CARRIER CODE

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TPL CARRIER FILE LISTING

CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

CITY

ST ZIP

AAA LIFE INSURANCE COMPANY AARP AARP HEALTH CARE OPTIONS AAU USA SPORTS ACCREDO ACE AMERICAN INSURANCE ADMINISTRATIVE CONCEPTS INC

ADMINISTRATIVE SYSTEMS RESEARCH CORP ADVANTAGE HEALTH ADVANTICA BENEFITS ADVANTRA FREEDOM AETNA AETNA DENTAL AETNA HEALTH MANAGEMENT AETNA LIFE AND CASUALTY AETNA PHARMACY MANAGEMENT AFLAC AIG LIFE INSURANCE COMPANY AIG-DENTAL BENEFIT PROVIDERS AITHER HEALTH ALIERA HEALTHCARE ALL SAVERS ALLEGIANCE BENEFIT PLAN MANAGEMENT ALLIANT HEALTH PLANS ALLIED BENEFITS SYSTEMS INC ALLIED NATIONAL ALLSTATE ALLWELL MEDICARE ADVANTAGE ALTA HEALTH STRATEGIES ALTERNATIVE BENEFITS INC ALTERNATIVE INSURANCE RESOURCES INC ALTERNATIVE RISK MANAGEMENT LTD ALTRISK ALWAYSCARE BENEFITS INC AMALGAMATED LIFE INSURANCE COMPANY AMBETTER FROM BUCKEYE COMMUNITY HEA

AMBETTER FROM MAGNOLIA HEALTH

AMBETTER FROM SUPERIOR HEALTH AMERCO INSURANCE AMERI HEALTH MERCY OF LOUISIANA AMERIBEN AMERIBEN SOLUTIONS AMERICA FIRST INSURANCE CO AMERICA'S FIRST CHOICE

AMERICAN ADMINISTRATIVE GROUP AMERICAN CONTINENTAL INSURANCE AMERICAN FAMILY INSURANCE

0001-00 3763-00 0522-00 3702-00 4182-00 4214-00 0030-14

2188-00 2841-00 3843-00 H084-60 1050-00 3757-00 H573-60 0828-00 3413-00 0026-00 0002-00 3398-00 4315-00 4230-00 4205-00 3407-00 3289-00 3033-00 4107-00 3594-00 H213-00 0907-00 4262-00 2976-00 2651-00 4304-00 3428-00 1449-00 4216-00

4197-00

4296-00 3167-00 4027-00 3662-00 3083-00 3161-00 4293-00

3495-00 3981-00 1584-00

17900 N LAUREL PARK DR PO BOX 13999 PO BOX 740819 PO BOX 189 10400 N 25TH AVE 436 WALNUT ST 994 OLD EAGLE SCHOOL RD STE 1005 PO BOX 6392 839 ST CHARLES AVE PO BOX 981607 PO BOX 7154 PO BOX 14079 PO BOX 14094 PO BOX 981107 151 FORMINGTON AVE PO BOX 398106 1932 WYNNTON RD PO BOX 305800 PO BOX 1581 P O BOX 211440 P O BOX 16818 P O BOX 31375 PO BOX 3018 PO BOX 3708 PO BOX 909786 PO BOX 29186 1776 AMERICAN HERITAGE 8585 ARCHIVES AVE/STE 310 PO BOX 671088 2601 FLOWERS RD PO BOX 660787 814 W NORTHWEST HWY P O BOX 21053 PO BOX 98100 770 BROADWAY 4349 EASTON WAY STE 300 111 E CAPITOL ST #500 P O BOX 5010 2721 N CENTRAL AVE PO BOX 7322 PO BOX 7887 PO BOX 5347 PO BOX 16708 250 BERRYHILL RD #311 PO BOX 93670 PO BOX 1188 3099 EAST WASHINGTON AVE

LIVONIA PHILADELPHIA ATLANTA BRIGHTON PHOENIX PHILADEPHIA WAYNE

GRAND RAPIDS NEW ORLEANS EL PASO LONDON LEXINGTON LEXINGTON EL PASO HARTFORD MINNEAPOLIS COLUMBUS NASHVILLE NEPTUNE EAGAN LUBBOCK SALT LAKE CITY MISSOULA CORPUS CHRISTI CHICAGO SHAWNEE MISSION JACKSONVILLE BATON ROUGE HOUSTON ATLANTA BIRMINGHAM ARLINGTON HEIGHTS EAGAN BATON ROUGE NEW YORK COLUMBUS

JACKSON

FARMINGTON PHOENIX LONDON BOISE BOISE JACKSON COLUMBIA

LUBBOCK BRENTWOOD MADISON

MI 48152 PA 19187 GA 30374 ME 04009 AZ 85021 PA 19106 PA 19087

MI 49516 LA 70130 TX 79998 KY 40742 KY 40512 KY 40512 TX 79998 CT 06156 MN 55439 GA 31999 TN 37230 NJ 07754 MN 55121 TX 79490 UT 84131 MT 59806 TX 78463 IL 60690 KS 66201 FL 32224 LA 70809 TX 77267 GA 30341 AL 35266 IL 60004 MN 55121 LA 70898 NY 10003 OH 43219

MS 39201

MO 63640 AZ 85004 KY 40742 ID 83707 ID 83705 MS 39236 SC 29210

TX 79493 TN 37027 WI 53704

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TPL CARRIER FILE LISTING

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CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

