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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM


TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
J07 ALLIED NATIONAL P O BOX 247 ALPHARETA GA 30009-0247
BS6 ALLMERICA FINANCE P O BOX 79059 HOUSTON TX 77279-9059
BV1 ALLMERICA FINANCIAL 440 LINCOLN STREET BOX 1014 WORCESTER MA 01653-1014
DX5 ALLMERICA FINANCIAL 333 PIERCE RD SUITE 310 ITASCA IL 60143-3116
CD5 ALLMERICA FINANCIAL EMPLOYEE BENEFIT CLAIMS 440 LINCOLN ST BOX 1018 WORCESTER MA 01605-1959
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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J95 ALLSTATE 1510 A AIRPORT ROAD HOT SPRINGS AR 71913
UW* ALLSTATE 5500 INTERSTATE N PARKWAY ATLANTA GA 30328
SO* ALLSTATE 1230 RAYMOND RD P O BOX 2031 JACKSON MS 39205
A65 ALLSTATE PO BOX 26743 AUSTIN TX 78731
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GU8 AMERICAN ADMINISTRATIVE GROUP INC PO BOX 619012 DALLAS TX 75261-9012
N60 AMERICAN ADMINISTRATORS 4200 CORPORATE DR STE 114 P O BOX 65887 WEST DES MOINES IA 50265
BT9 AMERICAN ADMINSTRATIVE SER 2626 S. SHERIDAN STE 100 TULSA OK 74129
B24 AMERICAN AMICABLE LIFE INS PO BOX 1849 WACO TX 76703
N66 AMERICAN BAPTIST CHURCH MEDICAL PLAN 475 RIVERSIDE ROOM 1700 NEW YORK NY 10115
EQ7 AMERICAN BEHAVIORAL 7540 LBJ FREEWAY STE 800 DALLAS TX 75251
DF4 AMERICAN BENEFIT 7301 N BROADWAY OKLAHOMA CITY OK 73116-9061
QL* AMERICAN BENEFIT CORP 222 SOUTH PROSPECT PARK RIDGE IL 60068
RH* AMERICAN BENEFIT PLAN ADMINISTRATORS 3785 SOUTH 700 EAST SALT LAKE CITY UT 84106
U59 AMERICAN BENEFIT PLAN ADMINISTRATORS INC 4040 MCEWEN, STE 100 DALLAS TX 75244-5018
BT1 AMERICAN BENEFIT PLAN SOUTHWESTERN TEAMSTER 1430 E MISSOURI B 155 PHOENIX AZ 85014
A2* AMERICAN CAPITOL INSURANCE P O BOX 42814 HOUSTON TX 77242
Y72 AMERICAN COMMERCIAL LINES P.O. BOX 610 JEFFERSONVILLE IN 47130
N27 AMERICAN COMMUNITY INSURAN 39201 SEVEN MILE ROAD LIVONIA MI 48152
HM2 AMERICAN CONTINENTAL INS C P O BOX 2368 BRENTWOOD TN 37024-2368
IL4 AMERICAN CONTINENTAL INSUR P O BOX 5008 BRENTWOOD TN 37024-5008
G20 AMERICAN CONTINENTAL LIFE POBOX 413636 KANSAS CITY MO 64141
VM* AMERICAN CYANAMID COMPANY EMPLOYEE BENEFITS 30 ROCKERFELLER PLAZA NEW YORK NY 10000
Q85 AMERICAN DENTAL PROVIDERS P O BOX 34045 LITTLE ROCK AR 72201
DB1 AMERICAN EXCHANGE LIFE INS P O BOX 1530 DALLAS TX 75221-1530
BQ5 AMERICAN EXPRESS ATTN GROUP BENEFITS T7111 IDS TOWER 10 MINNEAPOLIS MN 55440
P38 AMERICAN FAMILY INS CO 2804 EAST 26TH ST SIOUX FALLS SD 57103
AH9 AMERICAN FAMILY MUTUAL INSURANCE COMPANY P.O. BOX 7430 MADISON WI 53783
AX* AMERICAN FIDELITY ASSURANC SUITE 605 LITTLE ROCK AR 72205
GE* AMERICAN FIDELTY 2000 CLASSEN CENTER P O BOX 25160 OKLAHOMA CITY OK 73125
0H6 AMERICAN FOREIGN SERVICE 1750 PENN AVE NW SUITE 1305 WASHINGTON DC 20006
H6* AMERICAN FOREIGN SERVICE 1750 PENN AVE NW SUITE 1305 WASHINGTON DC 20006
Y92 AMERICAN FREIGHTWAYS ATTN HEALTH CLAIMS DEPT P.O. BOX 840 HARRISON AR 72602-0840
BF* AMERICAN GENERAL PO BOX 10845 CLEARWATER FL 33757-8845
IA4 AMERICAN GENERAL CENTER P.O. BOX 305293 NASHVILLE TN 37250
Y9* AMERICAN GENRL LIFE AND AC HEALTH CLAIMS P O BOX 1500 NASHVILLE TN 37202-1500
VP* AMERICAN HEALTH ACCIDENT LIFE INSURANCE COMPANY P O BOX 490 ENNIS TX 75119
FX7 AMERICAN HEALTH ALLIANCE PO BOX 8530 KANSAS CITY MO 64114-0530
DU5 AMERICAN HEALTH AND LIFE INS COMPANY 307 W 7TH STREET STE 400 FORT WORTH TX 76113
ZC* AMERICAN HEALTH AND LIFE 509 FIRST NATIONAL BLDG EL DORADO AR 71730
* - 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 10
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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D49 AMERICAN HEALTH AND LIFE I 300 ST PAUL PLACE BALTIMORE MD 21202
DW6 AMERICAN HEALTH CARE PO BOX 1659 MARILYN HEIGHTS MO 63043
QU* AMERICAN HEALTH GROUP INC PO BOX 1500 MAUMEE OH 43537
L94 AMERICAN HEALTH NETWORK 198 COMMERCE CONWAY AR 72032
K46 AMERICAN HEALTH TRUST P O BOX 899 CLEARWATER FL 34615
C90 AMERICAN HEALTHCARE PROVID 222 MERCHANDISE MART PLAZ SUITE 1450 CHICAGO IL 60654-1299
FD9 AMERICAN HEALTHCARE TRUST P O BOX 3048 MEMPHIS TN 38173
HD5 AMERICAN HERITAGE LIFE INSURANCE COMPANY P O BOX 853916 RICHARDSON TX 75085-3916
RW* AMERICAN HERITAGE LIFE 1776 HERITAGE LIFE DR JACKSONVILLE FL 32224
X18 AMERICAN INCOME LIFE P O BOX 3018 LITTLE ROCK AR 72203
AN* AMERICAN INCOME LIFE P O BOX 2608 WACO TX 76797
CU4 AMERICAN INS CO OF TEXAS 777 MAIN ST SUITE 900 FORT WORTH TX 76102
T34 AMERICAN INS OF TEXAS P O BOX 2650 WACO TX 76702
H2* AMERICAN INST OF ARCHIT 18872 MCARTHUR BLVD SUITE 400 IRVINE CA 92715
YQ* AMERICAN INSURANCE CO PO BOX 660254 DALLAS TX 75266-0254
C29 AMERICAN INTEGRITY INSURAN 2 PENN PLAZA PHILADELPHIA PA 19102
J5* AMERICAN INTERNATIONAL P O BOX 200 TEXARKANA TX 75501
M41 AMERICAN INVESTOR LIFE INS FEWELL AND ASSOCIATES P O BOX 8212 LITTLE ROCK AR 72221
0IN AMERICAN LANTERN GROUP HIGHWAY 67 NORTH NEWPORT AR 72112
L50 AMERICAN LIBERTY LIFE INS 4962 FLORIDA BLVD SUITE 302 P O BOX 64626 BATON ROUGE LA 70896
VU* AMERICAN LIFE AND ACCIDENT INSURANCE P O BOX 1287 FORT WORTH TX 76101
G89 AMERICAN LIFE AND ACCIDENT P O BOX 1600 DALLAS TX 76101
0M4 AMERICAN LIFE AND CASUALTY P O BOX 398 ROGERS AR 72756
CZ4 AMERICAN LIFE CARE 1100 POYDRAS STREET SUITE 2600 NEW ORLEANS LA 70163-2602
R8* AMERICAN LIFE CASUALTY INS P O BOX 2507 FARGO ND 58108
P32 AMERICAN LIFE INS CO 208 S LASALLE ST SUITE 2070 CHICAGO IL 60604-1177
GA5 AMERICAN LIFECARE PO BOX 2843 WARMINSTER PA 18974
0Q2 AMERICAN MAJ FED AGNCY SERV IN P O BOX 17237 MEMPHIS TN 38117
N8* AMERICAN MEDICAL INTERNATI P O BOX 2178E COSTA MESA CA 92626
P94 AMERICAN MEDICAL SECURITY PO BOX 19032 GREEN BAY WI 54307-9032
S7* AMERICAN MUTUAL LIFE INS DEPT C1 A AND H GRP CLMS WAKEFIELD MA 01880
DH6 AMERICAN NATIONAL INS CO P O BOX 1790 GALVESTON TX 77553
DD* AMERICAN NATIONAL LIFE INS HEALTH CLAIMS DEPT P O BOX 1520 GALVESTON TX 77553-1520
HF9 AMERICAN NATIONAL LIFE INS ONE MOODY PLAZA GALVESTON TX 77550
HD2 AMERICAN PIONEER P O BOX 399127 CAMBRIDGE MA 02139-9127
* - 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 11
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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LU* AMERICAN PIONEER P O BOX 130 PENSACOLA FL 32591
CZ6 AMERICAN PIONEER LIFE INS P O BOX 3509 ORLANDO FL 38202-3509
J62 AMERICAN PIONEERS 12596 W BAYARD SUITE 400 LAKEWOOD CO 80228
GH1 AMERICAN PPO 3500 PARKWAY LANE NORCROSS GA 30092
FV8 AMERICAN PPO 1825 WALNUT HILL LANE SUITE 120 IRVING TX 75038
FI6 AMERICAN PREFERRED PROVIDE ORGANIZATION 8080 TRISTAR DR STE 100 IRVING TX 75063-2823
G56 AMERICAN PROFFESSIONAL POBOX 80441 INDIANAPOLIS IN 46280
TT* AMERICAN PUBLIC LIFE INS P O BOX 925 JACKSON MS 39205
SE* AMERICAN REPUBLIC INS CO ATTN CLAIMS P O BOX 1 DES MOINES IA 50334-0010
FR7 AMERICAN REPUBLIC INS CO PO BOX 2975 CLINTON IA 52733-2975
IL1 AMERICAN REPUBLIC INSURANC P O BOX 21670 EAGAN MN 55121-0670
XQ* AMERICAN SECURITY LIFE P O BOX 2341 SAN ANTONIO TX 78298
IJ2 AMERICAN SENTINEL INSURANC P O BOX 61140 HARRISBURG PA 17106-1140
E67 AMERICAN SERVICE LIFE INS P O BOX 470768 FT WORTH TX 76147-0768
L23 AMERICAN SMALL BUSINESSES POBOX 612663 DALLAS TX 75261-9990
MO* AMERICAN STANDARD LIFE AND ACCIDENT P O DRAWER 3248 ENID OK 73702-3248
XS* AMERICAN STATES INSURANCE 500 NORTH MERIDIAN STREET P O BOX 1636 INDIANAPOLIS IN 46206-1636
T81 AMERICAN TRANSPORTATION 4210 SHAWNEE MISSION PKWY SHAWNEE MISSION KS 66205
Q66 AMERICAN TRAVELERS LIFE 3220 TILLMAN DR BENSALEM PA 19020
A22 AMERICAN TRUST ADM P O BOX 87 SHAWNEE MISSION KS 60201
HW9 AMERICAN UNDERWRITERS INSU 6429 S TACOMA WAY TACOMA WA 98409
P88 AMERICAN UNITED LIFE 12377 MERIT DR DALLAS TX 75251
Q68 AMERICAN VETERINARY MED AS 55 E JACKSON BLVD 8TH FLR CHICAGO IL 60604
U83 AMERICAN WORKERS POST OFFICE UNION P O BOX 967 SILVER SPRINGS MD 20910
AA7 AMERICARE PO BOX 22118 LITTLE ROCK AR 72221
L68 AMERICARE P O BOX 1 DES MOINES IA 50334
HS7 AMERICAS CHOICE HEALTH PLA PO BOX 55690 KING OF PRUSSIA PA 19406
HD6 AMERICAS CHOICE HEALTH PLA P O BOX 922043 HOUSTON TX 77292
BX4 AMERICORPS FORMOST INSURANCE COMPANY PO BOX 1659 PORTLAND OR 97207
DH3 AMERICORPS PROGRAMS P O BOX 78308 INDIANAPOLIS IN 46278-8308
ED9 AMERICORPS VISTA PO BOX 33757 INDIANAPOLIS IN 46203-0757
IF3 AMERIHEALTH 1901 MARKET STREET PHILADELPHIA PA 19103-1480
M75 AMERITAS LIFE INS P O BOX 82520 LINCOLN NE 68501
N71 AMERON JACKSON LIFE INS P O BOX 9610 LITTLE ROCK AR 72219
E89 AMEX LIFE ASSURANCE P O BOX 2070 SAN RAFAEL CA 94912
* - 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 12
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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A56 AMOCO CORP STANDARD OIL OF INDIANA PERSONNEL RECORDS P O BOX 5738 CHICAGO IL 60680
S85 AMSTAR SUGAR CORP 316 KENT AVE BROOKLYN NY 11211
P56 AMW INDUSTRIES PO BOX 8200 LITTLE ROCK AR 72221
JV* AMY K CRISSUP IRREVOCABLE TRUST C/O C. TAB TURNER. 4702 W COMMERICAL, STE B3 NORTH LITTLE ROCK AR 72116
K40 ANCHOR ACCESS CHICAGO IL 60617
N70 ANDREW JACKSON LIFE INS 2829 LAKELAND DR PLZ 2000 P O BOX 5025 JACKSON MS 39296-5025
DS* ANGONAL INSURANCE CO 250 MIDDLEFIELD ROAD MENLO PARK CA 94025
P83 ANNUITY BOARD SOUTHERN BAP 1304 WALNUT HILL STE 220 IRVING TX 75038
MA* ANTHEM BC BS P O BOX 37780 LOUISVILLE KY 70233-7690
IF0 ANTHEM BCBS DENTAL SERVICES PO BOX 659444 SAN ANTONIO TX 78265
T38 ANTHEM BCBS COMMUNITY MUTUAL BCBS P O BOX 425 WORTHINGTON OH 43085
CV* ANTHEM BCBS P O BOX 220 INDIANAPOLIS IN 46206
CO8 ANTHEM BCBS AUTOMOTIVE BUSINESS DIV P O BOX 700 WORTHINGTON OH 43085
MU* ANTHEM BENEFIT ADM P O BOX 18197 COLUMBUS OH 43218-0197
V69 ANTHEM BENEFITS SERVICES P O BOX 101511 SAN ANTONIO TX 78201-9511
HU8 ANTHEM BLUE CROSS PO BOX 10888 GREEN BAY WI 54307
HQ3 ANTHEM BLUE CROSS PO BOX 4458 CHICAGO IL 60680-4458
GA1 ANTHEM BLUE CROSS BLUE SHIELD OF NEVADA 5250 S VIRGINIA STREET RENO NV 89502
H70 ANTHEM BLUE CROSS BLUE SHIELD OF VIRGINIA P.O. BOX 27401 RICHMOND VA 23279-7401
BG8 ANTHEM BLUE CROSS BLUE SHIELD OF NEW HAMPSHIRE 3000 GOFFS FALL RD MANCHESTER NH 03111-0001
CC4 ANTHEM BLUE CROSS BLUE SHI PO BOX 37180 LOUISVILLE KY 47233
EY3 ANTHEM BLUE CROSS BLUE SHI P O BOX 7051 INDIANAPOLIS IN 46207-7051
CI8 ANTHEM CLAIMS PO BOX 650342 DALLAS TX 75265-0342
GZ4 ANTHEM HEALTH 1188 FRANKLIN STREET SAN FRANCISCO CA 94109
J8* ANTHEM HEALTH AND LIFE INS OF NEW YORK P O BOX 6848 PISCATAWAY NJ 08855-6848
CR9 ANTHEM HEALTH CLAIMS P O BOX 650342 DALLAS TX 75265-0342
0H* ANTHEM HEALTH PARTNERS P O BOX 3856 JACKSON TN 38303-3856
BA* ANTHEM LIFE AND HEALTH P O BOX 536 PISCATAWAY NJ 08855-0536
T83 ANTHEM LIFE AND HEALTH INS P O BOX 956353 DULUTH GA 30136
OZ* ANTHEM LIFE AND HEALTH INS 341 PONCE DE LEON AVE NE ATLANTA GA 30308
Q54 ANTHEM LIFE AND HEALTH INS PO BOX 11111 FORT SCOTT KS 66701-7111
Q95 ANTHEM LIFE INS CO 425 CALIFORNIA ST SUITE 1206 SAN FRANCISCO CA 94104
Y10 ANTHEM LIFE INSURANCE CO PO BOX 6146 INDIANAPOLIS IN 46206
AI2 ANTHEM LIFE INSURANCE CO 828 W. TAFT AVENUE ORANGE CA 92665-4232
HS0 ANTHEM PRESCRIPTION MANAGE PO BOX 145433 CINCINNATI OH 45250
* - 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 13
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Y73 ANTHEN LIFE CO OF INDIANA ACORDIA FINANCIAL IND BEN P.O. BOX 26929 INDIANAPOLIS IN 46226-0929
DO8 AON CONSULTING P O BOX 15 WINSTON SALEM NC 27103
P23 AON SELECT 110 GIBRALTAR RD SUITE 116 HORSHAM PA 19044
GV* APPALACHIAN LIFE P O BOX 264F KNOXVILLE TN 37900
K63 APPALACHIAN NATIONAL P O BOX 3232 L R AR 72201
GX5 APS HEALTHCARE PO BOX 1246 ROCKVILLE MD 20849
P97 APWU HEALTH PLAN UNITED POSTAL WORKERS PO BOX 1358 GLEN BURNIE MD 21060
W84 APWUHP P O BOX340429 SACRAMENTO CA 95834-0429
X2* AR CARPENTERS HEALTH AND WELFARE FUND 1000 BURR RIDGE PKWY BURR RIDGE IL 60527
EJ4 AR LIFE AND HEALTH GUARANT ADMIN BY EOSHEALTH PO BOX 27148 TEMPE AZ 85285-7148
W68 AR METHODIST HOSP EE BENEFIT TRUST P O BOX 40619 INDIANAPOLIS IN 46240-0619
X11 AR OKLAHOMA GAS CORP P O BOX 17004 FORT SMITH AR 72919
V53 AR PIPE TRADES HEALTH AND WELFARE FUND P O BOX 82987 OKLAHOMA CITY OK 73148
V74 AR PREFERRED PROVIDER ORGANIZATION P O BOX 6608 PINE BLUFF AR 71611
R38 AR SHEET METAL WORKERS HEALTH AND WELFARE FUND BOX 190315 LITTLE ROCK AR 72219
PS* AR STATE COUNCIL OF CARPEN 1501 N UNIVERSITY SUITE 314 LITTLE ROCK AR 72207
QZ* ARAMARK UNIFORM SERVICES P O BOX 8826 PINE BLUFF AR 71611
Z46 ARANON CORPORATION 285 W. 74TH PLACE HIALEAH FL 33014
HG5 ARCADIAN REGIONAL CLAIMS PROCESSIN PO BOX 484537 COVINA CA 91723
AC9 ARCHER DANIEL MIDLAND CO P.O. BOX 1470 DECATUR IL 62525
X12 ARETHUSA ZAPTA OFF SHORE CO P O BOX 2085 HOUSTON TX 77252
A15 ARGIS 12103 INTERSTATE 30 310 EXECUTIVE COURT LITTLE ROCK AR 72209
FZ5 ARGUS PO BOX 419019 KANSAS CITY MO 64141
GX2 ARGUS HEALTH SYSTEMS INC P O BOX 416019 KANSAS CITY MO 64141
L32 ARGUS HEALTH SYSTEMS INC P O BOX 29177 SHAWNEE MISSION KS 66201
XZ* ARIZONA HEALTH PLAN P O BOX 5000 PHOENIX AZ 85002
C60 ARK BUILDERS AND CONTRACTO P O BOX 3198 LITTLE ROCK AR 72203
U38 ARK ELECTRIC COOPS INC P O BOX 194208 LITTLE ROCK AR 72219-4208
T80 ARK FOUNDATION FOR MEDICAL CARE INC P O BOX 2424 FT SMITH AR 72902
F51 ARK GLASS CONTAINER P O DRAWER 1717 JONESBORO AR 72403
W85 ARK LA MISS LABORERS WEL 1 RIVERFRONT PLACE SUITE 700 NORTH LITTLE ROCK AR 72114
TX* ARK POULTRY FEDERATION P O BOX 8212 LITTLE ROCK AR 72221
CA8 ARKANASAS MANAGED CARE PO BOX 8219 LITTLE ROCK AR 72221
PY* ARKANSAS BEST CORP BENEFITS DEPT P O BOX 10048 FORT SMITH AR 72917-0048
HN4 ARKANSAS BLUE CROSS BLUE SHIELD DENTAL P O BOX 1206 ELK GROVE IL 60009-1206
* - 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 14
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GR4 ARKANSAS COMMUNITY CARE PO BOX 4946 COVINA CA 91723
D27 ARKANSAS FARMERS UNION BOX 4309 ASHER STATION LITTLE ROCK AR 72214
DW9 ARKANSAS FIRST SOURCE P O BOX 2181 LITTLE ROCK AR 72203
Y11 ARKANSAS FREIGHTWAYS INC HEALTH INS CLAIMS DEPT PO BOX 840 HARRISON AR 72602-0840
H87 ARKANSAS HOSPITAL ASSOCIAT P O BOX 16707 JACKSON MS 39236-6707
ED5 ARKANSAS MANAGED CARE FIRST ALLMERICA FINANCIAL P O BOX 23803 LITTLE ROCK AR 72221-3803
HY9 ARKANSAS MUNICIPAL LEAGUE P.O. BOX 38 NORTH LITTLE ROCK AR 72115
H88 ARKANSAS NATIONAL LIFE 5800 WEST 12TH STREET LITTLE ROCK AR 72204
X78 ARKANSAS STATE POLICE HEALTH FUND PO BOX 5901 LITTLE ROCK AR 72215
T76 ARKANSAS STEEL ASSOCIATES PRINCIPAL FINANCIAL 2803 VAN DYKE RD NEWPORT AR 72112
C4* ARKANSAS VALLEY HEALTH BENEFIT PLAN 3595 UPHAM SUITE 100 WHEAT RIDGE CO 80033
B9* ARKHOLA DIVISION P O BOX 1627 FORT SMITH AR 72902
K39 ARKLA PRODUCTS CO P O BOX 1467 PARAGOULD AR 72451-1467
AY6 ARM LTD NORTHWEST 8199 SW NUMBUS BEAVERTON OR 97008
W53 ARMCO MED SERVICE CENTER DEPT WN 2 573 6740 NORTH HIGH ST WORTHINGTON OH 43085
HN* ARMOUR AND COMPANY P O BOX 258 MURFREESBORO AR 71958
F33 ARMOUR COMPANY PO BOX 22777 TEMPE AZ 85282
P55 AROMATIQUE INC 504 4TH HEBER AR 72543
CB3 ARQUEST P.O. BOX 3107 CAMDEN AR 71707
M77 ARROW AUTOMOTIVE NO 1 ARROW DR MORRILTON AR 72110
Q10 ARROW INDUSTRIES PO BOX 810489 DALLAS TX 75381
AD1 ARROW INDUSTRIES INC P.O. BOX 166 PARIS AR 72855
R45 ARVEST HEALTH TRUST P O BOX 809 ROGERS AR 72757
W36 ASARCO HEALTH PLAN 180 MAIDEN LANE NEW YORK NY 10038
X23 ASHGROVE CEMENT PLANT P O BOX 130 FOREMAN AR 71836
N56 ASHLAND MEDICAL PLANS P O BOX 30430 TAMPA FL 33630
G38 ASHLEY LIFE INS CO HAMBURG AR 71646
IJ6 ASI P.O. BOX 2510 ROCKVILLE MD 20847
JJ* ASO NORTH AMERICA 1718 INDIAN WOOD CIRCLE SUITE E MAUMEE OH 43537-4090
LT* ASO NORTH AMERICA P O BOX 1028 HOUSTON TX 77251
Y38 ASO NORTH AMERICAN P O BOX 4582 HOUSTON TX 77210-4582
BP1 ASR ADMIN SYSTEMS RESEARCH CO P O BOX 6392 GRAND RAPID MI 49516-6392
IB1 ASRM 505 SOUTH LENOLA ROAD SUITE 231 MOORESTOWN NJ 08057
IS* ASSN OF ARKANSAS COUNTIES 314 S VICTORY LITTLE ROCK AR 72201
C81 ASSOC BLDRS AND CNTRCTRS P O BOX 3198 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 15
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EV8 ASSOCIATED BENEFITS CORP P O BOX 71039 DES MOINES IA 50325
AO9 ASSOCIATED BUILDERS AND CONTRACTORS P.O.BOX N GRAND RAPIDS MI 49501
U63 ASSOCIATED DOCTORS 2504 MCCAIN PLACE SUITE 119 NO LITTLE ROCK AR 72116
P92 ASSOCIATED DOCTORS HEALTH 400 UNIV TOWERS BLDG LITTLE ROCK AR 72204
R65 ASSOCIATED LIFE METROPOLITAN 11219 FINANCIAL CTR PKWY LITTLE ROCK AR 72211
T77 ASSOCIATED LIFE INSURANCE 401 N EXECUTIVE DR BROOKFIELD WI 53005
EM3 ASSOCIATED THIRD PARTY ADM LOCAL ONE HEALTH BENEFITS P O BOX 4912 CHICAGO IL 60680-4912
L95 ASSOCIATION COMBINED TRUST 13601 PRESTON ROAD AT LBJ DALLAS TX 75240
UF* ASSOCIATION LIFE P O BOX 2976 MILWAUKEE WI 53201
C53 ASSOCIATION OF AR COUNTIES COUNTY COURT HOUSE BLYTHEVILLE AR 72315
L34 ASSOCIATION PLAN AIR SYSTEM 3721 PHYLLIS NORTH LITTLE ROCK AR 72118
HF2 ASSURANCE EMPLOYEE BENEFIT P O BOX 2940 CLINTON IA 72733-2940
HH2 ASSURANT HEALTH PO BOX 981602 EL PASO TX 79998
DO* ASSURANT HEALTH P.O. BOX 624 501 W MICHIGAN AVENUE MILWAUKEE WI 53201-0624
IN7 ASSURANT HEALTH ASA P O BOX 91604 LUBBOCK TX 79490
IB4 ASSURANT INSURANCE P.O. BOX 2806 CLINTON IA 52733-2806
FH2 ASSURE CARE OF ILLINOIS 340 QUADRANGEL DRIVE BOLINGBURG IL 60440
J41 ASSURED BENEFITS ADMINISTRATORS 4100 RIO BRAVO SUITE 211 EL PASO TX 79902
L84 ATCO RUBBER PRODUCTS GROUP BENEFIT PLAN 3007 CENTRAL DRIVE PLANT CITY FL 33567
FK9 ATENA US HEALTHCARE P O BOX 1858 BISMARCK ND 58502-1858
ZT* ATKINS INSURANCE COMPANY 5TH AND LOUISIANA LITTLE ROCK AR 72203
L12 ATKINS PICKLE CO 602 SE FIRST STREET P O BOX 158 ATKINS AR 72823
AO* ATLANTA LIFE INS CO 148 AUBURN AVENUE NE ATLANTA GA 30308
F9* ATLANTA LIFE INSURANCE P O BOX 289 MARSHALL TX 75679
P4* ATLANTIC AMERICAN LIFE P O BOX 190750 4370 PEACHTREE RD NE ATLANTA GA 31119
U33 ATLANTIC HOME TRUST P O BOX 1362 PISCATAWAY NJ 08855
S30 ATLANTIC RESEARCH CORP 5390 CHEROKEE AVE ALEXANDRIA VA 22312
GK2 ATLAS ADMINISTRATORS PO BOX 801234 DALLAS TX 75038
HL* ATLAS LIFE INSURANCE BOX 1919 TULSA OK 74102
AP1 ATS INC P.O. BOX 36 9503 LAMAR OLIVE BRANCH MS 38654
Z86 AUDIO TECHNIA C/O WOODMAN ACCIDENT LIFE 1221 COMMERCE DR STOW OH 44224
HS3 AULTCARE PO BOX 6910 CANTON OH 44706-0910
IB8 AUTOMATED BENEFIT SERVICES 8220 IRVING ROAD STERLING HEIGHTS MI 48312
BU1 AUTOMOTIVE PETROLEUM ALLIE EMPLOYEE WELFARE FUND 300 S. GRAND STE 232 ST LOUIS MO 63103
D38 AUTOMOTIVE WHOLESALERS OF P O BOX 788 DALLAS TX 78767
* - 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 16
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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T89 AUTOZONE BENEFITS DEPT 3030 POPLAR AVE MEMPHIS TN 38111
HO9 AUXIANT PO BOX 75008 CEDAR RAPIDS IA 52407-5008
GE4 AV MED 9400 SOUTH DADELAND BLVD MIAMI FL 33156
HL2 AVERA HEALTH PLAN P.O. BOX 381506 BIRMINGHAM AL 35238
HZ0 AVESIS THIRD PARTY ADMINIS PO BOX 7777 PHOENIX AZ 85011-7777
GP4 AVMA GROUP HEALTH AND LIFE PO BOX 8789 SCOTTSDALE AZ 85252-8789
F59 AVMA GROUP INS TRUST 55 E JACKSON BLVD CHICAGO IL 60604
VW* AVON REP GROUP INSURANCE 2700 W PLANO PKY PLANO TX 75075-8205
T59 AVONDALE GROUP INS P O BOX 2230 NEW ORLEANS LA 70176
E10 B C S INSURANCE 676 NORTH ST. CLAIR ST CHICAGO IL 60611
I76 B M A B MA TOWER P.O. BOX 419458 KANSAS CITY MO 64141
I50 B M A BOX 1520 IOWA CITY IA 52244
FD3 B M S 8725 W HIGGINS ROAD CHICAGO IL 60631
T61 BABB INC 850 RIDGE AVE PITTSBURG PA 15212-6095
FI3 BAC BUSINESS ADMIN CONSULTANT P O BOX 107 REYNOLDSBURG OH 43068-0107
BQ* BAKERS UNION LOCAL 363 1828 L STREET NW WASHINGTON DC 20036
NK* BAKERY AND CONFECTIONERY 10401 CONNECTICUT AVE KENSINGTON MD 20795
W97 BAKERY CONFECTIONERY AND TOBACCO WKRS INT LOC 442 P O BOX 742 NO LITTLE ROCK AR 72115
E79 BALDOR ELECTRIC CO P O BOX 2400 FT SMITH AR 72902
AF9 BALL CORPORATION 1200 CRUTCHER ST SPRINGDALE AR 72764-6421
VH* BALTIMORE LIFE HMR P O BOX 4082 DENTAL CLAIMS ONLY KALAMAZOO MI 48003-4082
BX5 BANK OF AMERICA GROUP HEALTH PLAN 100 N TYRON STREET CHARLOTTE NC 28255
CX1 BANK OF ELMWOOD ATTY MARK LEUCK TRUSTEE 2704 LAPHROP AVENUE RACINE WI 53405
LD* BANK OF YELLVILLE JESSE ROBERTSON TRUST CHURCH AND MADISON STS YELLVILLE AR 72687
A7* BANKERS COMMERCIAL LIFE IN 5720 LBJ FREEWAY DALLAS TX 75240-6334
NH* BANKERS FIDELITY LIFE INS 4370 PEACHTREE DR NE P O BOX 190240 ATLANTA GA 31119-0240
0QK BANKERS LIFE 3347 PEARSON ROAD MEMPHIS TN 38118
EJ6 BANKERS LIFE DENTAL CLAIMS P O BOX 66932 CHICAGO IL 60666-0932
IL9 BANKERS LIFE AND CASUALTY P O BOX 1935 CARMEL IL 46082-1935
I18 BANKERS LIFE AND CASUALTY 2509 ELM STREET DALLAS TX 75222
0D* BANKERS LIFE AND CASUALTY 222 MERCHANDISE MART PLZA P O BOX 66927 CHICAGO IL 60666-0927
N1* BANKERS LIFE INS CLAIM CNTR GATEWAY 1 8131 LBJ FREEWAY 300 DALLAS TX 75251
B51 BANKERS LIFE INSURANCE P O BOX 908 SPRINGFIELD MO 65801
D7* BANKERS LIFE INSURANCE CO 2525 CUMBERLAND PARKWAY SUITE 475 ATLANTA GA 30339
CJ* BANKERS MULTIPLE LIFE INS 4810 NORTH KENNETH AVENUE CHICAGO IL 60630
* - 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 17
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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K51 BANKERS MULTIPLE LIFE INS ATTN KATHRYN HENDRIX 308 MOCKINGBIRD COVE JONESBORO AR 72401
V56 BANKERS MULTIPLE LINE INSURANCE P O BOX 5095 N SUBURBAN IL 60197
W37 BANKERS UNITED LIFE ASSURANCE CO 1020 W FOURTH ST LITTLE ROCK AR 72201
L70 BANKERS UNITED LIFE P O BOX 8063 LITTLE ROCK AR 72203
N6* BANNER LIFE INS CO 1701 RESEARCH BLVD ROCKVILLE MD 20850
AC6 BANUS LIFE AND CASUALTY 222 MERCHANDISE MAIT CHICAGO IL 60654
C33 BAPTIST AND PHYSICIANS HEALTHMARK/HEALTHPOINT P O BOX 381790 MEMPHIS TN 38183-1790
P5* BARNEY OSMENT SCHOOL INS P O BOX 716 JONESBORO AR 72403
W29 BAROID CLAIM DEPT PO BOX 62107 DALLAS TX 77205
CM2 BARRON BARRON AND TUCKER P TRUST FOR CYNTHIA ONEAL 212 CENTER STREET STE 600 LITTLE ROCK AR 72201
CO4 BARRON BARRON TUCKER REF SHAWN MEALLER 212 CENTER ST SUITE 600 LITTLE ROCK AR 72201
R67 BASIC KARE 777 MAIN ST 2200 CONTINENTAL PLAZA FT WORTH TX 76102
M71 BASLER ELECTRIC ATTN INSURANCE DEPT RT 67 BOX 368 CORNING AR 72422
B77 BASS COMPANIES 201 MAIN ST, STE 2700 FT WORTH TX 76102
I35 BASSETT UPHOLSTERY P.O. BOX 47 NEWTON NC 28658-0047
K70 BATHENEY SONS INC P O BOX 670602 DALLAS TX 75367
GA* BAXTER TRAVENOL LABORATORY PIDGEON CREEK RD MOUNTAIN HOME AR 72653
JA6 BCBS ARIZONA FEDERAL EMPLO P O BOX 2924 PHOENIX AZ 85062
JA7 BCBS DC FEDERAL EMPLOYEES P O BOX 14116 LEXINGTON KY 40512-4116
JA8 BCBS GEORGIA FEDERAL EMPLO P O BOX 4445 ATLANTA GA 30302-4445
ID1 BCBS MISSISSIPPI RX PO BOX 1043 JACKSON MS 39215-1043
ID2 BCBS NEW JERSEY RX 3 PENN PLAZA EAST NEWARK NJ 07105-2245
HK5 BCBS OF MONTANA PO BOX 4309 HELENA MT 59604
H93 BCBS PREMIER PO BOX 91059 SEATTLE WA 98111
JA9 BCBS VIRGINIA FEDERAL EMPL 2015 STAPLES MILL ROAD RICHMOND VA 23230-3119
FT5 BEECH STREET PO BOX 14040 IRVINE CA 92623
FF6 BEECH STREET CORPORATION P O BOX 70100 8002562657 SHREVEPORT LA 71137
CM5 BEECH STREET CORPORATION PO BOX 57015 IRVINE CA 92619-7015
GL2 BEECH STREET INSURANCE PO BOX 853925 RICHARDSON TX 75085-3925
NC* BEECH STREET REPRICING P O BOX 17719 IRVINE CA 92713-7719
CF8 BEHRENS INC P.O. BOX 2520 WACO TX 76702-0252
K76 BEKAERT CORP CORP CLAIMS CENTER 1867 W MARKET STREET AKRON OH 44313-6901
KK* BELDEN CORPORATION TRUST 2000 SO BATANIA AVE GENEVA IL 60134
Y8* BELL AND DENNY PO BOX 879 ANDERSON IN 46015
I55 BELL ATLANTIC P.O. BOX 7429 PHILADEPHIA PA 19101
* - 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 18
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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BQ9 BENACORP 5285 W LAKEVIEW PKWY S DR INDIANAPOLIS IN 46268
AW3 BENCHMARK INSURANCE CO P O BOX 2648 SHAWNEE MISSION KS 66201
ZE* BENEFICIAL STANDARD LIFE 3700 WILSHIRE BLVD LOS ANGELES CA 90054
Z28 BENEFIT ADMIN OF NEW ENG P.O. BOX 557 200 LEDGEWOOD PLACE ROCKLAND MA 02370
N59 BENEFIT ADMIN SERVICES LTD 4750 MCWILLIE SUITE 106 PO BOX 14208 JACKSON MS 39236-4208
K16 BENEFIT ADMIN SYSTEM IND 43 ORLAN PARK SQUARE SUITE 303 ORLAND PARK IL 60462
H01 BENEFIT ADMINISTRATIVE SER PO BOX 2920 MILWAUKEE WI 53201
GZ6 BENEFIT ADMINISTRATIVE SYS 17475 JOVANNA DRIVE SUITE 1B HOMEWOOD IL 60430-4623
MN* BENEFIT ADMINISTRATORS P O BOX 10868 SPRINGFIELD MO 65808
Q91 BENEFIT ADMINISTRATORS P O BOX 50101 SSS SPRINGFIELD MO 65805
CT3 BENEFIT ADMINISTRATORS P O BOX 10585 KNOXVILLE TN 37939
HN5 BENEFIT ADMINISTRAVIE SYST 17475 JOVANNA DRIVE STE 1B HOMEWOOD IL 60430
I57 BENEFIT AMERICA P.O. BOX 1268 TIFTON GA 31793
T26 BENEFIT AMERICA P O BOX 1365 COLUMBIA SC 29202
ID3 BENEFIT AND RISK MANAGEMEN PO BOX 2650 RANCHO CORDOVA CA 95741
Q75 BENEFIT CLAIMS PAYORS INC PO BOX 37400 PHOENIX AZ 85069-7400
DP5 BENEFIT CONCEPTS INC UNIVERSAL HEALTH SERV P O BOX 61572 KING OF PRUSSIA PA 19406
T18 BENEFIT CONSULTANTS INC 14500 S. 40 OUTER RD SUITE 502 CHESTERFIELD MO 63017
DN7 BENEFIT GROUP 11725 ARBOR ST OMAHA NE 68114
DW1 BENEFIT MANAGEMENT P O BOX 3767 BARTLESVILLE OK 74006
IN2 BENEFIT MANAGEMENT INC P O BOX 3001 2660 E 32ND STR SUITE 100 JOPLIN MO 64803
H26 BENEFIT MANAGEMENT INC 1531 W 32ND STREET PO BOX 3810 JOPLIN MO 64803
HO4 BENEFIT MANAGEMENT SERVICE PO BOX 2058 MADISON MS 39130
DK7 BENEFIT MGT SYSTEMS INC PO BOX 809 RIDGELAND MS 39157
DP1 BENEFIT PLAN ADM INC 10 SOUTH BROADWAY SUITE 1400 ST LOUIS MO 63102
Q15 BENEFIT PLAN ADMINISTRATOR 50 GLEN STREET GLEN COVE NY 11542
EP9 BENEFIT PLANNERS P O BOX 1917 BOERNE TX 78006-1917
GN4 BENEFIT PLANNERS P O BOX 250009 PLANO TX 75025
Q90 BENEFIT PLANNERS INC P O BOX 690450 SAN ANTONIO TX 78269-0450
FN2 BENEFIT SERVICES INC PO BOX 4138 AKRON OH 44321
GL6 BENEFIT SOURCE INC 23 EAST FRONT STREET PO BOX 240 MONROE MI 48161
GE2 BENEFIT SUPPORT INC PO BOX 2977 GAINESVILLE GA 30503
M20 BENEFIT SYSTEMS INC P O BOX 80447 INDIANAPOLIS IN 46280
Z52 BENEFIT SYSTEMS SVCS INC BRAMBLES USA 760 PASQUINELLI DR STE320 WESTMONT IL 60559
JR* BENEFIT TRUST LIFE INS 10777 SUNSET OFFICE DR SUITE 300 ST LOUIS MO 63127
* - 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 19
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EI* BENEFITS MANAGEMENT INC P.O. BOX 5989 628 BROADWAY NORTH LITTLE ROCK AR 72119
HR8 BENESCRIPT SERVICES PO BOX 921229 NORCROSS GA 30010
GU6 BENESIGHT PO BOX 360 PUEBLO CO 81002
FH4 BENESIGHT PO BOX 385 PUEBLO CO 81002
GD7 BENESIGHT 317 NORTH MAIN STREET PO BOX 320 PUEBLO CO 81002
BK2 BENESIGHT PO BOX 300 PUEBLO CO 81002
CH4 BENESIGHT PO BOX 340 PUEBLO CO 81002
GR6 BENESYS INC PO BOX 81189 LAFAYETTE LA 70598-1189
H65 BENICOMP INC 8210 CLINTON PARK DR FORT WAYNE IN 46825
CJ3 BENICORP INSURANCE COMPANY PO BOX 58917 INDIANAPOLIS IN 46268
H37 BENMARK INCORPORATED P O BOX 16767 JACKSON MS 39236-0767
N75 BENTONVILLE CASTING CO EMPLOYEE HEALTH BENEFITS P.O. BOX 1109 BENTONVILLE AR 72712
AZ1 BERG INC P O BOX 70100 SHREVEPORT LA 71137-0100
U52 BEST DIVERSIFIED PRODUCTS BENEFITS SECTION P O BOX 4017 JONESBORO AR 72403
E20 BEST LIFE ASSURANCE CO OF CALIFORNIA P O BOX 19721 IRVINE CA 92713-9721
W27 BFI OF ARKANSAS P O BOX 193120 LITTLE ROCK AR 72219
GH5 BIG LOTS EMPLOYEE BENEFIT PO BOX 9071 DUBLIN OH 43017
II3 BIOSCRIP 10050 CROSSTOWN CIRLCE ST SUITE 300 EDEN PRAIRIE MN 55344
TH* BLACK LUNG BENEFITS DIV OF COAL MINE WORKERS COMPENSATION WASHINGTON DC 20210
CV7 BLAIR MILL ADMINISTRATORS 720 BLAIR MILL RD HORSHAM PA 19077-0975
GO9 BLUE ADVANTAGE P O BOX 69413 HARRISBURG PA 17106
HL9 BLUE ADVANTAGE DENTAL CLAIMS ADMINISTRAT P O BOX 1206 ELK GROVE VILLAGE IL 60009-1206
N2* BLUE ADVANTAGE ADMINISTRAT FORMERLY USABLE P O BOX 1460 LITTLE ROCK AR 72203
XM* BLUE BELL BENEFIT TRUST PO BOX 605 BRENHAM TX 77834-0605
BL2 BLUE BONNETT ADMIN P. O. BOX 98018 BATON ROUE LA 70898-8018
ET7 BLUE CARE NETWORK OF SOUTHEAST MI P O BOX 5043 SOUTHFIELD MI 48086-5043
R61 BLUE CARE NETWORK 3624 SO WESTRIDGE KALAMAZOO MI 49008
GH4 BLUE CHOICE 165 COURT STREET ROCHESTER NY 14647
T19 BLUE CHOICE CLAIMS P O BOX 66834 ST LOUIS MO 63166-6834
HY* BLUE CROSS 1950 FRANKLIN STREET OAKLAND CA 94659
DN6 BLUE CROSS WASTE MGMT TECH P O BOX 4204 WOODLAND HILLS CA 91365
CD3 BLUE CROSS BLUE SHEILD OF UNITED WISCONSIN P O BOX 2025 MILWAUKEE WI 53201-2025
GM6 BLUE CROSS BLUE SHEILD OF MINNESOTA PO BOX 64653 ST PAUL MN 55164-0653
GW5 BLUE CROSS BLUE SHIELD DENTAL P O BOX 9201 OXNARD CA 93031-9201
GD* BLUE CROSS BLUE SHIELD NATIONAL ACCOUNT SERV CTR P O BOX 1870 INDIANAPOLIS IN 46206-1870
* - 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 20
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GA2 BLUE CROSS BLUE SHIELD OF OHIO 13550 TRITON PARK BLVD LOUISVILLE KY 40223
F96 BLUE CROSS BLUE SHIELD P O BOX 210 MONTICELLO AR 71655
F37 BLUE CROSS BLUE SHIELD 10455 RUN MILL CIRCLE OWINGS MILLS MD 21117
FZ9 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 100 HANCOCK STREET NORTH QUINCY MA 02171
FZ8 BLUE CROSS BLUE SHIELD OF KENTUCKY PO BOX 37690 LOUISVILLE KY 40233-7690
FZ7 BLUE CROSS BLUE SHIELD OF INDIANA PO BOX 37010 LOUISVILLE KY 40233
HQ5 BLUE CROSS BLUE SHIELD OF OKLAHOMA DENTAL CLAIMS PO BOX 23100 BELLEVILLE IL 62223
H12 BLUE CROSS BLUE SHIELD P O BOX 2709 2400 MARKET SQUARE YOUNGSTOWN OH 44507
HK* BLUE CROSS BLUE SHIELD OF OKLAHOMA P O BOX 3283 TULSA OK 74102-3283
HH* BLUE CROSS BLUE SHIELD BELLSOUTH DEDICATED SERV P O BOX 830279 BIRMINGHAM AL 35283-0279
EW* BLUE CROSS BLUE SHIELD OF TEXAS P O BOX 833888 RICHARDSON TX 75083-3888
EQ9 BLUE CROSS BLUE SHIELD 818 KEEAUMOKO ST PO BOX 860 HONOLULU HI 96814-2365
EP2 BLUE CROSS BLUE SHIELD OF TEXAS P O BOX 655488 DALLAS TX 75265
FE2 BLUE CROSS BLUE SHIELD OF WESTERN PA P O BOX 176 PITTSBURG PA 15230
FB* BLUE CROSS BLUE SHIELD 233 NORTH MICHIGAN AV PO BOX 1220 CHICAGO IL 60690-1220
E15 BLUE CROSS BLUE SHIELD OF NEW JERSEY THREE PENN PLAZA E NEWARK NJ 07105-2247
FM7 BLUE CROSS BLUE SHIELD OF MICHIGAN PO BOX 2089 DETROIT MI 48231
FL* BLUE CROSS BLUE SHIELD P O BOX 2141 MILWAUKEE WI 53201
FT7 BLUE CROSS BLUE SHIELD OF MICHIGAN PO BOX 1528 DETROIT MI 48231
FT6 BLUE CROSS BLUE SHIELD OF TENNESSEE PO BOX 182277 CHATTANOOGA TN 37422-7277
FQ8 BLUE CROSS BLUE SHIELD PO BOX 3001 LANCASTER PA 17604-3001
B82 BLUE CROSS BLUE SHIELD OF MAINE TWO GANNETT DR PORTLAND ME 04106-6911
B80 BLUE CROSS BLUE SHIELD P O BOX 64560 ST PAUL MN 55164
BY9 BLUE CROSS BLUE SHIELD OF CALIFORNIA P O BOX 272540 CHICO CA 95927-2540
BY4 BLUE CROSS BLUE SHIELD OF UTAH P O BOX 30270 SALT LAKE CITY UT 84130-0270
BL6 BLUE CROSS BLUE SHIELD OF CENTRAL NEW YORK P O BOX 4809 SYRACUSE NY 13221-4809
CT* BLUE CROSS BLUE SHIELD INDEPENDENCE BLUE CROSS P O BOX 13400 PHILADELPHA PA 19107
CI5 BLUE CROSS BLUE SHIELD OF NORTHEASTERN PA 70 N MAIN ST WILKES BARRE PA 18703-0029
CF5 BLUE CROSS BLUE SHIELD ATTN NASCO PROCESSING P O BOX 13427 BIRMINGHAM AL 35202-3427
BL* BLUE CROSS BLUE SHIELD 801 PINE STREET P O BOX 180150 CHATTANOOGA TN 37401-7150
BJ3 BLUE CROSS BLUE SHIELD 700 BROADWAY P O BOX 173660 DENVER CO 80273-0001
BF7 BLUE CROSS BLUE SHIELD OF TEXAS CLAIMS DEPT P O BOX 660044 DALLAS TX 75266-0044
BD8 BLUE CROSS BLUE SHIELD 1901 MAIN ST P. O. BOX 80 BUFFALO NY 14240
AW1 BLUE CROSS BLUE SHIELD OF GEORGIA P.O. BOX 4055 ATLANTA GA 30302
AV9 BLUE CROSS BLUE SHIELD 8515 PHOENIX DR MANASSAS VA 22110
* - 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 21
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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AV4 BLUE CROSS BLUE SHIELD 1901 MARKET STREET P O BOX 13400 PHILADELPHIA PA 19107
DH1 BLUE CROSS BLUE SHIELD OF ILLINOIS P O BOX 1220 CHICAGO IL 60690
C51 BLUE CROSS BLUE SHIELD 150 E MAIN ROCHESTER NY 14647
EB7 BLUE CROSS BLUE SHIELD PREFERRED CARE 450 RIVERCHASE PKWY EAST BIRMINGHAM AL 35205
EA9 BLUE CROSS BLUE SHIELD NASCO SERVICE UNIT P O BOX 2988 JACKSONVILLE FL 32232-9925
EA8 BLUE CROSS BLUE SHIELD OF TEXAS P O BOX 660152 DALLAS TX 75266-2227
D30 BLUE CROSS BLUE SHIELD NEW HAMPSHIRE AND VERMONT 2 PILLSBURY STRET CONCORD NH 03306
D19 BLUE CROSS BLUE SHIELD 3405 LIBERTY DRIVE SPRINGFIELD IL 62704
EP* BLUE CROSS BLUE SHIELD EMPLOYEE RETIREMENT SYSTE P O BOX 13207 AUSTIN TX 78711-3207
EO8 BLUE CROSS BLUE SHIELD KMART CLAIMS P O BOX 33249 DETROIT MI 48232
EO* BLUE CROSS BLUE SHIELD OF ALABAMA P O BOX 995 BIRMINGHAM AL 35298
EN1 BLUE CROSS BLUE SHIELD OF KENTUCKY P O BOX 23300 LEXINGTON KY 40223
EF9 BLUE CROSS BLUE SHIELD OF MICHIGAN PO BOX 2500 DETROIT MI 48231
TU* BLUE CROSS BLUE SHIELD OF FLORIDA P O BOX 1798 JACKSONVILLE FL 32231-0014
S62 BLUE CROSS BLUE SHIELD OF TEXAS INC P O BOX 655730 DALLAS TX 75265-5730
S35 BLUE CROSS BLUE SHIELD OF DELAWARE P O BOX 1991 WILMINGTON DE 19899-1991
S16 BLUE CROSS BLUE SHIELD OF VERMONT P O BOX 186 MONTPELIER VT 05602-0186
SN* BLUE CROSS BLUE SHIELD OF NATIONS CAPITAL 1021 14TH STREET NW WASHINGTON DC 20005
SG* BLUE CROSS BLUE SHIELD OF KANSAS P O BOX 239 TOPEKA KS 66601-0239
RO* BLUE CROSS BLUE SHIELD OF CONNECTICUT P O BOX 504 NORTH HAVEN CT 06473
QD* BLUE CROSS BLUE SHIELD CUSTOMER SERVICE P O BOX 98029 BATON ROUGE LA 70898-8029
PH* BLUE CROSS BLUE SHIELD OF ARIZONA P O BOX 13466 PHOENIX AZ 85002
OT* BLUE CROSS BLUE SHIELD 85 N DANNY THOMAS BLVD P O BOX 79 MEMPHIS TN 38101
NX* BLUE CROSS BLUE SHIELD OF MISSISSIPPI P O BOX 23071 JACKSON MS 39215-3071
N49 BLUE CROSS BLUE SHIELD OF MICHIGAN 600 E LAFAYETTE BLVD DETROIT MI 48226-2998
M22 BLUE CROSS BLUE SHIELD 4000 HOUSE AVENUE P O BOX 2266 CHEYENNE WY 82003
MK* BLUE CROSS BLUE SHIELD OF WASHINGTON ALASKA P O BOX 327 SEATTLE WA 98111-0327
ME* BLUE CROSS BLUE SHIELD OF WESTERN PA P O BOX 19 UNIT 4004 PITTSBURGH PA 15230
L73 BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA 1601 W MADISON SIOUX FALLS SD 57104-5710
L44 BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA I 20 E AT ALPINE RD COLUMBIA SC 29219-0001
LJ* BLUE CROSS BLUE SHIELD OF MISSOURI 1831 CHESNUT STREET ST LOUIS MO 63103-2275
J46 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS P O BOX 1658 BOSTON MA 02105
J32 BLUE CROSS BLUE SHIELD OF RHODE ISLAND 444 WESTMINISTER ST PROVIDENCE RI 02903-3279
JS* BLUE CROSS BLUE SHIELD OF KANSAS P O BOX 419169 KANSAS CITY MO 64141-6169
JO6 BLUE CROSS BLUE SHIELD OF HAWAII PO BOX 13400 HONOLULU HI 96801
* - 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 22
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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I17 BLUE CROSS BLUE SHIELD OF WESTERN PENNSYLVANIA P O BOX 3355 PITTSBURGH PA 15230
II0 BLUE CROSS BLUE SHIELD DENTAL CLAIMS PO BOX 69436 HARRISBURG PA 17106-9436
H8* BLUE CROSS BLUE SHIELD OF GEORGIA P O BOX 9907 COLUMBUS GA 31908-6007
H4* BLUE CROSS BLUE SHIELD OF COLORADO 700 BROADWAY DENVER CO 80273
XF* BLUE CROSS BLUE SHIELD OF NEW MEXICO P O BOX 27630 ALBUQUERQUE NM 87112-7630
W58 BLUE CROSS BLUE SHIELD 85 N DANNY THOMAS BLVD P O BOX 98 MEMPHIS TN 38101
WC* BLUE CROSS BLUE SHIELD OF NORTH DAKOTA 4510 13TH AVENUE SW FARGO ND 58121-0001
