Exhibit 4(a)



 EXHIBIT 4(a) 
 FORM OF POLICY 








			
	 




 A Stock Company (Hereafter called the Company, we, our or us)
	  	 Home Office:

4333 Edgewood Road N.E

Cedar Rapids, Iowa 52499
(319)355-8511



 


 ANNUITANT: 
 OWNER(S): 
 POLICY NUMBER: 

POLICY DATE: 

 



     


 


 


 WE AGREE 

 

	•	 	 To provide annuity payments as set forth in Section 10 of this policy, 



 

	•	 	 Or to pay withdrawal benefits in accordance with Section 5 of this policy, 



 

	•	 	 Or to pay death proceeds in accordance with Section 9 of this policy. 



These agreements are subject to the provisions of this policy. This policy is issued in consideration of the payment of the initial
premium. 
 Withdrawals may be subject to an excess interest adjustment reflecting changes in interest rates in accordance with
Section 5 of this policy. Transfers and amounts applied to an income option may also be subject to an excess interest adjustment in accordance with Sections 5, 8, and 10, respectively, of this policy.



 20 DAY RIGHT TO CANCEL 

You may cancel this policy by delivering or mailing a written notice or sending a telegram to us or your agent. You must return the
policy before midnight of the twentieth day after the day you receive it. Notice given by mail and return of the policy by mail are effective on being postmarked, properly addressed, and postage prepaid. 

We will pay you an amount equal to the sum of: 
  

	•	 	 the premiums paid; 


  

	•	 	 less prior withdrawals, if any; plus or minus 


  

	•	 	 the accumulated gains or losses, if any, in the separate account on the date of cancellation; 



unless otherwise required by law.


 

  
 Signed for us at our
home office. 
  

			
	



	  	




	SECRETARY	  	PRESIDENT

 This policy
is a legal contract between the policyowner and the Company. 
 READ YOUR POLICY CAREFULLY 

FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY 
 INCOME PAYABLE AT ANNUITY COMMENCEMENT DATE 
 BENEFITS BASED ON THE
PERFORMANCE OF THE SEPARATE ACCOUNT ARE 
 VARIABLE AND ARE NOT GUARANTEED 

AS TO DOLLAR AMOUNT (SEE SECTIONS 6 AND 10C) 
 NON-PARTICIPATING 
 AV1117 101 185 104 














 SECTION 1 – DEFINITIONS 

 


 ADJUSTED POLICY VALUE - The policy value increased or decreased by any excess
interest adjustment. 
 ANNUITANT - The person whose life annuity payments will be based on. 

ANNUITY COMMENCEMENT DATE - The date the payments under an income option will begin. This date may be changed by the owner
as described in Section 11. 
 CASH VALUE - The amount, defined in Section 5, that is available for partial or
full surrenders. 
 CUMULATIVE EARNINGS - An amount equal to the policy value at the time a lump sum payout or systematic
payout option payout is made, minus the sum of all premium payments reduced by all prior partial withdrawals deemed to have been from premium, if any. 
 CUSTODIAL CARE - Care designed essentially to help a person with the activities of daily living which does not require the continuous attention of trained medical or paramedical personnel.

 DISTRIBUTION - A disbursement of funds from the policy value or cash value. Policy value and cash value will be
reduced by any distribution. 
 EARNINGS - The gains, if any, in the policy value. 

FIXED ACCOUNT GUARANTEED MINIMUM EFFECTIVE ANNUAL INTEREST RATE - The minimum guaranteed credited rate used to determine the fixed
account portion of your policy value prior to the annuity commencement date. This rate will apply for the life of the policy and is shown on the Policy Data page.



 GAINS - Cumulative earnings, if any, in the policy value. 

HOSPITAL - An institution which 1) is operated pursuant to the laws of the jurisdiction in which it is located, 2) operates
primarily for the care and treatment of sick and injured persons on an inpatient basis, 3) provides 24-hour nursing service by or under the supervision of registered graduate professional nurses, 4) is supervised by a staff of one or more licensed
physicians, and 5) has medical, surgical and diagnostic facilities or access to such facilities. 
 INCOME OPTIONS -
Options as described in Section 10. 
 INVESTMENT OPTIONS - Any of the guaranteed fixed account options and any
of the subaccounts of the separate account 
 MINIMUM NONFORFEITURE INTEREST RATE - The interest rate shown on the policy
data page and which is used to determine the minimum required cash value as defined in your state’s nonforfeiture law. This rate is not the credited rate used to determine your policy’s cash value, but rather to develop the minimum cash
value required by the law of your state. 
 MINIMUM REQUIRED CASH VALUE - The minimum amount required to be paid on
surrender in accordance with your state’s nonforfeiture law. This minimum value is calculated according to a method described in the law, which is different than the method described in the policy used to determine your policy’s cash
value. 

 


  

					
	AVB1117	  	Page 2	  	









 SECTION 1 – CONTINUED 

 


 NURSING CARE - Care prescribed by a physician and performed or supervised by a
registered graduate nurse. Such care includes nursing and rehabilitation services available 24 hours. 
 NURSING FACILITY -
A facility which 1) is operated pursuant to the laws of the jurisdiction in which it is located, 2) provides care prescribed by a physician and performed or supervised by a registered graduate nurse on a 24 hour basis, or provides care designed
essentially to help a person with the activities of daily living which does require the continuous attention of trained medical or paramedical personnel, and 3) is not, other than incidentally, a hospital, a home for the aged, a retirement home, a
rest home, a community living center or a place mainly for the treatment of alcoholism, mental illness, or drug abuse. 

PAYEE - The person to whom annuity payments will be made. 

PHYSICIAN - Doctor of Medicine or Doctor of Osteopathy who is licensed as such and operating within the scope of the license.

 POLICY ANNIVERSARY - The anniversary of the policy date for each year the policy remains in force. 

POLICY DATE - The date shown on the Policy Data page of this policy and the date on which this policy becomes effective.



 POLICY VALUE - Amount defined in Section 4, that can be used to fund one of the
income options. 
 POLICY YEAR - The 12-month period following the policy date shown on the Policy Data page. The first
policy year starts on the policy date. Each subsequent year starts on the anniversary of the policy date. 
 SEPARATE ACCOUNT
- The separate investment account(s) established by us, as described in Section 6. 
 SUBACCOUNT - A division of
the separate account, as described in Section 6. 
 SURRENDER - A partial or full withdrawal of funds from the
policy value or cash value. 
 TERMINAL CONDITION - A condition resulting from an accident or illness which, as
determined by a physician, has reduced life expectancy to not more than 12 months, despite appropriate medical care. 

WITHDRAWAL - A disbursement of funds from the policy value or cash value. Policy value and cash value will be reduced by any
distribution. 
 YOU, YOUR - The owner of this policy. Unless otherwise specified, the annuitant and the owner shall be
one and the same person. If a joint owner is named, reference to “you” or “your” in this policy will apply to both the owner and joint owner.


 


  

					
	AVB1117B	  	Page 2(A)	  	









 SECTION 2 – POLICY DATA 

 

									
					
	POLICY NUMBER:	 		  	ANNUITANT:	  		  	
					
	 INITIAL PREMIUM

PAYMENT:
	 		  	ISSUE AGE/SEX:	  	                /	  	
					
	POLICY DATE:	 		  	OWNER(S):	  		  	
					
	ANNUITY	 		  		  		  	
	COMMENCEMENT	 		  	GUARANTEED	  		  	
	DATE:	 		  	MINIMUM	  		  	
		 		  	DEATH BENEFIT	  		  	
		 		  	OPTION:	  	        RETURN OF PREMIUM	  	
					
	BENEFICIARY:	 		  		  		  	

  

							
	 Fixed Account Guaranteed Minimum Effective Annual Interest Rate:         1.50%

				
	 Minimum Nonforfeiture Interest Rate:            1.00%
	  		  		  	
				
	 Before the Annuity Commencement Date:
	  		  		  	
	
	 Mortality and Expense Risk Fee and Administrative Charge:
        0.65%

				
	 After the Annuity Commencement Date:
	  		  		  	
	
	 Mortality and Expense Risk Fee and Administrative Charge:
        0.60%


 The amount paid on surrender will never be less than the greatest of the following three amounts: 1) 100%
of premium payments made to the fixed account less prior withdrawals and transfers from the fixed account, 2) cash value described in Section 5, and 3) minimum required cash value, described in Section 5, and determined in accordance with
the provisions in your state’s nonforfeiture law at the time of issue. 

  

					
	AV1114SP	  	Page 3	  	









 SECTION 3 – PREMIUM PAYMENTS 

 


 PAYMENT OF PREMIUMS 
 Premium payments may be made any time while this policy is in force before the annuity commencement date. You may start or stop, increase or decrease, or skip any premium payments. 

MAXIMUM AND MINIMUM PREMIUM PAYMENT 
 The minimum initial premium payment is $5,000. If this policy is being issued in connection with certain tax-qualified plans (such as IRAs, pension plans, or specially sponsored programs), the minimum
initial premium payment is $1,000. No minimum initial premium payment will be required for 403(b) annuities. The minimum subsequent premium payment we will accept is $50. The maximum total premium payments which we will accept without prior company
approval is $1,000,000 for issue ages 0-80. For issue ages over 80, the maximum total premium payments which we will accept without prior company approval is $500,000. The premium payments may not be more than the amount permitted by law if this is
a tax-qualified annuity. We reserve the right to refuse any subsequent premium payment. 
 PREMIUM PAYMENT DATE 

The premium payment date is the date on which the premium payment is credited to the policy. The initial premium payment less any
applicable premium taxes will be credited to the policy within two business days of receipt of the premium payment and the information needed. Subsequent additional premium payments, less any applicable premium taxes, will be credited to the policy
as of the business day the premium 


 payment and required information are received. A business day is any day that the New York
Stock Exchange is open for trading. 
 ALLOCATION OF PREMIUM PAYMENTS 

We will allocate your premium payment to the investment options you select. Your allocation must be in whole percentages and must total
100%. We will generally allocate subsequent premium payments the same way unless you request a different allocation. 
 CHANGE OF ALLOCATION

 You may change the allocation of premium payments to various investment options by providing us notice containing the
facts that we need. Premium payments received after the date on which we receive your notice will be applied on the basis of the new allocation. 
 PREMIUM TAXES 
 Any taxes paid by us to any governmental entity relating to
this policy will be deducted from the premium payment or policy value when incurred. We will, at our sole discretion, determine when taxes relate to the policy, including when they have resulted from: the investment experience of the separate
account; receipt by us of the premium payments; or commencement of annuity payments. We may, at our sole discretion, pay taxes when due and deduct that amount from your policy value at a later date. Payment at an earlier date does not waive any
right we may have to deduct amounts at a later date. We will deduct any withholding taxes required by applicable law. 

 

  
 SECTION 4 –
POLICY VALUE 

 


 POLICY VALUE 
 On or before the annuity commencement date, the policy value is the sum of your separate account value and your fixed account value, minus service charges, premium taxes, rider fees, and transfer fees, if
any. 
 ADJUSTED POLICY VALUE 
 The adjusted policy value is the policy value increased or decreased by any excess interest adjustment. 
 You may use the adjusted policy value on the annuity commencement date to provide lifetime income or income for a period of no less than 60 months under the income options in Section 10.



 SERVICE CHARGE 
 On each policy anniversary and at the time of full surrender during any policy year before the annuity commencement date, we reserve the right to assess a service charge up to $35 for policy
administration expenses. The service charge will be deducted from each investment option in proportion to the portion of policy value (prior to such charge) in each investment option. In no event will the service charge exceed 2% of the policy value
on the policy anniversary or at the time of full surrender. 
 The service charge will not be deducted on a policy anniversary
or at the time of full surrender if, at that time, ( 1) the sum of all premium payments less the sum of all withdrawals taken equals or exceeds $50,000; or (2) the policy value equals or exceeds $50,000.


 


  

					
	M1730	  	Page 4	  	









 SECTION 5 – CASH VALUE AND PARTIAL WITHDRAWALS 

 


 CASH VALUE 
 On or before the annuity commencement date, the cash value is equal to the adjusted policy value. Information on the current amount of your policy’s cash value is available upon request. The cash
value may be partially withdrawn or will be paid in the event of a full surrender of the policy. We must receive your written partial withdrawal or surrender request before the annuity commencement date. After the annuity commencement date, there is
no cash value. 
 EXCESS INTEREST ADJUSTMENT 
 Full surrenders, partial withdrawals, transfers, and amounts applied to a payment option (prior to the end of any guaranteed period option) from guaranteed period options of the fixed account described in
Section 7 will be subject to an excess interest adjustment except as provided for in the partial withdrawals provision below. 
 An excess interest adjustment also applies when death proceeds are calculated. However, if the net effect of all excess interest adjustments is negative, we will not reduce the death proceeds. 

The excess interest adjustment is based on any change in interest rates from the time the affected guaranteed period option started until
the time the excess interest adjustment occurs. The excess interest adjustment is applied as follows: 
  

	1)	 The excess interest adjustment is only applied when the transactions occur prior to the end of any guaranteed period option;



  

	2)	 Transfers to the guaranteed period options of the fixed account are considered premium payments for purposes of determining the excess interest
adjustment; 


  

	3)	 If interest rates have decreased from the time the affected guaranteed period(s) started until the time the transaction occurs, the excess interest
adjustment will result in additional funds available to you;






	4)	 If interest rates have increased from the time the affected guaranteed period(s) started until the time the transaction occurs, the excess interest
adjustment will result in a decrease in the funds available to you; 


  

	5)	 Certain amounts are not subject to the excess interest adjustment as provided in Sections 5, 7, and 8; 



 

	6)	 The excess interest adjustment for each guaranteed period option will not reduce the adjusted policy value for that guaranteed period option below
the amount paid into that guaranteed period option, less any prior withdrawals and transfers from that guaranteed period option, as they occur, all accumulated at the Fixed Account Guaranteed Minimum Effective Annual Interest Rate shown on Page 3.



