Transcription
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer ID1st Auto & CasualtyJ158521st Century Insurance4155622125 Roscoe Corp.41556AAA Minnesota/Iowa11983AAA Northern California, Nevada & Utah Insurance Exchange4155641556ABC Const. CompanyAcadia Insurance Company xxRejects OnlyxxxRejects OnlyxxxxxxRejects OnlyxxxRejects OnlyxxxxxxxxxRejects Onlyxxx835Paper OnlyAccident Fund Insurance Co of AmericaJ1790Accuride CorporationJ1024Ace Property & Casualty Ins Co41556ACIG Insurance CompanyJ1578xxACTS Retirement - Life CommunitiesJ2163xxxxAcuity, A Mutual Insurance CompanyJ1240xxxRejects OnlyAD-COMPJ1667xxxxAdelanto Correctional Facility (CA)J1798xxxxAdministaffJ1241xxxAdministrative Claim Service, IncJ1005xxxRejects OnlyAdminsureJ2292xxxRejects OnlyAdmiral Linen & Uniform ServiceJ2144xxxRejects OnlyAdvance America Cash Advance CentersJ1843xxxxAdvance Services, Inc.J1608xxxxAdvanced Auto Parts - All states EXCEPT TX MNJ2162xxxxAdvanced Auto Parts - TX MNJ2161xxxAdventist Health System (Bunch CareSolutions)J1973**xxxAdvocare MCO, IncJ1896xxxxAffiliated Foods, Inc.J1977xxxAG Facilities Operations, LLC41556xxxRejects OnlyAgri Beef Co.41556xxxRejects OnlyAIG-Chartis19402xxxRejects OnlyAlaska National InsuranceJ1577xxxxAlbertsons, Inc.J2376xxAlcoa Fasteners SystemsJ1244xxAlex Lee, Inc.J2166xxxxAlign Networks (One Call Physical Therapy)J1716xxxRejects OnlyAllen CanningJ1740xxxxAllergan W.C. Holding, INC.J2341xxxRejects OnlyAlliant EnergyJ1619xxxAllianzJ1452xxxxAllianz Global Corporate & Specialty (AGCS) - dates of injury on or after 1/1/2013J2332xxxxAllianz Resolution Management (ARM) - dates of injury on or before 12/31/2012J2326xxxxAllied Claims Administration, Inc.J1733xxxxAllied Construction (via EMC Risk Services)J1118xxxxxAllied Insurance CompaniesJ1550xxxxxxxxAllied Property and Casualty Ins CoJ1550xxxxxxxxAllmerica Financial Benefits Insurance CompanyJ1589xxxxxxxxxxxxxxxxxxxxxxPage 1 of 43xRejects Only
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer state - Except New JerseyC1037xxx835xAlta Healthcare41556xxxRejects OnlyAlternative Service Concepts (ASC)J2149xxxRejects OnlyAluminum Precision (Carl Warren) *Paper OnlyxAlvey Systems (AON Risk)J1025xxxAMCO Ins CoJ1550xxxxAmerica FirstJ1427xxxRejects OnlyAmerican Airlines - DOI after 9/1/2014 ONLYJ2000xxxAmerican Apparel, LLC (DOI after 7/14/16)J2189xxxxAmerican Claims Management (ACM)J1236xxxRejects OnlyAmerican Coin Merchandising, IncJ1026xxxxAmerican CyanamidJ1027xxxxAmerican Family Mutual Insurance CompanyJ2134xxxRejects OnlyAmerican Furniture Warehouse41556xxxRejects OnlyAmerican Home CraftJ1250xxxRejects OnlyAmerican Liberty Insurance Company41556xxxRejects OnlyAmerican Mining Insurance Group, LLCJ1524xxxxAmerican SelectJ3317xxxxAmerican Specialty CompaniesJ1028xxxxAmerican Specialty Ins. / MIBJ1029xxxxAmerican Standard Insurance Company of Ohio (AUTO ONLY)C1055xxxxAmerican Standard Insurance Company of Wisconsin (AUTO ONLY)C1055xxxxAmerisure InsuranceJ1206xxxRejects OnlyAmerisure Mutual InsuranceJ1205xxxRejects OnlyAmGuard Insurance Company - Guard DBAJ1453xxxxAmtrust North AmericaJ1868xxxANACO41556xxxRejects OnlyANAIC Cibus41556xxxRejects OnlyAnchor Glass Container CorporationJ2136xxxxAnheuser BuschJ1620xxxxAntelope Valley Community HospitalJ2197xxxxAntelope Valley Ret.41556xxxRejects OnlyAntelope Valley Union High School DistrictJ2185xxxApplied MaterialsJ2160xxxxApplied Underwriters (Except AZ)J1775xxxRejects OnlyArcher Daniels Midland CompanyJ1735xxxxArdagh GroupJ2344xxxRejects OnlyAreas USA, Inc.J1944xxxxArgent (Subsidiary of West Bend but this route is Argent only)J1420xxxxArgonaut Insurance Company(ARGO)19801xxxxArgus ClaimsJ3307xxxRejects OnlyArizona & 