CITY

ST ZIP

AMERICAN FIDELITY ASSURANCE CO. AMERICAN GENERAL GROUP INSURANCE COMPANY AMERICAN HERITAGE LIFE AMERICAN INCOME LIFE INS. CO. AMERICAN LIFE CARE

AMERICAN MARITIME OFFICERS MEDICAL PLAN AMERICAN MEDICAL SECURITY AMERICAN NATIONAL INS. CO. AMERICAN NATIONAL INSURANCE AMERICAN PIONEER AMERICAN POSTAL WORKERS UNION AMERICAN PUBLIC LIFE INS. CO. AMERICAN REBUBLIC INS. CO. AMERICAN RETIREMENT LIFE INS CO AMERICAN SENTINEL AMERICAN STERLING INSURANCE CO AMERICORPS BENEFITS AMERIGROUP AMERIHEALTH ADMINISTRATORS AMERITAS LIFE INSURANCE CORP APWU ARCADIAN COMMUNITY CARE

ARCADIAN HEALTH PLAN ARGUS ARKLA GAS CO ASCENSION SMARTHEALTH ASRM CORP ASSURANT EMPLOYEE BENEFITS ASSURANT HEALTH ASSURED BENEFITS ADMINISTRATORS

ASSURED LIFE ASSOC (WOODMEN OF THE WORLD) ASSURITY LIFE INSURANCE ATLAS (ZENITH ADMINISTRATORS)

AULTCARE AUXIANT

AV MED AV MED OF LOUISIANA AVERA HEALTH PLAN AVMA GROUP HEALTH & LIFE AXA EQUITABLE LIFE INSURANCE COMPANY BANKERS FIDELITY BANKERS LIFE AND CASUALTY BANKERS UNITED LIFE ASSURANCE CO. BAY BRIDGE BEACON HEALTH OPTIONS BENEFIT ADMINISTRATION SERVICES

0027-00 0839-00 0033-00 0034-00 2628-00

2796-00 1946-00 0041-00 4260-00 3695-00 0706-00 0045-00 0046-00 3992-00 3475-00 3325-00 3804-00 H283-00 3193-00 2110-00 3745-00 3584-00

H570-00 3388-00 0930-00 4312-00 4188-00 3450-00 3317-00 4237-00

3908-00 3302-00 4291-00

3479-00 3936-00

3893-00 0988-00 4249-00 4228-00 0148-00 4283-00 3812-00 0070-00 4303-00 3163-00 4232-00

PO BOX 25523 PO BOX 660238 1776 AMERICAN HERITAGE DR PO BOX 2608 1100 POYDRAS ST STE 2600 PO BOX 35 PO BOX 19032 ONE MOODY PLZ P O BOX 1520 PO BOX 130 PO BOX 3279 PO BOX 925 PO BOX 21670 PO BOX 300100 PO BOX 61140 PO BOX 26103 PO BOX 23907 P O BOX 720 BLAIR MIL RD PO BOX 82520 PO BOX 1358 920 PIERREMONT RD STE 506 PO BOX 4946 PO BOX 419090 PO BOX 21734 P O BOX 37705 509 S LENOLA RD PO BOX 2940 PO BOX 91604 8150 N CENTRAL EXPRESSWAY STE 1700 PO BOX 2397 PO BOX 82533 18861 90TH AVE STE A PO BOX 6910 424 1ST AVE NE STE 200 9400 SOUTH DADELAND BLVD 2900 RIDGELAKE DR 3816 S ELMWOOD AVE P O BOX 8789 PO BOX 1547 P O BOX 105652 PO BOX 1935 PO BOX 1447 1101 S CAPITAL OF TEXAS H 200 STATE ST P O BOX 21515

OKLAHOMA CITY DALLAS JACKSONVILLE WACO NEW ORLEANS

DANIA GREEN BAY GALVESTON GALVESTON PENSACOLA SILVER SPRING JACKSON EAGAN AUSTIN HARRISBURG OVERLAND PARK COLUMBIA LOS ANGELES HORSHAM LINCOLN GLEN BURNIE SHREVEPORT

COVINA KANSAS CITY SHREVEPORT OAK PARK MOORESTOWN CLINTON LUBBOCK DALLAS

OMAHA LINCOLN MOKENA

CANTON CEDAR RAPIDS

MIAMI METAIRIE SIOUX FALLS SCOTTSDALE SEACAUCUS ATLANTA CARMEL CEDAR RAPIDS AUSTIN BOSTON EAGAN

OK 73125 TX 75266 FL 32224 TX 76797 LA 70163

FL 33004 WI 54307 TX 77550 TX 77553 FL 32591 MD 20918 MS 39205 MN 55121 TX 78755 PA 17106 KS 66225 SC 29224 CA 90054 PA 19044 NE 68501 MD 21060 LA 71106

