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As Of Filer Filing For·On·As Docs:Size Issuer Agent 12/15/09 Sep Acct A of Pacific Life & … Co 485BPOS 12/15/09 3:578K RR Donnelley/FA → Separate Account A of Pacific Life & Annuity Co. (811-09203) ⇒ Pacific Value (333-107571) |
Document/Exhibit Description Pages Size 1: 485BPOS Post-Effective Amendment HTML 266K 3: EX-99.14 Exhibit 14 HTML 42K 2: EX-99.4(V) Exhibit 4(V) HTML 134K
e485bpos |
SECURITIES AND EXCHANGE COMMISSION
FORM N-4
REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
|
þ | |
Pre-Effective
Amendment No.
|
o | |
Post-Effective
Amendment No. 16
|
þ | |
and/or
REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940
|
þ | |
Amendment
No. 127
|
þ | |
(Check appropriate box or boxes)
SEPARATE ACCOUNT A
PACIFIC LIFE & ANNUITY COMPANY
700 Newport Center Drive
Newport Beach, California 92660
(Address of Depositor’s Principal Executive Offices) (Zip Code)
(949) 219-3943
(Depositor’s Telephone Number, including Area Code)
Brandon J. Cage
Assistant Vice President
Pacific Life & Annuity Company
700 Newport Center Drive
Newport Beach, California 92660
(Name and address of agent for service)
Approximate Date of Proposed Public Offering:
It is proposed that this filing will become effective (check appropriate box)
þ | immediately upon filing pursuant to paragraph (b) of Rule 485 |
o | on pursuant to paragraph (b) of Rule 485 |
o | 60 days after filing pursuant to paragraph (a) (1) of Rule 485 |
o | on ___________ pursuant to paragraph (a)(1) of Rule 485 |
If appropriate, check the following box:
o | this post-effective amendment designates a new effective date for a previously filed post-effective amendment. |
Title of Securities Being Registered: Interests in the Separate Account Under Pacific Value individual flexible premium deferred variable annuity contract.
Filing Fee: None
SEPARATE ACCOUNT A
FORM N-4
CROSS REFERENCE SHEET
PART A
Item No. |
Prospectus Heading |
|||
1.
|
Cover Page | Cover Page | ||
2.
|
Definitions | TERMS USED IN THIS PROSPECTUS | ||
3.
|
Synopsis | AN OVERVIEW OF PACIFIC VALUE | ||
4.
|
Condensed Financial Information | YOUR INVESTMENT OPTIONS — Variable Investment Option Performance; ADDITIONAL INFORMATION — Financial Statements; | ||
5.
|
General Description of Registrant, Depositor and Portfolio Companies |
AN OVERVIEW OF PACIFIC VALUE; PACIFIC LIFE & ANNUITY COMPANY, PACIFIC LIFE AND THE SEPARATE ACCOUNT — Pacific Life & Annuity Company (PL&A); — Pacific Life, — Separate Account A; YOUR INVESTMENT OPTIONS — Your Variable Investment Options; ADDITIONAL INFORMATION — Voting Rights | ||
6.
|
Deductions | AN OVERVIEW OF PACIFIC VALUE; CHARGES, FEES AND DEDUCTIONS; WITHDRAWALS — Optional Withdrawal | ||
7.
|
General Description of Variable Annuity Contracts |
AN OVERVIEW OF PACIFIC VALUE; PURCHASING YOUR CONTRACT — How to Apply for your Contract; HOW YOUR INVESTMENTS ARE ALLOCATED; ANNUITIZATION — Choosing Your Annuity Option, — Your Annuity Payments; DEATH BENEFITS AND OPTIONAL DEATH BENEFIT RIDERS — Death Benefits; ADDITIONAL INFORMATION — Voting Rights, — Changes to Your Contract, — Changes to All Contracts, — Inquiries and Submitting Forms and Requests, — Timing of Payments and Transactions | ||
8.
|
Annuity Period | ANNUITIZATION | ||
9.
|
Death Benefit | DEATH BENEFITS AND OPTIONAL DEATH BENEFIT RIDERS | ||
10.
|
Purchases and Contract Value | AN OVERVIEW OF PACIFIC VALUE; PURCHASING YOUR CONTRACT; HOW YOUR INVESTMENTS ARE ALLOCATED; PACIFIC LIFE & ANNUITY COMPANY, PACIFIC LIFE AND THE SEPARATE ACCOUNT — Pacific Life & Annuity Company, Pacific Life; THE GENERAL ACCOUNT — Withdrawals and Transfers | ||
11.
|
Redemptions | AN OVERVIEW OF PACIFIC VALUE; CHARGES, FEES AND DEDUCTIONS; WITHDRAWALS; ADDITIONAL INFORMATION — Timing of Payments and Transactions; THE GENERAL ACCOUNT — Withdrawals and Transfers | ||
12.
|
Taxes | CHARGES, FEES AND DEDUCTIONS — Premium Taxes; WITHDRAWALS — Optional Withdrawals, — Tax Consequences of Withdrawals; FEDERAL TAX ISSUES | ||
13.
|
Legal Proceedings | Not Applicable | ||
14.
|
Table of Contents of the Statement of Additional Information |
CONTENTS OF THE STATEMENT OF ADDITIONAL INFORMATION |
PART B
Statement of Additional | ||||
Item No. |
Information Heading |
|||
15.
|
Cover Page | Cover Page | ||
16.
|
Table of Contents | TABLE OF CONTENTS | ||
17.
|
General Information and History | Not Applicable | ||
18.
|
Services | Not Applicable | ||
19.
|
Purchase of Securities Being Offered | THE CONTRACTS AND THE SEPARATE ACCOUNT — Calculating Subaccount Unit Values, — Systematic Transfer Programs |
||
20.
|
Underwriters | DISTRIBUTION OF THE CONTRACTS — Pacific Select Distributors, Inc. (PSD) | ||
21.
|
Calculation of Performance Data | PERFORMANCE | ||
22.
|
Annuity Payments | THE CONTRACTS AND THE SEPARATE ACCOUNT — Variable Annuity Payment Amounts | ||
23.
|
Financial Statements | FINANCIAL STATEMENTS |
PART C
Information required to be included in Part C is set forth under the appropriate Item, so numbered, in Part C to this Registration Statement.
