Third-Party-Liability Codes

Commonwealth of Massachusetts
MassHealth
Provider Manual Series / Subchapter Number and Title
Appendix C.
Third-Party-Liability Codes / Page
C-1
All Provider Manuals / Transmittal Letter
ALL-213 / Date
11/01/14

Third-Party-Liability Codes

A searchable version of this appendix is available on the MassHealth website at MassHealth will update Appendix C as needed. Paper copies of this appendix can be requested by calling
1-800-841-2900, by e-mailing your request to , or by faxing your request to
617-988-8973.

This appendix contains a list of third-party-liability (TPL) coverage-type codes and a numeric list of carrier codes, including carrier names and addresses. For members with a temporary MassHealth card, any applicable TPL coverage-type and carrier codes are printed on the card itself.

How Appendix C Is Organized

There are five sections to the carrier code file. The first section contains commercial carrier codes. This is the section that most providers will use. Providers should use theses codes on claims for members who have commercial insurance. The second section contains Medicare carrier codes. Providers should use these on claims for members who have original Medicare Part A (Hospital Insurance) or Part B (Medical Insurance) coverage or both.The third section contains Medicare Advantage carrier codes. Providers should use these codes on claims for members who have Medicare Part A and B, and are enrolled in a Medicare Advantage Plan (Part C). The fourth section contains Medicare D carrier codes. These codes are for pharmacy use only. Other providers should never use these codes on a claim. The fifth section contains Casualty Payer (formerly PIP) carrier codes. Providers should use these codes for reporting Casualty Payer payments on claims.

The Eligibility Verification System (EVS) in MMIS provides the insurance information for the member. Please check EVS before submitting your claim. Casualty coverage is not considered health insurance; therefore, Casualty Payer information is not available on EVS. Refer to the applicable billing guide or companion guide for instructions on using EVS. These guides are available on the web at

I. Third-Party-Liability Coverage-Type Codes

The following is a list of TPL coverage-type codes that identify the type of insurance a member has. If you use the MassHealth EVS Automated Voice Response (AVR) system, you will be given one of the following TPL coverage-type codes.

MMIS Coverage Codes

Code / TPL Coverage Description / Code / TPL Coverage Description
01 / Hospital / 14 / Preferred Provider Organization (PPO)
02 / Major Medical / 17 / Pharmacy – Cost Avoid*
04 / Medicare Part A / 18 / Pharmacy – Pay and Chase*
05 / Medicare Part B / 35 / Commercial Insurance Without Mental Health
06 / Supplemental Policy / 56 / HMO-Medicare Risk
08 / Long Term Care / 57 / HMO-Medicare Risk (Evercare)
09 / HMO without Mental Health / 63 / Veterans Services (Noncomprehensive)
11 / Health Maintenance Organization (HMO) / 64 / Veterans Services (Comprehensive)
12 / Vision* / 98 / Medicare Hospice
13 / Dental Care* / 99 / Medicare Part D

* If a member has dental, vision, or pharmacy coverage only, the member may still be enrolled in a MassHealthmanaged care plan.

Commonwealth of Massachusetts
MassHealth
Provider Manual Series / Subchapter Number and Title
Appendix C.
Third-Party-Liability Codes / Page
C-1
All Provider Manuals / Transmittal Letter
ALL-213 / Date
11/01/14

II. Carrier Codes

The following is a list of carrier codes and the names and addresses of the insurance companies to which they refer. You will see these codes whether you use EVS or another billing method.

Commercial Carriers

Carrier

CodeCarrier, Address, Phone (if available)

