401k Plan data: COBLE PENSION GROUP, LLC 401(K) PLAN plan

COBLE PENSION GROUP, LLC 401(K) PLAN 401k Plan overview

Plan Name	COBLE PENSION GROUP, LLC 401(K) PLAN
Plan identification number	001

COBLE PENSION GROUP, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

COBLE PENSION GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: COBLE PENSION GROUP, LLC

Employer identification number (EIN): 860805040

NAIC Classification: 561490

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COBLE PENSION GROUP, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 RANDY COBLE 2021-04-15 RANDY COBLE 2021-04-15
001 2020-01-01 RANDY COBLE 2021-04-15 RANDY COBLE 2021-04-15
001 2019-01-01 MURPHY COBLE 2020-10-14 MURPHY COBLE 2020-10-14
001 2018-01-01 MURPHY R COBLE JR. 2019-10-15 MURPHY R COBLE JR. 2019-10-15
001 2017-01-01 MURPHY COBLE 2018-10-15 MURPHY COBLE 2018-10-15
001 2016-01-01 M RANDY COBLE 2017-10-16 M RANDY COBLE 2017-10-16
001 2015-01-01 M RANDY COBLE JR M RANDY COBLE JR 2016-10-17
001 2014-01-01 RANDY COBLE RANDY COBLE 2015-10-13
001 2013-01-01 RANDY COBLE RANDY COBLE 2014-10-15
001 2012-01-01 RANDY COBLE RANDY COBLE 2013-10-14
001 2011-01-01 M. RANDY COBLE
001 2009-01-01 M. RANDY COBLE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	RANDY COBLE	2021-04-15	RANDY COBLE	2021-04-15
001	2020-01-01	RANDY COBLE	2021-04-15	RANDY COBLE	2021-04-15
001	2019-01-01	MURPHY COBLE	2020-10-14	MURPHY COBLE	2020-10-14
001	2018-01-01	MURPHY R COBLE JR.	2019-10-15	MURPHY R COBLE JR.	2019-10-15
001	2017-01-01	MURPHY COBLE	2018-10-15	MURPHY COBLE	2018-10-15
001	2016-01-01	M RANDY COBLE	2017-10-16	M RANDY COBLE	2017-10-16
001	2015-01-01	M RANDY COBLE JR		M RANDY COBLE JR	2016-10-17
001	2014-01-01	RANDY COBLE		RANDY COBLE	2015-10-13
001	2013-01-01	RANDY COBLE		RANDY COBLE	2014-10-15
001	2012-01-01	RANDY COBLE		RANDY COBLE	2013-10-14
001	2011-01-01	M. RANDY COBLE
001	2009-01-01	M. RANDY COBLE

Plan Statistics for COBLE PENSION GROUP, LLC 401(K) PLAN

401k plan membership statisitcs for COBLE PENSION GROUP, LLC 401(K) PLAN

Measure Date Value
2015: COBLE PENSION GROUP, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2
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 6
Total of all active and inactive participants 2015-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 8
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COBLE PENSION GROUP, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3
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 8
Total of all active and inactive participants 2014-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 11
Number of participants with account balances 2014-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COBLE PENSION GROUP, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4
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 10
Total of all active and inactive participants 2013-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 14
Number of participants with account balances 2013-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COBLE PENSION GROUP, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 10
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 8
Total of all active and inactive participants 2012-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 18
Number of participants with account balances 2012-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COBLE PENSION GROUP, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
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 7
Total of all active and inactive participants 2011-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 15
Number of participants with account balances 2011-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2009: COBLE PENSION GROUP, LLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 12
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 14
Total participants 2009-01-01 14
Number of participants with account balances 2009-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: COBLE PENSION GROUP, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2
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	6
Total of all active and inactive participants	2015-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	8
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COBLE PENSION GROUP, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3
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	8
Total of all active and inactive participants	2014-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	11
Number of participants with account balances	2014-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COBLE PENSION GROUP, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4
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	10
Total of all active and inactive participants	2013-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	14
Number of participants with account balances	2013-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COBLE PENSION GROUP, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	10
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	8
Total of all active and inactive participants	2012-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	18
Number of participants with account balances	2012-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COBLE PENSION GROUP, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
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	7
Total of all active and inactive participants	2011-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	15
Number of participants with account balances	2011-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2009: COBLE PENSION GROUP, LLC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	12
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	14
Total participants	2009-01-01	14
Number of participants with account balances	2009-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on COBLE PENSION GROUP, LLC 401(K) PLAN

