist in understanding the benefits provided by this Rider
and to demonstrate how Purchase Payments received and withdrawals made from the
Contract prior to the Annuity Date affect the values and benefits under this
Rider over an extended period of time.
TABLE OF CONTENTS
|
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Page
|
Definition of Terms |
|
|
2 |
|
Guaranteed Withdrawal Benefit |
|
|
2 |
|
Annual Charge |
|
|
2 |
|
Initial Values |
|
|
3 |
|
Subsequent Purchase Payments |
|
|
3 |
|
Limitation on Subsequent Purchase Payments |
|
|
3 |
|
Annual Credit |
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|
3 |
|
Withdrawal of Protected Payment Amount |
|
|
4 |
|
Election to Reset Remaining Protected Balance |
|
|
4 |
|
Continuation of Rider if Surviving Spouse Continues Contract |
|
|
5 |
|
Termination of Rider |
|
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5 |
|
Rider Effective Date |
|
|
5 |
|
Sample Calculations |
|
|
6 |
|
1
Definition of Terms Unless redefined below, the terms defined in the Contract
will have the same meaning when used in this Rider. For purposes of this
Rider, the following definitions apply:
Protected Payment Amount The maximum amount that can be withdrawn under
this Rider without reducing the Protected Payment Base. The Protected
Payment Amount on any day after the Rider Effective Date is equal to the
lesser of:
|
(a) |
|
5% of the Protected Payment Base as of that day, less
cumulative withdrawals during that Contract Year; or |
|
|
(b) |
|
the Remaining Protected Balance as of that day. |
The Protected Payment Amount will never be less than zero.
Protected Payment Base An amount used to determine the Protected Payment
Amount. The Protected Payment Base will remain unchanged except as otherwise
described under the provisions of this Rider.
Remaining Protected Balance The amount available for future withdrawals
made under this Rider. The Remaining Protected Balance will never be less
than zero.
Reset Date Any Contract Anniversary beginning with the third (3rd) Contract
Anniversary after the Rider Effective Date or the most recent Reset Date,
whichever is later, on which you elect to reset the Remaining Protected
Balance to an amount equal to 100% of the Contract Value, determined as of
that Contract Anniversary.
Guaranteed Withdrawal Benefit You have purchased a Guaranteed Withdrawal
Benefit Rider. Subject to the terms and conditions described herein, this Rider
allows for withdrawals up to the Protected Payment Amount, regardless of market
performance, until the Remaining Protected Balance equals zero.
The Rider also provides for an amount (an annual credit) to be applied to the
Protected Payment Base and Remaining Protected Balance as described under the
Annual Credit provision of this Rider.
Additionally, on any Contract Anniversary beginning with the third (3rd)
Contract Anniversary after the Rider Effective Date or the most recent Reset
Date, whichever is later, you may elect to reset the Remaining Protected
Balance to an amount equal to 100% of the Contract Value on that Contract
Anniversary.
For purposes of this Rider, the term withdrawal includes any applicable
withdrawal charges and charges for premium taxes and/or other taxes, if
applicable. Amounts withdrawn under this Rider will reduce the Contract Value
by the amount withdrawn and will be subject to the same conditions,
limitations, restrictions and all other fees, charges and deductions, if
applicable, as withdrawals otherwise made under the provisions of the Contract.
This Rider may be purchased on the Contract Date or on any subsequent Contract
Anniversary, provided:
|
(a) |
|
the age of each Annuitant is 85 years or younger on the Rider
Effective Date; and |
|
|
(b) |
|
the entire Contract Value is invested according to an asset
allocation program established and maintained by us for this Rider. |
The date of purchase is the Rider Effective Date as shown on Page 5.
Annual Charge An annual charge for expenses related to this Rider will be
deducted from the Investment Options on a proportionate basis relative to the
Account Value in each such Investment Option.
The annual charge is deducted, in arrears, on each Contract Anniversary that
this Rider remains in effect. The annual charge is equal to [0.40%] (not to
exceed a maximum annual charge percentage of 1.20%) multiplied by the Contract
Value on the day the charge is deducted. The annual charge percentage
established on the Rider Effective Date will not change, unless you elect to
reset the Remaining Protected Balance.
2
If this Rider terminates on a Contract Anniversary, the entire annual charge
for the prior Contract Year will be deducted from the Contract Value on that
Contract Anniversary.
