Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2691 X A.B.S. BANKERS PO BOX 37511 OAK PARK MI 48237 98999 0248 X A.B.S. BANKERS CLAIM SER. PO BOX 37504 OAK PARK MI 48237 98999 1275 X AAA MI REVIEW DOF 443 PO BOX 26260 SAN DIEGO CA 921960260 98999 0803 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1311 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1318 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1348 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1507 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1522 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1705 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1744 X AAA MI REVIEW UNIT DOF 44 PO BOX 2946 CLINTON IA 52733 98999 1831 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 1981 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 2007 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 2417 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 2418 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 2598 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 2943 X AAA MI REVIEW UNIT DOF 44 PO BOX 26260 SAN DIEGO CA 921960260 98999 0198 X AARP CLAIM UNIT OBRA PO BOX 740819 GA 303740819 98999 2178 X AARP CLAIMS UNIT PO BOX 740819 ATLANTA GA 303740819 98999 0404 X AARP PRUDENTIAL CLAIMS PO BOX 740819 ATLANTA GA 303740819 36273 E AARP UNITEDHEALTHCARE ALL CLAIM OFFICE ADDRESSES 98999 2816 X ABS BANKERS PO BOX 37504 OAK PARK MI 48237 98999 1484 X ACCIDENT FUND OF MICHIGAN 232 S CAPITOL AVE LANSING MI 48901 98999 1581 X ACCIDENT FUND OF MICHIGAN PO BOX 40790 LANSING MI 48901 87815 E ACCORDIA NATIONAL ALL CLAIM OFFICE ADDRESSES 98999 2970 X ACEC HEALTHPLAN SERVICES PO BOX 44109 LAS VEGAS NV 89116 98999 2202 X ACTION INDUSTRIES PO BOX 1627 TUPELO MS 38802 98999 1449 X ADMIN SERVICE CONSULTANT 213 STANFORD PK FINDLAY OH 45840 98999 0289 X ADMIN SERVICE CONSULTANTS PO BOX 928 FINDLAY OH 45839 98999 2183 X ADMIN SYSTEMS RESEARCH PO BOX 6392 GRAND RAPIDS MI 49516 38265 E ADMIN SYSTEMS RESEARCH AS ALL CLAIM OFFICE ADDRESSES 98999 0924 X ADMINISTRATION SYSTEMS PO BOX 6392 GRAND RAPIDS MI 48506 98999 1452 X ADMINISTRATIVE SERVICES 215 STANFORD PK FINDLAY OH 45840 98999 2601 X ADOPTION SUBSIDY PROGRAM PO BOX 30037 LANSING MI 48909

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 0957 X ADULTCARE PO BOX 6910 CANTON OH 44706 98999 2750 X ADVANCED INSURANCE ADMIN 1525 MERRILL STE 2000 LITTLE ROCK AR 72211 25133 0003 E ADVANTRA FREEDOM ALL CLAIM OFFICE ADDRESSES 25152 E ADVANTRA FREEDOM ALL CLAIM OFFICE ADDRESSES 60054 NOCD E AETNA ALL CLAIM OFFICE ADDRESSES 98999 1387 X AFLAC 1932 WYNNTON ROAD COLUMBUS GA 31999 98999 1354 X ALEXIS CORP. SERVICE 17187 NORTH LAUREL PARK DR LIVONIA MI 48152 37308 E ALLIED BENEFIT SYSTEMS ALL CLAIM OFFICE ADDRESSES 98999 1464 X ALLIED BENEFIT SYSTEMS 208 S LASALLE STE 1300 IL 60604 98999 1927 X ALLSTATE 6200 HAGGERTY RD CANTON MI 48187 98999 2747 X ALLSTATE 7200 W SAGINAW HWY LANSING MI 48917 98999 0742 X ALLSTATE CLAIMS OFFICE PO BOX 380 FLINT MI 48501 98999 1736 X ALLSTATE INS CO 37650 GARFIELD MT CLEMENS MI 48043 98999 2817 X ALLSTATE INS. CO. PO BOX 85690 WESTLAND MI 48185 98999 1674 X ALLSTATE INSURANCE CO 3200 EAGLE PARK DR. NE GRAND RAPIDS MI 49505 98999 2619 X ALLSTATE INSURANCE COMP. 100 GALLERIA STE 300 SOUTHFIELD MI 48034 25133 0001 E ALTA HEALTH STRATEGIES ALL CLAIM OFFICE ADDRESSES 98999 1472 X AMERA PLAN 3001 W BIG BEAVER #320 TROY MI 48084 34187 E AMERICAN BENEFIT MANAGEME ALL CLAIM OFFICE ADDRESSES 98999 0720 X AMERICAN BENEFITS MANAGE PO BOX 35008 CANTON OH 44735 60305 E AMERICAN COMMUNITY MUT IN ALL CLAIM OFFICE ADDRESSES 98999 0409 X AMERICAN EXECUTICE ASSOC PO BOX 141700 GRAND RAPIDS MI 49514 98999 2869 X AMERICAN FMLY HLTHCARE NE 6000 AMERICAN PKWY MADISON WI 53783 98999 0177 X AMERICAN INTERNATIONAL PO BOX 25050 WILMINGTON DE 19899 81400 E AMERICAN MEDICAL SECURITY ALL CLAIM OFFICE ADDRESSES 60739 E AMERICAN NATIONAL INS CO ALL CLAIM OFFICE ADDRESSES 98999 0170 X AMERICAN NATIONAL INS CO PO BOX 1520 GALVESTON TX 77553 44444 NOCD E AMERICAN POSTAL WORKERS U ALL CLAIM OFFICE ADDRESSES 42011 E AMERICAN REPUBLIC INS CO ALL CLAIM OFFICE ADDRESSES 98999 2822 X AMERICAN STATES INS. CO. PO BOX 299 SOUTHFIELD MI 48037 98999 2924 X AMERICAN WHOLE HLTH NETWO PO BOX 503 HARTLAND WI 53029 54763 E AMERIHEALTH ADMINISTRATOR ALL CLAIM OFFICE ADDRESSES 98999 1427 X AMERISURE COMPANIES PO BOX 116 GRAND RAPIDS MI 49501 98999 0516 X AMERISURE COMPANIES PO BOX 2060 FARMINGTON HILL MI 48333 98999 0202 X AMERISURE INSURANCE COMP. PO BOX 116 GRAND RAPIDS MI 49501

