Hospital Outpatient Fee Schedule study: Data collection

Supplied data: Insurers, self-insurers and non-Critical-Access Hospitals

The Minnesota workers’ compensation insurers, self-insurers and non-Critical-Access Hospitals listed below supplied data for the Payment accuracy and timeliness in the Minnesota workers' compencation Hospital Outpatient Fee Schedule (HOFs) study. The Department of Labor and Industry (DLI) heartily thanks these entities for their demonstrated commitment to data-driven public policy.

Insurers

• Accident Fund General Insurance Company • American Select Insurance Company • Accident Fund Insurance Co Of America • Amerisure Insurance Company • Accident Fund National Insurance Company • Amerisure Mutual Ins Co • Ace American Ins Co • Amerisure Partners Insurance Company • Ace Fire Underwriters Ins • Amguard Insurance Company • Ace Property & Cas Ins Co • Arch Insurance Company • Acig Insurance Company • Argonaut Ins Co • Acuity A Mutual Insurance Company • Arrowood Indemnity Company • Addison Ins Co • Associated Indemnity Co • Aig Property Casualty Company • Assurance Co Of America • Allmerica Financial Benefit • Atlantic Specialty Ins Co C/O Onebeacon Ins • Insurance Co Group • • Amco Ins Co Auto Owners Ins Co • • Amer Cas Co Bankers Standard Ins Co • • Amer Compensation Ins Co Berkley National Insurance Company • • Amer Fire & Cas Co Berkley Regional Ins Co • • Amer Guarantee & Liab Ins Berkshire Hathaway Homestate Ins • Amer Home Assurance Co Company • • Amer Policyholders Liq Tr Bitco General Insurance Corporation • • Amer States Ins Co Bitco National Insurance Company • • Amer Zurich Ins Co Bloomington Compensation Insurance Company • American Alternative Ins • Brotherhood Mutual Insurance Company • American Economy Insurance Co • Carolina Casualty Ins Co • American Family Mutual Ins Co • Century Indemnity Co • American Insurance Company • Charter Oak Fire Ins Co • American Interstate Insurance Company • Cherokee Insurance Company

