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EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 401k Plan overview

Plan NameEMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC
Plan identification number 501

EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC Benefits

401k Plan TypeWelfare 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)

401k Sponsoring company profile

CAMBRIA RESIDENTIAL SERVICES INC has sponsored the creation of one or more 401k plans.

Company Name:CAMBRIA RESIDENTIAL SERVICES INC
Employer identification number (EIN):251405563
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01
5012023-01-01JAMES J. COOK
5012022-01-01
5012022-01-01JAMES J. COOK
5012021-01-01
5012021-01-01JAMES J. COOK
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01JAMES J. COOK
5012016-01-01JAMES J. COOK
5012015-01-01JAMES J. COOK
5012014-01-01JAMES J. COOK
5012013-01-01JAMES J. COOK
5012012-01-01JAMES J. COOK
5012011-01-01JAMES J. COOK
5012010-01-01JAMES J. COOK
5012009-01-01JAMES J. COOK

Plan Statistics for EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC

401k plan membership statisitcs for EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC

Measure Date Value
2023: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2023 401k membership
Total participants, beginning-of-year2023-01-01111
Total number of active participants reported on line 7a of the Form 55002023-01-0197
Total of all active and inactive participants2023-01-0197
2022: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2022 401k membership
Total participants, beginning-of-year2022-01-01127
Total number of active participants reported on line 7a of the Form 55002022-01-01111
Total of all active and inactive participants2022-01-01111
2021: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2021 401k membership
Total participants, beginning-of-year2021-01-01131
Total number of active participants reported on line 7a of the Form 55002021-01-01127
Total of all active and inactive participants2021-01-01127
2020: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2020 401k membership
Total participants, beginning-of-year2020-01-01128
Total number of active participants reported on line 7a of the Form 55002020-01-01131
Total of all active and inactive participants2020-01-01131
2019: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2019 401k membership
Total participants, beginning-of-year2019-01-01114
Total number of active participants reported on line 7a of the Form 55002019-01-01128
Total of all active and inactive participants2019-01-01128
2018: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2018 401k membership
Total participants, beginning-of-year2018-01-01121
Total number of active participants reported on line 7a of the Form 55002018-01-01114
Total of all active and inactive participants2018-01-01114
2017: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2017 401k membership
Total participants, beginning-of-year2017-01-01149
Total number of active participants reported on line 7a of the Form 55002017-01-01121
Total of all active and inactive participants2017-01-01121
2016: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2016 401k membership
Total participants, beginning-of-year2016-01-01168
Total number of active participants reported on line 7a of the Form 55002016-01-01149
Total of all active and inactive participants2016-01-01149
2015: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2015 401k membership
Total participants, beginning-of-year2015-01-01170
Total number of active participants reported on line 7a of the Form 55002015-01-01168
Total of all active and inactive participants2015-01-01168
2014: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2014 401k membership
Total participants, beginning-of-year2014-01-01178
Total number of active participants reported on line 7a of the Form 55002014-01-01170
Total of all active and inactive participants2014-01-01170
2013: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2013 401k membership
Total participants, beginning-of-year2013-01-01186
Total number of active participants reported on line 7a of the Form 55002013-01-01178
Total of all active and inactive participants2013-01-01178
2012: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2012 401k membership
Total participants, beginning-of-year2012-01-01194
Total number of active participants reported on line 7a of the Form 55002012-01-01186
Total of all active and inactive participants2012-01-01186
2011: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2011 401k membership
Total participants, beginning-of-year2011-01-01200
Total number of active participants reported on line 7a of the Form 55002011-01-01194
Total of all active and inactive participants2011-01-01194
2010: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2010 401k membership
Total participants, beginning-of-year2010-01-01212
Total number of active participants reported on line 7a of the Form 55002010-01-01200
Total of all active and inactive participants2010-01-01200
2009: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2009 401k membership
Total participants, beginning-of-year2009-01-01249
Total number of active participants reported on line 7a of the Form 55002009-01-01212
Total of all active and inactive participants2009-01-01212

Form 5500 Responses for EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC

2023: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan is a collectively bargained planYes
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: EMPLOYEE HEALTH AND WELFARE PLAN OF CAMBRIA RESIDENTIAL SERVICES INC 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
Insurance contract or identification numberG000586K
Number of Individuals Covered91
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,672
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
Insurance contract or identification numberG000586K
Number of Individuals Covered91
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,208
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124900
Policy instance 7
Insurance contract or identification number022124900
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $-663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 3
Insurance contract or identification number260123-000
Number of Individuals Covered88
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $736
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124300
Policy instance 4
Insurance contract or identification number022124300
Number of Individuals Covered95
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $31,507
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,165,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NC0
Policy instance 5
Insurance contract or identification number022124NC0
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $-3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NN0
Policy instance 6
Insurance contract or identification number022124NN0
Number of Individuals Covered97
Insurance policy start date2022-11-01
Insurance policy end date2023-10-31
Total amount of commissions paid to insurance brokerUSD $192
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 3
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NC0
Policy instance 5
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NN0
Policy instance 6
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124900
Policy instance 7
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124300
Policy instance 4
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NN0
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 3
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124300
Policy instance 4
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NC0
Policy instance 5
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124900
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 3
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124300
Policy instance 4
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NC0
Policy instance 5
UPMC HEALTH BENEFITS (National Association of Insurance Commissioners NAIC id number: 11018 )
Policy contract number022124NN0
Policy instance 6
UPMC HEALTH OPTIONS (National Association of Insurance Commissioners NAIC id number: 15345 )
Policy contract number022124900
Policy instance 7
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 6
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number260123-000
Policy instance 6
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 )
Policy contract number260123-000
Policy instance 6
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 5
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number4249700
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000586K
Policy instance 2

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