Alliance Standard Employers/Purchasers. Members new to The Alliance as of Jan. 1, 2019: Members no longer with The Alliance as of Jan.

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1 January 2019 Attached are your full Alliance membership reports for January This full report replaces our last full report, dated October We appreciate your cooperation in routing this information to appropriate staff within your organization. Please keep this set of reports for your reference in the coming months. You will receive updates only in February and March, as full reports are provided quarterly. Alliance Standard Employers/Purchasers Members new to The Alliance as of Jan. 1, 2019: Employer Advanced Laser Machining Inc. Altra Federal Credit Union American Roller Co. Benefit Plan Administrators Church Mutual Insurance Endeavor Business Media La Crosse County MultiStack LLC OneTouchPoint Reedsburg Area Medical Center School District of New Berlin The Weber Group TPA Cypress Benefit Administrators Continental Benefits Benefit Plan Administrators Benefit Plan Administrators Allied Benefit Services Auxiant Continental Benefits Members no longer with The Alliance as of Jan. 1, 2019: Employer Claims incurred prior to 1/1/2019 will be processed by: Claims will be accepted until: City of Beloit Dec. 31, 2019 Cleo Communications PBA Feb. 28, 2019 DAAR Engineering Cypress Dec. 31, 2019 Goellner-Hennig Inc. & Advanced Machine Group Administrators Dec. 31, 2019 GRAEF Dec. 31, 2019 Hillcrest Family Services SISCO June 30, 2019 J.B. Sullivan SISCO June 30, 2019 The Insurance Center Auxiant June 30, 2019 QCR Holdings, Inc. TBD Van Horn Automotive Group Prairie States Dec. 31, 2019 WCA-GHT Buffalo County Dec. 31, 2019 WPPI Energy Prairie States Dec. 31, 2019

2 Members who have switched Third Party Administrators (TPAs) as of Jan. 1, 2019: Employer Name New TPA 2018 claims will be accepted until: TPA responsible for processing 2018 claims: Bank of Prairie du Sac BPA March 31, 2019 Auxiant Brakebush Brothers Dec. 31, 2019 EBSO Fehr-Graham & Associates, LLC March 31, 2019 SISCO Foley & Lardner LLP Dec. 31, 2019 UHC J.F. Ahern Prairie States Dec. 31, 2019 Knight Barry Title, Inc. No run-out Menasha Corporation Dec. 31, 2019 Cypress Moring Disposal Inc. Auxiant No run-out Auxiant Park Bank June 30, 2019 Auxiant Trek Bicycle Corporation June 30, 2019 Auxiant TPA Name Change: UW-SHIP s TPA, Consolidated Health Plan, is rebranding in the new year. Effective January 7, 2019 they will be known as Wellfleet. Learn more at: QualityPath The following employers are currently accessing QualityPath: Member QP Effective Date Ballweg Management Services, Inc. 11/1/2017 Berner Foods 1/1/2015 Blackhawk Bank 1/1/2015 Bliss Communications, Inc. 4/1/2015 Boston Inc. 1/1/2017 Clack Corporation 1/1/2017 Concentric Rockford, Inc. 1/1/2017 Cooperative Resources International 8/1/2016 Cotta Transmission, LLC 6/1/2015 Crest Foods, Inc. 2/1/2017 Dexter Apache Holdings, Inc. 1/1/2016 Elderspan Management, LLC 1/1/2018 First Supply LLC 1/1/2016 Fiskars Brands, Inc. 8/1/2015 Flambeau, Inc. 1/1/2016 Genus 7/1/2017 Gordon Flesch, Inc. 8/1/2015 Interstate Roofing & Waterproofing 2/1/2017 Maranatha Baptist University 9/1/2015 MasterGraphics 5/1/2016 Mead and Hunt 10/1/2017

