1199 NATIONAL BENEFIT FUND AMERICAN HEALTHCARD AMERICAN MEDICAL SECURITY ACTION HEALTHCARE MANAGEMENT SERVICES AMERICAS CHOICE HEALTH PLANS

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1 1199 NATIONAL BENEFIT FUND AMERICAN HEALTHCARD 21ST CENTURY HEALTH AMERICAN INSURANCE SOLUTIONS 4MOST HEALTH NETWORK AMERICAN MARITIME OFFICERS PLAN AARP AMERICAN MEDICAL SECURITY ACCENT HEALTH AMERICAN NATIONAL INS ACCESS HEALTH SYSTEMS AMERICAN POSTAL WORKERS ACORDIA NATIONAL AMERICAN PROGRESSIVE ACS BENEFITS SERVICES AMERICAN REPUBLIC INS ACTION HEALTHCARE MANAGEMENT SERVICES AMERICARD ADENA CORP AMERICAS CHOICE HEALTH PLANS ADMINISTRATIVE BENEFIT MANAGEMENT AMERICLAIM SOLUTIONS ADMINISTRATIVE CONCEPTS AMERICOMP ADMINISTRATIVE SERVICES CORP AMERIHEALTH ADMINISTRATORS AND CONSULTANTS AMERISTAR ADVANCED CONCEPTS ANDIES COMPANY ADVENTIST RISK MANAGEMENT APA PARTNERS AETNA (ALL PRODUCTS) APPLIED RESEARCH ASSOCIATES AFFINITY ASCENT INC AFLAC ASSURANT HEALTH AFS INSURANCE SERVICES ASSURE CARE AFTRA HEALTH PLAN ATHENA GROUP AGWAY AULTCARE AIG AVMED INC AIM HEALTHCARE SERVICES BANKERS LIFE AND CASUALTY ALLEN CANNING COMPANY BARON ROUGE ELECTRIC HEALTH AND WELFARE ALLIED BENEFIT SYSTEM BASS PRO INC ALLSTATE BEACON ONE HEALTH SERVICES AMERIBEN SOLUTIONS BEECH STREET AMERICA LIFE AND HEALTH BENEFIT ADMINISTRATIVE SYSTEMS AMERICA REPUBLIC INSURANCE COMPANY BENEFIT MANAGEMENT SERVICES AMERICAN ADMINISTRATIVE GROUP BENEFIT PLANNERS AMERICAN BENEFITS ADMINISTRATIVE BENEFIT SERVICE INC BSI AMERICAN COMMUNITY MUTUAL BENEFITS CONCEPT

ADENA CORP AMERICAS CHOICE HEALTH PLANS ADMINISTRATIVE BENEFIT MANAGEMENT AMERICLAIM SOLUTIONS ADMINISTRATIVE CONCEPTS AMERICOMP ADMINISTRATIVE SERVICES CORP AMERIHEALTH ADMINISTRATORS AND

2 BENESIGHT BENESYS BENMARK ADMINISTRATORS BERRY PETROLEUM COMPANY BEST BENEFITS BEST CHOICE ADMINISTRATORS BEST LIFE AND HEALTH INSURANCE BLUE CROSS & BLUE SHIELD **** ALL PRODUCTS**** BOILER MAKERS NATIONAL CAPITAL ADMINISTRATORS CAPITAL DISTRICT PHYSICIANS HEALTH PLAN (CDPHP) CAPITOL ADMINISTRATORS CARDINAL HEALTH CARE CHOICES CARE ONE CAREINGTON INTERNATIONAL CARITEN TPA SERVICES CARPENTERS LOCAL 1098 WELFARE FUND CBA EMPLOYEE BENEFITS CBCA ADMINISTRATORS CDPHP UNIVERSAL BENEFITS *** ONLY WITH THE PHCS LOGO*** CELTIC LIFE INSURANCE CENTRA CENTRAL BENEFITS MUTUAL INSURANCE CENTRAL STATES SOUTHEAST AND SOUTHWEST AREAS HEALTH PLAN CENTURY PLANNERS ADMINISTRATORS CHAMPUS CHAMPVA CHESTERFIELD RESOURCES CHRISTIAN BROTHERS SERVICES CHUBB HEALTH CIGNA (ALL PRODUCTS) CLINTONS DITCH CNA COMBINED LIFE INSURANCE COMPANY COMMERCIAL TRAVELERS COMMONWEALTH ADMINISTRATORS COMPLETE BENEFIT SOLUTIONS COMPREHENSIVE CARE SERVICES CONCERT HEALTH PLANS CONNECTICARE INC CONNECTICUT GENERAL CONSECO MEDICAL CONSOCIATE GROUP HEALTH CONSOLIDATED HEALTH PLAN CONTINENTAL ASSURANCE COMPANY COOPER INDUSTRIES COOPER STANDARD CORESOURCE CORNERSTONE PREFERRED CORPORATE BENEFIT SERVICES OF AMERICA COVENANT ADMINISTRATORS COVENTRY HEALTH AND LIFE CSD HEALTH CARE PLAN DEFINITY HEALTH DESTINY HEALTH INSURANCE DIRECTORS GUILD OF AMERICA HEALTH PLAN EBS BENEFIT SOLUTIONS EXCELLUS BCBS EMPIRE PLAN EMPLOYEE BENEFIT ADMINISTRATION ENGINEERS JOINT WELFARE ENHANCED BENEFITS EOS HEALTHCARE FALLON COMMUNITY HEALTH PLAN FAMILY CARE PLUS FIDELIS MEDICAID FIDELIS MEDICARE

