Form of Income Test Drive Endorsement for Retirement Annuity Contracts. After-Tax Retirement Annuity Contracts, Supplemental Retirement Annuity Contracts and IRA Contracts (including Rollover IRA, Contributory IRA, Roth IRA, OneIRA)

EX-4.G 2 exhibit4g123117.htm EXHIBIT 4.G Exhibit
EXHIBIT 4(G)

Teachers Insurance and Annuity Association of America
730 Third Avenue, New York, NY 10017-3206
Telephone: [800 ###-###-####]
[Income Test Drive] Annuity Election Endorsement
[Effective Date: mo/day/year or upon receipt]
This endorsement is attached to, modifies, and becomes part of annuity contract number: [DA00000-0]
This endorsement covers only TIAA contract accumulation units, if any, applied to this [Income Test Drive] Election.
The purpose of this endorsement is to acknowledge your election of the [Income Test Drive] income option (“the [Income Test Drive] Election”) [with respect to the accumulations shown on page E3 from the above contract]. [The [Income Test Drive] Election is generally available if you are between ages [59½] [(or age [55] if you separate from service from the employer sponsoring the Employer Plan in or after the year you reach age 55)] and [88] and the Second Annuitant, if any, is less than age [88]. An Opt- Out will be triggered immediately upon discovery that the Endorsement has been issued to an ineligible contract.]
This endorsement also provides the detail regarding the [Income Test Drive] Election. For the amounts under the [Income Test Drive] Election, TIAA’s obligations under the contract are only as described in this endorsement. The terms and provisions of this endorsement are specific to the [Income Test Drive] Election and the amounts under the [Income Test Drive] Election and do not modify any terms or provisions pertaining to other amounts under the contract. Any terms not specifically defined in this endorsement should be understood as having the same meanings and applications that they otherwise have under the contract. Any other provisions of the underlying contract not addressed in this endorsement are applicable equally to the [Income Test Drive] Election as well as to other amounts under the contract. If, as pertains to amounts under the [Income Test Drive] Election, any provisions of this endorsement conflict with any provision of the underlying contract, this endorsement shall govern.
If any additional [Income Test Drive] Election covering additional accumulations from the contract is made subsequent to the effective date of this endorsement, a separate endorsement will be issued covering the terms of that election.
Note: This endorsement does not apply, and its provisions will have no effect, with respect to any contract issued in connection with a non-qualified deferred compensation plan, including, but not limited to, non-governmental 457(b) plans, 415(f) plans and 415(m) plans.
The provisions of the [Income Test Drive] Election do not apply to any accumulations held under the Traditional Annuity.


T-DA-OPT-E1
 
Page E 1


Your TIAA Deferred Annuity Endorsement

INDEX OF PROVISIONS
Section
Accumulation .............................................. 1
Accumulation Units
Number of .......................................... 7
Annuity Benefit
Choosing .......................................... 15
Number of Annuity Units ................ 17
Compliance with Laws and Regulations ... 24
Internal Transfer ..................................... 3, 20
Investment Account ..................................... 4
Lump-sum Benefit ................................. 5, 22
Minimum Distribution Amount ................... 6
Payment of ....................................... 13
No Separate Death Benefit ........................... 2
Opt-Out ................................................... 8, 18
[Income Test Drive] Payments
Amount ..........................................10, 11
Income Change Method ..................... 12
Spouse's Rights ............................................ 23
Transition Date ........................................ 9, 14



T-DA-OPT-E1
 
Page E 2


Your TIAA Deferred Annuity Endorsement

[Income Test Drive] Payments
TIAA Investment
Account

Accumulation Units
under the [Income
Test Drive] Election
Initial [Income Test
Drive] Payment
Income Change
Method
[TIAA Real Estate]
[500.000]
[$ 242.65]
[Monthly]
[TIAA Lifecycle
Retirement Income
Fund]
[100.000]
[$ 15.32]
[Monthly]
[TIAA Access Account
2]
[100.000]
[$ 17.01]
[Monthly]
[TIAA Access Account
3]
[300.000]
[$ 101.45]
[Monthly]

[TIAA has issued this endorsement in conjunction with proceeds applied to the [Income Test Drive]
Election from your companion CREF certificate. A companion CREF [Income Test Drive] Unit-Annuity
Election Endorsement has been issued under this Election.

Companion CREF Certificate Number: [C-000000-1/None]]

Date of First Periodic Payment: [07-01-2017]
Frequency of Payment: [Monthly]

Transition to a One-Life or Two-Life Unit-Annuity

Transition Date to [One-Life Unit-Annuity or Two-Life Unit-Annuity]: [07-01-2019]
On the Transition Date, the accumulation under the [Income Test Drive] Election will be converted to a
one-life or two-life unit-annuity, unless you have previously elected to Opt-Out of this [Income Test
Drive] Election. You may make this conversion before the Transition Date subject to forms and
procedures intended to provide an orderly transition from withdrawals to annuity payments. Payments
under the one-life or two-life unit-annuity may be greater or lesser than the payments under this [Income
Test Drive] Election.

The unit-annuity will be issued as follows, subject to any allowable modifications unless you Opt-Out
before the Transition Date.

[First] Annuitant: [Jane S. Public]
Date of Birth: [January 1, 1950]
SSN: [On File]
[Second Annuitant: [John Q. Public]
Date of Birth: [January 1, 1951]
SSN: [On File]]
Income Option: [Two-Life Unit-Annuity with Full Benefit to Survivor]
Issue Date: [July 1, 2019]
Guaranteed Period: [8 Years]
Date of Last Guaranteed Payment: [06 01 2027]
Beneficiary for Guaranteed Period: [Joan Public and James Public]
Frequency of Payment: [Monthly, quarterly, semi-annual or annual]

The number of annuity units payable will be determined on the Transition Date as described in Section 17
of this endorsement.

T-DA-OPT-E1
 
Page E 3


Your TIAA Deferred Annuity Endorsement



T-DA-OPT-E1
 
Page E 4


Your TIAA Deferred Annuity Endorsement

No change is allowed in the choice of the [First] Annuitant, [Second Annuitant,] Income Option, Issue
Date, Guaranteed Period and Date of Last Guaranteed Payment. Any correction to a Date of Birth shown
above on or after the Transition Date will be made under the provisions of the unit-annuity stated above.
Any such correction made before the Transition Date will result in a corresponding adjustment of the
[Income Test Drive] payments or trigger an Opt-Out under Part C of this Endorsement if you are
ineligible for the [Income Test Drive] Election after adjustment. You may change any other aspects of the
one-life or two-life unit-annuity stated above.

As of the effective date of this endorsement, the [Income Test Drive] Election is only available for
accumulations from the following Investment Account(s). [Your Employer Plan, if applicable, may
restrict your right to invest in some or all of the accounts:]
[TIAA Real Estate Account]

[TIAA Access Account Level [x] Subaccounts:
[Account 1]
[Account 2]
[Account 3]
.
.
.
.]

T-DA-OPT-E1
 
Page E 5


Your TIAA Deferred Annuity Endorsement

PART A: TERMS USED IN THIS ENDORSEMENT

1. Your accumulation under the [Income Test Drive] Election is the sum of the value of all
of your accumulation units in all of the Investment Accounts under the [Income Test
Drive] Election. Your accumulation will provide the benefits described in this
endorsement. Your accumulation under the [Income Test Drive] Election will remain
under the [Income Test Drive] Election until the Transition Date, unless there is an Opt-
Out. Unless otherwise specified, all references to accumulations in this endorsement refer
to accumulations under the [Income Test Drive] Election.

2. No separate death benefit is provided under the [Income Test Drive] Election. Upon your
death or the death of the Second Annuitant, if any, as provided in Part C, any remaining
accumulation units under this [Income Test Drive] Election will be released to the
contract. Upon your death, the death benefit under the contract (including the released
accumulation units) will then be paid.

3. An internal transfer is the movement of accumulations from one Investment Account
under the [Income Test Drive] Election to another, or between this contract and your
companion CREF certificate, if any, in connection with the [Income Test Drive] Election.

4. An Investment Account under the [Income Test Drive] Election refers to the Real Estate
Account or to any subaccount of any other Separate Account available under your
contract in accordance with the Employer Plan.
5. Except for withdrawals taken to satisfy the minimum distribution amount, a lump-sum
benefit is a withdrawal in a single sum of all or part of your accumulation under the
[Income Test Drive] Election.

6. The minimum distribution amount is the amount that is required under federal tax law
to be distributed to you for each calendar year for the accumulation under the [Income
Test Drive] Election. There is no minimum distribution amount for After Tax Retirement
Annuity (ATRA) contracts.

