iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID 1 Arnoff Moving & Storage - WC 1282 Dutchess Turnpike 1ARNO001 New York Workers' Poughkeepsie, NY 12603 Compensation 1st Auto & Casualty [Electronic] E1365B Auto/No-Fault , 1st Auto & Casualty [Electronic] E1365C Other WC (Non-NY) , 207 resolutions llc 8417 oswego rd 207RE002 New York Workers' mahopac, NY 10541 Compensation 207 RESOLUTIONS LLC 8417 Oswego Road 207RE001 New York Workers' PMB111 Compensation Baldwinsville, NY 13027 21 CENTURY INSURANCE 21ST CENTURY PLAZA 21CEN001 Auto/No-Fault PO BOX 15510 WILMINGTON, DE 19850 21st Century PO BOX 268820 21STC005 Auto/No-Fault Oklahoma City, OK 73126 21st Century PO BOX 52165 21STC002 Auto/No-Fault Phoenix, AZ 85072 21ST CENTURY PO BOX 29229 21STC001 Auto/No-Fault PHOENIX, AZ 85038 21st Century Insurance PO Box 268995 21STC006 Auto/No-Fault Oklahoma City, OK 73126-8995 21st Century Insurance [Electronic] E0657A New York Workers' , Compensation 21st Century Insurance [Electronic] E0657C Other WC (Non-NY) , 21ST CENTURY INSURANCE COMPANY 100 DUFFY AVENUE 21STC007 Auto/No-Fault HICKSVILLE, NY 11802 22125 Roscoe Corp. [Electronic] E0658A New York Workers' , Compensation 22125 Roscoe Corp. [Electronic] E0658C Other WC (Non-NY) , 3-HAB 9916 CARVER RD 3HAB001 New York Workers' STE 400 Compensation CINCINNATI, OH 45242 3M disability PO BOX 3115 3MDIS001 New York Workers' ST PAUL, MN 55133 Compensation 3M Disability Program/Sedgewick PO Box 14431 3MDIS002 New York Workers' Lexington, KY 40512 Compensation 7-ELEVEN 122 VICTORY HIGHWAY 7ELEV001 New York Workers' PAINTED POST, NY 14870 Compensation A & R DETHOMAS COMPANY 1 RAPP ROAD ARDET001 New York Workers' #2 Compensation ALBANY, NY 12203 A G ADMINISTRATORS PO BOX 979 AGADM001 Other WC (Non-NY) VALLEY FORGE, PA 194810000 A T & A Trucking Corp PO BOX 367 ATATR001 New York Workers' Lancaster, NY 14086 Compensation A W FARRELL & SON 3761 E LAKE ROAD AWFAR002 New York Workers' DUNKIRK, NY 14048 Compensation A&P AVE A & NORTH STREET AP001 New York Workers' BAYONNE, NJ 07002 Compensation AAA / Liability PO Box 66502 AAALI001 Auto/No-Fault Saint Louis, MO 63166 AAA [Electronic Indirect] 2560 East Paris, attn: Jennifer AAA001 New York Workers' Kentwood, MI 49516 Compensation AAA [Electronic Indirect] 2560 East Paris, attn: Jennifer AAA002 Other WC (Non-NY) Kentwood, MI 49516 AAA [Electronic Indirect] 3 Executive Campus, Suite 100 AAA003 New York Workers' Route 70 & Cuthbert Blvd. Compensation Cherry Hill, NJ 08002 AAA [Electronic Indirect] 3 Executive Campus, Suite 100 AAA010 Other WC (Non-NY) Route 70 & Cuthbert Blvd. Cherry Hill, NJ 08002 AAA [Electronic Indirect] 345 BAY RD. AAA004 New York Workers' QUEENSBURY, NY 12804 Compensation AAA [Electronic Indirect] 345 BAY RD. AAA011 Other WC (Non-NY) QUEENSBURY, NY 12804 AAA [Electronic Indirect] PO BOX 24523 AAA005 New York Workers' Oakland, CA 94623 Compensation AAA [Electronic Indirect] PO BOX 24523 AAA012 Other WC (Non-NY) Oakland, CA 94623 AAA [Electronic Indirect] PO Box 248 AAA006 New York Workers' Essington, PA 19029 Compensation AAA [Electronic Indirect] PO Box 248 AAA013 Other WC (Non-NY) Essington, PA 19029 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AAA [Electronic Indirect] PO Box 26260 AAA007 New York Workers' San Diego, CA 921960260 Compensation AAA [Electronic Indirect] PO Box 26260 AAA014 Other WC (Non-NY) San Diego, CA 921960260 AAA [Electronic Indirect] PO BOx 31107 AAA008 New York Workers' Tampa, FL 33631 Compensation AAA [Electronic Indirect] PO BOx 31107 AAA015 Other WC (Non-NY) Tampa, FL 33631 AAA [Electronic Indirect] PO Box 920 AAA009 New York Workers' Siusun, CA 94585 Compensation AAA [Electronic Indirect] PO Box 920 AAA016 Other WC (Non-NY) Siusun, CA 94585 AAA INSURANCE PO BOX 24523 AAAIN001 Auto/No-Fault OAKLAND, CA 94623-1523 AAA INSURANCE PO BOX 2946 AAAIN002 Auto/No-Fault CLINTON, IA 52733-2946 AAA Mid Atlantic PO BOX 5483 AAAMI001 Auto/No-Fault MT LAUREL, NJ 08054 AAA MID ATLANTIC 379 THORNALL ST AAAMI002 Auto/No-Fault EDISON, NJ 08837 AAA MID ATLANTIC PO BOX 5432 AAAMI003 Auto/No-Fault MT LAUREL, NJ 08054 AAA MIDATLANTIC PO BOX 348 AAAMI005 Auto/No-Fault ESSINGTON, PA 19029 AAA Minnesota/Iowa [Electronic] E3748B Auto/No-Fault , AAA Northern CA, NV & UT Ins exchange E9989A New York Workers' [Electronic] , Compensation AAA Northern CA, NV & UT Ins exchange E9989C Other WC (Non-NY) [Electronic] , AAA NORTHWAY WC 345 BAY RD. AAANO001 New York Workers' QUEENSBURY, NY 12804 Compensation AAC CONTRACTING 175 HUMBOLDT ST AACCO001 New York Workers' ROCHESTER, NY 14610 Compensation AAMCO 1701 UNION RD AAMCO001 New York Workers' WEST SENECA, NY 14224 Compensation AARLA PO Box 9783 AARLA001 New York Workers' Fresno, CA 97831 Compensation AARON'S SALES & LEASE 363 ELMIRA ROAD AARON001 New York Workers' ITHACA, NY 14850 Compensation AASGARD SUMMIT MANAGEMENT 4017 13TH AVE WEST AASGA001 New York Workers' SEATTLE, WA 98119 Compensation ABAR CONSTRUCTION 225 OLD LOUDON ROAD ABARC001 New York Workers' LATHAM, NY 12110 Compensation ABC COMP TRUST 6315 FLY RD ABC02 New York Workers' E SYRACUSE, NY 13057 Compensation ABC Const. Company [Electronic] E9990A New York Workers' , Compensation ABC Const. Company [Electronic] E9990C Other WC (Non-NY) , ABC HEAVY TRANSPORT 4460 107th CIRCLE ABCHEA01 New York Workers' CLEARWATER, FL 33762 Compensation ABC REFRIGERATION 6619 JOY ROAD ABCRE001 New York Workers' EAST SYRACUSE, NY 13057 Compensation ABDELHADI & ASSOCIATES 970 MAIN STREET SUITE# 1 ABDEL001 Auto/No-Fault PATERSON, NJ 07503 ABDY & KANE ATT 97 Lackawanna Ave ABDYK001 Auto/No-Fault Totowa, NJ 07512 Abercrombi, Simmons, and Gillette PO BOX 13367 ABERC001 New York Workers' Norfolk, VA 23506 Compensation ABF FREIGHT SYSTEM INC C/O RISK MANAGEMENT DEPT ABFFR001 Other WC (Non-NY) PO BOX 10048 FORT SMITH, AR 72917-0048 ABF FRIEGHT SYSTEMS 7020 NORTH BLVD ABF01 New York Workers' E SYRACUSE, NY 13057 Compensation ABF FRIEGHT SYSTEMS PO BOX 10048 ABFFREI01 New York Workers' FORTSMITH, AR 72917 Compensation ABLE 2 PO BOX 1554 ABLE2001 New York Workers' Elmira, NY 14904 Compensation ABLE COM ANSWERING SERVICE 265 CHANDLER ST ABLEC001 New York Workers' BUFFALO, NY 14207 Compensation ABM Industries 777 Sheridan Dr ABMIN001 New York Workers' Tonawanda, NY 14150 Compensation ABSCOPE PO BOX 487 ABSCO001 New York Workers' CANASTOTA, NY 13032 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ABSOLUT CARE OF GASPORT 4540 LINCOLN DR ABSOL005 New York Workers' GASPORT, NY 14067 Compensation ABSOLUT OF AURORA PARK 292 MAIN ST ABSOL003 New York Workers' E AURORA, NY 14052 Compensation ABSOLUT OF WESTFIELD 26 CASS STREET ABSOL006 New York Workers' ATTN:SALLY BRIGHTMAN Compensation WESTFIELD, NY 14787 ABSOLUTE CARE AT ENDICOTT 301 NANTUCKET DRIVE ABSOL001 New York Workers' ENDICOTT, NY 13760 Compensation Absolute Care at Three Rivers 101 Creekside Drive ABSOL007 New York Workers' Painted Post, NY 14870 Compensation ABSOLUTE FACILITY MANAGEMENT 300 GLEED AVENUE ABSOL002 New York Workers' EAST AURORA, NY 14052 Compensation ABSOLUTE OF HOUGHTON 56 EAST WATERLOO ST ABSOL004 New York Workers' CANAL WINCHESTER, OH 43110 Compensation ABSOLUTE OF ORCHARD PARK 6060 ARMOUR RD AOP01 New York Workers' ORCHARD PARK, NY 14127 Compensation ABSSOLUTE OF HOUGHTON 9876 LUCKEY DRIVE ABSSO001 New York Workers' HOUGHTON, NY 14744 Compensation ACA INSURANCE PO BOX 24523 ACAIN001 Auto/No-Fault OAKLAND, CA 94623 ACADIA 301 PLAINFIELD ROAD SUITE 250 ACADI001 New York Workers' SYRACUSE, NY 13212 Compensation ACADIA INS CO PO BOX 9010 ACA02 New York Workers' WESTBROOK, ME 04098-5010 Compensation Acadia Insurance Company [Electronic] E9991C Other WC (Non-NY) , Accede Mold & Tool 1125 Lexington Ave ACCED001 New York Workers' Rochester, NY 14606 Compensation Accelerated PO Box 6030 ACCEL001 Other WC (Non-NY) Parsippany, NJ 07054 ACCENT STRIPE INC 3275 NORTH BENZING RD ACCEN001 New York Workers' ORCHARD PARK, NY 14127 Compensation ACCESS GENERAL INS ADJSTR PO BOX 105143 ACCES003 Auto/No-Fault AUTO CLAIMS ATLANTA, GA 30348 Access General Insurance [Electronic] PO BOX 250087 ACCES001 Auto/No-Fault ATLANTA, GA 30325 ACCIDENT FUND P.O. BOX 40790 ACCID003 Other WC (Non-NY) LANSING, MI 48901 Accident Fund Ins Co of America / WC PO Box 40790 ACCID001 Other WC (Non-NY) Lansing, MI 48901 Accident Fund Insurance Co of America E1136C Other WC (Non-NY) [Electronic] , ACCIDENT FUNDS INS CO OF AMERICA P.O. Box 40790 ACCID002 New York Workers' Lansing, MI 48901-7990 Compensation ACCLAIM RISK MANAGEMENT 505 THORNALL STREET, STE 303 ACCLA004 Other WC (Non-NY) EDISON, NJ 08837 ACCLAIM RISK MANGEMENT 505 THORNALL STREET ACCLA003 New York Workers' SUITE 303 Compensation EDISON, NJ 08837 ACCUFAB 232 Cherry Street ACCUF001 New York Workers' Ithaca, NY 14850 Compensation ACCUMED DALLAS 4100 INTERNATIONAL PKWY ACCUM001 New York Workers' SUITE 1010 Compensation CARROLLTON, TX 75007 ACCURATE ACOUSTICAL INC 793 CANNING PKWY ACCUR001 New York Workers' VICTOR, NY 14564 Compensation Accuride Corporation [Electronic] E3033C Other WC (Non-NY) , Accustaff 106 West Main Street ACCUS002 New York Workers' Johnstown, NY 12095 Compensation ACCUSTAFF 53 BRIDGE ST ACCUS001 New York Workers' CORNING, NY 14830 Compensation ACE a/nf PO BOX 5122 ACEAN001 Auto/No-Fault Scranton, PA 18505 Ace American Insurance Company [Electronic PO BOX 14519 ACEAM002 New York Workers' Indirect] Lexington, KY 405124519 Compensation Ace American Insurance Company [Electronic PO BOX 14519 ACEAM003 Auto/No-Fault Indirect] Lexington, KY 405124519 Ace American Insurance Company [Electronic PO BOX 14519 ACEAM004 Other WC (Non-NY) Indirect] Lexington, KY 405124519 Ace Fire Underwriters Insurance Co [Electronic PO BOX 1000 ACEFI001 New York Workers' Indirect] WA04R Compensation PHILADELPHIA, PA 19106 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Ace Fire Underwriters Insurance Co [Electronic PO BOX 1000 ACEFI003 Auto/No-Fault Indirect] WA04R PHILADELPHIA, PA 19106 Ace Fire Underwriters Insurance Co [Electronic PO BOX 1000 ACEFI005 Other WC (Non-NY) Indirect] WA04R PHILADELPHIA, PA 19106 Ace Fire Underwriters Insurance Co [Electronic PO BOX 31080 ACEFI002 New York Workers' Indirect] WA04R Compensation TAMPA, FL 33631 Ace Fire Underwriters Insurance Co [Electronic PO BOX 31080 ACEFI004 Auto/No-Fault Indirect] WA04R TAMPA, FL 33631 Ace Fire Underwriters Insurance Co [Electronic PO BOX 31080 ACEFI006 Other WC (Non-NY) Indirect] WA04R TAMPA, FL 33631 ACE MASONRY 134 CECIL A MALONE DRIVE ACEMA001 New York Workers' ITHACA, NY 14850 Compensation Ace Private Risk Services PO Box 574 ACEPR001 Auto/No-Fault Deer Park, NY 11729 Ace Property & Casualty Ins Co [Electronic] E9992A New York Workers' , Compensation Ace Property & Casualty Ins Co [Electronic] E9992C Other WC (Non-NY) , ACE PROPERTY AND CASUALTY CO PO BOX 6561 ACEPR002 Other WC (Non-NY) SCRANTON, PA 185056561 ACHIEVE 125 CUTLER POND ROAD ACHIE001 New York Workers' ATT:HUMAN RESOURCES Compensation BINGHAMTON, NY 13905 ACIG INSURANCE COMPANY SUITE 1660 ACIG01 New York Workers' 12222 MERIT DRIVE Compensation DALLAS, TX 75251 ACIG Insurance Company [Electronic] E1366B Auto/No-Fault , ACIG Insurance Company [Electronic] E1366C Other WC (Non-NY) , ACME GARFIELD AVENUE ACME001 New York Workers' JERSEY CITY, NJ 07305 Compensation ACME BUS CORP 3355 VETERANS MEMORIAL HWY ACMEB001 New York Workers' RONKONKOMA, NY 11779 Compensation ACORN MARKET / PUTNAM COMPANY 11499 ROUTE 6 ACORN001 New York Workers' WELLSBORO, PA 16901 Compensation ACS Claims Service Po Box 257 ACSCL001 New York Workers' Mechanicsburg, PA 17055 Compensation ACS SEDWICK WC 101 YORKSHIRE BLVD ASW01 New York Workers' LEXINGTON, KY 40509 Compensation ACUITY 2800 S TAYLOR DR ACUIT001 New York Workers' PO BOX 58 Compensation SHEBOYGAN, WI 53081 ACUITY [Electronic Indirect] 2800 S TAYLOR DR ACUIT002 New York Workers' PO BOX 58 Compensation SHEBOYGAN, WI 53081 ACUITY [Electronic Indirect] 2800 S TAYLOR DR ACUIT003 Other WC (Non-NY) PO BOX 58 SHEBOYGAN, WI 53081 ACUITY INSURANCE PO BOX 58 ACUIT004 Auto/No-Fault SHEBOYGAN, WI 53082 Acuity, A Mutual Insurance Company [Electronic] E3627A New York Workers' , Compensation Acuity, A Mutual Insurance Company [Electronic] E3627C Other WC (Non-NY) , AD Call and Sons PO BOX 60 ADCAL001 New York Workers' Stafford, NY 14143 Compensation Adams Fairacre Farms - WC 765 Dutchess Turnpike ADAMS001 New York Workers' Poughkeepsie, NY 12603 Compensation ADAMS MARK HOTEL 120 CHURCH ST ADAMS002 New York Workers' BUFFALO, NY 14202 Compensation AD-COMP [Electronic] E1165A New York Workers' , Compensation AD-COMP [Electronic] E1165B Auto/No-Fault , AD-COMP [Electronic] E1165C Other WC (Non-NY) , Add Development 7A Johnson Road ADDDE001 New York Workers' Latham, NY 12110 Compensation Addis Group 2500 Renaissance Blvd ADDIS002 New York Workers' King of Prussia, PA 19406 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ADDISON CENTRAL SCHOOL 7787 STATE ROUTE 417 ADDIS001 New York Workers' ATTN: SUE/ PAYROLL Compensation ADDISON, NY 14801 ADDISON CENTRAL SCHOOL ATTN: SUE/ PAYROLL ADDIS003 New York Workers' 7787 STATE ROUTE 417 Compensation ADDISON, NY 14801 ADECCO EMPLOYMENT SERVICES 1 WEST MARKET STREET ADECC003 New York Workers' CORNING, NY 14830 Compensation ADECCO EMPLOYMENT SERVICES 218 WEST MAIN ST ADECC004 New York Workers' BATAVIA, NY 14020 Compensation ADECCO EMPLOYMENT SERVICES 4 EAST WILLIAM STREET ADECC001 New York Workers' CORNING, NY 14830 Compensation ADECCO EMPLOYMENT SERVICES 4100 OLD VESTAL ROAD ADECC002 New York Workers' VESTAL, NY 13850 Compensation Adelanto Correctional Facility (CA) [Electronic] E1100A New York Workers' , Compensation Adelanto Correctional Facility (CA) [Electronic] E1100B Auto/No-Fault , Adelanto Correctional Facility (CA) [Electronic] E1100C Other WC (Non-NY) , Adelanto School District (CA) [Electronic] E1166A New York Workers' , Compensation Adelanto School District (CA) [Electronic] E1166B Auto/No-Fault , Adelanto School District (CA) [Electronic] E1166C Other WC (Non-NY) , ADIN HEALTHCARE INC PO BOX 547 ADI01 New York Workers' BRENTWOOD, TN 37024 Compensation ADIRONDACK INS PO BOX 5155 ADIRO001 Auto/No-Fault BUFFALO, NY 14240 ADIRONDACK MOUNTAIN CLUB 814 GOGGINS ROAD ADIRO003 New York Workers' LAKE GEORGE, NY 12845 Compensation ADIRONDACK TRANSIT LINE 499 HURLEY AVE. ADIRO002 New York Workers' HURLEY, NY 12443 Compensation ADJUSTCO 403 MAIN ST ADJ01 New York Workers' #500 Compensation BUFFALO, NY 14203 ADJUSTCO PO BOX 639 ADJ02 New York Workers' WHITE PLAINS, NY 10603 Compensation ADMAR SUPPLY 1950 BRIGHTON HENRIETTA ADMAR001 New York Workers' TOWLINE RD Compensation ROCHESTER, NY 14623 Administaff [Electronic] E5521A New York Workers' , Compensation Administaff [Electronic] E5521C Other WC (Non-NY) , Administrative Claim Service 8970 WEst 35 W Service Dr NE ADMIN001 Other WC (Non-NY) Minneapolis, MN 55449 Administrative Claim Service, Inc [Electronic] E1101A New York Workers' , Compensation Administrative Claim Service, Inc [Electronic] E1101C Other WC (Non-NY) , ADMIRAL INDEMNITY CORP THREE UNIVERSITY PLAZA ADMI01 New York Workers' HACKENSACK, NJ 07601 Compensation ADP INCORPORATED 445 ELECTRONICS PARKWAY ADPIN002 New York Workers' LIVERPOOL, NY 13088 Compensation ADP STATEWIDE INS 325 COLUMBIA TURNPIKE SUITE ADPST001 New York Workers' 106 Compensation FLORHAM PARK, NJ 07932 ADP Total Source Inc. [Electronic] E7527A New York Workers' , Compensation ADP Total Source Inc. [Electronic] E7527C Other WC (Non-NY) , ADSCO MANFACTURING INC 4979 LAKE AVE ADSCO001 New York Workers' BASDELL, NY 14219 Compensation Advance Services, Inc. [Electronic] E1167A New York Workers' , Compensation Advance Services, Inc. [Electronic] E1167B Auto/No-Fault , Advance Services, Inc. [Electronic] E1167C Other WC (Non-NY) , ADVANCE SPORTS 10940 DUTTON ROAD ADVAN005 New York Workers' PHILADELPHIA, PA 19154 Compensation Advanced Glass Industry PO BOX 60467 ADVAN001 New York Workers' Attn Alicia Gionta Compensation ROCHESTER, NY 14606 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ADVANTAGE COMP PO BOX 235 ADVAN003 New York Workers' SOMERS POINT, NJ 08244 Compensation ADVANTAGE SPORTS AND FITNESS 2255 N TRIPHAMMER RD ADVAN002 New York Workers' ATTN: MARGO Compensation ITHACA, NY 14850 Advent Tool & Mold 999 Ridgeway Rd ADVEN001 New York Workers' Rochester, NY 14615 Compensation ADVO CARE 25001 EMERY RD ADVOC002 New York Workers' SUITE 300 Compensation CLEVELAND, OH 44128 ADVOCATE BROKERAGE 820 SCARSDALE AVE ADVOC001 New York Workers' SCARSDALE, NY 10583 Compensation AE Rosen Electrical 883 Broadway AEROS001 New York Workers' Albany, NY 12207 Compensation Aegis Security Ins co PO BOX 61140 AEGIS001 New York Workers' HARRISBURG, PA 17106 Compensation AERS / WC 3838 N. Causeway Blvd. AERSW001 Auto/No-Fault Metairie, LA 70002 AERS WC 3838 N. Causeway Blvd. AERSW002 Other WC (Non-NY) Metairie, LA 70002 Aetna P.O. Box 14586 AETNA003 New York Workers' Lexington, NY 50412 Compensation AETNA PO BOX 981106 AETNA004 New York Workers' EL PASO, TX 79998 Compensation AETNA LIFE & CASUALTY PO BOX 21645 AETNA02 New York Workers' SEATTLE, WA 98111 Compensation AF CENTRAL INSURANCE FUND 10100 REUNION PLACE SUITE 402 AFCEN001 New York Workers' SAN ANTONIO, TX 78216 Compensation Affiance Partners Woodside Center Bldg AFFIA002 New York Workers' 6281 Tri-Ridge Blvd Compensation Loveland, OH 45140 AFFILIATED F M INSURANCE CO 1301 ATWOOD AVE AFFF01 New York Workers' JOHNSTON, RI 02919 Compensation AFFINITY PERSONNEL SOLUTIONS 3407 DELAWARE AVE AFFIN001 New York Workers' KENMORE, NY 14217 Compensation Affirmative Insurance Po Box 9030 AFFIR001 Auto/No-Fault Addison, TX 75001 AFI CYBERNETICS CORPORATION 713 BATAVIA STREET AFICY001 New York Workers' ELMIRA, NY 14904 Compensation AFLAC 1932 Wynnton Rd. AFLAC001 Auto/No-Fault COLUMBUS, GA 31999 AFNI INSURANCE SERVICES PO BOX 3097 AFNII001 New York Workers' BLOOMINGTON , IL 61702 Compensation AFPC 550 C STREET WEST AFPC001 New York Workers' SUITE 57 MAILSTOP 667 Compensation RANDOLPH AIR BASE, TX 78150 AFRIM'S SPORTS 636 ALBANY SHAKER ROAD AFRIM001 New York Workers' ALBANY, NY 12211 Compensation AG Facilities Operations, LLC [Electronic] E0659A New York Workers' , Compensation AG Facilities Operations, LLC [Electronic] E0659C Other WC (Non-NY) , AG SHIP MAINTENANCE 99 CHAPEL STREET AGSHI001 New York Workers' NEWARK, NJ 07105 Compensation AGC CHEMICALS USA INC 229 EAST 22ND STREET AGCCH001 New York Workers' BAYONNE, NJ 07002 Compensation AGIA. P O BOX 9851 AGIA001 New York Workers' ATTN: PAR ACCIDENT CLAIMS Compensation PHOENIX, AZ 85068 Agri Beef Co. [Electronic] E0660A New York Workers' , Compensation Agri Beef Co. [Electronic] E0660C Other WC (Non-NY) , AGRI-BUSINESS CHILD DEVELOPM ATTN: TERESA AGRIB001 New York Workers' 847 UNION ST Compensation SCHENECTADY, NY 12308 AHRC CAMP CATSKILL 297 REVONAH HILL RD AHRC01 New York Workers' LIBERTY, NY 12754 Compensation AHRC NASSAU 189 WHEATLEY ROAD AHRCN001 New York Workers' MAIL DROP #7 Compensation BROOKVILLE, NY 11545 AIG PO BOX 1822 AIG079 New York Workers' ALPHARETTA, GA 30023 Compensation AIG PO BOX 25978 AIG080 New York Workers' SHAWNEE MISSION, KS 66225 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AIG PO BOX 2970 AIG078 Auto/No-Fault ALPHARETTA, GA 30023 AIG PO BOX 5700 AIG081 New York Workers' Alpharetta, GA 30023 Compensation AIG [Electronic Indirect] 100 CONNELL DR AIG004 New York Workers' SUITE 2100 Compensation BERKELEY HEIGHTS, NJ 07922 AIG [Electronic Indirect] 100 CONNELL DR AIG041 Other WC (Non-NY) SUITE 2100 BERKELEY HEIGHTS, NJ 07922 AIG [Electronic Indirect] 1000 Midatlantic Drive AIG005 New York Workers' Mt. Laurel, NJ 08054 Compensation AIG [Electronic Indirect] 1000 Midatlantic Drive AIG042 Other WC (Non-NY) Mt. Laurel, NJ 08054 AIG [Electronic Indirect] 11311 McCormick Avenue AIG006 New York Workers' Suite 200 Compensation Baltimore, MD 210318675 AIG [Electronic Indirect] 11311 McCormick Avenue AIG043 Other WC (Non-NY) Suite 200 Baltimore, MD 210318675 AIG [Electronic Indirect] 120 Great Oaks Office AIG007 New York Workers' 2nd Floor Compensation Albany, NY 12203 AIG [Electronic Indirect] 120 Great Oaks Office AIG044 Other WC (Non-NY) 2nd Floor Albany, NY 12203 AIG [Electronic Indirect] 15 Cornell Road AIG008 New York Workers' 2nd Floor Compensation Latham, NY 12110 AIG [Electronic Indirect] 15 Cornell Road AIG045 Other WC (Non-NY) 2nd Floor Latham, NY 12110 AIG [Electronic Indirect] 200 Old Country Road-Suite 240 AIG009 New York Workers' Mineola, NY 11501 Compensation AIG [Electronic Indirect] 200 Old Country Road-Suite 240 AIG046 Other WC (Non-NY) Mineola, NY 11501 AIG [Electronic Indirect] 3 Executive Campus-Ste 100, Rt.70 AIG010 New York Workers' & Cuthbert Compensation Attention: Dawn Adkins Cherry Hill, NJ 08002 AIG [Electronic Indirect] 3 Executive Campus-Ste 100, Rt.70 AIG047 Other WC (Non-NY) & Cuthbert Attention: Dawn Adkins Cherry Hill, NJ 08002 AIG [Electronic Indirect] 485 Route 1 South AIG011 New York Workers' Building D Suite 220 Compensation Woodbridge, NJ 07095 AIG [Electronic Indirect] 485 Route 1 South AIG048 Other WC (Non-NY) Building D Suite 220 Woodbridge, NJ 07095 AIG [Electronic Indirect] 505 8TH AVE AIG012 New York Workers' NEW YORK, NY 10018 Compensation AIG [Electronic Indirect] 505 8TH AVE AIG049 Other WC (Non-NY) NEW YORK, NY 10018 AIG [Electronic Indirect] 508 Virginia Drive AIG013 New York Workers' * Compensation Ft. Washington, PA 19034 AIG [Electronic Indirect] 508 Virginia Drive AIG050 Other WC (Non-NY) * Ft. Washington, PA 19034 AIG [Electronic Indirect] 8144 WALNUT HILL LANE AIG014 New York Workers' SUITE 1600 Compensation Dallas, TX 75231 AIG [Electronic Indirect] 8144 WALNUT HILL LANE AIG051 Other WC (Non-NY) SUITE 1600 Dallas, TX 75231 AIG [Electronic Indirect] 8607 WESTWOOD CENTER DRIVE AIG015 New York Workers' VIENNA, VA 22182 Compensation AIG [Electronic Indirect] 8607 WESTWOOD CENTER DRIVE AIG052 Other WC (Non-NY) VIENNA, VA 22182 AIG [Electronic Indirect] 999 Stewart Avenue AIG016 New York Workers' Garden City, NY 11530 Compensation AIG [Electronic Indirect] 999 Stewart Avenue AIG053 Other WC (Non-NY) Garden City, NY 11530 AIG [Electronic Indirect] P.O. Box 2006 AIG017 New York Workers' Chadsford, PA 19317 Compensation AIG [Electronic Indirect] P.O. Box 2006 AIG054 Other WC (Non-NY) Chadsford, PA 19317 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AIG [Electronic Indirect] PO Box 15701 AIG018 New York Workers' Wilmington, DE 198505701 Compensation AIG [Electronic Indirect] PO Box 15701 AIG055 Other WC (Non-NY) Wilmington, DE 198505701 AIG [Electronic Indirect] PO Box 1821 AIG019 New York Workers' Alpharetta, GA 300231822 Compensation AIG [Electronic Indirect] PO Box 1821 AIG056 Other WC (Non-NY) Alpharetta, GA 300231822 AIG [Electronic Indirect] PO Box 1832 AIG021 New York Workers' Alpharetta, GA 300231832 Compensation AIG [Electronic Indirect] PO Box 1832 AIG058 Other WC (Non-NY) Alpharetta, GA 300231832 AIG [Electronic Indirect] PO Box 1836 AIG022 New York Workers' Alpharetta, GA 300231836 Compensation AIG [Electronic Indirect] PO Box 1836 AIG059 Other WC (Non-NY) Alpharetta, GA 300231836 AIG [Electronic Indirect] PO Box 219059 AIG023 New York Workers' Dallas, TX 75231 Compensation AIG [Electronic Indirect] PO Box 219059 AIG060 Other WC (Non-NY) Dallas, TX 75231 AIG [Electronic Indirect] PO Box 2310 AIG024 New York Workers' Peck Slip Station Compensation New York, NY 10272 AIG [Electronic Indirect] PO Box 2310 AIG061 Other WC (Non-NY) Peck Slip Station New York, NY 10272 AIG [Electronic Indirect] PO Box 25588 AIG025 New York Workers' Shawnee Mission, KS 66225 Compensation AIG [Electronic Indirect] PO Box 25588 AIG062 Other WC (Non-NY) Shawnee Mission, KS 66225 AIG [Electronic Indirect] PO BOX 25971 AIG026 New York Workers' Shawnee Mission, KS 66225 Compensation AIG [Electronic Indirect] PO BOX 25971 AIG063 Other WC (Non-NY) Shawnee Mission, KS 66225 AIG [Electronic Indirect] PO Box 25972 AIG027 New York Workers' Shawnee Mission, KS 66225 Compensation AIG [Electronic Indirect] PO Box 25972 AIG064 Other WC (Non-NY) Shawnee Mission, KS 66225 AIG [Electronic Indirect] PO Box 25974 AIG028 New York Workers' Shawnee Mission, KS 66225 Compensation AIG [Electronic Indirect] PO Box 25974 AIG065 Other WC (Non-NY) Shawnee Mission, KS 66225 AIG [Electronic Indirect] PO Box 25975 AIG029 New York Workers' Shawnee Mission, KS 66225 Compensation AIG [Electronic Indirect] PO Box 25975 AIG066 Other WC (Non-NY) Shawnee Mission, KS 66225 AIG [Electronic Indirect] PO BOX 25987 AIG030 New York Workers' Overland Park, KS 66225 Compensation AIG [Electronic Indirect] PO BOX 25987 AIG067 Other WC (Non-NY) Overland Park, KS 66225 AIG [Electronic Indirect] PO BOX 29229 AIG031 New York Workers' Phoenix, AZ 850388945 Compensation AIG [Electronic Indirect] PO BOX 29229 AIG068 Other WC (Non-NY) Phoenix, AZ 850388945 AIG [Electronic Indirect] PO Box 2970 AIG032 New York Workers' Alpharetta, GA 30023 Compensation AIG [Electronic Indirect] PO Box 2970 AIG069 Other WC (Non-NY) Alpharetta, GA 30023 AIG [Electronic Indirect] PO Box 43025 AIG033 New York Workers' Phoenix, AZ 850803025 Compensation AIG [Electronic Indirect] PO Box 43025 AIG070 Other WC (Non-NY) Phoenix, AZ 850803025 AIG [Electronic Indirect] PO Box 499 AIG034 New York Workers' Essington, PA 19029 Compensation AIG [Electronic Indirect] PO Box 499 AIG071 Other WC (Non-NY) Essington, PA 19029 AIG [Electronic Indirect] PO Box 52165 AIG035 New York Workers' Phoenix, AZ 850722165 Compensation AIG [Electronic Indirect] PO Box 52165 AIG072 Other WC (Non-NY) Phoenix, AZ 850722165 AIG [Electronic Indirect] PO Box 5460 AIG036 New York Workers' Mt Laurel, NJ 08054 Compensation AIG [Electronic Indirect] PO Box 5460 AIG073 Other WC (Non-NY) Mt Laurel, NJ 08054 AIG [Electronic Indirect] PO Box 670 AIG037 New York Workers' Mineola, NY 11501 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AIG [Electronic Indirect] PO Box 670 AIG074 Other WC (Non-NY) Mineola, NY 11501 AIG [Electronic Indirect] PO BOX 830189 AIG038 New York Workers' BIRMINGHAM, AL 352830189 Compensation AIG [Electronic Indirect] PO BOX 830189 AIG075 Other WC (Non-NY) BIRMINGHAM, AL 352830189 AIG [Electronic Indirect] PO BOX 9973 AIG039 New York Workers' WILMINGTON, DE 19809 Compensation AIG [Electronic Indirect] PO BOX 9973 AIG076 Other WC (Non-NY) WILMINGTON, DE 19809 AIG [Electronic Indirect] PO Box 999 AIG040 New York Workers' Mt. Laurel, NJ 08054 Compensation AIG [Electronic Indirect] PO Box 999 AIG077 Other WC (Non-NY) Mt. Laurel, NJ 08054 AIG-Chartis [Electronic] E4655A New York Workers' , Compensation AIG-Chartis [Electronic] E4655C Other WC (Non-NY) , AIM 271 E FIRST STREET AIM001 New York Workers' CORNING, NY 14830 Compensation AIM 780 CANNING PKWY AIM002 New York Workers' VICTOR, NY 14564 Compensation AIM INSURANCE PO BOX 4070 AIMIN001 Other WC (Non-NY) BURLINGTON, MA 01803 AIM MUTUAL INSURANCE PO BOX 4070 AIMMU001 New York Workers' BURLINGTON, MA 01803 Compensation AIR CONTACT SUPPORT PO BOX 570 AIRCO001 New York Workers' 59 LOVE LANE Compensation BUD LAKE, NJ 07828 AIR FLO 40 SOUTH MAIN STREET AIRFL001 New York Workers' PRATTSBURG, NY 14873 Compensation Air Force Insurance Fund / WC 2261 Hughes Ave., Ste 156 AIRFO001 Other WC (Non-NY) Lackland AFB, TX 78236 AIR FORCE RESERVE 2720 KIRKBRIDGE ROAD AIRFO002 New York Workers' NIAGARA FALLS, NY 14304 Compensation AIR INNOVATIONS 7000 PERFORMANCE DRIVE AIRIN001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation Air Liquide USA LLC [Electronic] E0661A New York Workers' , Compensation Air Liquide USA LLC [Electronic] E0661C Other WC (Non-NY) , AIR NATIONAL GUARD WC 6001 E MOLLY RD AIR01 New York Workers' BUILDING 174 DPMC Compensation SYRACUSE, NY 13211 AIR TEMP 1165 FRONT ST AIRT01 New York Workers' BINGHAMTON, NY 13905 Compensation AIR-FLO MANUFACTURING 365 UPPER OAKWOOD AVE AIRFL002 New York Workers' ELMIRA HEIGHTS,NY, NY 14903 Compensation AIRFORCE CENTRAL INSURANCE 2261 HUGHES AVE SUITE 156 AIRFO003 New York Workers' LACKLAND AFB, TX 78236 Compensation AIRGAS SAFETY 1200 SULLIVAN STREET AIRGA001 New York Workers' ELMIRA, NY 14901 Compensation AIRSIDE TECHNOLOGIES 900 OLD LIVERPOOL ROAD SUITE AIRSI001 New York Workers' 17 Compensation LIVERPOOL, NY 13088 Airtex Products / WC 407 W. Main AIRTE001 Auto/No-Fault Attn: Jeff Jake Fairfield, IL 62837 Airtex Products / WC 407 W. Main AIRTE003 Other WC (Non-NY) Attn: Jeff Jake Fairfield, IL 62837 AirWay 1 Maguire Way AIRWA001 New York Workers' Newburg, NY 12550 Compensation AJAC TRUCKING INC ATTN: TERRY NOBLE AJACT001 New York Workers' 1842 LINWOOD RD Compensation LINWOOD, NY 14486 AJS MASONRY INC 2 DUNSBACK ROAD AJSMA001 New York Workers' CLIFTON PARK, NY 12065 Compensation A-KLEEN WINDOWS PO BOX 238 AKLEE001 New York Workers' GRANDISLAND, NY 14072 Compensation AKRON RULE CORP 8 INDIANOLA AVE AKRON001 New York Workers' AKRON, NY 14001 Compensation Ala Carte [Electronic] E2754A New York Workers' , Compensation Ala Carte [Electronic] E2754B Auto/No-Fault , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Ala Carte [Electronic] E2754C Other WC (Non-NY) , Alabama Retail Comp PO Box 240549 ALABA001 New York Workers' Montgomery, AL 36124 Compensation ALAN M BONDER ATT 5 Church St ALANM001 Auto/No-Fault Paterson, NJ 07505 ALASKA MUNICIPAL LEAGUE JOINT INS ASSOC 807 G STREET ALASK001 New York Workers' Ste 356 Compensation ANCHORAGE, AK 99501 Alaska National Insurance [Electronic] E1168A New York Workers' , Compensation Alaska National Insurance [Electronic] E1168B Auto/No-Fault , Alaska National Insurance [Electronic] E1168C Other WC (Non-NY) , ALBANY MEDICAL CENTER WC MAIL CODE A140 ALBAN001 New York Workers' ALBANY, NY 12208 Compensation ALBANY MOLECULAR RESEARCH, INC. 33 RIVERSIDE AVENUE ALBAN004 New York Workers' RENSSELAER, NY 12144 Compensation ALBANY RAMADA PLAZA 3 WATERVLIET AVENUE EXTENSION ALBAN002 New York Workers' ALBANY, NY 12206 Compensation ALBANY STEEL, INC 566 BROADWAY ALBAN003 New York Workers' ALBANY, NY 12204 Compensation ALBION AGENCY 30 N MAIN ST ALBIO001 New York Workers' ALBION, NY 14411 Compensation ALCO No Fault Ins PO Box541487 ALCON001 New York Workers' Attn: Theresa Oquendo Compensation Flushing, NY 11354 Alcoa Fasteners Systems [Electronic] E3575A New York Workers' , Compensation Alcoa Fasteners Systems [Electronic] E3575C Other WC (Non-NY) , ALCOTT GROUP 934 CLEVELAND DR ALCOT001 New York Workers' BUFFALO, NY 14225 Compensation ALEA NORTH AMERICA INSURANCE CO 55 CAPITAL BLVD ALEA01 New York Workers' ROCKY HILL, CT 06067 Compensation ALERT AMBULANCE CO 1170 AIRPORT ROAD ALERT001 New York Workers' LAKEWOOD, NJ 08701 Compensation ALEXIS 1280 WALL ST WEST ALE01 New York Workers' LYNDHURST, NJ 07071 Compensation ALEXIS PO BOX 4736 ALE02 New York Workers' SYRACUSE, NY 13202 Compensation ALEXSIS 420 FORT DUQUESNE BLVD ALE03 New York Workers' PITTSBURGH, PA 15243 Compensation ALEXSIS 48 SOUTH SERVICE RD ALE04 New York Workers' STE 301 Compensation MELVILLE, NY 11747 ALFRED STATE COLLEGE 10 UPPER COLLEGE DRIVE ALFRE001 New York Workers' ALFRED, NY 14802 Compensation Align Networks PO Box 25637 ALIGN001 Other WC (Non-NY) Tampa, FL 33622 ALIGN NETWORKS 7785 BAYMEADOWS WAY ALIGN002 New York Workers' STE 305 Compensation JACKSONVILLE, FL 33256 ALIGNETWORKS PO BOX 25637 ALI01 New York Workers' TAMPA, FL 33622-5637 Compensation ALL AMERICA INSURANCE COMPANY PO BOX 353 ALLA01 New York Workers' VAN WERT, OH 45891 Compensation All Brands Redemption Center 6272 State Route 9 ALLBR001 New York Workers' Chester Commons Compensation Chestertown, NY 12817 ALL BRITE SIGN & SERVICE PO BOX 62 ALLBR002 New York Workers' ADDISON, NY 14801 Compensation ALL CAR RENT/CITIWIDE AUTO 1941 UTICA AVENUE ALLCA001 Auto/No-Fault BROOKLYN, NY 11234 ALL CITY INS CO 325 ADAMS ST ALL01 New York Workers' BROOKLYN, NY 11201 Compensation ALL METRO HEALTHCARE 50 BROADWAY ALL02 New York Workers' LYNBROOK, NY 11563 Compensation ALL PRO PROPERTY SERVICES 16 WAYSIDE COURT ALLPR001 New York Workers' TONAWANDA, NY 14150 Compensation ALLEGHANY COUNTY SELF INS PLAN 5435B COUNTY RD 48 ACSI01 New York Workers' BELMONT, NY 14813 Compensation Allegheny Technologies [Electronic] E1791A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Allegheny Technologies [Electronic] E1791C Other WC (Non-NY) , Allegiant Professional Busines Services 11838 Bernardo Plaza Court, Ste ALLEG001 New York Workers' 220 Compensation San Diego, CA 92128 ALLEN CITY TRUCKING 25000 CENTER RIDGE ROAD SUITE ALLEN001 New York Workers' 8 Compensation WESTLAKE, OH 44145 ALLEN ENTERPRISES 1400 JAMISON RD ALLEN002 New York Workers' ELMA, NY 14059 Compensation ALLENS INC PO BOX 250 ALIN01 New York Workers' SILOAM SPRINGS, AR 72761 Compensation Alliance Coal / WC 771 Corporate Drive ALLIA002 Other WC (Non-NY) Suite 1000 Lexington, KY 40503 ALLIANCE GROUP 1341 FAIRPORT ROAD ALLIA003 New York Workers' FAIRPORT, NY 14450 Compensation ALLIANCE NATIONAL INS CO PO BOX 998 ALLIA004 Other WC (Non-NY) FT WASHINGTON, PA 19034 ALLIANCE NATIONAL INSURANCE PO BOX 998 ALLIA005 Other WC (Non-NY) FORT WASHINGTON, PA 19034 Alliance National Insurance Company PO BOX 998 ALLIA001 New York Workers' Fort Washington, PA 19034 Compensation ALLIANCE NATIONAL INSURANCE COMPANY 370 Commerce Dr. ALLI01 New York Workers' STE 101 Compensation Ft. Washington, PA 19034-2619 Alliant Energy [Electronic] E1367B Auto/No-Fault , Alliant Energy [Electronic] E1367C Other WC (Non-NY) , Allianz [Electronic] E1318C Other WC (Non-NY) , ALLIANZ INSURANCE CO PO BOX 7780 ALLI02 New York Workers' BURBANK, CA 91510-7780 Compensation ALLIED BENEFIT SYSTEM INC PO BOX 909786-60690 ABS01 New York Workers' CHICAGO, IL 60690 Compensation ALLIED BENEFIT SYSTEMS PO BOX 909786-60690 ALLIE009 Auto/No-Fault CHICAGO, IL 60690 ALLIED BUILDERS 250 STATE STREET ALLIE002 New York Workers' BROCKPORT, NY 14420 Compensation Allied Claims 372 Ellen St ALLIE011 New York Workers' Buffalo, NY 14225 Compensation Allied Claims Administration, Inc. [Electronic] E1153A New York Workers' , Compensation Allied Claims Administration, Inc. [Electronic] E1153C Other WC (Non-NY) , Allied Construction [Electronic] E7758C Other WC (Non-NY) , Allied Insurance 1 Nationwide Gateway ALLIE004 Other WC (Non-NY) Dept 5574 De Moines, IA 50391 ALLIED INSURANCE 1 NATIONWIDE GATEWAY DEPT ALLIE007 Auto/No-Fault 5574 DES MOINES, IA 50391-5574 ALLIED INSURANCE 1100 Locust / Dept. 2016 ALLIE005 Other WC (Non-NY) Des Moines, NY 50391 ALLIED INSURANCE PO BOX 10479 ALLIE008 Auto/No-Fault DES MOINES, IA 50306-0479 ALLIED INSURANCE PO BOX 909768-60690 ALLIE012 Auto/No-Fault CHICAGO, IL 60690 ALLIED INSURANCE PO BOX 909768-60690 ALLIE013 Other WC (Non-NY) CHICAGO, IL 60690 Allied Insurance Companies [Electronic] E8302C Other WC (Non-NY) , ALLIED NORTH AMERICA 390 N BROADWAY ALLIE001 New York Workers' JERICHO, NY 11753 Compensation Allied Property and Casualty Ins Co [Electronic] E8303C Other WC (Non-NY) , Allied Services 475 Morgan Highway ALLIE003 New York Workers' Scranton, NY 18501 Compensation ALLIED WELFARE FUND PO BOX 90360 ALLIE010 Auto/No-Fault STATEN ISLAND, NY 10309-0360 Allmerica Financial Benefits Insurance Company E1368B Auto/No-Fault [Electronic] , Allmerica Financial Benefits Insurance Company E1368C Other WC (Non-NY) [Electronic] , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ALLPRO RESTORATION & RECONSTRUCTION 1352 SARATOGA ROAD ALLPR002 New York Workers' GANSEVOORT, NY 12831 Compensation ALLRED & ASSOC. 321 RT 5 WEST ALLRE002 New York Workers' ELBRIDGE, NY 13060 Compensation ALLRED AND ASSOCIATES PO BOX 321 ALLRE001 New York Workers' ELBRIDGE, NY 13060 Compensation Allstate P.O. Box 660636 ALLST034 Auto/No-Fault Dallas, TX 75266 Allstate po box 660636 ALLST031 New York Workers' Dallas, TX 75266 Compensation ALLSTATE 2255 COLEMAN STREET, EXT 5068, ALLST037 Auto/No-Fault BROOKLYN, NY 11234 ALLSTATE ALLSTATE, ALLST036 Auto/No-Fault P O BOX 853916 RICHARDSON, TX 75085 ALLSTATE PO BOX 2874 ALLST030 Auto/No-Fault CLINTON, IA 52733 ALLSTATE PO BOX 440519 ALLST038 Auto/No-Fault KENNESAW, GA 30160 Allstate [Electronic] E1069B Auto/No-Fault , Allstate ASO 462 Ocean Parkway ALLST032 New York Workers' Brooklyn, NY 11218 Compensation ALLSTATE ASO PO BOX 47 ALLST033 New York Workers' WADING RIVER, NY 11792 Compensation Allstate/Procura PO Box 5227 ALLST011 Auto/No-Fault Janesville, WI 53547-5227 ALLSTEEL STRUCTURES 242 GLENWILD ROAD ALLST028 New York Workers' MIDDLEGROVE, NY 12850 Compensation ALP STEEL CORP P O BOX 1085 ALPST001 New York Workers' BUFFALO, NY 14220 Compensation ALPCO RECYCLING PO BOX 837 ALPR01 New York Workers' MACEDON, NY 14502 Compensation ALTA CLAIMS 300 AMERICAN METRO BLVD. ALTA01 New York Workers' HAMILTON, NJ 08619 Compensation Alta Healthcare [Electronic] E0662A New York Workers' , Compensation Alta Healthcare [Electronic] E0662C Other WC (Non-NY) , ALTAMURA & ASSOCIATES P.O. BOX 2195 ALTAM001 New York Workers' BALLSTON SPA, NY 12020 Compensation Altavista Group 914 Old Liverpool Road ALTAV001 New York Workers' Liverpool, NY 13088-5513 Compensation Altec [Electronic] E8976C Other WC (Non-NY) , Altec Industries [Electronic] E2304C Other WC (Non-NY) , ALTERNATIVE CONCEPTS PO BOX 291587 ALTE01 New York Workers' NASHVILLE, TN 37229 Compensation ALTERNATIVE SERVICE CONCEPTS PO BOX 291327 ALTER002 Other WC (Non-NY) NASHVILLE, TN 37229 Alternative Srvcs Concept 4 Tower Place ALTER001 New York Workers' Albany, NY 12203 Compensation ALTERNATIVE SVC CONCEPTS LLC PO BOX 1177 ATLS02 New York Workers' MECHANICSBURG, PA 17055 Compensation ALTON MANUFACTURING 825 LEE RD ALTON002 New York Workers' Rochester, NY 14620 Compensation ALTON RESTAURANT 2250 WALDEN AVE ALTON001 New York Workers' CHEEKTOWAGA, NY 14225 Compensation Alvey Systems (AON Risk) (AUTO ONLY) E4991B Auto/No-Fault [Electronic] , Alvey Systems (AON Risk) [Electronic] E2178C Other WC (Non-NY) , Alyne Trucking LLC 59 Aurora Street ALYNE001 New York Workers' PO Box 1118 Compensation Moravia, NY 13118 AM SKIER 209 MAIN ST AMSKI001 New York Workers' HAWLEY, PA 18428 Compensation AM TRUST PO BOX 105010 AMT02 New York Workers' ATLANTA, GA 30348 Compensation Am Trust - NYWC PO BOX 15096 AMTRU006 New York Workers' Albany, NY 12212 Compensation AMCO Ins Co [Electronic] E8304C Other WC (Non-NY) , AMCOMP PO BOX 291887 AMC01 New York Workers' NASHVILLE, TN 37229 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AMEDORE HOMES 1900 WESTERN AVENUE AMEDO001 New York Workers' ALBANY, NY 12203 Compensation America First [Electronic] E4196A New York Workers' , Compensation America First [Electronic] E4196B Auto/No-Fault , America First [Electronic] E4196C Other WC (Non-NY) , AMERICAN ALLIANCE INS 9600 BRYN MAWR AVENUE SUITE# AMERI052 Auto/No-Fault 275 ROSEMONT, IL 60018 AMERICAN ALTERNATIVE 665 COLLEGE RD EAST AMEALT01 New York Workers' PRINCETON, NJ 08543 Compensation AMERICAN AUTOMOBILE INSURANCE CO 777 SAN MARIN DRIVE AAMI01 New York Workers' NOVATO, CA 94998 Compensation AMERICAN BANKERS INS PO BOX 979055 AMERI056 New York Workers' MIAMI, FL 33517 Compensation American Bankers Ins Co attn: Specialty Property Claims Dept AMERI045 Auto/No-Fault PO BOX 979055 Miami, FL 33157 American Casino & Entertainment Properties LLC E1103B Auto/No-Fault [Electronic] , American Casino & Entertainment Properties LLC E1103C Other WC (Non-NY) [Electronic] , American Claims Management (ACM) [Electronic] E1403A New York Workers' , Compensation American Claims Management (ACM) [Electronic] E1403B Auto/No-Fault , American Claims Management (ACM) [Electronic] E1403C Other WC (Non-NY) , American Claims Service Po Box 8010 AMERI028 New York Workers' Goldsboro, NY 27533 Compensation American Coin Merchandising, Inc [Electronic] E4709C Other WC (Non-NY) , American Commerce Ins Co - ACIC - NJ 11 GORE ROAD AMERI011 Auto/No-Fault [Electronic] WEBSTER, MA 01570 American Commerce Ins Co - ACIC - NY 11 GORE ROAD AMERI013 Auto/No-Fault [Electronic] WEBSTER, MA 01570 American Commerce Ins Co - ACIC [Electronic] 11 GORE ROAD AMERI015 Auto/No-Fault WEBSTER, MA 01570 American Commerce Insurance P.O. Box 1126 AMERI030 Auto/No-Fault Dalphe, AL 36526 AMERICAN CONVEYOR 1601 HARMER ST AMERI031 New York Workers' LEVITTOWN, PA 19057 Compensation American Cyanamid [Electronic] E2415C Other WC (Non-NY) , AMERICAN ECONOMY INS CO SAFECO PLAZA AMCE01 New York Workers' T-15 Compensation SEATTLE, WA 98185-0001 AMERICAN EQUITY UNDERWRITERS, INC 3838 N CAUSEWAY BLVD AMERI004 New York Workers' #2424 Compensation METAIRIE, LA 70002 American Family / Liability PO Box 657 AMERI025 Auto/No-Fault Kalona, IA 52247 American Family Ins / Liability 4501 N Sterling Avenue AMERI026 Auto/No-Fault Suite 300 Peoria, IL 61615 American Family Insurance 6000 American Parkway AMERI024 Auto/No-Fault Madison, WI 53783 AMERICAN FAMILY INSURANCE 6000 AMERICAN PARKWAY, AMERI067 Auto/No-Fault MADISON, WI 53783 AMERICAN FAMILY INSURANCE PO BOX 247043 AMERI053 Auto/No-Fault OMAHA, NE 68124 AMERICAN FAMILY MUTUAL INSURANCE PO BOX 10 AMERI064 Auto/No-Fault COMPANY DES MOINES, IA 50306 AMERICAN FIRE & CASUALTY COMPANY 9450 SEWARD RD AFCC01 New York Workers' FAIRFIELD, OH 45014 Compensation AMERICAN FOOD & VENDING 3606 JOHN GLENN BLVD AMERI005 New York Workers' SYRACUSE, NY 13209 Compensation American Furniture Warehouse [Electronic] E0663A New York Workers' , Compensation American Furniture Warehouse [Electronic] E0663C Other WC (Non-NY) , AMERICAN GUARANTEE & LIABILITY 1400 AMERICAN LANE AMGL01 New York Workers' TOWER 1, 20TH FL Compensation SCHAUMBURG, IL 60196-1056 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AMERICAN HARDWARE INS GRP PO BOX 182476 AMHARIN01 New York Workers' COLUMBUS, OH 43218 Compensation American Home Assurance [Electronic Indirect] PO BOX 540549 AMERI020 New York Workers' GRAND PRAIRIE, NY 75057 Compensation American Home Assurance [Electronic Indirect] PO BOX 540549 AMERI021 Auto/No-Fault GRAND PRAIRIE, NY 75057 American Home Assurance [Electronic Indirect] PO BOX 540549 AMERI022 Other WC (Non-NY) GRAND PRAIRIE, NY 75057 American Home Assurance Co P.O. Box 115114 AMERI065 Other WC (Non-NY) Carrollton, TX 75011 American Home Craft [Electronic] E9925A New York Workers' , Compensation American Home Craft [Electronic] E9925B Auto/No-Fault , American Home Craft [Electronic] E9925C Other WC (Non-NY) , AMERICAN HOUSEHOLD STORAGE 1665 MAIN STREET AMERI057 New York Workers' BUFFALO, NY 14209 Compensation AMERICAN INDEPENDENT PO BOX 3002 AMERI036 New York Workers' PLYMOUTH MEETING, PA 19462 Compensation AMERICAN INDEPENDENT PO BOX 3002 AMERI060 Auto/No-Fault PLYMOUTH MEETING, PA 19462 American Independent Insurance Company P.O. Box 3000 AMERI058 Auto/No-Fault Plymouth Meeting, NJ 19462 American Interstae Insurance Co., Inc 2301 Hwy 190 West AMERI051 New York Workers' DeRidder, LA 70634 Compensation American Mining Insurance Group, LLC E0655A New York Workers' [Electronic] , Compensation American Mining Insurance Group, LLC E0655C Other WC (Non-NY) [Electronic] , American Modern PO Box 5323 AMERI040 Auto/No-Fault Cincinnati, OH 45201 AMERICAN MODERN INSURANCE PO BOX 5323 AMERI046 New York Workers' CINCINATTI, OH 45201 Compensation AMERICAN MODERN SELECT INSURANCE CO 7000 MIDLAND BOULEVARD AMERI066 Auto/No-Fault AMELIA, OH 45102 AMERICAN MOTORIST INSURANCE CO ONE KEMPER DRIVE AMMI01 New York Workers' LONG GROVE, IL 60049 Compensation AMERICAN NATIONAL 1949 E SUNSHINE ST AMERI037 Auto/No-Fault SPRINGFIELD, MO 65899-0001 American National General Insurance Co E7751A New York Workers' , Compensation American National General Insurance Co E7751B Auto/No-Fault , American National General Insurance Co E7751C Other WC (Non-NY) , AMERICAN PACKAGING CORP 777 DRIVING PARK AVE AMERI041 New York Workers' ROCHESTER, NY 14613 Compensation AMERICAN POLICY HOLDERS PO BOX 4070 AMPOLHO01 New York Workers' BURLINGTON, MA 01803 Compensation AMERICAN PRESIDENT LINES 3443 W MARGINAL WAY S.W AMERI055 New York Workers' SEATTLE, WA 98106 Compensation AMERICAN SERVICE INTL 150 NORTHWEST POINT BLVD AMERI038 Auto/No-Fault ELK GROVE VILLAGE, IL 60007 American Specialty Companies [Electronic] E8760C Other WC (Non-NY) , American Specialty Ins. / MIB [Electronic] E6862C Other WC (Non-NY) , AMERICAN STAFFING PO BOX 18443 AMERI034 New York Workers' GREENSBORO, NC 27419 Compensation AMERICAN STATES INSURANCE CO SAFECO PLAZA AMSI01 New York Workers' T-15 Compensation SEATTLE, WA 98185-0001 American Transit 1 Metrotech Center AMERI048 Auto/No-Fault Brooklyn, NY 11201 American Transit WC 1 Metrotech Center AMERI047 New York Workers' 7th Floor Compensation Brooklyn, NY 11201 AMERICHOICE PO BOX 695427 AME01 New York Workers' SAN ANTONIO, TX 78265 Compensation AMERIHEALTH (CAMP HILL) 100 CORPORATE CENTER DRIVE AMERI006 New York Workers' SUITE 101 Compensation CAMP HILL, PA 17011 AMERIHEALTH ADMINISTRATORS PO BOX 987 AMERI029 Auto/No-Fault HORSHAM, PA 19044-0987 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AMERIHEALTH CASUALTY 100 CORP CTR DR STE 101 AMERI054 Other WC (Non-NY) CAMP HILL, PA 17011 AMERIHEALTH CASUALTY 1880 JFK BLVD 8TH FL AMERI032 New York Workers' PHILADELPHIA, PA 19103 Compensation AMERIHEALTH CASUALTY P O BOX 3460 AMERI049 Other WC (Non-NY) PITTSBURGH, PA 15230-3460 AMERIHEALTH CASUALTY PO BOX 758 AMERI035 Auto/No-Fault MT. LAUREL, NJ 08054 AmeriHealth Casualty Services 2505 North Front Street AMERI003 New York Workers' Harrisburg, PA 17110 Compensation AMERIHEALTH CASUALTY SVS 1717 ARCH ST 45TH FLOOR AMERI033 New York Workers' PHILADELPHIA, PA 19103 Compensation Ameriprise PO BOX 19018 AMERI010 Auto/No-Fault GREEN BAY, WI 54307-9018 Ameriprise [Electronic] 10 East Stow Road AMERI018 Auto/No-Fault Suite 100 Marlton, NJ 08053 AMERIPRISE AUTO 3500 PACKERLAND DRIVE AMERI062 Auto/No-Fault DEPERE, WI 54115 Ameriprise Auto & Home Insurance [Electronic] E7771B Auto/No-Fault , Ameriprise/ CSG 3500 Packerland Drive AMERI019 New York Workers' Depere, WI 54115 Compensation Amerisafe 2301 Highway 190 West AMERI001 New York Workers' Deridder, LA 70634 Compensation Amerisafe Risk Services, Inc. / WC 2301 Hwy 190 West AMERI023 Other WC (Non-NY) Deridder, LA 70634 AMERISURE P O BOX 33478 AMERI027 New York Workers' DETROIT, MI 48232 Compensation AMERISURE PO BOX 3044 AMER01 New York Workers' LISLE, IL 60532 Compensation Amerisure Insurance [Electronic] E8851C Other WC (Non-NY) , Amerisure Mutual Insurance [Electronic] E4534C Other WC (Non-NY) , AMERISURE MUTUAL INSURANCE CO PO BOX 33458 AMERI068 Other WC (Non-NY) Detroit, MI 48232 AMERISURE MUTUAL INSURANCE COMPANY PO BOX 2060 AMER02 New York Workers' FARMINGTON HILLS, MI 48333- Compensation 2060 AMHERST SOCCER ASSOCIATION PO BOX 264 AMHER001 New York Workers' WILLIAMSVILLE, NY 14231 Compensation AMICA PO BOX 9690 AMICA013 Auto/No-Fault PROVIDENCE, RI 02940 Amica Insurance Company [Electronic] PO Box 6008 AMICA001 Auto/No-Fault Providence, RI 02940 Amica Mutual Insurance Company [Electronic] E1681B Auto/No-Fault , AMRI 26 CORPORATE CIRCLE AMRI001 New York Workers' ALBANY, NY 12203 Compensation AMS Staff Leasing 14160 Dallas Parkway AMSST001 Other WC (Non-NY) Suite 500 Dallas, TX 75254 AMSTAR OF WESTERN NY 825 REIN ROAD AMSTA001 New York Workers' CHEEKTOWAGA, NY 14225 Compensation AMTRAK 3301A LOWER TRIBLY ROAD AMTRA003 New York Workers' LINDEN, NJ 07036 Compensation AMTRAK CLAIMS 30TH & MARKET STS AMTRA004 New York Workers' PHILA, PA 19134 Compensation amtrak wc 15 river road AMTRA001 Auto/No-Fault wilton, CT 06897 amtrak wc 15 river road AMTRA002 Other WC (Non-NY) wilton, CT 06897 AMTRUST GROUP OF NORTH AMERICA PO BOX 105010 AMTRU007 Other WC (Non-NY) ATLANTA, GA 30348 Amy Peterson Attorney 128 Passaic Ave AMYPE001 Auto/No-Fault Passaic, NJ 07055 ANACO [Electronic] E0664A New York Workers' , Compensation ANACO [Electronic] E0664C Other WC (Non-NY) , ANAIC Cibus [Electronic] E0665A New York Workers' , Compensation ANAIC Cibus [Electronic] E0665C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ANCHOR GLASS CONTAINER CORP 151 E MCCANNS BLVD ANCHO001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation An-Cor Industrial Plastics 100 Melody Lane ANCOR001 New York Workers' North Tonawanda, NY 14120 Compensation Anderson Precision 20 Livingston Ave ANDER002 New York Workers' Jamestown, NY 14701 Compensation Anderson Trucking Inc PO Box 1377 ANDER003 Other WC (Non-NY) Saint Cloud, MN 56302 ANDERSON'S 6075 MAIN ST ANDER001 New York Workers' Williamsville, NY 14221 Compensation ANDREA M HEMSCHOOT ATT 8 SOUTH MAPLE AVENUE ANDRE003 Auto/No-Fault MARLTON, NJ 08053 ANDREW MANCINI 129 ODELL AVE ANDRE001 New York Workers' ENDICOTT, NY 13760 Compensation Andrew Park Attorney 450 7th Avenue ANDRE002 Auto/No-Fault Suite 1805 New York, NY 10123 ANDROMEDA HOUSE 39132 MOUNT PLEASANT RD ANDRO001 New York Workers' SPARTANSBURG, PA 16434 Compensation ANGELICA 1-3 APOLLO DR ANGEL001 New York Workers' Batavia, NY 14020 Compensation Anheuser Busch [Electronic] E1169A New York Workers' , Compensation Anheuser Busch [Electronic] E1169B Auto/No-Fault , Anheuser Busch [Electronic] E1169C Other WC (Non-NY) , ANIELLO'S PIZZERIA 68 E MARKET STREET ANIEL001 New York Workers' CORNING, NY 14830 Compensation ANNE ARUNDEL COUNTY RISK MGMT DIVSION PO BOX 6675 ANNEA001 Other WC (Non-NY) ANNAPOLIS, MD 21401 ANNSEAL INC 130 MAIN ST ANNSE001 New York Workers' ATTN TERESA Compensation JOHNSON CITY, NY 13790 ANOPLATE 459 PULASKI STREET ANOPL001 New York Workers' SYRACUSE, NY 13204 Compensation ANPAC [Electronic] E9697B Auto/No-Fault , Antelope Valley Ret. [Electronic] E0666A New York Workers' , Compensation Antelope Valley Ret. [Electronic] E0666C Other WC (Non-NY) , ANTHONY OLIVA, INC PO BOX 400 ANTHO001 New York Workers' EAST SYRACUSE, NY 13057 Compensation AON Risk Services - WC 199 Water St AONRI001 New York Workers' 12th Floor Compensation New York, NY 10038 APA PARTNERS INC. PO BOX 66601 APAP03 New York Workers' ALBANY, NY 12206 Compensation APA TRANSPORT 2100 88TH ST APAT01 New York Workers' NORTH BERGEN, NJ 07047 Compensation APA WC 5856 HERITAGE LANDING DRIVE APAW01 New York Workers' EAST SYRACUSE, NY 13057 Compensation APEX PLUMBING 872 ALBANY-SHAKER RD APEXP001 New York Workers' LATHAM, NY 12110 Compensation API BASCO 2777 WALDEN AVE APIBA001 New York Workers' BUFFALO, NY 14225 Compensation APL STEEL CORP 650 EXCHANGE ST APLST001 New York Workers' BUFFALO, NY 14210 Compensation APOLLO STEEL CORP 4800 WILTON AVE APOLL001 New York Workers' NIAGARA FALLS, NY 14224 Compensation APOLON INTERNATIONAL WC 5036 INDUSTRIAL APOLO001 New York Workers' FARMINGDALE, NJ 07727 Compensation APPLE VENDING 592 WINKS LANE APPLE001 New York Workers' BENSALEM, PA 19020 Compensation Applebee's 180 Lawrence Bell Dr Ste 100 APPLE002 New York Workers' Buffalo, NY 14221 Compensation APPLERIDGE SENIOR LIVING 168 MILLER STREET APPLE003 New York Workers' HORSEHEADS, NY 14845 Compensation APPLIANCES UNLIMITED 6606 JOY ROAD APPLI004 New York Workers' EAST SYRACUSE, NY 13057 Compensation Applied Ecological Services 17921 Smith Road APPLI001 New York Workers' PO Box 256 Compensation Broadhead, WI 53520 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID APPLIED FABRIC TECHNOLOGY PO BOX 575 APPLI003 New York Workers' 227 THORN AVE Compensation ORCHARD PARK, NY 14127 APPLIED RISK PO BOX 3804 APP01 New York Workers' OMAHA, NE 68103 Compensation APPLIED TECH (ATM CORP) PO BOX 189 APPLI002 New York Workers' OWEGO, NY 13827 Compensation Applied Underwriters [Electronic] E1131A New York Workers' , Compensation Applied Underwriters [Electronic] E1131C Other WC (Non-NY) , APS Temp Agency 3407 Delaware Ave APSTE001 New York Workers' Suite 221 Compensation Kenmore, NY 14217 Aramark [Electronic] E1294A New York Workers' , Compensation Aramark [Electronic] E1294C Other WC (Non-NY) , ARBELLA MUTUAL INS CO P.O. BOX 699195 ARBEL001 Auto/No-Fault QUINCY, MA 02269-9103 ARBOR LANDSCAPING 957 DIXON AVENUE ARBOR001 New York Workers' CROYDON, PA 19021 Compensation Arborscape Inc 75 Fields lane ARBOR002 New York Workers' Brewster, NY 10509 Compensation ARBYS 380 WEST MORRIS STREET ARBYS003 New York Workers' BATH, NY 14810 Compensation ARBY'S 511 EAST 4TH STREET ARBYS002 New York Workers' WATKINS GLENS, NY 14891 Compensation ARBY'S (PAINTED POST) 257 SOUTH HAMILTON STREET ARBYS001 New York Workers' PAINTED POST, NY 14870 Compensation ARC 245 Genesee St ARC001 New York Workers' Utica, NY 13501 Compensation ARC OF ORLEANS P O BOX 439 ARCOF002 New York Workers' ALBION, NY 14411 Compensation ARC OF SCHENECTADY 214 STATE STREET ARCOF003 New York Workers' SCHENECTADY, NY 12301 Compensation ARC OF SCHUYLER 203 12TH STREET ARCOF001 New York Workers' WATKINS GLEN, NY 14891 Compensation ARCADIA 1 ARCADIA COMMONS ARCAD001 New York Workers' WEST BROOK, ME 04098 Compensation ARCADIA INS CO 75 SOUTH HOUCAS RD ARIN01 New York Workers' HARRISBURG, PA 17109 Compensation Arcadia Insurance Company [Electronic] E8049C Other WC (Non-NY) , Arc-Chemung Co 711 Sullivan Street ARCCH001 New York Workers' Elmira, NY 14901 Compensation Arch 4 Flowers Dr. ARCH002 New York Workers' Mechanicsburg, PA 17050 Compensation Arch Insurance 330 Post Rd ARCHI013 New York Workers' #200 Compensation Darien, CT 06820 ARCH INSURANCE 30 EAST 7TH STREET ARCHI010 New York Workers' ST PAUL, MN 55101 Compensation ARCH INSURANCE 311 South Wacker Drive ARCHI012 New York Workers' Chicago, IL 60606 Compensation Arch Insurance Company 10909 Mill Valley RD ARCHI002 New York Workers' #210 Compensation Omaha, NE 68154 ARCH INSURANCE COMPANY ONE LIBERTY PLAZA ARCH01 New York Workers' 53RD FL Compensation NEW YORK, NY 10006 ARCH INSURANCE COMPANY PO BOX 14343 ARCHI014 Other WC (Non-NY) LEXINGTON, KY 40612 Arch Insurance Company [Electronic Indirect] 10909 Mill Valley RD ARCHI003 New York Workers' #210 Compensation Omaha, NE 68154 Arch Insurance Company [Electronic Indirect] 10909 Mill Valley RD ARCHI005 Auto/No-Fault #210 Omaha, NE 68154 Arch Insurance Company [Electronic Indirect] 10909 Mill Valley RD ARCHI007 Other WC (Non-NY) #210 Omaha, NE 68154 Arch Insurance Company [Electronic Indirect] ONE LIBERTY PLAZA ARCHI004 New York Workers' 53RD FL Compensation NEW YORK, NY 10006 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Arch Insurance Company [Electronic Indirect] ONE LIBERTY PLAZA ARCHI006 Auto/No-Fault 53RD FL NEW YORK, NY 10006 Arch Insurance Company [Electronic Indirect] ONE LIBERTY PLAZA ARCHI008 Other WC (Non-NY) 53RD FL NEW YORK, NY 10006 Arch Insurance Group PO BOX 542033 ARCHI001 New York Workers' Omaha, NE 68154 Compensation Archer Daniels Midland Company [Electronic] E1159A New York Workers' , Compensation Archer Daniels Midland Company [Electronic] E1159B Auto/No-Fault , Archer Daniels Midland Company [Electronic] E1159C Other WC (Non-NY) , Argenbright Holdings Limited [Electronic] E5599C Other WC (Non-NY) , ARGENTIERI BROTHERS INC 50 WEST HANOVER STREET ARGEN001 New York Workers' WELLSVILLE, NY 14895 Compensation ARGONAUT INS.CO BILL REVIEW OPERATIONS ARGON001 New York Workers' PO BOX 6028 Compensation SCRANTON, PA 18503 Argonaut Insurance Company(ARGO) [Electronic] E9935C Other WC (Non-NY) , Argus Services Corportation 7551 Callaghan Rd ARGUS001 Other WC (Non-NY) Ste 240 San Antonio, TX 78229 Ari Insurance 125 Pheasant Run ARIIN001 Auto/No-Fault Newtown, PA 19840 Arizona/21st Corp DBA Berkley East Conv Hosp E0667A New York Workers' [Electronic] , Compensation Arizona/21st Corp DBA Berkley East Conv Hosp E0667C Other WC (Non-NY) [Electronic] , ARKANSAS BEST CORP PO BOX 10048 ARK01 New York Workers' FORT SMITH, AR 72917 Compensation ARKANSAS BEST FREIGHT 50 FLYDER ST ARKAN001 New York Workers' TONAWANDA, NY 14150 Compensation Arkansas Claims Mgt PO Box 115114 ARKAN002 Other WC (Non-NY) CAROLLTON, TX 75011 Armour Building Supply 653 Ellicott St ARMOU001 New York Workers' BATAVIA, NY 14020 Compensation ARMSTRONG PUMPS 93 EAST AVE ARMST001 New York Workers' N TONAWANDA, NY 14120 Compensation ARNETT FOODS 453 ARNETT BLVD ARNET001 New York Workers' ROCHESTER, NY 14619 Compensation Arnot Ogden Emergency Room 600 Roe Avenue ARNOT002 New York Workers' Elmira, NY 14905 Compensation Arnot Ogden memorial Hospital 600 Roe Avenue ARNOT003 New York Workers' Elmira, NY 14905 Compensation Arnot Ogden Nursing Home 600 Roe Avenue ARNOT004 New York Workers' Elmira, NY 14905 Compensation ARNOT REALTY CORP PO BOX 209 ARNOT001 New York Workers' ATTN DEB KOSLOSKI Compensation ELMIRA, NY 14902 ARONBERG & KOUSER ATT 430 Marlton Pike W ARONB001 Auto/No-Fault Cherry Hill, NJ 08002 ARROW FENCE COMPANY 7784 NEW ROUTE 31 ARROW002 New York Workers' BALDWINSVILLE, NY 13027 Compensation ARROW TRANSPORTATION 7640 EDGECOMB DRIVE ARROW005 New York Workers' LIVERPOOL, NY 13088 Compensation Arrowpoint Capital PO Box 19809 ARROW006 New York Workers' Charlotte, NC 28219 Compensation Arrowpoint Capital PO BOX 19809 ARROW007 Other WC (Non-NY) Charlotte, NC 28219-9809 Arthur J. Gallagher Risk 444 Madison Avenue ARTHU001 New York Workers' 20th Floor Compensation New York, NY 10022 ARTISAN 7 WEST 34TH ST ART01 New York Workers' NEW YORK, NY 10001 Compensation ARTISTRY IN WOOD OF SYRACUSE 6804 MANLIUS CENTER ROAD ARTIS001 New York Workers' East Syracuse, NY 13057 Compensation ARTMETER TRUCKING 478 HOPKINS RD ARTME001 New York Workers' BUFFALO, NY 14220 Compensation Artone Manufacturing 107 Institute Street ARTON001 New York Workers' Jamestown, NY 14701 Compensation ASA PO BOX 4910 ASA001 New York Workers' SYRACUSE, NY 13221 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ASBURY PARK PRESS 3601 HIGHWAY 66 ASBUR001 New York Workers' NEPTUNE, NJ 07753 Compensation ASC 1755 E. PLUMB LANE SUITE 148 ASC002 Other WC (Non-NY) RENO, NV 89502 ASC 1755 E. PLUMB SUITE 267 ASC001 Other WC (Non-NY) RENO, NV 89502 Ashton Healthcare 200 South Main Street ASHTO001 New York Workers' Athens, NY 18810 Compensation ASPEN ADMINISTRATION PO BOX 800409 ASPEN003 New York Workers' DALLAS, TX 75380 Compensation ASPEN DENTAL 281 SANDERS CREEK PARKWAY ASPEN002 New York Workers' EAST SYRACUSE, NY 13057 Compensation ASPEN GENERAL CONTRACTORS INC 4201 NESHAMINY BLVD ASPEN004 New York Workers' BENSALEM, PA 19020 Compensation ASPEN SKIING CO 575 UNION BLVD ASP01 New York Workers' LAKEWOOD, CO 80228 Compensation ASPEN SKIING CO PO BOX 1248 ASPSKI01 New York Workers' ASPEN, CO 81612 Compensation Aspire of WNY 2495 Main Street - #417 ASPIR001 New York Workers' Buffalo, NY 14203 Compensation ASPIRE OF WNY 2356 NORTH FOREST RD ASPIR002 New York Workers' GETZVILLE, NY 14068 Compensation ASPLUNDH TREE COMPANY 708 BLAIR MILL ROAD ASPLU002 New York Workers' WILLOW GROVE, PA 19090 Compensation ASPLUNDH TREE EXPERTS 5154 STATE ROUTE 26 ASPLU001 New York Workers' WHITNEY POINT, NY 13862 Compensation ASSETS PROTECTION 113 W LINCOLN HWY ASSET001 New York Workers' PENNDEL, PA 19047 Compensation Assigned Risk Solutions PO BOX 6580 ASSIG002 Other WC (Non-NY) Saddlebrook, NJ 07663 Assigned Risk Solutions PO BOX 6580 ASSIG003 Auto/No-Fault Saddlebrook, NJ 07663 Assigned Risk Solutions PO BOX 6580 ASSIG004 New York Workers' Saddlebrook, NJ 07663 Compensation Assisting Angels PO BOX 445 ASSIS002 New York Workers' Getzville, NY 14068 Compensation ASSOC BLDRS & CONTRACTORS 6315 FLY RD ASS01 New York Workers' E SYRACUSE, NY 13057 Compensation ASSOCIATED BRANDS 4001 SALT WORKS ROAD ASSOC003 New York Workers' MEDINA, NY 14103 Compensation ASSOCIATED HEALTH CARE 85 WOODRIDGE DRIVE ASSOC001 New York Workers' WEST AMHERST, NY 14228 Compensation ASSOCIATED INDEMNITY PO BOX 740174 ASSOC002 New York Workers' ATLANTA, GA 30374 Compensation ASSOCIATED INDEMNITY CORP 777 SAN MARIN DRIVE ASSO01 New York Workers' NOVATO, CA 98998 Compensation ASSOCIATED MUTUAL INS CO PO BOX 307 AMI01 New York Workers' WOODRIDGE, NY 12789 Compensation ASSURANCE CO OF AMERICA 1400 AMERICAN LANE ASSU01 New York Workers' PTAX/20 Compensation SCHAUMBURG, IL 60196 Assurance Company of America (Commercial E2160B Auto/No-Fault Only) [Electronic] , ASSURED SOURCE 50 WEST BIG BEAVER ASSUR001 New York Workers' STE 245 Compensation TROY, MI 48084 Astor WC PO Box 5005 ASTOR001 New York Workers' Rhinebeck, NY 12572 Compensation ASTRONICS 130 COMMERCE WAY ASTRO001 New York Workers' EAST AURORA, NY 14052 Compensation AT&T IDSC PO BOX 14627 ATTID001 New York Workers' LEXINGTON, KY 40512 Compensation ATB STAFFING 534 MAIN ST ATBST001 New York Workers' MEDINA, NY 14103 Compensation ATLANTIC COUNTY JUSTICE 5060 ATLANTIC AVENUE ATLAN018 Other WC (Non-NY) MAYS LANDING, NJ 08330 ATLANTIC EXPRESS 7 NORTH STREET ATLAN012 New York Workers' STATEN ISLAND, NY 10302 Compensation Atlantic Imaging 110 South Jefferson Road ATLAN016 New York Workers' Whippany, NY 07981 Compensation Atlantic Imaging Group MVA 110 South Jefferson Rd ATLAN017 Auto/No-Fault STE 201 Whippany, NJ 07981 ATLANTIC MUTUAL 616 IDAHO ST ATLAN013 Auto/No-Fault SALEM, VA 24153 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ATLANTIC MUTUAL COMPANY 110 WILLIAM STREET ATLAN015 New York Workers' FLOOR 18 Compensation NEW YORK, NY 10038-3937 Atlantic Mutual Insurance [Electronic Indirect] 100 WALL ST ATLAN001 New York Workers' NEW YORK, NY 10005 Compensation Atlantic Mutual Insurance [Electronic Indirect] 100 WALL ST ATLAN004 Auto/No-Fault NEW YORK, NY 10005 Atlantic Mutual Insurance [Electronic Indirect] 100 WALL ST ATLAN007 Other WC (Non-NY) NEW YORK, NY 10005 Atlantic Mutual Insurance [Electronic Indirect] 3 GIRALDA FARMS ATLAN002 New York Workers' MADISON, NJ 07940 Compensation Atlantic Mutual Insurance [Electronic Indirect] 3 GIRALDA FARMS ATLAN005 Auto/No-Fault MADISON, NJ 07940 Atlantic Mutual Insurance [Electronic Indirect] 3 GIRALDA FARMS ATLAN008 Other WC (Non-NY) MADISON, NJ 07940 Atlantic Mutual Insurance [Electronic Indirect] 7 Giralda Farms-Suite 120 ATLAN003 New York Workers' Madison, NJ 07940 Compensation Atlantic Mutual Insurance [Electronic Indirect] 7 Giralda Farms-Suite 120 ATLAN006 Auto/No-Fault Madison, NJ 07940 Atlantic Mutual Insurance [Electronic Indirect] 7 Giralda Farms-Suite 120 ATLAN009 Other WC (Non-NY) Madison, NJ 07940 Atlantic Mutual Insurance [Electronic] E7349C Other WC (Non-NY) , ATLANTIC PACIFICA TEA CO 2 PARAGON DR APT01 New York Workers' MONTVALE, NJ 07645 Compensation ATLANTIC SPECIALTY INS CO ONE BEACON LANE ATSI01 New York Workers' CANTON, MA 02021-1030 Compensation ATLANTIC SPECIALTY INS CO PO BOX 9155 ATLSPE01 New York Workers' CANTON, MA 02021-1030 Compensation ATLAS PIZZERIA 35 EAST MARKET STREET ATLAS001 New York Workers' CORNING, NY 14830 Compensation ATLAS PIZZERIA BLANT INC 35 EAST MARKET STREET ATLAS002 New York Workers' CORNING, NY 14830 Compensation ATOFINA CHEMICALS 100 PA RT 413 ATOFI001 New York Workers' BRISTOL, PA 19007 Compensation ATTICA CORRECTIONAL FACILITY 639 EXCHANGE STREET ATTIC001 New York Workers' ATTICA, NY 14011 Compensation ATWATER FOODS 10190 RT 18 ATWF01 New York Workers' LYNDONVILLE, NY 14098 Compensation AUBURN ARMATURE 70 WRIGHT CIRCLE AUBA01 New York Workers' AUBURN, NY 13021 Compensation AUBURN MEMORIAL HOSPITAL 17 LANSING ST AUBM01 New York Workers' AUBURN, NY 13021 Compensation AUBURN POLICE DEPT 46 NORTH ST AUBP01 New York Workers' AUBURN, NY 13021 Compensation Auburn Tank & Mfg. Co. Inc PO Box 488 AUBUR001 New York Workers' 24 McMaster St Compensation Auburn, NY 13021 Auchinachie Plumbing 42 Frederick St AUCHI001 New York Workers' Binghamton, NY 13901 Compensation AUGUST BOHL CONTRACTING 197 BROAD STREET AUGUS001 New York Workers' ALBANY, NY 12202 Compensation AUSMUS CORPORATION PO BOX 633 ATTN: WORKERS COMP AUSMU001 New York Workers' BUFFALO, NY 14231 Compensation AUSTIN CONSTRUCTION 5054 COUNTY ROUTE 125 AUSTI001 New York Workers' CAMPBELL, NY 14821 Compensation AUSTIN EXCAVATING 121 TALMEDGE HILL WEST AUSTI002 New York Workers' WAVERLY, NY 14892 Compensation Austin Mutual Ins [Electronic] E1170A New York Workers' , Compensation Austin Mutual Ins [Electronic] E1170B Auto/No-Fault , Austin Mutual Ins [Electronic] E1170C Other WC (Non-NY) , Auto Club Group [Electronic] E7795B Auto/No-Fault , Auto Club Property-Casualty Insurance Company E7947B Auto/No-Fault [Electronic] , Auto Injury Solutions PO BOX 5038 AUTOI001 New York Workers' Woodbridge, NJ 07095 Compensation Auto Injury Solutions PO BOX 5038 AUTOI002 Auto/No-Fault Woodbridge, NJ 07095 Auto One Insurance PO Box 50 AUTOO001 New York Workers' Syracuse, NY 13214 Compensation AUTO ONE INSURANCE P O BOX 50 AUTOO003 Auto/No-Fault SYRACUSE, NY 13214 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AUTO OWNERS POBOX 30512 AUTOO013 Auto/No-Fault LANSING, MI 48909 Auto Owners / Liability P.O. Box 338 AUTOO007 Auto/No-Fault Mt. Vernon, IL 62864 Auto Owners Ins PO Box 3337 AUTOO005 Other WC (Non-NY) Peoria, IL 61612 AUTO OWNERS INS COMPANY P.O. BOX 3900 AUTOO014 Other WC (Non-NY) LAKELAND, FL 33802 AUTO ZONE INC PO BOX 2198 AUTOZ001 New York Workers' MEMPHIS, TN 38101-9842 Compensation AUTOMATED CELLS & EGUIPMENT, INC 13435 ENTERPRISE DRIVE AUTOM001 New York Workers' PAINTED POST, NY 14870 Compensation AUTOMATIC ROLLS 3 CORCORAN AUR01 New York Workers' AUBURN, NY 13021 Compensation Automotive Corp 4320 Federal Dr AUTOM002 New York Workers' Batavia, NY 14020 Compensation AutoOne Insurance [Electronic] 5788 Widewaters Parkway AUTOO002 Auto/No-Fault Syracuse, NY 13214 Auto-Owners \ Home-Owners Insurance Company E1171A New York Workers' [Electronic] , Compensation Auto-Owners \ Home-Owners Insurance Company E1171B Auto/No-Fault [Electronic] , Auto-Owners \ Home-Owners Insurance Company E1171C Other WC (Non-NY) [Electronic] , Auto-Owners \ Owners Insurance Company E1172A New York Workers' [Electronic] , Compensation Auto-Owners \ Owners Insurance Company E1172B Auto/No-Fault [Electronic] , Auto-Owners \ Owners Insurance Company E1172C Other WC (Non-NY) [Electronic] , Auto-Owners \ Property-Owners Insurance Co E1173A New York Workers' [Electronic] , Compensation Auto-Owners \ Property-Owners Insurance Co E1173B Auto/No-Fault [Electronic] , Auto-Owners \ Property-Owners Insurance Co E1173C Other WC (Non-NY) [Electronic] , Auto-Owners \ Southern-Owners Company E1174A New York Workers' [Electronic] , Compensation Auto-Owners \ Southern-Owners Company E1174B Auto/No-Fault [Electronic] , Auto-Owners \ Southern-Owners Company E1174C Other WC (Non-NY) [Electronic] , Auto-Owners Insurance Company [Electronic] E8317B Auto/No-Fault , Auto-Owners Insurance Company [Electronic] E8317C Other WC (Non-NY) , Auto-Owners Life Insurance Company [Electronic] E1175A New York Workers' , Compensation Auto-Owners Life Insurance Company [Electronic] E1175B Auto/No-Fault , Auto-Owners Life Insurance Company [Electronic] E1175C Other WC (Non-NY) , AUTOPART INCORPORATED 101 LESTER AVE AUTOP001 New York Workers' JOHNSON CITY, NY 13790-2261 Compensation AUTUMVIEW HEALTH CARE 4650 SOUTHWESTERN BLVD AUTUM001 New York Workers' HAMBURG, NY 14075 Compensation Auxillary Services 507 Culkin Hall, Osu AUXIL002 New York Workers' Oswego, NY 13126 Compensation Auxilliary Services Neubig Hall AUXIL001 New York Workers' 15 Neubig Rd. Compensation Cortland, NY 13045 AVETERAN CORP 700 HOWARD ST AVETE001 New York Workers' BUFFALO, NY 14206 Compensation Avid Insurance Co. 425 New Karner Rd AVIDI001 New York Workers' Albany, NY 12205 Compensation AVIR Inc. [Electronic] E0668A New York Workers' , Compensation AVIR Inc. [Electronic] E0668C Other WC (Non-NY) , AVIS BUDGET PO BOX 61247 AVISB003 Auto/No-Fault VIRGINIA BEACH, VA 23466 AVIS BUDGET CAR RENTALS 146 CONSTELLATION WAY NORTH AVISB001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation AVIS BUDGET RENTAL GROUP PO BOX 61247 AVISB002 Auto/No-Fault VIRGINIA BEACH, VA 32346 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID AVIS RENT A CAR 6 SYLVAN WAY AVISR001 Auto/No-Fault PARSIPPANY, NJ 07054 AVOX SYSTEMS 225 ERIE ST AVOXS001 New York Workers' LANCASTER, NY 14086 Compensation AVS INSURANCE AGENCY 1028 US HIGHWAY 206 SUITE# 4 AVSIN001 Auto/No-Fault BORDENTOWN, NJ 08505 Aw Farrell 3761 East Lake RD AWFAR001 New York Workers' Dunkirk, NY 14048 Compensation AW LAWRENCE CO 2716 ALBANY ST AWL01 New York Workers' SCHENECTADY, NY 12301 Compensation AXIOM MEDICAL CONSULTING 25511 BUDDE ROAD AXIOM001 New York Workers' WOODLANDS, TX 77380 Compensation Ayers Trucking [Electronic] E4001C Other WC (Non-NY) , AZLEC MACHINERY PO BOX 2069 AZLEC001 New York Workers' IVYLAND, PA 18974 Compensation AZTECH TECHNOLOGIES 5 MCCREA HILL ROAD AZTEC001 New York Workers' BALLSTON SPA, NY 12020 Compensation B GI INTERIORS INC 22 SIMON AVE ATTN: WORKERS BGIIN001 New York Workers' COMPENSATION Compensation LACKAWANNA, NY 14218 B.R. JOHNSON 6960 FLY ROAD BRJOH001 New York Workers' EAST SYRACUSE, NY 13057 Compensation BABB INC 480 E SWEDESFORD ROAD BABBI001 New York Workers' WAYNE, PA 19087 Compensation BABCOCK UTILITIES INC 7637 CANAL RD BABCO001 New York Workers' GASPORT, NY 14067 Compensation Badger Mutual / Liability PO Box 2092 BADGE001 Auto/No-Fault Milwaukee, WI 53201 Baker Tanks, Inc. [Electronic] E0669A New York Workers' , Compensation Baker Tanks, Inc. [Electronic] E0669C Other WC (Non-NY) , BAKER VICTORY SERVICES 780 RIDGE RD BAKER001 New York Workers' LACKAWANNA, NY 14218 Compensation BALDO FORD 6980 NIAGARA FALLS BLVD BALDO001 New York Workers' NIAGARA FALLS, NY 14304 Compensation BALDWIN STANTON MEADOWS 2 STANTON MEADOWS DRIVE BALDW001 New York Workers' SENECA FALLS, NY 13148 Compensation BALLAND POOL & EXCAVATION 60 OLD ITHACA ROAD BALLA001 New York Workers' HORSEHEADS, NY 14845 Compensation BALLARD SPORTS 320 BRIDGE STREET BALLA002 New York Workers' SYRACUSE, NY 13209 Compensation BALLEN BAILEY TAG & LABEL 3177 LEHIGH ST BALLE001 New York Workers' CALEDONIA, NY 14423 Compensation BALTZ CONCRETE 6626 ELLICOTT ST BALTZ001 New York Workers' PAVILION, NY 14525 Compensation Bank of America [Electronic] E1176A New York Workers' , Compensation Bank of America [Electronic] E1176B Auto/No-Fault , Bank of America [Electronic] E1176C Other WC (Non-NY) , BANKERS MULTI LINE INS CO PO BOX 66932 BAN01 New York Workers' CHICAGO, IL 60666 Compensation Bankers Standard Insurance [Electronic Indirect] PO BOX 1000 BANKE001 New York Workers' WA04R Compensation PHILADELPHIA, PA 19106 Bankers Standard Insurance [Electronic Indirect] PO BOX 1000 BANKE002 Auto/No-Fault WA04R PHILADELPHIA, PA 19106 Bankers Standard Insurance [Electronic Indirect] PO BOX 1000 BANKE003 Other WC (Non-NY) WA04R PHILADELPHIA, PA 19106 BARBAGALLO UNITED 6396 EAST MALLOY ROAD BARBA001 New York Workers' EAST SYRACUSE, NY 13057 Compensation BARE BONES FURNITURE, INC. 10 SAGAMORE STREET BAREB001 New York Workers' GLENS FALLS, NY 12801 Compensation Bari Management (Murphy and Beane) E0670C Other WC (Non-NY) [Electronic] , BARNES & CONE INC PO BOX 280 BARN01 New York Workers' COURT STREET RD Compensation SYRACUSE, NY 13206 Barnes [Electronic] E1295A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Barnes [Electronic] E1295C Other WC (Non-NY) , Barr Transportation 174 York STreet BARRT001 New York Workers' Auburn, NY 13021 Compensation Barrett Business Services Inc (BBSI) [Electronic] E1177A New York Workers' , Compensation Barrett Business Services Inc (BBSI) [Electronic] E1177B Auto/No-Fault , Barrett Business Services Inc (BBSI) [Electronic] E1177C Other WC (Non-NY) , BARTRICH ENTERPRISES INC 6060 COURT STREET ROAD BARTR001 New York Workers' SYRACUSE, NY 13206 Compensation BASCOL 4610 WETZEL ROAD BASCO001 New York Workers' LIVERPOOL, NY 13090 Compensation Basic Resources, Inc. [Electronic] E0671A New York Workers' , Compensation Basic Resources, Inc. [Electronic] E0671C Other WC (Non-NY) , BASIL FORD 1540 WALDEN AVE BASIL001 New York Workers' CHEEKTOWAGA, NY 14225 Compensation BASKIN LIVESTOCK 9778 CREEK RD BASKI001 New York Workers' BATAVIA, NY 14020 Compensation BASSETT HEALTHCARE 1 ATWELL RD BASS01 New York Workers' COOPERSTOWN, NY 13326 Compensation BATAVIA DOWNS AND GAMING 8315 PARK ROAD BATAV001 New York Workers' batavia, NY 14020 Compensation BATAVIA ENCLOSURES 6 TREADEASY AVE BATAV002 New York Workers' BATAVIA, NY 14020 Compensation Batavia Healthcare Center 257 State St BATAV003 New York Workers' Batavia, NY 14020 Compensation BATAVIA MUCKDOGS C/O MICHELLE CASANOVA BATAV004 New York Workers' 501 MARLINS WAY Compensation MIAMI, FL 33125 BATES TROY QUALITY DRY CLEANERS 151 LAUREL AVENUE BATES001 New York Workers' BINGHAMTON, NY 13905 Compensation BATH & BODY WORKS 3300 CHAMBERS ROAD BATHB001 New York Workers' SUITE 5006 Compensation HORSEHEADS, NY 14845 BATH AMERICAN LEGION 33 MAINE STREET BATHA001 New York Workers' BATH, NY 14810 Compensation BATH ELECTRIC & WATER SYSTEMS 7 SOUTH AVE BATHE001 New York Workers' BATH, NY 14810 Compensation BATH EXPRESS LUBE 654A STATE ROUTE 54 BATHE002 New York Workers' BATH, NY 14810 Compensation Bath Veterans Hospital 76 Veterans Ave BATHV001 New York Workers' Bath, NY 14810 Compensation BAUMANNS BROOKSIDE 77 JOHNNIE CAKE LANE BAUMA001 New York Workers' GREENVILLE, NY 12083 Compensation BAY ENTERPRISES, INC 771 ROUTE 70E BAYEN001 New York Workers' SUITE D100 Compensation MARLTON, NJ 08053 Bay Park PO Box 2015 BAYPA001 New York Workers' East Setauket, NY 11733 Compensation BAY VILLAGE CONDOS 100 BAY VILLAGE DR BAYVI001 New York Workers' ROCHESTER, NY 14609 Compensation BAYONNE BOARD OF ED AVE A & 29TH STREEET BAYON001 New York Workers' BAYONNE, NJ 07002 Compensation BAYONNE HOUSING AUTHORITY 50 EAST 21ST STREET BAYON002 New York Workers' BAYONNE, NJ 07002 Compensation BAYONNE MEDICAL CTR 29TH STREET AVE E BAYON003 New York Workers' ATTN: HR, MARYANN Compensation BAYONNE, NJ 07002 BBL CARLTON 302 WASHINGTON AVE EXT BBLCA001 New York Workers' ALBANY, NY 12203 Compensation BC/BS OF NEW JERSEY PO BOX 1407 BCBC01 New York Workers' CHURCH STREET STATION, NY Compensation 10008-1407 BCMW PO Box 729 BCMW001 Other WC (Non-NY) Centralia, IL 62801 BDD SERVICES PO BOX 8229 BDDSE001 New York Workers' HARRISBURG, PA 17105 Compensation BE WRIGHT PO BOX 9 BEW01 New York Workers' RT 414 Compensation SENECA FALLS, NY 13148 BEACHTREE CARE CENTER 318 SOUTH ALBANY ST BEACH001 New York Workers' ITHACA, NY 14850 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Beacon Mutual [Electronic] E5251A New York Workers' , Compensation Beacon Mutual [Electronic] E5251C Other WC (Non-NY) , BEACON POINT MEMORY CARE 1 EMMA LANE BEACO001 New York Workers' CLIFTON PARK, NY 12065 Compensation Beall's Inc / Midwest Employers [Electronic] E5689C Other WC (Non-NY) , BEAM MACK SALES 2674 WEST HENRIETTA ROAD BEAMM001 New York Workers' ROCHESTER, NY 14623 Compensation BEAR RIVER MUTUAL PO BOX 571310 BEARR001 Auto/No-Fault MURRAY, UT 84157 Bear Valley Unified School District (CA) E1178A New York Workers' [Electronic] , Compensation Bear Valley Unified School District (CA) E1178B Auto/No-Fault [Electronic] , Bear Valley Unified School District (CA) E1178C Other WC (Non-NY) [Electronic] , BEAUTY SYSTEM GROUP 3001 COLORADO BLVD BEAUT001 New York Workers' DENTON, TX 76210 Compensation Beck Bus PO Box 768 BECKB001 Other WC (Non-NY) Mt. Vernon, IL 62864 BECK EQUIPMENT INC PO BOX 243 BECKE001 New York Workers' PREBLE, NY 13143 Compensation BECKY'S DINER 310 BROAD STREET BECKY001 New York Workers' WAVERLY, NY 14892 Compensation bedford post inn 954 old post rd BEDFO001 New York Workers' bedford, NY 10506 Compensation BEECH TREE CARE CENTER 318 S ALBANY STREET BEECH001 New York Workers' PO BOX 6569 Compensation ITHACA, NY 14851 beechwood healthcare 2235 millersport hwy BEECH002 New York Workers' getzville,, NY 14068 Compensation Beelman Trucking / WC 1 Racehorse Drive BEELM001 Other WC (Non-NY) Attn: Kathy East Saint Louis, IL 62205 Beeville ISD [Electronic] E0672A New York Workers' , Compensation Beeville ISD [Electronic] E0672C Other WC (Non-NY) , BELLA PIZZA 3330 SOUTH PARK AVE BELLA002 New York Workers' LACKAWANNA, NY 14218 Compensation Bellamy Construction 3769 Ridge Road BELLA001 New York Workers' Scotia, NY 12302 Compensation Bellinger Electric 12134 Vaughn St BELLI001 New York Workers' East Concord, NY 14055 Compensation BEN WEITSMAN & SON INC 15 W MAIN ST BENWE001 New York Workers' OWEGO, NY 13827 Compensation BEN WEITSMAN & SONS PO BOX 420 BENWE002 New York Workers' OWEGO, NY 13827 Compensation Benchmark Insurance [Electronic] E5143A New York Workers' , Compensation Benchmark Insurance [Electronic] E5143B Auto/No-Fault , Benchmark Insurance [Electronic] E5143C Other WC (Non-NY) , BENDER INSURANCE 365 CROSSWAYS PK DR BENDE001 New York Workers' WOODBURY, NY 11797 Compensation BENETECH INC PO BOX 348 BENE01 New York Workers' WYNANTSKILL, NY 12198 Compensation BENIFIT CONCEPTS PO BOX C5009 BENI01 New York Workers' WARMINSTER, PA 18924 Compensation BENSALEM TWP 2400 BYBERRY ROAD BENSA001 New York Workers' BENSALEM, PA 19020 Compensation Bergen Risk PO Box 901 BERGE002 Other WC (Non-NY) Ramsey, NJ 07446 BERGEN RISK MANAGEMENT PO BOX 901 BERGE003 New York Workers' RAMSEY, NJ 07446 Compensation BERGEN RISK MANAGERS PO BOX 901 BERGE005 Other WC (Non-NY) RAMSEY, NJ 07446 BERGERS SKI & SNOWBOARD 16 LEWIS ST BERGE004 New York Workers' BINGHAMTON, NY 13901 Compensation BERGERS SKI & SNOWBOARD SHOP 45 WASHINGTON STREET BERGE001 New York Workers' BINGHAMTON, NY 13901 Compensation BERKEY'S NURSERY 138 JEFFERSON ST BERKE001 New York Workers' SPARTANSBURG, PA 16434 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Berkley Agribusiness Risk Specialists [Electronic] E0673C Other WC (Non-NY) , Berkley Mid Atlantic c/o MCMC BERKL011 Other WC (Non-NY) PO BOX 1290 Canonsburg, PA 15317 Berkley Mid Atlantic PO BOX 27707 BERKL012 Auto/No-Fault Richmond, VA 23261 BERKLEY MID-ATLANTIC GROUP P.O. BOX 1290 BERKL010 New York Workers' CANONSBURG, PA 15317 Compensation Berkley National Insurance Company [Electronic] E0674C Other WC (Non-NY) , Berkley Net Underwriters, LLC [Electronic] E0675A New York Workers' , Compensation Berkley Net Underwriters, LLC [Electronic] E0675C Other WC (Non-NY) , Berkley Regional Insurance Company [Electronic] E0676C Other WC (Non-NY) , Berkley Risk Administrators Company, LLC E0677A New York Workers' [Electronic] , Compensation Berkley Risk Administrators Company, LLC E0677C Other WC (Non-NY) [Electronic] , BERKLEY SPECIALTY UNDERWRITERS PO BOX 141299 BERKL013 Other WC (Non-NY) IRVING, TX 75014 Berkley Specialty Underwriters [Electronic] E5845A New York Workers' , Compensation Berkley Specialty Underwriters [Electronic] E5845C Other WC (Non-NY) , Berkley Valley Conv Hospital [Electronic] E0678A New York Workers' , Compensation Berkley Valley Conv Hospital [Electronic] E0678C Other WC (Non-NY) , BERKSHIRE HATHAWAY PO BOX 881716 BERKS001 New York Workers' SAN FRANCISCO, CA 94188 Compensation Berkshire Hathaway Homestate Companies E0679C Other WC (Non-NY) (BHHC) [Electronic] , BERKSHIRE HATHAWAY HOMESTATE INS CO PO BOX 881716 BERKS004 Other WC (Non-NY) SAN FRANCISCO, CA 94188 BERKSHIRE HATHAWAY HOMESTATES C 1725 WINWARD CONCOURSE BERKS002 New York Workers' SUITE 200 Compensation ALPHARETTA, GA 30005 BERKSHIRE HATHWAY HOMESTATE CO. PO BOX 881716 BERKS005 Other WC (Non-NY) SAN FRANCISCO, CA 94188 Bernardo H. Co. Club [Electronic] E0680A New York Workers' , Compensation Bernardo H. Co. Club [Electronic] E0680C Other WC (Non-NY) , BERNATT GRAVEL 13870 TAYLOR HOLLOW RD BERNA001 New York Workers' COLLINS, NY 14034 Compensation BERRY PLASTICS C/O DAVE HECKMAN BERRY001 New York Workers' 200 E MAIN ST Compensation MACEDON, NY 14502 Berwind Corporation [Electronic] E2032C Other WC (Non-NY) , BEST BAGELS 526 HOOPER ROAD BESTB001 New York Workers' ENDWELL, NY 13760 Compensation Bethany Baptist Camp 1633 Bates Rd. BETHA003 New York Workers' Sinclairville, NY 14782 Compensation Bethany Center 751 Watkins Road BETHA002 New York Workers' Horseheads, NY 14845 Compensation BETHANY RETIREMENT HOME 3005 WATKINS ROAD BETHA001 New York Workers' ATTN DAVE STANBRO Compensation HORSEHEADS, NY 14845 BETHLEHEM SCHOOL DIST. 90 ADAMS PLACE BETHL001 New York Workers' DELMAR, NY 12054 Compensation BETTE AND CRING 22 CENTURY HILL DRIVE, SUITE BETTE001 New York Workers' 201 Compensation LATHAM, NY 12110 BETTER BUSINESS FORMS PO BOX 250 BETT01 New York Workers' PINELLAS PARK, FL 33780 Compensation Beverly Hills Carmel [Electronic] E0681A New York Workers' , Compensation Beverly Hills Carmel [Electronic] E0681C Other WC (Non-NY) , Big 5 Corp [Electronic] E1160A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Big 5 Corp [Electronic] E1160B Auto/No-Fault , Big 5 Corp [Electronic] E1160C Other WC (Non-NY) , Big Muddy Corrections / WC 251 N Illinois Hwy 37 BIGMU001 Other WC (Non-NY) Ina, IL 62846 BIG O FARMS PO BOX 276 BIGOF001 New York Workers' ELBA, NY 14058 Compensation BIG TOP TENT RENTALS PO BOX 1086 BIGTO001 New York Workers' CAIRO, NY 12413 Compensation Bighorn Construction [Electronic] E0682A New York Workers' , Compensation Bighorn Construction [Electronic] E0682C Other WC (Non-NY) , Bill Cram 1913 Routes 5 & 20 BILLC001 New York Workers' Waterloo, NY 13148 Compensation BILL RAPP SUPER STORE 3449 BURNETT AVENUE BILLR001 New York Workers' SYRACUSE, NY 13206 Compensation BIRCH HILL CATERING 1 CELEBRATION WAY BIRCH002 New York Workers' CASTLETON ON HUDSON, NY 12033 Compensation BIRCHCREST TREE AND LANDSCAPE 1385 EMPIRE BLVD BIRCH001 New York Workers' ROCHESTER, NY 14609 Compensation BIRNEY MURRAYS 500 S MAIN STREET BIRNE001 New York Workers' ELMIRA, NY 14904 Compensation BIRNIE TRANSPORTATION SERVICES 124 VICTORY HWY BIRNI001 New York Workers' PAINTED POST, NY 14870 Compensation BISCOTTI CAFE AND GELATO 741 NORTH SALINA STREET BISCO001 New York Workers' SYRACUSE, NY 13208 Compensation BISON BATH AND KITCHEN 2991 SHERIDAN DR BISON001 New York Workers' AMHERST, NY 14226 Compensation BISON CITY TRUCK PARTS 489 WALDEN AVE BISON002 New York Workers' BUFFALO, NY 14211 Compensation Bitco Insurance P.O.Box 167968 BITCO001 Other WC (Non-NY) Irving, TX 75016 BITUMINOUS 651 HOLIDAY DRIVE FOSTER PLAZA BITUM001 New York Workers' 5 Compensation PITTSBURGH, PA 15220-2757 Bituminous / WC 10733 Sunset Office Drive BITUM002 Other WC (Non-NY) Suite 430 Saint Louis, MO 63127 BITUMINOUS CASUALTY CORP 320 18TH ST BITC01 New York Workers' ROCK ISLAND, IL 61201 Compensation BITUMINOUS FIRE & MARINE INS CO FOSTER PLAZA #5 BITUM003 Other WC (Non-NY) 651 HOLIDAY DRIVE PITTSBURGH, PA 15220-2757 Bituminous Fire and Marine [Electronic] E1179A New York Workers' , Compensation Bituminous Fire and Marine [Electronic] E1179B Auto/No-Fault , Bituminous Fire and Marine [Electronic] E1179C Other WC (Non-NY) , Bituminous Insurance Company [Electronic] E1180A New York Workers' , Compensation Bituminous Insurance Company [Electronic] E1180B Auto/No-Fault , Bituminous Insurance Company [Electronic] E1180C Other WC (Non-NY) , BJ MUIRHEAD 115 MID COUNTY DRIVE BJMUI001 New York Workers' ORCHARD PARK, NY 14127 Compensation BJ SULZE 1 NEEDLE LANE BJSU01 New York Workers' SYRACUSE, NY 13215 Compensation BK CONSTRUCTION W/C PO BOX 3880 BKCON001 New York Workers' HARRISBURG, PA 17105 Compensation BLACK DIAMOND CONSTRUCTION 179 GRAHAM RD BLACK002 New York Workers' ITHACA, NY 14850 Compensation BLACKS SERVICE CENTER 137 EAST PULTNEY STREET BLACK001 New York Workers' CORNING, NY 14830 Compensation BLAIR CONSTRUCTION 13 BRAE RIDGE RD BLAIR001 New York Workers' AUBURN, NY 13021 Compensation Bland Farms 11388 SCHULER RD BLAND002 New York Workers' Cato, NY 13033 Compensation Bland Farms 1389 Curtis Co Op Rd. BLAND001 New York Workers' Sterling, NY 13156 Compensation BLOOMING GLEN PO BOX 194 BLOOM001 New York Workers' SKIPPACK, PA 19474 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Bloomingdale's [Electronic] E0683A New York Workers' , Compensation Bloomingdale's [Electronic] E0683C Other WC (Non-NY) , Blowers Agra PO BOX 161 BLOWE001 New York Workers' HALL, NY 14463 Compensation BLUE CROSS ANIMAL HOSP 3921 MAIN ST BLUEC002 New York Workers' AMHERST, NY 14226 Compensation Blue Cross Blue Shield P.O. Box 22999 BLUEC001 New York Workers' Rochester, NY 14692 Compensation Blue Cross Blue Shield of Wny P.O.BOX 80 BLUEC003 New York Workers' Buffalo, NY 14240 Compensation Blue Cross Blue Shiled of PA P.O. Box 890062 BLUEC004 Auto/No-Fault Camp Hill, PA 17089 BLUE RIDGE INDEMNITY CO 86 HOPMEADOW ST BLUR01 New York Workers' SIMSBURY, CT 06070 Compensation BLUE STAR CLAIMS 21001 N TATUM BLVD BLUES001 New York Workers' PHOENIX, AZ 85050 Compensation BLUM BUILDERS 8750 ROLL ROAD BLUMB001 New York Workers' CLARENCE CENTER, NY 14032 Compensation BM & T MANAGEMENT 5 SOUTH ALLEN STREET BMTMA001 New York Workers' SUITE 1 Compensation ALBANY, NY 12203 BMG SYSTEMS P O BOX 1307 BMGSY001 New York Workers' ORCHARD PK, NY 14127 Compensation BMI Benefits PO Box 511 BMIBE001 Other WC (Non-NY) Matawan, NJ 07747 BMI Benefits PO Box511 BMIBE002 Auto/No-Fault Mattawan, NJ 07747 BMW Manufacturing Corp. [Electronic] E4540A New York Workers' , Compensation BMW Manufacturing Corp. [Electronic] E4540C Other WC (Non-NY) , BMW North America [Electronic] E7845A New York Workers' , Compensation BMW North America [Electronic] E7845C Other WC (Non-NY) , BNU Claims / WC P.O. Box 49129 BNUCL001 Other WC (Non-NY) Greensboro, NC 27419 BOB EVANS FARMS RESTAURANT 1 BUFFALO STREET BOBEV001 New York Workers' CORNING, NY 14830 Compensation BOBBY K ENTERTAINMENT PO BOX 937 BOBBY001 New York Workers' ELMIRA, NY 14902 Compensation Bobrick Washroom [Electronic] E0684A New York Workers' , Compensation Bobrick Washroom [Electronic] E0684C Other WC (Non-NY) , BOC GASES 1011 EAST MARKET STREET BOCGA001 New York Workers' BETHLEHEM, PA 18017 Compensation BOHNS RESTARANT 5256 CLINTON STREET BOHNS001 New York Workers' BATAVIA, NY 14020 Compensation Boise Cascade Company [Electronic] E1104A New York Workers' , Compensation Boise Cascade Company [Electronic] E1104B Auto/No-Fault , Boise Cascade Company [Electronic] E1104C Other WC (Non-NY) , BOLLINGER PO BOX 727 BOLLI002 Other WC (Non-NY) SHORT HILLS, NJ 07078 Bollinger Insurance PO Box 706 BOLLI001 Other WC (Non-NY) Short Hills, NJ 07078 BOMBARDIER 7940 RT 415 BOMBA002 New York Workers' BATH, NY 14810 Compensation BONADENT PO BOX 499 BON01 New York Workers' SENECA FALLS, NY 13148 Compensation BONCRAFT INC 4222 S TAYLOR RD ATTN:GLORIA BONCR001 New York Workers' WORKERS COMP Compensation ORCHARD PARK, NY 14127 BONDUELLE 40 STEVENS ST BONDU001 New York Workers' OAKFIELD, NY 14125 Compensation BONTRAGER AUCTION CENTER 8975 WORTENDYKE RD BONTR001 New York Workers' BATAVIA, NY 14020 Compensation BOON & SONS 1 BOON DRIVE BOONS002 New York Workers' NORTH CHILI, NY 14514-9825 Compensation Borg Automotive 800 Warren Road BORGA001 New York Workers' Ithaca, NY 14850 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID BOSTON BEST COFFEE ROAST 900 JEFFERSON AVE BOSTO001 New York Workers' ROCHESTER, NY 14623 Compensation BOTHAR CONSTRUCTION ATTN: KAREN O'BRIEN BOTHA001 New York Workers' 170 EAST SERVICE ROAD Compensation BINGHAMTON, NY 13901 BOTTLES & CORKS 130 W MARKET STREET BOTTL001 New York Workers' CORNING, NY 14830 Compensation BOUILLE ELECTRIC & CORP PO BOX 34 BOUIL001 New York Workers' 154 EAST 5TH STREET Compensation ELMIRA, NY 14902 Boulder Community Hospital [Electronic] E0685A New York Workers' , Compensation Boulder Community Hospital [Electronic] E0685C Other WC (Non-NY) , Bradford County Manor RR3 Box 322 BRADF001 New York Workers' Troy, NY 16947 Compensation BRADYS FLOOR WORKS 7 SEMINARY ST BFW01 New York Workers' UNION SPRINGS, NY 13160 Compensation Brandon Broderick Attorney 167 Main St BRAND002 Auto/No-Fault Hackensack, NJ 07601 BRAVO SOLUTIONS 1580 LAKE ST BRAVO001 New York Workers' Elmira, NY 14901 Compensation BRAWDY CONSTRUCTION PO BOX 470 BRAWD001 New York Workers' CLARENCE CENTER, NY 14032 Compensation Bremco Construction [Electronic] E0686A New York Workers' , Compensation Bremco Construction [Electronic] E0686C Other WC (Non-NY) , Brentwood Services / WC PO Box 7110 BRENT001 Other WC (Non-NY) Champaign, IL 61826 BRETHERN MUTUAL INSURANCE COMPANY 149 N EDGEWOOD DRIVE BRETH001 Other WC (Non-NY) HAGERSTOWN, MD 21740 Breton Industries One Sam Stratton Road BRETO001 New York Workers' Amsterdam, NY 12010 Compensation BRIAN DRATCH ATT 354 EISENHOWER PARKWAY BRIAN001 Auto/No-Fault LIVINGSTON, NJ 07039 BRICKLAYERS INS WELFARE 6605 WOODHAVEN BLVD BRICK001 New York Workers' REGO PARK, NY 11374 Compensation BRICKMAN GROUP 953 US HIGHWAY 202 NORTH BRICK002 New York Workers' BRANCHBURG, NJ 08876 Compensation Bridgefield Ins. Co. P.O.BOX 2928 BRIDG003 New York Workers' Lakeland, FL 33806 Compensation Bridges Cornell 407 Wyckoff ave BRIDG001 New York Workers' attn: Elizabeth Compensation Ithica, NY 14852 Bridgestreet Mutual PO