cc carriername address1 city state zip phone …dhhr.wv.gov/bms/provider/pcpp/documents/carrier...

62
rier Code History File CC CarrierName Address1 City State Zip Phone Comments 1010 BCBS of MICHIGAN PO BOX 2888 DETROIT MI 48231-2888 (800) 637-2227 emdeon online 1050 MUTUAL of OMAHA INSURANCE CO. MUTUAL of OMAHA PLAZA OMAHA NE 68175-0001 (800) 775-1000 emdeon online 1110 UNION BANKERS INS. CO. PO BOX 655433 DALLAS TX 75265-9952 (214) 939-0821 1120 UNION FIDELITY LIFE PO BOX 8132 FT WASHINGTON PA 01903-4000 (877) 825-9336 1131 BCBS of COLORADO PO BOX 5747 DENVER CO 80217-0000 (877) 833-5742 emdeon online 1210 WASHINGTON NATIONAL INS PO BOX 3091 EVANSTON IL 60204-3091 (800) 705-8424 www.conseco.com 1310 BCBS FEDERAL PO BOX 33932 SEATTLE WA 98133-0000 (800) 535-5266 navinet 1530 PEIA PO BOX 3262 CHARLESTON WV 25332-3262 (888) 680-7342 1540 CAMBRIDGE INTEGRATED 110 GIBRALTAR ROAD/SUITE 116 HORSHAM PA 19040-0000 (215) 443-0404 1570 BCBS of UTAH PO BOX 30270 SALT LAKE CITY UT 84130-0000 (801) 333-2320 emdeon online 1670 HEALTHSMART [WELLS FARGO TPA] PO BOX 3043 CHARLESTON WV 25331-3043 (304) 340-0253 emdeon online 1700 NATIONAL FOUNDATION LIFE 777 MAIN STREET SUITE 900 FT WORTH TX 76102-0000 [800] 221-9039 1710 WV LABORER'S TRUST 1 UNION SQUARE CHARLESTON WV 25302-0000 (304) 342-5142 1711 LABORERS AGC TRUST of MONTANA PO BOX 5434 SPOKANE WA 99205-0000 [877]434-0176 1720 UMWA PO BOX 619099 DALLAS TX 75261-9741 (800) 291-1425 888-865-5290 1750 PEOPLES BENEFIT LIFE MEM. CAPITAL HOLDING FAMILY VALLEY FORGE PA 19494-0000 (800) 523-7900 1772 TOWER LIFE INSURANCE CO 310 S ST. MARY'S STREET SUITE 400 SAN ANTONIO TX 78205-3164 (800) 592-5926 1785 NLI AMERICA (NIPPON LIFE INSURANCE CO) PO BOX 39710 COLORADO SPRING CO 80949-3910 (800) 937-6540 1845 CENTURY HEALTHCARE PO BOX 2256 GRAPEVINE TX 76099-0000 (866) 261-9998 1850 BCBS of PENNSYLVANIA HIGHMARK PO BOX 890062 CAMP HILL PA 17089-0062 (800) 547-3627 emdeon online 1880 UFCW LOCAL #347 600 D STREET SUITE 250 SOUTH CHARLESTONWV 25303-0000 (304) 343-7682 1950 AMERICAN POSTAL WORKERS (APW) PO BOX 967 SILVER SPRING MD 20910-0000 (800) 222-2798 emdeon online 2020 BCBS of OHIO PO BOX 956 TOLEDO OH 43697-0000 (800) 242-1936 emdeon online or www.anthem.com 2030 WAL-MART CLAIMS ADMINISTRATION 922 W. WALNUT /STE A ROGERS AR 72756-3206 (800) 421-1362 2040 HEALTH PLAN OF UPPER OHIO VALLEY (HMO) 52160 NATIONAL RD E. ST. CLAIRSVILLE OH 43950-0000 (800) 624-6961 2080 BCBS of ALBANY NEW YORK 187 WOLFE ROAD--PO BOX 15013 ALBANY NY 12212-0000 (800) 888-1238 emdeon online 2110 HUMANA INSURANCE CO PO BOX 740036 LOUSIVILLE KY 40512-4601 (800) 852-9556 emdeon online

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Page 1: CC CarrierName Address1 City State Zip Phone …dhhr.wv.gov/bms/Provider/PCPP/Documents/Carrier Lists/bms_provinfo... · Active Carrier Code History File . CC. CarrierName: Address1

Active Carrier Code History File

CC CarrierName Address1 City State Zip Phone Comments

1010 BCBS of MICHIGAN PO BOX 2888 DETROIT MI 48231-2888 (800) 637-2227 emdeon online

1050 MUTUAL of OMAHA INSURANCE CO. MUTUAL of OMAHA PLAZA OMAHA NE 68175-0001 (800) 775-1000 emdeon online

1110 UNION BANKERS INS. CO. PO BOX 655433 DALLAS TX 75265-9952 (214) 939-0821

1120 UNION FIDELITY LIFE PO BOX 8132 FT WASHINGTON PA 01903-4000 (877) 825-9336

1131 BCBS of COLORADO PO BOX 5747 DENVER CO 80217-0000 (877) 833-5742 emdeon online

1210 WASHINGTON NATIONAL INS PO BOX 3091 EVANSTON IL 60204-3091 (800) 705-8424 www.conseco.com

1310 BCBS FEDERAL PO BOX 33932 SEATTLE WA 98133-0000 (800) 535-5266 navinet

1530 PEIA PO BOX 3262 CHARLESTON WV 25332-3262 (888) 680-7342

1540 CAMBRIDGE INTEGRATED 110 GIBRALTAR ROAD/SUITE 116 HORSHAM PA 19040-0000 (215) 443-0404

1570 BCBS of UTAH PO BOX 30270 SALT LAKE CITY UT 84130-0000 (801) 333-2320 emdeon online

1670 HEALTHSMART [WELLS FARGO TPA] PO BOX 3043 CHARLESTON WV 25331-3043 (304) 340-0253 emdeon online

1700 NATIONAL FOUNDATION LIFE 777 MAIN STREET SUITE 900 FT WORTH TX 76102-0000 [800] 221-9039

1710 WV LABORER'S TRUST 1 UNION SQUARE CHARLESTON WV 25302-0000 (304) 342-5142

1711 LABORERS AGC TRUST of MONTANA PO BOX 5434 SPOKANE WA 99205-0000 [877]434-0176

1720 UMWA PO BOX 619099 DALLAS TX 75261-9741 (800) 291-1425 888-865-5290

1750 PEOPLES BENEFIT LIFE MEM. CAPITAL HOLDING FAMILY VALLEY FORGE PA 19494-0000 (800) 523-7900

1772 TOWER LIFE INSURANCE CO 310 S ST. MARY'S STREET SUITE 400 SAN ANTONIO TX 78205-3164 (800) 592-5926

1785 NLI AMERICA (NIPPON LIFE INSURANCE CO) PO BOX 39710 COLORADO SPRING CO 80949-3910 (800) 937-6540

1845 CENTURY HEALTHCARE PO BOX 2256 GRAPEVINE TX 76099-0000 (866) 261-9998

1850 BCBS of PENNSYLVANIA HIGHMARK PO BOX 890062 CAMP HILL PA 17089-0062 (800) 547-3627 emdeon online

1880 UFCW LOCAL #347 600 D STREET SUITE 250 SOUTH CHARLESTONWV 25303-0000 (304) 343-7682

1950 AMERICAN POSTAL WORKERS (APW) PO BOX 967 SILVER SPRING MD 20910-0000 (800) 222-2798 emdeon online

2020 BCBS of OHIO PO BOX 956 TOLEDO OH 43697-0000 (800) 242-1936 emdeon online or www.anthem.com

2030 WAL-MART CLAIMS ADMINISTRATION 922 W. WALNUT /STE A ROGERS AR 72756-3206 (800) 421-1362

2040 HEALTH PLAN OF UPPER OHIO VALLEY (HMO) 52160 NATIONAL RD E. ST. CLAIRSVILLE OH 43950-0000 (800) 624-6961

2080 BCBS of ALBANY NEW YORK 187 WOLFE ROAD--PO BOX 15013 ALBANY NY 12212-0000 (800) 888-1238 emdeon online

2110 HUMANA INSURANCE CO PO BOX 740036 LOUSIVILLE KY 40512-4601 (800) 852-9556 emdeon online

Page 2: CC CarrierName Address1 City State Zip Phone …dhhr.wv.gov/bms/Provider/PCPP/Documents/Carrier Lists/bms_provinfo... · Active Carrier Code History File . CC. CarrierName: Address1

2180 ANTHEM OF VA NATIONAL ACCOUNTS PO BOX 27401 RICHMOND VA 23279-0000 (800) 533-1120 emdeon online

2200 HIGHMARK BCBS WEST VIRGINIA PO BOX 7026 WHEELING WV 26003-0000 (800) 654-5028 emdeon online as Mountain State

2331 P5 HEALTH SERVICES PO BOX 9554 SALT LAKE CITY UT 84109-0554 (800) 569-0364

2333 HEALTHCARE SAVINGS 4530 PARK ROAD, SUITE 110 CHARLOTTE NC 28209-0000 (888) 330-8408

2334 ANTHEM BLUE CROSS AND BLUE SHIELD 120 MONUMENT CIRCLE INDIANAPOLIS IN 46204-0000 (317) 488-6000 emdeon online

2336 PRIORITY HEALTH CARE 621 LYNNHAVEN PKWY VIRGINIA BEACH VA 23452-0000 (800) 942-5999 emdeon online

2338 NATIONAL TELECOMMUNICATIONS COOP ASSN (NTCA) ONE WEST PACK SQ, SUITE 600 ASHVILLE NC 28801-3459 (828) 281-9000

2339 RX AMERICA 221 N CHARLES STREET SALT LAKE CITY UT 84109-0000 (800) 770-8014

2350 BANKERS FIDELITY PO BOX 105652 ATLANTA GA 30348-0000 (866) 458-7499

2410 BCBS of NATIONAL CAPITAL AREA 550 12TH ST. S.W. WASHINGTON DC 20065-0000 (202) 479-8000 emdeon online

2520 MED-BEN PO BOX 1099 NEWARK OH 43058-0000 (740) 522-8425 [email protected]

2580 IUOE PO BOX 2626 HUNTINGTON WV 25726-0000 (304) 525-0482

2584 BCBS of SOUTH DAKOTA PO BOX 5023 SIOUX FALLS SD 00005-7117 (800) 524-9242 emdeon online

2590 ALLIED BENEFIT PO BOX 59 HUNTINGTON WV 25706-0059 (304) 529-2345

2620 WESTERN-SOUTHERN LIFE INS. PO BOX 5735 CINCINNATI OH 45201-5735 (800) 333-5152

2833 KBA (KEY BENEFIT ADMINSTRATORS) PO BOX 1239 FORT MILLS SC 29716-1239 (866) 387-0489 emdeon online

2841 INDEPENDENT ADMINISTRATORS PO BOX 1010 HORSHAM PA 19044-8010 (888) 356-7899

2860 EMPLOYER-TEAMSTERS JOINT COUNCIL 6810 MACCORKLE AVE. SE CHARLESTON WV 25304-0000 (304) 925-4181

2890 BABB INC. 850 RIDGE AVENUE PITTSBURGH PA 15212-0000 (800) 245-6102

2930 WORKERS COMPENSATION FUND 601 MORRIS STREET CHARLESTON WV 25301-1416 (800) 628-4265

3170 AMERICAN COMBINED LIFE INS. CO. BOX 1009 LANGHORNE PA 19047-0000 (800) 871-0260

3250 PRINCIPAL MUTUAL INS. 401 EAST CITY AVE. BALA CYNWYD PA 19004-0000 (800) 843-1371 www.ebctpa.com

3290 BOILERMAKERS NATIONAL PO BOX 23825 TUCSON AZ 85734-0000 (866) 342-6555

3420 SELF-FUNDED PLANS INC. 2535 WASHINGTON RD. SUITE 1130 PITTSBURGH PA 15241-0000 (800) 228-7374

3530 COLONIAL BENEFITS ADMINISTRATOR PO BOX 3770 CAPITAL HEIGHTS MD 20791-0000 (301) 731-8855

3590 BCBS of NEW YORK EMPIRE 11 W. 42ND STREET NEW YORK NY 10036-0000 (800) 377-5156 emdeon online

3630 AMERICAN GENERAL LIFE & ACCIDENT PLANS PO BOX 1500 NASHVILLE TN 37202-1500 (800) 888-2452 emdeon online

3650 COMP I CENTER (BC/BS) DENTAL PO BOX 898857 CAMP HILL PA 17089-0000 (717) 541-3594

3780 AMALGAMATED LIFE INSURANCE CO. PO BOX 1440 NEW YORK NY 10116-1440 (800) 624-5844

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3810 UNDERWRITERS SAFETY & CLAIMS INSURANCE PO BOX 23507 LOUISVILLE KY 40223-0000 (502) 244-1343 www.ebctpa.com

3850 METLIFE DENTAL SERVICES PO BOX 30434 TAMPA FL 33630-0434 (800) 638-7452 emdeon online

3870 OPERATING ENGINEERS BENEFIT FUN 5901 HARFORD RD. SUITE C BALTIMORE MD 21214-0000 (410) 254-9595

3990 CORPORATE SYSTEMS ADMINISTRATION PO BOX 4985 JOHNSON CITY TN 37602-0000 (423) 282-3420 www.csabenefits.com

4170 AMERICAN BENEFITS PO BOX 2687 HUNTINGTON WV 25726-0000 (800) 527-9311 [email protected]

4320 FRANK, VACCARO & ASSOC - WV PIPE TRADES H&W FUND 600 CHARLES ST.TREET WELLSBURG WV 26070-0000 (304) 737-0768

4330 TIME INSURANCE COMPANY PO 624--501 W. MICHIGAN MILWAUKEE WI 53201-0000 (414) 299-1436 emdeon online

4340 PENN WESTERN BENEFITS INC. PO BOX 7834 GREENSBORO NC 27417-0000 (910) 292-4004

4610 CARPENTERS HEALTH. & WELFARE WV 401 ELEVENTH STREET HUNTINGTON WV 25701-0000 (304) 525-0331

4650 CAREFIRST BCBS MD PO BOX 804 OWINGS MILLS MD 21117-0000 (800) 843-4280 www.carefirst.com

4700 WV STEAMFITTERS-UNION LABOR PO BOX 90988 WASHINGTON DC 20090-0988 (304) 292-8713

4800 IRON WORKERS BENEFIT TRUST PO BOX 398 DAYTON OH 45401-0000 (800) 331-4277

4840 BCBS of ILLINOIS PO BOX 1220 CHICAGO IL 60690-0000 (800) 541-2762 emdeon online

4905 PLANNED ADMINISTRATORS PO BOX 6702 COLUMBUS SC 29260-0000 (888) 645-6410

5008 BCBS of ALABAMA PO BOX 2294 BIRMINGHAM AL 35201-0000 (800) 517-6425 emdeon online

5010 BENEFIT PLAN ADMIN (BPA) PO BOX 7060 MIDDLETOWN NY 10940-0000 (800) 277-8973 [email protected]

5110 ASSURANT HEALTH (FORTIS) PO BOX 624 MILWAUKEE WI 53201-0000 (414) 271-3011

5120 EMPLOYEE BENEFIT MANAGEMENT COR 4789 RINGS ROAD DUBLIN OH 43017-1599 (614) 278-6620

5141 RICHARDSON INS CO (JAN CARE AMBULANCE) 127 DOVE LANE GLEN MORGAN WV 25813-0000 (304) 253-8952

5190 HEALTHLINK (GENELCO) PO BOX 41904 ST. LOUIS MO 63141-9998 (800) 548-2042

5260 EDUCATORS MUTUAL LIFE INS. CO. PO BOX 83888 LANCASTER PA 17608-3888 (717) 397-2751 [email protected]

5270 BLUE CROSS of CALIFORNIA PO BOX 60007 LOS ANGELES CA 90060-0000 (800) 444-2595 emdeon online

5272 BLUE SHIELD of CALIFORNIA PO BOX 272540 CHICO CA 95927-0000 (800) 541-6652 emdeon online

5480 CENTRAL RESERVE LIFE 17800 ROYALTON ROAD CLEVELAND OH 44136-5197 (800) 253-4641 emdeon online

5530 MARTIN ASSOCIATES, INC. PO BOX 1158 BEAVER WV 25813-1158 (304) 255-4073

5600 BENEFIT COORDINATORS CORP. 111 RYAN STREET. SUITE 300 PITTSBURGH PA 15205-1301 (800) 685-1301

5640 NAT'L ASSOC OF LETTER CARRIERS HLTH BENEFIT PLAN (NALC)20547 WAVERLY ST. ASHBURN VA 22093-0000 (888) 636-6252

5670 NASI WELFARE FUND 8000 CORPORATE DR. LANDOVER MD 20785-0000 (301) 577-1700

5700 AMERICAN COMMUNITY 39201 SEVEN MILE RD LIVONIA MI 48152-0000 (734) 591-9000

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5750 GENERAL INS. EXCHANGE AGENCY PO BOX 1849 STOW OH 44224-0000 (216) 688-4822

5784 WELLCARE INC PO BOX 4438 SCRANTON PA 18505-0000 (866) 235-2770

5885 KENTUCKY LABORERS HEALTH & WELFARE 1996 BYPASS CIRCLE LAWRENCE KY 40342-0000 (800) 598-7330

6025 DELTA DENTAL of KANSAS PO BOX 789769 WICHITA KS 67278-9769 (800) 234-3375

6066 DEFINITY HEALTH (DIVISION OF UHC) PO BOX 9525 AMHERST NY 14226-0000 (866) 333-4648 www.definityhealth.com

6118 ENVISION RX 2182 E AURORA RD SUITE 201 TWINBURG OH 44087-0000 (800) 361-4542

6210 BCBS MASTER HEALTH PLUS PO BOX 1560 BOSTON MA 02104-1560 (800) 327-6716 emdeon online

6370 UNITED TEACHERS ASSOC. PO BOX 26580 AUSTIN TX 78755-0580 (512) 451-2224

6450 MANAGED CARE OF AMERICA - MCA 1910 COCHRAN RD MANOR OAK BLDG 2PITTSBURGH PA 15220-0000 (412) 922-0780 www.ebctpa.com

6460 STRATEGIC HEALTH SERVICE PO BOX 2633 CHARLESTON WV 25329-2633 (304) 414-0646

6500 NATIONWIDE INSURANCE ONE NATIONWIDE PLAZA COLUMBUS OH 43215-0000 (800) 882-2822

6501 NATIONWIDE SPECIALTY HEALTH PO BOX 42033 SPRINGFIELD MA 01101-0000 (800) 635-6585 emdeon online

6551 EQUITABLE PLAN SERVICES (EPS) PO BOX 720480 OKLAHOMA CITY OK 73172-0480 (405) 755-2929 www.ebctpa.com

6592 BC of WESTERN PA (ABRAXAS) PO BOX 540 PITTSBURGH PA 15230-0000 (800) 245-2763 emdeon online

6605 BCBS CAPITAL 2500 ELMERTON AVE. HARRISBURG PA 17177-9503 (800) 962-2242 emdeon online

6614 CONTINENTAL GENERAL PO BOX 247007 OMAHA NE 06812-4000 (800) 545-8905 emdeon online

6617 MONUMENTAL GENERAL INSURANCE GROUP PO BOX 97 SCRANTON PA 18504-0097 (800) 752-9797

6618 BCBS of MINNESOTA PO BOX 64061 ST.PAUL MN 55164-0000 (800) 382-2000 emdeon online

6626 LOCAL NO. 1 HEALTH FUND PO BOX 11137 CHICAGO IL 60611-1137 (312) 649-0444

6630 DERMOX CORP. G.H.C.P.HLTH.CR.FD PO BOX 6219 BLUEFIELD WV 24701-6219 (304) 325-5754

6631 BCBS of NORTH CAROLINA PO BOX 2291 DURHAM NC 27702-2291 (919) 489-7431 emdeon online

6645 NORTH AMERICAN BENEFITS NETWORK PO BOX 94928 CLEVELAND OH 44101-4928 (800) 321-4085

6660 AMERICAN COMMERICAL TERMINALS PO BOX 610 JEFFERSONVILLE IN 47130-0000 (800) 548-7689

6665 BELL ATLANTIC SERVICE UNIT PO BOX 3742 CHARLESTON WV 25337-3742 (800) 642-2411

6693 METRAHEALTH METLIFE PO BOX 30429 TAMPA FL 33630-0000 (813) 637-1200

6697 RAVENSWOOD ALUMINUM CORP. RT 1 BOX 37 RAVENSWOOD WV 26164-0000 (304) 273-6000

6710 ANTHEM BCBS of MISSOURI PO BOX 14882 ST LOUIS MO 63178-4882 (800) 392-1104 emdeon online

6711 ROYAL NEIGHBORS OF AMERICA PO BOX 10850 CLEARWATER FL 33757-8850 (877) 815-8877

6713 PHARMACY DATA MANAGEMENT (PDM) 940 WINDHAM COURT, SUITE 1 BOARDMAN OH 44512-0000 (866) 311-8433

Page 5: CC CarrierName Address1 City State Zip Phone …dhhr.wv.gov/bms/Provider/PCPP/Documents/Carrier Lists/bms_provinfo... · Active Carrier Code History File . CC. CarrierName: Address1

6714 DENTAL SERVICES PO BOX 9274 OXNARD CA 90131-0000 (800) 627-0004

6806 CENTRAL PA TEAMSTERS HLTH & WELFARE FUND PO BOX 15224 READING PA 19612-5224 (800) 422-8330

6870 SELECT BENEFIT ADMINISTRATORS PO BOX 440 ASHLAND WI 54806-0000 (800) 497-3699

6990 COVENTRY DENTAL PO BOX 7402 LONDON KY 00004-0742 [866] 690-4908

6991 METLIFE TRICARE DENTAL PO BOX 14181 LEXINGTON KY 40512-0000 (855)638-8371 FAX 855-763-1333 emdeon for metlife dental

