See All of This Company's Exhibits
EX-99.4(AB)
4
ex994ab.txt
INDIVIDUAL CONTRACT
(LOGO)
SECURITY BENEFIT(SM)
LIFE INSURANCE COMPANY
Security Benefit Life Insurance Company
FOUNDED IN 1892/TOPEKA, KS
Security Benefit Life, subject to the terms of this Policy, will pay the
following benefits:
1. A retirement income to the Annuitant, if living on the Maturity Date,
derived from applying the Policy Value to the option shown on the Policy
Specifications pages.
2. The Death Benefit when due proof of the Annuitant's death prior to the
Maturity Date is received at the Home Office at One Security Benefit
Place, Topeka, Kansas 66636-0001.
This and the following pages are the Policy.
This Policy may be returned within 10 days after the Applicant receives it by
delivering or mailing it to the Home Office or the agent through whom it was
purchased. Immediately on such delivery or mailing, the Policy shall be deemed
void from the beginning. Any purchase payments paid will be refunded.
SBL, when used in this Policy, means Security Benefit Life Insurance Company.
/s/ John F. Guyot (Signature)
Secretary President
A BRIEF DESCRIPTION OF THIS POLICY
This is a RETIREMENT ANNUITY POLICY:
- Benefit installments begin on the maturity date using the method as shown
on the Policy Specifications pages.
- Death Benefit is payable if the Annuitant dies prior to the Maturity Date.
- Flexible purchase payments are payable until the Maturity Date or until
the prior death of the Annuitant.
ALL PAYMENTS AND VALUES PROVIDED BY THIS POLICY, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT.
SECURITY BENEFIT LIFE INSURANCE COMPANY
Security Benefit
One Security Benefit Place, Topeka, KS 66636-0001
1-800-888-2461
V6009 (7-81) BP 6009N1
A GUIDE TO
THE PROVISIONS OF YOUR POLICY
PROVISION CONTENTS
POLICY SPECIFICATIONS Annuitant, dates, plan, payment, policy number, kind of
benefit, fees & charges, factors, interest rates,
separate account./PG 3
GENERAL PROVISIONS Introduction, the contract, incontestability,
misstatement of age or sex, claims of creditors,
dates./PG 5
OWNER Rights of Owner, change of ownership (if allowed)./PG 5
DEATH BENEFIT Benefit amount./PG 5
BENEFICIARY Designation and way to change, distribution of
benefits./PG 5 - 6
PAYMENT OF BENEFITS Way benefits may be paid, settlement options, additional
provisions./PG 6
PURCHASE PAYMENTS Payment of purchase payments./PG 8
VALUATION Value of General Account, Separate Account, state
premium taxes./PG 9
NONFORFEITURE Policy value, termination value./PG 9 - 10
SEPARATE ACCOUNT Introduction, ownership of Separate Account, Separate
PROVISIONS Account defined, guaranteed annuity, variable annuity,
valuing first annuity installment, investment factors,
accumulation unit value, annuity unit value, splitting
units, fluctuation of values, transfer rights, change of
account allocations./PG 11 - 12
APPLICATION Owner, Beneficiary, allocation of purchase payment to
accounts./Attached to and a part of this policy.
BP 6009N1
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POLICY SPECIFICATIONS
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ANNUITANT: LISA ROE
DATE OF BIRTH July 11, 1964
POLICY NUMBER: NJVAR94 AND SEX: Female
POLICY DATE: Date First Purchase
Payment Received by SBL
OWNER: LISA ROE
PLAN: Individual Retirement Annuity
MATURITY DATE: July 11, 2059 DATE OF ISSUE: July 15, 2008
KIND OF BENEFIT: Retirement Annuity Installments
MODE OF PAYMENT: None
METHOD OF INSTALLMENT: Life Annuity With Period Certain
ASSIGNMENT: This policy may not be assigned.
V6009A (11-81) 3
P O L I C Y S P E C I F I C A T I O N S
Fees & Charges: A $30.00 per year fee will be charged against the Policy
Value on each December 31st and the date the Policy is
terminated (First and last policy fee prorated to the
nearest $1). No charge will be made after the Effective
Date of Settlement Option 1, 2, 3, or 4. The charge will
be made sequentially against the Series listed in the
Separate Account section in descending order. The General
Account will be the last subject to charge. Each Series
will be depleted before the next is charged.
Withdrawal Charge
Factor: Policy Year at Withdrawal
Time of Charge
Termination
1 .08
2 .07
3 .06
4 .05
5 .04
6 .03
7 .02
8 .01
9 or later .0
Free Withdrawal
Factor: .10
Guaranteed Interest
Rates: 4.5% for all years.
Plan: As used in this Policy, the Plan shall mean a document or
agreement which provides the authority for purchase of the
Policy for the Annuitant. The Plan must meet the
requirements of the Internal Revenue Code as shown on the
Application. The Plan is not a part of this Policy. SBL
assumes no obligation under the Plan.
15-60090-12
V6009A (11-81) -3A- BP 60091
P O L I C Y S P E C I F I C A T I O N S
Separate Account: The Owner may allocate purchase payments to the following
SBL Separate Account and the Series in which the Separate
Account is invested. The Owner may allocate purchase
payments to the General Account of SBL.
Separate Account: VARIFLEX, containing:
Money Market Series: Which is invested in Series C of
SBL Fund. Annuity Unit value was set at $1 on
04-01-84.
High Grade Income Series: Which is invested in Series E
of SBL Fund. Annuity Unit value was set at $1 on
04-24-85.
Income-Growth Series: Which is invested in Series B of
SBL Fund. Annuity Unit value was set at $1 on
04-01-84.
Growth Series: Which is invested in Series A of SBL
Fund. Annuity Unit value was set at $1 on 04-01-84.
Worldwide Equity Series: Which is invested in Series D
of SBL Fund. Annuity Unit value was set at $1 on
04-01-84.
Social Awareness Series: Which is invested in Series S
of SBL Fund. Annuity Unit value was set at $1 on
04-23-91.
Actuarial Risk Fee: Accumulation Units: .00003307502 (1.2% Annually)
(ARF) Annuity Units: .00003307502 (1.2% Annually)
Allocation Fee: $0.00
15-60091-13
V6009A (11-81) -3B- BP 60092
P O L I C Y S P E C I F I C A T I O N S
Minimum Purchase If the purchase payment is allocated to more than one
Payment: Series or the General Account, the amount of each purchase
payment allocated to each of the Series or the General
Account must be at least $25.00.
Change of Account: The Owner may change the allocation of future purchase
payments to the General Account and the various Series. To
make a change, a written notice must be received in the
Home Office of SBL. If the change will allocate future
purchase payments to more than one Series or the General
Account, the amount of each purchase payment to each
Series or the General Account must be at least $25.00.
There will be no charge for the first allocation change in
a year. For each additional change in a year, a charge of
an allocation fee (shown previously) will be made. A
change in allocation will not affect purchase payment
allocations before the change.
