Document:

Exhibit 4.H

 EXHIBIT (4)(h) 
  
 FORM OF POLICY RIDER 
 (5 FOR LIFE – GROWTH – WITH DEATH BENEFIT) 

			
	

	  	 Home Office:
 4333 Edgewood Road N.E.
 Cedar Rapids, Iowa 52499
 (319)398-8511

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

  
 GUARANTEED MINIMUM WITHDRAWAL BENEFIT PLUS GROWTH

 AND DEATH BENEFIT RIDER 
  
 This rider is issued as a part of the policy (contract) to which it is attached. Policy refers to the individual policy if the rider is attached to an individual annuity
or the group certificate if the rider is attached to a group annuity. 
  
 Rider Data Specification 
  

				
	 Policy Number:
	  	07 - 12345	 
	 Rider Date:
	  	9-01-2005	 
	 Growth Rate Percentage:
	  	5.00	%
	 “For Life” Withdrawal Percentage:*
	  	5.00	%
	 Rider Fee Percentage:
	  	0.75	%

  

	*	If the annuitant is not yet 59 on the rider date, then this percentage will be zero until the January 1st following the annuitant’s 59th birthday. 

  
 ARTICLE I 
  
 This rider is not available for an existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner.
This rider will terminate upon the annuitant’s death, if you surrender your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the
policy to which this rider is attached is assigned or if the owner is changed without our approval. You can terminate this rider any time after the third rider anniversary. Termination of the rider will result in the loss of all benefits provided by
the 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 policy to a non-designated fund while this rider is in force. After
the third rider anniversary, if you wish to make a transfer to a non-designated fund, this rider must be terminated prior to making the transfer. 
  
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 
  
 DEFINITIONS: 
  
 Terms used that are not defined in this rider shall have the same meaning as those in your policy. 
  
 Gross Partial Withdrawal 
  
 The amount which will be deducted from your policy value as a result of each partial withdrawal. 
  
 Rider Anniversary 
  
 The anniversary of the rider date. 
  
 Rider Fee 
  
 The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This fee will be deducted from each investment option in proportion to the amount of
policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days that have elapsed since it was last deducted. 
  
 Rider Year 
  
 Each twelve–month period following the rider date. 
  

					
	RGMB 15 0905	  	(1)	  	 

 ARTICLE II 
  
 GROWTH BENEFIT AND GROWTH PERIOD 
  
 The total withdrawal base will accumulate using the growth rate percentage as described in Article II. The growth period is the period of time from the rider date until
the earlier of the first withdrawal or the 10th rider anniversary. 
  
 FOR LIFE
GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
  
 Under this rider, we guarantee that
you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the annuitant’s death. 
  
 Withdrawals will reduce the policy value of the policy to which this rider is attached. Once the policy value equals zero, you cannot make subsequent premium payments and
all other policy features, benefits and guarantees are terminated except those provided by this rider. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the
payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
  
 Maximum Annual Withdrawal Amount 
  
 On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2 where: 
  

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage shown on page 1. If the annuitant is not yet 59 on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year.

  

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the
annuitant’s age only if all of the following are true: 

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

  

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased,

  

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current calendar year. Amounts carried over from past calendar years are not considered. 

  
 If any of the above are not true, then 2) is equal to zero and it is not
available as a maximum annual withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an
excess gross partial withdrawal (as described under “Total Withdrawal Base” below). 
  
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal amount will be reset equal to the greater of 1 and 2 where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage shown on page 1. If the annuitant is not yet 59 on January 1st of the current calendar year, this percentage will be equal to 0%.

  

					
	RGMB 15 0905	  	(2)	  	 

 ARTICLE II CONTINUED 
  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true:

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

  

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased,

  

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current calendar year. Amounts carried over from past calendar years are not considered. 

  
 If any of the above are not true, then 2) is equal to zero and the minimum
required distribution is not available as a maximum annual withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be
considered an excess gross partial withdrawal (as described under “Total Withdrawal Base Adjustments” below). 
  
 Minimum Remaining Withdrawal Amount 
  
 The minimum remaining withdrawal amount is the total minimum dollar amount of guaranteed withdrawals you have remaining, provided withdrawals do not exceed the maximum
annual withdrawal amount each rider year. The minimum remaining withdrawal amount on the rider date is equal to the policy value (less premium enhancements, if the rider is added in the first policy year). The minimum remaining withdrawal amount
after the rider date is equal to the minimum remaining withdrawal amount on the rider date plus any premiums added after the rider date (not including premium enhancements, if any) less any adjustments for withdrawals (as described under
“Minimum Withdrawal Amount Adjustments” below). 
  
