401k Plan data: BASKERVILL & SON SECTION 125 CAFETERIA PLAN plan

BASKERVILL & SON SECTION 125 CAFETERIA PLAN 401k Plan overview

Plan Name	BASKERVILL & SON SECTION 125 CAFETERIA PLAN
Plan identification number	501

BASKERVILL & SON SECTION 125 CAFETERIA PLAN Benefits

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

401k Sponsoring company profile

BASKERVILL & SON, P.C. has sponsored the creation of one or more 401k plans.

Company Name: BASKERVILL & SON, P.C.

Employer identification number (EIN): 541258151

NAIC Classification: 541310
NAIC Description: Architectural Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BASKERVILL & SON SECTION 125 CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-09-01 APRIL MARTINEZ 2024-02-01
501 2021-09-01 PAM D'ARCY 2023-01-23
501 2020-09-01
501 2019-09-01
501 2017-09-01 PAMELA DARCY PAMELA DARCY 2019-02-18
501 2016-09-01 PAMELA DARCY
501 2015-09-01 PAMELA DARCY
501 2014-09-01 PAMELA DARCY
501 2013-09-01 PAMELA DARCY
501 2012-09-01 PAMELA DARCY
501 2011-09-01 PAMELA DARCY
501 2009-09-01 PAMELA DARCY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-09-01	APRIL MARTINEZ	2024-02-01
501	2021-09-01	PAM D'ARCY	2023-01-23
501	2020-09-01
501	2019-09-01
501	2017-09-01	PAMELA DARCY		PAMELA DARCY	2019-02-18
501	2016-09-01	PAMELA DARCY
501	2015-09-01	PAMELA DARCY
501	2014-09-01	PAMELA DARCY
501	2013-09-01	PAMELA DARCY
501	2012-09-01	PAMELA DARCY
501	2011-09-01	PAMELA DARCY
501	2009-09-01	PAMELA DARCY

