401k Plan data: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN plan

ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 401k Plan overview

Plan Name	ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN
Plan identification number	501

ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

TEXAS EM-1 MEDICAL SERVICES, P.A. has sponsored the creation of one or more 401k plans.

Company Name: TEXAS EM-1 MEDICAL SERVICES, P.A.

Employer identification number (EIN): 752744538

NAIC Classification: 621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01 DON KING
501 2016-01-01 DON KING
501 2015-01-01 DON KING
501 2014-01-01 DON KING
501 2013-01-01 DON KING
501 2012-01-01 DON KING
501 2011-01-01 DON KING
501 2009-01-01 DONALD KING
501 2009-01-01 DONALD L. KING 2010-10-12
501 2009-01-01 DONALD L. KING
501 2009-01-01 DONALD L. KING 2010-10-12
501 2009-01-01 DONALD L. KING 2010-10-15
501 2009-01-01 DONALD L. KING 2010-10-11
501 2009-01-01 DONALD L. KING 2010-10-11
501 2009-01-01 DONALD L. KING
501 2009-01-01 DONALD L. KING 2010-10-12
501 2009-01-01 DONALD L. KING

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2017-01-01	DON KING
501	2016-01-01	DON KING
501	2015-01-01	DON KING
501	2014-01-01	DON KING
501	2013-01-01	DON KING
501	2012-01-01	DON KING
501	2011-01-01	DON KING
501	2009-01-01	DONALD KING
501	2009-01-01		DONALD L. KING	2010-10-12
501	2009-01-01	DONALD L. KING
501	2009-01-01		DONALD L. KING	2010-10-12
501	2009-01-01		DONALD L. KING	2010-10-15
501	2009-01-01		DONALD L. KING	2010-10-11
501	2009-01-01		DONALD L. KING	2010-10-11
501	2009-01-01	DONALD L. KING
501	2009-01-01		DONALD L. KING	2010-10-12
501	2009-01-01	DONALD L. KING

Plan Statistics for ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN

401k plan membership statisitcs for ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN

Measure Date Value
2017: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 7,305
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
2016: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 5,281
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 7,305
Number of retired or separated participants receiving benefits 2016-01-01 115
Number of other retired or separated participants entitled to future benefits 2016-01-01 115
Total of all active and inactive participants 2016-01-01 7,535
2015: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 3,828
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 5,209
Number of retired or separated participants receiving benefits 2015-01-01 72
Number of other retired or separated participants entitled to future benefits 2015-01-01 72
Total of all active and inactive participants 2015-01-01 5,353
2014: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,732
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3,774
Number of retired or separated participants receiving benefits 2014-01-01 54
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 3,828
2013: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,508
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,675
Number of retired or separated participants receiving benefits 2013-01-01 57
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 2,732
2012: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 848
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,508
Number of retired or separated participants receiving benefits 2012-01-01 21
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 1,529
2011: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 833
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 993
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 23
Total of all active and inactive participants 2011-01-01 1,016
2009: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 329
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 355
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 355

Measure	Date	Value
2017: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	7,305
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
2016: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	5,281
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	7,305
Number of retired or separated participants receiving benefits	2016-01-01	115
Number of other retired or separated participants entitled to future benefits	2016-01-01	115
Total of all active and inactive participants	2016-01-01	7,535
2015: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	3,828
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	5,209
Number of retired or separated participants receiving benefits	2015-01-01	72
Number of other retired or separated participants entitled to future benefits	2015-01-01	72
Total of all active and inactive participants	2015-01-01	5,353
2014: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,732
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3,774
Number of retired or separated participants receiving benefits	2014-01-01	54
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	3,828
2013: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,508
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,675
Number of retired or separated participants receiving benefits	2013-01-01	57
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	2,732
2012: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	848
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,508
Number of retired or separated participants receiving benefits	2012-01-01	21
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	1,529
2011: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	833
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	993
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	23
Total of all active and inactive participants	2011-01-01	1,016
2009: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	329
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	355
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	355

