| Company Name: | LEADERS LIFE INSURANCE COMPANY |
| Employer identification number (EIN): | 431333608 |
| National Association of Insurance Commissioner's ID: | 74799 |
| NAIC Classification: | 74799 |
| GRAND LAKE MENTAL HEALTH CENTER, INC. | GRAND LAKE MENTAL HEALTH CENTER, INC. WELFARE BENEFIT PLAN | 2015-08-01 |