TPL-0021-M.txt 7/12/2021 Report : TPL-0021-M STATE OF ARKANSAS Run Date: 07/03/2021 Process : TPLJM002 MMIS REPORTING SYSTEM Run Time: 04:56:44 Location: TPL0021M CARRIER MASTER FILE - ALPHA Page: 1 REPORT PERIOD: 06/01/2021 - 06/30/2021 CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY ST ZIP HW6 1199 NATIONAL BENEFIT FUND 300 WEST 42ND STREET NEW YORK NY 10108-0933 UU 1ST HEALTH DEPT BMN HOSP O REF VF FOR OTHER CLAIMS P O BOX 10907 SCOTTSDALE AZ 85271-0907 EF5 21ST CENTURY HEALTH BENEFI 1760 MARKET STREET PO BOX 42930 PHILADELPHIA PA 19101 G96 55 PLUS BAPTIST HOSPITAL MEMMPHIS TN 38108 U24 65 SECURITY PLAN 3348 FONTAINE RD MEMPHIS TN 38116 U98 76 TRUCKSTOP P O BOX 15850 NO LITTLE ROCK AR 72231 S56 A AND H ADMINISTRATORS INC P O BOX 10223 MILWAUKEE WI 53223 Q19 A E STALEY MFG CO P O BOX 151 DECATUR IL 62525 UB A H AND L P O BOX 11111 FORT SCOTT KS 66701 RZ A H AND L PO BOX 88260 ATLANTA GA 30356 E85 A I G LIFE INSURANCE ACCIDENT AND HEALTH CLAIM PO BOX 15701 WILMINGTON DE 19850-5701 S82 A R G I S P O BOX 802516 DALLAS TX 75380 BJ7 AAA COOPER TRANSPORT P. O. BOX 6827 DOTHAN AL 36302 C8 AAA GROUP HOSPITAL INDEMNI AAA NEW MEXICO DIVISION 2201A SAN PEDRO BLVD NE ALBUQUERQUE NM 87110 U40 AAA OF WASHINGTON GROUP INSURANCE CO 222 NO MISSION WENATCHIE WA 98801 X95 AAC INC 16010 BARKERS PT LN 265 HOUSTON TX 77079 FI AARP HEALTHCARE OPTIONS UNITED HEALTHCARE CLAIMS P O BOX 740819 ATLANTA GA 30374-0819 CG8 ABAS AMER BENEFIT ADMIN SER 1733 PARK ST STE 300 NAPERVILLE IL 60564 J47 ABC ADVANTAGE PLAN P O BOX 2546 SHERMAN TX 75090 F99 ABC BENEFITS OF ARK 1500 RIVERFRONT DR P O BOX 3198 LITTLE ROCK AR 72203 S26 ABC INSURANCE P O BOX 3148 BALLWIN MO 63022 Q93 ABC INSURANCE TRUST 729 15TH ST. NW WASHINGTON DC 20005 BX7 ABC INSURANCE TRUST FUND KAM TECH INC 1300 N 17TH ST 8TH FLOOR ROSSLYN VA 22209 V94 ABI ADMINISTRATIVE SERVICES INC 14482 MCCORMICK DR TAMPA FL 33626 K97 ABI ADMINISTRATIVE SERVICE CORP 10159 WAYZAT BOULEVARD MINNETONKA MN 55343 FV5 ABP ADMINISTRATION PO BOX 82060 ROCHESTER MI 48308 RL ACADEMY INSURANCE GROUP P O BOX 3074 SOUTHEASTERN PA 19398 HF7 ACCESS ADMINISTRTORS 7430 REMCON CIRCLE BLDG C EL PASO TX 79912 JE4 ACCESS MOBILE CARE P O BOX 3398 LITTLE ROCK AR 72202 BE5 ACCORDIA PO BOX 11111 FORT SCOTT KS 66701-7111 B88 ACCORDIA BENEFIT OF TX P O BOX 130217 TYLER TX 75713 AM9 ACCORDIA BUSINESS BENEFITS P.O. BOX 419 EVANSVILLE IN 47703 FU3 ACCORDIA NATIONAL P O BOX 2621 CHARLESTON WV 25329 P20 ACCORDIA OF LEXINGTON EAGLES ADMINISTRATORS P O BOX 13307 LEXINGTON KY 40583 CI3 ACCOUNTABLE HEALTH PLAN 600 SIX FLAGS DR SUITE200 ARLINGTON TX 76011 AR8 ACORDIA BUSINESS BENEFITS P.O. BOX 957 EVANSVILLE IN 47706 DN4 ACORDIA OF CENTRAL INDIANA P O BOX 567 GREENWOOD IN 46142 EZ2 ACORDIA OF LEXINGTON P O BOX 14061 LEXINGTON KY 40512-4061 RK ACORDIA SENIOR OF THE SW P O BOX 37710 LOUISVILLE KY 40233-7710 GV3 ACS BENEFIT SERVICES PO BOX 2000 WINSTON SALEM NC 27102-2000 BV6 ACTION LANE P O BOX A PONTOTOC MS 38863 JE7 ACUITY PO BOX 21515 EAGAN MN 55121 EH8 ADAMS LAND COMPANY HEALTH FUND P O BOX 49 LEACHVILLE AR 72438 V95 ADJUSTCO INC P O BOX 945005 MAITLAND FL 32794 BK ADMIN AND CONSULTANTS FOODCRAFT EQUIP CO P O BOX 4925 LANCASTER PA 17604 FK3 ADMIN ONE CORPORATION PO BOX 2619 ROGERS AR 72757 H7 ADMIN SERVICES OF INDIANA P O BOX 6245 SOUTH BEND IN 46660 BQ3 ADMINASTAR SOLUTIONS P O BOX 40509 INDIANAPOLIS IN 46240-0509 L87 ADMINICORP CO P O BOX 938 SAN JOSE CA 95108-0938 Z47 ADMINISTRATIVE BENEF SVCS 1255 LYNNFIELD RD SUITE 140 MEMPHIS TN 38119 H75 ADMINISTRATIVE BENEFITS CONSOLIDATED FREIGHTWAYS PO BOX 3988 PORTLAND OR 97208 1 TPL-0021-M.txt 7/12/2021 Report : TPL-0021-M STATE OF ARKANSAS Run Date: 07/03/2021 Process : TPLJM002 MMIS REPORTING SYSTEM Run Time: 04:56:44 Location: TPL0021M CARRIER MASTER FILE - ALPHA Page: 2 REPORT PERIOD: 06/01/2021 - 06/30/2021 CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY ST ZIP DP2 ADMINISTRATIVE CONCEPTS P O BOX 1749 ROCKWALL TX 75087 JC2 ADMINISTRATIVE CONCEPTS 994 EAGLE SCHOOL ROAD STE 1005 WAYNE PA 19087 IE7 ADMINISTRATIVE ENTERPRISES 5810 WEST BEVERLY LANE GLENDALE AZ 85306 W87 ADMINISTRATIVE ENTERPRISES 3404 WEST CHERYL DRIVE SUITE 281 PHOENIX AZ 85051 M66 ADMINISTRATIVE SERVICE 3301 E ROYALTON ROAD CLEVELAND OH 44147 AE9 ADMINISTRATIVE SERVICES P.O. BOX 219325 KANSAS CITY MO 64121-9325 P59 ADMINISTRATIVE SERVICES P O BOX 839000 MIAMI FL 33283-9000 Q26 ADMINISTRATIVE SYSTEMS 1310 MECER ST SUITE 200 SEATTLE WA 98109 EQ2 ADMINITRON INC P O BOX 5095 BRENTWOOD TN 37024-5095 HU5 ADMIRAL LIFE INSRUANCE COMPANY OF AMERICA PO BOX 10861 CLEARWATER FL 33757-8861 Z82 ADVANCE INSURANCE ADMIN 1525 MERRILL DRIVE SUITE 2000 LITTLE ROCK AR 72211 FY7 ADVANCE PCS INC 9501 EAST SHEA BOULEVARD SCOTTSDALE AZ 85260-6719 B59 ADVANCED INSURANCE SERVICE P O BOX 19 MEMPHIS TN 38101 AR3 ADVANCED PRESCRIPTION 909 E COLLINS BLVD P O BOX 853901 RICHARDSON TX 75085-3901 FU8 ADVANCEPCS PHARMACY CLAIM WALMART CLAIM ADMIN 922 W WALNUT STE A ROGERS AR 72756-3540 AF8 ADVANTAGE BENEFITS CO ADMAR CORP P.O. BOX 4067 SANTA ANA CA 92701 HN2 ADVANTAGE HEALTH SOLUTIONS PO BOX 502530 INDIANAPOLIS IN 46209 HN1 ADVANTRA PO BOX 7154 LONDON KY 40742-7154 DO1 ADVENTIST RISK MGE CHRISTIAN RECORD SERVICE P O BOX 8007 RIVERSIDE CA 92515 K37 AEROQUIP RR 2 BOX IDD MOUNTAIN HOME AR 72653 IY AETNA REVERE COPPER BRASS HWY 67 NORTH NEWPORT AR 72112 FO2 AETNA PO BOX 14089 LEXINGTON KY 40512-4089 FZ2 AETNA 4630 WOODLANDS CORPORATE TAMPA FL 33614-2415 FZ3 AETNA PO BOX 981109 EL PASO TX 79998-1109 FZ4 AETNA PO BOX 3935 ALLENTOWN PA 18106-0935 AO7 AETNA PO BOX 85079 RICHMOND VA 23285-5079 B21 AETNA PO BOX 1058 MACON GA 31298 GG4 AETNA PO BOX 14094 LEXINGTON KY 40512-4094 GK9 AETNA 4050 PIEDMONT PARKWAY HIGH POINT NC 27262 GM8 AETNA P O BOX 1837 MARYLAND HEIGHTS MO 63043 GY AETNA P O BOX 5696 LONGVIEW TX 75604 DT7 AETNA P O BOX 23285 RICHMOND VA 23285 DZ1 AETNA PO BOX 6259 PEORIA IL 61601-6259 EN2 AETNA P O BOX 14586 18003459908 LEXINGTON KY 40512-4586 EQ5 AETNA P O BOX 209010 18004355597 AUSTIN TX 78720 ET1 AETNA P O BOX 795083 SAN ANTONIO TX 78279-5083 E91 AETNA DALLAS MARKET CENTER 2100 STEMMONS FRWY 80 DALLAS TX 75207 CC8 AETNA P O BOX 1211 TEWKSBURY MA 18760 DE9 AETNA PO BOX 3907 ALLENTOWN PA 18106 ZH AETNA 1001 ESE LOOP 323 STE 300 P O BOX 2520 TYLER TX 75710 Z48 AETNA EMPLOYEE BENEFIT DIVISION P.O. BOX 129122 SAN DIEGO CA 92112-9122 XJ AETNA P O BOX 120 GRAND RAPIDS MI 49501 SV AETNA 151 NORTH MAIN ST WICHITA KS 67202 S99 AETNA P O BOX 11000 ORANGE CA 92668-8100 T31 AETNA C/O ACC 1300 W OAK ST INDEPENDENCE KS 67301 EA2 AETNA HEALTH PLAN P O BOX 5367 ROCKFORD IL 61125 FB9 AETNA HEALTH PLAN 10459 MOUNTAIN VIEW AVE LOMA LINDA CA 92354 BP4 AETNA HEALTH PLAN 8023 E 63RD PLACE STE 310 TULSA OK 74133 EW8 AETNA HEALTH PLAN P O BOX 7064 DOVER DE 19903-1512 BG7 AETNA HEALTH PLANS P O BOX 35890 LOUISVILLE KY 40232-5890 Q65 AETNA HEALTH PLANS PO BOX 7012 DOVER DE 19903 2 TPL-0021-M.txt 7/12/2021 Report : TPL-0021-M STATE OF ARKANSAS Run Date: 07/03/2021 Process : TPLJM002 MMIS REPORTING SYSTEM Run Time: 04:56:44 Location: TPL0021M CARRIER MASTER FILE - ALPHA Page: 3 REPORT PERIOD: 06/01/2021 - 06/30/2021 CARRIER NAME ADDRESS LINE 1 ADDRESS LINE 2 CITY ST ZIP D59 AETNA HEALTH PLANS 3541 WINCHESTER RD UNIT 73 ALLENTOWN PA 18195-0519 AC7 AETNA HEALTH PLANS CLAIMS OFFICE P.O. BOX 91533 ARLINGTON TX 76015 X96 AETNA HEALTH PLANS UPS UNIT 52F PO BOX 26053 GREENSBORO NC 27420 ED8 AETNA HEALTH PLANS P O BOX 12122 OKLAHOMA CITY OK 73157-2122 X57 AETNA HEALTH PLANS P O BOX 1630 COLUMBUS OH 43216 EI1 AETNA HEALTH PLANS DELTA BEVERAGE CLAIMS P O BOX 26125 GREENSBORO NC 27402 FB3 AETNA HEALTH PLANS LOOP STATION P O BOX 2949 MINNEAPOLIS MN 55402-0949 CE4 AETNA HEALTH PLANS P O BOX 21645 SEATTLE WA 98111 EI6 AETNA HEALTH PLANS P O BOX 3903 ALLENTOWN PA 18106-0903 Z27 AETNA HEALTH PLANS P.O. BOX 26190 GREENSBORO NC 27402-6190 CI2 AETNA HEALTH PLANS P O BOX 91411 ARLINGTON TX 76015 V66 AETNA HEALTH PLANS OF TENN INC P O BOX 141176 IRVING TX 75014-1176 CA3 AETNA HEALTH PLANS OF CA P.O. BOX 50035 SAN BERNARDINO CA 92412 X97 AETNA HEALTH SERVICE 400 E SPRING STR BLUFTON TN 46714 K24 AETNA HEALTHCARE P O BOX 150417 HARTFORD CT 61150-417 FC8 AETNA HEALTHCARE P O BOX 1816 MACON GA 31202 BD4 AETNA INSURANCE CO C/O BOB EVANS 3776 S. HIGH ST COLUMBUS OH 43207 H98 AETNA INSURANCE CO P O BOX 26107 GREENSBORO NC 27402-6107 V41 AETNA INSURANCE CO P O BOX 709 WINDSOR CT 60950-709 MV AETNA LIFE AND CAASUALTY GROUP CLAIMS P O BOX 12340 FRESNO CA 93765 VS AETNA LIFE AND CASUALTY P O BOX 26200 NEW ORLEANS LA 70186 D62 AETNA LIFE AND CASUALTY P O BOX 6519 JACKSONVILLE FL 32236 AL5 AETNA LIFE AND CASUALTY P.O.