4/15/2014 Workers Compensation Agency Page 1 Insurance Company Listing

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1 4/15/2014 Workers Compensation Agency Page 1 A.I.U. Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Acadia Insurance Company NAIC Number: Acceptance Insurance Company 535 W. Broadway P.O. Box 1574 Council Bluffs, IA NAIC Number: Accident Fund General Insurance Co. P.O. Box Lansing, MI NAIC Number: Accident Fund Insurance Co. of America P.O. Box Lansing, MI NAIC Number: Accident Fund National Insurance Co. P.O. Box Lansing, MI NAIC Number: Ace American Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Ace Fire Underwriters Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Ace Property & Casualty Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: ACIG Insurance Company Merit Drive Suite 1660 Dallas, TX NAIC Number: Acuity, A Mutual Insurance Company 2800 S. Taylor Drive P.O. Box 58 Sheboygan, WI NAIC Number: Advantage Workers Compensation Insurance Company P.O. Box Salt Lake City, UT NAIC Number: Affiliated F M Insurance Company Allendale Park P.O. Box 7500 Johnston, RI NAIC Number: Alea North America Insurance Company 55 Capital Blvd. Rocky Hill, CT NAIC Number: All America Insurance Company 800 S. Washington Street Vanwert, OH NAIC Number: Alliance Assurance Company, Ltd Arco Corporate Drive Charlotte, NC NAIC Number: Allianz Insurance Company 2995 Prospect Park Drive, Suite 200 Rancho Cordova, CA NAIC Number: Allied Eastern Indemnity Company 25 Race Avenue P.O. Box Lancaster, PA NAIC Number: Allied Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Allied Property & Casualty Insurance Company th DesMoines, IA NAIC Number: Allmerica Financial Benefits Insurance Company P.O. Box Worcester, MA NAIC Number: Allmerica Financial Alliance Insurance Company P.O. Box Worcester, MA NAIC Number:

2 4/15/2014 Workers Compensation Agency Page 2 Allstate Indemnity Company 3075 Sanders Road, Suite H1A Northbrook, IL NAIC Number: Allstate Insurance Company 3075 Sanders Road, Suite H1A Northbrook, IL NAIC Number: Amco Insurance Company One Nationwide Plaza Columbus, OH NAIC Number: American & Foreign Insurance Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: American Alternative Insurance Company American RE Plaza 555 College Road East Princeton, NJ NAIC Number: American Automobile Insurance Company P.O. Box Atlanta, GA NAIC Number: American Casualty Company of Reading, PA NAIC Number: American Commercial Liability Insurance Co. NAIC Number: American Compensation Insurance Company 8500 Normandale Lake Blvd. Ste Bloomington, MN NAIC Number: American Continental Insurance Company NAIC Number: American Country Insurance Company 150 N. W. Point Blvd., Suite 300 Elk Grove Village, IL NAIC Number: American Druggists Insurance Company NAIC Number: American Economy Insurance Company NAIC Number: American European Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY NAIC Number: American Family Home Insurance Company 555 College Road East Princeton, NJ NAIC Number: American Fire & Casualty Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI NAIC Number: American Fuji Fire & Marine Insurance Company 3880 RFD Salem Lake Road Long Grove, IL NAIC Number: American Guarantee & Liability Insurance Co American Lane NAIC Number: American Hardware Mutual Insurance Company P.O. Box 435 Minneapolis, MN NAIC Number: American Home Assurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: American Insurance Company P.O. Box Atlanta, GA NAIC Number: American Interstate Insurance Company 2301 Highway 190 West Deridder, LA NAIC Number:

3 4/15/2014 Workers Compensation Agency Page 3 American Manufacturers Mutual Insurance Co. Fund NAIC Number: American Mining Insurance Company NAIC Number: American Modern Home Insurance Company 555 College Road East Princeton, NJ NAIC Number: American Motorists Insurance Company Fund NAIC Number: American Mutual Insurance Company of Boston 100 Unicorn Park Drive Woburn, MA NAIC Number: American Mutual Liability Insurance Company 100 Unicorn Park Drive Woburn, MA NAIC Number: American Physicians Assurance Corporation 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI NAIC Number: American Policyholders Insurance Co. 100 Unicorn Park Drive Woburn, MA NAIC Number: American Protection Insurance Company Fund NAIC Number: American Safety Casualty Insurance Company 100 Galleria Pkwy SE, Ste. 700 Atlanta, GA NAIC Number: American Select Insurance Company One Park Circle P.O. Box 5001 Westfield Center, OH NAIC Number: American States Insurance Company NAIC Number: American Universal Insurance Company NAIC Number: American Zurich Insurance Company 1400 American Lane NAIC Number: Amerisure Insurance Company P.O. Box Detroit, MI NAIC Number: Amerisure Mutual Insurance Company P.O. Box Detroit, MI NAIC Number: Amerisure Partners Insurance Company P.O. Box Detroit, MI NAIC Number: AmGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA NAIC Number: Ansur America Insurance Company One Mutual Avenue Frankenmuth, MI NAIC Number: AP Specialty Insurance Corp N. Hagadorn Road East Lansing, MI NAIC Number: Arch Insurance Company 330 Post Road #200 Darien, CT NAIC Number: Argonaut Great Central Insurance Company P.O. Box San Antonio, TX NAIC Number:

4 4/15/2014 Workers Compensation Agency Page 4 Argonaut Insurance Company P.O. Box San Antonio, TX NAIC Number: Argonaut Midwest Insurance Company P.O. Box San Antonio, TX NAIC Number: Arrowood Indemnity Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Associated Indemnity Corporation P.O. Box Atlanta, GA NAIC Number: Assurance Company of America 1400 American Lane NAIC Number: Athena Assurance Company NAIC Number: Atlantic Mutual Insurance Company NAIC Number: Atlantic Specialty Insurance Company 1051 Texas Street Salem, VA NAIC Number: Auto Owners Insurance Company Michigan Workers' Comp. Claims P.O. Box Lansing, MI NAIC Number: Automobile Insurance Company of Hartford, CT NAIC Number: Axa Corporate Solutions Insurance Company 17 State Street New York, NY NAIC Number: Badger Mutual Insurance Company 1635 W National Ave Milwaukee, WI NAIC Number: Balboa Insurance Company 3349 Michelson Drive Irvine, CA NAIC Number: Bancinsure, Inc N. Lincoln Blvd. Oklahoma City, OK NAIC Number: Bankers Standard Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Benchmark Insurance Company 775 Prairie Center Dr, Suite 420 Eden Prairie, MN NAIC Number: Berkley National Insurance Company NAIC Number: Berkley Regional Insurance Company NAIC Number: Berkshire Hathaway Homestate Insurance Company P.O. Box San Francisco, CA NAIC Number: Bituminous Casualty Corporation W. 14 Mile Road, Suite 211 Farmington Hills, MI NAIC Number: Bituminous Fire & Marine Insurance Company W. 14 Mile Road, Suite 211 Farmington Hills, MI NAIC Number: Bloomington Compensation Insurance Company 8500 Normandale Lake Blvd. Ste Bloomington, MN NAIC Number: Boston Insurance Company 1717 E. 9th Street Cleveland, OH NAIC Number:

5 4/15/2014 Workers Compensation Agency Page 5 Boston Old Colony Insurance Company NAIC Number: Brotherhood Mutual Insurance Company P.O. Box 2227 Fort Wayne, IN NAIC Number: Buckeye Union Insurance Company NAIC Number: Camden Fire Insurance Association Co. of NJ 1051 Texas Street Salem, VA NAIC Number: Capitol Indemnity Corporation P.O. Box 5900 Madison, WI NAIC Number: Carolina Casualty Insurance Company NAIC Number: Carriers Insurance Company NAIC Number: Castlepoint National Insurance Company 222 S. Riverside Plaza Chicago, IL NAIC Number: Casualty Reciprocal Exchange NAIC Number: Celina Mutual Insurance Company 1 Insurance Square Celina, OH NAIC Number: Centennial Insurance Company NAIC Number: Central Mutual Insurance Company 800 S. Washington Street Vanwert, OH NAIC Number: Central National Insurance Co. of Omaha 105 S. 17th Street Omaha, NE NAIC Number: Century Indemnity Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Charter Oak Fire Insurance Company NAIC Number: AIG Property Casualty Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Cherokee Insurance Company Mound Road Sterling Heights, MI NAIC Number: Chrysler Insurance Company P.O. Box 9220 Farmington Hills, MI NAIC Number: Chubb Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL NAIC Number: Chubb Nationial Insurance Company 202 Halls Mill Road Whitehouse Station, NJ NAIC Number: Church Mutual Insurance Company 3000 Schuster Lane P.O. Box 357 Merrill, WI NAIC Number: Cincinnati Casualty Company P.O. Box Grand Rapids, MI NAIC Number: Cincinnati Indemnity Company P.O. Box Grand Rapids, MI NAIC Number:

6 4/15/2014 Workers Compensation Agency Page 6 Cincinnati Insurance Company P.O. Box Grand Rapids, MI NAIC Number: Citizens Insurance Company of America P.O. Box Worcester, MA NAIC Number: Citizens Insurance Company of Ohio P.O. Box Worcester, MA NAIC Number: Citizens Insurance Company of the Midwest P.O. Box Worcester, MA NAIC Number: City Insurance Company NAIC Number: Clarendon National Insurance Company 411 5th Ave. FL 5 New York, NY NAIC Number: Colonial American Casualty & Surety Company 1400 American Lane NAIC Number: Colonial Penn Insurance Company P.O. Box 1998 Valley Forge, PA NAIC Number: Commerce & Industry Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Commercial Insurance Company of Newark NAIC Number: Companion Commercial Insurance Company 51 Clemson Road Columbia, SC NAIC Number: Companion Property & Casualty Insurance Company 51 Clemson Road Columbia, SC NAIC Number: Compass Insurance Company 9277 Centre Pointe Drive, Suite 140 West Chester, OH NAIC Number: Conifer Insurance Company P.O. Box 3003 Birmingham, MI NAIC Number: Connecticut Indemnity Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Consolidated American Insurance Company P.O. Box 1 Columbia, SC NAIC Number: Consolidated Insurance Company WC Processing Center P.O. Box Los Angeles, CA NAIC Number: Consolidated Underwriters NAIC Number: WC Continental Casualty Company NAIC Number: Continental Indemnity Company P.O. Box San Francisco, CA NAIC Number: Continental Insurance Company NAIC Number: Continental National American Casualty Co. NAIC Number:

7 4/15/2014 Workers Compensation Agency Page 7 Continental National Indemnity Company NAIC Number: Continental Western Insurance Company NAIC Number: Crum & Forster Indemnity Company 305 Madison Avenue Morristown, NJ NAIC Number: CUMIS Insurance Society, Inc. Workers' Compensation Claims P.O. Box 1221 Madison, WI NAIC Number: Dallas National Insurance Company 5501 L.B. J. Freeway Dallas, TX NAIC Number: Depositors Insurance Company 1100 Locust Street Des Moines, IA NAIC Number: Discover Property & Casualty Insurance Co Discover Re Managers, Inc. 5 Batterson Pk Farmington, CT NAIC Number: Dorinco Reinsurance Company 1320 Waldo Avenue, Suite 200 Midland, MI NAIC Number: Eagle Pacific Insurance Company Fund NAIC Number: Eagle Star Insurance Company 111 John Street New York, NY NAIC Number: Eastern Advantage Assurance Company 25 Race Avenue P.O. Box Lancaster, PA NAIC Number: Eastern Alliance Insurance Company 25 Race Avenue P.O. Box Lancaster, PA NAIC Number: Eastguard Insurance Company 16 S. River Street Wilkes Barre, PA NAIC Number: Edison Insurance Company 222 Merchandise Mart Plaza Ste Chicago, IL NAIC Number: Electric Insurance Company 260 Washington Avenue P.O. Box Albany, NY NAIC Number: Electric Mutual Liability Insurance Company 4 Corporate Plz #425 Albany, NY NAIC Number: Emcasco Insurance Company P.O. Box Lansing, MI NAIC Number: Employers Casualty Company NAIC Number: Employers Fire Insurance Company 1051 Texas Street Salem, VA NAIC Number: Employers Insurance of Wausau NAIC Number: Employers Mutual Casualty Company P.O. Box Lansing, MI NAIC Number: Everest National Insurance Company P.O. Box 830 Liberty Corner, NJ NAIC Number:

8 4/15/2014 Workers Compensation Agency Page 8 Evergreen National Indemnity Company 6140 Parkland Blvd. Mayfield, OH NAIC Number: Fairfield Insurance Company P.O. Box San Francisco, CA NAIC Number: Fairmont Insurance Company 250 Commercial Street Suite 5000 Manchester, NH NAIC Number: Farm Bureau General Insurance Company Medical Maintenance Unit P.O. Box Lansing, MI NAIC Number: Farm Bureau Mutual Insurance Company Medical Maintenance Unit P.O. Box Lansing, MI NAIC Number: Farmers Automobile Insurance Association 2505 Court Street Pekin, IL NAIC Number: Farmers Insurance Exchange P.O. Box Oklahoma City, OK NAIC Number: Farmington Casualty Company NAIC Number: Farmland Mutual Insurance Company 1100 Locust Street, Dept Des Moines, IA NAIC Number: FCCI Insurance Company P.O. Box Sarasota, FL NAIC Number: Federal Insurance Company 233 South Wacker Drive, Suite 4700 Chicago, IL NAIC Number: Federal Kemper Insurance Company Fund NAIC Number: Federated Mutual Insurance Company P.O. Box Minneapolis, MN NAIC Number: Federated Rural Electric Insurance Corp. P.O. Box Lenexa, KS NAIC Number: Federated Service Insurance Company P.O. Box Minneapolis, MN NAIC Number: Fidelity & Casualty Company of New York NAIC Number: Fidelity & Deposit Company of Maryland 1400 American Lane NAIC Number: Fidelity & Guaranty Insurance Company Discover Re Managers, Inc. 5 Batterson Park Farmington, CT NAIC Number: Fidelity & Guaranty Insurance Underwriters Discover Re Managers, Inc. 5 Batterson Park Farmington, CT NAIC Number: Fire & Casualty Insurance Company of Ct 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Firemans Fund Insurance Company P.O. Box Atlanta, GA NAIC Number: Firemans Fund Insurance Company of Wisconsin P.O. Box Atlanta, GA NAIC Number:

9 4/15/2014 Workers Compensation Agency Page 9 Firemens Insurance Company of Newark, N.J. NAIC Number: Firemens Insurance Company of Washington, D.C. NAIC Number: First Liberty Insurance Corporation NAIC Number: First National Insurance Company of America NAIC Number: Florists Mutual Insurance Company 1 Horticultural Lane Edwardsville, IL NAIC Number: Foremost Insurance Company NAIC Number: Foremost Property & Casualty Insurance Company NAIC Number: Foremost Signature Insurance Company NAIC Number: Frankenmuth Mutual Insurance Company One Mutual Avenue Frankenmuth, MI NAIC Number: Frank Winton Crum Insurance Company 100 S Missouri Ave Clearwater, FL NAIC Number: Fremont Casualty Insurance Company NAIC Number: Fremont Compensation Insurance Company NAIC Number: Fremont Indemnity Company NAIC Number: Fremont Insurance Company 933 E. Main Street Fremont, MI NAIC Number: Frontier Insurance Company 195 Lake Louise Marie Rd. Rock Hill, NY NAIC Number: Gateway Insurance Company 1401 S. Brentwood Blvd., Ste St.Louis, MO NAIC Number: General Casualty Insurance Company P.O. Box 975 Sun Prairie, WI NAIC Number: General Casualty Company of Wisconsin P.O. Box 975 Sun Prairie, WI NAIC Number: General Insurance Company of America NAIC Number: Genesis Insurance Company P.O. Box San Francisco, CA NAIC Number: Glens Falls Insurance Company NAIC Number: Globe Indemnity Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number:

10 4/15/2014 Workers Compensation Agency Page 10 Grange Insurance Company of Michigan 400 Galleria Officentre, Suite 115 Southfield, MI NAIC Number: Granite State Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Great American Alliance Insurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: Great American Assurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: Great American Insurance Co of NY P.O. Box 5432 Cincinnati, OH NAIC Number: Great American Insurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: Great American Security Insurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: Great American Spirit Insurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: Great Divide Insurance Company NAIC Number: Great Midwest Insurance Company 800 Gessner, Suite 600 Houston, TX NAIC Number: Great Northern Insurance Company 233 South Wacker Drive, Suite 4700 Chicago, IL NAIC Number: Great West Casualty Company P.O. Box 277 S. Sioux City, NE NAIC Number: Greater New York Mutual Insurance Company 200 Madison Avenue New York, NY NAIC Number: Greenwich Insurance Company 505 Eagleview Blvd. Exton, PA NAIC Number: Grocers Insurance Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Guarantee Insurance Company 401 E Las Olas Blvd Fort Lauderdale, FL NAIC Number: Guideone Mutual Insurance Company 1025 Ashworth Road, Suite 101 West DesMoines, IA NAIC Number: Gulf Insurance Company NAIC Number: Hamilton Mutual Insurance 717 Mulberry Street Des Moines, IA NAIC Number: Hamilton Mutual Insurance Company John Keller, Asst. VP 1520 Madison Road Cincinnati, OH NAIC Number: Hanover American Insurance Company P.O. Box Worcester, MA NAIC Number: Hanover Insurance Company P.O. Box Worcester, MA NAIC Number: Harco National Insurance Company P.O. Box Schaumburg, IL NAIC Number: Harleysville Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA NAIC Number:

11 4/15/2014 Workers Compensation Agency Page 11 Harleysville Lake States Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA NAIC Number: Harleysville Mutual Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA NAIC Number: Harleysville Preferred Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA NAIC Number: Harleysville Worcester Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA NAIC Number: Hartford Accident & Indemnity Company 4245 Meridian Pkwy Aurora, IL NAIC Number: Hartford Casualty Insurance Company 4245 Meridian Pkwy Aurora, IL NAIC Number: Hartford Fire Insurance Company 4245 Meridian Pkwy Aurora, IL NAIC Number: Hartford Insurance Company of the Midwest 4245 Meridian Pkwy Aurora, IL NAIC Number: Hartford Underwriters Insurance Company 4245 Meridian Pkwy Aurora, IL NAIC Number: Hastings Mutual Insurance Company Peggy Surma 404 E. Woodlawn Avenue Hastings, MI NAIC Number: Hawkeye Security Insurance Company P.O. Box 1848 Des Moines, IA NAIC Number: HDI - Gerling America Insurcance Company 150 N. Wacker Drive 29th Floor Chicago, IL NAIC Number: Highlands Insurance Company Richmond Avenue, Suite 175 Houston, TX NAIC Number: HIH America Compensation & Liability Ins. Co. NAIC Number: Home Indemnity Company NAIC Number: Home Insurance Company NAIC Number: Home Owners Insurance Company Michigan Workers Comp. Claims P.O. Box Lansing, MI NAIC Number: Housing Authority Property Insurance Company 189 Commerce Court P.O. Box 189 Cheshire, CT NAIC Number: Houston General Insurance Company 1051 Texas Street Salem, VA NAIC Number: Hudson Insurance Company 305 Madison Avenue Morristown, NJ NAIC Number: Ideal Mutual Insurance Company NAIC Number:

12 4/15/2014 Workers Compensation Agency Page 12 Illinois National Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Imperial Casualty & Indemnity Company NAIC Number: Imperium Insurance Company 600 Galleria Parkway Suite 770 Atlanta, GA NAIC Number: Indemnity Insurance Company of North America Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Indiana Insurance Company WC Processing Center P.O. Box Los Angeles, CA NAIC Number: Indiana Lumbermens Mutual Insurance Company 3600 Woodview Trace P.O. Box Indianapolis, IN NAIC Number: Insurance Co. of the State of Pennsylvania AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Insurance Company of Greater New York 200 Madison Avenue New York, NY NAIC Number: Insurance Company of North America Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Insurance Company of the West El Camino Real San Diego, CA NAIC Number: Insurance Corporation of America 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI NAIC Number: Intercontinental Insurance Company NAIC Number: International Insurance Company 305 Madison Avenue Morristown, NJ NAIC Number: Ironshore Indemnity, Inc. P.O. Box St. Paul, MN NAIC Number: Kansas City Fire & Marine Insurance Company NAIC Number: Legion Insurance Company Attn: Dean Bender P.O. Box Philadelphia, PA NAIC Number: Liberty Insurance Corporation NAIC Number: Liberty Mutual Fire Insurance Company NAIC Number: Liberty Mutual Insurance Company NAIC Number: Lincoln General Insurance Company P.O. Box 3709 York, PA NAIC Number: LM Insurance Corporation NAIC Number: LMI Insurance Company P.O. Box Raleigh, NC NAIC Number:

13 4/15/2014 Workers Compensation Agency Page 13 London Guarantee & Accident Company of NY 25 Independence Boulevard Warren, NJ NAIC Number: Lumber Mutual Insurance Company P.O. Box 9165 Framingham, MA NAIC Number: Lumbermens Mutual Casualty Company Fund NAIC Number: Lumbermens Underwriting Alliance P.O. Box 3061 Boca Raton, FL NAIC Number: M L B A Mutual Insurance Company P.O. Box 4067 East Lansing, MI NAIC Number: Manufacturers & Merchants Mutual Insurance Co P.O. Box 514 Concord, NH NAIC Number: Manufacturers Alliance Insurance Co. P.O. Box 5231 Janesville, WI NAIC Number: Manufacturing Technology Mutual Insurance Company P.O. Box 9150 Farmington Hills, MI NAIC Number: Markel Insurance Company 4600 Cox Rd. Glen Allen, VA NAIC Number: Maryland Casualty Company 1400 American Lane NAIC Number: Massachusetts Bay Insurance Company P.O. Box Worcester, MA NAIC Number: Massachusetts Bonding & Insurance Company 10 Post Office Square Boston, MA NAIC Number: Wc Medallion Insurance Company NAIC Number: Memic Indemnity Company 1750 Elm Street, Suite 500 Manchester, NH NAIC Number: Merchants Mutual Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY NAIC Number: Merchants Preferred Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY NAIC Number: Meridian Citizens Mutual Insurance Co. P.O. Box 1980 Indianapolis, IN NAIC Number: Meridian Mutual Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN NAIC Number: Meridian Security Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN NAIC Number: MHA Insurance Company 3100 West Road, Building 1, Suite 200 East Lansing, MI NAIC Number: MIC Property & Casualty Insurance Company Corporate Compliance Dept W. Grand Blvd x3301 Detroit, MI NAIC Number: Michigan Commercial Insurance Mutual P.O. Box Sarasota, FL NAIC Number:

14 4/15/2014 Workers Compensation Agency Page 14 Michigan Insurance Company P.O. Box Grand Rapids, MI NAIC Number: Michigan Millers Mutual Insurance Company Claims Department P.O. Box Lansing, MI NAIC Number: Mid-Century Insurance Company P.O. Box Oklahoma City, OK NAIC Number: Middlesex Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Middlesex Mutual Assurance Company 213 Court Street P.O. Box 891 Middletown, CT NAIC Number: Midland Insurance Company NAIC Number: Midland National Insurance Company 173 W. Madison Street Chicago, IL NAIC Number: Wc Midwest Employers Casualty Company NAIC Number: Millers Mutual Insurance Association 111 E. Fourth Street P.O. Box 9006 Alton, IL NAIC Number: Millers National Insurance Company 850 Warrenville Road 3rd Floor Lisle, IL NAIC Number: Mission Insurance Company NAIC Number: Mitsui Sumitomo Insurance Company of America P.O. Box 5435 Cincinnati, OH NAIC Number: Mitsui Sumitomo Insurance USA, Inc. P.O. Box 5435 Cincinnati, OH NAIC Number: Monroe Guaranty Insurance Company 9025 River Road Suite 300 Indianapolis, IN NAIC Number: Motorists Mutual Insurance Company 471 E. Broad Street Columbus, OH NAIC Number: N N Insurance Company P.O. Box 6426 Lawrenceville, NJ NAIC Number: National American Insurance Company 1006 Manval Avenue P.O. Box Drawer 9 Chandler, OK NAIC Number: National Ben Franklin Insurance Company NAIC Number: National Casualty Company P.O. Box 4110 Scottsdale, AZ NAIC Number: National Continental Insurance Company P.O. Box 5070 Cleveland, OH NAIC Number: National Farmers Union Property & Casualty 1051 Texas Street Salem, VA NAIC Number: National Farmers Union Standard Insurance Co Texas Street Salem, VA NAIC Number: National Fire Insurance Company of Hartford NAIC Number:

15 4/15/2014 Workers Compensation Agency Page 15 National General Insurance Company Corporate Compliance Dept 3044 W. Grand Blvd x3301 Detroit, MI NAIC Number: National Indemnity Company P.O. Box San Francisco, CA NAIC Number: National Interstate Insurance Company P.O. Box 5432 Cincinnati, OH NAIC Number: National Interstate Insurance Company of Hawaii P.O. Box 5432 Cincinnati, OH NAIC Number: National Liability & Fire, Inc. P.O. Box San Francisco, CA NAIC Number: National Mutual Insurance Company One Insurance Square Celina, OH NAIC Number: National Reinsurance Corporation P.O. Box San Francisco, CA NAIC Number: National Specialty Insurance Company 1900 L Don Dodson Drive Bedford, TX NAIC Number: National Surety Corporation P.O. Box Atlanta, GA NAIC Number: National Trust Insurance Company P.O. Box Sarasota, FL NAIC Number: National Union Fire Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: Nationwide Agribusiness Insurance Company 1100 Locust Street, Dept Des Moines, IA NAIC Number: Nationwide Mutual Fire Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Nationwide Mutual Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Nationwide Property & Casualty Insurance Company 1000 Nationwide Drive P.O. Box Harrisburg, PA NAIC Number: Netherlands Insurance Company WC Processing Center P.O. Box Los Angeles, CA NAIC Number: New Hampshire Indemnity Company, Inc. AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: New Hampshire Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA NAIC Number: New York Marine & General Insurance Company 59 Maiden Lane #2700 New York, NY NAIC Number: New York Underwriters Insurance Company 4245 Meridian Pkwy Aurora, IL NAIC Number: Newark Insurance Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: NGM Insurance Company 220 Salina Meadows, Suite 200 Syracuse, NY NAIC Number: Niagara Fire Insurance Company NAIC Number:

16 4/15/2014 Workers Compensation Agency Page 16 Nipponkoa Insurance Company, LTD 14 Wall Street, Suite 812 New York, NY NAIC Number: NLC Mutual Insurance Company 1301 Pennsylvania Avenue, NW Washington, DC NAIC Number: Nordia Insurance Company P.O. Box 886 Shelton, CT NAIC Number: NorGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA NAIC Number: North American Elite Insurance Company 650 Elm Street, Suite 600 Manchester, NH NAIC Number: North American Specialty Insurance Company 650 Elm Street, Suite 600 Manchester, NH NAIC Number: North Pointe Casualty Company P.O. Box 975 Sun Prairie, WI NAIC Number: North Pointe Insurance Company P.O. BOX 975 Sun Prairie, WI NAIC Number: North River Insurance Company 305 Madison Avenue Morristown, NJ NAIC Number: Northbrook Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL NAIC Number: Northern Assurance Company of America 1051 Texas Street Salem, VA NAIC Number: Northern Insurance Company of New York c/o Maryland Casualty 1400 American Lane, NAIC Number: Northwestern National Casualty Company c/o Highlands Insurance Co Richmond Avenue, Suite 175 Houston, TX NAIC Number: Northwestern National Insurance Company 9277 Centre Pointe Drive, Suite 140 West Chester, OH NAIC Number: Nova Casualty Company 2 Waterside Crossing, Suite 400 Windsor, CT NAIC Number: OBI National Insurance Company 1051 Texas Street Salem, VA NAIC Number: Occidental Fire & Casualty Company of NC John Mininger 702 Oberlin Road, Box Raleigh, NC NAIC Number: Ohio Casualty Insurance Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI NAIC Number: Ohio Farmers Insurance Company Mile Road, Suite 110 Livonia, MI NAIC Number: Ohio Security Insurance Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI NAIC Number: Old Republic General Insurance Corporation P.O. Box 2200 Greensburg, PA NAIC Number: Old Republic Insurance Company P.O. Box 2200 Greensburg, PA NAIC Number: OneBeacon America Insurance Company 1051 Texas Street Salem, VA NAIC Number:

17 4/15/2014 Workers Compensation Agency Page 17 OneBeacon Insurance Company 1051 Texas Street Salem, VA NAIC Number: Pacific Employers Insurance Company Civic Center Drive, Suite 400 Southfield, MI NAIC Number: Pacific Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL NAIC Number: Pacific Insurance Company NAIC Number: Park Avenue Property & Casualty NAIC Number: Partners Mutual Insurance Company Swenson Waukesha, WI NAIC Number: Patriot General Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Peerless Indemnity Insurance Company WC Processing Center P.O. Box Los Angeles, CA NAIC Nunber: Peerless Insurance Company WC Processing Center P.O. Box Los Angeles, CA NAIC Number: Penn Millers Insurance Company 72 N. Franklin Street Wilkes-Barre, PA NAIC Number: Pennsylvania General Insurance Company 1051 Texas Street Salem, VA NAIC Number: Pennsylvania Lumbermens Mutual Insurance 1 Commerce Square 2005 Market St., Ste Philadelphia, PA NAIC Number: Pennsylvania Manufacturers Assn. Insurance Co P.O. Box 5231 Janesville, WI NAIC Number: Pennsylvania Manufacturers Indemnity Co. P.O. Box 5231 Janesville, WI NAIC Number: Pennsylvania National Mutual Casualty Ins. P.O. Box 2361 Harrisburg, PA NAIC Number: Petroleum Casualty Company P.O. Box 3342 Houston, TX NAIC Number: Pharmacists Mutual Insurance Company 808 Hwy. 18 West P.O. Box 370 Algona, IA NAIC Number: Phico Insurance Company 5875 Castle Creek Pkwy N Dr. Ste. 300 P.O. Box Indianapolis, IN NAIC Number: Phoenix Assurance Company of New York 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Phoenix Insurance Company NAIC Number: Pioneer State Mutual Insurance Company 1510 N. Elms Road Flint, MI NAIC Number: Plaza Insurance Company P.O. Box 7183 Indianapolis, IN NAIC Number:

18 4/15/2014 Workers Compensation Agency Page 18 Potomac Insurance Company of Illinois 1051 Texas Street Salem, VA NAIC Number: Praetorian Insurance Company 88 Pine Street, 4th Floor New York, NY NAIC Number: Preferred Professional Insurance Company P.O. Box Omaha, NE NAIC Number: Preserver Insurance Company 120 Broadway, 31st Floor New York, NY NAIC Number: Princeton Insurance Company 746 Alexander Road Princeton, NJ NAIC Number: Progressive Casualty Insurance Company P.O. Box 5070 Cleveland, OH NAIC Number: Property & Casualty Insurance Company of Hartford 4245 Meridian Pkwy Aurora, IL NAIC Number: Protective Insurance Company 1099 N. Meridian Street Indianapolis, IN NAIC Number: Providence Washington Insurance Company 1275 Wampanoag Trail Riverside, RI NAIC Number: Prudential Commercial Insurance Company P.O. Box 6426 Lawrenceville, NJ NAIC Number: QBE Insurance Corporation P.O. Box 975 Sun Prairie, WI NAIC Number: Rampart Insurance Company 20 Exchange Place, 11th Floor New York, NY NAIC Number: Ranger Insurance Company 250 Commercial Street Suite 5000 Manchester, NH NAIC Number: Regent Insurance Company P.O. Box 975 Sun Prairie, WI NAIC Number: Reliance Insurance Company NAIC Number: Reliance National Indemnity Company NAIC Number: Reliance National Insurance Company NAIC Number: Republic Western Insurance Company 2721 N. Central Avenue Phoenix, AZ NAIC Number: Republic-Franklin Insurance Company P.O. Box 530 Utica, NY NAIC Number: Retailers Mutual Insurance Company 603 S. Washington Avenue Lansing, MI NAIC Number: Riverport Insurance Company NAIC Number: RLI Insurance Company P.O. Box 3736 Peoria, IL NAIC Number: Rockwood Casualty Insurance Company P.O. Box Portland, OR NAIC Number:

19 4/15/2014 Workers Compensation Agency Page 19 Royal Insurance Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Sable Insurance Company 433 California Street, 11th Floor San Francisco, CA NAIC Number: Safeco Insurance Company NAIC Number: Safeguard Insurance Company 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Safety First Insurance Company 1832 Schuetz Road St. Louis, MO NAIC Number: Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO NAIC Number: Sagamore Insurance Company 1099 N. Meridian Street Indianapolis, IN NAIC Number: SeaBright Insurance Company P.O. Box Seattle, WA NAIC Number: Secura Insurance Company P.O. Box 819 Appleton, WI NAIC Number: Security Casualty Company 222 S. Riverside Plaza Chicago, IL NAIC Number: Security Insurance Company of Hartford 3600 Arco Corporate Drive Charlotte, NC NAIC Number: Select Insurance Company NAIC Number: Selective Insurance Company of America 40 Wantage Avenue Branchville, NJ NAIC Number: Selective Insurance Co of South Carolina 40 Wantage Avenue Branchville, NJ NAIC Number: Selective Insurance Co of the Southeast 40 Wantage Avenue Branchville, NJ NAIC Number: Selective Way Insurance Company 40 Wantage Avenue Branchville, NJ NAIC Number: Seneca Insurance Company 305 Madison Avenue Morristown, NJ NAIC Number: Sentinel Insurance Company, Ltd Meridian Pkwy Aurora, IL NAIC Number: Sentry Casualty Company P.O. Box 8032 Stevens Point, WI NAIC Number: Sentry Insurance a Mutual Company P.O. Box 8032 Stevens Point, WI NAIC Number: Sentry Select Insurance Company P.O. Box 8032 Stevens Point, WI NAIC Number: Sequoia Insurance Company Park Run Drive, Suite 170 LasVegas, NV NAIC Number: SFM Mutual Insurance Company 3500 American Blvd. West, Suite 700 Bloomington, MN NAIC Number: Shelby Insurance Company Central Service Center 175 Mansfield Avenue Shelby, OH NAIC Number:

20 4/15/2014 Workers Compensation Agency Page 20 Society Insurance P.O. Box 1029 Fond Du Lac, WI NAIC Number: Sompo Japan Fire & Marine Insurance Company of America North Community House Rd Hayes Building Suite 600 Charlotte, NC NAIC Number: Sompo Japan Insurance Company of America North Community House Rd Hayes Building Suite 600 Charlotte, NC NAIC Number: South Carolina Insurance Company P.O. Box 1 Columbia, SC NAIC Number: Southern Insurance Company 222 S 15th St Ste 1500 North Omaha, NE NAIC Number: Sparta Insurance Company City Place II 185 Asylum Street, 9th Floor Hartford, CT NAIC Number: St. Paul Fire & Marine Insurance Company NAIC Number: St. Paul Guardian Insurance Company NAIC Number: St. Paul Medical Liability Insurance Co. NAIC Number: St. Paul Mercury Insurance Company NAIC Number: St. Paul Property & Casualty Insurance Co. NAIC Number: St. Paul Protective Insurance Company NAIC Number: Standard Fire Insurance Company NAIC Number: Star Insurance Company c/o Meadowbrook Claims Service American Drive Southfield, MI NAIC Number: StarNet Insurance Company NAIC Number: Starr Indemnity & Liability Co 399 Park Ave. 8th Floor New York, NY NAIC Number: State Auto Property & Casualty Insurance Company P.O. Box 7183 Indianapolis, IN NAIC Number: State Automobile Mutual Insurance Company P.O. Box 7183 Indianapolis, IN NAIC Number: State Farm Fire & Casualty Company Workers Compensation Claims P.O. Box Dallas, TX NAIC Number: State Farm General Insurance Company Workers Compensation Claims P.O. Box Dallas, TX NAIC Number: State Mutual Insurance Company P.O. Box 280 Lapeer, MI NAIC Number: State National Insurance Company, Inc L Don Dodson Drive Bedford, TX N AIC Number:

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