AMANDA BENT BOLT COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY
401k plan membership statisitcs for THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY
| Measure | Date | Value |
|---|
| 2023: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-03-01 | 419 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-03-01 | 500 |
| Number of retired or separated participants receiving benefits | 2023-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-03-01 | 0 |
| Total of all active and inactive participants | 2023-03-01 | 500 |
| 2022: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-03-01 | 387 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-03-01 | 419 |
| Number of retired or separated participants receiving benefits | 2022-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-03-01 | 0 |
| Total of all active and inactive participants | 2022-03-01 | 419 |
| 2021: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-03-01 | 258 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 387 |
| Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 0 |
| Total of all active and inactive participants | 2021-03-01 | 387 |
| 2020: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 229 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 258 |
| Number of retired or separated participants receiving benefits | 2020-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 0 |
| Total of all active and inactive participants | 2020-03-01 | 258 |
| 2019: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 229 |
| Number of retired or separated participants receiving benefits | 2019-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 0 |
| Total of all active and inactive participants | 2019-03-01 | 229 |
| 2017: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 231 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 264 |
| Number of retired or separated participants receiving benefits | 2017-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
| Total of all active and inactive participants | 2017-03-01 | 264 |
| 2015: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 182 |
| Number of retired or separated participants receiving benefits | 2015-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-03-01 | 0 |
| Total of all active and inactive participants | 2015-03-01 | 182 |
| 2014: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 172 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 185 |
| Number of retired or separated participants receiving benefits | 2014-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-03-01 | 0 |
| Total of all active and inactive participants | 2014-03-01 | 185 |
| 2013: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-03-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 172 |
| Total of all active and inactive participants | 2013-03-01 | 172 |
| 2012: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 146 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 154 |
| Total of all active and inactive participants | 2012-03-01 | 154 |
| 2011: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 177 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 146 |
| Total of all active and inactive participants | 2011-03-01 | 146 |
| 2010: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 125 |
| Total of all active and inactive participants | 2010-03-01 | 125 |
| 2023: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2023 form 5500 responses |
|---|
| 2023-03-01 | Type of plan entity | Single employer plan |
| 2023-03-01 | Plan funding arrangement – Insurance | Yes |
| 2023-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2022 form 5500 responses |
|---|
| 2022-03-01 | Type of plan entity | Single employer plan |
| 2022-03-01 | Plan funding arrangement – Insurance | Yes |
| 2022-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2021 form 5500 responses |
|---|
| 2021-03-01 | Type of plan entity | Single employer plan |
| 2021-03-01 | Plan funding arrangement – Insurance | Yes |
| 2021-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2020 form 5500 responses |
|---|
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | Plan funding arrangement – Insurance | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2019 form 5500 responses |
|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2013 form 5500 responses |
|---|
| 2013-03-01 | Type of plan entity | Single employer plan |
| 2013-03-01 | Plan funding arrangement – Insurance | Yes |
| 2013-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Submission has been amended | Yes |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: THE GROUP HEALTH PLAN FOR EMPLOYEES OF AMANDA BENT BOLT COMPANY 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 11 |
| Number of Individuals Covered | 194 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E5049507 |
| Policy instance | 1 |
| Insurance contract or identification number | E5049507 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $7,421 | | Total amount of fees paid to insurance company | USD $182 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5934140 |
| Policy instance | 2 |
| Insurance contract or identification number | 5934140 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $1,332 | | Total amount of fees paid to insurance company | USD $313 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1011351101 |
| Policy instance | 3 |
| Insurance contract or identification number | 1011351101 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $1,535 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890787G |
| Policy instance | 4 |
| Insurance contract or identification number | 890787G | | Number of Individuals Covered | 316 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $9,136 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00288046/0001 |
| Policy instance | 6 |
| Insurance contract or identification number | 00288046/0001 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2023-06-01 | | Insurance policy end date | 2024-05-31 | | Total amount of commissions paid to insurance broker | USD $4,172 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10174061001 |
| Policy instance | 7 |
| Insurance contract or identification number | 10174061001 | | Number of Individuals Covered | 67 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $502 | | Vision Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34704 |
| Policy instance | 8 |
| Insurance contract or identification number | HCL34704 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828182 |
| Policy instance | 9 |
| Insurance contract or identification number | E4828182 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $2,154 | | Temporary Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828174 |
| Policy instance | 10 |
| Insurance contract or identification number | E4828174 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2023-03-01 | | Insurance policy end date | 2024-02-29 | | Total amount of commissions paid to insurance broker | USD $2,956 | | Total amount of fees paid to insurance company | USD $56 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E5049507 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5934140 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1011351101 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890787G |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00611855/0001 |
| Policy instance | 6 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10174061001 |
| Policy instance | 7 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL34704 |
| Policy instance | 8 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828182 |
| Policy instance | 9 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828174 |
| Policy instance | 10 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 11 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E5049507 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5934140 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1011351101 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 890787G |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) |
| Policy contract number | 00288046/0001 |
| Policy instance | 6 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10174061001 |
| Policy instance | 7 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 8 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828174 |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E5049507 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) |
| Policy contract number | E4828182 |
| Policy instance | 2 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 2 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 1 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 4 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 752728 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156465 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156463 |
| Policy instance | 2 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156464 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156463 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156464 |
| Policy instance | 4 |
| MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156465 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156465 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010156463 |
| Policy instance | 3 |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | IIS2149 |
| Policy instance | 1 |
| FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
| Policy contract number | IIS2149 |
| Policy instance | 1 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 212751 |
| Policy instance | 2 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 201422 |
| Policy instance | 1 |