3 FIRST ADMINISTRATORS FIRST ALLAMERICAN FINANCIAL INSURANCE COMPANY FIRST AMERICAN INSURANCE COMPANY FIRST HEALTH FIRST UNITED HEALTH FOCUS HEALTHCARE FORTIS HEALTH FOX EVERETTE INC GE GROUP LIFE ASSURANCE GERBER LIFE INSURANCE GHI GILSBAR GLOBAL EXCEL GLOBAL MEDICAL GM SOUTHWEST GOLDEN RULE INSURANCE COMPANY GOVERNMENT EMPLOYEES ASSOCIATION GPA HOLDING GREAT FIDELITY GREAT NORTHERN CORP GREAT WEST GROUP ADMINISTRATION GROUP BENEFIT SERVICES GUARDIAN HANOVER HARRINGTON BENEFIT SERVICES HARVARD COMMUNITY HEALTH HARVARD PILGRIM HEALTH CARE HCNP HEALTH ADMINISTRATORS (TPA) HEALTH ALLIANCE PLAN HEALTH CARE AMERICA HEALTH CARE SAVINGS HEALTH COST SOLUTIONS HEALTH FIRST PHYSICIANS HEALTH NET INC HEALTH NEW ENGLAND HEALTH NOW HEALTH PARTNERS INC HEALTH PLAN EXTRAS HEALTH PLAN INC HEALTH TRADITION PREMIER/PREMIER PLUS HEALTHCARE DIRECT HEALTHCARE HORIZON HEALTHCORP HEALTHSCOPE BENEFITS HEARTLAND ALLIANCE AMERICA HEATING AND COOLING PRODUCTS HEREIU WELFARE FUND HERTZ CORPORATION HIGHMARK LIFE AND CASUALTY HMA INC HNA NETWORK HORIZON HEALTHCARE INSURANCE HUMANA **** ONLY HUMANA WITH THE MULTIPLAN LOGO**** IBEW IBEW LOCAL 41 HEALTH FUND IMERICA HEALTH AND LIFE INDEPENDENT HEALTH ASSOCIATION INDEPENDENT HEALTH BENEFIT CORPORATION INNOVATIVE HEALTH STRATEGIES INSURANCE ADMINISTRATIVE CORPORATION INSURANCE MANAGEMENT ASSOCIATION INSURANCE SYSTEMS INC INSUREX BENEFIT ADMINISTRATORS INTEGRA ADMINISTRATIVE GROUP INTER-AMERICAS INSURANCE COMPANIES INTERCONTINENTAL EXCHANGE INC INTERNATIONAL BROTHERHOOD OF TEAMSTERS IRON WORKERS DISTRICT COUNCIL OF WNY

GREAT WEST GROUP ADMINISTRATION GROUP BENEFIT SERVICES GUARDIAN HANOVER HARRINGTON BENEFIT SERVICES HARVARD COMMUNITY HEALTH HARVARD PILGRIM HEALTH CARE HCNP HEALTH ADMINISTRATORS (TPA) HEALTH

4 KAISER PERMENTE MVP KEMPER NALC KEYPARTNERS INC NALC 2 KEYSTONE NATIONAL AUTOMATIC SPRINKLERS KMART HEALTH BENEFIT TRUST NATIONAL CARE NETWORK LASALLE NATIONAL ELEVATOR INDUSTRY LIBERTY MUTUAL NATIONAL MEDCO INSURANCE LIFE INVESTORS INSURANCE COMPANY NATIONAL PRODUCTION WORKERS UNION LIFEWISE HEALTH PLAN NATIONWIDE LOCAL 73 HEALTH AND WELFARE FUND NEW ENGLAND LIFE INSURANCE COMPANY LOUISIANA LABORERS HEALTH AND WELFARE FUND NEW YORK LIFE LUMENOS INC NGS AMERICA MAGNA INTERNATIONAL NIPPON LIFE MAGNACARE NORTH AMERICAN BENEFITS MAHONEY BENEFIT ADMINISTRATORS NORTH AMERICAN HEALTH PLANS MAILHANDLERS NORTH AMERICAN PREFERRED MANAGED CARE ADMINISTRATORS ODS HEALTH PLANS MEDFOCUS OLYMPUS MANAGED CARE MEDICAID OMEGA MEDICAL ASSOCIATES HEALTH PLAN ONE CALL MEDICAL MEDICAL BENEFITS MUTUAL ONONDAGA COUNTY LABORERS HEALTH AND WELFARE MEDICAL GROUP INSURANCE SERVICES INC OX INTERNATIONAL MEDICAL MUTUAL OF OHIO OXFORD HEALTH PLAN MEDICARE PACIFIC BENEFIT TRUST MEDILLUME INC PACIFICARE LIFE ASSURANCE MEDPLAN PROGRAM PARAGON BENEFITS MEMORIAL HERMAN HEALTH NETWORK PEKIN LIFE INSURANCE MERCY HEALTH PLANS PERFROMANCE HEALTH MERITAIN HEALTH PHCS METLIFE PIONEER LIFE INSURANCE COMPANY METRAHEALTH PLAN PLUS HNA MIDWEST ASSURANCE PLANNED ADMINISTRATORS MIDWEST NATIONAL LIFE INSURANCE COMPANY PLUMBERS AND PIPEFITTERS (LOCALS 344 & 572) MULTI PLAN PLUMBERS AND STEAMFITTERS MUTUAL OF OMAHA POMCO

LOUISIANA LABORERS HEALTH AND WELFARE FUND NEW YORK LIFE LUMENOS INC NGS AMERICA MAGNA INTERNATIONAL NIPPON LIFE MAGNACARE NORTH AMERICAN BENEFITS MAHONEY BENEFIT ADMINISTRATORS NORTH AMERICAN HEALTH

5 POST MASTERS BENEFIT FUND PREFERRED CARE PREFERRED HEALTH CHOICES PREFERRED ONE ADMINISTRATIVE SERVICES PREMIER MEDICAL INSURANCE GROUP PRINCIPAL LIFE PRINCIPAL MUTUAL PRIORITY HEALTH PRIVATE HEALTH CARE SYSTEMS PRO-CLAIM PLUS PROFESSIONAL CLAIMS MANAGEMENT PROVIDENCE HEALTH PLANS PRUDENTIAL PUPIL BENEFITS PLAN QUAL CHOICE RISK MANAGEMENT RMSCO ROCHESTER LABORERS LOCAL 435 ROCKY MOUNTAIN HEALTH MAINTENANCE ROOFERS LOCAL 195 HEALTH PLAN ROOFERS LOCAL HEALTH PLAN RURAL CARRIER BENEFIT PLAN S&S HEALTH CARE STRATEGIES SAFEWAY INSURANCE COMPANY SEABURY AND SMITH SECURE HORIZONS UHC SELF FUNDED PLANS INC SELF INSURED SERVICES COMPANY SENIOR FIRST SENTRY HEALTH INSURANCE SERVICE EMPLOYEE BENEFIT PLAN SHEETMETAL WORKERS SIEBA SIERRA HEALTH AND LIFE INSURANCE SINCLAIR BROADCAST GROUP SMITH ADMINISTRATORS INC SOLUTIONS HEALTHCARE SOUTHERN BENEFIT SERVICES SOUTHERN TIER BUILDING TRADES BENEFIT PLAN SOUTHWEST LIFE AND HEALTH INSURANCE ST LAWRENCE LEWIS COUNTY ST REGIS MOHAWK HEALTH SERVICES STATE FARM STATEWIDE SUPERIAN HEALTH NETWORK THE ENCORE GROUP THE EPOCH GROUP THE HERTZ CORPORATION THE LOOMIS COMPANT THE MEGA LIFE AND HEALTH INSURANCE COMPANY THE NATIONAL ASBESTOS WORKERS MEDICAL FUND THE SALVATION ARMY THE SAVAGE COMPANY TODAYS OPTIONS TOTAL BENEFIT SERVICES TOTAL CARE TRANSAMERICA TRAVELERS TRICARE TOUCHSTONE UICI UNICARE UNICARE ONE UNITED AMERICAN INSURANCE

MAINTENANCE ROOFERS LOCAL 195 HEALTH PLAN ROOFERS LOCAL HEALTH PLAN RURAL CARRIER BENEFIT PLAN S&S HEALTH CARE STRATEGIES SAFEWAY INSURANCE COMPANY SEABURY AND SMITH SECURE HORIZONS UHC SELF FUNDED

6 UNITED BENEFITS UNITED BROTHERHOOD OF CARPENTERS & JOINERS LOCAL 953 UNITED HEALTH CARE UNITED MEDICAL RESOURCES UNITED OF OMAHA LIFE INSURANCE UNITED SECURITY LIFE INSURANCE UNITED STATES LIFE INSURANCE COMPANY UNITED WISCONSIN LIFE INSURANCE COMPANY UNITED WORLD LIFE INSURANCE COMPANY UNIVERA UNIVERA SENIOR CARE UPMC HEALTH PLAN UPSTATE ADMINISTRATORS UPSTATE CARPENTERS FUND UPSTATE EMPLOYEES BENEFIT FUND VANTAGE AMERICA WASHINGTON NATIONAL INSURANCE COMPANY WAUSAU WESTPORT BENEFITS WEYEO INC WILLIS ADMINISTRATIVE SERVICES WILLIS ASSOCIATES INC/NATIONAL CLAIMS ZENITH ADMINISTRATORS

UNIVERA UNIVERA SENIOR CARE UPMC HEALTH PLAN UPSTATE ADMINISTRATORS UPSTATE CARPENTERS FUND UPSTATE EMPLOYEES BENEFIT FUND VANTAGE AMERICA

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

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