401k Plan data: HY-VEE ELECTIVE BENEFITS PLAN plan

HY-VEE ELECTIVE BENEFITS PLAN 401k Plan overview

Plan Name	HY-VEE ELECTIVE BENEFITS PLAN
Plan identification number	502

HY-VEE ELECTIVE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

HY-VEE, INC. has sponsored the creation of one or more 401k plans.

Company Name: HY-VEE, INC.

Employer identification number (EIN): 420325638

NAIC Classification: 445110
NAIC Description: Supermarkets and Other Grocery (except Convenience) Stores

Additional information about HY-VEE, INC.

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1938-01-03

Company Identification Number: 019862

Legal Registered Office Address: 400 E COURT AVE

DES MOINES
United States of America (USA)
50309

More information about HY-VEE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HY-VEE ELECTIVE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-08-01 ANDREW SCHREINER 2024-02-27
502 2021-08-01 ANDREW SCHREINER 2023-02-26
502 2020-08-01 ANDREW SCHREINER 2022-02-24
502 2019-08-01 MICHAEL SKOKAN 2021-02-28
502 2019-08-01 MICHAEL SKOKAN 2021-02-21
502 2018-08-01 MICHAEL SKOKAN 2020-03-01
502 2017-08-01
502 2016-08-01 MICHAEL SKOKAN
502 2015-08-01 MICHAEL SKOKAN
502 2014-08-01 MICHAEL SKOKAN
502 2013-08-01 MICHAEL SKOKAN
502 2012-08-01 MICHAEL SKOKAN
502 2011-08-01 MICHAEL SKOKAN
502 2009-08-01 MICHAEL SKOKAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2022-08-01	ANDREW SCHREINER	2024-02-27
502	2021-08-01	ANDREW SCHREINER	2023-02-26
502	2020-08-01	ANDREW SCHREINER	2022-02-24
502	2019-08-01	MICHAEL SKOKAN	2021-02-28
502	2019-08-01	MICHAEL SKOKAN	2021-02-21
502	2018-08-01	MICHAEL SKOKAN	2020-03-01
502	2017-08-01
502	2016-08-01	MICHAEL SKOKAN
502	2015-08-01	MICHAEL SKOKAN
502	2014-08-01	MICHAEL SKOKAN
502	2013-08-01	MICHAEL SKOKAN
502	2012-08-01	MICHAEL SKOKAN
502	2011-08-01	MICHAEL SKOKAN
502	2009-08-01	MICHAEL SKOKAN