Form 5500 Responses for ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN

2017: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: ASSOCIATED PHYSICIANS FLEXIBLE SPENDING ACCOUNT BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000400146224
Policy instance	3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	00001D028522
Policy instance	9
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010146223
Policy instance	2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010146222
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010147466
Policy instance	5
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	209322
Policy instance	6
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number	52047
Policy instance	7
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010195495
Policy instance	8
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	9
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	8
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	7
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	70904
Policy instance	5
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	4
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963
Policy instance	2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001026
Policy instance	1
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number	800772
Policy instance	12
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	10
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	209322
Policy instance	11
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	6
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )
Policy contract number	1JZS
Policy instance	19
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	18
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	17
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number	000007267
Policy instance	16
BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 71714 )
Policy contract number	C03710
Policy instance	15
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number	52047
Policy instance	14
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number	16DS
Policy instance	13
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963 034964
Policy instance	4
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455465
Policy instance	12
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477590
Policy instance	11
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477589
Policy instance	10
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440583
Policy instance	9
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	8
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00456639
Policy instance	7
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	6
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00448646
Policy instance	5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455044
Policy instance	3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477592
Policy instance	14
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477593
Policy instance	15
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00482182
Policy instance	28
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number	52047
Policy instance	27
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number	16DS
Policy instance	26
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number	800772
Policy instance	25
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00482183
Policy instance	29
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	23
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	22
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	21
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	20
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	19
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	70904 74122
Policy instance	18
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477607
Policy instance	17
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477693
Policy instance	13
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00488131
Policy instance	30
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477591
Policy instance	16
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001026
Policy instance	1
BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 71714 )
Policy contract number	C03710
Policy instance	31
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	B6654
Policy instance	32
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	33
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number	000007267
Policy instance	34
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00497928
Policy instance	35
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	209322
Policy instance	24
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	25
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440583
Policy instance	11
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	10
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	A9632
Policy instance	9
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00456639
Policy instance	8
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00467963
Policy instance	7
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	6
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00448646
Policy instance	5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477590
Policy instance	14
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963*
Policy instance	4
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number	00007342
Policy instance	12
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	2
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001026
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455044
Policy instance	3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477589
Policy instance	13
GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )
Policy contract number	16DS
Policy instance	29
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number	800772
Policy instance	28
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	209322
Policy instance	27
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	26
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	24
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	23
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	22
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	70904
Policy instance	21
CHARTIS (National Association of Insurance Commissioners NAIC id number: 66842 )
Policy contract number	52047
Policy instance	30
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00482182
Policy instance	31
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455465
Policy instance	15
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477693
Policy instance	16
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477592
Policy instance	17
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477593
Policy instance	18
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477591
Policy instance	19
BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 71714 )
Policy contract number	C03710
Policy instance	34
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00488131
Policy instance	33
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00482183
Policy instance	32
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477607
Policy instance	20
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	10
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477589
Policy instance	17
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	76410
Policy instance	15
ANTHEM INSURANCE COMPANIES, INC. (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number	00007342
Policy instance	16
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0146623
Policy instance	14
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0144899
Policy instance	13
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440583
Policy instance	12
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number	30014151
Policy instance	11
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455044
Policy instance	3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963*
Policy instance	4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00448646
Policy instance	5
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	6
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00467963
Policy instance	7
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00456639
Policy instance	8
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	A9632
Policy instance	9
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477590
Policy instance	18
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455465
Policy instance	19
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477693
Policy instance	20
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477607
Policy instance	24
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	W0001026
Policy instance	1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number	12279540
Policy instance	35
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	209322
Policy instance	34
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0139509
Policy instance	33
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AI4R
Policy instance	32
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	31
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	30
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	29
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477592
Policy instance	21
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477593
Policy instance	22
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00477591
Policy instance	23
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	70904
Policy instance	25
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	* SEE BELOW
Policy instance	26
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	27
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	*SEE BELOW
Policy instance	28
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9754219
Policy instance	10
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number	3924
Policy instance	9
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number	1834
Policy instance	8
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	P99575-77
Policy instance	7
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963*
Policy instance	6
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	5
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	4
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number	27896
Policy instance	3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	A9632
Policy instance	2
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number	F017441
Policy instance	11
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00456639
Policy instance	12
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 )
Policy contract number	30014151
Policy instance	22
UNITED HEALTH CARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	519132
Policy instance	20
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number	VG 175193
Policy instance	19
HEALTH PLAN OF NEVADA (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	18
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00457259
Policy instance	17
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455044
Policy instance	16
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00448646
Policy instance	15
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440583
Policy instance	14
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00467963
Policy instance	13
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	*SEE BELOW
Policy instance	1
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	298763
Policy instance	21
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	30014151
Policy instance	30
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number	9754219
Policy instance	12
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	9793
Policy instance	11
CORPORATE FAMILY NETWORK (National Association of Insurance Commissioners NAIC id number: 81299 )
Policy contract number	EAP
Policy instance	10
LIFEWISE HEALTH PLANS OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 65105 )
Policy contract number	1033827
Policy instance	18
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	034963
Policy instance	9
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number	8031074
Policy instance	8
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number	P99575-77
Policy instance	7
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	A9632
Policy instance	6
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number	64712
Policy instance	5
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract number	945364
Policy instance	4
ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. (National Association of Insurance Commissioners NAIC id number: 53759 )
Policy contract number	355700
Policy instance	3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number	00007342
Policy instance	2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	80005474
Policy instance	1
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract number	F017441
Policy instance	13
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440583
Policy instance	14
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	298763
Policy instance	29
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	298763
Policy instance	28
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number	380699
Policy instance	27
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	121710
Policy instance	26
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	121710
Policy instance	25
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	121710
Policy instance	24
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	121710
Policy instance	23
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number	VG175193
Policy instance	22
UNITED HEALTHCARE (OPTIMUM CHOICE) (National Association of Insurance Commissioners NAIC id number: 96940 )
Policy contract number	M63199
Policy instance	21
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05599219
Policy instance	20
LIFEWISE HEALTH PLANS OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 65105 )
Policy contract number	1033827
Policy instance	19
HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE (National Association of Insurance Commissioners NAIC id number: 96342 )
Policy contract number	60000261
Policy instance	17
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00455044
Policy instance	16
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00448646
Policy instance	15

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Company Name:	TEXAS EM-1 MEDICAL SERVICES, P.A.
Employer identification number (EIN):	752744538
NAIC Classification:	621900