V81 BLUE CROSS BLUE SHIELD P O BOX 3850 GRAND CENTRAL STATION NEW YORK NY 10017
V67 BLUE CROSS BLUE SHIELD OF CENTRAL NEW YORK P O BOX 536 AUBURN NY 13021-0536
VC* BLUE CROSS BLUE SHIELD MAIN STATION P O BOX 3248 OMAHA NE 68180-0001
U73 BLUE CROSS BLUE SHIELD THE NATIONAL CAPITAL AREA 550 12TH ST SW WASHINGTON DC 20065
UA* BLUE CROSS BLUE SHIELD OF KANSAS CITY P O BOX 419169 KANSAS CITY MO 64141-6169
T51 BLUE CROSS BLUE SHIELD P O BOX 35 DURHAM NC 27702
T32 BLUE CROSS BLUE SHIELD OF WATERTOWN 12 RHOADS DR UTICA NY 13502-6306
0C* BLUE CROSS BLUE SHIELD CUSTOMER SERVICE P O BOX 2181 LITTLE ROCK AR 72203-2181
Z29 BLUE CROSS BLUE SHIELD OF CALIFORNIA P.O. BOX 3090 RANCHO CORDOVA CA 95741
Z22 BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA P.O. BOX 6000 GREENVILLE SC 29606
Y74 BLUE CROSS BLUE SHIELD ACORDIA BENEFITS 3760 GUION ROAD INDIANAPOLIS IN 46222
Y13 BLUE CROSS BLUE SHIELD 3265 S NATIONAL SUITE 100 SPRINGFIELD MO 65807-7304
X80 BLUE CROSS BLUE SHIELD 6100 AUBURN ROAD UTICA MI 48087
AG1 BLUE CROSS BLUE SHIELD OF IDAHO P O BOX 7408 BOISE ID 83707
AD2 BLUE CROSS BLUE SHIELD 1831 CHESTNUTT ST LOUIS MO 63103
AA5 BLUE CROSS BLUE SHIELD C/O COBRA SVC NAT SVC CTR P.O. BOX 9061 CLEARWATER FL 34616-9061
AK7 BLUE CROSS BLUE SHIELD OMNI STAFF P.O. BOX 9144 MOBILE AL 35591
AS5 BLUE CROSS BLUE SHIELD OF ALABAMA PO BOX 830389 BIRMINGHAM AL 35283-0389
FG8 BLUE CROSS BLUE SHIELD FOR FEDERAL EMPLOYEES PO BOX 2181 LITTLE ROCK AR 72203-2181
AF* BLUE CROSS BLUE SHIELD OF ATTN NATL SERV CTR B450 P O BOX 341 DETROIT MI 48231
IC4 BLUE CROSS BLUE SHIELD TEN FEDERAL EMPLOYEES PO BOX 52610 KNOXVILLE TN 37950-2610
H3* BLUE CROSS E SYSTEM 7700 ARLINGTON BLVD FALLS CHURCH VA 22046
OK* BLUE CROSS OF CA P O BOX 4255 WOODLAND HILLS CA 91365-4255
PM* BLUE CROSS OF CALIFORNIA PERSCARE P.O. BOX 4386 WOODLAND HILLS CA 91365
AN3 BLUE CROSS OF CALIFORNIA PO BOX 4217 WOODLAND HILLS CA 91365
FU5 BLUE CROSS OF CALIFORNIA PO BOX 60007 LOS ANGELES CA 90060-0007
FM9 BLUE CROSS OF CALIFORNIA PO BOX 4347 WOODLAND HILLS CA 91365-4347
EE6 BLUE CROSS OF CALIFORNIA NATIONAL ACCOUNTS P O BOX 9271 VAN NUYS CA 91409
* - 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 23
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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DX9 BLUE CROSS OF CALIFORNIA PO BOX 4239 WOODLAND HILLS CA 91368
CX7 BLUE CROSS OF CALIFORNIA PO BOX 9041 OXNARD CA 93031-9041
DL3 BLUE CROSS OF CALIFORNIA PRUDENT BUYER PLAN P O BOX 4124 WOODLAND HILLS CA 91365
IN5 BLUE CROSS OF GEORGIA P O BOX 445 ATLANTA GA 30302
IN3 BLUE CROSS OF ILLINOIS 1400 NORTH 30TH STREET QUINCY IL 62301
DB7 BLUE CROSS OF NEW JERSEY 33 WASHINGTON STREET NEWARK NJ 07102
DB3 BLUE SHIELD OF CALIFORNIA P O BOX 4202 WOODLAND HILLS CA 93165
AV3 BLUE SHIELD OF CALIFORNIA PERSCARE SERVICE CENTER RIVERBANK CA 95390-0001
BI8 BLUE SHIELD OF CALIFORNIA P O BOX 272570 CHICO CA 95927-2570
FY5 BLUE SHIELD OF CALIFORNIA 4203 TOWN CENTER BLVD EL DORADO HILLS CA 95762
K5* BLUE SHIELD OF IDAHO BOX 1106 LEWISTON ID 83501
EE5 BLUE SHIELD OF PENNSYLVANI VISION CLAIMS P O BOX 890500 CAMP HILL PA 17089-0500
EE4 BLUE SHIELD OF PENNSYLVANI DENTAL CLAIMS P O BOX 890400 CAMP HILL PA 17089-0400
AS3 BLUE SHIELD OF PHILADELPHI P.O. BOX 890062 CAMP HILL PA 17089-0062
PT* BLUE SHIELD 65 PLUS P O BOX 5014 WOODLAND HILLS CA 91365-9623
HA9 BLUECARE DENTAL PPO P.O. BOX 23059 BELLEVILLE IL 62223-0059
FH3 BLUECROSS BLUESHIELD OF ALABAMA PO BOX 2208 BIRMINGHAM AL 35201
GR7 BLUECROSS BLUESHIELD OF IL PO BOX 1364 CHICAGO IL 60690-1364
DE4 BLUECROSS BLUESHIELD OF MI PO BOX 14882 ST LOUIS MO 63178
ON* BLUEGRASS FAMILY HEALTH P O BOX 21970 LEXINGTON KY 40522-1970
HI9 BMI HEALTHPLANS PO BOX 9416 NORTH LITTLE ROCK AR 72119
HF8 BMI HEALTHPLANS PO BOX 9416 NORTH LITTLE ROCK AR 72119
A6* BOARD OF PENSIONS U PRESBYTERIAN CHURCH 200 KRAMS AVENUE PHILADELPHIA PA 19127
Y14 BOARD OF TRUSTEES GROUP BENEFITS PROGRAM PO BOX 44036 BATTON ROUGE LA 70804
M40 BOB HUNT TRUST ACCOUNT OSCEOLA TIMES P O BOX 408 OSCEOLA AR 72370
TO* BOILERMAKERS HEALTH AND WELFARE 522 BROTHERHOOD BLDG KANSAS CITY KS 66101
VF* BOILERMAKERS NAT HEALTH AN ALFARE FUND NO HOSP RE UU 754 MINNESOTA AVE STE 522 KANSAS CITY KS 66101-2766
GY3 BOILERMAKERS NATL HEALTH A WELFARE FUND P O BOX 23825 TUCSON AZ 85734
N47 BOISE CASCADE CORP GP BENEFITS DEPT P.O. BOX 61 BOISE ID 83707
HK8 BOLLINGER INC PO BOX 706 SHORT HILLS NJ 07078-0706
GP7 BOON CHAPMAN PAID DENTAL PO BOX 9150 AUSTIN TX 78766
EQ6 BOON CHAPMAN HEALTH SMART PO BOX 53010 LUBBOCK TX 79453
HP5 BOON CHAPMAN PO BOX 9201 AUSTIN TX 78766
DG5 BOON CHAPMAN BENEFIT ADMIN P O BOX 6269 FORT SMITH AR 72906
Y53 BOONE RITTER INSURANCE P.O. BOX 867 109 N SPRING SPRINGDALE AR 72764
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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M30 BORDEN HEALTH BENFITS P O BOX 189 COLUMBUS OH 43216
AD3 BORDER CITY FOODS C/O TIME INS P.O. 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
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. BOX 247 SHELDON IA 51201
TJ* BRIDGESTONE FIRESTONE INC PO BOX 29605 AKRON OH 44710
K33 BRITWELL COMPANY CLEVELAND CO NURSING HOME P BOX 365 RISON AR 71665
CU1 BROKER NATIONAL DENTAL INS P O BOX 1028 18006534427 HOUSTON TX 77251
F61 BROKERAGE CONCEPTS INC PRESIPTION DRUGS PROGRAM POBOX 52115 PHOENIX AR 00000
ED3 BROKERAGE SERVICES INC P O BOX 11020 ALBUQUERQUE NM 87192-0020
CC3 BROKERS NATIONAL LIFE ASSU CLAIMS DEPT P O BOX 659531 SAN ANTONIO TX 78265-9531
R41 BROOKFIELD 5440 N CUMBERLAND SUITE 250 CHICAGO IL 60656
I63 BROOKFIELD ADMIN SERVICES 1030 HIGGINS SUITE 200 PARKRIDGE IL 60068
J01 BROTHERHOOD MUTUAL 6400 BROTHERHOOD WAY P O BOX 2228 FORT WAYNE IN 46801
AD4 BROWN AUXILIARY GROUP P.O. BOX 659 POCAHONTAS AR 72455
D65 BROWN GROUP INC BOX 354 ST LOUIS MO 63166
D21 BROWN JORDAN GROUP P O BOX 990 NEWPORT AR 72112
U70 BROWN JORDAN GROUP HEALTH PLAN 3701 SO LINDBERGH ST LOUIS MO 63127
L16 BROWN ROOT P O BOX 3 HOUSTON TX 77001-0003
A29 BROWN SHOE COMPANY P O BOX 354 ST LOUIS MO 63166-0354
Z30 BRUNER IVORY HANDLE CO P.O. BOX 647 500 N. LAUREL HOPE AR 71801
P48 BRYCE CORPORATION 500 S BENTON ST SEARCY AR 72143
B69 BSC INSURANCE COMPANY 9330 LBJ FREEWAY STE 1050 DALLAS TX 75243
VY* BSP INSURANCE COMPANY 7575 EAST MAIN STREET P O BOX 1030 SCOTTSDALE AZ 85252
V11 BUHRMAN PHARR P O BOX 1818 TEXARKANA AR 75502
F79 BUILDERS TRANSPORT BENEFITS DEPARTMENT P O BOX 7005 CAMDEN SC 29020-7005
H24 BUNGE CORPORATION HWY 675 NEWPORT AR 72115
AT8 BUREAU OF INDIAN AFFAIRS P.O. BOX 948 TAHLEQUAH OK 74465
F98 BURLINGTON NORTHERN EMPLOY 20 WASHINGTON AVE MINNEAPOLIS MN 55440
H28 BURNETT INSURANCE CO 2015 S BROADWAY 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 25
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Z53 BURNS INTERNATL SCTY SVCS HEALTH WELFARE TRUST FUND 39429 LIBERTY ST STE 260 FREEMONT CA 94538
X3* BURROUGHS HEALTH AND DRUG 13003 ECKLES ROAD PLYMOUTH MI 48170
R54 BUSINESS MENS ASSURANCE 20 MAGUIRE RD LEXINGTON MA 02173
DA* BUSINESS MENS ASSURANCE BMA TOWER P O BOX 419315 KANSAS CITY MO 64141
V10 BUSINESS MENS INSURANCE 555MARRIOTT DRIVE SUITE 305 NASHVILLE TN 37210
BO8 BUYERS HEALTH COOPERATIVE PO BOX 150500 NASHVILLE TN 37215
M60 C AND L ELECTRIC P O DRAWER 9 STAR CITY AR 71667
J42 C C SYSTEM A AND G OF LEXA 6 PINE STREET LEXA AR 72355
Q38 C C SYSTEMS CORP 4660 S. HAGADORN SUITE 210 EAST LANSING MI 48823-5353
J74 CAL FARM LIFE INSURANCE PO BOX 1506 SACRAMENTO CA 95851-1016
ZG* CAL WEST HEALTH INSURANCE P O BOX 1953 SACRAMENTO CA 95809
P69 CALDWELL CULVERT PO BOX 1337 GREENVILLE NC 38202
FB7 CALIFORNIA CARE P O BOX 4089 WOODLAND HILLS CA 91365
A27 CALIFORNIA DENTAL SERVICE PO BOX 7736 SAN FRANCISCO CA 94120
IP* CALIFORNIA IRON WORKERS 221 EAST WALNUT STREET PASADENA CA 91103
M15 CALMAINE FOODS P O BOX 40 LINCOLN AR 72744
AZ2 CALMINE FOODS BENEFITS SECTION P.O. BOX 806 LAGRANGE TX 78945
FQ9 CAMBRIDGE PO BOX 1687 GRAND RAPIDS MI 49501
J48 CAMDEN WIRE CO INC 731 JAMES STREET SYRACUSE NY 13203
S43 CAMPBELL AND COMPANY P O BOX 1085 MAGNOLIA AR 71753
DQ5 CAMPFIRE CHARCOAL CO HEALTH CLAIMS P O BOX 1389 JACKSONVILLE TX 75766
FP5 CANADA LIFE PO BOX 1379 BUFFALO NY 14240-1379
EX1 CANNON COCHRAN MANAGEMENT SERVICES P O BOX 1430 DANVILLE IL 61834-1430
FA8 CAPCARE 100 W CLARENDON SUITE 2000 PHOENIX AZ 85013
X37 CAPCO PIPE COMPANY 603 SOUTH 28TH VAN BUREN AR 72956
FU2 CAPITAL BLUE CROSS 2500 ELMERTON AVENUE HARRISBURG PA 17110-9764
FB1 CAPITAL DISTRICT PHYSICIAN HEALTH PLAN 5 WASHINGTON SQUARE ALBANY NY 12205
M5* CAPITOL AMERICAN LIFE INS 1001 LAKE SIDE AVENUE CLEVELAND OH 44114
YL* CAPITOL LIFE INSURANCE 8383 SLEMMONS SUITE 217 DALLAS TX 75247
BS5 CAPP CARE P O BOX 6240 NEWPORT BEACH CA 92658
Z54 CAPPERS INSURANCE SVCS INC CLAIM SERVICE BUREAU 1503 S,W, 42 ST TOPEKA KS 66609-1265
BS8 CARE AMERICA P O BOX 946 WOODLAND HILLS CA 91365-0946
BX2 CARE CHOICE PO BOX 1407 CHATTANOOGA TN 37401-1407
IM1 CARE IMPROVEMENT PLUS 351 W CAMDEN STREET SUITE 100 BALTIMORE MD 21201
HJ4 CARE IMPROVEMENT PLUS PO BOX 4347 SCRANTON PA 18505
* - 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 26
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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E24 CARE SCAN P O BOX 899 CLEARWATER FL 34617
Y58 CARE SOURCE P.O. 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. BOX 981608 EL PASO TX 79998
HR3 CAREMARK P O BOX 52116 PHOENIZ AZ 85072-2116
HQ7 CAREMARK PO BOX 52196 PHOENIX AZ 85072-2196
HI5 CAREMARK P O BOX 52136 PHOENIX AZ 85072-2136
GY5 CAREMARK P O BOX 52154 PHOENIX AZ 85072-2154
CG4 CAREMARK 625 BERKLEY BLVD LINCOLINSHIRE IL 60069-4310
GR8 CAREMARK INC MEDICARE D CLAIM PO BOX 686007 SAN ANTONIO TX 78268
BM8 CAREMARK PRESCRIPTION SERV 7034 ALAMO DOWNS PARKWAY P.O. BOX 686005 SAN ANTONIO TX 78238
QE* CARITEN HEALTHCARE PO BOX 22337 KNOXVILLE TN 37933
HD3 CARITEN TPA SERVICES PO BOX 22987 KNOXVILLE TN 37933
U76 CAROLINA PREFERRED CARE P O BOX 25307 WINSTON SALEM NC 27114-5307
A93 CAROON AND BLACK BENEFITS P O BOX 1280 NASHVILLE TN 37202
E23 CARPENTERS HEALTH AND WELF 1401 HAMPTON AVE ST LOUIS MO 63139
F74 CARPENTERS HEALTH FUND 2233 WISCONSIN AVE NW SUITE 216 WASHINGTON DC 20007
B14 CARPENTERS HLTH AND WELFAR TRUST FOR SO CALIFORNIA 520 SOUTH VIRGIL AVE LOS ANGELES CA 90020
D16 CARPENTERS TRUST FUND P O BOX 2380 OAKLAND CA 94614
ED2 CARPENTERS WELFARE FUND P O BOX 791 GENEVA IL 60134-0791
K67 CARPET CUSHION CO P O BOX 156 HOPE AR 71801
IG8 CARRIE GOINS 832 MAIL ROUTE ROAD MALVERN AR 72104
P19 CARROLL ELECTRIC COOP ATTN BENEFITS ADM BOX 4000 BERRYVILLE AR 72616
C67 CARSON DOBBS HLTH CARE PLA 5100 POPLAR AVE MEMPHIS TN 38137
DC4 CASINO MAGIC 100 BUSINESS PARK DRIVE SUITE I JACKSON MS 39213
GJ7 CATALYST RX 800 KING FARM BLVD 4TH FL ROCKVILLE MD 20850
YD* CATERPILLAR BENEFITS 600 W WASHINGTON LD 1100 EAST PEORIA IL 61630
FH1 CATERPILLAR INC PO BOX 62920 COLORADO SPRINGS CO 80962-2920
G95 CATHOLIC DAUGHTERS OF AMER P O BOX 1140 FAIR FAX VA 22030
ZS* CATHOLIC KNIGHTS INS SOC STAR PLAN DIVISION 11100 WEST WELLS STREET MILWAUKEE WI 53201
IG6 CATRS P O BOX 30803 SALT LAKE CITY UT 84103
D51 CAULKINS P O BOX 458 INDIANTOWN FL 33456
MY* CBA COLONIAL BENEFIT ADM P O BOX 3770 CAPITOL HEIGHTS MD 78797-3770
X21 CBAGT AMIN BOX 130 PENSACOLA FL 32591-0130
* - 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 27
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GC8 CBCA PO BOX 9007 LONDON KY 40742
FU9 CBCA ADMINISTRATORS INC PO BOX 1181 MINNEAPOLIS MN 55440-1181
HU4 CBCA ADMINISTRATORS INC PO BOX 1339 MINNEAPOLIS MN 55440
A37 CC SYSTEMS CORPORATION 2001 KILLEBREW DRIVE BLN OFFICE PARK STE 141 MINNEAPOLIS MN 55420
DG8 CCEBT GROUP BENEFITS P O BOX 1755 MINNEAPOLIS MN 55440
EY7 CCI ADMINISTRATORS P O BOX 7152 DUBLIN OH 43017
CZ7 CCO INC 2740 SOUTH GLENSTONE SUITE 202 SPRINGFIELD MO 65804
GS8 CELTIC PO BOX 33839 INDIANAPOLIS IN 46203
XY* CELTIC INDIVIDUAL HEALTH 233 S WACKER DRIVE SUITE 700 CHICAGO IL 60606
HE7 CELTIC INSURANCE COMPANY P O BOX 46337 MADISON WI 53744-6337
H18 CELTIC LIFE INS CO SPECIAL HEALTH PRODUCTS P O BOX 96386 CHICAGO IL 60693
DV7 CEMARA HEALTH INC CENTENNIAL LIFE INS P O BOX 8902 WICHITA KS 67208
DC3 CEMENT MASON HEALTH AND WELFARE TRUST FUND 220 CAMPUS LANE SUISUN CA 94585
TN* CEMENT MASONS HEALTH FUND LBJ BUSINESS PK NO BLDG 2997 LBJ FREEWAY DALLAS TX 75234
W98 CENTENNIAL LIFE INS CO PLAN SERV INC P O BOX 30024 TAMPA FL 33630-3024
P28 CENTENNIAL LIFE INS CO PO BOX 470 SHAWNEE MISSION KS 66201
F13 CENTERAL LIFE INSURANCE 6401 CAMP BOWIE BLVD FT WORTH TX 76116
FL1 CENTRA PO BOX 34866 SEATTLE WA 98124
Q80 CENTRA TARGET STORES BENEFIT SERVICES P.O. BOX 869041 DEPT 198 PLANO TX 75086-9041
ES3 CENTRA BENEFIT SERVICE P O BOX 5420 JACKSON MS 39288
U61 CENTRA BENEFIT SERVICES 1255 WEST 15TH STREET PLANO TX 75075
Y16 CENTRA BENEFIT SERVICES PLAN ADMINISTRATOR PO BOX 869043 PLANO TX 75086-9043
N44 CENTRA HEALTHCARE CLAIMS DEPARTMENT PO BOX 42820 HOUSTON TX 77242-2820
Q13 CENTRA HEALTHCARE ADM SRV 1302 N HIGHWAY 81 P O BOX 6000 DUNCAN OK 73534-6000
CK1 CENTRAL AR BENEFIT SER P.O. BOX 5250 NORTH LITTLE ROCK AR 72119
M59 CENTRAL AR DEVELOPMENT COU 425 WALNUTTER PLAZA P O BOX 646 BENTON AR 72015
HK7 CENTRAL ARK NURSING CENTER FIRST DOLLAR PLAN 415 ROGER AVE FT SMITH AR 72901
HF1 CENTRAL BENEFITS P O BOX 612900 DALLAS TX 75261
I13 CENTRAL BENEFITS MUTUAL BCBS OF CENTRAL OHIO P O BOX 182042 COLUMBUS OH 43218
T74 CENTRAL BENEFITS OF OHIO P O BOX 16526 COLUMBUS OH 43216-6526
HB4 CENTRAL COAST ALLIANCE FOR 375 ENCINAL STREET SUITE A SANTA CRUZ CA 95060
DU4 CENTRAL FREIGHT LINES P O BOX 2638 WACO TX 76702
P91 CENTRAL HEALTH BENEFITS PO BOX 149 CLINTON AR 72031
B65 CENTRAL HLTH AND WELFARE F 6000 PATTERSON AVE P O BOX 9338 LITTLE ROCK AR 72219
J12 CENTRAL MOLONEY 200 E 11TH PINE BLUFF AR 71601
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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J52 CENTRAL NATIONAL LIFE INS 5001 ROYAL LANE IRVING TX 75063
R88 CENTRAL RESERVE LIFE 17800 ROYALTON ROAD STRONGSVILLE OH 44136
GY7 CENTRAL RESERVE LIFE INS C P O BOX 29190 SHAWNEE MISSION KS 66201-9190
C5* CENTRAL S W SYSTEMS MED PL P O BOX 21106 SHREVEPORT LA 71156
OA* CENTRAL SECURITY LIFE INS P.O. BOX 833879 RICHARDSON TX 75083-3879
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. BOX 5116 DES PLAINES IL 60017-5116
AK* CENTRAL STATES HEALTH AND LIFE CO OF OMAHA P O BOX 34350 OMAHA NE 68134-0350
EZ4 CENTRAL STATES SE SW AREAS HEALTH/WELFARE FUND P O BOX 5111 DES PLAINES IL 60017-5111
Y60 CENTRAL STATES SE SW AREAS TEAMSTERS LOCAL 604 300 SOUTH GRAND ST LOUIS MO 63103
E38 CENTRAL STATES SOUTHEAST A SOUTHWEST AREAS HEALTH P O BOX 5122 DES PLAINES IL 60017-5122
B56 CENTRAL TEXAS HLTH PLAN 3307 NORTHLAND DRIVE SUITE 300 AUSTIN TX 78766
HA3 CENTRAL UNITED LIFE P O BOX 925309 HOUSTON TX 77292-5309
BU3 CENTRAL UNITED LIFE INS WORTHAM TOWER 6TH FLOOR 2727 ALLEN PARKWAY HOUSTON TX 77019-2115
HT5 CENTURY HEALTHCARE PO BOX 2256 GRAPEVINE TX 76099
HR1 CENTURY LIFE INSURANCE PO BOX 8025 STEVENS POINT WI 54481
L79 CENTURY PLANNERS 9201 WATSON RD SUITE 350 ST LOUIS MO 63126-1533
BA5 CENTURY TELEPHONE ENTERPRISES P.O. 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 629 WARREN MI 48090
QH* CHEROKEE NATION ENTERPRISE PO BOX 3028 TULSA OK 74101
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
JC0 CHOICE BENEFITS P O BOX 10048 FORT SMITH AR 72917-0048
H03 CHOICE CARE PO BOX 3188 CINCINNATI OH 45201
II8 CHOICE NET INTERCARE P O BOX 76149 COLORADO SPRINGS CO 80976
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
HC4 CIGNA FEDEX PPO P.O. BOX 5909 SCRANTON PA 18505
JA3 CIGNA P O BOX 188061 CHATTANOOGO TN 37422-8061
XL* CIGNA PO BOX 188007 CHATTANOOGA TN 37422-8007
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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GD2 CIGNA PO BOX 1068 VISALIA CA 93279
FN4 CIGNA P O BOX 46270 EDEN PRAIRE MN 55344
CS8 CIGNA P O BOX 188034 18003341033 CHATTANOOGA TN 37422-8034
CS1 CIGNA P O BOX 68947 18003313287 INDIANAPOLIS IN 46268
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
BI5 CIGNA HEALTH PLAN P O BOX 2125 GLENDALE CA 91209
BQ7 CIGNA HEALTHCARE P O BOX 7100 WOOLRIDGE IL 60517-7100
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
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
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
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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
----------------------------------------------------------------------------------------------------------------------------------
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
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
Y6* CIGNA HEALTHCARE P O BOX 32200 PHOENIX AZ 85064
Y18 CIGNA HEALTHCARE PO BOX 850 JFK AIRPORT STATION JAMAICA NY 11430
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
HC2 CIGNA HEALTHCARE P.O. BOX 188006 CHATTANOOGA TN 37422-8006
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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CP5 CIGNA HEALTHCARE ATTN BETTY ELIG SERV C315 900 COTTAGE GROVE ROAD HARTFORD CT 06152
CO6 CIGNA HEALTHCARE PO BOX 188029 CHATTANOOGA TN 37422
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
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
DC1 CIGNA HEALTHCARE 60 CHARLES LINDBERGH BLVD MITCHEL FIELD NY 11553
DB* CIGNA HEALTHCARE P O BOX 31066 CHARLOTTE NC 28231
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
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
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
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
EE8 CIGNA HEALTHCARE EQUICOR PO BOX 13011 MERRILLVILLE IN 46411
EK3 CIGNA HEALTHCARE 2220 PARKLAKE DRIVE ATLANTA GA 30345
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
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
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
GL3 CIGNA HEALTHCARE P O BOX 14621 LEXINGTON KY 40512
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
F50 CIGNA HEALTHCARE 201 INTERNATIONAL CIRCLE SUITE 300 HUNT VALLEY MD 21030
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
EK7 CIGNA HEALTHSOURCE PROV P O BOX 182571 CHATTANOOGA TN 37421
FA4 CIGNA HEALTHSOURCE PROV P O BOX 28125 RALEIGH NC 27611-8125
EI9 CIGNA HEALTHSOURCE PROV P O BOX 182575 CHATTANOOGA TN 37422
EF8 CIGNA HEALTHSOURCE PROV P O BOX 8911 BRISTOL TN 37621-8911
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
DC8 CIGNA HEALTHSOURCE PROV P O BOX 5148 STATION B GREENVILLE SC 29606
DN2 CIGNA HEALTHSOURCE PROV P O BOX 30298 LANSING MI 48909-7798
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
C18 CIGNA HEALTHSOURCE PROV P O BOX 2048 GASTONIA NC 28053
CZ5 CIGNA HEALTHSOURCE PROV P O BOX 188013 CHATTANOOGA TN 37422
CP2 CIGNA HEALTHSOURCE PROV RUBBERMAID 2180 BARLOW RD HUDSON OH 44224
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
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
Y65 CIGNA HEALTHSOURCE PROV BFI CLAIMS P O BOX 219788 HOUSTON TX 77218
V3* CIGNA HEALTHSOURCE PROV P.O. BOX 40 6323 CINCINNATI OH 45240
U69 CIGNA HEALTHSOURCE PROV P O BOX 182519 CHATTANOOGA TN 37422-7519
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
AL1 CIGNA HEALTHSOURCE PROV BURLINGTON INDUSTRIES P.O. BOX 9900 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
* - 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 35
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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. BOX 459 CORNING AR 72422
CD1 CLEVELAND ELECTRIC COMPANY P O BOX 190458 LITTLE ROCK AR 72219
CF6 CLUBB LIFE AMERICA 8638 MAIDEN LANE KANSAS MO 64114
TR* CMC STEEL GROUP PO BOX 11549 TUCSON AZ 85734
DZ7 CNA MANAGED CARE CLAIMS P O BOX 305201 NASHVILLE TN 37230-5201
DW2 CNA C/O MUTUAL HEALTH AGENCY P O BOX 2888 LIVERPOOL NY 13089-2888
CQ7 CNA P O BOX 58528 HOUSTON TX 77258-8528
V9* CNA P O BOX 34060 DALLAS TX 75234
U36 CNA P O BOX 2872 PITTSBURGH PA 15230
SZ* CNA BOX 13925 ORLANDO FL 32809
RD* CNA C N A PLAZA CHICAGO IL 60605
HR4 CNA GROUP BENEFITS P.O. BOX 946760 MAITLAND FL 32794
Z56 CNA GROUP CLAIMS P O BOX 25942 OVERLAND PARK KS 66225
0T* CNA HEALTH PARTNERS WHITE RODGERS CLAIMS P O BOX 2360 LITTLE ROCK AR 72203
PL* CNA HEALTH PARTNERS WHIRLPOOL P O BOX 8071 LITTLE ROCK AR 72203
GJ* CNA HEALTH PARTNERS ATTN/REPRICING DEPT P O BOX 2061 LITTLE ROCK AR 72203
BH3 CNA HEALTH PARTNERS LENNOX INTERNATIONAL PO BOX 8070 LITTLE ROCK AR 72203
CW6 CNA HEALTH PARTNERS P O BOX 2181 LITTLE ROCK AR 72203
H44 CNA MANAGED CARE 2715 CHERRY RD MEMPHIS TN 72301
HF4 CNIC HEALTH SOLUTIONS P O BOX 3559 ENGLEWOOD CO 80155-3559
F82 COASTAL CORPORATION 310 MID CONTINENT PLAZA WEST MEMPHIS AR 72301
WN* COASTAL STATE HEALTH INS P O BOX 56189 ATLANTA GA 30343
M94 COBRA CONFED ADMIN SERVICE P O BOX 2941903 NORTH CHARLESTON SC 29419-9003
K79 COBRA INSURANCE 314 S VICTORY LITTLE ROCK AR 72201
FT9 COBRASERV NATIONAL SERVICE 3201 34TH STREET SOUTH ST PETERSBURG FL 33711-3828
CV5 COBRASERVE NAT SER CNT P O BOX 9061 CLEARWATER FL 34618-9061
HC6 COLE MANAGED VISION P.O. BOX 8504 MASON OH 45040-7111
DC2 COLE VISION 18903 S MILES ROAD WARRENSVILLE HTS OH 44128
W50 COLEMAN DAIRY INC P O BOX 4187 LITTLE ROCK AR 72214
D52 COLLEGE LIFE INS COMPANY OF AMERICA P O BOX 68759 INDIANAPOLIS IN 46268
D94 COLLEGE LIFE INSURANCE CO OF AMERICA P O BOX 1005 DELAWARE OH 43301
E66 COLONIAL INSURANCE CO P O BOX 4208 NORCROSS GA 30091
* - 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 36
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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VX* COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY PO BOX 1365 COLUMBIA SC 29202-1365
R83 COLONIAL LIFE AND ACCIDENT INSURANCE CO 2 FINANCIAL CENTER LITTLE ROCK AR 72211
VR* COLONIAL LIFE INSURANCE PALCO CONNECTOR INC 75 CENTER STREET BRISTOL CT 06010
HU6 COLONIAL LIFE INSURANCE PO BOX 100195 COLUMBIA SC 29202-3195
IM6 COLONIAL PENN LIFE INSURAN 399 MARKET STREET PHILADELPHIA PA 19181
CA6 COLONIALPENN MATURITY CARE 5 PENN CENTER PLAZA PHILADELPHIA PA 19185
ZR* COLONY CHARTER LIFE 3243 WILSHIRE BLVD LOS ANGELES CA 90005
RV* COLORADO LABORER HEALTH FUND 838 GRANT STREET PARACHUTE CO 80201
L64 COLUMBIA CO AMBULANCE 629 WEST MAIN STREET MAGNOLIA AR 71753
BT8 COLUMBIA FOREST PRODUCTS ATTN CLAIMS DEPT P O BOX 3768 PORTLAND OR 97208
HK1 COLUMBIA INSURANCE GROUP 950 CARSON COVE SUITE 103 CONWAY AR 72034
A78 COLUMBIA MUTUAL INSURANCE PO BOX 618 COLUMBIA MO 00000
W43 COLUMBUS HOSP HEALTH PLAN 1242 NO 28TH SUITE 300 A BILLINGS MT 59101
XT* COLUMBUS MUTUAL LIFE INSURANCE BOX 900 COLUMBUS OH 43216
DG* COMBINED INS CO OF AMERICA HOME OFFICE 5050 BROADWAY CHICAGO IL 60640
E54 COMBINED INS OF AMERICA 4860 STREET ROAD TREVOSE PA 19047
GT4 COMBINED INSURANCE PO BOX 638 BELLINGHAM WA 98227-0638
SX* COMBINED INSURANCE CO SOUTHWEST SERVICE CENTER 3141 HOOD STREET DALLAS TX 75219
B97 COMBINED INSURANCE CO P O BOX 568 LANGHORNE PA 19047
IN0 COMBINED INSURANCE OF AMER P O BOX 981625 EL PASO TX 79998
Z31 COMBINED INSURANCE SVCS P.O. BOX 2438 OCALA FL 34478
Q5* COMBINED UNDERWRITERS INSURANCE COMPANY P O BOX 149151 AUSTIN TX 78714-9151
P43 COMCAR INDUSTRIES INC PO DRAWER 67 AUBURNDALE FL 33823
B5* COMMERCIAL INSURANCE COMPA P O BOX 2003 TEXARKANA AR 75502
KN* COMMERCIAL TRAVELERS MUTUA SPECIAL RISKS DIVISION COMMERICAL TRAVELERS BLDG UTICA NY 13502
R9* COMMERCIAL UNION INSURANCE 10800 FINANICAL CTR PKWY LITTLE ROCK AR 72211
F73 COMMONWEALTH GROUP CLAIMS CENTER PO BOX 35310 LOUISVILLE KY 40202
EU3 COMMONWEALTH HEALTH ALLIANCE P O BOX 1323 CHARLOTTESVILLE VA 22902
U87 COMMONWEALTH INS CO BOX 240970 MEMPHIS TN 38124
HV* COMMONWEALTH LIFE AND ACCI 7200 WEST MAIN STREET BELLEVILLE IL 62223
H60 COMMONWEALTH LIFE INS CO 200 BAILEY AVE FORT WORTH TX 76107
V91 COMMONWEALTH NATIONAL LIFE INS P O BOX 1560 CLEVELAND MS 38732
FM4 COMMUNITY CARE HMO 218 WEST 6TH STREET TULSA OK 74119
GW6 COMMUNITY CARE LIFE AND HE P O BOX 176 TULSA OK 74101-0176
AB1 COMMUNITY HEALTH NETWORK P.O. BOX 80159 BATON ROUGE LA 70898
* - 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 37
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EU2 COMMUNITY HEALTH SYSTEMS P O BOX 4582 HOUSTON TX 77210
GM2 COMMUNITY HELATH PLAN PO BOX 3249 TULSA OK 74101-3249
IC1 COMP SERVICE INC P O BOX 8861 CAMP HILL PA 17001
DL4 COMPANION LIFE P O BOX 100133 COLUMBIA SC 29202-3133
F88 COMPASS HEALTH MANAGEMENT P O BOX 9507 SAVANNAH GA 31412
GY9 COMPBENEFITS P O BOX 30349 TAMPA FL 33630-3349
M98 COMPCARE 401 W MICHIGAN MILWAUKEE WI 53201
EL5 COMPDENT STANDARD DENTAL PLAN P O BOX 4605 CHICAGO IL 60607
DS8 COMPMED P O BOX 4780 TULSA OK 74159
AI4 COMPRECARE P.O. BOX 171017 DENVER CO 80217-1017
C57 COMPRECARE INC P O BOX 441170 AURORA CO 80044
IL2 COMPREHENSIVE BENEFITS P O BOX 8955 MELVILLE NY 11747
HQ2 COMPREHENSIVE CARE PO BOX 64668 ST PAUL MN 55164
BU6 COMPTON MANAGEMENT INC P O BOX 15070 GMF LITTLE ROCK AR 72231
Y93 CONAGRA P.O. BOX 726 FARMERVILLE LA 71241
A69 CONAGRA POULTRY CO CLAIMS PROCESSING CTR P.O. BOX 1758 EL DORADO AR 71731-1758
Y49 CONAGRA POULTRY COMPANY CLAIMS RT 5, BOX 311 MAGNOLIA AR 71753
K77 CONCEPT ADMIN P O BOX 7090 SACRAMENTO CA 95826
L26 CONCORDA HEALTH PLAN 1333 S KIRKWOOD ROAD PO BOX 26668 ST LOUIS MO 63122-6668
V57 CONFED ADMINISTRATION SERVICES INC P O BOX 2620 TULSA OK 74101
P80 CONFED ADMINISTRATIVE SERV 7410 N SIDE DR STE 202 PO BOX 2941903 N CHARLESTON SC 29419-9003
U5* CONFEDERATION LIFE PO BOX 105103 ATLANTA GA 30348
Q49 CONFEDERATION LIFE INS CO PO BOX 38058 TUSCON AZ 85740
ID8 CONNECTICARE PO BOX 546 FARMINGTON CT 06034-0546
P96 CONNECTICUT CARPENTERS HEA 10 BROADWAY HAMDEN CT 06518-2699
A38 CONNECTICUT GEN LIFE INSUR ALLIED CLAIM CENTER CALLER NUMBER 2 SYOSSET NY 11791
B46 CONNECTICUT GEN LIFE INSUR FALCON ATTN FLO NEWTON PO BOX 70 LEWISVILLE AR 71845
Z58 CONNECTICUT GEN NAWRO SW R COUNSEL GP MEDICAL PLAN P.O. BOX 542814 DALLAS TX 75354
HW1 CONNECTICUT GENERAL PO BOX 55270 PHOENIX AZ 85078
FI7 CONNECTICUT GENERAL PO BOX 10397 DES MOINES IA 50306
F15 CONNECTICUT GENERAL 600 GRANT ST, STE 1200 PITTSBURGH PA 15219
EX6 CONNECTICUT GENERAL LIFE 31 READS WAY NEW CASTLE DE 19720
GT* CONNECTICUT GENERAL LIFE 425 MAIN STREET ROOM 508 RACINE WI 53403
ZF* CONNECTICUT GENERAL LIFE 2400 POPLAR MEMPHIS TN 38112
RP* CONNECTICUT MEDICAL SERVIC 221 WHITNEY AVENUE NEW HAVEN CT 06511
* - 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 38
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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R32 CONNETICUT GENERAL LIFE IN P O BOX 6468 LAKELAND FL 33807-6468
DM1 CONSECO COMPANIES 11815 N PENNSYLVANIA P O BOX 2024 CARMEL IN 46082-2024
FW* CONSECO DIRECT COLONIAL PENN 399 MARKET STREET PHILADELPHIA PA 19181-1250
FG7 CONSECO HEALTH INS CO PO BOX 66909 CHICAGO IL 60666
BD2 CONSECO MEDICAL INS CO PIONEER LIFE MEDICAL P O BOX 1250 ROCKFORD IL 61105-1250
DI* CONSECO PIONEER LIFE MEDICARE SUPPLEMENT P O BOX 100 ROCKFORD IL 61105-0100
HL3 CONSECO SENIOR HEALTH PO BOX 2002 CARMEL IN 46082
BX1 CONSECO VARIABLE INS CO PO BOX 66967 CHICAGO IL 60666
HV2 CONSOCIATE GROUP PO BOX 1068 DECATUR IL 62525
S87 CONSOLIDAED EMPLOYEE BENEF PLAN WISCONSIN RAPIDS WI 54494
PE* CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES P O BOX 6130 TEMPLE TX 76503
CG6 CONSOLIDATED BENEFITS P O BOX 23686 COLUMBIA SC 29224
L93 CONSOLIDATED FREIGHT P O BOX 3988 PORTLAND OR 97208
CF2 CONSOLIDATED GROUP P O BOX 248 BRATTLEBORO VT 05302
BR1 CONSOLIDATED GROUP P O BOX 1350 FREEMONT OH 43420
AD9 CONSOLIDATED GROUP P O BOX 2070 NASHUA NH 03060-2070
B16 CONSOLIDATED INS PLANS INC FREEDOM TRUST P O BOX 1739 MUFREESBORO TN 37133-1739
H67 CONSOLIDATED MEDICAL PENROD 2200 THANKSGIVING TOWER DALLAS TX 75201
AI5 CONSOLIDATED NATIONAL LIFE INSURANCE COMPANY P.O. BOX 349 TROY AL 36081-0349
G87 CONSOLIDATED PROPERTIES P O BOX 5627 LITTLE ROCK AR 72215
GU7 CONSTITUTION LIFE INS CO PO BOX 130 PENSACOLA FL 32591-0130
AR* CONSTITUTION LIFE INS CO 325 WEST TRUDY AVENUE PARK RIDGE IL 60068
B98 CONSTRUCTION INDUSTRY LABO WELFARE FUND 116 COMMERCE DRIVE JEFFERSON CITY MO 65101
H10 CONSULTANTS AND ADMINISTRA P O BOX 720 DELAWARE OH 43015
S86 CONSUMER BENEFIT ASSOCIATI P O BOX 130 PENSACOLA FL 32591-0130
RJ* CONTINENTAL AMERICAN P O BOX 427 COLUMBIA SC 29202-0427
HY8 CONTINENTAL AMERICAN INS C CAIC P.O. BOX 427 COLUMIBA SC 29202
QA* CONTINENTAL AMERICAN LIFE 714 MAIN STREET FORT WORTH TX 76102
QG* CONTINENTAL AMERICAN LIFE FOR SUPPLEMENTS SEE QG1 P O BOX 15850 WILMINGTON DE 19850-5750
MZ* CONTINENTAL ASSURANCE C N A PLAZA CHICAGO IL 60685
P50 CONTINENTAL ASSURANCE CO PO BOX 3200 ATLANTA GA 30302
DP9 CONTINENTAL ASSURANCE CO 3404 W. CHERYL DR STE 281 PHOENIX AZ 85020-3900
CK2 CONTINENTAL CASUALTY CO P.O. BOX 1326 FORT WORTH TX 76101
FP* CONTINENTAL CASUALTY CO P O BOX 1134 CHICAGO IL 60690
L57 CONTINENTAL EXPRESS 1701 S SHACKLEFORD LITTLE ROCK AR 72211
* - 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 39
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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FG9 CONTINENTAL GENERAL PO BOX 2997 PARKERSBURG WV 26102
GB4 CONTINENTAL GENERAL PO BOX 247031 OMAHA NE 68124
L31 CONTINENTAL GENERAL INS CO PO BOX 2650 OMAHA NE 68103-2650
HX0 CONTINENTAL GENERAL INSURA PO BOX 29136 SHAWNEE MISSION KS 66201
H08 CONTINENTAL GENERAL INSURA PO BOX 30010 AUSTIN TX 78755
F86 CONTINENTAL GRAIN COMPANY WAYNE FARMS PO BOX 909 DANVILLE AR 72833-0909
QB* CONTINENTAL INSURANCE CNA 10810 EXECUTIVE CENTER DR SUITE 302 LITTLE ROCK AR 72211
ET3 CONTINENTAL LIFE ACCIDENT P O BOX 1300 ROCKFORD IL 61105-1300
P3* CONTINENTAL LIFE AND ACCIDENT CO P O BOX 1599 BOISE ID 83701
S51 CONTINENTAL LIFE AND ACCID C/O LEE TRANSPORTATION P O BOX 628 STUTTGART AR 72160
C93 CONTINENTAL LIFE AND ACCID 5100 GAMBLE DRIVE P O BOX 9398 MINNEAPOLIS MN 55440-9398
Q28 CONTINENTAL LIFE INS CO DIVISION OF FORESIGHT PO BOX 1387 MENA AR 71953
Q11 CONTINENTAL LIFE INS CO 101 CONTINENTAL PLACE P O BOX 1188 BRENTWOOD TN 37027-1188
M97 CONTINENTAL MEDICAL SYSTEM P O BOX 1523 LANCASTER PA 17603
G53 CONTINENTAL SYSTEMS VIP POBOX 51005 SHREVEPORT LA 70130
X61 CONTRA COSTA ELECT WORKERS HEALTH WELFARE TRUST RET LOCAL 302 P O BOX 668 PLEASANTON CA 94566
H33 CONTRA COSTA HEALTH PLAN 3052 WILLOW PASS ROAD CONCORD CA 94519
Y75 CONTRACT FREIGHTERS INC P.O. BOX 2547 JOPLIN MO 64803
HM8 CONVENTRY HEALTH INSURANCE P.O. BOX 7109 LONDON KY 40742
ZV* COOPER INDUSTRIAL RUBBER COMPANY 166 COOPER LANE EL DORADO AR 71730
U39 COOPER INDUSTRIES INC P O BOX 770 DUMAS AR 71639
U4* COOPER MAJOR MEDICAL 3500 WASHINGTON STREET FINDLEY OH 45840
H20 COOPER TIRE COMPANY RT 2 BOX 252 TEXARKANA AR 71854
HT2 COOPERATE SYSTEM ADMINISTR PO BOX 4985 JOHNSON CITY TN 37602-4985
Z87 COOPERATIVE BENEFIT ADMIN P.O. BOX 6249 LINCOLN NE 68506
DX8 COOPERATIVE BENEFIT ADMINS NATURAL RURAL ELECTRIC P O BOX 1000 SALEM AR 72576
F8* COOPERATIVE HEALTH ASSOC BENEFIT TRUST P O BOX 7305 KANSAS CITY MO 63105
IN9 COORDINATED BENEFIT PLAN L P O BOX 21994 EAGAN MN 21994
B3* COORS HEALTH CARE PLAN DEPARTMENT 311 GOLDEN CO 80401
AZ3 CORE STAR PO BOX 1195 MINNEAPOLIS MN 55440
BD5 CORESOURCE P. O. BOX 83301 LANCASTER PA 17608-3301
BN9 CORESOURCE P O BOX 879 ANDERSON IN 46015
BN3 CORESOURCE P O BOX 6179 WESTERFIELD OH 43081
BM6 CORESOURCE P O BOX 168 MATTESON IL 60443
AP9 CORESOURCE RELIASTAR 146 INDUSTRIAL PARK JACKSON MN 56143
* - 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 40
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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CN4 CORESOURCE P O BOX 6994 WAYNE PA 19087
CY7 CORESOURCE 6100 FAIRVIEW ROAD SUITE 1000 CHARLOTTE NC 28210
V24 CORESOURCE RELIASTAR P O BOX 29016 GLENDALE CA 91209-9016
GI1 CORESOURCE REPRICING DIVISION PO BOX 2181 LITTLE ROCK AR 72203-2181
FR3 CORESOURCE PO BOX 8215 LITTLE ROCK AR 72221
IB* CORESOURCE RELISTAR BOX 1195 MINNEAPOLIS MN 55440
GM9 CORESOURCE P O BOX 22920 CLINTON IA 52733
EV1 CORESOURCE FORMERLY CORPORATE BENEFIT SOLUTIO P O BOX 8215 LITTLE ROCK AR 72221
CX2 CORESOURCE INC 4940 CAMPBELL BLVD SUITE 200 BALTIMORE MD 21236
F67 CORKEN INTERNATIONAL CORP P O BOX 12338 OKLAHOMA CITY OK 73157
EF7 CORPORATE BENEFIT SERVICE CBSA P O BOX 5367 HOPKINS MN 55343-5367
GJ3 CORPORATE BENEFIT SERVICES 400 HWY 169 SOUTH MINNEAPOLIS MN 55426
CT7 CORPORATE BENEFIT SERVICES CBSA P O BOX 738 HOPKINS MN 55343
DT4 CORPORATE BENEFIT SERVICES 10159 WAYZATA BLVD MINNETONKA MN 55305
GC3 CORPORATE BENEFITS SERV IN PO BOX 12953 CHARLOTTE NC 28220-2953
W17 CORPORATE DIVERSIFIED SERVICES INC P O BOX 2835 OMAHA NE 68103-2835
K6* CORPORATE GROUP SYSTEMS HERTZ CLAIM MGMT CORP P O BOX 5710 LIVONIA MI 48151-5710
R44 CORPORATE GROUP SYSTEMS IN P O BOX 1470 BENTONVILLE AR 72712-1470
CT1 CORPORATE HEALTH ADM 1800 E INTERSTATE AVE P O BOX 1858 BISMARCK ND 58502
GC7 CORPORATE HEALTH BENEFITS PO BOX 27267 MINNEAPOLIS MN 55427
CX4 CORPORATE HEALTH INC 1300 SUMMIT AVENUE SUITE 600 FORT WORTH TX 76102-4420
CK7 CORPORATE PLAN MGE P O BOX 4651 TOPEKA KS 66604
D73 CORPORATION BENEFITS DIVIS 200 S LAMAS STREET P O BOX 101 JACKSON MS 39205-0101
AG3 CORRELL INC UNITED OF OMAHA PO BOX 417 CHARLESTON AR 72933
AJ5 CORVEL 1701 CENTERVIEW DRIVE SUITE 320 LITTLE ROCK AR 72211-4313
BC9 COST CARE UNICARE P O BOX 2006 ANDOVER MA 01810-0106
F32 COST CARE INCORPORATED 17011 BEACH BOULEVARD HUNTINGTON BEACH CA 92647
BG2 COST MANAGEMENT TECHNOLOGI 4435 MAIN SUITE 810 KANSAS CITY MO 64111
CR5 COST MANAGEMENT TECHNOLOGI PO BOX 29122 SHAWNEE MISSION KS 66201-1422
G35 COTTER MEMBERS INSURANCE 203 JANDUS ROAD CARY IL 60013
AU3 COTTON CLUB CASINO P.O. BOX 1777 GREENVILLE MS 38701-1777
K86 COUNTRY LIFE INS COUNTRY COMPANIES P O BOX 2000 BLOOMINGTON IL 61701
R51 COUNTRY LIFE INS CO 900 HILLSBORO EDWARDVILLE IL 62025
GY6 COVENANT ADMINISTRATORS IN P O BOX 105738 ATLANTA GA 30348-5738
HP2 COVENTRY HEALTH CARE OF NEBRASKA PO BOX 7705 LONDON KY 40742
* - 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 41
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GF8 COVENTRY HEALTH CARE 8301 E 21ST ST N STE 300 WICHITA KS 67206
GJ2 COVENTRY HEALTH CARE 2751 CENTERVILLE RD STE 400 WILMINGTON DE 19808
IL8 COVENTRY HEALTH CARE P O BOX 7121 LONDON KY 40742
IK2 COVENTRY HEALTH CARE P O BOX 7374 LONDON KY 40742
GS2 COVENTRY HEALTHCARE PO BOX 8400 LONDON KY 40742
GX8 COVENTRY HEALTHCARE OF IOW P O BOX 7709 LONDON KY 40742
J75 COWLITZ MEDICAL SERVICE PO BOX 2039 LONGVIEW WA 98351
GG7 COX HEALTH PLAN 1443 N ROBBERSON STE 70 PO BOX 5750 SPRINGFIELD MO 65801-5750
HP9 COX HEALTH SYSTEMS INSURAN PO BOX 5750 SPRINGFIELD MO 65801-5750
