Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List C of A Employer 142274 AFFINITY GAMING Elizabeth Guth VP - Insurance & Benefits 3755 Breakthrough Way, Suite 300 Las Vegas NV 89135 702-341-2419 Association Name DBA Date Subsidiary Flamingo Paradise Gaming, LLC Silver Sevens Hotel and Casino 31-JAN-17 Subsidiary Plantation Investments, LLC Rail City Casino 31-JAN-17 Subsidiary Primadonna Company, LLC (The) Whiskey Pete's Hotel and Casino 31-JAN-17 Subsidiary Primadonna Company, LLC (The) Buffalo Bill's Resort and Casino 31-JAN-17 Subsidiary Primadonna Company, LLC (The) Primm Valley Resort and Casino 31-JAN-17 Third Party Administrator Sierra Nevada Administrators 31-JAN-17 C of A Employer 122997 ARCBEST CORPORATION (FKA ARKANSAS BEST CORPORATION) Lynette Woodie Manager, Loss Prevention & Administration 8401 McClure Drive Fort Smith AR 72916 479-785-6047 Association Name DBA Date Subsidiary ABF FREIGHT SYSTEM, INC. 15-DEC-81 Subsidiary AcrBest II 01-NOV-20 Third Party Administrator GALLAGHER BASSETT SERVICES, INC.(TPA) 15-DEC-81 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List C of A Employer 123211 BEST BUY CO INC Allison Klonne Senior Analyst - Casualty Risk 7601 Penn Avenue South B4 Richfield MN 55423 612-291-6958 Association Name DBA Date Subsidiary BEST BUY STORES LP 01-DEC-97 Subsidiary BEST BUY WAREHOUSING LOGISTICS LLC 01-APR-17 Subsidiary GREATCALL INC 01-OCT-18 Third Party Administrator SEDGWICK CLAIMS MANAGEMENT SERVICES INC Sedgwick 01-DEC-97 C of A Employer 123005 BOYD GAMING CORPORATION Kim Cowley GL & WC Claims Manager 6465 South Rainbow Blvd Las Vegas NV 89118 702-792-7352 Association Name DBA Date Subsidiary ALIANTE CASINO AND HOTEL 27-SEP-16 Subsidiary BOYD ATLANTIC CITY, INC. 01-JAN-99 Subsidiary BOYD CENTRAL REGION, INC. 01-FEB-96 Subsidiary BOYD DEVELOPMENT CORPORATION 01-OCT-95 Subsidiary BOYD GAMING CORPORATION 01-NOV-90 Subsidiary BOYD SHARED SERVICES, INC. 01-JUN-07 Subsidiary BOYD TRAVEL, INC. VACATIONS-HAWAII 01-OCT-95 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List SAM'S TOWN HOTEL, GAMBLING HALL & Subsidiary CALIFORNIA HOTEL & CASINO 01-AUG-82 BOWLING CENTER Subsidiary CALIFORNIA HOTEL & CASINO CALIFORNIA HOTEL AND CASINO 01-AUG-82 Subsidiary CANNERY CASINO AND HOTEL 20-DEC-16 Subsidiary COAST CASINOS THE ORLEANS HOTEL & CASINO 01-FEB-89 Subsidiary CONSTELLATION INSURANCE COMPANY 01-JUL-05 Subsidiary EASTSIDE CANNERY HOTEL AND CASINO 20-DEC-16 Subsidiary ELDORADO, INC. ELDORADO CASINO 01-APR-93 Subsidiary ELDORADO, INC. JOKERS WILD CASINO 01-APR-93 Subsidiary GOLD COAST HOTEL & CASINO 01-FEB-89 MAIN STREET STATION HOTEL, CASINO & Subsidiary M.S.W., INC. 22-NOV-96 BREWERY Subsidiary SAM-WILL, INC. FREMONT HOTEL AND CASINO 01-JUL-81 Subsidiary SUNCOAST HOTEL & CASINO, THE 01-FEB-89 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-JUL-81 C of A Employer 123011 CAESARS ENTERTAINMENT, INC. Tracey Hudson Director of Risk Management 100 West Liberty St., Suite 1150 Reno NV 89501 