401k Plan data: ENVISION EMPLOYEE BENEFIT PLAN plan

ENVISION EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	ENVISION EMPLOYEE BENEFIT PLAN
Plan identification number	501

ENVISION EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

ENVISION, INC. has sponsored the creation of one or more 401k plans.

Company Name: ENVISION, INC.

Employer identification number (EIN): 480543705

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ENVISION EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01 NIKKI FREEMAN NIKKI FREEMAN 2019-06-13
501 2017-01-01 NIKKI FREEMAN NIKKI FREEMAN 2018-07-02
501 2016-01-01 NIKKI FREEMAN NIKKI FREEMAN 2017-06-16
501 2015-01-01 NIKKI FREEMAN NIKKI FREEMAN 2016-06-08
501 2014-01-01 KATHY COX KATHY COX 2015-06-17
501 2013-01-01 KATHY COX
501 2012-01-01 KATHY COX KATHY COX 2013-05-22
501 2011-01-01 KATHY COX KATHY COX 2012-05-21
501 2009-01-01 KATHY COX KATHY COX 2011-06-21
501 2008-01-01 KATHY COX KATHY COX 2011-06-21
501 2006-07-01 KATHY COX KATHY COX 2011-06-21
501 2005-07-01 KATHY COX KATHY COX 2011-06-21

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2018-01-01	NIKKI FREEMAN	NIKKI FREEMAN	2019-06-13
501	2017-01-01	NIKKI FREEMAN	NIKKI FREEMAN	2018-07-02
501	2016-01-01	NIKKI FREEMAN	NIKKI FREEMAN	2017-06-16
501	2015-01-01	NIKKI FREEMAN	NIKKI FREEMAN	2016-06-08
501	2014-01-01	KATHY COX	KATHY COX	2015-06-17
501	2013-01-01	KATHY COX
501	2012-01-01	KATHY COX	KATHY COX	2013-05-22
501	2011-01-01	KATHY COX	KATHY COX	2012-05-21
501	2009-01-01	KATHY COX	KATHY COX	2011-06-21
501	2008-01-01	KATHY COX	KATHY COX	2011-06-21
501	2006-07-01	KATHY COX	KATHY COX	2011-06-21
501	2005-07-01	KATHY COX	KATHY COX	2011-06-21

Plan Statistics for ENVISION EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for ENVISION EMPLOYEE BENEFIT PLAN

Measure Date Value
2018: ENVISION EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 355
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 513
Number of retired or separated participants receiving benefits 2018-01-01 6
Number of other retired or separated participants entitled to future benefits 2018-01-01 2
Total of all active and inactive participants 2018-01-01 521
2017: ENVISION EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 324
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 304
Number of retired or separated participants receiving benefits 2017-01-01 4
Total of all active and inactive participants 2017-01-01 308
2016: ENVISION EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 315
Number of retired or separated participants receiving benefits 2016-01-01 3
Number of other retired or separated participants entitled to future benefits 2016-01-01 3
Total of all active and inactive participants 2016-01-01 321
2015: ENVISION EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 406
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 406
2014: ENVISION EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 328
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 351
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 351
2013: ENVISION EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 366
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 328
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 328
2012: ENVISION EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 353
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 366
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 366
2011: ENVISION EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 353
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 353
2009: ENVISION EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 331
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 356
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 356
Total participants 2009-01-01 0
2008: ENVISION EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 287
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 331
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 331
2006: ENVISION EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year 2006-07-01 271
Total number of active participants reported on line 7a of the Form 5500 2006-07-01 286
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 2006-07-01 286
2005: ENVISION EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year 2005-07-01 271
Total number of active participants reported on line 7a of the Form 5500 2005-07-01 271
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 2005-07-01 271

