Self insured list - Colorado Department of Labor and Employment

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SELF INSURED LIST PERMIT ANNIVERSARY DATE NAME OF PERMIT TPA OR LOCAL PERMIT HOLDER 487 05/17/99 COBE CARDIOVASCULAR, INC. Theresa Rabinek Ms. Diane Marie Lucero Corvel Corporation Treasury Manager Now known as SORIN Group USA 950 South Cherry Street, Suite 1600 Cobe Cardiovascular, Inc. effective 1/1/2007 Denver, CO 80246-2689 14401 West 65th Way Arvada, CO 80004-3539 OFFICE: 303-692-9210 FAX: 303-692-9103 OFFICE: 303-467-6280 EMAIL: theresa_rabinek@corvel.com FAX: 303-467-6591 EMAIL: diane.lucero@sorin-na.com Sub CONTRACT Mr. Jim Howey CCMSI 7600 East Orchard Road, Suite 360N Greenwood Village, CO 80111-2518 OFFICE: 303-337-6161 FAX: 303-337-6165 EMAIL: jhowey@ccmsi.com 988 10/01/83 COLORADO HOSPITAL ASSOCIATION Kathy Gochnour Mr. Gary Swenson CorVell Corporation Director 6455 S Yosemite St Suite 700 Support Services, Inc. Greenwood Village, CO 80111-2518 7335 East Orchard Road, Suite 200 Greenwood Village, CO 80111-2518 OFFICE: 800-929-6090 OFFICE: 720-489-9300 FAX: 866-449-5059 FAX: 720-489-1166 EMAIL: EMAIL: gary.swenson@cha.com 839 01/01/92 COLORADO PERMANENTE MEDICAL Mr. John Walker Arne Haram, M.S. GROUP Operations Manager Human Resources Department Original Sedgwick CMS Kaiser Foundation Health Plan of Colorado 7400 East Orchard Road, Suite 4015 10065 E Harvard Ave suite 400 Anniversary P. O. Box 5107 (80155-5107) Denver, CO 80231 Date: 04/01/92 Greenwood Village, CO 80111-2518 OFFICE: 303-713-6030 OFFICE: 303-614-1546 800-507-9656 FAX: 303-614-1495 FAX: 303-713-6056 arne.i.haram@kp.org EMAIL: jewalker@sedgwickcms.com Page 8 6/22/2009
SELF INSURED LIST PERMIT ANNIVERSARY DATE NAME OF PERMIT TPA OR LOCAL PERMIT HOLDER 877 01/01/89 COLORADO SPRINGS, CITY OF Mr. Mark Anderson Mr. Mark Anderson Risk Manager Risk Manager §8-42-124 Risk Management Risk Management City of Colorado Springs City of Colorado Springs P. O. Box 1575 - Mail Code 630 P. O. Box 1575 - Mail Code 630 Colorado Springs, CO 80901-1575 Colorado Springs, CO 80901-1575 OFFICE: 719-385-5661 OFFICE: 719-385-5661 FAX: 719-385-5677 FAX: 719-385-5677 EMAIL: mkanderson@springsgov.com EMAIL: mkanderson@springsgov.com 858 07/01/91 COLORADO SPRINGS SCHOOL DISTRICT Mr. Charles R. Murray, ARM SAME AS LOCAL NO. 11 Risk Manager Colorado Springs School District 11 1115 North El Paso Boulevard Colorado Springs, CO 80903-2599 OFFICE: 719-520-2469 FAX: 719-520-2383 EMAIL: murracr@d11.org (Note: EMAIL: d11 are numbers) 471 08/01/04 COLORADO STATE UNIVERSITY Ms. Karen Marie Lesko Sally Alexander Director, Sales & Claims Services Director, Risk Management and Insurance (Claims from 08/01/04 and ongoing) TRI-Star Risk Management Colorado State University 200 Union Boulevard, Suite 580 Office of Risk Management & Insurance Environmental Health Sevices P. O. Box 5007 (80217-5007) 141A General Services Builduing Denver, CO 80228-1849 Campus Delivery 6002 Fort Collins, CO 80523-0001 OFFICE: 720-962-0274 OFFICE: 970-491-6745 FAX: 720-962-0301 FAX: 970-491-4804 EMAIL: karen.lesko@tristargroup.net EMAIL: sally.alexander@colostate.edu earlie.thomas@colostate.edu Page 9 6/22/2009
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Self insured list - Colorado Department of Labor and Employment

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