4/15/2014 Workers Compensation Agency Page 1 A.I.U. Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 193990012 Acadia Insurance Company NAIC Number: 313250098 Acceptance Insurance Company 535 W. Broadway P.O. Box 1574 Council Bluffs, IA 51502-1574 NAIC Number: 379580329 Accident Fund General Insurance Co. P.O. Box 40790 Lansing, MI 48901 NAIC Number: 123040572 Accident Fund Insurance Co. of America P.O. Box 40790 Lansing, MI 48901 NAIC Number: 101660572 Accident Fund National Insurance Co. P.O. Box 40790 Lansing, MI 48901 NAIC Number: 123050572 Ace American Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 226670626 Ace Fire Underwriters Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 207020626 Ace Property & Casualty Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 206990626 ACIG Insurance Company 12222 Merit Drive Suite 1660 Dallas, TX 75251 NAIC Number: 199840594 Acuity, A Mutual Insurance Company 2800 S. Taylor Drive P.O. Box 58 Sheboygan, WI 53081 NAIC Number: 141840289 Advantage Workers Compensation Insurance Company P.O. Box 571918 Salt Lake City, UT 84157-1918 NAIC Number: 405170000 Affiliated F M Insurance Company Allendale Park P.O. Box 7500 Johnston, RI 02919 NAIC Number: 100140065 Alea North America Insurance Company 55 Capital Blvd. Rocky Hill, CT 06067 NAIC Number: 248991325 All America Insurance Company 800 S. Washington Street Vanwert, OH 45891 NAIC Number: 202220036 Alliance Assurance Company, Ltd. 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 202730553 Allianz Insurance Company 2995 Prospect Park Drive, Suite 200 Rancho Cordova, CA 95670 NAIC Number: 353000761 Allied Eastern Indemnity Company 25 Race Avenue P.O. Box 83777 Lancaster, PA 17608-3777 NAIC Number: 112423158 Allied Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 365280626 Allied Property & Casualty Insurance Company 3820 109th DesMoines, IA 50391 NAIC Number: 425790140 Allmerica Financial Benefits Insurance Company P.O. Box 15144 Worcester, MA 01615 NAIC Number: 418400088 Allmerica Financial Alliance Insurance Company P.O. Box 15144 Worcester, MA 01615 NAIC Number: 102120088
4/15/2014 Workers Compensation Agency Page 2 Allstate Indemnity Company 3075 Sanders Road, Suite H1A Northbrook, IL 60062-7127 NAIC Number: 192400008 Allstate Insurance Company 3075 Sanders Road, Suite H1A Northbrook, IL 60062-7127 NAIC Number: 192320008 Amco Insurance Company One Nationwide Plaza Columbus, OH 43216 NAIC Number: 191000140 American & Foreign Insurance Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 245890553 American Alternative Insurance Company American RE Plaza 555 College Road East Princeton, NJ 08543 NAIC Number: 197200957 American Automobile Insurance Company P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 218490761 American Casualty Company of Reading, PA NAIC Number: 204270218 American Commercial Liability Insurance Co. NAIC Number: 303920713 American Compensation Insurance Company 8500 Normandale Lake Blvd. Ste. 1400 Bloomington, MN 55437 NAIC Number: 459344463 American Continental Insurance Company NAIC Number: 122460164 American Country Insurance Company 150 N. W. Point Blvd., Suite 300 Elk Grove Village, IL 60007-1015 NAIC Number: 382370000 American Druggists Insurance Company NAIC Number: 101540143 American Economy Insurance Company NAIC Number: 196900163 American European Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY 14240-9974 NAIC Number: 233370226 American Family Home Insurance Company 555 College Road East Princeton, NJ 08543 NAIC Number: 234500957 American Fire & Casualty Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI 53072 NAIC Number: 240660148 American Fuji Fire & Marine Insurance Company 3880 RFD Salem Lake Road Long Grove, IL 60047 NAIC Number: 403980000 American Guarantee & Liability Insurance Co. 1400 American Lane NAIC Number: 262470212 American Hardware Mutual Insurance Company P.O. Box 435 Minneapolis, MN 55440 NAIC Number: 133310291 American Home Assurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 193800012 American Insurance Company P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 218570761 American Interstate Insurance Company 2301 Highway 190 West Deridder, LA 70634 NAIC Number: 318950680
4/15/2014 Workers Compensation Agency Page 3 American Manufacturers Mutual Insurance Co. Fund NAIC Number: 305620108 American Mining Insurance Company NAIC Number: 159110098 American Modern Home Insurance Company 555 College Road East Princeton, NJ 08543 NAIC Number: 234690957 American Motorists Insurance Company Fund NAIC Number: 229180108 American Mutual Insurance Company of Boston 100 Unicorn Park Drive Woburn, MA 01801 NAIC Number: 195500015 American Mutual Liability Insurance Company 100 Unicorn Park Drive Woburn, MA 01801 NAIC Number: 195690015 American Physicians Assurance Corporation 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI 48826 NAIC Number: 330060966 American Policyholders Insurance Co. 100 Unicorn Park Drive Woburn, MA 01801 NAIC Number: 195770015 American Protection Insurance Company Fund NAIC Number: 189100108 American Safety Casualty Insurance Company 100 Galleria Pkwy SE, Ste. 700 Atlanta, GA 30339-5947 NAIC Number: 399691346 American Select Insurance Company One Park Circle P.O. Box 5001 Westfield Center, OH 44251-5001 NAIC Number: 199920228 American States Insurance Company NAIC Number: 197040163 American Universal Insurance Company NAIC Number: 197470021 American Zurich Insurance Company 1400 American Lane NAIC Number: 401420212 Amerisure Insurance Company P.O. Box 33478 Detroit, MI 48232-5478 NAIC Number: 194880124 Amerisure Mutual Insurance Company P.O. Box 33478 Detroit, MI 48232-5478 NAIC Number: 233960124 Amerisure Partners Insurance Company P.O. Box 33478 Detroit, MI 48232-5478 NAIC Number: 110500124 AmGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA 18703 NAIC Number: 423900828 Ansur America Insurance Company One Mutual Avenue Frankenmuth, MI 48787 NAIC Number: 109841309 AP Specialty Insurance Corp. 1301 N. Hagadorn Road East Lansing, MI 48823-2320 NAIC Number: 102290966 Arch Insurance Company 330 Post Road #200 Darien, CT 06820-3600 NAIC Number: 111500000 Argonaut Great Central Insurance Company P.O. Box 469012 San Antonio, TX 78246-9012 NAIC Number: 198600457
