United American s Administrative Guidelines For Flexible Premium Annuity

Transcription

1 United American s Administrative Guidelines For Flexible Premium Annuity For Internal Use Only UAFPA802-AG UAI

2 Table of Contents Mailing Funds and Applications 1 Policy Issue 1 Types of Funds 1 Documents Required 2 Interest Rates 2 Request Forms 2 Annual Report 2 Exhibits: A Flexible Premium Annuity Application (UFPA8-AP) 3 B Flexible Premium Annuity Certificate of Receipt (UAFPA8-CR R01) 4 C Automatic Payment Plan (FP-1048) 5 D Qualified Funds Identification Worksheet (UASA QFW) 6 E Request to Transfer Account Proceeds (UASA TQR) 7 F Section 1035 Exchange (UASA 1035) 8 G Annuity Systematic Withdrawal Request (UASA ASW) 10 H Interest Rate Chart 11 I Authorization Agreement for Direct Deposit (UASA DD) 12 J Deposit Confirmation Letter/Advice (UASA DAL) 13 K Beneficiary Designations (UASA BD) 14 L Your Guide to Your United American IRA (UASA DF) 15 M Minimum Distribution Withdrawal Request (UASA AMD) 16 N State Replacement Form (REPNOT/00) 17 O Annuity Withdrawal or Surrender Request (UASA SR) 18 P Annuity Request Form (UASA PR) 19 Q Withdrawal Charge Waiver Request (UASA WR) 20 R Additional Premium Receipt (UASA APR) 21 S New Business Envelope 22 UNITED AMERICAN INSURANCE COMPANY A LEGAL RESERVE STOCK COMPANY Tel: AMB#: Exec. Office: 3700 S. Stonebridge Drive McKinney, TX Page ii

3 United American Administrative Guidelines The following pages cover United American s administrative procedures for the Flexible Premium Annuity. Included are general guidelines, document requirements, interest rate information, request forms, and exhibits. Mailing Funds and Applications All funds and applications for regular and overnight mail are sent directly to: United American Insurance Company Attn: Annuity Coordinator P.O. Box 8080 McKinney, TX For customer service assistance call United American: (800) Policy Issue New Business Guidelines Make certain the application is completed in its entirety. Type or print legibly in black or blue ink. If an error is made during completion of the application, it may be neatly crossed out and corrected, with the approval of the owner (owner needs to initial correction). Never use correction tape or white-out fluid. Due to the potential of large sums of money involved, mail the legibly completed application and the gross premium by check to the Home Office without delay. The application, check, and transmittal should be mailed to the United American address above. Minimum initial deposit is $2,000. Maximum yearly amount is $20,000 per annuitant. Maximum premium amount accepted without prior Home Office approval is $1,000,000 over life of policy or amount permitted by the Internal Revenue Code. If premium is in excess of this amount, call the Home Office for approval. Policies will generally be mailed within 5 working days after receipt of application, funds and certificate of receipt (Exhibit B) in the Home Office. Make certain all Social Security numbers are listed. Types of Funds United American will accept funds in the form of: 1. Non qualified: Funds from a CD, Money Market, Savings Account, etc. to a United American non qualified annuity 2. Contributory IRA: Funds from a CD, Money Market, Savings Account, etc. to a United American IRA 3. IRA Transfer: Tax-free transfer of IRA funds directly from the previous IRA trustee/custodian to a United American IRA 4. IRA Rollover: Tax-free transfer of qualified funds (that is not an IRA Transfer) to a United American IRA. The qualified funds can come from two sources: (1) Previous IRA - customer receives the funds. These funds must be rolled over to a new IRA within 60 days of receipt to qualify for taxfree treatment. (2) Previous Qualified Plan (TSA, KEOGH; employer pension, profitsharing, stock bonus, or 401(k) plan) - if the customer receives an eligible rollover distribution, the customer can roll over all or part of it into an IRA. If the eligible rollover distribution is paid directly to the customer, the payer must withhold 20% of it. However, the customer can avoid withholding by choosing the Direct Rollover option. Under the Direct Rollover option, the payer transfers the eligible rollover distribution directly to an IRA. A Direct Rollover is a tax-free transfer of funds Exchange: Tax-free transfer of non qualified funds directly from one insurance company to a United American non qualified annuity Automatic Payment Plan (Bank Draft Premiums) Bank Draft is available for scheduled, predetermined amounts with a signed Automatic Payment Authorization Form (Form FP-1048) and voided check attached (Exhibit C). Page 1

