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A078347 - Coventry Workers' Comp Services

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A078347 - Coventry Workers' Comp Services Powered By Docstoc
					                                            tbl_CombinedCCL_0040a_Final_Cle


Patients using ID cards reflecting the First Health Network, CCN, SouthCare and HealthCare Preferred logos all signify access to The First
• Providers may not be eligible for participation in certain Coventry or First Health network products due to client requirements or restrictions. P


Payor Name
Advantage
Advocate Case Management
AIG Claim Services (AUTO)
AIG Claim Services Inc
AIG Claims Services
Air Force The
Airforce Insurance Fund
Allied Managed Care
Alpha Review Corporation
Alpha Review Ingenix Auto
Alpha Review Ingenix WC
America First Insurance
American Alternative Insurance Company
American Claims Management, Inc. ACM
American Family
American Red Cross - CA MPN
American Red Cross - NY
AMERISURE
AMERISYS ASI ASI STD RUNOFF
AMERISYS PGCS STD RUNOFF
AMERISYS USIS STD RUNOFF
AMF
AMFO FOCUS CA MPN NY Metracomp
AmSouth
AmTrust
Applied Underwriters
Arrowpoint Capital Corp
At Global PBOA
Athens Administrators
Atlantic Charter Insurance Co
Aurora East School District
AUTO Network Only
Baldwin and Lyons
Bass and Babb
Bass and Babb Auto
BassBabb Frankenmuth AUTO Network Only
BassBabb Frankenmuth WC Network Only
Berkley Risk Administrators of CT
Berkly Specialty Underwriting Managers LLC
Berkshire Hathaway Homestate Companies
Blessey Marine Services, Inc.
Breard-Shore & Associates for PTK to MCPS
Brickstreet Insurance Bill Review to MCPS
Bridgestone Firestone
Broadspire Legacy FOCUS CIGA Custom MPN
Broadspire Standard PPO Auto New York
Builders Insurance Company - Ingenix
Builders Insurance Group


                                                              Page 1
                                 tbl_CombinedCCL_0040a_Final_Cle


Bunch & Associates, Inc.
Cambridge Integrated Services/Allied Automotive Group
Cannon Cochran Management Services, Inc.
CareLogic
Caresys
CARESYS AUTO
CAS - Claims Administrative Services
CCMSI FOCUS Coventry Standard CA MPN
Cedar Hill Insurance
CF Jordan Construction LLC 003975
CGH Claims Service
CGH Claims Service (MCPS Acros Needed for PTK to MCPS Project)
Chapman and Associates
Chartis NYC
Chartis PBAMEDFEL
Chartis PBAMEDOBN
Chartis PBAMEDOBN
Chase Staffing
CHELMSFORD AUTO
Cherokee Insurance
City of Chattanooga
City of Chicago - Civilian, Fire and Police
Claims Control
Claims Indemnity Services Inc
CNA Commerical Insurance
CNA Federal
CNA GLOBAL INSURANCE
CNA Standard Networks
CNA TX HCN
Coastal Glass Distributors
Comp IQ - ASP
Comp IQ - ASP AUTO
Comp Management Primary Plus NY ROC
Comp Mgmt Sedgwick Custom CA MPN Non-Kaiser
Companion
CompIQ
CompIQ CompChoice
CompIQ Nordstrom
CompIQ Standard PPO
Compsource
Continental Western Group
County Healthcare Program 02347
County of Santa Barbara
Coventry Standard Certified Network Only
Cracker Barrel
Crawford & Company
Crawford and Company
CRM POLK COUNTY
CURA Group The
DALLAS NATIONAL
Dallas National Insurance Company
Dean Foods PTK to MCPS


                                              Page 2
                                tbl_CombinedCCL_0040a_Final_Cle


Definiti / P G & E
DHSI - Creative Risk Funding
DMI
Eastern Alliance
Eastern Forestry Insurance Group 02349
Electric Insurance
Electric Insurance Company
Electric Insurance Company
EM Management
EMC Insurance Companies
Emerson Electric
Employ Bridge
Employers Alliance Insurance
Epic
ESIS - Federal
ESIS - TX Non subscriber
ESIS (PowerTrak to MCPS NY)
ESIS (PowerTrak to MCPS Standard)
ESIS Kelly Federal
ESIS Kelly NY
ESIS Kelly Standard
ESIS TX HCN
Estes Express Lines
Everest
Everest ACM
Everest FARA MPN
Everest FARA PPO Only
F. A. Richard & Associates, Inc.
FARA Avondale
FARA CA Select MPN
FARA Ingalls
FARA TX Longshore
Farm Bureau Financial Services
FCCI Insurance Group
Federated Mutual Insurance Co
Ferrellgas
FH MPN Select Network Only
Firemans Fund Insurance Company
Firemans Fund Insurance Company
First Cardinal
First Cardinal LLC
First Health Group Corp.
Florida Fruits and Vegetables Association FFVA
Foot Locker
Forte
GAB Medinsights
GAB Robbins
Gainey Corporation
Gallagher Bassett Managed Care Services
Gallagher Bassett Managed Care Services TX HCN BR4 to MCPS OCT 2010
Gallagher Bassett MCS Auto
Gallagher Bassett MCS TX HCN Apr 2011


                                             Page 3
                                  tbl_CombinedCCL_0040a_Final_Cle


GALLAGHER BASSETT MCS TX HCN DEC 2010
Gallagher Bassett MCS TX HCN FEB 2011
Gallagher Bassett MCS TX HCN Mar 2011
Gallagher Bassett Minus Smartcomp
Gallagher Bassett Services, Inc.
GALLAGHER BASSETT WV MCO NOV 2010
GE Young and Co
GE/ERC
GEICO
Genesis Managed Care
GENEX Services Exclusive - CCN Transition
GENEX Services Exclusive AUTO
Genex Services, Inc.
GENEX Services, Inc. EPP
Genex TX Non Subscriber
Georgia Administration Services
Georgia Pacific
Goldkist
Grange Mutual Casualty Company
Gray Insurance Company The
Great American
Great American Insurance Company
Great American Insurance Company GAIC TX HCN
Greater NY New Jersey
Guard Insurance
Guard Insurance Group CA MPN
Guard Insurance Group with WV MHCP
Gulf Stream Marine
Hanover Insurance Company AUTO
Harford Mutual Insurance
HCA The Healthcare Company
Health Systems International, LLC
Health Systems International, LLC
Healthchoice ACS CompIQ
Hewitt, Coleman and Associates, Inc.
Hinz Claim Management Inc
Horizon Managed Care
Hortica Insurance
Hortica Insurance Company
HRH Insurance
Illinois Industrial Commission (IIC)
Indian Prairie School District
Indiana Lumbermens
Ingenix Test Acro 1 Standard PPO and OON
Ingenix Test Acro 2 FH Standard Certified
Ingenix Test Acro 3 Coventry Standard Certified
Ingenix Test Acro 4 FH Primary MPN
Ingenix Test Acro 5 FH Select MPN
Ingenix Test Acro 6 AUTO
Injury Care Services Inc
Input Options Test Client
Integrated Care Systems


                                                  Page 4
                                   tbl_CombinedCCL_0040a_Final_Cle


Intermed
Intracorp
Intracorp Auto
JI Companies Non HCN 504 Claims
JohnsEastern Network Only
Key Risk Management Services, Inc.
Labor Ready, Inc.
Laidlaw Transportation
Lemic Mississippi
Leonardo 02361
Letica Corporation
Liberty Mutual
Liberty Mutual Insurance Company
Liberty Mutual Insurance Company/Liberty Northwest Companies
LIBERTY MUTUAL WC PROD 16
LIBERTY MUTUAL WC PROD 16
Logans Roadhouse
Lumbermans Underwriting Alliance
MAC Risk Managament, Inc.
Macys Corporate Services Inc
Magna Carta Auto
Martin Boyer
Matrix Absence Mgmt
Matson Navigation Company
May Department Stores Co - Central
May Department Stores Co - Eastern
May Department Stores Co - Western
MCMC Nashville TX NS
MCMC Rancho
MCMC TX NS
MCO Advantage
MCO Advantage - EDI
Meadowbrook Insurance Group
Medical Consultants Network
MEDICOR AUTO
Memco Barge Line Inc
MERCURY INSURANCE
Mercury Insurance Company
MERIT AUTO
MetLife Insurance (Auto)
Metropolitan Life
METROPOLITAN PROPERTY AND CASUALTY INSURANCE
Michelangelo 02348
Michigan Commercial Insurance Mutual (MCIM)
Midlands Injury Management
Millennium Risk Managers
Mitchell Smart Advisor Solutions
MMO VANTAGE
MODOT/MSHP
Montlake Insurance Holdings
Murphy & Beane Medata
NARS North American Risk