7. Number of accumulation units under the [Income Test Drive] Election. The number
of your accumulation units in each Investment Account under the [Income Test Drive]
Election is the number of units in each Investment Account applied to the [Income Test
Drive] Election as shown on page E3. For any Investment Account, the number of such
units:
A) Will be increased by any internal transfers to that Investment Account from your
accumulation in another Investment Account under the [Income Test Drive]
Election or from the [Income Test Drive] Election under your companion CREF
certificate;
B) May be increased by accumulation units purchased, after the issuance of this
endorsement, as a result of additional premiums remitted by your employer to
the contract.


T-DA-OPT-E1
 
Page E 6


Your TIAA Deferred Annuity Endorsement

And will be reduced by:
C) Any premium taxes deducted from that Investment Account in connection
with the [Income Test Drive] Election;
D) Payments made from that Investment Account under this [Income Test
Drive] Election;
E) [Any distribution of accumulation units from that Investment Account to
provide any form of payment of benefit;]
[F)] Any distribution of accumulation units from that Investment Account (in
addition to [Income Test Drive] payments) to satisfy the minimum
distribution requirements;
[G)] Any internal transfers from that Investment Account to your companion
CREF certificate or to another Investment Account under the [Income Test
Drive] Election;
[H)] The release of all accumulation units under the [Income Test Drive]
Election to the contract if you Opt-Out; and
[I)] The conversion of all accumulation units to an income benefit on the
Transition Date.
8. An Opt-Out of the [Income Test Drive] Election means any action described in Part C
that results in the termination of the [Income Test Drive] Election.

9. The Transition Date is the date (shown on page E3) on which the accumulation units
under the [Income Test Drive] Election are converted to annuity units and converted to a
one-life or two-life unit-annuity. After the Transition Date, all provisions of this [Income
Test Drive] Election will end.

PART B: [INCOME TEST DRIVE] PAYMENTS

10. Amount of [Income Test Drive] payments. The amount of the initial payment from
each Investment Account is shown on page E3. Payments will continue until the
Transition Date, unless you die prior to the Transition Date or Opt-Out.

11. Initially and on each [Income Test Drive] payment revaluation date before the Transition
Date, the amount of each payment is determined by dividing the value of your
accumulation units by the actuarial present value of a unit-annuity due of $1 payable
under the [Income Test Drive] Election. TIAA will use the same assumed net annual
investment return and mortality assumptions it currently uses on the payment revaluation
date to calculate payments under the income option selected. The amount will be
determined on the basis of:
A. The value of your accumulation units in each Investment Account under this
[Income Test Drive] Election;
B. The income option, payment frequency and any guaranteed period shown on page
E3;
C. Your age and the age of the Second Annuitant, if any, shown on page E3; and
D. The income change method.


T-DA-OPT-E1
 
Page E 7


Your TIAA Deferred Annuity Endorsement

12. Income Change Method. [Income Test Drive] payments are determined under one of
two income change methods.
Under the annual income change method, the amount of each [Income Test Drive]
payment is revalued each year. Currently, the payment changes on [May 1], based on the
accumulation as of the prior [March 31, or if March 31 is not a business day the prior
business day]. If you start your [Income Test Drive] payments in [April], your first
payment change will occur on [May 1] of the following year.
Under the monthly income change method, the amount of each [Income Test
Drive] payment is revalued every month. The payment amount is based on your
accumulation as of the valuation date of the prior month. Currently, the payment
valuation date for the monthly income change method is the [twentieth] day of a month
(or if the [twentieth] is not a business day, the prior business day) for [Income Test
Drive] payments due on the first day of the following month.
TIAA can modify the payment valuation date under either method and the date
the payment changes under the annual method. We can stop offering either the annual or
the monthly income change method.

13. Your accumulations under this [Income Test Drive] Election endorsement are subject to
minimum distribution requirements in accordance with IRC Sections 401(a)(9),
403(b)(10), 408(a)(6), 408(b)(3) or 457(d)(2) and related regulations. Any such required
payments of accumulation units under the [Income Test Drive] Election will not trigger
an Opt-Out. Any excess of such required payments over the [Income Test Drive] Election
payments will result in a corresponding reduction of future payments in accordance with
Section 11. This provision does not apply to ATRA contracts.