CA 91723 MO 64141 LA 71151 MI 48237 NJ 08057 IA 52733 TX 79490 TX 75206

NE 68103 NE 68501 IL 60448

OH 44706 IA 52401

FL 33156 LA 70002 SD 57105 AZ 85252 NJ 07096 GA 30348 IN 46082 IA 52406 TX 78746 MA 02109 MN 41205

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TPL CARRIER FILE LISTING

CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

BENEFIT ADMINISTRATION SERVICES,LTD

BENEFIT ADMINISTRATIVE SYSTEMS, LLC BENEFIT ADMINISTRATORS

BENEFIT MANAGEMENT INC BENEFIT MANAGEMENT SERVICES BENEFIT MANAGEMENT SYSTEM BENEFIT PLAN ADMINISTRATORS BENEFIT SERVICES INC BENEFIT SUPPORT,INC BENESYS INC/BASS ADMINISTRATORS BLUE ADVATAGE ADMINISTRATION OF AR BLUE CARE NETWORK BLUE CROSS (REGENCE GROUP ADMIN) BLUE CROSS BLUE SHIELD BLUE CROSS FEB (ANTHEM) BLUE CROSS OF ALABAMA BLUE CROSS OF ALASKA (PREMERA) BLUE CROSS OF ARIZONA BLUE CROSS OF ARKANSAS BLUE CROSS OF ARKANSAS (FEP BLUE CROSS OF ARKANSAS (MED REPL) BLUE CROSS OF CALIFORNIA (ANTHEM) BLUE CROSS OF CALIFORNIA (MED REPL) BLUE CROSS OF COLORADO BLUE CROSS OF CONNECTICUT BLUE CROSS OF DELAWARE BLUE CROSS OF FLORIDA BLUE CROSS OF GEORGIA BLUE CROSS OF GEORGIA (FEP) BLUE CROSS OF HAWAII BLUE CROSS OF IDAHO BLUE CROSS OF IDAHO (FEP) BLUE CROSS OF ILLINOIS BLUE CROSS OF ILLINOIS (CHICAGO) BLUE CROSS OF ILLINOIS (DENTAL) BLUE CROSS OF INDIANA BLUE CROSS OF IOWA BLUE CROSS OF KANSAS BLUE CROSS OF KENTUCKY (ANTHEM) BLUE CROSS OF LOUISIANA BLUE CROSS OF LOUISIANA (FEP) BLUE CROSS OF MAINE BLUE CROSS OF MARYLAND BLUE CROSS OF MASSACHUSETTS BLUE CROSS OF MICHIGAN BLUE CROSS OF MICHIGAN (MED REPL) BLUE CROSS OF MINNESOTA BLUE CROSS OF MISSISSIPPI BLUE CROSS OF MISSOURI (ANTHEM)

0868-00

3512-00 1937-00

1869-00 1321-00 3323-00 1489-00 3099-00 4233-00 2245-00 3506-00 2770-00 3797-00 H014-70 3740-00 3463-00 3756-00 0532-00 0548-00 3894-00 H584-90 3558-00 H056-40 0835-00 1697-00 2888-00 0537-00 0979-00 3926-00 1936-00 1234-00 4211-00 0543-00 0535-00 3840-00 0964-00 0539-00 0837-00 3551-00 0546-00 2601-00 1405-00 0542-00 0545-00 0544-00 H231-90 1708-00 0515-00 1366-00

613 CRESCENT CIRCLE STE 201 17475 JOVANNA DR 9999 BREWSTER LN STE 100 PO BOX 3001 PO BOX 98044 PO BOX 3859 PO BOX 130217 PO BOX 4138 P O BOX 2977 PO BOX 81189 PO BOX 1460 25925 TELEGRAPH RD PO BOX 52890 PO BOX 98029 PO BOX 27401 450 RIVER CHASE PKWY E PO BOX 240609 PO BOX 13466 601 S GAINES ST PO BOX 2181 PO BOX 2181 PO BOX 60007 PO BOX 60007 PO BOX 5368 PO BOX 533 PO BOX 1991 PO BOX 1798 PO BOX 9907 PO BOX 105557 PO BOX 860 PO BOX 7408 3000 E PINE AVE 233 N MICHIGAN AVE PO BOX 805107 PO BOX 23059 PO BOX 62509 636 GRAND AVE PO BOX 239 PO BOX 37180 PO BOX 98029 PO BOX 98029 PO BOX 8884 PO BOX 14115 PO BOX 986030 600 LAFAYETTE EAST PO BOX 440 PO BOX 64061 PO BOX 1043 PO BOX 14882

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CITY

RIDGELAND

HOMEWOOD POWELL

JOPLIN BATON ROUGE PORTLAND TYLER AKRON GAINESVILLE LAFAYETTE LITTLE ROCK SOUTHFIELD BELLEVUE BATON ROUGE RICHMOND BIRMINGHAM ANCHORAGE PHOENIX LITTLE ROCK LITTLE ROCK LITTLE ROCK LOS ANGELES LOS ANGELES DENVER NORTH HAVEN WILMINGTON JACKSONVILLE COLUMBUS ATLANTA HONOLULU BOISE MERIDIAN CHICAGO CHICAGO BELLEVILLE VIRGINIA BEACH DES MOINES TOPEKA LOUISVILLE BATON ROUGE BATON ROUGE PORTLAND LEXINGTON BOSTON DETROIT SOUTHFIELD ST PAUL JACKSON SAINT LOUIS

ST ZIP

MS 39157

IL 60430 OH 43065

MO 64803 LA 70898 ME 04104 TX 75713 OH 44321 GA 30503 LA 70598 AR 72203 MI 48034 WA 98015 LA 70898 VA 23279 AL 35298 AK 99524 AZ 85002 AR 72203 AR 72203 AR 72203 CA 90060 CA 90060 CO 80217 CT 06473 DE 19899 FL 32231 GA 31908 GA 30348 HI 96808 ID 83707 ID 83642 IL 60601 IL 60680 IL 62223 VA 23466 IA 50307 KS 66601 KY 40233 LA 70898 LA 70898 ME 04104 KY 40512 MA 02298 MI 48226 MI 48037 MN 55164 MS 39205 MO 63178

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CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

BLUE CROSS OF MISSOURI (KC) BLUE CROSS OF MISSOURI (ST LOUIS) BLUE CROSS OF MONTANA BLUE CROSS OF NEBRASKA BLUE CROSS OF NEVADA BLUE CROSS OF NEW JERSEY BLUE CROSS OF NEW JERSEY (EXCELLUS) BLUE CROSS OF NEW MEXICO BLUE CROSS OF NEW YORK (EMPIRE) BLUE CROSS OF NEW YORK (EXCELLUS) BLUE CROSS OF NEW YORK (NORTHEASTERN) BLUE CROSS OF NEW YORK (ROCHESTER) BLUE CROSS OF NEW YORK (WESTERN) BLUE CROSS OF NORTH CAROLINA BLUE CROSS OF NORTH DAKOTA BLUE CROSS OF OHIO BLUE CROSS OF OHIO (ANTHEM) BLUE CROSS OF OKLAHOMA BLUE CROSS OF OREGON BLUE CROSS OF PENNSYLVANIA BLUE CROSS OF PENNSYLVANIA (HGHMRK) BLUE CROSS OF PENNSYLVANIA (IND) BLUE CROSS OF RHODE ISLAND BLUE CROSS OF SOUTH CAROLINA BLUE CROSS OF SOUTH DAKOTA BLUE CROSS OF TENNESSEE BLUE CROSS OF TEXAS BLUE CROSS OF UTAH BLUE CROSS OF VERMONT BLUE CROSS OF VIRGINIA-ANTHEM BLUE CROSS OF WASHINGTON (KING COUNTY MEDICAL) BLUE CROSS OF WASHINGTON (PREMERA) BLUE CROSS OF WASHINGTON & ALASKA BLUE CROSS OF WEST VIRGINIA BLUE CROSS OF WISCONSIN (ANTHEM) BLUE CROSS OF WYOMING BLUE CROSS PENNSYLVANIA (WESTERN) BLUE SHIELD OF CALIFORNIA BLUE SHIELD OF PUERTO RICO BMI BENEFIT BOLLINGER EMPLOYEES HEALTHCARE PLAN BOON CHAPMAN BOON GROUP BRECKPOINT INSURANCE

BROKERAGE CONCEPTS BUSINESS ADMINISTRATORS AND CONSULTANTS INC CALIFORNIA IRONWORKERS FIELD WELFARE PLAN CAPITAL BLUECROSS CAPITOL ADMINISTRATORS

1251-00 0533-00 2441-00 1402-00 2051-00 0947-00 3451-00 2916-00 0928-00 3809-00 0536-00 1023-00 0746-00 1058-00 3181-00 2693-00 3448-00 0521-00 1270-00 1657-00 3498-00 3481-00 1158-00 3492-00 3145-00 0880-00 3537-00 1818-00 2856-00 4229-00 1276-00 3672-00 1196-00 1432-00 3998-00 1190-00 0538-00 4270-00 2822-00 4288-00 3729-00 0971-00 4175-00 4246-00

3931-00 2952-00 0855-00 4199-00 4236-00

PO BOX 419169 444 FOREST PARK PO BOX 50004 PO BOX 3248 PO BOX 10330 PO BOX 420 165 COURT ST PO BOX 27630 PO BOX 3877 PO BOX 22999 PO BOX 15013 343 STATE ST PO BOX 80 PO BOX 35 4510 13TH AVE SW PO BOX 94754 9075 CENTRE POINT DR PO BOX 3283 PO BOX 1271 PO BOX 62 PO BOX 3355 1901 MARKET ST 444 WESTMINSTER MALL PO BOX 100605 1601 WEST MADISON 801 PINE ST PO BOX 660044 PO BOX 30272 PO BOX 186 P O BOX 27401 PO BOX 91015 PO BOX 91059 PO BOX 327 PO BOX 7026 PO BOX 105187 PO BOX 2266 PO BOX 358 4203 TOWN CENTER BLVD PO BOX 363628 P O BOX 511 PO BOX 706 PO BOX 9201 P O BOX 559017 5130 S FORT APACHE #215-365 801 LAKEVIEW DR PO BOX 107 475 HUNTINGTON DR P O BOX 211457 10951 WHITE ROCK RD STE 100

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CITY

KANSAS CITY ST LOUIS BUTTE OMAHA RENO NEWARK ROCHESTER ALBUQUERQUE NEW YORK ROCHESTER ALBANY ROCHESTER BUFFALO DURHAM FARGO CLEVELAND WESTCHESTER TULSA PORTLAND CAMPHILL PITTSBURGH PHILADELPHIA PROVIDENCE COLUMBIA SIOUX FALLS CHATTANOOGA DALLAS SALT LAKE CITY MONTPELIER RICHMOND SEATTLE SEATTLE SEATTLE WHEELING ATLANTA CHEYENNE PITTSBURGH EL DORADO HILLS SAN JUAN MATAWAN SHORT HILLS AUSTIN AUSTIN LAS VEGAS