 Minimum Remaining
Withdrawal Amount Adjustments 
  
 Gross partial withdrawals up to the maximum
annual withdrawal amount will reduce the minimum remaining withdrawal amount by the same amount (dollar for dollar). Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the minimum remaining withdrawal amount by
the greater of: 
  

	1)	the excess gross partial withdrawal amount; and 

  

	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

  

	 	B	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C	is the minimum remaining withdrawal amount after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount. 

 
 Total Withdrawal Base 
  
 The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first
policy year). 
  
 The total withdrawal base during the growth period (as
described in “Growth Benefit and Growth Period” above) is equal to: 
  

	 	A)	the total withdrawal base on the rider date; plus 

  

	 	B)	any premiums added during the growth period, 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

  
 The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period; less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any.

  

					
	RGMB 15 0905	  	(3)	  	 

 ARTICLE II CONTINUED 
  
 Total Withdrawal Base Adjustments 
  
 Gross partial withdrawals up to the maximum annual withdrawal amount will not reduce the total withdrawal base. Gross partial withdrawals in excess of the maximum annual
withdrawal amount will reduce the total withdrawal base by the greater of: 
  

	 	1)	the excess gross partial withdrawal amount; and 

  

	 	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

  

	 	B	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C	is the total withdrawal base prior to the withdrawal of the excess amount. 

  
 Death Benefit 
  
 Upon the death of the annuitant, we will pay an additional death benefit amount equal to the excess, if any, of the minimum remaining withdrawal amount over the base policy death benefit and this rider will then
terminate. 
  
 ARTICLE III 
  
 CONTINUATION 
  
 In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse
is the sole beneficiary, the surviving spouse may elect to continue the policy and rider and no additional death benefit will be paid under this rider. 
  
 In the case of non-spousal joint owners where an owner who is not the annuitant dies, the surviving owner (who is also the sole designated beneficiary) may elect to
receive lifetime income payments instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later than 1 year after the owner’s death and will be equal to the maximum annual withdrawal amount divided
by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional withdrawals will be paid. If these payments are elected but the annuitant dies before the minimum remaining
withdrawal amount equals zero, the annuitant’s beneficiary will receive a death benefit equal to the minimum remaining withdrawal amount. 
  
 RIDER UPGRADE 
  
 You may elect, in writing, to upgrade the total withdrawal base to the policy value, after the third rider anniversary, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will
terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Growth Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will also have its own
Rider Fee Percentage which may be higher than this rider’s rider fee percentage. 
  
 At the time of upgrade, the minimum remaining withdrawal amounts will also be upgraded to the policy value and the maximum annual withdrawal amounts will be recalculated based on the new total withdrawal base. 
  
 The new rider effective date will be the date the Company receives all information necessary,
in a written form acceptable to the Company, to process the upgrade. The Company currently allows an upgrade at any time after the third rider anniversary. After your fourth rider anniversary, the Company reserves the right to limit upgrade requests
to 30 calendar days after each rider anniversary. 
  
 Signed for us
at our home office. 
  

					
			
	

	 	 	 	

	SECRETARY	 	 	 	PRESIDENT

  

					
	RGMB 15 0905	  	(4)Exhibit 4.H

 EXHIBIT (4)(h) 
  
 FORM OF RIDER (5 FOR LIFE – GROWTH – WITHOUT DEATH BENEFIT) 

			
	WESTERN RESERVE LIFE	  	Home Office: Columbus, Ohio
	ASSURANCE CO. OF OHIO	  	Administrative Office:
	A Stock Company	  	P.O. Box 9051
	(Hereafter called the Company, We, Our or Us)	  	Clearwater, Florida 33758-9051
	 	  	(800) 851-9777

  
 GUARANTEED MINIMUM
WITHDRAWAL BENEFIT 
 PLUS GROWTH RIDER 
  
 This rider is issued as a part of the policy (contract) to which it is attached. 
  

Rider Data Specification 
  

				
	 Policy Number:
	  	07 - 12345	 
	 Rider Date:
	  	09-01-2005	 
	 Growth Rate Percentage:
	  	5.00	%
	 “For Life” Withdrawal Percentage:*
	  	5.00	%
	 Rider Fee Percentage:
	  	0.60	%

  

	*	lf the annuitant is not yet 59 on the rider date, then this percentage will be zero until the January 1st following the annuitant’s 59th birthday. 