Box 3151 BRIDG002 Other WC (Non-NY) Charleston, WV 25339 BRIGGS AUTO SERVICE 511 E HIGH STREET BRIGG001 New York Workers' PAINTED POST, NY 14870 Compensation Bright Horizons 150 pleasant Grove Road BRIGH001 New York Workers' Ithica, NY 14850 Compensation BRIGHT SKY 1001 FAIRWAY DRIVE BRIGH002 New York Workers' BENSENVILLE, IL 60106 Compensation BRIMAR ADMIN CO 1440 MAPLE AVE BRIM01 New York Workers' STE 6B Compensation LISLE, IL 60532 BRIMER ADMIN CO 2067 Burlington Ave BRIMER01 New York Workers' LISLE, IL 60532 Compensation BRISTOL HOME 1500 MAIN STREET BRIST001 New York Workers' BUFFALO, NY 14209 Compensation BRISTOL TOWNSHIP SCHOOLS 6401 MILL CREEK ROAD BRIST003 New York Workers' LEVITTOWN, PA 19057 Compensation Bristol West [electronic] E9996B Auto/No-Fault , Bristol West No Fault PO Box 22-9085 BRIST002 Auto/No-Fault Hollywood, FL 33314 Broad Acres Nursing Home RD 3 BOX 249 BROAD004 New York Workers' Wellsboro, PA 16901 Compensation Broadspire PO Box 14343 BROAD035 New York Workers' Lexington, KY 40512 Compensation BROADSPIRE P O BOX 14645 BROAD030 Other WC (Non-NY) LEXINGTON, KY 40512-4645 BROADSPIRE PO BOX 14645 BROAD027 New York Workers' LEXINGTON, KY 40512 Compensation BROADSPIRE PO BOX 14645 BROAD034 Auto/No-Fault LEXINGTON, KY 40512 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Broadspire [Electronic Indirect] 100 Passaic Avenue BROAD007 New York Workers' Suite 140 Compensation Fairfield, NJ 07004 Broadspire [Electronic Indirect] 100 Passaic Avenue BROAD011 Auto/No-Fault Suite 140 Fairfield, NJ 07004 Broadspire [Electronic Indirect] 100 Passaic Avenue BROAD015 Other WC (Non-NY) Suite 140 Fairfield, NJ 07004 Broadspire [Electronic Indirect] 333 Earle Ovington Blvd. BROAD008 New York Workers' Suite 303 Compensation Uniondale, NY 115533067 Broadspire [Electronic Indirect] 333 Earle Ovington Blvd. BROAD012 Auto/No-Fault Suite 303 Uniondale, NY 115533067 Broadspire [Electronic Indirect] 333 Earle Ovington Blvd. BROAD016 Other WC (Non-NY) Suite 303 Uniondale, NY 115533067 Broadspire [Electronic Indirect] PO BOX 25104 BROAD009 New York Workers' LEHIGH VALLEY, PA 18002 Compensation Broadspire [Electronic Indirect] PO BOX 25104 BROAD013 Auto/No-Fault LEHIGH VALLEY, PA 18002 Broadspire [Electronic Indirect] PO BOX 25104 BROAD017 Other WC (Non-NY) LEHIGH VALLEY, PA 18002 Broadspire [Electronic Indirect] PO BOX 5000 BROAD010 New York Workers' Smithtown, NY 11787 Compensation Broadspire [Electronic Indirect] PO BOX 5000 BROAD014 Auto/No-Fault Smithtown, NY 11787 Broadspire [Electronic Indirect] PO BOX 5000 BROAD018 Other WC (Non-NY) Smithtown, NY 11787 BROADSPIRE [electronic indirect] PO BOX 14343 BROAD031 New York Workers' LEXINGTON, KY 40512 Compensation BROADSPIRE [Electronic Indirect] PO BOX 14645 BROAD033 Auto/No-Fault LEXINGTON, KY 40512 BROADSPIRE SERVICES PO BOX 14645 BROAD036 Other WC (Non-NY) LEXINGTON, KY 40512 Broadspire, a Crawford Company [Electronic] E8088A New York Workers' , Compensation Broadspire, a Crawford Company [Electronic] E8088C Other WC (Non-NY) , BRODO 4548 MAIN ST BRODO001 New York Workers' SCHNEIDER, NY 14226 Compensation BROOKDALE SENIOR LIVING 103 BUNDY ROAD BROOK001 New York Workers' ITHACA, NY 14850 Compensation BROOKE & WHITTLE 215 JOHN GLEN DR BROOK003 New York Workers' AMHERST, NY 14228 Compensation BROOK'S PAINTING 78 EAST FIRST STREET BROOK002 New York Workers' CORNING, NY 14830 Compensation BROOME COUNTY RISK MANAGEMENT PO BOX 1766 BCRM01 New York Workers' BINGHAMTON, NY 13902 Compensation BROOME TIOGA ARC/OWEGO 56 BROADWAY BROOM001 New York Workers' OWEGO, NY 13827 Compensation BROOME TIOGA BOCES 435 GLENWOOD RD BROOM002 New York Workers' BINGHAMTON, NY 13905 Compensation Brotherhood Mutual 6400 Brotherhood Way BROTH001 New York Workers' Fort Wayne, IN 46825 Compensation BROTHERHOOD MUTUAL PO BOX 2228 BROTH002 New York Workers' FT WAYNE, IN 46801 Compensation BROTHERHOOD MUTUAL INS CO P O BOX 2228 BROTH003 Other WC (Non-NY) FORT WAYNE, IN 46801-2228 Brotherhood Mutual Insurance [Electronic] E1132B Auto/No-Fault , Brotherhood Mutual Insurance [Electronic] E1132C Other WC (Non-NY) , Brown & Brown Empire State 500 PLUM ST SUITE 200 BROWN001 Auto/No-Fault SYRACUSE, NY 13204 Brown & Brown of NY, Inc 45 East Ave Ste 700 BROWN003 New York Workers' Rochester, NY 14604 Compensation Brown Brothers Produce 9647 IDOT Shed Road BROWN002 Other WC (Non-NY) Nashville, IL 62263 Brownsville Independent School District E0687A New York Workers' [Electronic] , Compensation Brownsville Independent School District E0687C Other WC (Non-NY) [Electronic] , Brownyard Group Inc. (Arch Insurance) E5182C Other WC (Non-NY) [Electronic] , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID BRUCCOLERI STEPHEN W 11 WOODHURST DRIVE BRUCC001 Auto/No-Fault VOORHEES, NJ 08043 BRUCE RESNICK ATT 385 Kings Hwy N BRUCE001 Auto/No-Fault Cherry Hill, NJ 08034 Brunswick Corporation (AUTO ONLY) [Electronic] E7904B Auto/No-Fault , Brunswick Corporation [Electronic] E5737C Other WC (Non-NY) , BRUSH CUTTERS 8765 COUNTY ROUTE 8 BRUSH001 New York Workers' CAPE VINCENT, NY 13618 Compensation Buckeye Insurance Group [Electronic] ONE HERITAGE PLACE BUCKE001 Auto/No-Fault PIQUA, OH 45356 Buckmans Car Wash 2496 W. Ridge Rd Ste 204 BUCKM001 New York Workers' Rochester, NY 14626 Compensation BUDWEY'S MARKET 535 DIVISION ST BUDWE001 New York Workers' NORTH TONAWANDA, NY 14120 Compensation Buffalo Bandits HSBC Arena Plaza III BUFFA006 New York Workers' One Seymour Knox Plaza Compensation Buffalo, NY 14203-3096 BUFFALO BILLS ONE BILLS DRIVE BUFF01 New York Workers' ATTN ACCTS PAYABLE Compensation ORCHARD PARK, NY 14127 BUFFALO BISONS BASEBALL 1 JAMES D GRIFFIN PLAZA BUFFA003 New York Workers' BUFFALO, NY 14203 Compensation BUFFALO BOARD OF EDUCATION 721 B CITY HALL BBED01 New York Workers' BUFFALO, NY 14202 Compensation Buffalo Board of Education, Workers Comp 806 City Hall BUFFA008 New York Workers' Buffalo, NY 14202 Compensation BUFFALO CRUSH STONE 2544 CLINTON ST BUFFA002 New York Workers' WEST SENECA, NY 14224 Compensation BUFFALO DRILLING CO 10440 MAIN ST BUFFA011 New York Workers' CLARENCE, NY 14031 Compensation BUFFALO ENGINE COMPONENTS 171 WALDEN AVE BUFFA005 New York Workers' BUFFALO, NY 14211 Compensation BUFFALO EXTERMINATING 3636 NORTH BUFFALO ST BUFFA004 New York Workers' ORCHARD PARK, NY 14127 Compensation BUFFALO MEDICAL GROUP 85 HIGH ST BMG01 New York Workers' WC DEPT 85 Compensation BUFFALO, NY 14203 BUFFALO NEWPRESS INC 200 BROADWAY ST BUFFA001 New York Workers' BUFFALO, NY 14204 Compensation Buffalo Post Office 170 Manhattan Ave BUFFA012 New York Workers' Buffalo, NY 14215 Compensation Buffalo Powder Systems Tech 60 Clyde Ave BUFFA014 New York Workers' Buffalo, NY 14215 Compensation BUFFALO PUMPS 874 OLIVER ST BUFFA013 New York Workers' NORTH TONAWANDA, NY 14120 Compensation BUFFALO SABRES 1 SEYMOUR H KNOX III PLAZA BUFF02 New York Workers' HSBC ARENA Compensation BUFFALO, NY 14203 BUFFALO TRANSPORTATION 71 MILITARY ROAD BUFFA007 New York Workers' BUFFALO NY, NY 14207 Compensation BUFFALO WIRE WORKS 1165 CLINTON ST BWW01 New York Workers' BUFFALO, NY 14206 Compensation BUFFALO/NIAGARA MARRIOTT 1340 MILLERSPORT HWY BUFFA009 New York Workers' AMHERST, NY 14226 Compensation BUILDERS INSULATTION 136 TIVOLI ST BUILD002 New York Workers' ALBANY, NY 12207 Compensation BUILDING CONTROLS AND SERVICES 4 PEUQUET PARKWAY BUILD001 New York Workers' TONAWANDA, NY 14150 Compensation Bunch & Assoc. Inc [Electronic Indirect] PO BOX 32037 BUNCH002 New York Workers' LAKELAND, FL 33802 Compensation Bunch & Assoc. Inc [Electronic Indirect] PO BOX 32037 BUNCH004 Other WC (Non-NY) LAKELAND, FL 33802 Bunch & Assoc. Inc [Electronic Indirect] PO BOX 32045 BUNCH003 New York Workers' LAKELAND, FL 33802 Compensation Bunch & Assoc. Inc [Electronic Indirect] PO BOX 32045 BUNCH005 Other WC (Non-NY) LAKELAND, FL 33802 Bunch & Associates PO BOX 32045 BUNCH006 Other WC (Non-NY) LAKELAND, FL 38802 BUNCH & ASSOCIATES PO BOX 32045 BUNC01 New York Workers' LAKELAND, FL 33802 Compensation Bunch and Associates [Electronic] E5652A New York Workers' , Compensation Bunch and Associates [Electronic] E5652C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID BUNZL DIST. 10814 NORTHEAST AVE BUNZL001 New York Workers' PHILADELPHIA,, PA 19116 Compensation Burdick Lexus 5947 E Circle Dr BURDI001 New York Workers' Cicero, NY 13039 Compensation BUREAU OF DISABILITY 1171 S CAMERSON STREET BUREA001 New York Workers' ROOM 20O Compensation HARRISBURG, PA 17104 BURGER KING 130 PROSPECT STREET BURGE001 New York Workers' ATTICA, NY 14011 Compensation BURGER KING 230 WEST MAIN ST BURGE002 New York Workers' BATAVIA, NY 14020 Compensation BURGER KING 6060 COURT STREET ROAD BURGE003 New York Workers' SYRACUSE, NY 13206 Compensation Burke & Leavell Insurance 224 East Elm Street BURKE001 New York Workers' East Rochester, NY 14445 Compensation Burlington Coat Factory Wareho [Electronic] E5701C Other WC (Non-NY) , Burns Brosthes Construction 400 Leavenworth Avenue BURNS002 New York Workers' Syracuse, NY 13204 Compensation BURNS MANAGEMENT 1732 WESTERN AVE BURNS001 New York Workers' STE 1 Compensation ALBANY, NY 12203 BURROWS BROS INC 6360 DEAN PKWY BURRO001 New York Workers' ONTARIO, NY 14519 Compensation Burton Way Carmel [Electronic] E0688A New York Workers' , Compensation Burton Way Carmel [Electronic] E0688C Other WC (Non-NY) , BURTRANS 1522 ATWOOD ROAD BURTR001 New York Workers' MORAVIA,NY, NY 13118 Compensation BUSCH PRODUCTS 110 BAKER STREET BUSCH001 New York Workers' SYRACUSE, NY 13206 Compensation BUSINESS INS CO PO BOX 162667 BUSI01 New York Workers' ALTAMONTE SPRINGS, FL 32716 Compensation BV General (Murphy and Beane) [Electronic] E0689C Other WC (Non-NY) , Bycor Gen Contract [Electronic] E0690A New York Workers' , Compensation Bycor Gen Contract [Electronic] E0690C Other WC (Non-NY) , BYRON BERGEN TRANSPORTATION 6917 W BERGEN RD BYRON001 New York Workers' BERGEN, NY 14416 Compensation C & C READY MIX 3112 OLD VESTAL ROAD CCREA001 New York Workers' VESTAL, NY 13850 Compensation C & D LAFACE CONSTRUCTION INC. 3721 NEW COURT AVENUE CDLAF001 New York Workers' SYRACUSE, NY 13206 Compensation C & S DESIGN BUILDE INC. 499 COL. EILEEN COLLINS BLVD. CSDES001 New York Workers' SYRACUSE, NY 13212 Compensation C & S TECHNICAL RESOURCES HANCOCK INTERL AIRPORT CSTE01 New York Workers' SYRACUSE, NY 13212 Compensation C P WARD P O BOX 900 CPWAR001 New York Workers' SCOTTSVILLE, NY 14546 Compensation C.H. HETRICK ASSOCIATES 2018 DUNCAN ROAD CHHET001 Auto/No-Fault WILMINGTON, DE 19808 CA REED ASSOCIATES 200 SALTONSTALL ST CAREE001 New York Workers' CANANDAIGUA, NY 14424 Compensation CABLE EXPRESS 5404 SOUTH BAY ROAD CABLE001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation Cadet Uniform Supply [Electronic] E0691A New York Workers' , Compensation Cadet Uniform Supply [Electronic] E0691C Other WC (Non-NY) , CALABOOSE GRILLE 176 MAIN STREET CALAB002 New York Workers' OWEGO, NY 13827 Compensation CALABRESE GENERAL CONTRACTING 21 LUDWIG AVE CALAB001 New York Workers' CHEEKTOWAGA, NY 14227 Compensation CALEDONIA DIESEL 2105 SIMPSON RD CALED001 New York Workers' CALEDONIA, NY 14423 Compensation CALIFORNIA CASUALTY P.O. Box 39700 CALIF001 Auto/No-Fault Colorado Springs, CO 80949-9700 California Fair Services Authority [Electronic] E1154A New York Workers' , Compensation California Fair Services Authority [Electronic] E1154C Other WC (Non-NY) , California Water Service Company [Electronic] E0692A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID California Water Service Company [Electronic] E0692C Other WC (Non-NY) , Callahan, McCune [Electronic] E0693A New York Workers' , Compensation Callahan, McCune [Electronic] E0693C Other WC (Non-NY) , CALLAN FARMS 4194 CAMERON ROAD CALLA002 New York Workers' CALEDONIA, NY 14423 Compensation CALLANAN INDUSTRIES P.O. BOX 15097 CALLA001 New York Workers' ALBANY, NY 12212 Compensation CALSPAN 4455 GENESSEE ST CALSP001 New York Workers' BUFFALO, NY 14225 Compensation CAMALLI GROUP 7 WESTVIEW RD CAMAL001 New York Workers' PITTSFIELD, MA 01201 Compensation Cambridge 5700 Lombardo Ctr CAMBR015 New York Workers' STE 100 Compensation Independence, OH 44131 Cambridge Integrated Services [Electronic] E1125A New York Workers' , Compensation Cambridge Integrated Services [Electronic] E1125C Other WC (Non-NY) , Cambridge/Sedgwick PO box 14423 CAMBR014 New York Workers' Lexington, KY 40512 Compensation CAMCO MANUFACTURING INC 25 KING LANE CAMCO001 New York Workers' SAYRE, PA 18840 Compensation CAMERON MANUFACTURING AND DESIGN INC PO BOX 478 CAMER001 New York Workers' 727 BLOSTEIN BLVD Compensation HORSEHEADS, NY 14845 camp lokota 56 park road CAMPL001 New York Workers' wurtsboro, NY 12790 Compensation CAMP SCHODACK 40 KROUNER ROAD CAMPS001 New York Workers' NASSAU, NY 12123 Compensation Campbell Union School District [Electronic] E0694A New York Workers' , Compensation Campbell Union School District [Electronic] E0694C Other WC (Non-NY) , Canadain Pacific RR PO Box 3160 CANAD001 New York Workers' Binghamton, NY 13902 Compensation CANADIAN PACIFIC - DELAWARE & HUDSON 200 CLIFTON CORPORATE CPDH01 New York Workers' RAILWAY PARKWAY Compensation CLIFTON PARK, NY 12065-8002 CANAL WALK 23 SYRACUSE STREET CANAL001 New York Workers' BALDWINSVILLE, NY 13027 Compensation Canastota N/C Corp 121 W. Center St. CANAS001 New York Workers' Canastota, NY 13032 Compensation CANFIELD AND TACK INC. 925 EXCHANGE ST CANFI001 New York Workers' ROCHESTER, NY 14608 Compensation CANISIUS COLLEGE 2001 MAIN ST CANIS01 New York Workers' BUFFALO, NY 14208 Compensation CANNON COCHRAN MGT 8800 PAGE AVE CANNO001 New York Workers' ST LOUIS, MO 63114 Compensation CANTON MANUFACTURING PO BOX 97 CANTO001 New York Workers' CANTON, PA 17724 Compensation Capistrano Unified School District (CA) [Electronic] E1181A New York Workers' , Compensation Capistrano Unified School District (CA) [Electronic] E1181B Auto/No-Fault , Capistrano Unified School District (CA) [Electronic] E1181C Other WC (Non-NY) , CAPITAL CITY INSURANCE PO BOX 212128 CAPI01 New York Workers' COLUMBIA, SC 29221 Compensation Capital District Beginnings 597 Third Avenue CAPIT005 New York Workers' Troy, NY 12182 Compensation Capital Indemnity Corp Po Box 5900 CAPIT001 New York Workers' Madison, WI 53705-0900 Compensation CAPITOL ADMINISTRATORS P O BOX 2318 CAPIT008 Auto/No-Fault RANCO CORDOVA, CA 957412318 Capitol Indemnity [Electronic] E3595A New York Workers' , Compensation Capitol Indemnity [Electronic] E3595B Auto/No-Fault , Capitol Indemnity [Electronic] E3595C Other WC (Non-NY) , Capitol Insurance 1180 Welsh Rd CAPIT006 Auto/No-Fault STE 100 North Wales, PA 19454 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Capitol Insurance Companies [Electronic] E1105A New York Workers' , Compensation Capitol Insurance Companies [Electronic] E1105B Auto/No-Fault , Capitol Insurance Companies [Electronic] E1105C Other WC (Non-NY) , CAPITOL INSURANCE COMPANY 1180 WELSH ROAD, SUITE 100 CAPIT009 Auto/No-Fault NORTH WALES, PA 19454 Cappiello Electric 475 Peck Road CAPPI001 New York Workers' Rochester, NY 14559 Compensation CAPS-SIG [Electronic] E0695A New York Workers' , Compensation CAPS-SIG [Electronic] E0695C Other WC (Non-NY) , Carbondale Nursing Home 59 North Main Street CARBO001 New York Workers' Carbondale, PA 18407 Compensation CARE AMERICA 47 RIVERSIDE AVE CAREA001 New York Workers' JOHNSON CITY, NY 13790 Compensation CARE CAPITAL MANAGEMENT 4999 LOUISE DRIVE CAREC001 New York Workers' SUITE 204 Compensation MECHANICSBURG, PA 17055 CARE GIVERS 1300 COLLEGE AVE CAREG001 New York Workers' ELMIRA, NY 14901 Compensation CARE GIVERS 718 SOUTH STATE STREET CAREG003 New York Workers' CLARKS SUMMIT, PA 14811 Compensation CARE IMPROVEMENT PLUS PO BOX 488 CAREI003 Auto/No-Fault LINTHICUM HEIGHTS, MD 21090 CARE IQ IHCFA NYWC 301 PENNSYLVANIA PKWY STE 215 CAREI004 Auto/No-Fault INDIANAPOLIS, IN 46280 CARE WORKS PO BOX 94748 CARE01 New York Workers' CLEVELAND, OH 44101 Compensation CAREER START 727 ST PAUL ST CAREE002 New York Workers' Rochester, NY 14605 Compensation Caregivers 260 Harry L Drive CAREG004 New York Workers' Johnson City, NY 13790 Compensation CAREGIVERS AMERICA 703 S ELMER AVE CAREG002 New York Workers' SAYRE, PA 18840 Compensation CareIQ 301 Pennsylvania Pkwy CAREI002 New York Workers' Ste 215 Compensation Indianapolis, IN 46280 CARELINKS PO BOX 7373 CAREL001 New York Workers' LONDON, KY 40742 Compensation CAREWORKS PO BOX 94748 CAREW003 New York Workers' CLEVELAND, OH 44101 Compensation CAREWORKS CONSULTANTS INC PO BOX 8101 CAREW002 New York Workers' DUBLIN, OH 43016 Compensation CAREWORKS OF OHIO PO BOX 182726 CAREW001 New York Workers' COLUMBUS, OH 43218 Compensation Carey and Walsh p.o. box 2529 CAREY001 New York Workers' Briarcliff Manor, NY 10510 Compensation CARGILL TAYLOR BEEF PO BOX 188 CARGI001 New York Workers' ROUTE 706 Compensation WYALUSING, PA 18853 Carl Warren & Company P.O. Box 2916 CARLW001 Other WC (Non-NY) Mission, KS 66201 Carleton Nursing Home 10 West Avenue CARLE001 New York Workers' Wellsboro, PA 16901 Compensation Carpenter Care Home RR7 Box 12 Virginia Drive CARPE001 New York Workers' Tunkhannock, NY 18657 Compensation CARPENTER TECHNOLOGY CORP PO BOX 14662 CARPE002 New York Workers' HEALTH SERVICES BLDG 22 Compensation READING, PA 19612 CARPET MASTERS PO BOX 274 CARPE003 New York Workers' DRYDEN, NY 13053 Compensation CARSTAR COLLISION AMHERST 2753 NIAGARA FALLS BLVD. CARST001 New York Workers' AMHERST, NY 14226 Compensation CARUBBA COLLISION 9200 TRANSIT RD CARUB001 New York Workers' E AMHERST, NY 14051 Compensation Carver Construction 494 Western Tpke CARVE001 New York Workers' Ste 1 Compensation Altamont, NY 12009 CAS-CHEMICAL 40 AVENUE A CASCH001 New York Workers' BAYONNE, NJ 07002 Compensation Casella Waste Management 3555 County Rd 49 CASEL001 New York Workers' Attn:Lisa Archer Compensation Stanley, NY 14561 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CASELLA WASTE MANAGEMENT PO BOX 349 CASEL002 New York Workers' NEWFIELD, NY 14687 Compensation Caseys Hallmark Shop 1601 Penfield Rd CASEY001 New York Workers' Rochester, NY 14625 Compensation Cashman Dredging Attn: Chuck Towle CASHM001 New York Workers' Po Box 363 Compensation Fort Edward, NY 12828 CAS-HUMAN RESOURCES SUNY GENESEO CASHU001 New York Workers' 1 COLLEGE CIRCLE Compensation GENESEO, NY 14454 Casitas Municipal Water District (CA) [Electronic] E1182A New York Workers' , Compensation Casitas Municipal Water District (CA) [Electronic] E1182B Auto/No-Fault , Casitas Municipal Water District (CA) [Electronic] E1182C Other WC (Non-NY) , CASSETTE AGENCY 810 KENMORE AVE CASSE001 New York Workers' BUFFALO, NY 14216 Compensation CAST AND CREW PAYROLL INC 100 EAST TUJUNGA AVE CASTA001 New York Workers' 2ND FL Compensation BURBANK, CA 91502 CASTLE GARDENS SENIOR LIVING 2224 PIERCE CREEK ROAD CASTL002 New York Workers' BINGHAMTON, NY 13903 Compensation CASTLE GARDENS SENIOR LIVING CENTER 1715 CASTLE GARDENS ROAD CASTL003 New York Workers' VESTAL, NY 13850 Compensation CATAWISSA LUMBER PO BOX 176 CATAW001 New York Workers' CATAWISSA, PA 17820 Compensation CATERPILLAR INC 100 NE ADAMS CATER001 New York Workers' AB4320/WC Compensation PEORIA, IL 61629 Catholic Charities 4 Nichols Street CATHO006 New York Workers' Johnstown, NY 12095 Compensation CATHOLIC CHARITIES 1 PARK PL CACH01 New York Workers' STE 200 Compensation ALBANY, NY 12205 CATHOLIC CHARITIES 215 EAST CHURCH STREET CATHO004 New York Workers' SUITE 101 Compensation ELMIRA, NY 14901 CATHOLIC CHARTIES 232 MAIN ST CATHO005 New York Workers' BINGHAMTON, NY 13905 Compensation CATHOLIC DIOCESE PO BOX 511 CATH01 New York Workers' 240 EAST ONONDAGA ST Compensation SYRACUSE, NY 13202 Catholic Diocese of San Diego [Electronic] E0696A New York Workers' , Compensation Catholic Diocese of San Diego [Electronic] E0696C Other WC (Non-NY) , Catholic Mutual - Virginia Surety Company, Inc. E0698A New York Workers' [Electronic] , Compensation Catholic Mutual - Virginia Surety Company, Inc. E0698C Other WC (Non-NY) [Electronic] , Catholic Mutual Group 1011 First Ave CATHO008 New York Workers' Floor: 19 Compensation New York, NY 10022 Catholic Mutual Group 33 Elk Street CATHO001 New York Workers' Albany, NY 12207 Compensation CATHOLIC MUTUAL GROUP 10843 OLD MILL ROAD CATHO007 Other WC (Non-NY) OMAHA, NE 68154 Catholic Mutual Preferred Professional Ins Co E0697A New York Workers' [Electronic] , Compensation Catholic Mutual Preferred Professional Ins Co E0697C Other WC (Non-NY) [Electronic] , CATTARAUGUS COUNTY SELF INS PLAN 303 COURT ST CATT01 New York Workers' LITTLE VALLEY, NY 14755 Compensation Cavagnaro Construction 3429 Route 9 CAVAG001 New York Workers' Valatie, NY 12184 Compensation Cayuga Centers 101 Hamilton Ave CAYUG005 New York Workers' Auburn, NY 13201 Compensation CAYUGA LANDSCAPE CO 2712 N TRIPHAMMER RD CAYUG002 New York Workers' ITHACA, NY 14850 Compensation CAYUGA MEDICAL CENTER 101 DATES RD CAYU01 New York Workers' ITHACA, NY 14850 Compensation Cayuga Press 215 South Main St. CAYUG001 New York Workers' Cortland, NY 13045 Compensation CAYUGA RIDGE HEALTH & RESIDENTIAL CENTER 1229 TRUMANSBURG ROAD CAYUG004 New York Workers' ITHACA, NY 14850 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CAZENOVIA COLLEGE 12 LIBERTY STREET CAZEN001 New York Workers' CAZENOVIA, NY 13035 Compensation Cazenovia Equiment 2 Remington Parl Drive CAZEN002 New York Workers' Cazenovia, NY 13035 Compensation CBCS PO BOX 28 CBCS002 New York Workers' DUBUQUE, IA 52004 Compensation CBO GLASS 13595 BROADWAY ST CBOGL001 New York Workers' ALDEN, NY 14004 Compensation CBP / Liability P.O. Box 21282 CBPLI001 Auto/No-Fault Tampa, FL 33622 CBS Studios (Murphy and Beane) [Electronic] E0699C Other WC (Non-NY) , CCMG 911 MAIN ST STE 2340 CCMG001 New York Workers' KANSAS CITY, MO 64105 Compensation ccmsi PO BOX 27920 CCMSI017 New York Workers' scottsdale, AZ 85255 Compensation CCMSI 2 East Main Street CCMSI022 New York Workers' Suite 208 Compensation Danville, IL 61832 CCMSI 3535 Route 66 CCMSI003 Auto/No-Fault Building 6 Neptune, NJ 07753 CCMSI 3535 ROUTE 66 BUILDING 6 CCMSI018 Other WC (Non-NY) NEPTUNE, NJ 07753 CCMSI PO BOX 1127 CCMSI016 New York Workers' Neptune, NJ 07754 Compensation CCMSI PO BOX 20068 CCMSI019 Other WC (Non-NY) RENO, NV 89515 CCMSI PO Box 317 CCMSI014 New York Workers' Linwood, NJ 08221 Compensation CCMSI PO Box 317 CCMSI015 Other WC (Non-NY) Linwood, NJ 08221 CCMSI PO BOX 35350 CCMSI020 Other WC (Non-NY) LAS VEGAS, NV 891335350 CCMSI PO BOX 4990 CCMSI021 Other WC (Non-NY) CARSON CITY, NV 897024990 CCMSI [Electronic] E1932C Other WC (Non-NY) , CCN 200 LEHIGH ST CCN01 New York Workers' GENEVA, NY 14456 Compensation CCS HOLDINGS P O BOX 541328 CCSHO002 New York Workers' DALLAS, TX 75354 Compensation CCS HOLDINGS PO BOX 541388 CCSHO001 New York Workers' Dallas, TX 75354 Compensation CCSI / WC P.O. Box 542528 CCSIW001 Other WC (Non-NY) Dallas, TX 75354 CCSI LP PO BOX 542528 CCSIL001 New York Workers' DALLAS, TX 75354-2528 Compensation CDTA 110 WATERVLIET AVE CDTA001 New York Workers' ALBANY, NY 12206 Compensation CEBCOR SERVICES CORP 2995 LBJ FREEWAY CEBC01 New York Workers' STE 121 Compensation DALLAS, TX 75234 Cedar Lake 547 W. 26th St. CEDAR001 New York Workers' New York, NY 10001 Compensation Cedars-Sinai Health System [Electronic] E0700A New York Workers' , Compensation Cedars-Sinai Health System [Electronic] E0700C Other WC (Non-NY) , CEJON ACCESSORIES 53 HOOK RD CEJON001 New York Workers' BAYONNE, NJ 07002 Compensation Celina Insurance Group [Electronic] ONE INSURANCE SQUARE CELIN001 Auto/No-Fault CELINA, OH 45822 Cellino & Barnes Attorney 420 Lexington Ave CELLI001 Auto/No-Fault Suite 930 New York, NY 10170 Cement And Concrete Worker 35-30 Francis Lewis Blvd CEMEN001 New York Workers' Flushing, NY 11358 Compensation Cendant - Avis [Electronic] PO BOX 61247 CENDA003 Auto/No-Fault VIRGINIA BEACH, VA 23466 Cendant - Budget [Electronic] PO BOX 61247 CENDA001 Auto/No-Fault VIRGINIA BEACH, VA 23466 Cendant Corporation [Electronic] E8462C Other WC (Non-NY) , CENTENNIAL INS 55 E. JACKSON BLVD CEIN01 New York Workers' CHICAGO, IL 60604-4104 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Centennial Insurance Company [Electronic] E6521C Other WC (Non-NY) , Center For Ambulatory Surgery 950 A Union Rd, STE 424 CENTE003 New York Workers' Dept% of Human Resources Compensation West Seneca, NY 14224 CENTER FOR DISABILITY 314 SO. MANNING BLVD. CENTE001 New York Workers' ALBANY, NY 12208 Compensation CENTER ITHACA 171 EAST STATE STREET #146 CENTE005 New York Workers' ITHACA, NY 14850 Compensation CENTER MUTUAL INSURANCE CO PO BOX 365 CENTE002 Auto/No-Fault RUGBY, ND 58368 CENTER OF DISABILITY RIGHTS 23 WEST MARKET ST CENTE006 New York Workers' CORNING, NY 14830 Compensation Centers for Specialty Care 1601 Bronxdale Ave, Suite 209 CENTE004 New York Workers' Bronx, NY 10462 Compensation CENTRAL CONCETE WC 86 YELLOWBROOK RD CENTR008 New York Workers' FARMINGDALE, NJ 07727 Compensation Central Contra Costa Transit Authority [Electronic] E1183A New York Workers' , Compensation Central Contra Costa Transit Authority [Electronic] E1183B Auto/No-Fault , Central Contra Costa Transit Authority [Electronic] E1183C Other WC (Non-NY) , CENTRAL HEALTHCARE 958 CHURCH ST CENTR001 New York Workers' BALDWIN, NY 11510 Compensation Central Hockey League [Electronic] E7105C Other WC (Non-NY) , CENTRAL INS CO PO BOX 353 CENT01 New York Workers' 800 WASHINGTON ST Compensation VAN WERT, OH 45891 Central Mutual Insurance PO Box 353 CENTR009 Other WC (Non-NY) Van Wert, OH 45891 Central Mutual Insurance Co. 800 South Washington St. CENTR002 Auto/No-Fault PO Box 353 Van Wert, OH 45891-2381 CENTRAL RECYCLING 260 LATTABROOK PARK CENTR003 New York Workers' HORSEHEADS, NY 14845 Compensation Centralia Correctional Center PO Box 1266 CENTR006 Other WC (Non-NY) Centralia, IL 62801 Centralia High School / WC 2100 E Calumet CENTR005 Other WC (Non-NY) Centralia, IL 62801 Centralia Press / WC PO Box 627 CENTR007 Other WC (Non-NY) Centralia, IL 62801 CENTURY INDEMNITY COMPANY PO BOX 1000 CEIC01 New York Workers' WA04R Compensation PHILADELPHIA, PA 19106 CENTURY INS 204 BROADWAY CENTU001 New York Workers' BROOKLYN, NY 11211 Compensation Century Insurance POB 8220 CENTU002 Auto/No-Fault CORAOPOLIS, PA 15108-8220 CERES CRYSTAL INDUSTRIES 2250 LIBERTY DR CERES002 New York Workers' NIAGARA FALLS, NY 14304 Compensation CERES TERMINAL INSURANCE 565 MARRIOT DRIVE CERES001 New York Workers' NASHVILLE, TN 37214 Compensation CESAR INSURANCE GROUP 354 CAYUGA RD CESAR001 New York Workers' CHEEKTOWAGA, NY 14225 Compensation CFE INC (EVANS ROOFING COMPANY) 35 INDUSTRIAL PARK BLVD CFEIN001 New York Workers' ELMIRA, NY 14902 Compensation CG HOLLISTER CONSTRUCTION LLC 77 HOLLISTER STREET CGHOL001 New York Workers' DUNDEE, NY 14837 Compensation CGS PO BOX 20010 CGS001 Other WC (Non-NY) NASHVILLE, TN 37202 CGU GENERAL ACCIDENT PO BOX 302 CGU01 New York Workers' BUFFALO, NY 14240-0965 Compensation CH Wright 3 Wright Ave CHWRI001 New York Workers' Leroy, NY 14482 Compensation CH4 BIO GAS LLC 319 FIRST STREET CH4BI001 New York Workers' ATLANTIC BEACH, FL 33223 Compensation CHA, Inc. 3 Winners Cirlce CHAIN001 New York Workers' Suite 100 Compensation Albany, NY 12205 Chadler Group 100 Passaic Ave #120 CHADL001 New York Workers' Fairfield, NJ 07004 Compensation CHADWICK BAY COFFEE CO 92 LAKESHORE DRIVE EAST CHADW001 New York Workers' DUNKIRK, NY 14048 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CHAFFEE SARDINIA FIRE CO PO BOX 477 CHAFF001 New York Workers' SARDINIA, NY 14134 Compensation Chaffey Joint Union H. S. District (CA) [Electronic] E1184A New York Workers' , Compensation Chaffey Joint Union H. S. District (CA) [Electronic] E1184B Auto/No-Fault , Chaffey Joint Union H. S. District (CA) [Electronic] E1184C Other WC (Non-NY) , CHAMPLAIN STONE PO BOX 650 CHAMP001 New York Workers' WARRENSBURG, NY 12885 Compensation Chandler's P. Verdes [Electronic] E0701A New York Workers' , Compensation Chandler's P. Verdes [Electronic] E0701C Other WC (Non-NY) , Chapin MFG 700 Ellicott Street CHAPI001 New York Workers' Batavia, NY 14021-0549 Compensation Chapman Convalescent [Electronic] E0702A New York Workers' , Compensation Chapman Convalescent [Electronic] E0702C Other WC (Non-NY) , CHARLES DRISCOLL MASONRY RESTORATION PO BOX 1096 CHARL005 New York Workers' SKANEATELES, NY 13152 Compensation CHARLES F EVANS CO 800 CANAL ST CHARL002 New York Workers' ELMIRA, NY 14902 Compensation CHARLES M. CONE & ASSOCIATES PO BOX 195 CHMC01 New York Workers' GLEN SHAW, PA 15116 Compensation CHARLES OLIN & SONS 103 PHILO ROAD WEST CHARL003 New York Workers' ELMIRA, NY 14901 Compensation CHARLOTTE APPLIANCE 3200 LAKE AVENUE CHARL004 New York Workers' ROCHESTER, NY 14612 Compensation CHARLTON SCHOOL P.O. BOX 47 CHARL001 New York Workers' BURNT HILLS, NY 12027 Compensation CHARM POOLS MFG PO BOX 294 CHARM001 New York Workers' ATTEN: LINDA Compensation WAVERLY, NY 14892 Charming Shoppes, Inc. [Electronic] E3404C Other WC (Non-NY) , Chartis PO BOX 1822 CHART005 Other WC (Non-NY) ALPHARETTA, GA 30023 CHARTIS [ELECTRONIC INDIRECT] PO BOX 1822 CHART011 New York Workers' ALPHARETTA, GA 30023-1822 Compensation CHARTIS DOMESTIC CLAIMS PO BOX 1830 CHART012 Auto/No-Fault ALPHARETTA, GA 30023-1822 CHASE MANUFACTURING PO BOX 37 CHASE001 New York Workers' CORRY, PA 16407 Compensation Chautauqua Brick 3790 Rt. 430 CHAUT008 New York Workers' PO Box 310 Compensation Bemus Point, NY 14712 Chautauqua Brick PO Box 310 CHAUT003 New York Workers' Bemus Point, NY 14712 Compensation CHAUTAUQUA BRICK 13600 COLUMBUS AVE CHAUT005 New York Workers' CORRY, PA 16407 Compensation CHAUTAUQUA COUNTY 3 NORTH ERIE ST CHAUT002 New York Workers' MAYVILLE, NY 14757 Compensation Chautauqua Institution PO BOX 28 CHAUT004 New York Workers' Chautauqua, NY 14722 Compensation Chautauqua Marina 104 West Lake Rd. CHAUT007 New York Workers' Mayville, NY 14757 Compensation CHAUTAUQUA MARINA 104 WEST LAKE RD CHAUT001 New York Workers' MAYVILLE, NY 14757 Compensation CHAUTAUQUA OPPORTUNITIES 17 W COURTNEY ST CHAUT006 New York Workers' DUNKIRK, NY 14048 Compensation CHAWCT 110 BARNES RD CHAW01 New York Workers' WALLINGFORD, CT 06492 Compensation Chem Dry 8700 Ransom Rd. CHEMD001 New York Workers' Brocton, NY 14716 Compensation CHEMUNG CANAL TRUST COMPANY 1 CHEMUNG CANAL PLAZA CHEMU001 New York Workers' ELMIRA, NY 14902 Compensation Chemung Contracting 2105 South Broadway CHEMU003 New York Workers' Pine City, NY 14871 Compensation Chemung County Arc 711 Sullivan Street CHEMU004 New York Workers' Elmira, NY 14901 Compensation CHEMUNG COUNTY BUILDING PO BOX 707 CHEMU005 New York Workers' VESTAL, NY 13851 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Chemung County Self Insured PO BOX 588 CHEMU007 New York Workers' 203 Lake st. Compensation Elmira, NY 14902 CHEMUNG COUNTY/SPCA 2435 STATE RT 352 CHEMU002 New York Workers' ELMIRA, NY 14903 Compensation CHEMUNG FIRE DEPT 679 MAIN STREET CHEMU006 New York Workers' PO BOX 138 Compensation CHEMUNG, NY 14825 CHEMUNG SPRING WATER PO BOX 249 CHEMU008 New York Workers' CHEMUNG, NY 14825 Compensation CHEROKEE INSURANCE COMPANY 34200 MOUND RD CHER01 New York Workers' STERLING HEIGHTS, MI 48310 Compensation CHEROKEE INSURANCE COMPANY PO BOX 159 CHEROK01 New York Workers' WARREN, MI 48090 Compensation CHESTERFIELD RESOURCES INC (NY) PO BOX 1884 CHEST001 New York Workers' AKRON, OH 44309 Compensation Chesterfield Service / WC PO Box 610 CHEST002 Other WC (Non-NY) Green, OH 44232 CHESTERFIELD SERVICES PO BOX 610 CHES01 New York Workers' GREEN, OH 44232 Compensation Chesterfield Services, Inc. [Electronic] E0703B Auto/No-Fault , Chesterfield Services, Inc. [Electronic] E0703C Other WC (Non-NY) , CHEUMUNG SUPPLY CO PO BOX 527 CHEUM001 New York Workers' ELMIRA, NY 14902 Compensation CHICAGO WHITE SOC 333 WEST 35TH ST CHIC01 New York Workers' CHICAGO, IL 60616 Compensation Chicago Wolves 2301 Ravine Way CHICA001 New York Workers' Attn: Kevin Kacer Compensation Glenview, IL 60025 CHILD AND FAMILY SERVICES 330 DELAWARE AVE CHILD003 New York Workers' BUFFALO, NY 14202 Compensation Childrens Educational Services Attn: Lisa Beaudry CHILD002 New York Workers' 774 Fairmount Ave Compensation Jamestown, NY 14701 childrens home wyoming conf 1182 chenango street CHILD001 New York Workers' jo perez ext: 168 Compensation binghamton,, NY 13902 Children's Hospital Colorado [Electronic] E0704A New York Workers' , Compensation Children's Hospital Colorado [Electronic] E0704C Other WC (Non-NY) , Children's Hospital of Orange County [Electronic] E0705A New York Workers' , Compensation Children's Hospital of Orange County [Electronic] E0705C Other WC (Non-NY) , CHILSON WILCOX 660 ADDISON ROAD CHILS001 New York Workers' PAINTED POST, NY 14870 Compensation CHIROPRACTIC CARE CENTRE, PA 4247 WEST KENNEDY BLVD CHIRO001 Auto/No-Fault TAMPA, FL 33609 CHMIELOWIEC PAINTING INC 8123 PROLE RD EXT CHMIE001 New York Workers' BYRON, NY 14422 Compensation Choice Labor 2577 Francis Lewis Blvd CHOIC001 New York Workers' Flushing, NY 11358 Compensation CHRIS KEEFE BUILDERS 2977 MAGNOLIA STEDMAN RD CKB01 New York Workers' MAYVILLE, NY 14757 Compensation CHRISTIAN BROTHERS 1205 WINDHAM PARKWAY CHRIS004 New York Workers' ROMEOVILLE, IL 60446 Compensation CHRISTIAN STUEBEN ATT 1386 PALISADES AVENUE CHRIS003 Auto/No-Fault FORT LEE, NJ 07024 Christopher Community Inc. 990 James Street CHRIS001 New York Workers' Syracuse, NY 13203 Compensation CHRISTOPHER LIPARI 1301 South Main Street CHRIS002 Auto/No-Fault Pleasantville, NJ 08232 Chubb 3630 Peachtree Rd NE CHUBB022 New York Workers' STE 1500 Compensation Atlanta, GA 30326 CHUBB 233 SOUTH WACKER DR CHUBB014 New York Workers' CHICAGO, IL 60606 Compensation CHUBB PO BOX 1616 CHUBB007 Auto/No-Fault warren, NJ 07059 CHUBB 55 WATER ST CHUB03 New York Workers' NEW YORK, NY 10041 Compensation Chubb & Son [Electronic] E8318A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Chubb & Son [Electronic] E8318B Auto/No-Fault , Chubb & Son [Electronic] E8318C Other WC (Non-NY) , CHUBB GROUP 1600 JFK BLVD CHUBB016 Other WC (Non-NY) 4 PENN CENTER PHILADELPHIA, PA 19103 CHUBB GROUP INSURANCE 333 EARLE COVINGTON BLVD - 800 CHUBB006 New York Workers' UNIONDALE, NY 11533 Compensation CHUBB INS 333 EARLE OVINGTON BLVD CHUBB005 Auto/No-Fault UNIONDALE, NY 11553-3644 CHUBB INS PO BOX 4700 CHUBB013 Auto/No-Fault CHESAPEAKE, VA 233274700 Chubb Insurance 700 Clinton Sq CHUBB020 New York Workers' Rochester, NY 14604 Compensation Chubb Insurance P.O. Box 1903 CHUBB004 New York Workers' New Haven, CT 06059 Compensation Chubb Insurance P.O. Box 4700 CHUBB019 New York Workers' Chesapeake, VA 23327 Compensation Chubb Insurance PO Box 1903 CHUBB023 Other WC (Non-NY) New Haven, CT 06059 CHUBB INSURANCE 3445 PEACHTREE RD NE CHUBB008 New York Workers' STE 900 Compensation ATLANTA, GA 30326 CHUBB INSURANCE 4 PENN CTR CHUBB002 New York Workers' 1600 JFK BLVD Compensation PHILADELPHIA, PA 19103 Chubb Insurance / WC 233 S Wacker Drive CHUBB010 Other WC (Non-NY) Suite 4700, Sears Tower Chicago, IL 60606 CHUBB INSURANCE COMPANY 15 MOUNTAIN VIEW ROAD CHUBB009 New York Workers' WARREN, NJ 07059 Compensation CHUBB LIFE 1 LIBERTY PLACE CHUBB011 New York Workers' 1650 MARKET ST Compensation PHILA, PA 191037301 CHUBB SERVICES PO BOX 660403 CHUBB017 Other WC (Non-NY) DALLAS, TX 75266 CHUBB SERVICES PO BOX 660403 CHUBB018 New York Workers' DALLAS, TX 75266 Compensation Chubb Services [Electronic] E8319B Auto/No-Fault , Chubb Services [Electronic] E8319C Other WC (Non-NY) , CHUBB SERVICES CORP 2000 WEST PARK DR CHUBB015 New York Workers' WESTBOROUGH, MA 01581-3957 Compensation CHUBB SERVICES CORP PO BOX 1618 CHUBB021 Other WC (Non-NY) WARREN, NJ 07059 CHUBB SERVICES CORP PO BOX 1618 CHUBB012 Auto/No-Fault WARREN, NJ 07059 CHUBB SONS 555 LONGWHARF DRIVE CHUBB001 New York Workers' NEW HAVEN, CT 06511 Compensation CHUCK HAFNER'S 7265 BUCKLEY ROAD CHUCK001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation Chudy Paper attn:Bill Farrell CHUDY001 New York Workers' 2516 Walden Ave Compensation Cheektowaga, NY 14225 Chula Vista Elementary School District [Electronic] E0706A New York Workers' , Compensation Chula Vista Elementary School District [Electronic] E0706C Other WC (Non-NY) , Church Mutual PO Box 342 CHURC001 Other WC (Non-NY) Merrill, WI 54452 CHURCH MUTUAL INSURANCE COMPANY PO BOX 342 CHUR02 New York Workers' MERRILL, WI 54452 Compensation Church Mutual Insurance Company - AUTO ONLY E8726B Auto/No-Fault [Electronic] , Church Mutual Insurance Company (WC ONLY) E1137A New York Workers' [Electronic] , Compensation Church Mutual Insurance Company (WC ONLY) E1137C Other WC (Non-NY) [Electronic] , Churchville Golf Course 643 Kendall Road CHURC002 New York Workers' Churchville, NY 14428 Compensation chuyler Ambulatory Service 220 Steuben Street CHUYL001 New York Workers' Montour Falls, NY 14865 Compensation CIGA PO BOX 29066 CIGA001 New York Workers' GLENDALE, CA 91209-9066 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CIGA [Electronic] E0707B Auto/No-Fault , CIGA [Electronic] E0707C Other WC (Non-NY) , CIGNA PO BOX 5200 CIGN03 New York Workers' SCRANTON, PA 18505 Compensation CIGNA PO BOX 5200 CIGNA003 Auto/No-Fault SCRANTON, PA 18505 CINCINATI INSURANCE P.O. BOX 767 CINCI031 New York Workers' COLCHESTER, VT 05446 Compensation CINCINATTI INS PO BOX 950 CINCI030 New York Workers' MOORESVILLE, NC 27560 Compensation CINCINATTI INS CO PO BOX 1277 CINCINS01 New York Workers' CANONSBURG, PA 15317 Compensation CINCINATTI INS CO PO BOX 9333 CINC10 New York Workers' SYRACUSE, NY 13290 Compensation Cincinnati Ins PO Box 1098 CINCI005 New York Workers' Getzville, NY 14068 Compensation Cincinnati Ins PO Box 2682 CINCI004 New York Workers' Liverpool, NY 13089 Compensation CinCinnati Ins PO Box 327 CINCI037 New York Workers' Painted Post, NY 14870 Compensation CINCINNATI INS PO BOX 109 CINCI028 New York Workers' MEADVILLE, PA 16335 Compensation Cincinnati Ins Co PO Box 326 CINCI039 Auto/No-Fault Clay, NY 13041 CINCINNATI INS CO PO BOX 1230 CINI02 New York Workers' CANONSBURG, PA 15317 Compensation Cincinnati Ins. PO BOX 326 CINCI027 New York Workers' Clay, NY 13041 Compensation Cincinnati Insurance 265 Nichols Ave CINCI040 New York Workers' Syracuse, NY 13206 Compensation Cincinnati Insurance Po Box 145496 CINCI041 New York Workers' Cincinnati, OH 45250-5496 Compensation Cincinnati Insurance PO BOX 145496 CINCI034 Other WC (Non-NY) Cincinnati, OH 45250 Cincinnati Insurance PO BOX 44204 CINCI035 New York Workers' Madison, WI 53744 Compensation CINCINNATI INSURANCE PO BOX 1024 CINCI001 New York Workers' TROY, NY 12180 Compensation Cincinnati Insurance / Liability PO Box 495 CINCI029 Auto/No-Fault Centralia, IL 62801 Cincinnati Insurance [Electronic] E8320A New York Workers' , Compensation Cincinnati Insurance [Electronic] E8320B Auto/No-Fault , Cincinnati Insurance [Electronic] E8320C Other WC (Non-NY) , CINCINNATI INSURANCE CO PO BOX 1367 CINCI036 New York Workers' JANESVILLE, WI 53547 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 1024 CINCI006 New York Workers' TROY, NY 12180 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 1024 CINCI013 Auto/No-Fault TROY, NY 12180 Cincinnati Insurance Co [Electronic Indirect] PO BOX 1024 CINCI020 Other WC (Non-NY) TROY, NY 12180 Cincinnati Insurance Co [Electronic Indirect] PO BOX 1230 CINCI007 New York Workers' CANONSBURG, PA 15317 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 1230 CINCI014 Auto/No-Fault CANONSBURG, PA 15317 Cincinnati Insurance Co [Electronic Indirect] PO BOX 1230 CINCI021 Other WC (Non-NY) CANONSBURG, PA 15317 Cincinnati Insurance Co [Electronic Indirect] PO BOX 1277 CINCI008 New York Workers' CANONSBURG, PA 15317 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 1277 CINCI015 Auto/No-Fault CANONSBURG, PA 15317 Cincinnati Insurance Co [Electronic Indirect] PO BOX 1277 CINCI022 Other WC (Non-NY) CANONSBURG, PA 15317 Cincinnati Insurance Co [Electronic Indirect] PO BOX 23978 CINCI009 New York Workers' ROCHESTER, NY 14682 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 23978 CINCI016 Auto/No-Fault ROCHESTER, NY 14682 Cincinnati Insurance Co [Electronic Indirect] PO BOX 23978 CINCI023 Other WC (Non-NY) ROCHESTER, NY 14682 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Cincinnati Insurance Co [Electronic Indirect] PO BOX 42536 CINCI010 New York Workers' ST PETERSBURG, FL 33742 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 42536 CINCI017 Auto/No-Fault ST PETERSBURG, FL 33742 Cincinnati Insurance Co [Electronic Indirect] PO BOX 42536 CINCI024 Other WC (Non-NY) ST PETERSBURG, FL 33742 Cincinnati Insurance Co [Electronic Indirect] PO Box 920338 CINCI011 New York Workers' Norcross, GA 30092 Compensation Cincinnati Insurance Co [Electronic Indirect] PO Box 920338 CINCI018 Auto/No-Fault Norcross, GA 30092 Cincinnati Insurance Co [Electronic Indirect] PO Box 920338 CINCI025 Other WC (Non-NY) Norcross, GA 30092 Cincinnati Insurance Co [Electronic Indirect] PO BOX 9333 CINCI012 New York Workers' SYRACUSE, NY 13290 Compensation Cincinnati Insurance Co [Electronic Indirect] PO BOX 9333 CINCI019 Auto/No-Fault SYRACUSE, NY 13290 Cincinnati Insurance Co [Electronic Indirect] PO BOX 9333 CINCI026 Other WC (Non-NY) SYRACUSE, NY 13290 CINCINNATI INSURANCE GROUP PO BOX 1322 CINCI033 New York Workers' HAMBURG, NY 14075 Compensation CINCINNATTI INS CO PO BOX 42536 CINC03 New York Workers' ST PETERSBURG, FL 33742 Compensation Cincinnatti Insurance PO Box 209 CINCI038 New York Workers' New Hartford, NY 13413 Compensation Cincinnatti Insurance PO BOX 555 CINCI032 New York Workers' Spencerport, NY 14559 Compensation CINTAS 5740 GENESEE ST CINTA001 New York Workers' LANCASTER, NY 14086 Compensation CIR 400 INGRHAM DR CIR001 New York Workers' LACKAWANNA, NY 14218 Compensation CIRMA PO BOX 9558 CIRMA001 New York Workers' NEW HAVEN, CT 06510 Compensation CIS 6143 SOUTH WILLOW DR CIS01 New York Workers' STE. 330 Compensation GREENWOOD VILLAGE, CO 80111 CITIZENS INS CO PO BOX 15146 CITI01 New York Workers' WORCESTER, MA 16150 Compensation Citizens Insurance Company of America E1369B Auto/No-Fault [Electronic] , Citizens Insurance Company of America E1369C Other WC (Non-NY) [Electronic] , Citizens Management P.O. Box 620 CITIZ001 Other WC (Non-NY) Howell, MI 48844 Citizens United Reciprocal Exchange - (N 300 American Metro Blvd. CITIZ002 Auto/No-Fault Suite 170 Hamilton, NJ 08619 Citrus Valley Health Partners [Electronic] E1185A New York Workers' , Compensation Citrus Valley Health Partners [Electronic] E1185B Auto/No-Fault , Citrus Valley Health Partners [Electronic] E1185C Other WC (Non-NY) , City Center of Music and Drama Inc. 70 Lincoln Center Plaza CITYC002 New York Workers' 4th Floor Compensation New York, NY 10023 City Clerk Office 1007 City Hall CITYC001 New York Workers' Buffalo , NY 14202 Compensation CITY ELECTRIC 501 GENESEE STREET CITYE001 New York Workers' SYRACUSE, NY 13204 Compensation City of Amarillo (Austin) [Electronic] E7609A New York Workers' , Compensation City of Amarillo (Austin) [Electronic] E7609C Other WC (Non-NY) , City of Ames [Electronic] E7420C Other WC (Non-NY) , City of Arlington [Electronic] E3446C Other WC (Non-NY) , City of Ashland [Electronic] E0708A New York Workers' , Compensation City of Ashland [Electronic] E0708C Other WC (Non-NY) , City of Atlanta [Electronic] E0709A New York Workers' , Compensation City of Atlanta [Electronic] E0709C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID City of Banning (CA) [Electronic] E1106A New York Workers' , Compensation City of Banning (CA) [Electronic] E1106B Auto/No-Fault , City of Banning (CA) [Electronic] E1106C Other WC (Non-NY) , City of Barstow (CA) [Electronic] E1107A New York Workers' , Compensation City of Barstow (CA) [Electronic] E1107B Auto/No-Fault , City of Barstow (CA) [Electronic] E1107C Other WC (Non-NY) , CITY OF BAYONNE 630 AVE C CITYO012 New York Workers' BAYONNE, NJ 07002 Compensation City of Beaverton [Electronic] E0710A New York Workers' , Compensation City of Beaverton [Electronic] E0710C Other WC (Non-NY) , City of Belmont (Self Insured) [Electronic] E0711A New York Workers' , Compensation City of Belmont (Self Insured) [Electronic] E0711C Other WC (Non-NY) , City of Blythe (CA) [Electronic] E1108A New York Workers' , Compensation City of Blythe (CA) [Electronic] E1108B Auto/No-Fault , City of Blythe (CA) [Electronic] E1108C Other WC (Non-NY) , CITY OF BUFFALO 65 NIAGARA SQUARE COB03 New York Workers' RM 1014 Compensation BUFFALO, NY 14202 City of Buffalo, Board of Education Workers Compensation CITYO002 New York Workers' 721B City Hall Compensation Buffalo, NY 14202 CITY OF BUFFALO-POLICE 74 FRANKLIN ST CITYO006 New York Workers' BUFFALO, NY 14202 Compensation CITY OF BUFFALO-WATER 2 PORTER AVE CITYO004 New York Workers' BUFFALO, NY 14201 Compensation City of Campbell [Electronic] E0712A New York Workers' , Compensation City of Campbell [Electronic] E0712C Other WC (Non-NY) , City of Carlsbad [Electronic] E0713A New York Workers' , Compensation City of Carlsbad [Electronic] E0713C Other WC (Non-NY) , City of Carmel By The Sea [Electronic] E0714A New York Workers' , Compensation City of Carmel By The Sea [Electronic] E0714C Other WC (Non-NY) , City of Carson [Electronic] E0715A New York Workers' , Compensation City of Carson [Electronic] E0715C Other WC (Non-NY) , City of Chula Vista [Electronic] E0716A New York Workers' , Compensation City of Chula Vista [Electronic] E0716C Other WC (Non-NY) , City of Colton [Electronic] E0717A New York Workers' , Compensation City of Colton [Electronic] E0717C Other WC (Non-NY) , CITY OF CORNING 1 CIVIC CENTER CITYO008 New York Workers' CORNING, NY 14830 Compensation CITY OF CORNING/ PARKS 1 NASSER CIVIC CENTER PLAZA CITYO016 New York Workers' CORNING, NY 14830 Compensation City of Coronado [Electronic] E0718A New York Workers' , Compensation City of Coronado [Electronic] E0718C Other WC (Non-NY) , City of Dallas [Electronic] E6842A New York Workers' , Compensation City of Dallas [Electronic] E6842C Other WC (Non-NY) , City of Del Mar [Electronic] E0719A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID City of Del Mar [Electronic] E0719C Other WC (Non-NY) , City of Des Moines [Electronic] E3305C Other WC (Non-NY) , City of Desert Hot Springs (CA) [Electronic] E1109A New York Workers' , Compensation City of Desert Hot Springs (CA) [Electronic] E1109B Auto/No-Fault , City of Desert Hot Springs (CA) [Electronic] E1109C Other WC (Non-NY) , City of Edinburg, Texas [Electronic] E0721A New York Workers' , Compensation City of Edinburg, Texas [Electronic] E0721C Other WC (Non-NY) , City of El Paso [Electronic] E9928C Other WC (Non-NY) , City of Elmira 317 East Church Street CITYO007 New York Workers' Elmira, NY 14901 Compensation City of Encinitas [Electronic] E0722A New York Workers' , Compensation City of Encinitas [Electronic] E0722C Other WC (Non-NY) , City of Escondido [Electronic] E0723A New York Workers' , Compensation City of Escondido [Electronic] E0723C Other WC (Non-NY) , City of Fort Worth (TX) [Electronic] E1187A New York Workers' , Compensation City of Fort Worth (TX) [Electronic] E1187B Auto/No-Fault , City of Fort Worth (TX) [Electronic] E1187C Other WC (Non-NY) , City of Fountain Valley (CA) [Electronic] E1188A New York Workers' , Compensation City of Fountain Valley (CA) [Electronic] E1188B Auto/No-Fault , City of Fountain Valley (CA) [Electronic] E1188C Other WC (Non-NY) , City of Gardena (CA) [Electronic] E1189A New York Workers' , Compensation City of Gardena (CA) [Electronic] E1189B Auto/No-Fault , City of Gardena (CA) [Electronic] E1189C Other WC (Non-NY) , City of Glendale (AZ) [Electronic] E1110A New York Workers' , Compensation City of Glendale (AZ) [Electronic] E1110B Auto/No-Fault , City of Glendale (AZ) [Electronic] E1110C Other WC (Non-NY) , City of Grand Junction [Electronic] E0724A New York Workers' , Compensation City of Grand Junction [Electronic] E0724C Other WC (Non-NY) , City of Hillsboro [Electronic] E0725A New York Workers' , Compensation City of Hillsboro [Electronic] E0725C Other WC (Non-NY) , City of Houston [Electronic] E8981A New York Workers' , Compensation City of Houston [Electronic] E8981C Other WC (Non-NY) , City of Imperial Beach (Voucher) [Electronic] E0727A New York Workers' , Compensation City of Imperial Beach (Voucher) [Electronic] E0727C Other WC (Non-NY) , City of Imperial Beach [Electronic] E0726A New York Workers' , Compensation City of Imperial Beach [Electronic] E0726C Other WC (Non-NY) , City of Irving [Electronic] E0728A New York Workers' , Compensation City of Irving [Electronic] E0728C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CITY OF ITHACA FIRE DEPT 310 WEST GREEN STREET CITYO010 New York Workers' ITHACA, NY 14850 Compensation City of Jacksonville [Electronic] E1296A New York Workers' , Compensation City of Jacksonville [Electronic] E1296C Other WC (Non-NY) , CITY OF JERSEY CITY 280 GROVE ST B-6 CITYO013 New York Workers' JERSEY CITY, NJ 07302 Compensation City of La Mesa 11 (CA) [Electronic] E1190A New York Workers' , Compensation City of La Mesa 11 (CA) [Electronic] E1190B Auto/No-Fault , City of La Mesa 11 (CA) [Electronic] E1190C Other WC (Non-NY) , City of Laguna Hills (CA) [Electronic] E1191A New York Workers' , Compensation City of Laguna Hills (CA) [Electronic] E1191B Auto/No-Fault , City of Laguna Hills (CA) [Electronic] E1191C Other WC (Non-NY) , City of Lemon Grove [Electronic] E0729A New York Workers' , Compensation City of Lemon Grove [Electronic] E0729C Other WC (Non-NY) , City of Lewisville [Electronic] E2377C Other WC (Non-NY) , City of Los Altos [Electronic] E0730A New York Workers' , Compensation City of Los Altos [Electronic] E0730C Other WC (Non-NY) , City of Los Angeles [Electronic] E1319A New York Workers' , Compensation City of Los Angeles [Electronic] E1319C Other WC (Non-NY) , City of Merced [Electronic] E0731A New York Workers' , Compensation City of Merced [Electronic] E0731C Other WC (Non-NY) , City of Minneapolis [Electronic] E8528A New York Workers' , Compensation City of Minneapolis [Electronic] E8528C Other WC (Non-NY) , City of Monrovia (CA) [Electronic] E1192A New York Workers' , Compensation City of Monrovia (CA) [Electronic] E1192B Auto/No-Fault , City of Monrovia (CA) [Electronic] E1192C Other WC (Non-NY) , City of Montebello (CA) [Electronic] E1193A New York Workers' , Compensation City of Montebello (CA) [Electronic] E1193B Auto/No-Fault , City of Montebello (CA) [Electronic] E1193C Other WC (Non-NY) , City of Mount Vernon 1 Roosevelt Square CITYO001 New York Workers' Mount Vernon, NY 10550 Compensation City of Mt. Vernon / WC PO box 1708 CITYO011 Other WC (Non-NY) Mt. Vernon, IL 62864 City of Murieta (CA) [Electronic] E1111A New York Workers' , Compensation City of Murieta (CA) [Electronic] E1111B Auto/No-Fault , City of Murieta (CA) [Electronic] E1111C Other WC (Non-NY) , City of National City [Electronic] E0732A New York Workers' , Compensation City of National City [Electronic] E0732C Other WC (Non-NY) , CITY OF NEW ROCHELLE 515 NORTH AVE CITYO014 New York Workers' NEW ROCHELLE, NY 10801 Compensation CITY OF NEWBURGH POLICE DEPT 55 BROADWAY CNPD01 New York Workers' NEWBURGH, NY 12550 Compensation City of Niagara Falls PO Box 69 CITYO003 New York Workers' Niagara Falls, NY 14302 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID City of Oceanside [Electronic] E0733A New York Workers' , Compensation City of Oceanside [Electronic] E0733C Other WC (Non-NY) , City of Omaha (NE) [Electronic] E1194A New York Workers' , Compensation City of Omaha (NE) [Electronic] E1194B Auto/No-Fault , City of Omaha (NE) [Electronic] E1194C Other WC (Non-NY) , City of Ontario [Electronic] E0734A New York Workers' , Compensation City of Ontario [Electronic] E0734C Other WC (Non-NY) , City of Pasadena (CA) [Electronic] E1195A New York Workers' , Compensation City of Pasadena (CA) [Electronic] E1195B Auto/No-Fault , City of Pasadena (CA) [Electronic] E1195C Other WC (Non-NY) , City of Perris (CA) [Electronic] E1112A New York Workers' , Compensation City of Perris (CA) [Electronic] E1112B Auto/No-Fault , City of Perris (CA) [Electronic] E1112C Other WC (Non-NY) , CITY OF POUGHKEEPSIE 62 CIVIC CENTER PLAZA CITYO009 New York Workers' POUGHKEEPSIE, NY 12601 Compensation City of Redding (CA) [Electronic] E1196A New York Workers' , Compensation City of Redding (CA) [Electronic] E1196B Auto/No-Fault , City of Redding (CA) [Electronic] E1196C Other WC (Non-NY) , CITY OF RENO CCMSI CITYO019 Other WC (Non-NY) PO BOX 20068 RENO, NV 89515 City of Richardson [Electronic] E0735A New York Workers' , Compensation City of Richardson [Electronic] E0735C Other WC (Non-NY) , CITY OF ROCHESTER 30 CHURCH ST COR02 New York Workers' CITY HALL- ACCTS PAYABLE Compensation ROCHESTER, NY 14614 City of Rome 301 North James St CITYO017 New York Workers' Rome, NY 13440 Compensation CITY OF ROME 19800 N WASHINGTON ST COR01 New York Workers' ROME, NY 13440 Compensation City Of Rye 1051 Boston Post Road CITYO015 New York Workers' Rye, NY 10580 Compensation City of San Diego [Electronic] E0736A New York Workers' , Compensation City of San Diego [Electronic] E0736C Other WC (Non-NY) , City of San Jacinto (CA) [Electronic] E1113A New York Workers' , Compensation City of San Jacinto (CA) [Electronic] E1113B Auto/No-Fault , City of San Jacinto (CA) [Electronic] E1113C Other WC (Non-NY) , City of San Mateo (CA) [Electronic] E1197A New York Workers' , Compensation City of San Mateo (CA) [Electronic] E1197B Auto/No-Fault , City of San Mateo (CA) [Electronic] E1197C Other WC (Non-NY) , City of Santee [Electronic] E0738A New York Workers' , Compensation City of Santee [Electronic] E0738C Other WC (Non-NY) , CITY OF SARATOGA SPRINGS COMMISSIONER OF 474 BROADWAY SSCA01 New York Workers' ACCOUNTS SARATOGA SPRINGS, NY 12866 Compensation City of Snyder (TX) [Electronic] E1370B Auto/No-Fault , City of Snyder (TX) [Electronic] E1370C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID City of Solana Beach [Electronic] E0739A New York Workers' , Compensation City of Solana Beach [Electronic] E0739C Other WC (Non-NY) , City of South San Francisco [Electronic] E0740A New York Workers' , Compensation City of South San Francisco [Electronic] E0740C Other WC (Non-NY) , CITY OF SPARKS CCMSI CITYO020 Other WC (Non-NY) PO BOX 20068 RENO, NV 89515 City of St. Paul (MN) [Electronic] E1371B Auto/No-Fault , City of St. Paul (MN) [Electronic] E1371C Other WC (Non-NY) , City of Stanton (CA) [Electronic] E1198A New York Workers' , Compensation City of Stanton (CA) [Electronic] E1198B Auto/No-Fault , City of Stanton (CA) [Electronic] E1198C Other WC (Non-NY) , City of Stockton (CA) [Electronic] E1199A New York Workers' , Compensation City of Stockton (CA) [Electronic] E1199B Auto/No-Fault , City of Stockton (CA) [Electronic] E1199C Other WC (Non-NY) , City of Topeka (KS) [Electronic] E1200A New York Workers' , Compensation City of Topeka (KS) [Electronic] E1200B Auto/No-Fault , City of Topeka (KS) [Electronic] E1200C Other WC (Non-NY) , City of Upland (CA) [Electronic] E1201A New York Workers' , Compensation City of Upland (CA) [Electronic] E1201B Auto/No-Fault , City of Upland (CA) [Electronic] E1201C Other WC (Non-NY) , CITY OF UTICA 550 BLEEKER ST COU01 New York Workers' UTICA, NY 13501 Compensation City of Vista [Electronic] E0741A New York Workers' , Compensation City of Vista [Electronic] E0741C Other WC (Non-NY) , City of Waco [Electronic] E0742A New York Workers' , Compensation City of Waco [Electronic] E0742C Other WC (Non-NY) , City of West Covina (CA) [Electronic] E1202A New York Workers' , Compensation City of West Covina (CA) [Electronic] E1202B Auto/No-Fault , City of West Covina (CA) [Electronic] E1202C Other WC (Non-NY) , City of West Des Moines [Electronic] E8625C Other WC (Non-NY) , City of Westminster (CA) [Electronic] E1203A New York Workers' , Compensation City of Westminster (CA) [Electronic] E1203B Auto/No-Fault , City of Westminster (CA) [Electronic] E1203C Other WC (Non-NY) , City Of White Plains WC 255 Main Street CITYO018 New York Workers' White Plains, NY 10601 Compensation City of Yorba Linda (CA) [Electronic] E1204A New York Workers' , Compensation City of Yorba Linda (CA) [Electronic] E1204B Auto/No-Fault , City of Yorba Linda (CA) [Electronic] E1204C Other WC (Non-NY) , City of Yuma [Electronic] E0743A New York Workers' , Compensation City of Yuma [Electronic] E0743C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Civil Constructors [Electronic] E0744A New York Workers' , Compensation Civil Constructors [Electronic] E0744C Other WC (Non-NY) , CJ MURPHY 222 AVENUE E CJMUR001 New York Workers' BAYONNE, NJ 07002 Compensation CLAIM DIRECT ACCESS PO BOX 4439 CLAIM004 New York Workers' SANDY, UT 84091 Compensation CLAIMETRICS PO BOX 22478 CLAH01 New York Workers' OKLAHOMA CITY, OK 73123 Compensation Claims Administrative Services (CAS) [Electronic] E7414A New York Workers' , Compensation Claims Administrative Services (CAS) [Electronic] E7414C Other WC (Non-NY) , CLAIMS MANAGEMENT INSURANCE IHCFA 225 SMITH RD CLAIM007 Auto/No-Fault ST. CHARLES, IL 60174 Claims One WC 225 Smith Road CLAIM002 Other WC (Non-NY) St. Charles, IL 60174 CLAIMS SERVICE BUREAU 21 HEAMPSTEAD AVE CLAIM006 Auto/No-Fault LYNBROOK, NY 11563 CLAIMS SERVICE BUREAU 21 HEMPSTEAD AVENUE CLAIM003 Auto/No-Fault LYNBROOK, NY 11563 CLAIMS SERVICE BUREAU P.O. BOX 805 CLAIM005 Auto/No-Fault LYNBROOK, NY 11563 CLAIR BRIDGE 101 BUNDY ROAD CLAIR001 New York Workers' ITHACA, NY 14850 Compensation CLAREMONT INS 2 UNIVERSITY PLACE CLARE006 New York Workers' HACKENSACK, NJ 07601 Compensation CLARENCE FIRE D #1 PO BOX 340 CLARE001 New York Workers' CLARENCE, NY 14031 Compensation Clarion Hotel 8250 PARK ROAD CLARI001 New York Workers' Batavia, NY 14020 Compensation Clark Box it 45-53 Norwood Ave CLARK002 New York Workers' Jamestown, NY 14701 Compensation CLARK HOLDINGS INC 443 S CAYUGA RD CLARK001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Classic Residence By Hyatt [Electronic] E4781C Other WC (Non-NY) , CLAYTON COMPANIES PO BOX 3015 CLAYT001 New York Workers' 515 ROUTE 528 Compensation LAKEWOOD, NJ 08701 clean air quality service inc 161 brady ave CLEAN002 New York Workers' hawthorne, NY 10532 Compensation CLEAN SWEEP JANITORIAL 1 HSBC CENTER CLEAN001 New York Workers' BUFFALO, NY 14203 Compensation CLERMONT INSURANCE COMPANY 3 UNIVERSITY PLAZA CLEIC01 New York Workers' SUITE 604 Compensation HACKENSACK, NJ 07601 CliffStar Corp 1 Cliffstar Ave CLIF01 New York Workers' Dunkirk, NY 14048 Compensation clifton springs hospital 2 coulter road CLIFT001 New York Workers' clifton springs, NY 14432 Compensation CLINIC PHARMACY GUTHRIE SQUARE CLINI001 New York Workers' SAYRE, PA 18840 Compensation Clougherty Packing, LLC [Electronic] E1161A New York Workers' , Compensation Clougherty Packing, LLC [Electronic] E1161B Auto/No-Fault , Clougherty Packing, LLC [Electronic] E1161C Other WC (Non-NY) , Clover Leaf Grain Elevator / WC PO Box 97 CLOVE001 Other WC (Non-NY) 246 E St Louis St Hoyleton, IL 62803 CLOVER MANAGEMENT 348 HARRIS HILL RD CLOVE002 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Club 86, Bagels & Cakes 476 Hamilton Street CLUB8001 New York Workers' Geneva, NY 14456 Compensation CLYDES CHEMISTS LTD 926 MADISON AVE CCL01 New York Workers' NEW YORK, NY 10021 Compensation Cma P. O. Box 918 CMA001 New York Workers' Gainsville, GA 30503 Compensation CMI 922 W WALNUT ST CMI002 New York Workers' ROGERS, AR 72756 Compensation CMI PO BOX 14731 CMI003 Other WC (Non-NY) LEXINGTON, KY 40512 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CMI / WC PO Box 1288 CMIWC001 Other WC (Non-NY) Bentonville, AR 72712 CMI OCTAGON INC 100 MATSON FORD #505 CMIOC001 New York Workers' FIVE RADNOR CORP CTR Compensation RAFNOR, PA 19087 CMS / WC 201 E Madison CMSWC001 Other WC (Non-NY) Suite 3C Springfield, IL 62794 CNA ATTN CLAIMS DEPARTMENT P.O. CNA022 Other WC (Non-NY) BOX 8317 CHICAGO, IL 60680 CNA P.O. Box 8317 CNA006 Auto/No-Fault Chicago, IL 60680 CNA PO BOX 8317 CNAI02 New York Workers' CHICAGO, IL 60680 Compensation CNA [Electronic Indirect] 25 Melville Park Rd. CNA007 New York Workers' Ste 100 Compensation Melville, NY 11747 CNA [Electronic Indirect] 25 Melville Park Rd. CNA013 Other WC (Non-NY) Ste 100 Melville, NY 11747 CNA [Electronic Indirect] 401 Penn Street CNA008 New York Workers' Reading, PA 19601 Compensation CNA [Electronic Indirect] 401 Penn Street CNA014 Other WC (Non-NY) Reading, PA 19601 CNA [Electronic Indirect] 443 Electronics Parkway CNA009 New York Workers' building # 1 Compensation Liverpool, NY 13088 CNA [Electronic Indirect] 443 Electronics Parkway CNA015 Other WC (Non-NY) building # 1 Liverpool, NY 13088 CNA [Electronic Indirect] PO Box 16010 CNA010 New York Workers' Reading, PA 19612 Compensation CNA [Electronic Indirect] PO Box 16010 CNA016 Other WC (Non-NY) Reading, PA 19612 CNA [Electronic Indirect] PO BOX 16203 CNA011 New York Workers' READING, PA 19612 Compensation CNA [Electronic Indirect] PO BOX 16203 CNA017 Other WC (Non-NY) READING, PA 19612 CNA [Electronic Indirect] PO BOX 8317 CNA012 New York Workers' CHICAGO, IL 60680 Compensation CNA [Electronic Indirect] PO BOX 8317 CNA018 Other WC (Non-NY) CHICAGO, IL 60680 CNA Insurance (AUTO ONLY) [Electronic] E0745B Auto/No-Fault , CNA Insurance [Electronic] E3401A New York Workers' , Compensation CNA Insurance [Electronic] E3401C Other WC (Non-NY) , CNY Family Care 4939 Brittonfield Parkway CNYFA001 New York Workers' East Syracuse, NY 13057 Compensation CNY MANAGEMENT PO BOX 2308 CNYMA001 New York Workers' SYRACUSE, NY 13220 Compensation CNY SEALING 319 WEST SECOND STREET CNYSE002 New York Workers' EAST SYRACUSE, NY 13057 Compensation CNY SERVICES 518 JAMES STREET SUITE 240 CNYSE001 New York Workers' SYRACUSE, NY 13203 Compensation Co Grande Casino [Electronic] E0746A New York Workers' , Compensation Co Grande Casino [Electronic] E0746C Other WC (Non-NY) , COACH & EQUIP SALES CORP PO BOX 36 COACH001 New York Workers' PENN YAN, NY 14527 Compensation Coach USA [Electronic] E1186A New York Workers' , Compensation Coach USA [Electronic] E1186C Other WC (Non-NY) , COARC P.O.BOX 2 COARC001 New York Workers' MELENVILLE, NY 12544 Compensation Coast Converters [Electronic] E0747A New York Workers' , Compensation Coast Converters [Electronic] E0747C Other WC (Non-NY) , COASTAL LUMBER CO ATTN WKRS COMP DEPT COAST001 New York Workers' 43647 FAIRVIEW RD Compensation SPARTANSBURG, PA 16434 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID COASTAL STAFFING 1290 SHERIDAN DRIVE COAST002 New York Workers' BUFFALO, NY 14217 Compensation COBEY INC 1 SHIP CANAL PKWY COBEY001 New York Workers' BUFFALO, NY 14218 Compensation Coca-Cola Enterprises Inc. [Electronic] E1774C Other WC (Non-NY) , colarusso and son inc 200 country route 31 COLAR001 New York Workers' hudson, NY 12534 Compensation COLD SPRING CONSTRUCTION 3 JACKSON ST COLDS002 New York Workers' AKRON, NY 14001 Compensation COLD SPRING CONSTRUCTION PO BOX 358 COLDS001 New York Workers' AKRON, NY 14001 Compensation Coleman's 100 South Lowell Avenue COLEM001 New York Workers' Syracuse, NY 13204 Compensation Colgate Industries 142 Colgate Av COLGA001 New York Workers' Buffalo, NY 14220 Compensation Colgate University 13 Oak Drive COLGA002 New York Workers' Hamilton, NY 13346 Compensation COLLAMER STOP AND SHOP 6542 COLLAMER ROAD COLLA001 New York Workers' EAST SYRACUSE, NY 13057 Compensation COLLEGE POINT DEPOT 128 15 28 AVENUE COLLE001 Other WC (Non-NY) FLUSHING, NY 11354 Collin County [Electronic] E0748A New York Workers' , Compensation Collin County [Electronic] E0748C Other WC (Non-NY) , COLLINS & WALTON 1525 LAKE STREET COWA01 New York Workers' ELMIRA, NY 14901 Compensation COLONIAL AMERICAN CASUALTY 1400 AMERICAN LANE COAC01 New York Workers' PTAX - T2 - 20 Compensation SCHAUMBURG, IL 60196-1056 COLORADO AVALANCHE 1000 CHOPPER CIR CAVA01 New York Workers' DENVER, CO 80204 Compensation Colorado Casualty [Electronic] E5751A New York Workers' , Compensation Colorado Casualty [Electronic] E5751C Other WC (Non-NY) , Colorado Contractors Program [Electronic] E0749A New York Workers' , Compensation Colorado Contractors Program [Electronic] E0749C Other WC (Non-NY) , Colorado HealthCare - Safety National [Electronic] E0750A New York Workers' , Compensation Colorado HealthCare - Safety National [Electronic] E0750C Other WC (Non-NY) , Colorado Prime Corp. [Electronic] E0751A New York Workers' , Compensation Colorado Prime Corp. [Electronic] E0751C Other WC (Non-NY) , COLUMBIA DIVERSIFIED 527 CHARLES AVE COLD01 New York Workers' SYRACUSE, NY 13209 Compensation COLUMBIA GAS TRANSMISSION 4401 COLLEGE AVE COLUM002 New York Workers' CORNING, NY 14830-9115 Compensation Columbia Insurance / WC P.O. Box 618 COLUM003 Other WC (Non-NY) Columbia, MO 65205 COLUMBIA LIGHTING RT 13 AND BEAVER ST COLUM004 New York Workers' PO BOX 700 Compensation BRISTOL, PA 19007 Columbia Sussex Corporation [Electronic] E4326C Other WC (Non-NY) , Columbia University 410 W. 118th St. COLUM001 New York Workers' b230 Compensation New York, NY 10036 Columbine Health Systems [Electronic] E0752A New York Workers' , Compensation Columbine Health Systems [Electronic] E0752C Other WC (Non-NY) , COLUMBUS BLUE JACKETS 200 W NATIONWIDE BLVD COLB01 New York Workers' COLUMBUS, OH 43215 Compensation comforce information technologies 1000 pittsford victor rd COMFO002 New York Workers' pittsford, NY 14534 Compensation COMFORT SYSTEMS 6500 NEW VENTURE GEAR DRIVE COMFO001 New York Workers' EAST SYRACUSE, NY 13057 Compensation COMFORT WINDOWS 3624 JOHN GLENN BOULEVARD COMFO003 New York Workers' SYRACUSE, NY 13209 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Command Equipment 7324 State Rt 54 COMMA002 New York Workers' Bath, NY 14810 Compensation COMMERCE GROUP PO BOX 6001 COMME011 Auto/No-Fault GILBERT, AZ 85299 COMMERCE INSURANCE 11 Gore Road COMME005 Auto/No-Fault WEBSTER, MA 01570 COMMERCE INSURANCE 11 Gore Road COMME009 New York Workers' WEBSTER, MA 01570 Compensation COMMERCE INSURANCE PO BOX 758 COMME008 Auto/No-Fault WEBSTER, MA 01540 Commerce/ ACIS/ AIS PO BOX 5038 COMME006 Auto/No-Fault Woodbridge, NJ 07095 COMMERCIAL INS COMP 175 PINE LAWN RD CIC01 New York Workers' MELVILLE, NY 11747 Compensation COMMERCIAL MUTUAL INS 15 JOYS LANE COMME007 Auto/No-Fault KINGSTON, NY 12401 COMMERICAL TRAVELERS 70 GENESEE STREET COMME010 Auto/No-Fault UTICA, NY 13502 COMMON WEALTH CONTRACTORS 100 WALTON PARK LANE COMMO001 Other WC (Non-NY) MIDLOTHIAN, VA 23114 COMMUNITY ACTION OF ORLEANS & GENESEE 409 EAST STATE STREET COMMU005 New York Workers' ALBION, NY 14411 Compensation COMMUNITY ACTION ORG 70 HARVARD PL COMMU001 New York Workers' BUFFALO, NY 14209 Compensation Community Charter School 404 Edison Ave COMMU006 New York Workers' Buffalo, NY 14215 Compensation COMMUNITY COMPUTERS MEDENT 15 HUBERT ST COMMU004 New York Workers' PO BOX 980 Compensation AUBURN, NY 13021 Community Development Commission (CA) E1205A New York Workers' [Electronic] , Compensation Community Development Commission (CA) E1205B Auto/No-Fault [Electronic] , Community Development Commission (CA) E1205C Other WC (Non-NY) [Electronic] , COMMUNITY HEALTH CENTER 2-8 W. MAIN STREET COMMU002 New York Workers' JOHNSTOWN, NY 12095 Compensation Community Memorial Hospital 150 Broad Street COMMU007 New York Workers' Hamilton, NY 13346 Compensation COMMUNITY MISSIONS 1570 BUFFALO AVE COMMU003 New York Workers' NIAGARA FALLS, NY 14303 Compensation community services for developmental dis 180 oak st COMMU008 New York Workers' buffalo, NY 14203 Compensation Comp Services 1717 Arch Street COMPS008 Other WC (Non-NY) FL 45 Philadelphia, PA 19103 Comp Services P O BOX 535370 COMPS006 Other WC (Non-NY) PITTSBURGH, PA 15253-5370 Comp Services PO Box 8835 COMPS003 New York Workers' Camphill, PA 17001 Compensation COMP SERVICES PO BOX 3460 COMPS007 Other WC (Non-NY) PITTSBURGH, PA 15230-3460 COMP SERVICES INC PO BOX 59059 COMPS005 New York Workers' PHILA, PA 19102 Compensation Comp West PO Box 12859 COMPW001 Other WC (Non-NY) Newport Beach, CA 92658 companion care of rochester 556 South Clinton Ave COMPA004 New York Workers' Rochester, NY 14620 Compensation Companion Property & Casualty 8000 Midlantic Drive COMPA001 Auto/No-Fault E. 410 North Mount Laurel, NJ 08054 COMPANION PROPERTY & CASUALTY PO BOX 100165 COMPA002 New York Workers' COLUMBIA, SC 09202 Compensation Companion Property & Casualty / WC P.O. Box 100165 COMPA003 Other WC (Non-NY) Columbia, SC 29202 Companion Property And Casualty PO Box 100195 CPAC01 New York Workers' Columbia, SC 29202 Compensation Compass Group Usa, Inc. [Electronic] E9205C Other WC (Non-NY) , Compass Health (Murphy and Beane) [Electronic] E0753C Other WC (Non-NY) , COMPASS INVESTIGATORS & ADJUSTERS PO BOX 310 CIA01 New York Workers' GALWAY, NY 12074 Compensation COMPENSATION RISK MANAGERS LLC 2400 HERODIAN WAY COMPE001 New York Workers' STE 135 Compensation SMYRNA, GA 30080 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID COMPLETE PERSONNEL 2700 WILLIAM ST COMPL002 New York Workers' BUFFALO, NY 14227 Compensation COMPLOGIC 939 OFFICE PARK ROAD COMPL001 New York Workers' #331 Compensation WEST DES MOINES, IA 50265 COMPMGMT HEALTH SYSTEMS, INC PO BOX 1040 COMPM001 New York Workers' DUBLIN, OH 43017 Compensation COMPOSITE PANEL SOLUTION 7167 RT 353 COMPO001 New York Workers' CATTARAUGUS, NY 14719 Compensation COMPSERVICES 100 Corp. Center Drive COMPS001 New York Workers' ste 101 Compensation Camp Hill, PA 17011 COMPSERVICES INC 2505 NORTH FRONT STREET COMPS004 New York Workers' HARRISBURG, PA 17110 Compensation COMPSERVICES INC PO BOX 535370 CMPI01 New York Workers' PITTSBURGH, PA 15253-5370 Compensation CompServices, Inc. 1717 Arch Street COMPS002 New York Workers' 45th Floor Compensation Philadelphia, PA 19103 Compton Unified School District (CA) [Electronic] E1206A New York Workers' , Compensation Compton Unified School District (CA) [Electronic] E1206B Auto/No-Fault , Compton Unified School District (CA) [Electronic] E1206C Other WC (Non-NY) , COMTEC OF WNY, INC 6310 S. TRANSIT RD COMT01 New York Workers' LOCKPORT, NY 14094 Compensation Concentra 80 State Street CONCE005 New York Workers' Albany, NY 12207 Compensation CONCENTRA 10 WOODBRIDGE CTR 4TH FL CONCE004 Auto/No-Fault WOODBRIDGE, NJ 07095 CONCEPT CONSTRUCTION 2555 TRANSIT RD CONCE001 New York Workers' ELMA, NY 14059 Compensation Concord Grape Heritage Assoc. 8305 W. Main Rd. CONCO003 New York Workers' Westfield, NY 14787 Compensation CONCORD GROUP PO BOX 1350 CONCO002 Auto/No-Fault AUBURN, ME 04211 CONCORD RIDGE HOLSTEINS 20281 HAMMOND RD CONCO001 New York Workers' CORRY, PA 16407 Compensation CONCRETE DELIVERY CO 249 BOXART STREET CONCR001 New York Workers' ROCHESTER, NY 14612 Compensation CONFER PLASTICS 43 WITMER ROAD CONFE001 New York Workers' NORTH TONAWANDA, NY 14120 Compensation CONIFER PARK 79 GLENRIDGE ROAD CONIF001 New York Workers' SCHENECTADY, NY 12302 Compensation CONIFER REALTY 183 EAST MAIN STREET #600 CONIF002 New York Workers' ROCHESTER, NY 14604 Compensation Conklin Srvces Construction 94 Stewart Avenue CONKL001 New York Workers' Newburgh, NY 12550 Compensation Connors-Haas 6337 Dean Parkway CONNO001 New York Workers' Ontario, NY 14519 Compensation CONQUEST 504 IST CENTER CONQU001 New York Workers' HORSEHEADS, NY 14854 Compensation CONRAD BENEDETTO ATT 1814 East Route 70 CONRA001 Auto/No-Fault Suite 350 Cherry Hill, NJ 08003 CONRAIL WORKER COMPENSATI PO BOX 90 CONR01 New York Workers' MINOA, NY 13116 Compensation CONROW FARMS 3797 REDMAN ROAD CONRO001 New York Workers' BROCKPORT, NY 14420 Compensation CONSERVATION SERVICES GR 40 WASHINGTON ST CONS01 New York Workers' WESTBOROUGH, MA 01581 Compensation CONSOLE & HOLLAWELL ATT 525 Route 73 North CONSO004 Auto/No-Fault Suite 117 Marlton, NJ 08053 CONSOLIDATED CLAIMS SERVICES 985 OLD EAGLE SCHOOL CONS02 New York Workers' SUITE 504 Compensation WAYNE, PA 19087 Consolidated Edison Company of NY 4 Irving Pl CONSO001 New York Workers' New York , NY 10003 Compensation Consolidated Service Group 3 Executive Campus CONSO002 New York Workers' Ste: 100 Compensation Cherry Hill, NJ 08002 Consolidated Service Group Inc 300 American Metro Blvd, Ste170 CONSO003 Auto/No-Fault Hamilton, NJ 08619 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CONSTITUION STATE SERVICES PO BOX 3001 CONST003 Auto/No-Fault FORT SMITH, AR 72913 Constitution States (St. Paul Travelers) [Electronic 100 BAYLIS RD CONST001 New York Workers' Indirect] 2ND FL Compensation MELVILLE, NY 11747 Constitution States (St. Paul Travelers) [Electronic 100 BAYLIS RD CONST002 Other WC (Non-NY) Indirect] 2ND FL MELVILLE, NY 11747 CONSUMER DIRECTED CHOICES 7 WASHINGTON SQUARE CONSU001 New York Workers' C/O M.J. WALTERS Compensation ALBANY, NY 12205 Contech Construction Products [Electronic] E9017C Other WC (Non-NY) , Contemporary Personel Staffing 907 7th North St. CONTE001 New York Workers' Liverpool, NY 13088 Compensation CONTINENTAL 333 GLEN ST CONT01 New York Workers' GLENS FALLS, NY 12801 Compensation CONTINENTAL PO BOX 3646 CONT02 New York Workers' OMAHA, NE 68103 Compensation CONTINENTAL PO BOX 9010 CONT03 New York Workers' WESTBROOK, ME 04098-5010 Compensation Continental Airlines [Electronic] E9588C Other WC (Non-NY) , Continental Casualty Company 401 Penn St. CONTI001 New York Workers' Reading, PA 19601 Compensation CONTINENTAL INDEMNITY PO BOX 3804 CONTI018 Other WC (Non-NY) OMAHA, NE 68103 Continental Insurance Co [Electronic Indirect] 333 GLEN ST CONTI003 New York Workers' GLENS FALLS, NY 12801 Compensation Continental Insurance Co [Electronic Indirect] 333 GLEN ST CONTI009 Other WC (Non-NY) GLENS FALLS, NY 12801 Continental Insurance Co [Electronic Indirect] 401 Penn St. CONTI004 New York Workers' Reading, PA 19601 Compensation Continental Insurance Co [Electronic Indirect] 401 Penn St. CONTI010 Other WC (Non-NY) Reading, PA 19601 Continental Insurance Co [Electronic Indirect] PO BOX 3646 CONTI005 New York Workers' OMAHA, NE 68103 Compensation Continental Insurance Co [Electronic Indirect] PO BOX 3646 CONTI011 Other WC (Non-NY) OMAHA, NE 68103 Continental Insurance Co [Electronic Indirect] PO Box 5200 CONTI006 New York Workers' Scranton, PA 185055200 Compensation Continental Insurance Co [Electronic Indirect] PO Box 5200 CONTI012 Other WC (Non-NY) Scranton, PA 185055200 Continental Insurance Co [Electronic Indirect] PO Box 55270 CONTI007 New York Workers' Phoenix, AZ 85078 Compensation Continental Insurance Co [Electronic Indirect] PO Box 55270 CONTI013 Other WC (Non-NY) Phoenix, AZ 85078 Continental Insurance Co [Electronic Indirect] PO BOX 9010 CONTI008 New York Workers' WESTBROOK, ME 40985010 Compensation Continental Insurance Co [Electronic Indirect] PO BOX 9010 CONTI014 Other WC (Non-NY) WESTBROOK, ME 40985010 Continental Western PO Box 1594 CONTI016 Other WC (Non-NY) Des Moines, IA 50306 Continental Western Insurance Co (CWG) E1405C Other WC (Non-NY) [Electronic] , Contour Steel PO Box 7 CONTO001 New York Workers' Lakeview, NY 14085 Compensation CONTOUR STEEL 7254 SOUTHWESTERN BLVD CONTO002 New York Workers' EDEN, NY 14057 Compensation Contra Coastal County Schools Ins Group E1297A New York Workers' [Electronic] , Compensation Contra Coastal County Schools Ins Group E1297C Other WC (Non-NY) [Electronic] , Contract Claims PO Box 541328 CONTR002 Other WC (Non-NY) Dallas, TX 75354 CONTRACT CLAIMS SERVICES PO BOX 541388 COCS01 New York Workers' DALLAS, TX 75354 Compensation CONTRACT SPECIALIST 255 GREAT ARROW AVE STE 2 CONTR001 New York Workers' BUFFALO, NY 14207 Compensation Convergys Corporation [Electronic] E9716C Other WC (Non-NY) , Conway Truckload PO Box 2747 CONWA001 New York Workers' Joplin, MO 64803 Compensation Cook & Solis Const. [Electronic] E0754A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Cook & Solis Const. [Electronic] E0754C Other WC (Non-NY) , COOK AND COMPANY 1025 PLAIN STREET COOKA001 Other WC (Non-NY) PO BOX 1068 MARSHFIELD, MA 02050 Cook Moving Systems 145 Commerce Drive COOKM001 New York Workers' Rochester, NY 14623 Compensation COOL RISK MANAGEMENT 784 TROY SCHENECTADY RD COOLR001 Auto/No-Fault LATHAM, NY 12110 COOL RISK MGMT 784 TROY SCHENECTADY RD CORM01 New York Workers' LATHAM, NY 12110 Compensation COONEY AIR CONDIOTIONING AND HEATING 2516 LODI STREET COONE001 New York Workers' SYRACUSE, NY 13208 Compensation COONS SUPPLY RT 352 COONS001 New York Workers' PO BOX 456 Compensation BIG FLATS, NY 14814 COOP ASSOC OF FOOD ENTERP 10 BRITISH AMERICAN BLVD COAS01 New York Workers' LATHAM, NY 12110 Compensation COOPER PEST SOLUTION 351 LAWRENCE STATION COOPE001 New York Workers' LAWRENCE, NJ 08648 Compensation COOTS CONCRETE 7421 TELEGRAPH ROAD COOTS001 New York Workers' BATH, NY 14810 Compensation COPPOLA AGENCY 3625 SENECA ST COPPO001 New York Workers' SENECA, NY 14224 Compensation COREN METAL CRAFTS 600 CENTER AVE COREN001 New York Workers' BENSALEM, PA 19020 Compensation CORESOURCE PO BOX 2920 CORES001 New York Workers' CLINTON, IA 52733 Compensation CORFU-DARIEN VET CLINIC 9770 SNIPERY RD CORFU001 New York Workers' CORFU, NY 14036 Compensation CORIX UTILITIES 400 WEST AVE CORIX001 New York Workers' ROCHESTER, NY 14611 Compensation CORNELL LAUNDRY 527 WEST STATE STREET CORNE002 New York Workers' ITHACA, NY 14850 Compensation CORNELL UNIV (ROBT PERCELL DINI JESSUP ROAD CORNE003 New York Workers' ITHACA, NY 14850 Compensation CORNELL UNIVERSITY - DOWD 130 DAY HALL CORNE009 New York Workers' ITHACA, NY 14853 Compensation CORNELL UNIVERSITY - STATE 110 DAY HALL CORNE001 New York Workers' ITHACA, NY 14853 Compensation CORNELL UNIVERSITY- DOWD 365 PINE TREE ROAD CORNE008 New York Workers' ITHACA, NY 14850 Compensation Cornerstone Florida [Electronic] PO BOX 915499 CORNE004 Auto/No-Fault LONGWOOD, FL 32791 CORNERSTONE MANAGEMENT 944 COUNTY LINE RD CORNE010 New York Workers' BRYN MAWR, PA 19010 Compensation Cornerstone National Ins. Co. [Electronic] 3100 FALLING LEAF COURT SUITE CORNE006 Auto/No-Fault 200 COLUMBIA, MO 65201 Corning Ambulatory Surgery 176 Denison parkway CORNI008 New York Workers' Corning, NY 14830 Compensation Corning Appliances 330 West William Street CORNI007 New York Workers' Corning, NY 14830 Compensation CORNING BUILDING CO INC 346 PARK AVE CORNI013 New York Workers' CORNING, NY 14830 Compensation CORNING CATERING INC 9 ONTARIO STREET CORNI004 New York Workers' CORNING, NY 14830 Compensation Corning Center of Care 205 East First Street CORNI021 New York Workers' Corning, NY 14830 Compensation CORNING CHILDRENS CENTER 107 ARTHUR STREET CORNI001 New York Workers' CORNING, NY 14830 Compensation CORNING COMMUNITY COLLEGE 1 ACADEMIC DRIVE CORNI014 New York Workers' ATTEN: DEBRA HARTY Compensation CORNING, NY 14830 Corning Concrete 11819 E Corning Rd CORNI005 New York Workers' Corning, NY 14830 Compensation CORNING COUNTRY CLUB 2501 COUNTRY CLUB DRIVE CORNI015 New York Workers' CORNING, NY 14830 Compensation CORNING DENTAL ASSOCIATES 218 DENSION PKWY E SUITE 201 CORNI017 New York Workers' CORNING, NY 14830 Compensation Corning Guthriecancer Treatment 114 Columbia Street CORNI009 New York Workers' Corning, NY 14830 Compensation Corning Hospital 176 Denison parkway CORNI010 New York Workers' Corning, NY 14830 Compensation Corning Hospital ER 176 Denison parkway CORNI011 New York Workers' Corning, NY 14830 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CORNING INC 88 TIOGA AVE CORNI003 New York Workers' BUILDING: MP-US-02 Compensation CORNING, NY 14831 CORNING INC - BIG FLATS 673 COUNTY ROUTE 64 CORNI002 New York Workers' BIG FLATS, NY 14814 Compensation Corning Inn 255 South Hamilton Street CORNI019 New York Workers' Painted Post, NY 14870 Compensation CORNING INN PO BOX 542 CORNI018 New York Workers' CORNING, NY 14831 Compensation Corning medical Surgical 201 East First Street CORNI012 New York Workers' Corning, NY 14830 Compensation CORNING NATURAL GAS 330 WEST WILLIAM ST CORNI022 New York Workers' CORNING, NY 14830 Compensation CORNING PAINTED POST SCHOOLS 201 Cantigney Street CORNI020 New York Workers' CORNING, NY 14830 Compensation CORNISH LUMBER ATTN W/C DEPT CORNI016 New York Workers' RD 1 BOX 140 Compensation BEAR LAKE, PA 16402 CORPORATE CARE MANAGEMENT 1 KATTELVILLE RD CCM01 New York Workers' BINGHAMTON, NY 13901 Compensation CORPORATE CLAIMS 782 SPIRIT 40 PARK CORPO002 New York Workers' CHESTERFIELD, MO 63005 Compensation Corporate Council 38 Hawley Street CORPO001 New York Workers' Binghamton , NY 13901 Compensation CORPS CARE-CLEMENTS INTER 1600 L ST NW CORP01 New York Workers' 9TH FL Compensation WASHINGTON, DC 20036 Correctional Healthcare Co / Liability P.O. Box 4477 CORRE001 Auto/No-Fault Englewood, CO 80155 Correctional Management Service [Electronic] E3267C Other WC (Non-NY) , Corrections Corp of America [Electronic] E8250C Other WC (Non-NY) , CORRY FORGE/MCINNES STEEL 441 E MAIN ST CORRY001 New York Workers' CORRY, PA 16117 Compensation CORRY HOUSING AUTHORITY PO BOX 38 CORRY002 New York Workers' CORRY, PA 16407 Compensation CORRY LUMBER 630 E COLUMBUS AVE CORRY003 New York Workers' CORRY, PA 16407 Compensation CORRY MANOR ATTN BARB CORRY004 New York Workers' 640 WORTH ST Compensation CORRY, PA 16407 CORRY MANUFACTURING ATTN PAULA MERKLE CORRY005 New York Workers' 519 W MAIN ST Compensation CORRY, PA 16407 CORRY MEMORIAL HOSPITAL ATTN: JUDY LATHROP CORRY006 New York Workers' 612 W SMITH ST Compensation CORRY, PA 16407 CORRY RE-DEVELOPEMENT 120 SOUTH CENTER STREET CORRY007 New York Workers' CORRY, PA 16407 Compensation CORRY SCHOOL DISTRICT 800 EAST SOUTH STREET CORRY008 New York Workers' CORRY, PA 16407 Compensation CORTLAND CTY 60 CENTRAL AVE CORT01 New York Workers' CORTLAND, NY 13045 Compensation Cortland Housing Authority 42 Church Street CORTL001 New York Workers' Cortland, NY 13045 Compensation CORTLAND NURSING HOME 193 CLINTON AVE CORTL004 New York Workers' CORTLAND, NY 13045 Compensation Cortland Plastics 211 Main St CORTL003 New York Workers' Cortland, NY 13045 Compensation Cortland Wood Products 150 Mclean Road CORTL002 New York Workers' Cortland, NY 13045 Compensation Corvel 15301 N. Dallas Pkwy CORVE032 Other WC (Non-NY) Suite 300 Addison, TX 75001 Corvel 30001 NE Broadway CORVE012 Auto/No-Fault Suite 600 Minneapolis, MN 55413 Corvel 5694 Mission Center Rd CORVE014 Other WC (Non-NY) Ste. 700 San Diego, CA 92108 Corvel 600 City Parkway West CORVE025 New York Workers' Suite 700 Compensation Orange, NY 92868 Corvel PO Box 1573 CORVE026 New York Workers' Portland, OR 97208 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CORVEL 1000 MADISON AVE. CORVE011 New York Workers' VALLEY FORGE CORPORATE CE Compensation NORRISTOWN, PA 19403 CORVEL 1000 MADISON AVENUE CORVE035 Other WC (Non-NY) NORRISTOWN, PA 19403 CORVEL 51 HADDENFIELD RD CORV01 New York Workers' STE 200 Compensation CHERRY HILL, NJ 08002 CORVEL 9920 FRANKLIN SQ DR CORV02 New York Workers' STE 100 Compensation BALTIMORE, MD 21236-4971 CORVEL P O BOX 6423 CORVE020 Other WC (Non-NY) PORTLAND, OR 97228 CORVEL P.O. BOX 66665 CORVE031 Other WC (Non-NY) PHOENIX, AZ 85082 CORVEL PO BOX 2249 CORVE029 Other WC (Non-NY) SYRACUSE, NY 13220 CORVEL PO BOX 2910 CORVE027 Other WC (Non-NY) GLEN ALLEN, VA 23058 CORVEL PO BOX 43600 CORVE033 New York Workers' BALTIMORE, MD 21836 Compensation CORVEL PO BOX 44015 CORVE018 Other WC (Non-NY) BALTIMORE, MD 21236 CORVEL PO BOX 4410 CORV03 New York Workers' PORTLAND, OR 97208-4410 Compensation CORVEL PO BOX 768 CORVE017 New York Workers' MATTOON, IL 61938 Compensation CORVEL PO Box 979 CORVE003 New York Workers' ORANGE, CA 92856 Compensation Corvel / WC 1900 Northwest Expressway CORVE010 Other WC (Non-NY) Suite 1410 Oklahoma City, OK 73101 CORVEL CORP PO BOX 4240 CORVE024 New York Workers' PORTLAND, OR 97208 Compensation Corvel Corp. 320 Carleton Ave CORVE001 New York Workers' Suite 2200 Compensation Central Islip, NY 11722 Corvel Corporation po box 6019 CORVE021 New York Workers' PORTLAND, OR 97228 Compensation CORVEL CORPORATION 3001 NE BROADWAY ST CORVE030 Other WC (Non-NY) #640 WN MINNEAPOLIS, MN 55413 CORVEL CORPORATION PO BOX 2910 CORV05 New York Workers' GLEN ALLEN, VA 23058 Compensation CORVEL CORPORATION PO BOX 4157 CORVE023 New York Workers' PORTLAND, OR 97208 Compensation CORVEL CORPORATION PO BOX 5070 CORVE028 New York Workers' PORTLAND, OR 97208 Compensation CORVEL CORPORATION PO BOX 5209 CORVE034 Other WC (Non-NY) PORTLAND, OR 97208 CORVEL INSURANCE CO 3010 HIGHLAND PKWY CORVE008 New York Workers' Suite #600 Compensation DOWNERS GROVE, IL 60515 CORVEL MED CHECK KODAK CORVE007 New York Workers' PO BOX 4430 Compensation PORTLAND, OR 97208 Corvel WC P.O. Box 277580 CORVE022 New York Workers' Rancho Cordova, CA 95827 Compensation Corvell P.O. Box 30306 CORVE002 New York Workers' Cleveland, OH 44130 Compensation CORVELL PO Box 71652 CORVE004 New York Workers' DesMoines, IA 50325 Compensation CORVELL CORPORATION PO BOX 6423 CORVE016 New York Workers' PORTLAND, OR 97228 Compensation COST CUTTERS 7201 METRO BLVD COSTC001 New York Workers' MINNEAPOLIS, MN 55439 Compensation COTTINGHAM & BUTLER CLAIM SERVICE INC 300 SECURITY BLDG CBCS01 New York Workers' PO BOX 28 Compensation DUBUQUE, IA 52001 Cottingham & Butler Claim Services, Inc. E1207A New York Workers' [Electronic] , Compensation Cottingham & Butler Claim Services, Inc. E1207B Auto/No-Fault [Electronic] , Cottingham & Butler Claim Services, Inc. E1207C Other WC (Non-NY) [Electronic] , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID COTTON'S CONCRETE 604 GATEWAY INDUSTRIAL PARK COTTO001 New York Workers' ROA Compensation ATHENS, PA 18810 COUNTERTOP SOLUTIONS PO BOX 70 COUNT021 New York Workers' CLYMER, NY 14724 Compensation Country Casualty Insurance Company [Electronic] E1372B Auto/No-Fault , Country Casualty Insurance Company [Electronic] E1372C Other WC (Non-NY) , COUNTRY FINANCIAL PO BOX 2100 COUNT031 Auto/No-Fault BLOOMINGTON, IL 617022100 Country Financial / Liability PO Box 2020 COUNT019 Auto/No-Fault Bloomington, IL 61702 Country Financial / Liability PO Box 64035 COUNT009 Auto/No-Fault Saint Paul, MN 55164 COUNTRY FINANICAL 2325 DEAN STREET COUNT027 Auto/No-Fault SUITE 300 ST. CHARLES, IL 60175 COUNTRY FINANICAL 8121 WEST QUINAULT COUNT025 Auto/No-Fault STE F101 SHANNA BROST KENNEWICK, WA 99336 COUNTRY INN & SUITES 3707 ROUTE 281 COUNT029 New York Workers' CORTLAND, NY 13045 Compensation Country Ins. Claims / Liability PO Box 1265 COUNT014 Auto/No-Fault Effingham, IL 62401 COUNTRY INSURANCE PO BOX 14151 COUNT024 Auto/No-Fault SALEM, OR 97309 Country Insurance / Liability Country Insurance / Liability COUNT010 Auto/No-Fault Harrisburg, IL 62946 Country Insurance / Liability P.O. Box 1807 COUNT015 Auto/No-Fault Centralia, IL 62801 Country Insurance / Liability PO Drawer E COUNT011 Auto/No-Fault Harrisburg, IL 62946 Country Insurance \ Mountain States Insurance E1374B Auto/No-Fault [Electronic] , Country Insurance \ Mountain States Insurance E1374C Other WC (Non-NY) [Electronic] , Country Insurance Claims / Liability PO Box 1265 COUNT016 Auto/No-Fault Effingham, IL 62401 Country Insurance\Modern Service Casualty E1373B Auto/No-Fault [Electronic] , Country Insurance\Modern Service Casualty E1373C Other WC (Non-NY) [Electronic] , Country Insurance\MSI Preferred [Electronic] E1375B Auto/No-Fault , Country Insurance\MSI Preferred [Electronic] E1375C Other WC (Non-NY) , Country Insurance\Mutual Service Casualty E1376B Auto/No-Fault [Electronic] , Country Insurance\Mutual Service Casualty E1376C Other WC (Non-NY) [Electronic] , Country Max 6290 RT 96 COUNT028 New York Workers' Victor, NY 14564 Compensation Country Mutual Insurance Po Box 2100 COUNT007 Other WC (Non-NY) Bloomington, IL 61702 Country Mutual Insurance Po Box 2100 COUNT008 Auto/No-Fault Bloomington, IL 61702 Country Mutual Insurance Company [Electronic] E1320B Auto/No-Fault , Country Mutual Insurance Company [Electronic] E1320C Other WC (Non-NY) , Country Preferred Insurance Company [Electronic] E1377A New York Workers' , Compensation Country Preferred Insurance Company [Electronic] E1377B Auto/No-Fault , Country Preferred Insurance Company [Electronic] E1377C Other WC (Non-NY) , COUNTRY RISK 122 AVENUE OF THE AMERICAS COUNT023 New York Workers' NEW YORK, NY 10020 Compensation Country Villa Health Services - SNCC [Electronic] E0756A New York Workers' , Compensation Country Villa Health Services - SNCC [Electronic] E0756C Other WC (Non-NY) , Country Villa Ox Hlth [Electronic] E0757A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Country Villa Ox Hlth [Electronic] E0757C Other WC (Non-NY) , COUNTRY WIDE 40 WALL STREET COUNT020 Auto/No-Fault NEW YORK, NY 10005 COUNTRY WIDE INSURANCE COMPANY 40 WALL STREET 14TH FLOOR COUNT032 Auto/No-Fault NEW YORK, NY 10005 Country Wide Management 40 Wall St. COUNT002 New York Workers' New York, NY 10005 Compensation Countryside Manor / Liability 606 E IL Hwy 15 COUNT018 Auto/No-Fault Mt. Vernon, IL 62864 Countryside Manor Nursing Home / WC 606 E IL Hwy 15 COUNT017 Other WC (Non-NY) Mt. Vernon, IL 62864 COUNTRYWAY INS PO BOX 4851 COUNT004 Auto/No-Fault SYRACUSE, NY 13221 COUNTRYWAY INS CO PO BOX 4851 CTRY01 New York Workers' SYRACUSE, NY 13221 Compensation Countryway Insurance Company [Electronic] 224 Harrison Street COUNT003 Auto/No-Fault Syracuse, NY 13202 COUNTY ATTORNEY, WC DIVISION ONE WEST ST CAWC01 New York Workers' Compensation MINEOLA, NY 11501-4820 County Of Alameda/AIG [Electronic] E0758A New York Workers' , Compensation County Of Alameda/AIG [Electronic] E0758C Other WC (Non-NY) , COUNTY OF BUCKS 50 N MAIN STREET COUNT022 New York Workers' DOYLESTOWN, PA 18901 Compensation County of Humboldt (CA) [Electronic] E1208A New York Workers' , Compensation County of Humboldt (CA) [Electronic] E1208B Auto/No-Fault , County of Humboldt (CA) [Electronic] E1208C Other WC (Non-NY) , County of Los Angeles (AIMS Santa Clarita) E1209A New York Workers' [Electronic] , Compensation County of Los Angeles (AIMS Santa Clarita) E1209C Other WC (Non-NY) [Electronic] , County of Los Angeles (Tristar Santa Ana) E1210A New York Workers' [Electronic] , Compensation County of Los Angeles (Tristar Santa Ana) E1210C Other WC (Non-NY) [Electronic] , County of Los Angeles [Electronic] E1321A New York Workers' , Compensation County of Los Angeles [Electronic] E1321B Auto/No-Fault , County of Los Angeles [Electronic] E1321C Other WC (Non-NY) , County Of Marin [Electronic] E0759A New York Workers' , Compensation County Of Marin [Electronic] E0759C Other WC (Non-NY) , County of San Diego 444 w. beech street COUNT026 Other WC (Non-NY) 3rd floor San Diego, CA 92101 County of San Diego [Electronic] E0760C Other WC (Non-NY) , County of Santa Barbara (CA) [Electronic] E1211A New York Workers' , Compensation County of Santa Barbara (CA) [Electronic] E1211B Auto/No-Fault , County of Santa Barbara (CA) [Electronic] E1211C Other WC (Non-NY) , County of Santa Barbara-CSAC (CA) [Electronic] E1212A New York Workers' , Compensation County of Santa Barbara-CSAC (CA) [Electronic] E1212B Auto/No-Fault , County of Santa Barbara-CSAC (CA) [Electronic] E1212C Other WC (Non-NY) , County of Santa Barbara-Non-CSAC (CA) E1213A New York Workers' [Electronic] , Compensation County of Santa Barbara-Non-CSAC (CA) E1213B Auto/No-Fault [Electronic] , County of Santa Barbara-Non-CSAC (CA) E1213C Other WC (Non-NY) [Electronic] , County of Shasta (CA) [Electronic] E1215A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID County of Shasta (CA) [Electronic] E1215B Auto/No-Fault , County of Shasta (CA) [Electronic] E1215C Other WC (Non-NY) , County of Sonoma (CA) [Electronic] E1216A New York Workers' , Compensation County of Sonoma (CA) [Electronic] E1216B Auto/No-Fault , County of Sonoma (CA) [Electronic] E1216C Other WC (Non-NY) , COUNTY OF SUFFOLK 30 YAPHANK AVE COS01 New York Workers' YAPHANK, NY 11980 Compensation County of Tulare (CA) [Electronic] E1217A New York Workers' , Compensation County of Tulare (CA) [Electronic] E1217B Auto/No-Fault , County of Tulare (CA) [Electronic] E1217C Other WC (Non-NY) , county risk 425 madison avenue COUNT030 Auto/No-Fault suite 505 ny, NY 10017 COUNTY WASTE 1927 Route 9 COUNT001 New York Workers' PO BOX 431 Compensation CLIFTON PARK, NY 12065 COURIER TIMES 8400 ROUTE 13 COURI001 New York Workers' LEVITTOWN, PA 19057 Compensation COURSER INC 802 COUNTY RT 64 COURS001 New York Workers' ELMIRA, NY 14903 Compensation Courtyard Health C. [Electronic] E0761A New York Workers' , Compensation Courtyard Health C. [Electronic] E0761C Other WC (Non-NY) , COVENTRY DME PLUS PO BOX 11620 COVEN005 New York Workers' TUCSON, AZ 85734 Compensation Coventry DMEplus PO Box 14407 COVEN003 Other WC (Non-NY) Tucson, AZ 85732 COVENTRY HEALTHCARE 3611 QUEEN PALM DRIVE SUITE COVEN004 Other WC (Non-NY) 200 TAMPA, FL 33619 Coventry Worker's Comp PO Box 7713 COVEN001 Other WC (Non-NY) London, KY 40742 Coworx Staffing, LLC [Electronic] E3913C Other WC (Non-NY) , Cox Construction Co [Electronic] E0762A New York Workers' , Compensation Cox Construction Co [Electronic] E0762C Other WC (Non-NY) , COYNE TEXTILES 140 CORTLAND AVE COYNE001 New York Workers' SYRACUSE, NY 13202 Compensation CP WARD INC PO BOX 900 CPWAR002 New York Workers' SCOTTSVILLE,NY, NY 14546 Compensation CPS PROFESSIONALS 904 7TH NORTH STREET CPSPR001 New York Workers' LIVERPOOL, NY 13088 Compensation CPS Security Solutions [Electronic] E0763A New York Workers' , Compensation CPS Security Solutions [Electronic] E0763C Other WC (Non-NY) , CR BARD-KAREN SAUNDERS, NURSE 289 BAY RD CRBAR001 New York Workers' QUEENSBURY, NY 12804 Compensation CR DRYWALL INC. 11 DRYWALL LANE CRDRY001 New York Workers' VOORHEESVILLE, NY 12186 Compensation CR&R [Electronic] E0764A New York Workers' , Compensation CR&R [Electronic] E0764C Other WC (Non-NY) , CRA INC 2055 NIAGARA FALLS BLVD CRAIN001 New York Workers' NIAGARA FALLS, NY 14304 Compensation CRA MANAGED CARE PO BOX 261107 CRAM01 New York Workers' COLUMBUS, OH 43226 Compensation CRACKER BARREL PO BOX 787 CRACK002 New York Workers' LEBANON, TN 37088 Compensation CRAFTMASTERS MANUFACTURING INC PO BOX 311 CRAFT001 New York Workers' TOWANDA, PA 18848 Compensation CRAIG LINDSEY ASSOCIATES PO BOX 9063 CLAS01 New York Workers' JERICHO, NY 11753 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CRANES TOWING 691 ADDISON ROAD CRANE001 New York Workers' PAINTED POST, NY 14870 Compensation CRANESVILLE BLOCK CO 1250 RIVERFRONT CENTER CRANE002 New York Workers' AMSTERDAM, NY 12010 Compensation CRAWFORD & COMPANY 2 TOWER PLACE CRAWF078 New York Workers' ALBANY, NY 12203 Compensation Crawford and Co. 6711 Towpath Road, Ste 255 CRAWF074 New York Workers' East Syracuse, NY 13057 Compensation Crawford and Company 55 Broadway, 10th Floor CRAWF073 New York Workers' New York, NY 10006 Compensation Crawford Insurance [Electronic Indirect] 100 PASSAIC AVE CRAWF004 New York Workers' STE 140 Compensation FAIRFIELD, NJ 07004 Crawford Insurance [Electronic Indirect] 100 PASSAIC AVE CRAWF027 Auto/No-Fault STE 140 FAIRFIELD, NJ 07004 Crawford Insurance [Electronic Indirect] 100 PASSAIC AVE CRAWF050 Other WC (Non-NY) STE 140 FAIRFIELD, NJ 07004 Crawford Insurance [Electronic Indirect] 121 ExecutiveCenter Drive CRAWF005 New York Workers' Suite 220 Compensation Columbia, SC 29210 Crawford Insurance [Electronic Indirect] 121 ExecutiveCenter Drive CRAWF028 Auto/No-Fault Suite 220 Columbia, SC 29210 Crawford Insurance [Electronic Indirect] 121 ExecutiveCenter Drive CRAWF051 Other WC (Non-NY) Suite 220 Columbia, SC 29210 Crawford Insurance [Electronic Indirect] 122 E. 42ND ST CRAWF006 New York Workers' NEW YORK, NY 101680002 Compensation Crawford Insurance [Electronic Indirect] 122 E. 42ND ST CRAWF029 Auto/No-Fault NEW YORK, NY 101680002 Crawford Insurance [Electronic Indirect] 122 E. 42ND ST CRAWF052 Other WC (Non-NY) NEW YORK, NY 101680002 Crawford Insurance [Electronic Indirect] 160 LAWRENCE BELL RD CRAWF007 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Crawford Insurance [Electronic Indirect] 160 LAWRENCE BELL RD CRAWF030 Auto/No-Fault WILLIAMSVILLE, NY 14221 Crawford Insurance [Electronic Indirect] 160 LAWRENCE BELL RD CRAWF053 Other WC (Non-NY) WILLIAMSVILLE, NY 14221 Crawford Insurance [Electronic Indirect] 1842 CENTER POINT CR CRAWF008 New York Workers' STE 103S Compensation NAPERVILLE, IL 60563 Crawford Insurance [Electronic Indirect] 1842 CENTER POINT CR CRAWF031 Auto/No-Fault STE 103S NAPERVILLE, IL 60563 Crawford Insurance [Electronic Indirect] 1842 CENTER POINT CR CRAWF054 Other WC (Non-NY) STE 103S NAPERVILLE, IL 60563 Crawford Insurance [Electronic Indirect] 22 IBM RD CRAWF009 New York Workers' POUGHKEEPSIE, NY 12601 Compensation Crawford Insurance [Electronic Indirect] 22 IBM RD CRAWF032 Auto/No-Fault POUGHKEEPSIE, NY 12601 Crawford Insurance [Electronic Indirect] 22 IBM RD CRAWF055 Other WC (Non-NY) POUGHKEEPSIE, NY 12601 Crawford Insurance [Electronic Indirect] 220 Horizon Drive-Suite 203 CRAWF010 New York Workers' Raleigh, NC 27615 Compensation Crawford Insurance [Electronic Indirect] 220 Horizon Drive-Suite 203 CRAWF033 Auto/No-Fault Raleigh, NC 27615 Crawford Insurance [Electronic Indirect] 220 Horizon Drive-Suite 203 CRAWF056 Other WC (Non-NY) Raleigh, NC 27615 Crawford Insurance [Electronic Indirect] 2665 N Air FRESNO DR CRAWF011 New York Workers' Suite 111 Compensation FRESNO, CA 93727 Crawford Insurance [Electronic Indirect] 2665 N Air FRESNO DR CRAWF034 Auto/No-Fault Suite 111 FRESNO, CA 93727 Crawford Insurance [Electronic Indirect] 2665 N Air FRESNO DR CRAWF057 Other WC (Non-NY) Suite 111 FRESNO, CA 93727 Crawford Insurance [Electronic Indirect] 2829 Wehrle Dr. CRAWF012 New York Workers' STE:11A Compensation WILIIAMSVILLE, NY 14221 Crawford Insurance [Electronic Indirect] 2829 Wehrle Dr. CRAWF035 Auto/No-Fault STE:11A WILIIAMSVILLE, NY 14221 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Crawford Insurance [Electronic Indirect] 2829 Wehrle Dr. CRAWF058 Other WC (Non-NY) STE:11A WILIIAMSVILLE, NY 14221 Crawford Insurance [Electronic Indirect] 3 ADLER DRIVE CRAWF013 New York Workers' E. SYRACUSE, NY 13057 Compensation Crawford Insurance [Electronic Indirect] 3 ADLER DRIVE CRAWF036 Auto/No-Fault E. SYRACUSE, NY 13057 Crawford Insurance [Electronic Indirect] 3 ADLER DRIVE CRAWF059 Other WC (Non-NY) E. SYRACUSE, NY 13057 Crawford Insurance [Electronic Indirect] 3711 MAPLEWOOD AVE CRAWF014 New York Workers' #205 Compensation WICHITA FALLS, TX 76308 Crawford Insurance [Electronic Indirect] 3711 MAPLEWOOD AVE CRAWF037 Auto/No-Fault #205 WICHITA FALLS, TX 76308 Crawford Insurance [Electronic Indirect] 3711 MAPLEWOOD AVE CRAWF060 Other WC (Non-NY) #205 WICHITA FALLS, TX 76308 Crawford Insurance [Electronic Indirect] 45 BROADWAY CRAWF015 New York Workers' 27TH FL Compensation NEW YORK, NY 11501 Crawford Insurance [Electronic Indirect] 45 BROADWAY CRAWF038 Auto/No-Fault 27TH FL NEW YORK, NY 11501 Crawford Insurance [Electronic Indirect] 45 BROADWAY CRAWF061 Other WC (Non-NY) 27TH FL NEW YORK, NY 11501 Crawford Insurance [Electronic Indirect] 520 COLUMBIA DR CRAWF016 New York Workers' JOHNSON CITY, NY 13790 Compensation Crawford Insurance [Electronic Indirect] 520 COLUMBIA DR CRAWF039 Auto/No-Fault JOHNSON CITY, NY 13790 Crawford Insurance [Electronic Indirect] 520 COLUMBIA DR CRAWF062 Other WC (Non-NY) JOHNSON CITY, NY 13790 Crawford Insurance [Electronic Indirect] 629 FRENCH RD CAMPUS PLAZA CRAWF017 New York Workers' NEW HARTFORD, NY 13413 Compensation Crawford Insurance [Electronic Indirect] 629 FRENCH RD CAMPUS PLAZA CRAWF040 Auto/No-Fault NEW HARTFORD, NY 13413 Crawford Insurance [Electronic Indirect] 629 FRENCH RD CAMPUS PLAZA CRAWF063 Other WC (Non-NY) NEW HARTFORD, NY 13413 Crawford Insurance [Electronic Indirect] PO BOX 337 CRAWF018 New York Workers' EAST SYRACUSE, NY 13057 Compensation Crawford Insurance [Electronic Indirect] PO BOX 337 CRAWF041 Auto/No-Fault EAST SYRACUSE, NY 13057 Crawford Insurance [Electronic Indirect] PO BOX 337 CRAWF064 Other WC (Non-NY) EAST SYRACUSE, NY 13057 Crawford Insurance [Electronic Indirect] PO BOX 3608 CRAWF019 New York Workers' STUYVESANT PARK Compensation ALBANY, NY 12203 Crawford Insurance [Electronic Indirect] PO BOX 3608 CRAWF042 Auto/No-Fault STUYVESANT PARK ALBANY, NY 12203 Crawford Insurance [Electronic Indirect] PO BOX 3608 CRAWF065 Other WC (Non-NY) STUYVESANT PARK ALBANY, NY 12203 Crawford Insurance [Electronic Indirect] PO BOX 411280-Attn:Tina Litwiller CRAWF020 New York Workers' St. Louis, MI 63141 Compensation Crawford Insurance [Electronic Indirect] PO BOX 411280-Attn:Tina Litwiller CRAWF043 Auto/No-Fault St. Louis, MI 63141 Crawford Insurance [Electronic Indirect] PO BOX 411280-Attn:Tina Litwiller CRAWF066 Other WC (Non-NY) St. Louis, MI 63141 Crawford Insurance [Electronic Indirect] PO BOX 5000 CRAWF021 New York Workers' SMITHTOWN, NY 11787 Compensation Crawford Insurance [Electronic Indirect] PO BOX 5000 CRAWF044 Auto/No-Fault SMITHTOWN, NY 11787 Crawford Insurance [Electronic Indirect] PO BOX 5000 CRAWF067 Other WC (Non-NY) SMITHTOWN, NY 11787 Crawford Insurance [Electronic Indirect] PO BOX 5047 CRAWF022 New York Workers' ATLANTA, GA 30302 Compensation Crawford Insurance [Electronic Indirect] PO BOX 5047 CRAWF045 Auto/No-Fault ATLANTA, GA 30302 Crawford Insurance [Electronic Indirect] PO BOX 5047 CRAWF068 Other WC (Non-NY) ATLANTA, GA 30302 Crawford Insurance [Electronic Indirect] PO BOX 516 CRAWF023 New York Workers' GLASTONBURY, CT 06033 Compensation Crawford Insurance [Electronic Indirect] PO BOX 516 CRAWF046 Auto/No-Fault GLASTONBURY, CT 06033 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Crawford Insurance [Electronic Indirect] PO BOX 516 CRAWF069 Other WC (Non-NY) GLASTONBURY, CT 06033 Crawford Insurance [Electronic Indirect] PO Box 69 CRAWF024 New York Workers' Binghampton, NY 13903 Compensation Crawford Insurance [Electronic Indirect] PO Box 69 CRAWF047 Auto/No-Fault Binghampton, NY 13903 Crawford Insurance [Electronic Indirect] PO Box 69 CRAWF070 Other WC (Non-NY) Binghampton, NY 13903 Crawford Insurance [Electronic Indirect] PO BOX 9342 CRAWF025 New York Workers' UNIONDALE, NY 11553 Compensation Crawford Insurance [Electronic Indirect] PO BOX 9342 CRAWF048 Auto/No-Fault UNIONDALE, NY 11553 Crawford Insurance [Electronic Indirect] PO BOX 9342 CRAWF071 Other WC (Non-NY) UNIONDALE, NY 11553 Crawford Insurance [Electronic Indirect] TOWER PL #4 CRAWF026 New York Workers' EXECUTIVE PARK Compensation ALBANY, NY 12203 Crawford Insurance [Electronic Indirect] TOWER PL #4 CRAWF049 Auto/No-Fault EXECUTIVE PARK ALBANY, NY 12203 Crawford Insurance [Electronic Indirect] TOWER PL #4 CRAWF072 Other WC (Non-NY) EXECUTIVE PARK ALBANY, NY 12203 CRAZY CHEAP CARS 8 MAIN ST CRAZY001 New York Workers' OAKFIELD, NY 14125 Compensation CRCC 614 LOCUST ST CRCC01 New York Workers' ST LOUIS, MO 63101 Compensation Creative Risk Funding 6100 W. Plano Pkwy CREAT003 Other WC (Non-NY) Suite 1500 Plano, TX 75093 Creative Risk Sol. / WC 249 Research Pkwy / Ste 220 CREAT001 Other WC (Non-NY) Davenport, IA 52806 CREATIVE RISK SOLUTIONS P.O. BOX 9207 CREAT002 New York Workers' DES MOINES, IA 50306 Compensation CREATIVE RISK SOLUTIONS PO BOX 9207 CREAT004 Other WC (Non-NY) DES MOINES, IA 50306 Creative Risk Solutions [Electronic] E1322A New York Workers' , Compensation Creative Risk Solutions [Electronic] E1322C Other WC (Non-NY) , Crest Manor (Self Insured) 6745 Pittsford Palmyra Rd CREST001 New York Workers' Attn: Alana Mitchell Compensation Fairport, NY 14450 Crestbrook Insurance Company [Electronic] E8305C Other WC (Non-NY) , CRESTWOOD CHILDRENS CENTER 1 MUSTARD ST CCC02 New York Workers' ROCHESTER, NY 14609 Compensation CRESTWOOD CHILDRENS CENTER 2075 SCOTTSVILLE ROAD CCC01 New York Workers' ROCHESTER, NY 14623 Compensation CRISAFULLI BROTHERS 520 LIVINGSTON AVENUE CRISA001 New York Workers' ALBANY, NY 12206 Compensation CRITTENDEN ADJUSTER CO. 5700 HALIFAX AVE CRITT001 New York Workers' FORT MYERS, FL 33912 Compensation CROSBY CO 183 PRATT ST CROSB001 New York Workers' BUFFALO, NY 14204 Compensation CROSSROADS HOUSE 11 LIBERTY STREET CROSS002 New York Workers' BATAVIA, NY 14020 Compensation CROWLEY INSURANCE 202 NORTH CENTER STREET CROWL001 New York Workers' EAST SYRACUSE, NY 13057 Compensation CROWN CORK & SEAL ONE CROWN WAY CROWN002 New York Workers' PHILADELPHIA, PA 19159 Compensation CROWN RECYCLING 2 WATER ST CROWN001 New York Workers' CUBA, NY 14727 Compensation CRUCIBLE SPECIALTY METALS 575 STATE FAIR BOULEVARD CRUCI001 New York Workers' SOLVAY, NY 13209 Compensation Crum & Forster PO BOX 1973 CRUMF003 Auto/No-Fault MORRISTOWN, NJ 07962 Crum & Forster PO BOX 1973 CRUMF004 Other WC (Non-NY) MORRISTOWN, NJ 07962 Crum & Forster (PA WC) 200 South Executive Dr CRUMF005 Other WC (Non-NY) STE 350 Brookfield, WI 53005 Crum & Forster Indemnity Co [Electronic] E8205B Auto/No-Fault , Crum & Forster Indemnity Co [Electronic] E8205C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CRUM AND FORSTER PO BOX 1960 CRUMA004 Auto/No-Fault MORRISTOWN, NJ 07962 CRUM AND FORSTER PO BOX 1973 CRUMA003 New York Workers' MORRISTOWN, NJ 07962 Compensation CRYOMECH 113 FLASO DRIVE CRYOM001 New York Workers' SYRACUSE, NY 13211 Compensation CRYOVAC 1525 BROOKS AVENUE CRYOV001 New York Workers' ROCHESTER, NY 14624 Compensation CRYSTAL LANES 11749 EAST CORNING ROAD CRYST001 New York Workers' CORNING, NY 14830 Compensation CSG 300 American Metro Blvd CSG002 Other WC (Non-NY) HAMILTON, NJ 08619 CSG PO BOX 110 CSG001 New York Workers' SPENCERPORT, NY 14559 Compensation CSI PO BOX 3460 CSI001 New York Workers' PITTSBURGH, PA 15230 Compensation CSI PO BOX 955 CSI002 New York Workers' BLUE BELL, PA 19422 Compensation CSI INSURANCE 3218 HIGHWAY 67 CSII01 New York Workers' MESQUITE, TX 75150 Compensation CSP MANAGEMENT 407 WEST SENECA CSPMA001 New York Workers' ITHACA, NY 14850 Compensation CSX 1 BELL CROSSING CSX01 New York Workers' SELKIRK, NY 12158 Compensation CSX TRANSPORTATION 500 WATER ST CSXTR001 New York Workers' JACKSONVILLE, FL 32202 Compensation CTS Contracting 320 Crabapple LN CTSCO001 New York Workers' Cheektowaga, NY 14227 Compensation CTY OF NY OFFC OF COMPTRO 1 CENTRE STREET RM 1200 CTYOF001 Auto/No-Fault AUTO CLAIMS NEW YORK, NY 10007 Cucamonga School District (CA) [Electronic] E1218A New York Workers' , Compensation Cucamonga School District (CA) [Electronic] E1218B Auto/No-Fault , Cucamonga School District (CA) [Electronic] E1218C Other WC (Non-NY) , CULINARY ARTS SPECIALTY 2268 UNION RD CULIN001 New York Workers' CHEEKTOWAGA, NY 14227 Compensation CULLIGAN WATER 1316 COLLEGE AVE CULLI001 New York Workers' ELMIRA, NY 14901 Compensation CUMBERLAND INS GRP PO BOX 3002 CUMBE001 New York Workers' COATSVILLE, PA 19320 Compensation CUMIS INS PO BOX 1084 CUMI02 New York Workers' MADISON, WI 53701 Compensation CUMIS INS PO BOX 1221 CUMI01 New York Workers' MADISON, WI 53701-1221 Compensation Cumis Insurance Society [Electronic] E9613C Other WC (Non-NY) , CUNA MUTUAL PO BOX 1221 CUNA01 New York Workers' MADISON, WI 53701 Compensation CURBELL 7 COBHAM DR CURBE001 New York Workers' ATT: JILL HIMES Compensation ORCHARD PARK, NY 14127 Cure Auto Insurance 214 Carnegie Center Suite 101 CUREA001 Auto/No-Fault Princeton, NJ 08540 CURTIN, MURPHY & O'REILLY, P.C. 31 SAINT JAMES AVE. CURTI001 New York Workers' BOSTON, MA 02116-0430 Compensation CURTIS SCREW 50 THIELMAN DR CURTI002 New York Workers' BUFFALO, NY 14206 Compensation CUSHING BUILDERS 106 HUBBELL DRIVE CUSHI001 New York Workers' ITHACA, NY 14850 Compensation Custard Ins 602 Route 299 CUSTA001 New York Workers' HIGHLAND LAKES, NY 12528 Compensation CUSTARD INS ADJUSTERS 55 JERICHO TPKE STE 101 CUSTA002 Auto/No-Fault AUTO CLAIMS JERICHO, NY 11753 CUSTOM ALLOY ATTN: HR DEPT CUSTO003 Other WC (Non-NY) 3 WASHINGTON AVE HIGHBRIDGE, NJ 08829 CUSTOM MIX CONCRETE 1129 LOWMAN RD CUSTO001 New York Workers' LOWMAN, NY 14861 Compensation CUSTOMIZED HOME CARE 261 WARING ROAD CUSTO002 New York Workers' ROCHESTER, NY 14609 Compensation CVS CHEMUNG DISTRIBUTION 1 CVS DRIVE CVSCH001 New York Workers' WAVERLY, NY 14892 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID CVS/Caremark/Minute Clinic [Electronic] E1298A New York Workers' , Compensation CVS/Caremark/Minute Clinic [Electronic] E1298C Other WC (Non-NY) , CY FARMS 6465 TRANSIT RD CYFAR001 New York Workers' ELBA, NY 14058 Compensation CYPRESS CARE P O BOX 2829 CYPRE001 New York Workers' SUWANEE, GA 30024 Compensation CYPRESS CARE PO BOX 534430 CYPC01 New York Workers' ATLANTA, GA 30353 Compensation Cypress Insurance Company (Member of BHHC) E0765C Other WC (Non-NY) [Electronic] , D & R Depot 63 Lake Street DRDEP001 New York Workers' Leroy, NY 14482 Compensation D & W Diesel 1503 Clark Street Road DWDIE001 New York Workers' Auburn, NY 13021 Compensation D A WHEELER & CO PO BOX 391 DAWHE001 New York Workers' BATH, NY 14810 Compensation D&L RAIL SERVICE 403 PORT JERSEY BLVD DLRAI001 New York Workers' JERSEY CITY, NJ 07305 Compensation Dahl's Foods [Electronic] E5671C Other WC (Non-NY) , DAILEY MANAGEMENT 5140 MAIN STREET DLYM01 New York Workers' WILLIAMSVILLE, NY 14221 Compensation DAILY GAZETTE 2345 MAXON ROAD, EXT. DAILY001 New York Workers' SCHENECTADY, NY 12308 Compensation DaimlerChrysler Corporation [Electronic] E0766A New York Workers' , Compensation DaimlerChrysler Corporation [Electronic] E0766C Other WC (Non-NY) , DAIMLERCHRYSLER INSURANCE CO PO BOX 9220 DACH01 New York Workers' FARMINGTON HILLS, MI 48333- Compensation 9220 DAIRY ONE 730 WARREN ROAD DAIRY001 New York Workers' ITHACA, NY 14850 Compensation Dairyland Ins PO Box 8044 DAIRY003 New York Workers' Stevens Point, WI 54481 Compensation DAIRYLAND INS P O BOX 8044 DAIRY002 Auto/No-Fault STEVENS POINT, WI 54481-8021 Dakota Fire [Electronic] E2156A New York Workers' , Compensation Dakota Fire [Electronic] E2156C Other WC (Non-NY) , Dakota Fire [Electronic] E2788B Auto/No-Fault , DALE MILLER RESTAURANT 30 SOUTH PEARL STREET DALEM001 New York Workers' ALBANY, NY 12207 Compensation Dallas County Community College District E0767A New York Workers' [Electronic] , Compensation Dallas County Community College District E0767C Other WC (Non-NY) [Electronic] , Dallas Independent School District [Electronic] E0768C Other WC (Non-NY) , Dallas National Insurance Co PO BOX 22439 DALLA002 New York Workers' Tucson, AZ 85734 Compensation Dallas National Insurance/Coventry / WC PO Box 22439 DALLA001 Other WC (Non-NY) Tucson, AZ 85734 DALRYMPLE GRAVEL (PINE CITY NY) 2105 SOUTH BROADWAY DALRY001 New York Workers' PINE CITY, NY 14871 Compensation Danaher Corporation [Electronic] E2680C Other WC (Non-NY) , DANCE THEATER 211 W61ST ST 3RD FL DANCE001 New York Workers' NEW YORK, NY 10023 Compensation DANDEE'S BAR AND GRILL 239 ROBINSON STREET DANDE001 New York Workers' BINGHAMTON, NY 13904 Compensation DANDY MINI MARTS (MAIN OFFICE) 100 HENRY STREET DANDY001 New York Workers' SAYRE, PA 18840 Compensation DARIEN LAKE STATE PARK 10475 DARIE001 New York Workers' DARIEN, NY 14040 Compensation DARIO RONALD A ATT 1590 ANDERSON AVENUE DARIO001 Auto/No-Fault FORT LEE, NJ 07024 Darway Nursing Home RD 2 DARWA001 New York Workers' Forksville, PA 18616 Compensation Darymple Co (Pine City) 2105 S Broadway DARYM001 New York Workers' Pine City, NY 14871 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID DASH'S MARKET 1770 HERTEL AVE DASHS001 New York Workers' BUFFALO, NY 14216 Compensation DATES WIESER FURNITURE 1700 BROADWAY DATES001 New York Workers' BUFFALO, NY 14212 Compensation DAUGHTERS OF CHARITY 96 MENAND ROAD DAUGH001 New York Workers' MENANDS, NY 12204 Compensation DAUGHTERS OF SARAH 180 WASHINGTON AVE EXT DAUGH002 New York Workers' ALBANY, NY 12203 Compensation DAVID BURKE CONSTRUCTION S 5540 SOUTHWESTERN BLVD DAVID002 New York Workers' HAMBURG, NY 14075 Compensation DAVID DIBRIGIDA ATT 101 EISENHOWER PARKWAY SUITE DAVID005 Auto/No-Fault 100 ROSELAND, NJ 07068 DAVID SIDLE AGENCY PO BOX 191 DAVID001 New York Workers' WATKINS GLEN, NY 14891 Compensation DAVID URDA COMMUNITY DISPOSAL PO BOX 209 DAVID004 New York Workers' KANONA, NY 14856 Compensation DAVID'S BRIDAL 100 CROSSING ROAD DAVID003 New York Workers' BRISTOL, PA 19007 Compensation Davis Mech Systems [Electronic] E0769A New York Workers' , Compensation Davis Mech Systems [Electronic] E0769C Other WC (Non-NY) , DAVIS ULMER 1 COMMERCE DRIVE DAVIS001 New York Workers' AMHERST, NY 14228-2395 Compensation DAVIS WALLBRIDGE 5861 PYLE DRIVE DAVIS002 New York Workers' EAST SYRACUSE, NY 13057 Compensation Day Zimmerman 1827 Freedom Rd. DAYZI001 New York Workers' St. 101 Compensation Lancaster, PA 17601 Daylight Transport [Electronic] E0770A New York Workers' , Compensation Daylight Transport [Electronic] E0770C Other WC (Non-NY) , DBA SHADY DOG c/o PATRICIA K GRAHAM DBASH001 New York Workers' 7530 ROUTE 54 Compensation BATH, NY 14810 DC COMMUNICATIONS 112 ORCHARD HILL RD DCCOM001 New York Workers' ELMIRA, NY 14903 Compensation DC Rauscher 1622 State Route 414 DCRAU001 New York Workers' Waterloo, NY 13165 Compensation DDS COMPANIES 45 HENDRIX ROAD DDSCO001 New York Workers' WEST HENRIETTA, NY 14586 Compensation De Bartolos, Inc [Electronic] E2206C Other WC (Non-NY) , DEAN FOODS 1620B GRAND CENTRAL AVE DEANF001 New York Workers' ELMIRA, NY 14903 Compensation DECAROLIS TRUCK RENTAL 333 COLFAX STREET DECAR001 New York Workers' ROCHESTER, NY 14606 Compensation DECKER INC 1051 SOUTH MAIN STREET DECKE001 New York Workers' PO BOX 4075 Compensation ELMIRA, NY 14904 DECRESANTE DISTRIBUTION 211 N.MAIN STREET DECRE001 New York Workers' P.O. BOX 231 Compensation MECHANICVILLE, NY 12118 DEDICATED LOGISTICS, INC. 2900 GRANDA LANE N DEDIC001 New York Workers' OAKDALE, MN 55128 Compensation Defender Services P.O. Box 1775 DEFEN002 Other WC (Non-NY) Columbia, SC 29202 Defender Services PO BOX 1775 DEFEN001 New York Workers' Columbia, SC 29202 Compensation Defense Commissary Agency 1300 E Avenue DEFEN003 New York Workers' Fort Lee, VA 23801 Compensation DEKATHERM PO BOX 280 DEKAT001 New York Workers' AUBURN, NY 13021 Compensation Del Taco, LLC [Electronic] E1219A New York Workers' , Compensation Del Taco, LLC [Electronic] E1219B Auto/No-Fault , Del Taco, LLC [Electronic] E1219C Other WC (Non-NY) , DEL VALLEY TRUST 1015 N YORK RD DELVA001 New York Workers' WILLOW GROVE, PA 19090 Compensation DELANEY GROUP PO BOX J DELAN001 New York Workers' MAYFIELD, NY 12117 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID DELAWARE COUNTY SELF INS. 111 MAIN STREET DELAW001 New York Workers' DELHI, NY 13753 Compensation DELAWARE VALLEY PEST 3007 NEW RODGERS RD DELAW002 New York Workers' BRISTOL, PA 19007 Compensation DELMONICO'S ITALIAN STEAKHOUSE 151 NORTH GENESEE STREET DELMO001 New York Workers' UTICA, NY 13502 Compensation DELOS INS/COUNTRYWIDE PO BOX 10006 BOWLING GREEN DELOS001 Auto/No-Fault STA NEW YORK, NY 10274 Delta Sonic 570 Delaware Ave DELTA001 New York Workers' Buffalo, NY 14202 Compensation DELVAL DIRECT PO BOX 508 DELVA002 New York Workers' CASTILE, NY 14427 Compensation Demco NY Corp 6701 Manlius Center Rd DEMCO001 New York Workers' East Syracuse, NY 13057 Compensation DEMETS 1 TURTLE CIRCLE DEMET001 New York Workers' HORSEHEADS, NY 14845 Compensation Deming's Service Center 9615 River Road DEMIN001 New York Workers' Lindley, NY 14858 Compensation DENMARK PAINTING 6162 MAYO ROAD DENMA001 New York Workers' TRUMANSBURG, NY 14886 Compensation DENNIS MAHONEY ATT ONE WOODBRIDGE CENTER SUITE DENNI001 Auto/No-Fault 240 WOODBRIDGE, NJ 07095 Dentserv Dental 15 Canal Road DENTS001 New York Workers' Pelham Manor, NY 10803 Compensation Denver Public Schools [Electronic] E0771A New York Workers' , Compensation Denver Public Schools [Electronic] E0771C Other WC (Non-NY) , DEPARTMENT OF COMMERCE PO BOX 542528 DEPAR002 New York Workers' DALLAS, TX 75354 Compensation Department of Energy [Electronic] E1299A New York Workers' , Compensation Department of Energy [Electronic] E1299C Other WC (Non-NY) , Department Of Justice 950 Pennsylvania Avenue DEPAR003 New York Workers' Workers Compensation Compensation Washington, DC 20535 Department of Labor Uninsured Employers Fund DEPAR004 Other WC (Non-NY) PO BOX 399 Trenton, NJ 08625 DEPARTMENT OF LABOR PO BOX 5204 DOLA01 New York Workers' BINGHAMTON, NY 13902 Compensation Department of Labor [Electronic] E7322A New York Workers' , Compensation Department of Labor [Electronic] E7322C Other WC (Non-NY) , Department of Labor and Industry PO BOX 44269 DEPAR001 New York Workers' Olympia, WA 98504 Compensation Department of Labor Black Lung [Electronic] E1300A New York Workers' , Compensation Department of Labor Black Lung [Electronic] E1300C Other WC (Non-NY) , depaul community service 1931 buffalo road DEPAU001 New York Workers' rochester, NY 14624 Compensation Depositors Ins Co [Electronic] E8306C Other WC (Non-NY) , DEPT OF LABOR & INDUSTRY 100 LACKAWANNA AVE DEPTO003 New York Workers' PO BOX 5100 Compensation SCRANTON, PA 185055100 DEPT OF LABOR OWCP 800 NO CAPITAL ST DEPTO002 New York Workers' NW ROOM 800 Compensation WASHINGTON, DC 20211 DEPT OF TRANSPORTATION 5441 E MAIN ST RD DEPTO004 New York Workers' BATAVIA, NY 14020 Compensation DEPT OF VET AFFAIRS UNIVERSITY & WOODLAND AVE DEPTO001 New York Workers' PHILADELPHIA, PA 19104 Compensation DERICO OF EAST AMHERST CORP 18 LIMESTONE DR #4 DERIC001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation DERR FLOORING COMPANY 49 EXECUTIVE AVENUE DERRF001 New York Workers' EDISON, NJ 08816 Compensation DERRICK CORP 590 DUKE RD DEC01 New York Workers' CHEEKTOWAGA, NY 14225 Compensation Desert Hospital District [Electronic] E0773A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Desert Hospital District [Electronic] E0773C Other WC (Non-NY) , Desert Princess [Electronic] E0774A New York Workers' , Compensation Desert Princess [Electronic] E0774C Other WC (Non-NY) , DeVincentis one Brick Avenue DEVIN001 New York Workers' Binghamton, NY 13901 Compensation DHS/ICE 130 Delaware Ave DHSIC001 New York Workers' Buffalo, NY 14202 Compensation DIA TRI 19065 HICKORY CREEK DR DIAT01 New York Workers' STE 240 Compensation MOKENA, IL 60448 DIAGNOSTIC PLUS 11764 WEST SAMPLE RD DIAGN002 New York Workers' STE 104 Compensation CORAL SPRINGS, FL 33065 Diagnostics Plus / WC 703 Shotgun Rd. DIAGN001 Other WC (Non-NY) Bldg. E Sunrise, FL 33326 DIAMOND & BACORN 93 INDUSTRIAL PARK BLVD DIAMO002 New York Workers' ELMIRA, NY 14901 Compensation DIAMOND DISPOSAL 10549 WINFIELD STREET DIAMO004 New York Workers' CORNING, NY 14830 Compensation Diamond Farming Company [Electronic] E0775A New York Workers' , Compensation Diamond Farming Company [Electronic] E0775C Other WC (Non-NY) , DIAMOND PACKAGING 111 COMMERCE DR DIAMO001 New York Workers' ROCHESTER, NY 14623 Compensation DIAMOND ROOFING 411 CAMBRIDGE AVE DIAMO003 New York Workers' SYRACUSE, NY 13208 Compensation DICKMAN FARMS 13 Archie Street DICKM001 New York Workers' AUBURN, NY 13021 Compensation DICKSON SONS FARM 5226 BONNIE HILL ROAD DICKS001 New York Workers' BATH, NY 14810 Compensation DIETRICH'S MILK PRODUCTS PO BOX 102 DIETR001 New York Workers' ROUTE 287 Compensation MIDDLEBURY CENTER, PA 16935 DIETZ & HAMMER PO BOX 68 DIETZ001 New York Workers' NEWTON, NJ 07860 Compensation Digitell Inc 111 W 2nd St 3rd Fl DIGIT001 New York Workers' Jamestown, NY 14701 Compensation Dillard's Store Services [Electronic] E0776C Other WC (Non-NY) , Dimar Manufacturing Corp. 10123 Main Street DIMAR001 New York Workers' Clarence, NY 14031 Compensation DINOSAUR BBQ 234 WEST GENESEE STREET DINOS001 New York Workers' SYRACUSE, NY 13202 Compensation DIOCESE OF ALBANY 40 N. MAIN AVE DOA01 New York Workers' ALBANY, NY 12203 Compensation DIOCESE OF BUFFALO 795 MAIN ST DIOCE001 New York Workers' BUFFALO, NY 14203 Compensation DIOCESE OF OGDENSBG PO BOX 369 DIOCE002 New York Workers' OGDENSBURG, NY 13669 Compensation Diocese of Rockville Center 50 N Park Ave DIOCE003 New York Workers' Rockville Centre, NY 11570 Compensation Direct DME PO Box 857 DIREC002 Other WC (Non-NY) Farmington, CT 06034 DIRECT GENERAL INSURANCE 5905 HAMPTON OAKS PARKWAY DIREC003 Auto/No-Fault TAMPA, FL 33610 DIRECT TECH 217 AVENUE A DIREC001 New York Workers' CARLSTADT, NJ 07072 Compensation Directory Distributing Assoc. [Electronic] E9869C Other WC (Non-NY) , Discount Tire [Electronic] E1220A New York Workers' , Compensation Discount Tire [Electronic] E1220B Auto/No-Fault , Discount Tire [Electronic] E1220C Other WC (Non-NY) , DISCOVER PROPERTY AND CASUALTY IN 5 BATTERSON PARK RD DPCI01 New York Workers' FARMINGTON, CT 06032 Compensation Discover Re (Burger King) [Electronic] E8497C Other WC (Non-NY) , Discovery Hy-Vee [Electronic] E4377C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID DISTRIBUTION SERVICES INC PO BOX 160 DIST01 New York Workers' E SYRACUSE, NY 13057 Compensation DIVERSIFIED CONTROL 645 PERSONS ST DIVER002 New York Workers' EAST AURORA, NY 14052 Compensation DIVERSIFIED ERECTION 121 JACKSON AVENUE DIVER001 New York Workers' ATTN: MARYBETH SANTUCCI Compensation JAMESTOWN, NY 14701 DIVITA CORP P O BOX 823 DIVIT001 New York Workers' AMHERST, NY 14226 Compensation DLB ELEVATOR PO BOX 426 DLBEL001 New York Workers' LEWISTON, NY 14092 Compensation DLH ENERGY PO BOX 40 DLHEN001 New York Workers' ASHVILLE, NY 14710 Compensation Do Not Use (GEICO) *750 WOODBURY RD* *GEICO001* Auto/No-Fault *Woodbury*, NY *11797* DODSWORTH TRUCKING 3250 WEST 17TH STREET DODSW001 New York Workers' ERIE, PA 16505 Compensation Dolgencorp 1036 HWY 31 West DOLGE001 New York Workers' Goodlettsville, TN 37072 Compensation DOLLAR GENERAL 406 E MAIN ST DOLLA004 New York Workers' CORRY, PA 16407 Compensation DOLLAR GENERAL (ADDISON) 20 TUSCAORA STREET DOLLA002 New York Workers' ADDISON, NY 14801 Compensation DOLLAR GENERAL CORP PO BOX 3409 DOLLA003 New York Workers' Coppelle, TX 75019 Compensation dollar general risk mgmt po box 1728 DOLLA001 New York Workers' goodlettsville, TN 37070 Compensation DOLLAR TREE (PAINTED POST,NY) 1359 SILVERBACK LANE DOLLA006 New York Workers' PAINTED POST, NY 14870 Compensation DOLLAR TREE INCORPORATED ATTN: H.R. DEPT. DOLLA005 New York Workers' 500 VOLVO PARKWAY Compensation CHESAPEAKE, NY 23320-9924 DOLOMITE GROUP 1150 PENNFIELD RD DOLOM002 New York Workers' ROCHESTER, NY 14625 Compensation DOLOMITE PRODUCTS CO INC 7610 COUNTY ROUTE 65 DOLOM001 New York Workers' PO BOX 590 Compensation HORNELL, NY 14843 DOMINICK'S RESTAURANT 1370 BURNET AVENUE DOMIN001 New York Workers' SYRACUSE, NY 13206 Compensation DOMMER CONSTRUCTION 21 PALMER PL DOMME001 New York Workers' LANCASTER, NY 14086 Compensation DON DAVIS 2277 NIAGARA FALLS BLVD DONDA001 New York Workers' AMHERST, NY 14228 Compensation DONALD D SMITH DMD 174 VILLAGE SQUARE DONAL001 New York Workers' PAINTED POST, NY 14870 Compensation DONALD R DOLAN DDS 169 EAST SECOND STREET DONAL002 New York Workers' CORNING, NY 14830 Compensation DONEGAL COMPANIES PO BOX 302 DOCO01 New York Workers' MARIETTA, PA 17547 Compensation DONEGAL MUTUAL INS CO 1195 RIVER RD DONEG001 Other WC (Non-NY) PO BOX 302 MARRIETTA, PA 17547 don's automotive 216 Colesville Rd DONSA001 New York Workers' binghamton, NY 13904 Compensation DOODLE BUGS 20 LOSSON RD DOBU01 New York Workers' STE 215 Compensation CHEEKTOWAGA, NY 14227 DORITEX UNIFORM CO 11980 WALDEN AVE DUC01 New York Workers' ALDEN, NY 14004 Compensation DOTY MACHINE WORKS 35 SULLIVAN PARKWAY DOTYM001 New York Workers' FT EDWARD, NY 12828 Compensation DOUBLE DOUBLE P O BOX 646 DOUBL001 New York Workers' HAMBURG, NY 14075 Compensation DOUG GROSS CONSTRUCTION INC 600 RITA'S WAY DOUGG001 New York Workers' PAINTED POST, NY 14870 Compensation Douglas County [Electronic] E0777A New York Workers' , Compensation Douglas County [Electronic] E0777C Other WC (Non-NY) , DOUGLAS G PATERSON AND SONS PO BOX 826 DOUGL001 New York Workers' LOCKPORT, NY 14094 Compensation DR JOSEPH PISKOROWSKI DDS 26 BARR ROAD DRJOS001 New York Workers' ITHACA, NY 14850 Compensation DREICOR INC PO BOX 565 DREIC001 New York Workers' HENDERSONVILLE, NC 28793 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID DRESSER RAND (PAINTED POST) 100 CHEMUNG ST DRESS001 New York Workers' PAINTED POST, NY 14870 Compensation Dresser-Rand Holdings LLC 500 Paul Clark Dr DRESS003 New York Workers' Olean, NY 14760 Compensation DRIVERS INSURANCE PO BOX 4008 DRIVE002 Auto/No-Fault SUNNYSIDE, NY 11104 DRIVER'S VILLAGE 5885 EAST CIRCLE DRIVE STE 200 DRIVE001 New York Workers' CICERO, NY 13039 Compensation DRM MANAGEMENT 3430 TRANSIT RD DRMMA001 New York Workers' DEPEW, NY 14043 Compensation DS2 DEFENSE SUPPORT SERVICE BUILDING 2050F MUNNS CORNER DS2DE001 New York Workers' FORT DRUM, NY 13602 Compensation DS2 DEFENSE SUPPORT SERVICE PO BOX 71 DS2DE002 New York Workers' GREAT BEND, NY 13643 Compensation DTRIC INSURANCE COMPANY, LIMITED 1600 KAPIOLANI BOULEVARD, DTRIC001 Auto/No-Fault SUITE 1520 HONOLULU, HI 968143801 dual printing ,inc 340 nagel drive DUALP001 New York Workers' cheektowaga, NY 14225 Compensation DUEPPENGIESSER DAIRY CO 7835 BUTLER ROAD DUEPP001 New York Workers' PERRY, NY 14530 Compensation DUMAC 19 CORPORATE CIRCLE DUMAC001 New York Workers' EAST SYRACUSE, NY 13057 Compensation DUNKIN DONUTS 1315 UPPER FRONT ST DUNKI001 New York Workers' BINGHAMTON, NY 13905 Compensation DUNKIN DONUTS 201 VESTAL PARKWAY E. DUNKI004 New York Workers' VESTAL, NY 13850 Compensation DUNKIN DONUTS 3521 COUNTRY CLUB ROAD DUNKI005 New York Workers' ENDWELL, NY 13760 Compensation DUNKIN DONUTS 509 RTE 67 DUNKI002 New York Workers' BALLSTON SPA, NY 12020 Compensation DUNKIN DONUTS (CORNING) 125 CONHOCTON STREET DUNKI003 New York Workers' CORNING, NY 14830 Compensation DUNKIRK SPECIALTY STEEL 830 BRIGHAM RD DSS01 New York Workers' DUNKIRK, NY 14048 Compensation DUNN TIRE 475 CAYUGA RD STE 500 DUNNT002 New York Workers' BUFFALO, NY 14225 Compensation DUNN TIRE 9540 NIAGARA FALLS BLVD DUNNT001 New York Workers' NIAGARA FALLS, NY 14304 Compensation Dunn-Edwards Corporation [Electronic] E7603C Other WC (Non-NY) , DURA BUILT PO BOX 188 DURAB001 New York Workers' WELLSBURG,NY, NY 14894 Compensation DURAMIX 160 EAST 22ND STREET DURAM001 New York Workers' BAYONNE, NJ 07002 Compensation Durango Coffee Co. [Electronic] E0778A New York Workers' , Compensation Durango Coffee Co. [Electronic] E0778C Other WC (Non-NY) , DURHAM STAFFING 255 DELAWARE AVE DURHA001 New York Workers' BUFFALO, NY 14202 Compensation DURHAM STAFFING 4062 NORTH BUFFALO RD DURHA002 New York Workers' ORCHARD PARK, NY 14127 Compensation Dustrol [Electronic] E8290C Other WC (Non-NY) , DV BROWN AND ASSOCIATES 567 VICKERS STREET DVBRO001 New York Workers' TONAWANDA, NY 14150-2575 Compensation DWC Mechanical 49 Stradtman Street DWCME002 New York Workers' Cheektowaga, NY 14206 Compensation DWIGHT PLUMBING & HEATING 455 SOUTH STREET DWIGH001 New York Workers' RENSSELAER, NY 12144 Compensation Dynalec Corp PO Box 188 DYNAL001 New York Workers' 87 West Main St Compensation Sodus, NY 14551 Dynamex, Inc. [Electronic] E1882C Other WC (Non-NY) , Dynamic Claims Services P.O. Box 146 DYNAM001 New York Workers' Monsey, NY 10952 Compensation DYNAMIC EDUCATION SYS INC 8433 N. BLACK CANYON HWY DYED01 New York Workers' STE 200 Compensation PHOENIX, AZ 85021 DYNAMIC SYSTEMS, INC. P.O. BOX 1234 DYNAM002 New York Workers' ROUTE 355 Compensation POESTENKILL, NY 12140 E & G BINDING 5795 BRIDGE STREET EGBIN001 New York Workers' EAST SYRACUSE, NY 13057 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID E I C N PO BOX 3500 EICN01 New York Workers' RENO, NV 89511 Compensation E I N C PO BOX 539004 EINC01 New York Workers' HINDERSON, NV 89053 Compensation E&V ENERGY PO BOX 1176 EVENE001 New York Workers' WEEDSPORT, NY 13166 Compensation E.E. ROOT & SON 25 DEAN STREET EEROO001 New York Workers' OWEGO, NY 13827-3352 Compensation EAGLE CHEVROLET 1320 OLD COUNTRY RD EAGLE002 New York Workers' RIVERHEAD, NY 11901 Compensation Eagle Claims po box 2249 EAGLE006 New York Workers' Syracuse, NY 13220 Compensation EAGLE CLAIMS SERVICES PO BOX12895 EAGLE001 Auto/No-Fault Rochester, NY 14612 Eagle Pass ISD [Electronic] E0779A New York Workers' , Compensation Eagle Pass ISD [Electronic] E0779C Other WC (Non-NY) , EAGLE RIDGE KENNELS 7081 ELLICOTT RD EAGLE005 New York Workers' ORCHARD PARK, NY 14127 Compensation EAGLE TRUST MANAGEMENT 115 WEST COURT STREET 2ND EAGLE004 New York Workers' FLOOR Compensation DOYLESTOWN, PA 18901 EAGLE TRUST MGT 395 JACKSONVILLE RD EAGLE003 New York Workers' FIRST FLOOR Compensation WARMINSTER, PA 18944 East Aurora Country Club 300 Girdle Rd EASTA001 New York Workers' East Aurora, NY 14052 Compensation EAST IRONDEQUOIT SCHOOL 600 PARDEE ROAD EASTI001 New York Workers' ROCHESTER, NY 14609 Compensation East San Gabriel Valley ROP (CA) [Electronic] E1221A New York Workers' , Compensation East San Gabriel Valley ROP (CA) [Electronic] E1221B Auto/No-Fault , East San Gabriel Valley ROP (CA) [Electronic] E1221C Other WC (Non-NY) , EASTERN ALLIANCE P O BOX 83777 EASTE005 Other WC (Non-NY) LANCASTER, PA 17608-3777 EASTERN ALLIANCE INSURANCE PO BOX 83777 EAI01 New York Workers' LANCASTER, PA 17608-3777 Compensation Eastern Casualty Insurance 325 Donald J Lynch Blvd EASTE001 New York Workers' Marlborough, MA 01752 Compensation EASTERN HEATING & COOLING 880 BROADWAY EASTE003 New York Workers' ALBANY, NY 12207 Compensation EASTERN METAL OF ELMIRA 1430 SULLIVAN STREET EASTE002 New York Workers' ELMIRA, NY 14901 Compensation Eastern Municipal Water District (CA) [Electronic] E1222A New York Workers' , Compensation Eastern Municipal Water District (CA) [Electronic] E1222B Auto/No-Fault , Eastern Municipal Water District (CA) [Electronic] E1222C Other WC (Non-NY) , EASTERN NIAGARA HOSPITAL 2600 WILLIAM STREET EASTE004 New York Workers' NEWFANE, NY 14108 Compensation EASTERN SHORES PO BOX 480 EAST01 New York Workers' 101 CAYUGA ST Compensation FULTON, NY 13069 EastGUARD Insurance Company - Guard DBA E0780A New York Workers' [Electronic] , Compensation EastGUARD Insurance Company - Guard DBA E0780C Other WC (Non-NY) [Electronic] , EASTWOOD INDUSTRIES INC PO BOX 305 EASTW001 New York Workers' NORTH BOSTON, NY 14110 Compensation EATON CONSTRUCTION PO BOX 684 EATON003 New York Workers' CIRCLEVILLE, OH 43113 Compensation EATON CORPORATION 200 WESTINGHOUSE CIRCLE EATON001 New York Workers' HORSEHEADS, NY 14845 Compensation EATON INNS CORPORATION 705 ERIE BOULEVARD WEST EATON002 New York Workers' SYRACUSE, NY 13204 Compensation EBENEZER RAILCARS/ATTN JENNET J 1005 INDIAN CHURCH RD #3 EBENE001 New York Workers' WEST SENECA, NY 14224 Compensation EBERLE VIVIAN 206 RAILROAD AVE N EBERL001 Other WC (Non-NY) KENT, WA 98032 ECCO III Enterprises, Inc 201 Saw Mill River Road ECCOI001 New York Workers' Yonkers, NY 10701 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Echo Administrative Service PO Box 541487 ECHOA001 New York Workers' Flushing, NY 11354 Compensation ECHO LAKE CAMP 177 HUDSON STREET ECHOL001 New York Workers' WARRENSBURG, NY 12885 Compensation Echo Pacific Develop [Electronic] E0781A New York Workers' , Compensation Echo Pacific Develop [Electronic] E0781C Other WC (Non-NY) , ECOLOGY & ENVIRONMENT, INC. 368 PLEASANT VIEW DRIVE ECOLO001 New York Workers' LANCASTER, NY 14086 Compensation ECONO LODGE (PAINTED POST) 200 ROBERT DANN DRIVE ECONO001 New York Workers' PAINTED POST, NY 14870 Compensation ECONOLODGE 871 RTE 64 ECONO003 New York Workers' ELMIRA, NY 14903 Compensation ECONOMIC OPPORTUNITIES PROGRAM 650 BALDWIN STREET ECONO002 New York Workers' ELMIRA, NY 14901 Compensation Economy Paving 1819 RTE 13 ECONO004 New York Workers' Cortland, NY 13045 Compensation ED ARNOLD SCRAP 2216 ANGLING RD EDARN001 New York Workers' CORFU, NY 14036 Compensation ED BAUER CONSTRUCTION 2790 CLINTON ST EDBAU002 New York Workers' WEST SENECA, NY 14224 Compensation ED BAUER CONSTRUCTION 2790 W CLINTON STREET EDBAU001 New York Workers' WEST SENECA, NY 14224 Compensation EDC MANAGEMENT 101 COLUMBIA ST EDCMA001 New York Workers' CORNING, NY 14830 Compensation EDGER ENTERPRISE INC 330 EAST 14TH STREET EDGER001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation EDIC [Electronic] E5184A New York Workers' , Compensation EDIC [Electronic] E5184C Other WC (Non-NY) , Edinburg School District [Electronic] E0782A New York Workers' , Compensation Edinburg School District [Electronic] E0782C Other WC (Non-NY) , EDWARD SCHALK AND SONS 6801 MYERS ROAD EDWAR001 New York Workers' EAST SYRACUSE, NY 13057 Compensation EDWARD WEIL LAW OFFICE 777 Passaic Ave EDWAR002 Auto/No-Fault Clifton, NJ 07012 Edwards Claims Administration [Electronic] E6543C Other WC (Non-NY) , EGW PERSONNEL 1700 CLINTON ST EGW01 New York Workers' BUFFALO, NY 14206-3197 Compensation Ehret Inc / WC 111 Premier Drive EHRET001 New York Workers' Belleville, IL 62220 Compensation Ehret Inc / WC 111 Premier Drive EHRET002 Other WC (Non-NY) Belleville, IL 62220 EIGHT FOUR LUMBER 1019 ROUTE 519 EIGHT001 New York Workers' EIGHTY FOUR, PA 15330 Compensation Eimar Managed Care Svcs 15 Davis Avenue EIMAR001 New York Workers' Poughkeepsie, NY 12603 Compensation EJ CONSTRUCTION GROUP INC 4522 A WETZEL ROAD EJCON001 New York Workers' SYRACUSE, NY 13090 Compensation EJ DELMONTE CORP 909 LINDEN AVE EJDEL001 New York Workers' ROCHESTER, NY 14625 Compensation EJ MILLITELLO CONCRETE 6465 TRANSIT RD EJMIL001 New York Workers' PO BOX 770 Compensation AMHERST, NY 14051 El Paso Community College (TX Jur) [Electronic] E2421C Other WC (Non-NY) , El Paso Water Util TX Jur [Electronic] E2480C Other WC (Non-NY) , El Pollo Loco [Electronic] E1162A New York Workers' , Compensation El Pollo Loco [Electronic] E1162B Auto/No-Fault , El Pollo Loco [Electronic] E1162C Other WC (Non-NY) , ELC Electric Inc [Electronic] E0783A New York Workers' , Compensation ELC Electric Inc [Electronic] E0783C Other WC (Non-NY) , ELCO ADMIN SERVICE PO BOX 541487 ELCOA001 Auto/No-Fault FLUSHING, NY 11354-1548 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ELCO ADMINISTRATOR SERVICE PO BOX 541487 ELCOA002 Auto/No-Fault FLUSHING, NY 11354 Elcor Health Services 48 Colonial Drive ELCOR002 New York Workers' Horseheads, NY 14845 Compensation ELCOR NURSING 48 COLONIAL DRIVE ELCOR001 New York Workers' HORSEHEADS, NY 14845 Compensation ELDARADO PO BOX 12338, ELDAR001 Other WC (Non-NY) RENO, NV 89510 ELDER CHOICE 208 WEST MAIN ST ELDER005 New York Workers' ELBRIDGE, NY 13060 Compensation Elderlee Inc 729 Cross Road ELDER001 New York Workers' Oaks Corners, NY 14518 Compensation ELDERWOOD AT WEDGEWOOD 4459 BAILEY AVE ELDER004 New York Workers' AMHERST, NY 14226 Compensation ELDERWOOD HEALTHCARE AT TIOGA 37 NORTH CHEMUNG ST ELDER002 New York Workers' WAVERLY, NY 14892 Compensation Elderwood Nursing Home 37 North Chemung Street ELDER003 New York Workers' Waverly, NY 14892 Compensation ELECTRIC BOAT CORP 75 EASTERN PT ROAD ELECT009 New York Workers' MAIL J35B Compensation GROTON, CT 06340 ELECTRIC INS 152 CONANT ST ELEC01 New York Workers' BEERLY, MA 01915 Compensation ELECTRIC INS 2901 EAST LAKE RD ELEC02 New York Workers' ERIE, PA 16531 Compensation ELECTRIC INS PO BOX 1029 ELECT008 New York Workers' BEVERLY, MA 01915-0729 Compensation ELECTRIC INS CO 75 Sam Fonzo Drive ELECT005 Auto/No-Fault BEVERLY, MA 01915 ELECTRIC INSURANCE PO BOX 15065 ELECT010 New York Workers' ALBANY, NY 12212 Compensation Electric Insurance [Electronic] 10 East Stow Road-Suite 100 ELECT004 Auto/No-Fault Marlton, NJ 33172 ELECTRIC INSURANCE CO C/O SEDGWICK CMS ELECT012 Other WC (Non-NY) PO BOX 14017 LEXINGTON, KY 40512-4017 ELECTRIC INSURANCE COMPANY 75 SAM FONZO DRIVE ELECT001 New York Workers' PO BOX 1029 Compensation BEVERLY, MA 01915-0729 ELECTRICAL EMPLOY.SELF INS.SAFETY PLAN 158-11 HARRY VAN ARSDALE ELECT003 New York Workers' JR.AVE. Compensation FLUSHING, NY 11365 Electrical Employers 15811 Jewel Ave #203 ELECT002 New York Workers' Flushing, NY 11365 Compensation Elite Comp [Electronic] E0784A New York Workers' , Compensation Elite Comp [Electronic] E0784C Other WC (Non-NY) , ELLICOTTVILLE LANDSCAPING 5431 BURELSON RD ELLIC001 New York Workers' GREAT VALLEY, NY 14741 Compensation ELLIE'S DELI 201 CENTRAL AVE ELLIE001 New York Workers' SILVERCREEK, NY 14136 Compensation ELMER W DAVIS ROOFING 1217 CLIFFORD AVE ELMER001 New York Workers' ROCHESTER, NY 14621 Compensation ELMIRA CHRISTIAN ACADEMY 235 East Miller Street ELMIR010 New York Workers' Elmira, NY 14904 Compensation ELMIRA COLLEGE ONE PARK PLACE ELMIR009 New York Workers' ELMIRA, NY 14901 Compensation ELMIRA CORRECTIONAL FACILITY PO BOX 500 ELMIR005 New York Workers' ELMIRA, NY 14902 Compensation ELMIRA FLORAL PRODUCTS 410 14TH STREET ELMIR008 New York Workers' ELMIRA, NY 14903 Compensation ELMIRA HOUSING AUTHORITY 346 WOODLAWN AVE ELMIR004 New York Workers' ELMIRA, NY 14901 Compensation Elmira Police Dept 317 E Church Street ELMIR006 New York Workers' Elmira, NY 14901 Compensation ELMIRA PSYCHIATRIC CENTER 100 WASHINGTON ST ELMIR001 New York Workers' ELMIRA, NY 14902 Compensation ELMIRA ROAD MATERIAL 170 E SERVICE ROAD ELMIR007 New York Workers' BINGHAMTON, NY 13901 Compensation ELMIRA STAMPING CO 1704 CEDAR ST ELMIR003 New York Workers' ELMIRA, NY 14904 Compensation ELMIRA STRUCTURE INS 66 PHILO ROAD ELMIR011 New York Workers' ELMIRA, NY 14903 Compensation ELMIRA TROPHY AWARD 166 NORTH MAIN STREET ELMIR002 New York Workers' ELMIRA, NY 14901 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ELMWOOD VILLAGE CONTRACTING 436 GRANT ST ELMWO001 New York Workers' BUFFALO, NY 14213 Compensation ELWOOD FIRE PROTECTION 291 GROTE ST ELFP01 New York Workers' BUFFALO, NY 14207 Compensation ELWOOD NATIONAL FORGE 1 FRONT STREET ELWOO001 New York Workers' ATTN: DOTTY E/DAVID TIPTO Compensation IRVINE, PA 16329 ELWOOD STAFFING SUITE C ELWOO002 New York Workers' 940 CHEMUNG STREET Compensation HORSEHEADS, NY 14845 EM PFAFF AND SONS 204 E FRANKLIN STREET EMPFA001 New York Workers' HORSEHEADS, NY 14845 Compensation EMC INS CO PO BOX 884 EMCI01 New York Workers' DES MOINES, IA 50304 Compensation EMC INSURANCE P O BOX 297 EMCIN005 Other WC (Non-NY) POTTSTOWN, PA 19464-0297 EMC INSURANCE CO PO BOX 1657 EMCIN002 New York Workers' DAVENPORT, IA 52809-1657 Compensation EMC INSURANCE CO PO BOX 7911 EMCIN004 New York Workers' WARWICK, RI 02887 Compensation EMC Insurance Company PO BOX 297 EMCIN001 New York Workers' 10610 Medical D St 205 Compensation Pottstown, PA 19464 EMC INSURANCE COMPANY PO BOX 1897 EMCIN003 Auto/No-Fault BISMARCK, ND 58502 EMC Property and Casualty - AUTO ONLY E4835B Auto/No-Fault [Electronic] , EMC Property and Casualty - WC ONLY E2549A New York Workers' [Electronic] , Compensation EMC Property and Casualty - WC ONLY E2549C Other WC (Non-NY) [Electronic] , EMCASCO Insurance Co - AUTO ONLY [Electronic] E2435B Auto/No-Fault , EMCASCO Insurance Co - WC ONLY [Electronic] E1323A New York Workers' , Compensation EMCASCO Insurance Co - WC ONLY [Electronic] E1323C Other WC (Non-NY) , EMERALD CLAIMS MANAGEMENT 21977 EAST WALLIS DRIVE EMERA001 New York Workers' PORTER, TX 77365 Compensation Emerald Claims/Transcare C 1 Metrotech Center 20th Fl EMERA003 New York Workers' Brooklyn, NY 11201 Compensation EMERGICARE 1701 SASSAFRAS ST EMERG001 New York Workers' ERIE, PA 16502 Compensation Emeritus Corporation [Electronic] E1223A New York Workers' , Compensation Emeritus Corporation [Electronic] E1223B Auto/No-Fault , Emeritus Corporation [Electronic] E1223C Other WC (Non-NY) , EMERITUS SENIOR LIVING 120 CREEKSIDE DRIVE EMERI001 New York Workers' PAINTED POST, NY 14870 Compensation EMERLING AGENCY 8625 MAIN STREET EMERL001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation EMERSON EXPRESS ATT HR EMERS002 New York Workers' 545 LYELL AVE Compensation ROCHESTER, NY 14606 Emerson Power Transmission 620 South Aurora Street EMERS001 New York Workers' Ithica, NY 14850 Compensation EMG Insurance / WC 1815 S Meyers Road, Suite 500 EMGIN001 Other WC (Non-NY) Oak Brook Terrace, IL 60181 EMHART GLASS 1140 SULLIVAN STREET EMHAR001 New York Workers' ELMIRA, NY 14901 Compensation Empire Fire and Marine Insurance Company PO Box 542003 EMPIR003 Auto/No-Fault Omaha, NE 68154-8003 Empire Medicare PO Box 6178 EMPIR002 New York Workers' Indianapolis, IN 46206 Compensation Empire Merchants 16 Bridgewater St EMPIR006 New York Workers' Brooklyn, NY 11222 Compensation EMPIRE RECYCLING PO BOX 514 EMR01 New York Workers' UTICA, NY 13503 Compensation Empire Resource Recycling, Inc 1278 Gifford Rd EMPIR005 New York Workers' Phelps, NY 14532 Compensation EMPIRE SENECA 1606 ROUTE 414 EMS01 New York Workers' WATERLOO, NY 13165 Compensation EMPIRE SOUTHERN TIER PO BOX 5847 EST01 New York Workers' HILLSBOROUGH, NJ 08844 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID EMPIRE STATE COLLEGE 1 UNION AVE EMPIR001 New York Workers' SARATOGA SPRINGS, NY 12866 Compensation EMPIRE STATE TRANS 10 BRITISH AMERICAN BLVD EMP01 New York Workers' LATHAM, NY 12110 Compensation EMPIRE TRACTOR 5072 EAST MAIN ST EMPIR004 New York Workers' BATAIVA, NY 14020 Compensation Emplify 400 North West 74th Ave EMPLI001 New York Workers' Plantation, FL 33317 Compensation Employer Insurance Group (EIG) [Electronic] E3190C Other WC (Non-NY) , Employers Assurance Company [Electronic] E1407C Other WC (Non-NY) , EMPLOYER'S CLAIM SERVICE Naperville E1301C Other WC (Non-NY) [Electronic] , EMPLOYERS COMP PO BOX 539004 EMPLO005 New York Workers' HENDERSON, NV 89053 Compensation Employers Compensation Insurance Company E2716C Other WC (Non-NY) [Electronic] , EMPLOYERS FIRE INSURANCE COMPANY ONE BEACON LANE EMPF01 New York Workers' CANTON, MA 02021-1030 Compensation Employers General Insurance Group [Electronic] E1224A New York Workers' , Compensation Employers General Insurance Group [Electronic] E1224B Auto/No-Fault , Employers General Insurance Group [Electronic] E1224C Other WC (Non-NY) , Employers Insurance / WC PO Box 71088 EMPLO004 Other WC (Non-NY) Charlotte, NC 28272 Employers Mutual Casualty - AUTO ONLY E1138B Auto/No-Fault [Electronic] , Employers Mutual Casualty - WC ONLY E7352A New York Workers' [Electronic] , Compensation Employers Mutual Casualty - WC ONLY E7352C Other WC (Non-NY) [Electronic] , Employers Mutual Casualty / WC P.O. Box 1657 EMPLO003 Other WC (Non-NY) Davenport, IA 52807 EMPLOYERS MUTUAL INC 700 SE CENTRAL PKWY EMPLO002 New York Workers' STUART, FL 34994 Compensation Employers Preferred Insurance Company E1409C Other WC (Non-NY) [Electronic] , EMPLOYERS REINSURANCE CORP PO BOX 2991 EMPR01 New York Workers' OVERLAND PARK, KS 66201 Compensation EMPLOYMENT SOLUTIONS OF NY 111 NORTH MAIN STREET EMPLO001 New York Workers' ELMIRA, NY 14901 Compensation EMPOWERED STAFFING SOLUTIONS 107 SOUTH ELMER AVE EMPOW001 New York Workers' SAYRE, PA 18840 Compensation EMS-RMSCO 115 Continuum Drive EMSRM001 New York Workers' Liverpool, NY 13088 Compensation ENABLE 1603 Court Street ENABL001 New York Workers' Syracuse, NY 13208 Compensation ENCOMPASS INSURANCE ENCOMPASS INSURANCE, ENCOM013 Auto/No-Fault PO BOX 115001 CARROLTON, TX 75011 ENCOMPASS NY CLAIMS PO BOX 2873 ENCOM011 Auto/No-Fault CLINTON, IA 52733-2873 Encompass Property Casualty PO Box 2873 ENCOM012 Auto/No-Fault Clinton, IA 52733 ENDICOTT COIL 24 CHARLOTTE STREET ENDIC001 New York Workers' BINGHAMTON, NY 13905 Compensation Endless Mountains Healthcare Systems 3 Grow Avenue ENDLE001 New York Workers' Montrose, PA 18801 Compensation Endwell Rug Co 3646 George F Hwy ENDWE001 New York Workers' Endwell, NY 13760 Compensation ENERGETIX 87 ST PAULS RD NORTH ENERG003 New York Workers' HEMPSTEAD, NY 11550-1131 Compensation ENERGY INSURANCE BROKERS PO BOX 1729 ENERG004 New York Workers' ALBANY, NY 12201 Compensation Energy Machine LLC 5749 NW 132nd Street ENERG005 New York Workers' Oklahoma City, OK 73142 Compensation ENERGY SAVERS 207 PENNA AVENUE ENERG001 New York Workers' ELMIRA, NY 14904 Compensation Energy Saving Solutions 132 Nantucket Dr ENERG002 New York Workers' Cheektowaga, NY 14225 Compensation ENGAGE PEO 3001 EXECUTIVE DRIVE ENGAG001 New York Workers' ST PETERSBURG, FL 33762 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Engineered Composites 55 Roberts Ave ENGIN001 New York Workers' Buffalo, NY 14206 Compensation England Ins Brokerage 516 West 36th Street ENGLA001 New York Workers' Second Floor Compensation New York, NY 10018 Engler Electric 609 Columbia St. ENGLE001 New York Workers' PO Box 1745 Compensation Utica, NY 13503 ENGLEWOOD BOARD OF EDUCAT 12 TENAFLY RD ENGLE002 New York Workers' ENGLEWOOD, NJ 07631 Compensation ENGLEWOOD POLICE DEPT 75 SOUTH VANVARNT ST. ENGLE003 New York Workers' ENGLEWOOD, NJ 07631 Compensation ENR GENERAL CONSTRUCTION 38 SAINT DAVID DR ENRGE001 New York Workers' BUFFALO, NY 14224 Compensation ENSTAR US INC 7901 Fourth Street North ENSTA001 New York Workers' STE 203 Compensation St. Petersburg, FL 33702 Ensurance Agency 1834 Hylan BLVD ENSUR002 New York Workers' Staten Island, NY 10305 Compensation ENTERGY CLAIMS MGMT INC PO BOX 551 ENTE01 New York Workers' LITTLE ROCK, AK 72203 Compensation Enterprise Rent A Car [Electronic] E7679C Other WC (Non-NY) , ENTERTAINMENT BROKERS INTERNATIONAL 10940 WILSHIRE BLVD ENTER001 New York Workers' 17th Floor Compensation LOS ANGELES, CA 90024 ENVIRONMENTAL SERVICES 141 BROADWAY ENVIR001 New York Workers' RENSSELAER, NY 12144 Compensation Envirosource [Electronic] E9371C Other WC (Non-NY) , Envision Radiology, LLC [Electronic] E0785A New York Workers' , Compensation Envision Radiology, LLC [Electronic] E0785C Other WC (Non-NY) , EOP HEADSTART 650 BALDWIN STREET EOPHE001 New York Workers' ELMIRA, NY 14901 Compensation Eplica, Inc. [Electronic] E0786A New York Workers' , Compensation Eplica, Inc. [Electronic] E0786C Other WC (Non-NY) , EQ ENVIRONMENTAL 4 HOOK ROAD EQENV001 New York Workers' BAYONNE, NJ 07002 Compensation ERB Equipment / WC 200 ERB Ind. Drive ERBEQ001 Other WC (Non-NY) FEnton, MO 63026 ERICK FLOWBACK SERVICE LLC PO BOX 86 ERICK001 New York Workers' KINGFISHER, OK 73750 Compensation Erickson-Hall Constr [Electronic] E0787A New York Workers' , Compensation Erickson-Hall Constr [Electronic] E0787C Other WC (Non-NY) , ERIE PO BOX 605 ERIE004 Auto/No-Fault MURRYSVILLE,, PA 15668 ERIE PO BOX 9500 ERIE03 New York Workers' JOHNSTOWN, PA 15907-8500 Compensation ERIE CONTRACTING 188 ERIE STREET ERIEC002 New York Workers' LANCASTER, NY 14086 Compensation ERIE COUNTY NURSING HOME 11580 Walden Avenue ERIEC001 New York Workers' ALDEN, NY 14004 Compensation ERIE FORGE AND STEEL 1341 WEST 16TH STREET ERIEF001 New York Workers' ERIE, PA 16502 Compensation ERIE INS COMPANY 100 ERIE INS PLACE ERIEI014 Other WC (Non-NY) ERIE, PA 16530 ERIE INSURANCE 1400 N PROVIDENCE RD ERIEI009 Auto/No-Fault SUITE 216 MEDIA, PA 19063 ERIE INSURANCE PO BOX 2013 ERIEI024 Auto/No-Fault MECHANICSBURG, PA 17055 ERIE INSURANCE PO BOX 22840 ERIE01 New York Workers' ROCHESTER, NY 14692 Compensation ERIE INSURANCE PO BOX 22840 ERIEI003 Auto/No-Fault ROCHESTER, NY 14692 ERIE INSURANCE PO BOX 4158 ERIEI023 Auto/No-Fault HAGERSTOWN, MD 21741 ERIE INSURANCE PO BOX 4286 ERIEI011 Auto/No-Fault BETHLEHEM, PA 18018-4286 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ERIE INSURANCE PO BOX 4286 ERIEI022 Other WC (Non-NY) BETHLEHEM, PA 18018-4286 ERIE INSURANCE PO BOX 80129 ERIEI017 Auto/No-Fault INDIANAPOLIS, IN 46280 ERIE INSURANCE PO BOX 8267 ERIEI010 Auto/No-Fault ERIE, PA 16505 Erie Insurance [Electronic] E1163A New York Workers' , Compensation Erie Insurance [Electronic] E1163B Auto/No-Fault , Erie Insurance [Electronic] E1163C Other WC (Non-NY) , ERIE INSURANCE CO P O BOX 2013 ERIEI020 Other WC (Non-NY) MECHANICSBURG, PA 17055-0710 ERIE INSURANCE GROUP P O BOX 2410 ERIEI021 Auto/No-Fault E PEORIA, IL 61611 ERIE INSURANCE GROUP PO BOX 2832 ERIEI015 Other WC (Non-NY) NEW YORK, NY 10116-2832 ERIE INSURANCE GROUP PO BOX 2832 ERIEI016 Auto/No-Fault NEW YORK, NY 10116-2832 ERIE INSURANCE GROUP PO BOX 4409 ERIEI013 Other WC (Non-NY) SILVER SPRING, MD 20914 ERIE INSURANCE GROUP PO BOX 4409 ERIEI018 Auto/No-Fault SILVER SPRING, MD 20914 ERIE INSURANCE GROUP PO BOX 605 ERIEI019 Auto/No-Fault Murrysville, PA 15668 ERIE INSURANCE GROUP POBOX 20769 ERIEI012 Other WC (Non-NY) ROANOKE, VA 24018 Erie Insurance Group / Liability 100 Erie Ins. Pl. ERIEI007 Auto/No-Fault Erie, PA 16530 Erie Insurance Group / WC P.O. Box 2410 ERIEI006 Other WC (Non-NY) East Peoria, IL 61611 ERIE INTERSTATE CONTRACTORS 5428 GENESEE ST EIC01 New York Workers' LANCASTER, NY 14086 Compensation ERIE MECHANICAL PO BOX 37 ERIEM001 New York Workers' SYRACUSE, NY 13211 Compensation ERMC [Electronic] E3551C Other WC (Non-NY) , ERSI 311 ROTTERDAM INDUSTRIAL ERSI001 New York Workers' PKWY Compensation SCHENECTADY, NY 12306 ERWAY AMBULANCE 2030 COLLEGE AVENUE ERWAY001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation ES SYSTEMS INC 23 SAGINAW DRIVE ESSYS001 New York Workers' ROCHESTER, NY 14623 Compensation ESCHER'S TIRE 105 LYNWOOD AVE ESCHE001 New York Workers' ELMIRA HEIGHT, NY 14903 Compensation ESIS - Atlanta [Electronic] PO BOX 31145 ESISA001 Auto/No-Fault TAMPA, FL 33631 ESIS - Cherry Hill [Electronic] PO BOX 31079 ESISC003 Auto/No-Fault TAMPA, FL 33631 ESIS - Chicago [Electronic] PO BOX 31134 ESISC005 Auto/No-Fault TAMPA, FL 33631 ESIS - Columbia [Electronic] 55 HADDONFIELD ROAD #210 ESISC001 Auto/No-Fault CHERRY HILL, NJ 08002 ESIS - Dallas [Electronic] PO BOX 31090 ESISD003 Auto/No-Fault TAMPA, FL 33631 ESIS - Dallas MK [Electronic] 1100 POYDRAS STREET SUITE 2150 ESISD001 Auto/No-Fault NEW ORLEANS, LA 70163 ESIS - First American Insurance Co [Electronic] E5432C Other WC (Non-NY) , ESIS - Kelly Services [Electronic] E0789A New York Workers' , Compensation ESIS - Kelly Services [Electronic] E0789C Other WC (Non-NY) , ESIS - Lockheed Martin Corporation [Electronic] E0790A New York Workers' , Compensation ESIS - Lockheed Martin Corporation [Electronic] E0790C Other WC (Non-NY) , Esis - Minnetonka [Electronic] PO BOX31079 ESISM001 Auto/No-Fault TAMPA, FL 33631 ESIS - New Orleans [Electronic] 10320 LITTLE PATUXENT PARKWAY ESISN001 Auto/No-Fault COLUMBIA, MD 21044 ESIS - Tampa [Electronic] PO BOX 31052 ESIST002 Auto/No-Fault TAMPA, FL 33631 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ESIS - Wilmington [Electronic] 5100 WEST LEMON STREET SUITE ESISW001 Auto/No-Fault 207 TAMPA, FL 33609 ESIS - Windsor [Electronic] PO BOX 31145 ESISW005 Auto/No-Fault TAMPA, FL 33631 ESIS - Woodland Hills [Electronic] PO BOX 31123 ESISW003 Auto/No-Fault TAMPA, FL 33631 Esis (Florida) [Electronic Indirect] PO Box 31080 ESISF001 New York Workers' Tampa, FL 33631 Compensation Esis (Florida) [Electronic Indirect] PO Box 31080 ESISF002 Other WC (Non-NY) Tampa, FL 33631 Esis (Florida) [Electronic Indirect] PO BOX 31117 ESISF003 New York Workers' TAMPA, FL 336313117 Compensation Esis (Florida) [Electronic Indirect] PO BOX 31117 ESISF004 Other WC (Non-NY) TAMPA, FL 336313117 Esis (Florida) [Electronic Indirect] PO BOX 31133 ESISF005 New York Workers' TAMPA, FL 33631 Compensation Esis (Florida) [Electronic Indirect] PO BOX 31133 ESISF006 Other WC (Non-NY) TAMPA, FL 33631 ESIS (NE WC CLAIMS) P O BOX 6566 ESISN005 Other WC (Non-NY) SCRANTON, PA 18505-6566 Esis (New York) [Electronic Indirect] 300 Airborne Parkway ESISN003 New York Workers' Suite 300 Compensation Buffalo, NY 14225 Esis (New York) [Electronic Indirect] 300 Airborne Parkway ESISN004 Other WC (Non-NY) Suite 300 Buffalo, NY 14225 ESIS / ACE PO Box 6566 ESISA003 New York Workers' Scranton, PA 18505-6566 Compensation ESIS [ELECTRONIC INDIRECT] PO Box 6566 ESISE001 New York Workers' Scranton, PA 18505 Compensation ESIS [Electronic] E0788A New York Workers' , Compensation ESIS [Electronic] E0788C Other WC (Non-NY) , ESIS GETZVILLE WC PO BOX 6566 ESISG001 Other WC (Non-NY) SCRANTON, PA 18505 ESIS WORKCOMP PO BOX 6566 ESISW007 Other WC (Non-NY) SCRANTON, PA 185056566 ESIS/ACE PO BOX 5129 ESISA004 Auto/No-Fault SCRANTON, PA 18505 ESM SCHOOL DISTRICT 407 FREMONT RD ESMS01 New York Workers' E SYRACUSE, NY 13057 Compensation Essential Staffcare Insurance PO Box 6702 ESSEN001 Other WC (Non-NY) Columbia, SC 29260 ESSURANCE INS PO BOX 20666 ESSUR002 Auto/No-Fault CAMP HILL, FL 33622 ESTEE LAUDER 300 CROSSINGS ROAD ESTEE001 New York Workers' BRISTOL, PA 19007 Compensation Esurance Mitchell International ESURA005 Auto/No-Fault PO BOX 2981 Clinton, IA 52733-2981 Esurance PO Box 335 ESURA002 Auto/No-Fault Addison, TX 75001 Esurance PO Box 5250 ESURA008 Auto/No-Fault Sioux Falls, SD 57117 Esurance PO Box 5250 ESURA009 Other WC (Non-NY) Sioux Falls, SD 57117 ESURANCE PO BOX 2869 ESURA006 Auto/No-Fault CLINTON, IA 52733 Esurance Insurance NJ Claims Branch ESURA010 Auto/No-Fault PO BOX 623 Basking Ridge, NJ 07920 Esurance Insurance Company [Electronic] E5879B Auto/No-Fault , ESurance/Mitchell International PO Box 2869 ESURA004 New York Workers' Clinton, IA 52733-2869 Compensation Ethan Allen Personnel Group WC 59 Academy St ETHAN001 New York Workers' Poughkeepsie, NY 12601 Compensation ETS STAFFING 3259 SOUTH WINTON ROAD ETSST001 New York Workers' ROCHESTER, NY 14623 Compensation EUREST SERV/COMPASS 803 LINDEN AVE EURES001 New York Workers' E ROCHESTER, NY 14625 Compensation EVANS AGENCY 135 MAIN ST EVANS001 New York Workers' LOCKPORT, NY 14094 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID EVANS ROOFING COMPANY 1421 COLLEGE AVE EVANS002 New York Workers' ELMIRA, NY 14901 Compensation EVENS CHEMETICS 228 EAST MAIN ST EVCH01 New York Workers' WATERLOO, NY 13165 Compensation EVEREADY INSURANCE CO 59 MAIDEN LANE 43RD FLR EVERE003 Auto/No-Fault AUTO CLAIMS NEW YORK, NY 10038 EVEREST NATIONAL INS COMPANY PO BOX 830 EVNA01 New York Workers' 477 MARTINSVILLE RD Compensation LIBERTY CORNERS, NJ 07938-0830 Everest National Insurance (NJ) [Electronic PO BOX 830 EVERE001 New York Workers' Indirect] 477 MARTINSVILLE RD Compensation LIBERTY CORNERS, NJ 07938 Everest National Insurance (NJ) [Electronic PO BOX 830 EVERE002 Other WC (Non-NY) Indirect] 477 MARTINSVILLE RD LIBERTY CORNERS, NJ 07938 EVERYDRY WATERPROOFING 12 PIXLEY INDUSTRIAL PKWY EVERY001 New York Workers' BOX 5 DOOR 34 Compensation ROCHESTER, NY 14624 Evolution Insurance Company [Electronic] E4790C Other WC (Non-NY) , EXCALIBUR 213 SMITH ST EXCAL001 New York Workers' DUNMORE, PA 18512 Compensation Excelco-Newbrook Inc. 65 Main St.,PO Box 231 EXCEL006 New York Workers' Silver Creek, NY 14136 Compensation EXCELLUS BENEFIT SERVICE PO BOX 4863 EXCE04 New York Workers' SYRACUSE, NY 13221-4863 Compensation EXCELSIOR 275 GRANDVIEW AVENUE EXCEL003 New York Workers' SUITE 300 Compensation CAMP HILL, PA 17001 EXCELSIOR INS CO 62 MAPLE AVE EXCE03 New York Workers' KEENE, NH 03431 Compensation EXCELSIOR INS CO PO BOX 370 EXCE01 New York Workers' SYRACUSE, NY 13209 Compensation EXCELSIOR INS CO PO BOX 4858 EXCE02 New York Workers' SYRACUSE, NY 13221 Compensation Excelsior Insurance - WC 5062 Brittonfield Parkway EXCEL002 New York Workers' East Syracuse, NY 10388 Compensation EXCELSIOR ROOFING 10 CAYUGA VISTA DRIVE EXCEL005 New York Workers' LANSING, NY 14882 Compensation EXCHANGE MUTUAL 40 WANTAGE AVE EXCH01 New York Workers' BRANCHVILLE, NJ 07826-5640 Compensation Executive Security Specialists / WC 265 Stebbings Court EXECU001 Other WC (Non-NY) Bradley, IL 60915 Express Doctor Services 4350 West Cypress ST EXPRE004 New York Workers' STE 1000 Compensation Tampa, FL 33607 EXPRESS EMPLOYMENT SERVICES 3040 MONROE AVE EXPRE005 New York Workers' ROCHESTER, NY 14618 Compensation EXPRESS HEALTH SERVICES 5100 W.LEMON ST. SW.109 EXPRE001 New York Workers' TAMPA, FL 33609 Compensation Express Mart (Dewitt, NY) 6567 Kinne Road EXPRE002 New York Workers' Dewitt, NY 13214 Compensation EXPRESS SCRIPTS WC PO BOX 60924 EXPRE006 New York Workers' PHOENIX, AZ 85072 Compensation Express Staffing 49 South Main Street EXPRE003 New York Workers' Gloversville, NY 12078 Compensation EXXON MOBIL 3225 GALLOWS RD EXXO01 New York Workers' 2C Compensation FAIRFAX, VA 22037 ExxonMobil Corporation [Electronic] E1225A New York Workers' , Compensation ExxonMobil Corporation [Electronic] E1225B Auto/No-Fault , ExxonMobil Corporation [Electronic] E1225C Other WC (Non-NY) , eye care & vision associates 1 hopkins rd EYECA001 New York Workers' williamsville, NY 14221 Compensation F C YOUNG 400 HOWELL ST FCYOU001 New York Workers' BRISTOL, PA 19007 Compensation F&G Guaranty - Main St Program Colorado E0791A New York Workers' [Electronic] , Compensation F&G Guaranty - Main St Program Colorado E0791C Other WC (Non-NY) [Electronic] , F.G. MASONARY 150 VANETTA RD FGMAS001 New York Workers' WAVERLY, NY 14892 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID F.H.ALEXANDER, INC. 313 USHERS ROAD FHALE001 New York Workers' BALLSTON LAKE, NY 12019 Compensation F.P. RIESTER TRUCK EQUIP TROMBLEY RD FPR01 New York Workers' WEDDSPORT, NY 13166 Compensation Factory 2 U [Electronic] E1742C Other WC (Non-NY) , FAERY'S NURSERY 3170 RIDGE ROAD FAERY001 New York Workers' RANSOMVILLE, NY 14131 Compensation Fahs Construction Group 2224 Pierce Creek Rd. FAHSC001 New York Workers' Binghamton, NY 13903 Compensation Fairchild Fasteners [Electronic] E1226A New York Workers' , Compensation Fairchild Fasteners [Electronic] E1226B Auto/No-Fault , Fairchild Fasteners [Electronic] E1226C Other WC (Non-NY) , FAIRFIELD INN 3 SOUTH BUFFALO STREET FAIRF001 New York Workers' CORNING, NY 14830 Compensation FAIRFIELD INN & SUITES ITHACA 359 ELMIRA ROAD FAIRF003 New York Workers' ITHACA, NY 14850 Compensation Fairfield Inn / WC 217 Potomac Blvd FAIRF002 Other WC (Non-NY) Mt. Vernon, IL 62864 FAIRFIELD INSURANCE COMPANY PO BOX 10350 FAIC01 New York Workers' STAMFORD, CT 06904-2350 Compensation FAIRMONT SPECIALTY P O BOX 600183 FAIRM001 New York Workers' DALLAS, TX 75360 Compensation FAIRMONT SPECIALTY INSURANCE COMPANY 2850 Lake Vista Dr. FASI01 New York Workers' STE 150 Compensation Lewisville, TX 75067 Fairmont Specialty Insurance Company - TX E1227A New York Workers' [Electronic] , Compensation Fairmont Specialty Insurance Company - TX E1227B Auto/No-Fault [Electronic] , Fairmont Specialty Insurance Company - TX E1227C Other WC (Non-NY) [Electronic] , FAIRMOUNT ANIMAL HOSPITAL 4101 WEST GENESEE STREET FAIRM002 New York Workers' SYRACUSE, NY 13219 Compensation FAIRPLAY EQUINE INS 567 CHESTNUT ST FAIRP001 New York Workers' HARRODSBURG, KY 40330 Compensation Fairview Health Services [Electronic] E1228A New York Workers' , Compensation Fairview Health Services [Electronic] E1228B Auto/No-Fault , Fairview Health Services [Electronic] E1228C Other WC (Non-NY) , Falcigno Group 14 Peck Street FALCI001 New York Workers' North Haven, CT 06473 Compensation FALSO INDUSTRIES 4100 NEW COURT AVENUE FALSO001 New York Workers' SYRACUSE, NY 13206 Compensation FAMILY DOLLAR 42 WEST MAIN STREET FAMIL001 New York Workers' OWEGO, NY 13827 Compensation FAMILY SERVICES 1019 EAST WATER STREET FAMIL002 New York Workers' ELMIRA, NY 14901 Compensation FAMSA, Inc. [Electronic] E1114A New York Workers' , Compensation FAMSA, Inc. [Electronic] E1114B Auto/No-Fault , FAMSA, Inc. [Electronic] E1114C Other WC (Non-NY) , FANCHER APPLIANCE P.O. BOX 6 FANCH001 New York Workers' VESTAL, NY 13851 Compensation FARA INS SERVICES 1625 WEST CAUSEWAY APPROACH FAIS03 New York Workers' MANDEVILLE, LA 70471 Compensation FARADYNE MOTORS 1000 Technology Pkwy FARA01 New York Workers' Newark, NY 14513-2174 Compensation Farm Bureau Mutual [NEFB BC 1] [Electronic] PO BOX 80299 FARMB001 Auto/No-Fault LINCOLN, NE 68501 Farm Bureau Mutual [NEFB BC 2] [Electronic] PO BOX 80299 FARMB003 Auto/No-Fault LINCOLN, NE 68502 FARM CREDIT EAST 1 TECHNOLOGY PLACE #2 FARMC001 New York Workers' HOMER, NY 13077 Compensation FARM FAMILY CASUALTY INS CO PO BOX 656 FAFC01 New York Workers' ALBANY, NY 12201 Compensation FARM FAMILY INS CO PO BOX 656 FARMF002 Auto/No-Fault ALBANY, NY 12201-0656 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID FARM FAMILY INSURANCE 8865 SHERIDAN DR FARMF001 New York Workers' CLARENCE, NY 14221 Compensation Farm Family/ Procura 344 ROUTE 9W FARMF004 Auto/No-Fault Glenmont, NY 12077 FARM SANCUTARY PO BOX 150 FARMS001 New York Workers' WATKINS GLEN, NY 14891 Compensation FARMCO 2080 FARRAGUT AVE FARMC002 New York Workers' BRISTOL, PA 19007 Compensation Farmers PO BOX 268995 FARME007 Auto/No-Fault Oklahoma City, OK 73126 Farmers / WC PO Box 108843 FARME005 Other WC (Non-NY) Oklahoma City, OK 73101 Farmers \ Civic Property and Casualty Company E1229A New York Workers' [Electronic] , Compensation Farmers \ Civic Property and Casualty Company E1229B Auto/No-Fault [Electronic] , Farmers \ Civic Property and Casualty Company E1229C Other WC (Non-NY) [Electronic] , Farmers \ Exact Property and Casualty Company E1230A New York Workers' [Electronic] , Compensation Farmers \ Exact Property and Casualty Company E1230B Auto/No-Fault [Electronic] , Farmers \ Exact Property and Casualty Company E1230C Other WC (Non-NY) [Electronic] , Farmers \ Fire Insurance Exchange [Electronic] E1231A New York Workers' , Compensation Farmers \ Fire Insurance Exchange [Electronic] E1231B Auto/No-Fault , Farmers \ Fire Insurance Exchange [Electronic] E1231C Other WC (Non-NY) , Farmers \ Mid-Century Insurance Company E1232A New York Workers' [Electronic] , Compensation Farmers \ Mid-Century Insurance Company E1232B Auto/No-Fault [Electronic] , Farmers \ Mid-Century Insurance Company E1232C Other WC (Non-NY) [Electronic] , Farmers \ Truck Insurance Exchange [Electronic] E1234A New York Workers' , Compensation Farmers \ Truck Insurance Exchange [Electronic] E1234B Auto/No-Fault , Farmers \ Truck Insurance Exchange [Electronic] E1234C Other WC (Non-NY) , FARMERS AUTO INSURANCE P.O BOX 268994 FARME013 Auto/No-Fault OKLAHOMA CITY, OK 73126 FARMERS INS GROUP PO BOX 268993 FARME002 Auto/No-Fault OKLAHOMA CITY, OK 73126 Farmers Insurance PO Box 108843 FARME001 New York Workers' Oklahoma City, OK 73101 Compensation FARMERS INSURANCE P.O BOX 108843 FARME014 Auto/No-Fault OKLAHOMA CITY, OK 73101 FARMERS INSURANCE P.O. BOX 268994 FARME009 Auto/No-Fault OKLAHOMA CITY, OK 73126 Farmers Insurance (AUTO only) [Electronic] E8275B Auto/No-Fault , Farmers Insurance Exchange (WC ONLY) E8321C Other WC (Non-NY) [Electronic] , Farmers Insurance Group PO Box 268995 FARME006 New York Workers' Oklahoma City, OK 73126 Compensation FARMERS INSURANCE HAWAII, INC. P.O. BOX 770 FARME011 Auto/No-Fault HONOLULU, HI 968080770 FARMERS INSURANCE(21ST CENTURY P.O. BOX 268993 FARME008 Auto/No-Fault INSURANCE) OKLAHOMA CITY, OK 73126 FARMERS MEDICAL PO BOX 268993 FARME012 Auto/No-Fault OKLAHOMA, OK 731268993 FARMERS UNION CLAIMS PO BOX 2020 FARME004 Auto/No-Fault JAMESTOWN, ND 58402-2020 Farmers\Neighborhood Spirit Property Casualty E1233A New York Workers' [Electronic] , Compensation Farmers\Neighborhood Spirit Property Casualty E1233B Auto/No-Fault [Electronic] , Farmers\Neighborhood Spirit Property Casualty E1233C Other WC (Non-NY) [Electronic] , FASSETT ELEMENTARY SCHOOL 309 WEST THURSTON STREET FASSE001 New York Workers' ELMIRA, NY 14901 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID FBI 26 FEDERAL PLAZA FBI001 New York Workers' NEW YORK, NY 10278 Compensation FC CAPRERA CHEVY BUICK 3326 MAPLE AVENUE FCCAP001 New York Workers' PULASKI, NY 13042 Compensation FCCI PO BOX 58004 FCCI01 New York Workers' SARASOTA, FL 34232 Compensation FCCI / WC P.O. Box 58004 FCCIW001 Other WC (Non-NY) Sarasota, FL 34232 FCS ADMINISTRATORS PO BOX 1248 FCSA01 New York Workers' WILLIAMSVILLE, NY 14231 Compensation FED EX FREIGHT PO BOX 840 FDEX01 New York Workers' DEPT 226 Compensation HARRISON, AR 72602 Fed Ex Freight East / WC Del Code 2266 FEDEX002 Other WC (Non-NY) PO Box 840 Harrison, AR 72602 Fed Ex, Risk Management, WC Dept 3620 Hacks Cross, Bldg B 3rd Fl FEDEX001 New York Workers' Memphis, TN 38125 Compensation FEDERAL INS CO 55 WATER ST FIC02 New York Workers' 28TH AND 30TH FLR Compensation NEW YORK, NY 10041 FEDERAL INSURANCE 555 LONG WHARF DR FERDE001 New York Workers' NEW HAVEN, CT 06511 Compensation Federal Insurance Co 1330 Post Oak Blvd FEDER001 New York Workers' Suite 2400 Compensation Houston, TX 77056 Federal Insurance Co [Electronic Indirect] 1330 Post Oak Blvd FEDER003 New York Workers' Suite 2400 Compensation Houston, TX 77056 Federal Insurance Co [Electronic Indirect] 1330 Post Oak Blvd FEDER005 Auto/No-Fault Suite 2400 Houston, TX 77056 Federal Insurance Co [Electronic Indirect] 1330 Post Oak Blvd FEDER007 Other WC (Non-NY) Suite 2400 Houston, TX 77056 Federal Insurance Co [Electronic Indirect] PO BOX 1615 FEDER004 New York Workers' WARREN, NJ 07061 Compensation Federal Insurance Co [Electronic Indirect] PO BOX 1615 FEDER006 Auto/No-Fault WARREN, NJ 07061 Federal Insurance Co [Electronic Indirect] PO BOX 1615 FEDER008 Other WC (Non-NY) WARREN, NJ 07061 FEDERAL INSURANCE COMPANY P.O. BOX 1903 FEDER002 New York Workers' NEW HAVEN, CT 06509 Compensation FEDERAL INSURANCE COMPANY PO BOX 1615 FEIC01 New York Workers' WARREN, NJ 07061 Compensation FEDERAL WORKERS COMP 201 VARICK ST FEWC01 New York Workers' NEW YORK, NY 10014 Compensation Federated Claims Service Corp. [Electronic] E6531A New York Workers' , Compensation Federated Claims Service Corp. [Electronic] E6531C Other WC (Non-NY) , Federated Department Stores, Inc [Electronic] E0792A New York Workers' , Compensation Federated Department Stores, Inc [Electronic] E0792C Other WC (Non-NY) , FEDERATED DEPT STORES 7 WEST SEVENTH ST FEDS01 New York Workers' CINCINNATI, OH 45202 Compensation Federated Insurance PO BOX 50487 FEDER010 Other WC (Non-NY) Indianapolis, IN 46250 Federated Insurance / WC P.O. Box 390850 FEDER009 Other WC (Non-NY) Minneapolis, MN 55439 FEDERATED INSURANCE CO PO BOX 486 FEDER011 Other WC (Non-NY) OWATONNA, MN 55060-0486 Federated Linen & Uniform [Electronic] E0793A New York Workers' , Compensation Federated Linen & Uniform [Electronic] E0793C Other WC (Non-NY) , Federated Mutual Ins P.O. Box 486 FEDER012 Auto/No-Fault Owatonna, MN 55060 FEDERATED MUTUAL INSURANCE PO BOX 486 FEDER013 New York Workers' OWATONNA, MN 55060 Compensation Federated Mutual Insurance Company [Electronic] E1437A New York Workers' , Compensation Federated Mutual Insurance Company [Electronic] E1437C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Federated Rural Electric (Tx) [Electronic] E6523C Other WC (Non-NY) , FEDERATED RURAL ELECTRIC INS EXCH PO BOX 15147 FEDR01 New York Workers' LENEXA, KS 66285-5147 Compensation Federated Services Insurance Company E2820A New York Workers' [Electronic] , Compensation Federated Services Insurance Company E2820C Other WC (Non-NY) [Electronic] , Feher Rubbish 191 Border City Rd FEHER001 New York Workers' Geneva, NY 14456 Compensation Feline's Pride 4660 Harris Hill Rd. FELIN001 New York Workers' Clarence, NY 14221 Compensation Felix Roma & Son 2 S. Page Ave FELIX001 New York Workers' Endicott, NY 13760 Compensation FELIX SCHOELLER 179 COUNTY ROUTE 2A FELIX002 New York Workers' PULASKI, NY 13142 Compensation FERGUSON ELECTRIC 333 ELLICOTT ST FERGU001 New York Workers' BUFFALO, NY 14203 Compensation FERRANDINO & SONS 71 CAROLYN BLVD FERRA001 New York Workers' FARMINGDALE, NY 11735 Compensation FERRARIO FORD 2472 CORNING RD FERRA003 New York Workers' ELMIRA, NY 14903 Compensation ferraro pile & shoring 13590 genesee st FERRA002 New York Workers' alden, NY 14004 Compensation FERRELLGAS 5859 STATE RT 31 FERRE001 New York Workers' VERONA, NY 13478 Compensation Ferro Corporation 1789 Transelco Drive FERRO001 New York Workers' Penn Yan, NY 14527 Compensation FHM INSURANCE COMPANY PO BOX 616648 FHMI01 New York Workers' ORLANDO, FL 32861 Compensation FIBER CONVERSION 15 EASE ELM STREET FIBER001 New York Workers' BROADALBIN, NY 12025 Compensation FIBER INSTRUMENT SALES INC 161 CLEAR RD FIBER002 New York Workers' ORISKANY, NY 13424 Compensation FICO INSURANCE CO 3 UNIVERSITY PLAZA FICO01 New York Workers' HACKENSACK, NJ 07601 Compensation FIDDLER ROOFING 2335 NIAGARA FALLS BLVD FIDDL002 New York Workers' NIAGARA FALLS, NY 14304 Compensation FIDDLERS ROOFING 2335 NIAGARA FALLS BLVD FIDDL001 New York Workers' WHEATFIELD, NY 14304 Compensation FIDELITY & DEPOSIT COMPANY 1400 AMERICAN LANE FIDE01 New York Workers' PTAX/20 Compensation SCHAUMBURG, IL 60196 FIDELITY AND GUARANTY INS UND INC 385 WASHINGTON ST MAIL CODE FIDGUAR01 New York Workers' 102B Compensation ST. PAUL, MN 55102 Fidelity and Guaranty Insurance Co. [Electronic ONE TOWER SQUARE FIDEL002 New York Workers' Indirect] HARTFORD, CT 06104 Compensation Fidelity and Guaranty Insurance Co. [Electronic ONE TOWER SQUARE FIDEL003 Auto/No-Fault Indirect] HARTFORD, CT 06104 Fidelity and Guaranty Insurance Co. [Electronic ONE TOWER SQUARE FIDEL004 Other WC (Non-NY) Indirect] HARTFORD, CT 06104 FIDELITY DEPOSIT PO BOX 17171 FIDD01 New York Workers' BALTIMORE, MD 21297 Compensation FIDELITY INDERETY 5 BATTERSON PARK FIDI01 New York Workers' FARMINGTON, CT 06032 Compensation FIDUCIARY 45-07 DAVIS STREET FIDUC002 Auto/No-Fault LONG ISLAND, NY 11101 FIDUCIARY INSURANCE CO OF AMERICA 45-07 DAVIS STREET FIDUC001 New York Workers' LONG ISLAND CITY, NY 11101 Compensation FIELDBROOK FARMS 1 Ice Cream Dr FIELD001 New York Workers' PO Box 1318 Compensation Dunkirk, NY 14048 FILIP L TIFFENBERG 1775 BROADWAY STE 627 FILIP001 Auto/No-Fault NEW YORK, NY 10019 Final Fear Haunted House 5600 McKinley Parkway FINAL001 New York Workers' Hamburg, NY 14075 Compensation FINCH PAPER LLC 1 GLEN STREET FINCH001 New York Workers' GLENS FALLS, NY 12801 Compensation Finger Lakes Construction 10269 Old Route 31 FINGE004 New York Workers' Clyde, NY 14433 Compensation FINGER LAKES DEVELOPMENTAL CENTER 620 WEST FALL ROAD FINGE002 New York Workers' ROCHESTER, NY 14620 Compensation Finger Lakes Extrusion PO Box 558 FINGE003 New York Workers' Union Springs, NY 13160 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID FINGER LAKES TIMBER CORP INC 6237 DECKER ROAD FINGE006 New York Workers' LIVONIA, NY 14487 Compensation Finger Lakes Visiting Nurse 756 Pre-Emption Rd FINGE005 New York Workers' Geneva, NY 14456 Compensation FINGERLAKES DDSO (CORNING) 2985 GORTON RD FINGE001 New York Workers' CORNING, NY 14830 Compensation FINN-POWER 555 ALGONQUIN RD FINNP001 New York Workers' ARLINGTON HGTS, IL 60005 Compensation FIRE & CASUALTY INS CO 9 FARMS SPRINGS RD FICI01 New York Workers' FARMINGTON, CT 06032 Compensation FIRE AND WATER RESTORATION 7035 VAN BUREN ROAD FIREA001 New York Workers' SYRACUSE, NY 13209 Compensation FIRE DISTRICT MUTUAL INS WC 777 CHESTNUT RIDGE RD FIDN02 New York Workers' STE 302 Compensation CHESTNUT RIDGE, NY 10977 FIRE INSURANCE EXCHANGE PO BOX 2478 FIEX01 New York Workers' LOS ANGELES, CA 90051 Compensation FIREMAN INSURANCE CO OF WASHINGTON DC FIREM007 New York Workers' PO BOX 27827 Compensation RICHMOND, VA 23261 Firemans Fund po box 740174 FIREM010 Auto/No-Fault Atlanta, GA 30374 Fireman's Fund PO BOX 970 FIREM005 Auto/No-Fault O'Fallon, MO 63366 FIREMANS FUND 1 Chase Manhattan PLZ. Fl. 37 FIRF05 New York Workers' New York, NY 10005-1423 Compensation FIREMANS FUND 11475 GREAT OAKS WAY FIRF06 New York Workers' #200 Compensation ALPHARETTA, GA 30022 FIREMANS FUND 777 SAN MARIAN DR FIREM006 New York Workers' NOVATO, CA 94998 Compensation FIREMANS FUND P O BOX 740174 FIREM002 New York Workers' ATLANTA, GA 30374 Compensation FIREMANS FUND P.O. BOX 970 FIREM003 New York Workers' O FALLON, MO 63366 Compensation Firemans Fund Insurance 1 Progress Point Ct. FIRF03 New York Workers' Fallon, MO 63368-2216 Compensation FIREMAN'S FUND INSURANCE PO BOX 740174 FIREM009 Other WC (Non-NY) ATLANTA, GA 30374 FIREMANS FUND INSURANCE CO PO BOX 24506 FIRF10 New York Workers' TUCSON, AZ 85734 Compensation Fireman's Fund Insurance Company [Electronic] E7925B Auto/No-Fault , Fireman's Fund Insurance Company [Electronic] E8148A New York Workers' , Compensation Fireman's Fund Insurance Company [Electronic] E8148C Other WC (Non-NY) , Firemans Home 125 Harry Howard Ave. FIREM004 New York Workers' Hudson, NY 12534 Compensation Firemen's Insurance Company [Electronic] E0794C Other WC (Non-NY) , FIREMENS INSURANCE COMPANY OF 3 UNIVERSITY PLAZA FIIC01 New York Workers' WASHINGTON DC HACKENSACK, NJ 07601 Compensation FIRESTONE DISTRICT 4667 TRANSIT ROAD FIRES002 New York Workers' BUFFALO, NY 14221 Compensation FIRESTONE TIRE AND SERVICE CENT 100 VICTORY HIGHWAY FIRES001 New York Workers' PAINTED POST, NY 14870 Compensation FIRST AMHERST DEVELOPEMENT CO 4508 MAIN ST FIRST006 New York Workers' BUFFALO, NY 14226 Compensation FIRST CARDINAL INSURANCE PO BOX 2070 FIRST023 Other WC (Non-NY) LATHAM, NY 12110 FIRST COMP WC 222 SOUTH 15TH ST FCWC01 New York Workers' SUITE 1200 Compensation OMAHA, NE 68102-1608 FIRST COMP WC PO BOX 3188 FIRSTCWC01 New York Workers' OMAHA, NE 68103 Compensation First Keystone Risk Retention Group [Electronic] 4421 Aramingo Avenue FIRST002 Auto/No-Fault Philadelphia, PA 19124 FIRST LIBERTY INSURANCE CO 175 BERKELEY ST FILI01 New York Workers' 4TH FL Compensation BOSTON, MA 02117-0000 FIRST MANAGED CARE OPTION PO BOX 5010 FIRST004 New York Workers' PARSIPPANY, NJ 07054 Compensation First MCO PO Box 5010 FIRST010 Other WC (Non-NY) Parsippany, NJ 07054 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID First MCO PO Box 71 FIRST026 Other WC (Non-NY) Wilkes-Barre, PA 18703 FIRST MCO PO BOX 870 FIRST021 Other WC (Non-NY) MONROE, NY 10949 First Niagara PO BOX 410 FIRST011 New York Workers' Ashville, NY 14710 Compensation FIRST NIAGARA 555 PATROON CREEK FIRST022 New York Workers' ALBANY, NY 12206 Compensation FIRST NIAGARA RISK MANAGEMENT 239 VAN RENSSELAER ST FIRST015 New York Workers' BUFFALO, NY 14210 Compensation FIRST NIAGRA BUSINESS WORKS 777 CANAL VIEW BLVD FIRST003 New York Workers' SUITE 100 Compensation ROCHESTER, NY 14623 First Realty Management Corporation 301 Exchange Boulevard #200 FIRST020 New York Workers' Rochester, NY 14608 Compensation First Rehabilitation Life 600 Northern Boulevard FIRST005 New York Workers' Suite 310 Compensation Great Neck, NY 11021 FIRST TRANSIT P O BOX 34660 FIRST025 Other WC (Non-NY) LAS VEGAS, NV 89133 FIRST TRENTON 1 TOWER SQUARE FIRST013 Auto/No-Fault HARTFORD, CT 061839027 FIRST TRENTON PO BOX 509 FIRST012 Auto/No-Fault 225 LITTLETON ROAD MORRIS PLAINS, NJ 07950 First Unum Life Insurance 666 3rd Ave FIRST024 New York Workers' Suite 301 Compensation New York, NY 10017 Firstcomp [Electronic Indirect] PO BOX 3188 FIRST007 New York Workers' OMAHA, NE 68103 Compensation Firstcomp [Electronic Indirect] PO BOX 3188 FIRST008 Auto/No-Fault OMAHA, NE 68103 Firstcomp [Electronic Indirect] PO BOX 3188 FIRST009 Other WC (Non-NY) OMAHA, NE 68103 Firstcomp [Electronic] E2283A New York Workers' , Compensation Firstcomp [Electronic] E2283C Other WC (Non-NY) , FISHER MOVING & STORAGE 5175 SOUTHWESTEN BLVD FISHE001 New York Workers' HAMBURG, NY 14075 Compensation Fishkill Farms WC 9 Fishkill Farm Rd FISHK001 New York Workers' Hopewell Juntion, NY 12533 Compensation FISHMAN MCINTYRE ATT 2050 CENTER AVENUE FISHM001 Auto/No-Fault FORT LEE, NJ 07024 FITZHARRIS AGENCY PO BOX 9182 FHA01 New York Workers' FARMINGDALE, NY 11735 Compensation Five Corner Repair 6491 Younger Road FIVEC001 New York Workers' Bliss, NY 14024 Compensation FIVE GUYS ATTN ROBERT LEDEZMA FIVEG001 New York Workers' 3179 ERIE BOULEVARD Compensation DEWITT, NY 13214 FIVE STAR BANK 55 NORTH MAIN STREET FIVES001 New York Workers' WARSAW, NY 14569 Compensation FIVE STAR BANK 55 NORTH MAIN STREET FIVES002 New York Workers' WARSAW, NY 14569 Compensation FKI Industries, Inc. [Electronic] E3832C Other WC (Non-NY) , Flanders Group 2850 Clover Street FLAND001 New York Workers' Pittsford, NY 14534 Compensation FLEXICORPS 9611 WEST GRANT AVE FLEXI001 New York Workers' FRANKLIN PARK, IL 60131 Compensation Flexo Transparent PO BOX 128 FLEXO001 New York Workers' Buffalo, NY 14240 Compensation FLINT CREEK TRUCKING 1516 ROUTE 5 & 20 FLINT001 New York Workers' GENEVA, NY 14456 Compensation FLORI REALSTATE PO BOX 7135 FLORI006 New York Workers' PENNDEL, PA 19047 Compensation FLORIDA PANTHERS 1 PANTHER PKWY FLORI001 New York Workers' SUNRISE, FL 33323 Compensation FLORIDA SCHOOL BOARD PO BOX 10709 FLORI002 New York Workers' TALLAHASSEE, FL 32302 Compensation FLORIO CONSTRUCTION PO BOX 656 FLORI007 New York Workers' CROTON FALLS, NY 10519 Compensation Florist Mutual Insurance [Electronic Indirect] #1 HORTICULTURAL LN FLORI003 New York Workers' PO BOX 428 Compensation EDWARDSVILLE, IL 62025 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Florist Mutual Insurance [Electronic Indirect] #1 HORTICULTURAL LN FLORI004 Auto/No-Fault PO BOX 428 EDWARDSVILLE, IL 62025 Florist Mutual Insurance [Electronic Indirect] #1 HORTICULTURAL LN FLORI005 Other WC (Non-NY) PO BOX 428 EDWARDSVILLE, IL 62025 FLORISTS MUTUAL INSURANCE CO #1 HORTICULTURAL LN FLORMUT01 New York Workers' PO BOX 428 Compensation EDWARDSVILLE, IL 62025 FLUIDICS INC 9815 ROOSEVELT BLVD FLUID001 New York