4 Documents Required Non qualified Flexible Premium Annuity Application (Exhibit A) Certificate of Receipt (Exhibit B) Contributory IRA Flexible Premium Annuity Application (Exhibit A) Certificate of Receipt (Exhibit B) Qualified Funds Identification Worksheet UASA QFW (Exhibit D) Provide Your Guide to Your United American IRA (UASA DF) to applicant (Exhibit L) IRA Transfer or Rollover Flexible Premium Annuity Application (Exhibit A) Certificate of Receipt (Exhibit B) Qualified Funds Identification Worksheet UASA QFW (Exhibit D) Request to Transfer Account Proceeds UASA TQR (Exhibit E) For transfers from an Annuity/IRA with another insurance company, you will need to turn in the original policy to United American. State Replacement Form (if applicable) (Exhibit N) Provide Your Guide to Your United American IRA (UASA DF) to applicant (Exhibit L) 1035 Exchange Flexible Premium Annuity Application (Exhibit A) Certificate of Receipt (Exhibit B) Section 1035 Exchange Agreement and Absolute Assignment (Exhibit F) State Replacement Form (if applicable) (Exhibit N) Turn in original Policy or Notice of Lost Policy to United American Interest Rates The Flexible Premium Annuity has a guaranteed interest rate of 3%. The additional interest rate in effect when premium is received will be guaranteed for that premium until the next policy anniversary date. Thereafter, new additional interest rates will be declared not more than once in a 12-month period. Request Forms Annuity Systematic Withdrawal Request UASA ASW (Exhibit G) Individual Retirement Annuity Minimum Distribution Withdrawal Request UASA AMD (Exhibit M) Annuity Withdrawal or Surrender Request* UASA SR (Exhibit O) * A form is not required for these services; a letter signed by the owner will also be accepted. Annuity Request Form UASA PR (Exhibit P) Withdrawal Charge Waiver Request UASA WR (Exhibit Q) Additional Premium Receipt UASA APR (Exhibit R) Authorization Agreement for Direct Deposit UASA DD (Exhibit I) Annual Report Each year, the policyholder will receive an Annual Report. The Annual Report is an itemized summary that rolls forward the annuity balance from the beginning of the policy year to the end of the policy year. The statement will include deposits, withdrawals, interest credited, etc. Page 2

