Document:

Exhibit 4(b)

 EXHIBIT 4(b) 
 FORM OF POLICY RIDER 
 (RETURN OF PREMIUM) 

					
	

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

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

GUARANTEED MINIMUM DEATH BENEFIT RIDER 
 If You elect this rider, 100% of Your Policy Value must be in one or more of the designated funds. You can generally transfer between the designated funds as permitted under Your policy; however, You
cannot make transfers as provided for in the base policy to a non-designated fund. 
 The fee for this death benefit rider is 0.15%. This fee
has been included in the mortality and expense risk fee and the administrative charge, shown in Section 2 - Policy Data, of the policy to which this rider is attached. 
 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 Withdrawals (as
described below), as of the date of death. 
 A withdrawal will reduce the Guaranteed Minimum Death Benefit by an amount referred to as the
“Adjusted Withdrawal”. The Adjusted Withdrawal may be a different amount than the gross withdrawal. If at the time of the withdrawal, the Policy Value is greater than or equal to the death proceeds, the Adjusted Withdrawal will equal the
gross withdrawal. If at the time of the withdrawal, the Policy Value is less than the death proceeds, the Adjusted Withdrawal will be greater than the gross withdrawal. 
 The Adjusted Withdrawal is equal to the gross withdrawal multiplied by the death proceeds immediately prior to the withdrawal divided by the Policy Value immediately prior to the withdrawal. The formula
is AW = GW x (DP/PV) where: 
  

			
	GW	  	= Gross withdrawal
	DP	  	= Death proceeds prior to the withdrawal = greatest of (PV, CV, or GMDB)
	PV	  	= Policy Value prior to the withdrawal
	GMDB	  	= Guaranteed Minimum Death Benefit prior to the withdrawal
	CV	  	= Cash Value prior to the withdrawal

 The death benefit amount cannot be withdrawn as a lump sum. 

The amount of the death benefit will be included in a report sent to You at least once each year until the Annuity Commencement Date as described in
Section 3, Reports to Owner provision, in the policy. 
 This rider is effective on the Policy Date and can only be terminated when the
policy to which this rider is attached terminates, including when the Policy Value becomes zero, or is annuitized. Once terminated the rider fee will also terminate. This rider is subject to all the terms and conditions of the policy not
inconsistent herewith. In the event of any conflict between the provisions of this rider and provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

Signed for us at our home office. 
  

	
	 

 ICC12 RGMD80513Exhibit 4(c)

 EXHIBIT 4(c) 
 FORM OF POLICY RIDER 
 (ANNUAL STEP-UP) 

			
	 

	  	 Home Office:
 4333 Edgewood Road N.E.
 Cedar Rapids, Iowa 52499

(319)355-8511

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

 GUARANTEED MINIMUM DEATH BENEFIT RIDER 

If You elect this rider, 100% of Your Policy Value must be in one or more of the designated funds. You can generally transfer between the
designated funds as permitted under Your policy; however, You cannot make transfers as provided for in the base policy to a non-designated fund. 
 The fee for this death benefit rider is 0.35%. This fee has been included in the mortality and expense risk fee and the administrative charge, shown in Section 2 - Policy Data, of the policy to which
this rider is attached. 
 The Guaranteed Minimum Death Benefit (GMDB) 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 Guaranteed Minimum Death
Benefit is an Annual Step-Up to age 81 Death Benefit. The amount of this GMDB is equal to: 
 a) the step-up
value as described below; plus 
 b) any Premium Payments subsequent to the previous determination point; minus

 c) any Adjusted Withdrawals subsequent to the previous determination point. 

On the Policy Date, the step-up value is the Policy Value. On each Policy Anniversary (referred to as the determination points) prior to
the earlier of the date of death of the Annuitant or the Annuitant’s 81st birthday, a comparison is made between (a) and (b), where (a) is the Policy Value at this point in time and (b) is the previous step-up value, plus Premium
Payments minus Adjusted Withdrawals (as described below) made since the previous determination point. The larger of (a) and (b) becomes the new step-up value. This step-up process stops at the earlier of the date of death of the Annuitant
or the Annuitant’s 81st birthday. The then current step-up value becomes the final step-up value. 
 A withdrawal as
provided in Section 5 of the policy will reduce the Guaranteed Minimum Death Benefit by an amount referred to as the “Adjusted Withdrawal”. The Adjusted Withdrawal may be a different amount than the gross withdrawal described in
Section 5 of the policy. If at the time of the withdrawal, the Policy Value is greater than or equal to the death proceeds, the Adjusted Withdrawal will equal the gross withdrawal. If at the time of the withdrawal, the Policy Value is less than
the death proceeds, the Adjusted Withdrawal will be greater than the gross withdrawal. 
 The Adjusted Withdrawal formula is AW = GW multiplied
by DP divided by PV, where: 

					
	 AW
	 	=	 	Adjusted Withdrawal
	 GW
	 	=	 	Gross withdrawal
	 DP
	 	=	 	Death proceeds prior to the withdrawal = greatest of (PV, CV, or GMDB)
	 PV
	 	=	 	Policy Value prior to the withdrawal
	 GMDB
	 	=	 	Guaranteed Minimum Death Benefit prior to the withdrawal
	 CV
	 	=	 	Cash Value prior to the withdrawal

 The death benefit amount cannot be withdrawn as a lump sum. 

