All States Workers Comp Payer List - OfficeAlly

[Pages:26]All States Workers Comp Payer List

Payer ID WS052 WC100 WC101 WC224 WC229 WC188 A0001 WC231 WC313 10166 WC528 WC343 WC390 WR905 WB133 WC232 WC399 ACU99 WC240 WC241 WZ093 WC270 WC413 WB111 WZ327 WC413 WC102 WC492 WC680 WC312 WB108 WC680 WC680 WC331 WC543 WC680 WC814 WC892 WC893 WC894 WC896 WC904 WC905 WC906 WC909 WR378 WP985 WC103 WZ216 WZ232 WZ668 WC913

Name NOV01 1-800-OhioComp 3-HAB 3M 7-Eleven (Corp) AAA Automobile AAA Cooper Transportation Acceptance Insurance Access Group Accident Fund Insurance Co of America Accuride Corporation Ace American Insuarnce Company Ace Fire Underwriters Insurance Co ACE Insurance Company ACE/ESIS (excludes Sunoco) ACIG Insurance Acrometal Companies Acuity, A Mutual Insurance Company ACWA JPI Adams and Brooks, Inc. Administrative Claim Service, Inc. ADT Fire & Security Advance Auto Parts Advanced Auto Parts Advanced Medical Optics Advanced Micro Devices AdvoCare Inc Agilent Technologies AID Insurance Company AIG AIG Claim Services Al South Insurance Co Alamo Community College District Alaska National Allianz Insurance Allied Document Solutions Allied Group Incorporated Allied Group Ins Allied Group Ins Marketing Allied Life Insurance Company Allied Mutual Ins Co Allied Property and Casualty Ins Co Allied Texas Agency Colonial County Mutual Allied Texas Agency Inc MGA Allison Transmission Allstate Insurance Alpha Review ALPS CompCare Altec Altec Industries Alternative Insurance Management Alternative Service Concepts

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State TX & MN Only

All States All States TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States All States All States MN Only All States All States All States MN Only TX & MN Only TX & MN Only All States All States TX & MN Only All States TX & MN Only MN Only All States All States TX & MN Only TX Only All States TX & MN Only MN Only MN Only MN Only MN Only MN Only MN Only MN Only MN Only TX & MN Only TX Only All States TX & MN Only All States MN Only MN Only All States TX Only

Page 1 of 26 Revised 5/17/2010

Payer ID WC370 WC595 WP022 WP023 WZ921 WC213 WP979 19720 20427 WA065 WC633 WC212 WX732 WC391 WC634 WP030 WP065 WR899 WC400 WP073 21857 WP093 40258 WB100 WP095 30562 22918 18910 WC408 WB103 WP096 WZ672 WC638 WC643 WP103 WA054 WB101 WC422 WC111 WA056 WP113 WC435 WP119 WC454 WP122

Name Alternative Services Concepts Alvey Systems (AON Risk) Amazon Com, Inc. AMCO Ins Co Amcomp Assurance - Wisconsin American All Risk Insurnace Co (AARIS) American All Risk Loss Administrators (AARLA) American Alternative Ins Corp American Casualty Co of Reading PA American Claims Management (ACM) American Coin Merchandising, Inc American Commercial Claim Admin (ACCA) ( San Francisco ONLY) American Commercial Claim Admin (ACCA) (Pasedena, CA ONLY) American Commercial Claim Admin (ACCA) (San Diego ONLY) American Cyanamid American Express American Guarantee American Home Assurance American Home Craft American Honda Motor Company American Insurance Co American Insurance Company American International South Ins Co American Interstate - TX only American Lumber Underwriters American Manufacturers Mutual Insurance Company American Motorists Insurance Co American Protection Insurance Co American Protective Ins. American Risk Services, Inc and all subsidiaries (Amerisafe Insureance Co) American Rural Work American Select American Specialty Companies American Specialty Ins. / MIB American Zurich Ameriprise Auto & Home Insurance Amerisafe Risk Services - TX only Amerisure Insurance Amerisure Mutual Insurance Amica Mutual Insurance Company Amtrust Insurance Co of Kansas Anderson & Howard Anoka Hennepin-Isd 11 API Panel Apogee Enterprises Inc.

WB164 Applied Risk Services, A subsidiary of Applied Underwriters, California Insurance Co., and Continental Indemnity Co.

