<PAGE> 1
NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION
(A Delaware Corporation)
Executive Office - 51 Madison Avenue
New York, NY 10010
THE CORPORATION New York Life Insurance and Annuity Corporation (NYLIAC) will
pay the benefits of this policy in accordance with its provisions. The following
pages are also a part of this policy.
ANNUITY BENEFIT ON THE ANNUITY COMMENCEMENT DATE, THE ACCUMULATION VALUE WILL BE
APPLIED TO PROVIDE A MONTHLY INCOME PAYMENT, AS STATED IN THE ANNUITY BENEFIT
SECTION.
RIGHT TO RETURN POLICY PLEASE EXAMINE YOUR POLICY. WITHIN 10 DAYS (OR LONGER IF
REQUIRED BY STATE LAW) AFTER DELIVERY, YOU MAY RETURN IT TO THE CORPORATION OR
TO THE REGISTERED REPRESENTATIVE THROUGH WHOM IT WAS PURCHASED, WITH A WRITTEN
REQUEST FOR A CANCELLATION. UPON RECEIPT OF THIS REQUEST, WE WILL PROMPTLY
CANCEL THIS POLICY AND REFUND THIS POLICY'S ACCUMULATION VALUE LESS ANY PREMIUM
CREDITS WE HAVE CREDITED TO THIS POLICY. THE AMOUNT REFUNDED TO YOU MAY BE MORE
OR LESS THAN THE PREMIUM PAYMENTS.
PAYMENT OF PREMIUMS At any time before the Annuity Commencement Date and during
the lifetime of the Annuitant and Owner, premiums may be paid at any interval or
by any method we make available. Premium Payments are subject to the limitations
defined in this policy. The initial Premium Payment is shown on the Policy Data
Page.
REPORT TO OWNER At least once each Policy Year, New York Life Insurance and
Annuity Corporation will provide a report in connection with this policy. The
report will tell the Owner how much Accumulation Value there is as of the end of
the reporting period. It will also give the Owner any other facts required by
state law or regulations.
This policy is issued as of the Issue Date shown on the Policy Data Page.
/s/ Frederick J. Sievert
President
/s/ George J. Trapp
Secretary
FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY
Monthly Income Payments Begin On The Annuity Commencement Date.
Premiums May Be Paid During The Annuitant's Lifetime, As Defined Herein.
THE AMOUNT OF ANY ACCUMULATION VALUE MAY INCREASE OR DECREASE BASED ON THE
INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT.
ACCUMULATION VALUES BASED ON THE PERFORMANCE OF THE SEPARATE ACCOUNT ARE
VARIABLE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
A Stock Company Incorporated in Delaware.
Policy Is Non-Participating.
200-190 PAGE 1
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NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION
51 MADISON AVENUE - NEW YORK, NY 10010
POLICY DATA
Page 2
ANNUITANT -- JOHN DOE AGE: 55 MALE
POLICY NUMBER -- 00 000 000
POLICY DATE -- FEBRUARY 1, 2000
OWNER -- THE ANNUITANT
PLAN -- NON-QUALIFIED
ALLOCATION ALTERNATIVES:
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ALGER AMERICAN SMALL CAPITALIZATION
AMERICAN CENTURY INCOME & GROWTH
CALVERT SOCIAL BALANCED
DREYFUS LARGE COMPANY VALUE
EAGLE ASSET MANAGEMENT GROWTH EQUITY
FIDELITY VIP II CONTRAFUND
FIDELITY VIP EQUITY-INCOME
JANUS ASPEN SERIES BALANCED
JANUS ASPEN SERIES WORLDWIDE GROWTH
LORD ABBETT DEVELOPING GROWTH
MAINSTAY VP BOND
MAINSTAY VP CAPITAL APPRECIATION
MAINSTAY VP CASH MANAGEMENT
MAINSTAY VP CONVERTIBLE
MAINSTAY VP GOVERNMENT
MAINSTAY VP GROWTH EQUITY
MAINSTAY VP HIGH YIELD BOND
MAINSTAY VP INDEXED EQUITY
MAINSTAY VP INTERNATIONAL EQUITY
MAINSTAY VP TOTAL RETURN
MAINSTAY VP VALUE
MFS GROWTH WITH INCOME SERIES
MFS RESEARCH SERIES
MORGAN STANLEY DEAN WITTER EMERGING MARKETS EQUITY
T. ROWE PRICE EQUITY INCOME
VAN ECK WORLDWIDE HARD ASSETS
FIXED ACCOUNT
DOLLAR COST AVERAGING (DCA) PROGRAM:
6-MONTH DCA ACCOUNT
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<CAPTION>
INITIAL PREMIUM PAYMENT: $5,000
INITIAL PREMIUM PAYMENT DATE: FEBRUARY 1, 2000
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MINIMUM GUARANTEED FIXED INTEREST RATE: 3%
MINIMUM GUARANTEED DCA INTEREST RATE: 3%
MINIMUM GUARANTEED PREMIUM CREDIT RATE 2%
CURRENT PREMIUM CREDIT RATE 3% OF INITIAL PREMIUM PAYMENT
</TABLE>
PLANNED ADDITIONAL PREMIUMS:
PREMIUM AMOUNT: $5,000 - Monthly
ANNUITY COMMENCEMENT DATE: FEBRUARY 1, 2030
<TABLE>
<CAPTION>
SURRENDER CHARGE SCHEDULE:
PURCHASE YEAR PERCENTAGE PURCHASE YEAR PERCENTAGE
<S> <C> <C> <C>
1 8% 5 7%
2 8% 6 6%
3 8% 7 5%
4 8% 8 4%
</TABLE>
DATE OF ISSUE: FEBRUARY 5, 2000
200-190 PAGE 2
POLICY DATA
Page 2A
MINIMUMS:
MINIMUM ADDITIONAL PREMIUM PAYMENT: $5,000
MINIMUM PARTIAL WITHDRAWAL AMOUNT: $500
MINIMUM ACCUMULATION VALUE AFTER A PARTIAL WITHDRAWAL $2,000
MINIMUM INTEREST SWEEP TRANSFER: NO MINIMUM
MINIMUM AMOUNT OF A PREMIUM PAYMENT THAT
<PAGE> 4
CAN BE ALLOCATED TO AN ALLOCATION ALTERNATIVE: $100
MINIMUM TRANSFER AMOUNT FROM FIXED ACCOUNT,
EXCLUDING THE INTEREST SWEEP: $500
MINIMUM TRANSFER AMOUNT FROM INVESTMENT DIVISIONS: $500
MINIMUM DOLLAR COST AVERAGING OPTION TRANSFER IS: $100
MINIMUM AUTOMATIC ASSET REALLOCATION TRANSFER IS: NO MINIMUM
MINIMUM BALANCE THAT MUST BE MAINTAINED IN AN
INVESTMENT DIVISION AFTER A TRANSFER IS MADE: $500
MINIMUM BALANCE THAT MUST BE MAINTAINED IN THE
FIXED ACCOUNT AFTER A TRANSFER IS MADE: $500
MINIMUM ACCUMULATION VALUE REQUIRED TO ELECT DOLLAR COST
AVERAGING OR AUTOMATIC ASSET REALLOCATION OPTIONS IS: $5,000
MINIMUM FIXED ACCUMULATION VALUE REQUIRED
TO ELECT THE INTEREST SWEEP OPTION IS: $5,000
MINIMUM AMOUNT OF A PREMIUM PAYMENT THAT CAN BE
ALLOCATED TO THE DCA ACCOUNT: $5,000
MINIMUM ADDITIONAL PREMIUM PAYMENT INTO THE
DCA ACCOUNT: $5,000
MAXIMUM CHARGE FOR EACH TRANSFER MADE TO OR FROM AN
ALLOCATION ALTERNATIVE AFTER THE FIRST TWELVE (12) IN A POLICY
YEAR: $30
MAXIMUM AGE FOR WHICH ADDITIONAL PREMIUM PAYMENTS MAY BE MADE: 80
THE SUM OF ALL TRANSFERS FROM THE FIXED ACCOUNT, INCLUDING THE INTEREST SWEEP
OPTION TRANSFERS, IN A POLICY YEAR MAY NOT BE GREATER THAN 20% OF THE
ACCUMULATION VALUE IN THE FIXED ACCOUNT, AS OF THE BEGINNING OF THE POLICY YEAR.
POLICY SERVICE CHARGE: THE SUM OF $30 MAY BE DEDUCTED FROM THE ACCUMULATION
VALUE ON EACH POLICY ANNIVERSARY AND ON THE DATE THE POLICY IS SURRENDERED.
