Security Benefit Statement of Understanding Effective Date: June 13, 2014 Must be signed by the customer and agent and the signature page returned to Security Benefit with the application. 1.800.888.2461 One Security Benefit Place, Topeka, KS 66636-0001 securitybenefit.com IM-22310-03 2014/06/13
Security Benefit Total Value Annuity Statement of Understanding Thank you for your interest in the Total Value Annuity from Security Benefit Life Insurance Company (SBL). It is important for you to read this summary before you decide to purchase the annuity. This summary will help you understand the features of the annuity and determine if it will help you meet your financial goals. Once you have read this summary, please sign the last page to confirm that you understand the annuity and submit this document with your application for the annuity and the Annuity Suitability Form. For more specific information, please refer to the annuity contract, and its attached riders and endorsements, as it contains the terms of the annuity. What is the Total Value Annuity? The Total Value Annuity (TVA) is a flexible premium, deferred fixed index annuity with a Bonus, Surrender Charge, Bonus Recapture and, in most states, a Market Value Adjustment (MVA). The Surrender Charge, Bonus Recapture, and if applicable, MVA, apply for 10 contract years*. Accordingly, you should only purchase the TVA if you do not expect to need the funds in the next 10 years*, other than amounts available through free withdrawals. The TVA is designed to be held for the long term. Also available with the TVA is (i) the optional Guaranteed Lifetime Withdrawal Benefit Rider - the Income Rider or (ii) the optional Guaranteed Minimum Death Benefit Rider - the Death Benefit Rider. Only one of these riders may be purchased, and they cannot be cancelled. What are the key terms I need to know to understand the Total Value Annuity? The following terms are keys to understanding the Total Value Annuity: Account Value: is the value of your Total Value Annuity, and is the sum of the Fixed Account Value and the Index Account Values. Bonus: is an amount added to your Account Value related to purchase payments received by SBL in the first contract year. Bonus Recapture: is a charge that reduces the amount of previously credited Bonus and reduces the amount available from your annuity during the Surrender Charge Period. Thus, if you surrender your annuity during the Surrender Charge Period, all or part of the Bonus credited will be taken away. Cap: The maximum amount of interest that may be credited for a particular time period. Current Interest Rate: is the interest rate applied to your Fixed Account Value. It will never be less than the GMIR. Five year Index Account: refers to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account options. Fixed Account Value: is the amount allocated to the Fixed Account. Guaranteed Minimum Interest Rate or GMIR: is the minimum annual interest rate that is used to compute the Guaranteed Minimum Cash Surrender Value and is the minimum interest rate for the Fixed Account. Index Account: are the accounts we establish when you allocate your Account Value to the S&P 500 Annual Point to Point Index Account, the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. For both the 5 Year Annuity Linked TVI Index Account and the Transparent Value Blended Index Account, because of the five-year Index Term, we may establish more than one Index Account if you allocate to either five year index account on the date you purchase your annuity and on future contract anniversaries. Index Account Value: is the amount allocated to the S&P 500 Annual Point to Point Index Account, the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Index Interest Rate: is the interest rate based on the change of an index and credited on the Index Account Value. *9 years for contracts issued in CT and DE. Page 1 of 28 IM-22310-03 2014/06/13
Index Term: is the period for each Index Account during which you may not transfer out of an Index Account and at the end of which the Index Interest Rate is computed and credited (except for interim interest on the 5 Year Annuity Linked TVI Index Account and the Transparent Value Blended Index Account). Market Value Adjustment or MVA: is an increase or decrease of the amount available for withdrawals or, in most states, annuitization as a result of the change in the interest rate environment since your contract was issued. It applies during the Surrender Charge Period. Spread: the difference between the percentage change on underlying index value and the interest credited to the Index Account for a particular time period. Surrender Charge: is a charge that reduces the amount available from your annuity during the Surrender Charge Period. Surrender Charge Period: is the first 10 contract years (9 years for contracts issued in CT and DE). What do I pay for the Total Value Annuity? To purchase the Total Value Annuity, you must pay an initial amount or "purchase payment." The minimum initial purchase payment is $25,000. As a flexible premium annuity, you may make subsequent purchase payments to the annuity of at least $1,000. The maximum purchase payment is $1,000,000 without prior company approval. Can I change my mind after purchasing the Total Value Annuity? Yes, many states have laws that give you a specific number of days to You can return your annuity: review an annuity after you buy it. If you decide during that time that you During the free look period. do not want the annuity, you can return it and receive back your entire If you do, you will receive your purchase payment less any withdrawals. Read the cover page of your entire Purchase Payment, with contract to learn about your free look period. If your contract replaced a no penalty. previous annuity contract owned by you, the free look period may be You will not receive the Bonus. different than that listed on the cover page of your contract (varies by state). If so, there will be an additional notice for the free look period that was included with your contract. What is the Bonus? The "Bonus" is an amount we add to your Account Value for purchase payments we receive in the first contract year. The Bonus is equal to the purchase payments we receive in your first contract year multiplied by the Bonus rate. The Bonus rate depends on the state in which you purchase the contract, whether you purchased a rider, and for the Death Benefit Rider, your age. States All states except AK, IN, ME, MN, MO, NH, NJ, NV, OH, CA, FL CT, DE those listed at right OR, PA, SC, TX, UT, WA Bonus 7% 5% 6% 2% Bonus with Income Rider Purchase Bonus with Death Benefit Rider Purchase* 8% 6% 7% 2% 7% 5% 6% 2% *If a Death Benefit Rider is purchased and you are 76 or older, the Bonus is reduced by 1%. The Bonus rate remains the same with the purchase of either Rider in CT or DE. Bonus annuities may use factors to determine interest rates that result in lower interest credited in future years, have higher surrender charges, and longer surrender charge periods or other charges than similar annuities without a bonus or other charges. The reduction of interest or higher charges may exceed the amount of the bonus. What interest crediting options are available under the Total Value Annuity? Under the TVA, you may select among four different interest crediting options: the Fixed Account and the three Index Accounts the S&P 500 Annual Point to Point Index Account, the 5 Year Annuity Linked TVI Index Account and the Transparent Value Blended Index Account. You may allocate purchase payments along with Bonus among the Fixed Account and Index Accounts in whole percentages. Page 2 of 28 IM-22310-03 2014/06/13
What is the Fixed Account? The Fixed Account is an interest crediting option that guarantees to credit a fixed interest rate. We declare a Current Interest Rate equal to at least the GMIR. At the time we issue you your contract, we set the GMIR and it will be shown in your contract. The GMIR will be at least 1%. Interest is credited daily on your Fixed Account Value. What is the S&P 500 Annual Point to Point Index Account? The S&P 500 Annual Point to Point Index Account is an interest crediting option that credits interest based on the change in the S&P 500 Index up to a cap. At the end of each Index Term, the Index Interest Rate is determined and is credited on your S&P 500 Annual Point to Point Index Account Value. The Index Interest Rate will never be less than 0%. For the S&P 500 Annual Point to Point Index Account, the Index Term is the period starting on your contract date or contract anniversary and ending on the earliest of: (i) your next contract anniversary; or (ii) the date due proof of death is received by SBL. In certain cases we may terminate the S&P 500 Annual Point to Point Index Account. If any amounts are withdrawn from the S&P 500 Annual Point to Point Index Account before the end of the Index Term, including for a surrender, the Index Interest Rate is not credited on those amounts. How is the S&P 500 Annual Point to Point Index Account Index Interest Rate computed? You are not investing in and your premiums are not being invested in the S&P 500 or any equity securities. As such, the interest credited for the Index Account does not equal the change in the S&P 500 Index. For the S&P 500 Annual Point to Point Index Account, we compute the Index Interest Rate at the end of each Index Term based upon the change in the index value at the start and the end of your Index Term, up to a cap. The ending index value for one Index Term will be the starting index value for the next Index Term. If the index value is not available for any day, we use the index value reported on the prior business day to that day. We compute the difference in the starting and ending index values for the Index Term. If the difference is positive, we divide that difference by the Index Term's starting index value to determine the percentage change in the index value for the Index Term. We then compare the percentage change to the cap and use the lower of the percentage change or the cap as the Index Interest Rate. If the difference in the beginning and ending index values is negative, the Index Interest Rate is 0%. The cap is the maximum Index Interest Rate that we will credit for the S&P 500 Annual Point to Point Index Account. At the time we issue your contract, we set the initial cap and the guaranteed minimum cap and they are shown in your contract. Each Index Term, we may change the cap, but it will never be less than the guaranteed minimum cap indicated in your contract. Example - Index Interest Rate at the end of the Index Term: Assume that (i) Mary was issued a contract on February 1, 2011, (ii) on February 1, 2011, the S&P 500 Annual Point to Point Index Account Value was $100,000, (iii) Mary did not take any withdrawals during the Index Term, (iv) the cap was 1%, (v) on February 1, 2011, the index value of the S&P 500 Index was 1,000, and (vi) On February 1, 2012, the index value of the S&P 500 Index was 1,100, then: Difference in Index Value S&P 500 Index Ending Index Value - S&P 500 Index Beginning Index Value 100 1100-1000 Because the difference is positive, we determine the percentage change as follows: Percentage Change in Index Value Difference in Index Value Beginning Index Value 10% 100 1000 We then compare the percentage change to the cap and use the lower of the two. Because the 1% cap is lower than the 10% change in the index value, the Index Interest Rate for the S&P 500 Annual Point to Point Index Account for the year would be 1% and the index interest would be $1,000. Thus, Mary s ending S&P 500 Annual Point to Point Index Account Value would be $101,000. Page 3 of 28 IM-22310-03 2014/06/13