Current Charge |
Maximum Charge |
|||||||||||
Percentage | Percentage | |||||||||||
• CoreProtect Advantage Rider
Charge*
|
1.05 | % | 1.50 | % |
FROM | TO | WHEN | ||||
Income Access
|
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary. | ||||
CoreProtect Advantage
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage | On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
CoreIncome Advantage
|
Income Access | On any Contract Anniversary. | ||||
CoreProtect Advantage | On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Lifetime Income Access Plus
|
Income Access CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary. | ||||
Flexible Lifetime Income (Single)
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Flexible Lifetime Income (Joint)
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Foundation 10
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Flexible Lifetime Income Plus (Single)
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Flexible Lifetime Income Plus (Joint)
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
Automatic Income Builder
|
Income Access | On any Contract Anniversary. | ||||
CoreIncome Advantage CoreProtect Advantage |
On any Contract Anniversary beginning with the 5th Contract Anniversary measured from the Contract issue date. | |||||
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date. |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date. |
• | 5% multiplied by the Protected Payment Base as of that day, less cumulative withdrawals during that Contract Year, or | |
• | the Remaining Protected Balance as of that day. |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date, |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date, |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date, |
• | such withdrawal (an “RMD Withdrawal”) is for purposes of satisfying the minimum distribution requirements of Section 401(a)(9) and related Code provisions in effect at that time, | |
• | you have authorized us to calculate and make periodic distribution of the Annual RMD Amount for the Calendar Year required based on the payment frequency you have chosen, |
• | the Annual RMD Amount is based on this Contract only, and | |
• | only RMD withdrawals are made from the Contract during the Contract Year. |
• | if the oldest Owner (or youngest Annuitant, in the case of a Non-Natural Owner): |
• | was age 64 or younger when the first withdrawal was taken under the Rider, after the Rider Effective Date or the most recent Reset Date, whichever is later, the Protected Payment Amount will be paid each year until the Remaining Protected Balance is reduced to zero, or | |
• | was age 65 or older when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later, the Protected Payment Amount will be paid each year until the day of death of an Owner or sole surviving Annuitant. |
• | the Protected Payment Amount will be paid under a series of pre-authorized withdrawals under a payment frequency as elected by the Owner, but no less frequently than annually, | |
• | no additional Purchase Payments will be accepted under the Contract, | |
• | any Remaining Protected Balance will not be available for payment in a lump sum and will not be applied to provide payments under an Annuity Option, and | |
• | the Contract will cease to provide any death benefit. |
• | was age 64 or younger when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later, this Rider will terminate, or | |
• | was age 65 or older when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later, you may elect to withdraw up to the Protected Payment Amount each year until the day of death of an Owner or the sole surviving Annuitant. If an Automatic or Owner-Elected Reset occurs, the Remaining Protected Balance will be reinstated to an amount equal to the Contract Value as of that Contract Anniversary. |
• | the first withdrawal from the Contract since the Rider Effective Date, or | |
• | 10 Contract Anniversaries measured from the Rider Effective Date. |
• | total Purchase Payments if the Rider is purchased on the Contract Issue Date, or | |
• | the Contract Anniversary Value at the time the Rider is added to the Contract plus any subsequent Purchase Payments received after the Rider Effective Date. |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date, |
• | the first withdrawal since the Rider Effective Date, or | |
• | 10 Contract Anniversaries from the Rider Effective Date, |
• | the Life Only fixed annual payment amount based on the terms of your Contract, or | |
• | the Protected Payment Amount in effect at the maximum Annuity Date. |
• | the day any portion of the Contract Value is no longer allocated according the Investment Allocation Requirements, | |
• | the day the Remaining Protected Balance is reduced to zero if the oldest Owner (or youngest Annuitant, in the case of a Non-Natural Owner), was age 64 or younger when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later, | |
• | the date of death of an Owner or the sole surviving Annuitant (except as provided under the Continuation of Rider if Surviving Spouse Continues Contract subsection), | |
• | for Contracts with a Non-Natural Owner, the date of death of an Annuitant, including Primary, Joint and Contingent Annuitants, | |
• | the day the Contract is terminated in accordance with the provisions of the Contract, | |
