Nevada Division of Insurance Department of Business and ...

Department of Business and Industry

Nevada Division of Insurance

Self-Insured Employer List

C of A 142274

Employer AFFINITY INTERACTIVE Elizabeth Guth VP - Insurance & Benefits 3755 Breakthrough Way, Suite 300 Las Vegas NV 89135 702-341-2419

Doing Business As

Affinity Gaming

Association Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Third Party Administrator

Name Flamingo Paradise Gaming, LLC Plantation Investments, LLC Primadonna Company, LLC (The) Primadonna Company, LLC (The) Primadonna Company, LLC (The) SIERRA NEVADA ADMINISTRATORS

Effective Date: 01-JUL-21

DBA Silver Sevens Hotel and Casino Rail City Casino Whiskey Pete's Hotel and Casino Buffalo Bill's Resort and Casino Primm Valley Resort and Casino

C of A 122997

Employer ARCBEST CORPORATION (FKA ARKANSAS BEST CORPORATION) Lynette Woodie Manager, Loss Prevention & Administration P.O. Box 10048 Fort Smith AR 72917-0048 479-785-6047

Association Subsidiary Subsidiary Third Party Administrator

Name ABF FREIGHT SYSTEM, INC. AcrBest II GALLAGHER BASSETT SERVICES, INC.(TPA)

DBA

Date 31-JAN-17 31-JAN-17 31-JAN-17 31-JAN-17 31-JAN-17 31-JAN-17

Date 15-DEC-81 01-NOV-20 15-DEC-81

Department of Business and Industry

Nevada Division of Insurance

Self-Insured Employer List

C of A 123211

Employer BEST BUY CO INC Allison Klonne Senior Analyst - Casualty Risk 7601 Penn Avenue South B4 Richfield MN 55423 612-291-6958

Association Subsidiary Subsidiary Subsidiary Subsidiary Third Party Administrator

Name BEST BUY HEALTH INC. BEST BUY STORES LP BEST BUY WAREHOUSING LOGISTICS LLC GREATCALL INC SEDGWICK CLAIMS MANAGEMENT SERVICES INC

C of A 123005

Employer BOYD GAMING CORPORATION Kim Cowley GL & WC Claims Manager 6465 South Rainbow Blvd Las Vegas NV 89118 702-792-7352

Association Subsidiary Subsidiary Subsidiary Subsidiary

Name ALIANTE CASINO AND HOTEL BOYD ATLANTIC CITY, INC. BOYD CENTRAL REGION, INC. BOYD DEVELOPMENT CORPORATION

DBA Sedgwick

DBA

Date 01-FEB-20 01-DEC-97 01-APR-17 01-OCT-18 01-DEC-97

Date 27-SEP-16 01-JAN-99 01-FEB-96 01-OCT-95

Department of Business and Industry

Nevada Division of Insurance

Self-Insured Employer List

Subsidiary Subsidiary Subsidiary Subsidiary

BOYD GAMING CORPORATION BOYD SHARED SERVICES, INC. BOYD TRAVEL, INC. CALIFORNIA HOTEL & CASINO

Subsidiary

CALIFORNIA HOTEL & CASINO

Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary

CANNERY CASINO AND HOTEL COAST CASINOS CONSTELLATION INSURANCE COMPANY EASTSIDE CANNERY HOTEL AND CASINO ELDORADO, INC. ELDORADO, INC. GOLD COAST HOTEL & CASINO

Subsidiary

M.S.W., INC.

Subsidiary Subsidiary Third Party Administrator

SAM-WILL, INC. SUNCOAST HOTEL & CASINO, THE CANNON COCHRAN MANAGEMENT SERVICES, INC.