0178000A and H Administrators, P. O. Box 10223, Milwaukee, WI, 53210

0616000AARP, P. O. Box 740819, Atlanta, GA, 30301, (800) 523-5800

0616001 AARP, 215 Long Beach Blvd, Long Beach, CA, 90801

0616002 AARP Health Care Options, P. O. Box 985, Westport, CT, 06881, (888) 687-0977

0920005 AARP Pharmacy Only, P. O. Box 6083, Cypress, MA, 02111, (800) 552-0053

0105000 A-C Retirees Benefit Plan, 11270 W Park Pl Ste 950, C/O BPA of Wisconsin, Milwaukee, WI, 53224

0902020 Ace American Insurance Co, 1730 Park St Ste 207, Naperville, IL, 60563

0659014 ACI Administrative Concepts Inc, 994 Old Eagle School Rd, Ste 1005, Wayne, PA, 19087-1802,
(866) 261-9998

0288024 ACS Benefit Services, P. O. Box 2000, Winston Salem, NC, 40512, (800) 441-5741

0288021 ACS Health Net of North East, P. O. Box 14700, Lexington, KY, 27102, (336) 759-2013

0905082 Administration and Insurance Office Inc, 1220 SW Morrison S, Portland, OR, 97205, (410) 515-1190

0803020 Administrative Enterprises Inc, 3404 W Cheryl Dr, Phoenix, AZ, 85051

0803005 Administrative Service, P. O. Box 140173, Orlando, FL, 32814

0830000 Administrative Service Consultants, 3301 E Royalton Rd, Cleveland, OH, 44147, (419) 423-3823

0803010 Administrative Solutions, P. O. Box 2490, Alpharetta, GA, 30023

0830003 Administrators and Consultants, P. O. Box 4925, Lancaster, PA, 17604, (717) 299-0371

0872020 Advanced Administration, 101 N Lake Destiny Rd, Maitland, FL, 32751, (800) 785-4544

0872010 Advanced Benefit Resources, P. O. Box 350, Woodbury, AZ, 85050, (623) 889-7200

0872015 Advanced Benefit Solutions, P. O. Box 71490, Phoenix, NY, 11797

0367008 Advanced for Freedom, P. O. Box 7154, Lexington, KY, 04702-7151, (800) 713-5095

0872050 Advanced Insurance, P.O. Box 19, Memphis, TN, 38101

0920030 Advanced PCS, P. O. Box 52116, Phoenix, AZ, 85072

0017001 Advantage Star Plan by Rx American, 221 N Charles Lindbergh Dr, Salt Lake City, UT, 84116,
(800) 928-6101

0702021 Advantra Freedom, P. O. Box 7154, London, KY, 40742-7154, (800) 713-5095

Commonwealth of Massachusetts
MassHealth
Provider Manual Series / Subchapter Number and Title
Appendix C.
Third-Party-Liability Codes / Page
C-1
All Provider Manuals / Transmittal Letter
ALL-213 / Date
11/01/14

Carrier

CodeCarrier, Address, Phone (if available)