This example is only to show how the S&P 500 Annual Point to Point Index Account Index Interest Rate and index interest are computed and does not reflect what the interest would be for your annuity. What is the 5 Year Annuity Linked TVI Index Account? The 5 Year Annuity Linked TVI Index Account is a unique index crediting option available only through SBL that is based upon the change in the Annuity Linked TVI Index, which is reduced by the annual spread, currently 0.75% annually, and multiplied by a participation rate. What is the Annuity Linked TVI Index? The Index Interest Rate for the 5 Year Annuity Linked TVI Index Account is based on the Annuity Linked TVI Index. The Annuity Linked TVI Index is an index that is based upon the Trader Vic Index Excess Return index (TVI ) modified by an index cost fee and a volatility control overlay. The Annuity Linked TVI Index is a published index with the Bloomberg ticker "ALTVI:IND". The TVI is a published index on Bloomberg with the symbol "TVICTR:IND." The TVI was launched by the Royal Bank of Scotland N.V. (RBS) and EAM Partners LP (EAM). RBS serves as the calculation agent for the TVI and the Annuity Linked TVI Index. The TVI is an index that measures the movements in prices of futures contracts on physical commodities, global currencies and U.S. interest rates that are publicly traded on a U.S. exchange that publishes the contracts daily settlement prices. In computing the index value of the Annuity Linked TVI Index, RBS deducts from the TVI an index cost. The index cost is a charge by RBS to compute the Annuity Linked TVI Index. The index cost is deducted in computing the daily values of the Annuity Linked TVI Index at the rate of 125 basis points per annum. The volatility control overlay is a rules-based adjustment applied in computing the daily values of the Annuity Linked TVI Index. It measures how much the TVI s price is changing. The volatility control overlay reduces the impact of a fall in price, as well as increases in the price of the TVI. The volatility overlay will also reduce SBL's hedge costs for the 5 Year Annuity Linked TVI Index Account. The index cost and volatility overlay reduce the potential positive change in the Annuity Linked TVI Index and the Index Interest Rate for the Annuity Linked TVI Index Account. Because the TVI is based on the 24 futures contracts on commodities, global currencies and U.S. interest rates, the daily values of the TVI are likely to be independent from the price movement of equity and bond indices. In addition, unlike traditional equity and bond indices that increase and decrease when equities and bonds increase and decrease, the TVI can increase in value when the futures contract prices are decreasing. Because it is based on the TVI, the 5 Year Annuity Linked TVI Index Account provides you with the opportunity to receive index interest credits in times when an index crediting option based on equity or bond markets would not. What is the Transparent Value Blended Index Account? The Transparent Value Blended Index Account is another unique index crediting option, available only through SBL. It is based upon the Transparent Value Blended Index ( TVBI ), which is reduced by the annual spread, currently 1.25% annually, and multiplied by a participation rate. What is the Transparent Value Blended Index? The Transparent Value Blended Index is part of the Transparent Value Index family a series of quantitative strategy indexes offered by Transparent Value LLC using rules-based published analytics. The Transparent Value Indexes are designed to measure the performance of investment strategies based on the criteria established by Transparent Value LLC for the valuation of publicly traded companies. The Transparent Value Blended Index reallocates weights between the Price Return version of the Transparent Value Large-Cap Defensive Index without dividends ( Stock ) and the S&P 2-Year U.S. Treasury Note Futures Total Return Index ( Bond ). Components of the Transparent Value Large-Cap Defensive Index, which consists of 100 stocks chosen from the 750 stocks in the Dow Jones U.S. Large-Cap Total Stock Market Index, are selected in part based on their RBP probabilities. RBP, which stands for Required Business Performance, is calculated by using a reverse discounted cash flow approach to determine the future business performance required by a company to support its current stock price. RBP probabilities measure the Page 4 of 28 IM-22310-03 2014/06/13
likelihood that a company can deliver the required business performance identified by applying the methodology over specified time periods. The S&P 2-Year U.S. Treasury Note Futures Total Return Index tracks the performance of a portfolio that holds the nearest maturity 2-Year U.S. Treasury Note futures contract. The allocation between the two component indexes is calculated daily and the stock selection in the Transparent Value Large Cap Defensive Index is rebalanced quarterly. The goal of the Transparent Value Blended Index is to actively reallocate between the components depending on changing market conditions and volatility. During the times of increased stock market volatility followed by market downturn TVBI immediately allocates a larger portion to the Bond Index, while favoring the Stock Index during market upswings. General Information Regarding the 5 year Index Accounts At the end of each Index Term, the Index Interest Rate is determined and is credited on the 5 year Index Account Value. Any amount of a withdrawal (including Bonus Recapture, Surrender Charge, and MVA), deduction for rider charges, or amount for annuitization taken from the 5 Year Index after the first anniversary of the start of the Index Term but before the end of the Index Term, receives interim index credits that are based upon a vesting percentage. The Index Interest Rate will never be less than 0%, however, it is possible that no interest could be credited at the conclusion of a 5 year Index Account's Index Term. Because both 5 year Indexes have multi-year terms, no transfers from either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account are permitted before the end of the Index Term. For both 5 year Index Accounts, the Index Term is the period starting on the contract date or contract anniversary and ending on the earliest of: (i) the fifth anniversary of the start of the Index Term or (ii) the date due proof of death is received by SBL. In certain situations we may terminate both 5 Year Indexes. How is the Index Interest Rate computed for a 5 year Index Account? For a 5 year Index Account, we compute the Index Interest Rate at the end of each Index Term based upon the change in the Index from the start and at the end of the Index Term, or in computing interim index interest, the relevant date. In computing the Index Interest Rate, an annual spread currently applies (the specific spreads applicable to each of the 5 year Index Accounts are set forth above), and a participation rate may also apply in the future. We set the annual spread and participation rate at the beginning of each Index Term. The annual spread is guaranteed to never be more than 5% annually or 25% for the entire Index Term. The participation rate is guaranteed to never be less than 50%. In addition, in computing the interim index interest, the computation is the same except that a vesting percentage also applies. The vesting percentage is: Vesting Percentage When Applicable Based on Start of Index Term 20% On the 1st anniversary and before 2nd anniversary 40% On the 2nd anniversary and before 3rd anniversary 60% On the 3rd anniversary and before 4th anniversary 80% On the 4th anniversary and before 5th anniversary 100% On the 5th anniversary We compute the Index Interest Rate for a 5 year Index Account as follows: Step 1. Compute the percentage change in the index value of the Index over the relevant period. Step 2. Subtract five years' of annual spread from the result in Step 1. If interim index interest is being determined, this would be based on the amount of days that have elapsed since the start of the Index Term. Step 3. Multiply the participation rate by the result in Step 2. Step 4. If interim index interest is being determined for a withdrawal (including Bonus Recapture, Surrender Charge, and MVA), deduction for rider charges, or for annuitization prior to the end of the Index Page 5 of 28 IM-22310-03 2014/06/13
Term, multiply the applicable vesting percentage, based on the amount of time elapsed since the start of the Index Term. Example Index Interest Rate at the end of the Index Term: Assume that (i) Bill was issued a contract on February 1, 2011, (ii) on February 1, 2011, Index Account Value was $100,000, (iii) Bill did not take any withdrawals and no rider charges were deducted during the Index Term, (iv) on February 1, 2011, the index value of the Index was 1,000, (v) on February 1, 2016, the index value of the Index was 1,500, (vi) the annual spread was 3%, and (vii) the participation rate was 100%, then: Step 1: Compute the percentage index change Difference in Index Value Index Ending Index Value - Index Beginning Index Value 500 1500-1000 Because the difference is positive, we determine the percentage change as follows: Percentage Change in Index Value Difference in Index Value Index Beginning Index Value 50% 500 1000 Step 2: Subtract the annual spread from Step 1 Because for this example an annual spread of 3% applies, we subtract five years' of annual spread from the percentage change in the Index Value. Five years' of annual spread would be 15%. Subtracting 15% from Step 2 would be: Step 1 - Five Years' of Annual Spread 35% 50% - 15% Step 3: Multiply the participation rate by the result of Step 2 The percentage change in the index value, less the annual spread, is then multiplied by the participation rate. Because the participation rate is 100%, the Index Interest Rate for the Index Account would be 35% and the index interest would be $35,000. Thus, Bill s ending Index Account Value would be $135,000. This example is only to show how the 5 year Index Interest Rate and index interest are computed and does not reflect what the interest would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. Example Index Interest Rate for a withdrawal prior to the end of the Index Term: Assume that (i) Bill was issued a contract on February 1, 2011 and allocated his entire Purchase Payment to a 5 Year Index Account, (ii) on February 1, 2011, the Index Account Value was $100,000, (iii) on August 1, 2013 (two and one-half years after the beginning of the Index Term), Bill took a withdrawal that reduced the Index Account Value by $10,000 (including Bonus Recapture, Surrender Charge, and MVA), (iv) on February 1, 2011, the value of the Index was 1,000, (v) on August 1, 2013, the value of the Index was 1,200, (vi) the annual spread was 3%, and (vii) the participation rate was 100%, then: Step 1: Compute the percentage index change Difference in Index Value Index Ending Index Value - Index Beginning Index Value 200 1200-1000 Page 6 of 28 IM-22310-03 2014/06/13
Because the difference is positive, we determine the percentage change as follows: Percentage Change in Index Value Difference in Index Value Index Beginning Index Value 20% 200 1000 Step 2: Subtract annual spread from Step 1 For this example, because an annual spread of 3% applies, we then subtract two and one-half years' of annual spread from the percentage change in the index value. Two and one-half years' of annual spread would be 7.5%. Subtracting 7.5% from step 2 would be: Step 1 - Two and One-Half Years' of Annual Spread 12.5% 20% - 7.5% Step 3: Multiply the participation rate by the result of Step 2 The percentage change in the index value, less the annual spread, is then multiplied by the participation rate. Because the participation rate is 100%, this would result in 12.5%. Step 4: Because the withdrawal occurred during the index term, apply the vesting percentage Because Bill s withdrawal occurred after the second anniversary and before the third anniversary of the start of the Index Term, the vesting percentage would be 40% and it is applied to the result in Step 3. Index Interest Rate Step 3 x Vesting Percentage 5% 12.5% x 40% Thus, the Index Interest Rate used to determine the interim index interest credit would be 5%. To determine the Index Account Value after the withdrawal: Index Account Value After the Withdrawal Index Account Value Before the Withdrawal - Amount of Withdrawal / (1 + interim Index Interest Rate) $90,476.19 $100,000-10,000 / (1.05) This example is only to show how the Index Interest Rate and index interest, and the reduction to the Index Account Value are computed and does not reflect what the interest would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. Can I change how interest is credited under my contract? Yes, after each contract anniversary we will send you a notice about the Fixed Account Value and Index Account Values available to be transferred and information on the interest crediting options then available. You must request the transfer of Account Value as of the applicable contract anniversary on a form accepted and received by SBL on or before the 21st day after that contract anniversary. Any request for transfer received after such date will not be honored and the allocation of the Account Value will remain the same, unless SBL ceases to offer an Index Account in which Account Value is held. If you do not request a transfer, the allocation of the Account Value will remain the same, unless SBL ceases to offer an Index Account in which the Account Value is held. If SBL ceases to offer an Index Account in which Account Value is held and a transfer request is not received by SBL in time or a transfer is not requested, SBL will transfer the Index Account Value in that Index Account to the Fixed Account. No Bonus Recapture, Surrender Charge, or any MVA applies to transfers. Page 7 of 28 IM-22310-03 2014/06/13
