TPL Carrier Codes - Arkansas Medicaid
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REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 1 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------S56 A AND H ADMINISTRATORS INC P O BOX 10223 MILWAUKEE WI 53223 Q19 A E STALEY MFG CO P O BOX 151 DECATUR IL 62525 RZ* A H AND L PO BOX 88260 ATLANTA GA 30356 UB* A H AND L P O BOX 11111 FORT SCOTT KS 66701 E85 A I G LIFE INSURANCE ACCIDENT AND HEALTH CLAIM PO BOX 15701 WILMINGTON DE 19850-5701 S82 A R G I S P O BOX 802516 DALLAS TX 75380 BJ7 AAA COOPER TRANSPORT P. O. BOX 6827 DOTHAN AL 36302 C8* AAA GROUP HOSPITAL INDEMNI AAA NEW MEXICO DIVISION 2201A SAN PEDRO BLVD NE ALBUQUERQUE NM 87110 U40 AAA OF WASHINGTON GROUP INSURANCE CO 222 NO MISSION WENATCHIE WA 98801 X95 AAC INC 16010 BARKERS PT LN 265 HOUSTON TX 77079 FI* AARP HEALTHCARE OPTIONS UNITED HEALTHCARE CLAIMS P O BOX 740819 ATLANTA GA 30374-0819 CG8 ABAS AMER BENEFIT ADMIN SER 1733 PARK ST STE 300 NAPERVILLE IL 60564 J47 ABC ADVANTAGE PLAN P O BOX 2546 SHERMAN TX 75090 F99 ABC BENEFITS OF ARK 1500 RIVERFRONT DR P O BOX 3198 LITTLE ROCK AR 72203 S26 ABC INSURANCE P O BOX 3148 BALLWIN MO 63022 Q93 ABC INSURANCE TRUST 729 15TH ST. NW WASHINGTON DC 20005 BX7 ABC INSURANCE TRUST FUND KAM TECH INC 1300 N 17TH ST 8TH FLOOR ROSSLYN VA 22209 V94 ABI ADMINISTRATIVE SERVICES INC 14482 MCCORMICK DR TAMPA FL 33626 K97 ABI ADMINISTRATIVE SERVICE CORP 10159 WAYZAT BOULEVARD MINNETONKA MN 55343 FV5 ABP ADMINISTRATION PO BOX 82060 ROCHESTER MI 48308 RL* ACADEMY INSURANCE GROUP P O BOX 3074 SOUTHEASTERN PA 19398 HF7 ACCESS ADMINISTRTORS 7430 REMCON CIRCLE BLDG C EL PASO TX 79912 BE5 ACCORDIA PO BOX 11111 FORT SCOTT KS 66701-7111 B88 ACCORDIA BENEFIT OF TX P O BOX 130217 TYLER TX 75713 AM9 ACCORDIA BUSINESS BENEFITS P.O. BOX 419 EVANSVILLE IN 47703 FU3 ACCORDIA NATIONAL P O BOX 2621 CHARLESTON WV 25329 P20 ACCORDIA OF LEXINGTON EAGLES ADMINISTRATORS P O BOX 13307 LEXINGTON KY 40583 CI3 ACCOUNTABLE HEALTH PLAN 600 SIX FLAGS DR SUITE200 ARLINGTON TX 76011 AR8 ACORDIA BUSINESS BENEFITS P.O. BOX 957 EVANSVILLE IN 47706 DN4 ACORDIA OF CENTRAL INDIANA P O BOX 567 GREENWOOD IN 46142 EZ2 ACORDIA OF LEXINGTON P O BOX 14061 LEXINGTON KY 40512-4061 RK* ACORDIA SENIOR OF THE SW P O BOX 37710 LOUISVILLE KY 40233-7710 GV3 ACS BENEFIT SERVICES PO BOX 2000 WINSTON SALEM NC 27102-2000 BV6 ACTION LANE P O BOX A PONTOTOC MS 38863 EH8 ADAMS LAND COMPANY HEALTH FUND P O BOX 49 LEACHVILLE AR 72438 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 2 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------V95 ADJUSTCO INC P O BOX 945005 MAITLAND FL 32794 BK* ADMIN AND CONSULTANTS FOODCRAFT EQUIP CO P O BOX 4925 LANCASTER PA 17604 FK3 ADMIN ONE CORPORATION PO BOX 2619 ROGERS AR 72757 H7* ADMIN SERVICES OF INDIANA P O BOX 6245 SOUTH BEND IN 46660 BQ3 ADMINASTAR SOLUTIONS P O BOX 40509 INDIANAPOLIS IN 46240-0509 L87 ADMINICORP CO P O BOX 938 SAN JOSE CA 95108-0938 Z47 ADMINISTRATIVE BENEF SVCS 1255 LYNNFIELD RD SUITE 140 MEMPHIS TN 38119 H75 ADMINISTRATIVE BENEFITS CONSOLIDATED FREIGHTWAYS PO BOX 3988 PORTLAND OR 97208 DP2 ADMINISTRATIVE CONCEPTS P O BOX 1749 ROCKWALL TX 75087 IE7 ADMINISTRATIVE ENTERPRISES 5810 WEST BEVERLY LANE GLENDALE AZ 85306 W87 ADMINISTRATIVE ENTERPRISES 3404 WEST CHERYL DRIVE SUITE 281 PHOENIX AZ 85051 M66 ADMINISTRATIVE SERVICE 3301 E ROYALTON ROAD CLEVELAND OH 44147 P59 ADMINISTRATIVE SERVICES P O BOX 839000 MIAMI FL 33283-9000 AE9 ADMINISTRATIVE SERVICES P.O. BOX 219325 KANSAS CITY MO 64121-9325 Q26 ADMINISTRATIVE SYSTEMS 1310 MECER ST SUITE 200 SEATTLE WA 98109 EQ2 ADMINITRON INC P O BOX 5095 BRENTWOOD TN 37024-5095 HU5 ADMIRAL LIFE INSRUANCE COMPANY OF AMERICA PO BOX 10861 CLEARWATER FL 33757-8861 Z82 ADVANCE INSURANCE ADMIN 1525 MERRILL DRIVE SUITE 2000 LITTLE ROCK AR 72211 FY7 ADVANCE PCS INC 9501 EAST SHEA BOULEVARD SCOTTSDALE AZ 85260-6719 B59 ADVANCED INSURANCE SERVICE P O BOX 19 MEMPHIS TN 38101 AR3 ADVANCED PRESCRIPTION 909 E COLLINS BLVD P O BOX 853901 RICHARDSON TX 75085-3901 FU8 ADVANCEPCS PHARMACY CLAIM WALMART CLAIM ADMIN 922 W WALNUT STE A ROGERS AR 72756-3540 AF8 ADVANTAGE BENEFITS CO ADMAR CORP P.O. BOX 4067 SANTA ANA CA 92701 HN2 ADVANTAGE HEALTH SOLUTIONS PO BOX 502530 INDIANAPOLIS IN 46209 HN1 ADVANTRA PO BOX 7154 LONDON KY 40742-7154 DO1 ADVENTIST RISK MGE CHRISTIAN RECORD SERVICE P O BOX 8007 RIVERSIDE CA 92515 K37 AEROQUIP RR 2 BOX IDD MOUNTAIN HOME AR 72653 GY* AETNA P O BOX 5696 LONGVIEW TX 75604 IY* AETNA REVERE COPPER BRASS HWY 67 NORTH NEWPORT AR 72112 FO2 AETNA PO BOX 14089 LEXINGTON KY 40512-4089 FZ3 AETNA PO BOX 981109 EL PASO TX 79998-1109 FZ2 AETNA 4630 WOODLANDS CORPORATE TAMPA FL 33614-2415 FZ4 AETNA PO BOX 3935 ALLENTOWN PA 18106-0935 GM8 AETNA P O BOX 1837 MARYLAND HEIGHTS MO 63043 GK9 AETNA 4050 PIEDMONT PARKWAY HIGH POINT NC 27262 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 3 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------GG4 AETNA PO BOX 14094 LEXINGTON KY 40512-4094 ET1 AETNA P O BOX 795083 SAN ANTONIO TX 78279-5083 EQ5 AETNA P O BOX 209010 18004355597 AUSTIN TX 78720 E91 AETNA DALLAS MARKET CENTER 2100 STEMMONS FRWY 80 DALLAS TX 75207 EN2 AETNA P O BOX 14586 18003459908 LEXINGTON KY 40512-4586 S99 AETNA P O BOX 11000 ORANGE CA 92668-8100 SV* AETNA 151 NORTH MAIN ST WICHITA KS 67202 T31 AETNA C/O ACC 1300 W OAK ST INDEPENDENCE KS 67301 ZH* AETNA 1001 ESE LOOP 323 STE 300 P O BOX 2520 TYLER TX 75710 Z48 AETNA EMPLOYEE BENEFIT DIVISION P.O. BOX 129122 SAN DIEGO CA 92112-9122 XJ* AETNA P O BOX 120 GRAND RAPIDS MI 49501 AO7 AETNA PO BOX 85079 RICHMOND VA 23285-5079 DE9 AETNA PO BOX 3907 ALLENTOWN PA 18106 DT7 AETNA P O BOX 23285 RICHMOND VA 23285 DZ1 AETNA PO BOX 6259 PEORIA IL 61601-6259 CC8 AETNA P O BOX 1211 TEWKSBURY MA 01876 B21 AETNA PO BOX 1058 MACON GA 31298 BP4 AETNA HEALTH PLAN 8023 E 63RD PLACE STE 310 TULSA OK 74133 EA2 AETNA HEALTH PLAN P O BOX 5367 ROCKFORD IL 61125 FB9 AETNA HEALTH PLAN 10459 MOUNTAIN VIEW AVE LOMA LINDA CA 92354 EW8 AETNA HEALTH PLAN P O BOX 7064 DOVER DE 19903-1512 FB3 AETNA HEALTH PLANS LOOP STATION P O BOX 2949 MINNEAPOLIS MN 55402-0949 D59 AETNA HEALTH PLANS 3541 WINCHESTER RD UNIT 73 ALLENTOWN PA 18195-0519 ED8 AETNA HEALTH PLANS P O BOX 12122 OKLAHOMA CITY OK 73157-2122 EI6 AETNA HEALTH PLANS P O BOX 3903 ALLENTOWN PA 18106-0903 EI1 AETNA HEALTH PLANS DELTA BEVERAGE CLAIMS P O BOX 26125 GREENSBORO NC 27402 BG7 AETNA HEALTH PLANS P O BOX 35890 LOUISVILLE KY 40232-5890 CE4 AETNA HEALTH PLANS P O BOX 21645 SEATTLE WA 98111 CI2 AETNA HEALTH PLANS P O BOX 91411 ARLINGTON TX 76015 AC7 AETNA HEALTH PLANS CLAIMS OFFICE P.O. BOX 91533 ARLINGTON TX 76015 X57 AETNA HEALTH PLANS P O BOX 1630 COLUMBUS OH 43216 Z27 AETNA HEALTH PLANS P.O. BOX 26190 GREENSBORO NC 27402-6190 X96 AETNA HEALTH PLANS UPS UNIT 52F PO BOX 26053 GREENSBORO NC 27420 Q65 AETNA HEALTH PLANS PO BOX 7012 DOVER DE 19903 V66 AETNA HEALTH PLANS OF TENN INC P O BOX 141176 IRVING TX 75014-1176 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 4 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------CA3 AETNA HEALTH PLANS OF CA P.O. BOX 50035 SAN BERNARDINO CA 92412 X97 AETNA HEALTH SERVICE 400 E SPRING STR BLUFTON TN 46714 FC8 AETNA HEALTHCARE P O BOX 1816 MACON GA 31202 K24 AETNA HEALTHCARE P O BOX 150417 HARTFORD CT 06115-0417 H98 AETNA INSURANCE CO P O BOX 26107 GREENSBORO NC 27402-6107 V41 AETNA INSURANCE CO P O BOX 709 WINDSOR CT 06095-0709 BD4 AETNA INSURANCE CO C/O BOB EVANS 3776 S. HIGH ST COLUMBUS OH 43207 MV* AETNA LIFE AND CAASUALTY GROUP CLAIMS P O BOX 12340 FRESNO CA 93765 KX* AETNA LIFE AND CASUALTY GLEN HILL N BLDG 8 800 ROOSEVELT RD GLEN ELLYN IL 60137 JW* AETNA LIFE AND CASUALTY P O BOX 2117 FALL RIVER MA 02722 G77 AETNA LIFE AND CASUALTY 435 CAPTAIN THOMAS BLVD WEST HAVEN CT 06516 D62 AETNA LIFE AND CASUALTY P O BOX 6519 JACKSONVILLE FL 32236 VS* AETNA LIFE AND CASUALTY P O BOX 26200 NEW ORLEANS LA 70186 R42 AETNA LIFE AND CASUALTY 150 4TH AVE N NASHVILLE AR 37219 QI* AETNA LIFE AND CASUALTY CIVIL SERVICE RETIREMENT WASHINGTON DC 20415 WQ* AETNA LIFE AND CASUALTY GULF MEDICAL PYMNT UNIT 900 CHATHAM CNTR OFC BLDG PITTSBURGH PA 15259 AL5 AETNA LIFE AND CASUALTY P.O. BOX 795982 SAN ANTONIO TX 78279-5082 V52 AETNA LIFE AND CAUSALTY 301 INDUSTRIAL PARK MARKED TREE AR 72365 F56 AETNA LIFE INS POBOX DRAWER 11000 RUSTON LA 71270 F81 AETNA LIFE INS CO PO BOX 795080 SAN ANTONIO TX 78279-5080 H58 AETNA LIFE INS CO P.O. BOX 31450 TAMPA FL 33631-3450 EF6 AETNA LIFE INS CO P O BOX 578800 OKLAHOMA CITY OK 73157-8800 ED4 AETNA LIFE INS CO COCA COLA CLAIMS 166 16TH ST N W ATLANTA GA 30318 A64 AETNA LIFE INS CO LOOP STATION P O BOX 2907 MINNEAPOLIS MN 55402 CT4 AETNA LIFE INS CO P O BOX 91511 ARLINGTON TX 76015 AT* AETNA LIFE INS CO CLM DEPT EMPLOYEE BENEFITS DIV P O BOX 5060 ARLINGTON TX 76011 DE2 AETNA LIFE INSURANCE P O BOX 2523 FORT WAYNE IN 46801-0871 C28 AETNA LIFE INSURANCE P O BOX 59180 BIRMINGHAM AL 35259 DR6 AETNA LIFE INSURANCE P O BOX 26117 GREENSBORO NC 27402 DR5 AETNA LIFE INSURANCE P O BOX 28902 SAN ANTONIO TX 78228 DR4 AETNA LIFE INSURANCE P O BOX 3000 GRAND RAPIDS MI 49501 DK8 AETNA LIFE INSURANCE P O BOX 3901 ALLENTOWN PA 18106-0901 DF5 AETNA LIFE INSURANCE 2677 NORTH MAIN ST SUITE 600 SANTA ANA CA 92701 DG1 AETNA LIFE INSURANCE 2365 NORTHSIDE DRIVE SAN DIEGO CA 97207 DF9 AETNA LIFE INSURANCE P O BOX 16516 COLUMBUS OH 43216 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 5 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------DG2 AETNA LIFE INSURANCE P O BOX 871 FORT WAYNE IN 46801 D82 AETNA LIFE INSURANCE P O BOX 26279 MILWAUKEE WI 53226 E90 AETNA LIFE INSURANCE P O BOX 300 PORTLAND OR 97207 E65 AETNA LIFE INSURANCE LOOP STATION P O BOX 2947 MINNEAPOLIS MN 55402 DI6 AETNA LIFE INSURANCE CO P O BOX 91522 ARLINGTON TX 76015-0022 DI2 AETNA LIFE INSURANCE CO P O BOX 7027 ROCKFORD IL 61126-7027 DV2 AETNA LIFE INSURANCE CO P O BOX 50065 SAN BERNARDINO CA 92412 BW5 AETNA LIFE INSURANCE CO P O BOX 9070 TYLER TX 75711 WX* AETNA LIFE INSURANCE CO P O BOX 2539 HOUSTON TX 77001 X56 AETNA LIFE INSURANCE CO 350 SRPINGSIDE DRIVE P O BOX 5569 AKRON OH 44340-5690 X98 AETNA LIFE INSURANCE CO PO BOX 5048 ROCKFORD IL 61125 X58 AETNA LIFE INSURANCE CO P O BOX 18040 COLUMBUS OH 43218 OF* AETNA LIFE INSURANCE CO P O BOX 2369 FORT WORTH TX 76113 N5* AETNA LIFE INSURANCE CO PO BOX 129107 SAN DIEGO CA 92112-9107 FY4 AETNA PHARMACY MANAGEMENT AETRX SUITE 400 11100 WAYZATA BLVD MINNETONKA MN 55305 FJ7 AETNA PPO PO BOX 44128 JACKSONVILLE FL 32231 AP3 AETNA PPO P O BOX 981107 EL PASO TX 79988-1107 HT1 AETNA RX MANAGEMENT PO BOX 14024 LEXINGTON KY 40512 HE9 AETNA U S HEALTHCARE P O BOX 12626 FRESNO CA 93778 FD8 AETNA U S HEALTHCARE PEPSICO CLAIMS P O BOX 52117 MINNEAPOLIS MN 55402-5117 CW8 AETNA U S HEALTHCARE P O BOX 14079 LEXINGTON KY 40512-4079 DC7 AETNA U S HEALTHCARE P O BOX 981107 18004482180 EL PASO TX 79998 AH8 AETNA US HEALTHCARE PO BOX 91533 ARLINGTON TX 76015-0033 A59 AETNA US HEALTHCARE P O BOX 182082 COLUMBUS OH 43218-2082 AX8 AETNA US HEALTHCARE PO BOX 578802 OKLAHOMA CITY OK 73157-8802 NO* AETNA US HEALTHCARE HOME DEPOT P O BOX 26106 GREENSBORO NC 27402-6106 OE* AETNA US HEALTHCARE P O BOX 52120 MINNEAPOLIS MN 55402-5120 N55 AETNA US HEALTHCARE P O BOX 91544 ARLINGTON TX 76015-0044 QJ* AETNA US HEALTHCARE GROUP CLAIMS P O BOX 26102 GREENSBORO NC 27402-6102 PI* AETNA US HEALTHCARE P O BOX 150409 HARTFORD CT 06115-0409 UP* AETNA US HEALTHCARE 4151 EXECUTIVE PKWY SUITE 105 WESTERVILLE OH 43081 ZN* AETNA US HEALTHCARE PO BOX 44128 JACKSONVILLE AR 32231-4128 XX* AETNA US HEALTHCARE EMPLOYEE BENEFIT DIV PO BOX 2295 FORT WAYNE IN 46801 CA4 AETNA US HEALTHCARE PO BOX 14110 LEXINGTON KY 40512 BM* AETNA US HEALTHCARE P O BOX 24024 FRESNO CA 93765 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 6 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------DW8 AETNA US HEALTHCARE PO BOX 353 GRAND RAPIDS MI 49501 DK* AETNA US HEALTHCARE P O BOX 2265 BLUE BELL PA 19422 DH9 AETNA US HEALTHCARE PO BOX 129219 SAN DIEGO CA 92112-9219 FE1 AETNA US HEALTHCARE P O BOX 182756 COLUMBUS OH 43218-2756 FF4 AETNA US HEALTHCARE PO BOX 981106 EL PASO TX 79998-1106 FF3 AETNA US HEALTHCARE PO BOX 3924 ALLENTOWN PA 18106-3924 E26 AETNA US HEALTHCARE LOOP STATION P O BOX 2909 MINNEAPOLIS MN 55402 EZ8 AETNA US HEALTHCARE P O BOX 30555 SALT LAKE CITY UT 84130-0555 EU* AETNA US HEALTHCARE P O BOX 2301 BLUE BELL PA 19422-2301 EC1 AETNA US HEALTHCARE 7400 W CAMPUS ROAD NEW ALBANY OH 43054 EM9 AETNA US HEALTHCARE PO BO X52119 MINNEAPOLIS MN 55402 EK8 AETNA US HEALTHCARE P O BOX 2954 HARTFORD CT 06143-2954 EO5 AETNA US HEALTHCARE P O BOX 2170 COLUMBUS OH 43216-2170 EQ* AETNA US HEALTHCARE P O BOX 2250 BLUE BELL PA 19422-8250 EP7 AETNA US HEALTHCARE LOCKHEED MARTIN BENEFITS P O BOX 12495 OKLAHOMA CITY OK 73157 IV* AETNA US HEALTHCARE P O BOX 2095 BISMARCK ND 58504 KE* AETNA US HEALTHCARE CENTIMARK CLAIMS P O BOX 16423 PITTSBURG PA 15242-0423 MQ* AETNA US HEALTHCARE P O BOX 660239 DALLAS TX 75266 LA* AETNA US HEALTHCARE P O BOX 916 BISMARCK ND 58502-0916 FJ1 AETNA US HEALTHCARE PO BOX 14100 LEXINGTON KY 40512-4100 FN7 AETNA US HEALTHCARE PO BOX 54159 LOS ANGELES CA 90054 FY* AETNA US HEALTHCARE P O BOX 3909 ALLENTOWN PA 18106-0909 FV2 AETNA US HEALTHCARE PO BOX 14066 LEXINGTON KY 40512 FS3 AETNA US HEALTHCARE PO BOX 981204 EL PASO TX 79998 FP9 AETNA US HEALTHCARE PO BOX 9160 VANNUYS CA 91410-0160 FO7 AETNA US HEALTHCARE PO BOX 4266 BISMARCK ND 93765 F43 AETNA US HEALTHCARE PO BOX 91555 ARLINGTON TX 76015-0033 GD4 AETNA US HEALTHCARE 4400 NW LOOP 410 SAN ANTONIO TX 78229 GD3 AETNA US HEALTHCARE PO BOX 1125 BLUE BELL PA 19422 GC2 AETNA US HEALTHCARE PO BOX 14091 LEXINGTON KY 40512-4091 AO8 AFCO METALS HEALTH CARE P.O. BOX 6026 FT SMITH AR 72906 T48 AFCO METALS P O BOX 95010 LITTLE ROCK AR 72209 V14 AFCO STEEL HEALTH CARE P O BOX 231 LITTLE ROCK AR 72203 K23 AFFILATED FOOD STORES P O BOX 802516 DALLAS TX 75380 Y52 AFFILIATED FOOD STORE EMPLOYEES INS PLAN P.O. BOX 3627 LITTLE ROCK AR 72203 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 7 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------RU* AFG INDUSTRIES INC P O BOX 929 KINGSPORT TN 37662 ZB* AFGE INSURANCE DEPT 1325 MASSACHUSETTS AVE NW WASHINGTON DC 20005 R36 AFLAC AMERICAN FAMILY LIFE 1932 WEYNNTON RD COLUMBUS GA 31999 EX4 AFLAC P O BOX 715 TEXARKANA TX 75503 V31 AG PROCESSING INC P O BOX 9120 DES MOINE IA 50306 BS1 AGA AUTOMATED GROUP ADMIN PO BOX 15568 FORT WAYNE IN 46885-5568 P89 AGENCY RENT A CAR 30000 AURORA RD SOLON OH 44139 K52 AGENCY SERVICE INC P.O. BOX 17237 MEMPHIS TN 38187-0237 T98 AHA CARE P O BOX 809 RIDGELAND MS 39158-0809 EE3 AIA INSURANCE P O BOX 2198 SHAWNEE MISSION KS 66201 AR1 AIA UNIVERSE P.O. BOX 538 LEWISTON ID 83501 KF* AID ASSOCIATION FOR LUTHERANS 4321 N BALLARD ROAD APPLETON WI 54919 HK6 AIG CLAIMS SERVICE P O BOX 44139 LAS VEGAS NV 89116 JO1 AIG DOMESTIC CLAIMS A AND H CLAIMS DEPARTMENT PO BOX 25987 SHAWNEE MISSION KS 66225 F60 AIR LOGISTICS POBOX 53178 LAFAYETTE LA 70505 X25 AIR PRODUCTS AND CHEMICALS P O BOX 252 FT SMITH AR 72902 AD* AIRTHERM PRODUCTS INSURANCE DEPT P O BOX 1895 FORREST CITY AR 72335 CE6 ALADDIN INDUSTRIES INC 703 MURFREESBORO RD NASHVILLE TN 37210 E73 ALAN WHITE CO P O BOX 249 STAMPS AR 71860 IK9 ALASKA LABORERS H S FUND P O BOX 34567 SEATTLE WA 98124-1567 HV7 ALCOHOL DRUG ABUSE PREVENT 305 SOUTH PALM STREET LITTLE ROCK AR 72205 A10 ALL AMERICAN LIFE INSUR CO 8501 WEST HIGGINS ROAD CHICAGO IL 60631 HN3 ALLEGIANCE BENEFIT PLAN MA PO BOX 3018 MISSOULA MT 59806 CI9 ALLIANCE BLUE CROSS BLUE S P O BOX 14882 ST LOUIS MO 63178-4882 CB7 ALLIANZE LIFE INS CO CITICORP INS P O BOX 7055 DOVER DE 19903-7055 V98 ALLIED ADMINISTRATORS P O BOX 419257 KANSAS CITY MO 64141 M89 ALLIED BENEFIT SYSTEMS P O BOX 909786 CHICAGO IL 60690 BS6 ALLMERICA FINANCE P O BOX 79059 HOUSTON TX 77279-9059 BV1 ALLMERICA FINANCIAL 440 LINCOLN STREET BOX 1014 WORCESTER MA 01653-1014 CD5 ALLMERICA FINANCIAL EMPLOYEE BENEFIT CLAIMS 440 LINCOLN ST BOX 1018 WORCESTER MA 01605-1959 DX5 ALLMERICA FINANCIAL 333 PIERCE RD SUITE 310 ITASCA IL 60143-3116 ER6 ALLMERICA FINANCIAL 440 LINCOLN ST BOX 3844 WORCESTER MA 01653-3844 EJ8 ALLMERICA FINANCIAL P O BOX 105893 ATLANTA GA 30348-5893 E13 ALLSTATE 3090 W MARKER ST FAIRLAWN OH 44313 J95 ALLSTATE 1510 A AIRPORT ROAD HOT SPRINGS AR 71913 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 8 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------A65 ALLSTATE PO BOX 26743 AUSTIN TX 78731 UW* ALLSTATE 5500 INTERSTATE N PARKWAY ATLANTA GA 30328 SO* ALLSTATE 1230 RAYMOND RD P O BOX 2031 JACKSON MS 39205 I32 ALLSTATE INS CO 2330 GRAVEL ROAD FORTH WORTH TX 76118 V45 ALLSTATE INSURANCE 3996 FRONTAGE RD FAYETTEVILLE AR 72703 Q77 ALLSTATE INSURANCE 201 EXECUTIVE COURT LITTLE ROCK AR 72205 AR2 ALLSTATE INSURANCE CO P.O. BOX 30447 TAMPA FL 33630-3447 AT5 ALLSTATE INSURANCE COMPANY PO BOX 800 DEERFIELD IL 60015 EH5 ALLSTATE LIFE INS P O BOX 3580 AKRON OH 44309-3580 EZ3 ALLSTATE LIFE INSURANCE CO P O BOX 3063 NORTHBROOK IL 60065-3063 AR9 ALLTRISTA BENEFIT DEPARTMENT 8307 BALL ROAD FORT SMITH AR 72903 G81 ALPHA DATA SYSTEMS PO BOX 791428 DALLAS TX 56742 PN* ALTA P O BOX 11111 FORT SCOTT KS 66701 FK4 ALTERNATIVE INS RESOURCE PO BOX 660787 BIRMINGHAM AL 35266-0787 GR1 ALTIUS P O BOX 7147 LONDON KY 40742 B41 ALTON PKGING CORP THRU AETNA INSURANCE PO BOX 276 ALTON IL 62002 N73 ALUMACRAFT GROUP MEDICAL P O BOX 189 ARKADELPHIA AR 71923 HP7 ALWAYSCARE BENEFITS P O BOX 14389 BATON ROUGE LA 70898-4389 AM8 AMALGAMATED CLOTHING AND TEXTILE WORKERS UNION 33 W. 14TH STREET NEW YORK NY 10011 SB* AMALGAMATED INSURANCE AGENCY 8550 WEST BRYN MAWR AVE CHICAGO IL 60631 N7* AMALGAMATED LABOR LIFE INS 7380 N LINCOLN AVE LINCOLNWOOD IL 60646 0B* AMALGAMATED LIFE INS CO 730 BROADWAY P O BOX 1451 NEW YORK NY 10116-1451 IM3 AMBETTER OF ARKANSAS ATTN CLAIMS P O BOX 5010 FARMINGTON MO 63640-5010 CK9 AMCO PO BOX 691030 SAN ANTONIO TX 78269-1030 CK8 AMCO PO BOX 22118 LITTLE ROCK AR 72221-2118 FO9 AMCO REPRICING P O BOX 1979 SEARCY AR 72145 DO2 AMCO REPRICING DEPT PO BOX 8219 LITTLE ROCK AR 72221-8219 B35 AMER CONSUMERS ASSOC ADMIN PO BOX GA CORONA DEL MAR CA 92625 N38 AMERAPLAN INC 22500 METROPOLITAN PKWY SUITE 100 CLINTON TOWNSHIP MI 48035 BA3 AMERCO MEDICAL PLAN 2721 NORTH CENTRAL AVENUE PHOENIX AZ 85004-1120 BZ5 AMERI PLUS IDEAL INS P O BOX 9100 CLEARWATER FL 34618 GT2 AMERIBEN PO BOX 7186 BOISE ID 83707 II7 AMERICA TPA P O BOX 398220 MINNEAPOLIS MN 55439 MR* AMERICAN ADMINISTRATIVE GROUP INC P O BOX 268900 OKLAHOMA CITY OK 73216 GU8 AMERICAN ADMINISTRATIVE GROUP INC PO BOX 619012 DALLAS TX 75261-9012 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 9 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------N60 AMERICAN ADMINISTRATORS 4200 CORPORATE DR STE 114 P O BOX 65887 WEST DES MOINES IA 50265 BT9 AMERICAN ADMINSTRATIVE SER 2626 S. 