Plan Statistics for BASKERVILL & SON SECTION 125 CAFETERIA PLAN

401k plan membership statisitcs for BASKERVILL & SON SECTION 125 CAFETERIA PLAN

Measure Date Value
2022: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year 2022-09-01 153
Total number of active participants reported on line 7a of the Form 5500 2022-09-01 174
Number of retired or separated participants receiving benefits 2022-09-01 0
Number of other retired or separated participants entitled to future benefits 2022-09-01 0
Total of all active and inactive participants 2022-09-01 174
Total participants 2022-09-01 174
2021: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-09-01 124
Total number of active participants reported on line 7a of the Form 5500 2021-09-01 153
Number of retired or separated participants receiving benefits 2021-09-01 0
Number of other retired or separated participants entitled to future benefits 2021-09-01 0
Total of all active and inactive participants 2021-09-01 153
Total participants 2021-09-01 153
2020: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year 2020-09-01 142
Total number of active participants reported on line 7a of the Form 5500 2020-09-01 124
Number of retired or separated participants receiving benefits 2020-09-01 0
Number of other retired or separated participants entitled to future benefits 2020-09-01 0
Total of all active and inactive participants 2020-09-01 124
Total participants 2020-09-01 124
2019: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year 2019-09-01 165
Total number of active participants reported on line 7a of the Form 5500 2019-09-01 142
Number of retired or separated participants receiving benefits 2019-09-01 0
Number of other retired or separated participants entitled to future benefits 2019-09-01 0
Total of all active and inactive participants 2019-09-01 142
Total participants 2019-09-01 142
2017: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year 2017-09-01 137
Total number of active participants reported on line 7a of the Form 5500 2017-09-01 148
Number of retired or separated participants receiving benefits 2017-09-01 0
Number of other retired or separated participants entitled to future benefits 2017-09-01 0
Total of all active and inactive participants 2017-09-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-09-01 0
Total participants 2017-09-01 148
2016: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year 2016-09-01 111
Total number of active participants reported on line 7a of the Form 5500 2016-09-01 137
Number of retired or separated participants receiving benefits 2016-09-01 0
Number of other retired or separated participants entitled to future benefits 2016-09-01 0
Total of all active and inactive participants 2016-09-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-09-01 0
Total participants 2016-09-01 137
2015: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-09-01 99
Total number of active participants reported on line 7a of the Form 5500 2015-09-01 111
Number of retired or separated participants receiving benefits 2015-09-01 0
Number of other retired or separated participants entitled to future benefits 2015-09-01 0
Total of all active and inactive participants 2015-09-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-09-01 0
Total participants 2015-09-01 111
2014: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year 2014-09-01 96
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 99
Number of retired or separated participants receiving benefits 2014-09-01 0
Number of other retired or separated participants entitled to future benefits 2014-09-01 0
Total of all active and inactive participants 2014-09-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-09-01 0
Total participants 2014-09-01 99
2013: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year 2013-09-01 91
Total number of active participants reported on line 7a of the Form 5500 2013-09-01 96
Number of retired or separated participants receiving benefits 2013-09-01 0
Number of other retired or separated participants entitled to future benefits 2013-09-01 0
Total of all active and inactive participants 2013-09-01 96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-09-01 0
Total participants 2013-09-01 96
2012: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year 2012-09-01 93
Total number of active participants reported on line 7a of the Form 5500 2012-09-01 91
Number of retired or separated participants receiving benefits 2012-09-01 0
Number of other retired or separated participants entitled to future benefits 2012-09-01 0
Total of all active and inactive participants 2012-09-01 91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-09-01 0
Total participants 2012-09-01 91
2011: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year 2011-09-01 95
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 93
Number of retired or separated participants receiving benefits 2011-09-01 0
Number of other retired or separated participants entitled to future benefits 2011-09-01 0
Total of all active and inactive participants 2011-09-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-09-01 0
Total participants 2011-09-01 93
2009: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year 2009-09-01 108
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 76
Number of retired or separated participants receiving benefits 2009-09-01 0
Number of other retired or separated participants entitled to future benefits 2009-09-01 0
Total of all active and inactive participants 2009-09-01 76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-09-01 0
Total participants 2009-09-01 76

