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| Plan Name | PETERSEN ALUMINUM CORPORATION INSURANCE PLAN |
| Plan identification number | 514 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | PETERSEN ALUMINUM CORPORATION |
| Employer identification number (EIN): | 362551478 |
| NAIC Classification: | 332300 |
Additional information about PETERSEN ALUMINUM CORPORATION
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 1985-10-28 |
| Company Identification Number: | 0006729606 |
| Legal Registered Office Address: |
1005 TONNE RD ELK GROVE VLG United States of America (USA) 60007 |
More information about PETERSEN ALUMINUM CORPORATION
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 514 | 2019-07-01 | ROBERT HARTMAN | 2020-01-21 | ||
| 514 | 2018-07-01 | ROBERT HARTMAN | 2020-01-16 | ||
| 514 | 2017-07-01 | ||||
| 514 | 2016-07-01 | ||||
| 514 | 2015-07-01 | ||||
| 514 | 2014-07-01 | ||||
| 514 | 2013-07-01 | ||||
| 514 | 2012-07-01 | ROBERT A. HARTMAN | |||
| 514 | 2011-07-01 | ROBERT A. HARTMAN | |||
| 514 | 2009-07-01 | ||||
| 514 | 2008-07-01 | ||||
| 514 | 2007-07-01 | ||||
| 514 | 2006-07-01 | ||||
| 514 | 2005-07-01 | ||||
| 514 | 2004-07-01 | ||||
| 514 | 2003-07-01 | ||||
| 514 | 2002-07-01 | ||||
| 514 | 2001-07-01 | ||||
| 514 | 2000-07-01 | ||||
| 514 | 1999-07-01 | ||||
| 514 | 1998-07-01 | ||||
| 514 | 1997-07-01 | ||||
| 514 | 1996-07-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-07-01 | 216 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
| Total of all active and inactive participants | 2019-07-01 | 0 |
| 2018: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-07-01 | 211 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 215 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2018-07-01 | 0 |
| Total of all active and inactive participants | 2018-07-01 | 216 |
| 2017: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 323 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| 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 | 323 |
| 2016: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 303 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 313 |
| 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 | 313 |
| 2015: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 303 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 302 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 1 |
| 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 | 303 |
| 2014: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 343 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 303 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| 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 | 303 |
| 2013: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 378 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 343 |
| 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 | 343 |
| 2012: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 381 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 378 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| 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 | 378 |
| 2011: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 384 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 381 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| 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 | 381 |
| 2009: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 391 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 388 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 0 |
| 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 | 388 |
| 2008: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2008 401k membership | ||
| Total participants, beginning-of-year | 2008-07-01 | 418 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-07-01 | 391 |
| Number of retired or separated participants receiving benefits | 2008-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-07-01 | 0 |
| Total of all active and inactive participants | 2008-07-01 | 391 |
| 2007: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2007 401k membership | ||
| Total participants, beginning-of-year | 2007-07-01 | 428 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-07-01 | 418 |
| Number of retired or separated participants receiving benefits | 2007-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2007-07-01 | 0 |
| Total of all active and inactive participants | 2007-07-01 | 418 |
| 2006: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2006 401k membership | ||
| Total participants, beginning-of-year | 2006-07-01 | 660 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-07-01 | 428 |
| Number of retired or separated participants receiving benefits | 2006-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2006-07-01 | 0 |
| Total of all active and inactive participants | 2006-07-01 | 428 |
| 2005: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2005 401k membership | ||
| Total participants, beginning-of-year | 2005-07-01 | 394 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-07-01 | 660 |
| Number of retired or separated participants receiving benefits | 2005-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2005-07-01 | 0 |
| Total of all active and inactive participants | 2005-07-01 | 660 |
| 2004: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2004 401k membership | ||
| Total participants, beginning-of-year | 2004-07-01 | 397 |
| Total number of active participants reported on line 7a of the Form 5500 | 2004-07-01 | 394 |
| Number of retired or separated participants receiving benefits | 2004-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2004-07-01 | 0 |
| Total of all active and inactive participants | 2004-07-01 | 394 |
| 2003: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2003 401k membership | ||
| Total participants, beginning-of-year | 2003-07-01 | 378 |
| Total number of active participants reported on line 7a of the Form 5500 | 2003-07-01 | 397 |
| Number of retired or separated participants receiving benefits | 2003-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2003-07-01 | 0 |
| Total of all active and inactive participants | 2003-07-01 | 397 |
| 2002: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2002 401k membership | ||
| Total participants, beginning-of-year | 2002-07-01 | 360 |
| Total number of active participants reported on line 7a of the Form 5500 | 2002-07-01 | 378 |
| Number of retired or separated participants receiving benefits | 2002-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2002-07-01 | 0 |
| Total of all active and inactive participants | 2002-07-01 | 378 |
| 2001: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2001 401k membership | ||
| Total participants, beginning-of-year | 2001-07-01 | 342 |
| Total number of active participants reported on line 7a of the Form 5500 | 2001-07-01 | 360 |
| Number of retired or separated participants receiving benefits | 2001-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2001-07-01 | 0 |
| Total of all active and inactive participants | 2001-07-01 | 360 |
| 2000: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2000 401k membership | ||
| Total participants, beginning-of-year | 2000-07-01 | 324 |
