0001193125-10-135639 Sample Contracts

PARTICIPATION AGREEMENT Life Insurance Company
Participation Agreement • June 9th, 2010 • Ivy Funds Variable Insurance Portfolios • Kansas

This Participation Agreement (“Agreement”), dated as of the day of , 200 , is made by and between LIFE INSURANCE COMPANY (“Company”), on behalf of itself and each of the separate accounts identified on Exhibit A, which is attached hereto, as the parties hereto may amend from time to time (“Variable Accounts”), WADDELL & REED, INC. (“W&R”), distributor for Ivy Funds Variable Insurance Portfolios, and IVY FUNDS VARIABLE INSURANCE PORTFOLIOS (“Ivy Funds VIP”).

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