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BOX 1383 FORT SMITH AR 72901 DD8 BOYLE VAUGHAN AND ASSC PROTECTIVE LIFE INS P O BOX 8628 COLUMBIA SC 29202 AA6 BPS INCORPORATED 201 HENRY PLACE SPARTANBURG SC 29306 Z51 BRADEN MANUFACTURING 2100 WHEELER FT SMITH AR 72901 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 24 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------C52 BRANWOOD CORPORATION P O BOX 550 WARREN AR 71671 CD9 BRAVELL CLAIMS MGMT P O BOX 846 BROOKFIELD WI 53008-0846 M18 BRENCO INCORP P O BOX 389 PETERSBURG VA 23804 W94 BRENT TRANSPORTATION P O BOX 5758 GREENVILLE MS 38704 HL5 BRIDGESTONE AMERICAS HOLDI P.O. 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BOX 2305 MT CLEMENS MI 48046-2305 HT6 CAREFIRST PO BOX B900 MERRIFIELD VA 22116-3900 HV8 CAREFIRST ADMINISTRATORS PO BOX 3800 MERRIFIELD VA 27116 IE5 CAREFIRST ADMISTRATORS P.O. 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BOX 833879 RICHARDSON TX 75083-3879 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 28 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------LW* CENTRAL STATE HEALTH AND WELFARE 9377 W HIGGINS ROAD ROSEMONT IL 60018-4901 H97 CENTRAL STATE HEALTH AND LIFE OF OMAHA P.O. BOX 1139 HOT SPRINGS AR 71902 I20 CENTRAL STATES P O BOX 5103 DES PLAINES IL 60017-5103 AI3 CENTRAL STATES HEALTH AND WELFARE TEAMCARE P.O. 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BOX 4065 MONROE LA 71211-4065 WF* CERTIFIED LIFE INS 14724 VENTURA BLVD SHERMAN OAKS CA 91403 W51 CERTIFIED LIFE INS CO CLAIM DEPT 4800 N KENNETH AVE CHICAGO IL 60630 D32 CERTIFIED LIFE INS CO P O BOX 650209 DALLAS TX 75265-0209 LE* CHAMPION PARTS P O BOX 579 HOPE AR 70812 0E* CHAMPUS CLAIMS PROCESSING TRICARE PRIME/FHF P O BOX 8999 MADISON WI 53708-8999 GN9 CHAMPUS TRICARE WPS TRICARE FOR LIFE PO BOX 7890 MADISON WI 53707-7890 CJ4 CHAMPUS TRICARE PO BOX 7031 CAMDEN SC 29020 BR6 CHAMPVA CENTER ATTN CLAIMS P O BOX 469064 DENVER CO 80246-9064 EW2 CHAMS CHILD HEALTH ALLIANCE P O BOX 845 BRENTWOOD TN 37027 T44 CHARTER BENEFIT ADMINISTRATOR P O BOX 1328 FRANKLIN TN 37065-1328 TM* CHARTER NATIONAL INSURANCE 8301 MARYLAND AVENUE ST LOUIS MO 63105 EZ6 CHATWINS HEALTHCARE ADM 300 WEYMAN PLAZA SUITE 305 PITTSBURGH PA 15236 BE8 CHER A BUMP ASSOC P O BOX 18108 OKLAHOMA CITY OK 73154 HQ0 CHEROKEE INSURANCE COMPANY PO BOX 159 WARREN MI 48090 QH* CHEROKEE NATION ENTERPRISE PO BOX 3028 TULSA OK 74101 F1* CHICAGO HEALTH AND WELFARE FUND LOCAL 245 332 SOUTH MICHIGAN AVENUE CHICAGO IL 60604 BO7 CHICAGO METALLIC CORP CRESCO STEEL PO DRAWER 1409 BENTON AR 72018 G47 CHIROPRACTIC BENEFITS TRUS INSURANCE PROGRAM PO BOX 1326 FORT WORTH TX 76101 H03 CHOICE CARE PO BOX 3188 CINCINNATI OH 45201 II8 CHOICE NET INTERCARE P O BOX 76149 COLORADO SPRINGS CO 80976 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 29 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------BK3 CHOICE PLUS P. O. BOX 36007 MINNEAPOLIS MN 55435-6007 L58 CHRISTIAN BROTHERS EMPLOYE BENEFIT TRUST 1205 WINDHAM PARKWAY ROMEOVILLE IL 60446-1693 FS2 CHRISTIAN CARE MEDI SHARE CCMS PO BOX 674 STERLING IL 61081 HB5 CHRISTIAN FIDELITY INS CO P.O. BOX 44990 MADISON WI 53744 ZZ* CHRISTIAN FIDELITY LIFE INSURANCE COMPANY 316 DALLAS HIGHWAY WAXAHACHIE TX 75165 T84 CHRISTIAN HOSPITALIZATION P O BOX 336 MONTEZUMA KS 67867 M7* CHRISTIAN ORGANIZATION MEDICAL SOCIETY P O BOX 18752 FORT WORTH TX 76118 HP1 CHRISTUS DENTAL PO BOX 1339 MINNEAPOLIS MN 55440 Q72 CIBA GEIGY CORP 444 SAW MILL RIVER RD ARDSLEY NY 10502 SH* CIGNA PO BOX 188002 CHATTANOOGA TN 37422-8002 XL* CIGNA PO BOX 188007 CHATTANOOGA TN 37422-8007 HC4 CIGNA FEDEX PPO P.O. BOX 5909 SCRANTON PA 18505 FZ6 CIGNA 200 REGENCY EXECUTIVE PARK DRIVE CHARLOTTE NC 28233 GC4 CIGNA PO BOX 188036 CHATTANOOGA TN 37422 GC1 CIGNA PO BOX 188037 CHATTANOOGA TN 37422 GL4 CIGNA PO BOX 3077 BOURBONNAIS IL 60914 GJ4 CIGNA PO BOX 5200 SCRANTON PA 18505 GD2 CIGNA PO BOX 1068 VISALIA CA 93279 FX1 CIGNA PO BOX 1976 BOURBONNAIS IL 60914-5003 FW9 CIGNA PO BOX 962 BRISTOL CT 06011-0962 FW8 CIGNA PO BOX 10397 DES MOINES IA 50306-0397 FW7 CIGNA PO BOX 8012 PLAINVILLE CT 06062-8012 FW6 CIGNA PO BOX 182331 COLUMBUS OH 43218-2331 FW5 CIGNA PO BOX 31353 RICHMOND VA 23294-1353 FW4 CIGNA PO BOX 33638 CHARLOTTE NC 28233-3638 FW3 CIGNA 4025 WEST MINERAL KING VISALIA CA 93277-1631 FW2 CIGNA PO BOX 15553 WILMINGTON DE 19850 FW1 CIGNA PO BOX 16672 COLUMBUS OH 43216-6672 FV9 CIGNA PO BOX 9018 SHERMAN TX 75060-6018 FN4 CIGNA P O BOX 46270 EDEN PRAIRE MN 55344 CS1 CIGNA P O BOX 68947 18003313287 INDIANAPOLIS IN 46268 CS8 CIGNA P O BOX 188034 18003341033 CHATTANOOGA TN 37422-8034 HL7 CIGNA DENTAL PO BOX 188045 CHATTANOOGA TN 37422 S79 CIGNA EQUICOR EAGLE WINGS IND 400 SHELHOUSE DR RANTOUL IL 61866 V18 CIGNA ETHIX MIDWEST 8500 MORMANDALE LAKE RD BLOOMINGTON MN 55437 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 30 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------BI5 CIGNA HEALTH PLAN P O BOX 2125 GLENDALE CA 91209 BQ7 CIGNA HEALTHCARE P O BOX 7100 WOOLRIDGE IL 60517-7100 BG6 CIGNA HEALTHCARE P O BOX 590 RICHMOND VA 23205-0590 BG1 CIGNA HEALTHCARE 101 S WEBB ROAD SUITE 200 WICHITA KS 67202 BE3 CIGNA HEALTHCARE P O BOX 3050 EASTON PA 18043-3050 CO* CIGNA HEALTHCARE P O BOX 12001 CHATTANOOGA TN 37401 CM9 CIGNA HEALTHCARE PO BOX 978 BRISTOL CT 06011 CM* CIGNA HEALTHCARE P O BOX 12830 WILMINGTON DE 19850 CL2 CIGNA HEALTHCARE P O BOX 8200 LONDON KY 40742-8200 CJ6 CIGNA HEALTHCARE P O BOX 182352 COLUMBUS OH 43218 CF4 CIGNA HEALTHCARE P O BOX 219900 HOUSTON TX 77218-9900 CA5 CIGNA HEALTHCARE PO BOX 188031 CHATTANOOGA TN 37422 B71 CIGNA HEALTHCARE P O BOX 182546 COLUMBUS OH 43218-2546 BU4 CIGNA HEALTHCARE PO BOX 188023 CHATTANOOGA TN 37422 BA6 CIGNA HEALTHCARE P.O. BOX 10392 DES MOINES IA 50306 BA4 CIGNA HEALTHCARE P O BOX 9318 SHERMAN TX 75091-9318 BA2 CIGNA HEALTHCARE PO BOX 9304 SHERMAN TX 75091 AX1 CIGNA HEALTHCARE 2502 ROCKY POINT RD SUITE 400 TAMPA FL 33607 A62 CIGNA HEALTHCARE P O BOX 2307 PITTSBURGH PA 15230-2307 A61 CIGNA HEALTHCARE PO BOX 8014 PLAINSVILLE CT 06062 AK3 CIGNA HEALTHCARE PO BOX 188008 CHATTANOOGA TN 37422-8006 AI1 CIGNA HEALTHCARE PO BOX 188027 CHATTANOOGA TN 37422-8027 AG8 CIGNA HEALTHCARE P O BOX 7378 PHILADELPHIA PA 19101 AV6 CIGNA HEALTHCARE P O BOX 182544 COLUMBUS OH 43218-2544 AU2 CIGNA HEALTHCARE P O BOX 9013 SHERMAN TX 75091-9310 AT9 CIGNA HEALTHCARE