0006006 Advantra Rx Premier, P. O. Box 686007, San Antonio, TX, 78268, (866) 755-2776

0606010 Adventist Risk Management, 7083 Grand National Dr, Orlando, FL, 32819

0962002 Adventist Risk Management, P. O. Box 1021, Horsham, PA, 19044, (888) 276-4732

0962001 Adventist Risk Management Inc, P. O. Box 4759, Silver Spring, MD, 20914

0106004 Aetna, P. O. Box 981106, El Paso, TX, 79998-1106, (888) 632-3862

0867005 Aetna, P. O. Box 10223, Milwaukee, WI, 53210

0106098 Aetna Dental, P. O. Box 14094, Lexington, KY, 40512, (800) 872-3862

0920040 Aetna Pharmacy, P. O. Box 398106, Minneapolis, MN, 55439

0122005 AFLAC, 1932 Wynnton Rd, Columbus, GA, 31999, (800) 992-3522

0900096 AFTRA American Federation TV Radio, 261 Madison Ave, New York, NY, 10016

0867010 AG Administrators, P. O. Box 979, Valley Forge, PA, 19482

0705030 AG Edward andSons, 1 N Jefferson Ave, St Louis, MO, 63013

0107002 AIG, 80 Pine St, New York, NY, 10005, (877) 640-2450

0107005 Aim Administrators, 4645 Sweetwater Blvd, Sugarland, TX, 77479, (281) 265-5111

0840020 Alicare, P. O. Box 1435, New York, NY, 10116, (212) 539-5111

0840080 Alicare Inc, P. O. Box 1442, New York, NY, 10116, (212) 539-5000

0895020 All Risk Administrators, P. O. Box 66237, St Pete Beach, FL, 33736

0128000 Allstate Workplace Division, 1776 American Heritage Dr, Jacksonville, FL, 32224, (904) 992-1776

0640050 Allied Administrators, P. O. Box 2500, San Francisco, CA, 94126, (415) 986-6276

0600010 Allied Benefit Systems, P. O. Box 909786, Chicago, IL, 60696, (312) 906-8050

0112015 Allstate WorkplaceDivision, P. O. Box 853916, Richardson, TX, 75085-3916, (800) 937-7039

0638012 Alta Administrators, 350 Glenborough Dr, Houston, TX, 77067, (800) 937-6824

0638030 Alta Health, P. O. Box 59059, Minneapolis, MN, 55459, (800) 937-6824

0638038 Alta Health Strategies, P. O. Box 27142, Baltimore, MD, 21230

0638010 Alternative Risk Management, 10200 Southwest Nimbus, Portland, OR, 97223

0144045 Altius Health Plans, P. O. Box 7147, Lexington, KY, 40472, (800) 377-4161

0638050 Altus Dental, P. O. Box 1557, Providence, RI, 02901, (877) 223-0558

0653000 AM Maritime Officers Med Plan, P. O. Box 35, Dania Beach, FL, 33004, (800) 348-6515

0614089 Amalgamated Clothing Textile, 730 Broadway St, New York, NY, 10003

0528000 Amalgamated Insurance, P. O. Box 1449, New York, NY, 10116, (212) 539-5105

0528001 Amalgamated Insurance, 867 State Rd, North Dartmouth, MA, 02724

0528010 Amalgamated Insurance, 99 University Pl, New York, NY, 10003

0528008 Amalgamated Life, P. O. Box 5442, White Plains, NY, 10602, (914) 367-5111

0528006 Amalgamated Life Insurance, 333 S Ashland Ave, Chicago, IL, 60607

0528013 Amalgamated Life Insurance, P.O. Box 1440, New York, NY, 10116

0528005 Amalgamated Local 298, 825 E State Blvd, Garden City, NY, 11530

0138045 AmeriBen Solutions, P. O. Box 7186, Boise, ID, 83707, (800) 786-7930

0908064 American Administrative Group, P. O. Box 5227, Lisle, IL, 60532, (630) 773-3800

0832000 American Baptist Churches Med Plan, 475 Riverside Dr, New York, NY, 10115

0624000 American Chambers Life Insurance Co, P. O. Box 3048, Naperville, IL, 60566

0624001 American Chambers Life Insurance Co, UCIP NE, Hyannis, MA, 02601

0872030 American Consulting Engineers Council, P. O. Box 9007, St Louis, MO, 63101

0811000 American Express, 1650 Los Gamos Dr, San Rafael, CA, 94903

0122010 American Fidelity, P. O. Box 559017, Austin, TX, 78755, (800) 247-7724