Workers' PHILADELPHIA, PA 19115 Compensation FLUORO-SEAL INTERNATIONAL 16360 PARK TEN PL FLUOR001 New York Workers' STE 325 Compensation HOUSTON, TX 77084 FMC PO BOX 845 FMC001 New York Workers' BUFFALO, NY 14240 Compensation FOLEY, SMIT, OBOYLE & WEISMAN 100 WILLIAM ST FROW01 New York Workers' NEW YORK, NY 10038 Compensation FOODLINK 1999 MT READ BLVD FOODL001 New York Workers' Rochester, NY 14615 Compensation Foot Locker Human Resources FOOTL001 New York Workers' 112 W 34th St Compensation New York, NY 10001 Forbes 135 Bedford Rd. FORBE001 New York Workers' Katonah, NY 10536 Compensation FORD MOTOR CO. WC 3663 LAKESHORE RD FORD01 New York Workers' BUFFALO, NY 14219 Compensation FORD MOTOR COMPANY PO BOX 607 FRD01 New York Workers' DEARBORN, MI 481210607 Compensation FORDYCE NORTH TRANSPORT 15 WATTSBURG STREET FORDY001 New York Workers' UNION CITY, PA 16438 Compensation Foremost [Electronic] E5478B Auto/No-Fault , Foremost Ins Co PO Box 258807 FOREM004 Auto/No-Fault Oklahoma City, OK 73125 Foremost Insurance Group PO BOX 268995 FOREM003 Auto/No-Fault Oklahoma City, OK 73126 FOREVER GREEN FARMS 230 PITKIN HILL ROAD FOREV001 New York Workers' JOHNSON CITY, NY 13790 Compensation Forge Industrial Staffing [Electronic] E0795A New York Workers' , Compensation Forge Industrial Staffing [Electronic] E0795C Other WC (Non-NY) , FORT EDWARD EXPRESS CO. INC PO BOX 394 FEE01 New York Workers' FORT EDWARD, NY 12828 Compensation FORTE PLUMBING & HEATING 225 PATERSON AVE FORTE001 New York Workers' WALLINGTON, NJ 07057 Compensation Founders Insurance PO BOX 1455 FOUND002 Auto/No-Fault Harrisburg, PA 17105 FountainView At College Road Po Box 480 FOUNT001 New York Workers' Lawrence, NY 11559 Compensation FOUR CORNERS CAFE 8571 NORTH MAIN ST FOURC002 New York Workers' EDEN, NY 14057 Compensation FOUR C'S MARINA 988 POINT BREEZE RD FOURC001 New York Workers' KENT, NY 14477 Compensation Four Seasons Window 23 Diane Ln FOURS001 New York Workers' Cheektowaga, NY 14225 Compensation FOX'S INSURANCE 315 W SMITH ST FOXSI001 Auto/No-Fault CORRY, PA 16407 FOXY HOME ENHANCEMENTS 5742 ELLICOTT STREET ROAD FOXYH001 New York Workers' EAST BETHANNY, NY 14054 Compensation FPI MECHANICAL 11 GREEN MOUNTAIN DRIVE FPIME001 New York Workers' COHOES, NY 12047 Compensation FRAME PRO 3551 RT 43 FRAME001 New York Workers' WEST SAND LAKE, NY 12196 Compensation FRANCIS W KING PETROLEUM 7871 TRNASIT RD FRANC002 New York Workers' E. AMHERST, NY 14051 Compensation FRANCISCAN 333 BUTTERNUT DRIVE SUITE 100 FRANC001 New York Workers' DEWITT, NY 13214 Compensation Franco Construction [Electronic] E0796A New York Workers' , Compensation Franco Construction [Electronic] E0796C Other WC (Non-NY) , FRANK BITONTI & MIGNOGNA 523 HADDON AVENUE FRANK002 Auto/No-Fault COLLINGSWOOD, NJ 08018 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Frank Lindy Plumbing 2 John Walsh Blvd FRANK006 New York Workers' peekskill, NY 10566 Compensation FRANK MISCHLERS FLORIST 118 SOUTH FOREST RD FMF01 New York Workers' WILLIAMSVILLE, NY 14221 Compensation FRANK TRIEF LAAWYER 49 WEST 37TH STREET 7TH FLOOR FRANK003 Auto/No-Fault NEW YORK, NY 10018-6216 FRANK ZAZARRO ATT 39 SOUTH FULLERTON AVENUE FRANK004 Auto/No-Fault MONTCLAIR, NJ 07072 Frankenmuth Mutual [Electronic] E6662A New York Workers' , Compensation Frankenmuth Mutual [Electronic] E6662C Other WC (Non-NY) , Franklin Mutual PO BOX 400 FRANK005 Other WC (Non-NY) Branchville, NJ 07826 FRANKS VACUUM TRUCKS SER INC 4500 ROYAL AVE FRANK001 New York Workers' NIAGARA FALLS, NY 14303 Compensation FRANZISKA RACKER CENTERS,INC 3226 WILKINS ROAD FRANZ002 New York Workers' ADMINISTRATION OFFICES Compensation ITHACA, NY 14850 Fredonia Child Development Attn: Kathy Hopkins. FREDO001 New York Workers' 145 E. Main St. Compensation Fredonia, NY 14063 Freeport Restaurant 11104 East Lake Rd. FREEP001 New York Workers' North East, PA 16428 Compensation FREMONT INSURANCE 933 E MAIN ST FREMO001 New York Workers' FREMONT, MI 49453 Compensation Fremont Insurance Co. Auto 933 East Main Street FREMO002 Auto/No-Fault Fremont, MI 49412 FRENKEL & CO 560 SYLVAN ACE FREN01 New York Workers' ENGELWOOD CLIFFS, NJ 07632 Compensation Fresno County Office of Education [Electronic] E0797A New York Workers' , Compensation Fresno County Office of Education [Electronic] E0797C Other WC (Non-NY) , Fresno County Self Insurance Group [Electronic] E0798A New York Workers' , Compensation Fresno County Self Insurance Group [Electronic] E0798C Other WC (Non-NY) , FREY ELECTRIC 100 PIERCE FREY01 New York Workers' TONAWANDA, NY 14150 Compensation FREY'S ELECTRIC 100 PEARCE AVE FREYS001 New York Workers' TONAWANDA, NY 14150 Compensation FRIEDLANDER GROUP 2500 WESTCHESTER AVE FRIED002 New York Workers' SUITE 400A Compensation PURCHASE, NY 10577 FRIENDLYS/ITHACA 323 ELMIRA ROAD FRIEN001 New York Workers' ITHACA, NY 14850 Compensation FRIGO DESIGN 5860 MCKINLEY ROAD FRIGO001 New York Workers' BREWERTON, NY 13029 Compensation FRINGE HAIRDRESSERS 79 EAST MARKET STREET FRING001 New York Workers' CORNING, NY 14830 Compensation FRITZ HARRIS & CO. P.O. BOX 9182 FRITZ001 New York Workers' FARMINGDALE, NY 11735-9182 Compensation Front Porch (Murphy and Beane) [Electronic] E0799C Other WC (Non-NY) , FRONTIER GOLF CLUB 1058 LAKE ROAD FRONT002 New York Workers' YOUNGSTOWN, NY 14174 Compensation Frontier Insurance Co 195 Lake Louise Marie Road FRONT001 New York Workers' Rock Hill, NY 12775-8000 Compensation FRY CONSTRUCTION PO BOX 185 FRYCO001 New York Workers' NEW PALASTINE, IN 46163 Compensation FS LOPKE CONTRACTING,INC 3430 STATE ROUTE 434 FSLOP001 New York Workers' APALACHIN, NY 13732 Compensation FSA SUNY COLLEGE FSA001 New York Workers' GREGORY HALL Compensation FREDONIA, NY 14063 FSA/ SUNYAB 146 FARGO QUAD FSASU001 New York Workers' BUFFALO, NY 14261 Compensation FT SEISMIC 5596 MILLS ROAD FTSEI001 New York Workers' CAMPBELL, NY 14821 Compensation FT SEISMIC SUPPORT 4520 COUNTY ROUTE 6 FTSEI002 New York Workers' AVOCA, NY 14809 Compensation FT WELLS SUPPORT 5596 MILLS ROAD FTWEL001 New York Workers' CAMPBELL, NY 14821 Compensation Fugate Enterprises / Sonic Liability 208 South Maize Road FUGAT001 Auto/No-Fault Wichita, KS 67209 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Fullerton Union High School District (CA) E1235A New York Workers' [Electronic] , Compensation Fullerton Union High School District (CA) E1235B Auto/No-Fault [Electronic] , Fullerton Union High School District (CA) E1235C Other WC (Non-NY) [Electronic] , Fulmont Community Action 20 Park Street FULMO001 New York Workers' Fonda, NY 12068 Compensation FUNK LAWN CARE 330 FILLMORE AVE FUNKL001 New York Workers' TONAWANDA, NY 14150 Compensation FURMANITE AMERICA INC ATTEN: MICHELLE HARPER FURMA001 New York Workers' 101 OLD UNDERWOOD RD BLDG E Compensation LAPORTE, TX 77571 FUSCO & MACALUSO ATT PO BOX 838 150 PASSAIC AVENUE FUSCO001 Auto/No-Fault PASSAIC, NJ 07055-4702 FUTURE CARE INC 757 THIRD AVENUE STE 1703 FUTUR004 New York Workers' NEW YORK, NY 10017 Compensation future comp 75 john roberts rd bldg c FUTUR007 New York Workers' south portland, ME 04106 Compensation FUTURE FACES DAY CARE 356 CONKLIN AVENUE FUTUR002 New York Workers' BINGHAMTON, NY 13903 Compensation FutureComp 95 Glastonbury Blvd FUTUR006 New York Workers' STE 102 Compensation Glastonbury, CT 06033 G & C PO BOX 19000 GC001 New York Workers' SYRACUSE, NY 13209 Compensation G & J Construction PO Box 255 GJCON001 New York Workers' Hemlock, NY 14466 Compensation G&L DAVIS MEAT COMPANY PO BOX 5430 GLDAV001 New York Workers' SYRACUSE, NY 13220 Compensation G. O, WICK, INC POX 305 GOWIC001 New York Workers' ELMIRA, NY 14902 Compensation GA FARM BUREAU PO BOX 7777 GAFAR001 Auto/No-Fault MACON, GA 31209 Gab Robbins - WC 3 Terri Lane GABRO001 New York Workers' Suite 1 Compensation Burlington, NJ 08016 GAB Robbins, Inc. [Electronic] E2831C Other WC (Non-NY) , Gainsco [Electronic] 730 NW 107th Ave. GAINS001 Auto/No-Fault Miami, FL 33172 GALLAGER BASSETT PO BOX 419797 GALLA022 Other WC (Non-NY) KANSAS CITY, MO 64141 GALLAGHER AND BASSETT (NF) 1HUNTINGTON QUADRANGLE 1S10 GALLA024 Other WC (Non-NY) MELVILLE, NY 11747 Gallagher Bassett P O Box 23812 GALLA004 Auto/No-Fault Tucson, AZ 85734 Gallagher Bassett Po Box 23812 GALLA001 Other WC (Non-NY) Tucson, AZ 85734 GALLAGHER BASSETT P.O. BOX 70300 GALLA026 Other WC (Non-NY) LAS VEGAS, NV 89710 GALLAGHER BASSETT PO BOX 23812 GALL01 New York Workers' TUSCON, AZ 85734 Compensation Gallagher Bassett [Electronic] E2350A New York Workers' , Compensation Gallagher Bassett [Electronic] E2350C Other WC (Non-NY) , Gallagher Bassett Services 100 Sterling Way GALLA021 New York Workers' STE:110 Compensation Mechanicsburg, PA 17050-8204 GALLAGHER BASSETT SERVICES PO BOX 4068 GALLA025 Other WC (Non-NY) ENGLEWOOD, CO 801554068 Gallagher Bassett Services, Inc. [Electronic P.O. Box 23812 GALLA002 New York Workers' Indirect] Tuscon, AZ 85734 Compensation Gallagher Bassett Services, Inc. [Electronic P.O. Box 23812 GALLA003 Other WC (Non-NY) Indirect] Tuscon, AZ 85734 GALLIANO INSURANCE PO BOX 310 GALLI001 New York Workers' LOS ANGELES, CA 70354 Compensation GALSON LABS 6601 KIRKVILLE ROAD GALSO001 New York Workers' EAST SYRACUSE, NY 13057 Compensation Garces & Grabler, P.C 235 Livingston Avenue GARCE001 Auto/No-Fault New Brunswick, NJ 08901 Garden Grove Unified School District [Electronic] E0800C Other WC (Non-NY) , Garden Regional Hospital & Med Center, Inc. E0801A New York Workers' [Electronic] , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Garden Regional Hospital & Med Center, Inc. E0801C Other WC (Non-NY) [Electronic] , GARDEN STATE REINSURANCE PO BOX 98 GARDE001 New York Workers' GLEN ROCK, NJ 074520058 Compensation GARY TAFFET ATT 50 PARK PLACE SUITE# 1227 GARYT001 Auto/No-Fault NEWARK, NJ 07102-4307 Gategourmet #836 [Electronic] E6481A New York Workers' , Compensation Gategourmet #836 [Electronic] E6481B Auto/No-Fault , Gategourmet #836 [Electronic] E6481C Other WC (Non-NY) , GATES AUTOMOTIVE 50 THRUWAY PARK DRIVE GATES001 New York Workers' HENRIETTA, NY 14586 Compensation Gates Corp DBA Gates Rubber Co [Electronic] E5885C Other WC (Non-NY) , Gates McDonald 1 Sheakley Way GATES002 New York Workers' Suite 100 Compensation Cincinnati, OH 45246-3779 Gates O'Doherty [Electronic] E0802A New York Workers' , Compensation Gates O'Doherty [Electronic] E0802C Other WC (Non-NY) , Gates O'Doherty G&G [Electronic] E0803A New York Workers' , Compensation Gates O'Doherty G&G [Electronic] E0803C Other WC (Non-NY) , GATEWAY - LONGVIEW 605 NIAGARA ST GATW02 New York Workers' BUFFALO, NY 14204 Compensation GATEWAY INS CO 1401 S BRENTWOOD BLVD GATW01 New York Workers' SUITE 1000, 10TH FL Compensation ST LOUIS, MO 63144-1416 Gateway Trans., Inc. [Electronic] E0804A New York Workers' , Compensation Gateway Trans., Inc. [Electronic] E0804C Other WC (Non-NY) , Gayle Caron - WC 22 Fox Court GAYLE001 New York Workers' Suffern, NY 10901 Compensation Gaymark Tire and Wheel 6624 Rt. 60 GAYMA001 New York Workers' Cassadaga, NY 14718 Compensation GCG 100 CHURCH STREET GCG003 New York Workers' SUITE 810 Compensation NEW YORK, NY 10007 GCG Risk Management 11 Beach Street GCGRI001 Other WC (Non-NY) London, KY 40742 GCR 3160 LAKE ROAD GCR001 New York Workers' HORSEHEADS, NY 14845 Compensation GCR TIRE 6300 BRIDGEPOINT PARKWAY GCRTI001 New York Workers' SUITE #200 Compensation AUSTIN, TX 78730 GE Auto [Electronic] E8322B Auto/No-Fault , GE Auto [Electronic] E8322C Other WC (Non-NY) , GE HEALTH AND DISABILITY PO BOX 15065 GEHD01 New York Workers' ALBANY, NY 12212 Compensation Geico One Geico Landing GEICO019 Auto/No-Fault Virginia Beach, VA 23454 Geico P O BOX 9507 GEICO004 Auto/No-Fault Fredericksburg, VA 22403-9526 Geico PO Box 9091 GEICO008 Auto/No-Fault Macon, GA 31208 GEICO 1 GEICO BLVD GEICO012 Auto/No-Fault FREDERICKSBURG, VA 22412 GEICO 1 GEICO CENTER GEICO018 Auto/No-Fault MACON, GA 31296 GEICO 4201 SPRING VALLEY RD GEICO029 Auto/No-Fault DALLAS, TX 75244 GEICO 5260 WESTON ROAD GEICO013 Auto/No-Fault CHEVY CHASE, MD 20815 GEICO 750 WOODBURY RD GEICO009 Auto/No-Fault WOODBURY, NY 11797 GEICO 750 WOODBURY RD GEICO2 New York Workers' WOODBURY, NY 11797 Compensation GEICO 8000 LINCOLN DR GEICO010 Auto/No-Fault MARLTON, NJ 08053 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GEICO ONE GEICO PLAZA GEIC01 New York Workers' WASHINGTON, DC 20076 Compensation GEICO ONE GEICO PLAZA GEICO027 Auto/No-Fault WASHINGTON, DC 20076-0001 GEICO PO BOX 509090 GEICO014 Auto/No-Fault SAN DIEGO, CA 92186 GEICO PO BOX 509119 GEICO020 Auto/No-Fault SAN DIEGO, CA 92150 GEICO PO BOX 9518 GEICO028 Auto/No-Fault FREDERICKSBURG, VA 22403 Geico - DOS PO BOX 9515 GEICO025 Auto/No-Fault Fredericksburg, VA 22403-9515 GEICO (AUTO CLMS FOR PA) PO BOX 9505 GEICO015 Auto/No-Fault FREDERICKSBURG, VA 22403 Geico [Electronic] E1155B Auto/No-Fault , GEICO DIRECT PO BOX 116 GEICO031 Auto/No-Fault WOODBURY, NY 11797 GEICO INSURANCE 300 CROSSPOINT PKWY GEICO016 Auto/No-Fault ATTN CLAIMS GETZVILLE, NY 14068 GELMAN & GELMAN 1 BROADWAY SUITE# 401 GELMA001 Auto/No-Fault ELMWOOD PARK, NJ 07407 GENERAL ACCIDENT PO BOX 303 GENA03 New York Workers' Compensation BUFFALO, NY 14240-0302 GENERAL ACCIDENT PO BOX 4860 GENA01 New York Workers' 973 JAMES ST Compensation SYRACUSE, NY 13203 GENERAL ELECTRIC 2901 EAST LAKE ROAD GENER004 New York Workers' ERIE, PA 16501 Compensation GENERAL MOTORS PO BOX 69 GENM01 New York Workers' SOUTHFIELD, MI 48037 Compensation General Parts International [Electronic] E1236A New York Workers' , Compensation General Parts International [Electronic] E1236B Auto/No-Fault , General Parts International [Electronic] E1236C Other WC (Non-NY) , GENESEE COUNTY ARC 64 Walnut Street GENES002 New York Workers' BATAVIA, NY 14020 Compensation GENESEE COUNTY SELF INS 15 MAIN ST GEN02 New York Workers' BATAVIA, NY 14020 Compensation GENESEE GRANDE HOTEL 1060 EAST GENESEE STREET GENES001 New York Workers' SYRACUSE, NY 13210 Compensation Genesis Construction [Electronic] E0805A New York Workers' , Compensation Genesis Construction [Electronic] E0805C Other WC (Non-NY) , GENESIS INSURANCE CO PO BOX 10352 GIC01 New York Workers' FINANCIAL CENTRE - B4 Compensation STAMFORD, CT 06904-2352 Geneva Homes 947 Waterloo Geneva Road GENEV001 New York Workers' Waterloo, NY 13165 Compensation Geneva Housing Authority PO BOX 153 GENEV002 New York Workers' GENEVA, NY 14456 Compensation GENEX 5795 WIDEWATERS PKWY GENX01 New York Workers' SYRACUSE, NY 13214 Compensation GENEX P.O. BOX 469010 GENEX004 New York Workers' SAN ANTOINIO, TX 78246 Compensation GENEX 2950 EXPRESSWAY DR SOUTH GENX02 New York Workers' Compensation ISLANDIA, NY 11722 GENEX Services 555 Route 1 South GENEX001 Auto/No-Fault Iselin, NJ 08830 Genex Services / WC 5795 Widewaters Parkway GENEX003 Other WC (Non-NY) Dewitt, NY 13214 GENEX SERVICES/PDM 2241 LAVA RIDGE COURT, STE #1 GENEX002 New York Workers' ROSEVILLE, CA 95661 Compensation GEO [Electronic] E1302A New York Workers' , Compensation GEO [Electronic] E1302C Other WC (Non-NY) , GEORGEN-MACKWIRTH 765 HERTLE AVE GEMA01 New York Workers' BUFFALO, NY 14207 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GEORGIA PACIFIC COMP PO BOX 105605 GEPC01 New York Workers' ATLANTA, GA 30348 Compensation GEORGINE'S 3915 RT 413 GEORG001 New York Workers' LEVITTOWN, PA 19056 Compensation GERALD F MISKIS Auto 1125 ATLANTIC AVENUE SUITE 647 GERAL001 Auto/No-Fault ATLANTIC CITY, NJ 08401 GERBER & GERBER 26 COURT ST SUITE 1405 GERBE001 Auto/No-Fault AUTO CLAIMS BROOKLYN, NY 11242 GERHART SCALE 390 VICTORY HIGHWAY GERHA001 New York Workers' PAINTED POST, NY 14870 Compensation GERMANIA SELECT INS PO BOX 645 GERMA001 Auto/No-Fault BRENHAM, TX 77834 GEVA THEATRE 75 WOODBURY BLVD GEVAT001 New York Workers' ROCHESTER, NY 14607 Compensation GHI EMBLEM COMP PO BOX 2832 GHIEM001 New York Workers' NEW YORK, NY 10116 Compensation GILBERT'S CONSULTING 300 EAST STATE STREET GILBE001 New York Workers' SHARON, PA 16146 Compensation Gilroy, Kernan, & Gilroy 210 CLINTON ROAD GILRO001 New York Workers' PO BOX 542 Compensation NEW HARTFORD, NY 13413 GINSBERG FOODS WC PO BOX 17 GINSB001 New York Workers' HUDSON, NY 12534 Compensation Glacier Bay PO Box 2070 GLACI001 New York Workers' Latham, NY 12110 Compensation Glatfelter Claims Inc. PO BOX 5126 VFIS001 New York Workers' YORK, PA 17405 Compensation GLATFELTER CLAIMS MANAGEMENT PO BOX 5126 GLATF001 Other WC (Non-NY) YORK, PA 17405 Glendale Elementary School District #40 E0806A New York Workers' [Electronic] , Compensation Glendale Elementary School District #40 E0806C Other WC (Non-NY) [Electronic] , GLENNS FALLS EYE ASSOCIATES 535 BAY ROAD GLENN002 New York Workers' SUITE 1 Compensation GLENS FALLS, NY 12804 GLENNS FALLS HOSPITAL 100 PARK STREET GLENN001 New York Workers' GLENNS FALLS, NY 12801 Compensation GLOBAL ESTAFIN 800 SOUTH BRONX GLOBA006 New York Workers' TRENTON, NJ 08618 Compensation Global Indemnity Group PO Box 532 GLOBA007 Auto/No-Fault Willow Grove, PA 19090 GLOBAL INDUSTRIES 5677 PENNA AVE GLOBA004 New York Workers' APALACHIN, NY 13732 Compensation GLOBAL LIBERTY PO BOX 100 GLOBA008 Auto/No-Fault PLAINVIEW, NY 11803 GLOBAL LIBERTY INS PO BOX 100 GLOBA003 New York Workers' PLAINVIEW, NY 11803 Compensation GLOBAL LIBERTY INS OF NY PO BOX 100 GLOBA002 Auto/No-Fault PLAINVIEW, NY 11803 Global Sports Services PO Box 1149 GLOBA001 New York Workers' Amarillo, TX 79105 Compensation GLOBAL TERMINAL PO BOX 273 GLOBA005 New York Workers' JERSEY CITY, NJ 07305 Compensation Glove House Inc 220 Franklin St GLOVE002 New York Workers' Elmira, NY 14904 Compensation GLR SERVICES & CONTRACTING 11216 RIVER ROAD GLRSE001 New York Workers' CORNING, NY 14830 Compensation GM NATIONAL BENEFITS STR PO BOX 14594 GMNB01 New York Workers' LEXINGTON, KY 40512 Compensation GM Sipes Construction / WC PO Box 109 GMSIP001 Other WC (Non-NY) Rushville, IL 62681 GMAC 500 West 5th Street GMAC002 Auto/No-Fault WINSTON SALEM, NC 27102 GMAC PO BOX 1040 GMAC004 New York Workers' WINSTON SALEM, NC 27102 Compensation GMAC Insurance PO BOX 1623 GMACI001 Auto/No-Fault WINSTON SALEM, NC 27102 GMAC INSURANCE PO BOX 3199 GMACI003 Auto/No-Fault WINSTON SALEM, NC 27102-3199 Gold Mine Jewelry attn: Joyce GOLDM001 New York Workers' 25 Liberty Street Compensation Bath, NY 14810 Golden Corral Corporation [Electronic] E3300C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GOLDEN DAWN 7115 NEW FALLS RD GOLDE003 New York Workers' LEVITTOWN, PA 19055 Compensation Golden Eagle [Electronic] E7646A New York Workers' , Compensation Golden Eagle [Electronic] E7646C Other WC (Non-NY) , GOLDEN RULE 7440 WOODLAND DRIVE GOLDE002 Auto/No-Fault INDIANAPOLIS, IN 46278 Golden State Supply [Electronic] E4030A New York Workers' , Compensation Golden State Supply [Electronic] E4030B Auto/No-Fault , Golden State Supply [Electronic] E4030C Other WC (Non-NY) , GOLDEN VALLEY TRANSPORT PO BOX 3918 GOLDE001 New York Workers' ATTN: DIXIE Compensation MERCED, CA 95344 Golub Corp attn: Workers Comp GOLUB002 New York Workers' 461 Nott Street Compensation Schenectady, NY 12308 GOLUB CORPORATION PO BOX 1074 GOLU02 New York Workers' SCHENECTADY, NY 12301 Compensation Good Samaritan Hospital / Liability 605 N 12th Street GOODS001 Auto/No-Fault Mt. Vernon, IL 62864 Good Samaritan Hospital [Electronic] E1237A New York Workers' , Compensation Good Samaritan Hospital [Electronic] E1237B Auto/No-Fault , Good Samaritan Hospital [Electronic] E1237C Other WC (Non-NY) , Goodrich [Electronic] E1303A New York Workers' , Compensation Goodrich [Electronic] E1303C Other WC (Non-NY) , GOODRICH AUTO WORKS 7255 WORTH ROAD GOODR001 New York Workers' BATH, NY 14810 Compensation Goodwill Industries [Electronic] E1238A New York Workers' , Compensation Goodwill Industries [Electronic] E1238B Auto/No-Fault , Goodwill Industries [Electronic] E1238C Other WC (Non-NY) , GORDON TRUCK LEASING 835 EAST LYCOMING ST GORDO001 New York Workers' PHILADELPHIA, PA 19111 Compensation GP 50 NEWYORK ATTN: JENNIFER 2770 LONG RD GP50N001 New York Workers' GRANDISLAND, NY 14072 Compensation GPM ASSOCIATES 10 FORBES STREET GPMAS001 New York Workers' DANSVILLE, NY 14437 Compensation GRAFIC ART MUTUAL 180 GENESEE ST GRAM01 New York Workers' NEW HARTFORD, NY 13413 Compensation graham corp 20 florence ave GRAHA001 New York Workers' batavia, NY 14020 Compensation GRANAHAN ELECTRIC PO BOX 1866 GRANA001 New York Workers' DOYLESTOWN, PA 18901 Compensation GRANCO FEED 299 WAVERLY AVE GRANC001 New York Workers' SPRINGVILLE, NY 14141 Compensation GRAND CENTRAL PLAZA INC 1020 CENTER ST GRAND001 New York Workers' SUITE 4 Compensation HORSEHEADS, NY 14845 GRAND ISLAND SCHOOL 1100 RANSOM RD GRAND003 New York Workers' GRAND ISLAND, NY 14072 Compensation Grand River Insurance (AUTO Only) [Electronic] E1150B Auto/No-Fault , Grand River Insurance (WC Only) [Electronic] E1151A New York Workers' , Compensation Grand River Insurance (WC Only) [Electronic] E1151C Other WC (Non-NY) , GRAND VALLEY FIRE DEPT ATTN PRES NEVEL-W/C CLAIM GRAND002 New York Workers' MAIN STREET Compensation GRAND VALLEY, PA 16420 Grange Mutual Casualty Company [Electronic] E8873B Auto/No-Fault , Grange WC [Electronic] E4264A New York Workers' , Compensation Grange WC [Electronic] E4264C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GRANITE WORKS 133 WILLIAM DONNELLY PARKWAY GRANI001 New York Workers' WAVERLY, NY 14892 Compensation Grant Ave Development 69 South Street GRANT001 New York Workers' Auburn, NY 13021 Compensation Grant Street Construction 48 Grant Street GRANT002 New York Workers' Cortland, NY 13045 Compensation Graphic Arts Mutual [Electronic] E4895C Other WC (Non-NY) , Graphic Arts Mutual Ins PO Box 5310 GRAPH001 New York Workers' Bonghampton, NY 13902 Compensation GRAPHIC ARTS MUTUAL INS CO PO BOX 530 GRAP01 New York Workers' UTICA, NY 13503 Compensation GRAPHIC SOLUTIONS 100 VILLAGE SQUARE GRAPH002 New York Workers' PAINTED POST, NY 14870 Compensation Gray Metal Products 495 Rochester ST GRAYM001 New York Workers' Attn Patty Mager Compensation Avon, NY 14414 GREAT AMERICAN 500 LANIPEX CENTER GREA01 New York Workers' PARSIPPANY, NJ 07054 Compensation Great American Alliance Ins Co. [Electronic] E5047C Other WC (Non-NY) , Great American Assurance Co. [Electronic] E1280C Other WC (Non-NY) , Great American Ins Group 5 Waterside Crossing GREAT016 New York Workers' STE 3 Compensation Windsor, CT 06095 Great American Ins. Co. [Electronic] E4612C Other WC (Non-NY) , Great American Ins. Co. of N.Y. [Electronic] E3060C Other WC (Non-NY) , Great American Insurance 301 East 4th Street GREAT015 Auto/No-Fault Cincinnati, OH 45202 Great American Insurance 401 Plymouth Rd. GREAT005 New York Workers' Suite 100 Compensation Plymouth Meeting, PA 19462 GREAT AMERICAN STRATEGIC COMP CLAIMS PO BOX 5789 GREAT020 New York Workers' CINCINNATI, OH 45201 Compensation Great Central PO BOX 807 GREAT001 New York Workers' Peoria, IL 65612 Compensation Great Central [Electronic] E6515A New York Workers' , Compensation Great Central [Electronic] E6515B Auto/No-Fault , Great Central [Electronic] E6515C Other WC (Non-NY) , GREAT DIVIDE INS CO PO BOX 141299 GREAT003 New York Workers' IRVING, TX 75014 Compensation Great Divide Insurance [Electronic] E9227A New York Workers' , Compensation Great Divide Insurance [Electronic] E9227C Other WC (Non-NY) , GREAT DIVIDE INSURANCE CO 7233 EAST BUTHERUS DRIVE GRD01 New York Workers' SCOTTSDALE, AZ 85260 Compensation GREAT ESCAPE PO BOX 511 GREAT012 New York Workers' LAKE GEORGE, NY 12845 Compensation GREAT ESCAPE LODGE P.O. BOX 511 GREAT011 New York Workers' LAKE GEORGE, NY 12845 Compensation GREAT LAKE DREDGE 2122 YORK RD. GREAT004 New York Workers' OAK BROOK, IL 60523 Compensation GREAT LAKES CASE&CABINET ATTN W/C DEPT GREAT010 New York Workers' 18433 SCIOTA RD Compensation CORRY, PA 16407 GREAT LAKES CONCRETE 5690 CAMP RD GREAT009 New York Workers' HAMBURG, NY 14075 Compensation Great Lakes Ins. Services Group Attn: Pete Zaphiris GREAT018 New York Workers' 3205 Peach St. Compensation Erie,, PA 16508 GREAT LAKES ORTHODONTICS 200 COOPER AVE GREAT013 New York Workers' TONAWANDA, NY 14150 Compensation GREAT NORTHERN INS P O BOX 1903 GREAT014 New York Workers' NEW HAVEN, CT 06509 Compensation GREAT NORTHERN INSURANCE CO PO BOX 1615 GRN01 New York Workers' WARREN, NJ 07061 Compensation Great Wall Logistics 188 JEFFERSON ST GREAT002 New York Workers' ST 192 Compensation NEWARK, NJ 07105 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GREAT WEST CASUALITY PO BOX 277 GRWC01 New York Workers' SO SIOUX CITY, NE 68776-0277 Compensation Great West Casualty Po Box 94 GREAT019 New York Workers' South Sioux City, NE 68776 Compensation Great West Casualty / WC PO Box 277 GREAT008 Auto/No-Fault South Sioux City, NE 68776 Great West Casualty [Electronic] E1126A New York Workers' , Compensation Great West Casualty [Electronic] E1126C Other WC (Non-NY) , GREAT WESTERN INSURANCE 301 EAST 4TH ST GREAT017 New York Workers' CINCINATTI, OH 45202 Compensation GREATER NY INSURANCE 200 MADISON AVE GRNI01 New York Workers' NEW YORK, NY 10016 Compensation Greco Painting 790 Washington St. GRECO001 New York Workers' Geneva, NY 14456 Compensation GREEK PEAK SKI RESORT 200 NYS RT 392 GPSR01 New York Workers' CORTLAND, NY 13045 Compensation Green Diamond WA [Electronic] E1239A New York Workers' , Compensation Green Diamond WA [Electronic] E1239B Auto/No-Fault , Green Diamond WA [Electronic] E1239C Other WC (Non-NY) , GREEN ENVIROMENTAL INC 8335 QUARRY RD GREEN007 New York Workers' NIAGARA FALLS, NY 14304 Compensation GREEN HILLS FARMS 5933 SOUTH SALINA STREET GREEN003 New York Workers' SYRACUSE, NY 13205 Compensation Green Home Nursing Home 37 Central Avenue GREEN002 New York Workers' Wellsboro, PA 16901 Compensation GREEN TREE ADMIN INC. PO BOX 7306 GRTA01 New York Workers' BEAUMONT, TX 77726 Compensation GREEN TREE SCHOOL 146 WEST WALNUT LANE GREEN004 New York Workers' PHILADELPHIA, PA 19144 Compensation Greenbelt Industries 45 Comet Ave GREEN001 New York Workers' Buffalo, NY 14216 Compensation Greene Rad Maloney [Electronic] E0807A New York Workers' , Compensation Greene Rad Maloney [Electronic] E0807C Other WC (Non-NY) , GREENFIELD HEALTH/REHAB CENTER 5949 BROADWAY GREEN006 New York Workers' LANCASTER, NY 14059 Compensation GREENFIELD HEALTH/REHAB CENTER 752 CENTER ST GREEN005 New York Workers' EAST AURORA, NY 14052 Compensation GREENWICH INSURANCE CO 1201 NORTH MARKET ST GREW01 New York Workers' WILMINGTON, DE 19801 Compensation Greer Constructon CO [Electronic] E0808A New York Workers' , Compensation Greer Constructon CO [Electronic] E0808C Other WC (Non-NY) , GREGORY E. SCIOLLA LLP 712 EAST MAIN STREET SUITE 1A GREGO001 Auto/No-Fault MOORESTOWN, NJ 08057 Greif Brothers Corporation [Electronic] E0809A New York Workers' , Compensation Greif Brothers Corporation [Electronic] E0809C Other WC (Non-NY) , Greve Clifford Wengel & Paras [Electronic] E0810A New York Workers' , Compensation Greve Clifford Wengel & Paras [Electronic] E0810C Other WC (Non-NY) , GRIDLEY EXCAVATING 41 RIVER RD GRIDL001 New York Workers' CORNING, NY 14830 Compensation Grimmway Enterprises, Inc. [Electronic] E0811A New York Workers' , Compensation Grimmway Enterprises, Inc. [Electronic] E0811C Other WC (Non-NY) , Grinnell Mutual / Liability PO Box 790 GRINN001 Auto/No-Fault 4215 Highway 146 Grinnell, IA 50112 Grinnell Reinsurance Company [Electronic] E1378B Auto/No-Fault , Grinnell Reinsurance Company [Electronic] E1378C Other WC (Non-NY) , Grinnell Select [Electronic] E0812B Auto/No-Fault , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Grinnell Select [Electronic] E0812C Other WC (Non-NY) , GRNAGE INSURANCE COMPANY PO BOX 1218 GRNAG001 Auto/No-Fault COLUMBUS, OH 43216 GROOVE ROOFING 131 READING ST GRVR01 New York Workers' BUFFALO, NY 14220 Compensation Groveland Correctional Facility 7000 Sonyea Road GROVE001 New York Workers' Sonyea, NY 14556 Compensation GROWERS CO-OP 112 N PORTAGE ST GROWE001 New York Workers' WESTFIELD, NY 14787 Compensation Grundfos Manufacturing Corporation [Electronic] E0813A New York Workers' , Compensation Grundfos Manufacturing Corporation [Electronic] E0813C Other WC (Non-NY) , GS Metals [Electronic] E0814A New York Workers' , Compensation GS Metals [Electronic] E0814C Other WC (Non-NY) , Gse Lining Technology, Inc. [Electronic] E9125C Other WC (Non-NY) , GST BOCES 431 PHILO ROAD GSTBO001 New York Workers' ELMIRA, NY 14903 Compensation GTL CONSTRUCTION LLC 1230 MAMARONECK AVE GTLCO001 New York Workers' WHITE PLAINS, NY 10605 Compensation Guarantee Funds Management Services One Bowdoin Square GUARA002 New York Workers' 2nd Floor Compensation Boston, MA 02114 Guarantee Insurance P.O. Box 958470 GUARA006 New York Workers' Lake Mary, FL 32795 Compensation Guarantee Insurance Co 401 East Las Olas Blvd GUARA007 New York Workers' Fort Lauderdale, FL 33301 Compensation Guarantee Insurance Co PO Box 1160 GUARA003 New York Workers' Canonsburg, PA 15317 Compensation Guarantee Insurance Co - W 401 E LAS OLAS BLVD GUARA001 New York Workers' Fort Lauderdale, FL 33301-2247 Compensation Guarantee Trust Life Insurance p.o. box 1144 GUARA004 New York Workers' glenview, IL 60025 Compensation Guard [Electronic] E0815A New York Workers' , Compensation Guard [Electronic] E0815C Other WC (Non-NY) , Guard Contracting 3755 River Road GUARD007 New York Workers' Tonawanda, NY 14150 Compensation Guard Insurance PO BOX 1368 GUARD006 New York Workers' Wilks-Barre, PA 18703 Compensation Guard Insurance Group PO Box A-H, 16 S. River St. GUARD008 New York Workers' Wilkes-Barre, PA 18703 Compensation GUARDIAN INSURANCE CO PO BOX 26150 GUARD001 New York Workers' LEHIGH VALLEY, PA 18002 Compensation Guardian Life Ins Of America 7 Hanover Square GUARD004 New York Workers' New York, NY 10004 Compensation GUARNATEE INSURANCE COMPANY 401 E LAS OLAS BLVD GUIC01 New York Workers' STE 1540 Compensation FT LAUDERDALE, FL 33301-2247 GUIDE ONE INS PO BOX 14543 GUOI02 New York Workers' DES MOINES, IA 50306 Compensation GUIDEONE 1025 ASHWORTH RD GUIP01 New York Workers' STE 101 Compensation WEST DES MOINES, IA 50265 GUIDEONE 1111 ASHWORTH RD GUIP02 New York Workers' WEST DES MOINES, IA 50265 Compensation GUIDEONE PO BOX 71652 GUOI01 New York Workers' DES MOINES, IA 50325 Compensation GuideOne Elite Insurance [Electronic] E1240A New York Workers' , Compensation GuideOne Elite Insurance [Electronic] E1240B Auto/No-Fault , GuideOne Elite Insurance [Electronic] E1240C Other WC (Non-NY) , GuideOne Mutual Insurance [Electronic] E1241A New York Workers' , Compensation GuideOne Mutual Insurance [Electronic] E1241B Auto/No-Fault , GuideOne Mutual Insurance [Electronic] E1241C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID GUILDERLAND CENTER NURSING HOME P.O. BOX 36 GUILD001 New York Workers' GUILDERLAND CENTER, NY 12085 Compensation GUILDERLAND CENTER REHABILITATION 428 ROUTE 146 GUILD002 New York Workers' GUILDERLAND CENTER, NY 12085 Compensation GULF COAST CLAIM SVCS 11505 CHIMNEY ROCK GUCC01 New York Workers' HUSTON, TX 77035 Compensation GULF INS PO BOX 660281 GULFI001 New York Workers' DALLAS, TX 75266 Compensation GULF INSURANCE PO BOX 130446 GULFI002 New York Workers' DALLAS, TX 75313 Compensation GUNLOCKE COMPANY INC. 1 GUNLOCK DR GUNLO001 New York Workers' WAYLAND, NY 14572 Compensation Guthrie Clinic Employees Inc 1 Guthrie Square GUTHR001 New York Workers' Sayre, PA 18840 Compensation Guthrie Clinic Endoscopy Suite 1 Guthrie Square GUTHR002 New York Workers' Sayre, PA 18840 Compensation Guthrie Same Day Surgery 31 Arnot Road GUTHR003 New York Workers' Big Flats, NY 14814 Compensation GWINNETTE SCHOOLS 53 GWINNETTE DR GWSC01 New York Workers' BLDG A Compensation LAWRENCEVILLE, GA 30046 Gypsum Express 8280 Sixty Rd. GYPSU004 New York Workers' Baldwinsville, NY 13027 Compensation GYPSUM SYSTEMS INCORPORATED PO BOX 449 GYPSU002 New York Workers' ELMA, NY 14059 Compensation GYPSUM SYSTEMS INTERIORS, LTD 6055 LOOMIS ROAD GYPSU003 New York Workers' FARMINGTON, NY 14425 Compensation H & R Block [Electronic] E1242A New York Workers' , Compensation H & R Block [Electronic] E1242B Auto/No-Fault , H & R Block [Electronic] E1242C Other WC (Non-NY) , H AND M EQUIPMENT 4551 STATE HIGHWAY 30 HANDM001 New York Workers' AMSTERDAM, NY 12010 Compensation H W STREETER PAVING PO BOX 184 HWSTR001 New York Workers' PINE CITY, NY 14871 Compensation H. D. E. ELECTRIC INC 5841 SENECA ST HDEEL001 New York Workers' ELMA, NY 14059 Compensation H. P. Neun Insurance 75 N. Main Street HPNEU001 New York Workers' Fairport, NY 14450 Compensation H.H. DOBBINS 99 WEST AVE HHD01 New York Workers' LYNDONVILLE, NY 14098 Compensation HADDAD'S TRUCKING 221 CURRYHALLOW RD HADDA001 New York Workers' PITTSBURG, PA 15236 Compensation HADLEY EXHIBITS INC 1700 ELMWOOD AVENUE HADLE001 New York Workers' BUFFALO, NY 14207 Compensation HAGEN PET FOODS INC BROAD STREET EXT HAGEN001 New York Workers' PO BOX 29 Compensation WAVERLY, NY 14892 HAGERTY 188 INVERNESS DRIVE WEST HAGER002 Auto/No-Fault SUITE 600 ENGLEWOOD, CO 80112 Hagerty Ins. P.O. Box 87 HAGER001 Auto/No-Fault Traverse City, MI 49685 HAINES EQUIPMENT INC 20CARRINGTON STREET HAINE001 New York Workers' AVOCA, NY 14809 Compensation HAITZ CONTRACTING 4754 E SAILE DR HAITZ001 New York Workers' BATAVIA, NY 14020 Compensation HAKES CONSTRUCTION 4644 MEADS CREEK ROAD HAKES001 New York Workers' PAINTED POST, NY 14870 Compensation HALCO 865 County Road 6 HALCO001 New York Workers' Phelps, NY 14532 Compensation HALE CONTRACTING 2054 GRAND CENTRAL AVE HALEC001 New York Workers' HORSEHEADS, NY 14845 Compensation HALLMARK MANAGEMENT PO BOX 22478 HALLM001 New York Workers' OKLAHOMA CITY, OK 73123 Compensation HALL'S HOME & LUMBER 18759 ROUTE 287 HALLS001 New York Workers' TIOGA, PA 16946 Compensation HALSTEAD COMMUNICATIONS 13 COMMERCE DRIVE HALST001 New York Workers' BALLSTON SPA, NY 12020 Compensation HAMBURG OVERHEAD DOOR 5659 HERMAN HILL RD HAMBU001 New York Workers' HAMBURG, NY 14075 Compensation Hamilton Mutual - AUTO [Electronic] E5139B Auto/No-Fault , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Hamilton Mutual - WC [Electronic] E3469A New York Workers' , Compensation Hamilton Mutual - WC [Electronic] E3469C Other WC (Non-NY) , HAMILTON PRINTING 22 HAMILTON WAY HAMIL001 New York Workers' CASTLETON, NY 12033 Compensation HAMILTON YAMAHA 2635 SOUTH BROAD STREET HAMIL002 New York Workers' HAMILTON, NJ 08610 Compensation HAMMOND SAFETY MANAGEMENT,LLC 6800 JERICHO TURNPIKE STE 105W HAMMO003 New York Workers' SYOSSET, NY 11791 Compensation HAMMOND SAFETY MGT LLC 1983 MARCUS AVE HAMMO002 New York Workers' SUITE C-102 Compensation LAKE SUCCESS, NY 11012-0408 HAMMONDSPORT FIRE DISTRICT PO BOX 676 HAMMO001 New York Workers' HAMMONDSPORT, NY 14840 Compensation HAMPTON INN 9775 VICTORY HIGHWAY HAMPT001 New York Workers' PAINTED POST, NY 14870-9194 Compensation HANDICAPP CHILDREN ASSOCIATION 139 GRAND AVENUE HANDI001 New York Workers' JOHNSON CITY, NY 13790 Compensation HANNAFORD [Electronic Indirect] PO BOX 32045 HANNA001 New York Workers' LAKELAND, FL 33802 Compensation HANNAFORD [Electronic Indirect] PO BOX 32045 HANNA002 Other WC (Non-NY) LAKELAND, FL 33802 Hannaford [Electronic] E1304A New York Workers' , Compensation Hannaford [Electronic] E1304C Other WC (Non-NY) , HANNAFORD BROS CO 1112 COMMERCIAL DR HANN01 New York Workers' NEW HARTFORD, NY 13413 Compensation HANNAFORD BROTHERS P.O. BOX 1000 HANNA003 New York Workers' PORTLAND, MN 04104 Compensation HANNAFORD BROTHERS WC SELF INSURED 970 ROUTE 9 HANN02 New York Workers' SCHODACK LANDING, NY 12156 Compensation Hanover PO BOX 15146 HANOV004 Auto/No-Fault Worcester, MA 07615 HANOVER INSURANCE PO BOX 15144 HANOV003 New York Workers' WORCESTER, MA 01615 Compensation Hanover Insurance Company [Electronic] E1379B Auto/No-Fault , Hanover Insurance Company [Electronic] E1379C Other WC (Non-NY) , Hanover Insurance Group Workers Compensation HANOV005 Other WC (Non-NY) PO Box 15144 Worcester, MA 01615 Hanover Lloyd's Insurance Company [Electronic] E1380B Auto/No-Fault , Hanover Lloyd's Insurance Company [Electronic] E1380C Other WC (Non-NY) , HANSEN TRUCKING RR 1 BOX 195AA HANSE001 New York Workers' 570-744-2251, PA 18837 Compensation HARCO NATIONAL PO BOX 68309 HARC01 New York Workers' SCHAUMBURG, IL 60168-0309 Compensation HARCO NATIONAL INS CO PO BOX 68309 HARCO001 Auto/No-Fault schaumburg, IL 60168-0309 HARD MANUFACTURING 230 GRIDER ST HARDM001 New York Workers' BUFFALO, NY 14215 Compensation HARDINGE INC 1 HARDINGE DRIVE HARDI001 New York Workers' PO BOX 1507 Compensation ELMIRA, NY 14902 Harford Mutual Insurance 200 N. Main Street HARFO001 Auto/No-Fault Bel Air, MD 21014 Harleysville 355 Maple Avenue HARLE001 New York Workers' Harleysville, PA 19455 Compensation HARLEYSVILLE 120 FRONT ST HARL01 New York Workers' SUITE 500 Compensation WORCESTER, MA 01608 HARLEYSVILLE INS PO BOX 199 HARLE014 Auto/No-Fault HARLEYSVILLE, PA 19438 HARLEYSVILLE INS PO BOX 244 HARLE009 Auto/No-Fault HARLEYSVILLE, PA 19438 HARLEYSVILLE INS NYWC CENTRAL CLAIMS UNIT HARLE011 New York Workers' PO BOX 244 Compensation HARLEYSVILLE, PA 19438 HARLEYSVILLE INS WC CENTRAL CLAIMS UNIT HARLE010 Other WC (Non-NY) PO BOX 244 HARLEYSVILLE, PA 19438 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Harleysville Ins.WC (MidAtlantic claims) P.O. Box 198 HARLE012 New York Workers' Harleysville, PA 19438-9919 Compensation Harleysville Insurance 120 Front Street HARLE007 New York Workers' Suite 400 Compensation Worcester, MA 01608 Harleysville Insurance P.O. Box 198 HARLE013 Auto/No-Fault Harleysville, NJ 19438-9919 Harleysville Insurance Company [Electronic] E1243A New York Workers' , Compensation Harleysville Insurance Company [Electronic] E1243B Auto/No-Fault , Harleysville Insurance Company [Electronic] E1243C Other WC (Non-NY) , HARMAC MED PRODUCTS 2201 BAILEY AVE HARMA001 New York Workers' BUFFALO, NY 14211 Compensation Harris County [Electronic] E0816C Other WC (Non-NY) , HARRIS HILL NURSING FAC 2699 WEHRLE DR HARRI001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation HARRIS RF COMMUNICATIONS 1680 University Avenue HARRI002 New York Workers' ROCHESTER, NY 14610 Compensation HARRISON BURROWS BRIDGE CO. P.O. BOX 335 HARRI003 New York Workers' 22 HAMILTON LANE Compensation GLENMONT, NY 12077 Hartford Po Box 14269 HARTF004 Auto/No-Fault Lexington, KY 40512 HARTFORD PO BOX 14170 HARTF005 Other WC (Non-NY) LEXINGTON, KY 40512 HARTFORD PO BOX 14170 HATI01 New York Workers' LEXINGTON, KY 40512 Compensation Hartford Accident and Indemnity Company E1381B Auto/No-Fault [Electronic] , Hartford Casualty Insurance Company [Electronic] E1382B Auto/No-Fault , Hartford Fire Insurance Company [Electronic] E1383B Auto/No-Fault , Hartford Insurance Company of the Midwest E1384B Auto/No-Fault [Electronic] , Hartford Life and Accident Insurance Company E1385B Auto/No-Fault [Electronic] , Hartford Life and Annuity Insurance Company E1386B Auto/No-Fault [Electronic] , Hartford Life Insurance Company [Electronic] E1387B Auto/No-Fault , Hartford Underwriters Insurance Company E1388B Auto/No-Fault [Electronic] , Hastings College of the Law [Electronic] E0817A New York Workers' , Compensation Hastings College of the Law [Electronic] E0817C Other WC (Non-NY) , Hastings Mutual Insurance 404 E. Woodlawn Ave. HASTI001 New York Workers' Hastings, MI 49058 Compensation Hawkeye [Electronic] E2827A New York Workers' , Compensation Hawkeye [Electronic] E2827C Other WC (Non-NY) , HAWKEYE LLC 100 MARCUS BLVD HAWKE002 New York Workers' SUITE 1 Compensation HAUPPAUGE, NY 11788 Hawthorne Valley Assoc. 327 Rt. 21 C HAWTH001 New York Workers' Ghent, NY 12075 Compensation Hayhoe Construction [Electronic] E0818A New York Workers' , Compensation Hayhoe Construction [Electronic] E0818C Other WC (Non-NY) , Hays & Wormuth Insur. 207 Wallins Corners Rd. Suite 1 HAYSW001 New York Workers' Amsterdam, NY 12010 Compensation HAZMAT ENVIRONMENTAL 60 COMMERCE DR HAEN01 New York Workers' BUFFALO, NY 14218 Compensation HCA-Hosptial Corporation of America [Electronic] E0819C Other WC (Non-NY) , HCR MANORCARE WORKERS COMPENSATION DEPT HCRMA001 New York Workers' PO BOX 10086 Compensation TOLEDO, OH 43699 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID HDI GERLING 161 N CLARK STREET HDIGE001 New York Workers' 48TH FLOOR Compensation CHICAGO, IL 60601 HEALTH & HOSPITALS CORP 125 WORTH ST HHC01 New York Workers' NEW YORK, NY 10013 Compensation HEALTH AMERICA 100 STATE ST SUITE 320 HEALT007 New York Workers' ERIE, PA 16512 Compensation HEALTH DIRECT INC PO BOX 22038 HEALT009 New York Workers' PITTSBURGH, PA 15222 Compensation HEALTH MGT SOLUTIONS 2545 FARMERS DR., STE 400 HEALT010 New York Workers' COLUMBUS, OH 43235 Compensation HEALTH PLUS PHSP INC EXECUTIVE DR STE, FL 26 HEALT005 New York Workers' 335 ADAMS ST Compensation BROOKLYN, NY 11201 HEALTH RESOURCES PO BOX 8872 HEALT003 New York Workers' CAMP HILL, PA 170118872 Compensation HEALTH SPECIAL RISK INC HSR PLAZA II HEALT006 New York Workers' 4100 MEDICAL PARKWAY Compensation CARROLLTON, TX 75007-1517 HEALTH SYSTEM INTERNATIONAL PO BOX 240338 HEALT012 New York Workers' MONTGOMERY, AL 36124-0338 Compensation Health System Int'l PO Box 90198 HEALT002 New York Workers' attn: NCL Claims Compensation Milwaukee, WI 53209 HEALTH SYSTEMS INTL 5975 CASTLE CREEK PKWY STE 100 HEALT004 New York Workers' INDIANAPOLIS, IN 46250 Compensation HEALTHCARE ADMINSTRATORS SERVIC 2716 ALBANY STREET HART04 New York Workers' SCHENECTADY, NY 12304-1857 Compensation HEALTHCARE COMPARE PO BOX 5182 HECO01 New York Workers' SOUTHFIELD, MI 48086 Compensation HEALTHCARE COMPARE PO BOX 530790 HECO02 New York Workers' LIVONIA, MI 48153 Compensation HEALTHCARE SERVICES GROUP 3220 TILLMAN DR HEALT008 New York Workers' BENSALEM, PA 19020 Compensation Healthnet Po Box 14700 HEALT011 New York Workers' Lexington, NY 40512 Compensation HealthPartners [Electronic] E3822C Other WC (Non-NY) , Healthsmart [Electronic] E0820C Other WC (Non-NY) , HEARTH & HOME 726 WEST COURT ST HEART001 New York Workers' ITHACA, NY 14850 Compensation Heartland Employment Services, LLC [Electronic] E0821A New York Workers' , Compensation Heartland Employment Services, LLC [Electronic] E0821C Other WC (Non-NY) , heartland express 901 north kansas ave HEART002 New York Workers' north liberty, IA 52317 Compensation Heartland Express [Electronic] E1244A New York Workers' , Compensation Heartland Express [Electronic] E1244B Auto/No-Fault , Heartland Express [Electronic] E1244C Other WC (Non-NY) , HEBERLE DISPOSAL 269 ALVANAR ROAD HEBER001 New York Workers' ATTN PATTI Compensation ROCHESTER,, NY 14606 Helmsman Management PO BOX 29073 HELMS001 New York Workers' Glendale, CA 91209 Compensation HELMSMAN MANAGEMENT SERVICES PO BOX 4836 HELM02 New York Workers' SYRACUSE, NY 13221 Compensation Helmsman Management Services [Electronic] E8861A New York Workers' , Compensation Helmsman Management Services [Electronic] E8861C Other WC (Non-NY) , Hemet Unified School District (CA) [Electronic] E1245A New York Workers' , Compensation Hemet Unified School District (CA) [Electronic] E1245B Auto/No-Fault , Hemet Unified School District (CA) [Electronic] E1245C Other WC (Non-NY) , HEMIC 1001 BISHOP ST SUITE HEMIC001 New York Workers' 1000,PAUAHI TOWER Compensation KOLOA, HI 96813 HENDERSON JOHNSON COMPANY 918 CANAL STREET HENDE002 New York Workers' SYRACUSE, NY 13210 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID HENDERSON JOHNSON, CO. P.O. BOX 6964 HENDE001 New York Workers' SYRACUSE, NY 13217 Compensation HENNIGH WAREHOUSE 35033 LAKE ROAD HENNI001 New York Workers' CENTERVILLE, PA 16404 Compensation HEP SALES 446 WATERLOO-GENEVA ROAD HEPSA001 New York Workers' WATERLOO, NY 13165 Compensation HEREFORD 36-01 43rd Ave HEREF002 New York Workers' 2nd Floor Compensation Long Island City, NY 11101 HEREFORD INS CO 36-01 43RD AVE 2ND FLOOR HEREF001 Auto/No-Fault LONG ISLAND, NY 11101 HEREFORD INSURANCE CO. W/C 36 01 43RD AVENUE HEREF005 Other WC (Non-NY) LONG ISLAND CITY, NY 11101 HERITAGE BARNES LLC 257 FORT GRAHAM ROAD HERIT007 New York Workers' WACO, TX 76705-5711 Compensation HERITAGE CENTER 101 OAK STREET HERIT001 New York Workers' BUFFALO, NY 14214 Compensation HERITAGE CENTERS W/C CLAIMS 2643 MAIN STREET HERIT003 New York Workers' BUFFALO, NY 14214 Compensation HERITAGE CHRISTIAN SVC 349 W COMMERCIAL ST HERI01 New York Workers' SUITE 2795 Compensation EAST ROCHESTER, NY 14445 Heritage Crystal Clean/HC 2175 Point Blvd HERIT005 New York Workers' Ste 375 Compensation elgin, IL 60123 Heritage Group [Electronic] E5735C Other WC (Non-NY) , Heritage Ministries PO BOX 350 HERIT006 New York Workers' Gerry, NY 14740-0350 Compensation Heritage Woods / WC 2049 E McCord HERIT004 Other WC (Non-NY) Centralia, IL 62801 HERMAN GOLDNER COMP 7777 BREWSTER AVE HERMA001 New York Workers' PHILADELPHIA, PA 19153 Compensation HERR FOODS INC PO BOX 300 HERRF001 New York Workers' NOTTINGHAM, PA 19362 Compensation HERTZ 168 CONSTELLATION WAY HERTZ004 New York Workers' NORTH SYRACUSE, NY 13212 Compensation HERTZ 900 DOREMUS AVE HERTZ003 New York Workers' NEWARK, NJ 07114 Compensation HERTZ PO BOX 719 HERTZ005 Auto/No-Fault PARK RIDGE, NJ 07656 Hertz Claim Management - W PO Box 719 HERTZ001 New York Workers' Park Ridge, NJ 07656 Compensation HERTZ CLAIMS MANAGEMENT PO BOX 719 HERTZ002 Auto/No-Fault PARK RIDGE, NJ 07656-0719 HEWITT, COLEMAN, & ASSOC PO BOX 244 HEWI01 New York Workers' KINGSTON, TN 37082 Compensation HICKORY STICK GOLF COURSE 4560 CREEK ROAD HICKO001 New York Workers' LEWISTON, NY 14092 Compensation High Falls Brewing Co 445 St Paul St HIGHF001 New York Workers' Rochester, NY 14605 Compensation High Point Insurance PO Box 907 HIGHP010 Auto/No-Fault Lincroft, NJ 07738 Highland Golf [Electronic] E0822A New York Workers' , Compensation Highland Golf [Electronic] E0822C Other WC (Non-NY) , HIGHLAND HOSPITAL LAB 1000 SOUTH AVE HHL01 New York Workers' ACCOUNTS PAYABLE Compensation ROCHESTER, NY 14620 HIGHLAND MASONRY 33 RANSIER DR HIGHL001 New York Workers' WEST SENECA, NY 14224 Compensation HIGHLANDS INSURANCE P.O. BOX 42307 HIGHL002 New York Workers' HOUSTON, TX 77242 Compensation HIGHMARK CASUALTY INS CO PO BOX 2738 HIGHM002 Other WC (Non-NY) PITTSBURGH, PA 15230-2738 HIGHMARK CASUALTY WC PO BOX 2738 HIGHM003 Other WC (Non-NY) PITTSBURGH, PA 15230 HIGHMARK CASUALTY WORKERS COMPE PO BOX 2738 HIGHM001 New York Workers' PITTSBURGH, PA 15230 Compensation HIGHPOINT PREF INS COM PO BOX 900 HIGHP011 Auto/No-Fault LINCROFT, NJ 07738 HIGHPOINT SAFETY PO BOX 856900 HIGHP007 Auto/No-Fault LOUISVILLE, KY 40285 Higlands Care Center (Laporte) Route 42 Main Street HIGLA001 New York Workers' Laporte, PA 18626 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Hilb Rogal & Hobbs - WC 101 Merritt 7 Corporate Park Fl. 5 HILBR001 New York Workers' Norwalk, CT 06851 Compensation HILLCREST AUTOMOTIVE PO BOX 104 HILLC002 New York Workers' STRYKERSVILLE, NY 14145 Compensation HILLCREST SPRING ADULT HOME PO BOX 368 HILLC001 New York Workers' AMSTERDAM, NY 12010 Compensation HILLIARD CORPORATION 100 West Fourth Street HILLI001 New York Workers' Elmira, NY 14902 Compensation Hillmont Associates 1134 NYS Rte 13 HILLM001 New York Workers' Cortland, NC 13045 Compensation HILLSIDE CHILDREN'S CENTER 7320 SNELL HILL RD HILLS001 New York Workers' BATH, NY 14810 Compensation HILTON GARDEN INN 235 HOOSICK STREET HILTO003 New York Workers' TROY, NY 12180 Compensation HILTON GARDEN INN 302 WASHINGTON AVENUE HILTO002 New York Workers' EXTENSION Compensation ALBANY, NY 12203 HILTON GARDEN INN 62 NEW SCOTLAND AVENUE HILTO004 New York Workers' ALBANY, NY 12208 Compensation HILTON INN (HORSEHEADS) 35 ARNOT RD HILTO001 New York Workers' HORSEHEADS, NY 14845 Compensation HINSPERGER POLY INC 430 WEST OAK ORCHARD ST HIPI01 New York Workers' MEDINA, NY 14103 Compensation Hinz Claim Management / WC 525 W. Monroe Street HINZC001 Other WC (Non-NY) Suite 2400 Chicago, IL 60661 HIP PO BOX 2803 HIP01 New York Workers' NEW YORK, NY 10116-2803 Compensation Hip Shot Products 8248 State Route 96 HIPSH001 New York Workers' Interlaken, NY 14847 Compensation HMI MECHANICAL 345 STATE ROUTE 14 HMIME001 New York Workers' LYONS, NY 14489 Compensation HMIC 200 N MAIN ST HMIC001 Other WC (Non-NY) BELAIR, MD 21014 HMSHost [Electronic] E1246A New York Workers' , Compensation HMSHost [Electronic] E1246B Auto/No-Fault , HMSHost [Electronic] E1246C Other WC (Non-NY) , HOBART SALES & SERVICE 371 SOUTH MAIN STREET HOBAR002 New York Workers' ELMIRA, NY 14904 Compensation hobart stone dealers inc. 761 conklin road HOBAR001 New York Workers' binghamton, NY 13903 Compensation HOBBY LOBBY STORES INC 7707 SOUTH WEST 44TH STREET HOBBY001 New York Workers' OKLAHOMA CITY, OK 73179 Compensation HOFFMAN CAR WASH 1757 CENTRAL AVENUE HOFFM001 New York Workers' ALBANY, NY 12205 Compensation Hogan Motor Leasing [Electronic] E0823A New York Workers' , Compensation Hogan Motor Leasing [Electronic] E0823C Other WC (Non-NY) , Hogan Personell [Electronic] E0824A New York Workers' , Compensation Hogan Personell [Electronic] E0824C Other WC (Non-NY) , HOHL INDUSTRIAL 770 RIVERVIEW BLVD HOHLI001 New York Workers' TONAWANDA, NY 14150 Compensation HOLIDAY INN 114 BUFFALO AVE HOLID004 New York Workers' NIAGARA FALLS, NY 14303 Compensation HOLIDAY INN (ELMIRA) 760 E WATER STREET HOLID003 New York Workers' ELMIRA, NY 14901 Compensation Holiday Inn (Ithica) 222 S Cayuga Street HOLID002 New York Workers' attn: Casey Compensation Ithica, NY 14850 HOLIDAY INN ARENA 2 HAWLEY ST HIA01 New York Workers' BINGHAMTON, NY 13901 Compensation HOLIDAY VALLEY RT 219 PO BOX 370 HOLID001 New York Workers' ELLICOTTVILLE, NY 14731 Compensation HOLIMONT SKI AREA 6921 RT 242 HOLIM001 New York Workers' ELLICOTTVILLE, NY 14731 Compensation HOLLAND HIGHLIFT 10033 EAST ROAD HOLLA001 New York Workers' EAST BETHANY, NY 14054 Compensation HOLLENBECK FOODS & INC 17 MAIN STREET HOLLE001 New York Workers' NEWARK VALLEY, NY 13811 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Holly Farms Corp. [Electronic] E9739C Other WC (Non-NY) , HOLLYMONT SKI RESORT P O BOX 279 HOLLY001 New York Workers' ELLICOTTVILLE, NY 14731 Compensation Hollywood Restaurant PO BOX 533 HOLLY002 New York Workers' CORTLAND, NY 13045 Compensation HOLMES MURPHY WC PO BOX 9207 HMWC01 New York Workers' DES MOINES, IA 50306 Compensation HOLMES PLATE 54 WEST MARKET STREET HOLME001 New York Workers' CORNING, NY 14830 Compensation Holy Sepulchre Cemetery 2461 Lake Avenue HOLYS001 New York Workers' Rochester, NY 14612 Compensation HOME & HEALTH CARE SERVICES (HO PO BOX 250 HOMEH001 New York Workers' HORNELL, NY 14843 Compensation HOME AIDES OF CENTRAL NY 1050 WEST GENESEE STREET HOMEA001 New York Workers' SYRACUSE, NY 13204 Compensation HOME CENTRAL 151 CENTRAL AVENUE HOMEC001 New York Workers' OWEGO, NY 13827 Compensation HOME DEPOT 4181 VETERANS MEMORIAL DRIVE HOMED001 New York Workers' BATAVIA, NY 14020 Compensation HOME INDEMNITY CO 59 MAIDEN LANE HOME01 New York Workers' 5th FLOOR Compensation New York, NY 10038 HOME INSURANCE CO PO BOX 4835 HOME03 New York Workers' SYRACUSE, NY 13221 Compensation HOME LEASING 180 CLINTON SQUARE HOMEL001 New York Workers' ROCHESTER, NY 14604 Compensation HOME OF THE GOOD SHEPHERD 390 CHURCH STREET HOMEO001 New York Workers' SARATOGA SPRINGS, NY 12866 Compensation HOME PROPERTIES 850 CLINTON SQUARE HOMEP001 New York Workers' ROCHESTER, NY 14604 Compensation Home Sweet Home [Electronic] E0825A New York Workers' , Compensation Home Sweet Home [Electronic] E0825C Other WC (Non-NY) , HOMELAND INS COMPANY OF NY ONE BEACON LANE HOML01 New York Workers' CANTON, MA 02021-1030 Compensation HOMER C GOW & SONS PO BOX 451 HOMER001 New York Workers' VESTAL, NY 13851 Compensation Hometown IGA Main Street HOMET001 Auto/No-Fault Fairfield, IL 62837 HOMETOWN MARKETS PO BOX 171 HOMET002 New York Workers' BALDWINSVILLE, NY 13027 Compensation HOMEWOOD SUITES 275 ELWOOD DAVIS ROAD HOMEW001 New York Workers' LIVERPOOL, NY 13088 Compensation HONDA OF ITHACA 316 ELMIRA ROAD HONDA001 New York Workers' ITHACA, NY 14850 Compensation HONEYWELL 175 EAST PARK AVE HONEY001 New York Workers' TONAWANDA, NY 14150 Compensation HONEYWELL INC 1 EXECUTIVE CENTER DR HONE01 New York Workers' CORPORATE PLAZA Compensation ALBANY, NY 12203 HONY TRUST 159 WEST FIRST ST HONY02 New York Workers' OSWEGO, NY 13126 Compensation HOPE FARMS 5908 HORSESHOE LAKE ROAD HOPEF001 New York Workers' ATTENTION: BRENDA Compensation STAFFORD, NY 14143 HOPE TRUCKING CO SUNSET ROAD HOPET001 New York Workers' BURLINGTON, NJ 08640 Compensation HOPES WINDOWS ATTN: PAM PARLA HOPES001 New York Workers' 84 HOPKINS AVE Compensation Jamestown, NY 14701 HORACE MANN INSURANCE P O BOX 962 HORAC001 Auto/No-Fault MORRISVILLE, NC 27560 HORACE MANN INSURANCE P.O. BOX 631790 HORAC002 Auto/No-Fault IRVING, TX 75063 HORIONTAL WELL DRILLERS PO BOX 1626 HORIO001 New York Workers' PURCELL, OK 73080 Compensation Horizon Casualty 33 Washington St HORIZ004 Auto/No-Fault 11th Floor Newark, NJ 07102 Horizon Casualty 33 Washington St., 11th Fl. HORIZ002 Other WC (Non-NY) Newark, NJ 07102 HORIZON CASUALTY SERVICES 33 WASHINGTON ST HORIZ005 Other WC (Non-NY) 11TH FLOOR NEWARK, NJ 071020000 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Horizon Casualty Svcs - WC 33 Washington Street 33-11 HORIZ001 New York Workers' Newark, NJ 07102 Compensation HORIZON HEALTH SERVICES 3020 BAILEY AVENUE HORIZ003 New York Workers' 2ND FLOOR Compensation BUFFALO, NY 14215 HORNBECK OFFSHORE 671 COURT STREET HORNB001 New York Workers' BROOKLYN, NY 11020 Compensation HORNELL AREA HUMANE SOCIETY 7649 INDUSTRIAL PARK ROAD HORNE001 New York Workers' HORNELL, NY 14843 Compensation Hornell Gardens PO BOX 430 HORNE002 New York Workers' Hornell, NY 14843-0430 Compensation HORSCHEL BROS PRECISION 180 ZOAR VALLEY RD HORSC001 New York Workers' SPRINGVILLE, NY 14141 Compensation HORSEHEADS DO IT CENTER 124 NORTH MAIN STREET HORSE003 New York Workers' HORSEHEADS, NY 14845 Compensation HORSEHEADS HIGHWAY DEPARTMENT 150 WYGANT ROAD HORSE001 New York Workers' HORSEHEADS, NY 14845 Compensation HORSEHEADS PICK A PART 1592 SEARS RD HORSE002 New York Workers' ELMIRA, NY 14903 Compensation Hortica Florist Mutual Insurance [Electronic] E3262C Other WC (Non-NY) , HORTICA INS PO BOX 428 HORT01 New York Workers' EDWARDSVILLE, IL 62025 Compensation Hortica Insurance PO Box 428 HORTI001 Auto/No-Fault Edwardsville, IL 62025 HOSFELD INS AGENCY 211 RT 100 SOUTH HOSFE001 Auto/No-Fault ALLENTOWN, PA 18106 HOSPICARE 172 EAST KING ROAD HOSPI002 New York Workers' ITHACA, NY 14850 Compensation HOSPICE BUFFALO 225 COMO PARK BLVD HOSBU01 New York Workers' CHEEKTOWAGA, NY 14227 Compensation Hospice Chautauqua County 20 W Fairmount Ave HOSPI001 New York Workers' LAKEWOOD, NY 14750 Compensation HOSPICE OF CNY 990 7TH NORTH ST HOSPI003 New York Workers' LIVERPOOL, NY 13088 Compensation HOTEL ALBANY 40LODGE STREET HOTEL001 New York Workers' ALBANY, NY 12207 Compensation HOUGHTON COLLEGE ATTN: CLAIMS, HUMAN RESOURCES HOUGH001 New York Workers' 1 WILLARD AVE Compensation HOUGHTON, NY 14744 Household Merch Nni [Electronic] E6568C Other WC (Non-NY) , HOUSING AUTH.INS.GR. 189 Commerce Court HOUSI001 New York Workers' PO BOX 189 Compensation CHESHIRE, CT 06410-0189 Housing Authority El Paso (TX) [Electronic] E8947C Other WC (Non-NY) , Houston Hunters Patrol, Inc [Electronic] E8035C Other WC (Non-NY) , HOV PO BOX 5028 HOV001 Auto/No-Fault TROY, MI 48007 HP SMITH & SON PO BOX 140 HPSMI001 New York Workers' WOODHULL, NY 14898 Compensation HQ HOME AND OFFICE 950 COUNTY ROAD 64 HQHOM001 New York Workers' ELMIRA, NY 14903 Compensation HR KELLER CO 1520 SHERIDAN DR HRKE01 New York Workers' BUFFALO, NY 14217 Compensation Hub International PO Box 1237 HUBIN001 Auto/No-Fault Bismark, ND 58502 HUDSON PARK REHABILITATION 325 NORTHERN BOULEVARD HUDSO004 New York Workers' ALBANY, NY 12204 Compensation HUDSON RIVER CONSTRUCTION 101 DUNHAM DR. HUDSO003 New York Workers' ALBANY, NY 12202 Compensation Hudson Tribal First Po Box 609015 HUDSO002 New York Workers' San Diego, CA 92160 Compensation HUFF ICE CREAM 3 WINKLER ROAD HUFFI001 New York Workers' ATTEN: JOHN HUFF Compensation SIDNEY, NY 13838 Hughes Tool Company [Electronic] E6034C Other WC (Non-NY) , HUGHESCO 140 IRWIN DR HUGHE001 New York Workers' W. AMHERST, NY 14228 Compensation HUMES FORD PO BOX 391 HUMES001 New York Workers' CORRY, PA 16407 Compensation HUNTER MOUNTAIN SKI BOWL P.O. BOX 295, RT 23A HUNTE001 New York Workers' HUNTER, NY 12442 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID HUNTER TRUCK SALES 8125 WATTSBURG ROAD HUNTE002 New York Workers' ERIE, PA 16509 Compensation HUNT'S AUTO SERVICE 225 ELMIRA ROAD HUNTS001 New York Workers' ITHACA, NY 14850 Compensation HURON PLUMBING 61 FILLMORE AVE HURON001 New York Workers' TONAWANDA, NY 14150 Compensation Hutchinson Technology [Electronic] E1389B Auto/No-Fault , Hutchinson Technology [Electronic] E1389C Other WC (Non-NY) , Hy-Vee [Electronic] E1671C Other WC (Non-NY) , I & S Inc Of New York 4174 Route 417 ISINC001 New York Workers' Allegany, NY 14706 Compensation IBM ENDICOTT 1701 NORTH STREET IBMEN001 New York Workers' ENDICOTT,NY, NY 13760 Compensation ICA SPECIAL FUND DIVISION PO BOX 19070 ICA01 New York Workers' PHOENIX, AZ 85005 Compensation ICAZA & BURGESS ATT 550 BROAD STREET ICAZA001 Auto/No-Fault NEWARK, NJ 07102 ICCO DESIGN/BUILD PO BOX 1227 ICCOD001 New York Workers' WEEDSPORT, NY 13166 Compensation Icon Design 9 LENT AVENUE ICOND001 New York Workers' leory, NY 14482 Compensation ICS 33 WOOD AVE ICS002 Auto/No-Fault STE 600 ISELIN, NJ 08830 ICT WC 1151 E. Warrenville Road ICTWC002 Other WC (Non-NY) PO Box 3015 Naperville, IL 60566 ICW (Insurance Co of the West) [Electronic] E9937A New York Workers' , Compensation ICW (Insurance Co of the West) [Electronic] E9937C Other WC (Non-NY) , ID BOOTH 602 WILLIAM STREET IDBOO001 New York Workers' ELMIRA, NY 14901 Compensation IDS Property Casualty [Electronic] 10 East Stow Road IDSPR001 Auto/No-Fault Suite 100 Marlton, NJ 08053 IDS Property Casualty Insurance Company E2612B Auto/No-Fault [Electronic] , IFA Insurance 14 Walnut Avenue IFAIN001 Auto/No-Fault Claims department Clark, NJ 07066 IiMAK 310 COMMERCE DR IIMAK001 New York Workers' AMHERST, NY 14228 Compensation IL Compensation Trust / WC 1151 East Warrenville Road ILCOM001 Other WC (Non-NY) PO Box 3015 Naperville, IL 60566 IL Dept of Agriculture / WC PO Box 19281 ILDEP001 Other WC (Non-NY) Springfield, IL 62794 IL Dept of Corrections / WC 1301 Concordia Ct ILDEP003 Other WC (Non-NY) PO Box 19277 Springfield, IL 62794 IL Dept of Transportation 1102 East Port Plaza Drive ILDEP002 Other WC (Non-NY) Collinsville, IL 62234 IL Dept. of Transportation / WC PO Box 100 ILDEP004 Other WC (Non-NY) Carbondale, IL 62903 IL Depto f Natural Resources / WC 1 Natural Resources Way ILDEP005 Other WC (Non-NY) Springfield, IL 62702 IL Public Risk Fund / WC 3333 Warrenville Rd., Ste 550 ILPUB001 Other WC (Non-NY) Lisle, IL 60532 IL State Police 1391 S Washington ILSTA001 Other WC (Non-NY) DuQuoin, IL 62832 ILIO DIPAOLOS 3785 SOUTHPARK AVE ILIOD001 New York Workers' BALSDELL, NY 14219 Compensation Illinois Casualty [Electronic] E1390B Auto/No-Fault , Illinois Casualty [Electronic] E1390C Other WC (Non-NY) , ILLINOIS NATIONAL INSURANCE CO 80 PINE ST ILN01 New York Workers' 5TH FL Compensation NEW YORK, NY 10005 Illinois National Insurance Co [Electronic Indirect] 80 PINE ST ILLIN001 New York Workers' 5TH FL Compensation NEW YORK, NY 10005 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Illinois National Insurance Co [Electronic Indirect] 80 PINE ST ILLIN002 Other WC (Non-NY) 5TH FL NEW YORK, NY 10005 IMMACULATE CONCEPTION CONVENT ATTN: LENA 5229 SOUTH PARK AVE IMMAC001 New York Workers' HAMBURG, NY 14075 Compensation IMMORTAL ENTERTAINMENT 3301 ZOELLER RD IMMOR001 New York Workers' ALDEN, NY 14004 Compensation IMPERIAL BAG & PAPER 59 HOOK ROAD IMPER001 New York Workers' BAYONNE, NJ 07002 Compensation Imperial Irrigation District [Electronic] E0826A New York Workers' , Compensation Imperial Irrigation District [Electronic] E0826C Other WC (Non-NY) , IMPERIUM INS PO BOX 2806 IMPER002 New York Workers' CLINTON, IA 52733 Compensation IMR Test Labs 131 Woodsedge Drive IMRTE001 New York Workers' Lansing, NY 14882 Compensation IMS GROUP NE CORP PO BOX 129 IMSG01 New York Workers' CAMILLUS, NY 13031 Compensation INCHCAPE SHIPPING 1000 ROUTE 9 NORTH INCHC001 Other WC (Non-NY) SUITE 301 WOODBRIDGE, NJ 07095 Inconen Corporation [Electronic] E0827A New York Workers' , Compensation Inconen Corporation [Electronic] E0827C Other WC (Non-NY) , indemnity Ins of N America C/O York Insurance Serv INDEM002 Other WC (Non-NY) PO BOX 183188 COLUMBUS, OH 43218 INDEPENDANT PROC INC PO BOX 023143 INDEP001 Auto/No-Fault BROOKLYN, NY 11202 INDEPENDENT REVIEW SERVICES 6091 ROUTE 31 IRS01 New York Workers' PO BOX 1478 Compensation CICERO, NY 13039 INDIAN VALLEY INDUSTRIES PO BOX 810 INDIA009 New York Workers' JOHNSON CITY, NY 13790 Compensation INDIAN VALLEY INDUSTRIES PO BOX 810 INDIA010 New York Workers' JOHNSON CITY, NY 13790 Compensation Indiana Farm Bureau [Electronic] 6767 EAST WASHINGTON STREET INDIA003 Auto/No-Fault INDIANAPOLIS, IN 46219 Indiana Insurance PO Box 815 INDIA002 New York Workers' Pewaukee, WI 53072 Compensation Indiana Insurance / WC PO Box 815 INDIA006 Other WC (Non-NY) Pewaukee, WI 53072 Indiana Insurance [Electronic] E5936A New York Workers' , Compensation Indiana Insurance [Electronic] E5936C Other WC (Non-NY) , INDIANA LUMBERMENS MUTUAL P.O. BOX 68600 INDIA005 New York Workers' INDIANAPOLIS, IN 46268 Compensation Industrial Furnace 40 Humboldt St INDUS001 New York Workers' Rochester, NY 14609 Compensation INDUSTRIAL POWER AND LIGHTING 701 SENECA ST STE 500 INDUS002 New York Workers' BUFFALO, NY 14210 Compensation INERGY #2 BRUSH CREEK BLVD INERG001 New York Workers' SUITE 200 ATTN MACKENZIE Compensation DOUGHERTY KANAS CITY, MO 64112 Infinity Assurance Insurance PO BOX 830807 INFIN005 New York Workers' Birmingham, AL 35283 Compensation INFINITY AUTO INSURANCE PO BOX 830807 INFIN001 Auto/No-Fault BIRMINGHAM, AL 35283 INFINITY LOW COST 2700 MARKET TOWER INFIN003 Auto/No-Fault 10 WEST MARKET STREET INDIANAPOLIS, IN 46204 INFINITY RESOURCES 421 CENTRAL AVENUE INFIN004 New York Workers' DUNKIRK, NY 14048 Compensation INFO PRINT SOLUTION CO 33 lewis road INFOP001 New York Workers' binghamton,, NY 13905 Compensation InFocus Advisors Inc. 8035 Oswego Road INFOC001 New York Workers' Liverpool, NY 13090 Compensation INGERSOLL PLACE 3359 CONSAUL ROAD INGER002 New York Workers' SCHENECTADY, NY 12304 Compensation INGERSOLL RAND ATHENS 101 NORTH MAIN STREET INGER001 New York Workers' ATHENS, PA 18810 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Injured Worker's Ins Fund 8722 Loch Raven Boulevard INJUR001 New York Workers' Towson, MD 21286-2235 Compensation INJURED WORKERS INS FUND PO BOX 9899 INJUR003 Other WC (Non-NY) BALTIMORE, MD 21284 INJURED WORKERS INS FUND PO BOX 9899 IWIF01 New York Workers' BALTIMORE, MD 21284 Compensation INJURY COMP 1000 WESTCHESTER AVE INJUR002 New York Workers' WHITE PLAINS, NY, NY 10610-9431 Compensation INJURY COMP OFFICE PO BOX 9446 INC02 New York Workers' NEWBURGH, NY 12555 Compensation INJURY COMPENSATION 30 OLD KARNER RD INC01 New York Workers' ALBANY, NY 12288 Compensation Injury Management Organization 1250 W. Sam Houston Pkwy INJUR004 Other WC (Non-NY) STE 550 Houston, TX 77042 Inland Valley Hospice [Electronic] E0828A New York Workers' , Compensation Inland Valley Hospice [Electronic] E0828C Other WC (Non-NY) , INNOVAITIVE RISK CONCEPTS 179 SOUTH MAPLE AVE INNOV001 New York Workers' RIDGEWOOD, NJ 07450 Compensation INNOVATIVE 25 HAZELWOOD DR INNOV003 New York Workers' SUITE 116 Compensation AMHERST, NY 14228 Innovative Claim Solutions (ICS) - San Ramon E1248A New York Workers' [Electronic] , Compensation Innovative Claim Solutions (ICS) - San Ramon E1248B Auto/No-Fault [Electronic] , Innovative Claim Solutions (ICS) - San Ramon E1248C Other WC (Non-NY) [Electronic] , Innovative Claim Solutions Rancho Cordova E1247A New York Workers' [Electronic] , Compensation Innovative Claim Solutions Rancho Cordova E1247B Auto/No-Fault [Electronic] , Innovative Claim Solutions Rancho Cordova E1247C Other WC (Non-NY) [Electronic] , INNOVATIVE CONCEPTS 10123 MAIN ST INNOV002 New York Workers' CLARENCE, NY 14031 Compensation INNOVATIVE RISK MANAGEMEN 1431 GREENWAY DR INRM01 New York Workers' #620 Compensation IRVING, TX 75038 INOVATIVE CLAIMS STRATEGIES 33 WOOD AVE INOVA001 New York Workers' #600 Compensation ISELIN, NY 08830 INS CO OF THE STATE OF PENN 80 PINE ST INSP01 New York Workers' 5TH FL Compensation NEW YORK, NY 10005 Inserco Insurance WC (NJ) PO BOX 1457 INSER006 Other WC (Non-NY) Harrisburg, PA 17105-1457 Inserra Supermarkets 20 Ridge Rd INSER004 New York Workers' Mahwah, NJ 07430 Compensation INSERVCO INS PO BOX 1451 INSER003 New York Workers' HARRISBURG, PA 171051545 Compensation INSERVCO INS SERVICE PO BOX 3899 INIS01 New York Workers' HARRISBURG, PA 17105 Compensation INSERVCO INS SERVICES 3150 BRUNSWICK PIKE INSER001 New York Workers' SUITE 200 Compensation LAWRENCEVILLE, NJ 08648 INSERVCO INS SERVICES P O BOX 3899 INSER005 Other WC (Non-NY) HARRISBURG, PA, PA 17105-3899 INSERVCO INSURANCE PO BOX 1457 INSER002 New York Workers' HARRISBURG, PA 171051457 Compensation Insilco Corp [Electronic] E7350C Other WC (Non-NY) , Insley McEntee 1112 Emerson St INSLE001 New York Workers' Rochester, NY 14606 Compensation INSTANTHEAT WOOD PELLETS INC 7780 STATE ROUTE 417 INSTA001 New York Workers' ADDISON, NY 14801 Compensation INSTITUTE FOR HUMAN SERVICES 666 COUNTY ROAD 11 INSTI001 New York Workers' BATH, NY 14810 Compensation INSURANCE ADMINISTRATION PO BOX 132 INSA01 New York Workers' BATAVIA, NY 14021-0132 Compensation INSURANCE CO STATE OF PA 70 PINE ST ICPA01 New York Workers' NEW YORK, NY 10270 Compensation INSURANCE COMPANY OF THE WEST PO BOX 85563 INSUR001 New York Workers' SAN DIEGO, CA 92186 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID INSURANCE COVERAGE OFFICE 500 West Lockerman ST INSUR002 Auto/No-Fault SUITE 300 DOVER, DE 19904 INSURANCE OF NEW YORK PO BOX 380 INSUR003 New York Workers' ALLEGENY, NY 14706 Compensation INSURED SOLUTIONS 2 RAVINIA DR STE 270 INSUR004 New York Workers' ATLANTA, GA 30346 Compensation Integon Casualty Insurance Co. [Electronic] E3998B Auto/No-Fault , INTEGRATED ADMINISTRATION PO BOX 45171 INTEG002 New York Workers' JACKSONVILLE, FL 32232 Compensation INTEGRATED LINER TECHNOLOGIES 45 DISCOVERY DRIVE INTEG003 New York Workers' RENSSELAER, NY 12144 Compensation INTEGRATED PROPERTIES 15 THORNWOOD DRIVE INTEG001 New York Workers' ITHACA, NY 14852 Compensation Integrity Mutual Insurance Company [Electronic] E4268B Auto/No-Fault , Interboro 155 Mineola Blvd INBO01 New York Workers' New York , NY 11501 Compensation INTERBORO MUTUAL 155 MINEOLA BLVD INTER004 Auto/No-Fault MINEOLA, NY 11501 INTERCARE PO BOX 7111 INTER006 New York Workers' PASADENA, CA 91109 Compensation Intercare [Electronic] E0830A New York Workers' , Compensation Intercare [Electronic] E0830B Auto/No-Fault , Intercare [Electronic] E0830C Other WC (Non-NY) , INTERIM HEALTHCARE 38 FRONT STREET INTER002 New York Workers' SUITE D Compensation BINGHAMTON, NY 13905 Interinsurance Exchange of the Automobile Club E1115A New York Workers' [Electronic] , Compensation Interinsurance Exchange of the Automobile Club E1115B Auto/No-Fault [Electronic] , Interinsurance Exchange of the Automobile Club E1115C Other WC (Non-NY) [Electronic] , Internal Revenue Service Worker's Compensation Center INTER003 New York Workers' 400 North 8th Street Compensation Richmond, VA 23219 INTERNATIONAL MARINE UNDERWRITERS 77 WATER ST 17TH FL INTER008 New York Workers' NEW YROK, NY 10005 Compensation International Risk Management 3295 River Exchange Drive INTER001 New York Workers' Norcross, GA 30092 Compensation INTERSTATE TRANSPORT 1 CAPE MAY ST INTER007 New York Workers' HARRISON, NJ 07029 Compensation Interstate Waste Service 500 North Franklin Turnpike INTER005 New York Workers' Suite 212 Compensation Ramsey, NJ 07446 Intracorp 3567 Parkway Lane INTRA002 New York Workers' Suite 300 Compensation Norcross, GA 30092 INTRACORP 3010 HIGHLAND PKWY INTRA001 New York Workers' DOWNERS GROVE, IL 60515 Compensation INTRACORP/MAGNA COMP 2455 PACES FERRY RD NW INMC01 New York Workers' ATLANTA, GA 30339 Compensation Iowa Mutual 509 9th STreet IOWAM001 Other WC (Non-NY) PO Box 290 DeWitt, IA 52742 IOWA PACIFIC HOLDINGS 118 SO CLINTON ST-400 IOWAP001 New York Workers' CHICAGO, IL 60661 Compensation IRA DAVENPORT & TAYLOR HEALTH F 7571 STATE RTE 54 IRADA001 New York Workers' BATH, NY 14810 Compensation IRA Davenport Hospital Box 350 IRADA004 New York Workers' Bath, NY 14810 Compensation Irex Corporation [Electronic] E5645C Other WC (Non-NY) , Ironworking Contract I.P. [Electronic] E3265C Other WC (Non-NY) , IROQUOIS BAR CORP 155 COMMERCE DR IROQU002 New York Workers' LACKAWANNA, NY 14218 Compensation IROQUOIS NURSING HOME 4600 SOUTHWOOD HEIGHTS DRIVE IROQU001 New York Workers' JAMESVILLE, NY 13078 Compensation IRR SUPPLY CENTERS 908 NIAGARA FALLS BLVD IRRSU001 New York Workers' NORTH TONAWANDA, NY 14120 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID IRVING WEBER ASSOCIATES 761 COEHLER AVE IRVIN001 New York Workers' RONKONKOMA, NY 11779 Compensation ISAAC HEATING AND AIR CONDITIONING 180 CHARLOTTE ST ISAAC001 New York Workers' ROCHESTER, NY 14607 Compensation ITE CIRCUIT BREAKER 1966 WC Claim ITECI001 New York Workers' Unknown, NY 00000 Compensation ITHACA BAKERY 400 N MEADOW ST ITHAC001 New York Workers' ATTN: DEBBIE BENSON Compensation ITHACA, NY 14850 ITHACA CITY SCHOOL 1601 N CAYUGA STREET ITHAC006 New York Workers' ITHACA, NY 14850 Compensation ITHACA CITY SCHOOL DISTRICT PO BOX 549 ITHAC004 New York Workers' ITHACA, NY 14850 Compensation ITHACA JOURNAL/USA 123 W STATE STREET ITHAC005 New York Workers' ITHACA, NY 14850 Compensation ITHACA RENTING PO BOX 642 ITHAC003 New York Workers' ITHACA, NY 14851 Compensation ITHACO INCORPORATED 950 DANDY RD ITHAC002 New York Workers' SUITE 100 Compensation ITHACA, NY 14850-5714 J & G ASSOCIATES PO BOX 574 JGASS001 New York Workers' MANASQUAN, NJ 08736 Compensation J & P PAPPAS 1780 ORCHARD PARK RD JPPAP001 New York Workers' WEST SENECA, NY 14224 Compensation J & T AUTO CAFE 5 BRIDGE STREET JTAUT001 New York Workers' CORNING, NY 14830 Compensation J A ROOFING 3 CLARENDON AVENUE JAROO001 New York Workers' KINGSTON, NY 12401 Compensation J B Hunt Transport Inc. [Electronic] E2397C Other WC (Non-NY) , J DAVID CONSTRUCTION 550 DRYBROOK ROAD JDAVI001 New York Workers' WAVERLY, NY 14892 Compensation J&B Installations PO Box 188 JBINS001 New York Workers' 4449 Jordan Road Compensation Skaneateles Falls, NY 13153 J&K CONSTRUCTION 6484 MONTEREY ROAD JKCON001 New York Workers' SAVONA, NY 14879 Compensation J&K HEATING & PLUMBING 24 THORPE STREET JKHEA001 New York Workers' BINGHAMTON, NY 13905 Compensation J&M DISTRIBUTOR 3647 CEDAR CREST ROAD JMDIS001 New York Workers' BENSALEM, PA 19020 Compensation J.C.N.C. CONSTRUCTION 80 WATERVLIET AVENUE JCNCC001 New York Workers' ALBANY, NY 12206 Compensation J.H. Mccormack Const [Electronic] E0831A New York Workers' , Compensation J.H. Mccormack Const [Electronic] E0831C Other WC (Non-NY) , J.J. YOUNG 1500 CENTRAL AVENUE JJYOU001 New York Workers' ALBANY, NY 12205 Compensation J.M. WHEELER CONSTRUCTION INC PO BOX 2299 JMWHE001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation JACK PIERMONT ATT 26 JOURNAL SQUARE SUITE 1102 JACKP001 Auto/No-Fault JERSEY CITY, NJ 07036 JACK'S OYSTER HOUSE 42 STATE STREET JACKS001 New York Workers' ALBANY, NY 12207 Compensation JACKSON WELDING 4 PIXLEY INDUSTRIAL PKWY JACKS002 New York Workers' ROCHESTER, NY 14624 Compensation JACOBSON COMPANIES 100 HORSESHOE BLVD JACOB001 New York Workers' AVON, NY 14414 Compensation JAE E.LEE ESQ 2050 CENTER AVENUE JAEEL001 Auto/No-Fault FORT LEE, NJ 07024 JAMES DESIDERIO INC 550 BAILEY AVE JAMES005 New York Workers' BUFFALO, NY 14206 Compensation JAMES MALOW, INC 421 ALBANY SHAKER ROAD JAMES006 New York Workers' LOUDONVILLE, NY 12211 Compensation JAMES MALOY, INC. P.O. BOX 11016 JAMES003 New York Workers' LOUDONVILLE, NY 12211 Compensation JAMESTOWN BOWLING COMPANY 850 FOOTE AVE JAMES001 New York Workers' JAMESTOWN, NY 14701 Compensation Jamestown Metal Products 178 Blackstone Ave JAMES002 New York Workers' Jamestown, NY 14701 Compensation JAMESTOWN PUBLIC SCHOOLS 201 EAST 4TH STREET JAMES004 New York Workers' JAMESTOWN, NY 14701 Compensation JAMKO 932 Sohn Alloway Rd JAMKO001 New York Workers' Lyons, NY 14489 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID JANTRONICS 1988 CENTRAL AVENUE JANTR001 New York Workers' ALBANY, NY 12205 Compensation Jascor Inc #3481 298 Lake St JASCO001 New York Workers' Penn Yan, NY 14527 Compensation Jasper County Insurance / WC P.O. Box 71 JASPE001 Other WC (Non-NY) Newton, IL 62448 JAY CASHMAN 2877 RICHMAN TERRACE JAYCA001 New York Workers' STATEN ISLAND, NY 10303 Compensation JAYNESS ENTERPRISE 463 REYNOLDS STREET JAYNE001 New York Workers' ATTN SHARI Compensation ELMIRA, NY 14904 Jays Diner 2612 West Henrietta Road JAYSD001 New York Workers' Rochester, NY 14623 Compensation JB HUNT 4 TREADEASY AVE JBHUN001 New York Workers' BATAVIA, NY 14020 Compensation JB HUNT TRANSPORT P.O BOX 130 JBHUN002 Auto/No-Fault LOWELL, AR 72745 JD Mechanical [Electronic] E0832A New York Workers' , Compensation JD Mechanical [Electronic] E0832C Other WC (Non-NY) , JEFFERSON COUNTY 175 ARSENAL ST JEFF01 New York Workers' WATERTOWN, NY 13601 Compensation Jefferson County Texas [Electronic] E0833A New York Workers' , Compensation Jefferson County Texas [Electronic] E0833C Other WC (Non-NY) , JEG CONTRACTING 289 RAMSDELL AVENUE JEGCO001 New York Workers' BUFFALO, NY 14216 Compensation JEM ERECTORS 664A CLEARVIEW AVE JEMER001 New York Workers' SHAMONG, NJ 08088 Compensation JEREMIAS E. BATISTA LLC 417 Clifton Ave JEREM001 Auto/No-Fault Clifton, NJ 07011 JERSEY CITY BORAD OF EDUC 346 CLAIRMONT AVE JERSE001 New York Workers' JERSEY CITY, NJ 07305 Compensation JGB Enterprises 115 Metropolitan Drive JGBEN001 New York Workers' Liverpool, NY 13088 Compensation JI Specialty Services [Electronic] E4603A New York Workers' , Compensation JI Specialty Services [Electronic] E4603C Other WC (Non-NY) , JIM BALL 3475 SOUTHWESTERN BLVD JIMBA001 New York Workers' ORCHARD PARK, NY 14127 Compensation JIM MURPHY BUICK-GMC 3000 WALDEN AVE JIMMU001 New York Workers' DEPEW, NY 14043 Compensation JIM RAY MOBILE 9 NEWFIELD DEPOT RD JIMRA001 New York Workers' NEWFIELD, NY 14867 Compensation JIM'S EQUIPMENT 4072 LEWIS ROAD JIMSE001 New York Workers' CAMPBELL, NY 14821 Compensation JIM'S MARINE 67 SACKETT CREEK RD JIMSM001 New York Workers' NICHOLS, NY 13812 Compensation JK JEWELRY INC 1500 BRIGHTON HENRIETTA TL RD JKJEW001 New York Workers' ROCHESTER, NY 14623 Compensation Joe Benson Svc 1421 Scottsville Road JOEBE001 New York Workers' Rochester, NY 14624 Compensation JOE'S OSBORNE STREET GARAGE 191 OSBORNE STREET JOESO001 New York Workers' ALBANY, NY 12209 Compensation JOHL & COMPANY 199 CENTER AVENUE JOHLC001 Auto/No-Fault WESTWOOD, NJ 07675 JOHN C LOWERY 80 ETNA LANE JOHNC001 New York Workers' FREEVILLE, NY 13068 Compensation JOHN H COOK PAINTING 510 BALDWIN STREET JOHNH001 New York Workers' ELMIRA, NY 14901 Compensation JOHN J KANE ATT 1315 STELTON ROAD SUITE# 1 JOHNJ001 Auto/No-Fault PISCATAWAY, NJ 08854 JOHN J. SHEPTOCK LLC 2424 MORRIS AVENUE SUITE# 302 JOHNJ002 Auto/No-Fault UNION CITY, NJ 07083 John Menard DDS 6 E. Park Row JOHNM002 New York Workers' Clinton, NY 13323 Compensation JOHN MILLS ELECTRIC 1836 GRAND CENTRAL AVE JOHNM001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation John Muir Health [Electronic] E0834A New York Workers' , Compensation John Muir Health [Electronic] E0834C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID JOHN OCONNOR PLUMBING AND HEATI 121 SOUTH KINYON STREET JOHNO001 New York Workers' ELMIRA, NY 14904 Compensation JOHN THOMPKINS 6 APOLLO DR JOHNT001 New York Workers' BATAVIA, NY 14020 Compensation JOHN W DANFORTH 300 COLVIN WOODS PARKWAY JOHNW001 New York Workers' TONAWANDA, NY 14150 Compensation Johns Eastern Co, Inc PO Box 110279 JOHNS006 New York Workers' Lakewood Ranch, FL 34211 Compensation JOHN'S TRUCK & AUTO PO BOX 327 JOHNS003 New York Workers' BIG FLATS, NY 14814 Compensation Johnson & Son 45 Pannel Street JOHNS001 New York Workers' Buffalo, NY 14215 Compensation Johnson Estate Winery Po Box 52 JOHNS005 New York Workers' Westfield, NY 14787 Compensation JOHNSON ROSE CORP 5303 CROWN DR JOHNS004 New York Workers' LOCKPORT, NY 14094 Compensation JOHNSONS POOLS & SPAS 1088 STATE ROUTE 434 JOHNS002 New York Workers' OWEGO, NY 13827 Compensation Johnston Schools [Electronic] E7737C Other WC (Non-NY) , JON T RICH CONSTRUCTION 1 CORPORATE PARK DRIVE JONTR001 New York Workers' CENTRAL SQUARE, NY 13036 Compensation JONATHAN P NISIVOCCIA 175 MARKET STREET SUITE# 206 JONAT001 Auto/No-Fault PATERSON, NJ 07505 JONES APPAREL 250 RITTENHOUSE CIRCLE JONES001 New York Workers' BRISTOL, PA 19007 Compensation Jones Services 2099 Route 17A JONES002 New York Workers' Goshen, NY 10924 Compensation Jones Truck Lines,Inc. [Electronic] E1156C Other WC (Non-NY) , JORDAN ELBRIDGE SCHOOLS PO BOX 902 JORDA001 New York Workers' JORDAN, NY 13080 Compensation JOSEPH BALDWIN CONSTRUCTION 689 SILK ROAD JOSEP001 New York Workers' FULTON, NY 13069 Compensation JOSEPH DAVIS INC 120 WEST TUPPER ST JOSE01 New York Workers' BUFFALO, NY 14201 Compensation JOURNEYS CHILD ENRICHMENT CENTER 1125 MAIN ST JOURN001 New York Workers' BUFFALO, NY 14209 Compensation Jrlon, Inc. Po Box 244 JRLON001 New York Workers' Palmyra, NY 14522 Compensation JSMC EMPL WRK COMP 1945 CORLIES AVE JSMCE001 New York Workers' NEPTUNE, NJ 07753 Compensation Judson ISD [Electronic] E0835A New York Workers' , Compensation Judson ISD [Electronic] E0835C Other WC (Non-NY) , JUPITER ENVIRONMENTAL 3 LYNN COURT JUPIT001 New York Workers' LINCOLN PARK, NJ 07035 Compensation Juvenile Jail Facility Managem [Electronic] E7353C Other WC (Non-NY) , K & K Insurance / Liability PO Box 2338 KKINS001 Auto/No-Fault 1712 Magnavox Way Fort Wayne, IN 46801 K&K INS GROUP PO BOX 2338 KKIG01 New York Workers' 1712 MAGNAVOX WAY Compensation FORT WAYNE, IN 46801 K.J. ELECTRIC PO BOX 160 KJELE001 New York Workers' SYRACUSE, NY 13206 Compensation KAG INSURANCE CO 3760 EXPRESS DR SOUTH KAGIN001 New York Workers' ISLANDIA, NY 11749 Compensation KAISER PERMANENTE W/C C/O SEDGWICK KAISE002 Other WC (Non-NY) PO BOX 14188 LEXINGTON, KY 40512 KAISER PERMANENTE W/C PO BOX 12927 KAISE001 Other WC (Non-NY) OAKLAND, CA 94604-2927 Kaleida Health PO BOX 4551 KALEI001 New York Workers' Buffalo, NY 14240 Compensation KAMINSKI & SONS TRUCK EQUIP 245 LEWIS ST KAMIN001 New York Workers' BUFFALO, NY 14206 Compensation KAPPA KAPPA GAMMA 508 THURSTON AVE KAPPA001 New York Workers' ITHACA, NY 14850 Compensation KAPRALS AUTO SERVICE 29 W. PULTNEY STREET KAPRA001 New York Workers' CORNING, NY 14830 Compensation Kaskaskia College / WC 27210 College Road KASKA001 Other WC (Non-NY) Centralia, IL 62801 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Katz Cohen & Price 123 Clements Bridge Rd # 1 KATZC001 Auto/No-Fault Barrington, NJ 08007 Kautz Vinyards [Electronic] E0836A New York Workers' , Compensation Kautz Vinyards [Electronic] E0836C Other WC (Non-NY) , KAYDEN INDUSTRIES 224 N MAIN ST BUILDING T KAYDE001 New York Workers' HORSEHEADS, NY 14845 Compensation KAZ BROTHERS CONSTRUCTION 150 N AMERICA DR KAZBR001 New York Workers' WEST SENECA, NY 14224 Compensation kbh construction 90 river road KBHCO001 New York Workers' scottsville, NY 14546 Compensation KCI Holdings USA [Electronic] E4205C Other WC (Non-NY) , KECKS MEAT PLANT RR 1 BOX 70 KECKS001 New York Workers' MILLERTON, PA 16936 Compensation Keenan and Associates [Electronic] E1281A New York Workers' , Compensation Keenan and Associates [Electronic] E1281C Other WC (Non-NY) , keenan's restrurant 1010 e ridge road KEENA001 New York Workers' rochester, NY 14621 Compensation KEEVILYSPERO WHITELAW 500 MAMARONECK AVE KEEV01 New York Workers' HARRISON, NY 10528 Compensation KEITH MARTIN ATT 123 SOUTH BROAD STREET SUITE# KEITH001 Auto/No-Fault 1820 PHILADELPHIA, PA 19109 KELBER ENTERPRISES 181 OWEGO STREET KELBE001 New York Workers' CANDOR, NY 13743 Compensation keller foundation inc 1130 annapolis road ste 202 KELLE001 New York Workers' odenton, MD 21113 Compensation KELLER GROUP 2706 PINE AVE KELLE002 New York Workers' NIAGARA FALLS, NY 14072 Compensation KELLER TECHNOLOGY 2320 MILITARY RD KELLE004 New York Workers' TONAWANDA, NY 14150 Compensation KELLEY CONSTRUCTION 10419 GILLETT ROAD KELLE003 New York Workers' ALEXANDER, NY 14005 Compensation KELLNER VROTHERS 222 CHICAGO ST KELLN001 New York Workers' BUFFALO, NY 14204 Compensation Kellogg Companies [Electronic] E1116A New York Workers' , Compensation Kellogg Companies [Electronic] E1116B Auto/No-Fault , Kellogg Companies [Electronic] E1116C Other WC (Non-NY) , KELLY BROTHERS CONSTRUCTION 310 9TH STREET KELLY005 New York Workers' WATKINS GLEN, NY 14891 Compensation KELLY SERVICES 110 WEST MAIN STREET KELLY001 New York Workers' SUITE 6 Compensation LEROY, NY 14482 KELLY SERVICES 3225 EAST LAKE RD KESE01 New York Workers' CANADAIGUA, NY 14424 Compensation KELLY SERVICES (CORNING) 55 FERRIS STREET KELLY002 New York Workers' CORNING, NY 14830 Compensation Kelly Services at Samina 1200 Taylor Road KELLY003 New York Workers' Owego, NY 13827 Compensation KELLY SHULTZ ANTIQUE 11145 MAIN ST KELLY004 New York Workers' CLARENCE, NY 14031 Compensation KELMAR CONSTRUCTION SALES INC PO BOX 282 KELMA001 New York Workers' ITHACA, NY 14851 Compensation Kelsey Construction 2375 Route 89 KELSE001 New York Workers' Seneca Falls, NY 13148 Compensation Kemper PO BOX 2935 KEMPE007 New York Workers' Clinton, IA 52733 Compensation kemper inurance p.o.box 4729 KEMPE008 Auto/No-Fault syracuse, NY 13201 Kemper Preferred [Electronic] E7868B Auto/No-Fault , KEMPER UNITRIN PO BOX 2845 KEMPE005 Auto/No-Fault SYRACUSE REGIONAL CLAIMS CLINTON, IA 527332845 Kemper\UniTrin Auto and Home [Electronic] E1249A New York Workers' , Compensation Kemper\UniTrin Auto and Home [Electronic] E1249B Auto/No-Fault , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Kemper\UniTrin Auto and Home [Electronic] E1249C Other WC (Non-NY) , Kemper\UniTrin Safeguard Ins Company E1250A New York Workers' [Electronic] , Compensation Kemper\UniTrin Safeguard Ins Company E1250B Auto/No-Fault [Electronic] , Kemper\UniTrin Safeguard Ins Company E1250C Other WC (Non-NY) [Electronic] , KEN BARRETT CHEVROLET 229 WEST MAIN ST KENBA001 New York Workers' BATAVIA, NY 14020 Compensation Ken Davis Industries Inc. [Electronic] E3772C Other WC (Non-NY) , KENCREST SERVICES ONE PLYMOUTH MEETING KENCR001 New York Workers' PLYMOUTH MEETIN, PA 19462 Compensation KENDAL AT ITHACA 2230 NORTH TIRPHAMMER RD KENDA002 New York Workers' ITHACA, NY 14850 Compensation Kendal Rest Home-Ithaca Savage Drive KENDA003 New York Workers' Ithica, NY 14850 Compensation kenmore mercy hospital 2950 ELMWOOD AVE. IDM DEPT. KENMO001 New York Workers' kenmore, NY 14217 Compensation KENNEDY VALVE 1021 E WATER STREET KENNE001 New York Workers' PO BOX 931 Compensation ELMIRA, NY 14901 KENNETH G ANDRES ATT 264 KINGS HIGHWAY EAST KENNE002 Auto/No-Fault HADDONFIELD, NJ 08033 KENNEY, MURPHY AND BEANE 1 UNION PLAZA KMB01 New York Workers' NEW LONDON, CT 06320 Compensation KENN-SCHL PO BOX 1319 KESC01 New York Workers' RICHFIELD SPRINGS, NY 13439 Compensation KENS MARINE 22ND STREET KENSM001 New York Workers' BAYONNE, NJ 07002 Compensation Kenworth of Buffalo 100 COMMERCE DRIVE KENWO001 New York Workers' LACKAWANNA, NY 14218 Compensation KERSAT LANDSCAPING 348 CONLON ROAD KERSA001 New York Workers' LANSING, NY 14882 Compensation KESSLER FAMILY LLC 410 WHITE SPRUCE BLVD KESSL001 New York Workers' ROCHESTER, NY 14830 Compensation KEUKA CONSTRUCTION PO BOX 19 KEUKA001 New York Workers' CORNING, NY 14830 Compensation KEY RISK INS CO C/O MID-ATLANTIC REGION KEYRI002 Other WC (Non-NY) PO BOX 49129 GREENSBORO, NC 27419 KEY RISK MANAGEMENT PO BOX 49129 KEYRI001 New York Workers' GREENSBORO, NC 27419 Compensation Key Risk Management Services LLC [Electronic] E0837A New York Workers' , Compensation Key Risk Management Services LLC [Electronic] E0837C Other WC (Non-NY) , KEYBANK 127 PUBLIC SQUARE KEY01 New York Workers' CLEVELAND, OH 44114 Compensation Keystone [Electronic] E8792C Other WC (Non-NY) , keystone automotive industries 8 cairn street KEYST005 New York Workers' rochester, NY 14611 Compensation KEYSTONE AUTOMOTIVE OPS 5 MARAWAY CIRCLE KEYST004 New York Workers' ROCHESTER, NY 14624 Compensation KEYSTONE BANK PO BOX 12201 KEYST006 New York Workers' ALBANY, NY 12201 Compensation KEYSTONE BUILDERS 5 ELM AVENUE KEYST002 New York Workers' DELMAR, NY 12054 Compensation KEYSTONE INSURANCE CO 1 RIVER PLACE KEYST003 New York Workers' WILMINGTON, DE 19801 Compensation Keystone Mills 1975 Route 336 KEYST001 New York Workers' Romulus, NY 14541 Compensation KICHNER, LLC PO BOX 242 KICH01 New York Workers' TONAWANDA, NY 14150 Compensation KIMBLE INC 1004 SULLIVAN ST KIMBL001 New York Workers' ELMIRA, NY 14901 Compensation KIMBLE REAL ESTATE 186 PLEASANT GROVE ROAD KIMBL002 New York Workers' ITHACA, NY 14850 Compensation KIMIL CONSTRUCTION 485 KENNEDY R KIMIL001 New York Workers' CHEEKTOWAGA, NY 14227 Compensation KIMMEL COMPANY 33 CLARK RIDGE DRIVE KIMME001 New York Workers' KIM KIMMEL Compensation BROCKPORT, NY 14420 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID King Pak Potato Company LLC [Electronic] E0838A New York Workers' , Compensation King Pak Potato Company LLC [Electronic] E0838C Other WC (Non-NY) , King Ranch [Electronic] E0839A New York Workers' , Compensation King Ranch [Electronic] E0839C Other WC (Non-NY) , KINGS EXPRESS 3813 BROADWAY KINGS005 New York Workers' CHEEKTOWAGA, NY 14227 Compensation KINGSLEY ARMS 1352 STATE ROUTE 40 KINGS007 New York Workers' SCHAGHTICOKE, NY 12154 Compensation KINGSLEY LUMBER CO RR2 BOX 160-B KINGS003 New York Workers' MILAN, PA 18831 Compensation KINGSTON HOSPITAL 396 BROADWAY KINGS006 New York Workers' KINGSTON, NY 12401 Compensation KINGSTREE GROUP P O BOX 2217 KINGS002 New York Workers' SOUTHEASTERN, PA 19399 Compensation KINGSVIEW PAVING PO BOX 2 KINGS001 New York Workers' 7 WEST 1ST ST Compensation LAKEWOOD, NY 14750 KINGSWAY ARMS NURSING HOME 323 KINGS ROAD KINGS004 New York Workers' SCHENECTADY, NY 12304 Compensation KINNEY DRUGS 2255 TRIPHAMMER ROAD KINNE001 New York Workers' ITHACA, NY 14850 Compensation KINNEY PIKE SERVICES PO BOX 370 KINNE002 New York Workers' RUTLAND, VT 05701 Compensation KINSHIP FAMILY YOUTH SERVICE 79 FLINT AVE KINSH001 New York Workers' CORNING, NY 14830 Compensation KIRBY OFFSHORE MARINE PO BOX 1537 KIRBY001 New York Workers' HOUSTON, TX 77251 Compensation Kirkland's, Inc. [Electronic] E1251A New York Workers' , Compensation Kirkland's, Inc. [Electronic] E1251B Auto/No-Fault , Kirkland's, Inc. [Electronic] E1251C Other WC (Non-NY) , KIRSCH CONSTRUCTION P O BOX 171 KIRSC001 New York Workers' NORTH BOSTON, NY 14110 Compensation KIRST CONSTRUCTION 7170 BOSTON STATE RD KIRST001 New York Workers' NORTH BOSTON, NY 14110 Compensation KISSING BRIDGE PO BOX 73 RT 240 KISSI001 New York Workers' GLENWOOD, NY 14069 Compensation KJ Poultry P.O. Box 596 KJPOU001 New York Workers' Monroe, NY 10949 Compensation KJP BAGELS LLC 1435 UPPER FRONT STREET KJPBA001 New York Workers' BINGHAMTON, NY 13901 Compensation KLEEBER AGENCY PO BOX 794 KLEEB001 New York Workers' VALATIE, NY 12184 Compensation KLEIN STEEL 105 VANGUARD PKWY KLST01 New York Workers' ROCHESTER, NY 14606 Compensation KMART WAREHOUSE 1 KRESEGE RD KMART001 New York Workers' FAIRLESS HILLS, PA 19030 Compensation KMC PROPERTY 1848 E. MAIN ST KMCPR001 New York Workers' ROCHESTER, NY 14621 Compensation KNAPP ELECTRIC 7012 POTTER ROAD KNAPP002 New York Workers' AUBURN, NY 13021 Compensation Knapp Winery 2770 County Rd 128 KNAPP001 New York Workers' Romulus, NY 14541 Compensation KNIGHTBROOK INS CO 4751 WILSHIRE BLVD SUITE# 111 KNIGH001 Auto/No-Fault LOS ANGELES, CA 90010 Kobackers Market 570 n main st KOBAC001 New York Workers' Brewster, NY 10509 Compensation Koch Metal Spinning 74 E. Jewett Ave KOCHM001 New York Workers' Buffalo, NY 14204 Compensation Koldin Law Center PO