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BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 2 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 0010 X AMICA 900 VICTORS WAY ANN ARBOR MI 48106 98999 2898 X AMO BENEFIT PLAN PO BOX 35 DANIA FL 33004 38254 E AMWAY CORPORATION ALL CLAIM OFFICE ADDRESSES 75278 E ARKANSAS BEST CORPORATION ALL CLAIM OFFICE ADDRESSES 98999 2422 X ASO NORTH AMERICA INDIANA PO BOX 8311 FORT WAYNE IN 46898 98999 2228 X ASR CLAIM MASTER PLUS PO BOX 6392 GRAND RAPIDS MI 49516 98999 2229 X ASSOC BUILD CONTR PO BOX 1273 GRAND RAPIDS MI 49501 98999 2876 X ASSOC. FOR HLTH CARE INC. PO BOX 981 BROOKFIELD WI 53008 36326 E ASSOCIATES FOR HEALTHCARE ALL CLAIM OFFICE ADDRESSES 39065 0002 E ASSURANT HEALTH ALL CLAIM OFFICE ADDRESSES 98999 0318 X ASU RISK MANAGEMENT PO BOX 0077 OKEMOS MI 48805 98999 2230 X ATLANTA LIFE INS CO 30755 BARRINGTON MADISON HEIGHTS MI 48071 98999 0794 X ATWOOD GRP. BENE. PLAN PO BOX 4509 ROCKFORD IL 61110 98999 0671 X AUTO OWNERS PO BOX 30660 LANSING MI 48909 98999 0789 X AUTO OWNERS INS PO BOX 4480 TROY MI 48099 98999 1502 X AUTO OWNERS INSURANCE CO 2401 EAST PARIS, SE GRAND RAPIDS MI 49508 98999 0249 X AUTOMATED BENEFIT SERV PO BOX 37511 OAK PARK MI 48237 98999 0736 X AUTOMATED BENEFIT SERV PO BOX 37506 OAK PARK MI 48237 38259 E AUTOMATED BENEFIT SERVICE ALL CLAIM OFFICE ADDRESSES 98999 MI12 X AUTOMATED BENEFIT SERVICE 8220 IRVING STERLING HEIGHT MI 48312 98999 2885 X AUTOMATED BENEFIT SVS. IN PO BOX 37705 OAK PARK MI 48237 98999 2009 X BABB INC 850 RIDGE AVENUE PITTSBURGH PA 152126095 98999 2953 X BAKERY CONFECTIONARY 10401 CONNECTICUT AVENUE KENSINGTON MD 20895 98999 1814 X BANKERS LIFE 000045 4444 W LAWRENCE AVE CHICAGO IL 60630 98999 2920 X BANKERS LIFE AND CASUALTY PO BOX 66927 CHICAGO IL 60666 98999 1101 X BANKERS LIFE CASUALTY COM PPOM PO BOX 37504 OAK PARK MI 48237 98999 2921 X BANKERS LIFE INS CO OF IL 222 MERCHANDISE MART PLAZA CHICAGO IL 606542001 74227 0001 E BANKERS UNITED LIFE ALL CLAIM OFFICE ADDRESSES 94156 0001 E BAY AREA FOUNDATION ALL CLAIM OFFICE ADDRESSES 98999 2879 X BEECH STREET CORP PO BOX 853925 RICHARDSON TX 75085 95377 E BEECH STREET CORPORATION ALL CLAIM OFFICE ADDRESSES 98999 2433 X BENEFIT ADMIN 17475 JOVANNA DR SUITE 18 HOMEWOOD IL 60430 98999 1044 X BENEFIT ADMIN OF AMERICA PO BOX 9120 DES MOINES IA 50306 98999 0294 X BENEFIT ASSISTANCE CORP PO BOX 950 HURRICANE WV 255260950 51037 E BENEFIT CONCEPTS ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2956 X BENEFIT COORDINATORS CORP 111 RYAN COURT SUITE 300 PITTSBURGH PA 15205 98999 2434 X BENEFIT MANAGEMENT CORP PO BOX 269000 WESTON FL 333269000 37118 E BENEFIT PLAN ADM ROANOKE, ALL CLAIM OFFICE ADDRESSES 74223 E BENEFIT PLANNERS INC. ALL CLAIM OFFICE ADDRESSES 98999 1478 X BENEFIT SOURCE INC PO BOX 240 MONROE MI 48161 36342 E BENEFIT SYSTEMS AND SERVI ALL CLAIM OFFICE ADDRESSES 98999 0283 X BENEFIT SYSTEMS, INC. PO BOX 80447 INDIANAPOLIS IN 46280 61425 0005 E BENEFIT TRUST ALL CLAIM OFFICE ADDRESSES 61425 0001 E BENEFIT TRUST INSURANCE ALL CLAIM OFFICE ADDRESSES 61425 0003 E BENEFIT TRUST LIFE ALL CLAIM OFFICE ADDRESSES 61425 0002 E BENEFIT TRUST LIFE INS ALL CLAIM OFFICE ADDRESSES 61425 0006 E BENEFIT TRUSTS ALL CLAIM OFFICE ADDRESSES 98999 2886 X BENEFITS ADMIN. SERVICES PO BOX 4509 ROCKFORD IL 61110 98999 2436 X BENEFITS SERVICES INC PO BOX 4138 AKRON OH 44321 98999 0402 X BENEPLAN STRATEGIES INC PO BOX 1391 DAYTON OH 45401 87265 E BENESIGHT THE TPA ALL CLAIM OFFICE ADDRESSES 98999 2437 X BENTELER SCREENING EXAMS 9000 E MICHIGAN AVE GALESBURG MI 49053 98999 0221 X BOA INSURANCE PO BOX 20945 COLUMBUS OH 43220 98999 2888 X BOARD OF PENSIONS PO BOX 13896 PHILADELPHIA PA 19101 36609 E BOILERMAKERS NAT'L HEALTH ALL CLAIM OFFICE ADDRESSES 74238 E BOON CHAPMAN BENEFIT ALL CLAIM OFFICE ADDRESSES 98999 0494 X BORDEN EMPLOYEE BENEFITS PO BOX 189 COLUMBUS OH 43216 98999 2883 X BORGESS MNG CARE 5943 STADIUM DR KALAMAZOO MI 49909 98999 2239 X BR ASSOCIATES 4201 A MANNIHEIM RD JASPER IN 47546 98999 2613 X BRADFORD WHITE CORP. 200 LAFAYETTE ST MIDDLEVILLE MI 49333 98999 2762 X BREAST CERVICAL CANCER PR PO BOX 42 NAZARETH MI 49074 98999 2240 X BRIDEGESTONE/FIRESTON PO BOX 26605 AKRON OH 44319 98999 2448 X BRONSON HEALTH CARE/SFGIA PO BOX 51100 KALAMAZOO MI 49007 98999 0200 X BUSINESS ADMIN. CONSULT. PO BOX 107 REYNOLDSBURG OH 43068 98999 0263 X CAM ADM. SERVICES, INC. PO BOX 5131 SOUTHFIELD MI 48086 98999 2941 X CAMBRIDGE IHDS PO BOX 998 BIRMINGHAM MI 48012 98999 0885 X CAVANAUGH INSURANCE 2000 THORN APPLE VALLEY RD PONCA CITY OK 746012107 41124 E CBSA (FORTIS SELF-FUNDED) ALL CLAIM OFFICE ADDRESSES 98999 2453 X CC SYSTEMS ALLEGAN CO MEN PO DRAWER 130 ALLEGAN MI 49010 98999 2452 X CC SYSTEMS CORP 4660 S HAGADORN RD STE 210 EAST LANSING MI 48823

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BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 4 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2589 X CC SYSTEMS CORP 4660 SOUTH HAGADORD RD EAST LANSING MI 48823 98999 0238 X CC SYSTEMS GROUP CLAIMS PO BOX 3017 CENTERLINE MI 48015 98999 0279 X CCI ADMINISTRATORS PO BOX 7152 DUBLIN OH 43017 73159 E CCN ALL CLAIM OFFICE ADDRESSES 98999 2821 X CELTIC LIFE INS. CO. PO BOX 30075 TAMPA FL 33630 98999 1389 X CENT STATES JOINT BOARD 1950 W. ERIE ST CHICAGO IL 60622 31118 NOCD E CENTRAL BENEFITS LIFE ALL CLAIM OFFICE ADDRESSES 31118 0001 E CENTRAL BENEFITS MUTUAL ALL CLAIM OFFICE ADDRESSES 31118 0002 E CENTRAL BENEFITS NATIONAL ALL CLAIM OFFICE ADDRESSES 31118 E CENTRAL BENEFITS SVCS ALL CLAIM OFFICE ADDRESSES 34097 NOCD E CENTRAL RESERVE LIFE ALL CLAIM OFFICE ADDRESSES 36215 NOCD E CENTRAL STATES HLTH & WEL ALL CLAIM OFFICE ADDRESSES 98999 2243 X CENTURY TELEPHONE PO BOX 4065 MONROE LA 71211 98999 2455 X CHAMPION INTERNATIONAL CO 101 KNIGHTS BRIDGE DR HAMILTON OH 45020 84146 E CHAMPVA HAC ALL CLAIM OFFICE ADDRESSES 98999 0936 X CHAMPVA INS COMPANY PO BOX 469064 DENVER CO 802469064 98999 2960 X CHEROKEE INSURANCE COMPAN P.O. BOX 159 WARREN MI 48090 59223 E CHESAPEAKE LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES 34154 E CHESTERFIELD RESOURCES ALL CLAIM OFFICE ADDRESSES 98999 0492 X CHESTERFIELD RESOURCES PO BOX 1884 AKRON OH 44309 61271 0001 E CHRISTIAN BROTHERS SERVIC ALL CLAIM OFFICE ADDRESSES 61425 0008 E CHUA TRUSTMARK ALL CLAIM OFFICE ADDRESSES 62308 E CIGNA ALL CLAIM OFFICE ADDRESSES 62308 0002 E CIGNA - PPO ALL CLAIM OFFICE ADDRESSES 02331 E CIGNA BEHAVIORAL HEALTH ALL CLAIM OFFICE ADDRESSES 62308 0001 E CIGNA HEALTH PLAN - HMO ALL CLAIM OFFICE ADDRESSES 98999 0825 X CITIZENS INS PO BOX 290 HOWELL MI 48844 98999 1702 X CITY MANAGEMENT CORP 3400 E LAFAYETTE DETROIT MI 48207 98999 2767 X CLAIM MANAGEMENT SERV PO BOX 2790 WEST BEND WI 53095 98999 2734 X CLAIMS MANG SERVICES PO BOX 10888 GREEN BAY WI 54307 71063 0001 E CNA HEALTH PARTNERS ALL CLAIM OFFICE ADDRESSES 71063 NOCD E CNA HEALTH PARTNERS ALL CLAIM OFFICE ADDRESSES 98999 MI11 D COFINITY/PPOM 28588 NORTHWESTERN HWY, SUITE 3 SOUTHFIELD MI 48034 98999 MI16 D COFINITY/PPOM PO BOX 2720 FARMINGTON HILL MI 48333 98999 1859 X COMBINED INS OF AMERICA 5050 BROADWAY CHICAGO IL 60640