3 Miniature Precision Components, Inc 1/1/2015 NORD Gear Corporation 10/1/2017 Ott Schweitzer Distributing, Inc. 1/1/2016 Park Bank 1/1/2015 Plank Enterprises Inc. 1/1/2018 Promega 1/1/2017 QBE the Americas 8/1/2017 Rockford Manufacturing Group 2/1/2017 Sauk Prairie Healthcare, Inc. 1/1/2016 Seats Incorporated 1/1/2016 Southwest Wisconsin Technical College 6/1/2016 Spacesaver Corporation 1/1/2016 Spuncast, Inc. 6/1/2015 St. Coletta of Wisconsin 10/13/2017 Stoughton Trailers, LLC 6/1/2015 The Fall River Group, Inc. 6/1/2015 Thern Inc 4/1/2017 Top Die Casting 9/1/2016 Trachte Building Systems, Inc. 1/1/2016 Trek Bicycle Corporation 5/1/2015 UW SHIP 8/15/2017 Wesley Willows Corporation 7/1/2015 Wieser Brothers General Contractor, Inc. 1/1/2017 Wisconsin Mutual Insurance 9/1/2015 Women's International Pharmacy 1/1/2015 Woodman's Food Market, Inc. 3/1/2015 Zimbrick, Inc. 1/1/2017 Please ask your front-line staff to capture the third-party administrators (TPA) information from patients medical ID cards for important phone numbers to call regarding pre-certification, eligibility and coverage questions. These types of calls go to the TPAs, not The Alliance. Claims are repriced by The Alliance and then sent on to the TPA for payment. If you identify operational issues/improvement opportunities, please share your feedback with me at or If you have questions about the enclosed reports, call Customer Service, or Best regards, Carlene Boehmer Director of Claims and Customer Service

4 The Alliance Standard Employer/Purchasers January 2019 Name City State Effective Date Provider Types Accessed (see key on last page) Benefit Plan Administrator To call about benefits or payment after The Alliance discounts please see patient's ID card for pre-certification information Adelman Travel Systems, Inc. Milwaukee WI 1/1/ Fiserv Health Advance Concrete Form, Inc. Madison WI 9/1/ Auxiant Advanced Laser Machining Inc. Chippewa Falls WI 1/1/ Cypress Benefit Admin Alkar Rapid Pak, Inc. Lodi WI 1/1/ CIGNA Healthcare Tennessee ALL Erection & Crane Rental Madison WI 1/1/ Fiserv Health Alpha Controls & Services, LLC Rockford IL 7/1/ Auxiant Alsum Farms & Produce, Inc. Friesland WI 3/1/ WPS Administrative Services Alter Trading Corporation Madison WI 1/1/ Fiserv Health Altra Federal Credit Union Onalaska WI 1/1/ Fiserv Health Alum Line, Inc. Cresco IA 1/1/ Benefit Plan Administrators American Roller Co. Union Grove WI 1/1/ Continental Benefits Andes Candies Delavan WI 1/1/ Benefit Admin Systems Applied Ecological Services, Inc. Brodhead WI 1/1/ Auxiant Aqua Aerobic Systems, Inc. Loves Park IL 1/1/ Northern IL Health Plan ATC Management, Inc. Waukesha WI 1/1/ Fiserv Health Coord HC Auxiant Madison WI 4/1/ Auxiant Iowa Ballweg Automotive Group Middleton WI 7/1/ Benefit Plan Administrators Bank of Prairie du Sac Prairie du Sac WI 1/1/ Benefit Plan Administrators Beaver Dam Community Hospital Beaver Dam WI 7/1/ Auxiant Benefit Plan Administrators Onalaska WI 1/1/ Benefit Plan Administrators Berner Foods Dakota IL 1/1/ SISCO Blackhawk Bank Beloit WI 1/1/ Auxiant Blackhawk Insurance Cooperative Dakota IL 1/1/ Group Administrators, Ltd Bliss Communications Janesville WI 1/1/ Professional Benefit Admin Body Shop Supply Co, Inc. Madison WI 8/1/ Benefit Admin Systems Boston Inc Madison WI 12/1/ Auxiant Brakebush Brothers, Inc. Westfield WI 1/1/ EBSO Findlay Cardiac Science Corporation Deerfield WI 1/1/ UHC Cardiac Science Corp Care Wisconsin First, Inc. Madison WI 1/1/ Prairie States Cell Plus, Inc. Baraboo WI 1/1/ Allied Benefit Systems Chambers & Owen, Inc. Janesville WI 11/1/ WPS Administrative Services Charter NEX Films Milton WI 1/1/ Fiserv Health Children's Service Society of Wisconsin Milwaukee WI 10/1/ Fiserv Health Church Mutual Insurance Merrill WI 1/1/ Fiserv Health City of Janesville Janesville WI 3/1/ Dean TPA Clack Corporation Windsor WI 7/1/ Fiserv Health Cleary Building Systems Verona WI 5/1/ Fiserv Health Colony Brands, Inc. Monroe WI 12/1/ SISCO Concentric Rockford, Inc. Rockford IL 1/1/ Allied Benefit Systems Construction Resources Management Waukesha WI 1/1/ Fiserv Health Cotta Transmission Beloit WI 12/1/ Auxiant Cottingham & Butler Dubuque IA 7/27/ SISCO Cox Transfer, Inc. Eureka IL 1/1/ Fiserv Health Crest Foods, Inc. Ashton IL 1/1/ Auxiant CSM Companies, Inc. Madison WI 10/1/ Fiserv Health Data Dimensions Janesville WI 8/1/ Fiserv Health Deere & Inc. Moline IL 1/1/ UHC Deere Dexter Apache Holdings, Inc. Beaver Dam WI 1/1/ Fiserv Health Diocese of La Crosse La Crosse WI 7/1/ Benefit Plan Administrators Dubuque Stamping & Manufacturing, Inc. Dubuque IA 8/1/ SISCO E80 Plus Constructors, LLC DeForest WI 2/1/ Benefit Plan Administrators Edgerton Hospital and Health Services Edgerton WI 1/1/ Benefit Plan Administrators Elderspan Management, LLC Madison WI 1/1/ Auxiant Electric Coalition of Wisconsin Lancaster WI 9/1/ Auxiant Electronic Theatre Controls Middleton WI 9/1/ Fiserv Health Endeavor Business Media Fort Atkinson WI 1/1/ Fiserv Health Esaote North America, Inc. Fishers IN 1/1/ Fiserv Health Faith Technologies, Inc. Menasha WI 1/1/ Fiserv Health Fehr Graham & Associates LLC Freeport IL 1/1/ Fiserv Health Festival Foods Onalaska WI 3/1/ Fiserv Health First National Bank and Trust Beloit WI 1/1/ Fiserv Health First Supply LLC Madison WI 10/1/ Auxiant Fiskars Brands, Inc. Middleton WI 1/1/ Fiserv Health Flambeau, Inc. Baraboo WI 5/1/ Fiserv Health Foley & Lardner LLP Milwaukee WI 1/1/ Fiserv Health Franklin Fueling Systems Madison WI 1/1/ CIGNA Healthcare Tennessee Furst McNess Freeport IL 1/1/ SISCO General Beverage Sales Fitchburg WI 10/1/ Auxiant GENEX Cooperative Shawano WI 1/1/ Fiserv Health Coord HC Genus De Forest WI 7/1/ Fiserv Health Gleason Cutting Tools Corporation Loves Park IL 1/1/ Northern IL Health Plan Godfrey & Kahn, S.C. Madison WI 7/1/ Fiserv Health Good Karma Brands Beaver Dam WI 11/1/ Auxiant Gordon Flesch, Inc. Madison WI 7/1/ Fiserv Health Grande Cheese Co. Fond du Lac WI 1/1/ Fiserv Health H.G. Meigs, LLC Portage WI 1/1/ Auxiant Habush Habush and Rottier Madison WI 1/1/ Fiserv Health Hallman Lindsay Quality Paints, Inc. Sun Prairie WI 1/1/ Auxiant Hartung Brothers Incorporated Madison WI 3/1/ Meritain Health fka CBSA Heartwood Creations, Inc. Rockford IL 2/1/ Group Administrators, Ltd Helm Group Inc Freeport IL 1/1/ SISCO

