All States Workers Comp Payer List - Office Ally Comp... · Revised 5/17/2010. Payer ID Name State ... (San Jose, CA) TX & MN Only WC540 AT&T ... WX167 Center for Employee Training

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Payer ID Name StateWS052 NOV01 TX & MN OnlyWC100 1-800-OhioComp All StatesWC101 3-HAB All StatesWC224 3M TX & MN OnlyWC229 7-Eleven (Corp) TX & MN OnlyWC188 AAA Automobile All StatesA0001 AAA Cooper Transportation TX & MN OnlyWC231 Acceptance Insurance TX & MN OnlyWC313 Access Group MN Only10166 Accident Fund Insurance Co of America TX & MN Only

WC528 Accuride Corporation TX & MN OnlyWC343 Ace American Insuarnce Company TX & MN OnlyWC390 Ace Fire Underwriters Insurance Co TX & MN OnlyWR905 ACE Insurance Company All StatesWB133 ACE/ESIS (excludes Sunoco) All StatesWC232 ACIG Insurance All StatesWC399 Acrometal Companies MN OnlyACU99 Acuity, A Mutual Insurance Company All StatesWC240 ACWA JPI All StatesWC241 Adams and Brooks, Inc. All StatesWZ093 Administrative Claim Service, Inc. MN OnlyWC270 ADT Fire & Security TX & MN OnlyWC413 Advance Auto Parts TX & MN OnlyWB111 Advanced Auto Parts All StatesWZ327 Advanced Medical Optics All StatesWC413 Advanced Micro Devices TX & MN OnlyWC102 Ad C I All St t

All States Workers Comp Payer List

WC102 AdvoCare Inc All StatesWC492 Agilent Technologies TX & MN OnlyWC680 AID Insurance Company MN OnlyWC312 AIG All StatesWB108 AIG Claim Services All StatesWC680 Al South Insurance Co TX & MN OnlyWC680 Alamo Community College District TX OnlyWC331 Alaska National All StatesWC543 Allianz Insurance TX & MN OnlyWC680 Allied Document Solutions MN OnlyWC814 Allied Group Incorporated MN OnlyWC892 Allied Group Ins MN OnlyWC893 Allied Group Ins Marketing MN OnlyWC894 Allied Life Insurance Company MN OnlyWC896 Allied Mutual Ins Co MN OnlyWC904 Allied Property and Casualty Ins Co MN OnlyWC905 Allied Texas Agency Colonial County Mutual MN OnlyWC906 Allied Texas Agency Inc MGA TX & MN OnlyWC909 Allison Transmission TX OnlyWR378 Allstate Insurance All StatesWP985 Alpha Review TX & MN OnlyWC103 ALPS CompCare All StatesWZ216 Altec MN OnlyWZ232 Altec Industries MN OnlyWZ668 Alternative Insurance Management All StatesWC913 Alternative Service Concepts TX Only

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Page 1 of 26Revised 5/17/2010

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http://www.officeally.com/RegisterForms/Office_Ally_Forms/Workers%20Compensation%20Claims%20-%20Submitting%20Attachments%20Instructions%20and%20Cover%20Sheet.pdf

Payer ID Name StateWC370 Alternative Services Concepts All StatesWC595 Alvey Systems (AON Risk) TX & MN OnlyWP022 Amazon Com, Inc. TX OnlyWP023 AMCO Ins Co MN OnlyWZ921 Amcomp Assurance - Wisconsin All StatesWC213 American All Risk Insurnace Co (AARIS) All StatesWP979 American All Risk Loss Administrators (AARLA) All States19720 American Alternative Ins Corp TX & MN Only20427 American Casualty Co of Reading PA TX & MN Only

WA065 American Claims Management (ACM) All StatesWC633 American Coin Merchandising, Inc TX & MN OnlyWC212 American Commercial Claim Admin (ACCA) ( San Francisco ONLY) All StatesWX732 American Commercial Claim Admin (ACCA) (Pasedena, CA ONLY) All StatesWC391 American Commercial Claim Admin (ACCA) (San Diego ONLY) All StatesWC634 American Cyanamid TX & MN OnlyWP030 American Express TX & MN OnlyWP065 American Guarantee TX & MN OnlyWR899 American Home Assurance TX & MN OnlyWC400 American Home Craft All StatesWP073 American Honda Motor Company TX & MN Only21857 American Insurance Co TX & MN Only

WP093 American Insurance Company MN Only40258 American International South Ins Co TX & MN Only

WB100 American Interstate - TX only All StatesWP095 American Lumber Underwriters TX Only30562 American Manufacturers Mutual Insurance Company TX & MN Only22918 American Motorists Insurance Co TX & MN Only18910 American Protection Insurance Co TX & MN Only

WC408 American Protective Ins. TX & MN OnlyWB103 American Risk Services, Inc and all subsidiaries (Amerisafe Insureance Co) All StatesWP096 A i R l W k TX & MN O lWP096 American Rural Work TX & MN OnlyWZ672 American Select All StatesWC638 American Specialty Companies TX & MN OnlyWC643 American Specialty Ins. / MIB TX & MN OnlyWP103 American Zurich TX & MN OnlyWA054 Ameriprise Auto & Home Insurance All StatesWB101 Amerisafe Risk Services - TX only All StatesWC422 Amerisure Insurance TX & MN OnlyWC111 Amerisure Mutual Insurance TX & MN OnlyWA056 Amica Mutual Insurance Company All StatesWP113 Amtrust Insurance Co of Kansas TX & MN OnlyWC435 Anderson & Howard All StatesWP119 Anoka Hennepin-Isd 11 MN OnlyWC454 API Panel All StatesWP122 Apogee Enterprises Inc. TX & MN Only

WB164 Applied Risk Services, A subsidiary of Applied Underwriters, California Insurance Co., and Continental Indemnity Co. All States

WR904 Aramark (Dental Only) All StatesWB112 Aramark (Prof & Inst Only) All StatesWC130 Arcadia Insurance Company TX & MN OnlyWP125 Archdiocese Of St Paul & Mpls MN OnlyWX852 ARCMI TX & MN OnlyWP126 Arctic Cat Inc MN OnlyWP127 Arctic Cat Of South Dakota MN OnlyWP129 Arden Foods, Inc MN OnlyWZ233 Argenbright Holdings Limited MN Only



Payer ID Name StateWZ478 Argonaut Claims Services, Ltd All StatesWZ479 Argonaut Midwest Insurance Co All StatesWZ502 Argonaut Southwest Insurance Co All StatesWB165 Arrow Point Capital (Formerly Royal&SunAlliance) All StatesWC503 Arrowhead Water (Los Angeles, CA) TX & MN OnlyWC504 Arrowhead Water (Oakland, CA) TX & MN OnlyWC505 Arrowhead Water (Orange, CA) TX & MN OnlyWC506 Arrowhead Water (San Diego, CA) TX & MN OnlyWC507 Arrowhead Water (South San Fran, CA) TX & MN OnlyWC516 Artistree, Inc. All StatesWC518 Asbury Environmental Corp (Southgate, CA) All StatesWC519 Asbury Environmental Corp (Spring Valley, CA) All StatesWC520 ASC All StatesWP130 Ascension Health TX Only21865 Associated Indemnity Corp TX & MN Only

WP987 Association Casualty Insurance Company All StatesA0016 AT & T Corp TX & MN OnlyWC539 AT&T Worldwide Customer Service TX & MN OnlyWC542 AT&T (El Segundo, CA) TX & MN OnlyWC541 AT&T (San Francisco, CA) TX & MN OnlyWC544 AT&T (San Jose, CA) TX & MN OnlyWC540 AT&T (San Ramon, CA) TX & MN OnlyWC550 Atlantic Mutual All StatesWP131 Atlantic Mutual Insurance TX & MN OnlyWC104 AultComp All StatesWZ744 Austin Mutual All StatesWA053 Auto Club Insurance Association All StatesWZ751 Auto Owners Insurance Company All StatesWZ788 Auto Owners Life Insurance Company All StatesWC564 Auto Zone (Fullerton, CA) TX OnlyWC563 A t Z (M d t CA) TX O lWC563 Auto Zone (Modesto, CA) TX OnlyWC562 Auto Zone(San Diego, CA) TX OnlyWC567 Automotive Clinic All StatesWC105 AvatarComp All StatesWP930 Aviation Safeguard All StatesWX601 Avizent TX & MN OnlyWC429 Ayers Trucking TX & MN OnlyWP132 Bancinsure, Inc. TX & MN OnlyWP135 Bankers Standard Insurance TX & MN OnlyWB113 Barnes All StatesWC618 Bas Tire Recycling All StatesWC621 Bassett Unified School District All StatesWZ806 Beacon All StatesWC648 Beall's Inc / Midwest Employers TX & MN OnlyWP136 Bed Bath & Beyond (Auto Only) TX & MN OnlyWB114 Bed Bath and Beyond (WC Only) All StatesWC657 Bell Gardens Family Medical Center All StatesWP137 Bell South Corporation TX & MN OnlyWP138 Bemis Company Inc. TX & MN OnlyWP049 Benchmark Insurance All StatesWP139 Benedictine Group Self-Insurance Assoc. MN OnlyWC669 Bennett Landscaping All StatesWC679 Berkley Specialty Underwriters TX & MN OnlyWBH01 Berkshire Hathaway Homestate Co. All StatesWC681 Berkshire Hathaway Homestate Co. (San Fran, CA) All StatesWP140 Bermo, Inc. MN Only



