INSURANCE CARRIER/SELF-INSURER LIST OF DESIGNATED CONTACTS

Transcription

1 State of New Jersey Department of Labor & Workforce Development Division of Workers Compensation INSURANCE CARRIER/SELF-INSURER LIST OF DESIGNATED CONTACTS P.L Chapter 96, effective October 1, 2008, applies to workers compensation insurance carriers and authorized self-insured employers. The law provides that: Every carrier and self-insured employer shall designate a contact person who is responsible for responding to issues concerning medical and temporary disability benefits where no claim petition has been filed or where a claim petition has not been answered. The full name, telephone number, address, address, and fax number of the contact person shall be submitted to the division. Any changes in information about the contact person shall be immediately submitted to the division as they occur. After an answer is filed with the division, the attorney of record for the respondent shall act as the contact person in the case. Failure to comply with the provisions of this section shall result in a fine of $2,500 for each day of noncompliance, payable to the Second Injury Fund. The Division has compiled the attached contact person listing from information submitted to us by workers compensation insurance carriers and authorized self-insurers. You can search for a particular company in this document by using the Find tool in Adobe Reader or by clicking on the embedded bookmarks. If you find an error with a particular entry in the attached list, please contact the following to verify our records: Joanne Allen (joanne.allen@dol.state.nj.us), tel: , fax: Carriers/self-insurers that have not yet designated a contact person as required by law must do so by downloading and completing the Insurance Carrier Contact form available on our website: Note: If you are a representative from a specific carrier/self-insurer who has already submitted an Insurance Carrier Contact Form to the Division but cannot locate your company in this listing, please contact us to verify that the form has been received by us. Thank you. Last revised: 12/22/2014

2 ABF FREIGHT SYSTEM, INC. RACHELLE PRATT, WC CLAIMS SPECIALIST ATTN: RISK MANAGEMENT, P.O. BOX 10048, FORT SMITH, AR TEL #: FAX #: ALLEN KING, MANAGER, WORKERS' COMP P.O. BOX FORT SMITH, AR TEL #: FAX #: ACCIDENT FUND GENERAL INSURANCE COMPANY JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACCIDENT FUND INSURANCE COMPANY OF AMERICA JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACCIDENT FUND NATIONAL INSURANCE COMPANY JEAN KLUISZA, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE, LANSING, MI TEL #: FAX #: -- KAREN HOLTZ, CORPORATE CLAIMS CONSULTANT 200 N. GRAND AVENUE LANSING, MI TEL #: FAX #: ACE AMERICAN INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON DE TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 1

3 GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON DE TEL #: FAX #: ACE FIRE UNDERWRITERS INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON DE TEL #: FAX #: ACE PROPERTY & CASUALTY INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON, DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON, DE TEL #: FAX #: ACIG INSURANCE COMPANY RON ARTHUR, VICE PRESIDENT - CLAIMS MANAGER MERIT DRIVE, SUITE 1660, DALLAS, TX TEL #: FAX #: acigregulatory@acig.com SUSIE MCGEE, VICE PRESIDENT - CLAIMS MERIT DRIVE, SUITE 1660 DALLAS, TX TEL #: FAX #: acigregulatory@acig.com ACME MARKETS, INC. JEAN MICHETTI, TEAM LEADER SPECIALTY RISK SERVICES (SRS), 150 SOUTH WARNER ROAD, KING OF PRUSSIA, PA TEL #: FAX #: jean.michetti@srsconnect.com CASSANDRA GOMEZ, OPERATIONS MANAGER SPECIALTY RISK SERVICES (SRS), 4245 MERIDIAN PARKWAY AURORA, IL TEL #: FAX #: cassandra.gomez@srsconnect.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 2

4 ADVANTAGE WORKERS COMPENSATION INSURANCE COMPANY TERESA J. MARECK, VICE PRESIDENT & GENERAL COUNSEL P.O. BOX , SALT LAKE CITY, UT TEL #: FAX #: GWEN E. CHURCH, ASSISTANT VICE PRESIDENT P.O. BOX SALT LAKE CITY, UT TEL #: FAX #: AIG PROPERTY CASUALTY COMPANY JANICE MOORE, ASST. VICE PRESIDENT CHARTIS, P.O. BOX 4050, ALPHARETTA, GA TEL #: FAX #: MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 4050 ALPHARETTA, GA TEL #: FAX #: ALCATEL-LUCENT USA INC SHERRY D BAKER, CLAIMS MANAGER 624 S.E. 29TH STREET, CAPE CORAL, FL TEL #: FAX #: sherry.baker@alcatel-lucent.com SOPHIE CHEVILLET, DIRECTOR NA RISK MANAGEMENT 600 MOUNTAIN AVENUE, ROOM 7B-503 MURRAY HILL, NJ TEL #: FAX #: sophie.chevillet@alcatel-lucent.com ALLAMERICA FINANCIAL ALLIANCE INSURANCE COMPANY CHERYL UNGAR, WC UNIT MANAGER P.O. BOX 15144, WORCESTER, MA TEL #: FAX #: cungar@hanover.com PAULA ANDRADE, WC UNIT MANAGER P.O. BOX WORCESTER, MA TEL #: FAX #: pandrade@hanover.com ALLAMERICA FINANCIAL BENEFIT INSURANCE COMPANY CHERYL UNGAR, WC UNIT MANAGER P.O. BOX 15144, WORCESTER, MA TEL #: FAX #: cungar@hanover.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 3

5 PAULA ANDRADE, WC UNIT MANAGER P.O. BOX WORCESTER, MA TEL #: FAX #: ALLIANCE NATIONAL INSURANCE COMPANY JOHN EAGEN, MANAGER 220 W. GERMANTOWN PIKE, PLYMOUTH MEETING, PA TEL #: FAX #: MARY BETH TORUNIAN, UNDERWRITER 220 W. GERMANTOWN PIKE PLYMOUTH MEETING, PA TEL #: FAX #: ALLIED EASTERN INDEMNITY COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS 25 RACE AVENUE, LANCASTER PA TEL #: ext FAX #: TARA HOOPER, MANAGER OF REGIONAL CLAIMS 25 RACE AVENUE LANCASTER PA TEL #: ext FAX #: AMERICAN ALTERNATIVE INSURANCE COMPANY CHARLES KROH, VICE PRESIDENT 555 COLLEGE ROAD EAST, PRINCETON, NJ TEL #: FAX #: STEPHEN DIONISIO, VICE PRESIDENT 555 COLLEGE ROAD EAST PRINCETON, NJ TEL #: FAX #: AMERICAN AUTOMOBILE INSURANCE COMPANY THOMAS CUEL, SR. CLAIMS DIRECTOR GREAT OAKS WAY, SUITE 200, ALPHARETTA, GA TEL #: FAX #: JENNIFER FELCH, WORKERS' COMPENSATION SUPERVISOR GREAT OAKS WAY, SUITE 200 ALPHARETTA, GA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 4