• | the day we are notified of a change in ownership of the Contract to a non-spouse Owner if the Contract is Non-Qualified (excluding changes in ownership to or from certain trusts), | |
• | the day you exchange this Rider for another withdrawal benefit Rider, | |
• | the Annuity Date (see the Annuitization subsection for additional information), or | |
• | the day the Contract Value is reduced to zero as a result of a withdrawal (except an RMD withdrawal) that exceeds the Protected Payment Amount. |
• | the day the Remaining Protected Balance is reduced to zero if the oldest Owner (or youngest Annuitant, in the case of a Non-Natural Owner), was age 64 or younger when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later, or | |
• | the date of death of an Owner or the sole surviving Annuitant if the oldest Owner (or youngest Annuitant, in the case of a Non-Natural Owner) was age 65 or older when the first withdrawal was taken under the Rider after the Rider Effective Date or the most recent Reset Date, whichever is later. |
• | Initial Purchase Payment = $100,000 | |
• | Rider Effective Date = Contract Date | |
• | Owner’s Age = 65 on the Contract Date |
Annual |
Highest |
Protected |
Protected |
Remaining |
||||||||||||
Purchase |
Contract Value |
Credit |
Anniversary |
Payment |
Payment |
Protected |
||||||||||
Payment | Withdrawal | after Activity | Value | Value | Base | Amount | Balance | |||||||||
Rider Effective Date
|
$100,000 | $104,000 | $100,000 | $100,000 | $100,000 | $5,000 | $100,000 | |||||||||
• | Annual Credit Value = $100,000 | |
• | Highest Anniversary Value = $100,000 | |
• | Protected Payment Base = Initial Purchase Payment = $100,000 | |
• | Remaining Protected Balance = Initial Purchase Payment = $100,000 | |
• | Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
• | Initial Purchase Payment = $100,000 | |
• | Rider Effective Date = Contract Date | |
• | Owner’s Age = 65 on the Contract Date | |
• | A subsequent Purchase Payment of $100,000 is received during Contract Year 1. | |
• | No withdrawals taken. | |
• | Each Contract Anniversary referenced in the table represents the first day of the applicable Contract Year. |
Annual |
Highest |
Protected |
Protected |
Remaining |
||||||||||||
Purchase |
Contract Value |
Credit |
Anniversary |
Payment |
Payment |
Protected |
||||||||||
Payment | Withdrawal | after Activity | Value | Value | Base | Amount | Balance | |||||||||
Rider Effective Date
|
$100,000 | $104,000 | $100,000 | $100,000 | $100,000 | $5,000 | $100,000 | |||||||||
Activity
|
$100,000 | $208,000 | $200,000 | $200,000 | $200,000 | $10,000 | $200,000 | |||||||||
Year 2 Contract Anniversary
|
$208,000 | $210,000 | $208,000 | $210,000 | $10,500 | $210,000 | ||||||||||
• | Initial Purchase Payment = $100,000 | |
• | Rider Effective Date = Contract Date | |
• | Owner’s Age = 65 on the Contract Date | |
• | A subsequent Purchase Payment of $100,000 is received during Contract Year 1. | |
• | A withdrawal equal to or less than the Protected Payment Amount is taken during Contract Years 2 and 4. | |
• | Each Contract Anniversary referenced in the table represents the first day of the applicable Contract Year. |
Annual |
Highest |
Protected |
Protected |
Remaining |
||||||||||||
Purchase |
Contract Value |
Credit |
Anniversary |
Payment |
Payment |
Protected |
||||||||||
Payment | Withdrawal | after Activity | Value | Value | Base | Amount | Balance | |||||||||
Rider Effective Date
|
$100,000 | $104,000 | $100,000 | $100,000 | $100,000 | $5,000 | $100,000 | |||||||||
Activity
|
$100,000 | $208,000 | $200,000 | $200,000 | $200,000 | $10,000 | $200,000 | |||||||||
Year 2 Contract Anniversary
|
$208,000 | $210,000 | $208,000 | $210,000 | $10,500 | $210,000 | ||||||||||
Activity
|
$10,500 | $205,000 | $210,000 | $0 | $199,500 | |||||||||||
Year 3 Contract Anniversary
|
$205,000 | NA | NA | $210,000 | $10,500 | $199,500 | ||||||||||
Year 4 Contract Anniversary
|
(Prior to Automatic Reset) | $215,000 | NA | NA | $210,000 | $10,500 | $199,500 | |||||||||
Year 4 Contract Anniversary
|
(After to Automatic Reset) | $215,000 | NA | NA | $215,000 | $10,750 | $215,000 | |||||||||
Activity
|
$10,750 | $212,000 | $215,000 | $0 | $204,250 | |||||||||||
Year 5 Contract Anniversary
|
(Prior to Automatic Reset) | $217,000 | NA | NA | $215,000 | $0 | $204,250 | |||||||||
Year 5 Contract Anniversary
|
(After to Automatic Reset) | $217,000 | NA | NA | $217,000 | $10,850 | $217,000 | |||||||||
(a) | the Protected Payment Base remains unchanged; |
(b) | the Remaining Protected Balance is reduced by the amount of the withdrawal to $199,500 ($210,000 – $10,500); and |
(c) | since a withdrawal occurred, the Annual Credit Value and Highest Anniversary Value are no longer applicable. |
(a) | the Protected Payment Base remains unchanged; and |
(b) | the Remaining Protected Balance is reduced by the amount of the withdrawal to $204,250 ($215,000 – $10,750). |
• | Initial Purchase Payment = $100,000 | |
• | Rider Effective Date = Contract Date | |
• | Owner’s Age = 65 on the Contract Date | |
• | A subsequent Purchase Payment of $100,000 is received during Contract Year 1. | |
• | A withdrawal greater than the Protected Payment Amount is taken during Contract Year 2. | |
• | Each Contract Anniversary referenced in the table represents the first day of the applicable Contract Year. |
