DOMESTIC LIST OREGON INSURANCE COMPANIES

TYPE EXEMPT MEWA

HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC HCSC

HCSC

CERTIFICATE OF AUTHORITY # 503 650 150 164 166 154 15114 147 165 158 956591 106 956497 108 956520 133 105 141

164

DATE AUTHORIZED

8/4/1966 12/30/1994

3/3/1995 1/28/2005 3/31/2005 11/24/1997 4/18/2013 6/22/1989 3/4/2005 10/8/1999 10/28/2014 7/23/1962 4/1/2013 6/20/1940 6/14/2013 9/5/1984 5/5/1942 11/19/1986

1/31/2005

DOMESTIC LIST OREGON INSURANCE COMPANIES

October 1, 2020

COMPANY NAME

DOMICILE STREET ADDRESS

PHONE

VERBOORT BENEVOLENT SOCIETY OF OREGON

5750 NW GLENCOE RD HILLSBORO, OR 97124

503-648-9442

WESTERN GROCERS EMPLOYEE BENEFITS TRUST

12901 SE 97 TH AVE # 200 CLACKAMAS R 97015

503-968-2360

ADVANTAGE DENTAL PLAN INC

442 SW UMATILLA, STE 200 REDMOND OR 97756

541-323-4671

ALLCARE HEALTH PLAN, INC.

740 SE 7TH STREET GRANTS PASS OR 97526

541-471-4106

ATRIO HEALTH PLANS, INC.

2270 NW AVIATION DR, STE 3 ROSEBURG OR 97470

541-672-8620

FAMILYCARE HEALTH PLANS, INC.

825 NE MULTNOMAH, STE 300 PORTLAND OR 97232

503-345-5924

HEALTH REPUBLIC INSURANCE COMPANY

4000 KRUSE WAY PL BLDG 2 STE 300 LAKE OSWEGO, OR 97035

503-922-3337

HEALTH NET HEALTH PLAN OF OREGON, INC.

13221 SW 68TH PARKWAY, STE 200 TIGARD OR 97223

888-802-7001

HEALTH PLAN OF CAREOREGON, INC.

315 SW FIFTH AVE, SUITE 900 PORTLAND OR 97204

503-416-4100

MODA HEALTH PLAN, INC.

601 SW SECOND AVENUE PORTLAND OR 97204

503-228-6554

NEXDENT DENTAL PLANS, INC.

10535 NE GLISAN ST 3RD FLR PORTLAND OR 97220

800-996-0122

OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON

601 SW SECOND AVENUE PORTLAND OR 97204

503-228-6554

OREGON'S HEALTH CO-OP

315 SW 5TH AVE #201 PORTLAND, OR 97204

503-416-1771

PACIFICSOURCE HEALTH PLANS

110 INTERNATIONAL WAY SPRINGFIELD OR 97477

541-686-1242

PROVIDENCE HEALTH ASSURANCE

4400 NW HALSEY ST BLDG 2 SUITE 690 PORTLAND OR 97208

503-574-7500

PROVIDENCE HEALTH PLAN

3601 SW MURRAY BLVD STE 10 BEAVERTON OR 97005

503-574-7500

REGENCE BLUECROSS BLUESHIELD OF OREGON

100 SW MARKET ST PORTLAND OR 97201

503-225-5221

REGENCE HEALTH MAINTENANCE OF OREGON, INC.

100 SW MARKET PORTLAND OR 97201

503-225-5221

SAMARITAN HEALTH PLANS, INC. dba SAMARITAN ADVANTAGE

HEALTH PLAN

3600 NW SAMARITAN DRIVE

CORVALLIS OR 97330

541-768-5328

Page 1 of 3

TYPE HCSC

CERTIFICATE OF AUTHORITY #

169

HCSC

142

HCSC

159

HCSC

956529

HMO

126

HMO

121

HEALTH

3293

LIFE/HEALTH

2635

LIFE/HEALTH

2465

LIFE/HEALTH

1694

PROP/CAS

2665

PROP/CAS

2665

PROP/CAS

2580

PROP/CAS

955977

PROP/CAS

1827

PROP/CAS

2476

PROP/CAS

954170

PROP/CAS

1192

PROP/CAS

1208

PROP/CAS

1370

PROP/CAS

1200

PROP/CAS

3157

DATE AUTHORIZED

4/18/2006 1/30/1987 12/31/1999 8/4/2014 12/30/1981 3/1/1977 6/22/2006 12/24/1986 12/17/1982 4/12/1906 10/14/1987 11/15/1974 9/26/1985 8/14/2015 9/15/1970 2/18/1983 8/14/2015 7/1/1958 12/31/1925 2/7/1918 3/1/1963 11/29/2000

COMPANY NAME

DOMICILE STREET ADDRESS

PHONE

TRILLIUM COMMUNITY HEALTH PLAN, INC.

UO RESEARCH PK, 1800 MILLRACE EUGENE OR 97403

541-338-2938

UNITEDHEALTHCARE OF OREGON, INC.

