 |
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| Plan Name | OAKWOOD SCHOOL WRAP BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | OAKWOOD SCHOOL |
| Employer identification number (EIN): | 951698608 |
| NAIC Classification: | 611000 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-07-01 | CHRISTOPHER B. THOMAS | 2024-01-05 | ||
| 501 | 2021-07-01 | EVA PETRA HEFFRON | 2022-12-08 | ||
| 501 | 2020-07-01 | CHRISTOPHER B. THOMAS | 2021-12-15 | ||
| 501 | 2019-07-01 | CHRISTOPHER B. THOMAS | 2021-01-12 | ||
| 501 | 2018-07-01 | CHRISTOPHER B. THOMAS | 2019-12-10 | ||
| 501 | 2017-07-01 | ||||
| 501 | 2016-07-01 | ||||
| 501 | 2015-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2014-07-01 | CHRISTOPHER B THOMAS | |||
| 501 | 2013-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2012-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2011-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2010-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2009-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2008-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2007-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2006-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2005-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2004-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2003-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2002-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2001-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 2000-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1999-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1998-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1997-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1996-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1996-07-01 | CHRISTOPHER THOMAS | |||
| 501 | 1995-07-01 | CHRISTOPHER THOMAS |
| 2022: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Submission has been amended | No |
| 2022-07-01 | This submission is the final filing | No |
| 2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-07-01 | Plan is a collectively bargained plan | No |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Submission has been amended | No |
| 2021-07-01 | This submission is the final filing | No |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-07-01 | Plan is a collectively bargained plan | No |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | No |
| 2020-07-01 | This submission is the final filing | No |
| 2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-07-01 | Plan is a collectively bargained plan | No |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Submission has been amended | No |
| 2019-07-01 | This submission is the final filing | No |
| 2019-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-07-01 | Plan is a collectively bargained plan | No |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2018 form 5500 responses | ||
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2014 form 5500 responses | ||
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2010 form 5500 responses | ||
| 2010-07-01 | Type of plan entity | Single employer plan |
| 2010-07-01 | Submission has been amended | No |
| 2010-07-01 | This submission is the final filing | No |
| 2010-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-07-01 | Plan is a collectively bargained plan | No |
| 2010-07-01 | Plan funding arrangement – Insurance | Yes |
| 2010-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2008: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2008 form 5500 responses | ||
| 2008-07-01 | Type of plan entity | Single employer plan |
| 2008-07-01 | Submission has been amended | No |
| 2008-07-01 | This submission is the final filing | No |
| 2008-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-07-01 | Plan is a collectively bargained plan | No |
| 2008-07-01 | Plan funding arrangement – Insurance | Yes |
| 2008-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2008-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2008-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2007: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2007 form 5500 responses | ||
| 2007-07-01 | Type of plan entity | Single employer plan |
| 2007-07-01 | Submission has been amended | No |
| 2007-07-01 | This submission is the final filing | No |
| 2007-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-07-01 | Plan is a collectively bargained plan | No |
| 2007-07-01 | Plan funding arrangement – Insurance | Yes |
| 2007-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2007-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2007-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2006: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2006 form 5500 responses | ||
| 2006-07-01 | Type of plan entity | Single employer plan |
| 2006-07-01 | Submission has been amended | No |
| 2006-07-01 | This submission is the final filing | No |
| 2006-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-07-01 | Plan is a collectively bargained plan | No |
| 2006-07-01 | Plan funding arrangement – Insurance | Yes |
| 2006-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2005 form 5500 responses | ||
| 2005-07-01 | Type of plan entity | Single employer plan |
| 2005-07-01 | Submission has been amended | No |
| 2005-07-01 | This submission is the final filing | No |
| 2005-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-07-01 | Plan is a collectively bargained plan | No |
| 2005-07-01 | Plan funding arrangement – Insurance | Yes |
| 2005-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2004: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2004 form 5500 responses | ||
| 2004-07-01 | Type of plan entity | Single employer plan |
| 2004-07-01 | Submission has been amended | No |
| 2004-07-01 | This submission is the final filing | No |
| 2004-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2004-07-01 | Plan is a collectively bargained plan | No |
| 2004-07-01 | Plan funding arrangement – Insurance | Yes |
| 2004-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2003: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2003 form 5500 responses | ||
| 2003-07-01 | Type of plan entity | Single employer plan |
| 2003-07-01 | Submission has been amended | No |
| 2003-07-01 | This submission is the final filing | No |
