Insurance Carrier List - Lawrenceville Family Practice...alliant health plans y po box 2667 dalton, ga 30722 (800) 811-4793 alliant health plans y po box 3708 corpus christi, tx 78463 - [PDF Document] (2024)

Insurance Carrier List

Name Active

Address

City/State

Zip Contact Phone

Not Assigned-1-1199 NATIONAL BENEFIT FUND Y PO BOX 1007 NEW YORK, NY 10108 (888) 819-1199

-G-GROUP HEALTH N PO BOX 34585 SEATTLE, WA 98124

-M-MOUNTAIN STATES ADMIN SERVICES N PO BOX 67117 PHOENIX, AAZ 85082

-P-pan american life insurance N po box 75261 dallas, TX 75261

-U-UNICARE N PO BOX 8504 MASON, OH 45050 (800) 521-9605UNITED HEALTHCARE N PO BOX 5210 KINGSTON, NY 12402 (877) 972-8845

AETNA-A-AETNA N PO BOX 981105 EL PASO, TX 79998 (888) 632-3862AETNA Y PO BOX 14100 LEXINGTON, KY 40512 (888) 632-3862

CLAIMS DEPTAETNA N PO BOX 15708 BOSTON, MA 02215 (888) 632-3862AETNA N PO BOX 30259 TAMPA, FL 33630 (800) 414-0596AETNA - 14079 Y PO BOX 14079 LEXINGTON, KY 40512 (800) 844-5562

MEDICAL CLAIMS DEPARTMENT (888) 553-3449AETNA - 981107 Y PO BOX 981107 EL PASO, TX 79998 (800) 248-3132

MEDICAL CLAIMS DEPARTMENT (800) 245-1206AETNA 981543 Y PO BOX 981543 EL PASO, TX 79998 (866) 505-6001

CLAIMS DEPT.AETNA HEALTH AND LIFE INSURANCE COMPANY

Y PO BOX 14770 LEXINGTON, KY 40512 (800) 264-4000

AETNA HMO - 14089 Y PO BOX 14089 LEXINGTON, KY 40512 (800) 245-0618MEDICAL CLAIMS DEPARTMENT (800) 417-2386

AETNA LIFE INSURANCE N PO BOX 2250 BLUE BELL, PA 19422 (800) 233-6697

AETNA LIFE INSURANCE COMPANY N PO BOX 13441 PENSACOLA, FL 32591 (800) 557-5078AETNA PPO- 14068 N PO BOX 14068 LEXINGTON, KY 40512 (888) 723-7484

MEDICAL CLAIMS DEPARTMENTAETNA PPO- 981204 N PO BOX 981204 EL PASO, TX 79998 (866) 565-1236

MEDICAL CLAIMS DEPARTMENT

-A-AETNA STUDENT HEALTH-15708 N PO BOX 15708 BOSTON, MA 02215

MEDICAL CLAIMS DEPARTMENTAETNA- 14052 Y PO BOX 14052 LEXINGTON, KY 40512 (888) 318-6016

MEDICAL CLAIMS DEPARTMENTAETNA- 14586 Y PO BOX 14586 LEXINGTON, KY 40512 (888) 416-2277

MEDICAL CLAIMS DEPARTMENTAETNA- 981106 Y PO BOX 981106 EL PASO, TX 79998 (800) 839-8920

MEDICAL CLAIMS DEPARTMENTAETNA-14094 Y PO BOX 14094 LEXINGTON, KY 40512 (877) 238-6200

MEDICAL CLAIMSAETNA-981109 N PO BOX 981109 EL PASO, TX 79998 (888) 632-3862

MEDICAL CLAIMS DEPARTMENTASSURANT HEALTH N PO BOX 91604 LUBBOCK, TX 79490 (888) 853-3267AVMA N PO BOX 909720 CHIGAGO, IL 60690 (800) 621-6360

-F-MEDICAL CLAIMS DEPARTMENT

FSBP AETNA Y 1620 L STREET NW SUITE 800 WASHINGTON, DC 20036 (202) 833-5751

-H-HARRINGTON HEALTH N PO BOX 30544 SALT LAKE CITY, UT 84130 (800) 235-7160

-M-MEDICARE SUPPLEMENT CLAIMS Y PO BOX 5008 BRENTWOOD, TN 37024 (800) 264-4000MEDICARE SUPPLEMENT CLAIMS Y PO BOX 1188 BRENTWOOD, TN 37024 (800) 264-4000

-N-NIPPON LIFE (Aetna network) Y PO BOX 39710 COLORADO SPRINGS, CO80949 (800) 937-6542NIPPON LIFE(Aetna network) Y PO BOX 25951 SHAWNEE MISSIONS, KS 66225 (800) 374-1835

-W-WEBTPA (AETNA NETWORK) Y PO BOX 1868 GRAPEVINE, TX 76099 (855) 688-1302WEBTPA(AETNA NETWORK) Y PPO BOX 99906 GRAPEVINE, TX 76099 (800) 952-7429

MEDICAL CLAIMS

AETNA MEDICARE

-A-AETNA - 981110 Y PO BOX 981110 EL PASO, TX 79998 (800) 248-9977AETNA MEDICARE - 14079 Y PO BOX 14079 LEXINGTON, KY 40512 (800) 844-5562

MEDICAL CLAIMS DEPARTMENT (800) 553-3449AETNA MEDICARE 981106 Y PO BOX 981106 EL PASO, TX 79998 (800) 839-8920

MEDICAL CLAIMS DEPARTMENT

BCBS-B-BCBS (ANTHEM) N PO BOX 60007 LOS ANGELES, CA 90060-0007 (626) 279-3000BCBS -9907 Y PO BOX 9907 COLUMBUS, GA 31908 (800) 635-2184

MEDICAL CLAIMS DEPARTMENT (866) 241-2273BCBS EMPIRE-1600 N PO BOX 1600 KINGSTON, NY 12402 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTBCBS FEDERAL Y PO BOX 7037 COLUMBUS, GA 31908 (800) 282-2473

MEDICAL CLAIMS DEPARTMENTBCBS HMO- 9907 Y PO BOX 9907 COLUMBUS, GA 31908 (800) 635-2184

MEDICAL CLAIMS DEPARTMENT (866) 241-2273BCBS MEDICARE Y PO BOX 9907 COLUMBUS, GA 31908 (800) 635-2184

MEDICAL CLAIMS DEPARTMENT (800) 241-2273BCBS OF LA -98044 N PO BOX 98044 BATON ROUGE, LA 70898 (800) 227-8927

MEDICAL CLAIMS DEPARTMENTBCBS-7728 N PO BOX 7728 COLUMBUS, GA 31908 (800) 424-8950

MEDICAL CLAIMS DEPARTMENTBLUE CHOICE HEALTH PLAN N PO BOX 6170 COLUMBIA, SC 29260 (800) 821-3023

MEDICAL CLAIMS DEPARTMENT

-U-UNICARE (BCBS NETWORK) Y PO BOX 4458 CHICAGO, IL 60680 (800) 333-3304

MEDICAL CLAIMS DEPARTMENTUNICARE (BCBS NETWORK) Y PO BOX 9016 ANDOVER, MA 01810-9016 (800) 442-9300

MEDICAL CLAIMS DEPARTMENT

Beechstreet-B-BEECH STREET N PO BOX 853925 RICHARDSON, TX 75085 (800) 753-1000

MEDICAL CLAIMS DEPARTMENTBEECHSTREET N PO BOX 24672 SEATTLE, WA 98124 (877) 483-7105

CIGNA-C-CGHB Y PO BOX 15050 WILMINGTON, DE 19850 (800) 982-8950CIGNA Y PO BOX 188007 CHATTANOOGA, TN 37422 (800) 638-6589CIGNA Y PO BOX 6000 SCRANTON, PA 18505 (800) 258-6534CIGNA Y PO BOX 6010 SCRANTON, PA 18505 (800) 638-6589cigna N po box 6185 GREENVILLE, SC 29606 (800) 251-0670CIGNA Y PO BOX 188061 CHATTANOOGA, TN 37422 (866) 273-0059CIGNA Y PO BOX 188064 CHATTANOOGA, TN 37422 (800) 680-8728

-C-CIGNA Y PO BOX 21741 EGAN, MN 55121 (800) 244-6224CIGNA Y PO BOX 188053 CHATTANOOGA, TN 37422 (800) 244-6224CIGNA - 5710 N PO BOX 5710 SCRANTON, PA 18505 (800) 981-9112

MEDICAL CLAIMS DEPARTMENTCIGNA -182223 Y PO BOX 182223 CHATTANOOGA, TN 37422 (800) 244-6224

MEDICAL CLAIMS DEPARTMENTCIGNA -188023 Y PO BOX 188023 CHATTANOOGA, TN 37422 (800) 845-3136

MEDICAL CLAIMS DEPARTMENTCIGNA GLOBAL Y PO BOX 15050 WILMINGTON, DE 19850 (800) 982-8950CIGNA HEALTH CARE N PO BOX 188008 CHATTANOOGA, TN 37422 (800) 251-0670CIGNA HEALTH SPRING N PO BOX 981706 EL PASO, TX 79998 (800) 230-6138CIGNA HEALTHCARE N 5810 BRAINERD ROAD CHATTANOOGA, TN 37411 (888) 616-4224CIGNA PPO-5909 N PO BOX 5909 SCRANTON, PA 18505 (800) 546-1900

MEDICAL CLAIMS DEPARTMENTCIGNA- 188004 Y PO BOX 188004 CHATTANOOGA, TN 37422 (877) 552-5016CIGNA-188050 Y PO BOX 188050 CHATTANOOGA, TN 37422 (800) 633-8519

CLAIMS DEPARTMENTCIGNA-29000 N PO BOX 29000 ATLANTA, GA 30359 (800) 351-4113

MEDICAL CLAIMSCIGNA-49500 N PO BOX 49500 ATLANTA, GA 30359 (800) 832-3211

MEDICAL CLAIMSCIGNA-5200 N PO BOX 5200 SCRANTON, PA 18505 (800) 351-4113

MEDICAL CLAIMS DEPARTMENTCONNETICUT GENERAL LIFE INSUR N PO BOX 55270 PHOENIX, AZ 85078

MEDICAL CLAIMS DEPARTMENT

-F-FOUNDATION BENEFIT ADMINISTRATION N PO BOX 559017 AUSTIN, TX 78755 (866) 337-8417

MEDICAL CLAIMS DEPARTMENT

-M-MVP Y 625 STATE ST SCHENECTADY, NY 12301 (800) 684-9286

PO BOX 2207MVP HEALTHCARE N PO BOX 1083 SCHENECTADY, NY 12301 (800) 999-3920

CLAIMS DEPARTMENT

-P-PREFERRED CARE N PO BOX 22920 ROCHESTER, NY 14692 (800) 999-3920

MEDICAL CLAIMS DEPARTMENT

-S-SOUTHEASTERN CARPENTERS & MILLWRIGHTS HEALTH TRUST

Y PO BOX 1449 GOODLETTSVILLE, TN 37070 (800) 831-4914

MEDICAL CLAIMS DEPARTMENT

COMMERCIAL-1-119SEIU BENEFIT(AETNA NETWORK) Y 330 WEST 42ND STREET NEW YORK, NY 10036 (888) 819-11991st Medical Network N PO BOX 724317 ATLANTA, GA 31139 (229) 388-0977

(800) 871-3114

-A-AARP- 740819 Y PO BOX 740819 ATLANTA, GA 30374 (800) 227-7789

MEDICAL CLAIMS DEPARTMENTAARP-PRUDENTIAL N PO BOX 13999 PHILADELPHIA, PA 19187 (800) 523-5800ACI (AETNA NETWORK). Y 994 OLD EAGLE SCHOOL RD WAYNE, PA 19087 (800) 964-7096

SUITE1005ACS N PO BOX 2000 WINSTON-SALEM, NC 27102 (800) 849-5370ADMINISTRATIVE SOLUTIONS N PO BOX 2490 ALPHARETTA, GA 30023 (678) 339-0211

MEDICAL CLAIMS DEPARTMENTADMIRAL LIFE INSURANCE COMPANY OF AMERICA

Y PO BOX 10861 CLEARWATER, FL 33757 (866) 398-9305

ADVANTRA FREEDOM N PO BOX 7154 LONDON, KY 40742 (800) 713-5095MEDICAL CLAIMS DEPARTMENT

AFID LLC N 1 S. LIMESTONE STREET SUITE 301 SPRINGFIELD, OH 45502 (866) 766-9016MEDICAL CLAIMS DEPARTMENT

AFLAC N 1932 WYNNTON ROAD COLUMBUS, GA 31999 (800) 992-3522ALIERA Y PO BOX 16818 LUBBOCK, TX 79490 (866) 905-7796ALIERA CLAIMS DEPARTMENT Y 5901B PEACHTREE DUNWOODY RD ATLANTA, GA 30328 (844) 457-7726

SUIT 200

ALLIANT HEALTH PLANS Y PO BOX 2667 DALTON, GA 30722 (800) 811-4793ALLIANT HEALTH PLANS Y PO BOX 3708 CORPUS CHRISTI, TX 78463 (800) 811-4793ALLIED BEN (AETNA NETWORK) Y PO BOX 909786-60690 CHIGAGO, IL 60690 (800) 288-2078

MEDICAL CLAIMS DEPARTMENTALLIED NATIONAL-GLOBAL CARE Y PO BOX 247 ALPHARETTA, GA 30009 (866) 807-6193ALPHA N PO BOX 21367 BILLINGS, MT 59104 (800) 824-9789

MEDICAL CLAIMS DEPARTMENTALTERNATIVE BENEFIT PLAN N PO BOX 921849 NORCROSS, GA 30010 (800) 241-7319

MEDICAL CLAIMS DEPARTMENTALTERNATIVE INSUR RESOURCES N PO BOX 660787 BIRMINGHAM, AL 35266 (800) 451-4318

MEDICAL CLAIMS DEPARTMENTALTRUA NATIONAL Y PO BOX 247 ALPHARETTA, GA 30009 (888) 244-3839AMERI HEALTH N PO BOX 8530 KANSAS CITY, MO 64114 (800) 480-5032