Box 279 KOLDI001 New York Workers' East Syracuse, NY 13057 Compensation KOPP-WORKERS COMP BILLING PO BOX 2337 KOPP01 New York Workers' SYRACUSE, NY 13220 Compensation KOST TIRE 3461 ERIE BLVD EAST KOST01 New York Workers' DEWITT, NY 13214 Compensation KOST TIRE & MUFFLER #41 512 NORTH ELMIRA STREET KOSTT002 New York Workers' SAYRE, PA 18840 Compensation KOST TIRE & MUFFLER BINGHAMTON 335 COURT STREET KOSTT001 New York Workers' BINGHAMTON, NY 13904 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID KRAFT FOODS 140 SPRINGS ST KRAFT001 New York Workers' AVON, NY 14414 Compensation Krasdale Foods 400 Food Center KRASD002 New York Workers' Bronx, NY 10474 Compensation KRG 666 TANGLEWOOD RD. KRG001 New York Workers' WEST ISLIP, NY 11795 Compensation KRG Management 38-27 18th Avenue KRGMA001 New York Workers' Brooklyn, NY 11218 Compensation K-SCA TRANSPORTATION ONE TOWER CENTER BLOULEVARD KSCAT001 New York Workers' 17TH FLOOR Compensation EAST BRUNSWICK, NJ 08816 KSP PAINTING 1010 COLD SPRINGS ROAD KSPPA001 New York Workers' LIVERPOOL, NY 13088 Compensation KTA Construction (COSD2) [Electronic] E0840A New York Workers' , Compensation KTA Construction (COSD2) [Electronic] E0840C Other WC (Non-NY) , Kuszlyk Cattle Company 7982 Batavia Byron Road KUSZL001 New York Workers' Batavia, NY 14020 Compensation KW Textile 659 Exchange Street KWTEX001 New York Workers' Buffalo, NY 14210 Compensation KWIK FILL 3408 EAST MAIN STREET KWIKF001 New York Workers' ENDWELL, NY 13760 Compensation L & L GARAGE 1428 FILLMORE AVE LLGAR001 New York Workers' BUFFALO, NY 14211 Compensation L & R INSTALLATION 2070 HARTELL LRINS001 New York Workers' LEVITTOWN, PA 19057 Compensation L B BOUCHER PO BOX 570 LBBOU001 Auto/No-Fault GALWAY, NY 12074 L&M TRUCKING 563 LINDLEY RD LMTRU001 New York Workers' LINDLEY, NY 14858 Compensation L&S Drywall 11500 Transit Road LSDRY002 New York Workers' E. Amherst, NY 14051 Compensation L&S DRYWALL INCORP 7332 TOWNLINE RD LSDRY001 New York Workers' N TONAWANDA, NY 14120 Compensation L. Arrowhead C. Club [Electronic] E0841A New York Workers' , Compensation L. Arrowhead C. Club [Electronic] E0841C Other WC (Non-NY) , Lab Alliance CNY 1304 Buckley Road LABAL001 New York Workers' North Syracuse, NY 13212 Compensation LABOR READY 1587 KENMORE AVE LABOR001 New York Workers' KENMORE, NY 14217 Compensation LACKAWANA 2 VALLEY SQUARE LACKA005 New York Workers' SUITE 301 Compensation BLUE BELL, PA 19422 LACKAWANNA P O BOX 270 LACKA006 Other WC (Non-NY) WILKES BARRE, PA 18703-0270 LACKAWANNA CASUALTY 46 PUBLIC SQUARE LACKA003 New York Workers' SUITE 101 Compensation WILKESBORO, PA 18701 Lackawanna Insurance 46 Public Square LACKA001 New York Workers' Suite 501 Compensation Wilkes Barres, PA 18701 LACKAWANNA INSURANCE GRP ATTN: MED CLAIMS LACKA004 New York Workers' PO BOX 270 Compensation WILKS-BARRE, PA 18703 Lackland AFB PO Box 657 LACKL001 Auto/No-Fault Kalona, IA 52247 Laclede Chain [Electronic] E0842A New York Workers' , Compensation Laclede Chain [Electronic] E0842C Other WC (Non-NY) , Laclede Steel [Electronic] E0843A New York Workers' , Compensation Laclede Steel [Electronic] E0843C Other WC (Non-NY) , Lake Elsinore School District [Electronic] E0844A New York Workers' , Compensation Lake Elsinore School District [Electronic] E0844C Other WC (Non-NY) , Lakeshore Behavioral Health 255 Delaware Ave. LAKES006 New York Workers' STE 300 Compensation Buffalo, NY 14202 LAKESHORE CENTRAL SCHOOL 959 BEACH ROAD LAKES004 New York Workers' ANGOLA, NY 14006 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID LAKESHORE PAVING 7 OSMER ST LAKES005 New York Workers' JAMESTOWN, NY 14701 Compensation LAKESIDE HOSPITAL 156 WEST AVE LAKES002 New York Workers' ATTENT: JANICE DOLLARD Compensation BROCKPORT, NY 14420 Lakeside Nursing Home 1229 Trumansburg Road LAKES001 New York Workers' Ithaca, NY 14850 Compensation LAKESIDE RESTAURANT 13780A WESTLAKE ROAD LAKES003 New York Workers' HAMMONDSPORT, NY 14840 Compensation lakeview mental health 600 w washington st LAKEV001 New York Workers' geneva, NY 14456 Compensation LALOR CREEKSIDE DENTISTRY 2521 VESTAL PARKWAY WEST LALOR001 New York Workers' VESTAL, NY 13850 Compensation Lamar Consolidated ISD [Electronic] E0845A New York Workers' , Compensation Lamar Consolidated ISD [Electronic] E0845C Other WC (Non-NY) , LAMB & WEBSTER 5304 STATE RT 417 LAMBW001 New York Workers' WOODHULL, NY 14898 Compensation LAMB FARMS INC 6880 ALBION ROAD LAMBF001 New York Workers' OAKFIELD, NY 14125 Compensation LAMBERT MATERIAL HANDLING 6581 TOWNLINE ROAD LAMBE001 New York Workers' SYRACUSE, NY 13206 Compensation Lamesa ISD [Electronic] E0846A New York Workers' , Compensation Lamesa ISD [Electronic] E0846C Other WC (Non-NY) , Lamorte Burns 1101 Kingshighway North LAMOR001 New York Workers' Cherry Hill, NJ 08034 Compensation LAMORTE BURNS 100 CENTURY PKWY STE 300 LAMOR003 New York Workers' MOUNT LAUREL, NJ 08054 Compensation LAMORTE BURNS COMPANY 3850 NORTH CAUSEWAY LAMOR002 New York Workers' METARIE, LA 70002 Compensation LANCASTER 1ST AID/LISA FARARA 77 CENTRAL AVE LANCA002 New York Workers' LANCASTER, NY 14086 Compensation LANCASTER KNIVES 165 COURT ST LANCA001 New York Workers' LANCASTER, NY 14086 Compensation LANCER INS CO PO BOX 9123 LANCE001 Auto/No-Fault PLAINVIEW, NY 11803-9123 LANCER INSURANCE 370 W PARK AVE LANCE002 Auto/No-Fault LONG BEACH, NY 11561 Lan-Co Companies 7330 Eastman Road LANCO001 New York Workers' North Syracuse, NY 13212 Compensation LAND GATE REALTY PO BOX 1841 LANDG001 New York Workers' SPRING VALLEY, NY 10977 Compensation LAND STAR LIGHT TOWERS INC 2963 RUGER ROAD LANDS001 New York Workers' ROYCE CITY, TX 75187 Compensation LANDMARK CONSTRUCTION PO BOX 616 LANDM001 New York Workers' TONAWANDA, NY 14150 Compensation Landmark Golf Co [Electronic] E0847A New York Workers' , Compensation Landmark Golf Co [Electronic] E0847C Other WC (Non-NY) , Landmark Grad&Paving [Electronic] E0848A New York Workers' , Compensation Landmark Grad&Paving [Electronic] E0848C Other WC (Non-NY) , Landstar Bco Wc Program [Electronic] E7278C Other WC (Non-NY) , Lane County [Electronic] E0849A New York Workers' , Compensation Lane County [Electronic] E0849C Other WC (Non-NY) , LANGER TRANPORT 420 RTE 440 LANGE001 New York Workers' JERSEY CITY, NJ 07307 Compensation LANGHORNE WOOD PROD 150 TRENTON RD LANGH001 New York Workers' LANGHORNE, PA 19047 Compensation LAPP INSULATORS 130 GILBERT ST LAPPI001 New York Workers' LEROY, NY 14482 Compensation Larimer County - WC [Electronic] E0850A New York Workers' , Compensation Larimer County - WC [Electronic] E0850C Other WC (Non-NY) , LAS CHICAS TAQUERIA 208 FRONT STREET LASCH001 New York Workers' OWEGO, NY 13827 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID LASALLE SCHOOL 391 WESTERN AVENUE LASAL001 New York Workers' ALBANY, NY 12203 Compensation Laura's Critter Care 142 Burroughs Dr LAURA001 New York Workers' Amherst, NY 14226 Compensation LAVERACK & HAINES 238 MAIN ST LAVE01 New York Workers' BUFFALO, NY 14202 Compensation Law Department 100 Church Street LAWDE001 New York Workers' New York, NY 10007 Compensation LAW OFCS OF ERIC A SHORE ONE GATEWAY CENTER SUITE# LAWOF001 Auto/No-Fault 2600 NEWARK, NJ 07102 Lawley Insurance 565 Taxter Road LAWLE001 New York Workers' Attn: Claims Dept. Compensation Elmsford, NY 10523 LAWLEY SERVICES 361 DELAWARE AVE LAW01 New York Workers' BUFFALO, NY 14202 Compensation Lawrence Correctional Center / WC Lawrence Correctional Center / WC LAWRE001 Other WC (Non-NY) Sumner, IL 62466 LB Auto/Pacific Part [Electronic] E0851A New York Workers' , Compensation LB Auto/Pacific Part [Electronic] E0851C Other WC (Non-NY) , LB Auto/Pacific Supp [Electronic] E0852A New York Workers' , Compensation LB Auto/Pacific Supp [Electronic] E0852C Other WC (Non-NY) , LC WHITFORD COMPANY PO BOX 663 LCWHI001 New York Workers' WELLSVILLE, NY 14895 Compensation LEAGUE OF MINNESOTA CITIES INSURANCE 145 UNIVERSITY AVE N LEAGU001 Other WC (Non-NY) ST PAUL, MN 55103 League of Minnesota Cities Insurance Trust E0853C Other WC (Non-NY) [Electronic] , LECHASE CONSTRUCTION 205 INDIGO CREEK LECHA004 New York Workers' ROCHESTER, NY 14606 Compensation LECHASE CONSTRUCTION 300 TROLLEY BLVD LECHA002 New York Workers' ROCHESTER, NY 14606 Compensation LECHASE CONSTRUCTION 609 ERIE BLVD W LECHA003 New York Workers' SYRACUSE,, NY 13204 Compensation LECHASE INSURANCE 300 TROLLEY BLVD LEIN01 New York Workers' ROCHESTER, NY 14606 Compensation LEDGE CREEK 10100 COUNTRY RD LEDGE001 New York Workers' ATTN: JOE Compensation CLARENCE CENTER, NY 14032 LEE BRASWELL MASONARY 17240 TOWNHOUSE ROAD LEEBR001 New York Workers' SAGERTWON, PA 16433 Compensation LEE SHUKNECHT AND SON 4458 FORD ROAD LEESH001 New York Workers' ELBA, NY 14058 Compensation LeGasse Works 5 Old RT 31 LEGAS001 New York Workers' Lyons, NY 14489 Compensation Leighton Home Co. PO Box 165 LEIGH001 New York Workers' 2 Hadley Bay Rd. Compensation Stow, NY 14785 Lekos Electric [Electronic] E0854A New York Workers' , Compensation Lekos Electric [Electronic] E0854C Other WC (Non-NY) , LEMOYNE INTERIORS 625 ERIE BLVD WEST LEMOY001 New York Workers' SYRACUSE, NY 13204 Compensation LENOX 1414 RADCLIFFE ST LENOX001 New York Workers' BRISTOL, PA 19007 Compensation Leonardi Manufacturing 2728 Erie Drive LEONA001 New York Workers' Weedsport, NY 13166 Compensation Leroy Manor P.O. Box 40 LEROY001 New York Workers' LeRoy, NY 14482 Compensation Leroy Police Department 3 WEST MAIN STREET LEROY002 New York Workers' leroy, NY 14482 Compensation leroy recreation 48 Main Street LEROY003 New York Workers' Leroy, NY 14482 Compensation LEROY VILLAGE GREEN 10 MUNSON ST LEROY004 New York Workers' LEROY, NY 14482 Compensation LETCHWORTH STATE PARK 7 LETCHWORTH STATE PARK LETCH001 New York Workers' CASTLE, NY 14427 Compensation LEVIN & MALKIN ATT 75 ESSEX STREET LEVIN001 Auto/No-Fault HACKENSACK, NJ 07102 Levin Enterprises, Inc. [Electronic] E0855A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Levin Enterprises, Inc. [Electronic] E0855C Other WC (Non-NY) , LEVITT & FUIRST INSURANCE 1 EXECUTIVE BLVD LFI01 New York Workers' YONKERS, NY 10701 Compensation LEVITTOWN TRACE APT 3000 FORD RD LEVIT001 New York Workers' BRISTOL, PA 19007 Compensation LEWIS COUNTY SELF INSURANCE 7669 STATE ST LEWCOU01 New York Workers' LOWVILLE , NY 13367 Compensation LEWIS TREE SERVICE 300 LUCIUS DR LEWIS001 New York Workers' W HENRIETTA, NY 14586 Compensation LFP Corporation [Electronic] E1252A New York Workers' , Compensation LFP Corporation [Electronic] E1252B Auto/No-Fault , LFP Corporation [Electronic] E1252C Other WC (Non-NY) , LI RAILROAD 173 MINEOLA BLVD LIRAI001 New York Workers' MINEOLA, NY 11501 Compensation LIBERTY MUTUAL WC PO BOX 1052 LIBER185 Other WC (Non-NY) MONTGOMERYVILLE, PA 18936 LIBERTY BELL P O BOX 159 LIBER011 New York Workers' WARREN, MI 48090 Compensation Liberty Brass 3801 Queens Blvd LIBER181 New York Workers' Long Island City, NY 11101 Compensation LIBERTY COLLISION 6131 COURT STREET ROAD LIBER183 New York Workers' SYRACUSE, NY 13206 Compensation LIBERTY ENTERPRISES 43 LIBERTY DRIVE LIBER016 New York Workers' AMSTERDAM, NY 12010 Compensation LIBERTY INSURANCE CORP 175 BERKELEY ST LIMU16 New York Workers' BOSTON, MA 02117 Compensation LIBERTY MARITIME CORP 757 THIRD AVE SUITE 1703 LIBER186 Other WC (Non-NY) NEW YORK, NY 10017 Liberty Mutual PO BOX 7203 LIBER021 Other WC (Non-NY) London, KY 40742 Liberty Mutual po Box 7205 LIBER020 Other WC (Non-NY) London, KY 40742 Liberty Mutual po Box 7205 LIBER175 New York Workers' London, KY 40742 Compensation Liberty Mutual PO BOX 7230 LIBER178 Auto/No-Fault LONDON, KY 40742 LIBERTY MUTUAL PO BOX 1052 LIBER172 Auto/No-Fault MONTGOMERYVILLE, PA 18936 LIBERTY MUTUAL PO BOX 8413 LIBER188 Auto/No-Fault WESTMINSTER, CA 92684 Liberty Mutual Imaging Center PO BOX 515099 LIBER173 Other WC (Non-NY) Los Angeles, CA 90051 Liberty Mutual Insurance Co [Electronic Indirect] 10 Corporate Drive LIBER22 New York Workers' STE 100 Compensation Bedford, NH 03110 Liberty Mutual Insurance Co [Electronic Indirect] 10 Corporate Drive LIBER23 Auto/No-Fault STE 100 Bedford, NH 03110 Liberty Mutual Insurance Co [Electronic Indirect] 10 Corporate Drive LIBER24 Other WC (Non-NY) STE 100 Bedford, NH 03110 Liberty Mutual Insurance Co [Electronic Indirect] 10 East Stow Road LIBER25 Other WC (Non-NY) Suite 100 Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] 10 East Stow Road LIBER26 Auto/No-Fault Suite 100 Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] 10 East Stow Road LIBER27 New York Workers' Suite 100 Compensation Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] 1084 South Laurel Road LIBER28 New York Workers' London, KY 40744 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 1084 South Laurel Road LIBER29 Auto/No-Fault London, KY 40744 Liberty Mutual Insurance Co [Electronic Indirect] 1084 South Laurel Road LIBER30 Other WC (Non-NY) London, KY 40744 Liberty Mutual Insurance Co [Electronic Indirect] 1401 Matthews Township Parkway LIBER31 Other WC (Non-NY) Suite 300 Matthews, NC 28106 Liberty Mutual Insurance Co [Electronic Indirect] 1401 Matthews Township Parkway LIBER32 Auto/No-Fault Suite 300 Matthews, NC 28106 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Liberty Mutual Insurance Co [Electronic Indirect] 1401 Matthews Township Parkway LIBER33 New York Workers' Suite 300 Compensation Matthews, NC 28106 Liberty Mutual Insurance Co [Electronic Indirect] 175 BERKELEY ST LIBER34 New York Workers' BOSTON, MA 02117 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 175 BERKELEY ST LIBER35 Auto/No-Fault BOSTON, MA 02117 Liberty Mutual Insurance Co [Electronic Indirect] 175 BERKELEY ST LIBER36 Other WC (Non-NY) BOSTON, MA 02117 Liberty Mutual Insurance Co [Electronic Indirect] 2000 Westwood Drive LIBER37 Other WC (Non-NY) Wausau, WI 54401 Liberty Mutual Insurance Co [Electronic Indirect] 2000 Westwood Drive LIBER38 Auto/No-Fault Wausau, WI 54401 Liberty Mutual Insurance Co [Electronic Indirect] 2000 Westwood Drive LIBER39 New York Workers' Wausau, WI 54401 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 2100 WALNUT HILL LANE LIBER40 New York Workers' STE 100 Compensation IRVING, TX 75038 Liberty Mutual Insurance Co [Electronic Indirect] 2100 WALNUT HILL LANE LIBER41 Auto/No-Fault STE 100 IRVING, TX 75038 Liberty Mutual Insurance Co [Electronic Indirect] 2100 WALNUT HILL LANE LIBER42 Other WC (Non-NY) STE 100 IRVING, TX 75038 Liberty Mutual Insurance Co [Electronic Indirect] 2501 WILMINGTON RD LIBER43 Other WC (Non-NY) NEW CASTLE, PA 16105 Liberty Mutual Insurance Co [Electronic Indirect] 2501 WILMINGTON RD LIBER44 Auto/No-Fault NEW CASTLE, PA 16105 Liberty Mutual Insurance Co [Electronic Indirect] 2501 WILMINGTON RD LIBER45 New York Workers' NEW CASTLE, PA 16105 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 3 BECKER FARM RD LIBER46 New York Workers' ROSELAND, NJ 07068 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 3 BECKER FARM RD LIBER47 Auto/No-Fault ROSELAND, NJ 07068 Liberty Mutual Insurance Co [Electronic Indirect] 3 BECKER FARM RD LIBER48 Other WC (Non-NY) ROSELAND, NJ 07068 Liberty Mutual Insurance Co [Electronic Indirect] 323 ESSJAY RD LIBER49 Other WC (Non-NY) WILLIAMSVILLE, NY 14221 Liberty Mutual Insurance Co [Electronic Indirect] 323 ESSJAY RD LIBER50 Auto/No-Fault WILLIAMSVILLE, NY 14221 Liberty Mutual Insurance Co [Electronic Indirect] 323 ESSJAY RD LIBER51 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 43 LIBERTY DRIVE LIBER52 New York Workers' AMSTERDAM, NY 12010 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 43 LIBERTY DRIVE LIBER53 Auto/No-Fault AMSTERDAM, NY 12010 Liberty Mutual Insurance Co [Electronic Indirect] 43 LIBERTY DRIVE LIBER54 Other WC (Non-NY) AMSTERDAM, NY 12010 Liberty Mutual Insurance Co [Electronic Indirect] 50 Charles Lindbergh Blvd. LIBER55 Other WC (Non-NY) Uniondale, NY 11553 Liberty Mutual Insurance Co [Electronic Indirect] 50 Charles Lindbergh Blvd. LIBER56 Auto/No-Fault Uniondale, NY 11553 Liberty Mutual Insurance Co [Electronic Indirect] 50 Charles Lindbergh Blvd. LIBER57 New York Workers' Uniondale, NY 11553 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 520 White Plains Road LIBER58 New York Workers' Tarrytown, NY 10591 Compensation Liberty Mutual Insurance Co [Electronic Indirect] 520 White Plains Road LIBER59 Auto/No-Fault Tarrytown, NY 10591 Liberty Mutual Insurance Co [Electronic Indirect] 520 White Plains Road LIBER60 Other WC (Non-NY) Tarrytown, NY 10591 Liberty Mutual Insurance Co [Electronic Indirect] 70 East Sunrise HWY LIBER61 Other WC (Non-NY) STE 618 VALLEY STREAM, NY 11581 Liberty Mutual Insurance Co [Electronic Indirect] 70 East Sunrise HWY LIBER62 Auto/No-Fault STE 618 VALLEY STREAM, NY 11581 Liberty Mutual Insurance Co [Electronic Indirect] 70 East Sunrise HWY LIBER63 New York Workers' STE 618 Compensation VALLEY STREAM, NY 11581 Liberty Mutual Insurance Co [Electronic Indirect] 80 Grasslands Rd LIBER103 Other WC (Non-NY) Ste: 1 Elmsford, NY 10523-1100 Liberty Mutual Insurance Co [Electronic Indirect] 80 Grasslands Rd LIBER104 Auto/No-Fault Ste: 1 Elmsford, NY 10523-1100 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Liberty Mutual Insurance Co [Electronic Indirect] 80 Grasslands Rd LIBER105 New York Workers' Ste: 1 Compensation Elmsford, NY 10523-1100 Liberty Mutual Insurance Co [Electronic Indirect] P O BOX 7205 LIBER64 New York Workers' LONDON, KY 40742 Compensation Liberty Mutual Insurance Co [Electronic Indirect] P O BOX 7205 LIBER65 Auto/No-Fault LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] P O BOX 7205 LIBER66 Other WC (Non-NY) LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] P.O Box 7072 LIBER67 Other WC (Non-NY) London, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] P.O Box 7072 LIBER68 Auto/No-Fault London, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] P.O Box 7072 LIBER69 New York Workers' London, KY 40742 Compensation Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 1200 LIBER70 New York Workers' Elmsford, NY 10523 Compensation Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 1200 LIBER71 Auto/No-Fault Elmsford, NY 10523 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 1200 LIBER72 Other WC (Non-NY) Elmsford, NY 10523 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 3634 LIBER73 Other WC (Non-NY) Bala Cynwyd, PA 19004 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 3634 LIBER74 Auto/No-Fault Bala Cynwyd, PA 19004 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 3634 LIBER75 New York Workers' Bala Cynwyd, PA 19004 Compensation Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 490 LIBER76 New York Workers' Central Islip, NY 117229814 Compensation Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 490 LIBER77 Auto/No-Fault Central Islip, NY 117229814 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 490 LIBER78 Other WC (Non-NY) Central Islip, NY 117229814 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 8027 LIBER79 Other WC (Non-NY) Huntington Station, NY 11746 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 8027 LIBER80 Auto/No-Fault Huntington Station, NY 11746 Liberty Mutual Insurance Co [Electronic Indirect] P.O. Box 8027 LIBER81 New York Workers' Huntington Station, NY 11746 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 100058 LIBER82 New York Workers' DELUTH, GA 30096 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 100058 LIBER83 Auto/No-Fault DELUTH, GA 30096 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 100058 LIBER84 Other WC (Non-NY) DELUTH, GA 30096 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1046 LIBER85 Other WC (Non-NY) Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1046 LIBER86 Auto/No-Fault Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1046 LIBER87 New York Workers' Marlton, NJ 08053 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1050 LIBER88 New York Workers' Marlton, NJ 08053 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1050 LIBER89 Auto/No-Fault Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1050 LIBER90 Other WC (Non-NY) Marlton, NJ 08053 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1052 LIBER91 Other WC (Non-NY) MONTGOMERYVILLE, PA 18936 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1052 LIBER92 Auto/No-Fault MONTGOMERYVILLE, PA 18936 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1052 LIBER93 New York Workers' MONTGOMERYVILLE, PA 18936 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1128 LIBER94 New York Workers' Blue Bell, PA 19422 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1128 LIBER95 Auto/No-Fault Blue Bell, PA 19422 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1128 LIBER96 Other WC (Non-NY) Blue Bell, PA 19422 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1507 LIBER97 Other WC (Non-NY) DOVER, NH 03825 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1507 LIBER98 Auto/No-Fault DOVER, NH 03825 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 1507 LIBER99 New York Workers' DOVER, NH 03825 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1901 LIBER100 New York Workers' 100 Eagle Rock Ave. Compensation East Hanover, NJ 07936 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1901 LIBER101 Auto/No-Fault 100 Eagle Rock Ave. East Hanover, NJ 07936 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 1901 LIBER102 Other WC (Non-NY) 100 Eagle Rock Ave. East Hanover, NJ 07936 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 31204 LIBER106 New York Workers' TAMPA, FL 33631 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 31204 LIBER107 Auto/No-Fault TAMPA, FL 33631 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 31204 LIBER108 Other WC (Non-NY) TAMPA, FL 33631 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3423 LIBER109 Other WC (Non-NY) GAINESVILLE, GA 30503 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3423 LIBER110 Auto/No-Fault GAINESVILLE, GA 30503 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3423 LIBER111 New York Workers' GAINESVILLE, GA 30503 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3634 LIBER112 New York Workers' BALACYNWID, PA 19004 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3634 LIBER113 Auto/No-Fault BALACYNWID, PA 19004 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 3634 LIBER114 Other WC (Non-NY) BALACYNWID, PA 19004 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 4834 LIBER115 Other WC (Non-NY) Syracuse, NY 13221 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 4834 LIBER116 Auto/No-Fault Syracuse, NY 13221 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 4834 LIBER117 New York Workers' Syracuse, NY 13221 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 4836 LIBER118 New York Workers' STE 202 Compensation SYRACUSE, NY 13221 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 4836 LIBER119 Auto/No-Fault STE 202 SYRACUSE, NY 13221 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 4836 LIBER120 Other WC (Non-NY) STE 202 SYRACUSE, NY 13221 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 5061 LIBER121 Other WC (Non-NY) Freehold, NJ 07728 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 5061 LIBER122 Auto/No-Fault Freehold, NJ 07728 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 5061 LIBER123 New York Workers' Freehold, NJ 07728 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7072 LIBER124 New York Workers' LONDON, KY 40742 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7072 LIBER125 Auto/No-Fault LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7072 LIBER126 Other WC (Non-NY) LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7170 LIBER127 Other WC (Non-NY) Indianapolis, IN 46207 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7170 LIBER128 Auto/No-Fault Indianapolis, IN 46207 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7170 LIBER129 New York Workers' Indianapolis, IN 46207 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7203 LIBER130 New York Workers' LONDON, KY 40742 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7203 LIBER131 Auto/No-Fault LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 7203 LIBER132 Other WC (Non-NY) LONDON, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] po Box 7205 LIBER133 Other WC (Non-NY) London, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] po Box 7205 LIBER134 Auto/No-Fault London, KY 40742 Liberty Mutual Insurance Co [Electronic Indirect] po Box 7205 LIBER135 New York Workers' London, KY 40742 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 8016 LIBER136 New York Workers' WAUSAU, WI 54402 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 8016 LIBER137 Auto/No-Fault WAUSAU, WI 54402 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 8016 LIBER138 Other WC (Non-NY) WAUSAU, WI 54402 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9045 LIBER139 New York Workers' Farmingdale, NY 11735 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9045 LIBER140 Other WC (Non-NY) Farmingdale, NY 11735 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9045 LIBER141 Auto/No-Fault Farmingdale, NY 11735 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9101 LIBER142 Auto/No-Fault Weston, MA 02493 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9101 LIBER143 Other WC (Non-NY) Weston, MA 02493 Liberty Mutual Insurance Co [Electronic Indirect] PO Box 9101 LIBER144 New York Workers' Weston, MA 02493 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 9525 LIBER145 New York Workers' MANCHESTER, NH 03108 Compensation Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 9525 LIBER146 Other WC (Non-NY) MANCHESTER, NH 03108 Liberty Mutual Insurance Co [Electronic Indirect] PO BOX 9525 LIBER147 Auto/No-Fault MANCHESTER, NH 03108 LIBERTY MUTUAL INSURANCE COMPANY PO BOX 7203 LIBER006 New York Workers' LONDON, KY 40742 Compensation Liberty Mutual Tarrytown PO BOX 1203 LIBER179 New York Workers' Elmsford, NY 10523 Compensation Liberty Mututal Po Box 7072 LIBER176 New York Workers' Home Depot Claims Compensation London, KY 40742 Liberty Northwest [Electronic] E7346A New York Workers' , Compensation Liberty Northwest [Electronic] E7346C Other WC (Non-NY) , LIBERTY PAPER 180 WEST 52ND S LIBER150 New York Workers' BAYONNE, NJ 07002 Compensation LIBERTY RESEARCH CO PO BOX 107 LIBER010 New York Workers' ROUTE 17C Compensation WAVERLY, NY 14892 Liberty Resources 1065 James St. LIBER015 New York Workers' Syracuse, NY 13203 Compensation Liberty Wausau [Electronic] E9314A New York Workers' , Compensation Liberty Wausau [Electronic] E9314C Other WC (Non-NY) , Liberty/Peerless Imaging Center PO BOX 515099 LIBER182 New York Workers' Los Angeles, CA 90051 Compensation LIFE CARE CENTER P.O. BOX 70300 LIFEC002 Other WC (Non-NY) LAS VEGAS, NV 89710 LIFE CARE CENTER OF RENO 445 HOLCOMB RANCH LANE LIFEC003 Other WC (Non-NY) RENO, NV 89511 LifeCare WC 7010 Little River Turnpike LIFEC001 New York Workers' Suite 450 Compensation Annandale, VA 22003 LifeSpire - WC 350 Fifth Ave LIFES001 New York Workers' New York, NY 10118 Compensation LIFESTYLE PROPERTIES 959 DRYDEN ROAD LIFES002 New York Workers' ITHACA, NY 14850 Compensation LIFETIME ASSISTANCE 425 PAUL RD LIFET001 New York Workers' ROCHESTER, NY 14624 Compensation LIFETIME CARE 3111 WINTON RD S LIF01 New York Workers' ROCHESTER, NY 14623 Compensation LIFETRAC NETWORK 111000 WAYZATA BLVD LTN01 New York Workers' STE 350 Compensation MINNEAPOLIS, MN 55305-5556 LILL OVERHEAD DOORS 142 COLUMBIA TURNPIKE LILLO001 New York Workers' RENSSELAER, NY 12144 Compensation LIME ENERGY 16810 KENTON DR LIMEE001 New York Workers' HUNTERSVILLE, NC 28078 Compensation Lincare 939 Jefferson Road LINCA001 New York Workers' Rochester, NY 14623 Compensation LINCOLN GENERAL INS CO 3350 WHITEFORD ROAD LINC01 New York Workers' YORK, PA 17402 Compensation LINCOLN GENERAL INS CO 999 STEWART AVE LINCO001 Auto/No-Fault BETHPAGE, NY 11714 Lincoln General Insurance PO Box 3608 LINCO002 New York Workers' York, PA 17402 Compensation Lincoln General Insurance PO Box 3608 LINCO003 Auto/No-Fault York, PA 17402 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID LINDLEY WOOD WORKS 9449 MORGAN CREEK RD LINDL001 New York Workers' LINDLEY, NY 14858 Compensation Liquid Products, LLC 631 Waterloo Geneva Rd LIQUI001 New York Workers' Waterloo, NY 13165 Compensation LITTLE CAESARS 709 NORTH MAIN STREET LITTL001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation LIVE NATION 9993 ALLEGHANY ROAD LIVEN001 New York Workers' DARIEN CENTER, NY 14040 Compensation LIVERPOOL POOL AND SPA 3424 ROUTE 31 LIVER001 New York Workers' BALDWINSVILLE, NY 13027 Compensation Livingston Associates 80 West River Road LIVIN001 New York Workers' Scottsville, NY 14546 Compensation LIVINGSTON CORRECTIONAL FACILITY PO BOX 49 LIVIN004 New York Workers' RT 36 SONYEA RD Compensation SONYEA, NY 14556 Livingston Hills Nursing and Rehab PO BOX 95 LIVIN003 New York Workers' Livingston, NY 12541 Compensation Livingston ISD [Electronic] E0856A New York Workers' , Compensation Livingston ISD [Electronic] E0856C Other WC (Non-NY) , Lk Arrowhead Co Club [Electronic] E0857A New York Workers' , Compensation Lk Arrowhead Co Club [Electronic] E0857C Other WC (Non-NY) , LMC INDUSTRIAL CONTRACTORS INC 2060 LAKEVILLE ROAD LMCIN001 New York Workers' AVON, NY 14414 Compensation LMS Shipmanagement Inc 11 North Water St. Ste. 18 LMSSH001 New York Workers' Mobile, AL 36602 Compensation LOBUS & WAUSAU SERVICES PO BOX 100341 LWS01 New York Workers' BROOKLYN, NY 11210 Compensation LOCAL 15 WELFARE FUND 265 WEST 14TH ST ROOM 500 LOCAL003 Other WC (Non-NY) NEW YORK, NY 10011 LOCAL 15 WELFARE FUND 265 WEST 14TH ST. ROOM 500 LOCAL002 New York Workers' NEW YORK, NY 10011 Compensation LOCAL 4 COMP ROOFERS 385 PARSIPPANY RD LOCAL001 New York Workers' PARSIPPANY, NJ 07054 Compensation Locton Company 725 S Figueroa Street LOCTO001 New York Workers' 35th Floor Compensation Los Angeles, CA 90017, NY 90017 LODGES AT CRESTHAVEN 3210 LAKE SHORE DRIVE LODGE001 New York Workers' LAKE GEORGE, NY 12845 Compensation Lodi Memorial Hospital [Electronic] E0858A New York Workers' , Compensation Lodi Memorial Hospital [Electronic] E0858C Other WC (Non-NY) , Long Beach Unified School District [Electronic] E0859C Other WC (Non-NY) , LONG ISLAND COLLEGE HOSPITAL 339 HICKS STREET LONGI004 New York Workers' BROOKLYN, NY 11201 Compensation LONG ISLAND INSURANCE PO BOX 1345 LONGI005 Auto/No-Fault 425 BROAD HOLLOW RD MELVILLE, NY 11747 Long Island Rail Road Claims Dept LONGI006 New York Workers' 93-02 Sutphin Blvd Compensation Jamaica, NY 11435 Long Island Rail Road Claims Jamaica Station LONGI002 New York Workers' Claims Dept 1144 Compensation Jamaica, NY 11435 Longs Drugs [Electronic] E1305A New York Workers' , Compensation Longs Drugs [Electronic] E1305C Other WC (Non-NY) , LONGVIEW NURSNG HOME ITHACARE COMMUNITY LONGV001 New York Workers' 1 BELLA VISTA DRIVE Compensation ITHACA, NY 14850 Loomis Co PO BOX 14162 LOOMI001 New York Workers' Reading, PA 19612 Compensation Lopke Gravel Products 3430 State Route 434 LOPKE001 New York Workers' Apalachin, NY 13732 Compensation LORD & KOBRIN 1283 ROUTE 22 LORDK001 Auto/No-Fault MOUNTAINSIDE, NJ 07092 LORRE SYLVAN SMITH ATT 111 NORTHFIELD AVENUE LORRE001 Auto/No-Fault WEST ORANGE, NJ 07052 LOR-ROB DAIRY FARM 10171 BETHANY CENTER RD LOR01 New York Workers' EAST BETHANY, NY 14054 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID LOUDONVILLE CHRISTIAN SCHOOL 374 LOUDON RD LOUDO001 New York Workers' LOUDONVILLE, NY 12211 Compensation LOUIS N PICCIANO & SON PO BOX 448 LOUIS002 New York Workers' VESTAL, NY 13851 Compensation louis picciano & son plumbing 320 n jenson road LOUIS001 New York Workers' vestal, NY 13850 Compensation Louisiana Work Comp Corp [Electronic] E1282A New York Workers' , Compensation Louisiana Work Comp Corp [Electronic] E1282C Other WC (Non-NY) , LOURDES HOSP 169 RIVERSIDE DR LOURD001 New York Workers' BINGHAMTON, NY 13905 Compensation LOURDES HOSPITAL H.R. 169 RIVERSIDE DR LHHR01 New York Workers' BINGHAMTON, NY 13905 Compensation LOVELL SAFETY MANAGEMENT 110 WILLIAM LOVE02 New York Workers' 12TH FLOOR Compensation NEW YORK, NY 10038 LOWER BUCKS HOSPITAL PERSONNEL/WORKCOMP LOWER001 New York Workers' 501 BATH RD Compensation BRISTOL, PA 19007 Lowe's [Electronic] E1306A New York Workers' , Compensation Lowe's [Electronic] E1306C Other WC (Non-NY) , LOWRY ELECTRIC 8 CHERRY STREET LOWRY001 New York Workers' HATFIELD, PA 19053 Compensation LOYOLA RECOVERY FOUNDATION 1159 PITTSFORD VICTOR ROAD LOYOL001 New York Workers' PITTSFORD, NY 14534 Compensation LPS ENTERPRISES 200 SALINA STREET LPSEN001 New York Workers' LIVERPOOL, NY 13088 Compensation Lsg Sky Chefs International [Electronic] E4591C Other WC (Non-NY) , LUA CLAIMS PO BOX 6050 LUACL001 New York Workers' SCRANTON, PA 18505 Compensation Luba Casualty Insurance Company [Electronic] E6474B Auto/No-Fault , Luba Casualty Insurance Company [Electronic] E6474C Other WC (Non-NY) , luedtke 10th fourth st LUEDT001 New York Workers' po box 111 Compensation frankfort, MI 49635-0111 Luedtke PO BOX 111 LUEDT002 New York Workers' Frankfort, MI 49635 Compensation LUKOIL 501 S OX VALLEY RD LUKOI001 New York Workers' FAIRLESS HILLS, PA 19030 Compensation LUMBARMAN UNDERWRITING ALLIANCE PO BOX H LUMBA001 Other WC (Non-NY) WHIPPANY, NJ 07981 Lumber Insurance Companies 1671 Worcester RD LUMBE005 New York Workers' STE 300 Compensation Framingham, MA 01701-5400 LUMBERMAN ASSOC 2101 HUNTER RD LUMBE004 New York Workers' BRISTOL, PA 19007 Compensation LUMBERMANS MUTUAL CASUALTY 5784 WIDEWATERS PKWY LUBU02 New York Workers' SYRACUSE, NY 13214 Compensation Lumbermans Mutual Group 1 Corporate Dr LUMBE003 New York Workers' Suite 200 Compensation Lake Zurich, IL 60047 LUMBERMANS UNDERWRITING 1905 NW CORP BLVD LUMU03 New York Workers' BOCA RATON, FL 33431-7315 Compensation LUMBERMANS UNDERWRITING 7401 METRO BLVD LUMBE001 New York Workers' SUITE 250 Compensation MINNEAPOLIS, MN 55439 LUMBERMANS UNDERWRITING PO BOX 3061 LUMU01 New York Workers' BOCA RATON, FL 33431 Compensation Lumbermans Underwriting Alliance / WC 7401 Metro Blvd. LUMBE002 Other WC (Non-NY) Suite 250 Minneapolis, MN 55439 Lumbermen's Underwriting Alliance [Electronic] E0860C Other WC (Non-NY) , Lupo's Federal Plant PO BOX 5721 LUPOS001 New York Workers' Endicott, NY 13763 Compensation LVI ENVIRONMENTAL 120 ELMGROVE PK LVIEN001 New York Workers' ROCHESTER, NY 14620 Compensation LWP Claims Solution P.O Box 349016 LWPCL001 New York Workers' Sacramento, CA 95834 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID LYNCOURT FIRE DEPARTMENT 2909 COURT STREET LYNCO001 New York Workers' SYRACUSE, NY 13208 Compensation Lynn H Scott Inc PO Box 70 LYNNH002 New York Workers' Blossvale, NY 13308 Compensation LYNN H. SCOTT 8830 BLOSSVALE RD LYNNH001 New York Workers' BLOSSVALE, NY 13308 Compensation Lynwood Unified School District (CA) [Electronic] E1253A New York Workers' , Compensation Lynwood Unified School District (CA) [Electronic] E1253B Auto/No-Fault , Lynwood Unified School District (CA) [Electronic] E1253C Other WC (Non-NY) , M ROMANO & SONS INC WC NYS 6 ALYSSA COURT MROMA001 New York Workers' ALBANY, NY 12205 Compensation MAC RISK MANAGEMENT PO BOX 200001 MACRI002 Other WC (Non-NY) WOODSTOCK, GA 30189 Macarat, Inc 2437 Berg Rd MACAR001 New York Workers' West Seneca, NY 14224 Compensation MACHUGA CONTRACTORS PO BOX 383 MACHU001 New York Workers' BATH, NY 14810 Compensation MACRISK MANAGEMENT PO BOX 200001 MAMA01 New York Workers' WOODSTOCK, GA 30189 Compensation macy's 7 west 7th street MACYS004 New York Workers' 8th floor Compensation cinncinati, OH 45202 Macys PO BOX 3069 MACYS001 New York Workers' Cincinnati, OH 45201 Compensation Macys (Daly City) [Electronic] E8206A New York Workers' , Compensation Macys (Daly City) [Electronic] E8206C Other WC (Non-NY) , Macys (Newport Beach) [Electronic] E9183A New York Workers' , Compensation Macys (Newport Beach) [Electronic] E9183C Other WC (Non-NY) , MACYS CORP. SERVICES 3300 FASHION WAY MACS02 New York Workers' JOPPA, MD 21085-3205 Compensation Macys Corporate Services [Electronic Indirect] PO BOX 3069 MACYS002 New York Workers' CINCINNATI, OH 45201 Compensation Macys Corporate Services [Electronic Indirect] PO BOX 3069 MACYS003 Other WC (Non-NY) CINCINNATI, OH 45201 Madera Community Hospital [Electronic] E0861A New York Workers' , Compensation Madera Community Hospital [Electronic] E0861C Other WC (Non-NY) , Madison Cortland ARC 701 Lenox Avenue MADIS001 New York Workers' Oneida, NY 13421 Compensation MADISON-ONEIDA-HERKIMER SCHOOLS WC PO BOX 753 MADIS002 New York Workers' CANTON, NY 13617 Compensation MAGELLAN 3897 ADLER PLACE MAGEL001 New York Workers' BETHLEHEM, PA 18017 Compensation MAGNA CARTA CO ONE PARK AVE MACC01 New York Workers' NEW YORK, NY 10016 Compensation MAGNA CARTA COMPANIES 1 PARK AVENUE MAGNA007 New York Workers' NEW YORK, NY 10157-2500 Compensation Magna Comp 825 East Gate Rd MAGNA02 New York Workers' Garden City, NY 11530 Compensation MAGNACARE PO BOX AA MAGNA01 New York Workers' 825 E GATE BLVD Compensation GARDEN CITY, NY 11530 MagnaCare Workers Comp PO BOX 1001 MAGNA003 New York Workers' Garden City, NY 11530 Compensation Magnacomp 1600 Stewart Ave. MAGNA004 Other WC (Non-NY) Westbury, NY 11590 Magnacomp 1600 Stewart avenue MAGNA006 New York Workers' Suite 200 Compensation Westbury, NY 11590 MAGNACOMP 2 HUNTINGTON QUADRANGLE MAGNA008 New York Workers' STE 4N10 Compensation MELVILLE, NY 11747 MAGNETIC IMAGING SERVICE 6281 BEACH BLVD MAIS01 New York Workers' #220 Compensation BUENA PARK, CA 90621 MAGUIRE GROUP 801 GAZZOLA DR MAGUI001 New York Workers' EAST PATCHOGUE, NY 11772 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MAHER TERMINAL 1210 CORBIN ST MAHER001 New York Workers' ELIZABETH, NJ 07201 Compensation Maid Brigade 2065 River Rd, Unit 5 MAIDB001 New York Workers' Niagara Falls, NY 14304 Compensation MAIL HANDLERS BENEFIT PLAN PO BOX 8402 MAIL01 New York Workers' LONDON, KY 40742 Compensation Mailstop WCS National Interstate 135801 MAILS001 New York Workers' Po Box 2848 Compensation Clinton, IA 52733 Main Care Energy Po Box 11029 MAINC001 New York Workers' Albany, NY 12211 Compensation MAIN CARE ENERGY P.O. BOX 11029 MAINC002 New York Workers' ALBANY, NY 12211 Compensation MAIN STREET AMERICA CLAIMS DEPT PO BOX 19000 MAINS004 New York Workers' JACKSONVILLE, FL 32245-9000 Compensation MAIN STREET AMERICA CLAIMS DEPT (A/NF) PO BOX 19000 MAINS005 Auto/No-Fault JACKSONVILLE, FL 32245-9000 Main Street American Assurance 220 Salina Meadows Pkwy MAINS007 New York Workers' Syracuse, NY 13212 Compensation Main Street Pizza 206 EAST MAIN STREET MAINS006 New York Workers' SUITE 2 Compensation Batavia, NY 14020 MAIN TRANSIT FIRE DEPT 6777 MAIN ST MAINT002 New York Workers' WILLIAMSVILLE, NY 14221 Compensation MAIN TRANSIT FIRE DEPT. 6777 MAIN STREET MAINT001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation MAINE AUTO DEALERS ASSOC PO BOX 2667 MAINE001 Other WC (Non-NY) AUGUSTA, ME 04338-2667 Major League Baseball 8 [Electronic] E4393C Other WC (Non-NY) , Maksin PO Box 2648 MAKSI001 Other WC (Non-NY) Camden, NJ 08101 MALONEY ASSOCIATES PO BOX 622 MALON001 New York Workers' LYNBROOK, NY 11563 Compensation Managed Care Innovations PO Box 1140 MANAG001 New York Workers' Richmond, VA 23261-7472 Compensation MANAGED CARE NETWORK INC PO BOX 696 MANAG003 New York Workers' NIAGARA FALLS, NY 14313 Compensation Managed Care Network Inc. PO BOX 347 MANAG002 New York Workers' Elma, NY 14059 Compensation Mandel & Sawyer PC 45 Essex Street MANDE001 Auto/No-Fault Suite 200 Millburn, NJ 07041 MANFI LEASING CO 100 MAIN STREET MANFI001 New York Workers' TULLYTOWN, PA 19007 Compensation MANG INS. GROUP 66 SOUTH BROAD ST MANGI001 New York Workers' NORWICH, NY 13815 Compensation MANITOBA CORPORATION 122 CENTRAL AVE MANIT001 New York Workers' LANCASTER, NY 14086 Compensation Manleys Mighty Mart 1249 Front St MMMA01 New York Workers' Binghampton, NY 13905 Compensation Manning Squire Henning PO BOX 685 MANNI001 New York Workers' Batavia, NY 14021 Compensation Manor Care North 300 leader Drive MANOR001 New York Workers' Williamsport, PA 17701 Compensation MANPOWER 117 GREAT OAKS MANPO002 New York Workers' ALBANY, NY 12203 Compensation MANPOWER 411 WASHINGTON AVENUE MANPO003 New York Workers' KINGSTON, NY 12401 Compensation MANPOWER (ELMIRA) 1600 COLLEGE AVE MANPO001 New York Workers' ELMIRA, NY 14901 Compensation MANUFACTURERS ALLIANCE INS CO 380 SENTRY PARKWAY MANA01 New York Workers' PMA BUILDING Compensation BLUE BELL, PA 19422-2357 Manufacturers Alliance Insurance Company E0862A New York Workers' [Electronic] , Compensation Manufacturers Alliance Insurance Company E0862C Other WC (Non-NY) [Electronic] , MANZO/RAM INS AGENCY 484 WESTSIDE AVE MANZO001 Auto/No-Fault JERSEY CITY, NJ 07304 MAPFRE PO BOX 9301 MAPFR004 Auto/No-Fault Garden City, NY 11530 MAPFRE INS. CO. OF NY PO BOX 9301 MAPFR006 Auto/No-Fault GARDEN CITY, NY 11530 MAPFRE Insurance [Electronic] PO Box 986 MAPFR005 Auto/No-Fault Marlton, NJ 08053 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Mapfre Insurance Company of Florida [Electronic] 5959 BLUE LAGOON DRIVE SUITE MAPFR001 Auto/No-Fault NUMBER 400 MIAMI, FL 33126 MAPLEVALE FARMS 2063 ALLEN ST EXT MAPLE002 New York Workers' FALCONER, NY 14733 Compensation MAPLEVALE FARMS WHOLESALE ATTN WKRS COMP MAPLE001 New York Workers' 8956 WEST MAIN STREET Compensation CLYMER, NY 14724 MARC A ROSS Auto 175 MARKET STREET SUITE# 301 MARCA002 Auto/No-Fault PATERSON, NJ 07505 Marcotte & Hearne [Electronic] E0863A New York Workers' , Compensation Marcotte & Hearne [Electronic] E0863C Other WC (Non-NY) , MARDI-BOB LANES 45 TAFT AVENUE MARDI001 New York Workers' POUGHKEEPSIE, NY 12603 Compensation Maricopa County Community College District E0864A New York Workers' [Electronic] , Compensation Maricopa County Community College District E0864C Other WC (Non-NY) [Electronic] , MARINO SIGN 904 GRAND CENTRAL AVE MARIN001 New York Workers' ELMIRA, NY 14901 Compensation Marion County Jail / Liability 204 N Washington MARIO001 Auto/No-Fault Salem, IL 62881 Mariposa County [Electronic] E0865A New York Workers' , Compensation Mariposa County [Electronic] E0865C Other WC (Non-NY) , MARITIME CLAIMS ASSOCIATES PO BOX 615 MARIT001 New York Workers' FAIRHAVEN, MA 02719 Compensation MARK CERRONE, INC PO BOX 3009 MARKC001 New York Workers' NIAGARA FALLS, NY 14304 Compensation MARK S. TEPPER 570 WEST MOUNT PLEASANT MARKS001 Auto/No-Fault AVENUE SUITE# 101 LIVINGSTON, NJ 07039 MARKEL AMERICIAN PO BOX 906 MARKE002 Auto/No-Fault PEWAUKEE, WI 53072 Markel First Comp Insurance 700 W. Virginia St MARKE003 Other WC (Non-NY) Ste 401 Milwaukee, WI 53204 MARKEL INS CO 10 PARKWAY N MARK01 New York Workers' DEERFIELD, IL 60015-2544 Compensation MARKET STREET BREWING CO 63 WEST MARKET STREET MARKE001 New York Workers' CORNING, NY 14830 Compensation MARRIOTT PO BOX 29202 MARR01 New York Workers' HOT SPRINGS, AR 71903 Compensation MARRIOTT CLAIMS SERVICE MID ATLANTI PO BOX 29202 MARRI001 Other WC (Non-NY) HOT SPRINGS, AR 71903 MARRIOTT MARQUIS CORP 1 MARRIOTT DR MARR02 New York Workers' Dept. 924.37 Compensation WASHINGTON, DC 20058-0003 Marsh Tree Landscaping 4946 Bayview Rd MARSH005 New York Workers' Bemus Pt, NY 14712, NY 14712 Compensation MARSHALL & STERLING 113 SARATOGA RD MARSH001 New York Workers' GLENVILLE, NY 12302 Compensation Marshall Farms 5800 Lake Bluff Rd MARSH006 New York Workers' North Rose, NY 14516 Compensation MARTEN TRANSPORT LTD C/O WC CLAIMS DEPT MARTE001 Other WC (Non-NY) 129 MARTEN ST MONDOVI, WI 54755-1733 MARTHA LLOYD SCHOOL 66 LLOYD LANE MARTH001 New York Workers' TROY, PA 16947 Compensation MARTIN & WINKLER 3150 ERIE BOULEVARD EAST MARTI003 New York Workers' SYRACUSE, NY 13214 Compensation MARTIN ELECTRIC 2 COOPER AVENUE MARTI004 New York Workers' RENSSELAER, NY 12144 Compensation MARTINEC BUILDING & REMODELING 83 CANAL STREET MARTI001 New York Workers' BIG FLATS, NY 14814 Compensation MARTIN'S PLUMBING & HEATING 3908 WAVERLY RD MARTI002 New York Workers' OWEGO, NY 13827 Compensation Mary Cariola Childrens Center 1000 ELMWOOD AVE MARYC001 New York Workers' STE 100 Compensation ROCHESTER, NY 14620 MARYLAND AUTO INS 1750 FORESTER DR MARYL001 Auto/No-Fault ANNAPOLIS, MD 21401 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MARYLAND CASUALTY PO BOX 968064 MARCA01 New York Workers' SCHAUMBURG , IL 60196 Compensation Maryland Casualty Company (Commercial Only) E9347B Auto/No-Fault [Electronic] , MASEL INC 2701 BARTRAM RD MASEL001 New York Workers' BRISTOL, PA 19007 Compensation MASSACHUSETTS BAY INSURANCE CO 440 LINCOLN STREET MASS01 New York Workers' WORCESTER, MA 01653 Compensation Massachusetts Bay Insurance Company E1392B Auto/No-Fault [Electronic] , Massachusetts Bay Insurance Company E1392C Other WC (Non-NY) [Electronic] , MASSE CONTRACTOR INC PO BOX 394 MASSE001 New York Workers' LOCKPORT, LA 70374 Compensation MASSI'S GREENHOUSE 246 VICTORY HIGHWAY MASSI001 New York Workers' PAINTED POST, NY 14870 Compensation MASTER CARE PO BOX 746 MACA01 New York Workers' CRANFORD, NJ 07016 Compensation Matagorda County [Electronic] E0866A New York Workers' , Compensation Matagorda County [Electronic] E0866C Other WC (Non-NY) , Matco Electric 3913 Gates Rd MATCO002 New York Workers' Vestal, NY 13850 Compensation Matheson Trucking [Electronic] E1164A New York Workers' , Compensation Matheson Trucking [Electronic] E1164B Auto/No-Fault , Matheson Trucking [Electronic] E1164C Other WC (Non-NY) , Matrix Abscence Management Po Box 2987 MATRI011 Other WC (Non-NY) Clinton, IA 52733 Matrix Abscence Mgmt Po Box 2987 MATRI010 New York Workers' Clinton, IA 52733 Compensation Matrix Absence Management PO BOX 1468 MATRI002 New York Workers' San Jose, CA 95109 Compensation Matrix Absence Management [Electronic Indirect] PO BOX 1468 MATRI004 New York Workers' San Jose, CA 95109 Compensation Matrix Absence Management [Electronic Indirect] PO BOX 1468 MATRI005 Other WC (Non-NY) San Jose, CA 95109 Matrix Absence Management [Electronic] E7860A New York Workers' , Compensation Matrix Absence Management [Electronic] E7860C Other WC (Non-NY) , MATRIX ABSENCE MANAGEMENT Inc. PO BOX 779005 MATRI009 New York Workers' Rocklin, CA 95677 Compensation MATRIX ABSENCE MANEGEMENT PO BOX 43 MATRI003 New York Workers' PENNSBURG, PA 18073 Compensation Matrix Absence Mgmt. 181 metro Drive MATRI007 New York Workers' STE: 300 Compensation San Jose, CA 95110-1416 MATRIX/ COVENTRY P O BOX 11456 MATRI006 New York Workers' TUSCON, AZ 85737 Compensation MATSON NAVIGATION 555 12TH STREET MATSO001 New York Workers' OAKLAND, CA 94607-4046 Compensation MATTHEWS INTERNATIONAL 25 CHESTNUT ST MATTH001 New York Workers' SENECA FALLS, NY 13148 Compensation Mavis Tire 358 Saw Mill River Road MAVIS001 New York Workers' Millwood, NY 10546 Compensation Maxim Crane Works [Electronic] E2778C Other WC (Non-NY) , Maximum Security Products 3 Schoolhouse Lane MAXIM001 New York Workers' Waterford, NY 12188 Compensation May Department Stores [Electronic] E0867A New York Workers' , Compensation May Department Stores [Electronic] E0867C Other WC (Non-NY) , MAY DEPT STORES 614 LOCUST ST MAYD01 New York Workers' CNTRL REG Compensation ST LOUIS, MO 63101 Maya Assurance Co 45-18 Court Sq,Ste 502 MAYAA001 New York Workers' Long Island City, NY 11101 Compensation MAYA ASSURANCE CO PO BOX 1896 MAYAA002 Auto/No-Fault AUTO CLAIMS LONG ISLAND CITY, NY 11101 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MAYA ASSURANCE CO. 45-18 COURTS SQUARE SUITE 300 MAYAA003 Auto/No-Fault LIC, NY 11101 MAYA INSURANCE COMPANY PO BOX 1896 MAYAI001 Auto/No-Fault LONG ISLAND CITY, NY 11101 Mayo Clinic/Recovery and Claims Services E7767C Other WC (Non-NY) [Electronic] , MAYO MANAGEMENT SERVICES 1001 41ST STREET NW MAYOM001 Auto/No-Fault ROCHESTER, MN 55901 MAYSHARK BUILDERS PO BOX 12 MAYSH001 New York Workers' MAPLE SPRINGS, NY 14756 Compensation MAZZONE HOSPITALITY 1 GLEN AVENUE MAZZO001 New York Workers' SCOTIA, NY 12302 Compensation MB FARMS 8283 HARRIS RD MBFAR001 New York Workers' LEROY, NY 14482 Compensation mc donald corp. 521 e main street MCDON002 New York Workers' beth dibble owner Compensation endicott, NY 13760 mc donald corp. rr3 box 239 MCDON001 New York Workers' montrose, PA 18801 Compensation Mc Donald'S-Mcopco [Electronic] E8712C Other WC (Non-NY) , Mc Gard 3875 CALIFORNIA ROAD MCGAR001 New York Workers' ORCHARD PARK , NY 14127 Compensation MCAULEY RESIDENCE HOME 1503 MILITARY RD MCAUL001 New York Workers' KENMORE, NY 14217 Compensation McCarthy / WC 1341 N Rock Hill Road MCCAR001 Other WC (Non-NY) Saint Louis, MO 63124 MCCORMICK FARMS 10889 SANDPIT RD MCCOR001 New York Workers' ALEXANDER, NY 14005 Compensation MCDONALDS 1419 UNION ROAD MCDON015 New York Workers' WEST SENECA, NY 14224 Compensation MCDONALDS 355 W Morris St MCDON010 New York Workers' BATH, NY 14810 Compensation MCDONALDS 5150 SHERIDAN DR MCDON013 New York Workers' AMHERST, NY 14221 Compensation MCDONALDS 5316 MAIN STREET MCDON007 New York Workers' WILLIAMSVILLE, NY 14221 Compensation MCDONALD'S 185 GENESEE STREET MCDON014 New York Workers' UTICA, NY 13501 Compensation MCDONALD'S 205 Harrison Ave MCDON011 New York Workers' Endicott, NY 13760 Compensation MCDONALD'S 3701 NEW RODGERS RD MCDON009 New York Workers' LEVITTOWN, PA 19056 Compensation MCDONALD'S 3869 STATE ROUTE 31 MCDON016 New York Workers' LIVERPOOL, NY 13090 Compensation MCDONALD'S PO BOX 400 MCDON008 New York Workers' CORNING, NY 14830 Compensation MCDONALD'S (CORNING ) 80 DENISON PKWY MCDON006 New York Workers' CORNING, NY 14830 Compensation MCDONALD'S (ENDICOTT) 603 E MAIN ST MCDON004 New York Workers' ENDICOTT, NY 13760 Compensation MCDONALD'S (HORSEHEADS) 609 CHEMUNG STREET MCDON005 New York Workers' HORSEHEADS, NY 14845 Compensation MCDONALD'S (WELLSBORO) 12 CHARLESTON STREET MCDON003 New York Workers' WELLSBORO, PA 16901 Compensation MCDONALDS CORPORATION PO BOX 710 MCDON012 New York Workers' BATH, NY 14810 Compensation MCGUIRE GROUP 560 DELAWARE AVE MCG01 New York Workers' RM 400 Compensation BUFFALO, NY 14202 McJunkin/ MRC 835 Hillcrest Lane MCJUN001 New York Workers' Charleston, WV 25311 Compensation MCLAUGHLIN PHILLIPS, LLC 351 E Franklin Street MCLAU002 New York Workers' Horseheads, NY 14845 Compensation MCMC PO Box 1160 MCMC002 Auto/No-Fault Cannonsburg, PA 15317 MCMC PO Box 1160 MCMC003 Other WC (Non-NY) Cannonsburg, PA 15317 MCMC PO Box 1970 MCMC001 New York Workers' Danbury, CT 06813 Compensation MCMC attn Meadowbrook 2000 Mallory Ln MCMCA001 New York Workers' STE 133-603 Compensation Franklin, TN 37067 MCMC Attn: Delhaize America LLC PO Box 1106 MCMCA002 New York Workers' Canonsburg, PA 15317 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MCMC/Meadowbrook 2000 Mallory Ln MCMCM001 Other WC (Non-NY) STE 133-603 Franklin, TN 37067 MCN 1301 5TH AVENUE SUITE 2900 MCN001 New York Workers' SEATTLE, WA 98101 Compensation McNeil & Company P.O. Box 5670 MCNEI001 Auto/No-Fault Cortland, NY 13045 McNEIL & COMPANY PO BOX 5670 MCNE01 New York Workers' CORTLAND, NY 13045 Compensation MCPHERSON BUILDERS INC 710 WILLOW AVENUE MCPHE001 New York Workers' ITHACA, NY 14850 Compensation McQuade Children Srv - WC PO Box 4064 MCQUA001 New York Workers' New Windsor, NY 12553 Compensation MDM / WC 19065 Hickory Creek Dr Ste 240 MDMWC001 Other WC (Non-NY) Mokena, IL 60448 MDSI Phys Group INC [Electronic] E0868A New York Workers' , Compensation MDSI Phys Group INC [Electronic] E0868C Other WC (Non-NY) , Meadow View Senior Living Center RR 4 Box 4000 MEADO001 New York Workers' Montrose, PA 18801 Compensation MEADOWBROOK APARTMENTS 101 LAMPHEAR COURT MEADO005 New York Workers' CORNING, NY 14830 Compensation Meadowbrook Insurance / WC 3001 NE Broadway #645 MEADO003 Other WC (Non-NY) Minneapolis, MN 55413 Meadowbrook Insurance Group Po Box 219559 MEADO006 New York Workers' Kansas City, MO 64121-9559 Compensation Meadowbrook Insurance Group [Electronic] E0869A New York Workers' , Compensation Meadowbrook Insurance Group [Electronic] E0869B Auto/No-Fault , Meadowbrook Insurance Group [Electronic] E0869C Other WC (Non-NY) , MEC CONSTRUCTION LLC PO BOX 440 MECCO001 New York Workers' BRIDGE PORT, WV 26330 Compensation MECHANICAL TESTING 95 HUDSON RIVER ROAD MECHA001 New York Workers' WATERFORD, NY 12188 Compensation MECO CONSTRUCTORS 684 DUNKSFERRY ROAD MECOC001 New York Workers' BENSALEM, PA 19020 Compensation MED BILL INC PO BOX 30725 MEDBI001 New York Workers' WALNUT CREEK, CA 94598 Compensation MED EVAL 109 CARPENTER DRIVE MEDEV001 New York Workers' SUITE 200 Compensation STERLING, VA 20164 MED FIRST URGENT CARE/MASH 6 FOUNTAIN PLAZA MEDFI001 New York Workers' BUFFALO, NY 14202 Compensation MED FOCUS 2811 WILSHIRE BLVD MEDF01 New York Workers' STE 900 Compensation SANTA MONICA, CA 90403 Med Solution Insurance PO Box981612 MEDSO001 Auto/No-Fault El Paso, TX 79998 MEDAILLE COLLEGE 18 AGASSIZ CIRCLE MEDAI001 New York Workers' BUFFALO, NY 14214 Compensation Medata Service Bureau - For Vons PO Box 61656 MEDAT001 New York Workers' Irvine, CA 92602-6055 Compensation Medcor Inc. P.O. Box 550 MEDCO001 New York Workers' McHenry, IL 60050 Compensation MEDIA SERVICES 500 S SEPULVEDA BLVD 4TH FL MEDIA001 New York Workers' LOS ANGELES, CA 90049 Compensation Medical Ben Admin [Electronic] E0870A New York Workers' , Compensation Medical Ben Admin [Electronic] E0870C Other WC (Non-NY) , Medical Evaluation Specialists / WC 5700 E 11 Mile Rd MEDIC001 Other WC (Non-NY) Warren, MI 48091 MEDICAL MOTOR SERVICE 608 S CLINTON AVE MEDIC002 New York Workers' ROCHESTER, NY 14620 Compensation MEDICAL MUTUAL PO BOX 6018 MEDMU01 New York Workers' CLEVELAND, OH 44107 Compensation Medicare PO BOX 890418 MEDIC003 Other WC (Non-NY) Camp Hill, PA 17089 Medina Brunner 3959 Bates Road MEDIN003 New York Workers' Medina, NY 14103 Compensation Medina Memorial Healthcare System 200 Ohio St MEDIN002 New York Workers' Attn: Linda Paron Compensation Medina, NY 14103 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MEDINA MEMORIAL HOSPITAL 200 OHIO ST MEDIN001 New York Workers' MEDINA, NY 14103 Compensation MEDINA TREK INC 11601 MAPLE RIDGE RD MEDIN004 New York Workers' MEDINA, NY 14103 Compensation MEDIVEST BENEFITS 2100 ALAFAYA TRAIL #201 MEDIV001 New York Workers' OVIEDO, FL 32765 Compensation MEDLINK 703 MILLERS LANE MEDLI001 New York Workers' PITTSBURGH, PA 15239 Compensation MEDRISK PO BOX 14229 MEDRI001 New York Workers' Lexington, KY 40512 Compensation MEDRISK PO BOX 14229 MEDRI002 Other WC (Non-NY) Lexington, KY 40512 Meemic [Electronic] E2072B Auto/No-Fault , MEGA CONSTRUCTION 13451 DAMAR DRIVE MEGAC001 New York Workers' PHILEDALPHIA, PA 19053 Compensation Member Select Insurance Company [Electronic] E5060B Auto/No-Fault , MEMIC 12 METRO PARK RD STE 103 MEMIC001 New York Workers' ALBANY, NY 12205 Compensation MEMIC 1750 ELM ST STE 500 MEMIC003 New York Workers' MANCHESTER, NH 03104 Compensation MEMIC PO BOX 3606 MEMI02 New York Workers' PORTLAND, ME 04104 Compensation MEMIC PO BOX 3606 MEMIC002 Other WC (Non-NY) PORTLAND, ME 04104 MEMIC [Electronic] E9532A New York Workers' , Compensation MEMIC [Electronic] E9532C Other WC (Non-NY) , Memorial Home Health & Hospice 1 Hospital Drive MEMOR001 New York Workers' Towanda, PA 18848 Compensation Mendota Insurance Company [Electronic] E6064B Auto/No-Fault , MENORAH PARK 4101 EAST GENESEE STREET MENOR001 New York Workers' SYRACUSE, NY 13214 Compensation MERCANTILE AGENCY 6390 MAIN ST MERCA001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation MERCER INS CO 10 NORTH HIGHWAY 31 MEIN01 New York Workers' PO BOX 278 Compensation PENNINGTON, NJ 08534 MERCER MILLING PO BOX 57 MERM01 New York Workers' BALDWINSVILLE, NY 13027 Compensation MERCER MILLING COMPANY 4698 MERCE001 New York Workers' CROSSROADS PARK DRIVE Compensation LIVERPOOL, NY 13088 Merchants Insurance Group PO Box 78 MERCH002 Auto/No-Fault Buffalo, NY 14240 Merchants Mutual Ins Co 250 Main St. MERCH001 New York Workers' Buffalo, NY 14240 Compensation MERCHANTS MUTUAL INS CO PO BOX 78 MEMU01 New York Workers' BUFFALO, NY 14240 Compensation MERCHANTS MUTUAL INSURANC 309 FELLOWSHIP RD MERCH003 New York Workers' SUITE 300 Compensation MOUNT LAUREL, NJ 08054 MERCHANTS MUTUAL INSURANCE CO P O BOX 78 MERCH004 Other WC (Non-NY) BUFFALO, NY 14240 Mercury [Electronic] 200 Somerset Corporate Blvd. MERC001 Auto/No-Fault 7th Floor Bridgewater, NJ 08807 MERCURY AIRCRAFT CORP 17 WHEELER AVENUE MERCU001 New York Workers' HAMMONDSPORT, NY 14840 Compensation MERCURY CASUALTY PO BOX 367 MERCU014 New York Workers' MARLTON, NJ 08053 Compensation MERCURY INS CO 13 Cornell Road MERCU003 Auto/No-Fault Latham, NY 12110 MERCURY INS GROUP PO BOX 31476 MERCU008 Auto/No-Fault ATTN: PIP UNIT TAMPA, FL 33630 MERCURY INSURANCE PO BOX 30173 MERCU009 Auto/No-Fault TAMPA, FL 33630 MERCURY INSURANCE PO BOX 566188 MERCU012 Auto/No-Fault ATLANTA, GA 31156 Mercury Insurance Co. PO Box 367 MERCU013 Auto/No-Fault Marlton, NJ 08053 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MERCURY INSURANCE GROUP PO BOX 5919 MERCU007 Auto/No-Fault BRIDGEWATER, NJ 08807 MERCURY INSURANCE GRP PIP UNIT MERCU010 Auto/No-Fault PO BOX 31476 TAMPA, FL 336303476 MERCY FLIGHT 100 AMHERST VILLA RD MERCY002 New York Workers' BUFFALO, NY 14225 Compensation MERCY HOSPITAL HUMAN RESOURCES 565 ABBOTT RD ATTN JOY BACKER MERCY001 New York Workers' BUFFALO, NY 14220 Compensation MERCY WORK SOLUTIONS PO BOX 4802 MEWS01 New York Workers' TOLEDO, OH 43610 Compensation Meridian Construction Program [Electronic] E0871A New York Workers' , Compensation Meridian Construction Program [Electronic] E0871C Other WC (Non-NY) , Meridian Occupational Health 100 Commons Way, #160 MERID001 New York Workers' Holmdel, NJ 07733 Compensation Meridien Energy LLC PO BOX 8 MERID002 New York Workers' Randolph, NY 14772 Compensation Merit Insurance One Enterprise Drive MERIT001 New York Workers' Suite 310 Compensation Shelton, CT 06484 Meritage Corporation [Electronic] E0872A New York Workers' , Compensation Meritage Corporation [Electronic] E0872C Other WC (Non-NY) , MERRY MAIDS 2104 COLLEGE AVE MERRY002 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation MERRY MAIDS (OWEGO) 1118 STATE ROUTE 434 MERRY001 New York Workers' OWEGO, NY 13827 Compensation MERZ METAL 237 CHELSEA PLACE MERZM001 New York Workers' BUFFALO, NY 14211 Compensation Mesa County Colorado [Electronic] E0873A New York Workers' , Compensation Mesa County Colorado [Electronic] E0873C Other WC (Non-NY) , Mesa County Valley School District 51 [Electronic] E0874A New York Workers' , Compensation Mesa County Valley School District 51 [Electronic] E0874C Other WC (Non-NY) , MESCALL & ACOSTA ATT 80 MAIN STREET SUITE# 550 MESCA001 Auto/No-Fault WEST ORANGE, NJ 07052 MET CASUALTY INS CO PO BOX 410450 METCA001 New York Workers' CHARLOTTE, NC 28241 Compensation Met Life Auto & Home PO BOX 2205 METLI007 Auto/No-Fault Charlotte, NC 28241 MET WELD INC. 5727 OSTRANDER ROAD METWE001 New York Workers' ALTAMONT, NY 12009 Compensation METAL GOODS TRUST FUND PO BOX 1248 MGTF01 New York Workers' WILLIAMSVILLE, NY 14231 Compensation Metal Locking Service, Inc. 216 Colgate Avenue METAL001 New York Workers' Buffalo, NY 14220 Compensation METAL TRANSPORTATION 2319 FOOTHILL DR METR01 New York Workers' STE 280 Compensation SALT LAKE CITY, UT 84109 METLIFE PO BOX 6040 METLI010 Auto/No-Fault SCRANTON, PA 185056040 Metlife - PA Claims P.O. Box 6040 METLI009 Auto/No-Fault Scranton, PA 18505 MetLife [Electronic] PO Box 410400 METLIFE001 Auto/No-Fault Charlotte, NC 28241-0400 METLIFE AUTO & HOME PO BOX 410450 METLI008 Auto/No-Fault CHARLOTTE,, NC 28241 MetLife Disability PO Box 14590 METLI001 New York Workers' Lexington, KY 40511-4590 Compensation METRACOMP 5130 EISENHOWER BLVD METC01 New York Workers' TAMPA, FL 33634 Compensation Metro Group PSC Ins PO Box 48020 METRO005 Auto/No-Fault Dayton, OH 45475 METRO MATTRESS 3545 JOHN GLENN BLVD METRO001 New York Workers' SYRACUSE, NY 13209 Compensation METRO NORTH RAILROAD 347 MADISON AVE 11 FLOOR METRO006 Other WC (Non-NY) NEW YORK, NY 10007 METRO NORTH RAILROAD CLAIMS 347 MADISON AVE MNRC01 New York Workers' 6TH FLR Compensation NEW YORK, NY 10017 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID METROPLUS 160 WATER STREET FL 3 METRO002 New York Workers' NEW YORK, NY 10038 Compensation Metropolitan Council [Electronic] E1994A New York Workers' , Compensation Metropolitan Council [Electronic] E1994C Other WC (Non-NY) , Metropolitan Edison Company C/O Associated Comp Resources METRO004 Other WC (Non-NY) 26391 Curtis Wright PKWY STE 105 Richmond Heights, OH 44143 Metropolitan Edison Company C/O Associated Compensation METRO003 Other WC (Non-NY) Resources 26391 Curtis Parkway Suite 105 Richmond Heights, OH 44143 Metropolitan Property and Casualty [Electronic] E1324B Auto/No-Fault , Metropolitan Transit Authority [Electronic] E2389C Other WC (Non-NY) , Mexicana Airlines [Electronic] E0875A New York Workers' , Compensation Mexicana Airlines [Electronic] E0875C Other WC (Non-NY) , MIC General Insurance Corp. [Electronic] E4082B Auto/No-Fault , MIC Property and Casualty Ins. Corp [Electronic] E2742B Auto/No-Fault , MICHAEL A MIRDA 100 EAGLE ROCK AVENUE SUITE# MICHA004 Auto/No-Fault 307 EAST HANOVER, NJ 07936 MICHAEL ANTOLINO CON 106 BEECHWOOD DR MICHA001 New York Workers' WASHINGTON CROS, PA 18977 Compensation Michael D Russo III Attorney 534 Union Boulevard # 1 MICHA003 Auto/No-Fault Totowa, NJ 07512 MICHAEL GIBSON ATT 1125 ATLANTIC AVENUE MICHA005 Auto/No-Fault ATLANTIC CITY, NJ 08401 MICHAEL GRIMM SERVICES 4195 LAFAYETTE ROAD MICHA007 New York Workers' JAMESVILLE, NY 13078 Compensation Michael Hogan Assoc [Electronic] E0876A New York Workers' , Compensation Michael Hogan Assoc [Electronic] E0876C Other WC (Non-NY) , MICHAEL PIPELINE PO BOX 128 MICHA002 New York Workers' BROWNSVILLE,WI, NY 53006 Compensation MICHAEL S WITTENBERG ATT 26 JOURNAL SQUARE SUITE 802 MICHA006 Auto/No-Fault JERSEY CITY, NJ 07306 MICHELLE'S CATERING 4535 W. SAILE DR MICHE003 New York Workers' BATAVIA, NY 14020 Compensation MICHEL'S CORPORATION 817 WEST MAIN STREET MICHE002 New York Workers' BROWNSVILLE, WI 53006 Compensation MICHELS POWER 1775 E SHADY LANE MICHE001 New York Workers' NEENAH, WI 54956 Compensation MICHIGAN MILLER PO BOX 30060 MIMI01 New York Workers' LANSING, MI 48909 Compensation MICHIGAN MILLERS MUTUAL PO BOX 30060 MICHI001 Auto/No-Fault LANSING, MI 48909 Michigan Mutual Ins Co. 2677 Halsted Road MICHI002 New York Workers' Farmington Hill, NY 48333 Compensation MID ATLANTIC 321 HAMBURG TURNPIKE MIDAT002 Auto/No-Fault WAYNE, NJ 07470 MID ATLANTIC PO BOX 16203 MIDAT003 Auto/No-Fault READING, PA 19612 MID ATLANTIC GROWERS PO BOX 428 MIDAT001 New York Workers' NEW EGYPT, NJ 08533 Compensation Mid Century Insurance Company (Commercial E4301B Auto/No-Fault Only) [Electronic] , MIDDENDORF TRACTOR 932 WEST RIVER ROAD MIDDE001 New York Workers' NICHOLS, NY 13812 Compensation MIDDLESEX CNTY MUNICIPAL 2-JOCAMA BLVD MIDDL002 New York Workers' 4 Compensation OLD BRIDGE, NJ 08857 Middletown Enlarged Cty Shc 223 Wisner Avenue MIDDL001 New York Workers' Middletown, NY 10940 Compensation MIDEAST UNDERGROUND 3150 FIFTH AVENUE MIDU01 New York Workers' EAST MOLING, IL 61244 Compensation Midlakes Navigation 11 Jordan Rd MIDLA001 New York Workers' PO Box 61 Compensation Skaneateles, NY 13152 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MIDLAND CLAIMS ADMINISTRATOR PO BOX 238808 MIDLA002 New York Workers' OKLAHOMA CITY, OK 73123 Compensation MIDSTATE COMMUNICATIONS INC 185 CLEAR ROAD MIDST001 New York Workers' ORISKANY, NY 13424 Compensation MIDTOWN OCCUPATIONAL 550 NEWARK AVE MIDTO001 New York Workers' JERSEY CITY, NJ 07306 Compensation MIDWAY FIRE DEPARTMENT 1956 CENTRAL AVENUE MIDWA002 New York Workers' ALBANY, NY 12205 Compensation MIDWAY LANES INC 213 N JENSEN ROAD MIDWA001 New York Workers' VESTAL, NY 13850 Compensation MIDWEST DIAGNOSTIC MNGMT 19065 HICKORY CREEK DRIVE MIDWE003 New York Workers' SUITE 240 Compensation MOKENA, IL 60448 Midwest Drywall [Electronic] E1492C Other WC (Non-NY) , Midwest Family Mutual Insurance Co [Electronic] E1393B Auto/No-Fault , Midwest Family Mutual Insurance Co [Electronic] E1393C Other WC (Non-NY) , Midwest Insurance / WC PO Box 13369 MIDWE002 Other WC (Non-NY) Springfield, IL 62791 MIDWESTERN INSURANCE PO BOX 436909 MIDWE004 Auto/No-Fault LOUISVILLE, KY 40253 Midwestern Insurance Alliance Po Box 436909 MIDWE001 New York Workers' Louisville, KY 40253 Compensation MIGHTY TACO 9362 TRANSIT RD MIGHT001 New York Workers' EAST AMHERST, NY 14051 Compensation MIHERST CONSTRUCTION PO BOX 430 10025 COUNTY RD MIHER001 New York Workers' CLARENCE CENTER, NY 14032 Compensation MIKE RICH INC 1766 WINCHESTER RD MIKER001 New York Workers' BENSALEM, PA 19020 Compensation MIKE SCHMITZ 8857 KLONDYKE RD MIKES001 New York Workers' SHERMAN, NY 14781 Compensation MILBANK INSURANCE COMPANY PO BOX 869 MILB01 New York Workers' 518 EAST BROAD ST Compensation COLUMBUS, OH 43216-0869 Milbrandt & Co WC 159 Main Street Suite 2 MILBR001 New York Workers' New Rochelle, NY 10801 Compensation MILL RUN 1201 WILSON AVE MILLR001 New York Workers' BRISTOL, PA 19007 Compensation Millard Refrigerated [Electronic] E0877C Other WC (Non-NY) , MILLER AUTO GROUP PO BOX 37 MILLE001 New York Workers' VESTAL, NY 13851 Compensation MILLER BROTHERS 2939 FLETON ROAG MILLE002 New York Workers' BLDG 2 Compensation NORRISTOWN, PA 19401 MILLINGTON LOCKWOOD INC 470 CAYUGA ROAD MILLI001 New York Workers' BUFFALO, NY 14225 Compensation MILLVIEW TBI 7 AVIS DRIVE MILLV001 New York Workers' SUITE 1 Compensation LATHAM, NY 12110 MILTON CAT 4610 E SAILE DR MILTO001 New York Workers' BATAVIA, NY 14020 Compensation MINIER BROTHERS PO BOX 455 MINIE001 New York Workers' BIG FLATS, NY 14814 Compensation MINIERS PLAZA 84 CANAL STREET MINIE002 New York Workers' BIG FLATS, NY 14814 Compensation Minnesota Counties Ins Trust (MCIT) [Electronic] E0878A New York Workers' , Compensation Minnesota Counties Ins Trust (MCIT) [Electronic] E0878C Other WC (Non-NY) , Minnesota Twins 1 Twins Way MINNE001 New York Workers' Minneapolis, MN 55415 Compensation MIRABEAU 851 WEST GENESEE STREET MIRAB001 New York Workers' SKANEATELES, NY 13152 Compensation MIRABITO PO BOX 5306 MIRAB002 New York Workers' BINGHAMTON, NY 13902 Compensation MISHA LEE ATT 74 CENTRAL AVENUE MISHA001 Auto/No-Fault HACKENSACK, NJ 07601 Mission Aviation Fellowship [Electronic] E0879A New York Workers' , Compensation Mission Aviation Fellowship [Electronic] E0879C Other WC (Non-NY) , Mission Lodge Sanitarium [Electronic] E0880A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Mission Lodge Sanitarium [Electronic] E0880C Other WC (Non-NY) , Missoula Cart Co, In [Electronic] E0881A New York Workers' , Compensation Missoula Cart Co, In [Electronic] E0881C Other WC (Non-NY) , MISTER SNACKS ATTN: COLLEEN PO BOX 988 MISTE001 New York Workers' AMHERST, NY 14226 Compensation Mitchell Energy & Devel [Electronic] E2498C Other WC (Non-NY) , MITCHELL R FRIEDMAN LAW 347 MOUNT PLEASANT AVENUE MITCH001 Auto/No-Fault WEST ORANGE, NJ 07052 Mitsui Sumitomo PO BOX 5435 MITSU002 New York Workers' Cincinnati, OH 45201 Compensation MITSUI SUMITOMO INS 312 ELM ST STE 1100 MITSU003 New York Workers' CINCINNATI, OH 45201 Compensation MITSUI SUMITOMO INS CO OF AMERICA PO BOX 4602 MISU02 New York Workers' WARREN, NJ 07061 Compensation Mitsui Sumitomo Ins. 15 Independence Boulevard MITSU001 New York Workers' Warren, NJ 07059 Compensation Mitsui Sumitomo Insurance Group [Electronic] E1254A New York Workers' , Compensation Mitsui Sumitomo Insurance Group [Electronic] E1254B Auto/No-Fault , Mitsui Sumitomo Insurance Group [Electronic] E1254C Other WC (Non-NY) , Mitsui Sumitomo Insurance USA Inc. [Electronic] E1255A New York Workers' , Compensation Mitsui Sumitomo Insurance USA Inc. [Electronic] E1255B Auto/No-Fault , Mitsui Sumitomo Insurance USA Inc. [Electronic] E1255C Other WC (Non-NY) , MJ MECHANICAL SERVICES 2040 MILITARY RD MJMEC001 New York Workers' TONAWANDA, NY 14150 Compensation MJ WARD AND SON 9 CAMERON STREET MJWAR001 New York Workers' PO BOX 747 Compensation BATH, NY 14810 MLP PLUMBING & MECHANICAL 3198 UNION RD MLPPL001 New York Workers' CHEEKTOWAGA, NY 14227 Compensation MMIC [Electronic] E1256A New York Workers' , Compensation MMIC [Electronic] E1256B Auto/No-Fault , MMIC [Electronic] E1256C Other WC (Non-NY) , MN Dept of Labor & Industry Claims Unit E6830A New York Workers' [Electronic] , Compensation MN Dept of Labor & Industry Claims Unit E6830C Other WC (Non-NY) [Electronic] , Mobile Life Support Svcs PO Box 471 MOBIL001 New York Workers' 69 Dickson Street Compensation Newburgh, NY 12551 MODERN BUSINESS ASSOC 9455 KOGER BLVD SUITE 200 MODER002 New York Workers' ST. PETERSBURG, FL 33702 Compensation MODERN DISPOSAL 4746 MODEL CITY ROAD MODER004 New York Workers' PO BOX 209 Compensation MODEL CITY, NY 14107 Modern Marketing Concepts 29 Industrial Park Drive MODER001 New York Workers' Rebecca Bendert Compensation Binghamton, NY 13905 MODERN WELDING SCHOOL 1842 STATE STREET MODER003 New York Workers' SCHENECTADY, NY 12304 Compensation Modesto Irrigation District [Electronic] E0882A New York Workers' , Compensation Modesto Irrigation District [Electronic] E0882C Other WC (Non-NY) , MOD-PACK 1801 ELMWOOD AVE MOD01 New York Workers' BUFFALO, NY 14207 Compensation Mogen David-The Wine Group PO Box 128 MOGEN001 New York Workers' Westfield, NY 14787 Compensation MOHAWK AMBULANCE 793 STATE STREET MOHAW003 New York Workers' SCHENECTADY, NY 12307 Compensation MOHAWK INDUSTRIES 71 W 23RD STREET MOHAW001 New York Workers' NEW YORK, NY 10010 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MOHAWK VALLEY COMMUNITY ACTION ASSOC ATTN HUMAN RESOURCES MOHAW002 New York Workers' 9882 RIVER RD Compensation UTICA, NY 13502 MOLLEN IMMUNIZATION CLINICS KATHY MADDOX RN MOLLE001 New York Workers' 8324 EAST HARTFORD DRIVE Compensation SCOTTSDALE, AZ 85255 MONARCH PLASTICS 225 FOLCONER DR MONAR001 New York Workers' FREWSBURG, NY 14738 Compensation Monroe Ambulance 1669 Lyell Ave MONRO003 New York Workers' Rochester, NY 14606 Compensation MONROE MUFFLER 200 HOLLEDER PARKWAY MONRO001 New York Workers' ROCHESTER, NY 14615 Compensation Monroe School Transportation 970 Emerson Street MONRO002 New York Workers' Rochester, NY 14606-2708 Compensation MONROE TRACTOR 938 STATE RTE 21 MONRO005 New York Workers' HORNELL, NY 14843 Compensation MONTANA MILLS 2171 MONROE AVE MONT01 New York Workers' STE 205A Compensation ROCHESTER, NY 14618 MONTANA STATE FUND PO BOX 4759 MONTA003 Other WC (Non-NY) HELENA, MT 59604-4759 MONTANA STATE FUND PO BOX 4759 MONTA004 New York Workers' HELENA, MT 59604-4759 Compensation Montgomery [Electronic] E8484A New York Workers' , Compensation Montgomery [Electronic] E8484C Other WC (Non-NY) , Montgomery County Texas [Electronic] E6254C Other WC (Non-NY) , Montgomery Ward Oakdale Mall MONTG002 New York Workers' Johnson City, NY 13790 Compensation Monument Administrators - Cornerstone Comp E0883C Other WC (Non-NY) [Electronic] , Monument Administrators - Elite Country Club E0884C Other WC (Non-NY) [Electronic] , Moreno Valley Unified School District (CA) E1257A New York Workers' [Electronic] , Compensation Moreno Valley Unified School District (CA) E1257B Auto/No-Fault [Electronic] , Moreno Valley Unified School District (CA) E1257C Other WC (Non-NY) [Electronic] , MORFAB PO BOX 1187 MORFA001 New York Workers' MORAVIA, NY 13118 Compensation MORGAN LINEN 145 BROADWAY MORGA002 New York Workers' MENANDS, NY 12204 Compensation Morgan Materials 380 Vulcan Street MORGA001 New York Workers' PO BOX 68 Compensation Buffalo, NY 14207 Morongo Basin Transit Authority (CA) [Electronic] E1258A New York Workers' , Compensation Morongo Basin Transit Authority (CA) [Electronic] E1258B Auto/No-Fault , Morongo Basin Transit Authority (CA) [Electronic] E1258C Other WC (Non-NY) , Morris Material Handling [Electronic] E9399C Other WC (Non-NY) , Morrison Health Care, Inc. [Electronic] E9923C Other WC (Non-NY) , MORRISVILLE AMBULANCE 139 WASHINGTON STREET MORRI001 New York Workers' MORRISVILLE, PA 19067 Compensation MORSE MANUFACTURING PO BOX 518 MORSE001 New York Workers' EAST SYRACUSE, NY 13057 Compensation MORTONS CLEANERS 413 BROAD ST MORTO001 New York Workers' WAVERLY, NY 14892 Compensation MOSS ARCHITECTURAL PRODUCTS 6680 ONTARIO CENTER ROAD MOSSA001 New York Workers' ONTARIO, NY 14519 Compensation Motion Picture & Television Fund [Electronic] E0885A New York Workers' , Compensation Motion Picture & Television Fund [Electronic] E0885C Other WC (Non-NY) , MOTOR COMPONENTS LLC 2243 CORNING RD MOTOR001 New York Workers' ELMIRA, NY 14903 Compensation MOTOR INSURANCE CORP. AUTO CLAIMS MOTOR003 Auto/No-Fault PO BOX 5123 SOUTH FIELD, MI 48086 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Motor Vehicle Accident Indemnity 110 Williams Street 19th Floor MOTOR002 Auto/No-Fault New York, NY 10038 MOTOR VEHICLE CASUALTY CO 20 WASHINGTON PL MVC01 New York Workers' PROVIDENCE, RI 02903 Compensation MOTORIST INS GROUP PO BOX 182476 MOTOR004 New York Workers' COLUMBUS, OH 43218-2476 Compensation Motorist Mutual Insurance [Electronic] E4161B Auto/No-Fault , Motorist Mutual Insurance [Electronic] E4161C Other WC (Non-NY) , Motors Insurance Corporation [Electronic] E9895B Auto/No-Fault , MOUNT VERNON FIRE DEPT 470 EAST LINCOLN AVE MOUNT001 New York Workers' MOUNT VERNON, NY 10553 Compensation MOUNTAIN VIEW INN 34 MAIN STREET MOUNT002 New York Workers' ATLANTA, NY 14808 Compensation MRM TRUST 2591 WESFORD-BAINE ROAD MRMTR001 Other WC (Non-NY) BLDG 2 SUITE 301 SEWICKLEY, PA 15143 MS UNLIMITED PO BOX 577 MSUNL001 New York Workers' SYRACUSE, NY 13206 Compensation MSA Group P.O. Box 2004 MSAGR001 New York Workers' Keene, NH 03431 Compensation MSC Care Management PO Box 2005 MSCCA001 Other WC (Non-NY) Warren, MI 48090 MT VERNON POLICE DEPT 2 ROOSEVELT SQUARE MTVER001 New York Workers' MT VERNON, NY 10552 Compensation Mt. St. Mary's Hospital 5300 Military Road MTSTM001 New York Workers' Attn: Employee Benefits Compensation Lewiston, NY 14092 MTA 128 15 28TH AVENUE MTA003 Auto/No-Fault FLUSHING, NY 11354 MTA - RISK MGMT 2 BROADWAY 21ST FL MTARI001 New York Workers' NEW YORK, NY 10004 Compensation MTA - WC 128-15 28th Avenue MTAWC001 New York Workers' College Point Depot Compensation Flushing, NY 11354 MTA Bridges and Tunnels 2 Broadway MTABR001 New York Workers' 24th Floor Compensation New York, NY 10004 MTA BUS CO. 128 15 28TH AVENUE MTABU002 Other WC (Non-NY) FLUSHING, NY 11354 MTA BUS CO. COLLEGE POINT DEPOT 128-15 28TH AVENUE MTABU001 Auto/No-Fault FLUSHING, NY 11354 MTA BUS COMPANY 165-25 147 AVE MTA02 New York Workers' JFK DEPOT Compensation JAMAICA, NY 11434 MTA LONG ISLAND BUS 700 COMMERCIAL AVE MTA01 New York Workers' GARDEN CITY, NY 11530-6434 Compensation MTN DAIRY PO BOX 1020 MTN01 New York Workers' 88 ROCK HILL DR Compensation ROCK HILL, NY 12775 MTS [Electronic] E1259A New York Workers' , Compensation MTS [Electronic] E1259B Auto/No-Fault , MTS [Electronic] E1259C Other WC (Non-NY) , MTV (Murphy and Beane) [Electronic] E0886C Other WC (Non-NY) , MUELLER CORP 789 COLVIN BLVD. MUELL001 New York Workers' KENMORE, NY 14217 Compensation MUENCH-KREUZER CANDLE COMPANY 617 HIAWATHA BLVD E MUENC001 New York Workers' SYRACUSE, NY 13208 Compensation MULLEN DAIRY FARM,LLC 1595 COUNTY ROAD 98 MULLE001 New York Workers' REXVILLE, NY 14877 Compensation Munford, Inc. [Electronic] E7996C Other WC (Non-NY) , MUNSEE ESCAVATING 927 WEST SMITH STREET MUNSE001 New York Workers' CORRY, PA 16407 Compensation MURDOCK CLAIMS MGMT CO 425 DAY HILL RD MURD01 New York Workers' WINDSOR, CT 06095 Compensation Murphy & Beane 1 Union Plaza MURPH002 New York Workers' New London, CT 06320-6314 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID MURPHY & BEANE 5901 GREEN VALLEY CIR KNM02 New York Workers' STE 145 Compensation CLOVER CITY, CA 90230 MURPHY & BEANE PO BOX 590, ONE UNION PL MURPH001 New York Workers' NEW LONDON, CT 06320 Compensation MURPHY INSURANCE 111 PINE STREET MURPH003 New York Workers' LOCKPORT, NY 14094 Compensation Murray Center / WC 1535 W McCord MURRA002 Other WC (Non-NY) Centralia, IL 62801 Murray Insurance P.O.Box 1728 MURRA001 New York Workers' Lancaster, PA 17608 Compensation Musco [Electronic] E9682C Other WC (Non-NY) , MUSIP 111 MAIN ST MUSIP001 New York Workers' LOCKPORT, NY 14094 Compensation Musso Plumbing & Heating 8574 Sheridan Drive MUSSO001 New York Workers' Willaimsville, NY 14221 Compensation MUSTANG CONSTRUCTION GROUP 100 STINSON STREET MUSTA001 New York Workers' SYRACUSE, NY 13209 Compensation MUTUAL BENEFIT INS CO P O BOX 577 MUTUA001 Other WC (Non-NY) HUNTINGDON, PA 16652-0577 MVAC 110 William Street MVAC001 New York Workers' 19th floor Compensation New York, NY 10038 MVAIC 100 William St MVAIC001 Auto/No-Fault 14th Floor New York, NY 10038 MVP HEALTHCARE PO BOX 22920 PCR01 New York Workers' ROCHESTER, NY 14692-2920 Compensation MY PLACE & COMPANY 241 DELAWARE AVENUE MYPLA001 New York Workers' DELMAR, NY 12054 Compensation MYSTIQUE PRINCETON MARKET MYSTI001 New York Workers' PRINCETON, NJ 08824 Compensation MY-T-ACRES 8127 LEWISTON RAOD MYTAC001 New York Workers' BATAVIA, NY 14020 Compensation NACIREMA PO BOX 183 NACIR001 New York Workers' BAYONNE, NJ 07002 Compensation NAGLEE MOVING & STORAGE PO BOX 2039 NAGLE001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation NAHGA CLAIMS SERVICES PO BOX 189 NAHGA001 New York Workers' 88 MAIN STREET Compensation BRIDGTON, ME 00409-0189 NAI CLAIMS CONSULTING INC. 1122 FRANKLIN AVENUE NAICL001 New York Workers' SUITE 406 Compensation GARDEN CITY, NY 11530 NAL / WC 2275 S. Main NALWC001 Other WC (Non-NY) Paris, IL 61944 Name Address Line 1 NAME001 Auto/No-Fault Address Line 2 City, St Zip Nap Tools [Electronic] E2718C Other WC (Non-NY) , NAPA AUTO PARTS (GREENE, NY) 1112 NY 12 NAPAA001 New York Workers' GREENE, NY 13778 Compensation NARDE PAVING CO 400 EAST 14TH STREET NARDE001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation NARS P O BOX 166002 NARS002 New York Workers' ALTAMONTE SPG, FL 32716-6002 Compensation Nassau County Attorney's Office 1 West Street NASSA002 Other WC (Non-NY) Mineola, NY 11501 NATGUN CORP 11 TEAL ROAD NATGU001 New York Workers' WAKEFIELD, MA 01880 Compensation NATHAN H KELMAN 41 EUCLID STREET NATHA001 New York Workers' COHOES, NY 12047 Compensation NATIONAL AMERICAN P.O. BOX 38 NATIO002 New York Workers' CHANDLER, OK 74834 Compensation NATIONAL AMERICAN INSURANCE CO PO BOX 9 NATA01 New York Workers' CHANDLER, OK 74834 Compensation National American Insurance Co (NAICO) E1394B Auto/No-Fault [Electronic] , National American Insurance Co (NAICO) E1394C Other WC (Non-NY) [Electronic] , National Benefit Life Ins One Court Square NATIO008 New York Workers' Long Island City, NY 11120 Compensation National Benefit Life Ins Co PO BOX 1946 NATIO049 New York Workers' LONG ISLAND CITY, NY 11101 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID National Cable Craft 204 Front Street NATIO047 New York Workers' Vestal, NY 13850 Compensation National Casualty PO Box 4120 NATIO016 Auto/No-Fault Scottsdale, AZ 85261 National Casualty Co, Crawford 2301 Lucien Way NATIO069 New York Workers' STE 185 Compensation Maitland, FL 32751 National Casualty Company [Electronic] E8309C Other WC (Non-NY) , NATIONAL CONTINENTAL 103 MORGAN LANE NATIO058 Auto/No-Fault STE 250 PLAINSBORO, NJ 08536 NATIONAL CONTINENTAL PO BOX 94762 NATIO022 Auto/No-Fault CLEVELAND, OH 44101 NATIONAL CRANKSHAFT PO BOX 24278 NATIO020 New York Workers' TUCSON, AZ 85734 Compensation NATIONAL EARTH SERVICE 245 BUTLER AVENUE NATIO019 New York Workers' LANCASTER, PA 17601 Compensation NATIONAL EMPLOYER SERVICES (NES) 584 NORTH DIAMOND BAR BLVD NATIO032 New York Workers' DIAMOND BAR, CA 91765 Compensation National Farmers Union Property Casualty Co E0887C Other WC (Non-NY) [Electronic] , NATIONAL FIRE INSURANCE CO OF HARTFORD 333 SOUTH WABASH NATF01 New York Workers' 30S Compensation CHICAGO, IL 60604 NATIONAL FUEL GAS 6363 MAIN ST NAFG02 New York Workers' WILLIAMSVILLE, NY 14221 Compensation National General PO BOX 1623 NATIO068 New York Workers' Winston Salem, NC 27102 Compensation NATIONAL GENERAL INSURANCE PO BOX 1623 NATIO075 Auto/No-Fault WINSTON, NC 27102 National Government Services PO BOX 6239 NATIO025 New York Workers' Indianapolis, IN 46206 Compensation NATIONAL INDEMNITY COMPANY 4016 FARNHAM STREET NATIO026 Auto/No-Fault OMAHA, NE 68131 National Interstate PO BOX 521 NATIO050 New York Workers' Richfield, OH 44286 Compensation National Interstate [Electronic] E9457C Other WC (Non-NY) , NATIONAL INTERSTATE INS PO BOX 549 NATIO006 Auto/No-Fault RICHFIELD, OH 44286 National Interstate Insurance PO Box 549 NATIO057 New York Workers' Richfield, OH 44286 Compensation NATIONAL INTERSTATE INSURANCE CO 3250 INTERSTATE DRIVE NATI01 New York Workers' RICHFIELD, OH 44286-9000 Compensation National Jewish Health [Electronic] E0888A New York Workers' , Compensation National Jewish Health [Electronic] E0888C Other WC (Non-NY) , National Liability & Fire Insurance Co P.O. Box 6580 NATIO070 Auto/No-Fault Saddle Brook, NJ 07663 National Liability and Fire Insurance Company E0889C Other WC (Non-NY) [Electronic] , National Loss Prevention, Inc [Electronic] E5259C Other WC (Non-NY) , NATIONAL MACHINE & CONVEYER PO BOX 3128 NATIO051 New York Workers' MARION, IN 46953 Compensation NATIONAL MAINTENANCE CONTRACTING CORP. 5600 NIAGARA FALLS BLVD NATIO071 New York Workers' NIAGARA FALLS, NY 14304 Compensation National Market Claims Helmsman Mgmt svcs NATIO015 New York Workers' PO BOX 307230 Compensation COLUMBUS, OH 43230 NATIONAL ORG OF INDUSTRY 148-06 HILLSIDE AVENE NATIO018 New York Workers' JAMAICA, NY 11435 Compensation National Pipe & Plastics 3421 Old Vestal Road NPP01 New York Workers' Vestal , NY 13850 Compensation NATIONAL PIPE & PLASTICS ELECTR 3421 OLD VESTAL ROAD NATIO004 New York Workers' ATTN SHELLY/HUMAN RESOURCES Compensation VESTAL, NY 13850 National Structures 145 Dwight Park Circle NATIO001 New York Workers' Syracuse, NY 13209 Compensation NATIONAL SURETY CORP PO BOX 740174 NATIO066 New York Workers' ATLANTA,GA, NY 30374 Compensation NATIONAL SURETY CORPORATION 333 SOUTH WABASH AVE NAT02 New York Workers' CHICAGO, IL 60604 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NATIONAL SURETY CORPORATION 777 SAN MARIN DRIVE NATS01 New York Workers' NOVATO, CA 94998 Compensation NATIONAL UNION & FIRE 70 PINE ST NAUF02 New York Workers' NEW YORK, NY 10038 Compensation Nationwide PO BOX 26005 NATIO040 New York Workers' Daphne, AL 36526 Compensation Nationwide PO BOX 26005 NATIO063 Other WC (Non-NY) Daphne, AL 36526 NATIONWIDE 1000 NATIONWIDE DRIVE NATIO074 Auto/No-Fault HARRISBURG, PA 17105 NATIONWIDE PO BOX 69080 NATIO064 New York Workers' HARRISBURG, PA 17106 Compensation Nationwide Agribusiness Companies [Electronic] E8311C Other WC (Non-NY) , NATIONWIDE AGRIBUSINESS INS CO 1 NATIONWIDE GATEWAY NAWI04 New York Workers' DES MOINES, IA 50391 Compensation NATIONWIDE AGRIBUSINESS INS CO 1100 LOCUST ST NAWI02 New York Workers' DES MOINES, IA 50391-1100 Compensation Nationwide Agribusiness Insurance Co [Electronic 1 NATIONWIDE GATEWAY NATIO009 New York Workers' Indirect] DES MOINES, IA 50391 Compensation Nationwide Agribusiness Insurance Co [Electronic 1 NATIONWIDE GATEWAY NATIO011 Other WC (Non-NY) Indirect] DES MOINES, IA 50391 Nationwide Agribusiness Insurance Co [Electronic 1100 LOCUST ST NATIO010 New York Workers' Indirect] DES MOINES, IA 50391 Compensation Nationwide Agribusiness Insurance Co [Electronic 1100 LOCUST ST NATIO012 Other WC (Non-NY) Indirect] DES MOINES, IA 50391 NATIONWIDE CLEANERS 822 PALLISADES AVENUE NATIO060 New York Workers' TEANECK, NY 07666 Compensation NATIONWIDE HEALTH PLAN PO BOX 2399 NATIO021 New York Workers' SPECIAL RISK HEALTH DEPT Compensation COLUMBUS, OH 432162399 Nationwide Ins Co Of America (NICOA) E8313C Other WC (Non-NY) [Electronic] , Nationwide Ins. PO BOX 26005 NATIO048 Auto/No-Fault Daphne, AL 36526-1126 Nationwide Insurance PO Box 69080 NATIO065 Other WC (Non-NY) Harrisburg, PA 17106 Native Pride Diner PO Box 375 NATIV001 New York Workers' Irving, NY 14081 Compensation NATL UNION FIRE INS CO OF PITT PA 72 WALL ST NUFI03 New York Workers' 5TH FL Compensation NEW YORK, NY 10005 NATL UNION FIRE INS CO OF PITT PA 80 PINE ST NUFI01 New York Workers' 5TH FL Compensation NEW YORK, NY 10005 Navistar [electronic] E9993C Other WC (Non-NY) , NBA OPERATIONS DEPT 645 5TH AVE NBA01 New York Workers' NEW YORK, NY 10022 Compensation NBC Universal [Electronic] E3933A New York Workers' , Compensation NBC Universal [Electronic] E3933C Other WC (Non-NY) , NBT Bancorp, Inc. 52 South Broad Street NBTBA001 New York Workers' P.O. Box 351 Compensation Norwich, NY 13815 NC Department of Public Instruction [Electronic] E1260A New York Workers' , Compensation NC Department of Public Instruction [Electronic] E1260B Auto/No-Fault , NC Department of Public Instruction [Electronic] E1260C Other WC (Non-NY) , NCA 14 LAFAYETTE SQUARE NCA01 New York Workers' SUITE 700 Compensation BUFFALO, NY 14203 NCA Comp Inc. 14 Lafayette Sq. NCACO002 Other WC (Non-NY) Suite 700 New York, NY 14203 NCAP 1521 MAIN ST NCAP001 New York Workers' NIAGARA FALLS, NY 14305 Compensation NCLM - North Carolina League of Municipalities E1117A New York Workers' [Electronic] , Compensation NCLM - North Carolina League of Municipalities E1117C Other WC (Non-NY) [Electronic] , NCS PERSON HR SERVICES TS 4601 N FAIRFAX DR NCSP01 New York Workers' ARLINGTON, VA 22203 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ND WSI WORKFORCE SAFETY AND INS PO BOX 5585 NDWSI001 Other WC (Non-NY) BISMARK, ND 58506 NE PARENT & CHILD SOCIETY 530 FRANKLIN STREET NEPAR001 New York Workers' SCHENECTADY, NY 12305 Compensation NECSD 124 Grand Street NECSD001 New York Workers' Newburgh, NY 12550 Compensation NELSON DAVISON ADMIN PO BOX 12338 NELSO002 Other WC (Non-NY) RENO, NV 89510 NELSON TREE SERVICE 3300 OFFICE PARK DRIVE NELSO001 New York Workers' DAYTON, OH 45439 Compensation NES RENTALS 5 FRITZ BLVD. NESRE001 New York Workers' ALBANY, NY 12205 Compensation NESBIT FARMS 1051 WILSON RD NESBI001 New York Workers' WATERPORT, NY 14571 Compensation NESTICO'S 412 NORTH MAIN STREET NESTI001 New York Workers' NORTH SYRACUSE, NY 13212 Compensation Nestle Purina 3800 E. Middle Rd NESTL001 New York Workers' Dunkirk, NY 14048 Compensation NETH & SON 146 TAYLOR DR NETHS001 New York Workers' DEPEW, NY 14043 Compensation NETHERLANDS PO BOX 4858 NETH02 New York Workers' SYRACUSE, NY 13221 Compensation NETHERLANDS INSURANCE COMPANY 62 MAPLE AVE NETH01 New York Workers' KEENE, NH 03431 Compensation NETWORK ADJUSTERS PO BOX 9035 NEAD01 New York Workers' FARMINGDALE, NY 11735 Compensation NETWORK ADJUSTERS PO BOX 9035 NETWO001 Auto/No-Fault FARMINGDALE, NY 11735 NEW BRITAIN ROOFING 721 FOX STREET NEWBR004 New York Workers' HORSEHEADS, NY 14845 Compensation NEW DIRECTIONS 356 MAIN ST ER NDIR01 New York Workers' RANDOLPH, NY 14772 Compensation NEW ENGLAND MOTOR FREIGHT 1-71 NORTH AVENUE EAST NEWEN001 New York Workers' ELIZABETH, NJ 07201 Compensation NEW ENGLAND MOTOR FREIGHT 91 SILVER SPRINGS ROAD NEWEN002 New York Workers' OWEGO,NY, NY 13827 Compensation NEW ERA CAP CO INC 160 DELAWARE AVE NEWER001 New York Workers' BUFFALO, NY 14202 Compensation NEW FANE GENERAL 1998 QUAKER RD NEWFA001 New York Workers' BARKER, NY 14012 Compensation New Hampshire Ins Co 200 Metrocliff Dr NEWHA007 Auto/No-Fault Edison, NJ 08817 New Hartford Schools 33 Oxford Rd. NEWHA001 New York Workers' Westmoreland, NY 13490 Compensation NEW JERSEY DEVILS 165 MULBERRY STREET NEWJE004 New York Workers' NEWART, NJ 07102 Compensation New Jersey Manufacturing - Auto Only [Electronic] E1118B Auto/No-Fault , New Jersey Manufacturing - WC Only [Electronic] E0656A New York Workers' , Compensation New Jersey Manufacturing - WC Only [Electronic] E0656C Other WC (Non-NY) , NEW JERSEY SKYLANDS INS PO BOX 1287 NEWJE006 Auto/No-Fault BUFFALO, NY 14240 NEW PROCESS GEAR 6600 CHRYSLER DR NPG01 New York Workers' EAST SYRACUSE, NY 13057 Compensation New Rochelle Fire Dept 90 Beaufort Place NEWRO001 New York Workers' New Rochelle, NY 10801 Compensation New South Insurance Co. [Electronic] E3285B Auto/No-Fault , NEW VISIONS 334 KRUMKILL ROAD NEWVI001 New York Workers' SLINGERLANDS, NY 