HOWEVER, THIS FEE IS WAIVED IF ON THE POLICY ANNIVERSARY OR ON THE DATE OF
SURRENDER THE ACCUMULATION VALUE IS $100,000 OR GREATER. THE POLICY SERVICE
CHARGE IS DEDUCTED FROM EACH ALLOCATION ALTERNATIVE AND THE DCA ACCOUNT IN
PROPORTION TO ITS PERCENTAGE OF THE ACCUMULATION VALUE ON THE POLICY
ANNIVERSARY.
DATE OF ISSUE: FEBRUARY 5, 2000
200-190 PAGE 2A
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READ THIS POLICY CAREFULLY
200-190 PAGE 3
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WE & YOU
In this policy, the words "we," "our," "us," "Corporation" and "NYLIAC" refer to
New York Life Insurance and Annuity Corporation, and the words "you" and "your"
refer to the Owner of this policy.
When you write to us, please include the policy number, your full name and your
current address.
<TABLE>
<CAPTION>
CONTENTS
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<S> <C>
POLICY DATA........................................................................2
DEFINITIONS........................................................................6
SECTION ONE - ANNUITY BENEFIT......................................................9
1.1 WHEN WILL INCOME PAYMENTS BEGIN?...............................................9
1.2 MAY THE ANNUITY COMMENCEMENT DATE BE CHANGED?..................................9
SECTION TWO - INCOME PAYMENTS OF POLICY PROCEEDS...................................9
2.1 HOW ARE INCOME PAYMENTS MADE?..................................................9
2.2 HOW ARE PAYMENTS MADE UNDER THE LIFE INCOME PAYMENT OPTION?....................9
2.3 HOW ARE LIFE INCOME PAYMENT AMOUNTS DETERMINED?................................9
2.4 ARE THERE ANY OTHER METHODS OF INCOME PAYMENT?................................10
SECTION THREE - ANNUITANT, OWNER, BENEFICIARY.....................................10
3.1 WHAT ARE THE RIGHTS OF OWNERSHIP OF THIS POLICY?..............................10
3.2 MAY THE OWNER BE DIFFERENT FROM THE ANNUITANT?................................10
3.3 HOW DO YOU CHANGE THE OWNER OF THIS POLICY?...................................10
3.4 MAY MORE THAN ONE BENEFICIARY BE NAMED?.......................................10
3.5 MAY YOU CHANGE A BENEFICIARY?.................................................10
3.6 WHAT HAPPENS IF THE ANNUITANT DIES BEFORE THE ANNUITY COMMENCEMENT DATE?......10
3.7 WHAT HAPPENS IF THE ANNUITANT DIES AFTER THE ANNUITY COMMENCEMENT DATE?.......10
3.8 WHAT HAPPENS IF YOU DIE BEFORE THE ANNUITY COMMENCEMENT DATE?.................11
3.9 WHAT HAPPENS IF YOU DIE AFTER THE ANNUITY COMMENCEMENT DATE?..................11
3.10 DOES A BENEFICIARY HAVE TO ACCEPT THE ACCUMULATION VALUE OF THIS POLICY AT
YOUR DEATH?.......................................................................11
3.11 WHAT HAPPENS IF YOUR SPOUSE IS THE BENEFICIARY?..............................11
3.12 WHAT HAPPENS IF A BENEFICIARY WHO IS RECEIVING INCOME PAYMENTS DIES?.........11
3.13 WHAT HAPPENS IF NO BENEFICIARY SURVIVES THE ANNUITANT?.......................11
SECTION FOUR - PREMIUM PAYMENTS...................................................12
4.1 HOW ARE PREMIUM PAYMENTS CREDITED?............................................12
4.2 ARE THERE ANY LIMITATIONS REGARDING THE AMOUNTS AND FREQUENCY OF PREMIUM
PAYMENTS?.........................................................................12
4.3 HOW ARE PREMIUM PAYMENTS ALLOCATED?...........................................12
4.4 MAY THE ALLOCATION ALTERNATIVES FOR PREMIUM PAYMENTS BE CHANGED?..............12
4.5 MAY THE CORPORATION TERMINATE THIS POLICY?....................................12
SECTION FIVE - ACCUMULATION VALUE.................................................12
5.1 WHAT IS THE PREMIUM CREDIT AND HOW IS IT CREDITED?............................12
5.2 CAN THE PREMIUM CREDIT BE DEDUCTED FROM THE ACCUMULATION VALUE?...............12
5.3 HOW IS THE ACCUMULATION VALUE CALCULATED?.....................................12
SECTION SIX - CHARGES AND DISTRIBUTIONS...........................................13
6.1 WHEN CAN YOU SURRENDER THIS POLICY?...........................................13
6.2 WHEN CAN YOU MAKE A PARTIAL WITHDRAWAL FROM THIS POLICY?......................13
6.3 WHEN WILL A PARTIAL WITHDRAWAL OR SURRENDER BE PROCESSED?.....................13
</TABLE>
200-190 PAGE 4
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<TABLE>
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6.4 HOW MUCH IS THE SURRENDER CHARGE?.............................................14
6.5 ARE SURRENDER CHARGES EVER WAIVED?............................................14
6.6 ARE SERVICE CHARGES DEDUCTED FROM YOUR POLICY?................................14
6.7 WHEN ARE STATE PREMIUM TAXES DEDUCTED FROM YOUR POLICY?.......................14
SECTION SEVEN - SEPARATE ACCOUNT..................................................14
7.1 HOW IS THE SEPARATE ACCOUNT ESTABLISHED AND MAINTAINED?.......................14
7.2 HOW ARE THE SEPARATE ACCOUNT ASSETS INVESTED?.................................14
7.3 TO WHOM DO THE ASSETS IN THE SEPARATE ACCOUNT BELONG?.........................15
7.4 HOW WILL THE ASSETS OF THE SEPARATE ACCOUNT BE VALUED?........................15
7.5 CAN WE TRANSFER ASSETS OF THE SEPARATE ACCOUNT TO ANOTHER SEPARATE ACCOUNT?...15
7.6 WHAT OTHER RIGHTS DO WE HAVE?.................................................15
7.7 CAN A CHANGE IN THE OBJECTIVE OF THE FUND BE MADE?............................15
7.8 IF THE ASSETS IN THE SEPARATE ACCOUNT BELONG TO US, WHAT DO YOUR PREMIUM
PAYMENTS PURCHASE?................................................................15
7.9 HOW IS THE NUMBER OF ACCUMULATION UNITS DETERMINED?...........................15
7.10 HOW IS THE VALUE OF AN ACCUMULATION UNIT DETERMINED?.........................16
7.11 CAN YOU TRANSFER FROM THE INVESTMENT DIVISIONS TO THE DCA PROGRAM?...........16
7.12 CAN YOU TRANSFER BETWEEN INVESTMENT DIVISIONS AND TO THE FIXED ACCOUNT?......16
7.13 HOW DO YOU TRANSFER THE ACCUMULATION VALUE BETWEEN INVESTMENT DIVISIONS AND
TO THE FIXED ACCOUNT?.............................................................16
7.14 ARE THERE LIMITS ON WHAT YOU MAY TRANSFER BETWEEN INVESTMENT DIVISIONS AND
TO THE FIXED ACCOUNT?.............................................................17
SECTION EIGHT - FIXED ACCOUNT.....................................................17
8.1 HOW ARE THE FIXED ACCOUNT ASSETS INVESTED?....................................17
8.2 HOW IS THE FIXED ACCOUNT VALUED?..............................................17
8.3 CAN TRANSFERS BE MADE FROM THE FIXED ACCOUNT TO THE DCA PROGRAM?..............17
8.4 CAN TRANSFERS BE MADE FROM THE FIXED ACCOUNT TO THE INVESTMENT DIVISIONS?.....17
8.5 HOW DO YOU TRANSFER THE FIXED ACCUMULATION VALUE TO THE INVESTMENT DIVISIONS?.17
8.6 HOW WILL PARTIAL WITHDRAWALS AND TRANSFERS BE DEDUCTED FROM THE FIXED ACCOUNT?18
SECTION NINE - DCA PROGRAM........................................................18
9.1 HOW ARE THE DCA PROGRAM ASSETS INVESTED?......................................18
9.2 HOW IS THE DCA PROGRAM VALUED?................................................18
9.3 CAN TRANSFERS BE MADE FROM THE DCA ACCOUNT TO THE FIXED ACCOUNT?..............18
9.4 HOW DO YOU TRANSFER THE DCA ACCOUNT VALUE TO THE INVESTMENT DIVISIONS?........18
9.5 HOW WILL PARTIAL WITHDRAWALS AND TRANSFERS BE DEDUCTED FROM THE DCA PROGRAM?..18
SECTION TEN - GENERAL PROVISIONS..................................................19
10.1 WHAT CONSTITUTES THE ENTIRE CONTRACT?........................................19
10.2 HOW IMPORTANT IS THE INFORMATION YOU PROVIDE FOR THIS POLICY?................19
10.3 WILL WE BE ABLE TO CONTEST THIS POLICY?......................................19
10.4 HOW ARE THE DATES REFERRED TO IN THIS POLICY MEASURED?.......................19
10.5 HOW IS A PERSON'S AGE CALCULATED FOR THE PURPOSE OF THIS POLICY?.............19
10.6 WHAT HAPPENS IF IN THIS POLICY WE REFER TO A PERSON'S AGE OR SEX INCORRECTLY?19
10.7 MAY YOU ASSIGN OR TRANSFER YOUR POLICY?......................................19
10.8 HOW DO YOU ASSIGN THIS POLICY?...............................................19
10.9 MAY THE ASSIGNEE CHANGE THE OWNER, ANNUITANT, OR BENEFICIARY?................19
10.10 ARE THE PAYMENTS MADE UNDER THE TERMS OF THIS POLICY PROTECTED AGAINST
CREDITORS?........................................................................19
10.11 HOW SHOULD PAYMENTS FOR THIS POLICY BE MADE?................................19
10.12 HOW IS GUARANTEED INTEREST CALCULATED FOR THIS POLICY?......................19
10.13 IS THIS POLICY SUBJECT TO ANY LAW?..........................................20
10.14 ARE THERE ANY DIVIDENDS PAYABLE UNDER THIS POLICY?..........................20
</TABLE>
Note: This is a legal contract between the Owner and the Corporation.