4/15/2014 Workers Compensation Agency Page 4 Argonaut Insurance Company P.O. Box 469012 San Antonio, TX 78246-9012 NAIC Number: 198010457 Argonaut Midwest Insurance Company P.O. Box 469012 San Antonio, TX 78246-9012 NAIC Number: 198280457 Arrowood Indemnity Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 246780553 Associated Indemnity Corporation P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 218650761 Assurance Company of America 1400 American Lane NAIC Number: 193050212 Athena Assurance Company NAIC Number: 417690164 Atlantic Mutual Insurance Company NAIC Number: 198950024 Atlantic Specialty Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 271541129 Auto Owners Insurance Company Michigan Workers' Comp. Claims P.O. Box 30510 Lansing, MI 48909 NAIC Number: 189880280 Automobile Insurance Company of Hartford, CT NAIC Number: 190620041 Axa Corporate Solutions Insurance Company 17 State Street New York, NY 10004-1501 NAIC Number: 330220968 Badger Mutual Insurance Company 1635 W National Ave Milwaukee, WI 53204 NAIC Number: 134200000 Balboa Insurance Company 3349 Michelson Drive Irvine, CA 92713 NAIC Number: 248130165 Bancinsure, Inc. 5005 N. Lincoln Blvd. Oklahoma City, OK 73105 NAIC Number: 185380000 Bankers Standard Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 182790626 Benchmark Insurance Company 775 Prairie Center Dr, Suite 420 Eden Prairie, MN 55344 NAIC Number: 413940000 Berkley National Insurance Company NAIC Number: 389110098 Berkley Regional Insurance Company NAIC Number: 295800098 Berkshire Hathaway Homestate Insurance Company P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 200440031 Bituminous Casualty Corporation 31555 W. 14 Mile Road, Suite 211 Farmington Hills, MI 48334 NAIC Number: 200950150 Bituminous Fire & Marine Insurance Company 31555 W. 14 Mile Road, Suite 211 Farmington Hills, MI 48334 NAIC Number: 201090150 Bloomington Compensation Insurance Company 8500 Normandale Lake Blvd. Ste. 1400 Bloomington, MN 55437 NAIC Number: 123114463 Boston Insurance Company 1717 E. 9th Street Cleveland, OH 44114 NAIC Number: 333330000
4/15/2014 Workers Compensation Agency Page 5 Boston Old Colony Insurance Company NAIC Number: 207610218 Brotherhood Mutual Insurance Company P.O. Box 2227 Fort Wayne, IN 46801 NAIC Number: 135280000 Buckeye Union Insurance Company NAIC Number: 207880218 Camden Fire Insurance Association Co. of NJ 1051 Texas Street Salem, VA 24153 NAIC Number: 219461129 Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 NAIC Number: 104720501 Carolina Casualty Insurance Company NAIC Number: 105100098 Carriers Insurance Company NAIC Number: 105290338 Castlepoint National Insurance Company 222 S. Riverside Plaza Chicago, IL 60606 NAIC Number: 401343703 Casualty Reciprocal Exchange NAIC Number: 212370056 Celina Mutual Insurance Company 1 Insurance Square Celina, OH 45822 NAIC Number: 201760035 Centennial Insurance Company NAIC Number: 199090024 Central Mutual Insurance Company 800 S. Washington Street Vanwert, OH 45891 NAIC Number: 202300036 Central National Insurance Co. of Omaha 105 S. 17th Street Omaha, NE 68102 NAIC Number: 202490217 Century Indemnity Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 207100626 Charter Oak Fire Insurance Company NAIC Number: 256150041 AIG Property Casualty Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 194020012 Cherokee Insurance Company 34200 Mound Road Sterling Heights, MI 48310 NAIC Number: 106420000 Chrysler Insurance Company P.O. Box 9220 Farmington Hills, MI 48333-9220 NAIC Number: 104990240 Chubb Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 127770038 Chubb Nationial Insurance Company 202 Halls Mill Road Whitehouse Station, NJ 08889 NAIC Number: 100520038 Church Mutual Insurance Company 3000 Schuster Lane P.O. Box 357 Merrill, WI 54452 NAIC Number: 187670000 Cincinnati Casualty Company P.O. Box 150376 Grand Rapids, MI 49515 NAIC Number: 286650244 Cincinnati Indemnity Company P.O. Box 150376 Grand Rapids, MI 49515 NAIC Number: 232800244
4/15/2014 Workers Compensation Agency Page 6 Cincinnati Insurance Company P.O. Box 150376 Grand Rapids, MI 49515 NAIC Number: 106770244 Citizens Insurance Company of America P.O. Box 15144 Worcester, MA 01615 NAIC Number: 315340088 Citizens Insurance Company of Ohio P.O. Box 15144 Worcester, MA 01615 NAIC Number: 101760088 Citizens Insurance Company of the Midwest P.O. Box 15144 Worcester, MA 01615 NAIC Number: 103950088 City Insurance Company NAIC Number: 225000095 Clarendon National Insurance Company 411 5th Ave. FL 5 New York, NY 10016-2221 NAIC Number: 205320517 Colonial American Casualty & Surety Company 1400 American Lane NAIC Number: 343470212 Colonial Penn Insurance Company P.O. Box 1998 Valley Forge, PA 19482 NAIC Number: 347890239 Commerce & Industry Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 194100012 Commercial Insurance Company of Newark NAIC Number: 208180218 Companion Commercial Insurance Company 51 Clemson Road Columbia, SC 29229 NAIC Number: 107940661 Companion Property & Casualty Insurance Company 51 Clemson Road Columbia, SC 29229 NAIC Number: 121570661 Compass Insurance Company 9277 Centre Pointe Drive, Suite 140 West Chester, OH 45069 NAIC Number: 219890143 Conifer Insurance Company P.O. Box 3003 Birmingham, MI 48012 NAIC Number: 297344720 Connecticut Indemnity Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 248720553 Consolidated American Insurance Company P.O. Box 1 Columbia, SC 29202 NAIC Number: 249450168 Consolidated Insurance Company WC Processing Center P.O. Box 515099 Los Angeles, CA 90051-5099 NAIC Number: 226400111 Consolidated Underwriters NAIC Number: WC0080000 Continental Casualty Company NAIC Number: 204430218 Continental Indemnity Company P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 282580031 Continental Insurance Company NAIC Number: 352890218 Continental National American Casualty Co. NAIC Number: 204350218