12159 Compensation NEW YORK CITY POLICE DEPT. MEDICAL DIVISION QUEENS NEWYO010 New York Workers' HEALTHCARE Compensation 96-05 HORACE HARDING EXPRESSWAY CORONA, NY 11368 New York City Transit 130 Livingston Street NEWYO003 Other WC (Non-NY) New York, NY 11201 NEW YORK METS/BUFFALO BISON 12301 ROOSEVELT AVE NEWYO001 New York Workers' FLUSHING, NY 11368 Compensation NEW YORK POWER AUTHORITY 5777 LEWISTON ROAD NEWYO011 New York Workers' LEWISTON, NY 14092 Compensation NEW YORK PRESBYTERIAN/CHP PO BOX 6015 NEWYO007 New York Workers' HAUPPAUGE, NY 11788 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NEW YORK TRANSPORTATION INS 55-10 37TH AVENUE NEWYO009 Auto/No-Fault FLUSHING, NY 11377 NEW YORK TRANSPORTATION INS CORP 55-10 37TH AVE NYTR01 New York Workers' WOODSIDE, NY 11377 Compensation Newburgh Steel Product 5231 Route 9W NEWBU001 New York Workers' Newburgh, NY 12550 Compensation NEWPARK RESOURCES 2700 RESAERCH FOREST DRIVE NEWPA001 New York Workers' THE WOODLANDS, TX 77381 Compensation Nexans Energy USA 3 Enterprise Drive NEXAN001 New York Workers' Newburgh, NY 12550 Compensation NEXGEN VENTURES 760 ELMGROVE RD NEXGE001 New York Workers' ROCHESTER, NY 14624 Compensation NFMMC 621 10TH ST NFMMC001 New York Workers' NIAGARA FALLS, NY 14302 Compensation Nfrastructure 5 Enterprise Avenue NFRAS001 New York Workers' Clifton Park, NY 12065 Compensation NFTA-NF 181 ELLICOTT STREET NFTAN001 New York Workers' BUFFALO, NY 14203 Compensation NGM INSURANCE COMPANY 55 WEST ST NGM01 New York Workers' KEENE, NH 03431 Compensation NHADA WOKERS' COMP. TRUST P.O. BOX 2337 NHADA001 New York Workers' 507 SOUTH ST. Compensation CONCORD, NH 03302-2337 NHRMA / WC PO Box 7110 NHRMA001 Other WC (Non-NY) Champaign, IL 61826 NIACET CORP. 400 47TH ST NIACE001 New York Workers' NIAGARA FALLS, NY 14304 Compensation NIAGARA CEREBRAL PALSEY 9812 LOCKPORT RD NIAGA007 New York Workers' NIAGARA FALLS, NY 14304 Compensation NIAGARA COATINGS 8025 QUARREY RD NIAGA011 New York Workers' NIAGARA FALLS, NY 14304 Compensation Niagara County Mutual 111 Main Street NIAGA008 New York Workers' STE 102 Compensation Lockport, NY 14094 NIAGARA COUNTY SHERIFF'S DEPT 5526 NIAGARA ST EXT NIAGA005 New York Workers' LOCKPORT, NY 14094 Compensation Niagara Frontier Tran. Auth. 181 Ellicott Street NIAGA010 Auto/No-Fault Buffalo, NY 14203 NIAGARA HOSPICE, INC 4675 SUNSET DR NIAGA009 New York Workers' LOCKPORT, NY 14094 Compensation NIAGARA PISTON RING 18455 SCIOTA STREET NIAGA003 New York Workers' CORRY, PA 16407 Compensation NIAGARA REHAB 822 CEDAR AVE NIAGA004 New York Workers' NIAGARA FALLS, NY 14301 Compensation NIAGARA REMOVAL SERVICE 1950 LANGDON ROAD NIAGA006 New York Workers' RANSOMVILLE, NY 14131 Compensation NIAGARA SCIENTIFIC INC 6743 KINNE STREET NIAGA002 New York Workers' EAST SYRACUSE, NY 13057 Compensation NIAGRA MONTAUK 1908 LIBERTY BUILDING NIAGR001 New York Workers' BUFFALO, NY 14302 Compensation NICARETTA CONSTRUCTION CO 189 AVE E NICAR001 New York Workers' BAYONNE, NJ 07002 Compensation NICHOLAS DESIBIO 1253 COLONIAL ROAD NIC01 New York Workers' HEWLETT, NY 11557-2006 Compensation Nicholas Mattera LLC 470 Chamberlain Ave NICHO004 Auto/No-Fault Suite 6 Paterson, NJ 07522 Nichols Packs & Delivery Inc 15 South Maple Street NICHO002 New York Workers' Michael Compensation Corning, NY 14930 NICHOLS SCHOOL 1250 AMHERST ST NICHO003 New York Workers' BUFFALO, NY 14216 Compensation NICHOLSON & HALL CORP 41 COLUMBIA ST NICHO001 New York Workers' BUFFALO, NY 14204 Compensation Nickelodian (Murphy and Beane) [Electronic] E0890C Other WC (Non-NY) , NICKERSON FARMS RD 2 BOX 173 NICKE001 New York Workers' CORRY, PA 16407 Compensation NIMS OUTDOOR SERVICES 3395 STATE ROUTE 196 NIMSO001 New York Workers' FORT EDWARD, NY 12827 Compensation Nippon Life Insurance PO Box 25951 NIPPO001 Other WC (Non-NY) Shawnee Mission, KS 66225 NJ MANUFACTURERS PO BOX 928 NJMAN007 New York Workers' WEST TRENTON, NJ 08628 Compensation NJ MANUFACTURERS PO BOX 928 NJMAN008 Auto/No-Fault WEST TRENTON, NJ 08628 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NJ MANUFACTURERS PO BOX 928 NJMAN009 Other WC (Non-NY) WEST TRENTON, NJ 08628 NJ MANUFACTURERS INSURANCE 301 SULLIVAN WAY NJMAN010 Auto/No-Fault TRENTON, NJ 08628 NJ PLIGA 233 Mount Airy Road NJPLI002 Auto/No-Fault Basking Ridge, NJ 07920 NJ Skyland /HCS 33 Washington Street NJSKY001 Auto/No-Fault 11th floor Newark, NJ 07102-3194 NJ STATE OF RISK MGMT PO BOX 620 NJSTA001 New York Workers' TRENTON, NJ 08625 Compensation NJ STATE POLICE PO BOX 7068 NJSTA002 New York Workers' W. TRENTON, NJ 08628 Compensation NJ TRANSIT RAILROAD 1 PENN PLAZA EAST NJTRA001 Other WC (Non-NY) NEWARK, NJ 07105 NJ TURNPIKE AUTHORITY PO BOX 1121 NJTUR001 New York Workers' NEW BRNSWICK, NJ 08903 Compensation NJ WATER SUPPLY PO BOX 5196 NJWAT001 New York Workers' CLINTON, NJ 08809 Compensation No Fault Service Corp. PO Box 359 NOFAU001 Auto/No-Fault Larchmont, NY 10538 No Insurance Unit 328 State Street NOINS001 New York Workers' Schenectady, NY 12305 Compensation Noblehurst Farms 1818 Linwood Rd NOBLE001 New York Workers' Linwood, NY 14486 Compensation NORAMPAC ATTN: LYNN MONTGOMERY PO BOX NORAM001 New York Workers' 7575 Compensation LANCASTER, NY 14086 Nordland Farm 268 Frissel Rd NORDL001 New York Workers' Jamestown, NY 14701 Compensation Nordstrom 135 Westchester Avenue NORDS001 New York Workers' White Plains, NY 10601 Compensation NORDSTROM PO BOX 21865 NORD01 New York Workers' SEATTLE, WA 98111-3865 Compensation Nordstrom Risk Mgmt 1700 7th Ave NORDS002 New York Workers' Suite 1500 Compensation Seattle, WA 98101 Nordstrom, Inc. [Electronic] E3304A New York Workers' , Compensation Nordstrom, Inc. [Electronic] E3304C Other WC (Non-NY) , NORFOLK & DEDHAM 222 AMES STREET NORFO001 Auto/No-Fault P.O. 9109 DEDHAM, MA 02027-9109 Norfolk Southern 4600 Deer Path Road NOSOU01 New York Workers' Harrisburg, PA 17110 Compensation Norguard Ins Co P O Box 1368 NORGU001 Other WC (Non-NY) Wilkes Barre, PA 18703-1368 NorGUARD Insurance Company - Guard DBA E0891A New York Workers' [Electronic] , Compensation NorGUARD Insurance Company - Guard DBA E0891C Other WC (Non-NY) [Electronic] , NORLITE LLC 628 SO. SARATOGA STREET NORLI001 New York Workers' COHOES, NY 12047 Compensation North American Carbine 5720 Ellis Rd NORTH023 New York Workers' Orchard Park, NY 14127 Compensation NORTH AMERICAN RISK SERVICES (NARS) P.O. BOX 166002 NORTH030 Auto/No-Fault ALTAMONTE SPRINGS, FL 32716 NORTH AMERICAN RISK SVS PO BOX 166002 NORTH022 Auto/No-Fault ALTAMONTE SPRINGS, FL 32716 NORTH AMERICAN SPECIALTY INS CO 650 ELM ST NASI01 New York Workers' 6TH FL Compensation MANCHESTER, NH 03101 North American Specialty Insurance [Electronic 650 ELM ST NORTH014 New York Workers' Indirect] 6TH FL Compensation MANCHESTER, NH 03101 North American Specialty Insurance [Electronic 650 ELM ST NORTH015 Auto/No-Fault Indirect] 6TH FL MANCHESTER, NH 03101 North American Specialty Insurance [Electronic 650 ELM ST NORTH016 Other WC (Non-NY) Indirect] 6TH FL MANCHESTER, NH 03101 North Carolina Farm Bureau [electronic] E9997C Other WC (Non-NY) , North Clackamas School District #12 [Electronic] E0892A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID North Clackamas School District #12 [Electronic] E0892C Other WC (Non-NY) , North County Transit District [Electronic] E0893A New York Workers' , Compensation North County Transit District [Electronic] E0893C Other WC (Non-NY) , NORTH JERSEY DEVELOPMENT 169 MINI SINK ROAD NORTH019 New York Workers' NEWARK, NJ 07106 Compensation NORTH LAKE TAHOE FIRE PROTECTION DISTRICT 866 ORIOLE WY NORTH031 Other WC (Non-NY) INCLINE VILLAGE, NV 89451 NORTH LINE UTILITIES PO BOX 656 NORTH001 New York Workers' AUSABLE FORKS, NY 12912 Compensation NORTH RIVER INS CO PO BOX 1960 NORI01 New York Workers' MORRISTOWN, NJ 07962 Compensation North River Insurance Company [Electronic] E0894B Auto/No-Fault , North River Insurance Company [Electronic] E0894C Other WC (Non-NY) , NORTH SENECA AMBULANCE 1645 NORTH ROAD NORTH004 New York Workers' WATERLOO, NY 13165 Compensation NORTH STAR MUTUAL PO BOX 48 NORTH018 Auto/No-Fault Cottonwood, MN 56229-0048 NORTH TONAWANDA DEPT. OF PUBLIC WORKS 758 ERIE AVE NTDP01 New York Workers' N TONAWANDA, NY 14120 Compensation NORTHBROOK INDEMNITY CO 3075 SANDERS RD NOBI01 New York Workers' SUITE H2D Compensation NORTHBROOK, IL 60062 Northeast Community Care Arcadian Health Plan NORTH006 New York Workers' 955 Overland Compensation San Dimas, CA 91773 Northeast Health WC 315 South Manning Blvd NORTH027 New York Workers' STE 6521 Compensation Albany, NY 12208 Northeast Industrial PO Box 55 NORTH028 New York Workers' Leroy, NY 14482 Compensation NORTHEAST PARENT & CHILD SOCIETY 530 FRANKLIN STREET NORTH005 New York Workers' 3RD FLOOR Compensation SCHENECTADY, NY 12305 NORTHEAST SRS 2455 PACESFAIRY RD NSRS01 New York Workers' ATLANTA, GA 00339 Compensation NORTHERN ASSURANCE CO OF AMERICA PO BOX 9155 NOAC01 New York Workers' CANTON, MA 02021-1030 Compensation NORTHERN CLEARING 1805 MAIN STREET WEST NORTH017 New York Workers' ASHLAND, WI 54806 Compensation Northern Colorado School Districts WC Pool E0895A New York Workers' [Electronic] , Compensation Northern Colorado School Districts WC Pool E0895C Other WC (Non-NY) [Electronic] , NORTHERN CONCRETE BLOCK ATTN MELISSA NORTH024 New York Workers' PO BOX 420 Compensation FULTON, NY 13069 NORTHERN FRONTIER CAMP PO BOX 295 NORTH029 New York Workers' NORTH RIVER, NY 12856 Compensation NORTHERN INSURANCE CO OF NY 1400 AMERICAN LANE NICN01 New York Workers' PTAX 2/20 Compensation SCHAUMBURG, IL 60196 NORTHERN LIGHTS CANDLES 3474 ANDOVER ROAD NORTH026 New York Workers' WELLSVILLE, NY 14895 Compensation NORTHERN MECANICAL SERVICES 30 PROGRESS BLVD NORTH025 New York Workers' QUEESNBURY, NY 12804 Compensation Northfield Insurance Co(385 WASHINGTON S 385 WASHINGTON STREET NORTH008 Auto/No-Fault [Electronic] SAINT PAUL, MN 55102 Northland Auto [Electronic] E1307B Auto/No-Fault , Northland Casualty Ins [Electronic] 385 WASHINGTON STREET NORTH010 Auto/No-Fault SAINT PAUL, MN 55102 Northland Insurance Co(PO BOX 64808) PO BOX 64808 NORTH012 Auto/No-Fault [Electronic] SAINT PAUL, MN 55164 NORTHROP GRUMMAN SHIPBUILDING 4101 WASHINGTON AVE NORTH003 New York Workers' NEWPORT NEWS, VA 23607 Compensation NORTHTEC 411 SINCLAIR ST NORTH020 New York Workers' BRISTOL, PA 19007 Compensation NORTHTOWN AUTOMOTIVE 1135 MILLERSPORT HWY NAUT01 New York Workers' STE 14226 Compensation AMHERST, NY 14226 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NORTHWEST COMM MENTAL HEALTH 1300 NIAGARA ST PO BOX 657 NORTH002 New York Workers' BUFFALO, NY 14213 Compensation Northwest Insurance [Electronic] E9218A New York Workers' , Compensation Northwest Insurance [Electronic] E9218B Auto/No-Fault , Northwest Insurance [Electronic] E9218C Other WC (Non-NY) , NORTHWESTERN MUTUAL PO BOX 2918 NORTH021 New York Workers' MILWAUKEE, WI 532012918 Compensation NORTHWESTERN NATIONAL INS CO 9277 CENTRE POINTE DR NONA01 New York Workers' STE 140 Compensation WEST CHESTER, OH 45069-4844 NORTON AND SONS 148 EAST 5TH STREET NORTO001 New York Workers' BAYONNE, NJ 07002 Compensation Norwood [Electronic] E7876C Other WC (Non-NY) , NOVA CASUALTY COMPANY 2 WATERSIDE CROSSING NOCC02 New York Workers' STE 400 Compensation WINDSOR, CT 06095 NOVA CASUALTY COMPANY 326 EXCHANGE ST STE1020 NOVAC001 New York Workers' BUFFALO, NY 14210 Compensation Nova Dealership Advantage Program - WC E0896A New York Workers' [Electronic] , Compensation Nova Dealership Advantage Program - WC E0896C Other WC (Non-NY) [Electronic] , Nova Elite Comp Program [Electronic] E0897A New York Workers' , Compensation Nova Elite Comp Program [Electronic] E0897C Other WC (Non-NY) , Nova Metals Advantage Plus Program - WC E0898A New York Workers' [Electronic] , Compensation Nova Metals Advantage Plus Program - WC E0898C Other WC (Non-NY) [Electronic] , NOVA PRO RISK SOLUTIONS 4508 OAK FAIR BLVD NOVAP002 New York Workers' TAMPA, FL 33610 Compensation Nova Pro Risk Solutions [Electronic] E2635C Other WC (Non-NY) , NOVA PRORISK SOLUTIONS PO BOX 101600 NOVAP001 New York Workers' ANCHORGE, AK 99510 Compensation NOVELLO'S DRY CLEANING INC 3114 E MAIN STREET NOVEL001 New York Workers' ENDWELL, NY 13760 Compensation Novlet Lawrence Attorney 55 Washington Street NOVLE001 Auto/No-Fault Suite 304 East Orange, NJ 07017 NOYLE JOHNSON PO BOX 279 NOYLE001 New York Workers' MOUNTPELIER, VT 05601 Compensation NTA ASSOCIATES 300 W. SUMMERDALE RD. UNIT A,B NTAAS001 Auto/No-Fault VORHEES, NJ 08043 NTI GLOBAL PO BOX 189 NTIGL001 New York Workers' AMSTERDAM, NY 12010 Compensation Nu Look Collision 840Lehigh Station Rd NULOO001 New York Workers' W Henrietta, NY 14586 Compensation NUCOR 25 QUARRY RD NUCOR001 New York Workers' AUBURN, NY 13021 Compensation Nuevo Engineering [Electronic] E0899A New York Workers' , Compensation Nuevo Engineering [Electronic] E0899C Other WC (Non-NY) , NWBUFFALO COM. CENTER/ATTNPAT 155 LAWN AVE NWBUF001 New York Workers' KOWALEWSKI BUFFALO, NY 14207 Compensation NWBUFFALO COM. CENTER/ATTNPAT 155 LAWN AVE NWBUF002 New York Workers' KOWALEWSKI BUFFALO, NY 14207 Compensation NY Black Car Fund WC Claims 30 Wall Street NYBLA002 New York Workers' 10th Floor Compensation New York, NY 10005 NY CENTRAL MUTUAL 1899 CENTRAL PLAZA NCM01 New York Workers' Compensation EDMESTON, NY 13335 NY CENTRAL MUTUAL 1899 Central Plaza East NYCEN001 Auto/No-Fault EDMESTON, NY 13335 NY CENTRAL MUTUAL PO BOX 737 NYCEN002 Auto/No-Fault SHERBORNE, NY 13460 NY CONVENTION CENTER 655 W 34TH ST NYCON001 New York Workers' NEW YORK, NY 10001 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NY CRUISE LINE PIER 81 WEST 41ST ST & HUDSON NYCRU001 New York Workers' NEW YORK, NY 10018 Compensation NY Department of State Insurance 123 William Street NYDEP001 New York Workers' New York, NY 10038 Compensation NY Liquidation Bureau 110 William Street, 16th Floor NYLIQ002 New York Workers' New York, NY 10038 Compensation NY LUMBERMAN INS 9600 MAIN ST STE 3 NYLUM001 New York Workers' CLARENCE, NY 14031 Compensation NY MUTUAL INS PO BOX 1138 NYMUT001 Auto/No-Fault JAMESTOWN, NY 14702 NY OIL & PETROLEUM SELF INS PO BOX 1248 NYOP01 New York Workers' WILLIAMSVILLE, NY 14231 Compensation NY SAFETY GROUP LLZ 2500 WEST CHESTER AVE NYSAF001 New York Workers' STE 203 Compensation PURCHASE, NY 10577 NY STATE AUTO DEALERS INC PO BOX 7347 NYSA01 New York Workers' ALBANY, NY 12224 Compensation NY STATE DEPT OR CORRECTIONS PO BOX 149 NYSTA004 New York Workers' ATTICA, NY 14011 Compensation NY STATE EMP RISK MGMT 377 OAK Street NYSE01 New York Workers' GARDEN CITY, NY 11530 Compensation ny state insurance fund 225 oak street NYSTA002 New York Workers' buffalo, NY 14023 Compensation NY State Insurance Fund 8 Corporate Center Drive NYSTA006 New York Workers' 3rd Floor Compensation Melville, NY 11747 NY STATE INSURANCE FUND 100 CHESTNUT ST STE 1000 NYSTA007 Other WC (Non-NY) ROCHESTER, NY 146040000 NY STATE INSURANCE FUND 1045 7TH NORTH STREET NYSTA001 New York Workers' LIVERPOOL, NY 13088 Compensation NYAHSA C-O RISK 784 TROY-SCHENECTADY RD NYAHS001 New York Workers' LATHAM, NY 12110 Compensation NYC COMPTROLLER 130 LIVINGSTON ST 10TH FL NYCCO001 Auto/No-Fault BROOKLYN, NY 11201 NYC DEPARTMENT OF BUILDINGS 280 BROADWAY NYDB01 New York Workers' 6TH FLR Compensation NEW YORK, NY 10007 NYC DEPARTMENT OF LAW 350 JAY STREET NYCDE002 Other WC (Non-NY) BROOKLYN, NY 11201 NYC DEPT OF SANITATION 44 BEAVER ST NYDS01 New York Workers' 4TH FL, LODI BILLING UNIT Compensation NEW YORK, NY 10004 NYC DEPT OF SANITATION (WC) 44 BEAVER STREET 4TH FLOOR NYCDE003 Other WC (Non-NY) NEW YORK, NY 100040000 NYC Dept. of Sanitation 44 Beaver Street NYCDE001 Other WC (Non-NY) 4th Fl, Lodi Billing Unit New York, NY 10004 NYC FIRE DEPARTMENT 9 METROTECH CENTER NYCFI001 New York Workers' COMP UNIT 2ND FL Compensation BROOKLYN, NY 11201 NYC HOUSING AUTHORITY NYC HOUSING AUTHORITY, C/O NYCHO001 Other WC (Non-NY) RMPG PO BOX 508 MINEOLA, NY 11501 NYC Housing Authority WC 250 Broadway NYCHO002 New York Workers' New York, NY 10007 Compensation NYC Law Department 350 Jay Street NYCLA001 Other WC (Non-NY) 9th Floor Brooklyn, NY 11201 NYC Law Dept (AIG)-Joe Sidhom 350 Jay Street NYCLA002 Other WC (Non-NY) 9th Floor Brooklyn, NY 11201 NYC Office of the Comptroller 1 Centre Street NYCOF001 New York Workers' New York, NY 10007 Compensation NYC TRANSIT 130 LIVINGSTON STREET NYCTR002 Auto/No-Fault BROOKLYN, NY 11201 NYC TRANSIT AUTHORITY 130 LIVINGSTON STREET 10TH NYCTR003 Auto/No-Fault FLOOR BROOKLYN, NY 11201 NYC TRANSIT AUTHORITY 130 LIVINGSTON STREET 10TH NYCTR004 Other WC (Non-NY) FLOOR BROOKLYN, NY 11201 NYC TRANSIT AUTHORITY 370 JAY STREET NYCTR001 New York Workers' BROOKLYN, NY 11201 Compensation NYCC 2360 Route 89 NYCC001 New York Workers' Seneca Falls, NY 13148 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID NYCTA COMP DIV 130 LIVINGSTON ST NYCTA01 New York Workers' 10th FL Compensation BROOKLYN, NY 11201 NYEDA HEALTH & WELFARE PO BOX 3470 NHW01 New York Workers' EAST SYRACUSE, NY 13057 Compensation NYLB PO BOX 549 NYLB01 New York Workers' MINEOLA, NY 11501 Compensation NYMAT MACHINE TOOL 2650 BAIRD RD NYMAT001 New York Workers' FAIRPORT, NY 14450 Compensation NYPD Medical Billing Unit 1 Lefrak City Plaza NYPDM001 New York Workers' 59-17 Junction Blvd Compensation Corona, NY 11368 NYPD Medical Billing Unit 1 Lefrak City Plaza NYPDM002 Other WC (Non-NY) 59-17 Junction Blvd Corona, NY 11368 NYS DEPT OF ENVIRONMENTAL CON 1285 FISHER AVENUE NYSDE002 New York Workers' CORTLAND, NY 13045 Compensation NYS DEPT OF TRANSPORTATION 100 SENECA ST NYSDE001 New York Workers' BUFFALO, NY 14203 Compensation NYS DEPT OF TRANSPORTATION 107 Broadway NYSDE005 New York Workers' Hornel, NY 14843 Compensation NYS DEPT OF TRANSPORTATION PP 3863 MEADES CREEK ROAD NYSDE003 New York Workers' PAINTED PPOST, NY 14870 Compensation NYS Dept. of Civil Service Alfred Smith State Office Building NYSDE004 New York Workers' Albany, NY 12239 Compensation NYS DOT (WATKINS GLEN) 3545 COUNTY ROUTE 16 NYSDO001 New York Workers' WATKINS GLEN, NY 14891 Compensation NYS Insurance Fund 100 Chestnut Street NYSIN001 New York Workers' Suite 1000 Compensation Rochester, NY 14604 NYS Law Department Workers Compensation NYSLA001 New York Workers' 350 Jay Street - 9th Floor Compensation Brooklyn, NY 11201 NYS MUNICIPAL ALLIANCE 333 EARLE OVINGTON BLVD NYMA01 New York Workers' #505 Compensation UNIONDALE, NY 11553-3624 NYS OFFICE OF CHILDREN & FAMILY MACCORMICK SECURE CENTER NYSOF003 New York Workers' 300 SOUTH ROAD Compensation BROOKTONDALE, NY 14817 NYS Office of Victim Services 80 S. Swan St NYSOF004 New York Workers' 2nd Floor, AE Smith Bldg Compensation Albany, NY 12210 NYS POLICE BLD 22 1220 WASHINGON AVE NYSPO001 New York Workers' ALBANY, NY 12226 Compensation NYS VETS HOME BATAVIA 220 RICHMOND AVE NVET01 New York Workers' BATAVIA, NY 14020-1227 Compensation NYS Workers' Comp Board PO BOX 5205 NYSWO001 New York Workers' Binghamton, NY 13902-5205 Compensation NYSEG 1 ELECTRIC PARKWAY NYSEG001 New York Workers' HORSEHEADS, NY 14845 Compensation NYSIF 199 CHURCH STREET-2ND FLOOR NYSIF New York Workers' New York, NY 10007 Compensation NYSIF 199 CHURCH STREET-2ND FLOOR NYSIF1500 Other WC (Non-NY) New York, NY 10007 NYSIF-ALBANY 1 WATERVLIET AVE EXT NYSIF1501 New York Workers' ALBANY, NY 12206 Compensation O L V 780 RIDGE RD OLV001 New York Workers' LACKAWANA, NY 14218 Compensation Oak Hill Manor 602 Hudson Street OAKHI001 New York Workers' Ithaca, NY 14850 Compensation OAK ORCHARD COMM HEALTH 301 WEST AVE OOCH01 New York Workers' ALBION, NY 14411 Compensation Oak River Insurance Company (Member of BHHC) E0900C Other WC (Non-NY) [Electronic] , OAKGROVE CONSTUCTION INC PO BOX 103 OAKGR001 New York Workers' ATTN: DAVE LANG Compensation ELMA, NY 14059 OATKA MILK PO BOX 718 OATKA001 New York Workers' BATAVIA, NY 14020 Compensation OBRIEN AND GERE PO BOX 4873 OBRIE001 New York Workers' SYRACUSE, NY 13221 Compensation OCCHINO CORP 2650 SENECA ST OCCHI001 New York Workers' WEST SENECA, NY 14224 Compensation OCCIDENTAL AUTO CLAIMS DEPARTMENT OCCID001 Auto/No-Fault P O BOX 771270 CORAL SPRINGS, FL 33077 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID OCCUPATIONAL MEDICINE PROGRAM SMH BOX 654 OMP01 New York Workers' ROCHESTER, NY 14642 Compensation OCCUSURE INSURANCE PO BOX 682829 OCCUS001 New York Workers' FRANKLYN, TN 37068 Compensation Ocean Taxi Inc 1650 Broadway Suite 508 OCEAN001 New York Workers' Att: Filip Tiffenberg P.C. Compensation New York, NY 10019 OCG PO BOX 24 OCG02 New York Workers' TROY, NY 12182 Compensation OCONNELL ELECTRIC 830 PHILLIPS RD OCONN001 New York Workers' VICTOR, NY 14564 Compensation OCONNER PLUMBING AND HEATING 121 KINYON STREET OCONN002 New York Workers' ELMIRA, NY 14904 Compensation O'Daniel Trucking / WC 1249 County Road 1500 N ODANI001 Other WC (Non-NY) Carmi, IL 62821 ODD FELLOWS REBEKAH RHCC INC 140 OLD NIAGARA RD ODDFE001 New York Workers' LOCKPORT, NY 14094 Compensation O'DELL FAMILY CHIROPRACTIC 853 RIDGE ROAD ODELL001 New York Workers' WEBSTER, NY 14580 Compensation OEHLERS WELDING 242 ELK ST OEHLE001 New York Workers' BUFFALO, NY 14210 Compensation Oelze Equipment Co / WC PO Box 325 OELZE001 Other WC (Non-NY) Nashville, IL 62263 OFFHAUS FARMS 7892 OAK ORCHARD ROAD OFFHA001 New York Workers' BATAVIA, NY 14020 Compensation OFFICE OF RISK MANAGEMENT 280 GROVE STREET OFFIC001 Other WC (Non-NY) JERSEY CITY, NJ 07302 OFFICE OF RISK MGMT PO BOX 1766 ORM01 New York Workers' BINGHAMTON, NY 13902-1766 Compensation OHIO BWC 30 WEST SPRING ST OHIOB001 New York Workers' COLUMBUS, OH 43215 Compensation Ohio Casualty 275 Grandview Avenue, Suite 300 OHIOC004 New York Workers' Camp Hill, PA 17001 Compensation OHIO CASUALTY P.O. BOX 4858 OHIOC001 New York Workers' SYRACUSE, NY 13221 Compensation OHIO CASUALTY PO BOX 296 OHIOC003 Auto/No-Fault HAMILTON, OH 45012 OHIO CASUALTY PO BOX 29621 OHIOC012 Auto/No-Fault RALEIGH, NC 276907138 OHIO CASUALTY PO BOX 60521 OHIOC008 New York Workers' PHILA, PA 19145 Compensation OHIO CASUALTY (CAMP HILL) PO BOX 8851 OHIOC006 New York Workers' CAMP HILL, PA 17001-8851 Compensation OHIO CASUALTY GROUP 136 NORTH 3RD STREET OHIOC009 New York Workers' 5TH FLOOR Compensation HAMILTON, OH 45025 OHIO CASUALTY GROUP PO BOX 1129 OHIOC010 Auto/No-Fault MARLTON, NJ 08053 OHIO CASUALTY GROUP PO BOX 507 OCG01 New York Workers' KEENE, NH 03431 Compensation Ohio Casualty Group [Electronic] E2318C Other WC (Non-NY) , OHIO CASUALTY INSURANCE PO BOX 188066 OHIOC011 Auto/No-Fault AUTO CLAIMS FAIRFIELD, OH 45018 OHIO CASUALTY INSURANCE CO 9450 SEWARD RD OHI01 New York Workers' FAIRFIELD, OH 45014 Compensation OHIO COMP 2900 CARNEGIE AVE OHIOC005 New York Workers' CLEVELAND, OH 44115 Compensation OHIO EMPLOYEE HEALTH PARTNERS 445 HUTCHINSON AVE STE 205 OHIOE002 New York Workers' COLUMBUS, OH 43235 Compensation ohio employee health partnership 1105 schrock ste 210 OHIOE001 New York Workers' columbus, OH 43229 Compensation OHIO SECURITY INSURANCE COMPANY 9450 SEWARD RD OHIO01 New York Workers' FAIRFIELD, OH 45014 Compensation OIL REFINERY COMPANY OF PA PO BOX 599 OILRE001 New York Workers' WARREN, PA 16365 Compensation OJ FOOD GRADE TANK 47-49 OLD LINCOLN HWY OJFOO001 New York Workers' KEARNY, NJ 07032 Compensation OLD NAVY (ELMIRA) 845 COUNTY RT 64 OLDNA001 New York Workers' ATTN: JEN GRIFFEN Compensation ELMIRA, NY 14903 Old Republic PO BOX 2939 OLDRE003 New York Workers' MILWAUKEE, WI 53201 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID OLD REPUBLIC GENERAL INS CORP PO BOX 2200 OLD01 New York Workers' 133 OAKLAND AVE Compensation GREENSBURG, PA 15601-0789 OLD REPUBLIC INS 445 SOUTH MOORLAND RD OLDRE004 New York Workers' SUITE 300 Compensation BROOKFIELD, WI 53005 OLD REPUBLIC INS PO BOX 1590 OLDRE001 New York Workers' PIKEVILLE, KY 41502 Compensation OLD REPUBLIC INSURANCE CO C/O SEDGWICK OLDRE002 Other WC (Non-NY) PO BOX 14151 LEXINGTON, KY 40512 Old Republic Insurance Co [Electronic] E9345C Other WC (Non-NY) , OLEAN GENERAL HOSPITAL PO BOX 728 OGH01 New York Workers' OLEAN, NY 14760 Compensation OLIN CORPORATION 2400 BUFFALO AVENUNE OLINC001 New York Workers' NIAGARA FALLS, NY 14304 Compensation OMNE STAFFING INC 4 COMMERCE DR OMNE01 New York Workers' CRANFORD, NJ 07016 Compensation OMNI P.O. BOX 3000 OMNI001 Auto/No-Fault PLYMOUTH MEETING, PA 19462 Omni Asset Workers Comp 26 Journal Square 16th Fl OMNIA001 Other WC (Non-NY) Jersey City, NJ 07306 OMNI ELECTROMOTIVE 12 SEELEY HILL RD OMNIE001 New York Workers' NEWFIELD, NY 14867 Compensation Omni Insurance Group PO Box 105019 OMNII001 Auto/No-Fault Atlanta, GA 03348 OMNI MANAGEMENT 40 BEAVER STREET OMNIM001 New York Workers' ALBANY, NY 12207 Compensation On Point Underwriting 8390 East Crescent Pkwy ONPOI001 New York Workers' Suite 200 Compensation Greenwood Village, CO 80111 One Beacon PO Box 887 ONEBE007 Other WC (Non-NY) Brentwood, TN 37024 ONE BEACON 10940 WILSHIRE BLVD ONEBE009 Auto/No-Fault LOS ANGELES, CA 90024 ONE BEACON PO BOX 15052 ONEBE002 New York Workers' WORCHESTER, MA 01615 Compensation ONE BEACON PO BOX 302 ONEBE001 New York Workers' BUFFALO, NY 14240 Compensation One Beacon [Electronic] E1606C Other WC (Non-NY) , One Beacon Insurance PO Box 887 ONEBE011 New York Workers' Brentwood, TN 37024 Compensation ONE BEACON INSURANCE 188 INVERNESS DR WEST ONEBE008 New York Workers' STE 600 Compensation ENGELWOOD, CO 80112 ONE BEACON INSURANCE PO BOX 288 ONEBE004 Auto/No-Fault AUTO CLAIMS CANTON, MA 02021 ONE BEACON INSURANCE PO BOX 9155 ONEB08 New York Workers' CANTON, MA 02021 Compensation One Beacon Insurance - Auto [Electronic] E8196B Auto/No-Fault , ONE CALL MEDICAL PO BOX 614 ONEC01 New York Workers' 20 WATERVIEW BLVD Compensation PARSIPPANY, NJ 07054 One Call Medical / WC P.O. Box 614 ONECA001 Other WC (Non-NY) Parsippany, NJ 07054 ONE SEVENTY ONE CEDAR ARTS CENTER 171 CEDAR STREET ONESE001 New York Workers' CORNING, NY 14830-2603 Compensation ONE TREE DISTRIBUTION PO BOX 373 ONETR001 New York Workers' SYRACUSE, NY 13206 Compensation ONEDIA WAREHOUSING INC PO BOX 9 ONEDI001 New York Workers' AUBURN,NY, NY 13021 Compensation ONEIDA CTY COMP DEPARTMENT 800 PARK AVE OCCD01 New York Workers' COUNTY OFFICE BUILDING Compensation UTICA, NY 13501 Oneida Healthcare Center 321 Genesee St ONEID001 New York Workers' Oneida, NY 13421 Compensation ONEIDA INDIAN NATION 2 TERRITORY RD OIN01 New York Workers' ONEIDA, NY 13421 Compensation ONONDAGA BEVERAGE 7655 EDGECOMB DRIVE ONOND001 New York Workers' LIVERPOOL, NY 13088 Compensation ONSITE FACILITY SERVICES 6730 VIP PKWY OFS01 New York Workers' SYRACUSE, NY 13211 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID ONSITE FACILITY SERVICES PO BOX 373 ONSIT001 New York Workers' EAST SYRACUSE, NY 13057 Compensation Ontario ARC 3071 County Complex Drive ONTAR001 New York Workers' Canandaigua, NY 14424 Compensation Ontario County 239 Rensselaer St ONTAR003 New York Workers' Buffalo, NY 14210 Compensation ONTARIO COUNTY WOMENS HEALTH PA 3019 COUNTY COMPLEX DR OCWH01 New York Workers' CANANDAIGUA, NY 14424 Compensation Ontario Spec Contractors 6 Atlas Street ONTAR002 New York Workers' Rochester, NY 14604 Compensation ONTARIO SPECIALTY CONTRACT/ATT JIM WILLI 333 GANSON STREET ONTAR004 New York Workers' BUFFALO, NY 14203 Compensation ONYX TR 6 BOX 31A ONYX001 New York Workers' PITTSFIELD, PA 16340 Compensation Opportunities Unlimited L P O 360 OPPOR003 New York Workers' 2393 Niagara Falls Blvd Compensation Niagara Falls, NY 14304 Optacomp PO Box 44291 OPTAC001 New York Workers' Jacksonville, FL 32231 Compensation Optimax Systems Inc 6367 Dean Parkway OPTIM002 New York Workers' Ontario, NY 14519 Compensation Optimed Health Plan Ins 4 Terry Dr OPTIM003 Auto/No-Fault Suite 1 Newtown, PA 18940 OPTIMIZATION CONSULTING 4221 FORBES BLVD OPTIM001 New York Workers' LANHAM, MD 20706 Compensation ORACLE MANAGEMENT 358 SAWMILL RIVER RD ORMA01 New York Workers' MILLWOOD, NY 10546 Compensation ORANGE COUNTY AHRC 249 BROADWAY OROC01 New York Workers' NEWBURGH, NY 12550 Compensation ORCHARD HEIGHTS 5200 CHESTNUT RIDGE RD ORCHA003 New York Workers' ORCHARD PARK, NY 14127 Compensation ORCHARD PARK FIRE EMS INC P O BOX 488 ORCHA002 New York Workers' ORCHARD PARK, NY 14127 Compensation ORCHARD PARK VETERINARY MED 3930 NORTH BUFFALO RD ORCHA001 New York Workers' ORCHARD PARK, NY 14127 Compensation ORCHID MEDICAL PO BOX 560370 ORCHI001 New York Workers' ORLANDO, FL 32856 Compensation ORCON INDUSTRIES 8715 LAKE ST ORCON001 New York Workers' LEROY, NY 14482 Compensation Oregon State Accident Ins Fund Corp [Electronic] E1135A New York Workers' , Compensation Oregon State Accident Ins Fund Corp [Electronic] E1135C Other WC (Non-NY) , O'Reilly Auto Parts [Electronic] E1261A New York Workers' , Compensation O'Reilly Auto Parts [Electronic] E1261B Auto/No-Fault , O'Reilly Auto Parts [Electronic] E1261C Other WC (Non-NY) , Orica, Inc. [Electronic] E3179C Other WC (Non-NY) , ORIGINAL ITALIAN PIZZA 360 W PULTENEY ST ORIGI002 New York Workers' CORNING, NY 14830 Compensation ORIGINAL PANCAKE HOUSE 5479 MAIN ST ORIGI001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation ORISKA PO BOX 855 ORIN01 New York Workers' 1310 UTICA ST Compensation ORISKANY, NY 13424 Orleans County Self Insurance Fund 14016 Route 31 West ORLEA001 New York Workers' Albion, NY 14411 Compensation ORLEANS COUNTY SHERIFFS DEPT 13925 STATE RTE 31- STE 400 OCSD01 New York Workers' ADMINISTRATIVE OFFICE ATTN Compensation AGGI ALBION, NY 14411 O'ROURKE INC 208 FRONT STREET OROUR001 New York Workers' OWEGO, NY 13827 Compensation Orthopaedic Center of Southern Illinois 4121 Veterans Memorial Drive ORTHO001 Other WC (Non-NY) Mt. Vernon, IL 62864 Orville's Home Appliances 3979 Walden Ave ORVIL001 New York Workers' Lancaster, NY 14086 Compensation ORYX INSURANCE 3 ADLER DRIVE ORYXI004 New York Workers' East Syracuse, NY 13057 Compensation OSBORNE STREET GARAGE 191 OSBORNE STREET OSBOR001 New York Workers' ALBANY, NY 12209 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID OSC Equipment Services 333 Ganson St OSCEQ001 New York Workers' Buffalo, NY 14203 Compensation Osmose 980 Ellicott St OSMOS001 New York Workers' Buffalo, NY 14209 Compensation OSWEGO CITY SELF INS 46 EAST BRIDGE ST OCSI01 New York Workers' OSWEGO, NY 13126 Compensation OTAS 2495 MAIN ST SUITE 234 OTAS001 New York Workers' BUFFALO, NY 14214 Compensation Otis Eastern PO BOX 330 OTISE001 New York Workers' attn: Kevin Compensation Wellsville, NY 14895 OTSEGO COUNTY 197 MAIN ST OTSE01 New York Workers' COOPERSTOWN, NY 13326 Compensation OUR SAVIOR'S LUTHERAN CHURCH 63 MOUNTAIN VIEW AVENUE OURSA001 New York Workers' ALBANY, NY 12205 Compensation OURSOURCE CNTR 1649 FILLMORE AVENUE OURSO001 New York Workers' BUFFALO, NY 14211 Compensation Outrigger Lodging [Electronic] E0901A New York Workers' , Compensation Outrigger Lodging [Electronic] E0901C Other WC (Non-NY) , Overhill Farms, Inc. [Electronic] E0902A New York Workers' , Compensation Overhill Farms, Inc. [Electronic] E0902C Other WC (Non-NY) , owcp 200 constitution ave OWCP001 New York Workers' washington dc, DC 20210 Compensation OWEGO TREADWAY INN 1100 STATE RT 17C OWEGO001 New York Workers' OWEGO, NY 13827 Compensation OWL HOMES PO BOX 189 OWLHO002 New York Workers' ALLEGANY, NY 14706 Compensation OWL HOMES PO BOX 407 OWLHO001 New York Workers' BATH, NY 14706 Compensation Oxbo International 7275 Byron Road OXBOI001 New York Workers' Byron, NY 14422 Compensation OXBO INTERNATIONAL PO BOX 100 OXBOI002 New York Workers' BYRON, NY 14422 Compensation OXFORD WC 3827 18TH AVE OXFOR001 New York Workers' BROOKLYN, NY 11218 Compensation P & C (ITHACA) 315 PINETREE RD PCITH001 New York Workers' ITHACA, NY 14850 Compensation P & C (WATKINS) 504 1/2 SOUTH FRANKLIN ST PCWAT001 New York Workers' WATKINS GLEN, NY 14891 Compensation P COMP PO BOX 60769 PCOMP001 New York Workers' HARRISBURG, PA 17106 Compensation PA TURNPIKE COMMISSION PO BOX 67676 PATUR001 New York Workers' HARRISBURG, PA 17106 Compensation PACE PLUMBING AND HEATING 2323 CURRY ROAD PACEP001 New York Workers' SCHENECTADY, NY 12303 Compensation PACE SETTER ADJUSTMENT 3045 WESTFORK DRIVE PACES002 New York Workers' BATON ROUGE, LA 70816 Compensation PACESETTERS ADJ CO 3045 WESTFORK DR PACES001 Auto/No-Fault BATON ROUGE, LA 70816-2253 Pacific Coast Building Products [Electronic] E1119A New York Workers' , Compensation Pacific Coast Building Products [Electronic] E1119B Auto/No-Fault , Pacific Coast Building Products [Electronic] E1119C Other WC (Non-NY) , Pacific Dental Services [Electronic] E1120A New York Workers' , Compensation Pacific Dental Services [Electronic] E1120B Auto/No-Fault , Pacific Dental Services [Electronic] E1120C Other WC (Non-NY) , Pacific Hydrotech Co [Electronic] E0903A New York Workers' , Compensation Pacific Hydrotech Co [Electronic] E0903C Other WC (Non-NY) , Pacific Lumber Company (Marathon) [Electronic] E0904A New York Workers' , Compensation Pacific Lumber Company (Marathon) [Electronic] E0904C Other WC (Non-NY) , Pacific Motor Company [Electronic] E9774A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Pacific Motor Company [Electronic] E9774B Auto/No-Fault , Pacific Motor Company [Electronic] E9774C Other WC (Non-NY) , Pacific Specialty Insurance [Electronic] E0905A New York Workers' , Compensation Pacific Specialty Insurance [Electronic] E0905C Other WC (Non-NY) , Pacific Specialty-McGraw PO Box 40 PACIF002 New York Workers' Anaheim, CA 92815 Compensation Pacific Sunwear [Electronic] E1121A New York Workers' , Compensation Pacific Sunwear [Electronic] E1121B Auto/No-Fault , Pacific Sunwear [Electronic] E1121C Other WC (Non-NY) , Packstar 215 John Glenn Drive PACKS001 New York Workers' AMHERST, NY 14228 Compensation Pajaro Vly Comnty Health Trust [Electronic] E0906A New York Workers' , Compensation Pajaro Vly Comnty Health Trust [Electronic] E0906C Other WC (Non-NY) , Paladin Managed Care Services, Inc. [Electronic] E3756A New York Workers' , Compensation Paladin Managed Care Services, Inc. [Electronic] E3756C Other WC (Non-NY) , Palisades 200 Connell Drive PALIS003 Auto/No-Fault Suite 3000 Berkeley Heights, NJ 07922 Palisades Insurance PO BOX 46 PALIS002 Auto/No-Fault Newark, NJ 07101 Palisades/ HCS PO BOX 46 PALIS004 Auto/No-Fault Newark, NJ 07101 PALLET SERVICES ATTN: NANCY NEALY 310 GRAND PALLE001 New York Workers' ISLAND BLVD Compensation TONAWANDA, NY 14150 PALLISADES INSURANCE PO BOX 900 PALLI001 Auto/No-Fault LINCROFT, NJ 07738 PALMER FARMS 10089 WARNER GOLF RD PALME002 New York Workers' HOLLAND, NY 14080 Compensation PALMER MOBILE HOMES INC 147 ROUTE 17C PALME001 New York Workers' ATTN MARYLOU Compensation WAVERLY, NY 14892 Palo Alto Medical Foundation [Electronic] E0907A New York Workers' , Compensation Palo Alto Medical Foundation [Electronic] E0907C Other WC (Non-NY) , PAOLANGELI CONTRACTORS 226 CECIL A MILLONE DRIVE PAOLA001 New York Workers' STE 1 Compensation ITHACA, NY 14850 Papa John's International Inc [Electronic] E7562C Other WC (Non-NY) , PAPAGALLOS 205 WEST GENESEE STREET PAPAG001 New York Workers' FAYETTEVILLE, NY 13066 Compensation Paradigm 1277 Treat BLVD PARAD006 Other WC (Non-NY) STE 800 Walnut Creek, CA 94597 Paradigm [Electronic Indirect] 1001 GALAXY WAY, STE 300 PARAD002 New York Workers' CONCORD, CA 94520 Compensation Paradigm [Electronic Indirect] 1001 GALAXY WAY, STE 300 PARAD003 Auto/No-Fault CONCORD, CA 94520 Paradigm [Electronic Indirect] 1001 GALAXY WAY, STE 300 PARAD004 Other WC (Non-NY) CONCORD, CA 94520 Paradigm [Electronic] E6363C Other WC (Non-NY) , PARADIGM MGMT SERVICES LLC 1001 GALAXY WAY, STE 300 PARAD001 New York Workers' CONCORD, CA 94520 Compensation PARADIGM MGMT SERVIVES LLC 1277 TREAT BLVD PARAD005 New York Workers' SUITE 800 Compensation WALNUT CREEK, CA 94597 PARAGON MGMT PO BOX 6 PARA01 New York Workers' MEDICAL PLAZA Compensation GLENCOVE, NY 11542 PARAMOUNT INSURANCE COMPANY 1 PARK AVE PAIC01 New York Workers' 15TH FL Compensation NEW YORK, NY 10016-5002 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Paramount Pictures (Murphy and Beane) E0908C Other WC (Non-NY) [Electronic] , Park Darien Lake LLC PO BOX 91 PARKD001 New York Workers' Darien Center , NY 14040 Compensation Park District Risk Management Assoc [Electronic] E0909A New York Workers' , Compensation Park District Risk Management Assoc [Electronic] E0909C Other WC (Non-NY) , Park Insurance 475 Park Ave So. 23rd Fl. PARKI002 Auto/No-Fault New York, NY 10016 PARK INSURANCE 475 PARK AVE SOUTH 23RD PARKI003 Auto/No-Fault NEW YORK, NY 10016 PARKER HANNIFIN 100 DUN RD PAHA01 New York Workers' LYONS, NY 14489 Compensation PARKER,HAMMOND CONSTRUCTION 715 UPPER GLEN STREET PARKE001 New York Workers' QUEENSBURY, NY 12804 Compensation PARKITECTS INC 138 LUDLOWVILLE ROAD PARKI001 New York Workers' LANSING, NY 14882 Compensation Parkview Cemetery PO BOX 9154 PARKV002 New York Workers' 40 Fehr Ave Compensation Schenectady, NY 12309 PARKWAY INSURANCE 100 SOUTH ALTO MESA ST PARKW001 Auto/No-Fault ATTN: LIZ FRAKER EL PASO, TX 79912 PARSIPPANY OP CEN PO BOX 911 PARSI001 New York Workers' PARSIPPANY, NJ 07054 Compensation PARSON'S CHILDRENS & FAMILY SERVICES 60 ACADEMY ROAD PARSO001 New York Workers' ALBANY, NY 12208 Compensation PARTNERS HEALTH PLAN 101 MERRIMACK STREET PARTN001 Other WC (Non-NY) SUITE 420B, WC DIVISION BOSTON, MA 02114 Pas Coffee Roasters [Electronic] E0910A New York Workers' , Compensation Pas Coffee Roasters [Electronic] E0910C Other WC (Non-NY) , Pasadena Unified School District (CA) [Electronic] E1262A New York Workers' , Compensation Pasadena Unified School District (CA) [Electronic] E1262B Auto/No-Fault , Pasadena Unified School District (CA) [Electronic] E1262C Other WC (Non-NY) , Pastabilities 311 S. Franklin St. PASTA001 New York Workers' Syracuse, NY 13202 Compensation Pasternack Tilker Ziegler Walsh Stanton 233 Broadway PASTE001 New York Workers' Woolworth Building Compensation New York, NY 10279 PATHMARK INC 200 MILIK ST PATHM001 New York Workers' WC DEPT. M-154 Compensation CATERET, NJ 07008 PATHMARK STORES 200 MILIK ST PATHM002 New York Workers' DEPT M154 Compensation CARTERET, NJ 07008 PATHWAYS 130 WEST WATER STREET PATHW003 New York Workers' PAINTED POST, NY 14870 Compensation PATHWAYS 33 DENNISON PARKWAY PATHW001 New York Workers' CORNING, NY 14830 Compensation PATHWAYS 4162 MEADS CREEK RD PATHW002 New York Workers' PAINTED POST, NY 14870 Compensation PATIENT FINACIAL SERVICE 726 EXCHANGE ST STE 300 PATIE001 New York Workers' BUFFALO, NY 14209 Compensation Patrick Concrete Constructors 2455 State RT 21 PATRI005 New York Workers' Canandaigua, NY 14424 Compensation PATRIOT CONTRACT SERVICES 1320 WILLO PASS RD PATRIOT01 New York Workers' STE 485 Compensation CONCORD, CA 94520 PATRIOT CONTRACT SERVICES 2175 N CALIFORNIA BLVD PACS01 New York Workers' WALNUT, CA 94596 Compensation PATRIOT GENERAL INSURANCE CO 1800 NORTH POINT DR PGIN01 New York Workers' STEVENS POINT, WI 54481 Compensation patriot national ins group p.o.box 386 PATRI006 New York Workers' conshohocken, PA 19428 Compensation Patriot Risk Services PO Box 2159 PATRI003 New York Workers' Ft Lauderdale, FL 33303 Compensation PATRIOT RISK SERVICES 43 SKYONE DR PATRI001 New York Workers' SUITE 2020 Compensation LAKE MARY, FL 32746 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Patterson Bro Light. [Electronic] E0911A New York Workers' , Compensation Patterson Bro Light. [Electronic] E0911C Other WC (Non-NY) , PAUL FORNIER, INC 2458 YOUNGSTOWN WILSON ROAD PAULF001 New York Workers' RANSOMVILLE, NY 14131 Compensation PAUL PICARD 4 SYDNEY HILL RD. PAULP001 New York Workers' SARATOGA SPRINGS, NY 12866 Compensation PAULA TINER FCLS 8417 OSWEGO RD PTF01 New York Workers' PMB 111 Compensation BALDWINSVILLE, NY 13207 PAVERS & ROAD BUILDERS 136-25 37TH AVENUE PAVER001 New York Workers' FLUSHING, NY 11354 Compensation PAVILLION DRAINAGE PO BOX 219 PAVIL001 New York Workers' PAVILLION, NY 14525 Compensation Paychex 911 PANORAMA TRAIL PAYCH001 New York Workers' Rochester, NY 14625 Compensation PB INDUSTRIES 448 COMMERCE ROAD PBIND001 New York Workers' VESTAL, NY 13850 Compensation PBOA INS. PO BOX 49468 PBOAI001 New York Workers' ATTN RON WALKER Compensation SARASOTA, FL 34230 PCOMP-THE PA COUNTIES WC TRUST FUND PO BOX 60769 PCOMP002 Other WC (Non-NY) HARRISBURG, PA 17106 PDM 2241 LAVA RIDGE CT PDM01 New York Workers' STE 1 Compensation ROSEVILLE, CA 95661 PDQ DELIVERY P O BOX 93027 PDQDE001 New York Workers' ROCHESTER, NY 14692 Compensation PEACE CORPS 5TH FLOOR ATTN: WORKERS COMP PEACE001 New York Workers' 1111 20TH STREET Compensation WASHINGTON, DC 20526 Pearl Street Grill 76 Pearl Street PEARL001 New York Workers' Buffalo, NY 14202 Compensation PECKHAM-ATTN SUZANNE COULTER 2 UNION STREET EXT PECKH001 New York Workers' ATHENS, NY 12015 Compensation Peek N Peek Resort PO Box 360 PEEKN001 New York Workers' Attn: Heidi Buesink Compensation Findley Lake, NY 14736-0360 PEERLESS 62 MAPLE AVE PEER02 New York Workers' KEENE, NH 03431 Compensation PEERLESS PO BOX 4858 PEER01 New York Workers' SYRACUSE, NY 13221 Compensation PEERLESS PO BOX 4858 PEERL015 Auto/No-Fault SYRACUSE, NY 13221 PEERLESS PO BOX 515097 PEERL013 Auto/No-Fault attn: Safeco Claims Los Angeles, CA 90051 Peerless [Electronic] E5111A New York Workers' , Compensation Peerless [Electronic] E5111C Other WC (Non-NY) , Peerless Ins PO Box 4858 PEERL006 Other WC (Non-NY) Syracuse, NY 13221 PEERLESS INS 1170 PITTSFORD-VICTOR RD PEERL005 New York Workers' PITTSFORD, NY 14534 Compensation PEERLESS INS 5062 BRITTONFIELD PARKWAY PEERL014 New York Workers' EAST SYRACUSE, NY 13057 Compensation PEERLESS INS CO PO BOX 8851 PEERL010 Auto/No-Fault CAMPHILL, PA 17011 PEERLESS INSUR. EVANS 135 MAIN ST. PEERL001 New York Workers' LOCKPORT, NY 14094 Compensation Peg Discover Re [Electronic] E3358C Other WC (Non-NY) , Peg Discover Re( Foood Merchant) [Electronic] E4381C Other WC (Non-NY) , PEGASUS CLEANING CORP 1412 MAIN ST PEGAS001 New York Workers' BUFFALO, NY 14209 Compensation Pegi-Family Dining [Electronic] E3646C Other WC (Non-NY) , Pekin / Liability 2505 Court St PEKIN001 Auto/No-Fault Pekin, IL 61558 Pekin / WC PO Box 904 PEKIN003 Other WC (Non-NY) Attn: Mike Brasel Mt. Vernon, IL 62864 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Pekin Insurance PO Box 948 PEKIN004 Other WC (Non-NY) Mattoon, IL 61938 Pekin Insurance / WC 2505 Court St PEKIN002 Other WC (Non-NY) Pekin, IL 61558 PEMBROOKE SCHOOLS 8750 ALLEGHANY RD PEMBR001 New York Workers' CORFU, NY 14036 Compensation PEMCO INSURANCE PO BOX 778 PEMCO001 Auto/No-Fault SEATTLE, WA 98111 PEMCO INSURANCE CO PO BOX 778 PEMCO002 Auto/No-Fault SEATTLE, WA 98111 PENINSULA INSURANCE P O BOX 108 PENIN001 Auto/No-Fault SALISBURY, MD 21803 Penn Millers Insurance Co [Electronic] E1395B Auto/No-Fault , Penn Millers Insurance Co [Electronic] E1395C Other WC (Non-NY) , PENN MILLERS INSURANCE COMPANY PO BOX P PMICO01 New York Workers' 72 NORTH FRANKLIN ST Compensation WILKES BARRE, PA 18773 Penn Millers Mutual / WC PO Box P PENNM001 Other WC (Non-NY) Wilkes Barre, PA 18773 PENN NATIONAL 830 PENNSYLVANIA BLVD PENNN002 New York Workers' FEASTERVILLE, PA 19053 Compensation PENN NATIONAL PO BOX 1364 PENNN003 Auto/No-Fault HARRISBURG, PA 171051364 PENN NATIONAL PO BOX 1455 PENNN004 Auto/No-Fault HARRISBURG, PA 171051455 PENN NATIONAL INS CO P O BOX 3880 PENNN005 Other WC (Non-NY) HARRISBURG, PA 17105-3880 Penn National Insurance Co PO Box 3880 PENNN001 New York Workers' Harrisburg, PA 17105-3880 Compensation PENN TRAFFIC COMPANY PO BOX 4737 PETC01 New York Workers' SYRACUSE, NY 13221 Compensation PENNSYLVANIA GENERAL INS CO PO BOX 9155 PGIC01 New York Workers' CANTON, MA 02021-1030 Compensation PENNSYLVANIA LUMBERMANS 315 WALT WHITMAN RD PENNS001 Auto/No-Fault CO FRONTIER ADJUSTERS STE 316 HUNTINGTON STA, NY 11746 PENNSYLVANIA LUMBERMENS MUTUAL 2005 MARKET ST PLMU01 New York Workers' ONE COMMERCE SQUARE, SUITE Compensation 1200 PHILADELPHIA, PA 19103-7008 Pennsylvania Manufacturers Assoc Ins Co E0912A New York Workers' [Electronic] , Compensation Pennsylvania Manufacturers Assoc Ins Co E0912C Other WC (Non-NY) [Electronic] , Pennsylvania Manufacturing Associates E9429A New York Workers' [Electronic] , Compensation Pennsylvania Manufacturing Associates E9429C Other WC (Non-NY) [Electronic] , PENNSYLVANIA MFG INDEMNITY CO 300 SENTRY PARKWAY PMFG01 New York Workers' BLUE BELL, PA 19422-2357 Compensation PENNSYLVANIA NATIONAL MUTUAL PO BOX 2361 PNMU01 New York Workers' HARRISBURG, PA 17105-2361 Compensation Pennyan Hospitality Group 142 Lake St PENNY001 New York Workers' Pennyan, NY 14527 Compensation People 2.0 [Electronic] E1308A New York Workers' , Compensation People 2.0 [Electronic] E1308C Other WC (Non-NY) , PEOPLE, INC 1219 NORTH FOREST RD PEOPL001 New York Workers' WILLIAMSVILLE, NY 14231 Compensation PEOPLEASE 210 WINGO WAY PEOPL003 New York Workers' SUITE 400 Compensation MOUNT PLEASANT, SC 29464 PERAFLEX HOSE 155 GREAT ARROW AVE PERAF001 New York Workers' BUFFALO, NY 14207 Compensation PERFECT BUILDING 1466 BROADWAY PERFE001 New York Workers' NEW YORK, NY 10036 Compensation PERFORMANCE INS 4 PARAGON WAY PERFO001 New York Workers' FREEHOLD, NJ 07728 Compensation PERFORMANCE SPORTS TRAINING 1615 AMHERST MANOR DR PERFO002 New York Workers' WILLIAMSVILLE, NY 14221 Compensation PERLMAN'S TOWING & RECOVERY 90 INDUSTRIAL PARK ROAD PERLM001 New York Workers' ALBANY, NY 12206 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID perma p.o.box 12250 PERMA008 New York Workers' albany, NY 12201 Compensation PERMA C/O CORVEL PERMA006 New York Workers' PO BOX 2189 Compensation SYRACUSE, NY 13220 Perma [Electronic] E1263A New York Workers' , Compensation Perma [Electronic] E1263B Auto/No-Fault , Perma [Electronic] E1263C Other WC (Non-NY) , PERMA TECH 363 HAMBURG ST PERMA007 New York Workers' BUFFALO, NY 14204 Compensation Permanent General Assurance Corp(PGAC) 9700 ROCKSIDE ROAD SUITE 250 PERMA002 Auto/No-Fault [Electronic] CLEVELAND, OH 44125 PERMANENT GENERAL ASSURANCE CORP. PO BOX 305195 PERMA001 Auto/No-Fault Nashville, TN 37230-5195 Permian Claim Service P.O. Box 4353 PERMI001 Other WC (Non-NY) Odessa, TX 79760 PERRYS ICE CREAM 1 Ice Cream Plaza PERRY001 New York Workers' Akron, NY 14001 Compensation Personal Service Insurance 300 American Metro Blvd. PERSO006 Auto/No-Fault Suite 170 Hamilton, NJ 08619 PERSONAL SERVICE INSURANCE 1240 S. BROAD ST PERSO004 Auto/No-Fault LANDSDALE, PA 19446 PERSONAL TOUCH 120 W TUPPER STE 101 PERSO005 New York Workers' BUFFALO, NY 14201 Compensation Personel Service/ CSG 1000 River Road PERSO002 New York Workers' Ste: 300 Compensation Conshohoken, PA 19428 PERTHSHIRE CATERING 112 PERTHSHIRE DRIVE PERTH001 New York Workers' AMSTERDAM, NY 12010 Compensation Petaluma Valley Hospital [Electronic] E0914A New York Workers' , Compensation Petaluma Valley Hospital [Electronic] E0914C Other WC (Non-NY) , PETER KOCH AUTO REPAIR 201 FALL STREET PETER001 New York Workers' SENECA FALLS, NY 13148 Compensation Peter Rozell 129 Park Rd PETER002 New York Workers' Queensbury, NY 12804 Compensation PETRALL CORPORATION PO BOX 46 PETRA002 New York Workers' SYRACUSE, NY 13214 Compensation PETR-ALL PETROLEUM 6567 KINNE ROAD PETRA001 New York Workers' DEWITT, NY 13214 Compensation PETRI BAKING PRODUCTS 18 MAIN ST PBP01 New York Workers' SILVER CREEK, NY 14136 Compensation PETROCHEM MECHANICAL SERVICES 309 COLUMBIA STREET PETRO001 New York Workers' RENSSELAER, NY 12144 Compensation PETROLEUM CASUALTY CO PO BOX 3342 PECA01 New York Workers' HOUSTON, TX 77001 Compensation PETSMART 19601 NORTH 27TH AVE PETSM001 New York Workers' PHOENIX, AZ 85026 Compensation PF Northeast - WC 27 Highridge Road PFNOR001 New York Workers' Hopewell Junction, NY 12533 Compensation PFC ASSOCIATES 920 VARNUM ST NE PFCAS001 New York Workers' WASHINGTON, DC 20017 Compensation Pflugerville ISD [Electronic] E0915A New York Workers' , Compensation Pflugerville ISD [Electronic] E0915C Other WC (Non-NY) , Pharmacist Mutual Insurance Co. [Electronic] E1396B Auto/No-Fault , Pharmacist Mutual Insurance Co. [Electronic] E1396C Other WC (Non-NY) , Phelps Sungas 224 Cross Rd PHELP001 New York Workers' Geneva, NY 14456 Compensation Phh Fleetamerica [Electronic] E1352C Other WC (Non-NY) , PHILADELPHIA IND CO 1 BALA PLA STE 100 PHILA001 Auto/No-Fault BALA KYNWYD, PA 19004 PHILADELPHIA IND CO PO BOX 70251 PHILA002 Auto/No-Fault Philadeplhia, PA 19176-0251 PHILADELPHIA INDEMNITY INSURANCE CO PO BOX 950 PHILA006 Auto/No-Fault BALA CYNWYD, PA 19004 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Philadelphia Insurance P.O. Box 950 PHILA005 New York Workers' Bala Cynwyd, PA 19004 Compensation PHILADELPHIA INSURANCE PO BOX 950 PHILA007 Auto/No-Fault PIP CLAIMS BALA CYNWYD, PA 190040000 Philadelphia Insurance Company 1 Bala Kynwyd PHILA003 New York Workers' STE 100 Compensation Bala Kynwyd, PA 19004 PHILADELPHIA SCIENTIFIC 207 PROGRESS DRIVE PHILA004 New York Workers' MONTGOMERYVILLE, PA 18936 Compensation PHILLIES 651 NORTH OLD COACHMAN RD PHILL002 New York Workers' CLEARWATER, FL 33765 Compensation PHILLIPS FUNERAL HOME 17 WEST PULTNEY STREET PHILL001 New York Workers' CORNING, NY 14830 Compensation PHILLIPS, LYTE ET A1 3400 MARINE MIDLAND CTR PHIL01 New York Workers' BUFFALO, NY 14203 Compensation Philpac 1144 Military Rd PHILP001 New York Workers' Buffalo, NY 14217 Compensation PHOENIX DRILLING PO BOX 2289 PHOEN002 New York Workers' BUCKHANNON, WV 26201 Compensation PHOENIX INSURANCE CO PO BOX 5056 PHOE01 New York Workers' HARTFORD, CT 06183-1190 Compensation PHOENIX METAL INC. 295 1ST STREET PHOEN001 New York Workers' TROY, NY 12180 Compensation Piasecki Steel 1264 RTE 9 PIASE001 New York Workers' Castleton, NY 12033 Compensation PICCIRILLI,SLAVIK & VINCENT 37 BRANDYWINE ST PICCI001 New York Workers' BINGHAMTON, NY 13901 Compensation PIEDMARTO SONS 88 CADBURY WAY PIEDM002 New York Workers' HOLLEY, NY 14470 Compensation PIEDMONT STRUCTURAL 1432 N LEE ST PIEDM001 New York Workers' SALISBURY, NC 28144 Compensation Pier 1 Inc. USA [Electronic] E8149A New York Workers' , Compensation Pier 1 Inc. USA [Electronic] E8149C Other WC (Non-NY) , PIETRAFESA CO 7400 MORGAN RD PIET01 New York Workers' LIVERPOOL, NY 13090 Compensation PILGRIM INSURANCE P.O. BOX 120540 PILGR001 Auto/No-Fault BOSTON, MA 02112 PILOT PO BOX 10146 PILOT002 New York Workers' KNOXVILLE, PA 37939 Compensation Pilot Travel Centers / WC PO Box 10146 PILOT001 Other WC (Non-NY) Knoxville, TN 37939 Pima County [Electronic] E0916A New York Workers' , Compensation Pima County [Electronic] E0916C Other WC (Non-NY) , Pinckneyville Corrections / WC PO Box 1000 PINCK001 Other WC (Non-NY) Pinckneyville, IL 62274 Pine Valley 661 N Main St PINEV001 New York Workers' Spring Valley, NY 10901 Compensation PINNACLE MANUFACTURING 56 HARVESTER AVE PINNA002 New York Workers' BATAVIA, NY 14020 Compensation Pinnacle Risk Solutions 82 Bloomfield Avenue PINNA001 New York Workers' Pine Brook, NJ 07058 Compensation PINNACOL ASSURANCE PO BOX 469013 PINN01 New York Workers' STE 100N Compensation DENVER, CO 80246 PINTOS LLC TOWING AND RECOVERY 8700 MAIN ST PINTO001 New York Workers' ANGOLA NY, NY 14005 Compensation PIP MANAGEMENT 26 COURT ST SUITE 1100 PIPMA001 New York Workers' BROOKLYN, NY 11242 Compensation PIPEFITTERS 120 TRUSTEES 6305 HALLE DRIVE PIPEF001 New York Workers' CLEVELAND, OH 44125 Compensation PIZZA HUT 222 REYNOLDS ROAD PIZZA002 New York Workers' JOHNSON CITY, NY 13790 Compensation PIZZA HUT 357 MORRIS STREET PIZZA003 New York Workers' BATH, NY 14810 Compensation PIZZA HUT (CORNING) 55 E PULTENEY ST PIZZA001 New York Workers' CORNING, NY 14830 Compensation PJF ENTERPRISE 483 SULPHUR SPRING ROAD PJFEN001 New York Workers' OWEGO, NY 13827 Compensation PJ'S PUB AND GRILL 116 WALTON STREET PJSPU001 New York Workers' SYRACUSE, NY 13202 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Plainview ISD [Electronic] E0917A New York Workers' , Compensation Plainview ISD [Electronic] E0917C Other WC (Non-NY) , PLANET FITNESS MANAGEMENT 1259 GORDON ROAD PLANE001 New York Workers' SCHENECTADY, NY 12306 Compensation PLAVINS PO BOX 336 PLAVI001 New York Workers' LEVITTOWN, PA 19057 Compensation PLEASANT VALLEY ELECTRIC 405 THIRD STREET PLEAS001 New York Workers' ITHACA, NY 14850 Compensation PLIGA 222 Mount Airy Rd. PLIGA001 Auto/No-Fault Basking Ridge, NJ 07920 Plott Health Care [Electronic] E0918A New York Workers' , Compensation Plott Health Care [Electronic] E0918C Other WC (Non-NY) , PLUMBERS & PIPE FITTERS 7570 CAPLE BLVD PLUMB001 New York Workers' STE B Compensation NORTHWOOD, OH 43619 Plymouth Rock PO BOX 900 PLYMO002 Auto/No-Fault Lincroft, NJ 07738-0900 PLYMOUTH ROCK PO BOX 9112 PLYMO001 Auto/No-Fault Boston, MA 02112 Plymouth Rock Assurance PO Box 907 PLYMO003 Auto/No-Fault Uncroft, NJ 07738 PMA CLAIMS CORRESPONDENCE PO BOX 5231 PMACL001 Other WC (Non-NY) JAMESVILLE, WI 53547 PMA INSURANCE GROUP PO BOX 5231 PMAIN001 Other WC (Non-NY) JAMESVILLE, WI 53547 PMA MEDICAL BILLING PO BOX 5231 PMAME004 New York Workers' JANESVILLE, WI 53547 Compensation PMA MEDICAL BILLING PO BOX 5231 PMAME005 Auto/No-Fault JANESVILLE, WI 53547 PMA MEDICAL BILLING PO BOX 5231 PMAME006 Other WC (Non-NY) JANESVILLE, WI 53547 PMSI PO BOX 31340 PMSI001 New York Workers' TAMPA, FL 33631 Compensation POLLIO DAIRY PRODUCTS-CAMPBELL 8600 MAIN STREET POLLI001 New York Workers' CAMPBELL, NY 14821 Compensation POLMANTEERS SALES & SERVICES 691 ADDISON ROAD POLMA001 New York Workers' PAINTED POST, NY 14870 Compensation Poly America LP [Electronic] E1364C Other WC (Non-NY) , Poly-America [Electronic] E0919A New York Workers' , Compensation Poly-America [Electronic] E0919C Other WC (Non-NY) , Polymer Conversions 5732 Big Tree Road POLYM002 New York Workers' Orchard Park, NY 14127 Compensation POLYMER ENGINEERING 23 MOONLANDING RD POLYM001 New York Workers' ROCHESTER, NY 14624 Compensation POMCO GROUP PO BOX 325 POIC02 New York Workers' SYRACUSE, NY 13206 Compensation Ponderosa Landscape [Electronic] E0920A New York Workers' , Compensation Ponderosa Landscape [Electronic] E0920C Other WC (Non-NY) , POOLER ENTERPRISE PO BOX 436 POOLE001 New York Workers' FISHERS, NY 14453 Compensation POOLS UNLIMITED 3903 SENECA ST POOLS001 New York Workers' WEST SENECA, NY 14224 Compensation POROUS MATERIAL 20 DUCHT MILL ROAD POROU001 New York Workers' ITHACA, NY 14850 Compensation Port Authority Of NY and NJ PO Box 457 PORTA001 Other WC (Non-NY) Hempstead, NY 11550 Port of Oakland (CA) [Electronic] E1264A New York Workers' , Compensation Port of Oakland (CA) [Electronic] E1264B Auto/No-Fault , Port of Oakland (CA) [Electronic] E1264C Other WC (Non-NY) , PORTERS CONCRETE SERVICE INC PO BOX 390 PORTE001 New York Workers' 88 SIMMENTAL LANE Compensation WAVERLY, NY 14892 ports insurance 99 wood ave PORTS001 New York Workers' iselin, NJ 08830 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Post Creek Busy Mart 4644 State Route 414 POSTC001 New York Workers' Beaver Dams, NY 14812 Compensation POSTLER & JAECKLE (ROCHESTER) 615 SOUTH AVE POSTL002 New York Workers' ROCHESTER, NY 14620 Compensation POSTLER & JAECKLE CORP. 1062 CENTRAL AVENUE POSTL001 New York Workers' ALBANY, NY 12205 Compensation POWER AND CONSTRUCTION GROUP INC PO BOX 30 POWER002 New York Workers' SCOTTSVILLE, NY 14546-0030 Compensation POWER PALLETT 4715 STATE HIGHWAY 30 POWER003 New York Workers' AMSTERDAM, NY 12010 Compensation PPC 6176 EAST MOLLOY ROAD PPC002 New York Workers' EAST SYRACUSE, NY 13057 Compensation PPM MANAGEMENT PO BOX 58 PPMM01 New York Workers' HAMBURG, NY 14075 Compensation Praetorian PO Box 248 PRAET001 Auto/No-Fault Morgan Hill, CA 95038 Praetorian Insurance P.O. Box 6580 PRAET002 Auto/No-Fault Saddle Brook, NJ 07663 Prairie Meadows [Electronic] E1923C Other WC (Non-NY) , Precision Fabrication 40 South Pears St PRECI003 New York Workers' Attica, NY 14011 Compensation PRECISION LAWN CARE 6513 EAST MAIN RD PRECI002 New York Workers' STAFFORD, NY 14143 Compensation PRECISION PHOTO LAB 4020 JEFFEREY BLVD PRECI001 New York Workers' BLASDELL, NY 14219 Compensation Preferred Employers [Electronic] E7518C Other WC (Non-NY) , Preferred Employers Group [Electronic] E9167C Other WC (Non-NY) , Preferred Employers Insurance Company (PEI) E0921C Other WC (Non-NY) [Electronic] , PREFERRED LANDSCAPING PO BOX 404 PREFE003 New York Workers' CORNING, NY 14830 Compensation Preferred Mutual PO Box 541 PREFE004 New York Workers' New Berlin, NY 13411 Compensation PREFERRED MUTUAL INS 1 PREFERRED WAY PREFE002 Auto/No-Fault NEW BERLIN, NY 13411 PREFERRED PROFESSIONAL INS CO 11605 MIRACLE HILLS DR PRPR01 New York Workers' STE 200 Compensation OMAHA, NE 68154-4467 Preferred Professionals In PO Box 540658 PREFE001 New York Workers' Omaha , NE 68154 Compensation PREFERRED WORKS 403 MAIN ST PRW01 New York Workers' BUFFALO, NY 14203 Compensation PREMIER COMP 100 HIGHTOWER RD PREMI004 Other WC (Non-NY) SUITE 300 PITTSBURGH, PA 15205-1134 PREMIER COMP OF HOMETOWN PO BOX 97 PREMI002 New York Workers' ST CLAIRVILLE, OH 43950 Compensation PREMIER CREDIT 1 MILL ST PREMI005 New York Workers' BATAVIA, NY 14020 Compensation Premier Home Health Service WC 1285 Route 9 PREMI010 New York Workers' Corporate Park Suite 1 Compensation Wappingers Falls, NY 12590 Premier Prizm PO BOX 986 PREMI007 Other WC (Non-NY) Marlton, NJ 08053 Premier Prizm PO BOX 986 PREMI008 Auto/No-Fault Marlton, NJ 08053 Premier Prizm PO BOX 986 PREMI009 New York Workers' Marlton, NJ 08503 Compensation Premier Prizm Solutions 10 East Stoe Road PRIZM001 New York Workers' Suite 100 Compensation Marlton, NJ 08053 PREMIER TRANSPORTATION GROUP 456 NORTH PEARL STREET PREMI006 New York Workers' ALBANY, NY 12204 Compensation PREMIER UTILITY CONTRACTING 100 MARCUS BLVD. STE 3 PREMI001 New York Workers' HAUPPAUGE, NY 11788 Compensation Preserver Insurance 120 Broadway 31st Floor PRESE001 New York Workers' New York, NY 10271 Compensation Preserver Insurance Po Box 1287 PRESE002 Auto/No-Fault Buffalo, NY 14240 Prestige Services Inc. 743 Pierce Road PREST001 New York Workers' Clifton Park, NY 12065 Compensation PRICE CHOPPER 137 STATE ROUTE 104 E PRICE001 New York Workers' OSWEGO, NY 13126 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID PRIME FLIGHT 4200 GENESEE ST PRIME001 New York Workers' CHEEKTOWAGA, NY 14225 Compensation Prime Healthcare [Electronic] E1265A New York Workers' , Compensation Prime Healthcare [Electronic] E1265B Auto/No-Fault , Prime Healthcare [Electronic] E1265C Other WC (Non-NY) , PRIME INC 2740 NORTH MAYFAIR ROAD PRIME003 New York Workers' SPRINGFIELD, MO 65803 Compensation PRIME SARATOGA NATIONAL GOLF 458 UNION AVENUE PRIME002 New York Workers' SARATOGA SPRINGS, NY 12866 Compensation PRINCTON INSURANCE CO 746 ALEXANDER RD PRIN01 New York Workers' PRINCETON, NJ 08540 Compensation PRINCTON INSURANCE CO PO BOX 5322 PRIN02 New York Workers' PRINCETON, NJ 08543 Compensation PRIORITY TRANSPORTATION 6070 COLLETT ROAD PRIOR001 New York Workers' FARMINGTON,NY, NY 14425 Compensation Prism Consultants PO Box 2025 PRISM002 New York Workers' Lakewood, NJ 08701 Compensation PRISM CONSULTANTS PO BOX 508 PRISM003 New York Workers' CEDARHURST, NY 11516 Compensation PRISM SOLUTIONS 11 EVES DRIVE STE 170 PRISM001 Auto/No-Fault MEDICAL MGMT MARLTON, NJ 08053 PRM Claim Services PO BOX 12305 PRMCL001 New York Workers' Albany, NY 12212-2305 Compensation PRO ACTION OF STEUBEN & YATES 117 EAST STEUBEN STREET PROAC001 New York Workers' BATH, NY 14810 Compensation PRO AUTO SERVICE ROUTE 415 PROAU001 New York Workers' BATH, NY 14810 Compensation Procare Physical Therapy Center RR1 PROCA001 New York Workers' Box 140C Compensation Towanda, PA 18848 PROCURA 2500 MONROE BLVD PROCU005 New York Workers' STE 100 Compensation NORRISTOWN, PA 19403 Professional Claims Management [Electronic] E1127A New York Workers' , Compensation Professional Claims Management [Electronic] E1127C Other WC (Non-NY) , PROFESSIONAL DIAGNOS MGT 2241 LAVA RIDGE COURT PROFE003 New York Workers' SUITE 1 Compensation ROSEVILLE, CA 95661 PROFESSIONAL LIABILITY INS CO OF AMERICA TWO PARK AVE PLIC01 New York Workers' ROOM 2500 Compensation NEW YORK, NY 10016 PROFESSIONAL MEDICAL 1917 GARNET CT PROFE002 New York Workers' NEW LENOX, IL 60451 Compensation PROFESSIONAL PERSONNEL MANAG. 135 DELAWARE AVE PROFE001 New York Workers' BUFFALO, NY 14202 Compensation Progressive PO BOX 22031 PROGR029 Auto/No-Fault Albany, NY 12201 Progressive Po Box 512926 PROGR028 Other WC (Non-NY) Los Angeles, CA 90051 PROGRESSIVE 4221 WEST BOY SCOUT BLVD, PROGR031 Auto/No-Fault SUITE 500 TAMPA, FL 33607 PROGRESSIVE PO BOX 7247 PROGR032 Auto/No-Fault PHILADELPHIA, PA 19170 Progressive - NF PO Box 512926 PROGR027 New York Workers' Los Angelos, NY 90051 Compensation Progressive [Electronic] E1139B Auto/No-Fault , Progressive Classic Insurance Company E1140B Auto/No-Fault [Electronic] , Progressive Commercial Casualty Company E1141B Auto/No-Fault [Electronic] , Progressive Direct Insurance Company E1142B Auto/No-Fault [Electronic] , PROGRESSIVE IHCFA PO BOX 1470 PROGR033 Auto/No-Fault WESTERVILLE, OH 43086 Progressive Insurance PO BOX 512926 PROGR030 Auto/No-Fault Los Angeles, CA 90051 Progressive Max Insurance Company [Electronic] E1143B Auto/No-Fault , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Progressive Northern Insurance Company E1144B Auto/No-Fault [Electronic] , Progressive Northwestern Insurance Company E1145B Auto/No-Fault [Electronic] , Progressive Preferred Insurance Company E1146B Auto/No-Fault [Electronic] , Progressive Premier Insurance Company E1147B Auto/No-Fault [Electronic] , Progressive Specialty Insurance Company E1148B Auto/No-Fault [Electronic] , PROMARK ASSOCIATES 6470 MAIN STREET PROMA001 New York Workers' SUITE2 Compensation WILLIAMSVILLE, NY 14221 PROPERTY MANAGEMENT ALLIANCE 323 EAST WATER STREET PROPE001 New York Workers' SYRACUSE, NY 13202 Compensation PROPERTY OWNERS OF SLEEPY HOLLOW LAKE 92 RANDY ROAD PROPE002 New York Workers' UNIT 1095 Compensation ATHENS, NY 12015 PROSCAPES 6810 EAST SENECA TURNPIKE PROSC001 New York Workers' JAMESVILLE, NY 13078 Compensation PROSIGHT SPECIALTY INS 412 MT KEMBLE AVE STE 300C PROSI001 New York Workers' MORRISTOWN, NJ 07960 Compensation Protective Insurance PO BOX 2000 PROTE005 New York Workers' Carmel, IN 46082 Compensation Protective Insurance PO BOX 2000 PROTE006 Auto/No-Fault Carmel, IN 46082 Protective Insurance PO BOX 2000 PROTE007 Other WC (Non-NY) Carmel, IN 46082 Protective Insurance Co [Electronic] E1266A New York Workers' , Compensation Protective Insurance Co [Electronic] E1266B Auto/No-Fault , Protective Insurance Co [Electronic] E1266C Other WC (Non-NY) , PROTEGRITY SERVICES, INC 260 WEKIVA SPRINGS RD PROTE001 New York Workers' PO BOX 914700 Compensation LONGWOOD, FL 32791 PROVIDENCE ELECTRIC LLC 214 SECOND ST PROVI004 New York Workers' ELMIRA, NY 14903 Compensation PROVIDENCE PROPERTY & CAS PO BOX 2009 PPC01 New York Workers' FRISCO, TX 75034 Compensation PROVIDENCE STEEL PO BOX 1425 PROVI002 New York Workers' CONSHOCKEN, PA 19428 Compensation Providence Washington Ins Co 475 Kilvert St PROVI003 New York Workers' STE 330 Compensation Warwick, RI 02886 PROVIDENT LIFE & CASULTY PO BOX 11588 PRLC01 New York Workers' PITTSBURGH, PA 15238 Compensation PRUDENTIAL INSURANCE CO OF AMERICA DISABILITY MANAGEMENT PRUDE001 New York Workers' SERVICES Compensation PO BOX 13480 PHILADELPHIA, PA 19176 Prudential Overall Supply - AZ, CA [Electronic] E0922A New York Workers' , Compensation Prudential Overall Supply - AZ, CA [Electronic] E0922C Other WC (Non-NY) , PS BRUCKEL 1 WILLIAM J BRUCKEL DRIVE PSBRU001 New York Workers' AVON, NY 14414 Compensation PSI 396 WRITE RD PSI001 New York Workers' AKRON, NY 14001 Compensation PSK SUPERMARKETS, INC 444 SO. FULTON AVENUE PSKSU001 New York Workers' MOUNT VERNON, NY 10553 Compensation PSP GROUP 606 HALSTEAD AVENUE PSPGR001 New York Workers' MAMARONECK, NY 10543 Compensation PTS Services of Western New York 9155 Main Street PTSSE001 New York Workers' Clarence, NY 14033 Compensation PUBLIC SERVICE MUTUAL 1 PARK AVE PUSM01 New York Workers' 15TH FL Compensation NEW YORK, NY 10016 PUBLIC SERVICE MUTUAL INS 1 park ave PUBLI002 Auto/No-Fault NEW YORK, NY 10016 Publix Supermarket P.O. Box 32016 PUBLI001 New York Workers' Lakeland, FL 33802 Compensation PUDGIES PIZZA 61 BRIDGE STREET PUDGI001 New York Workers' CORNING, NY 14830 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID PUPIL BENEFITS PLAN 101 DUTCHMEADOWS LANE PUPIL001 New York Workers' GLENVILLE, NY 12302 Compensation Pure Insurance 10 East Stow Road PURE01 Auto/No-Fault Marlton, NJ 08503 Pure Insurance 44 South Broadway PUREI002 Auto/No-Fault STE 301 White Plains, NY 10601 PW Minor and Sons PO BOX 678 PWMIN001 New York Workers' Batavia, NY 14020 Compensation PW Wood Ins. P.O. Box 4798 PWWOO001 New York Workers' Ithaca, NY 14852 Compensation QBE PO BOX 975 QBE002 Auto/No-Fault Sun Prairie, WI 53590 QBE PO BOX 975 QBE004 New York Workers' Sun Prairie, WI 53590 Compensation QBE PO BOX 975 QBE005 Other WC (Non-NY) Sun Prairie, WI 53590 QBE - General Casualty - Eden Prairie [Electronic] E0923C Other WC (Non-NY) , QBE - General Casualty - Farmers Union E0924C Other WC (Non-NY) [Electronic] , QBE - General Casualty - Freeport [Electronic] E0925C Other WC (Non-NY) , QBE - General Casualty - Indianapolis [Electronic] E0926C Other WC (Non-NY) , QBE - General Casualty - Simsbury [Electronic] E0927C Other WC (Non-NY) , QBE - General Casualty - Sun Prairie [Electronic] E0928C Other WC (Non-NY) , QBE - General Casualty - West Des Moines E0929C Other WC (Non-NY) [Electronic] , QBE - General Casualty Co of Wisconsin E0930C Other WC (Non-NY) [Electronic] , QPS Employment Group [Electronic] E1267A New York Workers' , Compensation QPS Employment Group [Electronic] E1267B Auto/No-Fault , QPS Employment Group [Electronic] E1267C Other WC (Non-NY) , QUAKERS LANDING 101 STERLING DR QUAKE001 New York Workers' ORCHARD PARK, NY 14127 Compensation QUALCARE PLAN ADMIN PO BOX 309 QPA01 New York Workers' PISCATAWAY, NJ 08855 Compensation Qualcare WC Po Box 309 QUALC002 Other WC (Non-NY) Piscataway, NJ 08855-0309 QUALCARE/LYNX 100 DECADON DRIVE QUALC003 Other WC (Non-NY) EGG HARBOR TOWNSHIP, NJ 08234 Qualicoat 14 Sanford Road North QUALI001 New York Workers' Churchville, NY 14428 Compensation Quality Care Conv [Electronic] E0931A New York Workers' , Compensation Quality Care Conv [Electronic] E0931C Other WC (Non-NY) , Quality Health M. G. [Electronic] E0932A New York Workers' , Compensation Quality Health M. G. [Electronic] E0932C Other WC (Non-NY) , Quality Recruiting 250 Mill Street QUALI002 New York Workers' Rochester, NY 14614 Compensation QUAL-LYNX PO BOX 1209 QUALL001 New York Workers' PISCATAWAY, NJ 08855 Compensation QUAL-LYNX PO BOX 1209 QUALL002 Other WC (Non-NY) PISCATAWAY, NJ 08855 Queen of Angels - Hollywood [Electronic] E0933A New York Workers' , Compensation Queen of Angels - Hollywood [Electronic] E0933C Other WC (Non-NY) , QUEST SERVICES 845 ENGLEWOOD QUEST001 New York Workers' BUFFALO, NY 14223 Compensation Quick Check 3 Old Highway 28/PO Box 60 QUICK003 New York Workers' Whitehouse Station, NJ 08890 Compensation QUICK FILL 8280 ROUTE 54 QUICK002 New York Workers' HAMMONSPORT, NY 14810 Compensation QUICK RESPONSE PO BOX 824 QUICK001 New York Workers' CLIFTON PARK, NY 12065 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID QUINCY HEALTH CARE MANAGEMENT, INC. 57 WASHINGTON STREET QUINC001 Auto/No-Fault QUINCY, MA 02169 QUINTILES - ADVION BIOANALYTICA Attn: Accounts payable QUINT001 New York Workers' 19 BROWN ROAD Compensation ITHACA, NY 14850 R CONLEY TRUCKING 6891 SENECA ST RCONL001 New York Workers' ELMA, NY 14059 Compensation R&L CARRIERS 600 GILLAM ROAD RLCAR001 New York Workers' WILMINGTON, OH 45177 Compensation R&R PRECISION CONSTRUCTION 558 WERNER ROAD RRPRE001 New York Workers' ATTICA, NY 14011 Compensation R, Marcil and Associates 361 Duanesburg Road RMARC001 New York Workers' Schenectady, NY 12306 Compensation R. B. U'REN 1120 CONNECTING RD RBURE001 New York Workers' NIAGARA FALLS, NY 14304 Compensation R. DEVICENTIS CONSTRUCTION CO ONE BRICK AVE RDEVI001 New York Workers' BINGHAMTON, NY 13901 Compensation r.lindsey reglin employee leasing corp. po box 412 RLIND001 New York Workers' vestal, NY 13850 Compensation R.W. DAKE 100 BLUFF DRIVE RWDAK001 New York Workers' PO BOX 70 Compensation EAST ROCHESTER, NY 14445 RADEC CORP 100 ROCKWOOD ST RADEC001 New York Workers' ROCHESTER, NY 14610 Compensation Raff and Raff 30 Church St RAFFA001 Auto/No-Fault Paterson, NJ 07505 Rahway Center USHW of NJ 1044 E Hazelwood Ave RAHWA001 New York Workers' Rahway, NJ 07065 Compensation RAILWAY SPECIAL PO BOX 29 RAILW001 New York Workers' BRISTOL, PA 19007 Compensation Raley's Family of Fine Stores [Electronic] E0934C Other WC (Non-NY) , RALPHS TRUCKING 4644 MEADS CREEK ROAD RALPH001 New York Workers' PAINTED POST, NY 14870 Compensation Rampart Insurance Company [Electronic] E6475C Other WC (Non-NY) , Ramsey County (MN) [Electronic] E1397B Auto/No-Fault , Ramsey County (MN) [Electronic] E1397C Other WC (Non-NY) , Rancho Santiago Community College District (CA) E1268A New York Workers' [Electronic] , Compensation Rancho Santiago Community College District (CA) E1268B Auto/No-Fault [Electronic] , Rancho Santiago Community College District (CA) E1268C Other WC (Non-NY) [Electronic] , Rand Spear 1307 White horse Road RANDS001 Auto/No-Fault Voorhees, NJ 08043 RANSOME CAT 2975 GALLOWAY ROAD RANSO001 New York Workers' BENSALEM, PA 19020 Compensation RANSOMVILLE FIRE COMPANY 2521 YOUNGSTOWN LOCKPORT RD RANSO002 New York Workers' RANSOMVILLE, NY 14131 Compensation RAPP PETROLIUM PO BOX 298 RAPPP001 New York Workers' PORT CRANE, NY 13833 Compensation RAS-SD / WC P.O. Box 89310 RASSD001 Other WC (Non-NY) Sioux Falls, SD 57109 Raymond A Gill Jr. Attorney 655 Florida Grove Road RAYMO003 Auto/No-Fault Woodbridge, NJ 07095 RAYMOND CORP PO BOX 130 RAYCO02 New York Workers' 18-20 SOUTH CANAL ST Compensation GREENE, NY 13778 RAYMOND E KELLY INC 33 MAIN STREET RAYMO004 New York Workers' BOWMANSVILLE, NY 14026 Compensation RAYMOND HADLEY CORP ATT BRYAN RAYMO001 New York Workers' 89 TOMPKINS STREET Compensation SPENCER, NY 14883 RAYMOUR & FLANIGAN 7230 MORGAN RD RAYMO002 New York Workers' LIVERPOOL, NY 13088 Compensation RAYNOR CONSTRUCTION 166 N. PORTAGE ST RAC01 New York Workers' WESTFIELD, NY 14787 Compensation RAYTEL IMAGING NETWORK 101 WEST 4TH AVE RAYTE001 New York Workers' COLLEGEVILLE, PA 19426 Compensation RCH Protective - SNCC [Electronic] E0935A New York Workers' , Compensation RCH Protective - SNCC [Electronic] E0935C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID RCIL P.O. Box 210 RCIL001 New York Workers' 409 Columbia St. Compensation Utica, NY 13503 REACTION CONSTRUCTION P.O. BOX 4518 REACT001 New York Workers' QUEENSBURY, NY 12804 Compensation READY, SET, GROW CHILDREN'S CENTER 33 EAST FIRST STREET READY001 New York Workers' CORNING, NY 14830 Compensation Reagan Companies Po Box 191 REAGA001 New York Workers' Marcellus, NY 13108 Compensation Recology [Electronic] E1269A New York Workers' , Compensation Recology [Electronic] E1269B Auto/No-Fault , Recology [Electronic] E1269C Other WC (Non-NY) , RED BULLS NEW YORK 1 HARMON PLAZA REDBU001 New York Workers' SEACAUCUS, NJ 07094 Compensation RED LOBSTER (HORSEHEADS) 3328 CHAMBERS RD S REDLO001 New York Workers' HORSEHEADS, NY 14845 Compensation Red Oak Independent School District [Electronic] E3771C Other WC (Non-NY) , REDMOON CAREGIVERS 222 SOUTH ALBANY STREET REDMO001 New York Workers' ITHACA, NY 14850 Compensation Redwood Fire and Casualty Ins Co [Electronic] E0936C Other WC (Non-NY) , Regent Insurance Company - QBE DBA E0937C Other WC (Non-NY) [Electronic] , REGIONAL INTERNATIONAL 1007 LEHIGH STATION ROAD REGIO001 New York Workers' HENRIETTA, NY 14467 Compensation Regis Brands [Electronic] E1309A New York Workers' , Compensation Regis Brands [Electronic] E1309C Other WC (Non-NY) , Rehab Center of Beverly Hills [Electronic] E0938A New York Workers' , Compensation Rehab Center of Beverly Hills [Electronic] E0938C Other WC (Non-NY) , Rehab Resources 159 West First St. REHAB001 New York Workers' Oswego, NY 13126 Compensation REHABILITATION COUNSELING ASSESSMENT 311 ALEXANDER ST REHAB002 New York Workers' SUITE 308 Compensation ROCHESTER, NY 14604 REHABILITATION SUPPORT SERVICES 5174 WESTERN AVENUE REHAB003 New York Workers' ALTAMONT, NY 12009 Compensation REHIG PENN LOGISTIC 204 COUNTY HIGHWAY 157 REHIG001 New York Workers' GLOVERSVILLE, NY 12078 Compensation Reid Petroleum Corp PO BOX 987 REIDP001 New York Workers' Lockport, NY 14094 Compensation REIMANN & GEORGER CORP 1849 HARLEM RD REIMA001 New York Workers' BUFFALO, NY 14212 Compensation REINAUER TRANSPORTATION 1983 RICHMOND TERR RETR01 New York Workers' Staten Island, NY 10302 Compensation RELATED MANAGEMENT 400 CENTRAL AVENUE RELAT001 New York Workers' ALBANY, NY 12206 Compensation RELCO 7310 CHESTNUT RIDGE RD RELCO001 New York Workers' LOCKPORT, NY 14094 Compensation RELIANCE 10 AIRLINE DR RELI02 New York Workers' ALBANY, NY 12205 Compensation Reliance Fence 200 Plaza Dr RELIA013 New York Workers' Vestal, NY 13850 Compensation RELIANCE INS CO 1080 PITTSFORD-VICTOR RD RELI03 New York Workers' PITTSFORD, NY 14534 Compensation RELIANCE INS CO 3 PARKWAY RELI01 New York Workers' PHILADELPHIA, PA 19102 Compensation Reliance Insurance Company [Electronic Indirect] 10 AIRLINE DR RELIA001 New York Workers' ALBANY, NY 12205 Compensation Reliance Insurance Company [Electronic Indirect] 10 AIRLINE DR RELIA005 Auto/No-Fault ALBANY, NY 12205 Reliance Insurance Company [Electronic Indirect] 10 AIRLINE DR RELIA009 Other WC (Non-NY) ALBANY, NY 12205 Reliance Insurance Company [Electronic Indirect] 1080 PITTSFORD-VICTOR RD RELIA002 New York Workers' PITTSFORD, NY 14534 Compensation Reliance Insurance Company [Electronic Indirect] 1080 PITTSFORD-VICTOR RD RELIA006 Auto/No-Fault PITTSFORD, NY 14534 Reliance Insurance Company [Electronic Indirect] 1080 PITTSFORD-VICTOR RD RELIA010 Other WC (Non-NY) PITTSFORD, NY 14534 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Reliance Insurance Company [Electronic Indirect] 3 PARKWAY RELIA003 New York Workers' PHILADELPHIA, PA 19102 Compensation Reliance Insurance Company [Electronic Indirect] 3 PARKWAY RELIA007 Auto/No-Fault PHILADELPHIA, PA 19102 Reliance Insurance Company [Electronic Indirect] 3 PARKWAY RELIA011 Other WC (Non-NY) PHILADELPHIA, PA 19102 Reliance Insurance Company [Electronic Indirect] PO BOX 549 RELIA004 New York Workers' MINEOLA, NY 11501 Compensation Reliance Insurance Company [Electronic Indirect] PO BOX 549 RELIA008 Auto/No-Fault MINEOLA, NY 11501 Reliance Insurance Company [Electronic Indirect] PO BOX 549 RELIA012 Other WC (Non-NY) MINEOLA, NY 11501 RELIANCE LIQUIDATION PO BOX 549 RELQ01 New York Workers' MINEOLA, NY 11501 Compensation RELLER RISK MANAGEMENT 6315 FLY RD RRM01 New York Workers' EAST SYRACUSE, NY 13057 Compensation REM TRISTAR PO BOX 2805 REMTR001 New York Workers' CLINTON, IA 52733 Compensation Remedy Intelligent Staffing 97 Seneca St REMED001 New York Workers' Geneva, NY 14456 Compensation REMEDY INTELLIGENT STAFFING 1425 JEFFERSON RD REMED004 New York Workers' ROCHESTER, NY 14623 Compensation REMEDY INTELLIGENT STAFFING 79 GENESEE ST REMED002 New York Workers' AVON, NY 14414 Compensation REMEDY STAFFING 105 SENECA ST REMED003 New York Workers' GENEVA, NY 14456 Compensation RENKO TREE SERVICE 94 INDUSTRIAL PARK BLVD RENKO001 New York Workers' ELMIRA, NY 14901 Compensation RENNAISANCE WARRANTIED 147 E MAIN ST RENNA001 New York Workers' SPRINGVILLE, NY 14141 Compensation RENOLD INC 100 BOURNE ST RENI01 New York Workers' Attn: Laura Shearer Compensation WESTFIELD, NY 14787 RENT A CENTER 419 WEST MAIN ST RENTA003 New York Workers' BATAVIA, NY 14020 Compensation RENTAL INSURANCE SERVICES P.O BOX 350700 RENTA004 Auto/No-Fault WESTMINSTER, CO 80035 RENTAL INSURANCE SERVICES PO BOX 151227 RENTA002 Auto/No-Fault TAMPA, FL 33684 Rental Insurance Services, Inc. PO Box 670010 RENTA001 Auto/No-Fault Coral Springs, FL 33067 Reny Company attn Emerald Claims Mgt RENYC001 New York Workers' 3308 Preston Rd, STE 350-229 Compensation Plano, TX 75093 Republic Franklin Insurance [Electronic] E3299C Other WC (Non-NY) , Republic Indemnity Company of America E5422A New York Workers' [Electronic] , Compensation Republic Indemnity Company of America E5422C Other WC (Non-NY) [Electronic] , Republic Western Ins. Co [Electronic] E1398B Auto/No-Fault , Republic Western Ins. Co [Electronic] E1398C Other WC (Non-NY) , REPWEST INSURANCE CO. PO BOX 24463 REPWE001 Auto/No-Fault PHOENIX, AZ 85074 RER SUPPLY 20 COTLUSS RD RERSU001 New York Workers' RIVERDALE, NJ 07457 Compensation Rescare, Inc. [Electronic] E3669A New York Workers' , Compensation Rescare, Inc. [Electronic] E3669C Other WC (Non-NY) , RESCUE MISSION 155 GIFFORD STREET RESCU001 New York Workers' SYRACUSE, NY 13202 Compensation Resetarits Construction 1115 DELAWARE AVE RESET001 New York Workers' BUFFALO, NY 14209 Compensation Residential Services Group [Electronic] E1102C Other WC (Non-NY) , RESIDENTIAL STEELE SERVICES 500 LEE RD #8 RESID001 New York Workers' ROCHESTER, NY 14606 Compensation RESOURCE CENTER 200 DUNHAM AVE RESOU001 New York Workers' JAMESTOWN, NY 14701 Compensation RESPONSE INSURANCE PO BOX 1034 RESPO002 Auto/No-Fault MERIDAN, CT 06405 Response Worldwide PO Box 4199 RESPO001 New York Workers' Melville, NY 11747 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID RES-Q-JACK 1580 LAKE STREET RESQJ001 New York Workers' ELMIRA, NY 14901 Compensation Restaurant Reinsurance Limited [Electronic] E2796C Other WC (Non-NY) , Restoration Prof [Electronic] E0939A New York Workers' , Compensation Restoration Prof [Electronic] E0939C Other WC (Non-NY) , Retail Council of NYS 258 State St RETAI001 New York Workers' Albany, NY 12210 Compensation Retention Management Insurance 10816 Executive Center Drive RETEN001 New York Workers' Suite 203 Compensation Little Rock, AR 72211 RETTERER & SONS 566 STATE ROUTE 414 RETTE001 New York Workers' BEAVER DAMS, NY 14812 Compensation Return to Work [Electronic] E3022C Other WC (Non-NY) , Revere Copper & Brass 1 Revere Park Rd REVER001 New York Workers' Rome, NY 13440 Compensation RevMed [electronic] E9995A New York Workers' , Compensation RevMed [electronic] E9995C Other WC (Non-NY) , REXNORD CORP ATTN BENEFITS DEPT REXNO001 New York Workers' 304 MAIN AVENUE Compensation WARREN, PA 16365 RHI MONOFAX 1870 NEW YORK AVENUE RHIMO001 New York Workers' FAULKNER, NY 14724 Compensation Rhone-Poulenc,Inc. [Electronic] E9463C Other WC (Non-NY) , RICHARDSON BROS ELECTRICAL CONT 19 QUARRY ROAD RICHA001 New York Workers' ITHACA, NY 14850 Compensation Rick Concrete Const. [Electronic] E0940A New York Workers' , Compensation Rick Concrete Const. [Electronic] E0940C Other WC (Non-NY) , RICKS RENTAL WORLD 800 CASADILLA STREET RICKS001 New York Workers' ITHACA, NY 14850 Compensation RICO 92 WEST MARKET STREET RICO001 New York Workers' CORNING, NY 14830 Compensation Rider Insurance PO Box 1319 RIDER002 Auto/No-Fault Springfield, NJ 07081 Rider Insurance PO BOX 3141 RIDER001 Auto/No-Fault Union, NJ 07083 RIDGE ROAD EXPRESS 5355 JUNCTION ROAD RIDGE001 New York Workers' LOCKPORT, NY 14049 Compensation Rieth-Riley Construction Compa [Electronic] E5939C Other WC (Non-NY) , RIFENBURG CONSTRUCTION 159 BRICK CHURCH ROAD RIFEN001 New York Workers' TROY, NY 12180 Compensation RIGIDIZED METALS CORP 658 OHIO STREET ATTN: WORKERS RIGID001 New York Workers' COMP/DOUG LUM Compensation BUFFALO, NY 14203 RISING FINANCIAL SOLUTION PO BOX 2072 RISIN001 New York Workers' MILWAUKEE, WI 53201 Compensation RISK MANAGEMENT PLANNING GROUP PO BOX 670 RISKM019 Other WC (Non-NY) MINEOLA, NY 11501 Risk Administration Services [Electronic] E1122A New York Workers' , Compensation Risk Administration Services [Electronic] E1122B Auto/No-Fault , Risk Administration Services [Electronic] E1122C Other WC (Non-NY) , RISK ADMINISTRATION SERVICES, INC PO BOX 89310 RISKA001 Other WC (Non-NY) SIOUX FALLS, SD 57109 Risk Enterprise Management (REM) [Electronic] E0941C Other WC (Non-NY) , Risk Management P.O. Box 967 RISKM014 New York Workers' Peck Slip Station Compensation New York, NY 10272 RISK MANAGEMENT PO BOX 425 RISK15 New York Workers' HEMPSTEAD, NY 11550 Compensation RISK MANAGEMENT PO BOX 425 RISKM018 Auto/No-Fault HEMPSTEAD, NY 11550 RISK MANAGEMENT PO BOX 508 RISKM020 Other WC (Non-NY) MINEOLA, NY 11501 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID RISK MANAGEMENT PO BOX 670 RISK10 New York Workers' MINEOLA, NY 11501 Compensation Risk Management (Port Authority) PO BOX 457 RISKM017 New York Workers' Hempstead, NY 11550 Compensation Risk management Corp. PO Box 485 RISKM008 New York Workers' Hempstead, NY 11550 Compensation Risk Management Planning Group P.O. Box 427 RISKM003 New York Workers' Hempstead, NY 11550 Compensation Risk Management Planning Group PO Box 455 RISKM005 New York Workers' Hempstead, NY 11550 Compensation RISK MANAGEMENT PLANNING GROUP PO BOX 427 RISKM021 Other WC (Non-NY) HEMPSTEAD, NY 11550 Risk Management Service PO BOX 6309 RISKM015 New York Workers' SYRACUSE, NY 13217 Compensation RISK MANAGEMENT- STATE OF NJ P.O.BOX 620 RISKM011 New York Workers' TRENTON, NJ 08625 Compensation RISK MANAGEMENT WC PO BOX 10048 RISKM012 New York Workers' FORT SMITH, AR 72917 Compensation Risk Management/ Pilot Travel PO Box 10146 RISKM006 New York Workers' Noxville, TN 37920 Compensation Risk Managment 3827 18th Avenue RISKM016 New York Workers' Brooklyn, NY 11218 Compensation risk mgmt planning group - sif 211 station road RISKM009 New York Workers' suite 700 Compensation mineola, NY 11501 Risk Transfer Technologies, Inc. [Electronic] E1538C Other WC (Non-NY) , RIST TRANSPORTATION 369 BOSTWICK ROAD RISTT001 New York Workers' PHELPS, NY 14532 Compensation RIT OUTP 8 LOMB DR RIT01 New York Workers' ROCHESTER, NY 14623 Compensation RIVER RIDGE LIVING CENTER 100 SANDY DRIVE RIVER001 New York Workers' AMSTERDAM, NY 12010 Compensation RIVER VALLEY FOODS 5881 COURT STREET RD RVF01 New York Workers' SYRACUSE, NY 13221 Compensation Riverbay Corp-Risk Management 2049 Bartow Ave 23A RIVER003 New York Workers' Bronx, NY 10475 Compensation RIVERHAWK COMPANY 215 CLINTON ROAD RIVER004 New York Workers' NEW HARTFORD, NY 13413 Compensation Riverport Insurance Company (Agricultural ONLY) E0943C Other WC (Non-NY) [Electronic] , RIVERVIEW MANOR NURSING HOME 510 FIFTH AVENUE RIVER002 New York Workers' OWEGO, NY 13827 Compensation RJ SCHICKLER INC 860 SCOTSSVILLE CHILI ROAD RJSCH001 New York Workers' SCOTSSVILLE, NY 14546 Compensation RJ WILLIAMS LUMBER CO PO BOX 566 RJWIL001 New York Workers' APALACHIN, NY 13732 Compensation RL CALLAHAN CONSTRUCTION 1150 COUNTY ROAD 19 RLCAL001 New York Workers' BEAVER DAMS, NY 14812 Compensation RLI TRANSPORTATION 2970 CLAIRMONT ROAD STE 1000 RLITR001 Auto/No-Fault ATLANTA, GA 30329 RMCO PLASTICS 316 COLONIAL DRIVE RMCOP001 New York Workers' HORSEHEADS, NY 14845 Compensation RMG INVESTIGATIONS 104 WEST 27TH STREET #8 RMGIN001 Auto/No-Fault NEW YORK, NY 10001 RMPG P.O. Box 508 RMPG009 New York Workers' Mineola, NY 11501 Compensation RMPG PO BOX 423 RMPG012 New York Workers' HEMPSTEAD, NY 11550 Compensation RMPG PO BOX 485 RMPG010 Other WC (Non-NY) Mineola, NY 11550 RMPG PO BOX 670 RMPG02 New York Workers' MINEOLA, NY 11501 Compensation RMSCO PO BOX 6509 RMSC04 New York Workers' SYRACUSE, NY 13217 Compensation RMSCO INS CO PO BOX 6509 RMSCO001 Other WC (Non-NY) Syracuse, NY 13217 RMSCO Nofault PO Box 6509 RMSCO003 Auto/No-Fault Syracuse, NY 13217 ROBBIEHILL FAMILY DAIRY LLC 1480 TORREY HILL ROAD ROBBI001 New York Workers' JAVA CENTER, NY 14082 Compensation Robert J. Ryan Inc 180 Schwenk Dr ROBER001 New York Workers' Kingston, NY 12401 Compensation Robert Packer Hospital 1 Guthrie Square ROBER002 New York Workers' Sayre, PA 18840-1698 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Robert Packer Hospital Emergency Room 1 Guthrie Square ROBER003 New York Workers' Sayre, PA 18840-1698 Compensation Robert Packer Hospital Out Pt 1 Guthrie Square ROBER004 New York Workers' Sayre, PA 18840-1698 Compensation ROBERT THOMAS HEALTH CARE 96-05 HORACE HARDING EXPWY RTHC01 New York Workers' CORONA, NY 11368 Compensation ROBERT W LEVIN & ASSO 75 ESSEX STREET ROBER006 Auto/No-Fault HACKENSACK, NJ 07601 ROBINSON HOME PRODUCTS 170 LAWRENCE BELLDR STE 110 ROBIN002 New York Workers' WILLIAMSVILLE, NY 14221 Compensation ROBINSON LUMBER (OWEGO) 1878 DAY HOLLOW ROAD ROBIN001 New York Workers' OWEGO, NY 13827 Compensation ROB'S AUTOMOTIVE ATTN: GUY GUNNELLS ROBSA001 New York Workers' 2700 NEW RODGERS RD Compensation BRISTOL, PA 19007 ROBS TOWING 2501 OLD RODGERS RD ROBST001 New York Workers' BRISTOL, PA 19007 Compensation Robstown ISD [Electronic] E0944A New York Workers' , Compensation Robstown ISD [Electronic] E0944C Other WC (Non-NY) , ROCCO J TESTANI,INC 29 PHELPS STREET ROCCO001 New York Workers' PORT DICKINSON, NY 13902 Compensation ROCH SCL FOR THE DEAF 1545 ST PAUL ST ROCHS001 New York Workers' ROCHESTER, NY 14621 Compensation Rochdale Insurance PO BOX 105010 ROCHD009 New York Workers' Atlanta, GA 30348 Compensation ROCHESTER AMERICANS 1 WAR MEMORIAL SQ ROCH03 New York Workers' ROCHESTER, NY 14614 Compensation Rochester Area Schools WC Plan 3599 Big Ridge Rd ROCHE009 New York Workers' Spencerport, NY 14559 Compensation Rochester Business Alliance 150 State Street 4th floor ROCHE005 New York Workers' Rochester, NY 14614 Compensation ROCHESTER DAVIS FETCH CORP 175 DODGE ST ROCHE006 New York Workers' ROCHESTER, NY 14606 Compensation Rochester Fire Department 185 Exchange Blvd ROCHE003 New York Workers' Ste 673 Compensation Rochester, NY 14614 ROCHESTER FIRE DEPT 306 PUBLIC SAFETY BUILDING ROCH04 New York Workers' STE 673 Compensation ROCHESTER, NY 14614 ROCHESTER LABORERS WELFARE 18 FOURTH STREET ROCH06 New York Workers' ROCHESTER, NY 14609 Compensation ROCHESTER LEAD WORKS, INC 76-100 ANDERSON AVENUE ROCHE008 New York Workers' ROCHESTER, NY 14610 Compensation ROCHESTER MEDICAL TRANSPORT 150 JOSONS DRIVE ROCHE007 New York Workers' ROCHESTER, NY 14623 Compensation ROCHESTER POLICE DEPT 185 EXCHANGE BLVD ROCH07 New York Workers' 6TH FLOOR Compensation ROCHESTER, NY 14614-2125 ROCHESTER PSYCH CENTER 75 NEW SCOTLAND AVE ROCH08 New York Workers' ALBANY, NY 12208 Compensation Rochester Regional Transit 1372 E. Main St ROCHE001 New York Workers' Rochester, NY 14609 Compensation ROCHESTER RHINOS 460 OAK ST ROCH09 New York Workers' ROCHESTER, NY 14608 Compensation ROCHESTER RIGGINGH & ERECTORS ATTN KELLY GILLIGAN ROCHE010 New York Workers' 7819 STATE ROUTE 5 & 27 Compensation BLOOMFIELD, NY 14469 ROCHESTER STRUCTURE 961 LYELL AVE ROCHE002 New York Workers' BLDG 5 Compensation ROCHESTER, NY 14606 ROCHESTER TOWN HALL 50 SCENIC ROAD ROCHE004 New York Workers' P.O. BOX 65 Compensation ACCORD, NY 12404 Rockford Mutual PO Box 5626 ROCKF001 Auto/No-Fault Rockford, IL 61125 Rockford Mutual Insurance Company [Electronic] E1310B Auto/No-Fault , Rockford Mutual Insurance Company [Electronic] E1310C Other WC (Non-NY) , Rocking Horse Ranch 600 State Route 44 55 ROCKI001 New York Workers' Attn: JoAnne in Payroll Compensation Highland, NY 12528 Rockwall ISD [Electronic] E0945A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Rockwall ISD [Electronic] E0945C Other WC (Non-NY) , ROCKWOOD CASUALTY 654 MAIN STREET ROCKW001 New York Workers' ROCKWOOD , PA 15557 Compensation Rockwood Casualty Ins / WC 654 Main Street ROCKW002 Other WC (Non-NY) Rockwood, PA 15557 ROHM & HAAS 200 US HIGHWAY 13 ROHMH001 New York Workers' BRISTOL, PA 190073517 Compensation ROHRER 1180 ROUTE 6 ROHRE001 New York Workers' WATERFORD, PA 16404 Compensation ROMA TILE 306 WOLFF STREET ROMAT001 New York Workers' SYRACUSE, NY 13208 Compensation ROMAN CATHOLIC DIOCESE DEPT OF INSURANCE 795 MAIN ST ROMAN001 New York Workers' BUFFALO, NY 14203 Compensation ROMAR TRUCK REPAIR & MECHANICAL SERVICES 1989 HARLEM RD ROMAR001 New York Workers' BUFFALO, NY 14212 Compensation RONALD RICCI ATT 500 UNION BLVD SUITE# 1 RONAL001 Auto/No-Fault TOTOWA, NJ 07512 RONCO COMMUNICATIONS 7903 THORNDIKE RD RONCO001 New York Workers' GREENSBORO, NC 27409 Compensation ROSE CITY GLASS 2487 ROCHESTER ROAD ROSEC001 New York Workers' CANADIAGUA, NY 14424 Compensation Rose Garden Guest Ho [Electronic] E0946A New York Workers' , Compensation Rose