443 Lafayette Road N., St. Paul, MN 55155 • 651-284-5005 • www.dli.mn.gov • Chubb Indemnity Ins Co • First Liberty Ins Corp • Church Mutual Ins Co • First Nonprofit Insurance Co • Cincinnati Casualty Co • Firstcomp Insurance Company • Cincinnati Indemnity Co • Florists Mutual Ins Co • Cincinnati Ins Co • Foremost Insurance Company • Citizens Insurance Company Of America • Forest Products Ins Exch • Commerce & Industry Ins Co • General Cas Co Of Wi • Continental Cas Co • General Casualty Insurance Company • Continental Indemnity Company • General Insurance Company Of America • Continental Ins Co • Granite State Ins Co • Continental Western Insurance Company • Great American Alliance Ins Co • Crum & Forster Indemnity Company • Great American Assurance Co • Dakota Truck Underwriters • Great American Ins Co New York • Depositors Insurance Company • Great American Insurance Company • Diamond Insurance Company • Great Divide Insurance Company • Discover Property & Cas Ins Co • Great West Cas Co • Eastguard Insurance Company • Greenwich Insurance Company • Electric Ins Co • Grinnell Mutl Reins Co • Emcasco Ins Co • Guideone Mutual Ins Co • Employers Assurance Company • Hanover American Insurance Company • Employers Compensation Insurance (The) Company • Hanover Ins Group • Employers Ins Co Wausau • Harleysville Insurance Co • Employers Mutual Cas Co • Harleysville Lake States Ins Co • Employers Preferred Insurance Company • Harleysville Preferred Insurance Company • Everest National Ins Co • Harleysville Worcester Insurance Company • Farm Bureau Property & Casualty Insurance • Hartford Accident & Indemnity Co Co • Hartford Casualty Ins Co • Farmers Ins Exchange • Hartford Fire Ins Co • Farmington Cas Co • Hartford Ins Co Of The Midwest • Farmland Mutual Insurance Co • Hartford Underwriters Insurance Co • Federal Ins Co • Hawkeye-Security Ins Co • Federated Mutual Ins Co • Hdi Global Insurance Company • Federated Rural Elec Ins • Healthcare Ins Reciprocal • Federated Service Ins Co • Highlands Ins Co • Fidelity & Deposit Of Md • Illinois Casualty Company • Fidelity & Guaranty Ins • Illinois Natl Ins Co • Fidelity & Guaranty Und • Indemnity Ins Of N Amer • Firemans Fund Ins Co • Ins Co Of North Amer • Firemens Insurance Company Of • Insurance Co Of Pa Washington Dc • Integrity Mutual Ins Co • First Dakota Indemnity Company • Liberty Ins Corp • Liberty Mutual Fire Ins • Norguard Insurance Company • Liberty Mutual Ins Co • North Pointe Insurance Company • Lm Ins Corp • North River Ins Co • Lumber Mutual Ins Co • Northern Ins Co Of Ny • Mada Insurance Exchange • Northwestern Natl Cas Co • Maryland Cas Co • Northwestern Natl Ins Co • Massachusetts Bay Ins Co • Nova Casualty Company • Memic Indemnity Company • Obi National Insurance Co C/O Onebeacon • Meridian Security Ins Co Ins Group • Michigan Millers Mutual Insurance • Ohio Cas Ins Co Company • Ohio Farmers Ins Co • Mid Century Ins Co • Ohio Security Ins Co • Middlesex Insurance Company • Old Republic General Insurance Corp • Midwest Employers Casualty Company • Old Republic Ins Co • Midwest Family Mutual Ins • Owners Ins Co • Midwest Insurance Company • Pacific Employers Ins Co • Midwestern Indemnity Co • Pacific Indemnity Co • Milbank Ins Co • Patriot General Insurance Company • Milford • Peerless Indemnity Ins Co • Mitsui Sumitomo Insurance Company Of • Peerless Ins Co America • Penn Millers Insurance Company • Mn Assigned Risk Berkley Risk Admin Co Llc • Pharmacists Mutl Ins Co • Mn Assigned Risk Dca • Phoenix Ins Co • Mn Assigned Risk Ohms • Pioneer Specialty Insurance Company • Mn Assigned Risk Rtw • Plaza Insurance Company • Mn Assigned Risk Sfm Risk Solutions • Praetorian Insurance Company • Mn Assigned Risk St Paul Cos • Preferred Professional Ins Co • Mn Assigned Risk Wausau • Property & Casualty Ins Co Of Hartford • Motorists Commercial Mutual Ins Company • Protective Ins Co • National American Insurance Co. • Qbe Insurance Corporation • National Casualty Company • Ram Mutual Ins Co • National Indemnity Company Of Mid • Redwood Fire And Casualty Insurance America Company • National Interstate Ins Co • Regent Ins Co • National Liability & Fire Insurance Company • Riverport Insurance Company • National Surety Corporation • Safeco Ins Co Of Amer • Nationwide Agribusiness Insurance Co. • Safety Natl Cas Corp • Nationwide Mutual Fire Insurance Co. • Security National Insurance Company • Nationwide Mutual Ins Co • Selective Ins Co Of Amer • Natl Fire Ins Of Hartford • Selective Ins Co Of Sc • Natl Union Fire Ins Co • Selective Ins Co Of Se • New Hampshire Ins Co • Sentinel Insurance Company • Sentry Casualty Company • Travelers Property Casualty Co Of America • Sentry Insurance A Mutual Company • Tri State Ins Co Of Mn • Sentry Select Insurance Company • Triangle Insurance Company Inc • Sfm Mutual Insurance Company • Triumphe Casualty Company • Sfm Safe Insurance Company • Truck Ins Exchange • Sfm Select Insurance Company • Twin City Fire Ins Co • Sompo America Insurance Company • Union Insurance Company Of Providence • St Paul Fire & Marine Ins • United Fire & Cas Co • St Paul Guardian Ins Co • United Wisconsin Ins Co • St Paul Mercury Ins Co • Univ Underwriters Ins Co • St Paul Protective Ins Co • Us Fidelity & Guaranty • Standard Fire Ins Co • Us Fire Ins Co • Star Ins Co • Utica Mutual Ins Co • Starnet Insurance Company • Valiant Ins Co • Starr Indemnity & Liability Company • Valley Forge Ins Co • State Auto Prop & Cas • Vanliner Ins Co • State Automobile Mutl Ins • Vigilant Ins Co • Fire & Cas Co • Virginia Surety Company • State Farm General Ins Co • Wausau Business Ins Co • Stonington Insurance Co • Wausau Underwriters Ins • Technology Insurance Company • Wesco Insurance Company • The Netherlands Ins Co • West Amer Ins Co • Tig Insurance Co • West Bend Mutual Insurance Company • Tnus Insurance Company • Western Agricultural Insurance Company • Trans Pacific Ins Co • Western Natl Assur Co • Transguard Insurance Company Of America • Western Natl Mutl Ins Co Inc • Westfield Ins Co • Transport Ins Co • Westfield National Ins Co • Transportation Ins Co • Westport Ins Corp • Travelers Cas & Surety Co • Xl Insurance America, Inc. • Travelers Casualty Insurance Co Of America • Xl Specialty Insurance Company • Travelers Indemnity Amer • Zenith Insurance Co • Travelers Indemnity Co • Zurich Amer Ins Co Of Il • Travelers Indemnity Of Ct • Zurich American Ins Co

Self-insurers • ABF Freight System • Ag Processing Inc • Access Insurance Assoc • Ak Steel Corp • Adc Telecommunications C/O Commscope • Allete Inc Holding Comp • Allina Health System • American Crystal Sugar • Eep Workers Comp Fund • Amherst Wilder Foundation • Electric Insurance Co/Ge Wells Food • Anoka County • Elim Care Inc • Arcelormittal Minorca Mine Inc • Essentia Health • Archer Daniels Midland Co • Fabcon Inc • Arctic Cat Inc • Fairmont Foods Of Minn In • Atek Management Company • Fairview Health Services • Atlas Staffing Inc % Berkley Risk Admin Co • Fedex Corp/Federal Express Corporation Llc • Fedex Freight Inc • Benedictine Group • Ford Motor Company Workers' • Berkley Risk Administrators Co Llc Compensation Dept. • Bermo Inc • Forest Products Commercial Self Ins Group • Blandin Paper Co C/O Aon Global Risk • Frandsen Corporation • Bloomington City Of • Gopher Resource, Llc • Blue Cross/Blue Shield • Grand Itasca Clinic And Hospital • Builders & Contractors Workers Comp Fund • Greater Minnesota Self Insurance Fund • Care Providers Workers Compensation Fund • Hancock Concrete Products, Llc • , Incorporated • Hanson Pipe & Precast, Inc. • Carl Bolander & Sons Co • Health Care Select Group Self Insurance • Carleton College Fund • Centerpoint Energy • Healtheast • Childrens Hospitals And Clinics Of • Healthpartners Inc Minnesota • Hibbing Taconite • Chs Inc • Honeywell International • City Of Duluth • Foods Corporation • City Of Stillwater % Berkley Risk Admin Co • International Paper Co Llc • Isd 0011 Anoka % Sfm Risk Solutions • Coca-Cola Refreshments Usa, Inc • Isd 535 Rochester • Cold Spring Granite Co • Itasca County • Collectively Bargained Contractors Wc Fund • J & R Schugel Holdings Inc % Berkley Risk • Inc Admin Co • Construction Services Grp • Corporation • Crystal Cabinet Works • Knight Transportation Inc • Cummins Inc • Kolberg Pioneer Inc • Dairy Farmers Of America Inc • Lamb Weston/Rdo Frozen A Mn Genl • Dairy Farmers Of America, Inc (Miga) Partnership • Dakota County • Land O Lakes Inc • Dayco Products, Llc • League Of Mn Cities Ins • Diocese Of Winona - Rochester • Life-Science Innovations, Llc • Doherty Staffing Solutions • Lupient Grp Self Ins Fund • Eaton Corp • Lutheran Social Services Of Mn • Ecumen Group Self Insurance Association • Macys Inc • Marvin Lumber & Cedar Co • Rosemount Aerospace Inc • Mayo Clinic • Rosemount Inc • Medtronic Inc • Ryder Services Corp C/O Aon Global Risk • Metal Matic Consulting • Metro Airports Commission • Scherer Brothers Lumber Company • Metropolitan Council • Roebuck & Co • Midwest Safety Group S I • Sfm Risk Solutions - Archdiocese Of St Paul • Miners Incorporated & Mpls • Minn Assoc Of Townships • Sfm-Risk Solutions (Farmers Union • Minn Health Care Assoc Industries) • Minn Manufacturers Assoc • Shafer Contracting Co Inc • Minn Soft Drink Assoc • Smead Manufacturing Co • Minneapolis Building Commission • Southern Mn Beet Sugar Co • Minneapolis City Of • Southern Mn Beet Sugar Co Miga • Minnesota Masonic Charities • St Louis County • Mn Counties Intergovernmental Trust • St Paul City Of • Mpls. Park & Recreation Board • State Of Minn Risk Management • Nabisco Inc C/O Mondelez Global Llc Division/Worker Comp • Natl Supermarkets Inc • Target Corp Target Direct • Nonprofit Insurance Trust • Target Stores • Nordstrom Inc • Taylor Corporation • North Central Group S I • The Boldt Company • North Memorial Hlth Care • The Builders Group • Northern Tool & Equipment • The Davey Tree Expert Co • Otter Tail Corporation • The Dial Corp For Armour • Plymouth City Of • The Sherwin-Williams Company • Polaris Industries Inc. • The Thro Co • Potlatch Land & Lumber Llc • The Company • Presbyterian Homes Of Mn • The Work Connection • Pro Employ Ease, Inc • Trifac Workers Comp Fund • Quadrangle Grp Self Insur • Tyson Foods Inc • R.D. Offutt Farms Co • Ulland Brothers Inc % Berkley Risk Admin • Ramsey County Hr Work Comp Division Co Llc • Range Regional Health Svc • Umi Company Inc • Rci Minnesota • Steel Corporation • Red Wing Shoe Company Inc • Univ Of Mn Risk Mgmt Ins • Richfield City Of • University Of St Thomas • Ridgeview Medical Center • Upper Lakes Foods,Inc. • Riverview Healthcare Assc • Virginia Reg Med Ctr • Roadway Express Inc., C/O Yrc Worldwide • Wayne Transports Inc Inc. • Wells Concrete Product Co., C/O Ccmsi • Rochester City Of • Winona Health • Inc • Yrc Worldwide Inc