200-190 PAGE 5
<PAGE> 8
DEFINITIONS
ACCUMULATION UNIT: An accounting unit used to calculate the Variable
Accumulation Value prior to the Annuity Commencement Date. Each Investment
Division of the Separate Account has a distinct Accumulation Unit value.
ACCUMULATION VALUE: The Variable Accumulation Value, if any, plus the Fixed
Accumulation Value, if any, plus the Dollar Cost Averaging (DCA) Program
Accumulation Value, if any, of a policy for any Valuation Period.
AGE: The attained age on your last birthday.
ALLOCATION ALTERNATIVES: The Investment Divisions of the Separate Account and
the Fixed Account constitute the Allocation Alternatives.
ANNUITANT: The person named on the Policy Data Page and whose life determines
the Income Payments, and upon whose death prior to the Annuity Commencement Date
benefits under this policy may be paid.
ANNUITY COMMENCEMENT DATE: The date on which the first Income Payment under this
policy is to be made.
BENEFICIARY: The person or an entity having the right to receive the death
benefit set forth in this policy and who is the "designated Beneficiary" for
purposes of Section 72 of the Internal Revenue Code in the event of the
Annuitant's or Owner's death.
BUSINESS DAY: Generally, any day on which the New York Stock Exchange is open
for trading. Our Business Day ends at 4:00 p.m. Eastern Time or the closing of
the New York Stock Exchange, if earlier.
CORPORATION ("NYLIAC, WE, US, OUR"): New York Life Insurance and Annuity
Corporation, which is a wholly-owned Delaware subsidiary of New York Life
Insurance Company.
DOLLAR COST AVERAGING (DCA) ACCOUNT: An account used specifically for the Dollar
Cost Averaging Program, as shown on the Policy Data Page.
DOLLAR COST AVERAGING (DCA) PROGRAM: A program which permits you to transfer
amounts from the DCA Account to the Investment Divisions and/or to the Fixed
Account in proportional periodic amounts. The assets in the DCA Program are not
part of the Separate Account of New York Life Insurance and Annuity Corporation.
The DCA Program Accumulation Value is supported by assets in the General Account
of the Corporation, which are subject to the claims of its general creditors.
The DCA Account that is available under the DCA Program is shown on the Policy
Data Page.
DOLLAR COST AVERAGING (DCA) PROGRAM ACCUMULATION VALUE: The sum of the Premium
Payments allocated to the DCA Program, plus any Premium Credits and interest
credited on those Premium Payments and Premium Credits, less transfers and any
Partial Withdrawals from the DCA Program, and less any Surrender Charges and
Service Charges that may have already been assessed from the DCA Program.
ELIGIBLE PORTFOLIOS ("PORTFOLIOS"): The mutual fund portfolios of the Fund,
which are available for investment by the Investment Divisions of the Separate
Account, as shown on the Policy Data Page.
FIXED ACCOUNT: Assets in the Fixed Account are not part of the Separate Account
of New York Life Insurance and Annuity Corporation. The Fixed Accumulation Value
is supported by assets in the General Account of the Corporation, which are
subject to the claims of its general creditors.
FIXED ACCUMULATION VALUE: The sum of Premium Payments and transfers allocated to
the Fixed Account, plus any Premium Credits and interest credited on those
Premium Payments, Premium Credits, and transfers, less transfers and any Partial
Withdrawals from the Fixed Account, and less any Surrender Charges and Service
Charges that may have already been assessed from the Fixed Account.
FUND: MainStay VP Series Fund, Inc., a diversified open-end management
investment company registered under the Investment Company Act of 1940, and any
other registered open-end management investment company which offers Eligible
Portfolios.
GENERAL ACCOUNT: Includes all of NYLIAC's assets except those assets
specifically allocated to the Separate Account.
INCOME PAYMENTS: Payments made by NYLIAC to the named Payee, generally after the
Annuity Commencement Date.
INVESTMENT DIVISION ("DIVISION"): A division of the Separate Account. Each
Investment Division invests exclusively in shares of a specified Eligible
Portfolio.
200-190 PAGE 6
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ISSUE DATE: The date this policy is executed.
OWNER ("YOU, YOUR"): The person(s) or an entity designated as the Owner in this
policy, or as subsequently changed, and upon whose death prior to the Annuity
Commencement Date benefits under this policy may be paid. If NYLIAC issues a
jointly owned policy, ownership rights and privileges under this policy must be
exercised jointly and benefits under this policy will be paid upon the death of
any joint owner.
PARTIAL WITHDRAWAL: Any part of the Accumulation Value paid to you, at your
request, in accordance with the terms of this policy.
PAYEE: A recipient of payments under this policy, generally the owner.
POLICY ANNIVERSARY: An anniversary of the Policy Date displayed on the Policy
Data Page.
POLICY DATA PAGE: Page (2) of this policy, containing the policy specifications.
POLICY DATE: The date from which Policy Years, quarters, months, and
anniversaries are measured. It is shown on the Policy Data Page.
POLICY YEAR: A year commencing on the Policy Date. Subsequent Policy Years begin
on each Policy Anniversary unless otherwise indicated.
PREMIUM CREDIT: An additional crediting to this policy's Accumulation Value. The
Premium Credit is calculated as a percentage (the "Premium Credit Rate") of each
Premium Payment. The Premium Credit Rate will never be less than the rate shown
on the Policy Data Page. The Premium Credit will be applied to the policy's
Accumulation Value concurrent with the Premium Payment received.
PREMIUM PAYMENT: An amount paid to the Corporation as consideration for the
benefits provided by this policy.
PROPORTIONAL WITHDRAWAL: An amount equal to the amount withdrawn from this
policy divided by this policy's Accumulation Value immediately preceding the
withdrawal, multiplied by the reset value immediately preceding the withdrawal.
PURCHASE DATE: The Business Day on which a Premium Payment is received by us and
credited under this policy.
PURCHASE YEAR: A year as measured from the Purchase Date of the initial Premium
Payment or from the Purchase Date of any additional Premium Payments made.
QUALIFIED PLANS: A retirement plan under Section 219, 401(a), 403(b), or 408 of
the Internal Revenue Code.
RESET ANNIVERSARY: The anniversary occurring every year on the Policy Date until
either the Owner or the Annuitant is age 80. On the first Policy Anniversary,
the Policy Date as shown on the Policy Data Page, will be used as the prior
Reset Anniversary.
RESET VALUE: The Reset Value on the first Policy Anniversary is the greater of
a) the Accumulation Value of this Policy; and b) the total of the Premium
Payments made to this Policy, less any Proportional Withdrawals, Surrender
Charges on those Proportional Withdrawals, and less any rider premiums since
the prior Reset Anniversary. The value calculated on the second and subsequent
Reset Anniversary is based on a comparison between: (a) the Accumulation Value
on the current Reset Anniversary, and (b) the Reset Value on the prior Reset
Anniversary, plus any Premium Payments since the prior Reset Anniversary date,
less any Proportional Withdrawals, Surrender Charges on those Proportional
Withdrawals, and less any rider premiums since the last Reset Anniversary date.
The greater of the compared values will be the new Reset Value.