MEDICAL CLAIMS DEPARTMENTAMERI HEALTH N 720 BLAIR MILL RD HORSHAM, PA 19044

MEDICAL CLAIMS DEPARTMENTAMERIBAN Y PO BOX 7186 BOISE, ID 83707 (800) 786-7930

-A-MEDICAL CLAIMS DEPARTMENT

AMERICA'S FIRST CHOICE N PO BOX 211369 COLUMBIA, SC 29221 (866) 321-3947AMERICA'S FORST CHOICE N PO BOX 211369 COLUMBIA, SC 29221 (866) 321-3947AMERICAN ADMINISTRATIVE GROUP N PO BOX 93670 LUBBOCK, TX 79493 (800) 539-6331

MEDICAL CLAIMS DEPARTMENTAMERICAN HEALTHCARE ALLIANCE Y PO BOX 8530 KANSAS CITY, MO 64114 (800) 226-5116

CLAIMS DEPT.AMERICAN HEALTHCARE ALLIANCE N PO BOX 8530 KANSAS CITY, MO 64114 (800) 825-3540AMERICAN INSURANCE ADMINISTRATOR N PO BOX 1149 COLUMBUS, OH 43216 (800) 922-1245AMERICAN MEDICAL SECURITY N PO BOX 19032 GREEN BAY, WI 54307 (800) 232-5432AMERICAN NATIONAL N PO BOX 696520 SAN ANTONIO, TX 78269 (409) 763-4661AMERICAN PLAN ADMINISTRATORS N 18 HEYWARD STREET DEPT. 618 BROOKLYN, NY 11249 (888) 624-6300

MEDICAL CLAIMSAMERICAN PUBLIC LIFE INSURANCE Y PO BOX 925 JACKSON, MS 39205 (800) 256-8606AMERICAN REPUBLIC INSURANCE CO. N PO BOX 2975 CLINTON, IA 52733 (800) 640-9016

CLAIMS DEPT.AMERICAN REPUBLIC INSURANCE COMPANY N PO BOX 21670 EAGAN, MN 55121 (800) 247-2190AMERICAS TPA Y PO BOX 398220 MINNIAPOLIS, MN 55439 (800) 948-3253

MEDICAL CLAIMS DEPARTMENTAMERIHEALTH N PO BOX 41574 PHILADELPHIA, PA 19101 (800) 444-6282AMERIHEALTH N PO BOX 41574 PHILADELPHIA, PA 19101 (800) 227-3116

AMLI N PO BOX 34912 PHILADELPHIA, PA 19101 (866) 928-1536ANCHOR BENEFIT CONSULTING N PO BOX 945260 MAITLAND, FL 32794 (800) 845-7629APWU HEALTHPLAN Y PO BOX 1358 GLEN BURNIE, MD 21060 (800) 222-2798ASR N PO BOX 6392 GRANDRAPIDS, MI 49516 (616) 957-1751

MEDICAL CLAIMS DEPARTMENTASSOCIATION & SOCIETY INSUR CORP Y PO BOX 2510 ROCKVILLE, MD 20847 (800) 638-2610

MEDICAL CLAIMS DEPARTMENTASSOCIATION FOR LIFESTYLE REFORM N PO BOX 1606 ONTARIO, CA 91762 (877) 378-9240ASSURANT HEALTH N PO BOX 2877 CLINTON, IA 52733 (800) 328-4316

CLAIMS DEPT.ATLANTA PLUMBERS AND STEAMFITTERS N 3835 PRESIDENTIAL PARKWAY STE 123 ATLANTA, GA 30340 (800) 382-6926

MEDICAL CLAIMS DEPARTMENTAULTCARE N PO BOX 6910 CANTON, OH 44706 (888) 202-1654

MEDICAL CLAIMS DEPARTMENTAULTRA ADMINISTRATIVE GROUP N PO BOX 35276 CANTON, OH 44735 (800) 325-8424

MEDICAL CLAIMS DEPARTMENTAUTO OWNERS INSUR Y PO BOX 23 SHEBOYGAN, WI 53082 (800) 615-7020

MEDICAL CLAIMS DEPARTMENTAUXIANT- 853929 N PO BOX 853929 RICHARDSON, TX 75085 (800) 279-6772

MEDICAL CLAIMS DEPARTMENT

-A-AV MED Y PO BOX 569000 MIAMI, FL 33256 (800) 882-8633AVANTO HEALTH CARE Y 2370 W. CLEVELAND AVE SUITE 108 #274 MADERA, CA 93637 (844) 428-2686AWA N 2080 N HWY 360 STE 375 GRAND PRARIE, TX 75050 (800) 387-9027AXIS INSURANCE COMPANY Y PO BOX 211198 EAGAN, MN 55120 (855) 822-8191

-B-BANKERS FIDELITY LIFE INSURANCE COMPANY

Y PO BOX 105652 ATLANTA, GA 30348 (800) 282-0480

BANKERS LIFE & CASUALTY CO Y PO BOX 1935 CARMEL, IN 46082 (800) 773-4760MEDICAL CLAIMS DEPARTMENT

BANKERS LIFE AND CASUALITY N PO BOX 1935 CARMEL, IN 46082MEDICAL CLAIMS DEPARTMENT

BANKERS LIFE AND CASUALTY COMPANY N 222 MERCHANDISE MART PLAZA CHICAGO, IL 60654 (312) 396-6000BANKERS LIFE AND CASUALTY INSURANCE N PO BOX 1936 CARMEL, IN 46082 (800) 773-4760BANNER PLAN ADMINISTRATION N PO BOX 16423 MARSA, AZ 85211 (800) 827-2464Bay Bridge Adminstrators Y PO BOX 211196 EGAN, MN 55121 (800) 845-7519BENEFIT ADMINISTRATIVE SYSTEMS Y PO BOX 2920 MILWAUKEE, WI 53201 (800) 799-7400

MEDICAL CLAIMS DEPARTMENTBENEFIT CONCEPTS INC N PO BOX 60608 KING OF PRUSSIA, PA 19406 (800) 220-2600

MEDICAL CLAIMS DEPARTMENTBENEFIT PLAN ADMINISTRATORS N PO BOX 11746 ROANOKE, VA 24022 (800) 277-8973

MEDICAL CLAIMS DEPARTMENTBENEFIT SERVICES N PO BOX 4138 AKRON, OH 44321 (800) 367-3762

MEDICAL CLAIMS DEPARTMENTBENEFIT SUPPORT Y PO BOX 2977 GAINESVILLE, GA 30503 (800) 777-4782BENELECT Y PO BOX 7809 VISALIA, CA 93290 (888) 886-7973BENICOMP INC N 8310 CLINTON PARK DRIVE FORT WAYNE, IN 46825 (800) 837-7400BHP N 50 COMMERCE DRIVE WYOMISSING, PA 19610

CLAIMS DEPTBLUE BELL BENEFITS TRUST N PO BOX 605 BRENHAM, TX 77834 (979) 830-7388BMGI Y PO BOX 211397 EGAN, MN 55121 (855) 257-0145BOON CHAPMAN BENEFIT ADMINISTRATORS INC

N PO BOX 9201 AUSTIN, TX 78766 (800) 252-9653

MEDICAL CLAIMS DEPARTMENTBRENTWOOD SERVICES ADMINISTRATORS INC

N PO BOX 471127 CHARLOTTE, NC 28247 (800) 524-0604

BUSINESS ADMINISTRATORS AND CONSULTANTS

N PO BOX 107 REYNOLDSBURG, OH 43068 (800) 521-2654

MEDICAL CLAIMS DEPARTMENT

-C-CAPROCK HEALTH PLANS Y PO BOX 21548 EAGAN, MN 55121 (800) 747-9446CARE IMPROVEMENT PLUS N PO BOX 488 LINTHICUM, MD 21030 (866) 679-3119CARE IMPROVEMENT PLUS N PO BOX 4347 SCRANTON, PA 18505 (866) 686-2506

-C-MEDICAL CLAIMS DEPARTMENT

CARE IMPROVEMENT PLUS N PO BOX 488 LINTHICUM, MD 21090 (866) 679-3119CAREFIRST ADMIN N PO BOX 981608 EL PASO, TX 79998 (800) 676-2583CAREMED N 9 WEST BROAD STREET STAMFORD, CT 06902 (203) 399-5413CBCA ADMINISTRATORS INC N PO BOX 9888 SAVANNAH, GA 31412

MEDICAL CLAIMS DEPARTMENTCDPHP Y PO BOX 66602 ALBANY, NY 12206 (800) 926-7526CENTRAL STATES HEALTH AND WELFARE N PO BOX 5116 DES PLAINES, IL 60017 (800) 323-2190CENTRAL STATES HEALTH AND WELFARE FUND

N PO BOX 5116 DES PLAINES, IL 60017 (800) 323-2190

CENTRAL UNITED LIFE Y PO BOX 924408 HOUSTON, TX 77292 (800) 999-2971CENTURY HEALTHCARE Y PO BOX 2256 GRAPEVINE, TX 76099 (888) 444-7995

MEDICAL CLAIMS DEPARTMENTCHAMPVA Y PO BOX 469063 DENVER, CO 80246 (800) 424-4081

MEDICAL CLAIMS DEPT

CHAMPVA Y PO BOX 65024 DENVER, CO 80206 (800) 424-4081MEDICAL CLAIMS DEPARTMENT

CHAMPVA Y PO BOX 469064 DENVER, CO 80246-9064 (800) 424-4081CHP N PO BOX 1998 SPRINGFIELD, MA 01101 (877) 517-1403CHRISTIAN BROTHER INSURANCE N 1205 WINDHAM PKWY ROMEOVILLE, IL 60446 (800) 852-4877CIGNA HEALTHSPRING N PO BOX 981804 EL PASO, TX 79998 (800) 230-6138CINERGY HEALTH N 144 NORTH BEVERYCK SUITE 332 HIAWAPHA, NJ 07034 (800) 847-1148

MEDICAL CLAIMS DEPARTMENTCINERGY HEALTH INC N 1844 N. NOB HILL ROAD PLANTATION, FL 33322 (800) 364-4137

MEDICAL CLAIMS DEPTCLAIMS DEPARTMENT Y PO BOX 1850 HICKSVILLE, NY 11802 (212) 501-4444CMIC N PO BOX 76149 COLORADO SPRINGS, CO86970 (877) 321-4412COMBINED INSURANCE N PO BOX 638 BELLINGHAM, WA 98227 (800) 544-5531COMMERCE BENEFITS GROUP N PO BOX 900 ELYRIA, OH 44036 (800) 223-9941

MEDICAL CLAIMS DEPARTMENTCONSTITUTION LIFE INSURANCE N PO BOX 130 PENSACOLA, FL 32591 (800) 789-6364CONSUMERS LIFE INSUR N PO BOX 94875 CLEVELAND, OH 44101 (800) 362-1279

MEDICAL CLAIMS DEPARTMENTCONSUMERS LIFE INSURANCE N PO BOX 943 TOLEDO, OH 43656 (809) 823-116CONTINENTAL BENEFITS Y PO BOX 3610 BRANDON, FL 33509 (855) 206-8246CONTINENTAL GENERAL N PO BOX 2830 CLINTON, IA 52733

MEDICAL CLAIMS DEPARTMENTCONTINENTAL GENERAL INSURANCE COMPANY

Y PO BOX 30010 AUSTIN, TX 78755 (866) 459-4272

MEDICAL CLAIMS DEPARTMENTCONTINENTAL LIFE INSURANCE COMPANY N PO BOX 118 BRENTWOOD, TN 37024 (615) 377-1300

MEDICAL CLAIMS DEPARTMENT

-C-COORDINATED BENEFIT PLANS Y PO BOX 21673 EGAN, MN 55121 (888) 352-2912CORE ADMINISTRATIVE SERVICES N PO BOX 90 MACON, GA 31202 (888) 741-2673CORESOURCE Y PO BOX 25985 OVERLAND PARK, KS 66225 (866) 500-5048CORESOURCE Y PO BOX 2310 MT.CLEMENS, MI 48046CORESOURCE Y PO BOX 25946 OVERLAND PARK, KS 66225 (800) 990-9058CORESOURCE (AETNA NETWORK) Y PO BOX 2905 CLINTON, IA 52733 (833) 259-6757CORESOURCE (AETNA NETWORK) Y PO BOX 2920 CLINTON, IA 52733 (800) 371-4803

MEDICAL CLAIMS DEPARTMENTCORNERSTONE (PHCS) Y PO BOX 680185 HOUSTON, TX 77268 (281) 580-6865CORPORATE BENEFIT N PO BOX 12954 CHARLOTTE, NC 28220 (800) 277-9476

MEDICAL CLAIMS DEPARTMENT

CORPORATE BENEFIT SERVICES N PO BOX 247 ALPHARETTA, GA 30009 (888) 889-6494CORPORATE BENEFITS SERVICE Y PO BOX 211778 EGAN, MN 55121 (800) 277-9476CORPORATE BENEFITS SERVICE, INC N PO BOX 981800 EL PASO, TX 79998 (800) 277-9476

MEDICAL CLAIMS DEPARTMENTCOVENANT ADMINISTRATIVE SERVICES Y 2810 PREMIER PARKWAY DULUTH, GA 30097 (800) 680-8728

SUITE 400COVENANT ADMINISTRATIVE SERVICES N 1745 NORTH BROWN RD LAWRENCEVILLE, GA 30043 (678) 258-8230

STE 400COVENANT ADMINISTRATORS N 2810 PREMIERE PKWY DULUTH, GA 30097 (678) 258-8230

SUITE 400COVENANT ADMINISTRATORS N 1745 NORTH BROWN ROAD STE 400 LAWRENCEVILLE, GA 30043 (678) 258-8230COVENANT ADMINISTRATORS N PO BOX 105738 ATLANTA, GA 30348 (678) 258-8230