Non-Critical-Access Hospitals • Abbott Northwestern Hospital, Minneapolis • Mayo Clinic Health System, Albert Lea • Buffalo Hospital, Buffalo • Mayo Clinic Health System, Fairmont • Cambridge Medical Center, Cambridge • Mayo Clinic Health System, Mankato • District One Hospital, Faribault • Mayo Clinic Hospital, Rochester • Douglas County Hospital, Alexandria • Mercy Hospital, Coon Rapids • Essentia Health Duluth, Duluth • Northfield City Hospital, Northfield • Essentia Health St. Joseph's Medical Center, • Owatonna Hospital, Owatonna Brainerd • Park Nicollet Methodist Hospital, Saint Louis • Essentia Health St. Mary's Detroit Lakes, Park Detroit Lakes • Phillips Eye Institute, Minneapolis • Essentia Health St. Mary's Medical Center, • Regina Hospital, Hastings Duluth • Regions Hospital, St. Paul • Essentia Health Virginia, Virginia • Rice Memorial Hospital, Willmar • Fairview Lakes Medical Center, Wyoming • Ridgeview Medical Center, Waconia • Fairview Northland Regional Hospital, • Sanford Bemidji Medical Center, Bemidji Princeton • Sanford Worthington Medical Center, • Fairview Ridges Hospital, Burnsville Worthington • Fairview Southdale Hospital, Edina • St Luke's Hospital, Duluth • Grand Itasca Clinic and Hospital, Grand • St. Cloud Hospital, St. Cloud Rapids • St. Francis Regional Medical Center, • Healtheast Bethesda Hospital, St. Paul Shakopee • Healtheast St. John's Hospital, Maplewood • United Hospital, St. Paul • Healtheast St. Joseph's Hospital, St. Paul • University Medical Center — Mesabi, • Healtheast Woodwinds Hospital, Woodbury Hibbing • Hutchinson Health, Hutchinson • University of Minnesota Medical Center, • Lake Region Healthcare, Fergus Falls Minneapolis • Lakeview Memorial Hospital, Stillwater • Winona Health Services, Winona • Mayo Clinic Heallth System, Red Wing