| Total number of active participants reported on line 7a of the Form 5500 | 2000-07-01 | 342 |
| Number of retired or separated participants receiving benefits | 2000-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2000-07-01 | 0 |
| Total of all active and inactive participants | 2000-07-01 | 342 |
| 1999: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1999 401k membership | ||
| Total participants, beginning-of-year | 1999-07-01 | 306 |
| Total number of active participants reported on line 7a of the Form 5500 | 1999-07-01 | 324 |
| Number of retired or separated participants receiving benefits | 1999-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1999-07-01 | 0 |
| Total of all active and inactive participants | 1999-07-01 | 324 |
| 1998: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1998 401k membership | ||
| Total participants, beginning-of-year | 1998-07-01 | 303 |
| Total number of active participants reported on line 7a of the Form 5500 | 1998-07-01 | 306 |
| Number of retired or separated participants receiving benefits | 1998-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1998-07-01 | 0 |
| Total of all active and inactive participants | 1998-07-01 | 306 |
| 1997: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1997 401k membership | ||
| Total participants, beginning-of-year | 1997-07-01 | 300 |
| Total number of active participants reported on line 7a of the Form 5500 | 1997-07-01 | 303 |
| Number of retired or separated participants receiving benefits | 1997-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1997-07-01 | 0 |
| Total of all active and inactive participants | 1997-07-01 | 303 |
| 1996: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1996 401k membership | ||
| Total participants, beginning-of-year | 1996-07-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 1996-07-01 | 300 |
| Number of retired or separated participants receiving benefits | 1996-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 1996-07-01 | 0 |
| Total of all active and inactive participants | 1996-07-01 | 300 |
| 2019: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Submission has been amended | No |
| 2019-07-01 | This submission is the final filing | Yes |
| 2019-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2019-07-01 | Plan is a collectively bargained plan | No |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2018 form 5500 responses | ||
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Submission has been amended | No |
| 2018-07-01 | This submission is the final filing | No |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-07-01 | Plan is a collectively bargained plan | No |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2015 form 5500 responses | ||
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2014 form 5500 responses | ||
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2008 form 5500 responses | ||
| 2008-07-01 | Type of plan entity | Single employer plan |
| 2008-07-01 | Plan funding arrangement – Insurance | Yes |
| 2008-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2007 form 5500 responses | ||
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2006 form 5500 responses | ||
| 2006-07-01 | Type of plan entity | Single employer plan |
| 2006-07-01 | Plan funding arrangement – Insurance | Yes |
| 2006-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2005 form 5500 responses | ||
| 2005-07-01 | Type of plan entity | Single employer plan |
| 2005-07-01 | Plan funding arrangement – Insurance | Yes |
| 2005-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2004 form 5500 responses | ||
| 2004-07-01 | Type of plan entity | Single employer plan |
| 2004-07-01 | Plan funding arrangement – Insurance | Yes |
| 2004-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2003 form 5500 responses | ||
| 2003-07-01 | Type of plan entity | Single employer plan |
| 2003-07-01 | Plan funding arrangement – Insurance | Yes |
| 2003-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2002 form 5500 responses | ||
| 2002-07-01 | Type of plan entity | Single employer plan |
| 2002-07-01 | Plan funding arrangement – Insurance | Yes |
| 2002-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2001 form 5500 responses | ||
| 2001-07-01 | Type of plan entity | Single employer plan |
| 2001-07-01 | Plan funding arrangement – Insurance | Yes |
| 2001-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 2000 form 5500 responses | ||
| 2000-07-01 | Type of plan entity | Single employer plan |
| 2000-07-01 | Plan funding arrangement – Insurance | Yes |
| 2000-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1999: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1999 form 5500 responses | ||
| 1999-07-01 | Type of plan entity | Single employer plan |
| 1999-07-01 | Plan funding arrangement – Insurance | Yes |
| 1999-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1998: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1998 form 5500 responses | ||
| 1998-07-01 | Type of plan entity | Single employer plan |
| 1998-07-01 | Plan funding arrangement – Insurance | Yes |
| 1998-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1997: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1997 form 5500 responses | ||
| 1997-07-01 | Type of plan entity | Single employer plan |
| 1997-07-01 | Plan funding arrangement – Insurance | Yes |
| 1997-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1996: PETERSEN ALUMINUM CORPORATION INSURANCE PLAN 1996 form 5500 responses | ||
| 1996-07-01 | Type of plan entity | Single employer plan |
| 1996-07-01 | Plan funding arrangement – Insurance | Yes |
| 1996-07-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 4 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 3 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 4 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 4 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 2 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 160364 |
| Policy instance | 3 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 873644G |
| Policy instance | 2 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 873644G |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 873644G |
| Policy instance | 2 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 3 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD 101292 |
| Policy instance | 5 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD 101292 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD101292 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD101292 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD101292 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 5 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD101292 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | LTD101292 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 125554 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | G 157090 |
| Policy instance | 4 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 5 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |
| Policy contract number | F186922 |
| Policy instance | 2 |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | P86922 |
| Policy instance | 1 |