6999 TRICARE EXPRESS SCRIPTS PO BOX 66518 ST LOUIS MO 00006-3166 (877) 363-1303

7001 MYLAN PHARMACEUTICALS INC, PO BOX 4310 MORGANTOWN WV 26504-4310 (304) 599-2595

7017 BCBS of TENNESSEE PO BOX 180150 CHATTANOOGA TN 37401-7150 (423) 755-5993 emdeon online

7028 PENN TREATY LIFE INS. CO. PO BOX 151 SYBERTSVILLE PA 18251-0000 (800) 635-7418

7031 MEDICAL CLAIMS SERV. ONE WALL STREET, SUITE 2A RAVENSWOOD WV 26164-0160 (888) 225-0522

7035 AMERICAN NATIONAL LIFE of Texas ONE MOODY PLAZA GALVESTON TX 77553-1790 (800) 899-6520

7036 BCBS of WISCONSIN PO BOX 2141 MILWAUKEE WI 53201-2141 (800) 242-7296 emdeon online

7040 GOODYEAR TIRE & RUBBER CO. STATE RT. 2 APPLEGROVE WV 25550-0000 (304) 576-4519

7069 PIEDMONT ADMIN. PO BOX 78030 GREENSBORO NC 27427-8030 (336) 544-2222

7083 NATIONAL ASBESTOS WORKERS UNION 4600 POWDER MILL RD. STE. 100 BELTSVILLE MD 20705-0000 800.386.3632

7108 EMERALD HEALTH PO BOX 308014 CLEVELAND OH 44130-8014 (216) 479-2030

7110 EMPLOYEE BENEFIT SERVICE CENTER PO BOX 8130 SO. CHARLESTON WV 25303-8130 (304) 744-7723

7120 STAR MARKETING & ADMIN. INC. PO BOX 7922 LAKE FOREST IL 60045-2500 (800) 522-1246

7153 KANAWHA INSURANCE COMPANY PO BOX 610 LANCASTER SC 29721-0000 (800) 287-2434

7165 HAGERSTOWN TMSTRS & MTR.CARRIER 10312 REMINGTON DR. HAGERSTOWN MD 21740-0000 (301) 739-7550

7185 MDIPA (HMO) 4 TAFT CT. ROCKVILLE MD 20850-0000 (301) 251-4079

7203 NEW ERA LIFE INS. PO BOX 4884 HOUSTON TX 77210-4884 (800) 552-7879

7207 TRANS-GEN.SERV.CO INC PO BOX 16532/730 HOLIDAY DR PITTSBURGH PA 15242-6532 (800) 242-7385

7211 PIMCO PO BOX 2005/ONE PHICO DR. MECHANICSBURG PA 17055-0782 (800) 627-4626

7236 OHIO CARPENTERS H&W FUND 6281 YOUNGSTOWN NILES OH 44446-4690 (800) 362-9354

7240 CENTRAL STATES FUNDS PO BOX 5103 DES PLAINES IL 60017-5103 (800) 323-5000 emdeon online

7254 AMERICAN MEDICAL SECURITY PO BOX 19032 GREEN BAY WI 54307-9032 (800) 232-5432

7258 MEDI-SUN HEALTH (FIRST HEALTH) 13632 NORTH 99TH AVENUE SUN CITY AZ 08535-1000 (800) 627-4759

7268 COMMERCE GROUP PO BOX 900 ELYRIA OH 44036-0000 (800) 223-9941

Page 6: CC CarrierName Address1 City State Zip Phone …dhhr.wv.gov/bms/Provider/PCPP/Documents/Carrier Lists/bms_provinfo... · Active Carrier Code History File . CC. CarrierName: Address1

7281 DELTA DENTAL OF ARKANSAS PO BOX 15965 N. LITTLE ROCK AK 72231-0000 (800) 462-5410

7283 CHAPMAN PRINTING CO. PO BOX 2968 HUNTINGTON WV 25278-0000 (304) 528-2791

7285 BCBS WASHINTON /ALASKA (REGENCE) PO BOX 327 SEATTLE WA 98111-0000 (800) 345-6784 emdeon online

7294 CAREMARK ADVANCE PCS PO BOX 686005 SAN ANTONIO TX 78268-000 (800) 966-5772

7298 LOOMIS CO. PO BOX 7011 WYOMISSING PA 19610-0000 (866) 203-3931

7312 AMERITAS LIFE INS. CORP. PO BOX 82520 LINCOLN NE 68501-2520 (800) 487-5553 emdeon online

7317 BENEFIT MANAGEMENT SYSTEMS 6650 BELAIR RD. 2ND FLR. BALTIMORE MD 21206-0000 (410) 444-8518

7318 BENEFIT MANAGEMENT SERVICES PO BOX 1178 MATTHEWS NC 28106-0000 [800] 228-1803 [704] 845-5608

7321 EMPLOYEE BENEFIT CONSULTANTS MID AMERICA (EBC) 9200 SHELBYVILLE RD. SUITE 500 LOUISVILLE KY 40222-0000 (800) 354-9223 www.ebctpa.com

7323 WORLD INSURANCE PO BOX 3160 OMAHA NE 68103-0160 (402) 496-8195 Emdeon online

7332 ADVANTAGE HLTH CONGRESS LIFE 121 SEVENTH ST PITTSBURGH PA 15222-0000 [800]333-3930

7335 PAN AMERICAN LIFE INS. CO. PO BOX 61070 NEW ORLEANS LA 70160-0000 (877) 569-3075

7350 CHESTERFIELD RESOURCES PO BOX 1884 AKRON OH 44309-0000 (800) 321-0935

7370 CORPORATE BENEFITS 145 SCALEYBARK, RD SUITE E CHARLOTTE NC 28202-0000 (704) 373-0447 emdeon online

7377 BCBS of TEXAS PO BOX 660044 DALLAS TX 75266-0044 (214) 669-3900 emdeon online

7422 UNITED MEDICAL RESOURCES PO BOX 145801 CINCINNATI OH 45250-5801 (800) 837-3711 www.ebctpa.com

7431 BCBS of WESTERN NEW YORK (TRADITIONAL BLUE) 1901 MAIN STREET PO BOX 1199 BUFFALO NY 14204-0356 (716) 884-0774 emdeon online

7443 CORESOURCE 6100 FAIRVIEW RD SUITE 1000 CHARLOTTE NC 28210-0000 (704) 552-0900 emdeon online

7445 BCBS of NEBRASKA PO BOX 3248 OMAHA NE 68180-0001 (800) 642-8980 emdeon online

7452 BENEFIT ASSISTANCE PO BOX 950 HURRICANE WV 25526-0950 (800) 448-1131 [email protected]

7459 CHAMPVA CENTER DEPT. of VETERANS AFFAIRS PO BOX 65024 DENVER CO 80206-5024 (800) 733-8387 emdeon online

7482 NATIONAL HEALTH INSURANCE CO PO BOX 619999 DALLAS TX 75261-9999 (800) 237-1900

7491 OPTIMA HEALTH PLAN PO BOX 5028 TROY MI 48007-5028 (800) 229-8822

7513 PEOPLES SECURITY LIFE INS CO PO BOX 1144 BECKLEY WV 25801-0000 (800) 462-7729

7534 THE NEW ENGLAND MUTUAL PO BOX 30466 TAMPA FL 33630-3466 (304) 291-5174

7536 ASSURE CARE / GMP HEALTH & WELFARE FUND PO BOX 1849 STOW OH 44224-0000 (800) 968-7222

7562 GROUP BENEFITS SERVICES (was BEECH ST) C/O GBS PO BOX 4368 LUTHERVILLE MD 21094-0000 (410) 832-1300

7563 PHILADELPHIA AMER. LIFE PO BOX 2465 HOUSTON TX 77252-0000 (713) 871-4600

7574 VARIABLE PROTECTION ADMINISTRATORS 6902 PEARL RD. SUITE 500 CLEVELAND OH 44130-0000 (440) 884-8585

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7604 BCBS of NEW JERSEY PO BOX 387 NEWARK NJ 07105-0000 (201) 466-5460 emdeon online

7609 SIMPLIFI ESO (formerly CBCA of HCA) PO BOX 1479 MINNEAPOLIS MN 55440-0000 (800) 422-0055 www.ebctpa.com

7612 OHIO BRICKLAYERS H &W FUND 120 W 5TH ST.#1100 CINCINNATI OH 45202-0000 (513) 381-6886

7635 SOUTHERN HEALTH TPA PO BOX 7704 LONDON KY 40702-0000 (804) 747-3700 under coventry on emdeon online

7643 NASE - NATIONAL ASSOC SELF EMPLOYE PO BOX 982009 N RICHLANDS TX 76180-0000 (800) 527-2845

7653 AULT CARE INS. PO BOX 6910 DUEBER STATION CANTON OH 44706-6910 (800) 344-8858

7655 NYHART INS. PO BOX 80884 INDIANAPOLIS IN 46280-0884 (800) 428-7106

7688 OHIO OPERATING ENGINEERS H & W PO BOX 12009 COLUMBUS OH 43212-0009 (800) 282-1767

7690 STATE FARM INSURANCE ONE STATE FARM PLAZA BLOOMINGTON IL 61710-0000 (866) 855-1212

7695 HEALTH NET PO BOX 470 WHEELING WV 25329-0000 (800) 405-1616 healthnet national on emdeon online

7697 PACIFICARE PO BOX 6035 CYPRESS CA 90630-6035 (714) 952-1121 emdeon online

7702 TEAMCARE PO BOX 5116 DES PLAINES IL 60017-5116 (800) 323-2190

7704 AMERISCRIPT (RX) 4301 DARROW ROAD STOW OH 44224-0000 (330) 686-7010

7709 PHARMALINK PO BOX 9007 OVERLAND PARK KS 66201-0000 (800) 228-1436

7722 BENEFIT SERVICES INC. PO BOX 4138 AKRON OH 44321-0000 (330) 666-0337

7725 BCBS of FLORIDA PO BOX 1798 JACKSONVILLE FL 32231-0000 (800) 727-2227 emdeon online

7730 EXPRESS SCRIPTS PO BOX 66773/14000 RIVERPORT DR ST LOUIS MO 63043-0000 (800) 451-6245

7740 TRI-COUNTY BUILDING & TRADES PO BOX 4138 AKRON OH 44321-4138 (330) 753-8335

7757 BCBS of SOUTH CAROLINA PO BOX 6000 GREENVILLE SC 26960-6000 (803) 788-3860 www.southcarolinablues.com

7764 RISK MNGT SERVICE (RMSC) PO BOX 6309 SYRACUSE NY 13217-0000 (877) 300-9969

7765 COVENTRY HEALTH CARE of WV, INC PO BOX 7373 LONDON KY 40742-0000 (800) 348-2922 emdeon online

7769 MANAGE MED PO BOX 6125 GREENVILLE SC 29606-0000 (800) 992-8088

7779 FOLA COAL CO. PO BOX 180 BICKMORE WV 25019-0000 (304) 587-4100

7780 PACIFIC LIFE AND ANNUITY PO BOX 33699 PHOENIX AZ 85067-0000 (800) 729-8545

7781 ELECTRICAL WORKERS #369 906 MINOMA AVE LOUISVILLE KY 40217-0000 (800) 427-2495

7787 DELTA U S A 95 WHITEBRIDGE RT SUITE 506 NASHVILLE TN 37205-0000 (800) 223-3104

7801 ASSOCIATED ADMINSTRATORS 911 RIDGE BROOK ROAD SPARKS MD 21152-0000 (800) 638-2972

7806 METROPOLITAN LIFE PO BOX 2078 AURORA IL 60507-0000 (800) 638-7452

7813 VISION SERVICE PLAN (VSP) PO BOX 997100 SACRAMENTO CA 95899-7100 (800) 877-7195

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7821 SRC STRATEGIC RESOURCE CO. PO BOX 23759 COLUMBIA SC 29224-3759 (803) 736-1999