WR904 WB112 WC130 WP125 WX852 WP126 WP127 WP129 WZ233

Aramark (Dental Only) Aramark (Prof & Inst Only) Arcadia Insurance Company Archdiocese Of St Paul & Mpls ARCMI Arctic Cat Inc Arctic Cat Of South Dakota Arden Foods, Inc Argenbright Holdings Limited

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State All States TX & MN Only TX Only MN Only All States All States All States TX & MN Only TX & MN Only All States TX & MN Only All States All States All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only MN Only TX & MN Only All States TX Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only All States TX & MN Only TX & MN Only TX & MN Only All States All States TX & MN Only TX & MN Only All States TX & MN Only All States MN Only All States TX & MN Only

All States

All States All States TX & MN Only MN Only TX & MN Only MN Only MN Only MN Only MN Only

Page 2 of 26 Revised 5/17/2010

Payer ID WZ478 WZ479 WZ502 WB165 WC503 WC504 WC505 WC506 WC507 WC516 WC518 WC519 WC520 WP130 21865 WP987 A0016 WC539 WC542 WC541 WC544 WC540 WC550 WP131 WC104 WZ744 WA053 WZ751 WZ788 WC564 WC563 WC562 WC567 WC105 WP930 WX601 WC429 WP132 WP135 WB113 WC618 WC621 WZ806 WC648 WP136 WB114 WC657 WP137 WP138 WP049 WP139 WC669 WC679 WBH01 WC681 WP140

Name Argonaut Claims Services, Ltd Argonaut Midwest Insurance Co Argonaut Southwest Insurance Co Arrow Point Capital (Formerly Royal&SunAlliance) Arrowhead Water (Los Angeles, CA) Arrowhead Water (Oakland, CA) Arrowhead Water (Orange, CA) Arrowhead Water (San Diego, CA) Arrowhead Water (South San Fran, CA) Artistree, Inc. Asbury Environmental Corp (Southgate, CA) Asbury Environmental Corp (Spring Valley, CA) ASC Ascension Health Associated Indemnity Corp Association Casualty Insurance Company AT & T Corp AT&T Worldwide Customer Service AT&T (El Segundo, CA) AT&T (San Francisco, CA) AT&T (San Jose, CA) AT&T (San Ramon, CA) Atlantic Mutual Atlantic Mutual Insurance AultComp Austin Mutual Auto Club Insurance Association Auto Owners Insurance Company Auto Owners Life Insurance Company Auto Zone (Fullerton, CA) Auto Zone (Modesto, CA) Auto Zone(San Diego, CA) Automotive Clinic AvatarComp Aviation Safeguard Avizent Ayers Trucking Bancinsure, Inc. Bankers Standard Insurance Barnes Bas Tire Recycling Bassett Unified School District Beacon Beall's Inc / Midwest Employers Bed Bath & Beyond (Auto Only) Bed Bath and Beyond (WC Only) Bell Gardens Family Medical Center Bell South Corporation Bemis Company Inc. Benchmark Insurance Benedictine Group Self-Insurance Assoc. Bennett Landscaping Berkley Specialty Underwriters Berkshire Hathaway Homestate Co. Berkshire Hathaway Homestate Co. (San Fran, CA) Bermo, Inc.

| 866.575.4120 *Payer List subject to change without notice

State All States All States All States All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States All States All States All States TX Only TX & MN Only All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only All States All States All States All States All States TX Only TX Only TX Only All States All States All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States All States All States All States TX & MN Only TX & MN Only All States All States TX & MN Only TX & MN Only All States MN Only All States TX & MN Only All States All States MN Only

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Payer ID WP141 WC677 WP143 WP144 WC705 WC703 WC706 WC707 WC708 WC704 WP146 WZ570 WZ588 WP147 WC729 WC739 WP148 WP149 WP152 WP154 WZ817 20761 WP187 WP190 WP194 WP206 WP179 WP186 WB147 WB148 WP216 WC782 WP745 WC789 WP222 WP233 WC678 WC744 WC812 WB166 WB167 WB188 WB189 WP243 WC761 WR900 WP251 WP267 WC840 WR896 WP288 WP289 WC898 WR909 WP598 WC915