 The formula for determining the amount of the excess interest adjustment is as follows: 

 

					
	 Excess Interest Adjustment = S x (G–C) x (M/ 12)

	 where:
	  	S	  	 is the amount (before premium taxes, if any) being surrendered, partially withdrawn, transferred, or applied to a payment option that is subject to the excess
interest adjustment

			
		  	 G
	  	 is the guaranteed interest rate for the guaranteed period applicable to “S”,

			
		  	 C
	  	 is the current guaranteed interest rate then being offered on new premium payments for the next longer guaranteed period than “M”. If this policy
form or such a guaranteed period option is no longer offered, “C” will be the U.S. Treasury rate for the next longer maturity (in whole years) than “M” on the 25th day of the previous calendar month, plus up to
2%.

			
		  	 M
	  	 is the number of months remaining in the guaranteed period for “S”, rounded up to the next higher whole number of months.


 
 


  

					
	U1730	  	Page 5	  	









 SECTION 5 – CONTINUED 

 


 PARTIAL WITHDRAWALS 
 We will pay you a portion of the cash value as a partial withdrawal provided we receive your written request while the policy is in effect and before the annuity commencement date. Partial withdrawals
will be deducted in proportion to the amount of policy value in each investment option unless you tell us otherwise. If your request for a partial withdrawal from any investment option is less than or equal to the cash value in that option, we will
pay the amount of your request. However, if your request for a partial withdrawal from any investment option is greater than the cash value in that option, we will pay you the cash value of that investment option. 

The gross partial withdrawal is the total amount which will be deducted from your policy value as a result of each partial withdrawal.
The gross partial withdrawal may be more or less than your requested partial withdrawal amount, depending on whether excess interest adjustments apply at the time you request the partial withdrawal. 

The formula for determining the gross partial withdrawal is as follows: 
 Gross Partial Withdrawal R – E where: 
  

	R	 is the requested partial withdrawal; 



	E	 is the excess interest adjustment. 


 If any partial withdrawal reduces the cash value below $500, we reserve the right to pay the full cash value and terminate the policy. 

We may (with prior authorization from the commissioner) delay payment of the cash value from the fixed account for up to 6 months after
we receive the surrender or partial withdrawal request. If the annuitant dies before a surrender or partial withdrawal is processed, the request will be processed before the death proceeds are determined. 

Partial withdrawals in the amount of the cumulative interest in the guaranteed period option(s) of the fixed account at the time of
withdrawal may be withdrawn from the GPO(s) of the fixed account free of any excess interest adjustment.



 Amounts withdrawn under one of the options below may reduce the amount available under
another option. Excess interest adjustment may be waived as described below: 
 LUMP SUM 

Beginning in the first policy year, partial withdrawals are available as lump sum distributions in one or more withdrawals during a policy
year. 
 Any of these withdrawals taken from the fixed account in excess of cumulative earnings will be subject to an excess
interest adjustment. The minimum withdrawal is $500. 
 SYSTEMATIC PAYOUT OPTION 

Beginning in the first Policy Year, a Systematic Payout Option (SPO) is available on a monthly, quarterly, semi-annual or annual basis. At
the time a SPO payout is made, such payout must be at least $50 and may not exceed the maximum of A and B, divided by the number of payouts made per year (e.g. 12 for monthly). 

 

	A	 is the Cumulative Earnings, if any, in the Policy Value and 



 

	B	 is an amount equal to 10% of the premium payments. 


 No Excess Interest Adjustment will apply to the SPO payout. Monthly and quarterly payouts must be sent through electronic funds transfer directly to a checking or savings account. You may start or stop
SPO payouts at any time; however, 30 days’ written notice is required to stop SPO payouts. 
 Once you have elected a SPO,
you must wait a minimum time before the first SPO payment: 1 month for monthly, 3 months for quarterly, 6 months for semi-annual, or 12 months for annual.


 


  

					
	P1694	  	Page 6	  	









 SECTION 5 – CONTINUED 

 


 MINIMUM REQUIRED DISTRIBUTION 

Partial withdrawals taken to satisfy minimum distribution requirements with respect to this policy under Section 401 (a)(9) of the
Internal Revenue Code are available. 
 Systematic minimum required distributions must be at least $50 or a lump sum
distribution is available if systematic minimum required distributions are less than $50. 
 NURSING CARE AND TERMINAL CONDITION WITHDRAWAL
OPTION 
 Beginning in the first policy year, if the owner or owner’s spouse (annuitant or annuitant’s spouse if
the owner is not a natural person) has been 1) confined in a hospital or nursing facility for 30 consecutive days or 2) diagnosed as having a terminal condition and the confinement begins or diagnosis is made on or after the policy date, you may
elect to withdraw all or a portion of the policy value without an excess interest adjustment. The minimum withdrawal under this option is $1000. This option is available even during the policy years other partial withdrawal options were exercised
prior to nursing care. 
 For nursing care, we must receive each withdrawal request and proof of eligibility with each request
no later than 90 days following the date that confinement has ceased, unless it can be shown that it was not reasonably possible to provide the notice and proof within the above time period and that the notice and proof were given as soon as
reasonably possible. However, in no event, except the absence of legal capacity, shall the notice and proof be provided later than one year following the date that confinement has ceased. Proof of confinement may be a physician’s statement or a
statement from a hospital or nursing facility administrator. 
 For a terminal condition, we must receive each withdrawal
request and the applicable proof of eligibility no later than one year following diagnosis of the terminal condition. Proof of a terminal condition is required only with the initial withdrawal request and must be furnished by the owner’s,
owner’s spouse’s, annuitant’s, or annuitant’s spouse’s physician. 
 UNEMPLOYMENT WAIVER 

Beginning in the first policy year, you may withdraw all or a portion of the policy value free of any excess interest adjustment if the
owner or owner’s spouse (annuitant or annuitant’s spouse, if the owner is not a natural person) becomes unemployed. In order to qualify, you 1) must have been employed full-time for at least two years prior to your becoming unemployed, 2)
must have been employed full-time on your policy date, 3) must have been unemployed for at least 60 consecutive days at the time of



 
withdrawal and 4) must have a minimum cash value at the time of withdrawal of $5000. Proof of unemployment will consist of providing us with a determination letter from the applicable
State’s Department of Labor, which verifies that you qualify for and are receiving unemployment benefits at the time of withdrawal. The determination letter must be received by us no later than 15 days following the date of the withdrawal
request. 
 GUARANTEED RETURN OF FIXED ACCOUNT PREMIUM PAYMENTS 
 Upon full surrender of the policy, you will always receive at least the premium payments made to, less prior withdrawals and transfers from, the fixed account. 

MINIMUM VALUES 
 Benefits
available under this policy, including any paid up annuity or death benefits that may be available, are not less than those required by any statute of the state in which the policy is delivered. 

MINIMUM REQUIRED CASH VALUE 
 This amount is prescribed by your state’s minimum cash value law, and is the minimum amount required to be paid to you on surrender. 

The minimum amount is determined differently than your policy’s cash value, and is described on the Policy Data page. The minimum
amount is calculated according to a procedure specified in your state’s law using a prescribed Minimum Nonforfeiture Interest Rate, which will be fixed and not less than 1% (nor more than 3%) on the policy date, such rate determined as follows:

 On the policy date, the Minimum Nonforfeiture Interest Rate is equal to an “average Five Year Constant Maturity Treasury
rate” less 1.25%, but the result will not be less than 1% nor more than 3%. The averaged rate is determined by averaging the daily Treasury rates for the first 10 business days of the month immediately preceding the calendar quarter in which
your policy is issued. The average of these ten Treasury rates is rounded to the nearest 0.05% before the deduction of 1.25% occurs. For example, if your policy was issued on any business day during the third calendar quarter, your minimum
nonforfeiture interest rate would be determined by averaging the first ten business days’ Five Year Constant Maturity Treasury rates for the month of June during the same calendar year, rounding that result to the nearest 0.05%, then deducting
1.25% (with the resulting rate not being less than 1% nor more than 3%). 

 


  

					
	PB1694	  	Page 7	  	









 SECTION 6 – SEPARATE ACCOUNT 

 


 SEPARATE ACCOUNT 
 We have established and will maintain one or more separate accounts, under the laws of the state of Iowa. Any realized or unrealized income, net gains and losses from the assets of the separate account
are credited to or charged against it without regard to our other income, gains, or losses. Assets are put in the separate account for this policy, as well as for other variable annuity policies. Any separate account may invest assets in shares of
one or more mutual fund portfolio, or in the case of a managed separate account, direct investments in stocks or other securities as permitted by law. Fund shares refer to shares of underlying mutual funds or prorata ownership of the assets held in
a subaccount of a managed separate account. Fund shares are purchased, redeemed, and valued on behalf of the separate account. 

The separate account is divided into subaccounts. Each subaccount invests exclusively in shares of one of the portfolios of an underlying
fund. We reserve the right to add or remove any subaccount of the separate account. 
 The assets of the separate account are
our property. These assets will equal or exceed the reserves and other contract liabilities of the separate account. These assets will not be chargeable with liabilities arising out of any other business we conduct. We reserve the right, subject to
regulations governing the separate account, to transfer assets of a subaccount, in excess of the reserves and other contract liabilities with respect to that subaccount, to another subaccount or to our general account.



 We will determine the fair market value of the assets of the separate account in accordance
with a method of valuation, which we establish in good faith. Valuation period means the period of time from one determination of the value of each subaccount to the next. Such determinations are made when the value of the assets and liabilities of
each subaccount is calculated. This is generally the close of business on each day on which the New York Stock Exchange is open. You bear the entire investment risk for all amounts you allocate to the separate account. 

We also reserve the right to transfer assets of the separate account, which we determine to be associated with the class of policies to
which this policy belongs, to another separate account. If this type of transfer is made, the term “separate account”, as used in the policy, shall then mean the separate account to which the assets were transferred. 

We also reserve the right, when permitted by law, to: 
  

	(a)	 deregister the separate account under the Investment Company Act of 1940; 



 

	(b)	 manage the separate account under the direction of a committee at any time; 



 

	(c)	 restrict or eliminate any voting rights of policy owners or other persons who have voting rights as to the separate account;



  

	(d)	 combine the separate account with one or more other separate accounts; 



 

	(e)	 create new separate accounts; 


  

	(f)	 add new subaccounts to or remove existing subaccounts from the separate account, or combine subaccounts; and 



 

	(g)	 add new underlying mutual funds, remove existing mutual funds, or substitute a new fund for an existing fund.




 


  

					
	V1587	  	Page 8	  	









 SECTION 6 – CONTINUED 

 


 The net asset value of a fund share is the per-share value calculated by the mutual fund
or, in the case of a managed separate account, by the Company. The net asset value is computed by adding the value of the subaccount’s investments, cash and other assets, subtracting its liabilities, and then dividing by the number of shares
outstanding. Net asset values of fund shares reflect investment advisory fees and other expenses incurred in managing a mutual fund or a managed separate account 
 CHANGE IN INVESTMENT OBJECTIVE OR POLICY OF A MUTUAL FUND 
 If required by
law or regulation, an investment policy of the separate account will only be changed if approved by the appropriate insurance official of the state of Iowa or deemed approved in accordance with such law or regulation. If so required, the process for
obtaining such approval is filed with the insurance official of the state or district in which this policy is delivered. 
 CHARGES AND
DEDUCTIONS 
 The mortality and expense risk fee and the administrative charge are each deducted both before and after the
annuity commencement date to compensate for changes in mortality and expenses not anticipated by the mortality and administration charges guaranteed in the policy. The service charge is deducted prior to the annuity commencement date only.

 If the mortality and expense risk fee is more than sufficient, the Company will retain the balance as profit or may reduce
this fee in the future. 
 ACCUMULATION UNITS 
 The policy value in the separate account before the annuity commencement date is represented by accumulation units. The dollar value of accumulation units for each subaccount will change from business day
to business day reflecting the investment experience of the subaccount. Accumulation units shall be used to account for all amounts allocated to or withdrawn from a subaccount of the separate account as a result of premium payments, partial
withdrawals, transfers, or fees and charges. 
 Transfers and premium payments allocated to the subaccounts will be applied to
provide accumulation units in those subaccounts. The number of accumulation units purchased in a subaccount will be determined by dividing the



 
dollar amount allocated to or transferred to that subaccount, by the value of an accumulation unit for that subaccount on the premium payment or transfer date. 

The number of accumulation units withdrawn or transferred from the subaccounts will be determined by dividing the dollar amount withdrawn
or transferred by the value of an accumulation unit for that subaccount on the withdrawal or transfer date. 
 We set the
initial accumulation unit value for each subaccount. Subsequent accumulation unit values for each subaccount are determined by multiplying the accumulation unit value for the immediately preceding valuation period by the new investment factor of the
subaccount for the current valuation period. 
 The net investment factor used to calculate the value of an accumulation unit in
each subaccount for the valuation period is determined by dividing (a) by (b) and subtracting (c) from the result, where: 
  

	(a)	 is the result of: 


  

	 	(1)	 the net asset value of a fund share held in that subaccount determined as of the end of the current valuation period; plus



  

	 	(2)	 the per share amount of any dividend or capital gain distributions made by the fund for shares held in that subaccount if the ex-dividend date
occurs during the valuation period; plus or minus 


  

	 	(3)	 a per share credit or charge for any taxes reserved for, which we determine to have resulted from the investment operations of that subaccount



  

	(b)	 is the net asset value of a fund share held in that subaccount determined as of the end of the immediately preceding valuation period.



