LEVI STRAUSS & CO. has sponsored the creation of one or more 401k plans.
Additional information about LEVI STRAUSS & CO.
Submission information for form 5500 for 401k plan LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES
401k plan membership statisitcs for LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES
| Measure | Date | Value |
|---|
| 2023: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 2,120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 2,030 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 55 |
| Total of all active and inactive participants | 2023-01-01 | 2,085 |
| 2022: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 1,916 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 2,104 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 16 |
| Total of all active and inactive participants | 2022-01-01 | 2,120 |
| 2021: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,699 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1,849 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 67 |
| Total of all active and inactive participants | 2021-01-01 | 1,916 |
| 2020: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,978 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,677 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 22 |
| Total of all active and inactive participants | 2020-01-01 | 1,699 |
| 2019: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,869 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,956 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 22 |
| Total of all active and inactive participants | 2019-01-01 | 1,978 |
| 2018: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,775 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,828 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 41 |
| Total of all active and inactive participants | 2018-01-01 | 1,869 |
| 2017: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,725 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,743 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 32 |
| Total of all active and inactive participants | 2017-01-01 | 1,775 |
| 2016: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,814 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,536 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 189 |
| Total of all active and inactive participants | 2016-01-01 | 1,725 |
| 2015: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2,025 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,577 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 237 |
| Total of all active and inactive participants | 2015-01-01 | 1,814 |
| 2014: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 2,049 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 1,867 |
| Number of retired or separated participants receiving benefits | 2014-12-01 | 158 |
| Total of all active and inactive participants | 2014-12-01 | 2,025 |
| 2013: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-25 | 2,049 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-25 | 1,973 |
| Number of retired or separated participants receiving benefits | 2013-11-25 | 76 |
| Total of all active and inactive participants | 2013-11-25 | 2,049 |
| 2023: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 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: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 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: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 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: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2014 form 5500 responses |
|---|
| 2014-12-01 | Type of plan entity | Single employer plan |
| 2014-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2014-12-01 | Plan funding arrangement – Insurance | Yes |
| 2014-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: LEVI STRAUSS & CO. WELFARE PLAN FOR HOME OFFICE EMPLOYEES 2013 form 5500 responses |
|---|
| 2013-11-25 | Type of plan entity | Single employer plan |
| 2013-11-25 | First time form 5500 has been submitted | Yes |
| 2013-11-25 | Submission has been amended | Yes |
| 2013-11-25 | Plan funding arrangement – Insurance | Yes |
| 2013-11-25 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-11-25 | Plan benefit arrangement – Insurance | Yes |
| 2013-11-25 | Plan benefit arrangement – General assets of the sponsor | Yes |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 7 |
| Insurance contract or identification number | 4567 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| Insurance contract or identification number | 8384 | | Number of Individuals Covered | 501 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,051,268 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| Insurance contract or identification number | 00465A | | Number of Individuals Covered | 5 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $177,585 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 3 |
| Insurance contract or identification number | 00112676 | | Number of Individuals Covered | 1648 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $384,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | N14406554 |
| Policy instance | 4 |
| Insurance contract or identification number | N14406554 | | Number of Individuals Covered | 519 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $4,113 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $20,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 130392 |
| Policy instance | 5 |
| Insurance contract or identification number | LTD 130392 | | Number of Individuals Covered | 2087 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,718 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $867,764 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681637G/S09068 |
| Policy instance | 6 |
| Insurance contract or identification number | 681637G/S09068 | | Number of Individuals Covered | 2030 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $761,886 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 3 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | N14406554 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 130392 |
| Policy instance | 5 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681637G/S09068 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 7 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 3 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | N14406554 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 130392 |
| Policy instance | 5 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681637G/S09068 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 7 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 3 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN14406554 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 130392 |
| Policy instance | 5 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 681637G/S09068 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | LTD 130392 |
| Policy instance | 6 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165671 |
| Policy instance | 5 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN14406554 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 3 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0165671 |
| Policy instance | 7 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465B |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 4 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN14406554 |
| Policy instance | 5 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-860-039344 |
| Policy instance | 6 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0319863HOMEOFFI |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 3 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465B |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 5 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | PAI9109545 |
| Policy instance | 6 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 7 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) |
| Policy contract number | ADDN1124502A |
| Policy instance | 8 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-860-039344 |
| Policy instance | 9 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0319863HOMEOFFI |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 3 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465B |
| Policy instance | 4 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009109516 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 5 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 0319863HOMEOFFI |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 8384 |
| Policy instance | 3 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465A |
| Policy instance | 4 |
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 00465A |
| Policy instance | 5 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00465B |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 4567 |
| Policy instance | 7 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009109516 |
| Policy instance | 9 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 00112676 |
| Policy instance | 8 |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | PAI0009109545 |
| Policy instance | 10 |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 319863ERG |
| Policy instance | 11 |
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF386003934401 |
| Policy instance | 1 |