BLUE BELL REYNOLDSBURG SAN MARINO EAGAN RANCHO CORDOVA

ST ZIP

MO 64141 MO 63108 MT 59701 NE 68180 NV 89520 NJ 07101 NY 14647 NM 87125 NY 10008 NY 14692 NY 12212 NY 14650 NY 14240 NC 27702 ND 58121 OH 44101 OH 45069 OK 74102 OR 97207 PA 17001 PA 15230 PA 19101 RI 02901 SC 29260 SD 57104 TN 37402 TX 75266 UT 23279 VT 05601 VA 23279 WA 98111 WA 98111 WA 98111 WV 26105 GA 30348 WY 72211 PA 15230 CA 95762 PR 00936 NJ 07747 NJ 07078 TX 87866 TX 78755 NV 89148

PA 19422 OH 21060 CA 91108 MN 55121 CA 95670

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CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

CAPITOL DISTRICT PHYSICIANS HEALTH CAPROCK HEALTH GROUP CAREFIRST CAREINGTON INTERNATIONAL CAREMARK CAREMORE CAREPLUS HEALTH PLANS INC CARPENTERS HEALTH & SECURITY TRUST CATALYST RX CBA BLUE CBCA ADMINISTRATORS CCMSI

CELTIC INSURANCE COMPANY CELTIC LIFE INS. CO.

CENTRAL STATES HEALTH & LIFE CO. OF OMAHA CENTRAL STATES INDEMNITY CENTRAL STATES INS CO CENTURY HEALTHCARE CERNER HEALTH PLANS CERPASS RX CHEROKEE INSURANCE COMPANY CHEROKEE NATIONAL LIFE INS. CO. CHESTERFIELD RESOURCES INC CHITIMACHA EMPLOYEES HEALTH PLAN CHRISTIAN BROTHERS CHRISTIAN CARE MEDI-SHARE CHRISTIAN FIDELITY LIFE INS COMPANY CHRISTIAN HEALTH MINISTRIES CHRISTIAN HOSPITALIZATION AID CHRISTUS HEALTH/TEXAS TRUE CHOICE CIGNA CIGNA CIGNA BEHAVIORAL HEALTH CIGNA DENTAL CIGNA INTERNATIONAL EXPARTIATE BEN CIGNA VOLUNTARY CITIZENS RX CNIC HEALTH SOLUTIONS COLONIAL HEALTH COLONIAL LIFE & ACCIDENT COLONIAL PENN LIFE INS. CO. COMBINED INSURANCE COMMERCIAL TRAVELERS COMMONWEALTH LIFE INS CO COMMUNITY HEALTH SYSTEM INC COMMUNITY MUTUAL INSURANCE CO

COMMUNITYCARE OF OKLAHOMA COMPANION LIFE INS. CO.

4274-00 4243-00 3340-00 3009-00 3744-00 H054-40 H101-00 3723-00 3220-00 3850-00 3305-00 3210-00

3914-00 0086-00

0091-00 4013-00 0090-01 3489-00 3980-00 4213-00 4110-00 0095-00 1350-00 2774-00 0885-00 3482-00 0949-00 2708-00 0895-00 3255-00 3348-00 H276-20 3389-00 3803-00 3677-00 3904-00 4179-00 3296-00 4279-00 0102-00 0104-00 3754-00 3906-00 3709-00 2907-00 1237-00

3844-00 2532-00

17 COLUMBIA CIRCLE 11467 HUEBNER RD/STE 3 10455 MILL RUN CIRCLE 13155 NOEL RD PO BOX 52196 PO BOX 366 PO BOX 14697 PO BOX 1929 PO BOX 44036 PO BOX 2365 PO BOX 16579 2 EAST MAIN ST TOWN CENTRE BUILDING PO BOX 26440 208 S LASALLE ST STE 1644 PO BOX 34350 1212 N 96TH ST 10425 W NORTH AVE PO BOX 2256 PO BOX 188061 ONE COWBOYS WAY/STE 290 34200 MOUND RD 1122 GRAY HWY PO BOX 1884 PO BOX 39 1205 WINDHAM PKWY P O BOX 981652 2001 BATES DR 2700 NAPOLEON AVE PO BOX 336 PO BOX 250089 PO BOX 15408 PO BOX 182223 PO BOX 46270 PO BOX 189060 300 BELLEVUE PKWY PO BOX 55270 1144 LAKE ST PO BOX 3559 P O BOX 211282 1200 COLONIAL LIFE BLVD 399 MARKET ST PO BOX 6700 70 GENESEE ST PO BOX 9016 4000 MERIDIAN BLVD 433 RIVER ST STE 8002 218 W 6TH ST PO BOX 100102

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CITY

ALBANY SAN ANTONIO OWINGS MILL DALLAS PHOENIX ARTESIA LEXINGTON SEATTLE BATON ROUGE SOUTH BURLINGTON SAVANNAH DANVILLE

LITTLE ROCK CHICAGO

OMAHA OMAHA WAUWATOSA GRAPEVINE CHATTANOOGA FRISCO STERLING HEIGHTS MACON AKRON CHARENTON ROMEOVILLE EL PASO WAXAHACHIE NEW ORLEANS MONTEZUMA PLANO WILMINGTON CHATTANOOGA EDEN PRAIRIE PLANTATION WILMINGTON PHOENIX OAK PARK ENGLEWOOD EAGAN COLUMBIA PHILADELPHIA SCRANTON UTICA ANDOVER FRANKLIN TROY

