| Company Name: | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| Employer identification number (EIN): | 620334200 |
| National Association of Insurance Commissioner's ID: | 68195 |
| NAIC Classification: | 68195 |
| CREST DISCOUNT FOODS, INC. | CREST DISCOUNT FOODS, INC. FLEXIBLE BENEFITS PLAN | 2014-10-01 |