 |
|
|
|
| Plan Name | OPENTABLE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | OPENTABLE, INC. |
| Employer identification number (EIN): | 943374049 |
| NAIC Classification: | 561500 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | SOPHIE GELSTHORPE | 2022-10-11 | ||
| 501 | 2020-01-01 | SIMON JONES | 2021-07-14 | ||
| 501 | 2019-01-01 | SIMON JONES | 2020-10-02 | ||
| 501 | 2019-01-01 | SIMON JONES | 2023-11-13 | ||
| 501 | 2018-01-01 | ||||
| 501 | 2017-01-01 | VARUN RAI | |||
| 501 | 2016-01-01 | JULIANA LO | |||
| 501 | 2015-01-01 | RYAN WARD | RYAN WARD | 2016-07-27 | |
| 501 | 2014-01-01 | DYLAN ALLREAD | |||
| 501 | 2013-01-01 | GELENA GRINBERG | |||
| 501 | 2012-01-01 | IAN ROBERTSON | |||
| 501 | 2011-01-01 | IAN ROBERTSON | |||
| 501 | 2010-01-01 | STACEY MANES | |||
| 501 | 2009-01-01 | STACEY MANES |
| Measure | Date | Value |
|---|---|---|
| 2021: OPENTABLE HEALTH PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 757 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 747 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 37 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 784 |
| 2020: OPENTABLE HEALTH PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 857 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 746 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 44 |
| 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 | 790 |
| 2019: OPENTABLE HEALTH PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 861 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 793 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 801 |
| 2018: OPENTABLE HEALTH PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 826 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 818 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 9 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 34 |
| Total of all active and inactive participants | 2018-01-01 | 861 |
| 2017: OPENTABLE HEALTH PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 702 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 826 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 826 |
| 2016: OPENTABLE HEALTH PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 609 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 698 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 702 |
| 2015: OPENTABLE HEALTH PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 518 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 599 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 10 |
| 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 | 609 |
| 2014: OPENTABLE HEALTH PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 415 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 518 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 518 |
| 2013: OPENTABLE HEALTH PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 390 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 408 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 415 |
| 2012: OPENTABLE HEALTH PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 357 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 385 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 5 |
| 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 | 390 |
| 2011: OPENTABLE HEALTH PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 356 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 357 |
| 2010: OPENTABLE HEALTH PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 224 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 301 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 7 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 308 |
| 2009: OPENTABLE HEALTH PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 207 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 220 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 4 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 224 |
| 2021: OPENTABLE HEALTH PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: OPENTABLE HEALTH 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 | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OPENTABLE HEALTH 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: OPENTABLE HEALTH 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: OPENTABLE HEALTH 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: OPENTABLE HEALTH 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: OPENTABLE HEALTH 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: OPENTABLE HEALTH PLAN 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: OPENTABLE HEALTH PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: OPENTABLE HEALTH PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: OPENTABLE HEALTH PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: OPENTABLE HEALTH PLAN 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: OPENTABLE HEALTH PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |||||||||||||||||||
| Policy contract number | GF3-86006682001 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 232698 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |||||||||||||||||||
| Policy contract number | SA3-86006682001 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |||||||||||||||||||
| Policy contract number | GD3-86006682001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GF3-86006682001 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GD3-86006682001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | SA3-86006682001 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 232698 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GD3-86006682001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GF3-86006682001 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | SA3-86006682001 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 232698 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 0805037HNO | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GF3-86006682001 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GD3-86006682001 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 232698 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | SA3-86006682001 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | SA3-86006682001 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GF3-86006682001 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 0805037HNO | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GS3-860066820NJ | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GS3-860066820HI | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 088164205300075 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 232698 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 10 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1 | ||||||||||||||||||
| Policy instance | 11 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 12 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GD3-86006682001 | ||||||||||||||||||
| Policy instance | 13 | ||||||||||||||||||
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) | |||||||||||||||||||
| Policy contract number | GS3-860066820NY | ||||||||||||||||||
| Policy instance | 14 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207670 | ||||||||||||||||||
| Policy instance | 10 | ||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||
| Policy contract number | 207671 | ||||||||||||||||||
| Policy instance | 11 | ||||||||||||||||||
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 0805037HNO | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207672 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207673 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1-9 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207669 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207673 | ||||||||||||||||||
| Policy instance | 11 | ||||||||||||||||||
| AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 0805037HNO | ||||||||||||||||||
| Policy instance | 10 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207670 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||
| Policy contract number | 207671 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1-9 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 0805037 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207672 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207669 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207673 | ||||||||||||||||||
| Policy instance | 14 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207670 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1-9 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||
| Policy contract number | 207671 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207669 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 30036157 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | H11608/931409 | ||||||||||||||||||
| Policy instance | 10 | ||||||||||||||||||
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||
| Policy contract number | KM05986709 | ||||||||||||||||||
| Policy instance | 11 | ||||||||||||||||||
| SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION (National Association of Insurance Commissioners NAIC id number: 52009 ) | |||||||||||||||||||
| Policy contract number | KM05986709 | ||||||||||||||||||
| Policy instance | 12 | ||||||||||||||||||
| SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) | |||||||||||||||||||
| Policy contract number | KM05986709 | ||||||||||||||||||
| Policy instance | 13 | ||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||
| Policy contract number | 207672 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) | |||||||||||||||||||
| Policy contract number | KM05986709 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||
| Policy contract number | G610086 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1-9 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | F23009 20525 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |||||||||||||||||||
| Policy contract number | 5456302 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| HEALTH MANAGEMENT SYSTEMS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | EAP | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | H11608/931409 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |||||||||||||||||||
| Policy contract number | 5456302 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | F23009 20525 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 16872-1-9 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||
| Policy contract number | G610086 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | H11608/931409 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| HEALTH MANAGEMENT SYSTEMS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | EAP | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 88164205200075 | ||||||||||||||||||
| Policy instance | 9 | ||||||||||||||||||
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||
| Policy contract number | 463100 | ||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||
| |||||||||||||||||||
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||
| Policy contract number | 861034 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 602976 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||
| Policy contract number | LTD112083 | ||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||
| BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | F23009 20525 | ||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||
| HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 ) | |||||||||||||||||||
| Policy contract number | 168721 | ||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |||||||||||||||||||
| Policy contract number | 931409/H11608 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| HEALTH MANAGEMENT SYSTEMS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 0 | ||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||
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