Document:

Exhibit 4(b)

 

Individual Modified Guaranteed Annuity
Contract

 

Account Value is subject to a Market Value Adjustment

Non-Participating

This is a legal Contract

Read Your Contract Carefully

 

The Company agrees with the Owner to provide the benefits as described
in this Contract.

 

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT.  You may cancel this Contract within twenty
days after you receive it by returning the Contract to our Home Office or to
our Agent, with a written request for cancellation. The Contract will be as
though it had never been issued. We will promptly return any Annuity Deposit
made.

 

 

	
  /s/ John D. Johns

  	
   

  	
  /s/ Deborah J. Long

  
	
  President

  	
   

  	
  Secretary

  

 

 

	
  PROTECTIVE LIFE INSURANCE COMPANY

  
	
  P. O. Box 2606

  
	
  Birmingham, Alabama 35202

  
	
  (205) 879-9230

  
	
  (A Stock Insurance Company)

  

 

	
  Form No. IPD-2083

  	
  12/97

  

 

 

SCHEDULE

 

	
  John J. Doe

  	
   

  	
  None

  
	
  Owner

  	
   

  	
  Joint Owner

  
	
   

  	
   

  	
   

  
	
  John J. Doe

  	
   

  	
   February 14, 2000

  
	
  Annuitant

  	
   

  	
  Annuity Commencement Date

  
	
   

  	
   

  	
   

  
	
  PX00000001

  	
   

  	
   February 12, 2000

  
	
  Contract Number

  	
   

  	
  Effective Date

  

 

	
   

  	
   

  	
  Guaranteed

  	
   

  	
  Guaranteed

  	
   

  	
  Annuity

  	
   

  	
  Treasury

  	
   

  
	
  Sub-Account #

  	
   

  	
  Period

  	
   

  	
  Interest Rate

  	
   

  	
  Deposit

  	
   

  	
  Rate

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  PX0000000001-AA

  	
   

  	
  10 Years

  	
   

  	
  6.00

  	
  %

  	
  $

  	
  700,000.00

  	
   

  	
  5.88

  	
  %

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Total Annuity Deposit

  	
   

  	
   

  	
   

  	
   

  	
   

  	
  $

  	
  700.000.00

  	
   

  	
   

  	
   

  

 

Separate Account

The
assets supporting this Contract are held in a Separate Account. All values will
be determined as provided in the Contract, without regard to the actual
investment performance of the Separate Account.

 

Surrender Charge

The
Surrender Charge is equal to the Surrender Charge Percentage indicated below,
applied to the amount of each full or partial surrender requested less any
amount available under the “Interest
Withdrawal” provision of this Contract at the time of the
surrender.

 

	
  Number of Completed Years

  in a Guaranteed Period

  	
   

  	
  Surrender Charge

  Percentage

  	
   

  
	
  0

  	
   

  	
  6

  	
  %

  
	
  1

  	
   

  	
  6

  	
  %

  
	
  2

  	
   

  	
  5

  	
  %

  
	
  3

  	
   

  	
  4

  	
  %

  
	
  4

  	
   

  	
  3

  	
  %

  
	
  5

  	
   

  	
  2

  	
  %

  
	
  6

  	
   

  	
  1

  	
  %

  
	
  7+

  	
   

  	
  0

  	
  %

  

 

	
  IPD-2083

  	
  10/99

  

 

2

 

Market Value Adjustment

The
Market Value Adjustment is equal to the Market Value Adjustment Percentage
indicated below, applied to the amount of each full or partial surrender
requested less any amount available under the “Interest Withdrawal” provision of this Contract at the time of the
surrender.

 

Market Value Adjustment Percentage = (C - I +
0.25%) x (N/12), where:

 

C =
the Treasury Rate currently established for the same term as the Guaranteed
Period from which the surrender is being made;

 

I = the
Treasury Rate initially established for the Guaranteed Period from which the surrender
is being made;

 

N = The number of months remaining in the Guaranteed Period from which the
surrender is being made.

 

The
Treasury Rate is the annual effective interest rate credited to United States
Treasury instruments, as published by a nationally recognized source. On the
fifteenth day and the last day of each month, the Company will identify a
Treasury Rate for each Guaranteed Period. The method used by the Company to
determine the Treasury Rates under this Contract shall be consistent and is binding
upon any Owner, Annuitant and Beneficiary.

 

INDEX

 

	
  Schedule

  	
  2

  
	
  Definitions

  	
  4

  
	
  General Provisions

  	
  6

  
	
  Control Provisions

  	
  7

  
	
  Interest Credited and
  Guaranteed Periods

  	
  9

  
	
  Premium Taxes

  	
  8

  
	
  Surrenders - Termination

  	
  8

  
	
  Annuity Options

  	
  10

  
	
  Annuity Tables

  	
  11

  

 

	
  IPD-2083

  	
  10/99

  

 

3

 

DEFINITIONS

 

Account Value - The sum of all Sub-Account Values.

 

Annuitant - Annuity payments may depend upon the continuation of the life of a person. That
person is called an Annuitant and is named on the Schedule.

 

Annuity - A series of predetermined periodic payments.

 

Annuity Commencement Date -The
date on which annuity payments begin. It is shown on the Schedule.

 

Annuity Deposit(s) - Annuity Deposits (less Premium Taxes, if applicable) made and allocated
to the Guaranteed Period(s) you select under this Contract. Each Annuity
Deposit and each allocation to a Guaranteed Period must be at least $10,000. We
reserve the right to limit the amount of your Annuity Deposits. Only one Contract
will be issued regardless of the number of Annuity Deposits you make.

 

Beneficiary - The person entitled to receive the benefits under this Contract, if
any, upon the death of any Owner.

 

Primary - The person named to receive the death benefits upon any Owner’s death.
Upon the death of any Owner, the surviving Owner, if any, will become the
Primary Beneficiary.

 

Contingent - The person named to receive the death benefits if the Primary
Beneficiary is not living at the time of an Owner’s death. If no Beneficiary
designation is in effect or if no Beneficiary is living at the time of an Owner’s
death, the Estate of the deceased Owner will be the Beneficiary.

 

Irrevocable - An irrevocable Beneficiary is one whose consent is needed to change the
Beneficiary designation, or to exercise certain other rights.

 

Effective Date - The date shown on the Schedule and on which this Contract takes effect.
Contract Years are measured from the Effective Date.

 

Company - Protective Life Insurance Company.

 

Guaranteed Period - The period for which either an Initial or Subsequent Guaranteed
Interest Rate will be credited to a Sub-Account under this Contract. Guaranteed
Periods will be designated as being either “Initial” or “Subsequent”.

 

Home Office - 2801 Highway 280 South, Birmingham, Alabama.

 

Initial Guaranteed Interest Rate - The effective rate of interest, calculated after daily compounding has
been taken into account, which is used in determining the interest credited to
a Sub-Account during the Initial Guaranteed Period. This rate is specified in
the Schedule.

 

4

 

Market Value Adjustment - The adjustment made to a Sub-Account Value
when a partial or full surrender is requested prior to the end of an Initial or
Subsequent Guaranteed Period. The Market Value Adjustment is explained on the
Schedule.

 

Net Account Value - The sum of all Net Sub-Account Values.

 

Net Sub-Account Value - The Sub-Account Value after application of
the Market Value Adjustment and less any deductions for any Surrender Charges
and applicable Premium Taxes.

 

Owner - The
Owner(s) of the Contract. Herein referred to as “you” or “your”.

 

Sub-Account - Each Annuity Deposit will be allocated to one or more Sub-Accounts as
directed by the Owner. Each Sub-Account will correspond to a specified
Guaranteed Period and guaranteed interest rate you select.

 

Sub-Account Value -The
amount equal to that part of the Annuity Deposit allocated by the Owner to a
Sub-Account or any amount transferred to a Sub-Account or Sub-Accounts at the
end of a Guaranteed Period increased by all interest credited and decreased by
amounts due to previous full or partial surrenders (including Surrender
Charges, Market Value Adjustments and Premium Taxes thereon) and previous
interest withdrawals. The Sub-Account Value of each Sub-Account under this
Contract must be at least $10,000 at all times.

 

Subsequent Guaranteed Interest Rate - The effective rate of interest, calculated
after daily compounding has been taken into account, which is established by
the Company for any applicable Subsequent Guaranteed Period.

 

Surrender Charge - A Surrender Charge, if applicable, is deducted from any Sub-Account
Value from which a partial or full surrender is made prior to the end of an
Initial or Subsequent Guaranteed Period. The Surrender Charge is explained on
the Schedule.

 

Surrender Date - The date the Company receives a written request for a full or partial
surrender.

 

Surrender Value - The amount available for a full or partial surrender.

 

We, Us, Our - Protective Life Insurance Company.

 

Writing - A written form satisfactory to the Company and filed at the Home Office
of the Company in Birmingham, Alabama. All correspondence should be sent to P. O.
Box 10648, Birmingham, Alabama 35202-0648.

 

5

 

GENERAL PROVISIONS

 

Entire Contract

This
Contract, any endorsements attached hereto, and the Application, a copy of
which is attached, constitute the entire contract. All statements in the
application, shall be deemed representations and not warranties.

 

Modification of Contract

No
change or waiver of the terms of this Contract is valid unless made by us, in
Writing, and approved by our President, Vice President, or Secretary. We
reserve the right to change the provisions of this Contract to conform to any
applicable laws, regulations or rulings issued by a governmental agency.

 

Non-Participating

This
Contract does not share in our surplus or profits and does not pay dividends.

 

Error In Age or Sex

Questions
in the Application concern the Annuitant’s date of birth and sex. If the date
of birth or sex given is not correct, the benefits under this Contract shall be
adjusted to the amount which would have been payable at the correct age and
sex. If we made any underpayments on account of any misstatement, the amount of
any underpayment shall be immediately paid in one sum. Any overpayments made
shall be deducted from the current or succeeding payments due under the
Contract.

 

Assignment

Upon
notice to us, the Owner may assign his or her rights under this Contract. The
assignment must be in Writing. We assume no responsibility for the validity of
any assignment. Any claim under any assignment shall be subject to proof of
interest and the extent of the assignment.

 

Settlement

Any
payment by us under this Contract is payable at our Home Office. The Owner may
elect to apply settlement proceeds, including any full or partial surrender
proceeds or the death benefit, to any payout option offered by us for such
payments at the time the election is made.

 

Facility of Payment

If
the Annuitant or Beneficiary is incapable of giving a valid receipt for any
payment, we may make such payment to whoever has assumed his or her care and
principal support. Any such payment shall fully discharge us to the extent of
that payment.

 

Proof of Age

Proof
of age is required before the first payment will be made under an Annuity
Option involving lifetime payments.

 

6

 

Protection of Proceeds

To
the extent permitted by law, no benefits payable under this Contract will be
subject to the claims of creditors of any payee.

 

Annual Reports

At
least once every year, we will send you a report showing the current Account
Value, Sub-Account Values and interest credited.

 

Annuity Commencement Date Changes

Upon
notification in Writing, you may change the Annuity Commencement Date.
Notification must be received at least 30 days before the proposed Annuity
Commencement Date. The proposed Annuity Commencement Date you select cannot be
before the end of any Guaranteed Period or later than the Contract Year closest
to the Annuitant’s 85th Birthday.

 

Minimum Value Statement

Any
values available under the “Surrenders-Termination” provisions of this Contract
equal or exceed those required by the state in which the Contract is delivered.

 

CONTROL PROVISIONS

 

Annuitant

The
Owner may change the Annuitant prior to the Annuity Commencement Date. The
request must be in Writing. Once it is received and acknowledged at our Home
Office, any change will relate back to and take effect on the date the request
was signed. The Annuitant is the “Payee” for the purposes of the Annuity Table.

 

Beneficiary

The
Beneficiary will be as shown in the Application. You may change the Beneficiary
at any time. To make a change, we must receive a written request satisfactory
to us at our Home Office. If the Beneficiary has been designated irrevocably,
however, such designation cannot be changed or revoked without that Beneficiary’s
written consent. Any such change will relate back to and take effect on the
date the request was signed. We will not be liable for any payment we make
before such request has been received and acknowledged at our Home Office. Any
payment that has become due under this Contract and has not been paid prior to
an Owner’s death shall be paid to the Primary Beneficiary, if living; otherwise
to the Contingent Beneficiary.

 

Control

You
may, while the Annuitant is living, assign the Contract; surrender the
Contract; amend or modify the Contract with our consent; exercise, receive and
enjoy every other right and benefit contained in the Contract. The use of the
rights may be subject to the consent of any assignee or irrevocable
Beneficiary. Except with respect to termination, Joint Owners may provide that
each Owner alone may exercise all rights, options and privileges.

 

7

 

Death of the Annuitant or Owner

If
an Annuitant is not an Owner and dies prior to the Annuity Commencement Date,
the Owner first named on the Application will become the new Annuitant unless
the Owner designates otherwise. If any Owner is not a natural person, the death
or change of the Annuitant will be treated as the death of an Owner. If any
Owner dies while this Contract is in force prior to the Annuity Commencement
Date, a Death Benefit will be payable to the Beneficiary.

 

Death Benefit

The
Death Benefit will be determined as of the date due proof of death is received
by the Company. If a claim for the Death Benefit is received at our Home Office
within 6 months of the date of death, the Death Benefit will equal the greater
of: (1) the Account Value, less applicable Premium Taxes; or (2) the
Net Account Value. If a claim is received past 6 months after the date of
death, the Death Benefit will equal the Net Account Value. If any Owner of this
Contract is not a natural person, upon the change of the Annuitant, the Death
Benefit will equal the Net Account Value. Only one Death Benefit is payable
under this Contract, even though the Contract may continue beyond an Owner’s
death.

 

The
Death Benefit may be taken in one sum immediately. In all events the entire
Death Benefit, including any interest accrued thereon, must be distributed
within five years of the date of death unless:

 

(a)                                  it is payable over the life of the Beneficiary
with distributions beginning within one year of the date of death; or

 

(b)                                 it is payable over a period not extending
beyond the life expectancy of the Beneficiary with distributions beginning
within one year of the date of death; or

 

(c)                                  the deceased Owners spouse is the Beneficiary
and, in lieu of receiving the Death Benefit, continues the Contract and becomes
the new Owner.

 

If
the deceased Owner’s spouse continues the Contract and becomes the new Owner,
upon such spouse’s death, a Death Benefit will become payable to the new
Beneficiary (determined at the time of the spouse’s death). The Death Benefit,
including any interest accrued thereon, must be distributed within five years
of the spouse’s death.

 

PREMIUM TAXES

Premium
Taxes (including any related retaliatory taxes, if any) will be deducted, if
applicable. Premium Taxes may be deducted, as provided under applicable law,
from the Annuity Deposit when received, upon full or partial surrender, or from
the amount applied to effect an Annuity at the time the annuity payments
commence. Premium Taxes may also be deducted from the Death Benefit.

 

SURRENDERS - TERMINATION

Full
surrenders may be made at any time. Partial surrenders may only be made if each
remaining Sub-Account Value is at least $10,000. You must specify the
Sub-Accounts from

 

8

 

which
the partial surrender is to be made. If a Sub-Account has the same Guaranteed
Period as any other Sub-Account, the partial surrender must come from the Sub-Account
with the shortest time remaining in the Guaranteed Period.

 

Surrender
Charges and Market Value Adjustments will not apply to full or partial
surrenders made at the end of an Initial or Subsequent Guaranteed Period. The
Surrender Value will equal the Sub-Account Value on this date. A request for a
surrender at the end of an Initial or Subsequent Guaranteed Period must be
received in Writing within twenty days prior to the end of such Initial or
Subsequent Guaranteed Period.

 

The
Surrender Value will be calculated by the Company using the following formula:

 

(A - S - M - P), where:

 

	
  A =

  	
  the
  amount of the full or partial surrender;

  
	
  S =

  	
  the
  amount of Surrender Charge;

  
	
  M =

  	
  the
  amount of the Market Value Adjustment;

  
	
  P =

  	
  the
  amount of unpaid Premium Taxes, if any.

  

 

The
Company may defer payment of any partial or full surrender for the period
permitted by law. In no event will this deferral of payment exceed 6 months
from the date of receipt of the election to surrender partially or fully.

 

Interest Withdrawals

If
you notify the Company in Writing at any time during the current Contract Year,
the Company will send you all or portion of the interest credited during the
prior Contract Year. You may only make one withdrawal during a Contract Year.
No Surrender Charge or Market Value Adjustment will be imposed on such Interest
Withdrawals.

 

INTEREST CREDITED AND GUARANTEED PERIODS

 

The
portion of each Annuity Deposit allocated to a Sub-Account will earn interest
at the Initial Guaranteed Interest Rate for each Contract Year during the
Initial Guaranteed Period selected for that Sub-Account. A Guaranteed Period is
the period of years for which a rate of interest is guaranteed. You may select
from any Guaranteed Period offered by the Company under the Contract at the
time the Annuity Deposit or transfer is made. However, Guaranteed Periods
cannot extend beyond the Annuity Commencement Date then in effect.

 

You
may not transfer a Sub-Account Value to any other Sub-Account(s) prior to
the end of the existing Sub-Account’s Guaranteed Period. At the end of any
Guaranteed Period a Subsequent Guaranteed Period will begin. Unless you elect a
different duration from among those then offered by us within twenty days prior
to the end of the Guaranteed Period, your Sub-Account Value will be
automatically transferred to a Subsequent Guaranteed Period of either (1) the
same duration as your previous Guaranteed Period, if then offered by us; or (2)

 

9

 

the
shortest duration then offered by us which is closest to the same duration as
your previous Guaranteed Period.

 

Your
Sub-Account Value at the beginning of any Subsequent Guaranteed Period will be
equal to your Sub-Account Value at the end of the previous Guaranteed Period.
The Sub-Account Value will earn interest at the Subsequent Guaranteed Interest
Rate for each Contract Year in the Subsequent Guaranteed Period. At your
request within twenty days prior to the end of any Guaranteed Period, the
Company will notify you of the then effective Subsequent Guaranteed Interest
Rate. The actual Subsequent Guaranteed Interest Rate will be determined at the
beginning of the Subsequent Guaranteed Period.

 

ANNUITY OPTIONS

 

Annuity Benefit

If
the Annuitant is alive on the Annuity Commencement Date and unless directed
otherwise, the Company will apply the Net Account Value according to the
Annuity Option elected.

 

You
may elect to have all or a part of the Net Account Value applied on the Annuity
Commencement Date under any of the Annuity Options described below. In the
absence of an election, the Net Account Value will be applied on the Annuity
Commencement Date under Option 2 - Life Income with Payments for a 10 Year
Guaranteed Period.

 

Elections
of any of these options must be made in Writing to the Company at least 30 days
prior to the date such election is to become effective.

 

If
an Annuitant or Owner dies on or after the Annuity Commencement Date any
remaining payments will be distributed at least as rapidly as under the method
of distribution being used on the date of death.

 

An
Annuity affected under this Contract may not be surrendered after the
commencement of annuity payments.

 

Annuity Options

 

Option 1 - Payment For a Fixed Period. Equal monthly payments will be made for any
period of not less than 5 nor more than 30 years. The amount of each payment
depends on the total amount applied, the period selected and the monthly
payment rates we are using when the first payment is due.

 

Option 2 - Life Income with Payments for a Guaranteed Period. Equal monthly payments are based on the life
of the named Annuitant. Payments will continue for the lifetime of that person
with payments guaranteed for 10 or 20 years. Payments stop at the end of the
selected guaranteed period or when the named person dies, whichever is later.

 

10

 

Option 3 - Payments of a Fixed Amount. Equal
monthly payment will be made for an agreed fixed amount. The amount of each
payment may not be less than $10 for each $1,000 applied. Interest will be
credited each month on the unpaid balance and added to it. This interest will
be at a rate set by us, but not less than an effective interest rate of 4% per
year. Payments continue until the amount we hold runs out. The last payment will
be for the balance only.

 

Minimum Amounts - We reserve the right to pay the
full amount of this Contract in one lump sum, if less than $5,000. If monthly
payments are less than $100 we may make payments quarterly, semi-annually, or
annually, at our option.

 

All elected Annuity Options must comply with current Federal and state
statutes and Internal Revenue Service Regulations. If we have available, at the
time an Annuity Option is elected options or rates on a more favorable basis
than those guaranteed, the higher benefits shall apply.

 

Annuity Tables

The attached Annuity Tables show the dollar amount of the monthly
payments for each $1,000 applied. The tables are based on the 1983 Individual
Annuitant Mortality Table A projected 4 years with interest at 4% per annum.
One year will be deducted from the attained age of the Annuitant for every
completed three years beyond the year 1987.

 

Individual Modified Guaranteed Annuity Contract

 

Account Value is subject to a Market Value
Adjustment

Non-Participating

This is a legal Contract

Read Your Contract Carefully

 

	
  IPD-2083

  	
  12/97

  

 

11

 

MINIMUM
MONTHLY PAYMENT RATES FOR EACH $1,000 APPLIED

 

	
  OPTION 1 TABLE

  Payments for a

  Fixed Period

  	
   

  	
   

  	
   

  	
  OPTION 2 TABLE

  Life Income with Payments

  for a Guaranteed Period

  	
   

  
	
   

  	
   

  	
  Monthly

  	
   

  	
  Age of

  	
   

  	
  10 Years

  	
   

  	
  20 Years

  	
   

  
	
  Years

  	
   

  	
  Payment

  	
   

  	
  Payee

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  5

  	
   

  	
  18.32

  	
   

  	
  59

  	
   

  	
  5.29

  	
   

  	
  4.83

  	
   

  	
  4.98

  	
   

  	
  4.68

  	
   

  
	
  6

  	
   

  	
  15.56

  	
   

  	
  60

  	
   

  	
  5.40

  	
   

  	
  4.92

  	
   

  	
  5.04

  	
   

  	
  4.74

  	
   

  
	
  7

  	
   

  	
  13.59

  	
   

  	
  61

  	
   

  	
  5.51

  	
   

  	
  5.01

  	
   

  	
  5.10

  	
   

  	
  4.81

  	
   

  
	
  8

  	
   

  	
  12.12

  	
   

  	
  62

  	
   

  	
  5.63

  	
   

  	
  5.10

  	
   

  	
  5.17

  	
   

  	
  4.88

  	
   

  
	
  9

  	
   

  	
  10.97

  	
   

  	
  63

  	
   

  	
  5.75

  	
   

  	
  5.21

  	
   

  	
  5.24

  	
   

  	
  4.95

  	
   

  
	
  10

  	
   

  	
  10.06

  	
   

  	
  64

  	
   

  	
  5.88

  	
   

  	
  5.32

  	
   

  	
  5.30

  	
   

  	
  5.02

  	
   

  
	
  11

  	
   

  	
  9.31

  	
   

  	
  65

  	
   

  	
  6.02

  	
   

  	
  5.43

  	
   

  	
  5.37

  	
   

  	
  5.09

  	
   

  
	
  12

  	
   

  	
  8.69

  	
   

  	
  66

  	
   

  	
  6.16

  	
   

  	
  5.55

  	
   

  	
  5.43

  	
   

  	
  5.17

  	
   

  
	
  13

  	
   

  	
  8.17

  	
   

  	
  67

  	
   

  	
  6.31

  	
   

  	
  5.68

  	
   

  	
  5.49

  	
   

  	
  5.24

  	
   

  
	
  14

  	
   

  	
  7.72

  	
   

  	
  68

  	
   

  	
  6.47

  	
   

  	
  5.82

  	
   

  	
  5.55

  	
   

  	
  5.31

  	
   

  
	
  15

  	
   

  	
  7.34

  	
   

  	
  69

  	
   

  	
  6.63

  	
   

  	
  5.97

  	
   

  	
  5.60

  	
   

  	
  5.38

  	
   

  
	
  16

  	
   

  	
  7.00

  	
   

  	
  70

  	
   

  	
  6.79

  	
   

  	
  6.12

  	
   

  	
  5.65

  	
   

  	
  5.45

  	
   

  
	
  17

  	
   

  	
  6.71

  	
   

  	
  71

  	
   

  	
  6.96

  	
   

  	
  6.28

  	
   

  	
  5.70

  	
   

  	
  5.51

  	
   

  
	
  18

  	
   

  	
  6.64

  	
   

  	
  72

  	
   

  	
  7.13

  	
   

  	
  6.45

  	
   

  	
  5.74

  	
   

  	
  5.58

  	
   

  
	
  19

  	
   

  	
  6.21

  	
   

  	
  73

  	
   

  	
  7.31

  	
   

  	
  6.63

  	
   

  	
  5.78

  	
   

  	
  5.64

  	
   

  
	
  20

  	
   

  	
  6.00

  	
   

  	
  74

  	
   

  	
  7.48

  	
   

  	
  6.81

  	
   

  	
  5.82

  	
   

  	
  5.69

  	
   

  
	
  21

  	
   

  	
  5.81

  	
   

  	
  75

  	
   

  	
  7.66

  	
   

  	
  7.00

  	
   

  	
  5.85

  	
   

  	
  5.74

  	
   

  
	
  22

  	
   

  	
  5.64

  	
   

  	
  76

  	
   

  	
  7.84

  	
   

  	
  7.20

  	
   

  	
  5.88

  	
   

  	
  5.78

  	
   

  
	
  23

  	
   

  	
  5.49

  	
   

  	
  77

  	
   

  	
  8.02

  	
   

  	
  7.40

  	
   

  	
  5.90

  	
   

  	
  5.82

  	
   

  
	
  24

  	
   

  	
  5.35

  	
   

  	
  78

  	
   

  	
  8.20

  	
   

  	
  7.60

  	
   

  	
  5.92

  	
   

  	
  5.85

  	
   

  
	
  25

  	
   

  	
  5.22

  	
   

  	
  79

  	
   

  	
  8.37

  	
   

  	
  7.81

  	
   

  	
  5.94

  	
   

  	
  5.88

  	
   

  
	
  26

  	
   

  	
  5.10

  	
   

  	
  80

  	
   

  	
  8.54

  	
   

  	
  8.10

  	
   

  	
  5.96

  	
   

  	
  5.91

  	
   

  
	
  27

  	
   

  	
  5.00

  	
   

  	
  81

  	
   

  	
  8.70

  	
   

  	
  8.21

  	
   

  	
  5.97

  	
   

  	
  5.93

  	
   

  
	
  28

  	
   

  	
  4.90

  	
   

  	
  82

  	
   

  	
  8.85

  	
   

  	
  8.41

  	
   

  	
  5.98

  	
   

  	
  5.95

  	
   

  
	
  29

  	
   

  	
  4.80

  	
   

  	
  83

  	
   

  	
  8.99

  	
   

  	
  8.59

  	
   

  	
  5.98

  	
   

  	
  5.96

  	
   

  
	
  30

  	
   

  	
  4.72

  	
   

  	
  84

  	
   

  	
  9.12

  	
   

  	
  8.77

  	
   

  	
  5.99

  	
   

  	
  5.97

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
  & over

  	
   

  	
  9.25

  	
   

  	
  8.93

  	
   

  	
  5.99

  	
   

  	
  5.98

  	
   

  

 

Rates for monthly payments for ages not shown in the above tables will
be calculated on the same basis as those shown and may be obtained from us. The
basis for these calculations is the 1983 Individual Annuitant Mortality Table A
projected 4 years with interest at 4% per annum.

 

 

PROTECTIVE LIFE INSURANCE COMPANY

P. O. BOX 2606

BIRMINGHAM, ALABAMA 35202

 

ENDORSEMENT

 

The Contract or Certificate to which this Endorsement is attached is
amended as of its effective date, as follows:

 

If you cancel this Contract during the first ten days after you first
receive it according to the “Right to Return” provision of the face page of
the Contract, the amount we return to you will equal the Account Value on the
date we receive your written cancellation request, adjusted by the Market Value
Adjustment.

 

For the purpose of determining the Market Value Adjustment during the
ten-day cancellation period, we will identify a Treasury Rate each day. The current
Treasury Rate (“C” in the Market Value Adjustment formula on the Schedule of
this Contract) will be the Treasury Rate identified on the date we receive your
written cancellation request.

 

	
  Signed for the Company as of the Effective Date.

  	
   

  
	
   

  	
   

  
	
  PROTECTIVE LIFE INSURANCE COMPANY

  	
   

  
	
   

  	
   

  
	
   

  	
   

  
	
  /s/ Deborah J. Long

  	
   

  
	
  Deborah J. Long

  	
   

  
	
  Secretary

  	
   

  
			

 

	
  IPD-2092V

  	
  7/99Exhibit 4(c)

 

CERTIFICATE

 

Individual Certificate issued
under the Group Modified Guaranteed Annuity Contract

Account Value is subject to a Market Value Adjustment

Non-Participating

 

This Certificate is a summary of your rights under the Group Modified
Guaranteed Annuity Contract (“Contract”) identified on the Schedule. This
Certificate is subject to all provisions of the Contract, whether or not
summarized in this Certificate. The Contract alone governs the rights of the
parties. A copy of the Contract will be furnished on request.

 

Protective Life Insurance Company certifies that the person named as
Participant on the Schedule is a Participant under the Contract.

 

YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You
may cancel this Contract within twenty days after you receive it by returning
the Contract to our Home Office or to our Agent, with a written request for
cancellation. The Contract will be as though it had never been issued. We will
promptly return any Annuity Deposit made.

 

	
  /s/ John D.
  Johns

  	
   

  	
  /s/ Deborah J.
  Long

  
	
  President

  	
   

  	
  Secretary

  

 

PROTECTIVE LIFE INSURANCE
COMPANY

P. O. Box 2606

Birmingham, Alabama 35202

(205) 879-9230

(A Stock Insurance
Company)

 

	
  Form No. IPD-2084

  	
   

  	
  12/97

  

 

 

SCHEDULE

 

	
   

  	
   

  	
   

  
	
  Group Contract Holder

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  Participant

  	
   

  	
  Joint Participant

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  Annuitant

  	
   

  	
  Annuity Commencement Date

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  Certificate Number

  	
   

  	
  Certificate Date

  

 

	
   

  	
   

  	
  Guaranteed

  	
   

  	
  Guaranteed

  	
   

  	
  Annuity

  	
   

  	
  Treasury

  
	
  Sub-Account#

  	
   

  	
  Period

  	
   

  	
  Interest Rate

  	
   

  	
  Deposit

  	
   

  	
  Rate

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Total Annuity Deposit

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  

 

Separate Account

 

The assets supporting this Certificate are held in a Separate Account.
All values will be determined as provided in the Contract, without regard to
the actual investment performance of the Separate Account.

 

Surrender Charge

 

The Surrender Charge is equal to the Surrender Charge Percentage
indicated below, applied to the amount of each full or partial surrender
requested less any amount available under the “Interest
Withdrawal” provision of this Certificate at the time of the
surrender.

 

	
  Number of Completed Years

  in a Guaranteed Period

  	
   

  	
  Surrender Charge

  Percentage

  	
   

  
	
  0

  	
   

  	
  6

  	
  %

  
	
  1

  	
   

  	
  6

  	
  %

  
	
  2

  	
   

  	
  5

  	
  %

  
	
  3

  	
   

  	
  4

  	
  %

  
	
  4

  	
   

  	
  3

  	
  %

  
	
  5

  	
   

  	
  2

  	
  %

  
	
  6

  	
   

  	
  1

  	
  %

  
	
  7+

  	
   

  	
  0

  	
  %

  

 

2

 

Market Value Adjustment

 

The Market Value Adjustment is equal to the Market Value Adjustment
Percentage indicated below, applied to the amount of each full or partial
surrender requested less any amount available under the “Interest Withdrawal” provision
of this Certificate at the time of the surrender.

 

Market Value
Adjustment Percentage = (C - I + 0.25%) x (N/12), where:

 

C =
the Treasury Rate currently established for the same term as the Guaranteed
Period from which the surrender is being made;

 

I =
the Treasury Rate initially established for the Guaranteed Period from which
the surrender is being made;

 

N = The number of months remaining in the Guaranteed Period from which the
surrender is being made.

 

The Treasury Rate is the annual effective interest rate credited to
United States Treasury instruments, as published by a nationally recognized
source. On the fifteenth day and the last day of each month, the Company will
identify a Treasury Rate for each Guaranteed Period. For the purpose of
determining the Market Value Adjustment during the ten day cancellation period,
we will identify a Treasury Rate each day. The current Treasury Rate (“C” in
the Market Value Adjustment formula) will be the Treasury Rate identified on
the date we receive your written cancellation request. The method used by the
Company to determine the Treasury Rates under this Certificate shall be
consistent and is binding upon any Participant, Annuitant and Beneficiary.

 

INDEX

 

	
  Schedule

  	
  2

  
	
  Definitions

  	
  4

  
	
  General Provisions

  	
  6

  
	
  Control Provisions

  	
  7

  
	
  Premium Taxes

  	
  8

  
	
  Surrenders - Termination

  	
  8

  
	
  Interest Credited and Guaranteed Periods

  	
  9

  
	
  Annuity Options

  	
  10

  
	
  Annuity Tables

  	
  11

  

 

3

 

DEFINITIONS

 

Account Value - The sum of all Sub-Account Values.

 

Annuitant - Annuity payments may depend upon the
continuation of the life of a person. That person is called an Annuitant and is
named on the Schedule.

 

Annuity - A series of predetermined periodic
payments.

 

Annuity
Commencement Date - The
date on which annuity payments begin. This date is indicated on the Schedule.

 

Annuity
Deposit(s) - Annuity
Deposits (less Premium Taxes, if applicable) made and allocated to the
Guaranteed Period(s) you select under this Certificate. Each Annuity
Deposit and each allocation to a Guaranteed Period must be at least $10,000. We
reserve the right to limit the amount of your Annuity Deposits. Only one
Certificate will be issued regardless of the number of Annuity Deposits you
make.

 

Beneficiary - The person entitled to receive the
benefits under this Certificate, if any, upon the death of any Participant.

 

Primary - The person named to receive the death benefits upon
any Participant’s death. Upon the death of any Participant, the surviving
Participant, if any, will become the Primary Beneficiary.

 

Contingent - The person named to receive the death benefits if the
Primary Beneficiary is not living at the time of a Participant’s death. If no
Beneficiary designation is in effect or if no Beneficiary is living at the time
of a Participant’s death, the Estate of the deceased Participant will be the
Beneficiary.

 

Irrevocable - An irrevocable Beneficiary is one whose consent is
needed to change the Beneficiary designation, or to exercise certain other
rights.

 

Certificate - The individual Certificate issued by the
Company to a Participant. Your Certificate summarizes the provisions of the
Contract.

 

Certificate Date
- The date shown
on the Schedule and on which this Certificate takes effect. Certificate Years
are measured from the Certificate Date.

 

Contract - The Group Modified Guaranteed Annuity
Contract under which this Certificate has been issued.

 

Guaranteed Period
- The period for
which either an Initial or Subsequent Guaranteed Interest Rate will be credited
to a Sub-Account under a Contract. Guaranteed Periods will be designated as
being either “Initial” or “Subsequent”.

 

4

 

Home Office - 2801 Highway South, Birmingham, Alabama.

 

Initial Guaranteed
Interest Rate - The
effective rate of interest, calculated after daily compounding of interest has
been taken into account, which is used in determining the interest credited to
a Sub-Account under this Certificate during the Initial Guaranteed Period. This
rate is specified on the Schedule.

 

Market Value
Adjustment - The
adjustment made to a Sub-Account Value when a full or partial surrender is
requested prior to the end of an Initial or Subsequent Guaranteed Period. The
Market Value Adjustment is explained on the Schedule.

 

Net Account Value - The sum of all Net Sub-Account Values.

 

Net Sub-Account Value
- The
Sub-Account Value after application of the Market Value Adjustment and deductions
for any Surrender Charges and applicable Premium Taxes.

 

Participant - The
person(s) named in the Schedule, herein referred to as “you” or “your”.

 

Sub-Account - Each Annuity Deposit will be allocated to one
or more Sub-Accounts as directed by the Participant. Each Sub-Account will
correspond to a specified Guaranteed Period and guaranteed interest rate
selected by the Participant.

 

Sub-Account Value - The amount equal to that part of the Annuity
Deposit allocated by a Participant to a Sub-Account or any amount transferred
to a Sub-Account or Sub-Accounts at the end of a Guaranteed Period increased by
all interest credited and decreased by amounts due to previous full or partial
surrenders (including Surrender Charges, Market Value Adjustments, and Premium
Taxes thereon) and previous interest withdrawals. The Sub-Account Value of each
Sub-Account under this Certificate must be at least $10,000 at all times.

 

Subsequent Guaranteed
Interest Rate - The
effective rate of interest, calculated after daily compounding of interest has
been taken into account, which is established by the Company for any applicable
Subsequent Guaranteed Period.

 

Surrender Charge - A Surrender Charge, if applicable, is
deducted from any Sub-Account Value from which a full or partial surrender is
made prior to the end of an Initial or Subsequent Guaranteed Period. The
Surrender Charge is explained on the Schedule.

 

Writing - A written form satisfactory to the Company
and filed at the Home Office of the Company in Birmingham, Alabama. All
correspondence should be sent to P. O. Box 10648, Birmingham, Alabama
35202-0648.

 

5

 

GENERAL PROVISIONS

 

Entire Contract

The
Contract, this Certificate and any endorsements attached hereto, and the
Application, a copy of which is attached, constitute the entire contract. A
Certificate is a summary of the Contract.

 

Modification

No
change or waiver of the terms of this Contract is valid unless made by us, in
Writing, and approved by our President, Vice President, or Secretary. We
reserve the right to change the provisions of the Contract and this Certificate
issued under the Contract to conform to any applicable laws, regulations or
rulings issued by a governmental agency.

 

Error in Age or Sex

Questions
in the Application concern the Annuitant’s date of birth and sex. If the date
of birth or sex given is not correct, the benefits under this Contract shall be
adjusted to the amount which would have been payable at the correct age and
sex. If we made any underpayments on account of any misstatement, the amount of
any underpayment shall be immediately paid in one sum. Any overpayments made
shall be deducted from the current or succeeding payments due under the
Contract.

 

Assignment

Upon
notice to us, you may assign your rights under this Contract. The assignment
must be in Writing and filed with us. We assume no responsibility for the
validity of any assignment. Any claim under any assignment shall be subject to
proof of interest and the extent of the assignment.

 

Settlement

Any
payment by us under this Contract is payable at our Home Office. The
Participant may elect to apply settlement proceeds, including any full or
partial surrender proceeds or the death benefit, to any payout option offered
by us for such payments at the time the election is made.

 

Facility of Payment

If
the Annuitant or Beneficiary is incapable of giving a valid receipt for any
payment, we may make such payment to whoever has assumed his or her care and
principal support. Any such payment shall fully discharge us to the extent of
that payment.

 

Proof of Age

Proof
of age is required before the first payment under an Annuity Option involving
lifetime payments.

 

6

 

Annual Reports

We
will send you a report at least once per year showing your Account Value,
Sub-Account Values and interest credited.

 

Annuity Commencement Date Changes

Upon
thirty days notice in Writing, you may change the Annuity Commencement Date.
The proposed Annuity Commencement Date you select cannot be before the end of
any Guaranteed Period or later than the Certificate Year closest to the
Annuitant’s 85th birthday.

 

Protection of Proceeds

To
the extent permitted by law, no benefits payable under this Certificate will be
subject to the claims of creditors of any payee.

 

CONTROL PROVISIONS

 

Annuitant

The
Participant may change the Annuitant prior to the Annuity Commencement Date.
The request must be in Writing. Once it is received and acknowledged at our
Home Office, any change will relate back to and take effect on the date the
request was signed. The Annuitant is the “Payee” for the purposes of the
Annuity Table.

 

Beneficiary

The
Beneficiary will be as shown in the Application. You may change the Beneficiary
at any time. To make a change, we must receive a written request satisfactory
to us at our Home Office. If the Beneficiary has been designated irrevocably,
however, such designation cannot be changed or revoked without the Beneficiary’s
written consent. Any such change will relate back to and take effect on the
date the request was signed. We will not be liable for any payment we make
before such request has been received and acknowledged at our Home Office. Any
payment which has become due to an Annuitant and has not been paid prior to his
or her death shall be paid to the Primary Beneficiary, if living; otherwise to
the Contingent Beneficiary.

 

Death of the Annuitant or Participant

If
an Annuitant is not a Participant and dies prior to the Annuity Commencement
Date, the Participant first named on the Application will become the new
Annuitant unless the Participant designates otherwise. If any Participant is
not a natural person, the death or change of the Annuitant will be treated as
the death of a Participant. If any Participant dies while this Certificate is
in force prior to the Annuity Commencement Date, a Death Benefit will be
payable to the Beneficiary.

 

7

 

Death Benefit

 

The
Death Benefit will be determined as of the date due proof of death is received
by the Company. If a claim for the Death Benefit is received at our Home Office
within 6 months of the date of death, the Death Benefit will equal the greater
of: (1) the Account Value, less applicable Premium Taxes; or (2) the
Net Account Value. If a claim is received past 6 months after the date of
death, the Death Benefit will equal the Net Account Value. If any Participant
of this Certificate is not a natural person, upon the change of the Annuitant,
the Death Benefit will equal the Net Account Value. Only one Death Benefit is
payable under this Certificate, even though the Certificate may continue beyond
a Participant’s death.

 

The
Death Benefit may be taken in one sum immediately. In all events, the entire
Death Benefit, including any interest accrued thereon, must be distributed
within five years of the date of death unless:

 

(a)          it is payable over the life of the Beneficiary with
distributions beginning within one year of the date of death; or

 

(b)          it is payable over a period not extending beyond the life
expectancy of the Beneficiary with distributions beginning within one year of
the date of death; or

 

(c)          the deceased Participant’s spouse is the Beneficiary and,
in lieu of receiving the Death Benefit, continues the Certificate and becomes
the new Participant.

 

If
the deceased Participant’s spouse continues the Certificate and becomes the new
Participant, upon such spouse’s death, a Death Benefit will become payable to
the new Beneficiary (determined at the time of the spouse’s death). The Death
Benefit, including any interest accrued thereon must be distributed within five
years of the spouse’s death.

 

PREMIUM TAXES

 

Premium
Taxes (including any related retaliatory taxes, if any) will be deducted, if
applicable. Premium Taxes may be deducted, as provided under applicable law,
from the Annuity Deposit when received, upon full or partial surrender, or from
the amount applied to effect an Annuity at the time the annuity payments
commence. Premium Taxes may also be deducted from the Death Benefit.

 

SURRENDERS -
TERMINATION

 

Full
surrenders may be made at any time. Partial surrenders may only be made if each
remaining Sub-Account Value is at least $10,000. You must specify the
Sub-Accounts from which the partial surrender is to be made. If the Sub-Account
specified has the same Guaranteed Period as any other Sub-Account, the partial
surrender must come from the Sub-Account with the shortest time remaining in
the Guaranteed Period.

 

8

 

Surrender
Charges and Market Value Adjustments will not apply to full or partial
surrenders made at the end of an Initial or Subsequent Guaranteed Period. The
Surrender Value will equal the Sub-Account Value on this date. A request for a
surrender at the end of an Initial or Subsequent Guaranteed Period must be
received in Writing within twenty days prior to the end of such an Initial and
Subsequent Guaranteed Period.

 

The
Surrender Value will be calculated by the Company using the following formula:

 

(A - S - M - P), where:

 

A = the amount of the full or partial surrender;

S = the amount of Surrender Charge;

M = the amount of the Market Value Adjustment;

P = the amount of unpaid Premium Taxes, if any.

 

The
Company may defer payment of any partial or full surrender for the period
permitted by law. In no event will this deferral of payment exceed 6 months
from the date of receipt of the election to surrender partially or fully.

 

Interest Withdrawals

If
you notify the Company in Writing at any time during the current Certificate
Year, the Company will send you all or a portion of the interest credited
during the prior Certificate Year. You may only make one withdrawal during a
Certificate Year. No Surrender Charge or Market Value Adjustment will be imposed
on such interest withdrawals.

 

INTEREST CREDITED AND GUARANTEED PERIODS

 

The
portion of each Annuity Deposit allocated to a Sub-Account will earn interest
at the Initial Guaranteed Interest Rate for each Certificate Year during the
Initial Guaranteed Period selected for that Sub-Account. A Guaranteed Period is
the period of years for which a rate of interest is guaranteed. You may select
from any Guaranteed Period offered by the Company under the Contract at the
time the Annuity Deposit or transfer is made. However, Guaranteed Periods
cannot extend beyond the Annuity Commencement Date.

 

You
may not transfer a Sub-Account Value to any existing or new Sub-Account(s) prior
to the end of the Sub-Account’s Guaranteed Period. At the end of any Guaranteed
Period a Subsequent Guaranteed Period will begin. Unless you elect a different
duration from among those then offered by us within twenty days prior to the
end of the previous Guaranteed Period, your Sub-Account Value will be
automatically transferred to a Subsequent Guaranteed Period of either (1) the
same duration as your previous Guaranteed Period if then offered by us; or (2) the
shortest duration then offered by us which is closest to the same duration as
your previous Guaranteed Period.

 

9

 

Your
Sub-Account Value at the beginning of any Subsequent Guaranteed Period will be
equal to your Sub-Account Value at the end of the Guaranteed Period just
ending. The Sub-Account Value will earn interest at the Subsequent Guaranteed
Interest Rate for each Certificate Year in the Subsequent Guaranteed Period. At
your request within twenty days prior to the end of any Guaranteed Period, the
Company will notify you of the then effective Subsequent Guaranteed Interest
Rate. The actual Subsequent Guaranteed Interest Rate will be determined at the
beginning of the Subsequent Guaranteed Period.

 

ANNUITY OPTIONS

 

Annuity Benefit

If
the Annuitant is alive on the Annuity Commencement Date and unless directed
otherwise, the Company will apply the Net Account Value according to the
Annuity Option elected.

 

You
may elect to have all or a part of the Net Account Value applied on the Annuity
Commencement Date under any of the Annuity Options described below. In the
absence of an election, the Net Account Value will be applied on the Annuity
Commencement Date under Option 2 - Life Income with Payments for a 10 Year
Guaranteed Period. Elections of any of these options must be made in writing to
the Company at least 30 days prior to the date such election is to become
effective.

 

If
the Annuitant or Participant dies on or after the Annuity Commencement Date,
any remaining payments will be distributed at least as rapidly as under the
method of distribution being used at the time of death.

 

Annuity Options

Option 1- Payment for a Fixed Period. Equal monthly payments will be made for any
period of not less than 5 nor more than 30 years. The amount or each payment
depends on the total amount applied, the period selected and the monthly
payment rates we are using when the first payment is due.

 

Option 2 - Life Income with Payments for a Guaranteed Period.
Equal monthly
payments are based on the life of the named Annuitant. Payments will continue
for the lifetime of that person with payments guaranteed for 10 or 20 years.
Payments stop at the end of the selected guaranteed period or when the named
person dies, whichever is later.

 

Option 3 - Payments of a Fixed Amount. Equal monthly payments will be for an agreed
fixed amount. The amount of each payment may not be less than $10 for each
$1,000 applied. Interest will be credited each month on the unpaid balance and
added to it. This interest will be at a rate set by us, but not less than an
effective interest rate of 4% per year. Payments continue until the amount we
hold runs out. The last payment will be for the balance only.

 

10

 

Minimum Amounts - We reserve the right to
pay the total amount of this Certificate in one lump sum, if less than $5,000.
If monthly payments are less than $100, we may make payments quarterly,
semi-annually, or annually, at our option.

 

All elected Annuity Options must comply with current Federal and state
statutes and Internal Revenue Service Regulations. If we have available, at the
time an Annuity Option is elected, options or rates on a more favorable basis
than those guaranteed, the higher benefits shall apply.

 

Annuity Tables

The attached Annuity Tables show the dollar amount of the monthly
payments for each $1,000 applied. The tables are based on the 1983 Individual
Annuitant Mortality Table A projected 4 years with interest at 4% per annum.
One year will be deducted from the attained age of the Annuitant for every
three completed years beyond the year 1987.

 

Individual Certificate issued under the Group
Modified Guaranteed Annuity Contract

Account Value is subject to a Market Value Adjustment

Non-Participating

 

	
  IPD-2084

  	
  12/97

  

 

11

 

MINIMUM MONTHLY PAYMENT RATES FOR EACH $1,000 APPLIED

 

	
  OPTION 1 TABLE

  	
   

  	
  OPTION 2 TABLE

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Payments for a

  Fixed Period

  	
   

  	
   

  	
   

  	
  Life Income with Payments

  for a Guaranteed Period

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Monthly

  	
   

  	
  Age of

  	
   

  	
  10 Years

  	
   

  	
  20 Years

  	
   

  
	
  Years

  	
   

  	
  Payment

  	
   

  	
  Payee

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  5

  	
   

  	
  18.32

  	
   

  	
  59

  	
   

  	
  5.29

  	
   

  	
  4.83

  	
   

  	
  4.98

  	
   

  	
  4.68

  	
   

  
	
  6

  	
   

  	
  15.56

  	
   

  	
  60

  	
   

  	
  5.40

  	
   

  	
  4.92

  	
   

  	
  5.04

  	
   

  	
  4.74

  	
   

  
	
  7

  	
   

  	
  13.59

  	
   

  	
  61

  	
   

  	
  5.51

  	
   

  	
  5.01

  	
   

  	
  5.10

  	
   

  	
  4.81

  	
   

  
	
  8

  	
   

  	
  12.12

  	
   

  	
  62

  	
   

  	
  5.63

  	
   

  	
  5.10

  	
   

  	
  5.17

  	
   

  	
  4.88

  	
   

  
	
  9

  	
   

  	
  10.97

  	
   

  	
  63

  	
   

  	
  5.75

  	
   

  	
  5.21

  	
   

  	
  5.24

  	
   

  	
  4.95

  	
   

  
	
  10

  	
   

  	
  10.06

  	
   

  	
  64

  	
   

  	
  5.88

  	
   

  	
  5.32

  	
   

  	
  5.30

  	
   

  	
  5.02

  	
   

  
	
  11

  	
   

  	
  9.31

  	
   

  	
  65

  	
   

  	
  6.02

  	
   

  	
  5.43

  	
   

  	
  5.37

  	
   

  	
  5.09

  	
   

  
	
  12

  	
   

  	
  8.69

  	
   

  	
  66

  	
   

  	
  6.16

  	
   

  	
  5.55

  	
   

  	
  5.43

  	
   

  	
  5.17

  	
   

  
	
  13

  	
   

  	
  8.17

  	
   

  	
  67

  	
   

  	
  6.31

  	
   

  	
  5.68

  	
   

  	
  5.49

  	
   

  	
  5.24

  	
   

  
	
  14

  	
   

  	
  7.72

  	
   

  	
  68

  	
   

  	
  6.47

  	
   

  	
  5.82

  	
   

  	
  5.55

  	
   

  	
  5.31

  	
   

  
	
  15

  	
   

  	
  7.34

  	
   

  	
  69

  	
   

  	
  6.63

  	
   

  	
  5.97

  	
   

  	
  5.60

  	
   

  	
  5.38

  	
   

  
	
  16

  	
   

  	
  7.00

  	
   

  	
  70

  	
   

  	
  6.79

  	
   

  	
  6.12

  	
   

  	
  5.65

  	
   

  	
  5.45

  	
   

  
	
  17

  	
   

  	
  6.71

  	
   

  	
  71

  	
   

  	
  6.96

  	
   

  	
  6.28

  	
   

  	
  5.70

  	
   

  	
  5.51

  	
   

  
	
  18

  	
   

  	
  6.64

  	
   

  	
  72

  	
   

  	
  7.13

  	
   

  	
  6.45

  	
   

  	
  5.74

  	
   

  	
  5.58

  	
   

  
	
  19

  	
   

  	
  6.21

  	
   

  	
  73

  	
   

  	
  7.31

  	
   

  	
  6.63

  	
   

  	
  5.78

  	
   

  	
  5.64

  	
   

  
	
  20

  	
   

  	
  6.00

  	
   

  	
  74

  	
   

  	
  7.48

  	
   

  	
  6.81

  	
   

  	
  5.82

  	
   

  	
  5.69

  	
   

  
	
  21

  	
   

  	
  5.81

  	
   

  	
  75

  	
   

  	
  7.66

  	
   

  	
  7.00

  	
   

  	
  5.85

  	
   

  	
  5.74

  	
   

  
	
  22

  	
   

  	
  5.64

  	
   

  	
  76

  	
   

  	
  7.84

  	
   

  	
  7.20

  	
   

  	
  5.88

  	
   

  	
  5.78

  	
   

  
	
  23

  	
   

  	
  5.49

  	
   

  	
  77

  	
   

  	
  8.02

  	
   

  	
  7.40

  	
   

  	
  5.90

  	
   

  	
  5.82

  	
   

  
	
  24

  	
   

  	
  5.35

  	
   

  	
  78

  	
   

  	
  8.20

  	
   

  	
  7.60

  	
   

  	
  5.92

  	
   

  	
  5.85

  	
   

  
	
  25

  	
   

  	
  5.22

  	
   

  	
  79

  	
   

  	
  8.37

  	
   

  	
  7.81

  	
   

  	
  5.94

  	
   

  	
  5.88

  	
   

  
	
  26

  	
   

  	
  5.10

  	
   

  	
  80

  	
   

  	
  8.54

  	
   

  	
  8.10

  	
   

  	
  5.96

  	
   

  	
  5.91

  	
   

  
	
  27

  	
   

  	
  5.00

  	
   

  	
  81

  	
   

  	
  8.70

  	
   

  	
  8.21

  	
   

  	
  5.97

  	
   

  	
  5.93

  	
   

  
	
  28

  	
   

  	
  4.90

  	
   

  	
  82

  	
   

  	
  8.85

  	
   

  	
  8.41

  	
   

  	
  5.98

  	
   

  	
  5.95

  	
   

  
	
  29

  	
   

  	
  4.80

  	
   

  	
  83

  	
   

  	
  8.99

  	
   

  	
  8.59

  	
   

  	
  5.98

  	
   

  	
  5.96

  	
   

  
	
  30

  	
   

  	
  4.72

  	
   

  	
  84

  	
   

  	
  9.12

  	
   

  	
  8.77

  	
   

  	
  5.99

  	
   

  	
  5.97

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
  & over

  	
   

  	
  9.25

  	
   

  	
  8.93

  	
   

  	
  5.99

  	
   

  	
  5.98

  	
   

  

 

Rates for monthly payments for ages not shown
in the above tables will be calculated on the same basis as those shown and may
be obtained from us. The basis for these calculations is the 1983 Individual
Annuitant Mortality Table A projected 4 years with interest at 4% per annum.

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00150-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00150-of-00352.parquet"}]]