Medical Provider Networks Approved by DWC - California

Medical Provider Networks Approved by DWC (Sorted by Date of Approval)

NOTE: The status of the MPNs on this list were produced and processed from information known to DWC as of 04/02/2019. However, changes may have been made

since that date. Please contact the DWC Medical Unit to verify the information provided for a specific MPN.

Approved MPN Applications: 2434 *MPN Approval Status Legend BLANK = MPN status has not changed after approval; = MPN coverage period should be verified with the DWC Medical Unit; P = MPN is on Probation; R = MPN was revoked after approval; S = MPN is currently Suspended; T = MPN was terminated after approval; W = MPN was withdrawn after approval

1

MPN ID # Name of Applicant with Mailing Address Name of MPN Type of

Applicant Date of

Approval Internet Website Address of MPN MPN

Approval Status *

1564

99 Cents Only Stores LLC 4000 Union Pacific Avenue Commerce, CA 90023 Broadspire Signature MPN

Self-Insured Employer 08/24/2009 T

1302

99¢ Only Stores 4000 Union Pacific Avenue City of Commerce, CA 90023 WellComp Medical Provider Network


2301

A. Teichert & Son, Inc. 3500 American River Dr. Sacramento, CA 95851 WellComp Medical Provider Network

Self-Insured Employer 06/11/2014 www.WellComp.com T

1751

A.B. Ag Services, Inc. 2020 So. East Ave Fresno, CA 93721 Zacky Farms Custom CorVel MPN

Self-Insured Employer 01/12/2011 www.corvel.com T

0229

ABC Unified School District 16700 Norwalk Boulevard Cerritos, CA 90703 Prime Advantage Medical Network


0169

ABM Industries Incorporated 1775 The Exchange 6th Floor Atlanta, GA 30339 ABM ESIS MPN


1938

ABM Industries, Incorporated 1775 The Exchange, 6th Floor Atlanta, GA 30339 ABM MPN


0080

ACE American Insurance Company (Broadspire-Boeing MPN) 1601 Market Street Philadelphia, PA 19103 Broadspire MPN Insurer 03/07/2005 T

0716

ACE American Insurance Company 1 Beaver Valley Road Suite 4E Wilmington, DE 19803 Medex-ACE-GB Insurer 04/19/2005 T

1560

ACE American Insurance Company 1 Beaver Valley Road Suite 4E Wilmington, DE 19803 Wal-Mart-Medex MPN Insurer 08/13/2009 www.medexhco.com T

0340

ACE American Insurance Company 1601 Chestnut Street Philadelphia, PA 19103 Broadspire MPN Insurer 02/17/2005 T

0384

ACE American Insurance Company 1601 Chestnut Street Philadelphia, PA 19103 FARA-CVTY Insurer 04/21/2005 T





2


Applicant Date of


Approval Status *

0677

ACE American Insurance Company 1601 Chestnut Street Philadelphia, PA 19103

ACE American Insurance Company - Crawford Select Insurer 06/16/2005 T

0960

ACE American Insurance Company 1601 Chestnut Street Philadelphia, PA 19103 Intracorp-Gates McDonald MPN Insurer 07/28/2005 T

0983

ACE American Insurance Company 1601 Chestnut Street Philadelphia, PA 19103 ACE-Medex Select B Insurer 08/05/2005 T

0394

ACE American Insurance Company 1601 Market Street Philadelphia, PA 19103

First Health Comp America HCO Select Network Insurer 03/16/2005 T

0125

ACE American Insurance Company 1601 Market Street Philadelphia, PA 19103 First Health CompAmerica Primary Network Insurer 04/13/2005 T

0506



0748


MedInsights MPN accessing Prudent Buyer PPO Insurer 04/29/2005 T

0427


ACE/Frank Gates First Health CompAmerica Select Network Insurer 05/11/2005 W

1826

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE GBMCS KOJ MPN Insurer 05/03/2011 T

0157

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick CMS MPN Insurer 02/17/2005 T

0159

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick CMS Extended MPN Insurer 02/17/2005 T

0646

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Genex Medical Provider Network (MPN) Insurer 06/02/2005 www.genexservices.com

1573

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick CMS/Harbor Net - Ross Stores Insurer 12/14/2009 T





3


Applicant Date of


Approval Status *

1581

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Coventry Network Insurer 01/21/2010 T

1623

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick CMS/Harbor MPN - Ace CEC Insurer 04/20/2010 T

1650

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 WellComp Medical Provider Network Insurer 06/22/2010 www.wellcomp.com T

1673

ACE American Insurance Company 436 Walnut St Philadelphia, PA 19106 Broadspire Signature MPN Insurer 08/10/2010 T

1764

ACE AMERICAN INSURANCE COMPANY 436 Walnut St Philadelphia, PA 19106

ACE American Insurance Company-GENEX MPN Insurer 02/01/2011 genexservices.com T

1961

Ace American Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick/Harbor MPN Insurer 05/15/2012 T

0103

ACE American Insurance Company 436 Walnut St. Philadelphia, PA 19106 ACE ESIS MPN Insurer 02/03/2005 T

0768

ACE American Insurance Company 436 Walnut St. Philadelphia, PA 19106 ACE/BUNCH Network Insurer 05/06/2005 T

1605

ACE American Insurance Company 436 Walnut St. Philadelphia, PA 19105 CorVel MPN Insurer 04/01/2010 T

1734

ACE American Insurance Company 436 Walnut St. Philadelphia, PA 19106 Medtronic CV Santa Rosa MPN Insurer 12/22/2010 T

1857

ACE American Insurance Company 436 Walnut St. Philadelphia, PA 19106 ACE/Bunch/Buffets MPN Insurer 07/15/2011 T

1547

ACE American Insurance Company 436 Walnut St., P.O. Box 1000 Philadelphia, PA 19105

CCMSI/ACE First Health Comp America Select HCO Network Insurer 06/25/2009 T

0044

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Medex Insurer 12/07/2004 http://www.medexhco.com/





4


Applicant Date of


Approval Status *

0391

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE/Gallagher Bassett/Coventry MPN Insurer 02/23/2005 www.talispoint.com/cvty/gbcvtympn

0180

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 TCT CA MPN Insurer 03/07/2005 www.mywcinfo.com T

0361

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106

Sedgwick First Health CompAmerica Primary HCO Network Insurer 03/07/2005 T

0362


Sedgwick First Health CompAmerica Select HCO Network Insurer 03/07/2005 T

0302

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 CorVel MPN/ACE American/GB Insurer 03/14/2005 T

0218


First Health CompAmerica Select HCO Network Insurer 03/17/2005 www.talispoint.com/cvty/matrix

0821

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 TRISTAR MPN Insurer 05/03/2005 T

0587

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 INTRACORP Insurer 05/09/2005 W

0404

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE/Gallagher Bassett/First Health MPN Insurer 05/13/2005 www.talispoint.com/cvty/gbfhmpnselect T

0796

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE-Medex Select A Insurer 05/27/2005 T

1014

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Genex Insurer 08/02/2005 www.genexservices.com

0480

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Ace USA Cambridge MPN Insurer 09/12/2005 W

1192

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Intracorp/ACE Insurer 05/02/2006 T


NOTE: The status of the MPNs on this list were produced and processed from information known to DWC as of 04/02/2019. However, changes may have been made since that date. Please contact the DWC Medical Unit to verify the information provided for a specific MPN.

Approved MPN Applications: 2434 *MPN Approval Status LegendBLANK = MPN status has not changed after approval; = MPN coverage period should be verified with the DWC Medical Unit; P = MPN is on Probation; R = MPN was revoked afterapproval; S = MPN is currently Suspended; T = MPN was terminated after approval; W = MPN was withdrawn after approval

5


Applicant Date of


Approval Status *

1179

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Liberty Mutual Group MPN Insurer 06/01/2006 T

1220

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Genex Insurer 07/21/2006 T

1321

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 INTRACORP/Customized ACE MPN Insurer 11/20/2007 T

1380

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE/Bunch/Barnes Group MPN Insurer 05/14/2008 T

1466

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick CMS / Harbor Net - ACE Insurer 01/15/2009 T

1434

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn

1568

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick CMS / Harbor MPN - Ace Boeing Insurer 10/20/2009 T

1576

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 MLB CA MPN Insurer 02/11/2010 T

1620

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 CorVel MPN Insurer 04/08/2010 T

1846

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Wellcomp Medical Provider Network Insurer 06/16/2011 T

1864

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ACE MPN - HCA Insurer 08/04/2011 www.talispoint.com/cvty/hcawc

1995

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick CMS / Harbor MPN - ACE FD Insurer 11/08/2011 T

1904


Randstad/ACEAm/Conduent Care Solutions MPN Insurer 02/14/2012

https://www.conduent.com/workers-compensation-solutions/

https://www.conduent.com/workers-compensationsolutions/






6


Applicant Date of


Approval Status *

1909

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor MPN - ACE SUMC Insurer 02/14/2012 W

1917

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor MPN - ACE Nestle Insurer 02/17/2012 T

1975

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor MPN-ACE SSL Insurer 05/24/2012 W

2055

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 91906 Sedgwick/Harbor 2 MPN Insurer 09/20/2012 T

2070

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 19105 CorVel/Kaiser Select MPN Insurer 10/25/2012 www.corvel.com

2181

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 CorVel/Prime Healthcare MPN Insurer 06/18/2013 www.Corvel.com

2227

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 CorVel MPN Insurer 10/18/2013 www.corvel.com

2259

ACE AMERICAN INSURANCE COMPANY 436 Walnut Street Philadelphia, PA 19106 Iron Mountain/GENEX MPN Insurer 12/30/2013 T

2249

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Coventry Medical Provider Network Insurer 04/18/2014 www.talispoint.com/cvty/matrix

2286

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor 3 MPN Insurer 05/27/2014 www.harborsys.com/sedgwick3 T

2287

Ace American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor 4 MPN Insurer 05/27/2014 www.harborsys.com/sedgwick4 T

2316

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 None Provided Insurer 07/03/2014 www.genexservices.com T

2364

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 ACE American/BBSI MPN Insurer 02/27/2015 www.barrettbusiness.com





7


Applicant Date of


Approval Status *

2422

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 ALSCO Inc. Medical Provider Network Insurer 02/22/2016 www.talispoint.com/cvty/alsmpn

2462

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19106 Driscoll's MPN Insurer 03/25/2016 www.intermedccs.com/DriscollsMPN

2423

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 ACE/EI Pollo Loco MPN Insurer 04/21/2016 www.corvel.com

2490

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 ACE/Lineage MPN Insurer 06/21/2016 www.corvel.com

2508

ACE American Insurance Company 436 Walnut Street Philadelphia, PA 19105 CorVel/Cheesecake Factory MPN Insurer 10/28/2016 www.corvel.com

0838

ACE American Insurance Company PO Box 15059 Wilmington, DE 19850

First Health CompAmerica Select HCO Network Insurer 05/31/2005 T

0682

ACE Employers Insurance Company (CEI) 1601 Chestnut Street Philadelphia, PA 19103

ACE Employers Insurance Company (CEI) - Crawford Select Insurer 06/16/2005 W

1546

ACE Fire Underwriters Insurance Company 436 Walnut St. Philadelphia, PA 19105


2206

Ace Fire Underwriters Insurance Company 436 Walnut Street Philadelphia, PA 19106 Liberty Mutual Group MPN Insurer 07/24/2013 T

2234

ACE Fire Underwriters Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor MPN - ACE Irvine Company Insurer 12/03/2013 T

0681

ACE Guaranty RE 1601 Chestnut Street Philadelphia, PA 19103 ACE Guaranty RE - Crawford Primary Insurer 06/16/2005 W

0892

ACE Indemnity/ACE American Insurance Company 1601 Market Street Philadelphia, PA 19103 CorVel MPN/ACE/LWP MPN Insurer 05/19/2005 T





8


Applicant Date of


Approval Status *

1548

ACE Property and Casualty Insurance Company 436 Walnut St., PO Box 1000 Philadelphia, PA 19105


0899

ACIG Insurance Company 2600 No. Central Expressway, Ste 800 Richardson, TX 75080 Medex Insurer 07/01/2005 www.medexhco.com

0589

ACWA/JPIA 5620 Birdcage Street Citrus Heights, CA 95610 ACWA/JPIA MPN

Joint Powers Authority 05/09/2005 W

1689

Administrative Concepts Corp. 406 43rd St West Bradenton, FL 34209 Broadspire Signature


1865

Administrative Office of the Courts 455 Golden Gate Avenue San Francisco, CA 94102 CorVel MPN State 08/23/2011 T

0749

Advance Auto Parts 5673 Airport Road Roanoke, VA 24012

MedInsights Medical Provider Network accessing Prudent Buyer HCO

Self-Insured Employer 04/29/2005 W

1304

Advantage Workers Compensation Insurance Company P.O. Box 571918 Salt Lake City, UT 84157

Advantage Workers Compensation Insurance Company Medical Provider Network Insurer 09/13/2007 T

3104

Advantage Workers Compensation Insurance Company PO Box 57198 Salt Lake City, UT 84157 WCF Insurance / Advantage MPN Insurer 06/20/2018 www.wcfmpn.com

0528

AIG Casualty Company fka Birmingham Fire Insurance Company of Pennsylvania 175 Water Street New York, NY 10038 Chartis - Cambridge MPN Insurer 03/24/2005 W

3003

AIG Claims, Inc. 175 Water Street, 18th Floor New York, NY 10038 AIG Select Advantage

Entity that provides physician network services 03/03/2017 http://www.talispoint.com/aig/mpnselect/

3054

AIG Claims, Inc. 175 Water Street, 18th Floor New York, NY 10038 AIG EP MPN

Entity that provides physician network services 10/27/2017 www.talispoint.com/aig/EP





9


Applicant Date of


Approval Status *

3072

AIG Claims, Inc. 175 Water Street, 18th Floor New York, NY 10038 AIG JCP MPN

Entity that provides physician network services 12/11/2017 www.talispoint.com/aig/jcp

3002

AIG Claims, Inc. 175 Water Street, 18th Floor NY, NY 10038 AIG Primary Advantage

Entity that provides physician network services 03/06/2017 www.talispoint.com/aig/com

2042

AIG Property Casualty Company 175 Water St - 18th Floor New York, NY 10038 Sedgwick/Harbor MPN - CHARTIS EPS Insurer 08/16/2012 T

1658

AIG Property Casualty Company 175 Water St 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/23/2010 T

1407

AIG Property Casualty Company 175 Water Street - 18 Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com

0115

AIG Property Casualty Company 175 Water Street - 18th Floor New York, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

1986

AIG Property Casualty Company 175 Water Street - 18th Floor New York, NY 10038 Sedgwick/Harbor 2 MPN Insurer 06/01/2012 T

1978

AIG Property Casualty Company 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor MPN Insurer 05/24/2012 T

1757

AIG Property Casualty Company 175 Water Street, 18th Floor NY, NY 10038 AIG Select MPN Insurer 01/19/2011 www.talispoint.com/aig/mpnselect

0116

AIU Insurance Company 175 Water Street - 18th Floor New York, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

0526

AIU Insurance Company 70 Pine Street New York, NY 10270 Cambridge-Concentra MPN Insurer 03/23/2005 W

0649

AIU Insurance Company 70 Pine Street New York, NY 10270

AIU Insurance/Gallagher Bassett/Concentra MPN Insurer 03/24/2005 W





10


Applicant Date of


Approval Status *

0465

AIU Insurance Company 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0919

AIU Insurance Company 70 Pine Street New York, NY 10270

MedInsights/GAB Robins Medical Provider Network, accessing Prudent Buyer HCO Insurer 05/19/2005 W

1025

AIU Insurance Company 70 Pine Street New York, NY 10270 AIU Gallagher Bassett First Health Select MPN Insurer 08/05/2005 W

0855

AIU Insurance Company AIG 70 Pine Street New York, NY 10270 AIU Insurance Company, Crawford Select Insurer 07/01/2005 W

0864

AIU Insurance Company AIG 70 Pine Street New York, NY 10270 AIU Insurance Company, Crawford Select Insurer 07/01/2005 W

0610

AIU Insurance Company Chartis 32 Old Slip 19th FL New York, NY 10006 AIG ESIS MPN Insurer 03/28/2005 T

1326

AIX, Inc. 2 Waterside Crossing, Suite 400 Windsor, CT 06095 AIX/Gallagher Bassett/First Health MPN Insurer 11/16/2007 W

1328

AIX, Inc. 2 Waterside Crossing, Suite 400 Windsor, CT 06095 AIX/Gallagher Bassett/Coventry MPN Insurer 11/16/2007 W

1697

Alameda Contra Costa Transit District 1600 Franklin St. Oakland, ca 94612 AC Transit MPN

Self-Insured Employer 09/29/2010 www.actransitmpn.com T

0767

Alameda County Schools Insurance Group 5776 Stoneridge Mall Road, Suite 130 Pleasanton, CA 94588 ACSIG/AccessMedical Provider Network

Joint Powers Authority 05/19/2005 T

1345

Alameda County Schools Insurance Group P O Box 2487 Dublin, CA 94568 PRIME Plus Medical Provider Network


1032

Alameda County 1106 Madison Street Oakland, CA 94607 First Health CompAmerica Primary Network


1780

Alameda Health System 7677 Oakport Street, Suite 1200 Oakland, CA 94612 Alameda Health System MPN

Self-Insured Employer 02/03/2011 http://www.talispoint.com/AHS





11


Applicant Date of


Approval Status *

1799

Alaska National Insurance Company 1111 Third Ave, Suite 2600 Seattle, WA 94101 Alaska National Customized MPN Insurer 03/10/2011 www.corvel.com

1383

Alaska National Insurance Company 1111 Third Avenue Suite 2600 Seattle, WA 94101 CorVel MPN Insurer 06/19/2008 www.corvel.com T

0155

Alaska National Insurance Company 450 Sansome Street San Francisco, CA 94111 Alaska National Preferred Choice Network Insurer 02/01/2005 T

0827

Alea North America Insurance Company 55 Capital Blvd Rocky Hill, CT 06067 TRISTAR CompAmerica Primary HCO Insurer 05/03/2005 W

0415

Alea North America Insurance Company 55 Capital Blvd. - Corporate Ridge Rocky Hill, CT 06067 Medex Insurer 02/24/2005 W

0411

Alea North America Insurance Company 55 Capital Blvd. Rocky Hill, CT 06067 CorVel MPN Insurer 02/28/2005 T

0307

Alea North America Insurance Company 555 Capital Blvd, Corporate Ridge Rocky Hill, CT 06032

Alea/Frank Gates First Health Comp America Select HCO Network ("First Health Select") Insurer 05/11/2005 W

0185

Alea North American Insurance Company 55 Capital Blvd Rocky Hill, CT 06067 First Health CompAmerica Select MPN Insurer 03/08/2005 W

0163

Alea North American Insurance Company 55 Capital Blvd. Rocky Hill, CT 06067 CompUSA Primary MPN Insurer 02/17/2005 W

1224

Alisal Union School District 1205 E. Market St. Salinas, CA 93905 PRIME Advantage Medical Provider Network


0951

Alliance of Schools for Cooperative Insurance Programs (ASCIP) 16550 Bloomfield Ave Cerritos, CA 90703 WellComp Medical Provider Network


1699

Alliance of Schools for Cooperative Insurance Programs (ASCIP) 16550 Bloomfield Ave. Cerritos, CA 90703 ASCIP-Athens MPN

Joint Powers Authority 09/29/2010 www.medexhco.com T





12


Applicant Date of


Approval Status *

3089

Allianz Global Risks US Insurance Company 225 W Washington Street, Suite 1800 Chicago, IL 60606 Allianz Global Risk US Select

Entity that provides physician network services 03/07/2018 http://www.talispoint.com/cvty/agcs

2360

Allied Managed Care Incorporated 10445 Old Placerville Road Sacramento, CA 95827 Allied Managed Care MPN

Entity that provides physician network services 03/11/2015 http://www.alliedmanagedcare.com/mpn

3059

Allied Property And Casualty Insurance Company N2128-Nationwide/Three Nationwide Plaza Columbus, OH 43214 CorVel MPN Insurer 10/20/2017 www.corvel.com

1817

Allmerica Financial Benefit Insurance Company 440 Lincoln Street Worcester, MA 01615 CorVel/Kaiser Select MPN Insurer 04/22/2011 www.CorVel.com

1746

Alpha aka Association of California Hospital Districts, Inc. (Alpha Fund-ACHD) P.O. Box 419068 Rancho Cordova, CA 95741 Medex MPN


1460

Alta-Dena Certified Dairy, LLC 17637 East Valley Blvd City of Industry, CA 91744 Liberty Mutual Group MPN


3073

Alternative Service Concepts, L.L.C. 5620 Birdcage Tree Road Citrus Heights, CA 95610 Alternative Service Concepts Select MPN

Entity that provides physician network services 01/26/2018 www.talispoint.com/cvty/asc

1809

Alvord Unified School District 10365 Keller Ave Riverside, CA 92505 PRIME Advantage Medical Provider Network


0638

Alvord Unified School District 10365 Keller Avenue Riverside, CA 92505 Broadspire-Concentra Standard MPN


3062

AMCO Insurance Company N2128-Nationwide/Three Nationwide Plaza Columbus, OH 43214 CorVel MPN Insurer 10/31/2017 www.corvel.com

1891

Amcor Packaging Distribution 6600 Valley View St Buena Park, CA 90620 Broadspire Signature MPN






13


Applicant Date of


Approval Status *

1190

Amcor Sunclipse North America 6600 Valley View Buena Park, CA 90620 Suncare


1215

American Alternative Insurance Corporation (AAIC) 555 College Rd. East Princeton, NJ 08543

American Alternative/Gallagher Basset/First Health MPN Insurer 07/18/2006 T

1531

American Alternative Insurance Corporation 555 College Rd East Princeton, NJ 08543 American Alternative GBMCS MPN Insurer 05/08/2009 T

1763

American Alternative Insurance Corporation 555 College Road East Princeton, NJ 08543 WellComp Medical Provider Network Insurer 01/19/2011 T

1899

American Alternative Insurance Corporation 555 College Road East Princeton, NJ 08543 ACM/Munich RE MPN Insurer 01/19/2012 T

0621

American Automobile Insurance Company 777 San Marin Dr. Novato, CA 94998 First Health Select Insurer 02/14/2005 www.agcs.allianz.com/usclaims T

1735

American Casualty Company of Reading, PA 333 S. Wabash, 39th Flr. Chicago, IL 60604

MedInsights MPN accessing Prudent Buyer PPO Insurer 12/02/2010 T

2094

American Casualty Company of Reading, Pennsylvania 333 South Wabash Chicago, IL 60604 Sedgwick/Harbor MPN Insurer 12/27/2012 T

1869

American Casualty Company of Reading, Pennsylvania 333 S Wabash Ave. Chicago, IL 60685

Longwood Management Group/Anthem Medical Provider Network Insurer 07/28/2011 T

2161

American Casualty Company of Reading, Pennsylvania 333 S Wabash Avenue Chicago, IL 60604 GENEX Insurer 05/06/2013 www.genexservices.com T

1420

American Casualty Company of Reading, Pennsylvania 333 S. Wabash Ave Chicago, IL 60604






14


Applicant Date of


Approval Status *

1513

American Casualty Company of Reading, Pennsylvania 333 S. Wabash, 24 Fl Chicago, IL 60604 Sedgwick CMS MPN Insurer 03/05/2009 T

1878

American Casualty Company of Reading, Pennsylvania 333 S. Wabash, Floor 24 Chicago, IL 60604 Sedgwick CMS Extended MPN Insurer 08/31/2011 T

1770

American Casualty Company Of Reading, Pennsylvania 333 South Wabash Avenue Chicago, IL 60604 Broadspire Signature MPN Insurer 02/02/2011 T

1844

American Casualty Company of Reading, Pennsylvania 333 South Wabash Chicago, IL 60604

American Casualty/Gallagher Bassett/First Health MPN Insurer 06/16/2011 www.talispoint.com/cvty/gbfhmpnselect

1905

American Casualty Company Of Reading, Pennsylvania 333 South Wabash Avenue Chicago, IL 60604 CorVel MPN Insurer 02/14/2012 www.corvel.com

2095

American Casualty Company of Reading, Pennsylvania CAN 333 South Wabash Chicago, IL 60604 Sedgwick/Harbor 2 MPN Insurer 12/27/2012 T

0518

American Economy Insurance Company 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 02/14/2005 http://www.libertymutualgroup.com/providernetworks T

2153

American Family Home Insurance Company 555 College Road East Princeton, NJ 08543 ACM/American Family Home MPN Insurer 05/06/2013 T

0894

American Fuji Fire & Marine 3380 RFD Salem Lake Dr Suite E Long Grove, IL 60047 CorVel/American Fuji Fire & Marine Insurer 05/19/2005 T

0154

American Guarantee & Liability Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196






15


Applicant Date of


Approval Status *

0836



0700


First Health CompAmerica Primary HCO Network Insurer 08/02/2005 T

1262

American Guarantee & Liability Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 American Guarantee/CorVel MPN Insurer 12/07/2006 T

0435

American Guarantee & Liability 1299 Zurich Way Schaumburg, IL 60196 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0669

American Guarantee & Liability 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

American Guarantee & Liability, Crawford Select Insurer 07/01/2005 W

0173

American Guarantee and Liability Insurance Company 1299 Zurich Way Schaumburg, IL 60196 TCT CA MPN Insurer 03/08/2005 www.mywcinfo.com T

0137

American Guarantee and Liability Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich ESIS MPN Insurer 04/18/2005 T

0210

American Guarantee And Liability Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196

First Health CompAmerica Select HCO Network Insurer 04/18/2005 www.zurichna.com

1141

American Guarantee And Liability Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 www.zurichna.com

1350

American Guarantee and Liability Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T





16


Applicant Date of


Approval Status *

1684

American Guarantee And Liability Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Broadspire Signature Network MPN Insurer 08/18/2010 T

1824

American Guarantee and Liability Insurance Company 1299 Zurich Way Schaumburg, IL 60196 ACM/American Guarantee and Liability MPN Insurer 05/03/2011 http://mpn.acmclaims.com/zurich T

2262

American Guarantee and Liability Insurance Company 1400 American Lane, Tower 2-6th Floor Schaumburg, IL 60196

American Guarantee and Liability Insurance Company GBMCS MPN Insurer 12/30/2013 T

2261


American Guarantee and Liability Insurance Company/Gallagher Bassett/Coventry MPN Insurer 01/15/2014 www.talispoint.com/cvty/gbcvtympn T

2283


American Guarantee and Liability Insurance Company/Gallagher Bassett/First Health MPN Insurer 01/16/2014 www.talispoint.com/cvty/gbfhmpnselect T

1167

American Home Assurance Company 175 Water St 18th Floor New York, NY 10038 PCIC MPN Insurer 07/24/2006 T

0913

American Home Assurance Company 175 Water St, 18th Floor New York, NY 10038

MedInsights Medical Provider Network accessing Prudent Buyer PPO Insurer 05/19/2005 T

0114

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

0099

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 American Home Assurance Company/Lowe's Insurer 03/18/2005 T

0363

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038


0367

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038






17


Applicant Date of


Approval Status *

0996

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 CorVel MPN Insurer 08/12/2005 www.corvel.com

1404

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com

1656

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 Broadspire Signature MPN Insurer 06/22/2010 www.broadspireppo.com T

2296

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 Mentor/AmHome/Bunch MPN Insurer 05/08/2014 http://providernet.bunchcare.com T

2348

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 Sedgwick/Harbor MPN- AHAC Verizon Insurer 10/01/2014 www.harborsys.com/verizon T

3010

American Home Assurance Company 175 Water Street - 18th Floor New York, NY 10038 Silverado MPN Insurer 02/08/2017 www.corvel.com

1980

American Home Assurance Company 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor MPN Insurer 05/24/2012 T

1984

American Home Assurance Company 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

1295

American Home Assurance Company 175 Water Street 17th Floor New York, NY 10038 Chartis/Foster's Americas Insurer 06/08/2007 T

1320

American Home Assurance Company 175 Water Street 17th Floor New York, NY 10038 FARA - FHS Insurer 12/03/2007 T

1033

American Home Assurance Company 175 Water Street- 18th Floor New York, NY 10038

American Home Assurance/The GEO Group, Inc. Insurer 07/21/2005 T

1366

American Home Assurance Company 175 Water Street 18th Floor New York, NY 10038 WellComp Medical Provider Network Insurer 05/27/2008 T

1381

American Home Assurance Company 175 Water Street 18th floor New York, NY 10038 Chartis/JCP Insurer 07/01/2008 T





18


Applicant Date of


Approval Status *

0527

American Home Assurance Company 175 Water Street New York, NY 10038 Chartis - Cambridge MPN Insurer 03/24/2005 T

0650

American Home Assurance Company 175 Water Street, 18th Floor New York, NY 10038

American Home/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 www.talispoint.com/cvty/gbcvtympn

0625

American Home Assurance Company 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T

0483

American Home Assurance Company 175 Water Street, 18th Floor New York, NY 10038 TCT CA MPN Insurer 04/12/2005 www.mywcinfo.com T

1024


American Home Assurance Company/Gallagher Bassett/First Health MPN Insurer 08/05/2005 www.talispoint.com/cvty/gbfhmpnselect T

1518

American Home Assurance Company 175 Water Street, 18th Floor New York, NY 10038 Wal-Mart-Medex-MPN Insurer 03/13/2009 www.medexhco.com T

1453


American Home Assurance Company GBMCS MPN Insurer 05/08/2009 www.talispoint.com/cvty/gbmpn T

1725

American Home Assurance Company 175 Water Street, 18th Floor NY, NY 10038 AIG Select Medical Provider Network Insurer 12/08/2010 www.talispoint.com/aig/mpnselect

1424

American Home Assurance Company 70 Pine St New York, NY 10270

CCMSI/ AIG/ First Health CompAmerica Select HCO Network Insurer 01/07/2009 T

0501

American Home Assurance Company 70 Pine Street New York, NY 10270

Sedgwick CMS Extended Medical Provider Network Insurer 03/10/2005 T

0491

American Home Assurance Company 70 Pine Street New York, NY 10270 Sedgwick CMS Medical Provider Network Insurer 03/16/2005 T

0421

American Home Assurance Company 70 Pine Street New York, NY 10270 Tetra-FARA Insurer 04/21/2005 W

0422

American Home Assurance Company 70 Pine Street New York, NY 10270 Matrix - FARA Insurer 04/21/2005 W





19


Applicant Date of


Approval Status *

0464

American Home Assurance Company 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0479

American Home Assurance Company 70 Pine Street New York, NY 10270 Wal-Mart - First Health Primary MPN Insurer 05/10/2005 T

0517

American Home Assurance Company 70 Pine Street New York, NY 10270 AIGDC/Bank of America Insurer 05/10/2005 T

0788

American Home Assurance Company 70 Pine Street New York, NY 10270 FARA-CVTY Insurer 05/15/2005 T

0615

American Home Assurance Company 70 Pine Street New York, NY 10270 Intracorp - Gates McDonald MPN Insurer 06/02/2005 T

0868

American Home Assurance Company 70 Pine Street New York, NY 10270 AIGDC/Manpower Insurer 08/08/2005 T

1149

American Home Assurance Company 70 Pine Street New York, NY 10270 American Home Assurance/Central Parking Insurer 05/12/2006 T

1374

American Home Assurance Company 70 Pine Street New York, NY 10270 Athens/American Home Assurance MPN Insurer 04/15/2008 T

0851

American Home Assurance Company AIG 70 Pine Street New York, NY 10270

American Home Assurance Company-Crawford Select Insurer 07/01/2005 W

0861

American Home Assurance Company AIG 70 Pine Street New York, NY 10270

American Home Assurance Company, Crawford Primary Insurer 07/01/2005 W

0540

American Honda Motor Co., Inc. 700 Van Ness Ave., Bldg. #300 Torrance, CA 90501 Sedgwick CMS Medical Provider Network


1729

American Manufacturers Mutual Insurance Company 1 Corporate Dr Long Grove, IL 60047 Broadspire Signature MPN Insurer 12/10/2010 T





20


Applicant Date of


Approval Status *

2154

American Modern Home Insurance Company 555 College Road East Princeton, NJ 08543 ACM/American Modern Home MPN Insurer 05/06/2013 T

1730

American Motorist Insurance Company 1 Corporate Dr Long Grove, IL 60047 Broadspire Signature MPN Insurer 12/10/2010 T

0101

American Motorists Insurance Company One Kemper Drive Long Grove, IL 60049 First Health CompAmerica Select HCO Insurer 02/15/2005 T

0708

American Racing Equipment, Inc. 19067 S. Reyes Avenue Rancho Dominguez, CA 90211

MedInsights Medical Provider Network/Prudent Buyer HCO

Self-Insured Employer 04/20/2005 R

0519

American States Insurance Company of Texas 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 02/14/2005 http://www.libertymutualgroup.com/providernetworks T

0520

American States Insurance Company 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 02/14/2005 http://www.libertymutualgroup.com/providernetworks T

0211

American Zurich Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196


0840

American Zurich Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196

First Health CompAmerica Primary HCO Network Insurer 08/02/2005 www.zurichna.com

1142

American Zurich Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 www.zurichna.com

2402

American Zurich Insurance Company 1299 Zurich Way Schaumberg, IL 60196

American Zurich Insurance Company/GENEX MPN Insurer 09/03/2015 www.genexservices.com T

0358

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196


0438

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 TCT CA MPN Insurer 03/08/2005 www.mywcinfo.com T

0434

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T





21


Applicant Date of


Approval Status *

0134

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich ESIS MPN Insurer 04/19/2005 T

1348

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

1522



1682

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Broadspire Signature Network MPN Insurer 08/18/2010 T

1821

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 ACM/American Zurich MPN Insurer 05/03/2011 http://mpn.acmclaims.com/zurich T

1876


American Zurich Insurance Company/CorVel MPN Insurer 08/23/2011 www.corvel.com

1892



1910

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 TRISTAR MPN Insurer 02/14/2012 T

2098

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Sedgwick/Harbor MPN Insurer 12/24/2012 T

2101

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Sedgwick/Harbor 2 MPN Insurer 12/27/2012 T

3125

American Zurich Insurance Company 1299 Zurich Way Schaumburg, IL 60196 CorVel Select MPN Insurer 01/25/2019 www.corvel.com

0356

American Zurich Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

SRS First Health CompAmerica Primary HCO Network (or "SRS First Health Primary") Insurer 03/07/2005 W

0147







22


Applicant Date of


Approval Status *

0837



0672


American Zurich Insurance Company, Crawford Select Insurer 07/01/2005 W

1005


American Zurich Insurance Company - Crawford Primary Insurer 07/01/2005 W

1337

American Zurich Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 American Zurich Ins./The GAP, Inc. Insurer 02/05/2008 T

2256

American Zurich Insurance Company 1400 American Lane Tower 2-6th Floor Schaumburg, IL 60196

American Zurich/Gallagher Bassett/First Health MPN Insurer 12/30/2013 T

0345

AmerisourceBergen Corporation 1300 Morris Drive Chesterbrook, PA 19087

First Health CompAmerica/Select HCO Network


1835

AmerisourceBergen Corporation 1300 Morris Drive Chesterbrook, PA 19087 Broadspire Signature MPN


0166

AmGuard Insurance 16 South River Street Wilkes Barre, PA 18703 AM Guard Insurance (GUARD Insurance) Insurer 01/24/2005 T

0201

Anaheim Union High School District 501 Crescent Way Anaheim, CA 92801

Prime Advantage Medical Network accessing Prudent Buyer HCO


1049

Antelope Valley Community College District 3041 West Avenue "K" Lancaster, CA 93536 Prime Advantage Medical Network


2397

Anthem Workers' Compensation, LLC 120 Monument Circle Indianapolis, IN 46204 Anthem Premier MPN

Entity that provides physician network services 06/26/2015

https://www.anthemwc.com/medical_provider_networks.asp

2415

Anthem Workers' Compensation, LLC 120 Monument Circle Indianapolis, IN 46204 Anthem Premier Plus MPN











23


Applicant Date of


Approval Status *

1808

Apple Valley Unified School District 22974 Bear Valley Road Apple Valley, CA 92308 PRIME Advantage Medical Provider Network


2127

Arch Insurance Company 210 Hudson Street, #300 Jersey City, NJ 07311 LWP Signature MPN Insurer 02/20/2013 http://www.lwpsignaturempn.com

2128

Arch Insurance Company 210 Hudson Street, #300 Jersey City, NJ 07311 LWP Kaiser Signature MPN Insurer 02/20/2013 www.lwpkaisersignaturempn.com

1791

Arch Insurance Company 210 Hudson Street, Suite 300 Jersey City, NJ 07311-1107 Arch GBMCS KOJ MPN Insurer 03/02/2011 www.talispoint.com/cvty/gbkoj

2362

ARCH Insurance Company 210 Hudson Street, Suite 300 Jersey City, NJ 07311 Athens MPN Insurer 01/30/2015 www.medexhco.com

0907

ARCH Insurance Company 300 First Stamford Place 5th Flr Stamford, CT 06902

MedInsights Medical Provider Network accessing Prudent Buyer HCO Insurer 06/01/2005 W

0402

ARCH Insurance Company 300 First Stamford Place Stamford, CT 06902 ARCH Insurance Company Cambridge MPN Insurer 02/24/2005 W

1402

ARCH Insurance Company 300 Plaza 3 Jersey City, NJ 07311 ARCH ESIS MPN Insurer 09/29/2008 T

1484

ARCH Insurance Company 300 Plaza 3 Jersey City, NJ 07311 WellComp Medical Provider Network Insurer 01/08/2009 T

1606

Arch Insurance Company 300 Plaza Three - 3rd Floor Jersey City, NJ 07311 Wellcomp Medical Provider Network Insurer 03/10/2010 T

1685

Arch Insurance Company 300 Plaza Three, 3rd FL Jersey City, NJ 07311 Broadspire Signature Network Insurer 08/18/2010 T

1996

Arch Insurance Company 300 Plaza Three, 3rd Floor Jersey City, NJ 07311

CCMSI/Arch/First Health Comp America Select HCO Network Insurer 10/20/2011 T

2170

Arch Insurance Company 300 Plaza Three-3rd floor Jersey City, NJ 07311 Liberty Mutual Group MPN Insurer 05/06/2013 T





24


Applicant Date of


Approval Status *

1323

ARCH Insurance Company One Liberty Plaza - 53rd Flr New York, NY 10006 Broadspire MPN Insurer 11/05/2007 T

1419

ARCH Insurance Company One Liberty Plaza 53rd Floor New York, NY 10006 ARCH-FARA Insurer 03/24/2009 T

1035

ARCH Insurance Company One Liberty Plaza 53rd Flr New York, NY 10006 Arch/Gallagher Bassett/Coventry MPN Insurer 07/18/2005 T

1266

Arch Insurance Company One Liberty Plaza New York, NY 10006


1277

Arch Insurance Company One Liberty Plaza New York, NY 10006


1292

ARCH Insurance Company One Liberty Plaza New York, NY 10006 Arch/Bunch/BBY Ca MPN Insurer 05/18/2007 T

1330

ARCH Insurance Company One Liberty Plaza New York, NY 10006 Sedgwick CMS MPN Insurer 11/26/2007 T

1600

Arch Insurance Company One Liberty Plaza New York, NY 10006 Sedgwick CMS/Harbor MPN-Arch Ross Insurer 03/02/2010 T

1615

Arch Insurance Company One Liberty Plaza New York, NY 10006 Sedgwick CMS/Harbor MPN - Big Lots Insurer 03/26/2010 T

1796

Arch Insurance Company One Liberty Plaza New York, NY 10006 Arch/WSonoma/Bunch MPN Insurer 03/10/2011 W

1895

ARCH Insurance Company One Liberty Plaza New York, NY 10006 ARCH/Big Lots/Bunch MPN Insurer 12/20/2011 T

2008

Arch Insurance Company One Liberty Plaza New York, NY 10006 Sedgwick/Harbor MPN Insurer 06/01/2012 T

2009

Arch Insurance Company One Liberty Plaza New York, NY 10006 Sedgwick/Harbor 2 MPN Insurer 06/01/2012 T





25


Applicant Date of


Approval Status *

1464

ARCH Insurance Company One Liberty Plaza, 53rd Fl. New York, NY 10006 Sedgwick CMS Extended MPN Insurer 11/10/2008 T

0331

Arch Insurance Company One Liberty Plaza, 53rd Floor New York, NY 10006 CorVel MPN Insurer 03/07/2005 www.corvel.com

1447

ARCH Insurance Company One Liberty Plaza, 53rd Floor New York, NY 10006 ARCH GBMCS MPN Insurer 05/07/2009 T

0689

ARCH Insurance Company One Liberty Plaza, 53rd Flr New York, NY 10006 Arch/Gallagher Bassett/First Health MPN Insurer 05/24/2005 T

1206

Archer-Daniels-Midland Company 4666 Faries Parkway Decatur, IL 62525 CorVel MPN/Archer Daniels-Midland


1664

Argonaut Great Central Insurance Company 225 W Washington Street, 6th Floor Chicago, IL 60606

Argonaut Great Central Insurance Company/GENEX MPN Insurer 09/29/2010 www.genexservices.com T

1708

Argonaut Great Central Insurance Company 225 West Washington St. 8th Floor Chicago, IL 60606 Broadspire Signature Network Insurer 10/20/2010 T

0424

Argonaut Insurance Company 10101 Reunion Place Suite 500 San Antonio, TX 78216 Broadspire MPN Insurer 03/21/2005 T

1663

Argonaut Insurance Company 225 W. Washington Stree, 6th Floor Chicago, IL 60606 Argonaut Insurance Company/GENEX MPN Insurer 09/29/2010 www.genexservices.com T

1705

Argonaut Insurance Company 225 West Washington St. 8th Floor Chicago, IL 60606 Broadspire Signature Network Insurer 10/20/2010 T

0053

Argonaut Insurance Company 5250 North Palm Avenue, Suite 210 Fresno, CA 93704 CorVel MPN/Argonaut Insurer 02/17/2005 T

1666

Argonaut-Midwest Insurance Company 225 W. Washington Street, 6th Floor Chicago, IL 60606

Argonaut Midwest Insurance Company/GENEX MPN Insurer 09/29/2010 www.genexservices.com T

1707

Argonaut-Midwest Insurance Company 225 West Washington St. 8th Floor Chicago, IL 60606 Broadspire Signature Network Insurer 10/20/2010 T





26


Applicant Date of


Approval Status *

1665

Argonaut-Southwest Insurance Company 225 W. Washington Street, 6th Floor Chicago, IL 60606

Argonaut Southwest Insurance Company/GENEX MPN Insurer 09/29/2010 www.genexservices.com T

1706

Argonaut-Southwest Insurance Company 225 West Washington St. 8th Floor Chicago, IL 60606 Broadspire Signature Network Insurer 10/20/2010 T

1896

Arrowood Indemnity Company 3600 Arch Corporate Dr. Charlotte, NC 28273 Arrowood Indemnity-EK Health Select MPN Insurer 12/20/2011 T