5 A Flexible Premium Annuity Application (UFPA8-AP) Always put relationship of beneficiaries to the annuitant on the application. If known, put the Social Security number(s) of the beneficiary(ies) also. If more room is needed than is available on the application to clearly designate beneficiaries of the policy, both primary and contingent, use the Beneficiaries Designation form UASA BD shown as Exhibit K. Or, you may attach a separate piece of paper to provide such information. Make sure the owner of the contract signs and dates this additional page. If you are unable to define the "Amount Paid with Application" in the space provided for this information, designate whether the money is being transferred or 1035 Exchanged, the approximate amount (if known) and from where the money is to be transferred. If you mark the "Bank Draft" option under the payment method section of the application, include a completed Automatic Payment Plan form FP-1048, shown as Exhibit C, to initiate the bank draft. Bank drafts have a $50 minimum. Please see the replacement section of the application and mark the appropriate answer to the question regarding backup withholding. APPLICATION FOR FLEXIBLE PREMIUM DEFERRED ANNUITY UNITED AMERICAN INSURANCE COMPANY ADMINISTRATIVE OFFICE: P.O. BOX 8080, MCKINNEY, TX Annuitant Telephone No. Plan Code Home Office Use Only ( ) E91 ANNUITANT Annuitant Social Security # (Last Name, First Name, Middle Initial) Address Sex: M Birthday F City State Zip Age Last Birthday Relationship Beneficiary to Annuitant Social Security # (Last Name, First Name, Middle Initial) OWNER (if different from Annuitant) Owner (Last Name, First Name, Middle Initial) Relationship to Annuitant JOINT OWNER (if applicable) Owner (Last Name, First Name, Middle Initial) Relationship to Annuitant Birthdate Age Last Birthday Birthdate Age Last Birthday Taxpayer ID / Sex M Taxpayer ID / Sex M Social Security # F Social Security # F Address City State Zip Systematic Additional Premiums Mode Method Single Premium Direct Annual Semi-Annual Quarterly Monthly Mode Premium $ Amount Paid with App. Bank Draft $ Expected Maturity Date (The policy anniversary following Annuitant s age 100 unless otherwise indicated) Address City State Zip TYPE OF ANNUITY Qualified (Check applicable box) IRA: $Amt. Cont. Yr. $Amt. Cont. Yr. IRA Rollover IRA Transfer INTEREST 1 yr. Bonus rate ( %) Non-Qualified Will the annuity applied for replace any existing insurance or annuity? Yes No REPLACEMENT If yes, explain The Applicant agrees: (1) All statements and answers contained herein are full, complete and true to the best of my knowledge and belief. (2) This annuity contract is effective on the policy date unless: (a) the annuitant is not living on the policy date; (b) the check for the initial premium is not honored; or (c) the Owner exercises the contractual right to request a premium refund. (3) If the annuity contract is not effective on the policy date, the Company s sole obligation will be to refund all premiums received. (4) No agent can make or change any of the provisions in the policy, waive any of the Company s rights or bind the Company. (5) Any policy issued on the basis of this application will be considered delivered in and subject to, the laws of the jurisdiction in which the application was signed. Under penalties or perjury, I certify (1) that the number shown on this form is my correct social security number / taxpayer ID# and (2) THAT I AM I AM NOT SUBJECT TO A BACKUP WITHHOLDING ORDER UNDER SECTION 3406(a)(1)(C) OF THE INTERNAL REVENUE CODE. I understand that the annuity policy will not be Federally insured. MAKE CHECK PAYABLE TO: UNITED AMERICAN INSURANCE COMPANY. The Contract applied for shall take effect on the later of the date the application is approved by the Company at its Home Office, or the date the first stipulated payment is received, in full, at the Home Office of the Company. Signed at City and State Signature of Owner (if other than Annuitant) Date Signature of Annuitant Agent: To the best of your knowledge will this policy replace or change any existing life insurance or annuity? Yes No If Yes, comply with applicable replacement regulation or rule and furnish company name and cost basis. Signature of Agent Agent Name (Please Print) Agent # UFPA8-AP Mail Policy to: Policyowner Agent 8/03 Page 3

