OUACHITA COUNTY MEDICAL CENTER VISION CARE PLAN has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY
401k plan membership statisitcs for EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY
| Measure | Date | Value |
|---|
| 2023: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-02-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-02-01 | 168 |
| Total of all active and inactive participants | 2023-02-01 | 168 |
| 2022: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 194 |
| Total of all active and inactive participants | 2022-02-01 | 194 |
| 2021: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 170 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 163 |
| Total of all active and inactive participants | 2021-02-01 | 163 |
| 2020: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 170 |
| Total of all active and inactive participants | 2020-02-01 | 170 |
| 2019: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 154 |
| Total of all active and inactive participants | 2019-02-01 | 154 |
| 2018: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 181 |
| Total of all active and inactive participants | 2018-02-01 | 181 |
| 2017: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 284 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 194 |
| Total of all active and inactive participants | 2017-02-01 | 194 |
| Total participants | 2017-02-01 | 194 |
| 2016: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 276 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 284 |
| Total of all active and inactive participants | 2016-02-01 | 284 |
| Total participants | 2016-02-01 | 284 |
| 2015: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 692 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 276 |
| Total of all active and inactive participants | 2015-02-01 | 276 |
| Total participants | 2015-02-01 | 276 |
| 2014: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 692 |
| Total of all active and inactive participants | 2014-02-01 | 692 |
| Total participants | 2014-02-01 | 692 |
| 2013: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-02-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 277 |
| Total of all active and inactive participants | 2013-02-01 | 277 |
| Total participants | 2013-02-01 | 277 |
| 2012: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 257 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 274 |
| Total of all active and inactive participants | 2012-02-01 | 274 |
| Total participants | 2012-02-01 | 274 |
| 2011: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 262 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 257 |
| Total of all active and inactive participants | 2011-02-01 | 257 |
| Total participants | 2011-02-01 | 257 |
| 2009: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-02-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 255 |
| Total of all active and inactive participants | 2009-02-01 | 255 |
| Total participants | 2009-02-01 | 255 |
| 2023: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2023 form 5500 responses |
|---|
| 2023-02-01 | Type of plan entity | Single employer plan |
| 2023-02-01 | Plan funding arrangement – Insurance | Yes |
| 2023-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2022 form 5500 responses |
|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | Submission has been amended | No |
| 2015-02-01 | This submission is the final filing | No |
| 2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-02-01 | Plan is a collectively bargained plan | No |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2014 form 5500 responses |
|---|
| 2014-02-01 | Type of plan entity | Single employer plan |
| 2014-02-01 | Plan funding arrangement – Insurance | Yes |
| 2014-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2013 form 5500 responses |
|---|
| 2013-02-01 | Type of plan entity | Single employer plan |
| 2013-02-01 | Plan funding arrangement – Insurance | Yes |
| 2013-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2012 form 5500 responses |
|---|
| 2012-02-01 | Type of plan entity | Single employer plan |
| 2012-02-01 | Submission has been amended | Yes |
| 2012-02-01 | Plan funding arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2011 form 5500 responses |
|---|
| 2011-02-01 | Type of plan entity | Single employer plan |
| 2011-02-01 | Plan funding arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: EMPLOYEES' GROUP LIFE INS. & LONG TERM DISABILITY 2009 form 5500 responses |
|---|
| 2009-02-01 | Type of plan entity | Single employer plan |
| 2009-02-01 | Plan funding arrangement – Insurance | Yes |
| 2009-02-01 | Plan benefit arrangement – Insurance | Yes |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| Insurance contract or identification number | 0356000000 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $41,321 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $158,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50025207 |
| Policy instance | 2 |
| Insurance contract or identification number | 50025207 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $4,153 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | VOLUNTARY GROUP TERM LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $19,775 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50025207 |
| Policy instance | 1 |
| Insurance contract or identification number | 50025207 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2022-10-01 | | Insurance policy end date | 2023-09-30 | | Total amount of commissions paid to insurance broker | USD $5,376 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,920 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 2 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 2 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | A2956 |
| Policy instance | 1 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 3 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 0356000000 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 2 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010196184 |
| Policy instance | 7 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000405004057 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | A2956 |
| Policy instance | 2 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 035600000 |
| Policy instance | 3 |
| TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 ) |
| Policy contract number | 035600000 |
| Policy instance | 4 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010196185 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010198222 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 9 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 8 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 1 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 2 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 4 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 5 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 5 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 4 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 8 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 9 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 2 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 2 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 4 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 5 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 8 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 9 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 4 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 6 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 8 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 2 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 9 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 2 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 4 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 8 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 50003921 |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 0004363IN |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 5 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 7 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363 |
| Policy instance | 1 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 2 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363IND |
| Policy instance | 3 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363 |
| Policy instance | 4 |
| PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88536 ) |
| Policy contract number | 221738 |
| Policy instance | 9 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 113282 |
| Policy instance | 5 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363 |
| Policy instance | 6 |
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
| Policy contract number | 4363 |
| Policy instance | 8 |