X53 CRAIGHEAD ELECTRIC CORP P O BOX 7503 JONESBORO AR 72403
X27 CRANE COMPANY 201 NORTH 8TH STREET ROGERS AR 72756
CF3 CRANE KEMLITE C/O CIGNA 8500 C W POST ROAD JONESBORO AR 72401
K62 CRAWFORD AGENCY P O BOX 199 SEARCY AR 72143
L14 CRAWFORD COUNTY MEMORIAL EAST MAIN 20TH STREETS VAN BUREN AR 72956
AX7 CROUZET CORPORATION ATTN GLENDA KATE 2445 MIDWAY ROAD CARROLLTON TX 75006-2503
R71 CROWN CORK AND SEAL CO EMPLOYEE HEALTH PLAN 9300 ASHTON ROAD PHILADELPHIA PA 19136
W1* CROWN LIFE INS CO 546 STADIUM RD PORT ARTHUR TX 77642
KU* CROWN LIFE INS CO SOUTHERN CAST PROD 5701 KRUEGER DR JONESBORO AR 72401
D48 CROWN LIFE INSURANCE P O BOX 8222 CHICAGO IL 60680-8222
DZ* CROWN LIFE INSURANCE 100 FM 1960W STE 109 HOUSTON TX 77090
FS* CROWN LIFE INSURANCE CO P O BOX 30138 TAMPA FL 33630
WZ* CROWN LIFE INSURANCE CO 100 PINE STREET TWENTY THIRD FLOOR SAN FRANCISCO CA 94111
WE* CROWN LIFE INSURANCE CO 1601 PERIMETER CNTR EAST ATLANTA GA 30308
NG* CROWN LIFE INSURANCE CO 11500 NO RODNEY PARHAM RD LITTLE ROCK AR 72212
MI* CRUMP BENEFITS P O BOX 171377 MEMPHIS TN 38117
X13 CSWS CLAIM PROCESSING CENTRAL SOUTHWESTERN SERV P O BOX 21928 TULSA OK 74121-1928
DV8 CULINARY INS CO INTERNATIONAL UNION W F 1901 LAS VEGAS BLVD SO LAS VEGAS NV 89104
G76 CUNA MUTUAL INS SOCIETY CREDIT UNION MEMBERS INS MALVERN PA 19355
B52 CUNA MUTUAL INSURANCE CORP CU MEMBERS HOSP PLAN ATTN CLAIMS DIVISION VALLEY FORGE PA 19494
FY1 CURASCRIPT 7101 TPC DRIVE SUITE 150 ORLANDO FL 32822
G46 CUSTOM SECURITY MUTUAL LIF P O BOX 27247 AUSTIN TX 78755-2247
VL* CYANAMID PERSONAL PROTECTION 859 BERDAN AVENUE WAYNE NJ 07406
BJ9 D CANALE CO P. O. BOX 1739 MEMPHIS TN 38101-1739
L63 DAISY MANUFACTING HWY 71 ROGERS AR 72756
ES6 DAKOTA WESTERN HEALTH PLAN BROTHERHOOD OF ELECT WKRS P O BOX 1951 FARGO ND 58107
* - 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 42
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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FA9 DAKOTACARE P O BOX 89310 SIOUX FALLS SD 57109
A24 DALLAS NATIONAL CORP PO BOX 809059 DALLAS TX 75380-9059
BT3 DAVID REES P O BOX 1573 2110 EAST MATTHEWS ST JONESBORO AR 72403-1573
N25 DAVID SMITH INS AGENCY 108 HERON BRANDON MS 39042
G23 DAVIS AND GARVIN POBOX 21627 COLUMBIA SC 29221
EJ5 DAVIS VISION P O BOX 2270 SCHENECTADY NY 12301
FF5 DBL NORTH AMERICAN POB 853921 RICHARDSON TX PO BOX 9501 AMHERST NY 14226-9501
V86 DBL SERVICES 515 OLIVE STE 700 P O BOX 66714 ST LOUIS MO 63166
M70 DCA HEALTHCARE MGT 13100 WAYZATTA BLVD MINNETONKA MN 55343
IG9 DCDNT P O BOX 1348 MINNEAPOLIS MN 55440-1348
EC4 DEAN HEALTH PLAN P O BOX 56099 MADISON WI 53705
IJ8 DEARBORN NATIONAL DENTAL S P O BOX 23060 BALEVILLE IL 62223
GT9 DEFINITY 500 COLVIN WOODS PKWY TONAWANDA LA 14150
GT8 DEFINITY HEALTH 1600 UTICA AVE S STE 900 ST LOUIS PARK MN 55416-1465
GS4 DEFINITY HEALTH A UNITED HEALTH GROUP CO PO BOX 740810 ATLANTA GA 30374-0810
GB6 DEFINITY HEALTH P O BOX 9525 AMHERST NY 14226-9525
HE6 DEFINITY HEALTH EMPLOYERS HEALTH COALITIO P O BOX 250009 PLANO TX 75025
Q6* DELAM AM HEALTH TRUST P O BOX 899 CLEARWATER FL 33517
BJ5 DELPHI GROUP PO BOX 3611 BARRINGTON IL 60010
T75 DELTA AIR LINES HARTSFIELD ATLANTA INTNL ATLANTA GA 30320
L67 DELTA BENEFIT PLANS P O BOX 80 STOCKTON CA 95201
H72 DELTA BEVERAGE GROUP INC MINNEAPOLIS GRP CLA CT II P.O. BOX 1195 MINNEAPOLIS MN 55440
HN9 DELTA DENTAL PO BOX 789769 WICHITA KS 67278-9769
HC8 DELTA DENTAL P O BOX 8690 ST LOUIS MO 63126
GV4 DELTA DENTAL PO BOX 1809 ALPHARETTA GA 30023-1809
EA1 DELTA DENTAL P O BOX 152140 IRVING TX 75015-2140
HD4 DELTA DENTAL OF NORTH CAROLINA 343 SIX FORKS ROAD RALEIGH NC 27609
HW0 DELTA DENTAL OF CA PO BOX 537007 SACRAMENTO CA 95837-0078
CI6 DELTA DENTAL OF CA P O BOX 269023 SACRAMENTO CA 95826-9023
GV0 DELTA DENTAL OF CALIFORNIA PO BOX 537007 SACRAMENTO CA 95853-7007
GZ9 DELTA DENTAL OF GEORGIA PO BOX 1809 ALPHARETTA GA 30023
HB1 DELTA DENTAL OF HAWAII 700 BISHOP STREET SUITE 700 HONOLULU HI 96813
FJ8 DELTA DENTAL OF ILLINOIS PO BOX 5402 LISLE IL 60532
FR9 DELTA DENTAL OF IOWA PO BOX 919 ANKENY IA 50021-0919
CU6 DELTA DENTAL OF MA 465 MEDFORD STREET PO BOX 9695 BOSTON MA 02114-9695
* - 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 43
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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HG4 DELTA DENTAL OF MISSOURI C/O CUSTOMER SERVICES P O BOX 8690 ST LOUIS MO 63126-0690
CL6 DELTA DENTAL OF MISSOURI P O BOX 16921 ST LOUIS MO 63105
IN1 DELTA DENTAL OF NEW YORK P O BOX 2105 MECHANICSBURG PA 17055
IH5 DELTA DENTAL OF OKLAHOMA P O BOX 548809 OKLAHOMA CITY OK 73154
DS4 DELTA DENTAL OF PA ONE DELTA DRIVE MECHANICSBURG PA 17055
IH6 DELTA DENTAL OF VIRGINIA 4818 STARKEY ROAD ROANOKE VA 24018
FK1 DELTA DENTAL OF WASHINGTON PO BOX 75983 SEATTLE WA 98125
IA6 DELTA DENTAL OF WI PO BOX 828 STEPHENS POINT WI 54481
DY8 DELTA DENTAL PLAN OF ILLINOIS P O BOX 9500 DOWNERS GROVE IL 60515-9500
JO7 DELTA DENTAL PLAN P O BOX 997330 SACRAMENTO CA 95899-7330
Z25 DELTA DENTAL PLAN P O BOX 330 MINNEAPOLIS MN 55440
N86 DELTA DENTAL PLAN OF MICHIGAN P O BOX 9085 FARMINGTON HILLS MI 48333-9085
CX9 DELTA DENTAL PLAN OF NEW JERSEY P O BOX 222 PARSIPPANY NJ 07054
H92 DELTA DENTAL PLAN OF AR P.O. BOX 15965 NORTH LITTLE ROCK AR 72231
PC* DELTA DENTAL PLAN OF CO P O BOX 173803 DENVER CO 80217-3803
CU9 DELTA DENTAL PLAN OF KY 9901 LINN STATION ROAD LOUISVILLE KY 40223
A47 DELTA DENTAL PLN OF TN 240 VENTURE CIRCLE NASHVILLE TN 37228
GU1 DELTA HEALTH SYSTEM P O BOX 692350 STOCKTON CA 95269-2350
HX2 DELTA HEALTH SYSTEMS PO BOX 80 STOCKTON CA 95201-3080
BK8 DELTA HEALTH SYSTEMS PO BOX 12307 FRESNO CA 93777-2307
CC9 DELTA TRI CARE FAMILY MEDICAL DENTAL P.O. BOX 9086 FARMINGTON HILLS MI 48333-9086
FS6 DELTA USA PO BOX 59238 MINNEAPOLIS MN 55459
K59 DELTA WESTERN STATES PO BOX 8082 FRESNO CA 93747
W16 DENT A MED CUSTOMER SERVICE CENTER P O BOX 1567 FAYETTEVILLE AR 72702
IE8 DENTAL NETWORK OF AMERICA PO BOX 23060 BELLEVILLE IL 62223
BQ4 DENTICARE 7112 S MINGO SUITE 108 TULSA OK 74133
IE3 DENVER HEALTH PLAN 777 BANNOCK STREET MAIL CD 6000 DENVER CO 80204-4507
CR2 DEPT OF VETERANS AFFAIRS REGIONAL OFFICE 100 WEST CAPITOL STREET JACKSON MS 39269
EW6 DESERET MUTUAL BENEFIT ADMINISTRATION P O BOX 45530 SALT LAKE CITY UT 84145
BN6 DIAGNOSTIC INCORPERATED P O BOX 27870 ALBUQUERQUE NM 87125
Q50 DIDION MID SOUTH CORPORATI 2216 DODSON AVE SUITE A FORT SMITH AR 72901
AL7 DIGICON EMPLOYEE BENEFIT PLAN 3701 KIRBY DR, NO. 1050 HOUSTON TX 77098
L29 DILLON FOODS STORES P O BOX 1266 HUTCHINSON KS 67504-1266
CP6 DIVERSIFIED GROUP SERVICES P O BOX 330 CANONSBURG PA 15317
DD3 DIVERSIFIED PHARMACUTICALS ROUTE 4029 P O BOX 169052 DULUTH MN 55816-8220
* - 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 44
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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U43 DIXIE NATIONAL LIFE INS P O BOX 22587 JACKSON MS 39225-2587
EZ9 DMI INC P O BOX 65 GOODFIELD IL 61742
BE9 DOCFIRST P O BOX 17098 1 800 793 9403 BALTIMORE MD 21203
E11 DOLLAR GENERAL CORP 427 BEECH STREET P O BOX 291927 SCOTTSVILLE KY 42164
R76 DOLLAR GENERAL CORP P O BOX 121228 NASHVILLE TN 37212
CX6 DONOVAN BENEFIT SYSTEMS 440 LOUISIANA NO 1600 HOUSTON TX 77002
Q20 DONREY MEDIA GROUP 3600 WHEELER AVE P O BOX 170117 FORT SMITH AR 72917-7017
HR5 DORAL DENTAL P O BOX 45 GRAFTON WI 53024
R46 DORTH COOMBS INSURANCE INC EMPLOYEE GR BENEFIT PLAN 833 BEACHWOOD FAYETTEVILLE AR 72701
M19 DOW CHEMICAL COMPANY PO BOX 2349 MIDLAND MI 48667-2349
U79 DPS ROUTE 8071 P O BOX 1459 MINNEAPOLIS MN 55440-1459
AI6 DRAKE INSURANCE ADMIN P.O. BOX 1253 COLTON CA 92354
CI7 DREYER HMO 1877 W DOWNER PLACE AURORA IL 60506-9659
DV6 DRUMMOND CITIZEN INS CO 201 PINE STREET WEST MEMPHIS AR 72301
K78 DUAL PLUS 911 SLUDERBAKER ROAD SUITE 250 LONG BEACH CA 90815
I99 DUMMOND CITIZENS INS CO 609 LOCUST CONWAY AR 72032
JA4 DUNN AND ASSOCIATES P O BOX 2369 COLUMBUS IN 47202
G3* DUNN AND BRADSTREET P O BOX 30102 TAMPA FL 33630-3102
BE4 DUNN AND BRADSTREET ONONDAGA CO BENEFIT PLAN P. O. BOX 4773 SYRACUSE NY 13221-4773
BV9 DUTCH QUALITY HOUSE 5310 KENNON LANE BOSSIER CITY LA 71112
BV4 DYERSBURG FABRICS INC P O BOX 767 DYERSBURG TN 38025
J7* E AND E BENEFIT PLANS 3501 JOHNSON STREET HOLLYWOOD FL 33320
WT* E B A AND M CORPORATION 2393 TOWNSGATE ROAD SUITE 204 WESTLAKE VILLAGE CA 91361
P37 E B C GULF LIFE PO BOX 871 MERIDIAN MS 39302
BW7 E I S BRAKE ATTN SHIRLEY PO BOX 950 MANILA AR 72442
BY5 E SYSTEMS P O BOX 1567 HOUSTON TX 77251
R75 EARLE INDUSTRIES INC P O BOX 28 EARLE AR 72331
E57 EASTERN BENEFIT SYSTEM 200 FREEWAY DRIVE EAST EAST ORANGE NJ 07018
FK8 EATON CORPORATION PO BOX 23806 TUCSON AZ 85734
H40 EBAM PO BOX 2457 WEST HELENA AR 72390
HA1 EBMS P O BOX 21367 BILLINGS MT 59104-1367
BS9 EBP HEALTHPLANS FIRST HEALTH P O BOX 24007 FRESNO CA 97339
EE9 EBP US MARINE BAYLINER TPA OF WA 800 5TH AVE STE 2500 SEATTLE WA 98104-3122
X22 EBPA HEALTHSOURCE P O DRAWER 2000 HAMPTON NH 03842
FK7 EBS HARRINGTON BENEFIT SERVICES P O BOX 70100 SHREVEPORT LA 71137-0100
* - 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 45
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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BZ4 ECK ADAMS COMPANY 1300 RICHARD PREWITT DR OSCEOLA AR 72370
J97 ECLIPSE INDUSTRIAL 3201 WEST 34TH PINE BLUFF AR 71603
CV1 EDMOND ADMINISTRATORS P O BOX 419325 KANSAS CITY KS 64141-6325
CT6 EDS HEALTH PLAN P O BOX 796069 DALLAS TX 75379-0669
0X* EDSA P O BOX 868 BALTIMORE MD 21203-0868
DN1 EDUCATORS MUTAL LIFE P O BOX 83888 LANCASTER PA 17608-3888
JB3 EIIA PO BOX 189 BRIDGETON MA 04009
L7* ELDER CARE OF ARKANSAS P O BOX 545 HOT SPRINGS AR 71901
II* ELECTRONIC BENEFIT ADM 7557 RAMBLER ROAD SUITE 555 DALLAS TX 75231
X82 ELITE LAMP INC ATTN HEALTH INS DEPT PO BOX 936 WEST MEMPHIS AR 72303
RN* ELY WALKER SHIRT MFG 220 EAST PARK STREET PARAGOULD AR 72450
W28 EMPIRE BLUE CROSS 75 CRYSTAL RUN RD P O BOX 5012 MIDDLETOWN NY 10940-9012
IK8 EMPIRE BLUE CROSS DENTAL BENEFITS PROGRAM P O BOX 810 MINNESPOLIS MN 55440-0810
EF3 EMPIRE BLUE CROSS ATTN MILAN HABEL P O BOX 170 NEW YORK NY 10156-0170
DB8 EMPIRE BLUE CROSS BLUE SHIELD P O BOX 11800 ALBANY NY 12211
CQ4 EMPIRE BLUE CROSS BLUE SHI P O BOX 5071 1 800 223 7486 MIDDLETOWN NY 10940
BX3 EMPIRE BLUE CROSS BLUE SHI ATTN NYNEX DED SERV CTR P O BOX 5047 MIDDLETOWN NY 10941-9047
HQ* EMPIRE BLUE CROSS BLUE SHI 622 THIRD AVENUE P O BOX 345 NEW YORK NY 10163-0345
Q88 EMPIRE BLUE CROSS BLUE SHI GRAND CENTRAL STATION P O BOX 3850 NEW YORK NY 10163
X4* EMPIRE TRUST GRP UNDERWRIT 2 PUBLIC SQUARE PO BOX 6079 ELBERTON GA 30635
W65 EMPLOYEE BENEFIT ADMIN INC P O BOX 7965 OVERLAND PARK KS 66207
CU5 EMPLOYEE BENEFIT ADMIN INC P O BOX 425 MARSHFIELD MA 02050
S78 EMPLOYEE BENEFIT CLAIMS P O BOX 871 MERIDIAN MS 39302
I87 EMPLOYEE BENEFIT FUND 8600 HILLCREST RD STE 1 KANSAS CITY MO 64138
Z59 EMPLOYEE BENEFIT MGT CORP 4789 RINGS ROAD DUBLIN OH 43017
IH9 EMPLOYEE BENEFIT PLAN P O BOX 2000 EXETER NH 03833
V58 EMPLOYEE BENEFIT PLAN ADMINISTRATORS INC P O BOX 2000 HAMPTON NH 03842
BS4 EMPLOYEE BENEFIT PLAN P O BOX 392 EXTON PA 19341-0392
A5* EMPLOYEE BENEFIT SERVICES 601 SOUTH BLVD P O BOX 3247 TAMPA FL 33601
HB6 EMPLOYEE BENEFIT SERVICES LOUISIANA, INC P.O. BOX 94488 LUBBOCK TX 79493-4488
DY1 EMPLOYEE BENEFIT SOLUTION PO BOX 691030 SAN ANTONIO TX 78269
EL3 EMPLOYEE BENEFIT STRATEGIE 229 EAST MICHIGAN AVE SUITE 235 KALAMAZOO MI 49007
X83 EMPLOYEE BENEFIT SVCS INC P O BOX 70100 SHREVEPORT LA 71137-0100
F42 EMPLOYEE BENEFITS ADMINIST 10100 SANTE FE DR POBOX 14970 SHAWNEE MISSION KS 66215
M52 EMPLOYEE BENEFITS AMERICA P O BOX C3500 FEDERAL WAY WA 98003
* - 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 46
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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A11 EMPLOYEE BENEFITS CONSULT PO BOX 578 NORTH LITTLE ROCK AR 00000
BR9 EMPLOYEE BENEFITS CORPORAT PO BOX 3618 PEORIA HEIGHTS IL 61612
F49 EMPLOYEE BENEFITS DEPT POBOX 189 COLUMBUS OH 43216
BE6 EMPLOYEE BENEFITS TRUST CO P. O. BOX 8788 WILMINGTON DE 19899
H96 EMPLOYEE FINANCIAL SERVICE HEALTH CARE VISION CARE P.O. BOX 27003 RICHMOND VA 23261
EB6 EMPLOYEE HEALTH BENEFIT P O BOX 66922 ST LOUIS MO 63166
G27 EMPLOYEE HEALTH CARE BENEF P O BOX 2749 WEST HELENA AR 72390
FJ4 EMPLOYEE HEALTH PLAN P.O.BOX 232 MORTON IL 61550-0232
E99 EMPLOYEE HEALTH PLAN 8900INDIAN CREEK PARKWAY BOX 25900 OVERLAND PARK KS 66225
BH2 EMPLOYEE HEALTH PLAN P. O. BOX 70837 LAS VEGAS NV 89170
DN3 EMPLOYEE PLANS INC P O BOX 2362 FORT WAYNE IN 46801-2362
E53 EMPLOYEES BENEFIT ASSOC A T AND S F P O BOX 1625 TOPEKA KS 66601-1625
AA9 EMPLOYEES BENEFIT PLANS INC EBP 435 FORD ROAD SUITE 500C MINNEAPOLIS MN 55426
S75 EMPLOYEES BENEFITS SERVICE P O BOX 12477 CHARLOTTE NC 28220
BP7 EMPLOYEES COOP IND TRUST P O BOX 19884 INDIANAPOLIS IN 46219
AY1 EMPLOYEES GROUP INSURANCE PROGRAM P.O. BOX 24870 OKLAHOMA CITY OK 73124
YR* EMPLOYEES MUTUAL LIFE COMPANY 916 SHERWOOD DRIVE LAKE BLUFF IL 60044
Y94 EMPLOYEES MUTUAL WELFARE A 3100 SYCAMORE DRIVE DEKALB IL 60015
SA* EMPLOYER HEALTH AND WELFAR INTERNATL UNION OF OPERAT 1125 17TH STREET NW WASHINGTON DC 20036
AM7 EMPLOYER PLAN SERVICES PO BOX 19776 HOUSTON TX 77224-9776
FQ3 EMPLOYERS CHOICE HEALTH 1525 MERRILL DR STE 2000 LITTLE ROCK AR 72211
EU6 EMPLOYERS CLAIM SERVICE P O BOX 219010 DALLAS TX 75221
EE* EMPLOYERS EQUITABLE LIFE I P O BOX 1417 LITTLE ROCK AR 72203
DM6 EMPLOYERS HEALTH COALITION 4949 OLD GREENWOOD RD SUITE 1 FORT SMITH AR 72903
B57 EMPLOYERS INS OF TEXAS 4107 HIGHWAY 75 NORTH SHERMAN TX 75090
H52 EMPLOYERS OPERATING ENGINE HEALTH WELFARE PLAN 8 EXECUTIVE WOODS CT BELLEVILLE IL 62221
EU4 EMPLOYERS PERSONNEL SERVIC P O BOX 596 MONTICELLO AR 71655
AP4 EMS ADMINISTRATIVE SVCS 1115 W. LANCASTER AVE TRAC WORK INC FORT WORTH TX 76102
N64 ENCOMPASS HEALTH MGMT SYST 6000 WESTOWN PARKWAY SUITE 350E DEPT 1000 W DES MOINES IA 50266
I94 ENSCO INC AMERICAN OIL ROAD P.O. BOX 1957 EL DORADO AR 71731
P66 ENSERCH P O BOX 4271 HOUSTON TX 77210
N84 ENTERCORP P.O. BOX 922013 HOUSTON TX 77292-2013
DM9 EPIC LIFE INSURANCE CO P O BOX 8924 MADISON WI 53708
A41 EPOCH GROUP INC PENSION ASSOCIATES INC 10795 WATSON RD ST LOUIS MO 63127
XI* EPOCH GROUP INC LAHOOD AND ASSOCIATES P O BOX 12170 OVERLAND PARK KS 66212
* - 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 47
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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N95 EQUICOR 3200 PARK LANE DRIVE PITTSBURG PA 15275-1102
AN1 EQUICOR STUTTGART COOP BUYERS PO BOX 10392 DES MOINES IA 50300
R49 EQUICOR P O BOX 16795 COLUMBUS OH 43216
R47 EQUICOR CO 850 RIDGE LAKE RD MEMPHIS TN 38120
L69 EQUICOR INS 2 VANTAGE WAY P O BOX 1465 NASHVILLE TN 37202
RY* EQUITABLE P O BOX 3960 SAN FRANCISCO CA 94119
T54 EQUITABLE WATERFALL GLEN REG BENE P O BOX 549 LEMONT IL 60439
E63 EQUITABLE P O BOX 529 COLORADO SPRINGS CO 80901
CZ* EQUITABLE NORTH EIGHTH ROGERS AR 72756
CB* EQUITABLE 5100 POPLAR AVENUE SUITE 150C MEMPHIS TN 38137
WG* EQUITABLE ASSUR SOCTY OF U 3077 W JEFFERSON ST SUITE 101 JOLIET IL 60435
F66 EQUITABLE GROUP HEALTH INS POBOX 24009 FRESNO CA 93779
B18 EQUITABLE INS CO 3210 WATLING STREET EAST CHICAGO IN 46312
K9* EQUITABLE INSURANCE GENERAL DELIVERY GARDEN CITY NY 11530
KP* EQUITABLE LIFE AND CASUALT EQUITABLE BLDG P O BOX 2460 SALT LAKE CITY UT 84110
R89 EQUITABLE LIFE AND CASUALT LINDA MORRISON P O BOX 132 HOT SPRINGS AR 71902
WO* EQUITABLE LIFE ASSURANCE SOCIETY SOUTHERN SERVICE CENTER CHARLOTTE NC 28259
A8* EQUITABLE LIFE ASSURANCE P O BOX 885 TULSA OK 74102
BZ8 EQUITABLE LIFE ASSURANCE 4602 SUMMERHILL TEXARKANA TX 75503
E17 EQUITABLE LIFE ASSURANCE P O BOX 1 CYPRESS GARDENS FL 33880
GK* EQUITABLE LIFE ASSURANCE 785 CROSSOVER OFFICE SUITE 250 MEMPHIS TN 38117
E70 EQUITABLE LIFE ASSURANCE P O BOX 4000 PICAYUNE MS 39466
N4* EQUITABLE LIFE ASSURANCE 4220 JOHNSON DRIVE SHAWNEE MISSION KS 66205
NJ* EQUITABLE LIFE ASSURANCE 515 OLIVE STREET ST LOUIS MO 63101
P22 EQUITABLE LIFE ASSURANCE SOCIETY OF THE US 208 OLD LANCASTER DEVON PA 19333
CN* EQUITABLE LIFE ASSURANCE S FAIRVIEW OFF CTR ST 302 B4220 JOHNSON DRIVE SHAWNEE MISSION KS 66205
CC* EQUITABLE LIFE GROUP 100 MORRIS AVENUE SPRINGFIELD NJ 07081
0F* EQUITABLE LIFE INS CO P O BOX 2481 NEW YORK NY 10001
IE* EQUITABLE LIFE INS CO 9 GREENWAY PLAZA SUITE 2014 HOUSTON TX 77406
PK* EQUITABLE LIFE INSURANCE GENERAL DELIVERY TACOMA WA 93401
TQ* EQUITABLE LIFE INSURANCE 15 SOUTH FIFTH STREET 1000 CHMBR OF CMRCE BLDG MINNEAPOLIS MN 55400
HX* EQUITABLE MAJOR MEDICAL SERVICE CENTER P O BOX 3000 LANCASTER SC 29721-3000
K35 EQUITABLE PLAN SERVICES P O BOX 720460 OKLAHOMA CITY OK 73172
F29 EQUITY INTERNATIONAL LIFE 1320 LAKE STREET FORT WORTH TX 76102
BG3 ERISCO P O BOX 4773 SYRACUSE NY 13221
* - 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 48
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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AL9 ERN ADMINISTRATORS INC PO BOX 9137 FT WORTH TX 76147
N24 ESCOBAR ADMINISTRATORS PO BOX 5279 TORRANCE CA 90510-5279
J9* ESMARK INC HEALTH BENEFIT PLAN P O BOX 665 HUNTSVILLE AL 72740
IJ9 ESSENTIAL STAFF CARE P O BOX 6702 COLUMBIA SC 29260
T71 EUDORA GARMENT MFG 304 SUPERIOR DRIVE EUDORA AR 71640
HV3 EVEREST ADMINISTRATORS PO BOX 19002 PROVO UT 84605-9002
YZ* EVOLUTIONS HEALTH CARE ROCKLINE INDUSTRIES PO BOX 5001 NEW PORT RICHEY FL 31656
HV1 EXCELLUS BCBS PO BOX 22999 ROCHESTER NY 14692
FY6 EXPRESS PHARMACY PO BOX 390873 BLOOMINGTON MN 55439
CC2 EXPRESS SCRIPTS PO BOX 66773 ST LOUIS MO 63166-6773
IC8 EXPRESS SCRIPTS PO BOX 390873 BLOOMINGTON MN 55439-0873
GV9 EXPRESS SCRIPTS INC PO BOX 66583 ST LOUIS MO 63166
GB9 EXPRESS SCRIPTS INC PO BOX 66518 ST LOUIS MO 63166-6518
CY9 EYE CARE PLAN OF AMERICA P O BOX 35859 PHOENIX AZ 85069
GU3 EYEMED VISION CARE P O BOX 8504 MASON OH 45040-7111
H34 F H P INSURANCE CO P O BOX 3697 SEAL BEACH CA 90740
L37 FACET ENTERPRISES INC TWO WARREN PLACE 61005 YALE AVENUE TULSA OK 74136-1996
GH8 FALLON HEALTHCARE 10 CHESTNUT STREET PO BOX 15121 WORCESTER MA 01615
U25 FAMILY DOLLAR STORE P O BOX 1017 CHARLOTTE NC 00000
D75 FAMILY HEALTH PROGRAM 323 SOUTH 600 EAST SALT LAKE CITY UT 84103
GJ9 FAMILY HERITAGE LIFE INS PO BOX 470608 CLEVELAND OH 44147
FL8 FAMILY HERITAGE LIFE INS C P O BOX 31420 CLEVELAND OH 44131-0420
AW4 FANSTEEL WELLMAN DYNAMICS HWY 34 EAST P.O. BOX 147 CRESTON IA 50801
HO3 FARA BENEFIT SERVICES 3838 N CAUSEWAY BLVD SUITE 2400 METAIRIE LA 70002
GO5 FARA HEALTHCARE MANAGEMENT 2360 FIFTH STREET MANDEVILLE LA 70471
GM4 FARM BUREAU INSURANCE PO BOX 450 BENTONVILLE AR 72712
BJ2 FARMERS AND MERCHANTS BANK P O BOX 108 REYNO AR 72462
M69 FARMERS BANK AND TRUST TRUSTEE LARRY HOLMAN P O BOX 288 CLARKSVILLE AR 72830
EY5 FARMERS BANK AND TRUST 400 WEST MAIN ST P O BOX 688 BLYTHEVILLE AR 72316-0688
PA* FARMERS ELEC CO OP ATTN BENEFIT ADM P O BOX 400 NEWPORT AR 72112
FC* FARMERS INSURANCE GROUP 4601 WILSHIRE BLVD P O BOX 2478 LOS ANGELES CA 90051-0478
CP3 FARMERS UNION COOPERATIVE PO BOX 625 CABOT AR 72023
AW5 FARMLAND INDUSTRIES INC EMPLOYEE BENEFIT PLAN P.O. BOX 7305 KANSAS CITY MO 64116
T1* FARMLAND INSURANCE 1963 BELL AVENUE DES MOINES IA 50315
DC9 FARNELL AND SMITH INC P O BOX 650 SEAFORD DE 19973
* - 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 49
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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AL8 FEDERAL BLUE CROSS BLUE SHIELD 233 N. MICHIGAN AVENUE CHICAGO IL 60601
B40 FEDERAL EMPLOYEES HLTH BEN 1325 MASS AVE NW WASHINGTON DC 20005
Q32 FEDERAL LIFE AND CASUALTY 6277 SEA HARBOR DR ORLANDO FL 32887
P53 FEDERAL MOGUL CORPORATION HEALTH CARE SYSTEMS PO BOX 1999 DETROIT MI 48235
IG3 FEDERATED INSURANCE PO BOX 991 OWATONNA MN 55060
J54 FEDERATED INSURANCE CO 501 WOODLANE LITTLE ROCK AR 72203
NW* FEDERATED MUTUAL 129 EAST BROADWAY P O BOX 328 OWATONNA MN 55060
N15 FEDERATED MUTUAL INS 2701 NORTH ROCKYPOINT DR P O BOX 31716 TAMPA FL 33631
W20 FEDERATED MUTUAL INS BOX 41944 KANSAS CITY MO 64141
DA7 FEDERATED MUTUAL INS CO P O BOX 65509 WEST DES MOINES IA 50265-0509
Y76 FEDERATED MUTUAL INSURANCE P.O. BOX 1548 HURST TX 76053-1548
AK4 FERGUSON ENTERPRISES DELTA U.S. 4818 STARKEY ROAD SW ROANOKE VA 24014
AU* FEWELL AND ASSOCIATES P O BOX 8212 LITTLE ROCK AR 72221-8212
CR7 FHP HEALTH CARE P O BOX 441170 AURORA CO 80044
DG9 FHP TAKECARE 2300 CLAYTON RD STE 1000 P O BOX 4059 CONCORD CA 94524
U37 FIDELITY INS CO OF AM GREENHILL AGENCY ASSOC P O BOX 2426 JACKSON MS 39205
C95 FIDELITY SECURITY 3130 BROADWAY KANSAS CITY MO 64111
D46 FIDELITY SECURITY LIFE BOX 809059 DALLAS TX 75380-9059
G17 FINANCIAL SECURITY ASSURAN PO BOX 3156 LITTLE ROCK AR 72202
XK* FIREMANS FUND AMERICAN LIFE P O BOX 40726 NASHVILLE TN 37204
XP* FIREMANS FUND INSURANCE COMPANY P O BOX 3650 SAN RAFAEL CA 94902
YA* FIREMANS FUND P O BOX 61005 DALLAS TX 75261
A51 FIREMANS FUND MEDICAL CLAIMS P O BOX 1100 GREENBAY WI 54344
CL* FIRESTONE COMPANY 1200 FIRESTONE PARKWAY P O BOX 26605 AKRON OH 44319
HC9 FIRST ADMINISTRATORS 512 MAIN ST SUITE 200 PO BOX 8150 RAPID CITY SD 57709-8150
DZ5 FIRST ALLMERICA FINANCIAL P O BOX 107 HOWELL MI 48843
Y97 FIRST BENEFITS AGENCY INC P.O. BOX 4138 3636 COPLEY ROAD AKRON OH 44321
L65 FIRST BENEFITS INC P.O. BOX 737 TOPEKA KS 66601
ID9 FIRST CARE HEALTH PLANS 1901 WEST LOOP 289 LUBBOCK TX 79407
DJ1 FIRST CARE INC P O BOX 70100 SHREVEPORT LA 71137-0100
GA3 FIRST CHOICE HEALTH PO BOX 85008 BELLEVUE WA 98015
M96 FIRST CHOICE HEALTH INS 110GIBRALTA ROAD WORSHAM PA 19044
AK5 FIRST COMMERCIAL TRUST CO SASHA WASHINGTON TRUST 400 WEST CAPITOL LITTLE ROCK AR 72201
L99 FIRST CONTINENTAL LIFE P O BOX 27008 SALT LAKE CITY UT 84127-0008
D57 FIRST ELECTRIC COOP P O BOX 5018 JACKSONVILLE AR 72076
* - 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 50
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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F41 FIRST FAR WEST P O BOX 4107 PORTLAND OR 97208
F34 FIRST HEALTH PO BOX 26199 MILWAUKEE WI 53226
FX8 FIRST HEALTH P O BOX 23550 TUCSON AZ 85734
FT1 FIRST HEALTH PO BOX 23813 TUCSON AZ 85734
HE4 FIRST HEALTH PO BOX 9668 SCOTTSDALE AZ 85252
GZ7 FIRST HEALTH P O BOX 9668 SCOTTSDALE AZ 85252
GN6 FIRST HEALTH P O BOX 24220 TUCSON AZ 85734
GK3 FIRST HEALTH PO BOX 23070 TUCSON AZ 85734
GI5 FIRST HEALTH PO BOX 11807 TUCSON AZ 85734
GH7 FIRST HEALTH P O BOX 11420 TUCSON AZ 85734
GC9 FIRST HEALTH PO BOX 11010 TUCSON AZ 85734
GA4 FIRST HEALTH PO BOX 44242 JACKSONVILLE FL 32231
N48 FIRST HEALTH PO BOX 671248 HOUSTON TX 77267-1248
OM* FIRST HEALTH P O BOX 2700 CORAOPOLIS PA 15108
H80 FIRST HEALTH P O BOX 7189 ST LOUIS MO 63177
JB2 FIRST HEALTH 15560 N FRANK LLOYD WRIGHT SCOTTSDALE AZ 85260
I09 FIRST HEALTH P O BOX 211757 EAGAN MN 55121
Y98 FIRST HEALTH P.O. BOX 5500 CORAOPOLIS PA 15108
Y99 FIRST HEALTH P.O. BOX 17 BOISE ID 83707
AC5 FIRST HEALTH P O BOX 30081 SALT LAKE CITY UT 84130
AB8 FIRST HEALTH PO BOX 11680 TUCSON AZ 85734
AA4 FIRST HEALTH CLAIMS DEPT P O BOX 59185 MINNEAPOLIS MN 55440
AA1 FIRST HEALTH P O BOX 9500 1 800 533 5044 CORAOPOLIS PA 15108
X63 FIRST HEALTH P O BOX 2067 MILWAUKEE WI 53201
W35 FIRST HEALTH TERRA INTERNATIONAL INC P O BOX 2500 CORAOPOLIS PA 15108
W14 FIRST HEALTH P O BOX GG BOISE ID 83707
U74 FIRST HEALTH P O BOX 450989 ATLANTA GA 30345-0989
S74 FIRST HEALTH 15710 JFK BLVD SUITE 500 HOUSTON TX 77032
S24 FIRST HEALTH 1650 W ALAMEDIA DR P O BOX 22750 TEMPE AZ 85282
S13 FIRST HEALTH P O BOX 2903 MILWAUKEE WI 53201
Q41 FIRST HEALTH PO BOX 450450 ATLANTA GA 30345
DZ9 FIRST HEALTH P O BOX 945392 MAITLAND FL 32794-5392
D78 FIRST HEALTH P O BOX 30906 SALT LAKE CITY UT 84130
EK6 FIRST HEALTH PO BOX 11339 SCOTTSDALE AZ 85271-1339
EI4 FIRST HEALTH P O BOX 7394 LONDON KY 40742-7394
* - 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 51
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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FA7 FIRST HEALTH P O BOX 8091 LONDON KY 40742-8091
EX5 FIRST HEALTH P O BOX 8512 LONDON KY 87043
EW7 FIRST HEALTH P O BOX 9000 CORAOPOLIS PA 15108-0900
ES9 FIRST HEALTH P O BOX 30092 SALT LAKE CITY UT 84119
FS9 FIRST HEALTH PO BOX 25050 WILMINGTON DE 19899
FS1 FIRST HEALTH PO BOX 23806 TUCSON AZ 85734
FI9 FIRST HEALTH PO BOX 11549 TUCSON AZ 85734
AL6 FIRST HEALTH P O BOX 17376 SALT LAKE CITY UT 84117
AX4 FIRST HEALTH PO BOX 22890 TUCSON AZ 85734-2890
CZ9 FIRST HEALTH P O BOX 945480 MAITLAND FL 32794
CN7 FIRST HEALTH PO BOX 11127 TUCSON AZ 85734
DK4 FIRST HEALTH P O BOX 26247 SALT LAKE CITY UT 84126
DY9 FIRST HEALTH P O BOX 8507 LONDON KY 40742-8507
DT1 FIRST HEALTH P O BOX 671088 HOUSTON TX 77267-1088
C73 FIRST HEALTH 740 EAST LANCASTER AVE SUITE 200 EXTON PA 19341-2876
DI9 FIRST HEALTH PO BOX 23339 TUCSON AZ 85715
U10 FIRST HEALTH EBP HEALTH PL 2500 MAITLAND CENTER PKWY STE 203 MAITLAND FL 32751
QR* FIRST HEALTH NETWORK PO BOX 535900 PITTSBURGH PA 15253-5900
U64 FIRST HEALTH NETWORK 3200 HIGHLAND AVE DOWNERS GROVE IL 60515-1223
II9 FIRST HEALTH NETWORK P O BOX 8530 KANSAS CITY MO 64114
X68 FIRST HEALTHARKANSAS NUCOR STEEL P O BOX 671128 HOUSTON TX 77267-1128
F20 FIRST MARK STANDARD P O BOX 27000 INDIANAPOLIS IN 46227-7000
G49 FIRST NATIONAL BANK WEST CROSS STREET DEWITT AR 72042
H77 FIRST NATIONAL BANK P.O. BOX 810 CLINTON AR 72031
DC5 FIRST NATIONAL BANK TIFFANY HUDMAN TRUST 200 WEST COURT PARAGOULD AR 72450
AQ9 FIRST NATIONAL BANK OF EASTERN ARKANSAS P O BOX 2019 FORREST CITY AR 72335
EP6 FIRST NATIONAL BANK P O BOX 809 BLYTHEVILLE AR 72316
I67 FIRST NATIONAL BANK OF EASTERN ARKANSAS 101 N WASHINGTON FORREST CITY AR 72335
R28 FIRST NATIONAL LIFE P O BOX 130 PENSACOLA FL 32591-0130
N9* FIRST NATL LIFE OF ALABAMA 7 CLAYTON STREET MONTGOMERY AL 36101
N22 FIRST OF AMERICA BANK PENSION GROUP SERVICES 157 S KALAMAZOO MALL KALMAZOO MI 49007
EB* FIRST PYRAMID LIFE 320 W CAPITOL P O BOX 1151 LITTLE ROCK AR 72203
F22 FIRST SOUTHEAST RISK MGMT P O BOX 1268 TIFTON GA 31793
N65 FIRST STATE BANK OF WARREN TRUST/ANNETTE TEMPLE WARREN AR 71671
HR7 FISERV HEALTH 12668 SILICON DRIVE SAN ANTONIO TX 78249
* - 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 52
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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HK9 FISERV HEALTH PO BOX 740 PUEBLO CO 81002
HI7 FISERV HEALTH P O BOX 8024 WAUSAU WI 54402-8024
FS7 FISERV HEALTH PO BOX 2697 WICHITA KS 67201
F65 FISHBACK MOORE INTERNATION P O BOX 56490 DALLAS TX 75356-9490
YP* FLAGSTORE DENNYS, HARDYS 203 E MAIN ST SPARTANBURG SC 29319
W54 FLEET RESERVE KIKE VANOISDEL INC 400 LOCUST ST DES MOINES IA 50398
AP5 FLEMING GUARDIAN INS 1991 CORPORATE AVENUE MEMPHIS TN 38132
BP3 FLORIDA BENEFITS ADMIN 13080 S BELCHER RD LARGO FL 34643
K3* FLOUR ENGINEERS AND CONSTRUCTORS 3333 MICHAELSON DRIVE IRVINE CA 92730
BL8 FM CORPORATION P O BOX 1720 ROGERS AR 72756
FU* FMH BENEFIT SERVICES P O BOX 25946 OVERLAND PARK KS 66225
EU1 FOOD EMPLOYERS AND BAKERY CONFECTIONER WORKERS 2221 ROSECRANS STE 203 EL SEGUNDO CA 90245-4911
U35 FOOTHILLS BENEFIT ADMIN 800 NORTH FANT ST ANDERSON SC 29621
ER2 FOREMOST PPO CLAIMS 1009 LENOX DRIVE SUITE 107 LAWRENCEVILLE NJ 08648
DW7 FOREST T JONES CONSULT CO 645 E MISSOURI AVE SUITE 370 PHOENIX AZ 85012
CE8 FORTIS P.O. BOX 64296 ST PAUL MN 55164-0296
BP6 FORTIS BENEFITS P O BOX 64442 ST PAUL MN 55164-0442
DF2 FORTIS BENEFITS 1950 SPECTRUM CIRCLE SUITE B100 MARIETTA GA 30067-6052
EO9 FORTIS BENEFITS P O BOX 276442 KANSAS CITY MO 64180
FP8 FORTIS BENEFITS PO BOX 2940 CLINTON IA 52733
BH6 FORTIS BENEFITS 2425 N CENTRAL EXWY 550 RICHARDSON TX 75080-2714
X66 FORTIS BENEFITS INS CO KANSAS CITY GP BENEFI CTR P.O BOX 419876 KANSAS CITY MO 64141
IJ* FORTIS BENEFITS INS CO P O BOX 3195 MILWAUKEE WI 53201-3195
CD2 FORTIS DENTAL P.O. BOX 419227 KANSAS CITY MO 64141
EG6 FORTIS SELF FUNDED RIVERSIDE FURNITURE P O BOX 2043 HOPKINS MN 55343-2043
K89 FOSTER AND FOSTER P O BOX 382 2510 E NETTLETON SUITE 8 JONESBORO AR 72401
GS5 FOUNDATION BENEFITS ADMINI 6300 BRIDGEPOINR PARKWAY BLDG 3 SUITE 400 AUSTIN TX 78730
K49 FOUNDATION FINANCIAL SERVI GROUP SGI AS 1190 P O BOX TAJ HOPE AR 71801
AQ6 FOUNDATION HEALTH 41 MONTEBELLO ROAD SUITE 300B PUEBLO CO 81001
CO5 FOUNDATION HEALTH FEDERAL ATTENTION REGION 6 P O BOX 60000 SAN FRANCISCO CA 94160-2862
DJ7 FOUNDATION HEALTH NATIONAL LIFE INSURANCE P O BOX 1660 RANCHO CORDOVA CA 95670
BW4 FOUNTAINHEAD ADMINISTRATOR HEALTHSOUTH EMPLOYEES P O BOX 13188 BIRMINGHAM AL 35202-2188
0O* FOUNTAINHEAD ADMINISTRATOR P O BOX 2568 BIRMINGHAM AL 35202-2568
IF2 FOX EVERETT PO BOX 6006 RIDGELAND MS 39158
ES5 FOX EVERETT INC P O BOX 23096 JACKSON MS 39225-3096
* - 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 53
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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IM8 FOX EVERETT INC P O BOX 6012 RIDGELAND MS 39158
EO4 FRA INSURANCE 1776 WEST LAKES PARKWAY W DES MOINES IA 50398
EJ1 FRA INSURANCE P O BOX 4100 CAROL STREAM IL 60197-4100
L52 FRANKLIN LIFE INS CO P O BOX 3827 SPRINGFIELD IL 62708
J63 FREEDOM LIFE INSURANCE COMPANY OF AMERICA PO BOX 1628 ADDISON TX 75001
IN6 FREEDOM LIFE INSURANCE COM 2060 N HWY 360 SUITE 375 GRAND PRAIRIE TX 76050
IM7 FREEDOM LIFE INSURANCE COM 2080 N HWY 360 SUITE 375 GRAND PRAIRIE TX 75050
E62 FRINGE BENEFIT PLANS INC 3811 GILBERT AVE SHREVEPORT LA 71104
HX8 FRINGE BENEFITS SERVICES PO BOX 21240 DENVER CO 80221
F26 FRIT INDUSTRIES PO 149 WALNUT RIDGE AR 72476
CF7 FROLIC FOOTWEAR PO OBX 428 WALNUT AR 72476
A92 FROLIC FOOTWEAR PROVIDENT OF MEMPHIS 1020 AGGIE JONESBORO AR 72401
U97 FRONTIER NATIONAL LIFE INS CO 1300 E 9TH ST CLEVELAND OH 44114
IF7 FTJFS FORREST T JONES PO BOX 418131 KANSAS CITY MO 64141-9131
D89 FUQUA INDUSTRIES INC COLOR CRAFT CORP 2855 DIRECTORS COVE MEMPHIS TN 38131
D96 G I C INSURANCE COVERAGE 9100 I H 10 WEST SAN ANTONIO TX 78230
F6* G M UNDERWRITERS P O BOX 5004 ROCHESTER MI 48308-5004
GG2 G M SOUTHWEST CLARENDON NATIONAL INS CO P O BOX 803422 DALLAS TX 75380-3422
IG* GALBRAITH AND GREEN 5700 EAST PIMA STREET SUITE 4 TUCSON AZ 85712
FZ* GALBRAITH AND GREEN INC 625 NO MILWAUKEE STREET SUITE 250 MILWAUKEE WI 53201
CV9 GALLAGHER BASSETT P O BOX 43 MINNEAPOLIS MN 55440-0043
V43 GALLAGHER BASSETT BENEFITS PO BOX 34297 SAN ANTONIO TX 78265-4297
Q12 GALLAGHER BASSETT SERV INC PO BOX 8004 ITASCA IL 60143-8004
C38 GALLAGHER BENFIT ADMIN INC P O BOX 419397 KANSAS CITY MO 64141-6397
X19 GARANS MFG 2910 W COMMERCIAL ST OZARK AR 72949-3502
I21 GARDEN STATE LIFE INS HALLMARK INS ADMIN 800 QUAIL RIDGE DRIVE WESTMONT IL 60559
H63 GARDNER AND WHITE P O BOX 40619 INDIANAPOLIS IN 46240-2456
DL7 GARY EUBANKS AND ASSOC ATTORNEYS 708 WEST SECOND ST LITTLE ROCK AR 72201
M39 GATES RUBBER CO P O BOX 5887 DENVER CO 80217
HI2 GE CAPITAL LTC 11000 PRAIRIE LAKES DRIVE EDEN PRAIRIE MN 55344
GK6 GE FINANCIAL ASSURANCE MEDICARE CLAIMS PROCESSIN PO BOX 10821 CLEARWATER FL 33757-8821
AR4 GEHA PO BOX 4665 INDEPENDENCE MO 64051-4665
HO6 GEISINGER HEALTH PLAN 100 NORTH ACADENY AVENUE DANVILLE PA 17822
H32 GEM GROUP INS TRUST GRANVILLE ROAD 2021 EAST DUBLIN COLUMBUS OH 43229
DA1 GEN CARE P O BOX 419080 ST LOUIS MO 63141-9080
* - 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 54
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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VK* GENAM BENIFITS 719 TEACO ROAD 18779367052 KENNETT MO 63857
FB8 GENERAL ACCIDENT INSURANCE P O BOX 1776 NASHVILLE TN 37202
FD7 GENERAL AMERICAN 719 TEACO ROAD KENNETT MO 63857-3749
F97 GENERAL AMERICAN BROWN SHOE CO P O BOX 307 DYER TN 38344
F53 GENERAL AMERICAN EARLE INDUSTRIES INC POBOX 28 EARLE AR 72331
BI6 GENERAL AMERICAN JIM SESOW AUTO PAINT SUPP 1730 S BOSTON TULSA OK 74119
BE2 GENERAL AMERICAN 275 W CAMPBELL SUITE 401 P O BOX 834102 RICHARDSON TX 75083-4102
AT6 GENERAL AMERICAN LIFE INSURANCE P.O. BOX 5445 ROCKFORD IL 61125-0445
V13 GENERAL AMERICAN P O BOX 335 BARVER SPRINGS KS 66012
S29 GENERAL AMERICAN 1111 BAYHILL DR STE 390 SAN BRUNO CA 94066
K47 GENERAL AMERICAN 3495 PIEDMONT RD, BLDG 11 SUITE 414 ATLANTA GA 30305
AG5 GENERAL AMERICAN WENDYS PO BOX 66767 ST LOUIS MO 63166
Y59 GENERAL AMERICAN C/O HIGHLAND INDUST PARK P.O. BOX 3108 EAST CAMDEN AR 71701
X52 GENERAL AMERICAN PREFERRED ACCOUNT DEPT P O BOX 66883 ST LOUIS MO 63166
X76 GENERAL AMERICAN INS CO 1050 CROWN POINT PKWY SUITE 840 ATLANTA GA 30338
B76 GENERAL AMERICAN INSURANCE 11251 NORTHWEST FREEWAY STE 435 HOUSTON TX 77092
C10 GENERAL AMERICAN LIFE INS 5307 E MOCKINGBIRD LANE SUITE 600 DALLAS TX 75206
X84 GENERAL AMERICAN LIFE INS HOME OFFICE ACCTS D2 20 PO BOX 66817 ST LOUIS MO 63166
YB* GENERAL AMERICAN LIFE INS 8400 MARYLAND AVE ST LOUIS MO 63105
N99 GENERAL AMERICAN LIFE INS CHICAGO CLAIM OFF 612 1 WESTBROOK CORP CTR 205 WESTCHESTER IL 60153
V75 GENERAL AMERICAN LIFE INS ANHEUSER BUSH INC P O BOX 14476 ST LOUIS MO 63178
X40 GENERAL COUNCIL OF THE ASSEMBLY OF GOD 1445 BOONVILLE AVENUE SPRINGFIELD MO 65802
G44 GENERAL LIFE AND ACCIDENT P O BOX 11218 FORT WORTH TX 76109
F94 GENERAL MEDS P O BOX 14014 ORANGE CA 92668
HV0 GENERAL PRESCRIPTION 685 BLOOMFIELD AVENUE VERONA NJ 07044
B62 GENSTAR HEALTH PLAN NEW SYSTEMS INC P O BOX 42576 SAN FRANCISCO CA 94142
CS2 GEO A HORMEL AND COMPANY P O BOX 800 501 N E 16TH AVENUE AUSTIN MN 55912
FP6 GEO CARE PO BOX 9060 PHOENIX AZ 85068
CM4 GEORGE KOCH AND SONS 10 SOUTH ELEVENTH AVE EVANSVILLE IN 47744
L83 GEORGES INC MEDICAL PLAN P O DRAWER G SPRINGDALE AR 72765
OC* GEORGIA INTERNATIONAL LIFE INSURANCE P O BOX 7325 ATLANTA GA 30357
J70 GERBER LIFE INS CO P O BOX 269042 SACRAMENTO CA 95826-9042
J04 GERBER LIFE INSURANCE COMP P O BOX 2271 OMAHA NE 68103-2271
XB* GERBERS INSURANCE 66 CHURCH ST WHITE PLAINS NY 10601-1901
EX3 GIBRALTAR INSURANCE P O BOX 3663 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 55
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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ET4 GILSBAR INC 2100 CONVINGTON CTR P O BOX 998 COVINGTON LA 70434
V90 GILSTER MARY LEE CORP HWY 61 SOUTH WILSON AR 72395
Z32 GLIC ENVIRONMENTAL INC 2370 SCIENCE PARKWAY OKEMOS MI 48864
EL4 GLITSCH INC PO BOX 660053 DALLAS TX 75266-0053
Q3* GLOBAL MARINE INC HEALTH CARE P O BOX 218969 HOUSTON TX 77218
FM5 GLOBAL MATERIALS SERV LLC PO BOX 610 JEFFERSONVILLE IN 47131
JB4 GLOBALCARE INC P O BOX 247 ALPHARETA GA 30009-0247
0G* GLOBE LIFE AND ACCIDENT GLOBE LIFE CENTER PO BOX 26400 OKLAHOMA CITY OK 73126
HC* GLOBE LIFE AND ACCIDENT P O BOX 17237 MEMPHIS TN 38117
R12 GMP EMPLOYERS RETIREE TRUS 5245 BIG PINE WAY SE FT MYERS FL 33907-5998
K96 GNB TECHNOLOGIES 4115 ZERO ST FORT SMITH AR 72903
BU2 GOLD KIST INC P O BOX 99 PORTLAND OR 71663