Measure	Date	Value
2015 : COBLE PENSION GROUP, LLC 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$-14,045
Expenses. Total of all expenses incurred	2015-12-31	$160,444
Benefits paid (including direct rollovers)	2015-12-31	$160,444
Total plan assets at end of year	2015-12-31	$474,733
Total plan assets at beginning of year	2015-12-31	$649,222
Value of fidelity bond covering the plan	2015-12-31	$70,000
Total contributions received or receivable from participants	2015-12-31	$7,667
Other income received	2015-12-31	$-21,712
Net income (gross income less expenses)	2015-12-31	$-174,489
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$474,733
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$649,222
Assets. Value of participant loans	2015-12-31	$23,569
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : COBLE PENSION GROUP, LLC 401(K) PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$35,324
Expenses. Total of all expenses incurred	2014-12-31	$113,500
Benefits paid (including direct rollovers)	2014-12-31	$113,500
Total plan assets at end of year	2014-12-31	$649,222
Total plan assets at beginning of year	2014-12-31	$727,398
Value of fidelity bond covering the plan	2014-12-31	$70,000
Total contributions received or receivable from participants	2014-12-31	$28,438
Other income received	2014-12-31	$5,699
Net income (gross income less expenses)	2014-12-31	$-78,176
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$649,222
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$727,398
Assets. Value of participant loans	2014-12-31	$24,856
Total contributions received or receivable from employer(s)	2014-12-31	$1,187
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : COBLE PENSION GROUP, LLC 401(K) PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$147,164
Expenses. Total of all expenses incurred	2013-12-31	$693,929
Benefits paid (including direct rollovers)	2013-12-31	$693,929
Total plan assets at end of year	2013-12-31	$727,398
Total plan assets at beginning of year	2013-12-31	$1,274,163
Value of fidelity bond covering the plan	2013-12-31	$70,000
Total contributions received or receivable from participants	2013-12-31	$49,551
Other income received	2013-12-31	$93,627
Net income (gross income less expenses)	2013-12-31	$-546,765
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$727,398
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,274,163
Assets. Value of participant loans	2013-12-31	$55,401
Total contributions received or receivable from employer(s)	2013-12-31	$3,986
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : COBLE PENSION GROUP, LLC 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$159,140
Expenses. Total of all expenses incurred	2012-12-31	$167,680
Benefits paid (including direct rollovers)	2012-12-31	$167,380
Total plan assets at end of year	2012-12-31	$1,274,163
Total plan assets at beginning of year	2012-12-31	$1,282,703
Value of fidelity bond covering the plan	2012-12-31	$120,000
Total contributions received or receivable from participants	2012-12-31	$57,923
Expenses. Other expenses not covered elsewhere	2012-12-31	$300
Other income received	2012-12-31	$94,064
Net income (gross income less expenses)	2012-12-31	$-8,540
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,274,163
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,282,703
Assets. Value of participant loans	2012-12-31	$65,469
Total contributions received or receivable from employer(s)	2012-12-31	$7,153
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : COBLE PENSION GROUP, LLC 401(K) PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$123,968
Expenses. Total of all expenses incurred	2011-12-31	$8,154
Benefits paid (including direct rollovers)	2011-12-31	$8,154
Total plan assets at end of year	2011-12-31	$1,282,703
Total plan assets at beginning of year	2011-12-31	$1,166,889
Value of fidelity bond covering the plan	2011-12-31	$120,000
Total contributions received or receivable from participants	2011-12-31	$86,895
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$65,639
Other income received	2011-12-31	$-59,119
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$115,814
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,282,703
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,166,889
Assets. Value of participant loans	2011-12-31	$4,782
Total contributions received or receivable from employer(s)	2011-12-31	$30,553
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : COBLE PENSION GROUP, LLC 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$303,825
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,166,889
Total plan assets at beginning of year	2010-12-31	$863,064
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$121,286
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$58,375
Other income received	2010-12-31	$95,598
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$303,825
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,166,889
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$863,064
Assets. Value of participant loans	2010-12-31	$27,456
Total contributions received or receivable from employer(s)	2010-12-31	$28,566
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
2009 : COBLE PENSION GROUP, LLC 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for COBLE PENSION GROUP, LLC 401(K) PLAN

2015: COBLE PENSION GROUP, LLC 401(K) 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 funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COBLE PENSION GROUP, LLC 401(K) 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 funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COBLE PENSION GROUP, LLC 401(K) 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 funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COBLE PENSION GROUP, LLC 401(K) 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COBLE PENSION GROUP, LLC 401(K) 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: COBLE PENSION GROUP, LLC 401(K) 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 – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	SAVE-14472
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	SAVE-14472
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	SAVE-14472
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	SAVE-14472
Policy instance	1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number	21525
Policy instance	1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number	14472
Policy instance	1

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Company Name:	COBLE PENSION GROUP, LLC
Employer identification number (EIN):	860805040
NAIC Classification:	561490