Plan Statistics for HY-VEE ELECTIVE BENEFITS PLAN

401k plan membership statisitcs for HY-VEE ELECTIVE BENEFITS PLAN

Measure Date Value
2022: HY-VEE ELECTIVE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-08-01 14,064
Total number of active participants reported on line 7a of the Form 5500 2022-08-01 13,614
Number of retired or separated participants receiving benefits 2022-08-01 192
Number of other retired or separated participants entitled to future benefits 2022-08-01 0
Total of all active and inactive participants 2022-08-01 13,806
2021: HY-VEE ELECTIVE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-08-01 14,099
Total number of active participants reported on line 7a of the Form 5500 2021-08-01 14,064
Number of retired or separated participants receiving benefits 2021-08-01 201
Number of other retired or separated participants entitled to future benefits 2021-08-01 201
Total of all active and inactive participants 2021-08-01 14,466
2020: HY-VEE ELECTIVE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-08-01 11,662
Total number of active participants reported on line 7a of the Form 5500 2020-08-01 14,099
Number of retired or separated participants receiving benefits 2020-08-01 17
Number of other retired or separated participants entitled to future benefits 2020-08-01 17
Total of all active and inactive participants 2020-08-01 14,133
2019: HY-VEE ELECTIVE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-08-01 13,649
Total number of active participants reported on line 7a of the Form 5500 2019-08-01 11,652
Number of retired or separated participants receiving benefits 2019-08-01 10
Number of other retired or separated participants entitled to future benefits 2019-08-01 10
Total of all active and inactive participants 2019-08-01 11,672
2018: HY-VEE ELECTIVE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-08-01 13,200
Total number of active participants reported on line 7a of the Form 5500 2018-08-01 13,640
Number of retired or separated participants receiving benefits 2018-08-01 9
Number of other retired or separated participants entitled to future benefits 2018-08-01 0
Total of all active and inactive participants 2018-08-01 13,649
2017: HY-VEE ELECTIVE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-08-01 12,967
Total number of active participants reported on line 7a of the Form 5500 2017-08-01 13,200
Number of retired or separated participants receiving benefits 2017-08-01 15
Number of other retired or separated participants entitled to future benefits 2017-08-01 0
Total of all active and inactive participants 2017-08-01 13,215
2016: HY-VEE ELECTIVE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-08-01 14,540
Total number of active participants reported on line 7a of the Form 5500 2016-08-01 12,967
Number of retired or separated participants receiving benefits 2016-08-01 4
Number of other retired or separated participants entitled to future benefits 2016-08-01 0
Total of all active and inactive participants 2016-08-01 12,971
2015: HY-VEE ELECTIVE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-08-01 14,540
Total number of active participants reported on line 7a of the Form 5500 2015-08-01 14,539
Number of retired or separated participants receiving benefits 2015-08-01 1
Number of other retired or separated participants entitled to future benefits 2015-08-01 0
Total of all active and inactive participants 2015-08-01 14,540
2014: HY-VEE ELECTIVE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 11,685
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 13,360
Number of retired or separated participants receiving benefits 2014-08-01 25
Number of other retired or separated participants entitled to future benefits 2014-08-01 0
Total of all active and inactive participants 2014-08-01 13,385
2013: HY-VEE ELECTIVE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-08-01 10,788
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 11,632
Number of retired or separated participants receiving benefits 2013-08-01 53
Number of other retired or separated participants entitled to future benefits 2013-08-01 0
Total of all active and inactive participants 2013-08-01 11,685
2012: HY-VEE ELECTIVE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 9,708
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 10,765
Number of retired or separated participants receiving benefits 2012-08-01 23
Number of other retired or separated participants entitled to future benefits 2012-08-01 0
Total of all active and inactive participants 2012-08-01 10,788
2011: HY-VEE ELECTIVE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-08-01 8,997
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 9,681
Number of retired or separated participants receiving benefits 2011-08-01 27
Number of other retired or separated participants entitled to future benefits 2011-08-01 0
Total of all active and inactive participants 2011-08-01 9,708
2009: HY-VEE ELECTIVE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-08-01 8,878
Total number of active participants reported on line 7a of the Form 5500 2009-08-01 9,199
Number of retired or separated participants receiving benefits 2009-08-01 23
Number of other retired or separated participants entitled to future benefits 2009-08-01 0
Total of all active and inactive participants 2009-08-01 9,222

Measure	Date	Value
2022: HY-VEE ELECTIVE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-08-01	14,064
Total number of active participants reported on line 7a of the Form 5500	2022-08-01	13,614
Number of retired or separated participants receiving benefits	2022-08-01	192
Number of other retired or separated participants entitled to future benefits	2022-08-01	0
Total of all active and inactive participants	2022-08-01	13,806
2021: HY-VEE ELECTIVE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-08-01	14,099
Total number of active participants reported on line 7a of the Form 5500	2021-08-01	14,064
Number of retired or separated participants receiving benefits	2021-08-01	201
Number of other retired or separated participants entitled to future benefits	2021-08-01	201
Total of all active and inactive participants	2021-08-01	14,466
2020: HY-VEE ELECTIVE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-08-01	11,662
Total number of active participants reported on line 7a of the Form 5500	2020-08-01	14,099
Number of retired or separated participants receiving benefits	2020-08-01	17
Number of other retired or separated participants entitled to future benefits	2020-08-01	17
Total of all active and inactive participants	2020-08-01	14,133
2019: HY-VEE ELECTIVE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-08-01	13,649
Total number of active participants reported on line 7a of the Form 5500	2019-08-01	11,652
Number of retired or separated participants receiving benefits	2019-08-01	10
Number of other retired or separated participants entitled to future benefits	2019-08-01	10
Total of all active and inactive participants	2019-08-01	11,672
2018: HY-VEE ELECTIVE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-08-01	13,200
Total number of active participants reported on line 7a of the Form 5500	2018-08-01	13,640
Number of retired or separated participants receiving benefits	2018-08-01	9
Number of other retired or separated participants entitled to future benefits	2018-08-01	0
Total of all active and inactive participants	2018-08-01	13,649
2017: HY-VEE ELECTIVE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-08-01	12,967
Total number of active participants reported on line 7a of the Form 5500	2017-08-01	13,200
Number of retired or separated participants receiving benefits	2017-08-01	15
Number of other retired or separated participants entitled to future benefits	2017-08-01	0
Total of all active and inactive participants	2017-08-01	13,215
2016: HY-VEE ELECTIVE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-08-01	14,540
Total number of active participants reported on line 7a of the Form 5500	2016-08-01	12,967
Number of retired or separated participants receiving benefits	2016-08-01	4
Number of other retired or separated participants entitled to future benefits	2016-08-01	0
Total of all active and inactive participants	2016-08-01	12,971
2015: HY-VEE ELECTIVE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-08-01	14,540
Total number of active participants reported on line 7a of the Form 5500	2015-08-01	14,539
Number of retired or separated participants receiving benefits	2015-08-01	1
Number of other retired or separated participants entitled to future benefits	2015-08-01	0
Total of all active and inactive participants	2015-08-01	14,540
2014: HY-VEE ELECTIVE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	11,685
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	13,360
Number of retired or separated participants receiving benefits	2014-08-01	25
Number of other retired or separated participants entitled to future benefits	2014-08-01	0
Total of all active and inactive participants	2014-08-01	13,385
2013: HY-VEE ELECTIVE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-08-01	10,788
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	11,632
Number of retired or separated participants receiving benefits	2013-08-01	53
Number of other retired or separated participants entitled to future benefits	2013-08-01	0
Total of all active and inactive participants	2013-08-01	11,685
2012: HY-VEE ELECTIVE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	9,708
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	10,765
Number of retired or separated participants receiving benefits	2012-08-01	23
Number of other retired or separated participants entitled to future benefits	2012-08-01	0
Total of all active and inactive participants	2012-08-01	10,788
2011: HY-VEE ELECTIVE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-08-01	8,997
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	9,681
Number of retired or separated participants receiving benefits	2011-08-01	27
Number of other retired or separated participants entitled to future benefits	2011-08-01	0
Total of all active and inactive participants	2011-08-01	9,708
2009: HY-VEE ELECTIVE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-08-01	8,878
Total number of active participants reported on line 7a of the Form 5500	2009-08-01	9,199
Number of retired or separated participants receiving benefits	2009-08-01	23
Number of other retired or separated participants entitled to future benefits	2009-08-01	0
Total of all active and inactive participants	2009-08-01	9,222

