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| Company Name: | MT STATE BLUE CROSS BLUE SHIELD |
| Employer identification number (EIN): | 122346578 |
| National Association of Insurance Commissioner's ID: | 00000 |
| NAIC Classification: | 00000 |
| PCE INC | PCE, INC. EMPLOYEE BENEFITS PLAN | 2016-01-01 |
| GO-MART, INC. | GO-MART, INC. MEDICAL PLAN | 1998-01-01 |
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