  

  
 ARTICLE I 
  
 This rider is not available for an existing qualified policy which has been continued by a surviving spouse or beneficiary as the new owner. This rider will terminate upon the annuitant’s death, if you surrender
your policy, elect to upgrade (as described in Article III of this rider), or elect to receive annuity payments under your policy. This rider will also terminate if the policy to which this rider is attached is assigned or if the owner is changed
without our approval. You can terminate this rider any time after the third rider anniversary. Termination of the rider will result in the loss of all benefits provided by the 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 policy to a non-designated fund while this rider is in force. After the third rider anniversary, if you wish to make a transfer to a
non-designated fund, this rider must be terminated prior to making the transfer. 
  
 A rider fee will be deducted on each rider anniversary and upon rider termination as described below. 
  
 DEFINITIONS: 
  
 Terms used that are not
defined in this rider shall have the same meaning as those in your policy. 
  
 Gross Partial Withdrawal 
  
 The amount which will be deducted
from your policy value as a result of each partial withdrawal. 
  
 Rider
Anniversary 
  
 The anniversary of the rider date. 
  
 Rider Fee 
  
 The rider fee is the rider fee percentage referenced above, multiplied by the total withdrawal base at the time the fee is deducted. This
fee will be deducted from each investment option in proportion to the amount of policy value in that investment option on each rider anniversary. A portion of this fee will also be deducted when the rider is terminated based on the number of days
that have elapsed since it was last deducted. 
  
 Rider Year 
  
 Each twelve-month period following the rider date. 
  

					
	RGMB 16 0905	  	(1)	  	 

 ARTICLE II 
  
 GROWTH BENEFIT AND GROWTH PERIOD 
  
 The total withdrawal base will accumulate using the growth rate percentage as described in Article II. The growth period is the period of time from the rider date until
the earlier of the first withdrawal or the 10th rider anniversary. 
  
 FOR LIFE
GUARANTEED MINIMUM WITHDRAWAL BENEFIT 
  
 Under this rider, we guarantee that
you can withdraw up to the maximum annual withdrawal amount each year, regardless of the policy value, until the annuitant’s death. 
  
 Withdrawals will reduce the policy value of the policy to which this rider is attached. Once the policy value equals zero, you cannot make subsequent premium payments and
all other policy features, benefits and guarantees are terminated except those provided by this rider. Withdrawals guaranteed by this rider can be continued by selecting an amount and frequency of payment in a manner acceptable to us. Once the
payment amount and frequency are established, they cannot be changed and no additional withdrawals will be paid. 
  
 Maximum Annual Withdrawal Amount 
  
 On the rider date the maximum annual withdrawal amount will be equal to the greater of 1 and 2 where: 
  

	1)	is A multiplied by B multiplied by C where: 

  

	 	A)	is the total withdrawal base on the rider date, 

  

	 	B)	is the “For Life” withdrawal percentage shown on page 1. If the annuitant is not yet 59 on the rider date, this percentage will be equal to 0%, and

  

	 	C)	is equal to the number of days between the rider date and January 1st of the next calendar year, divided by the number of days in the current calendar year.

  

	2)	is an amount equal to the minimum required distribution amount (based on the premium paid to the policy to which this rider is attached) for the current calendar year using the
annuitant’s age only if all of the following are true: 

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

  

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased,

  

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current calendar year. Amounts carried over from past calendar years are not considered. 

  
 If any of the above are not true, then 2) is equal to zero and it is not
available as a maximum annual withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions, in certain situations. Such additional withdrawal amount will be considered an
excess gross partial withdrawal (as described under “Total Withdrawal Base Adjustments” below). 
  

					
	RGMB 16 0905	  	(2)	  	 

 ARTICLE II CONTINUED 
  
 On January 1st of each subsequent calendar year following the rider date, the maximum annual withdrawal amount will be reset equal to the
greater of 1 and 2 where: 
  

	1)	is A multiplied by B where: 

  

	 	A)	is the total withdrawal base as of this date, and 

  

	 	B)	is the “For Life” withdrawal percentage shown on page 1. If the annuitant is not yet 59 on January 1st of the current calendar year, this percentage will be equal to 0%.