0122001 American Fidelity Assurance Co, P. O. Box 25070, Oklahoma City, OK, 73125, (800) 654-8489

0122002 American General Life Dental, P. O. Box 3667, Seattle, WA, 98124, (877) 672-1648

0126001 American Hardware Mutual Insurance Co, 200 Unicorn Dr, Woburn, MA, 01801

0126007 American Heritage Life, P. O. Box 853916, Richardson, TX, 75085, (800) 937-7039

0106012 American Insurance Administrators, P. O. Box 1149, Columbus, OH, 43316-1149, (800) 922-1245

0908029 American Maritime Officers Medical, P. O. Box 35, Dania, FL, 33004

0135008 American Medical Security, P. O. Box 19032, Green Bay, WI, 54307, (800) 232-5432

0669010 American National Health Insurance, P. O. Box 1520, Galveston, TX, 77553, (800) 899-6806

0138001 American National Insurance Co, Regional Group Service Office, Ste 300, No Andover, MA, 01845

0629000 American Pioneer Life, P. O. Box 130, Pensacola, FL, 32591-0130

0629001 American Pioneer Life, P. O. Box 399127, Cambridge, MA, 02139-9127, (800) 538-1053

0126002 American Plan Administrators, 18 Heywood St, Brooklyn, NY, 11211

0614046 American Postal Workers Union, P. O. Box 1358, Glen Burnie, MD, 21060, (800) 222-2798

0669008 American Progressive, P. O. Box 130, Pensacola, FL, 32591

0683050 American Republic Insurance Co, P. O. Box 21670, Eagan, MN, 55121, (800) 247-2190

0700071 American Service Life, P. O. Box 470788, Fort Worth, TX, 76147

0733000 American Travelers Life Insurance, 3220 Tillman Dr, Bensalem, PA, 19220, (800) 441-3978

0682050 American Trust Administrators, P. O. Box 87, Shawnee Mission, KS, 66201, (913) 451-4900

0669005 Americas Choice Healthplans, P. O. Box 922043, Houston, TX, 77292, (800) 633-4227

0138015 Amerihealth, P. O. Box 41574, Philadelphia, PA, 19101-1574, (800) 275-2583

0138010 Amerihealth Administrators (AHA), P. O. Box 21545, Eagan, MN, 55121, (800) 275-2583

0144040 Ameritas Life Insurance, P. O. Box 82520, Lincoln, NE, 68501, (800) 487-5553

0028005 Anthem Blue Cross of California, P. O. Box 60007, Los Angeles, CA, 90060, (800) 888-8288

0028041 Anthem Blue Cross Blue Shield, P. O. Box 37180, Louisville, KY, 40233, (866) 755-2657

0028085 Anthem Blue Cross Blue Shield, P. O. Box 37010, Louisville, KY, 40233-7010, (866) 504-9617

0028100 Anthem Blue Cross Blue Shield, P. O. Box 5071, Middletown, NY, 10940-9071, (877) 224-0030

0028108 Anthem Blue Cross Blue Shield, P. O. Box 5078, Middletown, NY, 10940-9078, (800) 992-2518

0028018 Anthem Blue Cross Blue Shield Dental of California, P. O. Box 9274, Oxnard, CA, 93031

0028004 Anthem Blue Cross Blue Shield National Acct, P. O. Box 5419, Los Angeles, CA, 90054,
(800) 854-1837

0028006 Anthem Blue Cross Blue Shield of California, P. O. Box 60007, Los Angeles, CA, 90060

0028043 Anthem Blue Cross Blue Shieldof Colorado, P. O. Box 5747, Denver, CO, 80217, (800) 654-9338

0028088 Anthem Blue Cross Blue Shieldof Connecticut, P. O. Box 533, North Haven, CT, 06473

0028089 Anthem Blue Cross Blue Shieldof Connecticut, P. O. Box 105557, Atlanta, GA, 30348-5557,
(800) 676-2583

0028039 Anthem Blue Cross Blue Shieldof Maine, 2 Gannett Dr, South Portland, ME, 04106, (207) 822-7000

0027046 Anthem Blue Cross Blue Shieldof New Hampshire, P. O. Box 533, North Haven, CT, 06473-0533,
(800) 332-6558

0028109 Anthem Blue Cross Blue Shield of Oh, P. O. Box 105187, Atlanta, GA, 30348-5187, (800) 345-4344

0028102 Anthem Blue Cross Blue Shieldof Pennsylvania, P. O. Box 890179, Attn: First Priority Life
Insurance Co, Camp Hill, PA, 17089, (888) 338-2211

