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CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 401k Plan overview

Plan NameCRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION
Plan identification number 502

CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

POTOMAC CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:POTOMAC CORPORATION
Employer identification number (EIN):360897610
NAIC Classification:322200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01JAMARA RODRIGUEZ2024-07-17
5022022-01-01JAMARA RODRIGUEZ2023-07-20
5022022-01-01JAMARA RODRIGUEZ2024-07-17
5022021-01-01JAMARA RODRIGUEZ2022-09-26
5022021-01-01JAMARA RODRIGUEZ2024-07-17
5022020-01-01
5022019-01-01ROBERT KING2020-08-31
5022017-01-01
5022016-01-01ROBERT KING
5022015-01-01ANA GARCIA
5022014-01-01BRIDGET NELSON
5022013-09-01KEVIN MCCARTHY KEVIN MCCARTHY2014-06-13
5022012-09-01KEVIN MCCARTHY KEVIN MCCARTHY2014-03-27
5022011-09-01KEVIN MCCARTHY
5022009-09-01TERRY BOFFELI TERRY BOFFELI2011-02-14

Plan Statistics for CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION

401k plan membership statisitcs for CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION

Measure Date Value
2023: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2023 401k membership
Total participants, beginning-of-year2023-01-01191
Total number of active participants reported on line 7a of the Form 55002023-01-010
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-010
2022: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2022 401k membership
Total participants, beginning-of-year2022-01-01231
Total number of active participants reported on line 7a of the Form 55002022-01-01206
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01208
2021: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2021 401k membership
Total participants, beginning-of-year2021-01-0190
Total number of active participants reported on line 7a of the Form 55002021-01-01215
Number of retired or separated participants receiving benefits2021-01-011
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01216
2020: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2020 401k membership
Total participants, beginning-of-year2020-01-01165
Total number of active participants reported on line 7a of the Form 55002020-01-01153
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01155
2019: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2019 401k membership
Total participants, beginning-of-year2019-01-01111
Total number of active participants reported on line 7a of the Form 55002019-01-01111
Number of retired or separated participants receiving benefits2019-01-014
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01115
2017: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2017 401k membership
Total participants, beginning-of-year2017-01-01122
Total number of active participants reported on line 7a of the Form 55002017-01-01126
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01126
2016: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2016 401k membership
Total participants, beginning-of-year2016-01-01132
Total number of active participants reported on line 7a of the Form 55002016-01-01126
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01128
2015: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2015 401k membership
Total participants, beginning-of-year2015-01-01141
Total number of active participants reported on line 7a of the Form 55002015-01-01124
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01124
2014: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2014 401k membership
Total participants, beginning-of-year2014-01-01149
Total number of active participants reported on line 7a of the Form 55002014-01-01145
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01145
2013: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2013 401k membership
Total participants, beginning-of-year2013-09-01147
Total number of active participants reported on line 7a of the Form 55002013-09-01146
Number of retired or separated participants receiving benefits2013-09-011
Total of all active and inactive participants2013-09-01147
Total participants2013-09-01147
2012: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2012 401k membership
Total participants, beginning-of-year2012-09-01140
Total number of active participants reported on line 7a of the Form 55002012-09-01143
Number of retired or separated participants receiving benefits2012-09-014
Total of all active and inactive participants2012-09-01147
Total participants2012-09-01147
2011: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2011 401k membership
Total participants, beginning-of-year2011-09-01134
Total number of active participants reported on line 7a of the Form 55002011-09-01136
Number of retired or separated participants receiving benefits2011-09-014
Total of all active and inactive participants2011-09-01140
Total participants2011-09-01140
2009: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2009 401k membership
Total participants, beginning-of-year2009-09-01138
Total number of active participants reported on line 7a of the Form 55002009-09-01127
Number of retired or separated participants receiving benefits2009-09-018
Total of all active and inactive participants2009-09-01135
Total participants2009-09-01135

Form 5500 Responses for CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION

2023: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingYes
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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 planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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 planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-09-01Plan is a collectively bargained planYes
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – General assets of the sponsorYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – General assets of the sponsorYes
2012: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planYes
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes
2011: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planYes
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – General assets of the sponsorYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – General assets of the sponsorYes
2009: CRESCENT CARDBOARD GROUP HEALTH LIFE AND DENTAL PLAN FOR EMPLOYEES OF POTOMAC CORPORATION 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planYes
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan funding arrangement – General assets of the sponsorYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number868958
Policy instance 4
Insurance contract or identification number868958
Number of Individuals Covered276
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $14,957
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
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 $2,264,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberCRESCENT
Policy instance 3
Insurance contract or identification numberCRESCENT
Number of Individuals Covered35
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $7,647
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $61,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number802977
Policy instance 2
Insurance contract or identification number802977
Number of Individuals Covered88
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $10,436
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
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
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS, HOSPITAL
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 $21,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 1
Insurance contract or identification number6091109
Number of Individuals Covered7
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $247
Total amount of fees paid to insurance companyUSD $29
Health Insurance Welfare BenefitNo
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
Other welfare benefits providedLEGAL
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 $2,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number40436
Policy instance 5
Insurance contract or identification number40436
Number of Individuals Covered195
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $22,146
Total amount of fees paid to insurance companyUSD $1,864
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $115,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD607104
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604863
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606843
Policy instance 4
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1029503,1029504
Policy instance 5
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0868958
Policy instance 6
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberCRESCENT
Policy instance 7
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number759097
Policy instance 8
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0162252
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0162253
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD607104
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604863
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606843
Policy instance 6
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10295031001
Policy instance 7
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0868958
Policy instance 8
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberCRESCENT
Policy instance 9
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000321J
Policy instance 10
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0868958
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000321J
Policy instance 9
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 8
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0162252
Policy instance 7
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0162253
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD607104
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606843
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604863
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10019921001
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604863
Policy instance 4
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1001992
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0868958
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606843
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD607104
Policy instance 6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5930200
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0321J
Policy instance 8
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0321J
Policy instance 9
ADVANCE MEDICAL, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberCRES63
Policy instance 10
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1001992
Policy instance 2
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number6091109
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604863
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606843
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD607104
Policy instance 6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5930200
Policy instance 7
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0321J
Policy instance 8
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0321J
Policy instance 9
ADVANCE MEDICAL, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberCRES63
Policy instance 10
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0868958
Policy instance 1

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