North Carolina Department of Insurance Mike Causey, Commissioner Licensed Self-Insured Workers Compensation Individual
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1 North Carolina Department of Insurance Mike Causey, Commissioner Licensed Self-Insured Workers Compensation Individual Financial Analysis and Receivership Division 1203 Mail Service Center Raleigh, NC (919) Fax: (919) As of: 9 / 2 2 / AAA Cooper Transportation 1751 Kinsey Rd Dothan AL ABF Freight System, Inc. P. O. Box Fort Smith, AR Adventist Health System Sunbelt Healthcare Corporation 900 Hope Way Altamonte Springs, FL Alex Lee, Inc. P. O. Box 800 Hickory NC, Altec Industries, Inc. 210 Inverness Center Drive Birmingham, AL Asplundh Tree Expert Co. 708 Blair Mill Road Willow Grove, PA Averitt Express, Inc. P. O. Box 3166 Cookeville, TN BJ's Warehouse Club, Inc. 25 Research Dr. P.O. Box 5230 Westborough, MA Baxter International, Inc. One Baxter Parkway Deerfield, IL Blue Cross Blue Shield of North Carolina P. O. Box 2291 Durham, NC Boddie-Noell Enterprises, Inc. P. O. Box 1908 Rocky Mount, NC Butterball, LLC One Butterball Lane Garner, NC CVS Health Corporation One CVS Drive Woonsocket, RI 2895 CaroMont Health, Inc. P.O. Box 1747 Gastonia, NC Case Foods, Inc. P. O. Box 729 Troutman, NC Coats American, Inc Toringdon Way, Suite 301 Charlotte, NC Columbia Forest Products, Inc Thorndike Road Greensboro, NC 27409
2 Consolidated Diesel Company, Inc Norman Center Drive, Suite 1000 Minneapolis, MN Costco Wholesale Corporation 999 Lake Drive Issaquah, WA Cracker Barrel Old Country Store, Inc. 305 Hartmann Drive Lebanon, TN Cumberland County Hospital System Inc. P. O. Box 2000 Fayetteville, NC D. H. Griffin Wrecking Company, Inc. P O Box 7657 Greensboro, NC Dart Container Corporation of Georgia 500 Hogsback Road Mason, MI Davey Tree Expert Company 1500 N Mantua St Kent, OH Delhaize America LLC P. O. Box 1330 Salisbury, NC Depaul Adult Care Communities, Inc Buffalo Road Rochester, NY Dolgencorp, LLC. P. O. Box 1728 Goodlettsville, TN Duke Energy Corporation P. O. Box 1244 Charlotte, NC Duke University P. O. Box Durham, NC E. I. Du Pont De Nemours & Company 1007 Market St. D-8065 Wilmington, DE ESA Management, LLC N. Community House Rd., Suite 100 Charlotte, NC Engineered Controls International, LLC P. O. Box 247 Elon, NC Estes Express Lines, Inc. P. O. Box Richmond, VA FedEx Freight, Inc Forward Drive Harrison, AR FedEx Ground Package System, Inc. P. O. Box Pittsburgh, PA Federal Express Corporation 3620 Hacks Cross Road, Building B, 3rd Floor Memphis, TN First Citizens BancShares, Inc. P. O. Box Raleigh, NC 27611
3 FirstHealth of the Carolinas, Inc. P. O. Box 3000 Pinehurst, NC Flowers Foods, Inc Flowers Circle Thomasville, GA General Motors LLC P. O. Box 69 Southfield, MI Halifax Regional Medical Center, Inc. and Affiliates 250 Smith Church Road P.O. Box 1089 Roanoke Rapids, NC High Point Regional Health Care System P. O. Box HP-5 High Point, NC Hillcrest Foods, Inc. 50 Satellite Blvd. Ste. G Suwanee, GA Home Depot U.S. A., Inc. and Affiliates 2455 Paces Ferry Road NW Building C, 20th Floor Atlanta, GA Hyster-Yale Group, Inc Martin Luther King, Jr Hwy Greenville, NC Ingles