0028087 Anthem Blue Cross Blue Shieldof Virginia, P. O. Box 27401, Richmond, VA, 23279-7401,
(866) 452-4490

0028500 Anthem Dental, P. O. Box 659444, San Antonio, TX, 78265, (800) 440-3619

0025050 Anthem Document Management, P. O. Box 37010, Louisville, KY, 40233-7010, (800) 676-2583

0292003 Anthem Home Life Insurance, P. O. Box 1326, Piscataway, NJ, 08855

0701040 APA Partners Inc, 8 British Blvd, Latham, NY, 12110, (800) 833-3650

0700075 Archdiocese of Miami Health Plan Trust, 9401 Biscayne Blvd, Miami Shores, FL, 33138

0920021 Argus Health Systems, P. O. Box 419019, Kansas City, MO, 64141, (800) 424-6521

0606005 Arizona Foundation, P. O. Box 2909, Phoenix, AZ, 85062, (800) 522-1246

0414004 ARM Group, 340 Quadrangle Dr, Bolingbrook, IL, 60440, (800) 968-7222

0654000 ASR Corp, 3033 Orchard Vista Dr SE, Grand Rapids, MI, 49546, (616) 957-1751

0688045 Associated Administrative Inc, P. O. Box 6680, Portland, OR, 97228

0688050 Associated Administrators Group Inc, P. O. Box 700428, Dallas, TX, 75370

0149018 Associated Health Plan Administrators, P. O. Box 9568, New Haven, CT, 06535, (203) 287-1272

0259001 Associated Hospital Service, Aka Anthem Health Plans, Quincy, MA, 02169

0149016 Associated Plan Administrators, P. O. Box 189, Columbus, OH, 43216

0253065 Assurant Employee Benefits, P. O. Box 2877, Clinton, IA, 52733-2877, (800) 553-7654

0253080 Assurant Health Dental, P. O. Box 2940, Clinton, IA, 52733, (800) 442-7742

0901026 Atlantic Administrators, 135 Beaver St, Waltham, MA, 02452

0901031 Atlantic Administrators, P. O. Box 637, North Andover, MA, 01845

0962003 Atlantis Health Plan, P. O. Box 4656, Houston, TX, 77210-4656, (866) 747-8422

0253002 Aultcare, P. O. Box 6910, Canton, OH, 44706-0910, (800) 344-8858

0680020 A USA Insurance Plan, P. O. Box 10401, Des Moines, IA, 50306

0906087 Automated Benefit Services, P. O. Box 37506, Oak Park, MI, 48237, (586) 826-4410

0253003 Auxiant, P. O. Box 75008, Cedar Rapids, IA, 52407, (800) 279-6772

0143004 AVMA, P. O. Box 909720, Chicago, IL, 60690, (800) 621-6360

0538040 AVMED Health Plan, P. O. Box 2939, Gainesville, FL, 32602, (352) 372-8400

0322004 AWANE Benefit Plan Management, P. O. Box 536, Rockland, MA, 02370, (603) 924-9449

0730050 Babb Inc, 850 Ridge Ave, Pittsburgh, PA, 15212, (800) 245-6102

0614008 Bakery and Confectionary Union, 10401 Connecticut Ave, Kensington, MD, 20895

0154010 Bankers Life and Casualty Co, P. O. Box 1935, Carmel, IN, 46082-1935, (800) 621-3724

0160001 BCI Administrators, P. O. Box 251568, West Bloomfield, MI, 48325, (248) 626-8896

0908058 Benefit Administrator Systems, 17475 Jovanna Dr 18, Homewood, IL, 60430, (800) 523-0582

0900091 Benefit Concepts, P. O. Box 60608, King of Prussia, PA, 19406, (610) 337-2600

0908043 Benefit Management Services, P. O. Box 98044, Baton Rouge, LA, 70898, (800) 603-2299

0701010 Benefit Management Services Inc, P. O. Box 1178, Matthew, NC, 28106

0610050 Benefit Plan Management, P. O. Box 536, Rockland, MA, 02370, (781) 753-7500

0562002 Benefit Planners, P. O. Box 690450, San Antonio, TX, 78269, (800) 368-3653

0900094 Benefit Planners Inc, P. O. Box 690450, San Antonio, TX, 78269, (866) 868-8207

0701007 Benefit Risk Management, P. O. Box 2650, Rancho Gordova, CA, 95741, (916) 858-2950

0701008 Benefit Risk Management, P. O. Box 2140, Folsom, CA, 95763, (888) 225-7151