7823 BCBS of DELAWARE PO BOX 1991 WILMINGTON DE 19895-0000 (302) 429-0260 emdeon online

7833 TEAMSTERS #639 HLTH TRUST FUND PO BOX 1399 ROCKVILLE MD 20849-0000 (202) 636-8181

7836 HEALTHSCOPE PO BOX 8002 LITTLE ROCK AR 72203-0000 (800) 972-3025

7837 WV PLUMBERS & STEAMFITTERS 1200 THREE GATEWAY CTR. PITTSBURGH PA 15222-0000 (412) 471-2885

7846 MEDCOHEALTH PO BOX 247 LEE'S SUMMIT MO 64063-0000 (800) 988-2262

7847 STANDARD LIFE PO BOX 25097 OKLAHOMA CITY OK 73193-0000 [800] 827-2524

7851 ACS PO BOX 2000 WINSTON SALEM NC 27102-0000 (800) 849-5370

7868 PLUMBERS & PIPEFITERS LOCAL 189 1230 KINNEAR RD. COLUMBUS OH 43212-0000 (614) 486-5203

7877 AETNA PHARMACY MANAGEMENT PO BOX 398106 MINNEAPOLIS MN 55435-0000 (800) 238-6279

7884 JOHN DEER HEALTH INSURANCE 380 KINGS DAUGHTER DR. FRANKFORT KY 40601-0000 (800) 892-8602

7891 SISCO (SELF INSURED SERV.CO.) PO BOX 389 DUBUQUE IA 52004-0389 (800) 457-4726

7912 CARILION HLTH PLANS PO BOX 1531 ROANOKE VA 24007-0000 (540) 857-5260

7916 PARADIGM CARE PLANS PO BOX 1268 TIFTON GA 31793-1268 (800) 841-7735

7921 SHENANDOAH LIFE INSURANCE PO BOX 12847 ROANOKE VA 24015-4701 (740) 283-3640

7932 OPTUM RX--PRESCRIPTIONS SOLUTIONS LC07-190 PO BOX 6037 CYPRESS CA 90630-0000 (800) 797-9791

7939 ATRIUM HEALTH PLAN(HMO-MIDWEST) PO BOX 64338 ST. PAUL MN 55164-0000 (800) 535-4041

7940 PIPELINE INDUSTRY BEN. FUND PO BOX 470950 TULSA OK 74147-0950 (918) 280-4800

7945 PHARMACY NETWORK(PNNC) 4000 WAKE FOREST RD. RALEIGH NC 27607-0000 (800) 331-7108

7951 UNITED PROVIDER SERVICES PO BOX 820277 FT WORTH TX 76182-0277 (800) 852-4492

7953 SOUTHERN ELECTRICAL HEALTH FUND 3928 VOLUNTEER DR. CHATTANOOGA TN 37416-0000 (423) 899-2593

7956 KAISER PERMANENTE PO BOX 6473 ROCKVILLE MD 20849-0000 (800) 777-7902 emdeon online

7959 NGS AMERICAN INC.--- CORESOURCE PO BOX 2310 MT CLEMENS MI 48046-2310 (877) 647-0083 www.ngs-american.com

7981 DELTA DENTAL OF CAL PO Box 997330 SACRAMENTO CA 94120-0000 (415) 972-8300

7983 NCAS (NATIONAL CLAIMS ADMINISTRATIVE SERVICE) PO Box 1196 OWINGS MILLS MD 21117-1196 (703) 934-6232

7996 METLIFE DENTAL PO BOX 6106 UDICA NY 13504-0000 (800) 638-8908 emdeon online

8002 SPECTERA UNITED OPTICAL 2211 LORD BALTIMORE DR. BALTIMORE MD 21244-0000 (800) 638-3120

8004 ASC ADMIN. SERVICE CONSULT. PO BOX 928 FINDLAY OH 45839-0000 (800) 523-5789

8016 ALLIANCE HEALTH BENEFIT PLAN PO BOX 934 FREDERICK MD 21705-0000 (800) 342-3289

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8016 ALLIANCE HEALTH BENEFIT PLAN (ONENET PPO) PO BOX 934 FREDERICK MD 21705-0934 (800) 342-3289 PLUMBERS & PIPEFITTERS LOCAL 189 877-804-4629

8017 DELTA DENTAL ONE DELTA DRIVE MECHANICSBURG PA 17055-6999 (800) 932-0783

8021 UNITED AMERICAN INS CO PO BOX 8080 MCKINNEY TX 75070-8080 (972) 529-5085 www.medicalua.com

8029 OXFORD LIFE / NORTH AMERICAN INSURANCE 2721 N. CENTRAL AVE. PHOENIX AZ 85004-0000 (866) 641-9999

8053 GE VISION CARE PO BOX 2243 SCHENECTADY NY 12301-0000 (800) 433-9375 National Accounts 800-445-2158

8062 UNITED HEALTH CARE PO BOX 740800 ATLANTA GA 30374-0800 (877) 842-3210 emdeon online and navinet

8066 MEDICAL MUTUAL OF OHIO PO BOX 6018 CLEVELAND OH 44101-1018 (800) 585-2583 emdeon online

8068 MAMSI 4 TAFT COURT ROCKVILLE MD 20850-5327 (800) 447-6267

8077 THE RIGHT CHOICE 10795 WATSON RD. ST. LOUIS MO 63127-1011 (314) 821-3957

8079 PLUMBERS AND STEAMFITTERS PO BOX 2648 LOCAL 521 HUNTINGTON WV 25726-2648 (304) 525-0331

8086 WMS WALMART 702 SW. 8TH ST. BENTONVILLE AZ 72716-9113 (501) 273-8478

8093 FEDERAL MUTUAL PO BOX 50487 INDIANAPOLIS IN 46250-0487 (800) 428-4143

8095 ASSURED HEALTH (formally FORTIS) 501 W MICHIGAN ST MILWAUKEE WI 53203-0000 (800) 800-1212

8098 MED COST PREFERRED PO BOX 25307 WISTON SALEM NC 21657-2240 (336) 774-4400 www.ebctpa.com; self funded fax back 740-699-6163

8112 CENTRAL RESERVE LIFE PO BOX 934 FREDERICK MD 21705-0000 (440) 572-2400 emdeon online

8113 TRICARE/CHAMPUS PO BOX 7011 CAMDEN SC 29020-7011 (800) 578-1294 Emdeon online

8116 HEALTH AMERICA PO BOX 7088 LONDON KY 40742-0000 (800) 746-1411 emdeon online

8126 METLIFE DENTAL PO BOX 981282 EL PASO TX 79998-0000 (800) 638-7452 emdeon online

8128 ANTHEM BENEFITS PO BOX 18015 COLUMBUS OH 43218-8015 (888) 290-9160 emdeon online

8133 BCBS of GEORGIA PO BOX 9907 COLUMBUS GA 31908-0000 (800) 241-7475 emdeon online

8137 FCE BENEFITS 445 RECOLETA ROAD SAN ANTONIO TX 78216-0000 (800) 899-9355

8140 ANTHEM / CA PO BOX 4152 WOODLAWN HILL CA 91365-0000 (800) 888-8288

8142 OPTIMUM CHOICE PO BOX 930 FREDERICK MD 21705-0000 (800) 342-6141

8143 PRINCIPAL FINANCIAL GRP. 711 HIGH STREET DES MOINES IA 50392-0001 (800) 422-5002 emdeon online or [email protected]

8147 UNICARE PO BOX 4006 SCHAUMBURG IL 60168-4006 (800) 333-3304 emdeon online

8149 VALUE RX 636 LAREW AVE. BECKLEY WV 25801-0000 (800) 347-8777

8151 CCNN PPO PO BOX 939032 SAN DIEGO CA 92123-0000 (800) 247-2898

8160 CIGNA DENTAL PO BOX 8921 BRISTOL TN 37621-0000 (800) 542-4261 emdeon online

8163 COLE VISION PO BOX 18903 WARRENSVILLE OH 44128-0000 (800) 424-1155

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8165 EYE MED VISION CARE PO BOX 8504 MASON OH 45040-0000 (866) 939-3633

8180 CAREMARK - PHARMACARE 695 GEORGE WASHINGTON HWY. LINCOLN RI 02865-0000 (800) 777-1023

8182 PHARMACY CARE NETWORK 9343 TECH CENTER DR. SUITE 200 SACRAMENTO CA 95026-0000 (800) 742-8326

8185 TDI / CIGNA PO BOX 2860 PITTSBURGH PA 15230-0000 (800) 525-5803

8186 TUFTS ASSOC. HEALTH PLAN PO BOX 9163 WALTHAM MA 02254-0000 (800) 442-0422 Emdeon online

8198 MONTERRA HEALTH SYSTEM PO BOX 567 LOGAN WV 25601-0000 must mail claims

8199 MAMSI LIFE AND HEALTH PO BOX 930 FREDERICK MD 21705-0000 (800) 224-8535

8203 PRIMARY PHYSICIAN CARE PO BOX 11088 CHARLOTTE NC 28220-0000 (800) 446-5439

8206 PRIMARY SELECT P O BOX 1323 CHARLOTTESVILLE VA 22902-0000 (800) 815-8240

8207 AMERI HEALTH P O BOX 380786 BIRMINGHAM AL 35238-0786 (888) 329-5378

8209 SOUTHERN GROUP ADMIN. 200 SOUTH MARSHALLS ST. WINSTON-SALEM NC 27101-0000 (800) 334-8159

8211 NORTH AMERICAN ADMINISTRATORS PO BOX 9501 AMHERST NY 14226-9501 (716) 446-5500

8212 AMERICAN BENEFIT MANAGEMENT PO BOX 35008 CANTON OH 44735-0000 (800) 456-4002 www.ebctpa.com

8216 CENTRAL RESERVE LIFE-ONE SOURCE PO BOX 5190 TAMPA FL 33675-0000 (614) 764-7602 emdeon online

8228 PIONEER LIFE PO BOX 5151 JANESVILLE WI 53547-0000 (800) 937-7533

8234 OHIO HEALTH GROUP PO BOX 6029 WORTHINGTON OH 43085-0000 (888) 838-6337

8235 OPTUMHEALTH VISION (UHC) PO BOX 30978 SALT LAKE CITY UT 84130-0000 [800] 638-3120 emdeon online with uhc

8236 TRUSTMARK PO BOX 9055 BOARDMAN OH 44513-0000 (800) 544-7312 Emdeon online

8245 NEIGHBORHOOD HEALTH PLAN 214 SOUTH WAY 3 MEDFORD MA 02155-2062 (888) 828-5500 emdeon online

8246 AMERIHEALTH ADMINISTRATORS 720 BLAIRMILL RD. HORSHAM PA 19044-0000 (800) 480-5031

8247 MEDICAL CLAIMS MANAGEMENT CORP. PO BOX 12995 CHARLOTTE NC 28220-2995 (800) 334-0609

8248 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502-0000 [757] 233-4500

