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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH CARRIER I.D. LISTING OI Carrier ID Carrier Name Street City State Zip code 01 00056010 AETNA US HEALTHCARE PO BOX 2295 FORT WAYNE IN 46801 01 00056015 AETNA US HEALTHCARE PO BOX 871 FORT WAYNE IN 468010871 01 00056025 AETNA US HEALTHCARE 7400 WEST CAMPUS ROAD NEW ALBANY OH 43054 01 00056035 AETNA US HEALTHCARE PO 2265 BLUE BELL PA 19422 01 00056040 AETNA US HEALTHCARE PO BOX 26279 MILWAUKEE WI 53226 01 00056045 AETNA US HEALTHCARE 3541 WINCHESTER ROAD ALLENTOWN PA 181950504 01 00056055 AETNA US HEALTHCARE PO BOX 981107 EL PASO TX 799981107 01 00056065 AETNA US HEALTHCARE PO BOX 91511 ARLINGTON TX 760150011 01 00056070 AETNA US HEALTHCARE PO BOX 5569 AKRON OH 443340569 01 00056075 AETNA US HEALTHCARE PO BOX 2907 LOOP STATION MINNEAPOLIS MN 55402 01 00056085 AETNA US HEALTHCARE 4300 B STEET SUITE 205 ANCHORAGE AK 99503 01 00056090 AETNA US HEALTHCARE PO BOX 12340 FRESNO CA 93765 01 00056095 AETNA US HEALTHCARE PO BOX 150409 HARTFORD CT 061150409 01 00056100 AETNA US HEALTHCARE PO BOX 26107 GREENSBORO NC 274026107 01 00056110 AETNA US HEALTHCARE PO BOX 50031 SAN BERNADINO CA 92412 01 00557005 AETNA US HEALTHCARE PO BOX 15202 ALBANY NY 12212 01 00566010 AETNA US HEALTHCARE PO BOX 981114 EL PASO TX 799981114 01 00566015 AETNA US HEALTHCARE PO BOX 150431 HARTFORD CT 061150431 01 00566025 AETNA US HEALTHCARE 4300 CENTREWAY ARLINGTON TX 76018 01 00566040 AETNA US HEALTHCARE PO BOX 795080 SAN ANTONIO TX 78216 01 00566050 AETNA US HEALTHCARE PO BOX 182082 COLUMBUS OH 432182082 01 00566055 AETNA US HEALTHCARE PO BOX 2520 TYLER TX 75710 01 00566060 AETNA US HEALTHCARE PO BOX 26190 GREENSBORO NC 274106190 01 00566070 AETNA US HEALTHCARE PO BOX 12244 OKLAHOMA CITY OK 731572244 01 00566080 AETNA US HEALTHCARE PO BOX 16423 PITTSBURGH PA 152420423 01 00566085 AETNA US HEALTHCARE 7676 HAZARD CENTER DRIVE SAN DIEGO CA 92108 01 00566095 AETNA US HEALTHCARE PO BOX 5516 AKRON OH 443340516 01 00575005 AETNA US HEALTHCARE PO BOX 150417 HARTFORD CT 061150417 01 00584010 AETNA US HEALTHCARE PO BOX 31450 TAMPA FL 336313450 01 14810015 AETNA US HEALTHCARE PO BOX 14110 LEXINGTON KY 405124110 01 30034005 AETNA US HEALTHCARE PO BOX 7012 DOVER DE 199031512 01 30035005 AETNA US HEALTHCARE PO BOX 112 PORTLAND OR 97207 01 30305005 AETNA US HEALTHCARE PO BOX 26053 GREENSBORO NC 27420 1 of 64

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

01 00056010 AETNA US HEALTHCARE PO BOX 2295 FORT WAYNE IN 4680101 00056015 AETNA US HEALTHCARE PO BOX 871 FORT WAYNE IN 46801087101 00056025 AETNA US HEALTHCARE 7400 WEST CAMPUS ROAD NEW ALBANY OH 4305401 00056035 AETNA US HEALTHCARE PO 2265 BLUE BELL PA 1942201 00056040 AETNA US HEALTHCARE PO BOX 26279 MILWAUKEE WI 5322601 00056045 AETNA US HEALTHCARE 3541 WINCHESTER ROAD ALLENTOWN PA 18195050401 00056055 AETNA US HEALTHCARE PO BOX 981107 EL PASO TX 79998110701 00056065 AETNA US HEALTHCARE PO BOX 91511 ARLINGTON TX 76015001101 00056070 AETNA US HEALTHCARE PO BOX 5569 AKRON OH 44334056901 00056075 AETNA US HEALTHCARE PO BOX 2907 LOOP STATION MINNEAPOLIS MN 5540201 00056085 AETNA US HEALTHCARE 4300 B STEET SUITE 205 ANCHORAGE AK 9950301 00056090 AETNA US HEALTHCARE PO BOX 12340 FRESNO CA 9376501 00056095 AETNA US HEALTHCARE PO BOX 150409 HARTFORD CT 06115040901 00056100 AETNA US HEALTHCARE PO BOX 26107 GREENSBORO NC 27402610701 00056110 AETNA US HEALTHCARE PO BOX 50031 SAN BERNADINO CA 9241201 00557005 AETNA US HEALTHCARE PO BOX 15202 ALBANY NY 1221201 00566010 AETNA US HEALTHCARE PO BOX 981114 EL PASO TX 79998111401 00566015 AETNA US HEALTHCARE PO BOX 150431 HARTFORD CT 06115043101 00566025 AETNA US HEALTHCARE 4300 CENTREWAY ARLINGTON TX 7601801 00566040 AETNA US HEALTHCARE PO BOX 795080 SAN ANTONIO TX 7821601 00566050 AETNA US HEALTHCARE PO BOX 182082 COLUMBUS OH 43218208201 00566055 AETNA US HEALTHCARE PO BOX 2520 TYLER TX 7571001 00566060 AETNA US HEALTHCARE PO BOX 26190 GREENSBORO NC 27410619001 00566070 AETNA US HEALTHCARE PO BOX 12244 OKLAHOMA CITY OK 73157224401 00566080 AETNA US HEALTHCARE PO BOX 16423 PITTSBURGH PA 15242042301 00566085 AETNA US HEALTHCARE 7676 HAZARD CENTER DRIVE SAN DIEGO CA 9210801 00566095 AETNA US HEALTHCARE PO BOX 5516 AKRON OH 44334051601 00575005 AETNA US HEALTHCARE PO BOX 150417 HARTFORD CT 06115041701 00584010 AETNA US HEALTHCARE PO BOX 31450 TAMPA FL 33631345001 14810015 AETNA US HEALTHCARE PO BOX 14110 LEXINGTON KY 40512411001 30034005 AETNA US HEALTHCARE PO BOX 7012 DOVER DE 19903151201 30035005 AETNA US HEALTHCARE PO BOX 112 PORTLAND OR 9720701 30305005 AETNA US HEALTHCARE PO BOX 26053 GREENSBORO NC 27420

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

01 40413725 AETNA US HEALTHCARE PO BOX 1858 BISMARK ND 5850202 00403005 AARP PO BOX 740819 ATLANTA GA 30374081903 00207005 AMERICAN COMMUNITY MUTUAL 39201 SEVEN MILE ROAD LIVONIA MI 4815203 00207015 AMERICAN COMMUNITY MUTUAL PO BOX 7051 MIDDLETOWN NY 1094004 00430005 BANKERS LIFE & CASUALTY PO BOX 66932 CHICAGO IL 60666093004 00824005 AMERICAN BANKERS INS CO FL 600 BRICKELL AVE MIAMI FL 3313104 01741005 AMERITAS LIFE INSURANCE CORP PO BOX 82520 LINC0LN NE 68501252004 01750005 BANKERS MULTIPLE LINE 4810 NORTH KENNETH CHICAGO IL 6063004 01751005 BANKERS MULTIPLE LINE PO BOX 655433 DALLAS TX 75265543304 18598005 AMERICAN BANKERS INS CO PO BOX 2650 WACO TX 76702265004 26295005 BANKERS COMMERCIAL LIFE 5720 L B J FREEWAY DALLAS TX 75240969904 30105005 ABS BANKERS CLAIM SERVICE PO BOS 37504 OAK PARK MI 48239050405 00029005 BC BS OF MI 600 LAFAYETTE DETROIT MI 4822605 00029015 BC OF MI 600 LAFAYETTE DETROIT MI 4822605 04734015 ANTHEM HEALTH & LIFE PO BOX 88260 ATLANTA GA 30356826005 12208005 ANTHEM ACORDIA BC BS OF IN PO BOX 37010 LOUISVILLE KY 4023305 12217005 BC BS OF MN PO BOX 64338 ST PAUL MN 55164056005 12271005 ANTHEM BC BS OH 1351 WM HOWARD TAFT RD CINCINNATI OH 4520605 12306010 BC BS OF IL MEMBERS 1ST 300 EAST RANDOLPH CHICAGO IL 6060105 12333005 ANTHEM COMMUNITY MUTUAL BC BS PO BOX 425 WORTHINGTON OH 43085750005 12950005 BC BS OF AL 450 RIVERCHASE PKWY EAST BIRMINGHAM AL 3529805 12979005 BC BS OF AZ PO BOX 13466 PHOENIX AZ 8500205 12988005 BC BS OF AR PO BOX 2181 LITTLE ROCK AR 7220305 12997005 BC OF CA PO BOX 9043 OXNARD CA 9303105 13018005 BC BS OF CO 700 BROADWAY DENVER CO 8027305 13027005 ANTHEM BC BS OF CT PO BOX 533 NORTH HAVEN CT 06473053305 13036005 BC BS OF DE PO BOX 1991 WILMINGTON DE 1989905 13045005 CARE FIRST BC BS PO BOX 812 OWINGS MILLS MD 21117081205 13054005 BC BS OF FL INC PO BOX 1798 JACKSONVILLE FL 32231001405 13072005 BC BS OF KS PO BOX 239 TOPEKA KS 6662905 13081005 ANTHEM BC BS OF KY PO BOX 37180 LOUISVILLE KY 40233718005 13090005 BC BS OF LA PO BOX 98029 BATON ROUGE LA 70898902905 13107005 BC BS OF ME 2 GANNETT DRIVE SOUTH PORTLAND ME 041066911

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

05 13116005 BC BS OF MA 100 HANCOCK ST NORTH QUINCY MA 0217105 13125005 BC BS OF KANSAS CITY PO BOX 419169 KANSAS CITY MO 64141616905 13125010 BC BS OF MO PO BOX 14882 ST LOUIS MO 63178488205 13134005 BC BS OF MT PO BOX 4309 HELENA MT 59604430905 13143005 BC BS OF NE PO BOX 3248 OMAHA NE 68180000105 13152005 BC BS OF NH 3000 GOFFS FALLS RD MANCHESTER NH 03111000105 13161005 BC BS OF NJ PO BOX 1609 NEWARK NJ 0710505 13170005 BC BS OF THE ROCHESTER AREA 150 EAST MAIN STREET ROCHESTER NY 1460405 13199005 BC BS OF CENTRAL NY PO BOX 4809 SYRACUSE NY 13221480905 13205005 EMPIRE BC BS OF NY PO BOX 11800 ALBANY NY 12211080005 13214005 BC BS OF WESTERN NY 1901 MAIN ST BUFFALO NY 14240008005 13232005 BC BS OF NC PO BOX 35 DURHAM NC 27702229105 13241005 BC BS OF OK PO BOX 3283 TULSA OK 7410205 13250005 BC BS OF OR PO BOX 1271 PORTLAND OR 97207127105 13279005 INDEPENDENCE BC-OTHER PARTY LIABILITY1901 MARKET 19TH FL PHILADELPHIA PA 1910305 13288005 CAPITAL BC & PA BS 1221 W HAMILTON ST ALLENTOWN PA 18102437005 13297005 BC OF NORTHEASTERN PA PO BOX 3100 WILKES-BARRE PA 1877305 13303005 HIGHMARK BC BS PO BOX 1210 PITTSBURGH PA 1523005 13303010 BC BS OF PA DEPARTMENT 778974 HARRISBURG PA 17177897405 13304005 BC BS OF VT PO BOX 186 MONTPELIER VT 0561005 13312005 CAPITAL BC 2500 ELMERTON AVE HARRISBURG PA 1711005 13321005 BC BS OF SC I-20 AT ALPINE ROAD COLUMBIA SC 2921905 13330005 BC BS OF TN 801 PINE ST CHATTANOOGA TN 37402255505 13359005 BC BS OF TX PO BOX 660044 DALLAS TX 7526605 13368005 BC BS OF VA PO BOX 27401 RICHMOND VA 2327905 13377005 BC OF WA & AK PO BOX 327 SEATTLE WA 98111032705 13377015 BC OF IDAHO PO BOX 7408 BOISE ID 8370705 13386005 BC BS OF WV PO BOX 1353 CHARLESTON WV 2532505 13395005 BC BS OF WY PO BOX 2266 CHEYENNE WY 8200305 13457005 BC BS OF MD PO BOX 811 OWINGS MILLS MD 2111705 13457010 BC BS OF MD PO BOX 1694 CUMBERLAND MD 21501169405 13466005 BC BS OF MS PO BOX 1043 JACKSON MS 39215104305 13751005 BC BS OF ND 4510 13TH AVE SW FARGO ND 58121

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

05 14202005 BC BS OF GA PO BOX 9907 COLUMBUS GA 31908990705 14857005 BC BS OF NM PO BOX 27630 ALBUQUERQUE NM 87125763005 14982005 BC BS OF UT PO BOX 30270 SALT LAKE CITY UT 8412505 15540005 BC BS UNITED OF WI PO BOX 2025 MILWAUKEE WI 53201202505 16815005 HMSA BC BS OF HI 818 KEEAUMOKU STREET HONOLULU HI 96808086005 17302005 BS OF SD 1601 W MADISON ST SIOUX FALLS SD 5710405 17939005 REGENCE BS OF ID PO BOX 1106 LEWISTON ID 8350105 18883005 BC BS OF MEMPHIS PO BOX 98 MEMPHIS TN 38103239805 19405005 BC BS OF RI 444 WESTMINSTER MALL PROVIDENCE RI 0290305 21664005 BS OF PR GPO BOX G 3628 SAN JUAN PR 0093605 24906005 BC BS OF W IA & SD PO BOX 1677 SIOUX CITY IA 5110205 27525005 BS OF CA PO BOX 272530 CHICO CA 9592705 30038005 EMPIRE BC BS OF NY 622 THIRD AVENUE NEW YORK NY 10017670705 30078005 EMPIRE BC BS OF NY PO BOX 5012 MIDDLETOWN NY 10940901205 30736005 BC BS OF GA PO BOX 4445 ATLANTA GA 30302444505 30749005 BC BS OF IL PO BOX 1220 CHICAGO IL 6069005 30791005 REGENCE BS 1501 MARKET STREET TACOMA WA 9840505 30791025 TRIGON BC BS PO BOX 14046 ROANOKE VA 2403806 30079005 BENEFIT SERVICES INC PO BOX 4138 AKRON OH 44321013807 00172005 CT GENERAL LIFE PO BOX 10370 DES MOINES IA 5030607 00172020 CT GENERAL LIFE PO BOX 16682 COLUMBUS OH 4321607 00172025 CT GENERAL LIFE 2 VANTAGE WAY NASHVILLE TN 37228150407 00172030 CT GENERAL LIFE PO BOX 34335 CHARLOTTE NC 28234433507 00181005 CT GENERAL LIFE PO BOX 5046 SOUTHFIELD MI 4808607 00181025 CT GENERAL LIFE PO BOX 5132 SOUTHFIELD MI 4808607 00181040 CT GENERAL LIFE PO BOX 978 BRISTOL CT 0601107 00181045 CT GENERAL LIFE PO BOX 8014 PLAINVILLE CT 0606207 00181050 CT GENERAL LIFE PO BOX 2100 BOURBONNAIS IL 6091407 00181055 CT GENERAL LIFE PO BOX 2546 SHERMAN TX 7509007 00181060 CT GENERAL LIFE PO BOX 16782 COLUMBUS OH 4321607 00181075 CT GENERAL LIFE PO BOX 15408 WILMINGTON DE 19850540807 00181080 CT GENERAL LIFE PO BOX 29000 ATLANTA GA 3035907 00181090 CT GENERAL LIFE PO BOX 4007 VISALIA CA 93278

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

07 15460005 EQUITABLE LIFE PO BOX 2460 SALT LAKE CITY UT 8411007 19479005 EQUITABLE LIFE 777 E. MISSOURI AVE. PHOENIX AZ 8501407 23533005 CT GENERAL LIFE PO BOX 64143 ST PAUL MN 55164014307 30107005 CT GENERAL LIFE PO BOX 4010 FARMINGTON CT 06034401007 30307005 CT GENERAL LIFE 12225 GREENVILLE AVENUE DALLAS TX 7524307 30590005 CT GENERAL LIFE JFK AIRPORT STATION JAMAICA NY 1143008 00341015 CNA OF IL 333 S WABASH AVE CHICAGO IL 6068508 02892005 CNA CNA PLAZA CHICAGO IL 6060108 02892010 CNA PO BOX 55270 PHOENIX AZ 85078527008 02892015 CNA PO BOX 44242 JACKSONVILLE FL 32231424210 00305005 WAUSAU BENEFITS INC PO BOX 8013 WAUSAU WI 54402801310 00305010 WAUSAU INSURANCE PO BOX 8749 SCOTTSDALE AZ 85252874911 27102005 BENEFIT SOURCE 3900 SPARKS DR SE GRAND RAPIDS MI 4951813 00379005 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 11111 FORT SCOTT KS 6670113 00379025 GREAT WEST LIFE & ANNUITY INSURANCE CO1377 DUBLIN ROAD COLUMBUS OH 43215108713 00379030 GREAT WEST LIFE & ANNUITY INSURANCE CO10000 N CENTRAL EXPRSWY DALLAS TX 7523113 00379035 GREAT WEST LIFE & ANNUITY INSURANCE CO116 INVERNESS E - SUITE 210 DENVER CO 8020113 00379050 GREAT WEST LIFE & ANNUITY INSURANCE CO900 SECOND AVENUE S MINNEAPOLIS MN 55402334113 00379055 GREAT WEST LIFE & ANNUITY INSURANCE CO25145 COUNTRY CLUB BLVD NORTH OLMSTED OH 44070802013 00379060 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 429 PORTLAND OR 97207042913 00379065 GREAT WEST LIFE & ANNUITY INSURANCE CO455 MARKET STREET SAN FRANCISCO CA 94105240313 00379070 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 10188 GLENDALE CA 91209318813 00379075 GREAT WEST LIFE & ANNUITY INSURANCE CO10401 N MERIDIAN STREET INDIANAPOLIS IN 4629013 00379080 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 1120 SAN JOSE CA 95108112013 00379085 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 97313 BELLEVUE WA 98009931313 00379090 GREAT WEST LIFE & ANNUITY INSURANCE CO3875 FABER PLACE DR CHARLESTON SC 29405855913 00379095 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 38088 TUCSON AZ 85740808813 00379105 THE NEW ENGLAND FINANCIAL PO BOX 11111 FORT SCOTT KS 66701711113 00379115 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 88620 ATLANTA GA 30356826013 00379120 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 31251 TAMPA FL 3363113 00379130 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 920 FREDERICK MD 21705092013 04064005 GREAT WEST LIFE & ANNUITY INSURANCE CO1000 GREAT WEST DRIVE KENNETT MO 63857374914 28550005 AMERICAN MEDICAL SECURITY PO BOX 19032 GREEN BAY WI 543079032

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

15 25037005 PYRAMID BENEFIT SERVICES PO BOX 327 SOUTH BEND IN 46634032716 00190005 UNICARE/JOHN HANCOCK PO BOX 7677 SCHAUMBURG IL 60196767716 00190010 UNICARE/JOHN HANCOCK PO BOX 4040 KALAMAZOO MI 49003404016 00190015 UNICARE/JOHN HANCOCK PO BOX 111 BOSTON MA 0211716 00190020 UNICARE/JOHN HANCOCK 3200 GREENFIELD DEARBORN MI 4812716 00190025 UNICARE/JOHN HANCOCK CALLER #4005 SCHAUMBURG IL 60168400516 00190030 UNICARE/JOHN HANCOCK PO BOX 4045 SCHAUMBURG IL 60168404516 00190035 UNICARE/JOHN HANCOCK 1585 PAOLI PIKE WEST CHESTER PA 19380611316 00190045 UNICARE/JOHN HANCOCK PO BOX 4052 SCHAUMBURG IL 60168405216 00190050 UNICARE/JOHN HANCOCK PO BOX 566499 ATLANTA GA 3035616 00190055 UNICARE/JOHN HANCOCK PO BOX 833835 RICHARDSON TX 75083383516 00190060 UNICARE/JOHN HANCOCK PO BOX 4044 SCHAUMBURG IL 6016816 00190065 UNICARE/JOHN HANCOCK PO BOX 120 BALLWIN MO 6302216 00190070 UNICARE/JOHN HANCOCK PO BOX 4056 SCHAUMBURG IL 60168985116 00190075 UNICARE/JOHN HANCOCK PO BOX 2807 DEARBORN MI 48123280716 00190080 UNICARE/JOHN HANCOCK PO BOX 7677 SCHAUMBURG IL 60168767716 00190090 UNICARE/JOHN HANCOCK PO BOX 4055 SCHAUMBURG IL 6016816 00190095 UNICARE/JOHN HANCOCK PO BOX 4076 SCHAUMBURG IL 60168407616 00190110 UNICARE PO BOX 833813 RICHARDSON TX 75083381316 05885005 UNICARE PO BOX 5035 BOLINGBROOK IL 6044616 05885010 UNICARE PO BOX 201868 ARLINGTONN TX 76006186816 05885015 UNICARE PO BOX 5005 BOILINGBROOK IL 6044616 05885020 UNICARE PO BOX 5025 BOLINGBROOK IL 60440502516 05885025 UNICARE PO BOX 51660 INDIAN ORCHARD MA 0115116 05885030 UNICARE PO BOX 51130 SPRINGFIELD MA 01151513016 05885035 UNICARE PO BOX 60073 CITY OF INDUSTR CA 91716007316 05885040 UNICARE 179 TEMPLE POMONA CA 9176816 05885055 UNICARE PO BOX 9085 OXNARD CA 93901908516 05886005 UNICARE PO BOX 100008 DECATUR GA 30031000816 30043005 UNICARE/JOHN HANCOCK PO BOX 4046 SCHAUMBURG IL 60168404617 20836005 HARRINGTON BENEFIT SERVICES PO BOX 16789 COLUMBUS OH 43216678917 21753005 HARRINGTON BENEFIT SERVICES 333 WEST FIRST STREET DAYTON OH 45401139117 28749005 HARRINGTON BENEFIT SERVICES PO BOX 909772 CHICAGO IL 60690

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

17 28749015 HARRINGTON BENEFIT SERVICES PO BOX 3810 JOPLIN MO 64803381017 28749020 HARRINGTON BENEFIT SERVICES PO BOX 268902 OKLAHOMA CITY OK 73126890217 28749025 HARRINGTON BENEFIT SERVICES PO BOX 3700 YOUNGSTOWN OH 44513370017 30595005 HARRINGTON BENEFIT SERVICES PO BOX 182666 COLUMBUS OH 43218266617 40094005 HARRINGTON BENEFIT SERVICES PO BOX 6133 WESTERVILLE OH 4308117 40413205 HARRINGTON BENEFIT SERVICES PO BOX 30367 TAMPA FL 33630336717 40413505 HARRINGTON BENEFIT SERVICES PO BOX 19889 LOUISVILLE KY 4025919 00154005 MI EDUC SPEC SERV ASSOC PO BOX 2560 EAST LANSING MI 4882320 17901005 GROUP BENEFIT SERVICES INC PO BOX 1386 EAST LANSING MI 4882320 22625005 GROUP BENEFIT ADMINISTRATORS PO BOX 30749 SALT LAKE CITY UT 84130074920 40145005 GROUP BENEFIT 540 GLEN AVE MOORESTOWN NJ 08057174620 40196005 GROUP BENEFITS UNLIMITED 1000 PLAZA DRIVE SCHAUMBURG IL 6017320 40234005 GROUP BENEFIT PROGRAM PO BOX 44036 BATON ROUGE LA 7080421 15371005 REGENCY MEDICAL ADMIN INC P.O. BOX 610609 PORT HURON MI 48061771122 00421005 MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 6817522 00421010 MUTUAL OF OMAHA POB 668329 CHARLOTTE NC 28266832922 00421015 MUTUAL OF OMAHA PO BOX 9 WOODWARD OK 7380223 17563005 JOHN ALDEN PO BOX 9398 MINNEAPOLIS MN 5544024 09113005 UNITED TEACHER ASSOCIATES PO BOX 30010 AUSTIN TX 78755301025 12398005 GOLDEN RULE INSURANCE 712 ELEVENTH STREET LAWRENCEVILLE IN 6243926 11499005 HRM CLAIM MANAGEMENT PO BOX 4089 KALAMAZOO MI 49003408926 11499015 HRM CLAIM MANAGEMENT PO BOX 9498 MINNEAPOLIS MN 55440949826 20362005 HRM CLAIM MANAGEMENT INC. PO BOX 4022 KALAMAZOO MI 49003402226 26455010 HRM PO BOX 2061 LITTLE ROCK AR 7220327 03586005 FEDERATED INSURANCE PO BOX 50487 INDIANAPOLIS IN 4625027 03595005 FEDERATED MUTUAL INSURANCE CO PO BOX 328 OWATONNA MN 5506028 13439010 NGS AMERICAN INC PO BOX 7676 ST CLAIR SHORES MI 48080767629 00412005 PHYSICIANS MUTUAL PO BOX 2018 OMAHA NE 68103201830 00092010 CIGNA HEALTHCARE PO BOX 188006 CHATTANOOGA TN 37422800630 00092035 CIGNA HEALTHCARE STATION B BOX 6185 GREENVILLE SC 2960630 23239005 CIGNA BEHAVORIAL HEALTH CARE PO BOX 46270 EDEN PRARIE MN 55344627030 25082005 CIGNA HEALTHCARE PO BOX 5019 VISALIA CA 9327830 40413305 CIGNA PO BOX 5200 SCRANTON PA 185055200

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

31 00083005 PRUDENTIAL INSURANCE COMPANY PO BOX 1143 MINNEAPOLIS MN 5544031 00083010 PRUDENTIAL INSURANCE COMPANY PO BOX 44059 JACKSONVILLE FL 3223131 00083015 PRUDENTIAL INSURANCE COMPANY PO BOX 85080 SAN DIEGO CA 9213831 00083020 PRUDENTIAL INSURANCE COMPANY PO BOX 538 MATTESON IL 60443053831 00083025 PRUDENTIAL INSURANCE COMPANY PO BOX 1065 LINWOOD NJ 0822131 00083030 PRUDENTIAL INSURANCE COMPANY PO BOX 40985 INDIANAPOLIS IN 46240098531 00083035 PRUDENTIAL INSURANCE COMPANY PO BOX 207006 STOCKTON CA 95267950631 00083040 PRUDENTIAL INSURANCE COMPANY PO BOX 7001 PARKERSBURG WV 2610231 00083045 PRUDENTIAL INSURANCE COMPANY PO BOX 500 MT ARLINGTON NJ 0785631 00083055 PRUDENTIAL INSURANCE COMPANY PO BOX 450 ISELIN NJ 0883031 00083060 PRUDENTIAL INSURANCE COMPANY PO BOX 3018 MILLVILLE NJ 0833231 00083065 PRUDENTIAL INSURANCE COMPANY 1875 CENTURY BLVD ATLANTA GA 3034531 00083070 PRUDENTIAL INSURANCE COMPANY PO BOX 5012 MIDDLETOWN NY 10940901231 00083075 PRUDENTIAL INSURANCE COMPANY PO BOX 566 MATTESON IL 6044331 00083085 PRUDENTIAL INSURANCE COMPANY PO BOX 499 PITTSBURGH PA 15230049931 00083090 PRUDENTIAL INSURANCE COMPANY PO BOX C 11940 SANTA ANA CA 9271131 00083095 PRUDENTIAL INSURANCE COMPANY PO BOX 539 MATTESON IL 60443053931 00083100 PRUDENTIAL INSURANCE COMPANY PO BOX 8850 LINWOOD NJ 0822131 00083105 PRUDENTIAL INSURANCE COMPANY PO BOX 795031 SAN ANTONIO TX 7827931 00083110 PRUDENTIAL INSURANCE COMPANY PO BOX 411340 ST LOUIS MO 6314131 00083120 PRUDENTIAL INSURANCE COMPANY PO BOX 902 HORSHAM PA 19044090231 00083125 PRUDENTIAL INSURANCE COMPANY PO BOX 6020 MILLVILLE NJ 0833231 00083130 PRUDENTIAL INSURANCE COMPANY PO BOX 10100 HIGHPOINT NC 2726131 00083135 PRUDENTIAL INSURANCE COMPANY PO BOX 5060 MILLVILLE NJ 0833231 11597005 PRUDENTIAL INSURANCE COMPANY PO BOX 13997 PHILADELPHIA PA 1910131 21593005 PRUDENTIAL INSURANCE COMPANY PO BOX 540 MATTESON IL 60443054031 27149005 PRUDENTIAL INSURANCE COMPANY PO BOX 537 MATTESON IL 60443053731 28048005 PRUDENTIAL INSURANCE COMPANY PO BOX 565 MATTESON IL 6044331 30052005 PRUDENTIAL INSURANCE COMPANY PO BOX 4305 HOUSTON TX 77210430531 30052010 PRUDENTIAL INSURANCE COMPANY PO BOX 15055 ALBANY NY 1221231 30761005 PRUDENTIAL INSURANCE COMPANY PO BOX 567 MATTESON IL 6044331 30767005 PRU CARE OF CA PO BOX 9315 VAN NUYS CA 9140931 30771005 PRU CARE OF NJ PO BOX 4042 ISELIN NJ 00830