RMD AUTOMATED OPTION: The calculation and automatic processing of the Required
Minimum Distribution (RMD) under certain Qualified Plans on a scheduled interval
(monthly, quarterly, semi-annually, or annually) or on an interval made
available by us to meet the Internal Revenue Service (IRS) requirements. RMD is
an amount that the IRS requires the owners of certain Qualified Plans to
withdraw each year generally commencing with the year the owner attains age
70 1/2.
SEPARATE ACCOUNT: A Separate Account established by the Corporation into which
assets are placed for the purchasers of this class of policies.
SURRENDER CHARGE: An amount charged by the Corporation during the first eight
Purchase Years
200-190 PAGE 7
<PAGE> 10
after any Premium Payment is made, occurring when a Partial Withdrawal of the
Accumulation Value is made or when this policy is surrendered for its
Accumulation Value.
VALUATION PERIOD: The period from the close of the immediately preceding
Business Day to the close of the current Business Day.
VARIABLE ACCUMULATION VALUE: The sum of the products of the current Accumulation
Unit's value for each of the Investment Divisions multiplied by the number of
Accumulation Units held in the respective Investment Divisions.
200-190 PAGE 8
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SECTION ONE - ANNUITY BENEFIT
1.1 WHEN WILL INCOME PAYMENTS BEGIN?
We will apply the Accumulation Value of this policy to the Life Income Payment
Option and make Income Payments to you each month beginning on the Annuity
Commencement Date shown on the Policy Data Page. These payments will be made in
accordance with the 'Income Payments Of Policy Proceeds' section of this policy.
Income Payments will begin if you and the Annuitant, if you are not the
Annuitant, are alive and if this policy is in force on that date.
1.2 MAY THE ANNUITY COMMENCEMENT DATE BE CHANGED?
Yes. If we agree, you may have the Annuity Commencement Date shown on the Policy
Data Page changed to an earlier date or deferred to a later date. You must
notify us in writing of your wish to change the date at least one month before
the Annuity Commencement Date.
SECTION TWO - INCOME PAYMENTS OF POLICY PROCEEDS
2.1 HOW ARE INCOME PAYMENTS MADE?
If you and the Annuitant, if you are not the Annuitant, are alive, and this
policy is in force on the Annuity Commencement Date, we will make Income
Payments under the Life Income Payment Option. If the Accumulation Value of this
policy is less than $2,000 on the Annuity Commencement Date, payment will be
made in a single sum.
2.2 HOW ARE PAYMENTS MADE UNDER THE LIFE INCOME PAYMENT OPTION?
We will make equal payments each month during the lifetime of the Annuitant.
Once Life Income Payments start, they do not change and are guaranteed for 10
years even if the Annuitant dies sooner. We may require that the Payee submit
proof of the Annuitant's survivorship as a condition for future Income Payments.
2.3 HOW ARE LIFE INCOME PAYMENT AMOUNTS DETERMINED?
Life Income Payments are based on the annuity premium rate in effect when the
first Income Payment is due, however, the premium rate will not be less than the
corresponding minimum amount shown in the Life Income Payment Option Table.
These minimum amounts are based on the 1983 Table a with Projection Scale G and
with interest compounded annually at 3%.
When asked, we will state in writing what the minimum amount of each monthly
Income Payment would be under this provision. It is based on the sex and
adjusted Age of the Annuitant. To find the adjusted Age in the year the first
Income Payment is due, we increase or decrease the Annuitant's Age at that time,
according to the following table:
<TABLE>
<CAPTION>
2000-2005 2006-2015 2016-2025 2026-2035 2036 & later
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<S> <C> <C> <C> <C>
+1 0 -1 -2 -3
</TABLE>
<TABLE>
<CAPTION>
LIFE INCOME PAYMENT OPTION TABLE
(Minimum Monthly Payment Guaranteed for 10 years for $1,000 of Proceeds)
----------------------------------------------------------------------------
Adjusted Age Male Female
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60 4.46 4.03
61 4.55 4.11
62 4.66 4.19
63 4.76 4.27
64 4.87 4.37
65 4.99 4.46
66 5.11 4.57
67 5.24 4.67
68 5.38 4.79
69 5.52 4.91
70 5.66 5.04
71 5.81 5.18
72 5.96 5.32
73 6.12 5.47
74 6.28 5.63
75 6.45 5.79
76 6.61 5.96
77 6.78 6.14
78 6.96 6.32
79 7.13 6.51
80 7.30 6.70
81 7.46 6.89
82 7.63 7.07
83 7.78 7.26
84 7.93 7.44
85+ 8.07 7.62
</TABLE>
200-190 PAGE 9
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2.4 Are There Any Other Methods Of Income Payment?
Yes. You may elect to have the Accumulation Value paid to you in a single sum,
or if we agree, the proceeds may be placed under some other Income Payment
option.
SECTION THREE - ANNUITANT, OWNER, BENEFICIARY
3.1 WHAT ARE THE RIGHTS OF OWNERSHIP OF THIS POLICY?
As the Owner, you have the right to change the Beneficiary or the Owner of this
policy. These rights are nonforfeitable and include the right to receive Income
Payments or to name a Payee to receive these Income Payments.
3.2 MAY THE OWNER BE DIFFERENT FROM THE ANNUITANT?
Yes, but unless it is indicated on the Policy Data Page, or unless ownership is
subsequently changed, you are both the Annuitant and Owner of this policy.
3.3 HOW DO YOU CHANGE THE OWNER OF THIS POLICY?
You may change the Owner of this policy, from yourself to a new Owner, in a
notice you sign which gives us the facts that we need. This change will take
effect as of the date we receive your signed notice, subject to any payment we
made or action we took before recording the change. When this change takes
effect, all rights of ownership in this policy will pass to the new Owner.
Changing the Owner does not change the Beneficiary or the Annuitant.
3.4 MAY MORE THAN ONE BENEFICIARY BE NAMED?
Yes. You may name more than one Beneficiary. Multiple Beneficiaries may be
classified as first, second, and so on. If two or more beneficiaries are named
in a class, their shares in any amount payable may be stated. Any amount payable
to a Beneficiary will be applied to any first Beneficiaries who survive you. If
no first Beneficiaries survive, payment will be made to any surviving in the
second class, and so on. Those who survive in the same class have an equal share
to the extent possible in any amount payable, unless the shares are stated
otherwise. No amount will be payable to a Beneficiary if you die after the end
of an Income Payment period under any payment option.
3.5 MAY YOU CHANGE A BENEFICIARY?
Yes. You may change a Beneficiary during the lifetime of the Annuitant or Owner,
if you are not the Annuitant, in a signed notice that is satisfactory to us.
When we record a change, it will take effect as of the date we receive your
signed notice, subject to any payment we made or action we took before recording
the change.
3.6 WHAT HAPPENS IF THE ANNUITANT DIES BEFORE THE ANNUITY COMMENCEMENT DATE?
When we have proof that the Annuitant has died before the Annuity Commencement
Date, upon receipt of all necessary information, we will pay to the
Beneficiary(s) an amount equal to the greater of:
a) the Accumulation Value of this policy, less any Premium Credits credited to
the Accumulation Value if the credits occur within the immediately preceding 12
months of death, or
b) the sum of all Premium Payments paid, less the amount of any Partial
Withdrawals and any Surrender Charges assessed, less any rider premiums, or
c) the Reset Value on the last Reset Anniversary of this policy, plus, since the
last Reset Anniversary, any Premium Payments, plus any Premium Credits credited
to this policy, unless the credit occurs within the immediately preceding 12
months of death, less any Proportional Withdrawals, Surrender Charges on those
Proportional Withdrawals, less any rider premiums since the last Reset
Anniversary.
Payment will be made in a single sum, or in accordance with the Beneficiary's
election as provided for in Section 3.10. The Accumulation Value will be
calculated as of the date we receive due proof of death and all requirements
necessary to make the payment. This policy will end on such date. However, if
you are not the Annuitant, the Annuitant was your spouse, and you are the sole
primary Beneficiary, you may elect in writing to continue this policy with you
as the new Annuitant.
3.7 WHAT HAPPENS IF THE ANNUITANT DIES AFTER THE ANNUITY COMMENCEMENT DATE?
If the Annuitant dies after the Annuity Commencement Date, but before the end of
the guaranteed period of the Income Payments, we will continue to make these
payments to the Beneficiary for the remainder of the Income Payment period. No
amount will be payable to
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a Beneficiary if theAnnuitant dies after the end of an Income Payment period
under any payment option.