VISALIA CLAIMS PO BOX 5034 VISALIA CA 93278 AS2 CIGNA HEALTHCARE P O BOX 9337 SHERMAN TX 75091 AG2 CIGNA HEALTHCARE UTC SERVICE CENTER P O BOX 4010 FARMINGTON CT 06034 AE7 CIGNA HEALTHCARE BUNGE CORP PO BOX 182565 CHATTANNOGA TN 37422 AA8 CIGNA HEALTHCARE P O BOX 77350 ATLANTA GA 30309 AA3 CIGNA HEALTHCARE P O BOX 10367 DES MOINES IA 50306 X81 CIGNA HEALTHCARE P O BOX 9076 MELVILLE NY 11747-9076 X62 CIGNA HEALTHCARE EQUITABLE P O BOX 34336 CHARLOTTE NC 28234 X59 CIGNA HEALTHCARE P O BOX 32876 CHARLOTTE NC 28232 X49 CIGNA HEALTHCARE CONNECTICUT GENERAL P O BOX 3316 STATION D ALBUQUERQUE NM 87190 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 31 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------Y6* CIGNA HEALTHCARE P O BOX 32200 PHOENIX AZ 85064 Y18 CIGNA HEALTHCARE PO BOX 850 JFK AIRPORT STATION JAMAICA NY 11430 0A* CIGNA HEALTHCARE P O BOX 9341 SHERMAN TX 75091-9341 Z83 CIGNA HEALTHCARE P O BOX 3100 BOURBONNAIS IL 60914 Z5* CIGNA HEALTHCARE PO BOX 10307 GREENSBORO NC 27404 ZA* CIGNA HEALTHCARE P O BOX 29000 ATLANTA GA 30359 Y95 CIGNA HEALTHCARE P O BOX 2300 PITTSBURG PA 15230-2300 Y81 CIGNA HEALTHCARE PO BOX 188021 CHATTANOOGA TN 37422-8021 U93 CIGNA HEALTHCARE P O BOX 85903 SAN DIEGO CA 92186-5903 U23 CIGNA HEALTHCARE P O BOX 3025 BOURBONNAISE IL 60914 W72 CIGNA HEALTHCARE P O BOX 182014 COLUMBUS OH 43218 S64 CIGNA HEALTHCARE GROUP CLAIMS P O BOX 15124 WILMINGTON DE 19850-5124 T60 CIGNA HEALTHCARE 3M MEDICAL PLAN P O BOX 64143 ST PAUL MN 55164 T50 CIGNA HEALTHCARE 263 RT 17K 2ND FLOOR NEWBURGH NY 12550 T27 CIGNA HEALTHCARE CONNECTICUT GEN SERV CTR P O BOX 5038 VISALIA CA 93278-5038 T12 CIGNA HEALTHCARE P O BOX 2005 FARMINGTON CT 06032 S81 CIGNA HEALTHCARE P O BOX 9317 DES MOINES IA 50306 R7* CIGNA HEALTHCARE P O BOX 968 BRISTOL CT 06010 P76 CIGNA HEALTHCARE P O BOX 2V RICHMOND VA 23205 Q97 CIGNA HEALTHCARE P O BOX 419 CINCINNATI OH 45202 Q92 CIGNA HEALTHCARE P O BOX 50000 ATLANTA GA 30359 LO* CIGNA HEALTHCARE NFL PLAYERS MEDICAL P O BOX 34337 CHARLOTTE NC 28234-4337 K12 CIGNA HEALTHCARE P O BOX 24005 FRESNO CA 93779 KT* CIGNA HEALTHCARE DENTAL CLAIMS P O BOX 15558 WILMINGTON DE 19850 J96 CIGNA HEALTHCARE P O BOX 10365 DES MOINES IA 50306 J25 CIGNA HEALTHCARE OF ARIZONA P.O. BOX 9321 SHERMAN TX 75091-9321 JF* CIGNA HEALTHCARE P O BOX 3310 STATION D ALBUQUERQUE NM 87190 OJ* CIGNA HEALTHCARE P O BOX 182717 COLUMBUS OH 43218-2717 MX* CIGNA HEALTHCARE P O BOX 3087 BOURBONNAIS IL 60914 MG* CIGNA HEALTHCARE P O BOX 33683 CHARLOTTE NC 28233 HC2 CIGNA HEALTHCARE P.O. BOX 188006 CHATTANOOGA TN 37422-8006 G28 CIGNA HEALTHCARE P O BOX 2546 SHERMAN TX 75090 GU9 CIGNA HEALTHCARE PO BOX 1650 VISALIA CA 93279 GO7 CIGNA HEALTHCARE P O BOX 188020 CHATTANOOGA TN 37422 GO1 CIGNA HEALTHCARE P O BOX 15050 WILMINGTON DE 19850 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 32 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------GL3 CIGNA HEALTHCARE P O BOX 14621 LEXINGTON KY 40512 F50 CIGNA HEALTHCARE 201 INTERNATIONAL CIRCLE SUITE 300 HUNT VALLEY MD 21030 FL5 CIGNA HEALTHCARE PO BOX 188003 CHATTANOOGA TN 37422 FL2 CIGNA HEALTHCARE PO BOX 31552 CHARLOTTE NC 28231 FK2 CIGNA HEALTHCARE 1 800 654 9631 P O BOX 5008 VISALIA CA 93278-5008 FI8 CIGNA HEALTHCARE PO BOX 5019 VISALIA CA 93278 FH8 CIGNA HEALTHCARE PO BOX 188033 CHATTANOOGA TN 37422-8033 FH5 CIGNA HEALTHCARE PO BOX 182223 CHATTANOOGA TN 37422-7223 FF2 CIGNA HEALTHCARE PO BOX 188030 CHATTANOOGA TN 37422-8030 FE7 CIGNA HEALTHCARE 5005 LBJ FREEWAY SUITE 830 DALLAS TX 75244 FE* CIGNA HEALTHCARE RUAN TRANSPORTATION P O BOX 30151 LANSING MI 48909-7651 FV6 CIGNA HEALTHCARE P O BOX 188017 CHATTANOOGA TN 37422-8017 FS4 CIGNA HEALTHCARE PO BOX 188018 CHATTANOOGA TN 37422-8018 FR5 CIGNA HEALTHCARE PO BOX 9339 SHERMAN TX 75091-9339 FP2 CIGNA HEALTHCARE PO BOX 188014 CHATTANOOGA TN 37422 FP1 CIGNA HEALTHCARE PO BOX 10447 DES MOINES IA 50306 FO5 CIGNA HEALTHCARE PO BOX 188004 CHATTANOOGA TN 37422-8004 EY9 CIGNA HEALTHCARE P O BOX 16782 COLUMBUS OH 43216 EU7 CIGNA HEALTHCARE CITY OF PHOENIX P O BOX 9325 SHERMAN TX 75091 ES4 CIGNA HEALTHCARE P O BOX 3012 BOURBONNAIS IL 60914 ES2 CIGNA HEALTHCARE P O BOX 3099 BOURBONNAIS IL 60914 EQ3 CIGNA HEALTHCARE P O BOX 9313 SHERMAN TX 75091-9313 EO2 CIGNA HEALTHCARE P O BOX 129 ITASCA IL 60143 EN9 CIGNA HEALTHCARE DENTAL CLAIMS P O BOX 4029 FARMINGTON CT 06034 CT8 CIGNA HEALTHCARE P O BOX 800 UNIONVILLE CT 06085 CY8 CIGNA HEALTHCARE KRAFT CLAIMS P O BOX 10485 DES MOINES IA 50306 CW7 CIGNA HEALTHCARE DELTA AIRLINES CLAIMS P O BOX 15538 WILMINGTON DE 19850-5553 CP5 CIGNA HEALTHCARE ATTN BETTY ELIG SERV C315 900 COTTAGE GROVE ROAD HARTFORD CT 06152 CO6 CIGNA HEALTHCARE PO BOX 188029 CHATTANOOGA TN 37422 DG4 CIGNA HEALTHCARE 5500 CENEX DRIVE SUITE 100 INVER GROVE MN 55077 DG3 CIGNA HEALTHCARE P O BOX 9155 DES MOINES IA 50306 DE8 CIGNA HEALTHCARE 26877 NORTHWESTERN SUUITE 350 SOUTHFIELD MI 48034 DE7 CIGNA HEALTHCARE 1630 E SHAW AVE STE 106 P O BOX 24031 FRESNO CA 93779-4031 DC1 CIGNA HEALTHCARE 60 CHARLES LINDBERGH BLVD MITCHEL FIELD NY 11553 DB* CIGNA HEALTHCARE P O BOX 31066 CHARLOTTE NC 28231 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 33 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------C83 CIGNA HEALTHCARE P O BOX 4000 BOURBONNAISE IL 60914 C64 CIGNA HEALTHCARE P O BOX 5046 SOUTHFIELD MI 48086 C41 CIGNA HEALTHCARE P O BOX 10433 DES MOINES IA 50306 C24 CIGNA HEALTHCARE 600 E LAS COLINAS BLVD P O BOX 152036 IRVING TX 75015 EE8 CIGNA HEALTHCARE EQUICOR PO BOX 13011 MERRILLVILLE IN 46411 EK3 CIGNA HEALTHCARE 2220 PARKLAKE DRIVE ATLANTA GA 30345 EK4 CIGNA HEALTHCARE P O BOX 24867 NASHVILLE TN 37202 EM6 CIGNA HEALTHCARE P O BOX 34335 CHARLOTTE NC 28234-4335 EL8 CIGNA HEALTHCARE DANAHER CORP P O BOX 15408 WILMINGTON DE 19850-5408 EC9 CIGNA HEALTHCARE P O BOX 12035 CHATTANOOGA TN 37401 EB2 CIGNA HEALTHCARE CONN GEN SERV CENTER 1001 B MENAUL BLVD NE ALBUQUERQUE NM 87107 D41 CIGNA HEALTHCARE 21 HERITAGE PLAZA P O BOX 2100 BOURBONNAIS IL 60914 D26 CIGNA HEALTHCARE P O BOX 9361 SHERMAN TX 75091-9361 D17 CIGNA HEALTHCARE 12160 ABRAMS SUITE 211 DALLAS TX 75243 DS1 CIGNA HEALTHCARE 32 VALLEY ST P O BOX 969 BRISTOL CT 06010 DR9 CIGNA HEALTHCARE 1000 POLARIS PARKWAY COLUMBUS OH 43240-2005 DR8 CIGNA HEALTHCARE 600 TAYLOR ST SHERMAN TX 75090 DR7 CIGNA HEALTHCARE P O BOX 8019 