For Alaska, Arizona, Colorado, Hawaii, Iowa, Nevada, North Dakota, Oregon, South Dakota, Washington and Wyoming:

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1 The following companies are contracted with Noridian Administrative Services, LLC to receive Medicare Part B crossover claims. There is no need to submit Medigap information on claims for these companies. Doing so may delay processing and/or payment of the claim. For Alaska, Arizona, Colorado, Hawaii, Iowa, Nevada, North Dakota, Oregon, South Dakota, Washington and Wyoming: AARP Acordia dba Anthem Aetna American National Insurance Company American Postal Workers Union American Republic Anthem BC United of Wisconsin BCBS of Alabama BCBS of Iowa dba Wellmark BCBS of Kentucky dba Anthem BCBS of Minnesota BCBS of Oklahoma BCBS of South Dakota dba Wellmark Benefit Planners Caterpillar dba United Healthcare Centra dba Uniform Medical Plan Central States Life and Health Conseco Insurance Equitable Life and Casualty First Health Group Corporation dba SAMBA Fortis Insurance dba United Teachers Association General American dba Great West GHI New York Government Employees Hospital Association Great West Health Data Management AGE/USI Aid Association of Lutherans AMA Insurance Agency American Family Insurance American Family Life Assurance Company American Republic Bankers Fidelity Life, BCBS of Alabama BCBS of Arkansas Celtic Life dba North American Central Benefits National Insurance Company Continental General Healthcare Services Corporation Highmark Life & Casualty Mutual Protective North American Order of United Commercial Travelers Oxford Life dba North American Pacificare Pekin Insurance

2 Peoples Benefit Life dba Aegon Special Markets Physicians Mutual Insurance Company Principal Financial Group Savers Life dba North American State Farm Stirling and Stirling Transgeneral Services dba Highmark Life & Casualty Unified Life Insurance Comp any United Life Insurance Company USAble Life dba North American Westport Benefits, LLC World Insurance Company Horizon BCBS of NJ Humana dba United Teachers Association Kirk Van Orsdel dba Marsh Afinity Marsh Afinity Mayo Management Services, Inc. MetraHealth dba United Healthcare Met Life dba United Healthcare Metropolitan Life dba United Healthcare Monumental General Insurance Group Mutual of Omaha BC of California CIGNA Colonial Penn Life Insurance dba Conseco Direct Conseco Direct Health Source Provident Administrators, Inc. dba CIGNA ITT Hartford Life Insurance Company Mailhandlers Mennonite Mutual Aid, Incorporated Mutual of Omaha Mutual Protective/Medico Nationwide Health Plans New York Life Insurance Company Pyramid Life Insurance Company Special Agents Mutual Benefit Association USAA Life Insurance Company Wausau Insurance National Association of Letter Carriers Olympic Health Management Avera health Plans, Incorporated Bankers Life and Casualty Bankers Multiple Line Insurance Company Combined Insurance Company of America First Choice Health Plan, Incorporated Health Insurance Corporation of Alabama Healthguard Services of Washington Olympic Health Pioneer Life Insurance Company of Illinois Saint Joseph Care Management Corporation Seabord Life Insurance Co. (USA) Security Life Insurance Company of America Stirling Life Insurance Company The Health Insurance Exchange Pioneer Life dba Conseco Insurance Physicians Mutual Life Insurance

3 Providian Life and Health dba Aegon USA Regence BS Washington Seabury and Smith dba Marsh Afinity Sierra Life and Health Sioux Valley Health Standard Life and Accident dba American National Insurance Company Time Insurance dba United Teachers Association Torchmark Insurance Unicare dba Wellpoint Uniform Medical Plan United American Insurance dba Torchmark United Teachers Association United Healthcare Wakely and Associates Federal Home Life Insurance Company GE Capital Assurance Company GE Life Assurance and Annuity Company Lincoln Heritage Life Insurance Company Principal Life Insurance Company State Mutual Insurance Company Union Fidelity Insurance Company Wellmark Wellpoint World Net Services dba CHCS Services Inc. American Exchange Life American Pioneer Life American Progressive Life For Alaska, Arizona, Hawaii, Nevada, Oregon and Washington: BC of Washington and Alaska dba Premera BCBS of North Dakota dba Noridian Mutual Insurance Empire BCBS of NY Kitsap Physicians Services (KPS, Inc.) Oregon Dental Services, Inc. Premera Providence Health Plans Union Fidelity dba GE, Inc. For Arizona, Hawaii, and Nevada: BCBS of Michigan Continental Life Insurance Hawaii Medical Services Association For Alaska, Oregon and Washington:

4 For Colorado, North Dakota, South Dakota and Wyoming: BCBS of North Dakota dba Noridian Mutual Insurance Continental Life Insurance Lincoln Mutual Insurance For Iowa: Iowa Medicaid Nebraska Medicaid For Alaska: Alaska Medicaid Tricare dba Palmetto GBA For Arizona: Arizona Medicaid dba Arizona Health Care Cost Containment System BCBS of Arizona For Colorado: BC/BS of Colorado dba Anthem Colorado Medicaid For Hawaii: Hawaii Medicaid dba HAPA Tricare dba Palmetto GBA For Nevada: BCBS of Nevada dba Anthem Nevada Medicaid For North Dakota: North Dakota Medicaid

5 For Oregon: BS of Oregon dba Regence Oregon Medicaid dba Oregon Medical Assistance Program Tricare dba WPS Health Net Services For South Dakota: South Dakota Medicaid For Washington: BS of Washington and Alaska dba Regence Washington Medicaid Tricare dba WPS Health Net Services For Wyoming: Wyoming Medicaid

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