 |
|
|
|
| Plan Name | MASTER MOLD LLC EMPLOYEE WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | MASTER MOLD LLC |
| Employer identification number (EIN): | 391863073 |
| NAIC Classification: | 339900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-07-01 | JON BUTTS | 2024-01-31 | ||
| 501 | 2021-07-01 | JON BUTTS | 2023-01-20 | ||
| 501 | 2020-07-01 | JON BUTTS | 2022-01-31 | ||
| 501 | 2019-07-01 | JON BUTTS | 2021-01-29 | ||
| 501 | 2018-07-01 | TODD WEISBROD | 2020-01-22 | ||
| 501 | 2017-07-01 | ||||
| 501 | 2016-07-01 | ||||
| 501 | 2015-07-01 | ||||
| 501 | 2014-07-01 | FAYE NORA | |||
| 501 | 2013-07-01 | FAYE NORA | |||
| 501 | 2012-07-01 | FAYE NORA | |||
| 501 | 2011-07-01 | FAYE NORA | |||
| 501 | 2010-07-01 | FAYE NORA | |||
| 501 | 2009-07-01 | FAYE NORA |
| Measure | Date | Value |
|---|---|---|
| 2022: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-07-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 261 |
| Total of all active and inactive participants | 2022-07-01 | 261 |
| 2021: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-07-01 | 195 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 210 |
| Total of all active and inactive participants | 2021-07-01 | 210 |
| 2020: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-07-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 195 |
| Total of all active and inactive participants | 2020-07-01 | 195 |
| 2019: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-07-01 | 296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 184 |
| Total of all active and inactive participants | 2019-07-01 | 184 |
| 2018: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-07-01 | 294 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 296 |
| Total of all active and inactive participants | 2018-07-01 | 296 |
| 2017: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 333 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 294 |
| Total of all active and inactive participants | 2017-07-01 | 294 |
| 2016: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 416 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 333 |
| Total of all active and inactive participants | 2016-07-01 | 333 |
| 2015: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 376 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 416 |
| Total of all active and inactive participants | 2015-07-01 | 416 |
| 2014: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 450 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 376 |
| Total of all active and inactive participants | 2014-07-01 | 376 |
| 2013: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 317 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 450 |
| Total of all active and inactive participants | 2013-07-01 | 450 |
| 2012: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 241 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 317 |
| Total of all active and inactive participants | 2012-07-01 | 317 |
| Total participants | 2012-07-01 | 0 |
| 2011: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 240 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 1 |
| Total of all active and inactive participants | 2011-07-01 | 241 |
| Total participants | 2011-07-01 | 241 |
| 2010: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-07-01 | 178 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-07-01 | 253 |
| Number of retired or separated participants receiving benefits | 2010-07-01 | 1 |
| Total of all active and inactive participants | 2010-07-01 | 254 |
| 2009: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 182 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 176 |
| Number of retired or separated participants receiving benefits | 2009-07-01 | 2 |
| Total of all active and inactive participants | 2009-07-01 | 178 |
| 2022: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: MASTER MOLD LLC EMPLOYEE WELFARE 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 |
| 2018: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2018 form 5500 responses | ||
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: MASTER MOLD LLC EMPLOYEE WELFARE 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 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 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: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | Yes |
| 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 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: MASTER MOLD LLC EMPLOYEE WELFARE 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 funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2010 form 5500 responses | ||
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: MASTER MOLD LLC EMPLOYEE WELFARE PLAN 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) | |
| Policy contract number | M874 |
| Policy instance | 7 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 6 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 6 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) | |
| Policy contract number | M874 |
| Policy instance | 7 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 6 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | M874 |
| Policy instance | 7 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 6 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | M874 |
| Policy instance | 7 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 2 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 7 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | M874 |
| Policy instance | 8 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 7 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 4 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 3 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 2 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000400205625 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205624 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205623 |
| Policy instance | 4 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 3 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 2 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010205626 |
| Policy instance | 7 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 3 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 2 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 5 |
| SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC (National Association of Insurance Commissioners NAIC id number: 52005 ) | |
| Policy contract number | 208700 |
| Policy instance | 6 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 2 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 129100 00000 |
| Policy instance | 1 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 5 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 3 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 12910 00000 |
| Policy instance | 5 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 3 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 2 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 1 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 1 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 2 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 3 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 4 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 12910 00000 |
| Policy instance | 5 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 4 |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 085175 |
| Policy instance | 3 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) | |
| Policy contract number | M874 |
| Policy instance | 1 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |
| Policy contract number | 12910 |
| Policy instance | 2 |
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