8249 PIKA GROUP SERVICES 110 WESTWOOD PLACE SUITE 100 CLAIBRENTWOOD TN 37027-0000 (888) 949-2762

8251 WELL POINT PHARMACY MANAGEMENT PO BOX 9085 OXNARD CA 93031-9080 (888) 218-4844

8258 MIM - PHARMACY SOLUTIONS 33 NORTH ROAD WAKEFIELD RI 02879-0000 (800) 789-5445

8259 VISION BENEFITS OF AMERICA 300 WAYMAN PLAZA PITTSBURGH PA 15236-0000 (800) 432-4955

8262 MANAGED PHARMACY BENEFITS 1100 NORTH LINDBERGH ST. LOUIS MO 63132-0000 (800) 672-9540

8263 BENESIGHT PO BOX 320 PUEBLO CO 81003-0000 (800) 634-5924 www.benesight.com

8264 TOTAL SCRIPT 10901 EAST 120TH AVE. SUITE 175 BROOMFIELD CO 80021-0000 (800) 752-2211

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8270 GALLAGHER BENEFIT ADMINSTRATORS PO BOX 43297 SAN ANTONIO TX 78265-0000 (816) 421-6151

8274 JSL ADMINISTRATORS PO BOX 9580 FAYETTEVILLE NC 28311-0000 (910) 480-3100

8275 FEDEX FREIGHT, NPPN 419 E. MAIN STREET MIDDLETOWN NY 10940-0000 (870) 741-9000

8276 RESTAT PO BOX 758 WEST BEND WI 53095-0000 (800) 248-1062

8278 C&O EMPLOYEES HOSPITAL ASSOC. 511 MAIN ST. 2ND FLOOR CLIFTON FORGE VA 24422-1199 (800) 679-9135

8279 BENEFIT CONCEPTS INC PERFORMAX PO BOX 61505 KING OF PRUSSIA PA 19406-0000 (610) 337-2600

8281 STEWART C. MILLER CO,INC PO BOX 5769 ADMIN FOR:INDIANA ST LAFAYETTE IN 47903-5769 (800) 552-6550 www.ebctpa.com

8282 SUPERIOR VISION 11050 OLSEN DRIVE RANCHO CORDOVA CA 95670-0000 (800) 507-3800

8283 GUARDIAN INSURANCE PO BOX 2459 SPOKANE WV 99210-0000 (800) 541-7846

8284 ALL RISK ADMINISTRATORS INC. PO BOX 66237 ST. PETE. BEACH FL 33736-0000 (800) 338-4485

8285 HEALTH PARTNERS CLAIM DEPT PO BOX 1289 MINNEAPOLIS MN 55440-1289 (866) 429-1474 emdeon online

8286 TEAMSTERS BENEFITS LOCAL #710 HEALTH & WELFARE FUND42CHICAGO IL 60609-2674 (773) 254-2500

8288 DONLEY & CO. 6330 EAST 75TH STREET SUITE 106 INDIANAPOLIS IN 46250-0000 (800) 382-5220

8289 INFOR MED PO BOX 6752 ANNAPOLIS MD 21401-0000 (800) 459-2110

8290 EMPLOYEES MANAGEMENT SYSTEMS (EBMS) PO BOX 21367 BILLINGS MT 59104-0000 (406) 869-5555 emdeon online

8293 BCBS PREMIER PO BOX 91080 SEATTLE WA 98111-9180 (800) 527-6675 emdeon online

8294 BLUE CROSS of IDAHO PO BOX 7408 BOISE ID 83707-0000 (800) 627-1188

8296 HOSPICE 350 CAPITOL STREET ROOM 251 CHARLESTON WV 25301-3709 [304] 356-4913 emdeon online or www.or.regence.com

8298 BCBS of OREGON (REGENCE) PO BOX 1071 PORTLAND OR 97201-0000 (800) 452-7390 www.ebctpa.com

8299 QUAD MED 555S 108TH STREET WEST ALLIS WI 53214-0000 (800) 937-2230

8301 PCN 9343 TECH CENTER DRIVE #200 SACRAMENTO CA 95826-0000 (800) 777-0074

8302 LABORERS' NATL HEALTH & WELFARE PO BOX 1100 COLUMBIA MD 21044-0000 (800) 235-5805

8304 BLUE VIEW VISION (VOLUNTARY) PO BOX 8504 MASON OH 45040-0000 [866]723-0515

8305 AETNA VISION PO BOX 981107 EL PASO TX 79998-0000 (800) 334-2615 navinet & emdeon online

8306 AETNA PO BOX 851 HOUSTON TX 77001-0851 (800) 872-3862

8307 AETNA DENTAL PO BOX 14091 LEXINGTON KY 40912-4091 (877) 368-6605 emdeon online

8309 ANTHEM DENTAL 555 MIDDLE CREEK PARKWAY COLORADO SPRINGSCO 80921-0000 (800) 453-3622 emdeon online

8313 BCBS of PENNSYLVANIA PO BOX 3355 PITTSBURGH PA 15230-0000 (800) 241-5704 cigna online & emdeon online

8318 CIGNA PO BOX 5200 SCRANTON PA 18505-0000 (800) 244-6224 emdeon online

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8320 CIGNA PHARMACY PO BOX 3598 SCRANTON PA 18505-0000 (800) 622-5579 emdeon online GWH is part of Cigna now

8328 GREAT WEST HEALTH PLAN 1000 GREAT WEST DRIVE KENNETT MO 63857-0000 (800) 663-8081

8336 MEDICARE SUPPLEMENT CLAIMS PROCESSING CENTER PO BOX 1CLEARWATER FL 33757-8841 (800) 523-5758 emdeon online

8337 METLIFE PO BOX 14093 LEXINGTON KY 40512-4093 (888) 480-2037 emdeon online or www.anthem.com

8338 BCBS of IINDIANA / ANTHEM PO BOX 37010 LOUISVILLE KY 40233-0000 (800) 638-7425

8340 NPA (NATIONAL PRESCRIPTION ADMININSTRATOR) PO BOX 1981 E HANOVER NJ 79360-0000 (800) 467-2006 emdeon online

8346 PROVIDENCE HEALTHCARE PO BOX 12846 ROANOKE VA 24029-0000 (877) 870-4121

8348 UNITED CONCORDIA PO BOX 69421 HARRISBURG PA 17106-9421 (800) 332-0366

8354 DOCFIRST PO BOX 17098 OWINGS MILLS MD 21117-0000 (800) 360-4817

8368 DELTA DENTAL 801 OGDEN AVENUE LISLE IL 60532-0000 (800) 452-1987

8382 WALGREENS RX (WHI) PO BOX 545 DEERFIELD IL 60015-0000 (800) 207-2568 emdeon online OR www.bcbsok.com

8383 BCBS of OKLAHOMA PO BOX 3028 TULSA OK 74101-0000 (818) 560-3500 hb.umr.com or 800-848-4623

8387 UMR - FISERV-WAUSAU BENEFITS PO BOX 30541 SALT LAKE CITY UT 84130-0541 (866) 997-7980

8388 FIDELITY BENEFITS ADMIN 201 INTERNATIONAL CIRCLE 4TH FLOOHUNT VALLEY MD 21030-0000 (888) 915-6717

8390 KLAIS & COMPANY 1867 W MARKET STREET AKRON OH 44313-0000 (800) 686-8425 www.ebctpa.com

8395 PROFESSIONAL BENEFITS 2040 FRONT STREET CUYAHOGA FALLS OH 44221-0000 (800) 849-9300

8397 MED IMPACT 10680 TREENA STREET 5TH FLOOR SAN DIEGO CA 92181-0000 (800) 788-2949 emdeon online

8406 BCBS of KANSAS CITY PO BOX 419169 KANSAS CITY MO 64141-6169 (800) 892-6028 emdeon online

8407 CENTRAL RESERVE LIFE PO BOX 13429 CHARLESTON WV 25360-0000 (800) 321-3997

8411 PREMIER PHARMACY PLAN PO BOX 5824 SPARTANBURG SC 29304-0000 (800) 247-4526 www.starmark-inc.com

8412 STAR MARK PO BOX 7060 MIDDLETOWN NY 10940-0000 (800) 522-1246

8415 UPMC HEALTH PLAN PO BOX 2999 PITTSBURGH PA 15230-0000 (888) 876-2756

8416 ABATEMENT WORKERS NATIONAL HEALTH & WELFARE 2075 W. BIG BEAVTROY MI 48084-0000 (800) 772-0459 emdeon online

8419 ANTHEM BCBS of VA PO BOX 27401 RICHMOND VA 23279-0000 (800) 451-1527 emdeon online

8420 BCBS of MASSACHUSETTS PO BOX 9196 N. QUINCY MA 02171-9196 (800) 227-7759

8425 CLARITY VISION PO BOX 890500 CAMP HILL PA 17089-0000 (800) 541-2039

8426 DAVIS VISION PO BOX 1525 LATHAM NY 12110-0000 (800) 999-5431

8429 MERCER ADMINISTRATION 1220 BUTTERWORK CT STEVENSVILLE MD 21666-0000 (314) 241-6888

8442 CHA HEALTH PO BOX 269009 PLANO TX 75026-9009 (800) 457-5683

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8446 DELTA DENTAL OF MO PO BOX 8690 ST. LOUIS MO 63126-0690 (800) 392-1167

8450 PGBA (PALMETTO) PO BOX 870133 SURFSIDE SC 29587-9733 (888) 874-9378

8500 CIGNA HEALTH CARE PO BOX 55270 PHOENIX AZ 85078-5270 (800) 308-5948

8800 WV CHIP 350 CAPITOL ST ROOM 427 CHARLESTON WV 25301-0000 [304] 558-2732 emdeon online

9002 HUMANA (M-HMO) PO BOX 740036 LOUSIVILLE KY 40512-4601 [866] 427-7478 emdeon online

9003 UNITED HEALTH CARE (M-HMO) PO BOX 659429 SAN ANTONIO TX 78265-0000 (877) 844-9735

9004 AETNA (M-HMO) PO BOX 981107 EL PASO TX 50008-0000 ONLINE

9005 WELLCARE (M-HMO) PO BOX 4438 SCRANTON PA 15805-0000 (866) 235-2770

9009 UMWA (M-HMO) UNITED MINE WORKERS PO BOX 619099 DALLAS TX 75261-0000 (888) 865-5290

9010 UNICARE SECURITY CHOICE (M-HMO) PO BOX 795180 SAN ANTONIO TX 78279-0000 (888) 445-8916

9011 AMERICAN PROGRESSIVE LIFE & HEALTH INS (M-HMO) 6 INTERNATIONAL DRIVE RYE BROOK NY 10673-1068 (800) 664-6494

9012 FELRA & UFCW HEALTH & WELFARE FUND (Medicare HMO) 911 RIDGE BROOK ROAD SPARKS MD 21152-0000 (800) 638-2972 emdeon online