                                                Page 5
                           tbl_CombinedCCL_0040a_Final_Cle


NARS System Lease Auto
National Grange Mutual Insurance Company
National Grange Mutual Insurance Company
New Business 1
New Business 2
New Business 3
New Business 4
New Business 5
New Business 6
New Mexico Mutual
New York Special Funds Conservation
New York State Insurance Fund
NORTH AMERICAN RISK SERVICES (NARS) AUTO
Northstar Providers LLC
Northstar Providers LLC
Occunet
Octagon Risk Services, Inc
Ohio Casualty
OHIO CASUALTY
Ohio Casualty Group AUTO
One Beacon
ONPOINT Commercial Insurance
Overnight Transportation Company
Owens Illinois
Pacific Gas and Electric
Paradigm Management Services, LLC
Patriot Risk Services
PBM Corp
PBM CORP - EDI
Peninsula Insurance Company
Peter Chang Enterprises
Plainfield School District
PMA Insurance Group
PMA Insurance Group
PMA MC of New England
Pool 1 04017
Pool 3 04016
Premier Control Services
Primary MPN FH TX HCN Network Only
Progressive Insurance (Auto)
PROGRESSIVE INSURANCE COMPANY AUTO
PROGRESSIVE INSURANCE COMPANY AUTO OHIO
Providence Washington
Quincy School District
RAM
RENY Company
Reny Company The
Reny Company The Auto
Review Works AUTO
RIMCO
RISING MEDICAL
Rising Medical Solutions


                                       Page 6
                                    tbl_CombinedCCL_0040a_Final_Cle


Risk Administration Services Inc
Risk Management Planning Group
RMSCO
Rocor International
RSKCO Cunningham and Lindsey
RTW INC
Sagamore Insurance Company
Seabright Insurance Standard PPO
Sears Holdings Inc
Sears NY
Seaton Corporation
Sedgwick Claims Management Services
Sedgwick TX Non-Subscriber w/o Aetna
Selective Insurance Agency
Service Corporation International (SCI Management)
Setzer Associates
Shell Oil Company
Sierra Health Services
SISCO
SISCO
Sisters of Mercy
Solin USA
SOLUTIONS 4
Solutions4 - Nashvile Auto
SOLUTIONS4 AUTO
Southeastern Claims Services Inc
SPARTA
Specialty Risk Services (SRS)
SRS Select
SRS Standard with Qmedtrix
SRS Standard without Qmedtrix
SRS TX HCN Standard
Standard PPO and OON Network Only
STARR COMPREHENSIVE SOLUTIONS, INC
STATE AUTO INSURANCE COMPANIES
State Claims
State of Vermont
Sterling Administrators / Goff MGA
Stratacare Eastern Alliance Insurance
Stratacare Sedgwick TX NS and Longshore
SWIF
Swiss Re
Tandem
Texas Mutual FFS
The Hartford
The Heart Group 02362
TOKIO MARINE - CHANNELING
Tokio Marine Management
Tokio Marine Management Auto
Total Managed Care (TMC)
Tower Insurance
Tower Insurance Auto


                                                     Page 7
                                 tbl_CombinedCCL_0040a_Final_Cle


Tower TX HCN
TRAVELERS
TRISTAR Managed Care
TWR Intercare
U S Specialty Insurance Company
Unisource
United States Postal ServiceTRAVELERS
UNITRIN
Unitrin (Auto)
Unitrin Business Insurance
Unitrin Direct
VACo Risk Management Programs.
Valley Oak Systems
Venture Programs
VirtueMed
Walmart
Walt Disney Company
Wausau Insurance
WC CUNA Mutual Insurance Co CUMIS
WEBSTER AUTO
Wells Fargo Disability - Paper Only
Werner Enterprises
Whole Foods Market Inc
WMBR
Xchanging CA MPN AUG10
Xchanging CA MPN SEP10
Xchanging Southwest Airlines
Xchanging Southwest TX HCN
Xchanging TX non Subscriber
Yale University
York Risk Services
Zenith
ZURICH
Zurich Farmers Insurance Group
Zurich North America




                                             Page 8
                                                          tbl_CombinedCCL_0040a_Final_Cle


nd HealthCare Preferred logos all signify access to The First Health Network (July 2011)
network products due to client requirements or restrictions. Patient eligibility, benefits and compensability coverage MUST be confirmed by calling the telephon


               Affiliated With                                                                    Outpatient Care Network        Hospital
               ADVANTAGE                                                                          Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               AIG Claim Services                                                                 Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               Chartis                                                                            Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               Alpha Review Corporation                                                           Yes                            No
               Mitchell SmartAdvisor Solutions                                                    Yes                            Yes
               Mitchell SmartAdvisor Solutions                                                    Yes                            Yes
               RCS                                                                                Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               Mitchell SmartAdvisor Solutions                                                    Yes                            Yes
               Xchanging                                                                          Yes                            Yes
               Xchanging                                                                          Yes                            Yes
               SOLUTIONS4                                                                         Yes                            Yes
               AMERISYS INC                                                                       Yes                            Yes
               AMERISYS                                                                           Yes                            Yes
               AMERISYS INC                                                                       Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               Gallagher Bassett Managed Care Services                                            Yes                            Yes
               Genex Services, Inc.                                                               No                             Yes
               FairPay Solutions                                                                  Yes                            Yes
               Applied Underwriters                                                               Yes                            Yes
               Arrowpoint Indemnity Company                                                       Yes                            Yes
               At Global                                                                          Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               GENEX Services, Inc                                                                Yes                            Yes
               HINZ CLAIM MANAGEMENT INC                                                          Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               CompIQ                                                                             Yes                            Yes
               Ingenix Inc                                                                        Yes                            Yes
               Mitchell SmartAdvisor Solutions                                                    Yes                            Yes
               Medata                                                                             Yes                            Yes
               Blessey Marine                                                                     Yes                            Yes
               BREARD SHORE AND ASSOCIATES                                                        Yes                            Yes
               Brickstreet Mutual Insurance                                                       Yes                            Yes
               Genex Services, Inc.                                                               Yes                            Yes
               Broadspire A Crawford Company                                                      Yes                            Yes
               Broadspire A Crawford Company                                                      Yes                            Yes
               Ingenix Inc. WC                                                                    Yes                            Yes
               MITCHELL SMARTADVISOR SOLUTIONS                                                    Yes                            Yes


                                                                           Page 9
                                  tbl_CombinedCCL_0040a_Final_Cle


Bunch & Associates, Inc.                                      Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Stratacare                                                    Yes   Yes
StrataCare Inc.                                               Yes   Yes
MCMC LLC                                                      Yes   Yes
MCMC LLC                                                      Yes   Yes
STRATACARE                                                    Yes   Yes
Stratacare, Inc.                                              Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Gallagher Bassett Managed Care Services                       Yes   Yes
CGH CLAIMS SERVICE AUTO                                       Yes   Yes
CGH CLAIMS SERVICE                                            Yes   Yes
At Global                                                     Yes   Yes
Chartis                                                       Yes   Yes
Chartis                                                       Yes   Yes
Chartis                                                       No    Yes
Chartis                                                       Yes   No
Chase Staffing                                                Yes   Yes
MCMC LLC                                                      Yes   Yes
Cherokee Insurance                                            Yes   Yes
Hewitt Coleman and Associates Inc                             Yes   Yes
City of Chicago                                               Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Crawford and Company                                          Yes   Yes
CNA                                                           Yes   Yes
CAN                                                           Yes   Yes
CAN                                                           Yes   Yes
CAN                                                           Yes   Yes
Coastal Glass                                                 Yes   Yes
CompIQ                                                        Yes   Yes
CompIQ                                                        Yes   Yes
Stratacare, Inc.                                              Yes   Yes
Stratacare, Inc.                                              Yes   Yes
F A Richard                                                   Yes   Yes
CompIQ #13910                                                 Yes   Yes
CompIQ                                                        Yes   Yes
CompIQ                                                        Yes   Yes
CompIQ                                                        Yes   Yes
Compsource                                                    Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Eastern Alliance                                              Yes   Yes
Stratacare                                                    Yes   Yes
CompIQ                                                        Yes   Yes
Genex Services, Inc.                                          Yes   Yes
BROADSPIRE A CRAWFORD COMPANY                                 Yes   Yes
Genex Services, Inc.                                          Yes   Yes
CRM POLK COUNTY                                               Yes   Yes
Genex Services, Inc.                                          Yes   Yes
GENEX SERVICES, INC.                                          Yes   Yes
CompIQ #13910                                                 Yes   Yes
Dean Foods                                                    Yes   Yes


                                             Page 10
                                   tbl_CombinedCCL_0040a_Final_Cle


COMP IQ                                                        Yes   Yes
Diversified Healthcare Systems                                 Yes   Yes
CompIQ #13910                                                  Yes   Yes
Eastern Alliance Insurance Group                               Yes   Yes
Eastern Alliance                                               Yes   Yes
                                                               Yes   Yes
Electric Insurance Company                                     Yes   Yes
Genex Services, Inc.                                           Yes   Yes
Genex Services, Inc.                                           Yes   Yes
EMC Insurance Companies                                        Yes   Yes
Genex Services, Inc.                                           Yes   Yes
Genex Services, Inc.                                           Yes   Yes
EMPLOYERS ALLIANCE INSURANCE                                   Yes   Yes
Innovative Risk Management                                     Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
ESIS                                                           Yes   Yes
Genex Services, Inc.                                           Yes   Yes
Gallagher Bassett Managed Care Services                        Yes   Yes
CompIQ                                                         Yes   Yes
F A Richard and Associates                                     Yes   Yes
F A Richard and Associates                                     Yes   Yes
F. A. Richard & Associates, Inc.                               Yes   Yes
F. A. Richard & Associates, Inc.                               Yes   Yes
F A Richard and Associates                                     Yes   Yes
F. A. Richard & Associates, Inc.                               Yes   Yes
F A Richard and Associates                                     Yes   Yes
GENEX Services, Inc.                                           Yes   Yes
FCCI Insurance Group                                           Yes   Yes
Mitchell SmartAdvisor Solutions                                Yes   Yes
Genex Services, Inc.                                           Yes   Yes
CompIQ                                                         Yes   Yes
Firemans Fund Insurance Company                                No    Yes
Firemans Fund Insurance Company                                Yes   No
Cardinal Comp                                                  Yes   Yes
First Cardinal LLC                                             Yes   Yes
                                                               Yes   Yes
STRATACARE                                                     Yes   Yes
At Global                                                      Yes   Yes
Forte                                                          Yes   Yes
Mitchell SmartAdvisor Solutions                                Yes   Yes
Genex Services, Inc.                                           Yes   Yes
Genex Services, Inc.                                           Yes   Yes
Gallagher Bassett Managed Care Services                        Yes   Yes
Gallagher Bassett Managed Care Services                        Yes   Yes
Gallagher Bassett Managed Care Services                        Yes   Yes
Gallagher Bassett Managed Care Services                        Yes   Yes


