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| Company Name: | MEDICA INSURANCE COMPANY |
| Employer identification number (EIN): | 411480988 |
| National Association of Insurance Commissioner's ID: | 12459 |
| NAIC Classification: | 12459 |
| JEFF BELZERS TODD CHEVROLET, INC. | JEFF BELZER'S HEALTH INSURANCE PLAN | 2017-07-01 |