If the Rider terminates prior to a Contract Anniversary, we will prorate the
annual charge. The prorated amount will be based on the Contract Value as of
the day the Rider terminates. Such prorated amount will be deducted from the
Contract Value on the earlier of the day the Contract terminates or the
Contract Anniversary immediately following the day the Rider terminates.
We will waive the annual charge if the Rider terminates as a result of the
death of an Owner or sole surviving Annuitant, or upon full annuitization of
the Contract.
Any portion of the annual charge we deduct from any of our fixed-rate General
Account options (if available under the Contract) will not be greater than the
annual interest credited in excess of that options minimum guaranteed interest
rate.
Initial Values The Protected Payment Base, Remaining Protected Balance and
Protected Payment Amount are initially determined on the Rider Effective Date
as follows:
|
|
|
If this Rider is effective on the Contract Date, the Protected
Payment Base and Remaining Protected Balance are equal to the Initial
Purchase Payment. |
|
|
|
|
If this Rider is effective on a Contract Anniversary, the Protected
Payment Base and Remaining Protected Balance are equal to the Contract
Value on that Contract Anniversary. |
|
|
|
|
The Protected Payment Amount on the Rider Effective Date is equal to
5% of the Protected Payment Base. |
Subsequent Purchase Payments Purchase Payments received after the Rider
Effective Date will result in an increase in the Protected Payment Base and
Remaining Protected Balance equal to the amount of the Purchase Payment.
Limitation on Subsequent Purchase Payments For purposes of this Rider, in no
event may any Purchase Payment received on and after the first (1st) Contract
Anniversary, measured from the Rider Effective Date or the most recent Reset
Date, whichever is later, result in the total of all Purchase Payments received
since that Contract Anniversary to exceed $100,000, without our prior approval.
This provision only applies if the Contract permits Purchase Payments after the
first (1st) Contract Anniversary, measured from the Contract Date.
Annual Credit On each Contract Anniversary after the Rider Effective Date, an
annual credit will be applied to the Protected Payment Base and Remaining
Protected Balance if, as of that Contract Anniversary:
|
(a) |
|
no withdrawals have occurred after the Rider Effective Date or the
most recent Reset Date, whichever is later; and |
|
|
(b) |
|
that Contract Anniversary is prior to the sixth (6th) Contract
Anniversary, measured from the Rider Effective Date or the most recent
Reset Date, whichever is later. |
The annual credit is equal to [6%] of the sum of (A) and (B) as of the Contract
Anniversary on which the credit is added, where:
|
(A) |
|
is the Remaining Protected Balance on the Rider Effective Date or the
most recent Reset Date, whichever is later. |
|
|
(B) |
|
is cumulative Purchase Payments received after the Rider Effective
Date or the most recent Reset Date, whichever is later. |
Once a withdrawal has occurred, no annual credit will be applied to the
Protected Payment Base and Remaining Protected Balance on any Contract
Anniversary following the withdrawal, unless you elect to reset the Remaining
Protected Balance as described under the Election to Reset Remaining Protected
Balance provision of this Rider.
3
Withdrawal of Protected Payment Amount While this Rider is in effect, you may
withdraw up to the Protected Payment Amount without reducing the Protected
Payment Base, regardless of market performance, until the Remaining Protected
Balance equals zero.
If a withdrawal does not exceed the Protected Payment Amount immediately prior
to that withdrawal, the Protected Payment Base will remain unchanged. The
Remaining Protected Balance will decrease by the withdrawal amount immediately
following the withdrawal.
If a withdrawal exceeds the Protected Payment Amount immediately prior to that
withdrawal, we will adjust the Protected Payment Base and Remaining Protected
Balance immediately following the withdrawal to the lesser of:
|
(a) |
|
the Contract Value immediately after the withdrawal; or |
|
|
(b) |
|
the Remaining Protected Balance immediately prior to the withdrawal,
less the withdrawal amount. |
A withdrawal may not exceed the amount available for withdrawal under the
Contract if such withdrawal would exceed the Protected Payment Amount.
If a withdrawal: (a) does not exceed the Protected Payment Amount; and (b)
reduces the Contract Value to zero, the following will apply:
|
|
|
5% of the Protected Payment Base will be paid each year until the
Remaining Protected Balance is reduced to zero. The payments will be
made under a series of pre-authorized withdrawals under a payment
frequency, as elected by you, but no less frequently than annually; |
|
|
|
|
no additional Purchase Payments will be accepted under the Contract; |
|
|
|
|
any Remaining Protected Balance will not be available for payment in
a lump sum and may not be applied to provide payments under an Annuity
Option; and |
|
|
|
|
the Contract will cease to provide any death benefit. |
If the Owner or sole surviving Annuitant dies and the Contract Value is zero as
of the date of death, any Remaining Protected Balance will be paid to the
Beneficiary under the series of pre-authorized withdrawals and payment
frequency then in effect at the time of the Owners or sole surviving
Annuitants death.
Election to Reset Remaining Protected Balance You may, on any Contract
Anniversary beginning with the third (3rd) Contract Anniversary, measured from
the Rider Effective Date or the most recent Reset Date, whichever is later,
elect to reset the Remaining Protected Balance to an amount equal to 100% of
the Contract Value as of that Contract Anniversary.
The annual charge percentage, as described in the Annual Charge provision, may
change if you elect to reset the Remaining Protected Balance. However, the
annual charge percentage will never exceed the annual charge percentage then in
effect for new issues of this same rider. If we are no longer issuing this
rider, any change in the annual charge percentage will not result in an annual
charge percentage that exceeds the maximum annual charge percentage specified
in the Annual Charge provision.
On each Reset Date and after any annual credit is applied, we will set the
Protected Payment Base and Remaining Protected Balance to an amount equal to
100% of the Contract Value as of that Reset Date.
The election to reset the Remaining Protected Balance must be received, in a
form satisfactory to us, at our Service Center within thirty (30) days after
the Contract Anniversary on which the reset is effective. Your election to
reset the Remaining Protected Balance may result in a reduction in the
Protected Payment Base, Remaining Protected Balance, Protected Payment Amount
and any annual credit that may be applied. We will provide you with written
confirmation of your election.
On and after each Reset Date, the provisions of this Rider shall apply in the
same manner as they applied when the Rider was originally issued. Eligibility
for the annual credit, the limitations and restrictions on Purchase Payments
and withdrawals, the deduction of annual charges and any future reset options
available on and after the Reset Date, will again apply and will be measured
from that Reset Date.
4
Continuation of Rider if Surviving Spouse Continues Contract If the Owner
dies while this Rider is in effect and if the surviving spouse of the deceased
Owner elects to continue the Contract in accordance with its terms, then the
provisions of this Rider will continue, unless otherwise terminated.
Termination of Rider Except as otherwise provided under the Continuation of
Rider if Surviving Spouse Continues Contract provision of this Rider, this
Rider will automatically terminate upon the earliest to occur of one of the
following events:
|
(a) |
|
the day any portion of the Contract Value is no longer invested
according to an asset allocation program established and maintained by
us for this Rider; |
|
|
(b) |
|
the day the Remaining Protected Balance is reduced to zero; |
|
|
(c) |
|
the day of the first death of an Owner or the date of death of the
sole surviving Annuitant, except as otherwise provided in the paragraph
below; |
|
|
(d) |
|
the day the Contract is terminated in accordance with the provisions
of the Contract, except as otherwise provided in the paragraph below; or |
|
|
(e) |
|
the Annuity Date. |
This Rider and the Contract will not terminate under subparagraphs (c) and (d)
above, if at the time of these events, the Contract Value is zero and we are
making pre-authorized withdrawals of the Remaining Protected Balance, as
described in the Withdrawal of Protected Payment Amount provision of this
Rider. In this case, the Rider and Contract will terminate as described in
subparagraph (b) above.
Rider Effective Date This Rider is effective on the Contract Date, unless a
later date is shown below.
Rider Effective Date: [Date]
All other terms and conditions of the Contract remain unchanged by this Rider.
PACIFIC LIFE INSURANCE COMPANY
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 |
Chairman and Chief Executive Officer
|
|
Secretary |
5
GUARANTEED WITHDRAWAL BENEFIT RIDER
SAMPLE CALCULATIONS
The numeric examples shown in this section are based on certain assumptions.
They have been provided to assist in understanding the benefits provided by
this Rider and to demonstrate how Purchase Payments received and withdrawals
made from the Contract prior to the Annuity Date affect the values and benefits
under this Rider over an extended period of time. These examples are not
intended to serve as projections of future investment returns.
Example #1 No Subsequent Purchase Payments; No Withdrawals; No Reset in
Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
|
Initial Purchase Payment = $100,000 |
|
|
|
|
Rider Effective Date = Contract Date |
|
|
|
|
No subsequent Purchase Payments are received. |
|
|
|
|
No withdrawals taken. |
|
|
|
|
No reset in Remaining Protected Balance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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|
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|
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|
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|
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|
|
|
|
|
|
|
Protected |
|
Protected |
|
Remaining |
Beginning |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Annual |
|
Payment |
|
Payment |
|
Protected |
of Contract Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
106,090 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
109,273 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
5 |
|
|
|
|
|
|
|
|
|
$ |
112,551 |
|
|
$ |
6,000 |
|
|
$ |
124,000 |
|
|
$ |
6,200 |
|
|
$ |
124,000 |
|
6 |
|
|
|
|
|
|
|
|
|
$ |
115,927 |
|
|
$ |
6,000 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
7 |
|
|
|
|
|
|
|
|
|
$ |
119,405 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
8 |
|
|
|
|
|
|
|
|
|
$ |
122,987 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
9 |
|
|
|
|
|
|
|
|
|
$ |
126,677 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
10 |
|
|
|
|
|
|
|
|
|
$ |
130,477 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
11 |
|
|
|
|
|
|
|
|
|
$ |
134,392 |
|
|
$ |
0 |
|
|
$ |
130,000 |
|
|
$ |
6,500 |
|
|
$ |
130,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 6, an annual credit of $6,000 (6% of initial Remaining
Protected Balance) is applied to the Protected Payment Base and Remaining
Protected Balance on each Contract Anniversary up to the Contract Anniversary
at the beginning of Contract Year 6. As a result, on the Contract Anniversary
at the beginning of Contract Year 6, the Protected Payment Base and Remaining
Protected Balance are equal to $130,000 and the Protected Payment Amount is
equal to $6,500 (5% of $130,000).
No annual credit will be applied to the Protected Payment Base and Remaining
Protected Balance on any Contract Anniversary after the Contract Anniversary at
the beginning of Contract Year 6, as no reset in the Remaining Protected
Balance was assumed.
In addition to the Initial Purchase Payment, the Contract Value is further
subject to increases and/or decreases during each Contract Year as a result of
additional amounts credited, charges, fees and other deductions, and increases
and/or decreases in the investment performance of the Variable Account.
6
GUARANTEED WITHDRAWAL BENEFIT RIDER
SAMPLE CALCULATIONS
Example #2 Subsequent Purchase Payment.
The values shown below are based on the following assumptions:
|
|
|
Initial Purchase Payment = $100,000 |
|
|
|
|
Rider Effective Date = Contract Date |
|
|
|
|
A subsequent Purchase Payment of $50,000 is received during Contract Year 2. |
|
|
|
|
No withdrawals taken. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Protected |
|
Protected |
|
Remaining |
Beginning |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Annual |
|
Payment |
|
Payment |
|
Protected |
of Contract Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
$ |
50,000 |
|
|
|
|
|
|
$ |
154,534 |
|
|
|
|
|
|
$ |
156,000 |
|
|
$ |
7,800 |
|
|
$ |
156,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
156,834 |
|
|
$ |
9,000 |
|
|
$ |
165,000 |
|
|
$ |
8,250 |
|
|
$ |
165,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an annual credit of $6,000 (6% of initial Remaining
Protected Balance) is applied to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Immediately after the $50,000 subsequent Purchase Payment during Contract Year
2, the Protected Payment Base and Remaining Protected Balance are increased by
the Purchase Payment amount to $156,000 ($106,000 + $50,000). The Protected
Payment Amount after the Purchase Payment is equal to $7,800 (5% of the
Protected Payment Base after the Purchase Payment since there are no
withdrawals during that Contract Year).
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 3, an annual credit of $9,000 (6% of initial Remaining
Protected Balance plus 6% of the $50,000 subsequent Purchase Payment) is
applied to the Protected Payment Base and Remaining Protected Balance on that
Contract Anniversary, increasing both to $165,000. As a result, the Protected
Payment Amount on that Contract Anniversary is equal to $8,250 (5% of the
Protected Payment Base on that Contract Anniversary).
7
GUARANTEED WITHDRAWAL BENEFIT RIDER
SAMPLE CALCULATIONS
Example #3 Withdrawal Not Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
|
Initial Purchase Payment = $100,000 |
|
|
|
|
Rider Effective Date = Contract Date |
|
|
|
|
No subsequent Purchase Payments are received. |
|
|
|
|
A withdrawal of $5,000 is taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Protected |
|
Protected |
|
Remaining |
Beginning |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Annual |
|
Payment |
|
Payment |
|
Protected |
of Contract Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
101,016 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
104,046 |
|
|
$ |
0 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
101,000 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an annual credit of $6,000 (6% of initial Remaining
Protected Balance) is applied to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount immediately prior to the withdrawal ($5,300):
|
(a) |
|
the Protected Payment Base remains unchanged; |
|
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Since a withdrawal occurred during Contract Year 2, no annual credit will be
applied to the Protected Payment Base and Remaining Protected Balance on any
Contract Anniversary following the withdrawal.
8
GUARANTEED WITHDRAWAL BENEFIT RIDER
SAMPLE CALCULATIONS
Example #4 Withdrawal Exceeding Protected Payment Amount.
The values shown below are based on the following assumptions:
|
|
|
Initial Purchase Payment = $100,000 |
|
|
|
|
Rider Effective Date = Contract Date |
|
|
|
|
No subsequent Purchase Payments are received. |
|
|
|
|
Two separate withdrawals of $5,000 and $3,000 are taken during Contract Year 2. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Protected |
|
Protected |
|
Remaining |
Beginning |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Annual |
|
Payment |
|
Payment |
|
Protected |
of Contract Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
103,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
Activity |
|
|
|
|
|
$ |
5,000 |
|
|
$ |
99,534 |
|
|
|
|
|
|
$ |
106,000 |
|
|
$ |
300 |
|
|
$ |
101,000 |
|
Activity |
|
|
|
|
|
$ |
3,000 |
|
|
$ |
97,272 |
|
|
|
|
|
|
$ |
97,272 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
97,993 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
4 |
|
|
|
|
|
|
|
|
|
$ |
100,933 |
|
|
$ |
0 |
|
|
$ |
97,272 |
|
|
$ |
4,864 |
|
|
$ |
97,272 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
Since no withdrawal occurred prior to the Contract Anniversary at the beginning
of Contract Year 2, an annual credit of $6,000 (6% of initial Remaining
Protected Balance) is applied to the Protected Payment Base and Remaining
Protected Balance on that Contract Anniversary, increasing both to $106,000.
As a result, the Protected Payment Amount on that Contract Anniversary is equal
to $5,300 (5% of the Protected Payment Base on that Contract Anniversary).
Because the $5,000 withdrawal during Contract Year 2 does not exceed the
Protected Payment Amount immediately prior to the withdrawal ($5,300):
|
(a) |
|
the Protected Payment Base remains unchanged; |
|
|
(b) |
|
the Remaining Protected Balance is reduced by the amount of the
withdrawal to $101,000 ($106,000 $5,000); and |
|
|
(c) |
|
the Protected Payment Amount is equal to $300 (5% of the Protected
Payment Base after the withdrawal (5% of $106,000 = $5,300), less
cumulative withdrawals during that Contract Year ($5,000)). |
Because the $3,000 withdrawal during Contract Year 2 exceeds the Protected
Payment Amount immediately prior to the withdrawal ($3,000 > $300), the
Protected Payment Base and Remaining Protected Balance immediately after the
withdrawal are adjusted to the lesser of:
|
(a) |
|
the Contract Value immediately after the withdrawal ($97,272); or |
|
|
(b) |
|
the Remaining Protected Balance immediately prior to the withdrawal,
less the withdrawal amount ($101,000 $3,000 = $98,000). |
The Protected Payment Amount immediately after the withdrawal is equal to $0
(5% of the Protected Payment Base after the withdrawal (5% of $97,272 =
$4,864), less cumulative withdrawals during that Contract Year ($8,000), but
not less than zero).
Since a withdrawal occurred during Contract Year 2, no annual credit will be
applied to the Protected Payment Base and Remaining Protected Balance on any
Contract Anniversary following the withdrawal.
9
GUARANTEED WITHDRAWAL BENEFIT RIDER
SAMPLE CALCULATIONS
Example #5 Reset in Remaining Protected Balance.
The values shown below are based on the following assumptions:
|
|
|
Initial Purchase Payment = $100,000 |
|
|
|
|
Rider Effective Date = Contract Date |
|
|
|
|
No subsequent Purchase Payments are received. |
|
|
|
|
No withdrawals taken. |
|
|
|
|
Reset in Remaining Protected Balance at the Beginning of Contract Year 4. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Protected |
|
Protected |
|
Remaining |
Beginning |
|
Purchase |
|
|
|
|
|
Contract Value |
|
Annual |
|
Payment |
|
Payment |
|
Protected |
of Contract Year
|
|
Payment
|
|
Withdrawal
|
|
after Activity
|
|
Credit
|
|
Base
|
|
Amount
|
|
Balance
|
1 |
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
|
|
|
|
$ |
100,000 |
|
|
$ |
5,000 |
|
|
$ |
100,000 |
|
2 |
|
|
|
|
|
|
|
|
|
$ |
110,000 |
|
|
$ |
6,000 |
|
|
$ |
106,000 |
|
|
$ |
5,300 |
|
|
$ |
106,000 |
|
3 |
|
|
|
|
|
|
|
|
|
$ |
121,000 |
|
|
$ |
6,000 |
|
|
$ |
112,000 |
|
|
$ |
5,600 |
|
|
$ |
112,000 |
|
4
(Prior to Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,000 |
|
|
$ |
118,000 |
|
|
$ |
5,900 |
|
|
$ |
118,000 |
|
4
(After Reset) |
|
|
|
|
|
|
|
|
|
$ |
133,100 |
|
|
|
|
|
|
$ |
133,100 |
|
|
$ |
6,655 |
|
|
$ |
133,100 |
|
5 |
|
|
|
|
|
|
|
|
|
$ |
146,410 |
|
|
$ |
7,986 |
|
|
$ |
141,086 |
|
|
$ |
7,054 |
|
|
$ |
141,086 |
|
On the Rider Effective Date, the initial values are set as follows:
|
|
|
Protected Payment Base = Initial Purchase Payment = $100,000 |
|
|
|
|
Remaining Protected Balance = Initial Purchase Payment = $100,000 |
|
|
|
|
Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
On the Contract Anniversary at the beginning of Contract Year 4, the Contract
Value ($133,100) is greater than the Remaining Protected Balance ($118,000).
With the reset in Remaining Protected Balance, the Protected Payment Base and
Remaining Protected Balance are set equal to the Contract Value on that
Contract Anniversary. As a result, the Protected Payment Amount is equal to
$6,655 after the reset.
After the reset in Remaining Protected Balance, eligibility for any annual
credit will be based on the most recent Reset Date. That is, the annual credit
may be added to the Protected Payment Base and Remaining Protected Balance on
up to five (5) additional Contract Anniversaries if certain conditions are met.
The reset in Remaining Protected Balance may result in an increase in the
annual charge percentage.
The reset in Remaining Protected Balance may also result in a lower Protected
Payment Base, Remaining Protected Balance, Protected Payment Amount and any
annual credit that may be applied.
10
EX-99.5(I)
4
a02094exv99w5xiy.htm
EXHIBIT 5(I)
exv99w5xiy
|
|
|
|
|
|
|
Pacific Life Insurance Company
P.O. Box 7187 Pasadena, CA 91109-7187
www.PacificLife.com (800) 722-2333
(See instructions for mailing addresses)
|
|
Draft 2 9/24/04
PORTFOLIO OPTIMIZATION
RIDER REQUEST |
Use this form to:
|
|
Add the Guaranteed Protection Advantage5 (GPA5), Income Access Plus and GIA Plus riders to your contract. Complete Sections 1, 2 and 4. |
|
|
|
Terminate GPA5 or GIA Plus riders from your annuity contract. Complete Sections 1, 3 and 4. |
|
|
|
|
|
|
|
1
|
GENERAL INFORMATION Owners Name (First, Middle, Last)
|
|
Daytime Telephone Number
|
|
Annuity Contract Number If known. |
|
|
|
|
( ) |
|
|
2 |
|
ADD OPTIONAL RIDERS Check the box(es) to add GPA5, Income Access Plus or
GIA Plus to your annuity contract. You must enroll
or be enrolled in Portfolio Optimization to add any of these riders. Check
with your broker/dealer for availability. |
o GPA5 o Income Access Plus o GIA Plus
|
B. |
|
The following terms and conditions apply to GPA5, Income Access Plus and GIA Plus: |
|
|
|
Pacific Life must receive this form in good order within 60 days of
contract issue for the riders to be effective on the issue date
or 30 days after a contract anniversary to be effective on the anniversary
date. If this request is not received within these
timeframes, the riders will not be added, but Pacific Life will process
enrollment in Portfolio Optimization. |
|
|
|
|
To qualify for rider benefits, the entire contract value must stay
invested in an approved asset allocation program established
and maintained by Pacific Life for the riders. |
|
|
|
|
Riders will automatically terminate on the day the contract value
becomes less than 100% invested in the asset
allocation program. |
|
|
|
|
If the riders terminate for reasons other than death or annuitization,
the annual charge then in effect for the riders will be
calculated on a pro-rata basis on the date of rider termination and
deducted from the contract on the earlier of contract surrender
or contract anniversary. |
|
C. |
|
The following additional terms and conditions apply to GPA5 : |
|
|
|
An annual charge of 0.25% of the contract value will be assessed on
each contract anniversary for GPA5 protection received in
the prior contract year. This charge may change if a step-up is elected. |
|
|
|
|
Annuitants must be age 85 or younger to purchase GPA5. |
|
|
|
|
Any withdrawals taken while this rider is in effect, including
withdrawals taken to comply with minimum distribution
requirements for tax qualified plans, will reduce death benefits and the
benefits of this rider on a pro-rata basis. This means the
benefit will be reduced by the same percentage as the percentage of
contract value withdrawn. |
|
D. |
|
The following additional terms and conditions apply to Income Access Plus: |
|
|
|
An annual charge of 0.45% of contract value will be assessed on each
contract anniversary for Income Access Plus protection
received in the prior contract year. This charge may change if a reset
is elected. |
|
|
|
|
Annuitants must be age 85 or younger to purchase Income Access. |
|
|
|
|
The contracts standard withdrawal provisions are not changed or
replaced by adding Income Access Plus. Income Access Plus
withdrawals will be subject to the same conditions, restrictions and
limitations as other withdrawals under my contract and may
impact other contract benefits. |
|
|
|
|
Cumulative withdrawals of more than the protected payment amount in a
given contract year may result in reduced Income
Access benefits, and the amounts initially protected may no longer be
guaranteed. |
|
|
|
|
Any withdrawals taken while this rider is in effect, including
withdrawals taken to comply with minimum distribution
requirements for tax qualified plans, will reduce death benefits on a
pro-rata basis. This means the benefit will be reduced by
the same percentage as the percentage of contract value withdrawn. |
|
E. |
|
The following additional terms and conditions apply to GIA Plus: |
|
|
|
An annual charge of 0.50% of the contract value will be assessed on
each contract anniversary for GIA Plus protection received
in the prior contract year. This charge may change if a step-up is elected. |
|
|
|
|
Annuitants must be age 80 or younger to purchase GIA Plus. |
|
|
|
|
If the contract is annuitized under GIA Plus, GIA Plus guarantees a
minimum fixed income payout. |
|
|
|
|
Withdrawals taken up to 5% of the guaranteed income base, including
withdrawals taken to comply with minimum distribution
requirements for tax qualified plans, will reduce the guaranteed income
base on a dollar-for-dollar basis. This means the
guaranteed income base will decrease by the dollar amount of the
withdrawal. If more than 5% of the guaranteed withdrawal
base is withdrawn, the entire withdrawal is calculated on a pro-rata
basis. This means the benefit will be reduced by the same
percentage as the percentage of contract value withdrawn. All withdrawals
will reduce any death benefits and the GIA step-up
value on a pro-rata basis. |
Page 1 of 2
|
|
|
|
|
PORTFOLIO OPTIMIZATION
RIDER REQUEST |
3 |
|
TERMINATE OPTIONAL RIDERS Check the box to terminate the rider(s) from your annuity contract. |
|
o |
|
Terminate GPA5 |
|
|
o |
|
Terminate GIA Plus |
|
|
Terms and Conditions: By terminating this rider from my contract, I
understand that: |
|
|
|
If the riders terminate for reasons other than death or annuitization,
the annual charge then in effect for the riders will be
calculated on a pro-rata basis on the date of rider termination and
deducted from the contract on the earlier of contract surrender
or contract anniversary. |
|
|
|
|
All benefits of the rider(s) will be forfeited upon termination. |
|
|
|
|
All other provisions of the contract remain in force. |
4 |
|
ACKNOWLEDGMENT AND SIGNATURE(S) I agree that if I am providing this form to Pacific Life by fax, it is as valid as the original. |
If adding a rider to my contract:
I have discussed this rider with my investment professional and/or tax
adviser and received and read the applicable prospectus
describing the rider. I believe that this rider meets my insurable needs
and financial objectives. I understand and agree to the terms
and conditions in Section 2.
I understand that if I add a rider, my contract may require annual
rebalancing, as set forth in the applicable prospectus. I can select
a shorter frequency period by completing the appropriate section of the
Transfers and Allocations form.
I understand that Pacific Life must receive this form in good order within
60 days of contract issue for a rider to be effective on
the issue date or 30 days after a contract anniversary to be effective on
the anniversary date. If this request is not received in
good order within these timeframes, or if a rider is not currently
available for my contract, it will not be added. I may be able
to add it in the future by submitting a new request, subject to the terms
and conditions in effect at that time.
If removing a rider from my contract:
I understand and agree to the terms and conditions in Section 4.
If this request is received in good order by Pacific Life within 30 days
after a contract anniversary, the rider will terminate on
that contract anniversary. If this request is received 31 days or more
after the last contract anniversary, the rider will terminate
on the day Pacific Life receives the request in good order.
|
|
|
|
|
|
|
|
|
|
|
/
|
|
/ |
|
Owners Signature
|
|
mo
|
|
day
|
|
yr |
|
|
|
|
|
|
|
|
|
|
|
/
|
|
/ |
|
Joint
Owners Signature (if applicable)
|
|
mo
|
|
day
|
|
yr |
Page 2 of 2
|
|
|
|
|
PORTFOLIO OPTIMIZATION
RIDER REQUEST |
|
|
|
When to use this form:
|
|
Use this form to add the GPA5, Income Access Plus
and GIA Plus riders to your annuity contract, or to
terminate the GPA5 or GIA Plus riders from your annuity contract. |
|
|
|
To complete this form:
|
|
Print clearly in dark ink. Provide requested
information in full. An incomplete form may delay
processing. Do not highlight any information submitted on this form.
Paperwork submitted to Pacific
Life is scanned into an imaging system and highlighting could make that
information unreadable. |
|
|
|
|
|
|
|
Where to send this form:
|
|
By regular mail:
|
|
By overnight mail:
|
|
By fax: |
|
|
Pacific Life Insurance Company
|
|
Pacific Life Insurance Company
|
|
(626)403-9886 |
|
|
P.O. Box 7187
|
|
1111 S. Arroyo Parkway, Suite 205 |
|
|
|
|
Pasadena, CA 91109-7187
|
|
Pasadena, CA 91105-3967 |
|
|
|
|
|
For help or questions:
|
|
Contact your registered representative or call Pacific
Life customer service at (800) 722-2333.
Registered representatives can obtain additional copies of this form by
visiting our financial professional Web site at www.PacificLife.com. |
INSTRUCTIONS
1 |
|
General Information: Provide the owners name, daytime telephone number and contract number, if known. |
|
2 |
|
Add Optional Riders: If you are adding a rider to your contract, review
the terms and conditions in this section before checking the
appropriate box and signing the form. The riders are available with the
products shown below, subject to state availability. Refer to
the applicable products prospectus for more information. |
Available Products: (subject to state availability)
|
|
|
|
|
|
|
Pacific Innovations
|
|
Pacific Odyssey
|
|
Pacific One Select
|
|
Pacific Select Variable Annuity (PSVA) |
Pacific Innovations Select
|
|
Pacific One
|
|
Pacific Portfolios
|
|
Pacific Value |
3 |
|
Terminate the Rider(s): Complete this section to terminate a rider(s) from
your contract. Review the terms and conditions before
checking the appropriate box and signing the form. |
|
4 |
|
Acknowledgment and Signature(s): The form must be signed and dated by the
owner. In cases of joint ownership, both owners must sign. |
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