                                              Page 11
                            tbl_CombinedCCL_0040a_Final_Cle


Gallagher Basset Managed Care                           Yes   Yes
GALLAGHER BASSETT MANAGED CARE SERVICES                 Yes   Yes
Gallagher Bassett Managed Care Services                 Yes   Yes
Gallagher Bassett Managed Care Services                 Yes   Yes
Gallagher Bassett Services, Inc.                        Yes   Yes
Gallagher Bassett Managed Care Services                 Yes   Yes
Genex Services, Inc.                                    Yes   Yes
GE ERC                                                  Yes   Yes
Mitchell Smartadvisor Solutions                         Yes   Yes
                                                        Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
Genex Services, Inc.                                    Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
GENEX Services Inc                                      Yes   Yes
CompIq                                                  Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
Genex Services, Inc.                                    Yes   Yes
Mitchell Medical                                        Yes   Yes
Gray Insurance Company The                              Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
Genex Services, Inc.                                    Yes   Yes
MITCHELL SMARTADVISOR SOLUTIONS                         Yes   Yes
Greater New York Company                                Yes   Yes
WEB APPLICATIONS                                        Yes   Yes
Guard Insurance Group                                   Yes   Yes
Guard Insurance Group                                   Yes   Yes
F. A. Richard & Associates, Inc.                        No    Yes
The Hanover Insurance Company                           Yes   Yes
Genex Services, Inc.                                    Yes   Yes
HCA                                                     Yes   Yes
HIS                                                     Yes   Yes
HIS                                                     Yes   Yes
CompIQ                                                  Yes   Yes
HEWITT COLEMAN AND ASSOCIATES, INC                      Yes   Yes
HINZ CLAIMS MANAGEMENT INC                              Yes   Yes
CompIQ #13910                                           Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
STATE OF ILLINOIS                                       Yes   Yes
HINZ CLAIM MANAGEMENT INC                               Yes   Yes
Genex Services, Inc.                                    Yes   Yes
Ingenix Inc.                                            Yes   Yes
Ingenix Inc.                                            Yes   Yes
Ingenix Inc.                                            Yes   Yes
Ingenix Inc.                                            Yes   Yes
Ingenix Inc.                                            Yes   Yes
Ingenix Inc.                                            Yes   Yes
Injury Care Services Inc                                Yes   Yes
Coventry WC Test Clients                                Yes   Yes
CompIQ #13910                                           Yes   Yes


                                       Page 12
                            tbl_CombinedCCL_0040a_Final_Cle


CompIQ #13910                                           Yes   Yes
Intracorp                                               Yes   Yes
Intracorp                                               Yes   Yes
JI Companies                                            Yes   Yes
CompIQ                                                  Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
Genex Services, Inc.                                    Yes   Yes
Genex Services, Inc.                                    Yes   Yes
F. A. Richard & Associates, Inc.                        No    Yes
Eastern Alliance                                        Yes   Yes
Genex Services, Inc.                                    Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
Liberty Mutual Insurance Company                        Yes   Yes
Liberty Mutual Insurance Company/Liberty                Yes   Yes
Liberty Mutual Insurance Company                        No    Yes
Liberty Mutual Insurance Company                        Yes   No
Genex Services, Inc.                                    Yes   Yes
Genex Services, Inc.                                    Yes   Yes
MAC Risk Managament                                     Yes   Yes
CompIQ                                                  Yes   Yes
Magna Carta Companies                                   Yes   Yes
Cambridge                                               Yes   Yes
SALESFORCE COM                                          Yes   Yes
Matson Navigation Company                               Yes   Yes
May Department Stores Co.                               Yes   Yes
May Department Stores Co.                               Yes   Yes
May Department Stores Co.                               Yes   Yes
MCMC LLC                                                Yes   Yes
MCMC, LLC                                               Yes   Yes
MCMC LLC                                                Yes   Yes
MCO Advantage / PBM Corporation                         Yes   Yes
MCO Advantage / PBM Corporation                         Yes   Yes
At Global                                               Yes   Yes
Mitchell SmartAdvisor Solutions                         Yes   Yes
MEDICOR                                                 Yes   Yes
Genex Services, Inc.                                    Yes   Yes
MITCHELL MEDICAL                                        Yes   Yes
Mercury Insurance                                       Yes   Yes
MCMC LLC                                                Yes   Yes
Mitchell Medical                                        Yes   Yes
Mitchell Medical div. of Thompson Publishing Corp       Yes   Yes
Mitchell Medical                                        Yes   Yes
Eastern Alliance                                        Yes   Yes
Stratacare                                              Yes   Yes
Midlands Injury Management                              Yes   Yes
Genex Services, Inc.                                    Yes   Yes
MITCHELL SMARTADVISOR SOLUTIONS                         Yes   Yes
Medical Mutual of Oho                                   Yes   Yes
MO DEPT OF TRANSPORTATION & MO STATE HWY PATROL         Yes   Yes
GENEX Services, Inc.                                    Yes   Yes
Medata                                                  Yes   Yes
StrataCare                                              Yes   Yes


                                       Page 13
                          tbl_CombinedCCL_0040a_Final_Cle


CompIQ                                                Yes   Yes
Genex Services, Inc.                                  Yes   Yes
Genex Services, Inc.                                  Yes   Yes
Medata, Inc.                                          Yes   Yes
MEDATA, INC                                           Yes   Yes
MEDATA, INC                                           Yes   Yes
MEDATA, INC                                           Yes   Yes
MEDATA, INC.                                          Yes   Yes
MEDATA, INC.                                          Yes   Yes
StrataCare                                            Yes   Yes
New York Special Funds Conservation                   Yes   Yes
New York State Insurance Fund                         Yes   Yes
CompIQ #13910                                         Yes   Yes
COMP IQ                                               Yes   Yes
COMP IQ                                               Yes   Yes
CompIQ                                                Yes   Yes
CompManagement, Inc. (CMI)                            Yes   Yes
Genex Services, Inc.                                  Yes   Yes
OHIO CASUALTY                                         Yes   Yes
GENEX Services, Inc.                                  Yes   Yes
Mitchell Medical                                      Yes   Yes
ONPOINT UNDERWRITING                                  Yes   Yes
Genex Services, Inc.                                  Yes   Yes
Genex Services, Inc.                                  Yes   Yes
Pacific Gas and Electric                              Yes   Yes
Paradigm Management Services, LLC                     Yes   Yes
TIMCO/Guarantee Insurance Co                          Yes   Yes
MCO Advantage / PBM Corporation                       Yes   Yes
MCO Advantage / PBM Corporation                       Yes   Yes
BUSINESS ADMINISTRATORS AND CONSULTANTS               Yes   Yes
Peter Chang Enterprises                               Yes   Yes
HINZ CLAIM MANAGEMENT INC                             Yes   Yes
PMA Insurance Group                                   No    Yes
PMA Insurance Group                                   Yes   No
PMA Insurance Company                                 Yes   Yes
HINZ CLAIM MANAGEMENT INC                             Yes   Yes
HINZ CLAIM MANAGEMENT INC                             Yes   Yes
GENEX Services, Inc.                                  Yes   Yes
CompIQ                                                Yes   Yes
Mitchell Medical                                      Yes   Yes
MITCHELL MEDICAL                                      Yes   Yes
MITCHELL MEDICAL                                      Yes   Yes
Genex Services, Inc.                                  Yes   Yes
HINZ CLAIM MANAGEMENT INC                             Yes   Yes
Liberty                                               Yes   Yes
CompIQ                                                Yes   Yes
MCMC, LLC                                             Yes   Yes
MCMC, LLC                                             Yes   Yes
Review Works                                          Yes   Yes
STRATACARE                                            Yes   Yes
Rising Medical Solutions                              Yes   Yes
Rising Medical Solutions                              Yes   Yes