Method of Charging: The Allocation Fee will be charged sequentially to the
Policy Value in the Series in the descending order shown
in the Separate Account Section. The Policy Value of each
Series will be depleted before the next is charged. The
General Account will be the last charged.
Settlement Option Settlement Options will not be allowed which would result
Restrictions: in constructive receipt of Policy Values, if 1 and 2 both
occur:
1) This Policy is to qualify under Section 403(b)
of the Internal Revenue Code.
2) The Participant has no cost basis in the
Policy Value.
15-60090-07
V6009A (11-81) -3C- BP 60093
P O L I C Y S P E C I F I C A T I O N S
Transfer Rights The Owner may transfer part of the Policy Value between
(Prior to the the various Series and the General Account once every 30
Effective Date days. A transfer fee (shown following) will be charged
of a Settlement after the first transfer in a policy year. A transfer
Option): within 30 days of the Maturity Date can be made without
charge. The total of dollar amounts transferred from the
General Account during a policy year will be limited to
the greatest of the three following values:
1. Five thousand dollars ($5000.00).
2. One third (1/3) of the amount of the Policy
Value in the General Account at time of
transfer.
3. The product of multiplying "a" by "b", where:
"a" is the total of dollar amounts transferred
from the General Account during the previous
policy year.
"b" is 1.2.
Settlement Option, Once installments have begun, the Owner may elect, once
Transfer After each calendar year, to convert annuity units of one Series
First to annuity units of another Series. The conversion cannot
Installment: be made within the 5 day period prior to and including the
day an installment is to be paid. Conversions that would
have been made during this 5 day period shall be made on
the business day after the installment payment date. This
right to convert annuity units does not include the right
to convert a variable annuity of any Series into a fixed
annuity of the General Account. Neither may a fixed
annuity of the General Account be converted to a variable
annuity of any Series. The amount of each installment
after the conversion must still be at least $25.00 for
each Series.
Transfer Fee: $0.00
Method of Charging: The Transfer Fee will be charged sequentially to the
Policy Value in the Series in the descending order shown
in the Separate Account section. The Policy Value of each
Series will be depleted before the next is charged. The
General Account will be the last charged.
15-60091-15
V6009A (11-81) -3D- BP60098
GENERAL PROVISION
Introduction This Policy is a Retirement Annuity. The first annuity
installment is determined from the Policy Value and the
Settlement Option Rate.
The Contract The entire contract between the Owner and SBL consists of
the Application, this Policy, and any endorsements or
riders attached to the Policy. A copy of the Application
is attached to this Policy at issue. All statements made
in the Application will, in the absence of fraud, be
deemed representations and not warranties. SBL will use no
statement made by or on behalf of the Annuitant to void
this Policy unless it is in the written Application. Any
change in the contract can be made only with the written
consent of the President, a Vice President, or the
Secretary of SBL.
Incontestability SBL will not contest the validity of this Policy after it
has been in force during the lifetime of the annuitant for
2 years from the Date of Issue.
Misstatement of If the age or the sex of the annuitant has been
Age or Sex incorrectly stated, the benefits under this Policy will be
those the purchase payments would have purchased for the
correct age and sex.
Claims of The Policy Value, Termination Value, and benefits under
Creditors this Policy will be exempt from the claims of creditors to
the extent permitted by law.
Dates Years, months and anniversaries are all measured from the
Policy Date. The contestable period begins with the Date
of Issue. All dates are shown on the Policy Specifications
pages.
Facility of In some cases a payee will, in the opinion of SBL, not be
Payment able, for physical or mental reasons, to give a good
receipt and discharge for any benefit payment due. In this
case, SBL may make payment of the amount due in
installments to those persons whom SBL believes are caring
for and supporting the payee. The installment under this
section will not be greater than $250 per month. The
installments under this section will stop when a claim is
made by a duly appointed guardian or legal representative
of the payee. Payment to such persons will discharge SBL
from liability for the installments paid. SBL will assume
no responsibility for the proper use of the installments
paid under this section.
Evidence of SBL may require proof that any payee is living on any date
Survival a payment or installment is due to the payee. The proof
must be satisfactory to SBL.
Due Proof Any of the following items will be sufficient as due proof
of Death of death:
1. A copy of a certified death certificate
2. A copy of a certified decree of a court of
competent jurisdiction as to the finding of
death.
3. A written statement by a medical doctor who
attended the deceased annuitant.
4. Any proof satisfactory to SBL.
OWNER
Rights of Owner The Annuitant is the Owner of this Policy, unless 1 or 2
occurs:
1. Some other Owner is named in the application.
2. The Owner is later changed.
The Owner has all rights in this Policy while the
Annuitant is living.
If the Owner dies before the Annuitant, unless otherwise
provided, the Owner's estate shall become the Owner.
Change of If allowed by the Assignment section of the Policy
Ownership Specifications pages, the Owner can designate a new owner
by written notice satisfactory to SBL. The change in
ownership will take effect as of the date the notice was
signed. The change will be subject to any payment made or
other action taken by SBL before the change was received
by SBL. SBL may require the Policy for endorsement. A
Change of Ownership does not automatically cause a Change
of Beneficiary.
DEATH BENEFIT
Benefit Amount When due proof, satisfactory to SBL, of the Annuitant's
death prior to the Maturity Date is received at the Home
Office, SBL will pay the death benefit to the Beneficiary.
The death benefit will be the greater of 'a' or 'b' where:
a - is the Policy Value.
b - is the total of all purchase payments received
by SBL less the total of all Termination
Values Paid.
V6009B (R11-81) 5 BP 6009T1
BENEFICIARY
Beneficiary The Beneficiary will receive the benefits, if any, under
Designation and this Policy in the case of the death of the Annuitant
the Way to while this Policy is still in force. The Beneficiary is
Change It named in the Application. However, the Beneficiary may be
changed by the Owner during the Annuitant's lifetime. To
make a change, a written notice, satisfactory to SBL, must
be received at the Home Office. The change will take
effect as of the date the notice was signed, even if the
Annuitant has died before SBL receives it, unless SBL has
already paid the benefits. SBL may require this Policy for
endorsement.
Distribution More than one Primary Beneficiary may be named. The share
of Benefits each is to receive may also be specified. The respective
shares will be paid to any Primary Beneficiary alive at
the death of the Annuitant. If none survive the Annuitant,
payment will be made to any Contingent Beneficiaries who
are alive. Surviving Beneficiaries in the same class will
receive equal shares unless otherwise stated.
If no Beneficiary survives the Annuitant, the benefits
will be paid to the Annuitant's estate. If any Beneficiary
dies within twenty-four (24) hours after the Annuitant,
the benefits will be paid as if the Beneficiary died
before the Annuitant.
PAYMENT OF
BENEFITS
The Way The Owner, during the lifetime of the Annuitant and 30
Benefits May days prior to the Maturity Date, has the right to choose
be Paid to have the benefit amount paid in one of the following
ways instead of in a single sum. If the Owner has not
elected an option at the time of death of the Annuitant,
the Beneficiary may choose one of the options. To make an
election, a written notice, satisfactory to SBL, must be
received at the Home Office. No election can be put into
effect which requires SBL to make a periodic payment of
less than $25.00.
For settlement options 1, 2, 3, and 4 reference should be
made to the Separate Account portion of this Policy. In
that portion the definitions of a guaranteed and a
variable annuity, and the basis for the value of the
second and later installments are given.
Settlement 1. Life Option: Paid in annual, semiannual,
Options quarterly or monthly installments during the
lifetime of the payee. Table A (see Settlement
Option Installment Rates) shows the minimum
first monthly installment for each $1,000 of
benefit amount.
2. Life with Fixed Period Option: Paid in annual,
semiannual, quarterly, or monthly
installments. A period of five, ten, fifteen,
or twenty years may be specified. Installments
will be paid for the length of the period, and
after for as long as the payee lives. Table A
shows the minimum first installment payable
monthly for each number of years.
3. Life with Unit Refund Option: Paid in annual,
semiannual, quarterly or monthly installments.
Installments will be paid for the length of
the period obtained by dividing the benefit
amount by the first installment, and for as
long after as the payee lives. Table A shows
the minimum first monthly installment for each
$1,000 of benefit amount.
4. Joint and Last Survivor Option: Paid in
annual, semiannual, quarterly or monthly
installments to the last death of the payee
and a named secondary payee. Table B shows the
minimum first monthly installment for each
$1,000 of benefit amount.
5. Fixed Period Option: Paid in annual,
semiannual, quarterly or monthly installments
for a set number of years. Any number of years
(not over 20) may be specified. For variable
annuity installments, the installment will be
the product of 'a' times 'b' where:
a - is the accumulation unit value for the
day the installment is paid.
b - is the number of accumulation units
applied to the option divided by the
number of payments selected.
For a guaranteed annuity, the installments
will be determined by SBL and will reflect an
effective yearly interest rate of not less
than 2.5%.
6. Fixed Installment Option: Paid in equal
annual, semiannual, quarterly, or monthly
installments (not less than $6.25 per $1,000
applied) until the amount applied, adjusted
daily for investment results, is paid. On
benefit amounts placed in the General Account,
interest on the unpaid balance will be paid at
an effective yearly rate of not less than 2.5%
per year. The last installment will be the
remaining sum left with SBL.
7. Deposit Option: Left on deposit with SBL in
the General Account at an effective yearly
interest rate of not less than 2% per year.
Interest will be paid annually, semiannually,
quarterly or monthly as elected. Withdrawal of
the amount left on deposit may be made at any
time.
6 BP 6009T1
SETTLEMENT OPTION INSTALLMENT RATES
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SINGLE LIFE INCOME OPTIONS
Table A - Option - Monthly
Installments for a fixed term and
afterwards as long as the payee lives
per $1,000 of benefit amount
--------------------------------------------------------------------------------
Adjusted
Age Monthly Installments Guaranteed Unit
of Payee 0 60 120 180 240 Refund
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55 4.75 4.74 4.70 4.63 4.53 4.57
56 4.85 4.83 4.78 4.70 4.59 4.64
57 4.94 4.93 4.87 4.78 4.66 4.72
58 5.05 5.03 4.97 4.87 4.73 4.81
59 5.16 5.14 5.07 4.96 4.80 4.90
60 5.27 5.25 5.17 5.05 4.87 4.99
61 5.40 5.37 5.28 5.14 4.94 5.09
62 5.53 5.50 5.40 5.24 5.01 5.20
63 5.67 5.63 5.52 5.34 5.08 5.31
64 5.82 5.78 5.66 5.45 5.15 5.43
65 5.98 5.94 5.80 5.55 5.22 5.55
66 6.16 6.11 5.95 5.67 5.28 5.69
67 6.36 6.29 6.10 5.78 5.35 5.83
68 6.57 6.49 6.27 5.89 5.40 5.99
69 6.80 6.71 6.45 6.01 5.46 6.15
70 7.04 6.94 6.63 6.12 5.51 6.32
Rates not shown will be provided on request
--------------------------------------------------------------------------------
Joint & Last
Survivor Payee
Table B - Monthly Adjusted Secondary Payee Adjusted Age
Installments Age 55 60 62 65 70
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Until last Death 55 4.19 4.34 4.40 4.47 4.57
of Two Payees 60 4.34 4.56 4.65 4.77 4.94
per $1,000 of 62 4.40 4.65 4.75 4.89 5.10
benefit amount 65 4.47 4.77 4.89 5.07 5.36
70 4.57 4.94 5.10 5.36 5.81
V6009C-1 (7-82) -7- BP 600971
PAYMENT OF BENEFITS (Continued)
Additional Other reasonable provisions can be made for the payment of
Provisions For the benefits under this Policy. Any such provision must be
Payment of agreed to by SBL.
Benefits
Tables A and B assume 1906 as the year of birth of the
payee. To use Table A for a payee born after 1906, the
actual age is reduced by .05 for each year the year of
birth exceeds 1906. For a payee with a birth year prior to
1906, the actual age is increased in like manner. The
actual age (in completed months) reduced or increased
becomes the adjusted age with which to use Table A or B.
Tables A and B are based on the 1971 Individual Annuity
Mortality table with 3.5% interest.
Benefit payment options shall be available only with the
consent of SBL if the proposed payee be other than a
natural person not acting as fiduciary.
The Effective Date of a Settlement Option for options 1
through 6 is the date the first installment is due to the
payee. For option 7 the first interest payment will be
made at the end of the period selected, with the effective
date being the date at the beginning of the period. If
this Policy has a Policy Value, and the Owner has not made
any election to the contrary, the settlement option shown
on the Policy Specifications pages will become effective
on the Maturity Date. In this case, the amount applied
will be the Policy Value.
Installments required to be paid, if any, after the death
of a payee under a settlement option will be paid as due
to the surviving or next succeeding payee. If none was
named or has survived, SBL will pay the present value of
the remaining required installments, in a single sum, to
the payee's estate. The present value of any remaining
required installments is always less than the sum of those
installments because of the effect of compound interest.
The effective yearly interest rate to be used will be the
rate actually used to calculate the periodic installment
(but not less than 3.5%) for options 2 and 3. For options
5, 6, and 7 the present value will be the amount remaining
with SBL.
For guaranteed annuity settlements, additional interest
may be paid on the amount applied under the various
settlement options. The amount and method of payment of
the additional interest will be determined by SBL.
On the Effective Date of a Settlement Option, the
settlement option rates being used for single payment
immediate annuity policies of this class, which are then
being issued by SBL, may produce a higher first
installment than guaranteed in this policy. If this is the
case, the Owner may elect to have SBL use the rates from
the single payment immediate annuity policies then being
issued by SBL. This election can be made only if permitted
by the laws of the state where the election is made.