| 2003-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2003-07-01 | Plan is a collectively bargained plan | No |
| 2003-07-01 | Plan funding arrangement – Insurance | Yes |
| 2003-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2002: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2002 form 5500 responses | ||
| 2002-07-01 | Type of plan entity | Single employer plan |
| 2002-07-01 | Submission has been amended | No |
| 2002-07-01 | This submission is the final filing | No |
| 2002-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2002-07-01 | Plan is a collectively bargained plan | No |
| 2002-07-01 | Plan funding arrangement – Insurance | Yes |
| 2002-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2001: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2001 form 5500 responses | ||
| 2001-07-01 | Type of plan entity | Single employer plan |
| 2001-07-01 | Submission has been amended | No |
| 2001-07-01 | This submission is the final filing | No |
| 2001-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2001-07-01 | Plan is a collectively bargained plan | No |
| 2001-07-01 | Plan funding arrangement – Insurance | Yes |
| 2001-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2000: OAKWOOD SCHOOL WRAP BENEFIT PLAN 2000 form 5500 responses | ||
| 2000-07-01 | Type of plan entity | Single employer plan |
| 2000-07-01 | Submission has been amended | No |
| 2000-07-01 | This submission is the final filing | No |
| 2000-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2000-07-01 | Plan is a collectively bargained plan | No |
| 2000-07-01 | Plan funding arrangement – Insurance | Yes |
| 2000-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1999: OAKWOOD SCHOOL WRAP BENEFIT PLAN 1999 form 5500 responses | ||
| 1999-07-01 | Type of plan entity | Single employer plan |
| 1999-07-01 | Submission has been amended | No |
| 1999-07-01 | This submission is the final filing | No |
| 1999-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1999-07-01 | Plan is a collectively bargained plan | No |
| 1999-07-01 | Plan funding arrangement – Insurance | Yes |
| 1999-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1998: OAKWOOD SCHOOL WRAP BENEFIT PLAN 1998 form 5500 responses | ||
| 1998-07-01 | Type of plan entity | Single employer plan |
| 1998-07-01 | Submission has been amended | No |
| 1998-07-01 | This submission is the final filing | No |
| 1998-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1998-07-01 | Plan is a collectively bargained plan | No |
| 1998-07-01 | Plan funding arrangement – Insurance | Yes |
| 1998-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1997: OAKWOOD SCHOOL WRAP BENEFIT PLAN 1997 form 5500 responses | ||
| 1997-07-01 | Type of plan entity | Single employer plan |
| 1997-07-01 | Submission has been amended | No |
| 1997-07-01 | This submission is the final filing | No |
| 1997-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1997-07-01 | Plan is a collectively bargained plan | No |
| 1997-07-01 | Plan funding arrangement – Insurance | Yes |
| 1997-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1996: OAKWOOD SCHOOL WRAP BENEFIT PLAN 1996 form 5500 responses | ||
| 1996-07-01 | Type of plan entity | Single employer plan |
| 1996-07-01 | Submission has been amended | Yes |
| 1996-07-01 | This submission is the final filing | No |
| 1996-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1996-07-01 | Plan is a collectively bargained plan | No |
| 1996-07-01 | Plan funding arrangement – Insurance | Yes |
| 1996-07-01 | Plan benefit arrangement – Insurance | Yes |
| 1995: OAKWOOD SCHOOL WRAP BENEFIT PLAN 1995 form 5500 responses | ||
| 1995-07-01 | Type of plan entity | Single employer plan |
| 1995-07-01 | First time form 5500 has been submitted | Yes |
| 1995-07-01 | Submission has been amended | No |
| 1995-07-01 | This submission is the final filing | No |
| 1995-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 1995-07-01 | Plan is a collectively bargained plan | No |
| 1995-07-01 | Plan funding arrangement – Insurance | Yes |
| 1995-07-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000BX9M |
| Policy instance | 4 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| COUNSELING GLOBAL DOMESTIC (National Association of Insurance Commissioners NAIC id number: 54161 ) | |
| Policy contract number | 442791 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073-0800 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073-0800 |
| Policy instance | 5 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000BX9M |
| Policy instance | 4 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10175641001 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073-0800 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10175641001 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073-0800 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 3 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10175641001 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073-0800 |
| Policy instance | 8 |
| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: 0 ) | |
| Policy contract number | 3341030 |
| Policy instance | 6 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 7 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 47013 ) | |
| Policy contract number | 3341030 |
| Policy instance | 5 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 3341030 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073 |
| Policy instance | 4 |
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) | |
| Policy contract number | 010-045549 |
| Policy instance | 3 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 6 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM605292 |
| Policy instance | 6 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572073 |
| Policy instance | 5 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 579641/572073 |
| Policy instance | 5 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 572064 |
| Policy instance | 6 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253/860 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12018413 |
| Policy instance | 4 |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 71253 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 100588 |
| Policy instance | 2 |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | C18439 |
| Policy instance | 1 |
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