  

	(c)	 is a factor representing the mortality and expense risk fee and administrative charge before the annuity commencement date. This factor is less than
or equal to, on an annual basis, the percentage shown on the Policy Data page of the daily net asset value of a fund share held in that subaccount. 


 Since the net investment factor may be greater or less than one, the accumulation unit value may increase or decrease.


 


  

					
	VB1587	  	Page 9	  	









 SECTION 7 – FIXED ACCOUNT 

 


 FIXED ACCOUNT 
 The fixed account is comprised of guaranteed period options and the dollar cost averaging fixed account option that we may choose to offer. Premium payments applied to and any amounts transferred to the
fixed account will reflect a fixed interest rate. The interest rates we set will be credited for increments of at least one year measured from each premium payment or transfer date. These rates will never be less than the Fixed Account Guaranteed
Minimum Effective Annual Interest Rate shown on Page 3. 
 Upon full surrender of the policy, the cash value will never be less
than that required by the nonforfeiture laws of your state. 
 We reserve the right, at our sole discretion, to refuse premium
payments or transfers allocated to any of the fixed account options. 
 GUARANTEED PERIOD OPTIONS 

We may offer Guaranteed Period Options in the fixed account, into which premium payments may be paid or amounts transferred. The current
interest rate we set for funds entering each guaranteed period option is guaranteed until the end of that option’s guaranteed period. At that time, the premium payment made or amount transferred into the guaranteed period option, less any
withdrawals or transfers from that guaranteed period option, plus accrued interest, may be rolled into a new guaranteed period option (subject to availability of any guaranteed period option for such rollovers) or may be transferred to any
subaccount(s) within the separate account(s). 
 You may choose the investment option(s) you want the funds transferred into by
giving us a written notice within 30 days before the end of the expiring option’s guaranteed period. However, any available guaranteed period elected may not extend beyond the maximum annuity commencement date defined in Section 11. In the
absence of such election, the funds will be rolled into a new guaranteed period option which is the same as the expiring guaranteed period option unless that guaranteed period option is no longer offered. In that case, the funds will be rolled into
the next shorter guaranteed period option available, otherwise the next longer guaranteed period option available. You will be mailed a notice of completion of the rollover with the new interest rate applicable. The new guaranteed period option will
be deemed as accepted if we do not 


 receive a written rejection within 30 days from the postmark date of the completion notice.
We reserve the right, at our sole discretion, for new premium payments or transfers to offer or not to offer any guaranteed period option If we do not offer a guaranteed period option and we have not received directions from you in a form and manner
acceptable to us, how the premium payments or funds transferred are to be allocated, the funds will be placed in any available fixed account option at the lowest crediting rate then applicable, or otherwise may be refused as a fixed account
premium/transfer. If that occurs, we will require instructions as to which subaccounts to allocate such premiums/transfers. 

When funds are withdrawn or transferred from a guaranteed period option, the policy value associated with the oldest premium payment or
transfer is considered to be withdrawn or transferred first. If the amount withdrawn or transferred exceeds the policy value associated with the oldest premium, the policy value associated with the next oldest premium payment or transfer is
considered to be withdrawn or transferred next, and so on until the policy value associated with the most recent premium payment or transfer is considered to be withdrawn or transferred. 

Partial withdrawals, surrenders, transfers (except those transfers made at the end of a guaranteed period option), and amounts applied to
an income option from the guaranteed period option(s) are subject to an excess interest adjustment as described in Section 5. 
 DOLLAR
COST AVERAGING FIXED ACCOUNT OPTION 
 We may offer a dollar cost averaging fixed account option separate from the guaranteed
period options. This option will have a one-year interest rate guarantee. The current interest rate we set for the dollar cost averaging fixed account may differ from the rates credited on the one-year guaranteed period option in the fixed account
In addition, the current interest rate we credit may vary on different portions of the dollar cost averaging fixed account The credited interest rate will never be less than the Fixed Account Guaranteed Minimum Effective Annual Interest Rate shown
on Page 3. The dollar cost averaging fixed account option will only be available under a dollar cost averaging program as described in Section 8.


 


  

					
	L1170	  	Page 10	  	









 SECTION 8 – TRANSFERS 

 



	A.	TRANSFERS BEFORE THE ANNUITY COMMENCEMENT DATE 

 Prior to the annuity commencement date, you may transfer the policy values from one investment option to another by notifying us in a form and manner acceptable to us. 

Transfers of policy value from the guaranteed period options of the fixed account prior to the end of that guaranteed period option are
subject to an excess interest adjustment No excess interest adjustment will apply to policy value transfers at the end of a guaranteed period. 
 If the excess interest adjustment at the time of such policy value transfer results in a decrease in the funds available to you, then the maximum policy value transfer is 25% of that guaranteed period
option’s policy value, less policy values previously transferred out of that guaranteed period option during the current policy year. Each such transfer must be separated by a period of 12 months. 

If the excess interest adjustment at the time of such policy value transfer result in additional funds available to you, no maximum will
apply to such policy values transferred from the guaranteed period option. 
 Transfers of policy value from the separate
account are subject to a minimum of $500 or the entire subaccount policy value, if less. However, if the remaining subaccount policy value is less than $500, we reserve the right to include that amount as part of the transfer. 

Transfers of interest credited in the guaranteed period options to other Investment Options are allowed on a “First-In,
First-Out” basis. Such transfers may be made monthly, quarterly, semi-annually, or annually. Each such transfer must be at least $50 and will not be subject to an excess interest adjustment 

You may choose which guaranteed period option to transfer to or from, however, any guaranteed period option elected may not extend beyond
the maximum annuity commencement date defined in Section 11. 
 We reserve the right to limit transfers to no more than 12
in anyone policy year. Any transfers in excess of 12 per policy year may be charged a $10 per transfer fee. Transfers among multiple investment options will be treated as one transfer in determining the number of transfers that have occurred.
We also reserve the right, at our sole discretion, to refuse transfers allocated to any of the fixed account options.



 This policy is not designed for professional market timing organizations or other persons
that use programmed, large, or frequent transfers. The use of such transfers may be disruptive to an underlying portfolio. We reserve the right to reject any transfer request from any person in the interest of overall fund management or, if, in our
judgment, an underlying fund would be unable to invest effectively in accordance with its investment objectives and policies or would otherwise be potentially adversely affected or if an underlying fund would reject our purchase order. We also
reserve the right to revoke your telephone, fax, and electronic transfer privileges at any time without revoking all owner’s telephone, fax and electronic transfer privileges. 
 DOLLAR COST AVERAGING OPTION 
 Prior to the annuity commencement date, you
may instruct us to automatically transfer a specified amount from source accounts made available by us to any other subaccount(s) of the separate account The automatic transfers can occur monthly or quarterly. You may change the subaccounts to which
these transfers are allocated as permitted by us from time to time. 
 Transfers will continue until the elected source account
is depleted. The amount transferred each time must be at least $500. All transfers from the source account will be the same amount as the initial transfer. Transfers must be scheduled for at least 6 months, but not more than 24 months or for at
least 4 quarters, but not more than 8 quarters each time the dollar cost averaging program is started or restarted following termination of the program for any reason. 
 Dollar cost averaging results in the purchase of more accumulation units when the value of the accumulation unit is low, and fewer accumulation units when the value of the accumulation unit is high.
However, there is no guarantee that the dollar cost averaging program will result in higher policy values or will otherwise be successful. 
 Dollar cost averaging may be discontinued before its scheduled completion by sending written notice to us. If dollar cost averaging is discontinued prior to the end of the scheduled period, all remaining
funds in the dollar cost averaging fixed account will be transferred at that time. Unless we are notified otherwise the funds remaining in the dollar cost averaging fixed account will be transferred to the subaccounts in the percentages currently
indicated. While dollar cost averaging is in effect, asset rebalancing is not available. 

 


  

					
	LB1170	  	Page 11	  	









 SECTION 8 – CONTINUED 

 


 ASSET REBALANCING 
 Prior to the annuity commencement date, you may instruct us to automatically transfer amounts among the subaccounts of the separate account on a regular basis to maintain a desired allocation of the
policy value among the various subaccounts offered. Rebalancing will occur on a monthly, quarterly, semi-annual, or annual basis, beginning on a date selected by you. You must select the percentage of the policy value desired in each of the various
subaccounts offered (totaling 100%). Any amounts in the fixed account are ignored for the purposes of asset rebalancing. Rebalancing can be started, stopped or changed at any time. Asset rebalancing is not available while dollar cost averaging is in
effect Rebalancing will cease as soon as we receive a request for any other transfer.




	B.	TRANSFERS AFTER THE ANNUITY COMMENCEMENT DATE 

 After the annuity commencement date, you may transfer the value of the variable annuity units from one subaccount to another within the separate account or to the fixed account. If you want to transfer
the value of the variable annuity units, you must provide a signed notice, containing the facts that we need. We reserve the right to limit transfers between the subaccounts or to the fixed accounts to once per policy year. 

The minimum amount which may be transferred is the lesser of $10 monthly income or the entire monthly income of the variable annuity
units in the subaccount from which the transfer is being made. If the monthly income of the remaining units in a subaccount is less than $10, we have the right to include the value of those variable annuity units as part of the transfer. 

After the annuity commencement date, no transfers may be made from the fixed account to any other investment options.


 

  
 SECTION 9 –
DEATH PROCEEDS 

 



	A.	DEATH PROCEEDS PRIOR TO ANNUITY COMMENCEMENT DATE 

 The amount of death proceeds will be the greatest of (a), (b) or (c), where: 
  

	(a)	 is the policy value on the date we receive due proof of death and an election of a method of settlement; 



 

	(b)	 is the cash value on the date we receive due proof of death and an election of a method of settlement; and 



 

	(c)	 is the guaranteed minimum death benefit, if any, plus any additional premium payments received, less any gross partial withdrawals, from the date of
death to the date of payment of death proceeds. 


 Until the death proceeds are paid, the policy value will
remain in the subaccounts as previously specified by the owner or as reallocated pursuant to instructions received by us from all beneficiaries (due proof of death is required before we will accept such instructions). Therefore, the policy value
(and cash value) will fluctuate with the investment performance of the applicable subaccounts and accordingly, the amount of the death proceeds will also vary until the proceeds are paid. 
 For purposes of this policy, proof of death means: 
  

	(a)	 a certified copy of the death certificate; or 


  

	(b)	 a certified copy of a decree of a court of competent jurisdiction as to a finding of death; and 



 

	(c)	 any other proof or other documents required by us.





 Where there are joint annuitants, the death proceeds becomes payable only upon the death of
the surviving annuitant, subject to the distribution requirements under Subsection C.II. below. 
 If You have not directed how
death proceeds are to be paid by the date of death, the beneficiary may make such election within one year of the date we receive due proof of the owner’s or annuitant’s death as described in Subsection C below. The beneficiary may elect
to receive the death proceeds as a lump sum or in payments as described in Subsection C below. We will pay interest on death proceeds as required by law. 
 We must distribute death proceeds or continue making payments under an income option under this annuity policy as required in Internal Revenue Code Section 72(s). The requirements of Internal Revenue
Code Section 72(s) will override any provision of this policy to the contrary. 
  

	B.	 GUARANTEED MINIMUM DEATH BENEFIT 


 The amount of the guaranteed minimum death benefit, if any, is based on the guaranteed minimum death benefit option shown on the policy data page. The guaranteed minimum death benefit is only payable upon
the annuitant’s death. You may not change the guaranteed minimum death benefit option after we issue the policy. 

 


  

					
	D593	  	Page 12	  	









 SECTION 9 – CONTINUED 

 



	C.	 DEATH PRIOR TO ANNUITY COMMENCEMENT DATE 


 Payment of death proceeds depends on the relationships between the owner, annuitant, and beneficiary as outlined below. 
 If there are surviving owners, the surviving owners automatically take the place of any beneficiary designation. 
  

	I.	 Annuitant Death 


 When we have due proof that the annuitant died before the annuity commencement date, the death proceeds are payable to the beneficiary. If no beneficiary is designated and there is no surviving owner, the
owner’s estate will become the beneficiary. 
  

	 	a)	 When the beneficiary is the deceased annuitant’s surviving spouse. The beneficiary may elect to continue this policy as owner and
annuitant rather than receiving the death proceeds. If the policy is continued, an amount equal to the excess, if any, of the guaranteed minimum death benefit over the policy value will then be added to the policy value pro rata according to the
amount of policy value in each Investment Option at that time. This is a one-time only policy value adjustment applied at the time the policy is continued, and the guaranteed minimum death benefit previously selected will continue on as applicable.



 If the beneficiary elects to have the death proceeds paid rather than continue the policy,
the death proceeds must be distributed pursuant to subsections b)(1) and (2) below. 
  

	 	b)	 When the beneficiary is an individual who is not the deceased annuitant’s surviving spouse. The death proceeds must be distributed:



  

	 	(1)	 by the end of 5 years after the date of the deceased annuitant’s death; or 



 

	 	(2)	 payments must begin no later than one year after the deceased annuitant’s death and must be made for a period certain or for this
beneficiary’s lifetime, so long as any period certain does not exceed this beneficiary’s life expectancy (as defined by the Internal Revenue Code and regulations adopted under that Code). Election of this option must be made at least 60
days prior to the one year anniversary of the annuitant’s death.






	 	c)	 When the beneficiary is not a natural person. The death proceeds must be distributed within 5 years after the annuitant’s death.



