IMPORTANT INFORMATION REGARDING Workers Compensation … · 2019-03-20 · 232643430 Allmerica...

All Optum trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. This document contains information that is considered proprietary to

OptumRx and should not be reproduced without express written consent of OptumRx. ©2018 Optum, Inc. All rights reserved.

October 10, 2018

Dear Pharmacy Provider:

In accordance with Texas Labor Code §408.0281, OptumRx on behalf of itself and

each of its affiliate(s) that provides pharmacy benefit management services

(including but not limited to Catamaran LLC, Healthcare Solutions, Inc.

(collectively, “OptumRx”) is providing the following notification to providers in the

State of Texas. In an effort to comply with this Texas law, we are attaching a listing

of clients and their contact information who may access our pharmacy network.

IMPORTANT INFORMATION REGARDING

Workers Compensation Texas Quarterly Client Listing

OptumRx Phone Numbers:

No action is required on your part. If you have any questions regarding this communication,

contract status, or other pharmacy related issues please contact OptumRx Pharmacy

Network Relations at (877) 633-4701 option 2, or email your questions to

[email protected].

Thank you for your continued support. Please distribute immediately.

mailto:[email protected]

PBM: Healthesystems5100 W. Lemon St.

Tampa, FL 33609

800-758-5779

TX Carrier Listing - 3rd Qtr 2018 Network: Optum RX

1600 McConnor Parkway

Schaumbug, IL 60173

877-633-4701

FEIN Insurance Carrier NameContract Type

(direct, thru TPA, Other)

Thru

(TPA name, if not direct)Main Phone Street City State ZipCode Start Date End Date

203058200 Accident Fund General Insurance Company Direct Contract

203058200 Accident Fund General Insurance Company Thru Other Paradigm 866.206.5851 PO Box 40790 Lansing MI 48901

383207001 Accident Fund Insurance Co of America Thru Other Paradigm 866.206.5851 PO Box 40790 Lansing MI 48901

952371728 Ace American Insurance Co Thru Third Party Administrator Constitution State Services 813.281.1391 5100 W. Lemon Street #207 Tampa FL 33609

952371728 Ace American Insurance Co Thru Other Paradigm 813.281.1391 5100 W. Lemon Street #207 Tampa FL 33609

066032187 Ace Fire Underwriters Ins Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

060237820 Ace Property & Casualty Ins Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

751940467 ACIG Insurance Co Thru Other Paradigm 972.702.9004 2600 N. Central Expy Suite 800 Richardson TX 75080 3/7/2017

026008643 AIG Assurance Co Thru Third Party Administrator Constitution State Services 212.770.7000 175 Water Street NY NY 10038

251118791 AIG Property Casualty Co Thru Third Party Administrator Constitution State Services 212.770.7000 175 Water Street NY NY 10038

135303710 AIU Insurance Co Thru Third Party Administrator Constitution State Services 212.770.7000 175 Water Street 24th Floor NY NY 10038

232643430 Allmerica Financial Benefit Insurance Company Thru Other Paradigm 508.853.7200 440 Lincoln Street Worcester MA 01653

230342560 American Casualty Co of Reading PA Thru Other Paradigm 312.822.5000 333 S Wabash Avenue Chicago IL 60604 3/7/2017

366071400 American Guarantee & Liability Ins Co Thru Third Party Administrator Constitution State Services 847.605.6000 1400 American Ln Schaumburg IL 60196

366071400 American Guarantee & Liability Ins Co Thru Other Paradigm 847.605.6000 1400 American Ln Schaumburg IL 60196

135124990 American Home Assurance Co Thru Third Party Administrator Constitution State Services 212.458.5000 175 Water Street NY NY 10038

581181498 American Interstate Insurance Co Direct Contract 800.897.9719 2301 Hwy 190 West DeRidder LA 70634

412143145 American Interstate Insurance Co of Texas Direct Contract 800.897.9719 2301 Hwy 190 West DeRidder LA 70634

363141762 American Zurich Insurance Co Thru Third Party Administrator Constitution State Services 800.382.2150 1400 American Lane Tower2, Fl 5 Schaumburg IL 601196

363141762 American Zurich Insurance Co Thru Other Paradigm 800.382.2150 1400 American Lane Tower2, Fl 5 Schaumburg IL 601196

381869912 Amerisure Insurance Co Thru Other Paradigm 813.282.5820 5426 Bay Center Dr. #200 Tampa FL 33609

380829210 Amerisure Mutual Insurance Co Direct Contract 813.282.5820 5426 Bay Center Dr. #200 Tampa FL 33609

380829210 Amerisure Mutual Insurance Co Thru Other Paradigm 813.282.5820 5426 Bay Center Dr. #200 Tampa FL 33609

380829210 Amerisure Mutual Insurance Co Thru Other Paradigm 813.282.5820 5426 Bay Center Dr. #200 Tampa FL 33609

136081895 Assurance Co of America Thru Third Party Administrator Constitution State Services 410.366.1000 3910 Keswick Rd. Baltimore MD 21211

136081895 Assurance Co of America Thru Other Paradigm 410.366.1000 3910 Keswick Rd. Baltimore MD 21211

133362309 Atlantic Specialty Ins Co Thru Other Paradgim 877.248.3455 605 Highway, 169 North, Suite 800 Phymouth MN 55441

060848755 Automobile Ins Co of Hartford Cn Direct Contract Travelers 860.277.0111 One Tower Square Hartford CT 6183

756014863 Bankers Standard Fire & Marine Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

591320184 Bankers Standard Ins Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

232182777 Castlepoint National Insurance Co Thru Other Paradigm 312.277.1600 222 South Riverside Plaza Chicago IL 60606

066105395 Century Indemnity Co Thru Third Party Administrator Constitution State Services 215.640.1000 30 South 17th Street, Suite 1810 Philadelphia PA 19103