9013 HEALTH ALLIANCE (M-HMO) 2850 W. GRAND BLVD DETROIT MI 48202-0000 (800) 801-1766

9014 CARELINK ADVANTRA SILVER (M-HMO) PO BOX 7101 LONDON KY 40742-0000 (877) 843-1938 emdeon online

9018 AULT CARE INS PRIMETIME HEALTH PLAN (M-HMO) PO BOX 6905 CANTON OH 44706-0905 (800) 577-5084 emdeon online

9019 BCBS of TN BLUE ADVANTAGE 1 CAMERON HILL CIRCEL, SUITE 002 CHATTANOOGA TN 37402-0000 [800] 841-7434 www.mvphealthcare.com

9021 UPMC FOR LIFE (M-HMO) PO BOX 2997 PITTSBURGH PA 15320-2997 [888] 876-2756

9022 APWU (M-HMO) PO BOX 967 SILVER SPRING MD 20910-0000 [800] 222-2798

0003 EMPLOYEE BENEFITS ADMINISTRATORS (EBA) PO BOX 21875 LEXINGTON KY 40522-0000 (877) 467-6004

0005 ANTHEM PHARMACY PO BOX 145433 CINCINNATI OH 45250-0000 (800) 662-0210 emdeon online

0008 CM ADMINISTRATORS PO BOX 87269 FAYETTEVILLE NC 28304-0000 (800) 291-9586

0011 SHASTA ADMINISTRATORS PO BOX 1747 REDMOND OR 97756-0000 (800) 441-4518

0012 HEALTHSPAN PO BOX 58339 CINCINNATI OH 45211-0000 (513) 598-2929

0013 CUSTOM DESIGN BENEFITS 5589 CHEVLOT ROAD CINCINNATI OH 00004-5247 [800]598-2929

0017 BCBS of MISSISSIPPI PO BOX 1043 JACKSON MS 39215-0000 (800) 551-5258 emdeon online

0022 PRUDENTIAL PO BOX 7001 PARKERSBURG WV 26102-0000 (800) 828-0153

0023 DELTA DENTAL OF KY PO BOX 242810 LOUISVILLE MO 40224-0000 (800) 955-2030

0026 TPA PO BOX 742168 DALLAS TX 75374-0000 (972) 792-1000

0028 BCBS DENTAL PO BOX 23059 BELLVILLE IL 62223-0000 (800) 367-6401 emdeon online

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0031 DELTA DENTAL PO BOX 9085 FARMINGTON MI 48333-0000 (800) 638-0166

0032 DELTA DENTAL of VIRGINIA 4818 STARKEY ROAD ROANOKE VA 24014-0000 (800) 334-7591

0033 NVA - NATIONAL VISION ADMIN PO BOX 2187 CLIFTON NJ 07015-0000 (800) 672-7723

0035 HEALTH ASSUARNCE PO BOX 8103 LONDON KY 40742-0000 (800) 788-6445 emdeon online

0036 DELTA DENTAL PO BOX 828 STEVENS POINT WI 54481-0000 (800) 236-3712

0037 MEGA LIFE PO BOX 982017 RICHLAND HILLS TX 76182-0000 (800) 733-8880 emdeon online

0038 INDEPENDENCE BCBS of PA PO BOX 13038 PHILADELPHIA PA 19103-0000 (877) 585-5734 emdeon online

0039 EBRX 2045 MIDWAY DRIVE TWINSBURG OH 44087-0000 (800) 800-7153

0044 DELTA USA PO BOX 59238 MINNEAPOLIS MN 55459-0238 (800) 448-3815

0061 ADVENTIST RISK MANAGEMENT PO Box 4759 Silver Spring MD 20914-0000 (800) 638-0589

0063 AMERIBEN SOLUTIONS PO BOX 7186 BOISE ID 83707-0000 (800) 786-7930 wwe.ebctpa.com

0070 ANTHEM BCBS of KY PO BOX 37690 LOUISVILLE KY 40233-7690 (888) 650-4133 emdeon online or www.anthem.com

0074 HEALTH DESIGN PLUS CS 5060 FINDLAY OH 00004-5839 (877) 747-7818 www.ebctpa.com

0075 HEALTH REACH 445 HUTCHINSON AVE COLUMBUS OH 00004-3235 (800) 767-4226

0077 IBEW INTERNATIONAL BROTHERHOOD ELECTRICAL WORKERSPO BOX 2967 HUNTINGTON WV 25729-0000 (888) 466-9094

0084 PARTNERS RX MANAGEMENT PO BOX 35007 PHOENIX AZ 00000-8509 (800) 659-4112

0087 QUALCHOICE 6000 PARKLAND BLVD CLEVELAND OH 00004-4124 (800) 460-4677

0089 SHEET METAL WORKERS LOCAL 292 PO BOX 1449 GOODLETTSVILLE TN 37070-0000 (800) 831-4914

0099 VALUE OPTIONS 3110 FAIRVIEW PARK DRIVE FALLS CHURCH VA 22042-0000 (800) 236-4648

0103 EMPLOYEES BENEFIT CONSULTANTS 3301 E. ROYALTON RD. CLEVELAND OH 44147-0000 (866) 296-4002

0105 MEMBER HEALTH PO BOX 391180 CLEVELAND OH 44139-0000 (888) 868-5854

0107 ANTHEM BCBS of CONNECTICUT PO BOX 430 NORTH HAVEN CT 06473-4202 (800) 922-4670 emdeon online

0108 FLORIDA LIFE & HEALTH GUARANTEE ASSOCIATION 3740 BEACH BLVD. SUITE 201A JACKSONVILLE FL 32207-0000 (904) 398-3644

0111 FL (FINGER LAKES) RX/BCBS of CENTRAL NEW YORK PO BOX 22999 ROCHESTER NY 14642-0000 (800) 724-5033

0112 WASHINGTON DENTAL PO BOX 75983 SEATTLE WA 98175-0000 (800) 238-3107

0113 LUMENOS PO BOX 69309 HARRISBURG PA 17106-0000 (877) 495-8481

0115 COMPBENEFITS DENTAL INC 200 WEST JACKSON , 9th Floor CHICAGO IL 60606-0000 (312) 261-6200

0118 PHARMAVAIL 3380 TRICKUM ROAD WOODSTOCK GA 30188-0000 [800] 933-3734

0119 WELLPATH PO BOX 7102 LONDON KY 40742-0000 (800) 889-1947 emdeon online

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0122 UNION CONSTRUCTION WORKERS HEALTH PLAN 1600 MADISON AVE STE 300 BOX 697 TOLEDO OH 43624-1497 (419) 248-2401

0123 BCBS of NORTH DAKOTA 4510 12tTH AVE SOUTH FARGO ND 58121-0000 (800) 342-4718 emdeon online

0125 HEALTHSMART VISION 10100 LINN STATION ROAD LOUISVILLE KY 40223-0000 [800] 624-8605

0126 UNITED BEHAVIORAL HEALTH (UHCBH) PO BOX 30602 SALT LAKE CITY UT 84130-0602 [800] 557-5745

0127 AVESIS PO BOX 7777 PHOENIX AX 85011-7777 [800] 828-9341

0128 MEDICO INSURANCE COMPANY 1515 SOUTH 75TH STREET OMAHA NE 68124-0001 [800] 228-6080

0129 PAI PO BOX 6702 COLUMBIA SC 29260-0000 [888] 645-6410

0133 USABLE INSURANCE PO BOX 14601 LITTLE ROCK AR 72203-1460 [800] 370-5856

0134 CHARTIS (ASRM CLAIMS) 505 SOUTH LENOLA RAD, STE. 231 MOORESTOWN NJ 08057-0000 [800] 359-7475

0135 COMPASS ROSE HEALTH PLAN PO BOX 6430 ANNAPOLIS MD 21401-0000 (877) 531-1159

0136 PARAMOUNT HEALTH PLANS 1901 INDIAN WOOD CIRCLE MAUMEE OH 43537-0000 [800] 462-3589 [419] 887-2500

0137 MUTUAL ASSURANCE ADMINISTRATORS PO BOX 42096 OKLAHOMA CITY OK 73123-3096 [800] 825-3540 www.ebctpa.com

0138 MERCYCARE HEALTH PLANS PO BOX 4568 CHESTERFIELD MO 63017-0000 [800] 830-1918

0139 MENNONITE MUTUAL AID PO BOX 483 GOSHEN IN 46527-0000 [800] 348-7468

0141 CATALYST RX 800 KING FARM BLVD 4TH FLOOR ROCKVILLE MD 20850-0000 (800) 688-0438 [email protected]

0142 SAVRX 224 N PARK AVE FREMONT NE 68025-0000 (800) 396-2219

0143 CEBA CLAIMS 6300 BRIDGEPOINT PKWY BLDG 3, STE 500AUSTIN TX 78730-0000 (800) 247-7724

0145 FHM BENEFITS 13160 FOSTER STREET, SUITE 150 OVERLAND PARK KS 66213-0000 (800) 990-9058 www.f.m.h.com

0146 MIDLAND CHOICE PO BOX 5809 TROY MI 48007-5809 (800) 605-8259

0147 GROUP & PENSION ADMINISTRATORS 12770 MERIT DRIVE, 2ND FLOOR DALLAS TX 00007-5251 (800) 827-7223 emdeon online

0148 ADMINISTRATIVE SERVICES INC 2187 NORTHLAKE PKWY, BLDG 9 SUITE 106TUCKER GA 30084-0000 (800) 959-3953 www.abpa.com and emdeon online

0149 DELTA DENTAL of COLORADO 4582 S ULSTER STREET, SUITE 800 DENVER CO 80237-0000 (800) 233-0860 www.deltadentalco.com

0151 BCBS of MONTANA PO BOX 14882 ST LOUIS MO 63173-4882 (314) 923-5614 emdeon online

0152 BCBS of TEXAS DENTAL SERVICES PO BOX 660247 DALLAS TX 75266-0000 (800) 521-2227 emdeon online

0153 HEALTH CHOICE PO Box 24870 OKLAHOMA CITY OK 73124-0870 (800) 752-9745 www.ebctpa.com

0154 WEB-TPA, INC PO BOX 99906 GRAPEVINE TX 76099-0000 [866] 227-5400 on Emdeon online

0155 HAMMERMAN AND GAINER (HOMELAND HEALTHCARE) 809 LAKE CAROLYN PARKWAY, SUITE 1900IRVING TX 75039-000 [800] 493-4240

0156 STANDARD SECURITY LIFE PO BOX 21156 EAGAN MN 00005-5121 (800) 822-3906

0157 TRANS AMERICA LIFE -- HEALTH MARKETS PO BOX 97 SCRANTON PA 18504-0097 [800] 854-0186 Emdeon online

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0158 HEALTH SMART LLC PO BOX 6742 LUBBOCK TX 79493-0000 [800] 681-6912 www.ebctpa.com