  

	II.	 Owner Death 


 If the deceased owner is also the annuitant, Subsection C.I. “Annuitant Death” above applies. 
 If an owner or joint owner who is not an annuitant dies prior to the annuity commencement date and before the entire interest in the policy is distributed, the successor owner as defined below will become
the new owner, and no death proceeds are payable. The person or entity first listed below who is alive or in existence on the date of that death will become the successor owner: 

 

	 	a)	 surviving owner; 


  

	 	b)	 primary beneficiary; 


  

	 	c)	 contingent beneficiary; or 


  

	 	d)	 deceased owner’s estate. 


 The successor owner will need to take distributions according to a), b), or c) below: 
  

	 	a)	 If the sole successor owner is the deceased owner’s spouse, we will continue this policy with the successor owner as the new owner.



  

	 	b)	 If the successor owner is an individual who is not the deceased owner’s spouse, the adjusted policy value must be distributed:



  

	 	(1)	 by the end of 5 years after the date of the deceased owner’s death; or 



 

	 	(2)	 payments must begin no later than one year after the deceased owner’s death and must be made for a period certain or for the successor
owner’s lifetime, so long as any period certain does not exceed the successor owner’s life expectancy (as defined by the Internal Revenue Code and regulations adopted under that Code). Election of this option must be made at least 60 days
prior to the one year anniversary of the deceased owner’s death. 


  

	 	c)	 If the successor owner is not a natural person, the adjusted policy value must be distributed within 5 years after the owner’s death.




 


  

					
	DB593	  	Page 13	  	









 SECTION 9 – CONTINUED 

 



	D.	DEATH ON OR AFTER THE ANNUITY COMMENCEMENT DATE 

 The death proceeds on or after the annuity commencement date depend on the payment option selected. If any owner dies on or after the annuity commencement date, but before the entire interest in the
policy is distributed, the remaining portion of such interest in the policy will be distributed to the beneficiary at least as rapidly as under the method of distribution being used as of the date of that death.




	E.	 AN OWNER IS NOT AN INDIVIDUAL 


 If any owner is not an individual, then for purposes of the provisions in subsection C or D above, (1) the primary annuitant will be treated as the owner of the policy; and (2) the death of, or
any change in, the primary annuitant, will be treated as the death of the owner. 

 

  
 SECTION 10 –
INCOME OPTIONS 
  

 



	A.	 GENERAL PAYMENT PROVISIONS 


 Payment 
 If this policy is in force on the annuity commencement date, we
will use the fixed account portion and/or the separate account portion of the adjusted policy value to make payments under an income option to the payee under fixed income option 2 and/or variable income option 3-V, respectively, with 10 years
certain, or if elected, under one or more of the other income options described in this section, or any other method of payment if we agree. However, the income option elected must provide for lifetime income or income for a period of at least 60
months. You will become the annuitant upon annuitization, unless the owner is not a natural person. Payments will be made at 1, 3, 6, or 12-month intervals. We reserve the right to change the frequency of payments to avoid making payments of less
than $50. 
 Before the annuity commencement date, if the death proceeds become payable, or if you surrender this policy, we
will pay any proceeds in one sum, or if elected, all or part of these proceeds may be applied to one or more of the income options described in this section, or any other method of payment if we agree. 

Adjusted Age 
 Payments
under fixed income options 2 and 4 and the first payment under variable income options 3-V and 5-V are determined based on the adjusted age of the annuitant. The adjusted age is the annuitant’s actual age on the annuitant’s nearest
birthday, at the annuity commencement date, adjusted as follows: 
  

			
	 Annuity

Commencement Date
	  	 Adjusted Age

	 Before 2010
	  	Actual Age              
	 2010 - 2019
	  	Actual Age minus 1
	 2020 - 2026
	  	Actual Age minus 2
	 2027 - 2033
	  	Actual Age minus 3
	 2034 - 2040
	  	Actual Age minus 4
	 After 2040  
	  	Actual Age minus 5

 

 Election of Optional Method of Payment 

Before the annuity commencement date, you can elect or change an income option. You may elect, in a notice in a form and manner acceptable
to us, income options that may be either variable, fixed, or a combination of both. If you elect a combination, you must also tell us what part of the adjusted policy value on the annuity commencement date are to be applied to provide each type of
payment. (You must also specify which subaccounts.) The amount of a combined payment will be the sum of the variable and fixed payments. Payments under a variable income option will reflect the investment performance of the selected subaccount(s) of
the separate account. 
 Payee 

Unless you specify otherwise, the payee shall be the annuitant, or the beneficiary as described in Section 11. 

In the event of the death of a payee who is not the annuitant prior to the end of payments pursuant to the terms of the income option
chosen, payments will be continued to the beneficiary or their present value may be paid in a single sum. 
 Proof of Age 

We may require proof of the age of any person who elects income options 2, 3-V, 4 and 5-V of this Section before we make the first
payment. 
 Minimum Proceeds 
 If the proceeds are less than $2,000, we reserve the right to pay them out as a lump sum instead of applying them to an income option. 
 Premium Tax 
 We may be required by law to pay premium tax on the amount
applied to an income option. If so, we will deduct the premium tax before applying the proceeds. 
 Supplementary Contract 

Once proceeds become payable and an income option has been selected, we will issue a supplementary contract to reflect the terms of the
selected income option. The supplemental contract will name the payee(s) and will describe the payment schedule. 

 


  

					
	S1297	  	Page 14	  	









 SECTION 10 – CONTINUED 

 



	B.	 FIXED INCOME OPTIONS 


 Guaranteed Income Options 
 The amount of the fixed payment is determined by
multiplying each $1,000 of policy proceeds allocated to fixed income option 1, 2, or 4 by the amounts shown on pages 18 and 19 for the option you select. Income options 1 and 3 are based on the guaranteed interest rate shown on page 18. Income
options 2 and 4 are based on the guaranteed interest rate shown on page 18 and the “Annuity 2000” (male, female, and unisex if required by law) mortality table projected for improvement using projection scale G. 

Fixed Income Option 1 - Income for a Specified Period 
 We will make level payments only for the specific period you choose. The specified period may not exceed your life expectancy. No funds will remain at the end of the specified period. 

Fixed Income Option 2 - Life Income 
 You may choose between: 
  

	(a)	 No Period Certain - We will make level payments only during the annuitant’s lifetime. 



 

	(b)	 10 Years Certain - We will make level payments for the longer of the annuitant’s lifetime or ten years.



  

	(c)	 Guaranteed Return of Policy Proceeds - We will make level payments for the longer of the annuitant’s lifetime or until the total
dollar amount of payments equals the amount applied to this option. 


  

	(d)	 Life with Emergency Cash (SM) - We will make level payments during the annuitant’s lifetime, but the annuity may be surrendered
(in full or part). The emergency cash value is equal to a multiple of the payment where that multiple reduces over time to zero at age 101. We will apply a surrender charge. Should the annuitant die before age 101 (or, for qualified policies, the
applicable age based on IRS Life Expectancy table(s) if earlier), the same value would be payable, but without the surrender charge. 


 Fixed income options 2(a) and 2(d) are not available for annuitant adjusted age(s) greater than 85.



 Fixed Income Option 3 - Income of a Specified Amount 

We will make payments for any specified amount you choose until the amount applied to this option, with interest, is exhausted. The
duration of the payments may not exceed the annuitant’s life expectancy. This will be a series of level payments followed by a smaller final payment. 
 Fixed Income Option 4 - Joint and Survivor Annuity 
 You may choose between:

  

	(a)	 No Period Certain - We will make payments during the joint lifetime of the annuitant and a joint annuitant of your choosing. We will make
payments as long as either person is living. 


  

	(b)	 Life with Emergency Cash (SM) - We will make level payments during the joint lifetime of the annuitant and a joint annuitant of your
choosing. We will make payments as long as either person is living, but the annuity may be surrendered (in full or part). The emergency cash value is equal to a multiple of the payment, where that multiple reduces over time to zero at age 101 of the
younger annuitant. We will apply a surrender charge. Should the last surviving annuitant die before age 101 (or, for qualified policies, the applicable age based on IRS Life Expectancy table(s) if earlier), the same value would be payable, but
without the surrender charge. 


 Fixed income options 4(a) and 4(b) are not available for annuitant adjusted
age(s) greater than 85. 
 Current Income Options 
 The amounts shown in the tables on pages 18 and 19 are the guaranteed amounts. You may obtain current amounts we offer to individuals of the same class, subject to availability as described under
“Guaranteed Income Options” above. 

 


  

					
	SB1297	  	Page 15	  	









 SECTION 10 – CONTINUED 

 



	C.	 VARIABLE INCOME OPTIONS 


 Variable Annuity Units 
 We will use the adjusted policy value you tell us
to apply to a variable income option to purchase variable annuity units in your chosen subaccounts. The dollar value of variable annuity units in your chosen subaccounts will increase or decrease reflecting the investment experience of your chosen
subaccounts. The value of a variable annuity unit in a particular subaccount on any business day is equal to (a) multiplied by (b) multiplied by (c), where: 
  

	(a)	 is the variable annuity unit value for that subaccount on the immediately preceding business day; 



 

	(b)	 is the net investment factor for that subaccount for the valuation period; and 



 

	(c)	 is the assumed investment return adjustment factor for the valuation period 



The assumed investment return adjustment factor for the valuation period is the product of daily discount factors which reflect the
effective annual assumed investment return shown on page 20. 
 The net investment factor used to calculate the value of a
variable annuity unit in each subaccount for the valuation period is determined by dividing (a) by (b) and subtracting (c) from the result, where: 
  

	(a)	 is the net result of: 


  

	 	(1)	 the net asset value of a fund share held in that subaccount determined as of the end of the current valuation period; plus



  

	 	(2)	 the per share amount of any dividend or capital gain distributions made by the fund for shares held in that subaccount if the ex-dividend date
occurs during the valuation period; plus or minus 


  

	 	(3)	 a per share credit or charge for any taxes reserved for, which we determine to have resulted from the investment operations of the subaccount



  

	(b)	 is the net asset value of a fund share held in that subaccount determined as of the end of the immediately preceding valuation period






	(c)	 is a factor representing the mortality and expense risk fee and administrative charge applicable after the annuity commencement date. This factor is
less than or equal to, on an annual basis, the percentage shown on the Policy Data page, plus any additional fee applicable to the initial payment guarantee of the daily net asset value of a fund share held in the separate account for that
subaccount 


 Determination of the First Variable Payment 

The amount of the first variable payment is determined by multiplying each $1,000 of adjusted policy value allocated to a variable income
option by the amounts shown on the variable income option table for the variable income option you select. The tables are based on the effective annual assumed investment return shown on page 20 and the “Annuity 2000” (male, female, and
unisex if required by law) mortality table projected for improvement using projection scale G. 
 Variable Income Option 3-V - Life Income

 You may choose between: 
  

	(a)	 No Period Certain - We will make payments during the lifetime of the annuitant 



 

	(b)	 10 Years Certain - We will make payments for the longer of the annuitant’s lifetime or ten years. 



 

	(c)	 Life with Emergency Cash (SM) - We will make payments during the annuitants lifetime, but the annuity may be surrendered (in full or part).
The emergency cash value is equal to a multiple of the supportable payment (see definition below), where that multiple reduces over time to zero at age 101. We will apply a surrender charge. Should the annuitant die before age 101 (or, for qualified
policies, the applicable age based on IRS Life Expectancy table(s) if earlier), the same value would be payable, but without the surrender charge. 


 Variable Income Options 3-V(a) and 3-V(c) are not available for adjusted age(s) greater than 85.


 


  

					
	C957	  	Page 16	  	









 SECTION 10 – CONTINUED 

 


 Variable Income Option 5-V - Joint and Survivor Annuity 

You may choose between: 
  

	(a)	 No Period Certain - We will make payments as long as either the annuitant or the joint annuitant is living. 



 

	(b)	 Life with Emergency Cash (SM) - We will make payments during the joint lifetime of the annuitant and a joint annuitant of your selection.
Payments will be made as long as either person is living, but the annuity may be surrendered (in full or part). The emergency cash value is equal to a multiple of the supportable payment (see definition below), where that multiple reduces over time
to zero at age 101 of the younger annuitant We will apply a surrender charge. Should the last surviving annuitant die before age 101 (or, for qualified policies, the applicable age based on IRS Life Expectancy table(s) if earlier), the same value
would be payable, but without the surrender charge. 


 Variable income options 5-V(a) and 5-V(b) are not
available for annuitant adjusted age(s) greater than 85. 
 Initial Payment Guarantee 

At the time you annuitize, you may elect an initial payment guarantee under which we guarantee your variable annuity payments will never
be less than a percentage of the initial variable annuity payment. You cannot terminate the initial payment guarantee after you have elected it. The percentage applicable to the initial payment and the additional fee for this option will be those
currently applicable at the time of annuitization. 
 Supportable Payment 

The supportable payment is the sum of each selected subaccount’s variable annuity unit value times the number of variable annuity
units. The variable annuity units are adjusted to reflect the year-to-date difference between the stabilized payment and the payment had they not been stabilized. Supportable payments are used to determine surrender values, death benefits and
transfers. 
 Determination of Subsequent Variable Payments Without Stabilization 

The number of variable annuity units in each selected subaccount is determined by dividing the first variable annuity payment allocated to
the subaccount by the variable annuity unit value of that subaccount on the annuity commencement date. The amount of each variable annuity payment after the first payment will increase or decrease according to the value



 of the variable annuity units which reflect the investment experience of the selected
subaccounts. Each variable annuity payment after the first payment will be equal to the number of variable annuity units in the selected subaccounts multiplied by the variable annuity unit value on the date the payment is made. 