21st Corp. DBA Berkley East Conv. Hospital41556xxxRejects OnlyArkansas BestJ2142xxxRejects OnlyArrowpointJ1564xxxxAssociation Casualty Insurance CompanyJ1254xxxxxxxxxxxxxxxxxxxPage 2 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer sociation County Commissioners of Georgia (ACCG).J1869xxxRejects OnlyAthensJ1914xxxRejects OnlyAthens - ABF Freight Systems, IncJ2096xxxRejects OnlyAthens - Alemeda Health SystemsJ2097xxxRejects OnlyAthens - American Apparel, Inc (DOI prior to 7/14/16)J2098xxxRejects OnlyAthens - American Brass & Iron FoundryJ2099xxxRejects OnlyAthens - Angelus BlockJ2100xxxRejects OnlyAthens - Bay Area Housing Authority Risk ManagementJ2101xxxRejects OnlyAthens - Central County Fire DepartmentJ2102xxxRejects OnlyAthens - Children's Hospital Los AngelesJ2103xxxRejects OnlyAthens - City of Beverly HillsJ2104xxxRejects OnlyAthens - City of Mountain ViewJ2105xxxRejects OnlyAthens - City of San JoseJ2106xxxRejects OnlyAthens - City of VernonJ2107xxxRejects OnlyAthens - County of SolanoJ2108xxxRejects OnlyAthens - East Bay Municipal Utility DistrictJ2109xxxRejects OnlyAthens - East Bay Regional Parks DistrictJ2110xxxRejects OnlyAthens - Fairmont HotelJ2111xxxRejects OnlyAthens - FASISJ2112xxxRejects OnlyAthens - Golden Gate Bridge Highway & TransportationJ2113xxxRejects OnlyAthens - Goodwill Industries (San Francisco, San Mateo, Marin Counties)J2114**xxRejects OnlyAthens - H&S VentureJ2335xxxxAthens - Household Industries Self Insured GroupJ2115xxxRejects OnlyAthens - Kings Seafood CompanyJ2116xxxRejects OnlyAthens - KPC HealthcareJ2117xxxRejects OnlyAthens - Long Beach Public Transportation CompanyJ2118xxxRejects OnlyAthens - McKesson CorporationJ2119xxxRejects OnlyAthens - Orora North AmericanJ2120xxxRejects OnlyAthens - Placentia-Yorba Linda Unified School DistrictJ2121xxxRejects OnlyAthens - Presbyterian Intercommunity Hospital PIHJ2122xxxRejects OnlyAthens - San Francisco Unified School DistrictJ2124xxxRejects OnlyAthens - Sony Corporation of AmericaJ2126xxxRejects OnlyAthens - Sunsweet Growers, Inc.J2127xxxRejects OnlyAthens - Temecula Valley Unified School DistrictJ2128xxxRejects OnlyAthens - The Conco Companies - ARCH WCJ2129xxxRejects OnlyAthens - The Conco Companies - ZurichJ2130xxxRejects OnlyAthens - The Permanente Medical Group, Inc.J2131xxxRejects OnlyAthens - Vintage Senior LivingJ2132xxxRejects OnlyAtlantic PPO to Atlantic Imaging GroupJ2013xxxRejects OnlyAtlantic PPO to Hartford InsuranceJ2035xxxRejects OnlyAtlantic PPO to Merchants MutualJ2046xxxRejects OnlyAtlantic PPO to New York City Law DepartmentJ2053xxxRejects OnlyAtlantic PPO to NJ-PLIGAJ2054xxxRejects OnlyAtlantic PPO to NY City TransitJ2055xxxRejects OnlyAtlantic PPO to NYC Dept. of SanitationJ2056xxxRejects OnlyPage 3 of 43NJ
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer lantic PPO to NYSIFJ2057xxxRejects OnlyAtlantic PPO TO QBE InsuranceJ2067xxxRejects OnlyAtlantic PPO to Sedgwick WC InsuranceJ2071xxxRejects OnlyAtlantic PPO to Sentry InsuranceJ2074xxxRejects OnlyAtlantic PPO to TravelersJ2079xxxRejects OnlyAtlantic PPO to U.S. Department of Labor-PAJ2081xxxRejects OnlyAtlantic PPO to US DOL NJ claimsJ2083xxxRejects OnlyAtlantic PPO to US DOL NY claimsJ2084xxxRejects OnlyAureon HR Solutions (via EMC Risk Services)J1118xxxxAustin Mutual InsJ1682xxxxAuto Club Group11983xxxxAuto Club Group Insurance Company11983xxxxAuto Club Insurance (ACIA)11983xxxxAuto Club Insurance Association11983xxxxAuto Club Property-Casualty Insurance Company11983xxxxAutomobile Dealers Insurance Company IncJ1861xxxRejects OnlyAuto-Owners \ Home-Owners Insurance CompanyJ1580xxxxAuto-Owners \ Owners Insurance CompanyJ1583xxxxAuto-Owners \ Property-Owners Insurance CoJ1699xxxxAuto-Owners \ Southern-Owners CompanyJ1688xxxxAuto-Owners Insurance CompanyJ1556xxxxAuto-Owners Life Insurance CompanyJ1596xxxxAVIR Inc.41556xxxRejects OnlyAvizentJ1415xxxRejects OnlyAyers TruckingJ1018xxxxBaker Tanks, Inc.41556xxxRejects OnlyBank of AmericaJ1729xxxxBaptist Healthcare Systems, Inc (KY ONLY)J2164xxxBardavon Health InnovationsJ2334xxxRejects OnlyBarnesJ1503xxxxBarrett Business Services Inc (BBSI)J1686xxxxBART - San Francisco Bay Area Rapid TransitJ1770xxxxBasic Resources, Inc.41556xxxRejects OnlyBass Pro Group, LLCJ1958xxxxBauman Workers' Compensation Loss Fund AccountJ3305xxxxBb&T Corporation (Branch Banking & Trust)J1995xxxBeacon Insurance Company Of AmericaJ3318xxxxBeacon MutualJ1234xxxxBeall's Inc / Midwest EmployersJ1030xxxxBed Bath & BeyondJ2167xxxxBeeville ISD41556xxxRejects OnlyBelk, Inc.J2168xxxxBenchmark InsuranceJ1257xxxRejects OnlyBerkley Agribusiness Risk SpecialistsJ2190xxxxBerkley National Insurance CompanyJ2192xxxxPage 4 of 43NJ
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer Berkley Net Underwriters, LLCJ1523xxxxBerkley Regional Insurance CompanyJ2194xxxxBerkley Risk Administrators Company, LLCJ1526xxxxBerkley Southeast Insurance Group (BSIG)J2145xxxRejects OnlyBerkley Specialty UnderwritersTP019xxxxBerkley Valley Conv Hospital41556xxxRejects OnlyxxxxxxxRejects OnlyBerkshire Hathaway Direct Insurance CompanyJ1975Berkshire Hathaway Homestate Companies (BHHC)20044Bernardo H. Co. Club41556xxxBerwind CorporationJ1031xxxxBeverly Hills Carmel41556xxxRejects OnlyBig 5 CorpJ1738xxxxBighorn Construction41556xxxRejects OnlyBI-MartJ2349xxxRejects OnlyBituminous Fire and MarineJ1691xxxxBituminous Insurance CompanyJ1579xxxxBloomingdale'sJ1347xxxBMW North AmericaJ1259xxBobrick Washroom41556xxxRejects OnlyBoeing CompanyJ1964xxxxxxxxxxBoeing Company - WC ONLYJ1964xxxxxxxxxxBoise Cascade CompanyJ1801xxxBoler CompanyJ1870xxxBoulder Community Hospital41556xxxRejects OnlyBremco Construction41556xxxRejects OnlyBriad Restaurant Group, LLCJ2169xxxxBrickstreet (EXCEPT PA)J1761xxxxBridgefield CasualtyJ1437xxxxBridgefield EmployersJ1437xxxxBroadspire, a Crawford CompanyTP021xxxxBrotherhood Mutual InsuranceJ1445xxxBrownsville Independent School District41556xxxRejects OnlyBrownyard Group Inc. (Arch Insurance)11150xxxxBrunswick CorporationBuffets Inc (Old Country Buffett, Ryan's, HomeTown Buffet, Fire Mountain, CountryBuffett, Granny's Buffett)J1032xxxxJ1501xxxxBuilders Group of MNJ1391xxxRejects OnlyBuilders Mutual InsuranceJ1968xxxxBunch and AssociatesJ1435xxxxBurlington Coat Factory WarehoJ1033xxxxBurton Way Carmel41556xxxRejects OnlyBusiness FirstJ1437xxxxBycor Gen Contract41556xxxRejects OnlyC A2:R1155ity Of New Orleans (LA)J2309xxxxCadet Uniform Supply41556xxxRejects OnlyCaliber Holdings CorporationJ1979xxxxxxxxxxxxxxxxxxxPage 5 of 43xxxxRejects Only
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer ID1500UB04835J1535xxxxCalifornia Schools Risk ManagementJ3326xxxxCalifornia Water Service Company41556xxxRejects OnlyCallahan, McCune41556xxxRejects OnlyCambridge Healthcare Services, LLCJ2182xxxxCambridge Integrated ServicesJ1819xxxRejects OnlyCampbell Union School District41556xxxRejects OnlyCapistrano Unified School District (CA)J1637xxxxCapital Insurance Group WcJ1980xxxxCapitol IndemnityJ1262xxxRejects OnlyCapitol Insurance CompaniesJ1809xxxxCAPS-SIG41556xxxRejects OnlyCardenas Markets (Carl Warren)J1516xxxxCareWorks Consultants, Inc. (aka CareWorks USA and CCI) - OHIO ONLYJ1866NOTExxxCarharttJ1931xxxxCarolina Healthcare Systems (Chs)J3320xxxxCasitas Municipal Water District (CA)J1630xxxxCatholic Diocese of San Diego41556xxxRejects OnlyCatholic Mutual - Preferred Professional Insurance Company41556xxxRejects OnlyCatholic Mutual - Virginia Surety Company, Inc.41556xxxRejects OnlyCC-Development Group, Inc.J1900xxxxCCMSIJ1010xxxRejects OnlyCedars-Sinai Health System41556xxxRejects OnlyCendant CorporationJ1034xxxxCentennial Insurance Company19895xxxCentral Contra Costa Transit AuthorityJ1605xxxxCentral Hockey LeagueJ1035xxxxCentral InsuranceJ1906xxxxCentral Texas Iron WorksJ2293xxxRejects OnlyChaffey Joint Union H. S. District (CA)J1646xxxxChandler's P. Verdes41556xxxRejects OnlyChapman Convalescent41556xxxRejects OnlyCharming Shoppes, Inc.J1036xxxxCherokee InsuranceJ1970xxxChesapeake InsuranceJ1908xxxRejects OnlyChesterfield Services, Inc.**J1479xxxxChico's Fas IncJ2315xxxxChildren's Hospital Colorado41556xxxRejects OnlyChildren's Hospital of Orange County - First Aid41556xxxRejects OnlyChubb (legacy Chubb & Son) - WCJ1554xxxxChula Vista Elementary School District41556xxxRejects OnlyxxxxxxRejects OnlyxxRejects OnlyxMNCAILLAJ1532Cincinnati InsuranceJ1562NYORWINCNMOKTNVAxxJ1265 / J1725CIGANJAllStatesCalifornia Fair Services AuthorityChurch Mutual Insurance Company (WC ONLY)TXxxPage 6 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer tizens Insurance Company of AmericaJ1582xxxxCitrus Valley Health PartnersJ1613xxxxCitrus World, Inc.J1945xxxxCity And County Of DenverJ3340xxxRejects OnlyCity and County of San Francisco (CCSF)J1885xxxCity of Ames (via EMC Risk Services)J1118xxxCity of ArlingtonA0033xxxxCity of Ashland41556xxxRejects OnlyCity Of BakersfieldJ3336xxxRejects OnlyCity of Banning (CA)J1792xxxxCity of Barstow (CA)J1793xxxxCity of Beaverton41556xxxRejects OnlyCity of Belmont (Self Insured)41556xxxRejects OnlyCity of Blythe (CA)J1794xxxxCity of BreaJ1880xxxRejects OnlyCity of Campbell41556xxxRejects OnlyCity of Carlsbad41556xxxRejects OnlyCity of Carmel By The Sea41556xxxRejects OnlyCity of Carson41556xxxRejects OnlyCity of CharlotteJ1928xxxRejects OnlyCity Of ChinoJ2306xxxRejects OnlyCity of Chula Vista *TXxxxxPaper OnlyCity of Colton41556xxxRejects OnlyCity of Coronado41556xxxRejects OnlyCity of Costa MesaJ2343xxxRejects OnlyCity of DallasJ1441xxxRejects OnlyCity of Del Mar41556xxxRejects OnlyCity of Des Moines (via EMC Risk Services)J1118xxxCity of Desert Hot Springs (CA)J1799xxxCity of Edinburg, Texas41556xxxRejects OnlyCity of El PasoA0046xxxxCity of Encinitas41556xxxRejects OnlyCity of Escondido41556xxxRejects OnlyCity Of Everett (Wa)J3332xxxxCity of Fort Worth (TX)J1680xxxxCity of Fountain Valley (CA)J1632xxxxCity of Fresno FPOA ADR1J2337xxxRejects OnlyCity of Gardena (CA)J1634xxxxCity of Glendale (AZ)J1800xxxxCity of Grand Junction41556xxxRejects OnlyCity of Hillsboro41556xxxRejects OnlyCity of HuntsvilleJ2340xxxRejects OnlyCity of Imperial Beach41556xxxRejects OnlyCity of Imperial Beach (Voucher)41556xxxRejects OnlyCity of Iowa City (via EMC Risk Services)J1118xxxxxxxxPage 7 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer City of Irving41556xxxRejects OnlyCity of Kansas City MOJ2389xxxRejects OnlyCity of La Mesa 11 (CA)J1711xxxxCity of Laguna Hills (CA)J1653xxxxCity Of Lake Charles (La)J1981xxxCity of LakelandJ2347xxxRejects OnlyCity of Lemon Grove41556xxxRejects OnlyCity Of LongmontCity of Los AltosJ3339xxxx41556xxxRejects OnlyCity of Los AngelesJ1536xxxRejects OnlyCity Of Margate (Fl)(Corvel)J3301xxxxCity of Merced41556xxxRejects OnlyCity of Miami Beach (FL)J1946xxxxCity of MinneapolisJ1269xxxxCity of Murieta (CA) *Paper OnlyCity of National City41556xxxRejects OnlyCity of Oceanside41556xxxRejects OnlyCity of Omaha (NE)J1721xxxxCity of Ontario41556xxxRejects OnlyCity of OrangeJ1881xxxRejects OnlyCity of Perris (CA)J1795xxxxCity of Pompano Beach (FL)J1947xxxxCity of RaleighJ2391xxxxCity of Redding (CA)J1617xxxxCity of Rialto, CAJ1901xxxxCity of Richardson41556xxxRejects OnlyCity of RiversideJ2377xxxRejects OnlyCity of SalinasJ1849xxxxCity of San DiegoJ1497xxxxCity Of San FernandoJ3311xxxxCity of San Jacinto (CA)J1796xxxxCity Of San Mateo (Athens)J3304xxxxCity of San Mateo (CA)J1727xxxxCity of Santa AnaJ2155xxxRejects OnlyCity Of Santa BarbaraJ3312xxxxCity of Santee41556xxxRejects OnlyCity of Solana Beach41556xxxRejects OnlyCity of South San Francisco41556xxxRejects OnlyCity of St. Paul (MN)J1602xxxxCity of Stanton (CA)J1636xxxxCity of Stockton (CA)J1664xxxxCity of Topeka (KS)J1607xxxxCity Of TucsonJ1982xxxCity of Upland (CA)J1645xxxxCity of Urbandale (via EMC Risk Services)J1118xxxxPage 8 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer xxxRejects OnlyxxxRejects OnlyxxxxCity of Vista41556City of Waco41556City of West Des Moines (via EMC Risk Services)J1118City of West Palm Beach (FL)J1948xxxCity of Yorba Linda (CA)J1708xxxxCity of Yuma41556xxxRejects OnlyCivil Constructors41556xxxRejects OnlyClaims Administrative Services (CAS)J1271xxxClassic Residence By HyattJ1037xxxxClougherty Packing, LLCJ1739xxxxCNA Insurance20443xxxxCo Grande Casino41556xxxRejects OnlyCoach USAJ1272xxCoachella Valley Water District (CA)J1902xxxxCoast Converters41556xxxRejects OnlyCoca-Cola Enterprises Inc.J1038xxxxCollin County41556xxxRejects OnlyColorado CasualtyJ1428xxxRejects OnlyColorado Contractors Program41556xxxRejects OnlyColorado HealthCare Assoc. - Safety National Casualty Corp.41556xxxRejects OnlyColorado Hospital AssociationJ3356xxxxColorado Prime Corp.41556xxxRejects OnlyColumbia Sussex CorporationJ1039xxxxColumbine Health Systems41556xxxRejects OnlyCommonwealth Of Virginia (COV)J3341xxxxCommunity Development Commission (CA)J1655xxxxCompWest Property and Casualty Insurance Company (dba Sussex InsuranceCompanionCompany)J1925xxxRejects OnlyJ1829xxxxCompass Group Usa, Inc.J1040xxxxConiferJ1744xxxContech Construction ProductsJ1041xxxxContinental AirlinesJ1042xxxxContinental Western Insurance Co (CWG)J1274xxxxContinuing Life (Athens)J3302xxxRejects OnlyContra Coastal County Schools Insurance Group (CCCSIG)J1715xxxRejects OnlyConvergys CorporationJ1043xxxxCon-Way Inc.J1844xxxxCook & Solis Const.41556xxxRejects OnlyCopperpoint Mutual Insurance CompanyJ2093xxxRejects OnlyCorecivicJ3342xxxxCorrectional Management ServiceJ1044xxxxCorrections Corp of AmericaJ1045xxxxCorrections Corporation of America (CCA)J1942xxxxCottingham & Butler Claim Services, Inc.J1683xxxxxxxxxPage 9 of 43xxRejects Only
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer xxxRejects OnlyCottingham and Butler (Equian)J2089Country Casualty Insurance CompanyJ1684xxxxxxxxCountry Insurance \ Modern Service Casualty Insur CoJ1712xxxxxxxxCountry Insurance \ Mountain States InsuranceJ1572xxxxxxxxCountry Insurance \ MSI Preferred Insurance CompanyJ1591xxxxxxxxCountry Mutual Insurance CompanyJ1702xxxxxxxxCountry Preferred Insurance CompanyJ1705xxxxxxxxCountry Villa Health Services - SNCC41556xxxRejects OnlyCountry Villa Ox Hlth41556xxxRejects OnlyCounty Of Alameda/AIG41556xxxRejects OnlyCounty of ChesterfieldJ1525xxxxCounty Of DupageJ3346xxxCounty of Humboldt (CA)J1603xxxxCounty of ImperialJ1960xxxRejects OnlyCounty of KernJ1935xxxxCounty of Los Angeles (1000)J1625xxxxCounty of Los Angeles (2000)J1722xxxRejects OnlyCounty of Los Angeles (3000)J1967xxxRejects OnlyCounty of Los Angeles (4000/5000)J1723xxxRejects OnlyCounty Of Marin41556xxxRejects OnlyCounty of San DiegoJ1513xxxCounty of Santa Barbara (CA)J1631xxxxCounty of Santa Barbara-CSAC (CA)J1631xxxxCounty of Santa Barbara-Non-CSAC (CA)J1631xxxxCounty of Shasta (CA)J1616xxxxCounty of Sonoma (CA)J1662xxxxCounty of Tulare (CA)J1666xxxxCourtyard Health C.41556xxxRejects OnlyCoworx Staffing, LLCJ1046xxxxCox Construction Co41556xxxRejects OnlyCPS Security Solutions41556xxxRejects OnlyCreative Risk SolutionsJ1455xxxRejects OnlyCrescent Crown DistributingJ1965xxxxCrescent Crown DistributingJ1965xxxxCrescent Facilities Operations, LLCJ2170xxxxCrestbrook Insurance CompanyJ1550xxxxCrum & Forster Indemnity Co31348xxxxxxxxxxRejects OnlyCW Montgomery County (Carl Warren) *xxPaper OnlyCypress Insurance Company (Member of BHHC)20044xxDahl's Foods (via EMC Risk Services)J1118xxDaimlerChrysler Corporation41556xxxDakota Fire21415xxxxDallas County Community College District41556xxxRejects OnlyDallas Independent School DistrictJ1494xxxDanaher CorporationJ1051xxxxxxxxxxxPage 10 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer igoldJ1936xxxxDavis Mech Systems41556xxxRejects OnlyDaylight Transport41556xxxRejects OnlyDe Bartolos, IncJ1058xxxxDefinitiJ2336xxxxDel Taco, LLCJ1681xxxxDell, Inc.J1983xxxDenver Public Schools41556xxxRejects OnlyDepartment of EnergyJ1449xxxxDepartment of LaborJ1438xxxxDepartment of Labor Black LungJ1448xxxxDepartment of Water and Power of the City of Los Angeles (LADWP)J1514xxxDepositors Ins CoJ1550xxxDesert Hospital District41556xxxRejects OnlyDesert Princess41556xxxRejects OnlyDiamond Farming Company41556xxxRejects OnlyDirectory Distributing Assoc.J1059xxxxDiscount TireJ1611xxxxDiscover Re (Burger King)J1060xxxxDiscovery Hy-Vee (via EMC Risk Services)J1118xxxDisneyland Resorts (Bunch)J1933xxxxDouglas County41556xxxRejects OnlyDunn-Edwards CorporationJ1061xxxxDurango Coffee Co.41556xxxRejects OnlyDurham County, NcJ1994xxxxDustrol (via EMC Risk Services)J1118xxxDynamex, Inc.J1062xxxxEagle ClaimsJ1934xxxxEagle Pass ISD41556xxxRejects OnlyEastern Alliance (EA)J2143xxxRejects OnlyEastGUARD Insurance Company - Guard DBAJ1453xxxxEastman Kodak CompanyJ1903xxxxEberle VivianJ2199xxxRejects OnlyEcho Pacific Develop41556xxxRejects OnlyEdinburg Consolidated Independent School District41556xxxRejects OnlyEdwards Claim Administration (SEE TAB)J1204xxxEl Paso Community College (TX Jur)A0106xxxxEl Paso Water Util TX JurJ1017xxxxEl Pollo LocoJ1737xxxxELC Electric Inc41556xxxRejects OnlyElite Comp41556xxxRejects OnlyEmbassy Of United EmiratesJ3347xxxRejects OnlyEMC Property and Casualty - WC ONLY21415xxxxEmeritus CorporationJ1679xxxxEmployer Insurance Group (EIG)J1232xxxxxxxxxxxxxxPage 11 of 43835
WORKERS' COMPENSATION PAYER LIST01/07/2019TXMNCA1500UB04835Employers Assurance CompanyJ1232xxxxxxxEmployers Compensation Insurance CompanyJ1232xxxxxxxEmployers General Insurance GroupJ1696xxxxEmployers Insurance (BUNCH)J1912xxxRejects OnlyEmployers Mutual Casualty - WC ONLY21415xxxxEmployers Preferred Insurance CompanyJ1232xxxEncompass Specialty Surgery NetworkJ2369xxxxEnvirosourceJ1063xxxxEnvision Radiology, LLC41556xxxRejects OnlyEplica, Inc.41556xxxRejects OnlyEquianJ2090xxxxErgon, Inc.J1952xxxxErickson-Hall Constr41556xxxRejects OnlyErie InsuranceJ1734xxxxERMCJ1022xxxxESISTP043xxxRejects OnlyESIS - First American Insurance CoJ1064xxxxESIS - Kelly ServicesJ1451xxxxESIS - Lockheed Martin CorporationJ1454xxxxEvolution Insurance CompanyJ1065xxxxExxonMobil CorporationJ1606xxxxF&G Guaranty Ins Co/Main Street Program Colorado41556xxxRejects OnlyFactory 2 UJ1019xxxxFairchild FastenersJ1624xxxxFairfax County GovernmentJ1884xxxxFairmont Specialty Insurance Company - TXJ1697xxxxFairview Health ServicesJ1618xxxxFamily Health & Housing41556xxxRejects OnlyFAMSA, Inc.J1807xxxxFarm Bureau Mutual Insurance Company (MN Only)J1853xxxFarmers \ Civic Property and Casualty CompanyJ1687xxxxFarmers \ Exact Property and Casualty CompanyJ1703xxxxFarmers \ Fire Insurance ExchangeJ1706xxxxFarmers \ Mid-Century Insurance CompanyJ1710xxxxFarmers \ Neighborhood Spirit Property and Casualty CompanyJ1701xxxxFarmers \ Truck Insurance ExchangeJ1713xxxxFarmers Insurance Exchange (WC ONLY)J1563xxxxFarmers of FlemingtonJ3298xxRejects OnlyFarmland Mutual Ins CoJ1551xxxxFCCIJ1830xxxxFederated Claims Service Corp.J1297xxxxFederated Department Stores, IncJ1297xxxxFederated Linen & Uniform41556xxxRejects OnlyFederated Mutual Insurance Company13935xxxxFederated Rural Electric r IDxxxxxxxPage 12 of 43xxx
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer ID1500UB0428304xxxxFFVA Mutual InsuranceJ1909xxxRejects OnlyJ3299Fireman's Fund Insurance erated Services Insurance CompanyFidelity MohawkTXx835xxRejects OnlyxxxxFiremen's Insurance Company *Paper OnlyFirst Patriot Insurance CompanyJ3324xxxxFirstcompJ1011xxxRejects OnlyFKI Industries, Inc.J1047xxxxFlorida Fruit and Vegetable AssociationJ1910xxxRejects OnlyFlorida Insurance AllianceJ3306xxxxFlorists Insurance CompanyJ1417xxxxFlorists Mutual Insurance CompanyJ1299xxxRejects OnlyFlorists Mutual Insurance CompanyJ1417xxxxFMIJ3296xxRejects OnlyFoot LockerJ2158xxxxForestry Mutual Insurance CompanyJ2153xxxRejects OnlyFranciscan AllianceJ1883xxxxFranciscan Sisters Of Chicago Service Corporation (FSCSC)J3345xxxFranco Construction41556xxxRejects OnlyFrankenmuth MutualJ1440xxxxFranklin MutualJ3297xxRejects OnlyFresno County Office of Education41556xxxRejects OnlyFresno County Self Insurance Group41556xxxRejects OnlyFriedkin Companies, IncJ1984xxxFullerton Union High School District (CA)J1633xxxxFuturecompGAB Robbins, Inc.J3353xxxRejects OnlyTP117xxxxxxGAB Robins (For Van Tuyl Companies ONLY)TP117xxxxxxGallagher BassettTP057xxxxGallagher Bassett - Former Chubb Services ClaimsJ1561xxxxGarden Grove Unified School DistrictJ1519xxxxGarden Regional Hospital & Med Center, Inc.41556xxxRejects OnlyGates Corp DBA Gates Rubber CoJ1066xxxxGates O'Doherty41556xxxRejects OnlyGates O'Doherty G&G41556xxxRejects OnlyGateway Trans., Inc.41556xxxRejects OnlyGE AutoJ1557xxxxGeicoJ1747xxRejects OnlyxxxxGeneral Parts InternationalJ1678xxxxGenesis Construction41556xxxRejects OnlyGenex Care for OhioJ1895xxxxGEOJ1461xxxxGeorgia Casualty & Surety CoJ1304xxxxGeorgie's Inc.J2137xxxxGillette Childrens Specialty HealthcareJ1927xxxxPage 13 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer Glendale Elementary School District #4041556xxxRejects OnlyGolden Corral CorporationJ1067xxxxGolden EagleJ1430xxxRejects OnlyGoodrichJ1462xxxxGoodwill IndustriesJ1621xxxGordmans (via EMC Risk Services)J1118xxxxGrand River Insurance (WC Only)J1566xxxxGrange WC14060xxxxGraphic Arts Mutual25984xxxxGreat American Alliance Ins Co.26832xxxxGreat American Assurance Co.26344xxxxGreat American Ins. Co.16691xxxxGreat American Ins. Co. of N.Y.22136xxxxGreat Divide Insurance25224xxxxGreen Diamond WAJ1642xxxxGreene Rad Maloney41556xxxRejects OnlyGreer Constructon CO41556xxxRejects OnlyGreif Brothers Corporation41556xxxRejects OnlyGreve Clifford Wengel & Paras41556xxxRejects OnlyGrimmway Enterprises, Inc.41556xxxRejects OnlyGrinnell Reinsurance CompanyJ1571xxxxxGrinnell SelectJ1541xxxxxGrundfos Manufacturing Corporation41556xxxRejects OnlyGS Metals41556xxxRejects OnlyGse Lining Technology, Inc.J1068xxxxGuardJ1453xxxxGuideOne Elite InsuranceJ1590xxxxGuideOne Mutual InsuranceJ1574xxxxGuidewell Mutual HoldingJ2345xxxRejects OnlyH & R BlockJ1672xxxxHamilton Mutual - WC21415xxxxHannafordJ1463xxxxHanover Insurance CompanyJ1693xxxxHanover Lloyd's Insurance CompanyJ1588xxxxHarbor Freight ToolsJ2159xxxxHarleysville Insurance CompanyJ1595xxxRejects OnlyHartford Dealership Advantage Program - WC41556xxxRejects OnlyHarvard MaintenanceJ2388xxxRejects OnlyHastings College of the Law41556xxxRejects OnlyHawkeyeJ1426xxxRejects OnlyHayhoe Construction41556xxxRejects OnlyHCA-Hosptial Corporation of AmericaJ1450xxxxHealthcare Risk Management Solutions J1481xxxxxxxxPage 14 of 43