MEDICAL CLAIMS DEPARTMENTCREATIVE MANAGEMENT RESOURCES INC. N PO BOX 247 ALPHARETTA, GA 30009 (888) 889-6494CROSSAMERICA HEALTH PLANS N PO BOX 5778 PARSIPPANY, NJ 07054 (800) 364-4137CTI ADMINISTRATORS N 100 COURT AVENUE SUITE 306 DES MOINES, IA 50309 (800) 245-8813

CLAIMS DEPTCWI Y PO BOX 6125 GREENVILLE, SC 29606 (800) 992-8088CYPRESS BENEFIT ADMINISTRATORS Y PO BOX 880 FARMINGTON, MI 48331 (866) 422-1081

-D-DART MANAGEMENT CORP N PO BOX 318 MASON, MI 48854 (800) 248-0457

CLAIMS DEPTDART MEMBER CARE Y PO BOX 173129 TAMPA, FL 33672 (800) 248-0457DELTA HEALTH SYSTEMS N PO BOX 80 STOCKTON, CA 95201 (800) 784-9298DESERET MUTUAL N PO BOX 45530 SALT LAKE CITY, UT 84145 (800) 777-3622

CLAIMS DEPT.DIVERSIFIED ADMINISTRATION CORPORATION

N PO BOX 848 BUCKEYSTOWN, MD 21717 (800) 661-7561

DIVERSIFIED ADMINISTRATION CORPORATION

N PO BOX BUCKEYSTOWN, MD 21717 (888) 322-2524

-D-DIVERSIFIED ADMINISTRATION CORPORATION

Y PO BOX 225829 DALLAS, TX 75225-289 (888) 322-2524

DIVERSIFIED ADMINISTRATION CORPORATION

Y PO BOX 225829 DALLAS, TX 75222-5829 (888) 322-2524

DOAS STATE OF GEORGIA WORKERS COMPENSATION

N PIEDMONT AVE SE ATLANTA, GA 30334 (404) 554-8316

SUITE 1208 WEST

-E-EBA&M Y PO BOX 5079 WESTLAKE VILLAGE, CA 91359 (800) 249-8440

EBMS Y PO BOX 21367 BILLINGS, MT 59104 (406) 869-5555EBPA Y PO BOX 2000 EXETER, NH 03833 (800) 525-8788EMBLEM HEALTH N PO BOX 2832 NEW YORK, NY 10116 (877) 842-3625EMBLEM HEALTH N PO BOX 2832 NEW YORK, NY 10116 (877) 444-3786EMBLEM HEALTH N PO BOX 3000 NY, NY (877) 793-6253EMI HEALTH N 852 EAST ARROWHEAD LN MURRAY, UT 84107 (801) 262-7475EMPLOYEE PLAN LLC N PO BOX 2362 FORT WAYNE, IN 46801 (800) 513-8013

MEDICAL CLAIMS DEPARTMENTEQUITABLE LIFE AND CASUALTY INSURANCE COMPANY

Y PO BOX 2460 SALT LAKE CITY, UT 84110 (800) 352-5160

EURO CENTER N 140 W. 57TH STREET STE 6A NEW YORK, NY 10019 (800) 844-3876EVOLUTIONS HEALTH CARE N PO BOX 5001 NEW PORT RICHEY, FL 34656 (800) 707-0501

MEDICAL CLAIMS DEPARTMENT

-F-FAMILY LIFE INSURANCE CO N PO BOX 925309 HOUSTON, TX 77292 (800) 877-7703FARM BUREAU HEALTH PLANS Y PO BOX 300 COLUMBIA, TN 38402 (844) 874-8301FCE BENEFIT ADMINISTRATORS Y PO BOX 211716 EAGAN, MN 55121 (402) 964-9900FCE BENEFITS ADMINISTRATOR N 4615 WALZEM RD SAN ANTONIO, TX 78218 (800) 899-9355

STE 300FEDERATED INSURANCE N PO BOX 328 OWATONNA, MN 55060 (877) 612-4477

MEDICAL CLAIMS DEPARTMENTFEDERATED SERVICES Y PO BOX 850958 RICHARDSON, TX 75085 (800) 337-2363

MEDICAL CLAIMS DEPARTMENTFIRST HEALTH N PO BOX 5001 NEW PORT RICHEY, FL 34656 (954) 366-0111

MEDICAL CLAIMS DEPARTMENTFIRST HEALTH Y PO BOX 21854 EGAN, MN 55121 (800) 822-3974FIRST HEALTH Y PO BOX 7820 LONDON, KY 40742 (888) 722-1668FIRST HEALTH NETWORK N PO BOX 636 MANSFIELD, OH 44901 (419) 525-3961FIRST HEALTH NETWORK N PO BOX 5190 TAMPA, FL 33675 (770) 813-8474FIRST HEALTH NETWORK N PO BOX 5319 TAMPA, FL 33675 (800) 247-4695

MEDICAL CLAIMS DEPARTMENTFIRST HEALTH NETWORK N PO BOX 16387 LUBBOCK, TX 79490 (800) 337-6288FIRST HEALTH/EVOLUTIONS N PO BOX 5001 NEW PORT RICHEY, FL 34656 (800) 818-6632

-F-MEDICAL CLAIMS DEPARTMENT

FIRST SERVICE ADMINISTRATORS N PO BOX 90847 LAKELAND, FL 33804 (866) 629-5456FIRST SERVICE ADMINISTRATORS N 3035 LAKELAND HILLS BLVD LAKELAND, FL 33805 (800) 226-3155FISERV N PO BOX 520 PUEBLO, CO 81002

MEDICAL CLAIMS DEPARTMENT

FISERV HEALTH N PO BOX 720 PUEBLO, CO 81002 (800) 446-8182MEDICAL CLAIMS DEPARTMENT

FISERV HEALTH- 690450 N PO BOX 690450 SAN ANTONIO, TX 78269 (800) 758-5314MEDICAL CLAIMS DEPARTMENT

FISERV HEALTH- 8077 N PO BOX 8077 WAUSAU, WI 54002 (866) 684-8090MEDICAL CLAIMS DEPARTMENT

FISERV HEALTH-450 N PO BOX 450 PUEBLO, CO 81002 (877) 233-1800MEDICAL CLAIMS DEPARTMENT

FORE THOUGHT LIFE INSURANCE N PO BOX 981721 EL PASO, TX 79998 (877) 492-5870FOREIGN SERVICE BENEFIT PLAN N 1716 N STREET NW WASHINGTON, DC 20036 (202) 833-4910

CLAIMS DEPT.FORTIS INSURANCE COMPANY N PO BOX 624 MILWAALLKEE, WI 53201 (866) 738-9686

MEDICAL CLAIMSFREEDOM LIFE INSURANCE N PO BOX 1468 ARLINGTON, TX 76004 (800) 387-9027

-G-GEHA Y PO BOX 4665 INDEPENDENCE, MO 64051 (800) 821-6136

MEDICAL CLAIMS DEPARTMENTGEHA/AETNA network Y PO BOX 981707 EL PASO, TX 79998 (800) 821-6136GERBER LIFE INSURANCE N PO BOX 2271 OMAHA, NE 68103GHI Y PO BOX 3000 NEW YORK, NY 10116 (212) 501-4444

MEDICAL CLAIMS DEPARTMENTGMMI N 1300 CONCORD TERRACE SUNRISE, FL 33323 (888) 298-6828

SUITE 300GPM HEALTH AND LIFE INSURACE COMPANY Y PO BOX 2679 OMAHA, NE 68103 (866) 242-7573GREAT WEST (cigna network) Y 1000 GREAT WEST DRIVE KENNETT, MO 63857 (800) 663-8081

MEDICAL CLAIMS DEPARTMENTGROUP HEALTH N PO BOX 34585 SEATTLE, WA 98124 (888) 901-4636GROUP HEALTH COOPERATIVE Y PO BOX 44971 MADISON, WI 53744-4971 (608) 828-4853GROUP RESOURCE N PO BOX 100043 DULUTH, GA 30096 (770) 813-8474

MEDICAL CLAIMS DEPARTMENTGUARANTEE TRUST LIFE INSURANCE COMPANY

Y PO BOX 1144 GLENVIEW, IL 60025 (866) 851-0284

GUARDIAN- 8024 N PO BOX 8024 APPLETON, WI 54912 (800) 227-6921MEDICAL CLAIMS DEPARTMENT

-H-HAA PREFERRED PARTNERS N PO BOX 981603 EL PASO, TX 79998 (800) 844-3876

-H-HAMMERMAN AND GAINER N 909 LAKE CAROLYN PARKWAY STE 1900 IRVING, TX 75039 (866) 444-5577

HAMMERMAN AND GAINER N 122 WEST JOHN CARPENTER FREEWAY IRVING, TX 75039 (877) 346-4434SUITE 485

HCC N PO BOX 863 INDIANAPOLIS, IN 46206 (866) 400-7102HCC LIFE INSURANCE COMPANY N PO BOX 2005 FARMINGTON HILLS, MI 48333 (800) 605-2282HEADQUARTER INSURANCE N PO BOX 1495 TOLDEO, OH 43603 (877) 222-7611HEALTH EXCHANGE N PO BOX 165750 KANSAS CITY, MO 64116 (800) 231-4015

CLAIMS DEPT.HEALTH NET (OUT OF NETWORK) Y PO BOX 14702 LEXINGTON, KY 40512 (800) 861-7214

MEDICAL CLAIMS DEPARTMENTHEALTH NETWORK AMERICA N PO BOX 490 WEST LONG BRANCH, NJ07764 (877) 387-8503

MEDICAL CLAIMS DEPARTMENTHEALTH OPTION ONE N PO BOX 21517 EGAN, MN 55121 (888) 633-5080HEALTH PARTNERS Y PO BOX 1289 MINNEAPOLIS, MN 55440 (800) 883-2177

MEDICAL CLAIMS DEPARTMENTHEALTH PARTNERS CLAIMS N PO BOX 750 MINNEAPOLIS, MN 55440 (800) 796-3813

CLAIMS DEPTHEALTH PLAN SELECT Y PO BOX 382767 BIRMINGHAM, AL 23588 (706) 549-0549

MEDICAL CLAIMS DEPARTMENTHEALTH PLAN SERVICES N PO BOX 3726 SEATTLE, WA 98124 (800) 493-4240HEALTH PLANS INC N PO BOX 5199 WEST BOROUGH, MA 01581 (800) 532-7575

MEDICAL CLAIMS DEPARTMENTHealth scope (AETNA NETWORK) Y PO BOX 99005 LUBBOCK, TX 79490 (800) 395-7069HEALTHCARE SOLUTIONS GROUP N PO BOX 1309 MUSKOGEE, OK 74402 (918) 781-4970HEALTHCOMP INC N PO BOX 45018 FRESNO, CA 93718 (800) 937-2277

MEDICAL CLAIMS DEPARTMENTHEALTHEZ (PHCS) Y PO BOX 398220 MINNIAPOLIS, MN 55439 (952) 896-9102HEALTHPLAN SERVICES N PO BOX 30075 TAMPA, FL 33630 (800) 848-5332

MEDICAL CLAIMS DEPARTMENTHEALTHSCOPE (AETNA NETWORK) Y PO BOX 16203 LUBBOCK, TX 79490 (888) 276-4732HEALTHSCOPE (Healthpartners network) Y PO BOX 99004 LUBBOCK, TX 79490 (800) 827-7026HEALTHSMART N PO BOX 42096 OKLAHOMA CITY, OK 73123 (800) 825-3540HEALTHSMART N PO BOX 42096 OKLAHOMA CITY, OK 73123 (800) 825-3540HEALTHSMART N PO BOX 6743 LUBBOCK, TX 79493 (800) 989-6739HEALTHSMART N PO BOX 53010 LUBBOCK, TX 79453 (979) 830-7388

MEDICAL CLAIMS DEPARTMENTHEALTHSMART BENEFIT SOLUTION N PO BOX 93670 LUBBOCK, TX 79493 (866) 536-6379HEALTHSMART BENEFIT SOLUTIONS N PO BOX 2451 CHARLESTON, WV 25329 (888) 440-7342HEWITT COLEMAN & ASSOC N PO BOX 6708 GREENVILLE, SC 29606 (888) 298-6828

MEDICAL CLAIMS DEPARTMENT

HMA Y PO BOX 22009 TEMPE, AZ 85285 (866) 826-5317

-H--I-I.U.O.E LOCAL 25 MEDICAL PLAN Y 461 STATE ROUT 33 MILLSTONE, NJ 08535 (732) 446-0394IHC HS Y PO BOX 21456 EGAN, MN 55121 (888) 342-7427IMA INC Y EGAN, MN 55121 (800) 833-4296IMA INC Y PO BOX 21704 EGAN, MN 55121 (800) 833-4296IMA INC. Y PO BOX 55121 EGAN, MN 55121 (800) 833-4296INFORMED N PO BOX 6752 ANNAPOLIS, MD 21401 (800) 459-2110

CLAIMS DEPT.INNOVATE BENEFIT ADMINISTRATORS N PO BOX 4118 GREENWOOD VILLAGE, CO80155 (866) 441-6528INSTIL HEALTH N PO BOX 1466 AUGUSTA, GA 30903 (877) 446-7845

MEDICAL CLAIMS DEPARTMENTINSURANCE ADMINISTRATORS Y PO BOX 1888061 CHATTANOOGA, TN 37422 (877) 251-6593INSURANCE DESIGN ADMIN N PO BOX 875 OAKLAND, NJ 07436 (800) 225-1345

MEDICAL CLAIMS DEPARTMENTINSURANCE MANAGEMENT ADMINISTRATORS

N PO BOX 71120 BOSSIER, GA 71171 (800) 742-9944

MEDICAL CLAIMS DEPARTMENTINSURANCE TPA Y PO BOX 15953 LUBBOCK, TX 79490 (855) 848-9591INTERGRITY BENEFIT NETWORK N PO BOX 4537 MARIETTA, 30061 (770) 428-1604INTERNATIONAL BENEFITS ADMINISTRATORS N PO BOX 9304 GARDEN CITY, NY 11530 (877) 390-2501

INTERNATIONAL BENEFITS ADMINISTRATORS N PO BOX 9306 GARDEN CITY, NY 11530 (888) 774-0848

INTERPLAN HEALTH GROUP N PO BOX 2388 STOW, OH 44224 (513) 603-5850MEDICAL CLAIMS DEPARTMENT

-J-JOHN ALDEN LIFE INSUR CO N PO BOX 42034 HAZELWOOD, MO 63042 (800) 328-4316

MEDICAL CLAIMS DEPARTMENTJSL ADMINISTRATORS INC N PO BOX 71489 NEWNAN, GA 30271 (800) 893-3223

MEDICAL CLAIMS DEPARTMENT

-K-KAISER N PO BOX 7004 DOWNEY, CA 90242-7004 (800) 788-0710KAISER Y PO BOX 370010 DENVER, CO 80237 (888) 541-7427KAISER PERMANENTE Y PO BOX 30766 SALT LAKE CITY, UT 84130 (888) 901-4636KEY BENEFIT ADMINISTRATORS N PO BOX 2050 FORT MILL, SC 29716 (800) 871-2335KEY BENEFIT ADMINISTRATORS N PO BOX 129 FORT MILL, SC 29716 (888) 342-7427

KEY BENEFIT SOLUTIONS Y PO BOX 3252 MILWAALLKEE, WI 53201 (877) 851-0906KEY BENEFITS N PO BOX 1279 FORT MILL, SC 29716 (866) 867-6883

MEDICAL CLAIMS DEPARTMENT

-L-LHS GLOBALCARE INC Y PO BOX 36908 CANTON, OH 44735 (855) 585-4237

-L-LHS GLOBALCARE INC N 931 NORTH MAIN STREET NORTH CANTON, OH 44720 (855) 585-4237Liberty Bankers Life Insurance Company Y P.O. BOX 14707 Clearwater, FL 33766-4707 (844) 770-2400LIFESTYLE HEALTH PLANS Y 345 N. RIVERVIEW WICHITA, KS 67203 (866) 827-6607

SUITE 600LOCAL 812 HEALTH FUND N PO BOX 090540 STATEN ISLAND, NY 10309 (800) 232-3165LUMICO Y po box 10876 CLEARWATER, FL 33757 (855) 774-4491

-M-MAC Y PO BOX 14770 LEXINGTON, KY 40512 (800) 264-4000MAGNACARE N PO BOX 1001 GARDEN CITY, NY 11530 (800) 226-5116MAMSI LIFE AND HEALTH N PO BOX 930 FREDERICK, MD 21705 (800) 962-2174

MEDICAL CLAIMS DEPARTMENTMANHATTAN LIFE INSURANCE COMPANY Y PO BOX 925568 HOUSTON, TX 77292 (800) 877-7703MARSH AFFINITY GROUP SERVICE N PO BOX 10401 DES MOINES, IA 50306 (800) 368-5396

CLAIMS DEPARTMENTMASTERCARE N PO BOX 9060 PHOENIX, AZ 85068 (800) 882-5707MAYO CLINIC HEALTH SOLUTIONS N PO BOX 211698 EGAN, MN 55121 (800) 635-6671MCGREGOR & ASSOCIATES INC. N 997 GOVERNORS LANE LEXINGTON, KY 40513 (866) 233-4377

SUITE 175MCS LIFE INSURANCE Y PO BOX 9023547 SAN JUAN, 00902 (800) 981-4766

MEDICAL CLAIMS DEPARTMENTMCS LIFE INSURANCE Y PO BOX 191720 SAN JUAN, PR 00919-1720 (888) 758-1292MEDCOST N PO BOX 25307 WINSTON SALEM, NC 27114 (800) 346-6509

MEDICAL CLAIMS DEPARTMENTMEDICAL CLAIMS MANAGEMENT CORP N PO BOX 12995 CHARLOTTE, NC 28220 (800) 334-0609

MEDICAL CLAIMS DEPARTMENTMEDICO CORP LIFE INSURANCE COMPANY Y PO BOX 21660 EGAN, MN 55121 (800) 822-9993MEDIMPACT N 10680 TREENA STREET SAN DIEGO, CA 92131 (800) 788-2949

STOP 5MEDIPLUS Y PO BOX 9126 DES MOINES, IA 50306 (800) 247-2192

MEDICAL CLAIMS DEPARTMENTMEGA LIFE INSURANCE CO N PO BOX 981606 EL PASO, TX 79998 (888) 757-0703MEGA LIFE/ INSURANCE CENTER N PO BOX 982017 NORTH RICHLAND, TX 76182 (888) 756-3534

MEGA LIFE/INSURANCE CENTER N PO BOX 982009 EL PASO, TX 79998 (877) 757-0703MEDICAL CLAIMS DEPARTMENT

MERCIER Y PO BOX 14426 DES MOINES, IA 50306 (800) 245-6728MERITAIN (AETNA NETWORK) Y PO BOX 853921 RICHARDSON, TX 75085 (800) 828-6922

MEDICAL CLAIMS DEPARTMENTMERITAIN HEALTH (AETNA NETWORK) Y PO BOX 41790 MINNEAPOLIS, MN 55441 (888) 306-9215MHBP (AETNA NETWORK) Y PO BOX 8402 LONDON, KY 40742 (800) 410-7778

MEDICAL CLAIMS DEPARTMENTMHBP (AETNA NETWORK) Y PO BOX 981106 EL PASO, TX 79998 (800) 410-7778

-M-MHTS/VALUE OPTIONS N PO BOX 12698 NORFOLK, VA 23502

CLAIMS DEPT.MID WEST NATIONAL N PO BOX 982017 NORTH RICHLAND, TX 76182 (888) 756-3534

MEDICAL CLAIMS DEPARTMENTMISSIONARY MEDICAL N PO BOX 45730 SALT LAKE CITY, UT 84145 (800) 777-1647

MEDICAL CLAIMS DEPARTMENTMISSOURI CONSOLIDATED HEALTHCARE N PO BOX 4568 SPRINGFIELD, MS 65808 (800) 836-0402MOUNTAIN STATES ADMINISTRATIVE SERVICES

N PO BOX 981693 EL PASO, TX 79998 (800) 866-4731

MUTUAL ASSURANCE ADMINISTRATORS N PO BOX 42098 OKLAHOMA CITY, OK 73123 (800) 825-3543MUTUAL ASSURANCE ADMINISTRATORS N PO BOX 42098 OKLAHOMA CITY, OK 73123 (800) 825-3540MUTUAL OF OMAHA Y MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 (877) 617-5587

MEDICAL CLAIMSMVP Y PO BOX 2207 SCHENECTADY, NY 12301 (800) 229-5851

MEDICAL CLAIMS DEPARTMENTMVP SELECT CARE N PO BOX 2207 SCHENECTADY, NY 12301 (800) 684-9286MVP-1083 N PO BOX 1083 SCHENECTADY, NY 12301

MEDICAL CLAIMS

-N-NALC HEALTH BENEFIT PLAN N 20547 WAVERLY COURT ASHBURN, VA 20149 (888) 636-6252

ASHBURNNATIONAL & COMMUN SERVICES N PO BOX 3430 CARMEL, IN 46082 (866) 699-4186

MEDICAL CLAIMS DEPARTMENTNATIONAL ELEVATOR INDUSTRY N PO BOX 910 NEWTOWN SQUARE, PA 19073 (800) 252-4611

MEDICAL CLAIMS DEPARTMENTNATIONAL FINANCE CENTER N PO BOX 790275 ST. LOUIS, MO 63179 (877) 829-9562NATIONAL STATES INSURANCE CO N 1830 CRAIG PARK CT ST. LOUIS, MS 63146 (314) 878-0101NATIVE CARE HEALTH N PO BOX 10704 SPRINGFIELD, MS 65808 (877) 810-4587NATIVE CARE HEALTH N PO BOX 50 QUAPAW, OK 74363 (877) 810-4587

NEW ERA LIFE INSURANCE CO Y PO BOX 4884 HOUSTON, TX 77210 (800) 552-7879NORTH AMERICA ADMINISTRATORS, LP N PO BOX 1984 NASHVILLE, TN 37202 (800) 411-3650Northeast GA (Healthpartners Network) Y PO BOX 3848 CORPUS CHRISTI, TX 78463 (844) 509-4672NOT IN NETWORK DONT USE N PO BOX 5679 BOISE, ID 83705 (800) 688-5008

MEDICAL CLAIMS DEPARTMENT

-O-OLD SURETY LIFE INSURANCE COMPANY N PO BOX 54407 OKLAHOMA CITY, OK 73154 (800) 272-5466OMAHA INSURANCE COMPANY Y 3300 MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 (800) 775-6000OXFORD Y PO BOX 29130 HOT SPRINGS, AR 71903 (800) 666-1353

-P-PACIFICARE SENIOR SUPPLEMENT N PO BOX 6072 CYPRESS, CA 90630 (800) 851-3802

CLAIMS DEPARTMENT

-P-PAI Y PO BOX 6702 COLUMBIA, SC 29260 (866) 798-0803

MEDICAL CLAIMS DEPARTMENTPAI -6927 Y PO BOX 6927 COLUMBIA, SC 29260 (800) 768-4375PAN AMERICA LIFE N PO BOX 21604 EAGAN, MN 55121 (877) 821-7797PAN AMERICAN LIFE N PO BOX 21604 EAGAN, MN 55121 (877) 821-7797PAN AMERICAN LIFE INSURANCE N PO BOX 619008 dallas, TX 75261

MEDICAL CLAIMS DEPTPAN AMERICAN LIFE INSURANCE N PO BOX 61050 NEW ORLEANS, LA 61050 (866) 227-5400

MEDICAL CLAIMS DEPARTMENTPAN AMERICAN LIFE INSURANCE COMPANY Y PO BOX 981644 EL PASO, TX 79998 (877) 569-3075PAN-AMERICAN LIFE INSURANCE CO. N PO BOX 99007 LUBBOCK, TX 79490 (877) 495-4616

CLAIMS DEPT.PARAGON BENEFITS INC N PO BOX 12288 COLUMBUS, GA 31917 (866) 360-9065PCIP N PO BOX 300 INDEPENDENCE, MO 64051 (866) 717-5826PCIP Y PO BOX 30783 SALT LAKE CITY, UT 84130 (877) 777-6872PEACH STATE HEALTH PLAN Y PO BOX 5010 FARMINTON, MO 63640-5010 (877) 687-1180PEARCE ADMINISTRATION N PO BOX 2439 FLORENCE, SC 29503 (888) 722-1668

CLAIMS DEPTPEARCE ADMINISTRATION N PO BOX 2271 FLORENCE, SC 29503 (888) 722-1668PETER INTERNATIONAL UNDERWRITERS Y PO BOX 92110 ELK GROVE VILLAGE, IL 60009 (844) 304-3550PHCS Y PO BOX 211186 EGAN, MN 55121 (800) 948-3253PHCS Y PO BOX 21823 EAGAN, MN 55121 (770) 813-8474PHCS N 15560 N. FRANK LLOYD WRIGHT BLVD. SCOTTSDALE, AZ 85260 (888) 298-6828PHP OF NORTHERN INDIANA N PO BOX 2359 FORT WAYNE, IN 46801 (800) 982-6257

MEDICAL CLAIMS DEPARTMENT

PHYSICIANS MUTUAL N PO BOX 3313 OMAHA, NE 68103 (800) 228-9100MEDICAL CLAIMS DEPARTMENT

PHYSICIANS MUTUAL Y PO BOX 2018 OMAHA, NE 68103 (800) 228-9100PIEDMONT HEALTH (CIGNA NETWORK) Y PO BOX 1000 PISCATAWAY, NJ 08855 (877) 601-3835PIEDMONT WELLSTAR HEALTHPLANS N PO BOX 1039 PITTSBURGH, PA 15230 (855) 869-7225PLUMBERS & STEAMFITTERS LOCAL 21 Y 1024 MCKINLEY STREET PEEKSKILL, NY 10566 (914) 737-7220PPO NEXT N PO BOX 5080 ADDISON, TX 75001 (800) 225-9674

MEDICAL CLAIMS DEPARTMENTPPO NEXT -549023 N PO BOX 549023 DALLAS, TX 75354 (800) 747-4370

MEDICAL CLAIMS DEPARTMENTPPONEXT N 1587 STEWART AVENUE WESTBURY, NY 11590 (516) 832-9200

CLAIMS DEPARTMENTPREFERRED CARE INC N PO BOX 1285 FREDERICK, MD 21705 (888) 264-1512

CLAIMS DEPTPREMIER HEALTH SYSTEMS N PO BOX 1640 COLUMBIA, SC 29202 (800) 773-1445

CLAIMS DEPARTMENT

-P-PRESBYTERIAN HEALTH PLAN Y P.O. BOX 27489 ALBUQUERQUE, NM 87125 (855) 780-7737PRIMETIME HEALTH PLAN N PO BOX 6905 CANTON, OH 44710 (800) 577-5084

MEDICAL CLAIMS DEPARTMENTPRINCIPAL LIFE INSUR CO N 1 INTERNATIONAL PLAZA PHILIDELPHIA, PA 19113 (800) 533-5044

SUITE 100PRINCIPAL LIFE INSURANCE N PO BOX 39710 COLORADO SPRINGS, CO80949 (800) 247-4695

MEDICAL CLAIMS DEPARTMENTPRINCIPAL LIFE INSURANCE COMPANY Y PO BOX 10826 CLEARWATER, FL 33757 (800) 447-4701PROFESSIONAL BENEFIT ADMINISTRATORS N PO BOX 4687 OAK BROOK, IL 60522 (630) 655-3755

MEDICAL CLAIMS DEPARTMENTPRUDENTIAL INSURANCE COMPANY OF AMERICA

Y PO BOX 19028 GREENVILLE, SC 29602 (800) 828-0153

PYRAMID LIFE N PO BOX 742568 HOUSTON, TX 77274 (866) 568-8921

-Q-QUIK TRIP N PO BOX 733 BUCKEYSTOWN, MD 21717 (918) 615-7972

MEDICAL CLAIMS DEPARTMENTQUIK TRIP N PO BOX 251369 PLANO, TX 75025 (918) 615-7972

MEDICAL CLAIMS DEPARTMENTQUIKTRIP N PO BOX 21690 EGAN, MN 55121 (918) 615-7972QUIKTRIP N PO BOX 224705 DALLAS, TX 75222 (918) 615-7972

-R-

REDWOOD HEALTH SERVICES Y 3510 UNOCAL PL SANTA ROSA, CA 95403STE. 108

RESERVE NATIONAL INSUR CO Y PO BOX 26620 OKLAHOMA CITY, OK 73126MEDICAL CLAIMS DEPARTMENT

RETIREE MEDICAL INSUR Y PO BOX 10439 DES MOINES, IA 50306 (877) 325-7265MEDICAL CLAIMS DEPARTMENT

RETIREE MEDICAL INSURANCE N PO BOX 10432 DES MOINES, IA 50306 (877) 325-7265ROYAL NEIGHBORS OF AMERICA N PO BOX 10850 CLEARWATER, FL 33757 (877) 815-8877

MEDICAL CLAIMS DEPARTMENTRSL SPECIALTY PRODUCTS ADMIN Y 505 SOUTH LENOLA RD SUITE 231 MOORESTOWN, NJ 08057 (866) 375-0775RX SOLUTIONS N PO BOX 6082 CYPRESS, CO 90630 (888) 574-7416

CLAIMS DEPT.

-S-SAINT JOHNS CLAIMS ADMINISTRATION N PO BOX 14230 SPRINGFIELD, MO 65814 (877) 875-7700

MEDICAL CLAIMS DEPARTMENTSAMBA N PO BOX 8600 LONDON, KY 40742 (800) 638-6589

MEDICAL CLAIMSSCHALLER ANDERSON N PO BOX 60850 PHOENIX, AZ 85082 (866) 479-1130

MEDICAL CLAIMS DEPARTMENTSDS N 4676 HWY 41N SPRINGFIELD, TN 37172

-S-SECURE HEALTH N PO BOX 13447 MACON, GA 31208 (478) 314-2400SELECT BENEFIT ADMINISTRATORS N PO BOX 4250 HOUSTON, TX 77210 (800) 497-3699SELECT BENEFIT PLAN Y PO BOX 3245 MILWAULKEE, WI 53201 (800) 497-3699

(800) 280-9297SELECT HEALTH N PO BOX 30192 SALT LAKE CITY, UT 84130 (800) 538-5038SEVEN CORNERS N 303 CONGRESSIONAL BLVD CARMEL, IN 46032 (800) 690-6295SGIC Y PO BOX 211282 EGAN, MN 55121 (888) 912-4767SHASTA ADMINISTRATIVE SERVICES N PO BOX 1747 REDMOND, OR 97756 (800) 317-1342

MEDICAL CLAIMS DEPARTMENTSHEET METAL WORKERS LOCAL NO 85 N 3835 PRESIDENTIAL PARKWAY STE 123 ATLANTA, GA 30340 (800) 577-1713SIMPLE N PO BOX 2478 MADISON, WI 53701 (800) 610-1920

C/O IFLSMITH ADMINISTRATORS N PO BOX 161125 FORT WORTH, TX 76161 (817) 335-2582

MEDICAL CLAIMS DEPARTMENTSMITH ADMINISTRATORS N PO BOX 853937 RICHARDSON, TX 75085 (800) 867-2582SMW PLUS SUPP MEDICARE N PO BOX 1449 GOODLETTSVILLE, TN 37070

MEDICAL CLAIMS DEPARTMENT

SOUTHCARE N PO BOX 8530 KANSAS CITY, MO 64114 (800) 843-1787MEDICAL CLAIMS DEPARTMENT

SOUTHERN BENEFIT ADMINISTRATORS N 3835 PRESIDENTIAL PARKWAY ATLANTA, GA 30340 (770) 455-3802SUITE 123

SOUTHERN GRAPHIC COMMUNICATION N PO BOX 607 JONESBORO, GA 30237 (800) 852-0049MEDICAL CLAIMS

SOUTHERN INSURANCE UNDERWRITTERS N PO BOX 819020 DALLAS, TX 75381 (800) 550-8009SPECIALTIES & PAPER PRODUCTS Y PO BOX 641 MABLETON, GA 30126 (770) 944-7348

MEDICAL CLAIMS DEPARTMENT (800) 248-8853STANDARD LIFE AND ACCIDENT INSURANCE COMPANY

N PO BOX 1800 GALVESTON, TX 77553 (888) 350-1488

MEDICAL CLAIMS DEPARTMENTSTANDARD LIFE AND ACCIDENT INSURANCE COMPANY

N PO BOX 16708 JACKSON, MS 39236 (888) 888-2519

STANDARD SECURITY LIFE INSURANCE COMPANY

N PO BOX 21156 EAGAN, MN 55121 (800) 822-3906

STAR HRG N PO BOX 55270 PHOENIX, AZ 85078 (800) 308-5948MEDICAL CLAIMS DEPARTMENT

STARMARK Y PO BOX 2942 CLINTON, IA 52733 (800) 522-1246STATE FARM INSURANCE COMPANIES N PO BOX 3070 NEWARK, OH 43058 (866) 855-1212

MEDICAL CLAIMS DEPARTMENTSTERLING INVESTORS LIFE INSURANCE N PO BOX 10848 CLEARWATER, FL 33757

CLAIMS DEPT.STERLING OPTION II N PO BOX 69314 HARRISBURG, PA 17106 (888) 858-8551

MEDICAL CLAIMS DEPARTMENT

-S-STERLING OPTION ONE N PO BOX 69314 HARRISBURG, PA 17106 (888) 858-8551STERLING PREMIER N PO BOX 5348 BELLINGHAM, WA 98227STRATEGIC RESOURC COMPANY- 23759 N PO BOX 23759 COLUMBIA, SC 29224 (888) 772-9682

MEDICAL CLAIMS DEPARTMENT

-T-T.W. LORD AND ASSOCIATES N PO BOX 1185 MARIETTA, 30061 (800) 633-2360TALL TREE ADMINISTRATORS N PO BOX 71747 SALT LAKE CITY, UT 84171 (800) 922-4362TAYLOR BENEFIT RESOURCE INC N PO BOX 6580 THOMASVILLE, GA 31758 (888) 352-5246

MEDICAL CLAIMS DEPARTMENTTEAMASTER SECURITY FUND FOR SOUTHERN NEVADA

N PO BOX 27287 LAS VEGAS, NV 89126 (702) 318-5089

TECHMER PM LLC N C/O USA MCO PHOENIX, AZ 85064 (800) 924-8605PO BOX 10170 DEPT 130

THE GUARDIAN N PO BOX 8019 APPLETON, WI 54913 (800) 624-4050

MEDICAL CLAIMS DEPARTMENTTHE LOOMIS COMPANY Y PO BOX 13668 READING, PA 19612 (866) 218-6016THE LOOMIS COMPANY Y PO BOX 7011 WYOMISSING, PA 19610 (610) 376-6994TIME INSURANCE COMPANY N PO BOX 981602 EL PASO, TX 79998 (800) 454-5105

MEDICAL CLAIMS DEPARTMENTTODAYS OPTIONS PYRAMID LIFE N PO BOX 391885 CAMBRIDGE, MA 02139 (866) 568-8921

MEDICAL CLAIMS DEPARTMENTTR PAUL INC N 14 COMMERCE ROAD NEWTOWN, CT 06470 (800) 678-8161

PO BOX 5508TRANSAMERICA Y PO BOX 310 GRAPEVINE, TX 76099 (800) 550-5287

CLAIMS DEPTTRANSAMERICA LIFE INSURANCE COMPANY Y PO BOX 97 SCRANTON, PA 18504 (800) 752-9797

MEDICAL CLAIMS DEPARTMENTTRANSAMERICA LIFE INSURANCE COMPANY N PO BOX 8043 LITTLEROCK, AR 72203 (866) 224-3100TRANSAMERICA LIFE INSURANCE COMPANY Y PO BOX 3350 CEDAR RAPIDS, IA 52406 (800) 854-0186TRUSTMARK LIFE INSURANCE COMPANY N PO BOX 2942 CLINTON, IA 52733 (800) 396-2960

MEDICAL CLAIMS DEPARTMENTTUFTS HEALTH PLAN N PO BOX 9165 WATERTON, MA 02471

-U-UAB HLA LAB N 619 19TH STREET RM: W99290 BIRMINGHAM, AL 35249 (205) 934-4987

ATTN: JOY CAMPBELLUCH -981504 N PO BOX 981504 EL PASO, TX 79998 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUFCW TRUST FUND N PO BOX 9000 WALNUT CREEK, CA 94598 (800) 794-5678

MEDICAL CLAIMS DEPARTMENTUNIFIED LIFE (UHC NETWORK) Y PO BOX 25326 OVERLAND PARK, KS 66225 (877) 492-2467 [8]

(800) 237-4463

-U-UNIFIED LIFE (UNITED NETWORK) Y PO BOX 25326 OVERLAND PARK, KS 66225 (877) 258-8594UNIFORM MEDICAL PLAN N P0 BOX 34850 SEATTLE, WA 98124 (800) 937-2277

MEDICAL CLAIMS DEPARTMENTUNITED AMERICAN INSURANCE N PO BOX 810 DALLAS, TX 75221 (214) 328-2841UNITED AMERICAN INSURANCE COMPANY Y PO BOX 8080 MCKINNEY, TX 75070 (972) 529-5085

MEDICAL CLAIMS DEPARTMENTUNITED AMERICAN INSURANCE COMPANY N PO BOX 26400 OKLAHOMA CITY, OK 73126 (972) 529-5085

MEDICAL CLAIMS DEPARTMENTUNITED CLAIM SOLUTIONS/IMS-CG N 23048 N. 15TH AVENUE PHOENIX, AZ 85027 (800) 426-8739UNITED COMMERCIAL TRAVELERS OF AMERICA

N 1801 WATERMARK DRIVE SUITE 100 COLUMBUS, OH 43215 (800) 848-0123

PO BOX 159019UNITED HEALTH ONE N PO BOX 31374 SALT LAKE CITY, UT 84131 (800) 657-8205UNITED WORLD LIFE INSURANCE COMPANY N 3316 FARNAM STREET OMAHA, NE 68175 (877) 617-5587

MEDICAL CLAIMS DEPARTMENTUNITEDHEALTH INTEGRATED SERVICES N PO BOX 30783 SALT LAKE CITY, UT 84130UNIVERSAL HEALTHCARE N PO BOX 3211 ST. PETERSBURG, FL 33731 (866) 690-4842

MEDICAL CLAIMS DEPARTMENTUNIVERSAL HEALTHCARE INC N PO BOX 294 ST. PETERSBURG, FL 33731 (866) 616-6404

MEDICAL CLAIMS DEPARTMENTUNTIED TEACHERS ASSOCIATES INSURANCE COMPANY

N PO BOX 26580 AUSTIN, TX 78755 (866) 459-1755

UNTIY HEALTH INSURANCE N PO BOX 610 SAUK CITY, WI 53583 (800) 362-3310UPREHS Y PO BOX 161020 SALT LAKE CITY, UT 84116 (800) 547-0421US BENEFITS N 1919 NORTH EAST PACIFIC STREET STE 100PORTLAND, OR 97232 (800) 797-3888USA PLUS CLAIMS N PO BOX 6080-174 MISSION VIEJO, CA 92690 (800) 952-4320USAA Y PO BOX 12750 PENSACOLA, FL 32591USAA LIFE INSURANCE Y 9800 FREDERICKSBURG ROAD SAN ANTONIO, TX 78288 (800) 531-6978UTAH PIPE TRADES WELFARE TRUST FUND N PO BOX 1618 SAN RAMON, CA 94583 (925) 398-7041

-V-VALECE HEALTH Y PO BOX 3848 CORPUS CHRISTI, TX 78463 (844) 509-4672VETERANS ADMINISTRATION N ATTN 508/16 FEE; EWL/CHARLES OR FLO DECATUR, GA 30033 (404) 231-6111

1670 CLARIMONT RDVETERANS CHOICE PROGRAM N PO BOX 2748 VIRGINA BEACH, VA 23450 (866) 606-8198village md Y village md ATLANTA, GA 30348 (800) 999-9999

-W-WARN INDUSTRIES CLAIMS OFFICE N 1200 SW MORRISON, SUITE 200 PORTLAND, OR 97205 (800) 811-8862

CLAIMS DEPARTMENTWAUSAU BENEFITS- 8013 N PO BOX 8013 WAUSAU, WI 54402 (866) 874-2789

MEDICAL CLAIMS DEPARTMENTWEB TPA N P.O. BOX 1928 GRAPEVINE, TX 76099 (800) 758-1633

-W-WELLCARE Y PO BOX 31224 TAMPA, FL 33631 (866) 334-7730WELLCARE Y PO BOX 31372 TAMPA, FL 33631 (855) 538-0454WELLMEC Y PO BOX 559017 AUSTIN, TX 78755 (866) 868-4139WELLS FARGO THIRD PARTY ADMINISTRATORS

N PO BOX 71489 NEWNAN, GA 30271 (888) 295-4864

MEDICAL CLAIMS DEPARTMENTWESTERN & SOUTHERN FINANCIAL GROUP N PO BOX 5735 CINCINNATI, OH 45201 (866) 295-6879

BENEFITS DEPARTMENTWPS PREFERRED PROVIDER PLAN N PO BOX 8190 MADISON, WI 53708 (800) 351-9946

CLAIMS DEPARTMENT

-Y-YOUNG LIFE BENEFITS PLAN N PO BOX 520 COLORADO SPRINGS, CO80901 (719) 381-1759

MEDICAL CLAIMS DEPARTMENT

COVENTRY-C-COVENTRY N PO BOX 7807 LONDON, KY 40742 (866) 847-8235COVENTRY (MEDICARE) Y PO BOX 7370 LONDON, KY 40742 (800) 727-9712COVENTRY -7797 N PO BOX 7797 LONDON, KY 40742 (800) 467-4917

MEDICAL CLAIMS DEPARTMENTCOVENTRY ADVANTRA Y PO BOX 7156 LONDON, KY 40742 (866) 613-4977COVENTRY HEALTH CARE N PO BOX 8403 LONDON, KY 40742 (800) 254-0227COVENTRY HEALTH CARE OF THE CAROLINAS

N PO BOX 7102 LONDON, KY 40742 (800) 889-1947

COVENTRY- 7711 Y PO BOX 7711 LONDON, KY 40742 (800) 395-2545MEDICAL CLAIMS DEPARTMENT

COVENTRY- 8400 N PO BOX 8400 LONDON, KY 40742MEDICAL CLAIMS DEPARTMENT

COVENTRY-7128 N PO BOX 7128 LONDON, KY 40742ATTN: CLAIMS DEPT.

COVENTRY-7806 N PO BOX 7806 LONDON, KY 40742MEDICAL CLAIMS DEPT.

-R-RURAL CARRIER BENEFIT PLAN N PO BOX 7404 LONDON, KY 40742 (800) 638-8432

-W-WELLPATH N PO BOX 7102 LONDON, KY 40742 (800) 935-7234WELLPATH N PO BOX 7102 LONDON, KY 40742 (800) 935-7284

FIRST HEALTH/COVENTRY-A-ARM GRP N 340 QUADRANGLE DR BOLINGBROOK, IL 60440 (800) 968-7222ASSURANT HEALTH N PO BOX 2806 CLINTON, IA 52733 (800) 553-7654ASSURANT HEALTH N PO BOX 7806 LONDON, KY 40742 (800) 553-7654

MEDICAL CLAIMS DEPARTMENT

-C-CBCA N PO BOX 1339 MINNEAPOLIS, MN 55440 (800) 226-5116Cooperative Benefit Administrators N PO BOX 6249 LINCOLN, NE 68506 (402) 483-9200COVENTRY -7705 N PO BOX 7705 LONDON, KY 40742 (800) 467-4917

-F-FIRST HEALTH Y PO BOX 3040 FARMINGTON HILLS, MI 48333 (770) 813-8474FOX- EVERETT INC N PO BOX 6012 RIDGELAND, MS 39158 (877) 476-6327

-H-HEALTH ASSURANCE N PO BOX 7089 LONDON, KY 40742 (800) 788-8445

MEDICAL CLAIMS DEPARTMENTHEALTH NET N PO BOX 14700 LEXINGTON, KY 40512 (888) 747-7823

-M-MEDICAL MUTUAL OF OHIO N PO BOX 94648 CLEVELAND, OH 44101 (800) 493-2583MERCER ADMINSTRATOR N PO BOX 4542 IOWA CITY, IA 52244 (800) 290-7303

MEDICAL CLAIMS DEPT

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-S-SISCO N PO BOX 389 DUBUQUE, IA 52004 (800) 457-4726

-T-TPSC N PO BOX 2950 TACOMA, WA 98401 (800) 426-9786

-U-UABT N 54 CORPORATE PARK IRVINE, CA 92606 (800) 223-4590

HUMANA-H-HUMANA Y PO BOX 195560 SAN JUAN, PR 00919 (866) 773-5959HUMANA Y PO BOX 87581 CHICAGO, IL 60680 (800) 594-0977HUMANA - 14601 (double check) Y PO BOX 14601 LEXINGTON, KY 40512 (877) 511-5000

MEDICAL CLAIMS DEPARTMENTHUMANA - 14610 Y PO BOX 14610 LEXINGTON, KY 40512 (800) 558-4444

MEDICAL CLAIMS DEPARTMENT

-H-HUMANA ONE Y PO BOX 14635 LEXINGTON, KY 40512 (800) 833-6917

MEDICAL CLAIMS DEPARTMENT

-M-MOTOROLA HEALTH N PO BOX 14601 LEXINGTON, KY 40512 (800) 448-3810

MEDICAL CLAIMS DEPARTMENT

-T-TRS (HUMANA MEDICARE) Y PO BOX 14678 LEXINGTON, KY 40512 (800) 320-9566

HUMANA MEDICARE-H-HUMANA MEDICARE Y PO BOX 14601 LEXINGTON, KY 40512 (877) 511-5000

MEDICAL CLAIMS DEPARTMENT

KAISER-K-KAISER- 190849 Y PO BOX 190849 ATLANTA, GA 31119 (404) 261-2825

MEDICAL CLAIMS DEPARTMENTKPIC SELF FUNDED CLAIMS N PO BOX 30547 SALT LAKE CITY, UT 84130

MEDICAL CLAIMS

MEDICARE-C-CIGNA MEDICARE N PO BOX 696018 SAN ANTONIO, TX 78269 (800) 577-9410

MEDICAL CLAIMS

-M-MEDICARE Y PO BOX 3076 SAVANNAH, GA 31402 (877) 567-7271

MEDICAL CLAIMS DEPARTMENTMEDICARE RAILROAD Y PO BOX 10066 AUGUSTA, GA 30499 (877) 288-7600

MEDICAL CLAIMS DEPARTMENTMEDICARE SECONDARY N PO BOX 3076 SAVANNAH, GA 31402 (877) 567-7271

-P-PACIFICARE N PO BOX 12466 PENSACOLA, FL 32591 (888) 202-4340

CLAIMS DEPARTMENT

-R-REGIONAL CLAIMS N PO BOX 4946 COVINA, CA 91723 (800) 573-8597

-W-

WINDSOR STERLING N PO BOX 269003 PLANO, TX 75026 (888) 839-9052

-W-

MULTIPLAN-M-MULTI PLAN N PO BOX 211033 EAGAN, MN 55121 (800) 851-6268MULTIPLAN Y 6116 SHALLOWFORD ROAD CHATANOOGA, TN 37421 (888) 640-8707

SUITE 109B

NRS RECOVERIES-N-NRS RECOVERIES N CLIENT SERVICES CLEVELAND, TN 37320 (800) 776-4600 [0]

PO BOC 8005

PHCS-A-ALLSTATE WORKPLACE DIVISION Y PO BOX 853916 RICHARDSON, TX 75085 (800) 937-7039

MEDICAL CLAIMS DEPARTMENTAMERI HEALTH ADMIN N PO BOX 1008 HORSHAM, PA 19044 (888) 972-8244AMERICAN HERITAGE LIFE INSURANCE N PO BOX 853916 RICHARDSON, TX 75085 (800) 497-4856

MEDICAL CLAIMSAMERICAN MARITIME OFFICERS N PO BOX 35 DANIA BEACH, FL 33004 (800) 348-6515

MEDICAL CLAIMS DEPARTMENTAMERICAN WORKER HEALTH N PO BOX 20765 INDIANAPOLIS, IN 46220 (866) 225-8880ASSURANT HEALTH N PO BOX 42033 HAZELWOOD, MO 63042 (800) 444-6254

MEDICAL CLAIMS DEPARTMENT (800) 553-7654ASSURE CARE N PO BOX 1570 EAST LANSING, MI 48826 (800) 759-7422

MEDICAL CLAIMS DEPARTMENTASSURECARE RISK MANAGEMENT N 13700 WATERTOWN CIR STE D PLYMOUTH, MN 55441 (866) 885-4944AUXIANT- 909991 N PO BOX 909991 MILWAUKEE, WI 53209 (800) 279-6772

MEDICAL CLAIMS DEPARTMENT

-B-BENEFIT ADMINISTRATIVE SYSTEMS LLC N 17475 JOVANA DRIVE HOMEWOOD, IL 64030 (800) 799-7400

SUITE 1BBENEFIT MANAGEMENT SERVICE N PO BOX 1317 MATTHEWS, NC 28106 (800) 821-4398

MEDICAL CLAIMS DEPARTMENT

BENEFIT MANAGEMENT SERVICES, INC N PO BOX 1178 MATTHEWS, NC 28106 (800) 228-1803BENEFIT SYSTEMS AND SERVICES N 760 PASQUINELLI DR SUITE 320 WESTMONT, IL 60559 (800) 240-1940

-C-CAIC N PO BOX 2086 FORT MILL, SC 29716 (866) 543-0896

-C-CANUS N PO BOX 819 BUCKEYSTOWN, MD 21717 (800) 778-1695CBSA N PO BOX 27267 MINNEAPOLIS, MN 55427 (800) 925-2272

MEDICAL CLAIMS DEPARTMENTCELTIC INSURANCE N PO BOX 33839 INDIANAPOLIS, IN 46203 (800) 477-7870

MEDICAL CLAIMS DEPARTMENTCHESAPEAKE LIFE N PO BOX 60510 HARRISBURG, PA 17106 (800) 282-1414

MEDICAL CLAIMS DEPARTMENTCHESTERFIELD RESOURCES N PO BOX 1884 AKRON, OH 44309 (800) 321-0935

MEDICAL CLAIMS DEPARTMENTCLAIMS PROCESSING CONTRACTOR N PO BOX 3823 DURHAM, NC 27702 (800) 422-4658CONCERT HEALTH PLAN N 2605 W 22ND ST SUITE 25 OAKBROOK, IL 60523 (866) 818-3106

MEDICAL CLAIMS DEPARTMENT

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CLAIMS DEPT.DIVERSIFIED ADMINISTRATION CORP N PO BOX 299 MARLBOROUGH, CT 06447 (888) 322-2524

-E-EMPLOYEE BENEFIT CONCEPTS,INC. N PO BOX 2365 FARMINGTON HILLS, MI 48333 (800) 355-8040

CLAIMS DEPT.EMPLOYEE BENEFIT CONSULTANTS Y PO BOX 928 FINDLAY, OH 45839 (866) 941-7427

MEDICAL CLAIMS DEPARTMENT

-F-FMH BENEFIT SERVICES N PO BOX 25946 OVERLAND PARK, KS 66225 (800) 990-9058

MEDICAL CLAIMS DEPARTMENTFREEDOM LIFE INSURANCE Y PO BOX 1628 ADDISON, TX 75001 (800) 387-9027

-G-GROUP & PENSION ADMINISTRATORS Y PO BOX 749075 DALLAS, TX 75374 (800) 827-7223

MEDICAL CLAIMS DEPARTMENTGROUP ADMINISTRATORS N 450 EAST REMINGTON RD SCHAUMBURG, IL 60173 (800) 323-1683

MEDICAL CLAIMS DEPARTMENTGROUP AMINISTRATORS Y PO BOX 95600 HOFFMAN ESTATES, IL 60195 (800) 323-1683

MEDICAL CLAIMS DEPARTMENT

GROUP RESOURCES N PO BOX 997 DULUTH, GA 30096 (800) 319-9416GUARDIAN- 8007 N PO BOX 8007 APPLETON, WI 54912 (800) 873-4542

MEDICAL CLAIMS DEPARTMENT

-H-HEALTH COST SOLUTIONS Y PO BOX 1439 HENDERSONVILLE, TN 37077 (800) 526-3919HEALTH EOS N PO BOX 6090 DE PERE, WI 54115 (608) 282-8900HPHC INSURANCE CO Y PO BOX 699183 QUINCY, MA 02269 (888) 333-4742

MEDICAL CLAIMS DEPARTMENT

-I-IAC N PO BOX 21456 EGAN, MN 55121 (866) 429-0608

MEDICAL CLAIMSIMERICA INSURANCE N 100 GARDEN CITY PLAZA, SUITE 102 GARDEN CITY, NY 11530 (877) 463-7422INDEPENDENT HEALTH N PO BOX 9066 BUFFALO, NY 14231 (800) 862-4728

-K-KANAWHA HEALTHCARE N PO BOX 1000 LANCASTER, SC 29721 (800) 822-1274

MEDICAL CLAIMS DEPARTMENTKPIC N PO BOX 261155 PLANO, TX 75026 (800) 788-2949

-L-LBA HEALTHPLANS INC N PO BOX 981801 EL PASO, TX 79998 (800) 793-9403

-M-MEDICAL MUTUAL Y PO BOX 6018 CLEVELAND, OH 44101 (800) 362-1279

MEDICAL CLAIMS DEPARTMENTMEDICAL PARTNERS OF AMERICA N 90 FORT WADE ROAD PONTE VEDRA, FL 32081 (706) 243-5661

MEDICAL CLAIMS (866) 273-0059MEDISHARE NOT INSURANCE SELF PAY ONLY

Y PO BOX 981652 EL PASO, TX 79998 (800) 328-4316

CLAIMS DEPT.MEGA LIFE AND HEALTH N PO BOX 69510 HARRISBURG, PA 17106 (800) 379-0804MERITAIN HEALTH - 27267 Y PO BOX 27267 MINNEAPOLIS, MN 55427 (800) 925-2272

MEDICAL CLAIMS DEPARTMENTMERITAIN HEALTH-27725 N PO BOX 27725 MINNEAPOLIS, MN 55427 (866) 839-4301

CLAIMS DEPTMUTUAL OF OHIO Y PO BOX 94648 CLEVELAND, OH 44101 (888) 532-3467MUTUAL OF OMAHA Y PO BOX 9 WOODWARD, OK 73802 (888) 225-0046

MEDICAL CLAIMS DEPARTMENT

-N-NATIONWIDE N PO BOX 420 SPRINGFIELD, MA 01101 (866) 457-8809NCAS N PO BOX 10153 FAIRFAX, VA 22038 (800) 888-6227

NCAS N PO BOX 221169 CHARLOTTE, NC 28222 (866) 232-3646MEDICAL CLAIMS DEPARTMENT

-P-PAN AMERICA LIFE N PO BOX 260957 PLANO, TX 75026 CLAIMS DEPT (866) 277-5400

Medical Claims DepartmentPAN AMERICAN LIFE Y PO BOX 2947 COVINGTON, LA 70434 (866) 781-6736

CLAIMS DEPT.PHCS Y 4574 LAWRENCEVILLE HWY SUITE 201 LILBURN, GA 30047 (877) 875-7700

MEDICAL CLAIMSPREFERRED ONE N PO BOX 59212 MINNEAPOLIS, MN 55459 (800) 997-1750

MEDICAL CLAIMS DEPARTMENT

-Q-QUALCHOICE N PO BOX 25610 LITTLE ROCK, AR 72221 (501) 228-7111

CLAIMS DEPARTMENT (800) 235-7111

-R-REGIONAL CARE N 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 (800) 795-7772RMSCO N PO BOX 6309 SYRACUSE, NY 13217 (877) 300-9969

-S-SIHO INSURANCE N PO BOX 1787 COLUMBUS, IN 47202 (800) 873-2022

MEDICAL CLAIMS DEPARTMENTSTM N PO BOX 828 PARK RIDGE, IL 60068 (800) 678-7427

MEDICAL CLAIMS DEPARTMENTSUPERMED NETWORK Y PO BOX 94648 CLEVELAND, OH 44101 (888) 532-3467

-T-TOTAL BROKER BENEFITS N 225 SMITH ROAD ST CHARLES, IL 60174 (630) 789-2082TOWER LIFE INSURANCE CO. N TOWER LIFE BUILDING SAN ANTONIO, TX 78205 (866) 499-4884

310 S. ST. MARY'S STREETTPA OF GEORGIA-- NO LONGER ACCEPT N 4574 LAWRENCEVILLE HWY STE 201 LILBURN, GA 30047 (770) 451-7550

-W-WELLNET HEALTHCARE N PO BOX 354 SOUTHAMPTON, PA 18966 (800) 727-1733

CLAIMS DEPARTMENTWELLS FARGO N PO BOX 3262 CHARLESTON, WV 25332 (800) 624-8605

MEDICAL CLAIMS DEPARTMENT

TRICARE-F-

FIX INSURANCE N PO BOX 7031 CAMDEN, SC 29020 (866) 773-0404MEDICAL CLAIMS DEPARTMENT (800) 444-5445

-T-TRICARE EAST Y PO Box 7981 MADISON, WI 53707-7981 (800) 444-5445TRICARE FOR LIFE-7890 Y PO BOX 7890 MADISON, WI 53707 (866) 773-0404

MEDICAL CLAIMS DEPARTMENTTRICARE NORTH N PO BOX 870140 SURFSIDE BEACH, SC 29587 (877) 874-2273

SURFSIDE BEACH

UHC MEDICARE-U-UHC MEDICARE Y PO BOX 31362 SALT LAKE CITY, UT 84131 (800) 643-4845UHC MEDICARE Y PO BOX 31362 SALT LAKE CITY, UT 84131 (888) 980-8117UHC MEDICARE Y PO BOX 30436 SALT LAKE CITY, UT 84130 (877) 842-3210

-U-UHC MEDICARE Y PO BOX 30995 SALT LAKE CITY, UT 84130 (877) 842-3210UHC MEDICARE COMMUNITY PLAN CALL - 31350

Y PO BOX 31350 SALT LAKE CITY, UT 84131 (877) 842-3210

MEDICAL CLAIMS DEPTUHC MEDICARE-30883 Y PO BOX 30883 SALT LAKE CITY, UT 84130 (866) 579-8811

MEDICAL CLAIMS

UNITED HEALTHCARE-A-ALL SAVERS (UHC NETWORK) Y PO BOX 31375 SALT LAKE CITY, UT 84131 (800) 291-2634

-D-DEFINITY HEALTH N PO BOX 740810 ATLANTA, GA 30374 (866) 333-4648

MEDICAL CLAIMS DEPARTMENTDEFINITY HEALTH-30555 N PO BOX 30555 SALT LAKE CITY, UT 84130 (888) 444-4314

MEDICAL CLAIMS DEPARTMENT

-G-GOLDEN RULE (UHC Network) Y PO BOX 31374 SALT LAKE CITY, UT 84131 (800) 657-8205GOLDEN RULE (uhc network) Y 712 ELEVENTH STREET LAWRENCEVILLE, IL 62439 (877) 298-3017

MEDICAL CLAIMS DEPARTMENT

-H-HEALTH SPECIAL RISKS INC. N PO BOX 117558 CARROLLTON, TX 75011

-L-LIFETIME BENEFIT (UHC NETWORK) Y PO BOX 780 LIVERPOOL, NY 13088 (866) 616-7216LIFETIME BENEFIT (UHC NETWORK) Y PO BOX 21951 EAGAN, MN 55121 (866) 616-7216

-M-MEDICA N PO BOX 659752 SAN ANTONIO, TX 78265 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTMEDICA (UHC NETWORK) Y PO BOX 30990 SALT LAKE CITY, UT 84130 (800) 228-1403

-O-OXFORD HEALTH PLANS N PO BOX 7082 BRIDGEPORT, CT 06601 (800) 666-1353

MEDICAL CLAIMS DEPARTMENT

-S-SHL N PO BOX 15645 LAS VEGAS, NV 69114 (800) 888-2264

-U-UHC Y PO BOX 740825 ATLANTA, GA 30374 (877) 842-3210UHC N PO BOX 30783 SALT LAKE CITY, UT 84130UHC Y PO BOX 740111 ATLANTA, GA 30374 (877) 842-3210UHC N PO BOX 400066 SAN ANTONIO, TX 78229 (187) 784-2321 [0]

-U-UHC - 740803 Y PO BOX 740803 ATLANTA, GA 30374 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUHC -30985 Y PO BOX 30985 SALT LAKE CITY, UT 84130 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUHC -31353 Y PO BOX 31353 SALT LAKE CITY, UT 84131 (866) 579-8811

MEDICAL CLAIMS DEPARTMENTUHC GLOBAL CHOICE N PO BOX 869035 PLANO, TX 75086 (866) 592-2355

CLAIMS DEPT.UHC river vally Y PO BOX 5230 KINGSTON, NY 12402 (800) 224-6602UHC STUDENT RESOURCES Y PO BOX 809025 DALAS, TX 75380 (800) 505-5450

MEDICAL CLAIMS DEPARTMENTUHC- 30304 Y PO BOX 30304 SALT LAKE CITY, UT 84130 (800) 809-0453

MEDICAL CLAIMS DEPARTMENTUHC- 30555 Y PO BOX 30555 SALT LAKE CITY, UT 84130 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUHC- 740802 Y PO BOX 740802 ATLANTA, GA 30374 (800) 577-8567

MEDICAL CLAIMS DEPARTMENTUHC- 740806 Y PO BOX 740806 ATLANTA, GA 30374 (877) 842-3210

MEDICAL CLAIMS DEPARTMENT

UHC- 740831 N PO BOX 740831 ATLANTA, GA 30374 (877) 842-3210UHC- 981502 N PO BOX 981502 EL PASO, TX 79998 (866) 844-4864

MEDICAL CLAIMS DEPARTMENTUHC-1600 Y PO BOX 1600 KINGSTON, NY 12402UHC-30557 Y PO BOX 30557 SALT LAKE CITY, UT 84130 (877) 506-7221

MEDICAL CLAIMS DEPARTMENTUHC-30884 Y PO BOX 30884 SALT LAKE CITY, UT 84130 (877) 842-3210

CLAIMS DEPT.UHC-3800 N 3800 AVENUE OF THE CITIES STE. 200 MOLINE, IL 61265 (800) 224-6602

MEDICAL CLAIMSUHC-740800 Y PO BOX 740800 ATLANTA, GA 30374 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUHC-740801 N PO BOX 740801 ATLANTA, GA 30374 (877) 842-3210

MEDICAL CLAIMS DEPARTMENTUHC-740813 N PO BOX 740813 ATLANTA, GA 30374 (800) 641-4146UHC-930 N PO BOX 930 FREDERICK, MD 21705 (877) 842-3210

MEDICAL CLAIMSUMR N PO BOX 266 ONALASKA, WI 54650 (800) 783-9281

MEDICAL CLAIMS DEPARTMENTUMR N PO BOX 826 ONALASKA, WI 54650 (866) 893-4879UMR (UHC NETWORK) Y PO BOX 30515 SALT LAKE CITY, UT 84130 (877) 223-1800UMR -30530 N PO BOX 30530 SALT LAKE CITY, UT 84130 (800) 446-8182

MEDICAL CLAIMS DEPARTMENT

-U-UMR -30541 (UHC NETWORK) Y PO BOX 30541 SALT LAKE CITY, UT 84130 (877) 233-1800

MEDICAL CLAIMS DEPARTMENTUMR-0704 N PO BOX 2838 CLINTON, IA 52733 (866) 440-1450

CLAIMS DEPT.UNITED HEALTH (UHC NETWORK) Y PO BOX 30783 SALT LAKE CITY, UT 84130 (888) 830-0179UNITED HEALTH CARE Y PO BOX 740809 ATLANTA, GA 30374 (877) 842-3210UNITED HEALTH CARE N PO BOX 30968 SALT LAKE CITY, UT 84130 (866) 546-0510UNITED HEALTH CARE Y PO BOX 30551 SALT LAKE CITY, UT 84130 (877) 842-3210UNITED HEALTH CARE /CIP N PO BOX 31361 SALT LAKE CITY, UT 84131UNITED HEALTHCARE Y PO BOX 740372 ATLANTA, GA 30374 (800) 753-2696UNITED HEALTHCARE Y PO BOX 31359 SALT LAKE CITY, UT 84131 (877) 717-9517UNITED HEALTHCARE Y PO BOX 31375 SALT LAKE CITY, UT 84131 (800) 291-2634UNITED HEALTHCARE N PO BOX 52064 PHOENIX, AZ 85072 (888) 866-8297UNITED MEDICAL RESOURCES N PO BOX 145804 CINCINNATI, OH 45250

MEDICAL CLAIMS DEPARTMENT

WELLCARE-W-WELLCARE N DO NOT USE!!! TAMPA, FL 33631 (866) 334-7730

MEDICAL CLAIMSWELLCARE -31224 Y PO BOX 31224 TAMPA, FL 33631 (866) 334-7730

MEDICAL CLAIMS DEPARTMENTWELLCARE- 4438 N PO BOX 4438 SCRANTON, PA 18505 (866) 238-9898

MEDICAL CLAIMS DEPARTMENT

WORKERS COMP-A-ACCG CLAIMS ADMINISTRATIVE SERVICES N 3169 HOLCOMB BRIDGE RD SUITE 400 NORCROSS, GA 30071 (404) 522-5022ACCIDENT FUNDS INSURANCE COMPANY OF AMERICA

N PO BOX 40790 LANSING, MI 48901 (866) 206-5851

ACS N 75 LANGLEY DRIVE LAWRENCEVILLE, GA 30045 (770) 822-7878AIG N PO BOX 305902 NASHVILLE, TN 37230 (770) 870-2434AIG N 600 NORTH PEARL ST DALLAS, TX 75201 (866) 642-5246AM TRUST NORTH AMERICA N PO BOX 740042 ATLANTA, GA 30734 (888) 239-3909AMERICAN RESOURCES INSURANCE Y 111 Hillcrest Rd. Mobile, AL 36695 (251) 509-0842AMERICAN RESOURCES INSURANCE COMPANY

N PO BOX 91149 MOBILE, AL 36691 (251) 509-0842

AMTRUST N PO BOX 740042 ATLANTA, GA 30374 (866) 272-9267AMTRUST NORTH AMERICA N PO BOX 740042 ATLANTA, GA 30374 (866) 272-9267AMTRUST NORTH AMERICA Y PO BOX 94405 CLEVELAND, OH 44101 (678) 258-8505

-A-AMTRUST NORTH AMERICA N PO BOX 740042 ATLANTA, GA 30374 (678) 258-8325AMTRUST NORTH AMERICA/TECHNOLOGY INSURANCE COMPANY

N PO BOX 740042 ATLANTA, GA 30374 (888) 239-3909

ASSOCIATED CLAIMS ADMINISTRATORS N PO BOX 230848 MONTGOMERY, AL 36123 (800) 388-6268 [207](334) 271-6733

AVERITT EXPRESS N PO BOX 683049 FRANKLIN, TN 37068 (931) 525-5384

-B-BERKLEY SOUTHEAST INSURANCE Y P.O. BOX 1290 CANNONSBURG, PA 15317BERKLEY SOUTHEAST INSURANCE GROUP N PO BOX 1290 CANNONSBURG, PA 15317 (888) 350-1150BRENTWOOD SERVICES N PO BOX 1125 BRENTWOOD, TN 37024 (770) 729-5919

MEDICAL CLAIMS DEPARTMENTBROADSPIRE N PO BOX 5065 ATLANTA, GA 30302

BROADSPIRE COMPANY SERVICES N PO BOX 14645 LEXINGTON, KY 40512 (800) 393-0815BROTHERHOOD MUTUAL INSURANCE COMPANY

Y 6400 BROTHERHOOD WAY FORT WAYNE, IN 46801 (770) 719-8330

PO BOX 228BUILDERS INSURANCE N PO BOX 723026 ATLANTA, GA 31139 (678) 309-4000BUILDERS INSURANCE GROUP N PO BOX 723099 ATLANTA, GA 31139 (800) 883-9305BUNCH ASSOCIATES N PO BOX 32045 JAKELYNN, FL 33802 (888) 853-4735BURKLEY SOUTHWEST INSURANCE GROUP N PO BOX 1290 CANNONSBURG, PA 15317 (855) 802-5273

-C-CAREWORKS N PO BOX 94748 CLEVELAND, OH 44101 (888) 627-7586CASH ENVIROMENTAL Y PO BOX 600 GAINESVILLE, GA 30503 (678) 450-5825CCMSI N 2 EAST MAIN STREET Danville, IL 61832 (217) 444-1415CHARTIS N PO BOX 3086 ALPHARETTA, GA 30023 (214) 758-3211CHUBB GROUP OF INSURANCE N 3445 PEACHTREE RD NE ATLANTA, GA 30326 (404) 266-4179

STE 900CHURCH MUTUAL INSURANCE N PO BOX 342 MERRILL, WI 54452 (800) 554-2642

MEDICAL CLAIMS DEPARTMENTcincinnati insurance companies Y po box 1277 CANNONSBURG, PA 15317 (706) 367-7580CNA N PO BOX 8317 CHICAGO, IL 60680 (877) 262-2727CNA N 333 S. WABASH CHICAGO, IL 60604 (000) 000-0000CNA N PO BOX 740152 ATLANTA, GA 30374 DALE HARRIS (678) 473-3641

MEDICAL CLAIMS DEPARTMENT (615) 886-3093CNA PLAZA OF THE AMERICAS N 600 NORTH PERAL STREET SUITE #1800 DALLAS, TX 75221 (877) 262-2727

MEDICAL CLAIMS DEPARTMENTCYPRESS INSURANCE CO. N 1725 WINWARD CONCOURSE ALPHARETTA, GA 30005 (877) 212-3816

SUITE 200

-D-DEPARTMENT OF ADMIN SERVICES N 205 JESSIE HILL JR DR SUITE 206 ATLANTA, GA 30334 (678) 325-2645

EAST TOWER PMB 38198

-D-DEPARTMENT OF ADMINISTRATION SERVICES

N 200 PEIDMONT AVE SE STE 1208 W ATLANTA, GA 30334 (800) 900-1582

DEPARTMENT OF ADMINISTRATIVE SERVICES

N 200 PIEDMONT AVE SE ATLANTA, GA 30334 (404) 554-8322

SUITE 1208 WESTDEPARTMENT OF ADMINISTRATIVE SERVICES

N 200 PIEDMONT AVE SE ATLANTA, GA 30334 (404) 554-8300

SUITE 1208 WESTDOAS Y 200 PIEDMONT AVE S.E ATLANTA, GA 30334 JOVITA CUEVAS (800) 900-1582

SUIT 1220 WEST

DOAS N PO BOX 38198 CAPITAL HILLS STATION ATLANTA, GA 30334 (678) 781-2829MEDICAL CLAIMS DEPARTMENT

DOAS RISK MANAGEMENT SERVICES N 200 PIEDMONT AVE ATLANTA, GA 30334 (404) 554-8316SUITE 1208 WEST

-E-EMPLOYERS CLAIM MANAGEMENT N PO BOX 5614 MONTGOMERY, AL 36103 (800) 392-1551

MEDICAL CLAIMS DEPARTMENTENCOMPASS PART DISTRIBUTION N 7060 STATE RD 84 #12 FT. LAUDERDALE, FL 33317 (800) 432-8542ESIS SOUTHEAST WC CLAIMS N PO BOX 6560 SCRANTON, PA 18505 (800) 685-7361

-F-FCCI SERVICES INCORPORATED Y PO BOX 58004 SARASOTA, FL 34232 (800) 226-3224

(941) 907-3224FEDERATE MUTUAL INSURANCE N PO BOX 31716 TAMPA, FL 33631 (866) 636-8660FFVA N PO BOX 945927 MAITLAND, FL 32794 (321) 214-5354

CLAIMS DEPT.FRANK GATES N 701 INTERNATIONAL PARKWAY STE #175 LAKE MARY, FL 32746 (888) 755-1441

MEDICAL CLAIMS DEPARTMENT

-G-GA ADMINISTRATIVE SERVICES N 1775 SPECTRUM DRIVE LAWRENCEVILLE, GA 30043 (770) 963-7732

SUITE 100GA DEPT OF LABOR N PO BOX 8300 LONDON, KY 40742 (904) 357-4777

DISTRICT 6GADA N 2060 POWERS FERRY RD. SE ATLANTA, 30339 (866) 646-8516GADA WORKER'S COMP INS N 2060 POWERS FERRY RD ATLANTA, 30339 (866) 646-8516GALLAGHER N PO BOX 23812 TUSAN, AZ 85734 (770) 280-2500

CLAIMS DEPARTMENTGALLAGHER AND BASSETT N PO BOX 23812 TUSAN, AZ 85734 (866) 749-1255GALLAGHER AND BASSETT N TWO PIERCE PLACE ITASCA, IL 60143 (214) 245-3148GALLAGHER AND BASSETT N PO BOX 5900 SUGARLOAF MILLS CIRCLE LAWRENCEVILLE, GA 30043 (405) 254-9622GALLAGHER AND BASSETT N PO BOX 23812 TUSAN, AZ 85734 (405) 254-9622GALLAGHER BASSETT N 1300 EAST 10TH STREET SUITE 200 KANSAS CITY, MO 64131 (818) 942-8555

MEDICAL CLAIMS DEPARTMENT

-G-GEORGIA ADMINISTRATIVE SERVICES N SUITE 100 LAWRENCEVILLE, GA 30043 (678) 325-2665GEORGIA ADMINISTRATIVE SERVICES N SUITE 100 LAWRENCEVILLE, GA 30043 (678) 325-2663GEORGIA ADMINISTRATIVE SERVICES N SUITE 100 LAWRENCEVILLE, GA 30043 (678) 325-2663GEORGIA CUMBERLAND CONFRENCE N PO BOX 12000 CALHOUN, GA 30703 (706) 629-7951GEORGIA DEPARTMENT OF ADMINISTRATIVE SERVICES

N 200 PIEDMONT AVE. SE ATLANTA, GA 30334 (404) 554-8342

GEORGIA DEPARTMENT OF ADMINISTRATIVE SERVICES

SUITE 1208 WESTGEORGIA DEPARTMENT OF WORKER'S COMP N 270 PEACHTREE STREET ATLANTA, 30303 (404) 656-3818

GEORGIA INSURERS INSOLVENCY POOL N 2177 FLINTSTONE DRIVE, SUITE R TUCKER, GA 30084 (770) 621-9835CLAIMS DEPT.

GEORGIA POWER/ATTN WORKERS COMP Y 241 RALPH MCGILL BLVD NE ATLANTA, 30308 (404) 242-0343GM BENEFITS AND SERVICE CENTER N PO BOX 14607 LEXINGTON, KY 40512GM BENEFITS AND SERVICE CENTER N PO BOX 14607 LEXINGTON, KY 40512 (800) 489-4646GMA N PO BOX 105377 ATLANTA, GA 30348 (678) 686-6200GREAT AMERICAN INSURANCE COMPANY N PO BOX 5432 CINCINNATI, OH 45201 (800) 545-4269GREAT AMERICAN INSURANCE. DONT ACCEPT

Y 301 EAST FOURTH STREET CINCINNATI, OH 45202 (877) 589-6846

24TH FLOORGSBA N PO BOX 465328 LAWRENCEVILLE, GA 30042 (678) 376-0003GUARD INSURANCE GROUP N PO BOX 1368 WILKES BARRE, PA 18703 (888) 639-2567

CLAIMS DEPARTMENTGUIDE ONE INSURANCE N PO BOX 14543 DES MOINES, IA 50306 (800) 659-1232

-H-HANOVER INSURANCE COMPANY N PO BOX 15146 WORCESTER, MA 01615 (800) 239-4686HARTFORD Y PO BOX 14170 LEXINGTON, KY 40512 (877) 673-9222HOME DEPOT 1754 Y 1480 SATELLITE BLVD SUWANEE, GA 30024 (770) 232-0998

-I-IDSC N PO BOX 14627 LEXINGTON, KY 48512 (866) 276-2278

-K-KEY RISK N PO BOX 8000 DAPHNE, AL 36526 (800) 942-0225KEYRISK MANAGMENT SERVICES Y PO BOX 8000 DAPHNE, AL 36526 (866) 847-8872

-L-LIBERTY MUTAUL INSURANCE COMPANY N 3550 BUSCHWOOD PARK DR TAMPA, FL 33618 (800) 282-6218LIBERTY MUTUAL N PO BOX 7203 LONDON, KY 40742 (813) 264-6588LIBERTY MUTUAL N PO BOX 7071 LONDON, KY 40742 (800) 500-7044LIBERTY MUTUAL N PO BOX 7072 LONDON, KY 40742 (813) 804-6017LIBERTY MUTUAL N PO BOX 8021 WAUSAU, WI 54402 (866) 539-6449LIBERTY MUTUAL N PO BOX 31204 TAMPA, FL 33621 (800) 282-6218LIBERTY MUTUAL Y PO BOX 7203 LONDON, KY 40742 (800) 282-6218LIBERTY MUTUAL Y PO BOX 7072 LONDON, KY 40742 (800) 282-6218

-L-LIBERTY MUTUAL N PO BOX 7205 LONDON, KY 40742 (800) 282-6218

LIBERTY MUTUAL N 3901 PRIMIERE WORTH DR TAMPA, FL 33624 (800) 282-6218LIBERTY MUTUAL N PO BOX 49000 CHARLOTTE, NC 28277 (800) 532-7706LIBERTY MUTUAL INSURANCE COMPANY N 3550 BUSCHWOOD PARK DR TAMPA, FL 33618 (800) 282-6218

SUITE 300

-M-MCIM N PO BOX 19769 SARASOTA, FL 34276 (941) 921-0613MCIM N PO BOX 1227 CANNONSBURG, PA 15317 (888) 922-5246MCIM N PO BOX 15317 CANNONSBURG, PA 15317 (888) 922-5246MCMC-GUARANTEE INSURANCE COMPANY N PO BOX 1160 CANNONSBURG, PA 15317 (866) 479-1554

MEDICAL CLAIMS DEPARTMETMEDISHARE NOT INSURANCE SELF PAY ONLY

Y PO BOX 981652 EL PASO, TX 79998 (321) 308-7777

MONTGOMERY INSURANCE N PO BOX 49130 CHARLOTTE, NC 28277 (704) 759-7799MEDICAL CLAIMS DEPARTMENT

-N-NETWORK REFERRAL UNIT (SPECIALTY RISK) N PO BOX 2042 AURORA, IL 60507 (866) 880-1777

CLAIMS DEPARTMENT

-O-OCCUSURE N PO BOX 682829 FRANKLIN, TN 37068 (615) 515-1791OCCUSURE N PO BOX 682829 FRANKLIN, TN 37068 (615) 373-0500

-P-PETE CHAMBERS N 3700 CRESTWOOD PKWY DULUTH, GA 30096 (770) 621-9835

SUIT 400

-R-RISK MANAGEMENT N PO BOX 6676 ASHEVILLE, NC 28816 (828) 669-2941ROCHDALE INSURANCE COMPANY N PO BOX 740042 ATLANTA, GA 30374 (678) 258-8000

MEDICAL CLAIMS DEPARTMENT

-S-SEDGEWICK Y PO BOX 14434 LEXINGTON, KY 40512 (770) 901-3629

MEDICAL CLAIMS DEPARTMENTSEDGEWICK N PO BOX 14451 LEXINGTON, KY 40512 (800) 253-4527SEDGWICK N PO BOX 14434 LEXINGTON, KY 40512 (877) 872-0911SEDGWICK N PO BOX 14421 LEXINGTON, KY 40215 (803) 551-2124SEDGWICK Y PO BOX 14514 LEXINGTON, KY 40512 (407) 833-4100SEDGWICK N PO BOX 14432 LEXINGTON, KY 40512 (866) 669-4151SEDGWICK CMS N PO BOX 14531 LEXINGTON, KY 40512 (866) 495-7844SELECTIVE INSURANCE N 3420 TORINGDON WAY STE #300 CHARLOTTE, NC 28277 (800) 688-9656

MEDICAL CLAIMS DEPARTMENT

-S-SENTRY INSURANCE Y PO BOX 8032 STEVENS POINT, WI 54481 (800) 739-3344SPECIALTY RISK SERVICES N PO BOX 305104 NASHVILLE, TN 37230 RITA REEDER (800) 541-0139

MEDICAL CLAIMS DEPT.SRS N PO BOX 14205 LEXINGTON, KY 40512 (615) 493-5990STATE BOARD OF WORKERS COMP N 270 PEACHTREE STREET NW ATLANTA, 30303 (404) 656-3818STATE FARM INSURANCE N 6955 MCGINNIS FERRY ROAD JOHNS CREEK, GA 30097 (770) 476-1313

SUITE 111STATE OF GA DEPARTMENT OF ADMINISTRATIVE SERVICES

N PO BOX 38198 CAPITOL HILL STATION ATLANTA, GA 30334 (678) 781-2805

MEDICAL CLAIMS DEPARTMENTSTATE OF GEORGIA/ DOAS N PO BOX 38198 ATLANTA, GA 30334 (800) 900-1582

CAPITOL HILL STATIONSUMMIT N PO BOX 600 GAINESVILLE, GA 30503 (800) 863-2181

MEDICAL CLAIMS DEPARTMENT

-T-TEAM ONE REPAIR N 1440 LAKES PARKWAY SUITE 100 LAWRENCEVILLE, GA 30043 DEB BROWN (678) 618-8912

CLAIMS DEPTTHE HANOVER Y PO BOX 15144 WORCESTER, MA 01653 (800) 628-0250TRAVELERS INSURANCE N 4400 North Point Parkway Alpharetta, 30022 (800) 238-6214

MEDICAL CLAIMS DEPARTMENTTRAVELERS INSURANCE N CS 1818 ALPHARETTA, GA 30023 (800) 238-6214TRAVELERS INSURANCE N PO BOX 466 ALBANY, NY 12201 (800) 223-4820

-U-UNITED BUISNESS INSURANCE COMPANY N 350 FRANKLIN RD SUITE 330 MARIETTA, GA 30067 DEBBIE SYLER (678) 766-8242

(770) 332-8424UNITED BUSINESS INSURANCE CO N 350 FRANKLIN ROAD MARIETTA, GA 30067 (678) 766-8242

SUITE 330UNITED CEREBRAL PALSY N 3300 NORTH EAST EXPRESS WAY atlanta, GA 30341 (770) 676-2000UNITED STATES DEPARTMENT OF LABOR N PO BOX 8300 LONDON, KY 40742 (904) 366-0100US DEPT OF LABOR N PO BOX 8300 LONDON, KY 40742 (866) 335-8319

MEDICAL CLAIMSUTICA MUTUAL N PO BOX 5310 BINGHAMTON, NY 13902 (800) 477-1914UTICA NATIONAL INSURANCE CO. N 41 PERIMETER CENTER EAST NE ATLANTA, GA 30346 (770) 510-4210

SUITE 300

-W-WASUSAU N 943 NORTH POINT PKWY STE 300 ALPHARETTA, GA 30005 (800) 943-1113

WELLSTAR HEALTH SYSTEM N 1800 PWKY PLACE STE 600 MARIETTA, GA 30067 (470) 956-5147

-Z-ZENITH INSURANCE N PO BOX 1558 SARASOTA, FL 34230 (800) 440-5020

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