At any time, any amount remaining under option 5, 6 or 7
may be withdrawn. For options 5 and 6, a Withdrawal Charge
may be made if 5 years have not elapsed from the Effective
Date of the Settlement Option. For option 7, a Withdrawal
Charge may be made regardless of how long interest has
been paid. Refer to the Nonforfeiture portion of this
Policy for details. If the amount withdrawn is at least
$2,000, it may be applied to any one of the first four
options.
When any of the options 1, 2, 3, or 4 are elected, the
Owner may choose to increase the installments. Such
election must be made in writing to SBL before the
Effective Date of the Settlement Option and must be
accompanied by a cash purchase payment to provide the
additional installments. A cash purchase payment of $1,030
is required to increase the installments by the amount
indicated per $1,000 of benefit amount shown in Tables A
and B. Cash purchase payments applied under this provision
which produce a total installment of more than 2 times the
installment produced using the benefit amount alone must
be approved by SBL.
-8- BP 600971
PURCHASE PAYMENTS
Payment of This Policy will be in force when the first purchase
Purchase Payments payment is received by SBL. Purchase payments are payable
from the Policy Date to the Maturity Date or to the death
of the Annuitant. The amount of a purchase payment may be
increased or decreased from the prior payment amount. A
purchase payment may not be less than $25.00 without the
approval of SBL. The total of the purchase payment may not
exceed $100,000 without the approval of SBL. Any excess
purchase payments will be subject to conditions that SBL
may apply at that time.
All purchase payments are payable at the Home Office of
SBL. If the Owner stops paying purchase payments and this
Policy is not terminated, the Owner may resume paying
purchase payments subject to the conditions above.
Purchase payment intervals are determined by the mode
selected by the Owner and shown on the Policy
Specifications pages. The mode of the purchase payment may
be changed by notifying SBL in writing.
VALUATION
Accumulations of The purchase payments received by SBL from the Policy Date
Purchase Payments to the Maturity Date will be applied to increase the
Allocated to the Policy Value of this Policy. The purchase payments will be
General Account deposited in the General Account of SBL and the Series of
the Separate Account of SBL as directed by the Owner. The
investments of the General Account of SBL meet the
requirements for the investment of life and annuity
reserves under the insurance code of the state where this
Policy was issued.
The Policy Value in the General Account on any date will
be the Policy Value in the General Account on the previous
anniversary date increased with interest to the date and
increased or decreased by the following events occurring
after the anniversary date:
1. Purchase payments received and allocated to
the General Account.
2. Benefits paid from the General Account.
3. Deductions from the Policy Value in the
General Account for the various charges and
fees of this Policy.
4. Transfers of part of the Policy Value in the
General Account to the Separate Account.
5. Transfers of part of the Policy Value in the
Separate Account to the General Account.
6. Interest on items 1 through 5 from the
transaction date to the date.
The effective yearly rate of interest used to calculate
the Policy Value in the General Account will be at least
the amount shown in the Guaranteed Interest Rate section
of the Policy Specifications. SBL may, at the decision of
its Board of Directors, credit interest in excess of that
guaranteed. The amount and method of crediting this excess
interest will be determined by SBL.
The transfers noted in items 4 and 5 can not be made
unless specific allowance is made for them in the Policy
Specifications pages.
Separate Account In addition to the General Account Policy Value, the
Policy Value will be increased by the dollar value of the
accumulation units in the Separate Account.
State Premium The Policy Value will be reduced by any state premium
Taxes taxes which SBL is required to pay on behalf of this
Policy.
NONFORFEITURE
Policy Value The Policy Value will be as explained in the Valuation
portion of this Policy. SBL will notify the Annuitant
annually of the Policy Value to date. This Policy will
cease to have a Policy Value after termination of this
Policy, death benefits are paid, or the Effective Date of
a Settlement Option.
Termination Value The Owner may terminate the Policy or withdraw part of the
Policy Value any time prior to the Maturity Date. The
request for termination or withdrawal must be sent to the
Home Office of SBL in writing. When SBL receives the
request it will determine a Termination Value and pay the
Termination Value to the Owner.
-9- BP 600973
NONFORFEITURE
(Continued)
Termination Value The Termination Value will be the value asked to be
(Continued) withdrawn reduced by a Withdrawal Charge. The Withdrawal
Charge will be the product of 'a' times 'b' where:
a - is the value asked to be withdrawn.
b - is the appropriate Withdrawal Charge Factor
shown on the Policy Specifications pages.
The value of 'a' in the above product will be reduced if,
at the time the request is processed, either or both of 1
or 2 occur:
1. The value asked to be withdrawn is greater
than the total of the following:
i. total purchase payments received by SBL;
ii. plus any amount by which 'a' was reduced
because of item 1 or 2 at the time of any
prior withdrawal;
iii. less total prior values asked to be
withdrawn from this Policy.
2. This is the first withdrawal processed this
year and at the time more than one year has
elapsed from the Policy Date.
For item 1, 'a' will be the value defined in item 1. For
item 2, 'a' will be reduced by the Free Withdrawal Amount.
The Free Withdrawal Amount is the product of the Policy
Value, at the time the request is processed, times the
Free Withdrawal Factor shown on the Policy Specifications
pages. In the case where both item 1 and 2 apply, 'a' will
be reduced by the greater of the two possible reductions.
In no case will the Withdrawal Charge be less than zero.
If a request to withdraw part of the Policy Value does not
state which of the Series or the General Account the value
is to be withdrawn from, SBL will deplete the Policy Value
of the Series in the descending order listed under the
Separate Account section of the Policy Specifications
pages. The General Account will be the last to be
depleted.
When part of the Policy Value is withdrawn, the Policy
Value will be reduced by the value asked to be withdrawn.
If the value asked to be withdrawn would reduce the Policy
Value by 90% or more, SBL may terminate this Policy and
pay the Owner the total Termination Value.
The Termination Value will always equal or exceed the
minimum required by law.
The Termination Value is a benefit of this Policy.
Any Termination Value paid for a partial withdrawal may be
repaid under this Policy only within the 30 day period
immediately preceding the Effective Date of a Settlement
Option elected under options 1, 2, 3, or 4. SBL may apply
its then current annuity settlement option rates for this
class of policies to convert these repayments to
installments.
The Termination Value will be the value asked to be
withdrawn if:
1. The Value is applied under settlement options
1, 2, 3, or 4 (See Payment of Benefits portion
of this Policy).
2. The Value is applied under settlement options
5 or 6, and the installments will be paid over
5 or more years.
Payment of any Termination Value will be made within 7
days of the day the request is received at the Home Office
of SBL, except that a day on which one of the following
events occur will not be counted as one of the 7:
1. The New York Stock Exchange is closed except
for holidays or weekends.
2. The Securities and Exchange Commission has
determined that trading on the New York Stock
Exchange is restricted.
3. The Securities and Exchange Commission permits
postponement and so orders.
4. An emergency exists, as defined by the
Securities and Exchange Commission, so that
valuation of the assets or disposal of
securities is not reasonably practicable.