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

31 30802005 PRU CARE OF CO PO BOX 378710 DENVER CO 8023731 30802010 PRU CARE OF CINCINNATI PO BOX 45088 JACKSONVILLE FL 3223131 30831005 PRU CARE OF ATLANTA PO BOX 44097 JACKSONVILLE FL 32231409731 30876005 PRUDENTIAL INSURANCE COMPANY PO BOX 2688 JACKSONVILLE FL 3223231 30896005 PRUDENTIAL INSURANCE COMPANY PO BOX 100 MONROEVILLE PA 15146010033 00074005 MI CONF OF TEAMSTERS WELFARE 2700 TRUMBULL DETROIT MI 4821633 40096005 LOCAL 135 WELFARE FUND 1233 SHELBY STREET INDIANAPOLIS IN 4620334 00065030 UNITED HEALTHCARE INS CO 1375 EAST 9TH ST CLEVELAND OH 4411434 00065040 UNITED HEALTHCARE INS CO PO BOX 740800 ATLANTA GA 30374080034 00065060 UNITED HEALTHCARE INS CO PO BOX 30304 SALT LAKE CITY UT 84130040434 00065065 BENESIGHT PO BOX 3098 NAPERVILLE IL 60566709834 00065104 BENESIGHT PO BOX 380 PUEBLO CO 8100234 00065108 UNITED HEALTHCARE INS CO 6TH & MCKINLEY LITTLE ROCK AR 7220534 00065109 UNITED HEALTHCARE INS CO 7878 N 16TH ST, STE 140 PHOENIX AZ 8502034 00065113 UNITED HEALTHCARE INS CO PO BOX 740801 ATLANTA GA 30374080134 00065114 UNITED HEALTHCARE INS CO 250 JOHNSON RD MORRIS PLAINS NJ 0795034 00065120 UNITED HEALTHCARE INS CO PO BOX 901069 FORT WORTH TX 76101206934 00065123 BENESIGHT PO BOX 350 PUEBLO CO 8100234 00065130 BENESIGHT PO BOX 7046 ROCKFORD IL 61125704634 00065170 BENESIGHT 2500 MAITLAND CENTER PARKWAYMAITLAND FL 3275134 00163005 UNITED HEALTHCARE INS CO P O BOX 2007 AURORA IL 6050734 09300005 TRAVELERS INSURANCE COMPANY 3316 FARNAM OMAHA NE 5095534 15531005 BENESIGHT PO BOX 121212 MARIETTA GA 30067009234 28269015 UNITED HEALTHCARE INS CO PO BOX 659744 SAN ANTONIO TX 78265974434 30025005 METROPOLITAN LIFE INS CO PO BOX 14105 ORANGE CA 9261334 30046005 UNITED HEALTHCARE INS CO 2929 EXPRESS HAUPPAUGE NY 1178734 30047005 UNITED HEALTHCARE INS CO PO BOX 1600 KINGSTON NY 12402160034 40010005 UNITED HEALTHCARE INS CO PO BOX 182281 COLUMBUS OH 4321834 40308015 BENESIGHT PO BOX 320 PUEBLO CO 8100335 24737005 AUTOMATED BENEFIT SERVICES P O BOX 37506 OAK PARK MI 48237050436 16510005 AMERA PLAN INC 22500 METROPOLITAN PKWY. CLINTON TWP MI 4803536 40012005 ACORDIA CORPORATE BENEFITS PO BOX 567 GREENWOOD IN 4614238 00065080 RAILROAD MAINT & IND H & W 2205 W WABASH AVE #211 SPRINGFIELD IL 62704

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 00065118 CONSECO SENIOR HEALTH INS CO PO BOX 10319 DES MOINES IA 50306031938 00270005 SENTRY INSURANCE COMPANY PO BOX 8888 STEVENS POINT WI 5448138 00299005 NATIONWIDE INSURANCE COMPANY P O BOX 182163 COLUMBUS OH 43218216338 00397005 MUTUAL LIFE INSUR CO OF NY ONE MONY PLAZA SYRACUSE NY 1322138 00412010 PHYSICIANS LIFE INSURANCE 2600 DODGE OMAHA NE 6813138 00468005 AMER GEN LIFE & ACCIDENT IN CO P O BOX 1500 NASHVILLE TN 3720238 00486005 UNITED INSURANCE CO OF AMERICA ONE E WACKER DRIVE CHICAGO IL 6060138 00486010 UNITED INSURANCE CO OF AMERICA PO BOX 29149 SHAWNEE MISSION KS 66201914938 00539005 ACADEMY LIFE INSURANCE PO BOX 3074 SOUTHEASTERN PA 1939838 00619005 AID ASSN FOR LUTHERANS 4321 N BALLARD ROAD APPLETON WI 54919000138 00940005 AMERICAN FAMILY LIFE ASSURANCE 1932 WYNNTON RD COLUMBUS GA 31999000138 00978005 AMERICAN FAMILY MUT INS CO 6000 AMERICAN PARKWAY MADISON WI 5378338 01035005 AMERICAN GENERAL LIFE & ACCID P.O. BOX 307 LANGHORNE PA 19047030738 01044010 AMERICAN GENERAL PO BOX 449 WYANDOTTE MI 4819238 01080005 ZENITH ADMINISTRATORS PO BOX 422279 SAN FRANCISCO CA 94142227938 01106005 AMERICAN HERITAGE LIFE INS 1776 AMERICAN HERITAGE JACKSONVILLE FL 32224668838 01124005 AMERICAN INCOME LIFE INS PO BOX 2608 WACO TX 7679738 01296005 AMERICAN NATIONAL INSURANCE CO PO BOX 1520 GALVESTON TX 7755038 01358005 AMERICAN REPUBLIC INS CO PO BOX 10 DES MOINES IA 5030138 01429005 AMERICAN STATES INS CO 542 NORTH MERIDIAN INDIANAPOLIS IN 4620638 01554005 UNIFIED LIFE PO BOX 25326 OVERLAND PARK KS 66225532638 01572005 SELECT BROKERAGE SERVICE PO BOX 2708 JOPLIN MO 64803270838 01572010 SELECT BROKERAGE SERVICE PO BOX 2976 MILWAUKEE WI 53201297638 01607005 ATLANTA LIFE INS CO 100 AUBURN AVENUE NE ATLANTA GA 3030138 01661005 AUTO OWNERS LIFE INSURANCE PO BOX 30660 LANSING MI 4890338 01699005 AVEMCO INSURANCE CO 411 AVIATION WAY FREDERICK MD 21701475638 01886030 ERN ADMINISTRATORS PO BOX 9137 FORT WORTH TX 76417213738 01957005 BOSTON MUTUAL LIFE 120 ROYALL STREET CANTON MA 0202138 02130010 CNA INSURANCE COMPANIES PO BOX 1475 PEORIA IL 61655147538 02168005 CAPITOL ADMINISTRATORS PO BOX 346 ALPHARETTA GA 3000938 02266005 WILLIAM PENN ASSOCIATION 709 BRIGHTON RD PITTSBURGH PA 1523338 02328005 CELINA MUTUAL INS INSURANCE SQUARE CELINA OH 4582238 02524005 CINCINNATI LIFE INSURANCE CO PO BOX 145496 CINCINNATI OH 452505496

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 02598005 COLONIAL LIFE PO BOX 1365 COLUMBIA SC 2920238 02613005 CONSECO DIRECT LIFE INSURANCE CO 399 MARKET STREET PHILADELPHIA PA 19181125038 02613010 CONSECO MEDICAL INSURANCE CO PO BOX 1250 ROCKFORD IL 61105125038 02613015 CONSOCIATE GROUP PO BOX 1068 DECATUR IL 62525106838 02613020 CONSECO HEALTH INSURANCE PO BOX 66904 CHICAGO IL 60666090438 02640005 COMBINED INS CO AMER 4860 STREET ROAD TREVOSE PA 1905338 02936005 COUNTRYWIDE INS CO 1150 SO OLIVE ST LOS ANGELES CA 9001538 03002005 CUMIS INS SOCIETY PO BOX 1084 MADISON WI 5370138 03011005 CUNA MUTUAL INS SOC PO BOX 391 MADISON WI 5370138 03067005 DANISH BRO IN AMER PO BOX 31748 OMAHA NE 6813138 03138005 PEOPLES SECURITY LIFE INSURANC PO BOX 61 DURHAM NC 2770238 03174005 EDUCATORS MUTUAL LIFE PO BOX 83888 LANCASTER PA 1760438 03183005 ELECTRIC INS CO 715 LYNNWAY LYNN MA 0190538 03254005 EMPLOYERS FIRE INS ONE BEACON ST BOSTON MA 0210838 03942005 ASSURITY LIFE INSURANCE COMPANY PO BOX 888407 GRAND RAPIDS MI 49588840738 04162005 GERBER LIFE INS CO 445 STATE ST FREMONT MI 4941238 04233005 GLOBE LIFE AND ACCIDENT GLOBE LIFE CENTER OKLAHOMA CITY OK 7318438 04251005 GOLDEN STATE MUTUAL LIFE INS PO BOX 2332 LOS ANGELES CA 9005138 04458005 GUARANTEE MUTUAL LIFE CO 8721 INDIAN HILLS OMAHA NE 68103264038 04467005 GUARANTEE TRUST LIFE 1275 MILWAUKEE AVE GLEN VIEW IL 6002538 04556010 HARBOR BENEFIT SERVICES PO BOX 2775 ELKHART IN 46515277538 04574005 HARTFORD PO BOX 2910 HARTFORD CT 06104291038 04734005 ANTHEM HEALTH HOME LIFE INS CO P O BOX 1370 PISCATAWAY NJ 08855132638 04761005 HORACE MANN INS CO HORACE MANN PLAZA SPRINGFIELD IL 62715000138 04823005 ITT HARTFORD LIFE & ANNUITY 505 HWY, 169 NORTH MINNEAPOLIS MN 55441640038 04841005 IL MUTUAL LIFE 300 SW ADAMS ST PEORIA IL 6163438 04986015 INSURANCE DESIGN ADMINISTRATORS PO BOX 690 OAKLAND NJ 0743638 05025005 BENEFIT ADMINISTRATORS OF AMER PO BOX 9120 DES MOINES IA 5030638 05043005 INTERNATIONAL INS CO CHICAGO PO BOX 2387 MORRISTOWN NJ 0796038 05212005 JOHN DEERE HEALTH CARE INC 3800 23RD AVE STE 200 MOLINE IL 6126538 05230005 KANSAS CITY LIFE INS PO BOX 219325 KANSAS CITY MO 64121932538 05339005 LAFAYETTE LIFE INS CO 1905 TEAL RD PO BOX 7007 LAFAYETTE IN 47903700738 05428005 LIBERTY MUTUAL INSURANCE GROUP 175 BERKELEY STREET BOSTON MA 02117

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 05615005 LOYAL AMERICAN INSURANCE PO BOX 6408 MOBILE AL 36660040838 05689005 LUTHERAN BROTHERHOOD 625 4TH AVE SOUTH MINNEAPOLIS MN 5541538 05867005 MA GENERAL LIFE 7730 E BELLEVIEW AVE ENGLEWOOD CO 8011138 05947005 MERCHANTS MUT INS CO 250 MAIN ST BUFFALO NY 1424038 06022005 MI LIFE INSURANCE CO P O BOX 2399 COLUMBUS OH 4321638 06149005 MIDLAND MUTUAL LIFE INS 250 E BROAD ST COLUMBUS OH 4321538 06292005 MONARCH LIFE INS CO ONE MONARCH PLACE SPRINGFIELD MA 0113338 06318005 MONUMENTAL GENERAL INS CO P O BOX 97 SCRANTON PA 18504009738 06499005 PFL AND LIFE 9151 GRAPEVINE HWY N RICHLAND HILL TX 76182800938 06621005 PEOPLES BENEFIT LIFE INSURANCE COMPANYCLAIMS DIVISION VALLEY FORGE PA 1949338 06766005 FIRST SECURITY LIFE & HEALTH 30775 BARRINGTON AVENUE MADISON HEIGHTS MI 48071183338 06793005 NATIONAL TRAVELERS LIFE P O BOX 9197 DES MOINES IA 50306919738 06828005 NATIONWIDE LIFE INSUR CO P O BOX 16786 COLUMBUS OH 43216678638 06855005 NEW ENGLAND, THE PO BOX 11111 FORT SCOTT KS 66701711138 06855010 NEW ENGLAND EMP BEN GROUP PO BOX 11111 FORT SCOTT KS 66701711138 06856005 NEW ENGLAND INSURANCE 115 PERIMETER-STE465 W ATLANTA GA 3035638 06857005 NEW ENGLAND, THE 900 SECOND AVE,S-STE650 MINNEAPOLIS MN 55402334138 07093005 NORTHERN INSURANCE CO OF NY PO BOX 91 BALTIMORE MD 2120338 07128005 NORTHERN LIFE INS CO PO BOX 12530 SEATTLE WA 9811138 07137005 NORTHERN MUTUAL FIRE INS CO 112 CLEVELAND ISHPEMING MI 4984938 07146005 NORTHERN NATIONAL LIFE BOX 580 BISMARCK ND 5850138 07155005 NORTHLAND INSUR CO HAMM BUILDING ST PAUL MN 5510238 07191005 CORESTAR 146 INDUSTRIAL PARK JACKSON MN 56143951138 07191010 CORESTAR PO BOX 1195 MINNEAPOLIS MN 55440119538 07191015 CORESTAR 7830 E BROADWAY TUCSON AZ 85710399138 07226005 OGDEN RIGA MUT FIRE ROUTE 1 BLISSFIELD MI 4922838 07244005 OH FARMERS INS CO 1 WESTFIELD CTR OH 4425138 07271005 OH SECURITY INS CO 136 N THIRD STREET HAMILTON OH 4501238 07306005 OLD AMERICAN INSUR CO 3520 BROADWAY KANSAS CITY MO 6414138 07324005 OLD LINE LIFE INS AM 707 N ELEVENTH ST MILWAUKEE WI 5323338 07333005 OLD RELIABLE FIRE 231 W LOCKWOOD AVE WEBSTER GROVES MO 6311938 07342005 OLD REPUBLIC INS CO PO BOX 789 GREENSBURG PA 1560138 07389005 OLYMPIC INSURANCE CO BOX 2138 LOS ANGELES CA 90054

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 07398005 OMAHA INDEMNITY CO 3113 DODGE ST OMAHA NE 6813138 07404005 PACIFIC EMPLOYER INS 1600 ARCH ST PHILADELPHIA PA 1910138 07413005 PACIFIC FIDELITY LIF PO BOX 24022 LOS ANGELES CA 9002438 07422005 PACIFIC INDEMNITY CO 51 J F KENNEDY PKY SHORT HILLS NJ 0707838 07469005 PAN AMERICAN LIFE INSUR CO 8550 UNITED PLAZA BLVD BATON ROUGE LA 70809701438 07511005 PA SECURITY LIFE 7777 BONHOMME ST LOUIS MO 6310538 07567005 PA SLOVAK CATH UNION 173 N MAIN ST WILKES-BARRE PA 1870138 07585005 PEOPLES LIFE INS CO 601 NEW HAMPSHIRE NW WASHINGTON DC 2003738 07594005 PEOPLES MUTUAL INS C O538 WEST MAIN ST IONIA MI 4884638 07600005 PERSONAL INDEM MUT 6150 W FOND DU LAC MILWAUKEE WI 5321838 07629005 PERSONAL LIFE INS CO 7711 BONHOMME AVE ST LOUIS MO 6310538 07638005 PETROLEUM CASUALTY PO BOX 2180 HOUSTON TX 7700138 07647005 PHILADELPHIA AMERICAN LIFE PO BOX 2465 HOUSTON TX 77252246538 07656005 PHILADELPHIA MANUF MUT INS CO PO BOX 824 VALLEY FORGE PA 1948238 07665005 PHILADELPHIA UNITED LIFE INS PO BOX 4583 PHILADELPHIA PA 1913138 07674005 PHOENIX ASSUR OF NY 80 MAIDEN LANE NEW YORK NY 1003838 07692005 PHOENIX HOME LIFE PO BOX 1477 GREENFIELD MA 0130238 07692010 GE GROUP ADMINISTRATORS PO BOX 3005 AGAWAM MA 0100138 07727005 POLICE & FIREMEN INS 3550 N WASHINGTON INDIANAPOLIS IN 4620538 07745005 POLISH FALCONS 97-99 SOUTH 18TH ST PITTSBURGH PA 1520338 07754005 POLISH NAT ALL BROOK 155 NOBLE STREET BROOKLYN NY 1122238 07763005 POLISH NAT ALL US NA 1514-1520 W DIVISION CHICAGO IL 6062238 07772005 POLISH ROMAN CATHOLIC INS 984 MILWAUKEE AVE CHICAGO IL 6062238 07781005 POLISH UNION OF AMER 761 FILLMORE AVE BUFFALO NY 1421238 07790005 POLISH UNION US INS 53-59 N MAIN STREET WILKES BARRE PA 1870138 07807005 POLISH WOMENS ALL IN 1309-15 N ASHLAND AV CHICAGO IL 6062238 07816005 POTOMAC INS CO 414 WALNUT PHILADELPHIA PA 1910538 07834005 GUIDE ONE LIFE INS CO 1111 ASHWORTH RD WEST DES MOINES IA 5026538 07870005 PROGRESSIVE CASUALTY 3600 EUCLID AVENUE CLEVELAND OH 4411538 07905005 PROTECTED HOME MUT 30 EAST STATE STREET SHARON PA 1614638 07932005 PROTECTIVE NAT OF OM 105 S 17TH ST OMAHA NE 6810238 07997005 PRUDENT AMER LIFE 55 PUBLIC SQUARE CLEVELAND OH 4411338 08027005 PURITAN LIFE INS CO PO BOX 519 PROVIDENCE RI 02901

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 08036005 PYRAMID LIFE INS CO PO BOX 772 SHAWNEE MISSION KS 6620138 08045005 RLI INSURANCE CO 9025 N LINDBERG DR PEORIA IL 6161438 08054005 RANGER INSURANCE CO PO BOX 2807 HOUSTON TX 7700138 08063005 RECIPROCAL EXCHANGE 92ND AND STATE LINE KANSAS CITY MO 6411438 08072005 REINSURANCE CO OF NY 99 JOHN STREET NEW YORK NY 1003838 08090005 RELIABLE LIFE INS CO 231 W LOCKWOOD AVE WEBSTER GROVES MO 6311938 08107005 RELIANCE THREE PARKWAY PHILADELPHIA PA 19102137638 08107010 RELIANCE INSURANCE COMPANY PO BOX 2996 PARKERSBURG WV 2610238 08116005 RELIANCE INSURANCE CO 4 PENN CENTER PLAZA PHILADELPHIA PA 1910238 08125005 REPUBLIC FRANKLIN BOX 1438 COLUMBUS OH 4321638 08152005 AMERICAN GENERAL GROUP LIFE PO BOX 660238 DALLAS TX 7526638 08368005 SAFECO INSURANCE CO OF AMERICA 4347 BROOKLYN AVE NE SEATTLE WA 9818538 08662010 SHEFFIELD OLSON & MCQUEEN INC 2145 FORD PARKWAY ST PAUL MN 55116186238 08671005 SIOUX VALLEY HEALTH PLAN PO BOX 91110 SIOUX FALLS SD 57109111038 08724005 SONS OF NORWAY 1455 W LAKE ST MINNEAPOLIS MN 5540838 08902005 STATE LIFE INS CO PO BOX 406 INDIANAPOLIS IN 4620638 08920005 STATE MUTUAL INSURANCE CO 33 NORTH GARDEN AVENUE CLEARWATER FL 33755660638 09042010 SUN HEALTH CARE GROUP PO BOX 93098 ALBURQUERQUE NM 87199309838 09060005 SURETY LIFE INS CO PO BOX 2520 SALT LAKE CITY UT 8411038 09098005 SWISS AMERICA 237 PARK AVE NEW YORK NY 1001738 09258005 TRANSPORT LIFE INS 714 MAIN ST FORT WORTH TX 7610238 09507005 UNION FIDELITY LIFE PO BOX 10841 CLEARWATER FL 33757884138 09516005 UNION LABOR LIFE INS CO 111 MASSACHUSETTS AVE,NW WASHINGTON DC 2000138 09516010 UNION LABOR LIFE INSURANCE CO SERVICE CENTER VALLEY FORGE PA 1949338 09570005 WORLD SERVICE LIFE INS PO BOX 2548 FORT WORTH TX 7611338 09599015 UNITED BENEFIT LIFE INSUR CO PO BOX 30214 TAMPA FL 3363038 09605005 UNITED COMMERC TRAVELERS AMER 632 N PARK STREET COLUMBUS OH 43215091938 09721010 UNITED SECURITY LIFE INSURANCE 10275 W HIGGINS ROAD ROSEMONT IL 6001838 09721015 CITIZENS INS CO OF AMERICA PO BOX 149151 AUSTIN TX 78714915138 09730005 UNITED SERVICES AUTO ASSOC 9800 FREDRICKSBURG RD SAN ANTONIO TX 7821538 09801005 UNITED STATES LIFE INSURANCE P O BOX 1581 NEPTUNE NJ 07554158138 09801010 UNITED STATES LIFE INSURANCE PO BOX 15205 READING PA 19612520538 10016005 WARNERS RECIPROCAL 4210 PETERSON AVE CHICAGO IL 60646

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 10114005 WESTERN & SOUTHERN LIFE 400 BROADWAY CINCINNATI OH 4520238 10259010 WOODMEN ACCIDENT & LIFE 4250 GRAND HAVEN ROAD MUSKEGON MI 4944138 10286005 WORKMENS BENEFIT FUND OF USA 99 N BROADWAY HICKSVILLE NY 11801290538 10295005 WORKMENS CIRCLE 45 EAST 33RD STREET NEW YORK NY 10016533638 10310005 WORLD INS CO PO BOX 3160 OMAHA NE 68103016038 10491005 AR BEST CORP 1000 SOUTH 21ST ST FORT SMITH AR 7290138 10517005 BAKERY & CONFEC FUND 10401 CONNECTICUT AVE KENSINGTON MD 2089538 10535010 CAM ADMINISTRATIVE SERVICES PO BOX 5131 SOUTHFIELD MI 48086513138 10562005 BROWN GROUP INS 8400 MARYLAND AVE ST LOUIS MO 63166002938 10606005 CERT LIFE INS CO PO BOX 66933 CHICAGO IL 6066638 10698010 CONSOLIDATED GROUP CLAIMS PO BOX 2817 GAINESVILLE GA 30503281738 10929005 GERBER LIFE INSURANCE 204 W MAIN STREET FREMONT MI 4941238 10947005 GOODYEAR MEDICAL BENEFITS DEPT PO BOX 677 AKRON OH 4430938 11004005 GUARANTEE RESERVE LIFE INS CO 530 RIVER OAKS WEST CALUMET CITY IL 60409540738 11040010 HOSPITAL BENEFITS INC PO BOX 16248 ALTEMONTE SPRINGS FL 32716214838 11069005 HOTEL RESTAURANT EMPLOYEES UN P O BOX 588 NAPERVILLE IL 6056638 11102005 INTERSTATE LIFE 3750 DEERFIELD RD RIVERWOOD IL 60015354138 11185005 LEWER AGENCY INC 4534 WORNALL ROAD KANSAS CITY MO 6411138 11200005 LIBERTY NATL LIFE IN 301 S 20TH ST BIRMINGHAM AL 3520238 11283010 MARYLAND INSURANCE GROUP PO BOX 7131 INDIANAPOLIS IN 46206713138 11381005 MI FUNERAL DIRECTORS PO BOX 27158 LANSING MI 4890938 11425005 MI STATE PAINTERS INSURANCE PO BOX 3039 BIRMINGHAM MI 48012303938 11470005 MID CONTINENTAL CLAIMS PO BOX 3039 BIRMINGHAM MI 4801238 11686005 OXFORD LIFE 2721 N CENTRAL AVE PHOENIX AZ 8500438 11710005 JEFFERSON PILOT LIFE INSURANCE P O BOX 26011 GREENSBORO NC 27420601138 11864010 SANFORD INSURANCE GROUP PO BOX 51368 KALAMAZOO MI 49005136838 12057005 AMERICAN CHAMBERS LIFE PO BOX 3048 NAPERVILLE IL 6056638 12093005 UNITED MINE WORKERS PO BOX 389 EPHRAIM UT 84627036138 12137005 UNITED OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 98175000138 12164005 MEDI CLAIM PO BOX 4007 DANVILLE IL 61834400738 12208010 ACORDIA 4310 OLD MCDONOUGH ROAD CONLEY GA 3002738 12208015 ACORDIA PO BOX 68416 INDIANAPOLIS IN 46268041638 12226005 CENTRAL BENEFITS MUTUAL INS CO 255 E MAIN STREET COLUMBUS OH 43216