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BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 5 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 39026 0001 E COMM PREFERRED HEALTH PLA ALL CLAIM OFFICE ADDRESSES 98999 2958 X COMMUNITY CARE PLAN PO BOX 7069 GRAND RAPIDS MI 495107069 35193 NOCD E COMMUNITY HEALTH ALLIANCE ALL CLAIM OFFICES 98999 2664 X COMMUNITY HEALTH PARTNERS PO BOX 9084 FARMINGTON HILL MI 48333 59314 E COMP BEHAVIORIAL CARE ALL CLAIM OFFICE ADDRESSES 98999 2944 X COMPREHENSIVE CARE 3405 W DR MLK JR BLVD STE 101 TAMPA FL 33607 98999 1270 X CONCORDIA HEALTH PLAN 1333 SOUTH KIRKWOOD ST LOUIS MO 631227295 06105 NOCD E CONNECTICARE INC ALL CLAIM OFFICE ADDRESSES 62308 NOCD E CONNECTICUT GENERAL LIFE ALL CLAIM OFFICE ADDRESSES 87726 0001 E CONSOLIDATED GRP/TRAVELER ALL CLAIM OFFICE ADDRESSES 98999 2827 X CONSTRUCTION ASSOC. OF MI PO BOX 5131 SOUTHFIELD MI 48086 71404 E CONTINENTAL GENERAL ALL CLAIM OFFICE ADDRESSES 52132 NOCD E COOPERATIVE BENEFIT ADMIN ALL CLAIM OFFICE ADDRESSES 98999 2736 X CORE SOURCE PO BOX 1687 GRAND RAPIDS MI 49501 98999 2806 X CORESOURCE PO BOX 2305 MT CLEMENS MI 48046 35182 NOCD E CORESOURCE-AZ,IL,IN,MD,MN ALL CLAIM OFFICE ADDRESSES 98999 0490 X CORORATE HEALTH ADM PO BOX 1858 BISMARCK ND 58502 98999 2967 X CORPHEALTH INC 1300 SUMMIT AVE STE 811 FORT WORTH TX 76102 56116 E CORPORATE BENEFIT SVCS ALL CLAIM OFFICE ADDRESSES 98999 1352 X CORPORATE SERVICE 17187 N LAUREL LIVONIA MI 48152 43160 0001 E CORRECTIONAL MED SERVS(CM ALL CLAIM OFFICE ADDRESSES 98999 1421 X COTTER MEMBER INSURANCE 203 JANDUS RD CARY IL 60013 25133 E COVENTRY HEALTH CARE ALL CLAIM OFFICE ADDRESSES 98999 0852 X CRAWFORD & CO. PO BOX 5154 SOUTHFIELD MI 48086 98999 2261 X CRAWFORD AND CO DEPT 752 PO BOX 5047 ATLANTA GA 30302 98999 0556 X CREATIVE RISK MANAGEMENT 34820 HARPER MT. CLEMENS MI 48046 98999 1707 X CREATIVE RISK MANAGMENT 34820 HARPER AV MT CLEMENS MI 48043 98999 2460 X CROWN CORK AND SEAL 9300 ASHTON ROAD PHILADELPHIA PA 19136 80705 0012 E CROWN LIFE ALL CLAIM OFFICE ADDRESSES 98999 0437 X CUNA MUTUAL INSURANCE PO BOX 1648 MADISON WI 53701 98999 2585 X CUSTOM BENEFITS 106 FARMERS ALY STE 300 BOX 511 KALAMAZOO MI 49005 98999 1598 X D.R.S. SERVICES INC 28104 ORCHARD LAKE RD STE #104 FARMINGTON HILL MI 48334 98999 1851 X DART MANAGEMENT CORP. 500 HOGSBACK RD MASON MI 48854 87726 0013 E DEFINITY SERVICES ALL CLAIM OFFICE ADDRESSES 98999 1285 X DET. CARPENTERS HEALTH 30700 TELEGRAPH STE 2400 BINGHAM FARMS MI 48025

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2902 X DISNEY WLD SVS. GROUP INS PO BOX 10130 LAKE BUENA VIST FL 32830 06102 NOCD E DIVERSIFIED GRP BROKERAGE ALL CLAIM OFFICE ADDRESSES 56240 D DMC DETROIT MEDICAL CENTE ALL CLAIM OFFICE ADDRESSESS 98999 2669 D DMC HEALTH PLAN PO BOX 44290 DETROIT MI 48244 98999 2463 X EB MORRIS ASSOCIATES PO BOX 50440 INDIANAPOLIS IN 46250 98999 0585 X EDS METAL HEALTH CLAIMS 5525 N MACARTHUR BLVD STE 800 IRVING TX 75038 98999 0827 X EDWARD B MORRIS PO BOX 50440 INDIANAPOLIS IN 46250 98999 2021 X EDWARD C LEVY COMPANY 8800 DIX AVE DETROIT MI 48209 98999 2268 X EMPLOYEE BENEF TRUST PO BOX 8788 WILIMGTON DE 19899 38241 E EMPLOYEE BENEFIT CONCEPTS ALL CLAIM OFFICE ADDRESSES 98999 0223 X EMPLOYEE BENEFIT CONCEPTS PO BOX 2365 FARMINGTON HILL MI 48333 98999 1843 X EMPLOYEE BENEFIT MANAGE 4789 RINGS RD DUBLIN OH 43017 98999 1793 X EMPLOYEE BENEFIT MNG CORP 4789 RINGS RD DUBLIN OH 43017 98999 2824 X EMPLOYEE BENEFIT PLAN ADM PO BOX 2000 HAMPTON NH 3842 98999 2469 X EMPLOYEE BENEFIT STRAGEI 229 E MICHIGAN AVE KALAMAZOO MI 49007 98999 0182 X EMPLOYEE BENEFITS, INC PO BOX 438 GRAND BLANC MI 48439 98999 2471 X EMPLOYEE PLANS INC PO BOX 2362 FORT WAYNE IN 46801 98999 0667 X EMPLOYERS MUTUAL INS CO PO BOX 30546 LANSING MI 489098046 62308 0003 E EQUICOR ALL CLAIM OFFICE ADDRESSES 62308 0004 E EQUICOR - PPO ALL CLAIM OFFICE ADDRESSES 98999 0347 X EQUICOR INS PO BOX 10485 DES MOINES IA 50306 75196 0002 E EQUIFAX HLTHCR ADM.SRV EH ALL CLAIM OFFICE ADDRESSES 62308 0005 E EQUITABLE ALL CLAIM OFFICE ADDRESSES 87726 0014 E ERICKSON ADVANTAGE ALL CLAIM OFFICE ADDRESSES 98999 0172 X ETHIX GREAT LAKES PO BOX 1677 TROY MI 48084 98999 0377 X ETHIX GREAT LAKES PO BOX 1236 TROY MI 48099 71412 0001 E EXCLUSICARE ALL CLAIM OFFICE ADDRESSES 98999 2946 X FAMILY HEALTH PLAN PO BOX 4708 TOLEDO OH 43610 98999 1970 X FARM BUREAU 7373 W SAGINAW PO BOX 30400 LANSING MI 48909 98999 0645 X FARM BUREAU INS GROUP PO BOX 30100 LANSING MI 48909 98999 0220 X FARMERS GRP BRANCH CLM OF PO BOX 268993 OKLAHOMA CITY OK 73126 98999 1049 X FARMERS INS PO BOX 268993 OKLAHOMA CITY OK 73126 98999 1588 X FARMERS INS CO 27260 HAGGERTY STE A2 FARMINGTON HILL MI 48331 98999 2935 X FCNBD PHCS CORESOURCE PO BOX 83301 LANCASTER PA 17608 98999 0190 X FEDERAL BLACK LUNG PROGRA PO BOX 8302 LONDON KY 40742

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2608 X FEDERAL EXPRESS CLMS DEPT PO BOX 2218 MARYLAND HGTS MO 63043 98999 2475 X FEDERAL MOGUL HEALTH CARE PO BOX 1999 DETROIT MI 48235 98999 0185 X FEDERATED INSURANCE CO PO BOX 50487 INDIANAPOLIS IN 46250 41041 E FEDERATED MUTUAL ALL CLAIM OFFICE ADDRESSES 98999 0831 X FEDERATED MUTUAL PO BOX 50487 INDIANAPOLIS IN 46250 98999 2694 X FEDERATED MUTUAL PO BOX 50487 INDIANAPOLIS IN 46250 98999 0227 X FEISCO FCCI INSURANCE GRP PO BOX 58004 SARASOTA FL 342320800 77054 E FIDELIS SECURE CARE ALL CLAIM OFFICE ADDRESSES 98999 2476 X FIRST AGENCY 5071 WEST H AVE KALAMAZOO MI 49009 25133 0004 E FIRST HEALTH ALL CLAIM OFFICE ADDRESSES 98999 1129 X FIRST OF AMERICA SUITE 270 KALAMAZOO MI 49007 98999 2829 X FIRST OF AMERICA PO BOX 4022 KALAMAZOO MI 49003 98999 2477 X FIRST PRESB CHURCH CLINIC 321 W SOUTH STREET KALAMAZOO MI 49007 59276 NOCD E FLORIDA FIRST ALL CLAIM OFFICE ADDRESSES 48117 E FMH BENEFIT SERVICES ALL CLAIM OFFICE ADDRESSES 98999 2830 X FORD MOTOR WORKMANS COMP. 3001 MILLER RD DEARBORN MI 48121 70408 0015 E FORTIS BENEFIT-PHCS NETWO ALL CLAIM OFFICE ADDRESSES 70408 0006 E FORTIS BENEFITS INS CO ALL CLAIM OFFICE ADDRESSES 70408 NOCD E FORTIS BENEFITS INSURANCE ALL CLAIM OFFICE ADDRESSES 39065 0001 E FORTIS INSURANCE ALL CLAIM OFFICE ADDRESSES 70408 0014 E FORTIS WESTERN ALL CLAIM OFFICE ADDRESSES 98999 0440 X FRANK GATES SERVICE CO PO BOX 16580 COLUMBUS OH 43216 98999 0165 X FRANKEN MUTUAL INS. CO. ONE MUTUAL AVE FRANKENMUTH MI 487870001 98999 1250 X FRANKENMUTH MUTUAL 125 ONE MUTUAL AVENUE FRANKENMUTH MI 48787 34171 E FRONTPATH ALL CLAIM OFFICE ADDRESSES 98999 0815 X G M UNDERWRITERS PO BOX 5004 ROCHESTER MI 48308 63665 0003 E GA ALL CLAIM OFFICE ADDRESSES 98999 2903 X GALLAGHER BASSETT PO BOX 419397 KANSAS CITY MO 64141 98999 2620 X GALLAGHER BASSETT BENEFIT PO BOX 34297 SAN ANTONIO TX 782654297 98999 1511 X GALLAGHER BASSETT INS. PO BOX 687 SOUTHFIELD MI 48034 98999 2859 X GALLAGHER BASSETT SERVICE PO BOX 33159 SAN ANTONIO TX 78265 98999 2930 X GE LIFE AND ANNUITY COMP PO BOX 10821 CLEARWATER FL 337578821 98999 2917 X GEICO ONE GEICO CENTER MACON GA 31296 63665 0004 E GENELCO ALL CLAIM OFFICE ADDRESSES 98999 2831 X GENERAL ACCIDENT INSURANC 2455 CORPORATE WEST DR LISLE IL 60532

