Premier Choice Annuity is no longer available for new contract issues.

If you are a current contract holder, or your client is a current contract holder, and you need assistance regarding renewal rates or other matters, please contact us at 800.888.2461.

Renewal Rates

Premier Choice Annuity Renewal Rates

February 7, 2022


Year 1: 2.00%
Year 2: 1.00%

3 Year*

Year 1: 2.00%
Years 2-3: 1.00%

*Includes an 1.00% interest rate bonus in Year 1.

5 Year:

Years 1-5: 2.00%

Guaranteed Minimum Interest Rate: 1.00%

Premier Choice Annuity Forms 

For help on filling out the forms, please view the instructions .

Annuitization Election of Option

For annuitizing your contract, designating Annuity Life and Non-Life options and Secondary Payee information. Select your investment basis, method and frequency of the payout, and tax withholding information.

Collateral Assignment

Use this form to assign a Non-Qualified Contract/Policy (the "Contract") as collateral.

Domestic Violence Confidential Communication

Form for victims of domestic violence in New York to submit a valid order of protection and request a confidential alternative means of communication. Use this form to provide an alternative address, telephone number or other method of contact.

Electronic Authorization

Use this form to activate electronic services such as telephone authorization. This authorization allows you to submit a one-time re-balance, an exchange between funds, change your future allocation and make address changes via the telephone.

Electronic Bank Information

For establishing the privilege to have payments made from your First Security Benefit Life Contract directly to your Bank Account. This form works similar to the Electronic Funds Transfer form, it enables you to transfer funds electronically.

Incoming Funds Transfer

For transferring assets from your Current Carrier to a First Security Benefit Life Annuity Contract.

Information Authorization

For replacing an existing life insurance policy or annuity contract with a First Security Benefit Life product.

One-Time Withdrawal

To make a one-time withdrawal from your account, please contact your Financial Representative or our Service Center (800.888.2461) to request a form.

Non-Financial Change (Name, Address, Beneficiary, etc.)

For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner, or Joint Owner of the Contract.

Proof of Death

For selecting how to handle proceeds, applying to receive payments electronically via Electronic Funds Transfer (EFT), and selecting Federal income tax options. Note: Every beneficiary is required to complete his or her own form in the case of a death benefit.

Reallocation of Assets

Use this form to indicate the guarantee period for a new allocation or to select the new guarantee period for reallocations.

Scheduled Systematic Withdrawals

To add or change Scheduled Systematic Withdrawal options, contact your Advisor or our Service Center (800.888.2461) to request a form.

Required Minimum Distribution

To add or change Required Minimum Distribution options, contact your Advisor or our Service Center (800.888.2461) to request a form.

Surrender Charge Waiver

For establishing privileges to withdraw funds from your contract without incurring a surrender penalty. Must meet requirements outlined on the form and in your contract. This form must accompany any withdrawal form requested under the Hospital/Nursing Home Waiver Option.

Scheduled Systematic Withdrawals

To add or change Scheduled Systematic Withdrawal options, contact your Financial Representative or our Service Center (800.888.2461) to request a form.

Restricted Beneficiary Designation Form (NY only)

This form should be used if you wish to place restrictions on the payout of your death benefit to your beneficiaries. This Beneficiary Designation supersedes any and all previous Beneficiary designations. Security Benefit suggests that you keep a copy of this form.


Form Completion Instructions
Please review these instructions prior to completing any of the forms online. The majority of our forms are designed in a fillable format so you may enter the required information online. If you experience problems and need assistance, please call our Service Center at 800.888.2461.

  • Select the form you wish to complete.
  • Enter the information into the fillable fields.
  • Save the form in a desired location on your computer.
  • Print a copy of the form.
  • Make sure you obtain all applicable signatures.
  • Return the form to First Security Benefit Life for processing. You may mail or fax the form.

First Security Benefit Life Administrative Office
P.O. Box 750497
Topeka, KS 66675-0497
Fax to: 785.368.1772

These forms are formatted in Adobe Acrobat. To view and print these forms, you will need the Adobe Acrobat "plug-in" for your browser. You may experience difficulties if you do not have the latest version installed on your computer. The link below will take you to the Adobe Acrobat site where you can download the "plug-in" free of charge.

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Plan for Retirement With One of Our Annuities

Whether you’re searching for options to save enough for retirement or to ensure your savings last long enough in retirement, First Security Benefit Life can help.

Explore Our Annuities

Annuities are long-term investments suitable for retirement investing. All guarantees provided in an annuity are subject to the claims-paying ability of the issuing insurer.

Annuities are not insured by the FDIC or otherwise insured or guaranteed by the Federal government or any of its agencies. They are not obligations of, or guaranteed by, any bank, savings and loan or credit union.

Annuities are issued by First Security Benefit Life Insurance and Annuity Company of New York (FSBL), Albany, NY. The Premier Choice Annuity® (form FSB233 (12-02)), is a flexible premium deferred fixed annuity issued by FSBL.

FSBL is not a fiduciary and the information provided is not intended to be investment advice. This information is general in nature and intended for use with the general public. For additional information, including any specific advice or recommendations, please visit with your financial professional.