Garden Guest Ho [Electronic] E0946C Other WC (Non-NY) , ROSEDALE MILLS INC 101 RT 31 NORTH ROSED001 New York Workers' PENNINGTON, NJ 08053 Compensation ROSEWOOD REHABILITATION 284 TROY ROAD ROSEW001 New York Workers' RENSSELAER, NY 12144 Compensation Rosewoood Equipment [Electronic] E0947A New York Workers' , Compensation Rosewoood Equipment [Electronic] E0947C Other WC (Non-NY) , Rosina/Celentano 170 French Rd ROSIN001 New York Workers' Buffalo, NY 14227 Compensation ROSSETTI ROSETTIE & MARTION 269 W PULTENEY ST ROSSE001 New York Workers' CORNING, NY 14830 Compensation Rossi Concrete, Inc [Electronic] E0948A New York Workers' , Compensation Rossi Concrete, Inc [Electronic] E0948C Other WC (Non-NY) , ROTORK 675 MILE CROSSING BLVD ROTOR002 New York Workers' ROCHESTER, NY 14624 Compensation ROTO-ROOTER PO BOX 614 ROTOR001 New York Workers' ITHACA, NY 14851-0614 Compensation ROUND HOUSE MILL 41 ELM ST ROUND001 New York Workers' CORTLAND, NY 13045 Compensation ROYAL CARIBBEAN CRUISE PO BOX 1087 ROYAL008 New York Workers' CHICAGO, IL 60690 Compensation ROYAL CARRIBEAN INT 1050 CARRIBEAN WAY ROYAL001 New York Workers' MIAMI, FL 33132 Compensation Royal Chevrolet 3838 West Road ROYAL010 New York Workers' Cortland, NY 13045 Compensation ROYAL CHRYSLER MOTORS INC PO BOX 118 ROYAL003 New York Workers' 3961 WAVERLY ROAD Compensation OWEGO, NY 13827 ROYAL FAMILY RESTAURANT 1320 SHERIDAN DR ROYAL002 New York Workers' KENMORE, NY 14217 Compensation ROYAL FORD & MERCURY MOTORS 3964 WAVERLY RD ROYAL011 New York Workers' OWEGO, NY 13827 Compensation ROYAL UNDERWRITERS 6004 EMILIE ROAD ROYAL009 Auto/No-Fault LEVITTOWN, PA 19057 ROYAL WINE CORP 63 NORTH HOOK ROAD ROYAL006 New York Workers' BAYONNE, NJ 07002 Compensation ROYCE & ROSENCRANS 60 FALL ST RNR01 New York Workers' SENECA FALLS, NY 13148 Compensation Roys Plumming 140 Cooper Ave ROYSP001 New York Workers' Tonawanda, NY 14150 Compensation RPM WAREHOUSING 99 HOOK ROAD RPMWA001 New York Workers' BAYONNE, NJ 07002 Compensation RS CRUSHING 6891 South 700 West RSCRU002 New York Workers' Midvale, UT 84047 Compensation RSC Insurance Services, Ltd. [Electronic] E7140C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID RSKCO 6712 BROOKLAWN PKWY RSKC04 New York Workers' SUITE 102 Compensation SYRACUSE, NY 13211-2167 RSKCO PO BOX 946600 RSKC01 New York Workers' MAITLAND, FL 37294-6600 Compensation RTW PO BOX 30189 RTW002 Other WC (Non-NY) TAMPA, FL 33630 RTW INC PO BOX 390327 RTW01 New York Workers' MINNEAPLOIS, MN 55439 Compensation RURAL METRO 811 WEST AVENUE RURAL002 New York Workers' ROCHESTER, NY 14611 Compensation Rural Metro Med 481 William L Gaiter Pkwy RURAL003 New York Workers' Buffalo, NY 14215 Compensation RURAL METRO MEDICAL SERVICES 25 E PULTNEY ST RURAL001 New York Workers' CORNING, NY 14830 Compensation Rural Special District Insurance Program E0949A New York Workers' [Electronic] , Compensation Rural Special District Insurance Program E0949C Other WC (Non-NY) [Electronic] , RUSH-HENRIETTA CENTRAL SCHOOL 2034 LEHIGH STATION ROAD RUSHH001 New York Workers' HENRIETTA, NY 14467 Compensation RUSS WHELAN INC 1375 ADAMS ROAD RUSSW001 New York Workers' BENSALEM, PA 19020 Compensation RUSSELL BENTLEY 285 N. MAIN ST RUNE01 New York Workers' LYNDONVILLE, NY 14098 Compensation RUSSO DEVELOPMENT 535 WEST MAIN STREET RUSSO001 New York Workers' SPRINGVILLE, NY 14141 Compensation RUTGERS CAS INS CO MVA 2250 CHAPEL AVE W RUTGE001 Auto/No-Fault CHERRY HILL, NJ 07626 RYDER po box 2830 RYDER002 Auto/No-Fault Clinton, IA 52733 RYDER po box 2830 RYDER003 Other WC (Non-NY) Clinton, IA 52733 RYDER PO BOX 2830 RYDER001 New York Workers' CLINTON, IA 52733-2830 Compensation Ryder Services, Inc. [Electronic] E6016A New York Workers' , Compensation Ryder Services, Inc. [Electronic] E6016C Other WC (Non-NY) , RYNONE MANUFACTURING 229 HOWARD STREET RYNON001 New York Workers' WAVERLY, NY 14892 Compensation RYNONE MFG CORP-SAYRE,PA PO BOX 128 RYNON002 New York Workers' SAYRE, PA 18840 Compensation S&B CONSTRUCTION SHORTCUT RD SBC01 New York Workers' STERLING, NY 13156 Compensation S&T KNITTING PO BOX 1512 STKNI001 New York Workers' BINGHAMTON, NY 13902 Compensation SA Recycling, LLC [Electronic] E1270A New York Workers' , Compensation SA Recycling, LLC [Electronic] E1270B Auto/No-Fault , SA Recycling, LLC [Electronic] E1270C Other WC (Non-NY) , SAFE 620 ERIE BLVD WEST SAFE01 New York Workers' #100 Compensation SYRACUSE, NY 13204 Safe Auto / Liability PO Box 182384 SAFEA001 Auto/No-Fault Columbus, OH 43218 SAFE GUARD SECURITY 201 BUSTLETON PK SAFEG001 Auto/No-Fault TREVOSE, PA 19053 SAFE HORIZON 27 SECOND AVENUE SAFEH001 New York Workers' UNION CITY, PA 16438 Compensation Safeco PO Box 461 SAFEC006 Auto/No-Fault St. Louis, MO 63166 SAFECO PO BOX 461 SAIC01 New York Workers' ST LOUIS, MO 63166 Compensation Safeco / Peerless / Ohio PO Box 515097 SAFEC009 New York Workers' Los Angeles, CA 90051-5097 Compensation SAFECO [Electronic] PO BOX 515097 SAFEC003 Auto/No-Fault LOS ANGELES, CA 90051 SAFECO INS CO. - DAVID RODRIGUEZ PO BOX 515097 SAFEC011 Auto/No-Fault LOS ANGELES, CA 90051 SAFECO INSURANCE PO BOX 515097 SAFEC012 Auto/No-Fault LOS ANGELES, CA 90051 Safeco Insurance [Electronic Indirect] PO Box 461 SAFEC007 New York Workers' St. Louis, MO 63166 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Safeco Insurance [Electronic Indirect] PO Box 461 SAFEC008 Other WC (Non-NY) St. Louis, MO 63166 SafeCo Insurance [Electronic] E0950A New York Workers' , Compensation SafeCo Insurance [Electronic] E0950C Other WC (Non-NY) , SAFESPAN 252 FILLMORE AVE SAFES001 New York Workers' TONAWANDA, NY 14150 Compensation SAFETY INS CO PO BOX 9098 SAFET001 Auto/No-Fault BOSTON, MA 02205-9098 SAFETY NATIONAL CASUALTY CORP 1832 SCHETZ RD SAFENAT01 New York Workers' ST LOUIS, MO 63146 Compensation Safety-Kleen Corporation [Electronic] E4353C Other WC (Non-NY) , SAFEWAY PO BOX 1504 SAFEW001 New York Workers' LANHAM, MD 20703 Compensation SAHLENS PO BOX 280 SAHLE001 New York Workers' BUFFALO, NY 14240 Compensation SAIF Corporation 400 High St SAIFC001 New York Workers' Southeast Compensation Salem, OR 97312 Saint Louis County (MN) [Electronic] E1399B Auto/No-Fault , Saint Louis County (MN) [Electronic] E1399C Other WC (Non-NY) , Salit Specialty Rebar 3235 Lockport Road SALIT002 New York Workers' Naigara Falls, NY 14305-2309 Compensation Salt Lake City Corporation [Electronic] E0951A New York Workers' , Compensation Salt Lake City Corporation [Electronic] E0951C Other WC (Non-NY) , Salt Lake City Corporation [Electronic] E1271A New York Workers' , Compensation Salt Lake City Corporation [Electronic] E1271B Auto/No-Fault , Salt Lake City Corporation [Electronic] E1271C Other WC (Non-NY) , SALVATION ARMY (CORNING) 32 EAST DENISON PKWY SALVA001 New York Workers' CORNING, NY 14830 Compensation Sam Kane Beef Processors, Inc. [Electronic] E0952A New York Workers' , Compensation Sam Kane Beef Processors, Inc. [Electronic] E0952C Other WC (Non-NY) , SAM'S CLUB (BIG FLATS) 830 COUNTY RTE 64 SAMSC001 New York Workers' BUILDING 2 Compensation ELMIRA, NY 14903 San Bernardino City Unified School District E1133A New York Workers' [Electronic] , Compensation San Bernardino City Unified School District E1133C Other WC (Non-NY) [Electronic] , San Bernardino County Schools Superintendent E1272A New York Workers' [Electronic] , Compensation San Bernardino County Schools Superintendent E1272B Auto/No-Fault [Electronic] , San Bernardino County Schools Superintendent E1272C Other WC (Non-NY) [Electronic] , San Diego Community College District (CA) E1273A New York Workers' [Electronic] , Compensation San Diego Community College District (CA) E1273B Auto/No-Fault [Electronic] , San Diego Community College District (CA) E1273C Other WC (Non-NY) [Electronic] , San Diego Hospice Inst for Palliative Med E0953A New York Workers' [Electronic] , Compensation San Diego Hospice Inst for Palliative Med E0953C Other WC (Non-NY) [Electronic] , San Diego Met Transit (SCHIP Liability) E0955A New York Workers' [Electronic] , Compensation San Diego Met Transit (SCHIP Liability) E0955C Other WC (Non-NY) [Electronic] , San Diego Metropolitan Transit System E0954A New York Workers' [Electronic] , Compensation San Diego Metropolitan Transit System E0954C Other WC (Non-NY) [Electronic] , San Diego Transit Corp. [Electronic] E0956A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID San Diego Transit Corp. [Electronic] E0956C Other WC (Non-NY) , San Diego Trolley, Inc. [Electronic] E0957A New York Workers' , Compensation San Diego Trolley, Inc. [Electronic] E0957C Other WC (Non-NY) , San Diego/Imperial Schools JPA (CA) [Electronic] E1274A New York Workers' , Compensation San Diego/Imperial Schools JPA (CA) [Electronic] E1274B Auto/No-Fault , San Diego/Imperial Schools JPA (CA) [Electronic] E1274C Other WC (Non-NY) , San Francisco BART [electronic] E9994C Other WC (Non-NY) , San Joaquin County [Electronic] E0958A New York Workers' , Compensation San Joaquin County [Electronic] E0958C Other WC (Non-NY) , SANDERS ROOFING PO BOX 814 SANDE001 New York Workers' BUFFALO, NY 14240 Compensation SANDZEE ONTAP PO BOX 511 SANDZ001 New York Workers' Horseheads, NY 14845 Compensation SANMINA SCT 1200 TAYLOR ROAD SANMI001 New York Workers' OWEGO, NY 13827 Compensation SANO RUBIN CONSTRUCTION CO 624 DELAWARE AVENUE SANOR001 New York Workers' ALBANY, NY 12209 Compensation SANS SPAY AND NEUTER SYRACUSE 1108 SPRING STREET SANSS001 New York Workers' SYRACUSE, NY 13208 Compensation Santa Clara Co Office Of Educ [Electronic] E0959A New York Workers' , Compensation Santa Clara Co Office Of Educ [Electronic] E0959C Other WC (Non-NY) , Santa Clara Valley Tansportation Authority E0960C Other WC (Non-NY) [Electronic] , SANTERO DEVELOPMENT PO BOX 11125 SANTE001 New York Workers' SYRACUSE, NY 13218 Compensation SARATOGA COUNTY SELF INSURANCE 40 MCMASTER ST SAC01 New York Workers' BALLSTON SPA, NY 12020 Compensation SARKISIAN BROTHERS INC 11 CHARLOTTE STREET SARKI001 New York Workers' PO BOX 1925 Compensation BINGHAMTON, NY 13902 SASCO INSURANCE SERVICE 313 HIGH STREET SASCO001 Auto/No-Fault HACKETTSTOWN, NJ 07840 SAYRE BOROUGH 110 WEST PACKER AVE SAYRE001 New York Workers' SAYRE, PA 18840 Compensation Sayre House Inc 1001 North Elmer Ave SAYRE002 New York Workers' Sayre, PA 18840 Compensation SCA PAPER 1 RIVER STREET SOUTH SCAPA001 New York Workers' SOUTH GLENS FALLS, NY 12803 Compensation SCARANO BOAT BLDG, INC 194 SO. PORT ROAD SCARA001 New York Workers' ALBANY, NY 12202 Compensation SCENIC LANDSCAPE 400 ITHACA ROAD SCENI001 New York Workers' SPENCER, NY 14883 Compensation Scenic Services Inc 1116 Marsh Road SCENI003 New York Workers' Corning, NY 14830 Compensation SCEPTOR 11 LAMB RD SCEP01 New York Workers' SENECA FALLS, NY 13148 Compensation SCF Arizona PO Box 36070 SCFAR001 Other WC (Non-NY) Phoenix, AZ 85067 SCF OF ARIZONA PO BOX 33069 SCF01 New York Workers' PHOENIX, AZ 85067 Compensation SCHAAP MOVING SYSTEMS 6 BROWN ROAD SCHAA001 New York Workers' ALBANY, NY 12205 Compensation SCHAFFER INS 9920 FRANKLIN SQUARE DR SCHAF001 New York Workers' BALTIMORE, MD 21236 Compensation SCHICKLE CONSTRUCTION 210 SCHUTT RD SCHIC001 New York Workers' DRYDEN, NY 13053 Compensation SCHLUMBERGER (HORSEHEADS,NY) 224 N.MAIN ST SCHLU001 New York Workers' BLDG S Compensation HORSEHEADS, NY 14845 Schlumberger Technology [Electronic] E1838C Other WC (Non-NY) , SCHMID PIPELINE 850 MALLARD DRIVE SCHMI001 New York Workers' MAYVILLE, WI 53050 Compensation SCHMIDT TRUCKING INC 10216 MANHATTAN DR SCHMI002 New York Workers' BREWERTON, NY 13029 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SCHNABEL FOUNDATION 45240 BUSINESS CT, STE 250 SCHNA001 New York Workers' STERLING, VA 20166 Compensation Schneider Gain [Electronic] E0961A New York Workers' , Compensation Schneider Gain [Electronic] E0961C Other WC (Non-NY) , SCHNEIDER NATIONAL PO BOX 2545 SCHNE001 New York Workers' GREEN BAY, WI 543069970 Compensation Schnuck Market, Inc [Electronic] E1311C Other WC (Non-NY) , Schnucks Market / WC 11420 Lackland Road SCHNU001 Other WC (Non-NY) Saint Louis, MO 63146 SCHOOL CLAIM SERVICES C/O MCMC SCHOO006 Other WC (Non-NY) 333 TECHNOLOGY DRIVE SUITE 108 CANONSBURG, PA 15317 School Claims Serivces P.O. Box 813 SCHOO005 Other WC (Non-NY) New Cumberland, PA 17070 SCHOOL CLAIMS SERVICE PO BOX 813 SCHOO001 New York Workers' NEW CUMBERLAND, PA 17070 Compensation SCHOOL CLAIMS SVS LLC PO BOX 67073 SCHOO003 New York Workers' ATTN PAT BARES Compensation HARRISBURG, PA 17106 SCHOOL DISTRICTS INS PO BOX 1249 SCHOO004 New York Workers' NORTH WALES, PA 19454 Compensation Schuler-Haas Electric Corp 240 Commerce Dr SCHUL003 New York Workers' Rocester, NY 14623 Compensation SCHUYLER COUNTY HIGHWAY DEPT 105 Nine Street SCHUY001 New York Workers' Unit 32 Compensation WATKINS GLEN, NY 14891 Schuyler Hospital 220 Steuben Street SCHUY002 New York Workers' Montour Falls, NY 14865 Compensation Schuyler Hospital ER 220 Steuben Street SCHUY003 New York Workers' Montour Falls, NY 14865 Compensation Schuyler Long Term Care Townsend Line Road SCHUY004 New York Workers' Montour Falls, NY 14865 Compensation SCHWEBEL'S BAKING CO PO BOX 6013 SCHWE002 New York Workers' YOUNGSTOWN, OH 44501 Compensation SCHWEIZER AIRCRAFT CORP 1250 SCHWEIZER RD SCHWE001 New York Workers' HORSEHEADS, NY 14845 Compensation SCIARRABA & WALKER PO BOX 788 SCIAR001 New York Workers' ITHACA, NY 14851 Compensation SCIBAL ASSOC 23 MAYS LANDING RD SCIBA008 New York Workers' SOMERS POINT, NJ 08244 Compensation Scibal Associate 6750 Alexander Bell Dr SCIBA001 New York Workers' Columbia, MD 21046 Compensation Scibal Associates 100 Decadon Dr Ste 115 SCIBA012 New York Workers' Egg Harbor Twp, NJ 08234 Compensation SCIBAL ASSOCIATES 1035 ANDREW DRIVE SCIBA011 New York Workers' SUITE A Compensation WEST CHESTER, PA 19380 SCIBAL ASSOCIATES 1195 MCDERMOTT DR STE 3 SCIBA006 New York Workers' WEST CHESTER, PA 19380 Compensation SCIBAL ASSOCIATES 1195 MCDERMOTT DRIVE SCIBA013 Other WC (Non-NY) WEST CHESTER, PA 19380 SCIBAL ASSOCIATES 250D CORPORATE COURT SCIBA007 New York Workers' S PLAINFIELD, NJ 07080 Compensation SCIBAL ASSOCIATES 6700 OLD COLLAMER RD SCAS01 New York Workers' STE 117 Compensation E SYRACUSE, NY 13057 SCIBAL ASSOCIATES 8019 Corporate Drive. SCIBA003 New York Workers' STE: C Compensation Baltimore, MD 21236-4917 SCIBAL ASSOCIATES PO BOX 2849 SCAS02 New York Workers' SYRACUSE, NY 13220 Compensation SCIBALL 1601 N BROAD ST SCIBA010 New York Workers' USB ROOM 205 Compensation PHILA, PA 19122 SCIF AZ [Electronic] E0962A New York Workers' , Compensation SCIF AZ [Electronic] E0962C Other WC (Non-NY) , SCOLFIELD REPAIR 7211 STATE RT 54 SCOLF001 New York Workers' BATH, NY 14810 Compensation SCOTT ENTERPRISES 120 GRUNER RD SCOTT007 New York Workers' CHEEKTOWAGA, NY 14227 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SCOTT LAND AND YARD SERVICE PO BOX 13 SCOTT002 New York Workers' SLATERVILLE SPRINGS, NY 14881 Compensation SCOTT LAWN/YARD 5552 TOWNLINE RD SCOTT008 New York Workers' SANBORN, NY 14132 Compensation SCOTT SMITH & SON INC 8 DELPHINE STREET SCOTT001 New York Workers' OWEGO, NY 13827 Compensation SCOTT WALLACE 64 NEW BUFFALO ROAD SCOTT006 New York Workers' CLYMER, NY 14724 Compensation Scotts Miracle-Gro Company [Electronic] E7535C Other WC (Non-NY) , Scottsdale Ins PO Box 4120 SCOTT005 New York Workers' Scottsdale, AZ 85261 Compensation Scottsdale Insurance Company [Electronic] 8877 NORTH GAINEY CENTER SCOTT003 Auto/No-Fault DRIVE SCOTTSDALE, AZ 85258 SCOVILLE MENO AUTO PLAZA 839 STATE RTE 17C SCOVI001 New York Workers' OWEGO, NY 13827 Compensation SCS ADMIN. SELF FUNDED WC GROUP PO BOX 1248 SCSAD001 New York Workers' WILLIAMSVILLE, NY 14231 Compensation SDC CONCRETE 60 SOUTHSIDE DRIVE SDCCO001 New York Workers' OWEGO, NY 13827 Compensation SDC INFORMATION SERVICES 250 INTERNATIONAL DR SDCIN001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation SDIC INSURANCE P O BOX 1249 SDICI001 Other WC (Non-NY) NORTH WALES, PA 19454 SDS OF NEW YORK 1618 SEARS ROAD SDSOF001 New York Workers' ELMIRA, NY 14903 Compensation SEA WOLF MARINE 473 BROADWAY SEAWO001 New York Workers' BAYONNE, NJ 07002 Compensation Seabright (SBIC) [Electronic] E0963C Other WC (Non-NY) , SEABRIGHT INSURANCE CO 150 N RADNOR CHESTER RD SEABR001 New York Workers' STE E110 Compensation Radnor, PA 19087 SEABRIGHT INSURANCE COMPANY PO BOX 91100 SCIB01 New York Workers' SEATTLE, WA 98111 Compensation SEAL AND DESIGN 4015 CASILIO PKWY SEALA001 New York Workers' CLARENCE, NY 14031 Compensation SEALY 30 VETERANS MEMORIAL DRIVE SEALY001 New York Workers' TROY, NY 12183 Compensation SEARS ROEBUK & CO 3333 BEVERLY RD SEARS001 New York Workers' HOFFMAN, IL 60179 Compensation SEATTLE MARINERS PO BOX 4100 SEMA01 New York Workers' SEATTLE, WA 98194 Compensation Secretary of State /WC 196 Howlett Building SECRE001 Other WC (Non-NY) Springfield, IL 62756 SECURA Insurance A Mutual Company [Electronic] E1317A New York Workers' , Compensation SECURA Insurance A Mutual Company [Electronic] E1317C Other WC (Non-NY) , SECURITAS 345 HARRY L DRIVE SECUR003 New York Workers' JOHNSON CITY, NY 13790 Compensation SECURITY MUTUAL PO BOX 1620 SECUR001 New York Workers' BINGHAMTON, NY 13902 Compensation SECURITY SUPPLY CORP 196 MAPLE AVE SECUR002 New York Workers' SELKIRK, NY 12158 Compensation sedgewick po box 14533 SEDGE006 Other WC (Non-NY) lexington, KY 40512 Sedgewick P.O. Box 14627 SEDGE012 New York Workers' Lexington, KY 40512 Compensation Sedgewick PO Box 14440 SEDGE007 Other WC (Non-NY) lexington, KY 40510 Sedgewick PO BOX 15065 SEDGE004 Auto/No-Fault Albany, NY 12212 SEDGEWICK 120 E BALTIMORE ST SEDGE008 New York Workers' SUITE 1910 Compensation BALTIMORE, MD 21202 SEDGEWICK PO BOX 14459 SEDGE002 New York Workers' LEXINGTON, KY 40519 Compensation SEDGEWICK PO BOX 14517 SEDGE009 Other WC (Non-NY) LEXINGTON, KY 40512-4517 SEDGEWICK PO BOX 14545 SCMS19 New York Workers' LEXINGTON, KY 40512 Compensation SEDGEWICK PO BOX 14667 SEDGE011 New York Workers' LEXINGTON, NY 40512 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SEDGEWICK CLAIMS PO BOX 14156 SEDGE014 Auto/No-Fault LEXINGTON, KY 40512 SEDGEWICK CLAIMS SERVICES P.O. BOX 14155 SEDGE013 Auto/No-Fault LEXINGTON, KY 40512 SEDGEWICK CMS PO BOX 14453 SEDGE003 New York Workers' Lexington, KY 40512 Compensation SEDGEWICK INSURANCE P.O. BOX 14151 SEDGE015 Other WC (Non-NY) LEXINGTON, KY 40512 Sedgewick WC PO Box 15065 SEDGE005 Other WC (Non-NY) Albany, NY 12212 sedgwick po box 14520 SEDGW086 New York Workers' lexington, KY 40512 Compensation Sedgwick Claims Management Inc. SEDGW109 New York Workers' PO Box 14731 Compensation Lexington, KY 40512 Sedgwick P.O. Box 14439 SEDGW007 New York Workers' Lexington, KY 40512 Compensation Sedgwick P.O. Box 14447 SEDGW085 New York Workers' Lexington, KY 40512 Compensation Sedgwick P.O. Box 14454 SEDGW101 New York Workers' Lexington, NY 40512 Compensation Sedgwick P.O. Box 14572 SEDGW102 New York Workers' Lexington, NY 40512 Compensation Sedgwick P.O. Box 190670 SEDGW087 New York Workers' Atlanta, GA 31119 Compensation Sedgwick PO BOX 14029 SEDGW067 New York Workers' Lexington, KY 40512 Compensation Sedgwick PO Box 14437 SEDGW006 New York Workers' Lexington, KY 40512 Compensation Sedgwick PO BOX 14490 SEDGW100 New York Workers' LEXINGTON, KY 40512 Compensation Sedgwick PO BOX 14491 SEDGW094 Other WC (Non-NY) Lexington, KY 40512 Sedgwick PO Box 14497 SEDGW046 Other WC (Non-NY) Lexington, KY 40512 Sedgwick PO BOX 14511 SEDGW077 New York Workers' Lexington, KY 40512 Compensation Sedgwick PO Box 14518 SEDGW111 New York Workers' Lexington, KY 40512 Compensation Sedgwick PO BOX 14519 SEDGW076 Other WC (Non-NY) Lexington, KY 40512 Sedgwick PO BOX 14519 SEDGW078 New York Workers' Lexington, KY 40512 Compensation Sedgwick Po Box 14537 SEDGW034 New York Workers' Lexington, KY 40512 Compensation Sedgwick Po Box 14666 SEDGW093 New York Workers' Lexington, KY 40512 Compensation SEDGWICK 111 WESTPORT PLAZA SCMS12 New York Workers' SUITE 900 Compensation ST LOUIS, MO 63146-3011 SEDGWICK 1555 W PALM BEACH SEDGW084 New York Workers' W PALM BEACH, FL 33406 Compensation SEDGWICK 1801 MARKET ST #10 SEDGW052 New York Workers' PENN CTR, 5TH FLOOR Compensation PHILADELPIA, PA 19103 SEDGWICK 600 GRANT ST SEDGW048 New York Workers' USX TOWER SUITE 1160 Compensation PITTSBURGH, PA 15219 SEDGWICK PO BOX 14017 SEDGW069 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14151 SEDGW081 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14153 SEDGW079 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14434 SEDGW107 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14436 SEDGW092 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14440 SEDGW068 New York Workers' LEXINGTON, KY 40509 Compensation SEDGWICK PO BOX 14441 SEDGW083 New York Workers' LEXINGTON, KY 40512-4441 Compensation SEDGWICK PO BOX 14484 SEDGW011 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14498 SEDGW098 New York Workers' LEXINGTON, KY 40512 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SEDGWICK PO BOX 14498 SEDGW099 Other WC (Non-NY) LEXINGTON, KY 40512 SEDGWICK PO BOX 14514 SEDGW119 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14531 SEDGW088 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14538 SEDGW113 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14541 SEDGW112 Other WC (Non-NY) LEXINGTON, KY 40512 SEDGWICK PO BOX 14667 SEDGW114 Other WC (Non-NY) LEXINGTON, KY 40512 SEDGWICK PO BOX 14670 SEDGW089 New York Workers' LEXINGTON, NY 40512 Compensation SEDGWICK PO BOX 34660 SEDGW120 Other WC (Non-NY) LAS VEGAS, NV 89133 SEDGWICK PO BOX 830 SEDGW008 New York Workers' BROOKFIELD, WI 53008 Compensation SEDGWICK PO BOX 95407 SEDGW061 New York Workers' HOFFMAN ESTATES, IL 60195 Compensation SEDGWICK 179 John Roberts Rd SCMS04 New York Workers' Ste 300 Compensation S. Portland, ME 04106 SEDGWICK 4 CORPORATE PLAZA SEJA01 New York Workers' ALBANY, NY 12203-5372 Compensation SEDGWICK PO BOX 14515 SCMS07 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 14574 SCMS06 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK PO BOX 15065 SEJA02 New York Workers' ALBANY, NY 12212 Compensation SEDGWICK PO BOX 5186 SCMS11 New York Workers' SOUTHFIELD, MI 48056 Compensation SEDGWICK PO BOX 69 SCMS10 New York Workers' SOUTHFIELD, MI 48034 Compensation SEDGWICK (LEXINGTON) PO BOX 14565 SEDGW010 New York Workers' LEXINGTON, KY 40512 Compensation Sedgwick / Cargill, Inc. [Electronic] E1275A New York Workers' , Compensation Sedgwick / Cargill, Inc. [Electronic] E1275B Auto/No-Fault , Sedgwick / Cargill, Inc. [Electronic] E1275C Other WC (Non-NY) , Sedgwick / Liability PO Box 14452 SEDGW041 Auto/No-Fault Lexington, KY 40512 Sedgwick / WC P.O. Box 14627 SEDGW039 Other WC (Non-NY) Lexington, KY 40512 Sedgwick / WC PO Box 111189 SEDGW055 Other WC (Non-NY) Carrollton, TX 75011 Sedgwick / WC PO Box 14446 SEDGW043 Other WC (Non-NY) Lexington, KY 40512 Sedgwick / WC PO Box 14448 SEDGW044 Other WC (Non-NY) Lexington, KY 40512 Sedgwick / WC PO Box 14459 SEDGW042 Other WC (Non-NY) Lexington, KY 40512 Sedgwick / WC PO Box 14538 SEDGW045 Other WC (Non-NY) Lexington, KY 40512 SEDGWICK CLAIMS P.O BOX 94950 SEDGW104 Auto/No-Fault CLEVELAND, OH 44101 SEDGWICK CLAIMS P.O. BOX 14421 SEDGW105 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK CLAIMS CMS PO BOX 14155 SEDGW071 New York Workers' LEXINGTON, KY 40512-4155 Compensation sedgwick claims management 200 meridian centre SEDGW090 New York Workers' rochester, NY 14618 Compensation Sedgwick Claims Management - Verizon PO BOX 14454 SEDGW014 Auto/No-Fault [Electronic] LEXINGTON, KY 40512 Sedgwick Claims Mgmt Services P.O. Box 8901 SEDGW040 New York Workers' Melville, NY 11747 Compensation sedgwick cms 3 huntington quadrangle so SEDGW004 New York Workers' melville, NY 11747 Compensation Sedgwick CMS 1100 Ridgeway Loop Rd. SEDGW103 New York Workers' Memphis, TN 38120-4053 Compensation Sedgwick CMS P. O .Box 14446 SEDGW037 New York Workers' LEXINGTON, KY 40512 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Sedgwick CMS PO Box 14154 SEDGW108 New York Workers' Lexington, KY 40512 Compensation Sedgwick CMS Po Box 14491 SEDGW035 New York Workers' Lexington, KY 40512 Compensation Sedgwick CMS PO BOX 14497 SEDGW003 New York Workers' Lexington, KY 40512-4497 Compensation Sedgwick CMS PO BOX 29079 SEDGW005 New York Workers' GLENDALE, CA 91209-9079 Compensation SEDGWICK CMS P.O. BOX 14516 SEDGW110 New York Workers' LEXINGTON, KY 40512-4516 Compensation SEDGWICK CMS P.O.BOX 14205 SEDGW056 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK CMS PO BOX 14492 SCMS17 New York Workers' LEXINGTON, KY 40512-4492 Compensation SEDGWICK CMS PO BOX 14517 SEDGW002 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK CMS PO BOX 14532 SEDGW097 New York Workers' LEXINGTON, KY 40512 Compensation SEDGWICK CMS PO BOX 14545 SEDGW115 Auto/No-Fault LEXINGTON, KY 40512 SEDGWICK CMS PO BOX 14545 SEDGW116 Other WC (Non-NY) LEXINGTON, KY 40512 SEDGWICK CMS PO BOX 14661 SCMS21 New York Workers' LEXINGTON, KY 40512-4661 Compensation SEDGWICK CMS PO BOX 8006 SEDGW050 New York Workers' PHILADELPHIA, PA 19101 Compensation SEDGWICK CMS PO BOX 9002 SEDGW049 New York Workers' HARRISBURG, PA 17108 Compensation Sedgwick CMS - Colgate [Electronic] PO BOX 14517 SEDGW012 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick CMS / WC PO Box 14441 SEDGW038 Other WC (Non-NY) Lexington, KY 40512 Sedgwick CMS [Electronic] E0964C Other WC (Non-NY) , Sedgwick CMS Ascension Health Po Box 14562 SEDGW058 New York Workers' Lexington, KY 40512 Compensation SEDGWICK CMS/ADELPHI PO BOX 14422 SEJA04 New York Workers' DELPHI NATIONAL BENEFIT Compensation CENTER- LEXINGTON, KY 40512-4422 Sedgwick Coach [Electronic] PO BOX 14517 SEDGW030 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick Coach Audit [Electronic] PO BOX 14517 SEDGW028 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick Cola [Electronic] PO BOX 14517 SEDGW016 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick Insurance 10 East Stow Rd., Suite 100 SEDG01 Auto/No-Fault Marlton, NJ 08053 Sedgwick Insurance P.O.BOX 1326 SEDGW106 New York Workers' Buffalo, NY 14240 Compensation SEDGWICK INSURANCE 9930 W. CHEYENNE #150 SEDGW118 Other WC (Non-NY) LAS VEGAS, NV 89129 SEDGWICK- LOWE'S PO BOX 14671 SEDGW072 New York Workers' LEXINGTON, KY 40512 Compensation Sedgwick Lowe's Claims PO Box 14482 SEDGW082 New York Workers' Lexington, KY 40512-4482 Compensation SEDGWICK MANAGED - GM WC PO BOX 14607 SEJA06 New York Workers' LEXINGTON, KY 40512-4607 Compensation SEDGWICK MANAGED CARE PO BOX 14432 SEMC02 New York Workers' LEXINGTON, KY 40512-4432 Compensation SEDGWICK WC CLAIMS PO BOX 14156 SEDGW117 Other WC (Non-NY) LEXINGTON, KY 40512 SEDGWICK/SRS PO BOX 14156 SEDGW070 New York Workers' LEXINGTON, KY 40512 Compensation Sedgwick-AMEX [Electronic] PO BOX 14432 SEDGW022 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick-Bill [Electronic] 2700 NORTH MILITARY TRAIL SUITE SEDGW032 Auto/No-Fault 380 BOCA RATON, FL 33431 Sedgwick-Cigna Corporation [Electronic] PO BOX 14517 SEDGW018 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick-North Carolina [Electronic] PO BOX 14517 SEDGW020 Auto/No-Fault LEXINGTON, KY 40512 Sedgwick-Pepsi [Electronic] PO BOX 14517 SEDGW024 Auto/No-Fault LEXINGTON, KY 40512 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Sedgwick-Sunrise Sr. Living [Electronic] 5260 PARKWAY PLAZA SEDGW026 Auto/No-Fault CHARLOTTE, NC 28217 Sedwick CMS PO Box 14485 SEDWI001 Other WC (Non-NY) Lexington, KY 40512 SEEBALD & ASSOCIATES 659 OAKWOOD DR SEEBA001 New York Workers' EAST AURORA, NY 14052 Compensation Seeno Construction (Chartis) [Electronic] E0965A New York Workers' , Compensation Seeno Construction (Chartis) [Electronic] E0965C Other WC (Non-NY) , Seeno Homes [Electronic] E0966A New York Workers' , Compensation Seeno Homes [Electronic] E0966C Other WC (Non-NY) , SEGAL & BURNS P.A. 71 North Main Street SEGAL001 Auto/No-Fault Medford, NJ 08055 SEGWICK JAMES 2901 E LAKE RD BLD 2 D SEGWI001 New York Workers' ERIE, PA 16531 Compensation Sela Health Care [Electronic] E0967A New York Workers' , Compensation Sela Health Care [Electronic] E0967C Other WC (Non-NY) , SELBY & SMITH 1074 BROADWAY SELBY001 New York Workers' ALBANY, NY 12204 Compensation SELECT INSURANCE 95 MAIN ST SELEC019 New York Workers' TUCKAHOE, NY 10707 Compensation SELECT STAFFING - RISK MGMT 3820 STATE ST SSRM01 New York Workers' SANTA BARBRA, CA 93105 Compensation SELECTIVE PO BOX 7950 SELEC014 Auto/No-Fault TRENTON, NJ 08650-7950 Selective [Electronic] E7483A New York Workers' , Compensation Selective [Electronic] E7483C Other WC (Non-NY) , Selective Ins.-Corporate WC claims PO Box 7253 SELEC018 New York Workers' London, KY 40742 Compensation selective insurance p.o.box 763 SELEC020 Auto/No-Fault branchville, NJ 07826 Selective Insurance 11711 N. Meridian St. #800 SELEC005 Other WC (Non-NY) Carmel, IN 46032 Selective Insurance 1395 Yardville Hamilton Square SELEC002 Auto/No-Fault Suite 202 Hamilton, NJ 08691 Selective Insurance PO Box 7255 SELEC017 New York Workers' London, KY 40742 Compensation SELECTIVE INSURANCE P.O. BOX 7250 SELEC013 Auto/No-Fault LONDON, KY 40742 SELECTIVE INSURANCE PO BOX 158 SELEC010 Auto/No-Fault AUGUSTA, NJ 07822 SELECTIVE INSURANCE PO BOX 420 SELEC022 New York Workers' BRANCHVILLE, NJ 07826 Compensation SELECTIVE INSURANCE PO BOX 7250 SELEC021 Other WC (Non-NY) LONDON, KY 40742 SELECTIVE INSURANCE WC (NJ) PO BOX 7251 SELEC016 Other WC (Non-NY) LONDON, KY 40742 Selective Insurance` P O Box 7255 SELEC015 Other WC (Non-NY) London, KY 40742-7255 SELF FUNDING INC 5687 MAIN ST SFI01 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Self-Insured Schools of California (SISC) E0968C Other WC (Non-NY) [Electronic] , SELINGER & SELINGER ATT 1144 CLIFTON AVENUE SELIN001 Auto/No-Fault CLIFTON, NJ 07013 SELMAN AND COMPANY 6110 PARKLAND BLVD SELMA001 New York Workers' WC CLAIMS Compensation CLEVELAND, OH 441244187 Selman Breitman [Electronic] E0969A New York Workers' , Compensation Selman Breitman [Electronic] E0969C Other WC (Non-NY) , SENECA 7701 ROUNDPOND ROAD SENEC005 New York Workers' NORTH SYRACUSE, NY 13212 Compensation SENECA ALLEGHANY CASINO 777 SENECA ALLEGHANY BLVD SENEC009 New York Workers' SALAMANCA, NY 14779 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SENECA BEVERAGE CORP 388 UPPER OAKWOOD SENEC002 New York Workers' PO BOX 148 Compensation ELMIRA, NY 14902 SENECA CAYUGA ARC 1083 WATERLOO GENEVA RD SCA01 New York Workers' WATERLOO, NY 13165 Compensation SENECA CO SELF INSURED PLAN 1 DIPRONIO DR SCSI01 New York Workers' WATERLOO, NY 13165 Compensation SENECA COUNTY SELF INSURANCE 1 DIPRONIO DR SENEC008 New York Workers' WATERLOO, NY 13165 Compensation Seneca Falls School 2 Butler Ave SENEC006 New York Workers' Seneca Falls, NY 13148 Compensation SENECA GAMING AND ENTERTAINMENT 310 4TH STREET ATTN: AMY SENEC003 New York Workers' SHERIDAN Compensation NIAGARA FALLS, NY 14303 SENECA HOSE 2829 SENECA ST SENEC007 New York Workers' BUFFALO, NY 14224 Compensation SENECA INSURANCE COMPANY INC 160 WATER ST SENC01 New York Workers' NEW YORK, NY 10038-4922 Compensation SENECA MEADOWS 1786 SALCMAN RD SEM01 New York Workers' WATERLOO, NY 13165 Compensation SENECA NATION HEALTH DEPARTMENT PO BOX 480 SENC02 New York Workers' SALAMANCA, NY 14779 Compensation SENECA NURSING & REHAB 200 DOUGLAS DR SNR01 New York Workers' WATERLOO, NY 13165 Compensation Seneca Pipe & Paving 184 Ovid Street SENEC004 New York Workers' Seneca Falls, NY 13148 Compensation SENECA STEEL 12130 SPRINGVILLE BOSTON RD SENEC010 New York Workers' SPRINGVILLE, NY 14141 Compensation Seneca View Nursing Home 220 Steuben Street SENEC001 New York Workers' Montour Falls, NY 14865 Compensation Sentinal 516 N. Charles St SENTI001 New York Workers' Suite 305 Compensation Baltimore, MD 21201 Sentinel Insurance 1274 Bailey Ave SENTI004 New York Workers' Buffalo, NY 14206 Compensation SENTINEL INSURANCE CO LTD 690 ASYLUM AVE SICI01 New York Workers' HARTFORD, CT 06105-9701 Compensation SENTINEL INSURANCE CO, LTD C/O MURRAY SECURUS SENTI003 Other WC (Non-NY) PO BOX 1728 LANCASTER, PA 17068-1728 Sentinel Insurance Company One Hartford Plaza SENTI002 New York Workers' Hartford, CT 06155 Compensation Sentry PO Box 8042 SENTR015 Auto/No-Fault Stevenspoint, WI 54481 SENTRY 1800 NORTH POINT DRIVE SENI04 New York Workers' STEVENS POINT, WI 54481 Compensation SENTRY PO BOX 4944 SENI01 New York Workers' SYRACUSE, NY 13221 Compensation SENTRY PO BOX 584 SENI02 New York Workers' WESTFORD, MA 01886 Compensation SENTRY PO BOX 8032 SENI03 New York Workers' STEVENS POINT, WI 54481 Compensation Sentry Auto [Electronic] E1312B Auto/No-Fault , SENTRY CLAIM SERVICE PO BOX 584 SENTR002 Auto/No-Fault WESTFORD, MA 01886 Sentry Claims 3 Carlsisle Rd. SENTR016 New York Workers' POB 584 Compensation Westford, MA 01886 Sentry Claims Center PO Box 584 SENTR018 Other WC (Non-NY) 2 Technology Dr. Westford, MA 01886 Sentry Insurance PO Box 8032 SENTR017 Other WC (Non-NY) Stevens Point, WI 54481 SENTRY INSURANCE 204 BROADWAY SENTR001 New York Workers' BROOKLYN, NY 11211 Compensation SENTRY INSURANCE PO BOX 26363 SENI05 New York Workers' RICHMOND, VA 23260 Compensation SENTRY INSURANCE PO BOX 8041 SENTR019 Auto/No-Fault STEVENSPOINT, WI 544810000 Sentry Insurance [Electronic Indirect] 204 BROADWAY SENTR006 New York Workers' BROOKLYN, NY 11211 Compensation Sentry Insurance [Electronic Indirect] 204 BROADWAY SENTR009 Auto/No-Fault BROOKLYN, NY 11211 Sentry Insurance [Electronic Indirect] 204 BROADWAY SENTR012 Other WC (Non-NY) BROOKLYN, NY 11211 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Sentry Insurance [Electronic Indirect] PO BOX 26363 SENTR007 New York Workers' RICHMOND, VA 23260 Compensation Sentry Insurance [Electronic Indirect] PO BOX 26363 SENTR010 Auto/No-Fault RICHMOND, VA 23260 Sentry Insurance [Electronic Indirect] PO BOX 26363 SENTR013 Other WC (Non-NY) RICHMOND, VA 23260 Sentry Insurance [Electronic Indirect] PO Box 8021 SENTR008 New York Workers' Davenport, IA 52808 Compensation Sentry Insurance [Electronic Indirect] PO Box 8021 SENTR011 Auto/No-Fault Davenport, IA 52808 Sentry Insurance [Electronic Indirect] PO Box 8021 SENTR014 Other WC (Non-NY) Davenport, IA 52808 Sentry Insurance [Electronic] E5077C Other WC (Non-NY) , SENTRY INSURANCE CO PO BOX 26363 SENTR003 Auto/No-Fault 1025 BOULDERS PKWY RICHMOND, VA 23260-6363 Sentry Select Ins. / AIS PO BOX 5038 SENTR005 Auto/No-Fault Woodbridge, NJ 07095 Sentry/ AIS 485 D Route 1 South SENTR004 New York Workers' Ste: 220 - attn: diversified account Compensation Iselin, NJ 08830 Sentz Carlson Agency Inc 84 Sweeney Street SENTZ001 New York Workers' North Tonawanda, NY 14120 Compensation SEPTA 1234 MARKET ST SEPTA001 New York Workers' PHILA, PA 19107 Compensation SERAFINI & SERAFINI LAW 269 PATERSON HAMBURG SERAF001 Auto/No-Fault TURNPIKE WAYNE, NJ 07470 SERMAR MANAGEMENT Suite 3100 SERMA001 New York Workers' 349 WEST COMMERICAL STREET Compensation EAST ROCHESTER, NY 14445 Service Lloyds Insurance Co [Electronic] E1276A New York Workers' , Compensation Service Lloyds Insurance Co [Electronic] E1276B Auto/No-Fault , Service Lloyds Insurance Co [Electronic] E1276C Other WC (Non-NY) , SERVICE MACHINE & TOOL CO 206 EAST MCANN BLVD SERVI003 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation SERVICE MASTER 38 Chapel St SERVI002 New York Workers' MOUNT MORRIS, NY 14510 Compensation SERVICE MASTER (HORSEHEADS) 243 OLD ITHACA RD SERVI001 New York Workers' HORSEHEADS, NY 14845 Compensation SESSLER TRUCKING 1257 STATE RT 96 SESSL002 New York Workers' WATERLOO, NY 13165 Compensation Sessler Wrecking Company 1257 Route 96 North SESSL001 New York Workers' Waterloo, NY 13165 Compensation SETTERSTIX 261 S MAIN ST SETT01 New York Workers' CATTARAUGUS, NY 11201 Compensation SEVEN CORNERS 303 CONGRESSIONAL BLVD SEVEN001 New York Workers' CARMEL, IN 46082-3370 Compensation SHANDELMAN BUILDERS 9250 KEYSTONE STREET SHAND001 New York Workers' PHILADELPHIA, PA 19114 Compensation SHAREL VENTURES 3300 MONROE AVE SHARE001 New York Workers' #14 Compensation ROCHESTER, NY 14618 Sharyland Independent School District [Electronic] E0970A New York Workers' , Compensation Sharyland Independent School District [Electronic] E0970C Other WC (Non-NY) , SHAWBUCKS 212 WEST 2ND STREET SHAWB001 New York Workers' JAMESTOWN, NY 14701 Compensation Shaws/StarMarket [Electronic] E1313A New York Workers' , Compensation Shaws/StarMarket [Electronic] E1313C Other WC (Non-NY) , SHEAKLEY COMP 1 SHEAKLEY WAY SHEAK01 New York Workers' CINCINNATI, OH 45246 Compensation SHEAKLEY COMP PO BOX 422402 SHEA01 New York Workers' CINCINNATI, OH 45242 Compensation SHEAS 646 MAIN ST SHEAS001 New York Workers' BUFFALO, NY 14202 Compensation SHEESLEY SEWER SERVICE 1862 GRAND CENTRAL AVE SHEES001 New York Workers' ELMIRA, NY 14903 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SHELDRAKE POINT WINERY 7448 COUNTY ROAD 153 SHELD001 New York Workers' OVID, NY 14521 Compensation SHELTER INSURANCE PO BOX 6008 SHELT001 Auto/No-Fault COLUMBIA, MO 65205 SHEPARD HILLS COUNTRY CLUB PO BOX 516 SHEPA001 New York Workers' WAVERLY, NY 14892 Compensation SHERIDAN FAMILY RESTAURANT 3901 SHERIDAN DR SHERI001 New York Workers' AMHERST, NY 14226 Compensation SHERWIN WILLIAMS PO BOX 5819 SHER01 New York Workers' CLEVELAND, OH 44101 Compensation SHOE SHOW INC PO BOX 648 SHOES001 New York Workers' CONCORD, NC 28026 Compensation SHOPRITE 583 AVENUE C SHOPR001 New York Workers' BAYONNE, NJ 07002 Compensation SHORELINE FRUIT LLC 10190 ROUTE 18 SHORE001 New York Workers' LYNDONVILLE, NY 14098 Compensation SHULMAN & SONS 197 E WASHINGTON AVE SHULM001 New York Workers' ELMIRA, NY 14901 Compensation SHURLINE FRUIT 10190 ROUTE 18 SHURL001 New York Workers' LYNDONVILLE, NY 14098 Compensation Shwangunk River Inc. 20 Gristmill Lane SHWAN001 New York Workers' Gardiner, NY 12525 Compensation SIBLEY NURSING 590 PRE EMPTION ROAD SIBLE001 New York Workers' Suite 6 Compensation GENEVA, NY 14456 SIDLER INSURANCE 304 N FRANKLIN STREET SIDLE001 New York Workers' WATKINS GLEN, NY 14891 Compensation SIDNEY ALBERT JEWISH COMMUNITY CTR 340 WHITEHALL ROAD SIDNE001 New York Workers' ALBANY, NY 12208 Compensation SIEGER AND SMITH 700 WHITE PLAINS RD SIEGE001 New York Workers' SCARSDALE, NY 10583 Compensation Sierra Claim Service 228 Park Ave South SIERR002 New York Workers' #43584 Compensation New York, NY 10003 SIERRA CLAIM SERVICE 228 PARK AVENUE SOUTH # 43584 SIERR001 Auto/No-Fault NEW YORK, NY 10003 Sierra Nevada Memorial [Electronic] E0971A New York Workers' , Compensation Sierra Nevada Memorial [Electronic] E0971C Other WC (Non-NY) , SIGMA INTERNATIONAL 711 PARK AVENUE SIGMA001 New York Workers' MEDINA, NY 14103 Compensation Silberberger Engn [Electronic] E0972A New York Workers' , Compensation Silberberger Engn [Electronic] E0972C Other WC (Non-NY) , SILICON CARBIDE PRODUCTS 361 DANIEL ZENKER DR SILIC001 New York Workers' HORSEHEADS, NY 14845 Compensation SILK ROAD TRANSPORT 8781 STATE ROUTE 36 SILKR001 New York Workers' ARKPORT, NY 14807 Compensation SILVER LEGACY NELSON DAVISON ADMIN SILVE002 Other WC (Non-NY) PO BOX 12338 RENO, NV 89510 SILVERMAN AND ROEDEL LLC 1187 MAIN AVENUE SUITE 2C SILVE001 Auto/No-Fault CLIFTON, NJ 07011 SIMMONS MACHINE TOOLS 1700 NO. BROADWAY SIMMO001 New York Workers' ALBANY, NY 12204 Compensation SIMMONS-ROCKWELL FORD INC. 1160 COUNTY ROUTE 66 SIMMO002 New York Workers' HORNELL, NY 14843 Compensation SIMON ELECTRIC 367 ELLICOTT ST SIMON001 New York Workers' BUFFALO, NY 14203 Compensation SIMON SARVER&R LEWKOWICZ 1 PASSAIC AVENUE SIMON002 Auto/No-Fault FAIRFIELD, NJ 07004-3814 SITEL 101 CANADA ROAD SITEL001 New York Workers' PAINTED POST, NY 14870 Compensation SJB SERVICES, INC 5167 PARK AVE SJB01 New York Workers' HAMBURG, NY 14075 Compensation SKB Corporation [Electronic] E0973A New York Workers' , Compensation SKB Corporation [Electronic] E0973C Other WC (Non-NY) , SKF AERO ENGINE 1 MOROCCO RD SKFAE001 New York Workers' FALCONER, NY 14733 Compensation SKF SELF INSURED 1 MAROCO ROAD SKF01 New York Workers' FALCONER, NY 14733 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SKYCHIEFS 1 BLUE JAYS WAY SKY01 New York Workers' TORONTO, ON M5V1J Compensation Skylands Insurance 33 Washington St., 11th Fl SKYLA002 Auto/No-Fault Newark, NJ 07102 SKYWAY ROOFING 1268 BROADWAY SKYWA001 New York Workers' ALBANY, NY 12204 Compensation SLATTERY SKANSKA 1616 WHITESTONE EXP SLATT001 New York Workers' WHITESTONE, NY 113573055 Compensation SLOAN FIRE CO 151 WASNER AVE SLOAN001 New York Workers' SLOAN, NY 14212 Compensation SLONE MELHUISH PO BOX 878 SLONE001 New York Workers' JAMESTOWN, NY 14702 Compensation SM Communications 899 Pardee Rd SMCOM001 Other WC (Non-NY) Campti, LA 71411 Smart and Final [Electronic] E1128A New York Workers' , Compensation Smart and Final [Electronic] E1128B Auto/No-Fault , Smart and Final [Electronic] E1128C Other WC (Non-NY) , SMART SYSTEMS INCORPORATED 320 E WASHINGTON STREET SMART001 New York Workers' BATH, NY 14810 Compensation SMC METAL 95 MT READ BLVD SMCME001 New York Workers' STE 159 Compensation ROCHESTER, NY 14611 Smith Boys 280 Michigan St SMITH001 New York Workers' North Tonawanda, NY 14120 Compensation SMITH'S CONSTRUCTION 2383 ROUTE 11 SMITH002 New York Workers' LAFAYETTE, NY 13084 Compensation SMOKIN JOES 2293 SAUNDERS SETTLEMENT SMOKI001 New York Workers' ROAD Compensation SANBORN, NY 14132 Snap-On Incorporated [Electronic] E9107C Other WC (Non-NY) , SNAPTITE/OLD REPUBLIC 414 WEST PITTSBURGH ST SNAPT001 New York Workers' GREENSBURG, PA 15601 Compensation SNELL CONTRACTING 294 SANDBANK ROAD SNELL002 New York Workers' ERIN, NY 14838 Compensation SNELLING PERSONNEL SERVICES 42 W MARKET STREET SNELL001 New York Workers' CORNING, NY 14830 Compensation Sobo and Sobo 1 Dolson Ave SOBOA001 New York Workers' Middletown, NY 10940 Compensation Soldiers and Sailors Emergency 32-36 Central Avenue SOLDI001 New York Workers' Wellsboro, PA 16901 Compensation Soldiers and Sailors Hospital 32-36 Central Avenue SOLDI002 New York Workers' Wellsboro, PA 16901 Compensation SOLID SURFACE ACRYLLICS 800 WALCK RD SOLID001 New York Workers' NORTH TONAWANDA, NY 14120 Compensation SOLOMON ORGANIZATION 1A LAKEVIEW DRIVE SOLOM001 New York Workers' CLIFTON PARK, NY 12065 Compensation Solvay America Inc [Electronic] E1040C Other WC (Non-NY) , SOLVAY IRON WORKS INC 3546 WALTERS RD SOLV01 New York Workers' SYRACUSE, NY 13209 Compensation SOMPO JAPAN INSURANCE CO 777 3RD AVE SOMPO001 New York Workers' FLOOR 28 Compensation NEW YORK, NY 10017-1401 Sonic Automotive Inc. [Electronic] E9197A New York Workers' , Compensation Sonic Automotive Inc. [Electronic] E9197C Other WC (Non-NY) , Sonoma Valley Healthcare District [Electronic] E0974A New York Workers' , Compensation Sonoma Valley Healthcare District [Electronic] E0974C Other WC (Non-NY) , Sonoma Valley Hlth [Electronic] E0975A New York Workers' , Compensation Sonoma Valley Hlth [Electronic] E0975C Other WC (Non-NY) , SOPRANOS2 543 WEST RIVER STREET SOPRA001 New York Workers' NICHOLS, NY 13812 Compensation SOS STAFFING 2650 SOUTH DECKER LAKE BLVD SOSST001 New York Workers' SALT LAKE CITY, UT 84095 Compensation SOUTH BUFFALO CHARTER SCHOOL 2219 SOUTH PARK AVE SOUTH017 New York Workers' ATTN: JACK BALA Compensation BUFFALO, NY 14220 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SOUTH BUFFALO ELECTRIC 1250 BROADWAY ST SOUTH001 New York Workers' BUFFALO, NY 14212 Compensation South Coast Area Transit (CA) [Electronic] E1277A New York Workers' , Compensation South Coast Area Transit (CA) [Electronic] E1277B Auto/No-Fault , South Coast Area Transit (CA) [Electronic] E1277C Other WC (Non-NY) , South Corning Fire Department 7 Clark Street SOUTH007 New York Workers' Corning, NY 14830 Compensation South Seneca Central School 7263 Main Street SOUTH013 New York Workers' Ovid, NY 14521 Compensation SOUTH WEST GRILL 111 GRANT AVE SOUTH008 New York Workers' SUITE 210 Compensation ENDICOTT, NY 13760 SOUTHERN AUTO OWNERS 2710 WEST MEMORIAL BLVD SOUTH015 Auto/No-Fault LAKELAND, FL 33815 Southern California Edison [Electronic] E1134A New York Workers' , Compensation Southern California Edison [Electronic] E1134C Other WC (Non-NY) , Southern California Risk Management [Electronic] E1278A New York Workers' , Compensation Southern California Risk Management [Electronic] E1278B Auto/No-Fault , Southern California Risk Management [Electronic] E1278C Other WC (Non-NY) , Southern Care Hospice 190 Choate Circle SOUTH005 New York Workers' Suite 2 Compensation Montoursville, PA 17754 Southern Care Inc 190 Choate Cirle SOUTH006 New York Workers' Suite 2 Compensation Montoursville, PA 17754 Southern IL Lumber / WC PO Box 10 SOUTH010 Other WC (Non-NY) Fairfield, IL 62837 Southern Ilinois University 805 S Elizabeth SOUTH011 Other WC (Non-NY) Carbondale, IL 62901 SOUTHERN TEIR ENVIRONMENTAL 715 CENTRAL AVE SOUTH019 New York Workers' DUNKIRK, NY 14048 Compensation Southern Textile Recycling, Inc. (CA) [Electronic] E1279A New York Workers' , Compensation Southern Textile Recycling, Inc. (CA) [Electronic] E1279B Auto/No-Fault , Southern Textile Recycling, Inc. (CA) [Electronic] E1279C Other WC (Non-NY) , Southern Tier Brewing Co 2072 Stoneman Circle SOUTH002 New York Workers' Lakewood, NY 14750 Compensation SOUTHERN TIER CUSTOM FAB 1322 COLLEGE AVE SOUTH003 New York Workers' ELMIRA, NY 14902 Compensation SOUTHERN TIER HIDE AND TALLOW 3385 LOWER MAPLE AVE SOUTH004 New York Workers' Apt A Compensation ELMIRA, NY 14901 SOUTHERN TIER INSULATIONS INC 3150 BUCKINGHAM ROAD SOUTH014 New York Workers' Endwell, NY 13760 Compensation SOUTHERN TIER LOGISTICS PO BOX 387 SOUTH012 New York Workers' PAINTED POST, NY 14870 Compensation SOUTHERN TIER PERMASIDE 558 OLD FRONT ST. SOUTH018 New York Workers' BINGHAMTON, NY 13905 Compensation SOUTHERN TIER RECYCLERS, INC PO BOX 550 SOUTH009 New York Workers' 352 GLENMARY DRIVE Compensation OWEGO, NY 13827 SOUTHTOWN DOOR 400 VULCAN STREET SOUTH016 New York Workers' BUFFALO, NY 14207 Compensation Southwest Airlines (SWA) [Electronic] E7097C Other WC (Non-NY) , Southwest Gas Corporation [Electronic] E0976A New York Workers' , Compensation Southwest Gas Corporation [Electronic] E0976C Other WC (Non-NY) , Sovena USA 1 Olive Grove St. SOVEN001 New York Workers' Rome, NY 13441 Compensation SP Net PO Box 621080 SPNET001 New York Workers' Cincinnati, OH 45262-1080 Compensation Spain Agency 625 U.S 6 SPAIN001 New York Workers' Mahopac, NY 10541 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SPARTA INSURANCE 185 ASYLUM STREET SPART001 New York Workers' HARTFORD, CT 06103 Compensation Special Fund Conservation PO Box 5301 SPECI028 New York Workers' Binghamton, NY 13902 Compensation SPECIAL FUNDS 2875 UNION RD SPECI034 New York Workers' STE 3510 Compensation CHEEKTOWAGA, NY 14227 SPECIAL FUNDS 60 East 42nd Street SPFU04 New York Workers' 27th Floor Compensation New York, NY 10165 Special Funds [Electronic] E10000A New York Workers' , Compensation Special Funds [Electronic] E10000C Other WC (Non-NY) , SPECIAL FUNDS CONSERVATION PO BOX 5301 SPECI032 Other WC (Non-NY) BINGHAMTON, NY 13902 Special Funds Conservation Committee PO BOX 5311 SPECI027 New York Workers' Binghamton, NY 13902 Compensation SPECIAL FUNDS CONSERVATION COMMITTTEE PO BOX 5304 SPECI024 New York Workers' BINGHAMTON, NY 13902 Compensation SPECIAL FUNDS-ALB PO BOX 5312 SPECI023 New York Workers' BINGHAMTON, NY 13902 Compensation SPECIAL RISK CLAIMS 70 GENESEE ST SRC01 New York Workers' UTICA, NY 13502 Compensation SPECIALITY RISK SERVICES LLC P.O.BOX 61513 SPECI006 New York Workers' KING OF PRUSSIA, PA 19406 Compensation SPECIALTY CLAIM SERVICES PO BOX 188 SPECI031 Other WC (Non-NY) WALLINGFORD, PA 19086-0188 Specialty Coffee [Electronic] E0977A New York Workers' , Compensation Specialty Coffee [Electronic] E0977C Other WC (Non-NY) , Specialty Risk / WC P.O. Box 790066 SPECI008 Other WC (Non-NY) Saint Louis, MO 63179 Specialty Risk Services PO Box 14151 SPECI012 Auto/No-Fault Lexington, KY 40512 Specialty Risk Services po box 14154 SPECI011 Other WC (Non-NY) Lexington, KY 40512 Specialty Risk Services PO BOX 14214 SPECI010 Other WC (Non-NY) Lexington, KY 40512 SPECIALTY RISK SERVICES 150 SOUTH WARNER ROAD SPECI015 New York Workers' KING OF PRUSSIA, PA 19406 Compensation SPECIALTY RISK SERVICES PO BOX 14152 SPECI029 New York Workers' Lexington, KY 40512 Compensation SPECIALTY RISK SERVICES PO BOX 14152 SPECI033 Other WC (Non-NY) Lexington, KY 40512 Specialty Risk Services / WC P.O. Box 14205 SPECI007 Other WC (Non-NY) Lexington, KY 40512 Specialty Risk Services / WC PO Box 14155 SPECI019 Other WC (Non-NY) Lexington, KY 40512 SPECIALTY SERVICES 1101 MARKET ST SPS01 New York Workers' 13TH FL Compensation PHILADELPHIA, PA 19107 Specialty Silicon Products 3 McCrea HIll Road SPECI002 New York Workers' Ballston Spa, NY 12020 Compensation SPECIALTY SUPPORT 2100 HARTEL ST SPECI014 New York Workers' LEVITTOWN, PA 19057 Compensation SPECIALTY SURPLUS INSURANCE CO ONE KEMPER DRIVE SSIC01 New York Workers' LONG GROVE, IL 60049-0001 Compensation SPECIALTY WELDING AND FABRICATORS PO BOX 145 SPECI030 New York Workers' SYRACUSE, NY 13211 Compensation SPEED GLOBAL SERVICES 229 KENMORE AVE SPEED003 New York Workers' BUFFALO, NY 14217 Compensation SPEED MOTOR EXPRESS PO BOX 738 SPEED001 New York Workers' KENMORE, NY 14217 Compensation Speed Transportation P.O. Box 738 SPEED002 New York Workers' Kenmore, NY 14217 Compensation SPENCER SHURFINE FOOD MART 15 NORTH MAIN STREET SPENC003 New York Workers' SPENCER, NY 14883 Compensation SPENCER VANETTEN CFD 16 DARTTS CROSSROAD SPENC001 New York Workers' PO BOX 307 Compensation SPENCER, NY 14883 Spencerport Fire District PO BOX 359 SPENC002 New York Workers' ATTN: TOM FRIEDO Compensation SPENCERPORT, NY 14559 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID SPERRY RAIL SERVICE 46 SHELTER ROCK RD SPERR001 New York Workers' DANBURY, CT 06810 Compensation Spooner's Woodworks [Electronic] E0978A New York Workers' , Compensation Spooner's Woodworks [Electronic] E0978C Other WC (Non-NY) , SPRAGUE INSURANCE PO BOX 98 SPRAG001 New York Workers' CORNING, NY 14830 Compensation SPREEMO 33-41 NEWARK ST STE 4A SPREE001 New York Workers' HOBOKEN, NJ 07030 Compensation SPREEMO INSURANCE 33-41 NEWARK STREET SUITE 4-A SPREE002 Auto/No-Fault HOBOKEN, NJ 07030 Spring Creek Point Break P.O. Box 25 SPRIN001 New York Workers' Springville, NY 14141 Compensation SPS TEMP WORKERS COMPENSATION 135 SPSTE001 New York Workers' DELAWARE AVE Compensation BUFFALO, NY 14202 SRI FIRE SPRINKLER 1060 CENTRAL AVENUE SRIFI001 New York Workers' ALBANY, NY 12205 Compensation SRS(LEXINGTON) PO BOX 14214 SRSLE001 New York Workers' LEXINGTON, KY 40512 Compensation ST BARNABAS COMM ENTER INC 11 BEACH STREET STBAR001 New York Workers' 8TH FL Compensation NEW YORK, NY 10013 ST JAMES MERCY HOSPITAL 411 CANISTEO STREET STJAM001 New York Workers' ATTN GAIL WEIR Compensation HORNELL, NY 14843 St Joseph Emergency Room 555 E Market Street STJOS002 New York Workers' Elmira, NY 14902 Compensation St Joseph ER Carbondale 100 Lincoln Ave STJOS003 New York Workers' Carbondale, PA 18407 Compensation St Joseph Rehab 555 East Market Street STJOS005 New York Workers' Elmira, NY 14902 Compensation ST JOSEPHS HOSPITAL 555 EAST MARKET STREET STJOS001 New York Workers' ELMIRA, NY 14902 Compensation St Jospeh Skilled Nursing Unit 555 East Market Street STJOS006 New York Workers' Elmira, NY 14902 Compensation St Lawrence-Lewis Counties Workers' Comp PO BOX 646 STLAW001 New York Workers' CANTON, NY 13617 Compensation ST PETER'S PREP 144 GRAND STREET STPET001 New York Workers' JERSEY CITY, NJ 07302 Compensation ST. ANNE'S INSTITUTE 160 NORTH MAIN AVENUE STANN001 New York Workers' ALBANY, NY 12206 Compensation ST. CAMILLUS 813 FAY ROAD STCAM001 New York Workers' SYRACUSE, NY 13219 Compensation ST. JOHNS HOME 150 HIGHLAND AVENUE STJOH001 New York Workers' ROCHESTER, NY 14620 Compensation St. Lawrence WC Self Ins. 48 COURT ST STLS01 New York Workers' CANTON, NY 13617 Compensation St. Louis Cardinals 3500 REYNOLD RD STLOU001 New York Workers' LAKELAND, FL 33803 Compensation St. Mary's Hospital ATT: Kelly Flewelling STMAR001 New York Workers' 427 Guy Park Ave. Compensation Amsterdam, NY 12010 St. Rose Hospital [Electronic] E0979A New York Workers' , Compensation St. Rose Hospital [Electronic] E0979C Other WC (Non-NY) , ST.COLMANS HOME 11 HASWELL ROAD STCOL001 New York Workers' WATERVLIET, NY 12189 Compensation STACK VETERINARY HOSPITAL 5092 VELASKO ROAD STACK001 New York Workers' SYRACUSE, NY 13215 Compensation STAFF SOURCE 258 GENESEE ST STSO01 New York Workers' STE 103 Compensation UTICA, NY 13502 STAFFKINGS PO BOX 1015 STAFF002 New York Workers' BINGHAMTON, NY 13902 Compensation Staffworks 600 French Road STAFF001 New York Workers' New Hartford, NY 13413 Compensation STAFKINGS 319 West Water St STAFK003 New York Workers' Elmira, NY 14901 Compensation STAFKINGS PO BOX 1015 STAFK002 New York Workers' BINGHAMTON, NY 13902 Compensation STAFKINGS Personnel Systems PO BOX 1015 STAFK001 New York Workers' ATTN: DEANNA COBB Compensation BINGHAMTON, NY 13902 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Stahlka Agency Inc. 21 Princeton Place Ste 105 STAHL001 New York Workers' Orchard Park, NC 14217 Compensation STAKMORE CO INC 30 ELM STREET STAKM001 New York Workers' OWEGO, NY 13827 Compensation Standard Forwarding [Electronic] E4492C Other WC (Non-NY) , Standard Fruit & Veg [Electronic] E0980A New York Workers' , Compensation Standard Fruit & Veg [Electronic] E0980C Other WC (Non-NY) , Standard Life Insurance 85 Allen Street, Suite 210 STAND003 New York Workers' Rochester, NY 14608 Compensation Standard Life Insurance WC P.O. Box 5031 STAND002 New York Workers' White Plains, NY 10602 Compensation standard security po box 25339 STAND001 New York Workers' farmington, NY 14425 Compensation STANLEY FALK SCHOOL 1 CAMBRIDGE ST STANL001 New York Workers' BUFFALO, NY 14223 Compensation Stanley Works, Inc. [Electronic] E9970A New York Workers' , Compensation Stanley Works, Inc. [Electronic] E9970C Other WC (Non-NY) , Stant Corporation [Electronic] E8369C Other WC (Non-NY) , stantec consulting service 2060 brighton-henrietta townline STANT001 New York Workers' road Compensation rochester, NY 14623 STAPLES 125 MUSHROOM BLVD STAPL001 New York Workers' ROCHESTER, NY 14623 Compensation STAR ADMIN PO BOX 5086 STARA001 New York Workers' SOUTHFIELD, MI 480865086 Compensation Star Concrete PO Box 138 STARC001 New York Workers' Point of Rock, MD 21777 Compensation STAR INSURANCE CO 9201 STAE LINE RD STARI001 New York Workers' KANSAS CITY, MO 64114 Compensation STAR INSURANCE COMPANY 26255 AMERICAN DRIVE STAR01 New York Workers' SOUTHFIELD, MI 48034-6112 Compensation STAR SNACKS 105 HARBORSIDE DRIVE STARS001 New York Workers' JERSEY CITY, NJ 07305 Compensation STARBUCKS P O BOX 6570 STARB001 New York Workers' SCRANTON, PA 18503 Compensation STARFIRE SWORDS LTD 74 RAILROAD AVENUE STARF001 New York Workers' ATTN: SANDY Compensation SPENCER, NY 14883 STATE ACC FUND PO BOX 102100 STAF01 New York Workers' COLUMBIA, SC 29221 Compensation State Auto / WC P.O. Box 7183 STATE021 Other WC (Non-NY) Indianapolis, IN 46206 STATE AUTO INSURANCE PO BOX 6165 STATE119 Auto/No-Fault INDIANAPOLIS, IN 46206-6165 State Comp Fund of AZ PO Box 33069 STATE088 Other WC (Non-NY) Phoenix, AZ 85067 STATE COMP INS FUND PO BOX 3171 STATE139 New York Workers' SUISIN CITY, CA 94585-6171 Compensation STATE COMP INS FUND PO BOX 65005 STCI01 New York Workers' Pinedale, CA 93650-5005 Compensation STATE COMPENSATION INS PO BOX 92622 STATE098 New York Workers' LOS ANGELES, CA 92103 Compensation State Compensation Ins Fund 6000 State Farm Dr STATE170 New York Workers' Rohnert Park, CA 94928-2133 Compensation STATE COMPENSATION INSURANCE FUND (SCIF) P.O. BOX 3171 STATE178 Other WC (Non-NY) SUISUN CITY, CA 94584 State Compensation Insurance Fund (SCIF) E2229A New York Workers' [Electronic] , Compensation State Compensation Insurance Fund (SCIF) E2229C Other WC (Non-NY) [Electronic] , State Farm Po Box 106107 STATE171 Auto/No-Fault Atlanta, GA 30348 State Farm Po Box 106107 STATE185 Other WC (Non-NY) Atlanta, GA 30348 STATE FARM 819 MAIN STREET STATE191 Auto/No-Fault EXT. 60 WINDSOR, CO 80550 STATE FARM P O BOX 106134 STATE184 Auto/No-Fault ATLANTA, GA 303486134 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID STATE FARM PO BOX 8013 STATE189 Auto/No-Fault BALLSTON SPA, NY 12020 STATE FARM [Electronic Indirect] 300 KIMBALL DR STATE024 New York Workers' PO BOX 911 Compensation Parsippany, NJ 07054 STATE FARM [Electronic Indirect] 300 KIMBALL DR STATE025 Auto/No-Fault PO BOX 911 Parsippany, NJ 07054 STATE FARM [Electronic Indirect] 300 KIMBALL DR STATE026 Other WC (Non-NY) PO BOX 911 Parsippany, NJ 07054 STATE FARM [Electronic Indirect] 900 Old River RD STATE030 New York Workers' Bakersfield, CA 93311 Compensation STATE FARM [Electronic Indirect] 900 Old River RD STATE031 Auto/No-Fault Bakersfield, CA 93311 STATE FARM [Electronic Indirect] 900 Old River RD STATE032 Other WC (Non-NY) Bakersfield, CA 93311 STATE FARM [Electronic Indirect] Centralized Medical Unit STATE027 New York Workers' P.O. Box 3020 Compensation Newark, OH 43058 STATE FARM [Electronic Indirect] Centralized Medical Unit STATE028 Auto/No-Fault P.O. Box 3020 Newark, OH 43058 STATE FARM [Electronic Indirect] Centralized Medical Unit STATE029 Other WC (Non-NY) P.O. Box 3020 Newark, OH 43058 STATE FARM [Electronic Indirect] ONE STATE FARM PLAZA STATE033 New York Workers' BLOOMINGTON, IL 61701 Compensation STATE FARM [Electronic Indirect] ONE STATE FARM PLAZA STATE034 Auto/No-Fault BLOOMINGTON, IL 61701 STATE FARM [Electronic Indirect] ONE STATE FARM PLAZA STATE035 Other WC (Non-NY) BLOOMINGTON, IL 61701 STATE FARM [Electronic Indirect] PO BOX 1003 STATE036 New York Workers' DULUTH, GA 30096 Compensation STATE FARM [Electronic Indirect] PO BOX 1003 STATE037 Auto/No-Fault DULUTH, GA 30096 STATE FARM [Electronic Indirect] PO BOX 1003 STATE038 Other WC (Non-NY) DULUTH, GA 30096 STATE FARM [Electronic Indirect] PO Box 2361 STATE039 New York Workers' Bloomington, IL 61702 Compensation STATE FARM [Electronic Indirect] PO Box 2361 STATE040 Auto/No-Fault Bloomington, IL 61702 STATE FARM [Electronic Indirect] PO Box 2361 STATE041 Other WC (Non-NY) Bloomington, IL 61702 STATE FARM [Electronic Indirect] Po box 2363 STATE042 New York Workers' Bloomington, IL 61702-2363 Compensation STATE FARM [Electronic Indirect] Po box 2363 STATE043 Auto/No-Fault Bloomington, IL 61702-2363 STATE FARM [Electronic Indirect] Po box 2363 STATE044 Other WC (Non-NY) Bloomington, IL 61702-2363 STATE FARM [Electronic Indirect] PO BOX 41 STATE045 New York Workers' CONCORDVILLE, PA 19331 Compensation STATE FARM [Electronic Indirect] PO BOX 41 STATE046 Auto/No-Fault CONCORDVILLE, PA 19331 STATE FARM [Electronic Indirect] PO BOX 41 STATE047 Other WC (Non-NY) CONCORDVILLE, PA 19331 STATE FARM [Electronic Indirect] PO Box 8000 STATE051 New York Workers' Ballston Spa, NY 12020 Compensation STATE FARM [Electronic Indirect] PO Box 8000 STATE052 Auto/No-Fault Ballston Spa, NY 12020 STATE FARM [Electronic Indirect] PO Box 8000 STATE053 Other WC (Non-NY) Ballston Spa, NY 12020 STATE FARM [Electronic Indirect] PO BOX 8011 STATE078 New York Workers' BALLSTON SPA, NY 12020 Compensation STATE FARM [Electronic Indirect] PO BOX 8011 STATE079 Auto/No-Fault BALLSTON SPA, NY 12020 STATE FARM [Electronic Indirect] PO BOX 8011 STATE080 Other WC (Non-NY) BALLSTON SPA, NY 12020 STATE FARM [Electronic Indirect] PO BOX 8016 STATE075 New York Workers' BALLSTON SPA, NY 12020 Compensation STATE FARM [Electronic Indirect] PO BOX 8016 STATE076 Auto/No-Fault BALLSTON SPA, NY 12020 STATE FARM [Electronic Indirect] PO BOX 8016 STATE077 Other WC (Non-NY) BALLSTON SPA, NY 12020 STATE FARM [Electronic Indirect] PO BOX 8020 STATE072 New York Workers' BALLSTON SPA, NY 12020-8020 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID STATE FARM [Electronic Indirect] PO BOX 8020 STATE073 Auto/No-Fault BALLSTON SPA, NY 12020-8020 STATE FARM [Electronic Indirect] PO BOX 8020 STATE074 Other WC (Non-NY) BALLSTON SPA, NY 12020-8020 STATE FARM [Electronic Indirect] PO Box 820 STATE069 New York Workers' Ballston Spa, NY 12020 Compensation STATE FARM [Electronic Indirect] PO Box 820 STATE070 Auto/No-Fault Ballston Spa, NY 12020 STATE FARM [Electronic Indirect] PO Box 820 STATE071 Other WC (Non-NY) Ballston Spa, NY 12020 STATE FARM [Electronic Indirect] PO BOX 905 STATE066 New York Workers' Parsippany, NJ 07054 Compensation STATE FARM [Electronic Indirect] PO BOX 905 STATE067 Auto/No-Fault Parsippany, NJ 07054 STATE FARM [Electronic Indirect] PO BOX 905 STATE068 Other WC (Non-NY) Parsippany, NJ 07054 STATE FARM [Electronic Indirect] PO Box 92 STATE063 New York Workers' Concordville, PA 19331-0092 Compensation STATE FARM [Electronic Indirect] PO Box 92 STATE064 Auto/No-Fault Concordville, PA 19331-0092 STATE FARM [Electronic Indirect] PO Box 92 STATE065 Other WC (Non-NY) Concordville, PA 19331-0092 STATE FARM [Electronic Indirect] PO BOX 926 STATE060 New York Workers' Parsippany, NJ 07054 Compensation STATE FARM [Electronic Indirect] PO BOX 926 STATE061 Auto/No-Fault Parsippany, NJ 07054 STATE FARM [Electronic Indirect] PO BOX 926 STATE062 Other WC (Non-NY) Parsippany, NJ 07054 STATE FARM [Electronic Indirect] PO Box 953 STATE057 New York Workers' Frederick, MD 21705 Compensation STATE FARM [Electronic Indirect] PO Box 953 STATE058 Auto/No-Fault Frederick, MD 21705 STATE FARM [Electronic Indirect] PO Box 953 STATE059 Other WC (Non-NY) Frederick, MD 21705 STATE FARM [Electronic Indirect] PO Box 9608 STATE054 New York Workers' Winterhaven, FL 33883 Compensation STATE FARM [Electronic Indirect] PO Box 9608 STATE055 Auto/No-Fault Winterhaven, FL 33883 STATE FARM [Electronic Indirect] PO Box 9608 STATE056 Other WC (Non-NY) Winterhaven, FL 33883 State Farm [Electronic] E3276A New York Workers' , Compensation State Farm [Electronic] E3276B Auto/No-Fault , State Farm [Electronic] E3276C Other WC (Non-NY) , State Farm Auto Po Box 106105 STATE172 Auto/No-Fault Atlanta, GA 30348 STATE FARM AZ PO BOX 52270 STATE183 Auto/No-Fault PHOENIX, AZ 850722270 STATE FARM FIRE CASUALTY COMPANY C/O STATE FARM INSURANCE STATE164 Other WC (Non-NY) PO BOX 106110 ATLANTA, GA 30348-6110 STATE FARM INS PO BOX 106110 STATE167 New York Workers' ATLANTA, GA 30348 Compensation State Farm Insurance po box 696044 STATE014 Other WC (Non-NY) san antonio, TX 78269 STATE FARM INSURANCE P.O. BOX 106120 STATE188 Auto/No-Fault ATLANTA, GA 303486120 STATE FARM INSURANCE PO BOX 52299 STATE180 Auto/No-Fault PHOENIX, AZ 85072 State Farm Insurance / Liability PO Box 661011 STATE123 Auto/No-Fault Dallas, TX 75266 State Farm Insurance / WC PO Box 2313 STATE081 Other WC (Non-NY) Bloomington, IL 61702 STATE FARM NORTHWEST AUTO CLAIMS PO BOX 52299 STATE182 Auto/No-Fault PHENOX, AZ 85072 STATE FUND 2952 SACRAMENTO ST STATE193 Other WC (Non-NY) BERKELEY, CA 94702 State Fund Mutual [Electronic] E8325B Auto/No-Fault , State Fund Mutual [Electronic] E8325C Other WC (Non-NY) , STATE FUND MUTUAL COMPANIES PO BOX 9416 STATE187 Other WC (Non-NY) MINNEAPOLIS,, MN 55440 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID STATE INDUSTRIAL INS PO BOX 26929 STII01 New York Workers' LAS VEGAS, NV 89126 Compensation STATE INDUSTRIAL PRODUCTS 3100 HAMILTON AVE STATE022 New York Workers' CLEVELAND, OH 44114 Compensation State Insurance Fund 8 Corporate Drive STATE177 Other WC (Non-NY) Melville, NY 11747 State Insurance Fund 935 James Street STATE007 New York Workers' Syracuse, NY 13203 Compensation STATE INSURANCE FUND 1 MARINE MIDLAND PLAZA NYSIF10 New York Workers' ROCHESTER, NY 14604 Compensation STATE INSURANCE FUND 105 CORPORATE PARK DR NYSIF09 New York Workers' SUITE 200 Compensation WHITE PLAINS, NY 10604 STATE INSURANCE FUND 159 N. FRANKLIN ST NYSIF16 New York Workers' HEMPSTEAD, NY 11550 Compensation STATE INSURANCE FUND 161 DELAWARE ST NYSIF12 New York Workers' BUFFALO, NY 14202 Compensation STATE INSURANCE FUND 524 ROUTE 303 NYSIF14 New York Workers' ORANGEBURG, NY 10962-1397 Compensation STATE INSURANCE FUND PO BOX 3922 NYSIF17 New York Workers' CHURCH ST STATION Compensation NEW YORK, NY 10008 STATE INSURANCE FUND PO BOX 3934 NYSIF11 New York Workers' UNIT 329 Compensation NEW YORK, NY 10008-3934 STATE INSURANCE FUND PO BOX 608 NYSIF18 New York Workers' PLAINVIEW, NY 11803 Compensation STATE INSURANCE FUND PO BOX 977 NYSIF15 New York Workers' PLAINVIEW, NY 11803 Compensation STATE INSURANCE FUND [Electronic] 1 WATERVLIET EXT NYSIF07 New York Workers' ALBANY, NY 12206 Compensation STATE INSURANCE FUND [Electronic] 100 CHESTNUT ST NYSIF05 New York Workers' ROCHESTER, NY 14604 Compensation STATE INSURANCE FUND [Electronic] 1045 7TH NO ST NYSIF03 New York Workers' LIVERPOOL, NY 13088 Compensation STATE INSURANCE FUND [Electronic] 15 COMPUTER DRIVE WEST NYSIF04 New York Workers' ALBANY, NY 12205 Compensation STATE INSURANCE FUND [Electronic] 2001 PERIMETER RD EAST NYSIF02 New York Workers' ENDICOTT, NY 13760 Compensation STATE INSURANCE FUND [Electronic] 225 OAK ST NYSIF01 New York Workers' BUFFALO, NY 14203 Compensation STATE INSURANCE FUND [Electronic] 701 WESTCHESTER AVE NYSIF06 New York Workers' WHITE PLAINS, NY 10604 Compensation STATE INSURANCE FUND [Electronic] 8 CORPORATE CENTER DRIVE NYSIF13 New York Workers' 2ND FLOOR Compensation MELVILLE, NY 11747 STATE INSURANCE FUND [Electronic] 8 CORPORATE CENTER DRIVE NYSIF08 New York Workers' 3RD FLOOR Compensation MELVILLE, NY 11747 STATE INSURANCE FUND OF PA 607 MAIN STREET STATE173 New York Workers' JOHNSTOWN, PA 15901 Compensation STATE LINE AUTO AUCTION 830 TALMADGE HILL ROAD SOUTH STATE008 New York Workers' PO BOX 351 Compensation WAVERLY, NY 14892 STATE NATIONAL INS. CO P.O BOX 7 STATE176 Auto/No-Fault GREENVILLE,, SC 29602 STATE NATIONAL INSURANCE COMPANY INC PO BOX 24622 SNIC01 New York Workers' FORT WORTH TEXAS, TX 76124 Compensation State of Arizona Mgmt 100 North 15th Ave STATE089 Other WC (Non-NY) Suite 301 Phoenix, AZ 85007 State of Minnesota - DOER [Electronic] E8326B Auto/No-Fault , State of Minnesota - DOER [Electronic] E8326C Other WC (Non-NY) , STATE OF NEVADA CCMSI STATE192 Other WC (Non-NY) PO BOX 4990 CARSON CITY, NV 897024990 STATE OF NJ WORKERS COMP PO BOX 381 STATE099 New York Workers' DEPT OF LABOR WC Compensation TRENTON, NJ 086250381 State of North Carolina [Electronic] E1325A New York Workers' , Compensation State of North Carolina [Electronic] E1325B Auto/No-Fault , State of North Carolina [Electronic] E1325C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID STATE OF RHOADE ISLAND 1 CAPITAL HILL STRI01 New York Workers' PROVIDENCE, RI 02908 Compensation State Office of Risk Management [Electronic] E7490C Other WC (Non-NY) , State Wide Ins Co [Electronic] PO BOX 9301 STATE011 Auto/No-Fault GARDEN CITY, NY 11530 State Wide Insurance 901 Franklin STATE141 New York Workers' Garden City, NY 11530 Compensation State Wide Insurance PO BOX 9301 STATE186 Auto/No-Fault Garden City, NY 11530 STATE WIDE INSURANCE CO 90 FRANKLIN AVENUE STATE110 Auto/No-Fault AUTO CLAIMS GARDEN CITY, NY 11530 STATE WORKERS GUARANTEE FUND C/O ACS CLAIM SERVICE STATE163 Other WC (Non-NY) PO BOX 257 MECHANICSBURG, PA 17055 STATE WORKERS' INS 444 NORTH THIRD STREET STATE096 New York Workers' 4TH FLOOR Compensation PHILADELPHIA, PA 19123 STATE WORKERS INS FD 1316 STATE STREET STATE100 New York Workers' ROOM 1 Compensation ERIE, PA 165031916 STATE WORKERS INS FUND 100 LACKAWANNA AVE STWF02 New York Workers' SCRANTON, PA 18503 Compensation STATE WORKERS INS FUND 100 LACKAWANNA AVE STATE161 Other WC (Non-NY) SCRANTON, PA 18503-1904 STATE WORKERS INS FUND 75 PENN AVENUE STATE095 New York Workers' MORRISVILLE, PA 19067 Compensation STATE WORKERS INS FUND PO BOX 5100 STWF01 New York Workers' SCRANTON, PA 18505 Compensation State Workers Insurance Fund 607 Main St. Suite 300 STATE018 New York Workers' Fisher Building Compensation Johnstown, PA 15901 STATEWIDE AQUASTORE 6010 DROTT DRIVE STATE175 New York Workers' EAST SYRACUSE, NY 13057 Compensation STAYBRIDGE SUITES 201 TOWNLEY AVE STAYB001 New York Workers' CORNING, NY 14830 Compensation Stedman's Corner Coffee 169 W. Fairmount Ave. STEDM001 New York Workers' Lakewood, NY 14750 Compensation STEIN FARMS, LLC 8343 GULLY RD STEIN001 New York Workers' LEROY, NY 14482 Compensation STELLAR TECHNOLOGIES 237 COMMERCE DRIVE STELL001 New York Workers' AMHERST, NY 14228 Compensation STERLING COOKE INS PO BOX 49228 STCO01 New York Workers' SARASOTA, FL 34230 Compensation Sterling Insurance POB 9 STERL003 Auto/No-Fault Cobleskill, NY 12043 STERLING MODULAR HOMES 5661 TRANSIT RD STERL001 New York Workers' DEPEW, NY 14043 Compensation STEUBEN ARC 6838 INDUSTRIAL PARK RD STEUB002 New York Workers' BATH, NY 14810 Compensation STEUBEN COUNTY HEALTHCARE 7009 RUMSEY STREET EXTENSION STEUB003 New York Workers' BATH, NY 14810 Compensation STEUBEN COUNTY SELF INSURANCE CORVEL CORP. 350 SOLINA STEUB004 New York Workers' MEADOW PARKWAY Compensation SUITE 150 NORTH SYRACUSE, NY 13212 STEUBEN COUNTY SOCIAL SERVICES 3 E PULTENEY SQUARE STEUB001 New York Workers' ATTN GARY BROCKWAY Compensation BATH, NY 14810 STEUBEN FOODS INC 1150 MAPLE ROAD STEUB005 New York Workers' ELMA, NY 14059 Compensation STEVE HODGES 374 GURNSPRINGS ROAD STEVE003 New York Workers' GANSEVOORT, NY 12831 Compensation STEVEN A VARANO LAW OFF 10 FURLER STREET SUITE# 2 STEVE001 Auto/No-Fault TOTOWA, NJ 07512-1828 STEVE'S HEATING AND COOLING 3001 MILITARY ROAD STEVE002 New York Workers' NIAGARA FALLS, NY 14304 Compensation STEWARTS SHOPS PO BOX 435 STEWA001 New York Workers' SARATOGA SPRINGS, NY 12866 Compensation STICKLEY FURNITURE PO BOX 480 STFU01 New York Workers' 1 STICKLEY DR Compensation MANLIUS, NY 13104 STILLA AUTOMOTIVE 1217 W. ARTESIA BLVD STILL001 New York Workers' COMPTON, CA 90220 Compensation STILSING ELECTRIC, INC. 500 SOUTH STREET STILS001 New York Workers' RENSSELAER, NY 12144 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Stimson Lumber Company - MT, OR, WA E0981A New York Workers' [Electronic] , Compensation Stimson Lumber Company - MT, OR, WA E0981C Other WC (Non-NY) [Electronic] , Stonewood Insurance Company PO Box 97308 STONE001 New York Workers' Raleigh, NC 27624 Compensation Stonington C. Club [Electronic] E0982A New York Workers' , Compensation Stonington C. Club [Electronic] E0982C Other WC (Non-NY) , STORE AMERICA 4 TECHNOLOGY BLVD STORE001 New York Workers' CANASTOTA, NY 13032 Compensation STORFLEX FIXTURE CORP(CORNING) 392 W PULTENEY STREET STORF001 New York Workers' CORNING, NY 14830 Compensation STORK H & E TURBO BLADING (ITHA 334 COMFORT ROAD STORK001 New York Workers' ITHACA, NY 14850 Compensation STRACUSE CITY SCHOOL DISTRICT 725 HARRISON STREET STRAC001 New York Workers' SYRACUSE, NY 13210 Compensation Strategic Claims Solution 120 Madison Street, Suite STRAT002 New York Workers' Chittenango, NY 13037 Compensation STRATEGIC RESOURCE CO PO BOX 1445 STRAT001 New York Workers' ALPHARETTA, GA 30009 Compensation STRATHMORE INSURANCE CO 200 MADISON AVE STRA01 New York Workers' NEW YORK, NY 10016 Compensation Streeter Association Inc 101 East Woodlawn Ave STREE002 New York Workers' PO BOX 118 Compensation Elmira, NY 14902 STROEHMANN BAKERY 11 CORCORAN STROE01 New York Workers' AUBURN, NY 13021 Compensation STROEHMANN BROS SAYRE 901 NORTH ELMER AVENUE STROE002 New York Workers' SAYRE, PA 18840 Compensation STROEHMANS BAKERY (ELMIRA) 1700 CEDAR STREET STROE003 New York Workers' ELMIRA, NY 14904 Compensation STS P.O. Box 5936 STS001 New York Workers' Bridgewater, NJ 08807 Compensation STS Trailer & Truck Equipment 3496 Court St. STSTR001 New York Workers' Syracuse, NY 13206 Compensation Suburban Adult Services 960 West Maple St SUBUR002 New York Workers' Elma, NY 14059 Compensation SUBURBAN DISPOSAL 22 TURNER DRIVE SUBUR001 New York Workers' SPENCERPORT, NY 14559 Compensation SUBWAY 12765 BROADWAY SUBWA001 New York Workers' ALDEN, NY 14004 Compensation SUE ESPINAL PO BOX 3489 SUEES001 New York Workers' BETHLEHEM, PA 18017 Compensation SUFFOLK COUNTY RISK MANAGEMENT PO BOX 6100 SCRM01 New York Workers' HAUPPAUGE, NY 11788 Compensation SUFFOLK COUNTY WATER AUTHORITY PO BOX 38 4060 SUNRISE HWY SUFFO001 New York Workers' OAKDALE, NY 11769 Compensation SUIT-KOTE 1911 LORINGS CROSSING SUITK001 New York Workers' CORTLAND, NY 13045 Compensation SULLIVAN CORRECTIONAL FACILITY PO BOX 116 SULLI001 New York Workers' 325 RIVERSIDE DR Compensation FALLSBURG, NY 12733 SUMITOMO MARINE INC PO BOX 4602 SUMA01 New York Workers' WARREN, NJ 07059 Compensation Summersville School District 79 / WC 1118 Fairfield Road SUMME001 Other WC (Non-NY) Mt. Vernon, IL 62864 SUMMIT CLAIMS PO BOX 80793 SUMMI003 New York Workers' ATTN: CYNTHIA MELANCON Compensation BATON ROUGE, LA 71040 SUMMIT EDUCATIONAL RESOURCE 150 STAHL RD SUMMI002 New York Workers' GETZVILLE, NY 14068 Compensation Summit Health Ltd [Electronic] E6224C Other WC (Non-NY) , Summit Holdings [Electronic] E7508A New York Workers' , Compensation Summit Holdings [Electronic] E7508C Other WC (Non-NY) , Summit Milk Products 61 Swift St SUMMI004 New York Workers' Waterloo, NY 13165 Compensation SUN LIFE FINANCIAL ONE SUN LIFE EXECUTIVE PARK SUNLI001 New York Workers' WELLESLEY HILLS, MA 02481 Compensation Sun Mar Healthcare [Electronic] E1283A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Sun Mar Healthcare [Electronic] E1283B Auto/No-Fault , Sun Mar Healthcare [Electronic] E1283C Other WC (Non-NY) , SUNNYSIDE CARE CENTER 7000 COLLAMER ROAD SUNNY001 New York Workers' EAST SYRACUSE, NY 13057 Compensation Sunoco 1735 Market St SUNO01 New York Workers' Suite LL Compensation Philadelphia, PA 19103 SUNOCO INC C/O SEDGWICK SUNOC001 Other WC (Non-NY) PO BOX 14151 LEXINGTON, KY 40512 Sunrise Country Club [Electronic] E0983A New York Workers' , Compensation Sunrise Country Club [Electronic] E0983C Other WC (Non-NY) , Sunshine Bulk 2094 Route 96 SUNSH001 New York Workers' Clifton Springs, NY 14432 Compensation SUNZ Insurance Company [Electronic] E1284A New York Workers' , Compensation SUNZ Insurance Company [Electronic] E1284B Auto/No-Fault , SUNZ Insurance Company [Electronic] E1284C Other WC (Non-NY) , SUPER 8 MOTEL 421 7TH NORTH STREET SUPER007 New York Workers' LIVERPOOL, NY 13088 Compensation SUPER 8 MOTEL (ITHACA) 400 SOUTH MEADOW STREET SUPER002 New York Workers' ITHACA, NY 14850 Compensation SUPERCUTS 2158 GRAND ISLAND BLVD SUPER008 New York Workers' GRAND ISLAND, NY 14072 Compensation Superior Access Ins Services [Electronic] E0984A New York Workers' , Compensation Superior Access Ins Services [Electronic] E0984C Other WC (Non-NY) , Superior Adjusters PO BOX 407193 SUPER004 Auto/No-Fault FORT LAUDERDALE, FL 33340 SUPERIOR AMBULANCE SERVICE 46 EXCHANGE STREET SUPER003 New York Workers' MARK FORREST Compensation BINGHAMTON, NY 13901 SUPERIOR CONSTRUCTION PO BOX 146 SUPER011 New York Workers' XHITTENANGO, NY 13037 Compensation Superior Enterprises 1000 Jorie Blvd Suite 228 SUPER006 Other WC (Non-NY) Oak Brook, IL 60523 Superior Industries International, Inc. [Electronic] E0985A New York Workers' , Compensation Superior Industries International, Inc. [Electronic] E0985C Other WC (Non-NY) , SUPERIOR LUBRICANTS CO, INC 32 WARD AVE SUPER001 New York Workers' N TONAWANDA, NY 14120 Compensation SUPERIOR PLUS ENERGY 1870 WINTON ROAD SOUTH SUPER009 New York Workers' SUITE 200 Compensation ROCHESTER, NY 14618 Superior Ready Mix [Electronic] E0986A New York Workers' , Compensation Superior Ready Mix [Electronic] E0986C Other WC (Non-NY) , SUPERIOR TECHNOLOGIES 200 PARAGON DR SUPER010 New York Workers' ROCHESTER, NY 14624 Compensation Supermarket Insurance Group 7050 W. 107th Street SUPER005 Auto/No-Fault Suite 210 Overland Park, KS 66212 SUPERMARKET MANAGEMENT 460 NIAGARA ST SUPMA001 New York Workers' BUFFALO , NY 14201 Compensation SUPPORT CLIAM SERVICES 125 BAYLIS ROAD SUITE 290 SUPPO001 New York Workers' MELVILLE, NY 11747 Compensation SUPPORTIVE SERVICES CORP 245 ELMWOOD AVE SUPPO002 New York Workers' BUFFALO, NY 14222 Compensation Supreme Court of California [Electronic] E1123C Other WC (Non-NY) , SURFACE FINISH TECHNOLOGIES 215 JUDSON STREET SURFA001 New York Workers' ELMIRA, NY 14901 Compensation Sutter Health [Electronic] E0987C Other WC (Non-NY) , SWECO PO BOX 15110 SWECO001 New York Workers' ODESSA, TX 79768 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Swedish Hill Vineyard 4565 State Route 414 SWEDI001 New York Workers' Romulus, NY 14541 Compensation SWIF (STATE WORKERS' INS) 1171 S CAMERON ST SWIFS001 New York Workers' RM 103 Compensation HARRISBURG, PA 17104 SWIFT GLASS PO BOX 879 SWIFT001 New York Workers' ELMIRA, NY 14902 Compensation Swift Transportation [Electronic] E4337C Other WC (Non-NY) , SYNCHRONOUS SUPPORT CTR 3830 JEFFREY BLVD SYNCH002 New York Workers' BLASDELL, NY 14219 Compensation Synergy Coverage Solutions/WC 3440 Toringdon Way Suite 300 SYNER001 Other WC (Non-NY) Charlotte, NC 28277 Synergy Ins. Co. 217 S. Tryon St. SYNER002 New York Workers' Charlotte, NC 28202 Compensation SYNTHES 35 AIRPORT ROAD SYNTH001 New York Workers' BUILDING 17-2 Compensation HORSEHEADS, NY 14845 SYR UNIV RISK MANAGEMENT SKYTOP OFFICE BUILDING SYRU01 New York Workers' RM 104 Compensation SYRACUSE, NY 13244 SYRACUSE BANANA 900 WOLF STREET SYRAC011 New York Workers' SYRACUSE, NY 13208 Compensation SYRACUSE CITY SCHOOL DISTRICT 725 HARRISON STREET SYRAC001 New York Workers' SYRACUSE, NY 13210 Compensation SYRACUSE CLAIMXCHANGE CTR PO BOX 14187 SYRAC006 New York Workers' LEXINGTON, KY 40512 Compensation Syracuse Constructors 5870 fisher Rd. SYRAC002 New York Workers' East Syracuse, NY 13057 Compensation SYRACUSE Fire & Police DEPT 511 SOUTH STATE ST SYFP01 New York Workers' SYRACUSE, NY 13202 Compensation SYRACUSE GLASS ONE GENERAL MOTORS SYRAC010 New York Workers' SYRACUSE, NY 13206 Compensation SYRACUSE HOUSING AUTHORITY 516 BURT STREET SYRAC007 New York Workers' SYRACUSE, NY 13202 Compensation Syracuse Model Neighborhood 401 South Ave SYMN01 New York Workers' Syracuse, NY 13204 Compensation Syracuse Mosaic 110 Game Rd SYRAC008 New York Workers' Syracuse, NY 13210 Compensation SYRACUSE OFFICE ENVIRONMENTS 375 ERIE BOULEVARD WEST SYRAC004 New York Workers' SYRACUSE, NY 13202 Compensation SYRACUSE SALES 124 PICKARD DRIVE EAST SYRAC003 New York Workers' SYRACUSE, NY 13211 Compensation SYSCO FOOD SERVICE 20 THEODORE CONRAD DR SYSCO001 New York Workers' JERSEY CITY, NJ 07305 Compensation System One 27 Northeast Dr SYSTE001 New York Workers' Hershey, PA 17033 Compensation SZELIGA BUILDERS PO BOX 1011 SZELI001 New York Workers' NIAGARA FALLS, NY 14304 Compensation T.H.E. Insurance [Electronic] E1124A New York Workers' , Compensation T.H.E. Insurance [Electronic] E1124B Auto/No-Fault , T.H.E. Insurance [Electronic] E1124C Other WC (Non-NY) , TAG'S SUMMER STAGE & RESTAURANT PO BOX 15 TAGSS001 New York Workers' BIG FLATS, NY 14814 Compensation TALLON DRILLING 100 LEXINGTON AVE TALLO001 New York Workers' TRENTON, NJ 08086 Compensation Tampa Bay Rays 1 Tropicana Drive TAMPA001 New York Workers' St. Petersburg, FL 33705 Compensation TAMPA WORK COMP CTR PO BOX 21607 TWCC01 New York Workers' TAMPA, FL 33622 Compensation Tan Medical Group [Electronic] E0988A New York Workers' , Compensation Tan Medical Group [Electronic] E0988C Other WC (Non-NY) , TANASEYBERT 270 SHIEFFELD STREET TANAS001 New York Workers' MOUNTAINSIDE, NJ 07092 Compensation Tanglewood Manor Attn: Human Resources TANGL001 New York Workers' 560 Fairmount Ave Compensation Jamestown, NY 14701 TAP STEEL INC PO BOX 457 TAPST001 New York Workers' CONSTABLEVILLE, NY 13225 Compensation Target Stores 3181 Chili Avenue TARGE001 New York Workers' Rochester, NY 14624 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Tarjac 2241 Mound Rd TARJA001 New York Workers' Waterloo, NY 13165 Compensation Taylor Corporation (Murphy and Beane) E0989C Other WC (Non-NY) [Electronic] , TAYLOR METAL WORKS 3925 CALIFORNIA RD TAYLO002 New York Workers' ORCHARD PARK, NY 14127 Compensation TBTA / Claims Service Bureau 21 Hempstead Avenue TBTAC001 New York Workers' PO BOX 805 Compensation Lynbrook, NY 11563 T-CAT 737 WILLOW AVENUE TCAT001 New York Workers' ITHACA, NY 14850 Compensation TCI PO BOX 83246 TCI001 New York Workers' LINCOLN, NE 68501 Compensation TD Tile [Electronic] E0990A New York Workers' , Compensation TD Tile [Electronic] E0990C Other WC (Non-NY) , TDA CONSTRUCTION 200 WHITE PLAINES ROAD TDACO001 New York Workers' TARRYTOWN, NY 10591 Compensation TECH HEALTH INC 14025 RIVEREDGE DR TEHI01 New York Workers' STE 400 Compensation TAMPA, FL 33637 TECH VALLEY ELECTRIC 357 MILTON AVENUE TECHV001 New York Workers' BALLSTON SPA, NY 12020 Compensation TECHHEALTH 14025 RIVEREDGE DRIVE SUITE# TECHH001 Auto/No-Fault 400 TAMPA, FL 33637-2203 Technical Solutions 37 Summit Avenue TECHN002 New York Workers' Walden, NY 12586 Compensation TECHNOLOGY INSURANCE PO BOX 318004 TECHN003 New York Workers' CLEVELAND, OH 44131 Compensation TED DAVIS WC P.O. BOX 459 TEDDA001 New York Workers' WINDHAM, NY 12496 Compensation Ted Hosmer Enterprises P O BOX 888 TEDHO001 New York Workers' HENRIETTA, NY 14467 Compensation Tedd Cycle, Inc 436A Robinson Avenue TEDDC001 New York Workers' Newburgh, NY 12550 Compensation Telescope Furniture 85 Church Street TELES001 New York Workers' Granville, NY 12832 Compensation Texas A&M [Electronic] E1779C Other WC (Non-NY) , Texas Association of School Boards [Electronic] E4314A New York Workers' , Compensation Texas Association of School Boards [Electronic] E4314C Other WC (Non-NY) , Texas Builders Insurance Co [Electronic] E1285A New York Workers' , Compensation Texas Builders Insurance Co [Electronic] E1285B Auto/No-Fault , Texas Builders Insurance Co [Electronic] E1285C Other WC (Non-NY) , TEXAS DEPARTMENT OF INSURANCE PO BOX 12029 TEXAS002 New York Workers' AUSTIN, TX 78711 Compensation Texas Hospital Insurance Exchange 8310 N. Capital of Texas Hwy TEXAS005 Other WC (Non-NY) STE 250 Bld 1 Austin, TX 78731 Texas Municipal League (TML) [Electronic] E2634C Other WC (Non-NY) , TEXAS MUTUAL INS PO BOX 12029 TEXAS001 New York Workers' AUSTIN, TX 78711 Compensation Texas Mutual Insurance PO BOX 12029 TEXAS003 Other WC (Non-NY) Austin, TX 78711 Texas Mutual Insurance [Electronic] E1657A New York Workers' , Compensation Texas Mutual Insurance [Electronic] E1657C Other WC (Non-NY) , Texas Political Subdivision P.O. Box 803356 TEXAS004 Other WC (Non-NY) Dallas, TX 75380 Texas Roadhouse, Inc. [Electronic] E1286A New York Workers' , Compensation Texas Roadhouse, Inc. [Electronic] E1286B Auto/No-Fault , Texas Roadhouse, Inc. [Electronic] E1286C Other WC (Non-NY) , Texas Small Business Pool [Electronic] E3690C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TGI FRIDAYS 830 COUNTY ROUTE 64 TGIFR001 New York Workers' ELMIRA, NY 14903 Compensation THALLE CONSTRUCTION 900 N.C. HIGHWAY 86 NORTH THALL001 New York Workers' HILLSBOROUGH, NC 27278 Compensation The Aquinas Institute Attn: Patti Crean THEAQ001 New York Workers' 1127 Dewey Ave Compensation Rochester, NY 14613 The Auto Club Group [Electronic] E8381B Auto/No-Fault , THE AVENUE NURSING AND REHAB CENTER 526 ALTAMONT AVENUE THEAV001 New York Workers' SCHENECTADY, NY 12303 Compensation The Barton Center WC PO Box 356 THEBA001 New York Workers' ATTN: Bonnie Compensation North Oxford, MA 01537 THE BRICKMAN GROUP LTD. 953 ROUTE 202 NORTH THEBR001 Other WC (Non-NY) BRANCHBURG, NJ 08876 THE BUFFALO CLUB 388 DELAWARE AVE THEBU001 New York Workers' BUFFALO, NY 14215 Compensation THE BUFFALO NEWS 1 NEWS PLAZA THEBU002 New York Workers' BUFFALO, NY 14203 Compensation THE CAMDEN FIRE INS ASSOC. PO BOX 9511 TCFA01 New York Workers' CANTON, MA 02021-1030 Compensation The Center for Discovery P.O. Box 840 THECE001 New York Workers' Harris, NY 12742 Compensation The Cincinnati Insurance Company PO Box 1230 THECI001 Other WC (Non-NY) Canonsburg, PA 15317 THE DUKE COMPANY 7 HALL ROAD THEDU002 New York Workers' ITHACA, NY 14850 Compensation THE DUKE COMPANY PO BOX 92280 THEDU001 New York Workers' ROCHESTER, NY 14692 Compensation The Employment Store 1320 University Ave THEEM002 New York Workers' Rochester, NY 14607 Compensation The Gap, Inc. [Electronic] E1400B Auto/No-Fault , The Gap, Inc. [Electronic] E1400C Other WC (Non-NY) , The Gary Insurance Company 1717 E. Loop THEGA001 Other WC (Non-NY) STE 333 Houston, TX 77029 THE GINGER MAN RESTAURANT 234 WESTERN AVENUE THEGI001 New York Workers' ALBANY, NY 12203 Compensation THE GRAHAM COMPANY 1 PENN SQUARE W GRAC01 New York Workers' PHILADELPHIA, PA 19102 Compensation THE GUARDIAN LIFE INSURANCE CO 116 JOHN ST GLIC01 New York Workers' NEW YORK, NY 10038 Compensation THE HAMISTER GROUP 10 LAFAYETTE SQ THEHA028 New York Workers' SUITE 1900 Compensation BUFFALO, NY 14203 THE HAMISTER GROUP ATTN: DENISE 6400 SHERIDAN DR SUITE 120 THEHA005 New York Workers' WILLIAMSVILLE, NY 14221 Compensation THE HARTFORD PO BOX 14170 THEHA024 Auto/No-Fault LEXINGTON, KY 40512 THE HARTFORD PO BOX 14268 THEHA026 Other WC (Non-NY) LEXINGTON, KY 405124268 THE HARTFORD PO BOX 14268 THEHA027 Auto/No-Fault LEXINGTON, KY 405124268 The Hartford [Electronic] E5231A New York Workers' , Compensation The Hartford [Electronic] E5231C Other WC (Non-NY) , The Hartford Ins. Co. PO BOX 14187 THEHA025 Other WC (Non-NY) Lexington, KY 40512 The Hartford Insurance Group [Electronic Indirect] CN 3605, 21 Christopher Way THEHA006 New York Workers' Eatontown, NJ 77013605 Compensation The Hartford Insurance Group [Electronic Indirect] CN 3605, 21 Christopher Way THEHA012 Auto/No-Fault Eatontown, NJ 77013605 The Hartford Insurance Group [Electronic Indirect] CN 3605, 21 Christopher Way THEHA018 Other WC (Non-NY) Eatontown, NJ 77013605 The Hartford Insurance Group [Electronic Indirect] Northeast Work Comp THEHA007 New York Workers' PO BOX 14473 Compensation Lexington, KY 40512 The Hartford Insurance Group [Electronic Indirect] Northeast Work Comp THEHA013 Auto/No-Fault PO BOX 14473 Lexington, KY 40512 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID The Hartford Insurance Group [Electronic Indirect] Northeast Work Comp THEHA019 Other WC (Non-NY) PO BOX 14473 Lexington, KY 40512 The Hartford Insurance Group [Electronic Indirect] PO BOX 14219 THEHA009 New York Workers' Lexington, KY 40512 Compensation The Hartford Insurance Group [Electronic Indirect] PO BOX 14219 THEHA015 Auto/No-Fault Lexington, KY 40512 The Hartford Insurance Group [Electronic Indirect] PO BOX 14219 THEHA021 Other WC (Non-NY) Lexington, KY 40512 The Hartford Insurance Group [Electronic Indirect] PO BOX 2910 THEHA010 New York Workers' HARTFORD, CT 61042910 Compensation The Hartford Insurance Group [Electronic Indirect] PO BOX 2910 THEHA016 Auto/No-Fault HARTFORD, CT 61042910 The Hartford Insurance Group [Electronic Indirect] PO BOX 2910 THEHA022 Other WC (Non-NY) HARTFORD, CT 61042910 The Hartford Insurance Group [Electronic Indirect] PO BOX 4771 THEHA011 New York Workers' SYRACUSE, NY 13221 Compensation The Hartford Insurance Group [Electronic Indirect] PO BOX 4771 THEHA017 Auto/No-Fault SYRACUSE, NY 13221 The Hartford Insurance Group [Electronic Indirect] PO BOX 4771 THEHA023 Other WC (Non-NY) SYRACUSE, NY 13221 THE HOMESTEADS 6 MAIN STREET THEHO001 New York Workers' APALACHIN, NY 13732 Compensation THE HURLBUT NURSING HOME 1177 EAST HENRIETTA RD THEHU001 New York Workers' ROCHESTER, NY 14607 Compensation THE INS COMPANY 10451 GULF BLVD THEIN002 New York Workers' TREASURE ISLAND, FL 33706 Compensation THE LOOMIS COMPANY PO BOX 14162 THELO001 Auto/No-Fault READING, PA 19612-4162 THE MAGLIONE FIRM 186 Clinton Ave THEMA001 Auto/No-Fault Newark, NJ 07108 THE MAXON CO 76 N BROADWAY MAX01 New York Workers' IRVINGTON, NY 10533 Compensation The Men's Wearhouse, Inc [Electronic] E1288A New York Workers' , Compensation The Men's Wearhouse, Inc [Electronic] E1288B Auto/No-Fault , The Men's Wearhouse, Inc [Electronic] E1288C Other WC (Non-NY) , The Muffler Shop II 1334 Fairport Rd THEMU001 New York Workers' Fairport, NY 14450 Compensation THE NIGHT SHIFT 2721 EAST MAIN STREET THENI001 New York Workers' ENDICOTT, NY 13760 Compensation The Pike Company Christine Scheene THEPI002 New York Workers' 1 Circle Street Compensation Rochester, NY 14607 THE PINES 9822 RT 16 PO BOX 310 THEPI001 New York