TULSA COLUMBIA

ST ZIP

NY 12203 TX 78230 MD 21117 TX 75240 AZ 85072 CA 90702 KY 40512 WA 98111 LA 70804 VT 05407 GA 31416 IL 61832

AR 72221 IL 60604

NE 68134 NE 68114 WI 53226 TX 76099 TN 37422 TX 75034 MI 48310 GA 31201 OH 44309 LA 70523 IL 60446 TX 79998 TX 75167 LA 70115 KS 67867 TX 75025 DE 19850 TN 37422 MN 55344 FL 33318 DE 19809 AZ 85051 IL 60301 CO 80155 MN 55121 SC 29202 PA 19181 PA 18505 NY 13502 MA 01810 TN 37067 NY 12180

OK 74119 SC 29202

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TPL CARRIER FILE LISTING

CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

COMPASS ROSE BENEFITS COMPLETE BENEFIT SOLUTIONS COMPREHENSIVE CARE SERVICES INC CONEXIS CONNECTICARE INC CONNECTION DENTAL CONSECO HEALTH INS CO CONSOCIATE CONSOLIDATED HEALTH PLAN CONSTITUTION LIFE CONTINENTAL BENEFITS CONTINENTAL GENERAL INSURANCE COMPANY CONTINENTAL LIFE INS. CO. COOPERATIVE BENEFIT ADMINISTRATORS COORDINATED BENEFITS

CORE MANAGEMENT SERVICES

CORE SOURCE CORPORATE BENEFIT SOLUTIONS INC

CORPORATE BENEFITS SERVICE INC CORRECT CARE INTEGRATED

COVENANT SERVICES GROUP

COVENTRY HEALTH CARE COVENTRY HEALTHCARE OF LA COVENTRY--MEDICARE ADVANTAGE CRESCENT SOLUTION CREST INDUSTRIES (SELF-EMPLOYED) CULINARY HEALTH & WELFARE CYPRESS BENEFIT ADMINISTRATORS DAKOTACARE DEAN HEALTH PLAN DELAWARE AMERICAN LIFE INS. CO. DELTA DENTAL DELTA DENTAL OF ARKANSAS DELTA DENTAL OF ILLINOIS DELTA DENTAL OF KANSAS DELTA DENTAL OF MASSACHUSETTS DELTA DENTAL OF MICHIGAN DELTA DENTAL OF MINNESOTA DELTA DENTAL OF MISSOURI DELTA DENTAL OF OKLAHOMA DELTA DENTAL OF PENNSYLVANIA DELTA DENTAL OF TENNESSEE DELTA DENTAL OF VIRGINIA DENTAL NETWORK OF AMERICA DENTAL SELECT

3977-00 3171-00 3299-00 3544-00 H352-80 3933-00 2983-00 3676-00 2712-00 4286-00 4187-00 0125-00 0127-00 3813-00 3898-00

4271-00

2462-00 3078-00

2387-00 4184-00

3608-00

3001-00 3517-00 H392-80 4082-00 1507-00 4183-00 4247-00 3235-00 3327-00 0547-00 3739-00 3604-00 4299-00 3787-00 3408-00 3712-00 4231-00 2903-00 3326-00 3735-00 3888-00 3805-00 2587-00 4220-00

PO BOX 8095 102 NORTH RANGE PO BOX 64008 PO BOX 226101 PO BOX 546 PO BOX 2336 11825 N PENNSYLVANIA ST PO BOX 1068 2077 ROOSEVELT AVE P O BOX 130 P O BOX 1050 PO BOX 247007 PO BOX 14770 8701 FIRETHORN LN 923 N PLUM GROVE RD STE C 515 MULBERRY ST STE 300 PO BOX 168 5750 NEW KING DR STE 310 139 S TRYON ST 1218 S BROADWAY STE 250 2810 PREMIERE PKWY STE 400 PO BOX 7707 3838 N CAUSEWAY BLVD PO BOX 7819 PO BOX 247 PO BOX 1432 1933 LAS VEGAS BLVD P O BOX 7020 1323 S MINNESOTA AVE PO BOX 56099 600 KING ST PO BOX 1809 PO BOX 15965 P O BOX 5402 PO BOX 789769 PO BOX 9695 PO BOX 9085 P O BOX 59238 PO BOX 8690 PO BOX 548809 ONE DELTA DR 240 VENTURE CIRCLE 4818 STARKEY RD PO BOX 1842 P O BOX 851917 CLAIMS ADMINISTRATION

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6

CITY

WAUSAU DENHAM SPRINGS ST PAUL DALLAS FARMINGTON INDEPENDENCE CARMEL DECATUR SPRINGFIELD PENSACOLA BRANDON OMAHA LEXINGTON LINCOLN SCHAUMBURG

MACON

MATTESON TROY

CHARLOTTE LEXINGTON

DULUTH

LONDON METAIRIE LONDON ALPHARETTA ALEXANDRIA LAS VEGAS APPLETON SIOUX FALLS MADISON WILMINGTON ALPHARETTA LITTLE ROCK LISLE WICHITA BOSTON FARMINGTON HILL MINNEAPOLIS ST LOUIS OKLAHOMA CITY MECHANICSBURG NASHVILLE ROANOKE MEMPHIS RICHARDSON

ST ZIP

WI 54402 LA 75265 MN 55164 TX 75222 CT 06034 MO 64051 IN 46032 IL 62525 MA 01104 FL 32519 FL 33509 NE 68124 KY 40512 NE 68520 IL 60173