                                     Page 14
                                  tbl_CombinedCCL_0040a_Final_Cle


Genex Services, Inc.                                          Yes   Yes
Risk Management Planning Group                                Yes   Yes
RMSCO INC                                                     Yes   Yes
Genex Services, Inc.                                          Yes   Yes
RSKCO Cunningham and Lindsey                                  Yes   Yes
RTW INC                                                       Yes   Yes
GENEX Services, Inc                                           Yes   Yes
Total Healthcare Management Inc                               Yes   Yes
SEARS                                                         Yes   Yes
Sears                                                         Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Sedgwick Claims Management                                    Yes   Yes
Mitchell SmartAdvisor Solutions                               Yes   Yes
Genex Services, Inc.                                          Yes   Yes
CompIQ                                                        Yes   Yes
Genex Services, Inc.                                          Yes   Yes
STRATACARE INC                                                Yes   Yes
Mitchell SmartAdvisor Solutions                               Yes   Yes
VALLEY OAKS SYSTEMS                                           Yes   Yes
STRATACARE INC                                                Yes   Yes
Solin USA                                                     Yes   Yes
MCMC LLC                                                      Yes   Yes
MCMC LLC                                                      Yes   Yes
MCMC LLC                                                      Yes   Yes
Genex Services, Inc.                                          Yes   Yes
COMPIQ                                                        Yes   Yes
The Hartford & SRS                                            Yes   Yes
CompIQ                                                        Yes   Yes
The Hartford & SRS                                            Yes   Yes
The Hartford & SRS                                            Yes   Yes
ACS CompIQ                                                    Yes   Yes
CompIQ                                                        Yes   Yes
COMPIQ                                                        Yes   Yes
Mitchell SmartAdvisor Solutions                               Yes   Yes
Genex Services, Inc.                                          Yes   Yes
FairPay Solutions, Inc.                                       Yes   Yes
Genex Services, Inc.                                          Yes   Yes
Stratacare                                                    Yes   Yes
STRATACARE INC                                                Yes   Yes
MedRisk                                                       Yes   Yes
Swiss Re                                                      Yes   Yes
At Global                                                     Yes   Yes
Texas Mutual                                                  Yes   Yes
The Hartford & SRS                                            Yes   Yes
Eastern Alliance                                              Yes   No
Tokio Marine Management, Inc.                                 Yes   Yes
Tokio Marine Management, Inc.                                 Yes   Yes
Tokio Marine Management Auto                                  Yes   Yes
CompIQ                                                        Yes   Yes
Tower Insurance Company                                       Yes   Yes
Tower Insurance Company                                       Yes   Yes


                                             Page 15
                           tbl_CombinedCCL_0040a_Final_Cle


SUA INSURANCE TX HCN                                   Yes   Yes
TRAVELERS                                              Yes   Yes
CompIQ #13910                                          Yes   Yes
SUA Insurance Company                                  Yes   Yes
Genex Services, Inc.                                   Yes   Yes
GENEX Services, Inc.                                   Yes   Yes
United States Postal Service                           Yes   Yes
MITCHELL MEDICAL                                       Yes   Yes
Mitchell Medical                                       Yes   Yes
Unitrin Business Insurance                             Yes   Yes
Mitchell Medical                                       Yes   Yes
VACo Risk Management Programs.                         Yes   Yes
Valley Oak Systems                                     Yes   Yes
Genex Services, Inc.                                   Yes   Yes
VirtueMed, Inc.                                        Yes   Yes
MITCHELL SMARTADVISOR SOLUTIONS                        Yes   Yes
StratacareYTD NOAS102 Report                           Yes   Yes
Liberty Mutual Insurance Group                         Yes   Yes
CUNA MUTUAL INSURANCE CO PTK TO MCPS WC                Yes   No
MCMC LLC                                               Yes   Yes
Wells Fargo                                            Yes   Yes
Genex Services, Inc.                                   Yes   Yes
Genex Services, Inc.                                   Yes   Yes
At Global                                              Yes   Yes
Cambridge                                              Yes   Yes
Cambridge                                              Yes   Yes
Exchanging Southwest Airlines                          Yes   Yes
Xcchanging Southwest Airlines                          Yes   Yes
Xchanging                                              Yes   Yes
Yale University                                        Yes   Yes
York Risk Services                                     Yes   Yes
Zenith                                                 Yes   Yes
COMPIQ                                                 Yes   Yes
Zurich Farmers Insurance Group                         Yes   Yes
Zurich Services Corporation                            Yes   Yes
Atlantic Mutual Insurance                              Yes   Yes




                                      Page 16
                                                          tbl_CombinedCCL_0040a_Final_Cle



confirmed by calling the telephone numbers and/or employer indicated under the "Eligibility/Benefits/Compensability" section.


              Auto   Source FundID Statename Effective Date Term Effective Date                     Plan Type
              No     FH            GA               1/1/2004                                        Workers' Compensation
              No     FH            GA               6/1/2006                                        Workers' Compensation
              Yes    FH            GA             10/1/2006                                         Auto
              No     FH            GA             11/1/2003                                         Workers' Compensation
              No     FH            GA             2/15/1992                                         Workers' Compensation
              No     FH            GA             10/1/2003                                         Workers' Compensation
              No     FH            GA             11/1/2002                                         Workers' Compensation
              No     FH            GA               4/1/2005                                        Workers' Compensation
              No     FH            GA             12/1/2003                                         Workers' Compensation
              Yes    FH            GA               8/1/2003                                        Auto
              No     FH            GA               3/1/2009                                        Workers' Compensation
              No     FH            GA               1/1/2010                                        Workers' Compensation
              No     FH            GA               9/1/2002                                        Workers' Compensation
              No     FH            GA               4/1/2009                                        Workers' Compensation
              No     FH            GA               6/1/2010                                        Workers' Compensation
              No     FH            GA               5/1/2010                                        Workers' Compensation
              No     FH            GA             4/20/2010                                         Workers' Compensation
              No     FH            GA               1/1/2007                                        Workers' Compensation
              No     FH            GA               4/1/2007                                        Workers' Compensation
              No     FH            GA               4/1/2007                                        Workers' Compensation
              No     FH            GA               4/1/2007                                        Workers' Compensation
              No     FH            GA               2/1/2003                                        Workers' Compensation
              No     FH            GA            12/15/2009                                         Workers' Compensation
              No     FH            GA               6/1/2000                                        Workers' Compensation
              No     FH            GA               3/1/2006                                        Workers' Compensation
              No     FH            GA               1/1/2003                                        Workers' Compensation
              No     FH            GA               1/1/2003                                        Workers' Compensation
              No     FH            GA               2/1/2009                                        Workers' Compensation
              No     FH            GA               4/1/2005                                        Workers' Compensation
              No     FH            GA               3/1/2003                                        Workers' Compensation
              No     FH            GA             11/1/2008                                         Workers' Compensation
              No     FH            GA                                                               Auto
              No     FH            GA               9/1/2003                                        Workers' Compensation
              No     FH            GA               4/1/2004                                        Workers' Compensation
              Yes    FH            GA               5/1/2004                                        Auto
              No     FH            GA               5/1/2010                                        Auto
              No     FH            GA               5/1/2010                                        Workers' Compensation
              No     FH            GA               2/5/2010                                        Workers' Compensation
              No     FH            GA               4/1/2003                                        Workers' Compensation
              No     FH            GA               8/1/2010                                        Workers' Compensation
              No     FH            GA               1/1/2000                                        Workers' Compensation
              No     FH            GA               5/1/2002                                        Workers' Compensation
              No     FH            GA               9/1/2009                                        Workers' Compensation
              No     FH            GA             12/1/2008                                         Workers' Compensation
              No     FH            GA               8/1/2009                                        Workers' Compensation
              No     FH            GA               8/1/2009                                        Workers' Compensation
              No     FH            GA               6/1/2008                                        Workers' Compensation
              No     FH            GA               4/1/2003                                        Workers' Compensation


                                                                          Page 17
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA       8/1/2003                      Workers' Compensation
No    FH   GA      11/1/2001                      Workers' Compensation
No    FH   GA       4/1/2004                      Workers' Compensation
No    FH   GA       1/1/2010                      Workers' Compensation
No    FH   GA       6/1/2008                      Workers' Compensation
Yes   FH   GA      10/1/2003                      Auto
No    FH   GA      12/1/2005                      Workers' Compensation
No    FH   GA       1/1/2009                      Workers' Compensation
No    FH   GA       9/1/2001                      Workers' Compensation
No    FH   GA       7/1/2010                      Workers' Compensation
No    FH   GA       1/1/2000                      Auto
No    FH   GA       1/1/2000                      Workers' Compensation
No    FH   GA       2/1/2007                      Workers' Compensation
No    FH   GA       5/1/1992                      Workers' Compensation
No    FH   GA       7/1/1992                      Workers' Compensation
No    FH   GA      2/15/1992                      Workers' Compensation
No    FH   GA      2/15/1992                      Workers' Compensation
No    FH   GA       1/1/2000                      Workers' Compensation
Yes   FH   GA      10/1/2003                      Auto
No    FH   GA       1/1/2005                      Workers' Compensation
No    FH   GA       5/1/2010                      Workers' Compensation
No    FH   GA       1/1/2008                      Workers' Compensation
No    FH   GA      12/1/2001                      Workers' Compensation
No    FH   GA       8/1/2000                      Workers' Compensation
No    FH   GA      12/1/1999                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       7/1/2009                      Workers' Compensation
No    FH   GA       8/1/2006                      Workers' Compensation
Yes   FH   GA       1/1/2007                      Auto
No    FH   GA      12/1/2004                      Workers' Compensation
No    FH   GA       2/1/2010                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA       4/1/2002                      Workers' Compensation
No    FH   GA       2/1/2011                      Workers' Compensation
No    FH   GA       4/1/2002                      Workers' Compensation
No    FH   GA       1/1/2011                      Workers' Compensation
No    FH   GA       6/1/2010                      Workers' Compensation
No    FH   GA      11/1/2000                      Workers' Compensation
No    FH   GA       1/5/1970                      Workers' Compensation
No    FH   GA      1/16/2004                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA       9/1/2002                      Workers' Compensation
Yes   FH   GA      10/1/1999                      Auto
No    FH   GA       8/1/2003                      Workers' Compensation
No    FH   GA       1/1/2010                      Workers' Compensation
No    FH   GA       5/1/2003                      Workers' Compensation
No    FH   GA       1/1/2007                      Workers' Compensation
No    FH   GA       5/1/2005                      Workers' Compensation
No    FH   GA       6/1/2010                      Workers' Compensation