What is the value of my annuity? For the TVA, we compute your Account Value and your Cash Surrender Value. The greater of the Account Value and Cash Surrender Value is used to determine the amount received upon the death of the owner/annuitant and the death of the joint owner who is the spouse of the annuitant. The Cash Surrender Value is used to determine the amount received upon a surrender of the TVA, applied to an annuity option, or paid as a result of the death of the joint owner who is not the spouse of the annuitant. The "Account Value" equals the sum of the Fixed Account Value and the Index Account Values. The Fixed Account Value and Index Account Values include interest credited and take into account withdrawals or annuitization, including the Bonus Recapture, Surrender Charge, and any MVA that is applied to the withdrawals or annuitization, premium tax and rider charge. The "Cash Surrender Value" is equal to the greater of: (i) The Guaranteed Minimum Cash Surrender Value or (ii) The Account Value, (a) minus any Surrender Charge, (b) minus any Bonus Recapture, (c) minus any premium or other taxes that apply, including federal tax withholding, and (d) minus any rider charge that applies and (e) in most states, plus or minus any MVA. The "Guaranteed Minimum Cash Surrender Value" is equal to 87.5% of the purchase payments, increased by interest credited at the GMIR, less withdrawals, and less premium or other taxes that apply. What is a Bonus Recapture? A Bonus Recapture is a charge that reduces the amount of previously credited Bonus that applies during the Surrender Charge Period. The Bonus Recapture varies by contract year and is based upon the state where you purchase your contract. The Bonus Recapture provision is not applicable to contracts issued in CT or DE. If you take money from your Total Value Annuity during the surrender charge period, a surrender charge, bonus recapture and a Market Value Adjustment may apply. Year 1 2 3 4 5 6 7 8 9 10 11+ All states except those listed below 100% 100% 100% 100% 100% 100% 80% 60% 40% 20% 0% AK, IN, MN, MO, NH, NJ, NV, OH, OR, PA, SC, TX, UT, WA 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% What is the Surrender Charge? The Surrender Charge is a charge that reduces the amount available from your annuity during the Surrender Charge Period. The Surrender Charge varies by contract year and is based upon where you purchase your contract. Year 1 2 3 4 5 6 7 8 9 10 11+ All states except those listed 12% 12% 11% 11% 10% 9% 8% 7% 6% 4% 0% below AK, IN, MN, MO, NH, NJ, NV, OH, OR, PA, SC, TX, 9% 8.1% 7.2% 6.3% 5.4% 4.5% 3.6% 2.7% 1.8% 0.9% 0% UT, WA Florida 10% 10% 10% 10% 10% 9% 8% 7% 6% 4% 0% CT, DE 8.25% 7.25% 6.50% 5.50% 4.50% 3.50% 2.50% 1.50% 0.75% 0% 0% Page 8 of 28 IM-22310-03 2014/06/13
What is a Market Value Adjustment? The MVA applies during the Surrender Charge Period. The MVA is based on the interest rate market at the time you purchase your contract and when the MVA applies, measured by the 10-year Constant Maturity Treasury interest rate. If interest rates in the market are lower by 0.25% or less, or if the market interest rates are higher than when you purchase your contract, an additional amount is deducted. If market interest rates are lower by more than 0.25% than when you purchase your contract, an additional amount is added. The 0.25% threshold does not apply to contracts issued in Connecticut. The MVA does not apply in Alaska, California, Indiana, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington. Examples of the Market Value Adjustment These examples show how the Market Value Adjustment (MVA) increases or decreases the Cash Surrender Value based on changes in the market interest rate and the GMIR. The MVA is equal to MVA Factor multiplied by the Account Value less any unvested Bonus, subject to the MVA limit. The MVA Factor is: [[(1 + i0) / (1 + i1 + 0.0025*)]^T] - 1 Where: i0 10-year treasury rate on the date prior to the contract date; i1 10-year treasury rate on the date prior to the withdrawal; and T the number of whole and fraction years until the end of the surrender charge period. *The 0.0025 in the MVA Factor is not applicable in Connecticut. The examples assume: $100,000 Purchase Payment allocated 50% to the 5 Year Annuity Linked TVI Index Account and 50% to the Transparent Value Blended Index Account with the following index interest rates for each Index Account: 5 Year Annuity Linked TVI Index Account Transparent Value Blended Index Account Year 1 0.00% 0.00% Year 2 0.00% 0.00% Year 3 0.00% 0.00% Year 4 0.00% 0.00% Year 5 0.00% 42.79% The surrender occurs at the start of the sixth contract year. The TVA was sold in Kansas. Therefore at the beginning of the sixth year the surrender charge is 9% and the Bonus Recapture is 100%. At the beginning of the sixth contract year, the Account Value is $131,107. Page 9 of 28 IM-22310-03 2014/06/13
The MVA limit is based upon the Guaranteed Minimum Cash Surrender Value. The Guaranteed Minimum Cash Surrender Value is based on the GMIR. The MVA limit based on different GMIRs is shown below: 3% GMIR The MVA limit is $11,639. 2% GMIR The MVA limit is $16,946. 1% GMIR The MVA limit is $22,049. Interest Rate Increase MVA Reduction Market interest rate at purchase 6% Market interest rate at surrender 8% First Step Compute the MVA: MVA the MVA Factor multiplied by the Account Value minus the bonus recapture. [[(1+.06) / (1+.08 +.0025)]^5] -1-0.099694712 The MVA is -$12,273 [-0.099694712 * ($131,107- $8,000)]. Second Step See if MVA Limit Applies: If the GMIR is 3%, the MVA limit applies and the reduction to the Cash Surrender Value for the MVA would be $11,639. If the GMIR is 2%, the MVA limit does not apply and the reduction to the Cash Surrender Value for the MVA would be $12,273. If the GMIR is 1%, the MVA limit does not apply and the reduction to the Cash Surrender Value for the MVA would be $12,273. Interest Rate Reduction MVA Increase Market interest rate at purchase 6% Market interest rate at surrender 4% First Step Compute the MVA: MVA the MVA Factor multiplied by the Account Value minus the bonus recapture. [[(1+.06) / (1+.04 +.0025)]^5] -1 0.086798444 The MVA is $10,686 [0.086798444 * ($131,107- $8,000)]. Second Step See if MVA Limit Applies: If the GMIR is 3%, the MVA limit does not apply, and the increase to the Cash Surrender Value for the MVA would be $10,686. If the GMIR is 2%, the MVA limit does not apply, and the increase to the Cash Surrender Value for the MVA would be $10,686. If the GMIR is 1%, the MVA limit does not apply, and the increase to the Cash Surrender Value for the MVA would be $10,686. A surrender charge, bonus recapture and Market Value Adjustment apply to any partial withdrawal, surrender or when annuity payouts start,* unless: The total amount withdrawn during the contract year is equal to or less than the Free Withdrawal amount; The surrender charge period no longer applies. If you qualify for the Nursing Home or Terminal Illness Waiver. *In Florida, these do not apply when annuity payouts start. When do the Market Value Adjustment, Surrender Charge, and Bonus Recapture apply? In all states except those listed below, the Surrender Charge, Bonus Recapture, and an MVA apply during the Surrender Charge Period if: (i) you surrender your contract; (ii) you take withdrawals in excess of the free withdrawal amount; (iii) a payment is made upon the death of a joint owner who is not the spouse of the annuitant; or (iv) you apply your contract to an annuity option. In Alaska, California, Indiana, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington, the Surrender Charge and Bonus Recapture apply if: (i) you surrender your contract; (ii) you take withdrawals in excess of the free withdrawal amount; or (iii) a payment is made upon the death of a joint owner who is not the spouse of the annuitant. No MVA applies. In Florida, the Surrender Charge, Bonus Recapture, and an MVA apply during the Surrender Charge Period if: (i) you surrender your contract; (ii) you take withdrawals in excess of the free withdrawal amount; or (iii) a payment is made upon the death of a joint owner who is not the spouse of the annuitant. If you apply your contract to an annuity option, in Florida, only the Bonus Recapture applies. Additionally, limited annuity options are available for contracts annuitized during the Surrender Charge Period in Florida. Page 10 of 28 IM-22310-03 2014/06/13
During the Surrender Charge Period, the Surrender Charge, Bonus Recapture, and MVA do not apply if you satisfy conditions in the Nursing Home Waiver or Terminal Illness Waiver, if allowed in your state after the waiting period. Rider charge and premium tax We deduct any rider charge as well as any premium tax from the Fixed Account. If any rider charges or premium tax is not fully paid from the Fixed Account, then we deduct the unpaid portion pro rata from the Account Value held in all Index Accounts with the same term, starting with the shortest term Index Accounts. For example, the unpaid portion is deducted first from the Account Value held in the S&P 500 Annual Point to Point Index Account and then pro rata from the Account Value held in the 5 year Index Accounts. The pro rata amounts are based upon the Index Account Values and the Account Value as of the date the rider charge, premium tax or both are deducted. If no funds are left in either the Fixed Account or the S&P 500 Annual Point to Point Index Account and you have purchased either the Income Rider or the Death Benefit Rider, the rider charge will be deducted pro rata from the 5 year Index Accounts. The amount of rider charge deducted from the 5 year Index Accounts may not receive any index interest or may only receive interim index interest, which is subject to a vesting percentage. How can I access funds from my annuity? You may request funds from your annuity at any time. During the Surrender Charge Period, the Surrender Charge, Bonus Recapture, and in most states, MVA, may apply if you access funds from your annuity. When you request funds from your annuity you may select from which interest crediting options we take the funds. If you do not make a selection, we will take the funds in the same way we deduct the rider charge and premium tax. Can I access funds from my annuity without any fees or charges? After the first contract year, you may take free withdrawals each contract year. After the first contract year, the total amount that you may withdraw as a free withdrawal in any contract year is 10% of the Account Value as of the beginning of the contract year. Limits: 1. On a surrender during the Surrender Charge Period, the Surrender Charge, Bonus Recapture, and in most states, MVA, applies to the entire amount surrendered; and 2. During the Surrender Charge Period, the Surrender Charge, Bonus Recapture, and in most states, MVA will be applied to the decrease in the Account Value with respect to all free withdrawals if within the 12 months after the free withdrawal (i) a surrender is taken, or (ii) a death payment is made as a result of the death of the joint owner who is not the spouse of the annuitant; or (iii) the annuity contract is annuitized (if permitted during the Surrender Charge Period). What annuity income may I take from my annuity? If you do not select a payout Under your annuity, you may receive annuity payments from your annuity option, the Life with 10-Year based on the eight different annuity Fixed Period Option applies. Up options we currently offer, except in Florida. If you purchased the annuity in to 30 days prior to the annuity Florida, (i) if you decide to take annuity payments during the Surrender start date, you may change the Charge Period, you may only elect options 1 through 4 or option 8 and; (ii) if payout option. you decide to take annuity payments after the Surrender Charge Period, you may elect any one of the eight options. The annuity options are: Option 1 Life Option: For the life of the annuitant. Upon death, no further payments will be made. Option 2 Life with Fixed Period Option: For the later of: (i) life of the annuitant or (ii) the end of a 5, 10, 15, or 20 contract year period that you choose.* Option 3 Life with Installment or Unit Refund Option: For the later of: (i) life of the annuitant or (ii) the end of the period equal to the annuity start amount divided by the first payment.* Page 11 of 28 IM-22310-03 2014/06/13
