Commonwealth of Massachusetts Subchapter … American Express, 1650 Los Gamos Dr, San Rafael, CA,...

Commonwealth of Massachusetts MassHealth

Provider Manual Series

Subchapter Number and Title Appendix C.

Third-Party-Liability Codes

Page

C-1

All Provider Manuals Transmittal Letter

ALL-213

Date

11/01/14


A searchable version of this appendix is available on the MassHealth website at www.mass.gov/masshealth.

MassHealth will update Appendix C as needed. Paper copies of this appendix can be requested by calling

1-800-841-2900, by e-mailing your request to [email protected], or by faxing your request to

617-988-8973.

This appendix contains a list of third-party-liability (TPL) coverage-type codes and a numeric list of carrier

codes, including carrier names and addresses. For members with a temporary MassHealth card, any applicable

TPL coverage-type and carrier codes are printed on the card itself.

How Appendix C Is Organized

There are five sections to the carrier code file. The first section contains commercial carrier codes. This is the

section that most providers will use. Providers should use theses codes on claims for members who have

commercial insurance. The second section contains Medicare carrier codes. Providers should use these on

claims for members who have original Medicare Part A (Hospital Insurance) or Part B (Medical Insurance)

coverage or both. The third section contains Medicare Advantage carrier codes. Providers should use these

codes on claims for members who have Medicare Part A and B, and are enrolled in a Medicare Advantage Plan

(Part C). The fourth section contains Medicare D carrier codes. These codes are for pharmacy use only. Other

providers should never use these codes on a claim. The fifth section contains Casualty Payer (formerly PIP)

carrier codes. Providers should use these codes for reporting Casualty Payer payments on claims.

The Eligibility Verification System (EVS) in MMIS provides the insurance information for the member.

Please check EVS before submitting your claim. Casualty coverage is not considered health insurance;

therefore, Casualty Payer information is not available on EVS. Refer to the applicable billing guide or

companion guide for instructions on using EVS. These guides are available on the web at

www.mass.gov/masshealth.

I. Third-Party-Liability Coverage-Type Codes

The following is a list of TPL coverage-type codes that identify the type of insurance a member has. If you use

the MassHealth EVS Automated Voice Response (AVR) system, you will be given one of the following TPL

coverage-type codes.

MMIS Coverage Codes

Code TPL Coverage Description Code TPL Coverage Description

01 Hospital 14 Preferred Provider Organization (PPO)

02 Major Medical 17 Pharmacy – Cost Avoid*

04 Medicare Part A 18 Pharmacy – Pay and Chase*

05 Medicare Part B 35 Commercial Insurance Without Mental Health

06 Supplemental Policy 56 HMO-Medicare Risk

08 Long Term Care 57 HMO-Medicare Risk (Evercare)

09 HMO without Mental Health 63 Veterans Services (Noncomprehensive)

11 Health Maintenance Organization (HMO) 64 Veterans Services (Comprehensive)

12 Vision* 98 Medicare Hospice

13 Dental Care* 99 Medicare Part D

* If a member has dental, vision, or pharmacy coverage only, the member may still be enrolled in a

MassHealth managed care plan.





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II. Carrier Codes

The following is a list of carrier codes and the names and addresses of the insurance companies to which they

refer. You will see these codes whether you use EVS or another billing method.

Commercial Carriers

Carrier

Code Carrier, Address, Phone (if available)