Name Bertelmanns Inc. Berwind Corporation Best American Hospitality Big Lots Big Lots (Garden Grove, CA) Big Lots (Lornita, CA) Big Lots (Mission Viejo, CA) Big Lots (Rancho Cucamonga, CA) Big Lots (Redlands, CA) Big Lots (Santa Ana, CA) Birmingham Fire Insurance Co PA Bituminous Casualty Corp Bituminous Fire & Marine Insurance Co Blockbuster Inc Bloodsource, Inc. Blueline Food Services Bob Evans Bois Forte Reservation Tribal Council Boise Cascade Corporation Boise Paper Holdings Boldt Company Boston Old Colony Insurance Co Brickman Group (Dallas) Brickman Group (Houston) Brickman Group (Plano) Brickman Group (Roanoke) Brickman Group (Woodlands) Brickman Groupp (Austin) Bridgefield Casualty Insurance Company Bridgefield Employers Insurance Company Brinker International Bristol Park Medical British American Insurance Company Broadspire Broadspire - Dallas Broadspire - Lewisville Brownyard Group Inc. (Arch Insurance) Brunswick Corporation Bunch & Assoc. Inc Bunch & Associates - CostCo Bunch & Associates - Food Lion Bunch and Associates - Aramark (LIMITED) Bunch and Associates - Lowes (LIMITED) Burger King Corporation Burlington Coat Factory Wareho Burtons Fire Butterball, L.L.C. C & S Wholesale Grocers C.O.P. CA American Water Company Cal Southampton Calfarm Insurance company Cambridge (Carrolton, TX) Cambridge (Concord, CA) Cambridge (Glendale, CA) Cambridge (Los Angeles, CA)

| 866.575.4120 *Payer List subject to change without notice

State TX & MN Only TX & MN Only TX & MN Only

TX Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only

All States All States TX & MN Only All States All States TX Only MN Only TX & MN Only TX & MN Only All States TX & MN Only TX Only TX Only TX Only TX Only TX Only TX Only All States All States TX Only All States All States TX & MN Only TX Only TX Only TX & MN Only TX & MN Only All States All States All States All States All States TX & MN Only TX & MN Only All States TX Only TX Only All States All States TX Only MN Only All States All States All States All States

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Payer ID WP472 WR872 WC902 WC897 WC900 WX163 WR911 WP123 WR841 WC903 WC910 WC907 WC908 WP978 WC413 30589 WC931 WP291 WC107 WP311 WP312 WZ279 WP870 WP290 WR322 WP315 WR888 WC783 WX167 WC966 WC787 WP336 WP370 WB149 WC788 WX007 WP371 WP385 WP406 A0031 WP407 WZ528 12777 10052 WP422 WP424 WP428 WP470 WZ922 10677 WZ923 WX067 WX063 WX064 WX066 WX068

Name Cambridge (Pasedena, CA) Cambridge (Portland, OR) Cambridge (Rancho Cordova, CA) Cambridge (Sacramento, CA) Cambridge (San Diego, CA) Cambridge Integrated Services Group Cambridge Integrated Services Group (Glendale, CA) Cambridge Integrated Services Group (Modesto, CA) Cambridge Integrated Services Group (now Xchanging) Cambridge Integrated Services Group (Pasedena, CA) Cambridge Integrated Services Group (Rancho Cordova, CA) Cambridge Integrated Services Group (Sacramento, CA) Cambridge Integrated Services Group (Salt Lake City, UT) Cambridge Integrated Services Group, Inc. (Warren, MI) Canyon House Capital City Insurance Company, Inc Cardinal Health Careage CareWorks Carleton College Casella Ins. Co Caseys General Stores Catholic Mutual CCMLBOI CCMSI Cedar Fair L.P. Cen Cal Machine Cendant Corporation Center for Employee Training (Student Accident ONLY) Center for Employee Training (WorkComp ONLY) Central Hockey League Cerenity Senior Care Large Deductible Certified Power Train Specialists, Inc. Charlotte County Charming Shoppes, Inc. Cherokee Insurance Chesterfield Serv-Uniontown Chick-fil-A Children's Hospitals and Clinics of MN Christus Health Chrysler Group LLC Chubb & Sons - Federal Insurance Chubb Indemnity Co Chubb National Insurance Company Church - Auto Church Mutual Insurance Company Church of Jesus Christ of Latter Day Saints CIGNA CIM Insurance Corporation Cincinnati Insurance Co Cincinnati Specialty Underwriters Company Cintas (Ontario) Cintas (Pico Rivera) Cintas (Sacramento) Cintas (San Diego) Cintas (San Fran)

| 866.575.4120 *Payer List subject to change without notice

State All States All States All States All States All States All States All States All States All States All States All States All States All States All States All States TX & MN Only TX & MN Only TX Only All States MN Only MN Only TX & MN Only TX & MN Only MN Only TX Only MN Only All States TX & MN Only All States All States TX & MN Only MN Only MN Only All States TX & MN Only All States TX & MN Only TX Only MN Only TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only All States All States All States All States All States All States

Page 5 of 26 Revised 5/17/2010

Payer ID WX065 WX069 WX070 WX060 WR898 WX078 WX059 WC293 WP473 WP474 WP857 A0051 WB115 WR497 WP475 WB150 WB151 WP476 WP478 WP480 WC152 WP481 WX090 WZ842 WP482 WX115 WP492 WR889 WB152 WZ843 WP980 20532 WX124 WC790 WX137

WP493

WA041 WB168 WP929 WX160 WX161 WX164 WX165 WP496 WP497 WC791 WC834 WC835 WR320 WP502 WP513 WC792 WP514 WB136 WX214

Name Cintas (San Jose) Cintas (Tustin) Cintas (Vista) Cintas Fire And Safety Cirq Wire Works City Fibers, Inc. (Vernon) City of Amarillo (Austin) City Of Arlington City of Bloomington City of Eagan City Of El Paso City of Hurst City of Jacksonville City of Lewisville City of Minneapolis City of North Miami Beach City of Plant City City of Plymouth City of Richfield City of Rochester City of San Angelo City of San Antonio City of San Bernardino City of St. Paul City of Waco Claim Quest (was Centurion) Claimetrics Claims Administrative Services (CAS) Claims Center Claims Services & Investigations Clarendon National Clarendon National Insurance Co Clarendon National Insurance Co (Santa Ana) Classic Residence By Hyatt Clean Harbors, LLC (all locations) Cleveland Cliffs (Empire, Tilden, Cleveland Cliffs, Marquette Iron, United Taconite, Hibbing Taconite, Northshore, LS&I Railroad) CNA Insurance CNA Insurance CNA Insurance (FL) CNA Insurance (TX) CNA Insurance (CA) CNA Insurance (OR) CNA Insurance (PA) Coach America Coach USA Coca-Cola Enterprises Inc. Cochran Canon Management Service, Inc. (CCMSI) (Concord, CA) Cochran Canon Management Service, Inc. (CCMSI) (Danville, IL) Cochran Canon Management Service, Inc. (CCMSI) (Minnetonka) Colgate-Palmolive Corporate Colonial General Insurance Company Columbia Sussex Corporation Commerce & Industry Insurance Commonwealth Industries Comp West

| 866.575.4120 *Payer List subject to change without notice

State All States All States All States All States All States All States All States TX & MN Only MN Only MN Only TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only All States All States MN Only MN Only MN Only TX & MN Only TX Only All States All States TX Only All States TX Only TX & MN Only All States All States All States TX & MN Only TX & MN Only TX & MN Only All States

MN Only

All States All States All States All States All States All States All States TX & MN Only All States TX & MN Only All States All States All States TX Only MN Only TX & MN Only TX & MN Only

TX All States

Page 6 of 26 Revised 5/17/2010

Payer ID WC793 WC109 WC108 WC106 WX753 WP526 WX226 WP565 WP674 WB102 WP575 WX239 WC803 WC813 20443 35289 WP578 WC131 WP589 WC826 00622 WP612 WC846 WC899 WC110 WB116 WZ902 WZ903 WZ904 WZ905 WX286 WP613 WX307 WX318 WP615 WC901 WX335 WR916 WP618 WC153 WC132 WP155 WB117 WX381 WP619 WP640 WC127 32271 WP441 WP647 WX037 WP649 WB105 WX444 WB104 WP651