Workers' MATHIAS, NY 14101 Compensation The RE Krug Corp. 190 Oliver Street THERE001 New York Workers' North Tonawanda, NY 14120 Compensation THE REFRIGERATION COMPANY ELMIRA 1474 CATON AVE THERE002 New York Workers' ELMIRA, NY 14904 Compensation The Reis Group 79 North Front Street THERE003 New York Workers' Kingston, NY 12401 Compensation THE RESOURCE CENTER 200 Dunham Ave RECE01 New York Workers' Jamestown, NY 14701 Compensation THE RIVERSIDE GROUP 655 DRIVING PARK AVE THERI001 New York Workers' ROCHESTER, NY 14613 Compensation The Salvation Army [Electronic] E1314A New York Workers' , Compensation The Salvation Army [Electronic] E1314C Other WC (Non-NY) , The Scotts Company [Electronic] E9330C Other WC (Non-NY) , THE STATE GROUP INDUSTRIAL 13800 HWY 57 N THEST001 New York Workers' EVANSVILLE, IN 47725 Compensation The Vascular Group 43 New Scotland Avenue THEVA001 New York Workers' Mail Code 157 Compensation Albany, NY 12208 The Walters Nixon Group 123 North Union Avenue THEWA001 New York Workers' STE 105 Compensation Cranford, NJ 07016 THE YELLOW JAGUAR 7200 TRANSIT RD THEYE001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation The Zenith [Electronic] E7264A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID The Zenith [Electronic] E7264C Other WC (Non-NY) , THERM INC ITHACA,NY PO BOX 220 THERM001 New York Workers' ITHACA, NY 14851 Compensation THERMAL FOAMS PO BOX 1981 THERM002 New York Workers' CICERO, NY 13039 Compensation THERMOLD 7059 HARP RD THERM003 New York Workers' CANASTOTA, NY 13032 Compensation THIELSCH ENGINEERING INC. 195 FRANCIS AVE. THIEL001 New York Workers' CRANSTON, RI 02910 Compensation THIRD COAST UNDER WRITERS PO BOX 40721 THIRD002 New York Workers' LANSING, MI 48091 Compensation THIRD COAST UNDERWRITERS 200 WEST MADISON STREET THIRD001 New York Workers' SUITE 3850 Compensation CHICAGO, IL 60606 THOMANN ASPHALT 56 GUNNVILLE RD THOMA002 New York Workers' LANCASTER, NY 14086 Compensation Thomas Electronics 208 Davis Parkway THOMA001 New York Workers' Clyde, NY 14433 Compensation THOMAS J SHUSTED ATT 212 HADDON AVENUE THOMA003 Auto/No-Fault WESTMONT, NJ 08108 Thomas McGee [Electronic] E1157A New York Workers' , Compensation Thomas McGee [Electronic] E1157B Auto/No-Fault , Thomas McGee [Electronic] E1157C Other WC (Non-NY) , THOMAS REYNOLDS ESQ 1200 MILL ROAD SUITE# C THOMA004 Auto/No-Fault NORTHFIELD, NJ 08225 Thomas Staffing Services, Inc/Venturi Staffing E0991A New York Workers' [Electronic] , Compensation Thomas Staffing Services, Inc/Venturi Staffing E0991C Other WC (Non-NY) [Electronic] , THOMPSON & JOHNSON EQUIP/ELMIRA 6926 FLAY ROAD THOMP001 New York Workers' ATTN: ANGEL GIAMARTINO Compensation SYRACUSE, NY 13057 THOMPSON MAPLE PRODUCTS PO BOX 99 THOMP002 New York Workers' CORRY, PA 16407 Compensation THREE BIRDS RESTAURANT CORNING 73 EAST MARKET STREET THREE003 New York Workers' CORNING, NY 14830-2708 Compensation THRUWAY FASTENERS PO BOX 870 THFA01 New York Workers' N TONAWANDA, NY 14122 Compensation THURSTON CORPORATION 508 THURSTON AVENUE THURS001 New York Workers' ITHACA, NY 14850 Compensation Tidewater Marine Western [Electronic] E1287A New York Workers' , Compensation Tidewater Marine Western [Electronic] E1287B Auto/No-Fault , Tidewater Marine Western [Electronic] E1287C Other WC (Non-NY) , Tier NY LLC 5745 Lincoln Hwy TIERN001 New York Workers' Human Resources Compensation Gap, PA 17527 TILE AND CARPET TOWN 3195 ERIE BOULEVARD TILEA001 New York Workers' DEWIIT, NY 13214 Compensation Tim Hortons 501 W. 3rd St. Suite 5 TIMHO002 New York Workers' Jamestown, NY 14701 Compensation TIM HORTONS 460 NIAGARA ST TIMHO001 New York Workers' BUFFALO, NY 14201 Compensation TIM HORTONS 5140 MAIN ST TIMHO003 New York Workers' WILLIAMSVILLE, NY 14221 Compensation TIME WARNER CABLE 20 CENTRY HILL DR TIMEW001 New York Workers' ATTEN: LORAINE Compensation LATHEM, NY 12110 Timebuyer Inc 4033 Route 281 TIMEB001 New York Workers' Cortland, NY 13045 Compensation TIMOTHY HILL CHILDREN'S RANCH 298 MIDDLE ROAD TIMOT001 New York Workers' RIVERHEAD, NY 11901 Compensation Tioga Ambulatory Service 37 North Chemung Street TIOGA003 New York Workers' Waverly, NY 14892 Compensation TIOGA CONSTRUCTION 333 GROS BOULEVARD TIOGA011 New York Workers' HERKIMER, NY 13350 Compensation TIOGA CONTAINER CO INC 9 FISH STREET TIOGA006 New York Workers' PO BOX 456 Compensation TIOGA, PA 16946 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TIOGA COUNTY SELF INSURANCE PLAN 56 MAIN ST TIOGA007 New York Workers' OWEGO, NY 13827 Compensation TIOGA DOWNS RACETRACK PO BOX 509 TIOGA010 New York Workers' NICHOLS, NY 13812 Compensation TIOGA FARM & HOME INC. 38 WEST AVE TIOGA009 New York Workers' OWEGO, NY 13827 Compensation Tioga Healthcare facility 37 North Chemung Street TIOGA002 New York Workers' Waverly, NY 14892 Compensation Tioga Nursing Home 37 North Chemung Street TIOGA004 New York Workers' Waverly, NY 14892 Compensation TIOGA OPPORTUNITIES INC 9 SHELDON GUILE BLVD TIOGA001 New York Workers' OWEGO, NY 13827 Compensation Tioga Senior Living 37 North Chemung Street TIOGA005 New York Workers' Waverly, NY 14892 Compensation TIOGA STATE BANK (SPENCER) PO BOX 386 TIOGA008 New York Workers' SPENCER, NY 14883 Compensation TITAN INDEMNITY COMPANY PO BOX 659792 TITA01 New York Workers' SAN ANTONIO, TX 78265 Compensation Titan Insurance Co. P O Box 7024 TITAN001 Auto/No-Fault Troy, MI 48007 TLC EMS 638 BURNET AVE TLCEM001 New York Workers' ATTN:JIM ALEXANDER Compensation SYRACUSE, NY 13203 TLC Health Care 845 RTES 5 And 20 TLCHE001 New York Workers' Irving, NY 14081 Compensation TMP Technologies 1200 Northland Avenue TMPTE001 New York Workers' Buffalo,, NY 14215 Compensation TOBERT LOGISTICS 38 PULASKI STREET TOBER001 New York Workers' BAYONNE, NJ 07002 Compensation TOBEY CO MGF INC 165 CEDAR SR TOBEY001 New York Workers' CORNING, NY 14830 Compensation TOBIN REITMAN GREENSTEIN 1743 SAINT GEORGES AVENUE PO TOBIN001 Auto/No-Fault BOX 1536 RAHWAY, NJ 07065 TOKIO MARINE CLAIMS PO BOX 4563 TOKIO002 New York Workers' NEW YORK, NY 10163-4563 Compensation Tokio Marine Mgmt inc 230 Park Ave TOKIO003 New York Workers' New York, NY 10001 Compensation TOLEDO ELECTRICAL PO BOX 60408 TOLED001 New York Workers' ROSSFORD, OH 43460 Compensation TOM GREENHAUER DEVELOPMENT PO BOX 250 TOMGR001 New York Workers' SPRINGBROOK, NY 14140 Compensation TOM KUBRICKY CO, INC. 1166 SARATOGA ROAD TOMKU001 New York Workers' GANSEVOORT, NY 12831 Compensation TOMKINS METAL 6 APOLLO DR TOMKI001 New York Workers' BATAVIA, NY 14020 Compensation Tompkins 90 Main Street TOMPK003 New York Workers' Batavia, NY 14020 Compensation TOMPKINS COMMUNITY ACTION 701 SPENCER ROAD TOMPK001 New York Workers' ITHACA, NY 14850 Compensation Tompkins Cortland CC PO BOX 139 TOMPK005 New York Workers' Dryden, NY 13053 Compensation TOMPKINS DENTAL HEALTH 2309 NORTH TRIPHAMMER ROAD TOMPK002 New York Workers' ITHACA, NY 14850 Compensation Tompkins-Seneca-Tioga Schools WC Plan PO BOX 772 TOMPK004 New York Workers' Canton, NY 13617 Compensation TONAWANDA COKE 3875 RIVER ROAD TONAW001 New York Workers' TONAWANDA, NY 14150 Compensation Tonawanda Valley Federal Credit Union 10 Jefferson Square TONAW002 New York Workers' Batavia, NY 14020 Compensation Toner Paving 124 North Genesee Street TONER001 New York Workers' Geneva, NY 14456 Compensation TONNARD MFG 4820 LAKE BROOK DRIVE TONNA001 New York Workers' GLENN ALAM, VA 23060 Compensation TONY R STEAK AND SEAFOOD 2 EAST MARKET STREET TONYR001 New York Workers' CORNING, NY 14830 Compensation TOP LINE RESTAURANTS 3205 WEST RAY ROAD TOPLI001 New York Workers' STE 2 Compensation CHANDLER, AZ 85226 TOPA Insurance Company [Electronic] E0992C Other WC (Non-NY) , Topanga Roscoe Corp. [Electronic] E0993A New York Workers' , Compensation Topanga Roscoe Corp. [Electronic] E0993C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TOPS MARKET 710 S MEADOW STREET TOPSM002 New York Workers' ITHACA, NY 14850 Compensation TOPS MARKETS LLC 408 WEST AVE TOPSM001 New York Workers' ALBION, NY 14411 Compensation TORONTO BLUE JAYS 1 BLUE JAY WAY TOBJ01 New York Workers' TORONTO, ON M5V1J1 Compensation TORPEDO SPECIALTY 1115 INSTRUMENT DRIVE TORPE001 New York Workers' ROCKY MOUNT, NC 27804 Compensation Torrey Farms PO BOX 187 TORRE001 New York Workers' Elba, NY 14058 Compensation Total Benefits 1 Lawrence Street TOTAL001 New York Workers' Glens falls, NY 12801 Compensation Total Petroleum, Inc. [Electronic] E5468C Other WC (Non-NY) , TOTAL PROGRAM MGMT 4175 VETS MEMORIAL HWY STE TOTAL003 New York Workers' 306 Compensation RONKONKOMA, NY 11779 TOUGHER INDUSTRIES 175 BROADWAY TOUGH002 New York Workers' ALBANY, NY 12204 Compensation TOUGHER INDUSTRIES 47 BROADWAY TOUGH001 New York Workers' MENANDS, NY 12204 Compensation Towanda Ambulatory Surgery 1 Hospital Drive TOWAN001 New York Workers' Towanda, NY 18848 Compensation Towanda Hospital Emergency Room 1 Hospital Drive TOWAN002 New York Workers' Towanda, PA 18848 Compensation Towanda Memorial Hospital 1 Hospital Drive TOWAN003 New York Workers' Towanda, PA 18848 Compensation Towanda Memorial Nursing Home 1 Hospital Drive TOWAN004 New York Workers' Towanda, PA 18848 Compensation Towanda Skilled Nursing 1 Hospital Drive TOWAN005 New York Workers' Towanda Drive, PA 18848 Compensation Tower Energy Group [Electronic] E1289A New York Workers' , Compensation Tower Energy Group [Electronic] E1289B Auto/No-Fault , Tower Energy Group [Electronic] E1289C Other WC (Non-NY) , Tower Group Po Box 948154 TOWER010 Other WC (Non-NY) Maitland, FL 32794 Tower Group [Electronic] 225 Broadhollow Rd TOWER001 Auto/No-Fault Melville, NY 11747 Tower Group Companies PO Box 1287 TOWER012 Auto/No-Fault Buffalo, NY 14240 Tower Group Companies [Electronic] 95 ROUTE 17 SOUTH TOWER003 Auto/No-Fault PARAMUS, NJ 07653 TOWER INSURANCE PO BOX 948154 TOWER009 New York Workers' MAITLAND, FL 32794 Compensation TOWER INSURANCE WORKERS COMPENSATION 225 TOWER013 Other WC (Non-NY) BROADHOLLOW ROAD MELVILLE, NY 11747 Tower Insurance Company [Electronic] E0994A New York Workers' , Compensation Tower Insurance Company [Electronic] E0994C Other WC (Non-NY) , TOWER NATIONAL PO BOX 3355 TOWER011 New York Workers' JERSEY CITY, NJ 07303 Compensation TOWN O ORCHARD PARK 4295 S BUFFALO ST TOWNO024 New York Workers' ORCHARD PARK, NY 14127 Compensation TOWN OF ALEXANDER PO BOX 1 TOA01 New York Workers' RAILROAD AVE Compensation ALEXANDER, NY 14005 TOWN OF BRIGHTON 2300 ELMWOOD AVE TOWNO001 New York Workers' ROCHESTER, NY 14618 Compensation TOWN OF CATON HIGHWAY DEPT 11161 HENDY ROAD TOWNO008 New York Workers' CORNING, NY 14830 Compensation TOWN OF CHEEKTOWAGA 3145 UNION RD TOWNO015 New York Workers' CHEEKTOWAGA, NY 14227 Compensation Town of Clarence 1 Town Place TOWNO006 New York Workers' Attn: Pam Smith Compensation Clarence, NY 14031 Town of Colma (CA) [Electronic] E1290A New York Workers' , Compensation Town of Colma (CA) [Electronic] E1290B Auto/No-Fault , Town of Colma (CA) [Electronic] E1290C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TOWN OF COLONIE P.O. BOX 508 TOWNO014 New York Workers' NEWTONVILLE, NY 12128 Compensation TOWN OF CORNING 20 SOUTH MAPLE STREET TOWNO005 New York Workers' CORNING, NY 14830 Compensation TOWN OF DANBY TOWN HALL 1830 DANBY RD TOWNO003 New York Workers' ITHACA, NY 14850 Compensation TOWN OF EASTCHESTER LAW DEPT 40 MILL RD TOWNO009 New York Workers' EASTCHESTER, NY 10709 Compensation TOWN OF ELMA 1600 BOWEN RD TOWNO017 New York Workers' ELMA, NY 14059 Compensation TOWN OF ENFIELD 168 ENFIELD MAIN RD TOWNO016 New York Workers' ITHACA, NY 14850 Compensation TOWN OF FISHKILL 801 ROUTE 52 TOWNO020 New York Workers' FISHKILL, NY 12524 Compensation Town Of Gates 1605 Buffalo Rd TOWNO012 New York Workers' Rochester, NY 14624 Compensation Town of Greece - (town clerk) 1 Vince Tofany BLVD TOWNO019 New York Workers' Greece, NY 14612 Compensation TOWN OF GREENBURGH 177 HILLSIDE AVE TOWNO021 New York Workers' WHITE PLAINS, NY 10607 Compensation TOWN OF GUILDERLAND P.O. BOX 339 TOWNO007 New York Workers' GUILDERLAND, NY 12084 Compensation TOWN OF HEMPSTEAD 200 N FRANKLIN ST TOH01 New York Workers' HEMPSTEAD, NY 11550 Compensation TOWN OF HEMPSTEAD-SANITATION DEPARTMENT 1253 COLONIAL ROAD TOWNO022 New York Workers' HEWLETT, NY 11557 Compensation TOWN OF LANCASTER 21 CENTRAL AVE TOWNO002 New York Workers' LANCASTER, NY 14086 Compensation TOWN OF NICHOLS PO BOX 359 TOWNO018 New York Workers' NICHOLS, NY 13812 Compensation Town of Ocean City MD PO BOX 158 TOWNO023 New York Workers' Ocean City, MD 21843 Compensation TOWN OF ORANGE HIGHWAY DEPT 899 HORNDY ROAD TOWNO004 New York Workers' BEAVER DAMS, NY 14812 Compensation Town Of Oyster Bay 1253 Colonial Road TOWNO010 New York Workers' Hewlett, NY 11557 Compensation TOWN OF OYSTER BAY 54 AUDREY AVE TOWN HALL TOWNO011 New York Workers' OYSTER BAY, NY 11771 Compensation TOWN OF PATTERSON 1142 ROUTE 311 TOWNO013 New York Workers' PATTERSON, NY 12563 Compensation TOWNE FORD 3535 SOUTHWESTERN BLVD TOWNE001 New York Workers' ATTN: DONNA HOWARD Compensation ORCHARD PARK, NY 14127 TOWNSHIP OF WALL 2700 BLIR RD TOWNS001 New York Workers' WALL TOWNSHIP, NJ 07719 Compensation TPA OF NEW HAMPSHIRE INS CO PO 9061 TPAOF001 New York Workers' BRANDON, FL 33509-9061 Compensation TRACTOR SUPPLY 3148 SILVERBACK LANE TRACT002 New York Workers' PAINTED POST, NY 14870 Compensation TRACTOR SUPPLY 848 STATE ROUTE 13 TRACT001 New York Workers' CORTLAND, NY 13045 Compensation Tractor Supply Company [Electronic] E1315A New York Workers' , Compensation Tractor Supply Company [Electronic] E1315C Other WC (Non-NY) , Tradesman International 9760 Shepard Rd TRADE001 New York Workers' Macedonia, OH 44056 Compensation TRAFFIC LINES INC 5100 AHBURY RD TRAFF001 New York Workers' FARMINGDALE, NJ 07727 Compensation TRANE CORPORATION 75 TOWNE CENTRE DRIVE TRANE001 New York Workers' ROCHESTER, NY 14623 Compensation TRANS AMERICA INSURANCE 250 COMMERCIAL ST, SUITE 5000 TRANS007 New York Workers' MANCHESTER, NH 03101 Compensation TRANS GUARD PO BOX 4403 TRANS004 New York Workers' CHICAGO, IL 606804403 Compensation TRANS WORKERS COMP TRUST PO BOX 1506 TWCT01 New York Workers' LATHAM, NY 12110-8006 Compensation TRANSAM TRUCKING 15910 S.169 HWY TRANS008 New York Workers' OLATHE, KS 66062 Compensation TRANSGUARD PO BOX 2148 TRANS002 New York Workers' WARRENVILLE, IL 60555 Compensation TRANSGUARD INS CO OF AMERICA INC 215 SHUMAN BLVD TRANSG01 New York Workers' STE 400 Compensation NAPERVILLE, IL 60563 TRANSGUARD INS CO OF AMERICA INC 702 OBERLIN RD TGUA01 New York Workers' RALEIGH, NC 27605 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TRANSIT ANIMAL HOSPITAL 6020 TRANSIT RD TRANS009 New York Workers' DEPEW, NY 14043 Compensation TRANSIT TOWN DODGE 7408 TRANSIT RD TRANS003 New York Workers' WILLIAMSVILLE, NY 14221 Compensation TRANSIT TOWN HYUNDAI 7420 TRNASIT ROAD TRANS006 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Transportation Claims PO Box 83246 TRANS001 New York Workers' Lincoln, NE 68501-3246 Compensation TRANSPORTATION INSURANCE COMPANY 333 SOUTH WABASH TRAN01 New York Workers' 30S Compensation CHICAGO, IL 60604 TRATTORIA AROMA 307 BRYANT ST TRATT001 New York Workers' BUFFALO, NY 14222 Compensation Travelers 3 Huntington Quad STE 4015 TRAVE151 New York Workers' Melville, NY 11747 Compensation Travelers P.O. Box 660456 TRAVE163 Other WC (Non-NY) Dallas, TX 75260 Travelers PO Box 2927 TRAVE111 New York Workers' Hartford, CT 06104 Compensation Travelers PO Box 42927 TRAVE130 Other WC (Non-NY) Houston, TX 77242 Travelers PO Box 430 TRAVE142 Auto/No-Fault Buffalo, NY 14240-0430 Travelers PO BOX 430 TRAVE135 New York Workers' Buffalo, NY 14240 Compensation Travelers Po Box 50405 TRAVE154 Auto/No-Fault Indianapolis, IN 46250 Travelers PO Box 66852 TRAVE103 Other WC (Non-NY) St. Louis, MO 63166 Travelers PO BOX 85554 TRAVE009 New York Workers' Richmond, VA 23285 Compensation Travelers PO BOX 9024 TRAVE156 New York Workers' Mellville, NY 11747 Compensation TRAVELERS 1TOWER SQUARE TRAVE160 Auto/No-Fault HARTFORD, CT 06101 TRAVELERS 343 THORNALL ST TRAVE139 Auto/No-Fault STE 530 EDISON, NJ 08837-2224 TRAVELERS 60 LAKEFRONT BLVD TRAVE158 Auto/No-Fault SUITE 200 BUFFALO, NY 14202 TRAVELERS 900 WATERVLIET/SHAKER RD TRAV15 New York Workers' ALBANY, NY 12205 Compensation TRAVELERS ONE TOWER SQUARE TPCC01 New York Workers' HARTFORD, CT 06183-1190 Compensation TRAVELERS P O BOX 173762 TRAVE017 New York Workers' DENVER, CO 80217 Compensation TRAVELERS P.O. BOX 17623 TRAVE107 Auto/No-Fault BALTIMORE, MD 21297 TRAVELERS P.O. BOX 2954 TRAVE159 Auto/No-Fault HARTFORD, CT 06101 TRAVELERS P.O. BOX 3205 TRAVE143 New York Workers' NAPERVILLE, IL 60566 Compensation TRAVELERS PO BOX 13933 TRAV13 New York Workers' READING, PA 19612 Compensation TRAVELERS PO BOX 13933 TRAVE140 Other WC (Non-NY) READING, PA 19612 TRAVELERS PO BOX 1450 TRAV18 New York Workers' MIDDLEBORO, MA 02344 Compensation TRAVELERS PO BOX 150448 TRAV05 New York Workers' HARTFORD, CT 06115 Compensation TRAVELERS PO BOX 1507 TRAVE004 New York Workers' PITTSBURGH, PA 15230 Compensation TRAVELERS PO BOX 1507 TRAVE164 Other WC (Non-NY) PITTSBURGH, PA 15230 TRAVELERS PO BOX 17158 TRAI01 New York Workers' BALTIMORE, MD 21297 Compensation TRAVELERS PO BOX 1900 TRAVE144 Auto/No-Fault MORRISTOWN, NJ 07962-1900 TRAVELERS PO BOX 1900 TRAVE145 New York Workers' MORRISTOWN, NJ 07962-1900 Compensation TRAVELERS PO BOX 220 TRAVE014 Auto/No-Fault BUFFALO, NY 14240-0220 TRAVELERS PO BOX 22986 TRAVE132 New York Workers' ROCHESTER, NY 14692 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TRAVELERS PO BOX 260 TRAVE157 Auto/No-Fault BUFFALO, NY 14201 TRAVELERS PO BOX 2928 TRAVE010 New York Workers' OVERLAND PARK, KS 66201 Compensation TRAVELERS PO BOX 3001 TRAVE165 Other WC (Non-NY) FORT SMITH, AR 72913 TRAVELERS PO BOX 3570 TRAVE138 Other WC (Non-NY) BRANDON, FL 33509 TRAVELERS PO BOX 3570 TRAVE149 New York Workers' BRANDON, FL 33509 Compensation TRAVELERS PO BOX 4614 TRAV03 New York Workers' BUFFALO, NY 14240 Compensation TRAVELERS PO BOX 5008 TRAV04 New York Workers' HARTFORD, CT 06102 Compensation TRAVELERS PO BOX 50472 TRAVE011 New York Workers' INDIANAPOLIS, IN 40513 Compensation TRAVELERS PO BOX 521 TRAVE116 New York Workers' MORRIS PLAINS, NJ 079500521 Compensation TRAVELERS PO BOX 660281 TRAV26 New York Workers' DALLAS, TX 75266 Compensation TRAVELERS PO BOX 660456 TRAV25 New York Workers' DALLAS, TX 75266 Compensation TRAVELERS PO BOX 715 TRAV07 New York Workers' ORLANDO, FL 32802 Compensation TRAVELERS PO BOX 8924 TRAV06 New York Workers' MELVILLE, NY 11747 Compensation TRAVELERS PO BOX 8924 TRAVE161 Other WC (Non-NY) MELVILLE, NY 11747 TRAVELERS PO BOX 929 TRAVE148 New York Workers' FAYETTEVILLE, NY 13066 Compensation TRAVELERS (CLEVELAND) PO BOX 94918 TRAVE013 New York Workers' CLEVELAND, OH 44101 Compensation TRAVELERS (WORKERS COMPENSATION) PO BOX 9093 TRAV19 New York Workers' MELVILLE, NY 11747 Compensation Travelers / Liability P.O. Box 3095 TRAVE102 Auto/No-Fault Naperville, IL 60566 Travelers / WC P.O. Box 3205 TRAVE098 Other WC (Non-NY) Naperville, IL 60566 Travelers / WC PO Box 64907 TRAVE104 Other WC (Non-NY) Saint Paul, MN 55164 TRAVELERS [Electronic Indirect] P.O. BOX 3205 TRAVE100 New York Workers' NAPERVILLE, IL 60566 Compensation TRAVELERS [Electronic Indirect] P.O. BOX 3205 TRAVE101 Other WC (Non-NY) NAPERVILLE, IL 60566 Travelers [Electronic] E6538A New York Workers' , Compensation Travelers [Electronic] E6538C Other WC (Non-NY) , TRAVELERS CAR INSURA 21 CEDAR AVE TRAVE119 Auto/No-Fault FAIRHAVEN, NJ 07704 TRAVELERS COMMERCIAL CASUALTY COMPANY PO BOX 2928 TRAVE162 Other WC (Non-NY) OVERLAND PARK, KS 66201 TRAVELERS COMMERCIAL INSURANCE COMPANY PO BOX 59059 TRAVE137 New York Workers' KNOXVILLE, TN 37950-9059 Compensation TRAVELERS HOME AND MARINE 50 MAIN ST TRAVE134 Auto/No-Fault BATAVIA, NY 14020 TRAVELERS INDEMNITY PO BOX 1538 TRAVE122 Auto/No-Fault PITTSBURGH, PA 15230 TRAVELERS INDEMNITY PO BOX 6050 TRAVE115 New York Workers' GLEN FALLS, NY 12801 Compensation TRAVELERS INS 75 TOWN CENTER RD TRAV14 New York Workers' ROCHESTER, NY 14692 Compensation TRAVELERS INS P.O BOX 9093 TRAVE106 Auto/No-Fault MELVILLE, NY 11747 TRAVELERS INS PO BOX 42927 TRAVE131 New York Workers' HOUSTON, TX 77242 Compensation TRAVELERS INS PO BOX 64907 TRAVE136 New York Workers' ST PAUL, MN 55164 Compensation Travelers Insurance 60 Lakefront Boulevard TRAVE150 New York Workers' Buffalo, NY 14202 Compensation Travelers Insurance PO Box 10892 TRAVE007 New York Workers' Chantilly, VA 20153 Compensation Travelers Insurance PO BOX 6510 TRAVE129 Other WC (Non-NY) Diamond Bar, CA 91765 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TRAVELERS INSURANCE PO BOX 1450 TRAVE126 Auto/No-Fault MIDDLEBORO, MA 02344 TRAVELERS INSURANCE PO BOX 1450 TRAVE127 Other WC (Non-NY) MIDDLEBORO, MA 02344 TRAVELERS INSURANCE PO BOX 220 TRAVE146 New York Workers' BUFFALO, NY 14240 Compensation TRAVELERS INSURANCE PO BOX 5008 TRAVE012 New York Workers' HARTFORD, CT 06102 Compensation TRAVELERS INSURANCE PO BOX 6890 TRAVE125 Auto/No-Fault PORTLAND, OR 97228 Travelers Insurance [Electronic Indirect] 100 BAYLIS RD TRAVE020 New York Workers' MELVILLE, NY 11747 Compensation Travelers Insurance [Electronic Indirect] 100 BAYLIS RD TRAVE059 Other WC (Non-NY) MELVILLE, NY 11747 Travelers Insurance [Electronic Indirect] 75 TOWN CENTER RD TRAVE021 New York Workers' ROCHESTER, NY 14692 Compensation Travelers Insurance [Electronic Indirect] 75 TOWN CENTER RD TRAVE060 Other WC (Non-NY) ROCHESTER, NY 14692 Travelers Insurance [Electronic Indirect] 900 WATERVLIET/SHAKER RD TRAVE022 New York Workers' ALBANY, NY 12205 Compensation Travelers Insurance [Electronic Indirect] 900 WATERVLIET/SHAKER RD TRAVE061 Other WC (Non-NY) ALBANY, NY 12205 Travelers Insurance [Electronic Indirect] ONE TOWER SQUARE TRAVE023 New York Workers' HARTFORD, CT 061831190 Compensation Travelers Insurance [Electronic Indirect] ONE TOWER SQUARE TRAVE062 Other WC (Non-NY) HARTFORD, CT 061831190 Travelers Insurance [Electronic Indirect] P O BOX 173762 TRAVE024 New York Workers' DENVER, CO 80217 Compensation Travelers Insurance [Electronic Indirect] P O BOX 173762 TRAVE063 Other WC (Non-NY) DENVER, CO 80217 Travelers Insurance [Electronic Indirect] P.O. Box 260 TRAVE025 New York Workers' Buffalo, NY 14240 Compensation Travelers Insurance [Electronic Indirect] P.O. Box 260 TRAVE064 Other WC (Non-NY) Buffalo, NY 14240 Travelers Insurance [Electronic Indirect] PO BOX 10069 TRAVE026 New York Workers' ALBANY, NY 12201 Compensation Travelers Insurance [Electronic Indirect] PO BOX 10069 TRAVE065 Other WC (Non-NY) ALBANY, NY 12201 Travelers Insurance [Electronic Indirect] PO Box 10892 TRAVE027 New York Workers' Chantilly, VA 20153 Compensation Travelers Insurance [Electronic Indirect] PO Box 10892 TRAVE066 Other WC (Non-NY) Chantilly, VA 20153 Travelers Insurance [Electronic Indirect] PO Box 111 TRAVE028 New York Workers' Middleborough, MA 02346 Compensation Travelers Insurance [Electronic Indirect] PO Box 111 TRAVE067 Other WC (Non-NY) Middleborough, MA 02346 Travelers Insurance [Electronic Indirect] PO Box 13485 TRAVE029 New York Workers' Reading, PA 19612 Compensation Travelers Insurance [Electronic Indirect] PO Box 13485 TRAVE068 Other WC (Non-NY) Reading, PA 19612 Travelers Insurance [Electronic Indirect] PO BOX 136 TRAVE030 New York Workers' CORNING, NY 14830 Compensation Travelers Insurance [Electronic Indirect] PO BOX 136 TRAVE069 Other WC (Non-NY) CORNING, NY 14830 Travelers Insurance [Electronic Indirect] PO BOX 13933 TRAVE031 New York Workers' READING, PA 19612 Compensation Travelers Insurance [Electronic Indirect] PO BOX 13933 TRAVE070 Other WC (Non-NY) READING, PA 19612 Travelers Insurance [Electronic Indirect] PO BOX 1430 TRAVE032 New York Workers' ALBANY, NY 12201 Compensation Travelers Insurance [Electronic Indirect] PO BOX 1430 TRAVE071 Other WC (Non-NY) ALBANY, NY 12201 Travelers Insurance [Electronic Indirect] PO BOX 1450 TRAVE033 New York Workers' MIDDLEBORO, MA 02344 Compensation Travelers Insurance [Electronic Indirect] PO BOX 1450 TRAVE072 Other WC (Non-NY) MIDDLEBORO, MA 02344 Travelers Insurance [Electronic Indirect] PO BOX 150448 TRAVE034 New York Workers' HARTFORD, CT 06115 Compensation Travelers Insurance [Electronic Indirect] PO BOX 150448 TRAVE073 Other WC (Non-NY) HARTFORD, CT 06115 Travelers Insurance [Electronic Indirect] PO BOX 1507 TRAVE035 New York Workers' PITTSBURGH, PA 15230 Compensation Travelers Insurance [Electronic Indirect] PO BOX 1507 TRAVE074 Other WC (Non-NY) PITTSBURGH, PA 15230 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Travelers Insurance [Electronic Indirect] PO BOX 17158 TRAVE036 New York Workers' BALTIMORE, MD 21297 Compensation Travelers Insurance [Electronic Indirect] PO BOX 17158 TRAVE075 Other WC (Non-NY) BALTIMORE, MD 21297 Travelers Insurance [Electronic Indirect] PO BOX 199 TRAVE037 New York Workers' ALBANY, NY 12205 Compensation Travelers Insurance [Electronic Indirect] PO BOX 199 TRAVE076 Other WC (Non-NY) ALBANY, NY 12205 Travelers Insurance [Electronic Indirect] PO BOX 203 TRAVE038 New York Workers' ISELIN, NJ 08830 Compensation Travelers Insurance [Electronic Indirect] PO BOX 203 TRAVE077 Other WC (Non-NY) ISELIN, NJ 08830 Travelers Insurance [Electronic Indirect] PO BOX 220 TRAVE039 New York Workers' BUFFALO, NY 142400220 Compensation Travelers Insurance [Electronic Indirect] PO BOX 220 TRAVE078 Other WC (Non-NY) BUFFALO, NY 142400220 Travelers Insurance [Electronic Indirect] PO BOX 22005 TRAVE040 New York Workers' ALBANY, NY 12201 Compensation Travelers Insurance [Electronic Indirect] PO BOX 22005 TRAVE079 Other WC (Non-NY) ALBANY, NY 12201 Travelers Insurance [Electronic Indirect] PO BOX 22986 TRAVE041 New York Workers' ROCHESTER, NY 14692 Compensation Travelers Insurance [Electronic Indirect] PO BOX 22986 TRAVE080 Other WC (Non-NY) ROCHESTER, NY 14692 Travelers Insurance [Electronic Indirect] PO BOX 2928 TRAVE042 New York Workers' OVERLAND PARK, KS 66201 Compensation Travelers Insurance [Electronic Indirect] PO BOX 2928 TRAVE081 Other WC (Non-NY) OVERLAND PARK, KS 66201 Travelers Insurance [Electronic Indirect] Po Box 3060 TRAVE043 New York Workers' Blue Bell, PA 19422 Compensation Travelers Insurance [Electronic Indirect] Po Box 3060 TRAVE082 Other WC (Non-NY) Blue Bell, PA 19422 Travelers Insurance [Electronic Indirect] PO BOX 5008 TRAVE047 New York Workers' HARTFORD, CT 06102 Compensation Travelers Insurance [Electronic Indirect] PO BOX 5008 TRAVE086 Other WC (Non-NY) HARTFORD, CT 06102 Travelers Insurance [Electronic Indirect] PO BOX 50472 TRAVE048 New York Workers' INDIANAPOLIS, IN 40513 Compensation Travelers Insurance [Electronic Indirect] PO BOX 50472 TRAVE087 Other WC (Non-NY) INDIANAPOLIS, IN 40513 Travelers Insurance [Electronic Indirect] PO BOX 530 TRAVE049 New York Workers' MORRIS PLAINS, NJ 07950 Compensation Travelers Insurance [Electronic Indirect] PO BOX 530 TRAVE088 Other WC (Non-NY) MORRIS PLAINS, NJ 07950 Travelers Insurance [Electronic Indirect] PO BOX 660281 TRAVE050 New York Workers' DALLAS, TX 75266 Compensation Travelers Insurance [Electronic Indirect] PO BOX 660281 TRAVE089 Other WC (Non-NY) DALLAS, TX 75266 Travelers Insurance [Electronic Indirect] PO BOX 660456 TRAVE051 New York Workers' DALLAS, TX 75266 Compensation Travelers Insurance [Electronic Indirect] PO BOX 660456 TRAVE090 Other WC (Non-NY) DALLAS, TX 75266 Travelers Insurance [Electronic Indirect] PO BOX 715 TRAVE052 New York Workers' ORLANDO, FL 32802 Compensation Travelers Insurance [Electronic Indirect] PO BOX 715 TRAVE091 Other WC (Non-NY) ORLANDO, FL 32802 Travelers Insurance [Electronic Indirect] PO BOX 85554 TRAVE053 New York Workers' Richmond, VA 23285 Compensation Travelers Insurance [Electronic Indirect] PO BOX 85554 TRAVE092 Other WC (Non-NY) Richmond, VA 23285 Travelers Insurance [Electronic Indirect] PO Box 906 TRAVE055 New York Workers' Cedar Knolls, NJ 07927 Compensation Travelers Insurance [Electronic Indirect] PO Box 906 TRAVE094 Other WC (Non-NY) Cedar Knolls, NJ 07927 Travelers Insurance [Electronic Indirect] PO BOX 9093 TRAVE056 New York Workers' MELVILLE, NY 11747 Compensation Travelers Insurance [Electronic Indirect] PO BOX 9093 TRAVE095 Other WC (Non-NY) MELVILLE, NY 11747 Travelers Insurance [Electronic Indirect] PO BOX 94918 TRAVE057 New York Workers' CLEVELAND, OH 44101 Compensation Travelers Insurance [Electronic Indirect] PO BOX 94918 TRAVE096 Other WC (Non-NY) CLEVELAND, OH 44101 Travelers NJ PO Box 5038 TRAVE018 Auto/No-Fault Woodbridge, NJ 07095 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Travelers WC Po Box 650403 TRAVE153 New York Workers' Dallas, TX 75265 Compensation TRAVELERS WORK COMP PO BOX 1900 TRAVE133 Other WC (Non-NY) MORRISTOWN, NJ 07962-1900 TRAVELERS/WC UNIT PO BOX 9511 TRAVE121 Auto/No-Fault MANCHESTER, NH 03108 Travelers-WC P.O. Box 1564 TRAVE147 New York Workers' Elmira, NY 14902 Compensation TRAVELLERS PO BOX 13089 TRAVE123 Auto/No-Fault SACRAMENTO, CA 95813 TRAVELLERS WC PO BOX 350 TRAVE112 New York Workers' MORRIS PLAINS, NJ 07950 Compensation Trayer Products inc. 541 East Clinton Street TRAYE001 New York Workers' attn: Jerry Compensation Elmira, NY 14902 Treadwell Enterprises 3880 W. Battlefield Rd TREAD001 New York Workers' Springfield, MO 65807 Compensation TREVCON CONSTRUCTION PO BOX 0811 TREVC001 New York Workers' LIBERTY CORNER, NJ 07938 Compensation TRI LIFT, INC P.O. BOX 120247 TRILI001 New York Workers' EAST HAVEN, CT 06512 Compensation Tri Star Risk Management P.O. Box 2805 TRIST007 Other WC (Non-NY) Clinton, IA 52733 TRI STATE CONSUMER INS CO 575 JERICHO TURNPIKE TRIST004 Auto/No-Fault AUTO CLAIMS JERICHO, NY 11753 Triad Group 185 Jordan Road TRIAD001 Other WC (Non-NY) Troy, NY 12180 TRIAD GROUP 185 JORDAN RD TRGR01 New York Workers' TROY, NY 12180 Compensation Triad Group, LLC PO Box 629 TRIAD002 New York Workers' Armonk, NY 10504 Compensation Triangle Insurance Company PO Box 6008 TRIAN001 Other WC (Non-NY) Sherwood, AR 72124 Tribal First 4160 6th Ave SE TRIBA001 New York Workers' Ste 207 Compensation Lacey, WA 98503 TRIBAL FIRST PO BOX 609015 TRIB01 New York Workers' SAN DIEGO, CA 92160 Compensation TRI-C,INC 1 BABCOCK ST TRICI001 New York Workers' BUFFALO, NY 14210 Compensation TRICARE PO BOX 870140 TRIC01 New York Workers' SURFSIDE BEACH, SC 29587 Compensation Tri-City Healthcare District [Electronic] E0995A New York Workers' , Compensation Tri-City Healthcare District [Electronic] E0995C Other WC (Non-NY) , Tri-City Linen Suppl [Electronic] E0996A New York Workers' , Compensation Tri-City Linen Suppl [Electronic] E0996C Other WC (Non-NY) , Tricity Uniform [Electronic] E0997A New York Workers' , Compensation Tricity Uniform [Electronic] E0997C Other WC (Non-NY) , Tri-County Electric PO Box 309 TRICO001 Other WC (Non-NY) Mt. Vernon, IL 62864 Tri-County Restoration 16 Cottage St. TRICO002 New York Workers' Westfield, NY 14787 Compensation TRIDENT INSURANCE SVCS PO BOX 469011 TRIDE003 New York Workers' SAN ANTONIO, TX 78246-9011 Compensation TRIDENT INSURANCE SVCS PO BOX 469011 TRIDE004 Auto/No-Fault SAN ANTONIO, TX 78246-9011 Trillium Staffing Solutions [Electronic] E1291A New York Workers' , Compensation Trillium Staffing Solutions [Electronic] E1291B Auto/No-Fault , Trillium Staffing Solutions [Electronic] E1291C Other WC (Non-NY) , TRINITY P.O. BOX 1723 TRINI001 New York Workers' MANDEVILLE, LA 70470 Compensation Trinity Universal Insurance [Electronic] E3504B Auto/No-Fault , TRIPI FOODS 1427 WILLIAMS ST TRIPI001 New York Workers' BUFFALO, NY 14206 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Triple A [Electronic] E5516B Auto/No-Fault , TRIPLE V ELECTRIC RR2 BOX 493 TRIPL001 New York Workers' ATHENS, PA 18810 Compensation Triplett Machine 1374 Phelps Junction Rd TRIPL002 New York Workers' Phelps, NY 14532 Compensation Tri-R Mechanical 25 Ransier Drive TRIRM001 New York Workers' West Seneca, NY 14224 Compensation TRISTAR RISK MANAGEMENT 2540 RTE 130 STE 109 TRIST008 New York Workers' CRANBURY, NJ 08512 Compensation TRISTAR RISK MANAGEMENT PO BOX 29106 TRIST006 Other WC (Non-NY) GLENDALE, CA 912099106 TRISTATE CONTAINER 1440 BRIDGEWATER RD TRIST003 New York Workers' BENSALEM, PA 19020 Compensation TriState Employment Services Inc. 160 Broadway TRIST002 New York Workers' New York, NY 10038 Compensation Tri-State Insurance Company [Electronic] E0999C Other WC (Non-NY) , Trombley Tire & Auto 370 South Main St, TROMB001 New York Workers' SUITE 1 Compensation Canandaigua, NY 14424 Trombley Tire & Auto 370 South Main St, TROMB002 New York Workers' SUITE 1 Compensation Canandaigua, NY 14424 TROPICANA 9 LINDEN AVE TROPI001 New York Workers' JERSEY CITY, NJ 07305 Compensation Troy Community Hospital 100 John Street TROYC001 New York Workers' Troy, PA 16947 Compensation Troy Hospital Emergency 100 John Street TROYH001 New York Workers' Troy, PA 16947 Compensation TRS 7314 SCHUYLER TRS001 New York Workers' EAST SYRACUSE, NY 13057 Compensation TRUCK INSURANCE EXCHANGE 4680 WILSHIRE BLVD TRUI01 New York Workers' LOS ANGELES, CA 90010 Compensation Truck Insurance Exchange (Commercial Only) E8704B Auto/No-Fault [Electronic] , TRUCK-LITE 310 EAST ELMWOOD AVE TRUCK001 New York Workers' FALCONER, NY 14733 Compensation TRUGREEN 629 DICKSON ST TRUGR001 New York Workers' ENDICOTT, NY 13760 Compensation TRUMP NATIONAL GOLF CLUB 100 SHADOW TREE LANE TRUMP001 New York Workers' BRIARCLIFF MANOR, NY 10510 Compensation TRY LOCK ROOFING CO., INC 440 NORTHWOOD DR TRYLO001 New York Workers' TONAWANDA, NY 14223 Compensation TUCKER TECHNOLOGY 300 FRANK HOGAWA PLAZA TUCKE001 New York Workers' SUITE 251 Compensation OAKLAND, CA 94612 Tucson Unified School Dist WC [Electronic] E1000A New York Workers' , Compensation Tucson Unified School Dist WC [Electronic] E1000C Other WC (Non-NY) , TULIP CORPORATION 3125 HIGHLAND AVE TULIP001 New York Workers' NIAGARA FALLS, NY 14305 Compensation TULLY'S GOOD TIMES ONE TECHNOLOGY PLACE TULLY001 New York Workers' EAST SYRACUSE, NY 13057 Compensation TUNISION LABORATORY OF AQUATIC 3075 GARCIE ROAD TUNIS001 New York Workers' CORTLAND, NY 13045 Compensation Tunkhannock Manor 50 West Tioga Street TUNKH001 New York Workers' Tunkhannock, PA 18657 Compensation TURKEY HILL C/O SEDGWICK TURKE001 Other WC (Non-NY) PO BOX 14452 LEXINGTON, KY 40512 TUSCARORA PROPANE 2301 SAUNDERS SETTLEMENT RD TUSCA001 New York Workers' SANBORN, NY 14132 Compensation Tweens Brands Justice 8323 Wlaton Parkway TWEEN001 New York Workers' New Albany, OH 43054 Compensation TWIN LIGHTS INSURANCE PO BOX 923 TWINL002 Auto/No-Fault LINCROFT, NJ 07738 TWIN TIER KITCHEN & BATH 168 BEARTOWN ROAD TWINT001 New York Workers' PAINTED POST, NY 14870 Compensation Twinlights Insurance PO Box 1428 TWINL001 Auto/No-Fault Newark, NJ 07101 Two Plus Four Management Co. 6320 Fly Road TWOPL001 New York Workers' East Syracuse, NY 13057 Compensation TWO RIVERS TIMBER 7778 STATE ROUTE 417 TWORI001 New York Workers' ADDISON, NY 14801 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID TYLER FIRE EQUIPMENT 703 ERIE STREET TYLER002 New York Workers' ELMIRA, NY 14904 Compensation Tyler Memorial Hospital Route 6 TYLER001 New York Workers' Road 1 Compensation Tunkhannock, PA 18657 TYMETAL CORPORATION PO BOX 139 TYMET001 New York Workers' SCHUYLERVILLE, NY 12871 Compensation TYSON FOODS 403 CUSTER AVE TYF01 New York Workers' NEW HOLLAND, PA 17557 Compensation Tyson Foods Inc [electronic] E9998A New York Workers' , Compensation Tyson Foods Inc [electronic] E9998C Other WC (Non-NY) , TZETZO BROTHERS 1100 MILITARY RD TZETZ001 New York Workers' BUFFALO, NY 14217 Compensation U STORE IT 192 OLD ITHACA RD USTOR001 New York Workers' HORSEHEADS, NY 14845 Compensation U.S. Dept. Of Labor (DOL) [Electronic Indirect] 200 Constitution Ave. N.W. USDEP006 Auto/No-Fault OWC Room c35134 Washington, DC 20210 U.S. Dept. Of Labor (DOL) [Electronic Indirect] 200 Constitution Ave. N.W. USDEP007 Other WC (Non-NY) OWC Room c35134 Washington, DC 20210 U.S. Dept. Of Labor (DOL) [Electronic Indirect] PO BOX 8300 USDEP009 Auto/No-Fault LONDON, KY 40742 U.S. Dept. Of Labor (DOL) [Electronic Indirect] PO BOX 8300 USDEP010 Other WC (Non-NY) LONDON, KY 40742 U.S. Management Inc. 129 South 8 Street USMAN001 New York Workers' Brooklyn, NY 11211 Compensation U.S. Postal Service 16 Hudson Avenue USPOS004 Other WC (Non-NY) Glens Falls, NY 12839 U.S. Steel [Electronic] E7394C Other WC (Non-NY) , UAW 9 35 GEORGE KARL BLVD UAW9001 New York Workers' WILLIAMSVILLE, NY 14221 Compensation UB FOUNDATION C/O J ZENOSKY UBFOU001 New York Workers' PO BOX 900 Compensation BUFFALO, NY 14226 UB ORTHOPAEDICS & SPORTS MEDICINE 5500 MAIN ST STE 107 UBORT001 New York Workers' ATTN: MICHELLE Compensation WILLIAMSVILLE, NY 14221 Ullico 704 North King St ULLIC004 New York Workers' STE 602 Compensation Wilmington, DE 19801 Ulster County Self Insurance P.O. Box 1800 ULSTE002 New York Workers' Kingston, NY 12401 Compensation Ulster County Self-Insured PO Box 1800 ULSTE001 Auto/No-Fault Kingston, NY 12401 ULTIMATE CATERERS 52CN MAIN STREET ULTIM002 New York Workers' MARLBORO, NJ 07746 Compensation Ultimate Goal 3800 Lee Mulroy Road ULTIM001 New York Workers' Marcellus, NY 13108 Compensation UMR PO Box 30541 UMR001 New York Workers' Salt Lake City, UT 84130-0541 Compensation UNCLE JOE'S DINER 4869 SOUTHWESTERN BLVD UNCLE001 New York Workers' HAMBURG, NY 14075 Compensation Underwriters Safety & Claims PO Box 23640 UNDER001 New York Workers' Louisville, KY 40223 Compensation Underwriters Safety & Claims [Electronic Indirect] PO Box 23640 UNDER002 New York Workers' Louisville, KY 40223 Compensation Underwriters Safety & Claims [Electronic Indirect] PO Box 23640 UNDER003 Other WC (Non-NY) Louisville, KY 40223 Underwriters Safety and Claims [Electronic] E1001C Other WC (Non-NY) , UNICARE P O BOX 4479 UNICA001 New York Workers' DEARBORN, MI 48126 Compensation UNICELL BODY CO 571 HOWARD ST UNICE001 New York Workers' BUFFALO, NY 14208 Compensation UNIFIRST CORP 157 TROY SCHENECTADY ROAD UNIFI001 New York Workers' WATERVLIET, NY 12189 Compensation Unigard Insurance Company - QBE DBA E1002C Other WC (Non-NY) [Electronic] , Union Central Life Ins 85 Allen Street UNION005 New York Workers' Suite 210 Compensation Rochester, NY 14608 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID UNION COLLEGE WC 807 UNION STREET UNION002 New York Workers' SCHENECTADY, NY 12308 Compensation UNION CONCRETE & CONSTRUCTION PO BOX 410 UNION003 New York Workers' W. SENECA, NY 14224 Compensation Union Construction Workers' Comp Program E1401B Auto/No-Fault [Electronic] , Union Construction Workers' Comp Program E1401C Other WC (Non-NY) [Electronic] , UNION INSURANCE COMPANY PO BOX 9010 UNIC01 New York Workers' WESTBROOK, ME 04098-5010 Compensation Union Insurance Company of Providence E1037A New York Workers' [Electronic] , Compensation Union Insurance Company of Providence E1037C Other WC (Non-NY) [Electronic] , Union Insurance Company of Providence E3108B Auto/No-Fault [Electronic] , Union Pacific Claims Management / WC 100 N. Broadway, Suite 1500 UNION004 Other WC (Non-NY) Saint Louis, MO 63102 Unique Personnel Consultants / WC 2501 Chatham Rd Ste 310 UNIQU001 Other WC (Non-NY) Springfield, IL 62804 UNISOURCE ADMINISTRATORS 5951 CATTLERIDGE BLVD UNIS01 New York Workers' SARASOTA, FL 34234 Compensation UNITAN DISTRICT 1808 N. WESTSHORE DISTRICT UND01 New York Workers' TAMPA, FL 33607 Compensation UNITED AUTO SUPPLY 237 WEST VESTAL PARKWAY UNITE005 New York Workers' VESTAL, NY 13850 Compensation United Auto Workers 8000 East Jefferson UAW01 New York Workers' Detroit , MI 48214 Compensation United Automobile Insurance P.O. Box 694120 UNITE012 Auto/No-Fault Miami, FL 33269 UNITED COMMUNITY INS CO 24 AVIATION RD UNCO01 New York Workers' ALBANY, NY 12212 Compensation United Convalescent [Electronic] E1003A New York Workers' , Compensation United Convalescent [Electronic] E1003C Other WC (Non-NY) , UNITED DIVIDERS INC 108 STEPHENS PLACE UNITE004 New York Workers' ELMIRA, NY 14901 Compensation United Dominion Realty Trust [Electronic] E7750C Other WC (Non-NY) , United Financial Casualty Company [Electronic] E1149B Auto/No-Fault , United Fire [Electronic] E5617A New York Workers' , Compensation United Fire [Electronic] E5617B Auto/No-Fault , United Fire [Electronic] E5617C Other WC (Non-NY) , United Fire Group / WC PO Box 73909 UNITE008 Other WC (Non-NY) Cedar Rapids, IA 52407 United Health Services 33 Mitchell Ave UNITE014 New York Workers' STE 204 Compensation Binghamton, NY 13903 UNITED HEALTH SERVICES 33 MITCHELL AVE UNITE011 New York Workers' BINGHAMTON, NY 13903 Compensation UNITED HEALTHCARE OCC CL PO BOX 5500 UNHO01 New York Workers' KINGSTON, NY 12402 Compensation UNITED HEALTHCARE OXFORD PO BOX 7082 UNITE001 New York Workers' BRIDGEPORT, CT 06601 Compensation UNITED HEARTLAND PO BOX 3026 UNITE003 New York Workers' MILWAUKEE, WI 53201 Compensation United Heartland / WC P.O. Box 3026 UNITE007 Other WC (Non-NY) Milwaukee, WI 53201 UNITED MEDICAL RESOURCES PO BOX 145804 UNITE002 New York Workers' CINCINNATI, OH 45214 Compensation UNITED MEMORIAL MEDICAL CENTER 127 NORTH ST UMMC01 New York Workers' BATAVIA, NY 14020 Compensation United Occupation Medicine 33 Mitchell Ave UNITE013 New York Workers' STE 204 Compensation Binghamton, NY 13903 UNITED PACIFIC INS OF NY 10 AIRLINE DR UNPA01 New York Workers' #200 Compensation ALBANY, NY 13202 UNITED SELF INS SERVICE PO BOX 616648 UNSS01 New York Workers' ORLANDO, FL 32861 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID UNITED SERVICE AUTO ASSOC PO BOX 659468 UNITE009 Auto/No-Fault AUTO CLAIMS SAN ANTONIO, TX 78265 United States Cold Storage [Electronic] E7351C Other WC (Non-NY) , UNITED STATES FIRE INS CO 994 305 MADISON AVE UFIR01 New York Workers' MORRISTOWN, NJ 07960 Compensation United States Fire Ins. Co PO Box 1960 UNITE010 New York Workers' Morristown, NJ 07962 Compensation United States Fire Insurance Company [Electronic] E1004B Auto/No-Fault , United States Fire Insurance Company [Electronic] E1004C Other WC (Non-NY) , UNITED STATES LIABILITY INS CO PO BOX 6700 UNSL01 New York Workers' 190 SOUTH WARNER RD Compensation WAYNE, PA 190872191 United Wisconsin Insurance Company [Electronic] E5267A New York Workers' , Compensation United Wisconsin Insurance Company [Electronic] E5267B Auto/No-Fault , United Wisconsin Insurance Company [Electronic] E5267C Other WC (Non-NY) , UNITEK 1777 SENTRY PARKWAY WEST UNITE015 New York Workers' BLUE BELL, PA 19422 Compensation Unitran Direct PO Box 4199 UNITR002 Auto/No-Fault TEACHERS INS Scranton, PA 18505-6199 Unitrin Auto & Home Insurance [Electronic] E6421B Auto/No-Fault , Unitrin Direct Auto Insurance [Electronic] E7812B Auto/No-Fault , UNITRIN DIRECT INS PO BOX 9927 UNITR001 Auto/No-Fault SALT LAKE CITY, UT 84109 Unitrin Direct Property & Casualty Company E6785B Auto/No-Fault [Electronic] , Unitrin Safeguard Insurance [Electronic] E3129B Auto/No-Fault , UNITY HOUSE 2431 SIXTH AVENUE UNITY002 New York Workers' TROY, NY 12180 Compensation UNITY HOUSE OF CAYUGA COUNTY INC 34 WRIGHT AVE SUITE C UNITY001 New York Workers' AUBURN, NY 13021 Compensation UNIVERSAL SERVICES 13549 SOUTH MOSIERTOWN RD UNIVE006 New York Workers' MEADVILLE, PA 16335 Compensation UNIVERSAL SMART COMP P O BOX 14469 UNIVE009 Other WC (Non-NY) LEXINGTON, KY 40512-4469 UNIVERSAL SMART COMP P.O. BOX 14469 UNIVE004 New York Workers' LEXINGTON, KY 40512 Compensation UNIVERSAL SMARTCOMP P.O. BOX 800 UNIVE001 New York Workers' MEADOWLANDS, PA 15347 Compensation UNIVERSAL UNDERWRITERS PENN CENTER W BLG 2 UNUN01 New York Workers' # 200 Compensation PITTSBURGH, PA 15276 UNIVERSAL UNDERWRITERS 7045 COLLEGE BLVD UNUN02 New York Workers' OVERLAND PARK, KS 66211 Compensation UNIVERSAL UNDERWRITERS GROUP PO BOX 2904 UNUN03 New York Workers' SHAWNEE MISSION, KS 66201- Compensation 1304 Universal Underwriters Ins. Company [Electronic] 100 WALNUT AVENUE SUITE 600 UNIVE002 Auto/No-Fault CLARK, NJ 07066 UNIVERSAL WELLS SERVICES ATTN:TERRY BENFIELD UNIVE007 New York Workers' 201 ARCH STREET 2ND FL Compensation MEADVILLE, PA 16335 UNIVERSITY INN CONFERENCE CENTER 2402 NORTH FOREST ROAD UNIVE005 New York Workers' GETZVILLE, NY 14068 Compensation University of Colorado [Electronic] E1005A New York Workers' , Compensation University of Colorado [Electronic] E1005C Other WC (Non-NY) , University of Illinois Claim Office / WC 100 Trade Center Drive UNIVE008 Other WC (Non-NY) Suite 103 Champaign, IL 61820 UNIVERSITY OF NEVADA RENO CCMSI UNIVE010 Other WC (Non-NY) PO BOX 35350 LAS VEGAS, NV 891335350 UNIVERSITY OF ROCHESTER PO BOX 270025 UNOR01 New York Workers' ROCHESTER, NY 14627 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID UNIVERSITY OF ROCHESTER HR 260 CRITTENDEN BLVD UNOR02 New York Workers' ROCHESTER, NY 14642 Compensation UNUM P.O. Box 100158 UNUM001 New York Workers' Columbia, SC 29202 Compensation UPMC HEALTH BENEFITS INC C/O UPMC WORK PARTNERS UPMCH002 Other WC (Non-NY) PO BOX 2971 PITTSBURGH, PA 15230 UPMC Health Plan PO BOX 2939 UPMCH001 New York Workers' Pittsburgh, PA 15230 Compensation UPS 18 Forge Avenue UPS001 New York Workers' Geneva, NY 14456 Compensation UPS STORE 3983 (CORNING,NY) 60 EAST MARKET STREET UPSST001 New York Workers' CORNING, NY 14830 Compensation UPSTATE CEREBAL PALSEY RISK MANAGEMENT DEPT UPSTA003 New York Workers' 1020 MARY ST Compensation UTICA, NY 13501 UPSTATE MACHINERY PO BOX 206 UPSTA004 New York Workers' TIOGA CENTER, NY 13845 Compensation UPSTATE SHREDDING PO BOX 420 UPSTA002 New York Workers' OWEGO, NY 13827 Compensation UPSTATE STEEL ATTN: JOHN 1800 DALE RD UPSTA001 New York Workers' BUFFALO, NY 14225 Compensation UPSTATE THERMO KING 8408 COLLAMER RD UPTK01 New York Workers' E SYRACUSE, NY 13057 Compensation UPS-UNITED PARCELS SVS SECAUCUS ROAD UPSUN001 New York Workers' SECAUCUS, NJ 07094 Compensation URBAN LEAGUE OF ROCHESTER 265 CLINTON AVE N. URBAN001 New York Workers' ROCHESTER, NY 14605 Compensation URSO CONSTRUCTION 10225 MAIN ST URSOC001 New York Workers' CLARENCE, NY 14031 Compensation US ADMINISTRATORS 800 OAK RIDGE TPK USADM001 New York Workers' OAKRIDGE, TN 37831 Compensation US AIR ELMIRA/CORNING AIRPORT ATT: CHUCK HATHAWAY USAIR001 New York Workers' 276 SING SING RD SUITE 7 Compensation Horseheads, NY 14845 US ARMY NATIONAL GUARD 1 BUFFINGTON STREET USARM001 New York Workers' WATERVLIET, NY 12189 Compensation US ARMY ROTC PO BOX 2024 USARM002 New York Workers' NIAGARA UNIVERSITY, NY 14109 Compensation US CENSUS BUREAU 1 BEACON ST USCB01 New York Workers' FL 7 Compensation BOSTON, MA 10041 US CENSUS BUREAU (BOSTON,MA) 4 COPLEY PLACE SUITE 301 USCEN001 New York Workers' BOSTON, MA 02117 Compensation US CHROME 31 SWAN STREET USCHR001 New York Workers' BATAVIA, NY 14020 Compensation US CONCRETE 101 E. CENTRAL PARK BLVD USCON001 New York Workers' DESOTO, TX 75115 Compensation US CONCRETE 2925 BRIARPARK USCON002 New York Workers' SUITE 1050 Compensation HOUSTON, TX 77042 US DEP OF LABOR WC 494 BROAD ST RM,210 USDEP013 New York Workers' NEWARK, NJ 07102 Compensation US DEPT OF LABOR 201 VARICK STREET USDEP016 Other WC (Non-NY) NEW YORK, NY 10014 US DEPT OF LABOR 800 N CAPITOL ST USDEP012 Other WC (Non-NY) RM #800 WASHINGTON, DC 20211 US DEPT OF LABOR 800 N CAPITOL ST USDL03 New York Workers' RM #800 Compensation WASHINGTON, DC 20211 US DEPT OF LABOR CURTIS CENTER, STE.715 E. USDEP014 New York Workers' 170 S. INDEP. MALL WEST Compensation PHILADELPHIA, PA 191063308 US DEPT OF LABOR PO BOX 8300 USDEP003 Other WC (Non-NY) LONDON, KY 40742 US DEPT OF LABOR OWCP\LONGSHORE PO BOX 249 USDEP015 New York Workers' NEW YORK, NY 10014-0249 Compensation US DEPT OF LABOR,DIVISION OF ENERGY P.O.BOX 8304 USDEP004 New York Workers' LONDON, KY 40742 Compensation US FIRE INSURANCE WC PO BOX 1960 UFIR02 New York Workers' MORRISTOWN, NJ 07960 Compensation US Foodservice, Inc. [Electronic] E3815C Other WC (Non-NY) , US GYPSUM COMPANY POB 139 USGYP001 New York Workers' OAKFIELD, NY 14125 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID US MARITIME ADM 500 POYDRAS ST USMAR001 New York Workers' #1223 Compensation NEW ORLEANS, LA 70130 US Mobile Wireless [Electronic] E1006A New York Workers' , Compensation US Mobile Wireless [Electronic] E1006C Other WC (Non-NY) , US National Resources (Aigrm) [Electronic] E7423C Other WC (Non-NY) , US PIPELINE PO BOX 179 USPIP001 New York Workers' OWEGO, NY 13827 Compensation US Postal Service 300 E. Third St. USPOS006 New York Workers' Jamestown, NY 14701 Compensation US POSTAL SERVICE 1200 WILLIAMS STREET USPS02 New York Workers' BUFFALO, NY 14240 Compensation US POSTAL SERVICE 30 OLD KARNER RD USPS01 New York Workers' ALBANY, NY 12288 Compensation US Postal Service - HRM 421 8th Ave USPOS001 New York Workers' Room 4129 Compensation New york, NY 10199-9425 US POSTAL SERVICE (BUFFALO) 1200 WILLIAM STREET USPOS002 New York Workers' BUFFALO, NY 14240-9998 Compensation US POSTAL SERVICE (CORNING) 198 BAKER STREET USPOS003 New York Workers' CORNING, NY 14830 Compensation US POSTAL SERVICE WC 4326 HARBOR BEACH BLVD USPOS005 Other WC (Non-NY) BRIGANTINE , NJ 08203 US PROBATION 2 NIAGARA SQUARE USPRO001 New York Workers' BUFFALO, NY 14202 Compensation US SECURITY ASSOCIATES INC 625 DELAWARE AVE #200 USSEC001 New York Workers' BUFFALO, NY 14202 Compensation US Specialty Ins 13403 N.W. Freeway USSPE001 New York Workers' Houston, TX 77040 Compensation US SURETY 108 GREENWICH ST 7TH FLOOR USSUR001 New York Workers' NEW YORK, NY 10006 Compensation USA TPA P O BOX 3580 USATP001 New York Workers' SYRACUSE, NY 13220 Compensation USA TPA PO BOX 28 USATP002 New York Workers' DUBUQUE, IA 52004 Compensation USA TRUCK INC PO BOX 449 USATR001 New York Workers' 3200 INDUSTRIAL PARK ROAD Compensation VANBUREN, AR 72957 USAA 9800 FREDERICKSBURG ROAD USAA004 Auto/No-Fault SAN ANTONIO, TX 78288 USAA PO BOX 26001 USAA003 Auto/No-Fault ATTN: MEDICAL MAIL DEPT DAPHNE, AL 36526 USAA PO BOX 33490 USAA005 Auto/No-Fault SAN ANTONIO, TX 78265 USAA PO BOX 33490 USAA01 New York Workers' SAN ANTONIO, TX 78265 Compensation USAA (UNITED STATES AUTOMOBILE 9800 FREDRICKSBURG RD. USAAU001 Auto/No-Fault ASSOCIATION) SAN ANTONIO, TX 78288 USAA [Electronic] E1129A New York Workers' , Compensation USAA [Electronic] E1129C Other WC (Non-NY) , USAA [Electronic] PO BOX 33490 USAA001 Auto/No-Fault SAN ANTONIO, TX 78265 USAA 3RD PARTY PO BOX 26001 USAA3001 Auto/No-Fault DAPHNE, AL 36526 USAA AUTO INJURY SOLUTION PO BOX 5000 USAAA001 Auto/No-Fault DAPHNE, AL 36526 USAA MEDICAL DEPT PO BOX 5000 USAAM002 Auto/No-Fault DAPHNE, AL 36526 USAA MEDICAL MAIL DEPT. PO BOX 5000 USAAM001 Auto/No-Fault DAPHNE, AL 36526 USAI 1126 River Road USAI001 New York Workers' New Windsor, NY 12553 Compensation USF&G PO BOX 4929 USFG01 New York Workers' SYRACUSE, NY 13221 Compensation USGS 810 BEAR TAVERN ROAD USGS001 New York Workers' STE 206 Compensation WEST TRENTON, NJ 08628 USHERS MACHINE & TOOLS 180 USHERS ROAD USHER001 New York Workers' ROUND LAKE, NY 12151 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID USI OF GEORGIA PO BOX 1025 USIOF001 New York Workers' DECATOR, GA 30031 Compensation USIS Claims PO BOX 616648 USISC001 New York Workers' Orlando, FL 32861 Compensation USMA Civilian PA Center 626 Swift Road USMAC001 New York Workers' Karen Wood, ICPA/LMER Spec Compensation West Point, NY 10996 USPS 1000 WESTCHESTER AVE USPS003 New York Workers' WHITE PLAINS, NY 10610 Compensation USS-POSCO Industries [Electronic] E1007C Other WC (Non-NY) , UTICA PO BOX 5310 UTICA009 Other WC (Non-NY) BINGHAMTON, NY 13902 Utica [Electronic] E8378B Auto/No-Fault , Utica Mutual Insurance Co [Electronic] E5207C Other WC (Non-NY) , UTICA NATIONAL PO BOX 5310 UTICA005 New York Workers' BINGHAMTON, NY 13902 Compensation UTICA NATIONAL PO BOX 5310 UTICA008 Auto/No-Fault BINGHAMTON, NY 13902 Utica National Insurance Co of Texas [Electronic] E8788C Other WC (Non-NY) , Utica Police Department 413 Oriskany St West UTICA002 New York Workers' Utica, NY 13502 Compensation UTICA/LOCKWOOD AGENCY 617 N MAIN ST ULA01 New York Workers' JAMESTOWN, NY 14701 Compensation Utilities Mutual PO Box 2789 UTILI001 New York Workers' North Syracuse, NY 13220 Compensation UTILITIES MUTUAL 56 PINE ST UTMU03 New York Workers' 11TH FLOOR Compensation NEW YORK, NY 10005 V&M Restoration [Electronic] E1008A New York Workers' , Compensation V&M Restoration [Electronic] E1008C Other WC (Non-NY) , VA HEALTHCARE NETWORK 113 HOLLAND AVE VAHN01 New York Workers' ALBANY, NY 12208 Compensation VA Medical Center 3495 Bailey Avenue VAMED002 New York Workers' Buffalo, NY 14215 Compensation VA Medical Center Bath 78 Veterans Ave VAMED001 New York Workers' Bath, NY 14810 Compensation VA MEDICAL CENTER WC 800 IRVING AVE VAMC01 New York Workers' SYRACUSE, NY 13210 Compensation VA REGIONAL OFFICE 130 S ELMWOOD AVE VAREG001 New York Workers' BUFFALO, NY 14202 Compensation VACRI CONSTRUCTION CORPORATION 1 BRICK AVE VACRI001 New York Workers' BINGHAMTON, NY 13901-2099 Compensation Valenzuela Eng. Inc [Electronic] E1009A New York Workers' , Compensation Valenzuela Eng. Inc [Electronic] E1009C Other WC (Non-NY) , VALLEY BOWLING CENTER 13 N CHEMUNG STREET VALLE002 New York Workers' WAVERLY, NY 14892 Compensation Valley Casework Inc [Electronic] E1010A New York Workers' , Compensation Valley Casework Inc [Electronic] E1010C Other WC (Non-NY) , VALLEY FORGE INSURANCE PO BOX 16030 VALLE003 New York Workers' READING, PA 19612 Compensation VALLEY FORGE INSURANCE COMPANY 333 SOUTH WABASH VALL01 New York Workers' 30S Compensation CHICAGO, IL 60604 Valley Harvesting & Packing, Inc. [Electronic] E1011A New York Workers' , Compensation Valley Harvesting & Packing, Inc. [Electronic] E1011C Other WC (Non-NY) , Valley Health Care Management Services, LLC E1012A New York Workers' [Electronic] , Compensation Valley Health Care Management Services, LLC E1012C Other WC (Non-NY) [Electronic] , Valley Health System [Electronic] E1013A New York Workers' , Compensation Valley Health System [Electronic] E1013C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Valley Memorial Hospital [Electronic] E1014A New York Workers' , Compensation Valley Memorial Hospital [Electronic] E1014C Other WC (Non-NY) , Valley Metro Barbosa Group 4152 West Main St VALLE004 New York Workers' Batavia, NY 14020 Compensation VALLEYVIEW FARMS 9970 ALEXANDER ROAD VALLE005 New York Workers' ALEXANDER, NY 14005 Compensation VALLYE PETROLEUM SERVICES 16 WILBUR AVENUE VALLY001 New York Workers' SCHECTADY, NY 12304 Compensation VALUE HOME CENTERS 45 South Rossler Street VHC01 New York Workers' BUFFALO, NY 14206 Compensation VAN PUTTE GARDENS 136 NORTH AVE VANPU001 New York Workers' ROCHESTER, NY 14626 Compensation Vance Metal Fabricators 251 Gambee Rd VANCE001 New York Workers' GENEVA, NY 14456 Compensation VANDERHEYDEN HALL P.O. BOX 219 VANDE001 New York Workers' WYNANTSKILL, NY 12198 Compensation VANDERHOOF ROOFING 4914 WEST GENESEE STREET VANDE002 New York Workers' CAMILLUS, NY 13031 Compensation VanDuyne 5075 W. Seneca Tpke VANDU001 New York Workers' Attn: WC Personnel Compensation Syracuse, NY 13215 VANGUARD CLAIMS DEPT PO BOX 22299 VANGU001 Auto/No-Fault TULSA, OK 741212299 Vanliner Insurance Co po box 26352 VANLI001 New York Workers' Fenton, MO 63026 Compensation Vanliners Insurance Company [Electronic] E2251A New York Workers' , Compensation Vanliners Insurance Company [Electronic] E2251C Other WC (Non-NY) , VANNER INS GROUP 11 PINCHOT CT STE 100 VANNE001 New York Workers' AMHERST, NY 14228 Compensation VANOCUR REFRACTORIES LLC PO BOX 146 VANOC001 New York Workers' TONAWANDA, NY 14151 Compensation VECTOR MAGNETICS 236 CHERRY ST VECTO001 New York Workers' ITHACA, NY 14850 Compensation VENSURE 4140 EAST BASELINE ROAD SUITE VENSU001 New York Workers' 201 Compensation MESA, AZ 85206 Venture Pac Develop [Electronic] E1015A New York Workers' , Compensation Venture Pac Develop [Electronic] E1015C Other WC (Non-NY) , VEOLIA ENVIRONMENTAL PO BOX 31A VEOLI001 New York Workers' PITTSFIELD, PA 16340 Compensation Vergason Technology 166 State Route 224 VERGA001 New York Workers' Van Etten, NY 14889 Compensation Verizon 204 Second Ave, 4th Floor VERIZ003 New York Workers' New York, NY 10003 Compensation Verizon Workers Compensation 204 2nd Avenue VERIZ004 Other WC (Non-NY) 4th Floor New York, NY 10003 Vermeer [Electronic] E8713C Other WC (Non-NY) , Vermont Mutual Ins [Electronic] 89 STATE STREET VERMO001 Auto/No-Fault MONTPELIER, VT 05601 Vertical Concrete [Electronic] E1016A New York Workers' , Compensation Vertical Concrete [Electronic] E1016C Other WC (Non-NY) , VESTAL DENTAL ASSOCIATES 533 CLAYTON AVE VESTA002 New York Workers' VESTAL, NY 13850 Compensation VESTAL HEALTH CARE LLC 116 NORTH JENSON STREET VESTA001 New York Workers' VESTAL, NY 13850 Compensation VFBL VOLUNTEER FIRE DEPTS 7852 WALKER DR VFBL02 New York Workers' SUITE 450 Compensation GREENBELT, MD 27770 VFIS PO BOX 5126 VFIS002 New York Workers' YORK, PA 17405-9726 Compensation Viad Corp [Electronic] E7345C Other WC (Non-NY) , VICKERY INC 3325 PASSADENA BLVD VICK01 New York Workers' PASSADENA, TX 77503 Compensation Vicorp Restaurants, Inc. [Electronic] E3361C Other WC (Non-NY) , iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Victor Plastics [Electronic] E7347C Other WC (Non-NY) , VICTORIA INSURANCE ATTN: JASON ROSENBERGER VICTO002 Auto/No-Fault PO BOX 93863 CLEVELAND, OH 44101 Victoria ISD [Electronic] E1017A New York Workers' , Compensation Victoria ISD [Electronic] E1017C Other WC (Non-NY) , VICTORY HIGHWAY WESLEYAN CHURCH 150 VICTORY HIGHWAY VICTO001 New York Workers' PAINTED POST, NY 14870 Compensation VIGILANT INSURANCE COMPANY PO BOX 1615 VIGI01 New York Workers' WARREN, NJ 07061 Compensation VIKING CIVES (USA) PO BOX 188 VIKIN001 New York Workers' OAKFIELD, NY 14125 Compensation VILLA OFM HOPE 3300 DEWEY AVE VILLA014 New York Workers' ROCHESTER, NY 14616 Compensation VILLAGE CLEANERS 5338 WEST TAFT ROAD VILLA011 New York Workers' NORTH SYRACUSE, NY 13212 Compensation VILLAGE HARDWARE 43 EAST GENESEE STREET VILLA007 New York Workers' BALDWINSVILLE, NY 13027 Compensation VILLAGE MANOR APARTMENTS 300 STEUBEN STREET VILLA004 New York Workers' PAINTED POST, NY 14870 Compensation VILLAGE OF BATH MUNICIPAL BUILDING 110 LIBERTY STREET VILLA001 New York Workers' BATH, NY 14810 Compensation VILLAGE OF BLASDELL 121 MIRIAM AVE VILLA013 New York Workers' BLASDELL, NY 14219 Compensation VILLAGE OF CAYUGA HEIGHTS 836 HANSHAW ROAD VILLA010 New York Workers' ITHACA, NY 14850 Compensation Village of Corfu 116 E Main Street VILLA003 New York Workers' Corfu, NY 14036 Compensation VILLAGE OF EAST AURORA 571 MAIN STREE VILLA012 New York Workers' EAST AURORA, NY 14052 Compensation VILLAGE OF HOLLEY 72 PUBLIC SQUARE VOH01 New York Workers' HOLLEY, NY 14470 Compensation VILLAGE OF HORSEHEADS 202 S MAIN ST VILLA009 New York Workers' HORSEHEADS, NY 14845 Compensation Village of Mamaroneck (public works) 123 Mamaroneck Avenue VILLA008 New York Workers' Mamaroneck, NY 10543 Compensation VILLAGE OF PAINTED POST PO BOX 110 VILLA006 New York Workers' PAINTED POST, NY 14870 Compensation Village of South Corning 7 Clark Street VILLA002 New York Workers' Corning, NY 14830 Compensation Village Of Walden 1 Municipal Square VILLA005 New York Workers' Walden, NY 12586 Compensation VININGS INSURANCE GROUP C/O BUILDERS INS GRP VININ001 Other WC (Non-NY) PO BOX 723099 ATLANTA, GA 31139 VIOLET REALTY, INC. 2100 LIBERTY BLDG VIOLE001 New York Workers' BUFFALO, NY 14202 Compensation VIP STRUCTURES 1 WEBSTERS LANDING VIPS01 New York Workers' SYRACUSE, NY 13202 Compensation Virginia Property and Casualty Ins 1 Bowdoin Square VIRGI002 New York Workers' Boston, MA 02114 Compensation virginia surety 1000 milwaukee #6 VIRGI001 New York Workers' glenview , IL 60025 Compensation VIRGINIA SURETY COMPANY INC 200 EAST RANDOLPH ST VIRG01 New York Workers' 18TH FL Compensation CHICAGO, IL 60601 Virginia Surety Company, Inc. [Electronic] E9988A New York Workers' , Compensation Virginia Surety Company, Inc. [Electronic] E9988B Auto/No-Fault , Virginia Surety Company, Inc. [Electronic] E9988C Other WC (Non-NY) , VISION RISK SERVICES 6333 JERICHO TPKE VRS01 New York Workers' COMMACK, NY 11725 Compensation VISION RISK SERVICES 6333 JERICHO TURNPIKE VISIO002 Auto/No-Fault COMMACK, NY 11725 VISIONS HOTEL 382 EAST SECOND STREET VISIO001 New York Workers' CORNING, NY 14830 Compensation VISITING NURSE SERVICE AND HOSPICE 505 MAIN ST VISIT002 New York Workers' NORTHPORT, NY 11768 Compensation Visiting Nurses Home Care 150 Broadway, Suite 310 VISIT001 New York Workers' Menands, NY 12204 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Vista Hills C Club [Electronic] E1018A New York Workers' , Compensation Vista Hills C Club [Electronic] E1018C Other WC (Non-NY) , VONROLL USA 200 VONROLL DRIVE VONRO001 New York Workers' SCHENECTADY, NY 12306 Compensation Vons / Safeway [Electronic] E1158A New York Workers' , Compensation Vons / Safeway [Electronic] E1158B Auto/No-Fault , Vons / Safeway [Electronic] E1158C Other WC (Non-NY) , VONS SAFEWAY CO PO BOX 29223 VONSS001 New York Workers' MS 7300 Compensation PHOENIX, AZ 85038 Vought Aircraft Industries [Electronic] E7897A New York Workers' , Compensation Vought Aircraft Industries [Electronic] E7897C Other WC (Non-NY) , VULCAN STEAM FORGE PO BOX 87 VSF01 New York Workers' BUFFALO, NY 14207 Compensation VULCRAFT OF NY, INC C/O TOM DONNELLS-INVOICE- VULCR004 New York Workers' CONFIDENTIAL Compensation PO BOX 280 CHEMUNG, NY 14825 W Co Radiology Cntr [Electronic] E1019A New York Workers' , Compensation W Co Radiology Cntr [Electronic] E1019C Other WC (Non-NY) , W J RIEGEL RAIL SOLUTIONS LLC 22 HAMILTON LANE WJRIE001 New York Workers' GLENMONT, NY 12077 Compensation W.D. MALONE 708 COUNTY ROUTE 7 WDMAL001 New York Workers' HANNIBAL, NY 13074 Compensation W.M.SCHULTZ CONSTRUCTION P.O. BOX 2620 WMSCH001 New York Workers' BALLSTON SPA, NY 12020 Compensation W.W. PATENAUDE SONS, INC PO BOX 408 WWPAT001 New York Workers' MECHANICVILLE, NY 12118 Compensation WA DEPARTMENT OF LABOR AND INDUSTRIES PO BOX 44269 WADEP002 Other WC (Non-NY) OLYMPIA, WA 985044269 WA DEPT LABOR INDUSTRIES PO BOX 44269 WADEP001 Other WC (Non-NY) OLYMPIA, WA 98504 WADES BUILDING SUPPLY 2 WALL STREET WADES003 New York Workers' ADDISON, NY 14801 Compensation WADE'S CONCRETE 206 W WATER STREET WADES002 New York Workers' ADDISON, NY 14801 Compensation WADE'S FARM & HOME 94 FRONT STREET WADES001 New York Workers' ADDISON, NY 14801 Compensation WADHAMS ENTERPRISES 369 BOSTWICK ROAD WADHA001 New York Workers' PHELPS, NY 14532 Compensation WAGNER HARDWOOD LLC PO BOX 68 WAGNE002 New York Workers' CAYUTA, NY 14824 Compensation WAGNER LUMBER COMPANY 4060 GASKILL RD WAGNE001 New York Workers' OWEGO, NY 13827 Compensation WALDORF AND ASSOCIATES 30 PROSPECT STREET WALDO001 New York Workers' HUNTINGTON, NY 11743 Compensation Walgreens/WC 5100 Lake Terrace NE WALGR001 Other WC (Non-NY) Mt. Vernon, IL 62864 WALMART 4975 TRANSIT RD WALMA001 New York Workers' DEPEW, NY 14043 Compensation Wal-Mart [Electronic] E9210C Other WC (Non-NY) , Walsh Duffield PO BOX 5016 WALSH001 New York Workers' Buffalo, NY 14205 Compensation WALT DISNEY WORLD PO BOX 10050 WALT01 New York Workers' LAKE BUENA VISTA, FL 32830 Compensation WALTER NIXON GROUP 123 N UNION AVE WANG01 New York Workers' STE 105 Compensation CRANFORD, NJ 07016 WARD & VAN SCOY INC 162 NORTH AVE WARDV001 New York Workers' PO BOX 359 Compensation OWEGO, NY 13827 WARD NORTH AMERICA 1636 CRESCENT DR WARDN001 New York Workers' TARRYTOWN, NY 10591 Compensation WARD TRUCKING & LOGISTICS PO BOX 1553 WARDT001 New York Workers' ALTOONA, PA 16603-1553 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID WARREN COUNTY SELF-INSURANCE 1340 STATE ROUTE 9 WCSI01 New York Workers' LAKE GEORGE, NY 12845 Compensation Warren Equities 27 Warren Way WARRE002 New York Workers' Providence, RI 02905 Compensation WASAU INSURANCE 925 N. POINT PARKWAY WAIN03 New York Workers' STE 300 Compensation ALPHARETTA, GA 30005 Washington County [Electronic] E1020A New York Workers' , Compensation Washington County [Electronic] E1020C Other WC (Non-NY) , Washington Hospital [Electronic] E1021A New York Workers' , Compensation Washington Hospital [Electronic] E1021C Other WC (Non-NY) , WASHINGTON INTERNATIONAL INS 108 GREENWICH ST 7TH FLOOR WASHI002 Auto/No-Fault NEW YORK, NY 10006 WASHINGTON L&I PO BOX 44291 WASHI008 Other WC (Non-NY) OLYMPIA, WA 98504 Washington Mills 1801 Buffalo Ave, PO box 423 WASHI006 New York Workers' Attn: HR Confidential Compensation Niagara Falls, NY 14303 WASHINGTON MILLS 1000 E NIAGARA STREET WASHI001 New York Workers' TONAWANDA, NY 14150 Compensation Washington Nationals 1500 South Capital Street SE WASHI007 New York Workers' Washington DC, DC 20003 Compensation WASHINGTON ST DEPT/LABOR PO BOX 44299 WASH01 New York Workers' OLYMPIA, WA 98501 Compensation Washington State Dept of Labor & Indust PO Box 44000 WASHI005 New York Workers' Olympia, WA 98504-4000 Compensation Washington US Dept Of Labor PO Box 44291 WASHI003 New York Workers' Olympia, WA 98504 Compensation WASHITA VALLEY ENTERPRISE PO BOX 270 WASHI004 New York Workers' TOWANDA, PA 18848 Compensation WASTE MANAGEMENT 1661 MT READ BLVD WASTE002 New York Workers' ROCHESTER, NY 14621 Compensation WASTE MANAGEMENT 2590 OLD RODGERS RD WASTE001 New York Workers' BRISTOL, PA 19007 Compensation WATERFRONT HEALTHCARE CTR 200 7TH ST WATER002 New York Workers' BUFFALO, NY 14201 Compensation WATERLOO CONTAINER PO BOX 262 WATER003 New York Workers' WATERLOO, NY 13165 Compensation Watervliet City Hall #2 15th Street WATER001 New York Workers' ATT: Bruce Hidley Compensation Watervliet, NY 12189 Watkins Manufacturing Corporation [Electronic] E1022A New York Workers' , Compensation Watkins Manufacturing Corporation [Electronic] E1022C Other WC (Non-NY) , WATKINS MILIK HAULING 3486 DRY BRIDGE ROAD WATKI002 New York Workers' ALEXANDER, NY 14005 Compensation WATKINS MOTOR LINE 2509 BRISTOL PIKE WATKI001 New York Workers' CROYDON, PA 19021 Compensation WATTSBURG FIRE DEPT 14437 MAIN STREET WATTS001 New York Workers' WATTSBURG, PA 16442 Compensation WATTSHealth Foundation, Inc. (SNCC) E1023A New York Workers' [Electronic] , Compensation WATTSHealth Foundation, Inc. (SNCC) E1023C Other WC (Non-NY) [Electronic] , Wausau Claims Service 2000 Westwood Dr. WAUSA001 New York Workers' MS3260 Compensation Wausau, WI 54401 WAUSAU INS PO BOX 4025 WAUI01 New York Workers' BEAVERTON, OR 97076-4025 Compensation WAUSAU INS CO 300 EXECUTIVE DR WAUSA003 New York Workers' WEST ORANGE, NJ 07052 Compensation WAUSAU INS CO PO BOX 3499 WAIN15 New York Workers' CHARLOTTE, NC 28106 Compensation WAUSAU INS CO PO BOX 4836 WAIN05 New York Workers' SYRACUSE, NY 13221-4836 Compensation WAUSAU SIGNATURE AGENCY 27201 BELLA VISTA PKWY WAUSA004 New York Workers' WARRENVILLE, IL 60555 Compensation WAVERLY CENTRAL SCHOOL DIST 15 FREDERICK STREET WAVER001 New York Workers' ATTN: KATHY ROTE Compensation WAVERLY, NY 14892 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Wawona Packing [Electronic] E1024A New York Workers' , Compensation Wawona Packing [Electronic] E1024C Other WC (Non-NY) , WAYNE ARC 150 VAN BUREN ST WARC01 New York Workers' NEWARK, NY 14513 Compensation WAYNE FINGER LAKES SCHOOL WORKERS' COMP 3599 BIG RIDGE RD WAYNE001 New York Workers' SPENCERPORT, NY 14559 Compensation WC FUND OF UTAH 100 WEST TOWNE RIDGE PARKWAY WCFUN001 New York Workers' SANDY, UT 84070 Compensation WC SERVICES LIC 5109 BLEIGH AVE WCSER001 New York Workers' PHILADELPHIA, PA 19136 Compensation WC TRUST PO BOX 5042 WCTRU001 New York Workers' WALLINGFERD, CT 06492 Compensation WCA OCCUPATIONAL HEALTH 51 GLASGOW AVE WCAOC001 New York Workers' ATTN: LISA MILLER Compensation JAMESTOWN, NY 14701 WE CARE TRANSPORTATION 401 EAST AMHERST ST WECAR001 New York Workers' BUFFALO, NY 14215 Compensation Weatherpanel 285 Chandler St WEATH001 New York Workers' Buffalo, NY 14207 Compensation Webb's Captains Table 115 W. Lake Rd. WEBBS001 New York Workers' Mayville, NY 14757 Compensation WEBSTER ELECTRIC 8599 WEST CENTER AVE WEBST001 New York Workers' SHIRLEY, IN 47384 Compensation WEBSTER RISK SERVICES #9915 PO BOX 1041 WEBR01 New York Workers' MERIDEN, CT 06450 Compensation WEBSTER RISK SVCS PO BOX 120650 WEBR02 New York Workers' EAST HAVEN, CT 06512 Compensation Webter Insurance - WC 550 Mamaroneck Ave WEBTE001 New York Workers' Harrison, NY 10528 Compensation Wegman Comp. Department 1500 Brooks Avenue WEGMA003 New York Workers' Rochester, NY 14692 Compensation WEGMANS 1885 CHILI AVE WEGMA002 New York Workers' ROCHESTER, NY 14624 Compensation WEGMANS (ELMIRA) 1100 CLEMENS CENTER PRWY WEGMA004 New York Workers' ELMIRA, NY 14901 Compensation WEGMANS ACCIDENT INS P O BOX 30844 WEGMA006 Other WC (Non-NY) ROCHESTER, NY 14603-0844 WEGMANS ACCIDENT SERVICES PO BOX 30844 WEGMA005 New York Workers' ROCHESTER, NY 14603 Compensation WEGMANS EMPLOYEE ASSISTANCE 160 ALLENS CREEK OFFICE PARK WEA01 New York Workers' ROCHESTER, NY 14618 Compensation WEIL ENTERPRISES INC 766 ADDISON ROAD WEILE001 New York Workers' PAINTED POST, NY 14870 Compensation WEIR SPM 36 LEVEL ACRES DRIVE WEIRS001 New York Workers' HORSEHEADS, NY 14845 Compensation WEISS WEXLER AND WORNOW 25 PARK PL WWAW01 New York Workers' 4TH FL Compensation NEW YORK, NY 10007 WEISS,WEXLER &WORNOW 25 PARK PLACE WEISS001 New York Workers' 4TH FLOOR Compensation NEW YORK, NY 10007 WELCH ALLYN PO BOX 97 WEAL01 New York Workers' SKANEATELES FALLS, NY 13153 Compensation Welch-Allyn 4341 State Street Road WELCH001 New York Workers' Skaneateles Falls, NY 13153-5300 Compensation WELLIVER MCGUIRE INC 250 NORTH GENESSEE STREET WELLI001 New York Workers' MONTOUR FALLS, NY 14865 Compensation Wells College 170 Main Street WELLS005 New York Workers' Aurora, NY 13026 Compensation Wells Fargo 580 N 4th Street WELLS001 New York Workers' Suite 400 Compensation Columbus, OH 43216 WELLS FARGO PO BOX 1567 WELLS003 New York Workers' ABINGDON, VA 24212 Compensation WELLS FARGO PO BOX 95 WELLS002 New York Workers' HOUSTON, TX 15342 Compensation WELLS FARGO DISABILITY MGMT PO BOX 95 WELLS004 Other WC (Non-NY) HOUSTON, PA 15342-0095 WENDE CORRECTIONAL 3040 WENDE ROAD WENDE001 New York Workers' ALDEN, NY 14004 Compensation WENDY'S 20 NORTH UNION STREET WENDY005 New York Workers' ROCHESTER, NY 14607 Compensation WENDYS (CORNING) 5 S BUFFALO STREET WENDY003 New York Workers' CORNING, NY 14830 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID WENDYS (CORTLAND)(WENDBING CORP) 27 CENTRAL AVE WENDY002 New York Workers' ATTN TRICIA Compensation CORTLAND, NY 13045 WENDYS (HORSEHEADS) 2123 GRAND CENTRAL AVENUE WENDY001 New York Workers' HORSEHEADS, NY 14845 Compensation WENDY'S (OWEGO) 170 FIFTH AVE WENDY004 New York Workers' OWEGO, NY 13827 Compensation WENZEL CONTRACTORS 169 PRESCOTT AVE WENZE001 New York Workers' ELMIRA HEIGHTS, NY 14903 Compensation Werner Enterprises PO BOX 45308 WERNE001 New York Workers' Omaha, NE 68145 Compensation Weslaco Independent School District [Electronic] E1025A New York Workers' , Compensation Weslaco Independent School District [Electronic] E1025C Other WC (Non-NY) , Wesley Health Care 131 Lawrence Street WESLE001 New York Workers' Saratoga Springs, NY 12866 Compensation WEST AMERICAN INSURANCE CO 9450 SEWARD RD WEAI01 New York Workers' FAIRFIELD, OH 45014 Compensation WEST BEND MUTUAL 1900 S 18TH AVE WESTB002 Other WC (Non-NY) WEST BEND, WI 53095 West Bend Mutual / WC 1900 18th Ave WESTB001 Other WC (Non-NY) West Bend, WI 53095 West Coast Hospitals, Inc. [Electronic] E1026A New York Workers' , Compensation West Coast Hospitals, Inc. [Electronic] E1026C Other WC (Non-NY) , West Genesee School District 300 Sanderson Drive WESTG001 New York Workers' Camillus, NY 13031 Compensation WEST HERR AUTOMOTIVE 5025 CAMP RD WESTH001 New York Workers' HAMBURG, NY 14075 Compensation WEST HERR AUTOMOTIVE P O BOX 1998 WESTH002 New York Workers' BLASDELL, NY 14219 Compensation West Oso ISD [Electronic] E1027A New York Workers' , Compensation West Oso ISD [Electronic] E1027C Other WC (Non-NY) , West Texas Rural Counties Preferred Risk Pool E1028A New York Workers' [Electronic] , Compensation West Texas Rural Counties Preferred Risk Pool E1028C Other WC (Non-NY) [Electronic] , WEST VALLEY DEMONSTRATION PROJECT 1082 ROCK SPRING RD WESTV002 New York Workers' WEST VALLEY, NY 14171 Compensation WEST VALLEY FIRE DIST 9091 PO BOX 240 WESTV001 New York Workers' WEST VALLEY, NY 14171 Compensation WEST VIRGINIA WORKERS PO BOX 3151 WVW01 New York Workers' CHARLESTON, WV 25332 Compensation Westamerica/Phil Long Dealerships [Electronic] E1029A New York Workers' , Compensation Westamerica/Phil Long Dealerships [Electronic] E1029C Other WC (Non-NY) , WESTCHESTER COUNTY 148 MARTINE AVE WESTC001 New York Workers' WHITE PLAINS, NY 10601 Compensation WESTECH PROCESSING SOLUTIONS 1 CHIPS LANE WESTE009 New York Workers' FISHKILL, NY 12524 Compensation WESTERN BENEFITS PO BOX 22185 WEBE01 New York Workers' PORTLAND, OR 97269 Compensation WESTERN NATIONAL PO BOX 1463 WESTE007 Auto/No-Fault MINNEAPOLIS, MN 55440 Western National Assurance [Electronic] E1292A New York Workers' , Compensation Western National Assurance [Electronic] E1292B Auto/No-Fault , Western National Assurance [Electronic] E1292C Other WC (Non-NY) , Western National Insurance Group [Electronic] E1326B Auto/No-Fault , Western National Insurance Group [Electronic] E1326C Other WC (Non-NY) , WESTERN NATIONAL MUTUAL 5350 - WEST 78TH STREET WESTE010 Auto/No-Fault EDINA, MN 55439 WESTERN NATIONAL MUTUAL 5350 - WEST 78TH STREET WESTE011 Other WC (Non-NY) EDINA, MN 55439 Western National\Pioneer Specialties [Electronic] E1293A New York Workers' , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Western National\Pioneer Specialties [Electronic] E1293B Auto/No-Fault , Western National\Pioneer Specialties [Electronic] E1293C Other WC (Non-NY) , WESTERN NY DDSO 303 WEST CENTER STREET WESTE006 New York Workers' MEDINA, NY 14103 Compensation WESTERN NY ENERGY PO BOX 191 WESTE008 New York Workers' MEDINA, NY 14103 Compensation WESTERN NY VA HEALTH CARE SY 222 Richmond Ave WESTE004 New York Workers' batavia, NY 14020 Compensation WESTERN REGIONAL OFF TRACK BETTING 8315 PARK RD WESTE001 New York Workers' BATAVIA, NY 14120 Compensation WESTFIELD GROUP 800 CRANBERRY WOODS DR WESTF002 New York Workers' SUITE 150 Compensation CRANBERRY TWNSH, NJ 16066 WESTFIELD GROUP (LANCASTER) 201 E OREGON ROAD WESTF001 New York Workers' PO BOX 3010 Compensation LANCASTER, PA 17604 WESTFIELD INS PO BOX 5005 WESTF003 New York Workers' WESTFIELD CTR, OH 44251 Compensation WESTFIELD INS CO 2325 DEAN ST WESTF004 New York Workers' STE 100 Compensation ST. CHARLES, IL 60175 WESTFIELD INS CO C/O RISING MEDICAL SOLUTIONS WESTF005 Other WC (Non-NY) P O BOX 3098 MILWAUKEE, WI 53201-3098 WESTFIELD INSURANCE COMPANY PO BOX 3010 WESTF006 Other WC (Non-NY) LANCASTAER, PA 17604 WESTPORT INSURANCE CORP 5200 METCALF WEST01 New York Workers' OPN323 Compensation OVERLAND PARK, KS 66202-1265 WEYDMAN ELECTRONIC,INC 747 YOUNGS ST WEYDM001 New York Workers' TONAWANDA, NY 14150 Compensation WHEATFIELD PEDIATRICS 2890 NIAGARA FALLS BLVD WHEAT001 New York Workers' N TONWANDA, NY 14120 Compensation White County Coal / WC PO Box 457 WHITE001 Other WC (Non-NY) Carmi, IL 62821 WHITING DOOR 113 CEDAR ST WHITI001 New York Workers' AKRON, NY 14001 Compensation Whitmore Fence Po Box 846 WHITM001 New York Workers' Dryden, NY 13053 Compensation WILBRI INC 8280 KANONA ROAD WILBR001 New York Workers' AVOCA, NY 14809 Compensation WILDWOOD PROGRAMS 2995 Curry Road WILDW001 New York Workers' SCHENECTADY, NY 12303 Compensation Will O Crest Farms 817 County Rd 27 WILLO002 New York Workers' Clifton Springs, NY 14432 Compensation WILL POULTRY CO 1075 WILLIAM ST WILLP001 New York Workers' BUFFALO, NY 14240 Compensation Willamette View [Electronic] E1030A New York Workers' , Compensation Willamette View [Electronic] E1030C Other WC (Non-NY) , Willard Drug Treatment Center 7116 County Rd 132 WILLA001 New York Workers' Willard, NY 14588 Compensation WILLCARE 346 DELAWARE AVE WILLC001 New York Workers' BUFFALO, NY 14202 Compensation WILLET DAIRY 379 STATE ROUTE 34 WILLE001 New York Workers' LOCKE, NY 13092 Compensation William A Smith & Son 380 Broadway WILLI008 New York Workers' Newburgh, NY 12550 Compensation WILLIAM FRANDSEN & SON 19 ORCHARD ST WILLI003 New York Workers' SPENCER, NY 14883 Compensation WILLIAM GEORGE AGENCY 380 FREEVILLE ROAD WILLI004 New York Workers' FREEVILLE, NY 13068 Compensation WILLIAM WOOD MASONARY PO BOX 181 WILLI002 New York Workers' PAINTED POST, NY 14870 Compensation Williams & Sonoma [Electronic] E1316A New York Workers' , Compensation Williams & Sonoma [Electronic] E1316C Other WC (Non-NY) , WILLIAMS CONSTRUCTION 1241 PENNSYLVANIA AVE WILLI010 New York Workers' PINE CITY, NY 14871 Compensation WILLIAMS HONDA 465 E WATER ST WILLI005 New York Workers' ELMIRA, NY 14901 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Williamsburg Nat. Ins. PO BOX 219559 WILLI006 New York Workers' Kansas City, MO 64121-9559 Compensation WILLIAMSBURG NATIONAL INS CO PO BOX 3190 WNIC01 New York Workers' CERRITOS, CA 90703-3190 Compensation WILLIS - NY 4 TOWER PLACE WILL02 New York Workers' EXECUTIVE PARK Compensation ALBANY, NY 12203 WILLIS OF NORTHERN NEW ENGLAND 60 PINELAND DRIVE WILLI007 New York Workers' SUITE 130, BLDG 2 Compensation NEW GLOUCESTER, ME 04260 Willis of NY 200 Liberty Street WILLI009 New York Workers' New York, NY 10281 Compensation WILLOW GROUP 34 CLINTON ST WILLO001 New York Workers' BATAVIA, NY 14020 Compensation Wilmer-Hutchins ISD/Dallas ISD [Electronic] E1031A New York Workers' , Compensation Wilmer-Hutchins ISD/Dallas ISD [Electronic] E1031C Other WC (Non-NY) , WILSON FARMS (ELMIRA) 1412 MAPLE AVE WILSO001 New York Workers' ELMIRA, NY 14904 Compensation WILSON FARMS (WILLIAMSVILLE,NY) 1780 WEHRLE DRIVE WILSO002 New York Workers' WILLIAMSVILLE, NY 14221 Compensation Wilson Hospital 33-57 Harrison Street WILSO004 New York Workers' Johnson City, NY 13790 Compensation WILSON RENTAL 369 PARK AVE WILSO003 New York Workers' CORNING, NY 14830 Compensation WILTSIE CONSTRUCTION 735 EAST STREET WILTS001 New York Workers' OSWEGO,NY, NY 13126 Compensation WINCHESTER VOLUNTEER FIRE DEPT 514 HARLEM RD WINCH001 New York Workers' WEST SENECA, NY 14224 Compensation windsong radiology 55 spindrift drive WINDS001 New York Workers' williamsville, NY 14221 Compensation Wingate at Beacon 10 Hastings Drive WINGA001 New York Workers' Beacon, NY 12508 Compensation WINTER HARBOR MARINA 604 COUNTY ROUTE 37 WINTE001 New York Workers' CENTRAL SQUARE, NY 13036 Compensation WIREWORKS 517 BALDWIN STREET WIREW001 New York Workers' ELMIRA, NY 14901 Compensation WJ COX ASSOCIATES 9600 MAIN ST WJC01 New York Workers' STE 3 Compensation CLARENCE, NY 14031 WKMNCOMP NJ NETS PO BOX 42065 WKMNC001 New York Workers' PHOENIX, AZ 85027 Compensation WNY ARENA LLC 1 SEYMOUR KNOX PLAZA WNYAR001 New York Workers' BUFFALO, NY 14203 Compensation WNY FACILITY SERVICES 3125 WALDEN AVE WNYFA001 New York Workers' DEPEW, NY 14043 Compensation Woodland Farms [Electronic] E3071A New York Workers' , Compensation Woodland Farms [Electronic] E3071B Auto/No-Fault , Woodland Farms [Electronic] E3071C Other WC (Non-NY) , Woodland Park West [Electronic] E1032A New York Workers' , Compensation Woodland Park West [Electronic] E1032C Other WC (Non-NY) , WORK FIRST CASUALTY COMPANY 25 CHESTNUT STREET WFCC01 New York Workers' STE 105 Compensation HADDONFIELD, NJ 08033 WORK FORCE SAFETY AND INSURANCE PO BOX 5585 WORKF002 New York Workers' BISMARCK, ND 58506 Compensation WORKER COMP CHOICE 800 CARTER ST WCC01 New York Workers' ROCHESTER, NY 14621 Compensation WORKER'S COMPENSATION PO BOX 5205 WORKE003 Other WC (Non-NY) BINGHAMPTON, NY 13902 WORKERS COMPENSATION FUND 100 WEST TOWN RIDGE PARKWAY WORKE004 Other WC (Non-NY) SANDY, UT 84070 Workers Compsensation Fund PO Box 2227 WORKE002 New York Workers' 100 West Towne Ridge Parkway Compensation Sandy, UT 84070 WORKFIT STAFFING 1160 CHILI AVE WORKF001 New York Workers' STE 200 Compensation ROCHESTER, NY 14624 Workforce Safety and Insurance (WSI) E1152A New York Workers' [Electronic] , Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Workforce Safety and Insurance (WSI) E1152C Other WC (Non-NY) [Electronic] , Workmens Ins Group [Electronic] 714 WEST OLYMPIC BOULEVARD WORKM001 Auto/No-Fault SUITE 800 LOS ANGELES, CA 90015 WORKNET OF OKLAHOMA PO BOX 3206 WORKN001 New York Workers' TULSA, OK 74101-3206 Compensation WORKWELL 112 THIRD AVENUE WORKW001 Other WC (Non-NY) CARNEGIE, PA 15106 WORLD KITCHEN FACTORY STORE 114 PINE STREET WORLD004 New York Workers' CORNING, NY 14830 Compensation WORLD KITCHEN,INC 1 STEUBEN STREET WORLD002 New York Workers' CORNING, NY 14830 Compensation WORLD SOURCE 600 NORTH PEARL WORLD001 New York Workers' STE 700 Compensation DALLAS, TX 75201 WORLDWIDE INS CO PO BOX 7246 WORLD003 Auto/No-Fault ST LOUIS, MO 63177 WRIGHT RISK MANAGEMENT 333 EARLE OVINGTON BLVD WRM01 New York Workers' STE 505 Compensation UNIONDALE, NY 11553 Wyman-Gordon Companies [Electronic] E1840C Other WC (Non-NY) , WYOMING CASING SERVICE POX 225 WYOMI003 New York Workers' NEW ALBANY, PA 18833 Compensation Wyoming Co Comm Hospital 400 N Main St WYOMI004 New York Workers' Warsaw, NY 14569 Compensation WYOMING COUNTY WORKERS COMP 338 NORTH MAIN STREET WYOMI001 New York Workers' WARSAW, NY 14569 Compensation WYTHEWILLTZETZP LLC 1100 MILITARY RD WYTHE001 New York Workers' BUFFALO, NY 14217 Compensation X CHANGING 1420 MINERAL SPRINGS AVE CAMBR002 New York Workers' NORTH PROVIDENCE, RI 02904 Compensation X CHANGING 1701 UTICA AVE CQC01 New York Workers' BROOKLYN, NY 11234 Compensation X CHANGING 850 CLINTON SQ CHP01 New York Workers' ROCHESTER, NY 14604 Compensation X CHANGING PO BOX 1270 XCHAN027 New York Workers' WORTHINGTON, OH 43085-1270 Compensation X CHANGING PO BOX 21405 CAMB13 New York Workers' EAGAN, MN 55121 Compensation X CHANGING PO BOX 610 XCHAN028 New York Workers' OAKLAND, NJ 07436 Compensation X CHANGING PO BOX H XCHAN024 New York Workers' Whippany, NJ 07981 Compensation Xcel Energy [Electronic] E1402B Auto/No-Fault , Xcel Energy [Electronic] E1402C Other WC (Non-NY) , Xchanging 8755 W. Higgins Rd XCHAN001 New York Workers' 11th Floor OHare Plaza Compensation Chicago, IL 60631 Xchanging PO BOX 94950 XCHAN006 Auto/No-Fault Cleveland, OH 44113 Xchanging / WC PO Box 16000 XCHAN023 Other WC (Non-NY) Columbus, OH 43216 Xchanging, Inc [Electronic] E7348C Other WC (Non-NY) , XCHANGING/WC 8755 W Higgins Rd XCHAN022 Other WC (Non-NY) Suite 1100 Chicago, IL 60631 xl Environmental, Inc. [Electronic] E2514C Other WC (Non-NY) , XL SPECIALTY INS 505 EAGLEVIEW BLVD # 100 XLSPE001 New York Workers' EXTON, PA 19341-1120 Compensation XL Specialty Insurance [Electronic] E1130A New York Workers' , Compensation XL Specialty Insurance [Electronic] E1130C Other WC (Non-NY) , XL SPECIALTY INSURANCE COMPANY 1201 NORTH MARKET ST XLSI01 New York Workers' WILMINGTON, DE 19801 Compensation XL SPECIALTY INSURANCE COMPANY C/O ALTERNATIVE SERVICE XLSPE002 Other WC (Non-NY) CONCEPT 5010 RITTER ROAD MECHANICSBURG, PA 17055 iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID YANCEY'S FANCY 857 MAIN STREET ROAD YANCE001 New York Workers' CORFU, NY 14036 Compensation YELLOW FREIGHT 1000 HOMESTEAD AVE YFS02 New York Workers' MAYBROOK, NY 12543 Compensation YELLOW FREIGHT SYSTEMS PO BOX 7932 YFS01 New York Workers' OVERLAND PARK, KS 66207 Compensation YMCA 127 CENTERWAY YMCA003 New York Workers' ATTEN: RITA Compensation CORNING, NY 14830 YMCA 150 TECH DR YMCA005 New York Workers' AMHERST, NY 14228 Compensation YMCA 465 NEW KARNER ROAD YMCA002 New York Workers' #4 Compensation Albany, NY 12205 YMCA 600 GLEN STREET YMCA004 New York Workers' GLENS FALLS, NY 12801 Compensation YMCA [Electronic] E1033A New York Workers' , Compensation YMCA [Electronic] E1033C Other WC (Non-NY) , YMCA BUFFALO NIAGARA 301 CAYUGA RD SUITE 100 YMCAB001 New York Workers' ATTN: DEBBIE VIA Compensation BUFFALO, NY 14225 YMCA CORPORATE OFFICE 280 CAYUGA ATTN: WORKERS YMCAC001 New York Workers' COMPENSATION Compensation CHEEKTOWAGA, NY 14225 YMCA GREATER ROCHESTER 444 EAST MAIN STREET YMCA01 New York Workers' ROCHESTER, NY 14604 Compensation YORK CENTRAL SCHOOL 2578 GENESEE ST YORKC003 New York Workers' RETSOF, NY 14539 Compensation YORK CLAIM SERVICE 99 CHERRY HILL RD YCS03 New York Workers' PARSIPPANY, NJ 07054 Compensation YORK CLAIM SERVICES PO BOX 253 YCS02 New York Workers' PARSIPPANY, NJ 07054-0250 Compensation York Claim Services [Electronic] E1034A New York Workers' , Compensation York Claim Services [Electronic] E1034B Auto/No-Fault , York Claim Services [Electronic] E1034C Other WC (Non-NY) , YORK CLAIMS SERVICE 1 WHITEHALL ST YCS01 New York Workers' #14 Compensation NEW YORK, NY 10004 YORK CLAIMS SERVICE 2 PENN CENTER WEST YORKC002 Auto/No-Fault SUITE 320 PITTSBURGH, PA 15276 YORK INSURANCE 125 WOLS SVE STE 314 YORKI001 New York Workers' ALBANY, NY 12205 Compensation YORK METAL TELL PROCESSING INC 8 DWIGHT PARK DRIVE YORKM001 New York Workers' SYRACUSE, NY 13209 Compensation YORK RISK SERVICES P.O.BOX 183188 YORKR009 New York Workers' COLUMBUS, OH 43218-3188 Compensation YORK RISK SERVICES PO BOX 182364 YORKR006 New York Workers' COLUMBUS, OH 43218 Compensation YORK RISK SERVICES PO BOX 182364 YORKR007 Auto/No-Fault COLUMBUS, OH 43218 YORK RISK SERVICES PO BOX 182364 YORKR008 Other WC (Non-NY) COLUMBUS, OH 43218 YOUNG AGENCY 500 PLUM ST YOAG01 New York Workers' SYRACUSE, NY 13204 Compensation YOUNGBLOOD DISPOSAL PO BOX 64463 YOUNG002 New York Workers' ROCHESTER, NY 14624 Compensation YOUNGSVILLE BOROUGH 40 RAILROAD STREET YOUNG001 New York Workers' YOUNGSVILLE, PA 16371 Compensation Zachry Construction [Electronic] E7787A New York Workers' , Compensation Zachry Construction [Electronic] E7787C Other WC (Non-NY) , ZANDRI CONSTRUCTION INC WC 98 NIVER STREET ZANDR001 New York Workers' COHOES, NY 12047 Compensation Zelasko 136 Pfohl Rd ZELAS001 New York Workers' Cheektowaga, NY 14225 Compensation ZENITH 2 VALLEY SQUARE ZENIT003 New York Workers' BLUE BELL, PA 194222717 Compensation ZENITH INSURANCE TWO VALLEY SUITE 301 ZENIT002 New York Workers' BLUE BELL, PA 19422 Compensation iHCFA.com Master Payor List - Generated on 12/2/2014 4:29:18 AM

Name Address Payer ID Zenith Insurance (IL) / WC P.O. Box 1558 ZENIT001 Other WC (Non-NY) Sarasota, FL 34230 ZENITH INSURANCE CO 21255 CALIFA ST ZENI01 New York Workers' WOODLAND HILLS, CA 91367-5021 Compensation ZENITH INSURANCE CO PO BOX 1558 ZENIT004 New York Workers' SARASOTA, FL 34230-1558 Compensation ZENNER AND RITTER 3404 BAILEY AVE ZENNE001 New York Workers' ATTN: LINDA Compensation BUFFALO, NY 14215 ZERO DRAFT 2824 LEMOYNE AVENUE ZEROD001 New York Workers' SYRACUSE, NY 13211 Compensation ZIEBART 1505 LYELL AVE ZIEBA001 New York Workers' ROCHESTER, NY 14606 Compensation ZIESER WILBURT 750 HOWARD STREET ZIESE001 New York Workers' ELMIRA, NY 14904 Compensation ZIOLKOWSKI CONSTRUCTION 1005 S LAFAYETTE ZIOLK001 New York Workers' SOUTH BEND, IN 46601 Compensation ZMK CONSTRUCTION 3430 ROUTE 434 ZMKCO001 New York Workers' APALACHIN, NY 13732 Compensation Z-Nat Insurance (Zenith National) [Electronic] E2140A New York Workers' , Compensation Z-Nat Insurance (Zenith National) [Electronic] E2140C Other WC (Non-NY) , ZOLADZ CONSTRUCTION CO INC PO BOX 157 ZOLAD001 New York Workers' ALDEN, NY 14004 Compensation ZOTO'S INTERNATIONAL 300 FORGE AVE ZOTOS002 New York Workers' GENEVA, NY 14456 Compensation ZUBER FARMS 5633 TOWER HILL ROAD ZUBER001 New York Workers' BRYON, NY 14422 Compensation Zurich PO BOX 66946 ZURIC040 Other WC (Non-NY) Chicago, IL 60666 Zurich PO BOX 66946 ZURIC042 New York Workers' Chicago, IL 60666 Compensation Zurich PO BOX 968044 ZURIC036 New York Workers' SCHAUMBURG, IL 60196 Compensation Zurich PO BOX 968044 ZURIC037 Auto/No-Fault SCHAUMBURG, IL 60196 Zurich PO BOX 968044 ZURIC038 Other WC (Non-NY) SCHAUMBURG, IL 60196 ZURICH PO BOX 968023 ZURIC043 Other WC (Non-NY) SCHAUMBURG, IL 60196 Zurich Farmers [Electronic] E9698C Other WC (Non-NY) , Zurich Insurance PO Box 968053 ZURIC039 Other WC (Non-NY) Schaumburg, IL 60196 ZURICH INSURANCE PO BOX 4034 ZURIC044 Other WC (Non-NY) SCHAUMBURG, IL 60168 ZURICH INSURANCE COMPANY PO BOX 968044 ZURIC045 Other WC (Non-NY) SCHAUMBURG, IL 60196 Zurich Insurance N.A. [Electronic] E5567C Other WC (Non-NY) ,