Registration Statement for a Separate Account (Unit Investment Trust) — Form N-4
Filing Table of Contents
Document/Exhibit Description Pages Size
1: N-4 Metropolitan Life Separate Account E - Gold Track 66 397K
Select
20: COVER ¶ Comment-Response or Cover Letter to the SEC 2± 3K
19: EX-99.13 Powers of Attorney 24 110K
2: EX-99.4(A) Form of Gold Track Select Contract and Contract 20 89K
Schedule
3: EX-99.4(A)(I) Form of Gold Track Select Certificate and 20 86K
Certificate Schedule
4: EX-99.4(A)(II) Fixed Account Rider 4 23K
5: EX-99.4(B) Form of Gold Track Select Contract and Contract 20 91K
Schedule
6: EX-99.4(B)(I) Form of Gold Track Select Certificate and 21 88K
Certificate Schedule
7: EX-99.4(B)(II) Fixed Account Rider 4 23K
8: EX-99.4(B)(III) Fixed Account Rider 3 18K
9: EX-99.4(C) Form of Gold Track Select Contract and Contract 19 79K
Schedule
10: EX-99.4(C)(I) Fixed Account Rider 3 21K
11: EX-99.4(D) 401(A)/403(A) Plan Endorsement 2 13K
12: EX-99.4(E) 457(B) Plan Endorsement 2 16K
13: EX-99.4(F) Roth 401 Endorsement 1 9K
14: EX-99.4(G) Tax-Sheltered Annuity Endorsement 24± 90K
15: EX-99.4(H) Roth 403(B) Endorsement 2 12K
16: EX-99.4(I) Automatic Rollover Endorsement 1 9K
17: EX-99.4(J) Cash Loan Rider 3 18K
18: EX-99.4(K) Death Benefit Endorsement 2± 10K
‘EX-99.4(A)(I)’ — Form of Gold Track Select Certificate and Certificate Schedule
Exhibit Table of Contents
METROPOLITAN LIFE INSURANCE COMPANY . [200 PARK AVENUE . NEW YORK, NY . 02116]
A STOCK COMPANY
WE ARE PLEASED TO PROVIDE YOU THE PLEASE READ ALL ATTACHED FORMS
BENEFITS OF THIS ANNUITY CERTIFICATE. CAREFULLY.
THE CERTIFICATE IS SUBJECT TO THE TERMS AND CONDITIONS STATED IN THE ATTACHED.
WE WILL PAY THE BENEFITS AS DESCRIBED IN THE CERTIFICATE. THE CERTIFICATE IS
ISSUED IN CONSIDERATION OF THE PURCHASE PAYMENTS.
RIGHT TO EXAMINE THIS CERTIFICATE
IN ORDER TO CANCEL THIS CERTIFICATE, YOU MUST PROVIDE A WRITTEN
REQUEST AND THIS CERTIFICATE TO US OR TO OUR AGENT WITHIN 10 CALENDAR
DAYS AFTER ITS DELIVERY TO YOU, UNLESS IT IS A REPLACEMENT
CERTIFICATE, IN WHICH CASE YOU HAVE 60 DAYS.
IF ANY PORTION OF YOUR PURCHASE PAYMENT IS ALLOCATED TO THE FUNDING
OPTIONS, WE WILL PAY YOU THE CASH VALUE OF THE AMOUNT ALLOCATED TO
THE FUNDING OPTIONS PLUS ANY PREMIUM TAX AND CERTIFICATE CHARGES PAID.
IF ANY PORTION OF YOUR PURCHASE PAYMENT IS ALLOCATED TO THE FIXED
ACCOUNT, IF APPLICABLE. WE WILL PAY YOU THE FULL AMOUNT OF YOUR
PURCHASE PAYMENT ALLOCATED TO THE FIXED ACCOUNT.
WE WILL CALCULATE THE AMOUNT DUE YOU AS OF THE NEXT VALUATION DATE
AFTER WE RECEIVE THE WRITTEN REQUEST AT OUR OFFICE OR YOU DELIVER THE
CERTIFICATE TO US OR TO THE AGENT WHO SOLD IT TO YOU. AFTER THE
CERTIFICATE IS RETURNED, IT WILL BE CONSIDERED AS NEVER IN EFFECT.
Based on the maximum charges of the Separate Account assets, the smallest
yearly gross investment rate which would have to be earned on the assets of an
Underlying Fund so that the dollar amount of variable annuity payments will not
decrease is [4.30%]. The Smallest Yearly Gross Investment Rate is equal to the
Assumed Net Investment Rate of 3.00% plus the annual mortality and expense risk
deduction for all funds.
EXECUTED AT NEW YORK, NEW YORK
[GRAPHIC]
[Steven A. Kandarian
President]
THIS IS A LEGAL CERTIFICATE BETWEEN PLEASE READ YOUR CERTIFICATE
YOU AND US. CAREFULLY.
CERTIFICATE OF PARTICIPATION UNDER A FLEXIBLE PREMIUM DEFERRED GROUP VARIABLE
ANNUITY CONTRACT
TAX QUALIFIED
ELECTIVE OPTIONS NON-PARTICIPATING
ANNUITY PAYMENTS, DEATH BENEFITS, WITHDRAWAL VALUES AND OTHER CASH VALUES
PROVIDED BY THIS CERTIFICATE, WHEN BASED ON INVESTMENT EXPERIENCE OF THE
UNDERLYING FUNDS, ARE VARIABLE AND MAY INCREASE OR DECREASE IN ACCORDANCE WITH
FLUCTUATIONS IN THE NET INVESTMENT FACTOR, AS APPLICABLE, AND ARE NOT
GUARANTEED AS TO FIXED DOLLAR AMOUNT.
WE RESERVE THE RIGHT TO RESTRICT THE AVAILABILITY OF THE FIXED ACCOUNT AFTER
ISSUE.
M-14672 (4223)
TABLE OF CONTENTS
[Enlarge/Download Table]
Certificate Specifications...................................................... [Page 3
Definitions..................................................................... Page 7
Purchase Payments............................................................... Page 8
General Certificate Provisions.................................................. Page 9
Valuation Information........................................................... Page 10
Transfers Between Underlying Funds.............................................. Page 11
Transfers from Underlying Funds to Contracts or Certificates not Issued by Us... Page 12
Transfers from Other Contracts or Certificates Issued by Us..................... Page 12
Transfers to Other Contracts or Certificates Issued by Us....................... Page 12
Distributions from the Certificate.............................................. Page 12
Certificate Charges............................................................. Page 12
Death Benefit Provisions........................................................ Page 12
Account Termination Provisions.................................................. Page 13
Contract Discontinuance Provisions.............................................. Page 13
Settlement Provisions........................................................... Page 13
Variable Annuity............................................................. Page 14
Fixed Annuity................................................................ Page 15
Annuity Options.............................................................. Page 15
Annuity Tables.................................................................. Page 17]
Any Riders or Endorsements follow the Life Annuity Tables.
