Savings Incentive Match Plan for Employees Individual Retirement Annuity Endorsement (Form No. E6004202NW) (SIMPLE IRA) is

EX-4.(B)(4) 8 d463873dex4b4.htm EX-4.(B)(4) EX-4.(B)(4)

Exhibit 4(b)(4)

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Home Office: Cincinnati, Ohio

Administrative Office: [P.O. Box 5420, Cincinnati, Ohio ###-###-####]

SAVINGS INCENTIVE MATCH PLAN FOR EMPLOYEES

INDIVIDUAL RETIREMENT ANNUITY

ENDORSEMENT

The annuity contract is changed as set out below to make it a SIMPLE Individual Retirement Annuity.

APPLICABLE TAX LAW RESTRICTIONS. This annuity contract is intended to receive contributions under a Savings Incentive Match Plan for Employees of Small Employers (“SIMPLE IRA plan”) that qualify for deferred tax treatment under Internal Revenue Code (“IRC”) Section 408(p). It is restricted as required by federal tax law. We may change the terms of this annuity contract or administer this annuity contract at any time as needed to comply with that law. Any such change may be applied retroactively.

EXCLUSIVE BENEFIT. This annuity contract is established for the exclusive benefit of you and your beneficiaries. Your interest in this annuity contract is nonforfeitable.

NON-PARTICIPATING. This annuity contract does not pay dividends or share in our surplus.

NO ASSIGNMENT OR TRANSFER. You cannot assign, sell, or transfer your interest in this annuity contract. You cannot pledge it to secure a loan or the performance of an obligation, or for any other purpose. The only exceptions to these rules are:

an interest in this annuity contract may be transferred to a spouse or former spouse under a divorce or separation instrument described in IRC Section 71(b)(2)(A); and

you may designate another person to receive payments with you based on joint lives or joint life expectancies, but any such designation shall not give that other person any present rights under the annuity contract during your lifetime.

CONTRIBUTIONS. This annuity contract does not require fixed premiums, purchase payments, or other contributions, but we may decline to accept any contribution of less than $50. This annuity contract will not lapse if contributions are not made for you. This annuity contract will remain subject to cancellation under any involuntary surrender or termination provision of this annuity contract; provided, however, that in no event shall any such cancellation occur unless, at a minimum, contributions have not been made for at least two (2) full contract years and the value of this annuity contract (increased by any guaranteed interest) would provide a benefit at age 70-1/2 of less than $20 a month under the regular settlement option.


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All contributions to us must be made in cash BY CHECK OR MONEY ORDER MADE PAYABLE TO US.

This annuity contract will only accept contributions made by an employer under a SIMPLE IRA plan that meets the requirements of IRC Section 408(p), and rollover contributions and transfers from another SIMPLE IRA owned by you. No other contributions to this annuity contract will be accepted.

ANNUAL REPORT. Following the end of each calendar year, we will send you a report concerning the status of your annuity contract. This report will include (i) the amount of all regular contributions received during or after the calendar year which relate to such calendar year; (ii) the amount of all rollover contributions received during such calendar year; (iii) the contract value(s) determined as of the end of such calendar year; (iv) such information concerning required minimum distributions as is prescribed by the Commissioner of Internal Revenue; and (v) such other information as may be required under federal tax law.

If contributions to this annuity contract are paid directly by your employer under a SIMPLE IRA plan, we will provide your employer with the summary description required by IRC Section 408(l)(2)(B).

DESIGNATED FINANCIAL INSTITUTION. If we are the designated financial institution for your employer’s SIMPLE IRA plan, as defined in IRC Section 408(p)(7), then you may direct that contributions paid on your behalf be transferred without cost or penalty to another SIMPLE IRA owned by you or to an IRA or other eligible retirement plan described in IRC Section 402(c)(8)(B), provided that you elect such a transfer either before the beginning of the calendar year to which such contribution relates or within the 60-day election period which includes the date you first become eligible to participate in the SIMPLE IRA plan.

LIMITS ON ROLLOVERS AND TRANSFERS; ADDITIONAL TAXES. During the first two (2) years that you participate in the SIMPLE IRA plan of your employer, any rollover or transfer otherwise permitted under this annuity contract must be made to another SIMPLE IRA owned by you. In some cases, any distribution to you during this two (2)-year period may be subject to a twenty-five (25) percent additional penalty tax if you do not roll over the amount distributed into a SIMPLE IRA. After the end of this two (2)-year period, a rollover or transfer otherwise permitted under this annuity contract may be made to another SIMPLE IRA owned by you or to an IRA or other eligible retirement plan described in IRC Section 402(c)(8)(B).

REQUIRED MINIMUM DISTRIBUTIONS DURING LIFE. All distributions made hereunder shall be made in accordance with the requirements of IRC Section 408(b)(3) and the regulations thereunder. If distributions are not made in the form of an annuity on an irrevocable basis (except for acceleration), then distribution of your entire interest in this annuity contract must satisfy the requirements of IRC Section 408(a)(6) and the regulations thereunder instead of the requirements set out herein.