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BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 8 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 63665 0001 E GENERAL AMERICAN ALL CLAIM OFFICE ADDRESSES 63665 0002 E GENERAL AMERICAN LIFE ALL CLAIM OFFICE ADDRESSES 63665 NOCD E GENERAL AMERICAN LIFE INS ALL CLAIM OFFICE ADDRESSES 07689 E GLOBAL CARE, INC. ALL CLAIM OFFICE ADDRESSES 37602 E GOLDEN RULE INSURANCE CO ALL CLAIM OFFICE ADDRESSES 98999 0609 X GOOD SAMARITAN PROGRAM PO BOX 279 BEECH GROVE IN 46107 98999 1214 X GOODYEAR EMPLOYEE BENEFIT 1144 E. MARKET AKRON OH 44316 98999 0953 X GOODYEAR MEDICAL BENEFITS PO BOX 677 AKRON OH 44309 98999 0469 X GORDON FOOD SERVICE PO BOX 1787 GRAND RAPIDS MI 49501 44054 NOCD E GOVERNMENT EMP HOSP ASSOC ALL CLAIM OFFICE ADDRESSES 98999 MI05 X GRAND VALLEY HEALTH PLAN 829 FOREST HILLS AVE GRAND RAPIDS MI 49546 98999 2481 X GREAT LAKES EMP ASSOC PO BOX 19040 KALAMAZOO MI 49019 95467 2744 D GREAT LAKES HEALTH PLAN PO BOX 2127 SOUTHFIELD MI 48037 98999 2744 D GREAT LAKES HEALTH PLAN PO BOX 2127 ATTN.D.GRIFFITH SOUTHFIELD MI 480372127 80705 0001 E GREAT WEST ALL CLAIM OFFICE ADDRESSES 80705 0005 E GREAT WEST BELLEVUE ALL CLAIM OFFICE ADDRESSES 80705 0006 E GREAT WEST CARE ALL CLAIM OFFICE ADDRESSES 80705 0007 E GREAT WEST DENVER ALL CLAIM OFFICE ADDRESSES 80705 0003 E GREAT WEST LIFE ASSURANCE ALL CLAIM OFFICE ADDRESSES 80705 NOCD E GREAT WEST LIFE ASSURANCE ALL CLAIM OFFICE ADDRESSES 80705 0004 E GREAT WEST LIFE BENEFIT ALL CLAIM OFFICE ADDRESSES 80705 0002 E GREAT WEST LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES 80705 0010 E GREAT WEST SF ALL CLAIM OFFICE ADDRESSES 80705 0011 E GREAT WEST WA ALL CLAIM OFFICE ADDRESSES 80705 0009 E GREAT WESTLIFE ALL CLAIM OFFICE ADDRESSES 98999 2622 X GREEN SPRING N.J. 8 WOODHOLLOW RD STE 200 PARSIPPANY NJ 7054 36338 E GROUP ADMINISTRATORS INC ALL CLAIM OFFICE ADDRESSES 98999 1376 X GROUP ADMINISTRATORS LTD 450 EAST RAMINGTON RD SCHAUMBURG IL 60173 98999 2940 X GROUP AND PENSION ADM INC PO BOX 834150 RICHARDSON TX 750830248 48143 E GROUP AND PENSION ADMIN ALL CLAIM OFFICE ADDRESSES 98999 2482 X GROUP BENEFITS-MEIJER PO BOX 1747 GRAND RAPIDS MI 49501 98999 0651 X GROUP CLAIM DIVISION PO BOX 3017 CENTERLINE MI 48015 98999 2864 X GROUP HEALTH PO BOX 1167 DAYTON OH 45401 98999 2832 X GROUP HEALTH INC. PO BOX 2832 NEW YORK NY 10116 38194 E GROUP HEALTH MANAGERS ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 1558 X GROUP HEALTH MANAGERS INC 26205 FIVE MILE REDFORD MI 48239 13551 E GROUP HEALTH -NY ALL CLAIM OFFICE ADDRESSES 98999 0500 X GROUP MARKETING SERVICES PO BOX 19040 KALAMAZOO MI 49019 64246 0001 E GUARDIAN LIFE ALL CLAIM OFFICE ADDRESSES 64246 NOCD E GUARDIAN LIFE INS CO OF A ALL CLAIM OFFICE ADDRESSES 64246 0002 E GUARDIAN LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES 64246 0003 E GUARDIAN LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES 80705 0008 E GWL ALL CLAIM OFFICE ADDRESSES 38224 0001 E HAP HEALTH CHOICE ALL CLAIM OFFICE ADDRESSES 95266 E HARRINGTON BENEFIT SERVIC ALL CLAIM OFFICE ADDRESSES 98999 2933 X HARTFORD INS PO BOX 2910 HARTFORD CT 6104 98999 1773 X HASTINGS MUTUAL INS. CO. 404 EAST WOODLAWN AVENUE HASTINGS MI 49058 98999 2488 X HAWORTH INC ONE HAWORTH CIRCLE HOLLAND MI 49423 98999 0772 X HEALTH & WELFARE FUND PO BOX 5103 DES PLAINES IL 600175103 98999 1642 X HEALTH & WELFARE FUND P O BOX 3039 BIRMINGHAM MI 480123039 38224 NOCD E HEALTH ALLIANCE PLAN OF M ALL CLAIM OFFICE ADDRESSES 98999 0354 X HEALTH CARE COMPARE PO BOX 10907 SCOTTSDALE AZ 85271 98999 2291 X HEALTH CLAIM CENTER PO BOX 30367 TAMPA FL 33630 75196 NOCD E HEALTH ECONOMICS CORP ALL CLAIM OFFICE ADDRESSES 95567 NOCD E HEALTH NET CA AND OR ALL CLAIM OFFICE ADDRESSES 98999 1290 X HEALTH NETWORK BCE EMERGI PO BOX 200037 ARLINGTON TX 76006 63719 E HEALTH PLAN MGMT HPMS ALL CLAIM OFFICE ADDRESSES 98999 2936 D HP OF MICHIGAN MERIDIAN 1001 WOODWARD AVE SUITE 510 DETROIT MI 48226 59140 E HEALTH PLAN SERV (FLORIDA ALL CLAIM OFFICE ADDRESSES 41170 NOCD E HEALTH RISK MANAGEMENT ALL CLAIM OFFICE ADDRESSES 98999 2788 X HEALTH SERVICES 1855 WINCHESTER RD PARIS KY 40361 98999 2834 X HEALTHCARE COMPARE PO BOX 5182 SOUTHFIELD MI 48086 98999 0072 X HEALTHCARE COMPARE CORP 4141 N SCOTTSDALE SCOTTSDALE AZ 85251 59087 NOCD E HEALTHHELP NETWORKS INC ALL CLAIM OFFICE ADDRESSES 98999 2968 D HEALTHSOURCE (DMC) PO BOX 44290 DETROIT MI 48244 68195 E HEALTHSOURCE PROVIDENT IN ALL CLAIM OFFICE ADDRESSES 61127 NOCD E HEALTHSOURCE(KENTUCKY) ALL CLAIM OFFICE ADDRESSES 31141 NOCD E HEALTHSOURCE-OH ALL CLAIM OFFICE ADDRESSES 36332 E HEALTHSTAR, INC. ALL CLAIM OFFICE ADDRESSES 59230 E HERITAGE CONSULTANTS ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 0883 X HERTZ CLAIM MANAGEMENT PO BOX 2305 MOUNT CLEMENS MI 48046 98999 1881 X HHS,INC. 5363 44TH ST SE GRAND RAPIDS MI 49512 98999 2495 X HOSPICE OF GREATER KALAMA 300 W CEDAR STREET KALAMAZOO MI 49007 41170 0001 E HRM CLAIM MANAGEMENT ALL CLAIM OFFICE ADDRESSES 61101 E HUMANA ALL CLAIM OFFICE ADDRESSES 98999 2911 X IBA HEALTH PO BOX 51100 KALAMAZOO MI 490051100 98999 1565 X IBEW LOCAL 17 PO BOX 1347 TROY MI 48099 98999 1664 X IBEW LOCAL 252 FF OFFICE 3135 S STATE ST ANN ARBOR MI 48104 98999 2962 X INNOVATIVE RESOURCE GROUP P.O. BOX 916 BROOKFIELD WI 63008 98999 2293 X INSUREX BENEFITS ADM PO BOX 41779 MEMPHIS TN 38174 37124 NOCD E INTEGRATED BENEFIT SERVIC ALL CLAIM OFFICE ADDRESSES 98999 2638 X INTERCARE HEALTH PO BOX 3559 ENGLEWOOD CO 801553559 98999 2795 X INTERMOUNTAIN COMPANIES PO BOX 3018 MISSOULA MT 59806 98999 1625 X ITT AUTOMOTIVE 300 UNIVERSITY DR AUBURN HILLS MI 48321 98999 2882 X ITT HARTFORD HTH CLMS OFF PO BOX 5003 BOLINGBROOK IL 60440 98999 2639 X ITT HARTFORD SYSTEMS PO BOX 7954 WHEATON IL 60189 98999 2839 X JAMES SEDGEWICK 3001 W. BIG BEAVER STE 700 TROY MI 48084 61271 0003 E JF MOLLOY & ASSOCIATES IN ALL CLAIM OFFICE ADDRESSES 98999 0495 X JFP BENEFIT MANAGEMENT PO BOX 189 JACKSON MI 49204 98999 2914 X JMS ADMIN. PO OBX 99433 TROY MI 48099 41099 NOCD E JOHN ALDEN LIFE INS CO ALL CLAIM OFFICE ADDRESSES 98999 2812 X JOHN HANCOCK PO BOX 4052 SCHAUMBURG IL 60168 98999 0132 X JOHN HANCOCK GROUP CLAIMS PO BOX 4045 SCHAUMBURG IL 60168 34136 E JP FARLEY CORPORATION ALL CLAIM OFFICE ADDRESSES 98999 2503 X KALAMAZOO PSYCH HOSP 1312 OAKLAND DR ACCT DPT KALAMAZOO MI 49008 57038 E KANAWHA INSURANCE CO. ALL CLAIM OFFICE ADDRESS 98999 2845 X KEMPER INS. CO. PO BOX 537902 LIVONIA MI 48153 98999 0456 X KEMPER NATIONAL PO BOX 171 GRAND RAPIDS MI 49501 37217 E KEY BENEFIT ADMINISTRATOR ALL CLAIM OFFICE ADDRESSES 98999 0875 X KEY BENEFITS ADMIN PO BOX 55210 INDIANAPOLIS IN 46205 39026 0008 E KEY HEALTH PLAN (CA) ALL CLAIM OFFICE ADDRESSES 98999 1762 X KIRKE-VAN ORSDEL 1776 WEST LAKES PARKWAY DES MOINES IA 50306 98999 2617 X KIRKE-VAN ORSDEL INC P.O. BOX 9007 ST. LOUIS MO 631019007 98999 1025 X KIRK-VAN ORSDEL INC PO BOX 8895 ST LOUIS MO 63102 98999 0547 X KOCH IND WILLIS CORROON K PO BOX 2906 WICHITA KS 67201