Determination of Subsequent Variable Payments With Stabilization 
 If “Life with Emergency Cash” is chosen (variable income option 3-V(c) or 5-V(b)), or if the initial payment guarantee is chosen, variable annuity payments during the first year following the
annuity commencement date will be stabilized to equal the initial payment. On each anniversary of the annuity commencement date, the stabilized variable annuity payment will be increased or decreased (but never below the guaranteed payment if the
initial payment guarantee is chosen) and held level for that year. On each anniversary of the annuity commencement date, the stabilized variable annuity payment will equal the supportable payment at that time (or if the initial payment guarantee is
chosen, the stabilized variable payment will equal the greater of the guaranteed payment or the supportable payment at that time). 
 If the payment without stabilization (at any payment date during the year) is greater than the stabilized variable annuity payment for that year, the excess will be used to purchase additional annuity
units (as described below). If the payment without stabilization (at any payment date during the year) is less than the stabilized variable annuity payment for that year, annuity units will be redeemed (as described below) to fund the deficiency.

 Purchase/Redemption of Annuity Units with Stabilized Variable Annuity Payments 

The number of annuity units purchased or redeemed is equal to the annuity income purchased or redeemed, respectively, divided by the
annuity unit value for each respective subaccount. Purchases and redemptions of annuity income will be allocated to each subaccount on a proportionate basis. The amount of annuity income purchased or redeemed is the difference between the payment
without stabilization during that year and the stabilized variable annuity payment, times an attained adjusted age nearest birthday payment factor divided by $1,000. The payment factor will reflect any remaining guaranteed payments, if any, and is
determined using the same assumptions for mortality and interest as the payment factors listed in this policy for variable income options 3-V and 5-V.


 


  

					
	CB957	  	Page 17	  	









 GUARANTEED FIXED INCOME OPTIONS ** 

The amounts shown in these tables are the guaranteed amounts for each 1,000 of the proceeds. Higher current amounts may be available at
the time of settlement. 
  

																																																									
	Option 1	 	  	 	 	  	Option 2 (a)	 	  	Option 2 (b)	 	  	Option 2 (c)	 	  	Option 2 (d)	 
	 Number
of
Years
Payable
	  	Amount of
Monthly
Installment	 	  	 	 	  	Monthly Installment
For 
Life No Period
Certain	 	  	Monthly Installment For
Life 10 Years Certain	 	  	Monthly Installment For
Life Guaranteed Return
of Policy Proceeds	 	  	Monthly Installment
For Life
With
Emergency Cash (SM)	 
	 	  	 	 	  	Age*	 	  	Male	 	  	Female	 	  	Unisex	 	  	Male	 	  	Female	 	  	Unisex	 	  	Male	 	  	Female	 	  	Unisex	 	  	Male	 	  	Female	 	  	Unisex	 
		  				  	 	50	  	  	$	2.97	  	  	$	2.86	  	  	$	2.90	  	  	$	2.96	  	  	$	2.86	  	  	$	2.89	  	  	$	2.79	  	  	$	2.74	  	  	$	2.76	  	  	$	2.69	  	  	$	2.66	  	  	$	2.67	  
		  				  	 	51	  	  	 	3.04	  	  	 	2.92	  	  	 	2.96	  	  	 	3.02	  	  	 	2.91	  	  	 	2.94	  	  	 	2.84	  	  	 	2.79	  	  	 	2.80	  	  	 	2.74	  	  	 	2.70	  	  	 	2.72	  
		  				  	 	52	  	  	 	3.10	  	  	 	2.98	  	  	 	3.02	  	  	 	3.08	  	  	 	2.97	  	  	 	3.01	  	  	 	2.89	  	  	 	2.84	  	  	 	2.85	  	  	 	2.79	  	  	 	2.75	  	  	 	2.76	  
		  				  	 	53	  	  	 	3.18	  	  	 	3.05	  	  	 	3.09	  	  	 	3.15	  	  	 	3.03	  	  	 	3.07	  	  	 	2.94	  	  	 	2.89	  	  	 	2.90	  	  	 	2.84	  	  	 	2.80	  	  	 	2.81	  
	5	  	 	17.28	  	  	 	54	  	  	 	3.25	  	  	 	3.11	  	  	 	3.15	  	  	 	3.22	  	  	 	3.10	  	  	 	3.14	  	  	 	3.00	  	  	 	2.94	  	  	 	2.96	  	  	 	2.89	  	  	 	2.85	  	  	 	2.86	  
	6	  	 	14.51	  	  	 	55	  	  	 	3.33	  	  	 	3.18	  	  	 	3.23	  	  	 	3.30	  	  	 	3.17	  	  	 	3.21	  	  	 	3.06	  	  	 	3.00	  	  	 	3.02	  	  	 	2.94	  	  	 	2.90	  	  	 	2.91	  
	7	  	 	12.53	  	  	 	56	  	  	 	3.41	  	  	 	3.26	  	  	 	3.30	  	  	 	3.38	  	  	 	3.24	  	  	 	3.28	  	  	 	3.12	  	  	 	3.06	  	  	 	3.07	  	  	 	3.00	  	  	 	2.96	  	  	 	2.97	  
	8	  	 	11.04	  	  	 	57	  	  	 	3.50	  	  	 	3.34	  	  	 	3.39	  	  	 	3.46	  	  	 	3.32	  	  	 	3.36	  	  	 	3.18	  	  	 	3.12	  	  	 	3.14	  	  	 	3.06	  	  	 	3.01	  	  	 	3.03	  
	9	  	 	9.89	  	  	 	58	  	  	 	3.60	  	  	 	3.42	  	  	 	3.47	  	  	 	3.55	  	  	 	3.39	  	  	 	3.44	  	  	 	3.25	  	  	 	3.18	  	  	 	3.20	  	  	 	3.12	  	  	 	3.07	  	  	 	3.08	  
	10	  	 	8.96	  	  	 	59	  	  	 	3.69	  	  	 	3.51	  	  	 	3.56	  	  	 	3.65	  	  	 	3.48	  	  	 	3.53	  	  	 	3.32	  	  	 	3.25	  	  	 	3.27	  	  	 	3.18	  	  	 	3.13	  	  	 	3.15	  
	11	  	 	8.21	  	  	 	60	  	  	 	3.80	  	  	 	3.60	  	  	 	3.66	  	  	 	3.75	  	  	 	3.57	  	  	 	3.62	  	  	 	3.39	  	  	 	3.32	  	  	 	3.34	  	  	 	3.25	  	  	 	3.20	  	  	 	3.21	  
	12	  	 	7.58	  	  	 	61	  	  	 	3.91	  	  	 	3.70	  	  	 	3.76	  	  	 	3.85	  	  	 	3.66	  	  	 	3.72	  	  	 	3.46	  	  	 	3.39	  	  	 	3.41	  	  	 	3.32	  	  	 	3.27	  	  	 	3.28	  
	13	  	 	7.05	  	  	 	62	  	  	 	4.03	  	  	 	3.81	  	  	 	3.87	  	  	 	3.96	  	  	 	3.76	  	  	 	3.82	  	  	 	3.54	  	  	 	3.47	  	  	 	3.49	  	  	 	3.39	  	  	 	3.34	  	  	 	3.35	  
	14	  	 	6.59	  	  	 	63	  	  	 	4.16	  	  	 	3.92	  	  	 	3.99	  	  	 	4.07	  	  	 	3.87	  	  	 	3.93	  	  	 	3.63	  	  	 	3.55	  	  	 	3.57	  	  	 	3.47	  	  	 	3.41	  	  	 	3.43	  
	15	  	 	6.20	  	  	 	64	  	  	 	4.30	  	  	 	4.04	  	  	 	4.12	  	  	 	4.20	  	  	 	3.98	  	  	 	4.04	  	  	 	3.72	  	  	 	3.63	  	  	 	3.66	  	  	 	3.55	  	  	 	3.49	  	  	 	3.51	  
	16	  	 	5.85	  	  	 	65	  	  	 	4.45	  	  	 	4.16	  	  	 	4.25	  	  	 	4.32	  	  	 	4.09	  	  	 	4.16	  	  	 	3.81	  	  	 	3.72	  	  	 	3.75	  	  	 	3.63	  	  	 	3.57	  	  	 	3.59	  
	17	  	 	5.55	  	  	 	66	  	  	 	4.60	  	  	 	4.30	  	  	 	4.39	  	  	 	4.46	  	  	 	4.22	  	  	 	4.29	  	  	 	3.91	  	  	 	3.81	  	  	 	3.84	  	  	 	3.72	  	  	 	3.66	  	  	 	3.68	  
	18	  	 	5.27	  	  	 	67	  	  	 	4.77	  	  	 	4.45	  	  	 	4.54	  	  	 	4.60	  	  	 	4.35	  	  	 	4.42	  	  	 	4.01	  	  	 	3.91	  	  	 	3.94	  	  	 	3.81	  	  	 	3.75	  	  	 	3.77	  
	19	  	 	5.03	  	  	 	68	  	  	 	4.95	  	  	 	4.60	  	  	 	4.71	  	  	 	4.75	  	  	 	4.49	  	  	 	4.57	  	  	 	4.11	  	  	 	4.01	  	  	 	4.04	  	  	 	3.90	  	  	 	3.85	  	  	 	3.86	  
	20	  	 	4.81	  	  	 	69	  	  	 	5.14	  	  	 	4.77	  	  	 	4.88	  	  	 	4.90	  	  	 	4.64	  	  	 	4.71	  	  	 	4.23	  	  	 	4.12	  	  	 	4.15	  	  	 	4.01	  	  	 	3.95	  	  	 	3.96	  
		  				  	 	70	  	  	 	5.34	  	  	 	4.95	  	  	 	5.07	  	  	 	5.06	  	  	 	4.79	  	  	 	4.87	  	  	 	4.34	  	  	 	4.24	  	  	 	4.27	  	  	 	4.11	  	  	 	4.05	  	  	 	4.07	  
		  				  	 	71	  	  	 	5.56	  	  	 	5.15	  	  	 	5.27	  	  	 	5.22	  	  	 	4.95	  	  	 	5.03	  	  	 	4.47	  	  	 	4.36	  	  	 	4.39	  	  	 	4.22	  	  	 	4.17	  	  	 	4.18	  
		  				  	 	72	  	  	 	5.79	  	  	 	5.36	  	  	 	5.49	  	  	 	5.39	  	  	 	5.12	  	  	 	5.20	  	  	 	4.60	  	  	 	4.49	  	  	 	4.52	  	  	 	4.34	  	  	 	4.29	  	  	 	4.30	  
		  				  	 	73	  	  	 	6.03	  	  	 	5.59	  	  	 	5.72	  	  	 	5.56	  	  	 	5.30	  	  	 	5.38	  	  	 	4.73	  	  	 	4.62	  	  	 	4.66	  	  	 	4.46	  	  	 	4.40	  	  	 	4.42	  
		  				  	 	74	  	  	 	6.30	  	  	 	5.83	  	  	 	5.97	  	  	 	5.74	  	  	 	5.49	  	  	 	5.57	  	  	 	4.88	  	  	 	4.77	  	  	 	4.80	  	  	 	4.59	  	  	 	4.54	  	  	 	4.55	  
		  				  	 	75	  	  	 	6.58	  	  	 	6.10	  	  	 	6.24	  	  	 	5.93	  	  	 	5.68	  	  	 	5.76	  	  	 	5.03	  	  	 	4.92	  	  	 	4.95	  	  	 	4.72	  	  	 	4.67	  	  	 	4.69	  
		  				  	 	76	  	  	 	6.88	  	  	 	6.39	  	  	 	6.53	  	  	 	6.11	  	  	 	5.88	  	  	 	5.95	  	  	 	5.18	  	  	 	5.08	  	  	 	5.11	  	  	 	4.85	  	  	 	4.81	  	  	 	4.82	  
		  				  	 	77	  	  	 	7.20	  	  	 	6.70	  	  	 	6.85	  	  	 	6.30	  	  	 	6.09	  	  	 	6.15	  	  	 	5.35	  	  	 	5.25	  	  	 	5.28	  	  	 	5.00	  	  	 	4.96	  	  	 	4.97	  
		  				  	 	78	  	  	 	7.55	  	  	 	7.03	  	  	 	7.19	  	  	 	6.49	  	  	 	6.30	  	  	 	6.36	  	  	 	5.53	  	  	 	5.43	  	  	 	5.46	  	  	 	5.15	  	  	 	5.12	  	  	 	5.12	  
		  				  	 	79	  	  	 	7.92	  	  	 	7.40	  	  	 	7.55	  	  	 	6.68	  	  	 	6.51	  	  	 	6.56	  	  	 	5.71	  	  	 	5.61	  	  	 	5.64	  	  	 	5.31	  	  	 	5.28	  	  	 	5.29	  
		  				  	 	80	  	  	 	8.32	  	  	 	7.79	  	  	 	7.95	  	  	 	6.87	  	  	 	6.72	  	  	 	6.77	  	  	 	5.90	  	  	 	5.81	  	  	 	5.84	  	  	 	5.48	  	  	 	5.45	  	  	 	5.46	  
		  				  	 	81	  	  	 	8.75	  	  	 	8.22	  	  	 	8.38	  	  	 	7.06	  	  	 	6.93	  	  	 	6.97	  	  	 	6.11	  	  	 	6.02	  	  	 	6.05	  	  	 	5.67	  	  	 	5.64	  	  	 	5.64	  
		  				  	 	82	  	  	 	9.20	  	  	 	8.69	  	  	 	8.84	  	  	 	7.24	  	  	 	7.13	  	  	 	7.16	  	  	 	6.32	  	  	 	6.24	  	  	 	6.27	  	  	 	5.84	  	  	 	5.83	  	  	 	5.84	  
		  				  	 	83	  	  	 	9.69	  	  	 	9.19	  	  	 	9.34	  	  	 	7.41	  	  	 	7.33	  	  	 	7.36	  	  	 	6.55	  	  	 	6.48	  	  	 	6.50	  	  	 	6.05	  	  	 	6.04	  	  	 	6.04	  
		  				  	 	84	  	  	 	10.21	  	  	 	9.74	  	  	 	9.88	  	  	 	7.58	  	  	 	7.52	  	  	 	7.54	  	  	 	6.78	  	  	 	6.72	  	  	 	6.74	  	  	 	6.24	  	  	 	6.24	  	  	 	6.24	  
		  				  	 	85	  	  	 	10.77	  	  	 	10.33	  	  	 	10.46	  	  	 	7.74	  	  	 	7.69	  	  	 	7.71	  	  	 	7.03	  	  	 	6.98	  	  	 	7.00	  	  	 	6.48	  	  	 	6.48	  	  	 	6.48	  
		  				  	 	86	  	  				  				  				  	 	7.89	  	  	 	7.86	  	  	 	7.87	  	  	 	7.29	  	  	 	7.26	  	  	 	7.27	  	  				  				  			
		  				  	 	87	  	  				  				  				  	 	8.03	  	  	 	8.01	  	  	 	8.01	  	  	 	7.57	  	  	 	7.54	  	  	 	7.55	  	  				  				  			
		  				  	 	88	  	  				  				  				  	 	8.16	  	  	 	8.15	  	  	 	8.15	  	  	 	7.86	  	  	 	7.84	  	  	 	7.85	  	  				  				  			
		  				  	 	89	  	  				  				  				  	 	8.28	  	  	 	8.27	  	  	 	8.27	  	  	 	8.17	  	  	 	8.15	  	  	 	8.16	  	  				  				  			
		  				  	 	90	  	  				  				  				  	 	8.38	  	  	 	8.38	  	  	 	8.38	  	  	 	8.49	  	  	 	8.48	  	  	 	8.48	  	  				  				  			
		  				  	 	91	  	  				  				  				  	 	8.48	  	  	 	8.48	  	  	 	8.48	  	  	 	8.83	  	  	 	8.82	  	  	 	8.83	  	  				  				  			
		  				  	 	92	  	  				  				  				  	 	8.57	  	  	 	8.57	  	  	 	8.57	  	  	 	9.19	  	  	 	9.18	  	  	 	9.19	  	  				  				  			
		  				  	 	93	  	  				  				  				  	 	8.65	  	  	 	8.64	  	  	 	8.65	  	  	 	9.58	  	  	 	9.56	  	  	 	9.57	  	  				  				  			
		  				  	 	94	  	  				  				  				  	 	8.72	  	  	 	8.71	  	  	 	8.71	  	  	 	10.00	  	  	 	9.97	  	  	 	9.98	  	  				  				  			
		  				  	 	95	  	  				  				  				  	 	8.78	  	  	 	8.77	  	  	 	8.77	  	  	 	10.45	  	  	 	10.40	  	  	 	10.42	  	  				  				  			