  

	2)	is an amount equal to the minimum required distribution amount for this policy for the current calendar year using the annuitant’s age only if all of the following are true:

  

	 	A)	the policy to which this rider is attached is a tax-qualified policy for which IRS minimum required distributions are required, 

  

	 	B)	the minimum required distributions do not start prior to the annuitant’s attained age 70 1/2, 

  

	 	C)	the minimum required distributions are based on either the Uniform Lifetime table or the Joint Life and Last Survivor Expectancy table, 

  

	 	D)	the minimum required distributions are based on age of the living annuitant. The minimum required distributions can not be based on the age of someone who is deceased,

  

	 	E)	the minimum required distributions are based only on the policy to which this rider is attached, and 

  

	 	F)	the minimum required distributions are only for the current calendar year. Amounts carried over from past calendar years are not considered. 

  
 If any of the above are not true, then 2) is equal to zero and the minimum
required distribution is not available as a maximum annual withdrawal amount. An amount in addition to the amount described in 2 above, may need to be taken to satisfy minimum required distributions. Such additional withdrawal amount will be
considered an excess gross partial withdrawal (as described under “Total Withdrawal Base Adjustments” below). 
  
 Total Withdrawal Base 
  
 The total withdrawal base on the rider date is equal to the policy value (less any premium enhancements, if the rider is added in the first policy year). 
  
 The total withdrawal base during the growth period (as described in “Growth Benefit and Growth Period” above) is equal to:

  

	 	A)	the total withdrawal base on the rider date; plus 

  

	 	B)	any premiums added during the growth period, 

  

	 	C)	all of which are accumulated daily to the end of the growth period at an annual effective rate equal to the growth rate percentage shown on page 1. 

  
 The total withdrawal base after the growth period is equal to: 
  

	 	A)	the total withdrawal base at the end of the growth period, plus 

  

	 	B)	any premiums added after the growth period; less 

  

	 	C)	any adjustments for withdrawals (as described under “Total Withdrawal Base Adjustments” below) including the withdrawal at the end of the growth period, if any.

  
 Total Withdrawal Base Adjustments 
  
 Gross partial withdrawals up to the maximum annual withdrawal amount will not reduce the
total withdrawal base. Gross partial withdrawals in excess of the maximum annual withdrawal amount will reduce the total withdrawal base by the greater of: 
  

	 	1)	the excess gross partial withdrawal amount; and 

  

	 	2)	the result of (A divided by B), multiplied by C, where: 

  

	 	A	is the excess gross partial withdrawal (the amount in excess of the maximum annual withdrawal amount remaining prior to the withdrawal); 

  

	 	B	is the policy value after the maximum annual withdrawal amount has been withdrawn, but prior to the withdrawal of the excess amount; and 

  

	 	C	is the total withdrawal base prior to the withdrawal of the excess amount. 

  

					
	RGMB 16 0905	  	(3)	  	 

 ARTICLE III 
  
 CONTINUATION 
  
 In the case of spousal joint owners where one spouse is the annuitant, if the spouse who is not the annuitant dies and the surviving spouse is the sole beneficiary, the surviving spouse may elect to continue the
policy and rider. 
  
 In the case of non-spousal joint owners where an owner who
is not the annuitant dies, the surviving owner (who is also the sole designated beneficiary) may elect to receive lifetime income payments instead of receiving any benefits applicable to the policy. The lifetime income payments must begin no later
than 1 year after the owner’s death and will be equal to the maximum annual withdrawal amount divided by the number of payments made per year. Once the payments begin, no additional premium payments will be accepted and no additional
withdrawals will be paid. 
  
 RIDER UPGRADE 
  
 You may elect, in writing, to upgrade the total withdrawal base to the policy value, after
the third rider anniversary, subject to the age restrictions on the new rider. If an upgrade is elected, this rider will terminate and a new rider with the same features will be issued with a new rider date. The new rider will have its own Growth
Rate Percentage which may be lower than this rider’s Growth Rate Percentage. The new rider will also have its own Rider Fee Percentage which may be higher than this rider’s rider fee percentage. 
  
 At the time of upgrade, the maximum annual withdrawal amounts will be recalculated based on
the new total withdrawal base. 
  
 The new rider effective date will be the date
the Company receives all information necessary, in a written form acceptable to the Company, to process the upgrade. The Company currently allows an upgrade at any time after the third rider anniversary. After your fourth rider anniversary, the
Company reserves the right to limit upgrade requests to 30 calendar days after each rider anniversary. 
  
 Signed for us at our home office. 
  

					
			
	

	 	 	 	

	SECRETARY	 	 	 	PRESIDENT

  

					
	RGMB 16 0905	  	(4)

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