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| Plan Name | HEALTH INSURANCE ACCIDENT & SICKNESS |
| Plan identification number | 509 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | SURGICAL APPLIANCE INDUSTRIES, INC. |
| Employer identification number (EIN): | 310397670 |
| NAIC Classification: | 339110 |
Additional information about SURGICAL APPLIANCE INDUSTRIES, INC.
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 1911-04-12 |
| Company Identification Number: | 29242 |
| Legal Registered Office Address: |
3960 ROSSLYN DR - CINCINNATI United States of America (USA) 45209 |
More information about SURGICAL APPLIANCE INDUSTRIES, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 509 | 2022-10-01 | ||||
| 509 | 2022-10-01 | JEFF CHILDS | |||
| 509 | 2021-10-01 | ||||
| 509 | 2021-10-01 | JEFF CHILDS | |||
| 509 | 2020-10-01 | ||||
| 509 | 2019-10-01 | ||||
| 509 | 2018-10-01 | ||||
| 509 | 2017-10-01 | ||||
| 509 | 2017-07-01 | ||||
| 509 | 2016-07-01 | JEFF CHILDS | JEFF CHILDS | 2018-04-12 | |
| 509 | 2015-07-01 | JEFF CHILDS | JEFF CHILDS | 2017-04-17 | |
| 509 | 2014-07-01 | JEFF CHILDS | JEFF CHILDS | 2016-04-14 | |
| 509 | 2013-07-01 | JEFF CHILDS | JEFF CHILDS | 2015-04-09 | |
| 509 | 2012-07-01 | JEFF CHILDS | JEFF CHILDS | 2014-04-09 | |
| 509 | 2011-07-01 | JEFF CHILDS | JEFF CHILDS | 2013-04-10 | |
| 509 | 2009-07-01 | JEFF CHILDS | |||
| 509 | 2009-07-01 | JEFF CHILDS | 2011-04-14 |
| Measure | Date | Value |
|---|---|---|
| 2022: HEALTH INSURANCE ACCIDENT & SICKNESS 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-01 | 74 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 68 |
| Total of all active and inactive participants | 2022-10-01 | 68 |
| Total participants | 2022-10-01 | 68 |
| 2021: HEALTH INSURANCE ACCIDENT & SICKNESS 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-10-01 | 78 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 70 |
| Total of all active and inactive participants | 2021-10-01 | 70 |
| Total participants | 2021-10-01 | 70 |
| 2020: HEALTH INSURANCE ACCIDENT & SICKNESS 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-10-01 | 83 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 73 |
| Total of all active and inactive participants | 2020-10-01 | 73 |
| Total participants | 2020-10-01 | 73 |
| 2019: HEALTH INSURANCE ACCIDENT & SICKNESS 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-10-01 | 87 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 83 |
| Total of all active and inactive participants | 2019-10-01 | 83 |
| Total participants | 2019-10-01 | 83 |
| 2018: HEALTH INSURANCE ACCIDENT & SICKNESS 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-10-01 | 83 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 80 |
| Total of all active and inactive participants | 2018-10-01 | 80 |
| Total participants | 2018-10-01 | 80 |
| 2017: HEALTH INSURANCE ACCIDENT & SICKNESS 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-10-01 | 70 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 69 |
| Total of all active and inactive participants | 2017-10-01 | 69 |
| Total participants | 2017-10-01 | 69 |
| Total participants, beginning-of-year | 2017-07-01 | 54 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 52 |
| Total of all active and inactive participants | 2017-07-01 | 52 |
| Total participants | 2017-07-01 | 52 |
| 2016: HEALTH INSURANCE ACCIDENT & SICKNESS 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 46 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 54 |
| Total of all active and inactive participants | 2016-07-01 | 54 |
| Total participants | 2016-07-01 | 54 |
| 2015: HEALTH INSURANCE ACCIDENT & SICKNESS 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 46 |
| Total of all active and inactive participants | 2015-07-01 | 46 |
| Total participants | 2015-07-01 | 46 |
| 2014: HEALTH INSURANCE ACCIDENT & SICKNESS 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 27 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 26 |
| Total of all active and inactive participants | 2014-07-01 | 26 |
| Total participants | 2014-07-01 | 26 |
| 2013: HEALTH INSURANCE ACCIDENT & SICKNESS 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 25 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 23 |
| Total of all active and inactive participants | 2013-07-01 | 23 |
| Total participants | 2013-07-01 | 23 |
| 2012: HEALTH INSURANCE ACCIDENT & SICKNESS 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 28 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 25 |
| Total of all active and inactive participants | 2012-07-01 | 25 |
| Total participants | 2012-07-01 | 25 |
| 2011: HEALTH INSURANCE ACCIDENT & SICKNESS 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 37 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 32 |
| Total of all active and inactive participants | 2011-07-01 | 32 |
| Total participants | 2011-07-01 | 32 |
| 2009: HEALTH INSURANCE ACCIDENT & SICKNESS 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 49 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 41 |
| Total of all active and inactive participants | 2009-07-01 | 41 |
| Total participants | 2009-07-01 | 41 |
| Measure | Date | Value |
|---|---|---|
| 2023 : HEALTH INSURANCE ACCIDENT & SICKNESS 2023 401k financial data | ||
| Total income from all sources | 2023-09-30 | $464,673 |
| Expenses. Total of all expenses incurred | 2023-09-30 | $464,673 |
| Benefits paid (including direct rollovers) | 2023-09-30 | $464,673 |
| Total contributions received or receivable from participants | 2023-09-30 | $278,912 |
| Net income (gross income less expenses) | 2023-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2023-09-30 | $185,761 |
| 2022 : HEALTH INSURANCE ACCIDENT & SICKNESS 2022 401k financial data | ||
| Total income from all sources | 2022-09-30 | $483,896 |
| Expenses. Total of all expenses incurred | 2022-09-30 | $483,896 |
| Benefits paid (including direct rollovers) | 2022-09-30 | $483,896 |
| Total contributions received or receivable from participants | 2022-09-30 | $240,160 |
| Net income (gross income less expenses) | 2022-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2022-09-30 | $243,736 |
| 2021 : HEALTH INSURANCE ACCIDENT & SICKNESS 2021 401k financial data | ||
| Total income from all sources | 2021-09-30 | $495,487 |
| Expenses. Total of all expenses incurred | 2021-09-30 | $495,487 |
| Benefits paid (including direct rollovers) | 2021-09-30 | $495,487 |
| Total contributions received or receivable from participants | 2021-09-30 | $250,805 |
| Net income (gross income less expenses) | 2021-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2021-09-30 | $244,682 |
| 2020 : HEALTH INSURANCE ACCIDENT & SICKNESS 2020 401k financial data | ||
| Total income from all sources | 2020-09-30 | $540,249 |
| Expenses. Total of all expenses incurred | 2020-09-30 | $540,249 |
| Benefits paid (including direct rollovers) | 2020-09-30 | $540,249 |
| Total contributions received or receivable from participants | 2020-09-30 | $259,689 |
| Net income (gross income less expenses) | 2020-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2020-09-30 | $280,560 |
| 2019 : HEALTH INSURANCE ACCIDENT & SICKNESS 2019 401k financial data | ||
| Total income from all sources | 2019-09-30 | $549,609 |
| Expenses. Total of all expenses incurred | 2019-09-30 | $549,609 |
| Benefits paid (including direct rollovers) | 2019-09-30 | $549,609 |
| Total contributions received or receivable from participants | 2019-09-30 | $269,969 |
| Net income (gross income less expenses) | 2019-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2019-09-30 | $279,640 |
| 2017 : HEALTH INSURANCE ACCIDENT & SICKNESS 2017 401k financial data | ||
| Total income from all sources | 2017-06-30 | $378,517 |
| Expenses. Total of all expenses incurred | 2017-06-30 | $378,517 |
| Benefits paid (including direct rollovers) | 2017-06-30 | $378,517 |
| Total contributions received or receivable from participants | 2017-06-30 | $185,576 |
| Net income (gross income less expenses) | 2017-06-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-06-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2017-06-30 | $192,941 |
| 2016 : HEALTH INSURANCE ACCIDENT & SICKNESS 2016 401k financial data | ||
| Total income from all sources | 2016-06-30 | $291,662 |
| Expenses. Total of all expenses incurred | 2016-06-30 | $291,662 |
| Benefits paid (including direct rollovers) | 2016-06-30 | $291,662 |
| Total contributions received or receivable from participants | 2016-06-30 | $157,152 |
| Net income (gross income less expenses) | 2016-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2016-06-30 | $134,510 |
| 2015 : HEALTH INSURANCE ACCIDENT & SICKNESS 2015 401k financial data | ||
| Total income from all sources | 2015-06-30 | $219,318 |
| Expenses. Total of all expenses incurred | 2015-06-30 | $219,318 |
| Benefits paid (including direct rollovers) | 2015-06-30 | $219,318 |
| Total contributions received or receivable from participants | 2015-06-30 | $151,284 |
| Net income (gross income less expenses) | 2015-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2015-06-30 | $68,034 |
| 2014 : HEALTH INSURANCE ACCIDENT & SICKNESS 2014 401k financial data | ||
| Total income from all sources | 2014-06-30 | $196,702 |
| Expenses. Total of all expenses incurred | 2014-06-30 | $196,702 |
| Benefits paid (including direct rollovers) | 2014-06-30 | $196,702 |
| Value of fidelity bond covering the plan | 2014-06-30 | $50,000 |
| Total contributions received or receivable from participants | 2014-06-30 | $137,184 |
| Net income (gross income less expenses) | 2014-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2014-06-30 | $59,518 |
| 2013 : HEALTH INSURANCE ACCIDENT & SICKNESS 2013 401k financial data | ||
| Total income from all sources | 2013-06-30 | $229,527 |
| Expenses. Total of all expenses incurred | 2013-06-30 | $0 |
| Benefits paid (including direct rollovers) | 2013-06-30 | $229,527 |
| Value of fidelity bond covering the plan | 2013-06-30 | $50,000 |
| Total contributions received or receivable from participants | 2013-06-30 | $163,763 |
| Net income (gross income less expenses) | 2013-06-30 | $229,527 |
| Total contributions received or receivable from employer(s) | 2013-06-30 | $65,764 |
| 2012 : HEALTH INSURANCE ACCIDENT & SICKNESS 2012 401k financial data | ||
| Total income from all sources | 2012-06-30 | $265,504 |
| Value of fidelity bond covering the plan | 2012-06-30 | $50,000 |
| Total contributions received or receivable from participants | 2012-06-30 | $195,797 |
| Net income (gross income less expenses) | 2012-06-30 | $265,504 |
| Total contributions received or receivable from employer(s) | 2012-06-30 | $69,707 |
| 2011 : HEALTH INSURANCE ACCIDENT & SICKNESS 2011 401k financial data | ||
| Total income from all sources | 2011-06-30 | $289,525 |
| Expenses. Total of all expenses incurred | 2011-06-30 | $289,525 |
| Benefits paid (including direct rollovers) | 2011-06-30 | $289,525 |
| Value of fidelity bond covering the plan | 2011-06-30 | $50,000 |
| Total contributions received or receivable from participants | 2011-06-30 | $221,869 |
| Net income (gross income less expenses) | 2011-06-30 | $0 |
| Total contributions received or receivable from employer(s) | 2011-06-30 | $67,656 |
| 2022: HEALTH INSURANCE ACCIDENT & SICKNESS 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Submission has been amended | No |
| 2022-10-01 | This submission is the final filing | No |
| 2022-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-10-01 | Plan is a collectively bargained plan | No |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: HEALTH INSURANCE ACCIDENT & SICKNESS 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Submission has been amended | No |
| 2021-10-01 | This submission is the final filing | No |
| 2021-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-10-01 | Plan is a collectively bargained plan | No |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: HEALTH INSURANCE ACCIDENT & SICKNESS 2020 form 5500 responses | ||
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Submission has been amended | No |
| 2020-10-01 | This submission is the final filing | No |
| 2020-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-10-01 | Plan is a collectively bargained plan | No |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: HEALTH INSURANCE ACCIDENT & SICKNESS 2019 form 5500 responses | ||
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Submission has been amended | No |
| 2019-10-01 | This submission is the final filing | No |
| 2019-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-10-01 | Plan is a collectively bargained plan | No |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HEALTH INSURANCE ACCIDENT & SICKNESS 2018 form 5500 responses | ||
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Submission has been amended | No |
| 2018-10-01 | This submission is the final filing | No |
| 2018-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-10-01 | Plan is a collectively bargained plan | No |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: HEALTH INSURANCE ACCIDENT & SICKNESS 2017 form 5500 responses | ||
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Submission has been amended | No |
| 2017-10-01 | This submission is the final filing | No |
| 2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-10-01 | Plan is a collectively bargained plan | No |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 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) | Yes |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HEALTH INSURANCE ACCIDENT & SICKNESS 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 benefit arrangement – Insurance | Yes |
| 2015: HEALTH INSURANCE ACCIDENT & SICKNESS 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 benefit arrangement – Insurance | Yes |
| 2014: HEALTH INSURANCE ACCIDENT & SICKNESS 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 benefit arrangement – Insurance | Yes |
| 2013: HEALTH INSURANCE ACCIDENT & SICKNESS 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 benefit arrangement – Insurance | Yes |
| 2012: HEALTH INSURANCE ACCIDENT & SICKNESS 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | Yes |
| 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 benefit arrangement – Insurance | Yes |
| 2011: HEALTH INSURANCE ACCIDENT & SICKNESS 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | First time form 5500 has been submitted | Yes |
| 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 benefit arrangement – Insurance | Yes |
| 2009: HEALTH INSURANCE ACCIDENT & SICKNESS 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | First time form 5500 has been submitted | Yes |
| 2009-07-01 | Submission has been amended | Yes |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 3 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 788550 |
| Policy instance | 2 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 95348 ) | |
| Policy contract number | 788550 |
| Policy instance | 1 |
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) | |
| Policy contract number | 00091563 |
| Policy instance | 1 |