  

	*	 Adjusted age as defined in Section 10.A. 



	**	 The guaranteed fixed income amounts are based on a guaranteed interest rate of 1.5%. 



Dollar amounts of monthly, quarterly, semi-annual and annual installments not shown in the above tables will be calculated on the same
basis as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 

  

					
	T1063	  	Page 18	  	









 Fixed Income Option 4 (a)

Monthly Installment For Joint and Full Survivor 
  

																													
	 Adjusted Age

of
 Male

Annuitant*
	  	Adjusted Age of Female Annuitant*	 
	  	15 Years
Less Than
Male	 	  	12 Years
Less Than
Male	 	  	9 Years
Less Than
Male	 	  	6 Years
Less Than
Male	 	  	3 Years
Less Than
Male	 	  	Same As
Male	 	  	3 Years
More Than
Male	 
	50	  	$	2.20	  	  	$	2.27	  	  	$	2.34	  	  	$	2.41	  	  	$	2.48	  	  	$	2.55	  	  	$	2.62	  
	55	  	 	2.35	  	  	 	2.44	  	  	 	2.52	  	  	 	2.61	  	  	 	2.71	  	  	 	2.80	  	  	 	2.88	  
	60	  	 	2.54	  	  	 	2.64	  	  	 	2.76	  	  	 	2.88	  	  	 	2.99	  	  	 	3.11	  	  	 	3.23	  
	65	  	 	2.77	  	  	 	2.91	  	  	 	3.06	  	  	 	3.22	  	  	 	3.38	  	  	 	3.54	  	  	 	3.69	  
	70	  	 	3.08	  	  	 	3.26	  	  	 	3.46	  	  	 	3.67	  	  	 	3.89	  	  	 	4.11	  	  	 	4.33	  
	75	  	 	3.47	  	  	 	3.72	  	  	 	3.99	  	  	 	4.29	  	  	 	4.60	  	  	 	4.93	  	  	 	5.24	  
	80	  	 	4.01	  	  	 	4.35	  	  	 	4.74	  	  	 	5.17	  	  	 	5.62	  	  	 	6.08	  	  	 	6.53	  
	85	  	 	4.75	  	  	 	5.25	  	  	 	5.81	  	  	 	6.44	  	  	 	7.09	  	  	 	7.75	  	  	 	8.36	  

 Monthly Installment For Unisex Joint and Full Survivor 

 

																													
	 Adjusted Age

of

First
 Annuitant*
	  	Adjusted Age of Joint Annuitant*	 
	  	15 Years
Less Than
First	 	  	12 Years
Less Than
First	 	  	9 Years
Less Than
First	 	  	6 Years
Less Than
First	 	  	3 Years
Less Than
First	 	  	Same As
First	 	  	3 Years
More Than
First	 
	50	  	$	2.20	  	  	$	2.27	  	  	$	2.34	  	  	$	2.41	  	  	$	2.48	  	  	$	2.55	  	  	$	2.61	  
	55	  	 	2.36	  	  	 	2.44	  	  	 	2.53	  	  	 	2.62	  	  	 	2.70	  	  	 	2.79	  	  	 	2.87	  
	60	  	 	2.55	  	  	 	2.65	  	  	 	2.76	  	  	 	2.88	  	  	 	2.99	  	  	 	3.10	  	  	 	3.20	  
	65	  	 	2.79	  	  	 	2.92	  	  	 	3.07	  	  	 	3.22	  	  	 	3.37	  	  	 	3.52	  	  	 	3.66	  
	70	  	 	3.10	  	  	 	3.28	  	  	 	3.47	  	  	 	3.67	  	  	 	3.88	  	  	 	4.09	  	  	 	4.28	  
	75	  	 	3.50	  	  	 	3.75	  	  	 	4.02	  	  	 	4.30	  	  	 	4.60	  	  	 	4.89	  	  	 	5.16	  
	80	  	 	4.06	  	  	 	4.40	  	  	 	4.78	  	  	 	5.19	  	  	 	5.62	  	  	 	6.04	  	  	 	6.44	  
	85	  	 	4.83	  	  	 	5.32	  	  	 	5.87	  	  	 	6.47	  	  	 	7.10	  	  	 	7.71	  	  	 	8.28	  

 Fixed Income Option 4 (b) 
 Monthly Installment For Joint and Full Survivor (Life with Emergency Cash (SM)) 
  

																													
	 Adjusted Age

of
 Male

Annuitant*
	  	Adjusted Age of Joint Annuitant*	 
	  	15 Years
Less Than
Male	 	  	12 Years
Less Than
Male	 	  	9 Years
Less Than
Male	 	  	6 Years
Less Than
Male	 	  	3 Years
Less Than
Male	 	  	Same As
Male	 	  	3 Years
More Than
Male	 
	50	  	$	2.15	  	  	$	2.21	  	  	$	2.28	  	  	$	2.35	  	  	$	2.42	  	  	$	2.49	  	  	$	2.54	  
	55	  	 	2.28	  	  	 	2.36	  	  	 	2.45	  	  	 	2.53	  	  	 	2.62	  	  	 	2.70	  	  	 	2.77	  
	60	  	 	2.45	  	  	 	2.54	  	  	 	2.65	  	  	 	2.76	  	  	 	2.87	  	  	 	2.97	  	  	 	3.06	  
	65	  	 	2.64	  	  	 	2.77	  	  	 	2.90	  	  	 	3.04	  	  	 	3.18	  	  	 	3.31	  	  	 	3.42	  
	70	  	 	2.89	  	  	 	3.04	  	  	 	3.21	  	  	 	3.39	  	  	 	3.57	  	  	 	3.75	  	  	 	3.89	  
	75	  	 	3.19	  	  	 	3.39	  	  	 	3.61	  	  	 	3.84	  	  	 	4.08	  	  	 	4.30	  	  	 	4.47	  
	80	  	 	3.57	  	  	 	3.83	  	  	 	4.12	  	  	 	4.42	  	  	 	4.73	  	  	 	5.02	  	  	 	5.23	  
	85	  	 	4.06	  	  	 	4.41	  	  	 	4.78	  	  	 	5.17	  	  	 	5.57	  	  	 	5.98	  	  	 	6.23	  

 Monthly Installment For Unisex Joint and Full Survivor (Life with Emergency Cash (SM))

  

																													
	 Adjusted Age

of

First
 Annuitant*
	  	Adjusted Age of Joint Annuitant*	 
	  	15 Years
Less Than
First	 	  	12 Years
Less Than
First	 	  	9 Years
Less Than
First	 	  	6 Years
Less Than
First	 	  	3 Years
Less Than
First	 	  	Same As
First	 	  	3 Years
More Than
First	 
	50	  	$	2.15	  	  	$	2.22	  	  	$	2.28	  	  	$	2.35	  	  	$	2.42	  	  	$	2.49	  	  	$	2.54	  
	55	  	 	2.29	  	  	 	2.37	  	  	 	2.45	  	  	 	2.53	  	  	 	2.62	  	  	 	2.70	  	  	 	2.76	  
	60	  	 	2.45	  	  	 	2.55	  	  	 	2.65	  	  	 	2.76	  	  	 	2.87	  	  	 	2.97	  	  	 	3.05	  
	65	  	 	2.65	  	  	 	2.78	  	  	 	2.91	  	  	 	3.04	  	  	 	3.18	  	  	 	3.31	  	  	 	3.40	  
	70	  	 	2.90	  	  	 	3.06	  	  	 	3.22	  	  	 	3.40	  	  	 	3.57	  	  	 	3. 74	  	  	 	3.86	  
	75	  	 	3.21	  	  	 	3.41	  	  	 	3.62	  	  	 	3.86	  	  	 	4.08	  	  	 	4.29	  	  	 	4.45	  
	80	  	 	3.60	  	  	 	3.86	  	  	 	4.14	  	  	 	4.44	  	  	 	4.73	  	  	 	5.02	  	  	 	5.21	  
	85	  	 	4.08	  	  	 	4.43	  	  	 	4.80	  	  	 	5.18	  	  	 	5.58	  	  	 	5.97	  	  	 	6.21	  

  

	*	 Adjusted age as defined in Section 10.A. 


 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same basis as those shown and may be obtained from the Company (if the
option is available based on adjusted age as described in Section 10). 

  

					
	TB1063	  	Page 19	  	









 VARIABLE INCOME OPTIONS 

BASED ON ASSUMED INVESTMENT RETURN** 
 The amounts shown in these are the initial payment amounts based on a 5.0% assumed investment return for each $ 1,000 of the proceeds. 

