Document:

livc_ex1032.htm

Exhibit 10.32

 

SETTLEMENT AGREEMENT AND RELEASE 

 

This Settlement Agreement and Release (“Agreement”) is entered into by and between Live Current Media Inc. and its subsidiaries including Domain Holdings Inc. (collectively, “Company”) and Chantal Iorio (“Ms. Iorio”).

 

Recitals

 

	
1.  

	
WHEREAS, as a result of a reduction in force, the Company has terminated Ms. Iorio’s employment without cause effective August 15, 2010 (the “Termination Date”), and Ms. Iorio and the Company desire to settle and resolve all possible disputes between them relating to Ms. Iorio’s employment with the Company or her termination.

 

	
2.  

	
No part of this Agreement or the decision of any party to resolve these matters and enter into this Agreement shall be construed as an admission of wrongdoing or liability.

 

Terms and Conditions

 

	
1.  

	
Upon final payment owing under this Settlement Agreement and Release, Ms. Iorio, on behalf of herself, her heirs, executors, administrators, and assigns, does hereby waive and release the Company, its parents, affiliates, subsidiaries, and related entities, its successors and assigns, and each of their present and former directors, officers, employees, agents and attorneys, both individually and in their representative capacities, from any and all claims (including any claim to legal fees, long term disability and any other payment under the Employment Agreement dated December 12, 2007 or any statute, code or otherwise), damages, causes of action, or disputes of any kind or nature, whether presently known or unknown.  This release is comprehensive and includes all claims (including claims under the Employment Agreement dated December 12, 2007 or Employment Standards, Human Rights, or Workplace Safety legislation), damages, causes of action, or disputes based upon acts or omissions occurring or which could be alleged to have occurred prior to the date of this Agreement.

 

	
2.  

	
Ms. Iorio warrants and affirms that she has not sold, transferred, or otherwise assigned all or any of her interest in any of her claims or causes of action released herein and that she is the only person or entity empowered to release said claims.

 

	
3.  

	
Ms. Iorio warrants that she has not and, upon final payment owing under this Agreement, agrees she will not file any charge or complaints with any federal, provincial, or local government entity or any civil action concerning any issues relating to his employment with the Company or the termination of that employment.

 

	
4.  

	
In consideration of Ms. Iorio’s execution of this Settlement Agreement and Release, the Company agrees to pay to Ms. Iorio the total gross amount of $75,000.00 (the “Severance Amount”) at a rate of $12,500 per month, less required deductions, on a salary continuance basis.  All severance payments shall be subject to the Company’s normal payroll practices and shall be made on regular company paydays.

 

	
5.  

	
On or before August 15, 2010, the Company will pay Ms. Iorio all accrued vacation pay.

 

	
6.  

	
The Company shall pay on Ms. Iorio’s behalf (i) premiums for the Medical Services Plan (“MSP”) of British Columbia (“Statutory Benefits”) and (ii) premiums for extended medical and dental benefits currently provided by the Sun Life Insurance Company (the “Discretionary Benefits”) which does not include long term disability insurance.  The Company shall pay for the Statutory Benefits until the Severance Amount is paid in full.  The Company shall pay for the Discretionary Benefits until the earlier of (A) the termination of the Discretionary Benefits for all of the Company’s employees or (B) until the Severance Amount is paid in full.  Ms. Iorio acknowledges that she is not entitled to any other compensation, benefit, or payment from the Company other than that expressly set forth in this Agreement.  Ms. Iorio further agrees that the Severance Amount may be applied as a set-off against any later claim that she may make.

 

 

  

1

  

 

	
7.  

	
Ms. Iorio acknowledges that she has not relied upon the Company or its legal counsel for any advice in connection with the tax treatment of this payment.  Ms. Iorio agrees to indemnify and hold the Company harmless from any and all claims or liability, including costs and legal fees, incurred as a result of Ms. Iorio’s tax treatment of this payment.

 

	
8.  

	
Ms. Iorio acknowledges that the Company’s business and future success depends on preservation of its trade secrets and other confidential, proprietary information concerning the Company, its affiliates, suppliers, and customers (“Secrets”).  Proprietary information means information, ideas and materials of or about the Company or its affiliates, employees, customers, or others with whom the Company conducts business.  These Secrets include, without limitation: marketing policies and practices; supplier identity and costs; contract renewal dates; employee lists and compensation; and other such business information.  Ms. Iorio warrants and agrees that she will keep these secrets confidential and will not use or disclose them for any reason, unless required to do so by law.  Nothing in this provision shall limit the right and obligation of Ms. Iorio to provide truthful information when the law so requires.

 

	
9.  

	
The parties agree that this Agreement imposes the duty of good faith on all parties, that this Agreement sets forth completely the terms of the parties’ agreement and understanding, that this Agreement supersedes any and all prior agreements or understandings, both oral and written, including the Employment Agreement dated December 12, 2007, and that this Agreement cannot be modified without the express written consent of the parties hereto.

 

	
10.  

	
In the event that any provision of the Agreement or compliance by any of the parties with any provision of this Agreement shall constitute a violation of any law, then such provision, to the extent only that it is so in violation, shall be deemed ineffective and unenforceable and shall be separable from the remaining provisions of the Agreement, which provisions shall remain binding on the parties.

 

	
11.  

	
The terms and conditions of this Agreement shall be binding upon and inure to the benefits of the parties hereto and their respective heirs, successors, personal representatives, and assigns.

 

	
12.  

	
This Agreement may be executed with electronic signatures which shall be treated as original signatures and in one or more counterparts, all of which together shall constitute one Agreement, and each of which separately shall constitute an original document.

 

	
13.  

	
This Agreement shall be governed by the laws of British Columbia, without reference to its choice of law rules.  The courts of British Columbia sitting in the City of Vancouver will have exclusive jurisdiction over this Agreement, including its enforcement and any dispute regarding its interpretation and application, and the parties hereby irrevocably submit to the jurisdiction of those courts for those purposes.

 

	
14.  

	
All dollar amounts in this Agreement are stated and payable in Canadian dollars unless stated otherwise.

 

	
15.  

	
The parties signing below hereby warrant and represent that (1) this Agreement is being entered into freely, knowingly, and voluntarily; (2) this Agreement is fair and equitable; (3) any and all conditions to the execution, validity, or enforceability of this Agreement have been met; and (4) this Agreement is valid, binding, and enforceable.

 

	
16.  

	
Ms. Iorio further warrants that: (1) she has read this Agreement and finds that it is written in a manner that she understands; (2) she understands that this Agreement does not waive rights or claims that may arise after the date this Agreement is executed; (3) she has been advised that she has the right to consult with legal counsel prior to executing this Agreement and has had a reasonable opportunity for independent advice; and (4) she has signed this Agreement as her free and voluntary act.

 

 

 

  

2

  

 

IN WITNESS WHEREOF the parties have executed this Agreement as of the day and year set forth below.

 

	
/s/ Chantal Iorio

	 	
June 16, 2010

	 
	
Chantal Iorio

	 	
Date

	 
	  	 	  	 
	  	 	  	 
	
/s/ Andrea Laird

	 	
June 16, 2010

	 
	
Witnessed by: Andrea Laird

	 	
Date

	 
	  	 	  	 
	  	 	  	 
	
Live Current Media Inc.

	 	  	 
	  	 	  	 
	  	 	  	 
	  	 	  	 
	
/s/ Geoff Hampson

	 	
June 16, 2010

	 
	
Geoff Hampson

	 	
Date

	 
	
Chief Executive Officer

	 	  	 

 

 

 

 

 

 

 

 

3Exhibit 4(ii)

 

EAGLE

LIFE INSURANCE COMPANY

 

[6000 Westown Parkway]

[West Des Moines, Iowa 50266]

[(866) 526-0995]

 

A STOCK LIFE INSURANCE COMPANY

 

We pay the benefits of this Contract, subject to all of its provisions, terms and conditions.  We issue this Contract based on the attached Application and payment of the Initial Premium on or before the Contract Date.

 

15 DAY RIGHT TO EXAMINE CONTRACT

 

YOU MAY RETURN THIS CONTRACT TO YOUR AGENT OR OUR HOME OFFICE FOR UP TO 15 DAYS AFTER YOU RECEIVE IT, 30 DAYS IF REPLACEMENT IS INVOLVED.  THIS CONTRACT WILL BE VOID UPON OUR, OR OUR AGENT’S, RECEIPT OF YOUR RETURNED CONTRACT.  WITHIN 10 DAYS OF THE EARLIER OF OUR, OR OUR AGENT’S, RECEIPT OF YOUR RETURNED CONTRACT, WE WILL REFUND ANY PREMIUM PAID.

 

Signed for the Company at Des Moines, Iowa, on the Contract Date.

 

	    
    	    
    
	    Debra J. Richardson
    	    D. J. Noble
    
	    Secretary
    	    President
    

 

FLEXIBLE PREMIUM DEFERRED ANNUITY CONTRACT WITH INDEX-LINKED INTEREST OPTIONS AND A MARKET VALUE ADJUSTMENT

The Market Value Adjustment feature may result in both upward and downward adjustments in Partial Withdrawals and Surrender Benefits

Index Credits currently linked to S&P 500 Index

10% Penalty-free Withdrawal Option available after 1st Contract Year

Death Benefit Prior to Maturity

Monthly Income at Maturity

No Dividends

Nonparticipating

Although Contract Values may be affected by an external Index, the Contract does not participate in any stock or equity investments

 

This is a legal Contract between You and Us.

READ YOUR CONTRACT CAREFULLY

 

ICC10-INDEX-4-09R

 

1

 

TABLE OF CONTENTS

 

	    Contract Proceeds and Pay-out Provisions
    	    Page 11
    
	     
    	     
    
	    Contract Specifications
    	    Page 3
    
	     
    	     
    
	    Contract Values Provisions
    	    Page 7,8,9,10
    
	     
    	     
    
	    Death Pay-out Provisions
    	    Page 13
    
	     
    	     
    
	    Definitions
    	    Page 4
    
	     
    	     
    
	    General Provisions
    	    Page 5
    
	     
    	     
    
	    Income for Specified Period Factors
    	    Page 15
    
	     
    	     
    
	    Joint and Survivor Income Factors
    	    Page 17
    
	     
    	     
    
	    Life Income with Specified Period Certain Factors
    	    Page 16
    
	     
    	     
    
	    Maturity Pay-out Provisions
    	    Page 11
    
	     
    	     
    
	    Premium Provisions
    	    Page 6
    
	     
    	     
    
	    Settlement Option Pay-out Provisions
    	    Page 14
    
	     
    	     
    
	    Table of Guaranteed Values
    	    Page 18
    
	     
    	     
    
	    Value Specifications
    	    Page 3a
    
	     
    	     
    
	    Withdrawal and Surrender Pay-out Provisions
    	    Page 12
    

 

“Standard & Poor’s®”, “S&P®”, “S&P 500®”, “Standard & Poor’s 500” and “500” are trademarks of The McGraw-Hill Companies, Inc. and have been licensed for use by Eagle Life Insurance Company.  This Product is not sponsored, endorsed, sold or promoted by Standard & Poor’s and Standard & Poor’s makes no representation regarding the advisability of purchasing this Product.

 

2

 

CONTRACT SPECIFICATIONS

 

	    Contract Number:
    	     
    	    [123456]
    
	     
    	     
    	     
    
	    Contract Date:
    	     
    	    [January 1,   2010]
    
	     
    	     
    	     
    
	    Owner:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant’s Issue Age:
    	     
    	    [35]
    
	     
    	     
    	     
    
	    Annuitant’s Sex:
    	     
    	    [M]
    
	     
    	     
    	     
    
	    Maturity Date:
    	     
    	    [January 1,   2089]
    
	     
    	     
    	     
    
	    Initial Premium:
    	     
    	    [$20,000]
    
	     
    	     
    	     
    
	    Planned Premium Mode:
    	     
    	    [Annual]
    
	     
    	     
    	     
    
	    Planned Premium Amount:
    	     
    	    [$4,000]
    
	     
    	     
    	     
    
	    Minimum Contract Value Allowed:
    	     
    	    $2,000
    
	     
    	     
    	     
    
	    Minimum Guaranteed Interest Rate (MGIR):
    	     
    	    [1.5%]*
    
	     
    	     
    	     
    
	    Index used in MVA calculation:
    	     
    	    [The   BofA Merrill Lynch 3-5 Year US Corporate Index (C2A0)]
    

 

*Applies to Minimum Guaranteed Surrender Value only.

 

	    Surrender Charge Period:
    	     
    	    3   Contract Years
    
	     
    	     
    	     
    
	    Surrender Charge Percentage:
    	     
    	     
    

 

	    Contract Year:
    	     
    	    1
    	    2
    	    3
    	    4+
    
	    Percentage: 
    	     
    	    8
    	    7
    	    6
    	    0
    

 

Nonforfeiture Values: The nonforfeiture values for this contract are calculated by accumulating 87.5% of all premiums, less all withdrawals, at the nonforfeiture interest rate of [1.10%].

 

The minimum contract values provided under this Contract meet or exceed the required minimum nonforfeiture values.

 

[Delivery State DOI]

Phone Number: [Phone # of delivery state DOI]

 

ICC10-INDEX-4-09R-3

 

3

 

CONTRACT SPECIFICATIONS

 

	    Contract Number:
    	     
    	    [123456]
    
	     
    	     
    	     
    
	    Contract Date:
    	     
    	    [January 1,   2010]
    
	     
    	     
    	     
    
	    Owner:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant’s Issue Age:
    	     
    	    [35]
    
	     
    	     
    	     
    
	    Annuitant’s Sex:
    	     
    	    [M]
    
	     
    	     
    	     
    
	    Maturity Date:
    	     
    	    [January 1,   2089]
    
	     
    	     
    	     
    
	    Initial Premium:
    	     
    	    [$20,000]
    
	     
    	     
    	     
    
	    Planned Premium Mode:
    	     
    	    [Annual]
    
	     
    	     
    	     
    
	    Planned Premium Amount:
    	     
    	    [$4,000]
    
	     
    	     
    	     
    
	    Minimum Contract Value Allowed:
    	     
    	    $2,000
    
	     
    	     
    	     
    
	    Minimum Guaranteed Interest Rate (MGIR):
    	     
    	    [1.5%]*
    
	     
    	     
    	     
    
	    Index used in MVA calculation:
    	     
    	    [The   BofA Merrill Lynch 5-7 Year US Corporate Index (C3A0)]
    

 

*Applies to Minimum Guaranteed Surrender Value only.

 

	    Surrender Charge Period:
    	     
    	    5   Contract Years
    
	     
    	     
    	     
    
	    Surrender   Charge Percentage:
    	     
    	     
    

 

	    Contract Year:
    	     
    	    1
    	     
    	    2
    	     
    	    3
    	     
    	    4
    	     
    	    5
    	     
    	    6+
    
	    Percentage:
    	     
    	    8
    	     
    	    7
    	     
    	    6
    	     
    	    5
    	     
    	    4
    	     
    	    0
    

 

Nonforfeiture Values: The nonforfeiture values for this contract are calculated by accumulating 87.5% of all premiums, less all withdrawals, at the nonforfeiture interest rate of [1.10%].

 

The minimum contract values provided under this Contract meet or exceed the required minimum nonforfeiture values.

 

[Delivery State DOI]

Phone Number: [Phone # of delivery state DOI]

 

ICC10-INDEX-4-09R-5

 

3

 

CONTRACT SPECIFICATIONS

 

	    Contract Number:
    	     
    	    [123456]
    
	     
    	     
    	     
    
	    Contract Date:
    	     
    	    [January 1,   2010]
    
	     
    	     
    	     
    
	    Owner:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant:
    	     
    	    [John   Doe]
    
	     
    	     
    	     
    
	    Annuitant’s Issue Age:
    	     
    	    [35]
    
	     
    	     
    	     
    
	    Annuitant’s Sex:
    	     
    	    [M]
    
	     
    	     
    	     
    
	    Maturity Date:
    	     
    	    [January 1,   2089]
    
	     
    	     
    	     
    
	    Initial Premium:
    	     
    	    [$20,000]
    
	     
    	     
    	     
    
	    Planned Premium Mode:
    	     
    	    [Annual]
    
	     
    	     
    	     
    
	    Planned Premium Amount:
    	     
    	    [$4,000]
    
	     
    	     
    	     
    
	    Minimum Contract Value Allowed:
    	     
    	    $2,000
    
	     
    	     
    	     
    
	    Minimum Guaranteed Interest Rate (MGIR):
    	     
    	    [1.5%]*
    
	     
    	     
    	     
    
	    Index used in MVA calculation:
    	     
    	    [The   BofA Merrill Lynch 5-7 Year US Corporate Index (C3A0)]
    

 

*Applies to Minimum Guaranteed Surrender Value only.

 

	    Surrender Charge Period:
    	     
    	    7   Contract Years
    
	     
    	     
    	     
    
	    Surrender   Charge Percentage:
    	     
    	     
    

 

	    Contract Year:
    	     
    	    1
    	     
    	    2
    	     
    	    3
    	     
    	    4
    	     
    	    5
    	     
    	    6
    	     
    	    7
    	     
    	    8+
    
	    Percentage:
    	     
    	    8
    	     
    	    7
    	     
    	    6
    	     
    	    5
    	     
    	    4
    	     
    	    3
    	     
    	    2
    	     
    	    0
    

 

Nonforfeiture Values: The nonforfeiture values for this contract are calculated by accumulating 87.5% of all premiums, less all withdrawals, at the nonforfeiture interest rate of [1.10%].

 

The minimum contract values provided under this Contract meet or exceed the required minimum nonforfeiture values.

 

[Delivery State DOI]

Phone Number: [Phone # of delivery state DOI]

 

ICC10-INDEX-4-09R-7

 

3

 

VALUE OPTION SPECIFICATIONS

 

FIXED VALUE OPTION

 

	    Initial Premium:
    	     
    	    [0.00]
    
	     
    	     
    	     
    
	    Initial Interest Rate:
    	     
    	    [1.50%]
    
	     
    	     
    	     
    
	    Initial Interest Rate Guarantee Period:
    	     
    	    1st   Contract Year
    
	     
    	     
    	     
    
	    Minimum Guaranteed Interest Rate (FV-MGIR):
    	     
    	    1.00%
    
	     
    	     
    	     
    
	    FV-MGIR Guarantee Period:
    	     
    	    Life   of Contract
    

 

INDEXED VALUE OPTIONS

 

	    Cap Rate Guarantee Period:
    	     
    	    One   Contract Year
    

 

The above Indexed Value Specification limit applies to each Indexed Value Option listed below.

 

ANNUAL POINT TO POINT VALUE OPTION

 

	    Index:
    	     
    	    [Standard &   Poor’s 500 Composite Stock Price Index]
    
	     
    	     
    	     
    
	    Initial Premium:
    	     
    	    [$10,000]
    
	     
    	     
    	     
    
	    Index on Contract Date:
    	     
    	    [800]
    
	     
    	     
    	     
    
	    Initial Cap Rate:
    	     
    	    [7%]
    
	     
    	     
    	     
    
	    Guaranteed Minimum Cap Rate:
    	     
    	    4%
    

 

MONTHLY POINT TO POINT (MPT) VALUE OPTION

 

	    Index:
    	     
    	    [Standard &   Poor’s 500 Composite Stock Price Index]
    
	     
    	     
    	     
    
	    Initial Premium:
    	     
    	    [$10,000]
    
	     
    	     
    	     
    
	    Index on Contract Date:
    	     
    	    [800]
    
	     
    	     
    	     
    
	    MPT Monthly Cap Rate:
    	     
    	    [3%]
    
	     
    	     
    	     
    
	    MPT Guaranteed Minimum Monthly Cap Rate:
    	     
    	    1%
    

 

Index Credits may not be reflected in Your Cash Surrender Value due to the calculation of the Minimum Guaranteed Surrender Value described on Page 10.

 

Note:  You may check current indices in the Wall Street Journal, in Barron’s, on the Internet, or with Your financial advisor.

 

Index linked returns do not include the portion of returns generated by the underlying Index that comes from dividends.

 

We can change Cap Rates once each Contract Year, subject to guaranteed minimums shown, and based on future anticipated experience.

 

ICC10-INDEX-4-09R

 

3a

 

DEFINITIONS

 

In this Contract, these terms mean:

 

	    WE,   OUR, US, COMPANY:
    	     
    	    EAGLE   LIFE INSURANCE COMPANY
    
	     
    	     
    	     
    
	    IIPRC:
    	     
    	    Interstate   Insurance Product Regulation Commission
    
	     
    	     
    	     
    
	    OWNER,   YOU, YOUR:
    	     
    	    The   person named in the Application or by later changes as the Owner. The Owner   has all rights under this Contract.
    
	     
    	     
    	     
    
	    ANNUITANT:
    	     
    	    The   person shown on Page 3 whose life is the measuring life for Your   Contract. The Annuitant and Owner must be the same unless the owner is a   non-natural person.
    
	     
    	     
    	     
    
	    PAYEE:
    	     
    	    The   person to whom We pay Proceeds.
    
	     
    	     
    	     
    
	    BENEFICIARY:
    	     
    	    The   person or persons shown on the Application or by later changes to whom We pay   death Proceeds. You may change a Beneficiary as this Contract allows.
    
	     
    	     
    	     
    
	    APPLICATION:
    	     
    	    The   form You filled out to apply for this Contract. We have attached a copy.
    
	     
    	     
    	     
    
	    NOTICE,   NOTIFY, NOTIFYING:
    	     
    	    Written   requests and information We receive at Our Home Office, at address shown on   Page 1, that You sign, and We accept.
    
	     
    	     
    	     
    
	    AGE:
    	     
    	    The   Annuitant’s Age last birthday.
    
	     
    	     
    	     
    
	    CONTRACT   DATE, ISSUE DATE:
    	     
    	    The   date this Contract becomes effective. This Contract does not take effect   until delivered to You and You have paid the Initial Premium.
    
	     
    	     
    	     
    
	    MATURITY   DATE:
    	     
    	    The   Maturity Date is the last date this Contract can remain in force, is first   Contract Anniversary after Annuitant’s 114th birthday, and is shown on Page 3.   Please Note: Annuitization Option is also available and is described on   Page 10.
    
	     
    	     
    	     
    
	    INDEX:
    	     
    	    The   Index is Standard & Poor’s 500 Composite Stock Price Index or any   substituted suitable alternative index.
    
	     
    	     
    	     
    
	    INDEX   PRICE:
    	     
    	    The   Index Price as of any date is the closing Price of the Index on that date.
    
	     
    	     
    	     
    
	    INDEX   DATE:
    	     
    	    The   Index Date is the Contract Date and the same day of each month thereafter. If   the same day does not exist in a month, such as the 31st, We use the first   preceding day. Example: If the Contract Date is January 31, 2009, the   next Index Date is February 28, 2009, and the last day of each month   thereafter.
    
	     
    	     
    	     
    
	    CONTRACT   YEAR, ANNIVERSARY:
    	     
    	    We   compute Contract Years and Anniversaries from the Contract Date. Example: If   the Contract Date is January 1, 2009, the first Contract Year ends on   December 31, 2009, and the first Anniversary falls on January 1,   2010.
    
	     
    	     
    	     
    
	    CAP RATES:
    	     
    	    The   percentages shown on Page 6, used in calculating the Index Credits as   described on Page 9. We declare the Cap Rates annually in advance. The   Cap Rates will never be less than the Guaranteed Minimum Cap Rate and are   guaranteed for the Cap Rate Guarantee Period shown on Page 6.
    

 

ICC10-INDEX-4-09R

 

4

 

GENERAL PROVISIONS

 

CONTRACT

 

This Contract, attached Application, and any attached amendments, riders or endorsements make up the entire Contract.  All statements made by Applicant on the Application for issuance of the Contract are representations and not warranties. This Contract is approved under authority of IIPRC and issued under Commission Standards.

 

CONTRACT CHANGES

 

No one may change any part of this Contract or waive any provision except You or one of Our officers.  Both must agree to the change.  All changes must be in writing.

 

CONFORMITY WITH THE IIPRC STANDARDS

 

The provisions of this Contract conform to the minimum requirements of the IIPRC Standards.  If any provision of this Contract is in conflict with IIPRC Standards, the Contract is hereby amended to conform with IIPRC Standards for this product type on the Contract Date.

 

CHANGES IN THE LAW

 

We will amend this Contract to comply with any changes in laws governing it or taxation of benefits under it.

 

OWNERSHIP*

 

This Contract belongs to You.  You have all rights, subject to the rights of: any irrevocable Beneficiary; any assignee of record with Us; and any restricted Ownership.  You may change the Owner by giving Us written Notice.  We reserve the right, except to the extent prohibited by applicable state law or regulation, or by the action of the Insurance Commissioner, Bank Commissioner, or any agency or officer performing like functions of the applicable State, to require that any change of Owner will be effective only upon Our acceptance, and to refuse such changes at any time on a non-discriminatory basis.  No change applies to any action We take before receiving Notice.  A change of Owner does not change the Beneficiary.

 

ASSIGNMENT*

 

You may assign this Contract by giving Us written Notice.  We reserve the right, except to the extent prohibited by applicable state law or regulation or by the action of the Insurance Commissioner, Bank Commissioner, or any agency or officer performing like functions of the applicable State, to require that assignment will be effective only upon Our acceptance, and to refuse assignments at any time on a non-discriminatory basis.  No assignment applies to any action We take before receiving Notice.

 

*Qualified contracts may not be transferred or assigned.

 

INCONTESTABILITY

 

If permitted by law in state of delivery, in the absence of fraud in the procurement of the Contract,  We will not contest this Contract after it has been in force during the Annuitant’s lifetime for 2 years from the Issue Date.  Read the Application, a copy of which is attached.  If anything is not true or complete to the best of Your knowledge and belief, Notify Us.

 

NONFORFEITABILITY

 

Before the Maturity Date, the Cash Surrender Value is always nonforfeitable.

 

INTEREST RATES

 

The rate and duration of the Fixed Value Initial Interest Rate shown on Page 6 apply only to Your Fixed Value Initial Premium.  We declare Our Current Fixed Value Interest Rate in advance and guarantee it will never be less than the Fixed Value Minimum Guaranteed Interest Rate(FV-MGIR).  The Minimum Guaranteed Interest Rate (MGIR) shown on Page 3, applies to Minimum Guaranteed Surrender Value only, is based on the average of the 5 Year Constant Maturity Treasury Rate for October of the previous year, and is guaranteed until this Contract terminates.  All Interest Rates are calculated as an effective annual rate, compounded daily.

 

ICC10-INDEX-4-09R

 

5

 

RESERVE BASIS

 

The reserve method and basis for this Contract are on file with the IIPRC.

 

STATEMENT OF VALUES

 

Once each year, We will send You a Statement of Values.  It will show:  Beginning and ending dates of the Statement of Values; Premiums paid; Withdrawals and applicable Surrender Charges; Values as described on Pages 10, 11, 12, & 13 before application of MVA; MVA amount used to determine Cash Surrender Value; Interest Rates; and Caps.

 

TERMINATION

 

This Contract terminates on the earliest of:

 

(1)           The date You do not maintain Minimum Values as described on Page 13;

(2)           The date You choose to exercise the Annuitization Option described on Page 14;

(3)           The date You Surrender Your Contract;

(4)           The date the Annuitant or Owner dies; or

(5)           The Maturity Date.

 

PREMIUM PROVISIONS

 

PAYMENT AND ALLOCATION OF PREMIUMS

 

The Initial Premium, the amount We receive with Your Application, as shown on Page 3, is due on the Contract Date.  You may direct all or any portion of Your Initial Premium to either Your Fixed Value Option, either of the Indexed Value Options, or any combination thereof, subject to the Limitations below.  You may make Additional Premium payments after the Initial Premium in any amount and frequency, also subject to Limitations below.  Your Additional Premiums will automatically go into Your Fixed Value Option as described in Transfer of Additional Premium Payments below.

 

If mandated under applicable law, We may be required to reject a Premium Payment.  We may also be required to provide additional information about an Owner and an Owner’s Contract to government regulators.

 

TRANSFER OF ADDITIONAL PREMIUM PAYMENTS

 

We will hold Your Additional Premiums in Your Fixed Value Option, credit Interest as described in Fixed Value Option section, and unless You elect otherwise under Transfer of Values Option, the Premiums and Interest thereon will remain in the Fixed Value Option.

 

LIMITATIONS

 

(1)           Initial Premium

a.             The minimum Initial Premium We will accept is $10,000.

b.             The minimum required to select allocation to an Indexed Value Option is 10% of Your Initial Premium.

(2)           Additional Premiums - You may pay Additional Premiums if:

a.             The Contract is in force;

b.             The Annuitant and Owner are alive;

c.             The Additional Premium is at least $1,000; and

d.             The maximum cumulative Premium per Owner/Annuitant is $1,000,000

 

ICC10-INDEX-4-09R

 

6

 

CONTRACT VALUES PROVISIONS

 

CONTRACT VALUE

 

Your Contract Value equals the sum of:

 

(1)           The value of Your Fixed Value Option; plus

(2)           The value of Your Indexed Value Options.

 

We allocate Your Premiums between Your Fixed and/or Indexed Value Options as You direct, subject to Our rules governing Premium allocation.  See “PREMIUM PROVISIONS” section above.

 

CASH SURRENDER VALUE

 

The Cash Surrender Value is the amount of Proceeds payable if You Surrender this Contract during the Surrender Charge Period, and is equal to the greater of:

 

(1)           Contract Value minus any applicable Surrender Charges and plus or minus applicable MVA, each calculated as described on page 11; or

(2)           Minimum Guaranteed Surrender Value.

 

MINIMUM GUARANTEED SURRENDER VALUE

 

The Surrender Value of Your Contract will never be less than:

 

(1)           87.5% of all Premiums; less

(2)           Any Withdrawal Proceeds;

(3)           Accumulated at Minimum Guaranteed Interest Rate as shown on Page 3.

 

SURRENDER CHARGE

 

We take a Surrender Charge on Partial Withdrawals or full Surrenders during the Surrender Charge Period. We calculate Surrender Charges as follows:

 

(1)           At Partial Withdrawal, the Withdrawal Amount times the applicable Surrender Charge Percentage shown on Page 3; or

(2)           At Surrender, the Contract Value, plus any Penalty-Free Withdrawal Proceeds taken in the last 12 months, times the applicable Surrender Charge Percentage shown on Page 3.

 

ICC10-INDEX-4-09R

 

7

 

 

MARKET VALUE ADJUSTMENT (MVA)

 

This form has a Market Value Adjustment. The Market Value Adjustment Factor is

 

MVA Factor = [A/B]t

Where

A = [1 + the Effective Yield* of the appropriate Index on the Contract Date] less 0.25%;

B = [1 + the Effective Yield* of the appropriate Index on the day before the Withdrawal or Surrender];

t = Number of days from the date of Surrender or Withdrawal to the next anniversary divided by 365, plus the number of whole years from the next anniversary to the end of the surrender charge period.

 

The appropriate index is based on the surrender charge period as follows:

 

	    Surrender Charge Period
    	     
    	    Appropriate Index
    
	    3
    	     
    	    The   BofA Merrill Lynch 3-5 Year US Corporate Index (C2A0)
    
	    5
    	     
    	    The   BofA Merrill Lynch 5-7 Year US Corporate Index (C3A0)
    
	    7
    	     
    	    The   BofA Merrill Lynch 5-7 Year US Corporate Index (C3A0)
    

 

MVA Factor = 1 (one) after the surrender charge period.

 

The Cash Surrender Value is equal to the greater of A – B + C or the Minimum Guaranteed Surrender Value.  Where

 

A = Contract Value

B = A x Surrender Charge Percentage

C = A x (MVA Factor-1); C can be positive or negative, subject to the limitations in the following paragraph; C = zero after the surrender charge period.

 

*Calculated on a semi-annual compounding basis.

 

The MVA can be positive or negative and will never cause the Cash Surrender Value to be greater than the Contract Value or less than the Minimum Guaranteed Surrender Value.  After the Surrender Charge Period, the MVA Factor is (1) one.

 

FIXED VALUE OPTION

 

The value of the Fixed Value Option equals:

 

(1)           On Contract Date - the Fixed Value Initial Premium shown on Page 3a, if any.

(2)           At each Anniversary:

 

a.             The value of the Fixed Value Option on the last Anniversary**; plus

b.             Any Premiums paid since the last Anniversary; less

c.             Any Withdrawal Amounts since last Anniversary; plus

d.             Interest credited***; plus or minus

e.             Any Transferred Values on the current Anniversary.

(3)           Between Anniversaries:

a.             The value of the Fixed  Value Option on the last Anniversary**; plus

b.             Any Premiums paid since the last Anniversary; less

c.             Any Withdrawal Amounts since the last Anniversary; plus

d.             Interest credited.***

 

**When calculating Values on the first Anniversary or during the first Contract Year (or for the first month or during the first month on the Monthly Point to Point Indexed Value Option), use the Value on the Contract Date.

 

***Never less than FV-MGIR shown on Page 3a.

 

ICC10-INDEX-4-09R

 

8

 

INDEX

 

The Index on the Issue Date is shown on Page 6 and is the Index on the last Index Date.  If the Index is not available for any Index Date, We will use the Index on the first preceding day for which it is available.  Indices are published in the Wall Street Journal.  If: (i) the Index is discontinued; (ii) We are unable to use the Index or; (iii) the calculation of the Index is changed substantially, We may substitute a suitable alternative equity index approved by the IIPRC and will Notify You.

 

If the Index is discontinued during a Contract Year, We may transfer the value of Your Indexed Value Options to Your Fixed Value Option and credit the amount transferred with the Current Fixed Value Interest Rate for the remainder of the Contract Year.  We treat any portion of the Contract Year in which the amount transferred remained in the Indexed Value Option as a full Contract Year for the purpose of crediting any Index Credits.

 

We may terminate or substitute any of the Indexed Value Options at any time by sending You written Notice at Your last known address at least 60 days in advance of the effective date on which the Indexed Value Option will terminate or be substituted.

 

INDEXED VALUE OPTIONS

 

The value of the Indexed Value Options equals the value of the Annual Point to Point Value Option plus the value of the Monthly Point to Point Value Option.

 

Annual Point to Point Value Option– The value of the Point to Point Value Option equals:

 

(1)           On the Contract Date - The Annual Point to Point Value Option Initial Premium shown on Page 3a, if any.

(2)           At each Anniversary:

a.             The value of the Annual Point to Point Value Option on the last Anniversary*; less

b.             Any Withdrawal Amounts since the last Anniversary; plus

c.             Annual Point to Point Value Option Index Credits; plus or minus

d.             Any Transferred Values on the current Anniversary.

(3)           Between Anniversaries:

a.             The value of the Annual Point to Point Value Option on the last Anniversary*; less

b.             Any Withdrawal Amounts since last Anniversary.

 

Monthly Point to Point Value Option – The value of the Monthly Point to Point Value Option equals:

 

(1)           On the Contract Date – The MPT Value Option Initial Premium shown on Page 3a, if any.

(2)           At each Anniversary =

a.             The value of the MPT Value Option on the last Anniversary*; less

b.             Any Withdrawal Amounts since the last Anniversary; plus

c.             MPT Value Option Index Credit; plus or minus

d.             Any Transferred Values on the current Anniversary.

(3)           Between Anniversaries =

a.             The value of the MPT Value Option on the last Anniversary*; less

b.             Any Withdrawal Amounts since last Anniversary.

 

*When calculating Values on the first Anniversary or during the first Contract Year (or for the first month or during the first month on the Monthly Point to Point Indexed Value Option), use the Value on the Contract Date.

 

Transferred Values:  The values transferred from one Value Option to another Value Option on any Anniversary as provided in the Transfer of Values Option section on Page 10.

 

ICC10-INDEX-4-09R

 

9

 

TRANSFER OF VALUES OPTION

 

On each Anniversary, You may transfer Your money between Your Fixed and/or Indexed Value Options, subject to a $1,000 minimum to maintain an Indexed Value Option.  We calculate and apply Index Credits before we process transfers.

 

To transfer Your money between Value Options, We must receive Our completed Transfer of Values form on or before the Anniversary on which You want the transfer to occur, or on another date which We may determine later.

 

If mandated under applicable law, We may block an Owner’s account and refuse to process any request for transfer until We receive instructions from the appropriate regulator.

 

MINIMUM VALUES

 

To be maintained, the value of an Indexed Value Option must be at least $1,000.  If, through Withdrawals or transfers, You reduce an Indexed Value Option to less than $1,000, We will automatically close that Indexed Value Option and transfer the remaining funds to Your Fixed Value Option on the next Contract Anniversary.  To be maintained, Your Contract must contain at least the Minimum Contract Value Allowed as shown on Page 3.  If through Withdrawals You reduce Your Contract Value to less than the Minimum Contract Value Allowed, Your Contract will automatically terminate and We will payout any remaining Cash Surrender Value.

 

INDEX CREDITS are added to the Indexed Value Options on the Contract Anniversary and are calculated as follows:

 

Annual Point to Point Index Credits –

 

(1)           The Index Price on the current Contract Anniversary; less

(2)           The Index Price on the last Anniversary;* divided by

(3)           The Index Price on the last Anniversary;*

(4)           Result not to exceed Cap; multiplied by

(5)                                  The value of the Annual Point to Point Value Option on the last Anniversary;** less any Withdrawal Amounts during the last Contract Year.

 

Monthly Point to Point Index Credits -

 

(1)           The value of the MPT Value Option on the last Anniversary;** less

(2)           Any Withdrawal Amounts during the last Contract Year; multiplied by

(3)           The MPT Sum.

 

MPT Sum:  The MPT Sum is the sum of the twelve MPT Ratios during each Contract Year.

 

MPT Ratios:

·                  Index Price on each monthly Index Date; less

·                  The Index Price on the first preceding monthly Index Date;* divided by

·                  The Index Price on first preceding monthly Index Date;* (result not to exceed MPT Cap).

 

* When calculating an Index Credit for the first Anniversary (or for the first month on the Monthly Point to Point Indexed Value Option) use the applicable Index Price on the Contract Date.

 

**When calculating Values on the first Anniversary or during the first Contract Year (or for the first month or during the first month on the Monthly Point to Point Indexed Value Option), use the Value on the Contract Date.

 

Each Index Credit will never be less than zero (0).

 

ICC10-INDEX-4-09R

 

10

 

CONTRACT PROCEEDS AND PAY-OUT PROVISIONS

 

MINIMUM BENEFITS

 

Any Proceed Pay-outs available under this Contract are at least the minimum required by NAIC Standard Nonforfeiture law for Individual Deferred Annuities, Model #805 using the nonforfeiture rate shown on Page 3.  The method of determining the nonforfeiture rate for this Contract is on file with the IIPRC.

 

PREMIUM TAXES

 

If We are required to pay premium taxes, We re-calculate Your Proceeds at pay-out as if We had deducted premium taxes from Your Premiums as We received them.

 

PROCEEDS

 

Proceeds means the amount payable when:  You take a Withdrawal; You Surrender this Contract; The Annuitant or Owner dies; or The Contract matures.

 

PAYMENT OF PROCEEDS

 

We pay Proceeds under the Automatic Settlement Option, unless You or Your Beneficiary elect to apply all or part of Death or Maturity Proceeds to provide payments under  another  Settlement Option  or in a lump sum.  We pay Death Proceeds to the Beneficiary on receipt of due proof of Death.  We always pay  Withdrawal and Surrender Proceeds in one sum unless You choose the Annuitization Option below.  If pay-out is not immediate, We credit Interest on the Proceeds from the date of Withdrawal, Surrender, Maturity, or Death until pay-out.  We add this Interest to the Proceeds and pay the greater of:

 

(1)           The current rate of Interest We declare; or

(2)           Any minimum rate required by the laws of the delivery state.

 

If mandated under applicable law, We may block an Owner’s account and refuse to process any request for Transfer, Withdrawal, Surrender or Death Proceeds until We receive instructions from the appropriate regulator.

 

ADJUSTMENT OF BENEFIT VALUES

 

If We find an error in the stated Age or sex of any Payee after making payments under a Settlement Option, We adjust the benefits to those that the Values of this Contract would have purchased using the correct Age and sex.  If We find an error and We have made income payments, We:

 

(1)                                  Pay the amount of any under-payments, plus  6%  Interest, compounded annually; or

(2)                                  Charge the amount of any over-payments, plus 6%  Interest, compounded annually, against the next income payments.

 

ANNUITIZATION OPTION

 

You may annuitize Your Surrender Proceeds under this Contract after the first Contract Year for a life option with at least 5 years certain.

 

MATURITY PAY-OUT PROVISIONS

 

MATURITY BENEFIT

 

If the Contract is in force on the Maturity Date, We pay the Maturity Proceeds to the Annuitant as described in Payment of Proceeds section.  The Maturity Proceeds equal the greater of the Contract Value or the Minimum Guaranteed Surrender Value on the Maturity Date.  We may change the mode of payment under a Settlement Option so each payment is at least $50.00.

 

Maturity benefits will not be less than those that would be provided by application of the Cash Surrender Value to purchase a single premium immediate annuity at purchase rates available at the time to the same class of Annuitants.

 

ICC10-INDEX-4-09R

 

11

 

WITHDRAWAL AND SURRENDER PAY-OUT PROVISIONS

 

DEFERRAL OF PAYMENT

 

We may defer payment of any Surrender Proceeds for up to six months from the date You Notify Us, only after We receive written approval of deferral from the Iowa Commissioner of Insurance, and pay interest on the Proceeds as described in the Payment of Proceeds section.

 

WITHDRAWALS

 

Withdrawal Amount is the amount We deduct from Your Contract Value to provide the Withdrawal Proceeds and does not include any Surrender Charges or MVA adjustments.  Withdrawal Proceeds include amounts withdrawn under both the Penalty-free Withdrawal and Partial Withdrawal Options as follows and are the actual amounts We pay to the Contract Owner after application of any applicable Surrender Charge and MVA adjustment:

 

(1)           Penalty-free Withdrawal Option

 

Each Contract Year, after the first, You may take one Penalty-free Withdrawal of up to 10% of Your Contract Value.  We determine the amount of Penalty-free Withdrawal Proceeds payable at the time of Withdrawal.  Penalty-free Withdrawal Proceeds equal the Penalty-free Withdrawal amount You request. No MVA or Surrender Charges apply to Penalty-free Withdrawals.  All Withdrawals taken after the end of the Surrender Charge Period are Penalty-free.

 

(2)           Partial Withdrawal Option

 

You may make Partial Withdrawals at any time subject to Surrender Charges, MVA, and Minimum Values.  We apply MVA and applicable Surrender Charges to:

 

a.                                       Amounts withdrawn in the first Contract Year;

b.                                      Amounts withdrawn in excess of the Penalty-free Withdrawal Option amount during the Surrender Charge Period; and

c.                                       Any Withdrawals taken after taking a Penalty-free Withdrawal in any Contract Year during the Surrender Charge Period.

 

We calculate MVAs and Surrender Charges as described on Page 7, pay You the Withdrawal Proceeds, and adjust Your Values as described in Contract Values Provisions.

 

We deduct Withdrawals first from Your Fixed Value Option, then proportionally from Your Indexed Value Option(s) until We reach the amount You requested.  We process Penalty-free Withdrawals before Partial Withdrawals.  For example, if You request a Withdrawal in excess of the Penalty-free Withdrawal amount, the Penalty-free Withdrawal Option provision applies to the Penalty-free Withdrawal amount with no Surrender Charge or MVA, and the remaining amount falls under the Partial Withdrawal Option provision, and is affected by any applicable Surrender Charges and MVA.  Some Limitations may apply, see Limitations section below.

 

SURRENDER

 

If You Surrender this Contract, We pay You the Surrender Proceeds in a single sum or under the Annuitization Option.  Surrender Proceeds equal the Cash Surrender Value on the date of Surrender.

 

LIMITATIONS

 

(1)           No portion of a Surrender taken during the Surrender Charge Period can be Penalty-free.

 

(2)           We treat any Penalty-free Withdrawal You take within the 12 months before Surrender as having been made in anticipation of Surrender.  Therefore, We apply a Surrender Charge and any applicable MVA to that amount at Surrender.

 

(3)           You must maintain Minimum Values, as described on Page 10.

 

ICC10-INDEX-4-09R

 

12

 

DEATH PAY-OUT PROVISIONS

 

DEATH BENEFIT

 

We will pay the death proceeds of this Contract to the beneficiary(ies) upon receipt of due proof of the Insured’s death.  Payment is subject to the provisions, terms and conditions of this Contract.

 

Annuitant’s Death -The Death Benefit Proceeds payable equal the greater of Contract Value or the Minimum Guaranteed Surrender Value on the Annuitant’s date of death in the case of a non-natural Owner.

 

Owner’s Death - The Death Benefit Proceeds payable equal the greater of the Contract Value or the Minimum Guaranteed Surrender Value on the Owner’s date of death.

 

If any Owner, or Annuitant in the case of a non-natural Owner, dies before the Maturity Date, We pay Death Proceeds to the Owner’s Beneficiary.  If You did not choose a Settlement Option, the Beneficiary may make a selection within 60 days of Our receiving proof of death.

 

We pay out the entire Death Benefit Proceeds in a lump sum unless:

 

(1)                                  It is payable to the Beneficiary over a 5 year period.  Entire Death Benefit Proceeds must be paid within 5 years;

(2)                                  It is payable over the lifetime, or life expectancy, of a designated Beneficiary.  Payment must begin within one year of the date of death; or

(3)                                  The designated Beneficiary is the Owner’s spouse and he or she continues the Contract in his or her name as new Owner.

 

Death after Maturity Date - If any Owner or the Annuitant dies after the Maturity Date and before the payment of the entire Maturity Proceeds, We pay any remaining balance as provided for in the Settlement Option selected, at least as rapidly as under the method of payment in effect at the Annuitant’s death.

 

Note:  We pay Death Benefit Proceeds once, at death of the first to die of either an Owner or Annuitant.

 

INTEREST ON DEATH BENEFIT

 

We pay Interest on the Death Proceeds as described in Payment of Proceeds section.

 

BENEFICIARY

 

You named the Beneficiary in the Application.  While the Annuitant is alive You may change the Beneficiary by Notifying Us.  A change will take effect on the date We receive Notice.  Any change is subject to payment or other action We take before receiving Notice.

 

Unless You Notify Us otherwise, these rules apply:

 

(1)                                  If You name more than one Beneficiary, and any one Beneficiary dies before the Annuitant, We pay the Death Benefit Proceeds to any surviving Beneficiary(ies).

(2)                                  If any Beneficiary dies within 30 days after the Annuitant dies and We receive Notice of the Death before We pay the Death Benefit Proceeds, We pay it as if the Beneficiary died before the Annuitant.

(3)                                  If You have not named a Beneficiary when the Annuitant dies, We pay the Death Benefit Proceeds to the Annuitant’s estate.

(4)                                  If no named Beneficiary is alive when the Annuitant dies, We pay the Death Benefit Proceeds to the Annuitant’s estate.

(5)                                  We pay equal amounts when more than one Beneficiary is to share the Death Benefit Proceeds.

(6)                                  When You do not state Beneficiaries by name (such as “children”), We may find who they are from sworn statements and not wait for court records.  The word “child” means only a child born to, or adopted by, the Annuitant, it does not mean grandchild or stepchild.

 

ICC10-INDEX-4-09R

 

13

 

SETTLEMENT OPTION PAY-OUT PROVISIONS

 

These are the guaranteed Pay-out options from which to choose at Maturity or Death of an Owner or Annuitant where there is a non-natural Owner.  You may also choose any other Settlement Option We currently offer by Notifying Us.  All Settlement Options are for a minimum of 5 years. We pay interest on the Proceeds as described in the Payment of Proceeds section.

 

OPTION 1 - INCOME FOR SPECIFIED PERIOD

 

We pay an income for a specific number of years in equal installments.  We guarantee these payments to be at least those shown in Table 1.

 

OPTION 2 - LIFE INCOME

 

We pay equal monthly payments for a specified period certain and then for life.  We guarantee these payments will be at least those shown in Table 2.

 

OPTION 3 - INCOME OF SPECIFIED AMOUNT

 

We pay income of the specified amount until the principal and interest are exhausted.

 

OPTION 4 - JOINT AND SURVIVOR INCOME

 

We pay equal monthly payments during the joint lifetime of the Annuitant and the named Beneficiary/Payee.  We determine the payment by the Age and sex of each person from Table 3. The Annuitant must be at least 50 years old, and the Beneficiary/Payee must be at least 45 years old, at the time of the first monthly payment.

 

AUTOMATIC SETTLEMENT OPTION

 

The Automatic Settlement Option is life income with five years certain unless otherwise provided under the Internal Revenue Code.  If You do not select a Settlement Option within 60 days of Maturity, the Automatic Settlement Option will take effect.

 

INTEREST ON SETTLEMENT OPTIONS

 

We pay at least the minimum rate required by the state of delivery.

 

EXCESS INTEREST

 

Excess Interest is the difference between Our current rates and the minimum rate required.  We determine Excess Interest, if any, on Settlement Option amounts.  We pay this excess under Option 1, 2, or 4 and add it to the period of payment under Option 3.

 

SUPPLEMENTARY CONTRACT

 

When We receive Notice requesting a Settlement Option, We issue a Supplementary Contract in exchange for this Contract, stating the terms under which We make payments.  The Supplementary Contract states to whom We pay any remaining Proceeds if the Payee dies.  Once a Supplementary Contract is in effect the method of pay-out cannot be changed and the contract cannot be commuted or assigned.

 

If any Owner of the Supplementary Contract dies before payments are complete, We pay any remaining balance at least as rapidly as under the method of payment in effect on the Owner’s date of death; provided however, that if the Owner is not an individual, then the Annuitant is deemed the Owner for purposes of this requirement.

 

ICC10-INDEX-4-09R

 

14

 

 

TABLE
1

 

INCOME FOR SPECIFIED PERIOD
FACTORS

 

	
  NO.
  OF YEARS

  PAYABLE

  	
   

  	
  MONTHLY

  INSTALLMENTS*

  	
   

  	
  NO. OF YEARS

  PAYABLE

  	
   

  	
  MONTHLY

  INSTALLMENTS*

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  1

  	
   

  	
  N/A

  	
   

  	
  11

  	
   

  	
  8.42

  	
   

  
	
  2

  	
   

  	
  N/A

  	
   

  	
  12

  	
   

  	
  7.80

  	
   

  
	
  3

  	
   

  	
  N/A

  	
   

  	
  13

  	
   

  	
  7.26

  	
   

  
	
  4

  	
   

  	
  N/A

  	
   

  	
  14

  	
   

  	
  6.81

  	
   

  
	
  5

  	
   

  	
  17.49

  	
   

  	
  15

  	
   

  	
  6.42

  	
   

  
	
  6

  	
   

  	
  14.72

  	
   

  	
  16

  	
   

  	
  6.07

  	
   

  
	
  7

  	
   

  	
  12.74

  	
   

  	
  17

  	
   

  	
  5.77

  	
   

  
	
  8

  	
   

  	
  11.25

  	
   

  	
  18

  	
   

  	
  5.50

  	
   

  
	
  9

  	
   

  	
  10.10

  	
   

  	
  19

  	
   

  	
  5.26

  	
   

  
	
  10

  	
   

  	
  9.18

  	
   

  	
  20

  	
   

  	
  5.04

  	
   

  

 

*
Monthly installments shown are for each $1,000 of net Proceeds applied at 2%
Interest, which is subject to change as described on Page 17, Interest
On Settlement Options.

 

ICC10-INDEX-4-09R

 

15

 

TABLE 2

 

LIFE INCOME WITH SPECIFIED PERIOD
CERTAIN FACTORS

	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
  120

  	
   

  	
  240

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
  120

  	
   

  	
  240

  	
   

  
	
   

  	
   

  	
  Life Only

  	
   

  	
  Months Certain

  	
   

  	
  Months Certain

  	
   

  	
   

  	
   

  	
  Life Only

  	
   

  	
  Months Certain

  	
   

  	
  Months Certain

  	
   

  
	
  Age

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Age

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  	
  Male

  	
   

  	
  Female

  	
   

  
	
  15

  	
   

  	
  $

  	
  2.28

  	
   

  	
  $

  	
  2.21

  	
   

  	
  $

  	
  2.28

  	
   

  	
  $

  	
  2.21

  	
   

  	
  $

  	
  2.28

  	
   

  	
  $

  	
  2.21

  	
   

  	
  65

  	
   

  	
  $

  	
  5.14

  	
   

  	
  $

  	
  4.65

  	
   

  	
  $

  	
  4.96

  	
   

  	
  $

  	
  4.55

  	
   

  	
  $

  	
  4.39

  	
   

  	
  $

  	
  4.21

  	
   

  
	
  16

  	
   

  	
  $

  	
  2.30

  	
   

  	
  $

  	
  2.23

  	
   

  	
  $

  	
  2.30

  	
   

  	
  $

  	
  2.23

  	
   

  	
  $

  	
  2.30

  	
   

  	
  $

  	
  2.23

  	
   

  	
  66

  	
   

  	
  $

  	
  5.32

  	
   

  	
  $

  	
  4.79

  	
   

  	
  $

  	
  5.10

  	
   

  	
  $

  	
  4.68

  	
   

  	
  $

  	
  4.45

  	
   

  	
  $

  	
  4.29

  	
   

  
	
  17

  	
   

  	
  $

  	
  2.32

  	
   

  	
  $

  	
  2.24

  	
   

  	
  $

  	
  2.32

  	
   

  	
  $

  	
  2.24

  	
   

  	
  $

  	
  2.31

  	
   

  	
  $

  	
  2.24

  	
   

  	
  67

  	
   

  	
  $

  	
  5.50

  	
   

  	
  $

  	
  4.95

  	
   

  	
  $

  	
  5.25

  	
   

  	
  $

  	
  4.82

  	
   

  	
  $

  	
  4.51

  	
   

  	
  $

  	
  4.36

  	
   

  
	
  18

  	
   

  	
  $

  	
  2.34

  	
   

  	
  $

  	
  2.26

  	
   

  	
  $

  	
  2.34

  	
   

  	
  $

  	
  2.26

  	
   

  	
  $

  	
  2.33

  	
   

  	
  $

  	
  2.26

  	
   

  	
  68

  	
   

  	
  $

  	
  5.70

  	
   

  	
  $

  	
  5.11

  	
   

  	
  $

  	
  5.40

  	
   

  	
  $

  	
  4.96

  	
   

  	
  $

  	
  4.57

  	
   

  	
  $

  	
  4.43

  	
   

  
	
  19

  	
   

  	
  $

  	
  2.36

  	
   

  	
  $

  	
  2.28

  	
   

  	
  $

  	
  2.35

  	
   

  	
  $

  	
  2.28

  	
   

  	
  $

  	
  2.35

  	
   

  	
  $

  	
  2.27

  	
   

  	
  69

  	
   

  	
  $

  	
  5.91

  	
   

  	
  $

  	
  5.29

  	
   

  	
  $

  	
  5.56

  	
   

  	
  $

  	
  5.11

  	
   

  	
  $

  	
  4.63

  	
   

  	
  $

  	
  4.50

  	
   

  
	
  20

  	
   

  	
  $

  	
  2.37

  	
   

  	
  $

  	
  2.29

  	
   

  	
  $

  	
  2.37

  	
   

  	
  $

  	
  2.29

  	
   

  	
  $

  	
  2.37

  	
   

  	
  $

  	
  2.29

  	
   

  	
  70

  	
   

  	
  $

  	
  6.13

  	
   

  	
  $

  	
  5.48

  	
   

  	
  $

  	
  5.72

  	
   

  	
  $

  	
  5.27

  	
   

  	
  $

  	
  4.68

  	
   

  	
  $

  	
  4.57

  	
   

  
	
  21

  	
   

  	
  $

  	
  2.39

  	
   

  	
  $

  	
  2.31

  	
   

  	
  $

  	
  2.39

  	
   

  	
  $

  	
  2.31

  	
   

  	
  $

  	
  2.39

  	
   

  	
  $

  	
  2.31

  	
   

  	
  71

  	
   

  	
  $

  	
  6.37

  	
   

  	
  $

  	
  5.69

  	
   

  	
  $

  	
  5.89

  	
   

  	
  $

  	
  5.44

  	
   

  	
  $

  	
  4.73

  	
   

  	
  $

  	
  4.63

  	
   

  
	
  22

  	
   

  	
  $

  	
  2.41

  	
   

  	
  $

  	
  2.33

  	
   

  	
  $

  	
  2.41

  	
   

  	
  $

  	
  2.33

  	
   

  	
  $

  	
  2.41

  	
   

  	
  $

  	
  2.33

  	
   

  	
  72

  	
   

  	
  $

  	
  6.62

  	
   

  	
  $

  	
  5.91

  	
   

  	
  $

  	
  6.06

  	
   

  	
  $

  	
  5.61

  	
   

  	
  $

  	
  4.78

  	
   

  	
  $

  	
  4.69

  	
   

  
	
  23

  	
   

  	
  $

  	
  2.44

  	
   

  	
  $

  	
  2.35

  	
   

  	
  $

  	
  2.43

  	
   

  	
  $

  	
  2.35

  	
   

  	
  $

  	
  2.43

  	
   

  	
  $

  	
  2.34

  	
   

  	
  73

  	
   

  	
  $

  	
  6.89

  	
   

  	
  $

  	
  6.16

  	
   

  	
  $

  	
  6.24

  	
   

  	
  $

  	
  5.80

  	
   

  	
  $

  	
  4.82

  	
   

  	
  $

  	
  4.74

  	
   

  
	
  24

  	
   

  	
  $

  	
  2.46

  	
   

  	
  $

  	
  2.37

  	
   

  	
  $

  	
  2.46

  	
   

  	
  $

  	
  2.37

  	
   

  	
  $

  	
  2.45

  	
   

  	
  $

  	
  2.36

  	
   

  	
  74

  	
   

  	
  $

  	
  7.18

  	
   

  	
  $

  	
  6.42

  	
   

  	
  $

  	
  6.41

  	
   

  	
  $

  	
  5.98

  	
   

  	
  $

  	
  4.85

  	
   

  	
  $

  	
  4.79

  	
   

  
	
  25

  	
   

  	
  $

  	
  2.48

  	
   

  	
  $

  	
  2.39

  	
   

  	
  $

  	
  2.48

  	
   

  	
  $

  	
  2.39

  	
   

  	
  $

  	
  2.47

  	
   

  	
  $

  	
  2.38

  	
   

  	
  75

  	
   

  	
  $

  	
  7.49

  	
   

  	
  $

  	
  6.70

  	
   

  	
  $

  	
  6.59

  	
   

  	
  $

  	
  6.18

  	
   

  	
  $

  	
  4.89

  	
   

  	
  $

  	
  4.83

  	
   

  
	
  26

  	
   

  	
  $

  	
  2.50

  	
   

  	
  $

  	
  2.41

  	
   

  	
  $

  	
  2.50

  	
   

  	
  $

  	
  2.41

  	
   

  	
  $

  	
  2.50

  	
   

  	
  $

  	
  2.40

  	
   

  	
  76

  	
   

  	
  $

  	
  7.82

  	
   

  	
  $

  	
  7.01

  	
   

  	
  $

  	
  6.78

  	
   

  	
  $

  	
  6.38

  	
   

  	
  $

  	
  4.91

  	
   

  	
  $

  	
  4.87

  	
   

  
	
  27

  	
   

  	
  $

  	
  2.53

  	
   

  	
  $

  	
  2.43

  	
   

  	
  $

  	
  2.53

  	
   

  	
  $

  	
  2.43

  	
   

  	
  $

  	
  2.52

  	
   

  	
  $

  	
  2.42

  	
   

  	
  77

  	
   

  	
  $

  	
  8.17

  	
   

  	
  $

  	
  7.34

  	
   

  	
  $

  	
  6.96

  	
   

  	
  $

  	
  6.58

  	
   

  	
  $

  	
  4.94

  	
   

  	
  $

  	
  4.90

  	
   

  
	
  28

  	
   

  	
  $

  	
  2.56

  	
   

  	
  $

  	
  2.45

  	
   

  	
  $

  	
  2.55

  	
   

  	
  $

  	
  2.45

  	
   

  	
  $

  	
  2.55

  	
   

  	
  $

  	
  2.45

  	
   

  	
  78

  	
   

  	
  $

  	
  8.55

  	
   

  	
  $

  	
  7.70

  	
   

  	
  $

  	
  7.14

  	
   

  	
  $

  	
  6.79

  	
   

  	
  $

  	
  4.96

  	
   

  	
  $

  	
  4.93

  	
   

  
	
  29

  	
   

  	
  $

  	
  2.58

  	
   

  	
  $

  	
  2.48

  	
   

  	
  $

  	
  2.58

  	
   

  	
  $

  	
  2.47

  	
   

  	
  $

  	
  2.57

  	
   

  	
  $

  	
  2.47

  	
   

  	
  79

  	
   

  	
  $

  	
  8.96

  	
   

  	
  $

  	
  8.09

  	
   

  	
  $

  	
  7.31

  	
   

  	
  $

  	
  6.99

  	
   

  	
  $

  	
  4.98

  	
   

  	
  $

  	
  4.96

  	
   

  
	
  30

  	
   

  	
  $

  	
  2.61

  	
   

  	
  $

  	
  2.50

  	
   

  	
  $

  	
  2.61

  	
   

  	
  $

  	
  2.50

  	
   

  	
  $

  	
  2.60

  	
   

  	
  $

  	
  2.49

  	
   

  	
  80

  	
   

  	
  $

  	
  9.39

  	
   

  	
  $

  	
  8.51

  	
   

  	
  $

  	
  7.49

  	
   

  	
  $

  	
  7.20

  	
   

  	
  $

  	
  4.99

  	
   

  	
  $

  	
  4.98

  	
   

  
	
  31

  	
   

  	
  $

  	
  2.64

  	
   

  	
  $

  	
  2.52

  	
   

  	
  $

  	
  2.64

  	
   

  	
  $

  	
  2.52

  	
   

  	
  $

  	
  2.63

  	
   

  	
  $

  	
  2.52

  	
   

  	
  81

  	
   

  	
  $

  	
  9.86

  	
   

  	
  $

  	
  8.97

  	
   

  	
  $

  	
  7.65

  	
   

  	
  $

  	
  7.40

  	
   

  	
  $

  	
  5.00

  	
   

  	
  $

  	
  4.99

  	
   

  
	
  32

  	
   

  	
  $

  	
  2.67

  	
   

  	
  $

  	
  2.55

  	
   

  	
  $

  	
  2.67

  	
   

  	
  $

  	
  2.55

  	
   

  	
  $

  	
  2.66

  	
   

  	
  $

  	
  2.54

  	
   

  	
  82

  	
   

  	
  $

  	
  10.36

  	
   

  	
  $

  	
  9.46

  	
   

  	
  $

  	
  7.81

  	
   

  	
  $

  	
  7.59

  	
   

  	
  $

  	
  5.01

  	
   

  	
  $

  	
  5.01

  	
   

  
	
  33

  	
   

  	
  $

  	
  2.70

  	
   

  	
  $

  	
  2.58

  	
   

  	
  $

  	
  2.70

  	
   

  	
  $

  	
  2.58

  	
   

  	
  $

  	
  2.69

  	
   

  	
  $

  	
  2.57

  	
   

  	
  83

  	
   

  	
  $

  	
  10.89

  	
   

  	
  $

  	
  10.00

  	
   

  	
  $

  	
  7.97

  	
   

  	
  $

  	
  7.78

  	
   

  	
  $

  	
  5.02

  	
   

  	
  $

  	
  5.02

  	
   

  
	
  34

  	
   

  	
  $

  	
  2.73

  	
   

  	
  $

  	
  2.61

  	
   

  	
  $

  	
  2.73

  	
   

  	
  $

  	
  2.60

  	
   

  	
  $

  	
  2.72

  	
   

  	
  $

  	
  2.60

  	
   

  	
  84

  	
   

  	
  $

  	
  11.46

  	
   

  	
  $

  	
  10.59

  	
   

  	
  $

  	
  8.11

  	
   

  	
  $

  	
  7.95

  	
   

  	
  $

  	
  5.03

  	
   

  	
  $

  	
  5.02

  	
   

  
	
  35

  	
   

  	
  $

  	
  2.77

  	
   

  	
  $

  	
  2.63

  	
   

  	
  $

  	
  2.76

  	
   

  	
  $

  	
  2.63

  	
   

  	
  $

  	
  2.75

  	
   

  	
  $

  	
  2.63

  	
   

  	
  85

  	
   

  	
  $

  	
  12.06

  	
   

  	
  $

  	
  11.22

  	
   

  	
  $

  	
  8.25

  	
   

  	
  $

  	
  8.11

  	
   

  	
  $

  	
  5.03

  	
   

  	
  $

  	
  5.03

  	
   

  
	
  36

  	
   

  	
  $

  	
  2.80

  	
   

  	
  $

  	
  2.67

  	
   

  	
  $

  	
  2.80

  	
   

  	
  $

  	
  2.66

  	
   

  	
  $

  	
  2.78

  	
   

  	
  $

  	
  2.65

  	
   

  	
  86

  	
   

  	
  $

  	
  12.71

  	
   

  	
  $

  	
  11.90

  	
   

  	
  $

  	
  8.37

  	
   

  	
  $

  	
  8.26

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.03

  	
   

  
	
  37

  	
   

  	
  $

  	
  2.84

  	
   

  	
  $

  	
  2.70

  	
   

  	
  $

  	
  2.84

  	
   

  	
  $

  	
  2.70

  	
   

  	
  $

  	
  2.82

  	
   

  	
  $

  	
  2.69

  	
   

  	
  87

  	
   

  	
  $

  	
  13.40

  	
   

  	
  $

  	
  12.63

  	
   

  	
  $

  	
  8.49

  	
   

  	
  $

  	
  8.39

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  38

  	
   

  	
  $

  	
  2.88

  	
   

  	
  $

  	
  2.73

  	
   

  	
  $

  	
  2.88

  	
   

  	
  $

  	
  2.73

  	
   

  	
  $

  	
  2.85

  	
   

  	
  $

  	
  2.72

  	
   

  	
  88

  	
   

  	
  $

  	
  14.14

  	
   

  	
  $

  	
  13.41

  	
   

  	
  $

  	
  8.59

  	
   

  	
  $

  	
  8.51

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  39

  	
   

  	
  $

  	
  2.92

  	
   

  	
  $

  	
  2.77

  	
   

  	
  $

  	
  2.92

  	
   

  	
  $

  	
  2.76

  	
   

  	
  $

  	
  2.89

  	
   

  	
  $

  	
  2.75

  	
   

  	
  89

  	
   

  	
  $

  	
  14.92

  	
   

  	
  $

  	
  14.23

  	
   

  	
  $

  	
  8.68

  	
   

  	
  $

  	
  8.62

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  40

  	
   

  	
  $

  	
  2.97

  	
   

  	
  $

  	
  2.80

  	
   

  	
  $

  	
  2.96

  	
   

  	
  $

  	
  2.80

  	
   

  	
  $

  	
  2.93

  	
   

  	
  $

  	
  2.79

  	
   

  	
  90

  	
   

  	
  $

  	
  15.75

  	
   

  	
  $

  	
  15.11

  	
   

  	
  $

  	
  8.77

  	
   

  	
  $

  	
  8.71

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  41

  	
   

  	
  $

  	
  3.01

  	
   

  	
  $

  	
  2.84

  	
   

  	
  $

  	
  3.00

  	
   

  	
  $

  	
  2.84

  	
   

  	
  $

  	
  2.97

  	
   

  	
  $

  	
  2.82

  	
   

  	
  91

  	
   

  	
  $

  	
  16.63

  	
   

  	
  $

  	
  16.02

  	
   

  	
  $

  	
  8.84

  	
   

  	
  $

  	
  8.80

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  42

  	
   

  	
  $

  	
  3.06

  	
   

  	
  $

  	
  2.88

  	
   

  	
  $

  	
  3.05

  	
   

  	
  $

  	
  2.88

  	
   

  	
  $

  	
  3.01

  	
   

  	
  $

  	
  2.86

  	
   

  	
  92

  	
   

  	
  $

  	
  17.57

  	
   

  	
  $

  	
  16.97

  	
   

  	
  $

  	
  8.91

  	
   

  	
  $

  	
  8.87

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  43

  	
   

  	
  $

  	
  3.11

  	
   

  	
  $

  	
  2.92

  	
   

  	
  $

  	
  3.10

  	
   

  	
  $

  	
  2.92

  	
   

  	
  $

  	
  3.06

  	
   

  	
  $

  	
  2.90

  	
   

  	
  93

  	
   

  	
  $

  	
  18.56

  	
   

  	
  $

  	
  17.97

  	
   

  	
  $

  	
  8.97

  	
   

  	
  $

  	
  8.93

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  44

  	
   

  	
  $

  	
  3.16

  	
   

  	
  $

  	
  2.96

  	
   

  	
  $

  	
  3.15

  	
   

  	
  $

  	
  2.96

  	
   

  	
  $

  	
  3.10

  	
   

  	
  $

  	
  2.94

  	
   

  	
  94

  	
   

  	
  $

  	
  19.63

  	
   

  	
  $

  	
  19.01

  	
   

  	
  $

  	
  9.02

  	
   

  	
  $

  	
  8.99

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  45

  	
   

  	
  $

  	
  3.21

  	
   

  	
  $

  	
  3.01

  	
   

  	
  $

  	
  3.20

  	
   

  	
  $

  	
  3.00

  	
   

  	
  $

  	
  3.15

  	
   

  	
  $

  	
  2.98

  	
   

  	
  95

  	
   

  	
  $

  	
  20.77

  	
   

  	
  $

  	
  20.10

  	
   

  	
  $

  	
  9.06

  	
   

  	
  $

  	
  9.04

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  46

  	
   

  	
  $

  	
  3.27

  	
   

  	
  $

  	
  3.06

  	
   

  	
  $

  	
  3.25

  	
   

  	
  $

  	
  3.05

  	
   

  	
  $

  	
  3.20

  	
   

  	
  $

  	
  3.02

  	
   

  	
  96

  	
   

  	
  $

  	
  22.01

  	
   

  	
  $

  	
  21.26

  	
   

  	
  $

  	
  9.10

  	
   

  	
  $

  	
  9.04

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  47

  	
   

  	
  $

  	
  3.33

  	
   

  	
  $

  	
  3.11

  	
   

  	
  $

  	
  3.31

  	
   

  	
  $

  	
  3.10

  	
   

  	
  $

  	
  3.25

  	
   

  	
  $

  	
  3.07

  	
   

  	
  97

  	
   

  	
  $

  	
  23.37

  	
   

  	
  $

  	
  22.50

  	
   

  	
  $

  	
  9.12

  	
   

  	
  $

  	
  9.11

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  48

  	
   

  	
  $

  	
  3.39

  	
   

  	
  $

  	
  3.16

  	
   

  	
  $

  	
  3.37

  	
   

  	
  $

  	
  3.15

  	
   

  	
  $

  	
  3.30

  	
   

  	
  $

  	
  3.12

  	
   

  	
  98

  	
   

  	
  $

  	
  24.88

  	
   

  	
  $

  	
  23.88

  	
   

  	
  $

  	
  9.14

  	
   

  	
  $

  	
  9.13

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  49

  	
   

  	
  $

  	
  3.45

  	
   

  	
  $

  	
  3.21

  	
   

  	
  $

  	
  3.43

  	
   

  	
  $

  	
  3.20

  	
   

  	
  $

  	
  3.35

  	
   

  	
  $

  	
  3.16

  	
   

  	
  99

  	
   

  	
  $

  	
  26.60

  	
   

  	
  $

  	
  25.43

  	
   

  	
  $

  	
  9.16

  	
   

  	
  $

  	
  9.15

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  50

  	
   

  	
  $

  	
  3.52

  	
   

  	
  $

  	
  3.27

  	
   

  	
  $

  	
  3.50

  	
   

  	
  $

  	
  3.26

  	
   

  	
  $

  	
  3.41

  	
   

  	
  $

  	
  3.22

  	
   

  	
  100

  	
   

  	
  $

  	
  28.57

  	
   

  	
  $

  	
  27.21

  	
   

  	
  $

  	
  9.17

  	
   

  	
  $

  	
  9.16

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  51

  	
   

  	
  $

  	
  3.59

  	
   

  	
  $

  	
  3.33

  	
   

  	
  $

  	
  3.56

  	
   

  	
  $

  	
  3.32

  	
   

  	
  $

  	
  3.47

  	
   

  	
  $

  	
  3.27

  	
   

  	
  101

  	
   

  	
  $

  	
  30.84

  	
   

  	
  $

  	
  29.28

  	
   

  	
  $

  	
  9.17

  	
   

  	
  $

  	
  9.17

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  52

  	
   

  	
  $

  	
  3.67

  	
   

  	
  $

  	
  3.40

  	
   

  	
  $

  	
  3.63

  	
   

  	
  $

  	
  3.38

  	
   

  	
  $

  	
  3.52

  	
   

  	
  $

  	
  3.32

  	
   

  	
  102

  	
   

  	
  $

  	
  33.48

  	
   

  	
  $

  	
  31.70

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  53

  	
   

  	
  $

  	
  3.74

  	
   

  	
  $

  	
  3.46

  	
   

  	
  $

  	
  3.71

  	
   

  	
  $

  	
  3.45

  	
   

  	
  $

  	
  3.59

  	
   

  	
  $

  	
  3.38

  	
   

  	
  103

  	
   

  	
  $

  	
  36.57

  	
   

  	
  $

  	
  34.56

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  54

  	
   

  	
  $

  	
  3.83

  	
   

  	
  $

  	
  3.53

  	
   

  	
  $

  	
  3.79

  	
   

  	
  $

  	
  3.51

  	
   

  	
  $

  	
  3.65

  	
   

  	
  $

  	
  3.44

  	
   

  	
  104

  	
   

  	
  $

  	
  40.20

  	
   

  	
  $

  	
  37.96

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  55

  	
   

  	
  $

  	
  3.91

  	
   

  	
  $

  	
  3.61

  	
   

  	
  $

  	
  3.87

  	
   

  	
  $

  	
  3.59

  	
   

  	
  $

  	
  3.71

  	
   

  	
  $

  	
  3.50

  	
   

  	
  105

  	
   

  	
  $

  	
  44.50

  	
   

  	
  $

  	
  42.00

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  56

  	
   

  	
  $

  	
  4.01

  	
   

  	
  $

  	
  3.69

  	
   

  	
  $

  	
  3.96

  	
   

  	
  $

  	
  3.66

  	
   

  	
  $

  	
  3.78

  	
   

  	
  $

  	
  3.56

  	
   

  	
  106

  	
   

  	
  $

  	
  49.61

  	
   

  	
  $

  	
  46.86

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  57

  	
   

  	
  $

  	
  4.10

  	
   

  	
  $

  	
  3.77

  	
   

  	
  $

  	
  4.05

  	
   

  	
  $

  	
  3.74

  	
   

  	
  $

  	
  3.84

  	
   

  	
  $

  	
  3.63

  	
   

  	
  107

  	
   

  	
  $

  	
  55.74

  	
   

  	
  $

  	
  52.73

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  58

  	
   

  	
  $

  	
  4.21

  	
   

  	
  $

  	
  3.86

  	
   

  	
  $

  	
  4.14

  	
   

  	
  $

  	
  3.82

  	
   

  	
  $

  	
  3.91

  	
   

  	
  $

  	
  3.70

  	
   

  	
  108

  	
   

  	
  $

  	
  63.15

  	
   

  	
  $

  	
  59.88

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  59

  	
   

  	
  $

  	
  4.32

  	
   

  	
  $

  	
  3.95

  	
   

  	
  $

  	
  4.24

  	
   

  	
  $

  	
  3.91

  	
   

  	
  $

  	
  3.98

  	
   

  	
  $

  	
  3.77

  	
   

  	
  109

  	
   

  	
  $

  	
  72.20

  	
   

  	
  $

  	
  68.70

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  60

  	
   

  	
  $

  	
  4.43

  	
   

  	
  $

  	
  4.05

  	
   

  	
  $

  	
  4.35

  	
   

  	
  $

  	
  4.01

  	
   

  	
  $

  	
  4.05

  	
   

  	
  $

  	
  3.84

  	
   

  	
  110

  	
   

  	
  $

  	
  83.42

  	
   

  	
  $

  	
  79.72

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  61

  	
   

  	
  $

  	
  4.56

  	
   

  	
  $

  	
  4.15

  	
   

  	
  $

  	
  4.46

  	
   

  	
  $

  	
  4.10

  	
   

  	
  $

  	
  4.12

  	
   

  	
  $

  	
  3.91

  	
   

  	
  111

  	
   

  	
  $

  	
  97.59

  	
   

  	
  $

  	
  93.78

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  62

  	
   

  	
  $

  	
  4.69

  	
   

  	
  $

  	
  4.27

  	
   

  	
  $

  	
  4.58

  	
   

  	
  $

  	
  4.21

  	
   

  	
  $

  	
  4.19

  	
   

  	
  $

  	
  3.98

  	
   

  	
  112

  	
   

  	
  $

  	
  116.03

  	
   

  	
  $

  	
  112.26

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  63

  	
   

  	
  $

  	
  4.83

  	
   

  	
  $

  	
  4.39

  	
   

  	
  $

  	
  4.70

  	
   

  	
  $

  	
  4.32

  	
   

  	
  $

  	
  4.25

  	
   

  	
  $

  	
  4.06

  	
   

  	
  113

  	
   

  	
  $

  	
  141.56

  	
   

  	
  $

  	
  138.22

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
  64

  	
   

  	
  $

  	
  4.98

  	
   

  	
  $

  	
  4.51

  	
   

  	
  $

  	
  4.83

  	
   

  	
  $

  	
  4.43

  	
   

  	
  $

  	
  4.32

  	
   

  	
  $

  	
  4.13

  	
   

  	
  114

  	
   

  	
  $

  	
  187.79

  	
   

  	
  $

  	
  185.87

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  9.18

  	
   

  	
  $

  	
  5.04

  	
   

  	
  $

  	
  5.04

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  

Installments shown are monthly and are for each $1,000 of net Proceeds
applied.  Based on 2000 Individual
Annuity Table, applied at 2% Interest, which is subject to change as described
on Page 13, Interest On Settlement Options.

 

ICC10-INDEX-4-09R

 

16

 

TABLE 3

 

JOINT AND SURVIVOR INCOME FACTORS

 

We will establish values for Age or sex combinations not shown in the
table on request.  They will be
calculated on the same basis as those in this table.

 

	
   

  	
   

  	
  Male Age

  	
   

  
	
  Female
  Age

  	
   

  	
  45

  	
   

  	
  50

  	
   

  	
  55

  	
   

  	
  60

  	
   

  	
  65

  	
   

  	
  70

  	
   

  
	
  45

  	
   

  	
  $

  	
  2.79

  	
   

  	
  $

  	
  2.86

  	
   

  	
  $

  	
  2.91

  	
   

  	
  $

  	
  2.95

  	
   

  	
  $

  	
  2.97

  	
   

  	
  $

  	
  2.99

  	
   

  
	
  50

  	
   

  	
  $

  	
  2.89

  	
   

  	
  $

  	
  3.00

  	
   

  	
  $

  	
  3.09

  	
   

  	
  $

  	
  3.15

  	
   

  	
  $

  	
  3.20

  	
   

  	
  $

  	
  3.23

  	
   

  
	
  55

  	
   

  	
  $

  	
  2.98

  	
   

  	
  $

  	
  3.13

  	
   

  	
  $

  	
  3.26

  	
   

  	
  $

  	
  3.38

  	
   

  	
  $

  	
  3.47

  	
   

  	
  $

  	
  3.53

  	
   

  
	
  60

  	
   

  	
  $

  	
  3.06

  	
   

  	
  $

  	
  3.25

  	
   

  	
  $

  	
  3.44

  	
   

  	
  $

  	
  3.61

  	
   

  	
  $

  	
  3.76

  	
   

  	
  $

  	
  3.88

  	
   

  
	
  65

  	
   

  	
  $

  	
  3.11

  	
   

  	
  $

  	
  3.34

  	
   

  	
  $

  	
  3.59

  	
   

  	
  $

  	
  3.84

  	
   

  	
  $

  	
  4.08

  	
   

  	
  $

  	
  4.28

  	
   

  
	
  70

  	
   

  	
  $

  	
  3.15

  	
   

  	
  $

  	
  3.41

  	
   

  	
  $

  	
  3.71

  	
   

  	
  $

  	
  4.04

  	
   

  	
  $

  	
  4.39

  	
   

  	
  $

  	
  4.72

  	
   

  

 

Installments shown are monthly and are for
each $1,000 of net Proceeds applied. 
Based on 2000 Individual Annuity Table a, applied at 2% Interest, and
subject to change as described on Page 13, Interest On Settlement
Options.

 

ICC10-INDEX-4-09R

 

17

 

TABLE OF GUARANTEED VALUES

 

Your
Values will never be less than shown here if You pay Your Initial Premium at
issue, pay additional Planned Premium Amounts as You indicated on Your
Application, and don’t take any Withdrawals. 
The Cash Surrender Value is calculated as described on Page 7 and
equals the greater of the Contract Value less Surrender Charges or the Minimum
Guaranteed Surrender Value.  The Death
Benefit equals the greater of the Contract Value or Minimum Guaranteed
Surrender Value.

