Beacon Data Entry

Company & Identity

COMPANY *

BENEFIT NAME *

INTERNAL BENEFIT NAME

DTCC RIDER ID

Dates & Status

INCEPTION DATE *

CLOSED DATE Must be on or after inception date

VERSION BEGIN DATE

Terminated

Life & Age

BASED ON LIFE *

RIDER SELECT RULE

MIN AGE Must be ≥ 0

MAX AGE Must be ≥ Min Age

WAITING PERIOD

WAITING TERM

Benefit Base

MAXIMUM BENEFIT BASE

MAXIMUM BENEFIT BASE %

WITH REDUCE BENEFIT BASE

Coverage Flags

Single Life Joint Life Exclude Premium Bonus Spousal Continuation Spousal Continuation Option

Description & Notes

BENEFIT DESCRIPTION

Available during accumulation phase. Upon death of annuitant, benefit will be greater of - 1) contract value, or 2) GMDB amount. Initial GMDB amount is total purchase payments made within three months after contract issue. GMDB amount is adjusted for withdrawals and increased by 1) additional purchase payments made and 2) increase for each valuation period, until annuitant's age 80, at 5% annually for values in variable portfolios or in one of asset allocation models. Values in Money Market Portfolio which are not in asset allocation models will accumulate at lesser of 5% or rate being credited to Money Market Portfolio or Fixed Accumulation Account. During free look period, a different rate may apply in certain states. Death benefit amount can never be more than 2 times of total purchase payments, adjusted for withdrawals. Withdrawals equal to or less than 5% of GMDB amount will reduce GMDB amount and maximum death benefit amount by dollar amount. Any withdrawals in excess of 5% of GMDB amount will reduce GMDB and maximum death benefit amounts in same proportion.

OTHER INFO

NOTES

VERSION NOTE

Lifecycle Events

CANCELLATION

TERMINATION

AVAILABLE WHEN ADDED

EFFECT CHANGE OWNERSHIP

State Availability

Exception

Not available in states

Edit Death Benefit

5% GMDBR80 Plus

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