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 12351005 WI PHYSICIANS SERVICE PO BOX 8190 MADISON WI 5370838 12656005 KAISER PERMANENTE MED CARE PRO P.O. BOX 41916 LOS ANGELES CA 90041091638 12656025 KAISER PERMANENTE PO BOX 6611 ROCKVILLE MD 20849661138 12674005 LIFE & CASUALTY INSURANCE PO BOX 1500 NASHVILLE TN 37202150038 12709005 MENNONITE MUTUAL AID 1110 NORTH MAIN STREET GOSHEN IN 46527048338 12763005 NATIONAL STATE INS CO PO BOX 46925 ST LOUIS MO 6314638 12772015 GROUP INSURANCE SERVICE CENTER PO BOX 9120 MARSHFIELD MA 0205038 12790005 PILGRIM HEALTH AND LIFE 1143 LANEY WALKER BLVD AUGUSTA GA 3090138 12807020 PIONEER MANAGEMENT SYSTEMS INC PO BOX 6600 HOLYOKE MA 0104138 12843010 STANDARD LIFE & ACCIDENT INSURANCE COPO BOX 1800 GALVESTON TX 77553180038 12997020 BC OF CA PO BOX 3190 RANCHO CORDOVA CA 9574138 13027010 ANTHEM BENEFIT ADMINISTRATORS PO BOX 528 COLUMBUS OH 43216052838 13223005 GHI ALBANY MSP UNIT PO BOX 15030 ALBANY NY 1221238 13303025 HIGHMARK SERVICES CO PO BOX 535078 PITTSBURGH PA 15253507838 13528005 AMERICAN BENEFIT CORP PO BOX 521 HUNINGTON WV 25701227638 13528010 AMERICAN BENEFIT ADMINISTRATIVE SERVICES1733 PARK STREET SUITE 300 NAPERVILLE IL 6056338 13546005 CATHOLIC KNIGHTS OF OH THE 16010 DETROIT AVENUE LAKEWOOD OH 4410738 13564005 PLANNED SEC TRUST GROUP INS 6866 FLORIDA BLVD BATON ROUGE LA 07080638 13635005 NATIONAL AUTO SPRINKLER SYSTEM 800 CORPORATE DRIVE LANDOVER MD 2078538 13798010 MI COUNCIL OF ABATEMENT WKRS PO BOX 3039 BIRMINGHAM MI 48012303938 13804005 CONSOLIDATED FREIGHTWAYS PO BOX 171841 MEMPHIS TN 38187184138 14060005 NRFEA INSURANCE SERVICE INC 10877 WATSON ROAD ST LOUIS MO 6312738 14220005 PLASTIC EMPLOYEES BENEFIT FUND PO BOX 191 ST CLAIRE MI 4807938 14356005 LIFE INVESTORS 4333 EDGEWOOD ROAD NE CEDAR RAPIDS IA 5249938 14383005 HEALTH CLAIMS ADMINISTRATION 1400 RENAISSANCE DR PARK RIDGE IL 6066838 14463010 ADVENTIST RISK MANAGEMENT INC PO BOX 8007 RIVERSIDE CA 9251538 14543005 NORTHWEST FED OF INDEP BUSINES PO BOX 8867 BOISE ID 8370738 14552010 PARAGON BENEFITS PO BOX 12288 COLUMBUS GA 3191738 14688005 LEGAL SECURITY LIFE INS CO PO 8476 DALLAS TX 7520538 14801005 PESCHKE 18615 SHERWOOD DETROIT MI 4823438 14866005 LANSING GENERAL HOSPITAL 2727 S PENNSYLVANIA AVE LANSING MI 48910349038 14884005 PURVIS & FORSTER INC 6440 WIGHT DETROIT MI 4820738 15086010 SCOTT & WHITE 2401 S 31ST STREET TEMPLE TX 76508

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 15101005 GALLAGHER BENEFITS PO BOX 5227 LISLE IL 6053238 15101015 GALLAGHER BENEFIT ADMINISTRATORS INCPO BOX 34297 SAN ANTONIO TX 7826538 15353005 FIRST CONTINENTAL LIFE & ACC PO BOX 27008 SALT LAKE CITY UT 8412738 15569010 HIGNAM-WHITRIDGE INC 850 RIDGE AVENUE PITTSBURGH PA 15212600338 15658005 PROPRIETORS LIFE ASSUR CO 7991 COLUMBUS PIKE DELAWARE OH 4301538 15676005 CENTRAL RESERVE LIFE OF NORTH 17800 ROYALTON RD. STRONGSVILLE OH 44136519738 15694005 CALIBER SYSTEMS PO BOX 88 AKRON OH 44309008838 15738005 DESERET HEALTHCARE 10 SOUTH MAIN STREET SALT LAKE CITY UT 8414538 15792005 RELIABLE LIFE & CASUALTY CO 3321 W BELTLINE HWY MADISON WI 5371138 15809005 SUN LIFE OF CANADA - SC3250 PO BOX 82520 LINCOLN NE 68501252038 15943010 CONSOLIDATED STORES ASSOCIATE BENEFIT PLANPO BOX 9071 DUBLIN OH 43017097138 16065015 CENTRA HEALTHCARE ADM SERVICES PO BOX 8000 DUNCAN OK 73534800038 16127025 FIRST ALLMERICA FINANCIAL LIFE PO BOX 1667 ROCKVILLE MD 2084938 16216005 SHOPKO HEALTH PLAN PO BOX 9478 MINNEAPOLIS MN 5544038 16225005 SOUTHWEST ADMINISTRATORS INC PO BOX 1121 ALHAMBRA CA 91802112138 16421010 HEALTH RESOURCES INC PO BOX 3607 EVANSVILLE IN 47735360738 16515000 AMERICAN ADMINISTRATORS GROUP PO BOX 268906 OKLAHOMA OK 7312638 16548005 GREAT SOUTHERN LIFE INS CO PO BOX 219040 DALLAS TX 75221904038 16557005 STATESMAN NATIONAL LIFE INS CO 3815 MONTROSE BLVD HOUSTON TX 7700638 16566005 NATIONAL BENEFIT LIFE INS CO 33 WEST 34TH STREET NEW YORK NY 10116560338 16593010 TX UNIVERSITY HEALTH PLAN PO BOX 266696 HOUSTON TX 77207669638 16619005 CENTURY TELEPHONE ENTERPR INC PO BOX 4065 MONROE LA 7121138 16691005 AMERICAN BAPTIST CHURCHES 475 RIVERSIDE DR RM 1700 NEW YORK NY 1011538 16824005 LIFE INSUR OF GA ASSOC DRS PO BOX 3013 LONGHORN PA 19047911338 16860005 NEW ENGLAND HEALTH PLANS INS 501 BOYLSTON STREET BOSTON MA 0211738 16904005 BROWN & WILLIAMSON HLTH CR PLN PO BOX 35090 LOUISVILLE KY 4023238 16904010 BROWN & BROWN INC PO BOX 2480 DAYTONA BEACH FL 32115248038 17017005 INTERNATIONAL ASSOC OF MACH 2441 W GRAND BLVD DETROIT MI 4820838 17160005 BABB INC 850 RIDGE AVE PITTSBURG PA 1521238 17213005 NIBCO MEDICAL BENEFITS PO BOX 1167 ELKHART IN 4651638 17358005 TIC INTERNATIONAL CORP HEALTH 11590 N MERIDIAN ST. CARMEL IN 46032452938 17581010 MCELROY METAL MILL INC PO BOX 527 MARSHALL MI 4906838 17590005 MONTGOMERY WARD INSURANCE PO BOX 5008 CAROL STREAM IL 601975008

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 17643005 PECK ASSOCIATES PO BOX 1208 MT CLEMENS MI 4804338 17714005 MI OIL & GAS ASSOCIATION PO BOX 15069 LANSING MI 4890138 17723005 AMERICAN TRUST ADMINISTRATORS PO BOX 87 SHAWNEE MISSION KS 6620138 17741005 AMERICAN CONSULTING ENGINEERS PO BOX 9007 ST LOUIS MO 63101900738 17750010 INDEPENDENT LIFE & HEALTH PO BOX 3161 ROCKFORD IL 6110838 17821005 PROTECTIVE LIFE INSURANCE PO BOX 830626 BIRMINGHAM AL 35283062638 18014005 ARMSTRONG WORLD INDUSTRIES INC PO BOX 3001 LANCASTER PA 1760438 18130005 INTER-COUNTY HOSP PLAN INC 720 BLAIR MILL HORSHAM PA 1904438 18159005 UNITED AIRLINES PO BOX 66100 CHICAGO IL 6066638 18248005 LAMAR LIFE INS CO PO BOX 66978 CHICAGO IL 60666097838 18346005 CHRISTIAN HOSPITALIZATION AID PO BOX 336 MONTEZUMA KS 6786738 18373005 RADCLIFFE ADMINISTRATORS INC 2550 S TELEGRAPH RD BLOOMFIELD HILL MI 4801338 18408005 ALLEN & OHARA INC 3385 AIRWAYS BOULEVARD MEMPHIS TN 3811638 18515005 GROUP ADMINISTRATION AGENCY 20 NORTH WACKER DRIVE CHICAGO IL 60606316738 18613005 DART CONTAINER CORP PO BOX 318 MASON MI 48854031838 19227005 NATIONAL HEALTH INSURANCE CO PO BOX 619999 DALLAS/FT WORTH TX 7526138 19290005 CELTIC LIFE INS CO PO BOX 30082 TAMPA FL 3363038 19290010 CELTIC INDIVDUAL HEALTH PO BOX 8073 CHICAGO IL 60680807338 19307005 DBL SERVICES INC 314 N BROADWAY ST LOUIS MO 6310238 19559050 BRITISH COLUMBIA MINISTRY OF HEALTH PO BOX 9050 VICTORIA BC V8W9E2 CAN 0000038 19601005 COMPLETE CARE CONTROL SIMPLEX PLAZA GARDNER MA 0144138 19639005 ELIAS BROTHERS RESTAURANTS INC 4199 MARCY WARREN MI 4809138 19719005 MIDWEST SECURITY INSURANCE 2700 MIDWEST DRIVE ONALSKA WI 54650876438 19755005 RESERVE NATIONAL INSURANCE CO PO BOX 18448 OKLAHOMA CITY OK 73154044838 19915010 UNION FIDELITY LIFE INSURANCE CO PO BOX 5008 CAROL STREAM IL 60197500838 19942005 NATIONAL FOOT CARE PROGRAM PO BOX 547 LATHRUP VILLAGE MI 4807638 19951005 PREFERRED BENEFITS SERV INC STC C700 DENVER CO 8022238 19960005 GENELCO 1600 S BRENTWOOD BLVD ST LOUIS MO 6314438 20030005 WI PUBLIC SERV CORP 700 N ADAMS ST GREEN BAY WI 5430138 20086005 INTERCONTINENTAL LIFE INS CO PO BOX 149138 AUSTIN TX 78701913838 20166005 SMA LIFE ASSURANCE COMPANY 440 LINCOLN ST WORCESTER MA 0160538 20219005 IBP INC 800 STEVENS PORT DRIVE DAKOTA DUNES SD 5704938 20326005 HARVEST LIFE INSURANCE 6277 SEA HARBOR DR ORLANDO FL 328870002

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 20344010 STAR ADMINISTRATIVE SERVICES INC PO BOX 55270 PHOENIX AZ 85078527038 20433005 AMERISURE CO MEDICAL CLAIMS P O BOX 9202 FARMINGTON HILL MI 48333920238 20611005 BENEFIT SOURCE PO BOX 240 MONROE MI 48161024038 20620005 BEST LIFE ASSURANCE CO OF CA PO BOX 7650 NEWPORT BEACH CA 9266038 20658005 CUMMINS GREAT LAKES EMP BENEF 1901 N STEPHENSON AVENUE IRON MOUNTAIN MI 4980138 20685005 TELEX COMMUNICATIONS INC 9600 ALDRICH AVE SOUTH MINNEAPOLIS MN 5542038 20765005 AMERICAN FIDELITY ASSURANCE BOX 25523 OKLAHOMA CITY OK 7312538 20792005 LIFEGUARD BOX 5506 SAN JOSE CA 9515038 20863005 ADJUSTCO 330 E KILBOURN AVENUE MILWAUKEE WI 5320238 20916005 MOTOROLA INC PO BOX 29005 PHOENIX AZ 8503838 20934005 CORPORATE DIVERSIFIED SERVICES PO BOX 2835 OMAHA NE 68103283538 21092005 BANKERS FIDELITY LIFE INS CO PO BOX 190240 ATLANTA GA 31119024038 21145005 OWENS & ASSOCIATES PO BOX 5766 LITTLE ROCK AR 7221538 21305010 BIG LOTS PO BOX 9074 DUBLIN OH 4301738 21314005 THE COMMERCE GROUP PO BOX 900 ELYRIA OH 4403638 21350005 CONTINENTAL LIFE & ACCIDENT CO PO BOX 1300 ROCKFORD IL 61105130038 21459010 HEALTHCARE RESOURCES GROUP PO BOX 177 SOUTH BEND IN 4662438 21477005 NATIONAL INSURANCE SERVICE INC P O BOX 30324 TAMPA FL 33630332438 21501005 SISCO INC PO BOX 389 DUBUQUE IA 5200138 21548005 UNITED MED RESOURCES-DEPT EPHT PO BOX 141337 CINCINNATI OH 45250133738 21646010 AMERICAN INTERNATIONAL COMPANY PO BOX 25050 WILMINGTON DE 1989938 21735010 ADVANCED BENEFIT SOLUTIONS PO BOX 30570 PHOENIX AZ 85046057038 21833005 INTERNATL UNDERWRITER BROKERS 243 CHURCH STREET WEST VIENNA VA 2218038 21889005 NYHART COMPANY PO BOX 10906 EVANSVILLE IN 4770638 21969005 AV MED HEALTH PLAN 9400 S DADELAND BLVD MIAMI FL 3315638 21997005 CHRISTIAN CARE MEDI SHARE PO BOX 674 STERLING IL 6108138 22106005 ACORDIA NATIONAL PO BOX 3262 CHARLESTON WV 2533238 22115005 NEW WORLD CLAIMS SERVICES 2624 N 5TH STREET NILES MI 4912038 22142005 SAUDER WOODWORKING COMPANY 502 MIDDLE ST ARCHBOLD OH 4350238 22302005 CONAGRA INC ONE CENTRAL PARK PLAZA OMAHA NE 1810238 22349005 THE EVANGELICAL ALLIANCE MISSION PO BOX 969 WHEATON IL 6018938 22536005 KIRKE VAN ORSDEL PO BOX 9007 ST LOUIS MO 6310138 22536010 KIRKE VAN ORSDEL PO BOX 10439 DES MOINES IA 503060439

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 22581005 NEW TRIBES MISSION 1000 EAST FIRST STREET SANFORD FL 32771148738 22590010 PEERLESS CORPORATION PO BOX 760 PARAGOULD AR 7245138 22625010 GROUP BENEFIT ADMINISTRATORS 527 S ROSE STREET KALAMAZOO MI 4900738 22652005 CHESTERFIELD RESOURCES INC PO BOX 1884 AKRON OH 4430938 22859005 BAKER INTERNATIONAL PO BOX 2274 LOS ANGELES CA 9005138 22868005 MED CHOICE PO BOX 385 TOLEDO OH 4369138 22877005 CONTINENTAL LIFE INSURANCE CO PO BOX 1188 BRENTWOOD TN 37027118838 22939005 ANDREWS UNIVERSITY NORTH U S 31 BERRIEN SPRINGS MI 4910438 22939010 ANGEL HEALTH CARE INC 2701 TROY CENTER DRIVE TROY MI 4808438 22993005 PROFESS ADMINISTRATORS INC 3751 MAGUIRE BLVD-STE100 ORLANDO FL 32814041538 23014005 DCA HEALTHCARE MANAGEMENT GROU 13100 WAYZATA BOULEVARD MINNETONKA MN 5534338 23032005 MN TIMBER PRODUCERS ASSOCIATIO 2002 LONDON RD DULUTH MN 5581238 23097005 RESOURCE PARTNERS PO BOX 189 COLUMBUS OH 4321638 23112005 STATE OF LA EMPLOYEES BEN GRP PO BOX 44036 BATON ROUGE LA 70804403638 23177005 CHUBB LIFE AMERICA PO BOX 268849 OKLAHOMA CITY OK 73126884938 23248005 NETWORK HEALTH PLAN 411 LINCOLN STREET NEENAH WI 5495638 23257005 NYHART COMPANY INC PO BOX 80884 INDIANAPOLIS IN 46208088438 23266010 ASO NORTH AMERICA PO BOX 8311 FORT WAYNE IN 46898831138 23284005 GROUP ADMINISTRATORS INC 10440 N CENTRAL EXPRESSW DALLAS TX 7523138 23284010 GROUP ADMINISTRATORS LTD 1880 N ROSELLE RD SCHAUMBURG IL 6019538 23364010 PRIORITY HEALTH PO BOX 232, 1231 E BELTLINE NE GRAND RAPIDS MI 49501023238 23480005 MEDICAL BENEFIT ADMINISTRATORS 217 BROADWAY MONTICELLO NY 1270138 23551005 ASO NORTH AMERICAN GREAT LAKES 1718 INDIAN WOOD CIR STE E MAUMEE OH 43537409038 23560005 CATHOLIC GOLDEN AGE 400 LACKAWANA SCRANTON PA 1850338 23631005 KOREX COMPANY 50000 WEST PONTIAC TRAIL WIXOM MI 4809638 23640005 BENEFIT PLAN ADMINISTRATION WI 11270 W PARK PL #950 MILWAUKEE WI 53224362338 23749005 MEMBER INSURANCE 203 JANDUS RD CARY IL 6001338 23785005 ADMINISTRATIVE SERVICE CONSULT 215 STANFORD PARKWAY FINDLAY OH 4583938 23785010 ADMINISTRATIVE SERVICES CONSULTANTS3301 E ROYALTON ROAD CLEVELAND OH 4414738 23990005 EMPLOYEE BENEFIT MANAGEMENT CORP 4789 RINGS ROAD DUBLIN OH 43017095938 24076005 LAHOOD AND ASSOCIATES PO BOX 12170 OVERLAND PARK KS 6621238 24156005 WESTERN UNION TELEGRAPH COMPAN ONE MACK CENTRE DRIVE PARAMUS NJ 0765238 24165005 BMS ADMINISTRATIVE SERVICES 2720 S RIVER RD STE232 DES PLAINES IL 600184111

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 24183005 CONSOLIDATED GROUP INC PO BOX 2062 NASHUA NH 20306130038 24192005 DIVERSIFIED GROUP BROKERAGE PO BOX 419 MARLBOROUGH CT 0644738 24227005 MUTUAL ASSURANCE AGENCY INC PO BOX 422096 OKLAHOMA CITY OK 7312338 24370005 WELS VEBA GROUP HEALTH PLAN 2949 NORTH MAYFAIR ROAD MILWAUKEE WI 5322238 24399005 HILLHAVEN CORPORATION 400 W MARKET STREET LOUISVILLE KY 40202334638 24405050 HEALTH DESIGN PLUS CS 5085 FINDLAY OH 4583938 24512005 AUTOMATED GROUP ADMINISTRATION PO BOX 15568 FORT WAYNE IN 46885556838 24530005 SIMPLIFIED EMPLOYEE CLAIMS INC PO BOX 330 CANONSBURG PA 1531738 24601005 MEDICO-OP PLAN ADMINISTRATIONS O BOX 507 WABASH IN 4699238 24657005 QUALCARE PO BOX 943 TOLEDO OH 4365638 24666005 CSA ADMINISTRATORS 1275 PECK ST MUSKEGON MI 4944138 24684005 PLANNED EMPLOYEE PROGRAMS 1 BALA CYNWYD BALA CYNWYD PA 1900438 24728005 AMERICAN VETERINARY MEDICAL PO BOX 909720 CHICAGO IL 60690972038 24782105 GA PORTS AUTHORITY PO BOX 2406 SAVANNAH GA 3140238 24871005 BENEFIT ADMINISTRATORS 635 S EARL AVENUE LAFAYETTE IN 47903576938 25019005 JW CARELL ADMINISTRATORS PO BOX 1984 NASHVILLE TN 3720238 25028005 KLAIS AND COMPANY INC 1867 W MARKET ST AKRON OH 4431338 25091005 KITSAP PHYSICIANS SERVICE PO BOX 339 BREMERTON WA 9831038 25313005 AULTCARE 2600 SIXTH STREET CANTON OH 44706091038 25411005 E & E BENEFIT PLANS INC PO BOX 18215 COLUMBUS OH 43218021538 25449005 EMPLOYER SPONSORED PLANS 1120 CHESTER AVENUE CLEVELAND OH 4411438 25494005 PROGRESSIVE ADMINISTRATORS 1370 W SIXTH ST #202 CLEVELAND OH 4411338 25583005 MI EMPLOYEES BENEFIT SER 25 JEFFERSON PLACE GRAND RAPIDS MI 4950338 25609005 FINANCIAL GUARDIAN P.O. BOX 6500 TROY MI 48008650038 25618005 LEGGETT & PLATT INC #1 LEGGETT RD PO BOX 757 CARTHAGE MO 6483638 25663005 AZ PUBLIC SERVICE PO BOX 53970 PHOENIX AZ 85072397038 25672005 HEALTHWIN HOSPITAL EMP BENEFIT PO BOX 55210 INDIANAPOLIS IN 4620538 25707005 SCREEN ACTORS GUILD PO BOX 7830 BURBANK CA 91510783038 25752005 BENEFIT SYSTEMS PO BOX 80447 INDIANAPOLIS IN 4628038 25912005 TR PAUL INC PO BOX 5508 NEWTOWN CT 06470055738 25921005 AUGUT INC BOX 488 MANSFIELD MA 0204838 25930005 ACCELERATION LIFE PO BOX 7187 DUBLIN OH 4301738 26025005 NORTH AMERICAN INSURANCE CO PO BOX 44160 MADISON WI 537444160

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 26052005 TUCKER & CLARK INC PO BOX 802516 DALLAS TX 7538038 26259010 UNITED FOOD & COMMERCIAL WKRS 1800 PHOENIX BLVD STE310 ATLANTA GA 30349983438 26339005 HOLY CROSS EMPLOYEE HEALTH ST.MARY'S BOX 5000 NOTRE DAME IN 4655638 26348005 MARKEL RHULEN PO BOX 2039 GLEN ALLEN VA 2305838 26366005 ALPHA DATA SYSTEMS PO BOX 791428 DALLAS TX 7537938 26375005 FIRST NATIONAL LIFE INS CO 7 CLAYTON STREET MONTGOMERY AL 36104408938 26393005 PATRIOT HEALTH SERVICES P.O. BOX 21166 TAMPA FL 3362238 26393010 PATIENT ADVOCATES PO BOX 8236 PORTLAND MA 0410438 26419005 PAUL BURKE & ASSOCIATES INC 4000 OLSON MEMORIAL HWY MINNEAPOLIS MN 55440986338 26428015 STATE FARM INSURANCE PO BOX 2978 CLINTON IA 52733297838 26446005 CORNING INCORPORATED HEALTH PO BOX 542 CORNING NY 14830054238 26473005 ADMINISTRATION & CREATIVE SERV 4250 GRAND HAVEN RD MUSKEGON MI 4944138 26517005 KAUMAGRAPH FLINT CORPORATION 4705 INDUSTRIAL DRIVE MILLINGTON MI 4874638 26526005 MUTUAL HEALTH SERVICE COMPANY PO BOX 9 4601 CLEVELAND OH 4410138 26535005 UHC OF OHIO SUITE 400 WEST CHESTER OH 45069487538 26553005 SAI NEW ENGLAND PO BOX 83301 LANCASTER PA 17608330138 26606005 BENEFIT PLANNERS PO BOX 690450 SAN ANTONIO TX 78269045038 26615005 KANAWHA INSURANCE PO BOX 1000 LANCASTER SC 2972038 26633005 KOHLER CO INSURANCE KOHLER AVE. KOHLER WI 5304438 26660005 MERVYN'S HEALTH PLAN TRUST PO BOX 3108 RANCHO CORDOVA CA 95741310838 26778005 DELFIELD COMPANY 980 S ISABELLA ROAD MT PLEASANT MI 4885838 26787005 MEDICAL SERVICE CORPORATION PO BOX 3048 SPOKANE WA 99220304838 26796005 SOUTHWEST HEALTH PLAN 3310 LIVE OAK STREET DALLAS TX 75204613338 26900005 UNION LABOR LIFE INSURANCE CO 2607 W. 22ND OAKBROOK IL 6052138 26929005 WILLSE & ASSOCIATES INC PO BOX 1196 BALTIMORE MD 21297041738 26947010 BOLLINGER INSURANCE INC PO BOX 727 SHORT HILLS NJ 0707838 26956005 EMRO PROPANE PO BOX 1500 SPRINGFIELD OH 45501150038 27013005 MEDICAL SERVICE CORP OF E WA PO BOX 3048 SPOKANE WA 99220304838 27031005 PIEDMONT ASSOCIATES PO BOX 420188 ATLANTA GA 3034238 27176005 PACIFIC MUTUAL GROUP PO BOX 34799 PHOENIX AZ 85067479938 27247005 RMSCO INC PO BOX 6309 SYACUSE NY 13217630938 27283005 CONTINENTAL GENERAL INS CO 8901 INDIAN HILLS DRIVE OMAHA NE 6811438 27327005 JEFFERSON PILOT PO BOX 26011 GREENSBORO NC 274206011

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 27327020 JEFFERSON PILOT PO BOX 2615, DEPT BE OMAHA NE 6810338 27336005 LIFE OF AMERICA 2727 ALLEN PARKWAY HOUSTON TX 77019211538 27390005 GAINEY INSURANCE SERVICES 6000 CLAY AVE SW GRAND RAPIDS MI 49548578538 27470005 WI HEALTH FUND PO BOX 601 MILWAUKEE WI 5320138 27489005 RWDSU HEALTH & BENEFIT PO BOX 55728 BIRMINGHAM AL 35255050938 27498005 RAM PRODUCTS 1111 N CENTERVILLE RD STURGIS MI 4909138 27543005 AMERICAN INSURANCE CO OF TX PO BOX 2645 WACO TX 7670238 27561005 BOA EMPLOYEE BENEFIT PO BOX 20945 COLUMBUS OH 4322038 27741005 EVANGELICAL LUTHERN CHUR IN AM PO BOX 59093 MINNEAPOLIS MN 55459009338 27759005 AMERICAN MEDICAL & LIFE 35 BROADWAY CS 546 HICKSVILLE NY 1180238 27768010 BENEFIT COORDINATORS CORPORATION 111 RYAN COURT SUITE 300 PITTSBURGH PA 15205132438 27795010 KEY LINK GROUP 216 N GREEN BAY ROAD THIENSVILLE WI 53092162538 27831005 MARATHON OIL CO 539 SOUTH MAIN ST. FINDLAY OH 4584038 28011005 WARREN STEINBORN ASSOCIATES 310 E 96TH ST SUITE 200 INDIANAPOLIS IN 46240373238 28039005 WA NATIONAL INSURANCE PO BOX 1250 ROCKFORD IL 61105125038 28065005 TN VALLEY OPERATING ENGINEERS HEALTH FUND907 TWO WILW PARKWAY GOODLETTSVILLE TN 3707238 28093005 HARRINGTON 1302 N HIGHWAY 81 DUNCAN OK 73533000038 28250005 CHANDLER & ASSOCIATES 35 RIVER ST CHAGRIN FALLS OH 4402238 28314005 EDWARD B MORRIS ASSOC INC PO BOX 50440 INDIANAPOLIS IN 46250044038 28341005 LATVIAN RELIEF FUND PO BOX 8857 ELKINS PARK PA 1902738 28438005 INTERMOUNTAIN COMPANIES PO BOX 3018 MISSOULA MT 5980638 28461005 INSURERS ADMINISTRATIVE CORP PO BOX 39119 PHOENIX AZ 85069911938 28483005 NEW ENGLAND MUTUAL PO BOX 4015 ISELIN NJ 08830401538 28594005 CHURCH OF THE BRETHREN MED PLA 1451 DUNDEE ELGIN IL 6012038 28616005 CORPORATE HEALTH ADMINISTRATOR PO BOX 1858 BISMARK ND 58502185838 28638005 IL CENTRAL HOSPITAL ASSO 2024 HICKORY HOMEWOOD IL 60430219938 28761005 CASCADE DIE CASTING GROUP 3040 CHARLEVOIX DR SE GRAND RAPIDS MI 4954638 28772005 CHASE BRASS & COPPER PO BOX 152 MONTPELIER OH 4354338 28794005 EPIC LIFE INSURANCE PO BOX 8924 MADISON WI 5370838 28838005 HEALTH CLAIM SERVICES INC PO BOX 9615 DEERFIELD BCH FL 33442961538 28850005 INTERNATIONAL MASTER PRODUCTS 9350 WALSH MONTAGUE MI 4943738 28861005 KEY BENEFIT ADMINISTRATORS PO BOX 55210 INDIANAPOLIS IN 4620538 29071005 BENEFIT ADMINISTRATORS KY PO BOX 17750 FORT MITCHELL KY 41017