060291290 Charter Oak Fire Insurance Co Direct Contract Travelers 860.277.0111 1 Tower Sq. Hartford CT 06183

060291290 Charter Oak Fire Insurance Co Thru Other Paradgim 860.277.0111 1 Tower Sq. Hartford CT 06183

521096670 Colonial American Casualty & Surety Co Thru Third Party Administrator Constitution State Services 215.723.3044 673 E. Cherry Lane Souderton PA 18964

131938623 Commerce & Industry Insurance Co Thru Third Party Administrator Constitution State Services 800.513.4813 211 Main Street Webster MA 01570

362999370 Discover Property & Casualty Insurance Co Direct Contract Travelers 385 Washington Street Saint Paul MN 55102

010125870 Eastguard Insurance Co Direct Contract 570.825.9900 16 S River Street Wilkes-Barre PA 1702

610477370 Employers Assurance Co Thru Other Paradigm 561.840.7171 701 US Highway One Suite 300 North Palm Beach CA 33408

222660372 Everest National Insurance Co Thru Other Paradigm 908.604.3000 477 Martinsville Road Liberty Corner NJ 07938

061067463 Farmington Casualty Co Direct Contract Travelers 860.277.0111 One Tower Square Hartford CT 06183

591365094 Fcci Insurance Company Direct Contract Fcci 941.907.3224 6300 Univeritsy Parkway Sarasota FL 34240

133046577 Fidelity & Deposit Co of Maryland Thru Third Party Administrator Constitution State Services 847.605.6000 600 Red Brook Blvd Owing Mills MD 21117

520616768 Fidelity & Guaranty Ins Underwriters Inc Direct Contract Travelers 651.310.7911 385 Washington Street Saint Paul MN 551052

421091525 Fidelity & Guaranty Insurance Co Direct Contract Travelers 651.310.7911 385 Washington Street Saint Paul MN 551052

421091525 Fidelity & Guaranty Insurance Co Thru Third Party Administrator Sentry 651.310.7911 385 Washington Street Saint Paul MN 551052

421091525 Fidelity & Guaranty Insurance Co Thru Third Party Administrator Sentry Insurance 651.310.7911 385 Washington Street Saint Paul MN 551052

941610280 Firemans Fund Insurance Co Thru Other Paradigm 312.224.3300 225 W. Washting Street Chicago IL 60606

370277830 Florists Mutual Insurance Co Direct Contract Sentry 618.656.4240 #1 Horticultural Lane Edwardsville IL 62025

020140690 Granite State Insurance Co Thru Third Party Administrator Constitution State Services 828.396.3342 56 N Main Street Granite Falls NC 28630

7/27/2018 1 of 3


Tampa, FL 33609

800-758-5779



Schaumbug, IL 60173

877-633-4701



Thru


043063898 Hanover American Ins Co Thru Other Paradigm 800.626.6601 440 Lincoln Street Worcester MA 01653

370344310 Illinois National Insurance Co Thru Third Party Administrator Constitution State Services 300 South Riverside Plaza Chicago IL 60606

370344310 Illinois National Insurance Co Thru Other Paradigm 300 South Riverside Plaza Chicago IL 60606

132930697 Imperium Insurance Co Thru Other Paradigm 713.935.4830 800 Gessner Rd #600 Houston TX 77024

061016108 Indemnity Insurance Co of North America Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

061016108 Indemnity Insurance Co of North America Thru Other Paradigm 215.640.1000 436 Walnut Street Philadelphia PA 19106

230723970 Insurance Co of North America Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

135540698 Insurance Co of the State of PA Thru Third Party Administrator Constitution State Services 212.770.7000 70 Pine Street NY NY 10270

390394230 Kimberly Clark Corp Thru Third Party Administrator Sentry 351 Phelps Drive Irving TX 75038

520403120 Maryland Casualty Co Thru Third Party Administrator Constitution State Services 847.605.6000 1400 Amican Lane Tower 1 Schaumburg IL 60196

351135866 Meridian Security Insurance Co Direct Contract 614.464.5000 2955 N. Meridian St. Indianapolis IN 46208

351135866 Meridian Security Insurance Co Thru Other Paradigm 614.464.5000 2955 N. Meridian St. Indianapolis IN 46208

041619070 Middlesex Insurance Co Direct Contract Sentry 715.346.7452 1800 N. Point Drive Stevens Point WI 54481

351322669 Monroe Guaranty Insurance Company Direct Contract Fcci 317.816.2982 11590 N. Meridian St Carmel IN 46032

060464510 National Fire Insurance Co of Hartford Thru Other Paradigm 312.822.1634 333 S Wabash Avenue Chicago IL 60685 3/7/2017

341607395 National Interstate Insurance Co Thru Other Paradigm 330.659.8900 3250 Interstate Drive Richfield OH 44286

362704643 National Surety Corp Thru Other Paradigm 777 San Marin Drive Novato CA 94998

620729866 National Trust Insurance Company Direct Contract Fcci 866.269.0944 33 S Gay Street Baltimore MD 21202

250687550 National Union Fire Ins Co of Pittsb PA Direct Contract 212.770.7000 175 Water Street 18th Floor NY NY 10038

250687550 National Union Fire Ins Co of Pittsb PA Thru Other Constitution State Services 212.770.7000 175 Water Street 18th Floor NY NY 10038

