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A B C E G H I J K

Send Enrollment Forms To This Contact Phone Number Phone Number

Carrier 

Code Plan Name

Enrollment Forms Contact 

Name Address City State Zip Code Work FAX

18 Humana Care Plan NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

2C PIEDMONT COMMUNITY HEALTHCARE (VIRGINIA) CHERYL F MIDKIFF 2255 LANGHORNE ROAD SUITE 2 LYNCHBURG VA 24501 (804)947-4463 x216 (804)947-4465

2U Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

2X Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

3G Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

3N HIP Health Plan of Florida MR JOSE RAMIREZ 300 SOUTH PARK ROAD HOLLYWOOD FL 33021 (954)962-3008 (954)893-6482

3N HIP Health Plan of Florida PAMELA WOODSON 300 SOUTH PARK ROAD HOLLYWOOD FL 33021 (954)962-3008

5B Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

5U Aetna U.S. Healthcare MS. JOANNE DOTY (215)775-4340

5Y MDNY Healthcare MS MARGARET PULCINI ONE HUNTINGTON QUADRANGLE, SUITE4C01 MELVILLE NY 11747 (516)454-1900 (516)454-1915

5Y MDNY Healthcare MR TOM MCCABE (516)454-1900

5Y MDNY Healthcare MS ROCHELLE BATTINO ONE HUNTINGTON QUADRANGLE, SUITE4CO1MELVILLE NY 11747 (516)454-1900

68 Harvard Pilgrim Health Care, Inc. KAREN WALSH 1200 CROWN COLONY DRIVE QUINCY MA 2169 (800)742-8326

6F Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

6J Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

6L HealthAssurance HMO KIM MCCLEARY 2575 INTERSTATE DRIVE HARRISBURG PA 17110 (717)540-6763 (717)541-5979

6T Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

75 Humana Health Plan, Inc. - Chicago NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

7F Humana Medical Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

7K Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

8J Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

8L Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

8T SuperBlue HMO CHRISTINA WIEGEL 700 MARKET STREET PARKERSBURG WV 26101 (304)424-9883 (304)424-7737

8U MDNY Healthcare MS ROCHELLE BATTINO ONE HUNTINGTON QUADRANGLE, SUITE4CO1MELVILLE NY 11747 (516)454-1900

8U MDNY Healthcare MS MARGARET PULCINI ONE HUNTINGTON QUADRANGLE, SUITE4CO1MELVILLE NY 11747 (516)454-1900 (516)454-1915

8U MDNY Healthcare MR TOM MCCABE (516)454-1900

8V Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

8X Aetna U.S. Healthcare MS. JOANNE DOTY (215)775-4340

8Z Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

9D Humana Medical Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

9M Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

BU Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

D2 Humana Health Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

DY Humana Health Plan of Arizona NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

EB HMO-CNY THERESA THOMPSON 344 SOUTH WARREN ST. SYRACUSE NY 13221 (315)448-3847 (315)448-4999

EE Humana Medical Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

H1 Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

HR Humana Care Plan NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

JC Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

JH Humana Medical Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

JN Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

K7 HIP Health Plan of Florida MR JOSE RAMIREZ 300 SOUTH PARK ROAD HOLLYWOOD FL 33021 (954)962-3008 (954)893-6482

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Enrollment Forms Contact 

Name Address City State Zip Code Work FAX

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K7 HIP Health Plan of Florida PAMELA WOODSON 300 SOUTH PARK ROAD HOLLYWOOD FL 33021 (954)962-3008

KA OmniCare Health Plan MIYOKA YOUNG 1155 BREWERY PARK BLVD STE 250 DETROIT MI 48207 (313)393-2254

KL Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

MS Humana Kansas City NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

NE Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

NG Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

NK Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

NQ HealthGuard of Lancaster TRACY EVANS 280 GRANITE RUN DRIVE LANCASTER PA 17601 (717)581-4548

P3 Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

P5 Humana Medical Plan, Inc. NATALIE HALL (502)580-7427

P7 Humana Medical Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

R5 Health Maintenance Plan (HMP) JOAN SHELTON (800)851-3379

RD Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

SG Capital District Physicians' Health Plan MS BARBARA WAGNER 17 COLUMBIA CIRCLE ALBANY NY 12203 (518)218-6432

SU Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

TK Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

TL Humana Health Plan, Inc. NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

TS Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

TW Humana Health Plan of Texas NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

TX Humana Health Plan of Texas NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

UB Prudential HealthCare HMO Tennessee DONNA BLACK 3150 LENOX PARK BLVD MEMPHIS TN 38115 (901)541-9316 (901)368-0643

UE Humana Health Plan of Texas NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

UM NYLCare Health Plans of the Gulf Coast PATTI ROGAN 4500 FULLER DR IRVING TX 75038 (972)791-8813

UR Humana Health Plan of Texas NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

V2 NYLCare Health Plans of the Southwest PATTI ROGAN 4500 FULLER DR IRVING TX 75038 (972)791-8813

W4 Unity Health Plans Insurance Corporation PAUL THUMS 840 CAROLINA STREET SAUK CITY WI 53583 (608)643-1447

WQ Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

X1 Humana Wisconsin Health Organization NATALIE HALL 101 E MAIN ST 9TH FL LOUISVILLE KY 40201 (502)580-7427

XC Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

Z1 Aetna U.S. Healthcare MS. JOANNE DOTY 1425 UNION MEETING RD BLUE BELL PA 19422 (215)775-4340

ZE NYLCare Health Plans of the Gulf Coast PATTI ROGAN 4500 FULLER DR IRVING TX 75038 (972)791-8813

ZF NYLCare Health Plans of the Gulf Coast PATTI ROGAN 4500 FULLER DR IRVING TX 75038 (972)791-8813

AH HMO Blue TIMOTHY S ALLEN 12 RHOADS DRIVE UTICA NY 13501 (315)731-2547

IN M*Plan LANI COHEN (317)571-5311 (317)571-5306

WH Family Health Plan DORA TALAVERA 11524 WEST THEORDORE TRECKER WAY MILWAUKEE WI 53214 (414)256-0040

X5 HealthPlus of Michigan MICHELLE BURKE (517)797-4022 (517)797-4044

3Q SecureCare of Iowa MS. JODI NOGA 11141 AURORA AVENUE DES MOINES IA 50322 (515)222-0606 (515)331-7848

4C Carelink Health Plans DARIN VIRAG 141 SUMMERS SQUARE CHARLESTON WV 25326 (304)388-6994

7W Principal Health Care of Kansas City, Inc. CYNTHIA SMITH (316)630-6243 (316)634-1266

A7 Intergroup of Arizona, Inc. LISA M OCHOA 930 N FINANCE CENTER DR TUCSON AZ 85710 (520)319-3807 (520)319-3830

L2 HMO Colorado/HMO Nevada JOHN HUTCHINSON 700 BROADWAY DENVER CO 80273 (303)864-6452

VS HMO Colorado/HMO Nevada JOHN HUTCHINSON 700 BROADWAY DENVER CO 80273 (303)864-6452

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Enrollment Forms Contact 

Name Address City State Zip Code Work FAX

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WJ Group Health Cooperative of South Central Wisconsin LORI MILLER 8201 EXCELSIOR DR MADISON WI 53717 (608)828-4827 (608)828-9333

2G CapitalCare, Inc. DENISE ALOMAR 550 12TH STREET, SW WASHINGTON DC 20065 (202)479-6567

1K Prudential HealthCare HMO Kansas City CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

RR Prudential HealthCare HMO Oklahoma City CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

RS Prudential HealthCare HMO Oklahoma City CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

UP Prudential HealthCare HMO Houston CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

VX Prudential HealthCare HMO Houston CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

VZ Prudential HealthCare HMO St. Louis CHARLA FRYE ONE PRUDENTIAL CIRCLE MS 201 HOUSTON TX 77478 (281)637-5322

G2 Arnett HMO Health Plan CONNIE PHILLIPS (765)448-7702

FA Care Choices PATRICIA MARDUESZ 34605 TWELVE MILE RD FARMINGTON HILLSMI 48331 (248)489-6388

EG M-Care JASON L HELLING 25330 TELEGRAPH RD., SUITE 150 SOUTHFIELD, MI 48034 (248)945-4108 (248)223-9133

DA Blue Chip, Coordinated Health Partners FRANK COLANTUONO 444 WESTMINSTER ST PROVIDENCE RI 2903 (716)631-3001 (716)631-3001

HU CIGNA HealthCare of New York RODNEY WILLIAMS 195 BROADWAY NEW YORK NY 10007 (212)618-5419

6A Vantage Health Plan DEBRA WAGENHALS 924 E PERKINS AVE SANDUSKY OH 44870 (419)621-9858 (419)621-9859

5D Foundation Health, A Florida Health Plan MICHAEL J. COMERFORD 1340 CONCORD TERRACE SUNRISE FL 33323 (954)858-3585

5E Foundation Health, A Florida Health Plan MICHAEL J. COMERFORD 1340 CONCORD TERRACE SUNRISE FL 33323 (954)858-3585

VA Preferred Plus of Kansas CARLA DALLAS 8535 EAST 21ST STREET WICHITA KS 67206 (316)268-0401

51 Health Insurance Plan of Greater New York (HIP/HMO) PETER MALLETT 7 WEST 34TH STREET NEW YORK NY 10001 (212)630-8380

AC American HMO Health Plan - Illinois DENISE DICKSON-MATHEWS4601 SAUK TRAIL RICHTON PARK IL 60471 (708)503-5000

QJ QualMed Plans for Health of Ohio & WVA (formerly Advantage HP) SHIRLEY BLEVINS 121 SEVENTH STREET PITTSBURGH PA 15222 (412)391-9300

N9 Penn State Geisinger Health Plan ARLENE EDWARDS 100 N ACADEMY AVE DANVILLE PA 17822 (800)441-6211 (570)271-5871

38 The National Rural Letter Carriers Association MS CARRIE FRAZIER 1630 DUKE STREET, SUITE 200 ALEXANDRIA VA 22314 (703)684-5552

LD Free State Health Plan DIXIE CRITZMAN 10455 MILL RUN CIR. OWINGS MILL MD 21117 (410)998-6264

JV Fallon Community Health Plan MICHELLE DUMONT 10 CHESTNUT STREET WORCESTER MA 1608 (800)333-2535

WD Dean Health Plan HEATHER HEILIGER 1277 DEMING WAY MADISON WI 53717 (608)836-9620

88 The Rocky Mountain Health Maintenance Organization SUE DILLON 2775 CROSSROADS BLVD GRAND JUNCTION CO 81506 (800)843-0719

47 APWU Health Plan DONNA SONDLO 12345 NEW COLUMBIA PIKE SILVER SPRING MD 20904 (301)622-5530 (301)622-5712

31 Government Employees Hospital Association, Inc. (GEHA) SANDRA K MOLDER 17306 E 24 HWY INDEPENDENCE MO 64056 (816)257-5500 (816)257-0972

8W UPMC HEALTH PLAN THERESA WASHINGTON 112 WASHINGTON PLACE SUITE 800 PITTSBURGH PA 15219 (412)454-7773

24 QualMed Plans for Health of Western PA (formerly Advantage HP) KENNETH ALLEN (412)391-9300

1R Alliance Health Benefit Plan CLAUDETTE JOHNSON 1628 11TH ST NW WASHINGTON DC 20001 (202)939-6374 (202)939-6389

3A AultCare HMO KEVIN HARVEY (330)438-6360

2T TEXAS HEALTH CHOICE MARY KOKER 2716 N TENAYA WAY LAS VEGAS NV 89128 (702)242-7384

UK TEXAS HEALTH CHOICE MARY KOKER P. O. BOX 14688 LAS VEGAS NV 89114 (702)242-7384

40 Foreign Service Benefit Plan LARRY NEWFELD 1716 N STREET, NW WASHINGTON DC 20036 (202)833-4910

M5 Blue Cross CaliforniaCare THYS DEYOUNG 21555 OXNARD STREET WOODLAND HILLS CA 91367 (818)703-4912

4U American Healthcare Trust, Inc. JOSHLYNN ALFORD 22 NORTH FRONT STREET SUITE 960 MEMPHIS TN 38103 (901)523-1149 x415

E5 George Washington University Health Plan DEBORAH GIBSON 4550 MONTGOMERY AVE STE 800 BETHESDA MD 20814 (301)941-2049

JV Fallon Community Health Plan MS. LISA SAUCIER 10 CHESTNUT STREET WORCESTER MA 1608 (800)333-2535

5W SummaCare Health Plan TRACIE BABARICK 400 WEST MARKET STREET AKRON OH 44303 (330)996-8444

DA Blue Chip, Coordinated Health Partners FRED COLARDO 444 WESTMINSTER ST PROVIDENCE RI 2903 (401)459-5706

52 Health Alliance Plan WESTON DIGGS 2850 WEST GRAND BLVD DETROIT MI 48202 (248)443-1035 (248)443-0090

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LB Health Net TINA SMITH P.O. BOX 10196 VAN NUYS CA 91410 (818)719-6870

36 Postmasters Benefit Plan ISAAC SIMMONS 1019 NORTH ROYAL STREET ALEXANDRIA VA 22314 (703)683-1664

VH Valley Health Plan JAN LEVENDUSKY 2270 EASTRIDGE CENTER EAU CLAIRE WI 54702 (715)836-1216

44 SAMBA Health Benefit Plan CINDY BREWBAKER 11301 OLD GEORGETOWN ROAD ROCKVILLE MD 20852 (301)984-4115

N2 Total Health Care MS SANDRA SPEARS 3011 WEST GRAND BLVD DETROIT MI 48202 (313)871-7805

R5 Health Maintenance Plan (HMP) DANIEL DUNDES 1351 WILLIAM H. TAFT ROAD CINCINNATI OH 45206 (513)872-6546

NM Health Plan of Nevada, Inc. LINDA MOLNAR PO BOX 15645 LAS VEGAS NV 89114 (702)242-7326 (702)869-2490

C8 First Priority Health of Northeastern Pennsylvania ALICE RUSSOMANO 70 N MAIN STREET WILKES BARRE PA 18711 (570)829-6182

27 QualMed Plans for Health (formerly Greater Atlantic Health Service)MARK CHRISTMAN 1835 MARKET STREET PHILADELPHIA PA 19103 (215)209-6622

2K QualMed Plans for Health (formerly Greater Atlantic Health Service)MARK CHRISTMAN (215)209-6622

6X Compcare Health Services CAROLINE BERGHAMMER (414)226-5569 (414)226-5500

26 HealthAmerica Pennsylvania DIANNE DOLL (717)671-2476 (717)541-5979

SW HealthAmerica Pennsylvania DIANNE DOLL 2575 INTERSTATE DRIVE HARRISBURG PA 17110 (717)671-2476 (717)541-5979

PW Kaiser Permanente SUSAN KLUG 1 CHP PLAZA LATHAM NY 12110 (518)783-1864 (518)782-9976

QB Kaiser Permanente SUSAN KLUG 1 CHP PLAZA LATHAM NY 12110 (518)783-1864 (518)782-9976

QH Kaiser Permanente SUSAN KLUG 1 CHP PLAZA LATHAM NY 12110 (518)783-1864 (518)782-9976

GV Preferred Care MARISOL AZNARAN 259 MONROE AVENUE ROCHESTER NY 14607 (716)327-5795 (716)325-3478

6Q UNIVERSAL CARE MR ALLAN RAHN 1600 E HILL STREET SIGNAL HILL CA 90806 (562)981-4083 (562)427-6710

QK United HealthCare of Florida, Inc. MANNIE PEREZ 13621 NORTHWEST SUNRISE FL 33323 (305)461-8436

69 Compcare Health Services CAROLINE BERGHAMMER MILWAUKEE WI 53201 (414)226-5569 (414)226-5500

S4 Keystone Health Plan Central SCOTT STEWART FOURTH FLOOR CAMP HILL PA 17011 (717)730-1691 (717)730-1111

4K Beacon Health Plans DANIA MENENDEZ 2511 PONCE DE LEON BLVD CORAL GABLES FL 33134 (305)774-2546 (305)774-2619

8B Generations Family Health Plan MS. DIANE TOOMER SUITE 100 CHAPEL HILL NC 27514 (919)490-0102 (919)490-1790

5L BlueChoice HMO SHARON FISHER ONE WORLD TRADE CENTER NEW YORK NY 10048 (212)476-6803

S7 BlueChoice HMO SHARON FISHER ONE WORLD TRADE CENTER NEW YORK NY 10048 (212)476-6803

8F Premera HealthPlus KAREN ENGLAND 7001 220TH ST SW MOUNTLAKE TERRACE WA 98043 (800)422-0032 (425)670-5057

7P Physicians Plus HMO JEANINNE CRAVILLION WAUSAU WI 54402 (800)916-9162

5Z Western Health Advantage CATHERINE KYPTA 1331 GARDEN HIGHWAY SACRAMENTO CA 95833 (916)563-3190 (916)568-1338

5G First Choice Health Plan MS JANET WALTHEW 601 UNION ST SEATTLE WA 98101 (206)268-2356

S3 Prudential HealthCare HMO Midwest SUSIE REUSCH 312 ELM ST CINCINNATI OH 45202 (513)784-7087 (513)784-7011

4A Total Health Choice MS. CONSTANCE SCRIVER 8701 SW 137TH AVE MIAMI FL 33183 (305)408-5722

9F OSF HealthPlans, Inc. MARY MCCUMBER 7915 N HALE AVENUE PEORIA IL 61615 (309)677-8382 (309)677-8259

6W Healthcare Oklahoma MS. AMY TAYLOR 3030 NW EXPRESSWAY OKLAHOMA CITY OK 73112 (405)951-4837 (405)951-4783

7X Health Alliance HMO JOAN SHELTON 102 E. MAIN STREET URBANA IL 61801 (800)851-3379

FX Health Alliance HMO JOAN SHELTON 102 E. MAIN STREET URBANA IL 61801 (800)851-3379

SV Principal Health Care of Iowa, Inc. TERRY S. NOONEN 4600 WESTOWN PARKWAY WEST DES MOINESIA 50266 (800)257-4692

DF Health Partners of Alabama MS ALICE RANKIN TWO PERIMETER PARK SOUTH BIRMINGHAM AL 35243 (800)888-7647

9K ALTIUS HEALTH PLANS (Formerly PacifiCare of Utah) DEBBIE BJERREGAARD 10421 SOUTH JORDAN GATEWAY SOUTH JORDAN UT 84095 (801)933-3536

MC PARTNERS National Health Plans of Indiana, Inc. MS. JODIE WENSITS 100 E. WAYNE ST. SOUTH BEND IN 46601 (800)876-2655

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