-10- BP 600973
SEPARATE ACCOUNT
PROVISIONS
Introduction This portion of this Policy contains the provisions
relating to the Separate Account of SBL to which the Owner
of this Policy may allocate purchase payments. The
Separate Account and Series are shown in the Separate
Account section of the Policy Specifications pages.
Ownership of SBL has exclusive and absolute ownership and control of
Separate the assets of the Separate Account. The Owner of this
Account Policy is entitled to vote at meetings of Owners of
policies of this class as required under the Investment
Company Act of 1940. SBL will send the Owner at least once
each year a report stating the number of accumulation
units credited to his account, a statement of investments
held by each Fund, proxy material, and a voting form.
Separate The Separate Account which is invested in the Series, as
Account shown on the Policy Specifications pages, has been
Defined established by SBL under the laws of Kansas. The Separate
Account is a unit investment trust. When used in this
Policy, Separate Account will mean the assets of SBL in
the Separate Account and Series shown on the Policy
Specifications pages, established by SBL to provide
variable benefits for this class of policies. The income,
gains, and losses from the Separate Account and each of
the Series will be charged to it, without regard to the
experience of the other Series and Separate Account.
Funds The Series of the Separate Account each are invested
Defined wholly in the Funds as shown on the Policy Specifications
pages. The Funds are diversified, open-end management
investment companies registered under the Investment
Company Act of 1940.
Guaranteed A guaranteed annuity is an annuity with installments which
Annuity are guaranteed as to dollar amount throughout the payment
Defined period. The reserves, required by law to be maintained, to
fund the installments will be held in the General Account
of SBL. The installments for a guaranteed annuity must be
at least $25.00.
Variable In contrast, a variable annuity is an annuity with
Annuity installments varying with the net investment results of a
Defined Series within the Separate Account. The first installment
is determined by using the values in Table A or B and
settlement options 1, 2, 3, 4, 5 or 6 of the Payment of
Benefits portion of this Policy. Also, other reasonable
provisions for the first installment can be made. Any such
provision must be agreed to by SBL.
After the first installment is determined for a particular
Series the number of annuity units is determined by
dividing the first installment by the annuity unit value
for that day for each Series from which installments are
to be made. The amount of each subsequent installment is
that number of annuity units for the Series multiplied by
the annuity unit value for the Series for the day the
installment is due. The sum of the installments for all
Series and the General Account is the total installment
the payee will receive.
The first installment from each Series must be at least
$25.00. If at any time any installment from any Series
becomes less than $25.00, SBL may change the frequency of
installments. The change will be such as will result in
installments of at least $25.00.
SBL guarantees that the dollar amount of any variable
annuity installment will not be affected by the mortality
experience of the payees. SBL also guarantees that the
variable annuity installment will not be affected by the
actual expenses of administering the benefits.
At the time of election of a Settlement Option, it may be
specified how the total benefit amount is to be allocated
between the Series and the General Account for calculation
of the first installments. If the allocation is not
specified, the benefit amount as it then exists among the
Series and the General Account will be applied to
calculate the first installments.
Valuing First For calculating the first installment for an annuity, the
Annuity value of the accumulation units applied to settlement
Installment options 1, 2, 3, or 4, will be the value at the end of the
second day before the first installment is paid. For
settlement options 5, 6, and 7, the value of the
accumulation units applied will be the value on the day
the installment is paid.
V6009B (R11-81) -11- BP 6009U1
SEPARATE ACCOUNT
PROVISIONS
(Continued)
Investment The Gross Investment Factor (GIF) for any day for a Series
Factors is equal to value 'a' divided by value 'b'. For each
Series, value 'a' is the sum of the Fund's net asset value
per share at the close of business on that day plus the
dividends or other distributions per share on that day.
Value 'b' is the net asset value at the close of business
on the preceding day. On days when the New York Stock
Exchange is not open for trading, the GIF is one. No
purchase, benefit, or installment payments will be made on
days when the New York Stock Exchange is closed.
The Net Investment Factor (NIF) for any day for a Series
is the GIF for the Series less the Actuarial Risk Fee
(ARF) and less a deduction for any increases in the income
tax expense for the Series for the day. The ARF is shown
on the Policy Specifications pages.
Accumulation The value of the accumulation unit for each Series in the
Unit Separate Account is the net asset value per share of the
Values Fund in which the Series is invested. Dividend and other
cash distributions made by the Fund to the Series will be
reinvested in additional mutual fund shares of the same
Fund and additional accumulation units will be credited to
this Policy. The expense items applied in the calculation
of the NIF (the ARF and taxes) will be applied to the
Policy Value. Mutual Fund shares of the Fund will be sold
to pay for these expense items and the accumulation units
credited to this Policy will be reduced. Also, the Charges
and Fees, explained in that section of the Policy
Specifications pages, will result in the sale of shares of
the Fund and a reduction of the accumulation units
credited to this Policy. Purchase payment amounts
allocated to each Series will be used by SBL to purchase
additional accumulation units of that Series. The number
of units purchased will be the amount allocated to the
Series divided by the value of one accumulation unit for
the Series on the day the purchase payment is received by
SBL. Benefit payments because of death or by withdrawal of
part or all of the Termination Value will result in a
reduction of the number of accumulation units credited to
this Policy. The reduction will be sufficient to generate
the necessary Policy Value Change.
Annuity Unit The annuity unit value associated with a Series for any
Values day is determined by multiplying the annuity unit value
for the immediately preceding day by the product of 'a'
times 'b':
a - is the NIF for the Series for the second day
preceding the date for which the value is
being determined.
b - is the daily Interest Neutralization Factor
(INF) of .9999057540.
The INF is required to neutralize the assumed interest
rate built into Table A and B. The value of an annuity
unit may increase or decrease in dollar amount. The first
annuity unit value and the date it was set for each Series
is shown in the Separate Account Section of the Policy
Specifications pages.
Splitting Units SBL has the right to split the value of any annuity or
accumulation unit if such is deemed to be in the best
interest of the Owner, the Annuitant and SBL. Any split
made will be made equitably and will have no material
effect on the benefits and provisions of the Policy.
Fluctuation of The Policy Value and Termination Value of the Separate
Values Account may be less than the total value of the purchase
payments allocated to it adjusted for withdrawals,
transfers, and benefits. SBL does not guarantee the
investment performance of the Funds in which the Separate
Account is invested.
-12- BP 6009U1
ENDORSEMENT FOR ANNUITY POLICY LOAN PROVISION
INTRODUCTION AND REQUIREMENTS FOR LOAN:
This endorsement is attached to and made part of your Policy as of its
date of issue or as of the date shown below. If attached after the date of issue
any new loans permitted on or after the date shown below will be governed by
this endorsement; not by any loan endorsement with an earlier effective date.
The dollar value of the Policy in the General Account (i.e. GA) is herein called
the "General Account Value" or "GAV". The Owner of the Policy is herein called
"the Borrower", "you", or "your". Security Benefit Life Insurance Company is
herein called "SBL", "we", or "our".
Prior to the scheduled start of retirement annuity installments (i.e. the
maturity date), SBL will lend an amount applied for to the Owner subject to the
limitations, interest rates, and repayment procedures set out in this
endorsement and in the loan agreement between the Owner and SBL. All annuity
policy loans must be repaid before the start of retirement annuity installments
(i.e. the maturity date).
Any new loan will be secured by part or all of the GAV equal to the amount
of the loan. This GAV will be the collateral for the loan. Any new loan must be
for at least twenty-five hundred dollars ($2500.00). At the time of loan
approval the sum of the following may not exceed the dollar value limit on debt
specified herein: (1) all outstanding principal and interest on prior loans
under all loan endorsements attached to the Policy; plus (2) the current loan
applied for. Only two new loans will be permitted per policy year. All loans
under this and prior loan endorsements must be repaid as specified in the loan
agreement and endorsement. All loans must be repaid before the beginning of
retirement annuity installments (i.e. the maturity date) under the Policy.
Except for cases that qualify under the Internal Revenue Code as determined by
SBL, all loans must be repaid within 5 years of approval. All loan repayments
must be scheduled to be paid in equal amounts on the same day of each calendar
month or calendar quarter. For monthly repayments the first scheduled repayment
may not be later than 30 days after the date of approval of the loan application
by SBL. For quarterly repayments, the first scheduled repayment may not be later
than 90 days after the date of approval of the loan application by SBL. Before a
loan is permitted a written application and loan agreement must be received by
SBL. The written application and loan agreement must be completed on a form
acceptable to SBL. At the time of loan approval a fee of ten dollars ($10.00)
will be charged and must be submitted with the loan application. Other loan
arrangements may be made, but only with the advance approval of SBL. SBL may
postpone final approval or disapproval of a loan for up to six months after the
application for a loan is received.
If a loan is not repaid as specified and scheduled herein and in the loan
agreement SBL may withdraw or surrender the amount of GAV from the Policy
necessary to pay the late payment and interest thereon from the scheduled
payment date to the withdrawal date. Any surrender or withdrawal charges
required under the Policy will be imposed in addition to the loan repayment and
interest. If the Policy provides for a free withdrawal factor (i.e. a FWF), the
surrender or withdrawal charges will be calculated assuming a FWF of zero. The
amount of GAV surrendered or withdrawn to pay for the repayment and interest
will first be surrendered from the GAV acting as collateral for the loan. If the
GAV acting as collateral is insufficient, amounts will be surrendered from the
remaining GAV. The amount of GAV surrendered or withdrawn to pay the surrender
charges will be taken from the GAV not acting as collateral for a loan. If the
remaining GAV is insufficient for repayments, interest or surrender charges, SBL
may surrender amounts from the dollar value of the Policy in the Separate
Account (i.e. SA).
INTERNAL REVENUE CODE:
SBL makes no representations or guarantees as to the tax effect a loan may
have on the Borrower. SBL suggests that the Borrower consult independent tax
counsel for specific advice.
INTEREST RATES AND REPAYMENT PROCEDURES:
The loan rate of interest on loans approved after the effective date of
this endorsement will be an effective annual rate of six and one-half percent
(6.5%). The GAV acting as collateral for a loan will be credited with an
effective annual interest rate of four and one-half percent (4.5%). Interest
will be charged each day that the debt (i.e. principal of loan outstanding plus
interest) is not repaid. The GAV acting as collateral will be credited with
interest each day that the debt remains unrepaid. Payments on the debt will
decrease the amount of the debt and reduce the amount of GAV securing the loan.
The debt may be repaid in full at any time. Any loan repayment must be
identified as such by the Borrower to prevent confusion of the payment with a
normal purchase payment into the GA. The payments on the debt, when received,
will be allocated to the value of the Policy in the GA and Series of the SA in
the same relationship as then currently applicable to normal purchase payments.
V6047L (12-86)
DOLLAR VALUE LIMIT ON DEBT:
The total outstanding debt under this and all prior endorsements may not
exceed:
1. Seventy-five percent (75%) of the GAV, if the GAV is less than
or equal to thirteen thousand three hundred thirty-three
dollars and thirty-three cents ($13,333.33).
2. Ten thousand dollars ($10,000.00), if the GAV is greater than
$13,333.33 but less than twenty thousand dollars ($20,000.00).
3. Fifty percent (50%) of the GAV, if the GAV is $20,000 or more.
OTHER EFFECTS ON POLICY PROVISIONS:
The Borrower's total value in the GA will be terminated or surrendered if
the total debt under this and all prior endorsements at any time equals or
exceeds the total value for which the GA may be surrendered plus interest that
will be paid and less charges that will be assessed in the next thirty-one (31)
days. If the policy provides for a FWF, the charges will be made based on a FWF
of zero. The GAV will become the property of SBL 31 days after notice of
termination has been mailed to the Borrower at the last address known to SBL The
debt will then be reduced by the amount of the termination or surrender value of
the GA. If this is not sufficient to repay the total debt, the remaining amount
will be surrendered from the value of the Policy in the SA.
During the existence of a loan, that part of the GAV securing the loan
will have a guaranteed interest rate as specified in the Policy but not in
excess of 4.5%.
The maturity date or date that annuity installments are to begin under the
Policy cannot be changed to be earlier than the latest final repayment date
under any outstanding loan.
In the following cases the GAV remaining may not be less than the GAV
necessary to meet the dollar value limit on debt required for the then total
current outstanding debt:
1. After a transfer of part of the GAV to any Separate Account.
2. After a partial withdrawal or surrender from the GAV.
If the Policy contains the two following provisions, the part which may be
withdrawn free of charge will be reduced by the ratio which the total
outstanding debt bears to the GAV as of the time of withdrawal:
1. Policy provides for withdrawal or surrender charges.
2. Policy allows withdrawal of part of the GAV free of charge.
In the following cases the amount otherwise receivable will be reduced by
any outstanding debt and withdrawal or surrender charges on the amount withdrawn
to repay the debt if applicable:
1. Death of the Annuitant.
2. Total surrender of the GAV or termination of the GA.
3. Application of the GAV under a settlement option.
4. Maturity of the Policy.
5. Attachment, levy or other involuntary transfer of the GA.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
----------
Endorsement Effective Date, if other than
Date of Issue of Policy. '
15-60470-02
TAX-SHELTERED ANNUITY
ENDORSEMENT
TAX-SHELTERED This Contract is established as a Tax-Sheltered Annuity
ANNUITY ("TSA") under Section 403(b) of the Internal Revenue Code
ENDORSEMENT of 1986, as amended (the "Code") or any successor
provision, pursuant to the Owner's request in the
application. Accordingly, this Endorsement is attached to
and made part of the Contract as of its issue date or, if
later, the date shown below. If this is a group contract,
references to the "Owner" and to the "Contract" shall,
respectively, be deemed to include the Participant and the
Participant's Certificate where appropriate.
TAX-SHELTERED To ensure treatment as a TSA, this Contract will be
ANNUITY PROVISIONS subject to the requirements of Code Section 403(b), which
are briefly summarized below:
CONTRIBUTION (a) Purchase Payments made on behalf of the Owner
LIMITATIONS pursuant to a salary reduction agreement when
added to "elective deferral" contributions
under all other plans, contracts or
arrangements in which the Owner participates,
may not exceed the annual limitation on such
contributions as provided in Code Section
401(a)(30).
(b) Purchase Payments applied to the Contract on
behalf of the Owner which exceed the
applicable "exclusion allowance" (within the
meaning of Code Section 403(b)(2)) or the
limitations contained in Code Section 415
shall not be excludable from gross income.
(c) Purchase Payments that exceed any of the
foregoing limitations may be returned,
distributed or otherwise corrected using any
method permissible under the Code.
NONDISCRIMINATION (a) Except if this Contract is purchased by a
REQUIREMENTS "church" (within the meaning of Code Section
3121(w)), the Plan must satisfy the
nondiscrimination requirements of Code Section
403(b)(12).
(b) Purchase Payments not made pursuant to a
salary reduction agreement will satisfy the
nondiscrimination requirements of Code Section
403(b)(12) provided they satisfy the
requirements of Code Section 401(a)(4)
(nondiscrimination in contributions), Code
Section 401(a)(5) (permitted disparity), Code
Section 401(a)(17) (annual limit on
compensation), Code Section 401(m) (average
contribution percentage test) and Code Section
410(b) (coverage).
(c) Purchase Payments made pursuant to a salary
reduction agreement will satisfy the
nondiscrimination requirements of Code Section
403(b)(12) provided that every employee of the
Employer sponsoring the Plan, may elect to
make Purchase Payments of more than $200
pursuant to a salary reduction agreement.
DISTRIBUTION (a) Distributions attributable to Purchase
RESTRICTIONS AND Payments made pursuant to a salary reduction
REQUIREMENTS agreement may be made only when the Owner
attains age 59 1/2, separates from service,
dies, becomes "disabled" (within the meaning
of Code Section 403(b)(11)) or incurs a
hardship. A distribution made due to a
hardship may not include income attributable
to such Purchase Payments.
6832A (R9-96) -1- SP 83261
(b) Distributions from this Contract must comply
with the minimum distribution and incidental
death benefit requirements of Code Section
403(b)(10). Accordingly, an Owner's entire
interest under the Contract generally must be
distributed (or begin to be distributed) by
April 1 of the calendar year following the
later of (i) the calendar year in which the
Owner attains age 70 1/2, or (ii) the calendar
year in which the Owner retires (the "Required
Beginning Date").
Distributions commencing not later than the
Required Beginning Date may be made over the
life of the Owner or over the lives of the
Owner and his or her Designated Beneficiary
(or over a period not extending beyond the
life expectancy of the Owner or the life
expectancy of the Owner and his or her
Designated Beneficiary).
(c) If the Owner dies before distribution of his
or her interest in the Contract has begun in
accordance with paragraph (b) above, the
Owner's entire interest must be distributed
within five years, unless: (i) such interest
is distributed to a Designated Beneficiary
over his or her life (or over a period not
extending beyond such Designated Beneficiary's
life expectancy); and (ii) such distribution
begins not later than one year after the
Owner's death. If the Designated Beneficiary
is the Owner's surviving spouse, the date on
which the distributions are required to begin
shall not be earlier than the date on which
the Owner would have attained age 70 1/2.
(d) If the Owner dies after distribution of his or
her interest in this Contract has begun in
accordance with paragraph (b) above but before
his or her entire interest has been
distributed, the remaining interest must be
distributed at least as rapidly as under the
method of distribution being used prior to the
Owner's death.
(e) All distributions must comply with a method of
distribution offered by the Company under this
Contract.
(f) If the Owner receives a distribution from this
Contract that qualifies as an "eligible
rollover distribution" (within the meaning of
Code Section 402(f)(2)(A)) and elects to have
such distribution paid directly to an
"eligible retirement plan" (within the meaning
of Code Section 402(c)), such distribution
shall be made in the form of a direct transfer
to the eligible retirement plan. The Company
may establish reasonable administrative rules
applicable to such direct transfers.
NONFORFEITABILITY (a) The Owner's rights under this Contract shall
be nonforfeitable except for failure to pay
future Premiums.
(b) This Contract may not be transferred, sold,
assigned or pledged as collateral for a loan
or as security for the performance of an
obligation or for any other purposes to any
person other than the Company.
MULTIPLE (a) If for any taxable year an Owner is covered by
CONTRACTS this Contract and any other TSA, all such
contracts shall be treated as a single
contract.
-2- SP 683261
PLAN PROVISIONS The Plan, including certain Plan provisions required by
the Employee Retirement Income Security Act of 1974 or
other applicable law, may limit the Owner's rights under
this Contract. The Plan provisions may:
(a) Limit the Owner's right to make Purchase
Payments;
(b) Restrict the time when the Owner may elect to
receive payments under this Contract;
(c) Require the consent of the Owner's spouse
before the Owner may elect to receive payments
under this Contract;
(d) Require that all distributions be made in the
form of a joint and survivor annuity for the
Owner and the Owner's spouse unless both
consent to a different form of distribution;
(e) Require that the Owner's spouse be the
Designated Beneficiary;
(f) Require that the Owner remain employed by the
Employer sponsoring the Plan for a specified
period of time before the Owner's rights under
this Contract become fully vested; or
(g) Otherwise restrict the Owner's exercise of
rights under the Contract or give the Employer
sponsoring the Plan (or a Plan representative)
the right to exercise certain rights on the
Owner's behalf.
No such Plan provision shall limit an Owner's rights under
this Contract, unless the Employer sponsoring the Plan has
provided the Company with written notification of such
provision. In no event shall any such Plan provision
enlarge the Company's obligations under this Contract.
TAX CONSEQUENCES (a) The Company will not incur any liability or be
responsible for the timing, purpose or
propriety of any contribution or distribution;
any tax or penalty imposed on account of any
such contribution or distribution; or any
other failure, in whole or in part, by the
Owner or the Employer to comply with the
provisions set forth in the Code or any other
law.
ADMINISTRATION The Company does not act as the Administrator of the Plan.
Accordingly, the Company will not incur any liability or
be responsible for interpreting the Plan or deciding any
questions arising thereunder.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
----------
Endorsement Effective Date
(If Other Than Issue Date)
6832A (R9-96) -3- SP 683261
ENDORSEMENT
ENDORSEMENT This Endorsement is attached to and made part of this
Policy as of its Issue Date or, if later, the date shown
below.
FEES & CHARGES The "Fees & Charges" section of the Policy is amended by
adding the following: The $30.00 per year fee will not be
charged during a Policy Year, provided that: (1) the
Policy has been in force for eight Policy Years or more;
and (2) Policy Value on December 31 of that Policy Year
(or in the event the Policy is terminated, on the date of
termination) is $25,000 or more.
BENEFIT AMOUNT The "Benefit Amount" section of the Policy is deleted in
its entirety and replaced with the following: If the
Annuitant dies prior to the Maturity Date, a Death Benefit
will be paid to the Beneficiary when: (1) due proof of
death, satisfactory to SBL; and (2) instructions regarding
payment, are received at the Home Office.
If the age of the Annuitant was 75 or less on the Policy
Date, the Death Benefit will be the greatest of: (1) the
sum of all purchase payments, less any premium taxes due
or paid by SBL and less the sum of all Termination Values
paid; (2) the Policy Value on the date due proof of death
and instructions regarding payment are received at the
Home Office, less any premium taxes due or paid by SBL; or
(3) the Stepped-Up Death Benefit described below.
The Stepped-Up Death Benefit is:
1. the largest Policy Value on any Policy Anniversary
that is both an exact multiple of six and occurs
prior to the Annuitant reaching age 76; plus
2. any purchase payments received since the applicable
sixth Policy Anniversary; less
3. any reductions caused by Termination Values paid
since the applicable sixth Policy Anniversary; less
4. any premium taxes due or paid by SBL.
For policies in effect for six Policy Years or more as of
May 1, 1991, the Policy Value on the Policy Anniversary
immediately preceding May 1, 1991, will be used as the
sixth Policy Anniversary in determining the Stepped-Up
Death Benefit.
If the age of the Annuitant on the Policy Date was 76 or
more, the Death Benefit will be the greater of: (1) the
sum of all purchase payments, less any premium taxes due
or paid by SBL and less the sum of all Termination Values
paid; (2) the Policy Value on the date due proof of death
and instructions regarding payment are received at the
Home Office, less any premium taxes due or paid by SBL.
V 6050 (3-96) SP 605011
BENEFIT AMOUNT If a lump sum payment is requested, the payment will be
(Continued) made in accordance with any laws and regulations that
govern the payment of Death Benefits.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
July 1, 1996
--------------------------
Endorsement Effective Date
(If Other Than Issue Date)
SP 605011
NOTICE: CONSULT YOUR TAX ADVISOR PRIOR TO REQUESTING THIS BENEFIT. RECEIPT OF
BENEFITS UNDER THIS ENDORSEMENT MAY BE SUBJECT TO AN IRS 10% PENALTY TAX IN
ADDITION TO ANY INCOME TAX THAT MAY BE DUE.
WITHDRAWAL CHARGE WAIVER
ENDORSEMENT
ENDORSEMENT This Endorsement is attached to and made part of this
Contract/Policy (the "Policy") as of: (1) its Issue Date;
or (2) if later, the date shown below. The Policy is
changed by adding the following:
WAIVER OF Security Benefit Life Insurance Company ("SBL") will waive
WITHDRAWAL CHARGES the Withdrawal Charge on any full or partial Withdrawal of
Contract Value/Policy Value if: (1) the Owner has been
confined to a "Hospital" or "Qualified Skilled Nursing
Facility" for at least 90 consecutive days immediately
prior to the date of such Withdrawal and is so confined
when the request to withdraw is received by SBL; (2) such
confinement began after the Issue Date; and (3) the
request to withdraw is received along with: (a) a properly
completed claim form; and (b) a written statement by a
licensed physician that certifies such confinement is a
medical necessity and is due to illness or infirmity. Such
written statement must be approved by SBL.
SBL reserves the right to have the Owner examined by a
physician of SBL's choice and at SBL's expense to
determine if the Owner is eligible for the Withdrawal
Charge Waiver. SBL reserves the right to require the claim
form and written statement described in 3(a) and (b) above
with each request to withdraw.
DEFINITIONS A "Hospital" is: (1) an institution that is licensed as
such by the Joint Commission of Accreditation of
Hospitals; or (2) any lawfully operated institution that
provides: (a) in-patient treatment of sick and injured
persons through medical, diagnostic and surgical
facilities directed by a staff of physicians; and (b) 24
hour nursing services. A "Qualified Skilled Nursing
Facility" must be licensed by the state to provide, on a
daily basis, convalescent or chronic care for in-patients
who, by reason of illness or infirmity, are not able to
care for themselves.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
----------
Endorsement Effective Date
(If Other Than Issue Date)
V6051 (3-96) SP 60511
AMENDMENT
The "Ownership of Separate Account" provision on page 11 of this Policy is
amended by the addition of the following:
SBL will send the Owner at least once each year any report required by
law.
The "Accumulation Unit Values" provision on page 12 of this Policy is amended by
the addition of the following:
The value of an accumulation unit may increase or decrease in dollar
amount.
Attached to and made a part of this Policy on the Policy Date.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
15-68190-00
Form 6819 (6-82) SP 68194
--------------------------------------------------------------------------------
ENDORSEMENT
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This Endorsement is attached to and made part of this Contract as of the Policy
Date, or if later, the date shown below. Terms not defined herein have the
meaning given to them in the Contract.
The Section, "Fees & Charges," is amended to provide as follows. The annual fee
set forth under the Section, "Fees & Charges," shall be deducted at each Policy
Date anniversary. The annual fee shall be deducted from the Series of the
Separate Account and the General Account. The annual fee shall be deducted in
the same proportion that the Policy Value is allocated to the Series and the
General Account.
Also, the Section, "Method of Charging," is changed to provide that any Transfer
Fee or Allocation Fee will be deducted from the Series of the Separate Account
and the General Account. Such fee shall be deducted in the same proportion that
the Policy Value is allocated to the Series and the General Account. Any terms
of the "Method of Charging" that do not agree with this Endorsement shall be
deleted.
Also, the Section, "Termination Value," as set forth in the Nonforfeiture
section of the Contract shall be changed. That Section now provides that any
withdrawals shall be made from the Series of the Separate Account and the
General Account. Such withdrawal shall be made in the same proportion that the
Policy Value is allocated to the Series and the General Account.
SECURITY BENEFIT LIFE INSURANCE COMPANY
/s/ John F. Guyot
Secretary
Endorsement Start Date
(If Other Than Contract Date)
(LOGO)
SECURITY BENEFIT(SM)
LIFE INSURANCE COMPANY
A BRIEF DESCRIPTION OF THIS POLICY
This is a RETIREMENT ANNUITY POLICY:
- Benefit installments begin on the maturity date using the method as shown
on the Policy Specification spages.
- Death Benefit is payable if the Annuitant dies prior to the Maturity Date.
- Flexible purchase payments are payable until the Maturity Date or until
the prior death of the Annuitant.
ALL PAYMENTS AND VALUES PROVIDED BY THIS POLICY, WHEN BASED ON THE INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO
FIXED DOLLAR AMOUNT.
SECURITY BENEFIT LIFE INSURANCE COMPANY
Security Benefit
One Security Benefit Place, Topeka, KS 66636-0001
1-800-888-2461
BP 6009N4