3.8 WHAT HAPPENS IF YOU DIE BEFORE THE ANNUITY COMMENCEMENT DATE?
If you are not the Annuitant, and if you die before the Annuity Commencement
Date, when we have proof of your death, upon receipt of all necessary
information, we will pay to the Beneficiary an amount equal to the greater of:
a) the Accumulation Value of this policy, less any Premium Credits credited
within the immediately preceding 12 months of death, or
b) the sum of all Premium Payments paid, less the amount of any Partial
Withdrawals and any Surrender Charges assessed, less any rider premiums, or
c) the Reset Value on the last Reset Anniversary of this policy, plus, since the
last Reset Anniversary, any Premium Payments, plus any Premium Credits credited
to this policy, unless the credit occurs within the immediately preceding 12
months of death, less any Proportional Withdrawals, Surrender Charges on those
Proportional Withdrawals, less any rider premiums since the last Reset
Anniversary.
Payment will be made in a single sum or in accordance with the Beneficiary's
election as provided for in Section 3.10. The Accumulation Value will be
calculated as of the date we receive due proof of death and all requirements
necessary to make payment. This policy will end on such date. However, if you
are not the Annuitant and your surviving spouse is the sole primary Beneficiary,
your spouse may elect in writing to become the new Owner of this policy.
3.9 WHAT HAPPENS IF YOU DIE AFTER THE ANNUITY COMMENCEMENT DATE?
If you die before the Annuitant, we will make payment to the Beneficiary in an
amount equal to the present value of remaining Income Payments under a fixed
option or the current value of any amount remaining with us under a variable
option if then available. That amount will be determined based on the method,
interest rate and mortality table used to determine the monthly Income Payment.
3.10 DOES A BENEFICIARY HAVE TO ACCEPT THE ACCUMULATION VALUE OF THIS POLICY AT
YOUR DEATH?
Upon receiving proof of your death, full payment will be made within five (5)
years after the date of your death to the Beneficiary. Your Beneficiary is not
required to accept the Accumulation Value of this policy if, while the Annuitant
is alive, you or the Beneficiary (after your death), choose in a signed notice
which gives us the facts that we need, to have all or part of this payment
placed under the Life Income Payment Option or any other payment option for the
Beneficiary. Payment under the option must be for the life of the Beneficiary or
for a number of years that is not more than the life expectancy of the
Beneficiary, at the time of your death (as determined for federal tax purposes),
and must begin within one year after your death.
3.11 WHAT HAPPENS IF YOUR SPOUSE IS THE BENEFICIARY?
If your spouse is the sole primary Beneficiary and you die before the Annuity
Commencement Date, this policy may be continued with your spouse as the new
Owner. If you are also the Annuitant, your spouse will become the new Annuitant.
If your spouse chooses to continue this policy, no death benefit proceeds will
be paid as a consequence of your death.
3.12 WHAT HAPPENS IF A BENEFICIARY WHO IS RECEIVING INCOME PAYMENTS DIES?
Each remaining Income Payment will be made to those Beneficiaries in the same
class who are alive when that payment becomes due. If no Beneficiary for any
amount payable, or for a stated share, survives you, the right to this amount or
this share will pass to your estate.
3.13 WHAT HAPPENS IF NO BENEFICIARY SURVIVES THE ANNUITANT?
If no Beneficiary for any amount payable is alive at the death of the Annuitant,
the right to this amount or this share will pass to you or, in the case of your
death, to your estate. Payment of the proceeds will be made in a single sum to
your estate. If any Beneficiary dies at the same time as you, or within 15 days
after your death, but before we receive proof of your death, we will pay any
amount payable as though the Beneficiary died first.
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SECTION FOUR - PREMIUM PAYMENTS
4.1 HOW ARE PREMIUM PAYMENTS CREDITED?
If we have received all of the information we require to issue this policy, the
initial Premium Payment will be credited within two Business Days after receipt.
Additional Premium Payments will be credited to this policy as of the Purchase
Date.
4.2 ARE THERE ANY LIMITATIONS REGARDING THE AMOUNTS AND FREQUENCY OF PREMIUM
PAYMENTS?
At any time before the maximum age shown on the Policy Data Page, during the
lifetime of the Annuitant or Owner, if you are not the Annuitant, and before
settlement of this policy under the 'Income Payments Of Policy Proceeds'
section, payments may be made at any interval and by any method we make
available. The initial Premium Payment is the amount shown on the Policy Data
Page. The minimum payment you can make, as well as the frequency of the
premiums, are shown on the Policy Data Page. We reserve the right to limit the
dollar amount of any additional Premium Payment.
4.3 HOW ARE PREMIUM PAYMENTS ALLOCATED?
The initial Premium Payment may be applied to one or more of the Allocation
Alternatives and to the DCA Account shown on the Policy Data Page or to any
other Investment Division(s) which may be made available by us for this policy,
in accordance with established procedures. All additional Premium Payments will
be allocated as requested unless subsequently changed by you.
4.4 MAY THE ALLOCATION ALTERNATIVES FOR PREMIUM PAYMENTS BE CHANGED?
Yes. The allocation for Premium Payments may be changed among the Allocation
Alternatives after the Issue Date shown on the Policy Data Page in accordance
with established procedures. Premium Payments received after the date on which
we receive your notice will be applied on the basis of the new instructions. You
must indicate what percentage of each Premium Payment to allocate to the
Allocation Alternatives. The minimum amount of a Premium Payment that can be
allocated to an Allocation Alternative is shown on the Policy Data Page. We
reserve the right to limit the maximum amount of a Premium Payment that may be
allocated to any one Allocation Alternative.
4.5 MAY THE CORPORATION TERMINATE THIS POLICY?
It may happen that no Premium Payment has been received for two or more
consecutive years and both (a) the sum of all Premium Payments for this policy,
less any Partial Withdrawals and any Surrender Charges, and (b) the Accumulation
Value, are less than $2,000. If so, we have the right, subject to any applicable
state law or regulation, to terminate this policy by paying you the Accumulation
Value in a single sum. We will notify you of our intention to exercise this
right and allow you 90 days to make a Premium Payment.
SECTION FIVE - ACCUMULATION VALUE
5.1 WHAT IS THE PREMIUM CREDIT AND HOW IS IT CREDITED?
The Premium Credit is an additional crediting to this policy's Accumulation
Value. Premium Credits are not considered Premium Payments for purposes of any
discussion in this policy. The amount credited is a percentage (the "Premium
Credit Rate") of each Premium Payment received and is applied to this policy's
Accumulation Value concurrent with the Premium Payment received. The Premium
Credit Rate(s) will be set in advance at least once a year. The Premium Credit
Rate will never be less than the rate shown on the Policy Data Page. The Premium
Credit is allocated to the Allocation Alternative(s) and/or the DCA Account in
the same percentages as the Premium Payment. The Premium Credit Rate applicable
to the initial Premium Payment is shown on the Policy Data Page. Subsequent
Premium Payments will receive the Premium Credit Rate in effect at the time the
Premium Payment is received.
5.2 CAN THE PREMIUM CREDIT BE DEDUCTED FROM THE ACCUMULATION VALUE?
The Premium Credit may be deducted from your policy if you elect to return your
policy under the terms of the Right to Return Policy provision on the face page
of this policy. We will also deduct any Premium Credits credited within the
immediately preceding 12 months of death. The amount deducted will be an amount
equal to the Premium Credit(s) credited to your policy without regard to the
Premium Credit's current value.
5.3 HOW IS THE ACCUMULATION VALUE CALCULATED?
On any day on or before the Annuity Commencement Date, the Accumulation Value of
this policy is equal to:
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a) the Fixed Accumulation Value, which is: the sum of Premium Payments and
transfers allocated to the Fixed Account, plus any Premium Credits and interest
credited on those Premium Payments, Premium Credits, and transfers, less
transfers and any Partial Withdrawals from the Fixed Account, and less any
Surrender Charges and Service Charges that may have already been assessed from
the Fixed Account, plus
b) the Variable Accumulation Value, which is: the sum of the products of the
current Accumulation Unit's value(s) for each of the Investment Divisions of the
Separate Account multiplied by the number of Accumulation Units held in the
respective Investment Divisions, plus
c) the DCA Program Accumulation Value, which is, the sum of Premium Payments
allocated to the DCA Program, plus any Premium Credits and interest credited on
those Premium Payments, less transfers and any Partial Withdrawals from the DCA
Program, and less any Surrender Charges and Service Charges that may have
already been assessed from the DCA Program.
The Fixed Accumulation Value, the DCA Program Accumulation Value and death
benefits that are available are not less than the minimum benefits required by
law.
The instances in which Surrender Charges will be assessed, and the amount of
those charges is explained in Section Six herein. When you ask us, we will tell
you how much Accumulation Value there is.
