Ambulatory Surgical Center Payment System study: Data collection

Supplied data: Insurers, self-insurers and ambulatory surgical centers

The Minnesota workers' compensation insurers, self-insurers and ambulatory surgical centers (ASCs) listed below supplied data for the Evaluation of the impact of the Minnesota workers' compensation Ambulatory Surgical Center Payment System (ASCPS) 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 Interstate Insurance Company • Accident Fund Insurance Co Of America • American Select Insurance Company • Accident Fund National Insurance Company • Amerisure Insurance Company • Ace American Ins Co • Amerisure Mutual Ins Co • Ace Fire Underwriters Ins • Amerisure Partners Insurance Company • Ace Property & Cas Ins Co • Amguard Insurance Company • Acig Insurance Company • Arch Insurance Company • Acuity A Mutual Insurance Company • Argonaut Ins Co • Addison Ins Co • Arrowood Indemnity Company • Aig Property Casualty Company • Associated Indemnity Co • Allmerica Financial Benefit • Assurance Co Of America • Allstate Insurance Co • Atlantic Specialty Ins Co C/O Onebeacon Ins • Amco Ins Co Group • Amer Cas Co • Auto Owners Ins Co • Amer Compensation Ins Co • Bankers Standard Ins Co • Amer Fire & Cas Co • Berkley National Insurance Company • Amer Guarantee & Liab Ins • Berkley Regional Ins Co • Amer Home Assurance Co • Berkshire Hathaway Homestate Ins • Amer Policyholders Liq Tr Company • Amer States Ins Co • Bitco General Insurance Corporation • Amer Zurich Ins Co • Bitco National Insurance Company • American Alternative Ins • Bloomington Compensation Insurance • American Economy Insurance Co Company • American Family Mutual Ins Co • Brotherhood Mutual Insurance Company • American Insurance Company • Carolina Casualty Ins Co

443 Lafayette Road N., St. Paul, MN 55155 • 651-284-5005 • www.dli.mn.gov • Century Indemnity Co • First Nonprofit Insurance Co • Charter Oak Fire Ins Co • Firstcomp Insurance Company • Cherokee Insurance Company • Florists Mutual Ins Co • Chubb Indemnity Ins Co • Foremost Insurance Company • Church Mutual Ins Co • Forest Products Ins Exch • Citizens Insurance Company Of America • General Cas Co Of Wi • Commerce & Industry Ins Co • General Casualty Insurance Company • Continental Cas Co • General Insurance Company Of America • Continental Indemnity Company • Granite State Ins Co • Continental Ins Co • 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 • First Liberty Ins Corp • Liberty Mutual Fire Ins • 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 • Norguard Insurance Company • Sentry Casualty Company • 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 • State Farm 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 • Travelers Property Casualty Co Of America

Self-insurers • ABF Freight System • Ak Steel Corp • Access Insurance Assoc • Allete Inc • Adc Telecommunications C/O Commscope • Allina Health System Holding Comp • American Crystal Sugar • Ag Processing Inc • Amherst Wilder Foundation • 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 • Cargill, 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 • Hormel 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 • Conagra Brands Inc Admin Co • Construction Services Grp • Kmart 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 • Eep Workers Comp Fund • Marvin Lumber & Cedar Co • Electric Insurance Co/Ge Wells Food • Mayo Clinic • Medtronic Inc • Ryder Services Corp C/O Aon Global Risk • Metal Matic Consulting • Metro Airports Commission • Scherer Brothers Lumber Company • Metropolitan Council • Sears 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 Corporation 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 Toro 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 • United States 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 • Rosemount Aerospace Inc • Xcel Energy Inc • Rosemount Inc • Yrc Worldwide Inc Ambulatory surgical centers • Avera Medical Group Worthington Surgery • Midsota Surgery Center Center • Minnesota Valley Surgery Center • Blaine Orthopedic Surgery Center • Monticello Surgery Center • Burnsville Surgery Center • Nura Surgical Center — Edina • Carris Health Surgery Center • Nura Surgical Center — Maple Grove • Centers for Diagnostic Imaging — St. Louis • Pavilion Surgery Center Park • Plymouth Asc • Centers for Diagnostic Imaging — • Plymouth Surgery Center (Summit Woodbury Corner Stone Orthopedics) • Centracare Surgery Center • Sanford Detroit Lakes Ambulatory Surgical • Chaska Plaza Surgery Center Center • Crosstown Surgery Center • Southhealth Surgery Center • Eagan Orthopedic Surgery Center • Southwest Surgical Center • Eagan Surgery Center (Summit Orthopedics) • St. Cloud Surgical Center (only supplied data • Family Surgery Center for analysis of payment timing, not • Greenway Surgery Center (Hiawatha payment accuracy) Surgery Center) • Surgicare of Minneapolis (Centennial Lakes • High Pointe Surgery Center Surgery Center) • Horseshoe Surgery Center • TRIA Orthopedic Center • Lakewalk Surgery Center • TRIA Woodbury Orthopedic Center • Landmark Surgery Center (Summit • Twin Cities Surgery Center Orthopedics) • Vadnais Heights Surgery Center (Summit • Mankato Surgery Center Orthopedics) • Maple Grove Ambulatory Surgical Center • Westhealth Surgery Center • Maple Grove Center For Restorative Surgery

Did not supply data: Insurers, self-insurers and ACSs

The Minnesota workers' compensation insurers, self-insurers and ACSs listed here did not supply data for this study.

Insurers • Acceptance Ind Ins Co • Bedivere Insurance Company C/O • American Mining Insurance Company Inc Onebeacon Ins Group • American National Property And Casualty • Cincinnati Casualty Co Company • Cincinnati Indemnity Co • American Physicians Assurance Corporation • Cincinnati Ins Co • Austin Mutual Insurance Company • Continental Western Insurance Company

443 Lafayette Road N., St. Paul, MN 55155 • 651-284-5005 • www.dli.mn.gov • Employers Fire Ins Co C/O Onebeacon Ins • Sea Bright Insurance Company Group • Secura Ins Co • Genesis Ins Co • Secura Supreme Ins Co • Insurance Co Of The West • Spring Valley Mutual Insurance Company • Iowa Mutual Ins Co • State National Insurance Company • Lamorak Insurance Company C/O • T H E Insurance Company Onebeacon Ins Group • Tower Insurance Company Of New York • Mha Insurance Company (did not receive • Union Insurance Company request by DLI error) • Work First Casualty Company • Pennsylvania Manufacturers' Association Ins Co

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

Ambulatory surgical centers • ACMC-Marshall Surgery Center • North Memorial Ambulatory Surgery • Brainerd Lakes Surgery Center • North Metro Surgery Center • Center for Pain Management • Pain Centers of Minnesota — Chaska • Chu Surgery Center • Pain Centers of Minnesota — Mankato • Fairview Maple Grove Surgery Center • Ridges Surgery Center • HealthEast-Maplewood Surgery Center • South Central Surgical Center • ILBNC Special Procedures • Southwest Minnesota Surgery Center • Midwest Surgery Center • University of Minnesota Health Clinics and • Minneapolis Pain Centers — Edina Surgery Center • Minneapolis Pain Centers — Maple Grove • Wayzata Surgery Center • Minnetonka Ambulatory Surgery • Woodbury Surgical Suites • Minnesota Orthopaedic Surgery Center