1344

Artisan Confections Company c/o Hershey Co 100 Crystal A Drive Hershey, PA 17033 Sedgwick CMS CA MPN


1079

Asplundh Tree Expert Co. 708 Blair Mill Road Willow Grove, PA 19090 Liberty Mutual Group MPN


0620

Associated Indemnity Corporation 777 San Marin Dr. Novato, CA 94998 First Health Select Insurer 02/14/2005 www.agcs.allianz.com/usclaims T

0151

Assurance Company of America 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0212


FirstHealth CompAmerica Select HCO Network Insurer 04/18/2005 T

0674


Assurance Company of America - Crawford Select Insurer 07/01/2005 W

1008


Assurance Company of America - Crawford Primary Insurer 07/01/2005 W

0841



1143

Assurance Company of America 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 T

1351

Assurance Company of America 1400 American Lane Tower 1-13th Floor Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T





27


Applicant Date of


Approval Status *

0751

AT&T Corporation One AT & T Way Bedminster, NJ 07921 Broadspire-Concentra Standard MPN


1237

AT&T Inc. 208 South Akard Street, 27th Floor Dallas, TX 75202

Sedgwick CMS Extended Medical Provider Network


2377

ATHENS INSURANCE SERVICE, INC. 2552 STANWELL DR Concord, CA 94520 Athens Administrators


http://www.athensmci.com/services/athens-administrators-california-mpn/

0941

Atlantic Mutual Insurance Company PO Box 2307 Brea, CA 92822 Atlantic Mutual Companies/Coventry MPN Insurer 09/06/2005 T

2373

Atlantic Specialty Insurance Company 150 Royal Street Canton, MA 02021 WellComp Medical Provider Network Insurer 02/24/2015 www.wellcomp.com T

3005

Atlantic Specialty Insurance Company 605 Highway 169 North Ste 800 Plymouth, MN 55441

Atlantic Specialty Insurance Company - Select MPN

Entity that provides physician network services 12/14/2016 www.coventrywcs.com

0777

Auto Dealers Compensation of California, Inc. c/o Bickmore Risk Services 1831 K St. Sacramento, CA 95814 AD-COMP MPN

Group of Self-Insured Employers 09/15/2005 T

0530

B.V. General, Inc. 1506 South Glendale Avenue Glendale, CA 91205 First Health Comp America HCO Select

Self-Insured Employer 04/21/2005 www.talispoint.com/cvty/mpnsel T

1259

Bakersfield City School District 1300 Baker Street Bakersfield, CA 93305

Self-Insured Schools Of California(SISC)/California Foundation For Medical Care Network

Self-Insured Employer 12/07/2006 www.cfmcnet.org/SISC

3110

Baldwin Park Unified School District 3699 Holly Avenue Baldwin Park, CA 91706 Baldwin Park USD MPN

Self-Insured Employer 08/29/2018 www.talispoint.com/intermed/baldwinparkusdmpn

0348

Ball Corporation, Ball Metal Beverage Container Corp., and Ball Plastic Corp.,Ball Metal Food Container LLC, Ball Aerosol and Specialty Container, Inc. 10 Longs Peak Drive Broomfield, CO 80021

First Health CompAmerica Select HCO Network (or "First Health Select")








28


Applicant Date of


Approval Status *

1268

Bancinsure Inc. 5104 N. Francis Ave., Suite 101 Oklahoma City, OK 73105 Midwest/CorVel MPN Insurer 12/14/2006 T

1335

BancInsure, Inc. 5005 N. Lincoln Blvd. Oklahoma City, OK 73108 BancInsure MPN Insurer 02/05/2008 T

0702

Bankers Standard Insurance Company (BSI) 1601 Chestnut Street Philadelphia, PA 19103

Bankers Standard Insurance Company (BSI), Crawford Select Insurer 06/16/2005 W

0703

Bankers Standard Insurance Company (BSI) 1601 Chestnut Street Philadelphia, PA 19103

Bankers Standard Insurance Company (BSI), Crawford Primary Insurer 06/16/2005 W

0769

Bankers Standard Insurance Company 436 Walnut St Philadelphia, PA 19106 ACE/BUNCH Network Insurer 05/06/2005 T

0417

Bari Management, Inc. 620 N. Brand Blvd., 6th Floor Glendale, CA 91203 FH Select MPN


0409

Barrett Business Services, Inc. 9100 NE Parkway Drive, Ste 200 Vancouver, WA 98662 BBSI MPN

Self-Insured Employer 02/28/2005 www.barrettbusiness.com √

0112

Bay Cities JPA/Bickmore Risk Services 1831 K Street Sacramento, CA 95814 First Health CompAmerica Primary Network


0141

BCI Coca-Cola Bottling Company of Los Angeles (Coca-Cola Enterprises, Inc.) 1334 South Central Avenue Los Angeles, CA 90012 Sedgwick CMS Medical Provider Network


1234

Bedivere Insurance Company 3 Battery March Park Quincy, MA 02169 Bedivere-Coventry CA MPN Insurer 01/04/2007 http://www.talispoint.com/cvty/bed

1329

Benchmark Insurance Company 100 Lake Street West Wayzata, MN 55391 CorVel/Kaiser Select MPN Insurer 11/30/2007 www.corvel.com T

2275

Benchmark Insurance Company 100 West Lake St. Wayzata, MN 55391 Sierra MPN Insurer 05/27/2014 www.benchmarkadministrators.com





29


Applicant Date of


Approval Status *

1332

Benchmark Insurance Company 6405 Metcalf Ave., Suite 400 Overland Park, KS 66202 Rising Interplan MPN Insurer 12/28/2007 T

1610

Benchmark Insurance Company 775 Prairie Center Dr Ste 420 Eden Prairie, MN 55344 Athens MPN Insurer 03/18/2010 T

0959

Benefit & Liability Programs of California 16703 S. Clark Ave. Bellflower, CA 90706 WellComp Medical Provider Network

Joint Powers Authority 08/04/2005 www.wellcomp.com

1459

Berkeley Farms, LLC 25500 Clawiter Road Hayward, CA 94545 Liberty Mutual Group MPN


3076

Berkley Insurance Company 10851 Mastin Blvd., Suite 200 Overland Park, KS 66210 Berkley Care Network Select

Entity that provides physician network services 04/18/2018 http://www.talispoint.com/cvty/bmms

1942

Berkley National Insurance Company 215 Shuman Blvd., Ste 200 Naperville, IL 60563 WellComp Medical Provider Network Insurer 05/02/2012 T

1945

Berkley Regional Insurance Company 11201 Douglas Ave Urbandale, IA 50322 WellComp Medical Provider Network Insurer 05/02/2012 T

1229

Berkley Regional Insurance Company 11201 Douglas Ave. Urbandale, IA 50322 San Francisco 49er MPN Insurer 09/01/2006 T

1038

Berkshire Hathaway Homestate Companies-Cypress Insurance Company P.O. Box 7008 Pasadena, CA 91109

Berkshire Hathaway Homestate Companies MPN Insurer 08/16/2005 W

0454

Berkshire Hathaway Homestate Companies-Oak River Insurance Co. P.O. Box 7008 Pasadena, CA 91109


1037

Berkshire Hathaway Homestate Companies-Redwood Fire & Casualty Company P.O. Box 7008 Pasadena, CA 91109






30


Applicant Date of


Approval Status *

2225

Big 5 Corp. 2525 E. El Segundo Blvd El Segundo, CA 90245 CorVel MPN

Self-Insured Employer 10/18/2013 www.corvel.com

0791

Big 5 Corp. 2525 E. El Segundo Blvd. El Segundo, CA 90245 Big 5 ESIS MPN


0900

Birmingham Fire Insurance Company of Pennsylvania AIG 70 Pine St. New York, NY 10270

Birmingham Fire Insurance Company of Pennsylvania, Crawford Primary Insurer 10/05/2005 W

0859

Birmingham Fire Insurance Company of Pennsylvania Birmingham Fire Ins Co of PA New York, NY 10038

Birmingham Fire Insurance Company of Pennsylvania Crawford Select Insurer 10/19/2005 W

0388

Bourns, Inc. 1200 Columbia Avenue Riverside, CA 92507 Medex


2265

Bright Health Physicians PIH 12401 Washington Blvd. Whittier, CA 90602 Athens MPN


2399

Broadspire Services, Inc. 1391 NW 136th Avenue Sunrise, FL 33323 Broadspire MPN


www.choosebroadspire.com/resources/medicalmanagement

2403

Bunch CareSolutions LLC 3500 Reynolds Rd Lakeland, FL 33803 Aramark Bunch CS MPN

Entity that provides physician network services 08/07/2015 www.bunchcare.com T

2478

Bunch CareSolutions LLC 3500 Reynolds Rd. Lakeland, FL 33803 BunchCS FHSelect MPN

Entity that provides physician network services 05/09/2016 www.bunchcare.com T

2088

Cajon Valley Union School District 750 E.Main Street El Cajon, CA 92020 PRIME Advantage Medical Provider Network


0712

Calexico Unified School District 901 Andrade Ave Calexico, CA 92231 Prime Advantage Medical Network


http://www.choosebroadspire.com/resources/medicalmanagement

http://www.choosebroadspire.com/resources/medicalmanagement





31


Applicant Date of


Approval Status *

1129

California Agricultural Network Self Insured Group (CANSIG) 2151 Convention Center Way #203 Ontario, CA 91764 CANSIG-MPN


2156

California Agricultural Network, Inc. 430 N Vineyard #102 Ontario, CA 91764 California Agricultural Network, Inc. MPN

Group of Self-Insured Employers 05/06/2013 www.intermedccs.com/CANSIGMPN

1284

California Agricultural Products, Inc. Self Insured Group 2151 Convention Ctr Way #203 Ontario, CA 91764 California Agricultural Products MPN


1646

California Agricultural Products, Inc. 2151 Convention Center Way #203 Ontario, CA 91764 WellComp Medical Provider Network

Group of Self-Insured Employers 06/10/2010 www.wellcomp.com T

2406

California Association for Park and Recreation Indemnity(CAPRI) 6341 Auburn Blvd., SuiteA Citrus Heights, CA 95621 EIA Medical Provider Network

Joint Powers Authority 01/13/2016 www.eiampn.csac-eia.org T

0426

California Autism Foundation 4075 Lakeside Drive San Pablo, CA 94806 Medex


0745

California Casualty & Fire Insurance Company PO Box M San Mateo, CA 94402


0743

California Casualty Compensation Insurance Company P.O. Box M San Mateo, CA 94402


0744

California Casualty General Insurance Company of Oregon 10260 SW Greenburg Rd., Suite 448 Portland, OR 97223


0747

California Casualty Indemnity Exchange (The) P.O. Box M San Mateo, CA 94402


0746

California Casualty Insurance Company P.O. Box M San Mateo, CA 94402






32


Applicant Date of


Approval Status *

1207

California Contractors Network Self Insured Group 2151 Convention Ctr Way #203 Ontario, CA 91764 California Contractors Network (CCN)


2152

California Contractors Network, Inc. 430 North Vineyard Ave, Ste 102 Ontario, CA 91764 ACM/California Contractors Network MPN


1643

California Contractors Network-Self-Insured Group 430 N. Vinyard Ave., Ste 102 Ontario, CA 91764 WellComp Medical Provider Network


1334

California Farm Management Self-Insured Group 2151 Convention Ctr Dr #203 Ontario, CA 91764


2018

California Farm Management, Inc. 430 N Vineyard, Suite 103 Ontario, CA 91764 California Farm Management MPN

Group of Self-Insured Employers 10/05/2012 www.intermedccs.com/CFMSIGMPN

1644

California Farm Management-Self-Insured Group 2151 Convention Center Way #203 Ontario, CA 91764 WellComp Medical Provider Network


0510

California Indemnity Insurance Company 2716 North Tenaya Way Las Vegas, NV 89130 CIIC MPN Insurer 05/20/2005 T

1054

California Insurance Company 10805 Old Mill Road Omaha, NE 68154 Promesa Health MPN Insurer 07/20/2005

www.auw.com/promesa_california_provider_search.aspx

3118

California Insurance Guarantee Association (CIGA) 101 N Brand Blvd # 600 Glendale, CA 91203 CIGA Anthem MPN Insurer 10/12/2018 www2.viiad.com/CIGA

0508

California Insurance Guarantee Association (CIGA) 101 N. Brand Blvd. #600 Glendale, CA 91203 CIGA MPN Insurer 09/16/2005 http://www.talispoint.com/cvty/cigampn

http://www.auw.com/promesa_california_provider_search.aspx

http://www.auw.com/promesa_california_provider_search.aspx





33


Applicant Date of


Approval Status *

1289

California Livestock Producers, Inc. Self-Insured Group 2151 Convention Ctr. Way #203 Ontario, CA 91764


2379

California Livestock Producers, Inc. 430 N Vineyard Ave #102 Ontario, CA 91764 CLPSIG MPN

Group of Self-Insured Employers 09/29/2015 www.intermedccs.com/CLPSIGMPN

1645

California Livestock Producers-Self-Insured Group 2151 Convention Center Way #203 Ontario, CA 91764 WellComp Medical Provider Network


1325

California Private Schools Self Insurance Group Inc. 1750 Creekside Oaks Ste 200 Sacramento, CA 95833 TRISTAR MPN


1712

California Restaurant Mutual Benefit Corporation 430 N Vineyard Ave. #102 Ontario, CA 91764 One Source Medical Network

Group of Self-Insured Employers 11/04/2010 www.one-source-medical.com T

1709

California Risk Management Authority 1430 W. Herndon Fresno, CA 93711 CRMA MPN

Joint Powers Authority 01/12/2011 www.intermedccs.com/CRMAMPN

0933

California Risk Management Authority 40356 Oak Park Way, Suite A Oakhurst, CA 93644 CRMA MPN


1012

California Sanitation Risk Management Authority 100 Pine Street, 11th Floor San Francisco, CA 94111 Healthsmart


2375

California Sanitation Risk Management Authority 100 Pine Street, 11th Floor San Francisco, CA 94111 WellComp Medical Provider Network

Joint Powers Authority 02/24/2015 www.wellcomp.com T

1183

California Truckers Safety Association 985 Old Eagle School Rd., Suite 504 Wayne, PA 19087 Medex


2062

Caminol Management, LLC 2360 Lindbergh Street Auburn, CA 95602 MedInsights Medical Provider Network






34


Applicant Date of


Approval Status *

2107

Caminol Management, LLC 2360 Lindbergh Street Auburn, CA 95602 Caminol Management, LLC GBMCS MPN


2385

Cannon Cochran Management Services, Inc. 2 East Main Street Danville, IL 61832

CCMSI/First Health CompAmerica Select HCO Network

Entity that provides physician network services 08/06/2015 http://www.coventrywcs.com/client-tools/index.htm

2392

Cannon Cochran Management Services, Inc. 2 East Main Street Danville, IL 61832 CCMSI Custom Network

Entity that provides physician network services 08/06/2015 http://www-sf.talispoint.com/talispoint/login.pl

0687

Capistrano Unified School District 33122 Valle Road San Juan Capistrano, CA 92675 Capistrano USD/CorVel Select MPN

Self-Insured Employer 05/20/2005 http://www.corvel.com

1112

Care West Insurance Company 2521 Warren Drive Rocklin, CA 95677 Care West MPN Insurer 01/13/2006 www.statusmedical.com/carewest

3123

Care West Insurance Company 2521 Warren Drive Rocklin, CA 95677 CorVel/Care West MPN Insurer 12/03/2018 www.corvel.com

2351

Careworks Managed Care Services, Inc. 405 Duke Drive, Ste. 270 Franklin, TN 37067 Careworks MPN

Entity that provides physician network services 03/12/2015 www.careworks.com/Non-Ohio-tpas/resources/

2387

CareWorks Managed Care Services, Inc. 8855 Haven Avenue Rancho Cucamonga, CA 91730 WellComp Medical Provider Network

Entity that provides physician network services 04/13/2015 www.wellcomp.com

1267

Cargill Incorporated and its subsidiaries 15407 McGinty Road West MS12 Wayzata, MN 55391

First Health CompAmerica Select HCO Network


2310

Casa Pacifica, dba Freedom Village 23442 El Toro Road Lake Forrest, CA 92630 Medex MPN

Self-Insured Employer 09/05/2014 www.medexhco.com T

1561

Castaic Union School District 28131 Livingston Ave Valencia, CA 91355 PRIME Advantage Medical Provider Network






35


Applicant Date of


Approval Status *

1016

CastlePoint National Insurance Company 120 Broadway, 31st Floor New York, NY 10271 Tower Group Companies MPN Insurer 08/05/2005 T

1662

CastlePoint National Insurance Company 1655 Grant Street Concord, CA 94524 WellComp Medical Provider Network Insurer 07/15/2010 www.wellcomp.com T

0902

Catholic Mutual 10843 Old Mill Rd Omaha, NE 68154 TRISTAR/First Health CompAmerica/HCO


2124

CBS Operations Inc. 51 West 52nd Street New York, NY 10019

First Health CompAmerica HCO Select Network

Self-Insured Employer 02/26/2013 https://www.talispoint.com/cvty/mandb

0776

Cedars-Sinai Medical Center 8700 Beverly Blvd. Los Angeles, CA 90048 Cedars-Sinai Medical Provider Network

Self-Insured Employer 08/10/2005

http://www.cedars-sinai.edu/Patients/Programs-and-Services/Medical-Provider-Network/

0942

Centennial Insurance Company 7 Giralda Farms Suite 120 Madison, NJ 07940 Atlantic Mutual Companies/Coventry MPN Insurer 09/06/2005 T

2313

Central Concrete Supply Co., Inc. 331 N. Main Street Euless, TX 76039 Medex


0910

Central Contra Costa Transit Authority aka CCCTA/County Connection 2477 Arnold Industrial Way Concord, CA 94596 Interplan/Kaiser


1491

Central Region School Insurance Group 4101 Tully Road Ste 501 Modesto, CA 95356 WellComp Medical Provider Network


3007

Central Region School Insurance Group 4101 Tully Road, Ste. 501 Modesto, CA 95356 Central Region School MPN

Joint Powers Authority 12/23/2016 secure.simon-companies.com/crsig/

0872

Central Region Schools Insurance Group 3600 Sisk Road, #2D Modesto, CA 95356 CRSIG MPN


1285

Centre Insurance Company 105 E. 17th Street New York, NY 10003 PRIME Advantage MPN Insurer 03/27/2007 T







36


Applicant Date of


Approval Status *

0780

Cerritos Community College District 11110 East Alondra Blvd Norwalk, CA 90650 Prime Advantage Medical Network


1232

CertainTeed Corporation 20 Moores Road Malvern, PA 19355 CertainTeed Corporation ESIS MPN


1340

Chabot-Las Positas Community College District 5020 Franklin Drive Pleasanton, CA 94588 PRIME Plus Medical Provider Network


1104

Chaffey Joint Union High School District 211 West Fifth Street Ontario, CA 91762

Chaffey Joint Union High School District/CorVel Select MPN


0778

Charming Shoppes, Inc. 450 Winks Lane Bensalem, PA 19020

MedInsights Medical Provider Network, accessing Prudent Buyer HCO Insurer 05/06/2005 W

0651

Chartis Property Casualty Company 175 Water Street, 18th Floor New York, NY 10038

Chartis Property Casualty Company/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

0628

Chartis Property Casualty Company 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T

1026

Chartis Property Casualty Company 175 Water Street, 18th Floor New York, NY 10038

Chartis Property Casualty Company/Gallagher Bassett/First Health MPN Insurer 08/05/2005 T

1525

Chartis Property Casualty Company 175 Water Street, 18th Floor New York, NY 10038 Chartis Property GBMCS MPN Insurer 05/07/2009 T

0503

Chartis Property Casualty Company 70 Pine Street New York, NY 10270


0493

Chartis Property Casualty Company 70 Pine Street New York, NY 10270 Sedgwick CMS Medical Provider Network Insurer 03/16/2005 T

0914

Chartis Property Casualty Company 70 Pine Street New York, NY 10270






37


Applicant Date of


Approval Status *

0463

Chartis Property Casualty Company, (fka AIG Casualty Company) 175 Water St, 18th Floor New York, NY 10038 Broadspire MPN Insurer 04/26/2005 T

1261

Chevron Corporation 6001 Bollinger Canyon Road San Ramon, CA 94583 Chevron Medical Provider Network


http://hr2.chevron.com/disabilitymanagement/8_FAQ_2.asp T

1436

Chevron Stations, Inc. 6001 Bollinger Canyon Road San Ramon, CA 94583 Chevron Stations Medical Provider Network


0452

Children's Hospital of Los Angeles 4650 Sunset Blvd. Los Angeles, CA 90027 Children's Hospital of Los Angeles, MPN


1999

Children's Hospital of Los Angeles 4650 Sunset Boulevard Los Angeles, CA 90027 Medex MPN


3094

Children's Hospital Of Orange County 1201 W. La Veta Ave Orange, CA 92868 Children's Hospital Of Orange County MPN

Self-Insured Employer 03/26/2018 http://choc.employermpn.com

0270

Chubb Indemnity Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1472

Chubb Indemnity Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com

0271

Chubb National Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1479

Chubb National Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com

0962

Chula Vista Elementary School District 84 East "J" Street Chula Vista, CA 91910 TRISTAR MPN


2237

Church Mutual Insurance Company 3000 Schuster Lane Merrill, WI 54452

Church Mutual Insurance Company Medical Provider Network Insurer 11/21/2013

https://www.churchmutual.com/3261/California-Medical-Provider-Network







38


Applicant Date of


Approval Status *

0416

CIMM'S Incorporated 620 N. Brand Blvd., 6th Floor Glendale, CA 91203 FH Select MPN


0854

Circuit City Stores, Inc. 9954 Mayland Drive Richmond, VA 23223 Sedgwick CMS Extended Medical Provider


1316

Circuit City Stores, Inc. 9954 Mayland Drive Richmond, VA 23223 SRS First Health CompAmerica Primary


1819

Citizens Insurance Company Of America 440 Lincoln Street Worcester, MA 01615 CorVel/Kaiser Select MPN Insurer 04/22/2011 www.Corvel.com

0196

Citrus Community College District 1000 West Foothill Blvd Glendora, CA 91741 Prime Advantage Medical Network


2372

Citrus Valley Health Partners, Inc. 1115 S. Sunset Avenue West Covina, CA 91790 CorVel/CVHP MPN


1258

City And County Of San Francisco 1 South Van Ness Avenue, 4th Floor San Francisco, CA 94103 City And County Of San Francisco MPN

Self-Insured Employer 02/21/2007 www.talispoint.com/intermed/ccsfmpn

1256

City of Bakersfield, CA 1501 Truxtun Ave. Bakersfield, CA 93301 City of Bakersfield MPN


3120

City Of Banning 99 E. Ramsey Street Banning, CA 92220 CorVel MPN


1305

City Of Barstow 220 E. Mountain View Street Barstow, CA 92311 CorVel/City Of Barstow MPN

Self-Insured Employer 07/27/2007 http://www.corvel.com T

0904

City of Campbell 70 N. First St. Campbell, CA 95008 First Health CompAmerica Primary HCO


2077

City of Carlsbad 1635 Faraday Ave. Carlsbad, CA 92008 PRIME Advantage Medical Provider Network


0473

City of Carlsbad 1635 Faraday Avenue Carlsbad, CA 92008 TRISTAR MPN






39


Applicant Date of


Approval Status *

0905

City of Carmel-by-the-Sea PO Box CC Carmel, CA 93921 First Health CompAmerica Primary HCO


2021

City of Carson 701 East Carson Street Carson, CA 90749 City of Carson MPN


0806

City of Clovis 1033 Fifth Street Clovis, CA 93612 City of Clovis Medical Provider Network


0459

City of Colton 650 N. La Cadena Drive Colton, CA 92324 TRISTAR MPN


0808

City of Compton 205 S. Willowbrook Ave. Compton, CA 90220 TRISTAR - CompAmerica Primary HCO


2030

City of Corona 400 S. Vicentia Avenue Corona, CA 92882 Sedgwick CMS Extended MPN


0998

City of Corona 400 S. Vicentia Corona, CA 92882 WellComp Medical Provider Network


0814

City of Culver City 9770 Culver Blvd. Culver City, CA 90230


1314

City of Culver City 9770 Culver Blvd. Culver City, CA 90232 WellComp Medical Provider Network


3018

City Of Desert Hot Springs 65-950 Pierson Blvd. Desert Hot Springs, CA 92240 CorVel MPN


1057

City of Escondido 201 North Broadway Escondido, CA 92025 City of Escondido Medical Provider Network


1269

City of Fremont 3300 Capitol Ave. Fremont, CA 94538 WellComp Medical Provider Network


0901

City Of Fresno 2600 Fresno Street Fresno, CA 93721 Risico TMC City Of Fresno MPN

Self-Insured Employer 08/09/2005 http://www.risico.com





40


Applicant Date of


Approval Status *

0278

City of Glendale 613 E. Broadway, Room 100 Glendale, CA 91206 City of Glendale/Concentra


0338

City of Hawthorne 4455 W. 126th Street Hawthorne, CA 90250 Broadspire-Concentra Standard MPN


1202

City of Hawthorne 4455 W. 126th Street Hawthorne, CA 90250 City of Hawthorne MPN


1652

City of Hesperia 9700 Seventh Avenue Hesperia, CA 92345 WellComp Medical Provider Network


0797

City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648

Huntington Beach Medical Provider Network, accessing Prudent Buyer HCO


0694

City of Irvine One Civic Center Plaza P.O. Box19575 Irvine, CA 92623 State Fund Medical Provider Network


0461

City of Lemon Grove 3232 Main Street Lemon Grove, CA 91945 TRISTAR CompAmerica Primary HCO


0661

City of Long Beach 333 W. Ocean Blvd., 8th Floor Long Beach, CA 90802 City of Long Beach MPN


2365

City of Long Beach 333 West Ocean Blvd. 8th Floor Long Beach, CA 90802 Medex MPN


3096

City Of Los Angeles 700 E Temple Street, RM 210 Los Angeles , CA 90012

Los Angeles Police Protective League ADR Medical Provider Network

Self-Insured Employer 04/13/2018 www.cityoflampn.com

3095

City Of Los Angeles 700 E Temple Street, RM 210 Los Angeles, CA 90012

City Of Los Angeles ADR Medical Provider Network


3097

City Of Los Angeles 700 E Temple Street, RM 210 Los Angeles, CA 90012 City Of Los Angeles Medical Provider Network


0507

City of Los Angeles 700 East Temple Street, Room 210 Los Angeles, CA 90012 First Health CompAmerica Select HCO






41


Applicant Date of


Approval Status *

0509

City of Los Angeles 700 East Temple Street, Room 210 Los Angeles, CA 90012 Interplan Health Group


0965

City of Merced 678 West 18th Street Merced, CA 95340 TRISTAR MPN


1109

City of Milpitas 455 East Calaveras Blvd. Milpitas, CA 95035 WellComp Medical Provider Network


1015

City of Monterey Park 320 W. Newmark Avenue Monterey Park, CA 91754 City of Monterey Park - MPN


1257

City Of Monterey 735 Pacific Street, Suite B Monterey, CA 93940 City Of Monterey MPN

Self-Insured Employer 06/29/2007 https://secure.simon-companies.com/cityofmonterey/

1185

City Of Murrieta 1 Town Square Murrieta, CA 92562 CorVel/City Of Murrieta MPN


0451

City of Napa 1541 2nd Street Napa, CA 94559 North Bay MPN


0386

City of National City 1243 National City Boulevard National City, CA 91950 State Fund Medical Provider Network


2300

City Of Oakland 150 Frank H. Ogawa Plaza #2352 Oakland, CA 94612 EIA Medical Provider Network

Self-Insured Employer 06/24/2014 www.eiampn.csac-eia.org

0757

City of Oceanside 300 N. Coast Highway Oceanside, CA 92054 Tristar MPN


0217

City of Orange Risk Management 637 W. Struck Avenue Orange, CA 92867 State Fund Medical Provider Network


1122

City Of Perris 101 North D Street Perris, CA 92570 CorVel/City Of Perris MPN


0929

City of Rancho Cucamonga 1525 Response Road Ste 1 Sacramento, CA 95815 WellComp Medical Provider Network






42


Applicant Date of


Approval Status *

1965

City Of Rialto 150 S. Palm Ave. Rialto, CA 92376 CorVel MPN


0481

City of Riverside 3900 Main St 2nd Flr Riverside, CA 92522 City of Riverside - Network

Self-Insured Employer 04/06/2005 www.riversideca.gov/human/workerscomp/mpn.asp

2196

City of San Bernardino 300 N. D Street San Bernardino, CA 92418 WellComp Medical Provider Network


0695

City of San Clemente 100 Avenida Presidio San Clemente, CA 92672 State Fund Medical Provider Network


0439

City Of San Diego P.O. Box 129013 San Diego, CA 92112 City Of San Diego Medical Provider Network


https://www.sandiego.gov/riskmanagement/services/workerscomp/mpn

1058

City of San Gabriel 8081 Moody St. La Palma, CA 90623 WellComp Medical Provider Network


3038

City Of San Jose 200 E. Santa Clara Street San Jose, CA 95113 City Of San Jose MPN

Self-Insured Employer 08/18/2017 www.talispoint.com/intermed/sanjosempn

2241

City of San Jose 200 East Santa Clara Street San Jose, CA 95113 City of San Jose MPN


0817

City of San Leandro 835 E. 14th Street San Leandro, CA 94577 InterPlan/Kaiser


0923

City of Santa Maria 110 E. Cook St Santa Maria, CA 93454 InterPlan


1029

City of Santa Rosa P.O. Box 1674 Santa Rosa, CA 95402 Santa Rosa K


0597

City of Solana Beach 635 South Highway 101 Solana Beach, CA 92075 TRISTAR MPN


2064

City Of Stockton 22 E. Weber Ave., Ste 150 Stockton, CA 95202 City Of Stockton MPN








43


Applicant Date of


Approval Status *

2361

City of Temecula 41000 Main Street Temecula, CA 92590 Medex MPN


1101

City of Thousand Oaks 2100 E. Thousand Oaks Blvd. Thousand Oaks, CA 91362 WellComp Medical Provider Network


2211

City of Turlock 156 S. Broadway Ste. 235 Turlock, ca 95380 PRIME Advantage Medical Provider Network


0303

City of Tustin 300 Centennial Way Tustin, CA 92780 State Fund Medical Provider Network


1181

City of Upland 460 N. Euclid Ave. Upland, CA 93009 CorVel MPN


0639

City of Vernon 4305 Santa Fe Avenue Vernon, CA 90058 City of Vernon MPN


1861

City of Vernon 4305 Santa Fe Avenue Vernon, CA 90058 Athens MPN


0562

City of Visalia 707 W. Acequia Visalia, CA 93291 Prime Advantage Medical Network


0456

City of Vista 600 Eucalyptus Avenue Vista, CA 92085 First Health CompAmerica Primary HCO


2388

City of West Covina 1444 W. Garvey Avenue West Covina, CA 91790 CorVel MPN

Self-Insured Employer 04/23/2015 www.corvel.com W

1048

City of West Covina 1444 West Garvey Ave. West Covina, CA 91793 City of West Covina


0316

Civic Property & Casualty 4680 Wilshire Blvd Los Angeles, CA 90010

First Health CompAmerica Select HCO Network (First Health MPN Network) Insurer 03/09/2005 T

0323

Civic Property & Casualty 4680 Wilshire Blvd Los Angeles, CA 90010

FirstHealth CompAmerica Primary HCO Network (First Health Primary Network) Insurer 03/09/2005 T





44


Applicant Date of


Approval Status *

1592

Civic Property And Casualty Company 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 03/11/2010 www.corvel.com

0081

Clarendon American Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel HCO Insurer 02/04/2005 W

0274

Clarendon American Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 Clarendon Medical Provider Network One Insurer 02/09/2005 W

0100

Clarendon National Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel MPN Insurer 02/04/2005 T

0231

Clarendon National Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 Clarendon Medical Provider Network 1 Insurer 02/09/2005 W

0385

Clarendon National Insurance Company 6831 Edgewater Commerce Pkwy #1101 Orlando, FL 32810 Clarendon TMC Provider Network Insurer 02/22/2005 T

0186

Clougherty Packing, LLC 3049 E. Vernon Avenue Los Angeles, CA 90058 Clougherty Packing Company MPN


2235

Clougherty Packing, LLC 3049 E. Vernon Ave. Los Angeles, CA 90058 CorVel MPN

Self-Insured Employer 12/12/2013 http://www.corvel.com W

1264

Coachella Valley Water District 85-995 Avenue 52 Coachella, CA 92236 Interplan through CompPartners (CP)


2108

Coachella Valley Water District Attn Risk Management PO Box 1058 Coachella, CA 92236 CorVel/Coachella VWD MPN


0460

Coachella Valley Water District P.O. Box 1058 Coachella, CA 92236 TRISTAR CompAmerica Primary HCO


0228

Coast Community College District 1370 Adams Avenue Costa Mesa, CA 92626 Prime Advantage Medical Network


0032

Coherent, Inc (Coherent) 5100 Patrick Henry Drive Santa Clara, CA 95054 First Health Comp America Select HCO






45


Applicant Date of


Approval Status *

0675

Colonial American Casualty Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

Colonial American Casualty Insurance Company, Crawford Select Insurer 07/01/2005 W

1007

Colonial American Casualty Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

Colonial American Casualty Insurance Company - Crawford Primary Insurer 07/01/2005 W

0893

Colton Joint Unified School District 1212 Valencia Drive Colton, CA 92324 WellComp Medical Provider Network


1759

Commerce And Industry Insurance Company 175 Water St., 18th Flr New York, NY 10038 AIG Select MPN Insurer 01/19/2011 www.talispoint.com/aig/mpnselect

0119

Commerce And Industry Insurance Company 175 Water Street - 18th Floor NY, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

0763

Commerce And Industry Insurance Company 175 Water Street - 18th Floor New York, NY 10038

Commerce And Industry Insurance Company/Gallagher Bassett/CorVel MPN Insurer 05/05/2005 www.corvel.com

1660

Commerce And Industry Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/30/2010 www.broadspireppo.com T

2298

Commerce and Industry Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Mentor/Commerce/Bunch MPN Insurer 05/08/2014 http://providernet.bunchcare.com T

1408

Commerce And Industry Insurance Company 175 Water Street- 18th Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com

0525

Commerce and Industry Insurance Company 175 Water Street New York, NY 10038 Chartis - Cambridge MPN Insurer 03/24/2005 W

0652

Commerce and Industry Insurance Company 175 Water Street, 18th Floor New York, NY 10038

Commerce and Industry/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

0631

Commerce and Industry Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T





46


Applicant Date of


Approval Status *

1027

Commerce and Industry Insurance Company 175 Water Street, 18th Floor New York, NY 10038

Commerce and Industry/Gallagher Bassett/First Health MPN Insurer 08/05/2005 T

1486

Commerce and Industry Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Commerce and Industry GBMCS MPN Insurer 05/08/2009 T

1426

Commerce and Industry Insurance Company 70 Pine St New York, NY 10270

CCMSI/ AIG/ First Health Comp America Select HCO Network Insurer 12/16/2008 T

0368

Commerce and Industry Insurance Company 70 Pine Street New York, NY 10270

SRS First Health CompAmerica Primary HCO Network Insurer 03/28/2005 W

0469

Commerce and Industry Insurance Company 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0921

Commerce and Industry Insurance Company 70 Pine Street New York, NY 10270

MedInsights Medical Provider Network, accessing Prudent Buyer PPO Insurer 05/19/2005 T

1377

Commerce and Industry Insurance Company 70 Pine Street New York, NY 10270 Athens/Commerce and Industry Ins. Co. MPN Insurer 04/15/2008 T

0850

Commerce and Industry Insurance Company AIG 70 Pine Street New York, NY 10270

Commerce and Industry Insurance Company-Crawford Select Insurer 07/01/2005 W

0860

Commerce and Industry Insurance Company AIG 70 Pine Street New York, NY 10270

Commerce and Industry Insurance Company, Crawford Primary Insurer 07/01/2005 W

0364

Commerce and Industry Insurance Group 70 Pine Street New York, NY 10270

SRS First health CompAmerica Select HCO Network Insurer 03/28/2005 W

0511

Commercial Casualty Insurance Company 30 South 17th St. Philadelphia, PA 19103 CCIC MPN Insurer 05/20/2005 www.talispoint.com/sierra/shle T

2340

Commercial Protective Services, Inc. 436 W. Walnut St. Gardena, CA 90248 WellComp Medical Provider Network






47


Applicant Date of


Approval Status *

1875

Community Hospital of the Monterey Peninsula 23625 Holman Highway Monterey, CA 93942 CHOMP MPN


3048

Community Hospitals Of Central California 7370 N. Palm Fresno, CA 93711

CorVel/Community Hospitals Of Central CA MPN


1613

Companion Property & Casualty Insurance Company 51 Clemson Rd Columbia, SC 29202 Athens MPN Insurer 03/25/2010 T

1778

Companion Property & Casualty Insurance Company 51 Clemson Rd Columbia, SC 29229 Sedgwick CMS MPN Insurer 02/03/2011 T

1779

Companion Property & Casualty Insurance Company 51 Clemson Rd. Columbia, SC 29229 Sedgwick CMS Extended MPN Insurer 02/10/2011 T

1898

Companion Property & Casualty Insurance Company P.O. Box 100165 Columbia, SC 29202

Companion Property & Casualty Insurance Company GBMCS MPN Insurer 12/22/2011 T

1788

Companion Property and Casualty Insurance Company 51 Clemson Rd Columbia, SC 29202 Medex Insurer 02/24/2011 T

2157

Companion Property and Casualty Insurance Company 51 Clemson Road, PO Box 100165 Columbia, SC 29202 WellComp Medical Provider Network Insurer 05/28/2013 W

1894

Companion Property and Casualty Insurance Company PO Box 100165 Columbia, SC 29202

Companion Property and Casualty Insurance Company Medical Provider Network Insurer 02/08/2012 T

1313

Compton Community College District 1111 East Artesia Blvd Compton, CA 90221 PRIME Advantage Medical Provider Network






48


Applicant Date of


Approval Status *

1128

Compton Unified School District 500 S. Santa Fe Avenue Compton, CA 90221 Compton USD/CorVel Select MPN


0107

CompWest Insurance Company P.O. Box 40790 Lansing, MI 48901-7990 CompWest Select MPN Insurer 03/01/2005

http://www.compwestinsurancecompany.com/compwest-insurance-company-mpn/

0079

CompWest Insurance Company P.O. Box 40790 Lansing, MI 48901-7990 CompWest Select MPN


http://www.compwestinsurance.com/compwest-toolbox/claims/medical-provider-search/

0220

ConAgra Foods, Inc & Subsidiaries One ConAgra Drive Omaha, NE 68102 Sedgwick CMS Medical Provider Network


2386

Conduent Care Solutions, LLC 2345 Commerce Point Drive, Suite 140 Lakeland, FL 33801 Conduent Care Solutions KOJ HS MPN



0285

Conejo Valley Unified School District 1400 E. Janss Road Thousand Oaks, CA 91362



0931

Conejo Valley Unified School District 1400 E. Janss Road Thousand Oaks, CA 91362 WellComp Medical Provider Network


1039

Conopco, Inc. 33 Benedict Place Greenwich, CT 06836 Broadspire-Concentra Standard MPN


0420

Consolidated RIBS, Inc. 620 N. Brand Blvd., 6th Floor Glendale, CA 91203 FOCUS - CONCENTRA [FARA-CIMMS]


1741

Construction Protective Services, Inc. 436 W. Walnut St. Gardena, CA 90248 Medex


2341

Construction Protective Services, Inc. 436 W. Walnut St. Gardena, CA 90248 WellComp Medical Provider Network


0647

Continental Casualty Company (CNA) 333 S. Wabash Chicago, IL 60604 CNA/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T











49


Applicant Date of


Approval Status *

0966

Continental Casualty Company (CNA) C N A Plaza Chicago, IL 60685

Continental Casualty Company, Crawford Primary Insurer 06/16/2005 W

0967

Continental Casualty Company (CNA) C N A PLAZA Chicago, IL 60685

Continental Casualty Company, Crawford Select Insurer 06/16/2005 W

0985

Continental Casualty Company (CNA) CNA Plaza Chicago, IL 60685 First Health CompAmerica Select HCO Insurer 06/23/2005 T

0871

Continental Casualty Company 333 S Wabash Chicago, IL 60604 CNA ESIS MPN Insurer 05/24/2005 T

1062

Continental Casualty Company 333 S. Wabash Ave. Chicago, IL 60604 Liberty Mutual Group MPN Insurer 08/09/2005 T

2096

Continental Casualty Company 333 S. Wabash Chicago, IL 60604 Sedgwick/Harbor MPN Insurer 12/24/2012 T

0728

Continental Casualty Company 333 S. Wabash Chicago, IL 60685

First Health Comp America Select HCO Network (First Health Select) Insurer 04/26/2005 W

0732

Continental Casualty Company 333 S. Wabash Chicago, IL 60685

First Health CompAmerica Primary HCO Network (First Health Primary) Insurer 04/28/2005 W

0798

Continental Casualty Company 333 S. Wabash Chicago, IL 60685 Broadspire MPN Insurer 05/16/2005 T

1837

Continental Casualty Company 333 S. Wabash, Floor 24 Chicago, IL 60604 Sedgwick CMS Extended MPN Insurer 05/24/2011 T

1838

Continental Casualty Company 333 S. Wabash, Floor 24 Chicago, IL 60604 Sedgwick CMS MPN Insurer 05/24/2011 T

2097

Continental Casualty Company 333 S. Wabash, Floor 39 Chicago, IL 60604 Sedgwick/Harbor 2 MPN Insurer 12/24/2012 T

1768

Continental Casualty Company 333 South Wabash Chicago, IL 60604 Broadspire Signature MPN Insurer 02/02/2011 T





50


Applicant Date of


Approval Status *

1131

Continental Casualty Company CNA Plaza 38S Chicago, IL 60685 Medex Insurer 05/10/2006 T

0560

Continental Casualty Company PO Box 8317 Chicago, IL 60680 CNA CA Medical Provider Network


www.cna.com/web/guest/cna/ps/services/ct-servicecaliforniamedicalprovidernetwork

1116

Contractors Access Program of California 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


0938

Converium Insurance (North America) Inc. (n/k/a Allied World Reinsurance Company) 100 First Stamford Place, 2nd Floor Hartford, CT 06902 PRIME Advantage Medical Provider Network Insurer 07/08/2005 T

0886

Cooper US, Inc. P O Box 4446 Houston, TX 77210 The Liberty Mutual Group MPN


0585

Coors Brewing Company 311 10th Street Golden, CO 80401 Sedgwick CMS Medical Provider Network


2069

Cornerstone Comp, Inc. 255 Great Valley Parkway, Ste 255 Malvern, PA 19355 Monument MPN

Group of Self-Insured Employers 10/25/2012 www.monumentllc.com T

1483

Cornerstone Comp, Inc. 255 Great Valley Pkwy Ste 200 Malvern, PA 19355 Monument MPN


0430

Cornerstone Comp, Inc. 7405 N. First Street Fresno, CA 93720 CorVel HCO/CorVel HCO Select


0887

Corona-Norco Unified School District 2820 Clark Ave Norco, CA 92860

TRISTAR/First Health CompAmerica Primary HCO


1915

Corona-Norco Unified School District 2820 Clark Avenue Norco, CA 92860 PRIME Advantage Medical Provider Network


2238

Corporation of the President of the Church of Jesus Christ of Latter Day Saints 50 E North Temple Fl 16 Salt Lake City, UT 81450 Deseret Signature MPN


http://www.cna.com/web/guest/cna/ps/services/ct-servicecaliforniamedicalprovidernetwork

http://www.cna.com/web/guest/cna/ps/services/ct-servicecaliforniamedicalprovidernetwork





51


Applicant Date of


Approval Status *

0310

Corporation of the Presiding Bishop of The Church of Jesus Christ of the Latter-day Saints 50 E North Temple, Floor 16 Salt Lake City, UT 81450 Deseret Signature MPN

Self-Insured Employer 02/16/2005 www.deseretsignaturempn.com T

2041

Costco Wholesale Corporation 999 Lake Dr. Issaquah, WA 98027 Costco Wholesale MPN

Self-Insured Employer 08/16/2012 www.helmsmantpa.com/CAMPN

0382

Costco Wholesale Corporation 999 Lake Drive Issaquah, WA 98027 Costco MPN


1150

Cottage Health System PO Box 689 Pueblo at Bath St Santa Barbara, CA 93102

PRIME Advantage Medical Network for HealthCare


0187

Countrywide Financial Corporation c/o Bank of America, One Bank of America Center, NC1-028-16-01, 150 N. College St Charlotte, NC 28255 Countrywide Financial Corporation ESIS MPN


1211

County Of Fresno 2220 Tulare Street 16th Floor Fresno, CA 93721 County Of Fresno MPN 1211

Self-Insured Employer 05/31/2006 http://www.countyoffresnompn.com

0822

County of Kern 1115 Truxtun Avenue, 4th Floor Bakersfield, CA 93301 County of Kern Medical Provider Network

Self-Insured Employer 08/10/2005 www.co.kern.ca.us/rm/MPNList

0061

County of Los Angeles 333 Wilshire Blvd, Suite 820 Los Angeles, CA 90010 First Health CompAmerica Select HCO


0062

County of Los Angeles 333 Wilshire Blvd, Suite 820 Los Angeles, CA 90010 Interplan Health Group


0060

County Of Los Angeles 3333 Wilshire Blvd., Ste. 1000 Los Angeles, CA 90010 County Of Los Angeles/CorVel MPN


0790

County of Madera 333 West Olive Ave. Madera, CA 93637


1908

County Of Monterey 168 W Alisal Street, 3rd Fl Salinas, CA 93901 COM MPN

Self-Insured Employer 03/21/2012 www.intermedccs.com/COMMPN





52


Applicant Date of


Approval Status *

0816

County of Monterey 230 Church St Bldg 3 Salinas, CA 93901 Liberty Mutual Group MPN


1273

County of Orange 12 Civic Center Plaza Room 324 Santa Ana, CA 92701 Cambridge Orange County MPN


0375

County of Orange 12 Civic Center Plaza, Suite 324 Santa Ana, CA 92701 Intracorp


1412

County of Orange 600 W. Santa Ana Blvd., Suite 104 Santa Ana, CA 92701 WellComp Medical Provider Network


2345

County Of Riverside 3403 10th Street, Ste. 500 Riverside, CA 92501

County Of Riverside Workers' Compensation Division MPN


1309

County of Riverside 3880 Lemon Street, Suite 100 Riverside, CA 92501 CorVel MPN/County of Riverside


0688

County of San Bernardino 222 West Hospitality Lane, 3rd Floor San Bernardino, CA 92408 CorVel MPN


0131

County of San Luis Obispo 1087 Santa Rosa Street San Luis Obispo, CA 93408 First Health CompAmerica Primary Network


0784

County of San Mateo 455 County Center Redwood City, CA 94063 San Mateo County MPN

Self-Insured Employer 07/13/2005 smcmpn.info

0126

County of Santa Cruz 701 Ocean Street Santa Cruz, CA 95060 First Health Primary Network


1138

County Of Stanislaus 1010 Tenth Street Suite 5900 Modesto, CA 95354 Stanislaus County MPN

Self-Insured Employer 05/11/2006 https://secure.simon-companies.com/stancty/

0198

County of Tulare 2900 West Burrell, County Civic Center Visalia, CA 93291



1300

County Of Tulare 3530 W. Mineral King, Ste. E Visalia, CA 93291 Corvel MPN






53


Applicant Date of


Approval Status *

0786

County of Tuolumne 2 South Green Street Sonora, CA 95270 Interplan/Kaiser MPN


3065

Coventry Health Care Workers Compensation, INC 750 Riverpoint Drive West Sacramento, CA 95605 CVTY Aramark Custom MPN

Entity that provides physician network services 10/10/2017 http://www.talispoint.com/cvty/arampn

3117

Coventry Health Care Workers Compensation, INC. 750 Riverpoint Drive West Sacramento, CA 95605 FirstGroup MPN

Entity that provides physician network services 08/16/2018 http://www.talispoint.com/cvty/fga

2430

Creative Risk Solutions, LLC P.O. Box 9207 Des Moines, IA 50306 Creative Risk Solutions/Coventry MPN


www.creativerisksolutions.com/network-provider-directory.aspx

2239

Crum & Forster Indemnity Company 1100 Town And Country Rd., Ste. 550 Orange, CA 92868 Broadspire Signature MPN Insurer 11/19/2013 T

2369

Crum & Forster Indemnity Company 305 Madison Avenue Morristown, NJ 07962 CorVel/C&F Select MPN Insurer 04/02/2015 www.corvel.com

1163

CSAC Excess Insurance Authority 75 Iron Point Circle, Ste 200 Folsom, CA 95630 EIA Medical Provider Network

Joint Powers Authority 03/27/2006 www.eiampn.csac-eia.org

3106

CSAC Excess Insurance Authority 75 Iron Point Circle, Ste. 200 Folsom, CA 95630 EIA Medical Provider Network

Entity that provides physician network services 07/25/2018 www.eiampn.csac-eia.org

0577

Cupertino Union School District 10301 Vista Drive Cupertino, CA 95014



0145

Cypress Insurance Company P.O. Box 881716 San Francisco, CA 94118

Berkshire Hathaway Homestate Companies MPN

Entity that provides physician network services 02/16/2005 https://www.bhhc.com

0876

Daimler Chrysler 4400 Chrysler Dr. Toledo, OH 43608 TRISTAR/First Health CompAmerica


http://www.creativerisksolutions.com/network-provider-directory.aspx

http://www.creativerisksolutions.com/network-provider-directory.aspx





54


Applicant Date of


Approval Status *

1052

Dameron Hospital Association 525 West Acacia Street Stockton, CA 95203 San Joaquin MPN

Self-Insured Employer 09/22/2005 www.netbyd.com/sanjoaquinmpn/dameronhospital

1059

Dansk Investment Group, Inc. 6591 Collins Drive, Ste E-11 Moorpark, CA 93021 WellComp Medical Provider Network

Self-Insured Employer 08/04/2005 www.wellcomp.com T

0354

De La Rue, Inc. 6401 Commerce Drive Irving, TX 75063



1227

Dean Foods Company of California, LLC 3600 North River Road Franklin Park, IL 60131 Liberty Mutual Group MPN


1254

Delos Insurance Company 120 West 45th Street 36th Floor New York, NY 10036

Delos Insurance Company/TMC Medical Provider Network Insurer 11/13/2006 T

1317

Delos Insurance 120 West 45th Street 36th Floor New York, NY 10036 Athens/Delos MPN Insurer 10/12/2007 T

0567

Desert Community College District 43-500 Monterey Avenue Palm Desert, CA 92260 Prime Advantage Medical Network


0573

Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 Prime Advantage Medical Network


0344

DHL Holdings (USA), Inc. 1571 Sawgrass Corporate Parkway, 2nd Flr Sunrise, FL 33323



1680

Discover Property & Casualty Insurance Company 1 Tower Square- MS 12 Hartford, CT 06183 Broadspire Signature Network Insurer 08/18/2010 T

0401

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Discover Re Cambridge MPN Insurer 02/24/2005 W

0497

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Extended MPN Insurer 03/10/2005 T





55


Applicant Date of


Approval Status *

0486

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS MPN Insurer 03/15/2005 T

0550

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032

First Health CompAmerica Primary HCO Network (or "First Health Primary") Insurer 03/22/2005 W

0552


SRS First Health CompAmerica Select HCO Network (or "First Health Select") Insurer 03/22/2005 W

0595

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Discover Re/DP&C/GAB-MedInsights Insurer 03/22/2005 T

0445


Frank Gates/DRE/First Health CompAmerica Select HCO Network Insurer 05/11/2005 W

0538


Discover Property & Casualty/Gallagher Bassett/First Health MPN Insurer 05/13/2005 T

0812


CorVel MPN/Discover Property & Casualty/Frank Gates Insurer 05/18/2005 W

0832

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Intracorp - Dre GatesMcDonald MPN Insurer 06/02/2005 T

0662


Discover Property & Casualty Insurance Company - Crawford Select Insurer 06/16/2005 W





56


Applicant Date of


Approval Status *

2115

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor MPN Insurer 02/01/2013 T

2116

Discover Property & Casualty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor 2 MPN Insurer 02/01/2013 T

0259

Discover Property & Casualty Insurance Company 500 Madison Street, Suite 2600 Chicago, IL 60661 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

0189

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Discover Re ESIS MPN Insurer 02/02/2005 T

0722

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0514

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032

Discover Property & Casualty/Gallagher Bassett/Coventry MPN Insurer 04/27/2005 T

0882

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 TRISTAR CompAmerica Primary HCO Insurer 05/03/2005 W

0969

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, IL 06032

Discover Property & Casualty Insurance Company - Crawford Primary Insurer 06/16/2005 W

1369

Discover Property & Casualty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 SCRMA-WellComp Medical Provider Network Insurer 05/27/2008 W





57


Applicant Date of


Approval Status *

0289

Discover Property & Casualty Insurance Company C/O Discover Re, 5 Batterson Park Road Farmington, CT 06032

CorVel MPN/Discover Property & Casualty/LWP Insurer 02/17/2005 www.corvel.com

0408

Discover Property & Casualty Insurance Company C/O Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN Insurer 02/28/2005 www.CorVel.com

1444

Discover Property & Casualty Insurance Company c/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 Discover Property & Casualty GBMCS MPN Insurer 05/07/2009 T

1385

Discover Property & Casualty Insurance Company c/o Traveler's National Accounts Unbundled, 5 Batterson Park Rd Farmington, CT 06032 Wellcomp Medical Provider Network Insurer 06/20/2008 T

0987

Discover Property & Casualty Insurance Company c/o Travelers National Accounts Unbundled One Tower Square, 12-MS Hartford, CT 06183 Liberty Mutual Group MPN Insurer 07/28/2005 T

1732

Discover Property & Casualty Insurance Company One Tower Square MS-12 Hartford, CT 06183 Sedgwick CMS/Harbor MPN - DPC POG Insurer 12/08/2010 www.sedgwickproviders.com/POG T

0691

DNC Parks & Resorts at Yosemite, Inc. Yosemite-Administration Center Yosemite, CA 95389 First Health CompAmerica Select MPN


1924

Dole Food Company, Inc. One Dole Dr. Westlake Village, CA 91362 Sedgwick CMS Extended MPN


0548

Dole Food Company, Inc. One Dole Drive Westlake Village, CA 91362



2151

Dole Packaged Foods, LLC One Dole Drive Westlake Village, CA 91362 Sedgwick CMS Extended MPN






58


Applicant Date of


Approval Status *

2264

Downey Regional Medical Center - Hospital, Inc. 11500 Brookshire Avenue Downey, CA 90241 Athens MPN


0132

Downey Regional Medical Center 1150 Brookshire Avenue Downey, CA 90241 First Health CompAmerica Primary Network


1293

Downey Regional Medical Center 11500 Brookshire Avenue Downey, CA 90241 WellComp Medical Provider Network


0961

Downey Unified School District 11627 Brookshire Avenue Downey, CA 90241 WellComp Medical Provider Network


1718

E. & J. Gallo Winery PO Box 1130 Modesto, CA 95353 Gallo-Status MPN

Self-Insured Employer 11/23/2010 https://secure.simon-companies.com/gs/

0738

E.I.I. Holding Co. 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


0164

East Guard Insurance 16 South River Street Wilkes Barre, PA 18703 GUARD Insurance MPN Insurer 01/24/2005 T

1076

Eastern Municipal Water District 2270 Trumble Road Perris, CA 92572

Eastern Municipal Water District/CorVel Select MPN


1563

Eastside Union School District 45006 North 30th St East Lancaster, CA 93535 PRIME Advantage Medical Provider Network Insurer 08/13/2009 T

2342

ECAMSECURE 436 W. Walnut Street Gardena, CA 90248 WellComp Medical Provider Network


0133

Economy Foods, dba Facciola Meat Company PO Box 14160 Fremont, CA 94539 First Health CompAmerica Primary Network


0766

Eden Medical Center and San Leandro Hospital (EMC & SLH) 20103 Lake Chabot Road Castro Valley, CA 94546 Medical Partners @ Work (MPW)






59


Applicant Date of


Approval Status *

1099

Eisenhower Medical Center 39000 Bob Hope Dr, Probst Bldg Suite 311 Rancho Mirage, CA 92270

PRIME Advantage Medical Network for HealthCare MPN


2282

EK Health Services Inc. 992 S. De Anza Blvd. #101 San Jose, CA 95129 EK Health Select MPN

Entity that provides physician network services 05/21/2014 www.ekhealthselect.ekhealth.com

0280

El Camino Community College District 16007 Crenshaw Blvd Torrance, CA 90506 Prime Advantage Medical Network


2201

El Camino Hospital 2500 Grant Road Mountain View, CA 94040 ACM/ El Camino Hospital MPN


1303

Electric Insurance Company 75 Sam Fonzo Dr. Beverly, MA 01915 Electric Insurance Insurer 09/19/2007 W

0441

Electric Insurance Company 75 Sam Fonzo Drive Beverly, MA 01915 Intracorp Insurer 04/04/2005 W

1437

Electric Insurance Company 75 Sam Fonzo Drive Beverly, MA 01915 Sedgwick CMS Extended MPN Insurer 11/10/2008 W

1438

Electric Insurance Company 75 Sam Fonzo Drive Beverly, MA 01915 Sedgwick CMS MPN Insurer 11/10/2008 T

2203

Electric Insurance Company 75 Sam Fonzo Drive Beverly, MA 01915 Sedgwick/Harbor MPN -EIC GE Insurer 07/12/2013 T

0431

Elite Golf Club Program, Inc. 1357 E. Lassen Avenue, Suite 100 Chico, CA 95927 CorVel HCO/CorVel HCO Select


2068

Elite Golf Club Program, Inc. 255 Great Valley Parkway, Ste 255 Malvern, PA 19355 Monument MPN


1480

Elite Golf Club Program, Inc. 255 Great Valley Pkwy Ste 200 Malvern, PA 19355 Monument MPN






60


Applicant Date of


Approval Status *

0474

Emanuel Medical Center 825 Delbon Avenue Turlock, CA 95832 First Health CompAmerica Primary HCO


1175

Emanuel Medical Center, Inc. 825 Delbon Ave. Turlock, CA 95382 EMC - MPN

Self-Insured Employer 06/02/2006 https://www.statusmedical.com T

0037

Employers Compensation Insurance Company 10375 Professional Circle Reno, NV 89521 Employers MPN


https://www.employers.com/workers/provider_locator.aspx

0091

Employers Insurance Company of Wausau 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

1127

Endurance Assurance Corporation 4 Manhattanville Rd Purchase, NY 10577 Rising MPN Insurer 02/27/2006 https://www.markelfirstcomp.com/injured-workers T

1490

Ensign Facility Services, Inc. 27101 Puerta Real #450 Mission Viejo, CA 92691


0839

Ensign Facility Services, Inc. 27101 Puerta Real Ste 450 Mission Viejo, CA 92691 Ensign Coventry Network


2050

Ensign Services, Inc. 27101 Puerta Real #450 Mission Viejo, CA 92691 WellComp Medical Provider Network

Self-Insured Employer 09/14/2012 www.wellcomp.com

1031

Episcopal Homes Foundation 3650 Mt. Diablo Blvd., #100 Lafayette, CA 94549 First Health's CompAmerica Primary Network


1465

Episcopal Senior Communities 2185 N. California Blvd., Suite 575 Walnut Creek, CA 94596 Sedgwick CMS Extended MPN


2433

ESIS, INC. 436 Walnut St Philadelphia, PA 19106 ESIS Medical Impact MPN

Entity that provides physician network services 03/24/2016 http://www.acegroup.com/esis-en/client-resources/

2054

Eskaton Properties, Incorporated 5105 Manzanita Ave. Carmichael, CA 95608 WellComp Medical Provider Network








61


Applicant Date of


Approval Status *

0389

Esparza Enterprises, Inc. 7201 Schirra Court, Suite A Bakersfield, CA 93313 Medex


0021

Everest National Insurance Company 477 Martinsville Rd PO Box 830 Liberty Corner, NJ 07968 Everest National Medical Provider Network Insurer 01/11/2005 www.everestnational.com/workcomp T

0888

Everest National Insurance Company 477 Martinsville Rd PO Box 830 Liberty Corner, NJ 07938 Everest National MPN-Coventry Broadbase Insurer 07/19/2005 W

1034

Everest National Insurance Company 477 Martinsville Rd PO Box 830 Liberty Corner, NJ 07968 Everest National MPN-Coventry Standard Insurer 07/26/2005 www.everestnational.com/workcomp T

1719

Everest National Insurance Company 477 Martinsville Rd Liberty Corner, NJ 07938 Everest Medical Provider Network Insurer 11/05/2010 www.everestnational.com/workcomp

1421

Everest National Insurance Company 477 Martinsville Road PO Box 830 Liberty Corner, NJ 07938 Everest National MPN-ACM Insurer 10/17/2008 www.everestnational.com/workcomp T

0315

Exact Property & Casualty 4680 Wilshire Blvd Los Angeles, CA 90010


1590

Exact Property And Casualty Company 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 02/11/2010 www.corvel.com

0322

Exact Property and Casualty 4680 Wilshire Blvd Los Angeles, CA 90010

First Health CompAmerica Primary HCO Network (First Health Primary Network) Insurer 03/09/2005 T

0272

Executive Risk Indemnity Inc. 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1475

Executive Risk Indemnity Inc. 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com

0273

Executive Risk Specialty Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 T

1474

Executive Risk Specialty Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 T





62


Applicant Date of


Approval Status *

0870

Explorer Insurance Company 11455 El Camino Real San Diego, CA 92130

PRIME Advantage Medical Network, accessing Prudent Buyer HCO Insurer 05/03/2005 T

0723

Farmer Bros. Co. 20333 S. Normandie Avenue Torrance, CA 90502 Sedgwick CMS Medical Provider Network


0319

Farmers Insurance Exchange 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0311

Farmers Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010

First Health CompAmerica Select HCO (First Health MPN Network) Insurer 03/09/2005 T

1593

Farmers Insurance Exchange 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 02/11/2010 www.corvel.com

0246

Farmington Casualty Company One Tower Square 4MS Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

3105

Farmington Casualty Company One Tower Square, Main South 12 Hartford, CT 06183 CorVel MPN Insurer 07/05/2018 www.corvel.com

0245

Farmington Casualty Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

2144

Farmland Mutual Insurance Company 1100 Locust St., Dept 3010 Des Moines, IA 50391

Farmland Mutual Insurance Company-GENEX MPN Insurer 04/08/2013 www.genexservices.com T

0010

FBO Marin General and Novato Community Hospital 166 Hillside Ave. Mill Valley, CA 94941 Mezzo Forte Medical Provider Network


1510

Federal Express Corporation 3620 Hacks Cross Road, Building B Memphis, TN 38125

GENEX-Federal Express Corporation Medical Provider Network

Self-Insured Employer 04/01/2009 www.genexservices.com

1792

Federal Insurance Company 15 Mountain View Rd Warren, NJ 07059 Dick's Sporting Goods MPN Insurer 03/02/2011 T





63


Applicant Date of


Approval Status *

1939

Federal Insurance Company 15 Mountain View Rd Warren, NJ 07059 Forever 21 Broadspire Signature MPN Insurer 04/20/2012 T

2186

Federal Insurance Company 15 Mountain View Rd Warren, NJ 07059 American Campus Communities GBMCS MPN Insurer 06/12/2013 T

2052

Federal Insurance Company 15 Mountain View Rd. Warren, NJ 07059 American Cancer Society GBMCS MPN Insurer 09/13/2012 T

2103

Federal Insurance Company 15 Mountain View Rd. Warren, NJ 07059 Edward Thomas Companies GBMCS MPN Insurer 01/10/2013 T

0267

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1476

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com

1851

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Columbia Sussex MPN Insurer 07/28/2011 T

1871

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Guckenheimer GBMCS MPN Insurer 08/04/2011 T

1872

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Hot Topic GBMCS MPN Insurer 08/04/2011 T

1873

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Starr Aviation GBMCS MPN Insurer 08/04/2011 T

1874

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 American Assets GBMCS MPN Insurer 08/04/2011 T

1990

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Berry Plastics GBMCS MPN Insurer 09/22/2011 T

1991

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 American Golf GBMCS MPN Insurer 09/22/2011 T





64


Applicant Date of


Approval Status *

1994

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 OLS Hotels & Resorts LP GBMCS MPN Insurer 10/27/2011 T

1902

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Taylor Corporation GBMCS MPN Insurer 02/14/2012 T

1903

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Invacare Medical Provider Network Insurer 03/02/2012 T

2014

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 KSL DC Management LLC GBMCS MPN Insurer 06/07/2012 T

2037

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059

Nevins Lewbel Property Management, Inc. GBMCS MPN Insurer 09/27/2012 T

2043

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Pacifica Hotels GBMCS MPN Insurer 09/27/2012 T

2044

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 BCBG Max Azria Group, Inc. GBMCS MPN Insurer 09/27/2012 T

2084

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Medallion Hotels GBMCS MPN Insurer 01/10/2013 T

2111

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Crestline Hotels & Resorts, Inc. GBMCS MPN Insurer 02/11/2013 T

2112

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Moana Corporation GBMCS MPN Insurer 02/11/2013 T

2091


Goldrich & Kest Industries, LLC GBMCS MPN Insurer 03/13/2013 T

2137

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 The Container Store GBMCS MPN Insurer 03/27/2013 T

2174


CordeValle, LP dba CordeValle Golf Club GBMCS MPN Insurer 05/28/2013 T





65


Applicant Date of


Approval Status *

2175

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 TRG Hospitality, LLC GBMCS MPN Insurer 05/28/2013 T

2184

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Hersha Group, LLC GBMCS MPN Insurer 06/12/2013 T

2185

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Richman Property Services, Inc. GBMCS MPN Insurer 06/12/2013 T

2202

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Starr Aviation GBMCS KOJ MPN Insurer 07/29/2013 T

2233

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 The Olympic Club GBMCS MPN Insurer 11/12/2013 T

2243

Federal Insurance Company 15 Mountain View Road Warren, NJ 07059 Northwood Hospitality GBMCS MPN Insurer 12/06/2013 T

2254


Apartment Management Consultants, LLC GBMCS MPN Insurer 12/20/2013 T

2268


SoHo House West Hollywood, LLC GBMCS MPN Insurer 01/10/2014 www.coventrywcs.com/client-tools/index.htm T

0055

Federated Dept. Stores, Inc. 7 West Seventh Street Cincinnati, OH 45202 CorVel MPN/Federated Department Stores


1881

FedEx Freight Inc. 2200 Forward Drive Harrison, AR 72601 Sedgwick CMS Extended MPN


0803

Fedex Freight West, Inc. 6411 Guadalupe Mines Rd #3180 San Jose, CA 95120 Cambridge Fedex West MPN


0149

Fidelity & Deposit Company of Maryland 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0670


Fidelity and Deposit of Maryland Crawford Select Insurer 07/01/2005 W





66


Applicant Date of


Approval Status *

1000


Fidelity and Deposit of Maryland - Crawford Primary Insurer 07/01/2005 W

0842



0916

Fidelity & Guaranty Insurance Company (Discover Re Managers, Inc.) 5 Batterson Park Road Farmington, CT 06032

Fidelity & Guaranty Insurance Company/The GAP, Inc. Insurer 05/12/2005 T

0398

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Discover Re Cambridge MPN Insurer 02/24/2005 T

0499

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Extended MPN Insurer 03/10/2005 T

0488

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS MPN Insurer 03/15/2005 T

0720

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0555

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032


0592

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Discover Re/FGIC/GAB-Medinsights Insurer 03/22/2005 T

0443



0811

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 CorVel/Fidelity & Guaranty/Frank Gates Insurer 05/18/2005 W

0830

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Intracorp - Dre GatesMcDonald MPN Insurer 06/02/2005 T





67


Applicant Date of


Approval Status *

0664


Fidelity and Guaranty Insurance Company - Crawford Select Insurer 06/16/2005 W

0828

Fidelity & Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 AIGDC/Discover Re Insurer 07/26/2005 W

0188

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Discover Re ESIS MPN Insurer 02/02/2005 T

0516

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032

Fidelity and Guaranty Insurance Company/Gallagher Bassett/Coventry MPN Insurer 04/27/2005 T

0883

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 TRISTAR CompAmerica Primary HCO Insurer 05/03/2005 W

0970

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, IL 06032

Fidelity and Guaranty Insurance Company - Crawford Primary Insurer 06/16/2005 W

1081

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 First Health Network - DRe Matrix MPN Insurer 12/07/2005 W

1169

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 DRe Sedgwick Intracorp OD MPN Insurer 05/04/2006 T

1370

Fidelity & Guaranty Insurance Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 SCRMA-WellComp Medical Provider Network Insurer 05/27/2008 T

1387

Fidelity & Guaranty Insurance Company c/o Traveler's National Accounts Unbundled 5 Batterson Park Rd. Farmington, CT 06032 WellComp Medical Provider Network Insurer 06/20/2008 T

0399

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032 Discover Re Cambridge MPN Insurer 02/24/2005 W

0498

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Extended MPN Insurer 03/10/2005 T





68


Applicant Date of


Approval Status *

0487

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS MPN Insurer 03/15/2005 T

0547

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032


0551


First Health CompAmerica Select HCO Network (or "First Health Select") Insurer 03/22/2005 W

0593

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032 Discover Re/FGIU/GAB-MedInsights Insurer 03/22/2005 T

0444



0539


Fidelity and Guaranty Insurance Underwriters, Inc./Gallagher Bassett/First Health MPN Insurer 05/13/2005 T

0810


CorVel MPN/Fidelity and Guaranty/Frank Gates Insurer 05/18/2005 W

0831

Fidelity & Guaranty Insurance Underwriters, Inc 5 Batterson Park Road Farmington, CT 06032 Intracorp - Dre GatesMcDonald MPN Insurer 06/02/2005 T

0663


Fidelity and Guaranty Insurance Underwriters, Inc. - Crawford Select Insurer 06/16/2005 W





69


Applicant Date of


Approval Status *

0721

Fidelity & Guaranty Insurance Underwriters, Inc c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0971

Fidelity & Guaranty Insurance Underwriters, Inc c/o Discover Re 5 Batterson Park Road Farmington, IL 06032

Fidelity and Guaranty Insurance Underwriters, Inc. - Crawford Primary Insurer 06/16/2005 W

1368

Fidelity & Guaranty Insurance Underwriters, Inc. c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 SCRMA-WellComp Medical Provider Network Insurer 05/27/2008 W

1388

Fidelity & Guaranty Insurance Underwriters, Inc. c/o Travelers National Accounts Unbundled, 5 Batterson Park Road Farmington, CT 06032 Wellcomp Medical Provider Network Insurer 06/20/2008 T

0213

Fidelity And Deposit Company Of Maryland 1299 Zurich Way 3W Schaumburg, IL 60196


1144

Fidelity And Deposit Company Of Maryland 1299 Zurich Way 3W Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 www.zurichna.com

1352

Fidelity And Deposit Company Of Maryland 1299 Zurich Way Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

1597

Fidelity and Guarantee Insurance Company c/o Discover Re 5 Batterson Park Farmington, CT 06032 Medex/CCMSI Insurer 01/25/2010 www.medexhco.com T

1676

Fidelity And Guaranty Insurance Company 1 Tower Square - MS 12 Hartford, CT 06183 Broadspire Signature Network/FGIC Insurer 08/18/2010 T

0556

Fidelity and Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032


2117

Fidelity and Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor MPN Insurer 02/01/2013 T





70


Applicant Date of


Approval Status *

2118

Fidelity and Guaranty Insurance Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor 2 MPN Insurer 02/01/2013 T

0288

Fidelity And Guaranty Insurance Company C/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN Insurer 02/17/2005 www.corvel.com

0407

Fidelity And Guaranty Insurance Company C/O Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN Insurer 02/28/2005 www.CorVel.com

1441

Fidelity and Guaranty Insurance Company c/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 F & G Insurance Company GBMCS MPN Insurer 05/07/2009 T

0989

Fidelity and Guaranty Insurance Company c/o Travelers National Accounts Unbundled One Tower Square, 12-MS Hartford, CT 06183 Liberty Mutual Group MPN Insurer 07/28/2005 T

0535

Fidelity and Guaranty Insurance Company One Tower Square MS-12 Hartford, CT 06183

Fidelity and Guaranty/Gallagher Bassett/First Health MPN Insurer 05/13/2005 T

0260

Fidelity and Guaranty Insurance Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

2245

Fidelity And Guaranty Insurance Company One Towers Square Hartford, CT 06183 Coventry Medical Provider Network Insurer 04/18/2014 www.talispoint.com/cvty/matrix

1443

Fidelity and Guaranty Insurance Underwriters Inc c/o Discover Re, 5 Batterson Park Road Farmington, CT 06032

F & G Insurance Underwriters, Inc. GBMCS MPN Insurer 05/07/2009 T

0261

Fidelity and Guaranty Insurance Underwriters, Inc One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

1677

Fidelity And Guaranty Insurance Underwriters, Inc. 1 Tower Square- MS 12 Hartford, CT 06183 Broadspire Signature Network/FGIU Insurer 08/18/2010 T





71


Applicant Date of


Approval Status *

2119

Fidelity and Guaranty Insurance Underwriters, Inc. 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor MPN Insurer 02/01/2013 T

2120

Fidelity and Guaranty Insurance Underwriters, Inc. 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor 2 MPN Insurer 02/01/2013 T

0191

Fidelity and Guaranty Insurance Underwriters, Inc. c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Discover Re ESIS MPN Insurer 02/02/2005 T

0290

Fidelity And Guaranty Insurance Underwriters, Inc. C/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN Insurer 02/17/2005 www.corvel.com

0410

Fidelity And Guaranty Insurance Underwriters, Inc. C/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN/Fidelity & Guaranty/LWP Insurer 02/28/2005 www.corvel.com

0990

Fidelity and Guaranty Insurance Underwriters, Inc. c/o Travelers National Accounts Unbundled, One Tower Square, 12-MS Hartford, CT 06183 Liberty Mutual Group MPN Insurer 07/28/2005 T

0512

Fidelity and Guaranty Insurance Underwriters, Inc. One Tower Square MS-12 Hartford, CT 06183

Fidelity and Guaranty Insurance Underwriters, Inc./Gallagher Bassett/Coventry MPN Insurer 04/27/2005 T

2461

Finish Line Self Insurance Group, Inc. 4961 Katella Ave Los Alamitos, CA 90720 Finish Line MPN

Self-Insured Employer 03/25/2016 Flsig.EmployerMPN.com

1225

Finish Line Self-Insurance Group, Inc. 4961 Katella Ave. Los Alamitos, CA 90720 Finish Line MPN

Group of Self-Insured Employers 01/13/2012 www.tristarrisk.com T

0317

Fire Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010






72


Applicant Date of


Approval Status *

0324

Fire Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010

FirstHealth CompAmerica Primary HCO Network (First Health Primary Network) Insurer 03/09/2005 T

1596

Fire Insurance Exchange 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 02/11/2010 www.corvel.com

0042

Fireman's Fund Insurance Company 777 San Marin Dr. Novato, CA 94998 First Health Select Insurer 02/01/2005 www.agcs.allianz.com/usclaims T

0326

Fireman's Fund Insurance Company 777 San Marin Drive, Ste A12 Novato, CA 94945 First Health CompAmerica Primary Network Insurer 04/21/2005 T

0521

First National Insurance Company of America 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 02/14/2005 http://www.libertymutualgroup.com/providernetworks T

1288

FirstComp Underwriters Group Inc., dba FirstComp Insurance Agency 222 S 15th Street Suite 1200 Omaha, NE 68102 FirstComp/CorVel MPN Insurer 04/19/2007 R

0035

Fleetwood Enterprises, Inc. (Fleetwood) 3125 Myers Street Riverside, CA 92513 First Health CompAmerica Select HCO


2059

Florists' Mutual Insurance Company 1 Horticultural Edwardsville, IL 62025 Hortica California Signature MPN Insurer 10/11/2012 T

1504

Florists' Mutual Insurance Company One Horticultural Lane, Box 428 Edwardsville, IL 62025 Hortica California MPN Insurer 02/24/2009 T

1505

Florists' Mutual Insurance Company One Horticultural Lane, Box 428 Edwardsville, IL 62025 Hortica California Select MPN Insurer 02/24/2009 T

2499

Florists' Mutual Insurance Company PO Box 8032 Stevens Point, WI 54481 Hortica MPN Insurer 09/09/2016 www.hortica.com

1906

Flyers Energy, LLC 2360 Lindbergh Street Auburn, CA 95602 MedInsights Medical Provider Network






73


Applicant Date of


Approval Status *

2105

Flyers Energy, LLC 2360 Lindbergh Street Auburn, CA 95602 Flyers Energy, LLC GBMCS MPN


1010

Flyers Transportation LLC 2360 Lindbergh Street Auburn, CA 95602 MedInsights Medical Provider Network


2106

Flyers Transportation, LLC 2360 Lindbergh St. Auburn, CA 95602 Flyers Transportation, LLC GBMCS MPN


0958

Fontana Unified School District 9680 Citrus Avenue Fontana, CA 92335


1422

Fontana Unified School District 9680 Citrus Avenue Fontana, CA 92335 WellComp Medical Provider Network


1228

Food Products of California Workers' Compensation Program Inc. 11601 Wilshire Blvd., Suite 500 Los Angeles, CA 90025

Group of Self-Insured Employers 08/18/2006 W

1614

Food Products of California Workers' Compensation Program, Inc. 11601 Wilshire Blvd, Ste 50, Brentwood Center Los Angeles, CA 90025 Medex

Group of Self-Insured Employers 04/08/2010 www.medexhco.com

2102

Ford Motor Company 16800 Executive Plaza Dearborn, MI 48121 Corvel MPN


2509

Foremost Insurance Company Grand Rapids, Michigan 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 10/27/2016 www.talispoint.com/farmers/com

2512

Foremost Property And Casualty Insurance Company 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 10/27/2016 www.talispoint.com/farmers/com

2511

Foremost Signature Insurance Company 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 10/27/2016 www.talispoint.com/farmers/com





74


Applicant Date of


Approval Status *

0380

Foster Dairy Farms 1707 McHenry Ave. Modesto, CA 95350 Medex Healthcare Inc. MPN


1339

Foster Farms 1000 Davis Street Livingston, CA 95334 CorVel Custom MPN


0378

Foster Farms, LLC 1000 Davis Street Livingston, CA 95334 Medex Healthcare Inc. MPN


1502

Foster Farms, LLC 1000 Davis Street Livingston, CA 95334 Foster Farms Custom CorVel MPN


0379

Foster Poultry Farms 1000 Davis Street Livingston, CA 95334 Medex Healthcare Inc. MPN


1503

Foster Poultry Farms 1000 Davis Street Livingston, CA 95334 Foster Farms Custom CorVel MPN


2455

Foster Poultry Farms 1000 Davis Street Livingston, CA 95334 Foster Farms MPN

Self-Insured Employer 03/18/2016 www.fosterfarmsmpn.com

0230

Fountain Valley School District 17210 Oak Street Fountain Valley, CA 92708 Prime Advantage Medical Network


1102

Frank C. Alegre Trucking, Inc. PO Box 1508 Lodi, CA 95241 CorVel HCO/CorVel HCO Select


0043

Freedom Communications, Inc. 17666 Fitch Irvine, CA 92617 Sedgwick CMS Medical Provider Network


1773

Freedom Communications, Inc. 625 N. Grand Ave. Santa Ana, CA 92710 Broadspire Signature Network


2309

Freedom Properties-Hemet, LLC 2200 West Acacia Hemet, CA 92545 Medex MPN






75


Applicant Date of


Approval Status *

1073

Fresno County Self-Insurance Group c/o Tuker-Alexander Ins Assoc. 2133 High St Suite E Selma, CA 93662 TRISTAR MPN


0059

Frito-Lay, Inc. 7701 Legacy Drive Plano, TX 75024 Sedgwick CMS Medical Provider Network


1554

Front Porch Communities and Services 800 North Brand Blvd, 19th Fl Glendale, CA 91203 First Health Comp America HCO Select

Self-Insured Employer 07/21/2009 www.talispoint.com/cvty/mpnsel T

0139

Front Porch 303 No. Glen Oaks, Suite 1000 Burbank, CA 91502 Front Porch Network


1103

Fullerton Joint Union High School District 1051 W. Bastanchury Rd Fullerton, CA 92883

Fullerton Joint Union High School District - Comp Care MPN


1964

Fullerton School District 1401 W. Valencia Dr. Fullerton, CA 92833 WellComp Medical Provider Network


0283

Futures Academy 3701 Stephens Drive North Highlands, CA 95660



2470

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 Gallagher Bassett Platinum-H MPN

Entity that provides physician network services 04/13/2016 www.talispoint.com/cvty/gbmpn

2396

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows , IL 60008 Gallagher Bassett First Health MPN

Entity that provides physician network services 09/04/2015 www.talispoint.com/cvty/gbfhmpnselect

2346

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 Gallagher Bassett Platinum MPN


2349

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 Gallagher Bassett Chubb Real Estate Unit MPN






76


Applicant Date of


Approval Status *

2350

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008

Gallagher Bassett Chubb Risk Management Group MPN


2395

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 Gallagher Bassett Coventry MPN

Entity that provides physician network services 09/09/2015 www.talispoint.com/cvty/gbcvtympn

2471

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 Gallagher Bassett Platinum-M MPN


3075

Gallagher Bassett Services, Inc. 2850 Golf Road Rolling Meadows, IL 60008 GB Care MPN


2445

Gallagher Bassett Services, Inc. Two Pierce Place, 4th Floor Itasca, IL 60143 ORCPG MPN

Entity that provides physician network services 01/21/2016 www.talispoint.com/cvty/gbmpn T

1397

General Casualty Company of Wisconsin One General Drive Sun Prairie, WI 53596 Genex MPN Insurer 11/19/2008 T

2168

General Casualty Company of Wisconsin One General Drive Sun Prairie, WI 53596 Sedgwick/Harbor MPN Insurer 05/10/2013 T

2169

General Casualty Company of Wisconsin One General Drive Sun Prairie, WI 53596 Sedgwick/Harbor 2 MPN Insurer 05/10/2013 T

0611

General Motors LLC 300 Renaissance Center - Mail Code 482-C26-A68 Detroit, MI 48256



2401

GENEX Services LLC 440 E Swedesford Road Wayne, PA 19087 GENEX

Entity that provides physician network services 09/03/2015 www.genexservices.com





77


Applicant Date of


Approval Status *

2472

Genex Services, LLC 440 E Swedesford Road Wayne, PA 19087 Genex

Entity that provides physician network services 04/13/2016 http://www.genexservices.com

2500


Entity that provides physician network services 08/10/2016 www.genexservices.com

3084



3021

Genex Services, LLC 440 E. Swedesford Road Wayne, PA 19087 Genex/United Airlines

Entity that provides physician network services 05/01/2017 genexservices.com

3074

Genex Services, LLC 440 E. Swedesford Road Wayne, PA 19087 Genex


0295

Georgia Pacific 133 Peachtree Street NE, 8th Floor Atlanta, GA 30303

First Health CompAmerica HCO Select Network


2082

Giorgio Beverly Hills, Inc. 6300 Center Hill Rd. Cincinnati, OH 45224 Sedgwick/Harbor 2 MPN


2200

Giorgio Beverly Hills, Inc. 6300 Center Hill Rd. Cincinnati, OH 45224 Sedgwick/ Harbor MPN- PG


1283

Global Experience Specialists, Inc. 7000 Lindell Road Las Vegas, NV 87118 CorVel MPN


0095

Golden Eagle Insurance Corporation 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

2046

Golden Empire Transit District 1830 Golden State Avenue Bakersfield, CA 93301

Risico TMC Golden Empire Transit District MPN






78


Applicant Date of


Approval Status *

2332

Golden Gate Bridge Highway and Transportation District 1011 Anderson Drive San Rafael, CA 94901 ATHENS MPN


1290

Golden Gate Bridge Highway and Transportation District 1101 Andersen Dr. San Rafael, CA 93108 WellComp Medical Provider Network


0178

Golden Oaks Upholstery Inc. 16000 Heron Ave La Mirada, CA 90638 First Health CompAmerica Select


0641

Golden State Risk Management Authority P.O. Box 706 Willows, CA 95988 GSRMA MPN


2294

Golden State Water Company 630 E. Foothill Blvd. San Dimas, CA 91773 Sedgwick/Harbor 2 MPN

Self-Insured Employer 06/17/2014 www.harborsys.com/sedgwick2 T

1458

Golden State Water Company 630 E Foothill Blvd San Dimas, CA 91773 WellComp Medical Provider Network


1161

Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles, CA 90017 Good Samaritan Hospital-Comp Care MPN


0352

Goodrich Corporation Which Will Do Business In California As New York Goodrich Corporation Four Coliseum Center, 2730 West Tyvola Rd Charlotte, NC 28217 Goodrich/Chartis Medical Provider Network

Self-Insured Employer 03/18/2005 www.talispoint.com/aig/goodrich √

1265

Goodwill Industries Of San Diego County 3663 Rosecrans Street San Diego, CA 92110

Goodwill Industries Of San Diego County MPN


2318

Goodwill Industries of San Francisco, San Mateo, and Marin Counties, Inc. 1500 Mission Street San Francisco, CA 94103 ATHENS MPN


0717

Goodwill Industries of Southern California 342 N. San Fernando Road Los Angeles, CA 90031 Medex






79


Applicant Date of


Approval Status *

1223

Gordon Trucking Inc. 151 Stewart Rd. SW Pacific, WA 98047 Cambridge Gordon Trucking MPN


1867

Gordon Trucking, Inc. 151 Steward Rd SW Pacific, WA 98047 Sedgwick CMS Medical Provider Network


0911

Granite State Insurance Company 175 Water St, 18th Floor New York, NY 10038


0117

Granite State Insurance Company 175 Water Street - 18th Floor New York, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

0762

Granite State Insurance Company 175 Water Street - 18th Floor New York, NY 10038

Granite State Insurance Company/Gallagher Bassett/CorVel MPN Insurer 05/05/2005 www.corvel.com

1405

Granite State Insurance Company 175 Water Street - 18th Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com

1659

Granite State Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/30/2010 www.broadspireppo.com T

0529

Granite State Insurance Company 175 Water Street New York, NY 10038 Chartis - Cambridge MPN Insurer 03/24/2005 W

0653

Granite State Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Granite State/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

0623

Granite State Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T

1023

Granite State Insurance Company 175 Water Street, 18th Floor New York, NY 10038

Granite State/Gallagher Bassett/First Health MPN Insurer 08/05/2005 T

1452

Granite State Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Granite State GBMCS MPN Insurer 05/07/2009 T

1760

Granite State Insurance Company 175 Water Street, 8th Floor NY, NY 10038 AIG Select MPN Insurer 01/19/2011 www.talispoint.com/aig/mpnselect





80


Applicant Date of


Approval Status *

0462

Granite State Insurance Company 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

1376

Granite State Insurance Company 70 Pine Street New York, NY 10270 Athens/Granite State Ins. Co. MPN Insurer 04/15/2008 T

0858

Granite State Insurance Company AIG 70 Pine Street New York, NY 10270

Granite State Insurance Company, Crawford Select Insurer 07/01/2005 W

0867

Granite State Insurance Company AIG 70 Pine Street New York, NY 10270

Granite State Insurance Company, Crawford Primary Insurer 07/01/2005 W

0194

Grant Community Outreach Academy 3180 Del Paso Blvd Sacramento, CA 95815



0195

Grant Joint Union High School District 1333 Grand Avenue Sacramento, CA 95838



2335

Great American Alliance Insurance Company 301 E. Fourth Street Cincinnati, OH 45202 WellComp Medical Provider Network Insurer 08/26/2014 T

2475

Great American Alliance Insurance Company 301 East 4th Street 16NE Cincinnati, OH 45202 Strategic Comp MPN Insurer 04/07/2016 www.strategiccompmpn.com

2190

Great American Alliance Insurance Company 310 E. Fourth Street, 24th Floor Cincinnati, OH 45202 Athens MPN Insurer 06/21/2013 T

2338

Great American Assurance Company 301 E. Fourth Street Cincinnati, OH 45202 WellComp Medical Provider Network Insurer 08/28/2014 www.WellComp.com T

2188

Great American Assurance Company 310 E Fourth Street, 24th Floor Cincinnati, OH 45202 Athens MPN Insurer 06/21/2013 T

0727

Great American Custom Insurance Services, Inc. 725 So. Figueroa St. Ste 3400 Los Angeles, CA 90017

First Health Comp America Select HCO Network (First Health Select) Insurer 04/26/2005 W





81


Applicant Date of


Approval Status *

2374

Great American Insurance Company of New York 301 E. Fourth Street Cincinnati, OH 45202 WellComp Medical Provider Network Insurer 02/24/2015 www.wellcomp.com T

2187

Great American Insurance Company of New York 310 E. Fourth Street, 24th Floor Cincinnati, OH 45202 Athens MPN Insurer 06/21/2013 T

2337

Great American Insurance Company 301 E. Fourth Street Cincinnati, OH 45202 WellComp Medical Provider Network Insurer 08/28/2014 www.WellComp.com T

2289

Great American Insurance Company 301 East Fourth St, Suite 2400 Cincinnati, OH 45202 Great American Alternative Markets MPN Insurer 06/17/2014 https://intelleserver.com/gaic/

2189

Great American Insurance Company 310 E Fourth St, 24th Floor Cincinnati, OH 45202 Athens MPN Insurer 06/20/2013 T

1286

Great American Insurance Company 4 East 4th Street Cincinnati, OH 45202


1907

Great Divide Insurance Company 600 East Las Colinas Blvd Suite 1400 Irving, TX 75039 Berkley Specialty MPN Insurer 02/14/2012 www.talispoint.com/cvty/berkley

1230

Great Divide Insurance Company 7233 Butherus Drive Scottsdale, AZ 85260 San Francisco 49er MPN Insurer 09/01/2006 T

0269

Great Northern Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1477

Great Northern Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com

1493

Great West Casualty Company 1100 West 29th Street South Sioux City, NE 68776 CorVel MPN Insurer 01/08/2009 T

1678

Greenwich Insurance Company 100 Caitlin Constitution Plaza Hartford, CT 06103 Broadspire Signature Network MPN Insurer 08/18/2010 T





82


Applicant Date of


Approval Status *

1669

Greenwich Insurance Company 200 Liberty Street, 21st Floor New York, NY 10281 Greenwich Insurance Company/ACS/GENEX Insurer 09/29/2010 www.genexservices.com T

0908

Greenwich Insurance Company 520 Eagleview Blvd Exton, PA 19341


0973

Greenwich Insurance Company One World Financial Center 200 Liberty St New York, NY 10281

Greenwich Insurance Company/Gallagher Bassett/Coventry MPN Insurer 12/07/2006 T

1551

Greenwich Insurance Company One World Financial Center 200 Liberty St New York, NY 10281 Avizent/Greenwich Insurance Co. MPN Insurer 09/17/2009 T

0956

Greenwich Insurance Company One World Financial Center, 200 Liberty Street New York, NY 10281 CorVel MPN Insurer 08/02/2005 www.corvel.com

1448

Greenwich Insurance Company One World Financial Center,200 Liberty Street 21st Floor New York, NY 10281 Greenwich Insurance Company GBMCS MPN Insurer 05/07/2009 T

1173

Greenwich Insurance Company One World Financial Center-200 Liberty St. New York, NY 10281


1174

Greenwich Insurance Company One World Financial Center-200 Liberty St. New York, NY 10281 Sedgwick CMS Medical Provider Network Insurer 03/24/2006 T

0986

Greenwich Insurance Company One World Financial Center-200 Liberty St. 21st Flr New York, NY 10281

Greenwich Insurance Company/Gallagher Bassett/First Health MPN Insurer 01/27/2012 T

0945

Greenwich Insurance Company XL Insurance Inc-One World Financial Center, 200 Liberty Street New York, NY 10281

First Health CompAmerica Primary HCO Network (or "First Health Primary") Insurer 06/16/2005 W

0946

Greenwich Insurance Company XL Insurance Inc-One World Financial Center, 200 Liberty Street New York, NY 10281

First Health CompAmerica Select HCO Network (or "First Health Select") Insurer 06/16/2005 W





83


Applicant Date of


Approval Status *

0954

Greenwich Insurance Company XL Insurance Inc-One World Financial Center, 200 Liberty Street New York, NY 10281 Broadspire MPN Insurer 07/12/2005 T

0715

Grimmway Enterprises, Inc. 14141 Di Giorgio Road Arvin, CA 93203 Medex


0710

Grossmont Cuyamaca Community College District 8800 Grossmont College Dr El Cajon, CA 92020



1482

Guardian Comp, Inc. 255 Great Valley Pkwy Ste 200 Malvern, PA 19355 Monument MPN


0428

Guardian Comp, Inc. 700 W. Center Street Visalia, CA 93291 CorVel HCO/CorVel HCO Select


0146

Guardian Industries Corp 2300 Harmon Road Auburn Hills, MI 48326 Guardian Industries ESIS MPN


2067

GuardianComp, Inc. 255 Great Valley Parkway, Ste 255 Malvern, PA 19355 Monument MPN


0287

GuideOne Mutual Insurance Company 1111 Ashworth Road West Des Moines, IA 50265 CorVel MPN/GuideOne Insurer 02/17/2005 www.corvel.com

1111

Hacienda La Puente Unified School District 15959 E. Gale Avenue City of Industry, CA 91716 WellComp Medical Provider Network


3109

Hacienda La Puente Unified School District 15959 E. Gale Avenue City Of Industry, CA 91716 HLPUSD MPN

Self-Insured Employer 09/07/2018 www.talispoint.com/intermed/haciendampn.com

0558

Harbor Specialty Insurance Company 1177 6th Avenue of the Americas, 45th Floor New York City, NY 10036 Harbor Specialty MPN Insurer 03/22/2005 W

0232

Harbor Specialty Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 Clarendon Medical Provider Network 1 Insurer 02/09/2005 W





84


Applicant Date of


Approval Status *

0083

Harbor Specialty Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel MPN Insurer 02/17/2005 T

0701

Harco National Insurance Company 2850 West Golf Road Rolling Meadows, IL 60008 Harco National Insurance Company Insurer 04/18/2005 www.networkhco.com

0432

Harco National Insurance Company P.O. Box 68309 Schaumburg, IL 60168 Broadspire-Concentra Standard MPN Insurer 07/11/2005 T

0787

Harker School 1471 Saratoga Ave., Suite 100 San Jose, CA 95129 Inter Plan/Kaiser MPN


0583

Harrah's Rincon Hotel and Casino, HCAL Corporation aka Harrah's Rincon 33750 Valley Center Road Valley Center, CA 92082 Intracorp


2104

Harris Farms, Inc. RR 1, Box 400 Coalinga, CA 93210 Tristar MPN

Self-Insured Employer 01/14/2013 www.tristarrisk.com T

0075

Hartford Accident and Indemnity Company 690 Asylum Avenue Hartford, CT 06115


1130

Hartford Accident and Indemnity Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Accident and Indemnity Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

1517

Hartford Accident and Indemnity Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Accident and Indemnity/Gallagher Bassett/First Health MPN Insurer 04/23/2009 T

1970

Hartford Accident and Indemnity Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 05/24/2012 T

1987

Hartford Accident and Indemnity Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

0076

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155






85


Applicant Date of


Approval Status *

1602

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sedgwick CMS Medical Provider Network Insurer 02/25/2010 T

1603



1632

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 HA&IC/ESIS MPN Insurer 05/26/2010 T

1711

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Hartford/Regis/Bunch MPN Insurer 12/03/2010 T

1847


Hartford Accident and Indemnity Company GBMCS MPN Insurer 07/28/2011 T

1900

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Medex wcSolutions MPN Insurer 01/19/2012 T

1932

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 CCMSI/HA&I/First Health Select HCO Insurer 04/19/2012 T

1941


Hartford/A&I/CCMSI/RISING MEDICAL/SOI MPN Insurer 04/26/2012 www.viiad.com/anthemcompass/kbccmsih000 T

2017

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Medex/CCMSI/HA&I/SJK MPN Insurer 06/15/2012 T

2045

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 CorVel/HA&I/Caliber MPN Insurer 08/30/2012 T

2208

Hartford Accident and Indemnity Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sedgwick/ Harbor MPN- HAIC Hendrick Insurer 08/27/2013 T

2138

Hartford Accident And Indemnity Company One Hartford Plaza HO-1-09 Hartford, CT 06155 CorVel/HA&I/Kirkland's MPN Insurer 04/02/2013 www.corvel.com

3017

Hartford Accident And Indemnity Company One Hartford Plaza HO-1-09 Hartford, CT 06155 CorVel/HA&I/ChicosFAS MPN Insurer 04/12/2017 www.corvel.com





86


Applicant Date of


Approval Status *

1159

Hartford Accident and Indemnity Company One Hartford Plaza Hartford, CT 06155

Hartford Accident & Indemnity/Gallaher Bassett/Coventry MPN Insurer 03/20/2006 T

1648

Hartford Accident and Indemnity Company One Hartford Plaza Hartford, CT 06155 Athens MPN - HA&I Insurer 06/10/2010 www.medexhco.com T

1637

Hartford Accident And Indemnity Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 RISICO TMC HARTFORD A&I MPN Insurer 06/01/2010 www.risico.com

2210

Hartford Accident And Indemnity Company One Hartford Plaza, HO-I-09 Hartford, CT 06155 CorVel/HA&I/BB&T MPN Insurer 08/01/2013 www.corvel.com

1834

Hartford Accident And Indemnity Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 HA&I/Broadspire Signature MPN Insurer 05/13/2011 T

2019

Hartford Accident And Indemnity Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HA&I/Prime Healthcare MPN Insurer 06/22/2012 http://www.corvel.com

2139

Hartford Accident And Indemnity Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HA&I/HMSHost MPN Insurer 04/03/2013 www.corvel.com

2412

Hartford Accident And Indemnity Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 Corvel/HA&I/AdvanceAmerica MPN Insurer 10/02/2015 www.corvel.com

1248

Hartford Casualty Insurance Company 690 Asylum Ave Hartford, CT 06115 Frank Gates Svc Co/Hartford/CorVel MPN Insurer 09/29/2006 W

0074

Hartford Casualty Insurance Company 690 Asylum Avenue Hartford, CT 06115


1137

Hartford Casualty Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Casualty Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

1516

Hartford Casualty Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Casualty/Gallagher Bassett/First Health MPN Insurer 04/23/2009 T

0073

Hartford Casualty Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155






87


Applicant Date of


Approval Status *

1158

Hartford Casualty Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

Hartford Casualty/Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

3022

Hartford Casualty Insurance Company One Hartford Plaza HO-1-09 Hartford, CT 06155 CorVel/HCIC/Burberry MPN Insurer 04/25/2017 www.corvel.com

1855

Hartford Casualty Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 HCIC/Broadspire Signature MPN Insurer 07/15/2011 T

2494

Hartford Casualty Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HCIC/AdvanceAmerica MPN Insurer 08/15/2016 www.corvel.com

2496

Hartford Casualty Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HCIC/BB&T MPN Insurer 08/15/2016 www.corvel.com

0022

Hartford Fire Insurance Company 690 Asylum Avenue Hartford, CT 06115


0023

Hartford Fire Insurance Company 690 Asylum Avenue Hartford, CT 06115


1133

Hartford Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Fire Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

1514

Hartford Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Fire/Gallagher Bassett/First Health MPN Insurer 04/23/2009 www.talispoint.com/cvty/gbfhmpnselect T

1971

Hartford Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 05/24/2012 T

2004

Hartford Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

1884

Hartford Fire Insurance Company One Hartford Plaza (HO-I-09) Hartford, CT 06155 Sedgwick CMS MPN Insurer 09/20/2011 T

1885

Hartford Fire Insurance Company One Hartford Plaza (HO-I-09) Hartford, CT 06155 Sedgwick CMS Extended MPN Insurer 09/20/2011 T





88


Applicant Date of


Approval Status *

1153

Hartford Fire Insurance Company One Hartford Plaza [HO-1-09) Hartford, CT 06155

Hartford Fire Ins. Co./Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

1633

Hartford Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 HFIC/ESIS MPN Insurer 05/26/2010 T

2023

Hartford Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

Hartford Fire Insurance Company GBMCS MPN Insurer 07/20/2012 T

2142

Hartford Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Athens MPN-HFIC Insurer 03/28/2013 T

2134

Hartford Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

WellComp Medical Provider Network-York- HFIC Insurer 05/02/2013 T

1856

Hartford Fire Insurance Company One Hartford Plaza HO-1-09 Hartford, CT 06155 HFIC/Broadspire Signature MPN Insurer 07/15/2011 T

3044

Hartford Fire Insurance Company One Hartford Plaza HO-1-09 Hartford, CT 06155 The Hartford Select Network Insurer 07/20/2017 http://thehartfordselectnetworkmpn.com/

3083

Hartford Fire Insurance Company One Hartford Plaza HO-1-09 Hartford, CT 06155 Hartford Choice MPN

Entity that provides physician network services 02/02/2018 www.hartfordchoicempn.com

1187

Hartford Insurance Company of the Midwest 1 College Park 8910 Purdue Rd Indianapolis, IN 46268 Sedgwick CMS Medical Provider Network Insurer 04/19/2006 T

1250

Hartford Insurance Company of the Midwest 690 Asylum Ave Hartford, CT 06115 Frank Gates Svc Co/Hartford/CorVel MPN Insurer 09/29/2006 W

0071

Hartford Insurance Company of the Midwest 690 Asylum Avenue Hartford, CT 06115


0072

Hartford Insurance Company of the Midwest 690 Asylum Avenue Hartford, CT 06115






89


Applicant Date of


Approval Status *

1134

Hartford Insurance Company of the Midwest One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Insurance Company of the Midwest accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

2003

Hartford Insurance Company of the Midwest One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

1439

Hartford Insurance Company of the Midwest One Hartford Plaza [HO-1-09] Hartford, CT 06155

Wellcomp Medical Provider Network-York-HICM Insurer 01/20/2009 T

1509

Hartford Insurance Company of the Midwest One Hartford Plaza [HO-1-09] Hartford, CT 06155 HICM/GABRobins-MedInsights MPN Insurer 02/23/2009 T

1494


Hartford Insurance Company of the Midwest/Gallagher Bassett/First Health MPN Insurer 04/23/2009 www.talispoint.com/cvty/gbfhmpnselect T

1572


HICMW Broadspire First Health CompAmerica Primary Network Insurer 10/28/2009 T

1594


Hartford Insurance Company of the Midwest GBMCS MPN Insurer 01/20/2010 www.talispoint.com/cvty/gbmpn T

1580


CCMSI/HICM/First Health CompAmerica Select HCO Network Insurer 02/10/2010 T

1969

Hartford Insurance Company of the Midwest One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 05/24/2012 T

2229

Hartford Insurance Company of the Midwest One Hartford Plaza [HO-1-09] Hartford, Ct 06155 Hartford MW Bunch MPN Insurer 10/29/2013 T

1156

Hartford Insurance Company of the Midwest One Hartford Plaza Hartford, CT 06155

Hartford Ins. Co. Midwest./Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

1468

Hartford Insurance Company of the Midwest One Hartford Plaza Hartford, CT 06155 Sedgwick CMS Extended MPN Insurer 11/10/2008 T

1649

Hartford Insurance Company of the Midwest One Hartford Plaza Hartford, CT 06155 Athens MPN - HICM Insurer 06/10/2010 www.medexhco.com T





90


Applicant Date of


Approval Status *

1635

Hartford Insurance Company Of The Midwest One Hartford Plaza, HO-1-09 Hartford, CT 06155 RISICO TMC Hartford IMC MPN Insurer 06/01/2010 www.risico.com

1737

Hartford Insurance Company Of The Midwest One Hartford Plaza, HO-1-09 Hartford, CT 06155 Broadspire Signature MPN Insurer 12/16/2010 T

2078

Hartford Insurance Company Of The Midwest One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HICM/TX Roadhouse MPN Insurer 11/15/2012 www.corvel.com

2419

Hartford Insurance Company Of The Midwest One Hartford Plaza, HO-1-09 Hartford, CT 06155 CorVel/HICM/RL Carriers MPN Insurer 10/09/2015 www.corvel.com

1246

Hartford Underwriters Insurance Company 690 Asylum Ave Hartford, CT 06115 Frank Gates Svc Co/Hartford/CorVel MPN Insurer 09/29/2006 W

0069

Hartford Underwriters Insurance Company 690 Asylum Avenue Hartford, CT 06115

First Health CompAmerica-Primary HCO Network Insurer 01/12/2005 T

0070

Hartford Underwriters Insurance Company 690 Asylum Avenue Hartford, CT 06115


1136

Hartford Underwriters Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Hartford Underwriters Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

1515


Hartford Underwriters/Gallagher Bassett/First Health MPN Insurer 04/23/2009 T

1607


HUIC Broadspire First Health CompAmerica Select HCO Network Insurer 04/27/2010 T

1933



1935

Hartford Underwriters Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick CMS Medical Provider Network Insurer 04/18/2012 T

2176

Hartford Underwriters Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/ Harbor MPN Insurer 05/10/2013 T





91


Applicant Date of


Approval Status *

2177

Hartford Underwriters Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/ Harbor 2 MPN Insurer 05/10/2013 T

1157

Hartford Underwriters Insurance Company One Hartford Plaza [HO-1-09) Hartford, CT 06155

Hartford Underwriters/Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

1638

Hartford Underwriters Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

HUIC Redwoods First Health CompAmerica Select HCO Network Insurer 05/26/2010 T

2141

Hartford Underwriters Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Athens MPN--HUIC Insurer 03/28/2013 T

2135

Hartford Underwriters Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

WellComp Medical Provider Network-York-HUIC Insurer 05/02/2013 T

1738

Hartford Underwriters Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 Broadspire Signature MPN Insurer 12/16/2010 T

0578

Hartnell Community College District 411 Central Avenue Salinas, CA 93901 Prime Advantage Medical Provider Network


1997

HDI Global Insurance Company 161 North Clark Street, 48th Floor Chicago, IL 60601 Energi-WellComp Medical Provider Network Insurer 01/27/2012 www.Wellcomp.com

1177

Healthcare Industry Self-Insurance Program 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


1555

Healthcare Industry Self-Insured Program 2600 Michelson Dr Ste 1620 Irvine, CA 92612

CorVel/Healthcare Industry Self-Insured Program


1299

Heartland Employment Services, LLC dba HCR Manor Care P.O. Box 10086 Toledo, OH 43699 Tristar MPN


2331

Heartland Express Inc. of Iowa 151 Stewart Rd. SW Pacific, WA 98047 Sedgwick/Harbor MPN

Self-Insured Employer 09/22/2014 www.harborsys.com/Sedgwick W





92


Applicant Date of


Approval Status *

1110

Heavenly Valley, Limited Partnership PO Box 2180 Stateline, NV 89449 Liberty Mutual Group MPN


1651

Hesperia Fire Protection District 9700 Seventh Avenue Hesperia, CA 92345 WellComp Medical Provider Network


0219

Hewlett-Packard Company 3000 Hanover Street Palo Alto, CA 94304



0031

Hexcel Corporation 281 Tresser Blvd Stamford, CT 06901 First Health Comp America Select HCO


0446

Hilton Hotels Corporation 9336 Civic Center Drive Beverly Hills, CA 90210 Intracorp


1191

Hilton Hotels Corporation 9336 Civic Center Drive Beverly Hills, CA 90210 Intracorp


2220

Hilton Worldwide, Inc. 7926 Jones Branch Drive McLean, VA 22102 Sedgwick/Harbor 2 MPN


1722

Hilton Worldwide, Inc. 7930 Jones Branch Dr. McLean, VA 22102 CorVel MPN


1065

Hoag Memorial Hospital Presbyterian, The 301 Newport Blvd. Ste. 200 Newport Beach, CA 92663 Hoag Memorial Hospital Presbyterian MPN

Self-Insured Employer 08/12/2005 http://hoag.employermpn.com/

0392

Home Depot U.S.A., Inc. 2455 Paces Ferry Road, Bldg C-20 Atlanta, GA 30339 The Home Depot Medical Provider Network

Self-Insured Employer 02/23/2005 www.helmsmantpa.com/CAMPN

2000

Household Industries Self-Insured Group c/o CHSI, 770 Pilot Road, Suite 1 Las Vegas, NV 89119 Athens MPN


0549

Hughes Supply, Inc. One Hughes Way Orlando, FL 32805

First Health CompAmerica Primary HCO Network (or "First Health Primary")


2011

Huntington Beach City School District 20451 Craimer Lane Huntington Beach, CA 92646 PRIME Advantage Medical Provider Network






93


Applicant Date of


Approval Status *

0063

Huntington Beach Union High School District 5832 Bolsa Ave Huntington Beach, CA 92649 TRISTAR CompAmerica Primary HCO


1193

Hydro Conduit Corporation 1501 Belvedere Road West Palm Beach, FL 33406 CorVel HCO


1078

Imperial County Office of Education 1398 Sperber Rd. El Centro, CA 92243 WellComp Medical Provider Network


0475

Imperial Irrigation District P.O. Box 937 Imperial, CA 92251 TRISTAR MPN


1830

Imperium Insurance Company 800 Gessner Rd., Ste. 600 Houston, TX 77024 CorVel MPN Insurer 05/04/2011 www.corvel.com

0706

Indemnity Insurance Co. of North American (IND) 1601 Chestnut Street Philadelphia, PA 19103

Indemnity Insurance Co. of North American (IND), Crawford Select Insurer 06/16/2005 W

0707

Indemnity Insurance Co. of North American (IND) 1601 Chestnut Street Philadelphia, PA 19103

Indemnity Insurance Co of North America (IND) - Crawford Primary Insurer 06/16/2005 W

0405

Indemnity Insurance Company of North America 1601 Market Street Philadelphia, PA 19103 CorVel MPN/Indemnity Ins Co of NA/LWP Insurer 02/28/2005 T

1963

Indemnity Insurance Company of North America 436 Walnut St. Philadelphia, PA 19106 Sedgwick/Harbor MPN Insurer 05/15/2012 T

0683

Indemnity Insurance Company of North America 436 Walnut Street Philadelphia, PA 19106 Sedgwick CMS MPN Insurer 04/01/2005 T

0686

Indemnity Insurance Company of North America 436 Walnut Street Philadelphia, PA 19106






94


Applicant Date of


Approval Status *

0770

Indemnity Insurance Company of North America 436 Walnut Street Philadelphia, PA 19106 ACE/BUNCH Network Insurer 05/06/2005 T

2057

Indemnity Insurance Company of North America 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor 2 MPN Insurer 09/20/2012 T

2226

Indemnity Insurance Company Of North America 436 Walnut Street Philadelphia, PA 19106 Broadspire Signature MPN Insurer 10/18/2013 T

2248

Indemnity Insurance Company Of North America 436 Walnut Street Philadelphia, PA 19106 Coventry Medical Provider Network Insurer 04/18/2014 http://www.talispoint.com/cvty/matrix

1545

Indemnity Insurance Company of North America 436 Walnut Street, P.O. Box 1000 Philadelphia, PA 19105


2207

Inglewood Unified School District 401 S. Inglewood Ave. Inglewood, CA 90301 PRIME Advantage Medical Provider Network


0823

Inland Empire Utilities Agency 6075 Kimball Avenue, Bldg. A Chino, CA 91710 WellComp Medical Provider Network


0704

Insurance Company of North America (INA) 1601 Chestnut Street Philadelphia, PA 19103

Insurance Company of North America (INA), Crawford Primary Insurer 06/16/2005 W

0705

Insurance Company of North America (INA) 1601 Chestnut Street Philadelphia, PA 19103

Insurance Company of North America (INA), Crawford Select Insurer 06/16/2005 W

0049

Insurance Company of the West (ICW) 11455 El Camino Real San Diego, CA 92130 Medex MPN Insurer 12/03/2004 T

1982

Insurance Company of the West 11455 El Camino Real San Diego, CA 92130 ICW Group Premier MPN Insurer 05/25/2012 T





95


Applicant Date of


Approval Status *

1172

Insurance Corporation of Hanover 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel HCO Insurer 02/28/2006 T

1747

Integrated Grain & Milling, Inc. 2020 So. East Ave. Fresno, CA 93721 Zacky Farms Custom CorVel MPN


1089

Intel Corporation 2200 Mission College Blvd. Santa Clara, CA 95052 Broadspire MPN


2279

Intel Corporation 2200 Mission College Blvd., RN6-68 Santa Clara, CA 95054 Sedgwick/Harbor 2 MPN

Self-Insured Employer 04/07/2014 www.harborsys.com/sedgwick2 T

1691

Intel Corporation RN6-68 2200 Mission College Blvd. Santa Clara, CA 95052 Broadspire Signature MPN


1106

International Paper Company 6400 Poplar Avenue Tower III Room 110 Memphis, TN 38197 Sedgwick CMS Medical Provider Network


1854

Interstate Distributor Co 11707 21st Ave Ct S Tacoma, WA 98444 Broadspire Signature MPN


1075

Irvine Ranch Water District 15600 Sand Canyon Ave Irvine, CA 92618 WellComp Medical Provider Network


0570

Irvine Unified School District 5050 Barranca Parkway Irvine, CA 92604 Prime Advantage Medical Network


0877

ITT Industries Inc. 666 E. Dyer Rd. Santa Ana, CA 92705 ITT ESIS MPN


0873

J. G. Boswell Company PO Box 877 Corcoran, CA 86321


1667

J.T. Wimsatt Contracting Company, Inc. 28064 Avenue Stanford Ste B Valencia, CA 91355

J.T. Wimsatt Contracting Company, Inc. GBMCS MPN


0172

John Muir Health 1601 Ignacio Valley Road Walnut Creek, CA 94598 TRISTAR MPN






96


Applicant Date of


Approval Status *

0895

Johnson Controls, Inc. PO Box 591 Milwaukee, WI 53201

Johnson Controls Medical Provider Network MPN


1251

Johnson Machinery Company 800 E. La Cadena Drive Riverside, CA 92502 N/A


0175

Judicial Council of California 455 Golden Gate Avenue San Francisco, CA 94102 First Health CompAmerica Primary HCO State 02/16/2005 T

1695

Kaiser Foundation Health Plan, Inc. 1800 Harrison St, 20th Floor Oakland, CA 94612 Kaiser Permanente/Harbor Net MPN


1087

Kaiser Foundation Health Plan, Inc., a California Corporation 1800 Harrison St. 20th Floor Oakland, CA 94612 Kaiser Permanente MPN


1696

Kaiser Foundation Hospitals 1800 Harrison St. 20th Floor Oakland, CA 94612 Kaiser Permanente/Harbor Net MPN


1084

Kaiser Foundation Hospitals, a California Corporation 1800 Harrison St., 20th Floor Oakland, CA 94612 Kaiser Permanente MPN


0590

Kaweah Delta Health Care District 400 W. Mineral King Visalia, CA 93291 TRISTAR CompAmerica Primary HCO


2481

Kellogg Company One Kellogg Square Battle Creek, MI 49017 CorVel MPN


0167

Kelly Services, Inc. 999 W. Big Beaver Road Troy, MI 48084 Kelly Services MPN


3068

Kern County Hospital Authority 1700 Mt. Vernon Ave. Bakersfied, CA 93306

Foundation For Medical Care Of Kern County MPN

Self-Insured Employer 01/08/2018 http://www.kernmedicalmpn.kernfmc.com

0807

Kern Ridge Growers, LLC 25429 Barbara St. Arvin, CA 93203 Allied Managed Care MPN






97


Applicant Date of


Approval Status *

2194

Kiewit Infrastructure West Co. Kiewet Plaza Omaha, NE 68131 Sedgwick CMS Extended MPN


0300

Kimco Staffing Services, Inc. 17872 Cowan Avenue Irvine, CA 92614 First Health CompAmerica Primary Network


0299

KimStaffHR, Inc. 17872 Cowan Avenue Irvine, CA 92614 First Health CompAmerica Primary Network


0328

Kmart Corporation 3100 W. Big Beaver Rd. Troy, MI 48084



1467

K-Mart Corporation 3333 Beverly Road Hoffman Estates, IL 60179

Sedgwick CMS-Harbor MPN - Sears Holdings Management Corporation


2222

Knight Transportation, Inc. Which will do Business in California as Arizona Knight Transportation, Inc. 5601 W Buckeye Road Phoenix, AZ 85043 WellComp Medical Provider Network


0350

Kwikset Corporation/Price Pfister, Inc. 19701 Da Vinci Lake Forest, CA 92610



0419

L&R Construction, Inc. 620 N. Brand Blvd., 6th Floor Glendale, CA 91203 FH Select MPN


1358

L.F.P., Inc. 8484 Wilshire Blvd., #900 Beverly Hills, CA 90211 CorVel/L.F.P., Inc. MPN


0820

Lake Elsinore Unified School District 545 Chaney Street Lake Elsinore, CA 92530 Tristar MPN


0222

Lancaster School District 44711 North Cedar Avenue Lancaster, CA 93534 Prime Advantage Medical Network


1655

Landmark Insurance Company 175 Water St 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/22/2010 T





98


Applicant Date of


Approval Status *

1758

Landmark Insurance Company 175 Water St., 18th Flr New York, NY 10038 Chartis Select Medical Provider Network Insurer 01/19/2011 T

0655

Landmark Insurance Company 175 Water Street 18th Floor New York, NY 10038

Landmark Insurance Company/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

0579

Landmark Insurance Company 175 Water Street New York, NY 10038 Chartis-Cambridge MPN Insurer 03/24/2005 W

0626

Landmark Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Chartis - Coventry MPN Insurer 03/28/2005 T

1021

Landmark Insurance Company 175 Water Street, 18th Floor New York, NY 10038

Landmark Insurance Company/Gallagher Bassett/First Health MPN Insurer 08/05/2005 T

0466

Landmark Insurance Company 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0760

Landmark Insurance Company 70 Pine Street New York, NY 10270

Landmark Insurance Company/Gallagher Bassett / CorVel MPN Insurer 05/05/2005 T

0918

Landmark Insurance Company 70 Pine Street New York, NY 10270


0120

Landmark Insurance Company 80 Pine Street, 10th Floor New York, NY 10005 Chartis Primary Medical Provider Network Insurer 02/17/2005 T

0856

Landmark Insurance Company AIG 70 Pine Street New York, NY 10270

Landmark Insurance Company, Crawford Primary Insurer 07/01/2005 W

0865

Landmark Insurance Company AIG 70 Pine Street New York, NY 10270 Landmark Insurance Company Crawford Select Insurer 07/01/2005 W

2236

LA-Z-BOY, Incorporated 301 Tennessee St. Redlands, CA 92373 Sedgwick/Harbor MPN - LZB


0029

Leprino Foods Company 1830 West 38th Avenue Denver, CO 80211 First Health Comp America Select HCO

Self-Insured Employer 03/24/2005 www.talispoint.com/cvty/matrix





99


Applicant Date of


Approval Status *

2075

Les Schwab Tire Centers of California, Inc 20900 Cooley Road Bend, OR 97701 Sedgwick/Harbor MPN-Les Schwab


1221

Les Schwab Tire Centers of California, Inc. P.O. Box 5350 Bend, OR 97708 Les Schwab ESIS MPN


2086

Liberty Insurance Corporation 175 Berkeley St. Boston, MA 02116 Liberty Mutual-Gerald Desmond Bridge MPN Insurer 12/21/2012 www.libertymutualgroup.com/providernetworks

0086

Liberty Insurance Corporation 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

0305

Liberty Insurance Corporation 175 Berkeley Street Boston, MA 02116 The Liberty Mutual UPS MPN Insurer 03/05/2005 T

1279

Liberty Insurance Corporation 175 Berkeley Street Boston, MA 02116 UPS-Liberty Mutual MPN Insurer 04/18/2007 T

0085

Liberty Mutual Fire Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

0089

Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

2378

Liberty Mutual Managed Care LLC 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN

Entity that provides physician network services 04/16/2015 www.libertymutualgroup.com/providernetworks

2411

Liberty Mutual Managed Care LLC 175 Berkeley Street Boston, MA 02116 Helmsman Management Services MPN

Entity that provides physician network services 11/24/2015 www.helmsmantpa.com/CAMPN

2453

Liberty Mutual Managed Care LLC 175 Berkeley Street Boston, MA 02116 Liberty Mutual Managed Care MPN

Entity that provides physician network services 02/17/2016 www.libertymutualgroup.com/providernetworks

0397

Liberty Northwest Insurance Corporation 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 03/08/2005 T





100


Applicant Date of


Approval Status *

0349

Limited Brands, Inc. and its subsidiaries Three Limited Parkway Columbus, OH 43230



1242

Lincoln General Insurance Co. 3350 Whiteford Road York, PA 17402 Lincoln General Ins. Co/LWP/CorVel MPN Insurer 09/25/2006 T

1398

Lincoln General Insurance Company 3501 Concord Rd. York, PA 17402 American Claims Management Inc. MPN Insurer 05/14/2009 http://mpn.acmclaims.com/ T

2160

Lion Farms L.L.C. 9500 S. De Wolf Ave Selma, CA 93622 Risico TMC Lion Farms MPN


2158

Lion Raisins, Inc. 9500 S. De Wolf Ave Selma, CA 93622 Risico TMC Lion Raisins MPN

Self-Insured Employer 05/06/2013 http://www.Risico.com

0088

LM Insurance Corporation 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

1322

Lockheed Martin Corporation 1011 Lockheed Way Palmdale, CA 93599 GENEX/Lockheed Martin MPN

Self-Insured Employer 11/20/2007 genexservices.com

0457

Lodi Memorial Hospital 975 S. Fairmont Avenue Lodi, CA 95240 First Health CompAmerica Primary HCO


0282

Long Beach Community College District 4901 E Carson Long Beach, CA 90808 Prime Advantage Medical Network


1324

Long Beach Transit 1963 E. Anaheim Street Long Beach, CA 90801 TRISTAR - CompAmerica Primary HCO


0997

Long Beach Transit P.O. Box 731 Long Beach, CA 90801 Long Beach Transit - Comp Care MPN


2032

Los Angeles Community College District 770 Wilshire Blvd. 3rd Floor Los Angeles, CA 90017 WellComp Medical Provider Network


1069

Los Angeles County Office of Education 9300 Imperial Highway Downey, CA 90242

Los Angeles County Office of Education - Comp Care MPN






101


Applicant Date of


Approval Status *

2215

Los Angeles County Office Of Education 9300 Imperial Highway Downey, CA 90242 LACOE- WellComp Medical Provider Network

Self-Insured Employer 08/14/2013 www.wellcomp.com T

0058

Los Angeles Dept. of Water & Power PO Box 5111, Room 553 Los Angeles, CA 90051 CorVel HCO / CorVel HCO Select


1189

Los Angeles Jewish Home for the Aging 7150 Tampa Ave. Reseda, CA 91335 WellComp Medical Provider Network


0162

Los Angeles Unified School District 333 S. Beaudry Avenue, 28th Floor Los Angeles, CA 90017



0193

Louisiana Pacific Corporation 805 SW Broadway, Suite 900 Portland, OR 97205



1100

Lowe's HIW, Inc. 1000 Lowe's Blvd, P.O. Box 1000 Mooresville, NC 28117 Lowe's CA MPN


2284

Lowe's Home Centers, LLC 1000 Lowe's Blvd, P.O. Box 1000 Mooresville, NC 28117 Lowe's Home Centers/Bunch MPN

Self-Insured Employer 02/28/2014 providernet.bunchcare.com T

0030

LSI Logic Corporation (LSI) 1621 Barber Lane, MS D263 Milpitas, CA 95035 First Health Comp America Select HCO


0472

Lumbermens Mutual Casualty Co. 1 Kemper Lane 12SW Long Grove, IL 60049 First Health CompAmerica Select Insurer 04/12/2005 T

0337

Lumbermens Mutual Casualty Co. One Kemper Drive Long Grove, IL 60049 Kemper Cambridge MPN Insurer 02/16/2005 W

0160

Lumbermens Mutual Casualty Company 1 Corporate Dr Ste 200 Lake Zurich, IL 60047


0161

Lumbermens Mutual Casualty Company 1 Corporate Dr Lake Zurich, IL 60047 Sedgwick CMS Medical Provider Network Insurer 09/23/2010 T





102


Applicant Date of


Approval Status *

0341

Lumbermens Mutual Casualty Company 1 Kemper Lane 12SW0781 Long Grove, IL 60049 Broadspire Signature MPN Insurer 02/22/2005 T

0448

Lumbermen's Underwriting Alliance 1905 N.W. Corporate Blvd. Boca Raton, FL 33431

Coventry/First Health Comp America HCO Select Network Insurer 04/21/2005 www.genexservices.com T

2376

LWP Claims Solutions, Inc. 35 Miller Ave. #214 Mill Valley, CA 94941 LWP Claims Solutions Platinum MPN

Entity that provides physician network services 04/03/2015 www.lwpclaimsplatinummpn.com

2394

LWP Claims Solutions, Inc. 35 Miller Ave. #214 Mill Valley, CA 94941 LWP Claims Solutions Premier MPN

Entity that provides physician network services 06/03/2015 www.lwpclaimspremiermpn.com

1205

Lynwood Unified School District 11321 Bullis Road Lynwood, CA 90262

PRIME Advantage Medical Provider Network, accessing Prudent Buyer HCO


1297

Lynwood Unified School District 11321 Bullis Road Lynwood, CA 90262 TRISTAR CompAmerica Primary HCO


1852

Lynwood Unified School District 11321 Bullis Road Lynwood, CA 90262 CorVel MPN


1235

LZB Manufacturing Incorporated 301 Tennessee St. Redlands, CA 92373 La-Z-Boy West MPN


1470

Macy's Retail Holdings, Inc. 7 West Seventh St Cincinnati, OH 45202 Macy's Inc. Medical Provider Network


0676

Maine Bonding and Casualty Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

Maine Bonding and Casualty Company - Crawford Select Insurer 07/01/2005 W

1003

Maine Bonding and Casualty Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196

Maine Bonding and Casualty Company - Crawford Primary Insurer 07/01/2005 W

1275

Mainstay Business Solutions 1180 Iron Point Rd Ste 210 Folsom, CA 95630 WellComp Medical Provider Network






103


Applicant Date of


Approval Status *

0144

Majestic Insurance Company 101 California St., 22nd Flr. San Francisco, CA 94111 Majestic Insurance Company MPN Insurer 02/14/2005 T

0304

Manpower Inc. 5301 N Ironwood Road Milwaukee, WI 53217 Concentra MPN


1372

Manpower, Inc. 100 Manpower Place Milwaukee, WI 53212 Sedgwick CMS MPN


0731

Manufacturers' Alliance Insurance Company (MAICO) 380 Sentry Parkway Blue Bell, PA 19422 First Health Comp America Select MPN Insurer 05/23/2005 T

1410

Manufacturers Alliance Insurance Company 380 Sentry Parkway Blue Bell, PA 19422 American Claims Management Inc. MPN Insurer 05/14/2009 http://mpn.acmclaims.com/ T

1239

Manufacturers Alliance Insurance Company 6990 Snowdrift Road Building A Allentown, PA 18106 Rising Interplan MPN Insurer 09/18/2006 T

1836

Markel Insurance Company 4521 Highwoods Parkway Glen Allen, VA 23060 Rising MPN Insurer 05/24/2011 https://www.markelfirstcomp.com/injured-workers T

0802

Markstein Beverage Co. 60 Main Avenue Sacramento, CA 95838 Broadspire Signature MPN


2485

Marquee Managed Care Solutions, Inc. PO Box 511274 Los Angeles, CA 90051 Marquee Managed Care Solutions MPN

Entity that provides physician network services 06/21/2016 https://www.viiad.com/anthemcompass/bcacmnse

2486

Marquee Managed Care Solutions, Inc. PO Box 511274 Los Angeles, CA 90051 Marquee Managed Care Solutions Plus MPN

Entity that provides physician network services 06/21/2016 https://www.viiad.com/anthemcompass/kbacmnse

1086

Marriott International, Inc. 3130 S. Harbor Blvd., #550 Santa Ana, CA 92704 Marriott's Medical Provider Network

Self-Insured Employer 10/12/2005 www.talispoint.com/marriott/campn T

0153

Maryland Casualty Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196






104


Applicant Date of


Approval Status *

0214



0668

Maryland Casualty Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Maryland Casualty Company-Crawford Select Insurer 07/01/2005 W

1004


Maryland Casualty Company - Crawford Primary Insurer 07/01/2005 W

0843



1145

Maryland Casualty Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 T

1355

Maryland Casualty Company 1400 American Lane Tower 1-13th Floor Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

0376

Masco Corporation 21001 Van Born Road Taylor, MI 48180 TCT CA MPN

Self-Insured Employer 03/07/2005 www.mywcinfo.com T

1818

Massachusetts Bay Insurance Company 440 Lincoln Street Worcester, MA 01615 CorVel/Kaiser Select MPN Insurer 04/22/2011 www.Corvel.com

3049

Matrix Absence Management, Inc. 2421 W. Peoria Ave., Ste 200 Phoenix, AZ 85029 Matrix MPN

Entity that provides physician network services 01/04/2018 http://www.talispoint.com/cvty/matmpn

3099

Matrix Absence Management, Inc. 2421 W. Peoria Avenue, Suite 200 Phoenix, AZ 85029 Matrix KOJ MPN

Entity that provides physician network services 03/29/2018 http://www.talispoint.com/cvty/matkoj

0182

May Department Stores Company dba Robinsons*May-David's Bridal PO Box 4699 Redondo Beach, CA 90278 Medex Healthcare, Inc


0390

MCM Construction, Inc. 6413 32nd Street No. Highlands, CA 95660 Broadspire-Concentra Standard MPN






105


Applicant Date of


Approval Status *

0881

McWane, Inc. dba Anaco 1001 El Camino Ave. Corona, CA 92879 TRISTAR MPN


2476

Meadowbrook, Inc. 26255 American Drive Southfield, MI 48034 Meadowbrook, Inc. MPN


http://www.meadowbrookinsgrp.com/report-a-claim/workers-compensation-claims/

1365

MeadWestvaco 11013 West Broad Street Glen Allen, VA 23060 Sedgwick CMS MPN


2266

Med Site - Hacienda Heights 12401 Washington Blvd. Whittier, CA 90602 Athens MPN


3042

Medex Healthcare 1201 Dove St., Ste. 300 Newport Beach, CA 92660 Medex Advantage Plus-Republic MPN

Entity that provides physician network services 08/04/2017 www.medexhco.com

2437

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Athens MPN


2436

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex MPN


2438

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage MPN


2439

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage Plus MPN


2454

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage Plus-POG MPN








106


Applicant Date of


Approval Status *

2459

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-wcSolutions MPN


2458

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-KPC MPN


2465

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-City Of Oceanside MPN


2466

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-City of Carson MPN


3040

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-ACIG MPN

Entity that provides physician network services 08/04/2017 http://www.medexhco.com

3041

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-DMS MPN

Entity that provides physician network services 08/04/2017 http://www.medexhco.com

3043

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Servicon MPN


3045

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Goodwill MPN


3027

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-SHARP MPN






107


Applicant Date of


Approval Status *

3050

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage - Grimmway MPN


3051

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage Plus - CFINS MPN


3088

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Walmart MPN


3085

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-City Of Long Beach MPN


3086

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage Plus-Best Buy MPN


3087

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage Plus-Hilton MPN


3100

MEDEX Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 MEDEX Advantage Plus-DART MPN


3101

MEDEX Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 MEDEX Advantage-CR&R MPN


3112

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660

Medex Advantage- Freedom Properties-Hemet MPN






108


Applicant Date of


Approval Status *

3113

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Parking Concepts MPN


3114

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Food Products Of CA MPN


3115

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660 Medex Advantage-Filtration Group MPN


3116

Medex Healthcare 1201 Dove Street, Ste 300 Newport Beach, CA 92660

Medex Advantage-Casa Pacifica Dba Freedom Village MPN


1777

MEMIC INDEMNITY COMPANY PO Box 3606 Portland, ME 04104 MEMIC-GENEX MPN Insurer 02/17/2011 T

2482

MEMIC Indemnity Company PO Box 3606 Portland, ME 04104 CorVel MPN Insurer 05/17/2016 www.corvel.com

0108

Memorial Health Services 17360 Brookhurst St Fountain Valley, CA 92708 TRISTAR MPN


0932

Memorial Hospital Association 1800 Coffee Road Suite 116 Modesto, CA 95355 Memorial Hospital MPN


1744

Merchants Building Maintenance Company 1190 Monterey Pass Rd Monterey Park, CA 91754 Merchants Building Maintenance MPN

Self-Insured Employer 01/07/2011 merchants.employermpn.com

0393

Merchants Building Maintenance Company 1190 Monterey Pass Road Monterey Park, CA 91754 Interplan MPN


0889

MERGE Risk Management Joint Powers Authority 3540 N. Lexington Ave El Monte, CA 91731 MERGE MPN






109


Applicant Date of


Approval Status *

3014

Methodist Hospital Of Southern California 300 W Huntington Drive Arcadia, CA 91007 Methodist Hospital MPN

Self-Insured Employer 03/14/2017 methodisthospital,employermpn.com

1993

Methodist Hospital of Southern California 300 West Huntington Drive Arcadia, CA 91066

PRIME Advantage Medical Provider Network for Healthcare


0658

Metro Risk Management 720 East "E" Street Wilmington, CA 90748 First Health Select


0009

Metropolitan Stevedore Company 720 East "E" Street Wilmington, CA 90748


1743

Mid Valley Plastering, Inc. 15300 McKinly Ave. Lathrop, CA 95330 MVP MPN


0318

Mid-Century Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0313

Mid-Century Insurance Company 4680 Wilshire Blvd Los Angeles, CA 90010

First Health CompAmerica Select HCO Network (First Health Select Network) Insurer 03/09/2005 T

0752

Mid-Century Insurance Company 4680 Wilshire Blvd Los Angeles, CA 90010 Liberty Mutual Group MPN Insurer 04/28/2005 T

1591

Mid-Century Insurance Company 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 02/11/2010 www.corvel.com

0947

Midwest Employers Casualty Company 14755 North Outer Forty Chesterfield, MO 63017

Midwest Employers/Gallagher Bassett/First Health MPN Insurer 07/11/2005 T

1449

Midwest Employers Casualty Company 14775 North Forty Drive Chesterfield, MO 63017 Midwest Employers GBMCS MPN Insurer 05/07/2009 T

2391

Midwest General Insurance Agency, LLC 300 South Bradfordton Rd Springfield, IL 62711 Midwest MPN

Entity that provides physician network services 06/25/2015 https://www.midins.com/ClaimsServices.php





110


Applicant Date of


Approval Status *

1544

Milpitas Unified School District 1331 E Calaveras Blvd Milpitas, CA 95035 PRIME Plus Medical Provider Network


0056

Mitsui Sumitomo Insurance Company Of America 15 Independence Blvd Warren, NJ 07059 CorVel MPN Insurer 02/07/2005 www.corvel.com

1430

Mitsui Sumitomo Insurance Company of America 15 Independence Blvd. Warren, NY 07059 MSIG MPN Insurer 11/04/2008 T

1832

Mitsui Sumitomo Insurance Company of America 15 Independence Blvd Warren, NJ 07059 MSIGBunch MPN Insurer 06/01/2011 T

1860

Mitsui Sumitomo Insurance Company of America 15 Independence Blvd. Warren, NJ 07059 Broadspire Signature MPN Insurer 08/04/2011 T

2389

Mitsui Sumitomo Insurance Company Of America 15 Independence Blvd. Warren, NJ 07059 Mitsui/CorVel-Kaiser Select MPN Insurer 10/02/2015 www.corvel.com

1535

Mitsui Sumitomo Insurance USA Inc. 15 Independence Blvd Warren, NJ 07059


1724

MITSUI SUMITOMO INSURANCE USA INC. 15 Independence Blvd. Warren, NJ 07059 MITSUI SUMITOMO GBMCS MPN Insurer 01/12/2011 T

2039

Mitsui Sumitomo Insurance USA Inc. 15 Independence Blvd. Warren, NJ 07059 CorVel MPN Insurer 08/03/2012 http://www.corvel.com/

2390

Mitsui Sumitomo Insurance USA Inc. 15 Independence Blvd. Warren, NJ 07059 Mitsui/CorVel-Kaiser Select MPN Insurer 10/02/2015 www.corvel.com

1833

Mitsui Sumitomo Insurance USA, Inc. 15 Independence Blvd Warren, NJ 07059 MSIGBunch MPN Insurer 06/01/2011 T





111


Applicant Date of


Approval Status *

1431

Mitsui Sumitomo Insurance USA, Inc. 15 Independence Blvd. Warren, NY 07059 MSIG MPN Insurer 11/04/2008 T

0906

Modesto Irrigation District 1241 11th Street Modesto, CA 95354 First Health CompAmerica Primary HCO


0926

Montebello Unified School District 123 S. Montebello Blvd. Room 14 Montebello, CA 90640 WellComp Medical Provider Network


0934

Monterey County Schools Workers' Compensation Joint Powers Authority 76 Stephanie Drive Salinas, CA 93901 Monterey County Schools MPN


2383

Monterey Educational Risk Management Authority 76 Stephanie Drive Salinas, CA 93901 MERMA MPN

Joint Powers Authority 01/15/2016 www.intermedccs.com/MERMAMPN

0298

Monterey Mushrooms, Inc 260 Westgate Drive Watsonville, CA 95076 Monterey Mushrooms Inc. MPN.

Self-Insured Employer 03/08/2005 http://mmimpn.com/ T

1276

Monterey Peninsula Unified School District 700 Pacific St PO Box 1030 Monterey, CA 93940 PRIME Advantage Medical Provider


1888

Monterey-Salinas Transit One Ryan Ranch Rd. Monterey, CA 93940 Monterey-Salinas Transit MPN


2213

Moreno Valley Unified School District 25634 Alessandro Blvd MorenoValley, CA 92553 PRIME Advantage Medical Provider Network

Self-Insured Employer 04/03/2014 www.keenan.com T

1080

Moreno Valley Unified School District 25634 Alessandro Blvd. Moreno Valley, CA 92553

Moreno Valley Unified School District/CorVel Select MPN


0202

Mt. San Antonio Community College District 1100 North Grand Avenue Walnut Creek, CA 91789 Prime Advantage Medical Network


0571

Mt. San Jacinto Community College 1499 N. State Street San Jacinto, CA 92583 Prime Advantage Medical Network






112


Applicant Date of


Approval Status *

3030

MWIA Insurance Services, LLC 3333 Camino Del Rio South, Suite 235 San Diego, CA 92108 Midwestern Insurance Alliance Select MPN

Entity that provides physician network services 09/19/2017 www.talispoint.com/cvty/mia

0824

National American Insurance Company of California 444 West Ocean Blvd 18th Floor Long Beach, CA 90802 TRISTAR MPN Insurer 05/03/2005 T

2136

National Casualty Company 1100 Locust St., Dept 3010 Des Moines, IA 50391

First Health CompAmerica Primary HCO Network Insurer 03/05/2013 www.genexservices.com T

1880

National Fire Insurance Company of Hartford 333 South Wabash Chicago, IL 60604 ESIS MPN Insurer 08/31/2011 T

1182

National Interstate Insurance Company 3250 Interstate Drive PO Box 521 Richfield, OH 44286 CorVel MPN/National Interstate Insurance Insurer 04/04/2006 T

2420

National Interstate Insurance Company 3250 Interstate Drive Richfield, OH 44826 National Interstate MPN Insurer 12/28/2015 www.natlmpn.com

0051

National Liability & Fire (NLF) 100 First Stamford Place Stamford, CT 06902 ACCA/NLF Interplan MPN Insurer 01/31/2005 T

0336

National RV, Inc. 411 N Perris Blvd Perris, CA 92571 National RV MPN


0027

National Semiconductor Corporation 2900 Semiconductor Drive Santa Clara, CA 95052 First Health Comp America Select HCO


0619

National Surety Corporation 777 San Marin Dr. Novato, CA 94998 First Health Select Insurer 02/14/2005 www.agcs.allianz.com/usclaims T

0113

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com





113


Applicant Date of


Approval Status *

0656

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street 18th Floor New York, NY 10038

National Union Fire/Gallagher Bassett/Coventry MPN Insurer 03/04/2005 www.talispoint.com /cvty/gbcvtympn T

0524

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street New York, NY 10038 Chartis-Cambridge MPN Insurer 03/24/2005 W

0366

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038


0633

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T

0759

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038

National Union Fire Insurance Company Of Pittsburgh, PA/Gallagher Bassett/CorVel MPN Insurer 05/05/2005 www.corvel.com

1020

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038

National Union Fire/Gallagher Bassett/First Health MPN Insurer 08/05/2005 www.talispoint.com/cvty/gbfhmpnselect T

0924

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 Chartis/Kaiser OCIP Insurer 08/08/2005 www.talispoint.com/aig/KaiserMPN

0912

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 Liberty Mutual Group MPN Insurer 08/09/2005 T

1406

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com





114


Applicant Date of


Approval Status *

1415

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 WellComp Medical Provider Network Insurer 09/16/2008 T

1489

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street 18th Floor New York, NY 10038 WellComp Medical Provider Network Insurer 01/22/2009 T

1496

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street- 18th Floor New York, NY 10038 Nat'l Union Fire Ins/The GEO Group, Inc. Insurer 02/09/2009 T

1520

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street 18th Floor New York, NY 10038 Walmart-Medex MPN Insurer 04/01/2009 www.medexhco.com T

1457

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 National Union Fire GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn

1657

National Union Fire Insurance Company Of Pittsburgh, Pa 175 Water Street - 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/24/2010 www.broadspireppo.com T

1731

National Union Fire Insurance Company Of Pittsburgh, Pa 175 Water Street, 18th Floor New York, NY 10038

Chartis/Treasury Wine Estates Medical Provider Network Insurer 12/08/2010 www.talispoint.com/aig/Treasury

1733

National Union Fire Insurance Company Of Pittsburgh, Pa 175 Water Street, 18th Floor New York, NY 10038 Chartis/JCP MPN Insurer 12/15/2010 www.talispoint.com/aig/JCP

1742

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 AIG Select MPN Insurer 12/23/2010 www.talispoint.com/aig/mpnselect


NOTE: The status of the MPNs on this list were produced and processed from information known to DWC as of 04/02/2019. However, changes may have been made since that date. Please contact the DWC Medical Unit to verify the information provided for a specific MPN.

Approved MPN Applications: 2434 *MPN Approval Status LegendBLANK = MPN status has not changed after approval; = MPN coverage period should be verified with the DWC Medical Unit; P = MPN is on Probation; R = MPN was revoked afterapproval; S = MPN is currently Suspended; T = MPN was terminated after approval; W = MPN was withdrawn after approval

115


Applicant Date of


Approval Status *

1810

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 National Union Fire GBMCS KOJ MPN Insurer 03/24/2011 www.talispoint.com/cvty/gbkoj

1811

National Union Fire Insurance Company of Pittsburgh, PA 175 Water St. 18th floor New York, NY 10038 Nat'l Union/Tractor/Bunch MPN Insurer 04/12/2011 T

1843

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038

Randstad/NUnion/Conduent Care Solutions MPN Insurer 06/02/2011

1849

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038

Helmsman Management Services-First Health MPN Insurer 06/17/2011 http://lmi.com/Lmnetworks T

1998

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 Wellcomp Medical Provider Network Insurer 11/10/2011 T

1937

National Union Fire Insurance Company of Pittsburgh, Pa 175 Water St 18th Floor New York, NY 10038 PCIC MPN Insurer 04/18/2012 T

1976

National Union Fire Insurance Company of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 Sedgwick/Harbor MPN Insurer 05/24/2012 T

1989

National Union Fire Insurance Company of Pittsburgh, Pa 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

2047

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 TRISTAR MPN Insurer 07/12/2013 T








116


Applicant Date of


Approval Status *

2214

National Union Fire Insurance Company Of Pittsburgh, Pa 175 Water Street, 18th Floor NY, NY 10038 AIG/Bristol-Myers Squibb MPN Insurer 09/17/2013 www.talispoint.com/aig/BristolMyersSquibb

2448

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 TCT CA MPN Insurer 04/25/2016 www.mywcinfo.com T

2507

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street - 18th Floor New York, NY 10038 Silverado MPN Insurer 10/13/2016 www.corvel.com

3012

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 National Union Fire GBMCS-M KOJ MPN Insurer 02/23/2017 http://www.talispoint.com/cvty/gbkoj T

3052

National Union Fire Insurance Company Of Pittsburgh, PA 175 Water Street, 18th Floor New York, NY 10038 CareFirst MPN Insurer 10/02/2017 http://www.talispoint.com/cvty/care1

0502

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine Street New York, NY 10270


0492

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine Street New York, NY 10270 Sedgwick CMS Medical Provider Network Insurer 03/16/2005 T

0370


SRS First Health CompAmerica Primary HCO Network Insurer 03/28/2005 W

0423

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine Street New York, NY 10270 Gainey-FARA Insurer 04/21/2005 W





117


Applicant Date of


Approval Status *

0467

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0922



0614

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine Street New York, NY 10270 Intracorp-Gates McDonald MPN Insurer 06/02/2005 T

1427

National Union Fire Insurance Company of Pittsburgh, PA 70 Pine St New York, NY 10270


0857

National Union Fire Insurance Company of Pittsburgh, PA AIG 70 Pine Street New York, NY 10270

National Union Fire Insurance Company of Pittsburgh, Pa., Crawford Select Insurer 07/01/2005 W

0866

National Union Fire Insurance Company of Pittsburgh, PA Nat'l Union Fire of Pittsburg, Pa 70 Pine St. New York, NY 10038

National Union Fire Insurance Company of Pittsburgh, Pa-Crawford Primary Insurer 10/05/2005 W

2061

Nationwide Agribusiness Insurance Company 1100 Locust St., Dept 3010 Des Moines, IA 50391 GENEX Insurer 12/07/2012 www.genexservices.com T

3060

Nationwide Insurance Company Of America N2128-Nationwide/Three Nationwide Plaza Columbus , OH 43214 CorVel MPN Insurer 10/20/2017 www.corvel.com

3057

Nationwide Mutual Fire Insurance Company N2128-Nationwide/Three Nationwide Plaza Columbus , OH 43214 CorVel MPN Insurer 11/06/2017 www.corvel.com

3058

Nationwide Mutual Insurance Company N2128-Nationwide/Three Nationwide Plaza Columbus, OH 43214 CorVel MPN Insurer 11/07/2017 www.corvel.com





118


Applicant Date of


Approval Status *

3061

Nationwide Property And Casualty Insurance Company N2128-Nationwide/Three Nationwide Plaza Columbus, OH 43214 CorVel MPN Insurer 10/31/2017 www.corvel.com W

0450

Naumes, Inc. P.O. Box 996 Medford, OR 97501 CorVel MPN


0447

Nautilus International Holding Corporation ("Nautilus") P.O. Box 547 Wilmington, CA 90748 First Health


0314

Neighborhood Spirit P & C 4680 Wilshire Blvd Los Angeles, CA 90010


0321

Neighborhood Spirit P & C 4680 Wilshire Blvd Los Angeles, CA 90010


1589

Neighborhood Spirit Property And Casualty Company 6301 Owensmouth Ave Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 03/11/2010 www.corvel.com

1011

Nella Oil Company 2349 Rickenbacker Way Auburn, CA 95602 MedInsights Medical Provider Network


3107

NETFLIX, INC. 100 Winchester Circle Los Gatos, CA 95032 First Health Comp America HCO Select

Self-Insured Employer 07/18/2018 www.talispoint.com/cvty/mandb

3093

Networks By Design, Inc. 231 W Tenth Street Tracy, CA 95376 Healthcare Services Group MPN

Entity that provides physician network services 03/26/2018 http://HCSG.employermpn.com

2404

Networks By Design, Inc. 231 West Tenth Street Tracy, CA 95376 NBD Plus MPN

Entity that provides physician network services 09/03/2015 www.netbyd.com/nbdmpn/

2463

Networks By Design, Inc. 231 West Tenth Street Tracy, CA 95376 NBD MPN

Entity that provides physician network services 04/06/2016 www.netbyd.com/nbdmpn





119


Applicant Date of


Approval Status *

2002

New Albertson's, Inc. 19011 Lake Drive East Chanhassen, MN 55317


Self-Insured Employer 11/15/2011 www.sedgwickproviders.com √

0077

New Albertsons, Inc.(A SuperValu Company) 1421 So. Manhattan Avenue Fullerton, CA 92831 New Albertson's Inc. CA MPN


1624

New Hampshire Insurance Company 175 Water St - 18th Floor New York, NY 10038 NH Ins/CVS/Bunch MPN Insurer 04/14/2010 T

0758

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038

New Hampshire Insurance Company/Gallagher Bassett/CorVel MPN Insurer 05/04/2005 www.corvel.com

1654

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Broadspire Signature Network Insurer 06/22/2010 www.broadspireppo.com T

1850

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Sedgwick CMS/Harbor MPN - NHIC AMR Insurer 07/08/2011 T

1879

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Medex MPN Insurer 08/31/2011 www.medexhco.com T

2297

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038 Mentor/NewHampshire/Bunch MPN Insurer 05/08/2014 http://providernet.bunchcare.com T

2498

New Hampshire Insurance Company 175 Water Street - 18th Floor New York, NY 10038 New Hampshire Insurance/Cambridge MPN Insurer 07/28/2016 www.corvel.com

1979

New Hampshire Insurance Company 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor MPN Insurer 05/25/2012 T

1983

New Hampshire Insurance Company 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T

2028

New Hampshire Insurance Company 175 Water Street -18th Floor New York, NY 10038 Sedgwick/Harbor MPN – NHIC DESC Insurer 07/20/2012 T

1400

New Hampshire Insurance Company 175 Water Street- 18th Floor New York, NY 10038 CorVel MPN Insurer 07/18/2008 www.corvel.com





120


Applicant Date of


Approval Status *

2071

New Hampshire Insurance Company 175 Water Street- 18th Floor New York, NY 10038 Athens MPN Insurer 10/31/2012 T

0657

New Hampshire Insurance Company 175 Water Street 18th Floor New York, NY 10038

New Hampshire Insurance/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 www.talispoint.com/cvty/gbcvtympn T

1359

New Hampshire Insurance Company 175 Water Street 18th Floor New York, NY 10038 Liberty Mutual Group MPN Insurer 03/17/2008 T

1360

New Hampshire Insurance Company 175 Water Street 18th Floor New York, NY 10038


0523

New Hampshire Insurance Company 175 Water Street New York, NY 10038 Chartis - Cambridge MPN Insurer 03/23/2005 W

0627

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038 Chartis ESIS MPN Insurer 03/28/2005 T

1019

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038

New Hampshire/Gallagher Bassett/First Health MPN Insurer 08/05/2005 www.talispoint.com/cvty/gbfhmpnselect

1450

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038 New Hampshire GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn

2290

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038 CVS/Coventry MPN Insurer 03/11/2014 www.talispoint.com/cvty/mpnfhp T

2317

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038 WellComp Medical Provider Network Insurer 07/09/2014 www.WellComp.com T

2447

New Hampshire Insurance Company 175 Water Street, 18th Floor New York, NY 10038 TCT CA MPN Insurer 04/25/2016 www.mywcinfo.com T

0121

New Hampshire Insurance Company 175 Water Street, 18th Floor NY, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

1762

New Hampshire Insurance Company 175 Water Street, 18th Floor NY, NY 10038 AIG Select MPN Insurer 01/19/2011 www.talispoint.com/aig/mpnselect





121


Applicant Date of


Approval Status *

1394

New Hampshire Insurance Company 70 Pine Street New York, NY 10270 Sedgwick CMS MPN Insurer 06/09/2008 T

1462

New Hampshire Insurance Company 70 Pine Street New York, NY 10270 Sedgwick CMS Extended MPN Insurer 11/10/2008 T

1423

New Hampshire Insurance Company, Ltd. 70 Pine St New York, NY 10270


0470

New Hampshire Insurance Company, Ltd. 70 Pine Street New York, NY 10279 Broadspire MPN Insurer 04/26/2005 T

0920

New Hampshire Insurance Company, Ltd. 70 Pine Street New York, NY 10270

MedInsights/ Medical Provider Network, accessing Prudent Buyer PPO Insurer 05/19/2005 T

0852

New Hampshire Insurance Company, Ltd. AIG 70 Pine Street New York, NY 10270

New Hampshire Insurance Company, Ltd.-Crawford Select Insurer 07/01/2005 W

0862

New Hampshire Insurance Company, Ltd. AIG 70 Pine Street New York, NY 10270

New Hampshire Insurance Company, Ltd., Crawford Primary Insurer 07/01/2005 W

0793

New United Motor Manufacturers, Inc. 45500 Fremont Blvd Fremont, CA 94538 NUMMI MPN


1887

New York Marine & General Insurance Company 412 Mt. Kemble Ave Ste 300C Morristown, NJ 07960 Sedgwick CMS MPN Insurer 09/20/2011 T

1886

New York Marine and General Insurance Company 412 Mt. Kemble Ave Ste 300C Morristown, NJ 07960 ProSight Coventry Primary MPN Insurer 09/20/2011 T

2126

New York Marine And General Insurance Company 412 Mt. Kimble Ave Morristown, NJ 07960 LWP Signature MPN Insurer 02/20/2013 http://www.lwpsignaturempn.com





122


Applicant Date of


Approval Status *

2125

New York Marine And General Insurance Company 412 Mt. Kimble Ave. Morristown, NJ 07960 LWP Kaiser Signature MPN Insurer 02/20/2013 http://www.lwpprosightsignaturempn.com

1222

Newport-Mesa Unified School District 2985 Bear St. Costa Mesa, CA 92626 PRIME Advantage Medical Provider Network


0237

Nipponkoa Insurance Company, LTD (US Branch) 14 Wall Street, 8th Floor New York, NY 10005 TCT CA MPN Insurer 03/02/2005 T

0238

Nipponkoa Insurance Company, LTD (US Branch) 14 Wall Street, 8th Floor New York, NY 10005 CorVel CorCare Insurer 03/09/2005 T

0607

Non Profits' United Workers' Compensation Group Inc. 344 Thomas Berkley Way, Suite 340 Oakland, CA 94612 Interplan/Kaiser


1723

Nonprofits' United Workers Compensation Group, Inc. 431 I St., Ste 200 Sacramento, CA 95814 WellComp Medical Provider Network

Group of Self-Insured Employers 11/23/2010 www.wellcomp.com

1218

Norcal Waste System, Inc. 160 Pacific Avenue, Suite 200 San Francisco, CA 94111 Interplan through CompPartners


0543

Norcal Waste Systems, Inc. and its Subsidiaries 160 Pacific Avenue, Suite 200 San Francisco, CA 94111



1203

Nordstrom, Inc. PO Box 25799 Santa Ana, CA 92799 Nordstrom Medical Provider Network

Self-Insured Employer 09/13/2006 www.nordstromcampn.com

0084

NorGuard Insurance 16 South River Street Wilkes Barre, PA 18703 Nor Guard Insurance (GUARD Insurance) Insurer 12/14/2004 T





123


Applicant Date of


Approval Status *

3082

North American Risk Services, Inc. 240 East Central Parkway, Suite 4010 Altamonte Springs, FL 32701 NARS Select MPN

Entity that provides physician network services 03/13/2018 www.talispoint.com/cvty/nrs

2228

North Bay Schools Insurance Authority 380 A Chadbourne Rd Fairfield, CA 94534 NBSIA/ CorVel Custom MPN


0106

North Bay Schools Insurance Authority 380-A Chadbourne Road Fairfield, CA 94534 TriCounty MPN


2505

North Bay Schools Insurance Authority 380A Chadbourne Road Fairfield, CA 94534 NBSIA MPN

Joint Powers Authority 09/29/2016 www.netbyd.com/nbsiampn/

1918

North County Transit District 810 Mission Avenue Oceanside, CA 92054 Tristar MPN


0692

North County Transit District 810 Mission Avenue San Diego, CA 92054 North County District-Comp Care MPN


1077

North Orange County Community College District 1830 N. Romneya Drive Anaheim, CA 92801 WellComp Medical Provider Network


0226

North Orange County Self-funded Workers' Compensation Agency 14121 Cedarwood Ave. c/o Westminster SD Westminster, CA 92683 Prime Advantage Medical Network


2058

NORTH POINTE INSURANCE COMPANY One General Drive Sun Prairie, WI 53596

North Pointe Insurance Company GBMCS MPN Insurer 09/27/2012 T

0205

North Valley Schools Insurance Group 2882 Prospect Park Dr., Ste 200 Rancho Cordova, CA 95670 Prime Advantage Medical Provider Network


0206

Northeastern JPA 609 South Gold Street Eureka, CA 96097 Prime Advantage Medical Network






124


Applicant Date of


Approval Status *

1336

Northern California Auto Dealers Self-Insurance Group, Inc. Brentwood Cntr 11601 Wilshire Blvd #500 Los Angeles, CA 90025 CorVel MPN


2292

Northern California Cities Self Insurance Fund 1792 Tribute Road, Ste. 450 Sacramento, CA 95818 WellComp Medical Provider Network

Joint Powers Authority 05/08/2014 www.WellComp.com T

1233

Northern California Cities Self-Insurance Fund 100 Pine Street 11th Floor San Francisco, CA 94111 NCCSIF MPN


0779

Northern California Community Colleges Pool (NCCCP) c/o Cabrillo CCD-6500 Soquell Dr Aptos, CA 95003 Prime Advantage Medical Network


0642

Northern California Special Districts Insurance Authority 9280 West Stockton Blvd., #102 Willows, CA 95988 NCSDIA MPN


0215

Northern Insurance Company of New York 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0666


Northern Insurance Company of NY, Crawford Select Insurer 07/01/2005 W

1002


Northern Insurance Company of NY - Crawford Primary Insurer 07/01/2005 W

0844



1146

Northern Insurance Company of New York 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 T

1354

Northern Insurance Company of New York 1400 American Lane Tower 1-13th Floor Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

0152

Northern Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196






125


Applicant Date of


Approval Status *

0265

Northwestern Pacific Indemnity Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 W

1478

Northwestern Pacific Indemnity Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 W

0927

Norwalk-La Mirada Unified School District 12820 Pioneer Blvd Norwalk, CA 90650 WellComp Medical Provider Network


2501

Norwalk-La Mirada Unified School District 12820 Pioneer Blvd. Norwalk, CA 90650 CorVel MPN


1552

Nova Casualty Company 2 Waterside Crossing Ste 400 Windsor, CT 06095 Wellcomp Medical Provider Network Insurer 08/26/2009 T

1357

Nova Casualty Company 2 Waterside Crossing Suite 400 Windsor, CT 06095 AIX/Gallagher Bassett/Coventry MPN Insurer 03/07/2008 T

1356

Nova Casualty Company 2 Waterside Crossing Suite 400 Windsor, CT 06095 AIX/Gallagher Bassett/First Health MPN Insurer 03/17/2008 www.talispoint.com/cvty/gbfhmpnselect T

1361

Nova Casualty Company 2 Waterside Crossing, Suite 400 New York, NY 10036 Athens/Nova Casualty Company MPN Insurer 03/25/2008 T

1616

Nova Casualty Company 726 Exchange St Ste 1200 Buffalo, NY 14210 TRISTAR MPN Insurer 05/05/2010 T

1622

Nova Casualty Company 726 Exchange Street, Suite 1020 Buffalo, NY 14210 WellComp Medical Provider Network Insurer 04/14/2010 www.wellcomp.com T

1798

Nova Casualty Company 726 Exchange Street, Suite 1020 Buffalo, NY 14210 Athens MPN Insurer 03/11/2011 T

0418

O.R.G. Restaurants, LLC 620 N. Brand Blvd., 6th Floor Glendale, CA 91203 FARA-CIMMS ORG


1036

Oak River Insurance Company P.O. Box 881716 San Francisco, CA 94188

Berkshire Hathaway Homestate Companies MPN Insurer 08/16/2005 T





126


Applicant Date of


Approval Status *

0949

Oakland Unified School District 1025 2nd Avenue Room 112 Oakland, CA 94606 Oakland Unified School District MPN


1500

Oceanside Unified School District 2111 Mission Ave Oceanside, CA 92058 PRIME Advantage Medical Provider Network


2325

OCM Coastal Acquisition Co., LLC 3501 Jamboree Road North Tower Suite 3000 Newport Beach, CA 92660 Sedgwick/Harbor 4 MPN

Entity that provides physician network services 08/19/2014 www.harborsys.com/Sedgwick4 W

2324

OCM Coastal Acquisition Co., LLC 3501 Jamboree Road North Tower, Suite 3000 Newport Beach, CA 92660 Sedgwick/Harbor 3 MPN

Entity that provides physician network services 08/19/2014 www.harborsys.com/Sedgwick3 W

2424

OCM Coastal Acquisition Co., LLC 3501 Jamboree Road North Tower, Suite 3000 Newport Beach, CA 92660 Sedgwick/Harbor MPN - LLNS

Entity that provides physician network services 12/01/2015 www.SedgwickProviders.com/LLNS W

2488

OCM Coastal Acquisition Co., LLC 3501 Jamboree Road North Tower, Suite 3000 Newport Beach, CA 92660 Sedgwick/Harbor MPN - Express

Entity that provides physician network services 06/20/2016 www.SedgwickProviders.com/Express T

3029

OCM Coastal Acquisition Co., LLC 3501 Jamboree Road North Tower, Suite 3000 Newport Beach, CA 92660 Sedgwick/Harbor MPN - LZB

Entity that provides physician network services 07/10/2017 www.SedgwickProviders.com/LZB T

2299

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Harbor One MPN

Entity that provides physician network services 05/21/2014 http://www.harborsys.com/harborone

2322

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN

Entity that provides physician network services 08/18/2014 www.SedgwickProviders.com/CAMPN1

2323

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor 2 MPN

Entity that provides physician network services 08/18/2014 http://www.SedgwickProviders.com/CAMPN2





127


Applicant Date of


Approval Status *

2328

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Arissa/Harbor MPN

Entity that provides physician network services 08/20/2014 www.harborsys.com/ArissaMPN

2334

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 HarborOne/Genex MPN

Entity that provides physician network services 08/20/2014 www.harborsys.com/GENEXMPN

2357

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658

PRIME Plus MPN Powered By Harbor Health Systems

Entity that provides physician network services 12/19/2014 www.harborsys.com/KeenanPlus

2358


PRIME Advantage MPN Powered By Harbor Health Systems

Entity that provides physician network services 12/19/2014 www.harborsys.com/Keenan

2359

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - AG

Entity that provides physician network services 02/12/2015 www.sedgwickproviders.com/AG

2393


Sedgwick/Harbor MPN - Sears Holdings Corporation

Entity that provides physician network services 08/27/2015 www.sedgwickproviders.com/Sears

2405

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - CEC

Entity that provides physician network services 09/17/2015 www.sedgwickproviders.com/CEC

2407

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Nestle

Entity that provides physician network services 10/29/2015 www.sedgwickProviders.com/Nestle

2408

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Eaton

Entity that provides physician network services 10/30/2015 www.SedgwickProviders.com/Eaton





128


Applicant Date of


Approval Status *

2409

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Scripps

Entity that provides physician network services 10/30/2015 www.SedgwickProviders.com/Scripps

2410

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - DTFD

Entity that provides physician network services 11/02/2015 www.SedgwickProviders.com/FamilyDollar

2414

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - UHG

Entity that provides physician network services 11/02/2015 www.SedgwickProviders.com/UHG

2428

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Carl Warren SmartComp/Harbor MPN

Entity that provides physician network services 12/03/2015 www.harborsys.com/CarlWarren

2429

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Pacific Claims/Harbor MPN

Entity that provides physician network services 12/10/2015 www.harborsys.com/PacClaims

2432

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 State Fund MPN By Harbor Health

Entity that provides physician network services 12/24/2015 www.statefundca.com/mpn

2431

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - DESC

Entity that provides physician network services 03/15/2016 www.SedgwickProviders.com/DESC

2460

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - EPS

Entity that provides physician network services 03/21/2016 www.SedgwickProviders.com/EPS

2487

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Les Schwab

Entity that provides physician network services 06/16/2016 www.SedgwickProviders.com/LesSchwab





129


Applicant Date of


Approval Status *

2489

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Vallarta Markets

Entity that provides physician network services 06/20/2016 www.SedgwickProviders.com/Vallarta

2495

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Genex/Harbor 2 MPN

Entity that provides physician network services 08/01/2016 www.harborsys.com/GenexMPN2

2503

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Genex/Harbor 3 MPN

Entity that provides physician network services 08/10/2016 www.harborsys.com/GenexMPN3

2504

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN-Boeing

Entity that provides physician network services 09/06/2016 www.sedgwickproviders.com/Boeing

3001

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Ross

Entity that provides physician network services 03/17/2017 www.SedgwickProviders.com/RossStores

3004

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Target

Entity that provides physician network services 03/17/2017 www.SedgwickProviders.com/Target

3006

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - GE

Entity that provides physician network services 03/17/2017 www.SedgwickProviders.com/GE

3008

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Tenet

Entity that provides physician network services 03/17/2017 www.SedgwickProviders.com/Tenet

3019

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Hendrick

Entity that provides physician network services 04/10/2017 www.SedgwickProviders.com/Hendrick





130


Applicant Date of


Approval Status *

3026

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Kaiser/Harbor MPN

Entity that provides physician network services 06/27/2017 www.sedgwickproviders.com/Kaiser

3028

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Irvine Company

Entity that provides physician network services 07/06/2017 www.SedgwickProviders.com/IrvineCompany

3079

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - American Airlines

Entity that provides physician network services 12/29/2017 www.IODMedical.com

3090

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Verizon

Entity that provides physician network services 03/15/2018 http://www.sedgwickproviders.com/verizon

3091

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Kroger

Entity that provides physician network services 03/15/2018 http://www.SedgwickProviders.com/Kroger

3098

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 ICW Group Premier MPN

Entity that provides physician network services 04/26/2018 http://www.harborsys.com/ICWGroup

3108

OCM Coastal Acquisition Co., LLC P.O. Box 11779 Newport Beach, CA 92658 TRISTAR Premier MPN

Entity that provides physician network services 08/17/2018 https://search.harborsys.com/TristarPremierMPN

3124

OCM Coastal Acquisition Co., LLC PO Box 11779 Newport Beach, CA 92658 Sedgwick/Harbor MPN - Williams-Sonoma

Entity that provides physician network services 01/23/2019 https://www.sedgwickproviders.com/Williams-Sonoma

1831

Ohlone Community College District 43600 Mission Boulevard Fremont, CA 94539 PRIME Advantage Medical Provider Network


1278

Old Republic General Insurance Corporation 307 N. Michigan Chicago, IL 60601

Old Republic Construction Program Group Coventry MPN Insurer 03/13/2007 www.talispoint.com/cvty/gbcvtympn





131


Applicant Date of


Approval Status *

1584

Old Republic General Insurance Corporation 307 North Michigan Chicago, IL 60601 GBMCS MPN Insurer 01/19/2010 www.talispoint.com/cvty/gbmpn

0135

Old Republic Insurance Company 133 Oakland Ave Greensburg, PA 15601 Old Republic ESIS MPN Insurer 02/21/2005 T

2244

Old Republic Insurance Company 133 Oakland Avenue Greensburg, PA 15601 Coventry Medical Provider Network Insurer 04/18/2014 www.talispoint.com/cvty/matrix

1495

Old Republic Insurance Company 445 S. Moorland Rd Brookfield, WI 53005 WellComp Medical Provider Network Insurer 01/27/2009 T

1051

Old Republic Insurance Company 445 S. Moorland Rd, Suite 300 Brookfield, WI 53005 CorVel MPN Insurer 08/10/2005 www.CorVel.com

0995

Old Republic Insurance Company 445 S. Moorland Rd, Suite 300 Brookfield, WI 53005 CorVel MPN/Old Republic/LWP Insurer 08/12/2005 www.CorVel.com

1912

Old Republic Insurance Company 445 S. Moorland Rd., Suite 300 Brookfield, WI 53005 CorVel/Kaiser Select MPN Insurer 02/14/2012 http://www.corvel.com

2131

Old Republic Insurance Company 445 S. Moorland Road Brookfield, WI 53005 Ryder/Conduent Care Solutions MPN Insurer 02/20/2013

https://www.conduent.com/workers-compensation-solutions

1532

Old Republic Insurance Company 445 South Moorland Rd Brookfield, WI 53005

CCMSI/Old Republic First Health Comp America Select HCO Network Insurer 05/14/2009 T

0156

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Sedgwick CMS Medical Provider Network Insurer 02/03/2005 T

0158

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005


0309

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Old Republic Cambridge MPN Insurer 02/16/2005 T

0177

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 TCT CA MPN Insurer 03/07/2005 www.mywcinfo.com T







132


Applicant Date of


Approval Status *

0343


First Health CompAmerica/Primary HCO Network (or "First Health Primary") Insurer 03/08/2005 W

0546


Sedgwick First Health CompAmerica Select HCO Network (or "First Health Select") Insurer 03/22/2005 T

0714

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Old Republic/Gallagher Bassett Coventry MPN Insurer 03/24/2005 www.talispoint.com/cvty/gbcvtympn T

0383

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 FOCUS - CVTY Insurer 04/21/2005 T

0374

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Broadspire MPN Insurer 04/26/2005 T

0764



0950

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Liberty Mutual Group MPN Insurer 07/28/2005 T

0885

Old Republic Insurance Company 445 South Moorland Rd, Ste 300 Brookfield, WI 53005 Interplan Insurer 09/22/2005 W

0129

Old Republic Insurance Company 445 South Moorland Rd. Ste 300 Brookfield, WI 53005 First Health CompAmerica Primary Network Insurer 04/13/2005 T

0292

Old Republic Insurance Company 445 South Moorland Rd., Suite 300 Brookfield, WI 53005 CorVel MPN/Old Republic Insurer 02/18/2005 www.CorVel.com

1557

Old Republic Insurance Company 445 South Moorland Road Brookfield, WI 53005 Eaton Corporation MPN Insurer 07/31/2009 W

2020

Old Republic Insurance Company 445 South Moorland Road Brookfield, WI 53005 Genex Medical Provider Network (MPN) Insurer 09/21/2012 www.genexservices.com

1698

Old Republic Insurance Company 445 South Moorland Road, Ste. 300 Brookfield, WI 53005 Broadspire Signature MPN Insurer 09/29/2010 T





133


Applicant Date of


Approval Status *

1862

Old Republic Insurance Company 445 South Moorland Road, Suite 300 Brookfield, WI 53005 Medex MPN Insurer 07/20/2011 T

0690

Old Republic Insurance Company 445 South Moreland Rd, Ste 300 Brookfield, WI 53005

Old Republic/Gallagher Bassett/First Health MPN Insurer 05/27/2005 www.talispoint.com/cvty/gbfhmpnselect

1455

Old Republic Insurance Company 445 South Moreland Rd, Ste. 300 Brookfield, WI 53005

Old Republic Insurance Company GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn

1802

Old Republic Insurance Company 455 S Moorland Rd Brookfield, WI 53005 Sedgwick CMS/Harbor MPN - OR EATON Insurer 03/15/2011 T

2197

Old Republic Insurance Company 455 S Moorland Road Brookfield, WI 53005 Sedgwick/ Harbor MPN - OR PG Insurer 07/09/2013 T

1926

Old Republic Insurance Company 455 S. Moorland Rd. Brookfield, WI 53005 Sedgwick/Harbor MPN Insurer 03/22/2012 T

1973

Old Republic Insurance Company 455 s. Moorland Rd. Brookfield, WI 53005 Sedgwick/Harbor 2 MPN Insurer 05/24/2012 T

3064

Omaha National Underwriters, LLC 11128 John Galt Blvd Ste. 500 Omaha, NE 68137 Omaha National MPN

Entity that provides physician network services 12/04/2017 http://mpn.omahanational.com

0572

Ontario-Montclair School District 950 W. D. Street Ontario, CA 91762



0026

Optical Coating Laboratory, Inc. (OCLI) 2789 Northpoint Parkway Santa Rosa, CA 95407 First Health Comp America Select


0034

Oracle America, Inc. 901 San Antonio Rd/ MS SJC01-202 Palo Alto, CA 94303 First Health Select MPN

Self-Insured Employer 04/07/2005 www.talispoint.com/cvty/matrix √

2327

Orange County Fire Authority 1 Fire Authority Road Irvine, CA 92602 OCFA/CorVel MPN






134


Applicant Date of


Approval Status *

0741

Orange County Sanitation District PO Box 8127 Fountain Valley, CA 92728

Cambridge Orange County Sanitation District MPN


0890

Orange Unified School District 1401 North Handy Street Orange, CA 92867 WellComp Medical Provider Network


2232

Orchard Supply Company, LLC 1000 Lowe's Blvd, P.O. Box 1000 Mooresville, NC 28117 Orchard Bunch MPN


2366

Orora North America 6600 Valley View Street Buena Park, CA 90620 ATHENS MPN


1064

Orthopaedic Hospital 2400 South Flower St Los Angeles, CA 90007

PRIME Advantage Medical Network for HealthCare Medical Provider Network, accessing selected physicians Blue Cross of California Prudent Buyer PPO


0372

PACCAR Inc. 777-106th Avenue N.E.; Bellevue, WA 98004 Broadspire-Concentra Standard MPN


0755

Pacific Bell Telephone Co. One AT&T Plaza, 208 South Akard, Room 2731 Dallas, TX 75202 Liberty Mutual Group MPN


0482

Pacific Bell Telephone Company 208 South Akard Street, 27th Floor Dallas, TX 75202



2195

Pacific Bell Telephone Company One AT&T Plaza, 208 S. Akard St., Room 2732 Dallas, TX 75202 Sedgwick/Harbor 2 MPN


3119

Pacific Claims Management PO Box 9714 Fresno, CA 93793 Pacific Claims Management MPN

Entity that provides physician network services 10/12/2018 pcm.employermpn.com

1018

Pacific Compensation Insurance Company 1 Baxter Way, Suite 170 Westlake Village, CA 91362 PCIC On The Job MPN Insurer 08/16/2005

https://www.pacificcomp.com/medical-provider-network







135


Applicant Date of


Approval Status *

0039

Pacific Compensation Insurance Company 30301 Agoura Road 1# Floor Agoura Hills, CA 91301

Employers Direct Insurance Company Medical Provider Network Insurer 02/02/2005 T

0678

Pacific Employers Insurance Company 1601 Chestnut Street Philadelphia, PA 19103

Pacific Employers Insurance Company - Crawford Primary Insurer 06/16/2005 W

0532

Pacific Employers Insurance Company 1601 Market Street Philadelphia, PA 19103

Broadspire-First Health CompAmerica Select HCO MPN Insurer 03/24/2005 T

0684

Pacific Employers Insurance Company 1601 Market Street Philadelphia, PA 19103


0685

Pacific Employers Insurance Company 1601 Market Street Philadelphia, PA 19103 Sedgwick CMS Medical Provider Network Insurer 04/01/2005 T

1670

Pacific Employers Insurance Company 436 Walnut St Philadelphia, PA 19106 Broadspire Signature MPN Insurer 08/10/2010 T

1962

Pacific Employers Insurance Company 436 Walnut St Philadelphia, PA 19106 Sedgwick/Harbor MPN Insurer 05/15/2012 T

2056

Pacific Employers Insurance Company 436 Walnut Street Philadelphia, PA 19106 Sedgwick/Harbor 2 MPN Insurer 09/20/2012 T

2247

Pacific Employers Insurance Company 436 Walnut Street Philadelphia, PA 19106 Coventry Medical Provider Network Insurer 04/18/2014 http://www.talispoint.com/cvty/matrix

0819

Pacific Employers Insurance Company P.O. Box 15059 Wilmington, DE 19850

PRIME Advantage Medical Network Medical, MPN, accessing Prudent Buyer HCO Insurer 05/03/2005 T

0339

Pacific Gas And Electric Company 77 Beale St San Francisco, CA 94105 Pacific Gas And Electric Company MPN


http://www.mypgebenefits.com/physical-medical-provider-network.shtml

0266

Pacific Indemnity Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1473

Pacific Indemnity Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.corvel.com







136


Applicant Date of


Approval Status *

3056

Pacific Secured Equities, Inc. PO Box 358 Roseville, CA 95661 InterMed Select MPN

Entity that provides physician network services 03/01/2018 www.talispoint.com/intermed/InterMedSelectMPN

0038

Pacific Warehouse Company 720 East "E" Street Wilmington, CA 90748 First Health Select


3013

Packard Claims Administration, Inc. 2739 US HWY 19 North Holiday, FL 34691 Packard MPN

Entity that provides physician network services 03/01/2017 www.netbyd.com/packardmpn/

1050

Pajaro Valley Unified School District 294 Green Valley Road Watsonville, CA 95076

Pajaro Valley Unified School District Medical Provider Network


3066

Paladin Managed Care Services, Inc. 770 The City Drive South, Suite 3000 Orange, CA 92868

Paladin Primary Medical Provider Network (CA)

Entity that provides physician network services 11/08/2017 http://www.paladinmc.com

3078

Paladin Managed Care Services, Inc. 770 The City Drive South, Suite 3000 Orange, CA 92868

Allianz Resolution Management Coventry Select MPN

Entity that provides physician network services 12/21/2017 http://www.paladinmc.com/providers.html

1789

Palm Springs Unified School District 980 East Tahquitz Canyon Way Palm Springs, CA 92262 PRIME Advantage Medical Provider Network


1790

Palo Alto Unified School District 25 Churchill Ave Palo Alto, CA 94306 PRIME Plus Medical Provider Network


0596

Palo Alto Unified School District 25 Churchill Avenue Palo Alto, CA 94306 First Health CompAmerica Primary HCO


0200

Palomar College 1140 W Mission Road San Marcos, CA 92069 Prime Advantage Medical Network


1180

Park and Recreation District Employee Compensation 910 Entrada Road Sacramento, CA 95864 PARDEC MPN






137


Applicant Date of


Approval Status *

1200

Parker Hannifin Corporation 6035 Parkland Blvd. Cleveland, OH 44124 Sedgwick CMS MPN


1736

Parker Hannifin Corporation 6035 Parkland Blvd. Cleveland, OH 44124 Parker Select MPN


2416

Parking Concepts Inc. 12 Mauchly, Building I Irvine, CA 92618 Medex MPN

Self-Insured Employer 11/06/2015 www.medexhco.com

0804

PARSAC Public Agency Risk Sharing Authority of CA 1525 Response Rd #1 Sacramento, CA 95815 Interplan


0568

Pasadena Area Community College District 1570 E. Colorado Blvd., C-215 Pasadena, CA 91106 Prime Advantage Medical Network


1056

Pasadena Unified School District 351 South Hudson Ave. Pasadena, CA 91106 CorVel/Pasadena Unified School District MPN


2291

Patriot Risk Services, Inc. Po Box 746 Woodland Hills, CA 91365 Patriot Risk Services MPN

Entity that provides physician network services 09/30/2014 www.patriotmpn.com/ca T

2257

Pebble Beach Company 220 Country Club Gate Center #27 Pacific Grove, CA 93950 PEBBLE BEACH COMPANY MPN

Self-Insured Employer 01/23/2014 www.intermedccs.com/PebbleBeachMPN W

1543

Peerless Indemnity Insurance Company 27201 Bella Vista Parkway Ste 130 Warrenville, IL 60555 Liberty Mutual Group MPN Insurer 06/29/2009 T

1542

Peerless Insurance Company 62 Maple Ave Keene, NH 03431 Liberty Mutual Group MPN Insurer 06/29/2009 T

1409

Pennsylvania Manufacturers Association Insurance Company (PMAIC) 380 Sentry Parkway Blue Bell, PA 19422 American Claims Management Inc. MPN Insurer 05/14/2009 http://mpn.acmclaims.com/ T





138


Applicant Date of


Approval Status *

0730

Pennsylvania Manufacturers' Association Insurance Company (PMAIC) 380 Sentry Parkway Blue Bell, PA 19422 First Health Comp America Select MPN Insurer 05/23/2005 T

1240

Pennsylvania Manufacturers' Association Insurance Company 6990 Snowdrift Road Building A Allentown, PA 18106 Rising Interplan MPN Insurer 09/18/2006 T

0729

Pennsylvania Manufacturers' Indemnity Company (PMIC) 380 Sentry Parkway Blue Bell, PA 19422 First Health Comp America Select MPN Insurer 05/23/2005 T

1411

Pennsylvania Manufacturers Indemnity Company (PMIC) 380 Sentry Parkway Blue Bell, PA 19422 American Claims Management Inc. MPN Insurer 05/14/2009 http://mpn.acmclaims.com/ T

0563

Perris Union High School District 155 East 4th Street Perris, CA 92570 Prime Advantage Medical Network


0346

Peter Kiewit Sons', Inc. Kiewit Plaza Omaha, NE 68131

First Health CompAmerica/Select HCO Network


1238

Pictsweet Ten Pictsweet Drive Bells, TN 38006

First Health Select/Medrisk/Progressive/One Call MPN


2267

PIH Foundation 12401 Washington Blvd. Whittier, CA 90602 Athens MPN


3102

Pitman Family Farms 1075 North Ave Sanger, CA 93657 Pitman Family Farms MPN

Entity that provides physician network services 06/21/2018 www.netbyd.com/pitmanfamilyfarmsmpn/

2183

Pitman Family Farms 1489 K Street Sanger, CA 93657 Pitman Family Farms MPN


0897

Placentia-Yorba Linda Unified School District 1301 E. Orangethorpe Ave. Placentia, CA 92870 WellComp Medical Provider Network






139


Applicant Date of


Approval Status *

1653

Placentia-Yorba Linda Unified School District 1301 E. Orangethorpe Ave. Placentia, CA 92870 Athens MPN


1178

Plastics Manufacturers Self-Insurance Program 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


1784

Pomona Unified School District 800 South Garey Ave Pomona, CA 91766

Pomona Unified School District/CorVel Select MPN


1151

Pomona Valley Hospital Medical Center 1798 N. Garey Ave. Pomona, CA 91767

PRIME Advantage Medical Network for HealthCare MPN accessing selected physicians of CA Prudent Buyer PPO


1715

PomWonderful LLC 11444 W. Olympic Blvd. 5th FL Los Angeles, CA 90064 Broadspire Signature MPN


0564

Poway Unified School District 13626 Twin Peaks Road Poway, CA 92064 Prime Advantage Medical Network


1389

PPG Industries, Inc. 4325 Rosanna Drive Suite G Allison Park, PA 15101 PPG Medical Provider Network


0896

PPG Industries, Inc. 4325 Rosanna Drive Allison Park, PA 15101 PPG Medical Provider Network


2123

Praetorian Insurance Company 116 Pine Street, Suite 320 Harrisburg, PA 17101

CCMSI/Praetorian/First Health Comp America Network Insurer 02/19/2013 T

1171

Praetorian Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 Praetorian Medical Provider Network One Insurer 04/26/2006 T

1291

Praetorian Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel MPN Insurer 05/07/2007 T

1195

Praetorian Insurance Company 557 N. Wynore Rd, #202 Maitland, FL 32751

QBE The Americas/TMC Medical Provider Network Insurer 07/05/2006 T

1923

Praetorian Insurance Company 88 Pine 4th Floor New York, NY 10005 Praetorian Insurance Company GBMCS MPN Insurer 03/15/2012 T





140


Applicant Date of


Approval Status *

1946

Praetorian Insurance Company 88 Pine 4th Floor New York, NY 10005 WellComp Medical Provider Network Insurer 05/02/2012 T

2230

Praetorian Insurance Company 88 Pine 4th Floor New York, NY 10005

Praetorian Insurance Company/Gallagher Bassett/First Health MPN Insurer 10/29/2013 T

1911

Praetorian Insurance Company 88 Pine St 16th Floor Wall St. Plaza New York, NY 10005 QBE Insurance Company, Praetorian MPN Insurer 03/06/2012 T

2205

Praetorian Insurance Company 88 Pine Street New York, NY 10005 CorVel MPN Insurer 07/15/2013 T

2167

Praetorian Insurance Company 88 Pine Street, 16h floor New York, NY 10005 Sedgwick/Harbor 2 MPN Insurer 05/10/2013 T

2166

Praetorian Insurance Company 88 Pine Street, 16th floor New York, NY 10005 Sedgwick/Harbor MPN Insurer 05/10/2013 T

1858

Praetorian Insurance Company 88 Pine, 4th Floor New York, NY 10005

Praetorian Insurance Company/Gallagher Bassett/Coventry MPN Insurer 07/20/2011 T

1901

Praetorian Insurance Company Wall Street Plaza 88 Pine St 18th Flr New York, NY 10005 Sedgwick CMS Extended MPN Insurer 01/27/2012 T

1117

Preferred Auto Dealers Self-Insurance Program 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


0640

Preferred Employers Insurance Company 1455 Frazee Road Suite 1000 San Diego, CA 92108 Quality Care Medical Provider Network (MPN) Insurer 03/30/2005 T

1226

Preferred Employers Insurance Company 9797 Aero Drive, Suite 200 San Diego, CA 92123 Preferred Select MPN Insurer 08/28/2006 www.peiwc.com

1066

Presbyterian Intercommunity Hospital 12401 Washington Blvd. Whittier, CA 90602

PRIME Advantage Medical Provider Network for HealthCare






141


Applicant Date of


Approval Status *

2263

Presbyterian Intercommunity Hospital 12401 Washington Blvd. Whittier, CA 90602 Athens MPN


1567

Preserver Insurance Company 120 Broadway 31st Floor New York, NY 10217 WellComp Medical Provider Network Insurer 09/15/2009 T

1631

Preserver Insurance Company 120 Broadway, 31st Floor New York, NY 10271 Tower Group Companies MPN Insurer 06/10/2010 T

2182

Preserver Insurance Company 120 Broadway, 31st Floor New York, NY 10271 ACM/Preserver MPN Insurer 05/20/2013 T

2473

Prime Health Services, Inc. 7110 Crossroads Blvd Brentwood, TN 37027 PHS MPN

Entity that provides physician network services 06/21/2016 www.primehealthservicesmpn.com

2474

Prime Health Services, Inc. 7110 Crossroads Blvd Brentwood, TN 37027 Prime Health MPN

Entity that provides physician network services 06/21/2016 www.primehealthservicesincmpn.com

1920

ProCentury Insurance Company 465 Cleveland Ave Westerville, OH 43082 Rising Interplan MPN Insurer 03/06/2012 T

3015

Programs Plus, Inc. 1431 Greenway Drive, Ste 620 Irving, TX 75038 Assurex Medical Provider Network

Entity that provides physician network services 03/22/2017 www.talispoint.com/cvty/irm

1155

Property and Casualty Insurance Company of Hartford 100 Hartford Plaza [HO-1-09] Hartford, CT 06155

Property and Casualty Insurance Co. of Hartford/Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

0067

Property and Casualty Insurance Company of Hartford 690 Asylum Avenue Hartford, CT 06115


0068

Property and Casualty Insurance Company of Hartford 690 Asylum Avenue Hartford, CT 06115






142


Applicant Date of


Approval Status *

1188

Property and Casualty Insurance Company of Hartford 690 Asylum Ave Hartford, CT 06115

Property and Casualty Insurance Company of Hartford accessing Anthem Blue Cross Prudent Buyer HCO Insurer 03/17/2006 W

1244

Property and Casualty Insurance Company of Hartford 690 Asylum Avenue Hartford, CT 06115 Frank Gates SVC Co/Hartford/CorVel MPN Insurer 09/29/2006 W

1523

Property and Casualty Insurance Company of Hartford One Hartford Plaza [HO-1-09] Hartford, CT 06155

Property & Casualty/Gallagher Bassett/First Health MPN Insurer 05/07/2009 T

2382

Property and Casualty Insurance Company of Hartford One Hartford Plaza [HO-1-09] Hartford, CT 06155

Property and Casualty Insurance Company of Hartford accessing Anthem Blue Cross Prudent Buyer PPO Insurer 10/09/2015 www.thehartford.com/ca-workers-compensation T

3103

Property And Casualty Insurance Company Of Hartford One Hartford Plaza HO-1-09 Hartford, CT 06155 CorVel/PCIH/BB&T MPN Insurer 06/14/2018 www.corvel.com

3122

Property And Casualty Insurance Company Of Hartford One Hartford Plaza HO-1-09 Hartford, CT 06155 CorVel/PCIH/Worthington Industries MPN Insurer 12/13/2018 www.corvel.com

1766

ProSight Global, Inc. 412 Mt. Kemble Ave Ste 300C Morristown, NJ 07960 Sedgwick CMS Extended MPN Insurer 02/02/2011 W

3069

Prospect Medical Holdings, Inc. 3415 S. Sepulveda Blvd., 9th Floor Los Angeles, CA 90034 CorVel MPN


2510

Protective Insurance Company P.O. Box 7099 Indianapolis, IN 46207 Protective/CorVel MPN Insurer 10/27/2016 www.corvel.com

2015

Protective Insurance Company PO Box 7099 Indianapolis, IN 46207 CorVel MPN Insurer 06/14/2012 www.corvel.com





143


Applicant Date of


Approval Status *

0207

Providence Health System Southern California (Self Insurance Certificate #2245) 506 2nd Avenue, Suite 1200 Seattle, WA 98104 First Health CompAmerica Select


1170

Providence Health System-Southern California 1801 Lind Avenue SW #9016 Renton, WA 98057 Genex-Providence Medical Provider Network


0598

Prudential Overall Supply 1661 Alton Parkway Irvine, CA 92606 Prudential Overall Supply MPN

Self-Insured Employer 03/18/2005 www.tristarmanagedcare.com

0952

Public Agencies Self-Insured Systems (PASIS) c/o Apple Valley Fire Protection District 22400 Headquarters Drive Apple Valley, CA 92307 WellComp Medical Provider Network


1618

Public Entity Risk Management Authority 36-951 Cook Street, Suite 101 Palm Desert, CA 92211 WellComp Medical Provider Network


1507

Public Service Insurance Company One Park Avenue New York, NY 10016 CorVel MPN Insurer 02/10/2009 http://www.corvel.com T

1162

Public Service Mutual Insurance Company 11755 Wilshire Blvd., Suite 1850 Los Angeles, CA 90025 Concentra Integrated Services, Inc. Insurer 08/03/2006 T

1919

QBE Insurance Corporation 88 Pine 4th Floor New York, NY 10005 QBE Insurance Corporation GBMCS MPN Insurer 11/02/2012 T

2171

QBE Insurance Corporation 88 Pine Street, 16th Floor New York, NY 10005 Sedgwick/ Harbor 2 MPN Insurer 05/06/2013 T

2172

QBE Insurance Corporation 88 Pine Street, 16th Floor New York, NY 10005 Sedgwick/ Harbor MPN Insurer 05/06/2013 T

0429

Quality Comp, Inc. 1357 E. Lassen Avenue, Suite 100 Chico, CA 95927 CorVel HCO/CorVel HCO Select


2066

Quality Comp, Inc. 255 Great Valley Parkway, Ste 255 Malvern, PA 19355 Monument MPN






144


Applicant Date of


Approval Status *

1481

Quality Comp, Inc. 255 Great Valley Pkwy Ste 200 Malvern, PA 19355 Monument MPN


1845

Raley's 500 W. Capitol Ave., West Sacramento, CA 95605 Athens MPN


2435

Raley's 500 W. Capitol Avenue West Sacramento, CA 95605 Raley's-CorVel MPN


1327

Raley's 500 West Capitol Ave. West Sacramento, CA 95605 Raley's Quality Medical Provider Network


0605

Raley's 500 West Capitol Avenue Sacramento, CA 95814 CorVel HCO/CorVel HCO Select


0795

Ravendale-Termo Elementary School District 472-13 Johnstonville Road North Susanville, CA 96130



2076

Ravenswood City School District 2120 Euclid Ave East Palo Alto, CA 94303 PRIME Plus Medical Provider Network


0575

Ravenswood City School District 2160 Euclid Avenue East Palo Alto, CA 94303 PRIME Advantage Medical Network


2053

Recology Inc. 50 California Street, 24th Floor San Francisco, CA 94111 CorVel/Recology MPN


1196

Redland Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751

Redland Insurance Company/TMC Medical Provider Network Insurer 07/05/2006 W

0082

Redlands Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 CorVel MPN/ Redlands Insurance Insurer 02/04/2005 T

0275

Redlands Insurance Company 2600 West Hall Lane, Suite 400 Maitland, FL 32751 Clarendon Medical Provider Network One Insurer 02/09/2005 W

0565

Redlands Unified School District 20 West Lugonia Ave Redlands, CA 92374 Prime Advantage Medical Network






145


Applicant Date of


Approval Status *

0455

Redwood Fire and Casualty Insurance Company P.O. Box 881716 San Francisco, CA 94188

Berkshire Hathaway Homestate Companies MPN Insurer 02/16/2005 T

2036

Regent Insurance Company One General Dr. Sun Prairie, WI 53396 Regent Insurance Company GBMCS MPN Insurer 11/02/2012 T

2164

Regent Insurance Company One General Drive Sun Prairie, WI 53596 Sedgwick/ Harbor MPN Insurer 05/06/2013 T

2165

Regent Insurance Company One General Drive Sun Prairie, WI 53596 Sedgwick/ Harbor 2 MPN Insurer 05/06/2013 T

1009

Regents of The University of California 1111 Franklin Street, 10th Floor Oakland, CA 94607 Regents of The University of California MPN


0433

Reinsurance Company of America 1310 Utica Street Oriskany, NY 13424 CorVel MPN Insurer 03/03/2005 T

2491

Republic Capital Claims Administrators, Inc. 2648 E Workman Ave., #223 West Covina, CA 91791

Republic Capital Claims Administrators Kaiser MPN

Entity that provides physician network services 08/10/2016 www.rccakaisermpn.com

2492

Republic Capital Claims Administrators, Inc. 2648 E Workman Ave., #223 West Covina, CA 91791 Republic Capital Claims Administrators MPN

Entity that provides physician network services 08/10/2016 www.rccampn.com

0102

Republic Indemnity Company of America PO Box 20036 Encino, CA 91416 Republic Indemnity MPN Insurer 02/14/2005 T

0782

Republic Indemnity Company of America PO Box 20036 Encino, CA 91416

Republic Indemnity Kaiser On-the Job Medical Provider Network Insurer 05/10/2005 T

2005

Republic Indemnity Company Of America PO Box 20036 Encino, CA 91416 Republic Indemnity Company MPN Insurer 06/06/2012 www.talispoint.com/ri

2006

Republic Indemnity Company Of California PO Box 20036 Encino, CA 91416 Republic Indemnity Company MPN Insurer 06/06/2012 www.talispoint.com/ri





146


Applicant Date of


Approval Status *

0327

Republic Indemnity Company of California PO Box 20036 Encino, CA 91416 Republic Indemnity MPN Insurer 02/14/2005 T

0781

Republic Indemnity Company of California PO Box 20036 Encino, CA 91416

Republic Indemnity Kaiser On-the Job Medical Provider Network Insurer 05/10/2005 T

1702

Republic Underwriters Insurance Company 5525 LBJ Freeway Dallas, TX 95240 Athens MPN Insurer 09/29/2010 www.medexhco.com T

2191

Republic Underwriters Insurance Company 5525 LBJ Freeway Dallas, TX 75240 Sedgwick/ Harbor MPN- Republic AG Insurer 06/21/2013 T

0569

Rialto Unified School District 182 E. Walnut Avenue Rialto, CA 92376 Prime Advantage Medical Network


0566

Rio Hondo College 3600 Workman Mill Road Whittier, CA 90608 Prime Advantage Medical Network


3023

Rising Medical Solutions, LLC 325 N. LaSalle St., Suite 600 Chicago, IL 60654 Rising Select MPN

Entity that provides physician network services 05/24/2017 https://www.risingms.com/risingmpn/

3024

Rising Medical Solutions, LLC 325 N. LaSalle St., Suite 600 Chicago, IL 60654 Rising FHSelectKOJ MPN


3025

Rising Medical Solutions, LLC 325 N. LaSalle St., Suite 600 Chicago, IL 60654 Rising FHSelect MPN


1944

Riverport Insurance Company 222 So 9th St., Ste 1300 Minneapolis, MN 55402 WellComp Medical Provider Network Insurer 05/02/2012 T

2040

Riverside Community College District 4800 Magnolia Ave. Riverside, CA 92506 WellComp Medical Provider Network


0281

Riverside Schools Risk Management Authority 41870 McAlby Court Murrieta, CA 92562 Prime Advantage Medical Network






147


Applicant Date of


Approval Status *

1629

Riverside Transit Agency (RTA) 1825 Third St Riverside, CA 92517 RTA MPN


1501

Riverside Transit Authority 1825 Third St Riverside, CA 92507 CorVel MPN


1829

RLI Insurance Company 9025 N. Lindbergh Drive Peoria, IL 60615

RLI Insurance/Gallagher Bassett/First Health MPN Insurer 05/03/2011 www.talispoint.com/cvty/gbfhmpnselect T

2193

Roadway Express, Inc. 10990 Roe Avenue Overland Park, KS 66211 Roadway Express, Inc. GBMCS MPN


0630

Robertson's Ready Mix, Ltd 200 South Main, # 200 Corona, CA 92882 WellComp Medical Provider Network


2231

Robertson's Transport, Ltd 200 South Main, #200 Corona, CA 92882 WellComp Medical Provider Network


0293

Roll International Corporation 11444 West Olympic Blvd, 10th Floor Los Angeles, CA 90064 Broadspire MPN


1701

Roll International Corporation 11444 West Olympic Blvd., 10th Flr. Los Angeles, CA 90064 Broadspire Signature MPN


0726

Roman Catholic Archbishop of Los Angeles, a corporation sole 3424 Wilshire Blvd Los Angeles, CA 90010 First Health Comp America Select MPN


0936

Royal & SunAlliance 9300 Arrowpoint Blvd. Charlotte, NC 28201 Royal & SunAlliance MPN Insurer 09/28/2005 T

0351

RR Donnelley 77 West Wacker Drive Chicago, IL 60601



0783

Sacramento Metropolitan Fire District 2101 Hurley Way Sacramento, CA 95825 InterPlan/Kaiser






148


Applicant Date of


Approval Status *

1263

Sacramento Municipal Utility District 6201 S St. Sacramento, CA 95817 SMUD MPN


1053

Sacramento Municipal Utility District 6201 S Street Sacramento, CA 95817 Medical Partners @ Work (MPW)


1553

Sacramento Municipal Utility District 6201 S. Street Sacramento, CA 95817 SMUD MPN

Self-Insured Employer 08/11/2009 www.smud.ekhealth.com

0937

Saddleback Valley Unified School District 25631 Peter A. Hartman Way Mission Viejo, CA 92691



1307

Safeco Insurance Company of America 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 07/10/2008 http://www.libertymutualgroup.com/providernetworks T

1308

Safeco Insurance Company of Illinois 175 Berkeley Street Boston, MA 02116 Safeco Preferred California MPN Insurer 07/10/2008 http://www.libertymutualgroup.com/providernetworks T

0054

Safeco Property & Casualty Insurance Companies 120 Vantis Aliso Viejo, CA 92656 Safeco Preferred California MPN Insurer 12/02/2004 W

1442

Safety First Insurance Company 1832 Schuetz Road St Louis, MO 63146 Safety First GBMCS MPN Insurer 05/07/2009 T

0976

Safety First Insurance Company 1832 Schuetz Road St. Louis, MO 63146 Safety First /Gallagher Bassett/Coventry MPN Insurer 07/12/2005 T

0800

Safety First Insurance Company 1834 Schuetz Road St. Louis, MO 63146 Safety First/Gallagher Basset/First Health MPN Insurer 05/27/2005 T

0991

Safety First Insurance Company 2043 Woodland Pkwy St. Louis, MO 63146 Broadspire MPN Insurer 06/10/2005 T

3053

Safety National Casualty Corporation 15509 Collections Center Drive Chicago, IL 60693 Glidewell Dental MPN Insurer 11/22/2017 www.talispoint.com/intermed/glidewelldentalmpn





149


Applicant Date of


Approval Status *

1710

Safety National Casualty Corporation 1832 Scheutz Rd. St. Louis, MO 63146 Athens MPN Insurer 10/20/2010 www.medexhco.com

0127

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 First Health CompAmerica Select Network Insurer 02/17/2005 www.talispoint.com/cvty/matrix

0740

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 Safety National Cambridge MPN Insurer 06/22/2005 T

1565

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 Sedgwick CMS MPN Insurer 09/29/2009 T

1566

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 Sedgwick CMS Extended MPN Insurer 09/29/2009 T

1621

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 WellComp Medical Provider Network Insurer 04/13/2010 www.wellcomp.com T

1625

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 Safety Nat'l/GAP/Bunch MPN Insurer 04/29/2010 T

1672

Safety National Casualty Corporation 1832 Schuetz Rd St. Louis, MO 63146 Broadspire Signature Network Insurer 08/10/2010 T

1958

Safety National Casualty Corporation 1832 Schuetz Rd. St. Louis, MO 63146

First Health Comp America Primary HCO Network Insurer 05/02/2012 T

1968

Safety National Casualty Corporation 1832 Schuetz Rd. St. Louis, MO 63146 Sedgwick/Harbor MPN Insurer 05/24/2012 T

2007

Safety National Casualty Corporation 1832 Schuetz Rd. St. Louis, MO 63146 Sedgwick/Harbor 2 MPN Insurer 06/01/2012 T

2129

Safety National Casualty Corporation 1832 Schuetz Rd. St. Louis, MO 63146 LWP Kaiser Signature MPN Insurer 02/20/2013 http://www.lwpsignaturempn.com

2130

Safety National Casualty Corporation 1832 Schuetz Rd. St. Louis, MO 63146 LWP Signature MPN Insurer 02/20/2013 http://www.lwpsignaturempn.com





150


Applicant Date of


Approval Status *

1416

Safety National Casualty Corporation 1832 Schuetz Road St Louis, MO 63146

CCMSI/SafetyNationalCasualty Corporation/First Health Comp America Select HCO Network Insurer 10/02/2008 T

1445

Safety National Casualty Corporation 1832 Schuetz Road St Louis, MO 63146 Safety National GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn

0412

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 CorVel MPN/Safety National Casualty/LWP Insurer 02/28/2005 www.corvel.com

0975

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146

Safety National/Gallagher Bassett/Coventry MPN Insurer 07/12/2005 www.talispoint.com/cvty/gbcvtympn

1017


First Health Comp America Select And Kaiser-on-the-Job Network Insurer 09/13/2005 www.talispoint.com/cvty/matrix

1782

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 CorVel MPN Insurer 02/10/2011 www.corvel.com

1863

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 Medex MPN Insurer 08/23/2011 T

2001

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 CorVel/Kaiser Select MPN Insurer 11/10/2011 www.corvel.com

1916


Sedgwick/Harbor MPN - Safety National SUMC Insurer 02/17/2012 W

2110

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 Sedgwick/Harbor MPN - SN Vallarta Insurer 02/01/2013 T

2083


PRIME Advantage Medical Provider Network for Healthcare Insurer 02/11/2013 T

2179

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 Liberty Mutual Group MPN Insurer 06/12/2013 T

2180

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 CorVel/Prime Healthcare MPN Insurer 06/25/2013 www.corvel.com





151


Applicant Date of


Approval Status *

2434

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 Safety National GBMCS KOJ MPN Insurer 12/16/2015 www.talispoint.com/cvty/gbkoj T

2446

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 TCT CA MPN Insurer 04/25/2016 www.mywcinfo.com T

2506

Safety National Casualty Corporation 1832 Schuetz Road St. Louis, MO 63146 El Pollo Loco MPN Insurer 10/13/2016 www.corvel.com

1559

Safety National Casualty Corporation 1932 Schuetz Rd St. Louis, MO 63146 Safety National ESIS MPN Insurer 08/25/2009 T

0359

Safety National Casualty Corporation 2043 Woodland Pkwy St. Louis, MO 63146

First Health CompAmerica Select HCO Network Insurer 03/07/2005 W

0360


First Health CompAmerica Primary HCO Network Insurer 03/07/2005 W

0643

Safety National Casualty Corporation 2043 Woodland Pkwy St. Louis, MO 63146 Broadspire MPN Insurer 04/04/2005 T

0789

Safety National Casualty Corporation 2043 Woodland Pkwy St. Louis, MO 63146 Insurer 05/15/2005 T

0799


Safety National/Gallagher Bassett/First Health MPN Insurer 05/27/2005 T

0335

Safeway Inc. 5918 Stoneridge Mall Rd Pleasanton, CA 94558 Safeway MPN

Entity that provides physician network services 04/08/2005 http://www.talispoint.com/safewaympn

0505

Saint John's Health Center 2420 W 26th Ave Ste 100 D Denver, CO 80211 Broadspire Signature MPN


2031

Samsung Fire & Marine Insurance Co., Ltd. (US Branch) 85 Challenger Rd. Ridgefield Park, NJ 07660 Broadspire Signature MPN Insurer 08/03/2012 T





152


Applicant Date of


Approval Status *

1083

San Antonio Community Hospital 999 San Bernardino Rd Upland, CA 91789



0334

San Bernardino City Unified School District 777 North F Street San Bernardino, CA 92410 SBCUSD MPN


0576

San Bernardino Community College District 114 S. Del Rosa Drive San Bernardino, CA 92408 Prime Advantage Medical Network


1928

San Diego Community College District 3375 Camino Del Rio South San Diego, CA 92108 San Diego CCD/CorVel Select MPN


1401

San Diego County Schools Risk Management Joint Powers Authority 6401 Linda Vista Road San Diego, CA 92111 San Diego County Schools JPA MPN

Joint Powers Authority 07/23/2008

Http://www.sdcoe.net/business-services/risk-management/Pages/workers-compensation-forms.aspx

0094

San Diego Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 www.libertymutualprs.com T

1801

San Diego Metropolitan Transit System 1255 Imperial Ave., Ste 1000 San Diego, CA 92101 SD MTS MPN


0413

San Diego Transit Corporation 1255 Imperial Ave Suite 1000 San Diego, CA 92101 SD MTS MPN


1800

San Diego Trolley, Inc. 1255 Imperial Ave., Ste 1000 San Diego, CA 92101 SD MTS MPN


0963

San Diego Unified School District 4100 Normal Street San Diego, CA 92103 TRISTAR - CompAmerica Primary HCO


1418

San Diego Unified School District 4100 Normal Street San Diego, CA 92103 WellComp Medical Provider Network


1375

San Diego Unified School District Revere Center Rm 7, 2100 Normal St San Diego, CA 92103 State Fund Medical Provider Network


http://www.sdcoe.net/business-services/risk-management/Pages/workers-compensation-forms.aspx

http://www.sdcoe.net/business-services/risk-management/Pages/workers-compensation-forms.aspx





153


Applicant Date of


Approval Status *

0992

San Diego/Imperial County Schools Joint Power Authority 6401 Linda Vista Rd #505 San Diego, CA 92111 Interplan through CompPartners


3111

San Francisco Unified School District 135 Van Ness Avenue - Room 312 San Francisco, CA 94102 SFUSD MPN

Self-Insured Employer 08/17/2018 https://www.netbyd.com/SFUSDMPN/

0875

San Francisco Unified School District 135 Van Ness, Room 217 San Francisco, CA 94102 First Health CompAmerica Primary HCO


0928

San Gabriel Valley School Districts' Self-Insurance Authority C/o Glendora Unified School District 500 N. Lorraine Ave Glendora, CA 91741 WellComp Medical Provider Network


1281

San Joaquin County Schools WC Insurance Group JPA P.O. Box 213030 Stockton, CA 95213 PRIME Plus Medical Provider Network


1890

San Joaquin Delta Community College District 5151 Pacific Ave. Stockton, CA 95207 PRIME Advantage Medical Provider Network


2027

San Jose Unified School District 2222 Unified Way, Bld T San Jose, CA 95125 Athens MPN


0903

San Jose Unified School District 855 Lenzen Avenue San Jose, CA 95126 First Health CompAmerica Primary HCO


3092

San Jose Unified School District 855 Lenzen Avenue, Suite 205 San Jose, CA 95126 San Jose USD MPN

Self-Insured Employer 08/23/2018 www.talispoint.com/intermed/sanjoseusdmpn

1252

San Jose/Evergreen Community College District 4750 San Felipe Road San Jose, CA 95135 PRIME Plus Medical Network


1013

San Mateo County Community College District 3401 CSM Drive San Mateo, CA 94402 Prime Advantage Medical Network






154


Applicant Date of


Approval Status *

0794

San Mateo County Schools Insurance Group 1791 Broadway Redwood City, CA 94063 Prime Advantage Medical Provider Network


2258

San Mateo County Schools Insurance Group 1791 Broadway Redwood City, CA 94063 PRIME Plus Medical Provider Network

Joint Powers Authority 01/03/2014 www.keenan.com T

1132

Santa Ana Unified School District 1601 East Chestnut Avenue Santa Ana, CA 92701 WellComp Medical Provider Network


0284

Santa Barbara Community College District 721 Cliff Drive Santa Barbara, CA 93109 Prime Advantage Medical Network


0898

Santa Barbara County Schools - SIPE c/o Santa Barbara County Education Office - 4400 Cathedral Oaks Santa Barbara, CA 93160 PacMed, Inc. HCO


0476

Santa Clara County Office of Education 1290 Ridder Park Drive San Jose, CA 95141 First Health CompAmerica Primary HCO


1253

Santa Clara County Schools Insurance Groups 3233 Union Ave. San Jose, CA 95124 PRIME Plus Medical Network


0711

Santa Clara Schools Insurance Group (SCCSIG) 3233 Union Avenue San Jose, CA 95124



0574

Santa Clara Unified School District 1889 Lawrence Road Santa Clara, CA 95052 Prime Advantage Medical Network


0168

Santa Clara Valley Transportation Authority 3331 North First Street San Jose, CA 95134

Santa Clara Valley Transportation Authority Network


1294

Santa Clara Valley Transportation Authority 3331 North First Street San Jose, CA 95134 Santa Clara Valley Transportation Authority

Self-Insured Employer 06/07/2007 www.genexservices.com T

0224

Santa Clarita Community College District 26455 North Rockwell Canyon Road Valencia, CA 91355 Prime Advantage Medical Network






155


Applicant Date of


Approval Status *

0204

Santa Cruz/San Benito County Schools Insurance Group 97 South 2nd Street, Suite 300 San Jose, CA 95113 Prime Advantage Medical Network


2319

Santa Fe Aggregates, Inc. 3500 American River Dr. Sacramento, CA 95851 WellComp Medical Provider Network


0176

Santa Monica Community College District 1900 Pico Blvd Santa Monica, CA 90405 Prime Advantage Medical Network


0930

Saticoy Lemon Association 7560 E. Bristol Santa Paula, CA 93061 WellComp Medical Provider Network


0197

Saugus Union School District 24930 Avenue Stanford Santa Clarita, CA 91355 Prime Advantage Medical Network


3047

Save Mart Supermarkets 1800 Standiford Avenue Modesto , CA 95350 CorVel MPN


0052

Save Mart Supermarkets 1800 Standiford Avenue Modesto, CA 95356 Status MPN-Save Mart

Self-Insured Employer 12/02/2004 https://secure.simon-companies.com/sm/ T

0754

Schneider National Carriers, Inc. 3101 South Packerland Drive, P.O. Box 2545 Green Bay, WI 54306 Liberty Mutual Group MPN


0123

Schnitzer Steel Industries, Inc. 3200 NW Yeon Ave. Portland, OR 97210 Schnitzer Steel ESIS MPN


0105

Schools Insurance Group (SIG) 550 High Street, Suite 210 Auburn, CA 95603 SIG MPN


1390

Schools Insurance Group 550 High Street Suite 210 Auburn, CA 95603 Allied Managed Care/SIG MPN


0279

Schools Linked For Insurance Management 4111 Las Virgenes Rd Calabasas, CA 91302 PRIME Advantage Medical Network






156


Applicant Date of


Approval Status *

2315

Schools Linked for Insurance Management 4111 Las Virgenes Road Calabasas, CA 91302 PRIME Plus Medical Provider Network

Joint Powers Authority 07/30/2014 www.keenan.com T

0183

Scope Industries 233 Wilshire Blvd, Suite 310 Santa Monica, CA 90401

Scope Industries First Health CompAmerica Select


1841

Scripps Health 4275 Campus Point Court San Diego, CA 92121 Sedgwick CMS/Harbor MPN-Scripps


0013

Sea Bright Insurance Company 2101 4th Avenue, Ste 1600 Seattle, WA 98121 First Health Comp America Select HCO Insurer 02/15/2005 W

0381

Sea Bright Insurance Company 2101 4th Avenue, Ste 1600 Seattle, WA 98121 Broadspire-Concentra Standard MPN Insurer 02/22/2005 W

1119

SeaBright Insurance Company 1501 4th Avenue, Suite 2600 Seattle, WA 98101 SeaBright BrightCure Customized MPN Insurer 12/16/2005 www.sbic.com T

1628

Securitas Security Services USA, Inc. 4330 Park Terrace Dr Westlake Village, CA 92361 Sedgwick CMS Extended MPN


0591

Securitas Security Services USA, Inc. 4330 Park Terrace Drive Westlake Village, CA 92361 Securitas Broadspire SNP


2295

Securitas Security Services USA, Inc. 4330 Park Terrace Drive Westlake Village, CA 91361 Sedgwick/Harbor MPN

Self-Insured Employer 05/21/2014 www.harborsys.com/sedgwick W

1806

Security National Insurance Company 12490 Merit Drive Dallas, TX 76251 Medex MPN Insurer 03/25/2011 W

1639

Security National Insurance Company 12790 Merit Dr Dallas, TX 75251

Majestic Insurance Company Medical Provider Network Insurer 05/26/2010 T

1775

Security National Insurance Company 12790 Merit Dr Dallas, TX 76251 Medex MPN Insurer 02/01/2011 T

1608

Security National Insurance Company 12790 Merit Dr. Ste 200 Dallas, TX 95251 WellComp Medical Provider Network Insurer 04/20/2010 T





157


Applicant Date of


Approval Status *

1579

Security National Insurance Company 12790 Merit Drive Dallas, TX 95251

Security National/Gallagher Bassett/First Health MPN Insurer 01/12/2010 T

1577


Security National/Gallagher Bassett/Coventry MPN Insurer 01/14/2010 T

1578

Security National Insurance Company 12790 Merit Drive Dallas, TX 95251 Security National GBMCS MPN Insurer 01/14/2010 T

1805


Security National Insurance Company accessing MedInsights Medical Provider Network Insurer 03/18/2011 W

1627

Security National Insurance Company 12790 Merit Drive, Suite 200 Dallas, TX 75251 CorVel MPN Insurer 04/28/2010 T

2479

Sedgwick Claims Management Services, Inc. 1100 Ridgeway Loop Road Memphis, TN 38120 Sedgwick Extended Medical Provider Network

Entity that provides physician network services 06/01/2016 www.sedgwickproviders.com

2480

Sedgwick Claims Management Services, Inc. 1100 Ridgeway Loop Road Memphis, TN 38120 Sedgwick Standard Medical Provider Network

Entity that provides physician network services 06/01/2016 www.sedgwickproviders.com

1260

Self-Insured Schools Of California 2000 K Street Bakersfield, CA 93301

Self-Insured Schools Of California(SISC)/California Foundation For Medical Care Network

Joint Powers Authority 12/07/2006 www.cfmcnet.org/SISC

2060

Sentinel Insurance Company, LTD One Hartford Plaza Hartford, CT 06155 Athens MPN - SIC Insurer 10/05/2012 T

2079

Sentinel Insurance Company, Ltd. One Hartford Plaza HO-1-09 Hartford, CT 06155 RISICO TMC Sentinel IC MPN Insurer 11/15/2012 www.risico.com

2092

Sentinel Insurance Company, Ltd. One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 12/24/2012 T

2093

Sentinel Insurance Company, Ltd. One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 12/24/2012 T





158


Applicant Date of


Approval Status *

1913

Sentinel Insurance Company, Ltd. One Hartford Plaza [HO-1-09] Hartford, CT 06155

Sentinel Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 02/24/2012 www.thehartford.com/ca-workers-compensation T

2016



2022



2024

Sentinel Insurance Company, Ltd. One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sentinel Insurance Company GBMCS MPN Insurer 08/01/2012 T

2025


Sentinel Insurance Company/Gallagher Bassett/First Health MPN Insurer 08/01/2012 T

2026


Sentinel Insurance Company/Gallagher Bassett/Coventry MPN Insurer 08/01/2012 T

2051


WellComp Medical Provider Network-York-SIC Insurer 09/14/2012 T

2255

Sentry Casualty Company 1800 North Point Drive Stevens Point, WI 54481 Medex MPN Insurer 12/04/2013 T

0584

Sentry Insurance A Mutual Company PO Box 8032 Stevens Point, WI 54481 Sentry MPN Insurer 03/24/2005 www.Sentry.com

1585

Sequoia Insurance Company 31 Upper Ragsdale Dr Monterey, CA 93940 Broadspire MPN Insurer 01/26/2010 T

1700

Sequoia Insurance Company 31 Upper Ragsdale Dr. Monterey, CA 93940 Sequoia Signature MPN Insurer 10/04/2010 T

2090

Sequoia Insurance Company 31 Upper Ragsdale Drive Monterey, CA 93940 Sedgwick/Harbor MPN Insurer 12/12/2012 T

2212

Sequoia Insurance Company 31 Upper Ragsdale Drive Monterey, CA 93940 Medex MPN Insurer 08/19/2013 T





159


Applicant Date of


Approval Status *

0449

Seven-Up Bottling Co. of San Francisco 1981 N. Broadway, Suite 215 Walnut Creek, CA 94596

CorVel HCO/CorVel HCO Select as CorVel MPN


1184

Seven-Up/RC Bottling Company of So. California 3220 East 26th Street Vernon, CA 90023 CorVel HCO


0414

Seven-Up/RC Bottling Company of Southern California, Inc. 3220 East 26th Street Los Angeles, CA 90023 Medex


1508

Shasta-Trinity Schools Insurance Group JPA 6724 Lockheed Dr Ste 3A Redding, CA 96002

Shasta-Trinity Schools Insurance Group JPA MPN


0935

Shasta-Trinity Schools Insurance Group 6724 Lockheed Drive Ste 3A Redding, CA 96002 CorVel MPN/ Shasta-Trinity Schools/LWP


0792

SIGNAL I Joint Powers Authority Insurance Group c/o Mendocino COE-2240 Eastside Road Ukiah, CA 95482 Prime Advantage Medical Network


2451

Signature Networks PLUS, Inc. 1501 E. Orangethorpe Ave, #150 Fullerton, CA 92831 Prime Health Services Inc MPN

Entity that provides physician network services 02/18/2016 www.PrimeHealthServicesIncMPN.com

2452

Signature Networks PLUS, Inc. 1501 E. Orangethorpe Ave, #150 Fullerton, CA 92831 Prime Health Services MPN

Entity that provides physician network services 02/18/2016 www.PrimeHealthServicesMPN.com

2468

Signature Networks PLUS, Inc. 1501 E. Orangethorpe Ave, #150 Fullerton, CA 92831 Signature Networks PLUS Sterling MPN

Entity that provides physician network services 05/05/2016 www.snpsterlingmpn.com

2469

Signature Networks PLUS, Inc. 1501 E. Orangethorpe Ave, #150 Fullerton, CA 92831 Signature Networks PLUS Golden MPN

Entity that provides physician network services 05/05/2016 www.snpgoldenmpn.com





160


Applicant Date of


Approval Status *

1882

Silver Valley Unified School District 35320 Daggett-Yermo Road, PO Box 847 Yermo, CA 92398 PRIME Advantage Medical Provider Network


1204

Simi Valley Unified School District 875 E. Cochran St. Simi Valley, CA 93065 WellComp Medical Provider Network


0064

Simpson Manufacturing Company, Inc. 5956 W. Las Positas Blvd. Pleasanton, CA 94588



0825

SKB Corporation 434 W. Levers Place Orange, CA 92867 TRISTAR MPN Insurer 05/03/2005 T

0818

Small Cities Organized Risk Effort, A California Public Entity 2933 Gold Pan Court, Suite E Rancho Cordova, CA 95670 InterPlan/Kaiser


0581

Smart & Final, Inc. 600 Citadel Drive Commerce, CA 90040



1807

Smurfit-Stone Container Corporation 6 City Place Dr Creve Coeur, MO 63141 Broadspire Signature MPN


1194

Solano Concrete Corporation 1501 Belvedere Road West Palm Beach, FL 33406 CorVel HCO


0636

Solano County 675 Texas Street Courthouse Fairfield, CA 94533 Interplan/Kaiser


0011

Solar Turbines Incorporated PO Box 85376 San Diego, CA 92186 Solar Medical Provider Network ("SMPN")


3077

Sompo America Insurance Company 11405 N Community House Rd Suite 600 Charlotte, NC 28277

Sompo/Global Risk Solutions GBMCS KOJ MPN Insurer 12/19/2017 www.talispoint.com/cvty/gbkoj

1688

SOMPO JAPAN FIRE & MARINE INSURANCE COMPANY OF AMERICA 11405 N. Community House Road, Ste. 600 Charlotte, NC 28277 Broadspire Signature MPN Insurer 08/19/2010 T





161


Applicant Date of


Approval Status *

1306

Sompo Japan Ins. Co. of America Two World Financial Center, 43rd Floor, 225 Liberty Street New York, NY 10281 Broadspire MPN Insurer 10/09/2007 T

1687

Sompo Japan Insurance Company Of America 2 WFC 43rd Flr 225 Liberty St New York, NY 10281 Broadspire Signature Network Insurer 08/19/2010 T

0495

Sompo Japan Insurance Company of America 225 Liberty Street, 43rd Floor New York, NY 10281 Sompo - Crawford Primary Insurer 06/16/2005 T

0496

Sompo Japan Insurance Company of America 225 Liberty Street, 43rd Floor New York, NY 10281 Sompo - Crawford Select Insurer 06/16/2005 W

0330

Sompo Japan Two World Financial Center, 43rd Floor 225 Liberty Street New York City, NY 10281 CorVel MPN Insurer 03/07/2005 T

2417

Sony Electronics Inc. 16530 Via Esprillo San Diego, CA 92127 Athens MPN

Self-Insured Employer 11/06/2015 www.medexhco.com

1108

Sony Electronics Inc., San Diego 16530 Via Esprillo San Diego, CA 92127


1521

South Bay Union School District 601 Elm Ave Imperial Beach, CA 91932 PRIME Advantage Medical Provider Network


0223

South Orange County Community College District 28000 Marguerite Parkway Mission Viejo, CA 92692 Prime Advantage Medical Network


0020

Southern California Edison Company PO Box 5038 Rosemead, CA 91770 SCE Select

Self-Insured Employer 12/30/2004 www.talispoint.com/sce/external

1694

Southern California Permanente Medical Group (a partnership) 1800 Harrison St, 20th Floor Oakland, CA 94612 Kaiser Permanente/Harbor Net MPN






162


Applicant Date of


Approval Status *

0977

Southern California Permanente Medical Group 1800 Harrison St., 20th Floor Oakland, CA 94612 Kaiser Permanente MPN


1704

Southern California Presbyterian Homes 516 Burchett St. Glendale, CA 91203 SCPH MPN

Self-Insured Employer 11/04/2010 scph.employermpn.com T

1152

Southern California Presbyterian Homes 516 Burchett Street Glendale, CA 91203 PRIME Advantage Medical Provider Network


1703

Southern Insurance Company 5525 LBJ Freeway Dallas, TX 75240 Athens MPN Insurer 09/29/2010 www.medexhco.com W

1797

Southern Insurance Company 5525 LBJ Freeway Dallas, TX 75240 CorVel MPN Insurer 03/10/2011 W

1825

Southern Insurance Company 5525 LBJ Freeway Dallas, TX 75240 Southern Insurance Company GBMCS MPN Insurer 05/03/2011 T

1929

Southern Insurance Company 5525 LBJ Freeway Dallas, TX 75240

Southern Insurance Company/US Administrator Claims/First Health Select Insurer 05/15/2012 T

1930

Southern Insurance Company 5525 LBJ Freeway Dallas, TX 75240

Southern Insurance Company/US Administrator Claims/First Health Primary Insurer 05/15/2012 T

2260

Southern Insurance Company P O Box 809076 Dallas, TX 75380 The Rising MPN Insurer 01/09/2014 http://midwest.risingms.com/ T

2224

Southern Insurance Company P.O. Box 809076 Dallas, TX 75380 The Rising Medical Solutions MPN Insurer 12/20/2013 T

1396

Southern Insurance Company P.O. Box 809076 Dallas, TX 75380-0976 Rising MPN Insurer 09/11/2008 https://www.markelfirstcomp.com/injured-workers T

0964

Southwest Gas Corporation PO Box 98510 Las Vegas, NV 89193 TRISTAR MPN






163


Applicant Date of


Approval Status *

0199

Southwestern Community College District 900 Otay Lakes Road Chula Vista, CA 91910 Prime Advantage Medical Network


2384

Space Exploration Technologies Corp. 1 Rocket Road Hawthorne, CA 90250 CorVel MPN


1786

Sparta American Insurance Company 185 Asylum St - City Plaza II Hartford, CT 06103 Wellcomp Medical Provider Network Insurer 02/24/2011 T

1787

Sparta American Insurance Company 185 Asylum St - City Plaza II Hartford, CT 06103 Wellcomp Medical Provider Network Insurer 05/24/2011 T

1765

SPARTA American Insurance Company City Place II 185 Asylum St Hartford, CT 06103 Sedgwick CMS MPN Insurer 02/02/2011 T

1749

SPARTA American Insurance Company City Place II 185 Asylum St. Hartford, CT 06103


1755

SPARTA American Insurance Company City Place II 185 Asylum St. Hartford, CT 06103 CorVel MPN Insurer 01/12/2011 T

1752

SPARTA American Insurance Company City Place II, 185 Asylum St. Hartford, CT 06103

SPARTA American/Gallagher Bassett/First Health MPN Insurer 01/12/2011 T

1754

SPARTA American Insurance Company City Place II, 185 Asylum St. Hartford, CT 06103 SPARTA American GBMCS MPN Insurer 01/12/2011 T

1767

SPARTA American Insurance Company City Place II, 185 Asylum St. Hartford, CT 06103 Sedgwick CMS Extended MPN Insurer 02/02/2011 T

1753

SPARTA American Insurance Company City Place II, 185 Asylum St. Hartford, CT 06103

SPARTA American/Gallagher Bassett/Coventry MPN Insurer 02/24/2011 T

1813

SPARTA American Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103 The ACM/SPARTA MPN Insurer 04/12/2011 http://mpn.acmclaims.com/sparta T





164


Applicant Date of


Approval Status *

1527

Sparta Insurance Company 185 Asylum St City Plaza II Hartford, CT 06103 WellComp Medical Provider Network Insurer 05/08/2009 T

1488

Sparta Insurance Company 185 Asylum Street City Plaza II Hartford, CT 06103 WellComp Medical Provider Network Insurer 01/27/2009 T

1435

Sparta Insurance Company 185 Asylum Street Philadelphia, PA 19106 SPARTA GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn T

1586

SPARTA Insurance Company City Place II 185 Asylum St Hartford, CT 06103 Sedgwick CMS MPN Insurer 02/10/2010 T

1587

SPARTA Insurance Company City Place II 185 Asylum St Hartford, CT 06103 Sedgwick CMS Extended MPN Insurer 02/10/2010 T

1341

SPARTA Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103

SPARTA Insurance Company/Gallagher Bassett/Coventry MPN Insurer 03/18/2008 T

1342

SPARTA Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103

SPARTA Insurance Company/Gallagher Bassett/First Health MPN Insurer 03/18/2008 T

1371

SPARTA Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103 Prudent Buyer HCO Insurer 09/19/2008 W

1599

Sparta Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103 CorVel MPN Insurer 03/01/2010 www.corvel.com

1814

SPARTA Insurance Company City Place II, 185 Asylum Street Hartford, CT 06103 The ACM/SPARTA MPN Insurer 04/12/2011 http://mpn.acmclaims.com/sparta T

1601

Special District Risk Management Authority 1112 I St., Ste 300 Sacramento, CA 95814 WellComp Medical Provider Network


0848

Special District Risk Management Authority 1112 I Street Suite 300 Sacramento, CA 95814 Interplan/Kaiser MPN


0045

Springfield Insurance Company 874 S. Village Oaks Drive Covina, CA 91724 Unified Grocery Employers Insurer 01/11/2005 T





165


Applicant Date of


Approval Status *

0588

SSA Containers, Inc. 1131 S.W. Klickitat Way Seattle, WA 98134 CorVel MPN


1040

St. Paul Fire and Casualty Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Fire and Casualty Insurance Company, Crawford Primary Insurer 09/28/2005 W

1046

St. Paul Fire and Casualty Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Fire and Casualty Insurance Company, Crawford Select Insurer 09/28/2005 W

0604

St. Paul Fire and Marine Insurance Co. 385 Washington St. St. Paul, MN 55102

The Hartford/SRS- First Health CompAmerica SM Primary (or "First Health Primary") Insurer 03/29/2005 T

1728

St. Paul Fire And Marine Insurance Company 1 Tower Square, Mail Stop 12 Hartford, CT 06183 Broadspire Signature MPN Insurer 12/21/2010 T

0253

St. Paul Fire and Marine Insurance Company 385 Washington St. St. Paul, MN 55102 FOCUS Astrasano HCO Insurer 03/17/2005 W

0601

St. Paul Fire and Marine Insurance Company 385 Washington St. St. Paul, MN 55102

The Hartford/SRS- First Health CompAmerica SM Select HCO Network (or "First Health Select") Insurer 03/29/2005 W

0644

St. Paul Fire and Marine Insurance Company 385 Washington St. St. Paul, MN 55102 Broadspire MPN Insurer 03/29/2005 T

1028

St. Paul Fire and Marine Insurance Company 385 Washington St. St. Paul, MN 55102 St. Paul Fire and Marine Cambridge MPN Insurer 08/09/2005 T

1045


St. Paul Fire and Marine Insurance Company, Crawford Select Insurer 09/28/2005 W

1047


St. Paul Fire and Marine Insurance Company, Crawford Primary Insurer 09/28/2005 W

0632

St. Paul Fire and Marine Insurance Company 387 Washington St. St. Paul, MN 55102 Travelers ESIS MPN Insurer 03/28/2005 T

0254

St. Paul Fire and Marine Insurance Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T





166


Applicant Date of


Approval Status *

1727

St. Paul Guardian Insurance Company 1 Tower Square, Mail Stop 12 Hartford, CT 06183 Broadspire Signature MPN Insurer 12/21/2010 T

0602

St. Paul Guardian Insurance Company 385 Washington St. St. Paul, MN 55102

The Hartford/SRS- First Health CompAmerica SM Select HCO Network (or "First Health Select") Insurer 03/29/2005 T

0603

St. Paul Guardian Insurance Company 385 Washington St. St. Paul, MN 55102

The Hartford/SRS- First Health CompAmerica SM Primary (or "First Health Primary") Insurer 03/29/2005 T

0940

St. Paul Guardian Insurance Company 385 Washington St. St. Paul, MN 55102 Broadspire MPN Insurer 07/07/2005 T

1030

St. Paul Guardian Insurance Company 385 Washington St. St. Paul, MN 55102 St. Paul Guardian Cambridge MPN Insurer 08/09/2005 W

0622

St. Paul Guardian Insurance Company 386 Washington St. St. Paul, MN 55102 St. Paul Travelers ESIS MPN Insurer 03/28/2005 T

0256

St. Paul Guardian Insurance Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

0258

St. Paul Medical Liability Insurance Company One Tower Square, MS05A Hartford, CT 06183 First Health CompAmerica Select Insurer 03/17/2005 W

0624

St. Paul Mercury Insurance Company 385 Washington St. St. Paul, MN 55102 St. Paul ESIS MPN Insurer 03/28/2005 T

1043

St. Paul Mercury Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Mercury Insurance Company, Crawford Select Insurer 09/28/2005 W

1044

St. Paul Mercury Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Mercury Insurance Company, Crawford Primary Insurer 09/28/2005 W

0255

St. Paul Mercury Insurance Company One Tower Sq, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T





167


Applicant Date of


Approval Status *

1041

St. Paul Property and Casualty Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Property and Casualty Insurance Company, Crawford Select Insurer 09/28/2005 W

1042

St. Paul Property and Casualty Insurance Company 385 Washington St. St. Paul, MN 55102

St. Paul Property and Casualty Insurance Company, Crawford Primary Insurer 09/28/2005 W

0616

St. Paul Protective Insurance Company 385 Washington St. St. Paul, MN 55102 St. Paul Travelers Network Insurer 04/08/2005 T

0263

St. Paul Protective Insurance Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

0347

Stanley Works 1000 Stanley Drive New Britain, CT 06053



0561

Star Insurance Company 26255 American Drive Southfield, MI 48034 Star/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

1538

Star Insurance Company P.O. Box 2054 Southfield, MI 48037 Rising Interplan MPN Insurer 07/28/2009 T

1848

Star Insurance Company PO Box 2054 Southfield, MI 48037 Star Insurance Co. - Harbor-HealthSmart MPN Insurer 06/17/2011 www.harborsys.com/meadowbrook T

2159

Star Transport L.L.C. 9500 S. De Wolf Ave Selma, CA 93622 Risico TMC Star Transport MPN


2087

StarNet Insurance Company 9797 Aero Drive, Suite 200 San Diego, CA 92123 Preferred Select MPN Insurer 01/10/2013 www.peiwc.com

1921

Starr Indemnity & Liability Company 399 Park Ave New York, NY 10022 STARR INDEMNITY/GBMCS Insurer 05/02/2012 T

3009

Starr Indemnity & Liability Company 399 Park Ave. New York, NY 10022 CorVel MPN Insurer 01/09/2017 www.corvel.com





168


Applicant Date of


Approval Status *

2049

Starr Indemnity & Liability Company 399 Park Ave., 8th Floor New York, NY 10022 WellComp Medical Provider Network Insurer 09/14/2012 T

2280

Starr Indemnity & Liability Company 399 Park Avenue, 8th floor New York, NY 10022 Sedgwick/Harbor MPN Insurer 01/30/2014 www.harborsys.com/Sedgwick T

2281

Starr Indemnity & Liability Company 399 Park Avenue, 8th Floor New York, NY 10022 Sedgwick/Harbor 2 MPN Insurer 01/30/2014 www.harborsys.com/Sedgwick2 T

2178

Starr Indemnity and Liability Company 399 Park Avenue 24th Floor New York, NY 10022 Broadspire Signature MPN Insurer 06/18/2013 T

2288

Starstone National Insurance Company Harborside Financial Ctr, Plaza 5 Ste. 2600 Jersey City, NJ 07311 Starstone MPN Insurer 05/13/2014 www.paladinmc.com T

0104

State Compensation Insurance Fund 333 Bush St., 8th Floor San Francisco, CA 94104 State Fund Medical Provider Network Insurer 01/20/2005 T

0612

State Compensation Insurance Fund 333 Bush St., 8th Floor San Francisco, CA 94104 State Fund Medical Provider Network State 06/09/2005 T

2133

State National Insurance Company, Inc 1900 L. Don Dodson Drive Bedford, TX 76021

WellComp Medical Provider Network (SNIC/Plymouth MPN) Insurer 03/29/2013 T

1927

State National Insurance Company, Inc. 1900 L Don Dodson Drive Bedford, TX 76021

SNIC/US Administrator Claims/First Health Select Insurer 05/31/2012 www.usadminclaims.com/workers-compensation.aspx

1931

State National Insurance Company, Inc. 1900 L Don Dodson Drive Bedford, TX 76021

SNIC/US Administrator Claims/First Health Primary Insurer 05/31/2012 T

3011

State National Insurance Company, Inc. 1900 L. Dodson Drive Bedford, TX 76021

State National Insurance Company GBMCS KOJ MPN Insurer 02/23/2017 http://www.talispoint.com/cvty/gbkoj

0325

State Of California 1515 S Street, North Building Suite 400 Sacramento, CA 95811 State Fund Medical Provider Network State 08/29/2005 T

0436

Steadfast Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T





169


Applicant Date of


Approval Status *

0835

Steadfast Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0813

Stockton Unified School District 55 South Madison Street Stockton, CA 95203 San Joaquin MPN


2204

Stonington Insurance Company 5801 Tennyson Pkwy, Ste. 600 Plano, TX 75024 CorVel MPN Insurer 07/15/2013 T

1957

Stonington Insurance Company 5801 Tennyson Parkway, Ste. 600 Plano, TX 75024 Stonington Insurance Company GBMCS MPN Insurer 05/02/2012 T

2145

Stonington Insurance Company 5801 Tennyson Parkway, Suite 600 Plano, TX 75024 Sedgwick CMS Extended MPN Insurer 03/29/2013 T

2162

Stonington Insurance Company 5801 Tennyson Parkway, Suite 600 Plano, TX 75024 Sedgwick/ Harbor MPN Insurer 05/06/2013 T

2163

Stonington Insurance Company 5801 Tennyson Parkway, Suite 600 Plano, TX 75024 Sedgwick/Harbor 2 MPN Insurer 05/10/2013 T

1562

Sulphur Springs Union School District 27000 Weyerhaeuser Way Canyon Country, CA 91351 PRIME Advantage Medical Provider Network


1331

Sun Valley Group 3160 Upper Bay Road Arcata, CA 95521 WellComp Medical Provider Network


0880

Sunline Transit Agency 32-505 Harry Oliver Trail Thousand Palms, CA 92276 TRISTAR-CompAmerica Primary HCO


0884

Superior Ready Mix Concrete, L.P. 1508 W. Mission Road Escondido, CA 92029 Tristar MPN


1611

Sussex Insurance Company 221 Dawson Road Columbia, SC 29223 Sussex MPN Insurer 03/25/2010 www.talispoint.com/intermed/sussexmpn T

2010

Sutter Central Valley Hospitals 1800 Coffee Rd. Suite 116 Modesto, CA 95355






170


Applicant Date of


Approval Status *

0693

Sutter Tracy Community Hospital (STCH) 1420 N. Tracy Blvd. Tracy, CA 95376 Medical Partners @ Work (MPN)


3070

Swift Transportation Co. Of Arizona, LLC 2200 S 75th Avenue Phoenix, AZ 85043 CorVel MPN


3071

Swift Transportation Services, LLC 2200 S 75th Avenue Phoenix, AZ 85043 CorVel MPN


0957

T&R Painting and Drywall 7116 Valjean Ave. Van Nuys, CA 91406 CorVel MPN


0582

Target Corporation 1000 Nicollet Mall, TPN 1301 Minneapolis, MN 55403 Target Medical Provider Network


1537

Target Corporation 1000 Nicollet Mall, TPN 1301 Minneapolis, MN 55403 Sedgwick CMS/Harbor Net-Target


0775

Tarzana Treatment Centers, Inc. 18646 Oxnard St Tarzana, CA 91356 Tarzana/Concentra MPN


3121

TBC-The Boring Company 12200 Crenshaw Blvd. Hawthorne, CA 90250 CorVel MPN


1840

Technology Insurance Company, Inc 59 Maiden Lane, 6th Floor New York, NY 10038 Medex MPN Insurer 06/01/2011 T

2132

Technology Insurance Company, Inc 98 Spit Brook Road, Suite #402 Nashua, NH 03062 Sedgwick CMS Medical Provider Network Insurer 04/18/2013 T

2320

Teichert Land Co. 3500 American River Dr. Sacramento, CA 95851 WellComp Medical Provider Network


2326

Teichert Pipelines, Inc. 3500 American River Dr Sacramento, CA 95851 WellComp Medical Provider Network


2321

Teichert, Inc. 3500 American River Dr. Sacramento, CA 95851 WellComp Medical Provider Network






171


Applicant Date of


Approval Status *

2033

Temecula Valley Unified School District 31350 Rancho Vista Rd. Temecula, CA 92592 Athens MPN


0545

Tenet Healthcare Corporation 13737 Noel Road Ste 100 Dallas, TX 75240



2150

Tenet Healthcare Corporation 1445 Ross Ave., Suite 1400 Dallas, TX 75202 Sedgwick/Harbor MPN - Tenet


1675

Textron Inc. 40 Westminster St, 14th Floor Providence, RI 02903 Broadspire Signature MPN


0192

Textron, Inc. 40 Westminster 21st Floor Providence, RI 02903 Broadspire MPN


1123

The 99 Cents Only Stores 4000 E. Union Pacific Ave. City of Commerce, CA 90025 The 99 Cents Only Stores MPN


0276

The American Insurance Company 33 W. Monroe Street, Ste 1100 Chicago, IL 60603 The American Insurance Company ESIS MPN Insurer 02/01/2005 T

0618

The American Insurance Company 777 San Marin Dr. Novato, CA 94998 First Health Select Insurer 02/14/2005 www.agcs.allianz.com/usclaims T

1428

The American Insurance Company 777 San Marin Drive Novato, CA 94998 Sedgwick CMS MPN Insurer 11/10/2008 T

1429

The American Insurance Company 777 San Marin Drive Novato, CA 94998 Sedgwick CMS Extended MPN Insurer 11/10/2008 T

1642

The American National Red Cross 2025 E. St. NW-RiskMgmt 3rd Flr Washington, DC 20006 Sedgwick CMS MPN


0698

The American Red Cross 2025 E. St, NW, Risk Management Div., 7th Fl. Washington, DC 20006 CA Red Cross MPN






172


Applicant Date of


Approval Status *

1271

The Cities Group P.O. Box 111 Burlingame, CA 94011 The Cities Group


1070

The Cities Group PO Box 111 Burlingame, CA 94011 The Cities Group Medical Provider Network


1231

The City of Redding 777 Cypress Ave Redding, CA 96001 City of Redding/CorVel MPN


1769

The Continental Insurance Company 333 South Wabash Avenue Chicago, IL 60604 Broadspire Signature MPN Insurer 02/02/2011 T

0096

The County of Fresno 2220 Tulare Street, 21st Floor Fresno, CA 93721 Status MPN - County of Fresno


0025

The County of Riverside PO Box 1120 Riverside, CA 92502 First Health Comp America Select


1803

The Dentists Insurance Company 1201 K Street, 17th Floor Sacramento, CA 95814 Sedgwick CMS Extended MPN Insurer 03/15/2011 T

3046

The Eggo Company One Kellogg Square Battle Creek, MI 49017 CorVel MPN


0048

The Explorer Insurance Company 11455 El Camino Real San Diego, CA 92130 Medex MPN Insurer 12/03/2004 T

1981

The Explorer Insurance Company 11455 El Camino Real San Diego, CA 91230 ICW Group Premier MPN Insurer 05/25/2012 T

0087

The First Liberty Insurance Corporation 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

1820

The Hanover American Insurance Company 440 Lincoln Street Worcester, MA 01615 CorVel/Kaiser Select MPN Insurer 04/22/2011 www.Corvel.com

1816

The Hanover Insurance Company 440 Lincoln St Worcester, MA 01615 CorVel/Kaiser Select MPN Insurer 04/22/2011 www.corvel.com





173


Applicant Date of


Approval Status *

1588

The Hanover Insurance Company 440 Lincoln St. Worcester, MA 01615 First Health Select MPN Insurer 01/20/2010 T

1785

The Harker School 3800 Blackford Ave. San Jose, CA 95117 WellComp Medical Provider Network


0028

The Herrick Corporation 3003 E. Hammer Lane Stockton, CA 95212 First Health CompAmerica Select HCO


1343

The Hershey Company 100 Crystal A Drive Hershey, PA 17033 Sedgwick CMS CA MPN


0978

The HON Company 2323 E. Firestone Blvd. South Gate, CA 90280 Interplan through CompPartners


1378

The HON Company 2323 East Firestone Blvd. South Gate, CA 90028

First Health CompAmerica Primary HCO Network


1417

The Hon Company 408 East Second Street Muscatine, IA 52761



0629

The Insurance Company of the State of Pennsylvania 175 Water St - 18th Flr. New York, NY 10038

Ins Co of ST of PA/Longs Drug Stores/Bunch MPN Insurer 07/19/2005 T

1959

The Insurance Company of the State of Pennsylvania 175 Water St - 18th Flr. New York, NY 10038 Liberty Mutual Group MPN Insurer 05/16/2012 T

1641

The Insurance Company Of The State Of Pennsylvania 175 Water St 18th Flr New York, NY 10038 Broadspire Signature MPN Insurer 05/26/2010 www.broadspireppo.com T

0580

The Insurance Company of the State of Pennsylvania 175 Water St New York, NY 10038 Chartis-Cambridge MPN Insurer 03/24/2005 W





174


Applicant Date of


Approval Status *

0118

The Insurance Company Of The State Of Pennsylvania 175 Water Street - 18th Floor NY, NY 10038 AIG Primary MPN Insurer 02/17/2005 www.talispoint.com/aig/com

0654

The Insurance Company of the State of Pennsylvania 175 Water Street 18th Floor New York, NY 10038

The Insurance Company of the State of Pennsylvania/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 www.talispoint.com/cvty/gbcvtympn T

0365

The Insurance Company of the State of Pennsylvania 175 Water Street - 18th Floor New York, NY 10038


0369

The Insurance Company of the State of Pennsylvania 175 Water Street - 18th Floor New York, NY 10038


0617

The Insurance Company of the State of Pennsylvania 175 Water Street, 18th Floor New York, NY 10038 AIG ESIS MPN Insurer 03/28/2005 T

0522

The Insurance Company of the State of Pennsylvania 175 Water Street, 18th Floor New York, NY 10038 TCT CA MPN Insurer 04/12/2005 www.mywcinfo.com T

0761

The Insurance Company Of The State Of Pennsylvania 175 Water Street 18th Fl New York, NY 10038

The Insurance Company Of The State Of Pennsylvania/Gallagher Bassett/CorVel MPN Insurer 05/05/2005 www.corvel.com

1022

The Insurance Company of the State of Pennsylvania 175 Water Street, 18th Floor New York, NY 10038

The Insurance Company of the State of Pennsylvania/Gallagher Bassett/First Health MPN Insurer 08/05/2005 www.talispoint.com/cvty/gbfhmpnselect T

0869

The Insurance Company Of The State Of Pennsylvania 175 Water Street, 18th Floor NY, NY 10038 Chartis/Northrop Grumman MPN Insurer 09/23/2005 www.talispoint.com/chartis/norgr





175


Applicant Date of


Approval Status *

1318

The Insurance Company of the State of Pennsylvania 175 Water Street, 17th Floor New York, NY 10038 Medex B Insurer 09/06/2007 T

1319

The Insurance Company of the State of Pennsylvania 175 Water Street, 17th Floor New York, NY 10038 Medex MPN Insurer 09/06/2007 T

1403

The Insurance Company Of The State Of Pennsylvania 175 Water Street - 18th Floor New York, NY 10038 CorVel MPN Insurer 08/06/2008 www.corvel.com

1492

The Insurance Company of the State of Pennsylvania 175 Water Street, 18th Floor New York, NY 10038 Wellcomp Medical Provider Network Insurer 01/30/2009 T

1519

The Insurance Company Of The State Of Pennsylvania 175 Water Street 18th Floor New York, NY 10038 Walmart-Medex ISOPO MPN Insurer 04/01/2009 www.medexhco.com T

1451

The Insurance Company of the State of Pennsylvania 175 Water Street, 18th Floor New York, NY 10038

The Insurance Company of the State of Pennsylvania GBMCS MPN Insurer 05/07/2009 www.talispoint.com/cvty/gbmpn T

1761

The Insurance Company Of The State Of Pennsylvania 175 Water Street, 18th Floor NY, NY 10038 AIG Select MPN Insurer 01/19/2011 www.talispoint.com/aig/mpnselect

1977

The Insurance Company of the State of Pennsylvania 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor MPN Insurer 05/25/2012 T

1985

The Insurance Company of the State of Pennsylvania 175 Water Street – 18th Floor New York, NY 10038 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T





176


Applicant Date of


Approval Status *

2347

The Insurance Company Of The State Of Pennsylvania 175 Water Street -18th Floor New York, NY 10038 Deseret Signature MPN

Entity that provides physician network services 09/25/2014 www.deseretsignaturempn.com

2418

The Insurance Company Of The State Of Pennsylvania 175 Water Street, 18th Floor NY, NY 10038 Chartis/EP MPN Insurer 10/30/2015 www.talispoint.com/aig/EP

1298

The Insurance Company of the State of Pennsylvania 300 S. Riverside Plaza Chicago, IL 60606 Medex Insurer 07/09/2007 W

1425

The Insurance Company of the State of Pennsylvania 70 Pine St New York, NY 10270


0504

The Insurance Company of the State of Pennsylvania 70 Pine Street New York, NY 10270


0494

The Insurance Company of the State of Pennsylvania 70 Pine Street New York, NY 10270 Sedgwick CMS Medical Provider Network Insurer 03/16/2005 T

0468

The Insurance Company of the State of Pennsylvania 70 Pine Street New York, NY 10270 Broadspire MPN Insurer 04/26/2005 T

0917


Medinsights Medical Provider Network accessing Prudent Buyer PPO Insurer 05/19/2005 T

0613

The Insurance Company of the State of Pennsylvania 70 Pine Street New York, NY 10270 INTRACORP-Gates McDonald MPN Insurer 06/02/2005 T





177


Applicant Date of


Approval Status *

0863


The Insurance Company of the State of Pennsylvania, Crawford Select Insurer 10/05/2005 W

1524

The Insurance Company of the State of Pennsylvania 70 Pine Street New York, NY 10270 Athens/Insurance Co. of PA MPN Insurer 05/06/2009 T

0395

The Insurance Company of the State of Pennsylvania 80 Pine Street, 10th Floor New York, NY 10005 ESIS INTRACORP Insurer 04/29/2005 T

0853

The Insurance Company of the State of Pennsylvania AIG 70 Pine Street New York, NY 10270

The Insurance Company of the State of Pennsylvania-Crawford Primary Insurer 07/01/2005 W

2333

The Kroger Co. 1014 Vine Street Cincinnati, OH 45202 Sedgwick/Harbor MPN - Kroger

Self-Insured Employer 09/05/2014 www.harborsys.com/kroger T

1534

The Kroger Co. P.O. Box 54143 Los Angeles, CA 90054 CorVel/Kroger Select MPN


0286

The Kroger Company PO Box 54143 Los Angeles, CA 90054 CorVel MPN/Kroger


1556

The Netherlands Insurance Company 62 Maple Ave Keene, NH 03431 Liberty Mutual Group MPN Insurer 06/29/2009 T

1210

The North River Insurance Company 110 William Street New York, NY 10038 Medex Insurer 06/12/2006 www.medexhco.com T

2240

The North River Insurance Company 1100 Town And Country Road, Ste. 550 Orange, CA 92868 Broadspire Signature MPN Insurer 11/19/2013 T

2250

The North River Insurance Company 305 Madison Ave Morristown, NJ 07962 Crum & Forster Primary MPN Insurer 12/06/2013 T





178


Applicant Date of


Approval Status *

2253

The North River Insurance Company 305 Madison Ave Morristown, NJ 07962 Crum & Forster Select MPN Insurer 12/06/2013 T

1310

The North River Insurance Company 305 Madison Ave. P.O. Box 1973 Morristown, NJ 07962 PRIME Advantage MPN for HealthCare Insurer 08/06/2007 T

1214

The North River Insurance Company 305 Madison Ave. Morristown, NJ 07962

GENEX HCO/First Health Comp America HCO Select Network Insurer 06/22/2006 T

0122

The North River Insurance Company 305 Madison Avenue Morristown, NJ 07962 Crum&Forster-Concentra MPN Insurer 12/20/2004 T

0993

The North River Insurance Company 305 Madison Avenue Morristown, NJ 07962 Concentra Broad Based Insurer 07/25/2005 T

1217

The North River Insurance Company 305 Madison Avenue Morristown, NJ 07962 GENEX/Interplan MPN Insurer 06/19/2006 T

1529

The North River Insurance Company 305 Madison Avenue Morristown, NJ 07962

First Health CompAmerica HCO Primary Network Insurer 05/12/2009 T

2368

The North River Insurance Company 305 Madison Avenue Morristown, NJ 07962 CorVel/C&F Select MPN Insurer 04/02/2015 www.corvel.com

3080

The Pep Boys Manny Moe & Jack Of California 3111 West Allegheny Avenue Philadelphia, PA 19132 CorVel MPN


1713

The Pep Boys Manny Moe and Jack of California 3111 W. Allegheny Ave. Philadelphia, PA 19132 TCT CA MPN

Self-Insured Employer 11/10/2010 www.mywcinfo.com T

1272

The Pictsweet Company 10 Pictsweet Drive Bells, TN 38006 Liberty Mutual Group MPN


2081

The Procter & Gamble Paper Products Company 6300 Center Hill Rd. Cincinnati, OH 45224 Sedgwick/Harbor 2 MPN






179


Applicant Date of


Approval Status *

2199

The Procter & Gamble Paper Products Company 6300 Center Hill Rd. Cincinnati, OH 45224 Sedgwick/ Harbor MPN - PG


2198

The Procter and Gamble Manufacturing Company 6300 Center Hill Rd. Cincinnati, OH 45224 Sedgwick/ Harbor MPN- PG


0874

The Roman Catholic Bishop of San Diego (a sole corporation) 3888 Paducah Drive San Diego, CA 92117 Tristar MPN


0513

The Salvation Army 180 E. Ocean Blvd. Long Beach, CA 90802 Red Shield MPN


0242

The Standard Fire Insurance Company (FH) One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

0241

The Standard Fire Insurance Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

0257

The Travelers Casualty Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/17/2005 www.mywcinfo.com T

3081

The Travelers Indemnity Company Of Connecticut One Tower Square Main South, 12 Hartford, CT 06183 CorVel MPN Insurer 01/09/2018 www.corvel.com

0234

The Travelers Indemnity Company of Connecticut One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

0233

The Travelers Indemnity Company of Connecticut One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T





180


Applicant Date of


Approval Status *

2493

The Travelers Indemnity Company One Tower Square, GS02A Hartford, CT 06183 TravNet MPN

Entity that provides physician network services 07/26/2016 www.mywcinfo.com

2443

The Travelers Indemnity Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 04/25/2016 www.mywcinfo.com T

0815

The Walt Disney Company 500 South Buena Vista St. Burbank, CA 91521 The Liberty Mutual Group MPN


2449

The Zurich Services Corporation 1299 Zurich Way 3W Schaumburg, IL 60196 ZSC Select MPN

Entity that provides physician network services 03/10/2016 www.zurichna.com

0544

Thomson, Inc. 10330 N. Meridian Street INH 330 Indianapolis, IN 46290



0699

Thor Industries West, Inc. 419 W. Pike Street Jackson Center, OH 45334 Thor Industries West, Inc. MPN


1236

TIMEC Holdings Inc. 2751 E. El Presidio St. Carson, CA 90810 Liberty Mutual Group MPN


1953

TNUS Insurance Company 230 Park Ave New York, NY 10169 Coventry MPN Insurer 05/02/2012 T

1954

TNUS Insurance Company 290 Park Ave. New York, NY 10169 First Health CompAmerica Select HCO Insurer 05/02/2012 T

1955

TNUS Insurance Company 499 Washington Blvd. Suite 1500 Jersey City, NJ 07310 Primary MPN Insurer 05/02/2012 www.coventrywcs.com

1966

TNUS Insurance Company 800 East Colorado Blvd., Ste. 600 Pasadena, CA 91101 Medex MPN Insurer 05/16/2012 T

1461

Tokio Marine & Nichido Fire Insurance Co Ltd 230 Park Ave New York, NY 10169 Sedgwick CMS MPN Insurer 11/10/2008 T





181


Applicant Date of


Approval Status *

1781

Tokio Marine & Nichido Fire Insurance Co., LTD 230 Park Ave. New York, NY 10169 TMNF-ESIS MPN Insurer 02/10/2011 T

1463

Tokio Marine & Nichido Fire Insurance Co., Ltd. 230 Park Ave New York, NY 10169 Sedgwick CMS Extended MPN Insurer 11/10/2008 T

1948

Tokio Marine & Nichido Fire Insurance Co., Ltd. 230 Park Ave New York, NY 10169 Coventry MPN Insurer 05/02/2012 T

0773

Tokio Marine & Nichido Fire Insurance Co., Ltd. 230 Park Avenue New York, NY 10169

First Health Comp America Primary HCO Network Insurer 04/28/2005 W

0774


Sedgwick First Health Comp America Select HCO Network Insurer 04/28/2005 T

0170



1949

Tokio Marine & Nichido Fire Insurance Co., Ltd. 290 Park Ave. New York, NY 10010 Primary MPN Insurer 05/02/2012 T

0333

Tokio Marine & Nichido Fire Insurance Co., Ltd. 800 East Colorado Blvd., Ste 600 Pasadena, CA 91101 Medex Insurer 02/12/2005 T

1301

Tokio Marine & Nichido Fire Insurance Co., Ltd. 8000 East Colorado Blvd., Ste 600 Pasadena, CA 91101 Medex Insurer 07/09/2007 T

2272

Tokio Marine America Insurance Company 230 Park Ave New York, NY 10169

Sedgwick First Health Comp America Select HCO Network Insurer 01/09/2014 www.talispoint.com/srs/login T





182


Applicant Date of


Approval Status *

2269

Tokio Marine America Insurance Company 230 Park Ave New York, NY 10169 Coventry MPN Insurer 01/10/2014 www.coventrywcs.com T

2270

Tokio Marine America Insurance Company 230 Park Ave New York, NY 10169

First Health CompAmerica Select HCO Network Insurer 01/10/2014 www.coventrywcs.com T

2273

Tokio Marine America Insurance Company 230 Park Ave New York, NY 10169 Sedgwick CMS Extended MPN Insurer 01/10/2014 www.coventrywcs.com T

2277

Tokio Marine America Insurance Company 230 Park Ave New York, NY 10169 TMAIC ESIS MPN Insurer 01/22/2014 http://www.esis.com/awcmpn T

2276

Tokio Marine America Insurance Company 230 Park Avenue New York, NY 10169 Medex MPN Insurer 01/10/2014 T

2271

Tokio Marine America Insurance Company 499 Washington Blvd. Suite 1500 Jersey City, NJ 07310 Primary MPN Insurer 01/10/2014 www.coventrywcs.com

0697

Topa Insurance Company PO Box 67810 Los Angeles, CA 90067 Topa Insurance Company/GENEX MPN Insurer 05/17/2005 www.genexservices.com T

1067

Torrance Health Associates, Inc. 3330 Lomita Blvd. Torrance, CA 90505



0277

Torrance Unified School District 2335 Plaza Del Amo Torrance, CA 90509 Prime Advantage Medical Network


1384

Tower Energy Group 1983 West 190th Street Torrance, CA 90504 CorVel MPN

Self-Insured Employer 06/24/2008 http://www.corvel.com/ T

1827

Tower Insurance Company of New York (DBA - Tower Select Insurance Company) 120 Broadway 31st Floor New York, NY 10271 ACM/Tower MPN Insurer 05/03/2011 http://mpn.acmclaims.com/zurich/ T

1393

Tower Insurance Company of New York dba Tower Select Insurance Company 777 E. Tahquitz Canyon Way Suite 200-27 Palm Springs, CA 92262 WellComp MPN Insurer 07/24/2008 T





183


Applicant Date of


Approval Status *

1499

Tower Insurance Company of New York dba Tower Select Insurance Company 777 E. Tahquitz Canyon Way Palm Springs, CA 92262 Tower Care MPN Insurer 04/03/2009 T

1333

Tower Insurance Company of New York 120 Broadway, 31st Floor New York, NY 10271 Rising Interplan MPN Insurer 12/28/2007 T

1630

Tower Select Insurance Company 120 Broadway, 31st Floor New York, NY 10271 Tower Group Companies MPN Insurer 05/20/2010 T

1951

Trans Pacific Insurance Company 230 Park Ave. New York, NY 10169 Coventry MPN Insurer 05/02/2012 T

1952

Trans Pacific Insurance Company 230 Park Ave. New York, NY 10169 First Health CompAmerica Select HCO Insurer 05/02/2012 T

0771

Trans Pacific Insurance Company 230 Park Avenue New York, NY 10169

First Health CompAmerica Primary HCO Network Insurer 04/28/2005 W

0772

Trans Pacific Insurance Company 230 Park Avenue New York, NY 10169

First Health Comp America Select HCO Network Insurer 04/28/2005 W

1950

Trans Pacific Insurance Company 499 Washington Blvd. Suite 1500 Jersey City, NJ 07310 Primary MPN Insurer 05/02/2012 www.coventrywcs.com

1967

Trans Pacific Insurance Company 800 East Colorado Blvd., Ste. 600 Pasadena, CA 91101 Medex MPN Insurer 05/16/2012 T

1771

Transportation Insurance Company 333 South Wabash Avenue Chicago, IL 60604 Broadspire Signature MPN Insurer 02/02/2011 T

0248

Travelers Casualty & Surety Company of America One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

0240

Travelers Casualty & Surety Company One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T





184


Applicant Date of


Approval Status *

0247

Travelers Casualty and Surety Company of America One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

0239

Travelers Casualty and Surety Company One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

0252

Travelers Casualty Company of Connecticut One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

0251

Travelers Casualty Company of Connecticut One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

2034

Travelers Casualty Insurance Company of America c/o Travelers National Accounts Unbundled, 5 Batterson Park Rd. Farmington, CT 06032

WellComp Medical Provider Network - (TRV-NAU-York) Insurer 08/30/2012 T

0244

Travelers Casualty Insurance Company of America One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 T

0243

Travelers Casualty Insurance Company of America One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

0249

Travelers Commercial Insurance Company One Tower Square Hartford, CT 06183 First Health CompAmerica Select Insurer 03/02/2005 W

0250

Travelers Commercial Insurance Company One Tower Square Hartford, CT 06183 CorVel CorCare Insurer 03/09/2005 W

1794

Travelers Property Casualty Company of America 5 Batterson Park Rd Farmington, CT 06032

Travelers Property Casualty Company of America/Gallagher Bassett/First Health MPN Insurer 03/10/2011 T





185


Applicant Date of


Approval Status *

1793

Travelers Property Casualty Company of America 5 Batterson Park Road Farmington, CT 06032

Travelers Property Casualty Company of America/Gallagher Bassett/Coventry MPN Insurer 03/15/2011 T

1868

Travelers Property Casualty Company of America 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Medical Provider Network Insurer 07/28/2011 T

1870



2109


Sedgwick/Harbor MPN-Travelers PCCA Express Insurer 01/15/2013 T

2121

Travelers Property Casualty Company of America 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor MPN Insurer 01/31/2013 T

2122

Travelers Property Casualty Company of America 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor 2 MPN Insurer 02/01/2013 T

1783

Travelers Property Casualty Company of America 5 Batterson Park Farmington, CT 06032 Travelers/Bunch/Barnes Group MPN Insurer 02/10/2011 T

1828

Travelers Property Casualty Company of America 5 Batterson Park Farmington, CT 06032 Discover Re/TIL/ESIS MPN Insurer 05/03/2011 T

1859

Travelers Property Casualty Company of America c/o Traveler's National Accounts Unbundled, 5 Batterson Park Rd. Farmington, CT 06032 Wellcomp Medical Provider Network Insurer 07/20/2011 T





186


Applicant Date of


Approval Status *

0236

Travelers Property Casualty Company Of America One Tower Square - Main South 12 Hartford, CT 06183 CorVel MPN Insurer 03/09/2005 www.corvel.com

1795

Travelers Property Casualty Company of America One Tower Square MS-12 Hartford, CT 06183

Travelers Property Casualty Company of America GBMCS MPN Insurer 03/10/2011 T

1925

Travelers Property Casualty Company of America One Tower Square MS-12 Hartford, CT 06183 Sedgwick/Harbor MPN-Travelers NAU UHG Insurer 03/20/2012 T

2442

Travelers Property Casualty Company of America One Tower Square MS-12 Hartford, CT 06183 MEDEX Advantage Plus Insurer 01/21/2016 www.medexhco.com

3039

Travelers Property Casualty Company Of America One Tower Square Main South, 12 Hartford, CT 06183 CorVel/Express MPN Insurer 06/29/2017 www.corvel.com

0235

Travelers Property Casualty Company of America One Tower Square, MS05A Hartford, CT 06183 TCT CA MPN Insurer 03/02/2005 www.mywcinfo.com T

1940

Travelers Property Casualty Company Of America One Tower Square, Mail Stop 12 Hartford, CT 06183 DRe TIL Broadspire Signature MPN Insurer 04/20/2012 T

2246

Travelers Property Casualty Company Of America One Towers Square Hartford, CT 06183 Coventry Medical Provider Network Insurer 04/18/2014 www.talispoint.com/cvty/matrix

0879

Tri-city Healthcare District 4002 Vista Way Oceanside, CA 92056 TRISTAR MPN


2400

Trindel Insurance Fund P.O.Box 2069 Weaverville, CA 96093 EIA Medical Provider Network

Joint Powers Authority 07/06/2015 www.eiampn.csac-eia.org





187


Applicant Date of


Approval Status *

2398

TRINET GROUP, INC 1100 San Leandro Blvd., Ste. 400 San Leandro, CA 94577 TRINET SOI MPN

Entity that provides physician network services 06/17/2016 https://www.risingms.com T

0110

Trinity Health Corporation 34605 W. Twelve Mile Farmington Hills, MI 48152 First Health CompAmerica Primary HCO


2502

TRISTAR Managed Care, Inc. P.O. Box 10220 Santa Ana, CA 92711 TRISTAR PLUS MPN

Entity that provides physician network services 08/25/2016 www.tristarmanagedcare.com

0312

Truck Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010

First Health CompAmerica Select HCO Network (First Health Select Network) Insurer 03/09/2005 T

0320

Truck Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010


1745

Truck Insurance Exchange 4680 Wilshire Blvd Los Angeles, CA 90010 Liberty Mutual Group MPN Insurer 06/16/2011 T

1595

Truck Insurance Exchange 6301 Owensmouth Ave. Woodland Hills, CA 91367 CorVel/Kaiser MPN Insurer 02/11/2010 www.corvel.com

2072

Trumbull Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

Trumbull Insurance Company utilizing First Health CompAmerica Primary HCO Network Insurer 11/15/2012 T

2073


Trumbull Insurance Company utilizing First Health CompAmerica Select HCO Network Insurer 11/15/2012 T

2074


Trumbull Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 11/15/2012 www.thehartford.com/ca-workers-compensation T

2155

Trumbull Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Trumbull Insurance Company GBMCS MPN Insurer 05/06/2013 T

2218

Trumbull Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 09/03/2013 T





188


Applicant Date of


Approval Status *

2219

Trumbull Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 09/03/2013 T

0203

Tulare County Schools Insurance Group Workers Compensation JPA 2637 West Burrel Visalia, CA 93291 Prime Advantage Medical Network


1176

Turlock Irrigation District 333 East Canal Drive Turlock, CA 95380 Turlock Irrigation District MPN

Self-Insured Employer 05/04/2006 secure.simon-companies.com/TID/

0713

Tustin Unified School District 300 South "C" Street Tustin, CA 92780 Prime Advantage Medical Network


1245

Twin City Fire Insurance Company 690 Asylum Ave Hartford, CT 06115 Frank Gates SVC Co/Hartford/Corvel MPN Insurer 09/29/2006 W

0065

Twin City Fire Insurance Company 690 Asylum Avenue Hartford, CT 06115


0066

Twin City Fire Insurance Company 690 Asylum Avenue Hartford, CT 06115


1135

Twin City Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155

Twin City Fire Insurance Company accessing Anthem Blue Cross Prudent Buyer PPO Insurer 03/17/2006 www.thehartford.com/ca-workers-compensation T

1934

Twin City Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155


1936

Twin City Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick CMS Insurer 04/18/2012 T

1972

Twin City Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor MPN Insurer 05/24/2012 T

1988

Twin City Fire Insurance Company One Hartford Plaza (HO-1-09) Hartford, CT 06155 Sedgwick/Harbor 2 MPN Insurer 05/29/2012 T





189


Applicant Date of


Approval Status *

1647

Twin City Fire Insurance Company One Hartford Plaza [HO 1-09] Hartford, CT 06155 Athens MPN-TCFIC Insurer 06/10/2010 www.medexhco.com T

1440

Twin City Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155

Wellcomp Medical Provider Network-York-TCFIC Insurer 01/20/2009 T

1609

Twin City Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 TCFIC Redwoods First Health CompAmerica Insurer 03/17/2010 T

1634

Twin City Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 TCFIC/ESIS MPN Insurer 06/20/2010 T

1956

Twin City Fire Insurance Company One Hartford Plaza [HO-1-09] Hartford, CT 06155 Twin City Fire GBMCS MPN Insurer 05/02/2012 T

1154

Twin City Fire Insurance Company One Hartford Plaza Hartford, CT 06155

Twin City Fire./Gallagher Bassett/Coventry MPN Insurer 03/20/2006 T

1636

Twin City Fire Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155

RISICO TMC Twin City Fire Insurance Company MPN Insurer 06/01/2010 www.risico.com

1853

Twin City Fire Insurance Company One Hartford Plaza, HO-1-09 Hartford, CT 06155 TCFIC/Broadspire Signature MPN Insurer 07/15/2011 T

1311

U.S. Fire Insurance Company 305 Madison Ave. P.O. Box 1973 Morristown, NJ 07962 PRIME Advantage MPN Insurer 08/06/2007 T

1213

U.S. Fire Insurance Company 305 Madison Ave. Morristown, NJ 07962

GENEX HCO/First Health Comp America HCO Select Network Insurer 06/22/2006 T

1772

U.S. Fire Insurance Company 305 Madison Ave. Morristown, NJ 07962 Broadspire Signature Network Insurer 02/02/2011 T

1216

U.S. Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962 GENEX/Interplan MPN Insurer 06/19/2006 T

1528

U.S. Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962

First Health CompAmerica HCO Primary Network Insurer 05/12/2009 T





190


Applicant Date of


Approval Status *

0660

U.S. Foodservice, Inc. 300 Lawrence Dr. Livermore, CA 94551 MedInsights/Prudent Buyer HCO


1315

Ulico Casualty Company PO Box 5131 Chino, CA 91708 Insurer 09/10/2007 T

1598

Ullico Casualty Company 1625 Eye St N.W. Washington, DC 20006 Athens MPN Insurer 01/25/2010 T

1922

Ullico Casualty Company 1625 Eye Street N.W. Washington, DC 20006 Medex MPN Insurer 03/15/2012 T

1575

Ullico Casualty Company 1625 Eye Street, NW Washington, DC 20006 Patriot Risk Services-Ullico Casualty MPN Insurer 02/17/2010 T

1379

ULLICO Casualty Company c/o Delaware Ins Dept, 704 N. King St., Ste. 602, Wilmington, DE 19801 ULLICO/Gallagher Bassett/Coventry MPN Insurer 08/05/2008 T

0050

United Airlines, Inc. PO Box 66100 Chicago, IL 60666 CorVel/UAL/Kaiser MPN


0801

United Cerebral Palsy of Los Angeles and Ventura Counties 1660 L St. NW Ste 700 Washington, DC 20036 UCPLA Cambridge MPN


1866

United Cerebral Palsy/Spastic Children's Foundation of Los Angeles and Ventura Counties 6430 Independence Avenue Woodland Hills, CA 91367



2242

United Cerebral Palsy/Spastic Children's Foundation of Los Angeles and Ventura Counties 6430 Independence Avenue Woodland Hills, CA 91367 WellComp Medical Provider Network


2038

United Rentals (North America), Inc. PO Box 4366 Modesto, CA 95352 Liberty Mutual Group MPN






191


Applicant Date of


Approval Status *

1498

United Rentals Inc. P.O. Box 4366 Modesto, CA 96352 United Rentals ESIS MPN


1681

United States Fidelity And Guaranty Company 1 Tower Square- MS 12 Hartford, CT 06183 Broadspire Signature Network/USF&G Insurer 08/18/2010 T

0400

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Discover Re Cambridge MPN Insurer 02/24/2005 T

0500

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Extended MPN Insurer 03/10/2005 T

0489

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick CMS Medical Provider Network Insurer 03/15/2005 T

0425

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0553

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032

SRS First Health CompAmerica Select HCO Network (or "SRS First Health Select") Insurer 03/22/2005 W

0554



0594

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Discover Re/USF&G/GAB-MedInsights Insurer 03/22/2005 T

0442



0809

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 CorVel MPN/USF&G/Frank Gates Insurer 05/18/2005 W

0829

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Intracorp - Dre GatesMcDonald MPN Insurer 06/02/2005 T

2113

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor MPN Insurer 02/01/2013 T





192


Applicant Date of


Approval Status *

2114

United States Fidelity and Guaranty Company 5 Batterson Park Road Farmington, CT 06032 Sedgwick/Harbor 2 MPN Insurer 02/01/2013 T

0190

United States Fidelity and Guaranty Company C/o Discover Re 5 Batterson Park Road Farmington, CT 06032 Discover Re ESIS MPN Insurer 02/02/2005 T

0878

United States Fidelity and Guaranty Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 First Health CompAmerica Primary HCO Insurer 05/03/2005 W

0665

United States Fidelity and Guaranty company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032

United States Fidelity and Guaranty Company-Crawford Select Insurer 06/16/2005 W

0968

United States Fidelity and Guaranty Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032

United States Fidelity and Guaranty Company - Crawford Primary Insurer 06/16/2005 W

1082

United States Fidelity and Guaranty Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 First Health Network - DRe Matrix MPN Insurer 12/07/2005 W

1367

United States Fidelity and Guaranty Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 SCRMA-WellComp Medical Provider Network Insurer 05/27/2008 W

1432

United States Fidelity and Guaranty Company c/o Discover Re 5 Batterson Park Road Farmington, CT 06032 USF & G Company GBMCS MPN Insurer 05/07/2009 T

0291

United States Fidelity And Guaranty Company C/o Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN/USF&G/ LWP Insurer 02/18/2005 www.corvel.com

0406

United States Fidelity And Guaranty Company C/O Discover Re, 5 Batterson Park Road Farmington, CT 06032 CorVel MPN Insurer 02/28/2005 www.corvel.com

1386

United States Fidelity and Guaranty Company c/o Traveler's National Accounts Unbundled, 5 Batterson Park Rd Farmington, CT 06032 Wellcomp Medical Provider Network Insurer 06/20/2008 T

0988

United States Fidelity and Guaranty Company c/o Travelers National Accounts Unbundled One Tower Square, 12-MS Hartford, CT 06183 Liberty Mutual Group MPN Insurer 07/28/2005 T





193


Applicant Date of


Approval Status *

0515

United States Fidelity and Guaranty Company One Tower Square MS-12 Hartford, CT 06183

United States Fidelity and Guaranty Company/Gallagher Bassett/Coventry MPN Insurer 04/27/2005 T

0537

United States Fidelity and Guaranty Company One Tower Square MS-12 Hartford, CT 06183

United States Fidelity and Guaranty Company/Gallagher Bassett/ First Health MPN Insurer 05/13/2005 T

1626

United States Fire Insurance Company 305 Madison Ave Morristown, NJ 07962 Crum & Forster ESIS MPN Insurer 06/24/2010 T

2173

United States Fire Insurance Company 305 Madison Ave Morristown, NJ 07962 LWP Signature MPN Insurer 05/06/2013 http://www.lwpsignaturempn.com

2252

United States Fire Insurance Company 305 Madison Ave Morristown, NJ 07962 Crum & Forster Select MPN Insurer 12/06/2013 T

1212

United States Fire Insurance Company 305 Madison Ave. Morrison, NJ 07962 Medex Insurer 06/12/2006 www.medexhco.com T

2251

United States Fire Insurance Company 305 Madison Ave. Morristown, NJ 07962 Crum & Forster Primary MPN Insurer 12/06/2013 T

0179

United States Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962 Crum&Forster-Concentra MPN Insurer 01/24/2005 T

0994

United States Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962 Concentra Broad Based Insurer 07/25/2005 T

2370

United States Fire Insurance Company 305 Madison Avenue Morristown, NJ 07962 CorVel/C&F Select MPN Insurer 04/02/2015 www.corvel.com

1583

United Wisconsin Insurance Company 200 N. Grand Avenue Lansing, MI 48933 United Heartland Medical Provider Network Insurer 01/28/2010 T

0294

Universal Underwriters Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


1574

University of Southern California 3434 S. Grand Ave CAL-120 Los Angeles, CA 90089 USC/Harbor MPN

Self-Insured Employer 12/16/2009 www.harborsys.com/usc T





194


Applicant Date of


Approval Status *

0396

University of Southern California 851 Downey Way, HSH 300 Los Angeles, CA 90089

University of Southern California Medical Provider Network


0033

University of the Pacific 3601 Pacific Avenue Stockton, CA 95211

UOP First health CompAmerica Select and Limited KOJ MPN


2381

Upland Unified School District 390 North Euclid Ave Upland, CA 91786 EIA Medical Provider Network

Self-Insured Employer 04/01/2015 www.eiampn.csac-eia.org T

0805

US Concrete 2925 Briar Park Drive, Ste 1050 Houston, TX 77042 CorVel MPN


0262

USF&G Specialty Company 111 Schilling Road Hunt Valley, MD 21031 TCT CA MPN Insurer 03/17/2005 W

0659

USS-POSCO Industries PO Box 471 Pittsburg, CA 94565 USS-POSCO MPN

Self-Insured Employer 05/05/2005 https://secure.simon-companies.com/UPI/ T

0753

Utility Trailer Manufacturing Company 17295 E. Railroad St City of Industry, CA 91748 Liberty Mutual Group MPN


1897

Val Verde Unified School District 975 West Morgan St Perris, CA 92570 PRIME Plus Medical Provider Network


0150

Valiant Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0216



0673

Valiant Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Valiant Insurance Company, Crawford Select Insurer 07/01/2005 W

1001


Valiant Insurance Company - Crawford Primary Insurer 07/01/2005 W

0845







195


Applicant Date of


Approval Status *

1147


Zurich Services Corporation Prudent Buyer HCO Insurer 05/05/2006 T

1353

Valiant Insurance Company 1400 American Lane Tower 1-13th Floor Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

1774

Valley Forge Insurance Company 333 South Wabash Avenue Chicago, IL 60604 Broadspire Signature MPN Insurer 02/02/2011 T

0826

Valley Harvesting & Packing, Inc. 101 East Main Street Heber, CA 92249 TRISTAR MPN


3016

Valley Harvesting & Packing, Inc. 101 East Main Street Heber, CA 92249 First Health Comp America HCO Select


1060

Valley Insurance Program (VIP) 170 W. San Jose Ave Claremont, CA 91711 WellComp Medical Provider Network


0737

ValleyCrest Companies 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


0734

ValleyCrest Golf Course Maintenance 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


0736

ValleyCrest Landscape Development, Inc. 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


0735

ValleyCrest Landscape Maintenance, Inc. 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


0733

ValleyCrest Tree Company 24151 Ventura Blvd Calabasas, CA 91302 First Health CompAmerica Select MPN


2421

Vanliner Insurance Company 3250 Interstate Drive Richfield, OH 44826 Vanliner MPN Insurer 12/28/2015 www.vanlinermpn.com

0225

Ventura County Community College District 333 Skyway Drive Camarillo, CA 93010 Prime Advantage Medical Network






196


Applicant Date of


Approval Status *

0849

Ventura County Schools Self-Funding Authority 5189 Verdugo Way, Ste A Camarillo, CA 93012 WellComp Medical Provider Network


0453

Viacom International Services Inc. 1515 Broadway New York, NY 10036

First Health Comp America HCO Select Network


1282

VIAD CORP 1850 N. Central Ave Suite 1900 Phoenix, AZ 85004 CorVel MPN


0586

Victor Valley Community College District 18422 Bear Valley Road Victorville, CA 92395 Prime Advantage Medical Network


1312

Victor Valley Union High School District 16350 Mojave Drive Victorville, CA 92395 PRIME Advantage Medical Provider Network


1105

Victory Comp, Inc. 2452 Lakewest Dr Chico, CA 95928 CorVel/Victory Comp


2065

Victory Comp, Inc. 255 Great Valley Parkway, Ste 255 Malvern, PA 19355 Monument MPN


1485

Victory Comp, Inc. 255 Great Valley Pkwy Ste 200 Malvern, PA 19355 Monument MPN


0268

Vigilant Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel MPN Insurer 02/17/2005 www.corvel.com

1471

Vigilant Insurance Company 15 Mountain View Road Warren, NJ 07059 CorVel/Chubb Kaiser Select MPN Insurer 12/24/2008 www.CorVel.com

1198

Vintners and Independent Producers Self-Insurance Program 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


0329

Virginia Surety Company Inc. 175 W Jackson, Ste 1100 Chicago, IL 60604 Virginia Surety Cambridge MPN Insurer 02/16/2005 W





197


Applicant Date of


Approval Status *

1558

Virginia Surety Company, Inc. 175 West Jackson Blvd, 11th Floor Chicago, IL 60604 Rising MPN Insurer 08/17/2009 https://www.markelfirstcomp.com/injured-workers T

1139

Virginia Surety Company, Inc. 175 West Jackson Blvd. Chicago, IL 60604 CPG/VSC/Coventry MPN Insurer 03/16/2006 T

0634

Virginia Surety Company, Inc. 175 West Jackson Blvd., Suite 1100 Chicago, IL 60604 Rising Interplan MPN Insurer 03/24/2005 T

1399

Vista Paint Corporation 2020 East Orangethorpe Ave., Ste. 210 Fullerton, CA 92831 Vista Paint Corporation MPN

Self-Insured Employer 09/25/2008 VistaPaint.EmployerMPN.com

1740

Vista Unified School District 1234 Arcadia Ave. Vista, CA 92084 PRIME Advantage Medical Provider Network


2140

Vista Unified School District 1234 Arcadia Avenue Vista, CA 92074 Prime Plus Medical Provider Network


1893

Walt Disney Parks And Resorts U.S., Inc. 1313 Harbor Blvd. Anaheim, CA 92802 Walt Disney Parks And Resorts U.S., Inc. MPN

Self-Insured Employer 12/13/2011 www.harborsys.com/WDPR

1287

Walt Disney World Co (The Disneyland Resort Division) 1313 South Harbor Blvd Anaheim, CA 92803 Disneyland Resort Medical Provider Network


0600

Washington Township Healthcare District 2000 Mowry Avenue Fremont, CA 94538 First Health CompAmerica HCO


1074

Watkins Manufacturing 1280 Park Center Drive Vista, CA 92081 TRISTAR MPN


0093

Wausau Business Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

0090

Wausau General Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 W





198


Applicant Date of


Approval Status *

0092

Wausau Underwriters Insurance Company 175 Berkeley Street Boston, MA 02116 Liberty Mutual Group MPN Insurer 02/03/2005 T

1612

Wendy's International, Inc. 1155 Perimeter Center West Atlanta, GA 30338

First Health CompAmerica Primary HCO Network


1839

Wesco Insurance Company 59 Maiden Lane, 6th Floor New York, NY 10038 Medex MPN Insurer 06/01/2011 T

1815

West Hills Community College District 9900 Cody Street Coalinga, CA 93210 PRIME Advantage Medical Provider Network


0680

Westchester Fire Insurance Company 1601 Chestnut Street Philadelphia, PA 19103

Westchester Fire Insurance Company - Crawford Primary Insurer 06/16/2005 W

0353

Western Digital Corporation 20511 Lake Forest Drive Lake Forest, CA 92630

First Health CompAmerica Select HCO Network (or First Health Select)


1115

Western Independent Bankers Self Insurance Group 2600 Michelson Dr., Suite 1620 Irvine, CA 92612 Medex


1392

Western Oilfields Supply Company 3404 State Rd. Bakersfield, CA 93308 Western Oilfields Supply Company ESIS MPN


2380

Western Orange County Self-Funded Workers' Compensation Agency 200 Kalmus Dr. Costa Mesa, CA 92626 WellComp Medical Provider Network

Joint Powers Authority 03/20/2015 www.wellcomp.com W

3020

Westlake Services, LLC 4751 Wilshire Blvd Ste 100 Los Angeles, CA 90010 Hankey Group MPN

Self-Insured Employer 04/27/2017 www.intermedccs.com/HankeyGroupMPN

0948

Westport Insurance Corporation 5200 Metcalf Ave Overland Park, KS 66202

Westport Insurance Corporation/Gallagher Bassett/First Health MPN Insurer 07/01/2005 T

1690

Westview Services, Inc. 10522 Katella Ave Anaheim, CA 92804 WellComp Medical Provider Network






199


Applicant Date of


Approval Status *

1201

Westview Services, Inc. 10522 Katella Avenue Anaheim, CA 92804 CorVel HCO


1255

Westview Services, Inc. 10522 Katella Avenue Anaheim, CA 92804 Broadspire MPN


0891

Whittier Area Schools Insurance Authority 10800 Benavon Street Whittier, CA 90606 WellComp Medical Provider Network


1072

Whittier Union High School District 9401 S. Painter Ave. Whittier, CA 90605 WellComp Medical Provider Network


0559

Williamsburg National Insurance Company 26255 American Drive Southfield, MI 48034

Williamsburg National/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 T

1539

Williamsburg National Insurance Company 26255 American Drive Southfield, MI 48034 Rising Interplan MPN Insurer 07/28/2009 T

1842

Williamsburg National Insurance Company 26255 American Drive Southfield, MI 48034 Williamsburg Co. - Harbor-HealthSmart MPN Insurer 06/17/2011 www.harborsys.com/meadowbrook T

1061

WinCo Holdings, Inc. PO Box 5756 Boise, ID 83705 Liberty Mutual Group MPN


0227

Wiseburn Elementary School District 13530 Aviation Blvd Hawthorne, CA 90250 Prime Advantage Medical Network


1199

Wm. Bolthouse Farms 7200 East Brundage Lane Bakersfield, CA 93307

Wm. Bolthouse Farms/TMC Medical Provider Network


1640

Wm. Bolthouse Farms, Inc. One Campbell Place Camden, NJ 08103 Broadspire Signature MPN


1714

Wonderful Citrus LLC 11444 West Olympic Blvd 5th Flr Los Angeles, CA 90064 Broadspire Signature MPN


1716

Wonderful Orchards LLC 11444 W. Olympic Blvd. 5th FL Los Angeles, CA 90064 Broadspire Signature MPN






200


Applicant Date of


Approval Status *

1717

Wonderful Pistachios & Almonds LLC 11444 W. Olympic Blvd. 5th FL Los Angeles, CA 90064 Broadspire Signature MPN


2302

XL Insurance America, Inc. 1201 N. Market Street Suite 501 Wilmington, DE 19801 Medex Insurer 09/05/2014 www.medexhco.com T

2209

XL Insurance America, Inc. 200 Liberty Street, 22nd Floor New York, NY 10281 CorVel MPN Insurer 08/01/2013 www.corvel.com

2441

XL Insurance America, Inc. 200 Liberty Street, 22nd Floor New York, NY 10281 CorVel/Select Staffing MPN Insurer 03/16/2016 www.corvel.com

2221

XL Insurance America, Inc. 70 Seaview Ave. Stamford, CT 06902 Tractor/XLGroup/Bunch MPN Insurer 09/17/2013 T

2456

XL Insurance America, Inc. 70 Seaview Avenue Stamford, CT 06902 Agri1 MPN Insurer 04/14/2016 www.intermedccs.com/Agri1MPN

3055

XL Insurance America, Inc. 70 Seaview Avenue Stamford, CT 06902 Agricultura MPN Insurer 10/30/2017 http://www.talispoint.com/intermed/agriculturampn

2216

XL Insurance America, Inc. One World Financial Center, 200 Liberty St New York, NY 10281 Sedgwick CMS MPN Insurer 08/23/2013 T

2217

XL Insurance America, Inc. One World Financial Center, 200 Liberty St New York, NY 10281 Sedgwick CMS Extended MPN Insurer 08/23/2013 T

2329

XL Insurance America, Inc. One World Financial Center/200 Liberty St New York, NY 10281 Sedgwick/Harbor MPN Insurer 09/05/2014 www.harborsys.com/harborone T

2330

XL Insurance America, Inc. One World Financial Center/200 Liberty Street New York, NY 10281 Sedgwick/Harbor 2 MPN Insurer 09/05/2014 www.harborsys.com/harborone T

0974

XL Specialty Insurance Company 200 Liberty Street, 21st Floor New York, NY 10281

XL Specialty Insurance Company/Gallagher Bassett/Coventry MPN Insurer 12/07/2006 www.talispoint.com/cvty/gbcvtympn T





201


Applicant Date of


Approval Status *

1118

XL Specialty Insurance Company 1 World Financial Center 200 Liberty St 27th Floor New York, NY 10281 XL Insurance Cambridge MPN Insurer 12/09/2005 W

1679

XL Specialty Insurance Company 100 Catlin Constitution Plaza Hartford, CT 06103 Broadspire Signature Network MPN Insurer 08/18/2010 T

1571

XL Specialty Insurance Company 100 Constitution Plaza Hartford, CT 06103 First Health CompAmerica Select Network Insurer 10/08/2009 www.talispoint.com/cvty/matrix

1756

XL Specialty Insurance Company 200 Liberty St 21st Floor New York, NY 10281

CCMSI/XL Specialty Insurance Company/First Health Comp American Select HCO Network Insurer 01/12/2011 T

1550

XL Specialty Insurance Company 200 Liberty St. New York, NY 10281 WellComp MPN Insurer 09/17/2009 T

2013

XL Specialty Insurance Company 200 Liberty St. New York, NY 10281 Insurer 06/07/2012 T

1433

XL Specialty Insurance Company 200 Liberty Street 21st Floor New York, NY 10281 XL Specialty GBMCS MPN Insurer 05/07/2009 T

0984

XL Specialty Insurance Company 200 Liberty Street, 21st Floor New York, NY 10281

XL Specialty Insurance Company/Gallagher Bassett/First Health MPN Insurer 07/11/2005 www.talispoint.com/cvty/gbfhmpnselect T

1668

XL Specialty Insurance Company 200 Liberty Street, 21st Floor New York, NY 10281 XL/ACS/GENEX Insurer 09/29/2010 www.genexservices.com T

0955

XL Specialty Insurance Company 200 Liberty Street, 22nd Floor New York, NY 10281 CorVel MPN/XL Specialty Insurance Company Insurer 07/11/2005 www.corvel.com

1469

XL Specialty Insurance Company 200 Liberty Street, 22nd Floor New York, NY 10281 CorVel MPN Insurer 12/02/2008 www.corvel.com

0909

XL Specialty Insurance Company 520 Eagleview Blvd Exton, PA 19434






202


Applicant Date of


Approval Status *

2089

XL Specialty Insurance Company 70 Seaview Avenue DEPT: Regulatory Stamford, CT 06902

Carl Warren and Company Medical Provider Network Insurer 12/07/2012 T

0943

XL Specialty Insurance Company One World Financial Center 200 Liberty St. New York, NY 10281

Sedgwick First Health CompAmerica Primary HCONetwork Insurer 06/16/2005 T

0944

XL Specialty Insurance Company One World Financial Center 200 Liberty St New York, NY 10281

Sedgwick First Health CompAmerica Select HCO Medical Provider Network Insurer 06/16/2005 T

1804

XL Specialty Insurance Company One World Financial Center 200 Liberty Street New York, NY 10281 XL Specialty ESIS MPN Insurer 01/19/2012 T

1974

XL Specialty Insurance Company One World Financial Center 200 Liberty St. New York, NY 10281 Sedgwick/Harbor MPN Insurer 05/24/2012 T

0953

XL Specialty Insurance Company One World Financial Center, 100 Liberty Street New York, NY 10281 Broadspire MPN Insurer 07/12/2005 T

1617

XL Specialty Insurance Company One World Financial Center, 200 Liberty Street New York, NY 10281 WellComp Medical Provider Network Insurer 04/28/2010 T

2012

XL Specialty Insurance Company One World Financial Center, 200 Liberty St. New York, NY 10281 Sedgwick/Harbor 2 MPN Insurer 06/01/2012 T

1164

XL Specialty Insurance Company One World Financial Center-200 Liberty St. New York, NY 10281


1165

XL Specialty Insurance Company One World Financial Center-200 Liberty St. New York, NY 10281 Sedgwick CMS Medical Provider Network Insurer 02/24/2006 T

1914

XL Specialty Insurance Company One World Financial Cntr-200 Liberty St. New York, NY 10281 Roth Staffing Companies MPN Insurer 03/27/2012 T

2344

XL Specialty Insurance Company Seaview House, 70 Seaview Avenue Stamford, CT 06902 Reiter Affiliated Companies MPN Insurer 09/30/2014 www.talispoint.com/intermed/reitermpn





203


Applicant Date of


Approval Status *

1219

Yellow Cab Cooperative 1200 Mississippi Street San Francisco, CA 94107 WellComp Medical Provider Network


1107

Yellow Transportation, Inc. 10990 Roe Avenue Overland Park, KS 66211 CorVel MPN


1413

Yellow Transportation, Inc. 10990 Roe Avenue Overland Park, KS 66211 First Health CompAmerica Select MPN


2192

Yellow Transportation, Inc. 10990 Roe Avenue Overland Park, KS 66211 Yellow Transportation GBMCS MPN


0599

YMCA of Metropolitan Los Angeles 625 S. New Hampshire Ave. Los Angeles, CA 90005 YMCA MPN


0477

YMCA of San Diego County 4715 Viewridge Ave., Suite 100 San Diego, CA 92123 TRISTAR CompAmerica Primary HCO


1085

Yolo County Public Agency Risk Management Insurance Authority 77 W. Lincoln Ave. Woodland, CA 95695 YCPARMIA MPN

Joint Powers Authority 09/21/2005 http://ycparmia.org/mpn

1540

Young Men's Christian Association of Metropolitan Los Angeles 625 So. New Hampshire Ave Los Angeles, CA 90005 YMCA ESIS MPN


0484

Youngs Market Company LLC 2164 N. Batavia Street Orange, CA 92865 Coventry MPN


1750

Zacky & Sons Poultry, LLC 2020 So. East Avenue Fresno, CA 93721 Zacky Farms Custom CorVel MPN


0024

Zenith Insurance Company 21255 Califa Street Woodland Hills, CA 91367 Zenith Medical Provider Network (ZMPN) Insurer 12/30/2004 www.thezenith.com

0373

ZNAT Insurance Company 21255 Califa Street Woodland Hills, CA 91367 Zenith Medical Provider Network Insurer 01/06/2005 W





204


Applicant Date of


Approval Status *

0209

Zurich American Insurance Company Of Illinois 1299 Zurich Way 3W Schaumburg, IL 60196


1148

Zurich American Insurance Company Of Illinois 1299 Zurich Way 3W Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 www.zurichna.com

0437

Zurich American Insurance Company of Illinois 1299 Zurich Way Schaumburg, IL 60196 Broadspire-Concentra Standard MPN Insurer 03/21/2005 T

0136

Zurich American Insurance Company of Illinois 1299 Zurich Way Schaumburg, IL 60196 Zurich ESIS MPN Insurer 04/18/2005 T

1349

Zurich American Insurance Company Of Illinois 1299 Zurich Way Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 06/30/2008 T

1692

Zurich American Insurance Company Of Illinois 1299 Zurich Way Schaumburg, IL 60196 Broadspire Signature Network MPN Insurer 08/18/2010 T

1823

Zurich American Insurance Company of Illinois 1299 Zurich Way Schaumburg, IL 60196 ACM/Zurich American of Illinois MPN Insurer 05/03/2011 http://mpn.acmclaims.com/zurich T

0148

Zurich American Insurance Company of Illinois 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0671


Zurich American Insurance Company of IL, Crawford Select Insurer 07/01/2005 W





205


Applicant Date of


Approval Status *

0999


Zurich American Insurance Company of IL - Crawford Primary Insurer 07/01/2005 W

0847


First Health Comp America Primary HCO Network Insurer 08/11/2005 T

0208

Zurich American Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196

FirstHealth CompAmerica Select HCO Network Insurer 04/18/2005 www.zurichna.com

0846

Zurich American Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196

First Health CompAmerica Primary HCO Network Insurer 08/02/2005 www.zurichna.com

1140

Zurich American Insurance Company 1299 Zurich Way 3W Schaumburg, IL 60196 Zurich Services Corporation Prudent Buyer Insurer 05/05/2006 www.zurichna.com

0355

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196

Sedgwick First Health Comp America Primary HCO Network Insurer 03/07/2005 T

0357



0174

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 TCT CA MPN Insurer 03/08/2005 www.mywcinfo.com T

0301

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 CorVel MPN Insurer 03/14/2005 www.corvel.com

0124

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 First Health Comp America Select HCO Insurer 03/17/2005 T

0648


Zurich American/Gallagher Bassett/Coventry MPN Insurer 03/24/2005 www.talispoint.com/cvty/gbcvtympn T

0645


Zurich/Ward North America Prudent Buyer Medical Provider Network, accessing Prudent Buyer HCO Insurer 03/29/2005 T





206


Applicant Date of


Approval Status *

0138

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich ESIS MPN Insurer 04/18/2005 T

0833

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 TRISTAR MPN Insurer 05/03/2005 T

0490

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Sedgwick CMS Medical Provider Network Insurer 05/07/2005 T

0485



1362

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 First Health CompAmerica Primary Network Insurer 05/13/2008 T

1347

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich Kaiser MPN Insurer 07/09/2008 T

1391


CCMSI/Zurich/First Health Comp America Network Insurer 08/19/2008 T

1533

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Insurer 04/30/2009 www.genexservices.com T

1526

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Roth Staffing Companies MPN Insurer 05/08/2009 T

1530

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Zurich GBMCS MPN Insurer 05/08/2009 www,talispoint.com/cvty/gbmpn

1686

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Broadspire Signature Network MPN Insurer 08/18/2010 T

1693

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Medex Insurer 08/19/2010 T

1822

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 ACM/American Zurich MPN Insurer 05/03/2011 http://mpn.acmclaims.com/zurich T





207


Applicant Date of


Approval Status *

1947

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Patriot Risk Services Insurer 05/02/2012 T

2099

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Sedgwick/Harbor MPN Insurer 12/27/2012 T

2100

Zurich American Insurance Company 1299 Zurich Way Schaumburg, IL 60196 Sedgwick/Harbor 2 MPN Insurer 12/27/2012 T

1883

Zurich American Insurance Company 1400 American Lane - Tower 1, 13th Floor Schaumburg, IL 60196 Sedgwick CMS / Harbor MPN - Zurich SUMC Insurer 09/07/2011 W

0308

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Zurich Cambridge MPN Insurer 02/16/2005 T

0140

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196


0557


MedInsights Medical Provider Network, MPN accessing Prudent Buyer HCO Insurer 03/22/2005 T

0531


Broadspire-First Health CompAmerica Select HCO MPN Insurer 03/24/2005 T

0342

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 FARA-CVTY Insurer 04/21/2005 T

0377

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Broadspire-Concentra Standard MPN Insurer 04/26/2005 T

0765



0834



0667


Zurich American Insurance Company, Crawford Select Insurer 07/01/2005 W





208


Applicant Date of


Approval Status *

1006


Zurich American Insurance Company - Crawford Primary Insurer 07/01/2005 W

1055

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Mezzo Forte Medical Provider Network Insurer 08/05/2005 W

1071

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Intracorp-Gates McDonald MPN Insurer 09/26/2005 T

1395

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Zurich/Harrah's Bunch CA MPN Insurer 07/01/2008 T

1497

Zurich American Insurance Company 1400 American Lane - Tower 2 - 6th Floor Schaumburg, IL 60196 Medex Insurer 02/25/2009 T

1241

Zurich American Insurance Company 1400 American Lane - Tower 2-6th Floor Schaumburg, IL 60196 First Health/Tribune Company MPN Insurer 09/25/2006 T

1541

Zurich American Insurance Company 1400 American Lane 6th Flr Schaumburg, IL 60196 Intracorp Insurer 07/28/2009 T

2048

Zurich American Insurance Company 1400 American Lane T2-6th Floor Schaumburg, IL 60196 WellComp Medical Provider Network Insurer 09/14/2012 T

1270

Zurich American Insurance Company 1400 American Lane Schaumburg, IL 60196

Zurich American/Gallagher Bassett/First Health MPN Insurer 01/31/2007 www.talispoint.com/cvty/gbfhmpnselect

1748

Zurich American Insurance Company 1400 American Lane Schaumburg, IL 60196 Zurich GBMCS KOJ MPN Insurer 01/12/2011 T

Documents

Medical Provider Networks Approved by DWC - California