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Carefirst +.V Family of health care plans CareFirst Third Party Administrator (TPA)/Network Lease Accounts Only CareFirst contracts with Third Party Administrators to the Network claims product. Please send all correspondence and non-claim inquiries to the TPA addresses below. Please submit claims electronically using EDI Payer Codes: Professional – 580, Facility – 190.

Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

PO Box NCAS NCAS MULTIPLE 981610 Customer A11 PO Box 981610 Customer Service 800-888-6227 Prof. 580/Inst. 190 GROUPS El Paso, TX Service El Paso, TX 79998 79998-1633 Group Benefit Group Benefit Services P.O. Box A12 Services 6 North Park Dr. 981633 Customer Service 410-832-1300 Call TPA Prof. 580/Inst. 190 A121 Delta Chemical Suite 310 El Paso, TX Group Hunt Valley, MD 21030 79998-1633 Employee Security/NEA Employee Securities P.O. Box A17 10400 Little Patuxent Pkwy. 981633 Customer Service 410-997-3300 Call TPA Prof. 580/Inst. 190 SM62 Timonium Toyota Suite 260 El Paso, TX NEA’s, Tenax, Columbia, MD 21044-3518 79998-1633 Builders Benefits Administration P.O. Box Corporation, Inc. (BACI) A22 Electrical 981633 410-444-8516 9411 RD. Customer Service Call TPA Prof. 580/Inst. 190 2003 Health Fund El Paso, TX 800-352-2741 Suite S 79998-1633 , MD 21237 UFCW National Health and P.O. Box WEPCO Federal A23 Welfare Fund 981633 Credit Union UFCW Customer Service 888-773-8329 Call TPA Prof. 580/Inst. 190 W33P 66 Grand Ave. El Paso, TX Local 27 Englewood, NJ 07631 79998-1633 Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

P.O. Box UFCW Local 27 A25 Sterling Care 981633 66 Grand Ave. Customer Service 888-773-8329 Call TPA Prof. 580/Inst. 190 W33F Frostburg Village El Paso, TX Englewood, NJ 07631 79998-1633 P.O. Box Frostburg Village UFCW Local 27 A26 981633 Assisted Living 66 Grand Ave. Customer Service 888-773-8329 Call TPA Prof. 580/Inst. 190 W33G El Paso, TX Englewood, NJ 07631 79998-1633 Seagram’s – UFCW UFCW National Fund – P.O. Box A36 Fund Contributing Employer Groups 981633 Customer Service 888-773-8329 Call TPA Prof. 580/Inst. 190 L026 Social Security 66 Grand Ave. El Paso, TX Fund/UFCW Englewood, NJ 07631 79998-1633 Construction BeneSys, Inc. P.O. Box A38 Workers Trust 7130 Columbia Gateway Dr. 981633 Customer Service 410-884-1406 Call TPA Prof. 580/Inst. 190 W31A Suite A El Paso, TX Columbia, MD 21046 79998-1633 Benefits Administration Plumbers & P.O. Box A39 Corporation, Inc. (BACI) Steamfitters Local 981633 410-254-4800 486W 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 486 El Paso, TX 855-505-0462 W31B Suite S 79998-1633 Baltimore, MD 21237 Benefits Administration Teamsters Local P.O. Box Corporation, Inc. (BACI) A42 #355 981633 443-573-3632 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W31F Truck Drivers & El Paso, TX 866-621-7974 Suite S Helpers 79998-1633 Baltimore, MD 21237 International Benefits Administration Alliance of P.O. Box Corporation, Inc. (BACI) A47 Theatrical Stage 981633 410-319-7264 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W31R Employees Local 22 El Paso, TX 800-941-2752 Suite S Pension & Welfare 79998-1633 Baltimore, MD 21237 Fund (IATSE) Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