775-348-3343 Association Name DBA Date Subsidiary 3535 LV CORP. 20-JUL-20 Subsidiary 3535 LV NEWCO LLC THE LINQ HOTEL AND CASINO (fka The Quad) 20-JUL-20 Subsidiary 3535 LV NEWCO LLC THE LINQ 20-JUL-20 Subsidiary CAESARS ENTERPRISE SERVICES, LLC 20-JUL-20 CAESARS HOLDINGS FKA CAESARS Subsidiary CAESARS HOLDINGS INC. 20-JUL-20 ENTERTAINMENT CORPORATION Subsidiary CAESARS INTERACTIVE ENTERTAINMENT LLC 20-JUL-20 Subsidiary CAESARS LINQ, LLC THE LINQ 20-JUL-20 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Subsidiary CC-RENO, LLC Circus Circus Reno 23-NOV-15 Subsidiary CEOC LLC HARRAH'S CASINO HOTEL RENO 20-JUL-20 Subsidiary CEOC LLC HARRAH'S RENO 20-JUL-20 Subsidiary CIRCUS AND ELDORADO JOINT VENTURE LLC Silver Legacy Hotel Casino 23-NOV-15 Subsidiary COLUMBIA PROPERTIES TAHOE LLC Montbleu 01-OCT-18 Subsidiary CORNER INVESTMENT COMPANY LLC THE CROMWELL 20-JUL-20 Subsidiary DESERT PALACE LLC CAESARS PALACE LAS VEGAS 20-JUL-20 Subsidiary DESERT PALACE LLC CAESARS PALACE 20-JUL-20 Subsidiary EASTSIDE CONVENTION CENTER LLC 20-JUL-20 Subsidiary ELDORADO RESORTS, LLC Eldorado Hotel Casino 01-NOV-82 Subsidiary FLAMINGO LAS VEGAS OPERATING COMPANY, LLC FLAMINGO LAS VEGAS 20-JUL-20 Subsidiary HARRAH SOUTH SHORE CORPORATION 20-JUL-20 Subsidiary HARRAH'S LAS VEGAS, LLC HARRAH'S LAS VEGAS 20-JUL-20 Subsidiary HARRAH'S LAS VEGAS, LLC HARRAH'S CASINO HOTEL, LAS VEGAS 20-JUL-20 Subsidiary HARRAH'S LAUGHLIN, LLC HARRAH'S LAUGHLIN 20-JUL-20 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARRAH'S CASINO HOTEL LAKE TAHOE 20-JUL-20 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEY'S RESORT HOTEL/CASINO 20-JUL-20 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARRAH'S LAKE TAHOE 20-JUL-20 Subsidiary HARVEYS TAHOE MANAGEMENT COMPANY LLC HARVEY'S LAKE TAHOE 20-JUL-20 Subsidiary PARBALL LLC 20-JUL-20 Subsidiary PARBALL NEWCO LLC THE SALON AT BALLY'S 20-JUL-20 Subsidiary PARBALL NEWCO LLC BALLY'S LAS VEGAS 20-JUL-20 Subsidiary PARIS LAS VEGAS OPERATING COMPANY, LLC PARIS LAS VEGAS 20-JUL-20 Subsidiary PHW MANAGER, LLC 20-JUL-20 Subsidiary PHWLV, LLC PLANET HOLLYWOOD 20-JUL-20 Subsidiary RIO PROPERTIES, LLC RIO ALL-SUITES HOTEL & CASINO 20-JUL-20 Subsidiary TROPICANA LAUGHLIN LLC Tropicana Laughlin 01-OCT-18 Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-NOV-82 C of A Employer 122973 CARSON CITY Cecilia Meyer, ASHM Risk Management Coordinator, CC Finance Division Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 201 North Carson Street Ste 3 Carson City NV 89701 775-283-7484 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-JUL-10 C of A Employer 122974 CARSON CITY SCHOOL DISTRICT Ann Cyr Risk Manager 1402 West King Street Carson City NV 89703 775-283-2006 Association Name DBA Date Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC 01-JUL-10 C of A Employer 122963 CATHOLIC CHARITIES OF SOUTHERN NEVADA Mary Spees 1501 Las Vegas Blvd North Las Vegas NV 89101 702-385-2662 Association Name DBA Date Third Party Administrator NEVADA ALTERNATIVE