Payer ID Name StateWP141 Bertelmanns Inc. TX & MN OnlyWC677 Berwind Corporation TX & MN OnlyWP143 Best American Hospitality TX & MN OnlyWP144 Big Lots TX OnlyWC705 Big Lots (Garden Grove, CA) TX & MN OnlyWC703 Big Lots (Lornita, CA) TX & MN OnlyWC706 Big Lots (Mission Viejo, CA) TX & MN OnlyWC707 Big Lots (Rancho Cucamonga, CA) TX & MN OnlyWC708 Big Lots (Redlands, CA) TX & MN OnlyWC704 Big Lots (Santa Ana, CA) TX & MN OnlyWP146 Birmingham Fire Insurance Co PA TX & MN OnlyWZ570 Bituminous Casualty Corp All StatesWZ588 Bituminous Fire & Marine Insurance Co All StatesWP147 Blockbuster Inc TX & MN OnlyWC729 Bloodsource, Inc. All StatesWC739 Blueline Food Services All StatesWP148 Bob Evans TX OnlyWP149 Bois Forte Reservation Tribal Council MN OnlyWP152 Boise Cascade Corporation TX & MN OnlyWP154 Boise Paper Holdings TX & MN OnlyWZ817 Boldt Company All States20761 Boston Old Colony Insurance Co TX & MN Only

WP187 Brickman Group (Dallas) TX OnlyWP190 Brickman Group (Houston) TX OnlyWP194 Brickman Group (Plano) TX OnlyWP206 Brickman Group (Roanoke) TX OnlyWP179 Brickman Group (Woodlands) TX OnlyWP186 Brickman Groupp (Austin) TX OnlyWB147 Bridgefield Casualty Insurance Company All StatesWB148 Bridgefield Employers Insurance Company All StatesWP216 B i k I t ti l TX O lWP216 Brinker International TX OnlyWC782 Bristol Park Medical All StatesWP745 British American Insurance Company All StatesWC789 Broadspire TX & MN OnlyWP222 Broadspire - Dallas TX OnlyWP233 Broadspire - Lewisville TX OnlyWC678 Brownyard Group Inc. (Arch Insurance) TX & MN OnlyWC744 Brunswick Corporation TX & MN OnlyWC812 Bunch & Assoc. Inc All StatesWB166 Bunch & Associates - CostCo All StatesWB167 Bunch & Associates - Food Lion All StatesWB188 Bunch and Associates - Aramark (LIMITED) All StatesWB189 Bunch and Associates - Lowes (LIMITED) All StatesWP243 Burger King Corporation TX & MN OnlyWC761 Burlington Coat Factory Wareho TX & MN OnlyWR900 Burtons Fire All StatesWP251 Butterball, L.L.C. TX OnlyWP267 C & S Wholesale Grocers TX OnlyWC840 C.O.P. All StatesWR896 CA American Water Company All StatesWP288 Cal Southampton TX OnlyWP289 Calfarm Insurance company MN OnlyWC898 Cambridge (Carrolton, TX) All StatesWR909 Cambridge (Concord, CA) All StatesWP598 Cambridge (Glendale, CA) All StatesWC915 Cambridge (Los Angeles, CA) All States



Payer ID Name StateWP472 Cambridge (Pasedena, CA) All StatesWR872 Cambridge (Portland, OR) All StatesWC902 Cambridge (Rancho Cordova, CA) All StatesWC897 Cambridge (Sacramento, CA) All StatesWC900 Cambridge (San Diego, CA) All StatesWX163 Cambridge Integrated Services Group All StatesWR911 Cambridge Integrated Services Group (Glendale, CA) All StatesWP123 Cambridge Integrated Services Group (Modesto, CA) All StatesWR841 Cambridge Integrated Services Group (now Xchanging) All StatesWC903 Cambridge Integrated Services Group (Pasedena, CA) All StatesWC910 Cambridge Integrated Services Group (Rancho Cordova, CA) All StatesWC907 Cambridge Integrated Services Group (Sacramento, CA) All StatesWC908 Cambridge Integrated Services Group (Salt Lake City, UT) All StatesWP978 Cambridge Integrated Services Group, Inc. (Warren, MI) All StatesWC413 Canyon House All States30589 Capital City Insurance Company, Inc TX & MN Only

WC931 Cardinal Health TX & MN OnlyWP291 Careage TX OnlyWC107 CareWorks All StatesWP311 Carleton College MN OnlyWP312 Casella Ins. Co MN OnlyWZ279 Caseys General Stores TX & MN OnlyWP870 Catholic Mutual TX & MN OnlyWP290 CCMLBOI MN OnlyWR322 CCMSI TX OnlyWP315 Cedar Fair L.P. MN OnlyWR888 Cen Cal Machine All StatesWC783 Cendant Corporation TX & MN OnlyWX167 Center for Employee Training (Student Accident ONLY) All StatesWC966 Center for Employee Training (WorkComp ONLY) All StatesWC787 C t l H k L TX & MN O lWC787 Central Hockey League TX & MN OnlyWP336 Cerenity Senior Care Large Deductible MN OnlyWP370 Certified Power Train Specialists, Inc. MN OnlyWB149 Charlotte County All StatesWC788 Charming Shoppes, Inc. TX & MN OnlyWX007 Cherokee Insurance All StatesWP371 Chesterfield Serv-Uniontown TX & MN OnlyWP385 Chick-fil-A TX OnlyWP406 Children's Hospitals and Clinics of MN MN OnlyA0031 Christus Health TX & MN OnlyWP407 Chrysler Group LLC TX & MN OnlyWZ528 Chubb & Sons - Federal Insurance All States12777 Chubb Indemnity Co TX & MN Only10052 Chubb National Insurance Company TX & MN Only

WP422 Church - Auto TX & MN OnlyWP424 Church Mutual Insurance Company TX & MN OnlyWP428 Church of Jesus Christ of Latter Day Saints TX & MN OnlyWP470 CIGNA TX & MN OnlyWZ922 CIM Insurance Corporation All States10677 Cincinnati Insurance Co TX & MN OnlyWZ923 Cincinnati Specialty Underwriters Company All StatesWX067 Cintas (Ontario) All StatesWX063 Cintas (Pico Rivera) All StatesWX064 Cintas (Sacramento) All StatesWX066 Cintas (San Diego) All StatesWX068 Cintas (San Fran) All States



Payer ID Name StateWX065 Cintas (San Jose) All StatesWX069 Cintas (Tustin) All StatesWX070 Cintas (Vista) All StatesWX060 Cintas Fire And Safety All StatesWR898 Cirq Wire Works All StatesWX078 City Fibers, Inc. (Vernon) All StatesWX059 City of Amarillo (Austin) All StatesWC293 City Of Arlington TX & MN OnlyWP473 City of Bloomington MN OnlyWP474 City of Eagan MN OnlyWP857 City Of El Paso TX & MN OnlyA0051 City of Hurst TX & MN OnlyWB115 City of Jacksonville All StatesWR497 City of Lewisville TX & MN OnlyWP475 City of Minneapolis TX & MN OnlyWB150 City of North Miami Beach All StatesWB151 City of Plant City All StatesWP476 City of Plymouth MN OnlyWP478 City of Richfield MN OnlyWP480 City of Rochester MN OnlyWC152 City of San Angelo TX & MN OnlyWP481 City of San Antonio TX OnlyWX090 City of San Bernardino All StatesWZ842 City of St. Paul All StatesWP482 City of Waco TX OnlyWX115 Claim Quest (was Centurion) All StatesWP492 Claimetrics TX OnlyWR889 Claims Administrative Services (CAS) TX & MN OnlyWB152 Claims Center All StatesWZ843 Claims Services & Investigations All StatesWP980 Cl d N ti l All St tWP980 Clarendon National All States20532 Clarendon National Insurance Co TX & MN Only

WX124 Clarendon National Insurance Co (Santa Ana) TX & MN OnlyWC790 Classic Residence By Hyatt TX & MN OnlyWX137 Clean Harbors, LLC (all locations) All States

WP493 Cleveland Cliffs (Empire, Tilden, Cleveland Cliffs, Marquette Iron, United Taconite, Hibbing Taconite, Northshore, LS&I Railroad) MN Only

WA041 CNA Insurance All StatesWB168 CNA Insurance All StatesWP929 CNA Insurance (FL) All StatesWX160 CNA Insurance (TX) All StatesWX161 CNA Insurance (CA) All StatesWX164 CNA Insurance (OR) All StatesWX165 CNA Insurance (PA) All StatesWP496 Coach America TX & MN OnlyWP497 Coach USA All StatesWC791 Coca-Cola Enterprises Inc. TX & MN OnlyWC834 Cochran Canon Management Service, Inc. (CCMSI) (Concord, CA) All StatesWC835 Cochran Canon Management Service, Inc. (CCMSI) (Danville, IL) All StatesWR320 Cochran Canon Management Service, Inc. (CCMSI) (Minnetonka) All StatesWP502 Colgate-Palmolive Corporate TX OnlyWP513 Colonial General Insurance Company MN OnlyWC792 Columbia Sussex Corporation TX & MN OnlyWP514 Commerce & Industry Insurance TX & MN OnlyWB136 Commonwealth Industries TXWX214 Comp West All States



Payer ID Name StateWC793 Compass Group Usa, Inc. TX & MN OnlyWC109 CompManagement Health Systems All StatesWC108 CompOne All StatesWC106 Comprehensive Manged Care Systems All StatesWX753 CompTech TX & MN OnlyWP526 Conagra Food, Inc. TX & MN OnlyWX226 Concepts Awnings Canvas, Inc. All StatesWP565 Connecticut Indemnity Co TX & MN OnlyWP674 Constitution State Services All StatesWB102 Constitution States (St. Paul Travelers) All StatesWP575 Construction Services Group Self Insured Association MN OnlyWX239 Container Store (San Diego) All StatesWC803 Contech Construction Products TX & MN OnlyWC813 Continental Airlines TX & MN Only20443 Continental Casualty Co TX & MN Only35289 Continental Insurance Co TX & MN Only

WP578 Continental National Insurance TX & MN OnlyWC131 Continental Western TX & MN OnlyWP589 Continental Western Ins Co TX & MN OnlyWC826 Convergys Corporation TX & MN Only00622 Coregis Insurance Co TX & MN Only

WP612 Core-Mark International TX & MN OnlyWC846 Correctional Management Service TX & MN OnlyWC899 Corrections Corp of America TX & MN OnlyWC110 CorVel Corp All StatesWB116 Costco (Corp) All StatesWZ902 Cottingham & Butler Claim Services, Inc. All StatesWZ903 Country Casualty Insurance Company All StatesWZ904 Country Mutual Insurance Company All StatesWZ905 Country Preferred Insurance Company All StatesWX286 C t Of K (Ri k M t D t) All St tWX286 County Of Kern (Risk Management Dept) All StatesWP613 County Of Olmsted MN OnlyWX307 County Of San Diego All StatesWX318 Couts Heating & Cooling (Sacramento) All StatesWP615 Covidien TX & MN OnlyWC901 Coworx Staffing, LLC TX & MN OnlyWX335 Crawford Insurance TX & MN OnlyWR916 Crescent Village All StatesWP618 Crestbrook Insurance Company TX & MN OnlyWC153 Crum & Forster Indemnity Co TX & MN OnlyWC132 Cumis Insurance Society TX & MN OnlyWP155 CVS Pharmacy TX & MN OnlyWB117 CVS Pharmacy / Caremark / Minute Clinic All StatesWX381 Cypress Security All StatesWP619 Daimler Trucks North America WC (fka Freightliner LLC) TX & MN OnlyWP640 Dallas County Schools TX OnlyWC127 Dallas County Schools All States32271 Dallas National Insurance Co All States

WP441 Danaher Corporation TX & MN OnlyWP647 DCI, Inc. MN OnlyWX037 De Bartolos, Inc TX & MN OnlyWP649 Delphi Corporation TX & MN OnlyWB105 Department of Energy All StatesWX444 Department of Labor and Industries All StatesWB104 Department of Labor Black Lung All StatesWP651 Depositors Insurance Co MN Only



Payer ID Name StateWX452 Dept. Of Veteran's Affairs (CA) All StatesWP652 Dillard Departmen (Little Rock) TX & MN OnlyWX294 Dillards Risk Management All StatesWP675 Diocese of Winona MN OnlyWX039 Directory Distributing Assoc. TX & MN OnlyWX040 Discover Re (Burger King) TX & MN OnlyWP697 Discover Reinsurance Company TX & MN OnlyWP748 Dixie Staffing (Lithia Springs) TX & MN OnlyWP749 Domino's Pizza LLC TX & MN OnlyWX500 Donovan's Steak House All StatesWP753 DPWN Holdings Inc. TX & MN OnlyWP756 Dreyer's Grand Ice Cream Holdings, Inc. TX & MN OnlyWX042 Dunn-Edwards Corporation TX & MN OnlyWX540 Durham School Services (Oxnard) All StatesWX541 Durham School Services (Santa Ana) All StatesWX570 Dustrol TX & MN OnlyWX043 Dynamex, Inc. TX & MN OnlyWP767 East Central ISD TX & MN OnlyWP768 Eaton Corporation TX & MN OnlyWP788 eBay TX & MN OnlyWP800 Eddie Bauer (Spiegel) TX OnlyWP804 Edgewood ISD TX OnlyWB021 EDIC All StatesWP805 EEP Workers Compensation Fund MN OnlyWX577 El Cholo Restaurant All StatesWC329 El Paso Community College (Tx Jur) TX & MN OnlyWC351 El Paso Water Util Tx Jur TX & MN OnlyWX574 Electric Insurance Company All StatesWP807 Elim Care, Inc. MN OnlyWC160 EMC Risk Services, LLC TX & MN OnlyWC157 EMCASCO I C TX & MN O lWC157 EMCASCO Insurance Co TX & MN OnlyWP812 Emergency Medical Services (AMR) TX OnlyWP813 Emerson Electric Company TX & MN OnlyWP818 Employ Bridge (Irving) TX & MN Only11512 Employers Compensation Insurance Co TX & MN Only

WP853 Employers Compensation Insurance Fund TX & MN OnlyWC158 Employers Mutual Casualty TX & MN OnlyWZ906 Employers Preferred All States39845 Employers Reinsurance Corp TX & MN OnlyWZ258 Enterprise Rent A Car MN OnlyWX045 Envirosource TX & MN OnlyWX638 Equity Resid (San Diego, CA) All StatesWB169 Erie Insurance Group All StatesWR894 ERMC TX & MN OnlyWB153 Escambia County All StatesWS026 Esis (Alabama) All StatesWS027 Esis (Alaska) All StatesWS028 Esis (Arizona) All StatesWS029 Esis (Arkansas) All StatesWS030 Esis (California) All StatesWS031 Esis (Colorado) All StatesWS032 Esis (Connecticut) All StatesWS033 Esis (Delaware) All StatesWX046 Esis (First American Insurance Co) TX & MN OnlyWS034 Esis (Florida) All StatesWS035 Esis (Georgia) All States



Payer ID Name StateWP975 Esis (HawaiI) All StatesWC730 Esis (Idaho) All StatesWP508 Esis (Illinois) All StatesWP989 Esis (Indiana) All StatesWP990 Esis (Iowa) All StatesWP766 Esis (Irving) TX & MN OnlyWP991 Esis (Kansas) All StatesWP992 Esis (Kentucky) All StatesWP993 Esis (Louisisana) All StatesWP994 Esis (Maine) All StatesWP995 Esis (Maryland) All StatesWP996 Esis (Massachusetts) All StatesWP997 Esis (Michigan) All StatesWP998 Esis (Minnesota) All StatesWP999 Esis (Mississippi) All StatesWS001 Esis (Missouri) All StatesWS002 Esis (Montana) All StatesWS003 Esis (Nebraska) All StatesWS004 Esis (Nevada) All StatesWS005 Esis (New Jersey) All StatesWS006 Esis (New Mexico) All StatesWS007 Esis (New York) All StatesWS008 Esis (North Carolina) All StatesWS009 Esis (North Dakota) All StatesWS010 Esis (Ohio) All StatesWS011 Esis (Oklahoma) All StatesWS012 Esis (Oregon) All StatesWS013 Esis (Pennsylvania) All StatesWS014 Esis (Rhode Island) All StatesWS015 Esis (South Carolina) All StatesWS016 E i (S th D k t ) All St tWS016 Esis (South Dakota) All StatesWS016 Esis (Sunoco Claims) All StatesWS018 Esis (Tennessee) All StatesWS019 Esis (Texas) TX & MN OnlyWS020 Esis (Utah) All StatesWS021 Esis (vermont) All StatesWS022 Esis (Washington DC) All StatesWS023 Esis (Washington) All StatesWS024 Esis (West Virginia) All StatesWS025 Esis (Wyoming) All StatesWX644 Esis Fremont W/C All StatesWX645 Esis Portland W/C All StatesWP854 Essential Health Large Deductible MN OnlyWA057 Esurance Insurance Company All StatesWR787 Everest National Insurance (Fresno) All StatesWX666 Everest National Insurance (NJ) All StatesWX665 Everest National Insurance (Oakland) All StatesWX667 Everest National Insurance (Orange) All StatesWX664 Everest National Insurance (SF) All StatesWX048 Evolution Insurance Company TX & MN OnlyWP855 Evolution Insurance Company, Ltd. TX & MN OnlyWX682 Exel, Inc TX & MN OnlyWX698 F.A. Richard & Associates, Inc. TX OnlyWX699 F.A.R.A TX OnlyWC133 Facility Insurance Group TX & MN OnlyWC431 Factory 2 U TX & MN Only



Payer ID Name StateWZ282 Factory Motor Parts TX & MN OnlyWP856 Fairmont Foods Of Minnesota (MN) MN Only25518 Fairmont Premier Insurance Company TX & MN OnlyWZ924 Fairmont Specialty Insurance Company All StatesWZ589 Fairview Health Services All StatesWP202 Fairview Redwing Health Services MN OnlyWB118 Family Dollar All StatesWP869 Farm Bureau Mutual Insurance Company MN OnlyWP907 Farm Family Casualty Insuarnce Company TX & MN OnlyWB170 Farmer's Insurance All States13818 Farmland Mutual Insurance Co TX & MN Only

WP910 Federal Express Corporation TX & MN Only20281 Federal Insurance Co TX & MN Only

WP917 Federal Mogul (AE Goetze) MN OnlyWZ313 Federated Claims Service Corp. All StatesWC161 Federated Mutual Insurance Company TX & MN OnlyWC168 Federated Rural Electric (TX) TX & MN OnlyWP932 FedEx Freight West, Inc. TX OnlyA0110 Fedex Ground Package System Inc TX & MN OnlyWP936 FedEx National LTL, Inc. TX & MN OnlyWP937 Fidelity & Casualty Company of New York TX & MN OnlyWP941 Fidelity & Gurananty Insurance Underwriters TX & MN OnlyWP938 Fidelity and Guaranty Insurance Co. TX & MN OnlyWP939 Fidelity National Financial Inc. TX & MN OnlyWP940 Fidelity National Information Services TX & MN OnlyWP942 Fire & Casualty Insuarnce Company of CT TX & MN OnlyWX777 Firemans Fund Insuarnce (Burbank, CA) TX OnlyWX774 Fireman's Fund Insuarnce (Tustin, CA) TX OnlyWX781 Fireman's Fund Insurance (Chicago, IL) TX Only21873 Fireman's Fund Insurance (Dallas, TX) TX Only

WX780 Fi ' F d I (N t CA) TX O lWX780 Fireman's Fund Insurance (Novato, CA) TX OnlyWX772 Fireman's Fund Insurance (Sacramento, CA) TX OnlyWA042 Fireman's Fund Insurance Company TX OnlyWP943 First Data Corporation TX & MN OnlyWX798 Firstcomp All StatesWP068 FKI Industries, Inc. TX & MN OnlyWX801 Fleetwood Motor Homes (Plan 47) All StatesWB154 Florida Retail Federation All StatesWX842 Florist Mutual Insurance All StatesWP944 Fond Du Lac Reservation MN OnlyWB119 Food Lion / Delhaize All StatesWP945 Ford Motor Credit Co. TX & MN OnlyWP946 Fort Worth ISD TX OnlyWP947 Fort Worth Transportation Authority TX OnlyWX692 Forte, Inc. TX & MN OnlyWX856 Frank Gates / Attenta TX & MN OnlyWB106 Frankenmuth All StatesWP948 Freedom Communications TX OnlyWP982 Fresno Police Officers Association All StatesWP949 G A B Business Services TX & MN OnlyWX907 GAB Robbins, Inc. TX & MN OnlyWP873 GAB Robins (For Van Tuyl Companies ONLY) TX & MN OnlyWP950 Gainey Corporation-Grand Rapids TX & MN OnlyWP951 Galderma Laboratories, LLC TX & MN OnlyWX915 Gallagher Bassett (IL) All StatesWX913 Gallagher Bassett (Sacramento) All States



Payer ID Name StateWX917 Gallagher Bassett Services, Inc. All StatesWP952 GameStop Inc. TX & MN OnlyWB120 Gap All StatesWX929 Gategourmet #836 All StatesWX052 Gates Corp Dba Gates Rubber Co TX & MN OnlyWC112 Gatews McDonald Health Plus, Inc. All StatesWCG01 Geico Insurance All StatesWP953 Genentech, Inc. TX OnlyWP955 General Accident Corp of America TX & MN OnlyWP957 General Casualty (Eden Prairie) TX & MN OnlyWP956 General Casualty (Farmers' Union) TX & MN OnlyWP958 General Casualty (Freeport) TX & MN OnlyWP959 General Casualty (Indianapolis) TX & MN OnlyWP960 General Casualty (Simsbury) TX & MN OnlyWP961 General Casualty (Sun Prairie) TX & MN OnlyWP962 General Casualty (West Des Moines) TX & MN Only24414 General Casualty Co of Wisconsin TX & MN Only

WP963 General Motors Corporation TX & MN OnlyWC113 Genex Care for Ohio TX & MN OnlyWX948 Genex Services (Orange County) TX & MN OnlyWX949 Genex Services (Sacramento) TX & MN OnlyWX946 Genex Services (Schaumburg, IL) TX & MN OnlyWB121 GEO All StatesWX952 George A Bicks Plumbing All StatesWC128 Georgia Casualty & Surety Co All StatesWP964 Georgia-Pacific Corp. TX & MN OnlyWP965 Georgia-Pacific Liability TX & MN OnlyWP966 Gillette Children'S Specialty H.C. MN OnlyWP967 GMAC LLC TX & MN OnlyWP553 Golden Corral Corporation TX & MN OnlyWX984 G ld St t S l All St tWX984 Golden State Supply All StatesWB122 Goodrich All StatesWP968 Gopher Resource Corporation MN OnlyWP969 Grand Portage Res. Tribal Council MN OnlyWP970 Grange TX & MN OnlyWA058 Grange Mutual Casualty Company All StatesWA043 Graphic Arts Mutual TX OnlyWP747 Graphics Art Mutual TX & MN OnlyWC134 Gray Insurance Co. TX & MN OnlyWC166 Great American Alliance Ins Co. TX & MN OnlyWC165 Great American Assurance Co. TX & MN OnlyWZ013 Great American Ins. Co. TX & MN OnlyWC164 Great American Ins. Co.of N.Y. TX & MN OnlyWP971 Great Central/Argonaut TX & MN OnlyWC156 Great Divide Insurance TX & MN OnlyWC154 Great River Insurance Co TX & MN Only11371 Great West Casualty Co TX & MN OnlyWZ907 Grinnell Reinsurance Company All StatesWZ908 Grinnell Select All StatesWX093 Gse Lining Technology, Inc. TX & MN OnlyWZ590 Guideone Mutual Insurance Co All StatesWZ043 Guy Evans Inc All StatesWP972 Hanesbrands Inc. TX & MN OnlyWB123 Hannaford All StatesWP927 Hanover Insurance TX & MN Only26433 Harco National Insurance Co TX & MN Only



Payer ID Name StateWP973 Harlandale ISD TX OnlyWZ591 Harleysville Insurance Company All StatesWB109 Hartford - SRS All StatesWB110 Hartford (Prof & Inst Only) All StatesWZ915 Hartford Accident and Indemnity Company TX & MN OnlyWZ916 Hartford Casualty Insurance Company TX & MN OnlyWZ917 Hartford Fire Insurance Company All StatesWP092 Hartford Insurance Company of the Midwest (All other states) All but CA, FL, NJ TXWZ911 Hartford Insurance Company of the Midwest (CA, FL, NJ & TX ONLY) CA, FL, NJ, TX OnlyWZ044 Hartford Insurance Company of the Midwest (Ruby Tuesday ONLY) All StatesWZ912 Hartford Life and Annuity Insurance Company All StatesWZ913 Hartford Life Insurance Company (Dent & Rx Only) All StatesWZ914 Hartford Underwriters Insurance Company All StatesWP974 HD Supply Inc. TX OnlyWR012 Health Care Group Self Insured Association MN OnlyWR019 Health Care Reciprocal MN OnlyWC114 Health Management Solutions All StatesWZ127 Health Partners TX & MN OnlyWR060 Health Smart-Lubbock All StatesWZ107 Healthcare Services Group All StatesWZ649 Helmsman Mgmt. Services All StatesWZ123 Helpmates (Irvine) All StatesWZ124 Helpmates (Los Angeles) All StatesWZ125 Helpmates Staffing Service All StatesWZ126 Heman G Stark Youth Corr Facility All StatesWX103 Heritage Group TX & MN OnlyWB155 Heritage Summit All StatesWR174 Hershey Company TX & MN OnlyWR175 Hewlett Packard Company TX & MN Only22489 Highlands Insurance Co TX & MN Only

WR179 H Ch k MN O lWR179 Ho Chunk MN OnlyWR180 Hobby Lobby Stores, Inc. TX & MN OnlyWX104 Holly Farms Corp. TX & MN OnlyWR183 Home Depot Corporate TX & MN OnlyWZ909 Home Owners Insurance Company All StatesWR184 Honeywell TX & MN OnlyWZ202 Hortica Florist Mutual Insurance TX & MN OnlyWX105 Household Merch Nni TX & MN OnlyWC332 Housing Authority El Paso (TX) TX & MN OnlyWR901 Houston Hunters Patrol, Inc TX & MN OnlyWX106 Hughes Tool Company TX & MN OnlyWR200 Hurst-Euless-Bedford ISD TX & MN OnlyWR210 Hutchinson Area Healthcare Center MN OnlyWZ919 Hutchinson Technology All StatesWZ229 Hyatt Regency (Irvine) All StatesWZ227 Hyatt Regency (San Diego) All StatesWZ283 Hy-Vee, Inc TX & MN OnlyWR281 IBOCO Inc. MN OnlyWP976 ICW Group (NV Only) All StatesWA055 IDS Property Casualty Insurance Company All StatesWZ241 IFCO Systems (Wasco Only) All StatesWZ250 IL Fornaio (America) Corp All StatesWR315 Illinois National Insurance Co TX & MN OnlyWR318 Illinois Tool Works TX & MN OnlyWR319 Incstar Corporation MN OnlyWR323 Indemnity Insuarnce North America TX & MN Only



Payer ID Name StateWR375 Indiana Lumbermen-Indianapolis TX & MN Only14265 Indiana Lumbermens Mutual Insurnace Co TX & MN OnlyWZ670 Innovative Care Systems (ICS) (San Ramon ONLY) All StatesWZ281 Innovative Care Systems (ICS) (Torrance ONLY) All StatesWZ287 Insight Health Corp. All StatesWX107 Insilco Corp TX & MN Only22713 Insurance Co of North America TX & MN OnlyWZ291 Insurance Company of the West (ICW) All StatesWR376 Insurance Company State of Pennsylvania TX & MN OnlyWZ910 Integon National Insurance All StatesWR377 Integrity TX & MN OnlyWR379 Integrity Auto TX & MN OnlyWA059 Integrity Mutual Insurance Company All StatesWZ298 Intercare Insurance Services (Irvine) All StatesWX602 Intercare Insurance Services (Orange) TX & MN OnlyWR388 International Paper Company TX & MN OnlyWR394 Iowa Assigned Risk Plan MN OnlyWR395 Iowa Group 14 Assigned Risk Plan MN OnlyWX108 Irex Corporation TX & MN OnlyWX109 Ironworking Contract I.P. TX & MN OnlyWC327 J B Hunt Transport Inc. TX & MN OnlyWZ362 Jack In The Box (Chino) All StatesWZ359 Jack In The Box (Colton) All StatesWZ360 Jack In The Box (Escondido) All StatesWZ364 Jack In The Box (Milpitas) All StatesWZ365 Jack In The Box (Modesto) All StatesWZ363 Jack In The Box (Ontario) All StatesWZ366 Jack In The Box (Ontario) All StatesWZ358 Jack In The Box (Riverside) All StatesWZ361 Jack In The Box (San Bernardino) All StatesWZ357 J k I Th B (T ) All St tWZ357 Jack In The Box (Torrance) All StatesA0141 Jeld Wen Inc TX & MN OnlyWZ920 Jennie O Foods All StatesWR397 Jenny Craig TX OnlyWA044 JI Specialty Services TX OnlyWZ386 Jiffy Lube / Allied Lube All StatesWX110 Jones Truck Lines, Inc. TX & MN OnlyWX111 Juvenile Jail Facility Managem TX & MN OnlyWR436 Kaiser Foundation Health Plan TX & MN OnlyWX112 KCI Holdings USA TX & MN OnlyWZ441 Keenan & Associates (Rancho Cordova) All StatesWZ436 Keenan & Associates (Redwood City) All StatesWZ439 Keenan & Associates (Riverside) All StatesWZ438 Keenan & Associates (San Jose) All StatesWZ437 Keenan & Associates (Torrance) All StatesWZ926 Kemper UniTrin Auto and Home All StatesWZ925 Kemper UniTrin Safeguard Ins Company All StatesWX113 Ken Davis Industries Inc. TX & MN OnlyWR452 Kindred Healthcare TX & MN OnlyWR482 Kinetic Concepts, Inc. TX & MN OnlyWZ489 King's Seafood All StatesWC115 Klais & Co All StatesWZ494 K-Med Inc. All StatesWR601 Kohl's Department Stores Inc. TX & MN OnlyWP981 KRM Risk Mgmt Insurance Services All StatesWR643 Kroger Co. TX Only



Payer ID Name StateWZ520 L.A. County Sheriff (Lennox Station / Inglewood) All StatesWZ564 Laidlaw (#816) TX & MN OnlyWR647 Laidlaw International, Inc. TX & MN OnlyWZ565 Laidlaw Transit (#9095) TX & MN OnlyWZ592 Lamesa ISD All StatesWZ572 Lamonica's Pizza Dough All StatesWR648 Landmark Insurance Company TX & MN OnlyWX125 Landstar Bco Wc Program TX & MN OnlyWZ599 Lazar Landscape Design & Construction All StatesWZ602 LDI Mechanical All StatesWZ943 League of MN Cities All StatesWR651 League Of Mn Cities Insurance Trust MN OnlyWR675 Leech Lake Band Of Ojibwe MN OnlyWZ608 Lefco Sheet Metal All StatesWR676 Lender Processing Services TX & MN OnlyWR677 Lester Electrical MN OnlyWZ634 Liberty Mutual All StatesWB171 Liberty Mutual and all subsidaries (excludes UPS) All StatesWZ626 Liberty Mutual Fire Insurance Co All StatesWZ635 Liberty Mutual Insurance Co All StatesWZ671 Little Ceasar Enterprise All StatesWZ674 LivHOME All StatesWR678 LKQ Corporation TX Only11087 Lone Star National Ins. Co. TX & MN Only

WR679 Longhorn Linen TX OnlyWB124 Longs Drugs All StatesWR680 Lower Sioux Indian Community Jacpot Junction MN OnlyWB126 Lowe's All StatesWX127 Lsg Sky Chefs International TX & MN OnlyA0167 Lubbock ISD TX & MN Only22977 L b M t l C lt C TX & MN O l22977 Lumbermens Mutual Casualty Co TX & MN Only

WR681 Lumbermens Mutual Casualty Company TX & MN OnlyWR682 Lumbermens Under-Carrollton TX & MN OnlyWR683 MAC (Metro Airports Comm) MN OnlyWZ721 Macys (Daly City) All StatesWZ727 Macys (Newport Beach) All StatesWZ310 Macys Corporate Services MN OnlyWR684 MADA Insurance Exchange MN OnlyWR685 Maersk Inc. / APM Terminals of North America, Inc. TX & MN OnlyWR013 Magnetic Imaging Services, Inc. (MIS) All StatesWZ742 Mainstay Business Solutions (Folsom) All StatesWZ743 Mainstay Business Solutions (Irvine) All StatesWR686 Major League Baseball TX & MN OnlyWX149 Major League Baseball 8 TX & MN OnlyWR691 Manpower TX & MN OnlyWZ775 Maric College - Student Injury (Riverside) All StatesWZ776 Maric College - Student Injury (San Diego) All StatesWR726 Marriott Claims-Plano TX & MN OnlyWZ877 Marvin All StatesWR727 Marvin Lumber & Cedar Company MN OnlyWZ809 Mass Electric Co. All StatesWX501 Mater Dei High School Dioces All StatesWZ812 Matheson Fast Freight, Inc. All StatesWA045 Matrix Absence Management All StatesWC150 Matrix Absence Management (Albuquerque, NM) All StatesWX817 Matrix Absence Management (Austin, TX) All States



Payer ID Name StateWC148 Matrix Absence Management (Hawthorne, NY) All StatesWC147 Matrix Absence Management (Kailua, HI) All StatesWC146 Matrix Absence Management (Las Vegas, NV) All StatesWC145 Matrix Absence Management (Naperville, IL) All StatesWC144 Matrix Absence Management (Ontario, CA) All StatesWC143 Matrix Absence Management (Overland Park, KS) All StatesWC142 Matrix Absence Management (Owing Mills, MD) All StatesWZ203 Matrix Absence Management (Pennsburg, PA) All StatesWX857 Matrix Absence Management (Phoenix, AZ) All StatesWX855 Matrix Absence Management (Plant City, FL) All StatesWX853 Matrix Absence Management (Portland, OR) All StatesWZ816 Matrix Absence Management (Rancho Cucamonga, CA) All StatesWZ818 Matrix Absence Management (Sacramento, CA) All StatesWZ820 Matrix Absence Management (San Jose, CA) All StatesWX854 Matrix Absence Management (Wilmington, NC) All StatesWZ831 Mayesh Wholesale Florist, Inc. All StatesWR749 Mayo Clinic TX & MN OnlyWZ835 MBM Food Service All StatesWX155 Mc Donald'S-Mcopco TX & MN OnlyWZ836 McDonald's (Warmel) All StatesWR751 McGraw-Hill Companies TX OnlyWR760 MCIT TX & MN OnlyWX776 MCMC All StatesWZ927 Meadowbrook - Insured All StatesWZ929 Meadowbrook - ProCentury All StatesWZ928 Meadowbrook Century All StatesWR778 Meadowbrook Inc TX & MN OnlyWR779 Meadowbrook Meat Company, Inc. (MBM) TX & MN OnlyWZ594 Meadowbrook TPA Assoc. All StatesWR802 MeadWestvaco Corporation TX OnlyWR833 M di G l I TX & MN O lWR833 Media General, Inc. TX & MN OnlyWC117 Medical Administrators, Inc. All StatesWZ876 Medrisk All StatesWR843 Member Insurance Agency Inc. MN OnlyWA064 MEMIC Insurance All StatesWA062 Mendota Insurance Company All StatesWZ954 Menemsha Co All StatesWR847 Menominee Ind. Tribe of WI MN OnlyWC118 Mercy Work Solutions, Inc. All StatesWZ976 Mervyn's All StatesWZ973 Mervyn's #23 (Mt. View, CA) All StatesWZ974 Mervyn's #267(Mission Viejo, CA) All StatesWZ977 Mervyn's #601 (Sun Valley, CA) All StatesWZ975 Mervyn's #89 (San Diego, CA) All StatesWR890 Metropolitan Council TX & MN OnlyWA060 Metropolitan Property and Casualty Insurance Company All StatesWZ930 MIC General Insurance Corporation All StatesWZ931 MIC Property and Casualty Ins. Corp. All StatesWZ878 Michels Corporation All StatesWB137 Middlesex Insurance Company TXWX605 Midwest Drywall TX & MN OnlyWR892 Midwest Employers Casualty Company TX & MN OnlyWR907 Midwest Family Insurance Company MN OnlyWX909 Midwest Insurance All StatesWR002 Military Aircraft Rest. All StatesWR908 Millard Refrigerated Service (FT.Wort) TX Only



Payer ID Name StateWR910 Milwaukee Casualty Insurance Co TX & MN OnlyWZ879 Milwaukee Taxing Unit All StatesWR912 Minneapolis Park & Recreation Board MN OnlyWR913 Minneapolis Public Schools TX & MN OnlyWR914 Minnesota Grp 4 Assigned Risk Plan MN OnlyWR917 Minnesota Grp 68 Assigned Risk Plan MN OnlyWR919 Minnesota Grp 78 Assigned Risk Plan MN OnlyWR923 Minnesota Manufacturers Group Self-Insured Association MN OnlyWR924 Minnesota Masonic Homes MN OnlyWR925 Minnesota Nonprofits Employers MN OnlyWR926 Minnesota School Boards Assoc. MN OnlyWR927 Minnesota Soft Drink Assoc. MN OnlyWZ880 Missouri Employers Mutual All StatesWX159 Mitchell Energy & Devel TX & MN OnlyWR028 Mitsui Sumitomo Insurance Group All StatesWZ932 Mitsui Sumitomo Insurance USA Inc. All StatesWC116 MMAC (Managed Medical Asurance Co) All StatesWB127 Modern Fibers All StatesWZ881 Modern Service Casualty Insurance Company All StatesWR928 Monsanto Company TX & MN OnlyWC470 Montgomery County Texas TX & MN OnlyWB172 Montgomery Insurance (Liberty RAM) All StatesWX166 Morris Material Handling TX & MN OnlyWX216 Morrison Health Care, Inc. TX & MN OnlyWR929 Motor Club of Iowa Insurance Company MN OnlyWZ595 Mountain States Insurance All StatesWR930 MSI MN OnlyWR931 MSI MSMM (Richardson) TX & MN OnlyWZ882 MSI Preferred Insurance Company All StatesWR932 MSI Risk Manage (Richardson) TX & MN OnlyWR933 M ll W t P d t I TX & MN O lWR933 Mueller Water Products, Inc TX & MN Only36326 Multi-Plan All States

WX248 Munford, Inc. TX & MN OnlyWR934 Munich Re - Aaic-Britt/Paulk MN OnlyWR935 Munich Re - Wf Clayton Aaic MN OnlyWR938 Munich Re -Britt/Paulk Peslic MN OnlyWZ883 Mutual Service Casualty Insurance Company All StatesWR082 Mygrant Glass (Hayward) All StatesWR083 Mygrant Glass (Stockton) All StatesWX608 Nap Tools TX & MN OnlyWR940 Nash Finch Company TX & MN OnlyWZ607 National American Insurance Co All StatesWR949 National Casualty Company MN OnlyWR953 National Continental Insurance Company MN OnlyWZ933 National General Assurance Company All StatesWC169 National Interstate (TX) TX & MN OnlyWS044 National Loss ControL Service Corporatin TX & MN OnlyWC462 National Loss Prevention, Inc TX & MN OnlyWR099 National RV All StatesWR957 National Union Fire Insuarnce Company of Pittsburgh (PA) TX & MN OnlyWR959 Nationwide Affinity Ins Co MN OnlyWR987 Nationwide Affinity Insurance Company of America MN OnlyWR988 Nationwide Agribusine (Des Moines) TX & MN Only28223 Nationwide Agribusiness Insurance Co TX & MN Only

WR988 Nationwide Assurance MN OnlyWR988 Nationwide General Insurance Company MN Only



Payer ID Name StateWR988 Nationwide Indemnity Company MN OnlyWS036 Nationwide Ins Company of America MN OnlyWS038 Nationwide Insurance (G)ainesville TX & MN OnlyWS039 Nationwide Insurance (Harrisburg) TX & MN OnlyWS037 Nationwide Insurance Company of Florida MN OnlyWS040 Nationwide Lloyd's MN OnlyWS041 Nationwide Mutual Fire Company MN OnlyWS042 Nationwide Mutual Insurance Company MN OnlyWS043 Nationwide Property And Casualty Insurance Company MN OnlyWX156 NES Rentals All StatesWS045 Nestle USA TX & MN OnlyWS046 Nestle Waters North America TX & MN OnlyWS047 New Hampshire Insurance Company TX & MN OnlyWS048 NewPage Corporation TX OnlyWZ939 Nordstrom, Inc. All StatesWR134 North American Risk Services All StatesWS049 North American Specialty Insurance TX & MN OnlyWR135 North Cal Hauling All StatesWZ884 North Country Health All StatesWC136 North River Insurance Co of NJ TX & MN OnlyWB161 Northland Auto All StatesWR148 Northrop Grumman (Mcclellan) All StatesWS050 Northside ISD TX OnlyWZ646 Northwest Insurance All StatesWS051 Northwestern National Casualty TX & MN OnlyWX283 Norwood TX & MN OnlyWR152 Nova Pro Risk Solutions TX & MN OnlyWB107 NYSIF All StatesWR182 Octagon Risk Services (Long Beach) TX & MN OnlyWR173 Octagon Risk Services (Oakland) TX & MN OnlyWX354 O t Ri k S i (O ) TX & MN O lWX354 Octagon Risk Services (Orange) TX & MN OnlyWR177 Octagon Risk Services (Rancho Cordova - UR Dept) TX & MN OnlyWR178 Octagon Risk Services (Rancho Cordova) TX & MN OnlyWR181 Octagon Risk Services (Sacramento) TX & MN OnlyWR176 Octagon Risk Services (San Diego) TX & MN OnlyWR897 Octagon Risk Services (Van Nuys) TX & MN OnlyWS053 Office Depot TX & MN OnlyWS054 Ohio Casualty Insurance (Cincinnati) TX & MN OnlyWS055 Ohio Casualty Insurance (Fairfield) TX & MN OnlyWS056 Ohio Casualty Insurance (Raleigh) TX & MN OnlyWS057 Ohio Casualty Insurance (Voorhees) TX & MN OnlyWC119 Ohio Employee Health Partnership All StatesWZ885 Ohio Farmers All StatesWS058 Ohio Farmers Insurance Company TX OnlyWZ886 Old Guard All StatesWS059 Old Home Foods, Inc MN OnlyWX285 Old Republic Insurance Co (PA) TX & MN OnlyWS060 Old Republic Insurance Company TX & MN OnlyWC526 One Beacon TX & MN OnlyWB173 One Beacon (formerly CGU) All StatesWX287 Orica, Inc. TX & MN OnlyWS061 Owatonna Canning Company MN OnlyWS062 Owner Operator Services, Inc. (McDonald's) TX OnlyWZ887 Owners Insurance Company All StatesWS063 P.A.M. Transport, Inc. TX & MN OnlyA0191 Paccar Inc TX & MN Only



Payer ID Name StateWS064 PACIFIC EMPLOYERS INSURANCE COMPANY TX & MN OnlyWZ121 Pacific Motor Company All StatesWX289 Papa John's International Inc TX & MN OnlyWZ079 Paradigm All StatesWC120 Paramount Preferred Network All StatesWP871 Parker Hannifan All StatesWB128 Pathmark All StatesWB138 Patriot General Insurance Company TXWS065 PCA - Packaging Corporation of America TX & MN OnlyWB174 Peerless Insurance (Liberty RAM) All StatesWR344 Pegasus Risk Mgmt. All StatesWX295 Pegi-Family Dining TX & MN OnlyWR346 Peninsula Metal Fabrication All StatesWZ901 Penn Millers Insurance All StatesWB129 People 2.0 All StatesWS066 Pepsi Bottling Group TX & MN OnlyWS067 PepsiCo Inc. TX & MN OnlyWS068 PESTSURE ASSOCIATION TX & MN OnlyWS069 PetSmart Inc. TX OnlyWS070 Pharmacist Mutual TX & MN OnlyWZ934 Pharmacist Mutual Insurance Co. All StatesWS071 PHARMACISTS MUTUAL INS CO TX & MN OnlyWX298 Phh Fleetamerica TX & MN OnlyWR408 Piano Disc (Burgett, Inc.) All StatesWS072 Pilgrim's Pride Corporation TX & MN OnlyWZ888 Pioneer Specialties All StatesWS073 Pitney Bowes Inc. TX & MN OnlyWR441 PMA - Pennsylvania Manufacturing Associates All StatesWB175 PMA Insurance Group & PMA Management Corp All StatesWS074 Polaris TX OnlyWC137 P l A i LP TX & MN O lWC137 Poly America LP TX & MN OnlyWR449 Porsche Motorsport of North America All StatesWB139 Ppg Industries TXWS075 Prairie Island Ind. Comm. Dba Treasure Island Resort & Casino MN OnlyWS076 Precision Cast Parts TX & MN OnlyWX299 Preferred Employers TX & MN OnlyWX300 Preferred Employers Group TX & MN OnlyWC121 Premier Comp of Home Town Health Nework All StatesWC122 Premier Managed Care Services, Inc. All StatesWR469 Premier Staffing (Stockton) All StatesWS077 Presbyterian Homes & Services MN OnlyWZ046 Professional Claims Management All StatesWR503 Professional Tree Care Co All StatesWS080 Progress Casting MN OnlyWS081 Progressive Casualty Insurance Company MN OnlyWS082 Progressive Classic Insurance Company MN OnlyWS083 Progressive Commercial Casualty Company MN OnlyWS084 Progressive Direct Insurance Company MN Only24260 Progressive Insurance All States

WS085 Progressive Max Insurance Company MN OnlyWS086 Progressive Norrn Insurance Company MN OnlyWS087 Progressive Northwestern Insurance Company MN OnlyWS088 Progressive Preferred Insurance Company MN OnlyWS089 Progressive Premier Insurance Company of Illinois MN OnlyWS090 Progressive Specialty Insurance Company MN OnlyWZ889 Property Owners Insurance Company All States



Payer ID Name StateWR511 Protective Insurance All StatesWR132 Providence Property and Casualty All States24295 Providence Washington Insurance Co TX & MN Only

WS091 Prudential / Everst National Insurance TX & MN OnlyWS092 Public Storage TX & MN OnlyWS093 Quadrangle Group Self-Insurance Association MN OnlyWS094 Qwest Communications International Inc. TX & MN OnlyWS095 R E M (Dallas) TX OnlyWS097 R E M (Nashville) TX OnlyWZ890 RAM Mutual Insurance Company All StatesWX301 Rampart Insurance Company TX & MN OnlyWR576 Randstad North America (Riverside) All StatesWS098 Range Regional Health Services MN OnlyWZ613 Ranger Insurance Co All StatesWR585 RBI Framing, Inc. All StatesWS099 RCI MN OnlyWX049 Red Lake Band Of Chippewa Ind. MN OnlyWC302 Red Oak Independent School District TX & MN Only24449 Regent Insurance Co TX & MN Only

WX050 Reliance Insurance Company TX & MN OnlyWX055 Reliance National Indemnity TX & MN OnlyWX062 Reliance Planet Insurance Company TX & MN OnlyWX121 Rem Group Workers Compensation Association MN OnlyWX158 Rentokil Initial TX & MN OnlyWP746 Republic Franklin Insurance TX & MN OnlyWR618 Republic Indemnity All StatesWZ620 Republic Western Ins. Co All StatesWB022 Rescare, Inc. All StatesWX302 Residential Services Group TX & MN OnlyWX303 Restaurant Reinsurance Limited TX & MN OnlyWX162 R H ldi LLC TX & MN O lWX162 Reyes Holdings LLC TX & MN OnlyWX311 Rhone-Poulenc,Inc. TX & MN OnlyWX186 Ridgeview Medical Center MN OnlyWX314 Rieth-Riley Construction Compa TX & MN OnlyWX204 RIO TINTO TX & MN OnlyWX235 Riscomp Industries Inc MN OnlyWR645 Risk Enterprise Management All StatesWX325 Risk Transfer Technologies, Inc. TX & MN OnlyWX238 Riverport - Great Divide MN OnlyWX354 Riverport Insurance Company P & C MN OnlyWX355 Riverport Insurance Company WC MN OnlyWP868 Road Carriers W&P Funds - Local 707 (NY) All StatesWX356 Roadlink USA TX & MN OnlyWR671 Robert Half International Inc. All StatesWR674 Robertson's Ready Mix Co All StatesWX361 Rochdale Insurance Company TX & MN OnlyWR694 Rochester Midland Corp All StatesWX377 Rochester Public Schools MN OnlyA0211 Rockwell Automation Inc TX & MN OnlyWX378 Rollins, Inc TX OnlyWX380 Rosemount Inc. MN OnlyWX397 Ross Stores, Inc. TX & MN OnlyWC463 Roth Staffing Companies TX & MN OnlyWX640 Roto-Rooter Services Company TX OnlyWR710 Roy Jorgensen & Associates All StatesWR713 Royal Ambulance All States



Payer ID Name StateWX641 Royal Caribbean Cruise Lines TX & MN Only24678 Royal Indemnity Co TX & MN Only

WX642 Royal Indemnity Company TX & MN Only26980 Royal Insurance Co of America TX & MN Only

WX643 Royal Insurance Company of America TX & MN OnlyWX326 RSC Insurance Services, Ltd. TX & MN OnlyJ1202 RTW All States

WR731 Ryder Services All StatesWR733 S & T Engineering, Inc. All StatesWA063 Sabago Brewing Company All StatesWX646 SABIC TX & MN OnlyWR746 Safeco All StatesWR745 Safeco Insuarnce (Seattle, WA) All StatesWR747 Safeco Insurance (Indianapolis, IN) All StatesWR750 Safeco Insurance (Mission Viejo, CA) All StatesWR748 Safeco Insurance (Santa Ana, CA) All States11123 Safety First Insurance Co TX & MN Only

WX647 Safety National TX & MN Only15105 Safety National Casualty Corp TX & MN Only

WX327 Safety-Kleen Corporation TX & MN OnlyWX648 Safey-Keen Corporation TX OnlyWR765 Salvation Army (Adult Rehab Cntr) All StatesWR767 Salvation Army (Sam Jose, CA) All StatesWR766 Salvation Army (San Bernandino, CA) All StatesWR768 Salvation Army (Stocton, CA) All StatesWR821 Savers (San Jose) All StatesWX649 Scherer Brors Lumber Company MN OnlyWX650 Schertz/Cibolo/Universal City ISD TX & MN OnlyWX328 Schlumberger Technology TX & MN OnlyWR839 SCIF (State Copensation Insurance Fund) All StatesWP150 S tt Mi l G C TX & MN O lWP150 Scotts Miracle-Gro Company TX & MN OnlyWX700 Scottsdale Indemnity Company MN OnlyWX720 Scottsdale Insurance Company MN OnlyWX723 Scottsdale Surplus Lines Insurance Co MN OnlyWX724 SD - Monoline MN OnlyWX725 Seabright / Total Health Manager TX OnlyWR862 Seabright Insurance (CA) All StatesWZ942 Seabright Insurance (Others) All StatesWR861 Seabright Insurance (WA) All StatesWX727 Sears Holdings Corporation MN OnlyWX728 Seaton Corporation-Chicago MN OnlyWZ082 SECURA Insurance A Mutual Company All StatesWX754 Secura Insurance Company TX OnlyWX840 Security Insurance Company of Hartford TX & MN OnlyWX865 Security National Insurance Company TX & MN OnlyWX867 Sedgwick Claims Management Services, Inc TX & MN OnlyWB176 Sedgwick Claims Management Services, Inc. (TPA) All StatesWX868 Sedgwick Claims Mgmt-Dallas TX OnlyWX910 Sedgwick Claims Mgmt-Memphis TX OnlyTP097 Sedgwick CMS TX & MN OnlyWR921 Select Build (#8830) All StatesWZ099 Selective Insurance TX & MN OnlyWB163 Sentry Auto All StatesWB140 Sentry Casualty Company TXWB141 Sentry Insurance A Mutual Company TXWB142 Sentry Lloyds Of Texas TX



Payer ID Name StateWB143 Sentry Select Insurance Company TXWZ638 Service Lloyds Insurance Co All StatesWR967 Servicon Systems, Inc. All StatesWX914 Shafer Contracting Co. MN OnlyWX930 Shakopee Mdewakaton/Mystic Lake MN OnlyWR972 Shark Trans Inc All StatesWB130 Shaws / StarMarket All StatesWC123 Sheakley UniComp All StatesWX931 Sherwin Williams Company TX OnlyWX964 SISF MN OnlyWZ033 Skilled Healthcare, LLC TX OnlyWZ122 SkyWest Airlines/Atlantic Souast Airlines TX OnlyWZ149 SMARCA MN OnlyWZ268 Smart & Final TX OnlyWX329 Snap-On Incorporated TX & MN OnlyWX330 Solvay America Inc TX & MN OnlyWZ280 Sompo Japan Insuarnce Company of America TX & MN Only11126 Sompo Japan Insurance Co of America TX & MN OnlyWZ300 Sourn Minnesota Beet Sugar Cooperative MN OnlyWP060 South Coast Repertory All StatesWZ326 South Dakota Group 1 Assigned Risk Plan MN OnlyWZ378 South Dakota Group 40 Assigned Risk Plan MN OnlyWZ511 South San Antonio ISD TX OnlyWB177 Southeastern Claims Services Inc. (SCS) All StatesWZ891 Southern Owners Company All StatesWP071 Southgate Engineering All StatesWZ617 Spansion Inc. TX & MN OnlyWZ618 Specialty Claims-N Little Rock TX OnlyWP090 Specialty Risk Services (SRS) All StatesWZ619 Spherion Corporation TX & MN OnlyWZ621 St M D l th Cli i MN O lWZ621 St Marys Duluth Clinic MN Only24767 St Paul Fire & Marine Insurance Co TX & MN Only24783 St Paul Insurance Co TX & MN OnlyWZ622 St. Joseph's Medical Center MN OnlyWZ623 St. Paul Fire & Marine Insurance Company TX & MN OnlyWZ297 STANDARD FORWARDING CO TX & MN OnlyWB023 Stanley Works, Inc. All StatesWX331 Stant Corporation TX & MN OnlyWP193 State Compensation Insurnace Fund (Los Angeles, CA) All StatesWP189 State Compensation Insurnace Fund (Pinedale) All StatesWP199 State Compensation Insurnace Fund (State Contracts) All StatesWP203 State Compensation Insurnace Fund (Suisun City) All StatesWZ624 State Farm Insurance (Non-Auto Only) TX OnlyWZ892 State Fund Mutual Insurance All StatesWZ893 State of Minnesota - DOER All StatesWZ894 State of Wisconsin All StatesWB125 State Office of Risk Management TX OnlyWB131 Strategic Outsourcing Inc All StatesWP245 Sua Insurance Co. All StatesWP250 Sullivan Stone Factory All StatesWZ625 Sumitomo Marine & Fire Insurance Company TX & MN OnlyWB156 Summit All StatesWX332 Summit Health Ltd TX & MN OnlyWP260 Sun Optics Skylights All StatesWZ627 Sunrise Senior Living Inc. TX OnlyWZ628 Sunshine Laundry, Inc. TX & MN Only



Payer ID Name StateWZ629 Supermarket Grp. Self-Insur. Assoc. MN OnlyWB132 SuperValu All StatesWB178 SWIF (State Workers Insurance Fund) All StatesWX333 Swift Transportation TX & MN OnlyWP324 T.X.I. River Cement All StatesWX670 Tansguard Insurance Company of America All StatesWP335 Target Corporate (WC Only) All StatesWZ630 Target Corporation (Auto Only) TX OnlyWZ631 TC / American Monorail, Inc. MN OnlyWZ632 Technology Insurance Co TX & MN OnlyWP352 Tecnico Corporation All StatesWA047 Texas A&M (TAMU) All StatesWZ633 Texas Association of Counties (TAC) TX & MN OnlyWR902 Texas Association of School Boards TX & MN OnlyWZ643 Texas Builders Insurance Co All StatesWC138 Texas Construction Trust TX & MN OnlyWC139 Texas Cotton Ginners Trust TX & MN OnlyWR891 Texas Cotton Ginners' Trust TX & MN OnlyWZ645 Texas Hospital Insurance Exchange All StatesWZ636 Texas Hospital Insurance Exchange TX & MN OnlyWA048 Texas Municipal League Intergovernmental Risk Pool (TML) TX & MN OnlyWX606 Texas Mutual Insurance (All Other States) All StatesA0234 Texas Mutual Insurance (Texas only) All StatesWX334 Texas Small Business Pool TX & MN OnlyWZ640 Texas Sonic Employers Trade Association TX OnlyA0248 Textron Inc TX & MN OnlyWZ084 The Builders Group of MN All StatesWZ935 The Cincinnati Casualty Company All StatesWZ936 The Cincinnati Indemnity Company All StatesWZ937 The Cincinnati Insurance Company All StatesWB144 Th Di l C ti TXWB144 The Dial Corporation TXWC124 The Health Plan All StatesWX616 The Reny Company TX & MN OnlyWP393 The Rouse Company All StatesWB134 The Salvation Army All StatesWX357 The Scotts Company TX & MN OnlyWA052 The Zenith All StatesWB179 The Zenith All StatesWC203 Thro Company MN OnlyWZ641 TI Automotive TX & MN OnlyWZ642 Tidewater Marine Western All StatesWZ662 TIG American Specialty Insurance Co All StatesWZ642 TIG Claims MN OnlyWZ648 TIG Insurance Co of Texas All StatesWZ644 TIG Insurance Company TX & MN OnlyWX123 TIG Insurance -Transamerica TX & MN OnlyWZ661 TIG Premier Insurance Co All StatesWP409 Timeworks, Inc. All StatesWZ647 Titan Indemnity Co MN OnlyWZ895 TMC Transportation All StatesWX365 Total Petroleum, Inc. TX & MN OnlyWZ308 Tower Group Inc. MN OnlyWZ014 Tower National Insurance Co All StatesWP443 Toyota (San Diego, CA) All StatesWZ706 Toyota Motor Sales, USA., Inc. TX Only21237 TPCIGA for Casualty Reciprocal Exchange TX & MN Only



Payer ID Name State24422 TPCIGA for Legion Insurance Co TX & MN Only24457 TPCIGA for Reliance Insurance Co TX & MN Only24430 TPCIGA for Reliance National Indemnity TX & MN Only40592 TPCIGA for Reliance National Insurance Co TX & MN Only

WC140 TPS Joint Self Insurance Fund TX & MN OnlyWZ720 Trade Contractors Assoc. MN Only20486 Transcontinental Insurance Co TX & MN Only20494 Transportation Insurance Co TX & MN Only

WB162 Travelers Auto All StatesWZ720 Travelers Casualty and Surety Company TX & MN OnlyWZ813 Travelers Indemnity TX & MN OnlyWP467 Travelers Insurance All StatesWZ814 Travis County TX OnlyWZ815 Trinity Universal Insurance Company TX & MN OnlyWZ819 Tri-State Ins Co MN OnlyWP509 Triumph Structures - Los Angeles All StatesWP511 Troon Golf All StatesWZ819 Twin City Freight, Inc. MN OnlyWZ821 TXI TX OnlyWZ822 Tyco Electronics TX & MN OnlyWZ830 Tyco International LTD TX & MN OnlyWB145 UFP Insurance TX37893 Ulico Casualty Co TX & MN OnlyWZ830 Ulico Insurance-Jacksonville TX OnlyWZ947 UMI Company, Inc. TX OnlyTP108 Underwriter's Safety & Claims TX & MN OnlyWA049 Underwriters Safety and Claims All StatesWP560 Unicco Service Corp. All StatesWB158 Unimed – AmCOMP All StatesWB184 Unimed - AmCOMP (LIMITED) All StatesWB157 U i d A i Fi t All St tWB157 Unimed - America First All StatesWB159 Unimed - City of Carrollton/TriStar All StatesWB160 Unimed - International Solutions All StatesWB223 Unimed Direct, Inc. (LIMITED) All StatesWZ948 Uninsured Employers Fund TX OnlyWZ896 Union Construction Workers' Comp Program All StatesWC141 Union Insurance Co TX & MN OnlyWZ455 Union Insurance Company of Providence TX & MN OnlyWC155 Union Standard Insurance Company TX & MN OnlyWZ957 Unisource Worldwide Inc TX & MN OnlyWZ962 United Components, Inc. TX OnlyWP128 United Dominion Realty Trust TX & MN OnlyWZ969 United Financial Casualty Company MN OnlyWZ997 United Fire TX & MN OnlyWA001 United Fire & Auto TX & MN OnlyWA002 United Pacific Insurance TX & MN OnlyWX420 United States Cold Storage TX & MN OnlyWA003 United States Fidelity & Guaranty Company TX & MN OnlyWP582 United States Fire Insurance Co TX & MN OnlyWX956 United Wisconsin Insurance Company All StatesWA004 UnitedHealth Group TX & MN OnlyWX157 Unitrin Business Insurance TX & MN OnlyWA061 Unitrin Direct Property & Casualty Company All StatesWC125 Univeristy CompCare All StatesWB146 Universal Forest Products TXWA005 Universal Health Services TX Only



Payer ID Name StateWP597 Universal Smart Comp All StatesA0261 University Medical Center TX & MN OnlyWA006 University of Minnesota MN OnlyWA007 Upper Lakes Foods MN OnlyWA008 Upper Sioux Indian Reservation Tribal Council - Prairie'S Edge Casino Resort MN OnlyWA009 URS Corporation TX & MN OnlyWB180 US Airways (Philadelphia Hub Based Employees Only) All StatesWX450 US Foodservice, Inc. TX & MN OnlyWX489 US National Resources (Aigrm) TX & MN OnlyWX945 US Precision Sheet Metal Inc. (First Aid Claims ONLY) All StatesWP635 USAA All StatesWB192 USC - CBS Companies (LIMITED) All StatesWB194 USC - CompServices, Inc. (LIMITED) All StatesWB199 USC - Employers Insurance (LIMITED) All StatesWB200 USC - FCCI (LIMITED) All StatesWB203 USC - Guarantee Insurance (LIMITED) All StatesWB205 USC - Insurance Company of the West (LIMITED) All StatesWB206 USC - InterCare (LIMITED) All StatesWB211 USC - Ohio Casualty Group - Fairfield (specialty) (LIMITED) All StatesWB217 USC - St. Tammy Parish School Board (LIMITED) All StatesWB221 USC - Tristar (LIMITED) All StatesWB222 USC - UPS - only Physical Therapy Bills (LIMITED) All StatesWB201 USC Firstier Administrators (LIMITED) All StatesWB183 USC-Accent (LIMITED) All StatesWB185 USC-Amerihealth Insurance Co. (LIMITED) All StatesWB186 USC-Attenta (LIMITED) All StatesWB187 USC-Babb Absence Management Services (LIMITED) All StatesWB190 USC-Cambridge - Genex (LIMITED) All StatesWB191 USC-Cambridge Integrated Services (LIMITED) All StatesWB193 USC-Chesterfield Services (LIMITED) All StatesWB195 USC C f d d C (LIMITED) All St tWB195 USC-Crawford and Company (LIMITED) All StatesWB196 USC-Cunningham Lindsey (LIMITED) All StatesWB197 USC-Dallas National Insurance (LIMITED) All StatesWB198 USC-Eastern Alliance Insurance Group (LIMITED) All StatesWB202 USC-Furmanite (LIMITED) All StatesWB204 USC-Harbor America (LIMITED) All StatesWB207 USC-InServco (LIMITED) All StatesWB208 USC-Kemper Insurance Company (LIMITED) All StatesWB209 USC-Odyssey One Source (LIMITED) All StatesWB210 USC-Ohio Casualty Group - Cincinnati (LIMITED) All StatesWB212 USC-Ohio Casualty Group - Lombard (LIMITED) All StatesWB213 USC-Ohio Casualty Group - Raleigh (LIMITED) All StatesWB214 USC-Ohio Casualty Group - Voorhees (LIMITED) All StatesWB215 USC-Penn National (LIMITED) All StatesWB216 USC-Rising Medical (LIMITED) All StatesWB218 USC-Secura Insurance-Appleton (LIMITED) All StatesWB219 USC-Staff Force (LIMITED) All StatesWB220 USC-TNT Staffing (LIMITED) All StatesWB224 USC-Valleon (LIMITED) All StatesWB225 USC-Wal Mart (LIMITED) All StatesWP637 Use Credit Union All States43478 Utica Mutual Insuarnce Co of Texas TX & MN Only

WA010 Utica Mutual Insurance Company TX & MN Only20508 Valley Forge Insurance Co TX & MN Only21172 Vanliner Insurance Co TX & MN Only

WA051 Vanliners Insurance Company All States



Payer ID Name StateWC126 Vantage Occupational Health Plan All StatesWP676 Varsity Contractors All StatesWA011 Veolia Environmental Services TX & MN OnlyWA012 Verizon Communications TX & MN OnlyWA013 Verizon Wireless TX & MN OnlyWZ307 Vermeer Mfg. Company TX & MN OnlyWA014 Verso Paper Holdings LLC MN OnlyWZ278 Viad Corp MN OnlyWX495 Vicorp Restaurants, Inc. TX & MN OnlyWA015 Victoria Firs & Casualty Company MN OnlyWA016 Victoria Select Insurance Company MN OnlyWA017 Victoria Specialty Insurance Company MN OnlyWP717 Viking Fabrication - Norther CA All StatesWP755 Viking Fabrication - Southern CA All StatesWA018 Virginia Regional Medical Center MN OnlyWA019 Virginia Surety - Minnesota Division MN OnlyWZ067 Virginia Surety Company, Inc. All StatesWP734 Vista Paint Corp All StatesWP738 Vitas Healthcare (Camarillo) All StatesWP739 Vitas Healthcare (Orange County) All StatesWP740 Vitas Healthcare (Sacramento) All StatesWP744 Volt Services Group All StatesWP754 Vons / Safeway All StatesWB024 Vought Aircraft Industries All StatesWP764 W.S. Dodge Oil Company All StatesWA020 Wachovia (Wells Fargo effective 1/1/09) TX & MN OnlyWA021 Walgreen Co TX & MN OnlyWA022 Walker Methodist, Inc. MN OnlyWA050 Wal-Mart Corporate TX & MN OnlyWP790 Washington Mutual All StatesWA023 W TX & MN O lWA023 Wausau TX & MN OnlyWB181 Wausau All StatesWZ637 Wausau Insurance All StatesWA024 Wells Fargo TX & MN OnlyWA025 Werner Enterprises TX & MN OnlyWA026 Wesco Insurance Company TX & MN OnlyWZ081 West Bend Mutual Insurance Co. All StatesWP831 Westaff (Carlsbad) All StatesWP832 Westaff (Inland Empire) All StatesWP833 Westaff (Oxnard) All StatesWP834 Westaff (Sacramento) All StatesWA027 Western Agricultural Insurance Company MN OnlyWP845 Western Electrical Contractors Assn All StatesWZ897 Western National Assurance All StatesWZ898 Western National Mutual All StatesWZ899 Westfield All StatesWZ900 Westfield National All StatesA0276 Weyerhaeuser Co TX & MN OnlyWA028 White Earth Reservation Tribal Council MN OnlyWA029 White Earth Rtc-Shooting Star Casino MN OnlyWB135 Williams & Sonoma All StatesWZ309 Wilson Mutual Insurance MN & WI OnlyWA030 Winn-Dixie TX OnlyWA031 Winona Health MN OnlyWA032 Winona Knitting Mills MN OnlyWA033 Wisconsin Assigned Risk Plan MN Only



Payer ID Name StateWP893 Woodland Farms All StatesWX515 Wyman-Gordon Companies TX & MN OnlyWZ918 Xcel Energy All StatesWZ277 Xchanging - SPX Corporation MN OnlyWR841 Xchanging, Inc. (formerly Cambridge Integrated Services Group) All StatesWA034 Xerox Corporatn TX & MN OnlyWP872 Xl Environmental, Inc. TX & MN OnlyWA035 XL Insurance America, Inc. TX & MN OnlyWA036 XL Specialty Insurance Company TX & MN OnlyWX778 York Claim Services All StatesWA037 Young America Corporation MN OnlyWP921 Zachry Construction All StatesWP925 Zebra Technologies All States13269 Zenith Insurance Co (Texas ONLY) TX & MN Only

WA038 Zenith Insurance Company TX & MN Only30120 Znat Insurance All StatesWB182 Zurich (LIMITED) All StatesWA039 Zurich American Insurance Company TX & MN OnlyWA040 Zurich American of Illinois TX & MN OnlyWC163 Zurich Farmers TX & MN OnlyWP954 Zurich Insurance N.A. TX & MN Only



All States Workers Comp Payer List - Office Ally Comp... · Revised 5/17/2010. Payer ID Name State ... (San Jose, CA) TX & MN Only WC540 AT&T ... WX167 Center for Employee Training

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