Annual |
Highest |
Protected |
Protected |
Remaining |
||||||||||||
Purchase |
Contract Value |
Credit |
Anniversary |
Payment |
Payment |
Protected |
||||||||||
Payment | Withdrawal | after Activity | Value | Value | Base | Amount | Balance | |||||||||
Rider Effective Date
|
$100,000 | $104,000 | $100,000 | $100,000 | $100,000 | $5,000 | $100,000 | |||||||||
Activity
|
$100,000 | $208,000 | $200,000 | $200,000 | $200,000 | $10,000 | $200,000 | |||||||||
Year 2 Contract Anniversary
|
$208,000 | $210,000 | $208,000 | $210,000 | $10,500 | $210,000 | ||||||||||
Activity
|
$20,000 | $195,000 | $200,235 | $0 | $190,000 | |||||||||||
Year 3 Contract Anniversary
|
$195,000 | NA | NA | $200,235 | $10,011 | $190,000 | ||||||||||
Year 4 Contract Anniversary
|
(Prior to Automatic Reset) | $215,000 | NA | NA | $200,235 | $10,011 | $190,000 | |||||||||
Year 4 Contract Anniversary
|
(After to Automatic Reset) | $215,000 | NA | NA | $215,000 | $10,750 | $215,000 | |||||||||
• | Contract Value = $215,000 | |
• | Protected Payment Base = $210,000 | |
• | Remaining Protected Balance = $210,000 | |
• | Protected Payment Amount = $10,500 (5% × Protected Payment Base; 5% × $210,000 = $10,500) | |
• | No withdrawals were taken prior to the excess withdrawal |
Annual |
Protected |
Protected |
Remaining |
|||||||||
Activity |
RMD |
Non-RMD |
RMD |
Payment |
Payment |
Protected |
||||||
Date | Withdrawal | Withdrawal | Amount | Base | Amount | Balance | ||||||
05/01/2006
|
$100,000 | $5,000 | $100,000 | |||||||||
Contract Anniversary |
||||||||||||
01/01/2007
|
$7,500 | |||||||||||
03/15/2007
|
$1,875 | $100,000 | $3,125 | $98,125 | ||||||||
05/01/2007
|
$100,000 | $5,000 | $98,125 | |||||||||
Contract Anniversary |
||||||||||||
06/15/2007
|
$1,875 | $100,000 | $3,125 | $96,250 | ||||||||
09/15/2007
|
$1,875 | $100,000 | $1,250 | $94,375 | ||||||||
12/15/2007
|
$1,875 | $100,000 | $0 | $92,500 | ||||||||
01/01/2008
|
$8,000 | |||||||||||
03/15/2008
|
$2,000 | $100,000 | $0 | $90,500 | ||||||||
05/01/2008
|
$100,000 | $5,000 | $90,500 | |||||||||
Contract Anniversary |
||||||||||||
Annual |
Protected |
Protected |
Remaining |
|||||||||
Activity |
RMD |
Non-RMD |
RMD |
Payment |
Payment |
Protected |
||||||
Date | Withdrawal | Withdrawal | Amount | Base | Amount | Balance | ||||||
05/01/2006
|
$0 | $100,000 | $5,000 | $100,000 | ||||||||
Contract Anniversary |
||||||||||||
01/01/2007
|
$7,500 | |||||||||||
03/15/2007
|
$1,875 | $100,000 | $3,125 | $98,125 | ||||||||
04/01/2007
|
$2,000 | $100,000 | $1,125 | $96,125 | ||||||||
05/01/2007
|
$100,000 | $5,000 | $96,125 | |||||||||
Contract Anniversary |
||||||||||||
06/15/2007
|
$1,875 | $100,000 | $3,125 | $94,250 | ||||||||
09/15/2007
|
$1,875 | $100,000 | $1,250 | $92,375 | ||||||||
11/15/2007
|
$4,000 | $96,900 | $0 | $88,300 | ||||||||
• | Initial Purchase Payment = $100,000 | |
• | Rider Effective Date = Contract Date | |
• | No subsequent Purchase Payments are received. | |
• | Owner is age 65 or older when the first withdrawal was taken. | |
• | Withdrawals, each equal to 5% of the Protected Payment Base are taken each Contract Year. | |
• | No Automatic Reset or Owner-Elected Reset is assumed during the life of the Rider. |
Protected |
Protected |
Remaining |
||||||||
Contract |
End of Year |
Payment |
Payment |
Protected |
||||||
Year | Withdrawal | Contract Value | Base | Amount | Balance | |||||
1
|
$5,000 | $96,489 | $100,000 | $5,000 | $95,000 | |||||
2
|
$5,000 | $94,384 | $100,000 | $5,000 | $90,000 | |||||
3
|
$5,000 | $92,215 | $100,000 | $5,000 | $85,000 | |||||
4
|
$5,000 | $89,982 | $100,000 | $5,000 | $80,000 | |||||
5
|
$5,000 | $87,681 | $100,000 | $5,000 | $75,000 | |||||
6
|
$5,000 | $85,311 | $100,000 | $5,000 | $70,000 | |||||
7
|
$5,000 | $82,871 | $100,000 | $5,000 | $65,000 | |||||
8
|
$5,000 | $80,357 | $100,000 | $5,000 | $60,000 | |||||
9
|
$5,000 | $77,768 | $100,000 | $5,000 | $55,000 | |||||
10
|
$5,000 | $75,101 | $100,000 | $5,000 | $50,000 | |||||
11
|
$5,000 | $72,354 | $100,000 | $5,000 | $45,000 | |||||
12
|
$5,000 | $69,524 | $100,000 | $5,000 | $40,000 | |||||
13
|
$5,000 | $66,610 | $100,000 | $5,000 | $35,000 | |||||
14
|
$5,000 | $63,608 | $100,000 | $5,000 | $30,000 | |||||
15
|
$5,000 | $60,517 | $100,000 | $5,000 | $25,000 | |||||
16
|
$5,000 | $57,332 | $100,000 | $5,000 | $20,000 | |||||
17
|
$5,000 | $54,052 | $100,000 | $5,000 | $15,000 | |||||
18
|
$5,000 | $50,674 | $100,000 | $5,000 | $10,000 | |||||
19
|
$5,000 | $47,194 | $100,000 | $5,000 | $5,000 | |||||
20
|
$5,000 | $43,610 | $100,000 | $5,000 | $0 | |||||
21
|
$5,000 | $39,918 | $100,000 | $5,000 | $0 | |||||
22
|
$5,000 | $36,115 | $100,000 | $5,000 | $0 | |||||
23
|
$5,000 | $32,199 | $100,000 | $5,000 | $0 | |||||
24
|
$5,000 | $28,165 | $100,000 | $5,000 | $0 | |||||
25
|
$5,000 | $24,010 | $100,000 | $5,000 | $0 | |||||
26
|
$5,000 | $19,730 | $100,000 | $5,000 | $0 | |||||
27
|
$5,000 | $15,322 | $100,000 | $5,000 | $0 | |||||
28
|
$5,000 | $10,782 | $100,000 | $5,000 | $0 | |||||
29
|
$5,000 | $6,105 | $100,000 | $5,000 | $0 | |||||
30
|
$5,000 | $1,288 | $100,000 | $5,000 | $0 | |||||
31
|
$5,000 | $0 | $100,000 | $5,000 | $0 | |||||
32
|
$5,000 | $0 | $100,000 | $5,000 | $0 | |||||
33
|
$5,000 | $0 | $100,000 | $5,000 | $0 | |||||
34
|
$5,000 | $0 | $100,000 | $5,000 | $0 | |||||
• | Protected Payment Base = Initial Purchase Payment = $100,000 | |
• | Remaining Protected Balance = Initial Purchase Payment = $100,000 | |
• | Protected Payment Amount = 5% of Protected Payment Base = $5,000 |
PART II
Part C: OTHER INFORMATION
Item 24. Financial Statements and Exhibits
(a) | Financial Statements | |||
Part A: None | ||||
Part B: |
(1) | Registrant’s Financial Statements | |||
Audited Financial Statements dated as of December 31, 2008 and for each of the periods presented which are incorporated by reference from the 2008 Annual Report include the following for Separate Account A: | ||||
Statements of Assets and Liabilities Statements of Operations Statements of Changes in Net Assets Notes to Financial Statements Report of Independent Registered Public Accounting Firm |
(2) | Depositor’s Financial Statements | |||
Audited Financial Statements dated as of December 31, 2008 and 2007, and for each of the three years in the period ended December 31, 2008, included in Part B include the following for Pacific Life & Annuity Company: | ||||
Independent Auditors’ Report Statements of Financial Condition Statements of Operations Statements of Stockholder’s Equity Statements of Cash Flows Notes to Financial Statements |
(b) | Exhibits |
1. | (a) | Minutes of Action of Board of Directors of PM Group Life Insurance Company (PM Group) (PL&A) dated July 1, 1998.1 |
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2. | Not applicable | |||||||
3. | (a) | Distribution Agreement between Pacific Life & Annuity Company (PL&A) and Pacific Select Distributors, Inc. (PSD)1 | ||||||
(b) | Form of Selling Agreement between Pacific Life & Annuity Company (PL&A), PSD and Various Broker-Dealers6 | |||||||
4. | (a) | Pacific Value—Individual Flexible Premium Deferred Variable Annuity Contract (Form No. 10-2100NY)1 | ||||||
(b) | Qualified Pension Plan Rider (Form No. 20-24200)1 | |||||||
(c) | (1) 403(b) Tax-Sheltered Annuity Rider (Form No. 20-25200)1 | |||||||
(2) 403(b) Tax-Sheltered Annuity Rider (Form No. 20-2156)11 | ||||||||
(d) | Individual Retirement Annuity Rider (Form No. 20-28900)1 | |||||||
(e) | Roth Individual Retirement Annuity Rider (Form No. 20-29000)1 | |||||||
(f) | SIMPLE Individual Retirement Annuity Rider (Form No. 20-29100)1 | |||||||
(g) | Stepped-Up Death Benefit Rider (Form No. 20-23500)1 | |||||||
(h) | Guaranteed Protection Advantage (GPA) Rider (Form No. 20-27000)1 | |||||||
(i) | Guaranteed Protection Advantage 5 (GPA 5) Rider (Form No. 20-295-1)2 | |||||||
(j) | Guaranteed Income Annuity (GIA) Rider (Form No. 20-2118)5 | |||||||
(k) | (1) Enhanced Guaranteed Withdrawal Benefit Rider (Form No. 20-2120)5 | |||||||
(2) Excess Withdrawal Endorsement (Form No. 15-2152A)10 | ||||||||
(l) | (1) 5% Guaranteed Withdrawal Benefit Rider (Form No. 20-2131)7 | |||||||
(2) Excess Withdrawal Endorsement (Form No. 15-2152)10 | ||||||||
(m) | (1) Joint Life 5% Guaranteed Withdrawal Benefit Rider (Form No. 20-2135)8 | |||||||
(2) Excess Withdrawal Endorsement (Form No. 15-2152B)10 | ||||||||
(n) | Guaranteed Protection Advantage 3 Rider (Form No. 20-2144)9 | |||||||
(o) | (1) Guaranteed Withdrawal Benefit II Rider (Form No. 20-2146)9 | |||||||
(2) Excess Withdrawal Endorsement (Form No. 15-2152)10 | ||||||||
(p) | Guaranteed Withdrawal Benefit III Rider (Form No. 20-2153)10 | |||||||
(q) | Guaranteed Withdrawal Benefit Rider (Form No. 20-2154)10 | |||||||
(r) | Joint Life Guaranteed Withdrawal Benefit Rider (Form No. 20-2155)10 | |||||||
(s) | Income Access Rider (Form No. 20-2104)11 | |||||||
(t) | Core Withdrawal Benefit Rider (Form No. 20-2162)12 | |||||||
(u) | DCA Plus Fixed Option Rider (Form No. 20-2103)13 | |||||||
(v) | Guaranteed Withdrawal Benefit IV Rider (Form No. 20-2176) | |||||||
5. | (a) | Pacific Value Variable Annuity Application (Form No. 25-2100)1 | ||||||
(b) | Guaranteed Protection Advantage Rider Request (Form No. N2066-2A)1 | |||||||
(c) | Portfolio Optimization Enrollment/Rider Request Form (Form No. N2150-5B)4 | |||||||
(d) | Pacific Value Variable Annuity Application (Form No. 25-2100-2)6 | |||||||
(e) | Portfolio Optimization Enrollment/Rider Request Form (Form No. N2150-6B)6 | |||||||
6. | (a) | Articles of Incorporation of PM Group Life1 | ||||||
(b) | Amended and Restated Articles of Incorporation of PL&A1 | |||||||
(c) | By-laws of Pacific Life & Annuity Company1 | |||||||
7. | Not applicable | |||||||
8. | (a) | Pacific Select Fund Participation Agreement1 | ||||||
(b) | Addendum to the Pacific Select Fund Participation Agreement (to add the Strategic Value and Focused 30 Portfolios)1 | |||||||
(c) | Addendum to the Pacific Select Fund Participation Agreement (to add nine new Portfolios)1 | |||||||
(d) | Addendum to the Pacific Select Fund Participation Agreement (to add the Equity Income and Research Portfolios)1 | |||||||
(e) | Administrative Agreement Between Pacific Life & Annuity Company (PL&A) and Pacific Life Insurance Company (“Pacific Life”)1 | |||||||
(f) | Fund Participation Agreement Between Pacific Life & Annuity Company, Pacific Select Distributors, Inc., American Funds Insurance Series, American Funds Distributors, and Capital Research and Management Company.3 | |||||||
(g) | Form of Exhibit B to the Pacific Select Fund Participation Agreement (to add International Small-Cap and Diversified Bond)6 | |||||||
(h) | Form of AllianceBernstein Variable Products Series Fund, Inc. Participation Agreement10 | |||||||
(i) | Form of BlackRock Variable Series Fund, Inc. Participation Agreement10 | |||||||
(j) | Form of Franklin Templeton Variable Insurance Products Trust Participation Agreement10 | |||||||
(k) | Form of AllianceBernstein Investments, Inc. Administrative Services Agreement10 | |||||||
(l) | Form of BlackRock Distributors, Inc. Administrative Services Agreement10 | |||||||
(m) | Form of Franklin Templeton Series, LLC Administrative Services Agreement10 | |||||||
(n) | Form of AIM Variable Insurance Funds Participation Agreement11 | |||||||
(o) | Form of Invesco Aim Distributors, Inc. Distribution Services Agreement11 | |||||||
(p) | Form of Invesco Aim Advisors, Inc. Administrative Services Agreement11 | |||||||
(q) | Form of GE Investments Funds, Inc. Participation Agreement11 | |||||||
(r) | Form of GE Investment Distributors, Inc. Distribution and Services Agreement11 | |||||||
(s) | Form of Van Kampen Life Investment Trust Participation Agreement11 | |||||||
(t) | Form of Van Kampen Funds, Inc. Shareholder Service Agreement11 | |||||||
(u) | Form of Van Kampen Asset Management Administrative Services Letter Agreement11 | |||||||
9. | Opinion and Consent of legal officer of Pacific Life & Annuity Company as to the legality of Contracts being registered.1 |
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10. | Consent of Independent Registered Public Accounting Firm and Consent of Independent Auditors12 | |||||||
11. | Not applicable | |||||||
12. | Not applicable | |||||||
13. | Pacific Value—Performance Calculations1 | |||||||
14. | Powers of Attorney | |||||||
1 | Included in Registration Statement on Form N-4, File No. 333-107571, Accession No. 0001017062-03-001534, filed on August 1, 2003, and incorporated by reference herein. | |||||||
2 | Included in Registration Statement on Form N-4/A, File No. 333-107571, Accession No. 0000892569-05-000072, filed on February 17, 2005, and incorporated by reference herein. | |||||||
3 | Included in Registration Statement on Form N-4/B, File No. 333-71081, Accession No. 0000892569-05-000248, filed on April 18, 2005, and incorporated by reference herein. | |||||||
4 | Included in Registration Statement on Form N-4/B, File No. 333-107571, Accession No. 0000892569-05-000250, filed on April 18, 2005, and incorporated by reference herein. | |||||||
5 | Included in Registration Statement on Form N-4/A, File No. 333-107571, Accession No. 0000892569-05-000914, filed on October 17, 2005, and incorporated by reference herein. | |||||||
6 | Included in Registration Statement on Form N-4/B, File No. 333-107571, Accession No. 0000892569-06-000562, filed on April 21, 2006, and incorporated by reference herein. | |||||||
7 | Included in Registrant’s Form N-4/A, File No. 333-107571, Accession No. 0000892569-06-001256, filed on October 19, 2006, and incorporated by reference herein. | |||||||
8 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-07-000477, filed on April 20, 2007, and incorporated by reference herein. | |||||||
9 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-07-001587, filed on December 28, 2007, and incorporated by reference herein. | |||||||
10 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-08-001275, filed on September 11, 2008, and incorporated by reference herein. | |||||||
11 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-08-001558, filed on December 4, 2008, and incorporated by reference herein. | |||||||
12 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-09-000477, filed on April 23, 2009, and incorporated by reference herein. | |||||||
13 | Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000950123-09-029433, filed on August 4, 2009, and incorporated by reference herein. | |||||||
Item 25. Directors and Officers of Pacific Life & Annuity Company
Name and Address |
Positions and Offices with Pacific
Life & Annuity Company |
|
James T. Morris
|
Director, President and Chief Executive Officer | |
Khanh T. Tran
|
Director, Executive Vice President and Chief Financial Officer | |
Sharon
A. Cheever
|
Director, Senior Vice President and General Counsel | |
Audrey L. Milfs
|
Director, Vice President and Secretary | |
Edward
R. Byrd
|
Senior Vice President and Chief Accounting Officer | |
Brian D. Klemens
|
Vice President and Controller | |
Dewey P. Bushaw
|
Executive Vice President | |
Denis
P. Kalscheur
|
Vice President and Treasurer | |
Mark
W. Holmlund
|
Director, Executive Vice President, and Chief Investment Officer |
The address for each of the persons listed above is as follows:
700 Newport Center Drive
Newport Beach, California 92660
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Item 26. | Persons Controlled by or Under Common Control with Pacific Life & Annuity Company or Separate Account A |
The following is an explanation of the organization chart of Pacific Life & Annuity Company’s subsidiaries: |
PACIFIC LIFE & ANNUITY COMPANY, SUBSIDIARIES & AFFILIATED
ENTERPRISES LEGAL STRUCTURE
Pacific Life & Annuity Company is an Arizona Stock Life Insurance Company wholly-owned by Pacific Life Insurance Company (a Nebraska Stock Life Insurance Company) which is wholly-owned by Pacific LifeCorp (a Delaware Stock Holding Company) which is, in turn, 100% owned by Pacific Mutual Holding Company (a Nebraska Mutual Insurance Holding Company).
