401k Plan data: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN plan

THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan Name	THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN
Plan identification number	505

THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

THE BON-TON DEPARTMENT STORES, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE BON-TON DEPARTMENT STORES, INC.

Employer identification number (EIN): 231269309

NAIC Classification: 452110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2017-07-01 ROBERT JONES GAIL MONREAL 2018-10-04
505 2016-07-01 ROBERT JONES DENISE DOMIAN 2018-01-04
505 2015-07-01 ROBERT JONES PAUL CORTESE 2016-10-28
505 2014-07-01 ROBERT JONES PAUL CORTESE 2015-10-30
505 2013-07-01 ROBERT JONES PAUL CORTESE 2014-10-09
505 2012-07-01 ROBERT JONES PAUL CORTESE 2013-11-22
505 2011-07-01 ROBERT JONES PAUL CORTESE 2012-11-02
505 2010-07-01 ROBERT JONES PAUL CORTESE 2012-01-27

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
505	2017-07-01	ROBERT JONES	GAIL MONREAL	2018-10-04
505	2016-07-01	ROBERT JONES	DENISE DOMIAN	2018-01-04
505	2015-07-01	ROBERT JONES	PAUL CORTESE	2016-10-28
505	2014-07-01	ROBERT JONES	PAUL CORTESE	2015-10-30
505	2013-07-01	ROBERT JONES	PAUL CORTESE	2014-10-09
505	2012-07-01	ROBERT JONES	PAUL CORTESE	2013-11-22
505	2011-07-01	ROBERT JONES	PAUL CORTESE	2012-11-02
505	2010-07-01	ROBERT JONES	PAUL CORTESE	2012-01-27

Plan Statistics for THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN

Measure Date Value
2017: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 21,929
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 15,775
Number of retired or separated participants receiving benefits 2017-07-01 149
Total of all active and inactive participants 2017-07-01 15,924
Total participants 2017-07-01 15,924
2016: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 22,590
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 21,789
Number of retired or separated participants receiving benefits 2016-07-01 140
Total of all active and inactive participants 2016-07-01 21,929
Total participants 2016-07-01 21,929
2015: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 24,065
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 22,422
Number of retired or separated participants receiving benefits 2015-07-01 168
Total of all active and inactive participants 2015-07-01 22,590
Total participants 2015-07-01 22,590
2014: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 24,693
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 23,904
Number of retired or separated participants receiving benefits 2014-07-01 161
Total of all active and inactive participants 2014-07-01 24,065
Total participants 2014-07-01 24,065
2013: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 25,372
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 24,516
Number of retired or separated participants receiving benefits 2013-07-01 177
Total of all active and inactive participants 2013-07-01 24,693
Total participants 2013-07-01 24,693
2012: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 25,634
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 25,108
Number of retired or separated participants receiving benefits 2012-07-01 264
Total of all active and inactive participants 2012-07-01 25,372
Total participants 2012-07-01 25,372
2011: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 26,296
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 25,341
Number of retired or separated participants receiving benefits 2011-07-01 293
Total of all active and inactive participants 2011-07-01 25,634
Total participants 2011-07-01 25,634
2010: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 26,455
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 25,973
Number of retired or separated participants receiving benefits 2010-07-01 323
Total of all active and inactive participants 2010-07-01 26,296
Total participants 2010-07-01 26,296

Measure	Date	Value
2017: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	21,929
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	15,775
Number of retired or separated participants receiving benefits	2017-07-01	149
Total of all active and inactive participants	2017-07-01	15,924
Total participants	2017-07-01	15,924
2016: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	22,590
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	21,789
Number of retired or separated participants receiving benefits	2016-07-01	140
Total of all active and inactive participants	2016-07-01	21,929
Total participants	2016-07-01	21,929
2015: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	24,065
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	22,422
Number of retired or separated participants receiving benefits	2015-07-01	168
Total of all active and inactive participants	2015-07-01	22,590
Total participants	2015-07-01	22,590
2014: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	24,693
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	23,904
Number of retired or separated participants receiving benefits	2014-07-01	161
Total of all active and inactive participants	2014-07-01	24,065
Total participants	2014-07-01	24,065
2013: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	25,372
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	24,516
Number of retired or separated participants receiving benefits	2013-07-01	177
Total of all active and inactive participants	2013-07-01	24,693
Total participants	2013-07-01	24,693
2012: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	25,634
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	25,108
Number of retired or separated participants receiving benefits	2012-07-01	264
Total of all active and inactive participants	2012-07-01	25,372
Total participants	2012-07-01	25,372
2011: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	26,296
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	25,341
Number of retired or separated participants receiving benefits	2011-07-01	293
Total of all active and inactive participants	2011-07-01	25,634
Total participants	2011-07-01	25,634
2010: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	26,455
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	25,973
Number of retired or separated participants receiving benefits	2010-07-01	323
Total of all active and inactive participants	2010-07-01	26,296
Total participants	2010-07-01	26,296

Form 5500 Responses for THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN

2017: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: THE BON-TON DEPARTMENT STORES, INC. WELFARE & FLEXIBLE BENEFIT PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	First time form 5500 has been submitted	Yes
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0189430
Policy instance	8
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	18839
Policy instance	9
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	2
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	819881
Policy instance	1
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number	16-012636-000
Policy instance	3
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009132370A
Policy instance	4
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	SA3-83050828301
Policy instance	5
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF3-83050828301
Policy instance	6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0189429
Policy instance	7
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number	16-012636-000
Policy instance	1
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF3-83050828301
Policy instance	2
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	SA3-83050828301
Policy instance	3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	4
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	819881
Policy instance	5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0122596
Policy instance	7
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	8
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009132370
Policy instance	9
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	R0539502
Policy instance	10
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number	0010204346
Policy instance	11
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	0010204346
Policy instance	12
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0122596
Policy instance	7
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number	16-012636-000
Policy instance	1
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF3-83050828301
Policy instance	2
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	R0539502
Policy instance	9
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009132370
Policy instance	8
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	819881
Policy instance	4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	1
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF383050828301
Policy instance	7
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0122596
Policy instance	2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	4
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	400955-0020-SLA
Policy instance	5
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	400955-0010-SLA
Policy instance	6
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP 0009132370
Policy instance	8
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 72664 )
Policy contract number	811276
Policy instance	9
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009132370
Policy instance	8
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4009550020SLA
Policy instance	6
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4009550010SLA
Policy instance	5
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0122596
Policy instance	4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	2
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF383050828301
Policy instance	1
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009132370
Policy instance	7
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	6
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4037620010SLA
Policy instance	5
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4009550010SLA
Policy instance	4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF383050828301
Policy instance	1
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	2
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract number	GF383050828301
Policy instance	1
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number	FV0980
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0117442
Policy instance	3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4009550020SLA
Policy instance	5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	12288685
Policy instance	6
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP9132370
Policy instance	7
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number	4009550010SLA
Policy instance	4

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Company Name:	THE BON-TON DEPARTMENT STORES, INC.
Employer identification number (EIN):	231269309
NAIC Classification:	452110