PLAINSVILLE CT 06062 DQ1 CIGNA HEALTHCARE BOEING CO P O BOX 85455 SAN DIEGO CA 92186 DN2 CIGNA HEALTHSOURCE PROV P O BOX 30298 LANSING MI 48909-7798 DL9 CIGNA HEALTHSOURCE PROV P O BOX 21189 LANSING MI 48909 DJ4 CIGNA HEALTHSOURCE PROV DENTAL CLAIMS P O BOX 182559 CHATTANOOGA TN 37422-7559 DX3 CIGNA HEALTHSOURCE PROV P O BOX 188009 CHATTANOOGA TN 37422-8009 DT5 CIGNA HEALTHSOURCE PROV LEVI STRAUSS P O BOX 180149 CHATTANOOGA TN 37422-7537 DS9 CIGNA HEALTHSOURCE PROV P O BOX 40 6300 CINCINNATI OH 45240-6300 EK7 CIGNA HEALTHSOURCE PROV P O BOX 182571 CHATTANOOGA TN 37421 EI9 CIGNA HEALTHSOURCE PROV P O BOX 182575 CHATTANOOGA TN 37422 EF8 CIGNA HEALTHSOURCE PROV P O BOX 8911 BRISTOL TN 37621-8911 C18 CIGNA HEALTHSOURCE PROV P O BOX 2048 GASTONIA NC 28053 CZ5 CIGNA HEALTHSOURCE PROV P O BOX 188013 CHATTANOOGA TN 37422 DC8 CIGNA HEALTHSOURCE PROV P O BOX 5148 STATION B GREENVILLE SC 29606 CP2 CIGNA HEALTHSOURCE PROV RUBBERMAID 2180 BARLOW RD HUDSON OH 44224 FA4 CIGNA HEALTHSOURCE PROV P O BOX 28125 RALEIGH NC 27611-8125 S33 CIGNA HEALTHSOURCE PROV 1241 VOLUNTEER PARKWAY P O BOX 8902 BRISTOL TN 37620 S17 CIGNA HEALTHSOURCE PROV P O BOX 30289 LANSING MI 48909 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 34 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------S57 CIGNA HEALTHSOURCE PROV PANHANDLE EASTERN CORP P O BOX 182524 CHATTANOOGA TN 37422 S73 CIGNA HEALTHSOURCE PROV P O BOX 171806 MEMPHIS TN 38117 V3* CIGNA HEALTHSOURCE PROV P.O. BOX 40 6323 CINCINNATI OH 45240 U69 CIGNA HEALTHSOURCE PROV P O BOX 182519 CHATTANOOGA TN 37422-7519 Y65 CIGNA HEALTHSOURCE PROV BFI CLAIMS P O BOX 219788 HOUSTON TX 77218 AL1 CIGNA HEALTHSOURCE PROV BURLINGTON INDUSTRIES P.O. BOX 9900 GASTONIA NC 28053 AJ6 CIGNA HEALTHSOURCE PROV P O BOX 6185 STATION B GREENVILLE SC 29606 AX6 CIGNA HEALTHSOURCE PROV LOWES EMPLOYEE HEALTH PLA P.O. BOX 7500 GASTONIA NC 28053 BD* CIGNA HEALTHSOURCE PROV CAMPBELL SOUP COMPANY P O BOX 182530 CHATTANOOGA TN 37422-7503 BJ6 CIGNA HEALTHSOURCE PROV P O BOX 40 6200 CINCINNATI OH 45240-6200 Z1* CIGNA HLTH PLAN OF FLORIDA 2603 MAITLAND CENTER PKWY SUITE 204B MAITLAND FL 32751 IH8 CIGNA VOLUNTARY P O BOX 5570 PHOENIX AZ 85051 HO5 CIMARRON HEALTH PLAN 8801 HORIZON BOULEVARD ALBUQUERQUE NM 87113 EN7 CINTAS PARTNERS MEDICAL BENEFIT PROGRAM P O BOX 145801 CINCINNATI OH 45250-5801 Y17 CITIZEN SECURITY LIFE INS PO BOX 436149 LOUISVILLE KY 40253-6149 BI9 CITIZENS BANK 100 W WASHINGTON JONESBORO AR 72401 BR5 CITIZENS BANK TRUST FUND PO BOX 469 VAN BUREN AR 72956 IF9 CITIZENS GROUP 12910 SHELBEVILLE LOUISVILLE KY 40243 EU9 CITIZENS INSURANCE CO OF AMERICA P O BOX 149151 AUSTIN TX 78714 H36 CITIZENS SECURITY INS CO P O BOX 3010 FRANKFORT KY 40603 CL3 CITY OF BARLETT 6400 STAGE ROAD BARLETT TN 38134 BE1 CITY OF DALLAS EMPLOYEE BENEFITS P O. BOX 15230 DALLAS TX 75201 DI1 CITY OF LAFAYETTE GROUP INSURANCE P O BOX 4017C LAFAYETTE LA 70502 W92 CITY OF LONGVIEW 300 W COTTON ST LONGVIEW TX 75601 P13 CITY OF SANTA FE EMP BENF GLEN SLAUGHTER ASSC ADM P O BOX 9054 SANTA FE NM 87504 BW6 CLAIM MANAGEMENT SERVICES P O BOX 10888 GREEN BAY WI 54307-0888 CZ2 CLAIMS ADMINISTRATIVE SERVICES P O BOX 7500 TYLER TX 75711 NB* CLAIMS ADMINISTRATIVE SERV STUDENT INSURANCE P O BOX 3968 BOCA RATON FL 33427-3968 FA6 CLAIMS DEVELOPEMENT CORP 1575 SAN IGNACIO SUITE 402 CORAL GABLES FL 33146 DT8 CLAIMSWARE MANAGEMED SINGER RETIREE VEBA TRUST P O BOX 17264 GREENVILLE SC 29606-8264 E71 CLALLAN COUNTY PHYSICIANS P O BOX 1307 PORT ANGELES WA 98362 Z55 CLAY CO ELECTRIC CO OP COR BENEFIT SECTION P.O. 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BOX 3169 DANBURY CT 06813 CP4 HRM CLAIM MANAGEMENT INC PO BOX 9410 MINNEAPOLIS MN 55440-9410 FM8 HRM CLAIM MGMT INC PO BOX 1181 MINNEAPOLIS MN 55440-1181 L46 HUGHES AIRCRAFT P O BOX 3310 FULLERTON CA 92634 R48 HUMANA CLAIMS OFFICE P O BOX 14635 LEXINGTON KY 40512-4635 CE9 HUMANA CLAIMS OFFICE PO BOX 14601 LEXINGTON KY 40512-4601 HU2 HUMANA DENTAL PLANS PO BOX 14611 LEXINGTON KY 40512-4611 D87 HUMANA EMPLOYERS HEALTH 1100 EMPLOYERS BLVD GREEN BAY WI 54344 CE2 HUMANA EMPLOYERS HEALTH PO BOX 14610 LEXINGTON KY 40512-4610 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 64 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------CJ1 HUMANA HEALTH CARE PO BOX 14603 LEXINGTON KY 40512-4603 CN3 HUMANA HEALTH CARE PLAN 222 S RIVERSIDE PLAZA SUITE 1051 CHICAGO IL 60606 T40 HUMANA HEALTH CARE PLANS P O BOX 2180 LOUISVILLE KY 40201-2180 D99 HUMANA HEALTH INSURANCE CO OF FLORIDA P O BOX 19080 F JACKSONVILLE FL 32245-9080 I61 HUNT AND TAYLOR P O BOX 291927 NASHVILLE TN 37229 UK* HUNT DREADER ASSOC INC DOLLAR GENERAL CORP 427 BEECH STREET SCOTTSVILLE KY 42164 H9* HYATT CORP HOSPITAL EXPENSE BENEFIT PLAN 939 RIDGELAKE BLVD MEMPHIS TN 38117 BT* HYDE INSURANCE COMPANY 1991 CORPORATE AVENUE MEMPHIS TN 38132 E39 HYTROL GROUP MEDICAL PLAN 2020 HYTROL DRIVE JONESBORO AR 72401 J72 I D S LIFE INSURANCE CO PO BOX 499 MINNEAPOLIS MN 55440 D55 I D S PLAN SERVICE BOX 30086 TAMPA FL 33630-3086 I31 I R M C P.O. 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BOX 52868 SHREVEPORT LA 71135 K38 IMASCO SUITE 300 3RD FLOOR ONE WOODLAWN CHARLOTTE NC 28217 FR4 INCENTUS BENEFITS PO BOX 8902 WICHITA KS 67208 J56 INDEPENDENT ADMIN CO 10801 WAYZATA BLVD MINNETONKA MN 55343 EB8 INDEPENDENT INS AGENT P O BOX 1326 FORT WORTH TX 76101-1326 AV* INDEPENDENT LIFE AND ACCIDENT INS CO ONE INDEPENDENT DRIVE JACKSONVILLE FL 32276 B66 INDEPENDENT LIFE INSURANCE 1610 WEST 3RD PO BOX 1191 LITTLE ROCK AR 72203 H69 INDIANA MANUF ASSOCIATES I P.O. 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BOX 19108 RALEIGH NC 27619 HL4 INTERAMERICANS INSURANCE PO BOX 9510 WITCHITA KS 67277 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 66 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------AI8 INTERCARE HEALTH PLANS P.O. 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BOX 619930 DFW AIRPORT TX 75261-9930 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 67 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------B48 JAMES BENEFITS PO BOX 987 WHEAT RIDGE CO 80034-0987 A97 JAMES BENEFITS 350 GLENBOROUGH DR SUITE 100 HOUSTON TX 77067-3699 R60 JAMES RIVER CORP P O BOX 428 FT SMITH AR 72902 T33 JAN RIDGE INSURANCE 33 W MISSISSIPPI MARIANNA AR 72360 Z64 JASON INCORPORATED HEATH AND WELFARE PLAN 5199 NORTH MINGO RD TULSA OK 74117 FY8 JAY N TOLLEY ATTORNEY 323 SPRING STREET P O BOX 728 FAYETTEVILLE AR 72702 GH3 JAY SCHOLTENS ATTORNEY AT LAW P.O. 