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Self insured list - Colorado Department of Labor and Employment

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SELF INSURED LIST<br />

PERMIT<br />

ANNIVERSARY<br />

DATE NAME OF PERMIT TPA OR LOCAL PERMIT HOLDER<br />

470 08/01/04 COLORADO STATE UNIVERSITY Ms. Karen Marie Lesko Sally Alex<strong>and</strong>er<br />

Director, Sales & Claims Services<br />

Director, Risk Management <strong>and</strong> Insurance<br />

(Tail claims from 07/01/96 - 06/30/04) TRI-Star Risk Management<br />

<strong>Colorado</strong> State University<br />

200 Union Boulevard, Suite 580 Office <strong>of</strong> Risk Management & Insurance Environmental<br />

Health Sevices<br />

P. O. Box 5007 (80217-5007) 141A General Services Builduing<br />

Denver, CO 80228-1849 Campus Delivery 6002<br />

Fort Collins, CO 80523-0001<br />

OFFICE: 720-962-0274 OFFICE: 970-491-6745<br />

FAX: 720-962-0301 FAX: 970-491-4804<br />

EMAIL: karen.lesko@tristargroup.net<br />

EMAIL: sally.alex<strong>and</strong>er@colostate.edu<br />

sally.alex<strong>and</strong>er@colostate.edu<br />

469 01/01/05 COLUMBINE HEALTH SYSTEMS Ms. Karen Marie Lesko Kim Gabriel<br />

Director, Sales & Claims Services<br />

Senior Accountant<br />

Effective 7/1/09 change in TPA TRI-Star Risk Management Columbine Health Systems<br />

Mr. Gary Swenson 200 Union Boulevard, Suite 580 947 Worthington Circle<br />

Director P. O. Box 5007 (80217-5007) Fort Collins, CO 80526-1841<br />

Support Services, Inc. Denver, CO 80228-1849<br />

7335 East Orchard Road, Suite 200 OFFICE: 970-482-0198<br />

Greenwood Village, CO 80111-2518 OFFICE: 720-962-0274 FAX: 970-482-9148<br />

FAX: 720-762-0301<br />

EMAIL: dawn.filsinger@columbinehealth.com<br />

OFFICE: 720-489-9300 EMAIL: karen.lesko@tristargroup.net kim.gabriel@columbinehealth.com<br />

FAX: 720-489-1166<br />

Dawn Filsinger, Safety Officer, Columbine Health<br />

EMAIL: gary.swenson@cha.com<br />

TRI-Star will h<strong>and</strong>le all self-Insured period<br />

claims<br />

Systems,802 West Drake Suite 145,Fort Collins80526<br />

970-492-6233 970-492-6206 Fax<br />

888 11/01/87 CONAGRA FOODS, INC. Mr. Mike Stefan Mr. Jeff Regler<br />

Area Manager<br />

Associate Financial Analyst<br />

Sedgwick CMS<br />

ConAgra Foods, Inc.<br />

P. O. Box 540040 One ConAgra Drive, I-220<br />

Omaha, NE 68154-0040 Omaha, NE 68102-5001<br />

OFFICE: 402-963-2823 OFFICE: 402-595-4491<br />

FAX: 402-496-9830 FAX: 402-517-3168<br />

EMAIL: kcorcoran@sedgwickcms.com<br />

EMAIL: Rebecca_Sch<strong>of</strong>f@ars.aon.com<br />

Linda_J_Smith@ars.aon.com<br />

mstefan@sedgwickcms.com<br />

Page 10 6/22/2009

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