 |
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| Plan Name | WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | WEAVERTOWN TRANSPORT LEASING INC |
| Employer identification number (EIN): | 251404579 |
| NAIC Classification: | 562000 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-07-01 | JEFFREY K. KIRKHAM | 2022-01-24 | ||
| 501 | 2020-07-01 | JEFFREY K. KIRKHAM | 2022-01-24 | ||
| 501 | 2019-07-01 | JEFFREY J. KIRKHAM | 2021-01-26 | ||
| 501 | 2017-07-01 | ZACH GRAY | |||
| 501 | 2016-07-01 | ZACH GRAY | |||
| 501 | 2015-07-01 | ZACH GRAY | |||
| 501 | 2014-07-01 | ZACH GRAY | |||
| 501 | 2013-07-01 | ZACH GRAY | |||
| 501 | 2012-07-01 | ZACH GRAY | |||
| 501 | 2011-07-01 | DONNA L MAYS | |||
| 501 | 2009-07-01 | DONNA L MAYS |
| Measure | Date | Value |
|---|---|---|
| 2021: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-07-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 0 |
| Number of employers contributing to the scheme | 2021-07-01 | 0 |
| 2020: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-07-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 125 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
| Total of all active and inactive participants | 2020-07-01 | 125 |
| Number of employers contributing to the scheme | 2020-07-01 | 0 |
| 2019: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-07-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 176 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 25 |
| Total of all active and inactive participants | 2019-07-01 | 208 |
| Number of employers contributing to the scheme | 2019-07-01 | 0 |
| 2017: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 300 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 234 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 238 |
| 2016: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 136 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 136 |
| 2015: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 148 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 148 |
| 2014: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 156 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 142 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 143 |
| 2013: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 156 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 156 |
| 2012: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 156 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 161 |
| 2011: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 245 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 219 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
| Total of all active and inactive participants | 2011-07-01 | 223 |
| 2009: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 141 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2009-07-01 | 0 |
| Total of all active and inactive participants | 2009-07-01 | 145 |
| 2021: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | This submission is the final filing | Yes |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2015 form 5500 responses | ||
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: WEAVERTOWN TRANSPORT LEASING WELFARE BENEFITS PLAN 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) | |
| Policy contract number | 85175-091 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0AC2Q |
| Policy instance | 5 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7405103 |
| Policy instance | 4 |
| DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) | |
| Policy contract number | 10049 |
| Policy instance | 3 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 21593 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 6 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 021593 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) | |
| Policy contract number | 406517 0010 |
| Policy instance | 7 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E7405103 |
| Policy instance | 8 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLTD0AC2Q |
| Policy instance | 9 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0AC2Q |
| Policy instance | 10 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GVTL0AC2Q |
| Policy instance | 12 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GUC0AC2Q |
| Policy instance | 11 |
| DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) | |
| Policy contract number | 10049 |
| Policy instance | 13 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 021593 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 6 |
| HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) | |
| Policy contract number | 404207 0010 |
| Policy instance | 7 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175, 902571 |
| Policy instance | 4 |
| HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) | |
| Policy contract number | 404207 0010 |
| Policy instance | 7 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 6 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 021593 |
| Policy instance | 5 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175, 902571 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 021593 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 6 |
| HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) | |
| Policy contract number | 404207 0010 |
| Policy instance | 7 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) | |
| Policy contract number | 404207 0010 |
| Policy instance | 7 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 021593 |
| Policy instance | 5 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 6 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 7 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 04771900 |
| Policy instance | 5 |
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) | |
| Policy contract number | 2181420000 |
| Policy instance | 6 |
| CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 ) | |
| Policy contract number | 2181420000 |
| Policy instance | 8 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600331 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM600475 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD600332 |
| Policy instance | 3 |
| UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 ) | |
| Policy contract number | 2181420000 |
| Policy instance | 8 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK600158 |
| Policy instance | 7 |
| HEALTHAMERICA OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 95060 ) | |
| Policy contract number | 2181420000 |
| Policy instance | 6 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 04771900 |
| Policy instance | 5 |
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