SECTION SIX - CHARGES AND DISTRIBUTIONS
6.1 WHEN CAN YOU SURRENDER THIS POLICY?
At any time, on or before the Annuity Commencement Date, after this policy has
an Accumulation Value, you may surrender it for the Accumulation Value, less any
Service Charges and/or Surrender Charges that may apply. Surrender Charges are
explained in Section 6.4, and Service Charges are explained in Section 6.6.
6.2 WHEN CAN YOU MAKE A PARTIAL WITHDRAWAL FROM THIS POLICY?
After this policy has an Accumulation Value, you may request a Partial
Withdrawal by sending us a written request at least 30 days before the Annuity
Commencement Date and while the Annuitant and Owner, if you are not the
Annuitant, are alive. The Partial Withdrawal may be for a selected amount or a
percentage of the Accumulation Value. The minimum amount you may withdraw is
shown on the Policy Data Page. You must indicate how it is to be withdrawn from
the Allocation Alternatives and/or from the DCA Account. However, if you do not
specify which Allocation Alternatives and/or DCA Account, NYLIAC will withdraw
the money on a pro-rata basis from each Allocation Alternative and/or from the
DCA Account. A Surrender Charge, which applies separately to each Premium
Payment as explained in Section 6.4, will be assessed as shown on the Policy
Data Page, except as provided in Section 6.5. If your request for a Partial
Withdrawal is greater than the amount in the Allocation Alternative(s) and/or
from the DCA Account, we will pay you the entire value of that Allocation
Alternative(s) and/or that DCA Account, less any Surrender Charges that may
apply. The minimum amount that must remain in the policy after a Partial
Withdrawal is shown on the Policy Data Page.
6.3 WHEN WILL A PARTIAL WITHDRAWAL OR SURRENDER BE PROCESSED?
We will pay any Partial Withdrawal or surrender proceeds within seven (7) days
after we receive all the necessary requirements. The Partial Withdrawal or
surrender value to be paid will be determined on the date we receive all
requirements. However, it may happen that the New York Stock Exchange is closed
for trading (other than the usual Business Day) or the Securities and Exchange
Commission restricts trading or determines that an emergency exists. If so, it
may not be practical for us to determine the investment experience of the
Separate Account. In that case, we may defer payment of Partial Withdrawals or
surrender proceeds. When permitted by law, we may defer payment of any Partial
Withdrawal or full surrender request from the Fixed Account and/or from the DCA
Program for up to six (6) months from the Partial Withdrawal or surrender
request date. Interest will be paid on any amount deferred for 30 days or more.
This rate will be at least three and one half percent (3.5%).
It may also happen that a request for a Partial Withdrawal would cause the total
Accumulation Value of this policy to fall below $2,000. If so, we may not
process the Partial Withdrawal request.
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6.4 HOW MUCH IS THE SURRENDER CHARGE?
A Surrender Charge applies separately to each Premium Payment. The amount of
this charge if any, will be a percentage, as shown on the Policy Data Page,
applied to the Accumulation Value of the amount withdrawn or surrender proceeds,
which, when added to the amount of all prior Surrender Charge free Partial
Withdrawals occurring during the current Policy Year, exceed the greater of:
a) ten percent (10%) of the current Accumulation Value of this policy less any
prior Surrender Charge free Partial Withdrawals made during the current Policy
Year, or
b) that portion of the Accumulation Value that exceeds the total Premium
Payments made to this policy.
In no event will the aggregate Surrender Charge applied under the policy exceed
eight and one half percent (8.5%) of the total Premium Payments.
For the initial Premium Payment, the Surrender Charge will be calculated from
the Policy Date. For each subsequent Premium Payment, the Surrender Charge will
be calculated from the Purchase Date of each Premium Payment. Therefore, for
purposes of calculating the Surrender Charge for additional Premium Payments,
the second Purchase Year begins on the first anniversary of that additional
Premium Payment, the third Purchase Year begins on the second anniversary of
that additional Premium Payment, and so on. Upon a Partial Withdrawal or
surrender, the Premium Payments producing the lowest Surrender Charge will be
surrendered first. If more than one Premium Payment produces the same Surrender
Charge, the oldest of those Premium Payments will be surrendered first. Once
Surrender Charges have been assessed on an amount equal to the total Premium
Payments made, no further Surrender Charges will apply.
6.5 ARE SURRENDER CHARGES EVER WAIVED?
Yes. Surrender Charges may be waived:
a) when proceeds are paid on the death of the Owner or the Annuitant; or
b) for any Qualified Plan Required Minimum Distribution (RMD) from the
Accumulation Value of this policy withdrawn under the RMD Automated Option,
unless the aggregated amount of Partial Withdrawals made from this policy during
the Policy Year exceeds the RMD amount as calculated by us; or
c) when the Life Income Payment option is elected after the first year; or
d) under conditions specified in any riders or endorsements attached to and made
a part of this policy; or
e) if we terminate this policy as explained in Section 4.5.
6.6 ARE SERVICE CHARGES DEDUCTED FROM YOUR POLICY?
An annual Service Charge may be applicable as shown on the Policy Data Page.
That charge, if any, will be deducted on each Policy Anniversary or the date of
surrender.
6.7 WHEN ARE STATE PREMIUM TAXES DEDUCTED FROM YOUR POLICY?
When any amount is placed under an Income Payment option on the Annuity
Commencement Date, we may deduct from that amount any state premium tax that we
are, or were, required to pay. We may also deduct any state premium tax that we
are, or were, required to pay when this policy is surrendered for its
Accumulation Value.
SECTION SEVEN - SEPARATE ACCOUNT
7.1 HOW IS THE SEPARATE ACCOUNT ESTABLISHED AND MAINTAINED?
We have established and maintained the Separate Account under the laws of the
State of Delaware. Any realized or unrealized income, net gains, and losses from
the assets of the Separate Account are credited or charged to it without regard
to our other income.
7.2 How Are The Separate Account Assets Invested?
The Separate Account invests its assets in shares of the Eligible Portfolios of
the Fund. Fund shares are purchased, redeemed, and valued on behalf of the
Separate Account. The Separate Account is divided into Investment Divisions. We
reserve the right to add or remove any Investment Division of the Separate
Account.
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7.3 TO WHOM DO THE ASSETS IN THE SEPARATE ACCOUNT BELONG?
The assets in the Separate Account are our property. The Separate Account assets
equal the reserves and other policy liabilities of the Separate Account. Those
assets will not be chargeable with liabilities arising out of any other business
we conduct. We reserve the right to transfer assets of an Investment Division,
in excess of the reserves and other policy liabilities with respect to that
Investment Division, to another Investment Division or to our General Account.
7.4 HOW WILL THE ASSETS OF THE SEPARATE ACCOUNT BE VALUED?
We will determine the value of the assets for the Separate Account on each
Business Day. The assets of the Separate Account will be valued at fair market
value, as determined in accordance with a method of valuation that we establish
in good faith. However, it may happen that the New York Stock Exchange is closed
for trading (other than the usual Business Day), or the Securities and Exchange
Commission restricts trading or determines that an emergency exists. If so, it
may not be practical for us to determine the investment experience of the
Separate Account. In that case, we may defer transfers among the Investment
Divisions and to the Fixed Account.
7.5 CAN WE TRANSFER ASSETS OF THE SEPARATE ACCOUNT TO ANOTHER SEPARATE ACCOUNT?
Yes. We reserve the right to transfer assets of the Separate Account, which we
determine to be associated with the class of policies to which this policy
belongs, to another Separate Account. If this type of transfer is made, the term
"Separate Account" as used in this policy, will then mean the Separate Account
to which the assets were transferred.
7.6 WHAT OTHER RIGHTS DO WE HAVE?
We also reserve the right, when permitted by law, to:
a) de-register the Separate Account under the Investment Company Act of 1940,
b) manage the Separate Account under the direction of a committee at any time,
c) restrict or eliminate any of the voting rights of Owners or other persons who
have voting rights as to the Separate Account, and
d) combine the Separate Account with one or more other Separate Accounts.
7.7 CAN A CHANGE IN THE OBJECTIVE OF THE FUND BE MADE?
Yes. When required by law or regulation, an objective of the Fund can be
changed. The objective of the Fund will not be changed unless approved by the
appropriate insurance official of the State of Delaware or deemed approved in
accordance with such law or regulation. If so required, the request to obtain
such approval will be filed with the insurance official of the state or the
district in which this policy is delivered.
7.8 IF THE ASSETS IN THE SEPARATE ACCOUNT BELONG TO US, WHAT DO YOUR PREMIUM
PAYMENTS PURCHASE?
The Variable Accumulation Value in the Investment Divisions of the Separate
Account prior to the Annuity Commencement Date is represented by Accumulation
Units. Premium Payments allocated or transferred to the Investment Divisions
will be applied to provide Accumulation Units in those Investment Divisions.
7.9 HOW IS THE NUMBER OF ACCUMULATION UNITS DETERMINED?
That portion of each Premium Payment or Premium Credit allocated or transferred
to a designated Investment Division of the Separate Account is credited to this
policy in the form of Accumulation Units. The number of Accumulation Units
credited to this policy is determined by dividing the amount allocated or
transferred to each Investment Division by the Accumulation Unit value for that
Investment Division for the Valuation Period during which the Premium Payment,
Premium Credit, or transfer request and all required documentation is received.
That portion of each Partial Withdrawal, Surrender Charge, Policy Service Charge
or transfer from a designated Investment Division of the Separate Account is
deducted from this policy in the form of Accumulation Units. The number of
Accumulation Units deducted from this policy is determined by dividing the
amount withdrawn or transferred from each Investment Division by the
Accumulation Units' value for that Investment Division for the Valuation Period.
The value of an Accumulation Unit will vary in accordance with the investment
experience of the Eligible Portfolios in which the Investment Divisions invest.
The number of Accumulation Units in a policy will not, however, change as a
result of any fluctuations in the value of an Accumulation Unit.
7.10 HOW IS THE VALUE OF AN ACCUMULATION UNIT
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DETERMINED?
The value of an Accumulation Unit on any Business Day is determined by
multiplying the value of that unit on the immediately preceding Business Day by
the net investment factor for the Valuation Period. The net investment factor
for this policy used to calculate the value of an Accumulation Unit in any
Investment Division of the Separate Account for the Valuation Period is
determined by dividing (a) by (b) and subtracting (c) from the result, where:
a) is the sum of:
1) the net asset value of a Fund share held in the Separate Account for
that Investment Division determined at the end of the current Valuation
Period, plus
2) the per share amount of any dividend or capital gain distributions made
by the Fund for shares held in the Separate Account for that Investment
Division if the ex-dividend date occurs during the Valuation Period.
b) is the net asset value of a Fund share held in the Separate Account for that
Investment Division determined as of the end of the immediately preceding
Valuation Period.
c) is a factor representing the mortality and expense risk fee, and
administrative charges. This factor is equal, on an annual basis, to one point
six percent (1.6%) of the daily net asset value of a Fund share held in the
Separate Account for that Investment Division.
Mortality and expense results will not adversely affect the dollar amount of the
Variable Accumulation Value.
The net investment factor may be greater or less than one. Therefore, the
Accumulation Unit value may increase or decrease.
The net asset value of a Fund share held in the Separate Account reflects a fee
paid to an investment advisor for investment advisory services provided.
7.11 CAN YOU TRANSFER FROM THE INVESTMENT DIVISIONS TO THE DCA PROGRAM?
No. Transfers may not be made into the DCA Program. For transfers made from the
DCA Program to the Investment Divisions, see Section Nine.
7.12 CAN YOU TRANSFER BETWEEN INVESTMENT DIVISIONS AND TO THE FIXED ACCOUNT?
Yes. Transfers of the Accumulation Value may be made between Investment
Divisions of the Separate Account and to the Fixed Account. For transfers made
from the Fixed Account to the Investment Divisions, see Section Eight.
7.13 HOW DO YOU TRANSFER THE ACCUMULATION VALUE BETWEEN INVESTMENT DIVISIONS AND
TO THE FIXED ACCOUNT?
Prior to 30 days before the Annuity Commencement Date, amounts may be
transferred between Investment Divisions of the Separate Account and to the
Fixed Account, in accordance with established procedures.
In addition to a request for a one-time transfer, transfers may be made on an
automatic basis based on established procedures.
Dollar Cost Averaging Option
You may specify a specific dollar amount to be transferred from any Investment
Division to any combination of Investment Divisions and/or to the Fixed Account.
We will automatically transfer the specific dollar amount into the Investment
Divisions and/or to the Fixed Account in accordance with established procedures.
This option is called Dollar Cost Averaging.
In order to elect this option the Variable Accumulation Value must equal the
minimum value shown on the Policy Data Page. The minimum amount that must be
transferred to or from an Investment Division, or to the Fixed Account is shown
on the Policy Data Page.
Transfers under the Dollar Cost Averaging option are not available from the
Fixed Account.
Automatic Asset Reallocation Option
You may specify a specific percentage of the Variable Accumulation Value
allocated to each Investment Division at a pre-set level. If you elect this
reallocation option, we will automatically transfer your Variable Accumulation
Value back to the percentages you specify in accordance with established
procedures. This option is called Automatic Asset Reallocation.
In order to elect this option, the Variable Accumulation Value must equal the
minimum value shown on the Policy Data Page. The minimum amount that must be
allocated among the Investment Divisions under this option is shown on the
Policy Data Page.
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You may not elect the Dollar Cost Averaging and Automatic Asset Reallocation
options at the same time.
7.14 ARE THERE LIMITS ON WHAT YOU MAY TRANSFER BETWEEN INVESTMENT DIVISIONS AND
TO THE FIXED ACCOUNT?
Except in connection with transfers made under the Dollar Cost Averaging or
Automatic Asset Reallocation options, the minimum amount that can be transferred
is the lesser of the amount shown on the Policy Data Page or the value of all
remaining Accumulation Units in the Investment Division. The Investment Division
from which the transfer is being made must maintain the minimum balance as shown
on the Policy Data Page after the transfer is completed. If, after a transfer,
the value of the remaining Accumulation Units in an Investment Division would be
less than the minimum, we have the right to include that amount as part of the
transfer.
There is no limit to the number of transfers that can be made. However, we
reserve the right to apply a charge, as shown on the Policy Data Page.
Transfers may not be made into the Fixed Account if there were transfers out of
the Fixed Account within the six month period prior to the transfer request,
unless the transfer is part of the Interest Sweep option, as explained in
Section 8.5. We reserve the right to limit the amount, which may be transferred
from the Investment Divisions to the Fixed Account.
SECTION EIGHT - FIXED ACCOUNT
8.1 HOW ARE THE FIXED ACCOUNT ASSETS INVESTED?
Premium Payments allocated to, or amounts transferred to, the Fixed Account are
held in NYLIAC's General Account. NYLIAC invests the assets of the General
Account in accordance with applicable law governing the investments of insurance
company General Accounts. NYLIAC's General Account assets are all of its assets
other than those allocated to the Separate Account. NYLIAC's General Account
assets support all of its liabilities except Separate Account liabilities.
8.2 HOW IS THE FIXED ACCOUNT VALUED?
Premium Payments allocated to, or amounts transferred to the Fixed Account are
credited with interest at an interest rate we set from time to time. This rate
will never be less than the minimum guaranteed fixed rate shown on the Policy
Data Page.
We will set an interest rate in advance at least once a year. All Premium
Payments allocated to, or amounts transferred to, the Fixed Account will receive
the rate declared for that period for one (1) year. Thereafter, the rate
applicable to those amounts will change on the anniversary of each Premium
Payment or any part of a Premium Payment allocated to the Fixed Account, or for
any amount transferred to the Fixed Account. The new rate will be the rate we
declare, and is in effect on the anniversary of the Premium Payment or any part
of that Premium Payment allocated to the Fixed Account or any amount transferred
to the Fixed Account.
The amount in the Fixed Account is equal to the sum of Premium Payments and
transfers allocated to the Fixed Account, plus any Premium Credits and interest
credited on those Premium Payments and transfers,
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less transfers and any Partial Withdrawals from the Fixed Account, and less any
Surrender Charges and Service Charges that may have already been assessed from
the Fixed Account.
8.3 CAN TRANSFERS BE MADE FROM THE FIXED ACCOUNT TO THE DCA PROGRAM?
No. Transfers may not be made from the Fixed Account to the DCA Account under
the DCA Program.
8.4 CAN TRANSFERS BE MADE FROM THE FIXED ACCOUNT TO THE INVESTMENT DIVISIONS?
Yes. Each Policy Year you may transfer from the Fixed Account to the Investment
Divisions with certain limitations, see Section 8.5.
8.5 HOW DO YOU TRANSFER THE FIXED ACCUMULATION VALUE TO THE INVESTMENT
DIVISIONS?
Prior to 30 days before the Annuity Commencement Date, amounts may be
transferred from the Fixed Account to the Investment Divisions. Transfer
requests must be in writing on a form approved by us or by telephone in
accordance with established procedures. Each transfer must be for an amount not
less than that shown on the Policy Data Page. The sum of all transfers from the
Fixed Account in a Policy Year may not be greater than the maximum percentage as
shown on the Policy Data Page, unless we agree otherwise. A minimum amount, as
shown on the Policy Data Page, must remain in the Fixed Account after a
transfer. If after a transfer, the Fixed Accumulation Value would fall below the
minimum, the remaining amount will be allocated to the Investment Division(s) in
the same proportion as the transfer request.
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In addition, transfers may be made on an automatic basis from the Fixed Account
based on established procedures.
Interest Sweep Option
For the interest earned on monies allocated or transferred to the Fixed Account,
you may request transfers from the Fixed Account to any combination of
Investment Divisions. This option is called Interest Sweep. The minimum Fixed
Accumulation Value required to elect this option is shown on the Policy Data
Page. If the Interest Sweep option would cause an amount greater than the
maximum amount shown on the Policy Data Page to be transferred from the Fixed
Account, the transfer may not be processed and the Interest Sweep option may be
canceled. The Interest Sweep option may be requested in addition to the Dollar
Cost Averaging option, the Automatic Asset Reallocation option, or the DCA
Program.
8.6 HOW WILL PARTIAL WITHDRAWALS AND TRANSFERS BE DEDUCTED FROM THE FIXED
ACCOUNT?
Partial Withdrawals and transfers will be made from the Fixed Account in the
following sequence: first from the Fixed Accumulation Value attributed to the
initial Premium Payment, then from the Fixed Accumulation Value attributed to
subsequent allocations and transfers in the order received.
SECTION NINE - DCA PROGRAM
9.1 HOW ARE THE DCA PROGRAM ASSETS INVESTED?
Premium Payments allocated to the DCA Program are held in NYLIAC's General
Account. NYLIAC invests the assets of the General Account in accordance with
applicable law governing the investments of insurance company General Accounts.
NYLIAC's General Account assets are all of its assets other than those allocated
to the Separate Account. NYLIAC's General Account assets support all of its
liabilities except Separate Account liabilities.
9.2 HOW IS THE DCA PROGRAM VALUED?
Under the DCA Program, we will specify a DCA Account having a specific
expiration date. We will set interest rates in advance at least annually for
each date on which Premium Payments may be received for allocation to a DCA
Account. The rate will never be less than the Minimum Guaranteed DCA Interest
Rate shown on the Policy Data Page. The DCA Account available on the Issue Date
is shown on the Policy Data Page.
The amount held with respect to the DCA Account is equal to the initial and any
subsequent Premium Payments allocated into the DCA Account, plus any Premium
Credits and interest credited at the rate specified for each Premium Payment,
less transfers and any Partial Withdrawals from the DCA Account, and less any
Surrender Charges and Service Charges that may have already been assessed from
the DCA Account.
The minimum Premium Payment that may be allocated to the DCA Account is
specified on the Policy Data Page. Premium Payments and Premium Credits
allocated to the DCA Account will receive the applicable interest rate as of the
Business Day received by us. Interest rates for subsequent Premium Payments and
Premium Credits allocated to the DCA Account may be different from the rate
applied to the initial Premium Payment and Premium Credit.
9.3 CAN TRANSFERS BE MADE FROM THE DCA ACCOUNT TO THE FIXED ACCOUNT?
Yes. Transfers may be made to the Fixed Account.
9.4 HOW DO YOU TRANSFER THE DCA ACCOUNT VALUE TO THE INVESTMENT DIVISIONS?
At the time you elect the DCA Account, you must tell us into which Investment
Division(s) and/or Fixed Account you want the DCA Account value allocated. We
will automatically transfer amounts from your DCA Account into the Investment
Division(s) and/or Fixed Account in proportional periodic amounts in accordance
with your instructions and in accordance with established procedures.
In no event may the expiration date of the DCA Account you elect extend beyond
your Annuity Commencement Date.
The DCA Program may be requested in addition to the Dollar Cost Averaging
option, the Automatic Asset
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Reallocation option, or the Interest Sweep option.
9.5 HOW WILL PARTIAL WITHDRAWALS AND TRANSFERS BE DEDUCTED FROM THE DCA PROGRAM?
Partial Withdrawals and transfers will be made from the DCA Program in the
following sequence: first from the DCA Program Accumulation Value attributed to
the initial Premium Payment, then from the DCA Program Accumulation Value
attributed to subsequent allocations in the order received.
SECTION TEN - GENERAL PROVISIONS
10.1 WHAT CONSTITUTES THE ENTIRE CONTRACT?
This entire contract consists of this policy, any attached riders, endorsements,
and a copy of the application, if attached. Only our Chairman, President,
Secretary, or one of our Executive Officers may change the policy and then only
in writing. No change will be made in the contract unless you agree to it in
writing, or by telephone, in accordance with established procedures. No
Registered Representative is authorized to change this contract or waive any
provisions of this contract.
10.2 HOW IMPORTANT IS THE INFORMATION YOU PROVIDE FOR THIS POLICY?
In issuing this policy, we have relied on the information you provided. If you
signed an application for this policy, we have relied on the statements made on
the application in issuing this policy. All such statements are deemed to be
representations and not warranties. We assume these statements are true and
complete to the best of the knowledge and belief of those who made them. No
statement made in connection with the application will be used by us to void
this policy unless that statement is a material misrepresentation and is part of
this policy.
10.3 WILL WE BE ABLE TO CONTEST THIS POLICY?
We will not contest this policy after it has been in force during the lifetime
of the Annuitant for two years from the Issue Date.
10.4 HOW ARE THE DATES REFERRED TO IN THIS POLICY MEASURED?
Policy Years, months, and anniversaries are measured from the Policy Date,
except where otherwise specified.
10.5 HOW IS A PERSON'S AGE CALCULATED FOR THE PURPOSE OF THIS POLICY?
In this policy when we refer to a person's Age on any date, we mean his or her
Age attained at his or her last birthday.
10.6 WHAT HAPPENS IF IN THIS POLICY WE REFER TO A PERSON'S AGE OR SEX
INCORRECTLY?
If a date on the Policy Data Page is based on an Age that is not correct, we may
change the date to reflect the correct Age. If the Age or sex of the Annuitant
shown on the Policy Data Page is not correct as stated, any amount payable under
this policy will be what would have been purchased at the correct Age and sex.
If payments were made based on an incorrect Age or sex, we will increase or
reduce a later payment or payments to adjust for the error. Any adjustment will
include interest, at three and one-half percent (3.5%) per year, from the date
of the wrong payment to the date the adjustment is made.
10.7 MAY YOU ASSIGN OR TRANSFER YOUR POLICY?
While the Annuitant is alive, you may assign this policy or any interest in it.
If you do this, your interest, and anyone else's, is subject to that of the
assignee. As Owner, you still have the rights of Ownership that have not been
assigned.
10.8 HOW DO YOU ASSIGN THIS POLICY?
You must provide us with a copy of the assignment. We are not responsible for
the validity of any assignment. Any assignment will be subject to any payment
previously made by us or any other action we may take before we record the
assignment.
10.9 MAY THE ASSIGNEE CHANGE THE OWNER, ANNUITANT, OR BENEFICIARY?
No. The assignee cannot change the Owner, Annuitant, or Beneficiary. The
assignee also may not elect an alternative payment option. Any amount payable to
the assignee will be made in a single sum.
10.10 ARE THE PAYMENTS MADE UNDER THE TERMS OF THIS POLICY PROTECTED AGAINST
CREDITORS?
Payments we make under this policy are to the extent the law permits, exempt
from the claims, attachments, or levies of any creditors.
10.11 HOW SHOULD PAYMENTS FOR THIS POLICY BE
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MADE?
Any payments made to us by check or money order must be payable to New York Life
Insurance and Annuity Corporation or NYLIAC. When asked, we will give a
countersigned receipt, also signed by our President or Secretary, for any
Premium Payment made to us.
10.12 HOW IS GUARANTEED INTEREST CALCULATED FOR THIS POLICY?
All guaranteed Accumulation Values referred to in this policy are based on
interest compounded annually at the guaranteed rate shown on the Policy Data
Page. Each value is at least as much as the value the law requires.
10.13 IS THIS POLICY SUBJECT TO ANY LAW?
Yes. This policy is subject to all laws that apply.
10.14 ARE THERE ANY DIVIDENDS PAYABLE UNDER THIS POLICY?
No. This is a non-participating policy. Therefore, no dividends are payable.
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NEW YORK LIFE INSURANCE
AND ANNUITY CORPORATION
Executive Office - 51 Madison Avenue
New York, NY 10010
A Stock Company Incorporated in Delaware.
FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY
Monthly Income Payments Begin On The Annuity Commencement Date. Premiums May Be
Paid During The Annuitant's Lifetime, As Defined Herein. The Amount Of Any
Accumulation Value May Increase Or Decrease Based On The Investment Experience
Of The Separate Account. Accumulation Values Based On The Performance Of The
Separate Account Are Variable And Are Not Guaranteed As To Dollar Amount.
A Stock Company Incorporated in Delaware. This Policy Is Non-Participating.
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