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| Plan Name | OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | OZARK GUIDANCE CENTER, INC. |
| Employer identification number (EIN): | 710416869 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-01-01 | WILLIAM M. SCHEERER | 2021-01-28 | WILLIAM M. SCHEERER | 2021-01-28 |
| 501 | 2019-01-01 | ROB BUSTEED | 2020-07-15 | ROB BUSTEED | 2020-07-15 |
| 501 | 2018-01-01 | CHRIS BOCKELMAN | 2019-10-11 | CHRIS BOCKELMAN | 2019-10-11 |
| 501 | 2017-01-01 | CHRIS BOCKELMAN | |||
| 501 | 2016-01-01 | BOB DONAGHE | |||
| 501 | 2015-01-01 | BOB DONAGHE | |||
| 501 | 2014-01-01 | BOB DONAGHE | |||
| 501 | 2013-01-01 | BOB DONAGHE | |||
| 501 | 2012-01-01 | BOB DONAGHE | BOB DONAGHE | 2013-10-11 | |
| 501 | 2011-01-01 | BOB DONAGHE | BOB DONAGHE | 2012-07-26 | |
| 501 | 2010-01-01 | BOB DONAGHE | BOB DONAGHE | 2011-07-29 | |
| 501 | 2009-01-01 | BOB DONAGHE | |||
| 501 | 2009-01-01 | BOB DONAGHE | BOB DONAGHE | 2010-09-17 |
| Measure | Date | Value |
|---|---|---|
| 2020: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 334 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| 2019: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 309 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 334 |
| Total of all active and inactive participants | 2019-01-01 | 334 |
| 2018: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 309 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 309 |
| 2017: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 409 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 426 |
| Total of all active and inactive participants | 2017-01-01 | 426 |
| Total participants | 2017-01-01 | 426 |
| 2016: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 407 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 409 |
| Total of all active and inactive participants | 2016-01-01 | 409 |
| Total participants | 2016-01-01 | 409 |
| 2015: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 393 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 407 |
| 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 | 407 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 407 |
| 2014: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 417 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 393 |
| Total of all active and inactive participants | 2014-01-01 | 393 |
| Total participants | 2014-01-01 | 393 |
| 2013: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 526 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 417 |
| Total of all active and inactive participants | 2013-01-01 | 417 |
| Total participants | 2013-01-01 | 417 |
| 2012: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 82 |
| 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 | 82 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 82 |
| Number of participants with account balances | 2012-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
| 2011: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 98 |
| Total of all active and inactive participants | 2011-01-01 | 98 |
| Total participants | 2011-01-01 | 98 |
| 2010: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 84 |
| Total of all active and inactive participants | 2010-01-01 | 84 |
| Total participants | 2010-01-01 | 84 |
| 2009: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 385 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 556 |
| Total of all active and inactive participants | 2009-01-01 | 556 |
| Total participants | 2009-01-01 | 556 |
| 2020: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS 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: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS 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: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS 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: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS 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: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS PLAN 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: OZARK GUIDANCE CENTERS INC FLEXIBLE BENEFITS 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 funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 028785 |
| Policy instance | 4 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 3 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000BGDL |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 4 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 3 |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 028785 |
| Policy instance | 5 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000BGDL |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170024 |
| Policy instance | 1 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 3 |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 028785 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170023 |
| Policy instance | 7 |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 028785 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100016321 |
| Policy instance | 4 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170023 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170024 |
| Policy instance | 7 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 8 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100016321 |
| Policy instance | 8 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 7 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 6 |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 028785 |
| Policy instance | 5 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170024 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170023 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170024 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100016321 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 3 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 6 |
| QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 ) | |
| Policy contract number | 53335 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170023 |
| Policy instance | 7 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 8 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05756183 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100016321 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170023 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 6 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010170024 |
| Policy instance | 8 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 000000154 |
| Policy instance | 9 |
| QCA HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95448 ) | |
| Policy contract number | 53335 |
| Policy instance | 7 |
| RELIANCE STANDARD (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPS 325465 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 000010153202 |
| Policy instance | 7 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 0154-0000 |
| Policy instance | 5 |
| DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 47155 ) | |
| Policy contract number | 00000154V |
| Policy instance | 4 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E3471554 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05756183 |
| Policy instance | 2 |
| ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) | |
| Policy contract number | 024787 |
| Policy instance | 6 |