4/15/2014 Workers Compensation Agency Page 7 Continental National Indemnity Company NAIC Number: 282580218 Continental Western Insurance Company NAIC Number: 108040098 Crum & Forster Indemnity Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 313480158 CUMIS Insurance Society, Inc. Workers' Compensation Claims P.O. Box 1221 Madison, WI 53701 NAIC Number: 108470306 Dallas National Insurance Company 5501 L.B. J. Freeway Dallas, TX 75240 NAIC Number: 322711631 Depositors Insurance Company 1100 Locust Street Des Moines, IA 50391 NAIC Number: 425870140 Discover Property & Casualty Insurance Co Discover Re Managers, Inc. 5 Batterson Pk Farmington, CT 06032 NAIC Number: 364630164 Dorinco Reinsurance Company 1320 Waldo Avenue, Suite 200 Midland, MI 48642 NAIC Number: 334990000 Eagle Pacific Insurance Company Fund NAIC Number: 369860108 Eagle Star Insurance Company 111 John Street New York, NY 10038 NAIC Number: 222220000 Eastern Advantage Assurance Company 25 Race Avenue P.O. Box 83777 Lancaster, PA 17608-3777 NAIC Number: 130193158 Eastern Alliance Insurance Company 25 Race Avenue P.O. Box 83777 Lancaster, PA 17608-3777 NAIC Number: 107243158 Eastguard Insurance Company 16 S. River Street Wilkes Barre, PA 18703 NAIC Number: 147020828 Edison Insurance Company 222 Merchandise Mart Plaza Ste. 1450 Chicago, IL 60654 NAIC Number: 242870000 Electric Insurance Company 260 Washington Avenue P.O. Box 15065 Albany, NY 12212 NAIC Number: 212610057 Electric Mutual Liability Insurance Company 4 Corporate Plz #425 Albany, NY 12203 NAIC Number: 212880057 Emcasco Insurance Company P.O. Box 30546 Lansing, MI 48909 NAIC Number: 214070062 Employers Casualty Company NAIC Number: 213690061 Employers Fire Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 206481129 Employers Insurance of Wausau NAIC Number: 214580111 Employers Mutual Casualty Company P.O. Box 30546 Lansing, MI 48909 NAIC Number: 214150062 Everest National Insurance Company P.O. Box 830 Liberty Corner, NJ 07938-0830 NAIC Number: 101201120
4/15/2014 Workers Compensation Agency Page 8 Evergreen National Indemnity Company 6140 Parkland Blvd. Mayfield, OH 44124-6106 NAIC Number: 127503592 Fairfield Insurance Company P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 447840031 Fairmont Insurance Company 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 188641111 Farm Bureau General Insurance Company Medical Maintenance Unit P.O. Box 30100 Lansing, MI 48909 NAIC Number: 215470067 Farm Bureau Mutual Insurance Company Medical Maintenance Unit P.O. Box 30100 Lansing, MI 48909 NAIC Number: 215550067 Farmers Automobile Insurance Association 2505 Court Street Pekin, IL 61558-001 NAIC Number: 242010153 Farmers Insurance Exchange P.O. Box 108843 Oklahoma City, OK 73101-8843 NAIC Number: 216520212 Farmington Casualty Company NAIC Number: 414830041 Farmland Mutual Insurance Company 1100 Locust Street, Dept. 3010 Des Moines, IA 50391-3010 NAIC Number: 138380140 FCCI Insurance Company P.O. Box 58004 Sarasota, FL 34232-0800 NAIC Number: 101780474 Federal Insurance Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 202810038 Federal Kemper Insurance Company Fund NAIC Number: 305030108 Federated Mutual Insurance Company P.O. Box 390850 Minneapolis, MN 55439 NAIC Number: 139350007 Federated Rural Electric Insurance Corp. P.O. Box 15147 Lenexa, KS 66215 NAIC Number: 111180000 Federated Service Insurance Company P.O. Box 390850 Minneapolis, MN 55439 NAIC Number: 283040007 Fidelity & Casualty Company of New York NAIC Number: 352700218 Fidelity & Deposit Company of Maryland 1400 American Lane NAIC Number: 393060212 Fidelity & Guaranty Insurance Company Discover Re Managers, Inc. 5 Batterson Park Farmington, CT 06032 NAIC Number: 353860164 Fidelity & Guaranty Insurance Underwriters Discover Re Managers, Inc. 5 Batterson Park Farmington, CT 06032 NAIC Number: 258790164 Fire & Casualty Insurance Company of Ct 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 248800553 Firemans Fund Insurance Company P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 218730761 Firemans Fund Insurance Company of Wisconsin P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 372730761
4/15/2014 Workers Compensation Agency Page 9 Firemens Insurance Company of Newark, N.J. NAIC Number: 208500218 Firemens Insurance Company of Washington, D.C. NAIC Number: 217840098 First Liberty Insurance Corporation NAIC Number: 335880111 First National Insurance Company of America NAIC Number: 247240163 Florists Mutual Insurance Company 1 Horticultural Lane Edwardsville, IL 62025 NAIC Number: 139780349 Foremost Insurance Company NAIC Number: 111850212 Foremost Property & Casualty Insurance Company NAIC Number: 118000212 Foremost Signature Insurance Company NAIC Number: 415130212 Frankenmuth Mutual Insurance Company One Mutual Avenue Frankenmuth, MI 48787 NAIC Number: 139861309 Frank Winton Crum Insurance Company 100 S Missouri Ave Clearwater, FL 33756 NAIC Number: 116000000 Fremont Casualty Insurance Company NAIC Number: 105450790 Fremont Compensation Insurance Company NAIC Number: 377610790 Fremont Indemnity Company NAIC Number: 210400790 Fremont Insurance Company 933 E. Main Street Fremont, MI 49412 NAIC Number: 139940000 Frontier Insurance Company 195 Lake Louise Marie Rd. Rock Hill, NY 12775 NAIC Number: 342660961 Gateway Insurance Company 1401 S. Brentwood Blvd., Ste. 1000 St.Louis, MO 63144 NAIC Number: 283390000 General Casualty Insurance Company P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 188210796 General Casualty Company of Wisconsin P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 244140796 General Insurance Company of America NAIC Number: 247320163 Genesis Insurance Company P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 389620031 Glens Falls Insurance Company NAIC Number: 346220218 Globe Indemnity Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 246000553