Option 4 Joint and Last Survivor Option: For as long as either the annuitant or joint annuitant is living. Option 5 Fixed Period Option: For a fixed number of contract years between 5 and 20.* Option 6 Option 7 Option 8 Fixed Payment Option: Of a fixed amount. If the annuitant dies before the amount applied plus daily interest credits is paid, the beneficiary receives the remaining annuity payments. Period Certain Option: Until the end of a 10, 15, or 20 contract year period that you choose.* Joint and Contingent Survivor Option: For the life of the primary annuitant and if the joint annuitant is living at the death of the primary annuitant, for the life of the joint annuitant. *If the annuitant dies before the end of the period, the beneficiary receives the remaining annuity payments. If you do not choose a payout option, the Life with 10-Year Fixed Period Option applies. Up to 30 days prior to the annuity start date, you may change the payout option. After the 30 days prior to the annuity start date, the Cash Surrender Value will be applied to the annuity option and you cannot change the payout option or surrender your annuity. When may I begin receiving annuity payments? When you may begin receiving annuity payments depends upon the terms of your contract. If your contract is issued in: For all states other than those listed below: You may begin receiving annuity payments on the later of: (i) the contract anniversary following the annuitant s 95 th birthday or (ii) the 26th contract anniversary. For Florida: The Income Rider guarantees that if you withdraw only a set amount each year, called the Lifetime Annual Income, this amount will be available for the rest of your life. The Income Rider allows you to choose the starting point the Income Phase Start Date at which to begin receiving Lifetime Annual Income. While the contract will state a maturity date, you may request to change the date to any day after the first contract anniversary and prior to the contract anniversary following the annuitant's 95 th birthday so long as we receive written notice at least 30 days prior to the day annuity payments are to begin. For Alaska, Indiana, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington: Annuity payments may begin on any date after the Surrender Charge Period has elapsed so long as we receive the written request at least 30 days prior to the day annuity payments are to begin. Annuity payments must begin by the contract anniversary following the annuitant's 95 th birthday. What happens upon a death? If you apply the entire value of your contract to an annuity option, then upon the death of an annuitant, we will continue to make annuity payments, if any, as may apply under the annuity option chosen. If you have not applied the entire value of your contract to an annuity option, then an amount is payable under the contract upon the death of the annuitant or the owner. The amount payable depends upon who died. If the annuitant dies, the amount payable is the greater of: (i) the Cash Surrender Value or (ii) the Account Value. If the joint owner dies, the amount payable is equal to the Cash Surrender Value, unless the joint owner is the spouse of the annuitant. In that case, the amount payable is the greater of: (i) the Cash Surrender Value or (ii) the Account Value. In certain circumstances, the contract can be continued. What benefit riders or endorsements are available? The Nursing Home Waiver and Terminal Illness Waiver endorsements are included with your annuity for no additional fee or charge. In addition, you may purchase the optional Income Rider or the optional Death Benefit Rider, but not both. Page 12 of 28 IM-22310-03 2014/06/13
What are the Nursing Home Waiver and Terminal Illness Waiver? 1. Nursing Home Waiver: If you are confined to a hospital or nursing facility for a minimum of 90 consecutive days immediately preceding a withdrawal and continue to be confined at the time we receive the withdrawal request, no Surrender Charge, Bonus Recapture, or MVA applies in connection with the withdrawal request. The confinement must begin after the contract date and the withdrawal must be made after the third contract anniversary. We require proof of the confinement to the hospital or nursing home. The Nursing Home Waiver is not available in all states, and other state variations may apply. 2. Terminal Illness Waiver: If you have been diagnosed with a terminal illness by a licensed physician and the terminal illness was first diagnosed after the contract date, no Surrender Charge, Bonus Recapture, or MVA applies in connection with the withdrawal request. The request for withdrawal must be made after the third contract anniversary. We require proof of the terminal illness. The Terminal Illness Waiver is not available in all states, and other state variations may apply. What is the Income Rider? You may purchase the Income Rider at the same time you purchase the TVA and it cannot be purchased later. You cannot terminate the rider. The Income Rider guarantees that a specified amount - Lifetime Annual Income - is available for a single life or joint lives as long as you do not take any other withdrawals. To maximize Lifetime Annual Income, only this amount may be withdrawn each contract year. You may take withdrawals from the TVA at any time and in any amount; but, withdrawals other than Lifetime Annual Income will reduce the amount of Lifetime Annual Income available in the future and may result in the termination of the Income Rider. The Income Rider allows you to choose the starting point the Income Phase Start Date at which to begin to receive Lifetime Annual Income. The Income Rider also allows you to choose whether Lifetime Annual Income will be available for your life, your life and your spouse's life, or for those states that require it, your life and your domestic or civil union partner s life. If both domestic or civil union partners are covered, please note that upon the death of a partner who is an owner or the annuitant, the Income Rider will terminate upon such death because the contract will terminate to comply with federal tax laws. In such event, the Income Rider may terminate before the death of the last living partner. If you take withdrawals other than Lifetime Annual Income, your future Lifetime Annual Income will be reduced. It may cause the rider to terminate before the end of your life or your life and your spouse's (or for those states that require it, domestic or civil union partner s) life. The following terms are key to understanding the Income Rider: Excess Withdrawal: is the amount of a withdrawal on or after your Income Phase Start Date, taking into account all amounts withdrawn during the same contract year that exceeds the Lifetime Annual Income. Excess Withdrawals may reduce your Lifetime Annual Income by more than the amount of the Excess Withdrawal. Income Benefit Base: is used to compute your Lifetime Annual Income and the charge for the Income Rider. It is not an amount you may withdraw, or apply to an annuity option or be paid upon death. Income Phase Start Date: is the date on which you elect to start withdrawing Lifetime Annual Income. Interim Roll-up: is equal to the weighted Index Interest Rates for a 5 year Index Account computed on the Income Start Date. Lifetime Annual Income: is the amount you may withdraw each year, without reducing the benefits available under the Income Rider. Lifetime Withdrawal Rate: is the age-based percentage that applies to the Income Benefit Base to determine your Lifetime Annual Income. Non-Excess Withdrawal: is the amount of a withdrawal on or after the Income Phase Start Date, taking into account all amounts withdrawn during the same contract year, that are equal to or less than the Lifetime Annual Income. RMD Annual Income Amount: is determined by us based solely on the values under your contract using the IRS Uniform Lifetime table or Joint Life and Survivor Expectancy table. It does not apply to amounts required to be distributed following the qualified annuity owner's death. Page 13 of 28 IM-22310-03 2014/06/13
Stacking Roll-up: is the rate by which the Income Benefit Base increases during the Stacking Roll-up Term. It is not interest credited to your Account Value. Stacking Roll-up Term: begins on your contract issue date and ends on the 10th contract anniversary, unless renewed for another 10 years, until you reach age 85, start taking Lifetime Annual Income or the Account Value is zero. If you purchase the TVA and Income Rider after age 75, the Stacking Roll-up Term will be less than 10 years. If I purchase the Income Rider, when can I take withdrawals? You have the flexibility to take withdrawals whenever you like. However, the timing and the amount of the withdrawal may cause your Lifetime Annual Income to be reduced. In fact, withdrawals could reduce your Lifetime Annual Income to zero. How do withdrawals impact the guarantees under the Income Rider? Under the Income Rider, treatment of withdrawals is based upon whether the withdrawal is made before or after the date you start Lifetime Annual Income. You select when you want to start your Lifetime Annual Income. If you elect to take withdrawals prior to starting Lifetime Annual Income, the withdrawals will cause your Lifetime Annual Income to be lower than if you had not taken the withdrawals. Taking withdrawals other than the Lifetime Annual Income will reduce your benefits under the GLWB Rider. If you elect to take withdrawals after you start your Lifetime Annual Income that are equal to or less than your Lifetime Annual Income, the withdrawals will not reduce your Lifetime Annual Income. If you elect to take withdrawals after you start your Lifetime Annual Income that are in excess of the Lifetime Annual Income, the withdrawals will reduce your subsequent Lifetime Annual Income. How much is my Lifetime Annual Income? Your Lifetime Annual Income is the maximum amount that can be withdrawn each contract year without reducing or eliminating the guarantee of the Income Rider. Lifetime Annual Income is the greater of: 1. The Income Benefit Base multiplied by the applicable Lifetime Withdrawal Rate; and 2. The RMD Annual Income Amount. Note that since the RMD Annual Income Amount is calculated on a calendar year basis, and Lifetime Annual Income determined using the Income Benefit Base is calculated on a contract year basis, (i) it is possible that you could take out two RMDs during one contract year and (ii) the actual Lifetime Annual Income may change during a contract year due to changes in the RMD Annual Income Amount. The RMD Annual Income Amount is determined by us based solely on the values under your contract using the IRS Uniform Lifetime table or Joint Life and Survivor Expectancy table. It does not apply to amounts required to be distributed following the qualified annuity owner's death. The Lifetime Withdrawal Rate is based upon your age on the Income Phase Start Date and whether single life or joint lives are covered. If joint lives are covered, it is based on the younger age of you or your spouse (or domestic or civil union partner in certain states) on the Income Phase Start Date. Once Lifetime Annual Income begins, your Lifetime Withdrawal Rate is set and does not change. A single life Lifetime Withdrawal Rate starts at 3.80% for age 50 and increases 0.10% each year up to 7.80% at age 90. For joint lives, the Lifetime Withdrawal Rate is 0.70% lower than the corresponding single life Lifetime Withdrawal Rate. Lifetime Annual Income is computed on: 1. The Income Start Date; 2. Each contract anniversary; 3. When a request for the Home Healthcare Doubler is received; and 4. When Excess Withdrawals are taken. For example, assume that (i) Mary elected her Income Phase Start Date, (ii) the Account Value on the Income Phase Start Date was $100,000, (iii) the Income Benefit Base on the Income Phase Start Date was $120,000, (iv) Mary elected a single life payout option, (v) the contract was an IRA contract, (vi) the RMD Annual Income Amount for the current calendar year was $8,000, and (vii) Mary was 75. Mary s Income Benefit Base on the Income Phase Start Date would be the greater of the Account Value ($100,000) or the Income Benefit Base ($120,000). Accordingly, the Income Benefit Base would be $120,000. At age 75, the Lifetime Withdrawal Rate is 6.3%. The Lifetime Withdrawal Rate (6.3%) is multiplied by the Income Benefit Base ($120,000) to equal $7,560. Page 14 of 28 IM-22310-03 2014/06/13
