H.O.BOSTROM COMPANY INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN
| Measure | Date | Value |
|---|
| 2019 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k financial data |
|---|
| Total plan liabilities at end of year | 2019-12-31 | $0 |
| Total plan liabilities at beginning of year | 2019-12-31 | $0 |
| Total income from all sources | 2019-12-31 | $756,079 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $756,079 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $513,467 |
| Total plan assets at end of year | 2019-12-31 | $0 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Value of fidelity bond covering the plan | 2019-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $133,355 |
| Net income (gross income less expenses) | 2019-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $622,724 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $242,612 |
| 2018 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k financial data |
|---|
| Total plan liabilities at end of year | 2018-12-31 | $0 |
| Total plan liabilities at beginning of year | 2018-12-31 | $0 |
| Total income from all sources | 2018-12-31 | $584,256 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $584,256 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $366,631 |
| Total plan assets at end of year | 2018-12-31 | $0 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Value of fidelity bond covering the plan | 2018-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $118,456 |
| Net income (gross income less expenses) | 2018-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $465,800 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $217,625 |
| 2017 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data |
|---|
| Total plan liabilities at end of year | 2017-12-31 | $0 |
| Total plan liabilities at beginning of year | 2017-12-31 | $0 |
| Total income from all sources | 2017-12-31 | $511,357 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $511,357 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $320,289 |
| Total plan assets at end of year | 2017-12-31 | $0 |
| Total plan assets at beginning of year | 2017-12-31 | $0 |
| Value of fidelity bond covering the plan | 2017-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2017-12-31 | $115,113 |
| Net income (gross income less expenses) | 2017-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $396,244 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $191,068 |
| 2016 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data |
|---|
| Total plan liabilities at end of year | 2016-12-31 | $0 |
| Total plan liabilities at beginning of year | 2016-12-31 | $0 |
| Total income from all sources | 2016-12-31 | $454,714 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $454,714 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $281,255 |
| Total plan assets at end of year | 2016-12-31 | $0 |
| Total plan assets at beginning of year | 2016-12-31 | $0 |
| Value of fidelity bond covering the plan | 2016-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $132,848 |
| Net income (gross income less expenses) | 2016-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $321,866 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $173,459 |
| 2015 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 | $527,003 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $527,003 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $342,594 |
| Total plan assets at end of year | 2015-12-31 | $0 |
| Total plan assets at beginning of year | 2015-12-31 | $0 |
| Value of fidelity bond covering the plan | 2015-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $150,792 |
| Net income (gross income less expenses) | 2015-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $376,211 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $184,409 |
| 2014 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 | $611,861 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $611,861 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $453,793 |
| Total plan assets at end of year | 2014-12-31 | $0 |
| Total plan assets at beginning of year | 2014-12-31 | $0 |
| Value of fidelity bond covering the plan | 2014-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $137,139 |
| Net income (gross income less expenses) | 2014-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $474,722 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $158,068 |
| 2013 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 | $448,904 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $448,904 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $326,593 |
| Total plan assets at end of year | 2013-12-31 | $0 |
| Total plan assets at beginning of year | 2013-12-31 | $0 |
| Value of fidelity bond covering the plan | 2013-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $92,577 |
| Net income (gross income less expenses) | 2013-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $356,327 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $122,311 |
| 2012 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2012 401k financial data |
|---|
| Total plan liabilities at end of year | 2012-12-31 | $0 |
| Total plan liabilities at beginning of year | 2012-12-31 | $0 |
| Total income from all sources | 2012-12-31 | $406,541 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $406,541 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $270,973 |
| Total plan assets at end of year | 2012-12-31 | $0 |
| Total plan assets at beginning of year | 2012-12-31 | $0 |
| Value of fidelity bond covering the plan | 2012-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2012-12-31 | $100,357 |
| Net income (gross income less expenses) | 2012-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $306,184 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $135,568 |
| 2011 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 | $737,666 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $737,666 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $622,889 |
| Total plan assets at end of year | 2011-12-31 | $0 |
| Total plan assets at beginning of year | 2011-12-31 | $0 |
| Value of fidelity bond covering the plan | 2011-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2011-12-31 | $97,309 |
| Net income (gross income less expenses) | 2011-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $640,357 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $114,777 |
| 2010 : H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2010 401k financial data |
|---|
| 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 | $572,419 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $572,419 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $449,467 |
| Total plan assets at end of year | 2010-12-31 | $0 |
| Total plan assets at beginning of year | 2010-12-31 | $0 |
| Value of fidelity bond covering the plan | 2010-12-31 | $120,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $99,731 |
| Net income (gross income less expenses) | 2010-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $472,688 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $122,952 |
| 2022: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 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: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 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: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT 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 – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | Yes |
| 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 – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: H.O.BOSTROM COMPANY INC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 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 – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 ) |
| Policy contract number | H858 |
| Policy instance | 4 |
| Insurance contract or identification number | H858 | | Number of Individuals Covered | 59 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $41,389 | | Total amount of fees paid to insurance company | USD $2,338 | | Welfare Benefit Premiums Paid to Carrier | USD $234,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
| Policy contract number | 42304 00000 |
| Policy instance | 3 |
| Insurance contract or identification number | 42304 00000 | | Number of Individuals Covered | 55 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $481 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,984 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000HG827 |
| Policy instance | 2 |
| Insurance contract or identification number | 000HG827 | | Number of Individuals Covered | 85 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $6,054 | | Total amount of fees paid to insurance company | USD $1,321 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $52,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 12298 00000 |
| Policy instance | 1 |
| Insurance contract or identification number | 12298 00000 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,325 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONWIDE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 25453 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 12298 00000 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000HG827 |
| Policy instance | 3 |
| WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
| Policy contract number | 42304 00000 |
| Policy instance | 4 |
| WYSSTA INSURANCE COMPANY INC. (National Association of Insurance Commissioners NAIC id number: 12352 ) |
| Policy contract number | 42304 00000 |
| Policy instance | 4 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000HG827 |
| Policy instance | 3 |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 12298 00000 |
| Policy instance | 2 |
| NATIONWIDE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 25453 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| NATIONWIDE LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 25453 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | HB858 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GERBER H858 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | H858 |
| Policy instance | 1 |