250687550 National Union Fire Ins Co of Pittsb PA Thru Other Paradigm 212.770.7000 175 Water Street 18th Floor NY NY 10038

020172170 New Hampshire Insurance Co Thru Third Party Administrator Constitution State Services 212.770.7000 70 Pine Street NY NY 10270

020172170 New Hampshire Insurance Co Thru Other Paradigm 212.770.7000 70 Pine Street NY NY 10270

980032627 Nipponkoa Insurance Co Limited US Direct Contract Travelers 212.405.1650 14 Wall Street 8th Floor NY NY 10005

135283360 Northern Insurance Co of New York Thru Third Party Administrator Constitution State Services 800.382.2150 1400 American Lane Tower2, Fl 5 Schaumburg IL 60196

366067575 Old Republic General Insurance Corp Thru Other Paradigm 312.346.8100 307 North Michigan Ave Chicago IL 60601

250410420 Old Republic Insurance Co Thru Other Paradigm 312.346.8100 307 North Michigan Ave Chicago IL 60601

951077060 Pacific Employers Insurance Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

340451060 Parker Hannifin Corp Direct Contract 216.896.300 6035 Parkland Blvd Cleveland OH 44124

042434763 Patriot General Insurance Company Direct Contract Sentry 715.346.7305 1800 N. Point Drive Stevens Point WI 54481

060303275 Phoenix Insurance Co Direct Contract 860.277.3966 One Tower Square Hartford CT 06183

060303275 Phoenix Insurance Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

250730780 PPG Industries Inc Thru Third Party Administrator Sentry 412.434.3131 One PPG Place Pittsburgh PA 15272

363030511 Praetorian Insurance Co Thru Other Paradigm 608.825.5625 One General Drive Sun Prarie WI 53596

756013697 Select Insurance Co Direct Contract Travelers 6300 Wilson Mills Road Mayfield Village OH 44143

880119246 Sentry Casualty Co Direct Contract 715.346.7305 1800 N. Point Drive Stevens Point WI 54481

390333950 Sentry Insurance A Mutual Co Direct Contract 715.346.7305 1800 N. Point Drive Stevens Point WI 54481

362674180 Sentry Select Insurance Co Direct Contract 715.346.7305 1800 N. Point Drive Stevens Point WI 54481

410406690 St Paul Fire & Marine Insurance Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

410963301 St Paul Guardian Insurance Co Direct Contract Travelers 615.310.7911 385 Washington Street Saint Paul MN 55102

410881659 St Paul Mercury Insurance Direct Contract Travelers 615.310.7911 385 Washington Street Saint Paul MN 55102

362542404 St Paul Protective Insurance Co Direct Contract Travelers 615.310.7911 385 Washington Street Saint Paul MN 55102

066033509 Standard Fire Insurance Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

066033509 Standard Fire Insurance Co Thru Other Paradigm 860.277.3966 One Tower Square Hartford CT 06183

430799570 TPCIGA for Lumbermens Underwriting Alliance Thru Other Paradigm 561.994.1900 1905 N.W. Corprate Blvd Baca Raton FL 33431

066033504 Travelers Casualty & Surety Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

066033504 Travelers Casualty & Surety Co Thru Other Paradigm 860.277.3966 One Tower Square Hartford CT 06183

060907370 Travelers Casualty & Surety Co of America Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

411435765 Travelers Casualty Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

061286266 Travelers Casualty Co of Connecticut Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

7/27/2018 2 of 3


Tampa, FL 33609

800-758-5779



Schaumbug, IL 60173

877-633-4701



Thru


060876835 Travelers Casualty Ins Co of America Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

953634110 Travelers Commercial Casualty Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

061286268 Travelers Commercial Insuranc Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

411435766 Travelers Constitution State Insurance Co 860.277.3966 One Tower Square Hartford CT 06183

060566050 Travelers Indemnity Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

060566050 Travelers Indemnity Co Thru Other Paradigm 860.277.3966 One Tower Square Hartford CT 06183

586020487 Travelers Indemnity Co of America Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

060336212 Travelers Indemnity Co of Connecticut Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

060336212 Travelers Indemnity Co of Connecticut Thru Other Paradigm 860.277.3966 One Tower Square Hartford CT 06183

760002592 Travelers Lloyds Ins Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

751732040 Travelers Lloyds of Tx Ins Co Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

362719165 Travelers Property Casualty Company of America Direct Contract Travelers 860.277.3966 One Tower Square Hartford CT 06183

520515280 United States Fidelity & Guaranty Co Direct Contract Travelers 651.310.7911 385 Washington Street Saint Paul MN 55102

135459190 United States Fire Insurance Co Thru Other Paradigm 973.490.6600 305 Madison Ave Morristown NJ 07960

431249228 Universal Underwriters Insurance Co Thru Third Party Administrator Constitution State Services 913.664.4270 7045 College Boulevard Overland Park KS 66211

363139101 Universal Underwriters of Tx Ins Co Thru Third Party Administrator Constitution State Services 847.605.6000 1299 Zurich Way Schaumburg IL 60173

920040526 Westchester Fire Insurance Co Thru Third Party Administrator Constitution State Services 215.640.1000 436 Walnut Street Philadelphia PA 19106

346516838 Westfield Insurance Co Direct Contract Westfield Insurance Co 330.887.0101 1 Park Circle Westfield Center OH 44251

362781080 Zurich American Ins Co of Illinois Thru Third Party Administrator Constitution State Services 847.605.6000 1400 American Lane Schaumburg IL 60196

362781080 Zurich American Ins Co of Illinois Thru Other Paradigm 847.605.6000 1400 American Lane Schaumburg IL 60196

364233459 Zurich American Insurance Co Thru Third Party Administrator Constitution State Services 847.605.6000 1400 American Lane Schaumburg IL 60196

364233459 Zurich American Insurance Co Thru Other Paradigm 847.605.6000 1400 American Lane Schaumburg IL 60196

060464510 NATIONAL FIRE INSURANCE COMPAN Paradigm Other 800-676-6777 333 S. WABASH CHICAGO IL 60604

230342560 AMERICAN CASUALTY COMPANY OF READING PA Paradigm Other 800-676-6777 333 S. WABASH CHICAGO IL 60604

751940467 ACIG INSURANCE COMPANY Paradigm Other 800-676-6777 12222 MERIT DR DALLAS TX 75251

362674180 Sentry Select Insurance Co Direct Contract Sentry 800-739-3344

7/27/2018 3 of 3

https://wwwapps.tdi.state.tx.us/inter/perlroot/sasweb9/cgi-bin/broker.exe?_service=wcExt&_program=progext.pharm_networkrpt.sas

PBM: Modern Medical, Inc.

7840 Graphics Way

Lewis Center, OH 43035

800-547-3330

TX Carrier Listing - 3rd Qtr 2018 Network: Optum RX .

1600 McConnor Parkway .

Schaumbug, IL 60173 .

877-633-4701 .


(Direct, Thru TPA, Other)

Thru

(TPA name, if not direct)

Main Phone

(Carrier)Street City State ZipCode Start Date End Date

134922640 American Electric Power Thru TPA Azivent 740-349-4040 777 Hopewell Drive Heath OH 43056 7/5/2011 Per Notification

746002039 Bexar County Thru TPA Tristar 210-335-2011 100 Dolorosa San Antonio TX 78205 7/5/2011 Per Notification

590733942 Carolina Casualty Insurance Co Thru TPA York Risk Mgmt 904-368-8093 4600 Touchton Rd E Jacksonville FL 32246 3/1/2013 Per Notification

756000566 City of Irving Thru TPA Tristar 512-983-2994 PO Box 152288 Irving TX 75015 1/1/2012 12/1/2016

756005194 City of North Richland Hills Thru TPA AS&G 817-427-6000 7301 NE Loop 820 North Richland Hills TX 76180 8/8/2011 Per Notification

746002070 City Of San Antonio Thru TPA Sedgwick and Tristar 210-207-8108 111 Soledad San Antonio TX 78205 1/1/2012 12/1/2016

746002468 City of Waco Direct Direct 512-329-6666 P.O.Box 2570 Waco TX 76702 4/1/2014 12/1/2016

756000873 Collin County Thru TPA Tristar 214-496-9913 2300 Bloomdale Rd Mckinney TX 75071 7/5/2011 Per Notification

756001613 Fort Worth Independent School District Thru TPA Tristar 817-814-2875 100 N University Dr. Fort Worth TX 76107 7/5/2011 Per Notification

350410420 Indiana Lumbermens Mutual Insurance Direct Direct 800-732-0777 3600 Woodtrace View Indianapolis IN 46268 7/5/2011 7/26/2021

756001854 Irving Independent School District Direct Direct 512-983-2994 2621 W. Airport Fwy Irving TX 75062 8/12/2013 Per Notification

741556846 Judson Independent School District Thru TPA Tristar 210-945-5402 8012 Shin Oak Drive Live Oak TX 78233 7/5/2011 Per Notification

311169435 Midwest Employers Casualty Co Thru TPA York Risk Mgmt 512-477-4405 14755 N Outer Rd Chesterfield MO 63017 3/1/2013 Per Notification

746001217 Port of Houston Authority Thru TPA AS&G 713-670-2400 111 East Loop North Houston TX 77029 8/8/2011 Per Notification

746002167 San Antonio Independent School District Thru TPA Tristar 210-554-2200 141 Lavaca San Antonio TX 78210 7/5/2011 Per Notification

223590451 Starnet Insurance Co Thru TPA York Risk Mgmt 512-477-4405 12701 Marblestone Dr Woodbridge VA 22192 3/1/2013 Per Notification

576010814 State Auto Property & Casualty Co Thru Other 800-777-7324 2955 N. Meridian Street Indianapolis IN 46208 7/5/2011 Per Notification

746249327 Texas Hospital Insurance Exchange Direct Direct 512-483-5550 8310 N. Capital of Texas HWYAustin TX 78731 7/5/2011 Per Notification

751931607 TPS Joint Self Insurance Fund Thru Other 888-301-4283 15660 N Dallas Parkway Dallas TX 75248 7/5/2011 Per Notification

742456753 Valero Energy Corp Thru Other 512-477-4405 PO Box 696080 San Antonio TX 78269 6/18/2012 Per Notification

741330327 Via Metropolitan Transit Workers' Comp Thru Other 210-362-2430 1021 San Pedro San Antonio TX 78212 7/5/2011 Per Notification

For more information regarding pharmacy informal networks click on the link:


7/27/2018 1 of 1


PBM: Healthcare Solutions, Inc.

2736 Meadow Church Rd., Suite 300

Duluth, GA 30097

866-810-4332




877-633-4701 .



Thru

(TPA name, if not direct) Main Phone Street City State ZipCode Start Date End Date

952371728 ACE American Insurance Co. TPA FA Richards 888-258-2562 510 Walnut Street Philadelphia PA 19106 10/06/03 Indefinite

746000019 Alief ISD TPA JI Specialty 800-580-5477 12102 High Star Houston TX 77072 12/01/09 Indefinite

366071400 American Guarantee & Liability Comp TPA Zurich Services 800-695-6036

One Liberty Plaza

165 Broadway New York NY 10006 04/19/02 Indefinite

135124990 American Home Assurance Company TPA FA Richards 888-258-2562 PO Box 115114 Carrollton TX 75011 10/06/03 Indefinite

363141762 American Zurich Insurance Company TPA FA Richards 888-258-2562 PO Box 13367 Austin TX 78711 10/06/03 Indefinite

363141762 American Zurich Insurance Company TPA Zurich Services 800-695-6036 1400 American Lane Schaumburg IL 60196 04/19/02 Indefinite

381869912 Amerisure Insurance Company Direct Contract 800-257-1900 26777 Halsted Rd Farmington Hills MI 48333 11/11/03 Indefinite

380829210 Amerisure Mutual Insurance Company Direct Contract 800-257-1900 26777 Halsted Rd Farmington Hills MI 48333 11/11/03 Indefinite

383553788 Amerisure Partners Insurance Co. Direct Contract 800-257-1900 26777 Halsted Rd Farmington Hills MI 48333 11/11/03 Indefinite

430990710 Arch Insurance Company TPA FA Richards 888-258-2562 26777 Halsted Rd Austin TX 78711 10/06/03 Indefinite

941390273 Argonaut Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

136081895 Assurance Company of America TPA Zurich Services 800-695-6036

One Liberty Plaza


746000317 Beaumont Independent School District TPA FA Richards 888-258-2562 3395 Harrison St. Beaumont TX 77706 10/06/03 Indefinite

752191453 Berkley National Insurance Co. Direct Contract

470529945 Berkshire Hathaway Homestate Insurance Bill Audit/Review Co. Genex

742137823 Brownsville Public Utilities TPA FA Richards 888-258-2562 PO Box 3270 Brownsville TX 78523 10/06/03 Indefinite

746000439 Bryan ISD TPA JI Specialty 800-580-5477

101 North Texas

Avenue Bryan TX 77803 01/01/09 Indefinite

590733942 Carolina Casualty Insurance Company TPA FA Richards 888-258-2562

4600 Touchton Rd

East Jacksonville FL 32246 10/06/03 Indefinite

756000328 Carrollton-Farmers Branch ISD TPA FA Richards 888-258-2562 1445 N Perry Road Carrollton TX 75011 04/01/06 Indefinite

390712210 Church Mutual Insurance Company Direct Contract 800-554-2642 PO Box 342 Merrill WI 54452 12/05/01 Indefinite

60303370 CIGNA Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

746000085 City of Austin TPA JI Specialty 800-580-5477

1 TX Cntr, 505

Barton Springs Rd Austin TX 78704 03/01/06 Indefinite

746000246 City of Baytown TPA AS&G Claims 281-422-8281

9101 LBJ Freeway,

Suite 600 Dallas TX 75243 01/26/00 Indefinite

746000278 City of Beaumont TPA AS&G Claims 713-680-2333

9101 LBJ Freeway,


746000441 City of Bryan TPA Argus Services 214-459-2000

9101 LBJ Freeway,


746000534 City of College Station TPA Argus Services 214-459-2000

9101 LBJ Freeway,


746000574 City of Corpus Christi TPA FA Richards 888-258-2562

1201 Leopard Dept.

of Risk Mgmt Corpus Christi TX 78401 10/06/03 Indefinite

756000508 City of Dallas Direct Contract 972-387-8297 1500 Marilla St. Dallas TX 75201 12/17/10 Indefinite

520266645 Clarendon National Insurance Co. TPA FA Richards 888-258-2562

1177 Avenue of the

Americas New York NY 10036 10/06/03 Indefinite

521096670 Colonial American Casualty Ins Comp TPA Zurich Services 800-695-6036 600 Red Brook Blvd Owings Mills MD 21117 04/19/02 Indefinite

570768836 Companion Property & Casualty Insur. TPA FA Richards 888-258-2562 PO Box 13367 Austin TX 78711 10/06/03 Indefinite

420594770 Continental Western Insurance Co Bill Audit/Review Co. Genex 888-464-3639

11201 Douglas

Avenue Urbandale IA 50322 10/23/14 Indefinite

7/27/2018 1 of 4



Duluth, GA 30097

866-810-4332




877-633-4701 .



Thru


420594770 Continental Western Insurance Co Direct Contract 866-810-4332

11201 Douglas

Avenue Urbandale IA 50322 10/23/14 Indefinite

751247307 Crowley ISD TPA JI Specialty 800-580-5477 1008 Hwy. 1187 Crowley TX 76036 09/01/07 Indefinite

741792014 Deep East Texas Self Insurance Fund Bill Audit/Review Co. Injury Management 972-387-8297

4100 Midway Road,

Suite 1145 Carrollton TX 75007 09/07/07 Indefinite

746000683 Dickinson ISD TPA JI Specialty 800-580-5477 2218 FM 517 East Dickinson TX 78758 12/01/09 Indefinite

362999370 Discover Property & Casualty Insurance TPA FA Richards 888-258-2562

1501 South MoPac

Expwy. Austin TX 78746 10/06/03 Indefinite

362999370 Discover Property and Casualty Ins TPA JI Specialty 800-580-5477

10535 Boyer Blvd,

Suite 100 Austin TX 78758 01/01/06 Indefinite

426070764 EMCASCO Insurance Company Direct Contract 800-447-2295 PO Box 853906 Richardson TX 75085 08/03/06 Indefinite

420234980 Employers Mutual Casualty Co Direct Contract 800-447-2295 PO Box 853906 Richardson TX 75085 08/03/06 Indefinite