0159 HEALTH SMART RX TOWER AT ERIEVIEW, 24th FLOOR, 1301 E 9th STCLEVELAND OH 00004-4114 [800] 681-6912 www.ebctpa.com

0161 EXCELLUS BCBS 165 COURT STREET ROCHESTER NY 14647-0000 (800) 847-1200

0162 OXFORD HEALTH PLAN PO BOX 7082 BRIDGEPORT CT 0001-7082 [800] 666-1353 800-444-6222 emdeon online

0163 MAGNACARE PO BOX 1001 GARDEN CITY NY 11530-1001 [800] 235-7267 WWW.MAGNACARE.COM

0164 HEALTH TRANS FORMULARY MANAGEMENT ATTN: DMR PO BOX 4557 GREENWOOD VILLAGECO 80155-4557 [877] 839-8119

0165 CHESAPEAKE LIFE INSURANCE [HEALTH MARKETS] 9151 BLVD 26 NORTH RICHLAND TX 76180-0000 [800] 527-5504

0166 US SCRIPTS 2425 WEST SHAW AVENUE FRESNO CA 93711-0000 [800] 460-8988

0167 SEGBP (STATE EMPLOYEES GRP BEN LOUISIANA) PO BOX 44036 BATON ROUGE LA 70804-436 [800] 272-9871

0168 PHYSICIANS HEALTH PLAN OF N. INDIANA PO BOX 2359, 8101 W JEFFERSON BLVDFORT WAYNE IN 46804-4163 [800] 982-6257 [260] 432-6690

0169 PHYSICIANS HEALTH PLAN OF MID MICHIGAN 1400 EAST MICHIGAN AVENUE LANSING MI 48912-2107 [800] 562-6197 [517] 364-8400

0170 AFLAC (AMERICAN FAMILY LIFE INSURANCE CO) 1932 WYNNTON RD COLUMBUS GA 31999-7251 (800) 992-3522 emdeon online

0171 COOPERATIVE BENEFIT ADMINISTRATORS, INC PO BOX 6249 LINCOLN NE 68506-0249 [402] 483-9200 emdeon online

0172 CELTIC INSURANCE COMPANY PO BOX 46337 MADISON WI 53744-0000 [800] 766-2525

0173 BLUEGRASS FAMILY HEALTH PO BOX 21973 LEXINGTON KY 40522-1973 [800] 787-2680 emdeon online

0174 AMERICA'S CHOICE HEALTH PLAN PO BOX 55690 KING OF PRUSSIA PA 19406-0000 [800] 633-4226 www.achonline.com

0175 AMERICAN HERITAGE LIFE 1776 AMERICAN HERITAGE DRIVE JACKSONVILLE FL 32224-6687 [800] 535-8086

0176 ADMINISTRATIVE ENTERPRISES INC 5810 WEST BEVERLY LANE GLENDALE AZ 85306-0000 [800] 762-2234

0177 1199 SEIU LOCAL 144 WELFARE & PENSION FUND 330 WEST 42ND STREET NEW YORK NY 10036-6977 [212] 541-9150

0178 DESERET MUTUAL 60 EAST SOUTH TEMPLE SALT LAKE CITY UT 84111-0000 [800] 777-1647 [801] 578-5765

0179 FIRST PRIORITY HEALTH--BLUE CROSS NEPA 10 NORTH MAIN STREET WILKES BARRE PA 18711-0000 [570] 825-4900

0181 HM BENEFITS ADMINISTRATORS PO BOX 535078 PITTSBURGH PA 15253-5078 (866) 401-3762

0182 FIRST SERVICES ADMINISTRATORS 3035 LAKELAND HILLS BLVE LAKELAND FL 33805-2225 [863] 293-0785 [863] 291-5010

0183 HIP (HEALTH INS PLAN of GREATER NY) 55 WATER STREET NEW YORK NY 10041-0000 [800] 447-8255

0184 AMERICAN HEALTHCARE 2217 PLAZA DRIVE, SUITE 100 ROCKLIN CA 95765-0000 (800) 872-8276

0185 INTERACTIVE MEDICAL SYSTEMS 11635 NORTHPARK DR, SUITE 335 WAKE FOREST NC 27587-0000 [800] 268-8739 FAX [919] 877-0615 www.ebctpa.com

0186 LOCKARD & WILLIAMS PO BOX 1688 PASCAGOULA MS 39568-0000 [228] 762-2500 FAX [228] 769-0401

0188 AVMA (AMERICAN VET MEDICAL ASSOCIATION PO BOX 909720 CHICAGO ILL 60690-9720 [800] 621-6380

0189 MIDLAND-COLT RETIREE MEDICAL PLAN 60 BLVD of the ALLIES, 5TH FLOOR PITTSBURGH PA 15222-0000 [866] 520-9203

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0191 SAMBA FEDERAL EMPLOYEE BENEFIT ASSOCIATION 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852-2800 [800] 638-6589 [email protected]

0192 UNITED COMMERCIAL TRAVELERS PO BOX 15901 COLUMBUS OH 43215-0000 [614] 487-9680

0193 ENTERPRISE GROUP PLANNING 5910 HARPER ROAD CLEVELAND OH 44139-1835 [800]229-2210

0194 AMERICAN REPUBLIC INSURANCE COMPANY PO BOX 1 DES MOINES IA 50306-0001 [800]247-2190 X4412 emdeon online

0196 CIGNA VISION CARE CLAIMS PO BOX 997561 SACRAMENTO CA 95899-0000 [877] 4787557 emdeon & cigna online

0197 BCBS of LOUISIANA PO BOX 98029 BATON ROUGE LA 00007-0898 [800] 599-2583

0197 BCBS of LOUISIANA PO BOX 98029 BATON ROUGE LA 70898-0000 [800] 599-2583

0198 COVENTRY HEALTHCARE of VA, INC PO BOX 7704 LONDON KY 40742-0000 [800] 627-4872 emdeon online

0199 COVENTRY HEALTHCARE of GA, INC PO BOX 7711 LONDON KY 40742-0000 (800) 395-2545

0201 HARRINGTON BENEFITS/FISERV HEALTH 130 W 2ND ST STE 400 DAYTON OH 45401-1391 [800] 848-4223 WWW.HB.UMR.COM

0202 DATA RX 5029 O'DELL STREET CUMMING GA 30040-0000 [800]454-9399

0203 COVENTRY HEALTHCARE of THE CAROLINAS PO BOX 7102 LONDON KY 40742-0000 [800] 935-7284

0204 HEALTHNOW PO BOX 211034 EAGAN MN 55121-0000 [877] 804-4629

0205 DELTA DENTAL of GA PO BOX 1809 ALPHARETTA GA 30023-0000 [800]521-2651

0206 DAKOTA CARE PO BOX 7406 SIOUX FALLS SD 57117-0000 (800) 628-3778

0207 DELTA DENTAL of MA PO BOX 9695 BOSTON MA 02114-9695 [800] 451-1249

0208 COVENTRY HEALTH CARE of DELAWARE PO BOX 7713 LONDON KY 40742-7713 (800) 833-7423

0209 GLOBE LIFE and ACCIDENT INSURANCE COMPANY PO BOX 8080 MCKINNEY TX 75070-8080 [800] 654-5433

0211 CONSECO SENIOR HEALTH INSURANCE COMPANY PO BOX 2034 CARMEL IN 46082-2034 [800]244-1423 www.conseco.com

0212 RENAISSANCE DENTAL PO BOX 17250 INDIANAPOLIS IN 46217-0000 [888] 358-9484

0213 UNITED HEALTH CARE SENIOR SUPPLEMENT PO BOX 31359 SALT LAKE CITY UT 84131-0000 [877] 440-1439

0214 CIGNA HEALTHCARE (A&B) PO BOX 182223 CHATTANOOGA TN 37422-0223 (800) 244-6224

0215 HORIZON BLUE CROSS of NJ PO BOX 1219 NEWARD NJ 07101-0000 (800) 624-1110 emdeon online

0216 BENESYS INC 700 TOWER DRIVE, SUITE 300 TROY MI 48098-0000 [248] 641-4950

0217 USAA INSURANCE COMPANY PO BOX 12750 PENSACOLA FL 32391-2750 (877) 429-9571 on emdeon online as USAAM

0218 SUMMIT AMERICA INSURANCE SERVICES, INC 7400 COLLEGE BLV, SUITE 100 OVERLAND PARK KS 66210-0000 (800) 955-1991 www.summitamerica-ins.com/index.asp

0219 VISION INSURANCE PLAN AMERICA PO BOX 44077 MILWAUKEE WI 53214-7077 (800) 883-5747

0221 UFCW SOUTHER CALIFORNIA 6425 KATELLA AVENUE CYPRESS CA 90630-5238 (714) 202-2297

0222 S&S HEALTHCARE PO BOX 46511 CINCINNATI OH 45246-0511 (800) 717-2872

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0223 QUALCARE 30 KNIGHTSBRIDGE ROAD PISCATAWAY NJ 08854-0000 (800) 992-6613