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 0909 X LABORERS HLTH WEL E B A PO BOX 61320 LAS VEGAS NV 891601320 98999 2952 X LABORERS METROPOLITAN 6525 CENTURION DRIVE LANSING MI 48917 98999 1513 X LIBERTY MUTUAL 2450 44TH ST S.E. KENTWOOD MI 49512 98999 1556 X LIBERTY MUTUAL INS PO BOX 9191 FARMINGTON HILL MI 48333 98999 2863 X LIFE INVESTORS PO BOX 97 SCRANTON PA 18504 98999 2494 X LIFESPAN 166 E. GOODALE AVE. BATTLE CREEK MI 49017 98999 2828 X LOCAL 190 BENEFITS 2320 WASHTENAW ANN ARBOR MI 48104 98999 2872 X LOCAL 322 HLTH WELFARE PO BOX 169 WINSLOW NJ 8095 98999 2623 X M.B.C. AT-T P.O.BOX 2188 MARYLAND HTS. MO 63043 98999 0592 X MAGELLAN EAST MI PO B0X 5160 COLUMBIA MD 21046 98999 2954 X MAGELLAN STATE OF MI CLAI PO BOX 2278 MARYLAND HEIGHT MO 63043 25133 0002 E MAIL HANDLERS BENEFIT PLA ALL CLAIM OFFICE ADDRESSES 62413 E MAILHANDLERS BENEFIT PLAN ALL CLAIM OFFICE ADDRESSES 98999 2780 X MAMSI ALLIANCEPPO PO BOX 930 FREDERICK MD 21705 98999 2928 X MANAGED HEALTH NETWORK IN PO BOX 470459 CA 90047 22771 E MANAGED HEALTH NETWORKS ALL CLAIM OFFICE ADDRESSES 75258 E MAPCO INC. ALL CLAIM OFFICE ADDRESSES 98999 1882 X MARATHON OIL CO CLAIMS 539 S MAIN STREET FINDLAY OH 45840 80314 0002 E MASSACHUSETTS MUTUAL LIFE ALL CLAIM OFFICE ADDRESSES 70408 0004 E MBL ALL CLAIM OFFICE ADDRESSES 98999 2957 X MCA ADMIN MULTI PLAN PO BOX 701 NEW YORK NY 10276 98999 0240 X MCDONOUGH CAPERTON BENE. PO BOX 3262 CHARLESTON WV 25332 38338 E MCLAREN HEALTH PLAN ALL CLAIM OFFICE ADDRESSES 98999 1713 X MEADOW BROOK CLAIMS 3501 LAKE EASTBROOK SE GRAND RAPIDS MI 49546 98999 0515 X MEADOWBROOK INS PO BOX 2054 SOUTHFIELD MI 48037 98999 2512 X MEBS MICH EMPLOY BENEFITS 3809 LAKE EASTBROOK BLVD SE GRAND RAPIDS MI 49546 98999 2844 X MED TAC PO BOX 9110 NEWTON MA 2160 98999 1274 X MEDCO BEHAVIORAL CARE SYS 13736 RIVERPORT MARYLAND HTS MO 63043 74323 E MEDICAL BENEFIT MUTUAL ALL CLAIM OFFICE ADDRESSES 29076 E MEDICAL MUTUAL OF OHIO ALL CLAIM OFFICE ADDRESSES 98999 2751 X MEDICAL MUTUAL OF OHIO PO BOX 6018 CLEVELAND OH 44101 98999 1544 X MEDICAL NETWORK 1 4986 N ADAMS RD #D ROCHESTER MI 483061416 98999 1045 X MEDIPLUS PO BOX 9126 DES MOINES IA 50306 62160 E MEDSOLUTIONS ALL CLAIM OFFICE ADDRESSES 59221 E MEGA LIFE AND HEALTH INS ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2641 X MEIJER WORK COMP PO BOX 3260 GRAND RAPIDS MI 49501 98999 2515 X MEIJER-MIDWEST BENEFITS PO BOX 1747 GRAND RAPIDS MI 49501 98999 0805 X MENNOITE MUT AID PO BOX 483 GOSHEN IN 46526 98999 1039 X MERCY HEALTH CORP PO BOX 9084 FARMINGTON HILL MI 48333 98999 2927 X MERIT BEHAVIORAL CARE PO BOX 1837 MARYLAND HGTS MO 63043 64157 E MERITAIN HEALTH ALL CLAIM OFFICE ADDRESSES 98999 0677 X MERVYNS PO BOX 3108 RANCHO CORDOVA CA 95741 87726 NOCD E METRAHEALTH ALL CLAIM OFFICE ADDRESSES 87726 0009 E METROPOLITAN LIFE INS CO ALL CLAIM OFFICE ADDRESSES 98999 2873 X MHP PO BOX 3545 PORTLAND ME 4104 98999 2518 X MI CARPENTERS HEALTH 6525 CENTURION DR LANSING MI 48917 98999 2520 X MI CONF OF TEAMSTER PSYCH PO BOX 331237 DETROIT MI 48232 98999 2336 X MI ELECTRICAL EMPLOY 6011 W JOSEPH STE 401 LANSING MI 48917 98999 2337 X MI LUMBER/BUILDING 5815 EXECUTIVE DR SUITE A LANSING MI 48911 98999 2338 X MI ST PAINTERS INS 6525 CENTURION DR LANSING MI 48917 98999 1920 X MICH ELECTRICAL HEALTH 6011 W ST. JOSEPH STE 401 LANSING MI 48917 98999 2301 X MICH LABORERS HEALTHCARE 6525 CENTURION LANSING MI 48917 98999 2597 X MICHIGAN ELECT EMPLOYEES 6011 WEST ST JOSEPH STE 401 LANSING MI 48917 98999 2596 X MICHIGAN TROWEL TRADES HL 2111 WEST LINCOLN HWY MERRILLVILLE IN 46410 98999 0615 X MID AMERICAN PLAN PO BOX 2850 ROCKFORD IL 61132 37281 E MID-AMERICA ASSOCIATES ALL CLAIM OFFICE ADDRESSES 61425 0004 E MIDWEST EMPLOYEE BENEFIT ALL CLAIM OFFICE ADDRESSES MHP77 E MIDWEST HEALTH PLAN INC. ALL CLAIM OFFICE ADDRESSES 59224 NOCD E MIDWEST NTNL LIFE INS CO ALL CLAIM OFFICE ADDRESSES 79480 E MIDWEST SECURITY ALL CLAIM OFFICE ADDRESSES 98999 0499 X MIDWEST SECURITY ADMIN PO BOX 19035 GREEN BAY WI 54307 98999 2922 X MIDWEST SECURITY LIFE INS 2700 MIDWEST DRIVE ONLASKA WI 546508764 74227 0003 E MID-WEST UNITED LIFE ALL CLAIM OFFICE ADDRESSES 38334 E MOLINA HEALTHCARE ALL CLAIM OFFICE ADDRESSES 98999 1512 X MOTOR CITY WELFARE FUND 2441 W GRAND BLVD. DETROIT MI 48208 98999 2846 X MOTOR INS CORP. GEN. INS. PO BOX 5123 SOUTHFIELD MI 48086 98999 0619 X MOTORALA PO BOX 29005 PHOENIX AZ 85038 70408 0002 E MUTUAL BENEFIT ALL CLAIM OFFICE ADDRESSES 70408 0003 E MUTUAL BENEFIT LIFE ALL CLAIM OFFICE ADDRESSES 70408 0001 E MUTUAL BENEFIT LIFE INS C ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 71412 NOCD E MUTUAL OF OMAHA INS CO ALL CLAIM OFFICE ADDRESSES 98999 1313 X MUTUAL PROTECTIVE 1515 S 75TH ST OMAHA NE 68172 71412 0002 E MUTUALLY PREFERRED ALL CLAIM OFFICE ADDRESSES 98999 1088 X NASE PO BOX 982009 NORTH RICHLAND TX 76182 98999 2344 X NAT AUTO SERVICE 8000 CORPORATE DRIVE LANDOVER MD 20785 71412 0003 E NAT RURAL LETTER CARR ASS ALL CLAIM OFFICE ADDRESSES 98999 1448 X NATIONAL ASSO FOR SELP EM 2121 PRECINCT LINE ROAD HURST TX 76053 56176 E NATIONAL BENEFIT ADMIN ALL CLAIM OFFICE ADDRESSES 98999 0800 X NATIONAL ELEVATOR HEALTH PO BOX 477 NEWTON SQUARE PA 19073 98999 0873 X NATIONAL FOOT CARE PO BOX 547 LATHRUP VILLAGE MI 48076 98999 2904 X NATIONAL HTH INSURANCE CO PO BOX 619999 TX 75261 63665 0007 E NATIONAL STEEL ALL CLAIM OFFICE ADDRESSES 31417 NOCD E NATIONWIDE GROUP ALL CLAIM OFFICE ADDRESSES 31417 0001 E NATIONWIDE INSURANCE ALL CLAIM OFFICE ADDRESSES 31417 0002 E NATIONWIDE LIFE & HEALTH ALL CLAIM OFFICE ADDRESSES 53011 E NAT'L ASC. OF LTR. CARRIE ALL CLAIM OFFICE ADDRESSES 98999 2028 X NATL ASSOC FOR SELF EMP 9151 GRAPEVINE N RICHLAND HILL TX 76182 53011 NOCD E NATL ASSOC OF LETTER CARR ALL CLAIM OFFICE ADDRESSES 53132 NOCD E NAT'L RULE ELECTRIC (NREC ALL CLAIM OFFICE ADDRESSES 75190 E NCAS ALL CLAIM OFFICE ADDRESSES 98999 1871 X NCAS MODERN BENEFITS PO BOX 4000 SOUTHFIELD MI 48037 39026 0010 E NCHPP ALL CLAIM OFFICE ADDRESSES 98999 0341 X NEW WORLD CLAIM SERVICE 2624 N 5TH ST. NILES MI 49120 38225 E NGS AMERICAN INC ALL CLAIM OFFICE ADDRESSES 98999 2527 X NGS-KAL CNTY EMP PSY 5363 44TH STREET SE GRAND RAPIDS MI 49512 81264 NOCD E NIPPON LIFE INSURANCE CO ALL CLAIM OFFICE ADDRESSES 98999 1071 X NORTH AMERICAN ADMINIST PO BOX 9501 AMHERST NY 14226 98999 1187 X NORTH MED HMO 109 EAST FRONT STREET TRAVERSE CITY MI 49684 98999 2951 X NORTH SHORE ADMINISTRATOR PO BOX 1210 SANDUSKY OH 448711210 98999 2529 X NORTHERN GROUP SERVICES PO BOX 7676 ST CLAIR SHORES MI 48080 98999 2948 X NORTHPOINTE INS PO BOX 2223 SOUTHFIELD MI 48037 98999 1936 X NOVAMAX CLAIMS 6475 28TH ST SE GRAND RAPIDS MI 49506 98999 1024 X NYHART COMPANY PO BOX 80884 INDIANAPOLIS IN 46280 98999 2908 X OHIO CASUALTY GROUP PO BOX 543 MILWAUKEE WI 53201 25150 E OMNICARE HEALTH PLAN OF M ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 22321 E ONE CALL MEDICAL ALL CLAIM OFFICE ADDRESSES 98999 1734 X OPERATING ENGINEERS 37450 SCHOOLCRAFT SUITE 130 LIVONIA MI 48150 06111 NOCD E OXFORD HEALTH PLAN ALL CLAIM OFFICE ADDRESSES 98999 2530 X PACC HEALTH PLANS PO BOX 286 CLACKAMAS OR 97015 98999 2848 X PAINTERS UNION INS. 26877 NORTHWESTERN HWY STE 100 SOUTHFIELD MI 48034 67814 0006 E PAL ALL CLAIM OFFICE ADDRESSES 98999 0434 X PANHANDLE EASTERN PIPE PO BOX 1642 TX 77251 98999 2937 X PARAMOUNT PO BOX 928 CLAIMS OFFICE TOLEDO OH 436970928 98999 2531 X PARKER HANNIFIN INS. OFFI 100 PARKER DR. OTSEGO MI 49078 98999 2351 X PARTNERS 101 E WAYNE STE 502 SOUTHBEND IN 46601 98999 2901 X PEKIN LIFE 2505 COURT ST. PEKIN IL 61558 98999 0817 X PENN GENERAL SERVICE CORP 3000 TOWN CTR STE 1900 SOUTHFIELD MI 48075 98999 2354 X PENSION GROUP PO BOX 4022 KALAMAZOO MI 49003 98999 1167 X PHILADELPHIA AM LIFE PO BOX 2465 HOUSTON TX 77252 98999 2915 X PHILLIPS ADMIN. SER. INC. PO BOX 218 ALBANY OR 97321 67814 0007 E PHL ALL CLAIM OFFICE ADDRESSES 67814 0004 E PHOENIX AMERICAN LIFE ALL CLAIM OFFICE ADDRESSES 67814 NOCD E PHOENIX HOME LIFE MUTUAL ALL CLAIM OFFICE ADDRESSES 67814 0003 E PHOENIX LIFE ALL CLAIM OFFICE ADDRESSES 67814 0001 E PHOENIX MUTUAL ALL CLAIM OFFICE ADDRESSES 98999 0698 X PHYSIANS MUTUAL PO BOX 3313 OMAHA NE 68172 37330 NOCD E PHYSICIANS HEALTH PLAN ALL CLAIM OFFICE ADDRESSES 87726 0011 E PHYSICIANS HTH PLN/UNTD H ALL CLAIM OFFICE ADDRESSES 98999 0324 X PIONEER LIFE PO BOX 5151 JANESVILLE WI 53547 98999 0798 X PIPELINE BENEFIT FUND PO BOX 470950 TULSA OK 74147 37224 E PITTMAN AND ASSOCIATES ALL CLAIM OFFICE ADDRESSES 37287 E PLANNED ADMINISTRATORS,IN ALL CLAIM OFFICE ADDRESSES 98999 1485 X PLUMBERS STEAMFITTERS 2320 WASHTENAW ANN ARBOR MI 48104 98999 2536 X POE AND BROWN PO BOX 2480 DAYTONA BEACH FL 32115 98999 2537 X POSTMASTERS BENEFIT PLAN PO BOX 1040 COLUMBIA MD 21044 36373 E PRAIRIE STATES ALL CLAIM OFFICE ADDRESSES 98999 2850 X PRARIE STATES PO BOX 23 SHEBOYGAN WI 53082 98999 2538 X PREFERRED HEALTH CARE PO BOX 1347 LATHAM NY 121108847 41147 E PREFERRED ONE ALL CLAIM OFFICE ADDRESSES 98999 2588 X PREFERRED PARTNERS INC 5943 STADIUM DR KALAMAZOO MI 49009