FH7 GOLDEN RULE PO BOX 6008 ARLINGTON TX 76005-6008
E32 GOLDEN RULE INSURANCE 7440 WOODLAND DRIVE INDIANAPOLIS IN 46278
CO3 GOLDEN RULE INSURANCE CO 712 ELEVENTH STREET LAWRENCEVILLE IL 62439-2395
IK1 GOLDEN RULE INSURANCE COMP P O BOX 31374 SALT LAKE CITY UT 84131
I25 GOLDEN STATE MUTUAL LIFE INS CO TERMINAL ANNEX P.O. BOX 2332 LOS ANGELES CA 90051
I60 GOLF BAG ASSOCIATES P.O. BOX 426 WALNUT RIDGE AR 72476
Z10 GOOD SAMARITAN L.A.M. ASSOCIATES P.O. BOX 279 BEECH GROVE IN 46107
B27 GOODYEAR TIRE RUBBER MEDICAL BENEFITS OFFICE P O BOX 677 AKRON OH 44309-0677
JP* GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION P O BOX 10304 KANSAS CITY MO 64111
Z33 GRAND CASINO MS ASSOC HEAL ATTN UHC MGT CO, INC P.O. BOX 1459 MINNEAPOLIS MN 55440-1459
BW9 GRATES HEALTH CARE ATTN CLAIMS PO BOX 5887 DENVER CO 80217-5887
E28 GRAYS HARBOR MEDICAL BUREA 421 W STATE STREET ABERDEEN WA 98500
D22 GREAT AMERICAN OF AMERICA BOX G A CORONA DEL MAR CA 92625-0906
C32 GREAT AMERICAN RESERVE P O BOX 1911 CARMEL IN 46032
EP4 GREAT COMMONWEALTH LIFE 7887 BELLEVIEW AVE ENGLEWOOD CO 80111
U96 GREAT LAKES CHEMICAL CORP P O BOX 1878 EL DORADO AR 71730
D1* GREAT LAKES CHEMICAL CORP BENEFITS ACCOUNT P O BOX 2200 WEST LAFAYETTE IN 47906
M45 GREAT PLAINS GAS P O BOX 2067 1101 2ND AVENUE CEDAR RAPIDS IA 52406
L22 GREAT REPUBLIC INS 470 S PASTTERSON SANTA BARBARA CA 93111
SC* GREAT SOUTHERN LIFE INS CO P O BOX 1977 HOUSTON TX 77097
SK* GREAT SOUTHWEST LIFE INS P O BOX 53330 HOUSTON TX 77052
M57 GREAT WEST CARE HEALTH PLA 115 PERIMETER CTR PLACE SUITE 460 WEST ATLANTA GA 30326
P24 GREAT WEST ENTERPRISES PO BOX 15929 IRVINE CA 92713
* - 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 56
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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WS* GREAT WEST HEALTHCARE 1000 GREAT WEST DRIVE KENNETT MO 63857-3749
T39 GREAT WEST LIFE 455 MARKET ST STE 2000 SAN FRANCISCO CA 94105
T13 GREAT WEST LIFE P O BOX 560049 DALLAS TX 75356-0049
SR* GREAT WEST LIFE P O BOX 11111 FORT SCOTT KS 66701-7111
R81 GREAT WEST LIFE P O BOX 97313 BELLEVUE WA 98009
AI7 GREAT WEST LIFE MORRIS CO. FINANCIAL CTR 5 SYLVAN WAY SUITE 220 PARSIPANNY NJ 07054
AN2 GREAT WEST LIFE P O BOX 963 1377 DUBLIN ROAD COLUMBUS OH 43216
CW3 GREAT WEST LIFE P O BOX 8020 NORTH OLMSTED OH 44070
CG7 GREAT WEST LIFE P O BOX 5011 FORT SCOTT KS 66701
BP8 GREAT WEST LIFE P O BOX 190018 N CHARLESTON SC 29419-9018
BF5 GREAT WEST LIFE P O BOX 429 PORTLAND OR 97207
G40 GREAT WEST LIFE 1401 DEAN ST ROME GA 30161
G13 GREAT WEST LIFE 200 GIBRALTER RD STE 350 P O BOX 1000 HORSHMAN PA 19044-1000
DX6 GREAT WEST LIFE P O BOX 38088 TUCSON AZ 85740
E31 GREAT WEST LIFE 1300 VIRGINIA DR SUITE 135 FT WASHINGTON PA 19034
U95 GREAT WEST LIFE AND ANNUNITY PO BOX 9109 HINSDALE IL 60522-9109
A81 GREAT WEST LIFE ASSURANCE P O BOX 1690 DENVER CO 80201
S88 GREAT WEST LIFE ASSURANCE SUITE 2166 100 RENAISSANCE CENTRE DETROIT MI 48243
FB5 GREAT WEST LIFE ASSURANCE 8515 EAST ORCHARD RD ENGLEWOOD CO 80111-5005
D81 GREAT WEST LIFE ASSURANCE 900 SECOND AVENUE SOUTH SUITE 650 MINNEAPOLIS MN 55402-3341
BD3 GREAT WEST LIFE INS P O BOX 5707 HOPKINS MN 55343
DF3 GREAT WEST LIFE INS 517 RTE ONE S ISELIN NJ 08830
Z34 GREAT WEST LIFE INS CO P.O. BOX 10188 GLENDALE CA 81209
P84 GREATER OREGON HEALTH SERV PO BOX 4800 6 PORTLAND OR 97208
K56 GREEN BAY FOODS 702 SE 1ST ATKINS AR 72823
EG5 GREENTREE ADMINISTRATORS P O BOX 7306 BEAUMONT TX 77726-7306
B34 GREENVILLE MILL ATTN SUE MORGAN PO BOX 887 GREENVILLE MS 38701
BP5 GREIF BROS CORP 230 W COLLEGE AVE BATESVILLE AR 72501
SI* GREYHOUND AND AFFILIATED COMPANIES GREYHOUND TOWER PHOENIX AZ 83077
G66 GREYHOUND LINE HEALTH AND WELFARE TRUST 2607 W 22ND ST OAKBROOK IL 60521
N35 GRINNELL MUTUAL LIFE INS P O BOX 790 GRINNELL IA 50112-0790
CW9 GROTTOES OF NORTH AMERICA HUMANATARION FOUNDATION 1696 BRICE RD REYNOLDSBURG OH 43068
D74 GROUP ADMINISTRATION SVCS 100 SOUTH CHARLES ST BALTIMORE MD 21201
DN5 GROUP ADMINISTRATORS 1880 N ROSELLE RD SUITE 214 SCHAUMBURG IL 60195
FE4 GROUP ADMINISTRATORS P O BOX 780159 SAN ANTONIO TX 78229
* - 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 57
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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N16 GROUP ADMINISTRATORS INC 10440 N CENTRALEXPRESSWAY SUITE 300 DALLAS TX 75231
M16 GROUP BENEFIT P O BOX 3199 500 W FIFTH STREET WINSTON SALEM NC 27102
TA* GROUP BENEFIT SERVICE 1736 E SUNSHINE STE 312 SPRINGFIELD MO 65804
GK1 GROUP BENEFIT SERVICES EHC CLAIM CENTER PO BOX 250009 PLANO TX 75025
BW2 GROUP BENEFIT SERVICES INC PO BOX 8219 LITTLE ROCK AR 72221-8219
W6* GROUP BENEFIT SYSTEMS INC 2350 VALLEY VIEW LANE SUITE 440 FARMERS BRANCH TX 75234
EZ5 GROUP BENEFITS P O BOX 44036 BATON ROUGE LA 70804
Z63 GROUP HEALTH AND LIFE P.O. BOX 2135 MEMPHIS TN 38101
M44 GROUP HEALTH COOPERATIVE 20015TH AVENUE SEATTLE WA 98112
CB5 GROUP HEALTH INC HEALTHPARTNERS 8100 34TH AVE SOUTH MINNEAPOLIS MN 55440-1289
DZ8 GROUP HEALTH INCORP G H I PO BOX 2832 NEW YORK NY 10116
Z62 GROUP HEALTH MGRS ADMIN 26205 FIVE MILE ROAD REDFORD MI 48239
ER9 GROUP HEALTH PLAN 940 WEST PORT PLAZA DR SUITE 300 ST LOUIS MO 63146
GD9 GROUP HEALTH PLAN 111 CORPORATE OFFICE DR EARTH CITY MO 63045
M8* GROUP HOSPITALIZATION MEDICAL SVC OF DC 550 12TH ST SW WASHINGTON DC 20024
Z11 GROUP INSURANCE CONSULTANT 2216 DODSON AVE SUITE A FORT SMITH AR 72901
HU1 GROUP LINK INC PO BOX 20593 INDIANAPOLIS IN 46220
CS3 GROUP MANAGEMENT SERVICES P O BOX 510436 NEW BERLIN WI 53151-0436
OS* GROUP MARKETING SERVICES INSURANCE TRUST 1729 H ST NW STE 100 WASHINGTON DC 20006
BI2 GROUP PENSION ADMIN 300 MUNCIPAL DRIVE P O BOX 830827 RICHARDSON TX 75083-0827
Z35 GROUP PENSION ADMIN 400 W CAPITOL SUITE 2310 P O BOX 3418 LITTLE ROCK AR 72203-3418
U15 GROUP RESOURCES INC 3080 PREMIERE PKWY STE 100 DULUTH GA 30097-4904
DV1 GROUP SERVICES AND ADM 3113 N CLASSEN BLVD OKLAHOMA CITY OK 73118-3818
DK3 GROUP SERVICES INC 3066 VICTORIA DRIVE BETTENDORF IA 52722
IU* GUARANTEE RESERVE LIFE INSURANCE CO 128 STATE STREET HAMMOND IN 46320
EG* GUARANTEE RESERVE LIFE INSURANCE COMPANY 530 RIVER OAKS WEST CALUMET CITY IL 60409
P1* GUARANTEE TRUST AND LIFE STUDENT PLANS INC 211 EAST ILLINOIS ST WHEATON IL 60187
R66 GUARANTEE TRUST LIFE INS 1275 MILWAUKEE AVE P O BOX 1144 GLENVIEW IL 60025-2425
W40 GUARANTY NATIONAL INS CO P O BOX 848 ASHDOWN AR 71822
BA7 GUARDIAN P O BOX 2457 SPOKANE WA 99210-2457
HK3 GUARDIAN THE DESTINY HEALTH PLAN PO BOX 4628 OAK BROOK IL 60523-4628
DO4 GUARDIAN DENTAL CLAIMS P O BOX 26185 LEHIGH VALLEY PA 18002-6185
DY2 GUARDIAN DENTALGUARD PREFERRED P O BOX 2459 SPOKANE WA 99210-2459
N45 GUARDIAN GROUP CLAIMS P O BOX 8007 APPLETON WI 54913
BB1 GUARDIAN LIFE P.O. BOX 2454 SPOKANE WA 99210-2454
* - 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 58
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Y40 GUARDIAN LIFE HEALTHLINK PO BOX 419104 ST LOUIS MO 63141-9998
BO9 GUARDIAN LIFE INS P O BOX 26020 LEE HIGH VALLEY PA 18002-6020
U48 GUARDIAN LIFE INS CO P O BOX 2458 SPOKANE WA 99210-2458
DT2 GUARDIAN RESOURCES CORPORA OPERATIONS OFFICE PO BOX 3767 HOLIDAY FL 34690
CA9 GUARDIN LIFE INS 4530 PARK RD SUITE 110 CHARLOTTE NC 28209
D84 GUARDSMAN CHEMICALS INS EMPLOYEE BENEFITS DIVISIO P O BOX 6488 GRAND RAPIDS MI 49516
YS* GUIDEONE INSURANCE PO BOX 4499 TULSA OK 74159
E75 GULF GUARANTY LIFE INSURAN P O BOX 14977 JACKSON MS 39236-4977
A85 GULF LIFE INS CO P O BOX 1018 FORREST CITY AR 72335
G94 GULF LIFE INS CO ROCK TEN DALLAS MILL P O BOX 1291 DALLAS TX 75221
DX7 GULF SOUTH ADM BEECH STREET P O BOX 17719 IRVINE CA 92713-7719
N67 GULF SOUTH ADMIN 5615 CORPORATE BLVD SUITE 5A BATON ROUGE LA 70808
FF1 GULF SOUTH ADMINISTRATORS PO BOX 14449 BATON ROUGE LA 70898-4449
J68 GULF STREAM AEROSPACE 5001 N ROCKWELL BETHANY OK 73008
V89 GYPSUM MANAGEMENT AND SUPPLY INC P O BOX 15628 LENEXA KS 66285
Z13 H AND P MEDICAL PLAN UTICA AT TWENTY FIRST TULSA OK 74114
N58 H B ZACHRY P O BOX 21130 SAN ANTONIO TX 78221
C42 H C A H C A PLAN ADM P O BOX 171816 MEMPHIS TN 38187-1116
FN8 H DAVID BLAIR BLAIR AND STOUD LAW FIRM P.O. BOX 2135 BATESVILLE AR 72503
G70 H H ROBERTSON CO OF BATESV P O BOX 4370 BATESVILLE AR 72503
H46 H M A COHEN BENEFIT GROUP 5100 NORTH FEDERAL HWY SUITE 102 FT LAUDERDELLE FL 33308
I34 HAFFINGER INDUSTRIES INC P.O. BOX 2457 WEST HELENA AR 72390
SJ* HALIBURTON P O BOX 1431 DUNCAN OK 73536
D8* HALLMARK ADMINISTRATION IN P O BOX 10009 AUSTIN TX 78766
FG6 HANEY GROUP SERVICES 12222 MERIT DRIVE, SUITE 1350 DALLAS TX 75251
FG* HARCO INSURANCE GROUP P O DRAWER 8B MILWAUKEE WI 53201
Y61 HARDEES FOOD SYSTEMS INC P.O. BOX 44058 JACKSONVILLE FL 32231-4058
CL4 HARDEN AND COMPANY P O BOX 4101 CONCORD CA 94521
Q17 HARDING UNIVERSITY STATION A P O BOX 873 SEARCY AR 72143
J66 HARDWICK CHEMICAL CORP HEALTH BENEFIT PLAN P O BOX 1008 WYNNE AR 72396
J84 HARLEYSVILLE MUTUAL INS 355 MAPLE AVENUE HARLEYSVILLE PA 19438
NA* HARRINGTON BENEFIT SERVICE P O BOX 16789 COLUMBUS OH 43216
TG* HARRINGTON BENEFIT SERVICE PO BOX 30219 TAMPA FL 33630-3219
A18 HARRINGTON BENEFIT SERVICE BENEPLAN STRATEGIES INC P.O. BOX 1391 DAYTON OH 45401-1391
DU6 HARRINGTON BENEFIT SERVICE P O BOX 3810 JOPLIN MO 64804
* - 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 59
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GS6 HARRINGTON BENEFIT SERVICE PO BOX 720 PUEBLO CO 81002-0720
BY3 HARRINGTON BENEFITS P O BOX 3900 YOUNGSTOWN OH 44513-3900
FN1 HARRINGTON BENEFITS SERVIC PO BOX 750 STOCKTON CA 95201-0750
FS5 HARRINGTON BENIFIT SERVICE P O BOX 3609 DAYTON OH 45401-3609
CN5 HARRINGTON BROOK FIELD HBS GROUP PO BOX 909772 CHICAGO IL 70790
HP8 HARRINGTON HEALTH PO BOX 30544 SALT LAKE CITY UT 84130
P30 HARRIS METHODIST HEALTH PL P O BOX 90100 ARLINGTON TX 76004
DO7 HARRISON STEEL P O BOX 60 ATTICA IN 47918
D4* HARTFORD P O BOX 14847F ST LOUIS MO 63150
BL1 HARTFORD ITT CLAIMS P. O. BOX 5003 BOLINGBROOK IL 60440
PQ* HARTFORD COMPANY 3033 WEST JEFFERSON JOLIET IL 60435
SD* HARTFORD GENERAL LIFE HARTFORD PLAZA HARTFORD CT 06115
FU4 HARTFORD INSURANCE ATTN ROBERT EXT 31040 P O BOX 47511 SAN ANTONIO TX 78265-7511
A91 HARTFORD INSURANCE CO WASHINGTON REG OFFICE PO BOX 11910 ALEXANDRIA VA 22312-0970
Q89 HARTFORD LIFE AND ACCIDENT NATIONAL INSURANCE ADMIN. 1620 KIPLING LAKEWOOD CO 80215
N72 HARTS OF AR 100 LEE DRIVE CORNING AR 72422
EY2 HARTSFIELD INSURANCE AGENC P O BOX 8 RUSSELLVILLE AR 72801
BO5 HARTZELL INDUSTRIES EMPLOYEE BENEFIT PLAN 4789 RINGS ROAD DUBLIN OH 43017
NZ* HARVARD MEDICAL AND DENTAL P O BOX 699183T RD QUINCY MA 02269-9183
N82 HARVEST LIFE INSURANCE CO 6277 SEA HARBOR DRIVE ORLANDO FL 32877
HG3 HAWKINS INSURANCE 211 EAST CHURCH STREET MORRILTON AR 72110
M73 HAYGOOD HEALTH BENEFIT P O BOX 13203 MEMPHIS TN 38113
VJ* HBA LIFE INSURANCE P O BOX 1272 PHOENIX AZ 85001
IN8 HCC MEDICAL INSURANCE SERV BOX NO 2005 FARMINGTON HILLS MI 48333
FQ6 HCH ADMINISTRATION PO BOX 1986 PEORIA IL 61656
Q47 HDR EMPLOYEE BENEFIT PO BOX 5150 GREENVILLE SC 29606-5150
HB8 HEALHT ASSURANCE 120 E KENSINGER DRIVE CRANBURY TWP PA 16066
FO4 HEALTH ADMINISTRATORS INC PO BOX 7045 WYOMISSING PA 19610
J80 HEALTH ADVANTAGE 26 CORPORATE HILL P O BOX 8069 LITTLE ROCK AR 72203
EX8 HEALTH ALLIANCE MEDICAL PL P O BOX 6003 URBANA IL 61801
BF3 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202
G67 HEALTH AND WELFARE FUND CHICAGO LOCAL 458 332 S MICHIGAN AVE CHICAGO IL 60604
SP* HEALTH BENEFIT ADMINISTRAT 901 MCCLAIN ROAD SUITE 805 BENTONVILLE AR 72712
CC5 HEALTH BENEFIT ALLIANCE 1734 GILSINN LANE FENTON MO 63026
GR5 HEALTH BENEFIT CLAIM DEPT FED EX FREIGHT EAST INC PO BOX 5007 HARRISON AR 72602-5007
* - 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 60
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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D91 HEALTH BENEFITS MANAGEMENT OF DALLAS P O BOX 152880 IRVING TX 75015-2880
BA8 HEALTH CARE ADMINISTRATORS 200 GARRISON AVENUE P O BOX 10657 FORT SMITH AR 72901
G83 HEALTH CARE ADMINISTRATORS POBOX 30906 SALT LAKE CITY UT 84130-0966
BZ1 HEALTH CARE ADVANTAGE P O BOX 54549 NEW ORLEANS LA 70156
HI8 HEALTH CARE DISTRICT OF PALM BEACH COUNTY 3777 N JOG RD, WPB WEST PALM BEACH FL 33411
R79 HEALTH CARE SOLUTIONS GROU P O BOX 1309 MUSKOGEE OK 74402
S21 HEALTH CHOICE P O BOX 40707 MEMPHIS TN 38174
EF1 HEALTH CHOICE OKLAHOMA STATE EDU PO BOX 850171 OKLAHOMA OK 73185-0171
EC3 HEALTH CHOICE P O BOX 24870 OKLAHOMA CITY OK 73124
FX6 HEALTH CHOICE INC 93 SPRING STREET NEWTON NJ 07860
Q30 HEALTH CLAIM SERVICES GENERAL MILLS CLAIMS P O BOX 1113 MINNEAPOLIS MN 55440-1113
N31 HEALTH CLAIM SERVICES P O BOX 273940 BOCA RATON FL 33427-3940
B75 HEALTH CLAIMS ADMIN 20 EAST CASS JOLIET IL 60431
AQ3 HEALTH COMP PO BOX 45018 FRESNO CA 93718
AT4 HEALTH CORP OF TENNESSEE 735 BROAD STREET 900 JAMES BLDG CHATTANOOGA TN 37402
EM8 HEALTH COST SOLUTIONS FORMERLY WM C BEELER P O BOX 1439 HENDERSONVILLE TN 37077
GB2 HEALTH DESIGN PLUS PO BOX 5095 FINDLAY OH 45835-5095
FU7 HEALTH DESIGN PLUS PO BOX 5085 FINDLAY OH 45839-5095
GQ1 HEALTH DESIGN PLUS PO BOX 2584 HUDSON OH 44236
GK7 HEALTH DESIGNS PLUS PO BOX 5060 FINDLAY OH 45839-5060
CM7 HEALTH DIRECT P O BOX 1728 DES PLAINES IL 60017-1728
AY2 HEALTH ECONOMICS CORP 625 PANORAMA TRL BLDG 3 ROCHESTER NY 14625
PF* HEALTH FIRST TPA P O BOX 130217 TYLER TX 75713-0217
IM0 HEALTH INSURANCE INNOVATIO COORDINATED BENEFITS PLAN P O BOX 21575 EAGAN MN 55121
BH9 HEALTH LINK P. O. BOX 419104 ST LOUIS MO 63141
U54 HEALTH MANAGEMENT ASSOCIATION INC P O 450989 ATLANTA GA 30345-0989
HY2 HEALTH MARKETS 9151 BLVD 26 RICHLAND HILLS TX 76180-5605
BV2 HEALTH NET P O BOX 35 NASHVILLE TN 37202-0035
CG2 HEALTH NET PO BOX 9103 VAN NUYS CA 91409-9103
FT2 HEALTH NET PO BOX 10223 VAN NUYS CA 91410-0223
FI1 HEALTH NET PO BOX 10196 VAN NUYS CA 91410-0196
DH4 HEALTH NET 650 E HOSPITALITY LANE SUITE 200 SAN BERNARDINO CA 92408
EV2 HEALTH NETWORK AMERICA 187 MONMOUTH PARKWAY WEST LONG BRANCH NJ 07764
N52 HEALTH NETWORK INC 1420 KENSINGTON STE 203 P O BOX 5105 OAK BROOK IL 60521
HX4 HEALTH NEW ENGLAND 1 MONARCH PLACE SUIT 1500 SPRINGFIELD MA 01144
* - 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 61
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Y78 HEALTH OPTIONS 3191 MAGUIRE BLVD STE 200 ORLANDO FL 35254-7912
HX6 HEALTH PARTNERS PO BOX 1309 MINNEAPOLIS MN 55440
GW4 HEALTH PARTNERS PO BOX 3730 JACKSON TN 38303-3730
FZ1 HEALTH PARTNERS PO BOX 3490 JACKSON TN 38303
DA5 HEALTH PLAN ADMINISTRATORS P O BOX 2638 ROCKFORD IL 61132-2638
R91 HEALTH PLAN ADMINISTRATORS INC BICOASTAL UNIT P O BOX 3986 DONBURY CT 06813-3986
HG7 HEALTH PLAN NEVADA PO BOX 15645 LAS VEGAS NV 89114-5645
GG5 HEALTH PLAN OF MICHIGAN PO BOX 1700 FLINT MI 48501
HX5 HEALTH PLAN OF OHIO VALLEY 52160 NATIONAL RD EAST ST CLAIRSVILLE OH 43950
CV6 HEALTH PLAN SERVICE DUNN AND BRADSTREET PO BOX 26220 OKLAHOMA CITY OK 73120
CL9 HEALTH PLAN SERVICES P O BOX 30075 TAMPA FL 33630-3075
DR1 HEALTH PLAN SERVICES DARDEN RESTAURANTS PO BOX 30367 TAMPA FL 33630
EP5 HEALTH PLAN SERVICES P O BOX 30351 TAMPA FL 33630
EH2 HEALTH PLAN SERVICES P O BOX 419 MARLBOROUGH CT 06447
HT7 HEALTH PLAN SERVICES PO BOX 3726 SEATTLE WA 98124
GT1 HEALTH PLAN SERVICES PO BOX 44109 LAS VEGAS NV 89116
K83 HEALTH PLAN SERVICES P O BOX 2085 NASHUA NH 03061-2085
Y1* HEALTH PLAN SERVICES CONSOLIDATED GROUP P O BOX 2062 NASHUA NH 03061-2062
GE5 HEALTH PLAN SOUTHEAST PO BOX 459011 SUNRISE FL 33345-9011
CU7 HEALTH PLUS 7601 ORA GLEN DR STE 200 GREENBELT MD 20770-3647
Q57 HEALTH PLUS PO BOX 30086 TAMPA FL 33630-3086
CX3 HEALTH PLUS OF LOUISIANA P O BOX 32625 SHREVEPORT LA 71130-2625
F63 HEALTH PLUS OF NEW MEXICO P O BOX 27489 ALBUQUQUERQUE NM 87125
AQ1 HEALTH POINT ADMIN BY SEABURY AND SMIT 2 WEST SECOND ST STE 1750 TULSA OK 74103-2131
FJ5 HEALTH RESOURCES INC 123 SOUTH GREEN RIVER RD P O BOX 15660 EVANSVILLE IN 47716-0660
AR5 HEALTH RISK MANAGEMENT P.O. BOX 1479 MINNEAPOLIS MN 55440-1479
BM5 HEALTH RISK MANAGEMET P. O. BOX 4022 KALAMAZOO MI 49003-4022
FV3 HEALTH SMART PO BOX 53025 LUBBOCK TX 79453
DI8 HEALTH SPECIAL RISK SCHOOL INS 16479 DALLAS PRKW ST 150 DALLAS TX 75248
IH1 HEALTH SPRING INC 44 VANTAGE WAY NASHVILLE TN 37228
DW5 HEALTH STAR 1100 E 31 TH PO BOX 1407 LAGRANGE PARK IL 60525
V28 HEALTHCARE BENEFITS INC 1201S SHERMAN STE 200 P O BOX 833889 RICHARDSON TX 75083-3889
CX5 HEALTHCARE INC P O BOX 38 GREENACRES WA 99016
D40 HEALTHCARE PLUS 900 SHACKLEFORD RD STE 509 LITTLE ROCK AR 72211
FL3 HEALTHCARE SOLUTIONS PO BOX 471950 TULSA OK 74147-1950
* - 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 62
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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HM7 HEALTHE EXHANGE PO BOX 165750 KANSAS CITY MO 64116
IF6 HEALTHFIRST NEW YORK 25 BROADWAY NEW YORK NY 10004
CK6 HEALTHGUARD OF LANCASTER I 280 GRANITE RUN DR ST 105 LANCASTER PA 17601-6810
GQ4 HEALTHLINK PO BOX 411580 ST LOUIS MO 63141
HJ2 HEALTHLINK MBS PO BOX 25987 WINSTONSALEM NC 27114
HF6 HEALTHNET P O BOX 14130 LEXINGTON KY 40512
T56 HEALTHNET 9494 SOUTHWEST FWY SUITE 300 HOUSTON TX 77074
CB1 HEALTHNET ALLIANCE TWO PERSHING SQUARE 2300 MAIN ST SUITE 700 KANSAS CITY MO 64108
GF9 HEALTHNET CA PO BOX 14702 LEXINGTON NY 40512
HW3 HEALTHNET NORTH EAST PO BOX 14700 LEXINGTON KY 40512
GF1 HEALTHNET NORTHEAST PO BOX 904 SHELTON CA 06484
HA5 HEALTHNET OF OREGON 13221 SW 68 PARKWAY TIGARD OR 97223
HH1 HEALTHNOW NEW YORK INC PO BOX 15013 ALBANY NY 12212-5013
BJ8 HEALTHPARTNERS MEDICAL CLA 8100 34TH AVE S P O BOX 1289 MINNEAPOLIS MN 55440-1289
IG0 HEALTHSCOPE BENEFIT P O BOX 16706 LUCBBOCK TX 79490-6706
GP8 HEALTHSCOPE BENEFIT INC P O BOX 99006 LUBBOCK TX 79490-9006
GP3 HEALTHSCOPE BENEFITS P O BOX 619055 DALLAS TX 75261
QP* HEALTHSCOPE BENEFITS FORMERLY CNA HEALTH PARTN PO BOX 8076 LITTLE ROCK AR 72203
AV5 HEALTHSCOPE BENEFITS EMERSON ELECTRICS PO BOX 2360 LITTLE ROCK AR 72203
GA9 HEALTHSCOPE BENEFITS PO BOX 8071 LITTLE ROCK AR 72203
DF7 HEALTHSCOPE BENEFITS INC PO BOX 2459 LITTLE ROCK AR 72203-2459
Z84 HEALTHSCOPE BENEFITS INC FORMERLY CNA HEALTH PARTN P O BOX 8002 LITTLE ROCK AR 72203
GW9 HEALTHSCOPE BENEFITS INC P O BOX 853940 RICHARDSON TX 75085-3940
IG5 HEALTHSMART P.O. BOX 94807 LUBBOCK TX 79493
V27 HEALTHSMART 1867 W MARKET ST AKRON OH 44313
M64 HEALTHSMART SOLUTIONS FORMERLY ACCORDIA NATIONA PO BOX 3262 CHARLESTON WV 25326-3262
AW6 HEALTHSOURCE AR CIGNA CO REGIONAL OPS CTR/HS AR P O BOX 182503 7503 CHATTANOOGA TN 37422-7503
OY* HEALTHSOUTH MEDICAL PLAN ADMINISTRATORS P O BOX 382617 BIRMINGHAM AL 35238
JO4 HEALTHTRANS LLC 8300 E MAPLEWOOD AVENUE SUITE 100 GREENWOOD VILLAGE CO 80906
IC6 HEARTLAND NATIONAL LIFE IN PO BOX 2878 SALT LAKE CITY UT 84110-2878
K57 HEEKIN CAN CO INSURANCE BENEFIT DEPT PO BOX H SPRINGDALE AR 72764
BY7 HELLER ASSOCIATES 2755 BRISTOL ST STE 250 COSTA MESA CA 92626
AE* HERALD LIFE INSURANCE P O BOX 3058 LITTLE ROCK AR 72203
TF* HERALD LIFE INSURANCE CORP 233 WEST DUVAL JACKSONVILLE FL 32201
FU6 HERITAGE CONSULTANTS PO BOX 1730 AUBURNDALE FL 33823
* - 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 63
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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BZ3 HERITAGE HEALTH PLAN 2505 N HWY 360 STE 670 GRAND PRAIRIE TX 75050
Z36 HERITAGE NATIONAL HEALTH 973 FEATHERSTONE RD ST300 ROCKFORD IL 61107-5901
SY* HERTZ PO BOX 365 PARSIPPANY NJ 07054-0365
S22 HERZFELD HEALTH CARE P O BOX 249 BENTON AR 72015
L3* HEWITT COLEMAN ASSOCIATES P O BOX 3808 GREENVILLE SC 29608
J71 HIGHLANDS INSURANCE 600 JEFFERSON ST HOUSTON TX 77002
TZ* HIGHMARK BLUE CROSS BLUE SHIELD P O BOX 1210 PITTSBURGH PA 15230
G57 HILB ROGAL HAMILTON COMPAN PO BOX 530470 BIRMINGHAM AL 35253-0470
Y20 HILL BROTHERS CONST CO INC ATTN INSURANCE DEPT PO BOX 131 FAULKNER MS 38624-0131
J4* HILL COUNTRY LIFE INS P O BOX 200225 AUSTIN TX 78720-0225
D90 HILLHAVEN CORP HEALTH BENEFITS DEPT CALLER SERVICE 2264 TACOMA WA 98401-2264
D66 HILLHOUSE ASSOCIATES BOX 201359 AUSTIN TX 78720
N51 HILTON EMPLOYEES MHM 190 N EAST FAYETTEVILLE AR 72701
K31 HINDERLITER INDUSTRIES CORHEN INTNL CORP P O BOX 12338 OKLAHOMA CITY OK 73157
HW8 HIP HEALTH PLAN NEW YORK 55 WATER STREET NEW YORK NY 10041-8190
GY2 HMBA P O BOX 535078 PITTSBURGH PA 15253-5078
A74 HMO ARKANSAS 26 CORPORATE HILL DRIVE LITTLE ROCK AR 72205-4538
CJ5 HMO KAISER P O BOX 5398 CLEVELAND OH 44101
DQ7 HMO OF VIRGINIA P O BOX 26623 RICHMOND VA 23261
BK1 HMO OREGON P. O. BOX 12625 SALEM OR 97309
G73 HOFFINGER INDUSTRIES INC P O BOX 2457 WEST HELENA AR 72390
EA3 HOLDEN AND COMPANY INC 20 EAST BAY STREET P O BOX 9360 SAVANNAH GA 31419
YM* HOLY FAMILY SOCIETY OF USA ONE FAIRLANE DRIVE JOLIET IL 60434
BR4 HOME LIFE FINANCIAL NEWELL HORNER GUNER INC P O DRAWER 22610 LITTLE ROCK AR 72221-2610
R13 HOME LIFE INSURANCE P O BOX 29005 GLENDALE CA 91209
V76 HOME LIFE INSURANCE CO P O BOX 85 HOLLANDALE MS 38748
C89 HOMESTEADERS LIFE CO GENERAL DELIVERY DES MOINES IA 50309
L9* HORACE MANN 1 HORACE MANN PLAZA SPRINGFIELD IL 62715
FX4 HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY PO BOX 247 DEPT V NEWARK NJ 07101-0247
BO4 HORIZON HEALTH 3841 W CHARLESTON BLVD SUITE 203 LAS VEGAS NV 89102
FR8 HOSPICE CARE SERVICES 1501 S UNIVERSITY LITTLE ROCK AR 72207
LY* HOSPITAL BENEFITS INC P O BOX 162148 ALTAMONTE SPRINGS FL 32716-2148
E18 HOSPITAL CASUALTY CO 720 N W 50TH BOX 18328 OKLAHOMA CITY OK 73154
M90 HOTEL EMPLOYEE INTL UNION WELFARE FUND 1933 LAS VEGAS BLVD LAS VEGAS NV 89104
EW3 HOUSING BENEFIT PLAN P O BOX 542077 DALLAS TX 75354-2077
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Z50 HPA INC BICOASTAL DIVISION P.O. 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
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. BOX 4705 MONROE LA 71211
AP6 IA CARE 500 SW 7TH STE 201 DES MOINES IA 74103-2131
Y21 IBA HEALTH LIFE ASSURANCE 106 FARMERS ALLEY STE 300 P O BOX 51100 KALAMAZOO MI 49005-1100
W22 IBEW LOCAL UNION 9 7045 N WESTERN AVE CHICAGO IL 60645
Q83 IBEW NECA SOUTHWESTERN HEA AND BENEFIT FUND 4040 MCEWEN, SUITE 100 DALLAS TX 75244-5092
T21 ICHA HEALTH CARE PLAN 2024 HICKORY RD HOMEWOOD IL 60430-2199
CD6 IEBC P O BOX 470 GENEVA IL 60134-0470
Y80 IGA GROUP EMPLOYMENT BENEFIT PROGRA 430 ORLAND SQ DR STE 303 ORLAND PARK IL 60462
F35 ILLINOIS CENTRAL HOSP ASSC 2024 HICKORY ROAD HOMEWOOD IL 60430-2199
Z57 ILLINOIS MUTUAL LIFE CASUA 300 S.W. ADAMS PEORIA IL 61634
Z88 IMA OF LOUISIANA P.O. 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
* - 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 65
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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. BOX 441280 INDIANAPOLIS IN 46244-1280
FP7 INDIANAN HEALTH NETWORK PO BOX 20490 INDIANAPOLIS IN 46220
P33 INDREX QUARLES 7633 E 63RD PLACE SUITE 500 TULSA OK 74133
G90 INDUSTRIAL LIFE INS CO HERITAGE INS MANAGERS P O BOX 790570 SAN ANTONIO TX 78279
A83 INDUSTRIAL LIFE INS CO ATTN CLAIMS DEPT 3815 MONTROSE HOUSTON TX 77006
G60 INFOLOB INS CO POBOX 1309 CLARKSDALE MS 38614
HS5 INFORMED RX 26 HARBOR PARK DRIVE PORT WASHINGTON NY 11050
Y22 INGERSOLL ATTN HEALTH INSURANCE SEC 707 FULTON AVENUE ROCKFORD IL 61103
I66 INGRAM INDUSTRIES INC P.O. BOX 23049 NASHVILLE TN 37202
VI* INLAND LIFE INSURANCE CO 223 WEST JACKSON CHICAGO IL 60601
M56 INNOVATOR P O BOX 938 SAN JOSE CA 95100-9380
GR2 INNOVIANT PO BOX 8082 WAUSAU WI 54402
K1* INS CO OF STATE OF PENNSYLVANIA 102 MAIDEN LANE NEW YORK NY 10005
GE3 INSERVCO INSURANCE CO ATTN MARY BETH ULP P O BOX 3899 HARRISBURG PA 17105-3899
J36 INSURANCE AND RISK MANAGEM P.O. BOX 414043 MAMI BEACH FL 33141
N13 INSURANCE BENEFIT ADMIN P O BOX41779 MEMPHIS TN 38174
K93 INSURANCE BENEFITS SERVICE PO BOX 218969 HOUSTON TX 77218-8969
T14 INSURANCE CLAIM SERVICE LANCASTER HEALTH BENEFIT P O BOX 1307 MENA AR 71953
CB9 INSURANCE CLAIMS SERVICE I P O BOX 43350 BIRMINGHAM AL 35243
OL* INSURANCE CO OF NORTH AMERICA 1600 ARCH STREET PHILADELPHIA PA 19101
A31 INSURANCE COMPANY OF AMERI 406 WEST 34 STREET KANSAS CITY MO 64111
V2* INSURANCE CONSULTING AND CLAIMS SERVICE INC 100 E SOUTH ST SUITE 320 ARLINTON TX 76010
L27 INSURANCE MANAGEMENT ADMIN OF LOUISIANA INC P O BOX 71120 BOSSIER CITY LA 71171-1120
EO7 INSURANCE MANAGEMENT SVCS P O BOX 15688 AMARILLO TX 79105
BV7 INSURANCE MARKETING RESOUR P O BOX 65500 LUBBOCK TX 79464
BM4 INSURANCE RISK MGMT P. O. BOX 2362 FORT WAYNE IN 46801-2362
N78 INSURANCE RISK MGT P O BOX 2067 CEDAR RAPIDS IA 52406
M85 INSURANCE SERVICE CENTER 11330 Z H 10 WEST SUITE 2100 SANANTONIO TX 78249
CH2 INSURANCE SERVICES AND BEN 3218 HWY 67 SUITE 218 MESQUITE TX 75150
G43 INSURANCE SERVICES INC 3015 E CENTRAL WICHITA KS 67214
AD7 INSURANCE SPECIALISTS INC P.O. BOX 669 2407 LINWOOD DRIVE PARAGOULD AR 72451
M14 INSURANCE TRUST P O BOX 65887 WEST DESMOINES IA 50265
IK5 INSURANCETPA P O BOX 15953 LUBBOCK TX 79490-5953
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EG8 INSURER ADM CORPORATION CONSUMER FOOD DRUG PO BOX 35309 PHOENIX AZ 85069
X85 INSURERS ADMINSTRATION CO PO BOX 39119 PHOENIX AZ 85069-9119
M63 INSUREX BENEFIT ADMIN P O BOX 41779 2158 UNION AVENUE MEMPHIS TN 38174
P93 INSURNATIONAL INCORPORATED P O BOX 619070 DFW AIRPORT TX 75261-9070
SF* INTEGON FRIT INDUSTRIES INC GENERAL DELIVERY WALNUT RIDGE AR 72476
VV* INTEGON LIFE INS GROUP P O BOX 18384 TAMPA FL 33679
Y4* INTER CO HOSPITAL PLAN PO BOX 7780 1292 PHILADELPHIA PA 19182-2000
AV7 INTERACTIVE MEDICAL SYSTEM 5621 DEPARTURE DR STE 117 P.O. BOX 19108 RALEIGH NC 27619
HL4 INTERAMERICANS INSURANCE PO BOX 9510 WITCHITA KS 67277
AI8 INTERCARE HEALTH PLANS P.O. BOX 3559 ENGLEWOOD CO 80155-3559
S3* INTERCONTINENTAL LIFE INS P O BOX 149138 AUSTIN TX 78701-9138
BW8 INTERGROUP 1010 N FINANCE CTR DRIVE SUITE 100 TUCSON AZ 85710-1361
SS* INTERMOUNTAIN HEALTH CARE 36 SOUTH STATE PO BOX 11670 SALT LAKE CITY UT 84147-0670
CC1 INTERNATIONAL BENEFIT SERV P O BOX 1326 FORT WORTH TX 76101-1326
IH4 INTERNATIONAL BENEFITS ADMINSTRATORS PO BOX 9306 GARDEN CITY NY 11530
QS* INTERNATIONAL CLAIM SVCS 5775 PEACHTREE DUNWOODY BLDG G SUITE 550 ATLANTA GA 30342
B8* INTERNATIONAL GROUP INS 6620 WEST BROAD STREET P O BOX 8287 RICHMOND VA 23226
GW8 INTERNATIONAL MEDICAL GROU P O BOX 88500 INDIANAPOLIS IN 46208-0500
F38 INTERNATIONAL MULTIFOODS MULTIFOODS TOWER BOX 2942 MINNEAPOLIS MN 55402-0942
OQ* INTERSTATE EAST CEDAR P O BOX 405 EL DORADO AR 71730
00H INTERSTATE LIFE AND ACCIDE PO BOX 69 LITTLE ROCK AR 72203
TI* INTERSTATE LIFE ASSURANCE 3750 DEERFIELD RD RIVERWOODS IL 60015-3541
E50 INTERSTATE UNIFORM UNIFIRST CORP 15 OLYMPIA AVE WOBURN MA 01888
C25 INTRNTNL UNION OPER ENG PI LN EMPLYRS HLTH WLFR FUND 4115 CHESAPEAKE ST NW WASHINGTON DC 20016
GK8 INVESTORS DIVERSIFIED SYND 227 AXP FINANCIAL CENTER MINNEAPOLIS MN 55474
TW* INVESTORS INSURANCE CORP P O BOX 23035 PORTLAND OR 97223
D63 INVESTORS LIFE INSURANCE P O BOX 1038 HURST TX 76053
I71 IOWA BENEFITS P.O. BOX 707 AMES IA 50010
XN* IOWA STATE TRAVELERS MUTUAL ASSOCIATION 7136 HASKELL AVENUE VAN NUYS CA 91406
JD* IRON WORKERS FIELD WELFARE 131 N EL MOLINO AVENUE SUITE 330 PASADENA CA 91101
BD1 IRON WORKERS HEALTH ST LOUIS DISTRICT COUNCIL 2160 S. FOSTER AVENUE WHEELING IL 60090
AZ4 IRON WORKERS HEALTH AND WELFARE 2605 NONCONNAH STE 170 MEMPHIS TN 38132
T52 ITA APPLE HMO 600 JEFFERSON AVE MEMPHIS TN 38101
J61 ITPE NMU WELFARE FUND P O BOX 23679 SAVANNA GA 31403
00T IV D CHILD SUPPORT TPL UNIT MEDICAL ASSISTANCE O M S 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 67
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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S44 J AND S TRUCKING 5415 S 31 FT SMITH AR 72906
W70 J CHRISTY CONSTRUCTION P O BOX 66 EL DORADO AR 71731-0066
P73 J F MOLLOY ASSOC INC P O BOX 68947 INDIANAPOLIS IN 46268
R14 J M HUBER CORP 333 THORNALL ST EDISON NJ 08818
GN7 J P FARLEY CORPORATION P O BOX 458022 WESTLAKE OH 44145
K95 J P PRICE LUMBER CO P O BOX 536 MONTICELLO AR 71655
P90 JACKSON GROUP CLAIM CENTER 146 INDUSTRIAL PARK JACKSON MN 56143
W86 JACKSON LONG AND ASSOC P O BOX 168 MATTESON IL 60443
Z37 JACUZZI EMPLOYEES MEDICAL BENEFIT TRUST INTERNATL P.O. BOX 619930 DFW AIRPORT TX 75261-9930
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. BOX 1267 JONESBORO AR 72403
NI* JCPENNEY AETNA US HEALTH P O BOX 91511 ARLINGTON TX 76015
Z65 JE MERIT CONSTRUCTORS INC P.O. BOX 80257 BATON ROUGE LA 70898
UX* JEFFERSON LIFE INSURANCE 9304 FORREST LANE NORTH SUITE 256 DALLAS TX 75243
GR3 JEFFERSON NATIONAL LIFE PO BOX 2034 CARMEL IN 46082-2034
U65 JEFFERSON PILOT PO BOX 26011 GREENSBORO NC 27420
EA7 JEFFERSON PILOT P O BOX 21008 GREENSBORO NC 27420
EP1 JEFFERSON PILOT P O BOX 268849 OKLAHOMA CITY OK 73126-8849
AI9 JEFFERSON PILOT 5950 FAIRVIEW ROAD SUITE 810 CHARLOTTE NC 28210
FC2 JEFFERSON PILOT INS CO P O BOX 20727 GREENSBORO NC 27420-0727
X64 JEFFERSON PILOT INSURANCE GROUP CLAIMS DEPT P O BOX 1561 LAKE CITY FL 32056-1561
I24 JEFFERSON PILOT LIFE INS 5211 LINBAR DR SUITE 513 NASHVILLE TN 37211
EE1 JELD WEN HEALTH BENEFITS P O BOX 5128 BEND OR 97708
I80 JERRY D LANCASTER AND ASSO 4825 LBJ FREEWAY STE 190 DALLAS TX 75234
T78 JIM WEST ATTORNEY AT LAW P O BOX 1446 FT SMITH AR 72902-1446
CR1 JIMMY WILSON ATTORNEY TRUST 801 PERRY ST HELENA AR 72342
S1* JOHN ALDEN 5100 GAMBLE DRIVE P O BOX 9398 MINNEAPOLIS MN 55440-9398
AU4 JOHN ALDEN P.O. BOX 1599 BOISE ID 83701
AS6 JOHN ALDEN P.O. BOX 659002 SACRAMENTO CA 95865-9002
AK6 JOHN ALDEN TRANSITANK CAR CORP PO BOX 025241 MIAMI FL 33102
* - 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 68
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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E97 JOHN ALDEN INSURANCE P.O. BOX 020270 7600 CORP CENTER DR MIAMI FL 33162
AB2 JOHN ALDEN INSURANCE CO P.O. BOX 829504 SOUTH FLORIDA FL 33082
G21 JOHN ALDEN LIFE INS P O BOX 50090 PHOENIX AZ 85076-0090
EJ3 JOHN ALDEN LIFE INS P O BOX 30308 TAMPA FL 33630
DP4 JOHN ALDEN LIFE INS 5500 GLENDON COURT P O BOX 1804 DUBLIN OH 43017-1804
GY8 JOHN ALDEN LIFE INSURANCE P O BOX 42034 HAZELWOOD MO 63042
GI4 JOHN BARTTELT ATTORNEY AT LAW 319 SOUTH CHURCH JONESBORO AR 72401
OR* JOHN DEERE HEALTH CARE 3800 23RD AVE SUITE 200 MOLINE IL 61265
ES1 JOHN HANCOCK UNICARE P O BOX 7605 SCHAUMBERG IL 60188
EH7 JOHN HANCOCK UNICARE P O BOX 801067 DALLAS TX 75380-1067
CL1 JOHN HANCOCK UNICARE P O BOX 3148 BALDWIN MO 63022
CD4 JOHN HANCOCK UNICARE WHIRLPOOL CORP P O BOX 4052 SCHAUMBURG IL 60168-4052
AW7 JOHN HANCOCK UNICARE 3200 GREENFIELD P O BOX 6113 DEARBORN MI 48120
Z8* JOHN HANCOCK UNICARE P O BOX 4046 SCHAUMBURG IL 60168-4046
Z12 JOHN HANCOCK UNICARE C/O GOLDEN POULTRY COMPAN P.O. BOX 919, MCNEAL DR DOUGLAS GA 31538
WW* JOHN HANCOCK UNICARE CLAYTON PLAZA BLDG 7700 CLAYTON RD STE 306 RICHMOND HEIGHTS MO 63117
Y23 JOHN HANCOCK UNICARE C/O LTV AEROSPCE PO BOX 655907 DALLAS TX 75265
YO* JOHN HANCOCK UNICARE 611 EAST WELLS STREET MILWAUKEE WI 53202
UQ* JOHN HANCOCK UNICARE 720 SW WASHINGTON ST PORTLAND OR 97205-3500
T2* JOHN HANCOCK UNICARE 1661 GATEWAY BLVD PO BOX 833835 RICHARDSON TX 75083-3835
S47 JOHN HANCOCK UNICARE P O BOX 26714 GREENSBORO NC 27417-6714
WV* JOHN HANCOCK UNICARE TODD SHIPYARDS CORP P O BOX 6158 NEW ORLEANS LA 70114
WM* JOHN HANCOCK UNICARE P O BOX 6715 WAYNE PA 19087-8715
V79 JOHN HANCOCK UNICARE P O BOX 4053 SCHAUMBERG IL 60168-4053
V59 JOHN HANCOCK UNICARE BOX 1000 BRAIN TREE MA 02184
V32 JOHN HANCOCK UNICARE 208 OLD LANCASTER RD DEVON PA 19333
DY5 JOHN HANCOCK UNICARE P O BOX 833823 RICHARDSON TX 75083
EJ9 JOHN HANCOCK UNICARE 7900 XERXES AVE SOUTH SUITE 2450 MINNEAPOLIS MN 55431
DQ9 JOHN HANCOCK UNICARE KELLOGGS CLAIMS UNIT PO BOX 4055 SCHAUMBERG IL 60168-4055
DJ* JOHN HANCOCK UNICARE 110 VETERANS MEMORIAL HWY SUITE 347 METAIRIE LA 70005
DH8 JOHN HANCOCK UNICARE 1585 PAOLI PIKE C 2680 WEST CHESTER PA 19380
DH7 JOHN HANCOCK UNICARE 1585 PAOLI PIKE C 2684 WEST CHESTER PA 19380
DE6 JOHN HANCOCK UNICARE P O BOX 68099 SCHAUMBERG IL 60168
DE5 JOHN HANCOCK UNICARE P O BOX 120 BALLWIN MO 63022-0120
C69 JOHN HANCOCK UNICARE 200 HANOVER PARK DR DUNWOODY GA 30338
* - 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 69
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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C55 JOHN HANCOCK UNICARE 2110 E STEVE OWENS MIAMI OK 74354
C46 JOHN HANCOCK UNICARE NUMBER 440 720 S W WASHINGTON PORTLAND OR 97205
C11 JOHN HANCOCK UNICARE P O BOX 33930 DETROIT MI 48232
FD4 JOHN HANCOCK UNICARE P O BOX 26038 GREENSBORO NC 27420-6038
G31 JOHN HANCOCK UNICARE 13601 PRESTON ROAD SUITE 201G DALLAS TX 75240
L1* JOHN HANCOCK UNICARE 3655 N W 87TH AVENUE MIAMI FL 33178
HT* JOHN HANCOCK UNICARE P O BOX 111 BOSTON MA 02117
HG* JOHN HANCOCK UNICARE HICKORY SPRINGS MFG P O BOX 26717 GREENSBORO NC 27417
R52 JOHN HANCOCK UNICARE GROUP CLAIMS OFFICE P O BOX 2074 AURORA IL 60507-2074
R2* JOHN HANCOCK UNICARE SUNSTRAND CORP P O BOX 4072 SCHAUMBURG IL 60194-4072
Q86 JOHN HANCOCK UNICARE P O BOX 5004 ROCHESTER MI 48308
QF* JOHN HANCOCK UNICARE 110 21ST AVE SOUTH NASHVILLE TN 37203
P49 JOHN P PEARL ASSOCIATES 1200 E GLEN AVE PEORIA HEIGHTS IL 61614-5348
C87 JOHN STROUD 2900 PERCY MACHIN DR NORTH LITTLE ROCK AR 72118
HD9 JOHNSON AND JOHNSON PO BOX 221857 CHARLOTTE NC 28222
X30 JOHNSON BROKERS ADM 2448 E 81ST STREET SUITE 5000 TULSA OK 74137-4227
P29 JOHNSONS ADMINIISTRATORS PO BOX 248 NEWTON PA 18940
U7* JON W HALL ASSOCIATES INC PO BOX 14868 SHAWNEE MISSION KS 66215
CG3 JONES HILLS AND MERCER EMPLOYEE BENEFITS INC PO BOX 9888 SAVANNAH GA 31412
E98 JONESBORO INST SUPPLY PO BOX 105014 ATLANTA GA 30310
V16 JOSEPH BEHR AND SONS P O BOX 740 ROCKFORD IL 61105
IB6 JP FARLEY PO BOX 41779 MEMPHIS TN 38174-1779
HQ9 JUST BENEFITS 11111 RICHMOND AVE. SUITE 2377 HOUSTON TX 77082-6602
PV* JUSTISS MEARS OIL CO P O DRAWER N JANA LA 71342
DP8 KAISER FOUNDATION PO BOX 23448 SAN DIEGO CA 92193-3448
TS* KAISER FOUNDATION 260 INTERNATIONAL CIRCLE SAN JOSE CA 95123
GI2 KAISER FOUNDATION HEALTH P CALIFORNIA CLAIMS ADMIN PO BOX 7004 DOWNEY CA 90242-7004
DD6 KAISER FOUNDATION HEALTHCA EMERGENCY CLAIM SERV CTR P O BOX 90430 CITY OF INDUSTRY CA 91716-0430
DA3 KAISER PERMANENTE 12720 HILLCREST SUITE 600 DALLAS TX 75230
CW* KAISER PERMANENTE 500 NE MULTNOMAH SUITE 100 PORTLAND OR 97232-2099
BN8 KAISER PERMANENTE 2500 S HAVANA AURORA CO 80014
EN6 KAISER PERMANENTE 10561 BARKLEY SUITE 200 OVERLAND PARK KS 66212
EG7 KAISER PERMANENTE P O BOX 921010 FORT WORTH TX 76121-9896
0S* KAISER PERMANENTE P O BOX 370898 DENVER CO 80237
ES7 KAISER PERMANENTE SOUTH P O BOX 41920 LOS ANGELES CA 90041-0920
* - 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 70
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EB5 KANAWHA BENEFIT SRVS PO BOX 9050 LANCASTER SC 29721-9050
