EX-99.4.G 8 c86086exv99w4wg.txt FORM OF MAX. ANNIVERSARY VALUE DEATH BENEFIT RIDER EXHIBIT 4(g) MAXIMUM ANNIVERSARY VALUE DEATH BENEFIT RIDER RIDER SECTION 1. GENERAL INFORMATION 1.1 WHAT IS OUR Our agreement with you includes this rider AGREEMENT WITH YOU? as a part of the contract to which it is attached. The provisions of the contract apply to this rider unless they conflict with the rider. If there is a conflict, the rider provision will apply. The issue date for this rider is the same issue date as the contract to which it is attached. We promise to provide the death benefit described in this rider as long as the contract and this rider are in force and all the terms and conditions of this rider are met. 1.2 WHAT IS THE BENEFIT This rider provides a maximum anniversary PROVIDED BY THIS value death benefit during the accumulation RIDER? period. 1.3 WHEN WILL THIS RIDER This rider will terminate on the earliest TERMINATE? of: a.) the date death proceeds become payable; b.) the payout date; c.) the date you surrender your contract; or d.) the date you choose to end this rider. You may end it by written request. Once this rider terminates, the charges for it will cease and the benefit will no longer be available. RIDER SECTION 2. RIDER CHARGES 2.1 IS THERE A CHARGE FOR There is an annual charge for this rider. THIS RIDER? The annual charge is determined by multiplying the annual percentage charge (shown on the contract data page) by the average monthly contract value for the prior year. The average monthly contract value is equal to the sum of each monthly contract value (the contract value as of the same day of the month as the contract issue date) divided by the number of months. During the accumulation period, this charge will be deducted pro-rata from your contract value on each contract anniversary. This charge will also be deducted upon full surrender of the contract, payment of death proceeds or selection of a payout option, if not on a contract anniversary. The charge for a partial year will be in proportion to the number of days since the prior contract anniversary RIDER SECTION 3. DEATH BENEFIT PROCEEDS 3.1 WHAT AMOUNT WILL BE PAID The amount that will be paid under this AS DEATH BENEFIT PROCEEDS contract as death benefit proceeds is equal DURING THE ACCUMULATION to the greater of: PERIOD? a.) the death benefit proceeds provided by the contract to which this rider is attached; b.) the death benefit proceeds provided by any other rider attached to the contract; or c.) the maximum anniversary value described in Rider Section 4 as of the date due proof of death is received. The death benefit proceeds described above will be reduced by any applicable premium expense charges not previously deducted. RIDER SECTION 4. MAXIMUM ANNIVERSARY VALUE 4.1 WHAT IS THE MAXIMUM On the contract issue date, the maximum ANNIVERSARY VALUE? anniversary value is equal to your initial purchase payment. After the contract issue date, the maximum anniversary value will be calculated on the following dates: a.) the date we receive an additional purchase payment; b.) the date of payment of a partial withdrawal; and c.) on each contract anniversary. Such value is calculated on each of these dates as follows: PURCHASE PAYMENT. The maximum anniversary value upon receipt of a purchase payment is equal to: a.) the most recently calculated maximum anniversary value; B.) PLUS the net purchase payment. PARTIAL WITHDRAWAL. The maximum anniversary value upon payment of a partial withdrawal is equal to: a.) the most recently calculated maximum anniversary value; b.) MINUS an adjustment for each partial withdrawal equal to (1) divided by (2), with the result multiplied by (3), where: (1)= the partial withdrawal amount; (2)= the contract value immediately prior to the partial withdrawal; and (3)= the most recently calculated maximum anniversary value immediately prior to the partial withdrawal, less any adjustments for prior partial withdrawals. CONTRACT ANNIVERSARY. The maximum anniversary value on each contract anniversary is equal to the greater of: a.) your contract value; or b.) the most recently calculated maximum anniversary value. CUNA Mutual Life Insurance Company A Mutual Insurance Company /s/ Michael B. Kitchen ----------------------- President