Date: march 26, 2016 tpl subsystem




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REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 1

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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S56 A AND H ADMINISTRATORS INC P O BOX 10223 MILWAUKEE WI 53223

Q19 A E STALEY MFG CO P O BOX 151 DECATUR IL 62525

RZ* A H AND L PO BOX 88260 ATLANTA GA 30356

UB* A H AND L P O BOX 11111 FORT SCOTT KS 66701

E85 A I G LIFE INSURANCE ACCIDENT AND HEALTH CLAIM PO BOX 15701 WILMINGTON DE 19850-5701

S82 A R G I S P O BOX 802516 DALLAS TX 75380

BJ7 AAA COOPER TRANSPORT P. O. BOX 6827 DOTHAN AL 36302

C8* AAA GROUP HOSPITAL INDEMNI AAA NEW MEXICO DIVISION 2201A SAN PEDRO BLVD NE ALBUQUERQUE NM 87110

U40 AAA OF WASHINGTON GROUP INSURANCE CO 222 NO MISSION WENATCHIE WA 98801

X95 AAC INC 16010 BARKERS PT LN 265 HOUSTON TX 77079

FI* AARP HEALTHCARE OPTIONS UNITED HEALTHCARE CLAIMS P O BOX 740819 ATLANTA GA 30374-0819

CG8 ABAS AMER BENEFIT ADMIN SER 1733 PARK ST STE 300 NAPERVILLE IL 60564

J47 ABC ADVANTAGE PLAN P O BOX 2546 SHERMAN TX 75090

F99 ABC BENEFITS OF ARK 1500 RIVERFRONT DR P O BOX 3198 LITTLE ROCK AR 72203

S26 ABC INSURANCE P O BOX 3148 BALLWIN MO 63022

Q93 ABC INSURANCE TRUST 729 15TH ST. NW WASHINGTON DC 20005

BX7 ABC INSURANCE TRUST FUND KAM TECH INC 1300 N 17TH ST 8TH FLOOR ROSSLYN VA 22209

V94 ABI ADMINISTRATIVE SERVICES INC 14482 MCCORMICK DR TAMPA FL 33626

K97 ABI ADMINISTRATIVE SERVICE CORP 10159 WAYZAT BOULEVARD MINNETONKA MN 55343

FV5 ABP ADMINISTRATION PO BOX 82060 ROCHESTER MI 48308

RL* ACADEMY INSURANCE GROUP P O BOX 3074 SOUTHEASTERN PA 19398

HF7 ACCESS ADMINISTRTORS 7430 REMCON CIRCLE BLDG C EL PASO TX 79912

BE5 ACCORDIA PO BOX 11111 FORT SCOTT KS 66701-7111

B88 ACCORDIA BENEFIT OF TX P O BOX 130217 TYLER TX 75713

AM9 ACCORDIA BUSINESS BENEFITS P.O. BOX 419 EVANSVILLE IN 47703

FU3 ACCORDIA NATIONAL P O BOX 2621 CHARLESTON WV 25329

P20 ACCORDIA OF LEXINGTON EAGLES ADMINISTRATORS P O BOX 13307 LEXINGTON KY 40583

CI3 ACCOUNTABLE HEALTH PLAN 600 SIX FLAGS DR SUITE200 ARLINGTON TX 76011

AR8 ACORDIA BUSINESS BENEFITS P.O. BOX 957 EVANSVILLE IN 47706

DN4 ACORDIA OF CENTRAL INDIANA P O BOX 567 GREENWOOD IN 46142

EZ2 ACORDIA OF LEXINGTON P O BOX 14061 LEXINGTON KY 40512-4061

RK* ACORDIA SENIOR OF THE SW P O BOX 37710 LOUISVILLE KY 40233-7710

GV3 ACS BENEFIT SERVICES PO BOX 2000 WINSTON SALEM NC 27102-2000

BV6 ACTION LANE P O BOX A PONTOTOC MS 38863

EH8 ADAMS LAND COMPANY HEALTH FUND P O BOX 49 LEACHVILLE AR 72438

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 2

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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V95 ADJUSTCO INC P O BOX 945005 MAITLAND FL 32794