                               Page 18
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA       4/1/2002                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA      10/1/2004                      Workers' Compensation
No    FH   GA       1/5/1970                      Workers' Compensation
No    FH   GA       1/5/1970                      Workers' Compensation
No    FH   GA      11/1/2002                      Workers' Compensation
No    FH   GA       1/1/2006                      Workers' Compensation
No    FH   GA       6/1/2000                      Workers' Compensation
No    FH   GA      10/1/2003                      Workers' Compensation
No    FH   GA       4/1/2003                      Workers' Compensation
No    FH   GA       1/1/2002                      Workers' Compensation
No    FH   GA       2/1/2003                      Workers' Compensation
No    FH   GA       8/1/2005                      Workers' Compensation
No    FH   GA       6/1/2005                      Workers' Compensation
No    FH   GA      12/1/2009                      Workers' Compensation
No    FH   GA      12/1/2009                      Workers' Compensation
No    FH   GA       5/1/2002                      Workers' Compensation
No    FH   GA       5/1/2002                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA       5/1/2002                      Workers' Compensation
No    FH   GA      11/1/2001                      Workers' Compensation
No    FH   GA      5/17/2010                      Workers' Compensation
No    FH   GA       4/1/2009                      Workers' Compensation
No    FH   GA      12/1/2010                      Workers' Compensation
No    FH   GA      12/1/2010                      Workers' Compensation
No    FH   GA       1/1/2004                      Workers' Compensation
No    FH   GA       4/1/2006                      Workers' Compensation
No    FH   GA      1/25/2008                      Workers' Compensation
No    FH   GA       4/1/2006                      Workers' Compensation
No    FH   GA       4/1/2010                      Workers' Compensation
No    FH   GA      11/1/2003                      Workers' Compensation
No    FH   GA       4/1/2004                      Workers' Compensation
No    FH   GA      12/1/2007                      Workers' Compensation
No    FH   GA       7/1/2000                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA      11/1/1999                      Workers' Compensation
No    FH   GA      11/1/1999                      Workers' Compensation
No    FH   GA      9/10/2009                      Workers' Compensation
No    FH   GA       6/1/2008                      Workers' Compensation
No    FH   GA       2/1/2004                      Workers' Compensation
No    FH   GA       6/1/2008                      Workers' Compensation
No    FH   GA       2/1/2007                      Workers' Compensation
No    FH   GA       2/1/2006                      Workers' Compensation
No    FH   GA      3/10/2010                      Workers' Compensation
No    FH   GA       8/1/2003                      Workers' Compensation
No    FH   GA       7/1/2002                      Workers' Compensation
No    FH   GA       3/1/1991                      Workers' Compensation
No    FH   GA      10/1/2010                      Workers' Compensation
Yes   FH   GA       6/1/2005                      Auto
No    FH   GA       3/1/1991                      Workers' Compensation


                               Page 19
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA      12/1/2010                       Workers' Compensation
No    FH   GA       3/1/1991                       Workers' Compensation
No    FH   GA       3/1/1991                       Workers' Compensation
No    FH   GA       3/1/1991                       Workers' Compensation
No    FH   GA       3/1/1991                       Workers' Compensation
No    FH   GA     11/15/2010                       Workers' Compensation
No    FH   GA       9/1/2001                       Workers' Compensation
No    FH   GA       3/1/1991                       Workers' Compensation
Yes   FH   GA       1/1/2010                       Auto
No    FH   GA       7/1/2001                       Workers' Compensation
No    FH   GA       1/1/2003                       Workers' Compensation
Yes   FH   GA       8/1/2003                       Workers' Compensation
No    FH   GA       1/1/1911                       Workers' Compensation
No    FH   GA      11/1/2003                       Workers' Compensation
No    FH   GA                                      Workers' Compensation
No    FH   GA       2/1/2005                       Workers' Compensation
No    FH   GA      10/1/2003                       Workers' Compensation
No    FH   GA       9/1/2003                       Workers' Compensation
Yes   FH   GA       2/1/2010                       Auto
No    FH   GA      11/1/2003                       Workers' Compensation
No    FH   GA       4/1/2003                       Workers' Compensation
No    FH   GA       6/1/2003                       Workers' Compensation
No    FH   GA      3/10/2010                       Workers' Compensation
No    FH   GA      11/1/2004                       Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA      11/1/2010                       Workers' Compensation
No    FH   GA       6/1/2010                       Workers' Compensation
No    FH   GA       1/1/2004                       Workers' Compensation
Yes   FH   GA       9/1/1999                       Auto
No    FH   GA       5/1/2002                       Workers' Compensation
No    FH   GA       1/1/2004                       Workers' Compensation
No    FH   GA      10/1/2007                       Workers' Compensation
Yes   FH   GA       1/1/2007                       Auto
No    FH   GA       4/1/2002                       Workers' Compensation
No    FH   GA       4/1/1997                       Workers' Compensation
No    FH   GA       4/1/2004                       Workers' Compensation
No    FH   GA       2/1/2004                       Workers' Compensation
No    FH   GA       7/1/2008                       Workers' Compensation
No    FH   GA      11/1/2003                       Workers' Compensation
No    FH   GA       4/1/2003                       Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA      11/1/2008                       Workers' Compensation
No    FH   GA       2/1/2000                       Workers' Compensation
No    FH   GA                                      Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA       1/1/2000                       Workers' Compensation
No    FH   GA       1/1/2000                       Auto
No    FH   GA       3/1/2009             5/31/2011 Workers' Compensation
No    FH   GA      3/20/2010                       Workers' Compensation
No    FH   GA       5/1/2005                       Workers' Compensation


                               Page 20
                        tbl_CombinedCCL_0040a_Final_Cle


No    FH           GA      12/1/2004                      Workers' Compensation
No    FH           GA       7/1/2002                      Workers' Compensation
Yes   FH           GA      12/1/2003                      Auto
No    FH           GA       7/1/2010                      Workers' Compensation
No    FH           GA       4/1/2010                      Workers' Compensation
No    FH           GA       6/1/2004                      Workers' Compensation
No    FH           GA       1/1/2000                      Workers' Compensation
No    FH           GA       5/1/2002                      Workers' Compensation
No    FH           GA       4/1/2006                      Workers' Compensation
No    FH           GA       1/5/1970                      Workers' Compensation
No    FH           GA       3/1/2002                      Workers' Compensation
Yes   FH           GA       1/1/2007                      Auto
Yes   FH           GA       7/1/1996                      Auto
No    FH   D8056   GA      10/1/1991                      Workers' Compensation
No    FH           GA       8/1/2007                      Workers' Compensation
No    FH           GA       8/1/2007                      Workers' Compensation
No    FH           GA       9/1/2002                      Workers' Compensation
No    FH           GA       3/1/1992                      Workers' Compensation
No    FH           GA      10/1/2001                      Workers' Compensation
No    FH           GA       4/1/2004                      Workers' Compensation
No    FH           GA      11/1/2009                      Workers' Compensation
No    FH           GA      10/1/1998                      Workers' Compensation
No    FH           GA       5/1/2008                      Workers' Compensation
No    FH           GA       6/1/1996                      Workers' Compensation
No    FH           GA       1/1/2003                      Workers' Compensation
No    FH           GA       1/1/2003                      Workers' Compensation
No    FH           GA       1/1/2003                      Workers' Compensation
No    FH           GA      10/1/2003                      Workers' Compensation
No    FH           GA       4/1/2004                      Workers' Compensation
No    FH           GA      10/1/2003                      Workers' Compensation
No    FH           GA       2/1/2004                      Workers' Compensation
No    FH           GA       2/1/2004                      Workers' Compensation
No    FH           GA       2/1/2007                      Workers' Compensation
No    FH           GA       4/1/2003                      Workers' Compensation
Yes   FH           GA       1/1/2006                      Auto
No    FH           GA      10/1/2000                      Workers' Compensation
Yes   FH           GA       7/1/2007                      Auto
Yes   FH           GA       8/1/2003                      Auto
Yes   FH           GA      10/1/2003                      Auto
Yes   FH           GA       8/1/2006                      Auto
Yes   FH           GA       9/1/2003                      Auto
Yes   FH           GA       8/1/2001                      Auto
No    FH           GA       1/1/2006                      Workers' Compensation
No    FH           GA      11/1/2008                      Workers' Compensation
No    FH           GA       5/1/1997                      Workers' Compensation
No    FH           GA       9/1/2003                      Workers' Compensation
No    FH           GA       4/1/2003                      Workers' Compensation
No    FH           GA       5/1/2010                      Workers' Compensation
No    FH           GA       1/1/2010                      Workers' Compensation
No    FH           GA       1/1/2003                      Workers' Compensation
No    FH           GA       5/1/2009                      Workers' Compensation
No    FH           GA       3/1/2010                      Workers' Compensation