5 The Alliance Standard Employer/Purchasers January 2019 Name City State Effective Date Provider Types Accessed (see key on last page) Benefit Plan Administrator To call about benefits or payment after The Alliance discounts please see patient's ID card for pre-certification information Herzing University Ltd. Menomonee Falls WI 1/1/ Fiserv Health Ho Chunk Nation Black River Falls WI 9/1/ Auxiant Iowa Hodge, Inc. Dubuque IA 6/1/ SISCO Hononegah High School Rockton IL 1/1/ Allied Benefit Systems Hydrite Chemical Co. Cottage Grove WI 1/1/ Fiserv Health HyPro, Inc. Waterford WI 9/1/ Fiserv Health Interstate Roofing & Waterproofing Onalaska WI 1/1/ Benefit Plan Administrators ITU Absorb Tech Inc. New Berlin WI 3/1/ Fiserv Health J.F. Ahern Fond du Lac WI 1/1/ Prairie States J.F. Brennan, Inc. La Crosse WI 1/1/ Auxiant J.H. Findorff & Son, Inc. Madison WI 7/1/ Auxiant Johnson Financial Group Inc. Racine WI 1/1/ UHC Johnson Financial JX Enterprises Hartland WI 4/1/ Fiserv Health Kahler Slater Inc. Milwaukee WI 1/1/ Auxiant Kalahari Development LLC Wisconsin Dells WI 6/1/ Fiserv Health Knight Barry Title, Inc. Milwaukee WI 1/1/ Fiserv Health Kobussen Buses, Ltd. Kaukauna WI 1/1/ Prairie States Kocourek Chevrolet Wausau WI 1/1/ Auxiant Kraemer North America LLC Plain WI 1/1/ Fiserv Health Kunes Country Superstore of Stoughton Stoughton WI 7/1/ Auxiant Kwik Trip, Inc. La Crosse WI 1/1/ Fiserv Health La Crosse County La Crosse WI 1/1/ Benefit Plan Administrators Laboratory Corporation of America Holdings Madison WI 1/1/ Fiserv Health Lakeside Foods Manitowoc WI 5/1/ Fiserv Health Coord HC Lakeside International, LLC Milwaukee WI 1/1/ SISCO LeMans Corporation Janesville WI 1/1/ Fiserv Health Lime Rock Springs Co. Dubuque IA 1/1/ SISCO Lou Bachrodt Chevrolet Cherry Valley IL 11/1/ WPS Administrative Services Mallery & Zimmerman, S.C. Wausau WI 8/1/ Auxiant Mansur Trucking, Inc. Janesville WI 1/1/ WPS Administrative Services Maranatha Baptist University Watertown WI 9/1/ Benefit Plan Administrators MasterGraphics Madison WI 3/1/ EBSO Findlay MasterMold, LLC Johnson Creek WI 7/1/ Auxiant McFarlane Manufacturing Co Inc. Sauk City WI 7/1/ Auxiant Mead and Hunt Middleton WI 10/1/ Fiserv Health Menasha Corporation Neenah WI 1/1/ Fiserv Health Metalcraft of Mayville, Inc. Mayville WI 6/1/ Fiserv Health Mid State Equipment Columbus WI 12/1/ Auxiant Mid States Concrete Industries South Beloit IL 8/1/ Professional Benefit Admin Midwest Gas Companies, Inc. La Crosse WI 7/1/ Benefit Plan Administrators Milwaukee Drivers Health & Welfare Trust Fund Milwaukee WI 3/1/ Humana Miniature Precision Components, Inc Walworth WI 4/1/ Auxiant MiTek Corporation Winslow IL 9/1/ SISCO Monroe Truck Equipment Monroe WI 1/1/ Fiserv Health Moring Disposal Inc. Forreston IL 1/1/ Auxiant MSA Professional Services Baraboo WI 5/1/ Fiserv Health Multistack LLC Sparta WI 1/1/ Allied Benefit Systems NASSCO, Inc. New Berlin WI 11/1/ Fiserv Health National Mutual Benefit Madison WI 2/1/ Benefit Plan Administrators Nicholson Hardware Rockford IL 5/1/ Northern IL Health Plan NORD Gear Corporation Waunakee WI 1/1/ SISCO North American Tool