Name Compass Group Usa, Inc. CompManagement Health Systems CompOne Comprehensive Manged Care Systems CompTech Conagra Food, Inc. Concepts Awnings Canvas, Inc. Connecticut Indemnity Co Constitution State Services Constitution States (St. Paul Travelers) Construction Services Group Self Insured Association Container Store (San Diego) Contech Construction Products Continental Airlines Continental Casualty Co Continental Insurance Co Continental National Insurance Continental Western Continental Western Ins Co Convergys Corporation Coregis Insurance Co Core-Mark International Correctional Management Service Corrections Corp of America CorVel Corp Costco (Corp) Cottingham & Butler Claim Services, Inc. Country Casualty Insurance Company Country Mutual Insurance Company Country Preferred Insurance Company County Of Kern (Risk Management Dept) County Of Olmsted County Of San Diego Couts Heating & Cooling (Sacramento) Covidien Coworx Staffing, LLC Crawford Insurance Crescent Village Crestbrook Insurance Company Crum & Forster Indemnity Co Cumis Insurance Society CVS Pharmacy CVS Pharmacy / Caremark / Minute Clinic Cypress Security Daimler Trucks North America WC (fka Freightliner LLC) Dallas County Schools Dallas County Schools Dallas National Insurance Co Danaher Corporation DCI, Inc. De Bartolos, Inc Delphi Corporation Department of Energy Department of Labor and Industries Department of Labor Black Lung Depositors Insurance Co

| 866.575.4120 *Payer List subject to change without notice

State TX & MN Only

All States All States All States TX & MN Only TX & MN Only All States TX & MN Only All States All States MN Only All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States All States All States All States All States All States All States MN Only All States All States TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States All States TX & MN Only TX Only All States All States TX & MN Only MN Only TX & MN Only TX & MN Only All States All States All States MN Only

Page 7 of 26 Revised 5/17/2010

Payer ID WX452 WP652 WX294 WP675 WX039 WX040 WP697 WP748 WP749 WX500 WP753 WP756 WX042 WX540 WX541 WX570 WX043 WP767 WP768 WP788 WP800 WP804 WB021 WP805 WX577 WC329 WC351 WX574 WP807 WC160 WC157 WP812 WP813 WP818 11512 WP853 WC158 WZ906 39845 WZ258 WX045 WX638 WB169 WR894 WB153 WS026 WS027 WS028 WS029 WS030 WS031 WS032 WS033 WX046 WS034 WS035

Name Dept. Of Veteran's Affairs (CA) Dillard Departmen (Little Rock) Dillards Risk Management Diocese of Winona Directory Distributing Assoc. Discover Re (Burger King) Discover Reinsurance Company Dixie Staffing (Lithia Springs) Domino's Pizza LLC Donovan's Steak House DPWN Holdings Inc. Dreyer's Grand Ice Cream Holdings, Inc. Dunn-Edwards Corporation Durham School Services (Oxnard) Durham School Services (Santa Ana) Dustrol Dynamex, Inc. East Central ISD Eaton Corporation eBay Eddie Bauer (Spiegel) Edgewood ISD EDIC EEP Workers Compensation Fund El Cholo Restaurant El Paso Community College (Tx Jur) El Paso Water Util Tx Jur Electric Insurance Company Elim Care, Inc. EMC Risk Services, LLC EMCASCO Insurance Co Emergency Medical Services (AMR) Emerson Electric Company Employ Bridge (Irving) Employers Compensation Insurance Co Employers Compensation Insurance Fund Employers Mutual Casualty Employers Preferred Employers Reinsurance Corp Enterprise Rent A Car Envirosource Equity Resid (San Diego, CA) Erie Insurance Group ERMC Escambia County Esis (Alabama) Esis (Alaska) Esis (Arizona) Esis (Arkansas) Esis (California) Esis (Colorado) Esis (Connecticut) Esis (Delaware) Esis (First American Insurance Co) Esis (Florida) Esis (Georgia)

| 866.575.4120 *Payer List subject to change without notice

State All States TX & MN Only All States MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only TX & MN Only TX & MN Only All States All States TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX Only TX Only All States MN Only All States TX & MN Only TX & MN Only All States MN Only TX & MN Only TX & MN Only TX Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only TX & MN Only All States TX & MN Only MN Only TX & MN Only All States All States TX & MN Only All States All States All States All States All States All States All States All States All States TX & MN Only All States All States

Page 8 of 26 Revised 5/17/2010

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