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer IDTX1500UB04J3313xxxxHeartland Employment Services, LLC41556xxxRejects OnlyHeartland ExpressJ1677xxxxHelmsman Management Services33600xxxxHelp At Home HoldingsJ1985xxxxHelpside, Inc.J2378xxxxHemet Unified School District (CA)J1654xxxxHereford ISDJ2342xxxxHeritage GroupJ1069xxxxHighland Golf41556xxxRejects OnlyHillshire BrandsJ1959xxxxHilmar Cheese CompanyJ1833xxxxHMSHostJ1612xxxxHogan Motor Leasing41556xxxRejects OnlyHogan Personell41556xxxRejects OnlyHolly Farms Corp.J1070xxxxHome Sweet Home41556xxxRejects OnlyHortica Florist Mutual Insurance13978xxxHortica Florist Mutual InsuranceJ1417xxxxHousehold Merch NniJ1071xxxxHousing Authority El Paso (TX)A0107xxxxHouston Hunters Patrol, IncJ1020xxxxHouston ISDJ1999xxxRejects OnlyHoward County Government (MD)J1888xxxxHughes Tool CompanyJ1072xxxxHusqvarna North AmericaJ2171xxxxHutchinson TechnologyJ1626xxxxxHy-Vee (via EMC Risk Services)J1118xxxxxICW (Insurance Co of the West)27847xxxxIllinois CasualtyJ1575xxxxIllinois EMCASCO21415xxxxIllinois State Toll Highway Authority (IL, IN, WI only)Imperial Irrigation DistrictJ3344xxx41556xxxRejects OnlyInconen Corporation41556xxxRejects OnlyIndiana InsuranceJ1425xxxRejects OnlyIngles MarketsJ1907xxxxInland Valley Hospice41556xxxRejects OnlyInnovative Claim Solutions (ICS) - Rancho CordovaJ1599xxxxInnovative Claim Solutions (ICS) - San RamonJ1601xxxxInnovative Risk Management (IRM)J2152xxxRejects OnlyInsilco CorpJ1073xxxxIntegrity Mutual Insurance Company (WC ONLY)14303xxxxIntercareJ1542xxxRejects OnlyIntercare - SussexJ1957xxxxIntercare - tesHealthsmart Casualty Claims SolutionsxMNxxxPage 15 of 43835
WORKERS' COMPENSATION PAYER LIST01/07/2019Payer IDTXCAILLANJNYOR1500UB04835J3352xxxxJ1810xxxxIPMG Claims Management Services (Insurance Program Managers Group)J1887xxxxIrex CorporationJ1074xxxxIronworking Contract I.P.J1075xxxxiSurityJ1911xxJ B Hunt Transport Inc.A0138xxxxJ.H. Mccormack Const41556xxxRejects OnlyJD Mechanical41556xxxRejects OnlyJefferson County Commission (Al)J3331xxxxJefferson County Texas41556xxxRejects OnlyJI Specialty ServicesJ1006xxxRejects OnlyJohn Muir Health41556xxxRejects OnlyJohnston Schools (via EMC Risk Services)J1118xxxJones Truck Lines,Inc.J1076xxxxJudson ISD41556xxxRejects OnlyJuvenile Jail Facility ManagemJ1077xxxxKautz Vinyards41556xxxRejects OnlyKCI Holdings USAJ1078xxxxKeenan and Associates (See note for exclusions)J1498xxxxKelley Amerit Holdings, LlcJ3343xxxxKellogg CompaniesJ1803xxxxKen Davis Industries Inc.J1079xxxxKentucky Employers Mutual Insurance - KEMIJ3680xxxRejects OnlyKern Medical Surgery CenterKey Risk Management Services LLCJ3335xxxxJ1521xxxxKing Pak Potato Company LLC41556xxxRejects OnlyKing Ranch41556xxxRejects OnlyKnoxville Utilities Board (Tn)J3330xxxxKoch Foods, IncJ1986xxxxWINCNMOKTNVAAllStatesIntergovernmental Risk Management Agency (IRMA)Interinsurance Exchange of the Automobile ClubxMNxxKroger Co.J2327xxxKTA Construction (COSD2)41556xxxRejects OnlyL. Arrowhead C. Club41556xxxRejects OnlyLA MetroJ2374xxxRejects OnlyLaclede Chain41556xxxRejects OnlyLaclede Steel41556xxxRejects OnlyLake Elsinore School Distr
WORKERS' COMPENSATION PAYER LIST 01/07/2019 Payer ID TX MN CA IL LA NJ NY OR WI NC NM OK TN VA All States 1500 UB04 835 Association County Commissioners of Georgia (ACCG). J1869 x Rejects Only Athens J1914 x Rejects Only Athens - ABF Freight Systems, Inc J2096 x Rejects Only Athens - Alemeda Health Systems J2097 x Rejects Only
