FIRST STATE BANK AND TRUST has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN
| Measure | Date | Value |
|---|
| 2024 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2024 401k financial data |
|---|
| Total income from all sources | 2024-01-01 | $184,109 |
| Total plan assets at end of year | 2024-01-01 | $1,785,100 |
| Total plan assets at beginning of year | 2024-01-01 | $1,600,991 |
| Other income received | 2024-01-01 | $184,109 |
| Net income (gross income less expenses) | 2024-01-01 | $184,109 |
| Net plan assets at end of year (total assets less liabilities) | 2024-01-01 | $1,785,100 |
| Net plan assets at beginning of year (total assets less liabilities) | 2024-01-01 | $1,600,991 |
| 2022 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2022 401k financial data |
|---|
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Was this plan covered by a fidelity bond | 2022-12-31 | No |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-12-31 | No |
| Did the plan have assets held for investment | 2022-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-01-01 | No |
| Was this plan covered by a fidelity bond | 2022-01-01 | No |
| If this is an individual account plan, was there a blackout period | 2022-01-01 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-01-01 | No |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-01-01 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-01-01 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-01-01 | No |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-01-01 | No |
| Was there a failure to transmit to the plan any participant contributions | 2022-01-01 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-01-01 | No |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-01-01 | No |
| Did the plan have assets held for investment | 2022-01-01 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-01-01 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-01-01 | No |
| 2021 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2021 401k financial data |
|---|
| Total income from all sources | 2021-12-31 | $234,302 |
| Total plan assets at end of year | 2021-12-31 | $1,639,467 |
| Total plan assets at beginning of year | 2021-12-31 | $1,405,165 |
| Other income received | 2021-12-31 | $234,302 |
| Net income (gross income less expenses) | 2021-12-31 | $234,302 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $1,639,467 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $1,405,165 |
| 2020 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2020 401k financial data |
|---|
| Total income from all sources | 2020-12-31 | $163,107 |
| Total plan assets at end of year | 2020-12-31 | $1,405,165 |
| Total plan assets at beginning of year | 2020-12-31 | $1,242,058 |
| Value of fidelity bond covering the plan | 2020-12-31 | $5,000,000 |
| Other income received | 2020-12-31 | $163,107 |
| Net income (gross income less expenses) | 2020-12-31 | $163,107 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $1,405,165 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $1,242,058 |
| 2019 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $363,947 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $144,226 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $122,587 |
| Total plan assets at end of year | 2019-12-31 | $1,242,058 |
| Total plan assets at beginning of year | 2019-12-31 | $1,022,337 |
| Value of fidelity bond covering the plan | 2019-12-31 | $1 |
| Total contributions received or receivable from participants | 2019-12-31 | $34,247 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $21,639 |
| Other income received | 2019-12-31 | $241,360 |
| Net income (gross income less expenses) | 2019-12-31 | $219,721 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $1,242,058 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,022,337 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $88,340 |
| 2018 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $-61,694 |
| Total plan assets at end of year | 2018-12-31 | $1,022,337 |
| Total plan assets at beginning of year | 2018-12-31 | $1,084,031 |
| Other income received | 2018-12-31 | $-61,694 |
| Net income (gross income less expenses) | 2018-12-31 | $-61,694 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $1,022,337 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $1,084,031 |
| 2017 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $135,652 |
| Total plan assets at end of year | 2017-12-31 | $1,084,031 |
| Total plan assets at beginning of year | 2017-12-31 | $948,379 |
| Other income received | 2017-12-31 | $135,652 |
| Net income (gross income less expenses) | 2017-12-31 | $135,652 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $1,084,031 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $948,379 |
| 2016 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $71,822 |
| Total plan assets at end of year | 2016-12-31 | $948,379 |
| Total plan assets at beginning of year | 2016-12-31 | $876,557 |
| Value of fidelity bond covering the plan | 2016-12-31 | $2,800,000 |
| Other income received | 2016-12-31 | $71,822 |
| Net income (gross income less expenses) | 2016-12-31 | $71,822 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $948,379 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $876,557 |
| 2015 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $-11,616 |
| Total plan assets at end of year | 2015-12-31 | $876,557 |
| Total plan assets at beginning of year | 2015-12-31 | $888,173 |
| Value of fidelity bond covering the plan | 2015-12-31 | $2,800,000 |
| Other income received | 2015-12-31 | $-11,616 |
| Net income (gross income less expenses) | 2015-12-31 | $-11,616 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $876,557 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $888,173 |
| 2014 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $49,124 |
| Total plan assets at end of year | 2014-12-31 | $888,173 |
| Total plan assets at beginning of year | 2014-12-31 | $839,049 |
| Value of fidelity bond covering the plan | 2014-12-31 | $2,800,000 |
| Other income received | 2014-12-31 | $49,124 |
| Net income (gross income less expenses) | 2014-12-31 | $49,124 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $888,173 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $839,049 |
| 2013 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $364,826 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $242,397 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $242,397 |
| Total plan assets at end of year | 2013-12-31 | $839,049 |
| Total plan assets at beginning of year | 2013-12-31 | $716,620 |
| Total contributions received or receivable from participants | 2013-12-31 | $63,595 |
| Other income received | 2013-12-31 | $122,429 |
| Net income (gross income less expenses) | 2013-12-31 | $122,429 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $839,049 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $716,620 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $178,802 |
| 2012 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $799,724 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $714,386 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $714,386 |
| Total plan assets at end of year | 2012-12-31 | $716,620 |
| Total plan assets at beginning of year | 2012-12-31 | $631,282 |
| Total contributions received or receivable from participants | 2012-12-31 | $143,553 |
| Other income received | 2012-12-31 | $85,337 |
| Net income (gross income less expenses) | 2012-12-31 | $85,338 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $716,620 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $631,282 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $570,834 |
| 2011 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $549,274 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $551,483 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $551,483 |
| Total plan assets at end of year | 2011-12-31 | $631,282 |
| Total plan assets at beginning of year | 2011-12-31 | $633,491 |
| Total contributions received or receivable from participants | 2011-12-31 | $140,273 |
| Other income received | 2011-12-31 | $-2,211 |
| Net income (gross income less expenses) | 2011-12-31 | $-2,209 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $631,282 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $633,491 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $411,212 |
| 2010 : FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $595,564 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $506,140 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $506,140 |
| Total plan assets at end of year | 2010-12-31 | $633,491 |
| Total plan assets at beginning of year | 2010-12-31 | $544,067 |
| Total contributions received or receivable from participants | 2010-12-31 | $128,057 |
| Other income received | 2010-12-31 | $77,426 |
| Net income (gross income less expenses) | 2010-12-31 | $89,424 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $633,491 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $544,067 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $390,081 |
| 2023: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Trust | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Trust | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Trust | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FIRST STATE BANK AND TRUST EMPLOYEE BENEFICIARY ASSOCIATION HEALTH & WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | GRP73128 |
| Policy instance | 4 |
| Insurance contract or identification number | GRP73128 | | Number of Individuals Covered | 18 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| Insurance contract or identification number | AJ251 | | Number of Individuals Covered | 27 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| Insurance contract or identification number | 138183 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| Insurance contract or identification number | 696979 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| Insurance contract or identification number | 696979 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| Insurance contract or identification number | 138183 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| Insurance contract or identification number | AJ251 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) |
| Policy contract number | AJ251-007 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 19997 |
| Policy instance | 3 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 19997 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 19997 |
| Policy instance | 3 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 19997 |
| Policy instance | 2 |
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 696979 |
| Policy instance | 1 |
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 28808-0 |
| Policy instance | 4 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 3 |
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 28808-0 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 138183 |
| Policy instance | 2 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) |
| Policy contract number | 19997 |
| Policy instance | 1 |