The amount of the death benefit will be included in a report sent to You at least once each year until the Annuity Commencement Date as
described in Section 3, Reports to Owner provision, in the policy. 
 This rider is effective on the Policy Date and can
only be terminated when the policy to which this rider is attached terminates, including when the Policy Value becomes zero, or is annuitized. Once terminated the rider fee will also terminate. This rider is subject to all the terms and conditions
of the policy not inconsistent herewith. In the event of any conflict between the provisions of this rider and provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

Signed for us at our home office. 
  

			
	 

	  	

	 SECRETARY
	  	PRESIDENT

  
 ICC12 RGMD50513Exhibit 4(d)

 EXHIBIT 4(d) 
 FORM OF POLICY RIDER 
 (ADDITIONAL DEATH DISTRIBUTION) 

			
	 

	  	 Home Office:
 4333 Edgewood Road N.E.    

Cedar Rapids, Iowa 52499    
 (319)355-8511

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

 ADDITIONAL DEATH BENEFIT RIDER 

We issued this rider as a part of the policy to which it is attached. All provisions of the policy that do not conflict with this rider
apply to this rider. In the event of any conflict between the provisions of this rider and the provisions of the policy, the provisions of this rider shall prevail over the provisions of the policy. 

This rider will pay an Additional Death Benefit amount equal to a percentage of the gains accumulated in the policy since the rider was
added. This Additional Death Benefit, if any, will be paid whenever death proceeds are payable on the base policy to which this rider is attached. 
 This rider can only be terminated when the policy to which this rider is attached terminates, including when the Policy Value becomes zero, is annuitized, or an Additional Death Benefit is paid or added
to the policy under spousal continuation under the terms of this rider. You may also terminate this benefit at any time by notifying us at our service center. Once terminated, this rider may be re-elected. However, a new rider will be issued and the
Additional Death Benefit amount will be re-determined. 
 Rider Data Specifications 

 

					
	 Policy Number:
	  	12345	  	
	 Rider Date:
	  	05/01/2013	  	
	 Additional Death Benefit Factor:
	  	40%	  	
	 Rider Fee Percentage:*
	  	0.25%	  	

 *The Rider Fee applies for the life of the rider. 
 DEFINITIONS 
 Rider Anniversary 

The anniversary of the Rider Date for each year the rider remains in force. 
 Rider Date 
 The date that this rider is added to the policy. 

Rider Earnings 
 The
policy gains accrued and not previously withdrawn since the Rider Date. On a given date, this amount is equal to: the current Policy Value of the base policy; minus the Policy Value of the base policy on the Rider Date; minus premiums paid after the
Rider Date; plus amounts withdrawn from the Policy Value after the Rider Date that exceed the Rider Earnings on the date of the withdrawal. 

Rider Fee 
 The Rider Fee
amount is equal to the Rider Fee Percentage above multiplied by the Policy Value on the date the fee is deducted. A Rider Fee is deducted annually on each Rider Anniversary prior to annuitization. We will also deduct this fee upon full Surrender of
the policy or other termination of the rider. However, once terminated the Rider Fee will also terminate. The Rider Fee is deducted pro rata from each Investment Option. The Rider Fee is deducted even during periods when the Additional Death Benefit
rider would not pay any benefit. 
 ADDITIONAL DEATH BENEFIT AMOUNT 

If death proceeds are payable under the terms of the base policy to which this rider is attached, this rider will pay an Additional
Death Benefit equal to the Additional Death Benefit Factor multiplied by the Rider Earnings on the date used to calculate the death proceeds. This amount cannot be withdrawn as a lump sum. 

  

					
	ICC12 RTP180513	  	Page 1	  	

 SPOUSAL CONTINUATION 

If a death occurs and the base policy gives the surviving spouse the right to continue the policy, the surviving spouse
has two options: 
  

	 	1.)	 Receive the death benefit attributable to this rider as well as the death benefit attributable to the base policy, at which time both rider and base
policy would terminate, or 

  

	 	2.)	 Continue the policy and receive a one-time Policy Value increase equal to the amount of the Additional Death Benefit paid by this rider. At this
time the rider would terminate. 

 If the policy is continued, the spouse would have the
option of immediately re-electing the rider if they meet issue requirements at the time the rider is re-elected. 
 REPORTS
TO OWNER 
 The amount of the Additional Death Benefit will be included in a report sent to You at least once
each year until the Annuity Commencement Date as described in Section 3, Reports to Owner provision, in the policy. 

Additional Death Benefit Example: 
  

					
	  

 
 Additional Death Benefit Example
Assumptions:
  
	 

   

	 Policy Value at rider
issue
	 	$	100,000	  
	 Premium Payments after rider
issue
	 	$	25,000	  
	 Policy Value on base
policy
	 	$	    225,000	  
	 Death proceeds on base
policy
	 	$	250,000	  
	 Additional Death Benefit
Factor
	 	 	40%	  
	 Withdrawals that exceed Rider
Earnings
	 	$	0	  
	  

Additional Death Benefit Calculations:

 
	 

  

	 Rider Earnings = Policy Value - Policy
Value on the Rider Date - Premium Payments after the Rider Date + withdrawals that exceed Rider Earnings on date of withdrawal = $225,000 - $100,000 - $25,000 + $0
	 	$	100,000	  
	 	 
	 Additional Death Benefit amount =
Additional Death Benefit Factor * Rider Earnings = 40% * $100,000
	 	$	40,000	  
	 	 
	 Total death proceeds = death proceeds on base policy + Additional Death Benefit amount = $250,000 + $40,000

 
	 	$  
	290,000  
	    

 Signed for us at our Home Office. 

 

			
	 

	  	

	 SECRETARY
	  	PRESIDENT

  

					
	ICC12 RTP180513	  	Page 2

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