Measure	Date	Value
2022: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2022 401k membership
Total participants, beginning-of-year	2022-09-01	153
Total number of active participants reported on line 7a of the Form 5500	2022-09-01	174
Number of retired or separated participants receiving benefits	2022-09-01	0
Number of other retired or separated participants entitled to future benefits	2022-09-01	0
Total of all active and inactive participants	2022-09-01	174
Total participants	2022-09-01	174
2021: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-09-01	124
Total number of active participants reported on line 7a of the Form 5500	2021-09-01	153
Number of retired or separated participants receiving benefits	2021-09-01	0
Number of other retired or separated participants entitled to future benefits	2021-09-01	0
Total of all active and inactive participants	2021-09-01	153
Total participants	2021-09-01	153
2020: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-09-01	142
Total number of active participants reported on line 7a of the Form 5500	2020-09-01	124
Number of retired or separated participants receiving benefits	2020-09-01	0
Number of other retired or separated participants entitled to future benefits	2020-09-01	0
Total of all active and inactive participants	2020-09-01	124
Total participants	2020-09-01	124
2019: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-09-01	165
Total number of active participants reported on line 7a of the Form 5500	2019-09-01	142
Number of retired or separated participants receiving benefits	2019-09-01	0
Number of other retired or separated participants entitled to future benefits	2019-09-01	0
Total of all active and inactive participants	2019-09-01	142
Total participants	2019-09-01	142
2017: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-09-01	137
Total number of active participants reported on line 7a of the Form 5500	2017-09-01	148
Number of retired or separated participants receiving benefits	2017-09-01	0
Number of other retired or separated participants entitled to future benefits	2017-09-01	0
Total of all active and inactive participants	2017-09-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-09-01	0
Total participants	2017-09-01	148
2016: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-09-01	111
Total number of active participants reported on line 7a of the Form 5500	2016-09-01	137
Number of retired or separated participants receiving benefits	2016-09-01	0
Number of other retired or separated participants entitled to future benefits	2016-09-01	0
Total of all active and inactive participants	2016-09-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-09-01	0
Total participants	2016-09-01	137
2015: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-09-01	99
Total number of active participants reported on line 7a of the Form 5500	2015-09-01	111
Number of retired or separated participants receiving benefits	2015-09-01	0
Number of other retired or separated participants entitled to future benefits	2015-09-01	0
Total of all active and inactive participants	2015-09-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-09-01	0
Total participants	2015-09-01	111
2014: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-09-01	96
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	99
Number of retired or separated participants receiving benefits	2014-09-01	0
Number of other retired or separated participants entitled to future benefits	2014-09-01	0
Total of all active and inactive participants	2014-09-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-09-01	0
Total participants	2014-09-01	99
2013: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year	2013-09-01	91
Total number of active participants reported on line 7a of the Form 5500	2013-09-01	96
Number of retired or separated participants receiving benefits	2013-09-01	0
Number of other retired or separated participants entitled to future benefits	2013-09-01	0
Total of all active and inactive participants	2013-09-01	96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-09-01	0
Total participants	2013-09-01	96
2012: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year	2012-09-01	93
Total number of active participants reported on line 7a of the Form 5500	2012-09-01	91
Number of retired or separated participants receiving benefits	2012-09-01	0
Number of other retired or separated participants entitled to future benefits	2012-09-01	0
Total of all active and inactive participants	2012-09-01	91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-09-01	0
Total participants	2012-09-01	91
2011: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-09-01	95
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	93
Number of retired or separated participants receiving benefits	2011-09-01	0
Number of other retired or separated participants entitled to future benefits	2011-09-01	0
Total of all active and inactive participants	2011-09-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-09-01	0
Total participants	2011-09-01	93
2009: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year	2009-09-01	108
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	76
Number of retired or separated participants receiving benefits	2009-09-01	0
Number of other retired or separated participants entitled to future benefits	2009-09-01	0
Total of all active and inactive participants	2009-09-01	76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-09-01	0
Total participants	2009-09-01	76

Form 5500 Responses for BASKERVILL & SON SECTION 125 CAFETERIA PLAN

2022: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2022 form 5500 responses
2022-09-01	Type of plan entity	Single employer plan
2022-09-01	Submission has been amended	No
2022-09-01	This submission is the final filing	No
2022-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-09-01	Plan is a collectively bargained plan	No
2022-09-01	Plan funding arrangement – Insurance	Yes
2022-09-01	Plan benefit arrangement – Insurance	Yes
2021: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2021 form 5500 responses
2021-09-01	Type of plan entity	Single employer plan
2021-09-01	Submission has been amended	No
2021-09-01	This submission is the final filing	No
2021-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-09-01	Plan is a collectively bargained plan	No
2021-09-01	Plan funding arrangement – Insurance	Yes
2021-09-01	Plan benefit arrangement – Insurance	Yes
2020: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2020 form 5500 responses
2020-09-01	Type of plan entity	Single employer plan
2020-09-01	Submission has been amended	No
2020-09-01	This submission is the final filing	No
2020-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-09-01	Plan is a collectively bargained plan	No
2020-09-01	Plan funding arrangement – Insurance	Yes
2020-09-01	Plan benefit arrangement – Insurance	Yes
2019: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2019 form 5500 responses
2019-09-01	Type of plan entity	Single employer plan
2019-09-01	Submission has been amended	No
2019-09-01	This submission is the final filing	No
2019-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-09-01	Plan is a collectively bargained plan	No
2019-09-01	Plan funding arrangement – Insurance	Yes
2019-09-01	Plan benefit arrangement – Insurance	Yes
2017: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2017 form 5500 responses
2017-09-01	Type of plan entity	Single employer plan
2017-09-01	Submission has been amended	No
2017-09-01	This submission is the final filing	No
2017-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-09-01	Plan is a collectively bargained plan	No
2017-09-01	Plan funding arrangement – Insurance	Yes
2017-09-01	Plan benefit arrangement – Insurance	Yes
2016: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2016 form 5500 responses
2016-09-01	Type of plan entity	Single employer plan
2016-09-01	Submission has been amended	No
2016-09-01	This submission is the final filing	No
2016-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-09-01	Plan is a collectively bargained plan	No
2016-09-01	Plan funding arrangement – Insurance	Yes
2016-09-01	Plan benefit arrangement – Insurance	Yes
2015: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2015 form 5500 responses
2015-09-01	Type of plan entity	Single employer plan
2015-09-01	Submission has been amended	No
2015-09-01	This submission is the final filing	No
2015-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-09-01	Plan is a collectively bargained plan	No
2015-09-01	Plan funding arrangement – Insurance	Yes
2015-09-01	Plan benefit arrangement – Insurance	Yes
2014: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	Submission has been amended	No
2014-09-01	This submission is the final filing	No
2014-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-09-01	Plan is a collectively bargained plan	No
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes
2013: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2013 form 5500 responses
2013-09-01	Type of plan entity	Single employer plan
2013-09-01	Submission has been amended	No
2013-09-01	This submission is the final filing	No
2013-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-09-01	Plan is a collectively bargained plan	No
2013-09-01	Plan funding arrangement – Insurance	Yes
2013-09-01	Plan benefit arrangement – Insurance	Yes
2012: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2012 form 5500 responses
2012-09-01	Type of plan entity	Single employer plan
2012-09-01	Submission has been amended	No
2012-09-01	This submission is the final filing	No
2012-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-09-01	Plan is a collectively bargained plan	No
2012-09-01	Plan funding arrangement – Insurance	Yes
2012-09-01	Plan benefit arrangement – Insurance	Yes
2011: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Submission has been amended	No
2011-09-01	This submission is the final filing	No
2011-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-09-01	Plan is a collectively bargained plan	No
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2009: BASKERVILL & SON SECTION 125 CAFETERIA PLAN 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	Submission has been amended	No
2009-09-01	This submission is the final filing	No
2009-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-09-01	Plan is a collectively bargained plan	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	VA2035
Policy instance	4
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	VA2035
Policy instance	3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	VA2035
Policy instance	2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	885975G
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	885975G
Policy instance	3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	VA2035
Policy instance	4
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	VA2035
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	VA2035
Policy instance	1
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	VA2035
Policy instance	4
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	VA2035
Policy instance	1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	885975G
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	VA2035
Policy instance	3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	VA2035
Policy instance	1
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	VA2035
Policy instance	2
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	VA2035
Policy instance	3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	885975G
Policy instance	4
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number	ECU-0210-GL-3
Policy instance	3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05938524
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GUG0AJP4
Policy instance	2
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number	ECU-0210-GL
Policy instance	3
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number	734241
Policy instance	2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AJP4
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AJP4
Policy instance	2
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number	734241
Policy instance	1
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	67866
Policy instance	3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440413
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	GUG0AJP4
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	341419
Policy instance	3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	89547893
Policy instance	4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AJP4
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	341419
Policy instance	3
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	67866
Policy instance	4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440413
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	G000AJP4
Policy instance	4
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	67866
Policy instance	1
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	341419
Policy instance	2
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	21714
Policy instance	2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	440413
Policy instance	4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	10118542
Policy instance	3
ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 )
Policy contract number	67866
Policy instance	5
HEALTHKEEPERS, INC (National Association of Insurance Commissioners NAIC id number: 95169 )
Policy contract number	67866
Policy instance	1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00440413
Policy instance	3

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Company Name:	BASKERVILL & SON, P.C.
Employer identification number (EIN):	541258151
NAIC Classification:	541310
NAIC Description:	Architectural Services