Q9* KANAWHA EMPLOYEE BENEFIT P O BOX 5150 GREENSBORO SC 29606-5150
HQ6 KANAWHA INSURANCE COMPANY PO BOX 2000 LANCASTER SC 29721
Z89 KANSAS CITY CHIEFS 1 ARROWHEAD DRIVE KANSAS CITY MO 64129
IL5 KANSAS CITY LIFE INSURANCE P O BOX 9040 AUSTIN TX 78766
K15 KANSAS CITY SOUTHERN RAILW 114 WEST 11TH STREET KANSAS CITY MO 54105
G42 KEARNEY DIVISION 3660 S SCHOOL FAYETTEVILLE AR 72703
LI* KELLY AND ASSOCIATES P O BOX 82987 OKLAHOMA CITY OK 73148
BO2 KELSEY NATIONAL CORP 3030 N BUNDY DRIVE LOS ANGELES CA 90066
0WB KEMPER GROUP INSURANCE 1401 PEACHTREE ST NE ATLANTA GA 30309
DV3 KEMPTON COMPANY P O BOX 54889 OKLAHOMA CITY OK 73154-1889
K92 KENTUCKY KARE SELECT P O BOX 37450 LOUISVILLE KY 40233
E1* KERR MCGEE CORPORATION BENEFIT SERVICES DIV P O BOX 3823 DEPT 199 RICHARDSON TX 75080
EN8 KEY BENEFIT ADMINISTRATORS WASHINGTON NATL EMP BENEF P O BOX 55210 INDIANAPOLIS IN 46205
GR9 KEY BENEFIT ADMINISTRATORS PO BOX 129 FORT MILL SC 29716
V78 KEY HEALTH PLAN 333 N ALABAMA INDIANAPOLIS IN 46204
AS4 KEYSTONE EMPLOYEE BENEFITS 4815 NORTH PROSPECT ROAD PEORIA IL 61614-6470
L45 KEYSTONE FASTENERS 1407 S POWELL SPRINGDALE AR 72764
CP* KEYSTONE INSURANCE COMPANY 1626 NORTH MAIN ROCKFORD IL 61103
KS* KEYSTONE LIFE INS CO BOX 892 CARROLLTON TX 75006
GH2 KEYSTONE WEST PO BOX 898819 CAMP HILL PA 17089-8316
HJ7 KHS PO BOX 1000 LANCASTER SC 29721
BQ1 KIMBALL HEALTH CARE SPRINGS VALLEY BANK TRUST P O BOX 830 JASPER IN 47547
AN5 KIMBERLY CLARK CORP PREFERRED SERVICES P.O. BOX 29800 ATLANTA GA 30359
AN4 KIMBERLY CLARK CORP PREFERRED SERVICES P.O. BOX 29300 ATLANTA GA 30359
W48 KIMBERLY D HOGAN TRUST MERCHANTS NATIONAL BANK P O BOX 17007 FT SMITH AR 72917
BF6 KING CO MEDICAL BLUE SHIEL P.O. BOX 21267 SEATTLE WA 98111
DL6 KIRK VAN ORSDEL INC 1776 W LAKES PARKWAY DES MOINES IA 50398
WR* KIRKE VAN ORSDEL PO BOX 1086 ST LOUIS MO 63188
EM7 KIRKE VAN ORSDEL INC P O BOX 9007 ST LOUIS MO 63101-9007
U11 KMART CORPORATION DEPT 771153 P O BOX 77000 DETROIT MI 48277-1153
C91 KNIGHTS OF COLUMBUS P O BOX 9961 PROVIDENCE RI 02940
N28 KOCH HEALTH PLAN THE NYHART CO P O BOX 1090 EVANSVILLE IN 47706-1090
G78 KOHLER KONNECT MS 014 444 HIGHLAND 18004561675 KOHLER WI 53044
IB2 KROGER RX 1014 VINE STREET CINCINNATI OH 45202
* - 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 71
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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M48 KUNZLER COMPANY P O BOX 1523 LANCASTER PA 17603
EE2 KYZER INSURANCE TEAMSTER LOCAL 856 1800 HARRISON ST OAKLAND CA 94612
E46 L T V CORPORATION ASSOCIATION SERVICES GRP T 12 P O BOX 111 BOSTON MA 02117
ZM* LA Z BOY CHAIR CO PENSION GROUP SVCS STE 400 161 E MICH AVE KALAMAZOO MI 49007
X16 LABARGE CORP P O BOX 324 DALLAS TX 75221
A4* LABARGE INC HEALTH BENEFIT P O BOX 311 FLIPPIN AR 72634
EN3 LABORATORY CORP OF AMERICA LABCORP CLAIMS UNIT P O BOX 8200 BURLINGTON NC 27216
N63 LABORER HEALTH AND WELFARE SOUTHERN CA P O BOX 8024 EL MONTE CA 91734
RB* LABORERS HEALTH AND WELFARE PLAN 4501 WEST 61 LITTLE ROCK AR 72209
HY4 LABORERS HEALTH CALIFORNIA 220 CAMPUS LANE FAIRFIELD CA 94534-1499
N33 LABORERS INSURANCE FUND 1541 1ST NATL BUILDING DETROIT MI 48226
W77 LABORERS INTERNATIONAL UNION OF NORTH AMERICA 220 CHAMPUS LN SUISURE CA 94585-1498
DM3 LABORERS INTERNATIONAL UNION OF NO AMERICA 2841 EAST MYRTLE ST STOCKTON CA 95205
BW3 LABORERS NATIONAL HEALTH 111 MASSACHUSETTS AVENUE N W SUITE 100 WASHINGTON DC 20001
UZ* LABORERS WELFARE FUND LOCAL 282 116 COMMERCE DRIVE JEFFERSON CITY MO 65101
EY8 LABORS NATIONAL HEALTH AND WELFARE FUND P O BOX 1100 COLUMBIA MD 21044
N12 LABORS PENSION FUND 11465 WEST CERMAK WEST CHESTER IL 60154
FE6 LAMAR LIFE INSURANCE P O BOX 66978 CHICAGO IL 60666
R80 LAMAR LIFE INSURANCE CO P O BOX 880 JACKSON MS 39205-0880
L78 LANCE INC 8600 S BOULEVARD CHARLOTTE NC 28232
EH4 LANDMARK INC INSURANCE DEPT P O BOX 478 PONTOTOC MS 38863
H53 LANGSTON COMPANIES INC P.O.BOX 60 MEMPHIS TN 38101-0060
J90 LAQUINTA INNS P O BOX 790064 SAN ANTONIO TX 78279-0064
Z66 LASALLE DEITCH CO INC P.O. BOX 98 ELKHART IN 46515
BH7 LAWRENCE HEALTH CARE P.O. BOX 40022 FRESNO CA 93755
DS3 LAWRENCE SMITH AND ASSOC SCHOOL INSURANCE P O BOX 411216 ST LOUIS MO 63141
R96 LCS EMPLOYEE BENEFIT PLAN ADMINISTRATIVE SERVICES 4747 LINCOLN MALL DR, 305 MATTESON IL 60443
HM1 LDI PHARMACY BENEFIT MGMT 300 S GRAND BLVD ST LOUIS MO 63103
Y24 LEER MFG HEALTH PLAN CLAIM MGT SERVICES 1043 S MAIN ST WEST BEND WI 53095
BO1 LEES TRUCKING INC P O BOX 70100 SHREVEPORT LA 71137
K58 LEGACY LIFE INSURANCE 100 AQUILA COURT OMAHA NE 86102-2779
FQ* LEGAL SECURITY P O BOX 8476 DALLAS TX 75205
V54 LEGAL SECURITY LIFE INS CO P O BOX 851348 MESQUITE TX 75185-1348
M62 LEGGETT AND PLATT GROUP 2806 BRYANT ROAD VAN BUREN AR 72956
R33 LEGIONNAIRE INSURANCE TRUS P O BOX 1146 SANTA BARBARA CA 93102-1146
* - 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 72
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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IZ* LEGIONS INSURANCE CLAIMS ADMINISTRATION P O BOX 3968 BOCA RATON FL 33427-3968
I12 LESTER SMITH TREML ARNEDT P.O. BOX 9 WISCONSIN RAPIDS WI 54494
U91 LEWER AGENCY 4534 WORNELL RD KANSAS CITY MO 64111-3211
HS9 LIBERTY DENTAL PLAN OF CA PO BOX 26110 SANTA ANA CA 92799
JA1 LIBERTY HEALTH SHARE LLC P O BOX 36908 CANTON OH 44735
J20 LIBERTY LIFE P.O. BOX 2817 GAINSVILLE GA 30503
F23 LIBERTY LIFE ASSURANCE 3567 PARKWAY LANE SUITE 200 NORCROSS GA 30092
C66 LIBERTY LIFE INSURANCE CO P O BOX 789 GREENVILLE SC 29602
WY* LIBERTY LIFE INSURANCE CO TEX ARK JOIST P O BOX TAJ HOPE AR 71801
JB8 LIBERTY MUTUAL P O BOX 515097 LOS ANGELES CA 90051-5097
RC* LIBERTY MUTUAL BOX 25708 CHARLOTTE NC 28212
P63 LIBERTY MUTUAL INS P O BOX 730 MISHAWAKA IN 46544
BE* LIBERTY MUTUAL INS CO 100 NORTH UNIVERSITY DR FORT WORTH TX 76107
C12 LIBERTY MUTUAL INSURANCE P O BOX 168208 IRVING TX 75016-8208
WD* LIBERTY NATIONAL LIFE INS P O BOX 728 BIRMINGHAM AL 35201
RS* LIBERTY NORTHWEST PO BOX 5117 PORTLAND OR 97208
AS8 LIFE AND CASUALTY CO OF TN LIFE AND CASUALTY TOWER NASHVILLE TN 37219
B84 LIFE AND HEALTH INS CO OF AMERICA 2200 WALNUT ST PHILADELPHIA PA 19103
I49 LIFE GENERAL SECURITY INS P.O. BOX 432050 SOUTH MIAMI FL 33243
I14 LIFE INS CO OF NORTH AMERI EDUCATIONAL INSTITUTIONAL 120 S RIVERSIDE STE 2150 CHICAGO IL 60606
D15 LIFE INS CO OF NORTH AMERI DOUG RUEDLINGER INC BOX 2159 TOPEKA KS 66601
OV* LIFE INS CO OF THE SW P O BOX 922001 HOUSTON TX 77292-2001
A88 LIFE INS CO OF THE SW PO BOX 47421 DALLAS TX 75247-0421
BB2 LIFE INSURANCE CO OF AMERICA P.O. BOX 23759 COLUMBIA SC 29224-3759
CQ1 LIFE INSURANCE CO OF AL POLICYHOLDER SERV DEPT P O BOX 349 GADSDEN AL 35902
LH* LIFE INSURANCE COMPANY OF AMERICA P O BOX 105014 ATLANTA GA 30308
HU3 LIFE INSURANCE COMPANY OF ALABAMA P O BOX 349 GADSON AL 35902
GS9 LIFE INVESTORS PO BOX 36580 LOUISVILLE KY 40233-6580
CZ1 LIFE INVESTORS P O BOX 982012 9151 GRAPEVINE HWY N RICHLAND HILLS TX 76182-8012
CX* LIFE INVESTORS TRANSAMERICA P O BOX 8063 LITTLE ROCK AR 72203
C63 LIFE INVESTORS CO OF AMERI 4333 EDGEWOOD ROAD NE CEDAR RAPIDS IA 52499
P54 LIFE OF AMERICA P O BOX 3101 LITTLE ROCK AR 72203
P42 LIFE OF AMERICA INS CO INDIVIDUAL CLAIMS PO BOX 25385 HOUSTON TX 77265
J13 LIFE OF ARKANSAS PREFERRED MEDIPAK P.O. BOX 1861 LITTLE ROCK AR 72203-1861
T3* LIFE OF GEORGIA ASSOCIATED DOCTORS SENIOR P O BOX 3013 LANGHORNE PA 19047-9113
* - 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 73
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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0I* LIFE OF GEORGIA 5780 POWERS FERRY RD P O BOX 105022 ATLANTA GA 30308-5022
XO* LIFE OF VIRGINIA P O BOX 27601 RICHMOND VA 23200
EK2 LIFE RE ADMINISTRATORS INC P O BOX 950 FOLSOM CA 95763-0950
AZ8 LIFE RE INSURANCE CO P O BOX 792070 SAN ANTONIO TX 78279
M35 LIFEGUARD P O BOX 5506 SAN JOSE CA 95150
HM4 LIFESTYLES HEALTH PLAN 345 N RIVERVIEW ST SUITE 600 WICHITA KS 67203
IB7 LIFESYNCH 10816 EXECUTIVE CENTER SUITE 206 LITTLE ROCK AR 72211
II5 LIFEWISE P O BOX 7709 BEND OR 97708
HX1 LIFEWISE PLAN OF ARIZONA PO BOX 99134 SEATTLE WA 98111
CR4 LIFT ALL 102 S HEINTZELMAN ST PO BOX 1030 MANHEIM PA 17545
FM3 LILLY HEALTH PLAN PO BOX 7164 INDIANAPOLIS IN 46207-7164
U29 LINCOLN COMPOSITES FORMERLY BRUNSWICK CORP P O BOX 3316 EAST CAMDEN AR 71701
IM4 LINCOLN DENTAL CONNECT DENTAL CLAIMS INPUT CENTE P O BOX 614008 ORLANDO FL 32861
HN8 LINCOLN HERITAGE PO BOX 10843 CLEARWATER FL 33757
AK8 LINCOLN NATIONAL DISTRICT 9 12365 ST CHARLES ROCK RD BRIDGETON MO 63044
F7* LINCOLN NATIONAL LIFE INS 222 SOUTH CENTRAL DRIVE SUITE 403 CLAYTON MO 63105
AH5 LINECO 2000 SPRINGER DRIVE LOMBARD IL 60148-6419
R27 LIPMAN INSURANCE ADMIN 39420 LIBERTY ST SUITE 260 FREMONT CA 94538
N54 LITTLE RIVER BANK LEPANTO AR 72354
IW* LOCAL 176 HEALTH AND WELFA 1100 N I55 AT E FRONTAGE JOLIET IL 60434
AB3 LOCAL 46 UNION 1620 S. MICHIGAN AVENUE CHICAGO IL 60616
H55 LOCAL 520 UNION EMPLOYEES ROUTE 159 8 EXECUTION WOODS COURT BELLEVILLE IL 82221
BL3 LOCAL 731 IBT 1100 E 31ST ST P.O. BOX 1407 LAGRANGE PARK IL 60525
GX9 LOCKARD AND WILLIAMS P A P O BOX 1688 PASCAGOULA MS 39568-1688
G2* LOCKHEED SUPPORT SYSTEMS 1600 E PIONEER PKWY SUITE 440 ARLINGTON TX 76010
E61 LONDON LIFE REINSURANCE CO P O BOX 1120 BLUE BELL PA 19422-0319
YF* LONE STAR INSURANCE CO PO BOX 879010 DALLAS TX 75287-9010
A80 LONE STAR LIFE INSURANCE GLOBE LIFE CENTER OKLAHOMA CITY OK 73102
AE1 LOUIS DREYFUS CORP P.O. BOX 35 NEW MADRID MO 63869
R16 LOUISIANA GENERAL SERVICES P O BOX 433 HARVEY LA 70059
T86 LOUISIANA LABORS HEALTH 3200 RIDGELAKE SUITE 303 METAIRIE LA 70002
M21 LOUISIANA MUNICIPAL RISK M P O BOX 14177 BATON ROUGE LA 70898
AN6 LOVE BOX COMPANY BENEFITS SECTION 833 BEECHWOOD FAYETTEVILLE AR 72701
GA6 LOVE BOX COMPANY PO BOX 10170 PHOENIX AZ 85064
FD5 LOVELACE HEALTH PLAN 5301 CENTRAL NE SUITE 1600 ALBURQUERQUE NM 87108
* - 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 74
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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K71 LOWER AGENCY 4534 WORDALL ROAD KANSAS CITY MO 64111
F4* LOYAL AMERICAN LIFE INS CO P O BOX 6407 MOBILE AL 36660
Z38 LTV AEROSPACE AND DEFENSE ATTN PERSONNEL P.O. BOX 655907 DALLAS TX 75265
HH9 LUCENT TECHNOLOGY P O BOX 57576 JACKSONVILLE FL 32241
HE2 LUCENT TECHNOLOGY PO BOX 0750 CAROL STREAMS IL 60132-0750
AE2 LUFKIN INDUSTRIES INC P.O. BOX 849 LUFKIN TX 75902
GL9 LUMENOS PO BOX 69309 HARRISBURG PA 17106
GN8 LUMENOS 1801 N BEAUREGARD ST SUITE 10 / PO BOX 11265 ALEXANDRIA VA 22312
CE1 LYON FOLDER COMPANY P O BOX 708 FORDYCE AR 71742
BL5 M CARE ADMINSITRATION PO BOX 130799 ANN ARBOR MI 48113-0799
I96 M H A DIVERSIFIED SERVICES P.O. BOX 16707 JACKSON MS 39236-6707
C72 M S CARRIERS OF MEMPHIS 3150 STARNES COVE MEMPHIS TN 38116
Q99 MAC KINNON CO INC 53 A DWIGHT PLACE FAIRFIELD NJ 07006
Y7* MACMILLIAN BLOEDEL INC 6540 POWERS FERRY RD ATLANTA GA 30339
HC3 MACORI ADMINISTRATION P.O. BOX 2508 SPRING TX 77383-2508
HB3 MACORI ADMINISTRATION P.O. BOX 2508 SPRING TX 77383-2508
JA5 MADISON NATIONAL LIFE P O BOX 5008 MADISON WI 53705
X67 MAGEE COMPANY P O BOX 507 POCAHONTAS AR 72455
II2 MAGELLAN 6950 COLUMBIA DRIVE COLUMBIA MD 21046
AB4 MAGNOLIA PRODUCTS C/O AMERICAN NATIONAL P.O. BOX 853 MAGNOLIA AR 71753
YW* MAIL HANDLERS POB 8402 LONDON KY 40742 P O BOX 44242 JACKSONVILLE FL 32231-4242
GN5 MAIL HANDLERS BENEFIT P O BOX 24503 TUCSON AZ 85734
CO7 MAKSIN MGE CORP KEVON OFFICE CNT 2500 MCCELLAN SUITE 160 PENNSAUKEN NJ 08109
J57 MALLOY GROUP INSURANCE P O BOX 9436 MEMPHIS TN 38109
EP8 MAMSI LIFE AND HEALTH 4 TAFT COURT ROCKVILLE MD 21771
BR7 MANAGED BENEFIT ADM 4604 S GARNETT SUITE 501 TULSA OK 74146
V73 MANAGED CARE ADMINISTRATOR P O BOX 269050 SAN DIEGO CA 92196
CK4 MANAGED CARE OF AMERICA FORMERLY EMPLOYEE BENEFIT 820 PARISH STREET PITTSBURGH PA 15220-3405
CS9 MANAGED HEALTH CARE INC 50 BRIAR HOLLOWLAND STE 500 HOUSTON TX 77020
Q55 MANAGED HEALTH FUNDING INS PO BOX 4221 WOODLAND HILLS CA 91365-4221
IE0 MANAGED HEALTH NETWORK 2019 AEROJET RANCHO CORDOVA CA 95742
FX2 MANAGED HEALTH NETWORK 3850 NORTH CAUSWAY BLVD 2 LAKEWAY CENTER STE 1140 METAIRE LA 70002
A3* MANAGED HEALTHCARE CONCEPT 125 NORTH MAIN MEMPHIS TN 38103
DV* MANAGEMENT HEALTH FUNDING P O BOX 11448 JACKSONVILLE FL 32239-1448
Q78 MANAGEMENT LIFE GROUP CLAI TEAM 11 P O BOX 2007 ARORA IL 60507-2007
* - 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 75
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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F36 MANAGEMENT SERVICES P O BOX 1430 DANVILLE IL 61834-1430
F3* MANFREDI MOTOR TRANSIT CO FOR CCI ADMINISTRATORS P O BOX 20267 COLUMBUS OH 43220
BP9 MANGEMED PO BOX 6125 GREENVILLE SC 29606
W79 MAPCO P O BOX 544 ARKADELPHIA AR 71923
KM* MAPC0 P O BOX 21628 TULSA OK 74121-1628
X74 MARATHON OIL COMPANY INSURED BENEFIT 539 SOUTH MAIN STREET FINDLY OH 45840
CR3 MARILYN DEROO C/O 1776 4360 GEORGETOWN SQ 8LL DUNWOODY GA 30338
K66 MARINE HANDLING FLEETING 222 NORTH LA SALLE ST CHICAGO IL 60601
NQ* MARITIME ILA WELFARE FUND 4603 GULF FREEWAY BOX 18374 HOUSTON TX 77023
SW* MARK TWAIN INSURANCE CORP 4400 LINCOLN BLVD P O BOX 548801 OKLAHOMA CITY OK 73154-8801
Z42 MARSH ADVANTAGE AMERICA FORMERLY SEABURY AND SMIT PO BOX 1520 IOWA CITY IA 52244
HI6 MARSH ADVANTAGE AMERICA ONE WEST THIRD STREET SUITE 900 TULSA OK 74103
HO7 MARSH AFFINITY GROUP SERVI PO BOX 5108 DES MOINES IA 50306
EJ2 MARTIN RESOURCES P O BOX 70100 SHREVEPORT LA 71137
A72 MARTIN SPROCKET AND GEAR V ATTENTION ORLAND CRAIL 1205 SOUTH THIRD AVENUE PARAGOULD AR 72450-5399
N23 MARTIN TRUMBO STERLING FIRST SOUTH CENTER SUITE 400 280 N COLLEGE FAYETTEVILLE AR 72701
LL* MARVELL INSURANCE AGENCY P O BOX 215 MARVELL AR 72366
H41 MARVELL PUBLIC EMPLOYEES CITY OF MARVELL PO BOX 837 MARVELL AR 72366
QC* MARYLAND CASUALTY P O BOX 1228 BALTIMORE MD 21203
J28 MASS INDM AND LIFE 3120 BRECKINRIDGE BLVD DULUTH GA 30199
AB5 MASTER CARE 1900 MAIN NUMBER 216 NORTH LITTLE ROCK AR 72114
T97 MAX FOOTE CONSTRUCTION PO BOX 37387 SHERVEPORT LA 71133
HL1 MAXOR NATIONAL 320 S. POLK SUITE 100 AMARILLO TX 79101
W76 MCC BEHAVIORAL CARE 11095 VIKING DR STE 350 EDEN PRAIRIE MN 55344
IH7 MCCREW CARE P O BOX 6702 COLUMBIA SC 29260-6702
S63 MCDONALD SUPPLY CO INC BENEFIT PLAN P O BOX 389 DUBUQUE IA 00000
D36 MCDONNELL DOUGLAS HLTHYCAR 5301 BOLSA AVE MAIL STATION A38 P53 HUNTINGTON BEACH CA 92647-2048
AU6 MCDOWELL AGENCY INC P.O. DRAWER 3088 GREENVILLE SC 29602-3088
P57 MCGEE COMPANY P O BOX 55 PIGGOTT AR 72454
I53 MCKEE BAKING COMPANY GROUP HEALTH AND DENTAL P.O. BOX 2078 COLLEGEDALE TN 37315
P21 MCKESSON HWY 43 HARRISON AR 72601
IA5 MCLAREN P.O. BOX 1511 FLINT MI 48501-1511
K68 MD PHYSICIANS INSURANCE CO P.O.BOX 51090 AMARILLO TX 79159
W24 MEBA MEDICAL AND BENEFITS PLAN 1007 AVE BALTIMORE MD 21202
I05 MED ADMIN SOLUTIONS PO BOX 723097 ATLANTA GA 31139
* - 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 76
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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CL5 MED BENEFIT SYSTEMS INC P O BOX 177 SOUTH BEND IN 46624
GE6 MED IMPACT 10680 TREENA ST 5TH FL SAN DIEGO CA 92131
L38 MED INCOME CONTINENTAL P O BOX 66388 HOUSTON TX 77006
M31 MED KEY PO BOX 1119 FT SMITH AR 72702
IG2 MED PARTNERS PO BOX 11167 FT WAYNE IN 46856-1167
C88 MED PAY P O BOX 10909 SPRINGFIELD MO 65801
W57 MEDALLION FOODS INC EMPLOYEE BENEFIT PROGRAM 3636 MEDALLION AVE NEWPORT AR 72112
HV5 MEDBEN PO BOX 1009 NEWARK OH 43058-1009
FK5 MEDCO P O BOX 747000 CINCINNOTI OH 45274-7000
FX9 MEDCO HEALTH SOLUTIONS 399 JEFFERSON ROAD MAIL STOP P15 PARSIPPANY NJ 07054
GQ9 MEDCO HEALTH SOLUTIONS PO BOX 2187 LEES SUMMIT MO 64063-2187
GU2 MEDCO HEALTH SOLUTIONS INC P O BOX 14711 LEXINGTON KY 40512
AY5 MEDCO LIFE 1515 SOUTH 75TH STREET OMAHA NE 68124
IK4 MEDCOST PPO P O BOX 25307 WINSTONSALEM NC 27114-5307
CP9 MEDCOST PREFERRED P O BOX 25307 WINSTON SALEM NC 27114-5307
BB3 MEDI PLAN 17 17 RT 208 DEPT H D FAIRLAWN NJ 07410
HY6 MEDICA PO BOX 659752 SAN ANTONIO TX 78265
L42 MEDICAL ADMINISTRATORS 217 BROADWAY MONTCICELLO NY 12201
HW7 MEDICAL ASSOCIATES HEALTH 1605 ASSOCIATES DRIVE SUITE 101 DUBUQUE IA 52002
GQ6 MEDICAL BENEFITS ADMINISTR 3103 EMMERTON ROAD PO BOX 1401 ABINGTON MD 21009
V97 MEDICAL CARE REFERRAL GROUP MELTON AVE TRUMANN AR 72472
I28 MEDICAL CARE REFERRAL GRP 4100 RIO BRAVA STE 211 EL PASO TX 79902
EG3 MEDICAL CLAIMS SERVICE P O BOX 160 RAVENSWOOD WV 26164
AJ1 MEDICAL CONTROL INC 9649 WEBB CHAPEL RD DALLAS TX 75220
D11 MEDICAL EXPENSE TRUST 1016 INS CONSULTING AND CLAIM 100 E SOUTH ST STE320 ARLINGTON TX 76010
FG5 MEDICAL MUTUAL OF OHIO 1 800 641 2583 P O BOX 94917 CLEVELAND OH 44101-4917
GV7 MEDICAL MUTUAL OF OHIO PO BOX 94648 CLEVELAND OH 44101
BW* MEDICAL MUTUAL OF OHIO 2060 EAST NINTH STREET P O BOX 6018 CLEVELAND OH 44101-1018
XG* MEDICAL MUTUAL OF OHIO BCBS OF OHIO P O BOX 943 TOLEDO OH 43656-0001
C99 MEDICAL PLANS INC P O BOX 5364 JACKSON MS 39216
D77 MEDICAL PLANS LOUISIANA 3525 N CAUSEWAY BLVD SUITE 1000 METAIRIE LA 70002
BU* MEDICAL RESOURCE P O BOX 544 DEPT D11 MARLTON NJ 08053
AC8 MEDICAL RESOURCE NET PO BOX 724317 ATLANTA GA 31139
BM2 MEDICAL SERVICE CORPORATIO P O BOX 3048 SPOKANE WA 99220-3048
CL8 MEDICAL SERVICES OF AMERIC P O BOX 1928 LEXINGTON SC 29071-1928
* - 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 77
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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L25 MEDICAL TRUST ADMIN 215 N MAIN P O BOX 540 CLARION IA 50525
DM8 MEDICAL VALUE PLAN 405 MADISON AVENUE TOLEDO OH 43604
IO1 MEDICAO INSURANCE COMPANY 601 6TH AVENUE P O BOX 10386 DES MOINES IA 50306-0386
K60 MEDICARE SERVICES P O BOX 1418 LITTLE ROCK AR 72203-1418
BH8 MEDICLAIM WALGREEN MEDICAL PLAN P O BOX 4007 DANVILLE IL 61834-4007
IO2 MEDICO INSURANCE COMPANY P O BOX 2160 EAGAN MN 55121
AF6 MEDIMET P.O. BOX 52011 PHOENIX AZ 85072
0J* MEDIPAK AR BLUE CROSS BLUE SHIELD P O BOX 2181 LITTLE ROCK AR 72203
D76 MEDIQUIK OF ARKANSAS 2923 E NETTLETON JONESBORO AR 72401
BR3 MEDPLANS 2000 P O BOX 1231 FORT SCOTT KS 66701
JA0 MEDTRACK 6310 LAMAR AVE SUITE 230 MISSION KS 66202
W46 MEGA LIFE P O BOX 18497 OKLAHOMA CITY OK 73154
HV4 MEGA LIFE AND HEALTH INSUR PO BOX 981606 EL PASO TX 79998
N92 MEGA LIFE HEALTH INSURANCE PO BOX 982010 N RICHLAND HILLS TX 76182-8010
FG4 MELTON BROTHERS 4215 S. STADIUM BLVD. P. O. BOX 1367 JONESBORO AR 72403-1066
N37 MEMBER SERVICE ADMINISTRAT P O BOX 3028 TULSA OK 74102
BB4 MEMORIAL HEALTH NETWORK 9301 SW FREEWAY STE 5000 PO BOX 742567 HOUSTON TX 77274
X9* MEMPHIS LGHT GAS AND WATER ATTN INSURANCE DEPT P O BOX 430 MEMPHIS TN 38101
S97 MENNONITE MUTUAL AID ASSOC 1110 NO MAIN ST P O BOX 483 GOSHEN IN 46526
AG4 MENTAL HEALTH NETWORK 1600 LOSGAMOS DR STE 300 18009228015 SAN RAFAEL CA 94903
HA7 MERCER ADMINISTRATION P O BOX 4542 IOWA CITY IA 52244-4542
HQ4 MERCY HEALTH PLAN PO BOX 52089 PHOENIX AZ 85072
AR7 MERCY HEALTH PLAN 1949 EAST SUNSHINE SUITE 1220 SPRINGFIELD MO 65804
GL8 MERCY HEALTH PLANS 14528 S OUTER 40 RD PO BOX 4568 SPRINGFIELD MO 65608
FU1 MERIDIAN BENEFIT PO BOX 4747 WAYNE NJ 07474-4747
IJ4 MERIDIAN HEALTH PLAN 777 WOODWARD AVE SUITE 600 DETROIT MI 48226
IG1 MERITAIN HEALTH 1405 XENIUM LANE NORTH SUITE 140 MINNEAPOLIS MN 55441
HV6 MERITAIN HEALTH PO BOX 9501 AMHERST NY 14226
IM5 MERITAIN HEALTH P O BOX 27267 MINNEAPOLIS MN 55427
IM9 MERITAIN HEALTH INC P O BOX 853921 RICHARDSON TX 75085-3921
MD* MERO AMO MEDICAL PLAN 635 FOURTH AVENUE BROOKLYN NY 11232
GB7 MET LIFE P O BOX 981282 EL PASO TX 79998-1282
K34 MET LIFE HMO SUITE 600 4500 E. PACIFIC COAST HWY LONG BEACH CA 90804
BV5 METHODIST HEALTH CHOICE 1930 S GERMANTOWN ROAD GERMANTOWN TN 38138
Q21 METHODIST HOSP OF JONESBOR 3024 STADIUM BLVD JONESBORO AR 72401
* - 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 78
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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T57 METLIFE ALBUQUERQUE GROUP CLAIMS P O BOX 27448 ALBUQUERQUE NM 87125-7448
KC* METLIFE 9797 SPRINGBORO PIKE P O BOX 8740 DAYTON OH 45401-8740
LP* METLIFE DENTAL CLAIMS P O BOX 14093 LEXINGTON KY 40512
BN1 METLIFE P. O. BOX 945630 MAITLAND FL 32794-5630
DB6 METLIFE DENTAL CLAIMS P O BOX 2078 AURORA IL 60507
CW1 METLIFE DENTAL CLAIMS P O BOX 30276 TAMPA FL 33630
EM4 METLIFE VISION CLAIMS P O BOX 3010 UTICA NY 13504
DD2 METLIFE DENTAL CLAIMS P O BOX 6109 UTICA NY 13504
IO5 METLIFE TRICARE DENTAL PRO P O BOX 14181 LEXINGTON KY 40512
KH* METRAHEALTH P O BOX 2050 PITTSBURGH PA 15230-2050
Y27 METROPLEX LIFE INSURANCE PO BOX 911 DWYER ROAD SEGUIN TX 78156
Z39 METROPOLITAN P.O. BOX 1477 BIRMINGHAM AL 35201
WL* METROPOLITAN DOWELL DIVISION P O BOX 42335 HOUSTON TX 77042
UN* METROPOLITAN DOW CHEMICAL CORP FREEPORT TX 77541
V68 METROPOLITAN P O BOX 9050 CLEARWATER FL 34618-9050
I65 METROPOLITAN 12902 EAST 51ST ST TULSA OK 74134
DJ8 METROPOLITAN P O BOX 740801 ATLANTA GA 30374-0801
GW* METROPOLITAN SPERRY VICKERS 400 LINCOLN STREET SEARCY AR 72143
RF* METROPOLITAN GROUP HEALTH CLAIMS DIVISION 2929 EXPRESS DR NORTH HAUPPAUGE NY 11787
US* METROPOLITAN INSURANCE 1201 L STREET MODESTA CA 95350
H83 METROPOLITAN INSURANCE P.O. BOX 105181 ATLANTA GA 30348
A52 METROPOLITAN INSURANCE PO BOX 487 BELLEVUE WA 98004
B36 METROPOLITAN INSURANCE CO GROUP CLAIMS RIC UNIT PO BOX 7688 SAN FRANCISCO CA 94120
CY1 METROPOLITAN LIFE DENTAL SERVICES P O BOX 3015 UTICA NY 13504
C94 METROPOLITAN LIFE NO AMERICAN PHILIPS LIGHT 2701 W ROOSEVELT LITTLE ROCK AR 72204
AJ2 METROPOLITAN LIFE 4200 COMMERCE CENTER LISLE IL 60532
GL* METROPOLITAN LIFE GEORGIA PACIFIC CO P O BOX 277 STAMPS AR 71860
K43 METROPOLITAN LIFE 10816 EXECUTIVE CENTER DR LITTLE ROCK AR 72211
K48 METROPOLITAN LIFE C/O CHICOPEE P O BOX 39 NORTH LITTLE ROCK AR 72115
T69 METROPOLITAN LIFE 30 GLOBE AVE TEXARKANA AR 75502
U80 METROPOLITAN LIFE P O BOX 6029 NEWARK DE 19714-6029
S60 METROPOLITAN LIFE P O BOX 900 KENNETT MO 63837
W21 METROPOLITAN LIFE P O BOX 5515 FAIRLAWN OH 44313
EF2 METROPOLITAN LIFE INS P O BOX 22026 ALBANY NY 12201
EK1 METROPOLITAN LIFE INS P O BOX 52011 PHOENIX AZ 85072
* - 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 79
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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AC3 METROPOLITAN LIFE INS 30445 N. WESTERN HWY SUITE 300 FARMINGTON HILLS MI 48334
AP7 METROPOLITAN LIFE INS CO GP HEALTH CLAIMS OFFICE P.O. BOX 71928 CHARLESTON SC 29415
BD9 METROPOLITAN LIFE INS CO P. O. BOX 6124 UTICA NY 13504-6124
DF1 METROPOLITAN LIFE INS CO P O BOX 27999 ALBUQUERUE NM 87125
GR* METROPOLITAN LIFE INS CO P O BOX 30074 TAMPA FL 33630-3074
Z68 METROPOLITAN LIFE INS CO P.O. BOX 30430 TAMPA FL 33630
Z90 METROPOLITAN LIFE INS CO P.O. BOX 9330 PINE BLUFF AR 71601
R17 METROPOLITAN LIFE INS CO C/O RAYLOC P O BOX 9437 MEMPHIS TN 38109
OW* METROPOLITAN LIFE INS CO 1720 SOUTH CARAWAY ROAD P O BOX 430 JONESBORO AR 72401
V30 METROPOLITAN LIFE INS CO 700 QUAKE LANE PO BOX 300 WARWICK RI 02887-0300
VE* METROPOLITAN LIFE INS CO 612 CHERRY STREET HELENA AR 72342
KZ* METROPOLITAN LIFE INS CO BASSETT UPHOLSTERY PO BOX 627 DUMAS AR 71639
I93 METROPOLITAN LIFE INS CO 2701 W ROOSEVELT RD LITTLE ROCK AR 72204
HE1 METROPOLITAN LIFE INSURANC P O BOX 937 WESTPORT CT 06881-0937
BB5 METROPOLITAN LIFE INSURANC DENTAL UNIT P.O. BOX 19929 INDIANAPOLIS IN 46219
C75 METROPOLITAN LIFE INSURANC P O BOX 17000 GREENVILLE SC 29606
X7* METROPOLITAN NATIONAL LIFE STANDARD OIL PERSONNEL PO BOX 5738 CHICAGO IL 60680
F44 METROPOLITIAN LIFE LIBBY ROUTE P O BOX 392 HEBER SPRINGS AR 72543
H76 MEYERS BAKERIES P.O. BOX 687 HOPE AR 71801
BI1 MF BLOCK 216 W EMERSON ST PARAGOULD AR 72450
Z14 MHA DIVERSIFIED SERVICES C/O LION OIL 1000 MCHENRY EL DORADO AR 71730
0V* MHC EMPLOYEE BENEFIT TRUST P O BOX 1110 ALEXANDRIA LA 71309-1110
YX* MIC LIFE INSURANCE CORP P O BOX 60217 LOS ANGELES CA 90060
ZO* MICHAEL LANDERS ATTORNEY 200 N JEFFERSON SUITE 516 1 870 862 5433 EL DORADO AR 71730
Z69 MICHIGAN CARPENTERS HEALTH CARE 241 E. SAGINAW STE 601 EAST LANSING MI 48823
A9* MICHIGAN MUTUAL INS CO 28 WEST ADAMS DETROIT MI 48226
EV7 MICRO PLASTICS ATTN PAT GRIFFIN P O BOX 149 FLIPPIN AR 72634
L6* MID AMERICA INSURANCE 324 WEST PERSHING SUITE 11 NO LITTLE ROCK AR 72114
D88 MID AMERICA LUMBERMANS ASS GROUP INS TRUST FUND 4510 BELLEVIEW AVE KANSAS CITY MO 64111
R18 MID AMERICAN BENEFITS ASSO C/O HEALTH PLAN ADMIN P O BOX 2638 ROCKFORD IL 61132-2638
ER3 MID AMERICAN HOLDING P O BOX 25946 OVERLAND PARK KS 66225
PG* MID CENTURY INSURANCE 6717 WEST 63RD ST SHAWNEE MISSION KS 66202
MT* MID SOUTH BENEFIT PLAN P O BOX 17208 NASHVILLE TN 37217-0208
D53 MID SOUTH INSURANCE CO P O BOX 2069 FAYETTEVILLE NC 28302
V93 MID SOUTH IRON WORKERS WELFARE FUND P O BOX 82987 OKLAHOMA CITY OK 73148
* - 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 80
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Z40 MID SOUTH MFG INC P.O. BOX 278 301 INDUSTRIAL PARK MARKED TREE AR 72365
EW5 MID SOUTH TRANSPORATION 1370 LEVEE ROAD MEMPHIS TN 38108
BN7 MIDAMERICA CLAIMS PROCESSI ATTN CBA ASSOCIATION CLAI P O BOX 24319 EDINA MN 55424
S18 MIDCONTINENT MEDICAL BENEF TRUST PRO ADMIN GROUP P O BOX 13390 OVERLAND PARK KS 66212-3390
Z70 MIDLAND BENEFITS ADMIN JEFFERSON PILOT P O BOX 17126 MEMPHIS TN 38187
C44 MIDLAND INSURANCE CO 1 MIDLAND PLAZA SIOUX FALLS SD 57101
HE3 MIDLANDS CHOICE PO BOX 24701 OMAHA NE 68124
Y28 MIDSOUTH MFG INCORPORATED 301 INDUSTRIAL PARK MARKED TREE AR 72365
AQ2 MIDWEST ASSURANCE COMPANY CLAIMS DEPARTMENT P.O. BOX 1289 MINNEAPOLIS MN 55440-1289
BB7 MIDWEST BENEFITS P.O. BOX 2040 OMAHA NE 68103-0040
UR* MIDWEST BENEFITS CORP 22255 GREENFIELD ROAD SUITE 404 SOUTHFIELD MI 48075
E69 MIDWEST NATL LIFE INS STUDENT INS DIVISION P O BOX 809025 DALLAS TX 75380-9025
M12 MIDWEST REGIONAL BENEFITS SUITE 3600 1 FINANCIAL PLACE CHICAGO IL 60605
HN6 MIDWEST SECURITY ADMIN 2700 MIDWEST DRIVE ONALASKA WI 54650
DT3 MIDWESTERN TEAMSTERS H AND W FUND 2160 S FOSTER AVE WHEELING IL 60090
Y62 MIKE WHITMAN INSURANCE 3632 CENTRAL AVENUE HOT SPRINGS AR 71913
W55 MILICARE PLUS 400 LOCUST ST DES MOINES LA 50398
R19 MILK AND ICE CREAM EMPLOYE WELFARE PLAN P O BOX 9800 FRESNO CA 93794
EM5 MILLER BURNS ASSOCIATES 1028 S SECOND STREET SPRINGFIELD IL 62704
C40 MILLERS GROUP P O BOX 2269 FORT WORTH TX 76113
LS* MINISTERS LIFE P O BOX 910 MINNEAPOLIS MN 55440
E2* MISSION INSURANCE COMPANY P O BOX 7745 PHOENIX AZ 85011
BZ7 MISSISSIPPI ADMIN SERVICES P O BOX DRAWER 1400 OXFORD MS 38655
IK7 MISSISSIPPI PHYSICIANS CAR P O BOX 1530 RIDGELAND MS 39158-1530
YC* MISSISSIPPI RIVER TRANSPORTATION CORP 9900 CLAYTON DRIVE ST LOUIS MO 63105
I7* MISSOURI FOREST PRODUCTS IXL MANUFACTURING CO 611 E CAPITOL JRFFERSON CITY MO 65101
EA5 MISSOURI KANSAS TEXAS RR EMPLOYESS HOSP ASSN P O BOX 340 DENISON TX 75020
V6* MISSOURI NATIONAL LIFE INS 1006 GRAND AVENUE KANSAS CITY MO 64106
CB4 MISSOURI PACIFIC EMPLOYEES 11516 MIRACLE HILLS DRIVE SUITE 102 OMAHA NE 68154
W78 MISSOURI STATE MEDICAL CAR P O BOX 104360 JEFFERSON CITY MO 65110
CM6 MISSOURI VALLEY LIFE P O BOX 419104 ST LOUIS MO 63141-9998
GB8 MITCHELL BLACKTOCK BARNES WAGONER IVERS AND SNEDDON P. O. BOX 1510 LITTLE ROCK AR 72203-1510
W45 MLGW P O BOX 430 MEMPHIS TN 38101
GX6 MMS P O BOX 22389 NASHVILLE TN 37202-2389
E27 MODERN PIONEERS LIFE P O BOX 691410 SAN ANTONIO TX 78269-1410
* - 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 81
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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L76 MOLEX INC 2222 WELLINGTON LISLE IL 60532
CO2 MONFORT INC HEALTH CARE BENEFITS P O BOX 6533 ENGLEWOOD CO 80155
GP* MONTGOMERY WARD LFE INS BENEFITS DEPT P O BOX 5008 SCHAUMBERG IL 60173-5008
J10 MONTGONERY WARD LIFE INS P.O. BOX 5008 NORTH SURBURBAN IL 60197-5008
M13 MONUMENT BUILDERS OF NORTH 1612 CENTRAL STREET EVANSTON IL 60201
DD5 MONUMENTAL GENERAL INS CO 1111 NORTH CHARLES ST BALTIMORE MD 21201-5574
QG1 MONUMENTAL GENERAL INS GRO P O BOX 97 SCRANTON PA 18504-0097
N53 MONUMENTAL LIFE INS ONE CITY CENTRE 515 N 6TH ST LOUIS MO 63101-1877
GQ8 MONUMENTAL LIFE INS PO BOX 17399 BALTIMORE MD 21203
EK9 MONUMENTAL LIFE INS CO 5001 LBJ FWY SUITE 200 DALLAS TX 75244
P34 MOORE AND SONS INC PO BOX 419458 KANSAS CITY MO 64141
IA7 MORGAN WHITE ADMINISTRATOR 5722 I 55 NORTH JACKSON MS 39211-2638
BY8 MORRIS ASSOCIATES P O BOX 50440 INDIANAPOLIS IN 46250
B55 MOSERS MEDICAL CARE PLAN PO BOX 2400 JEFFERSON CITY MO 65102
DX1 MOTEL 6 MEDICAL CLAIM SERVICE P O BOX 809092 DALLAS TX 75380-9092
WK* MOTION PICTURE HEALTH AND WELFARE FUND P O BOX 1999 STUDIO CITY CA 91614-1999
E58 MOTOR CAR DEALERS ASSN OF SOUTHERN CALIF STE 31 5757 W CENTURY BLVD LOS ANGELES CA 90045
BL9 MOTOROLA MEDICAL PLAN P O BOX 29005 PHOENIX AZ 85038-9005
V49 MOUNTAIN STATE BC BS P O BOX 7026 WHEELING WV 26003
Q98 MOUNTAIN STATES ADMINISTRA 2530 SOUTH PARKER RD SUITE 606 AURORA CO 80014
HH6 MSAG PO BOX 830650 BIRMINGHAM AL 35283-0650
S34 MSTA CLAIMS UNIT 1831 CHESTNUT STREET ST LOUIS MO 63103-2231
C16 MUELLER COMPANY PLAN ADMINISTRATOR GROUP BENEF 500 W ELDORADO DECATUR IL 62525
JB5 MULTIPLAN P O BOX 140067 KANSAS CITY MO 64114
CA7 MUNICIPAL HEALTH BENEFIT FUND PO BOX 188 NORTH LITTLE ROCK AR 72115
HD8 MURPHY HOFFMAN COMPANY 1524 N. CORRINGTON KANSAS CITY MO 64120
G99 MURPHY OIL USA INC 200 PEACH ST ELDORADO AR 71730
J26 MUTUAL ADMINISTRATORS INC 800 SOUTH 8TH STREET LAS VEGAS NV 89101
E49 MUTUAL ASSURANCE ADMNS P O BOX 42096 OKLAHOMA CITY OK 73123-3096
F11 MUTUAL BENEFIT LIFE PO BOX 726 KANSAS CITY MO 64141
F40 MUTUAL BENEFIT LIFE 2425 N CENTRAL EXPY SUITE 550 RICHARDSON TX 75080-2743
HW* MUTUAL BENEFIT LIFE INS BOX 19596 KANSAS CITY MO 64141
UY* MUTUAL BENEFIT LIFE INS S AND W IRON COMPANY 1441 A TERMINAL AVE SAN JOSE CA 95112
AG6 MUTUAL GROUP US EMPLOYEE BENEFIT 401 N. EXECUTIVE DRIVE BROOKFIELD WI 53008
I68 MUTUAL LIFE INS CO 1235 NORTH 7TH WEST MEMPHIS AR 72301
* - 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 82
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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RE* MUTUAL OF NEW YORK 246 EAST JANATA BLVD LOMBARD IL 60148
NF* MUTUAL OF OMAHA 51 MONROE STREET P O BOX 6097 ROCKVILLE MD 20850
GD6 MUTUAL OF OMAHA S6 GCQA FARNAM STREET OMAHA NE 68172
GS7 MUTUAL OF OMAHA PO BOX 3608 OMAHA NE 68103
AE3 MUTUAL OF OMAHA 100 W CLARENDON SUITE 1220 PHOENIX AZ 85013
CK5 MUTUAL OF OMAHA P.O. BOX 668329 CHARLOTTE NC 28266-8329
R99 MUTUAL OF OMAHA GROUP CLAIMS OFFICE P O BOX 1332 MINNEAPOLIS MN 55440
Z15 MUTUAL OF OMAHA P.O. BOX 9 WOODWARD OK 73802
0L* MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA DODGE AT 33RD STREET OMAHA NE 68175
GH* MUTUAL PROTECTIVE INS CO 1515 S 75TH ST P O BOX 3477 OMAHA NE 68103
L4* MUTUAL SAVINGS P O BOX 727 WINFIELD AL 35594
L5* MUTUAL SECURITY LIFE INS 3000 COLISEUM BLVD EAST FORT WAYN IN 46805
XD* MUTUAL SERVICE INSURANCE P O BOX 64035 ST PAUL MN 55164-0035
EI5 MVP HEALTH 111 LIBERTY STREET P O BOX 2207 SCHENECTADY NY 12301-2207
HS6 MVP HEALTHCARE 220 ALEXANDER STREET ROCHESTER NY 14607
M79 MYERS BAKERY P.O. BOX 687 HWY 67 HOPE AR 71801
CH7 N J CAR PO BOX 7510 TRENTON NJ 08628
E86 N L CLAIMS DEPT P O BOX 62107 HOUSTON TX 77205
NR* N R T A INSURANCE PLANS 5 PENN CENTER PLAZA PHILADELPHIA PA 19103
U68 NALC BENEFIT PLAN 20547 WAVERLY CT ASHBURN VA 20149
Y19 NALC HEALTH BENEFIT PLAN PO BOX340219 SACRAMENTO CA 95834-0219
L19 NAPA GROUP INSURANCE INS S PO BOX 790 BLOOMINGDALE IL 60108-0790
YJ* NAPUS HEALTH BENEFIT PLAN 550 TWELFTH STREET SW WASHINGTON DC 20024
Q39 NARFE INS PROGRAM 2135 WISCONSIN AVE WASHINGTON DC 20007
X31 NARFE SERVICES P O BOX 85049 LOUISVILLE KY 40285-5049
Y30 NASE MEGA LIFE AND HEALTH THE INSURANCE CTR CLAIMS P O BOX 982009 N RICHLAND HILLS TX 76182-8009
A44 NASHVILLE LIFE INSURANCE 1101 MAIN STREET TEXARKANA AR 75501
P25 NAT TELEPHONE COOP ASSOC ASHEVILLE SERV CTR GHP CL BBT BUILDING SUITE 600 ASHEVILLE NC 28801-3459
CP7 NATHAN E ENYEART 308 E ELM STREET ALPENA AR 72611
N36 NATIONAL ALUMINUM CORP ROLLING DIVISION HWY 67 NORTH NEWPORT AR 72112
M24 NATIONAL AMERICAN LIFE P O BOX 8082 FRESNO CA 93747
XU* NATIONAL ASBESTOS WORKERS WELFARE FUND SUITE 200 8401 CORPORATE DRIVE LANDOVER MD 20785
W25 NATIONAL ASSOC OF PRIVATE ENTERPRIZE P O BOX 612147 DALLAS TX 75261-2147
W99 NATIONAL BANK OF COMMERCE TRUST FOR ARMSTRONG TRUSTEE C DUKE ALLISON EL DORADO AR 71730
F5* NATIONAL BANKERS LIFE INS P O BOX 225433 DALLAS TX 75265
* - 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 83
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
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C58 NATIONAL BENEFIT ADMIN P O BOX 905 EL CAJON CA 92022
I22 NATIONAL BENEFIT ADMIN P.O. BOX 9000 CARLE PLACE NY 11514
BW1 NATIONAL BENEFIT ADMINISTR P O BOX 39118 COLORADO SPRINGS CO 80949-9118
B11 NATIONAL BENEFIT LIFE PO BOX 814 NORRISTOWN PA 19404
M6* NATIONAL BENEFIT LIFE P O BOX 11476 FORT WORTH TX 76100
P58 NATIONAL BENEFIT LIFE INS JAF BOX 2366 NEW YORK NY 10116
UC* NATIONAL BENEFIT LIFE INS CENTRAL STATE SVC OFFICE 666 DUNDEE ROAD NORTHBROOK IL 60082
A40 NATIONAL BENEFIT LIFE INSU TWO PARK AVENUE NEW YORK NY 10157-0041
I72 NATIONAL BENEFITS 9300 METCALF SUITE 230 OVERLAND PARK KS 66212
K53 NATIONAL BENEFITS P O BOX 13128 NORFOLK VA 23506-0128
HG2 NATIONAL BENEFITS P O BOX 263 PARSIPPANY NJ 07054
P65 NATIONAL BENEFITS CONSULTA P O BOX 19035 GREEN BAY WI 54307-9035
J29 NATIONAL BUSINESS ASSN TRU 332 WEST BROADWAY LOUISVILLE KY 40202
V85 NATIONAL CAPITAL ADMINISTR 525 NORTH WOODWARD SUITE 1050 BLOOMFIELD HILLS MI 48304
DI4 NATIONAL CARE INSURANCE 700 E 9TH SUITE 1D LITTLE ROCK AR 72201
G8* NATIONAL CASUALTY INSURANC GENERAL DELIVERY DETROIT MI 48200
AU7 NATIONAL CLAIMS ADMINISTRATORS P.O. BOX 221169 CHARLOTTE NC 28228-1169
M10 NATIONAL CONSUMERS ASSOCIA 3130 BROADWAY KANSAS CITY MO 64111
PR* NATIONAL COUNCIL OF SENIOR CITIZENS 925 15TH STREET WASHINGTON DC 20005
BY2 NATIONAL ELEVATOR INDUSTRY HEALTH BENEFIT PLAN 19 CAMPUS BLVD STE 200 NEWTOWN SQUARE PA 19073
J27 NATIONAL EMPLOYMENT BENEFI 3855 PRESIDENTAL PARKWAY ATLANTA GA 30340
F95 NATIONAL FAMILY CARE LIFE 13530 INWOOD ROAD DALLAS TX 75244
N46 NATIONAL FINANCIAL INS CO P O BOX 2650 WACO TX 76702-2650
ES* NATIONAL FOUNDATION LIFE 3100 BURNETT PLAZA 801 CHERRY STREET UNIT 33 FORT WORTH TX 76102
X32 NATIONAL FOUNDATION LIFE 11025 ANDERSON DRIVE LITTLE ROCK AR 72212
D43 NATIONAL GENERAL INSURANCE 3300 RIDERTRAIL S P O BOX 66822 ST LOUIS MO 63166
J53 NATIONAL GROUP INSURANCE C P O BOX 2650 WACO TX 76102
BY* NATIONAL HEALTH CARE CORP BOX 51012E 1341 WEST MOCKINGBIRD DALLAS TX 75247
U41 NATIONAL HEALTH CARE TRUST 10159 WAYZATA BLVD MINNETONKA MN 55343