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 29182005 TUCKER ADMINISTRATOR 9140 ARROWPOINT CHARLOTTE NC 2821738 29271005 JOHN P PEARL & ASSOCIATES LTD 4815 N PROSPECT RD PEORIA IL 61614647038 29303005 LESCO INC 20005 LAKE ROAD ROCKY RIVER OH 44116091538 29336005 MED TAC CLAIM CENTER PO BOX 9110 NEWTON MA 0216038 29347005 MEDIPLAN 502 VALLEY ROAD WAYNE NJ 0747038 29358005 MIDWEST SECUR ADMINISTRATORS 1150 SPRINGHURST-STE140 GREEN BAY WI 54307903538 29381005 RETAIL VENTURES INC PO BOX 788 WARRENDALE PA 1509538 29403005 STARMARK INSURANCE 400 FIELD DRIVE LAKE FOREST IL 60045792238 29403010 STARMARK PO BOX 2942 CLINTON IA 52733294238 29469015 CEBA 9003 WATERFORD CENTRE BLVD AUSTIN TX 7875838 29503005 KANAWHA INSURANCE COMPANY PO BOX 2000 LANCASTER SC 29721200038 29503010 KANAWHA BENEFIT SOLUTIONS INC PO BOX 5150 GREENVILLE SC 2960638 29558005 QUINCY IND GROUP HEALTH 4700 KNOWLES RD NORTH ADAMS MI 4926238 29647010 HEALTHPLAN SERVICES PO BOX 30367 TAMPA FL 33630336738 29670005 MBA PO BOX 651109 SALT LAKE CITY UT 84165110938 29692010 NCAS NORTHWEST PO BOX 91010 SEATTLE WA 98111911038 29703005 NORTH AMERICAN BENEFITS NETWORK PO BOX 94928 CLEVELAND OH 44101492838 29714005 PHILLIPS ADMINISTRATIVE SERVS BOX 218 ALBANY OR 9732138 29770005 BENEFIT ADMINISTRATIVE SYSTEMS 17475 JOVANNA DR #1B HOMEWOOD IL 6043038 29870005 SOLTEX POLYMER CORP PO BOX 27328 HOUSTON TX 7722738 29959005 IA BENEFITS PO BOX 707 AMES IA 50010070738 29960005 LEAHY & ASSOCIATES INC 900 W JACKSON BLVD CHICAGO IL 60607308338 29971005 MANAGEMENT SERVICES INC PO BOX 1430 DANVILLE IL 61834143038 29982005 MODERN AMERICAN LIFE INSUR CO 500 N AKARD DALLAS TX 75265543338 29994010 SECURITY LIFE INSURANCE CO OF AMERICAPO BOX 5348 BELLINGHAM WA 9822738 29996005 TRI TEC EMPLOYEE BENEFITS INC PO BOX 804 OKEMOS MI 4880538 29998005 COLUMBIA UNIVERSAL LIFE INS PO BOX 200225 AUSTIN TX 78720022538 30003005 AON SELECT 110 GIBRALTAR RD. HORSHAM PA 1904438 30004005 PACIFICARE OF CA PO BOX 6006 CYPRESS CA 90630000638 30004010 PACIFICARE OF OK 7666 E 61ST STREET, SUITE 500 TULSA OK 74133111238 30004015 PACIFICARE OF OR 5 CENTERPOINTE DRIVE LAKE OSWEGO OR 97035865038 30011005 HEALTH NETWORK CTDU 809 WEST MADISON STREET CHICAGO IL 6060738 30018005 PRE CARE FEDERAL BLDG 607 MARQUET MINNEAPOLIS MN 55402

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 30019005 WEA INSURANCE GROUP 45 W BELTLINE MADISON WI 53707733838 30024005 INSURANCE MANAGEMENT ADM 3010 KNIGHT ST SHREVEPORT LA 7110538 30030005 GM UNDERWRTERS AGENCY INC P O BOX 5004 ROCHESTER MI 48308500438 30031005 POSITIVE CARE SERVICES INC 11935 RILEY ST STE 200 SHAWNEE MISSION KS 66213113038 30063005 LEGIONNAIRE INSURANCE TRUST PO BOX 9060 PHOENIX AZ 85068906038 30064005 MCCLURE OIL CO PO BOX 1750 MARION IN 46952815038 30070005 STRATEGIC HEALTH CARE MANAGEME 2250 E DEVON DES PLAINS IL 6001838 30071005 WRLA EMPLOYEE BENEFIT PO BOX 840 GERMANTOWN WI 53022084038 30072005 ZENITH ADMINISTRATORS 201 QUEEN ANNE AVENUE SEATTLE WA 9810938 30072010 ZENITH ADMINISTRATORS PO BOX 11137 CHICAGO IL 6061138 30073005 ACTURIAL AND EMPLOYEE BENEFITS 310 TERRACE CINCINNATI OH 4522038 30085005 PRODUCERS EXCHANGE BEN SERV IN 14665 MIDWAY RD STE 110 DALLAS TX 7524438 30088005 SOUTHERN BENEFIT CONSULTANTS 222 W COLINAS BLVD #756 IRVING TX 7503938 30089005 STUDENT ASSURANCE SERVICES DRAWER 196 STILLWATER MN 5508238 30091005 BAC LOCAL 32 INSURANCE FUND 2075 W BIG BEAVER - SUITE 700 TROY MI 4808438 30092005 DONLEY HORAN & ASSOC 6330 E. 75TH STE. 106 INDIANAPOLIS IN 4625038 30094005 MEGA LIFE & HEALTH INSURANCE PO BOX 809025 DALLAS TX 75380902538 30094010 MEGA LIFE & HEALTH INSURANCE PO BOX 982009 N RICHLAND HILL TX 7618238 30099005 NORTH AMERICAN ADMINISTRATORS PO BOX 9501 AMHERST NY 14226950138 30100005 ROCK TENN COMPANY 431 HELEN AVE OTSEGO MI 4907838 30204005 MCCONACHIE FINANCIAL SERVICES PO BOX 859 PARK RIDGE IL 6006838 30207005 PARTNERS HEALTH PLAN PO BOX 7600 SOUTH BEND IN 4663438 30302005 SOUTHLAND CORP PO BOX 1510 DALLAS TX 7522138 30303005 TFE MEDICAL SYSTEMS 3665 WHEELER AUGUSTA GA 3090938 30306005 AMERICAN SERVICE LIFE INS PO BOX 982017 N RICHLAND HILLS TX 7618238 30402005 HYCORR MACHINE CORPORATION 5801 E KILGORE KALAMAZOO MI 49001870238 30404005 BASIC BENEFITS INC PO BOX 2667 ZANESVILLE OH 43702266738 30408010 JF MALLOY & ASSOCIATES PO BOX 68947 INDIANAPOLIS IN 4626838 30504005 BLAIR MILL ADMINISTRATION 720 BLAIR MILL RD HORSHAM PA 1904438 30504010 AMERIHEALTH ADMINISTRATORS 720 BLAIRMILL ROAD HORSHAM PA 1904438 30505005 CHRISTIAN FIDELITY 2001 BATES DR. WARAHACHIE TX 7516538 30505010 CHRISTIAN HEALTHCARE NETWORK 205 SOUTH BC AVENUE LYNDEN WA 9826438 30519005 QUEENS HEALTH CARE PLAN 1301 PUNCHBOWL HONOLULU HI 96813

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 30529005 COORDINATED BENEFIT PLANS PO BOX 31107 TAMPA FL 33631310738 30541005 ASSOCIATED THIRD PARTY ADMINISTRATIONPO BOX 61320 LAS VEGAS NV 89160132038 30542005 INTERCARE HEALTH SYSTEMS PO BOX 3559 ENGLEWOOD CO 80155355938 30549005 MONUMENTAL LIFE INSURANCE CO PO BOX 97 SCRANTON PA 18504009738 30569005 HCH ADMINISTRATION PO BOX 1986 PEORIA IL 61656198638 30572005 WHATCOM MEDICAL PO BOX 9753 BELLINGHAM WA 9822738 30574005 CAPITOL AMERICAN LIFE PO BOX 94953 CLEVELAND OH 44101495338 30579005 UNITED WI INSURANCE PO BOX 2013 MILWAUKEE WI 53201201338 30581005 CIRCLE CITY MEDICAL GROUP 830 OLD MAGNOLIA CORONA CA 9171938 30586005 NEW ENGLAND CLEVELAND TNE 25145 COUNTRY CLUB BLVD. NORTH OLMSTEAD OH 4407038 30589005 ADMINITRON INC 214 CENTERVIEW DR-#250 BRENTWOOD TN 37024509538 30596005 NATIONAL RURAL ELECTRIC COOP PO BOX 6249 LINCOLN NE 1005638 30597005 RAYMOND TAYLOR AGENCY 20155 GODDARD TAYLOR MI 4818038 30598005 ACIC CLAIM ADMINISTRATOR 540 LAKE COOK DEERFIELD IL 60015529038 30601005 JMS ADMINISTRATORS PO BOX 2141 MONROE MI 4816138 30602005 ODS PO BOX 40384 PORTLAND OR 9724038 30603005 PRIMERICA LIFE INSURANCE CO 3120 BRECKINRIDGE DULUTH GA 30199000138 30603010 PRIMERICA LIFE INSURANCE CO PO BOX 66953 CHICAGO IL 60666095338 30604005 PROFESSIONAL RISK MANAGEMENT PO BOX 1049 YOUNGSTOWN OH 4450138 30607005 DIVERSIFIED GROUP ADMIN INC PO BOX 330 CANONSBURG PA 1531738 30704005 MARKEL SERVICE INC PO BOX 5006 MONTICELLO NY 1270138 30709005 BENEFIT CONSULTANTS INC 13515 BARRETT PKWY DR BALLWIN MO 63021587038 30710005 BURGETT & LIFE PO DRAWER V VAN BUREN AZ 7295638 30711005 CCI ADMINISTRATORS PO BOX 7152 DUBLIN OH 4301738 30712005 BENEFIT CONCEPT PO BOX C5009 WARMINSTER PA 18974058038 30714005 STATELINE TPA INC 1718 INDIAN WOOD CIRCLE MAUMEE OH 4353738 30720005 BENEFIT RESOURCES INC 15721 N GREENWAY HAYDEN LOOPSCOTTSDALE AZ 85260165138 30723005 AG TRUCKING PO BOX 453 GOSHEN IN 4652638 30727005 PLASTIC MASTERS INC PO BOX 340 NEW BUFFALO MI 4911738 30735005 CALEND GROUP 5972 STELLHORN FORT WAYNE IN 4680138 30738005 PACIFIC CARE 410 N 4TH PHOENIX AZ 8500838 30740005 PEKIN LIFE 2505 COURT PEKIN IL 6155838 30743005 MEDICAL COLLEGE OF WI 11200 W PLAN CT STE 160 MILWAUKEE WI 53213

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 30747005 WILLIS CORROON CORP OF KS 300 W DOUGLAS STE 800 WICHITA KS 67201269738 30748005 ADMINISTRATIVE ENTERPRISES INC 3404 W CHERYL DRIVE #281 PHOENIX AZ 85051958838 30757010 NORTH AMERICA ADMINISTRATORS PO BOX 1984 NASHVILLE TN 3720238 30762010 AFL CIO FOOD & BEVERAGE DEALER 933 N SUMMIT STREET TOLEDO OH 4360438 30768005 EMPLOYEE BENEFIT SERVICES PO BOX 9888 SAVANNAH GA 31412008838 30773010 THIRD PARTY CLAIMS MANAGEMENT PO BOX 268820 OKLAHOMA CITY OK 73126882038 30776005 DEALERS ASSOCIATION PLAN 5526 PLYMOUTH SORRENTO APOPKA FL 32712511738 30784005 PROFESSIONAL BENEFITS SERVICES 2959 LUCERNE, SE GRAND RAPIDS MI 4954638 30787005 UNITED INSURANCE CO OF AMERICA P O BOX 4325 BATON ROUGE LA 7082138 30788005 WESTERN FIDELITY INSURANCE CO PO BOX 1250 ROCKFORD IL 6110538 30789005 ADMINISTRATIVE SERVICES INC 3203 LAWTON ROAD ORLANDO FL 32814017338 30789010 ADMINISTRATIVE SERVICES INC PO BOX 839000 MIAMI FL 33283900038 30792005 EPOCH GROUP 10795 WATSON RD ST LOUIS MO 6312738 30792010 EPOCH GROUP PO BOX 12170 OVERLAND PARK KS 66282217038 30793005 ME HEALTH PLAN INC 110 FREE STREET PORTLAND ME 04101390838 30800005 BOARD OF PENSIONS PRESBYTERIAN PO BOX 13896 PHILADELPHIA PA 1910138 30801005 MOTEL 6 MEDICAL CLAIM SERVICE PO BOX 809092 DALLAS TX 75380909138 30803010 FHP PO BOX 25187 SANTA ANA CA 92799518738 30804005 HIP OF GREATER NY 7 WEST 34TH STREET NEW YORK NY 1000138 30806010 MEDPLAN SELECT PO BOX 2088 DALTON GA 30722208838 30810005 ACLIC PO BOX 796 DEERFIELD IL 60015529038 30812005 GULF SOUTH ADMINISTRATORS 3616 S I-10 SERVICE ROAD METAIRIE LA 70011857038 30813005 ASSOCIATED PLAN ADMINISTRATORS 4133 WHITNEY AVENUE NEW HAVEN CT 06535956838 30815005 DUO FORM OF MI INC PO DRAWER C EDWARDSBURG MI 4911238 30819005 HEALTH CARE ADMINISTRATORS PO BOX 1309 MUSKOGEE OK 7440238 30821005 MUTUAL MEDICAL PLANS PO BOX 689 PEORIA IL 6165238 30825005 PRC CORPORATED 1500 PRC DRIVE #239-E MCLEAN VA 2210238 30826005 PAN AMERICAN PO BOX 60219 NEW ORLEANS LA 70160021938 30833015 TPA OF GA 2900 CHAMBLEE TUCKER ROAD ATLANTA GA 30341415638 30835005 ALL RISK ADMINISTRATORS INC PO BOX 66210 ST PETERSBURG FL 33763621038 30836005 CHICAGO GRAPHIC ARTS PO BOX 11137 CHICAGO IL 60611013738 30845005 ALTERNATIVE RISK MANAGEMENT 3275 N ARLINGTON HEIGHTS ARLINGTON HGTS IL 6000438 30846005 HEALTH BENEFIT PO BOX 1386 EAST LANSING MI 48823

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 30847005 HEHR GLASS 200 S 1ST STREET CHESANING MI 4861638 30853005 MCCREARY CORP 700 CENTRAL PARKWAY STUART FL 34994398538 30855005 WOODS & GROOMS PO BOX 2549 COLUMBUS IN 4720238 30859005 BENEFIT MANAGEMENT SERVICES PO BOX 1178 MATTHEWS NC 2810638 30859010 BENEFIT MANAGEMENT OF ME PO BOX 3859 PORTLAND ME 04104385938 30859015 BENEFIT MANAGEMENT ADMINISTRATION INCPO BOX 17 CALEDONIA MI 4931638 30862005 DIXIE NATIONAL LIFE PO BOX 22587 JACKSON MS 39225258738 30863005 DUNN & ASSOCIATES PO BOX 2369 COLUMBUS IN 4720238 30866005 ENTRUST INC PO BOX 441588 HOUSTON TX 77244158838 30869005 JEC HEALTH CLAIMS PO BOX 8210 CLEARWATER FL 3461838 30877005 QUAKER HEALTH SERVICES 100 S BROADWAY SALEM OH 4446038 30879005 SOUTHERN ADMINISTRATIVE PO BOX 8069 COLUMBUS GA 31908806938 30880005 TRIAD LLC 115 GLASTONBURY BLVD. GLASTONBURY, CT 0603338 30881005 UNITED EMPLOYEES BENEFIT TRUST PO BOX 8130 TACOMA WA 9840838 30882005 US ABLE ADMINISTRATORS PO BOX 1460 LITTLE ROCK AR 72203146038 30884005 AMERICAN BENEFITS MANAGEMENT PO BOX 35008 CANTON OH 4473538 30886005 CAPITAL CARE 550 12TH ST SW #12 WASHINGTON DC 20065000138 30887005 COMPANION LIFE PO BOX 100102 COLUMBIA SC 2920238 30894005 INSUREX BENEFITS ADMIN INC PO BOX 41779 MEMPHIS TN 38174177938 30899010 MASLAND INDUSTRIES 1855 STEPEHENSON HIGHWAY TROY MI 4808338 30906005 INDEPENDENT HEALTH 511 FARBER LAKES DRIVE BUFFALO NY 1422138 30907005 JEFFERSON PILOT 5211 LINBAR DR STE 513 NASHVILLE TN 3721138 30909005 BENEFIT PLAN ADMINISTRATORS 2901 W BELTLINE STE 100 MADISON WI 53713422638 30911005 WEST MI CUSTOMER SERVICE PO BOX 8947 GRAND RAPIDS MI 49518089438 30914005 NEXCALIBER 16775 ADDISON RD., SUITE 605 ADDISON TX 75001000038 30916005 BASSETT FURNITURE INDUSTRIES PO BOX 626 BASSETT VA 24055062638 30919005 VALUE OPTIONS PO BOX 1002 MERRIFIELD VA 2211638 30920005 FANSTEEL INC NUMBER ONE TANTALUM PLAC N CHICAGO IL 6006438 30921005 MEDICAL BENEFITS ADMIN PO BOX 259424 MADISON WI 53725942438 30927005 MID AMERICA PLAN ADMINISTRATOR PO BOX 2850 ROCKFORD IL 61132285038 30932005 OLIN CORPORATION 505 MERRITT- SEVEN NORWALK CT 06856450038 30933020 BENEFIT SOURCE PO BOX 19400 KALAMAZOO MI 4901938 30936005 REYNOLDS & REYNOLDS PO BOX 2608 DAYTON OH 45401

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 30938005 STANDARD INSURANCE COMPANY PO BOX 209 PORTLAND OR 97207020938 30939005 UNITED TEACHER ASSOC INSURANCE PO BOX 26580 AUSTIN TX 78755058038 30941005 ASSOCIATED AMINISTRATORS INC PO BOX 5096 PORTLAND OR 97208509638 30948005 JEFFERSON LIFE INSURANCE CO 9304 FORSEST LANE DALLAS TX 7524338 30950005 MED PAY INC PO BOX 10909 SPRINGFIELD MO 6580838 30951005 MIDWEST HEALTH SYSTEMS INC PO BOX 80247 FORT WAYNE IN 46898024738 30952005 MIDWEST BENEFIT CORP PO BOX 8500 CORAOPOLIS PA 15108082038 30954005 PRAIRIE STATES 500 N CLARK SUITE 300 CHICAGO IL 6061038 30956005 PROFESSIONAL CLAIM ADMINISTRAT 10560 WAYZATA BLVD MINNETONKA MN 5530538 30961005 ACS CONSULTING SERVICES INC PO BOX 2000 WINSTON-SALEM NC 27102200038 30963005 ADMINISTRATOR & CONSULT. LTD PO BOX 4925 LANCASTER PA 1760438 30964005 ALLEN MEDICAL CLAIMS ADMINISTR PO BOX 978 FT VALLEY GA 31030097838 30966005 BECKWITH HIGHTOWER INS SER INC 1617 ST MARKS PLAZA STOCKTON CA 9520738 30967005 BENE-FLEX INC 4801 W PETERSON AVENUE CHICAGO IL 6064638 30968005 BENEFITS ADMINISTRATION SERVIC PO BOX 4509 ROCKFORD IL 61110450938 30970005 BROWER GROUP SERVICES INC 3065 N 124TH STREET BROOKFIELD WI 5300538 30979005 NATIONAL ELEVATOR INDUSTRY PO BOX 477 NEWTOWN SQUARE PA 19073047738 30983005 PACIFIC HEALTH ADMINISTRATORS PO BOX 1550 HUNTINGTON BEAC CA 92647155038 30985005 PREFERRED WORKS INC PO BOX 2703 CHICAGO IL 60690270338 30985010 PREFERRED UNITED PLANS/SECURE ONE PO BOX 1847 GRAND RAPIDS MI 49501184738 30986005 RALSTON PURINA COMPANY 1100 OAKMAN BLVD DETROIT MI 4823838 30987005 SEABURY & SMITH TWO WEST SECOND STREET TULSA OK 74103312138 30987010 SEABURY & SMITH PO BOX 14426 DES MOINES IA 50306342638 30988005 NM UFCW UNION H&W TRUS 4775 INDIAN SCHOOL,NE105 ALBUQUERQUE NM 8711038 30990005 ALLIANCE PO BOX 02459 DETROIT MI 4820238 30994005 ARATEX SERVICES INC PO BOX 7891 BURBANK CA 9151038 40000005 MATTHEW THORNTON HEALTH PLAN PO BOX 9514 MANCHESTER NH 03108951438 40001005 NATIONAL FOUNDATION LIFE INS 777 MAIN STREET FORT WORTH TX 7610238 40004005 NOVA HEALTHCARE ADMINISTRATORS PO BOX 308 GRAND ISLAND NY 1407238 40007005 PREMIER BENEFITS 2030 S NATIONAL SPRINGFIELD MO 6580438 40011005 WYATT CO 601 THIRTEENTH STREET NW WASHINGTON DC 20005381338 40013005 AMERICAN FOREIGN SERVICE 1716 N STREET NW WASHINGTON DC 2003638 40015005 BALL CORPORATION 345 S HIGH STREET MUNCIE IN 473052326

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40022005 EB EDDY PAPER INC PO BOX 5003 PORT HURON MI 48061500338 40022010 EB BEVERAGES PO BOX 636 MANSFIELD OH 4490138 40027005 INLAND STEEL FLAT PRODUCTS CO 3210 WATLING STREET EAST CHICAGO IN 4631238 40034005 SILVER STATE MEDICAL 2073 E SAHARA STE B LAS VEGAS NV 8910938 40043005 WI AUTO & TRUCK DEALERS ASSOC PO BOX 5345 MADISON WI 5370538 40044005 ARKANSAS' FIRST SOURCE PO BOX 1520 IOWA CITY IA 5224438 40047010 PRINCIPAL HEALTH CARE PO BOX 410976 KANSAS CITY MO 6414138 40047015 PRINCIPAL HEALTH CARE 2751 CENTERVILLE RD WILMINGTON DE 19808162738 40048010 BENEFIT PLAN ADMINISTRATORS PO BOX 1008 MELVILLE NY 11747012838 40048015 BENEFIT PLAN ADMINISTRATORS PO BOX 2339 FARGO ND 5810838 40050005 AMERICAN HEALTH SERVICES 1855 WINCHESTER RD PARIS KY 4036138 40050010 AMERICAN HEALTH GROUP 1789 INDIAN WOOD CIRCLE MAUMEE OH 4353738 40050015 GPA PO BOX 834150 RICHARDSON TX 75083415038 40059005 ANTHEM HEALTH ACORDIA BENEFITS 1188 FRANKLIN ST #102 SAN FRANCISCO CA 94109680038 40060005 AMERICAN ADMINISTRATORS PO BOX 65887 WEST DES MOINES IA 5026538 40061005 ATWOOD AUTOMOTIVE INC 5701 W DICKMAN ROAD BATTLE CREEK MI 4901538 40062005 BOEHRINGER MANNHEIM PO BOX 1017 INDIANAPOLIS IN 46206101738 40063005 TRANS GENERAL LIFE & CASUALTY 730 HOLIDAY DRIVE PITTSBURGH PA 1522038 40066005 FRANK HELLER ASSOCIATES 8228 MAYFIELD ROAD CHESTERFIELD OH 4402638 40067005 JELD WEN HEALTH BENEFIT PLAN PO BOX 5128 BEND OR 97708512838 40071005 AE STALEY MANUFACTURING CO PO BOX 5769 LAFAYETTE IN 47903576938 40074005 FOCUS HOPE 1355 OAKMAN BOULEVARD DETROIT MI 4823838 40075005 FOUNDATION HEALTH PO BOX 255700 SACRAMENTO CA 9586538 40076005 GLOBE BUSINESS FURNITURE 1919 INDUSTRIAL DRIVE BIG RAPIDS MI 4930738 40079005 MCC BEHAVIORAL CARE 11095 VIKING DR EDEN PRAIRIE MN 5534438 40081005 MEDICAL BENEFITS MUTUAL PO BOX 1129 NEWARK OH 43058112938 40082005 PENN WESTERN BENEFITS INC PO BOX 7834 GREENSBORO NC 27417083438 40088005 W J JONES ADMINISTRATIVE SERVICES INC1979 MARCUS AVENUE LAKE SUCCESS NY 1104238 40091005 CONTRACT FREIGHTERS INC PO BOX 2547 JOPLIN MO 6480338 40100005 REGIT PO BOX 1461 ST LOUIS MO 63188146138 40104005 TBG PO BOX 1724 WAUSAU WI 54402172438 40105005 THREE RIVERS BENEFIT CORP PO BOX 3440 SIOUX CITY IA 5110238 40106005 UNITED PLANS INC PO BOX 30153 TAMPA FL 33630

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40107005 VERMEER PO BOX 200 PELLA IA 5021938 40108005 ASSOCIATION GROUP INSURANCE 1155 EUGENIA PLACE CARPINTERIA CA 9301338 40110005 NEW ERA LIFE INSURANCE COMPANY PO BOX 4884 HOUSTON TX 77210488438 40111005 OVERHEAD DOOR CO OF LANSING 2045 EAST M-78 EAST LANSING MI 4882338 40115005 AMERICAN SOCIETY OF CIVIL 1255 23RD STREET NW WASHINGTON DC 20037119338 40121005 DMBA PO BOX 45530 SALT LAKE CITY UT 8414538 40125005 ELI LILLY & COMPANY EMPLOYEE LILLY CORPORATE CENTER INDIANAPOLIS IN 4628538 40127005 I & K DISTRIBUTORS INC PO BOX 369 DELPHOS OH 4583338 40128005 MEDICAL BENEFIT ADMINISTRATORS PO BOX 9424 MADISON WI 5371538 40129005 MEDIPLUS THE HARTFORD PO BOX 9126 DES MOINES IA 50306912638 40131005 PITTMAN & ASSOCIATES PO BOX 111047 MEMPHIS TN 3811138 40138005 VEBA PO BOX 91588 ARLINGTON TX 76015008838 40139005 ALLIED BENEFIT SYSTEMS 208 LASALLE STREET CHICAGO IL 6060438 40139010 ANTHEM HEALTH & LIFE PO BOX 15244 NEWARK NJ 07192524438 40140005 ARCH MINERAL CORPORATION PO BOX 59345 MINNEAPOLIS MN 55459034538 40141005 BRIDGESTONE FIRESTONE INC PO BOX 26605 AKRON OH 44319999838 40143005 FSL ADMINISTRATIVE SERVICES PO BOX 1326 FORT WORTH TX 76101132638 40144005 GLOBAL BENEFITS INC 1030 15TH STREET NW WASHINGTON DC 2000538 40146005 HEP ADMINISTRATORS INC 100 S MAIN SUITE 400 OCONOMOWOK WI 5306638 40148005 MAXCO INC 1118 CENTENNIAL WAY LANSING MI 4890838 40149005 NIPPON LIFE INSURANCE PO BOX 39710 COLORADO SPRINGS CO 80949319038 40150005 PACIFIC HEALTH & LIFE PO BOX 7709 BEND OR 97708770938 40154005 ADMINISTAR SOLUTIONS P O BOX 43999 CLEVELAND OH 4414338 40158005 AMA INSURANCE AGENCY INC 200 N LASALLE STREET CHICAGO IL 6060138 40161005 CREATION WINDOWS OF IN PO BOX 1046 ELKHART IN 4651538 40163005 HEALTHNET 2300 MAIN ST SUITE 700 KANSAS CITY MO 6410838 40164005 IDEALIFE INSURANCE PO BOX 9100 CLEARWATER FL 3461838 40166005 RAPP & COMPANY 132 KINGS HIGHWAY EAST HADDONFIELD NJ 0803338 40171005 BR ASSOCIATES EMPLOYEE 4201-A MANNHEIM ROAD JASPER IN 47546961838 40172005 BUCKEYE EMPLOYEE BENEFIT SERVS PO BOX 18245 COLUMBUS OH 4321838 40174010 EB SERVICES INC 4801 CHASTAIN AVENUE CHARLOTTE NC 2821738 40174015 EMPLOYEE BENEFIT SERVICES PO BOX 70100 SHREVEPORT LA 71137010038 40176005 FOREIGN SERVICE BENEFIT PLAN 1716 N STREET NW WASHINGTON DC 20036

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40178005 GALLAGHER WOODSMALL PO BOX 419397 KANSAS CITY MO 6414138 40179005 INTERACTIVE MEDICAL SYSTEMS PO BOX 19108 RALEIGH NC 2761938 40180005 OPTIONS HEALTH CARE PO BOX 34750 SEATTLE WA 98124974538 40181010 OPTIONS MENTAL HEALTH 240 CORPORATE BOULEVARD NORFOLK VA 2350238 40182005 RADIO OFFICERS UNION 1415 MOYLIN ROAD PANAMA CITY BEA FL 3240738 40184005 SUBURBAN HEALTH CARE BENEFITS 5270 W 84TH ST STE 520 MINNEAPOLIS MN 55437137938 40186005 ARANON CORPORATION 285 W 74TH PLACE HIALEAH FL 3301438 40188005 BENICORP INSURANCE CO OF IN PO BOX 68917 INDIANAPOLIS IN 4626838 40191005 CITY OF TOLEDO EMPLOYER PO BOX 2790 TOLEDO OH 4360638 40191020 FUTUREPOINT INC 117 CENTER PARK DR KNOXVILLE TN 3792238 40191025 HEALTH CARE & RETIREMENT CORP ONE SEAGATE TOLEDO OH 43604261638 40191030 HEALTH CHOICE(HAP) PO BOX 02399 DETROIT MI 4820238 40191040 ALLIANCE HEALTH & LIFE INSURANCE PO BOX 02459 DETROIT MI 4820038 40192005 COMPREHENSIVE BENEFITS ADMIN PO BOX 2365 S BURLINGTON VT 0540738 40192015 DESTINY HEALTH PO BOX 9219 OAK BROOK IL 6052338 40193005 CORPORATE HEALTH INSURANCE CO PO BOX 2156 BISMARK ND 5850238 40195005 PROVIDENCE GOOD HEALTH PLAN OF OR PO BOX 3125 PORTLAND OR 9720838 40199005 HEALTHLINK PO BOX 41904 ST LOUIS MO 63141999838 40201005 MI EDUCATION EMP MUT INS 691 N SQUIRREL ROAD AUBURN HILLS MI 4832638 40205015 PRO-CLAIM PLUS INC PO BOX 9648 FORT WAYNE IN 4689938 40206005 PROFESSIONAL BENEFIT ADMINISTRATORSPO BOX 4687 OAKBROOK IL 60522468738 40207010 PEHP 560 EAST 200 SOUTH SALT LAKE CITY UT 84102200438 40208005 TECNOL INC INDUSTRIAL BOULEVARD FORT WORTH TX 7618038 40209005 UNDERWRITERS SAFETY & CLAIMS PO BOX 23507 LOUISVILLE KY 40223050738 40210005 GMP EMPLOYERS RETIREES TRUST 5245 BIG PINE WAY FORT MYERS FL 33907599838 40211005 PROFESSIONAL SERV INDUSTRIES PO BOX 3041 SPRINGFIELD IL 6270838 40213005 ALBERT H WOHLERS & CO 230 W MONROE STREET CHICAGO IL 60646499738 40217005 FLEET RESERVE ASSOCIATION P.O. BOX 10340R DESMOINES IA 50306034038 40220010 HERITAGE INSURANCE PO BOX 24825 FORT LAUDERDALE FL 33307482538 40222005 LUCKY STAR INDUSTRIES PO DRAWER K NETTLETON MS 3885838 40223005 MCKEE FOODS PO BOX 2078 COLLEGEDALE TN 3731538 40223100 INTERSTATE ADMINISTRATIVE SERVICES PO BOX 1670 DANVILLE IL 6183438 40224005 MI MANUFACTURERS ASSOC PO BOX 14247 LANSING MI 489014247

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40226005 PHYSICIANS PLUS INS CORP 340 WEST WASHINGTON AVE MADISON WI 5370338 40227005 PROFESSIONAL CLAIMS MANAGEMENT PO BOX 35276 CANTON OH 44735527638 40230005 UMWA HEALTH & RETIREMENT 852 HENDERSON AVENUE WASHINGTON PA 1530138 40232005 BENEFIX PO BOX 19 MEMPHIS TN 3810138 40236005 RAYOVAC CORPORATION 2317 WINNEBAGO STREET MADISON WI 53704528838 40238005 STANDARD REGISTER PO BOX 1167 DAYTON OH 45401116738 40239005 BENEFIT ASSISTANCE CORPORATION PO BOX 950 HURRICANE WV 25526095038 40239010 BENEFIT ASSOCIATES PO BOX 470 BROOKFIELD WI 53008047038 40243005 INTERNATIONAL BENEFIT SERVICES PO BOX 1326 FORT WORTH TX 7610138 40244010 MAGELLAN PO BOX 2278 MARYLAND HEIGHTS MO 6304338 40245010 FIRST CHOICE BENEFITS MANAGEME PO BOX 658 BELOIT WI 5351238 40247005 BENEFIT ADMINISTRATORS PO BOX 10585 KNOXVILLE TN 3793938 40250005 INSURANCE ADMINISTRATION CTR PO BOX 3257 TAMPA FL 3360138 40250010 INSURANCE ADMINISTRATOR OF AMERICA521 FELLOWSHIP ROAD MOUNT LAUREL NJ 0805438 40251005 PA TREATY LIFE INSURANCE CO 110 GILBRALTER ROAD HORSHAM PA 1904438 40252005 PRIMECARE HEALTH PLAN INC 10701 W RESEARCH DRIVE MILWAUKEE WI 5322638 40253005 PROVIDENTIAL LIFE INSURANCE CO PO BOX 8072 LITTLE ROCK AR 72203807238 40255005 QUAD GRAPHICS W224 N3322 DUPLAINVILLE PEWAUKEE WI 53702419538 40257010 WELLMARK PO BOX 9900 SIOUX CITY IA 5110238 40260005 AMERICAN ASSOCIATION FOR PO BOX 100877 FORT WORTH TX 7618538 40261005 BENEFIT PLAN ALTERNATIVES INC 7135 SYLVANIA AVE., BLDG 2C SYLVANIA OH 4356038 40263010 CHOICE BENEFITS ADMINISTRATORS PO BOX 5311 CINCINNATI OH 4520138 40267005 FIRST BENEFITS OF THE MIDWEST PO BOX 4310 AKRON OH 4432138 40268010 INTRACORP PREFERRED CARE PO BOX 17719 IRVINE CA 92713771938 40271005 PERSONAL CARE PLAN PO BOX 30004 DURHAM NC 27702300438 40271010 PERSONAL INSURANCE ADMINISTRATORSPO BOX 5004 THOUSAND OAKS CA 91359500438 40273005 SHAW MEDICAL CLAIMS CENTER PO BOX 10 DALTON GA 3072238 40274005 SOUTHEASTERN CA CONFERENCE PO BOX 8050 RIVERSIDE CA 0251538 40275010 MANAGEMED TPA PO BOX 17264 GREENVILLE SC 2960638 40276005 BMG ADMIN 10497 TOWN & COUNTRY WAY HOUSTON TX 7702438 40277005 COOK GROUP HEALTH PLAN PO BOX 489 BLOOMINGTON IN 4740238 40280005 MANAGING UNDERWRITERS INC PO BOX 1008 DELAWARE OH 4301538 40286005 JP FARLEY CORPORATION P.O. BOX 458022 WESTLAKE OH 441458022

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40287005 NYLACOR PO BOX 559005O AUSTIN TX 78755900538 40289005 ADMINISTRATIVE SOLUTIONS INC PO BOX 2547 NORCROSS GA 3009138 40291005 CONSULTEC PO BOX 2720 FARMINGTON HILL MI 4833338 40298005 SAVERS LIFE INSURANCE COMPANY PO BOX 11967 WINSTON SALEM NC 27116196738 40300005 ASSURECARE 13700 WATER TOWER CIRCLE PLYMOUTH MN 55441370538 40300010 ASSURECARE 4660 S HAGADORN ROAD EAST LANSING MI 4882338 40304005 DCA PHS AND AFFILIATES PO BOX 1489 STOW OH 44224048938 40305005 ASSURECARE OF IL 340 QUADRANGLE DRIVE BOLINGBROOK IL 60440344838 40306005 MAYO MANAGEMENT SERVICES INC 21 FIRST ST SW STE 401 ROCHESTER MN 5590238 40308005 BENEFIT CONCEPTS INC PO BOX 60608 KING OF PRUSSIA PA 1940638 40309005 GATES HEALTH CARE MANAGEMENT 5151 PFEIFFER ROAD CINCINNATI OH 45242485438 40312005 MEMPHIS LIGHT GAS & WATER PO BOX 430 MEMPHIS TN 3810138 40313005 MI BAPTIST BENEFIT PLAN PO BOX 956353 DULUTH GA 3013638 40316005 BALDOR MOTORS & DRIVES PO BOX 2400 FORT SMITH AR 72902240038 40317005 GILSBAR INC PO BOX 998 COVINGTON LA 7043438 40320005 CASI INC PO BOX 8244 SOUTH BEND IN 4666038 40322010 HEALTH STRATEGIES INC 2 PERIMETER PARK SOUTH BIRMINGHAM AL 3524338 40323005 MID-WEST NATIONAL INS CO OF TN PO BOX 982017 NORTE RICHLAND HILLS TX 76182801738 40324005 PENSIONED OPERATING ENGINEERS PO BOX 23980 OAKLAND CA 94623098038 40326005 USA HEALTH NETWORK PO BOX 163930 AUSTIN TX 7871638 40327005 EDSA PO BOX 1256 BALTIMORE MD 21203125638 40328005 AMIL INTERNATIONAL OF NV PO BOX 203698 AUSTIN TX 78720369838 40329005 PARAGON BENEFITS PO BOX 1526 DOUGLASVILLE GA 3013338 40330005 UNIFIED GROUP SERVICE PO BOX 10 PENDLETON IN 4606438 40331005 GROUP RESOURCES INC PO BOX 100043 DULUTH GA 30096934338 40332005 DAKOTA TRUCK UNDERWRITERS PO BOX 89310 SIOUX FALLS SD 57109100838 40333005 THE FUNDS PO BOX 389 ETHENY UT 84627036138 40335005 INSURANCE ADMINISTRATIVE SERVICES PO BOX 96 MINNEAPOLIS MN 55440000038 40335010 PCA HEALTH PLAN OF FL INC 6101 BLUE LAGOON DR MIAMI FL 3312638 40339005 OSF HEALTH PLANS PO BOX 1229 PEORIA IL 61654122938 40340005 AMERICAN COMMERCIAL LINE INC PO BOX 610 JEFFERSONVILLE IN 4713038 40342005 ADMINISTRATIVE SERVICES ONLY PO BOX 419325 KANSAS CITY MO 64141632538 40343005 HAGAN BENEFITS ADMINISTRATORS PO BOX 898 SIOUX FALLS SD 571010898

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40344005 ANCHOR BENEFIT CONSULTING INC PO BOX 945260 MAITLAND FL 32794526038 40345005 US HEALTH & LIFE INSURANCE CO PO BOX 1378 TROY MI 48099137838 40345010 AMERICAN FREIGHTWAYS INC PO BOX 840 HARRISON AR 72602084038 40346005 CONSOLIDATED BENEFITS INC 820 PARISH ST PITTSBURG PA 15220340538 40347005 CT NATIONAL LIFE PO BOX 1250 ROCKFORD IL 61105120538 40347010 CT NATIONAL LIFE PO BOX 3071 EVANSTON IL 6020438 40349005 BOON CHAPMAN BENEFIT ADMINISTR PO BOX 9201 AUSTIN TX 7876638 40352005 MIRAGE RESORTS EMPLOYEE HEALTH PO BOX 1180 LAS VEGAS NV 8912538 40354005 CUSTOM DESIGN BENEFIT PLAN 4373 HARRISON AVENUE CINCINNATI OH 45211332138 40356005 THE OLIGEAR COMPANY PO BOX 340414 MILWAUKEE WI 53234041438 40356010 IHC CARE PLUS PO BOX 11670 SALT LAKE CITY UT 84147067038 40356025 INTEGRATED BENEFIT SYSTEMS INC 1200 CHAMBERS RD STE 206 COLUMBUS OH 4321238 40356045 GE LIFE & ANNUITY ASSURANCE CO PO BOX 10821 CLEARWATER FL 33757882138 40359005 ROBINSON JULIENNE & BAILEY INC PO BOX 101 JACKSON MS 3920538 40361005 WILSON GREGORY AGENCY INC PO BOX 8 CAMP HILL PA 17001000838 40362005 MERIT BEHAVIORAL CARE PO BOX 2158 MARYLAND HEIGHT MO 6304338 40366005 ULTICARE INC PO BOX 321127 DETROIT MI 4821638 40367005 PROVIDENT AMERICAN LIFE PO BOX 679005 DALLAS TX 7536738 40368005 HEALTHCOMP ADMINISTRATORS PO BOX 45018 FRESNO CA 93718501838 40369010 PREFERRED ONE ADMINISTRATIVE SERVICESPO BOX 59212 MINNEAPOLIS MN 55459021238 40371010 JOHN HOPKINS EMPLOYER HEALTH PLANS111 MARKET PLACE BALTIMORE MD 2120238 40372005 NORTHWOOD INC 26834 LAWRENCE AVENUE CENTERLINE MI 4801538 40374005 BENICOMP INCORPORATED 8310 CLINTON PARK DRIVE FORT WAYNE IN 4682538 40375005 USI ADMINSTRATORS PO BOX 1909 DANBURY CT 06813190938 40375015 USI ADMINISTRATORS PO BOX 776 MELLVILLE NY 1174738 40376005 BRADFORD WHITE CORPORATION 200 LAFAYETTE STREET MIDDLEVILLE MI 4933338 40381005 PA EMPLOYEES BENEFIT TRUST FUND 150 S 43RD STEET SUITE 1 HARRISBURG PA 17111570038 40385005 SUPERIOR HEALTH SERVICES PO BOX 860 WOODRUFF WI 5456838 40387005 AON-SELECT INC PO BOX 81520 ROCHESTER MI 48308152038 40387010 AON SELECT INC PO BOX 2409 FLORENCE SC 2950338 40390005 LOOMIS COMPANY PO BOX 7011 WYOMISSING PA 19610601138 40391005 AMERICAN INSURANCE ADMINISTRATORS PO BOX 2348 COLUMBUS OH 43216234838 40392005 COVENANT ADMINISTRATORS INC PO BOX 105738 ATLANTA GA 303485738

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40393010 BENCHMARK HEALTH PO BOX 4158 ROCKFORD IL 61110065838 40393015 WESTPORT BENEFITS PO BOX 66743 ST LOUIS MO 6316638 40394005 SELECT BENEFIT ADMINISTRATORS PO BOX 440 ASHLAND WI 5480638 40395005 CHEROKEE INSURANCE CO PO BOX 159 WARREN MI 4809038 40396005 VIRGINIA MASON GROUP HEALTH ALLIANCEPO BOX 1207 SEATTLE WA 98111120738 40397005 AMERICAN SPECIAL RISK MANAGEMENT CORP509 S LENOLA RD BLDG 2 MOORESTOWN NJ 0805738 40398010 CORNERSTONE BENEFITS ADMINISTRATORS INCPO BOX 1007 ELKHART IN 4651538 40401010 BCI ADMINISTRATORS PO BOX 250878 WEST BLOOMFIELD MI 48325087838 40402020 SPECTERA INC 2811 LORD BALTIMORE DRIVE BALTIMORE MD 2124438 40402025 MVP HEALTH PLAN PO BOX 2207 SCHENECTADY NY 1230138 40402050 SPECTRUM RISK MANAGEMENT 6 EXECUTIVE DRIVE FAIRVIEW HTS IL 6220838 40403005 UNIVERSITY OF CHICAGO HEALTH PLAN 550 E BOUGHTON ROAD BOLLINGBROOK IL 6044038 40404005 FREEDOM LIFE 110 W 7TH STREET FORT WORTH TX 7610238 40406005 ERISA 12325 HYMEADOW AUSTIN TX 7875038 40406010 TML INTERGOVERNMENTAL EMPLOYEE BENEFITS POOLPO BOX 149140 AUSTIN TX 78714919038 40406015 INGLES MARKETS INCORPORATED PO BOX 15174 ASHEVILLE NC 28813017438 40406020 E-V BENEFITS MANAGEMENT INC PO BOX 29916 COLUMBUS OH 4322938 40406025 TN BEHAVIORAL HEALTH INC PO BOX 5260 COLUMBIA MD 21046526038 40407005 PRIDGEON & CLAY HEALTH TRUST 50 COTTAGE GROVE SW GRAND RAPIDS MI 4950738 40407010 HEALTH CHOICE AZ 1600 W BROADWAY - SUITE 260 TEMPE AZ 8528238 40408005 FL HEALTH ALLIANCE 701 PLYMOUTH AVENUE DELAND FL 3272038 40409005 EXTENDED HEALTH SERVICES PO BOX 1699 WINDSOR ONT N9A7G638 40410005 CONSOLIDATED BENEFIT RESOURCE PO BOX 581630 TULSA OK 7415838 40411205 E B A & M CORPORATION PO BOX 5079 WESTLAKE VILLAGE CA 91359507938 40411305 AMERICORPS PO BOX 33757 INDIANAPOLIS IN 4620338 40411405 COMMERCE BENEFIT GROUP PO BOX 900 ELYRIA OH 4403638 40411745 AMERICAS CHOICE HEALTHPLANS PO BOX 60432 KING OF PRUSSIA PA 1940638 40411805 AEBS 3481 CENTRAL PARKWAY SUITE 100CINCINNATI OH 4522338 40411845 AMERICAS CHOICE HEALTHPLANS PO BOX 60432 KING OF PRUSSIA PA 1940638 40411855 FIRST HEALTH PO BOX 10907 SCOTTSDALE AZ 85271090738 40411865 THIRD PARTY ADVANTAGE ADM INC PO BOX 742168 DALLAS TX 75374216838 40412205 PROVIDER BENEFIT PLANS INC PO BOX 346 SIMSONVILLE KY 40067034638 40412305 HFN EPO PO BOX 3428 OAKBROOK IL 60522

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

38 40412815 CATSKILL AREA SCHOOL EMPLOYEE BENEFIT PLANPO BOX 220 STANFORD NY 1216738 40413005 P5 ELECTRONIC HEALTH SERVICES PO BOX 9554 SALT LAKE CITY UT 8410938 40413105 MOUNTAIN STATES ADMINISTRATIVE PO BOX 32709 TUCSON AZ 85751270938 40413115 INTERNATIONAL MEDICAL GROUP IMG 407 FULTON ST INDIANAPOLIS IN 4620238 40413145 AMERICAN HEALTH CARE PARTNERSHIP 8105 GEORGIA ST MERRILLVILLE IN 4641038 40413155 SPECIALITY RISK INTERNATIONAL 92200 KEYSTONE CROSSING INDIANAPOLIS IN 4624638 40413165 EMPLOYEE BENEFIT CONSULTANTS 9275 N 49TH STREET MILWAUKEE WI 5322338 40413245 CARPENTERS HOSPITALIZATION PLAN 3611 CHESTER AVE CLEVELAND OH 4411438 40413255 FEDEX FREIGHT EAST INC PO BOX 5007 HARRISON AR 72602500738 40413265 ACCLAIM MEDICAL SERVICES 808 VARSITY DR TUPELO MS 3880138 40413315 SEARS LIFE INSURANCE CO PO BOX 475 NORTHBROOK IL 6006538 40413335 MCA ADMINISTRATORS 820 PARISH STREET PITTSBURGH PA 1522038 40413345 CIGNA HEALTHCARE PO BOX 188007 CHATTANOOGA TN 37422800738 40413365 ADVANTAGE DENTAL PLAN INC PO BOX 1328 ROSEBURG OR 9747038 40413405 OXFORD LIFE INSURANCE PO BOX 46518 MADISON WI 5374438 40413415 MEDICAL SAVINGS INSURANCE COMPANY 5835 WEST 74TH STREET INDIANAPOLIS IN 46278175738 40413425 US BENEFITS PO BOX 13190 PORTLAND OR 9721338 40413435 BENEFIT MANAGEMENT SYSTEM PO BOX 2058 MADISON MS 39130205838 40413465 PACIFIC SOURCE HEALTH PLANS PO BOX 7068 EUGENE OR 9740138 40413515 CIGNA HEALTHCARE PO BOX 5200 SCRANTON PA 1850538 40413525 SHEET METAL WORKERS LOCAL 20 PO BOX 42489 INDIANAPOLIS IN 4624238 40413535 BENEFIT MANAGEMENT COMPANY PO BOX 269000 WESTON FL 33326900038 40413545 STATE HEALTH BENEFIT PLAN PO BOX 38151 ATLANTA GA 3033438 40413645 MASTERS,MATES & PILOTS HEALTH & BENEFIT PLAN5700 HAMMONDS FERRY ROAD LINTHICUM HEIGHTS MD 21090199638 40413665 CYPRESS BENEFIT ADMINISTRATORS PO BOX 7020 APPLETON WI 5491238 40413755 FISERV HEALTH OF TN PO BOX 305154 NASHVILLE TN 3723038 40413825 S&S HEALTHCARE STRATEGY PO BOX 14407 CINCINNATI OH 4525038 40413845 DAN R WAGNON & ASSOC 3825 N 24TH ST PHOENIX AZ 8501638 40413855 EMPLOYERS MUTUAL INC PO BOX 40846 JACKSONVILLE FL 32203084638 40413945 HARRINGTON BENEFIT SERVICES PO BOX 730 PUEBLO CO 8100238 40413955 WALGREENS HEALTH INITIATIVES PO BOX 545 DEERFIELD IL 6001538 40441805 AEBS 3481 CENTRAL PARKWAY SUITE 100CINCINNATI OH 4522338 44112405 EHIM 24700 W 12 MILE RD SOUTHFIELD MI 48034

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

39 15166005 FIRST HEALTH PO BOX 2700 CORAOPOLIS PA 1510839 21163015 FIRST HEALTH 2222 EWING RD MON TWP PA 15108329839 21163025 FIRST HEALTH PO BOX 23806 TUSCON AZ 8573439 21163030 FIRST HEALTH PO BOX 2900 CORAOPOLIS PA 1510839 21163035 FIRST HEALTH PO BOX 11900 CORAOPOLIS PA 1510839 21163055 FIRST HEALTH PO BOX 26199 MILWAUKEE WI 5322639 21163070 FIRST HEALTH PO BOX 945030 MAITLAND FL 32794539239 21163075 FIRST HEALTH PO BOX 450450 ATLANTA GA 30345045039 21163080 FIRST HEALTH PO BOX 535935 PITTSBURG PA 15253593539 21163085 FIRST HEALTH 2514 S 102ND ST STE 250 WEST ALLIS WI 53227214239 21163090 FIRST HEALTH 6975 UN PARK CTR STE 600 MIDVALE UT 8404739 21163095 FIRST HEALTH PO BOX 9500 COROAPOLIS PA 1510839 21163100 FIRST HEALTH PO BOX 54170 LOS ANGELES CA 9005439 21163115 FIRST HEALTH PO BOX 671208 HOUSTON TX 77267120839 21163130 FIRST HEALTH PO BOX 8093 LONDON KY 40742809339 21163160 FIRST HEALTH PO BOX 11925 COROAPOLIS PA 1510839 21163165 FIRST HEALTH PO BOX 535935 PITTSBURGH PA 1525339 21163175 FIRST HEALTH BOX R BENTONVILLE AR 72716808639 21163185 FIRST HEALTH 100 S CHARLES BALTIMORE MD 21201276239 21163190 FIRST HEALTH PO BOX 104360 JEFFERSON CITY MO 6511039 21163200 FIRST HEALTH 3033 E FIRST AVE STE 810 DENVER CO 8020639 21163215 FIRST HEALTH ALLIANCE PO BOX 44365 MADISON WI 53744436539 21163220 FIRST HEALTH PO BOX 8507 LONDON KY 40742850239 21163225 FIRST HEALTH PO BOX 23070 TUCSON AZ 8573441 00261005 AMERICAN POSTAL WORKERS PO BOX 3279 SILVER SPRINGS MD 2091841 11541005 NALC HEALTH BENEFIT PLAN 20547 WAVERLY CT ASHBURN VA 2209341 11748005 POSTMASTERS BENEFIT PLAN 1019 N ROYAL ST ALEXANDRIA VA 2231441 13760005 GOVERNMENT EMPLOYEES HOSP ASSO PO BOX 4665 INDEPENDENCE MO 64051466541 13789005 MAIL HANDLERS BENEFIT PLAN PO BOX 45118 JACKONSVILLE FL 32232511842 29215010 ACTIVA BENEFIT 2905 LUCERNE DR GRAND RAPIDS MI 4954643 20237005 WEYCO INC PO BOX 30132 LANSING MI 4890944 01886005 TRUSTMARK PO BOX 1467 SOUTH BEND IN 4662444 01886010 TRUSTMARK PO BOX 9055 BOARDMAN OH 445139055

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

44 01886015 TRUSTMARK PO BOX 7900 LAKE FOREST IL 60045790045 27040005 PRINCIPAL LIFE INSURANCE CO PO BOX 10826 CLEARWATER FL 33757882645 30935005 PRINCIPAL FINANCIAL GROUP PO BOX 39710 COLORADO SPRINGS CO 80949391045 30935010 PRINCIPAL FINANCIAL GROUP PO BOX 781320 INDIANAPOLIS IN 4626847 10580005 CENTRAL STATES SE SW TEAMSTERS PO BOX 5103 DES PLAINES IL 60017510347 30917005 CENTRAL STATES PO BOX 5116 DES PLAINES IL 60017511647 30918005 CENTRAL STEEL & WIRE COMPANY PO BOX 5100 CHICAGO IL 60632219848 09561005 UNITED AMERICAN INSURANCE CO PO BOX 26400 OKLAHOMA CITY OK 73126980948 09561010 UNITED AMERICAN INSURANCE CO PO BOX 8080 MCKINNEY TX 75070808049 23408005 JFP BENEFIT MANAGEMENT 100 S JACKSON STREET JACKSON MI 49201225253 12084005 UNITED FURNITURE WORKERS 1910 AIR LANE DRIVE NASHVILLE TN 3721054 06434005 MUTUAL PROTECTIVE MEDICO LIFE 1515 SOUTH 75TH STREET OMAHA NE 68124161855 15578005 EMPLOYEE BENEFITS CLAIMS OF WI 9275 N 49TH ST STE 300 MILWAUKEE WI 5322355 19245005 EMPLOYEE BENEFIT CONCEPTS INC PO BOX 2365 FARMINGTON HILL MI 48333236555 24521005 EMPLOYERS HEALTH INSURANCE PO BOX 14610 LEXINGTON KY 40512461055 24764005 EMPLOYEE BENEFITS INC PO BOX 438 GRAND BLANC MI 4843955 27274005 EBP HEALTH PLANS STE BLDG 4 CORAOPOLIS PA 15108277355 30039005 EMPLOYEE BENEFIT MANAGEMENT 4789 RINGS DUBLIN OH 4301755 30301005 EMPLOYEE BENEFITS TRUST PO BOX 8788 WILMINGTON DE 1989955 30717010 EBP HEALTH PLANS 435 FORD ROAD MINNEAPOLIS MN 55426490855 30816005 EMPLOYEE PLANS INC LLC 3811 ILLINOIS ROAD FORT WAYNE IN 4680155 30839010 EMPLOYEE BENEFIT STRATEGIES 229 E MICHIGAN AVENUE KALAMAZOO MI 4900756 29569005 STRATEGIC RESOURCE COMPANY PO BOX 23759 COLUMBIA SC 29224375957 12852005 STATE FARM INSURANCE 1440 GRANVILLE ROAD NEWARK OH 4305557 26428005 STATE FARM INSURANCE PO BOX 2978 CLINTON IA 52733297858 23275005 GROUP HEALTH MANAGERS INC 26205 FIVE MILE RD REDFORD MI 4823959 12807015 PIONEER LIFE INSURANCE CO OF IL PO BOX 5151 JANESVILLE WI 53547515162 02346005 HUMANA EMPLOYERS HEALTH INSURANCEPO BOX 14610 LEXINGTON KY 40512461062 03773005 HUMANA EMPLOYERS HEALTH PO BOX 14610 LEXINGTON KY 40512461062 11784005 HUMANA INSURANCE CLAIM CENTER P O BOX 14601 LEXINGTON KY 4051162 40156005 HUMANA HEALTH CARE PLAN INC 8119 DATAPOINT SAN ANTONIO TX 7822963 30805005 PRESIDIUM INC PO BOX 24110 OKLAHOMA CITY OK 7312464 00225005 MI UNITED FOOD & COMMERCIAL 876 HORACE BROWN DR MADISON HEIGHTS MI 48071

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

64 26221005 UFCW UNIONS & EMPLOYERS 4150 E MAIN ST COLUMBUS OH 4321364 26259005 UNITED FOOD & COMMERCIAL WKRS 621 TRAIL DRIVE NAPOLEON OH 4354564 26562005 UNITED FOOD & COMMERCIAL WRKS 2001 N MAYFAIR RD MILWAUKEE WI 5322664 30599005 IN AREA UNITED FOOD AND PO BOX 42669 INDIANAPOLIS IN 46242066964 30834005 UFCW IN AREA 2601 FORTUNE CIRCLE E 103 A INDIANAPOLIS IN 4624164 40041005 UNITED FOOD & COMMERCIAL TRUST P O BOX 6010 CYPRESS CA 90630001064 40064005 CUB UFCW THE 1800 PHOENIX BLVD ATLANTA GA 3034964 40069005 UNITED FOOD & COMMERCIAL WKRS 1649 W ADAMS STREET CHICAGO IL 6061264 40386005 WI UFCW UNIONS & EMPLOYERS HEALTH PLAN2001 N MAYFAIR ROAD MILWAUKEE WI 5322665 11461005 MID AMERICA ASSOCIATES 30775 BARRINGTON AVE MADISON HEIGHTS MI 4807166 18589005 ADMINISTRATION SYSTEM RESEARCH PO BOX 6392 GRAND RAPIDS MI 49516639267 00136005 MI LABORERS H & W FUND 6525 CENTURION DRIVE LANSING MI 4891767 05114010 IA LABORERS DISTRICT COUNCIL 5806 MEREDITH DRIVE DES MOINES IA 5032267 10393005 AFGE HEALTH & WELFARE 80 F STREET, NW WASHINGTON DC 2000167 10455005 ACTWU INS FUND - SECONDARY 1550 HOWARD DETROIT MI 4821667 10544005 BOILERMAKERS NATIONAL H&W FUND 754 MINNESOTA AVENUE KANSAS CITY KS 66101276667 11111005 IRONWORKERS LOCAL 25 P.O. BOX 8006 NOVI MI 48376800667 11120005 IRONWORKERS LOCAL 340 510 E COLUMBIA BATTLE CREEK MI 4901567 11238005 LINE CONSTRUCTION BENEFIT FUND 2000 SPRINGER DR. LOMBARD IL 60148991267 11265005 AMERICAN MARITIME OFFICERS PO BOX 35 DANIA FL 33004003567 11443005 MI RETAILERS GROUP INS 221 N PINE ST LANSING MI 4893367 11505005 DETROIT MILLMENS LOC 1045 H&W 2075 W BIG BEAVER ROAD TROY MI 48084344667 11514005 MILLWRIGHTS LOCAL1102 H&W FUND 6525 CENTURION DRIVE LANSING MI 48917927567 11695005 PAINTERS UNION INSURANCE 26877 NORTHWESTERN HWY SOUTHFIELD MI 4803467 11775005 PLUMBERS & STEAMFITTERS 2320 WASHTENAW AVENUE ANN ARBOR MI 4810467 11882005 SEAFARERS WELFARE PLAN 5201 AUTHWAY CAMP SPRINGS MD 2074667 11917010 SHEET METAL WKRS LOCAL 292 PO BOX 1559 TROY MI 4809967 11926005 SHEET METAL WKRS LOCAL 360 P O BOX 1449 GOOLETTSVILLE TN 37070144967 11980005 UNION CONSTRUCTION WORKERS HEALTH PLANPO BOX 697 TOLEDO OH 43697069767 12001005 TOLEDO PLUMBERS AND PIPEFITTER 5050 BENNETT RD TOLEDO OH 4361267 12146005 UP PLUMBERS & PIPEFITTERS 6525 CENTURION LANSING MI 48917927567 12360005 LABORERS METRO DETROIT H & W 6525 CENTURION DRIVE LANSING MI 4891767 12745005 MIDWEST OPER ENG WELFARE FUND 6150 JOLIET RD COUNTRYSIDE IL 60525

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

67 13475005 TOLEDO ELECTRICAL WELFARE FUND PO BOX 60408 ROSSFORD OH 4346067 13706005 DETROIT VICINITY TRWL TRADES 2075 W BIG BEAVER RD TROY MI 4808467 13724005 MI REGIONAL COUNCIL OF CARPENTERS 2075 W BIG BEAVER ROAD TROY MI 48084344667 13798005 ASBESTOS WORKERS OF AMERICA 30700 TELEGRAPH STE 4601 BINGHAM FARM MI 4802567 14015005 RESILIENT FRINGE BENEFIT FUNDS 2075 W BIG BEAVER RD TROY MI 48084344667 14113005 ROOFERS INS FUND PO BOX 3039 BIRMINGHAM MI 48012303967 14211005 IN ST COUNCIL LABORS & HOD CAR PO BOX 1587 TERRE HAUTE IN 4780867 16083005 CARPENTERS WELFARE OF TX PO BOX 26166 HOUSTON TX 7720767 16172005 APAC HEALTH & WELFARE TRUST PO BOX 548 UPLAND IN 4698967 16735005 CO LABORERS H&W FUND 7000 N BROADWAY, BLDG 3 DENVER CO 80221290767 16913005 AMALGAMATED LIFE INS CO PO BOX 1435 NEW YORK NY 10116143567 17198005 PIPELINE INDUSTRS BENEFIT FUND 4845 S 83RD EAST AVENUE TULSA OK 74147095067 18201005 OH OPERATING ENG H&W PLAN PO BOX 12009 COLUMBUS OH 43212000967 18533005 ELECTRICAL INSURANCE TRUSTEES 228 N LASALLE ST CHICAGO IL 6060167 18776005 CA IRONWORKERS 131 N ELMOLINO AVE #330 PASADENA CA 9110167 19263005 IBEW LOCAL 640 4725 N. 19TH AVENUE, SUITE 1 PHOENIX AZ 8501567 19263010 IBEW LOCAL UNION 903 HEALTH & PO BOX 66745 MOBILE AL 3666067 19263015 IBEW LOCAL UNION 508 EASTERN DIVISION85 BAGBY DRIVE SUITE 216 BIRMINGHAM AL 3520967 19773005 SHEET METAL WKRS LOCAL 7 ZONE1 PO BOX 2141 MONROE MI 4816167 20415005 IRONWORKERS WELFARE TRUST MPO BOX 398 DAYTON OH 4540167 20961005 OH CONFERENCE OF PLASTERERS & CEMENT MASONSPO BOX 230 NILES OH 4444667 21047005 ELECTRICAL WORKERS H & W FUND 3135 S STATE STREET ANN ARBOR MI 4810467 21468005 NATIONAL ASBESTOS WORKER MED 8401 CORPORATE DRIVE LANDOVER MD 2078567 21851005 MONROE PLUMBERS & PIPEFITTERS PO BOX 2766 ANN ARBOR MI 4810667 22204005 UNITED CONSTRUCTION WKR INS PO BOX 65 ZEELAND MI 4946467 22661005 ASBESTOS WORKERS LOCAL 47 6525 CENTURION DRIVE LANSING MI 48917927567 24245010 ROOFERS LOCAL 70 HEALTH 2075 W BIG BEAVER RD TROY MI 4808467 24245015 ROOFERS LOCAL 74 HEALTH & WELFARE FUND1560 HARLEM ROAD - SUITE 4 BUFFALO NY 1420667 25215005 SHEET METAL WKRS VA 601 NORTH FAIRFAX STREET ALEXANDREA VA 2231467 25547005 IRONWORKERS LOCAL 17 1564 EAST 23RD STREET CLEVELAND OH 44114429067 25547010 IRON WORKERS LOCAL 8 WELFARE FUND 2100 N MAYFAIR RD SUITE 100 MILWAUKEE WI 5322667 25574005 TEAMSTERS UNION LOCAL 7 PO BOX 2047 KALAMAZOO MI 49003204767 26132005 MI LUMBER & BUILDING PO BOX 27095 LANSING MI 48909

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

67 26938010 BEVERAGE INDUSTRY LOCAL 733 300 S ASHLAND AVENUE CHICAGO IL 6060767 27516005 WI LABORERS HEALTH 2801 COHO STREET MADISON WI 53713451367 27642005 IRONWORKERS FRINGE BEN LOC 16 6229 N CHARLES BALTIMORE MD 2121267 27867005 WI SHEET METAL WORKERS FUND PO BOX 259628 MADISON WI 53725962867 27966005 MILWAUKEE PAINTERS LOCAL 781 633 S HAWLEY ROAD MILWAUKEE WI 5321467 28066010 CHICAGO PLASTERING HEALTH & WELFARE TRUST6547 N AVONDALE - SUITE 202 CHICAGO IL 6063167 28241005 CARPENTERS H & W TRUST FUND CA PO BOX 3010 CONCORD CA 9452267 28323005 IBEW LOCAL 17 SUITE 700 TROY MI 48084344667 28324005 IBEW 117 6525 CENTURION DRIVE LANSING MI 48917927567 28450005 CT PIPE TRADES H FUND/LOC 777 210 MAIN STREET MANCHESTER CT 06040355267 28750005 ASSOCIATION PLAN ADMINISTRATOR 2858 W. MARKET AKRON OH 4431367 28937005 MN LABORERS H & W FUND 7645 METRO BLVD MINNEAPOLIS MN 55439306067 29658005 IRONWORKERS LOCAL 395 TRUST 2111 W LINCOLN HWY MERRILLVILLE IN 4641067 30020005 STEWART C MILLER & CO INC 2111 W LINCOLN HWY MERRILLVILLE IN 4641067 30050005 MILWAUKEE CARPENTERS DISTRICT 3020 W VLIET MILWAUKEE WI 5320867 30407005 IBEW LOCAL 252 FRINGE FUNDS 3135 S STATE STREET ANN ARBOR MI 4810467 30526005 CARPENTERS LOCAL UNION 704 3101 ALLIED DR JACKSON MI 4920167 30554005 CARPENTERS H & W OF S CA PO BOX 76827 LOS ANGELES CA 9007667 30580005 MICHIANA AREA ELECTRICAL WORKERS 6525 CENTURION DRIVE LANSING MI 48917927567 30713010 PLUMBERS & PIPEFITTERS LOCAL 172 2111 W LINCOLN HIGHWAY MERRILLVILLE IN 4641067 30713015 WEST MI PLUMBERS FITTERS & SERVICE TRADES2111 W LINCOLN HIGHWAY MERRILLVILLE IN 4641067 30721005 OPERATING ENGINEERS LOCAL 2 2929 S JEFFERSON ST LOUIS MO 6311867 30721010 OPERATING ENGINEERS 7370 CHEF MENTUR HWY NEW ORLEANS LA 7012667 30721020 OPERATING ENGINEERS LOCAL 139 PO BOX 160 PEWAUKEE WI 53072016067 30790005 THREE RIVERS CONSTRUCTION 2700 EASTMAN ROAD MIDLAND MI 4864067 30823005 OH CARPENTERS H & W FUND WARREN RD SUITE 240 NILES OH 4444667 30883005 WI CARPENTERS HEALTH PO BOX 4002 EAU CLAIRE WI 5470267 30900005 CHICAGO CARPENTERS H & W 12 EAST ERIE STREET CHICAGO IL 6061167 30981005 OUTSIDE ELECTRICAL WELF FUND PO BOX 2967 HUNTINGTON WV 25729296767 40056005 PLUMBERS LOCAL UNION 93 H & W 100 LEBARRON STREET WAUKEGON IL 6008567 40056010 PLUMBERS & PIPEFITTERS LOCAL #9 PO BOX 1028 TRENTON NJ 08628023067 40090005 CARPENTERS HEALTH & WELFARE PO BOX 61320 LAS VEGAS NV 8916067 40096010 LOCAL UNIONS 19 & 127 H & W 11270 W PARK PLACE MILWAUKEE WI 53224

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

67 40142005 COMBINED ADMINISTRATIVE SERV PO BOX 4539 DALTON GA 3072167 40165005 MOTION PICTURE H & W PO BOX 1118 STUDIO CITY CA 9160467 40246005 AUTOMOBILE MECHANICS LOCAL 701 133 S ASHLAND AVENUE CHICAGO IL 6060767 40256005 STEAMFITTERS LOCAL UNION 464 1941 S 42ND ST SUITE 23 OMAHA NE 68105298567 40269005 MINNEAPOLIS MEAT CUTTERS & 6600 FRANCE AVE SOUTH EDINA MN 5543567 40307005 NM PIPE TRADES H & W TRUST 4316 CARLISLE NE ALBUQUERQUE NM 8710767 40337005 GRAPHIC COMMUNICATIONS NATIONA 5 GATEWAY CTR, SUITE 620 PITTSBURGH PA 1522267 40338005 BENESYS 2075 W BIG BEAVER TROY MI 4808467 40338010 ABATEMENT WORKERS NATIONAL 2075 W BIG BEAVER TROY MI 48084344667 40356015 UT LABORERS TRUST FUNDS 2156 WEST 2200 SOUTH SALT LAKE CITY UT 8411968 11087005 IBA HEALTH AND LIFE ASSURANCE PO BOX 51100 KALAMAZOO MI 4900568 29995005 SELF FUNDED PLANS INC 1432 HAMILTON AVE CLEVELAND OH 4411468 29995010 SELF FUNDED PLANS INC 1797 W STATE ST SUITE B GENEVA IL 6013468 30537005 IBA SELF FUNDED GROUP PO BOX 51719 KALAMAZOO MI 49005171968 30537010 SELF FUNDING ADMINISTRATORS IN PO BOX 6596 ANNAPOLIS IN 2140169 06407005 FORTIS INSURANCE CO PO BOX 624 MILWAUKEE WI 6414169 06407020 FORTIS SELF FUNDED PO BOX 2043 HOPKINS MN 55343304369 06407030 FORTIS BENEFITS INSURANCE CO 6600 FRANCE AVE S SUITE 300 MINNEAPOLIS MN 55435189569 06407035 FORTIS BENEFITS INSURANCE CO PO BOX 2940 CLINTON IA 5273369 40325005 FORTIS BENEFITS INSURANCE CO 501 W MICHIGAN MILWAUKEE WI 53201319570 10992005 GROUP MARKETING SERVICE PO BOX 19040 KALAMAZOO MI 4901971 23186005 UNITED MEDICAL RESOURCES INC PO BOX 145804 CINCINNATI OH 45250580472 26769005 CORPORATE BENEFIT SERVICES OF AMERICA10159 WAYZATA BLVD MINNETONKA MN 5530573 18453005 SECUREONE BENEFIT ADMIN INC PO BOX 2145 GRAND RAPIDS MI 4950474 00216005 SET SEG INC 415 WEST KALAMAZOO ST LANSING MI 4893375 18749005 CLAIM MANAGEMENT SERVICES INC PO BOX 10888 GREEN BAY WI 5430776 12010005 CAMBRIDGE 2600 HORIZON SE GRAND RAPIDS MI 4950176 27948005 CORESOURCE PO BOX 168 MATTESON IL 6044376 28102005 CORESOURCE PO 6179 WESTERVILLE OH 43086611876 29104005 CORESOURCE 6100 FAIRVIEW STE 1000 CHARLOTTE NC 2821076 30406005 CORESOURCE PO BOX 879 ANDERSON IN 4601576 30753005 CAMBRIDGE PO BOX 365 PARSIPPANY NJ 0705476 40119005 CORESOURCE PO BOX 6118 WESTERVILLE OH 430816118

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

76 40119010 CORESOURCE 4940 CAMPBELL BLVD BALTIMORE MD 2123676 40119015 CORESOURCE PO BOX 83301 LANCASTER PA 17609330276 40119020 CORESOURCE 419 E MAIN SUITE 2 MIDDLETON NY 1094076 40119040 CORESOURCE 4220 SHAWNEE MISSION PARKWAYSHAWNEE MISSION KS 6620579 04485005 GUARDIAN PO BOX 8007 APPLETON WI 54913800779 30841005 GUARDIAN PO BOX 26200 LEHIGH VALLEY PA 18002602579 30842005 GUARDIAN PO BOX 9128 NORWELL MA 02061912879 30844005 GUARDIAN PO BOX 2457 SPOKANE WA 99210245783 00181110 CT GENERAL LIFE PO BOX 2305 SOUTHFIELD MI 4803783 00252010 PTNA LIFE INSURANCE COMPANY PO BOX 7066 ALLENTOWN PA 18105706683 00341035 CNA OF TN PO BOX 305005 NASHVILLE TN 37230500583 00421105 MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 6817583 11449010 GREAT REPUBLIC LIFE INSURANCE 226 SECOND AVENUE WEST SEATTLE WA 98119422183 12843005 STANDARD LIFE/ACCIDENT INS CO PO BOX 1800 GALVESTON TX 77553180083 40356020 GE LIFE & ANNUITY ASSURANCE CO PO BOX 8021 SAN RAFAEL CA 94912802184 00421020 MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 6817584 00969005 AFLAC - WORLDWIDE HEADQUARTERS 1932 WYNNTON ROAD COLUMBUS GA 31999725184 00969015 AARP PO BOX 740819 ATLANTA GA 30374081984 01124010 AMERICAN INCOME LIFE PO BOX 2608 WACO TX 7679784 05150005 STONEBRIDGE LIFE INS CO 2700 WEST PLANO PARKWAY PLANO TX 7507584 19209005 WA NATIONAL INSURANCE 500 VIRGINIA DRIVE FORT WASHINGTON PA 1903484 21181010 BANKERS LIFE AND CASUALTY CO 222 MERCHANDISE MART PLAZA CHICAGO IL 60654200184 22723005 CIGNA HEALTHCARE PO BOX 10367 DES MOINES IA 50306036784 40167005 US LETTER CARRIERS MUTUAL 100 INDIANA AVE NW #510 WASHINGTON DC 2000184 40412085 MID AMERICA PO BOX 71507 MADISON HEIGHTS MI 4807184 40413355 PHYSICIANS MUTUAL PO BOX 2018 OMAHA NE 68103201886 00163030 METROPOLITAN LIFE INS 1925 ENTERPRISE PKWY TWINSBURG OH 44087220786 13662010 CO-OP OPTICAL 18193 8 MILE ROAD EAST DETROIT MI 4822586 13671010 VISION SERVICE PLAN PO BOX 997105 SACRAMENTO CA 95899710586 14679010 BC BS OF MI-VISION 600 LAFAYETTE DETROIT MI 4822686 18079010 COLE VISION 1925 ENTERPRISE PARKWAY TWINSBURG OH 4423686 19835005 STERLING VISION SHOPS INC PO BOX 464 MT CLEMENS MI 48046046486 23382005 PROVANTAGE VISION PLAN PO BOX 1662 WAUKESHA WI 53187

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

86 28383005 MUTUAL EYE CLAIM AUDITS INC PO BOX 17190 INDIANAPOLIS IN 4621786 30007010 DAVIS VISION PO BOX 2270 SCHENETADY NY 1230186 30200005 HEALTH APPLICATIONS NETWORK 4660 S HAGADORN RD EAST LANSING MI 48823535386 30564005 VISION CARE ADMINISTRATORS PO BOX 1822 LAPORTE IN 4635086 30915005 AVESIS VISION SERVICES 4201 N 24TH ST, STE 300 PHOENIX AZ 8506086 40009010 SUPERIOR VISION SERVICES INC PO BOX 967 RANCHO CORDOVA CA 9574186 40220005 HERITAGE OPTICAL 19010 LIVERNOIS DETROIT MI 4822186 40358005 PROTECTIVE VISION PLAN 1200 N ARLINGTON HEIGHTS ITASCA IL 6014386 40401015 EYECARE PLAN OF AMERICA PO BOX 51810 PHOENIX AZ 85076181086 40401020 EYEMED VISION CARE PO BOX 429491 CINCINNATI OH 45242949186 40412825 VISION ADVANTAGE 1700 S PARK KALAMAZOO MI 4900187 00029020 BC BS OF MI-PHARMACY 600 LAFAYETTE DETROIT MI 4822687 00566065 AETNA US HEALTHCARE RX MANAGEMENTPO BOX 398106 MINNEAPOLIS MN 5543987 04879005 IMMEDIATE PHARMACEUTICAL SERVICE PO BOX 33400 CLEVELAND OH 4413387 11541010 NALC PRESCRIPTION DRUG PROGRAM PO BOX 686005 SAN ANTONIO TX 78268600587 12164010 WHP 2275 HALF DAY RD BANNOCKBURN IL 6001587 13967005 PCS HEALTH SYSTEMS PO BOX 52116 PHOENIX AZ 85072211687 13967010 PCS HEALTH SYSTEMS PO BOX 52116 PHOENIX AZ 85072211687 17269005 MEDCO HEALTH PO BOX 247 LEES SUMMIT MO 6406387 19067010 AMERISCRIPT 4301 DARROW ROAD STOW OH 4422487 21163005 FIRST HEALTH RX PO BOX 85042 RICHMOND VA 23261504287 28959005 NATIONAL PRESCRIPTION ADMIN 711 RICHDALE AVENUE EAST HANOVER NJ 0793687 29769010 ANTHEM PRESCRIPTION MANAGEMENT PO BOX 145433 CINCINNATI OH 45250543387 30527005 PHARMACARE GROUP SALES DIVISION 24370 NORTHWESTERN HWY SOUTHFIELD MI 48075253387 30542010 INTERCHANGE PMP 2448 EAST 81ST TULSA OK 7413787 30547005 CAREMARK PO BOX 686005 SAN ANTONIO TX 78268600587 30550010 PHARMACEUTICAL CARE NETWORK 9343 TECH CENTER DRIVE SACRAMENTO CA 95826259287 30576005 PRESCRIPTION SOLUTIONS 3515 HARBOR BLVD COSTA MESA CA 9262687 30588005 WAUSAU PHARMACY BENEFITS PO BOX 8046 WAUSAU WI 54402804687 30592020 EXPRESS SCRIPTS PO BOX 390873 BLOOMINGTON MN 55439087387 30763005 BORGESS HUMAN RESOURCES 1521 GULL ROAD KALAMAZOO MI 4904887 30766010 PHARMACY NETWORK 4020 WAKE FOREST ROAD RALIEGH NC 2760987 30851005 PREMIER PHARMACY PLAN PO BOX 5824 SPARTANBURG SC 29304

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

87 30897005 RESTAT DRUG PROGRAM PO BOX 758 WEST BEND WI 53095075887 30902010 ADVANCE PCS PO BOX 52116 PHOENIX AZ 85072211687 40033005 SERVE YOU CUSTOM RX MGMT PO BOX 240034 MILWAUKEE WI 53224900287 40073005 ARGUS HEALTH SYSTEMS 1300 WASHINGTON KANSAS CITY MO 6414187 40084005 RX PRIME/CIGNA PHARMACY SERVICES P O BOX 3598 SCRANTON PA 18505059887 40084020 RX AMERICA 369 BILLY MITCHELL ROAD SALT LAKE CITY UT 8411687 40084025 RX WEST PO BOX 4517 ENGLEWOOD CO 80155451787 40086010 SCRIPT CARE 87 IH 10 N BEAUMONT TX 7770787 40086015 SCRIPTGUIDE 3990 W TWELVE MILE RD #224 BERKLEY MI 4807287 40099010 PHARMACARE 695 GEORGE WASHINGTON HWY LINCOLN RI 0286587 40157010 TDI MANAGED CARE SERVICES INC 620 EPSILON DRIVE PITTSBURGH PA 1523887 40162005 DRUG CARD INCORPORATED 55 SHUMAN BLVD NAPERVILLE IL 6056387 40174005 EB RX INC 2045 MIDWAY DRIVE TWINSBURG OH 4408787 40191010 EMPLOYEE HEALTH INS MANAGEMENT 24700 W 12 MILE ROAD SOUTHFIELD MI 4803487 40214005 SCRIPT SOLUTIONS 33 NORTH ROAD WAKEFIELD RI 0287987 40225005 PHARMACY GOLD INC PO BOX 64812 ST PAUL MN 5516487 40225010 GOLDNET PO BOX 64338 ST PAUL MN 5516487 40248005 CURA SCRIPTS 7101 T P C DRIVE, SUITE 150 ORLANDO FL 3282287 40249005 GENERAL PRESCRIPTION PROGRAMS INC 305 MADDISON AVE STE 1166B NEW YORK NY 1016587 40255010 QUAD MED PHARMACY W224 N3322 DUPLAINVILLE PEWAUKEE WI 5370287 40257005 WELLPOINT PHARMACY MANAGEMENT PO BOX 9085 OXNARD CA 93031908587 40259005 MEDIMPACT 10680 TREENA STREET SAN DIEGO CA 9213187 40294005 FFI RX MANAGED CARE INC 8536 CROW DRIVE SUITE 105 MACEDONIA OH 4405687 40297005 NMHC PO BOX 23007 LITTLE ROCK AR 72221300787 40321005 BENESCRIPT SERVICES INC PO BOX 921229 NORCROSS GA 30010122987 40351005 INTEQ 5445 LA SIERRA DRIVE DALLAS TX 7523187 40360005 UNITED PROVIDER SERVICES PO BOX 820277 FORT WORTH TX 7618287 40375010 USI RX 675 FOXON ROAD EAST HAVEN CT 0651387 40380005 SAV-RX 224 NORTH PARK AVUNUE FREMONT NE 6802587 40384005 TOTAL SCRIPTS 851 S RAMPART AVENUE LAS VEGAS NV 8914587 40391015 PROCARE NOVA SCRIPTS 3090 PREMIER PARKWAY DULUTH GA 3009787 40402015 NATIONAL MEDICAL HEALTH CARD SYSTEMSPO BOX 1170 PORT WASHINGTON NY 1105087 40413835 CATALYST RX 9525 HILLWOOD DRIVE LAS VEGAS NV 89134

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

87 99999999 CARRIER IDENTIFIED BY PHARMACY TEST STREET TEST CITY WI 99999999988 00056005 AETNA US HEALTHCARE PO BOX 353 GRAND RAPIDS MI 49501035388 00056190 AETNA US HEALTHCARE PO BOX 14094 LEXINGTON KY 40512409488 00056210 AETNA US HEALTHCARE DMO PO BOX 44259 JACKSONVILLE FL 3223188 00056215 AETNA US HEALTHCARE DMO PO BOX 15250 ALBANY NY 1221288 00083080 PRUDENTIAL INSURANCE COMPANY PO BOX 15077 ALBANY NY 1221288 00083115 PRUDENTIAL DMO PO BOX 725089 ATLANTA GA 3113988 00163015 METROPOLITAN LIFE INS 177 S COMMONS DR AURORA IL 6050788 00163020 METROPOLITAN LIFE INS PO BOX 14093 LEXINGTON KY 40512409388 00172050 CIGNA DENTAL HEALTH PO BOX 189060 PLANTATION FL 33318906088 00172060 CIGNA DENTAL HMO PO BOX 2125 GLENDALE CA 9120988 00181030 CT GENERAL LIFE PO BOX 183 SOUTHFIELD MI 4807588 00181035 CT GENERAL LIFE PO BOX 9013 SHERMAN TX 7509188 00181065 CIGNA DENTAL PPO PO BOX 5072 VISALIA CA 9327888 00190040 UNICARE/JOHN HANCOCK PO BOX 9178 OXNARD CA 93031917888 00216010 SET SEG INC 415 W KALAMAZOO STREET LANSING MI 4893388 00969010 AFLAC 1932 WYNNTON ROAD COLUMBUS GA 31999725488 03085010 DELTA DENTAL PLAN OF MI PO BOX 9085 FARMINGTON HILLS MI 48333908588 03085015 DELTA DENTAL PLAN OF AZ PO BOX 43000 PHOENIX AZ 85080300088 03085020 DELTA DENTAL PLAN OF GA 3405 PIEDMONT RD NE ATLANTA GA 3030588 03085025 DELTA DENTAL PLAN OF NC 333 SIX FORKS ROAD RALEIGH NC 2760988 03085030 DELTA DENTAL PLAN OF CO PO BOX 173803 DENVER CO 80217380388 03085035 DELTA DENTAL PLAN OF IL PO BOX 5402 LISLE IL 6053288 03085040 DELTA DENTAL PLAN OF MA PO BOX 9104 MEDFORD MA 0215588 03085045 DELTA DENTAL PLAN OF PA ONE DELTA DRIVE MECHANICSBURG PA 17055699988 03085050 DELTA DENTAL PLAN OF HI 700 BISHOP ST SUITE 700 HONOLULU HI 9681388 03085055 DELTA DENTAL PLAN OF MN PO BOX 59238 MINNEAPOLIS MN 55459023888 03085060 DELTA DENTAL OF RI PO BOX 1517 PROVIDENCE RI 02901151788 03085065 DELTA DENTAL OF NM 2500 LOUISIANA BOULEVARD ALBURQUERQUE NM 8711088 03085070 DELTA USA/WA DENTAL PO BOX 75983 SEATTLE WA 9812588 04064015 GREAT WEST LIFE & ANNUITY INSURANCE CO1000 GREAT WEST DRIVE KENNET MO 63857374988 07852010 PREMIER DENTAL GROUP PO BOX 47126 PLYMOUTH MN 55447012688 07923010 PROTECTIVE DENTAL CARE HMO PO BOX 801694 DALLAS TX 753801694

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

88 08662005 SHENANDOAH LIFE INS CO PO BOX 12847 ROANOKE VA 24029284788 10698005 CONSOLIDATED GROUP INC PO BOX 9191 FRAMINGHAM MA 01701919188 11087020 IBA HEALTH & LIFE ASSURANCE PO BOX 51100 KALAMAZOO MI 4900588 11256005 VOLUNTARY BENEFITS INTERNATION PO BOX 830626 BIRMINGHAM AL 35283062688 13161010 BC BS OF NJ PO BOX 1938 NEWARK NJ 07101193888 14679005 BC BS OF MI-DENTAL 600 LAFAYETTE DETROIT MI 4822688 14810010 AETNA US HEALTHCARE 151 FARMINGTON AVENUE, WP14 HARTFORD CT 0615688 14973005 DELTA DENTAL PLAN OF NE PO BOX 245 MINNEAPOLIS MN 55440024588 16065010 ACENTRA BENEFIT SERVICES PO BOX 869041 PLANO TX 75086904188 20273005 DELTA DENTAL PLAN OF OK PO BOX 54709 OKLAHOMA CITY OK 7315488 21038005 METLIFE PO BOX 14093 LEXINGTON KY 40512409388 21717005 MIDWESTERN DENTAL CENTER 5050 SCHAFER RD DEARBORN MI 4812688 23927010 DENTAL SELECT 65 E WADSWORTH PARK ROAD DRAPER UT 8402088 24432010 MODERN BENEFITS CORPORATION PO BOX 4000 SOUTHFIELD MI 48037400088 25162005 MIDA DENTAL PLANS 2000 TOWN CENTER SOUTHFIELD MI 4807588 25799005 DELTA DENTAL PLAN OF WI PO BOX 828 STEVENS POINT WI 5448188 26580005 DELTA DENTAL PLAN OF OH PO BOX 29979 COLUMBUS OH 43229097988 27327015 JEFFERSON PILOT P O BOX 51487 ONTARIO CA 91761008788 27633005 GOLDEN DENTAL 29377 HOOVER RD WARREN MI 4809388 28605010 COMPDENT PO BOX 769569 ROSWELL GA 30076822388 28749035 HARRINGTON BENEFIT SERVICES PO BOX 30367 TAMPA FL 33630336788 29093005 DENTAL CARE NETWORK 27000 WEST 11 MILE SOUTHFIELD MI 4803788 29926005 DELTA DENTAL PLAN OF CA PO BOX 7736 SAN FRANCISCO CA 9412088 30530005 DELTA DENTAL PLAN OF TN 240 VENTURE CIRCLE NASHVILLE TN 3722888 30577105 JLT SERVICES PO BOX 2233 SCHENECTADY NY 1230188 30591005 COMPDENT PO BOX 4677 CHICAGO IL 6068088 30606005 DENTAL BENEFIT PROVIDERS PO BOX 30217 BETHESDA MD 2081488 30606010 DENTAL CLAIMS ADMINISTRATIVE SERVICES INCPO BOX 256 MINNEAPOLIS MN 55440025688 30703005 KIRKWOOD IND TOLEDO COMMUTATOR 1101 S CHESTNUT OWOSSO MI 4886788 30705005 MICHIGAN DENTAL PLAN PO BOX 379 CLAWSON MI 4801788 30764005 DELTA DENTAL PLAN OF AR PO BOX 16450 NO LITTLE ROCK AR 72231645088 30794015 TRIGON BC BS 555 MIDDLECREEK PARKWAY MS425COLORADO SPINGS CO 8092188 30814005 DELTA DENTAL PLAN OF IN NORTH DRIVE #191 INDIANAPOLIS IN 462504327

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

88 30843005 GUARDIAN PO B0X 2459 SPOKANE WA 99210246788 30895005 PRUDENTIAL INSURANCE COMPANY PO BOX 1251 BUFORD GA 3051888 30943005 DELTA DENTAL PLAN OF IA 2401 S E TONES DRIVE ANKENY IA 5002188 30944005 DELTA USA 23 OLD DEPOT ROAD NEW CUMBERLAND PA 1707088 30944010 DELTA USA PO BOX 9085 FARMINGTON HILL MI 48333908588 30944015 DELTA USA 4818 STARKEY RD SW ROANOKE VA 2401488 30944020 DELTA USA PO BOX 9150 DOWNERS GROVE IL 6051588 30944025 DELTA USA PO BOX 59238 MINNEAPOLIS MN 5545988 40009005 SUPERIOR DENTAL CARE 6683 CENTERVILLE BUS PKY DAYTON OH 4545988 40092005 DENTAL GROUP OF AMERICA 500 PERRY RD GRAND BLANC MI 4843988 40097005 SIGNATURE DENTAL PLAN 200 N MARTINGALE RD SCHAUMBURG IL 60173209688 40122005 DELTA CARE HMO PLAN OF MI PO BOX 79001 DETROIT MI 48279171988 40123005 DELTA DENTAL PLAN OF NJ PO BOX 222 PARSIPPANY NJ 0705488 40124005 DELTA DENTAL PLAN OF MO PO BOX 16921 ST LOUIS MO 6310588 40157015 ECIT DENTAL PLANS PO BOX 19884 INDIANAPOLIS IN 4621988 40191015 FIRST COMMONWEALTH 444 N WELLS - SUITE 600 CHICAGO IL 6061088 40245005 AMERICAN EXECUTIVE ASSOCIATION PO BOX141700 GRAND RAPIDS MI 49514170088 40265005 CONSUMER DENTAL CARE 4061 POWDER MILL ROAD CALVERTON MD 20705314988 40266005 DENCAP DENTAL PLANS 45 E MILWAUKEE AVENUE DETROIT MI 48202323188 40279010 MANAGED DENTAL CHOICE 3 PENN PLAZA EAST PP-03Q NEWARK NJ 0710588 40288005 UNITED CONCORDIA COMPANIES INC PO BOX 69421 HARRISBURG PA 17106942188 40288010 UNITED CONCORDIA COMPANIES PO BOX 69422 HARRISBURG PA 17106942188 40295005 JARDINE GROUP SERVICES PO BOX 2209 SCHENECTADY NY 1230188 40315010 AMERICAN DENTAL GROUP OF MI 8609 W GRAND RIVER AVENUE BRIGHTON MI 4811688 40353005 NATIONAL DENTAL PLANS PO BOX 13009 NORFOLK VA 23506000988 40356030 HAGUE EQUIPMENT COMPANY 410 E DRESDEN STREET KALKASKA MI 4964688 40356035 BROKERS NATIONAL LIFE ASSURANC PO BOX 1028 HOUSTON TX 77251102888 40356040 DENTEMAX PPO PO BOX 1391 DAYTON OH 45401139188 40356050 GE FINANCIAL ASSURANCE PO BOX 1477 GREENFIELD MA 0130288 40388005 DENTAL HEALTH GROUP 3531 JUNCTION DETROIT MI 4821088 40388010 DENTAL NETWORK OF AMERICA PO BOX 5005 OAKBROOK TERRACE IL 6018188 40412805 HUMANA PO BOX 14610 LEXINGTON KY 40512461088 40413555 DENTAL GUARD PREFERRED NETWORK PO BOX 2459 SPOKANE WA 992102459

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

88 40413605 TRUSTMARK PO BOX 2980 CLINTON IA 52733298088 40413625 DELTA DENTAL PLAN OF KENTUCKY PO BOX 242810 LOUISVILLE KY 40224281088 40413655 UNITED HEALTHCARE DENTAL PO BOX 659747 SAN ANTONIO TX 78265974789 00029010 BC BS PPO 600 LAFAYETTE DETROIT MI 4822689 00038005 BC BS FEDERAL EMPLOYEE PROGRAM 600 LAFAYETTE DETROIT MI 4822689 00047005 TRICARE/CHAMPUS PO BOX 7021 CAMDEN SC 2902089 00056030 AETNA US HEALTHCARE PO BOX 150437 HARTFORD CT 06115043789 00056060 AETNA US HEALTHCARE PO BOX 26279 MILWAUKEE WI 5322689 00056080 AETNA US HEALTHCARE PO BOX 150409 HARTFORD CT 06115040989 00056105 AETNA US HEALTHCARE 7676 HAZARD CENTER DRIVE SAN DIEGO CA 92108450389 00056115 AETNA US HEALTHCARE PO BOX 2246 BLUE BELL PA 19422824689 00056120 AETNA US HEALTHCARE PO BOX 14079 LEXINGTON KY 40512407989 00056125 AETNA US HEALTHCARE PO BOX 26190 GREENSBORO NC 27402619089 00056130 AETNA US HEALTHCARE PO BOX 2523 FORT WAYNE IN 46801087189 00056135 AETNA US HEALTHCARE PO BOX 2295 FORT WAYNE IN 46801229589 00056140 AETNA US HEALTHCARE PO BOX 2559 FORT WAYNE IN 46801255989 00056145 AETNA US HEALTHCARE PO BOX 5569 AKRON OH 44333056989 00056150 AETNA US HEALTHCARE PO BOX 3926 ALLENTOWN PA 18106092689 00056155 AETNA US HEALTHCARE 7400 W CAMPUS ROAD NEW ALBANY OH 4305489 00056160 AETNA US HEALTHCARE PO BOX 182756 COLUMBUS OH 43218275689 00056165 AETNA US HEALTHCARE PO BOX 1858 BISMARK ND 5850289 00056170 AETNA US HEALTHCARE PO BOX 91555 ARLINGTON TX 7601589 00056175 AETNA US HEALTHCARE PO BOX 52121 MINNEAPOLIS MN 55402512189 00056180 AETNA US HEALTHCARE HMO PO BOX 1125 BLUE BELL PA 1942289 00056185 AETNA US HEALTHCARE PO BOX 2520 TYLER TX 7571089 00056195 AETNA US HEALTHCARE PO BOX 91028 SEATTLE WA 9811189 00056200 AETNA US HEALTHCARE PO BOX 54467 LOS ANGELES CA 9005489 00065135 BENESIGHT PO BOX 7046 ROCKFORD IL 61125704689 00065150 UNITED HEALTHCARE INS CO PO BOX 30555 SALT LAKE CITY UT 84130055589 00065155 BENESIGHT PO BOX 3098 NAPERVILLE IL 60566709889 00065160 UNITED HEALTHCARE INS CO PO BOX 740800 ATLANTA GA 30374080089 00065175 UNITED HEALTHCARE INS CO PO BOX 30985 SALT LAKE CITY UT 8413089 00065180 UNITED HEALTHCARE INS CO PO BOX 30551 SALT LAKE CITY UT 841300551

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 00083140 PRUDENTIAL HEALTH CARE SYSTEM 5900 N ANDREWS AVENUE FT LAUDERDALE FL 3330989 00083150 PRUDENTIAL HEALTHCARE HMO PO BOX 54289 LOS ANGELES CA 90054028989 00083155 PRUDENTIAL HEALTHCARE PPO PO BOX 5400 MILLVILLE NJ 08332010089 00083160 PRUDENTIAL HEALTHCARE POS PO BOX 4804 HOUSTON TX 7721089 00092040 HEALTHSOURCE NH PO BOX 2041 CONCORD NH 03302204189 00092045 CIGNA HEALTHCARE PO BOX 188007 CHATTANOOGA TN 37422800789 00092050 CIGNA HEALTHCARE PO BOX 5200 SCRANTON PA 18505520089 00154010 MI EDUC SPEC SERV ASSOC PO BOX 2560 EAST LANSING MI 4882389 00163040 UNITED HEALTHCARE INS CO PO BOX 2074 AURORA IL 60507207489 00172035 CIGNA HEALTHCARE PO BOX 182352 COLUMBUS OH 4321889 00172040 CT GENERAL LIFE PO BOX 10365 DES MOINES IA 5030689 00172045 CT GENERAL LIFE PO BOX 10370 DES MOINES IA 5030689 00172055 CT GENERAL LIFE PO BOX 31426 CHARLOTTE NC 28231142689 00181010 CT GENERAL LIFE PO BOX 29000 ATLANTA GA 3035989 00181015 CT GENERAL LIFE PO BOX 2546 SHERMAN TX 75091254689 00181020 CT GENERAL LIFE PO BOX 4010 FARMINGTON CT 0603489 00181085 CT GENERAL LIFE PO BOX 978 BRISTOL TN 0601189 00181100 CT GENERAL LIFE PO BOX 3077 BOURBONNAIS IL 6091489 00181105 CT GENERAL LIFE PO BOX 182467 COLUMBUS OH 4321889 00181115 CT GENERAL LIFE PO BOX 8014 PLAINVILLE CT 0606289 00181125 CT GENERAL LIFE PO BOX 24031 FRESNO CA 9377989 00181130 CT GENERAL LIFE PO BOX 800 UNIONVILLE CT 0608589 00181135 CT GENERAL LIFE PO BOX 15408 WILMINGTON DE 19850540889 00181140 CT GENERAL LIFE PO BOX 5046 SOUTHFIELD MI 4808689 00181145 CIGNA HEALTHCARE PO BOX 5019 VISALIA CA 9327889 00190085 UNICARE/JOHN HANCOCK PO BOX 4076 SCHAUMBURG IL 60168407689 00190100 UNICARE PO BOX 4069 SCHAUMBURG IL 6016889 00190105 UNICARE PO BOX 833813 RICHARDSON TX 75083381389 00207010 AMERICAN COMMUNITY MUTUAL 39201 SEVEN MILE ROAD LIVONIA MI 4815289 00225010 MI UNITED FOOD & COMMERCIAL WORKERS876 HORACE BROWN DRIVE MADISON HEIGHTS MI 4807189 00305015 WAUSAU BENEFITS INC PO BOX 8030 WAUSAU WI 54402803089 00341030 CNA MANAGED CARE PO BOX 305059 NASHVILLE TN 37230505989 00379010 GREAT WEST LIFE & ANNUITY INSURANCE CO900 SECOND AVENUE SOUTH MINNEAPOLIS MN 554022341

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 00379015 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 11111 FORT SCOTT KS 6670189 00379020 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 1120 SAN JOSE CA 95108112089 00379040 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 950 DENVER CO 8020189 00379100 GREAT WEST LIFE & ANNUITY INSURANCE CO1377 DUBLIN ROAD COLUMBUS OH 4321589 00379125 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 8020 NORTH OLMSTED OH 44070802089 00379135 GREAT WEST LIFE & ANNUITY INSURANCE CO10401 N MERIDIAN STREET INDIANAPOLIS IN 4629089 00379140 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 31251 TAMPA FL 33631325189 00379150 GREAT WEST LIFE & ANNUITY INSURANCE COPO BOX 27732 HOUSTON TX 77227773289 00566005 AETNA US HEALTHCARE PO BOX 981114 EL PASO TX 79998111489 00566030 AETNA US HEALTHCARE PO BOX 1214 TEWKSBURY MA 01876091489 00566035 AETNA US HEALTHCARE PO BOX 24002 FRESNO CA 9377989 00566045 AETNA US HEALTHCARE PO BOX 578808 OKLAHOMA CITY OK 73157880889 00566075 AETNA US HEALTHCARE PO BOX 24024 FRESNO CA 9377989 00566090 AETNA US HEALTHCARE PO BOX 12340 FRESNO CA 9376589 00584005 AETNA US HEALTHCARE PO BOX 44128 JACKSONVILLE FL 32231412889 00584015 AETNA US HEALTHCARE PO BOX 31450 TAMPA FL 33631345089 00726010 ALLIED BENEFIT SYSTEMS 208 LASALLE STREET CHICAGO IL 6060489 01296010 AMERICAN NATIONAL INSURANCE CO PO BOX 1520 GALVESTON TX 77553152089 01732080 PRINCIPAL FINANCIAL GROUP PO BOX 39710 COLORADO SPRINGS CO 80949391089 01886020 TRUSTMARK PO BOX 1467 SOUTH BEND IN 4662489 01886025 TRUSTMARK 400 FIELD DRIVE LAKE FOREST IL 6004589 01886035 ERN ADMINISTRATORS 6000 WESTERN PLACE FORT WORTH TX 7610789 01886040 TRUSTMARK PO BOX 9055 BOARDMAN OH 4451389 02426005 CHEC PO BOX 538508 GRAND PRAIRE TX 7505389 03595010 FEDERATED MUTUAL INSURANCE CO PO BOX 50487 INDIANAPOLIS IN 4625089 03595015 FEDERATED MUTUAL INSURANCE CO PO BOX 328 OWATONNA MN 5506089 03773010 HUMANA PO BOX 14610 LEXINGTON KY 40512461089 04019920 HEALTHSMART PO BOX 53010 LUBBOCK TX 7945389 04046005 GARDEN STATE LIFE IN PO BOX 4808 TRENON NJ 0865089 04064035 GREAT WEST LIFE & ANNUITY INSURANCE CO1000 GREAT WEST DRIVE KENNETT MO 63857374989 04681010 HEALTHSCOPE PO BOX 796 LITTLE ROCK AR 7220389 04734020 ANTHEM HEALTH HOME LIFE INS CO PO BOX 6881 PISCATAWAY NJ 0885589 05212010 JOHN DEERE HEALTH CARE INC PO BOX 8803 MOLINE IL 612668803

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 05286010 KEYSTONE HEALTH PLAN EAST PO BOX 8339 PHILADELPHIA PA 19101833989 05446010 PREVEA PO BOX 1625 GREEN BAY WI 54307162589 05704010 LUTHERAN PREFERRED NETWORK PO BOX 666 BROWNSBURG IN 46112066689 05885050 UNICARE PO BOX 51130 SPRINGFIELD MA 01151513089 06407015 FORTIS BENEFITS INSURANCE CO PO BOX 5182 DES PLAINES IL 60017518289 06407040 FORTIS SELF FUNDED PO BOX 2043 HOPKINS MN 55343304389 06603005 AON SELECT 110 GIBRALTAR ROAD HORSHAM PA 1904489 06855015 NEW ENGLAND THE PO BOX 11111 FORT SCOTT KS 66701711189 06908020 NYLCARE HEALTH PLANS PO BOX 509 GREENBELT MD 2077089 07191020 CORESTAR 7830 E BROADWAY TUCSON AZ 85710399189 07807010 POMCO PO BOX 6329 SYRACUSE NY 1321789 09599020 UNITED BENEFIT LIFE INSURANCE PO BOX TAMPA FL 3363089 10535015 CAM ADMINISTRATIVE SERVICES PO BOX 5131 SOUTHFIELD MI 48086513189 10544010 BOILERMAKERS NATIONAL H & W FUND 754 MINNESOTA AVENUE KANSAS CITY KS 66101276689 10580010 CENTRAL STATES SE SW TEAMSTERS PO BOX 5116 DES PLAINES IL 60017511689 10704005 CONCORDIA HEALTH PLAN PO BOX 229013 ST LOUIS MO 6312289 10992010 GROUP MARKETING SERVICES PO BOX 19040 KALAMAZOO MI 49019004089 11087010 IBA SELF FUNDED GROUP PO BOX 51719 KALAMAZOO MI 49005171989 11087015 IBA PPO NETWORK 106 FARMERS ALLEY KALAMAZOO MI 4900789 11087025 IBA/PHP PO BOX 51100 KALAMAZOO MI 4900589 11238010 LINECO 2000 SPRING DRIVE LOMBARD IL 6014889 11499010 DMC CARE PO BOX 44290 DETROIT MI 4824489 11686010 OXFORD HEALTH PLANS PO BOX 7082 BRIDGEPORT CT 0660189 11784010 HUMANA HEALTH INSURANCE CO OF FL PO BOX 19080-F JACKSONVILLE FL 32245908089 11980010 UNION CONSTRUCTION WORKERS HEALTH PLANPO BOX 697 TOLEDO OH 43697069789 12010010 CAMBRIDGE 2600 HORIZON SE GRAND RAPIDS MI 4950189 12039005 TOTAL HEALTH CARE 1600 FISHER BUILDING DETROIT MI 4820289 12084010 UNITED FURNITURE WORKERS PO BOX 100037 NASHVILLE TN 3722489 12191010 WILSON MCSHANE CORPORATION 2850 METRO DRIVE SUITE 404 BLOOMINGTON MN 5542589 12217010 BC BS OF MN PO BOX 64338 ST PAUL MN 55164056089 12253010 MEDICAL MUTUAL OF OH PO BOX 6018 CLEVELAND OH 44101101889 12280005 ANTHEM BC BS-CANTON REGION 4150 BELDEN VILLAGE,NW CANTON OH 44711859089 12306005 HMO ILLINOIS PO BOX A-3694 CHICAGO IL 60690

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 12333010 ANTHEM COMMUNITY MUTUAL BCBS PO BOX 425 WORTHINGTON OH 43085750089 12342010 BC BS OF WI 401 W MICHIGAN STREET MILWAUKEE WI 5320189 12351010 WI PHYSICIANS SERVICE PO BOX 8190 MADISON WI 5370889 12807005 PIONEER LIFE INSURANCE CO OF IL PO BOX 1250 ROCKFORD IL 61105125089 12852010 STATE FARM INSURANCE 1440 GRANVILLE ROAD NEWARK OH 4309389 12950010 BC BS OF AL 450 RIVERCHASE PARKWAY EAST BIRMINGHAM AL 3529889 12997010 BC OF CA PO BOX 9043 OXNARD CA 9303189 12997015 BS OF CA PO BOX 272560 CHICO CA 95927256089 13027015 ANTHEM BC BS OF CT 370 BASSETT RD NORTH HAVEN CT 06473420189 13045010 CARE FIRST BC BS PO BOX 812 OWINGS MILLS MD 21117081289 13054010 FL PSYCHIATRIC MANAGEMENT P O BOX 45297 JACKSONVILLE FL 32232529789 13054015 BC BS OF FL PO BOX 45034 JACKSONVILLE FL 32232503489 13072010 BC BS OF KS 1133 SW TOPEKA TOPEKA KS 6662989 13081010 ANTHEM BC BS OF IN ITS INDY PO BOX 37010 LOUISVILLE KY 4023389 13081025 ANTHEM BC BS OF KY PO BOX 37180 LOUISVILLE KY 40233718089 13116010 BC BS OF MA 100 SUMMER STREET BOSTON MA 0211089 13125015 BC BS OF MO PO BOX 14882 ST LOUIS MO 63178488289 13143010 BC BS OF NE PO BOX 3248 OMAHA NE 6818089 13170010 BC BS OF THE ROCHESTER AREA 165 COURT STREET ROCHESTER NY 1464789 13199010 BC BS OF CENTRAL NY PO BOX 4809 SYRACUSE NY 13221480989 13214010 BCBS OF WESTERN NY 1901 MAIN STREET BUFFALO NY 14240010989 13241010 BC BS OF OK PO BOX 3283 TULSA OK 74102328389 13250010 BC BS OF OR PO BOX 1071 PORTLAND OR 9720789 13279010 INDEPENDENCE BC 1901 MARKET,15TH FL PHILADELPHIA PA 19103000089 13303015 HIGHMARK BCBS PO BOX 1210 PITTSBURGH PA 15230335589 13303020 BC BS OF PA DEPARTMENT 778974 HARRISBURG PA 17177897489 13321010 BC BS OF SC I-20 AT ALPINE ROAD COLUMBIA SC 2921989 13330010 BC BS OF TN PO BOX 180150 CHATTANOOGA TN 37401715089 13359010 BC BS OF TX PO BOX 660044 DALLAS TX 75266004489 13377010 BC OF IDAHO PPO PO BOX 7408 BOISE ID 8370789 13439005 NGS AMERICAN INC PO BOX 7676 ST CLAIR SHORES MI 48080767689 13457015 BC BS OF MD PO BOX 1726 CUMBERLAND MD 21501172589 13733005 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 13733010 HEALTH ALLIANCE PLAN PPO NETWORK 2850 W GRAND BOULEVARD DETROIT MI 4820289 13742005 BC BS OF PA PO BOX 890016 CAMP HILL PA 17089001689 13760010 GOVERNMENT EMPLOYEES HOSP ASSOC PO BOX 4665 INDEPENDENCE MO 64051466589 13789010 MAIL HANDLERS BENEFIT PLAN PO BOX 45118 JACKSONVILLE FL 3223289 14060010 NATIONAL PREFERRED PROVIDER NETWORKPO BOX 7078 MIDDLETOWN NY 1094089 14178005 OMNICARE INC 1155 BREWERY PARK BLVD DETROIT MI 4820789 14202010 BC BS OF GA PO BOX 9907 COLUMBUS GA 3190889 14392005 WELLNESS PLAN 7700 2ND AVE, ADMIN BLDG/5THFLDETROIT MI 4820289 14697005 TRICARE/CHAMPVA 600 LAFAYETTE EAST DETROIT MI 4822689 14730005 ELECTRONIC DATA SYSTEMS CORP 5400 LEGACY DRIVE, H3-1C-05 PLANO TX 7502489 14810005 AETNA US HEALTHCARE PO BOX 14110 LEXINGTON KY 40512411089 15003005 HIGHAM WHITRIDGE INC 850 RIDGE AVENUE PITTSBURGH PA 15212610289 15101010 GALLAGHER BENEFITS PO BOX 5227 LISLE IL 60532522789 15540010 BC BS UNITED OF WI PO BOX 2141 MILWAUKEE WI 53201214189 15676010 CENTRAL RESERVE LIFE OF NORTH 17800 ROYALTON ROAD STRONGSVILLE OH 44136519789 16056005 FAMILY HEALTH PLAN OF OH PO BOX 4708 TOLEDO OH 43624145389 16056010 FAMILY HEALTH PLAN OF IN 3510 PARK PLACE WEST MISHAWAKA IN 4654589 16056015 FAMILY HEALTH PLAN OF WI PO BOX 1470 BROOKFIELD WI 53008147089 16118005 CENTRAL STATES JOINT BOARD 1950 W ERIE ST CHICAGO IL 6062289 16485010 HCAP PO BOX 6189 SAGINAW MI 4860889 16486010 ALTPROS 2607 S 159TH PLAZA OMAHA NE 6813089 16510010 AMERA PLAN INC 22500 METROPOLITAN PARKWAY CLINTON TOWNSHIP MI 4803589 16575010 IN AREA UNITED FOOD & COMMERCIAL WORKERSPO BOX 42669 INDIANAPOLIS IN 4624289 16753005 HEALTHPLUS OF MI PO BOX 1700 FLINT MI 4850189 16815010 HMSA BC BS OF HI PO BOX 860 HONOLULU HI 9680889 17143000 HFN PO BOX 3428 OAK BROOK IL 6052389 17723010 AMERICAN TRUST ADMINISTRATORS PO BOX 87 SHAWNEE MISSION KS 6620189 17732005 WATKINS ASSOCIATED INDUSTRIES PO BOX 1738 ATLANTA GA 30301173889 17993010 INFO TRUST PO BOX 7955 LAKE FOREST IL 6004589 18014010 ARNETT HEALTH PLANS PO BOX 6108 LAFAYETTE IN 47903010889 18364005 REGENCE BS 1800 NINTH AVENUE SEATTLE WA 98111326789 18589010 ASR PO BOX 6392 GRAND RAPIDS MI 49516639289 18604005 BC BS OF VA PO BOX 27401 RICHMOND VA 23279