Lifetime Annual Income is the greater of $7,560 or the RMD Annual Income Amount of $8,000. Because the RMD Annual Income Amount is greater, Mary s Lifetime Annual Income is $8,000. Even if $8,000 is greater than the free withdrawal amount, no Bonus Recapture, Surrender Charge, or MVA would apply. This example is only to show how the Lifetime Annual Income is computed and does not reflect what your Lifetime Annual Income would be under your contract. Income Benefit Base, Stacking Roll-up, and Interim Roll-up The Income Benefit Base increases: For purchase payments, including any Bonus on purchase payments in the first contract year. During the Stacking Roll-up Term, on each contract anniversary for the Stacking Roll-up. On each contract anniversary if on that date the Account Value is greater than the Income Benefit Base after any Stacking Roll-up, for a step-up of the Income Benefit Base to the Account Value. It may also increase on the Income Phase Start Date for the Interim Roll-up. The Income Benefit Base decreases: A Roll-up is used to compute the Benefit Base on each contract anniversary during which the Roll-up applies. The Roll-up is not interest and is not credited to your Account Value. You cannot receive the Roll-up upon a surrender or withdrawal, or as a death benefit. For withdrawals made prior to the Income Phase Start Date, proportionately by the amount of the withdrawal compared to the Account Value prior to the withdrawal. For an Excess Withdrawal, proportionately by the amount of the Excess Withdrawal compared to the Account Value prior to the Excess Withdrawal. Note that a withdrawal prior to the Income Phase Start Date and an Excess Withdrawal will reduce the Income Benefit Base by more than the amount of the withdrawal or Excess Withdrawal. In addition, any portion of a free withdrawal in excess of Lifetime Annual Income amount will be an Excess Withdrawal. On and after the Income Phase Start Date, withdrawals in a contract year that in sum are equal to or less than Lifetime Annual Income do not reduce the Income Benefit Base. The Income Benefit Base is not an amount that may be withdrawn and is not an amount payable at death or that may be annuitized. The Stacking Roll-up increases the Income Benefit Base during the Stacking Roll-up Term. The Stacking Roll-up on each contract anniversary is equal to 4% plus the sum of the interest rates applied to your Account Value weighted by allocation. The Interim Roll-up is equal to the sum of the Index Interest Rates weighted by allocation to a 5 year Index Account computed on the Income Phase Start Date. How is the Income Benefit Base computed following a withdrawal prior to the Income Phase Start Date or an Excess Withdrawal after the Income Phase Start Date? To compute the Income Benefit Base following a withdrawal prior to the Income Phase Start Date, first determine the percentage the withdrawal (including Bonus Recapture, Surrender Charge, and MVA) represents of your Account Value by dividing the amount withdrawn (including Bonus Recapture, Surrender Charge, and MVA and adjusting for interim index credits due to withdrawals from the 5 year Index Accounts) by your Account Value before the withdrawal. Next, reduce the Income Benefit Base by the same percentage. To compute the Income Benefit Base following an Excess Withdrawal after the Income Phase Start Date, first determine the amount of the Excess Withdrawal by subtracting the amount of Lifetime Annual Income from the total amount withdrawn. Next, determine the Account Value after withdrawal of Lifetime Annual Income. Then, determine the percentage the Excess Withdrawal (including Bonus Recapture, Surrender Charge, and MVA) represents of the Account Value. Finally, reduce the Income Benefit Base by the same percentage. Example Withdrawal Prior to Income Phase Start Date Assume that (i) Bill elected his Income Phase Start Date, (ii) he took a $20,000 withdrawal (including Bonus Recapture, Surrender Charge, and MVA), (iii) the Account Value at the time of his withdrawal was $100,000, and (iv) the Income Benefit Base at the time of his withdrawal was $120,000. Page 15 of 28 IM-22310-03 2014/06/13
The withdrawal is 20% of the Account Value ($20,000 / $100,000). Accordingly, the Income Benefit Base is also reduced by 20% or $24,000 ($120,000 x.20) and the new Income Benefit Base is $96,000. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. Example Withdrawal of entire Account Value Prior to Income Phase Start Date Assume that (i) Mary did not elect the Income Phase Start Date, (ii) Mary took a $100,000 withdrawal (including Bonus Recapture, Surrender Charge, and MVA), (iii) the Account Value at the time of her withdrawal was $100,000, and (iv) the Income Benefit Base at the time of her withdrawal was $120,000. The withdrawal amount is 100% of the Account Value ($100,000 / $100,000). Accordingly, the Income Benefit Base is also reduced by 100% or $120,000 ($120,000 x 100%) so the Income Benefit Base is now $0, which results in the termination of the Income Rider. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. Example Excess Withdrawal After Income Phase Start Date Assume that (i) Bill elected his Income Phase Start Date, (ii) the amount of Lifetime Annual Income was $6,600, (iii) after the Income Phase Start Date, Bill took a withdrawal of $26,600 (including Bonus Recapture, Surrender Charge, and MVA), (iv) the Account Value at the time of the withdrawal was $106,600, and (v) the Income Benefit Base at the time of the withdrawal was $120,000. The Excess Withdrawal is $20,000 ($26,600 - $6,600). Determine the Account Value before the Excess Withdrawal by subtracting the amount of Lifetime Annual Income from the Account Value ($106,600 - $6,600). The Excess Withdrawal is 20% of the Account Value prior to the Excess Withdrawal ($20,000 / $100,000). Accordingly, the Income Benefit Base is reduced by 20% or $24,000 ($120,000 x.20) and the new Income Benefit Base is $96,000. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. How is the Income Benefit Base computed on a contract anniversary during the Stacking Roll-up Term? During the Stacking Roll-up Term, on each contract anniversary, the Income Benefit Base is the greater of: (i) the Account Value on the contract anniversary or (ii) the last computed Income Benefit Base increased by the Stacking Roll-up. Thus, to compute the Income Benefit Base during the Stacking Roll-up Term, the first step is to compute the Stacking Roll-up on the contract anniversary. The following steps are taken to determine the Stacking Roll-up on a contract anniversary: Step 1. Determine the "weight" for your contract's allocation among the Fixed Account and each Index Account, as applicable, by dividing the Fixed Account Value and each Index Account Value, as applicable, by the Account Value. Step 2. For a contract anniversary, determine the weighted Fixed Account interest rate and the weighted Index Account interest rate by multiplying the weight of your contract's allocation to the Fixed Account by the current interest rate that applied that contract year, and the weight of the contract's allocation to each Index Account by the Index Interest Rate as determined that contract anniversary. If any amount is allocated to the 5 year Index Account, unless the date is the end of the Index Term, the Index Interest Rate will be zero. Step 3. Sum the interest rates weighted by allocation. Step 4. Add the 4% to the sum of the interest rates weighted by allocation calculated in Step 3. Once the Stacking Roll-up is determined, it is applied to the last computed Income Benefit Base. The result is compared to the Account Value on the contract anniversary to determine the Income Benefit Base. Example Income Benefit Base on the first contract anniversary Assume that (i) Mary s contract was issued on March 1, 2011, (ii) on March 1, 2011, her Account Value and Income Benefit Base were $100,000, (iii) $50,000 was allocated to the S&P 500 Annual Point to Point Index Account and $50,000 to the 5 year Index Account, (iv) on March 1, 2012, we determined that Page 16 of 28 IM-22310-03 2014/06/13
the S&P 500 Annual Point to Point Index Account Index Interest Rate was 1%, (v) on March 1, 2012, no index interest was credited to the 5 year Index Account because it was not the end of its Index Term, (vi) on March 1, 2012, the Account Value was $ $100,500, (vii) Mary had not taken any withdrawals, and (viii) she did not request Lifetime Annual Income. On March 1, 2012, the Stacking Roll-up would be calculated as follows: Step 1. Determine the "weight" for the contract's allocation among the Fixed Account and each Index Account For the S&P 500 Annual Point to Point Index Account: Weight of S&P 500 Annual Point to Point Index Account S&P 500 Annual Point to Point Index Account Value Account Value 50% $50,000 $100,000 For the 5 year Index Account: Weight of the 5 year Index Account 5 year Index Account Value Account Value 50% $50,000 $100,000 Step 2. Compute the interest rate weighted by allocation for the Fixed Account and each Index Account, as applicable For the S&P 500 Annual Point to Point Index Account: Weighted Interest Rate of the S&P 500 Annual Point to Point Index Account S&P 500 Annual Point to Point Index Account Value Weight x Index Interest Rate for the S&P 500 Annual Point to Point Index Account 0.5% 50% x 1% For the 5 year Index Account: Weighted Interest Rate of 5 year Index Account 5 year Index Account Value Weight x Interest Rate for the 5 year Index Account 0% 50% x 0%* *The Index Interest Rate is zero due to the fact that interest is only credited at the end of an Index Term and on March 1, 2012, the 5 year Index Account is not at the end of an Index Term. Step 3. Compute the sum of the interest rates weighted by allocation Sum of the Weighted Interest Rates Weighted Index Interest Rate of the S&P 500 Annual Point to Point Index Account + Weighted Index Interest Rate for the 5 year Index Account 0.5% 0.5% + 0% Step 4. Add the 4% The sum of the interest rates weighted by allocation and the 4% Roll-up is 4.5% (4% + 0.5%). Compute the Stacking Roll-up (4.5%) increase to the last computed Income Benefit Base ($100,000) and the increased Income Benefit Base is $104,500. Because the last computed Income Benefit Base increased by the Stacking Roll-up ($104,500) is greater than the Account Value ($100,500), the new Income Benefit Base is $104,500. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Page 17 of 28 IM-22310-03 2014/06/13
Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. Example Income Benefit Base on the fifth contract anniversary Now after five years, on March 1, 2016, assume that (i) we determined the S&P 500 Annual Point to Point Index Account Index Interest Rate was 1%, (ii) we determined the 5 year Index Account Index Interest Rate was 20% (iii) due to the rider charges that were deducted from the S&P 500 Annual Point to Point Index Account, 45% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 55% was allocated to the 5 year Index Account, (iv) Lifetime Annual Income was not requested, (v) on March 1, 2016, the Account Value was $115,000 (after interest was credited), and (vi) the last calculated Income Benefit Base was $124,000. On March 1, 2016, the Stacking Roll-up would be calculated as follows: Step 1. Determine the "weight" for the contract's allocation among the Fixed Account and each Index Account As shown above, this is done by dividing the value of each individual Index Account by the Account Value. For this example, we assumed that by March 1, 2016, 45% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 55% was allocated to the 5 year Index Account because the annual rider charge was deducted from the S&P 500 Annual Point to Point Index Account Value as it had the shortest Index Term (one year versus 5 years). Step 2. Compute the interest rate weighted by allocation for the Fixed Account and each Index Account, as applicable For the S&P 500 Annual Point to Point Index Account: Weighted Interest Rate of the S&P 500 Annual Point to Point Index Account Weight of S&P 500 Annual Point to Point Index Account Value x Index Interest Rate for the S&P 500 Annual Point to Point Index 0.45% 45% x 1% For the 5 year Index Account for the Index Term starting on March 1, 2011 and ending on March 1, 2016: Weighted Interest Rate of 5 year Index Account Weight of the 5 year Index Account Value x Index Interest Rate for the 5 year Index Account 11% 55% x 20% Step 3. Compute the sum of the interest rates weighted by allocation Sum of the Weighted Interest Rates Weighted Interest Rate of the S&P 500 Annual Point to Point Index Account + Weighted Interest Rate for the 5 year Index Account 11.45% 0.45% + 11% Step 4. Add the 4% By adding the sum of the interest rates weighted by allocation to the 4% Roll-up we get a total of 15.45% (4% + 11.45%). Compute the Stacking Roll-up (15.45%) increase to the last computed Income Benefit Base ($124,000) and the increased Income Benefit Base is $143,158. Because the last computed Income Benefit Base increased by the Stacking Roll-up ($143,158) is greater than the Account Value ($115,000), the new Income Benefit Base is $143,158. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. Page 18 of 28 IM-22310-03 2014/06/13