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Item 27. Number of Contractholders
Pacific Value — Approximately |
688 Qualified 476 Non Qualified |
||
Item 28. Indemnification
(a) | The Distribution Agreement between Pacific Life & Annuity Company and Pacific Select Distributors, Inc. (PSD), formerly called Pacific Mutual Distributors, Inc. (PMD) provides substantially as follows: |
Pacific Life & Annuity Company hereby agrees to indemnify and hold harmless PMD and its officers and directors, and employees for any expenses (including legal expenses), losses, claims, damages, or liabilities incurred by reason of any untrue or alleged untrue statement or representation of a material fact or any omission or alleged omission to state a material fact required to be stated to make other statements not misleading, if made in reliance on any prospectus, registration statement, post-effective amendment thereof, or sales materials supplied or approved by Pacific Life & Annuity Company or the Separate Account. Pacific Life & Annuity Company shall reimburse each such person for any legal or other expenses reasonably incurred in connection with investigating or defending any such loss, liability, damage, or claim. However, in no case shall Pacific Life & Annuity Company be required to indemnify for any expenses, losses, claims, damages, or liabilities which have resulted from the willful misfeasance, bad faith, negligence, misconduct, or wrongful act of PMD. | ||||
PMD hereby agrees to indemnify and hold harmless Pacific Life & Annuity Company, its officers, directors, and employees, and the Separate Account for any expenses, losses, claims, damages, or liabilities arising out of or based upon any of the following in connection with the offer or sale of the contracts: (1) except for such statements made in reliance on any prospectus, registration statement or sales material supplied or approved by Pacific Life & Annuity Company or the Separate Account, any untrue or alleged untrue statement or representation is made; (2) any failure to deliver a currently effective prospectus; (3) the use of any unauthorized sales literature by any officer, employee or agent of PMD or Broker; (4) any willful misfeasance, bad faith, negligence, misconduct or wrongful act. PMD shall reimburse each such person for any legal or other expenses reasonably incurred in connection with investigating or defending any such loss, liability, damage, or claim. |
(b) | The Form of Selling Agreement between Pacific Life & Annuity Company, Pacific Select Distributors, Inc. (PSD), formerly called Pacific Mutual Distributors, Inc. (PMD) and Various Broker-Dealers and Agency (Selling Entities) provides substantially as follows: |
Pacific Life & Annuity Company and PSD agree to indemnify and hold harmless Selling Entities, their officers, directors, agents and employees, against any and all losses, claims, damages, or liabilities to which they may become subject under the Securities Act, the Exchange Act, the Investment Company Act of 1940, or other federal or state statutory law or regulation, at common law or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon any untrue statement or alleged untrue statement of a material fact or any omission or alleged omission to state a material fact required to be stated or necessary to make the statements made not misleading in the registration statement for the Contracts or for the shares of Pacific Select Fund (the “Fund”) filed pursuant to the Securities Act, or any prospectus included as a part thereof, as from time to time amended and supplemented, or in any advertisement or sales literature provided by Pacific Life & Annuity Company and PSD. |
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Selling Entities agree to, jointly and severally, hold harmless and indemnify Pacific Life & Annuity Company and PSD and any of their respective affiliates, employees, officers, agents and directors (collectively, “Indemnified Persons”) against any and all claims, liabilities and expenses (including, without limitation, losses occasioned by any rescission of any Contract pursuant to a “free look” provision or by any return of initial purchase payment in connection with an incomplete application), including, without limitation, reasonable attorneys’ fees and expenses and any loss attributable to the investment experience under a Contract, that any Indemnified Person may incur from liabilities resulting or arising out of or based upon (a) any untrue or alleged untrue statement other than statements contained in the registration statement or prospectus relating to any Contract, (b)(i) any inaccurate or misleading, or allegedly inaccurate or misleading sales material used in connection with any marketing or solicitation relating to any Contract, other than sales material provided preprinted by Pacific Life & Annuity Company or PSD, and (ii) any use of any sales material that either has not been specifically approved in writing by Pacific Life & Annuity Company or PSD or that, although previously approved in writing by Pacific Life & Annuity Company or PSD, has been disapproved, in writing by either of them, for further use, or (c) any act or omission of a Subagent, director, officer or employee of Selling Entities, including, without limitation, any failure of Selling Entities or any Subagent to be registered as required as a broker/dealer under the 1934 Act, or licensed in accordance with the rules of any applicable SRO or insurance regulator. | ||||
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Item 29. Principal Underwriters