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2684 X PRESIDIUM PO BOX 1687 GRAND RAPIDS MI 49501 98999 2925 X PRESIDIUM INC PO BOX 2305 MT CLEMEMS MI 48046 60054 0004 E PRIMARY CHOICE AHP NY/NJ ALL CLAIM OFFICE ADDRESSES 61271 0002 E PRINCIPAL FINANCIAL GROUP ALL CLAIM OFFICE ADDRESSES 61271 NOCD E PRINCIPAL MUTUAL LIFE INS ALL CLAIM OFFICE ADDRESSES 98999 1245 D PRIORITY HEALTH 1231 EAST BELTLINE NE GRAND RAPIDS MI 49505 98999 0557 D PRIORITY HEALTH PO BOX 232 GRAND RAPIDS MI 49501 98999 2541 D PRIORITY HEALTH HMO 442 CENTURY LANE HOLLAND MI 49423 38329 E PRO CARE HEALTH PLAN,INC. ALL CLAIM OFFICE ADDRESSES 98999 2364 X PROAMERICA PO BOX 90603 ARLINGTON TX 76006 36331 E PROFESS BENEFIT ADMIN,INC ALL CLAIM OFFICE ADDRESSES 98999 2542 X PROFESSIONAL BENEFIT ADM PO BOX 4687 OAK BROOK IL 605224687 98999 2543 X PROFESSIONAL RISK MGMT PO BOX 1049 YOUNGSTOWN OH 44501 98999 2851 X PROGRESSIVE 46333 FIVE MILE RD STE 100 PLYMOUTH MI 481702421 68195 0003 E PROVIDEN PREFERRED NETWOR ALL CLAIM OFFICE ADDRESSES 68195 0004 E PROVIDENT ADMINISTRATORS ALL CLAIM OFFICE ADDRESSES 68195 0002 E PROVIDENT HEALTHCARE PLAN ALL CLAIM OFFICE ADDRESSES 68195 NOCD E PROVIDENT LIFE & ACCIDENT ALL CLAIM OFFICE ADDRESSES 68195 0001 E PROVIDENT LIFE & CASUALTY ALL CLAIM OFFICE ADDRESSES 98999 2547 X RALSTON PURINA CO 150 SOUTH MCCAMLY ST BATTLE CREEK MI 49017 98999 2852 X RAPP C O 3RD PARTY 132 KINGS HIGHWAY E. HADDONFIELD NJ 8033 98999 0270 X REGENCY MEDICAL ADMIN PO BOX 610609 PORT HURON MI 48061 98999 2950 X RESERVE NATIONAL PO BOX 26620 OKLAHOMA CITY OK 731260620 98999 1761 X REVIEW WORKS 400 GALLERIA SOUTHFIELD MI 48034 98999 MI06 X RISK CONTROL INC. BENECOM PO BOX N GRAND RAPIDS MI 49501 98999 0436 X RISK CONTROL, INC. PO BOX 1648 GRAND RAPIDS MI 49501 98999 0799 X RISK MANAGEMENT PO BOX 4759 SILVER SPRINGS MD 20904 98999 2550 X RMSCO-RICK MGMT SERVICES 115 CONTINUUM DR LIVERPOOL NY 13088 98999 2752 X ROBEY BARBER PO BOX 18446 TAMPA FL 33679 98999 2815 X ROBEY BARBER PO BOX 320847 TAMPA FL 33679 75196 0001 E ROCKWELL INTERNATIONAL ALL CLAIM OFFICE ADDRESSES 98999 2853 X ROYAL INS. PO BOX 5010 SOUTHFIELD MI 48086 98999 1816 X RSKCO 17187 N LAUREL PK DR STE 434 LIVONIA MI 48152 71412 0005 E RURAL CARRIER BENEFIT PLA ALL CLAIM OFFICE ADDRESSES 98999 2947 X SAFCO INS COMP PO BOX 154 GRAND RAPIDS MI 495010154