C27 NATIONAL HEALTH INS CO P O BOX 619999 DFW AIRPORT TX 75261-9999
R23 NATIONAL HEALTH SYSTEMS IN 9110 E NICHOLS AVE SUITE 320 ENGLEWOOD CO 80112
DJ2 NATIONAL HEALTHCARE ALLIANCE P O BOX 27358 HOUSTON TX 77227-7358
AW2 NATIONAL HEALTHCORP LIMITED PARTNERSHIP PO BOX 1398 MURFREESBORO TN 37130
EN* NATIONAL HERITAGE INS CO 7800 SHOAL CREEK BLVD AUSTIN TX 78771
EY* NATIONAL HOME LIFE ASSURAN 211 EAST CAPITAL JEFFERSON CITY MO 65101
* - 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 84
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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GQ* NATIONAL HOME LIFE INS 20 MOORES ROAD MALVEIN PA 19355
Z6* NATIONAL INS CO P O BOX 1899 B TAMPA FL 33679
W31 NATIONAL INS SERVICES INC P O BOX 19032 GREEN BAY WI 54307-9032
G30 NATIONAL INSUARANCE POBOX 11147 MEMPHIS TN 38111
X8* NATIONAL INSURANCE SERVICE PO BOX 18998 TAMPA FL 33679
N11 NATIONAL LEAGUE OF POSTMAS 1023 N ROYAL STREET P O BOX 9428 ALEXANDRIA VA 22314-1529
IA2 NATIONAL MEDICAL HEALTH CA 320 EXECUTIVE COURT LITTLE ROCK AR 72205
Y31 NATIONAL MEDICAL PROVIDERS 1005 W ORANGEBURG AVE B MODESTO CA 95350
E87 NATIONAL MOTOR CLUB AMERIC 2711 CEDAR SPRINGS ROAD DALLAS TX 75201
DP* NATIONAL OLD LINE INS CO P.O. BOX 2900 501 WOOD LANE LITTLE ROCK AR 72203-2900
K84 NATIONAL PLUMBING STORES P O BOX 1050 COLUMBUS OH 43216
FQ4 NATIONAL PREFERRED PROVIDER NETWORK 419 MAIN STREET MIDDLETON NY 10940
AZ7 NATIONAL PRESCRIPTION SERV P O BOX 1981 EAST HANOVER NJ 07936
C74 NATIONAL REPUBLIC LIFE P O BOX 911 BELINGTON TX 00000
M99 NATIONAL RESERVE INS CO 418 NW 5TH OKLAHOMA CITY OK 73102
VB* NATIONAL RETIRED TEACHERS ASSOCIATION P O BOX 13907 PHILADELPHIA PA 19101
BZ6 NATIONAL RURAL ELECTRIC P O BOX 877 CAMDEN AR 71701
FT* NATIONAL RURAL ELECTRIC COOPERATIVE ASSOC 4301 WILSON BLVD ARLINGTON VA 22203-1860
H21 NATIONAL RURAL ELECTRIC CO AR VALLEY ELECTRIC COOP 1811 W COMMERCIAL OZARK AR 72852
CU2 NATIONAL RURAL ELECTRIC CO 800 SCOTT HAMILTON DRIVE LITTLE ROCK AR 72203
AC4 NATIONAL RX SERVICE P O BOX 650322 DALLAS TX 75265-0322
AF3 NATIONAL RX SERVICES P O BOX 68385 HARRISBURG PA 17601-9986
CE7 NATIONAL RX SERVICES 500 RESEARCH DR WILMINGTON MA 01887
BX8 NATIONAL SECURITY LIFE AND ACCIDENT INS CO 100 E SOUTHMORE PASADENA TX 77502
H78 NATIONAL SELECTED MORTICIA GROUP INS TRUST POBOX 790 BLOOMINGDALE IL 60108
EX9 NATIONAL SENIOR CITIZENS PO BOX 8126 FORT WASHINGTON PA 19034-8126
N68 NATIONAL SERVICE INDUSTRIE 1180 PEACHTREE N E ATLANTA GA 30309
J85 NATIONAL SR CITIZENS GROUP P O BOX 41532 PHILADELPHIA PA 19101-1532
V8* NATIONAL STATES INS CO 1830 CRAIG PARK COURT P O BOX 46925 ST LOUIS MO 63146-4146
EU5 NATIONAL STATES INSURANCE 545 42ND AVENUE 206 EAST MOLINE IL 61244
N62 NATIONAL STUDENT SERVICES P O BOX 783 WALNUT RIDGE AR 72476
Z91 NATIONAL STUDENT SVCS INC 208 OLD LANCASTER ROAD DEVON PA 19333
M86 NATIONAL SWAGE P O BOX 906 JACKSONVILLE AR 72076
R29 NATIONAL TELEPHONE COOPERA P O BOX 650 SUGARLAND TX 77487-0650
VA* NATIONAL TRAVEL CLUB INC TRAVEL BUILDING FLORAL PARK NY 11001
* - 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 85
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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J21 NATIONAL TRAVELERS LIFE CO 5700 WEST TOWN PKWY P O BOX 9197 WEST DES MOINES IA 50266
Z16 NATIONAL TRAVELERS LIFE IN 6 VILLAGE TERRACE WAKE VILLAGE TX 75501
ED6 NATIONAL UNIFORM AND LINEN SERVICE HEALTH BENEFITS P O BOX 190060 LITTLE ROCK AR 72219
Y63 NATIONAL UNIFORM SVCS 3235 E. MATTHEWS JONESBORO AR 72401
CB8 NATIONS BANK JIM SHENEP TRUSTEE OFFICE P O BOX 1681 LITTLE ROCK AR 72203
EI2 NATIONS BANK P O BOX 2557 BATESVILLE AR 72503
CC6 NATIONS BANK MARK WHITSON TRUST OFFICE P O BOX 1681 LITTLE ROCK AR 72203
FC9 NATIONSBANK GUARDIAN OF HEATHER WHARTON,A MINOR P O BOX 1681 LITTLE ROCK AR 72203
MC* NATIONWIDE INSURANCE P O BOX 278 MEMPHIS TN 38101-0278
BB8 NATIONWIDE INSURANCE C/O FOAM FABRICATORS P.O. BOX 1737 FOREST CITY AR 72335
ZQ* NATIONWIDE INSURANCE INDEPENDENT EMPLYMT TRUST 907 WEST TENTH TOPEKA KS 66801
Q74 NATIONWIDE INSURANCE CO INDIVIDUAL HEALTH CLAIMS P O BOX 16786 COLUMBUS OH 43216-6786
AY3 NATIONWIDE INSURANCE CO ATTN CAROLINAS SVC CTR P.O. BOX 182364 COLUMBUS OH 43218-2364
MM* NATIONWIDE INSURANCE CO TEXAS SERVICE CENTER P O BOX 182163 COLUMBUS OH 43218-2163
HZ1 NATIONWIDE SPECIALTY HEALT PO BOC 420 SPRINGFIELD MA 01101
IK0 NATIVE CARE HEALTH PO BOX 50 QUAPAW OK 74363
K32 NATL BENEFIT ADMIN CARLE PLACE P O BOX 9000 NEW YORK NY 11514
C84 NATL FEDRTION STNDT PRTN T DOUG RUEDLINGER INC P O BOX 2159 TOPEKA KS 66601
WP* NATL FEDTN OF STDNT PROTEC TRUST DWIGHT JONES AGNCY P O BOX 529 NASHVILLE AR 71852
V5* NATL RURAL ELEC COOP ASSOC SOUTHWEST ARK ELEC CORP P O BOX 1807 TEXARKANA AR 75501
Q79 NATL RURAL ELECT COOPS ASS C/O FIRST ELECTRIC P O BOX 5018 JACKSONVILLE AR 72076
K13 NATL RURAL ELECTRIC COOP P O BOX 368 BERRYVILLE AR 72616
JO3 NAVITUS RX PO BOX 999 APPLETON WI 54912-0999
N69 NCAS P O BOX 1227 FAIRFAX VA 22030
R50 NCAS NATL CLAIMS ADMIN SERVS P O BOX 220887 CHARLOTTE NC 28222
XA* NCSC INSURANCE PLAN 76 NORTH BROADWAY IRVINGTON NY 10553
ER4 NEBA 7950 N W 53RD ST SUITE 202 MIAMI FL 32166
HX3 NEIGHBORHOOD HEALTH PLAN 7600 CORPORATE CTR DRIVE MIAMI FL 33126-1216
CG1 NEISD NE INDEPENDENT SCHOOL DIS 8961 TESORO DR SAN ANTONIO TX 78217
V44 NETWORK ADMINISTRATION 11651 PLANO RD STE 110 LB8 DALLAS TX 75355
HY7 NETWORK HEALTH PO BOX 120 MENASHA WI 54952
ID5 NEW DIRECTIONS PO BOX 6729 LEAWOOD KS 66206-0729
W32 NEW ENGLAND EMP BENEFITS G STE 465 W 115 PERIMETER CTR PLACE ATLANTA GA 30346
BK6 NEW ENGLAND HEALTH PLAN P. O. BOX 9107 OAKBROOK IL 60522-9107
DM4 NEW ENGLAND HEALTH PLAN COMUS INTERNATIONAL P O BOX 4015 ISELIN NJ 08830
* - 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 86
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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DT6 NEW ENGLAND INS INV HEALTH PLAN SERVICES INC P O BOX 30466 TAMPA FL 33630-3466
LG* NEW ENGLAND MUTUAL LIFE 501 BOYLSTON ST BOSTON MA 02117
E74 NEW ENGLAND MUTUAL LIFE LAKEWOOD CENTER NORTH 14600 DETROIT AVE LAKEWOOD OH 44107
AH4 NEW ERA LIFE INSURANCE P O BOX 4884 HOUSTON TX 77210-4884
U46 NEW HAMPSHIRE HEALTH CHOIC UNIVERSAL PACKING CORP P O BOX 2000 HAMPTON NH 03842
BB9 NEW YORK AUTO DEALERS ASSOCIATION P.O. BOX 7347 ALBANY NY 12224
AW8 NEW YORK LIFE P.O. BOX 6047 CAMARILLO CA 93011
C35 NEW YORK LIFE GROUP OFFICE STE 212 6525 N MEREDIAN OKLAHOMA CITY OK 73116
DQ6 NEW YORK LIFE HEALTH PLANS 2425 WEST LOOP S STE 1000 HOUSTON TX 77027-4208
DQ3 NEW YORK LIFE HEALTH PLANS P O BOX 569 GREENBELT MD 20770
P64 NEW YORK LIFE P O BOX 519 STILLWATER OK 74076
Y69 NEW YORK LIFE P.O. BOX 1090 LOUISVILLE KY 40201
DK1 NEW YORK LIFE INS P O BOX 105095 ATLANTA GA 30348
D44 NEW YORK LIFE INS CO P O BOX 767 KANSAS CITY MO 64141
E59 NEW YORK LIFE INS CO P O BOX 1007 ST ANN MO 63074
Q61 NEW YORK LIFE INS CO PO BOX 6924 VENTURA CA 93006
H82 NEW YORK LIFE INS CO P.O. BOX 5625 CHICAGO IL 60680
U67 NEW YORK LIFE INSURANCE P O BOX 30769 JAMAICA NY 11430-0769
E34 NEW YORK LIFE INSURANCE NILE CARE 1818 H ST NW STE N105 WASHINGTON DC 20433-0001
BN* NEW YORK LIFE INSURANCE 51 MADISON AVENUE NEW YORK NY 10003
Y82 NEW YORK LIFE INSURANCE CO DODGE AT 3RD STREET OMAHA NE 68175
H47 NEWBERRY TANKS INC 205 N WALKER WEST MEMPHIS AR 72301
E84 NEWPORT NEWS SHIPBUILDING HEALTH CLAIMS DEPT 210 39TH STREET NEWPORT NEWS VA 23607
Z3* NFC MARKETING INC LIFE 1301 BALD FORGE ROAD LITTLE ROCK AR 00000
L33 NFPEDA 10877 WATSON ROAD ST LOUIS MO 63127
V48 NGS AMERICAN NORTHERN GROUP SERVICES P O BOX 7676 ST CLAIR SHORES MI 48080
I02 NHP SPECIALTY HEALTH CLAIM P.O. BOX 420 SPRINGFIELD MO 01101
C54 NIBCO MEDICAL BENEFITS P O BOX 497 AUGUSTA AR 72006
Z17 NIBCO MEDICAL PLAN P O BOX 1167 ELKHART IN 46515-1167
IK6 NIPPON LIFE BENEFITS P O BOX 25951 SHAWNEE MISSION KS 66225-5951
J45 NITA P O BOX 30905 SALT LAKE CITY UT 84130-0906
GU5 NMHC RX PO BOX 1170 PORT WASHINGTON NY 11050
FI5 NMHC RX CLAIMS DEPARTMENT PO BOX 23007 LITTLE ROCK AR 72221-3007
J38 NN INVESTOR LIFE CO INC 2121 PRICINCUT LIVE ROAD P.O. BOX 1038 HURST TX 76053
JN* NORAM ENERGY CORP ARKLA INDUSTRIES P O BOX 21734 SHREVEPORT LA 71151
* - 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 87
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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CG5 NORTH AMERICA BENEFITS NET P O BOX 94928 CLEVELAND OH 44101-4928
Z93 NORTH AMERICAN ADMIN P.O. BOX 1984 1212 8TH AVE. SOUTH NASHVILLE TN 37202-1984
Z92 NORTH AMERICAN ADMIN P.O. BOX 853921 RICHARDSON TX 75085
X33 NORTH AMERICAN HARDWOOD FL P O BOX 190 MELBOURNE AR 72556-0190
R25 NORTH AMERICAN INSURANCE C P O BOX 4160 MADISON WI 53711
F55 NORTH AMERICAN LIFE CASUAL 1750 HENNEPIN AVE MINNEAPLOIS MN 81628-9000
ND* NORTH ARKANSAS ELECTRIC SALEM AR 72576
I4* NORTH BROOK INC 1340 CHANNEL AVE MEMPHIS TN 38105
XH* NORTH CAROLINA SENIOR CITIZENS 2100 M STREET WASHINGTON DC 20037
J34 NORTH WESTERN NATIONAL LIF 2 CENTER PLAZA BOSTON MS 02108
F62 NORTHBROOK LIFE INS CO POBOX 30096 TAMPA FL 33630
D58 NORTHBROOK LIFE INS CO SOUTHWESTERN AR DEVELOPME 2006 STATE LINE TEXARKANA AR 75502
H09 NORTHEAST DELTA DENTAL PO BOX 2002 CONCORD NH 03302
L90 NORTHERN AUTOMOTIVE CORP P O BOX 24005 FRESNO CA 95779
J37 NORTHERN GROUP SERVICES P.O. BOX 7676 ST CLAIRE MI 48080
M11 NORTHERN WIRE CABLE P O BOX 200 SOUTHFIELD MI 48037
B39 NORTHWEST HLTH CARE PLAN 9275 SW PEYTON LANE WILSONVILLE OR 97070
V7* NORTHWEST INVESTORS LIFE INSURANCE CO INC P O BOX 1038 HURST TX 76053
T93 NORTHWEST MUTUAL DALLAS GROUP BENEFITS 1700 ALMA STE 500 PLANO TX 75075
AP8 NORTHWESTERN LIFE ATTN INS HILLHAVEN 1149 MARKET STREET TACOMA WA 98402
EM* NORTHWESTERN NATIONAL P.O. BOX 1195 MINNEAPOLIS MN 55440
AK9 NORTHWESTERN NATIONAL C/O NORTHWEST STEEL/WIRE I21 WALLACE STERLING IL 61081
AE4 NORTHWESTERN NATIONAL LIFE 1600 OAKBROOK DRIVE NORCROSS GA 30093
CP1 NORTHWESTERN NATIONAL LIFE 7830 E BROADWAY TUCSON AZ 85710
C96 NORTHWESTERN NATL LIFE INS CHICAGO GROUP CLAIM CENTE 25 E WASHINGTON STE 715 CHICAGO IL 60602
J98 NORTHWESTERN NATL LIFE INS RAZORBACK STEEL CORP 1450 STARKS BUILDING LOUISVILLE KY 40202-2513
W80 NORTON ALCOA 5300 GERBER ROAD FT SMITH AR 72904
CE3 NORWEST FINANCIAL ATTN PERSONNEL 206 EIGHTH STREET DES MOINES IA 50309
HT4 NOVA MEDICALCARE NETWORK PO BOX 9010 BUFFALO NY 14231
GH6 NOVASYS PO BOX 25310 LITTLE ROCK AR 72221
HR2 NOVASYS HEALTH P O BOX 25224 LITTLE ROCK AR 72221
HI3 NOVASYS HEALTH P O BOX 25330 LITTLE ROCK AR 72221
FB4 NOVASYS HEALTH SYSTEM REPRICING DEPT P O BOX 25228 LITTLE ROCK AR 72221
HA6 NPPN 419 E MAIN STREET MIDDLETOWN NY 10940-2550
GY1 NPS P O BOX 407 BOYSTOWN NE 68010
* - 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 88
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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L47 NRA INSURANCE PLAN 400 LOCUST STREET DES MOINES IA 50398
AE5 NRECA P.O. BOX 194208 LITTLE ROCK AR 72219
S48 NRECA CLAY CO ELECTRIC COOP BOX 459 CORNING AR 72422
RT* NRLCA ASSOCS HOSPITAL PLAN 1750 PENNSYLVANIA AVENUE SUITE 1302 WASHINGTON DC 20006
D31 NSM NATIONAL SELECTED MORTICIANS INS CO P O BOX 74205 CHICAGO IL 60690-8205
X20 NUCOR P O BOX 1228 BLYTHEVILLE AR 72316
B25 NURSES SERVICE ORGANIZATIO PO BOX 1014 SOUTHEASTERN PA 19398-1014
Z2* NW NATIONAL LIFE INSURANCE GENERAL DELIVERY COLUMBUS OH 00000
G06 NWA CHILDCARE INC 1104 B NORTH COLLEGE HUNTSVILLE AR 72740
GO6 NWA CHILDCARE INC 1104 B NORTH COLLEGE HUNTSVILLE AR 72740
AJ3 NWNL GROUP GLENDALE GROUP CLAIM CTR 730 FAIRMONT AVE STE 202 GLENDALE CA 91203
U58 NWNL PREMIER BENEFITS NETWORK 1427 WASHINGTON AVE NEW ORLEANS LA 70130
BB* NWNL REGIONAL GROUP OFFICE 640 PLAZA WEST BLDG LITTLE ROCK AR 72205
CM3 NYHART CO INC P O BOX 1090 EVANSVILLE IN 47706-1090
DN8 NYL CARE HEALTH PLANS PREFERRED COMMUNITY CHOIC P O BOX 3270 TULSA OK 74159
B15 NYLCARE 4500 FULLER DR IRVING TX 75038-6597
AB* NYLCARE NEW YORK LIFE P O BOX 660239 DALLAS TX 75266
II1 NYS DEPT OF CIVIL SERVICE 800 NORTH PEARL STREET ALBANY NY 12239
BP2 NYSAW HEALTH WELFARE TRUST CIEBA LIMITED 5029 3206 VESTAL PRKWYEAST VESTAL NY 13850
P61 O P LINK HANDLE CO INC SO MAIN STREET P O BOX 350 SALEM IN 47167
C98 OAKLAND GROUP P O BOX 30128 OAKLAND CA 94604
FF7 OBA MIDWEST LTD 8160 SOUTH CASS AVENUE DARIEN IL 60561-5013
VT* OCCIDENTAL LIFE P O BOX 22111 HOUSTON TX 77027
LF* OCCIDENTAL LIFE 2813 STATE LINE TEXARKANA TX 75503
BC1 OCCIDENTAL LIFE P.O. BOX 10234 RALEIGH NC 27605
DE* OCCIDENTAL LIFE INSURANCE COMPANY OF CALIFORNIA GREENSBORO NC 27405
NS* OCCIDENTAL LIFE INSURANCE 4054 MCKINNEY SUITE 208 DALLAS TX 75204
HA* OCCIDENTAL LIFE OF CA 523 LOUISANA BANK BLDG 522 MARKET STREET SHREVEPORT LA 71101
X34 ODOMS TENNESSEE PRIDE SAUS 4701 ASHER AVENUE LITTLE ROCK AR 72204
L89 ODS HEALTH PLAN P O BOX 40384 PORTLAND OR 97240
S4* OHIO HERTIAGE P O BOX 364 DAYTON OH 45401
Y83 OHIO MED STATE EMPLOYEE HEALTH CAR P.O. BOX 94776 CLEVELAND OH 44101-4776
E35 OHIO STATE LIFE INSURANCE P O BOX 910 COLUMBUS OH 43216
0Q* OHS DENTAL CLAIMS P O BOX 830842 BIRMINGHAM AL 35283
ID0 OK AND AR CARPENTER HLTH W P O BOX 860007 PLANO TX 75086
* - 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 89
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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L97 OK INDUSTRIES P O BOX 1119 FORT SMITH AR 72902
V60 OKLAHOMA STATE EDUCATION E GROUP INS BOARD BOX 24870 OKLAHOMA CITY OK 73124
P16 OKLAHOMER SMITH P O BOX 1148 FORT SMITH AR 72902
QX* OLAN MILLS INC 4325 AMNICOLA HIGHWAY P O BOX 391 CHATTANOOGA TN 37401
KG* OLD AMERICAN INSURANCE CO 4900 OAK STREET P O BOX 41873 KANSAS CITY MO 64141
AI* OLD EQUITY LIFE EVANSTON IL 60201
A55 OLD LINE LIFE INS CO 3535 N W 58TH STREET OKLAHOMA CITY OK 73100
ZD* OLD RELIANCE INS CO P O BOX 13150 PHOENIX AZ 85002
IF* OLD SOUTHWEST INS CO P O BOX 823 JACKSONVILLE AR 72076
H94 OLD SURETY LIFE INS CO P O BOX 54407 OKLAHOMA CITY OK 73154
N19 OLIN CORPORATION P O BOX 4500 NORWALK CT 06856-4500
AB6 OMAHA CONSTRUCTION IND HEALTH AND WELFARE PLAN 121 65TH W. CTR, STE 80 OMAHA NE 68144
BK4 OMEGA BENEFITS SVC INC P. O. BOX 830979 RICHARDSON TX 75083-0979
DU8 OMEGA CLAIM SERVICE P O BOX 1100 MARRERO LA 70073
M49 OMNI TRUST P O BOX 2207 BRENTWOOD TN 37024
FL4 ONE HEALTH PLAN PO BOX 11111 FORT SCOTT KS 66701
R26 ONEOK GROUP LIFE AND HEALT 201 E JENSEN RD EL RENO OK 73036
BI* OPERATING ENGI TRUST FUND 4115 CHESAPEAKE ST NW WASHINGTON DC 20016
JX* OPERATING ENGINEERS LOCAL 1139 17261 W APPLETON AVE MILWAUKEE WI 53216
T36 OPERATING ENGINEERS HEALTH P O BOX 7067 PASADENA CA 91101
GW2 OPERATING ENGINEERS HEALTH LOCAL 139 PO BOX 160 PEWAUKEE WI 53072-0160
E88 OPTIC ELECTRONIC CORP 3414 HERRMAN DRIVE GARLAND TX 75041
0K* OPTIMA HEALTH PLAN 4417 CORPORATION LANE VIRGINIA BEACH VA 23462-3114
HI0 OPTIMED HEALTH PLANS 4 TERRY DR, SUITE 1 NEWTOWN PA 18940
GZ2 OPTIMED HEALTH PLANS 902 CLINT MOORE RD SUITE 100 BOCA RATON FL 33487
IC2 OPTUMHEALTH VISION PO BOX 30978 SALT LAKE CITY UT 84130
M29 ORBIT VALVE CO ATTN INS CLAIMS P O BOX 193520 LITTLE ROCK AR 72219
FQ2 OREGON LABORERS EMPLOYERS PO BOX 6711 PORTLAND OR 97228-6711
L77 OREGON PACIFIC STATES P O BOX 190 PORTLAND OR 97207
K80 OREGON SUPPLEMENTAL INS DI P O BOX 2260 LITTLE ROCK AR 72203
Q76 ORGAN TRANSPLANT FUND 1023 CAPITOL AVE LITTLE ROCK AR 72201
K88 ORKIN P O BOX 647 ATLANTA GA 30301
DA6 OSCHNER SISTER OF CHARITY HEALTH PLAN ONE GALLERIA BVDSTE 1224 METAIRIE LA 70001
GI8 OSF HEALTH PLANS 7915 NORTH HALE AVENUE PO BOX 5128 PEORIA IL 61601-5128
C14 OSMOSE EMPLOYEE HEALTHCARE REIMBURSEMENT DIVISION M P O BOX 2120 NIAGARA FALLS NY 14302
* - 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 90
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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IF4 OUTSOURCE ONE INC 730 SECOND AVENUE SOUTH SUITE 530 MINNEAPOLIS MN 55402
G52 OWATONNA FOOD CO EMPLOYEE BENEFIT PLAN 2001 SO BENTON ST SEARCY AR 72143
S38 OXFORD LIFE INSURANCE 2721 N CENTRAL AVE PHOENIX AZ 85004
IL7 OXFORD LIFE INSURANCE P O BOX 46618 MADISON WI 53744-6518
DJ5 OZARK ELECTRIC COOP 3641 WEDINGTON DR FAYETTEVILLE AR 72701
HW2 OZARK MEDICAL CENTER 18 PARKWAY CENTER PO BOX 1100 WEST PLAINS MO 65775
CY* OZARK NATIONAL LIFE INS CO 10201 WEST MARKHAM SUITE 300 LITTLE ROCK AR 72205
F91 P C S INC P O BOX 52115 PHOENIX AZ 85072
P70 P F L LIFE INSURANCE PO BOX 93014 HURST TX 76053
V71 P M GROUP BENEFIT P O BOX 95009 AUBURN WA 98071
P75 PACC HEALTH PLANS 12901 SE 97 AVE CLACKIMAS OR 97105
L15 PACE P O BOX 286 CLACHAMOS OR 97015
CS6 PACIFIC FOUNDATION 3033 CLEVELAND AVE SANTA ROSA CA 94928
YU* PACIFIC GUARDIAN LIFE INSURANCE COMPANY P O BOX 2083 PHOENIX AZ 85036
M55 PACIFIC HERITAGE INC P O BOX 1020 PORTLAND OR 97207
GF7 PACIFIC LIFE 2300 MAIN STREET IRVINE CA 92614
ZL* PACIFIC MUTUAL 700 NEWPORT CENTER P O BOX 9000 NEWPORT BEACH CA 92680
M32 PACIFIC MUTUAL 8144 WALNUT HILL LANE SUITE 248 DALLAS TX 75231
JA* PACIFIC MUTUAL CRAIN INDS 5401 SOUTH ZERO FORT SMITH AR 72906
Q27 PACIFIC MUTUAL 1717 DIXIE HWY SUITE 700 FT WRIGHT KY 41011
R22 PACIFIC MUTUAL 33400 8TH AVE SO FEDERAL WAY WA 98003
CP8 PACIFIC MUTUAL P M GROUP NO 13085 P O BOX 33699 PHOENIX AZ 85067-3699
BC* PACIFIC MUTUAL P M GROUP P O BOX 34799 PHOENIX AZ 85067-4799
E6* PACIFIC MUTUAL GROUP BENEF CARILLION TWR W SUITE 801 13601 PRESTON ROAD DALLAS TX 75240
Q58 PACIFIC MUTUAL LIFE INS CO PO BOX 105090 ATLANTA GA 30348
OG* PACIFIC MUTUAL LIFE INS CO ONE MERCANTILE CENTER SUITE 3100 ST LOUIS MO 63101
TV* PACIFIC SOURCE HEALTH PLAN P O BOX 7068 EUGENE OR 97401
GJ5 PACIFICARE PO BOX 6699 ENGLEWOOD CO 80155-6770
GC5 PACIFICARE PO BOX 6099 CYPRESS CA 90630
GT5 PACIFICARE PO BOX 29127 SAN ANTONIO TX 78229
HX7 PACIFICARE PO BOX 30975 SALT LAKE CITY UT 84130-0975
ID4 PACIFICARE DENTAL 3110 LAKE CENTER DRIVE SANTA ANA CA 92704-6921
EL* PACIFICARE OF AZ HMO CLAIMS P O BOX 52078 PHOENIX AZ 85072-2078
BM1 PACIFICARE OF CALIFORNIA P O BOX 6006 MAIL STOP 6301 CYPRESS CA 90630-6006
H35 PACIFICARE OF TEXAS P O BOX 400055 SAN ANTONIO TX 78229
* - 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 91
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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HK4 PAI MCDONALDS INSURANCE PO BOX 6702 COLUMBIA SC 29260
IJ1 PAI PO BOX 6702 COLUMBIA SC 29260
A86 PAID PRESCRIPTIONS 190 POLLITT DRIVE P O BOX 6121 FAIRLAWN NJ 07410
IE6 PAN AM LIFE INSURANCE PO BOX 619008 DALLAS TX 75261
W91 PAN AMERICAN 245 WAGNER PLACE STE 300 MEMPHIS TN 38100
Y84 PAN AMERICAN GP CLAIMS 8550 UNITED PLAZA BLVD SUITE 801 BATON ROUGE LA 70809
Y33 PAN AMERICAN GROUP CLAIMS PO BOX 4548 JACKSON MS 39296
GU4 PAN AMERICAN INSURANCE PO BOX 61070 NEW ORLEANS LA 70160-1070
HM9 PAN AMERICAN LIFE P.O. 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. BOX 865 BRIDGE CITY TX 77611
W26 PAN AMERICAN LIFE INS CO HERCULES BUMPER INC P O BOX 469 PELHAM GA 21779
QW* PAN AMERICAN LIFE INSURANC PAN AMERICAN LIFE CENTER P O BOX 60219 NEW ORLEANS LA 70130
CQ6 PAN PACIFIC BENEFIT ADM P O BOX 851 SALINAS CA 93902-0851
EQ8 PAN PACIFIC BENEFIT ADM 1915 ASTON SUITE 102 CARLSBAD CA 92008
U57 PANHANDLE EASTERN CORP GROUP MEDICAL P O BOX 1642 HOUSTON TX 77251-1642
CY3 PARADIGON CARE PLAN P O BOX 1268 TIFTON GA 31793-1268
GP1 PARAMOUNT HEALTH PLANS 1901 INDIAN WOOD CIRCLE MAUMEE OH 43537
A76 PARAMOUNT INSURANCE CO PO BOX 33999 SHREVEPORT LA 71130
FX* PARAMOUNT LIFE INSURANCE 11025 ANDERSON DR LITTLE ROCK AR 72212
BH5 PARTNERS HEALTH PLAN 5210 E WILLIAMS CIRCLE SUITE 300 TUCSON AZ 85711-7416
BS7 PARTNERS HEALTH PLAN ONE MICHIGAN SQ 100 E WAYNE ST STE 502 SOUTH BEND IN 46601
HS8 PARTNERS RX MANAGEMENT PO BOX 12119 SCOTTSDALE AZ 85260
Q16 PAT HANEY AND SONS PO BOX 670602 DALLS TX 75367
IF5 PATIENTS CHOICE RX PO BOX 6286 SAN ANTONIO TX 78209
AS7 PAUL M DAVIDSON TRANSPORT COMPANNY P.O. BOX 310 RUSTON LA 71273
GS* PAUL REVERE INS CO 18 CHESTNUT STREET WORCESTER MA 01608
AZ6 PAYLESS CASHWAYS INC CLAIMS CENTER P.O. BOX 419973 KANSAS CITY MO 64141
G6* PAYLESS DRUG NORTHWEST INC 2920 WHITEMORE AVE CERES CA 95307
W90 PCA HEALTH PLANS OF TEXAS P O BOX 9420 AUSTIN TX 78766
L96 PCS CAREMARK ADVANCED PCS P O BOX 52115 PHOENIX AZ 85072-2115
Y85 PEERLESS CORPORATION P.O. BOX 760 PARAGOULD AR 72451
DU9 PEKIN INSURANCE CO 2505 COURT STREET PEKIN IL 61558
* - 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 92
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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FB2 PEMISCOT HEALTH SYSTEM PO BOX 489 HOYTI MO 63851
S55 PENN GEN SERV CORP SW P O BOX 2977 AUSTIN TX 78768
H68 PENN GENERAL SER OF GEORGI P.O. BOX 720677 ATLANTA GA 30358
JO* PENN MUTUAL BRANDON COMPANY LITTLE ROCK AR 72203
UV* PENN MUTUAL INSURANCE CO INDEPENDENCE SQUARE PHILADELPHIA PA 19172
Z41 PENN WESTERN BENEFITS INC P.O. BOX 7834 GREENSBORO NC 27417
HG1 PENNSYLVANIA EMPLOYEES BEN 150 SOUTH 43RD STREET SUITE 1 HARRISBURG PA 17111
GG* PENNSYLVANIA LIFE 3130 WILSHIRE BLVD P O BOX 1710 SANTA MONICA CA 90406
G37 PENNSYLVANIA LIFE INS CO PO BOX 820969 HOUSTON TX 77282
CH5 PENNSYLVANIA LIFE INS CO 1001 WADE AVENUE P O BOX 10234 RALIEGH NC 27605
R58 PENSION AND GROUP SERVICES 157 SO KALAMAZOO MALL STE 270 KALAMAZOO MI 49007-4812
BF4 PENSION FUND LOCAL 705 1645 W JACKSON CHICAGO IL 60612
A32 PENSION HOSP BENEFIT PLAN OF ELECTRICAL INDUSTRIES 158 11 JEWEL AVE FLUSHING NY 11365
P60 PENSIONED OPERATING ENGINE HEALTH AND WELFARE TRUST 642 HARRISON STREET SAN FRANCISCO CA 94107
XV* PENSIONS AND GROUP CONSULTANT SIX EAST FOURTH STREET CINCINNATI OH 45202
S69 PENTECO 1825 JEFFERSON PLACE NW WASHINGTON DC 00000
GK5 PEOPLES BENEFIT LIFE INS C ATTN CLAIMS VALLEY FORGE PA 19493
JO5 PEOPLES HEALTH NETWORK 3838 N CAUSEWAY BLVD SUITE 2200 METAIRIE LA 70002
ER7 PERCS 2950 SO INDUSTRIAL RD LAS VEGAS NV 89109
GZ3 PERFORMAX P O BOX 1065 AMHERST NY 14226-7065
E64 PERSONAL SERVICE INS CO 100 EAST GAY ST COLUMBUS OH 43216
EQ1 PERSONALCARE INSURANCE 510 DEVONSHIRE SUITE G CHAMPAIGN IL 61820
AH6 PERY EXPRESS SCRIPTS P.O. BOX 27667 ST LOUIS MO 63146
I29 PETERSON FARMS P.O. BOX 248 DECATUR AR 72722
OI* PETIT JEAN ELECTRIC ATTN CLAIMS P O BOX 37 CLINTON AR 72031
BC2 PETIT JEAN POULTRY BENEFITS SECTION P.O. BOX 70 DANVILLE AR 72833
B78 PETTIT INSURANCE CO 431 WEST 2ND CORNING AR 72462
V62 PFL LIFE INS CO P O BOX 469 BILOXI MS 39533-0469
X60 PFS INSURANCE GROUP CONTINENTAL LIFE P O BOX 1300 ROCKFORD IL 61105
HJ3 PHARMA LINK PO BOX 412735 KANSAS CITY MO 64141
GZ1 PHARMACARE P O BOX 2860 PITTSBURGH PA 15230-2860
GE7 PHARMACARE 695 GEORGE WASHINGTON HWY LINCOLN RI 02865
HP4 PHARMACEUTICAL TECHNOLOGIE 13660 CALIFORNIA STREET OMAHA NE 68154
AY9 PHARMACY ASSOCIATES P O BOX 23007 LITTLE ROCK AR 72221
IA0 PHARMACY DATA MANAGEMENT PO BOX 5300 POLAND OH 44514
* - 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 93
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EL9 PHARMACY NETWORK NATL CORP 4000 OLD WAKE FOREST RD SUITE 101 RALEIGH NC 27609
FY2 PHARMACY SERVICE PO BOX 3598 SCRANTON PA 18505-0598
II6 PHARMASTAR P O BOX 3217 EAU CLAIRE WI 54702
FY3 PHARMATHERA HEALTH P O BOX 510 PUEBLE CO 81002-0510
HA2 PHCN 1510 MEADOW WOOD LANE RENO NV 89502
BY1 PHCS KVI PO BOX 1086 ST LOUIS MO 63188
U12 PHIDELPHIA AMERICAN LIFE PO BOX 2465 HOUSTON TX 77252-2465
A90 PHILADELPHIA AMER LIFE INS 3701 DURAN AVE RACINE WI 53405-4473
EF4 PHILADELPHIA AMERICA LIFE INSURANCE COMPANY PO BOX 4884 HOUSTON TX 77210
C86 PHILLIPS COMPANY REARICK AND LENIHAN P O BOX 400073 DALLAS TX 75240
MF* PHOENIX GROUP SERVICES 67 HUNT STREET P O BOX 3005 AGAWAM MA 01001
DB9 PHOENIX HOME LIFE MUTUAL INS COMPANY 100 BRIGHT MEADOWS BLVD ENFIELD CT 06083
E36 PHOENIX MUTUAL LIFE INSURA GROUP MEDICAL CLAIMS P O BOX 810 GREENFIELD MA 01302-0810
BX9 PHP HEALTHCARE CORPORATION WASHINGTON D C CLAIM CTR 5900 PRINCESS GARDEN PKWY LANTHAM NY 20706
HW5 PHP MID MICHIGAN 1400 EAST MICHIGAN AVENUE LANSING MI 48912-2107
GZ5 PHYSICIAN DIRECT P O BOX 23745 OKLAHOMA CITY OK 73123
HU0 PHYSICIANS CARE PO BOX 15165 SANTA ANA CA 92735
H91 PHYSICIANS HEALTH PLAN PLU 77 WESTPONT SUITE 500 P O BOX 66867 ST LOUIS MO 63166-6867
HY3 PHYSICIANS HEALTH SERVICES PO BOX 14700 LEXINGTON KY 40572
AC* PHYSICIANS MUTUAL 2600 DODGE P O BOX 2018 OMAHA NE 68172
FO1 PHYSICIANS MUTUAL PO BOX 3313 OMAHA NE 68103-2018
J24 PICKETT INDUSTRIES INC P.O. BOX 70100 SHREVEPORT LA 71137-0100
FT4 PIEDMONT ADMINISTRATORS PO BOX 78030 GREENSBORO NC 27427-8030
D33 PIEDMONT AMERICAN LIFE INSURANCE COMPANY BOX 11107 WINSTON SALEM NC 27116
S12 PILGRIM HEALTH APPLICATION P O BOX 25926 WINSTON SALEM NC 27114-5926
ZI* PILGRIM INDUSTRIES P O BOX 1268 MT PLEASANT TX 75455
AT7 PILGRIMS PRIDE P O BOX 3239 HUNTINGTON BEACH CA 92647
DK9 PILLSBURY COMPANY PO BOX 11925 CORAOPOLIS PA 15108-6928
G9* PILLSBURY COMPANY CLAIMS DEPT P O BOX 40 MINNEAPOLIS MN 55440
AE6 PIONEER CONTRACT SVCS INC C/O PACIFIC MUTUAL P.O. BOX 58652 HOUSTON TX 77258
AM3 PIONEER FINANCIAL SERVICE PO BOX 3204 MILWAUKEE WI 53201-3204
Q96 PIONEER LIFE INS CO P O BOX 1250 ROCKFORD IL 61105-1250
HB7 PIONEER MANAGEMENT P.O. BOX 9040 WEST SPRINGFIELD MA 01090
X36 PIPELINE EMPLOYEES HEALTH AND WELFARE FUND 4115 CHESAPEAKE STREET NW WASHINGTON DC 20016
MW* PIPELINE INDUSTRY BENEFIT FUND P O BOX 470950 TULSA OK 74147-0950
* - 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 94
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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DK6 PITTMAN AND ASSOCIATES PO BOX 22118 LITTLE ROCK AR 72221-2118
H71 PITTMAN AND ASSOCIATES INC P O BOX 111047 MEMPHIS TN 38111
AN8 PLAN ADMINISTRATORS INC 1250 EAST DIELHL ROAD SUITE 403 NAPERVILLE IL 60563
BV3 PLAN HANDLERS 11545 W BERNARDO SUITE 101 SAN DIEGO CA 92127
BC3 PLAN SERVICES INC 7655 MARKET ST SUITE 3800 YOUNGSTOWN OH 44512-6098
X69 PLAN SERVICES INC P O BOX 470 SHAWNEE MISSON KS 66201-0470
CJ7 PLANDATA P O BOX 719 UNION NJ 07083-0719
Z94 PLANNED ADMINSTRATORS INC P.O. BOX 6927 COLUMBIA SC 29260
W13 PLANTERS LIFESAVERS INC 4020 PLANTERS RD FT SMITH AR 72901
K4* PLESSY PERIPHERAL SYSTEMS INC P O BOX 19616 IRVING CA 92714
G7* PLUMBERS AND PIPEFITTERS LOCAL 155 4501 HOFFMAN RD LITTLE ROCK AR 72209
GO3 PLUMBERS AND PIPEFITTERS LOCAL 430 2908 N HARVARD AVE TULSA OK 74115
E56 PLUMBERS AND PIPEFITTERS LOCALS 454 AND 665 1900 HIGHWAY 70 HOT SPRINGS AR 71901
DR2 PLUMBLEY INDUSTRIES 100 PLUMBLEY DR P O BOX 758 PARIS TN 38242
J06 PMA COASTWISE P O BOX429101 SAN FRANSICO CA 94142
GC* PMAG CLAIMS ADMINSTRATORS P O BOX 5769 LAFAYETTE IN 47903
C17 POLAR STAINLESS HEALTH ONE PLAZA WEST SUITE 1100 MILWAUKEE WI 53223
K82 POLISH NATIONAL ALLIANCE GLOWNE BIURO 1002 PITTSTON AVE CHICAGO IL 60639
IF1 POMCO GROUP PO BOX 6329 SYRACUSE NY 13217
AJ4 POOLE COMPANY P.O. BOX 4271 HOUSTON TX 77210-4271
AN9 POSITIVE CARE ADMINISTRATO TRANSPORT DIST CO PO BOX 7930 SHAWNEE MISSION KS 66207
JY* POSTMASTERS BENEFIT PLAN 1019 NO ROYAL ST ALEXANDRIA VA 22314
L72 PPO HEALTH INS BAPTIST HEALTH SER GROUP 920 MADISON MEMPHIS TN 38101
GG9 PPO PLUS LLC PO BOX 90802 LUBBOCK TX 79408
K26 PRADCO P O BOX 1587 FORTSMITH AR 72902
Z4* PRAIRIE STATE LIFE INC CO P O OBX 2730 RAPID CITY SD 57709-2730
FE8 PRE DENT DENTAL CLAIMS P O BOX 2935 CHICAGO IL 60690
DY* PRECISION METALS 801 ROBERTS TEXARKANA TX 75501
GP6 PREFERRED BENEFIT ADMINIST P O BOX 916188 LONGWOOD FL 32791-6188
EN4 PREFERRED CARE THIRD PARTY ADMINISTRATOR 6 NESHAMINY INTRPLX 205 TREVOSE PA 19053
IG7 PREFERRED CARE PARTNERS P O BOX 565790 MIAMI FL 33256
YY* PREFERRED COMMUNITY CHOICE PO BOX 3270 TULSA OK 74101-3270
Y64 PREFERRED HEALTH P.O. BOX 4548 JACKSON MS 39296
GF2 PREFERRED HEALTH 8535 E 21ST STREET NORTH WICHITA KS 67206
YH* PREFERRED HEALTH NETWORK 301 E OCEAN BLVD STE 900 LONG BEACH CA 90802-4839
* - 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 95
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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G79 PREFERRED HEALTH PROFESSIO P O BOX 25938 SHAWNEE MISSION KS 66225-5938
IG4 PREFERRED HEALTH SYSTEMS P O BOX 47210 WICHITA KS 67201
EV9 PREFERRED PARTNERS 5943 STADIUM DRIVE KALAMZOO MI 49009-2005
AX2 PREFERRED PLUS OF KANSAS PREFERRED HEALTHCARE P O BOX 307C WHICHITA KS 67201
BZ2 PREFERRED WORKS INC P O BOX 945005 MAITLAND FL 32794
HS4 PREMERA BLUE CROSS BLUE SH 7001 220TH ST SW MOUNTAIN LAKE TERR WA 98043-2124
GQ2 PREMIER CARE PO BOX 1627 ROGERS AR 72757
IC9 PREMIER CARE P O BOX 11809 FORT WAYNE IN 46860-1809
CN1 PREMIER CARE PO BOX 1340 SPRINGDALE AR 72765
CV2 PREMIER CARE P O BOX 17006 FORT SMITH AR 72917
AE8 PREMIER CARE P O BOX 749 SPRINGDALE AR 72765-0749
XW* PREMIER HEALTH PLANS PO BOX 4528 SPRINGFIELD MO 65808-4528
GP5 PRESBYTERIAN HEALTHCARE SE PO BOX 26666 ALBUQUERQUE NM 87125
R30 PRESCOLITE P O BOX 151 EL DORADO AR 71731-0151
JO9 PRESCRIBA RX PO BOX 39668 SOLON OH 44139
CE5 PRESCRIPTION BY MAIL P.O. BOX 46775 CINCINNATI OH 45246
IC5 PRESCRIPTION SOLUTIONS PO BOX 9040 CARLSBAD CA 92108-9040
GI9 PRESCRIPTION SOLUTIONS MS LC07 190 PO BOX 6037 CYPRESS CA 90630-0037
EV* PRESIDENTIAL LIFE INSURANC P O BOX 12026 DALLAS TX 75225
LV* PREVENTIVE HEALTH PROGRAMS P O BOX 549 BARLING AR 72923
Z7* PREWAY INCORPORATED ROUTE 1 BOX 1 A PARAGOULD AR 72450
P6* PREWITT AND ASSOCIATES 5800 EVERGREEN SUITE 101 LITTLE ROCK AR 72205
QM* PRIER BRASS MFG CO EMPLOYEE HEALTH CARE PLAN GENERAL DELIVERY OVERLAND PARK KS 66212
N41 PRIMARY CARE NETWORK BAXTER HEALTHCARE P O BOX 28986 MILWAUKEE WI 53226
GP9 PRIMARY PHYSICIAN CARE INC PO BOX 11088 CHARLOTTE NC 28220-1088
R20 PRIME HEALTH 6801 E 117TH ST KANSAS CITY MO 64134
GL1 PRIME THERAPEUTICS PO BOX 64812 ST PAUL MN 55164
IO3 PRIME THERAPEUTICS P O BOX 14527 LEXINGTON KY 40512-4527
IH0 PRIME THERAPEUTICS PO BOX 14624 LEXINGTON KY 40512-4624
BX6 PRINCIPAL FINANCE GROUP REGIONAL GLAIMS CENTER 10210 NORTH 25TH AVE PHOENIX AZ 85021
CG* PRINCIPAL FINANCIAL 2505 W SHAW AVENUE SUITE 101 FRESNO CA 93711
CM1 PRINCIPAL FINANCIAL 851 SW 6TH SUITE 1200 PORTLAND OR 97204
DD7 PRINCIPAL FINANCIAL GROUP TAMPA REGIONAL CLAIMS CTR P O DRAWER 31298 TAMPA FL 33631-3298
E76 PRINCIPAL FINANCIAL GROUP 2525 CUMBERLAND PARKWAY ATLANTA GA 30339
ED1 PRINCIPAL FINANCIAL GROUP 7330 SAN PEDRO STE 700 P O BOX 795014 SAN ANTONIO TX 78279-5014
* - 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 96
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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J89 PRINCIPAL FINANCIAL GROUP 3817 NW ERP WLN SUITE 840 OKLAHOMA CITY OK 73112
P44 PRINCIPAL FINANCIAL GROUP 9428 BAYMEADOW RD ST 360 P O BOX 44206 JACKSONVILLE FL 32256-0143
IA* PRINCIPAL FINANCIAL GROUP NONE PPO ONLY P O BOX 39710 COLORADO SPRINGS CO 80949-3910
BM7 PRINCIPAL FINANCIAL GROUP 4021 S 700 E STE 500 P O BOX 57700 SALT LAKE CITY UT 84107
BC4 PRINCIPAL FINANCIAL GROUP 3025 W COLLEGE GRAND ISLAND NE 68803-1706
AH3 PRINCIPAL FINANCIAL GROUP 4050 RIVER RIDGE DR. NE CEDAR RAPIDS IA 52402-7587
AG7 PRINCIPAL FINANCIAL GROUP 3510 LINCOLN WAY AMES IA 50010-7598
S32 PRINCIPAL FINANCIAL GROUP 2185 LEMOINES FT LEE NJ 07024
T87 PRINCIPAL FINANCIAL GROUP 620 S GLENSTONE SUITE 300 SPRINGFIELD MO 65802
T62 PRINCIPAL FINANCIAL GROUP 6160 SUMMIT DR SUITE 440 BROOKLYN CENTER MN 55430
Z95 PRINCIPAL FINANCIAL GROUP 1755 TELSTAR DRIVE SUITE 500 COLORADO SPRINGS CO 80920
Y34 PRINCIPAL FINANCIAL GROUP 5100 POPLAR SUITE 2400 MEMPHIS TN 38137
Y86 PRINCIPAL FINANCIAL GROUP 330 N 117TH STREET OMAHA NE 68154
X46 PRINCIPAL FINANCIAL GROUP 1800 PACIFIC HWY SOUTH TOWER 1, SUITE 700 SEATTLE WA 98188
BT4 PRINCIPAL HEALTH CARE P O BOX 410976 KANSAS CITY MO 64141
EO1 PRINCIPAL HEALTH CARE P O BOX 419055 ST LOUIS MO 63141
CU8 PRINCIPAL HEALTH CARE OF IOWA P O BOX 71637 DES MOINES IA 50325
CA2 PRINCIPAL HEALTH CARE INC 3421 N CAUSEWAY STE 600 P O BOX 8175 METAIRIE LA 70011-8175
GB1 PRINCIPAL LIFE PO BOX 10826 CLEARWATER FL 33757-8826
FM2 PRINCIPAL LIFE PO BOX 781320 INDIANAPOLIS IN 46268
UM* PRINCIPAL LIFE COAM LIFECA PPO ONLY P O BOX 30749 NEW ORLEANS LA 70190-0749
RX* PRINCIPAL LIFE INSURANCE PO BOX 2591 SPRINGFIELD MO 65801
HF3 PRINCIPAL LIFE INSURANCE 711 HIGH STREET DES MOINES IA 50392-0001
QT* PRINCIPAL LIFE INSURANCE C PO BOX 2596 SPRINGFIELD MO 65801
W60 PRINTING INDUSTRIES ASSN OF TEXAS BENEFIT TRUST 910 W MOCKINGBIRD LANE DALLAS TX 75247
IB3 PRIORITY HEALTH 1231 EAST BELTLINE NE PO BOX 232 GRAND RAPIDS MI 49501
CJ8 PRIORTY CARE HEALTH VALUE CORE P.O. BOX 25790 FRESNO CA 93729-5790
GA8 PRIVATE HEALTHCARE 310 S ST MARY STE 400 SAN ANTONIO TX 78205
GN1 PRIVATE HEALTHCARE SYSTEMS P O BOX 69510 HARRISBURG PA 17106
GQ3 PRIVATE HEALTHCARE SYSTEMS PO BOX 14230 SPRINGFIELD MO 65814
GQ5 PRIVATE HEALTHCARE SYSTEMS PO BOX 39710 COLORADO SPRINGS CO 80949
JB9 PRIVATE HEALTHCARE SYSTEMS P O BOX 749075 DALLAS TX 75374-9075
DJ9 PRIVATE HEALTHCARE SYSTEMS PO BOX 30466 TAMPA FL 33630-3466
WI* PRO AMERICA 18008745254 P O BOX 90603 ARLINGTON TX 76006
V34 PRO GROUP HOTZE RD POCAHONTAS AR 72455
* - 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 97
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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ER5 PRO PREFERRED PRESCRIPTION PO BOX 577 SOUTHFIELD MI 48037
DI5 PRO VANTAGE PRES DRUG PLAN P O BOX 846 BROOKFIELD WI 53008-0846
H90 PROAMERICA P.O. BOX 507 POCAHONTAS AR 72455
U86 PROAMERICA REPRICING P O BOX 202008 ARLINGTON TX 76006
JO2 PROCARE RX 309 PREMIERE PARKWAY SUITE 100 DULUTH GA 30097
NU* PRODUCERS EXCHANGE BENEFIT SERVICES 14665 MIDWAY STE 110 DALLAS TX 75244
AZ5 PROFESSIONAL ADMINISTATORS PO BOX 140415 ORLANDO FL 32814-0415
DE1 PROFESSIONAL ADMINISTRATIO GROUP P O BOX 13390 OVERLAND PARK KS 66212-3390
EB3 PROFESSIONAL BENEFIT ADM P O BOX 4687 OAKBROOK IL 60522-4687
K81 PROFESSIONAL GOLFERS ASSOC PROCARE P O BOX 41963 ROCHESTER NY 14604
N80 PROFESSIONAL INS CORP P O BOX 130016 RALEIGH NC 27605-1016
HM6 PROFESSIONAL INSURANCE COM P.O. BOX 80637 LINCOLN NE 68501
D9* PROFESSIONAL INVESTORS LIFE INSURANCE P O BOX 2888 TULSA OK 74101
U99 PROFESSIONAL RISK MANAGEME P O BOX 1049 YOUNGSTOWN OH 44501
E81 PROFESSIONAL SALES CORP 23501 MOUND ROAD WARREN MI 48091
CR8 PROFFESSIONAL CLAIM ADMINI THE ARAZE GROUP 8500 NORMANDALE LAKE 2050 BLOOMINGTON MN 55437
R85 PROGRESSIVE CASUALTY INS C P O BOX 2931 AUSTIN TX 78768-2931
GA7 PRONET 2741 MERCED DRIVE RIVERSIDE CA 92503
Q48 PROTECTIVE LIFE PO BOX 57018 OKLAHOMA CITY OK 73157
DZ6 PROTECTIVE LIFE INS P O BOX 3129 BRENTWOOD TN 37024-3129
DM7 PROTECTIVE LIFE INS 8130 BAYMEADOWS WAY W 200 P O BOX 17577 JACKSONVILLE FL 32245-7577
A67 PROTECTIVE LIFE INS CO 5865 HYATT RIDGEWAY PKWAY MEMPHIS TN 38119
VN* PROTECTIVE LIFE INSURANCE P O BOX 830626 BIRMINGHAM AL 35283-0626
S20 PROTECTIVE LIFE INSURANCE P O BOX 4040 JONESBORO AR 72403
DD9 PROTEIN TECHNOLOGIES ATTN EMPLOYEE BENEFITS 4272 S MENDENHALL ROAD MEMPHIS TN 38141
V99 PROVIDENT AMERICAN INS CO 10501 N CENTRAL EXPWY DALLAS TX 75231-2203
G92 PROVIDENT INDEMNITY INS CO P O BOX 511 NORRISTOWN PA 19404-0511
H95 PROVIDENTIAL ELDER CARE P.O. BOX 1139 HOT SPRINGS AR 71902
A19 PROVIDENTIAL LIFE 525 SOUTH LOOP SUITE D DENTON TX 76205-9998
L39 PROVIDENTIAL MAINTENACE EM GROUP PLAN P O BOX 97 DADE CITY FL 33525
RQ* PROVIDER NETWORKS OF AMERI PO BOX 101387 FORT WORTH TX 76185
FK* PROVIDIAN LIFE NATIONAL HOME LIFE P O BOX 1776 VALLEY FORGE PA 19495
CL7 PROVIDIAN LIFE CLAIMS SERVICE DIV P O BOX 484 VALLEY FORGE PA 19493
G61 PROVIEW PLUS PO BOX 6868 PINE BLUFF AR 71603
B64 PRU CARE OF MEMPHIS 2620 THOUSAND OAKS BLVD SUITE 4000 MEMPHIS TN 38118-2461
* - 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 98
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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CY2 PRUCARE OF CALIFORNIA P O BOX 7590 SAN MATEO CA 94402
W8* PRUCARE OF OKLAHOMA 3330 NW 56TH SUITE 500 OKLAHOMA OK 73112
DA9 PRUCARE OF SAN ANTONIO P O BOX 795030 SAN ANTONIO TX 78279-5030
CW2 PRUDENTIAL P O BOX 85479 SAN DIEGO CA 92186
CV3 PRUDENTIAL P O BOX 15055 ALBANY NY 12212-5055
DQ4 PRUDENTIAL P O BOX 45098 JACKSONVILLE FL 32232-5098
DY7 PRUDENTIAL P O BOX 5352 CINCINNATI OH 45201-5352
EX2 PRUDENTIAL P O BOX 200831 HOUSTON TX 77216
EI8 PRUDENTIAL P O BOX 4046 ISELIN NJ 08830
FE9 PRUDENTIAL LUCENT TECH CLAIMS P O BOX 411340 ST LOUIS MO 63141-1340
FD1 PRUDENTIAL 6200 COURTNEY CAMPBELL CAUSEWAY SUITE 200 TAMPA FL 33607
ML* PRUDENTIAL 1875 CENTURY BLVD NE SUITE 2A ATLANTA GA 30345
PZ* PRUDENTIAL CARROLL ELEC COOPERATIVE P O BOX 368 BERRYVILLE AR 72616
JL* PRUDENTIAL P O BOX 24549 ST LOUIS MO 63141
KA* PRUDENTIAL P O BOX 2229 JACKSONVILLE FL 32231
V92 PRUDENTIAL 3592 TCHULAHOMA RD MWMPHIS TN 38118
V4* PRUDENTIAL P O BOX 10307 GREENSBORO NC 27404
Z71 PRUDENTIAL P.O. BOX 7590 SAN MATEO CA 94402
Z96 PRUDENTIAL P.O. BOX 7500 GASTONIA NC 28053
P99 PRUDENTIAL PO BOX 1567 HOUSTON TX 77251-1567
R73 PRUDENTIAL P O BOX 12666 CREVE COEUR MO 63141
ST* PRUDENTIAL P O BOX 470475 OKLAHOMA CITY OK 74147
R97 PRUDENTIAL ANDERSON HICKEY CO RT 1, INDUSTRIAL RD HALLS TN 38040
S40 PRUDENTIAL P O BOX 7020 MILLVILLE NJ 08332-9044
UH* PRUDENTIAL ST MARYS HOSPITAL 1808 WEST MAIN STREET RUSSELLVILLE AR 72203
U85 PRUDENTIAL 1301 PONCE DELEON BLVD CORAL GABLES FL 00000
U34 PRUDENTIAL ATT CLAIMS P O BOX 44123 JACKSONVILLE FL 32231-4123
BI4 PRUDENTIAL P O BOX 5066 MILLVILLE NJ 08332
BI7 PRUDENTIAL MORTON INTERNATIONAL P. O. BOX 3089 GREENVILLE SC 29602
AU8 PRUDENTIAL GROUP HEALTH DIVISION P.O. BOX 45064 JACKSONVILLE FL 32232
AJ7 PRUDENTIAL FRIGIDARE CO PO BOX 10120 HIGH POINT NC 27261
W56 PRUDENTIAL CUSTOM CARE SBC MEDICAL CLAIMS P O BOX 4723 HOUSTON TX 77210-4723
DA4 PRUDENTIAL GROUP DENTAL JC PENNEY CLAIMS P O BOX 9250 LINWOOD NJ 08221
TC* PRUDENTIAL GROUP INSURANCE HARRIS HOSPITAL 1205 MCLAIN STREET NEWPORT AR 72112
X86 PRUDENTIAL HEALTH CARE P O BOX 54717 LOS ANGELES CA 90054
* - 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 99
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EY6 PRUDENTIAL HEALTH CARE SYS OF TAMPA P O BOX 2739 JACKSONVILLE FL 32232-0053
EB4 PRUDENTIAL HEALTHCARE PO BOX 44163 JACKSONVILLE FL 32231-4163
PD* PRUDENTIAL HEALTHCARE DENTAL CLAIMS P O BOX 9065 VAN NUYS CA 91409
FA* PRUDENTIAL HEALTHCARE P O BOX 54550 LOS ANGELES CA 90054-0550
R95 PRUDENTIAL HEALTHCARE PO BOX 30008 LOS ANGELES CA 90030-0008
BZ* PRUDENTIAL HEALTHCARE P O BOX 2018 MILLVILLE NJ 08332-9002
BD7 PRUDENTIAL INS CO HIGH POINT CLAIMS CENTER P. O. BOX 10100 HIGH POINT NC 27261
H14 PRUDENTIAL INS CO PLANTERS PEANUTS 4020 PLANTERS ROAD FORT SMITH AR 72917
EC2 PRUDENTIAL INS CO ATT MEDICAL PLAN P O BOX 5060 MILLVILLE NJ 08332
DS5 PRUDENTIAL INS CO P O BOX 411006 ST LOUIS MO 63141-3006
DR* PRUDENTIAL INS CO OF AMERICA P O BOX 44059 JACKSONVILLE FL 32231-4059
DP6 PRUDENTIAL INS CO U S INDUSTRIES PO BOX 8850 LINWOOD NJ 08221
C92 PRUDENTIAL INS CO 7700 CHEVY CHASE DR SUITE 300 AUSTIN TX 78752-1558
C26 PRUDENTIAL INS CO P O BOX 949 HORSHAM PA 19044-0949
DK5 PRUDENTIAL INS CO IBM DEDICATED UNIT P O BOX 5400 MILLVILLE NJ 08332-0100
KJ* PRUDENTIAL INS CO OF AM GROUP CLAIMS P O BOX 9488 MINNEAPOLIS MN 55440
V35 PRUDENTIAL INS CO OF AM P O BOX 2588 201 UNIVERSITY AVE LUBBOCK TX 79408
0M* PRUDENTIAL INS CO OF AMERI 2620 THOUSAND OAKS RD SUITE 4000 MEMPHIS TN 38118
R6* PRUDENTIAL INS CO OF AMERI P O BOX 4034 200 WOOD AVENUE SOUTH ISELIN NJ 08830
BD6 PRUDENTIAL INS CO OF AMERI P. O. BOX 566 MATTESON IL 60443-0566
FG3 PRUDENTIAL INS CO OF AMERI PO BOX 4722 HOUSTON TX 77210
GI* PRUDENTIAL INS CO OF AMERI JACKSONVILLE GRP CLAIMS PO BOX 45097 JACKSONVILLE FL 32232
E55 PRUDENTIAL INS CO OF AMERI GROUP HEALTH CLAIM DIV PO BOX 44058 JACKSONVILLE FL 32231-4058
C36 PRUDENTIAL INS OF AMERICA BENEFITS DEPT HARDEES 1233 N CHURCH ST ROCKY MOUNT NC 27801
C19 PRUDENTIAL INSURANCE P O BOX 690 AKRON OH 44309-0690
E72 PRUDENTIAL INSURANCE 6209 EXECUTIVE BLVD ROCKVILLE MD 20852
BO* PRUDENTIAL INSURANCE 3701 KIRBY DRIVE P O BOX 1481 HOUSTON TX 77098
AM1 PRUDENTIAL INSURANCE DETROIT RESOURCE RECOVERY PO BOX 9032 ANDOVER MA 01810
AB7 PRUDENTIAL INSURANCE CO P.O. BOX 56428 HOUSTON TX 77256
BP* PRUDENTIAL INSURANCE CO P O BOX C11928 SANTA ANNA CA 92711
BF8 PRUDENTIAL INSURANCE CO P. O. BOX 537 MATTESON IL 60443
P98 PRUDENTIAL INSURANCE CO PO BOX 5080 MILLVILLE NJ 08332-5080
U30 PRUDENTIAL INSURANCE CO P O BOX 629 LAWRENCE MA 08142
VG* PRUDENTIAL INSURANCE CO 6500 W LOOP SOUTH BELLAIRE TX 77401
Z72 PRUDENTIAL INSURANCE CO P.O. BOX 5100 ROCKAWAY NJ 07866
* - 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 100
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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V61 PRUDENTIAL INSURANCE CO WMX TECH MEDICAL CLAIMS P O BOX 565 MATTESON IL 60443-0565
X6* PRUDENTIAL INSURANCE CO 2100 CENTRE CITY TOWER 650 SMITHFIELD STREET PITTSBURGH PA 15222
YI* PRUDENTIAL INSURANCE CO 8055 W MANCHESTER BLVD SUITE 205 PLAYA DEL REY CA 90291
X39 PRUDENTIAL INSURANCE CO P O BOX 200 MONROEVILLE PA 15146
EG2 PRUDENTIAL INSURANCE CO P O BOX 26699 AUSTIN TX 78755-0699
ER1 PRUDENTIAL INSURANCE CO P O BOX 100 MONROEVILLE PA 15146
D39 PRUDENTIAL INSURANCE CO 100 NO 56TH STREET STE 310 LINCOLN NE 68504
D3* PRUDENTIAL INSURANCE CO 4601 SAUK TRAIL RICKTON IL 60471
CZ8 PRUDENTIAL INSURANCE CO P O BOX 4250 LINWOOD NJ 08221
DA8 PRUDENTIAL INSURANCE CO P O BOX 2957 JACKSONVILLE FL 32232
DE3 PRUDENTIAL INSURANCE CO WMX TECH DENTAL CLAIMS P O BOX 540 MATTESON IL 60443-0540
CH6 PRUDENTIAL INSURANCE CO P O BOX 9315 VAN NUYS CA 91410
J17 PRUDENTIAL INSURANCE CO KENDAVIS HOLDING CO 7171 AIRWAYS BLVD SOUTHAVEN MS 38671
IX* PRUDENTIAL INSURANCE CO PINEWEST PLAZA 5 WASHINTON AVE EXTENSION ALBANY NY 12205
PP* PRUDENTIAL INSURANCE CO SOUTHWEST DIE CASTING P O BOX 281 FORT SMITH AR 72901
PW* PRUDENTIAL INSURANCE CO STE 301 MARQUAM II BLDG 2611 S W THIRD AVENUE PORTLAND OR 97201
PU* PRUDENTIAL INSURANCE CO P O BOX 2949 312 ELM STREET CINCINNATI OH 45201
NV* PRUDENTIAL INSURANCE CO 6060 NO CENTRAL EXPWY SUITE 238 DALLAS TX 78945
DH* PRUDENTIAL INSURANCE CO OF AMERICA GENERAL DELIVERY NEWARK NJ 07103
A16 PRUDENTIAL INSURSANCE CO PO BOX 26960 COLONIAL PARK INDIANAPOLIS IN 46226
R87 PRUDENTIAL JACKSONVILLE GR HEALTH CLAIM DIVISION P O BOX 45197 JACKSONVILLE FL 32232
EK5 PRUDENTIAL LIFE INS P O BOX 3699 AKRON OH 44309-3699
HT8 PRUDENTIAL LONG TERM CARE 2101 WELSH ROAD DRESCHER PA 19025
DL1 PRUDENTIAL MDO SOUTHWESTER 1 IMESON PARK BLVD BUILDING 100 JACKSONVILLE FL 32218-5696
BJ* PRUDENTIAL PLUS ATTN DENTAL CLAIMS 1701 CENTERVIEW STE210 LITTLE ROCK AR 72211
DZ4 PRUDENTIAL PLUS P O BOX 45100 JACKSONVILLE FL 32231
P14 PRUDENTIAL PLUS P O BOX 4804 HOUSTON TX 77210-4804
AF1 PRUDENTIAL PLUS SELECT P.O. BOX 27715 HOUSTON TX 77227-7715
A28 PUBLIC EMPLOYEE HLTH PROGR 540 EAST 200 SOUTH SALT LAKE CITY UT 84102
AT2 PURINA BENEFIT ASSOCIATION PROTEIN TECH INTERNATL P O BOX 2048 PRYOR OK 74362
U28 PURINA MILLS BENEFIT ASSOC P O BOX 26199 MILWAUKEE WI 53226-9714
GI7 PYRAMID PO BOX 12922 PENSACOLA FL 32591-2922
AO5 PYRAMID BENEFIT SERVICES P.O. BOX 1017 SOUTH BEND IN 46624
HC5 PYRAMID LIFE INSURANCE P.O. BOX 391885 CAMBRIDGE MA 02139
0N* PYRAMID LIFE INSURANCE 6201 JOHNSON DRIVE P O BOX 772 SHAWNEE MISSION KS 66202
* - 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 101
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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IB0 PYRAMID LIFE INSURNCE PO BOX 742568 HOUSTON TX 77274
HY5 P5E HEALTH SERVICES INC PO BOX 9554 SALT LAKE CITY UT 84109-0554
X35 QSC FINISHING 3912 E PROGRESS LITTLE ROCK AR 72117
EH9 QUAD MED CLAIMS DUPLAINVILLE RD PEWAUKEE WI 53072
L2* QUAKER OATS COMPANY P O BOX 830 ROCKFORD IL 61105
DO9 QUAKER STATE ADMINISTRATIV UNIT P O BOX 176 PITTSBURGH PA 15230
BN4 QUALCHOICE QCA 10825 FINANCIAL CTR PKWY SUITE 400 LITTLE ROCK AR 72211
I81 QUALITY ASSISTANCE CORP P.O. BOX 861 HWY 34E MT PLEASANT IA 52641
BK7 QUALMED PLANS FOR HEALTH 4800 SW MACADAM AV STE 400 PORTLAND OR 97201
HF5 QUALSERV CORPORATION 1222 OZARK ROAD NORTH KANSAS CITY MO 64116
FL7 QUENTIN HARPER P O BOX 463 DUE TO SETTLEMENT 25K ARKADELPHIA AR 71923
R57 QUIKRETE MATERIALS INC 315 PHILLIPS RD PO BOX 3209 N L R AR 72117
EL7 R H ADMINISTRATORS 6502 SLIDE ROAD SUITE 300 LUBBOCK TX 79424
ER8 R H CLARKSON INSURANCE ONE RIVERFRONT PLAZA P O BOX 70529 LOUISVILLE KY 40270
AY4 R L STOWE MILLS INC 85 EAST CATAWBA ST BELMONT NC 28012
FV7 R X PRIM P O BOX 780 HARTFORD CT 06142-0780
X14 RAILROAD RETIREMENT BOARD 844 RUSH STREET CHICAGO IL 60611
G93 RAINBOW FOODS 112 SOUTH LELIA TEXARKANA TX 75501
D42 RALSTON PURINA BENEFIT ASS CHECKERBOARD SQUARE ST LOUIS MO 63164
I91 RANDALL TEXTRON P.O. BOX 1048 BLYTHEVILLE AR 72315
P81 RANDS HEALTH FUND 1200 PIKE AVE N LITTLE ROCK AR 72114
Q37 RANDS IGA INC PO BOX 630 LITTLE ROCK AR 72209
U94 RASMUSSEN AGENCY INC P O BOX 2515 EAST ORANGE NJ 07018
H22 RATHER BEYER HARPER 362 PROSPECT BUILDING LITTLE ROCK AR 72207-5290
FX5 RAYMOND EASTERWOOD JR 221 W SECOND ST SUITE 923 LITTLE ROCK AR 72201
HE5 RBMS LLC PO BOX 241569 ANCHORAGE AK 99524-1569
BQ2 RCKY MTN UFCW UNION EMP HEALTH BENEFIT PLAN P O BOX 157 WESTMINSTER CO 80030-0157
L80 RE GROUP INS 16565 SOUTH STATE STREET SOUTH HOLLAND IL 60473
Q4* READING AND BATES CORP 2200 MID CONTINENT TOWER TULSA OK 74103
D18 REARICK AND LENIHAN ADMINISTRATIVE SRVC DIV P O BOX 400023 DALLAS TX 75240
M38 REASSURE AMERICA MODERN AMERICAN LIFE P O BOX 1147 JACKSONVILLE IL 62651-1147
C43 REBSAMEN INSURANCE CO HEALTH MNG NETWORK P O BOX 110845 NASHVILLE TN 37222
XE* REBSAMEN INSURANCE CO P O BOX 3198 1500 RIVERFRONT DRIVE LITTLE ROCK AR 72203
Z24 REBSAMEN INSURANCE COMPANY ATTN HOLLY SCHIEBER P O BOX 3398 LITTLE ROCK AR 72203-3398
J87 RECO INTERNATIONAL INC 5680 EAST HOUSTON SAN ANTONIO TX 78220
* - 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 102
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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FI2 REES LAW FIRM P O BOX 1573 2110 E MATTHEWS ST JONESBORO AR 72403-1573
ZW* REGENCE BLUE CROSS BLUE SHIELD OF OREGON P O BOX 1271 PORTLAND OR 97207-1271
FF9 REGENCE BLUE SHIELD OF IDA PO BOX 31602 SALT LAKE CITY UT 84131-0603
DL* REGENCE GROUP HEALTH P O BOX 1071 PORTLAND OR 97207-1071
Z19 REGENCY MEDICAL P.O. BOX 610609 PORT HURON MI 48061
N32 REGIONAL BENEFITS CENTER P O BOX 10365 DES MOINES IA 50306
DN* RELIABLE INSURANCE UNITED INSURANCE P O BOX 1735 FORREST CITY AR 72336
EF* RELIABLE INSURANCE UNITED INSURANCE P O BOX 1096 TEXARKANA AR 75504
EA* RELIABLE INSURANCE UNITED INSURANCE P O BOX 56320 LITTLE ROCK AR 72215
CK* RELIABLE INSURANCE COMPANY 231 WEST LOCKWOOD AVE SAINT LOUIS MO 63119
BU5 RELIABLE LIFE INSURANCE CO PO BOX 4325 BATON ROUGE LA 70821-4325
J6* RELIANCE LIFE CASUALTY P O BOX 16025 PHOENIX AZ 85016
HM3 RELIANCE STANDARD INSURANC 509 LENOA RD BUILDING 2 MOORSETOWN NJ 08057
LN* REPUBLIC NATIONAL LIFE P O BOX 6210 DALLAS TX 75204
AZ* REPUBLIC NATIONAL LIFE P O BOX 1280 NASHVILLE TN 37202
G63 RESERVE INSURED TRUST FOR PO BOX 791428 DALLAS TX 75379
DY3 RESERVE NATIONAL PO BOX 26620 OKLAHOMA CITY OK 73126
0P* RESERVE NATIONAL INS CO 6100 NW GRAND BLVD P O BOX 18448 OKLAHOMA CITY OK 73154-0448
JB6 RESOURCE ONE P O BOX 227046 DALLAS TX 75222
Q62 REST INSURANCE CO 9111 E DOUGLAS PO BOX 428 WICHITA KS 67201
AK2 RESTAT P.O. BOX 758 WEST BEND WI 53095-0758
K91 RETAIL CLERKS UNION P O BOX 1808 BAKERSFIELD CA 93303
Q51 RETIRED ENLISTED ASSOC PO BOX 50584 WASHINGTON DC 20004
U27 RETIRED OFFICERS ASSOC 400 LOCUST ST DES MOINES IA 50398
U89 RETIREMENT FUND TR OF THE PLUMB HEATING PIPING IND 501 SHATTO PLACE 5TH FL LOS ANGELES CA 90020
HB* REYNOLDS METALS CO ATT INSURANCE DEPT P O BOX 1155 HOT SPRINGS AR 71901
J78 REYNOLDS METALS CO EMPLOYEE HEALTH CARE MEDI POBOX C 32029 RICHMOND VA 23261
J65 REYNOLDS METALS CO RETIREE PERSONNEL DEPT P O BOX 97 BAUXITE AR 72015
J03 RH ADMINISTRATORS 5502 58TH ST LUBBOCK TX 79414
U56 RH MOORE CO INC P O BOX 830 MURRELLS INLETT SC 29576
D60 RHEEM MANUFACTURING CO 5600 OLD GREENWOOD RD PO BOX 17010 FT SMITH AR 72903
AME RICAN GENERAL LIFE P.O. BOX 550 JONESBORO AR 72401
I82 RICHARD V REESE AND ASSOCA CARPENTARS LOCAL 3100 BROADWAY 511 KANSAS CITY MO 64111
MH* RINGIER AMERICA INC P O BOX 129 ITASCA IL 60143
CZ3 RISK MANAGEMENT P O BOX 8007 RIVERSIDE CA 92515-8007
* - 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 103
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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YN* RISK MANAGEMENT RESOURCES PO BOX 251770 LITTLE ROCK AR 72205
G54 RMSCO INC 115 CONTINUUM DRIVE LIVERPOOL NY 13088-4387
GG8 RMSCO INC PO BOX 6309 SYRACUSE NY 13217-6309
M36 ROBERT A YOUNG FARMS P O BOX 48 FORT SMITH AR 72902
M68 ROBERTSON AND ASSOCIATES P O BOX DRAWER C BENTON AR 72015
DA2 ROBINSON AND JULIENNE BAILEY AND COMPANY P O BOX 101 JACKSON MS 39205-0101
X70 ROCK TENN COMPANY 198 COMMERCE ROAD CONWAY AR 72032
EB9 ROCKFORD HEALTH PLANS HMO PRODUCT CLINICARE 3401 PERRYVILLE RD ROCKFORD IL 61114
C48 ROCKWELL INTERNATIONAL 600 GRANT ST STE 4747 PITTSBURG PA 15219
M88 ROGER TOOL WORK 1602 E CENTRAL ROGERS AR 72756
V80 ROGERS GROUP INC P O BOX 2545 NASHVILLE TN 37219
DN9 ROGERS MACHINERY FAMILY HEALTHCARE PLAN PO BOX 25775 PORTLAND OR 97225-0775
BC5 ROLLINS LEASING CORP EMPLOYEE BENEFITS TRUST P.O. BOX 8788 WILMINGTON DE 19899
TY* ROSS LOOS HEALTH PLAN GENERAL DELIVERY INGLEWOOD CA 90301
N74 ROWLAND GROUP SERVICES SUITE 1302A 4210 SHAWNEE MISSION PKWY SHAWNEE MISSION KS 66205
HO8 ROYAL NEIGHBORS OF AMERICA PO BOX 10850 CLEARWATER FL 33757-8850
U45 ROYAL OAK ENTERPRISES P O BOX 1517 BRANSON MO 65616
HI1 RSL SPECIALITY PRODUCTS AD 505 SOUTH LENOLA RD SUITE 231 MOORESTOWN NJ 08057
T4* RURAL CARRIER BENEFIT PLAN PO BOX 7404 LONDON KY 40742
J23 RURAL SECURITY LIFE P.O. BOX 5535 MADISON WI 53705
Y36 RWDSU INTERNATIONAL UNION FUND OFFICE PO BOX 55728 BIRMINGHAM AL 35255-0509
HG8 RX AMERICA 221 N CHARLES LINDBERGH SALT LAKE CITY UT 84116
GM3 RX OPTIONS 2181 EAST AURORA ROAD TWINSBURG OH 44087
DJ3 RX PRIME RTG 1 121 HARTFORD CT 06152-1121
A42 RYDER SYSTEMS INC P O BOX 020816 MIAMI FL 33102
L18 S B HOWARD CO PO BOX 1627 ROGERS AR 72757
X89 S B POWER TOOL ROUTE 2 BOX 438 WALNUT RIDGE AR 72476
F71 S L M A P E BARNES LUMBER CO P O BOX 2527 WEST HELENA AR 72390
W59 S R OF ARKANSAS 68 UNION AVE WILSON AR 72395
E42 SAFECO BOX1214 STONE MOUNTAIN GA 30086-1214
VZ* SAFECO LIFE INSURANCE SAFECO PLAZA GENERAL DELIVERY SEATTLE WA 98185
I04 SAFEHEALTH LIFE INSURANCE P O BOX 30930 LAGUNA HILLS CA 92654
AQ5 SAFEWAY GROUP INSURANCE P.O. BOX 2099 OAKLAND CA 94604
AB9 SAFEWAY INC GROUP INS 2950 MERCED STREET SAN LEANDRO CA 94577
FB6 SAGAMORE HEALTH NETWORK 11555 N MERIDAN ST SUITE 400 CARMAL IN 46032
* - 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 104
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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HR6 SAINT MARYS HELATH PLANS 1510 MEADOW WOOD LANE RENO NV 89502
T11 SALLEE BROTHERS 409 SO MCDONALD P O BOX 190 POCAHONTAS AR 72455
L92 SALVATION ARMY P O BOX 1884 AKRON OH 44309
F48 SAMBA 6209 EXECUTIVE BLVD ROCKVILLE MD 43216
IE4 SAN LUIS HMO 700 MAIN STREET ALAMOSA CO 81101
HJ9 SANDFORD HEALTH PLAN 5300 BROADBAND LANE STE 300 SIOUX FALLS SD 57104
Y66 SANUS HEALTH PLAN P.O. BOX 56228 HOUSTON TX 77256
A57 SANYO MANUFACTURING CO C/0 GENERAL AMERICAN 3333 SANYO RD FORREST CITY AR 72335
J76 SCHUMACHER FINANCIAL SERVI P O BOX 549 SIKESTON MO 63801
E22 SCOTT WHITE HEALTH PLAN 2401 SOUTH 31ST ST TEMPLE TX 76508
BG5 SCRIPT CARE INC 6380 FOLSOM DRIVE BEAUMONT TX 77706
HX9 SCRIPT WORLD 250 NORTH REDWOOD ROAD SUIT 210 N SALT LAKE CITY UT 84054
R94 SE AND SW HEALTH AND WELFARE P O BOX 5103 DES PLAINES IA 60017
D29 SEA FARERS WELFARE PLAN 5201 AUTH WAY CAMP SPRINGS MD 20746
CN8 SEACOR MARINE INC P O BOX 2291 MORGAN CITY LA 70380
HK2 SEARS LIFE INSURANCE 3001 MEACHAM BLVE. STE200 PO BOX 901009 FT WORTH TX 76101-2009
X5* SECURE CARE 65 NATIONAL HOME LIFE P O BOX 1776 VALLEY FORGE PA 19493
IO6 SECURE HEALTH P O 13447 MACON GA 31208
IE1 SECURE HEALTH PLAN GEORGIA 3920 ARKWEIGHT ROAD SUITE 405 MACON GA 31210
HH8 SECURE HORIZONS DIRECT P O BOX 4169 SCRANTON PA 18505
GX3 SECURE HORIZONS DIRECT PO BOX 659787 SAN ANTONIO TX 78265-9787
P52 SECURITY LIFE 10159 WAYZATA BLVD MINNETONKA MN 65343
DL5 SECURITY LIFE TOTAL PLAN SECURITIES P O BOX 36631 DALLAS TX 75235
IF8 SECURITY LIFE INSURANCE 10901 RED CIRCLE DRIVE MINNETONKA MN 55343
R78 SEDRICK NOBLE LOWNDES P O BOX C5009 WARMINSTER PA 18974
H57 SEIBELS BRUCET CO P.O. BOX 1 COLUMBIA SC 29202
HY1 SEIU 1199 DENTAL 330 WEST 42ND STREET NEW YORK NY 10036-6977
T15 SELECT BENEFIT ADMINISTRATORS P O BOX 8339 DES MOINES IA 50301
BT5 SELECT BENEFIT ADMINISTRAT OF AMERICA PO BOX 440 ASHLAND WI 54806
GT6 SELECT HEALTH PO BOX 30192 SALT LAKE CITY UT 84130-0192
BA9 SELECT MED P O BOX 11670 SALT LAKE CITY UT 84147-1670
U31 SELECTCARE PRO P O BOX 7036 TROY MI 48077-7036
N20 SELF FUNDED PLANS 1432 HAMILTON AVENUE CLEVELAND OH 44114
BU8 SELF FUNDED PLANS INC 401 W STATE ST GENEVA IL 60134
M2* SELF INSURED SERVICES CO SISCO P O BOX 389 DUBUQUE IA 52004-0389
* - 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 105
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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YE* SELF INSURERS BENEFIT SVC 222 SOUTH PROSPECT PARK RIDGE IL 60068
P36 SENIOR CARE METHODIST HOSPITAL 3024 STADIUM BLVD JONESBORO AR 72401
IC7 SENTARA HEALTHCARE 6015 POPLAR HALL DRIVE NORFOLK VA 23502
BS3 SENTARA POINT OF SERVICE 4417 CORPORATION LANE VIRGINIA BEACH VA 23462
BR* SENTRY INSURANCE P O BOX 35728 RICHMOND VA 23235
E94 SENTRY LIFE PO BOX 17237 MEMPHIS TN 38187
P46 SENTRY LIFE HEALTH INS PO BOX 8888 STEVENS POINT WI 54481
JG* SENTRY LIFE INS CO P O BOX 105047 ATLANTA GA 30348
UT* SENTRY SELECT P O BOX 1387 18005384693 ST LOUIS MO 63188
CQ2 SERV U PRESCRIPTION PLAN P O BOX 23237 MILWAUKEE WI 53223-0237
J49 SERVCO INS AGENCY 501 FALL BLVD WYNNE AR 72396
IB5 SEVEN CORNERS ATTN CLAIMS P O BOX 3430 CARMEL IN 46082-3420
A73 SFA 125 WEST CENTRAL SUITE 319 BENTONVILLE AR 72712
GB5 SHARP INC PO BOX 690450 SAN ANTONIO TX 78269-0450
DB2 SHARP INC CLAIMS DEPT P O BOX 7097 JONESBORO AR 72403
FP4 SHASTA ADMIN SERV PO BOX 1747 REDMOND OR 97756
Q59 SHAW INDUSTRIES INC PO DRAWER 2128 DALTON GA 30722-2128
T42 SHEET METAL LOCAL 249 3721 PHILLIS NO LITTLE ROCK AR 72118
W64 SHEET METAL WORKERS FUND LOCAL 265 1065 SCHANLE RD CAROL STREAM IL 00000
B92 SHEET METAL WORKERS FUND 601 N FAIRFAX STREET SUITE 500 ALEXANDRIA VA 22314
DI7 SHEET METAL WORKERS FUND P O BOX 10067 MANHATTAN BEACH CA 90266-8567
J81 SHEET METAL WORKERS LOCAL H W FUND P O BOX 50440 INDIANAPOLIS IN 46250
IH2 SHEFFIELD OLSON AND MCQUEE 2145 FPRD PKWY STE 300 ST PAUL MN 55116
AG* SHELTER INSURANCE CO 1817 W BROADWAY COLUMBIA MO 65218
U21 SHELTER LIFE INSURANCE CO 508 W PLEASURE SEARCY AR 72143
GY4 SHENANDOAH LIFE GROUP DENTAL CLAIMS P O BOX 8112 PARK RIDGE IL 60068
G08 SHENANDOAH LIFE INSURANCE P O BOX 11807 ROANOKE VA 24022
FQ7 SHIPPERS RENTAL COMPANY PO BOX 3156 QUINCY IL 62305-3156
H64 SHIPPING SYSTEMS EMP HEALT GREEN BAY WI 54344
BN5 SHIRLEY TILLEY TRUSTEE FOR MELISSA TILLEY GEN DEL REYNO AR 72462
K10 SHOEMAKERS EMPLOYEES BENEF P O BOX 690450 SAN ANTONIO TX 78269-0450
ZJ* SHONEYS SOUTH INC 2158 UNION AVENUE P O BOX 41379 MEMPHIS TN 38104
S91 SHONEYS TPA P O BOX 290489 NASHVILLE TN 37229
K74 SIBS 222 SO PROSPECT PARK RIDGE IL 60068
Z73 SIDACO INC 17314 FM 249 SUITE 105 HOUSTON TX 77064
* - 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 106
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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AU9 SIERRA HEALTH AND LIFE P.O. BOX 18408 LAS VEGAS NV 89114
GN* SIERRA HEALTHCARE OPTIONS P O BOX 15392 LAS VEGAS NV 89114-5392
FE3 SILVER DOLLAR CITY INC BENEFITS ADMINISTRATOR HC 1 BOX 791 BRANSON MO 65616
GS1 SILVER SCRIPT PO BOX 280200 NASHVILLE TN 37228
GS3 SILVER SCRIPT PO BOX 52092 PHOENIX AZ 85072-2092
EC6 SILVER STATE MEDICAL ADM 2059 E SAHARA AVE LAS VEGAS NV 89104
QQ* SIMMONS PO DRAWER V VAN BUREN AR 72956
A36 SIMMONS INDUSTRIES PO BOX 430 SILOAM SPRINGS AR 72761
L53 SIMPLEK TIME RECORDER 1509 MART DRIVE LITTLE ROCK AR 72202
W30 SISTERS OF CHARITY CLAIMS PO BOX 922013 2600 NO LOOP WEST DR SUIT HOUSTON TX 77292-2013
Z43 SJA BROKERAGE INC PO BOX 101627 FORT WORTH TX 76185-1627
I73 SKIL CORPORATION 2 BOLTON SULLIUAN HWY 110 HEBER SPRINGS AR 72543
ZK* SKILL INSURANCE CORP HIGHWAY 67 NORTH P O BOX 689 WALNUT RIDGE AR 72476
S15 SLOAN VALVE COMPANY PRUDENTIAL HWY 33 SOUTH AUGUSTA AR 72006
V22 SLOANS LAKE MANAGED CARE MASSACHUSETTS MUTUAL 1355 S COLORADO STE 902 DENVER CO 80222
AQ4 SMC INC P.O. BOX 1979 SEARCY AR 72143
BM9 SMI JOIST P O BOX 2000 HOPE AR 71802-2000
Q44 SMI STEEL UNITED HEALTHCARE P O BOX 1147 MAGNOLIA AR 71753
U14 SMITH FIBERGLASS 2700 W. 65TH STREET LITTLE ROCK AR 72209
BT2 SNOHOMISH CTY PHYS SVC SCPC P O BOX 91050 SEATTLE WA 98111-9150
H48 SO CALIFORNIA RETAIL CLERK LOS FELIZ STATION P O BOX 27920 LOS ANGELES CA 90027
FG2 SO CENT UNITED FOOD COMM W UNION AND EMPL AND HEALTH 9550SKILLMAN ST SUITE 410 DALLAS TX 75243
CB6 SO CENTRAL REGIONAL LABORE HEALTH AND WELFARE FUND PO BOX 1449 GOODLETTSVILLE TN 37070-1449
R63 SO CENTRAL UNITED FOOD AND COMMERCIAL WORKERS 3218 E HIGHWAY 67 MESQUITE TX 75150
V19 SO WESTERN HEALTH AND WELF 4040 MCEWEN SUITE 100 DALLAS TX 75244
N81 SONOCO P O BOX 3336 EAST CAMDEN AR 71701
C1* SOUTH ARKANSAS DISTRICT CHURCH OF THE NAZARENE 8621 CHICOT ROAD LITTLE ROCK AR 72209
C7* SOUTH COAST CLAIMS MANAGEM P O BOX 2178 COSTA MESA CA 92626
FR1 SOUTH REGIONAL LABORERS PO BOX 1449 GOODLETTSVILLE TN 37070
Q81 SOUTHEAST HEALTH PLAN P O BOX 830636 BIRMINGHAM AL 35283-0636
CA1 SOUTHEAST MEDICAL ALLIANCE ETHIXOX 920 P O BOX 920 DUBLIN OH 43017
LC* SOUTHEASTERN BROKERS AND ADMINISTRATORS P O BOX 1268 TIFTON GA 31794
Y88 SOUTHEASTERN INDIANA HEALTH OPERATIONS INC P.O. BOX 1787 COLUMBUS IN 47202-1787
Z75 SOUTHERN BENEFITS SERVICE P.O. BOX 2568 BIRMINGHAM AL 35202-2568
CD7 SOUTHERN CA PIPETRADES TRU 501 SHATTO PLACE 5TH FLOOR LOS ANGELES CA 90020
* - 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 107
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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X51 SOUTHERN COUNCIL INDUSTRIAL WORKERS P O BOX 249 STAMPS AR 71860
IM* SOUTHERN COUNCIL OF IND P O BOX 1984 1212 8TH AVE SOUTH NASHVILLE TN 37202
DL2 SOUTHERN COUNCIL OF IND WKRS HEALTH WELFARE FUND 333 WEST VINE ST STE 600 LEXINGTON KY 40507-1627
CH8 SOUTHERN COUNCIL OF IND WO P.O. BOX 3262 CHARLESTON WV 25332
BM3 SOUTHERN ELECTRICAL HEALTH 3928 VOLUNTEER DRIVE CHATTANOOGA TN 37416
CH9 SOUTHERN FARM BUREAU LIFE P O BOX 78 JACKSON MS 39205
D71 SOUTHERN FARMERS ASSOC 310 EXECUTIVE COURT LITTLE ROCK AR 72205
N76 SOUTHERN GUARANTY IN CO P O BOX 235004 MONTGOMERY AL 36123-5004
EW9 SOUTHERN HEALTH PLAN MEDICAL CLAIMS P O BOX 97 MEMPHIS TN 38101-0097
H38 SOUTHERN HEALTH PLAN INC DENTAL CLAIMS P O BOX 120 MEMPHIS TN 38101
U88 SOUTHERN INS MGMT ASSOCIATION P O BOX 2469 TUSCALOOSA AL 35403
F12 SOUTHERN INSURANCE AGENCY PO BOX 32784 SAN ANTONIO TX 78216
F16 SOUTHERN LIFE AND HEALTH I P O BOX 671 BIRMINGHAM AL 35201
H1* SOUTHERN LIFE HEALTH 269 NORTH FREESTATE BLVD SHREVEPORT LA 71107
0P2 SOUTHERN MILK SALES INC TRUST P O BOX 32784 SAN ANTONIO TX 78216
HL6 SOUTHERN NATIONAL LIFE P.O. BOX 98044 BATON ROUGE LA 70989-9044
J08 SOUTHLAND BENEFITS SOLUTIO P O BOX 1250 TUSCALOOSA AL 35403
R37 SOUTHLAND LIFE INC P O BOX 105006 ATLANTA GA 30348-5006
AC1 SOUTHWEST ADMINISTRATORS P O BOX 1121 ALHAMBRA CA 91802-1121
R70 SOUTHWEST AR RURAL ELECTRIC COOP P O BOX 1807 TEXARKANA AR 75504
ZX* SOUTHWEST BENEFIT HEALTH P O BOX 458 18003327772 WEST LONG BRANCH NJ 07764
RA* SOUTHWEST CO LIFE INS 2600 CITADEL DRIVE SUITE 106 HOUSTON TX 77008
EH3 SOUTHWEST EMPLOYEE BENEFIT DENTAL CLAIMS P O BOX 30668 ALBUQUERQUE NM 87190-0668
J33 SOUTHWEST ENERGY CO BENEFITS SECTION P.O. BOX 1408 FAYETTEVILLE AR 72702
AM2 SOUTHWEST NAHRO MEDICAL PLAN P.O. BOX 542814 DALLAS TX 75354
N34 SOUTHWEST PARTNERS HEALTH 3310 LIVE OAK SUITE 300 DALLAS TX 75204
GV6 SOUTHWEST SERVICE ADMINIST 4775 INDIAN SCHOOL RD NE SUITE 105 ALBUQUERQUE NM 87110
CN9 SOUTHWESTERN ELECTRIC POWE INSURANCE DEPT BOX 21106 SHREVEPORT LA 71156
H39 SOUTHWESTERN GLASS DRAWER Z VAN BUREN AR 72956
YT* SOUTHWESTERN LIFE INSURANCE COMPANY P O BOX 2699 DALLAS TX 75221
CI1 SOUTHWIRE AND AFFILIATES EMPLOYEES BENEFIT PLAN 1400 SOUTHWIRE DRIVE OSCEOLA AR 72370
DM2 SOUTHWIRE CO P O BOX 1000 CARROLLTON GA 30119-0001
B4* SOUTHWIRE SPECIALTIES MEDICAL BENEFITS OFFICE P O BOX 643 OSCEOLA AR 72370
FO8 SPARKS PRIMARY CARE PO BOX 17006 FORT SMITH AR 72917-7006
AZ9 SPECIALTY BENEFITS 7830 STATE LINE ROAD SUITE 201 PRAIRIE VILLAGE KS 66208
* - 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 108
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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F72 SPECIALTY OIL CO INC P O BOX 8098 SHREVEPORT LA 71148
HJ5 SPECTERA VISION CLAIMS P O BOX 30978 SALT LAKE CITY UT 84130
FT3 SPECTRUM RISK MGMT SERV 6 EXECUTIVE DR SUITE 1 FAIRVIEW HEIGHTS IL 62208
L75 SPERRY VICKERS 400 LINCOLN SEARCY AR 72143
HH7 SPX BENEFITS SERVICE CENTER PO BOX 57325 JACKSONVILLE FL 32241-7325
FL6 SRC AMERICORPS PO BOX 23907 COLUMBIA SC 29224-3907
M37 SRC SERVICES INC P O BOX 23759 COLUMBIA SC 29224
FK6 SRT ADMINISTRATORS INC PO BOX 25160 SCOTTSDALE AZ 85255-0102
L91 ST EDWARDS HOSPITAL 7301 ROGERS FORT SMITH AR 72903
BO3 ST FRANCIS HOSPITAL GROUP HEALTH DEPT P O BOX 706161 TULSA OK 74170-6161
BC6 ST JOHN MEDICAL CENTER C/O COMPMED 1923 SOUTH UTICA TULSA OK 74104
GI6 ST JOHNS HEALTH CLAIMS ADM P O BOX 14409 SPRINGFIELD MO 65814
FH9 ST MARYS HEALTH FIRST 1155 WEST 4TH STE 121 RENO NV 89503
HI* ST PAUL FIRE MARINE INS 385 WASHINGTON ST ST PAUL MN 55102
B20 ST PAUL MERCURY INS CO 108 NORTH SHACKLEFORD LITTLE ROCK AR 72211
TP* ST PAUL PROPERTY LIABILITY ALLISON INSURANCE P O BOX 15018 NORTH LITTLE ROCK AR 72116
EA6 STANDARD INSURANCE CO GROUP DENTAL INS P O BOX 209 PORTLAND OR 97207-0209
I88 STANDARD LIFE AND ACCIDENT P O BOX 1800 GALVESTON TX 77553-1800
V25 STANDARD MOTOR PROD 3718 NORTHERN BLVD DEPT F 10 LONG ISLAND NY 11101
N87 STANDARD WELDERS SUPPLY EMPOLYEE HEALTH CARE PLAN 363 WALNUT POBOX 490 MEMPHIS TN 38101
DH5 STAR ADMINISTRATIVE SERVIC PO BOX 30870 PHOENIX AZ 85046
DP7 STAR ADMINISTRATIVE SERVIC P O BOX 55270 PHOENIX AZ 85078-5270
DW4 STAR BRIDGE SICKNESS AND ACCIDENT 3404 W CHERYL DR STE 281 PHOENIX AZ 85051
HA4 STAR HRG P O BOX 54150 PHOENIX AZ 85078
FC7 STARMARK P O BOX 787 BRENTWOOD TN 37024
FA1 STARMARK VOLUNTARY DENTAL PLAN P O BOX 420 FREEPORT IL 61032
FN9 STARMARK PO BOX 2942 CLINTON IA 52733-2942
AY8 STARMARK INSURANCE P O BOX 7922 LAKE FOREST IL 60045-7922
HL8 STARMOUNT LIFE INS CO 7800 OFFICE PARK BLVD PO BOX 98100 BATON ROUGE LA 70898-9100
IJ7 STARR INDEMNITY AND LIABIL P O BOX 21575 EAGAN MN 55121
E12 STATE FARM 4121 JFK BLVD NORTH LITTLE ROCK AR 72116
X47 STATE FARM P O BOX 10279 SCOTTDALE AZ 85271-0279
T8* STATE FARM 515 N MISSOURI P O BOX 1456 WEST MEMPHIS AR 72301
T64 STATE FARM 218 PINE BLUFF ST MALVERN AR 72104
S27 STATE FARM P O BOX 275 MCGEHEE AR 71654
* - 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 109
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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OP* STATE FARM 2429 WEST 28TH STREET PINE BLUFF AR 71602
Q43 STATE FARM 1796 N FALLS BLVD WYNNE AR 72396
P87 STATE FARM PO BOX 516 FORDYCE AR 71742
K20 STATE FARM P O BOX 556 ARKADELPHIA AR 71923
K19 STATE FARM 2917 KING JONESBORO AR 72401
K11 STATE FARM P O BOX 1432 FAYETTEVILLE AR 72702
AN7 STATE FARM 8900 AMBERGLEN 15129184862 AUSTIN TX 78729
J91 STATE FARM HEALTH INS P O BOX 490 GREENWOOD AR 72936
Q94 STATE FARM HEALTH INS P O BOX 820 MOUNTAIN HOME AR 72653
Q56 STATE FARM HEALTH INS 103 W MAIN ST PRESCOTT AR 71857
UD* STATE FARM INS MID SOUTH OFFICE 22 STATE FARM DRIVE MONROE LA 71208
F46 STATE FARM INS POBOX 1062 BENTON AR 72015
BK5 STATE FARM INS P. O. BOX 87 DANVILLE AR 72833
DM5 STATE FARM INS JIM BOYETTE AGENT P O BOX 774 CAMDEN AR 71701
A58 STATE FARM INS CO P O BOX 569 HEBER SPRINGS AR 72543
AF4 STATE FARM INS CO MID SOUTH OFFICE P O BOX 1221 HOT SPRINGS AR 71902
DW* STATE FARM INS CO 205 PINE CROSSETT AR 71635
Z99 STATE FARM INS CO 1305 ARKANSAS BOULEVARD SUITE 101 TEXARKANA AR 75502
NE* STATE FARM INSURANCE GROUP MEDICAL DIVISION P O BOX 2700 BLOOMINGTON IL 61702-2700
FN6 STATE FARM INSURANCE PO BOX 2978 CLINTON IA 52733-2978
IK3 STATE FARM INSURANCE 1512 HIGHWAY 675 SUITE E POCAHONTAS AR 72455
DC6 STATE FARM INSURANCE PO BOX 11107 FORT SMITH AR 72917-1107
B68 STATE FARM INSURANCE 5 LAKE SHORE DRIVE LAKE VILLAGE AR 71653
B13 STATE FARM INSURANCE CO COURT HOUSE SQUARE TRENTON GA 30752
Z9* STATE FARM INSURANCE CO PO BOX 1471 HOPE AR 71801
S10 STATE FARM INSURANCE CO P O BOX 546 EL DORADO AR 00000
JQ* STATE FARM MUTUAL 1327 AIRPORT RD HOT SPRINGS AR 71901
B67 STATE FARM MUTUAL PO BOX 2696 WEST HELENA AR 72390
B33 STATE FARM MUTUAL GENERAL DELIVERY VAN BUREN AR 72956
FO3 STATE FARM MUTUAL AUTOMOBI INSURANCE COMPANY PO BOX 339403 GREELEY CO 80633-8403
L13 STATE FARM NOEL WILLIAMS WALKER STREET GREENVILLE MS 38701
BO6 STATE GENERAL LIFE INSURAN 115 W 7TH STREET FORT WORTH TX 76102
A82 STATE MERIT SYSTEMS HEALTH BENEFIT SERVICE PO BOX 38342 ATLANTA GA 30334
C21 STATE MUTUAL ONE STATE MUTUAL DR P O BOX 153 ROME GA 30162-0153
FI4 STATE MUTUAL CLAIMS PROCES 1 877 872 5500 P O BOX 10811 CLEARWATER FL 33757-8811
* - 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 110
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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A60 STATE MUTUAL INSURANCE CO 4828 LOOP CENTRAL DRIVE SUITE 560 HOUSTON TX 77081
FJ3 STATE MUTUAL INSURANCE COM PO BOX 10811 CLEARWATER FL 33757-8811
F2* STATE MUTUAL LIFE ASSURANCE CO OF AMERICA WORCESTER MA 01600
K2* STATE MUTUAL LIFE ASSURANCE P O BOX 13029 ST PETERSBURG FL 33733
I33 STATE MUTUAL LIFE ASSURANC GROUP CLAIM ADMIN 1030 15TH ST NW STE200 WASHINGTON DC 20005
G1* STATE MUTUAL UNIFORM PRINTING SUPPLY 7460 NORTH LEHIGH AVE NILES IL 60648
ZU* STATE OF LOUISIANA GROUP INSURANCE SECTION BOX 44036 BATON ROUGE LA 70804
E4* STATE OF NORTH CAROLINA COMPREHENSIVE HEALTH BENEFIT RALEIGH NC 27600
G34 STATE OF OKLAHOMA GROUP INSURANCE PO BOX 24870 OKLAHOMA CITY OK 73124
DL8 STATELINE TPA INC P O BOX 1777 TOLEDO OH 43603-1777
C80 STATESMAN NATL INS CO 4701 W GATE BLVD STE A102 AUSTIN TX 78745-1479
Y89 STATESMANS LIFE INSURANCE P.O. BOX 2526 MONROE LA 71207
UL* STEAMFITTER LOCAL UNION 614 3746 JACKSON AVE MEMPHIS AVENUE TN 38108
BQ8 STEDMAN INSURANCE GROUP COOPER CLINIC HEALTH CARE 1360 WHITFIELD AVE SARASOTA FL 34243
HC7 STERLING INVESTORS LIFE IN P.O. BOX 10844 CLEARWATER FL 33757-8844
GM5 STERLING OPTION ONE P O BOX 69314 HARRISBURG PA 17106
FA2 STERLING PREMIER PO BOX 5348 BELLINGHAM WA 98227
CN2 STEVENS INDUSTRIES INC 1734 GELSINN LANE FENTON MO 63026
AW9 STEWART AND STEVENSON ATTN INSURANCE CLAIMS 4516 HARRISBURG BLVD HOUSTON TX 77011
T63 STEWART KANE INS INC 11300 N RODNEY PARHAM 222 LITTLE ROCK AR 72212
I08 STM CLAIMS DEPARTMENT P O BOX 21456 EAGEN MN 55121-0456
HU7 STONEBRIDGE PO BOX 30567 SALT LAKE CITY UT 84130-0567
BN2 STONEBRIDGE LIFE INS CO 2700 W PLANO PARKWAY PO BOX 869090 PLANO TX 75086
J93 STORAGE TEK CLORADO GROUP P O BOX 378710 DENVER CO 80237
H05 STOWE ASSOCIATES 2951 FLOWERS RD STE 217 ATLANTA GA 30341
BH4 STOWE ASSOCIATES 3084 MERCURY AVE STE 210 ATLANTA GA 30341
GE1 STRATEGIC OUTSOURCING INC PO BOX 241508 CHARLOTTE NC 27224
BY6 STRATEGIC RESOURCE CO PIZZA HUT CLAIMS P O BOX 23759 COLUMBIA SC 29224-3759
FQ1 STUDENT ASSURANCE SERVICE P O BOX 196 STILLWATER MN 55082
HD7 STUDENT INSURANCE P O BOX 809027 DALLAS TX 75380-9027
CQ3 STUDENT PLANS INC P O BOX 1390 WHEATON IL 60189-1390
N77 SUBURBAN TEAMSTERS OF NORTHERN IL WELFARE FUND 1000 NE 1 55 FRONTAGE JOLIET IL 60435
GL7 SUMMACARE PO BOX 3620 AKRON OH 44309
CI4 SUN HEALTH GROUP 5131 MOSTHEAD NE ALBUQUERQUE NM 87109
AH7 SUNBEAN OUTDOOR PRODUCTS 1600 JONES ROAD PARAGOULD AR 72450
* - 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 111
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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E80 SUNDERBRUCH CORP SUITE 1850 1034 S BRENTWOOD BLVD ST LOUIS MO 63117
HT0 SUNLIFE FINANCIAL PO BOX 81633 WELLESLEY HILLS MA 02481
F70 SUNMARK INC ONE FINANCIAL CTR STE 141 650 S SHACKLEFORD RD LITTLE ROCK AR 72211
G68 SUNNYFRESH INS CO P O BOX 40 LINCOLN AR 72744
E44 SUNSTRAND COPR GROUP BENEF 3007 HARRISON AVE ROCKFORD IL 61102
HN7 SUPERIEN HEALTH NETWORK PO BOX 2388 STOW OH 44224
K14 SUPERIOR 7800 WOODLEY AVENUE VAN NUYS CA 91406
DO3 SUPERIOR FEDERAL BANK TRUST FOR DESIREA BARTLET 1104 BROADWAY VAN BUREN AR 72956
BJ1 SUPERIOR FEDERAL BANK P O BOX 17012 FORT SMITH AR 72917
X48 SUPERIOR GRAPHITE CO CNA 3225 DOW DR RUSSELLVILLE AR 72801
V17 SUPERIOR GRAPHITE CO 120 SOUTH RIVERSIDE PLAZA CHICAGO IL 60606
GN2 SUPERIOR HELATH PLAN PO BOX 3003 FARMINGTON MO 63640
I85 SUPERIOR INDUSTRIES INTERNATIONAL INC 7800 WOODLEY AVE VAN NUYS CA 91406
Z76 SUPERIOR INSURANCE FORMERLY TAYSON INS ADMIN 3741 MERCED DR STE K RIVERSIDE CA 92503
UJ* SUPERIOR INSURANCE CO 3741 MERCED DRIVE SUITE K RIVERSIDE CA 92503-4974
J99 SUPERIOR SURGICAL MFG 100 2ND AVE SOUTH 11TH FL ST PETERSBURG FL 33701
HP3 SUPERIOR VISION PO BOX 967 RANCHO CORDOVA CA 95741
U55 SUPERMARKET EMPLOYEES BENEFIT PLAN P O BOX 14970 SHAWNEE MISSION KS 66215
