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ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 401k Plan overview

Plan NameASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM
Plan identification number 501

ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

ASSOCIATED GENERAL CONTRACTORS OF CALIFORNIA has sponsored the creation of one or more 401k plans.

Company Name:ASSOCIATED GENERAL CONTRACTORS OF CALIFORNIA
Employer identification number (EIN):952575486
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-12-01DAWNE BAAS
5012023-01-01
5012023-01-01DAWNE BAAS
5012022-01-01
5012022-01-01
5012022-01-01DAWNE BAAS
5012021-01-01
5012021-01-01MARY ANNE HATHAWAY
5012020-01-01
5012019-01-01

Financial Data on ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM

Measure Date Value
2023 : ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2023 401k financial data
Total plan liabilities at end of year2023-11-30$7,179
Total plan liabilities at beginning of year2023-11-30$98,559
Total income from all sources2023-11-30$674,823
Expenses. Total of all expenses incurred2023-11-30$682,002
Benefits paid (including direct rollovers)2023-11-30$676,640
Total plan assets at end of year2023-11-30$31,036
Total plan assets at beginning of year2023-11-30$129,595
Total contributions received or receivable from participants2023-11-30$674,823
Net income (gross income less expenses)2023-11-30$-7,179
Net plan assets at end of year (total assets less liabilities)2023-11-30$23,857
Net plan assets at beginning of year (total assets less liabilities)2023-11-30$31,036
Expenses. Administrative service providers (salaries,fees and commissions)2023-11-30$5,362
2022 : ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2022 401k financial data
Total plan liabilities at end of year2022-12-31$98,559
Total plan liabilities at beginning of year2022-12-31$98,559
Total income from all sources2022-12-31$699,338
Expenses. Total of all expenses incurred2022-12-31$693,706
Benefits paid (including direct rollovers)2022-12-31$687,260
Total plan assets at end of year2022-12-31$129,595
Total plan assets at beginning of year2022-12-31$123,963
Total contributions received or receivable from participants2022-12-31$699,338
Expenses. Other expenses not covered elsewhere2022-12-31$289
Net income (gross income less expenses)2022-12-31$5,632
Net plan assets at end of year (total assets less liabilities)2022-12-31$31,036
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$25,404
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$6,157
2021 : ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2021 401k financial data
Total plan liabilities at end of year2021-12-31$98,559
Total plan liabilities at beginning of year2021-12-31$98,559
Total income from all sources2021-12-31$754,901
Expenses. Total of all expenses incurred2021-12-31$737,090
Benefits paid (including direct rollovers)2021-12-31$724,444
Total plan assets at end of year2021-12-31$123,963
Total plan assets at beginning of year2021-12-31$106,152
Total contributions received or receivable from participants2021-12-31$755,038
Other income received2021-12-31$-137
Net income (gross income less expenses)2021-12-31$17,811
Net plan assets at end of year (total assets less liabilities)2021-12-31$25,404
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$7,593
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$12,646
2020 : ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2020 401k financial data
Total plan liabilities at end of year2020-12-31$98,559
Total plan liabilities at beginning of year2020-12-31$98,655
Total income from all sources2020-12-31$684,580
Expenses. Total of all expenses incurred2020-12-31$707,319
Benefits paid (including direct rollovers)2020-12-31$692,733
Total plan assets at end of year2020-12-31$106,152
Total plan assets at beginning of year2020-12-31$128,987
Total contributions received or receivable from participants2020-12-31$684,942
Other income received2020-12-31$-362
Net income (gross income less expenses)2020-12-31$-22,739
Net plan assets at end of year (total assets less liabilities)2020-12-31$7,593
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$30,332
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$14,586
2019 : ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2019 401k financial data
Total plan liabilities at end of year2019-12-31$98,655
Total plan liabilities at beginning of year2019-12-31$98,748
Total income from all sources2019-12-31$1,028,327
Expenses. Total of all expenses incurred2019-12-31$1,009,932
Benefits paid (including direct rollovers)2019-12-31$1,009,558
Total plan assets at end of year2019-12-31$128,987
Total plan assets at beginning of year2019-12-31$110,685
Total contributions received or receivable from participants2019-12-31$1,028,140
Other income received2019-12-31$187
Net income (gross income less expenses)2019-12-31$18,395
Net plan assets at end of year (total assets less liabilities)2019-12-31$30,332
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$11,937
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$374

Form 5500 Responses for ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM

2023: ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2023 form 5500 responses
2023-01-01Type of plan entityMulitple employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2022 form 5500 responses
2022-01-01Type of plan entityMulitple employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingYes
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2021 form 5500 responses
2021-01-01Type of plan entityMulitple employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2020 form 5500 responses
2020-01-01Type of plan entityMulitple employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ASSOCIATED GENERAL CONTRACTORS OF CA MEMBER BENEFITS PROGRAM 2019 form 5500 responses
2019-01-01Type of plan entityMulti-employer plan
2019-01-01First time form 5500 has been submittedYes
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10915002
Policy instance 1
Insurance contract or identification number10915002
Number of Individuals Covered19
Insurance policy start date2023-01-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $154
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 5
Insurance contract or identification number604973
Number of Individuals Covered69
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $13,742
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $505,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number232812
Policy instance 4
Insurance contract or identification number232812
Number of Individuals Covered5
Insurance policy start date2022-12-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $1,065
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $23,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number71921
Policy instance 3
Insurance contract or identification number71921
Number of Individuals Covered8
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $125
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 2
Insurance contract or identification number00641
Number of Individuals Covered83
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,181
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000A003
Policy instance 6
Insurance contract or identification number019000A003
Number of Individuals Covered5
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $7,384
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $92,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number38350
Policy instance 7
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10915
Policy instance 8
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 3
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number05890
Policy instance 6
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000-A003
Policy instance 5
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number71921
Policy instance 4
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number232812
Policy instance 2
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051224
Policy instance 9
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK811052
Policy instance 10
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number05890
Policy instance 1
NATIONAL GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number10915
Policy instance 10
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK811052
Policy instance 9
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051224
Policy instance 8
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 7
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000-A003
Policy instance 6
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number232812
Policy instance 5
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number38350
Policy instance 2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 1
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000-A003
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK811052
Policy instance 8
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 1
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number71921
Policy instance 3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 4
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number05890
Policy instance 5
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number38350
Policy instance 6
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051224
Policy instance 7
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 1
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000-A003
Policy instance 2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number71921
Policy instance 3
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 4
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number05890
Policy instance 5
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number38350
Policy instance 6
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051224
Policy instance 7
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK811052
Policy instance 8
WESTERN HEALTH ADVANTAGE (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number019000-A003
Policy instance 2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00641
Policy instance 3
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number05890
Policy instance 4
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number38350
Policy instance 5
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number71921
Policy instance 6
CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0003706
Policy instance 7
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberW0051224
Policy instance 8
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number212356
Policy instance 9
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK811052
Policy instance 10
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number604973
Policy instance 1

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