Did not supply data: Insurers, self-insurers and Non-Critical-Access Hospitals

The Minnesota workers’ compensation insurers, self-insurers and Non-Critical-Access Hospitals listed here did not supply data for this study.

Insurers • Acceptance Ind Ins Co • Mha Insurance Company (did not receive • American Mining Insurance Company Inc the request by DLI error) • American National Property And Casualty • Pennsylvania Manufacturers' Association Company Ins Co • American Physicians Assurance Corporation • Sea Bright Insurance Company • Austin Mutual Insurance Company • Secura Ins Co (submitted unusable data) • Bedivere Insurance Company C/O • Secura Supreme Ins Co (submitted unusable Onebeacon Ins Group data) • Employers Fire Ins Co C/O Onebeacon Ins • Spring Valley Mutual Insurance Company Group • State National Insurance Company • Genesis Ins Co • T H E Insurance Company • Insurance Co Of The West • Tower Insurance Company Of New York • Iowa Mutual Ins Co • Union Insurance Company • Lamorak Insurance Company C/O • Work First Casualty Company Onebeacon Ins Group

Self-insurers • Admiral Merchants Motor Freight C/O • Ecowater Systems Ahamnn Martin • Evangelical Lutheran Good Samaritan • Ae Goetze/Federal-Mogul Society • Alliant Techsystems Inc • Exon Mobil Corporation • Anderson Trucking Service Inc • Fmc Co C/O Aon Global Risk Consulting • Badger Equipment Co • Gillette Childrens Hosp • Board Of Water Commission • Graco Inc • Browning Ferris Ind Inc - C/O Republic • Grede Llc Services • Hennepin County • Butler Brothers I/C • Hpi Ramsey • Centurylink/Qwest Corporation • Hutchinson Technology Inc • • Interstate Power & Light Company • Citigroup Inc • Isd 0625 St Paul • Conwed Corp • J C Penney Corporation Inc • Covenant Ministries Of Benevolence • Jennie O Turkey Stores Inc • Dana Incorporated • Knife River Corporation North Central • Del Monte Foods • Kraft Amer Fruit & Prod C/O Mondelez • E. I. Du Pont De Nemours And Company International • Lear Corporation • Post Consumer Brands Company • Louisiana Pacific Corp (did not receive the • Rexam Beverage Can Americas request by DLI error) • Special School Dist 0001 • Lunda Construction Compan • Stan Koch & Sons Trucking, Inc. (did not • M A Hanna Company I/C receive request by DLI error) • Minn Rural Elect Wc Trust • The Gillette Co % Procter & Gamble • Minnesota Energy Resources Corporation Company • Minnesota Vikings / Mcombs Enterprises • Three Rivers Park District • Navistar, Inc. • Transportation Leasing Co • Nestle Purina Petcare Company • Vr Us Holdings Inc • Officemax Incorporated • West Central Turkey • Olmsted County • Westinghouse Elec % Cbs Corporation • Park Nicollet Health Serv • Weyerhaeuser Co • Parker Hannifin Corp • Whirlpool Corp • Peopleready, Inc. • White Castle System Inc • Poly America Inc

Non-Critical-Access Hospitals • Hennepin County Medical Center, • Olmsted Medical Center, Rochester Minneapolis • Regency Hospital of Minneapolis, Golden • Maple Grove Hospital, Maple Grove Valley • North Memorial Medical Center, Robbinsdale