BK* ADMIN AND CONSULTANTS FOODCRAFT EQUIP CO P O BOX 4925 LANCASTER PA 17604

FK3 ADMIN ONE CORPORATION PO BOX 2619 ROGERS AR 72757

H7* ADMIN SERVICES OF INDIANA P O BOX 6245 SOUTH BEND IN 46660

BQ3 ADMINASTAR SOLUTIONS P O BOX 40509 INDIANAPOLIS IN 46240-0509

L87 ADMINICORP CO P O BOX 938 SAN JOSE CA 95108-0938

Z47 ADMINISTRATIVE BENEF SVCS 1255 LYNNFIELD RD SUITE 140 MEMPHIS TN 38119

H75 ADMINISTRATIVE BENEFITS CONSOLIDATED FREIGHTWAYS PO BOX 3988 PORTLAND OR 97208

DP2 ADMINISTRATIVE CONCEPTS P O BOX 1749 ROCKWALL TX 75087

IE7 ADMINISTRATIVE ENTERPRISES 5810 WEST BEVERLY LANE GLENDALE AZ 85306

W87 ADMINISTRATIVE ENTERPRISES 3404 WEST CHERYL DRIVE SUITE 281 PHOENIX AZ 85051

M66 ADMINISTRATIVE SERVICE 3301 E ROYALTON ROAD CLEVELAND OH 44147

P59 ADMINISTRATIVE SERVICES P O BOX 839000 MIAMI FL 33283-9000

AE9 ADMINISTRATIVE SERVICES P.O. BOX 219325 KANSAS CITY MO 64121-9325

Q26 ADMINISTRATIVE SYSTEMS 1310 MECER ST SUITE 200 SEATTLE WA 98109

EQ2 ADMINITRON INC P O BOX 5095 BRENTWOOD TN 37024-5095

HU5 ADMIRAL LIFE INSRUANCE COMPANY OF AMERICA PO BOX 10861 CLEARWATER FL 33757-8861

Z82 ADVANCE INSURANCE ADMIN 1525 MERRILL DRIVE SUITE 2000 LITTLE ROCK AR 72211

FY7 ADVANCE PCS INC 9501 EAST SHEA BOULEVARD SCOTTSDALE AZ 85260-6719

B59 ADVANCED INSURANCE SERVICE P O BOX 19 MEMPHIS TN 38101

AR3 ADVANCED PRESCRIPTION 909 E COLLINS BLVD P O BOX 853901 RICHARDSON TX 75085-3901

FU8 ADVANCEPCS PHARMACY CLAIM WALMART CLAIM ADMIN 922 W WALNUT STE A ROGERS AR 72756-3540

AF8 ADVANTAGE BENEFITS CO ADMAR CORP P.O. BOX 4067 SANTA ANA CA 92701

HN2 ADVANTAGE HEALTH SOLUTIONS PO BOX 502530 INDIANAPOLIS IN 46209

HN1 ADVANTRA PO BOX 7154 LONDON KY 40742-7154

DO1 ADVENTIST RISK MGE CHRISTIAN RECORD SERVICE P O BOX 8007 RIVERSIDE CA 92515

K37 AEROQUIP RR 2 BOX IDD MOUNTAIN HOME AR 72653

GY* AETNA P O BOX 5696 LONGVIEW TX 75604

IY* AETNA REVERE COPPER BRASS HWY 67 NORTH NEWPORT AR 72112

FO2 AETNA PO BOX 14089 LEXINGTON KY 40512-4089

FZ3 AETNA PO BOX 981109 EL PASO TX 79998-1109

FZ2 AETNA 4630 WOODLANDS CORPORATE TAMPA FL 33614-2415

FZ4 AETNA PO BOX 3935 ALLENTOWN PA 18106-0935

GM8 AETNA P O BOX 1837 MARYLAND HEIGHTS MO 63043

GK9 AETNA 4050 PIEDMONT PARKWAY HIGH POINT NC 27262

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 3

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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GG4 AETNA PO BOX 14094 LEXINGTON KY 40512-4094

ET1 AETNA P O BOX 795083 SAN ANTONIO TX 78279-5083

EQ5 AETNA P O BOX 209010 18004355597 AUSTIN TX 78720

E91 AETNA DALLAS MARKET CENTER 2100 STEMMONS FRWY 80 DALLAS TX 75207

EN2 AETNA P O BOX 14586 18003459908 LEXINGTON KY 40512-4586

S99 AETNA P O BOX 11000 ORANGE CA 92668-8100

SV* AETNA 151 NORTH MAIN ST WICHITA KS 67202

T31 AETNA C/O ACC 1300 W OAK ST INDEPENDENCE KS 67301

ZH* AETNA 1001 ESE LOOP 323 STE 300 P O BOX 2520 TYLER TX 75710

Z48 AETNA EMPLOYEE BENEFIT DIVISION P.O. BOX 129122 SAN DIEGO CA 92112-9122

XJ* AETNA P O BOX 120 GRAND RAPIDS MI 49501

AO7 AETNA PO BOX 85079 RICHMOND VA 23285-5079

DE9 AETNA PO BOX 3907 ALLENTOWN PA 18106

DT7 AETNA P O BOX 23285 RICHMOND VA 23285

DZ1 AETNA PO BOX 6259 PEORIA IL 61601-6259

CC8 AETNA P O BOX 1211 TEWKSBURY MA 01876

B21 AETNA PO BOX 1058 MACON GA 31298

BP4 AETNA HEALTH PLAN 8023 E 63RD PLACE STE 310 TULSA OK 74133

EA2 AETNA HEALTH PLAN P O BOX 5367 ROCKFORD IL 61125

FB9 AETNA HEALTH PLAN 10459 MOUNTAIN VIEW AVE LOMA LINDA CA 92354

EW8 AETNA HEALTH PLAN P O BOX 7064 DOVER DE 19903-1512

FB3 AETNA HEALTH PLANS LOOP STATION P O BOX 2949 MINNEAPOLIS MN 55402-0949

D59 AETNA HEALTH PLANS 3541 WINCHESTER RD UNIT 73 ALLENTOWN PA 18195-0519

ED8 AETNA HEALTH PLANS P O BOX 12122 OKLAHOMA CITY OK 73157-2122

EI6 AETNA HEALTH PLANS P O BOX 3903 ALLENTOWN PA 18106-0903

EI1 AETNA HEALTH PLANS DELTA BEVERAGE CLAIMS P O BOX 26125 GREENSBORO NC 27402

BG7 AETNA HEALTH PLANS P O BOX 35890 LOUISVILLE KY 40232-5890

CE4 AETNA HEALTH PLANS P O BOX 21645 SEATTLE WA 98111

CI2 AETNA HEALTH PLANS P O BOX 91411 ARLINGTON TX 76015

AC7 AETNA HEALTH PLANS CLAIMS OFFICE P.O. BOX 91533 ARLINGTON TX 76015

X57 AETNA HEALTH PLANS P O BOX 1630 COLUMBUS OH 43216

Z27 AETNA HEALTH PLANS P.O. BOX 26190 GREENSBORO NC 27402-6190

X96 AETNA HEALTH PLANS UPS UNIT 52F PO BOX 26053 GREENSBORO NC 27420

Q65 AETNA HEALTH PLANS PO BOX 7012 DOVER DE 19903

V66 AETNA HEALTH PLANS OF TENN INC P O BOX 141176 IRVING TX 75014-1176

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 4

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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CA3 AETNA HEALTH PLANS OF CA P.O. BOX 50035 SAN BERNARDINO CA 92412

X97 AETNA HEALTH SERVICE 400 E SPRING STR BLUFTON TN 46714

FC8 AETNA HEALTHCARE P O BOX 1816 MACON GA 31202

K24 AETNA HEALTHCARE P O BOX 150417 HARTFORD CT 06115-0417

H98 AETNA INSURANCE CO P O BOX 26107 GREENSBORO NC 27402-6107

V41 AETNA INSURANCE CO P O BOX 709 WINDSOR CT 06095-0709

BD4 AETNA INSURANCE CO C/O BOB EVANS 3776 S. HIGH ST COLUMBUS OH 43207

MV* AETNA LIFE AND CAASUALTY GROUP CLAIMS P O BOX 12340 FRESNO CA 93765

KX* AETNA LIFE AND CASUALTY GLEN HILL N BLDG 8 800 ROOSEVELT RD GLEN ELLYN IL 60137

JW* AETNA LIFE AND CASUALTY P O BOX 2117 FALL RIVER MA 02722

G77 AETNA LIFE AND CASUALTY 435 CAPTAIN THOMAS BLVD WEST HAVEN CT 06516

D62 AETNA LIFE AND CASUALTY P O BOX 6519 JACKSONVILLE FL 32236

VS* AETNA LIFE AND CASUALTY P O BOX 26200 NEW ORLEANS LA 70186

R42 AETNA LIFE AND CASUALTY 150 4TH AVE N NASHVILLE AR 37219

QI* AETNA LIFE AND CASUALTY CIVIL SERVICE RETIREMENT WASHINGTON DC 20415

WQ* AETNA LIFE AND CASUALTY GULF MEDICAL PYMNT UNIT 900 CHATHAM CNTR OFC BLDG PITTSBURGH PA 15259

AL5 AETNA LIFE AND CASUALTY P.O. BOX 795982 SAN ANTONIO TX 78279-5082

V52 AETNA LIFE AND CAUSALTY 301 INDUSTRIAL PARK MARKED TREE AR 72365

F56 AETNA LIFE INS POBOX DRAWER 11000 RUSTON LA 71270

F81 AETNA LIFE INS CO PO BOX 795080 SAN ANTONIO TX 78279-5080

H58 AETNA LIFE INS CO P.O. BOX 31450 TAMPA FL 33631-3450

EF6 AETNA LIFE INS CO P O BOX 578800 OKLAHOMA CITY OK 73157-8800

ED4 AETNA LIFE INS CO COCA COLA CLAIMS 166 16TH ST N W ATLANTA GA 30318

A64 AETNA LIFE INS CO LOOP STATION P O BOX 2907 MINNEAPOLIS MN 55402

CT4 AETNA LIFE INS CO P O BOX 91511 ARLINGTON TX 76015

AT* AETNA LIFE INS CO CLM DEPT EMPLOYEE BENEFITS DIV P O BOX 5060 ARLINGTON TX 76011

DE2 AETNA LIFE INSURANCE P O BOX 2523 FORT WAYNE IN 46801-0871

C28 AETNA LIFE INSURANCE P O BOX 59180 BIRMINGHAM AL 35259

DR6 AETNA LIFE INSURANCE P O BOX 26117 GREENSBORO NC 27402

DR5 AETNA LIFE INSURANCE P O BOX 28902 SAN ANTONIO TX 78228

DR4 AETNA LIFE INSURANCE P O BOX 3000 GRAND RAPIDS MI 49501

DK8 AETNA LIFE INSURANCE P O BOX 3901 ALLENTOWN PA 18106-0901

DF5 AETNA LIFE INSURANCE 2677 NORTH MAIN ST SUITE 600 SANTA ANA CA 92701

DG1 AETNA LIFE INSURANCE 2365 NORTHSIDE DRIVE SAN DIEGO CA 97207

DF9 AETNA LIFE INSURANCE P O BOX 16516 COLUMBUS OH 43216

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 5

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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DG2 AETNA LIFE INSURANCE P O BOX 871 FORT WAYNE IN 46801

D82 AETNA LIFE INSURANCE P O BOX 26279 MILWAUKEE WI 53226

E90 AETNA LIFE INSURANCE P O BOX 300 PORTLAND OR 97207

E65 AETNA LIFE INSURANCE LOOP STATION P O BOX 2947 MINNEAPOLIS MN 55402

DI6 AETNA LIFE INSURANCE CO P O BOX 91522 ARLINGTON TX 76015-0022

DI2 AETNA LIFE INSURANCE CO P O BOX 7027 ROCKFORD IL 61126-7027

DV2 AETNA LIFE INSURANCE CO P O BOX 50065 SAN BERNARDINO CA 92412

BW5 AETNA LIFE INSURANCE CO P O BOX 9070 TYLER TX 75711

WX* AETNA LIFE INSURANCE CO P O BOX 2539 HOUSTON TX 77001

X56 AETNA LIFE INSURANCE CO 350 SRPINGSIDE DRIVE P O BOX 5569 AKRON OH 44340-5690

X98 AETNA LIFE INSURANCE CO PO BOX 5048 ROCKFORD IL 61125

X58 AETNA LIFE INSURANCE CO P O BOX 18040 COLUMBUS OH 43218

OF* AETNA LIFE INSURANCE CO P O BOX 2369 FORT WORTH TX 76113

N5* AETNA LIFE INSURANCE CO PO BOX 129107 SAN DIEGO CA 92112-9107

FY4 AETNA PHARMACY MANAGEMENT AETRX SUITE 400 11100 WAYZATA BLVD MINNETONKA MN 55305

FJ7 AETNA PPO PO BOX 44128 JACKSONVILLE FL 32231

AP3 AETNA PPO P O BOX 981107 EL PASO TX 79988-1107

HT1 AETNA RX MANAGEMENT PO BOX 14024 LEXINGTON KY 40512

HE9 AETNA U S HEALTHCARE P O BOX 12626 FRESNO CA 93778

FD8 AETNA U S HEALTHCARE PEPSICO CLAIMS P O BOX 52117 MINNEAPOLIS MN 55402-5117

CW8 AETNA U S HEALTHCARE P O BOX 14079 LEXINGTON KY 40512-4079

DC7 AETNA U S HEALTHCARE P O BOX 981107 18004482180 EL PASO TX 79998

AH8 AETNA US HEALTHCARE PO BOX 91533 ARLINGTON TX 76015-0033

A59 AETNA US HEALTHCARE P O BOX 182082 COLUMBUS OH 43218-2082

AX8 AETNA US HEALTHCARE PO BOX 578802 OKLAHOMA CITY OK 73157-8802

NO* AETNA US HEALTHCARE HOME DEPOT P O BOX 26106 GREENSBORO NC 27402-6106

OE* AETNA US HEALTHCARE P O BOX 52120 MINNEAPOLIS MN 55402-5120

N55 AETNA US HEALTHCARE P O BOX 91544 ARLINGTON TX 76015-0044

QJ* AETNA US HEALTHCARE GROUP CLAIMS P O BOX 26102 GREENSBORO NC 27402-6102

PI* AETNA US HEALTHCARE P O BOX 150409 HARTFORD CT 06115-0409

UP* AETNA US HEALTHCARE 4151 EXECUTIVE PKWY SUITE 105 WESTERVILLE OH 43081

ZN* AETNA US HEALTHCARE PO BOX 44128 JACKSONVILLE AR 32231-4128

XX* AETNA US HEALTHCARE EMPLOYEE BENEFIT DIV PO BOX 2295 FORT WAYNE IN 46801

CA4 AETNA US HEALTHCARE PO BOX 14110 LEXINGTON KY 40512

BM* AETNA US HEALTHCARE P O BOX 24024 FRESNO CA 93765

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 6

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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DW8 AETNA US HEALTHCARE PO BOX 353 GRAND RAPIDS MI 49501

DK* AETNA US HEALTHCARE P O BOX 2265 BLUE BELL PA 19422

DH9 AETNA US HEALTHCARE PO BOX 129219 SAN DIEGO CA 92112-9219

FE1 AETNA US HEALTHCARE P O BOX 182756 COLUMBUS OH 43218-2756

FF4 AETNA US HEALTHCARE PO BOX 981106 EL PASO TX 79998-1106

FF3 AETNA US HEALTHCARE PO BOX 3924 ALLENTOWN PA 18106-3924

E26 AETNA US HEALTHCARE LOOP STATION P O BOX 2909 MINNEAPOLIS MN 55402

EZ8 AETNA US HEALTHCARE P O BOX 30555 SALT LAKE CITY UT 84130-0555

EU* AETNA US HEALTHCARE P O BOX 2301 BLUE BELL PA 19422-2301

EC1 AETNA US HEALTHCARE 7400 W CAMPUS ROAD NEW ALBANY OH 43054

EM9 AETNA US HEALTHCARE PO BO X52119 MINNEAPOLIS MN 55402

EK8 AETNA US HEALTHCARE P O BOX 2954 HARTFORD CT 06143-2954

EO5 AETNA US HEALTHCARE P O BOX 2170 COLUMBUS OH 43216-2170

EQ* AETNA US HEALTHCARE P O BOX 2250 BLUE BELL PA 19422-8250

EP7 AETNA US HEALTHCARE LOCKHEED MARTIN BENEFITS P O BOX 12495 OKLAHOMA CITY OK 73157

IV* AETNA US HEALTHCARE P O BOX 2095 BISMARCK ND 58504

KE* AETNA US HEALTHCARE CENTIMARK CLAIMS P O BOX 16423 PITTSBURG PA 15242-0423

MQ* AETNA US HEALTHCARE P O BOX 660239 DALLAS TX 75266

LA* AETNA US HEALTHCARE P O BOX 916 BISMARCK ND 58502-0916

FJ1 AETNA US HEALTHCARE PO BOX 14100 LEXINGTON KY 40512-4100

FN7 AETNA US HEALTHCARE PO BOX 54159 LOS ANGELES CA 90054

FY* AETNA US HEALTHCARE P O BOX 3909 ALLENTOWN PA 18106-0909

FV2 AETNA US HEALTHCARE PO BOX 14066 LEXINGTON KY 40512

FS3 AETNA US HEALTHCARE PO BOX 981204 EL PASO TX 79998

FP9 AETNA US HEALTHCARE PO BOX 9160 VANNUYS CA 91410-0160

FO7 AETNA US HEALTHCARE PO BOX 4266 BISMARCK ND 93765

F43 AETNA US HEALTHCARE PO BOX 91555 ARLINGTON TX 76015-0033

GD4 AETNA US HEALTHCARE 4400 NW LOOP 410 SAN ANTONIO TX 78229

GD3 AETNA US HEALTHCARE PO BOX 1125 BLUE BELL PA 19422

GC2 AETNA US HEALTHCARE PO BOX 14091 LEXINGTON KY 40512-4091

AO8 AFCO METALS HEALTH CARE P.O. BOX 6026 FT SMITH AR 72906

T48 AFCO METALS P O BOX 95010 LITTLE ROCK AR 72209

V14 AFCO STEEL HEALTH CARE P O BOX 231 LITTLE ROCK AR 72203

K23 AFFILATED FOOD STORES P O BOX 802516 DALLAS TX 75380

Y52 AFFILIATED FOOD STORE EMPLOYEES INS PLAN P.O. BOX 3627 LITTLE ROCK AR 72203

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 7

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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RU* AFG INDUSTRIES INC P O BOX 929 KINGSPORT TN 37662