0224 PUBLIC EMPLOYEES HEALTH PROGRAM 560 EAST 200 S SALT LAKE CITY UT 84102-0000 (800) 765-7397

0225 OPTIMUM HEALTHCARE INC 5403 N CHURCH AVENUE TAMPA FL 33614-0000 (866) 245-5360

0226 MAGELLAN BEHAVIORAL PO BOX 1958 MARYLAND HEIGHTS MD 63043-0000 (800) 224-2125

0227 INSURANCE MANAGEMENT SERVICES PO BOX 15688 AMARILLO TX 79105-0000 (800) 687-5944

0228 HOTEL & RESTAURANT EMPLOYEES PO BOX 6020 AURORA IL 60598-0020 (412) 381-1032

0229 HOSPITAL BENEFITS INC PO BOX 162148 ALTAMONTE SPRINGS FL 32716-0000 (800) 833-0311

0231 GENERAL PRESCRIPTION PROGRAM 305 MADISON AVE, SUITE 1166B New YORK NY 10165-0000 (800) 341-2234

0232 HEALTH ADVANTAGE PO BOX 8069 LITTLE ROCK AR 72203-0000 (800) 843-1329

0233 HARVARD PILGRIM INSURANCE PO BOX 8699193 QUINCY MA 02269-9183 (800) 338-4247

0234 DELTA DENTAL of IOWA PO BOX 9000 JOHNSTON IA 50131-900 (800) 544-0718

0235 COVENTRY HEALTH of TN PO BOX 7170 LONDON KY 40702-0000 (800) 257-4692

0236 COVENTRY HEALTHCARE of LA 3838 N CAUSEWAY BLVD, SUITE 3350 METAIRIE LA 70002-0000 (800) 245-8327

0237 AIG LIFE INSURANCE 72 WALL STREET, 14TH FLOOR NEW YORK NY 10005-2800 (212) 770-7000

0238 ADVANTAGE HEALTH SOLUTIONS 9490 PRIORITY WAY INDIANAPOLIS IN 46240-0000 (800) 553-8933

0239 HEALTHSMART PREFERRED CARE PO BOX 93670 LUBBOCK TX 79493-3670 (888) 772-6372

0241 HEALTHEZ 7201 W 78TH STREET BLOOMINGTON MN 55439-0000 (800) 948-3253 WWW.ITFBENEFITS.COM

0242 BENEFIT ADMINISTRATORS INC 14214 U STREET OMAHA NE 68137-0000 (800) 228-0480

0243 BENEFIT ADMINISTRATIVE SYSTEMS LLC 17475 JOVANNA DRIVE, SUITE 1B HOMEWOOD IL 60430-0000 (708)799-7400

0244 APPRO RX 415 SOUTH MAIN STREET WAYNESVILLE OH 45068-0000 (866) 900-3711

0245 FORETHOUGHT LIFE INSURANCE COMPANY PO BOX 14659 CLEARWATER FL 337766-4659 (877) 492-5870

0260 PHYSICIANS MUTUAL INSURANCE COM PO BOX 2018 OMAHA NE 68103-2018 (800) 228-9100 emdeon online

0270 UNITED HEALTH CARE DENTAL PO BOX 30567 SALT LAKE CITY UT 84130-0567 (877) 816-3596 emdeon online

0280 BANKERS LIFE & CASUALTY PO BOX 66927 CHICAGO IL 60666-0927 (312) 396-7500 www.conseco.com

0286 PRO CARE RX--HEALTH SOLUTIONS 30 HUNTER LANE CAMP HILL PA 17011-0000 (800) 699-3542

0334 BCBS of ARKANSAS PO BOX 2181 LITTLE ROCK AK 07203-0000 (501) 548-2988 emdeon online

0336 COVENTRY - PERSONAL CARE PO BOX 7141 LONDON KY 40742-0000 (866) 557-8751

0360 GEHA/GOVERNMENT EMPLOYEE HOSPITAL ASSOCIATION PO BOX 4665 INDEPENDENCE MO 64051-0000 (800) 821-6136 emdeon online

0450 COLONIAL PENN INSURANCE 1818 MARKET ST. PHILADELPHIA PA 19181-0000 (215) 988-8000 www.conseco.com

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0490 COMBINED INS.CO. OF AMERICA 5050 N. BROADWAY 9TH FLR NW CHICAGO IL 60640-0000 (800) 225-4500

0500 RR HEALTH & WELFARE FUNDS PO BOX 44242 JACKSONVILLE FL 32231-4242 (800) 258-6534

0501 MAIL HANDLERS PO BOX 44242 JACKSONVILLE FL 32231-4242 (800) 410-7778 emdeon online

0550 HIGHMARK BCBS PA FIFTH AVE.PLACE PO BOX 70 PITTSBURGH PA 15222-3099 (800) 295-1902

0591 BROKERS NATIONAL LIFE ASSURANCE CO (BNLAC) PO BOX 1028 HOUSTON TX 77251-1028 (800) 653-4427

0595 UNIFIED LIFE INSURANCE COMPANY PO BOX 25326 OVERLAND PARK KS 66225-5326 (866) 846-9993

0700 FIDELITY SECURITY LIFE INSURANCE PO BOX 418131 KANSAS CITY MO 64141-0000 (816) 756-1060

0713 CONSTITUTION LIFE INSURANCE COMPANY PO BOX 13038 PENSACOLA FL 32591-0130 [800] 789-6364

0720 AARP PO BOX 740819 ATLANTA Ga 30374-0819 (800) 227-7789 emdeon online

0760 GOLDEN RULE INS. CO. 419E MAIN STREET MIDDLETOWN NY 10940-0000 (800) 657-8205

0800 GUARANTEE TRUST LIFE INS.CO. 1275 MILWAUKEE AVE GLENVIEW IL 60025-0000 (847) 699-0600

0813 HEALTH FIRST PO BOX 5196 New YORK NY 10274-0000 (888) 801-1660 www.ebctpa.com

1035 MERITAN HEALTH PO BOX 853921 RICHARDSON TX 75085-0000 (716) 319-5399

1099 UNITED HEALTHCARE of THE RIVER VALLEY PO BOX 5230 KINGSTON NY 12402-5230 (800) 690-1606 emdeon online

1125 ANTHEM VISION 555 MIDDLE CREEK COLORADO SPRINGSCO 80921-0000 (800) 453-3622 emdeon online

1266 UNIVERA HEALTH CARE PO BOX 23000 ROCHESTER NY 14692-0000 (800) 617-1114

1574 BLUE CROSS of IOWA PO BOX 9291 DES MONIES IA 50376-0000 (800) 362-2218 emdeon online

1634 INNOVIANT PO BOX 8082 WAUSAU WI 54402-0000 (877) 559-2955

1671 HEALTHSMART [WELLS FARGO TPA DENTAL] PO BOX 3043 CHARLESTON WV 25331-3043 (304) 340-0253 Emdeon online

1761 MEDTRAK 6310 LAMAR AVE SUITE 230 OVERLAND PARK KS 66202-0000 (800) 771-4648

1762 CATAMARAN - SXC HEALTH SOLUTIONS PO BOX 3163 LISLE IL 60532-0000 (800) 575-7712

1775 HEALTH & WELFARE BENEFIT SYSTEMS PO BOX 21109 ROANOKE VA 24018-0000 (800) 283-4927

2006 AVMED HEALTH PLAN PO BOX 569000 MIAMI FL 33256-0000 (800) 782-8633

2065 RELIANCE PO BOX 82510 LINCOLN NE 68501-0000 (800) 497-7044 emdeon online

2111 HUMANA DENTAL PO BOX 14601 LEXINGTON KY 40512-4601 (800) 448-6262

2113 HUMANA RX PO BOX 14610 LEXINGTON KY 40512-0000 (800) 448-6262

2141 INDIANA LABORERS WELFARE FUND PO BOX 20490 INDIANAPOLIS IN 46220-0000 (812) 238-2551

2142 PREFERRED ONE ADMINISTRATIVE SERVICES PO BOX 59212 MINNEAPOLIS MN 55459-0212 (763) 847-4477 emdeon online

2151 OHIO CONFERENCE of PLASTERERS & CEMENT MASONS 33 FITCH BLVD AUSTINTOWN OH 44515-0000 (800) 435-2388

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2171 PHCS - PRIVATE HEALTH CARE SYSTEMS PO BOX 1439 HENDERSON TN 37077-0000 (800) 352-4216

2261 SUMMA CARE PO BOX 3620 AKRON OH 44309-0000 (800) 996-8401

2347 BCBS of VERMONT PO BOX 186 MONTPELIER VT 05601-0000 (800) 247-2583 emdeon online

2645 IAA INSURANCE ADMINISTRATORS OF AMERICA PO BOX 5082 MOUNT LAUREL NJ 08054-0000 (888) 599-1515

2832 ASSURANT HEALTH PO BOX 42033 HAZELWOOD MO 63042-0000 (800) 800-1212 mdeon

3041 PRIME THERAPUTIC RX [BCBS of TX] PO BOX 64812 ST PAUL MN 55164-0000 (800) 423-1973 emdeon online

3408 GEISHP GEISINGER HEALTH PLAN PO BOX 82200 TANVILLE PA 17822-0000 (800) 447-4000

3871 SOUTHERN BENEFITS ADMINISTRATORS 5305 VIRGINIA BEACH BLVD NORFOLK VA 23502-0000 (757) 461-8091

4043 SCRIPT CARE 5380 FOLSOM DRIVE BEAUMONT TX 77706-0000 (800) 880-9988

5271 BLUE SHIELD of CA PHARMACY PO BOX 7168 SAN FRANCISCO CA 94120-0000 (800) 535-9481

5911 MADISON NATIONAL LIFE INSURANCE CO PO BOX 828 PARK RIDGE IL 60068-0000 (800) 843-3106

6408 AULTRA ADMINISTRATIVE GROUP PO BOX 6060 CANTON OH 44706-0000 (888) 653-7088

6800 BCBS of NEW JERSEY DENTAL PO BOX 1938 NEWARK NJ 07101-0000 (800) 433-6825 emdeon online

6820 FUTURE SCRIPTS (Pharmacy) PO BOX 419019 KANSAS CITY MO 64141-0000 (888) 678-7012

7369 BCBS of RHODE ISLAND 444 WESTMINSTER ST.P.O BX 1507 PROVIDENCE RI 02903-0000 (800) 637-3718 emdeon online

7399 IRON WORKERS HEALTH & WELFARE FUND 119 SOUTH CENTRE ST, ROOM 6 CUMBERLAND MD 21502-0000 (301) 777-7770

8044 ARGUS HEALTH SYSTEMS PO Box 419019 Kansas City MO 64141-0000 (800) 732-9331 DO NOT USE AS THIS IS A PRICING COMPANY ONLY & CAN'T VERIFY BENEFITS

8078 HEALTH PLAN SERVICES PO Box 30075 Tampa FL 33607-0000 (800) 529-4344 DO NOT USE AS THIS IS A PRICING COMPANY ONLY & CAN'T VERIFY BENEFITS

8455 DELTA DENTAL of NJ PO BOX 222 PARSIPPANY NJ 07054-0000 (800) 452-9310 Teresa Ross fax #602-328-4019

8456 STARBRIDGE-CIGNA VOLUNTARY PO BOX 5909 SCRANTON PA 00001-8505 (602) 328-4019 only part a & b supplement plcys

8457 TRICARE FOR LIFE / WISCONSIN PHYSICIAN SERVICES PO BOX 7890 MADISON WI 00005-3707 (866) 773-0404

8461 AAG BENEFIT PLAN ADMINISTRATORS PO BOX 230 EPHRAIM UT 84627-0230 (800) 641-2214

8505 HEALTHSCOPE / CENTRAL BENEFITS MUTUAL INS PO BOX 182424 COLUMBUS OH 43218-2424 (800) 333-5711 alternative #877-WVA-CHIP

9000 ADVANTRA FREEDOM (PEIA M-HMO) PO BOX 7154 LONDON KY 40742-0000 (877) 337-4178

9001 THE HEALTH PLAN (M-HMO) 52160 NATIONAL ROAD, EAST ST CLAIRSVILLE OH 43950-0000 (800) 624-6961

9006 HEALTH SPRING of TENNESSEE (M-HMO) PO BOX 20000 NASHVILLE TN 37202-0000 (888) 501-3965

9007 HHIC FREEDOM BLUE PPO (M-HMO) PO BOX 7026 WHEELING WV 26003-0000 (888) 759-7020

9008 UNIV of PITTSBURGH (M-HMO) PO BOX 2997 PITTSBURGH PA 15230-0000 (877) 539-3080

9015 NATIONAL ASSOC OF LETTER CARRIERS (NALC) (M-HMO) 20547 WAVERLY COURT ASHBURN VA 20149-0000 (888) 636-6252

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9016 STERLING LIFE INSURANCE (M-HMO) PO BOX 69314 HARRISBURG PA 17106-0000 (888) 858-8551

9017 UNISOM ADVANTAGE (M-HMO) 890 WILLOW TREE CIRCLE CORDOVA TN 38018-0000 (800) 290-4009

9020 MVP HEALTH PLAN OF NY PO BOX 2207 SCHENECTADY NY 12301-2207 [800] 777-4793

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0246 AETNA CONTINENTAL LIFE INS CO of BRENTWOOD 800 CRESCENT DRIVE, SUITE 200 FRANKLINT TN 37067-0000 (800) 264-4000 MEDICARE SUPPLEMENTS ONLY

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