C of A 123011

Employer CAESARS ENTERTAINMENT, INC. tim Healy Director of Risk Finance One Caesars Palace Drive Las Vegas NV 89109 949-606-3075

Association Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary

Name 3535 LV CORP. 3535 LV NEWCO LLC 3535 LV NEWCO LLC AMERICAN WAGERING INC. CAESARS ENTERPRISE SERVICES, LLC

VACATIONS-HAWAII CALIFORNIA HOTEL AND CASINO SAM'S TOWN HOTEL, GAMBLING HALL & BOWLING CENTER

THE ORLEANS HOTEL & CASINO

JOKERS WILD CASINO ELDORADO CASINO

MAIN STREET STATION HOTEL, CASINO & BREWERY FREMONT HOTEL AND CASINO

CCMSI

01-NOV-90 01-JUN-07 01-OCT-95 01-AUG-82

01-AUG-82

20-DEC-16 01-FEB-89 01-JUL-05 20-DEC-16 01-APR-93 01-APR-93 01-FEB-89

22-NOV-96

01-JUL-81 01-FEB-89 01-JUL-81

DBA

THE LINQ THE LINQ HOTEL AND CASINO (fka The Quad)

Date 20-JUL-20 20-JUL-20 20-JUL-20 01-AUG-21 20-JUL-20

Department of Business and Industry

Nevada Division of Insurance

Self-Insured Employer List

Subsidiary

CAESARS HOLDINGS INC.

Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Subsidiary Third Party Administrator

CAESARS INTERACTIVE ENTERTAINMENT LLC CAESARS LINQ, LLC CC-RENO, LLC CEOC LLC CEOC LLC CIRCUS AND ELDORADO JOINT VENTURE LLC COLUMBIA PROPERTIES TAHOE LLC CORNER INVESTMENT COMPANY LLC DESERT PALACE LLC DESERT PALACE LLC EASTSIDE CONVENTION CENTER LLC ELDORADO RESORTS, LLC FLAMINGO LAS VEGAS OPERATING COMPANY, LLC HARRAH SOUTH SHORE CORPORATION HARRAH'S LAS VEGAS, LLC HARRAH'S LAS VEGAS, LLC HARRAH'S LAUGHLIN, LLC HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEYS TAHOE MANAGEMENT COMPANY LLC PARBALL LLC PARBALL NEWCO LLC PARBALL NEWCO LLC PARIS LAS VEGAS OPERATING COMPANY, LLC PHW MANAGER, LLC PHWLV, LLC RIO PROPERTIES, LLC TROPICANA LAUGHLIN LLC WILLIAM HILL NEVADA I WILLIAM HILL NEVADA II WILLIAM HILL US HOLDCO INC. CANNON COCHRAN MANAGEMENT SERVICES, INC.

CAESARS HOLDINGS FKA CAESARS ENTERTAINMENT CORPORATION

THE LINQ Circus Circus Reno HARRAH'S CASINO HOTEL RENO HARRAH'S RENO Silver Legacy Hotel Casino Montbleu THE CROMWELL CAESARS PALACE LAS VEGAS CAESARS PALACE

Eldorado Hotel Casino FLAMINGO LAS VEGAS

HARRAH'S LAS VEGAS HARRAH'S CASINO HOTEL, LAS VEGAS HARRAH'S LAUGHLIN HARRAH'S CASINO HOTEL LAKE TAHOE HARRAH'S LAKE TAHOE HARVEY'S RESORT HOTEL/CASINO HARVEY'S LAKE TAHOE

BALLY'S LAS VEGAS THE SALON AT BALLY'S PARIS LAS VEGAS

PLANET HOLLYWOOD RIO ALL-SUITES HOTEL & CASINO Tropicana Laughlin

CCMSI

20-JUL-20

20-JUL-20 20-JUL-20 23-NOV-15 20-JUL-20 20-JUL-20 23-NOV-15 01-OCT-18 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 01-NOV-82 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 20-JUL-20 01-OCT-18 01-AUG-21 01-AUG-21 01-AUG-21 01-NOV-82

Department of Business and Industry

Nevada Division of Insurance

Self-Insured Employer List

C of A 122973

Employer CARSON CITY Cecilia Meyer, ASHM Risk Management Coordinator, CC Finance Division 201 North Carson Street Ste 3 Carson City NV 89701 775-283-7484

Association

Name

Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES, INC.

C of A 122974

Employer CARSON CITY SCHOOL DISTRICT Ann Cyr Risk Manager 1402 West King Street Carson City NV 89703 775-283-2006

Association

Name

Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC

C of A 122963

Employer CATHOLIC CHARITIES OF SOUTHERN NEVADA Mary Spees

DBA CCMSI

DBA

Date 01-JUL-10

Date 01-JUL-10

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