                                       Page 21
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA       1/1/2010                      Workers' Compensation
No    FH   GA       6/1/2000                      Workers' Compensation
Yes   FH   GA       8/1/2003                      Auto
No    FH   GA       3/1/2009                      Workers' Compensation
No    FH   GA       3/1/2009                      Workers' Compensation
No    FH   GA       3/1/2009                      Workers' Compensation
No    FH   GA       3/1/2009                      Workers' Compensation
No    FH   GA       3/1/2009                      Workers' Compensation
No    FH   GA       3/1/2009                      Auto
No    FH   GA       9/1/2009                      Workers' Compensation
No    FH   GA       1/1/2004                      Workers' Compensation
No    FH   GA      9/30/2009                      Workers' Compensation
Yes   FH   GA       1/1/2007                      Auto
No    FH   GA      10/1/2006                      Workers' Compensation
Yes   FH   GA       1/1/2007                      Auto
No    FH   GA       6/7/2010                      Workers' Compensation
No    FH   GA       7/1/2004                      Workers' Compensation
No    FH   GA       6/1/2000                      Workers' Compensation
No    FH   GA       1/1/2010                      Workers' Compensation
Yes   FH   GA      10/1/2003                      Auto
Yes   FH   GA       8/1/2001                      Auto
No    FH   GA       9/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       7/1/2000                      Workers' Compensation
No    FH   GA       5/1/2001                      Workers' Compensation
No    FH   GA       1/1/2002                      Workers' Compensation
No    FH   GA       8/1/1999                      Workers' Compensation
No    FH   GA       2/1/2004                      Workers' Compensation
No    FH   GA       2/1/2004                      Workers' Compensation
No    FH   GA       9/1/2008                      Workers' Compensation
No    FH   GA      12/1/2003                      Workers' Compensation
No    FH   GA      11/1/2008                      Workers' Compensation
No    FH   GA       8/1/1997                      Workers' Compensation
No    FH   GA       8/1/1997                      Workers' Compensation
No    FH   GA       8/1/1997                      Workers' Compensation
No    FH   GA      11/1/2008                      Workers' Compensation
No    FH   GA      11/1/2008                      Workers' Compensation
No    FH   GA      10/1/2003                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
Yes   FH   GA       8/1/2006                      Auto
Yes   FH   GA      12/1/2004                      Auto
Yes   FH   GA      12/1/2007                      Auto
No    FH   GA       3/1/2002                      Workers' Compensation
No    FH   GA      11/1/2008                      Workers' Compensation
No    FH   GA      11/1/2002                      Workers' Compensation
No    FH   GA       4/1/2004                      Workers' Compensation
No    FH   GA      10/1/2003                      Workers' Compensation
No    FH   GA       5/1/2007                      Auto
Yes   FH   GA       7/7/2005                      Auto
No    FH   GA       4/1/2006                      Workers' Compensation
No    FH   GA      4/10/2010                      Auto
No    FH   GA      12/1/2009                      Workers' Compensation


                               Page 22
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA      11/1/2001                      Workers' Compensation
No    FH   GA       9/1/2010                      Workers' Compensation
No    FH   GA       1/1/2007                      Workers' Compensation
No    FH   GA       8/1/2000                      Workers' Compensation
No    FH   GA       9/1/2003                      Workers' Compensation
No    FH   GA       7/1/2007                      Workers' Compensation
No    FH   GA      12/1/2002                      Workers' Compensation
No    FH   GA       8/1/2003                      Workers' Compensation
No    FH   GA       1/1/2011                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       9/1/2000                      Workers' Compensation
No    FH   GA      11/1/2000                      Workers' Compensation
No    FH   GA       4/1/2010                      Workers' Compensation
No    FH   GA       4/1/2003                      Workers' Compensation
No    FH   GA      12/1/2001                      Workers' Compensation
No    FH   GA       6/1/2006                      Workers' Compensation
No    FH   GA       1/1/2000                      Workers' Compensation
No    FH   GA       2/1/2001                      Workers' Compensation
No    FH   GA       4/1/2003                      Workers' Compensation
No    FH   GA       4/1/2003                      Workers' Compensation
No    FH   GA       3/1/2011                      Workers' Compensation
No    FH   GA       1/1/2004                      Workers' Compensation
No    FH   GA      10/1/2003                      Workers' Compensation
Yes   FH   GA       8/1/2006                      Auto
Yes   FH   GA      10/1/2003                      Auto
No    FH   GA       1/1/2002                      Workers' Compensation
No    FH   GA       4/1/2011                      Workers' Compensation
No    FH   GA      10/1/1994                      Workers' Compensation
No    FH   GA      10/5/2009                      Workers' Compensation
No    FH   GA      10/1/1994                      Workers' Compensation
No    FH   GA      10/1/1994                      Workers' Compensation
No    FH   GA     11/16/2009                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA       1/1/2007                      Workers' Compensation
Yes   FH   GA       3/1/2004                      Auto
No    FH   GA      11/1/2003                      Workers' Compensation
No    FH   GA       3/1/2006                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       4/1/2010                      Workers' Compensation
No    FH   GA      10/1/2008                      Workers' Compensation
No    FH   GA       1/1/2004                      Workers' Compensation
No    FH   GA       2/1/2007                      Workers' Compensation
No    FH   GA      9/25/2009                      Workers' Compensation
No    FH   GA      10/1/1994                      Workers' Compensation
No    FH   GA                                     Workers' Compensation
No    FH   GA       5/1/2006                      Workers' Compensation
No    FH   GA       3/1/2005                      Workers' Compensation
Yes   FH   GA      12/1/2004                      Auto
No    FH   GA       1/1/2005                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation
No    FH   GA       1/1/2001                      Workers' Compensation


                               Page 23
                tbl_CombinedCCL_0040a_Final_Cle


No    FH   GA      10/1/2006                       Workers' Compensation
No    FH   GA       7/1/1996                       Workers' Compensation
No    FH   GA       7/1/2003                       Workers' Compensation
No    FH   GA      10/1/2006                       Workers' Compensation
No    FH   GA       2/1/2002                       Workers' Compensation
No    FH   GA      10/1/2003                       Workers' Compensation
No    FH   GA      12/1/2000                       Workers' Compensation
Yes   FH   GA       8/1/2001                       Auto
Yes   FH   GA       8/1/2006                       Auto
No    FH   GA       4/1/2002                       Workers' Compensation
Yes   FH   GA      10/1/2008                       Auto
No    FH   GA      10/1/2007                       Workers' Compensation
No    FH   GA      10/1/2005                       Workers' Compensation
No    FH   GA       4/1/2002                       Workers' Compensation
No    FH   GA      11/1/2005                       Workers' Compensation
No    FH   GA       4/1/2003                       Workers' Compensation
No    FH   GA      11/1/2004                       Workers' Compensation
No    FH   GA      10/1/1999                       Workers' Compensation
No    FH   GA       9/1/2001                       Workers' Compensation
Yes   FH   GA      10/1/2003                       Auto
No    FH   GA       7/1/2001                       Workers' Compensation
No    FH   GA       8/1/2003                       Workers' Compensation
No    FH   GA       6/1/2003                       Workers' Compensation
No    FH   GA       2/1/2007                       Workers' Compensation
No    FH   GA      8/10/2010                       Workers' Compensation
No    FH   GA      8/31/2010                       Workers' Compensation
No    FH   GA      12/7/2009                       Workers' Compensation
No    FH   GA       7/1/2010                       Workers' Compensation
No    FH   GA                                      Workers' Compensation
No    FH   GA       3/1/2010                       Workers' Compensation
No    FH   GA       1/1/2011                       Workers' Compensation
No    FH   GA      11/1/2003                       Workers' Compensation
No    FH   GA       4/1/2011                       Workers' Compensation
No    FH   GA      11/1/2004                       Workers' Compensation
No    FH   GA      11/1/2001                       Workers' Compensation
No    FH   GA       1/1/2001             5/13/2011 Workers' Compensation




                               Page 24
                                      tbl_CombinedCCL_0040a_Final_Cle




Billing and Claims Attention   Billing and Claims Address

                               809 S Agnew Ste H Oklahoma City OK 73108




                               1807 Diehl Rd Naperville IL 60563




                               701 TECHNOLOGY DR STE 201 CANONSBURG PA 15317




Attn: Jon Peebles              14295 Midway Rd Ste 300 Addison TX 75001
                               PO Box 3804 Omaha NE 68103


                               35 Tesla Way #100 Irvine CA 92618




                               2 South Pointe Lake Forest CA 92630
                               2 South Pointe Lake Forest CA 92630




                               PO Box 723099 Atlanta GA 31139-0099


                                                    Page 25
       tbl_CombinedCCL_0040a_Final_Cle


PO Box 32045 Lakeland FL 33802

Town Centre Bldg 2 East Main St Ste 208 Danville IL 61832


701 Technology Dr Ste 100 Canonsburg PA 15317
501 Shelley Dr Tyler TX 75711




PO BOX 4839 Breckenridge CO 80424




701 Technology Dr Ste 100 Canonsburg PA 15317




35 Tesla Way #100 Irvine CA 92618
35 Tesla Way #100 Irvine CA 92618



35 Tesla Way #100 Irvine CA 92618

35 Tesla Way #100 Irvine CA 92618




440 E. SWEDESFORD RD STE 3050 WAYNE PA 19087
35 Tesla Way #100 Irvine CA 92618




                    Page 26
                                 tbl_CombinedCCL_0040a_Final_Cle


                          77 Beale St San Francisco CA 94105

                          35 Tesla Way #100 Irvine CA 92618



                          PO Box 11930 Tucson AZ 85734


                          717 Mulberry Des Moines IA 50309




Attn: Bridgette Hammant   1625 Causeway Approach Mandeville LA 70741
                          1625 W. Causeway Approach Mandeville LA 70471
                          1625 W. Causeway Approach Mandeville LA 70471
Attn: Bridgette Hammant   1625 Causeway Approach Mandeville LA 70741
                          1625 W. Causeway Approach Mandeville LA 70471
Attn: Bridgette Hammant   1625 Causeway Approach Mandeville LA 70741

                          6300 University Pkwy Sarasota FL 34240




                          PO Box 23010 Tucson AZ 85734




                          PO BOX 4839 Breckenridge CO 80424




                          PO Box 23812 Tucson AZ 85734
                          PO Box 23812 Tucson AZ 85734




                                              Page 27
       tbl_CombinedCCL_0040a_Final_Cle




PO Box 23812 Tucson AZ 85734

PO Box 17076 Charlotte NC 28227




1717 East Loop Ste 333 Houston TX 77029




PO Box 290 Howell MI 48844


527 COLMAN DR ROCKFORD IL 61108
527 COLMAN DR ROCKFORD IL 61108


2815 Old Jacksonville Rd Ste 204 Springfield IL 62704
2868 Prospect Park Dr Rancho Cordova CA 95670



604 William G. Stratton Office Building Springfield IL 62706




35 Tesla Way #100 Irvine CA 92618


                      Page 28
       tbl_CombinedCCL_0040a_Final_Cle



PO Box 11158 Scottsdale AZ 85271-1158



PO Box 49129 Greensboro NC 27419




PO Box 7128 PHOENIX AZ 85014




175 W Jackson Ste 1000 Chicago IL 60604

555 12th St Oakland CA 94607
7004 Security Blvd, Ste 304 Baltimore MD 21244
7004 Security Blvd, Ste 304 Baltimore MD 21244
7004 Security Blvd, Ste 304 Baltimore MD 21244


701 TECHNOLOGY DR STE 201 CANONSBURG PA 15317


PO BOX 4839 Breckenridge CO 80424
3 Huntington Quad Melville NY 11747
1745 N Brown Rd Ste 400 Lawrenceville GA 30043



701 Technology Dr Ste 100 Canonsburg PA 15317




PO Box 238804 Oklahoma City OK 73116


2060 E 9th St Cleveland OH 44115




                    Page 29
       tbl_CombinedCCL_0040a_Final_Cle




35 Tesla Way #100 Irvine CA 92618
8080 NW 155TH ST MIAMI LAKES FL 33016
8080 NW 155TH ST MIAMI LAKES FL 33016




77 Beale St., 28th Floor San Francisco CA 94105
1001 Galaxy Way Ste 300 Concord CA 94520
1061 521 Corporate Center Dr Ste 140 Fort Mill SC 29715


6331 E LIVINGSTON AVE REYNOLDSBURG OH 43068
28530 Orchard Lake Rd Ste 101 Farmington Hills MI 48334

PO Box 25249 Lehigh Valley PA 18002-5249
PO Box 25249 Lehigh Valley PA 18002-5249




2 South Pointe Lake Forest CA 92630




                    Page 30
                                 tbl_CombinedCCL_0040a_Final_Cle




Attn: Claims Department   115 CONTINUUM DR LIVERPOOL NY 13088


                          8500 NORMANDALE LK BLVD STE 1400 BLOOMINGTON MN 55437




                          40 Wantage Ave Branchville NJ 07890

                          1300 Sawgrass Corporate Pkwy Sunrise FL 33323

                          PO Box 7858 Burbank CA 91510-7858
                          PO Box 28 Dubuque IA 52004
                          555 FAIRMOUNT AVE TOWSON MD 21286
Attn: Amy Tamanaha        17838 Gillette Ave Irvine CA 92614
                          520 N Semoran Blvd Ste 220 Orlando FL 32807
                          701 Technology Dr Ste 100 Canonsburg PA 15317
                          701 Technology Dr Ste 100 Canonsburg PA 15317
                          701 Technology Dr Ste 100 Canonsburg PA 15317

Attn: Deirdre Millwood    PO Box 85251 San Diego CA 92186
                          PO Box 4020 Wheaton IL 60189




                          35 Tesla Way #100 Irvine CA 92618


Attn: Jon Peebles         14295 Midway Rd Ste 300 Addison TX 75001

Attn: Amy Tamanaha        17838 Gillette Ave Irvine CA 92614
Attn: Amy Tamanaha        17838 Gillette Ave Irvine CA 92614
Attn: Jerry Poole         2701 Renaissance Blvd King of Prussia pa 19406
                          PO Box 5318 Tampa FL 33675-5318


                          PO Box 4020 Wheaton IL 60189




                          2 South Pointe Lake Forest CA 92630




                                              Page 31
                                tbl_CombinedCCL_0040a_Final_Cle




                         203 N Golden Circle Dr Ste 310 Santa Ana CA 92705



                         PO Box 23808 Tucson AZ 85734-3808




                         104 Church Ave SE Roanoke VA 24011
                         Bishop Ranch 8 - 5000 Executive Pkwy Ste 340 San Ramon CA 94583




                         701 Technology Dr Ste 100 Canonsburg PA 15317




Attn: Deirdre Millwood   PO Box 85251 San Diego CA 92186




                                             Page 32
                              tbl_CombinedCCL_0040a_Final_Cle




Hospital Claims Phone   OCN Claims Phone             ECSPayorID
(800) 293-3131          (800) 293-3131
(405) 601-2498          (405) 601-2498




(630) 305-8108          (630) 305-8108




(888) 350-1150          (888) 350-1150




(972) 715-8000          (972) 715-8000
(800) 293-3131          (800) 293-3131


(800) 293-3131          (800) 293-3131




(800) 293-3131          (800) 293-3131
(800) 293-3131          (800) 293-3131




(678) 309-4172          (678) 309-4172


                                           Page 33
                       tbl_CombinedCCL_0040a_Final_Cle


(888) 853-4735   (888) 853-4735

(800) 277-6512   (800) 277-6512


(888) 350-1150   (888) 350-1150
(800) 765-2412   (800) 765-2412




(970) 423-7161   (970) 423-7161




(888) 350-1150   (888) 350-1150




(800) 293-3131   (800) 293-3131
(800) 293-3131   (800) 293-3131



(800) 293-3131   (800) 293-3131

(800) 293-3131   (800) 293-3131




(888) 382-0039   (888) 382-0039




(949) 923-4021   (949) 923-4021




                                  Page 34
                                tbl_CombinedCCL_0040a_Final_Cle


(415) 973-8017            (415) 973-8017

(800) 293-3131            (800) 293-3131




(800) 880-1279 Ext 2068   (800) 880-1279 Ext 2068




(985) 624-6740            (985) 624-6740
(985) 624-6740            (985) 624-6740

(985) 624-6740            (985) 624-6740


(800) 226-3224            (800) 226-3224




(970) 423-7161            (970) 423-7161
(800) 580-1642            (800) 580-1642



(800) 370-0594            (800) 370-0594
(800) 370-0594            (800) 370-0594




                                             Page 35
                       tbl_CombinedCCL_0040a_Final_Cle




(704) 321-3909   (704) 321-3909




(909) 353-6800   (909) 353-6800




(800) 322-9025   (800) 322-9025




(217) 698-1280   (217) 698-1280
(800) 293-3131   (800) 293-3131



(217) 782-2548   (217) 782-2548




(949) 923-4021   (949) 923-4021


                                  Page 36
                       tbl_CombinedCCL_0040a_Final_Cle




(800) 366-1511   (800) 366-1511




(312) 821-8800   (312) 821-8800


(410) 298-1866   (410) 298-1866
(410) 298-1866   (410) 298-1866
(410) 298-1866   (410) 298-1866




(970) 423-7161   (970) 423-7161
(631) 454-8399   (631) 454-8399




(888) 350-1150   (888) 350-1150




(405) 767-1760   (405) 767-1760


(216) 687-6395   (216) 687-6395




                                  Page 37
                       tbl_CombinedCCL_0040a_Final_Cle




(800) 293-3131   (800) 293-3131
(786) 507-1600   (786) 507-1600
(786) 507-1600   (786) 507-1600

(866) 672-9296   (866) 672-9296




(415) 973-3350   (415) 973-3350
(925) 677-4719   (925) 677-4719



(800) 521-2654   (800) 521-2654
(248) 455-8972   (248) 455-8972

(888) 476-2669   (888) 476-2669
(888) 476-2669   (888) 476-2669




(800) 293-3131   (800) 293-3131




                                  Page 38
                                    tbl_CombinedCCL_0040a_Final_Cle




(315) 448-9000                (315) 448-9000




(973) 948-1638                (973) 948-1638

(954) 452-3000                (954) 452-3000

(818) 846-5297                (818) 846-5297
(563) 587-5175                (563) 587-5175
(410) 339-7855                (410) 339-7855
(818) 844-4300 Ext 237        (818) 844-4300 Ext 237
(800) 293-3131                (800) 293-3131
(888) 350-1150                (888) 350-1150
(888) 350-1150                (888) 350-1150
(888) 350-1150                (888) 350-1150