14. On the Transition Date your accumulation units will be converted to a one-life or two-life
unit-annuity as described on page E3, unless you have previously Opted-Out.

15. Choosing an annuity. When you choose the [Income Test Drive] Election, you must
select a one-life or two-life unit-annuity option provided in the contract. The one-life or
two-life unit-annuity you selected may be modified as provided in the contract to comply
with applicable laws & regulations on the Transition Date.
On the Transition Date, to begin annuity income under the option chosen, you
must satisfy all requirements of the contract for the particular one-life or two-life unitannuity
selected.
If your accumulation is subject to spousal rights, then your choice of an annuity is
subject to the right of your spouse, if any, to benefits as described in Part F.

16. A unit-annuity is a series of periodic payments based on a specified number of annuity
units payable at a stated payment frequency. Each unit-annuity payment is equal to the
then-current value of one annuity unit multiplied by the number of annuity units payable.
The value of each annuity unit will change either once each year or once each month
according to the income change method you select. The annuity unit is the basic unit of
payment for a unit-annuity. There is a separate and distinct annuity unit for each income
change method within each Investment Account. The annuity unit value for an account
and income change method is determined by multiplying the annuity unit value at the end
of the previous valuation day by the account's net investment factor for the valuation
period, and dividing the result by the value of $1.00 accumulated with interest over the

T-DA-OPT-E1
 
Page E 8


Your TIAA Deferred Annuity Endorsement

valuation period at an effective annual rate of [4%]. The resulting value is then adjusted
to reflect that annuity income amounts are redetermined only on the payment valuation
date for that income change method.

17. The number of annuity units in each Investment Account under your unit- annuity will
be determined as of the issue date of the unit-annuity by:
A) The value of your accumulation units in each Investment Account under
the [Income Test Drive] Election at that time;
B) The one-life or two-life unit-annuity option chosen, the payment
frequency, the income change method and any guaranteed period shown
on page E3;
C) Your age and the age of your Second Annuitant, if any; and
D) The value of each Investment Account's unit-annuity unit at that time.
If, prior to the Transition Date, you elect to convert all your accumulation units in
all Investment Accounts immediately into annuity units in those Investment Accounts for
your income change method, then any such election will also result in a corresponding
conversion of all your accumulation units held under the companion CREF [Income Test
Drive] Unit-Annuity Election Endorsement that has been issued in conjunction with this
endorsement.
TIAA will convert your accumulation units into a number of annuity units based
on the factors above which may result in unit-annuity payments that are greater or lesser
than the amount of your [Income Test Drive] payments. If you begin unit-annuity
payments before the Transition Date, then you will receive additional annuity units
reflecting the value of the remaining Opt-Out period. The number of annuity units you
will receive is based on the above factors and is calculated as follows.
Accumulation units will be converted into a number of annuity units equal to the
value of those accumulation units divided by the product of the annuity unit value and an
annuity factor equal to the present value of an annuity due of $1 payable under your
income option. To calculate this annuity factor, TIAA will use the same assumed net
annual investment return and mortality assumptions TIAA then uses to calculate
payments under the income option selected.
To comply with IRC Section 401(a)(9), we may make a supplemental payment to
you in the year the accumulations under this [Income Test Drive] Election are converted
to a one-life or two-life unit-annuity. The amount of any supplemental payment will
reduce the number of your accumulation units under the [Income Test Drive] Election
applied to the one-life or two-life unit-annuity.
If the amount of your one-life or two-life unit-annuity benefit will be less than
$100 per payment, TIAA will have the right to change the payment frequency so that the
amount of one-life or two-life unit-annuity benefit will be $100 or more with the shortest
interval between payments.

PART C: OPTING OUT

18. You may elect to terminate the [Income Test Drive] Election at any time before the
Transition Date, for any reason. The [Income Test Drive] Election may also terminate in
certain circumstances specified in the endorsement. Any such action, whether initiated by
you, the Employer Plan or occurring by operation of the terms of the endorsement, will
be referred to as an Opt-Out. The following actions will trigger or require an Opt-Out:

T-DA-OPT-E1
 
Page E 9


Your TIAA Deferred Annuity Endorsement

A. You terminate the [Income Test Drive] Election in a form acceptable to TIAA;
B. You transfer any accumulation units under the [Income Test Drive] Election to an
investment not eligible for the [Income Test Drive] Election;
C. You convert any accumulation units under the [Income Test Drive] Election to a
lifetime income annuity prior to the Transition Date;
D. You elect a lump-sum benefit of any accumulation units under the [Income Test
Drive] Election;
E. You elect to take a loan against any accumulation units under the [Income Test
Drive] Election;
F. When accumulation units under the [Income Test Drive] Election are awarded to
another individual as a result of a Qualified Domestic Relations Order;
G. You or the Second Annuitant, if any, die;
H. If your date of birth or the date of birth of the Second Annuitant, if any, under
which [Income Test Drive] payments are being made is incorrect, and you would
not be eligible for the [Income Test Drive] Election after the correction;
I. Any other action by you, the Employer Plan or TIAA that results in accumulation
units being removed from the [Income Test Drive] Election unless you transfer
such accumulation units to another investment eligible for the [Income Test
Drive] Election.
J. [Any action resulting in an Opt-Out of the accumulation units held under the
companion CREF [Income Test Drive] Unit-Annuity Election Endorsement that
has been issued in conjunction with this endorsement.]
Upon the effective date of any event triggering an Opt-Out, future [Income Test Drive]
Election payments will cease. In the event of an Opt-Out due to action C above, the
provisions of Section 17 will apply. Otherwise, any remaining accumulation units under
this [Income Test Drive] Election will be released to the contract and, except as otherwise
specified in this endorsement or required by law, all provisions of the [Income Test
Drive] Election will end.

19. If you Opt-Out as described in A-E of Section 18, you may not choose another [Income
Test Drive] Election until [12 months] after the Opt-Out.

PART D: INTERNAL TRANSFERS
20. Internal transfers. You may transfer some or all of your accumulation units from an
Investment Account under your [Income Test Drive] Election to purchase accumulation
units in one of the other Investment Accounts under your [Income Test Drive] Election,
or to your companion CREF certificate under the [Income Test Drive] Election, if any. If
you have an accumulation under the [Income Test Drive] Election in your companion
CREF certificate, you may transfer from that certificate to this contract. Any transfer to
or from CREF is subject to the terms of your companion CREF certificate and CREF's
Rules of the Fund.

You may transfer some or all of your accumulation units from an Investment
Account under your [Income Test Drive] Election to an Investment Account, contract or
other investment that is not under the [Income Test Drive] Election. If you elect a full or
partial transfer to an Investment Account, contract or other investment that is not under
the [Income Test Drive] Election, an Opt-Out will occur as of the effective date of the
transfer.

T-DA-OPT-E1
 
Page E 10


Your TIAA Deferred Annuity Endorsement

21. Internal transfer to a TIAA Traditional or CREF pay-out annuity. You may transfer
some or all of your accumulation units from an Investment Account under the [Income
Test Drive] Election to the Traditional Annuity to purchase a guaranteed lifetime annuity
income. You may also transfer some or all of your accumulation units from an
Investment Account under the [Income Test Drive] Election to your companion CREF
certificate, if any, to receive benefits under an income option available under that
certificate. Any such transfer will result in an Opt-Out. The provisions pertaining to such
transfers and the bases for determining the resulting benefits as described in your contract
for transfers of other accumulations under your contract, also apply to such transfers of
amounts from your [Income Test Drive] Election as well.

PART E: LUMP-SUM BENEFIT

22. Availability of lump-sum benefit. Lump-sum benefits are available from your
accumulations under the [Income Test Drive] Election to the same extent they are
otherwise available from other accumulations under your contract subject to the same
restrictions. If you elect a lump sum benefit you will Opt-Out of the [Income Test Drive]
Election.

PART F: GENERAL PROVISIONS
23. Spouse's right to benefits. If you are married, your spouse must consent to the [Income
Test Drive] Election and such consent will include any later Opt-Out. You and your
spouse may also be required to provide consents prior to the issuance of the One-Life or
Two-Life Unit-Annuity. This provision does not apply to ATRA contracts and any other
contracts that are not subject to survivor annuity requirements under federal law.
[Renewal of such consent will be required at the end of each two-year period until the
Transition Date.]

24. Compliance with laws and regulations. TIAA will administer your contract, as
modified by this endorsement, to comply with the restrictions of all laws and regulations,
as provided by the contract.


T-DA-OPT-E1
 
Page E 11