6 B Flexible Premium Annuity Certificate of Receipt (UAFPA8-CR R01) 3700 SOUTH STONEBRIDGE DRIVE POST OFFICE BOX 8080 MCKINNEY, TEXAS FPA802 CERTIFICATE OF RECEIPT FLEXIBLE PREMIUM ANNUITY Please review the following highlights of your Annuity application and check the features and benefits for your understanding and satisfaction. Remember: This certificate is not the annuity contract but only a summary of the features. Only the annuity contract contains governing contractual provisions. Please read your contract carefully. 1. My United American contract includes a % bonus for the first year only. The renewal rate amount on my contract anniversary will not include any bonus. 2. The one-year non-bonus rate is %. 3. The surrender period for the contract is seven (7) years. The surrender charges are: 8%, 8%, 7%, 6%, 5%, 4%, 3%. However, interest earnings may be withdrawn in full without surrender charge. The interest earnings left in the contract are tax-deferred; withdrawals of earnings prior to age 59 1 /2 are taxable and may be subject to penalty tax. 4. I understand that I may make additions to my annuity and that the minimum addition to my annuity is $ The guaranteed minimum interest rate on my annuity is 3%. 6. If applicable, I am executing a 1035(a) tax-free exchange or tax-free transfer from an existing annuity or other contract to an annuity issued by United American Insurance Company, and I understand that the interest rate will be the rate in effect today for 60 days; otherwise it will be the rate in effect when the funds are received by United American Insurance Company. 7. I may make a partial or complete withdrawal under the Nursing Home Waiver (where state approved) without incurring withdrawal charges if the Annuitant or Annuitant s spouse: a. Is confined in a hospital or nursing home for a total of at least 30 days within a 35-day period, or has been discharged from such confinement within the previous 60 days; or b. Is enrolled in a hospice care program or has been discharged from such within the previous 60 days. 8. My principal (less withdrawals) is 100% guaranteed by United American Insurance Company, a legal reserve life insurance company. It is not insured by the FDIC or any other federal agency, nor is it a deposit, obligation or guarantee of any financial institution. I understand annuities may be subject to investment risk and possible loss of principal. 9. I have included a check made payable to United American Insurance Company for the purchase amount of $. Applicant Date Licensed Representative Date Applicant Date UAFPA802-CR R8/03 Need more information? Call United American Insurance Company at WHITE - United American Insurance Co. YELLOW - Customer PINK - Sales Representative Page 4

7 C Automatic Payment Plan (FP-1048) Use to initiate systematic bank drafts for subsequent investments into an existing contract. 1. Must attach a voided check to the form. 2. Minimum bank draft amount is $50. Page 5

8 D Qualified Funds Identification Worksheet (UASA QFW) The Qualified Funds Identification Worksheet is required for tax reporting purposes when annuities are used to fund an IRA. It must be completed at the time of sale and sent to United American, along with the annuity application. The annuity application will not be processed nor commissions paid until this form is received by United American. Contributory IRA Complete this section when the annuity premium is for a new contribution. It is important that you indicate the appropriate tax year. If the contribution is for more than one year, please break it down. IRA Transfer An IRA Transfer is a tax-free transfer of IRA funds directly from the previous IRA trustee/custodian to a new trustee/custodian (United American) at the request of the customer. The customer never has constructive receipt of the funds. There are no IRS restrictions as to the number of times IRA funds can be directly transferred. Funds (by check) should be made payable to United American "for the benefit of" the customer. Indicate the name of the IRA trustee/custodian transferring the funds. IRA Rollover An IRA rollover is a tax-free transfer of funds from one qualified retirement plan or IRA and its reinvestment in an IRA (United American). The customer is considered to have constructive receipt of the funds unless the funds are reinvested in an IRA within 60 days of receipt. If the funds come from a qualified retirement plan (TSA, KEOGH, SEP; employer pension, profit-sharing, stock bonus, 401(K) plan), a Direct Rollover option is available to transfer the funds directly to the United American IRA and avoid a 20% withholding requirement by the fund source. Under this option, funds (by check) should be made payable to United American "for the benefit of" the customer. Indicate the name of the fund source and the type rollover funds. Page 6

9 E Request to Transfer Account Proceeds (UASA TQR) Use this form when transferring any qualified funds directly to United American from the previous trustee/custodian. This form must be sent to United American accompanied by the Qualified Funds Identification Worksheet. Page 7

10 F Section 1035 Exchange (UASA 1035) Use for Non qualified exchanges from Life Insurance, Annuity, and/or Endowment contracts to the United American Annuity contract Exchanges permit the policyowner to avoid current taxation on the gain of a terminated policy or to carry a loss forward to the new policy. Remember, a 1035 Exchange is a replacement, and you must follow the replacement procedures in your state. The replacement forms for your state, if any, must be submitted along with the rest of the new business forms. Multiple Funds Per IRS regulations, 1035 Exchanges must be processed to a new contract, thus funds received from a 1035 exchange cannot be applied to an existing contract. When multiple 1035 exchanges are being processed to one contract, the contract will be issued with the effective date being the received date of the last 1035 exchange funds. Funds received prior to issue whether they be from one of the multiple 1035 exchanges or additional deposits by the annuitant will be entered on the pending contract, with the contract being issued for the total of all deposits once the final 1035 funds are received. Deposits made prior to issue will receive interest from the date they are actually received. The deposit advice sent to the annuitant two weeks after issue should reflect the total amount received with a breakdown of the deposits by effective date. Any of the 1035 exchanges with lock-in will receive a lock-in interest rate as requested as long as the funds are received within the 60 days allowed. Additional funds deposited by the annuitant prior to issue will receive the current interest rate in effect at the time of receipt. Page 8