FIVE CENTERPOINTE DR, STE 600 LAKE OSWEGO OR 97035

503-226-3321

WILLAMETTE DENTAL INSURANCE, INC.

6950 NE CAMPUS WAY HILLSBORO OR 97124-5611

503-952-2000

ZOOMCARE HEALTH INSURANCE, INC.

19075 NW TANASBOURNE RD STE 200

HILLSBORO OR 97124

503-941-3767

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST dba KAISER PERMANENTE

500 NE MULTNOMAH ST, STE 100 PORTLAND OR 97232-2099

503-813-2800

REGENCE HMO OREGON

100 SW MARKET ST PORTLAND OR 97201

503-225-5221

PACIFICSOURCE COMMUNITY HEALTH PLANS

2965 NW CONNERS AVE BEND, OR 97701

541-385-5315

LIFEWISE HEALTH PLAN OF OREGON INC. dba LIFEWISE HEALTH PLAN OF OREGON

2020 SW 4TH ST, STE 1000 PORTLAND OR 97201

503-295-6707

LIFEMAP ASSURANCE COMPANY

100 SW MARKET ST PORTLAND OR 97201

503-225-5221

STANDARD INSURANCE COMPANY

1100 SW 6TH AVE PORTLAND OR 97204-1093

503-321-7000

CALIFORNIA CASUALTY GENERAL OF OREGON

10260 SW GREENBURG RD, STE 448 PORTLAND OR 97204

503-892-3932

CALIFORNIA CASUALTY INSURANCE COMPANY

10260 SW GREENBURG RD, STE 448 PORTLAND OR 97204

503-892-3932

DENTISTS BENEFITS INSURANCE COMPANY

601 SW SECOND AVE PORTLAND OR 97204

503-228-6554

ENUMCLAW

PROPERTY AND CASUALTY INSURANCE COMPANY

4000 KRUSE WAY PL BLDG 3 STE 200 LAKE OSWEGO, OR 97035

360-825-2591

FARMERS INSURANCE COMPANY OF OREGON

23175 NW BENNETT ST HILLSBORO OR 97124

503-372-2000

LIBERTY NORTHWEST INSURANCE CORPORATION

ONE LIBERTY CENTRE PORTLAND OR 97232-2038

503-239-5800

MUTUAL OF ENUMCLAW INSURANCE COMPANY

4000 KRUSE WAY PL BLDG 3 STE 200 LAKE OSWEGO, OR 97035

360-825-2591

NORTH PACIFIC INSURANCE COMPANY

ONE LIBERTY CENTRE PORTLAND OR 97232-2038

503-239-5800

OREGON AUTOMOBILE INSURANCE COMPANY

ONE LIBERTY CENTRE PORTLAND OR 97232-2038

503-239-5800

OREGON MUTUAL INSURANCE COMPANY

400 NE BAKER ST MCMINNVILLE OR 97128

503-472-2141

PALOMAR SPECIALTY INSURANCE COMPANY

1001 SW 5TH AVE STE 1100 PORTLAND OR 97204-2018

503-660-8220

SAFECO INSURANCE COMPANY OF OREGON

ONE LIBERTY CENTRE PORTLAND OR 97232-2038

503-239-5800

Page 2 of 3

TYPE CAS PROP/CAS PROP/CAS PROP/CAS PROP/CAS PROP/CAS HCSC HEALTH

CERTIFICATE OF AUTHORITY # 700 1371 955957 956492 3031 1369 956635

510607051

DATE AUTHORIZED

7/1/1980 4/1/1918 1/1/1989 11/20/1978 12/30/1996 2/8/1918 2/16/2016

4/2/2020

COMPANY NAME

DOMICILE STREET ADDRESS

STATE ACCIDENT INSURANCE FUND CORPORATION

400 HIGH STREET SE SALEM OR 97312

SUBLIMITY INSURANCE COMPANY

100 SW SUBLIMITY BLVD SUBLIMITY OR 97385

TDC NATIONAL ASSURANCE COMPANY

2965 RYAN DRIVE SE SALEM OR 97303

UMIA INSURANCE INC.

310 E 4500 SOUTH STE 550 SALT LAKE CITY, UT 84107

VALLEY PROPERTY & CASUALTY INSURANCE COMPANY

4263 COMMERCIAL ST, STE 400 SALEM OR 97302

WESTERN PROTECTORS INSURANCE COMPANY

400 NE BAKER ST MCMINNVILLE OR 97128

MARQUIS ADVANTAGE, INC., DBA MARQUIS ADVANTAGE HEALTH4M5I6L0WSAEUKINIETEORRN9A7T2I2O2NAL WY #100

SUMMIT HEALTH PLAN, INC.

601 SW SECOND AVE. PORTLAND, OR 97204

PHONE 503-373-8000 503-769-6344 707-226-0100 801-531-0375 503-362-2415 503-472-2141

804-396-6412 503-228-6554

Page 3 of 3

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