(a) | PSD, formerly called PMD, also acts as principal underwriter for the Pacific Select Exec Separate Account of Pacific Life and Annuity Company, Pacific Select Fund, and the following Separate Accounts of Pacific Life Insurance Company: Pacific Select Separate Account, Pacific Select Exec Separate Account, Pacific Select Variable Annuity Separate Account, Pacific Corinthian Variable Separate Account, Separate Account B, COLI Separate Account, COLI II Separate Account, COLI III Separate Account, and Pacific Select Fund. | |||
(b) | For information regarding PSD, reference is made to Form B-D, SEC File No. 8-15264, which is herein incorporated by reference. | |||
(c) | PSD retains no compensation or net discounts or commissions from the Registrant. |
Item 30. Location of Accounts and Records
The accounts, books and other documents required to be maintained by Registrant pursuant to Section 31(a) of the Investment Company Act of 1940 and the rules under that section will be maintained by Pacific Life Insurance Company at 700 Newport Center Drive, Newport Beach, California 92660. |
Item 31. Management Services
Not applicable |
Item 32. Undertakings
The registrant hereby undertakes: | ||||
(a) | to file a post-effective amendment to this registration statement as frequently as is necessary to ensure that the audited financial statements in this registration statement are never more than 16 months old for so long as payments under the variable annuity contracts may be accepted, unless otherwise permitted. | |||
(b) | to include either (1) as a part of any application to purchase a contract offered by the prospectus, a space that an applicant can check to request a Statement of Additional Information, or (2) a post card or similar written communication affixed to or included in the prospectus that the applicant can remove to send for a Statement of Additional Information, or (3) to deliver a Statement of Additional Information with the Prospectus. | |||
(c) | to deliver any Statement of Additional Information and any financial statements required to be made available under this Form promptly upon written or oral request. |
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Additional Representations
(a) The Registrant and its Depositor are relying upon American Council of Life Insurance, SEC No-Action Letter, SEC Ref. No. 1P-6-88 (November 28, 1988) with respect to annuity contracts offered as funding vehicles for retirement plans meeting the requirements of Section 403(b) of the Internal Revenue Code, and the provisions of paragraphs (1)-(4) of this letter have been complied with.
(b) REPRESENTATION PURSUANT TO SECTION 26(f) OF THE INVESTMENT COMPANY ACT OF 1940: Pacific Life & Annuity Company and the sponsoring insurance company of the Registrant represent that the fees and charges to be deducted under the Variable Annuity Contract (“Contract”) described in the prospectus contained in this registration statement are, in the aggregate, reasonable in relation to the services rendered, the expenses expected to be incurred, and the risks assumed in connection with the Contract.
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SIGNATURES
SEPARATE ACCOUNT A | ||
(Registrant) | ||
By: |
PACIFIC LIFE & ANNUITY COMPANY |
|
By: | ||
|
||
James T. Morris* Director, President and Chief Executive Officer |
||
By: |
PACIFIC LIFE & ANNUITY COMPANY (Depositor) |
|
By: | ||
|
||
James T. Morris* Director, President and Chief Executive Officer |
Signature | Title | Date | ||||
James T. Morris* |
Director, President and Chief Executive Officer | December 15, 2009 | ||||
Khanh T. Tran* |
Director, Executive Vice President and Chief Financial Officer | December 15, 2009 | ||||
Sharon A. Cheever* |
Director, Senior Vice President and General Counsel | December 15, 2009 | ||||
Audrey L. Milfs* |
Director, Vice President and Secretary | December 15, 2009 | ||||
Edward R. Byrd* |
Senior Vice President and Chief Accounting Officer | December 15, 2009 | ||||
Brian D. Klemens* |
Vice President and Controller | December 15, 2009 | ||||
Dewey P. Bushaw* |
Executive Vice President | December 15, 2009 | ||||
Denis P. Kalscheur* |
Vice President and Treasurer | December 15, 2009 | ||||
Mark W. Holmlund* |
Director, Executive Vice President and Chief Investment Officer | December 15, 2009 | ||||
*By: | /s/ SHARON A. CHEEVER | December 15, 2009 | ||||
Sharon A. Cheever as attorney-in-fact |
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This ‘485BPOS’ Filing | Date | Other Filings | ||
---|---|---|---|---|
1/16/10 | ||||
Filed on / Effective on: | 12/15/09 | 485BPOS | ||
8/4/09 | 485BPOS, N-4 | |||
5/1/09 | 485BPOS, 497 | |||
4/23/09 | 485BPOS | |||
12/31/08 | 24F-2NT, N-30D, NSAR-U | |||
12/4/08 | 485BPOS | |||
9/11/08 | 485BPOS | |||
3/15/08 | ||||
12/31/07 | 24F-2NT, N-30D, NSAR-U, NT-NSAR | |||
12/28/07 | 485BPOS | |||
4/20/07 | 485BPOS | |||
10/19/06 | 485APOS | |||
4/21/06 | 485BPOS | |||
10/17/05 | 485APOS | |||
4/18/05 | 485BPOS | |||
2/17/05 | 485APOS | |||
8/1/03 | N-4 | |||
7/1/98 | ||||
List all Filings |
As Of Filer Filing For·On·As Docs:Size Issuer Filing Agent 4/15/24 Sep Acct A of Pacific Life & … Co 485BPOS 5/01/24 3:12M Toppan Merrill/FA 4/17/23 Sep Acct A of Pacific Life & … Co 485BPOS 5/01/23 3:11M Toppan Merrill/FA 4/18/22 Sep Acct A of Pacific Life & … Co 485BPOS 5/01/22 3:34M Toppan Merrill/FA 10/20/21 Sep Acct A of Pacific Life & … Co 485BPOS 10/20/21 2:397K Toppan Merrill/FA 4/19/21 Sep Acct A of Pacific Life & … Co 485BPOS 5/01/21 4:32M Toppan Merrill/FA |