The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. How is the Income Benefit Base computed on the Income Phase Start Date during the Stacking Rollup Term? During the Stacking Roll-up Term, on your Income Phase Start Date, the last computed Income Benefit Base may be increased by the Interim Roll-up. Thus, to compute the Income Benefit Base during the Stacking Rollup Term, the first step is to compute the Interim Roll-up on the Income Phase Start Date. The following steps are taken to determine the Interim Roll-up on the Income Phase Start Date: Step 1. Determine the "weight" for your contract's allocation to the 5 year Index Account by dividing the 5 year Index Account Value by the Account Value. Step 2. Determine the interest rate weighted by allocations to the 5 year Index Accounts by multiplying the weight of the contract's allocations to the 5 year Index Accounts by the Index Interest Rates for the 5 year Index Accounts. Once the Interim Roll-up is determined, that rate is applied to the last computed Income Benefit Base. Example Income Benefit Base on the Income Phase Start Date Assume that (i) on the seventh contract year, on June 1, 2018, Bill requested Lifetime Annual Income, (ii) we determined the 5 year Index Account interim Index Interest Rate was 5.5%, (iii) at that time 40% of his Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 60% was allocated to the 5 year Index Account, (iv) on June 1, 2018, the Account Value was $125,000 (after interest crediting to the S&P 500 Annual Point to Point Index Account), and (v) the Income Benefit Base last computed was $137,000. On June 1, 2018, the Interim Roll-up would be calculated as follows: Step 1. Determine the "weight" for the contract's allocation to the 5 year Index Accounts As shown above, this is done by dividing the 5 year Index Account by the Account Value. For this example, we assumed that on June 1, 2018, 40% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 60% was allocated to the 5 year Index Account. Step 2. Compute the interim interest rate weighted by allocation to the 5 year Index Accounts Weighted Interest Rate of 5 year Index Account Weight of the 5 year Index Account Value x Index Interest Rate for the 5 year Index Account 3.3% 60% x 5.5% So, on June 1, 2018, the Interim Roll-up would be 3.3%. Compute the Interim Roll-up (3.3%) increase to the last computed Income Benefit Base ($137,000) and the Income Benefit Base on the Income Phase Start Date is $141,521. This example is only to show how the Income Benefit Base is computed and does not reflect what it would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. Home Healthcare Doubler Under the Home Healthcare Doubler, your Lifetime Withdrawal Rate doubles for up to five contract years if proof is submitted that you (or if you elected joint lives coverage your spouse, or in certain states civil union or domestic partners) becomes unable to perform at least two of the basic activities of daily living during this period (bathing, continence, dressing, eating, toileting, and transferring). A two-contract year waiting period applies before the Home Healthcare Doubler may be requested and it may only be elected once. As of the contract date, you or your Page 19 of 28 IM-22310-03 2014/06/13
spouse (or in certain states civil union or domestic partners), as it may apply, must have been able to perform all of the basic activities of daily living. A request for the Home Healthcare Doubler must be on forms we accept and receive. The necessary forms will require statements by a licensed doctor certifying that at least two of the basic activities of daily living cannot be performed. We require the request, along with proof, to be submitted each contract year during which the increase to the Lifetime Withdrawal Rate is sought. The Home Healthcare Doubler is not available in California, Connecticut, Maryland, Missouri, New Hampshire and Washington. What is the charge for the Income Rider? The initial rider charge is 0.95% of the Income Benefit Base. The rider charge may be changed on the 10th contract anniversary if you elect to continue the Roll-up on the 10th contract anniversary. The Income Rider charge will never exceed the guaranteed maximum rider charge of 1.80% of the Income Benefit Base. What is the Death Benefit Rider? You may purchase the Death Benefit Rider at the same time you purchase the TVA and it cannot be purchased later. You cannot terminate the rider. The Death Benefit Rider may increase the amount paid upon the death of: (i) the owner, (ii) if the owner is a nonnatural person, the annuitant, or (iii) if the TVA is jointly owned by spouses, the last death of the owner and joint owner. It may be as much as 300% (200% in NJ) of all purchase payments (not including any bonus), less any applicable premium tax if no withdrawals are taken. Withdrawals reduce the potential amount payable under the Death Benefit Rider and may cause the rider to terminate before any amount is payable upon death. The Death Benefit Rider is not available in California, Connecticut, Missouri, Nevada, New Hampshire and Washington. The following terms are keys to understanding the Death Benefit Rider: Death Benefit Base: is an amount used to determine the Guaranteed Minimum Death Benefit. It is the lesser of the Death Benefit Roll-up Amount or the Death Benefit Cap. It is not an amount that you may withdraw or apply to an annuity option. Death Benefit Base Cap: is a cap, or upper limit, used to determine the Death Benefit Base, equal to 300% (200% in NJ) of your purchase payments (not including any bonus). It is reduced by withdrawals. Death Benefit Roll-up Amount: is used only to determine the Death Benefit Base. It is reduced by withdrawals. The Death Benefit Roll-up Amount is not an amount that you may withdraw or apply to an annuity option. Excess Withdrawal: is the amount of a withdrawal. Guaranteed Minimum Death Benefit: is the greater of the death benefit computed under the contract or the Death Benefit Base. Interim Roll-up: is equal to the weighted Index Interest Rates of the 5 year Index Accounts computed when the Death Benefit Rider is payable during the Stacking Roll-up Term. Stacking Roll-up: is an annual increase to the Death Benefit Roll-up Amount during the Stacking Roll-up Term. A Rider Charge is the charge for the Income Rider. No index interest is credited on amounts taken to pay the Rider Charge at the first contract anniversary after the start of a 2 year Index Term. A Roll-up is used to compute the Benefit Base on each contract anniversary during which the Roll-up applies. The Roll-up is not interest and is not credited to your Account Value. You cannot receive the Roll-up upon a surrender or withdrawal, or as a death benefit. Stacking Roll-up Term: begins on your contract issue date and ends on the 10th contract anniversary, unless renewed for another 10 years, until you reach 80 or the Account Value is zero. If you purchase the TVA and the Death Benefit Rider after age 70, the Stacking Roll-up will be less than 10 years, but it is guaranteed to be at least 5 years unless the Account Value is zero. Guaranteed Minimum Death Benefit and Death Benefit Base The Guaranteed Minimum Death Benefit is the amount payable upon the death of: (i) the owner; (ii) if the owner is a nonnatural person, the annuitant; or (iii) if the TVA is jointly owned by spouses, the last death of the owner and joint owner. It is equal to the greater of the amount payable under the contract and the Death Benefit Base. Withdrawals reduce the potential amount payable under the Death Benefit Rider and may cause the rider to terminate before any amount is payable upon death. Page 20 of 28 IM-22310-03 2014/06/13
The Death Benefit Base is an amount used to compute the Guaranteed Minimum Death Benefit and the Death Benefit Rider charge. The Death Benefit Base is equal to the lesser of the Death Benefit Roll-up Amount and the Death Benefit Cap. The Death Benefit Base is not an amount that may be withdrawn or annuitized. Example the Guaranteed Minimum Death Benefit Assume that Mary was issued a contract on March 1, 2011 and on March 1, 2017, (i) her Account Value was $135,000, (ii) the Death Benefit Roll-up Amount was $150,000, (iii) the Death Benefit Cap was $300,000, and (iv) the Cash Surrender Value was $120,000. First, determine the Death Benefit Base by taking the lesser of the Death Benefit Roll-up Amount and the Death Benefit Cap. Because the Death Benefit Roll-up Amount of $150,000 is lower than the Death Benefit Cap of $300,000, the Death Benefit Base is equal to $150,000. Next, determine the Guaranteed Minimum Death Benefit by taking the higher of the Death Benefit Base and the amount available under the contract. The amount available under the contract is equal to the greater of the Account Value and the Cash Surrender Value. Because the Account Value of $135,000 is greater than the Cash Surrender Value of $120,000, the amount available under the contract is $135,000. Because the Death Benefit Roll-up Amount of $150,000 is higher than the amount available under the contract of $135,000, Mary s Guaranteed Minimum Death Benefit is $150,000. This example is only to show how the Guaranteed Minimum Death Benefit is calculated and does not reflect what it would be under your contract. Death Benefit Roll-up Amount, Stacking Roll-up, and Interim Roll-up The Death Benefit Roll-up Amount is used to determine the Death Benefit Base. The Death Benefit Roll-up Amount is not an amount that may be withdrawn or annuitized. The Death Benefit Roll-up Amount increases: For purchase payments, including Bonus on purchase payments in the first contract year. During the Stacking Roll-up Term, on each contract anniversary for the Stacking Roll-up. On each contract anniversary, if on that date the Account Value is greater than the Death Benefit Roll-up Amount, for a step-up to the Death Benefit Roll-up Amount to the Account Value. It may also increase if the Death Benefit Rider becomes payable for the Interim Roll-up. The Death Benefit Roll-up Amount decreases: For Excess Withdrawals, proportionately by the amount of the Excess Withdrawal compared to the Account Value prior to the withdrawal. Note that an Excess Withdrawal will reduce the Death Benefit Roll-up Amount by more than the dollar amount of the Excess Withdrawal. The Stacking Roll-up increases the Death Benefit Roll-up Amount. The Stacking Roll-up is 4% plus the sum of the interest rates applied to your Account Value weighted based on allocation. It applies on each contract anniversary during the Stacking Roll-up Term. In addition, the Interim Roll-up may apply if the Guaranteed Minimum Death Benefit is payable and you allocated any amount to the 5 year Index Accounts. How is the Death Benefit Roll-up Amount computed after an Excess Withdrawal? To compute the Death Benefit Roll-up Amount following an Excess Withdrawal, first determine the percentage the Excess Withdrawal (including Bonus Recapture, Surrender Charge, and MVA) represents of the Account Value, and then subtract this percentage from 1 (one). Finally, multiply that resulting percentage by the last calculated Death Benefit Roll-up Amount. Page 21 of 28 IM-22310-03 2014/06/13
Example Death Benefit Roll-up Amount after an Excess Withdrawal Assume that Bill took a withdrawal of $12,000 (including Bonus Recapture, Surrender Charge, and MVA), the entire amount of which is an Excess Withdrawal, that the Death Benefit Roll-up Amount last calculated was $120,000, and that the Account Value at the time of the withdrawal $110,000. The Excess Withdrawal is 10.91% of the Account Value prior to the Excess Withdrawal ($12,000 / $110,000). Accordingly, the new Death Benefit Roll-up Amount is $106,909. This example is only to show how the Death Benefit Roll-up Amount is computed and does not reflect what it would be for your annuity. How is the Death Benefit Roll-up Amount computed on a contract anniversary during the Stacking Roll-up Term? During the Stacking Roll-up Term, on each contract anniversary, the Death Benefit Roll-up Amount is the greater of: (i) your Account Value on the contract anniversary or (ii) the last computed Death Benefit Roll-up Amount increased by the Stacking Roll-up. Thus, to compute the Death Benefit Roll-up Amount during the Stacking Roll-up Term, the first step is to compute the Stacking Roll-up on the contract anniversary. The following steps are taken to determine the Stacking Roll-up on a contract anniversary: Step 1. Determine the "weight" for your contract's allocation among the Fixed Account and each Index Account, as applicable, by dividing the Fixed Account Value and each Index Account Value, as applicable, by the Account Value. Step 2. For a contract anniversary, determine the weighted Fixed Account interest rate and the weighted Index Account interest rate by multiplying the weight of the contract's allocation to the Fixed Account by the Current Interest Rate that applied that contract year, and the weight of the contract's allocation to each Index Account by the Index Interest Rate as determined that contract anniversary. If any amount is allocated to the 5 year Index Accounts, unless the date is the end of the Index Terms, the Index Interest Rates will be zero. Step 3. Sum the interest rates weighted by allocation. Step 4. Add the 4% to the sum of the interest rates weighted by allocation calculated in Step 3. Once the Stacking Roll-up is determined, it is applied to the last computed Death Benefit Roll-up Amount. The result is compared to the Account Value on the contract anniversary to determine the Death Benefit Roll-up Amount. Example Death Benefit Roll-up Amount on the first contract anniversary Assume that (i) Mary s contract was issued on March 1, 2011, (ii) on March 1, 2011 her Account Value and Death Benefit Roll-up Amount were $100,000, (iii) $50,000 was allocated to the S&P 500 Annual Point to Point Index Account and $50,000 to the 5 year Index Account, (iv) on March 1, 2012, we determined that the S&P 500 Annual Point to Point Index Account Index Interest Rate was 1%, (v) on March 1, 2012, no index interest was credited to the 5 year Index Account because it is was not the end of its Index Term, (vi) on March 1, 2012, Mary s Account Value was $100,500, (vii) Mary did not take any withdrawals, and (viii) on March 1, 2012, Mary was still alive. On March 1, 2012, the Stacking Roll-up would be computed as follows: Step 1. Determine the "weight" for the contract's allocation among the Fixed Account and each Index Account For the S&P 500 Annual Point to Point Index Account: Weight of S&P 500 Annual Point to Point Index Account S&P 500 Annual Point to Point Index Account Value Account Value 50% $50,000 $100,000 For the 5 year Index Account: Weight of the 5 year Index Account 5 year Index Account Value Account Value 50% $50,000 $100,000 Page 22 of 28 IM-22310-03 2014/06/13
Step 2. Compute the interest rate weighted by allocation for the Fixed Account and each Index Account, as applicable For the S&P 500 Annual Point to Point Index Account: Weighted Interest Rate of the S&P 500 Annual Point to Point Index Account S&P 500 Annual Point to Point Index Account Value Weight x Index Interest Rate for the S&P 500 Annual Point to Point Index Account 0.5% 50% x 1% For the 5 year Index Account: Weighted Interest Rate of 5 year Index Account 5 year Index Account Value Weight x Interest Rate for the 5 year Index Account 0% 50% x 0%* *The Index Interest Rate is zero due to the fact that interest is only credited at the end of an Index Term and on March 1, 2012, the 5 Year Annuity Linked TVI Index Account is not at the end of an Index Term. Step 3. Compute the sum of the interest rates weighted by allocation Sum of the Weighted Interest Rates Weighted Index Interest Rate of the S&P 500 Annual Point to Point Index Account + Weighted Index Interest Rate for the 5 year Index Account 0.5% 0.5% + 0% Step 4. Add the 4% The sum of the interest rates weighted by allocation and the 4% Roll-up is 4.5% (4% + 0.5%). Compute the Stacking Roll-up (4.5%) increase to the last computed Death Benefit Roll-up Amount ($100,000) and the increased Death Benefit Roll-up Amount is $104,500. Because the last computed Death Benefit Roll-up Amount increased by the Stacking Roll-up ($104,500) is greater than the Account Value ($100,500), the new Death Benefit Roll-up Amount is $104,500. This example is only to show how the Death Benefit Roll-up Amount is computed and does not reflect what it would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts Example Death Benefit Roll-up Amount on the fifth contract anniversary Now after five years, on March 1, 2016, assume that (i) we determined the S&P 500 Annual Point to Point Index Account Index Interest Rate was 1%, (ii) we determined the 5 year Index Account Index Interest Rate was 20%, (iii) due to the rider charges that were deducted from the S&P 500 Annual Point to Point Index Account, 45% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 55% was allocated to the 5 year Index Account, (iv) on March 1, 2016, the Account Value was $115,000 (after interest was credited), and (v) the last calculated Death Benefit Roll-up Amount was $124,000, and (vi) on March 1, 2016, Mary was alive. On March 1, 2016, the Stacking Roll-up would be calculated as follows: Step 1. Determine the "weight" for the contract's allocation among the Fixed Account and each Index Account As shown above, this is done by dividing the value of each individual Index Account by the Account Value. For this example, we assumed that by March 1, 2016, 45% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 55% was allocated to the 5 year Index Account because the annual rider charge is deducted from the S&P 500 Annual Point to Point Index Account Value as it had the shortest Index Term (one year versus 5 years). Page 23 of 28 IM-22310-03 2014/06/13
Step 2. Compute the interest rate weighted by allocation for the Fixed Account and each Index Account, as applicable For the S&P 500 Annual Point to Point Index Account: Weighted Interest Rate of the S&P 500 Annual Point to Point Index Account Weight of S&P 500 Annual Point to Point Index Account Value x Index Interest Rate for the S&P 500 Annual Point to Point Index 0.45% 45% x 1% For the 5 year Index Account for the Index Term starting on March 1, 2011 and ending on March 1, 2016: Weighted Interest Rate of 5 year Index Account Weight of the 5 year Index Account Value x Index Interest Rate for the 5 year Index Account 11% 55% x 20% Step 3. Compute the sum of the interest rates weighted by allocation Sum of the Weighted Interest Rates Weighted Interest Rate for the S&P 500 Annual Point to Point Index Account + Weighted Interest Rate for the 5 year Index Account 11.45% 0.45% + 11% Step 4. Add the 4% By adding the sum of the interest rates weighted by allocation to the 4% Roll-up we get a total of 15.45% (4% + 11.45%). Compute the Stacking Roll-up (15.45%) increase to the last computed Death Benefit Roll-up Amount ($124,000) and the increased Death Benefit Roll-up Amount is $143,158. Because the last computed Death Benefit Roll-up Amount increased by the Stacking Roll-up ($143,158) is greater than the Account Value ($115,000), the new Death Benefit Roll-up Amount is $143,158. This example is only to show how the Death Benefit Roll-up Amount is computed and does not reflect what it would be for your annuity. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. How is the Death Benefit Roll-up Amount computed if the Guaranteed Minimum Death Benefit is payable during the Stacking Roll-up Term? During the Stacking Roll-up Term, if the Guaranteed Minimum Death Benefit is payable, the last computed Death Benefit Roll-up Amount may be increased by the Interim Roll-up if any amounts are allocated to the 5 year Index Accounts. To compute the Interim Roll-up, first, we must compute the Index Interest Rates for the 5 year Index Accounts, which would include a vesting percentage. Note that the vesting percentage does not apply in computing the Index Interest Rate for the 5 year Index Account applied to the Account Value in connection with the death. The following steps are taken to determine the Interim Roll-up if the Guaranteed Minimum Death Benefit is payable: Step 1. Compute the 5 year Index Account Index Interest Rates for the Death Benefit Rider during the Index Term. Step 2. Determine the "weight" for the contract's allocation to the 5 year Index Accounts by dividing the 5 year Index Account Values by the Account Value. Page 24 of 28 IM-22310-03 2014/06/13
Step 3. Determine the Index Interest Rates weighted by allocation for the 5 year Index Accounts by multiplying the weight of the contract's allocation to the 5 year Index Accounts by the Index Interest Rates for the 5 year Index Accounts. Once the Interim Roll-up is determined, it is applied to the last computed Death Benefit Roll-up Amount. Example Death Benefit Roll-up Amount if the Guaranteed Minimum Death Benefit is payable Assume that in the seventh contract year, on June 1, 2018, due proof of death was received by SBL and (i) on March 1, 2016, the index value of the 5 year Index Account was $1,000 (ii) on June 1, 2018, the index value of the 5 year Index Account was 1,200, (iii) at that time 40% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 60% was allocated to the 5 year Index Account, (iv) on June 1, 2018, the Account Value was $125,000, (v) the Death Benefit Roll-up Amount on the last contract anniversary was $137,000, (vii) the annual spread for the 5 year Index Account was 3%, (vi) the participation rate for the 5 year Index Account was 100%, and (viii) for the Interim Roll-up, the vesting percentage applied in computing the Index Interest Rate for the 5 year Index Account was 40% because due proof of death was received by SBL after the second contract anniversary but before the third contract anniversary. On June 1, 2018, Interim Stacking Roll-up would be computed as follows: Step 1. Compute the 5 year Index Account Index Interest Rate during the Index Term First, compute the percentage index change as follows: Difference in Index Value 5 year Index Account Ending Index Value - 5 year Index Account Beginning Index Value 200 1200-1,000 Because the difference is positive, we determine the percentage change in index value as follows: Percentage Change in Index Value Difference in Index Value 5 year Index Account Beginning Index Value 20% 200 1,000 Because for this example an annual spread of 3% applies, we subtract annual spread for the two years and three months from the percentage change in index value of 6.75% (2.25 x 3%). - 2.25 Years of Annual Spread 13.25% 20% - 6.75% Because we received due proof of death after the second anniversary and before the third anniversary of the start of the Index Term, the vesting percentage would be 40%. Thus, we determine the Index Interest Rate for the Interim Roll-up as follows: Index Interest Rate x Vesting Percentage 5.3% 13.25% x 40% Step 2. Determine the "weight" for the contract's allocation to the 5 year Index Account As shown above, this is done by dividing the 5 year Index Account by the Account Value. For this example, we assumed that on June 1, 2018, 40% of the Account Value was allocated to the S&P 500 Annual Point to Point Index Account and 60% was allocated to the 5 year Index Account. Step 3. Compute the interest rate weighted by allocation to the 5 year Index Account For the 5 Year Annuity Linked TVI Index Account for the Index Term starting on March 1, 2016 and ending on June 1, 2018: Page 25 of 28 IM-22310-03 2014/06/13
Weighted Interest Rate of 5 year Index Account Weight of the 5 year Index Account Value x Index Interest Rate for the 5 year Index Account 3.18% 60% x 5.3% So, on June 1, 2018, the Stacking Roll-up would be 3.18%. Compute the Interim Roll-up (3.18%) increase to the last computed Death Benefit Roll-up Amount ($137,000) and the Death Benefit Base Roll-up Amount on the date due proof of death is received by SBL is $141,357. This example is only to show how the Death Benefit Roll-up Amount is computed and does not reflect what it would be for your contract. The above example assumes that you only allocate purchase payments to either the 5 Year Annuity Linked TVI Index Account or the Transparent Value Blended Index Account. Under the Total Value Annuity, you may allocate a percentage of your purchase payments to the Fixed Account and each of the Index Accounts. Death Benefit Cap The Death Benefit Cap is a cap on the Death Benefit Base. The Initial Death Benefit Cap is equal to the initial purchase payments multiplied by the Death Benefit Cap factor of 3. The Death Benefit Cap increases: For purchase payments (less any premium tax) multiplied by the Death Benefit Cap factor of 3. The Death Benefit Cap decreases: For Excess Withdrawals, proportionately by the amount of the Excess Withdrawal compared to the Account Value prior to the withdrawal. An Excess Withdrawal is the amount of any withdrawal. Note that an Excess Withdrawal will reduce the Death Benefit Cap by more than the dollar amount of the Excess Withdrawal. Example Death Benefit Cap after a Purchase Payment Assume that (i) Bill s Death Benefit Cap on March 1, 2011 was $300,000, and (ii) Bill made a new purchase payment of $10,000 on August 1, 2011. The Death Benefit Cap on August 1, 2011 would be equal to the previous Death Benefit Cap ($300,000) plus the new purchase payment multiplied by the Death Benefit Cap factor ($10,000 x 3) for a total of $330,000. This example is only to show how the Death Benefit Cap is computed and does not reflect what it would be for your annuity. Example Death Benefit Cap after an Excess Withdrawal Assume that (i) Bill had taken a withdrawal under the contract of $26,600 (including Bonus Recapture, Surrender Charge, and MVA), (ii) his Account Value at the time of the withdrawal was $106,600, and (iii) the Death Benefit Cap Amount at the time of the withdrawal was $300,000. The amount of the withdrawal that is an Excess Withdrawal is $26,600. First, determine the percentage the Excess Withdrawal (including Bonus Recapture, Surrender Charge, and MVA) represents of the Account Value, and then subtract this percentage from 1 (one). Finally, multiply that resulting percentage by the last calculated Death Benefit Cap. The Excess Withdrawal is 24.95% of the Account Value prior to the Excess Withdrawal ($26,600 / $106,600). The new Death Benefit Cap is $225,141. This example is only to show how the Death Benefit Cap is computed and does not reflect what it would be for your annuity. Page 26 of 28 IM-22310-03 2014/06/13
What is the charge for the Death Benefit Rider? The initial Rider Charge is 0.95% of the Death Benefit Base. The rider charge may be changed on the renewal of the Stacking Roll-up but will never exceed the guaranteed maximum rider charge of 1.80% of the Death Benefit Base. How will annuity payments and withdrawals from my annuity be taxed? Interest credited on your annuity is tax-deferred. This means you do not pay taxes on the interest credited to your annuity until the money is paid to you. Your annuity earns interest tax-deferred, so you do not pay taxes on the interest earned under your contract until the money is paid to you. When you take annuity payments or make a withdrawal, you pay ordinary income taxes on the interest earned (and on the principal if the contract is tax qualified). You may also pay a 10% federal income tax penalty on amounts you withdraw before attaining age 59½, if they do not meet certain exceptions such as disability, health insurance expenses, medical expenses, or first-time home buyer expenses. However, this document is not intended to provide tax advice. You should consult your tax advisor to determine if your particular circumstances qualify as an exception to the 10% penalty tax. If your state imposes a premium tax, it will be deducted from the money you receive. You can exchange one tax-deferred annuity for another without paying income taxes on the earnings when you make the exchange. (Taxes may be assessed if you withdraw from the annuity that you exchanged into prior to the expiration of a 180-day period.) Before you make such an exchange, compare the benefits, features, and costs of the two annuities. You should consult a tax advisor to discuss the tax treatment of the benefits payable under the Income Rider or Death Rider, and the tax treatment of making exchanges or withdrawals to determine any potential tax consequences. A Rider Charge is the charge for the Death Benefit Rider. No index interest is credited on amounts taken to pay the Rider Charge at the first contract anniversary after the start of a 2 year Index Term. This guide is not intended to provide tax advice. You should consult your tax adviser to discuss your particular circumstances. Does buying an annuity in a retirement plan provide extra tax benefits? No. Buying an annuity within an IRA, 401(k), or other tax-deferred retirement plan does not give you any extra tax benefits. You should choose your annuity based on its features and benefits as well as its risks and costs, not on tax benefits alone. Important Information About Replacement A replacement occurs when funds are taken from an existing annuity contract or life insurance policy, whether by a loan, a partial withdrawal (including a free withdrawal), or a full surrender, and those funds are used to purchase a new annuity contract (or life insurance policy). The withdrawal of funds and the purchase of the new annuity contract need not occur simultaneously for the transaction to constitute a replacement. Some state laws specify that a replacement has occurred if funds taken from an existing annuity contract or life insurance policy are used to purchase a new annuity contract up to a year later. Replacement of an existing annuity contract or life insurance policy is something that should be considered carefully. You should weigh the benefits and costs of the existing contract or policy against those of the Total Value Annuity to determine whether the replacement would better serve your insurance needs and financial objectives. Page 27 of 28 IM-22310-03 2014/06/13
Statement of Understanding Effective Date: June 13, 2014 Please send this original, signed signature page to Security Benefi t with the Application, provide the client with a copy of the entire signed SOU, and retain a copy for your records. How can I reach Security Benefit? You can reach us in several ways: By Phone: 1.800.888.2461 By E-mail: annuityprocessing@securitybenefi t.com On the web: www.securitybenefi t.com By mail: One Security Benefi t Place Topeka, KS 66636-0001 Applicant Acknowledgment By signing below, I certify that: I have read the above information and it has been explained to me by the producer. I understand the features of the Total Value Annuity described. I understand that certain withdrawals, surrenders, and payments made during the Surrender Charge Period will be subject to a Market Value Adjustment (in most states), Surrender Charge, and Bonus Recapture. I understand that any values shown are for explanatory purposes only and are not guaranteed. I understand that the producer will be compensated if I purchase the annuity. I understand that I should consult my tax advisor regarding possible tax implications of the purchase, sale, surrender, and annuitization of an annuity and, if it applies, the exchange of an existing annuity or life insurance contract. Complete the following acknowledgements (refer to the Important Information About Replacement on page 26): Applicant: I acknowledge that a replacement is is not occurring by my purchase of the Total Value Annuity. Applicant s initials Joint Applicant s initials (if applicable) Producer: I acknowledge that a replacement is is not occurring by the applicant s purchase of the Total Value Annuity. Producer s initials Applicant signature Date Social Security number Joint Applicant signature Date Producer Acknowledgment By signing below, I certify that I have reviewed the above information with the Applicant and provided him or her with a signed copy of this document. I also certify that I have not made any statements that differ from what is stated in this document and that no promises or assurances were given as to the future value of any nonguaranteed elements of the Total Value Annuity. Producer signature Date Page 28 of 28 IM-22310-03 2014/06/13
S&P is a registered trademark of Standard & Poor s Financial Services LLC ( S&P ) and Dow Jones is a registered trademark of Dow Jones Trademark Holdings LLC ( Dow Jones.) These trademarks have been licensed for use by S&P Dow Jones Indices LLC. S&P and S&P 500 are trademarks of S&P and have been sublicensed for certain purposes by Security Benefi t Life Insurance Company. The Security Benefi t Total Value Annuity is not sponsored, endorsed, sold or promoted by S&P Dow Jones Indices LLC, Dow Jones, S&P or their respective affi liates make any representation regarding the advisability of purchasing such product. The Annuity Linked TVI (the ALTVI ) is derived from the Trader Vic Index - Excess Return (or TVI ). The ALTVI has a volatility control overlay that is adjusted daily based on recent historical volatility, so that more volatility generally leads to reduced exposure to the TVI and less volatility generally leads to more exposure.* The overlay may thus reduce or increase the potential positive change in the ALTVI relative to the TVI and thus may lessen or increase the interest that will be credited to a fi xed index annuity allocated to the ALTVI relative to one allocated to the TVI (which is not available). The overlay also reduces the cost to hedge the interest crediting risk to Security Benefi t Life Insurance Company ( SBL ). As a result, SBL may be able to offer a higher cap, higher participation rate, or lower spread on the ALTVI as a crediting option within a fi xed index annuity relative to what it would be able to offer with the TVI as a crediting option. The cost for the volatility control overlay and maintaining the ALTVI is 1.25% per annum. RBS collects this daily through an up-front pro rata deduction from the TVI in calculating the ALTVI. * As low as 10% (in the event of very high volatility) to as high as 150% (in the event of very low volatility). Historical average as of December 31, 2013 95.8%. TVI, TVI Index, Trader Vic Index, and EAM are trademarks of EAM Partners L.P. ( EAM ) and have been licensed for use by Security Benefi t Life Insurance Company. EAM created and owns rights to the methodology that is employed in connection with the Trader Vic Index. The Annuity Linked TVI Index, ALTVI, RBS, The Royal Bank of Scotland and the DAISY device logo are trademarks of The Royal Bank of Scotland Group plc and The Royal Bank of Scotland plc (together, RBS ) and have been licensed for use by Security Benefi t Life Insurance Company. This product is not sponsored, endorsed, sold or promoted by either EAM or RBS, and neither EAM nor RBS make any representation regarding the advisability of purchasing these products. The Transparent Value Blended Index SM (the Index ) is the property of Transparent Value, LLC, which has contracted with S&P Dow Jones Indices LLC or its affi liate ( S&PDJI ) to maintain and calculate the Index. Transparent Value, LLC and S&PDJI shall have no liability for any errors or omissions in calculating the Index. The Transparent Value Blended Index Account based on the Index is not sponsored, endorsed, sold or promoted by Transparent Value, LLC, S&P Dow Jones Indices LLC, its affi liates or their third party licensors and neither Transparent Value, LLC, S&P Dow Jones Indices LLC, its affi liates nor their its third party licensors make any representation regarding the advisability of allocating to the Transparent Value Blended Index Account. The Total Value Annuity is not: (i) a deposit, (ii) FDIC insured, (iii) guaranteed by a bank or credit union, or (iv) insured by any federal government agency or NCUA/NCUSIF. This Statement of Understanding describes the Security Benefi t Total Value Annuity, a fi xed index fl exible premium deferred annuity contract and its optional riders, the Guaranteed Lifetime Withdrawal Benefi t Rider Income Rider and the Guaranteed Minimum Death Benefi t Rider Death Benefi t Rider. In most states, the Total Value Annuity is issued on form 5700 (3-12), the Income Rider is issued on form 5720 (3-12), and the Death Benefi t Rider on form 5721 (3-12). In Alaska, Indiana, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah and Washington the Total Value Annuity form is ICC12 5700 (3-12), and in the states in which the Home Healthcare Doubler is not available (except California and Maryland), the Income Rider form is ICC12 5720 (3-12). 2014 Security Benefi t Life Insurance Company. All rights reserved. TO AND THROUGH RETIREMENT 1.800.888.2461 One Security Benefit Place, Topeka, KS 66636-0001 securitybenefit.com IM-22310-03 2014/06/13