GA 31201

IL 60443 MI 48098

NC 28202 KY 40504

GA 30097

KY 40742 LA 70002 KY 40742 GA 30039 LA 71301 NV 89104 WI 54912 SD 57105 WI 53705 DE 19801 GA 30023 AR 72231 IL 60532 KS 67278 MA 02114 MI 48335 MH 55459 MO 63126 OK 73154 PA 17055 TN 37228 VA 24018 TN 38101 TX 75085

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LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS LOUISIANA DEPARTMENT OF HEALTH - MEDICAL ASSISTANCE PROGRAM

TPL CARRIER FILE LISTING

CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

DENTAQUEST DESERET HEALTHCARE DIGNITY HEALTH PLANS DINA DENTAL PLAN

DIVERSIFIED GROUP BROKERAGE CORP EBA&M CORPORATION EBEN CONCEPTS EBMS EHIM ELECTRICIANS LOCAL 995 HEALTH & WELFARE PLAN EMBLEM HEALTH EMI HEALTH EMPLOYEE BENEFIT CONSULTANTS EMPLOYEE BENEFIT PLAN EMPLOYEE BENEFIT SERVICES EMPLOYEE PLANS SERVICES

EMPLOYER PLAN SERVICES INC ENTRUST

ENVISION RX OPTIONS

ENVOLVE PHARMACY

EQUITABLE LIFE & CASUALTY INS. CO. ESSENCE HEALTHCARE EVEREST REINSURANCE COMPANY EXPRESS SCRIPT EYEMED FALLON HEALTHCARE FAMILY LIFE INSURANCE COMPANY FCE BENEFITS FEDERATED LIFE INS. CO. FIDELIS FIRST ADMINISTRATORS FIRST CAROLINA CARE FIRST CHOICE INS CO FIRST CHOICE WASHINGTON

FIRST HEALTH FISERV HEALTH FISERV HEALTH-TENNESSEE FIZER V HEALTH FMH BENEFIT SERVICES FOREIGN SERVICE BENEFIT PLAN

FORETHOUGHT LIFE INSURANCE FOX EVERETT INC. FREEDOM LIFE INS CO OF AMERICA

9999-90 1763-00 H301-00 3842-00

2366-00 4280-00 4251-00 3731-00 4282-00 0850-00 4128-00 4300-00 3959-00 4258-00 3972-00 1206-00

1900-00 2557-00

3397-00

4278-00

0149-00 H261-00 4287-00 2133-00 4192-00 3391-00 3915-00 3507-00 0161-00 4294-00 3422-00 3973-00 1474-00 4204-00

3565-00 3371-00 3229-00 3656-00 3295-00 3266-00

4198-00 1367-00 3623-00

465 MEDFORD ST PO BOX 45530 P O BOX 3398 101 PARKLANE BLVD STE 301 PO BOX 225829 P O BOX 5079 921-C S MCPHERSON CHURCH PO BOX 21367 26711 NORTHWESTERN HWY 8181 TOM DR PO BOX 3736 5101 S COMMERCE DR PO BOX 670 4747 LINCOLN MALL DR PO BOX 13749 7100 BALTIMORE AVE STE 502 PO BOX 19776 22322 GRAND CORNER DR STE 200 2181 E AURORA RD STE 201 500 KIRTS BLVD STE 300 PO BOX 2460 PO BOX 12488 P O BOX 10877 PO BOX 14711 4000 LUXOTTICA PL PO BOX 211308 PO BOX 925568 PO BOX 211757 PO BOX 991 95-25 QUEENS BLVD PO BOX 9900 42 MEMORIAL DR 1308 E CENTER ST 600 UNIVERSITY ST STE 1400 3200 HIGHLAND AVE PO BOX 690450 PO BOX 305154 PO BOX 8013 PO BOX 25946 1620 L ST NW STE 800 P O BOX 14659 PO BOX 188 801 CHERRY ST UNIT 33

TP-0-32-2

PAGE:

7

CITY

BOSTON SALT LAKE CITY LITTLE ROCK SUGARLAND

DALLAS WESTLAKE VILLAGE FAYETTEVILLE BILLINGS SOUTHFIELD BATON ROUGE NEW YORK MURRAY RICHLANDS MATTESON JACKSON COLLEGE PARK

HOUSTON KATY

TWINSBURG

TROY

SALT LAKE CITY ST LOUIS CLEARWATER LEXINGTON MASON EAGAN HOUSTON EAGAN OWATONNA REGO PARK SIOUX CITY PINEHURST POCATELLO SEATTLE

DOWNERS GROVE SAN ANTONIO NASHVILLE WAUSAU OVERLAND PARK WASHINGTON

CLEARWATER JACKSON FORT WORTH

ST ZIP

MA 02129 UT 84145 AR 72202 TX 77478

TX 75222 CA 91359 NC 28303 MT 59104 MI 48033 LA 70815 NY 12008 UT 84107 VA 24641 IL 60443 MS 39236 MD 20740

TX 77224 TX 77494

OH 44087

MI 48084

UT 84110 MO 63132 FL 33757 KY 40512 OH 45040 MN 55121 TX 77292 MN 55121 MN 55060 NY 11374 IA 51102 NC 28374 ID 83201 WA 98101

IL 60515 TX 78269 TN 37230 WI 54402 KS 66225 DC 20415

FL 33766 MS 39205 TX 76102

LAM1R032 RUN: 10/23/21

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LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS LOUISIANA DEPARTMENT OF HEALTH - MEDICAL ASSISTANCE PROGRAM