Benefits Administration P.O. Box Corporation, Inc. (BACI) A48 Sheet Metal 981633 443-573-3635 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W29F Workers Local 100 El Paso, TX 888-805-7996 Suite S 79998-1633 Baltimore, MD 21237 Teamsters #570 Health Fund P.O. Box A49 Teamsters #570 1005 North Point Blvd. 981633 Customer Service 410-282-0510 Call TPA Prof. 580/Inst. 190 W29J Health Fund Suite 726 El Paso, TX Baltimore, MD 21224 79998-1633 Decision Sciences P.O. Box A52 Operating 3615 North Point Blvd. 981633 Customer Service 410-254-9595 Call TPA Prof. 580/Inst. 190 W29L Engineers Local 99 Suite C El Paso, TX Baltimore, MD 21222 79998-1633 Decision Sciences P.O. Box A54 Operating 3615 North Point Blvd. 981633 Customer Service 410-254-9595 Call TPA Prof. 580/Inst. 190 W29M Engineers Local 37 Suite C El Paso, TX Baltimore, MD 21222 79998-1633 Asbestos Workers BeneSys, Inc. P.O. Box A55 Local 24 Medical 7130 Columbia Gateway Dr. 981633 Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W29N Fund Suite A El Paso, TX (Eff. 9/1/21) Columbia, MD 21046 79998-1633 United Food & Commercial UFCW & Workers (UFCW Health & P.O. Box Participating Food A56 Welfare 981633 Industry Employers Customer Service 800-228-7484 Call TPA Prof. 580/Inst. 190 W29P 27 Roland Ave. El Paso, TX Tri-State Health & Suite 100 79998-1633 Welfare Fund Mt Laurel, NJ 08054 Zenith American Solutions P.O. Box 3 Gateway Center A58 Bricklayers & Allied 981633 401 Liberty Ave. Customer Service 410-828-5282 Call TPA Prof. 580/Inst. 190 W31W Craftsmen El Paso, TX Suite 1200 79998-1633 , PA 15222-1024 Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

P.O. Box Associated Administrators A59 981633 FELRA 911 Ridgebrook RD. Customer Service 800-638-2972 Call TPA Prof. 580/Inst. 190 W31Y El Paso, TX Sparks, MD 21152-9451 79998-1633 Zenith American Solutions P.O. Box 3 Gateway Center A62 Beverage Worker’s 981633 401 Liberty Ave. Customer Service 800-242-8923 Call TPA Prof. 580/Inst. 190 W32A Local 67 El Paso, TX Suite 1200 79998-1633 Pittsburgh, PA 15222-1024 Zenith American Solutions P.O. Box 3 Gateway Center A63 Iron Workers Local 981633 401 Liberty Ave. Customer Service 800-242-8923 Call TPA Prof. 580/Inst. 190 W32B #5 El Paso, TX Suite 1200 79998-1633 Pittsburgh, PA 15222-1024 P.O. Box Associated Administrators A64 Operating 981633 911 Ridgebrook RD. Customer Service 877-850-0977 Call TPA Prof. 580/Inst. 190 W32C Engineer’s Local 77 El Paso, TX Sparks, MD 21152-9451 79998-1633

BeneSys, Inc. P.O. Box A65 Plumbers & 7130 Columbia Gateway Dr. 981633 410-872-9500 Customer Service Call TPA Prof. 580/Inst. 190 W32D Pipefitters Local # 5 Suite A El Paso, TX 800-741-9249 Columbia, MD 21046 79998-1633

Benefits Administration P.O. Box Corporation, Inc. (BACI) A66 Heating Piping & 981633 410-444-3756 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W32E Refrigeration El Paso, TX 800-618-2879 Suite S 79998-1633 Baltimore, MD 21237 Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