11 F Section 1035 Exchange (UASA 1035) IMPORTANT PROCESSING INFORMATION: United American begins follow-up calls to the prior carrier to confirm receipt of the request and to ensure the request will be quickly initiated by the prior carrier. If any additional information is required, the agent is notified. Note: The policy being replaced must be submitted with the assignment form. Otherwise, if the policy is lost, check the appropriate box on the 1035 Exchange Form. Page 9

12 G Annuity Systematic Withdrawal Request (UASA ASW) This form is used to elect a systematic withdrawal option. The W-4P and W-9 forms are included on the form. The "first payment date" must be on the 1st or 15th of the month. Indicate the specific date on the space provided. This form should be used for "Systematic Withdrawals" ONLY. (Do not use this form for a Minimum Distribution Request. Use form #UASA AMD for Minimum Distribution Requests). Fill in "requested dollar amount" only if a specific amount is requested. If you are requesting interest only or Life Expectancy withdrawal options, indicate such by marking the correct box and leave the "requested dollar amount" option blank. United American will calculate the correct amount. Please do your own calculations on a separate piece of paper. Indicating a dollar amount when requesting options other than "specific dollar amount" can cause confusion regarding your objective and thereby delay the processing of your request while United American calls to confirm your intent. Page 10

13 H Interest Rate Chart Annual Yield Nominal Rate Number Of Days In Interest Accumulation Period Interest Income Projection Factor EXAMPLE AT 3.00% YIELD 31 DAY MONTH: 3.00% 2.96% % 2.96% % 2.96% Net Premium Accumulation FACTOR Value VALUE Net Premium Monthly Interest (30 Days) $20, $20, $20, $20, $50.28 Page 11

14 I Authorization Agreement for Direct Deposit (UASA DD) This form is used to initiate Direct Deposit (Electronic Funds Transfer) of annuity withdrawals. Be sure to attach a voided check to this form. Page 12

15 J Deposit Confirmation Letter/Advice (UASA DAL) Client letter to confirm receiving/processing annuity deposit. Perforated deposit advice is included below the letter for making additional deposit. Page 13

16 K Beneficiary Designations (UASA BD) Use this form in the event the number of beneficiaries exceeds the amount of space provided on the application. Page 14

17 L Your Guide to Your United American IRA (UASA DF) Every client who is establishing an IRA with United American must be given this form. This is an eight-page Guide. Cover only shown here. Page 15

18 M Minimum Distribution Withdrawal Request (UASA AMD) This form should be used for initiating minimum distributions ONLY. If customer desires to take a sum of income in excess of and in addition to their minimum distribution, that additional amount should be requested on form UASA ASW - ANNUITY SYSTEMATIC WITHDRAWAL REQUEST. Do not calculate on this sheet. If there is any discrepancy from United American s calculation and a figure written on this form, it will result in a customer service issue to determine if minimum distribution or the exact amount the Sales representative calculated is desired, thereby creating a delay in processing the request. Important: Only minimum distributions pertaining to United American contracts may be taken free of surrender charges. Commission chargebacks will apply on minimum distributions taken in the first year. (Refer to your Annuity Questionnaire for further details.) Page 16