 

																																					
	 	  	Option 3-V (a)	 	  	Option 3 - V (b)	 	  	Option 3 - V (c)	 
	 	  	Monthly Installment for Life
No Period Certain	 	  	Monthly Installment for Life
10 Years
Certain	 	  	Monthly Installment for Life
With Emergency Cash (SM)	 
	 Age*
	  	Male	 	  	Female	 	  	Unisex	 	  	Male	 	  	Female	 	  	Unisex	 	  	Male	 	  	Female	 	  	Unisex	 
	50	  	$	5.07	  	  	$	4.93	  	  	$	4.98	  	  	$	5.04	  	  	$	4.92	  	  	$	4.95	  	  	$	4.83	  	  	$	4.76	  	  	$	4.78	  
	51	  	 	5.13	  	  	 	4.99	  	  	 	5.03	  	  	 	5.09	  	  	 	4.96	  	  	 	5.00	  	  	 	4.87	  	  	 	4.80	  	  	 	4.82	  
	52	  	 	5.19	  	  	 	5.04	  	  	 	5.08	  	  	 	5.15	  	  	 	5.01	  	  	 	5.05	  	  	 	4.92	  	  	 	4.84	  	  	 	4.86	  
	53	  	 	5.26	  	  	 	5.10	  	  	 	5.14	  	  	 	5.21	  	  	 	5.07	  	  	 	5.11	  	  	 	4.96	  	  	 	4.88	  	  	 	4.91	  
	54	  	 	5.33	  	  	 	5.16	  	  	 	5.21	  	  	 	5.27	  	  	 	5.12	  	  	 	5.17	  	  	 	5.01	  	  	 	4.93	  	  	 	4.95	  
	55	  	 	5.40	  	  	 	5.22	  	  	 	5.27	  	  	 	5.34	  	  	 	5.18	  	  	 	5.23	  	  	 	5.06	  	  	 	4.98	  	  	 	5.00	  
	56	  	 	5.48	  	  	 	5.29	  	  	 	5.35	  	  	 	5.41	  	  	 	5.25	  	  	 	5.30	  	  	 	5.12	  	  	 	5.03	  	  	 	5.05	  
	57	  	 	5.57	  	  	 	5.36	  	  	 	5.42	  	  	 	5.49	  	  	 	5.32	  	  	 	5.37	  	  	 	5.18	  	  	 	5.08	  	  	 	5.11	  
	58	  	 	5.66	  	  	 	5.44	  	  	 	5.50	  	  	 	5.57	  	  	 	5.39	  	  	 	5.44	  	  	 	5.24	  	  	 	5.14	  	  	 	5.17	  
	59	  	 	5.75	  	  	 	5.52	  	  	 	5.59	  	  	 	5.66	  	  	 	5.47	  	  	 	5.52	  	  	 	5.31	  	  	 	5.20	  	  	 	5.23	  
	60	  	 	5.85	  	  	 	5.61	  	  	 	5.68	  	  	 	5.75	  	  	 	5.55	  	  	 	5.61	  	  	 	5.37	  	  	 	5.26	  	  	 	5.29	  
	61	  	 	5.97	  	  	 	5.70	  	  	 	5.78	  	  	 	5.85	  	  	 	5.63	  	  	 	5.70	  	  	 	5.45	  	  	 	5.33	  	  	 	5.37	  
	62	  	 	6.09	  	  	 	5.81	  	  	 	5.89	  	  	 	5.95	  	  	 	5.72	  	  	 	5.79	  	  	 	5.53	  	  	 	5.40	  	  	 	5.44	  
	63	  	 	6.21	  	  	 	5.91	  	  	 	6.00	  	  	 	6.06	  	  	 	5.82	  	  	 	5.89	  	  	 	5.61	  	  	 	5.48	  	  	 	5.52	  
	64	  	 	6.35	  	  	 	6.03	  	  	 	6.13	  	  	 	6.17	  	  	 	5.92	  	  	 	6.00	  	  	 	5.70	  	  	 	5.56	  	  	 	5.60	  
	65	  	 	6.50	  	  	 	6.16	  	  	 	6.26	  	  	 	6.29	  	  	 	6.03	  	  	 	6.11	  	  	 	5.79	  	  	 	5.65	  	  	 	5.69	  
	66	  	 	6.66	  	  	 	6.29	  	  	 	6.40	  	  	 	6.42	  	  	 	6.15	  	  	 	6.23	  	  	 	5.89	  	  	 	5.75	  	  	 	5.79	  
	67	  	 	6.83	  	  	 	6.43	  	  	 	6.55	  	  	 	6.55	  	  	 	6.27	  	  	 	6.36	  	  	 	6.00	  	  	 	5.85	  	  	 	5.89	  
	68	  	 	7.01	  	  	 	6.59	  	  	 	6.71	  	  	 	6.69	  	  	 	6.40	  	  	 	6.49	  	  	 	6.11	  	  	 	5.96	  	  	 	6.00	  
	69	  	 	7.21	  	  	 	6.76	  	  	 	6.89	  	  	 	6.83	  	  	 	6.54	  	  	 	6.63	  	  	 	6.23	  	  	 	6.07	  	  	 	6.12	  
	70	  	 	7.41	  	  	 	6.94	  	  	 	7.08	  	  	 	6.98	  	  	 	6.69	  	  	 	6.77	  	  	 	6.36	  	  	 	6.20	  	  	 	6.25	  
	71	  	 	7.63	  	  	 	7.14	  	  	 	7.28	  	  	 	7.13	  	  	 	6.84	  	  	 	6.93	  	  	 	6.49	  	  	 	6.33	  	  	 	6.38	  
	72	  	 	7.87	  	  	 	7.35	  	  	 	7.50	  	  	 	7.28	  	  	 	7.00	  	  	 	7.09	  	  	 	6.63	  	  	 	6.46	  	  	 	6.52	  
	73	  	 	8.12	  	  	 	7.58	  	  	 	7.74	  	  	 	7.45	  	  	 	7.17	  	  	 	7.25	  	  	 	6.78	  	  	 	6.62	  	  	 	6.66	  
	74	  	 	8.39	  	  	 	7.83	  	  	 	8.00	  	  	 	7.61	  	  	 	7.34	  	  	 	7.42	  	  	 	6.94	  	  	 	6.78	  	  	 	6.83	  
	75	  	 	8.68	  	  	 	8.11	  	  	 	8.28	  	  	 	7.78	  	  	 	7.52	  	  	 	7.60	  	  	 	7.11	  	  	 	6.95	  	  	 	7.00	  
	76	  	 	8.99	  	  	 	8.40	  	  	 	8.58	  	  	 	7.95	  	  	 	7.71	  	  	 	7.78	  	  	 	7.29	  	  	 	7.13	  	  	 	7.18	  
	77	  	 	9.32	  	  	 	8.72	  	  	 	8.90	  	  	 	8.12	  	  	 	7.90	  	  	 	7.97	  	  	 	7.47	  	  	 	7.33	  	  	 	7.36	  
	78	  	 	9.68	  	  	 	9.07	  	  	 	9.25	  	  	 	8.29	  	  	 	8.09	  	  	 	8.16	  	  	 	7.68	  	  	 	7.52	  	  	 	7.57	  
	79	  	 	10.06	  	  	 	9.45	  	  	 	9.63	  	  	 	8.47	  	  	 	8.29	  	  	 	8.34	  	  	 	7.88	  	  	 	7.74	  	  	 	7.79	  
	80	  	 	10.47	  	  	 	9.85	  	  	 	10.04	  	  	 	8.64	  	  	 	8.48	  	  	 	8.53	  	  	 	8.11	  	  	 	7.98	  	  	 	8.01	  
	81	  	 	10.91	  	  	 	10.30	  	  	 	10.48	  	  	 	8.80	  	  	 	8.67	  	  	 	8.71	  	  	 	8.34	  	  	 	8.23	  	  	 	8.26	  
	82	  	 	11.38	  	  	 	10.78	  	  	 	10.96	  	  	 	8.97	  	  	 	8.86	  	  	 	8.89	  	  	 	8.60	  	  	 	8.48	  	  	 	8.53	  
	83	  	 	11.88	  	  	 	11.30	  	  	 	11.47	  	  	 	9.12	  	  	 	9.04	  	  	 	9.06	  	  	 	8.84	  	  	 	8.75	  	  	 	8.77	  
	84	  	 	12.42	  	  	 	11.87	  	  	 	12.03	  	  	 	9.27	  	  	 	9.21	  	  	 	9.23	  	  	 	9.09	  	  	 	9.01	  	  	 	9.05	  
	85	  	 	12.99	  	  	 	12.48	  	  	 	12.63	  	  	 	9.41	  	  	 	9.37	  	  	 	9.38	  	  	 	9.35	  	  	 	9.31	  	  	 	9.32	  
	86	  				  				  				  	 	9.54	  	  	 	9.51	  	  	 	9.52	  	  				  				  			
	87	  				  				  				  	 	9.67	  	  	 	9.65	  	  	 	9.65	  	  				  				  			
	88	  				  				  				  	 	9.78	  	  	 	9.77	  	  	 	9.77	  	  				  				  			
	89	  				  				  				  	 	9.89	  	  	 	9.88	  	  	 	9.88	  	  				  				  			
	90	  				  				  				  	 	9.98	  	  	 	9.98	  	  	 	9.98	  	  				  				  			
	91	  				  				  				  	 	10.07	  	  	 	10.07	  	  	 	10.07	  	  				  				  			
	92	  				  				  				  	 	10.15	  	  	 	10.15	  	  	 	10.15	  	  				  				  			
	93	  				  				  				  	 	10.22	  	  	 	10.22	  	  	 	10.22	  	  				  				  			
	94	  				  				  				  	 	10.28	  	  	 	10.28	  	  	 	10.28	  	  				  				  			
	95	  				  				  				  	 	10.34	  	  	 	10.33	  	  	 	10.33	  	  				  				  			

  

	*	 Adjusted age as defined in Section 10.A. 



	**	 The discount factor per day which corresponds to the assumed investment return of 5.0% is .99986634. 



Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables will be calculated on the same
basis as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 

  

					
	H1358	  	Page 20	  	









 Variable Income Option 5-V (a)

Monthly Installment For Joint and Full Survivor 
  

																													
	 Adjusted Age

of
 Male

Annuitant*
	  	Adjusted Age of Female Annuitant*	 
	  	15 Years
Less Than
Male	 	  	12 Years
Less Than
Male	 	  	9 Years
Less Than
Male	 	  	6 Years
Less Than
Male	 	  	3 Years
Less Than
Male	 	  	Same As
Male	 	  	3 Years
More Than
Male	 
	50	  	$	4.37	  	  	$	4.42	  	  	$	4.46	  	  	$	4.51	  	  	$	4.56	  	  	$	4.62	  	  	$	4.67	  
	55	  	 	4.48	  	  	 	4.54	  	  	 	4.60	  	  	 	4.67	  	  	 	4.74	  	  	 	4.81	  	  	 	4.88	  
	60	  	 	4.62	  	  	 	4.70	  	  	 	4.79	  	  	 	4.88	  	  	 	4.98	  	  	 	5.08	  	  	 	5.18	  
	65	  	 	4.81	  	  	 	4.92	  	  	 	5.04	  	  	 	5.17	  	  	 	5.31	  	  	 	5.46	  	  	 	5.61	  
	70	  	 	5.07	  	  	 	5.23	  	  	 	5.40	  	  	 	5.59	  	  	 	5.79	  	  	 	6.00	  	  	 	6.22	  
	75	  	 	5.43	  	  	 	5.65	  	  	 	5.90	  	  	 	6.18	  	  	 	6.48	  	  	 	6.79	  	  	 	7.11	  
	80	  	 	5.94	  	  	 	6.26	  	  	 	6.63	  	  	 	7.04	  	  	 	7.49	  	  	 	7.95	  	  	 	8.40	  
	85	  	 	6.67	  	  	 	7.15	  	  	 	7.70	  	  	 	8.31	  	  	 	8.97	  	  	 	9.63	  	  	 	10.26	  

 Monthly Installment For Unisex Joint and Full Survivor 

 

																													
	 Adjusted Age

of

First
 Annuitant*
	  	Adjusted Age of Joint Annuitant*	 
	  	15 Years
Less Than
First	 	  	12 Years
Less Than
First	 	  	9 Years
Less Than
First	 	  	6 Years
Less Than
First	 	  	3 Years
Less Than
First	 	  	Same As
First	 	  	3 Years
More Than
First	 
	50	  	$	4.38	  	  	$	4.42	  	  	$	4.47	  	  	$	4.51	  	  	$	4.56	  	  	$	4.61	  	  	$	4.66	  
	55	  	 	4.48	  	  	 	4.54	  	  	 	4.60	  	  	 	4.67	  	  	 	4.73	  	  	 	4.80	  	  	 	4.87	  
	60	  	 	4.63	  	  	 	4.70	  	  	 	4.79	  	  	 	4.88	  	  	 	4.97	  	  	 	5.07	  	  	 	5.16	  
	65	  	 	4.82	  	  	 	4.93	  	  	 	5.05	  	  	 	5.17	  	  	 	5.30	  	  	 	5.44	  	  	 	5.57	  
	70	  	 	5.09	  	  	 	5.24	  	  	 	5.41	  	  	 	5.59	  	  	 	5.78	  	  	 	5.97	  	  	 	6.16	  
	75	  	 	5.46	  	  	 	5.68	  	  	 	5.93	  	  	 	6.19	  	  	 	6.47	  	  	 	6.75	  	  	 	7.03	  
	80	  	 	5.99	  	  	 	6.31	  	  	 	6.67	  	  	 	7.07	  	  	 	7.48	  	  	 	7.90	  	  	 	8.30	  
	85	  	 	6.75	  	  	 	7.23	  	  	 	7.76	  	  	 	8.35	  	  	 	8.97	  	  	 	9.59	  	  	 	10.17	  
	
	 *  Adjusted age as defined in Section 10.A
	      


 Variable Income Option 5-V (b) 

Monthly Installment For Joint and Full Survivor (Life with Emergency Cash (SM)) 

 

																													
	 Adjusted Age

of
 Male

Annuitant*
	  	Adjusted Age of Female Annuitant*	 
	  	15 Years
Less Than
Male	 	  	12 Years
Less Than
Male	 	  	9 Years
Less Than
Male	 	  	6 Years
Less Than
Male	 	  	3 Years
Less Than
Male	 	  	Same As
Male	 	  	3 Years
More Than
Male	 
	50	  	$	4.34	  	  	$	4.38	  	  	$	4.42	  	  	$	4.47	  	  	$	4.51	  	  	$	4.57	  	  	$	4.61	  
	55	  	 	4.43	  	  	 	4.48	  	  	 	4.54	  	  	 	4.60	  	  	 	4.67	  	  	 	4.74	  	  	 	4.79	  
	60	  	 	4.55	  	  	 	4.62	  	  	 	4.70	  	  	 	4.78	  	  	 	4.88	  	  	 	4.97	  	  	 	5.05	  
	65	  	 	4.71	  	  	 	4.80	  	  	 	4.91	  	  	 	5.03	  	  	 	5.16	  	  	 	5.30	  	  	 	5.41	  
	70	  	 	4.92	  	  	 	5.05	  	  	 	5.21	  	  	 	5.38	  	  	 	5.56	  	  	 	5.76	  	  	 	5.91	  
	75	  	 	5.21	  	  	 	5.40	  	  	 	5.61	  	  	 	5.86	  	  	 	6.12	  	  	 	6.40	  	  	 	6.61	  
	80	  	 	5.61	  	  	 	5.88	  	  	 	6.19	  	  	 	6.53	  	  	 	6.90	  	  	 	7.29	  	  	 	7.56	  
	85	  	 	6.16	  	  	 	6.54	  	  	 	6.98	  	  	 	7.46	  	  	 	7.95	  	  	 	8.41	  	  	 	8.76	  