TP-0-32-2

PAGE:

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TPL CARRIER FILE LISTING

CARRIER NAME

CARRIER CODE

CARRIER ADDRESS-LINE 1 CARRIER ADDRESS-LINE 2

CITY

ST ZIP

FREEDOM LIFE INUSRANCE COMPANY

FRESENIUS MEDICAL CARE HEALTH PLAN FRINGE BENEFIT GROUP FRINGE BENEFITS MANAGEMENT COMPANY FUTURE SCRIPTS FUTURE SCRIPTS G.M.P.-EMPLOYERS RETIRE TRUST

GALLAGER-BASSETT

GCA EMPLOYEE CHOICE BENEFIT GEHA GEISENGER HEALTH PLAN GENWORTH FINANCIAL GEOBLUE GEORGIA LIFE AND HEALTH INSURANCE GUARANTY ASSOC

GILSBAR INC GLENWOOD REGIONAL MEDICAL CENTER GLOBAL HEALTH GM SOUTHWEST GOLDEN RULE GOLDEN RULE INSURANCE GREAT WEST LIFE HEALTH GROUP AND PENSION ADMINISTRATORS GROUP HEALTH INSURANCE INC GROUP HEALTH PLAN GROUP RESOURCES GUARANTEE TRUST LIFE GUARDIAN GULF SOUTH HEALTH PLAN

GULF SOUTH RISK SERVICES HARRINGTON BENEFIT SERVICES INC HARRINGTON HEALTH HARTFORD LIFE AND ACCIDENT INS. CO. HARVARD PILGRIM INSURANCE HAWAII MAINLAND ADMINISTRATORS HAWAII MEDICAL ASSURANCE ASSOCIATIO

HEALTH ADVANTAGE HEALTH ALLIANCE PLAN HEALTH ALLIANCE PLAN HEALTH AMERICA HEALTH AND WELFARE PLAN HEALTH CHOICE HEALTH COMP HEALTH COST SOLUTION/WC BEELER HEALTH DESIGN PLUS HEALTH FIRST

4024-00

3798-00 4281-00 3318-00 4180-00 4123-00 1787-00

1728-00

4185-00 0727-00 2729-00 3622-00 4193-00 1429-00

0935-00 1994-00 4273-00 3497-00 3639-00 0784-00 2151-00 3546-00 0751-00 3385-00 3460-00 0206-00 0208-00 1131-00

3026-00 2679-00 3770-00 0213-00 3306-00 4301-00 4272-00

1790-00 1632-00 H231-20 0722-00 3776-00 4307-00 3159-00 3207-00 3300-00 1922-00

300 BURNETT ST STE 200 PO BOX 163390 11910 ANDERSON RD 3101 SESSSIONS RD 1901 MARKET ST PO BOX 384 5245 BIG PINE WAY STE 102 4120 INTERNATIONAL PKWY STE 1050 P O BOX 211196 PO BOX 4665 108 WOODBINE LN PO BOX 40007 100 MATSONFORD RD/STE 100 3700 CRESTWOOD PKWY NW STE 400 PO BOX 2947 503 MCMILLAN RD P O BOX 2328 PO BOX 6000 7440 WOODLAND DR PO BOX 740209 1000 GREAT WEST DR PO BOX 749075 80 WOLF RD PO BOX 7371 PO BOX 100043 PO BOX 1144 PO BOX 2459 8490 PICARDY AVE STE 600 PO BOX 3857 PO BOX 1352 PO BOX 30544 690 ASYLUM AVE PO BOX 699183 P O BOX 22009 737 BISHOP ST STE 1200 PO BOX 22255 2850 WEST GRAND BLVD 2850 WEST GRAND BLVD 5425 BRITTANY DR PO BOX 21109 36 SOUTH STATE ST PO BOX 45018 PO BOX 1439 PO BOX 2583 821 ESE LOOP 323

FORT WORTH

AUSTIN AUSTIN TALLAHASSEE PHILADELPHIA KANSAS CITY FORT MYERS

CARROLLTON

EAGAN INDEPENDENCE DANVILLE LYNCHBURG RADNOR DULUTH

COVINGTON WEST MONROE OKLAHOMA CITY FRISCO INDIANAPOLIS CINCINNATI KENNETT DALLAS ALBANY LONDON DULUTH GLENVIEW SPOKANE BATON ROUGE

HOUMA DAYTON SALT LAKE CITY HARTFORD QUINCY TEMPE HONOLULU

SHREVEPORT DETROIT DETROIT BATON ROUGE ROANOKE SALT LAKE CITY FRESNO HENDERSONVILLE HUDSON TYLER

TX 76102

TX 78716 TX 78726 FL 32303 PA 19103 MO 64141 FL 33907

TX 75007

MN 55121 MO 64051 PA 17822 VA 24506 PA 19087 GA 30096

LA 70434 LA 71291 OK 73101 TX 75034 IN 46278 OH 45274 MO 63857 TX 75374 NY 12205 KY 40742 GA 30096 IL 60025 WA 99210 LA 70809

LA 70361 OH 45401 UT 84130 CT 06115 MA 02269 AZ 85285 HI 96813

LA 71120 MI 48202 MI 48202 LA 70808 VA 24018 UT 84147 CA 93718 TN 37077 OH 44236 TX 75701

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