0178000 A and H Administrators, P. O. Box 10223, Milwaukee, WI, 53210

0616000 AARP, P. O. Box 740819, Atlanta, GA, 30301, (800) 523-5800

0616001 AARP, 215 Long Beach Blvd, Long Beach, CA, 90801

0616002 AARP Health Care Options, P. O. Box 985, Westport, CT, 06881, (888) 687-0977

0920005 AARP Pharmacy Only, P. O. Box 6083, Cypress, MA, 02111, (800) 552-0053

0105000 A-C Retirees Benefit Plan, 11270 W Park Pl Ste 950, C/O BPA of Wisconsin, Milwaukee, WI, 53224

0902020 Ace American Insurance Co, 1730 Park St Ste 207, Naperville, IL, 60563

0659014 ACI Administrative Concepts Inc, 994 Old Eagle School Rd, Ste 1005, Wayne, PA, 19087-1802,

(866) 261-9998

0288024 ACS Benefit Services, P. O. Box 2000, Winston Salem, NC, 40512, (800) 441-5741

0288021 ACS Health Net of North East, P. O. Box 14700, Lexington, KY, 27102, (336) 759-2013

0905082 Administration and Insurance Office Inc, 1220 SW Morrison S, Portland, OR, 97205, (410) 515-1190

0803020 Administrative Enterprises Inc, 3404 W Cheryl Dr, Phoenix, AZ, 85051

0803005 Administrative Service, P. O. Box 140173, Orlando, FL, 32814

0830000 Administrative Service Consultants, 3301 E Royalton Rd, Cleveland, OH, 44147, (419) 423-3823

0803010 Administrative Solutions, P. O. Box 2490, Alpharetta, GA, 30023

0830003 Administrators and Consultants, P. O. Box 4925, Lancaster, PA, 17604, (717) 299-0371

0872020 Advanced Administration, 101 N Lake Destiny Rd, Maitland, FL, 32751, (800) 785-4544

0872010 Advanced Benefit Resources, P. O. Box 350, Woodbury, AZ, 85050, (623) 889-7200

0872015 Advanced Benefit Solutions, P. O. Box 71490, Phoenix, NY, 11797

0367008 Advanced for Freedom, P. O. Box 7154, Lexington, KY, 04702-7151, (800) 713-5095

0872050 Advanced Insurance, P.O. Box 19, Memphis, TN, 38101

0920030 Advanced PCS, P. O. Box 52116, Phoenix, AZ, 85072

0017001 Advantage Star Plan by Rx American, 221 N Charles Lindbergh Dr, Salt Lake City, UT, 84116,

(800) 928-6101

0702021 Advantra Freedom, P. O. Box 7154, London, KY, 40742-7154, (800) 713-5095





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Carrier


0006006 Advantra Rx Premier, P. O. Box 686007, San Antonio, TX, 78268, (866) 755-2776

0606010 Adventist Risk Management, 7083 Grand National Dr, Orlando, FL, 32819

0962002 Adventist Risk Management, P. O. Box 1021, Horsham, PA, 19044, (888) 276-4732

0962001 Adventist Risk Management Inc, P. O. Box 4759, Silver Spring, MD, 20914

0106004 Aetna, P. O. Box 981106, El Paso, TX, 79998-1106, (888) 632-3862

0867005 Aetna, P. O. Box 10223, Milwaukee, WI, 53210

0106098 Aetna Dental, P. O. Box 14094, Lexington, KY, 40512, (800) 872-3862

0920040 Aetna Pharmacy, P. O. Box 398106, Minneapolis, MN, 55439

0122005 AFLAC, 1932 Wynnton Rd, Columbus, GA, 31999, (800) 992-3522

0900096 AFTRA American Federation TV Radio, 261 Madison Ave, New York, NY, 10016

0867010 AG Administrators, P. O. Box 979, Valley Forge, PA, 19482

0705030 AG Edward and Sons, 1 N Jefferson Ave, St Louis, MO, 63013

0107002 AIG, 80 Pine St, New York, NY, 10005, (877) 640-2450

0107005 Aim Administrators, 4645 Sweetwater Blvd, Sugarland, TX, 77479, (281) 265-5111

0840020 Alicare, P. O. Box 1435, New York, NY, 10116, (212) 539-5111

0840080 Alicare Inc, P. O. Box 1442, New York, NY, 10116, (212) 539-5000

0895020 All Risk Administrators, P. O. Box 66237, St Pete Beach, FL, 33736

0128000 Allstate Workplace Division, 1776 American Heritage Dr, Jacksonville, FL, 32224, (904) 992-1776

0640050 Allied Administrators, P. O. Box 2500, San Francisco, CA, 94126, (415) 986-6276

0600010 Allied Benefit Systems, P. O. Box 909786, Chicago, IL, 60696, (312) 906-8050

0112015 Allstate Workplace Division, P. O. Box 853916, Richardson, TX, 75085-3916, (800) 937-7039

0638012 Alta Administrators, 350 Glenborough Dr, Houston, TX, 77067, (800) 937-6824

0638030 Alta Health, P. O. Box 59059, Minneapolis, MN, 55459, (800) 937-6824

0638038 Alta Health Strategies, P. O. Box 27142, Baltimore, MD, 21230

0638010 Alternative Risk Management, 10200 Southwest Nimbus, Portland, OR, 97223

0144045 Altius Health Plans, P. O. Box 7147, Lexington, KY, 40472, (800) 377-4161

0638050 Altus Dental, P. O. Box 1557, Providence, RI, 02901, (877) 223-0558

0653000 AM Maritime Officers Med Plan, P. O. Box 35, Dania Beach, FL, 33004, (800) 348-6515

0614089 Amalgamated Clothing Textile, 730 Broadway St, New York, NY, 10003

0528000 Amalgamated Insurance, P. O. Box 1449, New York, NY, 10116, (212) 539-5105





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Carrier


0528001 Amalgamated Insurance, 867 State Rd, North Dartmouth, MA, 02724

0528010 Amalgamated Insurance, 99 University Pl, New York, NY, 10003

0528008 Amalgamated Life, P. O. Box 5442, White Plains, NY, 10602, (914) 367-5111

0528006 Amalgamated Life Insurance, 333 S Ashland Ave, Chicago, IL, 60607

0528013 Amalgamated Life Insurance, P.O. Box 1440, New York, NY, 10116

0528005 Amalgamated Local 298, 825 E State Blvd, Garden City, NY, 11530

0138045 AmeriBen Solutions, P. O. Box 7186, Boise, ID, 83707, (800) 786-7930

0908064 American Administrative Group, P. O. Box 5227, Lisle, IL, 60532, (630) 773-3800

0832000 American Baptist Churches Med Plan, 475 Riverside Dr, New York, NY, 10115

0624000 American Chambers Life Insurance Co, P. O. Box 3048, Naperville, IL, 60566

0624001 American Chambers Life Insurance Co, UCIP NE, Hyannis, MA, 02601

0872030 American Consulting Engineers Council, P. O. Box 9007, St Louis, MO, 63101

0811000 American Express, 1650 Los Gamos Dr, San Rafael, CA, 94903

0122010 American Fidelity, P. O. Box 559017, Austin, TX, 78755, (800) 247-7724

0122001 American Fidelity Assurance Co, P. O. Box 25070, Oklahoma City, OK, 73125, (800) 654-8489

0122002 American General Life Dental, P. O. Box 3667, Seattle, WA, 98124, (877) 672-1648

0126001 American Hardware Mutual Insurance Co, 200 Unicorn Dr, Woburn, MA, 01801

0126007 American Heritage Life, P. O. Box 853916, Richardson, TX, 75085, (800) 937-7039

0106012 American Insurance Administrators, P. O. Box 1149, Columbus, OH, 43316-1149, (800) 922-1245

0908029 American Maritime Officers Medical, P. O. Box 35, Dania, FL, 33004

0135008 American Medical Security, P. O. Box 19032, Green Bay, WI, 54307, (800) 232-5432

0669010 American National Health Insurance, P. O. Box 1520, Galveston, TX, 77553, (800) 899-6806

0138001 American National Insurance Co, Regional Group Service Office, Ste 300, No Andover, MA, 01845

0629000 American Pioneer Life, P. O. Box 130, Pensacola, FL, 32591-0130

0629001 American Pioneer Life, P. O. Box 399127, Cambridge, MA, 02139-9127, (800) 538-1053

0126002 American Plan Administrators, 18 Heywood St, Brooklyn, NY, 11211

0614046 American Postal Workers Union, P. O. Box 1358, Glen Burnie, MD, 21060, (800) 222-2798

0669008 American Progressive, P. O. Box 130, Pensacola, FL, 32591

0683050 American Republic Insurance Co, P. O. Box 21670, Eagan, MN, 55121, (800) 247-2190

0700071 American Service Life, P. O. Box 470788, Fort Worth, TX, 76147





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Carrier


0733000 American Travelers Life Insurance, 3220 Tillman Dr, Bensalem, PA, 19220, (800) 441-3978

0682050 American Trust Administrators, P. O. Box 87, Shawnee Mission, KS, 66201, (913) 451-4900

0669005 Americas Choice Healthplans, P. O. Box 922043, Houston, TX, 77292, (800) 633-4227

0138015 Amerihealth, P. O. Box 41574, Philadelphia, PA, 19101-1574, (800) 275-2583

0138010 Amerihealth Administrators (AHA), P. O. Box 21545, Eagan, MN, 55121, (800) 275-2583

0144040 Ameritas Life Insurance, P. O. Box 82520, Lincoln, NE, 68501, (800) 487-5553

0028005 Anthem Blue Cross of California, P. O. Box 60007, Los Angeles, CA, 90060, (800) 888-8288

0028041 Anthem Blue Cross Blue Shield, P. O. Box 37180, Louisville, KY, 40233, (866) 755-2657

0028085 Anthem Blue Cross Blue Shield, P. O. Box 37010, Louisville, KY, 40233-7010, (866) 504-9617

0028100 Anthem Blue Cross Blue Shield, P. O. Box 5071, Middletown, NY, 10940-9071, (877) 224-0030

0028108 Anthem Blue Cross Blue Shield, P. O. Box 5078, Middletown, NY, 10940-9078, (800) 992-2518

0028018 Anthem Blue Cross Blue Shield Dental of California, P. O. Box 9274, Oxnard, CA, 93031

0028004 Anthem Blue Cross Blue Shield National Acct, P. O. Box 5419, Los Angeles, CA, 90054,

(800) 854-1837

0028006 Anthem Blue Cross Blue Shield of California, P. O. Box 60007, Los Angeles, CA, 90060

0028043 Anthem Blue Cross Blue Shield of Colorado, P. O. Box 5747, Denver, CO, 80217, (800) 654-9338

0028088 Anthem Blue Cross Blue Shield of Connecticut, P. O. Box 533, North Haven, CT, 06473

0028089 Anthem Blue Cross Blue Shield of Connecticut, P. O. Box 105557, Atlanta, GA, 30348-5557,

(800) 676-2583

0028039 Anthem Blue Cross Blue Shield of Maine, 2 Gannett Dr, South Portland, ME, 04106, (207) 822-7000

0027046 Anthem Blue Cross Blue Shield of New Hampshire, P. O. Box 533, North Haven, CT, 06473-0533,

(800) 332-6558

0028109 Anthem Blue Cross Blue Shield of Oh, P. O. Box 105187, Atlanta, GA, 30348-5187, (800) 345-4344

0028102 Anthem Blue Cross Blue Shield of Pennsylvania, P. O. Box 890179, Attn: First Priority Life

Insurance Co, Camp Hill, PA, 17089, (888) 338-2211

0028087 Anthem Blue Cross Blue Shield of Virginia, P. O. Box 27401, Richmond, VA, 23279-7401,

(866) 452-4490

0028500 Anthem Dental, P. O. Box 659444, San Antonio, TX, 78265, (800) 440-3619

0025050 Anthem Document Management, P. O. Box 37010, Louisville, KY, 40233-7010, (800) 676-2583

0292003 Anthem Home Life Insurance, P. O. Box 1326, Piscataway, NJ, 08855

0701040 APA Partners Inc, 8 British Blvd, Latham, NY, 12110, (800) 833-3650

0700075 Archdiocese of Miami Health Plan Trust, 9401 Biscayne Blvd, Miami Shores, FL, 33138





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Carrier


0920021 Argus Health Systems, P. O. Box 419019, Kansas City, MO, 64141, (800) 424-6521

0606005 Arizona Foundation, P. O. Box 2909, Phoenix, AZ, 85062, (800) 522-1246

0414004 ARM Group, 340 Quadrangle Dr, Bolingbrook, IL, 60440, (800) 968-7222

0654000 ASR Corp, 3033 Orchard Vista Dr SE, Grand Rapids, MI, 49546, (616) 957-1751

0688045 Associated Administrative Inc, P. O. Box 6680, Portland, OR, 97228

0688050 Associated Administrators Group Inc, P. O. Box 700428, Dallas, TX, 75370

0149018 Associated Health Plan Administrators, P. O. Box 9568, New Haven, CT, 06535, (203) 287-1272

0259001 Associated Hospital Service, Aka Anthem Health Plans, Quincy, MA, 02169

0149016 Associated Plan Administrators, P. O. Box 189, Columbus, OH, 43216

0253065 Assurant Employee Benefits, P. O. Box 2877, Clinton, IA, 52733-2877, (800) 553-7654

0253080 Assurant Health Dental, P. O. Box 2940, Clinton, IA, 52733, (800) 442-7742

0901026 Atlantic Administrators, 135 Beaver St, Waltham, MA, 02452

0901031 Atlantic Administrators, P. O. Box 637, North Andover, MA, 01845

0962003 Atlantis Health Plan, P. O. Box 4656, Houston, TX, 77210-4656, (866) 747-8422

0253002 Aultcare, P. O. Box 6910, Canton, OH, 44706-0910, (800) 344-8858

0680020 A USA Insurance Plan, P. O. Box 10401, Des Moines, IA, 50306

0906087 Automated Benefit Services, P. O. Box 37506, Oak Park, MI, 48237, (586) 826-4410

0253003 Auxiant, P. O. Box 75008, Cedar Rapids, IA, 52407, (800) 279-6772

0143004 AVMA, P. O. Box 909720, Chicago, IL, 60690, (800) 621-6360

0538040 AVMED Health Plan, P. O. Box 2939, Gainesville, FL, 32602, (352) 372-8400

0322004 AWANE Benefit Plan Management, P. O. Box 536, Rockland, MA, 02370, (603) 924-9449

0730050 Babb Inc, 850 Ridge Ave, Pittsburgh, PA, 15212, (800) 245-6102

0614008 Bakery and Confectionary Union, 10401 Connecticut Ave, Kensington, MD, 20895

0154010 Bankers Life and Casualty Co, P. O. Box 1935, Carmel, IN, 46082-1935, (800) 621-3724

0160001 BCI Administrators, P. O. Box 251568, West Bloomfield, MI, 48325, (248) 626-8896

0908058 Benefit Administrator Systems, 17475 Jovanna Dr 18, Homewood, IL, 60430, (800) 523-0582

0900091 Benefit Concepts, P. O. Box 60608, King of Prussia, PA, 19406, (610) 337-2600

0908043 Benefit Management Services, P. O. Box 98044, Baton Rouge, LA, 70898, (800) 603-2299

0701010 Benefit Management Services Inc, P. O. Box 1178, Matthew, NC, 28106

0610050 Benefit Plan Management, P. O. Box 536, Rockland, MA, 02370, (781) 753-7500





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Carrier


0562002 Benefit Planners, P. O. Box 690450, San Antonio, TX, 78269, (800) 368-3653

0900094 Benefit Planners Inc, P. O. Box 690450, San Antonio, TX, 78269, (866) 868-8207

0701007 Benefit Risk Management, P. O. Box 2650, Rancho Gordova, CA, 95741, (916) 858-2950

0701008 Benefit Risk Management, P. O. Box 2140, Folsom, CA, 95763, (888) 225-7151

0701024 Benefits Claims Payor Inc, P. O. Box 37400, Phoenix, AZ, 85069, (800) 266-6868

0844001 Benesight, P. O. Box 29050, Phoenix, AZ, 85072, (800) 223-5228

0844021 Benesight, P. O. Box 375, Pueblo, CO, 81002, (800) 992-8354

0844040 Benesight, P. O. Box 370, Pueblo, CO, 81002, (800) 992-8354

0844022 Benesight Dental, P. O. Box 360, Pueblo, CO, 81002-0360

0813000 Berkshire Health Plan, 279 Dalton Ave, Pittsfield, MA, 01201

0749060 Big Lots Associates Plan, P. O. Box 9071, Dublin, OH, 43017

0027005 Blue Benefit Administrators, P. O. Box 55917, Boston, MA, 02205, (877) 707-2583

0028009 Blue Cross Blue Shield of Delaware, One Brandywine Gateway, Wilmington, DE, 19899,

(800) 633-2563

0028011 Blue Cross Blue Shield of Florida, 532 Riverside Ave, Jacksonville, FL, 32231, (800) 727-2227

0028022 Blue Cross Blue Shield of Indiana, 5451 Lakeview Pkwy S Dr, Indianapolis, IN, 46268

0028028 Blue Cross Blue Shield of Minnesota, P. O. Box 64338, St Paul, MN, 55164, (800) 262-0820

0028037 Blue Cross Blue Shield of Nebraska, P. O. Box 3248, Omaha, NE, 68180, (800) 642-8516

0028063 Blue Cross Blue Shield of Tennessee, 1 Cameron Hill Cir, Ste 0002, Chattanooga, TN, 37402-0002,

(800) 565-9140

0028019 Blue Cross of Idaho, P. O. Box 7408, Boise, ID, 83707, (800) 274-4018

0027076 Blue Cross Blue Shield of Hawaii, P. O. Box 2970, Honolulu, HI, 96802, (800) 468-3190

0028058 Blue Cross Blue Shield of Puerto Rico, P. O. Box 366068, San Juan, PR, 00936, (888) 284-7814

0028069 Blue Cross Blue Shield of Utah, P. O. Box 30270, Salt Lake City, UT, 84130, (800) 624-6519

0028072 Blue Cross Blue Shield of Washington, P. O. Box 30271, Salt Lake City, UT, 84130, (800) 624-6519

0028054 Blue Cross Blue Shield of Western Pennsylvania, 120 Fifth Ave, Pittsburgh, PA, 15222,

(800) 547-3627

0028057 Blue Cross Blue Shield Dental of Rhode Island, P. O. Box 219, Providence, RI, 02901

0027025 Blue Cross Blue Shield Dental of Massachusetts, P. O. Box 986005, Boston, MA, 02298,

(800) 882-1178

0027013 Blue Cross Blue Shield LA, P. O. Box 98029, Baton Rouge, LA, 70895, (800) 599-2583

0027089 Blue Cross Blue Shield Medex Basic, P. O. Box 9196, Boston, MA, 02105





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Carrier


0027085 Blue Cross Blue Shield Medex Bronze, P. O. Box 9196, Boston, MA, 02105

0027087 Blue Cross Blue Shield Medex Core, P. O. Box 9196, Boston, MA, 02105

0027088 Blue Cross Blue Shield Medex Core Plus, P. O. Box 9196, Boston, MA, 02105

0027003 Blue Cross Blue Shield Medex Gold, P. O. Box 9196, Boston, MA, 02105, (800) 451-8123

0027082 Blue Cross Blue Shield Medex One, P. O. Box 9196, Boston, MA, 02105

0027086 Blue Cross Blue Shield Medex Silver, P. O. Box 9196, Boston, MA, 02105

0027002 Blue Cross Blue Shield Medex Standard, P. O. Box 9196, Boston, MA, 02105, (800) 451-8123

0027084 Blue Cross Blue Shield Medex Three, P. O. Box 9196, Boston, MA, 02105

0027083 Blue Cross Blue Shield Medex Two, P. O. Box 9196, Boston, MA, 02105

0027060 Blue Cross Blue Shield of Kentucky, P. O. Box 37690, Louisville, KY, 40233, (866) 848-1056

0028073 Blue Cross Blue Shield of Alaska, P. O. Box 24649, Anchorage, AK, 99524, (800) 527-6675

0027080 Blue Cross Blue Shield of Alabama, P. O. Box 2294, Birmingham, AL, 35209-2294, (800) 334-9041

0027011 Blue Cross Blue Shield of Arkansas, P. O. Box 1460, Little Rock, AR, 72203-1460

0027012 Blue Cross Blue Shield of Arkansas, Dental Claims Administrator, P. O. Box 69436, Harrisburg, PA,

17106-9436, (888) 224-5213

0027020 Blue Cross Blue Shield of Arizona, P. O. Box 2924, Phoenix, AZ, 85062, (800) 676-2583

0027059 Blue Cross Blue Shield of Central NY, P. O. Box 4809, Syracuse, NY, 13221, (315) 671-6400

0028012 Blue Cross Blue Shield of Georgia, P. O. Box 9907, Columbus, GA, 31908-7368, (800) 441-2273

0028016 Blue Cross Blue Shield of Iowa, 636 Grand Ave, Des Moines, IA, 50309, (800) 526-8995

0028020 Blue Cross Blue Shield of Illinois, P. O. Box 805107, Chicago, IL, 60690-3625, (800) 972-8088

0027097 Blue Cross Blue Shield of Kansas, 1133 S West, Topeka, KS, 66629, (800) 432-0272

0028030 Blue Cross Blue Shield of Kansas, P. O. Box 419169, Kansas City, MO, 64141-6196, (800) 566-8443

0027000 Blue Cross Blue Shield of Massachusetts, P. O. Box 986015, Boston, MA, 02298-6015,

(800) 443-6657

0028026 Blue Cross Blue Shield of Maryland, P. O. Box 9784, Baltimore, MD, 21284, (800) 524-4555

0028000 Blue Cross Blue Shield of Michigan, 600 Lafayette E, Detroit, MI, 48226, (800) 637-2227

0028106 Blue Cross Blue Shield of Michigan, P. O. Box 80380, Lansing, MI, 48908-0380, (800) 422-9146

0027015 Blue Cross Blue Shield of Mississippi, P. O. Box 2312, Jackson, MS, 39225-2315, (800) 942-0278

0027016 Blue Cross Blue Shield of Mississippi, P. O. Box 1043, Jackson, MS, 39215-1043, (800) 676-2583

0027098 Blue Cross Blue Shield of Montana, P. O. Box 7982, Helena, MT, 59604, (800) 447-7828





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Carrier


0028034 Blue Cross Blue Shield of North Carolina, 5901 Chapel Hill Road, Durham, NC, 27702-2291,

(800) 250-3630

0027014 Blue Cross Blue Shield of North Dakota, 4510 13th Ave SW, Fargo, ND, 58121

0027048 Blue Cross Blue Shield of Northeastern and Western New York, P. O. Box 80, Buffalo, NY, 12212,

(800) 444-9940

0028038 Blue Cross Blue Shield of New Jersey, P. O. Box 1219, Newark, NJ, 07101, (973) 466-4000

0027090 Blue Cross Blue Shield of New Mexico, P. O. Box 11968, Albuquerque, NM, 87192, (800) 835-8699

0028052 Blue Cross Blue Shield of Oregon, P. O. Box 30805, Salt Lake City, UT, 84130, (800) 624-6519

0028031 Blue Cross Blue Shield of Pennsylvania, P. O. Box 898845, Camp Hill, PA, 17089, (800) 358-0050

0028055 Blue Cross Blue Shield of Pennsylvania, P. O. Box 1210, Pittsburgh, PA, 15230, (800) 547-3627

0028103 Blue Cross Blue Shield of Pennsylvania, P. O. Box 69352, Philadelphia, PA, 17106, (800) 275-2583

0028099 Blue Cross Blue Shield of Puerto Rico, 401 Park Dr, Boston, MA, 02215

0028059 Blue Cross Blue Shield of Rhode Island, 444 Westminster St, Providence, RI, 02903, (800) 639-2227

0027058 Blue Cross Blue Shield of Rochester, 150 E Main St, Rochester, NY, 14647

0028098 Blue Cross Blue Shield of Rochester, 165 Court St, Rochester, NY, 14647, (800) 462-0116

0028060 Blue Cross Blue Shield of South Carolina, P. O. Box 100300, Columbia, SC, 29202, (800) 868-2520

0028062 Blue Cross Blue Shield of South Carolina, P. O. Box 6000, Greenville, SC, 29606-6000,

(800) 845-6067

0028094 Blue Cross Blue Shield of Texas, P. O. Box 660044, Dallas, TX, 75266, (800) 521-2227

0027034 Blue Cross Blue Shield of Texas Dental, P. O. Box 660247, Dallas, TX, 75266, (800) 521-2227

0028076 Blue Cross Blue Shield of Washington, P. O. Box 91059, Seattle, WA, 98111, (800) 527-6675

0028075 Blue Cross Blue Shield of Wisconsin, P. O. Box 2270, Fond Du Lac, WI, 54936

0028015 Blue Cross Blue Shield of Wyoming, P. O. Box 2266, Cheyenne, WY, 82003-2266, (800) 442-2376

0028035 Blue Cross Blue Shield of Oklahoma, P. O. Box 3283, Tulsa, OK, 74102, (405) 787-6020

0027062 Blue Cross Blue Shield of Missouri, P. O. Box 419169, Kansas City, MO, 64141, (800) 892-6048

0028071 Blue Cross D Blue Shield of Vermont, 445 Industrial Ln, Montpelier, VT, 05601, (800) 255-4550

0027033 Blue Cross Dental of Rhode Island, P. O. Box 219, Providence, RI, 02901, (800) 676-2583

0028017 Blue Shield of California, P. O. Box 272540, Chico, CA, 95927-2540, (800) 334-9849

0028105 Blue Shield of Northeastern New York, P. O. Box 80, Buffalo, NY, 14240-0080, (518) 880-5700

0028061 Blue Shield of Puerto Rico, P. O. Box 363628, San Juan, PR, 00936, (888) 284-7814

0614029 Boilermaker S National Health and Welfare, P. O. Box 23825, Tucson, AZ, 85734





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0614028 Boilermakers National Health and Welfare, P. O. Box 5909, Scranton, PA, 18505, (866) 342-6555

0631001 Bollinger, P. O. Box 727, Short Hill, NJ, 07078, (866) 267-0092

0290050 Boon Chapman, P. O. Box 9201, Austin, TX, 78766, (800) 252-9653

0167000 Boston Mutual Life Insurance Co, 120 Royall St, Canton, MA, 02021, (800) 669-2668

0901089 Bravo Health Pennsylvania Inc, P. O. Box 4433, Baltimore, MD, 21223-0433, (800) 291-0396

0614020 Bricklayers and Masons Local 3, 645 Morrissey Blvd, Boston, MA, 02122

0699002 Bridgestone Firestone, P. O. Box 247, Sheldon, IA, 51201

0913003 Cambridge Hospital ESP, 270 Green St, Cambridge, MA, 02139

0895018 Cape Care Preferred Provider Network, P. O. Box 30367, Tampa, FL, 33630

0028053 Capital Blue Cross, P. O. Box 779503, Harrisburg, PA, 17177, (866) 333-0829

0171010 Capital Group Insurance Administrators, 320 Washington St, Norwell, MA, 02061

0171015 Capitol Administrators, P. O. Box 2318, Rancho Cordova, CA, 95741

0171005 Capitol District Physicians Health Plan, P. O. Box 66602, Albany, NY, 12206, (800) 926-7526

0171050 Cappcare, P. O. Box 6240, Newport Beach, CA, 92658

0028025 Care First Blue Cross Blue Shield, P. O. Box 14116, Lexington, KY, 40512-4116, (888) 567-9155

0028027 Care First Blue Cross Blue Shield of Maryland, P. O. Box 1725, Cumberland, MD, 21501,

(800) 843-4280

0632601 Carefirst Administrators, P. O. Box 981608, El Paso, TX, 97778, (800) 888-6227

0028008 Carefirst Blue Cross Blue Shield, P. O. Box 14116, Lexington, KY, 40512-4116, (800) 842-5975

0028032 Carefirst Blue Cross Blue Shield, P. O. Box 812, Owings Mills, MD, 21117, (800) 843-4280

0920025 Caremark, P. O. Box 686005, San Antonio, TX, 78268, (800) 841-5550

0442001 Careplus Health Plans Inc, P. O. Box 31286, Tampa, FL, 33631-3286, (866) 313-7587

0614054 Carpenters Health and Welfare, 29 Oakland St, Springfield, MA, 01101

0707000 Catholic Association of Foresters, 347 Commonwealth Ave, Boston, MA, 02115

0661002 CBA Inc, 3800 NW 12th, Lincoln, NE, 68521, (888) 673-2872

0702030 CBC Administrators, P. O. Box 776, Melville, NY, 11747, (877) 769-3942

0204008 CBCA, P. O. Box 1339, Minneapolis, MN, 55440-1339

0702040 CBCA, P. O. Box 5190, Tampa, FL, 33675

0702041 CBCA, P. O. Box 9888, Savannah, GA, 31412

0702042 CBCA, P. O. Box 9000, London, KY, 40742

0702025 CBCA Administrators, P. O. Box 1539, Fort Worth, TX, 76101, (800) 808-4515





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0702035 CBCA Administrators, P. O. Box 8911, Melville, NY, 11747, (877) 769-3942

0895040 CBPI Beech St Corp, P. O. Box 853925, Richardson, TX, 75085-3925, (800) 275-1171

0828010 CCN Superien Interplan, P. O. Box 6743, Lubbock, TX, 79493, (800) 903-2032

0702047 CDPHP, P. O. Box 66602, Albany, NY, 12206, (800) 926-7526

0712002 CDS, P. O. Box 50190, Sparks, NV, 50190, (800) 455-4236

0905070 CEBA, 6300 Bridge Point Pkwy, Austin, TX, 78730, (888) 350-1488

0172001 Celtic Insurance, P. O. Box 30082, Tampa, FL, 3082

0172007 Celtic Insurance Company, P. O. Box 06401, Chicago, IL, 60606, (800) 477-7870

0348015 Cement Workers, 35-30 Francis Lewis Blvd, Ste 300, Flushing, NY, 11358-1931, (718) 762-6133

0174020 Centra, P. O. Box 34866, Seattle, WA, 98124

0895019 Central Cartage E, P. O. Box 3017, Center Line, MI, 48015

0176000 Central States Health and Life, P. O. Box 34350, Omaha, NE, 68134, (402) 397-1111

0873000 Central United Life, P. O. Box 2728, Houston, TX, 77252

0638032 Century Healthcare, P. O. Box 2256, Grapevine, TX, 76099-2256

0615015 Colorado Fuel and Iron, 5 Gateway Center Ste 6, Pittsburg, PA, 15222

0690000 Champion International, Knights Bridge Dr, Hamilton, OH, 45020

0064001 CHAMPUS Tricare Military Health Systems, P. O. Box 870140, Camden, SC, 29587, (877) 874-2273

0006010 CHAMPVA, 99 River Ridge Dr, Denver, CO, 80206

0184005 Cherokee Insurance, P. O. Box 159, Warren, MI, 48090

0615001 Chesapeake Life Insurance Co, P. O. Box 981606, El Paso, TX, 79998, (888) 756-3534

0901020 Chesterfield Resource, P. O. Box 1884, Akron, OH, 44309, (800) 321-0935

0678010 Choice Benefits, P. O. Box 10048, Fort Smith, AR, 72917, (479) 785-6178

0678000 Choice Plus of Vermont, P. O. Box 6589, Syracuse, NY, 13217, (802) 479-9762

0184010 Christian Brothers Health Management Services, 1205 Windham Pkwy, Romeoville, IL, 60446

0787010 Christian Fidelity, P. O. Box 44990, Madison, WI, 53744-4990

0200064 Cigna Behavioral Health, P. O. Box 46270, Eden Prairie, MN, 55344

0200082 Cigna Dental Health, P. O. Box 4630, Miami, FL, 33269

0200083 Cigna Dental of Connecticut, P. O. Box 969, Bristol, CT, 06010, (800) 577-0576

0200050 Cigna Dental of Delaware, P. O. Box 15558, Wilmington, DE, 19850, (800) 441-7150

0200087 Cigna Dental of Florida, P. O. Box 189060, Plantation, FL, 33318, (800) 342-5234





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0200075 Cigna Dental of Tennessee, P. O. Box 188003, Chattanooga, TN, 37422, (800) 433-3926

0200008 Cigna Healthcare, P. O. Box 5200, Scranton, PA, 18505, (800) 244-6224

0200009 Cigna Healthcare Carelink, P. O. Box 182223, Chattanooga, TN, 37422-7223

0030000 Cigna International, P. O. Box 15050, Wilmington, DE, 19850, (800) 441-2668

0439025 Cigna Pharmacy, P. O. Box 3598, Scranton, PA, 18505

0001003 Cignature Rx, 13650 NW 8th St, Sunrise, FL, 33325, (800) 222-6700

0064101 Citizens Security Life Insurance, Attn Special Care Insurance, P. O. Box 436149, Louisville, KY,

40253, (800) 843-7752

0714020 Claims Management Service, P.O. Box 10888, Greenbay, WI, 54307

0714025 Claims Management Services, P.O. Box 279, West Bend, WI, 53095, (800) 245-6142

0714060 Claims Processing Center, P. O. Box 10841, Clearwater, FL, 33757

0607025 Claims Ware Inc (CWI), P. O. Box 6125, Greenville, SC, 29606-6125

0546019 CNIC Health Solutions Inc, P. O. Box 3559, Englewood, CO, 80155, (800) 426-7453

0700057 CNR Consulting, 1501 Broadway, New York, NY, 10036

0204002 Coast Wide Claims, 814 Mission St, San Francisco, CA, 94103-3030, (800) 955-7376

0187000 Collegiate Risk Management, P. O. Box 727, Short Hills, NJ, 07078

0906045 Colonial Benefit Insurance Administrators, P. O. Box 3770, Capital Heights, MD, 20743

0191002 Colonial Penn, P. O. Box 30102, Tampa, FL, 33630

0760050 Colorado Pipe Industry, 10620 E Bethany Dr, Aurora, CO, 80014

0194010 Combined Benefit Administration, 4704 W Jennifer Ave, Fresno, CA, 93722, (800) 709-4734

0194002 Combined Insurance Co, P. O. Box 638, Bellingham, WA, 98227, (800) 225-4500

0194001 Combined Insurance Co of America, 111 Washington St, Brookline, MA, 02146

0001010 Commonwealth Choice BMC Healthnet, P. O. Box 55282, Boston, MA, 02205-5282, (877) 492-6967

0001012 Commercial Travelers Mutual Insurance, College Claims Division, 70 Genesee St, Utica, NY, 13502,

(800) 756-3702

0198000 Commercial Union Insurance, One Beacon St, Boston, MA, 02108

0001002 Commonwealth Care Alliance, 30 Winter St, Boston, MA, 02108

0204003 Community Care Life Health, P. O. Box 176, Tulsa, OK, 74101-0176, (888) 589-5214

0006007 Community Care Rx Basic, 1 CSC Way, Rensselaer, NY, 12144, (866) 823-5178

0210006 Companion Life Dental, P. O. Box 100102, Columbia, SC, 29202, (800) 753-0404

0700015 Complete Care Control Simplex, Simplex Plaza, Gardner, MA, 01441





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0661005 Comprehensive Benefits Administrators, P. O. Box 2365, So. Burlington, VT, 05407, (888) 222-9206

0661020 Comprehensive Benefits Services, P. O. Box 8955, Melville, NY, 77292-8955, (800) 231-7269

0744000 Confederate Administrative Services, Ste 250, Wellesley, MA, 02181

0439004 Connecticare, P. O. Box 522, Farmington, CT, 06032, (860) 674-5700

0439007 Connecticare, P. O. Box 546, Farmington, CT, 06032, (800) 251-7722

0814041 Connecticut Carpenters Fund, 10 Broadway, Hamden, CT, 06518

0200017 Connecticut General, P. O. Box 55270, Phoenix, AZ, 85708-5270, (877) 209-7098

0200060 Connecticut General, P. O. Box 9004, Jericho, NY, 11753

0200085 Connecticut General, P. O. Box 850, JFK Airport Station, Jamaica, NY, 11430

0200015 Connecticut General Life, P. O. Box 2996, GE Dental Claims Office, Hartford, CT, 06104

0200018 Connecticut General Life Insurance, P. O. Box 2316, Pittsburgh, PA, 15230

0171002 Conseco Senior Health Insurance, P. O. Box 2002, Carmel, IN, 46082, (800) 242-4852

0171001 Conseco Washington National, P. O. Box 2034, Carmel, IN, 46082, (800) 523-4000

0827000 Conservative Baptist Foreign Mission Society, P. O. Box 828, Wheaton, IL, 61089

0203000 Consolidated Health Plans, 2077 Roosevelt Ave, Springfield, MA, 01104, (800) 633-7867

0203001 Constitution Health Network, P. O. Box 720, North Haven, CT, 06473

0614047 Construction Workers Local 147, 3235 John F Kennedy Blvd, Jersey City, NJ, 07306-3405,

(212) 447-5106

0205000 Continental Casualty Company, Can Plaza, Licensing 29 S, Chicago, IL, 60685

0205005 Continental General, P. O. Box 29134, Shawnee Mission, KS, 66201

0200024 Continental General Insurance, P. O. Box 2830, Clinton, IA, 52733-2830, (800) 545-8905

0205006 Continental Life, 101 Continental Place, P. O. Box 1188, Brentwood, TN, 37024, (800) 264-4000

0206000 Cook Group Health Plan, P. O. Box 489, Bloomington, IN, 47402-0489

0656002 Core Source, P. O. Box 5190, Tampa, FL, 33675, (800) 221-8490

0406000 Coresource, 20 Washington Ave S, Minneapolis, MN, 55440

0406024 Coresource, 7830 E Broadway, Tucson, AZ, 85710, (800) 888-7202

0703001 Coresource, P. O. Box 1195, Minneapolis, MN, 55440

0703002 Coresource, 146 Industrial Park, Jackson, MN, 56143, (800) 274-6965

0703025 Coresource, P. O. Box 83301, Lancaster, PA, 17608

0703040 Coresource, P. O. Box 168, Matteson, IL, 60443, (800) 848-3012

0703045 Coresource, P. O. Box 6118, Westerville, OH, 43086





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0703070 Coresource, Shawnee Mission Pkwy 422, Shawnee Mission, KS, 06205

0703075 Coresource, P. O. Box 2310, Mt Clemens, MI, 48046-2310, (800) 521-1555

0703080 Coresource, P. O. Box 2920, Clinton, IA, 52733, (800) 223-3943

0703030 Coresource Inc, 4940 Campbell Blvd, Baltimore, MD, 21236, (410) 931-5060

0703050 Coresource Inc, 6100 Fairview Rd Ste 10, Charlotte, NC, 28210

0900013 Corning Inc Health Benefits, P. O. Box 542, Corning, NY, 14830

0737005 Corporate Benefit Service, 145 Scaley Bark, Charlotte, NC, 28220, (800) 277-9476

0737004 Corporate Benefit Services of America, P.O. Box 27267, Minneapolis, MN, 55427

0737006 Corporate Benefits of America, P. O. Box 2043, Hopkins, MN, 55343

0737008 Corporate Benefits Service, P. O. Box 981800, El Paso, TX, 79998-1800

0737001 Corporate Benefits Service Inc, P. O. Box 12954, Charlotte, NC, 28220

0698000 Corporate Benefits Services, 139 S Tryon St, Armstrong Claims Division 6th Fl, Charlotte, NC,

28202, (704) 373-0447

0737003 Corporate Benefits Systems, 139 S Tyron St, Charlotte, NC, 28202

0127004 Corporate Diversified Services, P. O. Box 2835, Omaha, NE, 68103

0737007 Corporate Health Planners Insurance, 2464 Whitney Ave, Hamden, CT, 06518

0638048 Covenant Administrators Inc, 1745 Brown Rd Ste 40, Lawrenceville, GA, 30043-8181,

(678) 258-8230

0638002 Coventry Health, P. O. Box 11038, Scottsdale, AZ, 85271, (800) 937-6824

0638003 Coventry Health, P. O. Box 27142, Baltimore, MD, 02464, (617) 581-6655

0638017 Coventry Health, P. O. Box 22410, Tucson, AZ, 85734, (800) 937-6824

0638018 Coventry Health, P. O. Box 535920, Pittsburg, PA, 15253, (800) 937-6824

0638020 Coventry Health, P. O. Box 11950, Coraopolis, PA, 15108, (800) 815-8189

0638022 Coventry Health, P. O. Box 8400, London, KY, 40742, (800) 937-6824




0638033 Coventry Health, P. O. Box 9500, Coraopolis, PA, 15108, (800) 345-8994



0208005 Coventry Healthcare, P. O. Box 7088, London, KY, 40742





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0138000 American Medical Life Insurance, P. O. Box 1235, Frederick, MD, 21702-0235

0210002 Crown Cork and Seal Co, 155 Shepard St, Lawrence, MA, 01843

0214001 Cypress Benefit Administrators, P. O. Box 7020, Appleton, WI, 54912, (877) 236-0844

0600020 Dearborn National Dental, P. O. Box 23060, Belleville, IL, 62223-0060, (800) 721-7987

0734001 Definity Health, P. O. Box 740810, Atlanta, GA, 30374, (866) 333-4648

0734002 Definity Health, P. O. Box 5317, Tampa, FL, 33675

0734003 Definity Health, P. O. Box 63905, Harrisburg, PA, 17106

0734004 Definity Health, P. O. Box 30566, Salt Lake City, UT, 84130, (866) 333-4648

0083010 Delta Care Unit, P. O. Box 9595, Boston, MA, 02124, (800) 451-1249

0046016 Delta Dental of Arizona, P. O. Box 43026, Phoenix, AZ, 85080-3026, (800) 352-6132

0064000 Delta Dental of California, P. O. Box 997330, Sacramento, CA, 95899, (888) 335-8227

0064011 Delta Dental of Colorado, P. O. Box 173803, Denver, CO, 80217

0064031 Delta Dental of Georgia, P. O. Box 1809, Alpharetta, GA, 30023, (800) 521-8700

0064013 Delta Dental of Iowa, P. O. Box 9000, Johnston, IA, 50131, (800) 544-0718

0064012 Delta Dental of Illinois, P. O. Box 5402, Lisle, IL, 60532-5436

0204010 Delta Dental of Kansas, P. O. Box 789769, Wichita, KS, 67278

0064020 Delta Dental of Kentucky, P. O. Box 242810, Louisville, KY, 40224, (800) 955-2030

0064040 Delta Dental of Missouri, P. O. Box 8690, St Louis, MO, 63126, (800) 392-1167

0064050 Delta Dental of New Hampshire, P. O. Box 2002, Concord, NH, 03302, (800) 832-5700

0064045 Delta Dental of Oklahoma, P. O. Box 548809, Oklahoma City, OK, 73154-8809, (800) 990-7337

0064015 Delta Dental of Pennsylvania, 1 Delta Dr, Mechanicsburg, PA, 17055, (800) 932-0783

0064002 Delta Dental of Rhode Island, P. O. Box 1515, Providence, RI, 02901, (401) 752-6100

0064025 Delta Dental of Virginia, 4818 Starkey Rd, Roanoke, VA, 24014, (800) 237-6060

0064005 Delta Dental of Wisconsin, P. O. Box 828, Stevens Point, WI, 54481

0064030 Delta Dental Plan of Arkansas, P. O. Box 15965, No. Little Rock, AR, 72231, (800) 462-5410

0083000 Delta Dental Plan of Massachusetts, P. O. Box 249, Thiensville, WI, 53092, (800) 872-0500

0064003 Delta Dental Plan of Michigan, P. O. Box 9085, Farmington Hills, MI, 48333, (800) 482-8915

0064014 Delta Dental Plan of Minnesota, P. O. Box 59238, Minneapolis, MN, 55459, (800) 553-9536

0064035 Delta Dental Plan of New Jersey, P. O. Box 222, Parsippany, NJ, 07054, (800) 452-9310

0064017 Delta Dental Plan of New Mexico, 2500 Louisiana Blvd NE, Albuquerque, NM, 87110,

(877) 395-9420





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0064016 Delta Dental Plan of Ohio, P. O. Box 9785, Farmington Hills, MI, 48333

0064010 Delta Dental Plan of Tennessee, 240 Vencure Circle, Nashville, TN, 37228, (800) 223-3104

0658015 Delta Health System, P. O. Box 780, Stockton, CA, 95201, (800) 418-5408

0658010 Delta USA, P. O. Box 5402, Lisle, IL, 60532, (800) 398-7203

0058015 Dental Benefit Providers, P. O. Box 30640, Bethesda, MD, 20824, (800) 445-9090

0058010 Dental Service Group, 4510 13th Ave SW, Fargo, ND, 58121

0906047 Deseret Health Care, P. O. Box 45530, Salt Lake City, UT, 84145, (800) 869-0808

0734010 Destiny Health Plan, P. O. Box 4628, Oakbrook, IL, 60522, (704) 373-0447

0634001 Diversified Administration Corp, P. O. Box 848, Buckeystown, MD, 21717-0848, (860) 295-0238

0656001 Diversified Administration Corp., P. O. Box 299, Marlborough, CT, 06447, (888) 322-2524

0656003 Diversified Group Administrators, P. O. Box 6540, Harrisburg, PA, 17112, (800) 877-6490

0215005 Doc First, P. O. Box 17098, Owings Mills, MD, 21117

0063100 Doctors Choice Administrators, P. O. Box 260, Mansfield, MA, 02048-0260, (617) 581-6655

0900003 Dow Chemical Co, P. O. Box 1701, Group Insurance Dept, Midland, MI, 48640, (989) 636-1000

0095003 Dunn and Associates TPA, P. O. Box 2369, Columbus, IN, 47202-2369, (812) 378-9960

0913000 East Boston Geriatric Services, 10 Gove St, Boston, MA, 02128

0753001 Eastern Benefits Solution, 200 Freeway Dr. E, East Orange, NJ, 07019, (800) 524-0227

0700085 Eaton Benefit Payment Office, P. O. Box 8518, London, KY, 40742

0687009 EBPA, P. O. Box 2364, S Burlington, VT, 05407, (888) 234-1011

0687007 EBS Benefit Solutions, P. O. Box 4863, Billings, MT, 59104, (406) 245-3575

0920015 Eckerd, P. O. Box 2860, Pittsburgh, PA, 15238

0614040 Electrical Workers Health and Welfare, Local 103, Boston, MA, 02122, (617) 288-5999

0696000 Emblem Health, P. O. Box 3000, New York, NY, 10116, (877) 842-3625

0615013 Emerald Health Network, P. O. Box 94808, Cleveland, OH, 44101

0027049 Empire Blue Cross Blue Shield, P. O. Box 11800, Albany, NY, 12211, (518) 367-4737

0027050 Empire Blue Cross Blue Shield, P. O. Box 5076, Middletown, NY, 10940-9076, (800) 635-2184

0027053 Empire Blue Cross Blue Shield, P. O. Box 5012, Middletown, NY, 10940, (518) 367-4737

0027064 Empire Blue Cross Blue Shield, P. O. Box 5047, Middletown, NY, 10943, (800) 635-2184

0027067 Empire Blue Cross Blue Shield, P. O. Box 420, New York, NY, 10156, (518) 367-4737

0027068 Empire Blue Cross Blue Shield, P. O. Box 1407, New York, NY, 02205-1407, (800) 261-5962





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0027071 Empire Blue Cross Blue Shield, 622 Third Ave, New York, NY, 10017, (518) 367-4737



0027091 Empire Blue Cross Blue Shield, P. O. Box 3877, Church Street Station, New York, NY, 10008-3877,

(800) 453-0113

0028003 Empire Blue Cross Blue Shield, P. O. Box 5068, Middletown, NY, 10940

0258001 Empire Healthchoice Inc, P. O. Box 4846, Syracuse, NY, 13221

0687002 Employee Benefit Administrators Inc, 64 Schoosett St, Pembroke, MA, 02359, (781) 826-1177

0830008 Employee Benefit Consultants Inc, P. O. Box 928, Findlay, OH, 45830, (419) 423-3823

0687003 Employee Benefit Management Service, P. O. Box 4000, Draper, UT, 84020, (801) 572-0720

0687006 Employee Benefit Management Service, P. O. Box 21367, Billing, MT, 59104, (315) 671-7073

0687000 Employee Benefit Plan Administration, P. O. Box 2000, Exeter, NH, 03833, (800) 578-3272

0687008 Employee Benefit Plan Administrator, P. O. Box 2365, South Burlington, VT, 05407-2365,

(888) 234-1011

0687030 Employee Benefits Claims, 440 Lincoln St, Worcester, MA, 01653

0687020 Employee Benefits Corp, 1200 E Glen Ave, Peoria Heights, IL, 61616, (309) 679-0810

0223000 Employer Resource Network, P. O. Box 9137, Fort Worth, TX, 76147

0905075 Employers Health Alliance, P. O. Box 10399, Eugene, OR, 97440

0905029 Employers Health Insurance, P. O. Box 1100, Green Bay, WI, 54344

0222002 Employer's Mutual, 326 El Bolito Ave, Glendale, CA, 91204

0001011 Entrust, P. O. Box 441588, Houston, TX, 77244, (800) 436-8787

0001004 Envision Rx Plus Standard, 2181 E Aurora Rd, Twinsburg, OH, 44087, (866) 250-2005

0630065 Epoch, P. O. Box 12170, Overland Park, KS, 66282, (913) 385-2052

0630070 Epoch, 10795 Watson Rd, St Louis, MO, 63127, (800) 365-9036

0334005 Essential Staffcare- PAI, P. O. Box 6702, Columbia, SC, 29260, (886) 798-0803

0614050 EWTS Local 26, 4601 Presidents Dr, Lanham, MD, 20706

0027051 Excellus BCBS of New York, 12 Rhoads Dr, Utica, NY, 13502, (800) 311-3536

0711000 Excellus Benefit Services, P. O. Box 13221, Syracuse, NY, 13221, (315) 448-6925

0027057 Excellus Blue Cross Blue Shield, P. O. Box 22999, Rochester, NY, 14692-2999, (800) 462-0116

0920020 Express Scripts, P. O. Box 66773, St Louis, MO, 63166, (800) 206-4005

0091005 Fallon Community Health Plan, P. O. Box 15121, Worcester, MA, 01615, (866) 275-3247





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Carrier


0230000 Farm Family Life Insurance Co, P. O. Box 656, Albany, NY, 12201, (800) 843-3276

0632010 FCE Benefit Administrators, 4615 Walzem Rd, Ste 100, San Antonio, TX, 78218, (800) 899-9355

0711001 FCE Benefit Administrators Inc, 1010 Foster City Blvd, Foster City, CA, 94404, (800) 899-9355

0027008 Federal Blue Cross Blue Shield of Montana, P. O. Box 5029, Great Falls, MT, 59403

0610070 Federal Contract Employee, 445 Recoletta Rd, San Antonio, TX, 78216

0235005 Federated HR Services, P. O. Box 850958, Richardson, TX, 75085

0235006 Federated Insurance, P. O. Box 8530, Kansas City, MO, 64114, (800) 226-5116

0900005 FedEx Freight East, P. O. Box 5007, Harrison, AR, 72602

0900010 FedEx Freight East, 419 E Main St, Middletown, NY, 10940

0920022 Finger Lakes Rx, P. O. Box 22999, Rochester, NY, 14692, (800) 724-5033

0699000 Firestone Tire and Rubber Co, 1200 Firestone Pkwy, Attn Benefits, Akron, OH, 44317

0638031 First Administrators, P. O. Box 9900, Sioux City, IA, 51102-0479

0001005 First Health Premier, 2222 Ewing Rd, Moon Township, PA, 15108, (866) 865-0662

0670030 First United American Life Insurance Co, P. O. Box 3125, Syracuse, NY, 13220, (315) 451-2544

0602004 FISERV Dental Claims, P. O. Box 8032, Wausau, WI, 54402, (877) 559-4244

0720040 Florida First Administrators Inc, 3425 Lake Alfred Rd #2, Winter Haven, FL, 33881

0631002 Florida Hospital Health Care System, P. O. Box 536847, Orlando, FL, 32853, (800) 741-4810

0920006 FL Rx Pharmacy, P. O. Box 22999, Rochester, NY, 14692, (800) 806-8811

0229000 FMH Benefit Services, P. O. Box 25946, Overland Park, KS, 66225

0254015 Foundation Benefit Administrator, 6300 Bridge Point Pkwy, Austin, TX, 78730

0247015 Fox Everett, P. O. Box 6012, Ridgeland, MS, 39158, (877) 796-7899

0717000 Fra Milicare, P. O. Box 10340, Des Moines, IA, 50306, (800) 424-1120

0901092 Frank Heller Associates, 8228 Mayfield Rd, Chesterland, OH, 44026, (800) 222-2184

0905094 Freedom Care, P. O. Box 1290, Worcester, MA, 01613

0905095 Freedom Care Health Plan, 222 Boylston St, Boston, MA, 02109

0771005 Galaxy Health Lab, P. O. Box 224767, Dallas, TX, 75222

0908067 Gallagher Benefit Administrators, P. O. Box 162721 Dept 5010, Austin, TX, 78716

0908075 Galyan's Trading Co Health Benefits, P. O. Box 39710, Colorado Springs, CO, 80949,

(317) 612-2439

0712004 GE Capital Assurance, 1650 Los Gamos Dr, San Rafael, CA, 94903

0712006 GE Group Administrators, P. O. Box 3005, Agawam, MA, 01001, (888) 255-8961





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0712010 GE Group Administrators, P. O. Box 100252, Columbia, SC, 29202

0647020 Geisinger Health Plan, P. O. Box 8200, Danville, IA, 50306, (515) 243-1776

0558000 General Dynamic Corp, 97 E Howard St, Quincy, MA, 02169

0712007 General Electric Capital Assurance Co, File 56790, Los Angeles, CA, 90074

0712005 General Electric Health Care Preferred, P. O. Box 740801, Atlanta, GA, 30374, (800) 432-3450

0712001 General Electric Pensioners, P. O. Box 6125, Utica, NY, 13504

0712015 Genworth Dental, P. O. Box 40011, Lynchburg, VA, 24506

0712000 Genworth Life Insurance Co, P. O. Box 5718, Hopkins, MN, 55343

0260000 Gerber Life Insurance Co, 204 W Main St, Freemont, MI, 49412

0126003 Gilsbar, P. O. Box 2947, Covington, LA, 70434, (800) 445-7227

0262000 Global Exchange, P. O. Box 823067, South Florida, FL, 33082

0713012 GMP Employers Retiree Trust, 5245 Big Pine Way, Ft Myers, FL, 33907, (239) 936-6242

0265000 Golden Rule Insurance Co, 712 Eleventh St, Lawrenceville, IL, 62439, (618) 943-8000

0265001 Golden Rule Insurance Co, P. O. Box 31374, Salt Lake City, UT, 84131-0374, (800) 657-8205

0266001 Government Employees Hospital Association, P. O. Box 4665, Independence, MO, 64051,

(800) 821-6136

0275020 Great West Employees Only, P. O. Box 5080, Denver, CO, 80217-5080, (866) 495-2363

0275000 Great West Health Care, 850 Concord Pkwy, Maitland, FL, 32751

0275015 Great West Healthcare, 1000 Great West Dr, Kennett, MO, 63857, (800) 441-3234

0898030 Group Administrators Ltd, 1880 N Roselle Rd, Schaumburg, IL, 60195

0632000 Group and Pension Administrators, P. O. Box 749075, Dallas, TX, 75374-9075, (866) 206-3224

0898050 Group Benefit Services, P. O. Box 4368, Lutherville, MD, 21094, (800) 638-6085

0898051 Group Benefit Services, 1736 E Sunshine, Springfield, MO, 65804, (800) 995-3569

0906070 Group Dental Benefits, P. O. Box 1477, Greenfield, MA, 01302, (800) 451-2513

0600090 Group Health Insurance, P. O. Box 2832, New York, NY, 10116, (800) 624-2414

0696050 Group Health Plan, P. O. Box 7374, London, KY, 40742

0700081 Group Insurance Service Center, P. O. Box 9120, Marshfield, MA, 02050, (800) 242-3834

0696005 Group Management Services, P. O. Box 24708, Omaha, NE, 68124

0696030 Group Resources Inc, P. O. Box 100043, Duluth, GA, 30096, (770) 242-7776

0280008 Guardian, P. O. Box 8019, Appleton, WI, 54913, (920) 749-9200

0280035 Guardian, P. O. Box 9128, Norwell, MA, 02061, (800) 524-4542





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0280033 Guardian Dental, P. O. Box 2459, Spokane, WA, 99210, (800) 541-7846

0280009 Guardian Insurance, P. O. Box 8007, Appleton, WI, 54912, (800) 873-4542

0280032 Guardian Life, P. O. Box 8024, Appleton, WI, 54912, (800) 695-4542

0280000 Guardian Short Term Disability, P. O. Box 26160, Lehigh Valley, PA, 18002, (800) 268-2525

0279001 Guarantee Trust Life, P. O. Box 1144, Glenview, IL, 60025-8144, (866) 851-0284

0692001 Hallmark Health Advantage, 100 Hospital Rd, Malden, MA, 02148

0640000 Harborside Healthcare, P. O. Box 4925, Lancaster, PA, 17604, (800) 235-9562

0863002 Harrington Benefit Services Inc, P. O. Box 730, Pueblo, CO, 81002, (800) 446-8182

0876020 Harrington Benefit Services Inc, P. O. Box 1394, Duncan, OK, 73534, (800) 527-4296

0602000 Harrington Health, P. O. Box 30544, Salt Lake City, UT, 84130-0544, (800) 235-7160

0562000 Hartford Insurance, P. O. Box 1000, Shelton, CT, 06484

0562004 Hartford Insurance, P. O. Box 11910, Alexandria, VA, 22312

0092000 Harvard Pilgrim Health Care, P. O. Box 699183, Quincy, MA, 02269, (800) 676-2769

0564000 Harvard University, 1350 Massachusetts Ave, Cambridge, MA, 02138

0723050 HCC Life Insurance Company, P. O. Box 6222, Indianapolis, IN, 46206

0723055 HCCMIS- Core Care, P. O. Box 863, Indianapolis, IN, 46206, (800) 872-0067

0623000 HCH Administrators, P. O. Box 1986, Peoria, IL, 61656, (800) 447-3227

0814035 Health America Penn Inc, P. O. Box 7088, London, KY, 40742-7088, (800) 788-6445

0814003 Health and Welfare, P. O. Box 64, Lexington, MA, 02173

0614006 Health and Welfare Fund, 40 Commercial Way, The London Administrators, East Providence, RI,

02914, (800) 343-2236

0614090 Health and Welfare Fund, 140 Wood Rd, Braintree, MA, 02184

0894015 Health Care Savings, 4530 Park Rd, Charlotte, NC, 28209, (828) 684-3800

0854000 Health Choice, 164 High St, Greenfield, MA, 01301

0618020 Health Comp, P. O. Box 45018, Fresno, CA, 93718

0126005 Health Cost Solutions, P. O. Box 1439, Hendersonville, TN, 37077

0098010 Health Eos, P. O. Box 6090, De Pere, WI, 54115

0615003 Health First Health Plan Inc, P. O. Box 410129, Melbourne, FL, 32941

0638040 Health First Senior Plan, 25 Broadway 9th FL, New York, NY, 10041-1010

0615020 Health First TPA, P. O. Box 130217, Tyler, TX, 75713

0288045 Health Links, P. O. Box 149104, St Louis, MO, 63141





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0631000 Health Management Advisor, P. O. Box 260, Mansfield, MA, 02048, (888) 803-6188

0814079 Health Markets Care Assured, P. O. Box 69349, Harrisburg, PA, 17110-9349, (877) 219-5458

0288026 Health Net, P. O. Box 14700, Lexington, KY, 40512, (800) 861-7214

0001006 Health Net Orange Option 1, 950 N Finance Center Dr, Tucson, AZ, 85710, (800) 806-8811

0920007 Health Net Orange Pharmacy, P. O. Box 1054, Rancho Cordova, CA, 95670

0818001 Health Net Pearl, P. O. Box 2226, Augusta, GA, 30903-2226, (800) 644-8221

0817005 Health Network America, P. O. Box 307, Eaton Town, MN, 55440

0901041 Health New England, One Monarch Place, Springfield, MA, 01144, (413) 787-4000

0288030 Health Partners, P. O. Box 5194, New York, NY, 10185, (215) 849-9606

0288070 Health Partners, P. O. Box 1289, Minneapolis, MN, 55440-01289, (800) 883-2177

0906081 Health Partners, P. O. Box 750, Minneapolis, MN, 55440-750, (800) 883-2177

0700090 Health Plan Nevada, P. O. Box 15645, Las Vegas, NV, 89114, (702) 242-7300

0700013 Health Plan Select, P. O. Box 382767, Birmingham, AL, 35238, (800) 293-6260

0288055 Health Plans Aces Life, P. O. Box 628, St Louis, MO, 63188

0288035 Health Plans Inc, P. O. Box 5199, Westborough, MA, 01581, (508) 752-2480

0817000 Health Risk Management, P. O. Box 1479, Eatontown, NJ, 07724, (800) 332-7772

0288075 Health Scope Benefits, P. O. Box 8074, Little Rock, AR, 72203

0631003 Health Smart, P. O. Box 83670, Lubbock, TX, 79493-3670, (866) 761-6298

0439006 Health Source, P. O. Box 180149, Farmington, CT, 06034, (860) 674-5700

0439031 Health Source, P. O. Box 190023, N Charleston, SC, 21419

0291015 Health Span, 4373 Harrison Blvd, Cincinnati, OH, 43211

0288020 Healthnet, P. O. Box 7090, Bridgeport, CT, 06601

0614076 Healthnet, P. O. Box 2226, Augusta, GA, 30903-2226, (800) 977-8221

0288025 Healthnet PPO, P. O. Box 10223, Van Nuys, CA, 91410, (800) 641-7761

0001007 Healthspring Prescription Drug Plan, 44 Vantage Way, Nashville, TN, 86684, (866) 845-6941

0814051 Heavy and General Laborers, Local 472 and 172, Newark, NJ, 07105

0953010 Heller Associates, 8288 Mayfield Rd, Chesterland, OH, 44026, (800) 552-2929

0028010 Highmark Blue Cross Blue Shield of Pennsylvania, P. O. Box 1210, Pittsburgh, PA, 15230,

(800) 241-5703

0028001 Highmark Blue Shield, P. O. Box 890062, Pittsburgh, PA, 17089-0062, (866) 362-6116

0028014 Highmark Blue Shield, P. O. Box 890173, Camp Hill, PA, 17089-0173, (800) 345-3806





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Carrier


0758000 Hillcrest Community Health Plan, 1201 Troy Rd, Latham, NY, 12110

0900095 Hinchclift International, 11 Ascot Place, Ithaca, NY, 14850

0287002 Hip Health Insurance Plan, P. O. Box 2803, New York, NY, 10116-2803, (800) 447-8275

0639002 HM Benefit Administrators, P. O. Box 535078, Pittsburgh, PA, 15253

0638005 HMA Direct, P. O. Box 425, Newton Upper Falls, MA, 21230

0618005 HMC, P. O. Box 488, Farmington, CT, 06031

0292000 Home Life Insurance Co, 253 Broadway, New York, NY, 10007

0292010 Home Life Insurance Co of New York, P. O. Box 956353, Duluth, GA, 30136

0292020 Hometown Health Plan, 100 Lillian Gish Blvd, Massillon, OH, 44647

0028029 Horizon Blue Cross Blue Shield, P. O. Box 22439, Newark, NJ, 01701, (800) 624-1110

0028033 Horizon Blue Cross Blue Shield of New Jersey, P. O. Box 1609, Newark, NJ, 07101, (800) 414-7427

0028036 Horizon Blue Cross Blue Shield of New Jersey, P. O. Box 247, Dept V - PPO, Newark, NJ,

07101-0247, (800) 624-1110

0028042 Horizon Blue Cross Blue Shield of New Jersey, P. O. Box 1219, Newark, NJ, 071011219,

(800) 676-2583

0291010 Horizon Health Care of New York, P. O. Box 79, Newark, NJ, 07101

0814014 Hospital and Health Care Workers, 330 W 42nd St, New York, NY, 10036

0619000 Hospital Benefits Inc, P. O. Box 162148, Altamonte Springs, FL, 32716, (407) 862-0311

0700006 HPS Paradigm, P. O. Box 1268, Tifton, GA, 31793, (229) 386-1751

0900089 HRM Claim Management Inc, P. O. Box 4089, Upjohn Claims, Kalamazoo, MI, 49003

0902014 Hub Folding Box, 774 Norfolk St, Mansfield, MA, 02048

0886000 Humana Care Plus, P. O. Box 2180, Louisville, KY, 40202

0886001 Humana Care Plus, P. O. Box 19080F, Jacksonville, FL, 33245

0886005 Humana Claims, P. O. Box 14610, Lexington, KY, 40512, (800) 558-4444

0886002 Humana Dental, 1100 Employers Blvd, Green Bay, WI, 54344, (800) 233-4013

0886010 Humana Dental, P. O. Box 14611, Lexington, KY, 40512, (800) 955-0783

0001008 Humana PDP Complete, 500 W Main St, Louisville, KY, 40202, (800) 281-6918

0614018 IBEW Local 103, 256 Freeport St, Second Floor, Dorchester, MA, 02122, (800) 564-5999

0568001 Idealife Insurance Company, P. O. Box 12546, Pensacola, FL, 32591

0295000 IDS Life Insurance Co, Ids Tower 10, Minneapolis, MN, 55440

0701003 Indecs, P. O. Box 435, East Rutherford, NJ, 07073, (201) 460-3200





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Carrier


0905040 Indecs, 1099 Wall St W, P. O. Box 668, East Rutherford, NJ, 07073, (201) 460-3200

0028096 Independence BCBS of Pennsylvania, P. O. Box 69352, Harrisburg, PA, 17106-9352, (800) 676-2583

0028056 Independence Blue Cross Blue Shield of Pennsylvania, 1901 Market St, Philadelphia, PA, 19103,

(880) 227-3199

0028107 Independence Blue Cross Blue Shield of Pennsylvania, P. O. Box 1010, Horsham, PA, 19044,

(888) 356-7899

0204009 Independent Administrators, P. O. Box 1010, Horsham, PA, 19044-8010, (888) 356-7899

0300020 Independent Health, P. O. Box 1430, Buffalo, NY, 14231, (877) 593-3250

0650045 Insurance Trust For Delta Retirees, P. O. Box 10432, De Moines, IA, 50306, (877) 325-7265

0126004 Insurers Administrative Corp, P. O. Box 828, Parkridge, IL, 60068

0953015 Integra Administrative Group, 110 S Shipley St, Seaford, DE, 19973, (800) 959-3518

0304000 Inter Americas Insurance Corp, P. O. Box 9510, Wichita, KS, 67277, (316) 794-2200

0910000 Inter Plan Health Group, P. O. Box 6743, Lubbock, TX, 79493, (800) 903-2098

0832040 Interactive Corp, P. O. Box 567, Farmington, CT, 06034

0830005 Interactive Medical Systems, P. O. Box 1349, Wake Forest, NC, 27588, (919) 877-9933

0305002 Intercounty Hospital Plan, 720 Blair Mill Rd, Horsham, PA, 19044, (800) 492-2385

0307010 International Benefit Administration, 7083 Grand National Dr, Orlando, FL, 32819

0895006 International Benefits Services, P. O. Box 996, Fort Worth, TX, 76101

0307003 International Medical Group, P. O. Box 88500, Indianapolis, IN, 46208-0500, (800) 628-4664

0828001 International Total Services Benefit Admin, 5005 Rockside Rd, Cleveland, OH, 44131

0701080 Ironclad, 161 Granite Ave, Dorchester, MA, 02124, (617) 436-3500

0614007 Ironworkers Union Local 7, 100 Charles River Plaza, Brighton, MA, 02135

0310010 ITPE Health Welfare Fund, P. O. Box 13817, Savannah, GA, 31416, (912) 352-7169

0614001 IUNH Health and Welfare, 1101 N Lake Destiny Rd, Maitland, FL, 32751

0614041 IUOE Local #4 Health and Welfare, 177 Bedford St, Lexington, MA, 02173, (781) 861-1600

0630010 J F Molloy and Associates, P. O. Box 68947, Indianapolis, IN, 46268, (800) 331-3287

0638000 James Galbraith and Green, 757 E South Temple, Salt Lake City, UT, 85271, (800) 937-6824

0709000 Jefferson Pilot, P. O. Box 20727, Greensboro, NC, 27420

0709005 Jefferson Pilot Dental, P. O. Box 2670, Omaha, NE, 68103, (800) 441-4518

0709004 Jeld Wen Shanta Administrators, P. O. Box 1747, Redmond, OR, 97756, (800) 423-2765

0719004 Jesuit Health Trust, 1205 Windham Pkwy, Romeoville, IL, 60446





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0895035 JM Family Enterprise, 8019 Bayberry Rd, Jacksonville, FL, 32256

0313003 John Alden, P. O. Box 981652, El Paso, TX, 79998, (800) 328-4316

0313005 John Alden Life Insurance, P. O. Box 4243, Woodland Hills, CA, 91365

0314000 John Deere Insurance Co, 3800 Avenue of the Cities, Moline, IL, 61265, (800) 747-1446

0315038 John Hancock, P. O. Box 2074, Aurora, IL, 60507

0315042 John Hancock, P. O. Box 9186, Braintree, MA, 02184

0315058 John Hancock, P. O. Box 4034, Schaumburg, IL, 60168

0315072 John Hancock Financial Services, P. O. Box 3010, Andover, MA, 01810

0315025 John Hancock Insurance, P. O. Box 833898, Richardson, TX, 75083

0315000 John Hancock Mutual Life Insurance Co, P. O. Box 111, Boston, MA, 02117

0315001 John Hancock Mutual Life Insurance Co, P. O. Box 4000, Braintree, MA, 02184

0315004 John Hancock Mutual Life Insurance Co, P. O. Box 4061, Schaumburg, IL, 60168

0315010 John Hancock Mutual Life Insurance Co, 399 Taylor Rd, Pleasant Hill, CA, 94523

0315012 John Hancock Mutual Life Insurance Co, P. O. Box 8515, Exxon Claims, London, KY, 47042

0315013 John Hancock Mutual Life Insurance Co, P. O. Box 4005, Schaumberg, IL, 60168

0315021 John Hancock Preferred Health Plan, P. O. Box 9115, Braintree, MA, 02184

0900069 John T Riley, P. O. Box 356, West Boylston, MA, 01583

0895015 JP Farley, P. O. Box 268000, Cleveland, OH, 44126

0762010 Kaiser Permanente, P. O. Box 190849, Atlanta, GA, 31119

0762015 Kaiser Permanente, P. O. Box 370897, Denver, CO, 80237, (800) 382-4661

0762020 Kaiser Permanente, P. O. Box 12923, Oakland, CA, 94604, (800) 464-4000

0910014 Kanawha Employee Benefit, P. O. Box 8050, Lancaster, SC, 29721, (800) 635-4252

0895010 Kepple and Company Inc, P. O. Box 1986, Peoria, IL, 61656

0318020 Key Benefit Administrators, P. O. Box 55210, Indianapolis, IN, 46205, (800) 871-2335

0318000 Keystone Provident Life Insurance Co, 99 High St, Boston, MA, 02105

0316000 Klais Company, 1867 W Market St, Akron, OH, 44313, (800) 331-1096

0888010 KPS Health Plans, P. O. Box 339, Bremerton, WA, 98337, (800) 552-7114

0900093 Lab Corp, P. O. Box 3137, Scottsdale, AZ, 85271

0615066 Laborers Local 1298, P. O. Box 309, Fulton, NY, 13069, (516) 489-3644

0814056 Laborers National, P. O. Box 1100, Columbia, MD, 21044





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Carrier


0620013 LAV Dental Security Life, 701 Highlander Blvd, Arlington, TX, 76015

0700077 Leggett and Platt Company, P. O. Box 757, Carthage, MO, 64836, (417) 358-8131

0320000 Liberty Life Assurance Co Boston, 175 Berkeley St, Boston, MA, 02117

0322011 Liberty Mutual, P. O. Box 9004, Central Islip, NY, 11722

0701025 Life Wise Health Plan, P. O. Box 7709, Bend, OR, 97708, (800) 777-1502

0331002 Lincoln Financial Group Dental, P. O. Box 2640, Omaha, NE, 68103-2640, (800) 423-2765

0331000 Lincoln National Life Insurance Co, 1300 S Clinton St, Fort Wayne, IN, 46801

0615041 Lineco IBEW Local 322, 2000 Springer Dr, Lombard, IL, 60148, (800) 323-7268

0614027 Local 371 United Food and Commercial Workers, 290 Post Rd W, Westport, CT, 06881

0614022 Local 4 Health and Welfare, P. O. Box 4, Lexington, MA, 02420, (781) 861-1600

0633001 London Health Administration, 40 Commercial Way, East Providence, RI, 02914, (800) 343-2236

0840050 Longview Fibre Company, 1220 SW Morrison, Portland, OR, 97205, (503) 224-0048

0334001 Loomis Company, P. O. Box 7011, Wyomissing, PA, 19610, (610) 374-4040

0336002 Lovelace Insurance Company, P. O. Box 30536, Salt Lake City, UT, 84130-0536, (877) 277-7280

0337010 Lumenos, P. O. Box 69309, Harrisburg, PA, 17106

0701002 Machigonne Benefit Administrators, P. O. Box 3859, Portland, ME, 04104, (800) 245-3529

0650006 Macy's HR Services, P. O. Box 850958, Richardson, TX, 75085, (800) 337-2363

0614045 Magna Preferred, 158-11 Harry Vanarsdale, Flushing, NY, 11365

0528007 Magnacare, P. O. Box 1001, Garden City, NJ, 11530, (800) 352-6465

0609002 Mail Handlers Benefit Plan, P. O. Box 8402, London, KY, 40742, (800) 410-7778

0895008 Maine Sense, P. O. Box 9780, Portland, ME, 04103, (800) 348-9804

0908044 Managed Benefit Plan, P. O. Box 744, Hackettstown, NJ, 07840

0895002 Managed Care Concepts, 900 Haddon Ave, Collingswood, NY, 08108

0630000 Managed Care Strategies Network, 1 E Uwchlan Ave, Exton, PA, 19341

0908045 Managed Health Funding, P. O. Box 1148, Jacksonville, FL, 32229, (304) 346-0611

0095004 Managed Health Network, 2019 Aerojet Road, Rancho Cordova, CA, 95742, (800) 327-2133

0895011 Martins Point, P. O. Box 9746, Portland, ME, 04104-5040, (888) 732-7364

0650050 Mashantucket Plan Administrators, P. O. Box 3620, Mashantucket, CT, 06339, (888) 779-6872

0650007 Maskin Management, P. O. Box 2525, Camden, NJ, 08101, (866) 796-7899

0614021 Mason Health and Welfare Local 534, 7 Frederika St, Dorchester, MA, 02145





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Carrier


0614004 Mass Laborer S Health and Welfare Found, P. O. Box 4000, Burlington, MA, 01803, (781) 272-1000

0348014 Mass Mutual, 35 Circle Park, Austin, TX, 78753

0348020 Mass Mutual, 1320 Willard Road, Concord, CA, 94520

0348025 Mass Mutual, P. O. Box 90190, Springfield, MA, 01139

0348018 Mass Mutual Life Ins, P. O. Box 9048, Springfield, MA, 01151

0348003 Mass Mutual Life Insurance, P. O. Box 60004, City of Industry, CA, 91716

0800000 Masters Mates & Pilots Health & Benefit Plan, 700 Maritime Blvd, Linthicum Heights, MD, 21090,

(410) 850-8500

0095000 Matthew Thornton Health Plan, P. O. Box 9514, Manchester, NH, 03108

0614013 Maxon Local 210, P. O. Box 606, Neversink, NY, 12765, (800) 762-3137

0691035 MCrew Care Planned Administrators, P. O. Box 6702, Columbus, SC, 29260

0771000 MEBA, 1007 Eastern Ave, Baltimore, MD, 21203

0643011 Med Ben Dental, P. O. Box 1099, Newark, OH, 40358

0349020 Med Pay Inc, P. O. Box 10909, Springfield, MO, 65808

0643000 MedTac, P. O. Box 9110, Newton, MA, 02460, (617) 244-0222

0643010 MedBen, P. O. Box 2090C, Stow, OH, 44224, (800) 423-3151

0895005 Medco Behavioral Care Service, 6 Bedford Farms, Bedford, NH, 03110

0920010 Medco Health Solutions Inc, P. O. Box 14711, Lexington, KY, 40512

0895030 Medco Value Plus, 7083 Grand National Dr, Orlando, FL, 32819

0004001 Medco Your Rx Plan, P. O. Box 630246, Irving, TX, 75063, (800) 758-4574

0632501 Medcost Benefit Services, P. O. Box 25987, Winston-Salem, NC, 27114, (800) 852-7040

0693050 Medica Choice United Health Care, P. O. Box 30990, Salt Lake City, UT, 84130-0990,

(800) 952-3455

0905086 Medical Benefit Administrators, P. O. Box 1401, Abington, MD, 21009, (800) 547-4457

0600015 Medical Card System, P. O. Box 9023547, San Juan, PR, 00902

0622000 Medical Claims Service Inc, One Wall St, Ste 2A, Ravenswood, WV, 26164, (304) 273-5384

0622015 Medical Claims Services, 100 River Ridge Dr, Norwood, MA, 02062

0027007 Medical Mutual of Ohio, P. O. Box 6018, Cleveland, OH, 44101

0349000 Medico Life Insurance, 1515 S 75th St, Omaha, NE, 68124, (800) 228-6080

0816001 Mediplan, 502 Valley Rd, Wayne, NJ, 07470, (973) 696-3111

0349080 Medspan Inc, P. O. Box 340950, Hartford, CT, 06134, (860) 541-6789





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Carrier


0843040 Mega Life and Health Insurance Co, P. O. Box 98160, El Paso, TX, 79998-1606, (800) 527-2845

0843035 Mega Life Dental, P. O. Box 952009, N Richland Hills, TX, 76182

0843045 Mega Life Student Insurance, P. O. Box 809025, Dallas, TX, 75380, (800) 767-0700

0816005 Mennonite Mutual Aid Associates, P. O. Box 483, Goshen, IN, 46527, (574) 533-9511

0895012 Merit Behavior Care, P. O. Box 2188, Maryland Heights, MI, 63043

0397035 Meritain Health, 1000 Great West Dr, GWH-Cigna, Kennett, MO, 63857-3749, (866) 629-4551

0397031 Meritain Health Insurance, P. O. Box 27267, Minneapolis, MN, 55427-0267, (800) 922-2272

0397030 Meritain Health Insurance, P. O. Box 853921, Richardson, TX, 75085, (800) 423-6011

0351003 Met Life Dental, P. O. Box 981282, El Paso, TX, 79998, (800) 942-0854

0488017 Metrahealth United Healthcare, P. O. Box 26722, Greensboro, NC, 27417

0351036 Metro, P. O. Box 30195, Tampa, FL, 33630

0351041 Metro, P. O. Box 470, Warwick, RI, 02887

0351047 Metro Dental Claims, P. O. Box 460, Warwick, RI, 02887, (800) 556-3490

0351029 Metro Insurance Co, P. O. Box 495, Warwick, RI, 02887, (401) 828-2000

0351021 Metropolitan, 615 E Michigan St, Milwaukee, WI, 53802

0351027 Metropolitan, 99 High St, Boston, MA, 02111

0351034 Metropolitan, P. O. Box 468, Warwick, RI, 30374, (877) 842-3210

0351083 Metropolitan, P. O. Box 450, Warwick, RI, 02887

0351086 Metropolitan, P. O. Box 6017, Newark, DE, 19714

0351090 Metropolitan, P. O. Box 2078, Aurora, IL, 60507

0351060 Metropolitan Health Insurance, P. O. Box 2950, Inglewood, CO, 80110

0351061 Metropolitan Health Insurance, 960 Main St, Hartford, CT, 26115

0351032 Metropolitan Ins Co, P. O. Box 7777, Utica, NY, 13504

0351075 Metropolitan Life, P. O. Box 1922, Indianapolis, IN, 46206

0351092 Metropolitan Life, P. O. Box 3012, Utica, NY, 13504, (800) 300-4296

0351088 Metropolitan Life Dental Claims, P. O. Box 2579, Pittsburgh, PA, 15230

0351053 Metropolitan Life Ins Co Group Claims, P. O. Box 469, Warwick, RI, 02886

0351000 Metropolitan Life Insurance Co, 1 Madison Ave, New York, NY, 10010, (800) 848-8406

0351002 Metropolitan Life Insurance Co, P. O. Box 30430, Tampa, FL, 33630

0351006 Metropolitan Life Insurance Co, Oneida County Industrial Park, C/O Kanawha, Lancaster, SC, 29721





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Carrier


0351007 Metropolitan Life Insurance Co, 700 Quaker Ln P. O. Box 300, Warwick, RI, 02887

0351012 Metropolitan Life Insurance Co, 9797 Springboro Pike, Dayton, OH, 45448, (800) 260-1093

0351015 Metropolitan Life Insurance Co, Building 14 The Atrium, Philadelphia, PA, 19101

0351045 Metropolitan Life Insurance Co, P. O. Box 969, Latham, NY, 12110

0351050 Metropolitan Group Dental Claims, P. O. Box 5200, Greenville, SC, 29606

0354000 Michigonne Benefit Administrators, P. O. Box 3859, Portland, ME, 04104, (800) 245-3529

0348040 Mid Atlantic Medical Services MAMSI, P. O. Box 930, Frederick, MD, 21705

0908025 Midwest Security, P. O. Box 266, Onalaska, WI, 54650-0226

0357010 Midwest National Life Insurance Co, P. O. Box 982017, North Richland Hills, TX, 76182,

(800) 733-8880

0901042 Minuteman Health, One Monarch Place, Ste 1500, Springfield, MA, 01144, (855) 644-1776

0703000 MIT Health Plan, 77 Massachusetts Ave, Cambridge, MA, 02139

0606000 MMSI, 4401 41st St NW, Rochester, MN, 55901, (877) 832-1822

0701041 Mohawk Valley Health Plan, P. O. Box 1434, Schenectady, NY, 12301

0700037 Montachussett Health Plan, 285 Central St, Leominster, MA, 01453

0362010 Monumental Insurance, P. O. Box 97, Scranton, PA, 78504

0650008 Monumental Life, Attn Claims, Valley Forge, PA, 19493, (800) 523-7900

0362004 Monumental General Insurance, 1111 N Charles, Baltimore, MD, 21201

0741000 Morton Building Employee Health, P. O. Box 232, Morton, IL, 61550

0900098 Motel 6, P. O. Box 809092, Claims Processing, Dallas, TX, 75380

0905028 Motorola, P. O. Box 29005, Phoenix, AZ, 85038, (800) 421-3973

0171020 Mountain States Administration Services, P. O. Box 98163, El Paso, TX, 79998-1693,

(800) 866-4731

0028104 Mountain States Blue Cross Blue Shield, P. O. Box 7026, Wheeling, WV, 26003, (800) 654-5028

0098000 Multi Group Health Plan, 20 Walnut St, Wellesley, MA, 02181

0204004 Mutual Assurance Administrators, P. O. Box 42096, Oklahoma City, OK, 73123-3096,

(800) 825-3540

0366001 Mutual of Omaha, Mutual of Omaha Plaza, Omaha, NE, 68175, (800) 316-7518

0366004 Mutual of Omaha, 6301 Ivy Lane 100, Greenbelt, MD, 20770

0366005 Mutual of Omaha, 1160 Bay St, Springfield, MA, 01109

0366006 Mutual of Omaha, P. O. Box 9, Woodward, OK, 73802





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Carrier


0366011 Mutual of Omaha, P. O. Box 668329, Charlotte, NC, 28266

0367010 Mutual Protective Medico Life, P. O. Box 3735, Omaha, NE, 68103

0606002 MVP Select Care Inc, 111 Liberty St, Schenectady, NY, 12301, (800) 666-1762

0606004 MVP Select Care Inc, P. O. Box 1434, Schenectady, NY, 12301

0021000 NAHGA Inc, 303 Amherst St, Ste 9, Nashua, NH, 03063, (800) 920-4456

0621000 Nat Ben Fund Local 1199, P. O. Box 1007, New York, NY, 10108-1007

0609003 National Association of Letter Carriers, Cigna/NALC, P. O. Box 18004, Chattanooga, TN,

37442-8004, (888) 632-6252

0609005 National Association of Letter Carriers, 20547 Waverly Court, Ashburn, VA, 20149, (888) 636-6252

0611002 National Association of Self Employed, 41 N Summer St, Holyoke, MA, 01042

0905080 National Automatic Sprinkler Self Insured, 800 Corporate Dr, Landover, MD, 20785

0372000 National Benefit Life Insurance Co, JAF Box 2366, New York, NY, 10116, (800) 252-4611

0600060 National Benefit Plans, P. O. Box 1817, Suffolk, VA, 23439, (757) 923-3400

0681001 National Benefits Inc, P. O. Box 263, Parsippany, NJ, 07054, (800) 258-0103

0891038 National Claims Administrative Service, 7083 Grand National Dr, Orlando, FL, 32819

0891037 National Claims Administrative Service, P. O. Box 10104, Fairfax, VA, 22030, (866) 662-4084

0371000 National Elevator Industry, P. O. Box 477, Newtown Square, PA, 19073, (800) 221-2554

0374000 National Financial Insurance, 110 W 7th St, Fort Worth, TX, 76102, (800) 725-1407

0376003 National Health Insurance, P. O. Box 619999, Dallas/Ft. Worth Airport, TX, 75261, (800) 237-1900

0030002 National States Insurance, 1830 Craig Park Court, Ste 100, St Louis, MO, 63146, (800) 868-6788

0574003 National Union Fire, 466 Totten Pond Rd, Waltham, MA, 02401

0384041 Nationwide Specialty NHP, P. O. Box 420, Springfield, MA, 01101-0420, (800) 517-4791

0910010 Neighborhood Health Plan, 253 Summer St, Boston, MA, 02110, (855) 444-4647

0910012 Neighborhood Health Plan of Rhode Island, 50 Holden St, Providence, RI, 02908

0951000 Network Health Extend, P. O. Box 390310, Cambridge, MA, 02139, (888) 257-1985

0614011 New England Carpenters Health and Welfare, P. O. Box 7075, Wilmington, MA, 01887,

(978) 694-1000

0058020 New England Dental Administrators, P. O. Box 2006, Concord, NH, 03302

0615024 New England Electrical Worker's Benefits, P. O. Box 5817, Wallingford, CT, 06492, (800) 832-6538

0615026 New England Health Care Welfare Fund, 77 Huyshope Ave, Hartford, CT, 06106, (860) 728-1100

0614043 New England Laundry Workers Insurance, 697 Broadway, Somerville, MA, 02144





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0614024 New England Teamsters, P. O. Box 38, North Andover, MA, 01845, (978) 682-7407

0697050 New Tribes Mission, 1000 E First St, Sanford, FL, 32771

0810012 New World Claims Service, 2624 N 5th St, Niles, MI, 49120, (781) 762-5511

0390009 New York Life, P. O. Box 92449, Chicago, IL, 60675

0390035 New York Life, 8834 Capital of Texas Highway, Austin, TX, 78759, (800) 723-5555

0390000 New York Life Insurance Co, 3316 Farnam St, Omaha, NE, 68175

0390001 New York Life Insurance Co, P. O. Box 64022, Phoenix, AZ, 85082

0390005 New York Life Insurance Co, 420 Lexington Ave, New York, NY, 10170, (646) 227-8888

0390012 New York Life Insurance Co, 51 Madison Ave, New York, NY, 10010

0390020 New York Life Insurance Co, P. O. Box 30769, Jamaica, NY, 11430

0390016 New York State Health Plan, P. O. Box 1600, Kingston, NY, 12402-1600, (877) 769-7447

0906020 NGS Coresource, P. O. Box 2310, Mount Clemens, MI, 48046, (800) 521-1555

0393030 Nippon Life Co of America, P. O. Box 39710, Colorado Springs, CO, 80949, (800) 937-6542

0731000 North America Administrators, P. O. Box 11984, Nashville, TN, 37202, (800) 411-3650

0397001 North America Life and Casualty, Med Claims Services, Boston, MA, 02111

0893000 North Shore Health Plan, 1 Essex Cir Dr, Peabody, MA, 01960

0893010 North Shore Health System, P. O. Box 4445, Salem, MA, 01970, (978) 825-7085

0722000 Northeast Delta, 6 London St, Concord, NH, 03301

0095001 Northern New England Benefit Trust, P. O. Box 4604, Manchester, NH, 03105, (800) 258-9732

0405002 Northwest National Life, P. O. Box 5222, Norwalk, CT, 06856

0406001 Northwestern National, 180 Greenleaf Ave, Portsmouth, NH, 03801

0406006 Northwestern National Life, P. O. Box 2264, Tacoma, WA, 98401

0610010 NPPN, P. O. Box 7047, Middletown, NY, 10940, (800) 582-8547

0705038 ODS Delta Dental of Oregon, 601 SW 2nd Ave, Portland, OR, 97204-3154, (877) 277-7280

0688055 ODS Health Plan Inc, P. O. Box 40384, Portland, OR, 97240, (800) 452-1058

0910060 Olympus Managed Health Care, 777 Brickell Ave, Miami, FL, 33131

0614066 Operating Engineers Health and Welfare, P. O. Box 217, East Longmeadow, MA, 01028

0614037 Operating Engineers Local 302, P. O. Box 34684, Seattle, WA, 98124

0095006 Optima, P. O. Box 5028, HOV Systems Inc, Troy, MI, 48607-5028, (800) 275-3755

0095008 Optum Rx, P. O. Box 29044, Hot Springs, AR, 71903-9044, (877) 559-2955





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Carrier


0414002 Oxford Health Plan, P. O. Box 7082, Bridgeport, CT, 06601, (800) 444-6222

0414003 Oxford Health Plan, P. O. Box 2083, Nashua, NH, 03061

0414000 Oxford Life Insurance Co, 2721 N Central Ave, Phoenix, AZ, 85004, (888) 757-3732

0414001 Oxford Life Insurance Co, P. O. Box 46518, Madison, WI, 53744, (877) 469-3073

0693001 P5 Electronic Health Services, P. O. Box 9554, Salt Lake City, UT, 84109, (800) 551-4049

0414040 PACC Health Plans, P. O. Box 1707, Clackamas, OR, 97015

0844050 Pacific Atlantic Administrators, P. O. Box 7407, San Francisco, CA, 94120

0415050 Pacific Coast Administration Inc., 2100 W Orangewood Ave, Orange, CA, 92668

0416001 Pacific Fidelity Insurance Co, P. O. Box 1038, Hurst, TX, 76053

0418006 Pacific Life and Annuity Company, P. O. Box 34799, Phoenix, AZ, 85067, (800) 733-2285

0418002 Pacific Mutual, 100 W Clarendon, Phoenix, AZ, 85026

0894010 Pacific Source Health Plans, P. O. Box 7068, Eugene, OR, 97401, (541) 684-5582

0899003 PacifiCare, P. O. Box 30972, Salt Lake City, UT, 84130, (866) 316-9776

0615012 Painters District Council Local 35, P. O. Box 9165, Care Link Claims, Watertown, MA, 02471

0615010 Painting Industry, 8257 Dow Circle, Strongsville, OH, 44136

0910030 Pan American Life Insurance, P. O. Box 99007, Lubbock, TX, 79490-9007, (877) 569-3075

0646005 Paradigm, P. O. Box 1268, Tiston, GA, 31793

0421015 Patriot Health Care, 35 Industrial Way, Exeter, NC, 28220

0280034 Penn Treaty Network, P. O. Box 130, Pensacola, FL, 32591-0130, (800) 635-7418

0425020 Pennsylvania Employee Benefit Trust, 150 S 43rd St, Harrisburg, PA, 11711, (717) 561-4750

0378000 Peoples Benefit Life Insurance Co, Claims Dept, Valley Forge, PA, 19493, (610) 648-5000

0659016 Perfect Health, P. O. Box 140724, Staten Island, NY, 10314-0724, (718) 370-5380

0640111 Performax, P. O. Box 1065, Amherst, NY, 14226, (800) 283-9538

0641010 Performax, P. O. Box 61505, King of Prussia, PA, 19406, (888) 554-7629

0113000 Personalcare Health Management, 2110 Fox Dr, Champaign, IL, 61820, (800) 562-5792

0833000 Philadelphia America Life, 100 N 6th St Ste 800, Waco, TX, 76701

0910045 Phillip Administrative, P. O. Box 218, Albany, OR, 97321, (800) 356-9822

0430010 Phoenix, P. O. Box 1477, Greenfield, MA, 01302

0430012 Phoenix, P. O. Box 810, Greenfield, MA, 01302

0430000 Phoenix Insurance Co, One Tower Square, Hartford, CT, 06115





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Carrier


0430003 Phoenix Life, One American Row, Hartford, CT, 06115

0430004 Phoenix Life, P. O. Box 677, Greenfield, MA, 01302

0431040 Physician Care Plus, P. O. Box 31286, Tampa, FL, 33631, (800) 794-5907

0432000 Physicians Mutual Insurance Co, P. O. Box 2018, Omaha, NE, 68103, (800) 228-9100

0432030 Pine Health Benefits, P. O. Box 2160, Natick, MA, 01760

0435000 Pinkerton, P. O. Box 5049, Costa Mesa, CA, 92628

0433002 Pioneer Life Insurance, P. O. Box 5151, Janesville, WI, 53547, (888) 234-1011

0433001 Pioneer Management Systems, P. O. Box 9040, West Springfield, MA, 01090, (888) 234-1011

0650009 Pittman and Associates, P. O. Box 11047, Memphis, TN, 38111, (800) 238-1344

0700009 Plan 21, 4550 Post Oak Pl, Houston, TX, 77027

0712011 Plan Administrators Inc, P. O. Box 6202, Columbia, SC, 29260, (888) 208-1998

0700014 Plastek Group Dental Plan, 1250 Tower Ln, Erie, PA, 16505

0814085 Platinum Safety and Claims, P. O. Box 6460, Tyler, TX, 75711

0614015 Plumbers Union Health and Welfare, 1240 Mass Ave, Local 12, Boston, MA, 02125

0928000 Plymouth Rock Assurance Corp, 695 Atlantic Ave, Boston, MA, 02111

0580010 Polaris Benefit Administrator, P. O. Box 2090 C, Stow, OH, 44224

0836040 POMCO, P. O. Box 6329, Syracuse, NY, 13217, (866) 241-7403

0609004 Postmaster Benefit Plan, P. O. Box 782369, San Antonio, TX, 78278

0435005 PPO Next, P. O. Box 2000 214, Mission Viejo, CA, 92692, (800) 800-7616

0660050 Precise Benefits, P. O. Box 9064, Jericho, NY, 11753

0700008 Preferred Benefit Administrators, P. O. Box 916188, Longwood, FL, 32791-6188, (888) 524-2777

0903054 Preferred Care, P. O. Box 22920, Rochester, NY, 14607, (800) 999-3920

0204006 Preferred One, P. O. Box 59212, Minneapolis, MN, 55459-0212, (800) 997-1750

0095005 Premier Access Insurance, P. O. Box 659010, Sacramento, CA, 95865, (888) 715-0760

0660010 Presbyterian Health Plan, P. O. Box 27489, Albuquerque, NM, 87125, (800) 356-2219

0006008 Prescription Pathway Bronze Plan, P. O. Box 1232, Pensacola, FL, 32591, (866) 684-5353

0920023 Prescription Solutions, P. O. Box 9040, Carlsbad, CA, 92108-9040, (800) 479-7658

0421000 Primary Physician Care, 1515 Mockingbird Lane, Charlotte, NH, 03833, (603) 296-0312

0920024 Prime Therapeutics, P. O. Box 64812, Saint Paul, MN, 55164, (800) 858-0723

0373001 Primera Blue Cross Blue Shield of Alaska, P. O. Box 240609, Anchorage, AK, 99524-0609,

(800) 508-4722





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Carrier


0756005 Principal Financial Group, 1 International Plaza, Philadelphia, PA, 19113

0756015 Principal Life Insurance, P. O. Box 10357, De Moines, IA, 50306-0357, (800) 533-5044

0756013 Principle Financial Group, 1245 Corporate Blvd, Aurora, IL, 60504, (630) 978-4669

0430005 Priority Health, P. O. Box 232, Grand Rapids, MI, 49501, (222) 389-6645

0756080 Private Health Care Systems Claims, P. O. Box 1607, Des Plaines, IL, 60017, (631) 420-4100

0095002 Private Healthcare System, P. O. Box 6090, De Pere, WI, 54115, (888) 540-0094

0756075 Private Healthcare System, P. O. Box 8013, Wausau, WI, 54402

0756050 Private Healthcare Systems, P. O. Box 5066, PHCS/3M, Des Plaines, IL, 60017, (800) 292-9902

0756070 Private Healthcare Systems, P. O. Box 1934, Des Plaines, IL, 60017

0247010 Pro America, P. O. Box 90603, Arlington, TX, 76006

0815000 Pro Health Plus, P. O. Box 2385, Woburn, MA, 01888

0247005 Pro Net, P. O. Box 101387, Fort Worth, TX, 76185, (800) 344-5822

0823000 Professional Benefit Administration Inc, P. O. Box 4687, Oak Brook, IL, 60522-4681,

(800) 435-5694

0700011 Protective Dental Care, P. O. Box 830626, Birmingham, AL, 35283, (800) 866-5020

0700078 Providence Health Plan of Oregon, P. O. Box 3125, Portland, OR, 97208, (888) 244-6643

0439024 Provident Mutual, P. O. Box 7011, Portsmouth, NH, 03801

0441035 Prudential, P. O. Box 1400, Parsippany, NJ, 07054

0442050 Public Employees Healthplan, 560 E 200 S, Salt Lake City, UT, 84102, (800) 765-7347

0720020 Q3 Business Tech Corp for Votaw Electric, P. O. Box 15952, Fort Wayne, IN, 46885, (219) 492-9979

0720005 Qualcare, P. O. Box 1030, Piscataway, NJ, 08854, (800) 992-6613

0720060 Qualchoice of North Carolina, P. O. Box 350, Winston-Salem, NC, 27102

0784000 RE Harrington, P. O. Box 16789, Columbus, OH, 43216

0028101 Regence Group Administrators, P. O. Box 52890, Bellevue, WA, 98015-2890, (877) 462-1444

0448005 Reliance Standard Specialty Products, 509 S Lenola Rd, Moorestown, NJ, 08057-1548,

(866) 375-0775

0451010 Reserve National Insurance, P. O. Box 26620, Oklahoma City, OK, 73126, (800) 654-9106

0920026 Restat Rx, P. O. Box 758, West Bend, WI, 53095-0758, (800) 248-1062

0750030 Retiree Medical Insurance, P. O. Box 10432, Des Moines, IA, 50306

0444010 RMSCO, P. O. Box 6309, Syracuse, NY, 13217, (877) 300-7343

0444015 RMSCO, P. O. Box 678, Liverpool, NJ, 08057, (800) 321-2347





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Carrier


0670002 S and S Healthcare, P. O. Box 141097, Cincinnati, OH, 45250, (866) 266-1110

0670003 S and S Healthcare Strategies, P. O. Box 46511, Cincinnati, OH, 45246-0511, (860) 677-8118

0614097 Sagamore Health Network, P. O. Box 6051, Indianapolis, IN, 46206, (800) 552-6550

0006001 Sama Script, 13900 Riverport Dr, Maryland Heights, MO, 63043, (800) 605-9208

0702045 Samba, P. O. Box 8600, London, KY, 40742-8600

0776000 Samba, 11301 Old Georgetown Rd, Rockville, MD, 20852

0702026 Sanford Health Plan, P. O. Box 5809, Troy, MI, 48007, (800) 752-5863

0670010 Sauder Welfare Trust, P. O. Box 156, Archbold, OH, 43502

0783030 Scott and White Health Plan, 2401 S 31st St, Temple, TX, 76504

0783020 Screen Actors Guild Producers, P. O. Box 7830, Burbank, CA, 91503

0872025 SDS, 4676 Highway 41 N, Springfield, TN, 37172, (800) 591-6764

0750002 Seabury and Smith, P. O. Box 10408, Des Moines, IA, 50306

0750005 Seafarers Health, P. O. Box 380, Piney Point, MD, 20604

0670015 Securian Dental, P. O. Box 192, Minneapolis, MN, 55440, (800) 234-9009

0900097 Sedgwick Nobles and Lownes, P. O. Box 248, Newtown, PA, 18940

0614068 SEIU Local 254, 11 Beacon St, Boston, MA, 02108, (617) 367-7360

0680000 Select Benefit Administrators of America, P. O. Box 440, Ashland, WI, 54806, (800) 497-3699

0700010 Select Care Labor Care, P. O. Box 830489, Birmingham, AL, 35283-0489, (800) 515-2818

0680010 Select Health, P. O. Box 30192, Salt Lake City, UT, 84130, (800) 538-5038

0752001 Self Insured Services Company, P. O. Box 389, Dubuque, IA, 52004, (800) 793-5235

0589000 Sentry Life Policy Benefits, P. O. Box 8025, Stevens Point, WI, 54481, (800) 426-7234

0257000 Seven Corners, P. O. Box 3430, Carmel, IN, 46032-3430, (866) 699-4186

0709003 Shasta Administration Services, P. O. Box 1747, Redmond, OR, 97708, (800) 441-4518

0704010 Shaw Industries Inc, P. O. Box 1208, Dalton, GA, 30722

0615052 Sheet Metal Workers National Health Fund, P. O. Box 1449, Goodlettsville, TN, 37070,

(800) 831-4914

0720050 Shenandoah Life, P. O. Box 11807, Roanoke, VA, 24022

0614026 Shop Iron Workers, 556 S Fair Oaks Avenue #30, Pasadena, CA, 91105, (866) 790-7467

0750020 Sieba Ltd, P. O. Box 5000, Endicott, NY, 13761

0462040 Sierra Health Plan, P. O. Box 18408, Las Vegas, NV, 89114-8408, (800) 777-1840





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Carrier


0064008 Sierra Military Health System, P. O. Box 7889, Tricare For Life, Madison, WI, 53707,

(866) 835-7422

0006002 Silverscript, P. O. Box 52067, Phoenix, AZ, 85072, (800) 605-9208

0558001 Simplifi ESO, P. O. Box 1370, Minneapolis, MN, 55440-1370, (866) 859-5355

0720010 Sisco, P. O. Box 389, Dubuque, IA, 52004, (800) 793-5235

0614094 South West Administrators, P. O. Box 1121, Alhambra, CA, 91802, (877) 350-4792

0828005 Southern Health Services, P. O. Box 7704, London, KY, 40742, (800) 627-4872

0175000 Southern Indiana Health Organization, P. O. Box 1787, Columbus, IN, 47202, (800) 443-2980

0614065 Southwest Carpenters Health Welfare Trust, P. O. Box 17973, Los Angeles, CA, 90017-0973,

(800) 252-9255

0828002 Southwest Employee Benefits Administrator, P. O. Box 25500, Albuquerque, NM, 87125

0756081 St John Claim Administrator, P. O. Box 14230, Springfield, MO, 65814-0230, (877) 875-1100

0626000 St Paul Electrical Construction, 1330 Conway St, Medical Reimbursement Plan, St Paul, MN, 55106,

(651) 776-4239

0905054 Standard Life and Accident Insurance, P. O. Box 1800, Galveston, TX, 78730, (512) 339-4449

0895001 Star Administrative Services, P. O. Box 55270, Phoenix, AZ, 85078, (800) 308-5948

0606006 Star Mark, P. O. Box 2942, Clinton, IA, 52733, (800) 522-1246

0631004 Star Marketing and Administration Inc, P. O. Box 5190, Tampa, FL, 33675-5190, (800) 522-1246

0680050 Starmark, P. O. Box 420, Freeport, IL, 61032, (800) 371-1633

0592003 State Farm Mutual Health Insurance Inc, P. O. Box 3070, Newark, OH, 43058, (866) 855-1212

0677000 State Health Benefit Plan, P. O. Box 38342, Atlanta, GA, 30334

0472014 State Mutual London Agency, 223 Newport Ave, Pawtucket, RI, 02861

0398040 State of North Carolina Teachers, P. O. Box 30025, Durham, NC, 27702

0006003 Sterling Rx, P. O. Box 1917, Bellingham, WA, 98227, (866) 235-5660

0642020 Stirling and Stirling Inc, 20 Armory Lane, Milford, CT, 06460, (800) 447-6689

0642021 Stirling Benefits, P. O. Box 704, Buckeystown, MD, 21717, (800) 447-6689

0906049 Strategic Resource Company, P. O. Box 14079, Lexington, KY, 40512-3759, (888) 772-9682

0700076 Summacare, P. O. Box 3620, Akron, OH, 44309, (800) 996-8401

0478010 Sun Life Financial Dental, P. O. Box 81633, Wellesley Hills, MA, 02481, (800) 451-2513

0814084 Sunrise Healthcare, P. O. Box 93098, Albuquerque, NM, 87199

0747005 Susquehanna Administrators, 1 Executive Park Dr, Bedford, NH, 03102





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Carrier


0253004 Sutton Special Risk, 266 Elmwood Ave, #535, Buffalo, NY, 14222, (800) 461-3292

0708005 Team Health, P. O. Box 612768, Dallas, TX, 75261, (800) 275-1171

0614062 Teamsters Health Services 404, P. O. Box 1370, Springfield, MA, 01101, (413) 733-2191

0614088 Teamsters Central States, P. O. Box 5103, Des Plaines, IL, 60017

0614017 Teamsters Health and Welfare, 650 Beacon St, Boston, MA, 02115

0614030 Teamsters Health and Welfare Local 170, 805 Millbury St, Worcester, MA, 01607

0614000 Teamsters Health Services, 400 Chapel Rd Unit 2 A, South Windsor, CT, 06074, (860) 289-3409

0614052 Teamsters Local 59, 27 S Sixth St, New Bedford, MA, 02740, (800) 880-5959

0614070 Teamsters Local 671, Anthem BCBS, North Haven, CT, 06473

0615005 Teamsters Local 671, 18 Britton Dr, Bloomfield, CT, 06002

0614002 Teamsters Union 25 Health Services, 16 Sever St, Charlestown, MA, 02129, (617) 241-9220

0615049 Teamsters Union Local 20, 435 S Halley St, Toledo, OH, 43609, (419) 243-8800

0030001 Texas True Choice USA, P. O. Box 251369, Plano, TX, 75024, (800) 851-8320

0226031 The Equitable, P. O. Box 3000, Lancaster, SC, 29721, (800) 782-9355

0280006 The Guardian, P. O. Box 9128, Norwell, MA, 02001

0908065 The Lincoln National Life Insurance Co, P. O. Box 614008, Dental Claims Input Center, Orlando,

FL, 32861-0001, (800) 423-2765

0144041 The Standard Dental and Vision, P. O. Box 82622, Lincoln, NE, 68501, (800) 547-9515

0844030 The TPA Inc, P. O. Box 7045, Rockford, IL, 61125, (800) 842-5749

0910059 Thomas Cooper and Company, P. O. Box 2557, Charlestown, SC, 29413

0750010 Thompson Agency of New England, 763 Farmington Ave, Farmington, CT, 06032

0480000 Time Insurance Co, P. O. Box 624, Milwaukee, WI, 53201

0900099 Tom Lange Co, 5231 S 6th St, Springfield, IL, 62707

0481040 Touchstone Health PSO, P. O. Box 33519, Indianapolis, IN, 46203

0844015 TPA of Connecticut, 116 Washington Ave, No. Haven, CT, 06473

0844016 TPA of Illinois, P. O. Box 3098, Naperville, IL, 60566

0625000 TR Paul Inc, P. O. Box 5508, Newtown, CT, 06470, (800) 678-8161

0625001 TR Paul Inc, P. O. Box 14669, Cincinnati, OH, 45250-0669, (866) 334-4553

0394001 Trans American Insurance Company, P. O. Box 982009, North Richland Hills, TX, 76182,

(800) 527-2845

0638034 Transamerica, P. O. Box 310, Grape Vine, TX, 76099, (800) 431-2052





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Carrier


0484000 Transamerica Accidental Life Insurance, P. O. Box 92106, Bedford, TX, 76095, (800) 227-3740

0486000 Transport Life Insurance, 714 Main St, Fort Worth, TX, 76102

0488025 Travelers Insurance, P. O. Box 4215, Atlanta, GA, 30302

0488051 Travelers Insurance, P. O. Box 8026, San Rafael, CA, 94901, (877) 582-7767

0488030 Travelers Insurance Company, One Tower Square, Hartford, CT, 06183

0064060 Tricare Pharmacy, P. O. Box 7011, Camden, SC, 79020, (888) 999-5195

0028068 Trigon Blue Cross Blue Shield, 2015 Staples Mill Rd, Richmond, VA, 23279, (804) 358-1551

0028095 Trigon Blue Cross Blue Shield, P. O. Box 27287, Richmond, VA, 23261, (804) 354-7000

0098011 Triple-S Salud Inc, P. O. Box 363628, San Juan, PR, 009363628, (800) 810-2583

0489015 Trustmark Dental, P. O. Box 2942, Clinton, IA, 52733

0489000 Trustmark Insurance, P. O. Box 9137, Fort Worth, TX, 76147

0489010 Trustmark Insurance, P. O. Box 7900, Lake Forest, IL, 60045, (847) 615-1300

0101001 Tufts Health Plan, P. O. Box 9163, Watertown, MA, 02471, (800) 462-0224

0615011 Tufts Health Plan Carelink, P. O. Box 751, Englewood, NJ, 07631, (888) 773-8329

0615044 UFCW District 5, 108-36 Queens Blvd, Forest Hills, NY, 11375

0614016 UFCW Local 1459, 33 Eastland St, Springfield, MA, 01109, (413) 733-0177

0615009 UFCW Local 371, 290 Post Rd W, Westport, CT, 06880, (203) 226-4751

0760031 Ullico, P. O. Box 61593, King of Prussia, PA, 19406, (877) 800-2956

0767000 Ultra Benefits Inc, P. O. Box 763, Westboro, MA, 01581, (866) 858-7223

0600201 UMR, P. O. Box 145804, Cincinnati, OH, 45250-5804, (800) 436-3200

0602006 UMR, P. O. Box 450, Pueblo, CO, 81102-0450, (877) 233-1800

0602007 UMR, P. O. Box 30541, Salt Lake City, UT, 84130-0541, (877) 233-1800

0602008 UMR, P. O. Box 2838, Clinton, IA, 52733, (866) 868-9460

0602009 UMR, P. O. Box 30530, Salt Lake City, UT, 84130, (800) 446-8182

0315014 Unicare, P. O. Box 25307, Winston- Salem, NC, 27114

0315016 Unicare, P. O. Box 5005, Bolingbrook, IL, 60440, (800) 442-9300

0315020 Unicare, P. O. Box 795180, San Antonio, TX, 78279-5180, (866) 364-2374

0315023 Unicare, 13523 Barrett Parkway Dr, Association National Claim, Baldwin, MO, 63021

0315029 Unicare, P. O. Box 4050, Clint Service Center, Schaumburg, IL, 60168, (847) 706-4050

0315030 Unicare, P. O. Box 4109, Woodland, CA, 91365





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0315031 Unicare, P. O. Box 7062, Schaumburg, IL, 60168, (800) 258-5284


0315035 Unicare, P. O. Box 9016, GIC Indemnity Plan, Andover, MA, 01810, (800) 422-9300

0315046 Unicare, 7025 Albert Pick Rd 500, Greensboro Client Service, Greensboro, NC, 60680,

(800) 288-8630

0315051 Unicare, P. O. Box 4458, Chicago, IL, 01151, (800) 288-8630

0315052 Unicare, P. O. Box 51990, Indian Orchard, MA, 01151, (413) 858-5000

0315055 Unicare, P. O. Box 9201, Oxnard, CA, 91331, (800) 627-0004

0315057 Unicare, P. O. Box 51130, Springfield, MA, 01151, (800) 288-8630

0315090 Unicare, P. O. Box 51180, Indian Orchard, MA, 01151, (800) 422-9300

0315092 Unicare, P. O. Box 061109, Chicago, IL, 60606, (800) 438-6105


0315096 Unicare, P. O. Box 819, Buckeystown, MD, 21717, (800) 778-1695

0315079 Unicare Compaq Claims, P. O. Box 833895, Richardson, TX, 75083, (800) 342-0000

0315017 Unicare Ford Visteon, 3200 Greenfield Rd, Dearborn, MI, 48120

0315009 Unicare John Hancock, 233 S Wacker Dr, Chicago, IL, 60606

0315019 Unicare Mass Mutual, 3820 American Dr, Plano, TX, 75075

0315059 Unicare Pharmacy, P. O. Box 9282, Oxnard, CA, 93031

0706000 Union Bankers Insurance Company, P. O. Box 130, Pensacola, FL, 32591, (800) 789-6364

0491000 Union Fidelity Life Insurance Co, P. O. Box 10841, Clearwater, FL, 33757

0493002 Union Labor Life Insurance, 161 Forbes Rd, Ste 204, Braintree, MA, 02184

0493000 Union Labor Life Insurance Co, 360 Park Avenue S 2nd FL, New York, NY, 10010

0814026 Union Welfare Fund Local 202, Hunt's Point Terminal Mk, Bronx, NY, 10474

0498010 United Administrative Services, 33 Harrison Ave, Boston, MA, 02111

0753002 United Administrative Services, P. O. Box 5057, San Jose, CA, 95150, (408) 286-7663

0498005 United American, P. O. Box 26400, Oklahoma City, OK, 73126

0498000 United American Insurance Co, P. O. Box 8080, McKinney, TX, 75070, (972) 529-5085

0900032 United Benefits, P. O. Box 2480, Daytona Beach, FL, 32115, (800) 323-4890

0659010 United Chambers, P. O. Box 3209, Covina, CA, 91722

0498040 United Church of Christ, P. O. Box 197629, Louisville, KY, 40259

0204005 United Claims Solution, LLC, 10835 N 25th Avenue, Ste 105, Phoenix, AZ, 85029, (800) 362-5894





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Carrier


0905035 United Commercial Travelers, 632 N Park St, P. O. Box 159019, Columbus, OH, 43215,

(800) 848-0128

0352012 United Concorda, P. O. Box 69421, Harrisburg, PA, 17106, (800) 235-1847

0351081 United Evercare, P. O. Box 31350, Salt Lake City, UT, 84313, (877) 702-5110

0614049 United Furniture Workers, P. O. Box 100037, Nashville, TN, 37224

0900025 United Group Programs, 25 No Military Trail, Boca Raton, MI, 48007

0351005 United Healthcare, P. O. Box 1600, Kingston, NY, 12402, (800) 942-4640

0351011 United Healthcare, P. O. Box 981502, El Paso, TX, 79998

0351016 United Healthcare, P. O. Box 740801, Atlanta, GA, 30374, (800) 848-8406

0351017 United Healthcare, P. O. Box 74083, Verizon Claims, Atlanta, GA, 30374, (800) 344-4515


0351020 United Healthcare, P. O. Box 809025, Dallas, TX, 75380-9025, (800) 977-4698


0351026 United Healthcare, 450 Columbus Blvd, Hartford, CT, 06103

0351035 United Healthcare, P. O. Box 740800, Atlanta, GA, 06517

0351037 United Healthcare, P. O. Box 699183, Quincy, MA, 02269-9183

0351038 United Healthcare, P. O. Box 2517, Smyrna, GA, 30081

0351057 United Healthcare, P. O. Box 5090, Rolling Meadows, IL, 60008

0351064 United Healthcare, P. O. Box 30551, Salt Lake City, UT, 84130, (877) 842-3210

0351079 United Healthcare, P. O. Box 659768, San Antonio, TX, 78265, (877) 842-3210

0351084 United Healthcare, P. O. Box 659744, San Antonio, TX, 78265, (800) 526-2414

0351094 United Healthcare, P. O. Box 30990, Salt Lake City, UT, 84130-0990, (877) 842-3210

0351095 United Healthcare, P. O. Box 30755, Salt Lake City, UT, 84130, (800) 357-0978

0351098 United Healthcare, 601 Brooker Creek Blvd, Oldsmar, FL, 34677

0488000 United Healthcare, P. O. Box 9516, New Haven, CT, 06534

0488003 United Healthcare, P. O. Box 473519, Charlotte, NC, 28247

0488062 United Healthcare, P. O. Box 26722, Greensboro, NC, 27417

0351063 United Healthcare Dental, P. O. Box 30567, Salt Lake City, UT, 84130, (877) 816-3596

0351001 United Healthcare Metrahealth, P. O. Box 30555, Multi Case Services, Salt Lake City, UT, 84130,

(877) 842-3210

0351074 United Healthcare Metropolitan Under 65, P. O. Box 3025, Utica, NY, 13504





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Carrier


0488035 United Healthcare Railroad Active Employee, P. O. Box 30985, Salt Lake City, UT, 84130

0508040 United Medical Resources, 2343 Auburn Ave, Cincinnati, OH, 45221, (800) 436-3100

0508043 United Medical Resources, P. O. Box 141337, Cincinnati, OH, 45250

0901051 United Plans, P. O. Box 9098, Waltham, MA, 02254

0508001 United States Life Insurance, P. O. Box 1581, Neptune, NJ, 07754, (732) 922-7000

0510001 Universal Health Service, P. O. Box 2843, Warminster, PA, 18974, (800) 847-7718

0531002 University Health Plans, P. O. Box 7949, Lake Forest, IL, 60045

0615000 University of Massachusetts Supplemental Health Insurance, University Center, Amherst, MA, 01003

0495000 Unum Life Insurance, 2211 Congress St, Portland, ME, 04122

0388016 Unum Provident Corp, 18 Chestnut St, Worcester, MA, 01608, (508) 799-4441

0512020 Upstate Administrative Service Inc, P. O. Box 6589, Syracuse, NY, 13217

0715030 US Able Administration Blue Advantage, P. O. Box 1460, Little Rock, AR, 72203

0691000 US Administrators, P. O. Box 30654, Los Angeles, CA, 90030

0645050 US Family Health Plan, P. O. Box 9195, Watertown, MA, 02471, (800) 818-8589

0700048 US Now, 8350 N Central Expressway, Dallas, TX, 75206

0703005 USA MCO, P. O. Box 160300, Austin, TX, 78716

0715025 USA Life Insurance Company, 9800 Frederick Rd, San Antonio, TX, 78288, (800) 531-8000

0513001 Utica Mutual Insurance Company, 401 Edgewater Pl, Wakefield, MA, 01880

0810005 Value Options, P. O. Box 1347, Latham, NY, 12110, (800) 397-1630

0810000 Vanguard Group Inc, 1979 Marcus Ave, Lake Success, NY, 11042, (516) 616-6011

0600000 Veterans Aid and Attendance, J F K Building, Boston, MA, 02203

0901087 Veterans Benefits, 1 Government Center, Fall River, MA, 02722

0901085 Veterans Services, Framingham Town Hall, Framingham, MA, 01702

0900023 Vetri System, P. O. Box 5028, Troy, FL, 99431, (531) 997-9894

0753003 Vision Benefits of America, 300 Weyman Rd, Pittsburg, PA, 15236

0523015 Volusia Health Network, 400 N Clyde Morris Blvd, Daytona Beach, FL, 32114, (386) 258-4822

0112010 Vytra Health Plans, P. O. Box 9091, Melville, MA, 11747-9091, (888) 288-9872

0920027 Walgreens, P. O. Box 545, Deerfield, IL, 60015, (800) 745-7984

0516050 Walmart Benefit Administration, 922 W Walnut, Rogers, AR, 72756, (800) 421-1362

0658020 Washington Dental, P. O. Box 75983, Seattle, WA, 98125





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Carrier


0710014 Washington Gas Medical Claims, 6801 Industrial Rd, Springfield, VA, 22151

0171000 Washington National, P. O. Box 1934, Des Plaines, IL, 60017, (815) 987-0409

0805050 Watkins Associates Industries, P. O. Box 1738, Atlanta, GA, 30301, (800) 333-3841

0602001 Wausau Benefits Inc Georgia Pacific, P. O. Box 8092, Wausau, WI, 54402, (715) 841-7111

0204007 Web TPA, P. O. Box 535309, Grape Vine, TX, 75053-5309, (800) 808-4515

0844035 Web TPA, P. O. Box 1928, Grape Vine, TX, 76099-1928, (888) 796-2432

0126006 Well Path, P. O. Box 7102, London, KY, 40742, (800) 470-4523

0006004 Wellcare Classic, 875 Henderson Blvd, Tampa, FL, 33631, (888) 550-5252

0656005 Wellcare of Florida Inc, P. O. Box 31372, Tampa, FL, 33631, (800) 799-3081

0920035 Wellpoint, P. O. Box 4165, Woodland Hills, CA, 91365

0028023 Wellpoint Dental Services, P. O. Box 9201, Oxnard, CA, 93031, (800) 627-0004

0908055 Wells Fargo Insurance, P. O. Box 11522, Charleston, WV, 25339, (800) 624-8605

0520005 Western Health, 529 Kansas City St, Rapid City, SD, 57701

0705060 Westport Benefits, P. O. Box 66743, St Louis, MO, 63166

0895009 Weyco All Phase Electric, PPO Corporation, Irvine, CA, 96202

0895025 Weyco Inc Benefit Management, P. O. Box 30132, Lansing, MI, 48909, (800) 748-0003

0774030 Willis Corroon Insurance, P. O. Box 2697, Wichita, KS, 67201, (800) 235-7160

0694003 Willis of Kansas, P. O. Box 2906, Koch Industries Employee, Wichita, KS, 67201, (800) 235-7160

0614060 Woodmen of the World Omaha Woodmen, 1700 Parkman St, Omaha, NE, 61460, (800) 225-3108

0524002 World Insurance, P. O. Box 3160, Omaha, NE, 68103, (402) 496-8000

0900078 WW Grainger Inc, 333 Knights Bridge Pkwy, Lincolnshire, IL, 60069

0659005 Zenith Administrators, 101 Convention Ctr Dr, Las Vegas, NV, 89109

0659008 Zenith Administrators, 33 Eastland St, Springfield, MA, 01109

0659004 Zenith Administrators, 161 Forbes Rd, Braintree, MA, 02184

Medicare Carrier Codes

0084000 Medicare A Claims, 02106

0085000 Medicare B Claims, 02370





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Carrier


Medicare C Advantage Carrier Codes

0973005 AARP Medicare Complete, P. O. Box 31361, United Health Care, Salt Lake City, UT, 84131,

(888) 866-8296

0970001 Abrazo Advantage Health Plan, 787 N 16th St #105, Phoenix, AZ, 85020, (602) 824-3741

0971065 Acan Health Plan, 3800 Kilroy Airport Way, Ste 100, Long Beach, CA, 90806, (562) 989-5100

0970047 Advantage, 7711 Carondelet, Clayton, MO, 63105, (314) 725-4477

0978117 Advantage by Sunshine Health, 1301 International Pkwy, Ste 400, Sunrise, FL, 33323,

(512) 416-3720

0971077 Advantage Care, 250 S Australian Ave, Ste 400, West Palm Beach, FL, 33401, (561) 805-8500

0970003 Advantage Health Solutions Inc, 9490 Priority Way W Dr, Indianapolis, IN, 46240, (317) 573-2784

0972040 Advantage Plan From Medical Mutual of Ohio, 2060 E Ninth St, Cleveland, OH, 44115,

(419) 473-7844

0970061 Advantra, P. O. Box 7154, London, KY, 40742, (877) 359-5331

0971027 Advantra, 11 Stanwix St, Ste 2300, Pittsburgh, PA, 15222, (412) 577-5442

0970050 Advantra Freedom, P. O. Box 7154, London, KY, 40742, (866) 386-2330

0973007 Aetna Better Health Premier Plus, 1 S Wacker Ste 1200, Mailstop F646, Chicago, IL, 60606,

(800) 445-1796

0970004 Aetna Medicare, 730 Holiday Dr, Building 8 MS F221, Pittsburgh, PA, 15220, (800) 282-5366

0970005 Affinity Health Plan, 2500 Halsey St, Bronx, NY, 10461, (718) 794-5701

0978115 Akamai Advantage, 8-CA, 811 Keeaumoku St, Honolulu, HI, 96814, (808) 948-6000

0970008 Alexian Brothers Community Services (H2609), 3900 S Grand, St Louis, MO, 63118, (314) 771-5800

0970009 Alexian Brothers Community Services (H4402), 425 Cumberland St, Ste 110, Chattanooga, TN,

37404, (423) 698-0802

0970010 Alliance Medicare PPO, 2850 W Grand Blvd, Detroit, MI, 48375, (284) 443-2036

0970007 Alliance For Health, 1240 S Loop Rd, Alameda, CA, 94502, (510) 747-6243

0970011 Aloha Care, 1357 Kapiolani Blvd, Ste 1250, Honolulu, HI, 96814, (808) 973-1650

0970115 Alphacare of New York, 335 Adams St, Ste 2600, Brooklyn, NY, 11021-9816, (855) 652-5742

0970012 Altamed Senior Buena Care, 5425 E Pomona Blvd, Los Angeles, CA, 90022, (323) 832-7601

0970013 Altus Advantra, 10421 S Jordan Gateway, Ste 400, South Jordan, UT, 84095, (801) 933-3561

0970014 Amarillo Multiservice Center For the Aging Inc, 3108 S Fillmore, Amarillo, TX, 79110,

(806) 374-5516

0970015 American Health Medicare, P. O. Box 11320, San Juan, PR, 00922, (787) 620-1919





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0978114 America's First Choice, 45 Broadway, Ste 300, New York, NY, 10006

0970016 America's First Choice Health Plans Inc, 5600 Mariner St, Ste 227, Tampa, FL, 33609,

(813) 594-1027

0978100 America's First Choice Insurance Company of North Carolina, 250 Berryhill Rd, Ste 311, Columbia,

SC, 29210, (803) 748-4533

0970017 Americhoice Personal Care Plus (NJ), 100 Mulberry St, Four Gateway Center 4th Floor, Newark, NJ,

07102, (973) 297-5566

0970018 Americhoice Personal Care Plus (NY), 3141 N Third Ave, Phoenix, AZ, 85013, (602) 664-5483

0971092 Americhoice Secure Plus Complete, 3800 Avenue of the Cities, Ste 200, Moline, IL, 61265,

(800) 747-1446

0970019 Amerigroup Community Care, 4424 Corporation Ln, Virginia Beach, VA, 23462, (757) 473-2467

0970020 Amerihealth 65, 1901 Market St, Philadelphia, PA, 19103, (267) 675-1201

0970117 Anthem Blue Cross and Blue Shield, Matthew Thornton Healthplan, 3000 Goffs Falls Road,

Manchester, NH, 03111, (866) 289-4250

0970101 Anthem Blue Cross Compcare Medicare HMO, 201 High St, Salem, OR, 97309, (503) 588-4368

0970021 Anthem Blue Cross Medicare, 145 S Pioneer Rd, Mail Stop Wiw202-Fdl2, Fond du Lac, WI, 54935,

(920) 923-8334

0970103 Anthem Healthkeepers, P. O. Box 795180, San Antonio, TX, 78279, (888) 230-7338

0970116 Anthem Healthkeepers of Virginia, 2015 Staples Mill Rd, Richmond, VA, 23230, (866) 289-4250

0978110 Anthem Mediblue of Connecticut, P. O. Box 795180, San Antonio, TX, 78279

0970024 APIPA Personal Care Plus, 3141 N Third Ave, Az060-S225, Phoenix, AZ, 85013, (602) 664-5396

0970022 Appalachian Agency For Senior Citizens Inc, P. O. Box 765, Cedar Bluff, VA, 24609,

(276) 964-4915

0970023 Arcadian Care Health Plan, 955 Overland Court, Second Floor, San Dimas, CA, 91773,

(800) 775-6490

0970060 Archcare Advantage, 1339 York Ave, New York, NY, 10021, (646) 233-5723

0970025 Arkansas Blue Cross Medi Pak Advantage, 320 W Capitol, Ste 400, Little Rock, AR, 72201,

(501) 399-3810

0970027 Arnett HMO, P. O. Box 6108, Lafayette, IN, 46903, (765) 269-2209

0970028 Arta Medicare Health Plan, 3333 Michelson Dr, Ste 735, Irvine, CA, 92612, (949) 260-6515

0970030 Asuris North West Health Regence Blue Cross Blue Shield, 201 High St SE, P. O. Box 12625,

Salem, OR, 97309-0625, (503) 587-3274

0970031 Atrio My Advantage, 500 SE Cass Ave, Ste 230, Roseburg, OR, 97470, (541) 672-8620

0970033 Avalon Insurance Co, 2500 Elmerton Ave, Harrisburg, PA, 17177, (717) 541-7651





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Carrier


0970034 AvMed Medicare Preferred, 4300 NW 89 Blvd, Gainesville, FL, 32606, (352) 337-8833

0970035 Bienvivir Senior Health Services, 2300 McKinley, El Paso, TX, 79930, (915) 562-3444

0970038 Blue Cross Blue Shield of Florida (Medicare), 8400 NW 33rd St, Ste 100, Miami, FL, 33122-1632,

(800) 926-6565

0970036 Blue Care Network of Michigan (Medicare), 611 Cascade W Pkwy, Grand Rapids, MI, 49546,

(616) 956-5890

0970043 Blue Cross Blue Shield of Minnesota, 3400 Yankee Dr, Eagan, MN, 55122, (651) 662-9415

0027026 Blue Cross Blue Care 65, P. O. Box 9201, North Quincy, MA, 02171-9201, (800) 451-8123

0978096 Blue Cross Blue Shield FL Med C, 4800 Deerwood Campus Pkwy, DCC Building 200 Third Floor,

Jacksonville, FL, 32246, (904) 905-5423

0970041 Blue Cross Blue Shield Northern Plains Alliance, 1901 Market St, Second Floor, Philadelphia,

PA, 19103, (888) 457-3009

0970037 Blue Cross Blue Shield of Alabama (Medicare), 450 Riverchase Pkwy E, Birmingham, AL, 35244,

(205) 220-6401

0978112 Blue Cross Blue Shield of Georgia Medicare, P. O. Box 7037, Columbus, GA, 31908, (800) 282-2473

0970111 Blue Cross Blue Shield of Illinois; NM, 300 E Randolph St, Chicago, IL, 60601, (888) 285-2249

0970042 Blue Cross Blue Shield of Michigan (Medicare), 27000 W Eleven Mile Rd, H404, Southfield,

MI, 48034, (248) 350-4633

0970039 Blue Cross Blue Shield of Rhode Island (Medicare), 444 Westminster St, Providence, RI, 02903,

(401) 459-5301

0970040 Blue Cross Blue Shield of South Carolina (Medicare), P. O. Box 6170, Ax-415, Columbia,

SC, 29260, (803) 382-5267

0978104 Blue Cross Blue Shield of Tennessee Med C, 1 Cameron Hill Cir, Chattanooga, TN, 37402,

(423) 535-7023

0973009 Blue Cross Community MMAI, 300 E Randolph, Chicago, IL, 60601, (888) 285-2249

0970044 Blue Cross of Idaho Health Services Inc, 300 E Pine Ave, Meridian, ID, 83642, (208) 286-3717

0971024 Blue Medicare PPO, P. O. Box 3567, Scranton, PA, 18503, (800) 718-2031

0972009 Blue Plus, 3400 Yankee Dr, Eagan, MN, 55122, (651) 662-9415

0970049 Blue Shield of California, 6300 Canoga Ave, Woodland Hills, CA, 91367, (818) 228-3143

0970045 Boro Medical PC, 22-02 Steinway St, Astoria, NY, 11105, (718) 423-0808

0971052 Brand New Day, 1600 E Hill St, Signal Hill, CA, 90755, (562) 981-5054

0970026 Bravo Health, 3601 O'Donnell St, Baltimore, MD, 21224, (800) 556-4566

0970048 C and O Employees Hospital Association, 511 Main St, Second Floor, Clifton Forge, VA, 24422,

(540) 862-5728





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Carrier


0970051 Capital Advantage Insurance Company, 2500 Elmerton Ave, Harrisburg, PA, 17177, (717) 541-7561

0970053 Capital Health Plan, P. O. Box15349, Tallahassee, FL, 32317, (850) 383-3421

0970054 Care Improvement Plus, 351 W Camden St, Ste 100, Baltimore, MD, 21201, (410) 625-2200

0978105 Care N Care Health Plan, 170 River Run, Ste 402, Fort Worth, TX, 76107, (817) 529-9234

0971036 Care Oregon Advantage, 315 SW Fifth Ave, Ste 900, Portland, OR, 97204, (503) 416-1746

0970055 Care Plus Health Plans Inc, 101 E Main St, Louisville, KY, 40202, (800) 448-6262

0970056 Care Resources, 5363 44th St, Grand Rapids, MI, 49512, (616) 956-9440

0975001 Care Source, 740 SE 7th St, Grants Pass, OR, 97526, (541) 471-4106

0970057 Care Wisconsin Health Plan Inc, 2802 International Lane, Madison, WI, 53704, (608) 245-3437

0973001 Care1St Health Plan, 601 Potrero Dr, Monterey Park, CA, 91755, (323) 889-5258

0970086 Carelink Advantra PPO, 1000 Research Park Blvd, Charlottesville, VA, 22911, (434) 951-2432

0973000 Caremore Health Plan, 12900 Park Plaza Dr, Ste 150, Cerritos, CA, 90703, (562) 662-2900

0978097 Caremore Health Plan, 12900 Park Plaza Dr, Ste 150, Cerritos, CA, 90703, (562) 622-2900

0970058 Caresource, 1 S Main St, One Dayton Ctr, Dayton, OH, 45402, (937) 224-3300

0978106 Carillion Clinic Medicare Health Plan, P. O. Box 40032, 213 Jefferson St, Ste 1409, Roanoke,

VA, 24022, (540) 224-5330

0970059 Cariten Senior Health, 1420 Centerpoint Blvd, Knoxville, TN, 37932, (865) 670-7214

0970052 CDPHP Medicare Choice, 500 Patroon Creek Blvd, Albany, NY, 12206, (518) 641-3620

0970062 Center For Elders Independence, 510 17th St, Ste 400, Oakland, CA, 94612, (510) 433-1160

0970063 Central Health Medicare Plan, 1051 Park View Dr, Ste 120, Covina, CA, 91724, (626) 388-2386

0970064 Cherokee Elder Care, 1387 W 4th St, Tahlequah, OK, 74464, (918) 207-4936

0970066 Chinese Community Health Plan, 445 Grant Ave, Ste 700, San Francisco, CA, 94108, (415) 955-8800

0970067 Choice Care Health Plan Inc, P. O. Box 1980, Melbourne, FL, 32902, (321) 951-1010

0970105 Cigna Healthspring Preferred, P. O. Box 2001, Nashville, TN, 37202, (866) 893-4468

0970068 Cigna Medicare Access, P. O. Box 42005, Phoenix, AZ, 85080, (800) 627-7534

0970081 Cigna Medicare Access, 900 Cottage Grove Rd, Hartford, CT, 06152, (860) 226-5405

0906029 Cigna Medicare Access Plans, P. O. Box 22174, Tempe, AZ, 85285-2174

0970069 Citizens Choice Healthplan, 17315 Studebaker Rd, Ste 200, Cerritos, CA, 90706, (562) 207-4533

0970070 Citrus Health Care Inc, 5420 Bay Center Dr, Ste 250, Tampa, FL, 33609, (813) 490-8900

0970071 Clear Choice Health Plans, 2650 NE Courtney Dr, Bend, OR, 97701, (541) 385-5315

0970072 Colorado Access, 10065 E Harvard Ave, Ste 600, Denver, CO, 80231, (720) 744-5500





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Carrier


0978090 Commonwealth Care Alliance, 30 Winter St, Boston, MA, 02108-4720

0971023 Community Care, 218 W 6th St, Tulsa, OK, 74119, (918) 594-5200

0975088 Community Care, 1555 S Layton Blvd, Milwaukee, WI, 53215, (414) 902-2427

0970074 Community Care Senior Health Plan, 218 W 6Th St, Tulsa, OK, 74119, (918) 594-5200

0970076 Community Health Group, 740 Bay Blvd, Chula Vista, CA, 91910-5254, (619) 498-6456

0972095 Community Health Partnership, 2240 E Ridge Center, Eau Claire, WI, 54701, (715) 858-7815

0970077 Community Healthfirst Medicare Advantage Plan, 720 Olive Way, Ste 300, Seattle, WA,

89101-1830, (206) 515-7975

0978113 Community Insurance Co, 1351 William Howard Taft, Cincinnati, OH, 45206, (800) 467-1199

0972058 Community Life, 2400 Ardmore Blvd, Ste 700, Pittsburgh, PA, 15221, (412) 436-1333

0970078 Comprehensive Care Management Corp, 2275 Olinville Ave, Bronx, NY, 10467, (718) 944-2100

0970079 Concordia Care, 2373 Euclid Heights Blvd, Cleveland Heights, OH, 44106, (216) 719-3580

0970080 Connecticare Insurance Co Inc, 175 Scott Swamp Rd, Farmington, CT, 06032, (860) 674-2093

0970107 Constellation Health Apollo, P. O. Box 364547, San Juan, PR, 00936-4547, (866) 714-0724

0970108 Constellation Health Genesis SNP, P. O. Box 364547, San Juan, PR, 00936-4547, (866) 714-0724

0970082 Contra Costa Health Plan, 595 Center Ave, Ste 100, Martinez, CA, 94553, (925) 313-6000

0970083 CosviMed Care, P. O. Box 363428, San Juan, PR, 00936-3428, (787) 751-5656

0970084 Coventry Health and Life Insurance Co, 3721 Tecport Dr, P. O. Box 67103, Harrisburg, PA, 17106,

(717) 671-6827

0970085 Coventry Health and Life Insurance Co, 8320 Ward Pkwy, Kansas City, MO, 64114, (800) 727-9712

0978095 Coventry Health Care, P. O. Box 7154, London, KY, 40742, (866) 731-9574

0978111 Cuatro LLC, 5030 Broadway, Ste 664, New York, NY, 10034, (646) 216-3078

0970087 Da Vita Village Health Insurance, 3 Hawthorn Pkwy, Ste 410, Vernon Hills, IL, 60061,

(866) 838-1962

0972075 Dakotacare, 2600 W 49th St, Sioux Falls, SD, 57117, (605) 334-4000

0970088 Dean Health Plan Inc, 1277 Deming Way, Madison, WI, 53717, (608) 827-4247

0970089 Delaware Physicians Care Advantage, 4645 E Cotton Center Blvd, Phoenix, AZ, 85004,

(602) 659-1862

0970090 Denver Health Medical Plan, 777 Bannock St, Mail Code 6000, Denver, CO, 80204, (720) 956-2228

0970091 Deseret Mutual, 60 E South Temple, Salt Lake City, UT, 84111, (801) 578-5746

0970092 Easy Choice Health Plan, 20411 SW Birch St, Ste 200, Newport Beach, CA, 92660, (949) 999-3782

0970093 Educators Mutual Insurance Association, 852 E Arrowhead Ln, Murray, UT, 84107, (801) 262-7476





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0970094 Elderplan Inc, 6323 Seventh Ave, Brooklyn, NY, 11220, (800) 353-3765

0970095 Empire Health Choice Assurance Inc, 145 S Pioneer Rd, Mail Stop WIW202-FDL2, Fond du Lac,

WI, 54935, (920) 923-8334

0972098 Erickson Advantage, 2725 Mall Dr, W1080-1000, Eau Claire, WI, 54701, (715) 858-2200

0970096 Essence Healthcare, 12655 Olive, 4th Floor, Saint Louis, MO, 63141, (314) 851-3600

0351055 Evercare, P. O. Box 659777, San Antonio, TX, 78259-9777, (800) 393-0993

0972094 Evercare by United Healthcare, 2725 Mall Dr, W1080-1000, Eau Claire, WI, 54701, (715) 858-2200

0970097 Evercare Health Plans, 2725 Mall Dr, Wi080-1000, Eau Claire, WI, 54701, (715) 858-2200

0970098 Excellus Health Plan Inc, 205 Park Club Lane, Buffalo, NY, 14221, (716) 504-5579

0091001 Fallon Community Health Plan Senior, P. O. Box 15121, Attn: Claims Dept., Worcester, MA, 01615,

(800) 333-2535

0970099 Family Care Health Plans Inc, 2121 SW Broadway #300, Portland, OR, 97201, (847) 605-0501

0972032 Fidelis Care, 40 John Glenn, Amherst, NY, 14228, (716) 564-3630

0971000 Fidelis Secure Care of Michigan, 1700 E Golf Rd, Ste 1115, Schaumburg, IL, 60173, (847) 605-0501

0972081 First Care Advantage, 1901 West Loop 289, Ste 9, Lubbock, TX, 79407, (866) 229-4969

0971002 First Medical Health Plan Inc, P. O. Box 195559, San Juan, PR, 00919, (787) 625-9557

0971001 First Medical Health Plan of Florida Inc, P. O. Box 260308, Miami, FL, 33125-0007, (939) 969-3166

0971003 First Plan Blue, 525 S Lake Ave, Ste 222, Duluth, MN, 55802, (218) 740-2330

0971004 Florida Health Care Plan Inc, 1340 Ridgewood Ave, Holly Hill, FL, 32117, (800) 352-9824

0971005 Florida PACE Center Inc, 5200 NE Second Ave, Miami, FL, 33137, (305) 751-8826

0971007 Freedom Health, 5403 Church Ave N, Tampa, FL, 33614, (813) 506-6000

0253001 Fresenius Senior Plan Demo Project, P. O. Box 744920, Houston, TX, 77274, (713) 843-6720

0702022 Gateway Health Plan Medicare Assurance, P. O. Box 11 560, Albany, NY, 12211-0560,

(800) 685-5209

0971008 Gateway Health Plan Medicare Assured, 600 Grant St, 41st Floor, Pittsburgh, PA, 15219,

(800) 685-5205

0971010 Gemcare Health Plan, 4550 California Ave, Ste 500, Bakersfield, CA, 93309, (661) 716-7120

0971015 GHI Medicare Choice PPO, 441 Ninth Ave, Fifth Floor, New York, NY, 10001, (212) 615-0503

0971017 GHI Medicare Private Fee For Service, 55 Water St, New York, NY, 10041, (646) 447-6377

0971029 Golden Advantage Plus, 4645 E Cotton Center Blvd, Phoenix, AZ, 85040, (602) 659-1862

0978102 Golden State Medicare Health Plan, 3010 Old Ranch Parkway, Ste 260, Seal Beach, CA, 90740,

(562) 799-0514





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0971011 Great Lakes Personal Care Plus, 17117 W Nine Mile Rd, Ste 1600, Southfield, MI, 48075,

(248) 331-4322

0971013 Group Health Cooperative, P. O. Box 34590, Seattle, WA, 98124, (206) 901-4629

0971016 Group Health Plan Inc, 550 Maryville Center Dr, Ste 300, St Louis, MO, 63141-5818, (314) 506-1808

0978087 Guardian Health Care, 33 Market Point Dr, Greenville, SC, 29607, (864) 527-0473

0971019 Guildnet, 15 W 65th St, New York, NY, 10023, (917) 386-9129

0971020 Gundersen Lutheran Health Plan Inc, 1900 South Ave, Mail Stop NCA2-01, Lacrosse, WI, 54601,

(608) 775-8070

0971026 HAP Senior Plus, 2850 W Grand Blvd, Detroit, MI, 48375, (248) 443-2036

0092012 Harvard First Seniority Freedom, P. O. Box 699183, Quincy, MA, 02269, (800) 742-8326

0970109 Harvard Pilgrim Healthcare Stride, P. O. Box 1512888, Tampa, FL, 33684-1288, (888) 609-0692

0971025 Health Alliance Medical Plans, 301 S Vine St, Urbana, IL, 61801, (217) 337-8090

0971028 Health Choice Generations, 1600 W Broadway, Ste 110, Tempe, AZ, 74171, (480) 731-3505

0973002 Health Firs Medicare Plans, 6450 US Highway 1, Rockledge, FL, 32955-5747, (321) 434-5660

0978084 Health Insurance Plan of New York, 55 Water St, New York, NY, 10041, (866) 432-5849

0970065 Health Markets Care Assured, 2005 Market St, One Commerce Sq, Ste 3110, Philadelphia,

PA, 19103, (215) 988-6836

0971031 Health Net, P. O. Box 14130, Lexington, KY, 40512, (888) 445-8913

0971032 Health Net, P. O. Box 14225, Lexington, KY, 40512-4225, (800) 289-2818

0978118 Health Net Cal Mediconnect, 11971 Foundation Pl, Gold River, CA, 95670, (800) 275-4737

0971033 Health Net Life Insurance Co, P. O. Box 14703, Lexington, KY, 40512, (818) 676-6591

0971035 Health Net of California, P. O. Box 14703, Lexington, KY, 40512, (818) 676-6591

0971034 Health Net of Connecticut, 100 Beard Sawmill Rd, MS Ct 104-02-15, Shelton, CT, 06484,

(203) 402-4222

0971030 Health Net Pearl, 21271 Burbank Blvd, Mail Stop Ca-100-04-03, Woodland Hills, CA, 91367,

(800) 977-8221

0978080 Health New England Medicare C, One Monarch Place, Springfield, MA, 01144, (413) 787-4000

0971012 Health Partners, 8170 33rd Ave S, P. O. Box 1309, Minneapolis, MN, 55440-1309, (952) 883-7699

0970106 Health Partners Plans, 901 Market St, Ste 500, Philadelphia, PA, 19107, (888) 991-9023

0971037 Health Plan of Nevada Inc, 2716 N Tenaya Way, Las Vegas, NV, 89128, (702) 242-7073

0971062 Health Plan of San Mateo, 701 Gateway Blvd, Ste 400, South San Francisco, CA, 94080,

(650) 616-2118





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0978099 Health Plus Elite, 241 37th St, Ste 412, Brooklyn, NY, 11201, (866) 509-7999

0971041 Health Plus of Michigan, 2050 S Linden Rd, P. O. Box 1700, Flint, MI, 48501-1700, (810) 720-7787

0971043 Health Sun Health Plans Inc, 1205 SW 37th Ave, Miami, FL, 33135, (305) 234-9292

0978091 Healthamerica, P. O. Box 7154, London, KY, 40742, (800) 290-0190

0972028 Healthfirst Medicare Plan, P. O. Box 5196, New York, NY, 10004, (888) 801-1660

0971039 Healthfirst New Jersey, P. O. Box 5196, New York, NY, 10274, (866) 889-2523

0971040 Healthnow New York Inc, 257 W Genesee St, Buffalo, NY, 14202, (716) 887-2069

0970114 Healthplan of San Mateo Care Advantage, 701 Gateway Blvd, Ste 400, San Francisco, CA, 94080,

(866) 880-0606

0970104 Healthplus, P. O. Box 34168, Seattle, WA, 98124-1168, (800) 551-9903

0971042 Healthspring Inc, 601 Mainstream Dr, Nashville, TN, 37228, (615) 565-8110

0978116 Healthspring of Alabama Inc, 800 Great Circle Rd, Nashville, TN, 37228

0978108 Healthy Advantage/Florida Healthcare Plus, P. O. Box 9910, Daytona Beach, FL, 32120,

(386) 676-7176

0971038 Heart of America Health Plan, 810 S Main Ave, Rugby, ND, 58368, (701) 776-5848

0971044 Henry Ford Health System, 7800 W Outer Dr, Ste 240, Detroit, MI, 48235, (313) 653-2230

0971018 Highmark Inc, 120 Fifth Ave, Pittsburgh, PA, 15222, (412) 544-7075

0971045 HIP Health Plan of Greater New York, 55 Water St, New York, NY, 10041, (646) 447-3423

0971022 HMSA 65 C Plus, 818 Keeaumoku St, 8-CA, Honolulu, HI, 96814, (808) 948-5288

0972022 Hometown Health Plan, 830 Harvard Way, Reno, NV, 89502, (775) 982-3274

0971073 Hope Select Care, 2668 Winkler Ave, Ft Myers, FL, 33901, (239) 985-6400

0972004 Hopkins Elderplus, 4940 Eastern Ave, Mason Lord Building E Tower 1st Floor, Baltimore,

MD, 21224, (410) 550-7044

0972019 Horizon Blue Cross Blue Shield of New Jersey, 3 Penn Plaza E, Pp02Q, Newark, NJ, 07105-2200,

(973) 466-6651

0971098 Humana Insurance Co, 500 W Main St, Louisville, KY, 40202, (800) 448-6262

0971099 Humana Insurance Co, 101 E Main St, Louisville, KY, 40202, (800) 448-6262

0972092 ICare, 1555 N Rivercenter Dr, Ste 202A, Milwaukee, WI, 53212, (414) 231-1164

0971053 IEHP Medicare Dual Choice, 303 E Vanderbilt Way, Ste 100, San Bernardino, CA, 92408,

(909) 890-2790

0972024 Independent Health, 511 Farber Lakes Dr, Buffalo, NY, 14221, (716) 631-3286

0972025 Independent Living For Seniors Inc, 333 Humboldt St, Rochester, NY, 14610, (585) 922-1033





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0972026 Independent Living Services of Central NewYork, 100 Malta Lane, North Syracuse, NY, 13212,

(315) 703-3630

0971085 Instil Health Insurance Co, P. O. Box 1466, Augusta, GA, 30903-1466, (877) 907-2783

0971054 Inter Valley Health Plan, P. O. Box 6002, 300 S Park Ave, Pomona, CA, 91769-6002, (800) 251-8191

0972010 Itasca Medical Care, 1219 SE Second Ave, Grand Rapids, MN, 55744, (218) 327-5528

0978103 JMH Health Plan, 155 S Miami Ave, Ste 110, Miami, GA, 33130, (305) 575-3728

0971055 Kaiser Foundation Health Plan Inc, 3840 Murphy Canyon Rd, San Diego, CA, 92123, (858) 614-3921

0971087 Kaiser Foundation Health Plan Inc, 80 Mahalani St, Wailuku, HI, 96793, (877) 875-3805

0972038 Kaiser Foundation Health Plan of Ohio, 5420 Lancaster Dr, Brooklyn Heights, OH, 44131,

(216) 398-3159

0971069 Kaiser Permanente, 2500 S Havana St, Aurora, CO, 80014, (303) 338-3601

0972005 Kaiser Permanente Medicare Plus, 210 E Jefferson St, Rockville, MD, 20852, (301) 625-2201

0972045 Kaiser Permanente Senior Advantage, 500 NE Multnomah #100, Portland, OR, 97232,

(503) 813-2315

0971086 Kaiser Permanente Senior Advantage, 3495 Piedmont Rd Ne, Atlanta, GA, 30305, (404) 364-7379

0972078 Kelsey Care Advantage, 8900 Lakes At 610 Dr, Ste 1100, Houston, TX, 77054, (713) 442-2273

0972054 Keystone 65, 1901 Market St, Philadelphia, PA, 19103, (267) 675-1201

0972053 Keystone Health Plan Central Inc, 2500 Elmerton Ave, Harrisburg, PA, 17177, (717) 541-7561

0971056 La Care Health Plan, 555 W 5Th St, 29th Floor, Los Angeles, CA, 90013, (213) 694-1250

0971074 Leon Medical Centers Health Plans Inc, 11501 SW 40th St, Miami, FL, 33165, (305) 631-5337

0972027 Liberty Health Advantage, One Huntington Quadrangle, Ste 3N01, Melville, NY, 11747,

(631) 777-1070

0972055 Life At Home LLC, 101 E State St, Kennett Square, PA, 19348, (610) 925-4077

0971009 Life Geisinger, 100 N Academy Ave, MC60-65, Danville, PA, 17822-6065, (570) 373-2100

0972056 Life Pittsburgh, 875 Greentree Rd, One Parkway Center, Pittsburgh, PA, 15220, (412) 388-8042

0970110 Life St Francis, National PACE, 1435 Liberty St, Hamilton, NJ, 08629, (609) 599-5474

0972020 Lovelace Insurance Co, 4101 Indian School Rd Ne, Albuquerque, NM, 87110, (505) 262-3816

0972065 MAPFRE Life Insurance Company, P. O. Box 70297, San Juan, PR, 00936-8297, (787) 250-6500

0972046 Marion Pold Community Health Plan Advantage Inc, 245 Commercial St SE, Ste 200, Salem,

OR, 97301, (503) 371-7701

0972006 Martins Point Generation Advantage, P. O. Box 9746, 891 Washington Ave, Portland, ME, 04104,

(207) 253-6137





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0972066 MCS ClassiCare, P. O. Box 171720, San Juan, PR, 00919-1720, (787) 758-2500

0971057 MD Care Inc, 10941 Bloomfield St, Ste F, Los Alamitos, CA, 90720, (562) 344-3413

0971075 MD Medicare Choice, 5501 W Waters Ave, Ste 401, Tampa, FL, 33634, (813) 901-9208

0971058 Medcore HP, 2609 E Hammer Lane, Stockton, CA, 95210, (209) 320-2616

0972011 Medica Health Plans, 401 Carlson Parkway, Minnetonka, MN, 55305, (952) 992-3601

0971076 Medica Healthcare Plans Inc, 4000 Ponce De Leon Blvd, Ste 650, Coral Gables, FL, 33146,

(305) 460-0618

0971088 Medical Associates Health Plan Inc, 1605 Associates Dr, Ste 101 P. O. Box 5002, Dubuque,

IA, 52001, (563) 584-4895

0972068 Medicare Y Mucho MBS, Bechara Ind Park Marginal Ave, Segarra St Building 4, San Juan,

PR, 00936, (878) 622-3000

0972041 Medigold, 6150 E Broad St, Ee320, Columbus, OH, 43213, (614) 546-3204

0972089 Mennonite Mutual Aid Association, 2219 Rimland Dr, P. O. Box 5348, Bellingham, WA, 98227,

(360) 392-9241

0972067 Mennonite Medicare Advantage, P. O. Box 1379, Aibonito, PR, 00705, (787) 535-1001

0971049 Mercy Care Advantage, 4645 E Cotton Center Blvd, Phoenix, AZ, 85040, (602) 263-3000

0972016 Mercy Health Plans, 1949 E Sunshine, One Corporate Cntr, Springfield, MO, 65804, (417) 836-0438

0972060 Mercy Life, 1900 Broad St, Philadelphia, PA, 19145, (215) 339-4533

0973006 Mercy Life of Springfield, 271 Carew St, Springfield, MA, 01104, (413) 532-3246

0973008 Meridian Complete, 333 S Wabash Ave, Chicago, IL, 60604, (312) 980-0434

0972029 Metroplus Health Plan, 160 Water St, 4th Floor, New York, NY, 10038, (212) 908-8600

0972012 Metropolitan Health Plan, 400 S Fourth St, Ste 201, Minneapolis, MN, 55415, (612) 543-3317

0971096 Midland PACE, 200 SW Frazier Circle, Topeka, KS, 66606, (785) 232-2044

0972007 Midwest Advantage, 5050 Schaefer Rd, Dearborn, MI, 48126, (313) 586-6001

0978098 Molina Healthcare, 8300 NW 33rd St, Ste 400, Doral, FL, 33122

0971059 Molina Healthcare, 200 Oceangate, Ste 100, Long Beach, CA, 90802, (562) 951-8329

0978101 Molina Healthcare of Ohio, 8101 N High St, Ste 108, Columbus, OH, 43235, (866) 472-4584

0972083 Mountain Empire PACE, P. O. Box 888, Big Stone Gap, VA, 24219, (276) 523-4202

0972030 MVP Gold, 220 Alexander St, Rochester, NY, 14607, (585) 327-2529

0001009 National PACE, Administrative Use Only, Charlestown, MA, 02129

0972031 Neighborhood Health Providers, 1377 Motor Pkwy, Ste 400, Islandia, NY, 11749, (631) 582-5435





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0972093 Network Health Insurance Corp PFFS Plan, 1570 Midway Place, Menasha, WI, 54952,

(920) 720-1540

0972017 New West Health Services, 130 Neil Ave, Helena, MT, 59601, (406) 457-2253

0972047 ODS Health Plan Inc, 601 SW Second Ave, Portland, OR, 97204, (877) 299-9062

0971060 On Lok Lifeways, 1333 Bush St, San Francisco, CA, 94109, (415) 292-8742

0970075 OneCare by Carefirst Health Plan of Arizona, 2355 E Camelback Rd, Ste 300, Phoenix, AZ, 85016,

(602) 778-1850

0971061 Onecare, 1120 W La Veta Ave, Orange, CA, 92868, (714) 246-8432

0972084 Optima Medicare, 4417 Corporation Lane, Virginia Beach, VA, 23462, (757) 552-7401

0971078 Optimum Healthcare Inc, 5403 Church Ave N, Tampa, FL, 33614, (813) 506-6000

0971072 Oxford Health Plans, 48 Monroe Turnpike, Ct015-1000, Trumbull, CT, 06611, (203) 459-7853

0971006 PACE Baton Rouge, 2041 Silverside Dr, Baton Rouge, LA, 70808, (225) 765-8255

0972001 PACE Greater New Orleans, 4201 N Rampart St, New Orleans, LA, 70117, (504) 945-1531

0972072 PACE Organization of Rhode Island, 225 Chapman St, P. O. Box 7, Providence, RI, 02905,

(401) 490-6566

0972088 PACE Vermont Inc, 786 College Pkwy, Colchester, VT, 05446, (802) 655-6700

0971048 PacifiCare UHC, 4061 E Hilton Ave, Ma Az74-149, Phoenix, AZ, 85034, (480) 377-5001

0972073 Palmetto Senior Care, 15 Richland Medical Park Dr, Ste 203, Columbia, SC, 29203, (803) 434-3770

0972042 Paramount Elite, 1901 Indian Wood Circle, Maumee, OH, 43537, (419) 887-2604

0972018 Partners National Health Plans, 5660 University Pkwy, Winston-Salem, NC, 27105, (336) 201-4700

0971066 Partnership Health Plan of California, 360 Campus Lane, Ste 100, Fairfield, CA, 94534,

(707) 863-4201

0972000 Passport Advantage, 305 W Broadway, Third Floor, Louisville, KY, 40202, (800) 578-0775

0972002 Peoples Health, 3 Lakeway Center, 3838 N Causeway Blvd, Metairie, LA, 70002, (504) 849-4500

0971090 Personal Care Advantra, 2110 Fox Dr, Champaign, IL, 61820, (217) 373-3911

0972052 Personal Choice 65, 1901 Market St, Philadelphia, PA, 19103, (267) 675-1201

0973004 Physicians Health Choice, 8637 Fredericksburg Rd, Ste 360, San Antonio, TX, 78240,

(866) 550-4736

0971079 Physicians United Plan, 483 N Semoran Blvd, Winter Park, FL, 32792, (407) 215-6317

0978094 Piedmont Health Senior Care, 1214 Vaughn Rd, Burlington, NC, 27217, (336) 532-0000

0978088 Piedmont Health Senior Care, 1214 Vaughn Rd, Burlington, NC, 27217

0970119 Piedmont Wellstar Healthplans, 2859 Paces Ferry Rd, Atlanta, GA, 30339, (815) 869-7225





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0970006 Positive Healthcare Partners, 1001 N Martel Ave, Los Angeles, CA, 90046, (323) 436-5006

0971080 Preferred Care Partners Inc, 9100 S Dadeland Blvd, Ste 1250, Miami, FL, 33156, (305) 670-8440

0972069 Preferred Simplex, 1500 Ponce De Leon Ave, Ste 3, San Juan, PR, 00936, (787) 641-1500

0978085 Preferred Medicare Choice Inc, 350 Avenida Chard, Ste 500, San Juan, PR, 00918

0972021 Presbyterian Medicare, P. O. Box 27489, Albuquerque, NM, 87125-7489, (505) 923-5915

0972039 Prime Time Health Plan, 214 Dartmouth Ave SW, Canton, OH, 44710, (800) 577-5084

0972013 Primewest Health System, 2209 Jefferson St, Ste 101, Alexandria, MN, 56308, (320) 335-5231

0970102 Principal Healthcare of Florida, 1200 Riverplace Blvd, Ste 500, Jacksonville, FL, 33207,

(800) 250-9011

0972008 Priority Medicare, 1231 E Beltline Ave NE, Grand Rapids, MI, 49525, (616) 464-8688

0970029 Prossam Plus, 452 Ponce De Le Ave, San Juan, PR, 00919, (787) 767-2929

0972049 Providence Elderplace Portland, 4531 SE Belmont, Ste 100, Portland, OR, 97215, (503) 215-3681

0972048 Providence Health Plan, 3601 Murray Blvd, Beaverton, OR, 97005, (503) 574-5922

0972090 Providence Health System, 4515 Martin Luther King Jr Way, Ste 100, Seattle, WA, 98108,

(206) 320-5325

0972091 Puget Sound Health Partners, 7502 Lakewood Dr W, Ste A, Lakewood, WA, 98499, (253) 779-8830

0971081 Quality Health Plans, 2435 US Highway 19, Ste 470, Holiday, FL, 34691, (727) 945-8400

0971089 Regence Blue Shield of Idaho, 21602 21st Ave, Lewiston, ID, 83501, (208) 798-2412

0972085 Riverside PACE, 4107 W Mercury Blvd, Hampton, VA, 23666, (757) 325-6084

0971070 Rocky Mountain Health Plans, P. O. Box 10600, Grand Junction, CO, 81502, (970) 244-7760

0972070 Saluk Dorada Con Medicare, P. O. Box 3078, Bayamon, PR, 00960-3078, (787) 999-4848

0972050 Samaritan Advantage Health Plan, P. O. Box M, Corvallis, OR, 97339, (541) 768-4550

0970073 San Luis Valley HMO, 700 Main St, Ste 100, Alamosa, CO, 81101, (719) 589-3696

0971063 San Miguel Health Plan, 100 W Broadway, Ste 4000, Long Beach, CA, 90802, (562) 435-3400

0971064 Santa Clara Family Health Plan, 210 E Hacienda Ave, Campbell, CA, 95008, (408) 874-1750

0973003 Santa Fe Employees Hospital Association, 626 E San Bernardino Rd, Covina, CA, 91723,

(626) 967-3550

0972080 Scott and White Health Plan Senior Care, 2401 S 31st St, Temple, TX, 76508, (254) 298-3110

0972097 Secure Horizons by United Healthcare, 2725 Mall Dr, W1080-1000, Eau Claire, WI, 54701,

(715) 858-2295

0972096 Security Health Plan of Wisconsin Inc, 1515 Saint Joseph Ave, Marshfield, WI, 54449,

(715) 221-9763





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0972057 Select Advantage, 1901 Market St, Philadelphia, PA, 19103, (267) 675-1201

0970002 Select Care of Texas, 4888 Loop Central Dr, Ste 700, Houston, TX, 77081, (800) 462-0628

0972034 Senior Care Connection Inc, 504 State St, Schenectady, NY, 12305, (518) 382-3290

0972059 Senior Life Johnstown, 401 Broad St, Johnstown, PA, 15906, (814) 535-6000

0978092 Senior Whole Health, 58 Charles St, Second Floor, Cambridge, MA, 02141, (617) 494-5353

0972086 Sentara Senior Community Care, 554 Newton Rd, Ste 121, Virginia Beach, VA, 23462,

(757) 502-7806

0978093 Sidney Hillman Health Center, 333 S Ashland, Chicago, IL, 60607, (312) 738-6170

0972023 Sierra Health and Life Insurance Co, 2716 N Tenaya Way, Las Vegas, NV, 89128, (702) 242-7073

0978109 Simply Healthcare Plans, 1701 Ponce De Leon Blvd, Cora Gables, FL, 33134, (877) 915-0551

0972014 South Country Health Alliance, 110 W Fremont St, Owatonna, MN, 55060, (507) 431-6591

0970113 St Paul's PACE, National PACE, 111 Elm St, San Diego, CA, 92101, (619) 677-3800

0978107 Sterling Life Insurance Company, 2219 Rimland Dr, P. O. Box 5348, Bellingham, WA, 98227,

(360) 647-9080

0972043 Summa Care, P. O. Box 3620, Akron, OH, 44309-3620, (330) 996-8414

0971050 Sun Health Medisun Inc, 13632 N 99th Ave Ste B, P. O. Box1489, Sun City, AZ, 85372,

(623) 544-7446

0971067 Sutter Senior Care, 7000 Franklin Blvd, Ste 1020, Sacramento, CA, 95823, (916) 424-8412

0972037 The Health Plan, 52160 National Rd E, St Clairsville, OH, 43950, (740) 695-7605

0971095 The M Plan Senior Smart Choice, 8802 N Meridian St, Ste 100, Indianapolis, IN, 46260,

(317) 571-5397

0972074 The Methodist Oaks PACE, P. O. Drawer 327, Orangeburg, SC, 29116, (803) 534-1212

0971071 Total Community Care, 200 9th Ave, Denver, CO, 80203, (303) 869-4664

0971047 Total Life Healthcare, 225 E Jackson #92, Jonesboro, AR, 72401, (870) 336-5004

0972035 Touchstone Health, 14 Wall St, New York, NY, 10005, (212) 294-6555

0972044 Trihealth Senior Link, 4600 Wesley Ave, Ste N, Cincinnati, OH, 45212, (513) 569-5052

0972051 Trillium Advantage, 1800 Millrace Dr, Eugene, OR, 97403, (541) 485-2155

0972071 Triple-S Inc, P. O. Box 363628, San Juan, PR, 00936-3628, (787) 273-1110

0970032 Triple-S Inc, P. O. Box 363628, San Juan, PR, 00936-3628, (787) 273-1110

0972061 Trustees of the University of Pennsylvania, 4508 Chestnut St, Philadelphia, PA, 19139,

(215) 573-7201

0101002 Tufts Medicare Preferred, P. O. Box 9183, Watertown, MA, 02471, (800) 279-9022





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Carrier


0972076 UAHC Gold, 1769 Paragon Dr, Ste 100, Memphis, TN, 38132, (901) 348-3317

0972015 UCare, 500 Stinson Blvd NE, Minneapolis, MN, 55413, (612) 676-3411

0970100 Ultimate Health Plans Medicare HMO, 1800 Millrace Dr, Eugene, OR, 97403, (541) 762-2173

0970890 Unicare Health and Life, P. O. Box 795180, San Antonio, TX, 78279, (866) 364-2374

0971091 Union Medical Center, 1649 W Adams, Third Floor, Chicago, IL, 60612, (312) 829-0850

0972082 Union Pacific Railroad Employees Health Systems, 1040 N 1100 W, P. O. Box 161020,

Salt Lake City, UT, 84116, (801) 595-4362

0972062 Unison Advantage, 1001 Brinton Rd, Pittsburgh, PA, 15221, (800) 600-9007

0970118 United Healthcare Community Plan of Ohio, 9200 Worthington Road, Westerville, OH, 43082,

(888) 903-7587

0978089 United Healthcare Insurance Company, 4350 W Cypress St, Ste 1000, Tampa, FL, 33607-4164

0975083 United Healthcare Medicare Solutions, P. O. Box 31362, Salt Lake City, UT, 84131-0362,

(877) 842-3210

0972099 United Healthcare Personal Care Plus, 10701 W Research Dr, Milwaukee, WI, 53226,

(414) 443-4072

0488053 United Healthcare Railroad Medicare Over 65, P. O. Box 30304, Salt Lake City, UT, 84130

0978081 United Mine Workers of America, 222 W Lascolinas Blvd, Ste 400N, Irving, TX, 75039

0972079 Universal American, 9990 Richmond Ave, Ste 300 N, Houston, TX, 77042, (713) 273-8862

0971082 Universal Health Care Inc, 150 2nd Ave N, Ste 400, Saint Petersburg, FL, 33701, (866) 690-4842

0971051 University Physicians Maricopa Care Advantage, 2701 E Elvira, Tucson, AZ, 85706, (520) 874-5533

0972063 UPMC Health Plan, 112 Washington St, Pittsburgh, PA, 15219, (412) 454-5539

0972033 USA Care, 220 Alexander St, Rochester, NY, 14607, (585) 327-2529

0972003 Vantage Health Plan Inc, 130 De Siard St, Ste 300, Monroe, LA, 71201, (318) 361-0900

0971097 Via Christi Hope, 2622 W Central, Ste 100, Wichita, KS, 67203, (316) 946-5211

0972087 Virginia Premium Gold, 600 E Broad St, Ste 400, Richmond, VA, 23220, (804) 819-5151

0971083 Vista Healthplan Inc, 1340 Concord Terr, Sunrise, FL, 33323, (954) 858-3440

0970112 Vital Traditions, Scott & White Health Plan, P. O. Box 21800, Eagan, MN, 55121-0800,

(800) 782-5068

0971046 Viva Medicare Plus, 1222 14th Ave S, Birmingham, AL, 35205, (205) 939-0819

0972036 VNS Choice Medicare, 1250 Broadway, 11th Floor, New York, NY, 10001, (866) 783-1444

0971093 Wabash Memorial Hospital, 1340 N Water St, P. O. Box 1340, Decatur, IL, 62526, (217) 429-5246

0971094 Welborn Health Plans, 101 SE Third St, Evansville, IN, 47708, (812) 773-0307





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0971021 Wellcare, 8735 Henderson Rd, Tampa, FL, 33634, (813) 290-6200

0972064 Wellcare, P. O. Box 4438, Scranton, PA, 18505, (866) 235-2770

0971068 Western Health Advantage, 2349 Gateway Oaks Dr, Ste 100, Sacramento, CA, 95823,

(916) 563-2217

0972077 Windsor Medicare Extra, 7100 Commerce Way, Ste 285, Brentwood, TN, 37027, (615) 782-7949

0971014 Wisconsin Personal Care Plan, 2503 N Hillcrest Parkway, Altoona, WI, 54720, (715) 852-2600

Medicare D Carrier Codes

0017002 AARP Medicare Rx Plan, P. O. Box 29300, Hot Springs, AR, 71903, (806) 429-6686

0986011 Abrazo Advantage Health Plan, 7878 N 16th St, Phoenix, AZ, 85020-4449, (602) 487-3976

0986009 Advantra, 11 Stanwix St, Ste 2300, Pittsburgh, PA, 15222, (412) 577-5442

0986010 Advantra, 6705 Rockledge Dr, Bethesda, MD, 20817-1814, (866) 386-2330

0985002 Aetna Life Insurance Company, 151 Farmington Ave, Hartford, CT, 06156, (800) 444-5179

0986102 Aetna Medicare, 730 Holly Dr, Building 8, Pittsburgh, PA, 15220

0001001 Aetna Medicare Rx Essentials, 980 Jolly Rd, Blue Bell, PA, 19422, (877) 238-6211

0986094 Affinity Health Plan, 2500 Halsey St, Bronx, NY, 10461-3637, (718) 794-6228

0985003 Alliance Health and Life Insurance Co, 2850 W Grand Blvd, Detroit, MI, 48202, (248) 443-7511

0986012 Altus Advantra, 10421 S Jordan Gateway, South Jordan, UT, 84095, (801) 933-3561

0986013 American Health Medicare, Microsoft Building Metro Office, Guaynabo, PR, 00922, (787) 620-1919

0985004 American Progressive Life and Health Ins Co NY, 3050 Universal Blvd, Ste 150, Weston, FL, 33331,

(766) 766-3052

0986101 Americhoice Personal Care Plus, 9701 Data Park Dr, Minnetonka, MN, 55343

0986014 Amerigroup Community Care, 4200 W Cypress St, Tampa, FL, 33607-4156, (866) 805-4589

0985005 Amerihealth HMO Inc, 1901 Market St, Philadelphia, PA, 19103, (800) 331-0017

0985068 Amerihealth Ins Co, 1901 Market St, Philadelphia, PA, 19103, (800) 331-0017

0985006 Anthem Insurance Companies Inc, P. O. Box 34160, Louisville, KY, 40232, (866) 755-2776

0986016 APIPA Personal Care Plus, 3141 N Third Ave, Phoenix, AZ, 85013, (877) 614-0623

0986017 Arcadian Care Health Plan, 825 Washington St, Ste 300, Oakland, CA, 94607, (800) 573-8597

0985007 Arkansas BCBS A Mutual Ins Co, 320 W Capitol, Ste 400, Little Rock, AR, 72203, (800) 634-6314

0985008 Asuris Northwest Health, 1800 Ninth Ave, Seattle, WA, 98101-1322, (888) 734-3623

0985009 Avalon Insurance Co, 1400 Elmerton Ave, Harrisburg, PA, 17177, (877) 234-3853





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Carrier


0985010 BCBS of Alabama and BCBS of Tennessee, 450 Riverchase Pkwy E, Birmingham, AL, 35244,

(205) 220-2780

0985097 Blue Cross Blue Shield Massachusetts, HMO Med D, Pharmacy and Patient Care Contact,

401 Park Drive, Boston, MA 02215-3326

0985011 Blue Cross Blue Shield Northern Plains Alliance, P. O. Box 995, Blue Bell, PA, 19422-9987,

(866) 434-2037

0985014 Blue Cross Blue Shield of Florida, 8400 NW 33rd St, Ste 100, Miami, FL, 33122, (800) 926-6565

0986020 Blue Cross Blue Shield of Florida Medicare, 8400 NW 33rd St, Ste 100, Miami, FL, 33122

0986024 Blue Cross Blue Shield of Idaho Medicare, 801 Pine St, Chattanooga, TN, 37402, (800) 841-7434

0985012 Blue Cross Blue Shield of Kansas, P. O. Box 34160, Louisville, KY, 40232, (866) 755-2776

0985096 Blue Cross Blue Shield of Massachusetts Med D, Pharmacy and Patient Care, 401 Park Drive,

Boston, MA, 02215-3326

0985015 Blue Cross Blue Shield of Michigan, 27000 W Eleven Mile Rd, H404, Southfield, MI, 48034,

(800) 485-4415

0986021 Blue Cross Blue Shield of Michigan Medicare, 27000 W Eleven Mile Rd, H404, Southfield,

MI, 48034

0985016 Blue Cross Blue Shield of North Carolina, 5660 University Pkwy, Winston Salem, NC, 27105,

(336) 201-4700

0986019 Blue Cross Blue Shield of Rhode Island Medicare, 444 Westminster St, Providence, RI, 02903

0985013 Blue Cross Blue Shield of South Carolina, 1-20 St Alpine Rd, Columbus, SC, 29219, (803) 264-1440

0986022 Blue Medicare PPO Medicare D, 901 S Central Expressway, Richardson, TX, 75080, (972) 766-1676

0985017 Blue Medicare Rx, P. O. Box 34160, Louisville, KY, 40232, (766) 755-2776

0006005 Blue Medicare Rx Premier, 2 Gannett Dr, South Portland, ME, 04106, (866) 755-2776

0986023 Blue Shield of California Medicare D, 6300 Canoga Ave, Woodland Hills, CA, 91367,

(800) 776-4466

0985018 Bravo Health Insurance Co Inc, 360 O'Donnell St, Baltimore, MD, 21224, (877) 504-7252

0985019 C and O Employees Hospital Association, 511 Main St, Second Floor, Clinton Forge, VA, 24422,

(800) 679-9135

0985020 California Physicians Service dba Blue Shield of California, 6300 Canoga Ave, Woodland Hills,

CA, 91367, (800) 776-4466

0985021 Cambridge Life Insurance Co, 960 Macarthur Blvd, Mahwah, NJ, 07495-9935, (800) 882-3822

0985022 Capital Advantage Insurance Co, 2500 Elmerton Ave, Harrisburg, PA, 17177, (866) 987-4213

0986025 Capital Advantage Insurance Co, 2500 Elmerton Ave, Harrisburg, PA, 07177

0986108 Care First Medicare Advantage Plan, 604 Potrero Grande Dr, Monterey Park, CA, 91755





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Carrier


0986026 Care Improvement Plus, 351 W Camden St, Ste 100, Baltimore, MD, 21201, (410) 625-2200

0986095 Care Oregon Advantage, 315 SW Fifth Ave, Ste 900, Portland, OR, 97204, (800) 224-4840

0986027 Care Plus Health Plans, 11430 NW 20th St, Ste 300, Doral, FL, 33172, (305) 441-9400

0986109 Caresource, P. O. Box 8738, Dayton, OH, 45401

0985023 Carpenters Health and Welfare Trust Fund, 1419 Hampton Ave, St Louis, MO, 63139,

(314) 644-7226

0985024 CDPHP Universal Benefits Inc, 500 Patroon Creek Blvd, Albany, NY, 12206, (518) 641-3710

0986028 Cigna Medicare Access, 900 Cottage Grove Rd, Hartford, CT, 06152

0986029 Cigna Medicare Select, 11001 N Black Canyon Highway, Phoenix, AZ, 85029, (800) 627-7534

0985025 Citrus Healthcare, 5420 Bay Center Dr, Ste 250, Tampa, FL, 33609, (813) 490-8900

0985088 Commonwealth Care Alliance, 30 Winter St, Boston, MA, 02108

0986005 Commonwealth Care Med D, 30 Winter St, Boston, MA, 02108

0986030 Community Care, 218 W 6th St, Tulsa, OK, 74119

0986031 Community Health Group, 740 Bay Blvd, Chula Vista, CA, 91910, (619) 498-6597

0986032 Connecticare Insurance Co Medicare D, 175 Scott Swamp Rd, Farmington, CT, 06032,

(860) 409-2400

0985026 Connecticut General Life Insurance Co, P. O. Box 269005, Weston, FL, 33326-9927, (800) 222-6700

0985000 Cooperativa de Seguros de Vida de Puerto Rico, P. O. Box 363428, San Juan, PR, 00936,

(787) 751-5656

0986033 CosviMed Care, P. O. Box 363428, San Juan, PR, 00936, (787) 751-5656

0985027 Coventry Health and Life Insurance Co, 960 Macarthur Blvd, Mahwah, NJ, 07495-9935,

(800) 882-3822

0985028 Dean Health Insurance Inc, 1277 Deming Way, Madison, WI, 53717, (608) 827-4144

0986105 Easy Choice Health Plan, 180 E Ocean Blvd, Ste 700, Long Beach, CA, 90802

0985029 Educators Mutual Insurance Association, 852 E Arrowhead Lane, Murray, UT, 84107,

(801) 270-2974

0985094 Elder Service Plan, 270 Green St, Cambridge, MA, 02139

0985095 Elder Service Plan North Shore, 13 Water St, Holliston, MA, 01746

0986034 Empire Health Choice Assurance Inc, 145 S Pioneer Rd, WIW202-FDL2, Fond du Lac, WI, 54935

0985030 Envision Insurance Co, 2181 E Aurora Rd, Twinsburg, OH, 44087, (330) 405-8080

0986035 Erickson Advantage, 2725 Mall Dr, W10801000, Eau Claire, MN, 55343, (888) 861-5518

0986036 Essence Healthcare, 12655 Blvd, 4th Floor, St Louis, MO, 63141, (314) 851-3600





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Carrier


0985031 Excellus Health Plan Inc, 205 Park Club Lane, Buffalo, NY, 14221, (800) 659-1986

0985032 Express Scripts Insurance CO, One Express Way, St Louis, MO, 63121, (800) 332-5455

0985098 Fallon Community Health Med D, 6820 Fairfield Business Dr, Fairfield, OH, 45014

0985099 Fallon Community Health Plan Med D, 6820 Fairfield Business Dr, Fairfield, OH, 45014

0986037 Fidelis Care, 9300 Harris Corner Parkway, Ste 100, Charlotte, NC, 28269, (847) 592-9158

0986038 Fidelis Care, 95-25 Queens Boulevard, Rego Park, NY, 11374, (800) 247-1447

0985034 First Health Life and Health Insurance Co, 960 Macarthur Blvd, Mahwah, NJ, 07495-9935,

(800) 882-3822

0985035 First Medical Health Plan Inc, P. O. Box 195200, San Juan, PR, 00919, (787) 625-9557

0985033 First Care Inc, 150 S Clinton St, 8th Floor, Baltimore, MD, 21224, (410) 528-7897

0986098 Florida Health Care Plan, 1340 Ridgewood Ave, Holly Hill, FL, 32117

0985036 Fox Insurance Co, 40 W 25th St, 6th Floor, New York, NY, 10010, (469) 464-1258

0986039 Freedom Health Inc, 6403 N Church Ave, Tampa, FL, 33614, (800) 401-2740

0986040 Gateway Health Plan Medicare Assured, 600 Grant St, 41st Floor, Pittsburgh, PA, 15219,

(800) 685-5209

0985037 Geisinger Indemnity Insurance Co, 100 N Academy Ave, Danville, PA, 17822-3229, (800) 498-9731

0985038 GHI, 70 Wolf Rd, 6th Floor, Albany, NY, 12205, (518) 446-6941

0986041 GHI Medicare Choice PPO Medicare D, 80 Wolf Rd, 6th Floor, Albany, NY, 12206, (866) 557-7300

0986042 Group Health Plan Inc, 550 Maryville Center Dr, Ste 300, St Louis, MO, 63141

0985089 Harvard Pilgrim Medicare D, MedImpact Healthcare Systems, San Diego, CA, 92131

0985039 Hawaii Medical Services Association, 818 Keeaumoku St, Honolulu, HI, 96814, (809) 948-6584

0985040 HCSC Insurance Services Co, P. O. Box 2190, Chester, VA, 23831, (888) 285-2249

0986043 Health Alliance Medical Plans, 301 S Vine St, Urbana, IL, 61801-3347

0986044 Health Choice Generations, 410 N 44th St, Ste 510, Phoenix, AZ, 85008, (800) 656-8991

0986045 Health First Medicare Plans, 6450 Us Highway 1, Rockledge, FL, 32955, (321) 434-5665

0985041 Health Net Life Insurance Co of New York, 10540 White Rock Rd, Ste 280, Rancho Cordova,

CA, 95670, (800) 806-8811

0986046 Health Net of Arizona, 1230 W Washington St, Ste 401, Tempe, AZ, 85281, (800) 977-7522

0986047 Health Net of California, 21281 Burbank Blvd, Building B, Woodland Hills, CA, 91367,

(800) 275-4737

0986048 Health Net of Connecticut, One Far Mill Crossing, Shelton, CT, 06484, (800) 547-8734

0986049 Health Net Pearl, 21650 Oxnard St, Woodland Hills, CA, 91387, (800) 977-8221





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Carrier


0986050 Health New England Medicare D, One Monarch Place, Springfield, MA, 01144, (413) 787-4000

0986054 Health Partners, 8170 33rd Ave S, Bloomington, MN, 55425

0986051 Health Plan of Nevada Inc, 2720 N Tenaya Way, Las Vegas, NV, 89128, (702) 838-2066

0986110 Health Plus Elite, 241 37th St, Ste 412, Brooklyn, NY, 11201

0986055 Health Plus of Michigan, 2050 S Linden Rd, P. O. Box 1700, Flint, MI, 48501

0986106 Health Sun Health Plans Inc, 1205 SW 37th Ave, Miami, FL, 33135

0985043 Healthspring of Alabama Inc, 601 Mainstream Dr, Nashville, TN, 37228, (800) 331-6293

0985042 Heathnow New York Inc, 30 Century Hill Dr, Latham, NY, 12110, (518) 220-4699

0985044 Highmark Senior Resources Inc, 120 Fifth Ave, Ste 5501, Pittsburgh, PA, 15222, (800) 290-3914

0985045 HIP Health Plan of New York, 55 Water St, 12th Floor, New York, NY, 10041, (646) 447-7838

0985046 Horizon BCBS of New Jersey, Tree Penn Plaza E, Pp-09F, Newark, NJ, 07105, (800) 224-1234

0986099 Humana Health Plans, 101 E Main St, Louisville, KY, 40202

0985047 Humana Insurance, 500 W Main St, Louisville, KY, 40202, (800) 281-6918

0986056 Independent Health, 511 Farber Lakes Dr, Buffalo, NY, 14221

0985048 Instil Health Insurance Co, P. O. Box 100294, Mail Code Ag-790, Columbia, SC, 29202,

(803) 763-6539

0986057 Kaiser Foundation Health Plans Inc HI, 711 Kapiolani Blvd, Honolulu, HI, 96813, (800) 805-2739

0986059 Kaiser Permanente, 10350 E Dakota Ave, P. O. Box 378066, Denver, CO, 80247, (800) 632-9700

0986060 KelseyCare Advantage, 2727 W Holcombe, 4th Floor, Houston, TX, 77025, (713) 442-2273

0986061 Keystone 65, 1901 Market St, 45th St, Philadelphia, PA, 19103, (800) 331-0017

0986062 Keystone Health Plan Central, 2500 Elmerton Ave, Harrisburg, PA, 17177, (717) 541-7561

0985049 Louisiana Health Service and Indemnity Co, 5525 Reitz Ave, Baton Rouge, LA, 70809,

(888) 223-2583

0986063 MAPFRE Life Insurance Co, Urb Tres Monjitas Industrial Park, 297 Carlos Chard, San Juan,

PR, 00936

0985050 MCS Advantage Inc, 255 Ponce De Leon Ave, Second Floor, San Juan, PR, 00918, (787) 758-2500

0986004 Medco Containment Med D, 100 Parsons Pond Dr, Franklin Lakes, NJ, 07417

0985051 Medco Health Solutions of Texas, 8111 Royal Ridge Pkwy, Irving, TX, 75063, (972) 915-6113

0986064 Medica Health Plans, 401 Carlson Parkway, Minnetonka, MN, 55305

0985052 Medical Mutual of Ohio, 2060 E Ninth St, Cleveland, OH, 44115, (419) 473-7969

0980999 Medicare D Eligible, Ask Member For Copy of Card





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Carrier


0006009 Medicare Rx Rewards Value, P. O. Box 9092, Oxnard, CA, 93031

0986065 Medicare Y Mucho MBS, Bechara Ind Park Marginal, Building 4, San Juan, PR, 00922

0985053 Mennonite General Hospital, P. O. Box 1379, Aibonito, PR, 00705, (787) 735-4544

0986066 Mennonite Mutual Aid Associates, 2219 Rimland Dr, PO Noc 5348, Bellingham, WA, 98227,

(360) 392-9241

0986067 Mercy Care Advantage, 43350 E Cotton Center Blvd, Building D, Phoenix, AZ, 85040,

(602) 263-3000

0986097 Metroplus Health Plan, 160 Water St, 4th Floor, New York, NY, 10038

0985054 MoDOT and MSHP Medical and Life Insurance, 1061 Peruque Crossing Ct, O'Fallon, MO, 63366,

(636) 614-1344

0985055 National Rural Electric Cooperative Association, 4301 Wilson Blvd, Arlington, VA, 22203,

(866) 673-2299

0982031 Neighborhood Health Providers, 1377 Motor Pkwy, Ste 400, Islandia, NY, 11749, (631) 582-5435

0986068 New West Health Services, 130 Neil Ave, Helena, MT, 59601, (406) 457-2253

0985056 NMHC Group Solution Insurance Inc, 23 British American Pkwy, Latham, NY, 12110,

(518) 213-1631

0005001 NMHC Medicare PDP Gold, 9343 Tech Center Dr, Sacramento, CA, 95826, (866) 443-1095

0985057 ODS Health Plan Inc, 601 SW Second Ave, Portland, OR, 97204, (877) 299-9062

0985058 Oklahoma State and Education Emp Grp Ins Board, 3545 NW 58th St, Ste 110, Oklahoma City,

OK, 73112, (800) 865-5142

0986107 One Care, 1120 W La Veta Ave, Orange, CA, 92868

0986069 Optimum Health Care Inc, 5403 N Church Ave, Tampa, FL, 33614, (813) 506-6111

0989098 Out of Region PDP Plan, POPS, Boston, MA, 02112

0985090 PacifiCare, P. O. Box 841239, Houston, TX, 77284

0986070 PacifiCare UHC, 406 E Hilton Ave, Phoenix, AZ, 01255

0985059 Paramount Insurance Co, 1901 Indian Wood Circle, Maumee, OH, 43537, (419) 887-2525

0985060 Penn Life Insurance Co, 29100 Aurora Rd, Solon, OH, 44139, (440) 248-8448

0985061 Pennsylvania Life Insurance Co, 3050 Universal Blvd, Ste 150, Weston, FL, 33331, (866) 566-3050

0986071 Peoples Health, 3 Lakeway Center, 383800 Causeway Blvd, Metairie, LA, 70002, (504) 849-4500

0986073 Personal Care Advantra, 2110 Fox Dr, Champaign, NC, 55555

0986072 Personal Choice 65, 1901 Market St, Philadelphia, PA, 19103-1400, (800) 331-0017

0985062 Pharmacy Insurance Corporation of America, P. O. Box 70232, San Juan, PR, 00936-8232,

(787) 625-4343





Page

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Date

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Carrier


0986074 Physicians United Plan, 483 N Semoran Blvd, Winter Park, FL, 32792, (866) 571-0693

0985063 Preferred Health Inc, 1550 Ponce De Leon Ave Ste 3, Urb Caribe, San Juan, PR, 00926,

(787) 641-1500

0985064 Preferred Medicare Choice Inc, 350 Avenida, Ste 500, San Juan, PR, 00918, (787) 622-3000

0985065 Presbyterian Insurance Co, P. O. Box 27489, Albuquerque, NM, 87125-4789, (505) 923-5370

0986075 Prime Time Health Plan, 214 Dartmouth Ave SW, Canton, OH, 44710, (800) 577-5084

0985066 Priority Health Insurance Co, 1231 E Beltine Ave NE, Grand Rapids, MI, 49525, (888) 389-6648

0986077 Providence Elder Place Portland, 4531 SE Belmont, Ste 100, Portland, OR, 97215, (503) 215-6556

0985067 PSERS-HOP Program, 1061 Peruque Crossing Ct, O'Fallon, MO, 63366, (636) 614-1344

0985069 Quality Health Plans Inc, 2435 Us Highway 19, Ste 470, Holiday, FL, 34691, (727) 945-8400

0985070 Regence Life and Health Insurance Co, 1800 9th Ave, Seattle, WA, 98101-1322, (888) 734-3623

0985071 Rocky Mountain Health Maintenance Organization, P. O. Box 10600, Grand Junction, CO, 81502,

(800) 346-4643

0985072 Rx America LLC, 221 N Charles Lindbergh Dr, Salt Lake City, UT, 84116, (800) 429-6686

0986078 Salud Dorada Con Medicare, 28 Calle Santa Cruz, Baymam, PR, 00960, (787) 999-4848

0985073 Scott and White Health Plan, 2401 S 31st St, Temple, TX, 76508, (866) 344-3141

0986079 Secure Horizons by United Healthcare, 9900 Bren Road E, Minnetonka, MN, 55343, (888) 867-5517

0986081 Secure Horizons by United Healthcare, 6455 S Yosemite St, Greenwood Villa, CO, 80111-5139,

(500) 385-5588

0986082 Secure Horizons by United Healthcare, 410 N 44th St, P. O. Box 52078, Phoenix, AZ, 85034,

(800) 385-5588

0986083 Secure Horizons by United Healthcare, 5995 Plaza Dr, Cypress, CA, 90630, (800) 385-5588

0986084 Secure Horizons by United Healthcare, 48 Monroe Turnpike, Trumball, CT, 06611, (800) 234-1228

0986096 Secure Horizons by United Healthcare, 2725 Mall Dr, Eau Claire, WI, 54701

0985074 Select Health of South Carolina, 200 Stevens Dr, Philadelphia, PA, 19113, (215) 569-9244

0986085 Senior Care Plus, 830 Harvard Way, Reno, NV, 89502, (775) 982-3102

0985091 Senior Whole Health, 58 Charles St, Cambridge, MA, 02141

0986006 Senior Whole Health Med D, 58 Charles St, Cambridge, MA, 02141

0985075 Sierra Health and Life Insurance Co, 2716 N Tenaya Way, Las Vegas, NV, 89128, (702) 838-2066

0985076 Silverscript Insurance Co, 9501 E Shea Blvd, MC132, Scottsdale, AZ, 85260, (866) 552-6106

0985077 Sterling Life Insurance Co, 2219 Rimland Dr, P. O. Box 5348, Bellingham, WA, 98227-5348,

(360) 647-9080





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Date

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Carrier


0986086 Summacare, 10 N Main St, P. O. Box 3620, Akron, OH, 44308

0986104 Texas Community Care, 955 Overland Court, Second Floor, San Dimas, CA, 91773

0985078 The Port of Authority of New York and New Jersey, 711 Ridgedale Ave, East Hanover, NJ, 07936,

(800) 824-0898

0986087 Touchstone Health, 14 Wall St, New York, NY, 10005

0985079 Triple-S Inc, 1441 Franklin D Roosevelt Ave, San Juan, PR, 00920, (800) 510-0722

0986000 Tufts Health Plan Med D, 705 Mt Auburn St, Watertown, MA, 02471

0017003 UA Medicare Part D Rx Coverage Silver Plan, 3700 S Stonebridge Dr, McKinney, TX, 75070,

(866) 299-3406

0985080 Unicare Life and Health Insurance Co, P. O. Box 9092, Oxnard, CA, 93031, (800) 928-6201

0986015 Unicare Med D, 1 Wellpoint Way, Thousand Oaks, CA, 91362-3893, (888) 445-8916

0985081 Union Pacific Railroad Employees Health System, 1040 N 2200, Ste 200, Salt Lake City, UT, 84116,

(801) 595-4309

0986088 Unison Advantage, 1001 Brinton Rd, Pittsburgh, PA, 15221, (800) 290-4009

0985082 United American Insurance Co, 3700 S Stonebridge Dr, McKinney, TX, 75070, (972) 569-3667

0986003 United Health Care Med D, 1417 Lake Cook Rd, Deerfield, IL, 60015

0986007 United Health Group, 1417 Lake Cook Rd, Deerfield, IL, 60015

0986002 United Health Group Med D, 1417 Lake Cook Rd, Deerfield, IL, 60015

0985083 United Healthcare of New York, P. O. Box 29300, Hot Springs, AZ, 71903-9300, (888) 867-5575

0986089 Universal American, 1001 Heathrow Park Ln, Lake Mary, FL, 32746

0986103 Universal American, 4888 Loop Central Dr, Ste 700, Houston, TX, 77081

0986111 University Physicians Maricopa Care, 2701 E Elvira, Tucson, AZ, 85756

0985093 Upham Corner Health Committee, 1140 Dorchester Ave, Dorchester, MA, 02125

0985084 UPMC Health Benefits Inc, 112 Washington Place, Pittsburgh, PA, 15219, (877) 381-3765

0986091 USA Care, 220 Alexander St, Rochester, NY, 14607, (800) 999-3920

0986092 Vista Health Plan Inc, 1340 Concord Terr, Sunrise, FL, 33323, (800) 847-3995

0986093 VNS Choice Medicare, 107 E 70th St, New York, NY, 10021, (866) 783-1444

0985085 Wellcare Prescription Insurance Inc, 8735 Henderson Rd, Tampa, FL, 33634, (888) 423-5252

0985086 Windsor Health Plan Inc, 7100 Commerce Way, Brentwood, TN, 37207, (800) 811-8483

0985087 Wisconsin Physicians Service Insurance, 1717 W Broadway, P. O. Box 8190, Madison, WI, 53708,

(608) 226-7883





Page

C-64


ALL-213

Date

11/01/14

Carrier


Casualty Payer Carrier Codes

2222220 Automobile Accident, For Automobile Accident Claims Only, Boston, MA, 02111

2222221 Workers’ Compensation, For WC Claims Only, Boston, MA, 02111

2222222 Other Casualty, For Other Casualty Claims Use Only, Boston, MA, 02111

2222229 CP-HSN, For HSN CP Claims Only, Boston, MA, 02111

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