Attachment 2 - BAL 05-406 

Plan Contacts for Enrollment Forms

Carrier Code Guide Name Name (Full) Email Address Phone Number Fax Number Address Line 1 Address Line 10 Blue Cross and Blue Shield Service Benefit Plan ENROLLMENT SERVICES UNIT enrollment.service@fepoc.carefirst.com (202)488-4200 (202)479-5511 OPERATIONS CENTER 840 FIRST ST11 Blue Cross and Blue Shield Service Benefit Plan ENROLLMENT SERVICES UNIT enrollment.service@fepoc.carefirst.com (202)488-4200 (202)479-5511 OPERATIONS CENTER 840 FIRST ST17 Unicare HMO TIYOKA CURRY tiyoka.curry@wellpoint.com (312)234-7596 (312)234-8008 233 S WACKER DR 39 FL 22 Aetna HealthFund JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 26 HealthAmerica Pennsylvania GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE 2C Piedmont Community Healthcare CHERYL F MIDKIFF cmidkiff@pchp.net (804)947-4463 x216 (804)947-4465 2255 LANGHORNE ROAD SUITE 2 2G CareFirst BlueChoice DIXIE ADAMS Dixie.Critzman@carefirst.com (410)998-6264 (410)998-6250 10455 MILL RUN CIR. 2J Coventry Health Care DEEMETRESS DANZY dmdanzy@cvty.com (302)283-6978 (302)283-6788 211 LAKE DRIVE 2L Health Plan of Nevada MS MARY KOKER ENR109@SIERRAHEALTH.COM (702)242-7384 (702)242-9186 2720 N TENAYA WAY 2N PacifiCare of Oklahoma MS GLENENA O MCMAHON glenena.mcmahon@phs.com (210)474-5422 (210)474-5378 PO BOX 400046 2U Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 2X Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 31 GEHA Benefit Plan SHERYLL THOMAS sheryll.thomas@geha.com (816)257-5500 (816)257-0972 17306 E 24 HWY 32 NALC PATTI SCOTT nalchbpadmin@msn.com (703)729-4677 (703)729-8131 20547 WAVERLY COURT 34 GEHA High Deductible Health Plan SHERYLL THOMAS sheryll.thomas@geha.com (816)257-5500 (816)257-0972 17306 E 24 HWY 36 PBP Health Plan BRENDA GAMBLE bgamble@postmasters.org (703)329-3322 (703)317-0225 One Beltway Center 5904 Richmon38 Rural Carrier Benefit Plan BARBARA BRUCE bbruce@nrlca.org (703)684-5552 (703)684-9627 1630 DUKE ST, 2ND FLOOR 3A AultCare HMO KEVIN HARVEY kharvey@aultman.com (330)363-4878 (330)363-7658 2600 SIXTH ST 3N Vista Healthplan RON SNYDER ron.snyder@vistahealthplan.com (954)965-3315 (954)986-6067 300 SOUTH PARK ROAD 3U United Healthcare of Ohio, Inc. LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 40 Foreign Service Benefit Plan KATHY YELDELL kathy.yeldell@afspa.org (202)833-4910 (202)833-4918 1716 N STREET, NW 42 Association Benefit Plan GILES TOLLISON stephlp0@ucia.gov (703)613-7779 (703)734-7013 ATTN: GILES TOLLISON 4080, LF 7 43 Panama Canal Area Benefit Plan EMILY DURAND edurand@healthnetworkamerica.com (732)676-2637 (732)676-2657 HEALTH NETWORK AMERICA 246 INDUSTR44 SAMBA DARLENE CAMPBELL dcampbell@sambaplans.com (301)984-4140 (301)816-0191 11301 OLD GEORGETOWN ROAD 

45 Mail Handlers Benefit Plan MS VENRIS MITCHELL-PERRY venrismitchell@firsthealth.com (301)517-2201 (301)517-2353 15400 CALHOUN PLACE 47 APWU Health Plan KEVIN MACKLEY KMACKLEY@APWUHP.COM (410)424-1522 (410)424-1512 799 CROMWELL PARK DRIVE SUITES K-Z 48 Mailhandlers Benefit Plan Consumer Option MS VENRIS MITCHELL-PERRY venrismitchell@firsthealth.com (301)517-2201 (301)517-2353 15400 CALHOUN PLACE 4N HealthAmerica Pennsylvania GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE 51 HIP of Greater New York HAROLD MILLER hmiller@hipusa.com (212)630-8316 (212)630-8351 55 WATER STREET 52 Health Alliance Plan DORETHEA JENKINS djenkin1@hapcorp.org (248)443-1155 (248)443-8175 2850 WEST GRAND BLVD 53 HealthPartners Classic/Open Access Deductible MARGARET J SCHMOLLER margaret.j.schmoller@healthpartners.com (952)883-7943 (952)883-7666 8100 34TH AVE SOUTH P.O. BOX 13054 Group Health Cooperative MARIANNA HUNTER hunter.mx@ghc.org (206)988-7043 (206)988-7001 12401 E. MARGINAL WAY SO 57 Kaiser Foundation Health Plan of Northwest FEDERAL TEAM csc-FTW.Feds.Notice@kp.org (866)291-4008 x6300 (817)255-4424 300 Burnett Street, Suite 350 59 Kaiser Foundation Health Plan of California TEAM FEDERAL scal.csc-federalteam@kp.org (858)614-3386 (858)614-3344 3840 MURPHY CANYON ROAD, 3RD FL 5E Vista Healthplan of South Florida JERRY STERNFELD jerry.sternfeld@vistahealthplan.com (954)965-3165 (954)965-3320 300 SOUTH PARK ROAD MS 3407 5M SuperMed HMO PEGGY SIMS Peggy.Sims@mmoh.com (216)687-7179 (216)687-6362 2060 E 9TH STREET COST CENTE5W SummaCare Health Plan TRACIE BABARICK babarickt@summacare.com (330)996-8410 (330)996-8454 10 NORTH MAIN ST 62 Kaiser Foundation Health Plan of California TEAM FEDERAL scal.csc-federalteam@kp.org (858)614-3386 (858)614-3344 3840 MURPHY CANYON ROAD, 3RD FL 63 Kaiser Foundation Health Plan of Hawaii FEDERAL TEAM csc-FTW.Feds.Notice@kp.org (866)291-4008 x6300 (817)255-4424 300 Burnett Street, Suite 350 64 Kaiser Foundation Health Plan of Ohio FEDERAL TEAM csc-FTW.Feds.Notice@kp.org (866)291-4008 x3516 (817)735-4301 6777 CAMP BOWIE BLVD. #500 65 Kaiser Foundation Health Plan of Colorado FEDERAL TEAM csc-FTW.Feds.Notice@kp.org (866)291-4008 x6300 (817)255-4424 300 Burnett Street, Suite 350 6J Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 6N Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 6Q Universal Care MS. SUSAN BOCKELMAN SBockelman@UniversalCare.com (562)981-4030 (567)427-6710 1600 E HILL STREET 6U Firstcare SHARON MATTHEWS SMATTHEWS@FIRSTCARE.COM (512)257-6176 (512)257-6027 12940 RESEARCH BLVD 6V GHI HMO Select LINDA PINO LPino@ghihmo.com (845)340-2249 (845)334-8950 PO BOX 4181 6Y Advantage Health Solutions, Inc. MS LEATHA MILLER LMILLER@ADVANTGAEPLAN.COM (317)573-7933 (317)573-6639 9490 PRIORITY WAY, WEST DRIVE 72 Unicare HMO TIYOKA CURRY tiyoka.curry@wellpoint.com (312)234-7596 (312)234-8008 233 S WACKER DR 39 FL 75 Humana Health Plan Inc. ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 76 Union Health Service MARILYN ALMODOVAR jrock@unionhealth.org (312)829-4224 x306 (312)829-0184 1634 WEST POLK STREET 7D Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 7G Coventry Health Care of Kansas, Inc. (HDHP) KIMBERLY FIGGS klfiggs@cvty.com (302)283-6876 (302)283-6844 211 LAKE DRIVE 7M Mercy Health Plans KATHY SITZE KSITZE@MHP.SMHS.COM (314)214-8164 (314)214-8102 14528 SOUTH OUTER 40, #300 7T Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 7W Coventry Health Care of Kansas-Wichita/Salinas KIMBERLY FIGGS klfiggs@cvty.com (302)283-6876 (302)283-6844 211 LAKE DRIVE 7Z PacifiCare Northwest Region (Oregon/Washington) MS GLENENA O MCMAHON glenena.mcmahon@phs.com (210)474-5422 (210)474-5378 PO BOX 400046 TX70-100 80 GHI Health Plan CARYN HACKNEY CHackney@ghi.com (212)615-0767 (212)563-8679 441 NINTH AVENUE 7TH FLOOR 87 HMSA LUUKIA ABBLEY luukia_abbley@hmsa.com (808)948-5361 (808)948-6285 818 KEEAUMOKU STREET 89 Triple-S VIVIAN LOEW vloew@ssspr.com (787)277-6610 (787)277-6611 1441 ROOSEVELT AVENUE 8G Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 8J Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 8W UPMC Health Plan ALYSON STRAIGHT straightac@msx.upmc.edu (412)454-7694 (412)454-7800 112 WASHINGTON PLACE SUITE 800 9E Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N 9F OSF Health Plans, Inc. KELLEY WAGNER kelley.wagner@osfhealthcare.org (309)677-8287 (309)677-8259 7915 N HALE AVENUE STE D 9G BlueCHOICE SUSAN MILLER millers@bcbsmo.com (888)689-5161 (573)986-3821 1831 CHESTNUT ST 9H Coventry Health Care of Kansas (Kansas City)-HDHP KIMBERLY FIGGS klfiggs@cvty.com (302)283-6876 (302)283-6844 211 LAKE DRIVE 9J Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 9K Altius Health Plans JANET WENTZ jmwentz@cvty.com (701)250-5459 (701)866-5259 1720 S. Sykes Street 9L Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 9N Health America Pennsylvania-HDHP GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE 9R Optima Health Plan DIANA KIMBRO dlkimbro@sentara.com (757)552-7159 (757)552-7199 4417 CORPORATION LANE 9S Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE A3 PacifiCare of Arizona DINA CANALES dina.canales@phs.com (210)474-5490 (210)474-5378 6200 NW PARKWAY TX70-100 A7 Health Net of Arizona, Inc. MS DENISE D FORBIN DENISE.D.FORBIN@HEALTHNET.COM (818)676-7423 (818)676-5949 21281 BURBANK BLVD AD Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 

1
Attachment 2 - BAL 05-406 

Plan Contacts for Enrollment Forms

AH HMO Blue LISA SUTTER lsutter@bcbsuw.com (315)792-9725 (315)798-4326 12 RHOADS DR AK United Healthcare of Ohio, Inc. LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 AU Sioux Valley Health Plan TONI MCENTEE McenteeT@siouxvalley (605)328-6832 (605)328-6811 1100 EAST 21ST STREET SUITE 600 AV Avera Health Plans CORY FITZPATRICK cory.fitzpatrick@avera.org (605)322-4500 (605)322-4535 3900 WEST AVERA DRIVE SUITE 200 B9 UnitedHealthcare of the Midwest LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 BJ Coventry Health Care of Louisiana TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 BM Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE BP Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE BT Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE BW Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE CA United Healthcare of Ohio, Inc. LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 CH UnitedHealthcare of Colorado LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 CK Firstcare SHARON MATTHEWS SMATTHEWS@FIRSTCARE.COM (512)257-6176 (512)257-6027 12940 RESEARCH BLVD CY PacifiCare of California ELIZABETH LEONARD elizabeth.leonard@phs.com (210)474-5294 (210)474-5398 6200 NORTHWEST PARKWAY TX70-100 D6 PacifiCare of Colorado DINA CANALES dina.canales@phs.com (210)474-5490 (210)474-5378 6200 NW PARKWAY TX70-100 DA Blue CHiP Coordinated Health Plan - BCBS of RI FRED COLARDO colardo.a@bcbsri.org (401)459-5706 (401)459-5585 444 WESTMINSTER ST DB Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE DL Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE DQ Physicians Health Plan of Northern Indiana SANDY WINANS swinans@phpni.com (219)432-6690 x357 (219)432-0493 8101 W JEFFERSON BLVD DV Fallon Community Health Plan HDHP AMY STUCZYNSKI amy.stuczynski@fchp.org (508)368-9287 (508)831-1136 10 CHESTNUT ST ATTN: AMY SE3 Kaiser Foundation Health Plan Mid-Atlantic States ESTHER MANNING Esther.R.Manning@kp.org (301)625-6206 (301)625-6208 2101 EAST JEFFERSON ST PO BOX 6611 EA Capital Health Plan NANCY CARTER NCCarter@chp.org (805)383-3402 (805)383-3590 1545 RAYMOND DIEHL ROAD EB HMOBlue-CNY THERESA THOMPSON tthompson@bcbscny.org (315)448-3847 (315)448-4999 344 SOUTH WARREN ST. P.O. BOX 480ED Keystone Health Plan East REGINA GRIER regina.grier@ibx.com (215)241-2641 (215)241-2218 1901 MARKET ST EE Humana Medical Plan ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 500 WEST MAIN STREET 5TH FLOOR EG M-Care JASON L HELLING jhelling@mcare.med.umich.edu (248)945-4108 (248)223-9133 25330 TELEGRAPH RD., SUITE 150 F8 Kaiser Foundation Health Plan Of Geogria, Inc. FEDERAL TEAM csc-FTW.Feds.Notice@kp.org (866)291-4008 x6300 (817)255-4424 300 Burnett Street, Suite 350 FB Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE FC Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE FK AmeriHealth HMO JOANNE KADLE JoAnne.Kadle@ibx.com (610)225-6933 1901 MARKET ST FT Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE FX Health Alliance HMO PATRICIA COLLINS patricia.collins@healthalliance.org (800)851-3379 (217)377-8055 301 SOUTH VINE STREET G2 Arnett HMO DEBBIE GUCKIEN guckiend@arnett.com (765)448-7702 (765)449-0621 415 N 26TH ST, SUITE 101 GA MVP Health Care JENNY GREGG jgregg@mvphealthcare.com (518)386-7884 (518)386-7880 625 STATE ST 

GE PersonalCares HMO MS BRENDA WEBBER BJWEBBER@CVTY.COM (877)775-5657 (701)250-5394 1720 SOUTH SYKES DR GF Pacificare of Texas MS GLENENA O MCMAHON glenena.mcmahon@phs.com (210)474-5422 (210)474-5378 PO BOX 400046 GT Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE GV Preferred Care MICHAEL RAUGHTER mrauthter@preferredcare.org (585)258-8041 (585)327-2227 259 MONROE AVENUE GW Kaiser Foundation Health Plan of Georgia Inc. HDHP FEDERAL TEAM-CSC csc-FTW.Feds.Notice@kp.org (817)570-3516 (817)735-4301 6777 CAMP BOWIE BLVD. #500 GX UnitedHealthcare of the Midwest LORI HILL lori_a_hill@uhc.com (813)818-5549 (813)818-3606 601 BOOKER CREEK BLVD. P.O. Box 1918 GZ Coventry Health Care HDHP DEEMETRESS DANZY dmdanzy@cvty.com (302)283-6978 (302)283-6788 211 LAKE DRIVE HA Coventry Health Care of Kansas-Kansas City KIMBERLY FIGGS klfiggs@cvty.com (302)283-6876 (302)283-6844 211 LAKE DRIVE HB Coventry Health Care of Louisiana HDHP TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 HM Mercy Health Plans KATHY SITZE KSITZE@MHP.SMHS.COM (314)214-8164 (314)214-8102 14528 SOUTH OUTER 40, #300 HQ HealthPartners Primary Clinic Plan MARGARET J SCHMOLLER margaret.j.schmoller@healthpartners.com (952)883-7943 (952)883-7666 8100 34TH AVE SOUTH P.O. BOX 130HS Coventry Health Care of Louisiana TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 HZ Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE IB Carolina Care MICHELLE BAKER MBaker@CCareplan.com (803)750-7400 (803)750-7479 201 EXECUTIVE CENTER DRIVE IC Community Health Plan SHERREL PFEIFER sherrel.pfeifer@heartland-health.com (816)271-7380 (816)271-7976 HEARTLAND HEALTH BUSINESS PLAZA 141 NORTH BIE Coventry Health Care of Nebraska JOHN PROTO jproto@cvty.com (302)283-6628 (302)283-6796 211 LAKE DRIVE IG Coventry Health Care DEEMETRESS DANZY dmdanzy@cvty.com (302)283-6978 (302)283-6788 211 LAKE DRIVE IK Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N IM Globalhealth, Inc. DEBRA HYNEK debra.hynek@globalhealth.cc (405)280-5616 (405)280-2951 701 N.E. 10TH STREET SUITE 300 IN M*Plan LINDA HICKS lhicks@thcg.org (317)705-3574 (317)571-5306 8802 N MERIDIAN ST STE 100 J6 Vytra Health Plans SONJA KRUMHOLZ skrum@vytra.com (631)577-5304 (631)719-7769 395 N SERVICE RD J8 JMH Health Plan SERGE BOISETTE serge@jmhhp.com (305)575-3695 (305)545-5212 1801 NW 9TH AVENUE SUITE 700 JA Coventry Health Care of Louisiana TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 JC Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N JK PacifiCare Asia Pacific JOYCE QUINTANILLA joyce.quintanilla@phs.com (671)646-6956 (671)646-6923 761 S MARINE DRIVE MS GUAM JN Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N JP M.D. IPA KIMBERLY HOLMAN kholman@mamsi.com (240)379-1858 (301)360-8918 800 OAK STREET P.O. BOX 931 JR Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N JV Fallon Community Health Plan AMY STUCZYNSKI amy.stuczynski@fchp.org (508)368-9287 (508)831-1136 10 CHESTNUT ST ATTN: AMY SK5 Bluecare Network of MI MS LONITA LOVE LLOVE@BCBSM.COM (248)223-5147 (248)799-6327 25925 TELEGRAPH ROAD K9 PacifiCare of Nevada DINA CANALES dina.canales@phs.com (210)474-5490 (210)474-5378 6200 NORTHWEST PARKWAY TX70-100 KQ Univera Healthcare ESINASH MANGENA esinash.mangena@univerahealthcare.com (716)843-7897 (716)504-5573 205 PARK CLUB LANE KR Bluecare Network of MI MS LONITA LOVE LLOVE@BCBSM.COM (248)223-5147 (248)799-6327 25925 TELEGRAPH ROAD KS Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N L1 KPS Health Plans LIL KERLEE LKerlee@kpshealthplans.com (800)552-7114 x6712 (360)698-0982 400 WARREN AVENUE L3 Coventry Health Care of Louisiana HDHP TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 L4 HMO Health Ohio PEGGY SIMS Peggy.Sims@mmoh.com (216)687-7179 (216)687-6362 2060 E 9TH STREET COST CENTEL5 Coventry Health Care of Georgia HDHP SAGINA WILLIAMS gswilliams@cvty.com (678)202-2174 (678)202-2190 1100 CIRCLE 75 PARKWAY SUITE 1400 L6 Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE L8 Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE LB Health Net of California GRISEL MONTERO grisel.montero@healthnet.com (800)909-6362 (818)676-7411 P.O. BOX 9103 LK Coventry Health Care HDHP DEEMETRESS DANZY dmdanzy@cvty.com (302)283-6978 (302)283-6788 211 LAKE DRIVE LM Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE LN Bluecare Network of MI MS LONITA LOVE LLOVE@BCBSM.COM (248)223-5147 (248)799-6327 25925 TELEGRAPH ROAD LT Coventry Health Care of Louisiana HDHP TIFFANY MCGUIRE Tmcguire@cvty.com (504)834-0840 (504)828-6433 3838 N CAUSEWAY BLVD SUITE 3350 

2
Attachment 2 - BAL 05-406 

Plan Contacts for Enrollment Forms

LX Bluecare Network of MI MS LONITA LOVE LLOVE@BCBSM.COM (248)223-5147 (248)799-6327 25925 TELEGRAPH ROAD M5 Blue Cross- HMO MARILYN FERNANDO marilyn.fernando@wellpoint.com (818)234-4915 (818)234-3028 21555 OXNARD STREET M9 MVP Health Care JENNIFER LUCARELLI JLucarelli@mvphealthcare.com (518)386-7814 (518)386-7880 625 STATE ST MJ Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE MK Blue Choice PATRICIA KENT patricia.kent@excellus.com (585)454-1700x4772 (585)238-3694 165 COURT STREET 

ML Av-Med Health Plan NEREYDA CARDENTEY Nereyda.Pons@avmed.org (305)671-4795 (305)671-4764 9400 SOUTH DADELAND BLVD. MM Group Health Plan, Inc. KERRY FINK kfink@cvty.com (717)541-5724 (800)471-2252 3721 TECPORT DRIVE MQ Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE MS Humana Health Plan, Inc. ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 500 WEST MAIN STREET 5TH FLOOR MV Vantage Health Plan, Inc. GLORIA TURNER gturner@vhpla.com (318)361-0900 x203 (318)361-2168 130 DESIARD STREET SUITE 300 MW Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE MX MVP Health Care JENNIFER LUCARELLI JLucarelli@mvphealthcare.com (518)386-7814 (518)386-7880 625 STATE ST MZ Hometown Health Plan MARY FERRELL mferrell@hometownhealthnet.com (330)834-2214 (330)830-5634 100 LILLIAN GISH BOULEVARD ND Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N NM Health Plan of Nevada MS MARY KOKER ENR109@SIERRAHEALTH.COM (702)242-7384 (702)242-9186 2720 N TENAYA WAY NV New West Health Services SYBIL SHULTS sshults@nwhp.com (406)457-2271 (406)457-2299 130 NEILL AVENUE P1 Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N P2 Presbyterian Health Plan VICTORIA LUCERO vilucero@phs.org (505)923-5136 (505)923-8252 2501 BUENA VISTA SE P.O. BOX 274P3 Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N PH Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE PN HealthAmerica Pennsylvania GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE PU Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N PV WINhealth Partners BETH WASSON bwasson@winhealthpartners.org (307)638-7700 (307)638-7701 1200 EAST 20TH STREET SUITE A Q1 Lovelace Health Plan NORMA HUGHES Norma.Hughes@cigna.com (602)328-5300 (602)328-5431 2401 W PEORIA AVENUE Q8 Univera Healthcare ESINASH MANGENA esinash.mangena@univerahealthcare.com (716)843-7897 (716)504-5573 205 PARK CLUB LANE QA Independent Health Assoc LAURA WOLFF lwolff@independenthealth.com (716)631-8554 (716)631-4059 511 FARBER LAKES DRIVE QP Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE R5 Blue HMO KAY GILLILAND kay.gilliland@anthem.com (513)872-6412 (513)872-3929 1351 WILLIAM HOWARD TAFT RD. MAIL DROP ORD Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N RL Grand Valley Health Plan SHERYL LINTON lintons@gvhp.com (616)949-2410 (616)949-4978 829 FOREST HILL AVENUE SE RU Heart of America Health Plan SHARON PEDERSON hoahp@gondtc.com (701)776-5848 (701)776-5425 810 SOUTH MAIN S4 Keystone Health Plan Central TRACI SWINGLY Traci.Swingly@khpc.com (717)541-7760 (717)541-7575 2500 ELMERTON AVENUELMERTON AVENUE SA PacifiCare Northwest Region (Oregon/Washington) ELIZABETH LEONARD elizabeth.leonard@phs.com (210)474-5294 (210)474-5398 6200 NORTHWEST PARKWAY TX70-100 SG CDPHP Universal Benefits, Inc. SUSAN KLUG sklug@cdphp.com (518)641-5151 (518)641-5005 1223 WASHINGTON AVENUE SJ Blue Shield California Access+HMO LORRIE MOORE lorrie.moore@blueshieldca.com (209)367-6639 (209)367-6650 121 N. Guild Ave., Bldg. A SL Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N SV Coventry Health Care of Iowa GREG MONTOGMERY gmontgomery@cvty.com (302)283-6500 (302)283-6788 211 LAKE DRIVE SW HealthAmerica Pennsylvania GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE T2 Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE T8 Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE TE ConnectiCare TIFFANY MCNEALY tmcnealy@connecticare.com (860)409-6427 (860)678-5255 30 BATTERSON PARK RD TP Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE TU Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE TV Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE U2 Paramount Health Care JOAN JAEGER joan.jaeger@ProMedica.org (419)887-2928 (419)887-2016 1901 INDIAN WOOD CIR U4 The Health Plan of the Upper Ohio Valley JODY MCADAMS jodym@healthplan.org (740)695-7621 (740)699-6162 52160 NATIONAL ROAD E. 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MARGINAL WAY SO VT KPS Health Plans LIL KERLEE LKerlee@kpshealthplans.com (800)552-7114 x6712 (360)698-0982 400 WARREN AVENUE VW MVP Health Care JENNIFER LUCARELLI JLucarelli@mvphealthcare.com (518)386-7814 (518)386-7880 625 STATE ST WD Dean Health Plan HEATHER HEILIGER heiliger_heather_c@ssmhc.com (608)836-9620 (608)827-4215 1277 DEMING WAY WJ Group Health Cooperative LORI MILLER lm_miller@ghc-hmo.com (608)828-4827 (608)828-9333 1265 JOHN Q HAMMONS DRIVE WQ Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N X4 GHI HMO Select LINDA PINO LPino@ghihmo.com (845)340-2249 (845)334-8950 PO BOX 4181 X5 HealthPlus MI MONICA MASOLINI mmasolin@healthplus.com (810)230-2218 (810)733-1925 2050 S LINDEN RD Y1 Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N Y6 Health America Pennsylvania-HDHP GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE Y9 Vista Healthplan RON SNYDER ron.snyder@vistahealthplan.com (954)965-3315 (954)986-6067 300 SOUTH PARK ROAD YE Aetna Open Access JOANNE MCCABE McCabeJD@aetna.com (215)775-4340 (215)775-5870 1425 UNION MEETING RD MS U21N YG Humana CoverageFirst (Consumer Driven Plan) ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE YH John Deere Health Plan PATRICIA RUMLER rumlerpatriciam@johndeere.com (309)765-1362 (309)749-1220 1300 RIVER DR STE 200 YM HMO Blue Texas ALVIN WARREN alvin_warren@bcbstx.com (915)793-4318 (915)793-4496 4002 LOOP 322 FEP YN Health America Pennsylvania-HDHP GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE YW Health America Pennsylvania-HDHP GERI GARDNER ggardner@cvty.com (717)541-5729 (717)526-2920 3721 TECPORT DRIVE ZJ Humana Health Plans of Puerto Rico ROBIN ANDERSON randerson@humana.com (502)580-7484 (502)508-4613 101 E MAIN ST 9TH FL SE 

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