0701024 Benefits Claims Payor Inc, P. O. Box 37400, Phoenix, AZ, 85069, (800) 266-6868

0844001 Benesight, P. O. Box 29050, Phoenix, AZ, 85072, (800) 223-5228

0844021 Benesight, P. O. Box 375, Pueblo, CO, 81002, (800) 992-8354

0844040 Benesight, P. O. Box 370, Pueblo, CO, 81002, (800) 992-8354

0844022 Benesight Dental, P. O. Box 360, Pueblo, CO, 81002-0360

0813000 Berkshire Health Plan, 279 Dalton Ave, Pittsfield, MA, 01201

0749060 Big Lots Associates Plan, P. O. Box 9071, Dublin, OH, 43017

0027005 Blue Benefit Administrators, P. O. Box 55917, Boston, MA, 02205, (877) 707-2583

0028009 Blue Cross Blue Shieldof Delaware, One Brandywine Gateway, Wilmington, DE, 19899,
(800) 633-2563

0028011 Blue Cross Blue Shieldof Florida, 532 Riverside Ave, Jacksonville, FL, 32231, (800) 727-2227

0028022 Blue Cross Blue Shieldof Indiana, 5451 Lakeview Pkwy S Dr, Indianapolis, IN, 46268

0028028 Blue Cross Blue Shieldof Minnesota, P. O. Box 64338, St Paul, MN, 55164, (800) 262-0820

0028037 Blue Cross Blue Shieldof Nebraska, P. O. Box 3248, Omaha, NE, 68180, (800) 642-8516

0028063 Blue Cross Blue Shieldof Tennessee, 1 Cameron Hill Cir, Ste 0002, Chattanooga, TN, 37402-0002,
(800) 565-9140

0028019 Blue Crossof Idaho, P. O. Box 7408, Boise, ID, 83707, (800) 274-4018

0027076 Blue Cross Blue Shield of Hawaii, P. O. Box 2970, Honolulu, HI, 96802, (800) 468-3190

0028058 Blue Cross Blue Shield of Puerto Rico, P. O. Box 366068, San Juan, PR, 00936, (888) 284-7814

0028069 Blue Cross Blue Shield of Utah, P. O. Box 30270, Salt Lake City, UT, 84130, (800) 624-6519

0028072 Blue Cross Blue Shield of Washington, P. O. Box 30271, Salt Lake City, UT, 84130, (800) 624-6519

0028054 Blue Cross Blue Shield of Western Pennsylvania, 120 Fifth Ave, Pittsburgh, PA, 15222,
(800) 547-3627

0028057 Blue Cross Blue Shield Dentalof Rhode Island, P. O. Box 219, Providence, RI, 02901

0027025 Blue Cross Blue Shield Dental of Massachusetts, P. O. Box 986005, Boston, MA, 02298,
(800) 882-1178

0027013 Blue Cross Blue Shield LA, P. O. Box 98029, Baton Rouge, LA, 70895, (800) 599-2583

0027089 Blue Cross Blue Shield Medex Basic, P. O. Box 9196, Boston, MA, 02105

0027085 Blue Cross Blue Shield Medex Bronze, P. O. Box 9196, Boston, MA, 02105

0027087 Blue Cross Blue Shield Medex Core, P. O. Box 9196, Boston, MA, 02105

0027088 Blue Cross Blue Shield Medex Core Plus, P. O. Box 9196, Boston, MA, 02105

0027003 Blue Cross Blue Shield Medex Gold, P. O. Box 9196, Boston, MA, 02105, (800) 451-8123

0027082 Blue Cross Blue Shield Medex One, P. O. Box 9196, Boston, MA, 02105

0027086 Blue Cross Blue Shield Medex Silver, P. O. Box 9196, Boston, MA, 02105

0027002 Blue Cross Blue Shield Medex Standard, P. O. Box 9196, Boston, MA, 02105, (800) 451-8123

0027084 Blue Cross Blue Shield Medex Three, P. O. Box 9196, Boston, MA, 02105

0027083 Blue Cross Blue Shield Medex Two, P. O. Box 9196, Boston, MA, 02105

0027060 Blue Cross Blue Shieldof Kentucky, P. O. Box 37690, Louisville, KY, 40233, (866) 848-1056

0028073 Blue Cross Blue Shieldof Alaska, P. O. Box 24649, Anchorage, AK, 99524, (800) 527-6675

0027080 Blue Cross Blue Shield of Alabama, P. O. Box 2294, Birmingham, AL, 35209-2294, (800) 334-9041

0027011 Blue Cross Blue Shieldof Arkansas, P. O. Box 1460, Little Rock, AR, 72203-1460

0027012 Blue Cross Blue Shieldof Arkansas, Dental Claims Administrator, P. O. Box 69436, Harrisburg, PA,
17106-9436, (888) 224-5213

