Exhibit (5)(e)
Primary Insured Rider and Primary Insured Rider Plus
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
(A STOCK COMPANY)
Home Office: Columbus, Ohio
Administrative Office: Clearwater, Florida
PRIMARY INSURED RIDER
================================================================================
IN THIS RIDER, the Primary Insured is named on Page 3 of the Policy. The Primary
Insured will be referred to as YOU or YOUR. Western Reserve Life Assurance Co.
of Ohio will be referred to as WE, OUR or US.
================================================================================
BENEFIT We will pay the Face Amount of this Rider as
shown on Page 4 of the Policy when We receive
due proof that Your death occurred while this
Rider was In Force.
CONSIDERATION This Rider is issued in consideration of:
1. the application for this Rider; and
2. the payment of the Initial Premium.
INCONTESTABILITY This Rider shall be incontestable after it has
been In Force while You are still alive, for
two years after the effective date of this
Rider.
SUICIDE If this Rider is issued on the same date as the
Policy, the Suicide Provision of the Policy is
applicable to this Rider. If this Rider is
issued after the Policy and if You die by
suicide, while sane or insane, within two years
after the effective date of this Rider, Our
liability for this Rider shall be limited to an
amount equal to the excess of the total monthly
deductions for this Rider less any premiums
being refunded under the Suicide Provision of
the Policy to which this Rider is attached.
CONVERSION PRIVILEGE On any Monthiversary while this Rider is In
Force, the Owner may exchange this Rider,
without evidence of insurability, for a new
policy on Your life. Such new policy will be
issued upon written request subject to the
following:
1. The Rider has not reached the Anniversary
nearest Your 70th birthday; and
2. The new policy is on any permanent plan of
insurance then offered by Us; and
3. The amount of insurance upon conversion
will equal the Face Amount then In Force
under this Rider; and
4. The payment of the premium based on Your
rate class under this Rider.
TERMINATION This Rider will terminate on the earliest of:
1. The Anniversary nearest Your 95th
birthday;
2. The date this Policy terminates;
3. The date of conversion of this Rider;
4. The Monthiversary on which this Rider is
terminated on written request by the
Owner.
GENERAL This Rider is part of the Policy. It is subject
to all the terms of this Rider and the policy.
This Rider has no cash value.
The monthly deduction for this Rider, for each
of the first 12 policy months, is shown on Page
4 of the Policy. Monthly deductions after the
first policy year will be calculated consistent
with the monthly cost of insurance and monthly
cost of insurance rates provisions of the
Policy to which this Rider is attached.
EFFECTIVE DATE This Rider becomes effective on the same date
as the Policy unless a later date is shown
here.
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
/s/ WILLIAM H. GEIGER
Page 2
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
(A STOCK COMPANY)
Home Office: Columbus, Ohio
Administrative Office: Clearwater, Florida
PRIMARY INSURED RIDER PLUS
===============================================================================
IN THIS RIDER, the Primary Insured is named on Page 3 of the Policy. The Primary
Insured will be referred to as YOU or YOUR. Western Reserve Life Assurance Co.
of Ohio will be referred to as WE, OUR or US.
===============================================================================
BENEFIT We will pay the Face Amount of this Rider as
shown on Page 4 of the Policy when We receive
due proof that Your death occurred while this
Rider was In Force.
CONSIDERATION This Rider is issued in consideration of:
1. the application for this Rider; and
2. the payment of the Initial Premium.
INCONTESTABILITY This Rider shall be incontestable after it has
been In Force while You are still alive, for
two years after the effective date of this
Rider.
SUICIDE If this Rider is issued on the same date as the
Policy, the Suicide Provision of the Policy is
applicable to this Rider. If this Rider is
issued after the Policy and if You die by
suicide, while sane or insane, within two years
after the effective date of this Rider, Our
liability for this Rider shall be limited to an
amount equal to the excess of the total monthly
deductions for this Rider less any premiums
being refunded under the Suicide Provision of
the Policy to which this Rider is attached.
CONVERSION PRIVILEGE On any Monthiversary while this Rider is In
Force, the Owner may exchange this Rider,
without evidence of insurability, for a new
policy on Your life. Such new policy will be
issued upon written request subject to the
following:
1. The Rider has not reached the Anniversary
nearest Your 70th birthday; and
2. The new policy is on any permanent plan of
insurance then offered by Us; and
3. The amount of insurance upon conversion
will equal the Face Amount then In
Force under this Rider; and
4. The payment of the premium based on Your
rate class under this Rider.
TERMINATION This Rider will terminate on the earliest of:
1. The Anniversary nearest Your 90th
birthday;
2. The date this Policy terminates;
3. The date of conversion of this Rider;
4. The Monthiversary on which this Rider is
terminated on written request by the
Owner.
GENERAL This Rider is part of the Policy. It is subject
to all the terms of this Rider and the policy.
This Rider has no cash value.
The monthly deduction for this Rider, for each
of the first 12 policy months, is shown on Page
4 of the Policy. Monthly deductions after the
first policy year will be calculated consistent
with the monthly cost of insurance and monthly
cost of insurance rates provisions of the
Policy to which this Rider is attached.
EFFECTIVE DATE This Rider becomes effective on the same date
as the Policy unless a later date is shown
here.
WESTERN RESERVE LIFE ASSURANCE CO. OF OHIO
/s/ WIILIAM H. GEIGER