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BOX 260957 PLANO TX 75026 IO4 PAN AMERICAN LIFE PO BOX 981644 EL PASO TX 79998-1644 EA4 PAN AMERICAN LIFE INS P O BOX 30324 TAMPA FL 33630 CQ8 PAN AMERICAN LIFE INS CO 111 WESTWOOD PL SUITE 110 BRENTWOOD TN 37027-5021 I43 PAN AMERICAN LIFE INS CO P.O. 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BOX 449 VAN BUREN AR 72956 FT8 USAA BALDOR ELECTRIC PO BOX 34050 LITTLE ROCK AR 72203 T91 USAA LIFE INSURANCE CO 9800 FREDERICKSBURG ROAD USAA BLDG SAN ANTONIO TX 78288-0346 AF5 USABLE LIFE INSURANCE CO P O BO 1650 LITTLE ROCK AR 72203 FJ2 USI ADMINISTRATORS P O BOX 1539 1 800 546 2550 FORT WORTH TX 76101 CC7 USI ADMINSTRATORS PO BOX 16579 SAVANNAH GA 31416 D93 UTAH PUBLIC EMPLOYEES HEALTH PROGRAM 540 EAST 200 SOUTH SALT LAKE CITY UT 84102 AH2 VALLEY CLERKS TRUST FUND 2200 FROFESSIONAL DRIVE SUITE 190 ROSEVILLE CA 95661 TK* VALMAC GENERAL DELIVERY WILSON STREET CLARKSVILLE AR 72830 ET8 VALUE BEHAVIORAL HEALTH P O BOX 1002 MERRIFIELD VA 22116 ET9 VALUE BEHAVORIAL HEALTH P O BOX 1570 MERRIFIELD VA 22116 U18 VALUE LINE CO 1205 N 10TH ST ARKADELPHIA AR 71923 FM1 VALUE OPTIONS P O BOX 140489 IRVING TX 75014-0489 BE7 VALUE OPTIONS PO BOX 1347 LATHAN NY 12110 AO6 VALUE RX 30445 NORTHWESTERN HWY SUITE 300 FARMINGTON HILLS MI 48334 EJ7 VALUE RX PRESCRIPTION DRUG PLAN P O BOX 421150 PLYMOUTH MN 55442-1050 HC1 VANTAGE HEALTH PLAN 130 DESIARD ST STE 300 MONROE LA 71201-7363 H30 VARCO PRUDENTIAL BUILDING P O BOX 6868 PINE BLUFF AR 71611 T5* VARIABLE PROTECTION ADMINT 7123 PEARL RD CLEVELAND OH 44130 V39 VEBA BENEFIT DEPT 3RD AVE AND PEARL PARAGOULD AR 72450 HT9 VENTURA CITY HEALTH 2220 EAST GONZALES ROAD SUITE 210B VENTURA CA 93036 M47 VERMONT AMERICAN CORP P O BOX 1759 CINCINNATI OH 45201 AL3 VERY BEST BAKING CO 1111 E. 8TH MILE FERNDALE MI 48220 HO2 VETERAINS ASSOCIATION 1100 NORTH COLLAGE FAYETTEVILLE AR 72703 W7* VFW INSURANCE DEPARTMENT 406 WEST 34TH STREET KANSAS CITY MO 64111 Q64 VIC WEST STEEL PO BOX 6280 SPRINGDALE AR 72766 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 125 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------C45 VICKERS GROUP 400 E LINCOLN AVE SEARCY AR 72143 EZ1 VIGORTONE PMAG PRODUCTS CLAIMS ADMINISTRATOR P O BOX 5769 LAFAYETTE IN 47903-5769 FR6 VISION SERVICE PLAN PO BOX 997100 SACRAMENTO CA 95899-7100 AA2 VISION SERVICE PLAN P O BOX 28639 DALLAS TX 75228-0639 GV1 VISION SERVICE PLAN PO BOX 997105 SACRAMENTO CA 95899 FR2 VISSION CARE PLAN 1511 N WESTSHORE BLVD SUITE 1000 TAMPA FL 33607 GJ8 VISTA HEALTHPLAN PO BOX 819006 HOLLYWOOD FL 33081 IH3 VIVA HEALTH INC 1222 14TH AVENUE SOUTH BRIMINGHAM AL 35205 G11 VIVIAN INDUSTRIAL PLASTICS P O BOX 232 VIVIAN LA 71082 W74 VIVIAN M RUFFIN 310 S WOOD STUTTGART AR 72160-4221 CQ9 VOLUNTARY BENEFITS INTER P O BOX 830626 BIRMINGHAM AL 35283-0626 M9* VULCAN LIFE INSURANCE CO P O BOX 1886 BIRMINGHAM AL 35201 H81 W H P 100 2ND AVE 11TH FLOOR ST PETERSBURG FL 33701 AL2 W J JONES COMPANIES THREE STATES SUPPLY 1979 MARCUS AVE LAKE SUCCESS NY 11042 L43 W M BARR AND CO 2105 CHANNEL AVENUE MEMPHIS TN 38100 Y68 WABASH FIBER BOX COMPANY HEALTH CARE BENEFITS P.O. BOX 1540 JONESBORO AR 72403 FN* WABASH LIFE INS CO 2929 NORTH MERIDIAN ST INDIANAPOLIS IN 46208 CH* WAL MART CLAIMS ADM GROUP HEALTH PLAN 922 W WALNUT STE A ROGERS AR 72756-3206 HG9 WALGREENS PO BOX 545 DEERFIELD IL 60015 F30 WALTON BANK GROUP REARICH PO BOX 400073 DALLAS TX 75240 X93 WARREN AND ASSOCIATES 2100 S BROADWAY SUITE 101 LITTLE ROCK AR 72206 CK3 WASH NAT GROUP HEALTH INS SOUTH CENTRAL REGIONAL 106 PARK PLACE SUITE 101 COVINGTON LA 70433 CU3 WASHINGTON AREA CARPENTER 6196 OXON HILL SUITE 500 OXON HILL MD 20745 P35 WASHINGTON DC GROUP CLM CT 5900 PRINCESS GARDEN PKWY STE 500 LANHAM MD 20706 EU8 WASHINGTON EMPLOYERS TRUST P O BOX 12068 SEATTLE WA 98102 AY7 WASHINGTON NATIONAL P O BOX 740 WHITE WATER WI 53190 T53 WASHINGTON NATIONAL 303 N MAIN ST ROCKFORD IL 61101-1018 R90 WASHINGTON NATIONAL INS ADMINISTRATIVE OFFICES 4850 STREET RD TREVOSE PA 19049-8002 CQ5 WASHINGTON NATIONAL INS CO 2600 N CENTRAL SUITE 400 PHOENIX AZ 85004 Y90 WASHINGTON NATIONAL INSURA 3348 FONTAINE ROAD MEMPHIS TN 38116 LX* WASHINGTON NATL INSURANCE 1630 CHICAGO AVE P O BOX 3071 EVANSTON IL 60201 S84 WASTE MANAGEMANE INC HEALTH BENEFIT PLAN 6300 W 4TH AVE PINE BLUFF AR 71602 T43 WASTE MANAGEMENT P O BOX 2408 NORCROSS GA 30091 Y46 WASTE MANAGEMENT HEALTH BENEFIT PLAN 100 GLENBOROUGH SUITE 500 HOUSTON TX 77067 UG* WATER TRANSPORT INC 50 CRESTWOOD EXECUTIVE BLDG STE 501 CRESTWOOD MO 63126 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 126 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------EC8 WATKINS ASSOCIATED IND P O BOX 1738 ATLANTA GA 30301-1738 GI3 WAUSAU BENEFITS PO BOX 7050 MIDDLETOWN NY 10940-7050 GX1 WAUSAU BENEFITS P O BOX 8014 WAUSAU WI 54402-8014 GW1 WAUSAU BENEFITS PO BOX 8031 WAUSAU WI 54402-8031 DV5 WAUSAU BENEFITS INC PO BOX 8079 WAUSAU WI 54402-8079 FP3 WAUSAU INSURANCE PO BOX 8032 WAUSAU WI 54402-8032 Y45 WAUSAU INSURANCE CO PO BOX 8092 WAUSAU WI 54402-8092 H43 WAVERLEY GROUP INC PO BOX 12000 JACKSON MS 39236-2000 I26 WAYNE FARMS INSURANCE DEPT P.O. BOX 909 DANVILLE AR 72833 IJ0 WEB TPA P O BOX 99906 GRAPEVINE TX 76009-9706 FS8 WEB TPA PO BOX 536269 GRAND PRAIRIE TX 75053 AQ8 WEBB AND ASSOCIATES INSURANCE 530 N. COLLEGE FAYETTEVILLE AR 72701 BR2 WEBB WHEEL PRODUCTS INC 1111 E LAKE FRANCES DRIVE SILOAM SPRINGS AR 72761 XR* WEHCO MEDIA INCORPORATED BOX 2221 LITTLE ROCK AR 72203 GJ1 WELBORN HEALTH PLANS 421 CHESTNUT STREET EVANSVILLE IN 47713 A1* WELDON WILLIAMS AND LICK 711 NORTH A FORT SMITH AR 72901 M17 WELDON WILLIAMS LICK P O BOX 168 FORT SMITH AR 72902 D20 WELFARE AND PENSION SERVIC P O BOX C 34203 SEATTLE WA 98124 HH4 WELL CARE PO BOX 795184 SAN ANTONIO TX 77072 IO7 WELL FARGO TPA PO BOX 3262 CHARLESTON WV 25332 V47 WELL TECH BOX 623 VAN BUREN AR 00000 R24 WELL TECH INC 1000 LOUISIANA SUITE 2600 HOUSTON TX 77002 HJ6 WELLCARE P.O. BOX 25237 TAMPA FL 33622 I01 WELLDYNE RX PO BOX 4517 ENGLEWOOD CO 80155 N57 WELLMARK ADMINISTRATORS BAAI/AALFS P O BOX 9912 SIOUX CITY IA 51102 X79 WELLMARK ADMINISTRATORS BENEFIT ADMIN OF