480921040 Employers Reinsurance Corp. merged Westport TPA FA Richards 888-258-2562 PO Box 26050 Austin TX 78755 10/06/03 Indefinite

222660372 Everest National Insurance Company TPA FA Richards 888-258-2562

314 East Highland

Mall Blvd. Austin TX 78752 10/06/03 Indefinite

131963496 Federal Insurance Company TPA FA Richards 888-258-2562

115 Wild Basin Rd

Ste 207 Austin TX 78746 10/06/03 Indefinite

71052003 Fedex Freight Inc. Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

341441019 Fedex Ground Package System Inc Bill Audit/Review Co. Genex

133046577 Fidelity & Deposit Company of Maryl TPA Zurich Services 800-695-6036 600 Red Brook Blvd Owings Mills MD 21117 04/19/02 Indefinite

530067060 Firemens Insurance Co. of WA, D.C. TPA FA Richards 888-258-2562 PO Box 152180 Irving TX 75015 10/06/03 Indefinite

756001702 Grapevine-Colleyville ISD TPA JI Specialty 800-580-5477

3051 Ira E Woods

Ave. Grapevine TX 76051 07/01/08 Indefinite

310501234 Great American Insurance Company TPA FA Richards 888-258-2562 PO Box 5432 Cincinnati OH 45201 10/06/03 Indefinite

741536936 Harris County Hospital District TPA JI Specialty 800-580-5477 2525 Holly Hall, #100 Houston TX 77054 05/01/10 Indefinite

751277293 Harris Health System TPA JI Specialty 7135666243

61222527 Hartford Underwriters Insurance Co. TPA JI Specialty 8882582562 PO Box 26300 Austin TX 78755 10/06/03 Indefinite

370344310 Illinois National Insurance Company TPA FA Richards 888-258-2562

Capital Station, PO

Box 13367 Austin TX 78711 10/06/03 Indefinite

135540698 Insurance Company of the State of PA TPA FA Richards 888-258-2562 PO Box 13367 Austin TX 78711 10/06/03 Indefinite

756001894 Keller ISD TPA JI Specialty 800-580-5477 350 Keller Parkway Keller TX 76248 11/01/07 Indefinite

746001560 La Marque ISD TPA JI Specialty 800-580-5477 1727 Bayou Road La Marque TX 77568 12/01/09 Indefinite

593565930 Lion Insurance Co. TPA FA Richards 888-258-2562 2739 US Highway 19 Holiday FL 34691 10/06/03 Indefinite

746001620 Livingston Independent School District TPA FA Richards 888-258-2562 PO Box 1297 Livingston TX 77531 10/06/03 Indefinite

521893632 Lockheed Martin Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

746002915 Lower Colorado River Authority TPA JI Specialty 800-580-5477

3700 Lake Austin

Blvd Austin TX 78703 11/01/06 Indefinite

520403120 Maryland Casualty Company TPA Zurich Services 800-695-6036 600 Red Brook Blvd Owings Mills MD 21117 04/19/02 Indefinite

746017951 Maryland Insurance Co TPA Zurich Services 800-695-6036

12222 Merit Drive,

Suit 700 Dallas TX 75251 04/19/02 Indefinite

756002054 Mesquite Independent School District Bill Audit/Review Co. Argus Services 214-459-2000

9101 LBJ Freeway,


311169435 Midwest Employers Casualty Co. Direct Contract 888-258-2562

14755 N Outer 40,

Suite 300 Chesterfield MO 63017 10/06/03 Indefinite

7/27/2018 2 of 4



Duluth, GA 30097

866-810-4332




877-633-4701 .



Thru


311169435 Midwest Employers Casualty Co. TPA FA Richards 888-258-2562

14755 N. Outer

Forty Dr. Chesterfield MO 63017 11/14/08 Indefinite

470247300 National American Insurance Company TPA FA Richards 888-258-2562 PO Box 38 Chandler OK 74834 10/06/03 Indefinite

741289478 National Standard; merged into Maryland Casualty TPA Zurich Services 800-695-6036 1400 American Lane Schaumburg IL 60196 04/19/02 Indefinite

250687550 National Union Fire Insurance Compa TPA FA Richards 888-258-2562 PO 13367 Austin TX 78711 10/06/03 Indefinite

20172170 New Hampshire Insurance Company TPA FA Richards 888-258-2562 PO Box 13367 Austin TX 78711 10/06/03 Indefinite

20311919 North American Specialty Services TPA JI Specialty 800-580-5477

10535 Boyer Blvd,


746001177 North Forest Independent School District TPA Argus Services 214-459-2000 9101 LBJ Freeway, Suite 600 Dallas TX 75243 07/01/09 Indefinite

221964135 North River Insurance Co of New Jersey TPA FA Richards 888-258-2562 6404 International Pkwy Ste 1000Plano TX 75093 10/06/03 Indefinite

135283360 Northern Insurance Company of NY TPA Zurich Services 800-695-6036

One Liberty Plaza


756003004 Northwest Independent School District TPA JI Specialty 800-580-5477 2001 Texan Drive Justin TX 76247 07/20/12 Indefinite

250410420 Old Republic Risk Management TPA FA Richards 888-258-2562 PO Box 91569 Austin TX 78709 10/06/03 Indefinite

951077060 Pacific Employers Ins. Co TPA FA Richards 888-258-2562

115 Wild Basin Road,


231642962 PMA-Pennsylvania Manufacturer’s Associated Ins Co TPA FA Richards 888-258-2562 380 Sentry Pkwy Blue Bell PA 19422 10/06/03 Indefinite

756002311 Richardson Independent School District Direct Contract 469-593-0041 400 South Greenville Ave. Richardson TX 75081 03/09/04 Indefinite

746003668 Rio Grande City CISD TPA JI Specialty 800-580-5477 Fort Ringgold Rio Grande City TX 78582 12/01/09 Indefinite

430727872 Safety National Casualty Direct Contract 314-995-5300 1832 Schuetz Road St. Louis MO 63146 08/28/09 Indefinite

430727872 Safety National Casualty Corp TPA FA Richards 888-258-2562

2043 Woodland

Pkwy St. Louis MO 63146 10/06/03 Indefinite

221272390 Selective Insurance TPA Mitchell 800-238-9111

9889 Willow Creek

Road San Diego CA 92131 03/04/04 Indefinite

340526850 Sherwin Williams Bill Audit/Review Co. Genex 888-464-3639

440 East Swedesford

Rd. Wayne PA 19087 01/09/12 Indefinite

746002335 South San Antonio ISD TPA JI Specialty 800-580-5477 5622 Ray Ellison Blvd San Antonio TX 78242 02/01/11 Indefinite

746002339 Spring ISD TPA JI Specialty 800-580-5477 16717 Ella Blvd. Spring TX 77090 12/01/09 Indefinite

410406690 St. Paul Fire and Marine Insurace Co. TPA FA Richards 888-258-2562

1501 S Mopac

Expressway Austin TX 78759 10/06/03 Indefinite

911325671 Starbucks Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

742841540 State Office of Risk Management Direct Contract 678-690-5560

300 W 15th Street,

6th Floor Austin TX 78701 08/11/09 Indefinite

410215170 Target Corporation TPA Broadspire 866-830-2383

1000 Nicollet Mall,

TPS-2670 Minneapolis MN 55403 10/01/13 Indefinite

756001170 Tarrant County TPA JI Specialty 800-580-5477

100 E. Weatherford,

Suite 300 Fort Worth TX 76196 09/01/07 Indefinite

742717796 Texas Cotton Ginners Trust TPA Azivent 866-825-9891

12850 Spurling

Road, Suite 210 Dallas TX 75230 03/19/04 Indefinite

742509644 Texas Council Risk Management Fund TPA JI Specialty 800-580-5477 10535 Boyer Blvd, Suite 100Austin TX 78758 01/01/06 Indefinite

742615873 Texas Mutual Insurance Company Direct Contract 800-859-5995

6210 Highway East

290 Austin TX 78723 11/26/05 Indefinite

7/27/2018 3 of 4



Duluth, GA 30097

866-810-4332




877-633-4701 .



Thru


680512871 Texas Schools Property Casualty Coop. TPA JI Specialty 800-580-5477

5316 US Hwy 290 W,


742509824 Texas Water Conservation Association TPA JI Specialty 800-580-5477 10535 Boyer Blvd, Suite 100Austin TX 78758 01/01/06 Indefinite

361410470 TPCIGA for Lumbermans Mutual Casualty TPA FA Richards 888-258-2562

42739160 TPCIGA for Reliance Nat'l Insurance Co TPA FA Richards 888-258-2562 9120 Burnet Road Austin TX 78758 10/06/03 Indefinite

746000192 Travis County Bill Audit/Review Co. Forte, Inc. 800-734-4460

7600 Chevy Chase

Dr, Suite 400 Austin TX 78752 08/12/02 Indefinite

750818167 Trinity Mother Frances Health System TPA JI Specialty 800-580-5477 800 E. Dawson Tyler TX 75701 01/01/06 Indefinite

60732738 Twin City Fire Insurance Company TPA FA Richards 888-258-2562 One Hartford Plaza Hartford CT 12/09/11 Indefinite

710225165 Tyson Foods Bill Audit/Review Co. Mitchell 800-238-9111

9889 Willow Creek

Road San Diego CA 92131 03/04/04 Indefinite

470547953 Union Insurance Company TPA FA Richards 888-258-2562 PO Box 569370 Dallas TX 75356 10/06/03 Indefinite

50230479 Union Insurance Company of Povidcent Direct Contract 800-447-2295 PO Box 853906 Richardson TX 75085 8/3/2006 Indefinite

431249228 Universal Underwriters Ins Co TPA Zurich Services 800-695-6036 7045 College Blvd Overland Park KS 66211 04/19/02 Indefinite

363139101 Universal Underwriters of TX TPA Zurich Services 800-695-6036

6900 North Dallas

Parkway Plano TX 75024 04/19/02 Indefinite

746002164 University Health Systems TPA Argus Services 214-459-2000

9101 LBJ Freeway,


751771221 Utica National Insurance Co of Texas Bill Audit/Review Co. Genex 888-464-3639 1601 Chestnut St. Philadelphia PA 19192 06/26/07 Indefinite

520976199 Valiant Insurance Company TPA Zurich Services 800-695-6036 1400 American Lane Schaumburg IL 60196 04/19/02 Indefinite

850165753 Wesco Insurance Company TPA FA Richards 888-258-2562

1420 W Mockingbird

Ln Dallas TX 75247 10/06/03 Indefinite

746002890 West Oso Independent School District TPA FA Richards 888-258-2562 5050 Rockford Drive Corpus Christi TX 78146 10/06/03 Indefinite

480921045 Westport Insurance Corp TPA FA Richards 888-258-2562

5200 Metcalf

Avenue Overland Park KS 66202 10/06/03 Indefinite

363141762 Zurich American Insurance Company TPA FA Richards 888-258-2562 1400 American Lane Schaumburg IL 60196 10/06/03 Indefinite

363141762 Zurich American Insurance Company TPA Zurich Services 800-695-6036 1400 American Lane Schaumburg IL 60196 04/19/02 Indefinite

362781080 Zurich American Insurance Company of IL TPA Zurich Services 800-695-6036 1400 American Lane Schaumburg IL 60196 04/19/02 Indefinite

For more information regarding pharmacy informal networks click on the link:


7/27/2018 4 of 4


PBM: Equian

7480 Halcyon Point Dr., Suite 300

Montgomery, AL 36117

866-895-2021




877-633-4701 .


