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Separate Account A of Pacific Life & Annuity Co, et al. – ‘485BPOS’ on 12/15/09

On:  Tuesday, 12/15/09, at 1:19pm ET   ·   Effective:  12/15/09   ·   Accession #:  950123-9-70788   ·   File #s:  811-09203, 333-107571

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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/FASeparate Account A of Pacific Life & Annuity Co. (811-09203) Pacific Value (333-107571)

Post-Effective Amendment
Filing Table of Contents

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 


485BPOS   —   Post-Effective Amendment


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  e485bpos  

As filed with the Securities and Exchange Commission on December 15, 2009
Registrations Nos.

333-107571
811-09203



SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

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

(Exact Name of Registrant)

PACIFIC LIFE & ANNUITY COMPANY

(Name of Depositor)

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.

 



 

PROSPECTUS
(Included in Registrant’s Form N-4/B, File No. 333-107571, Accession No. 0000892569-09-000477, filed on April 23, 2009, supplemented August 4, 2009, Accession No. 0000950123-09-029433, and incorporated by reference herein.)

 



 

STATEMENT OF ADDITIONAL INFORMATION
(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.)

 



 

 
Supplement dated December 15, 2009 to the Prospectus dated May 1, 2009 for the
Pacific Value variable annuity contract issued by Pacific Life & Annuity Company
 
Capitalized terms used in this supplement are defined in the Prospectus referred to above unless otherwise defined herein. “We,” “us,” or “our” refer to Pacific Life & Annuity Company; “you” or “your” refer to the Contract Owner.
 
This supplement must be preceded or accompanied by the Prospectus dated May 1, 2009, as supplemented.
 
The AN OVERVIEW OF PACIFIC VALUE section is amended as follows:
 
The Optional Riders — Optional Living Benefit Riders subsection is amended to include the following:
 
At initial purchase and during the entire time that you own an optional living benefit Rider, you must invest your entire Contract Value in an asset allocation program or in Investment Options we make available for these Riders. The allocation limitations associated with these Riders may limit the number of Investment Options that are otherwise available to you under your Contract. See the OTHER OPTIONAL RIDERS — General Information — Investment Allocation Requirements section in the Prospectus. Failure to adhere to the Investment Allocation Requirements may cause your Rider to terminate.
 
CoreProtect Advantage Rider
 
This optional Rider lets you, before the Annuity Date, withdraw up to 5% of your Protected Payment Base per year, lock in market gains, and provides the potential to withdraw up to the Protected Payment Amount for life, if certain conditions are met. Lifetime withdrawals are available 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 after the Rider Effective Date or the most recent Reset Date, whichever is later. If your total withdrawals in a Contract Year exceed the annual withdrawal amount allowed under the Rider, then the Protected Payment Base may decrease and the amount you may withdraw in the future under the Rider may be reduced.
 
Before the first withdrawal or 10 Contract Anniversaries from the Rider Effective Date (whichever occurs first), the Protected Payment Base and Remaining Protected Balance will be increased to the greater of the Annual Credit Value (a 5% Annual Credit is added to this value) or the Highest Anniversary Value.
 
After the first withdrawal or 10 Contract Anniversaries from the Rider Effective Date (whichever occurs first), the Rider provides for Automatic Resets or Owner-Elected Resets of the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value. Any reset may include an increase in the annual charge percentage (up to a maximum of 1.50%) associated with the Rider. Protected Payment Base, Remaining Protected Balance, Rider Effective Date, Highest Anniversary Value, Annual Credit Value, Annual Credit, Automatic Reset, Owner-Elected Reset and Reset Date are described in the OTHER OPTIONAL RIDERS – CoreProtect Advantage Rider section in this supplement.
 
This Rider is called the Guaranteed Withdrawal Benefit IV Rider in the Contract’s Rider.
 
The Periodic Expenses section is amended to include the following:
 
                         
    Current Charge
    Maximum Charge
       
    Percentage     Percentage        
 
•     CoreProtect Advantage Rider Charge*
    1.05 %     1.50 %        
 
* If you buy the CoreProtect Advantage Rider, the annual charge is equal to the current charge percentage multiplied by the Protected Payment Base, deducted on a quarterly basis. The Protected Payment Base is the amount used to determine the allowable annual withdrawal amount under the Rider. The initial Protected Payment Base is equal to the initial Purchase Payment if purchased at Contract issue or is equal to the Contract Value if the Rider is purchased on a Contract Anniversary. For a complete explanation of the Protected Payment Base, see the OTHER OPTIONAL RIDERS — CoreProtect Advantage Rider section in this supplement. The charge is deducted from your Contract Value on a quarterly basis. The quarterly amount deducted may increase or decrease due to changes in your Protected Payment Base. Your Protected Payment Base may increase due to additional Purchase Payments, increases to the Annual Credit Value or Highest Anniversary Value, decrease due to withdrawals or also change due to Resets. We deduct this charge proportionately from your Investment Options (excluding the DCA Plus Fixed Option) every quarter following the Rider Effective Date, during the term of the Rider and while the Rider is in effect, and when the Rider is terminated. We will waive the annual charge if the Rider terminates as a result of the death of an Owner or sole surviving Annuitant, upon full annuitization of your Contract or if your Contract Value is zero. The annual charge is only waived for the quarter that we are notified of death or annuitization. See the CHARGES, FEES, AND DEDUCTIONS — Optional Rider Charges section in this supplement for further information.