SOLUTIONS INC 01-OCT-12 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List C of A Employer 130131 CHURCHILL COUNTY SCHOOL DISTRICT Christi Fielding Comptroller 690 S MAINE ST FALLON NV 89406-3807 775-428-7220 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-JUL-15 C of A Employer 123103 CITY OF HENDERSON Carol Banks Workers' Compensation Analyst 240 Water StreetPO Box 95050, MSC122 Henderson NV 89015 702-267-1922 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-APR-93 C of A Employer 123239 CITY OF LAS VEGAS John Raftery, Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 495 S. Main St. Las Vegas NV 89101 702-229-5048 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 29-DEC-85 C of A Employer 123155 CITY OF NORTH LAS VEGAS William Harty 2250 Las Vegas Blvd NorthSte. 820 North Las Vegas NV 89030 702-633-1462 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-JAN-94 C of A Employer 123079 CITY OF RENO Mark Gregersen Director of HR BACK UP 1 E. First Street, 9th Floor Reno NV 89501 775-334-1284 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-SEP-92 Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List C of A Employer 123097 CITY OF SPARKS Jill Valdez Human Resources Analyst 431 Prater Way Sparks NV 89432 775-353-4021 Association Name DBA Date Third Party Administrator CANNON COCHRAN MANAGEMENT SERVICES INC CCMSI 01-FEB-93 C of A Employer 122979 CITYCENTER HOLDINGS, LLC Mike Jokerst Director of Workers Compensation MGM Administration Building71 E Harmon Avenue Las Vegas NV 89109 702-692-9583 Association Name DBA Date Subsidiary ARIA RESORT AND CASINO LLC 30-NOV-11 Subsidiary CITY CENTER REALTY CORPORATION 30-NOV-11 Subsidiary PROJECT CC, LLC 30-NOV-11 Third Party Administrator SELF-ADMINISTERED 30-NOV-12 C of A Employer Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List 123236 CLARK COUNTY Erin DeFrates Employee Benefits Manager Workers' Compensation500 S Grand Central Pkwy Las Vegas NV 89155 702-455-5524 Association Name DBA Date Subsidiary MCCARRAN INTERNATIONAL AIRPORT 15-JUL-85 Subsidiary UNIVERSITY MEDICAL CENTER 01-AUG-86 Subsidiary VOLUNTEER ACCOUNT 01-APR-86 Third Party Administrator CORVEL ENTERPRISE COMP INC HRMS 15-JUL-85 C of A Employer 123140 CLARK COUNTY SCHOOL DISTRICT Kimberly Krumland Director III, Risk and Environmental Services 4828 S. Pearl Street MS 200 Las Vegas NV 89121 702-799-6496 x 5690 Association Name DBA Date Third Party Administrator Sierra Nevada Administrators 01-JUL-90 C of A Employer 123152 CLARK COUNTY WATER RECLAMATION DISTRICT Brenda Pappas Assistant General Manager 5857 East Flamingo Road Department of Business and Industry Nevada Division of Insurance Self-Insured Employer List Las Vegas NV 89122 702-668-8051 Association Name DBA Date Third Party Administrator DAVIES CLAIMS SOLUTIONS, LLC 01-APR-92 C of A Employer 156199 COMMONSPIRIT HEALTH Alan McVay Insurance Specialist 3900 Olympic Blvd.Suite #400 Erlanger KY 41018 859-594-3039 Association Name DBA Date