 

	
  End

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  of

  	
   

  	
   

  	
   

  	
  Cash

  	
   

  	
   

  	
   

  
	
  Contract

  	
   

  	
   

  	
   

  	
  Surrender

  	
   

  	
  Death

  	
   

  
	
  Year

  	
   

  	
  Premium(s)

  	
   

  	
  Value

  	
   

  	
  Benefit

  	
   

  
	
  1

  	
   

  	
  $

  	
  20,000

  	
   

  	
  $

  	
  18,400

  	
   

  	
  $

  	
  20,000

  	
   

  
	
  2

  	
   

  	
  4,000

  	
   

  	
  22,320

  	
   

  	
  24,000

  	
   

  
	
  3

  	
   

  	
  4,000

  	
   

  	
  26,320

  	
   

  	
  28,000

  	
   

  
	
  4

  	
   

  	
  4,000

  	
   

  	
  32,000

  	
   

  	
  32,000

  	
   

  
	
  5

  	
   

  	
  4,000

  	
   

  	
  36,000

  	
   

  	
  36,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  6

  	
   

  	
  4,000

  	
   

  	
  40,000

  	
   

  	
  40,000

  	
   

  
	
  7

  	
   

  	
  4,000

  	
   

  	
  44,000

  	
   

  	
  44,000

  	
   

  
	
  8

  	
   

  	
  4,000

  	
   

  	
  48,000

  	
   

  	
  48,000

  	
   

  
	
  9

  	
   

  	
  4,000

  	
   

  	
  52,000

  	
   

  	
  52,000

  	
   

  
	
  10

  	
   

  	
  4,000

  	
   

  	
  56,000

  	
   

  	
  56,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  11

  	
   

  	
  4,000

  	
   

  	
  60,000

  	
   

  	
  60,000

  	
   

  
	
  12

  	
   

  	
  4,000

  	
   

  	
  64,000

  	
   

  	
  64,000

  	
   

  
	
  13

  	
   

  	
  4,000

  	
   

  	
  68,000

  	
   

  	
  68,000

  	
   

  
	
  14

  	
   

  	
  4,000

  	
   

  	
  72,132

  	
   

  	
  72,132

  	
   

  
	
  15

  	
   

  	
  4,000

  	
   

  	
  76,767

  	
   

  	
  76,767

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  16

  	
   

  	
  4,000

  	
   

  	
  81,471

  	
   

  	
  81,471

  	
   

  
	
  17

  	
   

  	
  4,000

  	
   

  	
  86,245

  	
   

  	
  86,245

  	
   

  
	
  18

  	
   

  	
  4,000

  	
   

  	
  91,091

  	
   

  	
  91,091

  	
   

  
	
  19

  	
   

  	
  4,000

  	
   

  	
  96,010

  	
   

  	
  96,010

  	
   

  
	
  20

  	
   

  	
  4,000

  	
   

  	
  101,003

  	
   

  	
  101,003

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  25

  	
   

  	
  4,000

  	
   

  	
  127,112

  	
   

  	
  127,112

  	
   

  
	
  30

  	
   

  	
  4,000

  	
   

  	
  155,239

  	
   

  	
  155,239

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Maturity

  	
   

  	
  $

  	
  156,000

  	
   

  	
  $

  	
  185,540

  	
   

  	
  185,540

  	
   

  
											

 

Minimum Guaranteed Surrender Value at
Maturity: $185,540

 

These values are based on the following:

 

Total
Initial Premium:  $20,000.00

Planned
Premium Amount:  $4,000.00

Planned
Premium Mode: Annual

 

ICC10-INDEX-4-09R-3

 

18

 

 

TABLE OF GUARANTEED VALUES

 

Your
Values will never be less than shown here if You pay Your Initial Premium at
issue, pay additional Planned Premium Amounts as You indicated on Your
Application, and don’t take any Withdrawals. 
The Cash Surrender Value is calculated as described on Page 7 and
equals the greater of the Contract Value less Surrender Charges or the Minimum
Guaranteed Surrender Value.  The Death
Benefit equals the greater of the Contract Value or Minimum Guaranteed
Surrender Value.

 

	
  End

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  of

  	
   

  	
   

  	
   

  	
  Cash

  	
   

  	
   

  	
   

  
	
  Contract

  	
   

  	
   

  	
   

  	
  Surrender

  	
   

  	
  Death

  	
   

  
	
  Year

  	
   

  	
  Premium(s)

  	
   

  	
  Value

  	
   

  	
  Benefit

  	
   

  
	
  1

  	
   

  	
  $

  	
  20,000

  	
   

  	
  $

  	
  18,400

  	
   

  	
  $

  	
  20,000

  	
   

  
	
  2

  	
   

  	
  4,000

  	
   

  	
  22,320

  	
   

  	
  24,000

  	
   

  
	
  3

  	
   

  	
  4,000

  	
   

  	
  26,320

  	
   

  	
  28,000

  	
   

  
	
  4

  	
   

  	
  4,000

  	
   

  	
  30,400

  	
   

  	
  32,000

  	
   

  
	
  5

  	
   

  	
  4,000

  	
   

  	
  34,560

  	
   

  	
  36,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  6

  	
   

  	
  4,000

  	
   

  	
  40,000

  	
   

  	
  40,000

  	
   

  
	
  7

  	
   

  	
  4,000

  	
   

  	
  44,000

  	
   

  	
  44,000

  	
   

  
	
  8

  	
   

  	
  4,000

  	
   

  	
  48,000

  	
   

  	
  48,000

  	
   

  
	
  9

  	
   

  	
  4,000

  	
   

  	
  52,000

  	
   

  	
  52,000

  	
   

  
	
  10

  	
   

  	
  4,000

  	
   

  	
  56,000

  	
   

  	
  56,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  11

  	
   

  	
  4,000

  	
   

  	
  60,000

  	
   

  	
  60,000

  	
   

  
	
  12

  	
   

  	
  4,000

  	
   

  	
  64,000

  	
   

  	
  64,000

  	
   

  
	
  13

  	
   

  	
  4,000

  	
   

  	
  68,000

  	
   

  	
  68,000

  	
   

  
	
  14

  	
   

  	
  4,000

  	
   

  	
  72,132

  	
   

  	
  72,132

  	
   

  
	
  15

  	
   

  	
  4,000

  	
   

  	
  76,767

  	
   

  	
  76,767

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  16

  	
   

  	
  4,000

  	
   

  	
  81,471

  	
   

  	
  81,471

  	
   

  
	
  17

  	
   

  	
  4,000

  	
   

  	
  86,245

  	
   

  	
  86,245

  	
   

  
	
  18

  	
   

  	
  4,000

  	
   

  	
  91,091

  	
   

  	
  91,091

  	
   

  
	
  19

  	
   

  	
  4,000

  	
   

  	
  96,010

  	
   

  	
  96,010

  	
   

  
	
  20

  	
   

  	
  4,000

  	
   

  	
  101,003

  	
   

  	
  101,003

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  25

  	
   

  	
  4,000

  	
   

  	
  127,112

  	
   

  	
  127,112

  	
   

  
	
  30

  	
   

  	
  4,000

  	
   

  	
  155,239

  	
   

  	
  155,239

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Maturity

  	
   

  	
  $

  	
  156,000

  	
   

  	
  $

  	
  185,540

  	
   

  	
  $

  	
  185,540

  	
   

  

 

Minimum
Guaranteed Surrender Value at Maturity:     $185,540

 

These
values are based on the following:

 

Total
Initial Premium:  $20,000.00

Planned
Premium Amount:  $4,000.00

Planned
Premium Mode: Annual

 

ICC10-INDEX-4-09R-5

 

19

 

TABLE OF GUARANTEED VALUES

 

Your
Values will never be less than shown here if You pay Your Initial Premium at
issue, pay additional Planned Premium Amounts as You indicated on Your
Application, and don’t take any Withdrawals. 
The Cash Surrender Value is calculated as described on Page 7 and
equals the greater of the Contract Value less Surrender Charges or the Minimum
Guaranteed Surrender Value.  The Death
Benefit equals the greater of the Contract Value or Minimum Guaranteed
Surrender Value.

 

	
  End

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  of

  	
   

  	
   

  	
   

  	
  Cash

  	
   

  	
   

  	
   

  
	
  Contract

  	
   

  	
   

  	
   

  	
  Surrender

  	
   

  	
  Death

  	
   

  
	
  Year

  	
   

  	
  Premium(s)

  	
   

  	
  Value

  	
   

  	
  Benefit

  	
   

  
	
  1

  	
   

  	
  $

  	
  20,000

  	
   

  	
  18,400

  	
   

  	
  20,000

  	
   

  
	
  2

  	
   

  	
  4,000

  	
   

  	
  22,320

  	
   

  	
  24,000

  	
   

  
	
  3

  	
   

  	
  4,000

  	
   

  	
  26,320

  	
   

  	
  28,000

  	
   

  
	
  4

  	
   

  	
  4,000

  	
   

  	
  30,400

  	
   

  	
  32,000

  	
   

  
	
  5

  	
   

  	
  4,000

  	
   

  	
  34,560

  	
   

  	
  36,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  6

  	
   

  	
  4,000

  	
   

  	
  38,800

  	
   

  	
  40,000

  	
   

  
	
  7

  	
   

  	
  4,000

  	
   

  	
  43,120

  	
   

  	
  44,000

  	
   

  
	
  8

  	
   

  	
  4,000

  	
   

  	
  48,000

  	
   

  	
  48,000

  	
   

  
	
  9

  	
   

  	
  4,000

  	
   

  	
  52,000

  	
   

  	
  52,000

  	
   

  
	
  10

  	
   

  	
  4,000

  	
   

  	
  56,000

  	
   

  	
  56,000

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  11

  	
   

  	
  4,000

  	
   

  	
  60,000

  	
   

  	
  60,000

  	
   

  
	
  12

  	
   

  	
  4,000

  	
   

  	
  64,000

  	
   

  	
  64,000

  	
   

  
	
  13

  	
   

  	
  4,000

  	
   

  	
  68,000

  	
   

  	
  68,000

  	
   

  
	
  14

  	
   

  	
  4,000

  	
   

  	
  72,132

  	
   

  	
  72,132

  	
   

  
	
  15

  	
   

  	
  4,000

  	
   

  	
  76,767

  	
   

  	
  76,767

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  16

  	
   

  	
  4,000

  	
   

  	
  81,471

  	
   

  	
  81,471

  	
   

  
	
  17

  	
   

  	
  4,000

  	
   

  	
  86,245

  	
   

  	
  86,245

  	
   

  
	
  18

  	
   

  	
  4,000

  	
   

  	
  91,091

  	
   

  	
  91,091

  	
   

  
	
  19

  	
   

  	
  4,000

  	
   

  	
  96,010

  	
   

  	
  96,010

  	
   

  
	
  20

  	
   

  	
  4,000

  	
   

  	
  101,003

  	
   

  	
  101,003

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  25

  	
   

  	
  4,000

  	
   

  	
  127,112

  	
   

  	
  127,112

  	
   

  
	
  30

  	
   

  	
  4,000

  	
   

  	
  155,239

  	
   

  	
  155,239

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  Maturity

  	
   

  	
  $

  	
  156,000

  	
   

  	
  $

  	
  185,540

  	
   

  	
  $

  	
  185,540

  	
   

  
											

 

Minimum
Guaranteed Surrender Value at Maturity: $185,540

 

These
values are based on the following:

 

Total
Initial Premium:  $20,000.00

Planned
Premium Amount:  $4,000.00

Planned
Premium Mode: Annual

 

ICC10-INDEX-4-09R-7

 

20

 

EAGLE

LIFE INSURANCE COMPANY

 

[P. O. Box 71279]

[Des Moines, Iowa 50325-0279]

 

FLEXIBLE PREMIUM DEFERRED ANNUITY
CONTRACT WITH INDEX-LINKED INTEREST OPTIONS

Index Credits currently linked to
the S&P 500 Index

With Market Value Adjustment Provision

Which May Increase or Decrease Cash Surrender Values

Death Benefit Prior to Maturity

Monthly Income at Maturity

No Dividends

 

ICC10-INDEX-4-09R

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00175-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00175-of-00352.parquet"}]]