Measure	Date	Value
2018: ENVISION EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	355
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	513
Number of retired or separated participants receiving benefits	2018-01-01	6
Number of other retired or separated participants entitled to future benefits	2018-01-01	2
Total of all active and inactive participants	2018-01-01	521
2017: ENVISION EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	324
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	304
Number of retired or separated participants receiving benefits	2017-01-01	4
Total of all active and inactive participants	2017-01-01	308
2016: ENVISION EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	315
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	3
Total of all active and inactive participants	2016-01-01	321
2015: ENVISION EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	406
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	406
2014: ENVISION EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	328
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	351
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	351
2013: ENVISION EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	366
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	328
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	328
2012: ENVISION EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	353
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	366
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	366
2011: ENVISION EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	353
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	353
2009: ENVISION EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	331
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	356
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	356
Total participants	2009-01-01	0
2008: ENVISION EMPLOYEE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	287
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	331
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	331
2006: ENVISION EMPLOYEE BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year	2006-07-01	271
Total number of active participants reported on line 7a of the Form 5500	2006-07-01	286
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	286
2005: ENVISION EMPLOYEE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year	2005-07-01	271
Total number of active participants reported on line 7a of the Form 5500	2005-07-01	271
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	271

Form 5500 Responses for ENVISION EMPLOYEE BENEFIT PLAN

2018: ENVISION EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: ENVISION EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: ENVISION EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: ENVISION EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: ENVISION EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: ENVISION EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: ENVISION EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: ENVISION EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: ENVISION EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2008: ENVISION EMPLOYEE BENEFIT PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2006: ENVISION EMPLOYEE BENEFIT PLAN 2006 form 5500 responses
2006-07-01	Type of plan entity	Single employer plan
2006-07-01	Submission has been amended	No
2006-07-01	This submission is the final filing	No
2006-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2006-07-01	Plan is a collectively bargained plan	No
2006-07-01	Plan funding arrangement – Insurance	Yes
2006-07-01	Plan benefit arrangement – Insurance	Yes
2005: ENVISION EMPLOYEE BENEFIT PLAN 2005 form 5500 responses
2005-07-01	Type of plan entity	Single employer plan
2005-07-01	First time form 5500 has been submitted	Yes
2005-07-01	Submission has been amended	No
2005-07-01	This submission is the final filing	No
2005-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-07-01	Plan is a collectively bargained plan	No
2005-07-01	Plan funding arrangement – Insurance	Yes
2005-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	7
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	631162
Policy instance	1
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )
Policy contract number	22996-000-00001
Policy instance	2
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	3
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )
Policy contract number	22996-000-00006
Policy instance	4
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	5
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00006
Policy instance	6
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	5
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )
Policy contract number	22996-000-00006
Policy instance	4
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	3
SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )
Policy contract number	22996-000-00001
Policy instance	2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	631162
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00006
Policy instance	6
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	7
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	4
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number	30052530
Policy instance	2
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number	631162
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	5
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	5
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	4
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00006
Policy instance	3
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010145932
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010145932
Policy instance	2
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00006
Policy instance	5
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	3
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010145932
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	4
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	3
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	000010145932
Policy instance	3
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	4
COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
Policy contract number	500080
Policy instance	5
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	09288
Policy instance	6
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number	990048
Policy instance	7
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	144279
Policy instance	8
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	9
COVENTRY HEALTH CARE OF KANSAS, INC. (National Association of Insurance Commissioners NAIC id number: 95489 )
Policy contract number	500797
Policy instance	2
CONVENTRY HEALTH AND LIFE (National Association of Insurance Commissioners NAIC id number: 95060 )
Policy contract number	724005
Policy instance	1
EMPAC INC (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number
Policy instance	1
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number	500080
Policy instance	2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	144279
Policy instance	3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00005
Policy instance	4
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	5
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00002
Policy instance	3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	4
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number	144279
Policy instance	2
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number	500080
Policy instance	1
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number	500080
Policy instance	4
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	N93447
Policy instance	2
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00002
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	3
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	N93447
Policy instance	2
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00002
Policy instance	3
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number	500080
Policy instance	4
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	N93447
Policy instance	1
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00002
Policy instance	4
DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )
Policy contract number	22996-000-00001
Policy instance	3
PREFERRED PLUS OF KANSAS (National Association of Insurance Commissioners NAIC id number: 95390 )
Policy contract number	500080
Policy instance	2

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Company Name:	ENVISION, INC.
Employer identification number (EIN):	480543705
NAIC Classification:	339900