19 N State Replacement Form (REPNOT/00) This is a state specific form used by the Representative to do a 1035 exchange, rollover, or transfer for which he/she is replacing an existing insurance policy. Send this form in with the completed application. Be sure to specify state when ordering supplies of these forms. UNITED AMERICAN INSURANCE COMPANY A DELAWARE STOCK COMPANY ADMINISTRATIVE OFFICE: MCKINNEY, TEXAS (972) IMPORTANT NOTICE: Replacement of Life Insurance or Annuities This document must be signed by the applicant and the producer, if there is one, and a copy left with the applicant. You are contemplating the purchase of a life insurance policy or annuity contract. In some cases this purchase may involve discontinuing or changing an existing policy or contract. If so, a replacement is occurring. Financed purchases are also considered replacements. A replacement occurs when a new policy or contract is purchased and, in connection with the sale, you discontinue making premium payments on the existing policy or contract, or an existing policy or contract is surrendered, forfeited, assigned to the replacing insurer, or otherwise terminated or used in a financed purchase. A financed purchase occurs when the purchase of a new life insurance policy involves the use of funds obtained by the withdrawal or surrender of or by borrowing some or all of the policy values, including accumulated dividends, of an existing policy, to pay all or part of any premium or payment due on the new policy. A financed purchase is a replacement. You should carefully consider whether a replacement is in your best interest. You will pay acquisition costs and there may be surrender costs deducted from your policy or contract. You may be able to make changes to your existing policy or contract to meet your insurance needs at less cost. A financed purchase will reduce the value of your existing policy or contract and may reduce the amount paid upon the death of the insured. We want you to understand the effects of replacements before you make your purchase decision and ask that you answer the following questions and consider the questions on the back of this form. 1. Are you considering discontinuing making premium payments, surrendering, forfeiting, assigning to the insurer, or otherwise terminating your existing policy or contract? Yes No 2. Are you considering using funds from your existing policies or contracts to pay premiums due on the new policy or contract? Yes No If you answered Yes to either of the above questions, list each existing policy or contract you are contemplating replacing (include the name of the insurer, the insured or annuitant, and the policy or contract number if available) and whether each policy or contract will be replaced or used as a source of financing: Insurer Name Contract or Policy Number Insured or Annuitant Replaced(R) or Financing(F) Make sure you know the facts. Contact your existing company or its agent for information about the old policy or contact. If you request one, an in force illustration, policy summary or available disclosure documents must be sent to you by the existing insurer. Ask for and retain all sales material used by the agent in the sales presentation. Be sure that you are making an informed decision. The existing policy or contract is being replaced because: I certify that the responses herein are, to the best of my knowledge, accurate: Applicant s Signature Applicant s Printed Name Date Producer s Signature Producer s Printed Name Date I do not want this notice read aloud to me. (Applicants must initial only if they do not want the notice read aloud.) Home Office Copy REPNOT/00 (Continued on Reverse Side) 0106 Page 17

20 O Annuity Withdrawal or Surrender Request (UASA SR) Use this form whenever a customer needs to make: a full cash surrender (the contract must be returned with the form); a partial cash surrender (specify amount); a transfer of contract (contract must be submitted). Mark the appropriate place to mail the check (top section) and select the option (A, B, C) at the bottom. If this contract has joint owners, both owners must sign. Page 18

21 P Annuity Request Form (UASA PR) This form is used to delay the annuity maturity date or request an annuity payout option. Page 19

22 Q Withdrawal Charge Waiver Request (UASA WR) This form is used to initiate the contract withdrawal provision in regard to Nursing Home, Hospital Stay, and Hospice Care. (Not Available in CA, PA, or MA) Page 20

23 R Additional Premium Receipt (UASA APR) This form should be used when additional funds are received on an existing contract. Page 21

24 S New Business Envelope After marking the envelope where indicated for New Business, write ATTN: ANNUITY COORDINATOR on the black line. This will notify United American that the envelope contains new business and will expedite it to the correct New Business processing unit. Page 22

25 The UA FPA802 Flexible Premium Annuity issued by United American Insurance Company is not a product or deposit of, nor guaranteed by, any financial institution. It is not insured by the FDIC or any other federal agency. Early withdrawals or surrenders may be subject to taxes and/or tax penalties and withdrawal charges. Remember to have your clients consult their tax or financial advisor on details concerning tax or accounting consequences S. Stonebridge Dr., McKinney, Texas