The Required Beginning Date for distributions under this annuity contract is April 1 following the calendar year in which you reach age 70-1/2. No later than the Required Beginning Date, your entire interest in this annuity contract must begin to be distributed over (i) your life or the lives of you and your designated beneficiary, or (ii) a period certain not to exceed your life expectancy or the joint and last survivor expectancy of you and your designated beneficiary. Payments must be made in periodic payments at intervals of no longer than one year, and must be either nonincreasing or they may increase only as provided in Q&A-1 and Q&A-4 of Section 1.401(a)(9)-6T of the Temporary Income Tax Regulations. In addition, any distribution must satisfy the incidental benefit requirements specified in Q&A-2 of Section 1.401(a)(9)-6T of the Temporary Income Tax Regulations.


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The distribution period described above cannot exceed the period specified in Section 1.401(a)(9)-6T of the Temporary Income Tax Regulations. The first required payment can be made as late as the Required Beginning Date and must be the payment that is required for a single payment interval. The second payment need not be made until the end of the next payment interval.

Your interest in this annuity contract includes the amount of any outstanding rollover, transfer, or recharacterization under Q&A-7 or Q&A-8 of Section 1.408-8 of the Income Tax Regulations, and the actuarial value of any other benefits provided under the IRA, such as guaranteed death benefits, to the extent required by regulations.

For purposes of this provision, your designated beneficiary is an individual designated under this annuity contract to receive payments after your death and who qualifies as a designated beneficiary under Section 1.401(a)(9)-4 of the Income Tax Regulations.

REQUIRED MINIMUM DISTRIBUTIONS AFTER DEATH. If you die after required distributions begin, the remaining portion of your interest in this annuity contract will continue to be distributed under the contract option chosen.

If you die before required distributions begin, your entire interest in this annuity contract will be distributed as least as rapidly as follows:

If an individual other than your surviving spouse is your designated beneficiary, then your entire interest will be distributed over the remaining life expectancy of that individual, with payments starting by the end of the calendar year following the calendar year of your death. The life expectancy of the designated beneficiary will be determined using his or her age as of his or her birthday in the year following the year of your death. Alternatively, if elected, your entire interest in this annuity contract will be distributed by the end of the calendar year that contains the fifth anniversary of your death.

If your surviving spouse is your sole designated beneficiary, then your entire interest will be distributed over such spouse’s life, with payments starting by the end of the calendar year following the calendar year of your death, or if later, by the end of the calendar year in which you would have reached age 70-1/2. Alternatively, if elected, your entire interest in this annuity contract will be distributed by the end of the calendar year that contains the fifth anniversary of your death.

If your surviving spouse dies before required distributions begin to him or her, the remaining interest will be distributed over the remaining life expectancy of your spouse’s designated beneficiary, with payments starting by the end of the calendar year following the calendar year of your spouse’s death. The life expectancy of your spouse’s designated beneficiary will be determined using his or her age as of his or her birthday in the year following the death of your spouse. Alternatively, if elected, the remaining interest in this annuity contract will be distributed by the end of the calendar year that contains the fifth anniversary of your surviving spouse’s death.

If your surviving spouse dies after required distributions begin to him or her, any remaining interest will continue to be distributed under the contract option chosen.

If there is no designated beneficiary, then your entire interest in this annuity contract will be distributed by the end of the calendar year containing the fifth anniversary of your death.


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Life expectancy is determined using the Single Life Table in Q&A-1 of Section 1.401(a)(9)-9 of the Income Tax Regulations. If distributions are being made to your surviving spouse as your designated beneficiary, your spouse’s remaining life expectancy for a year is the number in the Single Life Table corresponding to such spouse’s age on his or her birthday in the year. In all other cases, remaining life expectancy for a year is the number in the Single Life Table in the year such individual’s life expectancy is first determined, reduced by one (1) for each subsequent year.

Required distributions are considered to begin on your Required Beginning Date or, if applicable, on the date distributions are required to begin to a surviving spouse. However, if distributions under this annuity contract start prior to such date on an irrevocable basis (except for acceleration) in a form meeting the requirements of Section 1.401(a)(9)-6T of the Temporary Income Tax Regulations, then required distributions are considered to begin on the annuity starting date.

For purposes of this provision, a designated beneficiary is an individual designated under this annuity contract to receive payments after your death (or the death of your surviving spouse) and who qualifies as a designated beneficiary under Section 1.401(a)(9)-4 of the Income Tax Regulations.

If your surviving spouse is the sole designated beneficiary, he or she may elect to treat this annuity contract as his or her own IRA. This election will be deemed to have been made if he or she becomes Successor Owner of this contract or fails to take distributions from this contract otherwise required by this provision. No contribution or rollover to this annuity contract may be made after your death unless your spouse becomes Successor Owner.

This is part of your annuity contract. It is not a separate contract. It changes the annuity contract only as and to the extent stated. In all cases of conflict with the other terms of the annuity contract, the provisions of this Endorsement shall control.

Signed for us at our office as of the date of issue.


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[MARK F. MUETHING]		[JOHN P. GRUBER]
[PRESIDENT]		[SECRETARY]


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