Form 5500 Responses for HY-VEE ELECTIVE BENEFITS PLAN

2022: HY-VEE ELECTIVE BENEFITS PLAN 2022 form 5500 responses
2022-08-01	Type of plan entity	Single employer plan
2022-08-01	Submission has been amended	No
2022-08-01	This submission is the final filing	No
2022-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-08-01	Plan is a collectively bargained plan	No
2022-08-01	Plan funding arrangement – Insurance	Yes
2022-08-01	Plan benefit arrangement – Insurance	Yes
2021: HY-VEE ELECTIVE BENEFITS PLAN 2021 form 5500 responses
2021-08-01	Type of plan entity	Single employer plan
2021-08-01	Submission has been amended	No
2021-08-01	This submission is the final filing	No
2021-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-08-01	Plan is a collectively bargained plan	No
2021-08-01	Plan funding arrangement – Insurance	Yes
2021-08-01	Plan benefit arrangement – Insurance	Yes
2020: HY-VEE ELECTIVE BENEFITS PLAN 2020 form 5500 responses
2020-08-01	Type of plan entity	Single employer plan
2020-08-01	Submission has been amended	No
2020-08-01	This submission is the final filing	No
2020-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-08-01	Plan is a collectively bargained plan	No
2020-08-01	Plan funding arrangement – Insurance	Yes
2020-08-01	Plan benefit arrangement – Insurance	Yes
2019: HY-VEE ELECTIVE BENEFITS PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	Submission has been amended	Yes
2019-08-01	This submission is the final filing	No
2019-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-08-01	Plan is a collectively bargained plan	No
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes
2018: HY-VEE ELECTIVE BENEFITS PLAN 2018 form 5500 responses
2018-08-01	Type of plan entity	Single employer plan
2018-08-01	Submission has been amended	No
2018-08-01	This submission is the final filing	No
2018-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-08-01	Plan is a collectively bargained plan	No
2018-08-01	Plan funding arrangement – Insurance	Yes
2018-08-01	Plan benefit arrangement – Insurance	Yes
2017: HY-VEE ELECTIVE BENEFITS PLAN 2017 form 5500 responses
2017-08-01	Type of plan entity	Single employer plan
2017-08-01	Submission has been amended	No
2017-08-01	This submission is the final filing	No
2017-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-08-01	Plan is a collectively bargained plan	No
2017-08-01	Plan funding arrangement – Insurance	Yes
2017-08-01	Plan benefit arrangement – Insurance	Yes
2016: HY-VEE ELECTIVE BENEFITS PLAN 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	No
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes
2015: HY-VEE ELECTIVE BENEFITS PLAN 2015 form 5500 responses
2015-08-01	Type of plan entity	Single employer plan
2015-08-01	Submission has been amended	No
2015-08-01	This submission is the final filing	No
2015-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-08-01	Plan is a collectively bargained plan	No
2015-08-01	Plan funding arrangement – Insurance	Yes
2015-08-01	Plan benefit arrangement – Insurance	Yes
2014: HY-VEE ELECTIVE BENEFITS PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: HY-VEE ELECTIVE BENEFITS PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
2012: HY-VEE ELECTIVE BENEFITS PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2011: HY-VEE ELECTIVE BENEFITS PLAN 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
2009: HY-VEE ELECTIVE BENEFITS PLAN 2009 form 5500 responses
2009-08-01	Type of plan entity	Single employer plan
2009-08-01	Submission has been amended	Yes
2009-08-01	This submission is the final filing	No
2009-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-08-01	Plan is a collectively bargained plan	No
2009-08-01	Plan funding arrangement – Insurance	Yes
2009-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95164
Policy instance	1
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	14029
Policy instance	2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	98527
Policy instance	3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	90257
Policy instance	4
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	7
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	8
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	9
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	10
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	09-LF0746
Policy instance	18
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	17
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	16
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	15
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	14
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41108
Policy instance	13
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41107
Policy instance	12
GLOBE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 91472 )
Policy contract number	5B00001
Policy instance	11
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	9
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	8
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	7
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	90257
Policy instance	4
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	98527
Policy instance	3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95164
Policy instance	1
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	14029
Policy instance	2
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	10
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41107
Policy instance	12
GLOBE LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 91472 )
Policy contract number	5B00001
Policy instance	11
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	09-LF0746
Policy instance	19
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	18
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	17
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	16
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	15
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	398485G
Policy instance	14
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41108
Policy instance	13
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	8
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	7
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	4
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95304
Policy instance	2
BEAZLEY INSURANCE COMPANY INC (National Association of Insurance Commissioners NAIC id number: 37540 )
Policy contract number	GLI5B, STD5B
Policy instance	9
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41107
Policy instance	10
DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 )
Policy contract number	41108
Policy instance	11
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	398485G
Policy instance	12
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	13
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	14
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	15
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	16
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	90257
Policy instance	1
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-001
Policy instance	8
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	4
Policy instance	4
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	20
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-003
Policy instance	9
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	7
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	6
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	98527
Policy instance	5
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	95168
Policy instance	4
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	20301
Policy instance	3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	14029
Policy instance	2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	G90257
Policy instance	1
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-004
Policy instance	10
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-006
Policy instance	11
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	19
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	18
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	17
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	398485G
Policy instance	16
BEAZLEY INSURANCE COMPANY INC (National Association of Insurance Commissioners NAIC id number: 37540 )
Policy contract number	GLI5B, STD5B
Policy instance	15
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-010
Policy instance	14
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8058048-005
Policy instance	13
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-008
Policy instance	12
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-007
Policy instance	8
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-006
Policy instance	7
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-004
Policy instance	6
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-001
Policy instance	4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	2
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	G90257
Policy instance	1
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4065
Policy instance	11
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-008
Policy instance	9
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4791
Policy instance	10
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	18
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	17
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	16
RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 )
Policy contract number	KB20691
Policy instance	15
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	398485G
Policy instance	14
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	VARIOUS
Policy instance	13
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD3995
Policy instance	12
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-003
Policy instance	5
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350783
Policy instance	2
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-006
Policy instance	7
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-004
Policy instance	6
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-003
Policy instance	5
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-001
Policy instance	4
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number	010-350930
Policy instance	3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	G90257
Policy instance	1
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-007
Policy instance	8
AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )
Policy contract number	8158048-008
Policy instance	9
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4791
Policy instance	10
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4913
Policy instance	11
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4065
Policy instance	12
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD3995
Policy instance	14
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number	VARIOUS
Policy instance	15
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	398485G
Policy instance	16
CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 )
Policy contract number	CD4521
Policy instance	13

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Company Name:	HY-VEE, INC.
Employer identification number (EIN):	420325638
NAIC Classification:	445110
NAIC Description:	Supermarkets and Other Grocery (except Convenience) Stores

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1938-01-03
Company Identification Number:	019862
Legal Registered Office Address:	400 E COURT AVE DES MOINES United States of America (USA) 50309