Zenith American Solutions P.O. Box 3 Gateway Center A67 981633 412-471-2885 Rodman Local 201 401 Liberty Ave. Customer Service Call TPA Prof. 580/Inst. 190 W32F El Paso, TX 800-242-8923 Suite 1200 79998-1633 Pittsburgh, PA 15222-1024 BeneSys, Inc. P.O. Box A68 D.C. 7130 Columbia Gateway Dr. 981633 Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W32G Cement Masons Suite A El Paso, TX Columbia, MD 21046 79998-1633 BeneSys, Inc. P.O. Box A70 Stone and Marble 7130 Columbia Gateway Dr. 981633 Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W32J Masons Suite A El Paso, TX Columbia, MD 21046 79998-1633 BeneSys, Inc. P.O. Box A71 7130 Columbia Gateway Dr. 981633 Man-U-Service Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W32K Suite A El Paso, TX Columbia, MD 21046 79998-1633 BeneSys, Inc. P.O. Box Washington A73 7130 Columbia Gateway Dr. 981633 Wholesalers Health Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W32M Suite A El Paso, TX and Welfare Fund Columbia, MD 21046 79998-1633 P.O. Box Hagerstown Zenith American Solutions A74 981633 Teamsters 10312 Remington Drive Customer Service 301-733-2602 Call TPA Prof. 580/Inst. 190 W32N El Paso, TX Effective 9/1/2020 Hagerstown, MD 21740 79998-1633 BeneSys, Inc. P.O. Box A75 7130 Columbia Gateway Dr. 981633 DC Pavers Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W32P Suite A El Paso, TX Columbia, MD 21046 79998-1633 Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

UFCW Unions & P.O. Box Participation Associated Administrators A77 981633 Employers Health & 911 Ridgebrook RD. Customer Service 800-638-2972 Call TPA Prof. 580/Inst. 190 W32R El Paso, TX Welfare Fund Sparks, MD 21152-9451 79998-1633 (NONFOOD)

Sheppard Pratt A80 PO Box Allegeant SHPS 981801 Upper PO Box 981801 Customer Service 800-553-8635 Call TPA Prof. 580/Inst. 190 UCH El Paso, TX El Paso, TX 79998 AOC 79998 Ascend One

Zenith American Solutions P.O. Box Council # 3 Gateway Center A81 981633 51 Health Fund 401 Liberty Ave. Customer Service 800-242-8923 Call TPA Prof. 580/Inst. 190 W32W El Paso, TX Suite 1200 79998-1633 Pittsburgh, PA 15222-1024 UFCW National Fund – P.O. Box Sun Products A87 International 981633 Corporation Retirees Customer Service 888-773-8329 Call TPA Prof. 580/Inst. 190 W33D Chemical El Paso, TX 66 Grand Ave. 79998-1633 Englewood, NJ 07631 P.O. Box Associated Associated Administrators A94 981633 Administrators – 911 Ridgebrook RD. Customer Service 800-638-2972 Call TPA Prof. 580/Inst. 190 W33K El Paso, TX Employee Group Sparks, MD 21152-9451 79998-1633 United Food & Commercial Workers (UFCW Health & P.O. Box A95 Welfare 981633 UFCW Customer Service 800-228-7484 Call TPA Prof. 580/Inst. 190 W33E 27 Roland Ave. El Paso, TX Suite 100 79998-1633 Mt Laurel, NJ 08054 Prefix Group Name TPA Name & Address Claims Filing Claims & Benefit Phone Filing Limit Electronic Payer Group Address Contact Name Number ID Number

Benefits Administration Transport Workers P.O. Box Corporation, Inc. (BACI) A96 Union Health and 981633 410-444-0659 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W33L Welfare Plan El Paso, TX 800-618-2879 Suite S 79998-1633 Baltimore, MD 21237 BeneSys, Inc. P.O. Box Teamsters Local A97 7130 Columbia Gateway Dr. 981633 922 Health Trust Customer Service 410-872-9500 Call TPA Prof. 580/Inst. 190 W33M Suite A El Paso, TX Columbia, MD 21046 79998-1633 Bakery and Sales Benefits Administration P.O. Box Drivers Local 33 Corporation, Inc. (BACI) A98 981633 410-444-3750 Industry Welfare 9411 Philadelphia RD. Customer Service Call TPA Prof. 580/Inst. 190 W33N El Paso, TX 800-922.0602 Fund Suite S 79998-1633 Baltimore, MD 21237

PRD1065 (9/21) CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In , CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans