| Plan Name | BLUE RIDGE BONE & JOINT FLEXIBLE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | BLUE RIDGE BONE & JOINT CLINIC, P.A |
| Employer identification number (EIN): | 560951119 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2015-09-01 | ||||
| 501 | 2014-09-01 | ||||
| 501 | 2013-09-01 | ||||
| 501 | 2012-09-01 | JUDY WEBSTER | |||
| 501 | 2011-09-01 | JUDY WEBSTER | |||
| 501 | 2009-09-01 | JUDY WEBSTER |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 ) | |
| Policy contract number | 891 |
| Policy instance | 4 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | SAJAH1006010114 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | SAJAH1006010114 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1026182 |
| Policy instance | 4 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1026182 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | SAJAH1006010114 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1026182 |
| Policy instance | 4 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | LL-0030-010111 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | LL-0030-010111 |
| Policy instance | 4 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | F8435 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) | |
| Policy contract number | 048-7932-00 |
| Policy instance | 5 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | F8435 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | LIF/LTD30640 |
| Policy instance | 2 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7531411 |
| Policy instance | 1 |
| J ALLAN HALL AND ASSOCIATES (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | LL-0030-010111 |
| Policy instance | 4 |