 

Footnote 6 is replaced with the following:
 
Only one CoreProtect Advantage, CoreIncome Advantage, Flexible Lifetime Income Plus (Single), Flexible Lifetime Income Plus (Joint), Foundation 10, Automatic Income Builder, Flexible Lifetime Income (Single), Flexible Lifetime Income (Joint), Lifetime Income Access Plus, or Income Access Rider may be owned or in effect at the same time. Only one GPA 3, GPA 5, or GPA Rider may be owned or in effect at the same time.
 
The CHARGES, FEES AND DEDUCTIONS section is amended as follows:
 
The Optional Rider Charges subsection is amended to include the following:
 
CoreProtect Advantage Rider Charge
 
If you purchase this Rider, we will deduct an annual charge of 1.05% for the Rider from your Investment Options on a quarterly basis. The quarterly deduction is equal to 0.2625% multiplied by the Protected Payment Base and is deducted from your Contract Value every three months following the Rider Effective Date (“Quarterly Rider Anniversary”). The charge is deducted on a proportionate basis from your Investment Options (excluding the DCA Plus Fixed Option) every Quarterly Rider Anniversary that the Rider remains in effect and when the Rider is terminated.
 
If this Rider terminates on a Quarterly Rider Anniversary, the entire charge for the prior quarter will be deducted from the Contract Value on that anniversary. If the Rider terminates prior to a Quarterly Rider Anniversary, we will prorate the charge based on the Protected Payment Base as of the day the Rider terminates. Such prorated amount will be deducted from the Contract Value on the earlier of the day the Contract terminates or on the Quarterly Rider Anniversary immediately following the day the Rider terminates.
 
We will waive the charge if the Rider terminates as a result of the death of an Owner or sole surviving Annuitant, upon full annuitization of the Contract or when the Contract Value is zero. The charge is only waived for the quarter that we are notified of death or annuitization, even if death occurs in a prior quarter.
 
Change in Annual Charge  — The annual charge percentage may increase as a result of any Automatic Reset or Owner-Elected Reset. The annual charge percentage will not exceed the maximum annual charge percentage of 1.50% (0.375% quarterly). You may elect to opt-out of a Reset and your annual charge percentage will remain the same as it was before the Reset. If an Automatic Reset or Owner-Elected Reset never occurs, the annual charge percentage established on the Rider Effective Date is guaranteed not to change.
 
The OTHER OPTIONAL RIDERS section is amended as follows:
 
The General Information subsection is amended to include the following:
 
Taking a withdrawal before a certain age or a withdrawal that is greater than the allowed annual withdrawal amount under a particular Rider, may result in adverse consequences such as a reduction in Rider benefits or the failure to receive lifetime withdrawals under a Rider.
 
The Multiple Rider Ownership subsection is replaced with the following:
 
Only one CoreProtect Advantage, CoreIncome Advantage, Flexible Lifetime Income Plus (Single), Flexible Lifetime Income Plus (Joint), Foundation 10, Automatic Income Builder, Flexible Lifetime Income (Single), Flexible Lifetime Income (Joint), Lifetime Income Access Plus, or Income Access Rider may be owned or in effect at the same time. Only one GPA 3, GPA 5, or GPA Rider may be owned or in effect at the same time.



 

All references to rider exchanges concerning the riders listed in the table below are replaced with the following:
 
Withdrawal Benefit Rider Exchanges
 
Subject to availability, you may elect to exchange among the following withdrawal benefit Riders:
 
             
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.
 
 
When you elect an exchange, you are terminating your existing Rider and purchasing a new Rider. The Initial Protected Payment Base and Remaining Protected Balance under the new Rider will be equal to the Contract Value on that Contract Anniversary. Generally, if your Contract Value is lower than the Protected Payment Base under your existing Rider, your election to exchange from one rider to another may result in a reduction in the Protected Payment Base, Remaining Protected Balance, Protected Payment Amount and any Annual Credit that may be applied. In other words, your existing protected balances will not carryover to the new Rider. If you elect an exchange, you will be subject to the charge for the new Rider in effect at the time of the exchange. Only one exchange may be elected each Contract Year. In addition, there are withdrawal percentages, annual credit percentages, and lifetime income age requirements that differ between the Riders listed above. Work with your investment professional prior to electing an exchange.



 

Effective January 16, 2010, the Purchasing the Rider subsections of the Flexible Lifetime Income Plus (Single), Flexible Lifetime Income Plus (Joint), Flexible Lifetime Income (Single), Flexible Lifetime Income (Joint) and Automatic Income Builder Riders are replaced with the following:
 
This Rider is no longer available for purchase.
 
The following withdrawal benefit rider is added:
 
CoreProtect Advantage Rider
 
This optional Rider lets you, before the Annuity Date, withdraw up to 5% of your Protected Payment Base per year, lock in market gains, and provides the potential to withdraw up to the Protected Payment Amount for life, if certain conditions are met.
 
Purchasing the Rider
 
You may purchase this optional Rider on the Contract Date or on any Contract Anniversary (if available) if the age of each Owner and Annuitant is at least 55 and no greater than 85 years of age on the date of purchase, the Contract is not issued as an Inherited IRA or Inherited TSA, and you allocate your entire Contract Value according to the Investment Allocation Requirements.
 
Rider Terms
 
Annual Credit – An amount added to the Annual Credit Value.
 
Annual Credit Value – One of two values (the other value is the Highest Anniversary Value) that determine the Protected Payment Base prior to the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date.
 
The Annual Credit Value is increased each year by any Annual Credits, plus any subsequent Purchase Payments received from the most recent Contract Anniversary, during the periods described above.
 
The initial Annual Credit Value amount is equal to the initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or the Contract Value, if the Rider Effective Date is on a Contract Anniversary.
 
Annual RMD Amount – The amount required to be distributed each Calendar Year for purposes of satisfying the minimum distribution requirements of Code Section 401(a)(9) (“Section 401(a)(9)”) and related Code provisions in effect as of the Rider Effective Date.
 
Highest Anniversary Value – One of two values (the other value is the Annual Credit Value) that determine the Protected Payment Base prior to the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date.
 
The Highest Anniversary Value will equal the highest Contract Value on any Contract Anniversary, plus any subsequent Purchase Payments received after the date the Highest Anniversary Value was established, during the periods described above.
 
The initial Highest Anniversary Value amount is equal to the initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or the Contract Value, if the Rider Effective Date is on a Contract Anniversary.
 
Protected Payment Amount – The maximum amount that can be withdrawn under this Rider without reducing the Protected Payment Base.
 
If the oldest Owner is age 65 or older (or youngest Annuitant, in the case of a Non-Natural Owner) when the first withdrawal was taken or the most recent reset, whichever is later, the Protected Payment Amount on any day after the Rider Effective Date is equal to 5% multiplied by the Protected Payment Base as of that day, less cumulative withdrawals during the Contract Year.
 
If the oldest Owner is age 64 or younger (or youngest Annuitant, in the case of a Non-Natural Owner) when the first withdrawal was taken or the most recent reset, whichever is later, the Protected Payment Amount on any day after the Rider Effective Date is equal to the lesser of:
 
  •  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 Protected Payment Amount will never be less than zero. The Initial Protected Payment Amount on the Rider Effective Date is equal to 5% of the initial Protected Payment Base.
 
Protected Payment Base – An amount used to determine the Protected Payment Amount. The Protected Payment Base will never be less than zero and will remain unchanged except as otherwise described under the provisions of this Rider. The initial Protected Payment Base amount is equal to the initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or the Contract Value, if the Rider Effective Date is on a Contract Anniversary.
 
Remaining Protected Balance – The amount available for future withdrawals made under this Rider, unless withdrawals are guaranteed until the death of an Owner or sole surviving Annuitant. The Remaining Protected Balance will never be less than zero. The initial Remaining Protected Balance amount is equal to the initial Purchase Payment, if the Rider Effective Date is on the Contract Date, or the Contract Value, if the Rider Effective Date is on a Contract Anniversary.
 
Reset Date – Any Contract Anniversary after the Rider Effective Date on which an Automatic Reset or an Owner-Elected Reset occurs.
 
Rider Effective Date – The date the guarantees and charges for the Rider become effective. If the Rider is purchased within 60 days of the Contract Date, the Rider Effective Date is the Contract Date. If the Rider is purchased within 60 days of a Contract Anniversary, the Rider Effective Date is the date of that Contract Anniversary.
 
Adjustment to Protected Payment Base and Remaining Protected Balance Using the Annual Credit Value or Highest Anniversary Value
 
On each Contract Anniversary, while this Rider is in effect, before the Annuity Date, and before the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date,
 
the Protected Payment Base and Remaining Protected Balance will be equal to the greater of the Annual Credit Value or the Highest Anniversary Value. An increase to the Annual Credit Value or Highest Anniversary Value is not considered an Automatic Reset or an Owner-Elected Reset and will not result in a change to the annual charge percentage. In addition, once resets become available (after the first withdrawal or 10 Contract Anniversaries as described above), eligibility for the Annual Credit Value or Highest Anniversary Value adjustment cannot be reinstated by any Automatic or Owner-Elected Resets.
 
Subsequent Purchase Payments
 
Purchase Payments received after the Rider Effective Date and prior to the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date,
 
will result in an increase in the Annual Credit Value, Highest Anniversary Value, Protected Payment Base, and Remaining Protected Balance equal to the Purchase Payment amount.
 
Purchase Payments received after the Rider Effective Date and after the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date,
 
will result in an increase in the Protected Payment Base and Remaining Protected Balance equal to the Purchase Payment amount.
 
In addition, for purposes of this Rider, we reserve the right to restrict additional Purchase Payments that result in a total of all Purchase Payments received on or after the later of the first (1st) Contract Anniversary or most recent Reset Date to exceed $100,000 without our prior approval. This provision only applies if the Contract to which this Rider is attached, permits Purchase Payments after the first (1st) Contract Anniversary, measured from the Contract Date.
 
How the Rider Works
 
On any day, this Rider guarantees you can withdraw up to the Protected Payment Amount each contract year, regardless of market performance, until the Rider terminates. Lifetime withdrawals up to the Protected Payment Amount may continue after the Remaining Protected Balance is reduced to zero (0) 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 after the Rider Effective Date or the most recent Reset Date, whichever is later. If a withdrawal was taken at age 64 or younger and there was no subsequent Reset, the Rider will terminate once the Remaining Protected Balance is reduced to zero (0). This Rider also provides for a Highest Anniversary Value feature



 

and for an amount (an “Annual Credit”) to be added to the Annual Credit Value. Once the Rider is purchased, you cannot request a termination of the Rider (see the Termination subsection of this Rider for more information).
 
The Protected Payment Base and Remaining Protected Balance may change over time. The Annual Credit Value or the Highest Anniversary Value (whichever is greater) will increase the Protected Payment Base and the Remaining Protected Balance prior to the earlier of the first withdrawal since the Rider Effective Date or 10 Contract Anniversaries from the Rider Effective Date. An Automatic Reset or Owner-Elected Reset will increase or decrease the Protected Payment Base and Remaining Protected Balance depending on the Contract Value on the Reset Date. A withdrawal that is less than or equal to the Protected Payment Amount will reduce the Remaining Protected Balance by the amount of the withdrawal and will not change the Protected Payment Base. If a withdrawal is greater than Protected Payment Amount and the Contract Value is less than the Protected Payment Base, both the Protected Payment Base and Remaining Protected Balance will be reduced by an amount that is greater than the excess amount withdrawn. For withdrawals that are greater than the Protected Payment Amount, see the Withdrawal of Protected Payment Amount subsection.
 
For purposes of this Rider, the term “withdrawal” includes any applicable withdrawal charges. Amounts withdrawn under this Rider will reduce the Contract Value by the amount withdrawn and will be subject to the same conditions, limitations, restrictions and all other fees, charges and deductions, if applicable, as withdrawals otherwise made under the provisions of the Contract. Withdrawals under this Rider are not annuity payouts. Annuity payouts generally receive a more favorable tax treatment than other withdrawals.
 
If your Contract is a Qualified Contract, including a TSA/403(b) Contract, you are subject to restrictions on withdrawals you may take prior to a triggering event (e.g. reaching age 591/2, separation from service, disability) and you should consult your tax or legal advisor prior to purchasing this optional guarantee, the primary benefit of which is guaranteeing withdrawals. For additional information regarding withdrawals and triggering events, see the FEDERAL TAX ISSUES – IRAs and Qualified Plans section in the Prospectus.
 
Withdrawal of Protected Payment Amount
 
While this Rider is in effect, you may withdraw up to the Protected Payment Amount, regardless of market performance, until the Rider terminates. Any portion of the Protected Payment Amount not withdrawn during a Contract Year may not be carried over to the next Contract Year.
 
If a withdrawal does not exceed the Protected Payment Amount immediately prior to that withdrawal, the Protected Payment Base will remain unchanged. The Remaining Protected Balance will decrease by the withdrawal amount immediately following the withdrawal.
 
Withdrawals Exceeding the Protected Payment Amount.  If a withdrawal (except an RMD withdrawal) exceeds the Protected Payment Amount immediately prior to that withdrawal, we will (immediately following the excess withdrawal) reduce the Protected Payment Base on a proportionate basis for the amount in excess of the Protected Payment Amount. We will reduce the Remaining Protected Balance either on a proportionate basis or by the total withdrawal amount, whichever results in the lower Remaining Protected Balance amount. (See Sample Calculations—Example #4 for a numerical example of the adjustments to the Protected Payment Base, Remaining Protected Balance and Protected Payment Amount as a result of an excess withdrawal.) If a withdrawal is greater than the Protected Payment Amount and the Contract Value is less than the Protected Payment Base, both the Protected Payment Base and Remaining Protected Balance will be reduced by an amount that is greater than the excess amount withdrawn.
 
The amount available for withdrawal under the Contract must be sufficient to support any withdrawal that would otherwise exceed the Protected Payment Amount.
 
For information regarding taxation of withdrawals, see the FEDERAL TAX ISSUES section in the Prospectus.
 
Required Minimum Distributions
 
No adjustment will be made to the Protected Payment Base as a result of a withdrawal that exceeds the Protected Payment Amount immediately prior to the withdrawal, provided:
 
  •  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.
 
Immediately following an RMD Withdrawal, the Remaining Protected Balance will decrease by the RMD Withdrawal amount.
 
The Worker, Retiree, and Employer Recovery Act of 2008 provides for a temporary waiver of 2009 RMDs. If you elect to take your 2009 RMD (do not waive) then no adjustment will be made to the Protected Payment Base as a result of an excess withdrawal if the above requirements are satisfied.
 
See the FEDERAL TAX ISSUES – Qualified Contracts – General Rules – Required Minimum Distributions section in the Prospectus.
 
Depletion of Contract Value
 
If a withdrawal (including an RMD withdrawal) does not exceed the Protected Payment Amount immediately prior to the withdrawal and reduces the Contract Value to zero, the following will apply:
 
  •  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.
 
Depletion of Remaining Protected Balance
 
If a withdrawal (including an RMD Withdrawal) reduced the Remaining Protected Balance to zero and Contract Value remains, the following will apply:
 
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, 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.
 
Before your Remaining Protected Balance is zero, if you took your first withdrawal at age 64 or younger and you would like to be eligible for lifetime payments under the Rider, an Automatic or Owner-Elected Reset must occur and your first withdrawal after that Reset must be taken on or after age 65. See the Reset of Protected Payment Base and Remaining Protected Balance subsection of this Rider. If you are age 64 or younger when the Remaining Protected Balance is zero and Contract Value remains, the Rider will terminate and there is no opportunity for a Reset.
 
If a withdrawal (except an RMD withdrawal) made from the Contract exceeds the Protected Payment Amount, the Protected Payment Base will be reduced according to the Withdrawals Exceeding the Protected Payment Amount subsection.
 
Any death benefit proceeds to be paid to the Beneficiary from remaining Contract Value will be paid according to the Death Benefit provisions of the Contract.



 

Annual Credit
 
On each Contract Anniversary after the Rider Effective Date, an Annual Credit will be added to the Annual Credit Value until the earlier of:
 
  •  the first withdrawal from the Contract since the Rider Effective Date, or
 
  •  10 Contract Anniversaries measured from the Rider Effective Date.
 
The Annual Credit is equal to 5% of either:
 
  •  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.
 
Once a withdrawal (including an RMD Withdrawal) or 10 Contract Anniversaries has occurred, as measured from the Rider Effective Date, no Annual Credit will be added to the Annual Credit Value. In addition, Annual Credit eligibility cannot be reinstated by any Automatic or Owner-Elected Reset.
 
The Annual Credit is not added to your Contract Value.
 
Reset of Protected Payment Base and Remaining Protected Balance
 
A reset occurs when the Protected Payment Base and Remaining Protected Balance are changed to an amount equal to the Contract Value as of the Reset Date.
 
Automatic Reset. On each Contract Anniversary, while this Rider is in effect, before the Annuity Date, and after the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date,
 
we will automatically reset the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value, if the Protected Payment Base is less than the Contract Value on that Contract Anniversary. The annual charge percentage may change as a result of any Automatic Reset (see the CHARGES, FEES AND DEDUCTIONS – Optional Rider Charges section in this supplement).
 
Automatic Reset – Opt-Out Election. Within 60 days after a Contract Anniversary on which an Automatic Reset is effective, you have the option to reinstate the Protected Payment Base, Remaining Protected Balance, Protected Payment Amount and annual charge percentage to their respective amounts immediately before the Automatic Reset. Any future Automatic Resets will continue in accordance with the Automatic Reset paragraph above.
 
If you elect this option, your opt-out election must be received, in a form satisfactory to us, at our Service Center within the same 60 day period after the Contract Anniversary on which the reset is effective.
 
Automatic Reset – Future Participation. You may elect not to participate in future Automatic Resets at any time. Your election must be received, in a form satisfactory to us, at our Service Center, while this Rider is in effect and before the Annuity Date. Such election will be effective for future Contract Anniversaries.
 
If you previously elected not to participate in Automatic Resets, you may re-elect to participate in future Automatic Resets at any time. Your election to resume participation must be received, in a form satisfactory to us, at our Service Center while this Rider is in effect and before the Annuity Date. Such election will be effective for future Contract Anniversaries as described in the Automatic Reset paragraph above.
 
Owner-Elected Resets (Non-Automatic). You may, on any Contract Anniversary after the earlier of:
 
  •  the first withdrawal since the Rider Effective Date, or
 
  •  10 Contract Anniversaries from the Rider Effective Date,
 
elect to reset the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value. An Owner-Elected Reset may be elected while Automatic Resets are in effect. The annual charge percentage may change as a result of this Reset.
 
If you elect this option, your election must be received, in a form satisfactory to us, at our Service Center within 60 days after the Contract Anniversary on which the reset is effective. The reset will be based on the Contract Value as of that Contract Anniversary. Your election of this option may result in a reduction in the Protected Payment Base, Remaining Protected Balance and Protected Payment Amount. Generally, the reduction will occur when your Contract Value is less than the Protected Payment



 

Base as of the Contract Anniversary you elected the reset. You are strongly advised to work with your investment professional prior to electing an Owner-Elected Reset. We will provide you with written confirmation of your election.
 
Annuitization
 
If you annuitize the Contract at the maximum Annuity Date specified in your Contract and this Rider is still in effect at the time of your election and a Life Only fixed annuity option is chosen, the annuity payments will be equal to the greater of:
 
  •  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.
 
If you annuitize the Contract at any time prior to the maximum Annuity Date specified in your Contract, your annuity payments will be determined in accordance with the terms of your Contract. The Protected Payment Base, Remaining Protected Balance and Protected Payment Amount under this Rider will not be used in determining any annuity payments. Work with your financial professional to determine if you should annuitize your Contract before the maximum Annuity Date or stay in the accumulation phase and continue to take withdrawals under the Rider.
 
The annuity payments described in this subsection are available to you even if your first withdrawal was taken prior to age 65 and no Resets have occurred.
 
Continuation of Rider if Surviving Spouse Continues Contract
 
If the Contract Value or Remaining Protected Balance is zero when the Owner dies, the Rider will terminate. If the Contract Value and Remaining Protected Balance are greater than zero and the Owner dies while this Rider is in effect, the surviving spouse of the deceased Owner may elect to continue the Contract in accordance with its terms and the surviving spouse may continue to take withdrawals of the Protected Payment Amount under this Rider, until the Remaining Protected Balance is reduced to zero.
 
The surviving spouse may elect any of the reset options available under this Rider for subsequent Contract Anniversaries. If a reset takes place, then the provisions of this Rider will continue in full force and in effect for the surviving spouse. If the surviving spouse is 65 when a reset occurs, the surviving spouse may take withdrawals of the Protected Payment Amount (based on the new Protected Payment Base) for life.
 
The surviving spouse may elect to receive any death benefit proceeds instead of continuing the Contract and Rider (see the DEATH BENEFITS AND OPTIONAL DEATH BENEFIT RIDERS – Death Benefits section in the Prospectus).
 
Termination
 
You cannot request a termination of the Rider. Except as otherwise provided below, the Rider will automatically terminate on the earliest of:
 
  •  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 Rider will not terminate 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 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 Rider and the Contract will not terminate the day the Contract Value is zero and you begin taking pre-authorized withdrawals of the Protected Payment Amount. In this case, the Rider and the Contract will terminate:
 
  •  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.
 
Sample Calculations
 
The examples provided are based on certain hypothetical assumptions and are for example purposes only. Where Contract Value is reflected, the examples do not assume any specific return percentage. The examples have been provided to assist in understanding the benefits provided by this Rider and to demonstrate how Purchase Payments received and withdrawals made from the Contract prior to the Annuity Date affect the values and benefits under this Rider over an extended period of time. Any Credit Enhancement added to your Contract is not counted as a Purchase Payment and is not included when determining the guarantees under any of the optional living benefit riders. Any calculations for determining a Reset/Step-Up are based on Contract Value, which includes any Credit Enhancement. There may be minor differences in the calculations due to rounding. These examples are not intended to serve as projections of future investment returns nor are they a reflection of how your Contract will actually perform.
 
Example #1 – Setting of Initial Values.
 
The values shown below are based on the following assumptions:
 
  •  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
 
 
On the Rider Effective Date, the initial values are set as follows:
 
  •  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
 
Example #2 – Subsequent Purchase Payments.
 
The values shown below are based on the following assumptions:
 
  •  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
 
 
Immediately after the $100,000 subsequent Purchase Payment during Contract Year 1, the Annual Credit Value, Highest Anniversary Value, Protected Payment Base and Remaining Protected Balance are increased by the Purchase Payment amount to



 

$200,000 ($100,000 + $100,000). The Protected Payment Amount after the Purchase Payment is equal to $10,000 (5% of the Protected Payment Base after the Purchase Payment since there were no withdrawals during that Contract Year).
 
Since no withdrawal occurred prior to Year 2 Contract Anniversary, an annual credit of $10,000 (5% of total Purchase Payments) is applied to the Annual Credit Value on that Contract Anniversary, increasing it to $210,000. On Year 2 Contract Anniversary, the Protected Payment Base and Remaining Protected Balance are reset to $210,000, which is the greater of Annual Credit Value or Highest Anniversary Value. As a result, the Protected Payment Amount on that Contract Anniversary is equal to $10,500 (5% of the Protected Payment Base on that Contract Anniversary).
 
In addition to Purchase Payments, the Contract Value is further subject to increases and/or decreases during each Contract Year as a result of additional amounts credited, charges, fees and other deductions, and increases and/or decreases in the investment performance of the Variable Account.
 
Example #3 – Withdrawals Not Exceeding Protected Payment Amount.
 
The values shown below are based on the following assumptions:
 
  •  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
 
 
For an explanation of the values and activities at the start of and during Contract Year 1, refer to Examples #1 and #2.
 
As the withdrawal during Contract Year 2 did not exceed the Protected Payment Amount immediately prior to the withdrawal ($10,500):
 
  (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.
 
Because at Year 4 Contract Anniversary, the Protected Payment Base was less than the Contract Value on that Contract Anniversary (see balances at Year 4 Contract Anniversary – Prior to Automatic Reset), an Automatic Reset occurred which resets the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value (see balances at Year 4 Contract Anniversary – After Automatic Reset). The Protected Payment Amount is equal to $10,750 (5% of the reset Protected Payment Base).
 
As the withdrawal during Contract Year 4 did not exceed the Protected Payment Amount immediately prior to the withdrawal ($10,750):
 
  (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).
 
Because at Year 5 Contract Anniversary, the Protected Payment Base was less than the Contract Value on that Contract Anniversary (see balances at Year 5 Contract Anniversary – Prior to Automatic Reset), an Automatic Reset occurred which resets the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value (see balances at Year 5 Contract Anniversary – After Automatic Reset). The Protected Payment Amount is equal to $10,850 (5% of the reset Protected Payment Base).



 

Example #4 – Withdrawals Exceeding Protected Payment Amount.
 
The values shown below are based on the following assumptions:
 
  •  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
 
 
For an explanation of the values and activities at the start of and during Contract Year 1, refer to Examples #1 and #2.
 
Because the $20,000 withdrawal during Contract Year 2 exceeds the Protected Payment Amount immediately prior to the withdrawal ($20,000 > $10,500), the Protected Payment Base and Remaining Protected Balance immediately after the withdrawal are reduced. Since a withdrawal occurred, the Annual Credit Value and Highest Anniversary Value are no longer applicable.
 
The Values shown below are based on the following assumptions immediately before the excess withdrawal:
 
  •  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
 
A withdrawal of $20,000 was taken, which exceeds the Protected Payment Amount of $10,500 for the Contract Year. The Protected Payment Base and Remaining Protected Balance will be reduced based on the following calculation:
 
First, determine the excess withdrawal amount. The excess withdrawal amount is the total withdrawal amount less the Protected Payment Amount. Numerically, the excess withdrawal amount is $9,500 (Total withdrawal amount – Protected Payment Amount; $20,000 – $10,500 = $9,500).
 
Second, determine the ratio for the proportionate reduction. The ratio is the excess withdrawal amount determined above divided by (Contract Value – Protected Payment Amount). Numerically, the ratio is 4.65% ($9,500 ¸ ($215,000 – $10,500); $9,500 ¸ $204,500 = 0.0465 or 4.65%).
 
Third, determine the new Protected Payment Base. The Protected Payment Base will be reduced on a proportionate basis. The Protected Payment Base is multiplied by 1 less the ratio determined above. Numerically, the new Protected Payment Base is $200,235 (Protected Payment Base × (1-ratio); $210,000 × (1-4.65%); $210,000 × 95.35% = $200,235).
 
Fourth, determine the new Remaining Protected Balance. The Remaining Protected Balance is reduced either on a proportionate basis or by the total withdrawal amount, whichever results in the lower Remaining Protected Balance amount.
 
To determine the proportionate reduction, the Remaining Protected Balance immediately before the withdrawal is reduced by the Protected Payment Amount multiplied by 1 less the ratio determined above. Numerically, after the proportionate reduction, the new Remaining Protected Balance is $190,223 ((Remaining Protected Balance immediately before the withdrawal – Protected Payment Amount) × (1-ratio); ($210,000 – $10,500) × (1-4.65%); $199,500 × 95.35% = $190,223).
 
To determine the total withdrawal amount reduction, the Remaining Protected Balance immediately before the withdrawal is reduced by the total withdrawal amount. Numerically, after the Remaining Protected Balance is reduced by the total withdrawal amount, the new Remaining Protected Balance is $190,000 (Remaining Protected Balance immediately before the withdrawal – total withdrawal amount; $210,000 – $20,000 = $190,000).



 

Therefore, since $190,000 (total withdrawal amount method) is less than $190,223 (proportionate method) the new Remaining Protected Balance is $190,000.
 
The Protected Payment Amount immediately after the withdrawal is equal to $0 (5% of the Protected Payment Base after the withdrawal (5% of $200,235 = $10,011), less cumulative withdrawals during that Contract Year ($20,000), but not less than zero).
 
Because at Year 4 Contract Anniversary, the Protected Payment Base was less than the Contract Value on that Contract Anniversary (see balances at Year 4 Contract Anniversary – Prior to Automatic Reset), an automatic reset occurred which resets the Protected Payment Base and Remaining Protected Balance to an amount equal to 100% of the Contract Value (see balances at Year 4 Contract Anniversary – After Automatic Reset). The Protected Payment Amount is equal to $10,750 (5% of the reset Protected Payment Base).
 
Example #5 – RMD Withdrawals.
 
This is an example of the effect of cumulative RMD Withdrawals during the Contract Year that exceed the Protected Payment Amount established for that Contract Year and its effect on the Protected Payment Base and Remaining Protected Balance. The Annual RMD Amount is based on the entire interest of your Contract as of the previous year-end.
 
This table assumes quarterly withdrawals of only the Annual RMD Amount during the Contract Year. The calculated Annual RMD amount for the Calendar Year is $7,500 and the Contract Anniversary is May 1 of each year.
 
                         
            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
                       
 
 
Since the RMD Amount for 2008 increases to $8,000, the quarterly withdrawals of the RMD Amount increase to $2,000, as shown by the RMD withdrawal on March 15, 2008. Because all withdrawals during the Contract Year were RMD Withdrawals, there is no adjustment to the Protected Payment Base for exceeding the Protected Payment Amount. The only effect is a reduction in the Remaining Protected Balance equal to the amount of each withdrawal. In addition, each contract year the Protected Payment Amount is reduced by the amount of each withdrawal until the Protected Payment Amount is zero.
 
This chart assumes quarterly withdrawals of the Annual RMD Amount and other non-RMD Withdrawals during the Contract Year. The calculated Annual RMD amount and Contract Anniversary are the same as above.
 
                         
            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
 



 

On 3/15/07 there was an RMD Withdrawal of $1,875 and on 4/1/07 a non-RMD Withdrawal of $2,000. Because the total withdrawals during the Contract Year (5/1/06 through 4/30/07) did not exceed the Protected Payment Amount of $5,000 there was no adjustment to the Protected Payment Base. The only effect is a reduction in the Remaining Protected Balance and the Protected Payment Amount equal to the amount of each withdrawal. On 5/1/07, the Protected Payment Amount was re-calculated (5% of the Protected Payment Base) as of that Contract Anniversary.
 