 Monthly Installment For Unisex Joint and Full Survivor (Life with Emergency Cash (SM)) 

 

																													
	 Adjusted Age

of

First
 Annuitant*
	  	Adjusted Age of Joint Annuitant*	 
	  	15 Years
Less Than
First	 	  	12 Years
Less Than
First	 	  	9 Years
Less Than
First	 	  	6 Years
Less Than
First	 	  	3 Years
Less Than
First	 	  	Same As
First	 	  	3 Years
More Than
First	 
	50	  	$	4.34	  	  	$	4.38	  	  	$	4.42	  	  	$	4.47	  	  	$	4.51	  	  	$	4.56	  	  	$	4.60	  
	55	  	 	4.43	  	  	 	4.48	  	  	 	4.54	  	  	 	4.60	  	  	 	4.67	  	  	 	4.73	  	  	 	4.78	  
	60	  	 	4.55	  	  	 	4.62	  	  	 	4.70	  	  	 	4.78	  	  	 	4.87	  	  	 	4.96	  	  	 	5.03	  
	65	  	 	4.71	  	  	 	4.81	  	  	 	4.92	  	  	 	5.03	  	  	 	5.16	  	  	 	5.29	  	  	 	5.38	  
	70	  	 	4.93	  	  	 	5.07	  	  	 	5.22	  	  	 	5.38	  	  	 	5.56	  	  	 	5.74	  	  	 	5.87	  
	75	  	 	5.23	  	  	 	5.42	  	  	 	5.63	  	  	 	5.87	  	  	 	6.12	  	  	 	6.38	  	  	 	6.56	  
	80	  	 	5.64	  	  	 	5.91	  	  	 	6.21	  	  	 	6.55	  	  	 	6.90	  	  	 	7.26	  	  	 	7.51	  
	85	  	 	6.21	  	  	 	6.58	  	  	 	7.02	  	  	 	7.48	  	  	 	7.97	  	  	 	8.41	  	  	 	8.74	  
	
	 *  Adjusted age as defined in Section 10.A
	      


 Dollar amounts of monthly, quarterly, semi-annual, and annual installments not shown in the above tables
will be calculated on the same basis as those shown and may be obtained from the Company (if the option is available based on adjusted age as described in Section 10). 

  

					
	J1358	  	Page 21	  	









 SECTION 11 – GENERAL PROVISIONS 

 


 THE CONTRACT 
 This policy, which includes any attached endorsements and riders, constitutes the entire contract between you and us. 
 MODIFICATION OF POLICY 
 No change in this policy is valid unless made in
writing by us and approved by one of our authorized officers. No agent or registered representative has authority to change or waive any provision of Your policy. 
 TAX QUALIFICATION 
 This policy is intended to qualify as an annuity
contract for federal income tax purposes. The provisions of this policy are to be interpreted to maintain such qualification, notwithstanding any other provisions to the contrary. To maintain such tax qualification, we reserve the right to amend
this policy to reflect any clarifications that may be needed or are appropriate to maintain such tax qualification or to conform this policy to any applicable changes in the tax qualification requirements. We will send you a copy in the event of any
such amendment If you refuse such an amendment it must be by giving us written notice, and your refusal may result in adverse tax consequences. 

NON-PARTICIPATING 
 This policy will not
share in our profits or surplus. 
 AGE OR SEX CORRECTIONS 
 If the age or sex of the annuitant has been misstated, the benefits will be those, which the premiums paid, would have purchased for the correct age and sex. Any underpayment made by us will be paid with
the next payment Any overpayment made by us will be deducted from future payments. Any underpayment or overpayment will include interest from the date of the incorrect payment to the date of the adjustment 

INCONTESTABILITY 
 This policy shall be
incontestable from the policy date. 
 EVIDENCE OF SURVIVAL 
 We have the right to require evidence satisfactory to us that a person was alive if a payment is based on that person being alive. No payment will be made until we receive the evidence of continued
survival. 
 SETTLEMENT 
 Any payment by us under this policy is payable at our administrative office. 
 RIGHTS OF OWNER

 Prior to the annuity commencement date, the owner may, while the annuitant is living:




	 	1.	 Assign this policy. 


  

	 	2.	 Surrender the policy to us. 


  

	 	3.	 Amend or modify the policy with our consent. 


  

	 	4.	 Elect to receive annuity payments or name a payee to receive the payments. 



 

	 	5.	 Exercise, receive, and enjoy every other right and benefit contained in the policy. 



The use of these rights may be subject to the consent of any assignee, irrevocable beneficiary, and of the spouse in a community or
marital property state. 
 CHANGE OF OWNERSHIP 
 As permitted by law, you can change the owner of this policy by notifying us in writing in a form and manner acceptable to us. When a change takes effect, all rights of ownership in this policy will pass
to the new owner. 
 A change of owner will not be effective until it is recorded in our records. After it has been so recorded,
the change will take effect as of the date you signed the notice. However, if the annuitant dies before the notice has been so recorded, it will not be effective as to those proceeds we have paid before the change was recorded in our records.

 We may require that the change be endorsed in the policy. Changing the owner does not change the beneficiary or the
annuitant. 
 A change of ownership may result in adverse tax consequences. 

COMMUNITY OR MARITAL PROPERTY 
 Unless we are notified in accordance with applicable law of a community or marital property interest in this policy, We are not bound by any such interest. 

ANNUITY COMMENCEMENT DATE 

The annuity commencement date is the date payments begin under an income option. In no event can this date be later than the last day of
the month following the month in which the annuitant attains age 95. You may change the annuity commencement date at any time by giving us 30 days’ written notice. 
 ASSIGNMENT 
 Before the annuity commencement date, you may assign this
policy as permitted by law. The assignment must be in writing and filed with us. We assume no responsibility for the validity of any assignment Any claim made under an assignment shall be subject to proof of interest and the extent of the
assignment. 
 Assignment of this policy may result in adverse tax consequences.


 


  

					
	R363	  	Page 22	  	









 SECTION 11 – CONTINUED 

 


 BENEFICIARY 
 Death proceeds, when payable in accordance with Section 9, are payable to the designated beneficiary or beneficiaries. Prior to the annuitant’s death, you may name or change a beneficiary,
without the beneficiary’s consent (unless irrevocably designated or required by law) at any time by notifying us in writing in a form and manner acceptable to us. The change will take effect upon the date you sign it, whether or not you are
living when we receive it. The notice must have been postmarked (or show other evidence of delivery that is acceptable to us) on or before the date of the annuitant’s death. Your most recent change of beneficiary notice will replace any prior
beneficiary designations in their entirety. No change will apply to any payment we made before the written notice was received. If an irrevocable beneficiary dies, you may designate a new beneficiary. 

You may direct the manner of payment of death proceeds pursuant to the terms of this policy, subject to applicable law. In the absence of
such direction, the beneficiary may elect the manner of payment or make an election of any option. 
 Only those beneficiaries
living or in existence at the time of the annuitant’s death will be eligible to receive a share of the death proceeds. If both primary and contingent beneficiaries have been named, payment will be made to the named primary beneficiaries living
or in existence at the time the death proceeds become payable. Payment will be made to the named contingent beneficiaries only if all primary beneficiaries have died before the death proceeds become payable. 

If death proceeds are payable to more than one beneficiary and you failed to specify their interest, they will share equally. If any
beneficiary is alive at the time the death proceeds become payable, but dies before receiving their payment, their share will be paid to their estate.



 PROTECTION OF PROCEEDS 
 The policy and payments under it will be exempt from the claims of creditors to the extent permitted by law. Unless you so direct by filing written notice with us, no beneficiary may assign any payments
under this policy before the payments are due. To the extent permitted by law, no payments under this policy will be subject to the claims of creditors of any beneficiary. 
 DEFERMENT 
 We will pay any partial withdrawals or surrender proceeds from
the separate account within 7 days after all requirements have been met. However, it may happen that the New York Stock Exchange is closed for trading (other than the usual weekend or holiday closings), or the Securities and Exchange Commission
restricts trading or determines that an emergency exists. If so, it may not be practical for us to determine the investment experience of the separate account In that case, we may defer transfers among the subaccounts and to the fixed account, and
determination or payment of partial withdrawals or surrender proceeds. 
 When permitted by law, we may defer paying any partial
withdrawals or surrender proceeds from the fixed account for up to 6 months from the date we receive your request. If the annuitant dies after the request is made, but before the request is processed, the request will be processed before the death
proceeds are determined. 
 REPORTS TO OWNER 
 We will give you an annual report at least once each policy year. This report will show the number and value of the accumulation units held in each of the subaccounts as well as the value of the fixed
account. It will also show the death benefit, cash value, and any other facts required by law or regulation The report will be sent to you at the most current address we have recorded for you.


 


  

					
	RB363	  	Page 23	  	










			
	 




	  	 Home Office:
 4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499 (319)355-8511

	  

 DEATH BENEFIT RIDER 
 The Guaranteed Minimum Death Benefit provision in the Death Proceeds Section of the policy to which this Rider is attached, is amended to include the addition of the following language: 

The amount of this Guaranteed Minimum Death Benefit is equal to 100% of the total premiums paid for this policy, less any Adjusted
Partial Withdrawals (as described below), as of the date of death. 
 A partial withdrawal will reduce the Guaranteed Minimum
Death Benefit by an amount referred to as the “Adjusted Partial Withdrawal”. The Adjusted Partial Withdrawal may be a different amount than the Gross Partial Withdrawal. If at the time of the partial withdrawal.the Policy Value is greater
than or equal to the Death Proceeds, the Adjusted Partial Withdrawal will equal the Gross Partial Withdrawal. If at the time of the partial withdrawal, the Policy Value is less than the Death Proceeds, the Adjusted Partial Withdrawal will be greater
than the Gross Partial Withdrawal. 
 The Adjusted Partial Withdrawal is equal to the Gross Partial Withdrawal multiplied by the
Death Proceeds immediately prior to the partial withdrawal divided by the Policy Value immediately prior to the partial withdrawal. The formula is APW = GPW x (DP/PV) where: 

 

					
	 GPW
	 	 =
	  	 Gross Partial Withdrawal

	 DP
	 	 =
	  	 Death Proceeds prior to the partial withdrawal = greatest of (PV, CV, or GMDB)

	 PV
	 	 =
	  	 Policy Value prior to the partial withdrawal

	 GMDB
	 	 =
	  	 Guaranteed Minimum Death Benefit prior to the partial withdrawal

	 CV
	 	 =
	  	 Cash Value prior to the partial withdrawal


 This Rider is effective on the Policy Date and can only be terminated when the policy to which this Rider
is attached terminates. This Rider is subject to all the terms and conditions of the policy not inconsistent herewith. 
 Signed
for us at our home office. 
  

			
	



	  	




	 SECRETARY
	  	PRESIDENT


  

					
	 RGMD 8 0603
	  		  	
























			
	



	  	 Home Office:
 4333 Edgewood Road N.E. Cedar Rapids, Iowa 52499 (319)355-8511

	  

 INDEX 

 



					
	 	  	Page	 
	 Accumulation Units
	  	 	9	  
	 Adjusted Age
	  	 	14	  
	 Adjusted Policy Value
	  	 	4	  
	 Age or Sex Corrections
	  	 	22	  
	 Annuity Commencement Date
	  	 	22	  
	 Assignment
	  	 	22	  
	 Beneficiary
	  	 	23	  
	 Cash Value
	  	 	5	  
	 Contract
	  	 	22	  
	 Death Proceeds
	  	 	12	  
	 Definitions
	  	 	2	  
	 Dollar Cost Averaging Option
	  	 	11	  
	 Evidence of Survival
	  	 	22	  
	 Excess Interest Adjustment
	  	 	5	  
	 Fixed Account
	  	 	10	  
	 Guaranteed Periods
	  	 	10	  
	 Guaranteed Return of Fixed Account Premium Payments
	  	 	8	  
	 Income Options
	  	 	14	  

 


					
	 	  	Page	 
	 Income Option Tables
	  	 	18	  
	 Incontestability
	  	 	22	  
	 Modification of Policy
	  	 	22	  
	 Non-participating
	  	 	22	  
	 Option to Change Annuity Commencement Date
	  	 	22	  
	 Partial Withdrawals
	  	 	6	  
	 Payee
	  	 	14	  
	 Payment of Premiums
	  	 	4	  
	 Policy Data Page
	  	 	3	  
	 Policy Value
	  	 	4	  
	 Proof of Age
	  	 	14	  
	 Protection of Proceeds
	  	 	23	  
	 Right to Cancel
	  	 	1	  
	 Rights of Owner
	  	 	22	  
	 Separate Account
	  	 	8	  
	 Service Charge
	  	 	4	  
	 Settlement
	  	 	22	  
	 Tax Qualification
	  	 	22	  
	 Transfers
	  	 	11	  

 
 

  
 FLEXIBLE PREMIUM
DEFERRED VARIABLE ANNUITY 
 INCOME PAYABLE AT ANNUITY COMMENCEMENT DATE 

BENEFITS BASED ON THE PERFORMANCE OF THE SEPARATE ACCOUNT 
 ARE VARIABLE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT (SEE SECTIONS 6 AND 10C) 
 NON-PARTICIPATING 

  

					
	Y1086