| Company Name: | EMPIRE HEALTHCHOICE ASSURANCE, INC. |
| Employer identification number (EIN): | 237391336 |
| National Association of Insurance Commissioner's ID: | 55093 |
| NAIC Classification: | 55093 |
| BOARD OF TRUSTEES OF DENTAL BENEFIT FUND OF THE ELECTRICAL INDUSTRY | DENTAL BENEFIT FUND OF THE ELECTRICAL INDUSTRY | 2015-07-01 |