Corp. South Beloit IL 7/1/ Prairie States Northern Metal and Roofing Co., Inc. Green Bay WI 3/1/ Benefit Plan Administrators Olin Corporation Moundsville WV 10/1/ Professional Benefit Admin Omega Enterprises Inc. Madison WI 1/1/ Fiserv Health OneTouchPoint Madison WI 1/1/ Fiserv Health ORC Industries La Crosse WI 1/1/ Benefit Plan Administrators Ott Schweitzer Distributing, Inc. Milton WI 1/1/ Fiserv Health Palmer Johnson Power Systems Sun Prairie WI 1/1/ Continental Benefits Park Bank Madison WI 1/1/ Fiserv Health Pearl Valley Farms Inc. Pearl City IL 11/1/ SISCO Plank Enterprises Inc. Eau Claire WI 1/1/ Cypress Benefit Admin Plastic Ingenuity, Inc. Cross Plains WI 1/1/ Professional Benefit Admin Pomp's Tire Service Monona WI 1/1/ Auxiant Prent Corporation Janesville WI 12/1/ Professional Benefit Admin Primex, Inc. Lake Geneva WI 1/1/ Fiserv Health Promega Madison WI 1/1/ Fiserv Health QBE the Americas Sun Prairie WI 1/1/ Fiserv Health R.A. Smith, Inc. Brookfield WI 1/1/ Fiserv Health Raymond Management Middleton WI 7/1/ Fiserv Health Reedsburg Area Medical Center Reedsburg WI 1/1/ Auxiant Reinders, Inc. Sussex WI 1/1/ Fiserv Health Renaissance Learning, Inc. Wisconsin Rapids WI 1/1/ Fiserv Health Rhodes International, Inc. Columbus WI 1/1/ Managed Care Administrators River Ridge School District Patch Grove WI 7/1/ Benefit Plan Administrators RiverSide Electronics LTD Lewiston MN 2/1/ Benefit Plan Administrators Robinson Brothers Environmental, Inc. Waunakee WI 5/1/ Fiserv Health Rock County Janesville WI 1/1/ Professional Benefit Admin Coord HC Rockford Ambulatory Surgery Center Rockford IL 1/1/ Cypress Benefit Admin Rockford Anesthesiologists Associated, LLC Loves Park IL 1/1/ Cypress Benefit Admin Rockford Manufacturing Group South Beloit IL 8/1/ Group Administrators, Ltd

6 The Alliance Standard Employer/Purchasers January 2019 Name City State Effective Date Provider Types Accessed (see key on last page) Benefit Plan Administrator To call about benefits or payment after The Alliance discounts please see patient's ID card for pre-certification information Rockford Mass Transit District Rockford IL 4/1/ Professional Benefit Admin Rogers Memorial Hospital Oconomowoc WI 9/1/ Fiserv Health Rottinghaus, Inc La Crosse WI 8/1/ Benefit Plan Administrators Rundle Spence Mfg. Co. New Berlin WI 1/1/ Fiserv Health Ryan Incorporated Central Janesville WI 5/1/ Fiserv Health Sanimax USA, Inc. De Forest WI 1/1/ Fiserv Health SASid, Inc. Janesville WI 1/1/ Benefit Plan Administrators Sauk Prairie Healthcare, Inc. Prairie du Sac WI 1/1/ Auxiant School District of Beloit Beloit WI 4/1/ Prairie States School District of New Berlin New Berlin WI 1/1/ Continental Benefits Scott Construction, Inc. Lake Delton WI 4/1/ Auxiant Seats Incorporated Reedsburg WI 6/1/ Auxiant SECURA Insurance Companies Appleton WI 1/1/ Cypress Benefit Admin Shared Medical Services Cottage Grove WI 1/1/ Auxiant Skyward Inc. Stevens Point WI 1/1/ Fiserv Health Southwest Wisconsin Technical College Fennimore WI 7/1/ Fiserv Health Spacesaver Corporation Fort Atkinson WI 1/1/ Fiserv Health Spuncast, Inc. Watertown WI 1/1/ SISCO St. Coletta of Wisconsin Jefferson WI 1/1/ SISCO