ZB* AFGE INSURANCE DEPT 1325 MASSACHUSETTS AVE NW WASHINGTON DC 20005

R36 AFLAC AMERICAN FAMILY LIFE 1932 WEYNNTON RD COLUMBUS GA 31999

EX4 AFLAC P O BOX 715 TEXARKANA TX 75503

V31 AG PROCESSING INC P O BOX 9120 DES MOINE IA 50306

BS1 AGA AUTOMATED GROUP ADMIN PO BOX 15568 FORT WAYNE IN 46885-5568

P89 AGENCY RENT A CAR 30000 AURORA RD SOLON OH 44139

K52 AGENCY SERVICE INC P.O. BOX 17237 MEMPHIS TN 38187-0237

T98 AHA CARE P O BOX 809 RIDGELAND MS 39158-0809

EE3 AIA INSURANCE P O BOX 2198 SHAWNEE MISSION KS 66201

AR1 AIA UNIVERSE P.O. BOX 538 LEWISTON ID 83501

KF* AID ASSOCIATION FOR LUTHERANS 4321 N BALLARD ROAD APPLETON WI 54919

HK6 AIG CLAIMS SERVICE P O BOX 44139 LAS VEGAS NV 89116

JO1 AIG DOMESTIC CLAIMS A AND H CLAIMS DEPARTMENT PO BOX 25987 SHAWNEE MISSION KS 66225

F60 AIR LOGISTICS POBOX 53178 LAFAYETTE LA 70505

X25 AIR PRODUCTS AND CHEMICALS P O BOX 252 FT SMITH AR 72902

AD* AIRTHERM PRODUCTS INSURANCE DEPT P O BOX 1895 FORREST CITY AR 72335

CE6 ALADDIN INDUSTRIES INC 703 MURFREESBORO RD NASHVILLE TN 37210

E73 ALAN WHITE CO P O BOX 249 STAMPS AR 71860

IK9 ALASKA LABORERS H S FUND P O BOX 34567 SEATTLE WA 98124-1567

HV7 ALCOHOL DRUG ABUSE PREVENT 305 SOUTH PALM STREET LITTLE ROCK AR 72205

A10 ALL AMERICAN LIFE INSUR CO 8501 WEST HIGGINS ROAD CHICAGO IL 60631

HN3 ALLEGIANCE BENEFIT PLAN MA PO BOX 3018 MISSOULA MT 59806

CI9 ALLIANCE BLUE CROSS BLUE S P O BOX 14882 ST LOUIS MO 63178-4882

CB7 ALLIANZE LIFE INS CO CITICORP INS P O BOX 7055 DOVER DE 19903-7055

V98 ALLIED ADMINISTRATORS P O BOX 419257 KANSAS CITY MO 64141

M89 ALLIED BENEFIT SYSTEMS P O BOX 909786 CHICAGO IL 60690

BS6 ALLMERICA FINANCE P O BOX 79059 HOUSTON TX 77279-9059

BV1 ALLMERICA FINANCIAL 440 LINCOLN STREET BOX 1014 WORCESTER MA 01653-1014

CD5 ALLMERICA FINANCIAL EMPLOYEE BENEFIT CLAIMS 440 LINCOLN ST BOX 1018 WORCESTER MA 01605-1959

DX5 ALLMERICA FINANCIAL 333 PIERCE RD SUITE 310 ITASCA IL 60143-3116

ER6 ALLMERICA FINANCIAL 440 LINCOLN ST BOX 3844 WORCESTER MA 01653-3844

EJ8 ALLMERICA FINANCIAL P O BOX 105893 ATLANTA GA 30348-5893

E13 ALLSTATE 3090 W MARKER ST FAIRLAWN OH 44313

J95 ALLSTATE 1510 A AIRPORT ROAD HOT SPRINGS AR 71913

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 8

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

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A65 ALLSTATE PO BOX 26743 AUSTIN TX 78731

UW* ALLSTATE 5500 INTERSTATE N PARKWAY ATLANTA GA 30328

SO* ALLSTATE 1230 RAYMOND RD P O BOX 2031 JACKSON MS 39205

I32 ALLSTATE INS CO 2330 GRAVEL ROAD FORTH WORTH TX 76118

V45 ALLSTATE INSURANCE 3996 FRONTAGE RD FAYETTEVILLE AR 72703

Q77 ALLSTATE INSURANCE 201 EXECUTIVE COURT LITTLE ROCK AR 72205

AR2 ALLSTATE INSURANCE CO P.O. BOX 30447 TAMPA FL 33630-3447

AT5 ALLSTATE INSURANCE COMPANY PO BOX 800 DEERFIELD IL 60015

EH5 ALLSTATE LIFE INS P O BOX 3580 AKRON OH 44309-3580

EZ3 ALLSTATE LIFE INSURANCE CO P O BOX 3063 NORTHBROOK IL 60065-3063

AR9 ALLTRISTA BENEFIT DEPARTMENT 8307 BALL ROAD FORT SMITH AR 72903

G81 ALPHA DATA SYSTEMS PO BOX 791428 DALLAS TX 56742

PN* ALTA P O BOX 11111 FORT SCOTT KS 66701

FK4 ALTERNATIVE INS RESOURCE PO BOX 660787 BIRMINGHAM AL 35266-0787

GR1 ALTIUS P O BOX 7147 LONDON KY 40742

B41 ALTON PKGING CORP THRU AETNA INSURANCE PO BOX 276 ALTON IL 62002

N73 ALUMACRAFT GROUP MEDICAL P O BOX 189 ARKADELPHIA AR 71923

HP7 ALWAYSCARE BENEFITS P O BOX 14389 BATON ROUGE LA 70898-4389

AM8 AMALGAMATED CLOTHING AND TEXTILE WORKERS UNION 33 W. 14TH STREET NEW YORK NY 10011

SB* AMALGAMATED INSURANCE AGENCY 8550 WEST BRYN MAWR AVE CHICAGO IL 60631

N7* AMALGAMATED LABOR LIFE INS 7380 N LINCOLN AVE LINCOLNWOOD IL 60646

0B* AMALGAMATED LIFE INS CO 730 BROADWAY P O BOX 1451 NEW YORK NY 10116-1451

IM3 AMBETTER OF ARKANSAS ATTN CLAIMS P O BOX 5010 FARMINGTON MO 63640-5010

CK9 AMCO PO BOX 691030 SAN ANTONIO TX 78269-1030

CK8 AMCO PO BOX 22118 LITTLE ROCK AR 72221-2118

FO9 AMCO REPRICING P O BOX 1979 SEARCY AR 72145

DO2 AMCO REPRICING DEPT PO BOX 8219 LITTLE ROCK AR 72221-8219

B35 AMER CONSUMERS ASSOC ADMIN PO BOX GA CORONA DEL MAR CA 92625

N38 AMERAPLAN INC 22500 METROPOLITAN PKWY SUITE 100 CLINTON TOWNSHIP MI 48035

BA3 AMERCO MEDICAL PLAN 2721 NORTH CENTRAL AVENUE PHOENIX AZ 85004-1120

BZ5 AMERI PLUS IDEAL INS P O BOX 9100 CLEARWATER FL 34618

GT2 AMERIBEN PO BOX 7186 BOISE ID 83707

II7 AMERICA TPA P O BOX 398220 MINNEAPOLIS MN 55439

MR* AMERICAN ADMINISTRATIVE GROUP INC P O BOX 268900 OKLAHOMA CITY OK 73216

GU8 AMERICAN ADMINISTRATIVE GROUP INC PO BOX 619012 DALLAS TX 75261-9012

* - INDICATES SPACES IN RESOURCE CODE KEY

REPORT: HMTR785J A R K A N S A S T I T L E X I X PAGE 9

DATE: MARCH 26, 2016 TPL SUBSYSTEM

TIME: 19:03:48 COMPANY NAME ORDER - NON-MEDICAID CARRIERS EXCLUDED

RES CODE INSURANCE CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP CODE

----------------------------------------------------------------------------------------------------------------------------------

N60 AMERICAN ADMINISTRATORS 4200 CORPORATE DR STE 114 P O BOX 65887 WEST DES MOINES IA 50265

BT9 AMERICAN ADMINSTRATIVE SER 2626 S. SHERIDAN STE 100 TULSA OK 74129

B24 AMERICAN AMICABLE LIFE INS PO BOX 1849 WACO TX 76703

N66 AMERICAN BAPTIST CHURCH MEDICAL PLAN 475 RIVERSIDE ROOM 1700 NEW YORK NY 10115

EQ7 AMERICAN BEHAVIORAL 7540 LBJ FREEWAY STE 800 DALLAS TX 75251

DF4 AMERICAN BENEFIT 7301 N BROADWAY OKLAHOMA CITY OK 73116-9061

QL* AMERICAN BENEFIT CORP 222 SOUTH PROSPECT PARK RIDGE IL 60068

RH* AMERICAN BENEFIT PLAN ADMINISTRATORS 3785 SOUTH 700 EAST SALT LAKE CITY UT 84106

U59 AMERICAN BENEFIT PLAN ADMINISTRATORS INC 4040 MCEWEN, STE 100 DALLAS TX 75244-5018

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