| Company Name: | BLUECROSS BLUESHIELD OF LOUISIANA |
| Employer identification number (EIN): | 237384556 |
| National Association of Insurance Commissioner's ID: | 81200 |
| NAIC Classification: | 81200 |
| JUSTISS OIL COMPANY, INC. | GROUP BENEFIT PLAN FOR EMPLOYEES OF JUSTISS OIL CO., INC. ET AL | 2015-01-01 |