(Direct, Thru TPA, Other)Thru (TPA name, if not direct)

Main Phone

(Carrier)Street City State ZipCode Start Date End Date

952371728 ACE AMERICAN INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 215-640-1000 P O Box 1000 Philadelphia PA 19105 10/8/2014 indefinite

363141762 AMERICAN ZURICH INSURANCE COMPANY Thru TPA Creative Risk Solutions 800-382-2150 1299 Zurich Way Schaumburg IL 60173 12/31/2006 indefinite

363141762 AMERICAN ZURICH INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-382-2150 1299 Zurich Way Schaumburg IL 60173 12/17/2007 indefinite

430990710 ARCH INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 866-413-5550 300 Plaza 3 3rd Floor Jersey City NJ 07311 4/1/2014 indefinite

362114545 CONTINENTAL CASUALTY COMPANY Thru TPA Cottingham Butler Claims Services 877-262-2727 333 South Wabash Chicago IL 60604 5/1/2002 indefinite

954139154 DALLAS NATIONAL INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 866-874-6860 704 North King St Ste 602 Wilmington DE 19801 8/22/2011 indefinite

362999370 DISCOVER PROPERTY & CASUALTY INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-356-4098 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

041027270 DISCOVERY MANAGERS, LLC Thru TPA Creative Risk Solutions 860-773-3410 5 Batterson Park Rd Fl 3 Farmington CT 06032 4/1/2013 indefinite

061067463 FARMINGTON CASUALTY COMPANY Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

520515280 FIDELITY & GUARANTY INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-252-4633 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

476024508 GREAT MIDWEST INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-829-8165 800 Gessner Road Suite 600 Houston TX 77024 7/25/2016 indefinite

476024508 GREAT WEST CASUALTY COMPANY Thru TPA Cottingham Butler Claims Services 800-228-8602 1100 W 29th St South Sioux City NE 68776 4/1/2013 indefinite

060294398 HARTFORD CASUALTY INSURANCE COMPANY Thru TPA Creative Risk Solutions 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/1/2003 indefinite

060294398 HARTFORD CASUALTY INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/31/2003 indefinite

060383750 HARTFORD FIRE INSURANCE COMPAY Thru TPA Creative Risk Solutions 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/1/2003 indefinite

061222527 HARTFORD UNDERWRITERS INSURANCE COMPANY Thru TPA Creative Risk Solutions 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/1/2003 indefinite

061222527 HARTFORD UNDERWRITERS INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/31/2003 indefinite

132930697 IMPERIUM INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-203-1179 800 Gessner Road Suite 600 Houston TX 77024 7/25/2016 indefinite

061016108 INDEMNITY INSURANCE COMPANY OF NORTH AMERICA Thru TPA Cottingham Butler Claims Services 215-640-1000 436 Walnut Street Philadelphia PA 10105 4/1/2013 indefinite

020172170 NEW HAMPSHIRE INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 877-638-4244 175 Water Street 18th Floor New York City NY 10038 2/1/2008 indefinite

250410420 OLD REPUBLIC INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 724-834-5000 P O Box 789 Greensburg PA 15601 9/15/2015 indefinite

060303275 PHOENIX INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

041027270 SPARTA INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 860-773-3410 5 Batterson Park Rd Fl 3 Farmington CT 06032 2/27/2009 indefinite

066033509 STANDARD FIRE INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

570768836 SUSSEX INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 803-735-0672 Po Box 100165 Columbia SC 29202 8/22/2011 indefinite

066033504 TRAVELERS CASUALTY AND SURETY COMPANY Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

060907370 TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

060566050 TRAVELERS INDEMNITY COMPANY Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

586020487 TRAVELERS INDEMNITY COMPANY OF AMERICA Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

060336212 TRAVELERS INDEMNITY COMPANY OF CONNECTICUT Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

362719165 TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Thru TPA Cottingham Butler Claims Services 800-238-6208 1 Tower Square Hartford CT 06183 3/1/2003 indefinite

060732738 TWIN CITY FIRE INSURANCE COMPANY Thru TPA Creative Risk Solutions 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/1/2003 indefinite

060732738 TWIN CITY FIRE INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 860-547-4497 One Hartford Plaza T 17 81 Hartford CT 06115 1/31/2003 indefinite

756017952 XL INSURANCE AMERICA Thru TPA Cottingham Butler Claims Services 800-622-7311 70 Seaview Avenue Stamford CT 06902 3/31/2014 indefinite

850277191 XL SPECIALTY INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-622-7311 70 Seaview Avenue Stamford CT 06902 3/31/2014 indefinite

364233459 ZURICH AMERICAN INSURANCE COMPANY Thru TPA Creative Risk Solutions 800-382-2150 1400 American Lane Tower 1 Floor 18 Schaumburg IL 60196 12/31/2006 indefinite

364233459 ZURICH AMERICAN INSURANCE COMPANY Thru TPA Cottingham Butler Claims Services 800-382-2150 1400 American Lane Tower 1 Floor 18 Schaumburg IL 60196 12/17/2007 indefinite

7/27/2018 1 of 1


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