6 AMERICAN CASUALTY COMPANY OF READING PA DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO, IL TEL #: FAX #: AMERICAN COMPENSATION INSURANCE COMPANY SUSAN PILON, MANAGER OF NATIONAL CLAIM QUALITY & COMPLIANCE P.O. BOX , MINNEAPOLIS, MN TEL #: FAX #: AMY HAWLEY, DIRECTOR OF OPERATIONS P.O. BOX MINNEAPOLIS, MN TEL #: FAX #: AMERICAN FIRE & CASUALTY INSURANCE COMAPNY TODD GANCARZ, UNIT LEADER 5062 BRITTONFIELD PARKWAY, E. SYRACUSE, NY TEL #: FAX #: KAREN PEINKOFER, UNIT LEADER 5062 BRITTONFIELD PARKWAY E. SYRACUSE, NY TEL #: FAX #: AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY BRIAN M. DOOLEY, ASST. VICE PRESIDENT 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C, PARSIPPANY, NJ TEL #: FAX #: RONALD TANELLI, TEAM MANAGER 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C PARSIPPANY, NJ TEL #: FAX #: AMERICAN HOME ASSURANCE COMPANY JANICE MOORE, ASSISTANT VICE PRESIDENT CHARTIS, P.O. BOX 9973, WILMINGTON, DE TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 5

7 MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 9973 WILMINGTON, DE TEL #: FAX #: AMERICAN INSURANCE COMPANY THOMAS CUEL, SR. CLAIMS DIRECTOR GREAT OAKS WAY, SUITE 200, ALPHARETTA GA TEL #: FAX #: JENNIFER FELCH, WORKERS' COMPENSATION SUPERVISOR GREAT OAKS WAY, SUITE 200 ALPHARETTA, GA TEL #: FAX #: AMERICAN ZURICH INSURANCE COMPANY BRIAN M. DOOLEY, ASST. VICE PRESIDENT 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C, PARSIPPANY, NJ TEL #: FAX #: RONALD TANELLI, TEAM MANAGER 300 INTERPACE PARKWAY, MORRIS CORPORATE 1, BLDG. B/C PARSIPPANY, NJ TEL #: FAX #: AMERIHEALTH CASUALTY INSURANCE COMPANY TERRY SMITH, MANAGER OF NJ OPERATIONS 8000 MIDLANTIC DRIVE, SUITE 410N, MT. LAUREL, NJ TEL #: FAX #: MARK MORRONE, SENIOR CLAIMS REPRESENTATIVE 8000 MIDLANTIC DRIVE, SUITE 410N MT. LAUREL, NJ TEL #: FAX #: AMERISURE INSURANCE COMPANY LAURA PIERMAN, CLAIMS MANAGER HALSTED, FARMINGTON HILLS, MI TEL #: ext FAX #: MICHAEL HEARSCH, CLAIMS SUPERVISOR HALSTED FARMINGTON HILLS, MI TEL #: ext FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 6

8 AMERISURE MUTUAL INSURANCE COMPANY LAURA PIERMAN, CLAIMS MANAGER HALSTED, FARMINGTON HILLS, MI TEL #: ext FAX #: MICHAEL HEARSCH, CLAIMS SUPERVISOR HALSTED FARMINGTON HILLS, MI TEL #: ext FAX #: AMERITRUST INSURANCE CORPORATION LINDA FEATHERNGILL, WC CLAIMS SUPERVISOR P.O. BOX 5086, SOUTHFIELD, MI TEL #: FAX #: RANDY LESTER, CLAIMS MANAGER P.O. BOX 5086 SOUTHFIELD, MI TEL #: FAX #: AMGUARD INSURANCE COMPANY HUGH SPIEGELMAN, CLAIMS SUPERVISOR GUARD INSURANCE GROUP, P.O. BOX 1368, WILKES BARRE, PA TEL #: FAX #: DIANA DUDA MONGO, STAFF ATTORNEY GUARD INSURANCE GROUP, 110 SOUTH JEFFERSON ROAD WHIPPANY, NJ TEL #: FAX #: AMSTED INDUSTRIES, INC. ROB GOULD, HUMAN RESOURCES MANAGER 1100 WEST FRONT STREET, FLORENCE, NJ TEL #: FAX #: JOHN GEANEY, ATTORNEY 8000 MIDLANTIC DRIVE, SUITE 300S MT. LAUREL, NJ TEL #: FAX #: ARCH INSURANCE COMPANY CHASE W DEITS, CPCU, ARM, AIC 1125 SANCTUARY PKWY, SUITE 200, ALPHARETTA, GA TEL #: FAX #: edeits@archinsurance.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 7

9 PAUL MILOSCIA, VP, CLAIMS ONE LIBERTY PLAZA, 53RD FLOOR NEW YORK, NY TEL #: FAX #: ARGONAUT INSURANCE COMPANY MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS 100 MARINE PARKWAY, REDWOOD CITY, CA TEL #: FAX #: MELINDA SEILER, REGIONAL CLAIMS DIRECTOR 8325 N. ALLEN RD., SUITE B PEORIA, IL TEL #: FAX #: mseiler@argogroupus.com ARGONAUT-MIDWEST INSURANCE COMPANY MARILYN BRANDS, VP OF WORKERS' COMPENSATION CLAIMS 100 MARINE PARKWAY, REDWOOD CITY, CA TEL #: FAX #: mbrands@argogroupus.com MELINDA SEILER, REGIONAL CLAIMS DIRECTOR 8325 N. ALLEN RD., SUITE B PEORIA, IL TEL #: FAX #: mseiler@argogroupus.com AT&T CORPORATION JULIE DUNCAN, CLAIMS SUPERVISOR 350 LINDEN OAKS, ROCHESTER, NY TEL #: FAX #: julie.duncan@sedgwickcms.com MARIANNE PEIKHAM, CLAIMS SUPERVISOR 350 LINDEN OAKS ROCHESTER, NY TEL #: FAX #: marianne.peikham@sedgwickcms.com ATLANTIC HEALTH SYSTEMS INC & SUBS LORI WILLIAMS, ESQ., ATTORNEY 475 SOUTH STREET, P.O. BOX 1905, MORRISTOWN NJ TEL #: FAX #: lori.williams@atlantichealth.org STEPHEN T FANNON 8000 MIIDLANTIC DR, STE 300, LAUREL CORPORATE CENTER MT LAUREL NJ TEL #: FAX #: sfanon@capehart.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 8

10 ATLANTIC STATES CAST IRON PIPE CO. ELIZABETH KUNIGUS, WORKERS' COMP. ADMINISTRATOR 183 SITGREAVES STREET, PHILLIPSBURG, NJ TEL #: ext. 276 FAX #: HEATHER KNIGHTEN, ACCOUNTANT 2900 HWY. 280, SUITE 300 BIRMINGHAM, AL TEL #: FAX #: ATLANTICARE REGIONAL MEDICAL CENTER TRUDY MANDIA, RN,CCM,CWCP, SR. MANAGER, WC DEPARTMENT 2500 ENGLISH CREEK AVENUE, ATLANTICARE HEALTH PARK BLDG. 600, EGG HARBOR TOWNSHIP, NJ TEL #: FAX #: PAT BITZER, W.C. SPECIALIST 2500 ENGLISH CREEK AVENUE, ATLANTICARE HEALTH PARK, BLDG. 600 EGG HARBOR TOWNSHIP, NJ TEL #: FAX #: BANCROFT NEUROHEALTH, INC. TONY DIBARTOLLO, V.P. HUMAN RESOURCES 800 NO. KINGS HWY., SUITE 305, CHERRY HILL, NJ TEL #: ext FAX #: MICHAEL SALERNO, ADMINISTRATOR 330 MILLTOWN ROAD, SUITE E-11 EAST BRUNSWICK, NJ TEL #: FAX #: BANKERS STANDARD INSURANCE COMPANY PAM LLEWELLYN, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E, WILMINGTON, DE TEL #: FAX #: GUS GONNELLA, AVP WORKERS' COMPENSATION ONE BEAVER VALLEY ROAD, SUITE 4E WILMINGTON, DE TEL #: FAX #: BARNABAS HEALTH INC DAVID A. MEBANE, ESQ., SR. V.P. FOR LEGAL AFFAIRS - CHIEF LEGAL OFFICER 95 OLD SHORT HILLS ROAD, WEST ORANGE, NJ TEL #: FAX #: dmebane@barnabashealth.org CARYL RUSSO, SR. VICE PRESIDENT, CORPORATE CARE KIMBALL MEDICAL CENTER, 600 RIVER AVENUE LAKEWOOD, NJ TEL #: FAX #: crusso@barnabashealth.org INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 9

11 BATH & BODY WORKS, INC. INNAH DULAY, CASE MANAGEMENT CONSULTANT 4 LIMITED PARKWAY, REYNOLDSBURG, OH TEL #: FAX #: Idulay@limitedbrands.com SUSAN MANOS, SUPERVISOR CASE MANAGEMENT 4 LIMITED PARKWAY REYNOLDSBURG, OH TEL #: FAX #: smanos@limitedbrands.com BERGEN REGIONAL MEDICAL CENTER VIKI ABRAMS, CLAIMS EXAMINER QUALCARE, P.O. BOX 309, PISCATAWAY, NJ TEL #: FAX #: vabrams@qualcareinc.com PRIMO SISCO, BENEFITS COORDINATOR BERGEN REGIONAL MEDICAL CENTER, 230 EAST RIDGEWOOD AVENUE PARAMUS, NJ TEL #: FAX #: psisco@bergenregional.com BERKLEY NATIONAL INSURANCE COMPANY ROBERT BUEHLER, ASSISTANT SECRETARY 215 SHUMAN BLVD., SUITE 200, NAPERVILLE, IL TEL #: FAX #: rbuehler@wrberkley.com PATRICIA PETERS, REGULATORY ADMINISTRATOR 215 SHUMAN BLVD., SUITE 200 NAPERVILLE, IL TEL #: FAX #: ppeters@wrberkley.com BERKLEY REGIONAL INSURANCE COMPANY JOHN THELAN, ASSISTANT SECRETARY DOUGLAS AVENUE, URBANDALE, IA TEL #: FAX #: bricinsdept@cwgins.com GREG KENDRICK, LEGAL ASSISTANT DOUGLAS AVENUE URBANDALE, IA TEL #: FAX #: bricinsdept@cwgins.com BERKSHIRE HATHAWAY HOMESTATE INSURANCE CO (FMLY CORNHUSKERS CASUALTY) KATHLEEN KOESTER-HOLT, CLAIMS SUPERVISOR BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY, P.O. BOX , SAN FRANCISCO, CA TEL #: FAX #: kholt@bhhc.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 10

12 NICOLE ALBRECHT, CLAIMS MANAGER BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY, P.O. BOX SAN FRANCISCO, CA TEL #: FAX #: BEST FOODS/CPC MICHELL LARGMANN, FINANCIAL ANALYST UNILEVER U.S. INC., 700 SYLVAN AVENUE, ENGLEWOOD CLIFFS, NJ TEL #: FAX #: -- SAM MALIK, ASSOCIATE FINANCE MANAGER UNILEVER U.S. INC., 700 SYLVAN AVENUE ENGLEWOOD CLIFFS, NJ TEL #: FAX #: -- BON SECOURS HEALTH SYSTEM INC. & SUBS KIM STEHLE, SR. CLAIM REPRESENTATIVE GALLAGHER BASSETT SERVICES, 3300 VICKERY ROAD, NORTH SYRACUSE, NY TEL #: FAX #: -- MARY BETH FITZGERALD, BRANCH MANAGER GALLAGHER BASSETT SERVICES, 3300 VICKERY ROAD NORTH SYRACUSE, NY TEL #: FAX #: -- BROTHERHOOD MUTUAL INSURANCE COMPANY DEBBIE BENZINGER, SR. MANAGER, WC CLAIMS 6400 BROTHERHOOD WAY, P.O. BOX 2227, FORT WAYNE, NJ TEL #: FAX #: DAVID ROESENER, REGULATORY AND COMPLIANCE DIRECTOR 6400 BROTHERHOOD WAY, P.O. BOX 2227 FORT WAYNE, NJ TEL #: FAX #: CAMDEN, RC DIOCESE OF PATRICIA NAPIER, SR. WC CLAIMS SUPERVISOR P.O. BOX 500, SOMERS POINT, NJ TEL #: ext FAX #: LINDA DEROUIN, LITIGATED SUPERVISOR P.O. BOX 500 SOMERS POINT, NJ TEL #: ext FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 11

13 CAPE REGIONAL MEDICAL CENTER MICHAEL MORLEY, V.P. RISK MANAGEMENT 2 SONE HARBOR BLVD., CAPE MAY COURT HOUSE, NJ TEL #: FAX #: mmorley@caperegional.com PATRICIA NAPIER, SENIOR CLAIMS ANALYST SCIBAL INSURANCE GROUP, P.O. BOX 500 SOMERS POINT, NJ TEL #: FAX #: -- pnapier@scibal.com CAROLINA CASUALTY INSURANCE COMPANY LORI ZOBLER, DIRECTOR OF CLAIMS 2445 KUSER RD, STE 201, HAMILTON NJ TEL #: FAX #: LZobler@berkleynet.com JOHN BURKE, SR VP AND CHIEF CLAIMS OFFICER BERKLEYNET UNDERWRITERS LLC, MARBLESTONE DRIVE, SUITE 250 WOODBRIDGE VA TEL #: FAX #: JBurke@berkleynet.com CASTLEPOINT INSURANCE COMPANY LAURA DANIELS, WC SUPERVISOR 225 BROADHOLLOW ROAD, SUITE 410E, MELVILLE, NY TEL #: FAX #: ldaniels@twrgrp.com DEBORAH KREMER, WC SUPERVISOR 225 BROADHOLLOW ROAD, SUITE 410E MELVILLE, NY TEL #: FAX #: dkremer@twrgrp.com CASTLEPOINT NATIONAL INSURANCE COMPANY TIM KARAGJIOZI, SR. HOME OFFICE CLAIM ANALYST 3 HUNTINGTON QUAD, SUITE 2015, MELVILLE, NY TEL #: FAX #: tkaragjiozi@twrgrp.com PHILIP KOZELETZ, ASST. VICE PRESIDENT, BRANCH CLAIM MANAGER 3 HUNTINGTON QUAD, SUITE 2015 MELVILLE, NY TEL #: FAX #: pkozeletz@twrgrp.com CBS BROADCASTING INC STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: stephanie.grossberg@cbs.com DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA NEW LONDON, CT TEL #: FAX #: drichardson@murphybeane.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 12

14 CBS CORPORATION STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: stephanie.grossberg@cbs.com EUGENE J. MELLEVOLD, VICE PRESIDENT 51 W. 52ND STREET NEW YORK, NY TEL #: FAX #: gene.mellevold@cbs.com CBS OUTDOOR GROUP INC STEPHANIE GROSSBERG, DIRECTOR, RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: stephanie.grossberg@cbs.com DAVE RICHARDSON, VP - CLAIMS MURPHY AND BEANE, ONE UNION PLAZA NEW LONDON, CT TEL #: ext. 240 FAX #: DRICHARDSON@MURPHYBEANE.COM CBS OUTDOOR INC STEPHANIE GROSSBERG, DIRECTOR - RISK MANAGEMENT 51 W. 52ND STREET, NEW YORK, NY TEL #: FAX #: stephanie.grossberg@cbs.com DAVID RICHARDSON, VICE PRESIDENT - CLAIMS ONE UNION PLAZA NEW LONDON, CT TEL #: FAX #: drichardson@murphybeane.com CECORR INC TIM B STARKS, SR. WC MANAGER 133 PEACHTREE STREET, NE, ATLANTA, GA TEL #: FAX #: Tistark@gapac.com LIZ WYNACHT, MANAGER - WC 1333 PEACHTREE STREET, NE ATLANTA, GA TEL #: FAX #: -- eawynach@gapac.com CHARTER OAK FIRE INSURANCE COMPANY MARGARET MUIR-O'CONNOR, FIELD PRODUCT LINE MANAGER TRAVELERS INSURANCE COMPANIES, INC., 445 SOUTH STREET, MORRISTOWN, NJ TEL #: FAX #: MMUIROCO@travelers.com TROY TICE, DIRECTOR OF OPERATIONS TRAVELERS INSURANCE COMPANIES, INC., 445 SOUTH STREET MORRISTOWN, NJ TEL #: FAX #: ttice@travelers.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 13

15 CHEROKEE INSURANCE COMPANY SCOTT PHILLIPS, CLAIM REPRESENTATIVE P.O. BOX 159, WARREN, MI TEL #: ext FAX #: LAURA BOOTH, CLAIM REPRESENTATIVE P.O. BOX 159 WARREN, MI TEL #: ext FAX #: CHUBB INDEMNITY INSURANCE COMPANY ANDY HERBERT, CLAIMS SUPERVISOR 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616, WARREN, NJ TEL #: FAX #: CRAIG FARINA, CLAIMS MANAGER 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616 WARREN, NJ TEL #: FAX #: CHURCH MUTUAL INSURANCE COMPANY DAVID A SEISER, CLAIM MANAGER, WC P.O. BOX 342, MERRILL, WI TEL #: FAX #: dseiser@churchmutual.com TEENA NOVOTNY, CLAIMS SUPERVISOR, WC P.O. BOX 342 MERRILL, WI TEL #: FAX #: tnovotny@churchmutual.com CINCINNATI CASUALTY COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: derek.nehil@yorkrsg.com TONI POSTELL, SUPERINTENDENT P.O. BOX CINCINNATI, OH TEL #: FAX #: toni_postell@cinfin.com CINCINNATI INDEMNITY COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: derek.nehil@yorkrsg.com TONI POSTELL, SUPERINTENDENT P.O. BOX CINCINNATI, OH TEL #: FAX #: toni_postell@cinfin.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 14

16 CINCINNATI INSURANCE COMPANY DEREK NEHIL, UNIT MANAGER YORK RISK SERVICES GROUP, P.O. BOX , COLUMBUS, OH TEL #: FAX #: TONI POSTELL, SUPERINTENDENT CINCINNATI INSURANCE COMPANY, P.O. BOX CINCINNATI, OH TEL #: FAX #: CITIZENS INSURANCE COMPANY OF AMERICA DANIEL GERMAIN, UNIT MANAGER HANOVER INSURANCE, 440 LINCOLN STREET, WORCESTER, MA TEL #: FAX #: MOLLY FLANAGAN, AVP WORK COMP HANOVER INSURANCE, 440 LINCOLN STREET WORCESTER, MA TEL #: FAX #: COLONIAL CONCRETE CO & SUBS KAREN SAYRE, ADMINISTRATIVE ASST. P.O. BOX 68, NEWTON, NJ TEL #: FAX #: APRIL GRANGER, CLAIMS REPRESENTATIVE P.O. BOX 68 NEWTON, NJ TEL #: FAX #: COMMERCE & INDUSTRY INSURANCE COMPANY JANICE MOORE, ASSISTANT VICE PRESIDENT CHARTIS, P.O. BOX 9973, WILMINGTON, DE TEL #: FAX #: MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 9973 WILMINGTON, DE TEL #: FAX #: COMPANION PROPERTY & CASUALTY INSURANCE COMPANY TERRY SMITH, MANAGER OF NJ OPERATIONS 8000 MIDLANTIC DRIVE, SUITE 410N, MT. LAUREL, NJ TEL #: FAX #: MARK MORRONE, SENIOR CLAIMS REPRESENTATIVE 8000 MIDLANTIC DRIVE, SUITE 410N MT. LAUREL, NJ TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 15

17 CONAGRA FOODS INC AND SUBS BRENDA MCGOWEN, SR. FINANCIAL ANALYST CONAGRA FOODS, INC., ONE CONAGRA DRIVE, 1-220, OMAHA, NE TEL #: FAX #: EMILY JONES, FINANCIAL ANALYST CONAGRA FOODS, INC., ONE CONAGRA DRIVE OMAHA, NE TEL #: FAX #: CONTINENTAL CASUALTY COMPANY (CNA) DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO, IL TEL #: FAX #: CONTINENTAL INDEMNITY COMPANY ERIC KENNEDY, UNIT SUPERVISOR P.O. BOX 3804, OMAHA, NE TEL #: FAX #: PETER GUNN, CLAIMS MANAGER P.O. BOX 3804 OMAHA, NE TEL #: FAX #: CONTINENTAL INSURANCE COMPANY DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 39S CHICAGO IL TEL #: FAX #: CONTINENTAL INSURANCE COMPANY OF NEW JERSEY DIANE WEBER, CLAIM MANAGER CNA, 401 PENN STREET, READING, PA TEL #: FAX #: ELIZABETH SIEKS, WC OPERATIONS ANALYSIS CONSULTING DIRECTOR CNA, 333 S. WABASH AVE., 30S CHICAGO, IL TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 16

18 COOPER HOSPITAL/UNIVERSITY MEDICAL CENTER MARYANN MIKULICH, BENEFITS SPECIALIST COOPER UNIVERSITY HOSPITAL, 3 COOPER PLAZA, SUITE 500, CAMDEN, NJ TEL #: FAX #: mikulich-maryann@cooperhealth.edu KATHLEEN VONDER HAYDEN, ADMIN. DIRECTOR OF HUMAN RESOURCES COOPER UNIVERSITY HOSPITAL, 3 COOPER PLAZA, SUITE 500 CAMDEN, NJ TEL #: FAX #: vonderhayden-k@cooperhealth.edu COSTCO WHOLESALE CORPORATION EDWARD W FRITSCH, CLAIMS SUPERVISOR SCMS, P.O. BOX 14517, LEXINGTON, KY TEL #: FAX #: njmotions@sedgwickcms.com MICKEY PINEIRO, WORKERS' COMP MANAGER SCMS, P.O. BOX LEXINGTON, KY TEL #: FAX #: njmotions@sedgwickcms.com CUMBERLAND INSURANCE COMPANY KEN MAILLEY, CLAIMS MANAGER 633 SHILO PIKE, P.O. BOX 556, BRIDGETON, NJ TEL #: FAX #: kmailley@cumberlandgroup.com NICOLE BANO, OPERATIONS MANAGER 633 SHILO PIKE, P.O. BOX 556 BRIDGETON, NJ TEL #: FAX #: NBano@cumberlandgroup.com CVS/CAREMARK CORPORATION LISA HOUDE, WC EXAMINER ONE CVS DRIVE, WOUNSOCKET, RI TEL #: ext FAX #: emhoude@cvs.com JOCELYN RUSHEY, WC MANAGER ONE CVS DRIVE WOUNSOCKET, RI TEL #: ext FAX #: jmbushey@cvs.com DAVIDS BRIDAL INC MARGARET MUIR-O'CONNOR, WC FIELD PRODUCT LINE MANAGER P.O. BOX 1900, MORRISTOWN, NJ TEL #: FAX #: None provided INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 17

19 DCH AUTO GROUP INC & SUBS JOHN BRUTHER, CFO 955 ROUTE 9 NORTH, SOUTH AMBOY, NJ TEL #: FAX #: jbruther@dchusa.com GENE HALLENBECK, VP OF HUMAN RESOURCES 955 ROUTE 9 NORTH SOUTH AMBOY, NJ TEL #: FAX #: ghallenbeck@dchusa.com DELHAIZE AMERICA LLC ROD BACK, CLAIMS MANAGER P.O. BOX 2527, SALISBURY, NC TEL #: FAX #: roderick.back@delhaize.com JAN PINION, LITIGATION SPECIALIST P.O. BOX 2527 SALISBURY, NC TEL #: FAX #: jan.pinion@delhaize.com DOLGENCORP, INC. DAVID STEFFES, SR.ANALYST 100 MISSION RIDGE, GOODLETTSVILLE, TN TEL #: FAX #: dsteffes@dollargeneral.com CHAD DAVIS, ACCOUNT EXECUTIVE 5000 BRADENTON AVENUE DUBLIN OH TEL #: FAX #: cdavis@avizentrisk.com E.I. DUPONT DE NEMOURS & COMPANY BRUCE D PEIFFER, TEAM MANAGER BROADSPIRE, A CRAWFORD COMPANY, CONNELL CORPORATE CTR. III, 3 OAK WAY, P.O. BOX 608 BERKELEY HEIGHTS, NJ TEL #: FAX #: bpeiffer@choosebroadspire.com CAROLE A CARR, TREASURY SPECIALIST E.I. SUPONT DE NEMOURS AND CO., 1007 MARKET STREET, D8065 WILMINGTON, DE TEL #: FAX #: carole.a.carr@usa.dupont.com EASTERN ADVANTAGE ASSURANCE COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS 25 RACE AVENUE, LANCASTER, PA TEL #: ext FAX #: kchapman@eains.com TARA HOOPER, MANAGER OF REGIONAL CLAIMS 25 RACE AVENUE LANCASTER, PA TEL #: ext FAX #: thooper@eains.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 18

20 EASTERN ALLIANCE INSURANCE COMPANY KELLI CHAPMAN, DIRECTOR OF CLAIMS EASTERN ALLIANCE INSURANCE GROUP, 25 RACE AVENUE, LANCASTER, PA TEL #: ext FAX #: TARA HOOPER, MANAGER OF REGIONAL CLAIMS EASTERN ALLIANCE INSURANCE GROUP, 25 RACE AVENUE LANCASTER, PA TEL #: ext FAX #: EASTGUARD INSURANCE COMPANY HUGH SPIEGELMAN, CLAIMS SUPERVISOR GUARD INSURANCE GROUP, P.O. BOX 1368, WILKES BARRE, PA TEL #: FAX #: DIANA DUDA MONGO, STAFF ATTORNEY GUARD INSURANCE GROUP, 110 SOUTH JEFFERSON ROAD WHIPPANY, NJ TEL #: FAX #: ELECTRIC INSURANCE COMPANY PAT NICKEL, ADJUSTER GE WC REGIONALSERVICE CENTER, 1 CORPORATE PLAZA, SUITE 104, 260 WASHINGTON STREET EXT. ALBANY, NY TEL #: FAX #: Pat.Nickel@electricinsurance.com JULIE KIELY, SPECIAL LITIGATION MANAGER 75 SAM FONZO DRIVE BEVERLY, MA TEL #: FAX #: julie.kiely@electricinsurance.com EMPLOYERS MUTUAL CASUALTY COMPANY JAMES N ZEIGLER, BRANCH CLAIMS MANAGER 1610 MEDICAL DRIVE, SUITE 205, POTTSTOWN, PA TEL #: FAX #: James.N.Zeigler@EMCIns.com CATHY BROWN, CLAIMS SUPERVISOR 1610 MEDICAL DRIVE, SUITE 205 POTTSTOWN, PA TEL #: FAX #: Cathy.M.Brown@EMCIns.com EMPLOYERS PREFERRED INSURANCE CO DAVID MACY, MANAGER, CLAIMS 412 E. PARKCENTER BLVD., SUITE 320, BOISE, ID TEL #: FAX #: dmacy@employers.com KATHRYN WHETSONE, VP, REGIONAL CLAIMS 851 TRAFALGAR COURT, SUITE 400E MAITLAND, FL TEL #: FAX #: kwhetstone@employers.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 19

21 EVEREST NATIONAL INSURANCE COMPANY ELENA BITNER, CLAIM MANAGER 477 MARTINSVILLE ROAD, LIBERTY CORNER, NJ TEL #: FAX #: TOM CAREY, CLAIM DIRECTOR 477 MARTINSVILLE ROAD LIBERTY CORNER, NJ TEL #: FAX #: EXCELSIOR INSURANCE COMPANY TODD GANCARZ, UNIT LEADER 5062 BRITTONFIELD PARKWAY, EAST SYRACUSE, NY TEL #: FAX #: KAREN PEINKOFER, UNIT LEADER 5062 BRITTONFIELD PARKWAY EAST SYRACUSE, NY TEL #: FAX #: EXXONMOBIL RESRCH & ENGINEERING CO JOHN E DILL, CLAIMS SUPERVISOR 3225 GALLOWS ROAD, ROOM 2C2126, FAIRFAX, VA TEL #: FAX #: john.e.dill@exxonmobile.com ALAN W RAPEE, TEAM LEAD 3225 GALLOWS ROAD, ROOM 2C1734 FAIRFAX, VA TEL #: FAX #: alan.w.rapee@exxonmobil.com FARM FAMILY CASUALTY INSURANCE COMPANY JULIE LAVIN, WC CLAIM MANAGER 344 ROUTE 9W, GLENMONT, NY TEL #: FAX #: Julile_Lavin@FarmFamily.com ALICIA HOGAN, HOME OFFICE EXAMINER - WC 344 ROUTE 9W GLENMONT, NY TEL #: FAX #: alicia_hogan@farmfamily.com FARMERS INSURANCE COMMPANY OF FLEMINGTON PATRICK ALLARD, VICE PRESIDENT - CLAIMS 23 ROYAL ROAD, SUITE 100, FLEMINGTON, NJ TEL #: ext. 104 FAX #: pallard@farmersofflemington.com MELINDA RUSSO, CLAIMS ADJUSTER P.O. BOX 400 BRANCHVILLE, NJ TEL #: FAX #: mhawkins@fmiweb.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 20

22 FARMERS INSURANCE EXCHANGE GRAHAM CADWALLADER, WC CLAIMS TEAM LEADER FARMERS INSURANCE, P.O. BOX , OKLAHOMA CITY, OK TEL #: FAX #: MIKE MCCABE, WC CLAIM MANAGER FARMERS INSURANCE, P.O. BOX OKLAHOMA CITY, OK TEL #: FAX #: FARMERS MUTUAL FIRE INSURANCE COMPANY OF SALEM COUNTY MELISSA KUCHTYAK, ADMINISTRATIVE SECRETARY 330 FELLOWSHIP ROAD, SUITE 200, MT. LAUREL, NJ TEL #: FAX #: JIM JORDAN, AVP CLAIMS 330 FELLOWSHIP ROAD, SUITE 200 MT. LAUREL, NJ TEL #: FAX #: FEDERAL EXPRESS CORP. THOMAS CONSTANCE, CLAIMS SUPERVISOR P.O. BOX 37726, PHILADELPHIA, PA TEL #: FAX #: MICKEY PINEIRO, WC CLAIMS MANAGER P.O. BOX PHILADELPHIA, PA TEL #: FAX #: FEDERAL INSURANCE COMPANY ANDY HERBERG, CLAIMS SUPERVISOR 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616, WARREN, NJ TEL #: FAX #: CRAIG FARINA, CLAIMS MANAGER 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616 WARREN, NJ TEL #: FAX #: FEDERATED MUTUAL INSURANCE COMPANY KAREN EBERHARDT, CLAIMS SUPERVISOR P.O. BOX 50487, INDIANAPOLIS, IN TEL #: FAX #: TODD FORBES, REGIONAL CLAIMS MANAGER P.O. BOX INDIANAPOLIS, IN TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 21

23 FEDEX GROUND PACKAGE SYSTEM, INC. THOMAS DITTOE, MANAGER, WORKERS' COMPENSATION 1000 FEDEX DRIVE, MOON TOWNSHIP, PA TEL #: FAX #: LAURA DETWILER, WORKERS' COMPENSATION ADMINISTRATOR 1000 FEDEX DRIVE MOON TOWNSHIP PA TEL #: FAX #: FEDEX SMARTPOST, INC THOMAS DITTOE, MANAGER, WORKERS' COMPENSATION 1000 FEDEX DRIVE, MOON TOWNSHIP, PA TEL #: FAX #: LAURA DETWILER, WC ADMINISTRATOR 1000 FEDEX DRIVE MOON TOWNSHIP, PA TEL #: FAX #: FIREMANS FUND INSURANCE COMPANY THOMAS CUEL, SR. CLAIMS DIRECTOR GREAT OAKS WAY, SUITE 200, ALPHARETTA, GA TEL #: FAX #: JENNIFER FELCH, WORKERS' COMPENSATION SUPERVISOR GREAT OAKS WAY, SUITE 200 ALPHARETTA, GA TEL #: FAX #: FIREMENS INSURANCE COMPANY OF WASHINGTON DC JEAN SHAW, REGIONAL CLAIM MANAGER BERKELY MID-ATLANTIC GROUP, 4820 LAKE BROOK DRIVE, SUITE 300, GLEN ALLEN, VA TEL #: ext FAX #: SUSAN HILL, WC CLAIM MANAGER BERKLEY MID-ATLANTIC GROUP, 4820 LAKE BROOK DRIVE, SUITE 300 GLEN ALLEN, VA TEL #: ext FAX #: FIRST LIBERTY INSURANCE COMPANY CHRISTOPHER NIESMERTELNY, CLAIMS MANAGER 3 BECKER FARM ROAD, ROSELAND, NJ TEL #: ext FAX #: christopher.niesmertelny@libertymutual.co m INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 22