(800) 762-0666                (800) 762-0666




(800) 293-3131                (800) 293-3131


(972) 715-8000                (972) 715-8000

(818) 844-4300 Ext 237        (818) 844-4300 Ext 237
(818) 844-4300 Ext 237        (818) 844-4300 Ext 237
(800) 225-9675 800-225-9675   (800) 225-9675 800-225-9675
(860) 282-4960                (860) 282-4960


(800) 762-0666                (800) 762-0666




(800) 293-3131                (800) 293-3131




                                                 Page 39
                       tbl_CombinedCCL_0040a_Final_Cle




(714) 245-4813   (714) 245-4813



(800) 571-4501   (800) 571-4501




(925) 242-4659   (925) 242-4659




(888) 350-1150   (888) 350-1150




                                  Page 40
                                     tbl_CombinedCCL_0040a_Final_Cle




Eligibility Benefits and Compensablility Name   Eligibility Phone
CONTACT EMPLOYER
Advocate Case Management                        (405) 601-2498
CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
Alpha Review Corporation



CONTACT EMPLOYER




CONTACT EMPLOYER



CONTACT EMPLOYER

CONTACT EMPLOYER
FairPay Solutions                               (972) 715-8000
Applied Underwriters                            (402) 827-3424
CHECK BENEFIT CARD

CompIQ Corporation                              (800) 293-3131
CONTACT EMPLOYER


CONTACT EMPLOYER
CompIQ Corporation                              (800) 293-3131
CompIQ Corporation                              (800) 293-3131




Builders Insurance Group                        (678) 309-4000


                                                 Page 41
                                       tbl_CombinedCCL_0040a_Final_Cle


Bunch & Associates Inc                           (888) 853-4735
CONTACT EMPLOYER
Cannon Cochran Management Services Inc           (800) 252-5059


MCMC LLC                                         (888) 350-1150
Claims Administrative Services, Inc.             (800) 765-2412

CONTACT EMPLOYER



AT Global                                        (970) 423-7161


CONTACT EMPLOYER
CONTACT EMPLOYER

MCMC LLC                                         (888) 350-1150
CONTACT EMPLOYER


CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER




CompIQ Corporation                               (800) 293-3131
CompIQ Corporation                               (800) 293-3131



CompIQ Corporation                               (800) 293-3131

CompIQ                                           (800) 293-3131


CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER

CONTACT EMPLOYER
Crawford & Company                               (888) 382-0039
CONTACT EMPLOYER

CONTACT EMPLOYER
GENEX SERVICES, INC.
CompIQ Corporation                               (949) 923-4021




                                                  Page 42
                                     tbl_CombinedCCL_0040a_Final_Cle


Definiti                                       (415) 973-8017
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
EMC Insurance Companies                        (800) 880-1279 Ext 2068
CONTACT EMPLOYER
CONTACT EMPLOYER

CONTACT EMPLOYER




CONTACT EMPLOYER



F A Richard and Associates
FARA - F. A. Richard & Associates, Inc.        (985) 624-6740
FARA - F. A. Richard & Associates, Inc.        (985) 624-6740
F A Richard and Associates
FARA - F. A. Richard & Associates, Inc.        (985) 624-6740
F A Richard and Associates
CONTACT EMPLOYER
FCCI Insurance Group                           (800) 226-3224

CONTACT EMPLOYER

CONTACT EMPLOYER
CONTACT EMPLOYER


CONTACT EMPLOYER

AT Global                                      (970) 423-7161
Forte                                          (800) 580-1642

CONTACT EMPLOYER
CONTACT EMPLOYER
First Health                                   (800) 370-0594
First Health                                   (800) 370-0594




                                                Page 43
                             tbl_CombinedCCL_0040a_Final_Cle




CONTACT EMPLOYER

CONTACT EMPLOYER
CONTACT EMPLOYER

Genesis Managed Care                   (704) 321-3909
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER

CHECK BENEFIT CARD
CONTACT EMPLOYER
CONTACT EMPLOYER

The Gray Insurance Company             (713) 671-2534
CONTACT EMPLOYER
CONTACT EMPLOYER

CONTACT EMPLOYER




CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
HEALTH SYSTEMS INTERNATIONAL
HEALTH SYSTEMS INTERNATIONAL

CONTACT EMPLOYER
CONTACT EMPLOYER
Horizon Managed Care                   (916) 631-1220

CONTACT EMPLOYER
HRH Insurance
STATE OF ILLINOIS                      (217) 785-1954

CONTACT EMPLOYER




CompIQ Corporation                     (949) 923-4021


                                        Page 44
                              tbl_CombinedCCL_0040a_Final_Cle


CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER


Key Risk Insurance Company              (800) 366-1511
CONTACT EMPLOYER
CONTACT EMPLOYER

CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
CONTACT EMPLOYER


CONTACT EMPLOYER
CONTACT EMPLOYER
MAC Risk Management, Inc.               (800) 288-8415


Cambridge                               (312) 821-8800

Matson Navigation Company
May Department Stores                   (410) 298-1866
May Department Stores                   (410) 298-1866
May Department Stores                   (410) 298-1866


MCMC LLC                                (888) 350-1150
CONTACT EMPLOYER
CONTACT EMPLOYER
AT Global                               (970) 423-7161
Medical Consultants Network             (631) 454-8399
MEDICOR
CONTACT EMPLOYER
CHECK BENEFIT CARD
CHECK BENEFIT CARD
MCMC LLC                                (888) 350-1150
CHECK BENEFIT CARD
CONTACT EMPLOYER
CHECK BENEFIT CARD


Deborah Storey                          (405) 767-1760
CONTACT EMPLOYER
CONTACT EMPLOYER
Medical Mutual of Ohio                  (216) 687-6395

CONTACT EMPLOYER




                                         Page 45
                                   tbl_CombinedCCL_0040a_Final_Cle



CONTACT EMPLOYER
CONTACT EMPLOYER




CONTACT EMPLOYER

CompIQ Corporation                            (800) 293-3131
NORTHSTAR PROVIDERS, LLC                      (786) 507-1600
NORTHSTAR PROVIDERS, LLC                      (786) 507-1600

Octagon Risk Services, Inc - Rancho Cordova   (866) 672-9296
CONTACT EMPLOYER

CONTACT EMPLOYER
CHECK BENEFIT CARD

CONTACT EMPLOYER
CONTACT EMPLOYER
Pacific Gas & Electric Company                (415) 973-3350
Paradigm Health (David Vargas)                (925) 677-4719
Patriot Risk Services
CONTACT EMPLOYER
CONTACT EMPLOYER
BAC                                           (800) 521-2654
Peter Chang Enterprises                       (248) 455-8972

CONTACT EMPLOYER
CONTACT EMPLOYER



CONTACT EMPLOYER

CHECK BENEFIT CARD
CHECK BENEFIT CARD

CONTACT EMPLOYER

CONTACT EMPLOYER
CompIQ Corporation                            (800) 293-3131


CHECK BENEFIT CARD
CONTACT EMPLOYER




                                               Page 46
                             tbl_CombinedCCL_0040a_Final_Cle


CONTACT EMPLOYER

RMSCO INC                              (315) 448-9000
CONTACT EMPLOYER
CONTACT EMPLOYER
                                       (952) 897-6142
CONTACT EMPLOYER



CONTACT EMPLOYER
CONTACT EMPLOYER

Selective Insurance Agency             (973) 948-1638
CONTACT EMPLOYER
Seltzer Associates                     (954) 452-3000
CONTACT EMPLOYER
Sierra Heatlh Services                 (818) 846-5297
SISCO                                  (563) 587-5175
SISCO                                  (410) 339-7855
StrataCare Inc                         (818) 844-4300 Ext 237
CONTACT EMPLOYER
CONTACT EMPLOYER
MCMC LLC                               (888) 350-1150
CHECK BENEFIT CARD
CONTACT EMPLOYER

The Hartford                           (800) 762-0666

CHECK BENEFIT CARD
CHECK BENEFIT CARD


CompIQ Corporation                     (800) 293-3131
CHECK BENEFIT CARD
CONTACT EMPLOYER
FairPay Solutions                      (972) 715-8000
CONTACT EMPLOYER
StrataCare Inc                         (818) 844-4300 Ext 237
StrataCare Inc                         (818) 844-4300 Ext 237
MedRisk                                (800) 225-9675 800-225-9675
Broadspire                             (860) 282-4960


The Hartford                           (800) 762-0666

CHECK BENEFIT CARD
CONTACT EMPLOYER
CHECK BENEFIT CARD
CompIQ Corporation




                                        Page 47
                       tbl_CombinedCCL_0040a_Final_Cle



CONTACT EMPLOYER
TRISTAR Managed Care             (714) 245-4813

CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CHECK BENEFIT CARD
CHECK BENEFIT CARD

CHECK BENEFIT CARD
CHECK BENEFIT CARD
Valley Oak Systems               (925) 242-4659
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER
CONTACT EMPLOYER

MCMC LLC                         (888) 350-1150

CONTACT EMPLOYER
CONTACT EMPLOYER




CONTACT EMPLOYER


CONTACT EMPLOYER
CONTACT EMPLOYER




                                  Page 48

				
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