Steinhafels Inc. Waukesha WI 1/1/ Professional Benefit Admin Stoughton Trailers, LLC Stoughton WI 11/1/ Benefit Plan Administrators SupplyCore Rockford IL 1/1/ Auxiant The Baraboo Bancorp, Inc. Baraboo WI 4/1/ Allied Benefit Systems The DeLong Co., Inc. Clinton WI 6/1/ Fiserv Health The Fall River Group, Inc. Fall River WI 6/1/ Fiserv Health The Morse Group Freeport IL 1/1/ Cypress Benefit Admin The Weber Group La Crosse WI 1/1/ Fiserv Health Thern Inc Winona MN 4/1/ Benefit Plan Administrators Top Die Casting South Beloit IL 8/1/ SISCO Trachte Building Systems, Inc. Sun Prairie WI 1/1/ Auxiant Trek Bicycle Corporation Waterloo WI 1/1/ Fiserv Health Tri North Builders Fitchburg WI 11/1/ Auxiant U.S. Venture, Inc. Appleton WI 2/15/ Fiserv Health United Stars, Inc. Beloit WI 1/1/ Fiserv Health UW SHIP Madison WI 8/15/ Consolidated Health Plans Vernon Memorial Healthcare, Inc Viroqua WI 10/1/ Cypress Benefit Admin Viroqua Area Schools Viroqua WI 5/1/ Benefit Plan Administrators Viterbo University La Crosse WI 5/1/ Benefit Plan Administrators Vollrath, LLC Sheboygan WI 1/1/ Prairie States W.M. Sprinkman Corp Waukesha WI 10/1/ Fiserv Health WAICU Benefits Consortium Madison WI 1/1/ Fiserv Health Walworth County Elkhorn WI 1/1/ Auxiant Waterstone Bank SSB Wauwatosa WI 3/1/ Fiserv Health Waukesha County Technical College Pewaukee WI 7/1/ Fiserv Health WB Holdings Inc. Allenton WI 1/1/ Fiserv Health WCA GHT Alma School District Alma WI 10/1/ Fiserv Health WCA GHT Bangor School District Bangor WI 7/1/ Fiserv Health WCA GHT CESA 2 Whitewater WI 1/1/ Fiserv Health WCA GHT CESA 4 West Salem WI 7/1/ Fiserv Health WCA GHT Holmen School District Holmen WI 7/1/ Fiserv Health WCA GHT Kickapoo School District Viola WI 1/1/ Fiserv Health WCA GHT La Crosse School District La Crosse WI 7/1/ Fiserv Health WCA GHT Melrose Mindoro Schools District Melrose WI 7/1/ Fiserv Health WCA GHT Richland School District Richland Center WI 7/1/ Fiserv Health WCA GHT Vernon County Viroqua WI 1/1/ Fiserv Health WCA GHT Whitehall School District Whitehall WI 7/1/ Fiserv Health WCA GHT Wisconsin Rapids Public Schools Wisconsin Rapids WI 4/1/ Fiserv Health Wesley Willows Corporation Rockford IL 7/1/ SISCO West Bend Mutual Insurance West Bend WI 1/1/ Fiserv Health West Point Dairy Products LLC Richland Center WI 4/1/ Benefit Plan Administrators Western Technical College La Crosse WI 7/1/ Fiserv Health Wieser Brothers General Contractor, Inc. La Crescent MN 1/1/ SISCO Wingra Stone Madison WI 2/1/ Auxiant Wipfli, LLP Wausau WI 5/1/ Fiserv Health Wisconsin Medical Society Madison WI 1/1/ WPS Administrative Services Wisconsin Medical Society Welfare Benefits Trust Madison WI 1/1/ WPS Administrative Services Wisconsin Mutual Insurance Madison WI 5/1/ Auxiant Women's International Pharmacy Madison WI 1/1/ Benefit Plan Administrators Woodman's Food Market, Inc. Janesville WI 1/1/ Fiserv Health Woodward Communications, Inc. Dubuque IA 1/1/ Fiserv Health WPS Jack Wolf Auto Group Belvidere IL 10/1/ WPS Healthy Choices WPS Kaney Aerospace, Inc. Rockford IL 1/1/ WPS Healthy Choices WPS Kar Kraft, Inc. Rockford IL 1/1/ WPS Healthy Choices WPS Kelley Williamson Rockford IL 1/1/ WPS Healthy Choices WPS Midwest Medical Center Galena IL 10/1/ WPS Healthy Choices WPS Prairie Street Brewing Rockford IL 2/1/ WPS Healthy Choices WPS Rock Valley Industries Rockford IL 1/1/ WPS Healthy Choices WPS Roper Whitney Rockford IL 1/1/ WPS Healthy Choices WPS Stepping Stones of Rockford Rockford IL 7/1/ WPS Healthy Choices WPS Warranty Processing Inc. Rockford IL 10/1/ WPS Healthy Choices WPS Insurance Corporation Madison WI 1/1/ WPS Administrative Services

