Document:

Exhibit 4(c)

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

			
	 

 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

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

					
	 

               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

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 2Exhibit 4(e)

 EXHIBIT 4(e) 
 FORM OF POLICY RIDER 
 (ADDITIONAL DEATH DISTRIBUTION+) 

					
	 

                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

 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 as described below. 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
cancel this benefit at any time by notifying us at our service center. However, if the rider is terminated it can not be re-elected within a year after it was last terminated. Once re-elected, 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
	 Rider Benefit Percentage:
	  	30%
	 Rider Fee Percentage:*
	  	0.55%

 *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 Benefit Base 
 This amount is equal to the Policy Value minus premiums paid after the
Rider Date. 
 Rider Date 
 The
date that this rider is added to the policy. 
 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 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. If death occurs prior to the fifth Rider Anniversary, the rider will pay an Additional Death Benefit equal to the sum of all Rider Fees paid since the Rider Date. If death occurs on or after the fifth Rider
Anniversary, the rider will pay an Additional Death Benefit equal to the Rider Benefit Percentage multiplied by the Rider Benefit Base on the date used to calculate the death proceeds. This amount cannot be withdrawn as a lump sum.

  

					
	ICC12 RTP170513	 	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: 
 The Additional Death Benefit rider is added to a new policy opened with $100,000 initial premium. The
Rider Benefit Percentage is 30% and the Rider Fee Percentage is 0.55%. On the first and second Rider Anniversaries, the Policy Value is $110,000 and $95,000 respectively when the Rider Fees are deducted. The client adds $25,000 premium in the third
Rider Year. After five years, the Policy Value has grown to $130,000 and death proceeds have grown to $150,000. 
  

					
	  

Additional Death Benefit Example Calculations:

 
	  	 	 	 
	 Death proceeds on Rider Date (= initial Policy Value)
	  	$	100,000	  
	 Additional Death Benefit during 1st rider year
	  	$	0	  
	 Rider Fee on first Rider Anniversary (= Rider Fee Percentage * Policy
Value = 0.55% * $110,000)
	  	$	605	  
	 Additional Death Benefit during 2nd rider year (= sum of total Rider Fees
paid)
	  	$	605	  
	 Rider Fee on second Rider Anniversary (= Rider Fee Percentage * Policy
Value = 0.55% * $95,000)
	  	$	522.50	  
	 Additional Death Benefit during 3rd
rider year (= sum of total Rider Fees paid =
$605 + $522.40)
	  	$	  1,127.50	  
	  
 Rider Fees will continue to be deducted each Rider Anniversary.
  
	 
   
 

	 Rider Benefit Base after 5th rider year (=
Policy Value - premiums = $130,000 - $25,000)
	  	$	105,000	  
	 Additional Death Benefit after 5th rider year = Rider Benefit Percentage
*
Rider Benefit Base = 30% * $105,000
	  	$	31,500	  
	 Total death proceeds (= base policy
death proceeds + Additional Death Benefit amount =
$150,000 + $31,500)
	  	$	181,500	  

 Signed for us at our Home Office. 

 

			
	 

 SECRETARY
	  	 

 PRESIDENT

  

					
	ICC12 RTP170513	 	Page 2

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00215-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00215-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00215-of-00352.parquet"}]]