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DEFINITIONS
(A) ACCUMULATION UNIT - An accounting unit of measure used to calculate the
value of this Certificate. An Accumulation Unit exists for each Underlying
Fund. The value of this measure is called the Accumulation Unit Value.
(B) ANNUITANT - The person on whose life the Annuity payments are made.
(C) ANNUITY - Payment of income for a stated period or amount.
(D) ANNUITY COMMENCEMENT DATE - The date on which Annuity payments begin.
(E) BENEFICIARY(IES) - The person(s) or entity You elect to receive Your vested
Cash Value at the time of Your Death.
(F) CASH SURRENDER VALUE - The Cash Value less any amounts deducted on
Surrender shown on the Certificate Specifications page and any applicable
Premium Tax.
(G) CASH VALUE - The value of the Accumulation Units in Your Individual Account
less any reduction for administrative charges. Sometimes referred to as
"Account Value."
(H) CERTIFICATE DATE - The date the Certificate is issued as shown on the
Certificate Specifications Page.
(I) CERTIFICATE OF PARTICIPATION - A certificate issued to You which explains
the benefits and provisions to which You are entitled under the contract.
(J) CERTIFICATE YEAR - The twelve-month period beginning with the Certificate
Date or any anniversary thereof.
(K) COMPETING FUND - Any funding option which, in Our opinion, consists
primarily of fixed income securities and/or money market instruments.
(L) CONTRACT DATE - The date the contract is issued as shown on the Certificate
Specifications page.
(M) CONTRACT DISCONTINUANCE - Termination of the contract by the Contract Owner.
(N) CONTRACT OWNER - The person or entity identified on the Certificate
Specifications page.
(O) DUE PROOF OF DEATH - (i) A copy of a certified death certificate; (ii) a
copy of a certified decree of a court of competent jurisdiction as to the
finding of death; (iii) a written statement by a medical doctor who attended
the deceased; or (iv) any other proof satisfactory to Us.
(P) EXCESS PLAN CONTRIBUTIONS - Plan contributions including excess deferrals,
excess contributions, excess aggregate contributions, excess annual additions,
and excess nondeductible contributions that require correction by a Plan
Administrator, if any, excluding reversions upon Plan Termination.
(Q) FIXED ANNUITY - An Annuity with payments which remain fixed as to dollar
amount throughout the payment period.
(R) INDIVIDUAL ACCOUNT - Accumulation Units credited to You or Your Beneficiary
under this certificate.
(S) OUR OFFICE - The home office of Metropolitan Life Insurance Company or any
other office which We may designate for the purpose of administering this
certificate. All correspondence concerning this certificate should be sent to
the mailing address stated on the cover page of this certificate.
(T) PARTICIPANT- An eligible person.
(U) PLAN - The Plan, if any, designated on the Certificate Specifications page.
We are not a party to the Plan. We do not assume the responsibilities of a Plan
Administrator, nor are We bound by the terms of the Plan. All records
pertaining to the Plan will be open for inspection by Us. We are not bound by
any material change in the Plan terms or administration after the Contract
Date, unless we agree otherwise.
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(V) PREMIUM TAX - The amount of tax, if any, charged by the state or
municipality. We maydeduct any applicable Premium Tax from the Cash Value
either upon Surrender, annuitization, death, or at the time Purchase Payments
are made, but no earlier than when We have a tax liability under state law.
(W)PURCHASE PAYMENTS - Payments made to this certificate.
(X) SEPARATE ACCOUNT - The Separate Account(s) indicated on the Certificate
Specifications which We established under Connecticut Insurance Laws and
complies with New York Insurance Laws, and which purchases shares of the
Underlying Funds for this class of contracts/certificates and certain other
contracts/certificates.
(Y) SEPARATION FROM SERVICE - The termination or permanent severance of Your
employment with the employer for any reason that is a separation from service
within the meaning of the Plan, if applicable. However, termination of Your
employment with the employer as a result of the sale of all or part of the
employer's business (including divisions or subsidiaries of the employer) will
not be considered Separation from Service unless You actually lose Your job or
are not immediately included in a pension or profit sharing plan of the
successor employer.
(Z) SURRENDER - Funds distributed from Your Individual Account for retirement,
Separation from Service, loans, hardship withdrawals, death, disability,
minimum distribution return of Excess Plan Contributions, payment of certain
Plan expenses as mutually agreed upon, Contract Discontinuance, or transfers to
other Plan funding vehicles. Such surrender may or may not be subject to
charges.
(AA) SURRENDER DATE - The date We receive a Written Request for a Surrender.
(BB) UNDERLYING FUND - An open-ended diversified investment management company
indicated on the application which is an underlying investment for the Separate
Account.
(CC) VALUATION DATE - The date on which the Separate Account is valued.
(DD) NEXT VALUATION DATE - If you submit a Written Request to Us for a
transaction that requires valuation of the funding options under this
Certificate, the Next Valuation Date(when those funds will be valued) will be:
1) The day the Written Request was received if prior to the close of
regular trading on the New York Stock Exchange (except for when
trading is restricted due to an emergency as defined by the Securities
and Exchange Commission); or
2) The next day regular trading on the New York Stock Exchange occurs.
(EE) VALUATION PERIOD - The period between successive valuations.
(FF) VARIABLE ANNUITY - An Annuity with payments which vary with the net
investment results of the Separate Account.
(GG) WE, OUR, US - Metropolitan Life Insurance Company.
(HH) WRITTEN REQUEST - A written form satisfactory to Us and received at Our
Office.
(II) YOU, YOUR - The certificate owner.
(JJ) YOUR ACCOUNT - Accumulation Units credited to You under this certificate.
PURCHASE PAYMENTS
PURCHASE PAYMENT
The Purchase Payments are the payments made by the Contract Owner and/or You to
this certificate. An initial lump sum Purchase Payment must be made before the
certificate becomes effective. Each Purchase Payment is payable to Us at Our
Office. The minimum Purchase Payment is shown on the Certificate Specifications
page. We reserve the right to limit the amount of the Purchase Payment which
will be accepted subject to the Maximum Aggregate Purchase Payment Amount shown
on the Certificate Specifications.
Net Purchase Payments are that part of the Purchase Payments applied to the
certificate. The net Purchase Payment is equal to the Purchase Payment less any
applicable Premium Tax.
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ALLOCATION OF PURCHASE PAYMENTS
The initial net Purchase Payment will be applied within two business days
following its receipt in good order at Our Office. Any subsequent net Purchase
Payments will be credited to Your Individual Account using the Accumulation
Unit Value determined after We receive those payments at Our Office. Each net
Purchase Payment will be allocated to the Underlying Funds in the proportion
specified by You. By Written Request You may change Your choice of Underlying
Funds or allocation percentages. The available Underlying Funds to which assets
may be allocated may be subsequently added or deleted.
The net Purchase Payments will be allocated to an account established for You
by Us. We will deposit each net Purchase Payment to Your Individual Account as
directed by the Contract Owner or You, if so authorized. We will satisfy
distribution requests from Your Individual Account and provide periodic reports
as described in the "Required Reports" provision.
GENERAL CERTIFICATE PROVISIONS
OWNER
The Contract belongs to the Contract Owner identified on the Certificate
Specifications Page. This Certificate belongs to You. As Certificate owner, You
have sole power during the Annuitant's lifetime to exercise any rights and to
receive all benefits given in this Certificate, provided You have not named an
irrevocable beneficiary You will be the recipient of all payments while the
Annuitant is alive unless You direct them to an alternate recipient by Written
Request. An alternate recipient does not become the owner. An alternate payment
directive is revocable by You at any time by giving Us 30 days advance notice
by Written Request.
In order to maintain tax qualification, the contract and certificates may not
be sold, assigned, transferred, discounted or pledged as collateral for a loan
or as security for the performance of an obligation or for any other purpose
except as may be required or permitted under applicable sections of the
Internal Revenue Code.
CREDITOR CLAIMS
No right or benefit to You, the Contract Owner or Beneficiary under this
certificate shall be subject to the claims of creditors or any legal process
other than to the extent permitted by law.
CONTROL OF THE CERTIFICATE
You may elect to exercise any options allowed by the certificate with respect
to Your Account. Elections made under the certificate must be made by a Written
Request, unless another manner is mutually agreed upon.
MINIMUM BENEFITS
Any paid-up annuity, cash surrender or death benefits that may be available
under this certificate are not less than the minimum benefits required by any
statute of the state in which this certificate is delivered.
THE CERTIFICATE
The entire certificate between You and Us consists of the certificate and all
attached pages.
CERTIFICATE OF PARTICIPATION
A certificate issued to You which explains who may exercise the rights,
privileges and receive the benefits from the certificate. Nothing in the
contract invalidates or impairs any right granted to the Participant under law
or this certificate.
CERTIFICATE CHANGES
The only way this certificate may be changed is by a written endorsement signed
by one of Our officers.
SUBSTITUTION OF UNDERLYING FUNDS
If it is not possible to continue to offer an Underlying Fund, or in Our
judgment becomes inappropriate for the purposes of this certificate, We may
substitute another Underlying Fund without Your consent. Substitutions may be
made with respect to both existing investments and investment of future
Purchase Payments subject to applicable law.
INCONTESTABILITY
We will not contest this certificate from its Certificate Date.
REQUIRED REPORTS
As often as required by law, but at least once in each Certificate Year, We
will furnish a report to You which will show the number of Accumulation Units
credited to this certificate for each Underlying Fund and the corresponding
Accumulation Unit Values as of the date of the report.
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VOTING RIGHTS
If required by federal law, You may have the right to vote at the meetings of
the Shareholders of the Underlying Funds. If You have voting rights, We will
send a notice telling the time and place of the meeting. The notice will also
explain matters to be voted upon and how many votes may be exercised.
MORTALITY AND EXPENSES
Neither expenses actually incurred, other than taxes on the investment return,
nor mortality actually experienced, shall adversely affect the dollar amount of
the variable annuity payments after such payments have commenced.
NON-PARTICIPATING
This certificate does not share in Our surplus earnings, so You will receive no
dividends under it.
CERTIFICATE MODIFICATION
We reserve the right to modify this certificate to qualify it under all related
laws and regulations which are in effect during the term of this certificate.
We will obtain the approval of any regulatory authority needed for the
modifications.
STATE LAWS
The contract and certificates issued under the contract are governed by the law
of the state in which they are issued for delivery. We may, at any time, make
any changes, including retroactive changes, in the contract and certificates to
the extent that the change is required to meet the requirements of any law or
regulation issued by any governmental agency to which We or You are subject.
EMERGENCY PROCEDURE
We reserve the right to suspend or postpone the date of any payment of any
benefit or values for any Valuation Period (1) when the New York Stock Exchange
is closed; (2) when trading on the Exchange is restricted; (3) when an
emergency exists as determined by the Securities and Exchange Commission so
that disposal of the securities held in the Underlying Funds is not reasonably
practicable or it is not reasonably practicable to determine the value of the
Underlying Fund's net assets; or (4) during any other period when the
Securities and Exchange Commission, by order, so permits for the protection of
security holders. Any provision of this certificate which specifies a Valuation
Date will be superseded by this Emergency Procedure.
RELATION OF THIS CERTIFICATE TO THE SEPARATE ACCOUNT
We will have exclusive and absolute ownership and control of the assets of the
Separate Account. That portion of the assets of the Separate Account equal to
the reserves and other certificate liabilities with respect to such Separate
Account shall not be chargeable with liabilities arising out of any other
business We conduct. Our determination of the value of an Accumulation Unit and
an Annuity Unit by the method described in this certificate will be conclusive.
Income, gains and losses, whether or not realized from assets allocated to a
Separate Account shall be credited to or charged against such account without
regard to other income, gains or losses or the insurer.
We will maintain in each Separate Account assets with a value at least equal to
the amount accumulated in accordance with applicable agreements with respect to
such Separate Account and the reserves for annuities in the course of payment
that vary with the investment experience of such Separate Account.
VALUATION INFORMATION
NUMBER OF ACCUMULATION UNITS
The number of Accumulation Units to be credited for each Underlying Fund once a
Purchase Payment has been received by Us will be determined by dividing the net
Purchase Payment allocated to each Underlying Fund by the corresponding
Accumulation Unit Value of that Underlying Fund.
ACCUMULATION UNIT VALUE
The initial value of an Accumulation Unit for each Underlying Fund is set at
$1.000000. We determine the value of an Accumulation Unit on each Valuation
Date by multiplying the value on the immediately preceding Valuation Date by
the net investment factor for that Underlying Fund for the Valuation Period
just ended.
The value of an Accumulation Unit on any date other than a Valuation Date will
be equal to its value on the Next Valuation Date.
NET INVESTMENT FACTOR
The net investment factor is a factor applied to measure the investment
performance of an Underlying Fund from one Valuation Period to the next. The
net investment factor for an Underlying Fund for any Valuation Period is equal
to the sum of 1.000000 plus the net investment rate.
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Each Underlying Fund's net investment rate for a Valuation Period is equal to
the gross investment rate for that Underlying Fund less the applicable daily
mortality and expense risk deduction. The mortality and expense risk deduction
is shown on the Certificate Specifications page.
The gross investment rate of an Underlying Fund for a Valuation Period is equal
to (1) divided by (2) where
(1) is:
(a) investment income; plus
(b) capital gains and losses, whether realized or unrealized; less
(c) a deduction for any expenses levied against the Separate Account
and its Underlying Funds; and
(2) is the amount of the net assets at the beginning of the Valuation
Period.
The gross investment rate for an Underlying Fund may be either positive or
negative. Underlying Fund assets are based on the net assets held in the
Underlying Fund. Investment income includes any distribution whose ex-dividend
date occurs during the Valuation Period.
TRANSFERS BETWEEN UNDERLYING FUNDS
You may transfer all or any part of Your Cash Value, subject to the
restrictions as noted on the Certificate Specifications page and in the Fixed
Account Rider, if applicable, from one Underlying Fund to any other Underlying
Fund. You may transfer all or any part of Your Individual Account's Cash Value
to any Underlying Fund. Transfers may be made at any time up to 30 days before
the due date of the first Annuity payment subject to the restrictions as noted
on the Certificate Specifications page and in the Fixed Account Rider, if
applicable.
We reserve the right to limit the number of transfers in an account between
Underlying Funds. The minimum number of transfers allowed are shown in the
Certificate Specifications.
Transfers between Underlying Funds will result in the addition or deletion of
Accumulation Units having a total value equal to the dollar amount being
transferred to or from a particular Underlying Fund. The Number of Accumulation
Units will be determined by using the Accumulation Unit Value of the Underlying
Funds involved as of the Next Valuation Date after We receive notification of
request for transfer. Transfers will be subject to any applicable Underlying
Fund Transfer Charge stated on the Certificate Specifications page.
Your right to make transfers is subject to limitations or modification by Us if
We determine, in Our sole opinion, that the exercise of the right by one or
more owners with interests in the Underlying Fund is, or would be, to the
disadvantage of other owners. Restrictions may be applied in any manner
reasonably designed to prevent any use of the transfer right that is considered
by Us to be to the disadvantage of other owners. We will notify You, in
writing, in advance of any restrictions on transfers. A limitation or
modification could be applied to transfers to, or from, one or more of the
Underlying Funds and may include:
(a) the requirement of no more than one transfer per six month period;
(b) requiring that You deliver an originally executed Written Request for
a transfer to Our Office;
(c) any restriction imposed by an Underlying Fund,
Frequent requests from certificate owners to make transfers/reallocations may
dilute the value of the Underlying Funds' shares if the frequent
transfers/reallocations involve an attempt to take advantage of pricing
inefficiencies created by a lag between a change in the value of the securities
held by the Underlying Funds and the reflection of that change in the
Underlying Funds' share price ("arbitrage trading"). Arbitrage trading may
adversely affect the long-term performance of the Underlying Funds, which may
in turn adversely affect contract owners and other persons who may have an
interest in the certificates (e.g., Annuitants and Beneficiaries). We have
policies and procedures that attempt to detect and deter frequent transfers in
situations where we determine there is a potential for arbitrage trading. The
Underlying Funds have their own policies and procedures with respect to
frequent transfers of their respective shares and we reserve the right to
enforce these policies and procedures. We may also conduct monitoring of
transfers based upon a request by a portfolio manager of an Underlying Fund.
When we deter such trades, we may impose restrictions based upon our policies
and procedures.
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TRANSFERS FROM UNDERLYING FUNDS TO CONTRACTS OR CERTIFICATES NOT ISSUED BY US
You may transfer all or any part of Your Individual Account's Cash Surrender
Value, subject to the restrictions as noted on the Certificate Specifications
page and in the Fixed Account Rider, if applicable, to any contract/certificate
not issued by Us. Such transfers may be subject to Amounts Deducted on
Surrender as shown on the Certificate Specifications page.
TRANSFERS FROM OTHER CONTRACTS OR CERTIFICATES ISSUED BY US
We may allow You to transfer funds held in another group annuity contract or
certificate issued by Us to this certificate without applying deferred sales
charges or surrender charges to the funds being transferred. Once the transfer
is complete and We have established a new account for You, new deferred sales
charges or surrender charges may apply to this certificate as shown on the
Certificate Specifications page.
TRANSFERS TO OTHER CONTRACTS OR CERTIFICATES ISSUED BY US
We may allow You to transfer funds in this certificate to another contract or
certificate issued by Us without incurring a deferred sales charge or surrender
charge as shown on the Certificate Specifications page to the funds being
transferred. Once the transfer is complete and We have established a new
account for You, new deferred sales charges or surrender charges may apply to
the new contract/certificate in accordance with the provisions of such
contract/certificate.
DISTRIBUTIONS FROM THE CERTIFICATE
CASH SURRENDER VALUE
The Cash Surrender Value will be determined as of the Next Valuation Date
following receipt of a Written Request by You. We may delay payment of the Cash
Surrender Value in the Underlying Funds for a period of not more than seven
days after We receive the request. The payment of the Cash Surrender Value of
the Fixed Account, may be delayed as described in the Fixed Account Rider, if
applicable. We will pay interest on delayed Cash Surrender Value payments in
accordance with applicable regulations or laws of the state of New York.
CERTIFICATE CHARGES
AMOUNTS DEDUCTED ON SURRENDER
The applicable amounts deducted on Surrender are shown on the Certificate
Specifications page. These amounts as well as the mortality and expense risk
deduction may be reduced or eliminated to the extent that We anticipate lower
sales expenses or perform fewer sales services due to:
1. the size of the group participating in the contract;
2. an existing relationship to the contract owner;
3. use of mass enrollment procedures, or;
4. performance of sales functions by a third party, which We would
otherwise perform.
DEATH BENEFIT PROVISIONS
A death benefit is payable in a single sum to the Beneficiary upon Your death
before the Annuity Commencement Date. A death benefit is also payable under
those Annuity Options which provide for death benefits. We will pay the
Beneficiary the death benefit as described below upon receiving Due Proof of
Death and a Written Request.
DEATH PROCEEDS PRIOR TO THE ANNUITY COMMENCEMENT DATE
If You die before age 75 and before the Annuity Commencement Date, We will pay
the Beneficiary the greater of a) or b) below, less any applicable Premium Tax,
prior surrender(s) not previously deducted as of the date We receive Due Proof
of Death:
a) the Cash Value of Your Individual Account; or
b) the total net Purchase Payments under Your Individual Account.
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If You die on or after age 75 and before the Annuity Commencement Date, We will
pay the Beneficiary the Cash Value of Your Individual Account, less any
applicable Premium Tax as of the date We receive Due Proof of Death.
INTEREST ON DEATH PROCEEDS
We will pay interest on death proceeds of Your Individual Account in accordance
with laws and regulations in effect by the state in which the certificate is
issued for delivery.
DEATH PROCEEDS AFTER THE ANNUITY COMMENCEMENT DATE
If You die on or after the Annuity Commencement Date, We will pay the
Beneficiary a death benefit consisting of any benefit remaining under the
Annuity option then in effect.
ACCOUNT TERMINATION PROVISIONS
TERMINATION AMOUNT
Prior to annuitization, We reserve the right to terminate this Certificate on
any Valuation Date if the Certificate value is less than the Termination amount
stated in the Certificate Specifications and Purchase Payments have not been
made to this Certificate for at least three years. Termination will not occur
until 31 day's after We have mailed notice of termination to You at Your last
known address. If we terminate this Certificate we will pay you the cash
surrender value, if any.
CONTRACT DISCONTINUANCE PROVISIONS
The Contract Owner may discontinue the contract by Written Request at any time
for any reason. Discontinuance of the Contract will only affect Your
Certificate if the Contract Owner provides notice to and receives consent from
all Certificate Owners under the Contract to terminate all Certificates and pay
all Certificate Owners the Cash Surrender Value the Underlying Funds and the
Fixed Account values, if any, as described in the Fixed Account Rider, if
applicable, in their Individual Accounts. If the Contract is discontinued under
those terms, We will distribute the values, as applicable to You no later than
seven days following Our mailing the written notice of discontinuance to the
Contract Owner. Discontinuance of the Contract will not affect payments We are
making under any Annuity options which began before the date of discontinuance.
SETTLEMENT PROVISIONS
ELECTION OF SETTLEMENT OPTIONS
Any amount distributed from the certificate may be applied to any one of the
Annuity options described below.
Election of any of these options must be made by Written Request to Our Office
at least 30 days prior to the date such election is to become effective. The
form of such Annuity option shall be determined You. The following information
must be provided with any such request:
a) Your name, address, date of birth, social security number; and
b) the amount to be distributed in the form of an Annuity option; and
c) the Annuity option which is to be purchased; and
d) the date the Annuity option payments are to begin, which is known as
the Annuity Commencement Date; and
e) if the form of the Annuity provides a death benefit in the event of
Your death, the name, relationship and address of the Beneficiary; and
f) any other data that We may require.
If no Annuity Commencement Date is specified, the automatic Annuity
Commencement Date for each Certificate will be the greater of when the
Annuitant reaches age 90 or ten years after the Certificate Date. Additionally,
to the extent permitted by law, at least 30 days before the original Annuity
Commencement Date, You may change the Annuity Commencement Date by Written
Request to any time prior to the Annuitant's 90th birthday, or ten years after
the Certificate Date, or if We agree, to a later date not to exceed the
Annuitant's 95/th/ birthday, subject to laws and regulations then in effect and
Our approval. Individuals taking minimum required distributions are allowed to
go beyond the maximum Annuity Commencement Date.
If no election has been made on the Annuity Commencement Date and if the
Annuitant is living and has a spouse, We will pay to You the first of a series
of monthly annuity payments based on the life of the Annuitant as primary payee
and the Annuitant's spouse as secondary payee in accordance with the Joint and
Last Survivor Life Annuity-Annuity Reduced on Death of Primary Payee Option.
During the Annuitant's lifetime, if no election has been made and the Annuitant
has no spouse on the Annuity Commencement Date, We will pay to You the first of
a series of monthly annuity payments based on the life of the Annuitant, in
accordance with the Life Annuity with Period Certain Annuity option, with 120
monthly payments assured.
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The Beneficiary, as specified in item (e) above, may be changed by You as long
as We are notified by Written Request while You are alive. If the Beneficiary
designation is irrevocable, such designation cannot be changed or revoked
without the consent of the Beneficiary. After We receive the Written Request
and the written consent of the Beneficiary (if required), the new Beneficiary
designation will take effect as of the date the notice is signed. We have no
further responsibility for any payment We made before the Written Request.
MINIMUM AMOUNTS
The minimum Cash Value amount that can be placed under an Annuity option is
$2,000 unless We consent to a lesser amount. If any periodic payments due are
less than $100, We reserve the right to make payments at less frequent
intervals resulting in a payment of at least $100 per year.
MISSTATEMENT
If an Annuitant's date of birth was misstated, all benefits of this certificate
are what the Cash Value would have purchased at the correct age on the date of
issue of the Annuity option elected. If an overpayment has occurred, the
overpaid amount will be charged an interest rate as specified on the
Certificate Specifications page per annum. This amount will be deducted from
the subsequent annuity payments as necessary. If an underpayment has occurred,
the underpaid amount will be credited an interest rate as specified on the
Certificate Specifications page per annum. This amount due will be added to
subsequent annuity payments as necessary. Proof of the Annuitant's age may be
filed at any time at Our Office.
RETIRED LIFE CERTIFICATE
We will issue a certificate if Annuity payments are elected setting forth the
benefits to which such person is entitled under this certificate.
ALLOCATION OF AN ANNUITY
When an Annuity option is elected You may further elect to have the Cash Value
attributable to Your Individual Account applied to provide a Variable Annuity,
a Fixed Annuity, or a combination of both.
If a Variable Annuity is elected, You may elect to transfer all or any part of
the Cash Value from one Underlying Fund to another, as described in the
provision "Transfer Between Underlying Funds," in order to reallocate the basis
on which Annuity payments will be determined. Once annuity payments start, You
may, with Our consent, change the allocation of Your values in each Funding
Option.
VARIABLE ANNUITY
RELATION OF VARIABLE ANNUITY PAYMENTS TO THE SEPARATE ACCOUNT
Once variable annuity payments have begun, neither expenses actually incurred,
other than taxes on the investment return, nor mortality actually experienced,
shall adversly affect the dollar amount of variable annuity payments.
AMOUNT OF FIRST PAYMENT
The LIFE ANNUITY TABLES are used to determine the first monthly Annuity
payment. They show the dollar amount of the first monthly Annuity payment which
can be purchased with each $1,000 applied. The amount applied to an Annuity
will be the Cash Value attributable to an Annuitant as of 14 days before the
date Annuity payments start. We reserve the right to require satisfactory proof
of the age of any person on whose life Annuity payments are based before making
the first payment under any of these options.
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ANNUITY UNIT VALUE
The initial value of an Annuity Unit for each Underlying Fund was set at
$1.000000. On any Valuation Date, the Annuity Unit Value for an Underlying Fund
equals the Underlying Fund Annuity Unit Value on the immediately preceding
Valuation Date, multiplied by the net investment factor for that Underlying
Fund for the Valuation Period just ended, divided by the Assumed Daily Net
Investment Factor. The Assumed Daily Net Investment Factor is shown on the
Certificate Specifications Page.
The value of an Annuity Unit as of any date other than a Valuation Date will be
equal to its value as of the Next Valuation Date.
NUMBER OF ANNUITY UNITS
We determine the number of Annuity Units credited to the Annuitant's account in
each Underlying Fund by dividing the first monthly Annuity payment attributable
to that Underlying Fund by the Underlying Fund's Annuity Unit Value as of 14
days before the due date of the first Annuity payment.
AMOUNT OF SECOND AND SUBSEQUENT PAYMENTS
The dollar amount of any or all payments made to an Annuitant after the first
payment may change from month to month based on the net investment results of
the Underlying Fund(s). The total amount of each Annuity payment made to an
Annuitant will be equal to the sum of the payments in each Underlying Fund
allocated to that Annuitant's account.
The actual amount of the payments made to an Annuitant for each Underlying Fund
is found by multiplying the number of Annuity Units credited to the Annuitant's
account for that Underlying Fund by the applicable Annuity Unit Value of the
Underlying Fund as of the date [14 days] prior to the date on which the payment
is due. Once the variable annuity payments begin, the scale of charges to be
made against the Separate Account will not adversely affect the dollar amount
of variable annuity payments.
FIXED ANNUITY
A Fixed Annuity is an Annuity with payments which remain fixed as to dollar
amount throughout the payment period. The dollar amount of the first Fixed
Annuity payment will be calculated as described above in the "Amount of First
Payment" provision. All subsequent payments will be in the same amount and that
amount will be assured throughout the payment period.
BETTERMENT OF RATES
We guarantee that any annuity purchased with respect to an amount equal to the
Your account value as determined at the time of its commencement shall not be
less than that which would be provided by the application of such amount to
purchase a single consideration immediate annuity offered by Us or Our
affiliates at that time for other group annuity contracts, which other
contracts are determined in good faith by Us to be substantially similar to
this certificate as to class, size, and date of issue.
ANNUITY OPTIONS
Subject to conditions stated in ELECTION OF SETTLEMENT OPTIONS AND MINIMUM
AMOUNTS, all or any part of the Cash Value of this certificate may be paid to
the Annuitant under one or more of the options below.
OPTION 1. LIFE ANNUITY - NO REFUND
We will make monthly Annuity payments during the lifetime of the person on
whose life the payments are based, ending with the last monthly payment
preceding death.
OPTION 2. LIFE ANNUITY WITH 120, 180, OR 240 MONTHLY PAYMENTS ASSURED
We will make monthly Annuity payments during the lifetime of the person on
whose life the payments are based and under the conditions stated below.
If at the death of the Annuitant, payments have been made for less than 120,
180, or 240 months, as elected, We will continue to make payments to the
designated Beneficiary during the remainder of the period.
OPTION 3. LIFE ANNUITY-CASH REFUND
We will make monthly Annuity payments during the lifetime of the Annuitant,
ceasing with the last payment due prior to the death of the Annuitant, provided
that, at the death of the Annuitant, the Beneficiary will receive an additional
payment equal to the dollar value of the excess, if any, of (a) over (b) where,
for a Variable Annuity:
(a) is the total amount applied under the option divided by the Annuity
Unit Value on the due date of the first Annuity payment; and
(b) is:
M-14672 (4223)
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(1) the number of Annuity Units represented by each payment; times
(2) the number of payments made;
and for a Fixed Annuity:
(a) is the Cash Value applied on the Annuity Commencement Date under this
option; and
(b) is the dollar amount of Annuity payments already paid.
OPTION 4. JOINT AND LAST SURVIVOR LIFE ANNUITY
We will make monthly Annuity payments during the joint lifetime of the
Annuitant and a secondary payee, and thereafter during the remaining lifetime
of the survivor, ceasing with the last payment prior to the death of the
survivor.
OPTION 5. JOINT AND LAST SURVIVOR LIFE ANNUITY--ANNUITY REDUCED ON DEATH OF
PRIMARY PAYEE
We will make monthly Annuity payments to the Annuitant during the joint
lifetime of two persons selected. One of the two persons will be designated as
the primary payee. The other will be designated as the secondary payee. On the
death of the secondary payee, if survived by the primary payee, We will
continue to make monthly Annuity payments to the primary payee in the same
amount that would have been payable during the joint lifetime of the two
persons.
On the death of the primary payee, if survived by the secondary payee, We will
continue to make monthly Annuity payments to the secondary payee in an amount
equal to 50% of the payments which would have been made during the lifetime of
the primary payee. No further payments will be made following the death of the
survivor.
OPTION 6. PAYMENTS FOR A FIXED PERIOD
We will make monthly payments for the period selected. If at the death of the
Annuitant, payments have been made for less than the period selected, We will
continue to make payments to the designated Beneficiary during the remainder of
that period.
OPTION 7. OTHER ANNUITY OPTIONS
We will make other arrangements for Annuity payments as may be mutually agreed
upon by You and Us.
M-14672 (4223)
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LIFE ANNUITY TABLES
GUARANTEED AMOUNT OF MONTHLY ANNUITY PAYMENTS
PURCHASED WITH EACH $1,000 APPLIED
OPTIONS 1, 2, AND 3 - SINGLE LIFE ANNUITIES
[Download Table]
MALE AND
FEMALE
ADJUSTED NUMBER OF MONTHLY PAYMENTS GUARANTEED CASH
AGE NONE 120 180 240 REFUND
50 3.95 3.93 3.90 3.86 3.81
51 4.03 4.00 3.97 3.91 3.87
52 4.10 4.08 4.04 3.97 3.93
53 4.19 4.15 4.11 4.04 3.99
54 4.27 4.24 4.18 4.10 4.06
55 4.37 4.32 4.26 4.17 4.13
56 4.47 4.42 4.34 4.23 4.20
57 4.57 4.51 4.43 4.30 4.27
58 4.68 4.61 4.51 4.37 4.35
59 4.80 4.72 4.60 4.44 4.44
60 4.93 4.83 4.70 4.52 4.52
61 5.07 4.95 4.80 4.59 4.62
62 5.21 5.07 4.90 4.66 4.71
63 5.36 5.20 5.00 4.74 4.81
64 5.53 5.34 5.11 4.81 4.92
65 5.70 5.48 5.21 4.88 5.03
66 5.89 5.62 5.32 4.95 5.15
67 6.08 5.78 5.43 5.01 5.28
68 6.29 5.94 5.54 5.08 5.41
69 6.51 6.10 5.66 5.13 5.54
70 6.75 6.27 5.76 5.19 5.69
71 7.00 6.45 5.87 5.24 5.84
72 7.28 6.63 5.98 5.29 6.00
73 7.57 6.82 6.08 5.33 6.17
74 7.89 7.01 6.18 5.36 6.35
75 8.23 7.20 6.27 5.40 6.54
Dollar amounts of the life Annuity payments are based on the 1994 Group Annuity
Mortality Table for males projected with mortality improvement scale AA with
ages set back two years and a net investment rate of 3%. The adjusted age of
the person on whose life the Annuity is based is determined from the actual age
last birthday on the due date of the first Annuity payment in the following
manner:
[Download Table]
Calendar year in which 2001 - 2010 2011 - 2020 2021 - 2030 2031 and later
first payment is due
Adjusted age is actual age minus 1 minus 2 minus 3 minus 4
M-14672 (4223)
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LIFE ANNUITY TABLES
GUARANTEED AMOUNT OF MONTHLY ANNUITY PAYMENTS
PURCHASED WITH EACH $1,000 APPLIED
OPTION 4 - JOINT AND LAST SURVIVOR LIFE ANNUITY
[Download Table]
MALE AND
FEMALE
ADJUSTED
AGES 50 55 60 65 70 75
50 3.53 3.65 3.74 3.81 3.87 3.90
55 3.65 3.81 3.97 4.09 4.19 4.26
60 3.74 3.97 4.19 4.40 4.57 4.70
65 3.81 4.09 4.40 4.71 4.99 5.23
70 3.87 4.19 4.57 4.99 5.42 5.82
75 3.90 4.26 4.70 5.23 5.82 6.43
OPTION 5 - JOINT AND LAST SURVIVOR LIFE ANNUITY - ANNUITY REDUCED ON DEATH OF
PRIMARY PAYEE
[Download Table]
MALE AND
FEMALE
ADJUSTED
AGES 50 55 60 65 70 75
50 3.73 3.79 3.84 3.88 3.91 3.93
55 3.97 4.07 4.16 4.23 4.28 4.31
60 4.25 4.40 4.53 4.65 4.74 4.81
65 4.57 4.77 4.97 5.16 5.32 5.46
70 4.92 5.17 5.45 5.74 6.01 6.25
75 5.29 5.61 5.99 6.40 6.82 7.22
Dollar amounts of the life Annuity payments are based on the 1994 Group Annuity
Mortality Table for males projected with mortality improvement scale AA with
ages set back two years and a net investment rate of 3%. The adjusted age of
the person on whose life the Annuity is based is determined from the actual age
last birthday on the due date of the first Annuity payment in the following
manner:
[Download Table]
Calendar year in which 2001 - 2010 2011 - 2020 2021 - 2030 2031 and later
first payment is due
Adjusted age is actual age minus 1 minus 2 minus 3 minus 4
M-14672 (4223)
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ANNUITY TABLES
GUARANTEED AMOUNT OF MONTHLY ANNUITY PAYMENTS
PURCHASED WITH EACH $1,000 APPLIED
OPTION 6 - PAYMENTS FOR A DESIGNATED PERIOD
[Download Table]
NUMBER MONTHLY PAYMENT NUMBER OF MONTHLY PAYMENT
OF YEARS AMOUNT YEARS AMOUNT
5 17.91 18 5.96
6 15.14 19 5.73
7 13.16 20 5.51
8 11.68 21 5.32
9 10.53 22 5.15
10 9.61 23 4.99
11 8.86 24 4.84
12 8.24 25 4.71
13 7.71 26 4.59
14 7.26 27 4.47
15 6.87 28 4.37
16 6.53 29 4.27
17 6.23 30 4.18
The dollar amounts of the monthly Annuity payments for the Sixth Option are
based on a net investment rate of 3% per annum.
M-14672 (4223)
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CERTIFICATE SPECIFICATIONS
[Download Table]
CERTIFICATE OWNER [JOHN DOE] ANNUITANT [JOHN DOE]
CERTIFICATE NUMBER [SPECIMEN] CERTIFICATE DATE [04/01/13]
ANNUITY COMMENCEMENT DATE [04/01/42]
CONTRACT NUMBER [SPECIMEN] CONTRACT DATE [03/01/13]
CONTRACT OWNER [TRUSTEE OF THE ABC RETIREMENT PLAN]
PLAN NAME [THE ABC RETIREMENT PLAN]
PURCHASE PAYMENT/TERMINATION AMOUNTS
Minimum Average Purchase Payment [$1,000] per Certificate Year
Amount:
Maximum Aggregate Purchase Payment [$3,000,000] without prior approval
Amounts: by Our Office
Termination Amount: $2,000 and no Purchase Payments
having been received for three years
AMOUNTS DEDUCTED ON SURRENDER:
For the purpose of determining the Amounts Deducted on Surrender, the surrender
charge is calculated as a percentage of the Cash Value being surrendered.
[Download Table]
CERTIFICATE YEAR SURRENDER CHARGE
---------------- ---------------------------------------
(on amounts not previously surrendered)
[1-2 [5%
3-4 4%
5-6 3%
7-8 2%
9 and thereafter] 0%]
We guarantee that the aggregate surrender charge will never exceed 8.5% of the
total Purchase Payments made.
ALLOWABLE DISTRIBUTIONS PRIOR TO CONTRACT DISCONTINUANCE NOT SUBJECT TO AMOUNTS
DEDUCTED ON SURRENDER:
[Retirement, Separation from Service, loan initiations if applicable, hardship
withdrawals (as defined by the Internal Revenue Code), death, disability (as
defined by the Internal Revenue Code section 72 [m] [7]), minimum distribution
(as defined by the Internal Revenue Code), return of Excess Plan Contributions,
certain Plan expenses as mutually agreed upon, transfers to an employer stock
fund, and annuitization under this certificate to another contract issued by
Us.] Distributions may be in the form of cash payments, Annuity Options or to a
deferred Annuity issued by Us.
For distributions subject to Amounts Deducted on Surrender, the applicable
portion of the Cash Surrender Value of Your Individual Account will be paid to
satisfy the requested distribution. For allowable distributions not subject to
Amounts Deducted on Surrender, the applicable portion of the Cash Value of Your
Individual Account will be paid to satisfy the requested distribution.
INTEREST RATE APPLICABLE TO UNDERPAYMENTS OR OVERPAYMENTS DUE TO MISSTATEMENT
OF AGE AND/OR SEX: [6%]
M-14672 (4223)
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CERTIFICATE SPECIFICATIONS
FIXED ACCOUNT (This section only applies if the Fixed Account is available
under this Certificate.)