24 JASON HACKLING, TEAM MANAGER 3 BECKER FARM ROAD ROSELAND, NJ TEL #: ext FAX #: jason.hackling@libertymutual.com FIRSTENERGY CORP & SUBS BARBARA J. MARSHALL, MANAGER, HEALTH & ABSENCE MGT. C/O FIRSTENERGY SERVICE, 76 S. MAIN STREET, AKRON, OH TEL #: FAX #: marshallb@firstenergycorp.com DONNA DUFFY, ACCOUNT MANAGER ASSOCIATED COMPENSATION RESOURCES, CURTISS WRIGHT PARKWAY, SUITE 100 RICHMOND HEIGHTS, OH TEL #: FAX #: donna@acrcomp.com FIRSTLINE NATIONAL INSURANCE COMPANY RICHARD HUGHES, CLAIM SUPERVISOR 200 NORTH MAIN STREET, BEL AIR, MD TEL #: FAX #: richard_hughes@harfordmutual.com DEBORAH BETTEN, CLAIM SUPERINTENDENT 200 NORTH MAIN STREET BEL AIR, MD TEL #: FAX #: deborah_betten@harfordmutual.com FITCHBURG MUTUAL INSURANCE COMPANY JOSEPH B. HASWELL, ASST. DIV. MANAGER, CASUALTY CLAIMS 222 AMES STREET, DEDHAM, MA TEL #: FAX #: jhaswell@ndgroup.com ALAN T. CONSOLETTI, SUPERVISOR, CASUALTY CLAIMS 222 AMES STREET DEDHAM, MA TEL #: FAX #: aconsoletti@ndgroup.com FLORISTS MUTUAL INSURANCE COMPANY DANIEL K SEYFERTH, WORKERS' COMPENSATION CLAIMS MANAGER #1 HORTICULTURAL LANE, EDWARDSVILLE, IL TEL #: FAX #: Dseyferth@hortica-insurance.com LINDA RENSING, WC CLAIMS MANAGER #1 HORTICULTURAL LANE EDWARDSVILLE, IL TEL #: FAX #: Lrensing@hortica-insurance.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 23

25 FMI INSURANCE COMPANY DALE MARTIN, CO-VICE PRESIDENT - CLAIMS P.O. BOX 400, BRANCHVILLE, NJ TEL #: FAX #: djmartin@fmiweb.com MELINDA RUSSO, CLAIMS ADJUSTER P.O. BOX 400 BRANCHVILLE, NJ TEL #: FAX #: mhawkins@fmiweb.com FOREMOST INSURANCE COMPANY GRAND RAPIDS MICHIGAN GRAHAM CADWALLADER, TEAM LEADER - WORKERS' COMPENSATION P.O. BOX , OKLAHOMA CITY, OK TEL #: FAX #: graham.cadwallader@hpcs.com MIKE MCCABE, CLAIMS MANAGER - WORKERS' COMPENSATION P.O. BOX OKLAHOMA CITY, OK TEL #: FAX #: michael.mccabe@hpcs.com FOREMOST PROPERTY & CASUALTY INSURANCE COMPANY GRAHAM CADWALLADER, TEAM LEADER - WORKERS' COMPENSATION P.O. BOX , OKLAHOMA CITY, OK TEL #: FAX #: graham.cadwallader@hpcs.com MIKE MCCABE, CLAIMS MANAGER - WORKERS' COMPENSATION P.O. BOX OKLAHOMA CITY, OK TEL #: FAX #: michael.mccabe@hpcs.com FOREMOST SIGNATURE INSURANCE COMPANY GRAHAM CADWALLADER, TEAM LEADER - WORKERS' COMPENSATION P.O. BOX , OKLAHOMA CITY, OK TEL #: FAX #: graham.cadwallader@hpcs.com MIKE MCCABE, CLAIMS MANAGER - WORKERS' COMPENSATION P.O. BOX OKLAHOMA CITY, OK TEL #: FAX #: michael.mccabe@hpcs.com FORT JAMES OPERATING COMPANY TIM B STARKS, SR. WC MANAGER 133 PEACHTREE STREET, NE, ATLANTA, GA TEL #: FAX #: Tistark@gapac.com LIZ WYNACHT, MANAGER - WC 133 PEACHTREE STREET, NE ATLANTA, GA TEL #: FAX #: eawynach@gapac.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 24

26 FRANK WINSTON CRUM INSURANCE INC ADELIN VINAS, CLAIMS MANAGER 100 S. MISSOURI AVENUE, CLEARWATER, FL TEL #: FAX #: BRIGITTE BECKER, VICE PRESIDENT-CLAIMS 100 S. MISSOURI AVENUE CLEARWATER, FL TEL #: FAX #: FRANKLIN MUTUAL INSURANCE COMPANY DALE MARTIN, CO-VICE PRESIDENT - CLAIMS P.O. BOX 400, BRANCHVILLE, NJ TEL #: FAX #: djmartin@fmiweb.com MELINDA RUSSO, CLAIMS ADJUSTER P.O. BOX 400 BRANCHVILLE, NJ TEL #: FAX #: mhawkins@fmiweb.com FRITO-LAY, INC. ELLEN MCGRATH, CLAIMS EXAMINER 45 MALLETT DRIVE, FREEPORT, ME TEL #: FAX #: -- ellen.mcgrath@sedgwickcms.com STEVE LANDIN, NORTH WC MANAGER 7701 LEGACY DRIVE, MAIL DROP 3C-114 PLANO, TX TEL #: FAX #: steve.landin@fritolay.com GANNETT SATELLITE INFO. NETWORK KIM HARRIS, RISK MANAGEMENT COORDINATOR GANNETT CO., INC., 7950 JONES BRANCH DRIVE, MCLEAN, VA TEL #: FAX #: None provided GENESIS HEALTH VENTURES, INC. PATRICE SIMCOX, WORKERS' COMPENSATION CLAIMS MANAGER 101 E. STATE STREET, KENNET SQUARE, PA TEL #: FAX #: patrice.simcox@genesiehcc.com NICOLE THOMPSON, WORKERS' COMPENSATION PROGRAM MANAGER 101 E. STATE STREET KENNET SQUARE, PA TEL #: FAX #: nicole.thompson(corporate)@genesishcc.co m INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 25

27 GEORGIA-PACIFIC CORPORATION TIM B STARKS, SR. WC MANAGER 133 PEACHTREE STREET, NE, ATLANTA, GA TEL #: FAX #: Tistark@gapac.com LIZ WYNACHT, MANAGER - WC 133 PEACHTREE STREET, NE ATLANTA, GA TEL #: FAX #: eawynach@gapac.com GERRESHEIMER GLASS INC SUSAN TINNON, VICE PRESIDENT, HUMAN RESOURCES GERRESHEIMER GLASS, INC., 537 CRYSTAL AVENUE, VINELAND, NJ TEL #: FAX #: -- S.Tinnon@Gerresheimer.com ED FRITSCH, CLAIMS SUPERVISOR CORVEL CORP., P.O. BOX NOTTINGHAM, MD TEL #: FAX #: ed_fritsch@corvel.com GRANITE STATE INSURANCE COMPANY JANICE MOORE, ASST. VICE PRESIDENT CHARTIS, P.O. BOX 4050, ALPHARETTA, GA TEL #: FAX #: JaniceM.Moore@chartisinsurance.com MELODY KENSEY, ADMINISTRATIVE ASSISTANT CHARTIS, P.O. BOX 4050 ALPHARETTA, GA TEL #: FAX #: melody.fralick@chartisinsurance.com GRAPHIC ARTS MUTUAL INSURANCE COMPANY DIANE SERVELLO, WORKERS' COMPENSATION SUPERVISOR P.O. BOX 5310, BINGHAMTON, NY TEL #: FAX #: diane.servello@uticanational.com JOSEPH SMITH, DISTRICT CLAIMS MANAGER 50 MILLSTONE ROAD, BLDG. 200, SUITE 240 EAST WINDSOR, NJ TEL #: FAX #: Joseph.Smith@uticanational.com GREAT AMERICAN ALLIANCE INSURANCE COMPANY PETER BUONPANE, SR. CLAIM MANAGER STRATEGIC COMP, P.O. BOX 1445, ALPHARETTA, GA TEL #: ext. 306 FAX #: pbuonpane@strategiccomp.com RON RAGNO, DIVISIONAL VP CLAIMS STRATEGIC COMP, P.O. BOX 1445 ALPHARETTA, GA TEL #: FAX #: rragno@strategiccomp.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 26

28 GREAT DIVIDE INSURANCE COMPAY ALSA ZUAITER, WC ASSISTANT MANAGER 600 E. LAS COLINAS BLVD., SUITE 1400, IRVING, TX TEL #: FAX #: CASSIE MEBES, WC MANAGER 600 E. LAS COLINAS BLVD., SUITE 1400 IRVING, TX TEL #: FAX #: GREAT NORTHERN INSURANCE COMPANY ANDY HERBERT, CLAIMS SUPERVISOR 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616, WARREN, NJ TEL #: FAX #: CRAIG FARINA, CLAIMS MANAGER 15 MOUNTAIN VIEW ROAD, P.O. BOX 1616 WARREN, NJ TEL #: FAX #: GREATER NEW YORK MUTUAL INSURANCE COMPANY JAMES M PRIMAMORE, NJ WORKERS' COMPENSATION MANAGER 377 SUMMERHILL ROAD, P.O. BOX 1064, EAST BRUNSWICK, NJ TEL #: ext. 284 FAX #: jprimamore@gny.com RICHARD ZWEIBEL, ASST. MANAGER, NJ WORKERS' COMPENSATION 377 SUMMERHILL ROAD, P.O. BOX 1064 EAST BRUNSWICK, NJ TEL #: ext. 288 FAX #: rzweibel@gny.com GREENWICH INSURANCE COMPANY LYNN MUNSON, ASST. VP CLAIMS REGULATORY & COMPLIANCE 20 N. MARTINGALE ROAD, SUITE 200, SCHAUMBURG, IL TEL #: FAX #: lynn.munson@xlgroup.com BRYAN SANDERS, ASST. VP PRIMARY CASUALTY & PROGRAM CLAIMS 505 EAGLEVIEW BLVD. EXTON, PA TEL #: FAX #: -- Bryan.Sanders@xlgroup.com GUARANTEE INSURANCE COMPANY MARK HOEHN, NE REGIONAL CLAIM MANAGER C/O PATRIOT RISK SERVICES, INC., P.O. BOX 386, CONSHOHOCKEN, PA TEL #: FAX #: mhoehn@pnigroup.com LORI SCARAMUCCI, CLAIM SUPERVISOR C/O PATRIOT RISK SERVICES, INC., P.O. BOX 386 CONSHOHOCKEN, PA TEL #: FAX #: lscaramucci@pnigroup.com INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 27

29 GUIDEONE MUTUAL INSURANCE COMPANY LINDA WILSON, WC SUPERVISOR 1025 ASHWORTH ROAD, WEST DES MOINES, IA TEL #: FAX #: LEIGH HOLLIS, WC ADJUSTER 1025 ASHWORTH ROAD WEST DES MOINES, IA TEL #: FAX #: HANOVER INSURANCE COMPANY JOHN FURTADO, UNIT MANAGER 440 LINCOLN STREET, WORCESTER, MA TEL #: FAX #: PAUL COUGHLIN, SENIOR ADJUSTER 440 LINCOLN STREET WORCESTER, MA TEL #: FAX #: HARFORD MUTUAL INSURANCE COMPANY RICHARD HUGHES, CLAIM SUPERVISOR 200 NORTH MAIN STREET, BEL AIR, MD TEL #: FAX #: DEBORAH BETTEN, CLAIM SUPERINTENDENT 200 NORTH MAIN STREET BEL AIR, MD TEL #: FAX #: HARLEYSVILLE INSURANCE COMPANY MELISSA TRIMMER, WC CLAIMS SUPERVISOR 355 MAPLE AVENUE, HARLEYSVILLE, PA TEL #: FAX #: JAMES FELBINGER, WC MANAGER 355 MAPLE AVENUE HARLEYSVILLE, PA TEL #: FAX #: HARLEYSVILLE INSURANCE COMPANY OF NEW JERSEY MELISSA TRIMMER, WC CLAIMS SUPERVISOR 355 MAPLE AVENUE, HARLEYSVILLE, PA TEL #: FAX #: JAMES FELBINGER, WC DIRECTOR 355 MALE AVENUE HARLEYSVILLE, PA TEL #: FAX #: INSURANCE COMPANY / SELF-INSURER CONTACTS December 22, page 28