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 35164 NOCD E SAGAMORE HEALTH NETWORK ALL CLAIM OFFICE ADDRESSES 63665 0005 E SANUS HMO - ST LOUIS ALL CLAIM OFFICE ADDRESSES 63665 0006 E SANUS PPO - ST LOUIS ALL CLAIM OFFICE ADDRESSES 98999 2753 X SAUDER WELFARE TRUST 502 MIDDLE ST ARCHBOLD OH 43502 98999 0913 X SECURA PO BOX 619 OKEMOS MI 48805 87726 0015 E SECUREHORIZONS DIRECT ALL CLAIM OFFICE ADDRESSES 98999 2969 X SECUREHORIZONS DIRECT PO BOX 31353 SALT LAKE CITY UT 841310358 98999 2549 X SECUREONE BENEFIT ADM. IN PO BOX N GRAND RAPIDS MI 49501 37282 E SELECT BENEFIT ADM OF AME ALL CLAIM OFFICE ADDRESSES 60054 0005 E SELECT CHOICE AHP CHICAGO ALL CLAIM OFFICE ADDRESSES 60054 0006 E SELECT CHOICE AHP E & C P ALL CLAIM OFFICE ADDRESSES 60054 0013 E SELECT CHOICE AHP GEORIGA ALL CLAIM OFFICE ADDRESSES 60054 0007 E SELECT CHOICE AHP LOUISIA ALL CLAIM OFFICE ADDRESSES 60054 0008 E SELECT CHOICE AHP MA F & ALL CLAIM OFFICE ADDRESSES 60054 0009 E SELECT CHOICE AHP NY/NJ ALL CLAIM OFFICE ADDRESSES 60054 0010 E SELECT CHOICE AHP OHIO IN ALL CLAIM OFFICE ADDRESSES 60054 0011 E SELECT CHOICE AHP S N ENG ALL CLAIM OFFICE ADDRESSES 60054 0012 E SELECT CHOICE AHP TEXAS ALL CLAIM OFFICE ADDRESSES 98999 0400 X SELECT HEALTH PLANS PO BOX 1378 TROY MI 48099 34131 NOCD E SELF FUNDED PLANS ALL CLAIM OFFICE ADDRESSES 60054 0014 E SENIOR CHOICE AHP NY/NJ ALL CLAIM OFFICE ADDRESSES 98999 2554 X SENTRY INSURANCE STEVENS PT PO BOX 8888 STEVENS POINT WI 54481 39033 E SENTRY INSURANCE COMPANY ALL CLAIM OFFICE ADDRESSES 98999 1791 X SET, INC. 415 WEST KALAMAZOO LANSING MI 48933 98999 1428 X SHEET METAL LOCAL 292 PO BOX 1559 TROY MI 48099 98999 2386 X SHEET METAL LOCAL 7 PO BOX 3039 BIRMINGHAM MI 48012 98999 2929 X SHEET METAL WORKERS PO BOX 1449 GOODLETTSVILLE TN 37070 98999 1747 X SHIELD BENEFIT ADMIN 3900 SPARKS DR SE PO BOX 8128 GRAND RAPIDS MI 49518 98999 1007 X SHIELD INSURANCE PO BOX 8128 GRAND RAPIDS MI 49518 98999 1014 X SHIELD INSURANCE SERVICES PO BOX 8489 GRAND RAPIDS MI 49518 98999 2614 X SIMPSON INDUSTRIES INC. 39 E STATE ST MIDDLEVILLE MI 49333 98999 2870 X SISCO PO BOX 389 DUBUQUE IA 52004 60054 0015 E SOUTHWEST HEALTH PLANS ALL CLAIM OFFICE ADDRESSES 98999 2785 X SPECIAL AGT MUTL BNFT ASS 11301 OLD GEORGETOWN RD ROCKVILLE MD 20852 43160 E SPECTRUM HEALTH ALL CLAIM OFFICE ADDRESSES

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8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 0562 X SRC INSURANCE SERVICES PO BOX 14079 LEXINGTON KY 40512 98999 2856 X ST. JOHN SMART PLAN PO BOX 37705 OAK PARK MI 482370705 98999 2786 X STANDARD REGISTER PO BOX 1167 DAYTON OH 45401 98999 2787 X STAR ADMINISTR SERVICES PO BOX 55270 PHEONIX AZ 85078 61425 E STARMARK ALL CLAIM OFFICE ADDRESSES 98999 0985 X STARMARK PO BOX 7922 LAKE FOREST IL 60045 98999 2557 X STATE AUTO INSURANCE CO 17197 NORTH LAUREL STE 167 LIVONIA MI 48152 31053 E STATE FARM ALL CLAIM OFFICE ADDRESSES 98999 2811 X STATELINE TPA 1718 INDIANWOOD CRL STE E MAUMEE OH 43537 98999 2796 X STOW ASSOC. ADMIN 2872 WOODCOCK BLVD ATLANTA GA 30341 98999 2801 X STUDENT INSURANCE PO BOX 809025 DALLAS TX 75380 74227 E STUDENT INSURANCE DIVISIO ALL CLAIM OFFICE ADDRESSES 74227 NOCD E STUDENT INSURANCE DIVISIO ALL CLAIM OFFICE ADDRESSES 95202 E SUMMACARE HEALTH PLAN ALL CLAIM OFFICE ADDRESSES 36215 E TEAMCARE ALL CLAIM OFFICE ADDRESSES 98999 1165 X TECUMSEH PRODUCTS 100 EAST PATTERSON TECUMSEH MI 49286 64246 0004 E THE GUARDIAN ALL CLAIM OFFICE ADDRESSES 98999 2546 X THE ONE BENEFIT SOURCE PO BOX 2775 ELKHART IN 46515 67814 0005 E THE PHOENIX ALL CLAIM OFFICE ADDRESSES 98999 2586 X THE PRUDENTIAL PO BOX 13999 PHILADELPHIA PA 19187 87726 0002 E THE TRAVELERS HEALTH NETW ALL CLAIM OFFICE ADDRESSES 87726 0003 E THE TRAVELERS PLAN ADMINI ALL CLAIM OFFICE ADDRESSES 98999 2926 X THIRD PARTY ADMINISTRATOR 1733 PARK ST NAPERVILLE IL 60563 06131 NOCD E THIRD PARTY CLAIMS MGT ALL CLAIM OFFICE ADDRESSES 39065 NOCD E TIME INSURANCE CO ALL CLAIM OFFICE ADDRESSES 98999 2650 X TITAL INSURANCE 901 WILSHIRE DRIVE TROY MI 48084 98999 2932 X TITAN INS PO BOX 7024 TROY MI 48007 61425 0009 E TMA TOOL AND MAN ASSOC ALL CLAIM OFFICE ADDRESSES 98999 2938 X TOLEDO ELECTRICAL WELF FD PO BOX 60408 ROSSFORD OH 43460 98999 2562 X TOTAL GP CORESOURCE-MURCO PO BOX 2364 GRAND RAPIDS MI 49501 98999 0451 X TOTAL GROUP SERV PO BOX 1687 GRAND RAPIDS MI 49501 98999 2584 X TOTAL GROUP SERVICE PO BOX 1687 GRAND RAPIDS MI 49501 98999 2805 X TOTAL HEALTH CARE PO BOX 380308 BIRMINGHAM AL 35238 38201 E TOTAL HEALTHCARE ALL CLAIM ADDRESSESS 69493 E TOWER LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES

Type column: X=print and mail, D=direct electronic connection to payer from BCBSM EDI, E=electronic transmission through clearinghouse

BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 18 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 98999 2843 X TPA INC PO BOX 901066 FORT WORTH TX 76101 98999 0855 X TPA OF ARIZONA PO BOX 52100 PHOENIX AZ 85072 98999 0981 X TRANSAMERICA INS GROUP PO BOX 770 BATTLE CREEK MI 49016 87726 0008 E TRAVELERS INS CO ALL CLAIM OFFICE ADDRESSES 87726 0004 E TRAVELERS MIDWEST REGION ALL CLAIM OFFICE ADDRESSES 87726 0007 E TRAVELERS NORTHEAST REGIO ALL CLAIM OFFICE ADDRESSES 87726 0005 E TRAVELERS SOUTHWEST REGIO ALL CLAIM OFFICE ADDRESSES 87726 0006 E TRAVELERS WEST REGION ALL CLAIM OFFICE ADDRESSES 98999 2563 X TRIAD INC 115 GLASTONBURY BLVD GLASTONBURY CT 6033 38520 E TRICARE ALL CLAIM OFFICE ADDRESSES 98999 0997 X TRI-TECH EMPLOYEE BENEFIT PO BOX 804 OKEMOS MI 48805 61425 NOCD E TRUSTMARK INS CO ALL CLAIM OFFICE ADDRESSES 61425 0007 E TRUSTMARK LIFE INSURANCE ALL CLAIM OFFICE ADDRESSES 98999 2965 E ULTIMED HMO 2401 20TH ST ATTN CLAIMS DETROIT MI 48216 39026 E UMR ALL CLAIM OFFICE ADDRESSES 52180 NOCD E UMWA HEALTH RETIRE FUNDS ALL CLAIM OFFICE ADDRESSES 52180 E UMWA HEALTH RETIRE FUNDS ALL CLAIM OFFICE ADDRESSES 98999 0041 X UMWA HEALTH RETIRE FUNDS PO BOX 619099 DALLAS TX 752619099 80314 0001 E UNICARE MAJOR ACCOUNTS ALL CLAIM OFFICE ADDRESSES 80314 E UNICARE MAJOR ACCOUNTS ALL CLAIM OFFICE ADDRESSES 80314 0003 E UNICARE SPECIAL ACCOUNTS ALL CLAIM OFFICE ADDRESSES 62170 E UNIFIED GROUP SERVICES ALL CLAIM OFFICE ADDRESSES 75243 NOCD E UNIFORM MEDICAL PLAN ALL CLAIM OFFICE ADDRESSES 98999 2565 X UNITED AMERICAN HEALTHCAR 1155 BREWERY PARK SUITE 200 DETROIT MI 48207 98999 2964 E UNITED AMERICAN INS PO BOX 8080 MCKINNEY TX 75070 87726 0012 E UNITED BEHAVIORAL HEALTH ALL CLAIM OFFICE ADDRESSES 98999 2409 X UNITED CONST WORKER PO BOX 65 ZEELAND MI 49464 98999 2566 X UNITED CONSTRUCTION WKRS PO BOX 65 ZEELAND MI 49464 98999 2651 X UNITED FURNITURE PO BOX 1000037 NASHVILLE TN 37224 87726 0010 E UNITED HEALTH CARE ALL CLAIM OFFICE ADDRESSES 87726 E UNITED HEALTH CARE ALL CLAIM OFFICE ADDRESSES 31107 E UNITED MEDICAL RESOURCES ALL CLAIM OFFICE ADDRESSES 71412 0004 E UNITED OF OMAHA ALL CLAIM OFFICE ADDRESSES 98999 1505 X UNITED PARCEL SERVICE 241 E SAGINAW EAST LANSING MI 48823 98999 2798 X UNITED TECH 5200 AUTO CLUB DR DEARBORN MI 48126

Type column: X=print and mail, D=direct electronic connection to payer from BCBSM EDI, E=electronic transmission through clearinghouse

BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 19 Blue Cross Blue Shield of Michigan, Electronic Interchange Group Professional Commercial Payer List

8/7/2012 Payer Claim ID Office # Type Name Address City St Zip 38337 E UPPER PENINSULA HLTH PLAN ALL CLAIM OFFICE ADDRESSES 74095 E USAA ALL CLAIM OFFICE ADDRESSES 98999 2916 X USI ADMIN. PO BOX 1909 DANBURY CT 6813 98999 0327 X VALUE BEHAVIORAL HEALTH PO BOX 1002 RAILROAD DEPT MERRIFIELD VA 22116 98999 1839 X VALUE BEHAVIORAL HEALTH PO BOX 1347 LATHAM NY 121108847 98999 0429 X VALUE BEHAVIORAL HEALTH I PO BOX 1570 MERRIFIELD VA 22116 98999 2722 X VALUE BEHAVIORAL MICHIGAN ONE TOWNE SQUARE SUITE 600 SOUTHFIELD MI 48076 98999 0895 X VALUE BEHAVORIAL HEALTH PO BOX 599 TROY NY 12180 98999 0351 X VALUE BEHAVORIAL HEALTH PO BOX 1079 TROY NY 12181 98999 2569 X VALUE BEHAVORIAL HEALTH ONE TOWNE SQUARE SUITE 600 SOUTHFIELD MI 48076 98999 2877 X VALUE BEHAVORIAL HLTH PO BOX 1347 LATHAM NY 12110 98999 2571 X VALUE BEHAVORIAL HLTH ONE TOWNE SQUARE SUITE 600 SOUTHFIELD MI 48076 98999 2945 X VALUE OPTIONS CLAIMS DEPT PO BOX 1347 LATHAM NY 121108847 98999 1500 X VALUEOPTIONS P.O. BOX 930321 WIXOM MI 483930321 98999 2572 X VETERANS ADMINISTRATION 4646 JOHN R DETROIT MI 48201 98999 2871 X WASHINGTON NATIONAL INS. PO BOX 1250 ROCKFORD IL 61105 39026 NOCD E WAUSAU INSURANCE COMPANIE ALL CLAIM OFFICE ADDRESSES 98999 1611 X WELS VEBA GROUP 2949 N. MAYFAIR RD #116 MILWAUKEE WI 53222 70408 0011 E WESTERN ALL CLAIM OFFICE ADDRESSES 98999 0360 X WESTERN AND SOUTHERN LIFE PO BOX 1119 CINCINNATI OH 45201 70408 0013 E WESTERN CARE ALL CLAIM OFFICE ADDRESSES 70408 0012 E WESTERN LIFE ALL CLAIM OFFICE ADDRESSES 70408 0010 E WESTERN LIFE INSURANCE CO ALL CLAIM OFFICE ADDRESSES 98999 2666 X WESTERN SOUTHERN INS PO BOX 5735 SEC PLAN DEPT CINCINNATI OH 452015735 38232 E WEYCO INC. ALL CLAIM OFFICE ADDRESSES 98999 1782 X WEYERHAEUSER 4111 WEST 4 MILE ROAD GRAYLING MI 49738 98010 E WILLIAM J SUTTON AND CO ALL CLAIM OFFICE ADDRESSES 98999 2907 X WISCONSIN HEALTH PO BOX 601 MILWAUKEE WI 53201 98999 0862 X WOLVERINE MUTUAL PO BOX 530 DOWAGIAC MI 49047 98999 2576 X WOODMEN ACCIDENT AND LIFE 4250 GRAND HAVEN ROAD MUSKEGON MI 49441 98999 2966 X WPPN PO BOX 6090 DEPERE WI 541156090 98999 1346 X WPS 1717 W BROADWAY MADISON WI 53713 98999 2971 X WPS PO BOX 1229 MADISON WI 537131229

Type column: X=print and mail, D=direct electronic connection to payer from BCBSM EDI, E=electronic transmission through clearinghouse

BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 20