WE RESERVE THE RIGHT TO RESTRICT THE AVAILABILITY OF THE FIXED ACCOUNT AT ISSUE.
FIXED ACCOUNT INITIAL INTEREST RATE FOR INITIAL PURCHASE PAYMENT: [1%]
MINIMUM GUARANTEED INTEREST RATE FOR THE FIXED ACCOUNT: [1%]
WE RESERVE THE RIGHT WITH 30 DAYS ADVANCE WRITTEN NOTICE TO RESTRICT PURCHASE
PAYMENTS AND TRANSFERS TO THE FIXED ACCOUNT IF THE CREDITED INTEREST RATE
EQUALS THE MINIMUM GUARANTEED INTEREST RATE. WE WILL PROVIDE YOU ADVANCE
WRITTEN NOTICE IF THESE RESTRICTIONS ON PURCHASE PAYMENTS ARE SUBSEQUENTLY
LIFTED.
MORTALITY AND EXPENSE RISK DEDUCTION
The annual mortality and expense risk deduction is [1.20%] for all funds. [An
annual administrative expense fee of [.10%] may be deducted on a pro-rata basis
from all Underlying Funds in Your Individual Account]. This amounts to a daily
deduction of [.00003562] per fund.
ASSUMED DAILY NET INVESTMENT FACTOR: Upon annuitization, the Assumed Daily Net
Investment Factor for variable payments is 1.000081 for each Funding Option.
When expressed on an annual basis this equals 3%, for variable payments,
assuming a 365-day year.
FUND TRANSFERS
UNDERLYING FUND TRANSFER CHARGE: [$0.00]
We reserve the right to limit the number of transfers in an account between
Underlying Funds. The minimum number of transfers allowed would be one in any
six month period. We reserve the right to assess a processing fee not to exceed
$10.00 per transaction upon 30 days' written notice to You.
Certain funds are considered Competing Funds as shown in the Funding Options
section of the Certificate Specifications and are subject to transfer
restrictions as described in the Fixed Account Rider, if applicable.
Transfers from the Fixed Account, either to the Underlying Funds or to
contracts/certificates not issued by Us, as described in the Fixed Account
Rider (if applicable), may not exceed [20%] per Certificate Year of the
certificate Cash Value in the Fixed Account valued on each Certificate Year
anniversary.
FREE WITHDRAWAL ALLOWANCE:
[After the first Certificate Year,] to the extent permitted under current law,
You may take partial surrenders annually of up to [10%] of the Cash Value in
Your Individual Account to the extent permitted by current law, as of the first
Valuation Date of any given Certificate Year without imposition of Amounts
Deducted on Surrender. The free withdrawal allowance applies to partial
surrenders of any amount and to full surrenders.
Note: Any free withdrawal taken will reduce Purchase Payments no longer subject
to a surrender charge. The available amount will be calculated as of the end of
the previous Certificate Year. The free withdrawal amount is not cumulative
from year to year.
M-14672 (4223)
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CERTIFICATE SPECIFICATIONS
SEPARATE ACCOUNT: [Metropolitan Life Separate Account E]
UNDERLYING FUNDS:
[Enlarge/Download Table]
[American Funds Balanced Allocation Portfolio MFS(R) Research International Portfolio
American Funds Global Growth Fund MFS(R) Total Return Portfolio **
American Funds Growth Allocation Portfolio MFS(R) Value Portfolio
American Funds Growth Fund Invesco Small Cap Growth Portfolio
American Funds Growth-Income Fund MetLife Aggressive Strategy Portfolio
American Funds Moderate Allocation Portfolio MetLife Conservative Allocation Portfolio
Barclays Aggregate Bond Index Portfolio * MetLife Conservative to Moderate Allocation
BlackRock Bond Income Portfolio * Portfolio
BlackRock Capital Appreciation Portfolio MetLife Mid Cap Stock Index Portfolio
BlackRock Diversified Portfolio ** MetLife Moderate Allocation Portfolio
BlackRock High Yield Portfolio* MetLife Moderate to Aggressive Allocation
BlackRock Large Cap Core Portfolio Portfolio
BlackRock Large Cap Value Portfolio MetLife Multi-Index Targeted Risk Portfolio
BlackRock Money Market Portfolio MetLife Stock Index Portfolio
Clarion Global Real Estate Portfolio MSCI EAFE(R) Index Portfolio
Davis Venture Value Portfolio Neuberger Berman Genesis Portfolio
Delaware VIP Small Cap Value Series Oppenheimer Global Equity Portfolio - Class B
Enterprise Portfolio Pioneer Fund Portfolio
Frontier Mid Cap Growth Portfolio Pioneer Strategic Income Portfolio ** *
Harris Oakmark International Portfolio PIMCO Inflation Protected Bond Portfolio *
Janus Forty Portfolio PIMCO Total Return Portfolio *
Jennison Growth Portfolio Pyramis(R) Managed Risk Portfolio
JPMorgan Small Cap Value Portfolio Russell 2000(R) Index Portfolio
ClearBridge Aggressive Growth Portfolio Templeton Developing Markets Securities Fund
ClearBridge Variable Appreciation Portfolio Templeton Foreign Securities Fund
ClearBridge Variable Equity Income Portfolio ** Third Avenue Small Cap Value Portfolio
ClearBridge Variable All Cap Value Portfolio T. Rowe Price Large Cap Growth Portfolio
ClearBridge Variable Large Cap Growth Portfolio T. Rowe Price Large Cap Value Portfolio
ClearBridge Variable Large Cap Value Portfolio T. Rowe Price Small Cap Growth Portfolio
ClearBridge Variable Small Cap Growth Portfolio Invesco Comstock Portfolio
Legg Mason Investment Counsel Variable Social VIP Contrafund(R) Portfolio
Awareness Portfolio VIP Mid Cap Portfolio
Lord Abbett Bond Debenture Portfolio * Western Asset Management U.S. Government
Lord Abbett Mid Cap Value Portfolio Portfolio *
MFS(R) Emerging Markets Equity Portfolio Western Asset Variable High Income Portfolio*]
The Underlying Funds marked with an asterisk (*) are considered Competing
Funds, and are subject to transfer restrictions as described in the Fixed
Account Rider (if applicable). We reserve the right to change which funds are
considered Competing Funds in the future, but We will provide advance written
notice to You of any such changes.
M-14672 (4223)
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CERTIFICATE OF PARTICIPATION UNDER A FLEXIBLE PREMIUM GROUP VARIABLE ANNUITY
CONTRACT
TAX QUALIFIED NON-PARTICIPATING
RIDERS
ENDORSEMENTS
M-14672 (4223)
8 Subsequent Filings that Reference this Filing
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