4/15/2014 Workers Compensation Agency Page 10 Grange Insurance Company of Michigan 400 Galleria Officentre, Suite 115 Southfield, MI 48034 NAIC Number: 111360267 Granite State Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 238090012 Great American Alliance Insurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 268320084 Great American Assurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 263440084 Great American Insurance Co of NY P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 221360084 Great American Insurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 166910084 Great American Security Insurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 311350084 Great American Spirit Insurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 337230084 Great Divide Insurance Company NAIC Number: 252240098 Great Midwest Insurance Company 800 Gessner, Suite 600 Houston, TX 77024 NAIC Number: 186940000 Great Northern Insurance Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 203030038 Great West Casualty Company P.O. Box 277 S. Sioux City, NE 68776 NAIC Number: 113710150 Greater New York Mutual Insurance Company 200 Madison Avenue New York, NY 10016 NAIC Number: 221870222 Greenwich Insurance Company 505 Eagleview Blvd. Exton, PA 19341-0636 NAIC Number: 223221285 Grocers Insurance Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 405410553 Guarantee Insurance Company 401 E Las Olas Blvd Fort Lauderdale, FL 33301 NAIC Number: 113980000 Guideone Mutual Insurance Company 1025 Ashworth Road, Suite 101 West DesMoines, IA 50265 NAIC Number: 150320303 Gulf Insurance Company NAIC Number: 222170041 Hamilton Mutual Insurance 717 Mulberry Street Des Moines, IA 50309 NAIC Number: 141250062 Hamilton Mutual Insurance Company John Keller, Asst. VP 1520 Madison Road Cincinnati, OH 45206 NAIC Number: 141250000 Hanover American Insurance Company P.O. Box 15144 Worcester, MA 01615 NAIC Number: 360640088 Hanover Insurance Company P.O. Box 15144 Worcester, MA 01615 NAIC Number: 222920088 Harco National Insurance Company P.O. Box 68309 Schaumburg, IL 60168 NAIC Number: 264330000 Harleysville Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA 19438-9950 NAIC Number: 235820253
4/15/2014 Workers Compensation Agency Page 11 Harleysville Lake States Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA 19438-9950 NAIC Number: 145160253 Harleysville Mutual Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA 19438-9950 NAIC Number: 141680253 Harleysville Preferred Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA 19438-9950 NAIC Number: 356960253 Harleysville Worcester Insurance Company 355 Maple Avenue P.O. Box 244 Harleysville, PA 19438-9950 NAIC Number: 261820253 Hartford Accident & Indemnity Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 223570091 Hartford Casualty Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 294240091 Hartford Fire Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 196820091 Hartford Insurance Company of the Midwest 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 374780091 Hartford Underwriters Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 301040091 Hastings Mutual Insurance Company Peggy Surma 404 E. Woodlawn Avenue Hastings, MI 49058 NAIC Number: 141760000 Hawkeye Security Insurance Company P.O. Box 1848 Des Moines, IA 50306 NAIC Number: 217410072 HDI - Gerling America Insurcance Company 150 N. Wacker Drive 29th Floor Chicago, IL 60606 NAIC Number: 413430517 Highlands Insurance Company 10200 Richmond Avenue, Suite 175 Houston, TX 77042-4132 NAIC Number: 224891116 HIH America Compensation & Liability Ins. Co. NAIC Number: 206561264 Home Indemnity Company NAIC Number: 225190095 Home Insurance Company NAIC Number: 225270095 Home Owners Insurance Company Michigan Workers Comp. Claims P.O. Box 30510 Lansing, MI 48909 NAIC Number: 266380280 Housing Authority Property Insurance Company 189 Commerce Court P.O. Box 189 Cheshire, CT 06410-0189 NAIC Number: 100690000 Houston General Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 388491129 Hudson Insurance Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 250570158 Ideal Mutual Insurance Company NAIC Number: 142300803
4/15/2014 Workers Compensation Agency Page 12 Illinois National Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 238170012 Imperial Casualty & Indemnity Company NAIC Number: 114870000 Imperium Insurance Company 600 Galleria Parkway Suite 770 Atlanta, GA 30339 NAIC Number: 354080000 Indemnity Insurance Company of North America 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 435750626 Indiana Insurance Company WC Processing Center P.O. Box 515099 Los Angeles, CA 90051-5099 NAIC Number: 226590111 Indiana Lumbermens Mutual Insurance Company 3600 Woodview Trace P.O. Box 68600 Indianapolis, IN 46268 NAIC Number: 142650246 Insurance Co. of the State of Pennsylvania AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 194290012 Insurance Company of Greater New York 200 Madison Avenue New York, NY 10016 NAIC Number: 221950222 Insurance Company of North America 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 227130626 Insurance Company of the West 11455 El Camino Real San Diego, CA 92130 NAIC Number: 278470922 Insurance Corporation of America 1301 N. Hagadorn P.O. Box 1471 East Lansing, MI 48826-1471 NAIC Number: 109270966 Intercontinental Insurance Company NAIC Number: 380910000 International Insurance Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 210830158 Ironshore Indemnity, Inc. P.O. Box 64035 St. Paul, MN 55164 NAIC Number: 236474509 Kansas City Fire & Marine Insurance Company NAIC Number: 208850218 Legion Insurance Company Attn: Dean Bender P.O. Box 59239 Philadelphia, PA 19102 NAIC Number: 244221172 Liberty Insurance Corporation NAIC Number: 424040111 Liberty Mutual Fire Insurance Company NAIC Number: 230350111 Liberty Mutual Insurance Company NAIC Number: 230430111 Lincoln General Insurance Company P.O. Box 3709 York, PA 17402 NAIC Number: 338551326 LM Insurance Corporation NAIC Number: 336000111 LMI Insurance Company P.O. Box 27257 Raleigh, NC 27611 NAIC Number: 230860297