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 18631005 GRAND VALLEY HEALTH 829 FOREST HILL AVE. GRAND RAPIDS MI 4954689 18749010 CLAIM MANAGEMENT SERVICES INC PO BOX 10888 GREEN BAY WI 54307088889 19227010 NATIONAL HEALTH INSURANCE CO PO BOX 619999 DALLAS TX 75261999989 19281005 PHP MID MICHIGAN 4316 RICE LAKE ROAD DULUTH MN 55811000089 19281015 UHC OF OH SUITE 400 COLUMBUS OH 45069487589 19405010 BC BS OF RI 444 WESTMINSTER MALL PROVIDENCE RI 0290389 19666010 BEECH STREET PPO NETWORK PO BOX 17719 IRVINE CA 92713771989 20237010 WEYCO INC PO BOX 30132 LANSING MI 4890989 20406005 CORESOURCE PO BOX 879 ANDERSON IN 46015087989 20498005 HEALTH AMERICA 1375 E 9TH ST STE 1400 CLEVELAND OH 4411489 20611010 BENEFIT SOURCE PO BOX 240 MONROE MI 48161024089 20970005 PHP JACKSON 4316 RICE LAKE ROAD DULUTH MN 5581189 20999005 PHP KALAMAZOO 4316 RICE LAKE ROAD DULUTH MN 55811000089 21000005 PHP MUSKEGON 4316 RICE LAKE ROAD DULUTH MN 55811000089 21154010 PREFERRED HEALTH NETWORK PO BOX 60308 6MF LOS ANGELES CA 9006089 21163040 FIRST HEALTH PO BOX 2900 CORAOPOLIS PA 1510889 21163120 FIRST HEALTH PO BOX 672768 HOUSTON TX 77267276889 21163135 FIRST HEALTH PO BOX 23070 TUCSON AZ 8573489 21163155 FIRST HEALTH NETWORK 750 RIVERPOINT DRIVE WEST SACRAMENTO CA 9560589 21163170 FIRST HEALTH PO BOX 15108 CORAOPOLIS PA 15108234789 21163180 FIRST HEALTH PO BOX 23550 TUCSON AZ 8573489 21163195 FIRST HEALTH PO BOX 535935 PITTSBURGH PA 1525389 21314010 COMMERCE BENEFITS GROUP INC PO BOX 900 ELYRIA OH 4403689 21323005 HUMANA HEALTH CARE PLAN INC 101 EAST MAIN LOUISVILLE KY 40201218089 21430005 MCARE 2301 COMMONWEALTH BLVD ANN ARBOR MI 48105294589 21459005 HEALTHCARE RESOURCES GROUP PO BOX 177 SOUTH BEND IN 4662489 21806010 ETHIX SOUTHWEST 9901 1H 10 WEST SAN ANTONIO TX 78230221389 21860005 MCAULEY HEALTH PLAN PO BOX 9082 FARMINGTON HILL MI 4833389 21978005 BENEFIT SERVICES PO BOX 4241 AKRON OH 4432189 22106010 ACORDIA NATIONAL PO BOX 3262 CHARLESTON WV 2533289 22788005 PHP OF MN 5601 SMETANA DRIVE MINNETONKA MN 5534389 22868010 MED COST PRIME NET PO BOX 25307 WINSTON SALEM NC 27114530789 23186010 UNITED MEDICAL RESOURCES INC PO BOX 145804 CINCINNATI OH 452505804

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 23195005 CT GENERAL LIFE PO BOX 978 BRISTOL CT 0601189 23364005 PRIORITY HEALTH PO BOX 232, 1231 E BELTLINE NE GRAND RAPIDS MI 49501023289 23364015 PRIORITY HEALTH - SELF FUNDED PO BOX 232 GRAND RAPIDS MI 49501023289 23408010 JFP BENEFIT MANAGEMENT 100 S JACKSON STREET JACKSON MI 49201225289 23435005 PREFERRED CHOICES PPO NETWORK PO BOX 9082 FARMINGTON HILL MI 48333908289 23865005 PHYSICIANS HEALTH PLAN PO BOX 2359 FORT WAYNE IN 46801235989 23874005 HEALTH MAINTENANCE PLAN P O BOX 425 WORTHINGTON OH 43085042589 24002005 FALLON COMMUNITY HEALTH PLAN PO BOX 15121 WORCESTER MA 0161589 24094005 CHESTERFIELD RESOURCES PO BOX 1884 AKRON OH 4430989 24272010 ATLAS ADMINISTRATORS INC PO BOX 801234 DALLAS TX 75380123489 24316010 SOUTH CENTRAL PREFERRED PO BOX 2347 YORK PA 1740589 24610005 EMERALD HEALTH NETWORK INC PO BOX 94808 CLEVELAND OH 44101480889 24737010 AUTOMATED BENEFIT SERVICES PO BOX 37506 OAK PARK MI 48237050489 24737015 AUTOMATED BENEFIT SERVICES PO BOX 47130 OAK PARK MI 4823789 24764010 EMPLOYEE BENEFITS PO BOX 347 GRAND BLANC MI 4843989 24924005 CARE CHOICES PO BOX 9082 FARMINGTON HILL MI 48333908289 25028010 KLAIS AND COMPANY INC 1867 W MARKET STREET AKRON OH 4431389 25117010 METRAHEALTH CARE PLAN OF TX PO BOX 945520 MAITLAND FL 32794552089 25752010 BENEFIT SYSTEMS PO BOX 80447 INDIANAPOLIS IN 46280044789 26034010 PHYSICIANS CARE NETWORK 3033 ORCHARD VISTA DRIVE SE GRAND RAPIDS MI 4954689 26428010 STATE FARM INSURANCE PO BOX 2978 CLINTON IA 52733297889 26455015 HRM CAREPASS USA PO BOX 583599 MINNEAPOLIS MN 55458359989 26455020 HRM CAREPASS USA PO BOX 4089 KALAMAZOO MI 49003408989 26464010 UHC/PHP SELF-FUNDED 4316 RICE LAKE ROAD DULUTH MN 55811000089 26769010 CORPORATE BENEFIT SERVICES OF AMERICAPO BOX 27267 MINNEAPOLIS MN 55427026789 26802010 SPARROW PHYSICIANS HEALTH NETWORK2900 HANNAH BOULEVARD LANSING MI 4882389 27102010 BENEFIT SOURCE PO BOX 8128 GRAND RAPIDS MI 4951889 27111010 SPARTAN STEEL 3300 WOLVERINE DRIVE MONROE MI 4816289 27200010 HEALTH MANAGEMENT & ASSOCIATES PO BOX 2069 COTTONWOOD AZ 8632689 27274010 COMPCARE NORTHWEST PO BOX 87 STEVENS POINT WI 54481008789 27407010 CHRISTIAN MISSIONARY ALLIANCE PO BOX 35690 COLORADO SPRINGS CO 8093589 27696005 MED CENTERS PO BOX 1289 MINNEAPOLIS MN 5544089 28102010 CORESOURCE PO BOX 6179 WESTERVILLE OH 430866118

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 28214005 BLUE CARE NETWORK 611 CASCADE W PARKWAY SE GRAND RAPIDS MI 49546214389 28269005 UNITED HEALTHCARE OF IL 500 N DEARBORN CHICAGO IL 6061089 28269010 UNITED HEALTHCARE INS CO PO BOX 659744 SAN ANTONIO TX 78265974489 28269105 UNITED HEALTHCARE OF TN PO BOX 659737 SAN ANTONIO TX 7826589 28314010 MORRIS ASSOCIATES PO BOX 50440 INDIANAPOLIS IN 4625089 28527010 VANTAGE HEALTH PLAN 4602 TIMBER COMMONS DRIVE SANDUSKY OH 4487089 28550010 AMERICAN MEDICAL SECURITY PO BOX 19032 GREEN BAY WI 5430789 28649005 INTERGROUP OF AZ 1010 N. FINANCE CTR DR TUCSON AZ 85710136189 28749010 HARRINGTON BENEFIT SERVICES PO BOX 1391 DAYTON OH 45401139189 28749030 HARRINGTON BENEFIT SERVICES PO BOX 197869 LOUISVILLE KY 4025989 28749040 HARRINGTON BENEFIT SERVICES PO BOX 30367 TAMPA FL 33630336789 28861010 KEY BENEFIT ADMINISTRATORS PO BOX 55210 INDIANAPOLIS IN 4620589 29104015 CORESOURCE 6100 FAIRVIEW RD SUITE 1000 CHARLOTTE NC 28210329189 29171005 PARAMOUNT HEALTH CARE PO BOX 497 TOLEDO TX # FOR DONNAOH 43697049789 29171010 PARAMOUNT HEALTH CARE OF MI 106 PARK PLACE DUNDEE MI 4813189 29381010 RETAIL CLERKS WELFARE TRUST PO BOX 2265 SEATTLE WA 98111226589 29469010 CCN 5501 LBJ FREEWAY DALLAS TX 7524089 29547015 PROAMERICA NETWORK 9901 IH-20 WEST SAN ANTONIO TX 7823089 29569010 STRATEGIC RESOURCE COMPANY PO BOX 23759 COLUMBIA SC 29224375989 29681010 MEDICAL CLAIMS SERVICE 1 WALL STREET RAVENSWOOD WV 2616489 29703010 NORTH AMERICAN BENEFITS NETWORK PO BOX 94928 CLEVELAND OH 44101492889 29770010 BENEFIT ADMINISTRATIVE SYSTEMS 17475 JOVANNA DR #1B HOMEWOOD IL 6043089 29836005 UNICARE PPO CLAIMS PO BOX 806467 CHICAGO IL 60680412589 30004020 PACIFICARE OF CA PO BOX 6006 CYPRESS CA 90630000689 30023005 HMO HEALTH OH PO BOX 6018 CLEVELAND OH 4410789 30032005 ADVANTAGE HEALTHPLAN HMO 11555 N MERIDIAN CARMEL IN 4603289 30034010 AETNA US HEALTHCARE PO BOX 7012 DOVER DE 19903151289 30038010 EMPIRE BC BS OF NY PO BOX 5012 MIDDLETOWN NY 10940901289 30039010 EMPLOYEE BENEFIT MANAGEMENT CORP 4789 RINGS RD DUBLIN OH 4301789 30040010 HEALTHCOMP ADMINISTRATORS PO BOX 45018 FRESNO CA 9371889 30047010 UNITED HEALTHCARE INS CO PO BOX 1600 KINGSTON NY 12402160089 30053005 SAGAMORE PO BOX 6051 INDIANAPOLIS IN 4620689 30408005 JF MOLLOY & ASSOCIATES PO BOX 68947 INDIANAPOLIS IN 46268

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 30500005 PHYSICIANS CORPS/AMER HEALTH P O BOX 830570 BIRMINGHAM AL 35283057089 30507005 HMO IL DREYER 1877 W DONNER PLACE AURORA IL 6050689 30514005 ROCKFORD HEALTH PLANS 3401 N PERRYVILLE RD ROCKFORD IL 6111489 30547100 CARITEN HEALTHCARE PO BOX 22987 KNOXVILLE TN 3793389 30561005 SAMBA MUTUAL BENEFIT ASSOCIATION INC11301 OLD GEORGETOWN RD ROCKVILLE MD 20852280089 30569010 HCI TOUCH POINT NETWORK PO BOX 6269 FORT SMITH AR 72906626989 30570005 M PREFERRED PPO PO BOX 134005 ANN ARBOR MI 48113400589 30586010 NEW ENGLAND HEALTH BENEFITS PO BOX 8020 N OLMSTEAD OH 44070802089 30601010 JMS ADMINISTRATORS PO BOX 2141 MONROE MI 4816189 30602010 ODS PO BOX 40384 PORTLAND OR 9724089 30712010 BENEFIT CONCEPT PO BOX C5009 WARMINSTER PA 1897489 30719005 PACIFICARE PO BOX 5105 ENGLEWOOD CO 80155510589 30721015 OPERATING ENGINEERS PO BOX 7067 PASADENA CA 9110989 30734005 CORESTAR PO BOX 1195 MINNEAPOLIS MN 55440002089 30743010 MEDICAL CONTROL NETWORK PO BOX 549005 DALLAS TX 75354900589 30750005 BC BS OF IL PO BOX 1364 CHICAGO IL 60690136489 30757015 NORTH AMERICA ADMINISTRATORS PO BOX 1984 NASHVILLE TN 3720289 30769005 BENESIGHT PO BOX 568 NORTH HAVEN CT 0647389 30770005 UNITED HEALTH PLAN 3405 W IMPERIAL HWY INGLEWOOD CA 9030389 30776010 DEAN HEALTH PLAN PO BOX 56099 MADISON WI 5370589 30792015 EPOCH GROUP PO BOX 12170 OVERLAND PARK KS 66282217089 30794005 TRIGON BC BS PO BOX 27401 RICHMOND VA 23279740189 30796005 UNITED HEALTHCARE SERVICES INC PO BOX 659747 SAN ANTONIO TX 78265974789 30796010 UNITED HEALTHCARE PPO NETWORK PO BOX 1459 MINNEAPOLIS MN 55440145989 30808005 SELECT HEALTH PLAN PO BOX 1378 TROY MI 48099137889 30824005 PPOM CLAIMS DEPARTMENT PO BOX 2720 FARMINGTON HILL MI 4833389 30827005 PARTNERS HEALTH PLAN PO BOX 7600 SOUTH BEND IN 4663489 30827010 HEALTH PARTNERS HEALTH PLANS 333 E WETMORE RD TUCSON AZ 85705715989 30827015 PARTNERS NATIONAL HEALTH PLANS OF NCPO BOX 24907 WINSTON SALEM NC 27114490789 30839015 EMPLOYEE BENEFIT STRATEGIES 229 E MICHIGAN KALAMAZOO MI 4900789 30841010 GUARDIAN PO BOX 26200 LEHIGH VALLEY PA 1800289 30855010 WOODS & GROOMS PO BOX 2549 COLUMBUS IN 4720289 30859020 BENEFIT MANAGEMENT SERVICES PO BOX 1178 MATTHEWS NC 28106

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 30868010 GROUP HEALTH COOPERATIVE HMO PO BOX 44971 MADISON WI 53744497189 30874010 PHYSICIANS CHOICE NETWORK PO BOX 4055 JACKSON MI 4920489 30884010 AMERICAN BENEFITS MANAGEMENT PO BOX 145804 CINCINNATI OH 45250580489 30898005 TUFT ASSOCIATED HEALTH PLAN 333 WYMAN STREET WALTHAM MA 0215489 30926010 KAISER PERMANENTE PO BOX 7102 PASADENA CA 91109720289 30929005 NATIONAL ELEVATOR INDUSTRY PO BOX 477 NEWTOWN SQUARE PA 19073047789 30931005 NCAS PO BOX 1227 FAIRFAX VA 2203089 30933005 BENEFIT SOURCE PO BOX 19400 KALAMAZOO MI 4901989 30933015 PREFERRED PARTNERS NETWORK PO BOX 19400 KALAMAZOO MI 4901989 30947005 HUMANA HEALTH CARE PLANS 3400 LAKESIDE DRIVE MIRAMAR FL 3302789 30950010 MED PAY INC PO BOX 10909 SPRINGFIELD MO 6580889 30960005 WI HEALTH ORGANIZATION 111 WEST PLEASANT MILWAUKEE WI 53212035989 30969005 BLUE CHOICE NETWORK PO BOX 2500 DETROIT MI 48231250089 30977005 MAMSI 4 TAFT COURT ROCKVILLE MD 2085089 40008005 SECURITY HEALTH PLAN 1000 NORTH OAK AVENUE MARSHFIELD WI 54449570389 40024005 FHP INC 698 E WETMORE ROAD TUCSON AZ 8570589 40029005 MEDICA P O BOX 1459 MINNEAPOLIS MN 55440107089 40032005 CNA HEALTH PARTNERS PO BOX 34197 LITTLE ROCK AR 7220389 40045005 AETNA HEALTH PLANS OF NORTHERN 1111 BAYHILL DR STE 300 SAN BRAVO CA 9406689 40047020 PRINCIPAL HEALTH CARE OF FL PO BOX 44029 JACKSONVILLE FL 32232507689 40055005 PLANNED ADMINISTRATORS INC PO BOX 6927 COLUMBIA SC 2926089 40057005 AETNA HEALTH PLANS OF THE 7700 A LEESBURG PIKE FALLS CHURCH VA 2204389 40064010 CULINARY WORKERS HEALTH FUND 1901 LAS VEGAS BOULEVARD LAS VEGAS NV 8910489 40070005 PRINCIPAL HEALTH CARE OF IN 1N PENNSYLVANIA STSTE300 INDIANAPOLIS IN 46204311489 40081500 MEDICAL CLAIMS MANAGEMENT CORPORATIONPO BOX 12995 CHARLOTTE NC 28220299589 40087005 SHARE HEALTH PLAN OF IL PO BOX 909714 CHICAGO IL 60690971489 40088010 W J JONES ADMINISTRATIVE SERVICES INC1979 MARCUS AVENUE LAKE SUCCESS NY 1104289 40096015 LOCAL UNION INSURANCE #1102 1587 STEWART AVENUE WESTBURY NY 1159089 40117005 COMMUNITY HEALTH PARTNERS P O BOX 9084 FARMINGTON HILLS MI 4833389 40117010 COMMUNITY HEALTH ALLIANCE NETWORKPO BOX 1293 SOUTH BEND IN 4663489 40119025 CORESOURCE PO BOX 83301 LANCASTER PA 17608330189 40119030 CORESOURCE 4940 CAMPBELL BLVD SUITE 200 BALTIMORE MD 2123689 40119035 CORESOURCE 4210 SHAWNEE MISSION PARKWAYSHAWNEE MISSION KS 66205

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 40136005 UNITED HEALTH CARE OF GA PO BOX 659750 SAN ANTONIO TX 78265975089 40136010 TOUCHPOINT HEALTH PLAN PO BOX 507 APPLETON WI 54912050789 40136015 UNITED HEALTHCARE OF FL P.O. BOX 659735 SAN ANTONIO TX 78265973589 40144010 GLOBAL EXCHANGE PO BOX 823067 SOUTH FLORIDA FL 33082306789 40147005 CEMARA 101 N WAUKEGAN ROAD LAKE BLUFF IL 6004489 40149010 NIPPON LIFE INSURANCE PO BOX 39710 COLORADO SPRINGS CO 80949319089 40156015 HUMANA HEALTH CARE PLAN INC PO BOX 14603 LEXINGTON KY 40512460389 40169005 ALTERNATIVE HEALTH PO BOX 23705 LOUISVILLE KY 4022389 40191035 HEALTH CHOICE (HAP) PO BOX 02399 DETROIT MI 4820289 40191045 ALLIANCE HEALTH & LIFE INSURANCE PO BOX 02459 DETROIT MI 4820089 40192010 COMPREHENSIVE CARE SERVICES PO BOX 64668 ST PAUL MN 5516489 40192020 PARTNERSHIP HEALTH PO BOX 130799 ANN ARBOR MI 48113079989 40196010 GROUP BENEFITS UNLIMITED 1000 PLAZA DRIVE SCHAUMBURG IL 6017389 40198005 HEALTH PLAN OF NV PO BOX 15645 LAS VEGAS NV 89114564589 40199010 ICON/TED PARKER & ASSOC 2002 W LOOP 289, SUITE 105 LUBBOCK TX 7940789 40199050 HEALTHGUARD 280 GRANITE RUN DRIVE LANCASTER PA 17601681089 40202005 GREAT WEST LIFE & ANNUITY PHCS PO BOX 11111 FORT SCOTT KS 66701711189 40206010 PROFESSIONAL BENEFIT ADMINISTRATORSPO BOX 4687 OAKBROOK IL 60522468789 40206015 PROFESSIONAL BENEFIT 6475 28TH STREET SE GRAND RAPIDS MI 4954689 40216005 HCN PPO NETWORK PO BOX 0978 BROOKFIELD WI 53008097889 40223010 MCLAREN HEALTH ADVANTAGE PO BOX 1511 FLINT MI 48201151189 40241005 DAYMED HMP INC PO BOX 1236 DAYTON OH 4540289 40245015 FIRST CHOICE HEALTH NETWORK PO BOX 2289 SEATTLE WA 9811189 40257015 WELLMARK BCBS PO BOX 7020 STATION 168 SIOUX CITY IA 5110289 40270005 MUTUALLY PREFERRED PPO MUTUAL OF OMAHA PLAZA OMAHA NE 6817589 40272005 QUAL MED 6100 UPTOWN BLVD NE ALBUQUERQUE NM 8711089 40272010 QUAL CHOICE OF NC 100 KIMEL FOREST DRIVE WINSTON-SALEM NC 2710289 40279005 MANAGED CARE OF AMERICA 820 PARISH STREET PITTSBURGH PA 1522089 40281005 PHYSICIANS HEALTH SERVICES ONE FAR MILL CROSSING SHELTONL CT 0648489 40286010 JP FARLEY CORPORATION PO BOX 458022 WESTLAKE OH 44145802289 40292005 PHP PLUS INC 4316 RICE LAKE ROAD DULUTH MN 5581189 40296005 PNI PPO NETWORK PO BOX 11328 SOUTH BEND IN 4663489 40300015 ASSURECARE 4660 S HAGADORN ROAD EAST LANSING MI 48823

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 40301005 CHOICE CARE PO BOX 3188 CINCINNATI OH 4520189 40301010 UNIVERA HEALTHCARE PO BOX 350 BUFFALO NY 14201035089 40308010 BENESIGHT PO BOX 395 PUEBLO CO 8100389 40311005 CHICKERING PO BOX 45708 BOSTON MA 02215001489 40314005 VALLEY HEALTH PLAN PO BOX 3128 EAU CLAIRE WI 54702312889 40319005 AHC PPO NETWORK PO BOX 981 BROOKFIELD WI 53008098189 40319015 FMH BENEFIT SERVICES INC PO BOX 25946 OVERLAND PARK KS 6622589 40320010 CASI INC PO BOX 8244 SOUTH BEND IN 4666089 40325010 FORTIS BENEFITS INSURANCE CO 501 W MICHIGAN MILWAUKEE WI 5320389 40330010 UNIFIED GROUP SERVICE PO BOX 10 PENDLETON IN 46064001089 40334005 THE AFFORDABLE MEDICAL NETWORK PO BOX 10636 SCOTTSDALE AZ 85271063689 40341005 HARRIS METHODIST HEALTH PLAN PO BOX 90100 ARLINGTON TX 76004310089 40347015 CT NATIONAL LIFE PO BOX 1250 ROCKFORD IL 61105125089 40348005 MANAGED CARE SERVICES PO BOX 5548 FORT WAYNE IN 4689589 40355005 SUMMA CARE PO BOX 3620 AKRON OH 4430989 40357005 HEALTH PARTNERS HEALTH PLANS PO BOX 36439 PHOENIX AZ 8506789 40363005 MOUNTAIN STATES ADMINISTRATIVE PO BOX 32709 TUCSON AZ 8575189 40365005 QUALCHOICE OF AR 10800 FINANCIAL CENTRE PKWY LITTLE ROCK AR 7221189 40369005 PREFERRED ONE PPO NETWORK 6105 GOLDEN HILLS DR GOLDEN VALLEY MN 55416102389 40370005 EMPLOYER PLAN SERVICES INC 2180 NORTH LOOP WEST HOUSTON TX 7701889 40371005 NCHPP PO BOX 8012 WAUSAU WI 54402801289 40371015 NATIONAL HEALTH PLAN 1005 W ORANGEBURG AVENUE MODESTO CA 9535089 40373005 HEALTHSTAR PPO INC PO BOX 66930 CHICAGO IL 60666093089 40377005 ACMG INC 2570 TECHNICAL DRIVE MIAMISBURG OH 4534289 40378005 AMERICAN BENEFIT PLANS PO BOX 82060 ROCHESTER MI 4830889 40379005 CAPELLA GROUP PO BOX 201115 ARLINGTON TX 7600689 40383005 XANTUS 3401 WEST END AVENUE NASHVILLE TN 3720389 40391010 NATIONAL IAM BENEFIT TRUST FUND 1300 CONNECTICUT AVE #300 WASHINGTON DC 2003689 40391020 SPI PO BOX 40132 FORT WAYNE IN 4680489 40393005 CONNECTICARE 30 BATTERSON PARK ROAD FARMINGTON CT 0603289 40393020 CONNECTCARE ALLIANCE 4009 ORCHARD DRIVE MIDLAND MI 4864089 40397010 POLARIS BENEFIT ADMINISTRATORS PO BOX 2010 WESTERVILLE OH 4308689 40398005 CORNERSTONE BENEFITS ADMINISTRATORS INCPO BOX 1007 ELKHART IN 46515

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 40399005 HEALTH EOS PO BOX 6090 DEPERE WI 5411589 40399105 MULTIPLAN 115 FIFTH AVENUE NEW YORK NY 1000389 40399200 REAL HEALTH/MULTIPLAN 24 WESTON STREET SW GRAND RAPIDS MI 4950389 40400010 PHCS NETWORK 1100 WINTER STREET WALTHAM MA 0245189 40401005 PREMERA HEALTH PLUS PO BOX 2113 SEATTLE WA 9811189 40402005 FIA ADMINISTRATORS INC PO BOX 97547 RALEIGH NC 2762489 40402010 EVOLUTIONS HEALTHCARE SYSTEMS NETWORKPO BOX 5001 NEW PORT RICHEY FL 1465689 40405005 ONE HEALTH PLAN BENEFIT PO BOX 11111 FORT SCOTT KS 6670189 40406030 ACCESS MEDPLUS PO BOX 22358 NASHVILLE TN 3720289 40411005 ENCORE PO BOX 50487 INDIANAPOLIS IN 4625089 40411105 INTERPLAN 2575 GRAND CANAL BLVD STE 200 STOCKTON CA 9520789 40411505 BS OF PA PO BOX 535045 PITTSBURG PA 1523089 40412005 MIDWEST SECURITY INSURANCE 2700 MIDWEST DRIVE ONALSKA WI 54650876489 40412015 DIRECT CARE AMERICA 5555 AIRPORT HIGHWAY TOLEDO OH 4361589 40412025 COOPERATIVE HEALTH NETWORK 5555 AIRPORT HIGHWAY TOLEDO OH 4361589 40412105 ATRIUM HEALTH PLAN PO BOX 64338 ST PAUL MN 55154033889 40412905 IBA 2211 GREEN WAY LOUISVILLE KY 4022089 40413125 CIGNA PO BOX 28087 RALEIGH NC 27611808789 40413135 BENEFIT PLAN ADMIN OF WI 11270 W PARK PLACE STE 950 MILWAUKEE WI 5322489 40413215 PRINCIPAL HEALTHCARE NETWORK PO BOX 9498 MINNEAPOLIS MN 5544089 40413225 PACIFIC LIFE AND ANNUITY BENEFITS OFFICEPO BOX 33699 PHOENIX AZ 8506789 40413235 CELTIC INDIVIDUAL HEALTH PO BOX 8073 CHICAGO IL 60680807389 40413325 4-MOST HEALTH NETWORK PO BOX 7597 CHARLESTON WV 2535689 40413445 HEALTHSCOPE BENEFITS PO BOX 8071 LITTLE ROCK AR 7220389 40413455 AMERICAN COMMUNITY MUTUAL PO BOX 7051 MIDDLETOWN NY 1094089 40413565 ASSOCIATES FOR HEALTH CARE INC PO BOX 981 BROOKFIELD WI 53008098189 40413615 FORMOST/BCE EMERGIS PO BOX 200248 ARLINGTON TX 7600689 40413635 NALC HEALTH BENEFIT PLAN 20547 WAVERLY CT ASHBURN VA 2209389 40413705 BENESIGHT PO BOX 310 PUEBLO CO 8100289 40413715 HEALTH ALLIANCE PLAN OF ILLINOIS 102 E MAIN ST URBANA IL 6180189 40413735 REGENTS HEALTH & LIFE PO BOX 30805 SALT LAKE CITY UT 8413089 40413745 PENNSYLVANIA BLUE SHIELD PO BOX 890173 CAMP HILL PA 17089017389 40413805 DELTA HEALTH SYSTEMS PO BOX 12307 FRESNO CA 937772307

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5/1/03 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

CARRIER I.D. LISTING

OI Carrier ID Carrier Name Street City State Zip code

89 40413815 NETWORK HEALTH PLAN PO BOX 568 MENASHA WI 5495289 40413905 BCBS OF IA 636 GRAND AVE STATION 39 DES MOINES IA 5030989 40413915 WLEC 1705 INDIAN WOOD CIRCLE MAUMEE OH 4353789 40413925 EMERALD HEALTH ALLIANCE PO BOX 10399 EUGENE OR 97440239989 40413935 AULTCARE PPA PLAN PO BOX 6910 CANTON OH 44706091089 41413125 CIGNA PO BOX 28087 RALEIGH NC 276118087

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