Disclosures Annuity Guarantees - Annuity guarantees rely on the financial strength and claims-paying ability of Atlantic Coast Life Insurance Company. Additionally, the Participation Rates for the CS Momentum Index One-year point-to-point and Two-year point-to-point crediting strategies are guaranteed for 10 years from the annuity issue date, provided that Atlantic Coast Life Insurance Company continues to have access to the CS Momentum Index. The Participation Rates for the CS ESG Macro 5 Index One-year point-to-point and Two-year point-to-point crediting strategies are guaranteed for 10 years from the annuity issue date, provided that Atlantic Coast Life Insurance Company continues to have access to the CS ESG Macro 5 Index. Fixed Account - If you select the Fixed Account, this account will earn the current fixed interest rate which is guaranteed for each Contract Year and credited daily. Index Account Interest Rate Calculation - At the end of each crediting period, the index value (ending value) is compared to the index value at the beginning of each crediting period (beginning value). When the ending value is higher than the beginning value, interest is credited to the index account. When the ending value is lower than the beginning value, no interest will be credited. Index Crediting Strategies - Value in the index strategies will grow if the applicable index increases. Your potential earnings are either capped at a maximum interest rate or limited by a certain percentage of the index gain, depending on the terms and conditions of your index strategy. S&P 500 ® cap and participation rates, and CS Trigger Rates are subject to change after the first crediting period. Cap - If you select an index account utilizing a cap, the maximum index interest rate for the crediting period may not be more than the cap. Participation Rate - If you select an index account utilizing a participation rate, the interest rate is equal to the percentage increase in the index value over the crediting period multiplied by the participation rate. Trigger Rate - The minimum percentage of change in the CS Momentum Index required to receive the Trigger Account Interest Rate. Penalty Free Withdrawal - Up to the greater of 5% of the Accumulation Value or the Required Minimum Distribution may be withdrawn without any Surrender Charges, forfeiture of Nonvested Bonus, or Market Value Adjustment starting in year two. Nursing Home Waiver - Must be confined to a nursing home for a period of at least 90 consecutive days. There is a waiting period of one year. If the owner is confined to a nursing home during the waiting period, this benefit would not be available in certain states. Terminal Illness Waiver - Terminal illness is defined as any medical condition which a physician certifies that the contract owner’s expected life span is twelve months or less. Proof of the terminal illness is required by a certified licensed physician that is not the owner, annuitant, or a family member to the owner or annuitant. The owner cannot be terminally ill during the waiting period. There is a waiting period of one year. Vested Value - The Accumulation Value less the amount of Premium Bonus that is not vested using the following Vesting Schedule:
1
2
3
4
5
6 7 8
9 10 11+
Contract Year
Vesting
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Market Value Adjustments - The Market Value Adjustment (MVA) is specified in the contract. The MVA expires at the end of the Surrender Charge Period. Surrender Value - The Surrender Value is subject to Surrender Charges, Market Value Adjustment (MVA), forfeiture of Non-vested Premium Bonus, and Minimum Guarantee Surrender Value required by Standard Non-Forfeiture Law. Surrender Charges are calculated according to the following schedule:
1
2
3
4
5 6 7
8
9 10 11+
Contract Year
10 year
10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0%
Federal Income Tax Penalty - Any distribution taken prior to any owner’s age 59 1/2 may be subject to an additional 10% federal income tax penalty. Settlement Options - Lifetime Income Only and Lifetime Income with Guarantee Period Certain payments are calculated utilizing the Annuity 2012 IAR table and calculated at a 1% interest rate. Rate Enhancement Rider – Provides higher interest rates, caps, and participation rates. Also includes the ROP benefit and penalty free increase. Rider Fees - If you elect the Rate Enhancement Rider, there is an annual fee on each contract anniversary of 0.95% multiplied by the value in each crediting account and subtracted from the corresponding crediting account. Death Benefit - The total Death Benefit that would be payable to the beneficiary when the Owner or the Annuitant, if the Owner is not a natural person, dies before annuity payments begin. The Death Benefit is the greater of the Vested Value or the Minimum Guaranteed Surrender Value on the date of the Owner’s death. Minimum Guaranteed Surrender Value – (1) 87.5% of Purchase Premium; less (2) Any Withdrawal amount including any applicable Market Value Adjustment and Surrender/Withdrawal Charges; plus (3) interest credited at the Minimum Guaranteed Surrender Value Interest Rate shown on the Contract Data Page from date Purchase Premium is received and accepted by Atlantic Coast Life Insurance Company and will in no event be less than the present value, at time of surrender, of the Accumulation Value then guaranteed on the later of the 10th Contract Anniversary or the anniversary next following the Owner’s 70th birthday. The present value will be calculated on the basis of an interest rate 1% higher than the interest rate which was used to accumulate the Accumulation Value from the date of Surrender to the later of the 10th Contract Anniversary or the anniversary next following the Owner’s 70th birthday. The paid-up annuity, Cash Surrender Values and Death Benefit available under this Contract are not less than the minimum benefits required by the NAIC Standard Nonforfeiture Law for Individual Deferred Annuities, model #805. A detailed description of the method by which these values are computed has been filed with the Interstate Insurance Product Regulation Commission (IIPRC).
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ACLAPPBR-OT 092223
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