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PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan NamePLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN
Plan identification number 507

PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC.
Employer identification number (EIN):470800148
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072023-01-01TRAVIS SELL2024-07-23
5072022-01-01TRAVIS SELL2023-07-26 SANDY MASSEY2023-07-24
5072021-01-01SANDY MASSEY2022-08-02
5072020-01-01TRAVIS SELL2021-07-30 SANDY MASSEY2021-07-30
5072019-01-01SANDY MASSEY2020-06-23
5072018-01-01
5072017-01-01
5072016-01-01
5072015-01-01
5072014-01-01
5072013-01-01
5072012-01-01SANDY MASSEY
5072011-01-01SANDY MASSEY
5072010-01-01SANDY MASSEY
5072009-01-01SANDY MASSEY

Plan Statistics for PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN

Measure Date Value
2023: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01366
Total number of active participants reported on line 7a of the Form 55002023-01-01376
Total of all active and inactive participants2023-01-01376
Total participants2023-01-01376
2022: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01350
Total number of active participants reported on line 7a of the Form 55002022-01-01359
Total of all active and inactive participants2022-01-01359
Total participants2022-01-01359
2021: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01317
Total number of active participants reported on line 7a of the Form 55002021-01-01338
Total of all active and inactive participants2021-01-01338
Total participants2021-01-01338
2020: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01321
Total number of active participants reported on line 7a of the Form 55002020-01-01301
Total of all active and inactive participants2020-01-01301
Total participants2020-01-01301
2019: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01307
Total number of active participants reported on line 7a of the Form 55002019-01-01306
Total of all active and inactive participants2019-01-01306
Total participants2019-01-01306
2018: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01296
Total number of active participants reported on line 7a of the Form 55002018-01-01285
Total of all active and inactive participants2018-01-01285
Total participants2018-01-01285
2017: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01278
Total number of active participants reported on line 7a of the Form 55002017-01-01287
Total of all active and inactive participants2017-01-01287
Total participants2017-01-01287
2016: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01252
Total number of active participants reported on line 7a of the Form 55002016-01-01261
Total of all active and inactive participants2016-01-01261
Total participants2016-01-01261
2015: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01250
Total number of active participants reported on line 7a of the Form 55002015-01-01254
Total of all active and inactive participants2015-01-01254
Total participants2015-01-01254
2014: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01217
Total number of active participants reported on line 7a of the Form 55002014-01-01271
Total of all active and inactive participants2014-01-01271
Total participants2014-01-01271
2013: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01194
Total number of active participants reported on line 7a of the Form 55002013-01-01204
Total of all active and inactive participants2013-01-01204
Total participants2013-01-01204
2012: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01198
Total number of active participants reported on line 7a of the Form 55002012-01-01200
Total of all active and inactive participants2012-01-01200
Total participants2012-01-01200
2011: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01195
Total number of active participants reported on line 7a of the Form 55002011-01-01193
Total of all active and inactive participants2011-01-01193
Total participants2011-01-01193
2010: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01195
Total number of active participants reported on line 7a of the Form 55002010-01-01194
Total of all active and inactive participants2010-01-01194
Total participants2010-01-01194
2009: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01192
Total number of active participants reported on line 7a of the Form 55002009-01-01198
Total of all active and inactive participants2009-01-01198
Total participants2009-01-01198

Form 5500 Responses for PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN

2023: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: PLATTE VALLEY FINANCIAL SERVICE COMPANIES, INC. WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

WASHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70319 )
Policy contract numberWG00003465
Policy instance 6
Insurance contract or identification numberWG00003465
Number of Individuals Covered7
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,419
Other welfare benefits providedSUPPLEMENTAL
Welfare Benefit Premiums Paid to CarrierUSD $6,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberCD5642
Policy instance 5
Insurance contract or identification numberCD5642
Number of Individuals Covered3
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00026532
Policy instance 4
Insurance contract or identification number00026532
Number of Individuals Covered377
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $15,168
Total amount of fees paid to insurance companyUSD $1,906
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $415,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 3
Insurance contract or identification number0007655724
Number of Individuals Covered48
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $1,403
Total amount of fees paid to insurance companyUSD $2,104
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $73,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 2
Insurance contract or identification number01326
Number of Individuals Covered12
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,537
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $13,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 1
Insurance contract or identification number63631
Number of Individuals Covered57
Insurance policy start date2022-06-01
Insurance policy end date2023-05-31
Total amount of commissions paid to insurance brokerUSD $7,376
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $70,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 1
Insurance contract or identification number63631
Number of Individuals Covered56
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $7,557
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 2
Insurance contract or identification number01326
Number of Individuals Covered20
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,244
Other welfare benefits providedLONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $10,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 3
Insurance contract or identification number0007655724
Number of Individuals Covered54
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $1,435
Total amount of fees paid to insurance companyUSD $2,152
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00026532
Policy instance 4
Insurance contract or identification number00026532
Number of Individuals Covered364
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,208
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $365,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMC NATIONAL LIFE COMPANY (National Association of Insurance Commissioners NAIC id number: 62928 )
Policy contract numberCD5642
Policy instance 5
Insurance contract or identification numberCD5642
Number of Individuals Covered3
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Other welfare benefits providedSUPPLEMENTAL
Welfare Benefit Premiums Paid to CarrierUSD $782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WASHINGTON NATIONAL (National Association of Insurance Commissioners NAIC id number: 70319 )
Policy contract numberWG00003465
Policy instance 6
Insurance contract or identification numberWG00003465
Number of Individuals Covered9
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,564
Other welfare benefits providedSUPPLEMENTAL
Welfare Benefit Premiums Paid to CarrierUSD $6,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 2
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 4
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 5
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 2
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberU7360
Policy instance 1
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 5
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 2
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberU7360
Policy instance 1
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 1
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberU7360
Policy instance 2
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 4
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 5
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 6
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number517916
Policy instance 2
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberU7360
Policy instance 3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number9041403720
Policy instance 4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number63631
Policy instance 5
LIFESECURE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77720 )
Policy contract number01326
Policy instance 6
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number624520
Policy instance 7
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007655724
Policy instance 8
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number624520
Policy instance 1

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