0027020 Blue Cross Blue Shieldof Arizona, P. O. Box 2924, Phoenix, AZ, 85062, (800) 676-2583

0027059 Blue Cross Blue Shield of Central NY, P. O. Box 4809, Syracuse, NY, 13221, (315) 671-6400

0028012 Blue Cross Blue Shieldof Georgia, P. O. Box 9907, Columbus, GA, 31908-7368, (800) 441-2273

0028016 Blue Cross Blue Shieldof Iowa, 636 Grand Ave, Des Moines, IA, 50309, (800) 526-8995

0028020 Blue Cross Blue Shieldof Illinois, P. O. Box 805107, Chicago, IL, 60690-3625, (800) 972-8088

0027097 Blue Cross Blue Shieldof Kansas, 1133 S West, Topeka, KS, 66629, (800) 432-0272

0028030 Blue Cross Blue Shieldof Kansas, P. O. Box 419169, Kansas City, MO, 64141-6196, (800) 566-8443

0027000 Blue Cross Blue Shieldof Massachusetts, P. O. Box 986015, Boston, MA, 02298-6015,
(800) 443-6657

0028026 Blue Cross Blue Shieldof Maryland, P. O. Box 9784, Baltimore, MD, 21284, (800) 524-4555

0028000 Blue Cross Blue Shieldof Michigan, 600 Lafayette E, Detroit, MI, 48226, (800) 637-2227

0028106 Blue Cross Blue Shieldof Michigan, P. O. Box 80380, Lansing, MI, 48908-0380, (800) 422-9146

0027015 Blue Cross Blue Shieldof Mississippi, P. O. Box 2312, Jackson, MS, 39225-2315, (800) 942-0278

0027016 Blue Cross Blue Shieldof Mississippi, P. O. Box 1043, Jackson, MS, 39215-1043, (800) 676-2583

0027098 Blue Cross Blue Shieldof Montana, P. O. Box 7982, Helena, MT, 59604, (800) 447-7828

0028034 Blue Cross Blue Shieldof North Carolina, 5901 Chapel Hill Road, Durham, NC, 27702-2291,
(800) 250-3630

0027014 Blue Cross Blue Shieldof North Dakota, 4510 13th Ave SW, Fargo, ND, 58121

0027048 Blue Cross Blue Shieldof Northeastern and Western New York, P. O. Box 80, Buffalo, NY, 12212,
(800) 444-9940

0028038 Blue Cross Blue Shieldof New Jersey, P. O. Box 1219, Newark, NJ, 07101, (973) 466-4000

0027090 Blue Cross Blue Shieldof New Mexico, P. O. Box 11968, Albuquerque, NM, 87192, (800) 835-8699

0028052 Blue Cross Blue Shieldof Oregon, P. O. Box 30805, Salt Lake City, UT, 84130, (800) 624-6519

0028031 Blue Cross Blue Shieldof Pennsylvania, P. O. Box 898845, Camp Hill, PA, 17089, (800) 358-0050

0028055 Blue Cross Blue Shieldof Pennsylvania, P. O. Box 1210, Pittsburgh, PA, 15230, (800) 547-3627

0028103 Blue Cross Blue Shieldof Pennsylvania, P. O. Box 69352, Philadelphia, PA, 17106, (800) 275-2583

0028099 Blue Cross Blue Shieldof Puerto Rico, 401 Park Dr, Boston, MA, 02215

0028059 Blue Cross Blue Shieldof Rhode Island, 444 Westminster St, Providence, RI, 02903, (800) 639-2227

0027058 Blue Cross Blue Shield of Rochester, 150 E Main St, Rochester, NY, 14647

0028098 Blue Cross Blue Shield of Rochester, 165 Court St, Rochester, NY, 14647, (800) 462-0116

0028060 Blue Cross Blue Shieldof South Carolina, P. O. Box 100300, Columbia, SC, 29202, (800) 868-2520

0028062 Blue Cross Blue Shieldof South Carolina, P. O. Box 6000, Greenville, SC, 29606-6000,
(800) 845-6067

0028094 Blue Cross Blue Shieldof Texas, P. O. Box 660044, Dallas, TX, 75266, (800) 521-2227

0027034 Blue Cross Blue Shieldof Texas Dental, P. O. Box 660247, Dallas, TX, 75266, (800) 521-2227

0028076 Blue Cross Blue Shieldof Washington, P. O. Box 91059, Seattle, WA, 98111, (800) 527-6675

0028075 Blue Cross Blue Shieldof Wisconsin, P. O. Box 2270, Fond Du Lac, WI, 54936

0028015 Blue Cross Blue Shieldof Wyoming, P. O. Box 2266, Cheyenne, WY, 82003-2266, (800) 442-2376

0028035 Blue Cross Blue Shield of Oklahoma, P. O. Box 3283, Tulsa, OK, 74102, (405) 787-6020

0027062 Blue Cross Blue Shieldof Missouri, P. O. Box 419169, Kansas City, MO, 64141, (800) 892-6048

0028071 Blue Cross D Blue Shieldof Vermont, 445 Industrial Ln, Montpelier, VT, 05601, (800) 255-4550

0027033 Blue Cross Dentalof Rhode Island, P. O. Box 219, Providence, RI, 02901, (800) 676-2583

0028017 Blue Shield of California, P. O. Box 272540, Chico, CA, 95927-2540, (800) 334-9849

0028105 Blue Shield of Northeastern New York, P. O. Box 80, Buffalo, NY, 14240-0080, (518) 880-5700

0028061 Blue Shieldof Puerto Rico, P. O. Box 363628, San Juan, PR, 00936, (888) 284-7814

0614029 Boilermaker S National Health and Welfare, P. O. Box 23825, Tucson, AZ, 85734

0614028 Boilermakers National Health and Welfare, P. O. Box 5909, Scranton, PA, 18505, (866) 342-6555

0631001 Bollinger, P. O. Box 727, Short Hill, NJ, 07078, (866) 267-0092

0290050 Boon Chapman, P. O. Box 9201, Austin, TX, 78766, (800) 252-9653

0167000 Boston Mutual Life Insurance Co, 120 Royall St, Canton, MA, 02021, (800) 669-2668

0901089 Bravo Health Pennsylvania Inc, P. O. Box 4433, Baltimore, MD, 21223-0433, (800) 291-0396

0614020 Bricklayers and Masons Local 3, 645 Morrissey Blvd, Boston, MA, 02122

0699002 Bridgestone Firestone, P. O. Box 247, Sheldon, IA, 51201

0913003 Cambridge Hospital ESP, 270 Green St, Cambridge, MA, 02139

0895018 Cape Care Preferred Provider Network, P. O. Box 30367, Tampa, FL, 33630

0028053 Capital Blue Cross, P. O. Box 779503, Harrisburg, PA, 17177, (866) 333-0829

0171010 Capital Group Insurance Administrators, 320 Washington St, Norwell, MA, 02061

0171015 Capitol Administrators, P. O. Box 2318, Rancho Cordova, CA, 95741

0171005 Capitol District Physicians Health Plan, P. O. Box 66602, Albany, NY, 12206, (800) 926-7526

0171050 Cappcare, P. O. Box 6240, Newport Beach, CA, 92658

0028025 Care First Blue Cross Blue Shield, P. O. Box 14116, Lexington, KY, 40512-4116, (888) 567-9155

0028027 Care First Blue Cross Blue Shieldof Maryland, P. O. Box 1725, Cumberland, MD, 21501,
(800) 843-4280

0632601 Carefirst Administrators, P. O. Box 981608, El Paso, TX, 97778, (800) 888-6227

0028008 Carefirst Blue Cross Blue Shield, P. O. Box 14116, Lexington, KY, 40512-4116, (800) 842-5975

0028032 Carefirst Blue Cross Blue Shield, P. O. Box 812, Owings Mills, MD, 21117, (800) 843-4280

0920025 Caremark, P. O. Box 686005, San Antonio, TX, 78268, (800) 841-5550

0442001 Careplus Health Plans Inc, P. O. Box 31286, Tampa, FL, 33631-3286, (866) 313-7587

0614054 Carpenters Health and Welfare, 29 Oakland St, Springfield, MA, 01101

0707000 Catholic Association of Foresters, 347 Commonwealth Ave, Boston, MA, 02115

0661002 CBA Inc, 3800 NW 12th, Lincoln, NE, 68521, (888) 673-2872

0702030 CBC Administrators, P. O. Box 776, Melville, NY, 11747, (877) 769-3942

0204008 CBCA, P. O. Box 1339, Minneapolis, MN, 55440-1339

0702040 CBCA, P. O. Box 5190, Tampa, FL, 33675

0702041 CBCA, P. O. Box 9888, Savannah, GA, 31412

0702042 CBCA, P. O. Box 9000, London, KY, 40742

0702025 CBCA Administrators, P. O. Box 1539, Fort Worth, TX, 76101, (800) 808-4515

0702035 CBCA Administrators, P. O. Box 8911, Melville, NY, 11747, (877) 769-3942

0895040 CBPI Beech St Corp, P. O. Box 853925, Richardson, TX, 75085-3925, (800) 275-1171

0828010 CCN Superien Interplan, P. O. Box 6743, Lubbock, TX, 79493, (800) 903-2032

0702047 CDPHP, P. O. Box 66602, Albany, NY, 12206, (800) 926-7526

0712002 CDS, P. O. Box 50190, Sparks, NV, 50190, (800) 455-4236

0905070 CEBA, 6300 Bridge Point Pkwy, Austin, TX, 78730, (888) 350-1488

0172001 Celtic Insurance, P. O. Box 30082, Tampa, FL, 3082

0172007 Celtic Insurance Company, P. O. Box 06401, Chicago, IL, 60606, (800) 477-7870

0348015 Cement Workers, 35-30 Francis Lewis Blvd, Ste 300, Flushing, NY, 11358-1931, (718) 762-6133

0174020 Centra, P. O. Box 34866, Seattle, WA, 98124

0895019 Central Cartage E, P. O. Box 3017, Center Line, MI, 48015

0176000 Central States Health and Life, P. O. Box 34350, Omaha, NE, 68134, (402) 397-1111

0873000 Central United Life, P. O. Box 2728, Houston, TX, 77252

0638032 Century Healthcare, P. O. Box 2256, Grapevine, TX, 76099-2256

0615015 Colorado Fuel and Iron, 5 Gateway Center Ste 6, Pittsburg, PA, 15222

0690000 Champion International, Knights Bridge Dr, Hamilton, OH, 45020

0064001 CHAMPUS Tricare Military Health Systems, P. O. Box 870140, Camden, SC, 29587, (877) 874-2273

0006010 CHAMPVA, 99 River Ridge Dr, Denver, CO, 80206

0184005 Cherokee Insurance, P. O. Box 159, Warren, MI, 48090

0615001 Chesapeake Life Insurance Co, P. O. Box 981606, El Paso, TX, 79998, (888) 756-3534

0901020 Chesterfield Resource, P. O. Box 1884, Akron, OH, 44309, (800) 321-0935

0678010 Choice Benefits, P. O. Box 10048, Fort Smith, AR, 72917, (479) 785-6178

0678000 Choice Plusof Vermont, P. O. Box 6589, Syracuse, NY, 13217, (802) 479-9762

0184010 Christian Brothers Health Management Services, 1205 Windham Pkwy, Romeoville, IL, 60446

0787010 Christian Fidelity, P. O. Box 44990, Madison, WI, 53744-4990