7 The Alliance Standard Employer/Purchasers January 2019 Name City State Effective Date Provider Types Accessed (see key on last page) Benefit Plan Administrator To call about benefits or payment after The Alliance discounts please see patient's ID card for pre-certification information Zimbrick, Inc. Madison WI 11/1/ Benefit Plan Administrators Provider Types Key: 1 - Medical/surgical providers (hospital billed home health included) 2 - Chiropractic providers 3 - Mental health providers 4 - Home health DME/hospice providers 5 - Medical/surgical providers - oral surgery 6 - NPPO

8 The Alliance Workers Compensation Program Participants January 2019 Carriers addresses are listed at the end of this report Effective Non Renewal Employer Billing and Reports to 7/1/2017 Walworth County WMMIC 1/1/ /31/2016 CUNA Mutual Group Sentry 3/1/2015 Spuncast Inc. West Bend Mutual Insurance 1/1/2015 Brakebush Inc. Sentry 11/1/ /31/2015 Zinga Industries West Bend Mutual Insurance 09/01/2014 6/30/2016 Blain Supply Inc. West Bend Mutual Insurance 04/01/2014 Woodman s Food Market West Bend Mutual Insurance for injuries incurred prior to 10/1/2015 Sentry for injuries incurred after 10/1/ /01/2008 Deere & Inc. Deere &, Inc. 10/01/2006 Rock County Minute Men HR 01/01/2003 Colony Brands (fka The Swiss Colony) Sentry 06/30/2001 Nordic Group (Seats, Inc. and Flambeau) Sentry (using the Sentry network of providers) for injuries incurred 7/1/2010 through 8/31/2011 Sentry (using The Alliance network of providers) for injuries incurred 9/1/2011 or later 01/01/1999 First Supply LLC First Supply LLC 01/01/1994 Stoughton Trailers, LLC Claims filed to Stoughton Trailers; claims processing administered by Corvel 11/15/1993 3/31/2016 Lands End Sentry How to contact the Workers Compensation carriers (or self funded employers) listed in this report: First Supply Mary Prahler LaCrosse Plumbing Supply PO Box 1028 LaCrosse, WI Phone: Fax: John Deere & Inc. Please file workers compensation claims with appropriate John Deere unit. This affects Wisconsin providers only. Claims will be paid by AON. Sentry Cheryl Rzentkowski Sentry Claims Service PO Box 8032 Stevens Point, WI Phone: Fax: Stoughton Trailers LLC Theresa Albrecht, Benefits/Workers Compensation Manager Stoughton Trailers LLC 416 S. Academy St. Stoughton, WI Phone: Fax: Minute Men HR Rock County Workers Compensation 100 W Lawrence St Ste 230 Appleton, WI Phone: West Bend Mutual Insurance th Ave. West Bend, WI Claims status inquiries (Woodmans & Spuncast): Equian Phone: Claim status inquires (all other West Bend employers) Corvel Corporation Phone: Wisconsin Municipal Mutual Insurance (WMMIC) Walworth County Workers Compensation 4785 Hayes Rd Ste 200 Madison, WI Phone: