The Alliance Membership Report for Providers - January 2013

January 2013
Dear Alliance Participating Provider:
Attached are The Alliance membership reports for January 2013. Your cooperation in routing this information to the
appropriate staff within your organization is greatly appreciated. Please keep this set of reports for your reference in
the coming months. You will receive updates only to these reports in February and March — full reports are only sent
quarterly. The attached set of reports replace the last full set dated October 2012 and all updates since then; please
discard all previous versions.
With this month’s Alliance membership reports we welcome:
Employer
Cygnus Business Media, Inc.
Promega Corporation
Concentric Rockford, Inc.
Menasha Corporation
Pomp’s Tire Service, Inc.
Vollrath Company
MacFarlane Pheasants
Fehr Graham
Furst-McNess Company
Hydrite Chemical Company
Reinders
SupplyCore, Inc.
WB Holdings
Zenith Cutter (Division of Fisher Barton)
TPA
UMR-Fiserv Health
UMR-Fiserv Health
Allied Benefit Systems
Cypress Benefit Administrators
Auxiant
Prairie States
Group Plan Solutions Benefit Administration
SISCO
SISCO
UMR – Midwest Security
UMR – Fiserv Health
Auxiant
UMR – Fiserv Health
Allied Benefit Systems
A few members are no longer with The Alliance. They include:
Employer
Claims incurred prior to 1/1/2013
will be accepted by:
Claims will be
accepted until:
CliftonLarsonAllen LLP UMR – Fiserv Health 12/31/2013
Skipper Marine Holdings, Inc. UMR – Fiserv Health 12/31/2013
Roundy’s Humana 6/30/2013
City of Monroe Cypress 6/30/2013
Springs Window Fashions UMR – Fiserv Health 6/30/2013
Skogen Foodliners UMR – Midwest Security 6/30/2013
iPacesetters, LLC SISCO 3/31/2013
Landmark Services Cooperative Dean 6/30/2013
Lexington Logistics
Health & Benefit Services
(RevStone Health Services)
6/30/2013
Gypsum Supply Company Group Administrators, Ltd 12/31/2013

January 2013
Several of our employer members have moved their administration services to new Third Party Administrators (TPAs)
including:
Employer
New TPA
2012 claims will TPA responsible for
be accepted until: processing 2012 claims:
MSA Professional Services Meritain 12/31/2013 Allied Benefit Services
Sanimax UMR – Fiserv Health 6/30/2013 Meritain
Alkar-Rapid Pak Cigna 12/31/2013 Allied Benefit Services
Spectrum Brands UMR – Fiserv Health Indefinitely UHC
Accelerated Genetics SISCO 6/30/2013 Meritain
Special Notes regarding:
Walker Group Holding ID Cards
Walker Group Holdings has issued new ID cards to its plan members listing two claims filing
addresses.
As an Alliance network participating provider you should continue to file claims directly to The
Alliance referenced under “All Other Medical Claims” on the back of the ID card.
UW SHIP Claims
We’ve recently been made aware of claims loading delays by UW SHIP plan administrator
MAKSIN. MAKSIN has advised that the delay in loading claims stems from providers not
referencing the correct policy number or member number on the original claim submitted. As
referencing anything other than what is listed on the member’s ID card for policy or member
number will result in claims processing delays.
Our own internal audit has exposed that many providers are adding two additional digits to the
member’s ID number on claims submitted. If at all possible, we recommend that you list only
what is referenced on the ID card for member number to avoid future claims payment delays.

January 2013
Cardiac Science, Foley & Lardner, John Deere, and Johnson Financial:
Identification cards for these four Alliance employers who utilize United HealthCare (UHC) as their Third
Party Administrator have been updated to accurately reflect The Alliance claims filing address and Payer
ID information. UHC’s online eligibility tool however, continues to incorrectly instruct you to file claims to
UHC. UHC is currently working to update this site for Alliance enrolled employees, but until the
necessary programming is completed, regardless of what UHC’s website advises, please continue to
file claims to The Alliance.
As a reminder our payer ID numbers are:
• EMDEON 88461
• McKesson HCFA 2712
• McKesson UB 1935
Would you like to access monthly membership reports and updates electronically
To access the reports and updates electronically, please send an e-mail to providerservices@the-alliance.org.
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 608.210.6601 or
cboehmer@the-alliance.org. If you have questions about the enclosed reports, call Customer Service, 608.276.6630
or 800.223.4139.
Best regards,
Carlene Boehmer
Manager of Claims and Customer Service
Enclosures

Alliance Standard Employers/Purchasers-January 2013
Effective Provider
Benefit Plan Administrator
Company Name
Date Types
To call about benefits or payment after The Alliance discounts
A.L.M. Holding Company 1/1/2009 1 2 3 4 7 Gundersen Lutheran Health Plan 800-897-1923
ABS Global, Inc. 7/1/2000 1 2 3 4 7 UMR - Fiserv Health 888-559-1855
ALL Erection & Crane Rental 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
ATC Management, Inc. 1/1/2002 1 2 3 4 7 UMR - Fiserv Health 866-360-7954
Accelerated Genetics 7/1/2004 1 2 3 4 7 SISCO 800-457-4726
Activision Blizzard (Raven Software) 1/1/2010 1 2 3 4 7 CIGNA Healthcare Tennessee 800-244-6224
Advance Concrete Form, Inc. 9/1/2001 1 2 3 4 7 Auxiant 800-279-6772
Alkar-Rapid Pak, Inc. 1/1/2002 1 2 3 4 7 CIGNA Healthcare Tennessee 800-244-6224
American Aluminum Extrusion Co., LLC 7/1/2007 1 2 3 4 7 Benefit Admin Systems 800-523-0582
Applied Ecological Services, Inc. 1/1/2012 1 2 3 4 7 CCStpa 800-365-2735
Aqua-Aerobic Systems, Inc. 1/1/2004 1 2 3 4 7 Northern IL Health Plan 800-723-0202
Austin Westran 3/1/2012 1 2 3 4 7 SISCO 800-457-4726
Ballweg Automotive Group 7/1/2011 1 2 3 4 7 Benefit Plan Administrators 800-236-7789
Baraboo Bancorporation Inc. 4/1/2005 1 2 3 4 7 Auxiant 800-279-6772
Beloit Box Board Company, Inc. 1/1/2008 1 2 3 4 SISCO 800-457-4726
Berner Foods 1/1/2012 1 2 3 4 7 Butler Benefit Service, Inc 866-927-2200
Blackhawk Bank 1/1/2011 1 2 3 4 7 Auxiant 800-279-6772
Blackhawk Community Credit Union 11/1/2006 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Blackhawk Insurance Cooperative 1/1/2012 1 2 3 4 7 Group Administrators, Ltd. 800-323-1683
Blain Supply, Inc. 7/1/2004 1 2 3 4 7 Humana 800-558-4444
Bliss Communications - Alliance 1/1/2007 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Bliss Communications - Mercy EPO 1/1/2007 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Body Shop Supply Co, Inc. 8/1/2007 1 2 3 4 7 Benefit Admin Systems 800-523-0582
Brooks Tractor, Inc. 4/1/2010 1 2 3 4 7 SISCO 800-457-4726
C.L. Swanson 10/1/2001 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
CSM Companies, Inc. 10/1/2000 1 2 3 4 7 Auxiant 800-279-6772
CUNA Mutual HRA 1/1/2004 1 2 3 4 7 CIGNA Healthcare Tennessee 800-244-6224
CUNA Mutual OAP 11/1/1990 1 2 3 4 7 CIGNA Healthcare Tennessee 800-244-6224
Cardiac Science Corporation 1/1/2012 1 2 3 4 7 UHC - Cardiac Science Corp 800-235-6261
Certco, Inc. 12/1/1995 1 2 3 4 7 Auxiant 800-279-6772
Chambers & Owen, Inc. 11/1/2010 1 2 3 4 7 WPS Administrative Services 866-615-9616

Children's Service Society of Wisconsin 10/1/2000 1 2 3 4 7 Humana 800-558-4444
City of Beloit 10/1/2011 1 2 3 4 7 UMR - Midwest Security/GB 800-236-2515
City of Janesville 3/1/2007 1 2 3 4 7 Dean TPA 800-965-2432
City of Reedsburg 2/1/1997 1 2 3 4 7 Auxiant 800-279-6772
City of Stoughton 1/1/1997 1 2 3 4 7 Auxiant 800-279-6772
Clack Corporation 7/1/1992 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Cleary Building Systems 5/1/2000 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Colony Brands, Inc. 12/1/1996 1 2 3 4 7 SISCO 800-457-4726
Concentric Rockford, Inc. 1/1/2013 1 2 3 4 7 Allied Benefit Systems 800-288-2078
Cottingham & Butler 7/27/2009 1 2 3 4 7 SISCO 800-457-4726
County of Rock 1/1/2010 1 2 3 4 7 Professional Benefit Admin 877-498-5975
Croell Redi-Mix 4/1/2011 1 2 3 4 7 First Administrators 800-206-0827
Culver Franchising System, Inc. 1/1/2002 1 2 3 4 7 SISCO 800-457-4726
Cygnus Business Media, Inc. 1/1/2013 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
Data Dimensions 8/1/2001 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
DeLong Company, Inc. 6/1/2009 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Dexter Apache Holdings, Inc. 1/1/2010 1 2 3 4 7 First Administrators 800-206-0827
Dubuque Stamping & Manufacturing, Inc. 8/1/2004 1 2 3 4 7 SISCO 800-457-4726
Edward Kraemer and Sons, Inc. 1/1/2000 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Electric Coalition of Wisconsin 9/1/2010 1 2 3 4 7 Auxiant 800-279-6772
Electronic Theatre Controls 9/1/1996 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Empire Level Manufacturing 8/1/1995 1 2 3 4 7 Auxiant 800-279-6772
Ever Ready Pin & Manufacturing 2/1/2012 1 2 3 4 7 Professional Benefit Admin 800-435-5694
FABCO Equipment, Inc. 1/1/1997 1 2 3 4 7 Auxiant 800-279-6772
Faith Technologies 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 800-716-2826
Fall River Group, Inc., The 6/1/2004 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Fehr-Graham & Associates 1/1/2013 1 2 3 4 7 SISCO 800-457-4726
Fiore Companies, Inc., The 3/1/1996 1 2 3 4 7 ARM, Ltd 800-392-1770
First Supply LLC 10/1/1991 1 3 4 7 Benefit Plan Administrators 800-236-7789
Fisher Barton, Inc. 3/1/2000 1 2 3 4 7 Auxiant 800-279-6772
Fiskars Brands, Inc. 1/1/2002 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Flambeau, Inc. 5/1/1993 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
Foley & Lardner LLP 1/1/1999 1 2 3 4 7 UHC - Foley & Lardner 877-842-3210
Foremost Farms USA 6/1/1993 1 2 3 4 7 Humana 888-357-6767
Furst-McNess Company 1/1/2013 1 2 3 4 7 SISCO 800-457-4726

Geiger Automotive Group 9/1/2009 1 2 3 4 7 Benefit Admin Systems 800-523-0582
General Beverage Sales Company 10/1/1999 1 2 3 4 7 Auxiant 800-279-6772
Gleason Cutting Tools Corporation 1/1/2012 1 2 3 4 7 Northern IL Health Plan 800-723-0202
Godfrey & Kahn, SC 7/1/2000 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
Goellner-Hennig/AM&E 1/1/2008 1 2 3 4 7 Benefit Admin Systems 800-523-0582
Gordon Flesch Company, Inc. 7/1/2000 1 2 3 4 7 WPS Administrative Services 888-915-1959
Graef 1/1/2000 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
HG Meigs, LLC/Meigs Trucking 1/1/2007 1 2 3 4 7 Auxiant 800-279-6772
HOPPE North America Inc. 1/1/2006 1 2 3 4 7 Auxiant 800-279-6772
HUFCOR Inc. - Alliance 10/1/2006 1 2 3 4 7 Professional Benefit Admin 877-498-7582
HUFCOR Inc. - Mercy EPO Union 10/1/2006 1 2 3 4 7 Professional Benefit Admin 877-498-7582
Hallman Lindsay Quality Paints 1/1/2005 1 2 3 4 7 Auxiant 800-279-6772
Hartung Brothers Incorporated 3/1/2012 1 2 3 4 7 Meritain Health fka CBSA 800-925-2272
Heartland Automotive Services 1/1/2010 1 2 3 4 7 UMR - Midwest Security/Onalask 800-783-9281
Helm Group Inc 1/1/2012 1 2 3 4 7 SISCO 800-457-4726
Herzing, Inc. 11/1/2007 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Ho-Chunk Nation, The 9/1/2003 1 2 3 4 7 Auxiant - Iowa 800-608-5471
Hodge Company 6/1/2011 1 2 3 4 7 SISCO 800-457-4726
HyPro, Inc. 9/1/2011 1 2 3 4 7 Auxiant 800-279-6772
Hydrite Chemical 1/1/2013 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Innovative Ag Services 10/1/2010 1 2 3 4 7 SISCO 800-457-4726
JX Peterbilt 4/1/1993 1 2 3 4 7 Humana 800-558-4444
John Deere & Company Inc. 1/1/2007 1 4 7 UHC - Deere 877-842-3210
Johnson Financial Group Inc. 1/1/2007 1 2 3 4 7 UHC - Johnson Financial 877-842-3210
KleenMark 8/1/1999 1 2 3 4 7 ThreePAdministrators 888-540-0094
Kwik Trip, Inc. 1/1/2005 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Lakeside Foods, Inc. 5/1/1997 1 2 3 4 7 UMR - Fiserv Health 866-360-7954
Lakeside International, LLC 1/1/2008 1 2 3 4 7 SISCO 800-457-4726
Lands' End 7/1/1992 1 2 3 4 7 Dean TPA 800-965-2432
LeMans Corporation 1/1/2007 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Leer, Inc. 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
Lime Rock Springs Company 1/1/2011 1 2 3 4 7 SISCO 800-457-4726
MSA Professional Services 5/1/1997 1 2 3 4 7 Meritain Health fka CBSA 800-925-2272
MacFarlane Pheasants 1/1/2013 1 2 3 4 7 Group Plan Solutions 888-301-0747
MajescoMastek 1/1/2009 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672

Mallery & Zimmerman 8/1/2010 1 2 3 4 7 Auxiant 800-279-6772
Mansur Trucking, Inc. 1/1/2008 1 2 3 4 7 SISCO 800-457-4726
Maranatha Baptist Bible College 9/1/2012 1 2 3 4 7 ThreePAdministrators 888-540-0094
MasterGraphics, Inc. 3/1/2004 1 2 3 4 7 EBC - Milwaukee 800-558-7798
MasterMold LLC 7/1/2009 1 2 3 4 7 Auxiant 800-279-6772
Mead & Hunt 10/1/1993 1 2 3 4 7 SISCO 800-457-4726
Menasha Corporation 1/1/2013 1 2 3 4 7 Cypress Benefit Admin 877-236-0844
MetaStar 1/1/1995 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
MiTek Corporation 9/1/2011 1 2 3 4 7 SISCO 800-457-4726
Milwaukee Drivers Health & Welfare Trust Fund 3/1/2012 1 2 3 4 7 Humana 866-424-2479
Minhas Craft Brewery 12/1/2006 1 2 3 4 7 Auxiant 800-279-6772
Miniature Precision Components 4/1/2003 1 2 3 4 7 Auxiant 800-279-6772
Monroe Truck Equipment 1/1/2005 1 2 3 4 7 UMR - Fiserv Health 866-360-7954
NASSCO Inc. 11/1/2012 1 2 3 4 7 UMR - Midwest Security/Onalask 800-651-8231
National Mutual Benefit 2/1/1993 1 2 3 4 7 Benefit Plan Administrators 800-236-7789
Nicholson Hardware 5/1/2012 1 2 3 4 7 Northern IL Health Plan 800-723-0202
Nord Gear Corporation 1/1/2007 1 2 3 4 7 SISCO 800-457-4726
Olin Corporation 10/1/1995 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Ott Schweitzer Distributing, Inc. 1/1/2007 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
PDQ Food Stores, Inc. 7/1/2005 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Painters Local Union #802 5/1/2012 1 2 3 4 7 WPS Administrative Services 888-915-3083
Paragon Development Systems, Inc. 11/1/2003 1 2 3 4 7 Humana 800-558-4444
Park Bank 1/1/1998 1 2 3 4 7 Auxiant 800-279-6772
Piggly Wiggly Midwest LLC 1/1/2012 1 2 3 4 7 Humana 866-424-2479
Plastic Ingenuity, Inc. 1/1/1998 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Pomp's Tire Service 1/1/2013 1 2 3 4 7 Auxiant 800-279-6772
Promega 1/1/2013 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
QBE the Americas 1/1/1998 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
QCR Holdings, Inc. 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Quality Liquid Feeds 6/1/2010 1 2 3 4 7 SISCO 800-457-4726
Raymond Management Company, Inc. 7/1/2000 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Reedsburg Area Medical Center 1/1/2011 1 2 3 4 7 Auxiant 800-279-6772
Regal Beloit Corporation 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
Renaissance Learning, Inc. 5/1/2001 1 2 3 4 7 Security Admin Services 800-570-8760
Rhodes International, Inc. 1/1/2008 1 2 3 4 7 Everest Administrators, Inc. 800-286-4160

Rice Management 2/1/2010 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
River Ridge School District 7/1/2008 1 2 3 4 7 Benefit Plan Administrators 800-236-7789
Robinson Brothers Environmental, Inc. 5/1/2009 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Rockford Mass Transit District 4/1/2012 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Rogers Memorial Hospital 9/1/2011 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Rundle Spence Manufacturing Co. 1/1/2008 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Ryan Incorporated Central 5/1/2007 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
SECURA Insurance Company, Inc. 1/1/2011 1 2 3 4 7 Cypress Benefit Admin 877-236-0844
SVA 4/1/1997 1 2 3 4 7 Auxiant 800-279-6772
Sanimax USA, Inc. 1/1/2012 1 2 3 4 7 UMR - Fiserv Health 877-233-1800
School District of Janesville 10/9/2006 1 2 3 4 7 Professional Benefit Admin 877-559-0255
Scott Construction, Inc. 4/1/1994 1 2 3 4 7 Auxiant 800-279-6772
Seats Incorporated 6/1/1994 1 2 3 4 7 Auxiant 800-279-6772
Shared Medical Services 1/1/2002 1 2 3 4 7 Auxiant 800-279-6772
Southern Imperial 7/1/2012 1 2 3 4 7 Group Administrators, Ltd. 800-323-1683
Spacesaver Corporation 1/1/2012 1 2 3 4 7 UMR - Midwest Security/Onalask 888-672-4342
Spahn & Rose Lumber Company 7/1/2011 1 2 3 4 7 SISCO 800-457-4726
Spectrum Brands, Inc (fka Rayovac) 11/1/1990 1 2 3 4 7 UMR - Fiserv Health 800-233-1800
Spuncast, Inc. 1/1/2009 1 2 3 4 7 Cypress Benefit Admin 877-236-0844
Steinhafels Inc. & Steinhafels Warehouse Inc. 1/1/2007 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Stepping Stones of Rockford, Inc. 7/1/2012 1 2 3 4 7 Northern IL Health Plan 800-723-0202
Stoughton Trailers, LLC 11/1/1990 1 2 3 4 7 Benefit Plan Administrators 800-236-7789
SupplyCore 1/1/2013 1 2 3 4 7 Auxiant 800-279-6772
Swiss Valley Farms, Co. 5/1/2003 1 2 3 4 7 First Administrators 800-206-0827
The Insurance Center 1/1/2011 1 2 3 4 7 Auxiant 800-279-6772
Top Die Casting Company 8/1/2012 1 2 3 4 7 Auxiant 800-279-6772
Trachte Building Systems 1/1/2011 1 2 3 4 7 Prairie States 800-615-7020
Trek Bicycle Corporation 1/1/1993 1 2 3 4 7 Auxiant 888-552-3755
Tri-North Builders, Inc. 11/1/1998 1 2 3 4 7 ThreePAdministrators 888-540-0094
TrueNorth Companies 7/1/2009 1 2 3 4 7 First Administrators 800-206-0827
UW Madison SHIP Domestic 8/15/2012 1 2 3 4 7 Maksin 866-796-7899
UW Madison SHIP Domestic Continuation 8/15/2012 1 2 3 4 7 Maksin 866-796-7899
UW Madison SHIP International 8/15/2012 1 2 3 4 7 Maksin 866-796-7899
UW Madison SHIP International Continuation 8/15/2012 1 2 3 4 7 Maksin 866-796-7899
UW Madison SHIP Scholar 8/15/2012 1 2 3 4 7 Maksin 866-796-7899

United Cooperative 11/1/2009 1 2 3 4 7 Dean TPA 800-965-2432
United Industries, Inc. 1/1/2003 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Van Horn Automotive Group 7/1/2012 1 2 3 4 7 Prairie States 800-615-7020
Vollrath Company 1/1/2013 1 2 3 4 7 Prairie States 800-615-7020
WEA Trust 1/1/2000 1 3 4 7 WEA Insurance Trust 800-279-4000
WP Beverages, LLC 7/1/1991 1 2 3 4 7 Professional Benefit Admin 800-435-5694
WPPI Benefit Plan Trust 2/1/1995 1 2 3 4 7 UMR - Midwest Security/GB 800-236-2515
Walker Group Holding 1/1/2009 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Waukesha County Technical College 7/1/2010 1 2 3 4 7 Humana 888-357-6767
Webcrafters, Inc. 11/1/1990 1 2 3 4 7 Professional Benefit Admin 888-552-0455
Wesley Willows Corporation 7/1/2012 1 2 3 4 7 SISCO 800-457-4726
West Bend Mutual Insurance Company 1/1/2009 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Williams McCarthy 1/1/2012 1 2 3 4 7 Northern IL Health Plan 800-723-0202
Wingra Stone Company 2/1/1997 1 2 3 4 7 Auxiant 800-279-6772
Winnebago Community Unit District #323 11/1/2012 1 2 3 4 7 Allied Benefit Systems 800-288-2078
Wipfli, LLP 5/1/1992 1 2 3 4 7 UMR - Fiserv Health 800-826-9781
Wis-Pak 1/1/2007 1 2 3 4 7 Professional Benefit Admin 800-435-5694
Wisc. Bankers Assn. Insurance Trust 1/1/1995 1 2 3 4 7 WPS Administrative Services 800-765-4977
Wisc. Mutual Insurance Company 5/1/1998 1 2 3 4 7 Auxiant 800-279-6772
Women's International Pharmacy 1/1/2010 1 2 3 4 7 ThreePAdministrators 888-540-0094
Woodman's Food Market, Inc. 1/1/2007 1 2 3 4 7 UMR - Midwest Security/Onalask 800-236-8672
Woodward Communications, Inc. 1/1/2006 1 2 3 4 7 First Administrators 800-206-0827
Zimbrick, Inc. 11/1/1990 1 2 3 4 7 Benefit Plan Administrators 888-553-8355
Zinga Industries, Inc. 2/1/1997 1 2 3 4 7 Benefit Admin Systems 800-523-0582
Provider Types Key:
4 - Home health/DME/hospice providers
1 - Medical/surgical providers (hospital billed home health included)
2 - Chiropractic provider
3 - Mental health providers
6 - Medical/surgical providers when care is rec’d in these primary service area counties: Adams,
Columbia, Dane, Dodge, Grant, Green, Iowa, Jefferson, Lafayette, Rock, Sauk, Walworth
7- Medical/surgical providers—oral surgery

January 2013
*Employers accessing The
Alliance through the
Wisconsin Bankers
Association Insurance
Trust:
Badger Bank--Fort Atkinson
Bank of Prairie du Sac--Prairie du
Sac
Clare Bank--Platteville
Commercial Bank--Whitewater
First National Bank & Trust--Beloit
First National Bank--Platteville
Greenwoods State Bank--Lake Mills
Highland State Bank--Highland
Horicon Bank--Horicon
State Bank of Reeseville--Reeseville
Wisconsin Bankers Association--
Madison
*Employers accessing The
Alliance through the
Wisconsin Education
Association Trust:
Primary Service Area
Barneveld School District
Benton School District
Big Foot UHS
Black Hawk School District
Cassville School District
CESA #2
Darlington Comm School District
Dodgeville School District
Elkhorn Area School District
Fontana J8 School District
Geneva J4 School District
Genoa City Jt.2 School District
Herman School District 22
Horicon School District
Linn J4 School District
Linn Jt.6 School District
Lomira School District
Mayville School District
Neosho Jt.3 School District
Pardeeville Area School District
Reedsburg School District
Rubicon Jt.6 School District
Sharon Jt.11 School District
Walworth Jt.1 School District
WEA Insurance Corp.
WEA Property and Casualty
Williams Bay School District
Wisc Educ Assoc Council
Wisconsin Dells School District
Outside Primary Service Area
Algoma School District
Altoona School District
Amery School District
Appleton Area School District
Arcadia School District
Auburndale School District
Augusta School District
Bayfield School District
Beecher Dunbar Pembine
Birchwood School District
Blair-Taylor School District
Bonduel School District
Boulder Junction Jt.1 School
Bowler School District
Brighton School District #1
Brown Co Hndcpd Edu Board
Bruce School District
Cameron School District
Central Westosha School District
CESA #11
City of Waupaca
Cornell School District
Crandon School District
Crivitz School District
Denmark School District
Dover #1 School District
Drummond Area School District
Erin #2 School District
Fond du Lac School District
Frederic School District
Freedom Area School District
Germantown School District
Gibraltar Area School District
Glendale River Hills School
Goodman Armstrong School Dis
Grafton School District
Hillsboro School District
Iola Scandinavia School District
Kenosha School District
Kewaunee School District
Lac Du Flambeau #1 School
Lake Holcombe School District
Lakeland U H School District
Lakeshore Tech College
Luxemburg Casco School District
Maple Dale Indian Hill
Marathon City School District
Marinette School District
Marion School District
Marshfield School District
Mauston School District
Menominee Indian School District
Milw Teachers Educ Assoc
Minocqua Jt.1 School District
Nekoosa School District
New Auburn School District
New Holstein School District
New Lisbon School District
Nicolet Union High School
North Fond du Lac School District
North Lakeland School District
Northwood School District
Norway J7 School District
Oak Creek - Franklin School
Oakfield School District
Osseo - Fairchild School
Pepin Area School District
Pittsville School Dist
Port Edwards School District
Princeton School District
Random Lake School District
Raymond #14 School District
Richfield Joint 1 School District
Rosendale Brandon School District
Royall School District
Sevastopol School District
Shiocton School District
South Shore School District
Southern Door Co School District
Stockbridge School District
Stratford School District
Sturgeon Bay School District

January 2013
Suring School District
Tigerton School District
Union Grove Jt.1 School District
Washington School District
Washington-Caldwell School District
Waupaca School District
West Allis-West Milwaukee School
District
West Depere School District
Whitefish Bay School District
Wild Rose School District
Wonewoc Union Center
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The Alliance “Healthy People At Work”
Workers’ Compensation Program Participants—January 2013
Carriers’ addresses are listed at the end of this report
Effective Non–Renewal Employer Billing and Reports to…
10/01/2009 12/31/2012 City of Monroe Cities and Villages Mutual Insurance Company (CVMIC)
01/01/2003 Colony Brands (fka The Swiss Colony) Sentry
01/01/1999 First Supply LLC First Supply LLC
05/01/2008 John Deere & Company Inc. John Deere & Company, Inc.
11/15/1993 Lands’ End Sentry
06/30/2001 Nordic Group (Seats, Inc. and Flambeau) Gallagher Bassett – for injuries incurred prior to 7/1/2010
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
10/01/2006 Rock County Willis HRH
01/01/1994 Stoughton Trailers, LLC Stoughton Trailers, LLC
07/01/2011 12/31/2011 Wisconsin Counties Association (Columbia County) Wisconsin County Mutual Insurance Corporation
How to contact the Workers’ Compensation carriers (or self–funded employers) listed in this report:
Cities and Villages Mutual Insurance Company (CVMIC)
1250 S. Sunnyslope Road
Brookfield, WI 53003
phone: 800.890.3159
First Supply LLC
Mary Prahler
LaCrosse Plumbing Supply
PO Box 1028
LaCrosse, WI 54602-1028
phone: 608.791.3613
fax: 608.791.3652
Gallagher Basset
PO Box 8004
Madison, WI 53708
phone: 608.249.1929
John Deere & Company, Inc.
Please file workers’ compensation claims with appropriate John
Deere unit. This affects Wisconsin providers only. Claims will be
paid by AON.
Stoughton Trailers, LLC
Theresa Albrecht, Benefits/Workers’ Compensation Manager
Stoughton Trailers, Inc.
416 S Academy Street
Stoughton, WI 53589-2610
phone: 608. 873-2611
fax: 608.873.2871
Willis HRH
Rock County Workers’ Compensation
PO Box 877
Appleton, WI 54912
phone: 800.236.3311
Wisconsin County Mutual Insurance Corporation
Cristin Fieber
AEGIS
18550 W Capitol Drive
Brookfield, WI 53045
phone: 800.236.6885 ext. 6563
Sentry
Cheryl Rzentkowski
Sentry Claims Service
PO Box 8032
Stevens Point, WI 54481
phone: 800.739.3344
fax: 715.346.6377