On 11/15/07, there was a non-RMD Withdrawal ($4,000) that caused the cumulative withdrawals during the Contract Year ($7,750) to exceed the Protected Payment Amount ($5,000). As the withdrawal exceeded the Protected Payment Amount immediately prior to the withdrawal ($1,250), and assuming the Contract Value was $90,000 immediately prior to the withdrawal, the Protected Payment Base is reduced to $96,900 and the Remaining Protected Balance is reduced to $88,300. The Protected Payment Base and Remaining Protected Balance will be reduced based on the following calculation:
 
First, determine the excess withdrawal amount. The excess withdrawal amount is the total withdrawal amount less the Protected Payment Amount. Numerically, the excess withdrawal amount is $2,750 (Total withdrawal amount − Protected Payment Amount; $4,000 − $1,250=$2,750).
 
Second, determine the ratio for the proportionate reduction. The ratio is the excess withdrawal amount determined above divided by (Contract Value − Protected Payment Amount). Numerically, the ratio is 3.10% ($2,750 ¸ ($90,000 − $1,250); $2,750 ¸ $88,750 = 0.0310 or 3.10%).
 
Third, determine the new Protected Payment Base. The Protected Payment Base will be reduced on a proportionate basis. The Protected Payment Base is multiplied by 1 less the ratio determined above. Numerically, the new Protected Payment Base is $96,900 (Protected Payment Base × (1-ratio); $100,000 × (1-3.10%); $100,000 × 96.90% = $96,900).
 
Fourth, determine the new Remaining Protected Balance. The Remaining Protected Balance is reduced either on a proportionate basis or by the total withdrawal amount, whichever results in the lower Remaining Protected Balance amount.
 
To determine the proportionate reduction, the Remaining Protected Balance is reduced by the Protected Payment Amount multiplied by 1 less the ratio determined above. Numerically, after the proportionate reduction, the Remaining Protected Balance is $88,300 ((Remaining Protected Balance − Protected Payment Amount) × (1-ratio); ($92,375 − $1,250) × (1-3.10%); $91,125 × 96.90% = $88,300).
 
To determine the total withdrawal amount reduction, the Remaining Protected Balance is reduced by the total withdrawal amount. Numerically, after the Remaining Protected Balance is reduced by the total withdrawal amount, the Remaining Protected Balance is $88,375 (Remaining Protected Balance − total withdrawal amount; $92,375 − $4,000 = $88,375).
 
Therefore, since $88,300 (proportionate method) is less than $88,375 (total withdrawal amount method) the new Remaining Protected Balance is $88,300.
 
Example #6 – Lifetime Income.
 
The values shown below are based on the following assumptions:
 
  •  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
 
 
On the Rider Effective Date, the initial values are set as follows:
 
  •  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
 
Because the amount of each withdrawal does not exceed the Protected Payment Amount immediately prior to the withdrawal ($5,000): (a) the Protected Payment Base remains unchanged; and (b) the Remaining Protected Balance is reduced by the amount of each withdrawal.
 
Since a withdrawal occurred during Contract Year 1, no annual credit will be applied. Since it was assumed that the Owner was age 65 or older when the first withdrawal was taken, withdrawals of 5% of the Protected Payment Base will continue to be paid each year (even after the Contract Value and Remaining Protected Balance have been reduced to zero) until the day of the first death of an Owner or the date of death of the sole surviving Annuitant, whichever occurs first.



 

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

II-1



 

                 
      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

II-2



 

                 
      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

II-3



 

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).

II-4



 

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.

II-5



 

      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.
 

II-6



 

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.

II-7



 

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.

II-8



 

SIGNATURES

     Pursuant to the requirements of the Securities Act of 1933 and the Investment Company Act of 1940, the Registrant certifies that it meets the requirements of Securities Act Rule 485(b) for effectiveness of this Registration Statement and has caused this Post-Effective Amendment No. 16 to the Registration Statement on Form N-4 to be signed on its behalf by the undersigned thereunto duly authorized in the City of Newport Beach, and the State of California on this 15th day of December, 2009.
     
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
     Pursuant to the requirements of the Securities Act of 1933, this Post-Effective Amendment No. 16 to the Registration Statement has been signed below by the following persons in the capacities and on the dates indicated:
             
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
(Powers of Attorney are contained in this Registration Statement as Exhibit 14.)

II-9

 


Dates Referenced Herein   and   Documents Incorporated by Reference

This ‘485BPOS’ Filing    Date    Other Filings
1/16/10
Filed on / Effective on:12/15/09485BPOS
8/4/09485BPOS,  N-4
5/1/09485BPOS,  497
4/23/09485BPOS
12/31/0824F-2NT,  N-30D,  NSAR-U
12/4/08485BPOS
9/11/08485BPOS
3/15/08
12/31/0724F-2NT,  N-30D,  NSAR-U,  NT-NSAR
12/28/07485BPOS
4/20/07485BPOS
10/19/06485APOS
4/21/06485BPOS
10/17/05485APOS
4/18/05485BPOS
2/17/05485APOS
8/1/03N-4
7/1/98
 List all Filings 


5 Subsequent Filings that Reference this Filing

  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
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