AMERICA P O BOX 9910 SIOUX CITY IA 51102 D95 WELLMARK ADMINISTRATORS BENEFIT ADM OF AMERICA P O BOX 9120 DES MOINES IA 50306 E93 WELLMARK ADMINISTRATORS BAAI P O BOX 9232 DES MOINES IA 50306 JT* WELLMARK BLUE CROSS BLUE SHIELD OF IOWA 636 GRAND AVE DES MOINES IA 50309-2502 GE9 WELLPOINT DENTAL SERVICES PO BOX 9085 OXNARD CA 93031 GE8 WELLPOINT PO BOX 4165 WOODLAND HILL CA 91365 HJ* WELLPOINT DENTAL SERVICES P O BOX 9125 OXNARD CA 93031-9125 GW7 WELLPOINT PHARMACY P O BOX 3249 TULSA OK 74101 GV2 WELLPOINT RX PO BOX 4458 CHICAGO IL 60680-4458 IO8 WELLS FARGO INSURANCE SERV 150 NORTH MICHIGAN AVE STE 3900 CHICAGO IL 60601 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 127 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------H07 WELLS FARGO TPA PO BOX 3262 CHARLESTON WV 25322 K69 WEST GENERAL INSURANCE CO PO BOX 2549 TULSA OK 74101 EH1 WEST LAKE GROUP P O BOX 1413 DUNCAN OK 73534-1413 FJ* WESTERN AMERICAN LIFE INS P O BOX 832687 RICHARDSON TX 75083 W81 WESTERN AMERICAN LIFE INS P O BOX 1788 AUSTIN TX 78767 K21 WESTERN AND SOUTHERN LIFE P O BOX 1119 CINCINNATI OH 45201 K18 WESTERN AR COUNSELING AND GUIDANCE CENTER 3111 SOUTH 70TH FORTH SMITH AR 72903 H51 WESTERN FEDELITY INSURANCE POBOX 901010 FT WORTH TX 76101 HW4 WESTERN HEALTH ADVANTAGE 1331 GARDEN HIGHWAY SUITE 100 SACRAMENTO CA 95833 S90 WESTERN LIFE INSURANCE P O BOX 64530 ST PAUL MN 55164-0530 QY* WESTERN LIFE INSURANCE CO P O BOX 64442 ST PAUL MN 55100 R55 WESTERN LOUISIANA LABORERS WELFARE FUND 4200 S1 10, SER. RD W134 METAIRIE LA 70001 FF8 WESTERN SOUTHERN LIFE BENEFITS DEPT P O BOX 5735 CINCINNATI OH 45201-5735 I56 WESTERN SOUTHERN LIFE 7405 N WESTERN AVE CHICAGO IL 60645 C23 WESTERN STATES ADMINISTRAT P O BOX 8082 FRESNO CA 93747 D83 WESTERN TEAMSTERS HLTH WLF NORTHWEST ADMINISTRATORS 2323 EASTLAKE AVE EAST SEATTLE WA 98102 N79 WESTERN UNION CORP ONE LAKE STREET UPPER SADDLE RIVER NJ 07458 L86 WESTERN US REGIONAL P O BOX 38058 TUSCON AZ 85740-8058 HP0 WESTLAKE FINANCIAL GROUP PO BOX 981805 EL PASO TX 79998-1805 PX* WESTLAKE GROUP HEALTHCARE BOX 16789 COLUMBUS OH 43216 G48 WESTLAND LIFE INSURANCE CO 1255 POST ST SAN FRANCISCO CA 94120 I69 WESTPHAL HEALTH 109 NORTH 6TH FORT SMITH AR 72901 KQ* WESTPORT BENEFITS INC P.O. BOX 66743 ST LOUIS MO 63166-6743 F64 WEYCO INC P O BOX 30132 LANSING MI 48907 N42 WHITAKER FURNITURE ATTN INSURANCE DEPT 409 REMINGTON STREET SEARCY AR 72143 SL* WHITE AND COMPANY 920 WEST SECOND ST P O BOX 2459 LITTLE ROCK AR 72203 LK* WHITE RIVER INDIAN FUND BOX 40 CUTTER AR 72626 S65 WHITE ROGERS CO P O BOX 2117 BATESVILLE AR 72503 BJ4 WI PREFERRED PROVIDER NETW WPPN 301 N BROADWAY STE 301 DEPERE WI 54115 C47 WILAMETTA INDUSTRIES P O DRAWER 1100 RUSTON LA 71270 CF1 WILLAMETTE INDUSTRIES C/O AETNA HEALTH PLANS P O DRAWER 190 MALVERN AR 72104 AF2 WILLAMETTE INDUSTRIES C/O AETNA 1235 NORTH 7TH STREET WEST MEMPHIS AR 72301 Y47 WILLAMETTE INDUSTRIES PO BOX 2667 FORT SMITH AR 72902 T79 WILLIAM AND GENICE HARLAN P O BOX 448 AUGUSTA AR 72006 L55 WILLIAM BUERGLER TRUST OFF FIRST NATL BANK OF FORT SMITH SIXTH AND GARRISON FORT SMITH AR 72902 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 128 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------FA5 WILLIS CORROON P O BOX 305154 NASHVILLE TN 37230-5154 BT7 WILLIS CORROON P O BOX 2697 WICHITA KS 67201 H73 WILSON INSURANCE 116 SOUTH ELM HOPE AR 71801 HV9 WINDSOR MEDICARE EXTRA PO BOX 269025 PLANO TX 75026 AX3 WINE AND ALLIED WORKERS UNION LOCAL 45 2918 N. WEST AVENUE FRESNO CA 93705 U20 WINN FLEX N TEXAS HEALTHCARE NETWK P O BOX 1540 FT WORTH TX 76101 AL4 WINSTON FURNITURE CO C/O JEFFERSON PILOT BOX 868 HALEYVILLE AL 35565-0868 Z81 WISCONSIN HEALTH ORGANIZTN CORP, 111 W. PLEASANT ST P.O. BOX 12359 MILWAUKE WI 53212 W88 WISCONSIN PHYSICIANS SER INS CO P O BOX 9 MADISON WI 53701 Z80 WISE COMPANY INC 5535 PLEASANT VIEW ROAD MEMPHIS TN 38134 CD8 WITTNER AND COMPANY ATTN JUDY WACHA P O BOX 11629 ST PETERSBURG FL 33733 EI3 WMS PRESCRIPTION DRUG PLAN 702 S W 8TH STREET BENTONVILLE AR 72716-9113 BT6 WOODMEN INSURANCE CO P O BOX 82288 LINCOLN NE 68501 HG6 WOODMEN OF THE WORLD ASSURED LIFE ASSOC. PO BOX 16960 CLEARWATER FL 33766 I07 WOODMEN OF THE WORLD ATTN CLAIMS P O BOX 2397 OMAHA NE 68103 KR* WOODMEN OF THE WORLD WOODMEN TOWER 1700 FARNHAM STREET OMAHA NE 68102 L30 WORLD HEALTH FOUNDATION P O BOX 45212 SUITE 282 BATON ROUGE LA 70896 FV4 WORLD INSURANCE PO BOX 2558 OMAHA NE 68103-2558 E78 WORLD INSURANCE CO P O BOX 3160 OMAHA NE 68103-0160 P8* WORLD MUTUAL HLTH INS CO OF PENNSYLVANIA 215 WEST CHURCH ROAD KING OF PRUSSIA PA 19406 T41 WORTHINGTON TRACTOR PARTS INC 1010 2ND AVE WORTHINGTON MN 56187 K27 WSTERN GROWERS ASSURANCE P O BOX 7240 NEWPORT AR 72658 F14 WYATTS CAFETERIA INC ATTN INSURANCE DEPT P O BOX 38388 DALLAS TX 75238 G41 YALE INDUSTRIALPRODUCTS IN PO BOX 1000 FORREST AR 72335 I6* YMM ADMINISTRATORS INC ALLIED PRODUCTS 170 BOULEVARD SE ATLANTA GA 30324 W44 ZAPATA OFF SHORE CO BENEFI P O BOX 2085 HOUSTON TX 77252 S5* ZEBA P O BOX 6000 NATICK MA 01760 BK9 ZEBA P. O. BOX 8092 LONDON KY 40742-8092 CB2 ZENITH ADMINISTRATORS 7645 METRO BLVD PO BOX 124 MINNEAPOLIS MN 55440-0124 EO6 ZENITH ADMINISTRATORS 12160 ABRAMS RD SUITE 211 DALLAS TX 75243 AV1 ZENITH ADMINISTRATORS 5421 SW 27TH ST OKLAHOMA CITY OK 73128-5805 BQ6 ZENITH ADMINISTRATORS INC 8700 TURNPIKE DR STE 200 WESTMINSTER CO 80030 R72 ZERO MOUNTAIN INC P O BOX 6209 FT SMITH AR 72906 C3* ZURICH INSURANCE COMPANY P O BOX 56466 HOUSTON TX 77256 UU* 1ST HEALTH DEPT BMN HOSP O REF VF FOR OTHER CLAIMS P O BOX 10907 SCOTTSDALE AZ 85271-0907 * - INDICATES SPACES IN RESOURCE CODE KEY REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 129 DATE: DECEMBER 27, 2015 TPL SUBSYSTEM TIME: 00:38:22 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE ---------------------------------------------------------------------------------------------------------------------------------HW6 1199 NATIONAL BENEFIT FUND 300 WEST 42ND STREET NEW YORK NY 10108-0933 EF5 21ST CENTURY HEALTH BENEFI 1760 MARKET STREET PO BOX 42930 PHILADELPHIA PA 19101 G96 55 PLUS BAPTIST HOSPITAL MEMMPHIS TN 38108 U24 65 SECURITY PLAN 3348 FONTAINE RD MEMPHIS TN 38116 U98 76 TRUCKSTOP P O BOX 15850 NO LITTLE ROCK AR 72231 * - INDICATES SPACES IN RESOURCE CODE KEY TOTAL CARRIERS REPORTED = 4485 *** END OF REPORT ***
