Home Office: Cincinnati, Ohio Administrative Office: P.O. Box 5420, Cincinnati, Ohio ###-###-#### EXTENDED CARE WAIVER RIDER

The annuity contract (“Contract”) is changed by this Extended Care Waiver Rider (this “Rider”) to add the following new provisions:

Upon your Written Request, we will waive the Early Withdrawal Charges that may otherwise apply under the Contract to a withdrawal or surrender if at the time of such withdrawal or surrender or within the immediately preceding ninety (90) days all of the following conditions are met:

You must provide us with proof of confinement that meets these conditions. The proof must be satisfactory to us. Your Written Request and satisfactory proof must be provided to us before the date of the withdrawal or surrender.

An amount withdrawn under this waiver will reduce the amount otherwise available under the free withdrawal allowance under the Contract.

Capitalized terms not defined in this Rider have the same meaning as such terms are defined in the Contract. The following additional definitions apply to this Rider:

Insured: An individual whose confinement is used to qualify for benefits under this Rider. Each Owner or joint owner of the Contract on the date that this Rider is issued who is a natural person is an Insured. If on the date that this Rider is issued you or a joint owner is a non-natural person, then each Annuitant on such date who is a natural person is an Insured. For this purpose, an individual acting as a trustee or plan sponsor is not treated as a natural person. Except as provided for a spouse who becomes successor owner, no person may become an Insured after the date that the Rider is issued. If the spouse of the person who is the Insured on the date that this Rider is issued becomes the successor owner of the Contract in lieu of a death benefit, then that spouse will become the Insured.

 

Early Withdrawal Charge: The early withdrawal charge that may apply to a withdrawal or surrender under the Contract. It does not include the reduction in the value of an Indexed Strategy on account of a decline in the Index. It does not include the impact of a vesting factor or other calculation applied to determine the increase in the value of an Indexed Strategy for a rise in the Index. It does not include a rider fee or charge.

Long-Term Care Facility: A Skilled Nursing Facility or an Intermediate Care Facility, other than a facility that:

1)    primarily treats drug addicts or alcoholics;

Skilled Nursing Facility: A facility that meets all of the following requirements:

1)    it is located in the United States or its territories;

4)    it maintains a daily medical record of each patient; and

5)    it provides skilled nursing care under the supervision of a Physician.

Intermediate Care Facility: A facility that meets all of the following requirements:

1)    it is located in the United States or its territories;

4)    it maintains a daily medical record of each patient.

Hospital: A facility that meets all of the following requirements:

1)    it is located in the United States or its territories;

5)    it maintains, or has access to, medical, diagnostic, and major surgical facilities; and

6)    it is supervised by a staff of Physicians.

Physician: A person who is licensed in the United States as a medical doctor (M.D.) or a doctor of osteopathy (D.O.) and who is practicing within the scope of his or her license. The term “Physician” does not include an Owner or joint owner, an Insured, a Family Member of an Owner, joint owner, or Insured, or an employee, officer, director, owner, partner, member, or agent of a non-natural Owner or joint owner.

Medically Necessary: Care that is:

1)    appropriate and consistent with the diagnosis of a Physician;

2)    in accord with accepted standards of practice; and

3)    could not be omitted without adversely affecting the condition of the Insured.

Family Member: A spouse, child, parent, grandparent, grandchild, sibling, aunt, uncle, first cousin, niece, or nephew, or any such relative by marriage or adoption, including in-laws and step-relatives.

This Rider will terminate and have no value when one of the following occurs:

This Rider is part of your Contract. It is not a separate contract. It changes your Contract only as and to the extent stated. In the case of conflict with other terms of the Contract, the terms of this Rider shall control.

Signed for us at our office as of the date of issue.