T10 SUSQUEHANNA ADMIN INC P O BOX 1523 LANCASTER PA 17603
S52 SUTTER PREFERRED HEALTH P O BOX 162287 SACRAMENT CA 95816
IE9 SW CARPENTERS NV HEALTH AND WELFARE PO BOX 17973 LOS ANGELES CA 90017-0973
U8* SW GENERAL LIFE INSURANCE PO BOX 10575 LYNCHBURG VA 24506-0575
M95 SWADC P O BOX 450 TEXARKANA TX 75504
N14 SWEPCO P O BOX 1328 FAYETTEVILLE AR 72702
H04 SXC HEALTH SOLUTIONS CORP 2441 WARRENVILLE ROAD SUITE 610 LISLE IL 60532-3101
H02 SYMETRA SELECT BENEFIT ADM PO BOX 440 ASHLAND WI 54806
G51 SYNCOR ADMINISTRATIVE SERV 3000 WEST DUNDEE ROAD PO BOX 1327 NORTHBROOK IL 60065
YK* SYNERGY GROUP 175 PRICE PARKWAY FARMINGDALE NY 11735
DU7 SYSTEM ELECTR INC SOUTHWEST MOBILE SEI BOX 196 THORNBG/MCDANIEL WEST PLAINS MO 65775
A68 SYSTEMATIC HEALTH CARE PLA 4001 N RODNEY PARHAM RD LITTLE ROCK AR 72212
J18 T AND D METAL PRODUCTS INC EAST WALNUT STREET WATSEKA IL 60970
DR3 T H ROGERS LUMBER CO P O BOX 5770 EDMUND OK 73083-5770
N96 T L JAMES CO P O BOX 1260 RUSTON LA 71273-1260
DY4 T M G LIFE INS CO 2800 DAUPHIN ST P O BOX 6548 MOBILE AL 36606-0548
L82 T N ELECTRIC CO 5800 EVERGREEN SUITE 101 LITTLE ROCK AR 72205
* - 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 112
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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Q46 TABER BROKERAGE SERV INC 519 NW 9TH STREET OKLAHOMA CITY OK 73102
L17 TANDYCRAFTS INC P O BOX 2903 FORT WORTH TX 76113
E92 TANG INDUSTRIES 1965 PRATT BLVD ELK GROVE VILLAGE IL 60007
AO2 TARGET BENEFIT SERVICES P.O. BOX 869041 DEPT 198 PLANO TX 75086
JA2 TAYLOR BENEFIT RESOURCE P O BOX 6580 THOMASVILLE GA 31758
AJ* TBG USA INC P O BOX 5383 PARSIPPANY NJ 07054
DD4 TDI MANAGED CARE P O BOX 2860 PITTSBURG PA 15230
D80 TEACHERS RETIREMENT SYSTEM OF KENTUCKY 216 W MAIN ST FRANKFORT KY 40601
HH3 TEAM ELECTRIC INC 1455 SOUTH LIPAN STREET DENVER CO 80223-3005
AS9 TEAMSTER UNION LOCAL 815 467 SYLVAN AVENUE ENGLEWOOD CLIFFS NJ 06632
M78 TEAMSTERS JOINT COUNCIL 8814 FARGO ROAD RICHMOND VA 23229
F18 TEAMSTERS LOCAL 627 4201 TEAMSTERS DRIVE PEORIA IL 61614
D54 TEAMSTERS MEDICARE TRUST 300 SOUTH GRAND ST LOUIS MO 63103
J2* TEAMSTERS 667 796 EAST BROOKS AVENUE MEMPHIS TN 38116
C37 TEMPLE EASTEX 540 EAST BARTON ST WEST MEMPHIS AR 72301
J3* TENNECO AUTOMOTIVE BENEFIT PROGRAM 4625 WASHINGTON AVE RACINE WI 53405
U75 TENNESSEE HEALTH CARE NETW 51 STONEBRIDGE BLVD JACKSON TN 38305
BL4 TENNESSEE HEALTH PARTNERS PO BOX 3490 JACKSON TN 38303-3490
C62 TENNESSEE NATIONAL 1201 W 8TH LITTLE ROCK AR 72203
M50 TERRA INTERNATIONAL INC 600 4TH STREET SIOUX CITY IA 51101
FC6 TETCO EMPLOYEE BENEFIT PLA P O BOX 171720 SAN ANTONIO TX 78217
L11 TEXANA TANK CAR MFG INC P O BOX 550 NASH TX 75569
M61 TEXAS GAS TRANSMISSION COR P O BOX 1160 OWENSBORO KY 43302
FM6 TEXAS IMPERIAL LIFE INSURA PO BOX 42813 HOUSTON TX 77242-2813
HJ8 TEXAS INTERNATINAL LIFE IN CITIZENS NATIONAL LIFE IN PO BOX 11007 WINSTON SALEM NC 27116
I92 TEXAS NATIONAL GROUP ADMIN P.O. BOX 820923 HOUSTON TX 77282-0929
Q22 TEXAS NEW MEXICO POWER CO PO BOX 433 FORT WORTH TX 76634
I36 TEXAS OIL MARKETERS ASSC TRUST AND WELFARE PLAN 701 WEST 15TH STREET AUSTIN TX 78701
Q82 TEXAS PIPE TRADE HEALTH BENEFIT FUND, SUITE 210 11910 GREENVILLE AV DALLAS TX 75243
UE* TEXAS PIPE TRADES HEALTH BENFIT FUND P O BOX 860037 PLANO TX 75086-0037
HP6 TEXAS TRUE CHOICE PO BOX 250089 PLANO TX 75025
M26 TEXTRON P O BOX 38813 AUGUSTA GA 30913
AX5 TFE MEDICAL SYSTEMS 3665 WHEELER RD SUITE 101 AUGUSTA GA 30909-6510
IB9 THE BRAD HENDRICKS LAW FIR 500 C PLESANT VALLEY DR LITTLE ROCK AR 72227
TD* THE BRINKLEY COMPANY P O BOX 80817 INDIANAPOLIS IN 46280
* - 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 113
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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TE* THE EATON BENEFITS OFFICE P O BOX 2900 CORAOPOLIS PA 15108
TB* THE GATE GROUP P O BOX 8219 LITTLE ROCK AR 72221
HB9 THE HEALTH PLAN GROUP M PLAN 8802 NORTH MERIDAN ST INDIANAPOLIS IN 46260
AQ7 THE INSURANCE CENTER 321 EAST 4TH JOSLIN MO 64801
I03 THE LINCOLN NATIONAL LIFE DENTAL CLAIMS INPUT CTR P O BOX 2640 OMAHA NE 68103-2640
GO2 THE LOOMIS COMPANY PO BOX 13814 READING PA 19612
GM7 THE LOOMIS COMPANY P O BOX 7011 WYOMISSING PA 19610-6011
GX4 THE MAIL HANDLERS BENEFIT P O BOX 8402 LONDON KY 40742
FN3 THE ONE BENEFIT SOURCE PO BOX 2775 ELKHART IN 46515
IJ3 THE TENNESSEE PLAN GOVERNMENT RETIREE PO BOX 118 SYRACUSE NY 13206
D2* THIRD PARTY ADMINISTRATORS 1919 S SHILOH SUITE 500 GARLAND TX 75042
EL2 THIRD PARTY CLAIM MGMT P O BOX 268814 OKLAHOMA CITY OK 73126-8814
EL1 THIRD PARTY CLAIM MGMT P O BOX 268820 OKLAHOMA CITY OK 73126-8820
AM4 THORNAPPLE VALLEY INC 26999 CENTRAL PARK BLVD SUITE 300 SOUTHFIELD MI 48076
HR9 THREE RIVERS BENEFIT CORP PO BOX 3440 SIOUX CITY IA 57101
DX4 THURSTON CO BLUE SHIELD P O BOX 91048 SEATTLE WA 98111
K8* TIDELANDS LIFE INS CO P O BOX 2991 FORT WORTH TX 76100
X24 TIGG 2549 PANGBURN ROAD HEBER SPRINGS AR 72543
GP2 TIME INSURANCE COMPANY FOR ASSURANT HEALTH PO BOX 42033 HAZELWOOD MO 63042
V26 TOLLIE FREIGHTWAYS INC 1020 SUNSHINE RD KANSA CITY KS 66115
P85 TOMA TRUST 701W 15 STREET AUSTIN TX 78701-1599
M91 TOMFORD INS ADMIN 21032 DEVONSHIRE SUITE202 CHANTSWORTH CA 91311
EC5 TOTAL BENEFIT SERVICES P O BOX 30180 NEW ORLEANS LA 70190
GO8 TOTAL CLAIMS SOLUTION TCS PO BOX 10888 GREEN BAY WI 54307
F85 TOTAL GROUP SERVICES INC P O BOX 1687 GRAND RAPIDS MI 49501
EX7 TOTAL PLAN ADM TPA LIFE OF THE SOUTH P O BOX 12288 COLUMBUS GA 31907
GW3 TOTAL PLAN SERVICES 14001 DALLAS PKWY NORTH SUITE 700 DALLAS TX 75240
X72 TOTAL PROGRAM ADMINISTRATORS P O BOX C85012 RICHMOND VA 23261-5012
G82 TOTAL PROGRAM ADMINISTATOR WORRELL ENTERPRISE INC PO BOX C32011 RICHMOND VA 23200
S93 TOWER LIFE INS CO P O BOX 21130 SAN ANTONIO TX 78221-0130
H31 TOWNSEND LIFE ASSOCIATES I 18 N 6TH ST PO BOX 2210 HAINES CITY FL 33844
H49 TOY R US 2501MCKENIZE DR CAROLLTON TX 75006
DK2 TPA PO BOX 320 PUEBLO CO 81002-0320
RI* TPA PO BOX 52125 PHOENIX AZ 85072
DC* TPA 5214 MARYLAND WAY SUITE 207 BRENTWOOD TN 37027
* - 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 114
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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I37 TPA MICHIGAN 5455 CORPORATR DRIVE TROY MI 48098
CT2 TPA OF FLORIDA P O BOX 121212 MARIETTA GA 30067-0092
Q52 TPA OF PENNSYLVANIA INC PO BOX 1127 BLUE BELL PA 19422
AV8 TPA PLAN ADMINISTRATORS P.O. BOX 901066 FORT WORTH TX 76101
DB4 TR PAUL GROUP SERVICES 14 COMMERCE ROAD NEWTOWN CT 06470
BF1 TRACKER MARINE 1935C. S. CAMPBELL SPRINGFIELD MO 65898
D5* TRACOR MBA P O BOX 3297 CAMDEN AR 71701
A13 TRANAMERICA OCCIDENTAL CO 10300 NO CEN EXPRESSWAY DALLAS TX 75231
K90 TRANS AMERICA FORMERLY AEGON USA PO BOX 8063 LITTLE ROCK AR 72203
LM* TRANS AMERICAN INDIVIDUAL HEALTH CLAIMS 1600 WORTHERN BANK BLDG LITTLE ROCK AR 72201
Z77 TRANS STATE LINES INC ATTN HEALTH CLAIMS DIV P.O. BOX 17011 FT SMITH AR 72917
S6* TRANSAMERICA ACCIDENTAL LI 1400 CENTERVIEW DRIVE LITTLE ROCK AR 72211
W10 TRANSAMERICA OCCIDENTAL LIFE P O BOX 5803 ROCKFORD IL 61125-0803
EV3 TRANSAMERICA OCCIDENTAL LIFE INSURANCE CO P O BOX 2101 LOS ANGELES CA 90051-0101
E52 TRANSAMERICA OCCIDENTAL ABT TOWERS P O BOX 1558 HOT SPRINGS AR 71902
E8* TRANSCONTINENTAL ENERGY CO GROUP INSURANCE COMPANY P O BOX 21568 SHREVEPORT LA 71120
S80 TRANSPORT CO INC P O BOX 190625 LITTLE ROCK AR 00000
J31 TRANSPORT COMPANY HIGHWAY 15 SOUTH EL DORADO AR 71730
C2* TRANSPORT LIFE INSURANCE P O BOX 66953 CHICAGO IL 60666-0953
EB1 TRAVELERS CONSOLIDATED GROUP 110000 P O BOX 2070 NASHUA NH 03061
RG* TRAVELERS 3316 FARNAM STREET OMAHA NE 68175
NY* TRAVELERS METRA HEALTH GROUP HEALTH ONE MERCANTILE TOWER ST LOUIS MO 63101
PO* TRAVELERS METRAHEALTH 6435 CASTLEWAY DRIVE P O BOX 50863 INDIANAPOLIS IN 46250
OB* TRAVELERS METRAHEALTH 600 CITY PARKWAY WEST P O BOX 5170 ORANGE CA 92667
I48 TRAVELERS METRAHEALTH 1701 CENTERVIEW LITTLE ROCK AR 72221
G86 TRAVELERS METRAHEALTH OF ILLINOIS INC P O BOX 7045 ROCKFORD IL 61126-7045
R62 TRAVELERS METRAHEALTH OF ILLINOIS 929 SI ALPINE RD ROCKFORD IL 61108
R21 TRAVELERS METRAHEALTH P O BOX 22545 JACKSON MS 39225-2545
S68 TRAVELERS METRAHEALTH SOUTHWESTERN ENERGY CO P O BOX 1408 FAYETTEVILLE AR 72702-1408
W63 TRAVELERS METRAHEALTH P O BOX 59049 MINNEAPOLIS MN 55459-0049
Z44 TRAVELERS METRAHEALTH P.O. BOX 660451 DALLAS TX 75266
Y35 TRAVELERS METRAHEALTH 1901 N ROSELLE RD STE 600 SCHAUMBURG IL 60195
DF8 TRAVELERS METRAHEALTH 500 GRANT STREET PITTSBURG PA 15219
DF6 TRAVELERS METRAHEALTH 7090 SOUTH UNION PARK AVE MIDVALE UT 84047
FR* TRAVELERS METRAHEALTH 4 GREENWAY PLAZA EAST HOUSTON TX 77046
* - 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 115
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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E19 TRAVELERS METRAHEALTH P O BOX 5472 ALEXANDRIA LA 71301
AT1 TRAVELERS METRAHEALTH P.O. BOX 660457 DALLAS TX 75266
BC8 TRAVELERS METRAHEALTH GENERAL BOARD OF PENSIONS P O BOX 19896 MATTESON IL 60443-1989
A71 TRAVELERS METRAHEALTH JAMESTOWN OFFICE PARK 3035 NW 63RD STREET OKLAHOMA CITY OK 73187
A14 TRAVELERS METRAHEALTH EMPLOYEE BENEFITS CLAIMS P O BOX 7579 GREENSBORO NC 27417-0579
B93 TRAVELERS METRAHEALTH P O BOX 26426 RICHMOND VA 23261
BX* TRAVELERS METRAHEALTH 6750 POPLAR P O BOX 171812 MEMPHIS TN 38187
BU9 TRAVELERS METRAHEALTH C/O COOK COMMUNICATIONS P.O. BOX 1017037 PHOENIX AZ 85064
VQ* TRAVELERS MOTOR CLUB 720 N W 50TH P O BOX 54799 OKLAHOMA CITY OK 73154
EZ7 TRAVELERS PROTECTIVE ASSOC RAY ROBERTSON 3755 LINDELL BLVD ST LOUIS MO 63108-3476
DP3 TRI STATE ARMATURE AND ELECTRICAL WORKS INC P O BOX 466 MEMPHIS TN 38101
CY4 TRIAD EMPLOYESS HEALTH AND DENTAL PLAN P O BOX 965 MCALESTER OK 74501
M33 TRIANGLE INS AGENCY 106 SOUTH OAK SHERIDAN AR 72150
CO9 TRIANGLE PACIFIC 4040 MCEWEN SUITE 100 DALLAS TX 75244
J09 TRIBUTE HEALTH PLAN OF AR 1401 W CAPITOL AVE, SUITE 430 LITTLE ROCK AR 72201
H06 TRIDENT PLAN ADMINISTRATOR 3825 N 24TH STREET PHOENIX AZ 85016
BU7 TRIGON ADMINISTRATORS P O BOX C85016 RICHMOND VA 23261-5016
H85 TRINITY INDUSTRIES P O BOX 569640 DALLAS TX 75356-9640
CW4 TRISM BENEFITS P O BOX 163930 DEPT 55 AUSTIN TX 78716
AM5 TRISM BENEFITS INFORMATION CENTER P O BOX 9000 KENNESAW GA 30144
W89 TROA MEDIPLUS P O BOX 9126 DES MOINES IA 50398-9126
GB3 TRUE CHOICE USA PO BOX 251369 PLANO TX 75025
L59 TRUST ACCOUNT TRUSTEE STEVEN ALLEN P O BOX 1276 LITTLE ROCK AR 72203
GG3 TRUSTEED PLAN PO BOX 1894 TACOMA WA 98401
BF9 TRUSTMARK P O BOX 7909 LAKE FOREST IL 60045
FV1 TRUSTMARK INS CO PO BOX 2942 CLINTON IA 52733
FQ5 TRUSTMARK INSURANCE CO PO BOX 7900 LAKE FOREST IL 60045
CY5 TRUSTMARK INSURANCE CO PO BOX 9055 BOARDMAN OH 44513-0055
I8* TRYCO INSURANCE CO 5231 BELLAIRE CO BOX 550 BELLAIRE TX 77401
G71 TUCKER AND CLARK P O BOX 802516 DALLAS TX 75380
BL7 TUFFS TOTAL HEALTH PLAN 333 WYMAN STREET P O BOX 9094 WALTHAM MA 02254-9094
ID6 TUFTS HEALTH PLAN 333 WYMAN STREET WALTHAM MA 02451-1209
HD1 TX TEACHERS RETIRE 1000 RED RIVER STREET AUSTIN TX 78701-2698
GM* TYSON FOODS ATTN CP501 P O BOX 2020 SPRINGDALE AR 72765-2020
H79 U P S PROGRAM 51 WEAVER ST GREENWICH OFFICE PARK 5 GREENWICH CT 06836
* - 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 116
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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YG* U S FIDELITY AND GUARANTY 1 SHACKLEFORD ROAD P O BOX 5880 LITTLE ROCK AR 72215
X1* U S FIDELITY AND GUARANTY 4120 ROGERS AVE SUITE B P O BOX 5286 FORT SMITH AR 72913
N30 U S ADMINISTRATORS P O BOX 9125 VAN NUYS CA 91409-9125
D97 U S BENEFITS P O BOX 40747 MEMPHIS TN 38174-0747
L20 U S GUARDIAN HEALTH SUITE 200 15280 ADDISON ROAD DALLAS TX 75248
E25 U S LIFE INSURANCE CO 125 MARDEN LANE NEW YORK NY 10038
P71 U S OFFICE OF PERSONNEL MG RETIREMENT PROGRAMS WASHINGTON DC 20415
V1* UARCO CLAIM OFFICE P O BOX 1950 BARRINGTON IL 60011-1950
CO1 UAW CLAIMS DEPARTMENT P O BOX 7051 BLOOMFIELD HILLS MI 48302-7051
DW3 UAW LOCAL 6519 WM C BEELER AND CO P O BOX 1439 HENDERSONVILLE TN 37077
BA1 UBH CLAIMS PO BOX 659745 ROUTE 2007 SAN ANTONIO TX 78265
FO6 UCFW UNIONS AND FOOD EMPLOYERS BENEFIT FUND PO BOX 6010 CYPRESS CA 90630-0010
IL6 UFAC P O BOX 1526 DUNCAN OK 73534-1526
GO4 UFCE LOCAL 1459 ULLICARE P O BOX 61593 KING OF PRUSSIA PA 19406
U44 UFCW AND EMPLOYERS ARIZONA HEALTH 1990 W CAMELBACK RD PHOENIX AZ 85015
RR* UFCW DIST UNIONS EMPLOYEES FUND P O BOX 12506 ATLANTA GA 30315
S19 UFCW HEALTH WELFARE TRUST 12160 ABRAMS, SUITE 201 DALLAS TX 75243
X73 UFCW LOCAL 1529 P O BOX 970 CORDOVA TN 38018-0970
V38 UFCW LOCAL 1583 3218 E HWY 67 MESQUITE TX 75150
CF9 UFCW LOCAL 954 7441 INTERNATIONAL DR P O BOX 967 HOLLAND OH 43528-0967
IA1 UFCW NORTHERN CALIFORNIA 1277 TREAT BOULEVARD 10TH FLOOR WALNUT CREEK CA 94597-8863
ID7 UFCW SOUTHERN CALIFORNIA 6425 KATELLA AVENUE CYPRESS CA 90630-5238
S94 UFCW UNION LOCAL 1525 AND EMP HEALTH WELFARE P O BOX 970 CORDOVA TN 38018-0970
S23 UFCW UNIONS AND EMP MIDWES HEALTH BENEFITS FUND 4858 N SHERIDAN RD CHICAGO IL 60640
W47 UFCW WORKERS UNION AND EMP MIDWEST HEALTH BENEFITS 2200 E SUNSHINE STE 202 SPRINGFIELD MO 65804-1898
CT9 UHC MANAGEMENT COMPANY P O BOX 169055 ROUTE 2702 DULUTH MN 55816-8251
EM2 UHC MEDICA CLAIMS RT 2901 P O BOX 169061 DULUTH MN 55816-8310
JO8 UMR P.O. BOX 30541 SALT LAKE UT 84130-0541
IO9 UMR PO BOX 145804 CINCINNATI OH 45250
IA9 UMR 675 BROOKSEDGE BOULEVARD WESTERVILLE OH 43081
KO* UMR FISER HLTH FORMERLY WAUSAU BENEFITS P O BOX 8013 WAUSAU WI 54402-8013
RM* UMWA HEALTH AND RETIREMENT FUNDS 2021 K STREET WASHINGTON DC 20006
DJ6 UMWA HEALTH RETIREMENT THE FUNDS P O BOX 4410 ALBANY NY 12204-0410
L71 UNC ALTA REVIEW SUITE 750 4 STATION SQUARE PITTSBURGH PA 15219
G50 UNDERWRITER LIFE INS CO 6210 CAMPBELL RD DALLAS TX 75248
* - 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 117
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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BF2 UNDERWRITERS AND ADMINISTR P O BOX 6250 HARRISBURG PA 17112
Q7* UNDERWRITERS NATIONAL ASSURANCE COMPANY 3637 MERIDIAN STREET INDIANAPOLIS IN 46208
S61 UNICARE MASS MUTUAL P O BOX 9088 OXNARD CA 93031-9088
GT3 UNICARE PO BOX 4458 CHICAGO IL 60680-4458
GL5 UNICARE PO BOX 4006 SCHAUMBURG IL 60168-4006
GG6 UNICARE PO BOX 4239 WOODLAND HILLS CA 91365
GF6 UNICARE PO BOX 70000 VAN NUYS CA 91470
GF5 UNICARE PO BOX 833882 RICHARDSON TX 75083
GF4 UNICARE PO BOX 4444 OXNARD CA 93031
GF3 UNICARE PO BOX 4124 WOODLAND HILL CA 91365
BZ9 UNICARE MASS MUTUAL P O BOX 5005 BOLLINGBROOK IL 60440
CS5 UNICARE P O BOX 4061 18003047258 SCHAUMBURG IL 60168-4061
CR6 UNICARE PO BOX 4069 SCHAUMBURG IL 60168-4069
CJ2 UNICARE P O BOX 4005 SCHAUMBERG IL 60168-4005
B29 UNICARE 24650 CENTER RD SUITE 310 WESTLAKE OH 44145
WU* UNICARE PO BOX 5037 BOLINGBROOK IL 60440-5037
Z74 UNICARE SOUTHEAST MEDICAL ALLIANC 111 VETERANS MEM BLVD 500 METAIRIE LA 70005
0U* UNICARE NCR CORPORATION BOX 4050 SCHAUMBURG IL 60188-4050
DX2 UNICARE P O BOX 4054 SCHAUMBERG IL 60168-4054
DO5 UNICARE CARGILL CLAIMS P O BOX 4061 SCHAUMBERG IL 60168
DQ* UNICARE 1295 STATE ST P O BOX 51130 SPRINGFIELD MA 01151
FC1 UNICARE DALLAS SERVICE CENTER P O BOX 833933 RICHARDSON TX 75083-3933
NM* UNICARE HEALTH AND LIFE MEMBERS INSURANCE PROGRAM 203 JANDUS RD CARY IL 60013
GJ6 UNICARE HEALTH PLANS PO BOX 5036 BOLINGBROOK IL 60440-5036
J83 UNICARE HOMES INC 105 WEST MICHIGAN STREET MILWAUKEE WI 53203
J11 UNICARE INSURANCE CO 5171 VERDUGO WAY CAMARILLO CA 93012-8603
OU* UNICARE LIFE AND HEALTH 3820 AMERICAN DRIVE PLANO TX 75075
DO6 UNICARE LIFE AND HEALTH INSURANCE COMPANY PO BOX 833876 RICHARDSON TX 75083
AD8 UNICARE LIFE HEALTH ITT HARTFORD P O BOX 5010 FORT SCOTT KS 66701-5010
Y26 UNICARE MASS MUTUAL 700 VETERANS HWY STE 202 P O BOX 18037 HAUPPAUGE NY 11788
CG9 UNICARE MASS MUTUAL 1 CORPORATE CTR STE 300 1320 WILLOW PASS RD CONCORD CA 94520-5280
BS2 UNICARE MASS MUTUAL REGIONAL SERVICE CENTER BOX 5012 FORT SCOTT KS 66701-5010
BR8 UNICARE MASS MUTUAL GROUP CLAIMS PO BOX 5024 WOODBRIDGE NJ 07095-5024
C22 UNICARE MASS MUTUAL 24650 CENTER RIDGE RD SUITE 310 WESTLAKE OH 44145
C78 UNICARE MASS MUTUAL 315 W PONCE DE LEON P O BOX 100008 DECATUR GA 30031-7008
* - 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 118
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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C9* UNICARE MASS MUTUAL MELTON TRUCK LINES 1925 CENTENARY SHREVEPORT LA 71107
C15 UNICARE MASS MUTUAL 212 LAKESIDE DR HORSHAM PA 19044
OH* UNICARE MASS MUTUAL 1295 STATE STREET SPRINGFIELD MA 01111
MJ* UNICARE MASS MUTUAL VILLAGE WEST OFFICE CTR 3649 WEST 183RD STREET HAZEL CREST IL 60429
Q45 UNICARE MASS MUTUAL 1050 E GARVEY AVE S P O BOX 60004 CITY OF INDUSTRY CA 91716-0041
TZ2 UNIDENTIFIED AT THE TIME 00000
HS2 UNIFIED GROUP SERVICES PO BOX 10 PENDLETON IN 46064
V36 UNIFIED LIFE INSURANCE P O BOX 25326 OVERLAND PARK KS 66225-5326
G97 UNIFIRST CORP HEALTH BENEF 68 JONSBIN RD WILMINGTON MA 01888
GD5 UNION BANKERS PO BOX 13006 PENSACOLA FL 32591
V82 UNION BANKERS 115 HAMMOND DR HOT SPRINGS AR 71913
AD5 UNION BANKERS INSURANCE CO P O BOX 9110 CLEARWATER FL 33758-9110
0R* UNION BANKERS LIFE INS CO P O BOX 655433 DALLAS TX 75265-5433
M84 UNION CAMP P O BOX 14509 SAVANNAH GA 31416
I45 UNION CAMP 730 ENTERPRISE AVE CONWAY AR 72032
H5* UNION CASUALTY CO 100 AQUILA CT OMAHA NE 68102
PB* UNION CENTRAL LIFE INS GENERAL DELIVERY CINCINNATI OH 45203
FJ6 UNION FIDELITY PROCESSING CENTER P O BOX 10841 CLEARWATER FL 33757-8841
J02 UNION FIDELITY LIFE INS CO P O BOX 8121 FT WASHINGTON PA 19034
FV* UNION FIDELITY LIFE INS CO 4850 STREET ROAD TREVOSE PA 19049-0002
E95 UNION LABOR LIFE OAK BRIDGE OFFICE 2607 WEST 22 ST OAK BROOK IL 60521
YV* UNION LABOR LIFE INSURANCE COMPANY 111 MASSACHUSETTS AVE NW WASHINGTON DC 20001
V65 UNION LABOR LIFE INS 395 HUDSON ST NEW YORK NY 10014
VD* UNION LABOR LIFE INS CO 4115 CHESAPEAKE ST NW WASHINGTON DC 20016
I46 UNION LIFE 10401 CONNECTCUT AVE KENSINGTON MD 20895-3960
A50 UNION LIFE INSURANCE AOG P O BOX 2406 FORT SMITH AR 72906
J60 UNION LIFE INSURANCE CO 3415 NEW BOSTON ROAD TEXARKANA TX 75501
R92 UNION LIFE SERVICES CORP GROUP CLAIMS P O BOX 3418 LITTLE ROCK AR 72203-3418
L36 UNION MEDICAL RESOURCES IN 2343 AUBURN AVE CINCINNATI OH 45219
XC* UNION MUTUAL 700 EAST MAIN STREET 700 BLDG SUITE 1525 RICHMOND VA 23219
B1* UNION MUTUAL LIFE INS CO P O BOX 9515 PORTLAND ME 04124
ES8 UNION PACIFIC RAILROAD EMPLOYEE HEALTH SYSTEM PO BOX 161020 SALT LAKE CITY UT 84116-1020
Y5* UNION ROOFERS HLTH AND WEL FUND 9901 PARAMOUNT BLVD DOWREY GA 90240
NP* UNION STANDARD INSURANCE P O BOX 35865 DALLAS TX 75235
FN5 UNIROYAL RETIREE BENEFITS PO BOX 1266 MISHAWAKA IN 46546-1266
* - 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 119
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EG4 UNISYS P O BOX 8090 LINDEN KY 40742-8090
I74 UNISYS CORPORATION P.O. BOX 500 BLUE BELL PA 19424-0001
S96 UNITED AMERICAN INS CO CLAIMS OFFICE P O BOX 26400 OKLAHOMA CITY OK 73126
IM2 UNITED AMERICAN INSURANCE P O BOX 810 DALLAS TX 75221
AH* UNITED AMERICAN INSURANCE P O BOX 8080 MCKINNEY TX 75070-8080
AF7 UNITED ARKANSAS LIFE ASSURANCE COMPANY P O BOX 659531 SAN ANTONIO TX 78265-9537
WJ* UNITED BEHAVIORAL HEALTH PO BOX 169053 DULUTH MN 55816
IN4 UNITED BEHAVIORAL HEALTH P O BOX 30602 SALT LAKE CITY UT 84130
IA8 UNITED BEHAVIORAL HEALTH 425 MARKET STREET 27TH FLOOR SAN FRANCISCO CA 94105
QK* UNITED BEHAVIORAL HEALTH PO BOX 12286 COLUMBUS OH 43218
PJ* UNITED BEHAVIORAL HEALTH PO BOX 23250 OAKLAND CA 94623-0250
G5* UNITED BENEFIT INS CO ALLIED ADMIN SUITE 311 2831 CANINO DEL RIO SO SAN DIEGO CA 92101
EH6 UNITED BENEFIT LIFE 3909 HULEN ST FORT WORTH TX 76107
GX* UNITED BENEFIT LIFE INS DODGE AT 33RD OMAHA NE 68102
MB* UNITED BENEFIT LIFE INS CO P O BOX C34014 SEATTLE WA 98124
DS2 UNITED BENEFIT LIFE INS CO PO BOX 30214 TAMPA FL 33630-3214
H61 UNITED CHAMBERS LIFE P O BOX 3048 NAPERVILLE IL 60566
AC2 UNITED CHURCH OF CHRIST UCC CLAIMS PROCESSING UNI PO BOX 3900 YOUNGSTOWN OH 44513-3600
P67 UNITED COMMERCIAL TRAVELER P O BOX 159019 COLUMBUS OH 43215-8619
JB7 UNITED COMMERICAL TRAVELER P O BOX 159019 COLUMBUS OH 43215
FJ9 UNITED CONCORDIA PO BOX 69411 HARRISBURG PA 17106
FY9 UNITED CONCORDIA PO BOX 298230 CAMP HILL PA 17089
EW4 UNITED CONCORDIA PO BOX 69413 HARRISBURG PA 17106
FE5 UNITED CONCORDIA COMPANY P O BOX 69421 HARRISON PA 17106-9421
HY0 UNITED DRUGS 1625 EAST GLENDALE AVENUE PHOENIX AZ 85020
WH* UNITED EQUITABLE INSURANCE 7373 N CICERO AVE LINCOLNWOOD IL 60646
B94 UNITED FIDELITY LIFE 2300 CONTINENTAL PLAZA P O BOX 1778 FT WORTH TX 76101
NL* UNITED FIDELITY LIFE INS 1025 ELM STREET DALLAS TX 75202
HM5 UNITED FOOD AND COMMERCIAL WORKERS PO BOX 090558 MILWAUKEE WI 53209
QN* UNITED FOUNDERS UNTD FOUNDERS LIFE TOWER 5900 MOSTELLER DRIVE OKLAHOMA CITY OK 73112
NT* UNITED FURNITURE WORKERS I 1910 AIR LANE DRIVE P O BOX 100037DRIVE NASHVILLE TN 37210
GZ8 UNITED GROUP PROGRAMS 902 CLINT MOORE ROAD SUITE 100 BOCA RATON FL 33487
L56 UNITED GROUP SERVICES ATTN ELAINE D 2330 GRAVEL ROAD FT WORTH TX 76118
S50 UNITED HEALTH CARE METRA TRAVELERS 1600 WEST PLANO PARKWAY PLANO TX 75075
R93 UNITED HEALTH CARE TRAVELERS P O BOX 2258 BREA CA 92822
* - 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 120
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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B26 UNITED HEALTH CARE METROPOLITAIN LIFE P O BOX 2981 ENGLEWOOD CO 80150
AJ9 UNITED HEALTH CARE 4228 N. SANTA FE OKLAHOMA CITY OK 73118
AL* UNITED HEALTHCARE MONSANTO COMPANY P O BOX 30552 SALT LAKE CITY UT 84130-0552
AP2 UNITED HEALTHCARE GERBER 18888425667 P O BOX 659737 SAN ANTONIO TX 78265
AO4 UNITED HEALTHCARE METRAHEALTH P O BOX 30998 SALT LAKE CITY UT 84130
AO3 UNITED HEALTHCARE THE TPAOF TEXAS P O BOX 809076 DALLAS TX 75380-9076
Z85 UNITED HEALTHCARE METRAHEATH P O BOX 473505 CHARLOTTE NC 28247
W11 UNITED HEALTHCARE METRAHEALTH P O BOX 105312 ATLANTA GA 30348
BI3 UNITED HEALTHCARE GROUP MEDICAL CLAIMS P. O. BOX 2074 AURORA IL 60507-2074
BG9 UNITED HEALTHCARE 5214 MARYLAND WAY STE 207 BRENTWOOD TN 37027
BG4 UNITED HEALTHCARE 82 IONIA AVE N W P O BOX 323 GRAND RAPIDS MI 49501-0323
AT3 UNITED HEALTHCARE THE TPA OF ARIZONA P O BOX 52100 PHOENIX AZ 85072
BC7 UNITED HEALTHCARE METRAHEALTH P O BOX 30900 SALT LAKE CITY UT 84130-0990
BB6 UNITED HEALTHCARE METRAHEALTH/METLIFE P.O. BOX 1290 PITTSBURG PA 15230-1290
A98 UNITED HEALTHCARE MONSANTO EMPLOYEE BENEFIT P O BOX 2502 AURORA IL 60507
CF* UNITED HEALTHCARE P O BOX 5091 ROLLING MEADOWS IL 60008
CH3 UNITED HEALTHCARE METRAHEALTH P O BOX 10066 AUGUSTA GA 30999
CN6 UNITED HEALTHCARE 1250 S CAPITAL OF TEXAS HWY I 400 AUSTIN TX 78746-6443
CV8 UNITED HEALTHCARE P O BOX 591208 DAYTON OH 45459-8028
CV4 UNITED HEALTHCARE 1854 SHACKLEFORD COURT NORCROSS GA 30093
CU* UNITED HEALTHCARE RAILROAD CLAIMS P O BOX 30985 SALT LAKE CITY UT 84130-0985
CT5 UNITED HEALTHCARE UMBRELLA CARE P O BOX 660683 DALLAS TX 75266-0693
CS7 UNITED HEALTHCARE METRAHEALTH P O BOX 7964 SAN FRANCISCO CA 94120-7964
FH6 UNITED HEALTHCARE PO BOX 30557 SALT LAKE CITY UT 84130-0557
FC4 UNITED HEALTHCARE P O BOX 5097 ROLLING MEADOWS IL 60008
FD6 UNITED HEALTHCARE 3838 N CAUSEWAY SUITE 1200 METARIE LA 70002
FD2 UNITED HEALTHCARE P O BOX 30555 SALT LAKE CITY UT 84130-0555
EY1 UNITED HEALTHCARE MEDICAL CLAIMS P O BOX 55967 BIRMINGHAM AL 35255-5967
EW1 UNITED HEALTHCARE STATE OF AR PLAN DENTAL P O BOX 55947 BIRMINGHAM AL 35255-5947
EV6 UNITED HEALTHCARE P O BOX 169056 RT 2941 DULUTH MN 55816-8260
FA3 UNITED HEALTHCARE P O BOX 30551 SALT LAKE CITY UT 84130-0551
E33 UNITED HEALTHCARE 1701 DIRECTORS BLVD P O BOX 19137 AUSTIN TX 78760-9137
E30 UNITED HEALTHCARE PARIS MANUFACTURING SOUTH ELM PARIS AR 72855
EI7 UNITED HEALTHCARE MOBILE OIL CO P O BOX 3021 UTICA NY 13504
EM1 UNITED HEALTHCARE P O BOX 2072 AURORA IL 60507-2072
* - 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 121
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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EL6 UNITED HEALTHCARE METRAHEALTH P O BOX 22026 ALBANY NY 12201
EG1 UNITED HEALTHCARE ROCKWELL INTERNATIONAL P O BOX 6101 AUBURN NY 13021
EH* UNITED HEALTHCARE P O BOX 740800 ATLANTA GA 30374-0800
EP3 UNITED HEALTHCARE GENERAL MOTORS P O BOX 2517 SMYRBA GA 30081-2517
EO3 UNITED HEALTHCARE 1 SO WACKER DRIVE P O BOX 909714 CHICAGO IL 60690
EV5 UNITED HEALTHCARE P O BOX 169066 RT 2711 DULUTH MN 55816-8360
EV4 UNITED HEALTHCARE P O BOX 182286 COLUMBUS OH 43218
ET6 UNITED HEALTHCARE P O BOX 182281 RT 210003 COLUMBUS OH 43218
ET2 UNITED HEALTHCARE RAILROAD PLAN G23111D P O BOX 30404 SALT LAKE CITY UT 84130-0404
DQ8 UNITED HEALTHCARE GROUP HEALTH CONVERSIONS PO BOX 9612 NEW HAVEN CT 06535
DQ2 UNITED HEALTHCARE MANAGED CARE SYSTEM P O BOX 9448 NEW HAVEN CT 06534
DI3 UNITED HEALTHCARE METRAHEALTH P O BOX 650403 DALLAS TX 75265-0403
DH2 UNITED HEALTHCARE METRAHEALTH P O BOX 3017 SMITHTOWN NY 11787
C20 UNITED HEALTHCARE METRAHEALTH P O BOX 22092 ALBANY NY 12201
CY6 UNITED HEALTHCARE METRAHEALTH P O BOX 30994 SALT LAKE CITY UT 84130-0991
DB5 UNITED HEALTHCARE AMOCO MEDICAL CLAIMS P O BOX 2007 AURORA IL 60507
DG6 UNITED HEALTHCARE 2743 PERIMETER PARKWAY BLDG 2 AUGUSTA GA 30909
DV9 UNITED HEALTHCARE METRAHEALTH P O BOX 660455 DALLAS TX 75266-0455
DV4 UNITED HEALTHCARE METRAHEALTH P O BOX 9562 NEW HAVEN CT 06535
DU2 UNITED HEALTHCARE METRAHEALTH P O BOX 2002 NEW HAVEN CT 06536
DU1 UNITED HEALTHCARE 600 HOLIDAY PLAZA MATTESON IL 60443
DT9 UNITED HEALTHCARE METRAHEALTH P O BOX 9818 NEW HAVEN CT 06536
DS6 UNITED HEALTHCARE USG CORP P O BOX 507 MATTESON IL 60443-0507
EC7 UNITED HEALTHCARE THE TPA P O BOX 29050 PHOENIX AZ 85038
EE7 UNITED HEALTHCARE P O BOX 2002 AURORA IL 60507
ED7 UNITED HEALTHCARE METRAHEALTH P O BOX 71928 CHARLESTON SC 29415-1928
D6* UNITED HEALTHCARE WESTINGHOUSE P O BOX 1890 PITTSBURGH PA 15230-1890
D23 UNITED HEALTHCARE METROPOLITIAN 800 N LINDBERGH BLVD ST LOUIS MO 63167
D13 UNITED HEALTHCARE METRAHEALTH P O BOX 740122 ATLANTA GA 30374-0122
DZ3 UNITED HEALTHCARE P O BOX 169050 RT 2971 DULUTH MN 55816-8200
DZ2 UNITED HEALTHCARE PROCTOR AND GAMBLE P O BOX 1279 PITTSBURG PA 15230-1279
DY6 UNITED HEALTHCARE METRAHEALTH P O BOX 2508 AURORA IL 60507
SQ* UNITED HEALTHCARE GROUP HLTH CLAIMS PO BOX 6089 UTICA NY 13504-6089
S49 UNITED HEALTHCARE METRAHEALTH P O BOX 9806 NEW HAVEN CT 06536
Q1* UNITED HEALTHCARE METROPOLITAN METRAHEALTH P O BOX 1267 PITTSBURGH PA 15230-1267
* - 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 122
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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QV* UNITED HEALTHCARE METLIFE PO BOX 2005 AURORA IL 60507-2005
TL* UNITED HEALTHCARE PO BOX 659738 SAN ANTONIO TX 78265-9738
U42 UNITED HEALTHCARE THE TPA OF COLORADO P O BOX 6533 ENGLEWOOD CO 80155
KW* UNITED HEALTHCARE P O BOX 477 700 QUAKER LANE WARWICK RI 02887
K50 UNITED HEALTHCARE C/O PARTEE FLOORING P.O. BOX 667 MAGNOLIA AR 71753
K30 UNITED HEALTHCARE TRAVELERS/METRAHEALTH PO BOX 2049 MATTESON IL 60443
J05 UNITED HEALTHCARE PO BOX 30436 SALT LAKE CITY UT 84130
OD* UNITED HEALTHCARE 330 EAST KILBOURNE AVE P O BOX 92488 MILWAUKEE WI 53202
GV8 UNITED HEALTHCARE PO BOX 1600 KINGSTON NY 12402
GK4 UNITED HEALTHCARE PO BOX 659758 SAN ANTONIO TX 78205
GM1 UNITED HEALTHCARE PO BOX 981502 EL PASO TX 79998-1502
GQ7 UNITED HEALTHCARE PO BOX 30304 SALT LAKE CITY UT 84130-0304
GN3 UNITED HEALTHCARE P O BOX 720 PUEBLO CO 81002
F68 UNITED HEALTHCARE 4 BRITISH AMERICAN BLVD LATHAM NY 12110
F52 UNITED HEALTHCARE GROUP DENTAL CLAIMS P O BOX 6088 UTICA NY 13504-6088
FL9 UNITED HEALTHCARE P O BOX 659745 SAN ANTONIO TX 78268
GD8 UNITED HEALTHCARE ONE TOWER SQUARE HARTFORD CT 06101-1000
GD1 UNITED HEALTHCARE PO BOX 30567 SALT LAKE CITY UT 84130
GC6 UNITED HEALTHCARE PO BOX 30755 SALT LAKE CITY UT 84130
HO1 UNITED HEALTHCARE P O BOX 650394 DALLAS TX 75265-0394
HA8 UNITED HEALTHCARE P O BOX 740801 ATLANTA GA 30374-0801
HE8 UNITED HEALTHCARE P O BOX 2560 MARYLAND HEIGHTS MO 63045-8560
I83 UNITED HEALTHCARE METRAHEALTH P.O. BOX 3098 NAPERVILLE IL 60566
I58 UNITED HEALTHCARE METRAHEALTH P.O. BOX 7202 SAN FRANCISCO CA 94120-7202
IJ5 UNITED HEALTHCARE P O BOX 30783 SALT LAKE CITY UT 84130-0783
X55 UNITED HEALTHCARE ADM THE TPA P O BOX 862 SEATTLE WA 98111-0862
EQ4 UNITED HEALTHCARE ADM INC WEST PLAINS CHARCOAL PO BOX 121212 MARIETTA GA 30006-0092
FX3 UNITED HEALTHCARE DENTAL PO BOX 30560 BETHESDA MD 20804-0560
WB* UNITED HEALTHCARE INS CO P O BOX 30557 SALT LAKE CITY UT 84130-0557
DU3 UNITED HEALTHCARE INS CO PO BOX 740802 ATLANATA GA 30374-0802
CX8 UNITED HEALTHCARE METLIFE GENUINE PARTS CLAIMS P O BOX 30170 TAMPA FL 33630-3170
BV8 UNITED HEALTHCARE METRAHEA ALCOA CLAIMS P O BOX 105380 ATLANTA GA 30348
IC3 UNITED HEALTHCARE OF RIVER VALLEY PO BOX 5230 KINGSTON NY 12402
W41 UNITED HEALTHCARE OF AR P O BOX 830638 BIRMINGHAM AL 35283-0638
L10 UNITED HEALTHCARE TPA 6160 SUMMITT DRIVE SUITE 360 BROOKLYN CENTER MN 55430
* - 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 123
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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UI* UNITED INSURANCE 46 STILL FOREST HOUSTON TX 77024
AG9 UNITED INSURANCE 211 N. WASHINGTON P O BOX 1604 EL DORADO AR 71730
SU* UNITED INSURANCE COMPANY 1324 EAST THIRD STREET P O BOX 699 TULSA OK 74101
AU1 UNITED LIFE INSURANCE P.O. BOX 33513 SAN ANTONIO TX 78265
HT3 UNITED MEDICAL ALLIANCE 2021 BATTLECREEK DRIVE SUITE A FORT COLLINS CO 80528
M67 UNITED MEDICAL RESOURCES P O BOX 141337 CINCINNATI OH 45250-1337
Z23 UNITED MEDICAL RESOURCES I P O BOX 145804 CINCINNATI OH 45214
KY* UNITED MINE WORKERS OF AMERICA 945 BOND STREET EVANSVILLE IL 47708
V64 UNITED MINE WORKERS OF AMERICA P O BOX 9224 VAN NUYS CA 91409
HH5 UNITED MINE WORKERS OF AME PO BOX 619099 DALLAS TX 75261-9741
Y42 UNITED MINE WORKERS OF AME HEALTH RET 1950 PENSION T 4455 CONNECTICUT AVE NW WASHINGTON DC 20008
IL3 UNITED NATIONAL LIFE INSUR P O BOX 1154 GLENVIEW IL 60025-1154
ZY* UNITED OF OMAHA MUTUAL OF OMAHA PLAZA GENERAL DELIVERY OMAHA NE 68175
AM6 UNITED OF OMAHA P.O. BOX 1332 MINNEAPOLIS MN 55440
AK1 UNITED OF OMAHA P.O. BOX 590 ADDISON TX 75001
JB1 UNITED OF OMAHA LIFE INSUR ATTEN CLAIMS 3300 MUTUAL OF OMAHA PLAZ OMAHA NE 68175
X41 UNITED OF OMAHA MOTOC 3100 BROADWAY SUITE 1300 KANSAS CITY MO 64111
FG1 UNITED OPTICAL SPECTER ATTN MEMBER REIMBURSEMENT 2811 LORD BALTIMORE DR BALTIMORE MD 21244
I64 UNITED PARCEL SERVICE HEALTH PROGRAM 5501 FOURCHE DAM PIKE LITTLE ROCK AR 72206
J35 UNITED PARCEL SERVICE OF A 51 WEAVER STREET GREENWICH OFFICE PARK 5 GREENWICH CT 06830
Z45 UNITED PARCELL SERVICE 3215 EAST 50TH TEXARKANA AR 75502
AS1 UNITED PROVIDER SERVICES PO BOX 71120 BOSSIER CITY LA 71171
J1* UNITED SAVINGS LIFE INS 901 ELM STRET HINSDALE IL 60521
T65 UNITED SECURITY LIFE INSURANCE CO 10275 W HIGGINS RD ROSEMONT IL 60018
S66 UNITED SECURITY LIFE INSURANCE CO P O BOX 2186 HOT SPRINGS AR 71914
HQ1 UNITED SECURITY LIFE PO BOX 2870 CLINTON IA 52733-2870
CS4 UNITED SECURITY LIFE INS P O BOX 13587 JACKSON MS 39236
A84 UNITED SR CITIZENS SUPP ME FIDELITY SECURITY LIFE P O BOX 131 KANSAS CITY MO 64141-0131
DG7 UNITED STATE LIFE INS P O BOX 15205 READING PA 19612-5205
HJ1 UNITED STATES DEPT OF STAT SEVEN CORNERS PO BOX 3724 CARMEL IN 46082-3724
HI4 UNITED TEACHER ASSOCIATES P O BOX 30010 DALLAS TX 78755
GV5 UNITED TEACHER ASSOCIATES PO BOX 33010 AUSTIN TX 78755-3001
ZP* UNITED TECHNOLOGIES CARRIER 100 MURPHY DRIVE MAUMELLE AR 72118
OX* UNITED THOROUGHBRED TRAINERS OF AMERICA 19363 JAMES COUZENS HWY DETROIT MI 48235
G91 UNITED TRANSPORTATION UNIO 14600 DETROIT AVE CLEVELAND OH 44107
* - 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 124
DATE: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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SM* UNITED WESTERN LIFE INS CO GENERAL DELIVERY AUSTIN TX 78776
EG9 UNITED WISCONSIN GROUP UWG PO BOX 2013 MILWAUKEE WI 53201-2013
HB2 UNITED WORLD LIFE INS CO 3316 FARNAM ST OMAHA NE 68175
IE2 UNIVERA HEALTHCARE PO BOX 23000 ROCHESTER NY 14692
GT7 UNIVERSAL CARE INC 1600 EAST HILL STREET SIGNAL HILL CA 90755
Q33 UNIVERSAL FIDELITY LIFE 2211 N HIGHWAY 81 DUNCAN OK 73533
U22 UNIVERSAL INS CO HWY 67 W CORNING AR 72422
KI* UNIVERSAL INSURANCE CO P O BOX 1569 WEST MEMPHIS AR 72301
WA* UNIVERSAL LIFE 1516 SOUTH IZARD LITTLE ROCK AR 72206
CD* UNIVERSAL LIFE 840 BISCOE P O BOX 308 HELENA AR 72342
GF* UNIVERSAL LIFE INS CO P O BOX 834 TEXARKANA AR 75502
IH* UNIVERSAL LIFE INS CO 113 SOUTH FIFTH STREET BLYTHEVILLE AR 72315
U6* UNIVERSAL LIFE INSUR CO 834 LAUREL STREET TEXARKANA AR 75502
UO* UNIVERSAL LIFE INSURANCE P O BOX 1645 EL DORADO AR 71730
ED* UNIVERSAL LIFE INSURANCE 480 LINDEN AVE MEMPHIS TN 38126
Y43 UNIVERSE LIFE GRAIN GROWERS MEMBERSHIP PO BOX 2272 FORT WAYNE IN 46801
P15 UNIVERSE LIFE P O BOX 538 LEWISTON ID 83501
CM8 UNIVERSITY HEALTH PLAN ATTN PAT JINKERSON 3635 VISTA AT GRAND AVE ST LOUIS MO 63110
HS1 UPMC FOR YOU 112 WASHINGTON PLACE PITTSBURGH PA 15219
I06 UPREHS 795 NORTH 400 WEST SALT LAKE CITY UT 84103
FC5 US HEALTH INSURANCE P O BOX 2156 BISMARCK ND 58502
U72 US LIFE INS CO P O BOX 15205 READING PA 19612-5205
CJ9 US LIFE INS CO 3600 ROUTE 66 P O BOX 1581 NEPTUNE NJ 07754-1581
U16 US MOTORS 401 NORTH MORROW MENA AR 71953
GX7 US NOW 8350 N CENTRAL EXPRESSWAY SUITE 650A DALLAS TX 75206
IA3 US SCRIPT 2425 WEST SHAW AVENUE FRESNO CA 93711
T17 US STEEL AND CARNEGIE PENSION FUND 600 GRANT ST PITTSBURG PA 15230
DS7 USA CORPORATE CARE 150 2ND AVE N STE 500 P O BOX 3942 ST PETERSBURG FL 33731-3942
Z78 USA HEALTH NET INC P O BOX 142709 IRVING TX 75014
EY4 USA HEALTH NETWORK P O BOX 163930 DEPARTMENT 195 AUSTIN TX 78716-3930
II4 USA PLUS PO BOX 6080 MISSION VIEJO CA 00000
S95 USA PLUS P O BOX 619999 D FW AIRPORT TX 75261-9999
AH1 USA TRUCK INC P.O. 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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
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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
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
* - 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: SEPTEMBER 23, 2017 TPL SUBSYSTEM
TIME: 20:31:23 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED
RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE
----------------------------------------------------------------------------------------------------------------------------------
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
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 = 4508
*** END OF REPORT ***

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