Markets, Inc. P. O. Box 6676 Asheville, NC Kimberly-Clark Corporation PO Box 349 Neenah, WI Knight Transportation, Inc W. Buckeye Rd. Phoenix, AZ Kroger Co. and Subsidiaries, The 3631 Peters Creek Road Roanoke, VA LA-Z-Boy Incorporated One La-Z-Boy Drive Monroe, MI Louisiana-Pacific Corporation 805 SW Broadway Portland, OR Lowe's Companies, Inc. P. O. Box 1000 Mooresville, NC M. B. Kahn Construction Company, Inc. P. O. Box 1179 Columbia, SC Macy's Retail Holdings, Inc. 7 West Seventh Street Cincinnati, OH Marriott International, Inc Fernwood Rd. Dept 52/ Bethesda, MD MasTec Incorporated 800 Douglas Road Coral Gables, FL Masco Corporation Masco Way Livonia, MI 48152
4 Maxwell Family Holding Company System P. O. Box Goldsboro, NC Meritor, Inc. 444 Hebron Rd Heath, OH Mission Health, Inc. 509 Biltmore Avenue Asheville, NC Moses H. Cone Memorial Hospital 1200 North Elm Street Greensboro, NC Mount Vernon Mills Chemicals, LLC 503 South Main Street Mauldin, SC Nash Johnson & Sons Farms, Inc. 441 Sunset Blvd West Columbia, SC Nordstrom, Inc. P. O. Box Seattle, WA Novant Health, Inc. P. O. Box Winston-Salem, NC Old Dominion Freight Lines, Inc. 500 Old Dominion Way Thomasville, NC PB Enterprises of Claremont, Inc. P.O. 339 Claremont, NC PCC Airfoils, LLC Chagrin Blvd. Ste.290 Beachwood, OH PPG Industries, Inc. One PPG Place - 9 Pittsburgh, PA PSNC Energy 220 Operation Way - C122 Cayce, SC Parkdale Mills, Inc. P. O. Box 1787 Gastonia, NC Parker Hannifin Corporation 6035 Parkland Boulevard Cleveland, OH Piedmont Natural Gas Company P. O. Box Charlotte, NC Precor Incorporated nd Ave NE Woodinville, WA Procter & Gamble Company 6300 Center HIll Ave, Box 112 Cincinnati, OH Progress Energy, Inc. P. O. Box 1551 Raleigh, NC QuikTrip Corporation P.O. Box 3475 Tulsa, OK 74101
5 Research Triangle Institute P. O. Box Research Triangle Park, NC Reynolds American, Inc. 401 North Main Street Winston-Salem, NC Roberts Company Acquisitions, LLC (The ) 133 Forlines Road Winterville, NC STM Industries, Inc P. O. Box 2228 Hickory NC Saia Inc. P. O. Box A Station 1 Houma, LA Sherwin Williams Company 101 Prospect Avenue, NW Cleveland, OH Southeastern Freight Lines, Inc. P. O. Box 1691 Columbia, SC St. Joseph of the Pines, Inc Victor Parkway Livonia, MI Terminix Service, Inc. P. O. Box 2627 Columbia, SC Textron, Inc Norman Center Dr, Ste. 400 Minneapolis, MN Tyson Foods, Inc. P. O. Box 2020 Springdale, AR VF Corporation P. O. Box Greensboro, NC Variety Wholesalers, Inc. P. O. Box 947 Henderson, NC Virginia Electric & Power Company P. O. Box Richmond, VA Vulcan Materials Company P. O. Box Birmingham, AL Waffle House, Inc. P. O. Box 6450 Norcross, GA Wake Forest University Baptist Medical Center Medical Center Blvd. Winston-Salem, NC Wake Forest University P. O. Box 7201 Winston-Salem, NC WakeMed P. O. Box Raleigh, NC Wegmans Food Markets 1500 Brooks Ave Rochester, NY 14624
6 Wendy's International, LLC One Dave Thomas Blvd Dublin, OH Western and Southern Life Insurance Company (The) 400 Broadway Cincinnati, OH Weyerhaeuser Company P. O. Box 9777 MS:EC2-2B2 Federal Way, WA YRC, Inc Roe Avenue Overland Park, KS Count: 101
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