4/15/2014 Workers Compensation Agency Page 13 London Guarantee & Accident Company of NY 25 Independence Boulevard Warren, NJ 07059 NAIC Number: 346490553 Lumber Mutual Insurance Company P.O. Box 9165 Framingham, MA 01701-9165 NAIC Number: 144350946 Lumbermens Mutual Casualty Company Fund NAIC Number: 229770108 Lumbermens Underwriting Alliance P.O. Box 3061 Boca Raton, FL 33431-3061 NAIC Number: 231080000 M L B A Mutual Insurance Company P.O. Box 4067 East Lansing, MI 48826-4067 NAIC Number: 301390000 Manufacturers & Merchants Mutual Insurance Co P.O. Box 514 Concord, NH 03302 NAIC Number: 231670116 Manufacturers Alliance Insurance Co. P.O. Box 5231 Janesville, WI 53547-5231 NAIC Number: 368970767 Manufacturing Technology Mutual Insurance Company P.O. Box 9150 Farmington Hills, MI 48333-9150 NAIC Number: 128240000 Markel Insurance Company 4600 Cox Rd. Glen Allen, VA 23060 NAIC Number: 389700785 Maryland Casualty Company 1400 American Lane NAIC Number: 193560212 Massachusetts Bay Insurance Company P.O. Box 15144 Worcester, MA 01615 NAIC Number: 223060088 Massachusetts Bonding & Insurance Company 10 Post Office Square Boston, MA 00000 NAIC Number: Wc0050000 Medallion Insurance Company NAIC Number: 232800000 Memic Indemnity Company 1750 Elm Street, Suite 500 Manchester, NH 03104 NAIC Number: 110301332 Merchants Mutual Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY 14240-9974 NAIC Number: 233290226 Merchants Preferred Insurance Company 250 Main Street P.O. Box 903 Buffalo, NY 14240-9974 NAIC Number: 129010226 Meridian Citizens Mutual Insurance Co. P.O. Box 1980 Indianapolis, IN 46206 NAIC Number: 105020175 Meridian Mutual Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN 46206 NAIC Number: 233450175 Meridian Security Insurance Company 2955 N. Meridian Street P.O. Box 7183 Indianapolis, IN 46206 NAIC Number: 233530175 MHA Insurance Company 3100 West Road, Building 1, Suite 200 East Lansing, MI 48823 NAIC Number: 331110000 MIC Property & Casualty Insurance Company Corporate Compliance Dept. 3044 W. Grand Blvd. 482 1x3301 Detroit, MI 48202 NAIC Number: 386010079 Michigan Commercial Insurance Mutual P.O. Box 19769 Sarasota, FL 34276-2769 NAIC Number: 109980000
4/15/2014 Workers Compensation Agency Page 14 Michigan Insurance Company P.O. Box 152120 Grand Rapids, MI 49515 NAIC Number: 108571243 Michigan Millers Mutual Insurance Company Claims Department P.O. Box 30060 Lansing, MI 48909 NAIC Number: 145080000 Mid-Century Insurance Company P.O. Box 108843 Oklahoma City, OK 73101-8843 NAIC Number: 216870212 Middlesex Insurance Company P.O. Box 8032 Stevens Point, WI 54481 NAIC Number: 234340169 Middlesex Mutual Assurance Company 213 Court Street P.O. Box 891 Middletown, CT 06457 NAIC Number: 145320050 Midland Insurance Company NAIC Number: 234930128 Midland National Insurance Company 173 W. Madison Street Chicago, IL 60602 NAIC Number: Wc0090000 Midwest Employers Casualty Company NAIC Number: 236120098 Millers Mutual Insurance Association 111 E. Fourth Street P.O. Box 9006 Alton, IL 62002 NAIC Number: 145830855 Millers National Insurance Company 850 Warrenville Road 3rd Floor Lisle, IL 60532 NAIC Number: 235660131 Mission Insurance Company NAIC Number: 236040133 Mitsui Sumitomo Insurance Company of America P.O. Box 5435 Cincinnati, OH 45201-5435 NAIC Number: 203622978 Mitsui Sumitomo Insurance USA, Inc. P.O. Box 5435 Cincinnati, OH 45201-5435 NAIC Number: 225512978 Monroe Guaranty Insurance Company 9025 River Road Suite 300 Indianapolis, IN 46240-6443 NAIC Number: 325060000 Motorists Mutual Insurance Company 471 E. Broad Street Columbus, OH 43215 NAIC Number: 146210291 N N Insurance Company P.O. Box 6426 Lawrenceville, NJ 08648 NAIC Number: 297851116 National American Insurance Company 1006 Manval Avenue P.O. Box Drawer 9 Chandler, OK 74834 NAIC Number: 236630000 National Ben Franklin Insurance Company NAIC Number: 208930218 National Casualty Company P.O. Box 4110 Scottsdale, AZ 85261 NAIC Number: 119910140 National Continental Insurance Company P.O. Box 5070 Cleveland, OH 44101 NAIC Number: 102430155 National Farmers Union Property & Casualty 1051 Texas Street Salem, VA 24153 NAIC Number: 162171129 National Farmers Union Standard Insurance Co. 1051 Texas Street Salem, VA 24153 NAIC Number: 237521129 National Fire Insurance Company of Hartford NAIC Number: 204780218
4/15/2014 Workers Compensation Agency Page 15 National General Insurance Company Corporate Compliance Dept 3044 W. Grand Blvd. 482-1x3301 Detroit, MI 48202 NAIC Number: 237280079 National Indemnity Company P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 200870031 National Interstate Insurance Company P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 326200084 National Interstate Insurance Company of Hawaii P.O. Box 5432 Cincinnati, OH 45201 NAIC Number: 110510084 National Liability & Fire, Inc. P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 200520031 National Mutual Insurance Company One Insurance Square Celina, OH 45822 NAIC Number: 201840035 National Reinsurance Corporation P.O. Box 881716 San Francisco, CA 94188 NAIC Number: 348350031 National Specialty Insurance Company 1900 L Don Dodson Drive Bedford, TX 76021 NAIC Number: 226080093 National Surety Corporation P.O. Box 740174 Atlanta, GA 30374-0174 NAIC Number: 218810761 National Trust Insurance Company P.O. Box 58004 Sarasota, FL 34232-0800 NAIC Number: 201410474 National Union Fire Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 194450012 Nationwide Agribusiness Insurance Company 1100 Locust Street, Dept. 3010 Des Moines, IA 50391-3010 NAIC Number: 282230140 Nationwide Mutual Fire Insurance Company 1000 Nationwide Drive P.O. Box 69080 Harrisburg, PA 17106-9080 NAIC Number: 237790140 Nationwide Mutual Insurance Company 1000 Nationwide Drive P.O. Box 69080 Harrisburg, PA 17106-9080 NAIC Number: 237870140 Nationwide Property & Casualty Insurance Company 1000 Nationwide Drive P.O. Box 69080 Harrisburg, PA 17106-9080 NAIC Number: 378770140 Netherlands Insurance Company WC Processing Center P.O. Box 515099 Los Angeles, CA 90051-5099 NAIC Number: 241710111 New Hampshire Indemnity Company, Inc. AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 238330012 New Hampshire Insurance Company AIG Domestic Claims P.O. Box 4230 Alpharetta, GA 30023-4230 NAIC Number: 238410012 New York Marine & General Insurance Company 59 Maiden Lane #2700 New York, NY 10038 NAIC Number: 166080256 New York Underwriters Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 223730091 Newark Insurance Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 246430553 NGM Insurance Company 220 Salina Meadows, Suite 200 Syracuse, NY 13212 NAIC Number: 147880311 Niagara Fire Insurance Company NAIC Number: 351060218
4/15/2014 Workers Compensation Agency Page 16 Nipponkoa Insurance Company, LTD 14 Wall Street, Suite 812 New York, NY 10005 NAIC Number: 270732558 NLC Mutual Insurance Company 1301 Pennsylvania Avenue, NW Washington, DC 20004 NAIC Number: 279050000 Nordia Insurance Company P.O. Box 886 Shelton, CT 06484 NAIC Number: 261070000 NorGuard Insurance Company P.O. Box A-H Wilkes-Barre, PA 18703 NAIC Number: 314700828 North American Elite Insurance Company 650 Elm Street, Suite 600 Manchester, NH 03101 NAIC Number: 297000181 North American Specialty Insurance Company 650 Elm Street, Suite 600 Manchester, NH 03101 NAIC Number: 298740181 North Pointe Casualty Company P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 394621141 North Pointe Insurance Company P.O. BOX 975 Sun Prairie, WI 53590 NAIC Number: 277401141 North River Insurance Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 211050158 Northbrook Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 364550038 Northern Assurance Company of America 1051 Texas Street Salem, VA 24153 NAIC Number: 383691129 Northern Insurance Company of New York c/o Maryland Casualty 1400 American Lane, NAIC Number: 193720212 Northwestern National Casualty Company c/o Highlands Insurance Co 10200 Richmond Avenue, Suite 175 Houston, TX 77042-4132 NAIC Number: 239061116 Northwestern National Insurance Company 9277 Centre Pointe Drive, Suite 140 West Chester, OH 45069 NAIC Number: 239140143 Nova Casualty Company 2 Waterside Crossing, Suite 400 Windsor, CT 06095 NAIC Number: 425524257 OBI National Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 141901129 Occidental Fire & Casualty Company of NC John Mininger 702 Oberlin Road, Box 10800 Raleigh, NC 27605 NAIC Number: 232480225 Ohio Casualty Insurance Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI 53072 NAIC Number: 240740148 Ohio Farmers Insurance Company 38695 7 Mile Road, Suite 110 Livonia, MI 48152 NAIC Number: 241040228 Ohio Security Insurance Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI 53072 NAIC Number: 240820148 Old Republic General Insurance Corporation P.O. Box 2200 Greensburg, PA 15601 NAIC Number: 241390150 Old Republic Insurance Company P.O. Box 2200 Greensburg, PA 15601 NAIC Number: 241470150 OneBeacon America Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 206211129
4/15/2014 Workers Compensation Agency Page 17 OneBeacon Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 219701129 Pacific Employers Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 227480626 Pacific Indemnity Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 203460038 Pacific Insurance Company NAIC Number: 373380218 Park Avenue Property & Casualty NAIC Number: 287113499 Partners Mutual Insurance Company 20935 Swenson Waukesha, WI 53186 NAIC Number: 134390000 Patriot General Insurance Company P.O. Box 8032 Stevens Point, WI 54481 NAIC Number: 234420169 Peerless Indemnity Insurance Company WC Processing Center P.O. Box 515099 Los Angeles, CA 90051-5099 NAIC Nunber: 183330111 Peerless Insurance Company WC Processing Center P.O. Box 515099 Los Angeles, CA 90051-5099 NAIC Number: 241980111 Penn Millers Insurance Company 72 N. Franklin Street Wilkes-Barre, PA 18773 NAIC Number: 149820125 Pennsylvania General Insurance Company 1051 Texas Street Salem, VA 24153 NAIC Number: 219621129 Pennsylvania Lumbermens Mutual Insurance 1 Commerce Square 2005 Market St., Ste. 1200 Philadelphia, PA 19103-7008 NAIC Number: 149740000 Pennsylvania Manufacturers Assn. Insurance Co P.O. Box 5231 Janesville, WI 53547-5231 NAIC Number: 122620767 Pennsylvania Manufacturers Indemnity Co. P.O. Box 5231 Janesville, WI 53547-5231 NAIC Number: 414240767 Pennsylvania National Mutual Casualty Ins. P.O. Box 2361 Harrisburg, PA 17105 NAIC Number: 149900271 Petroleum Casualty Company P.O. Box 3342 Houston, TX 77253 NAIC Number: 122970000 Pharmacists Mutual Insurance Company 808 Hwy. 18 West P.O. Box 370 Algona, IA 50511 NAIC Number: 137140775 Phico Insurance Company 5875 Castle Creek Pkwy N Dr. Ste. 300 P.O. Box 50465 Indianapolis, IN 46250 NAIC Number: 357180711 Phoenix Assurance Company of New York 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 352620553 Phoenix Insurance Company NAIC Number: 256230041 Pioneer State Mutual Insurance Company 1510 N. Elms Road Flint, MI 48532 NAIC Number: 183090000 Plaza Insurance Company P.O. Box 7183 Indianapolis, IN 46206-7183 NAIC Number: 309450175
4/15/2014 Workers Compensation Agency Page 18 Potomac Insurance Company of Illinois 1051 Texas Street Salem, VA 24153 NAIC Number: 401341129 Praetorian Insurance Company 88 Pine Street, 4th Floor New York, NY 10005 NAIC Number: 372570517 Preferred Professional Insurance Company P.O. Box 540658 Omaha, NE 68154 NAIC Number: 362340000 Preserver Insurance Company 120 Broadway, 31st Floor New York, NY 10271-3199 NAIC Number: 155863703 Princeton Insurance Company 746 Alexander Road Princeton, NJ 08543 NAIC Number: 422260924 Progressive Casualty Insurance Company P.O. Box 5070 Cleveland, OH 44101 NAIC Number: 242600155 Property & Casualty Insurance Company of Hartford 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 346900091 Protective Insurance Company 1099 N. Meridian Street Indianapolis, IN 46204 NAIC Number: 124160867 Providence Washington Insurance Company 1275 Wampanoag Trail Riverside, RI 02915 NAIC Number: 242950156 Prudential Commercial Insurance Company P.O. Box 6426 Lawrenceville, NJ 08648 NAIC Number: 364390304 QBE Insurance Corporation P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 392170796 Rampart Insurance Company 20 Exchange Place, 11th Floor New York, NY 10005 NAIC Number: 385120686 Ranger Insurance Company 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 243840158 Regent Insurance Company P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 244490796 Reliance Insurance Company NAIC Number: 244570159 Reliance National Indemnity Company NAIC Number: 244300159 Reliance National Insurance Company NAIC Number: 405920159 Republic Western Insurance Company 2721 N. Central Avenue Phoenix, AZ 85004 NAIC Number: 310890574 Republic-Franklin Insurance Company P.O. Box 530 Utica, NY 13503 NAIC Number: 124750201 Retailers Mutual Insurance Company 603 S. Washington Avenue Lansing, MI 48933 NAIC Number: 124710000 Riverport Insurance Company NAIC Number: 366840098 RLI Insurance Company P.O. Box 3736 Peoria, IL 61612 NAIC Number: 130560783 Rockwood Casualty Insurance Company P.O. Box 22146 Portland, OR 97269-2146 NAIC Number: 355060457
4/15/2014 Workers Compensation Agency Page 19 Royal Insurance Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 269800553 Sable Insurance Company 433 California Street, 11th Floor San Francisco, CA 94104 NAIC Number: 108230000 Safeco Insurance Company NAIC Number: 247400163 Safeguard Insurance Company 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 246940553 Safety First Insurance Company 1832 Schuetz Road St. Louis, MO 63146 NAIC Number: 111230074 Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 NAIC Number: 151050074 Sagamore Insurance Company 1099 N. Meridian Street Indianapolis, IN 46204 NAIC Number: 404600867 SeaBright Insurance Company P.O. Box 91100 Seattle, WA 98111 NAIC Number: 155630000 Secura Insurance Company P.O. Box 819 Appleton, WI 54912 NAIC Number: 225430096 Security Casualty Company 222 S. Riverside Plaza Chicago, IL 60606 NAIC Number: 249290000 Security Insurance Company of Hartford 3600 Arco Corporate Drive Charlotte, NC 28273 NAIC Number: 249020553 Select Insurance Company NAIC Number: 222330041 Selective Insurance Company of America 40 Wantage Avenue Branchville, NJ 07894 NAIC Number: 125720242 Selective Insurance Co of South Carolina 40 Wantage Avenue Branchville, NJ 07894 NAIC Number: 192590242 Selective Insurance Co of the Southeast 40 Wantage Avenue Branchville, NJ 07894 NAIC Number: 399260242 Selective Way Insurance Company 40 Wantage Avenue Branchville, NJ 07894 NAIC Number: 263010242 Seneca Insurance Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 109361271 Sentinel Insurance Company, Ltd. 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 110000091 Sentry Casualty Company P.O. Box 8032 Stevens Point, WI 54481 NAIC Number: 284600169 Sentry Insurance a Mutual Company P.O. Box 8032 Stevens Point, WI 54481 NAIC Number: 249880169 Sentry Select Insurance Company P.O. Box 8032 Stevens Point, WI 54481 NAIC Number: 211800169 Sequoia Insurance Company 10091 Park Run Drive, Suite 170 LasVegas, NV 89145 NAIC Number: 229850009 SFM Mutual Insurance Company 3500 American Blvd. West, Suite 700 Bloomington, MN 55431 NAIC Number: 113470000 Shelby Insurance Company Central Service Center 175 Mansfield Avenue Shelby, OH 44875 NAIC Number: 151560269
4/15/2014 Workers Compensation Agency Page 20 Society Insurance P.O. Box 1029 Fond Du Lac, WI 54936 NAIC Number: 152610000 Sompo Japan Fire & Marine Insurance Company of America 11405 North Community House Rd Hayes Building Suite 600 Charlotte, NC 28277 NAIC Number: 389973219 Sompo Japan Insurance Company of America 11405 North Community House Rd Hayes Building Suite 600 Charlotte, NC 28277 NAIC Number: 111263219 South Carolina Insurance Company P.O. Box 1 Columbia, SC 29202 NAIC Number: 249530168 Southern Insurance Company 222 S 15th St Ste 1500 North Omaha, NE 68102 NAIC Number: 192163489 Sparta Insurance Company City Place II 185 Asylum Street, 9th Floor Hartford, CT 06103 NAIC Number: 206130000 St. Paul Fire & Marine Insurance Company NAIC Number: 247670164 St. Paul Guardian Insurance Company NAIC Number: 247750164 St. Paul Medical Liability Insurance Co. NAIC Number: 417500164 St. Paul Mercury Insurance Company NAIC Number: 247910164 St. Paul Property & Casualty Insurance Co. NAIC Number: 415210164 St. Paul Protective Insurance Company NAIC Number: 192240164 Standard Fire Insurance Company NAIC Number: 190700041 Star Insurance Company c/o Meadowbrook Claims Service 26255 American Drive Southfield, MI 48034-6112 NAIC Number: 180230748 StarNet Insurance Company NAIC Number: 400450098 Starr Indemnity & Liability Co 399 Park Ave. 8th Floor New York, NY 10022 NAIC Number: 383184670 State Auto Property & Casualty Insurance Company P.O. Box 7183 Indianapolis, IN 46206-7183 NAIC Number: 251270175 State Automobile Mutual Insurance Company P.O. Box 7183 Indianapolis, IN 46206-7183 NAIC Number: 251350175 State Farm Fire & Casualty Company Workers Compensation Claims P.O. Box 661012 Dallas, TX 75266-1012 NAIC Number: 251430176 State Farm General Insurance Company Workers Compensation Claims P.O. Box 661012 Dallas, TX 75266-1012 NAIC Number: 251510176 State Mutual Insurance Company P.O. Box 280 Lapeer, MI 48446 NAIC Number: 152020000 State National Insurance Company, Inc. 1900 L Don Dodson Drive Bedford, TX 76021 N AIC Number: 128310093
4/15/2014 Workers Compensation Agency Page 21 Stonington Insurance Company P.O. Box 975 Sun Prairie, WI 53590 NAIC Number: 103400796 Strathmore Insurance Company 200 Madison Avenue New York, NY 10016 NAIC Number: 110240222 Sun Insurance Office, Ltd. 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 203700038 T H E Insurance Company 10451 Gulf Blvd. Treasure Island, FL 33706 NAIC Number: 128660000 Technology Insurance Company, Inc. P.O. Box 105074 Atlanta, GA 30348 NAIC Number: 423762538 TIG Insurance Company 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 255341111 TIG Insurance Company of Michigan 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 255421111 TIG Insurance Corporation of America 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 255261111 TIG Premier Insurance Company 250 Commercial Street Suite 5000 Manchester, NH 03101 NAIC Number: 255181111 TNUS Insurance Company 230 Park Avenue New York NY 10169 NAIC Number: 323013098 Tokio Marine & Nichido Fire Insurance Company LTD 205 N. Michigan, Suite 830 Chicago, IL 60601 NAIC Number: 129043098 Tower Insurance Company of New York Claims Department P.O. Box 907 Paramus, NJ 07635-0907 NAIC Number: 443003703 Tower National Insurance Company 120 Broadway New York, NY 10271-3199 NAIC Number: 437023703 Toyota Motor Insurance Company 19001 S. Western Ave., FS 21 Torrance, CA 90509 NAIC Number: 376210372 Trans Pacific Insurance Company P.O. Box 3347 New York, NY 10163-3347 NAIC Number: 412380950 Transcontinental Insurance Company NAIC Number: 204860218 Transguard Insurance Company of America, Inc. 215 Shurman Blvd., Suite 400 NAIC Number: 288860000 Transit Casualty Company NAIC Number: 129550337 Transport Indemnity Company 2 Cross Roads of Commerce, Suite 700 Rolling Meadows, IL 60008 NAIC Number: 256070084 Transport Insurance Company 11300 Highland Corporate Drive, Suite 103 Cumberland, RI 02864 NAIC Number: 330140000 Transportation Insurance Company NAIC Number: 204940218 Travelers Casualty & Surety Co. of America NAIC Number: 311940041 Travelers Casualty & Surety Company NAIC Number: 190380041 Travelers Casualty Company of Connecticut NAIC Number: 361700041
4/15/2014 Workers Compensation Agency Page 22 Travelers Casualty Insurance Company of America NAIC Number: 190460041 Travelers Commercial Casualty Company NAIC Number: 402820041 Travelers Commercial Insurance Company NAIC Number: 361370041 Travelers Indemnity Co. Of Connecticut NAIC Number: 256820041 Travelers Indemnity Company NAIC Number: 256580041 Travelers Indemnity Company of America NAIC Number: 256660041 Travelers Insurance Company NAIC Number: 393570041 Travelers Property Casualty Company of America NAIC Number: 256740041 Tri State Insurance Company of Minnesota NAIC Number: 310030098 Truck Insurance Exchange P.O. Box 108843 Oklahoma City, OK 73101-8843 NAIC Number: 217090212 Trumbull Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 271200091 Twin City Fire Insurance Company 4245 Meridian Pkwy Aurora, IL 60504-7901 NAIC Number: 294590091 U S Specialty Insurance Company 13403 Northwest Freeway Houston, TX 77040 NAIC Number: 295990984 Ullico Casualty Company Fund NAIC Number: 378930781 Unigard Security Insurance Company 15805 N.E. 24 Street Bellevue, WA 98008 NAIC Number: 257630356 Union Insurance Company NAIC Number: 258440098 United Pacific Insurance Company NAIC Number: 244730159 United Security Insurance Company P.O. Box 1848 Des Moines, IA 50306 NAIC Number: 217760072 United States Fidelity & Guaranty Discover Re Managers, Inc. 5 Batterson Park Farmington, CT 06032 NAIC Number: 258870164 United States Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962 NAIC Number: 211130158 United States Liability Insurance Company 190 S. Warner Road Wayne, PA 19087 NAIC Number: 258950232 United Wisconsin Insurance Company P.O. Box 3026 Milwaukee, WI 53201 NAIC Number: 291570572 Universal Underwriters Insurance Company 1400 American Lane NAIC Number: 411810212
4/15/2014 Workers Compensation Agency Page 23 Utica Mutual Insurance Company 2600 Corporate Exchange Drive Suite 200 Columbus, OH 43231-1672 NAIC Number: 259760201 Valiant Insurance Company 1400 American Lane NAIC Number: 266110212 Valley Forge Insurance Company NAIC Number: 205080218 Vanliner Insurance Company One United Drive P.O. Box 26352 Fenton, MO 63026 NAIC Number: 211720000 Vigilant Insurance Company 233 South Wacker Drive, Suite 4700 Chicago, IL 60606 NAIC Number: 203970038 Virginia Surety Company, Inc. c/o AON Corporation 200 E. Randolph St. Ste. 1800 Chicago, IL 60601 NAIC Number: 408270317 Wausau Business Insurance Company NAIC Number: 260690111 Wausau Underwriters Insurance Company NAIC Number: 260420111 West American Insurance Company N14 W24200 Tower Place P.O. Box 815 Pewaukee, WI 53072 NAIC Number: 443930148 West Bend Mutual Insurance Company 1900 S. 18th Avenue West Bend, WI 53095 NAIC Number: 153500000 Westchester Fire Insurance Company 20700 Civic Center Drive, Suite 400 Southfield, MI 48076 NAIC Number: 211210626 Western Casualty & Surety Company c/o American States Ins. Co. P.O. Box 461 St. Louis, MO 63166-0461 NAIC Number: 260930020 Western Continental Insurance Company 20 Exchange Place, 11th Floor New York, NY 10005 NAIC Number: 257710686 Western Employers Insurance Company 1400 N. Harbor Boulevard P.O. Box 5347 Fullerton, CA 92635 NAIC Number: 328830369 Westfield Insurance Company 38695 7 Mile Road, Suite 110 Livonia, MI 48152 NAIC Number: 241120228 Westfield National Insurance Company 38695 7 Mile Road, Suite 110 Livonia, MI 48152 NAIC Number: 241200228 Westport Insurance Corporation 5200 Metcalf P.O. Box 2991 Overland Park, KS 66201 NAIC Number: 398450181 Williamsburg National Insurance Company c/o Meadowbrook Claims Service 26600 Telegraph Rd., Box 2054 Southfield, MI 48037 NAIC Number: 257800748 Work First Casualty Company 2636 Biehn Street Klamath Falls, OR 97601 NAIC Number: 312320000 X L Insurance America, Inc. 505 Eagleview Blvd. Exton, PA 19341-0636 NAIC Number: 245541285 X L Specialty Insurance Company 505 Eagleview Blvd. Exton, PA 19341-0636 NAIC Number: 378851285 Zenith Insurance Company 2105 W. White Oaks Drive Springfield, IL 62074 NAIC Number: 132690336
4/15/2014 Workers Compensation Agency Page 24 Zurich American Insurance Company of Illinois 1400 American Lane NAIC Number: 278550212 Zurich Insurance Company 1400 American Lane NAIC Number: 165350212