177
SBWC # Insurer Name Address Email 10114 WILMINGTON DULUTH GA 30097 Phone: SBWC # Insurer Name Address Email 20582 ATLANTA ATLANTA GA 30328 Phone: SBWC # Insurer Name Address Email 20622 DOTHAN FL 32716 Phone: SBWC # Insurer Name Address Email 20764 FORT SMITH FORT SMITH AR 72917 Phone: SBWC # Insurer Name Address Email 13246 LANSING LANSING MI 48901 Phone: BRUNSWICK GA 31520 Phone: SBWC # Insurer Name Address Email 13214 LANSING LANSING MI 48901 888-888-8136 Ext. PMA MANAGEMENT CORPORATION 23-2652239 1100 ABERNATHY ROAD [email protected] A G RHODES HOME INC 3715 NORTHSIDE PKWY, BLDG 400 STE 305 GA 30327 [email protected] GAB ROBINS NORTH AMERICA INC 13-2747054 3039 PREMIERE PARKWAY [email protected] 770-813-0997 Ext. 230 Georgia State Board of Workers' Compensation Insurer and Claim Offices by Name 21ST CENTURY PREMIER INS CO FKA COLONIAL PENN FRAN INS CO 21ST CENTURY PLAZA, 3 BEAVER VALLEY ROAD DE 19803 ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR [email protected] 912-264-0988 Ext. 800-395-2366 Ext. 1702 ACCIDENT FUND GENERAL INSURANCE COMPANY MI 48933 [email protected] ACCIDENT FUND CLAIMS DEPT 38-3207001 200 N GRAND AVE [email protected] 800-961-9744 Ext. ABF FREIGHT SYSTEM INC. AR 72917 [email protected] ABF FREIGHT SYSTEM INC 71-0249444 P O BOX 10048 [email protected] 800-315-6090 Ext. AAA COOPER TRANSPORTATION AL 36302 [email protected] NORTH AMERICAN RISK SERVICES INC 13-3901415 P O BOX 166002 ALTAMONTE SPRINGS [email protected] ACCIDENT FUND CLAIMS DEPT 38-3207001 200 N GRAND AVE [email protected] ACCIDENT FUND INSURANCE CO OF AMERICA MI 48933 [email protected]

Georgia State Board of Workers' Compensation Insurer and Claim

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Page 1: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

10114 WILMINGTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20582 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20622 DOTHAN

FL 32716

Phone:

SBWC # Insurer Name Address Email

20764 FORT SMITH

FORT SMITH AR 72917

Phone:

SBWC # Insurer Name Address Email

13246 LANSING

LANSING MI 48901

Phone:

BRUNSWICK GA 31520

Phone:

SBWC # Insurer Name Address Email

13214 LANSING

LANSING MI 48901

888-888-8136 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

A G RHODES HOME INC 3715 NORTHSIDE PKWY,

BLDG 400 STE 305

GA 30327 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

Georgia State Board of Workers' Compensation

Insurer and Claim Offices by Name

21ST CENTURY PREMIER INS CO FKA

COLONIAL PENN FRAN INS CO

21ST CENTURY PLAZA, 3

BEAVER VALLEY ROAD

DE 19803

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR [email protected]

912-264-0988 Ext.

800-395-2366 Ext. 1702

ACCIDENT FUND GENERAL INSURANCE

COMPANY

MI 48933 [email protected]

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE [email protected]

800-961-9744 Ext.

ABF FREIGHT SYSTEM INC. AR 72917 [email protected]

ABF FREIGHT SYSTEM INC 71-0249444 P O BOX 10048 [email protected]

800-315-6090 Ext.

AAA COOPER TRANSPORTATION AL 36302 [email protected]

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

[email protected]

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE [email protected]

ACCIDENT FUND INSURANCE CO OF AMERICA MI 48933 [email protected]

Page 2: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

BRUNSWICK GA 31520

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13240 LANSING

LANSING MI 48901

Phone:

BRUNSWICK GA 31520

Phone:

SBWC # Insurer Name Address Email

13235 IRMO

KENNESAW GA 30144

Phone:

SBWC # Insurer Name Address Email

10253 PHILADELPHIA

LITTLE ROCK AZ 72231

Phone:

BIRMINGHAM AL 35209

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR [email protected]

912-264-0988 Ext.

800-395-2366 Ext. 1702

ACCIDENT FUND NATIONAL INSURANCE

COMPANY

MI 48933 [email protected]

ACCIDENT FUND CLAIMS

DEPT

38-3207001 200 N GRAND AVE [email protected]

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ACCIDENT FUND INSURANCE 20-3058200 129 FREDERICK DR [email protected]

912-264-0988 Ext.

800-395-2366 Ext. 1702

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

ALTERNATIVE SERVICE

CONCEPTS LLC

43-1954328 P O BOX 15550 [email protected]

800-669-0437 Ext. 108

ACE AMERICAN INS CO 436 WALNUT STREET, PA 19106 [email protected]

800-896-6884 Ext. 8459

US ADMINISTRATOR CLAIMS 26-3357762 3440 BLUE SPRINGS ROAD [email protected]

ACCIDENT INSURANCE COMPANY SC 29063 [email protected]

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG [email protected]

800-742-4248 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

678-969-7337 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

Page 3: Georgia State Board of Workers' Compensation Insurer and Claim

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

FORT MILL SC 29715

Phone:

TAMPA FL 33618

Phone:

ATLANTA GA 30328

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-685-7361 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR [email protected]

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

800-282-6218 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 607 [email protected]

803-547-8036 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

Page 4: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30338

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

SAVANNAH GA 31405

Phone:

PARSIPPANY NJ 07054

Phone:

SBWC # Insurer Name Address Email

10221 PHILADELPHIA

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-353-4591 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS BELLSOUTH

DISABILITY

36-2685608 1200 ASHWOOD PARKWAY [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

800-347-4494 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

ACE FIRE UNDERWRITERS 436 WALNUT STREET,

WB04G

PA 19106 [email protected]

912-355-8989 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD [email protected]

877-927-2255 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

800-541-0139 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

CT

[email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

Page 5: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

ORLANDO FL 32878

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13034 PHILADELPHIA

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

615-824-5095 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

800-685-7361 Ext.

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

ACE INDEMNITY INSURANCE CO PA 19106 [email protected]

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

Page 6: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

10002 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13193 DALLAS,

TAMPA FL 33602

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13176 SALT LAKE CITY

TUCKER GA 30084

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21753 ORLANDO

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

ACE PROPERTY & CASUALTY 436 WALNUT STREET,

WB04G

PA 19106 [email protected]

ACIG INSURANCE COMPANY 12222 MERIT DRIVE,

SUITE 1660

TX 75251 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ADVENTIST HEALTH SYSTEM SUNBELT

HEALTHCARE CORP

602 COURTLAND ST, STE

330

FL 32804 [email protected]

800-354-6494 Ext. 201

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

866-710-0908 Ext.

ADVANTAGE WORKERS COMPENSATION

INSURANCE COMPANY

UT 84157 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

678-731-9091 Ext. 252

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD [email protected]

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE [email protected]

Page 7: Georgia State Board of Workers' Compensation Insurer and Claim

ORLANDO FL 32804

Phone:

SBWC # Insurer Name Address Email

20315 ATLANTA

ATLANTA GA 30302

Phone:

SBWC # Insurer Name Address Email

30047 COMMERCE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10066 NEW YORK

ALPHARETTA GA 30023

SBWC # Insurer Name Address Email

21130 ALBANY

JOHNS CREEK GA 30097

SBWC # Insurer Name Address Email

21715 ALBANY

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13202 ROCKY HILL

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

407-200-4894 Ext.

ADVENTIST HEALTH

SYSTEM RISK MANAGEMENT

59-2170012 602 COURTLAND STREET [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

ALBANY CITY OF GA 31702 [email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

AIU INSURANCE COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

[email protected]

800-421-0710 Ext.

AGRI TRUST OF GA GA 30529

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

404-584-3782 Ext.

AGL RESOURCES INC. DBA ATLANTA GAS

LIGHT

GA 30302 [email protected]

AGL RISK MANAGEMENT 58-2210952 P O BOX 4569 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

404-266-4855 Ext.

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

800-906-4461 Ext.

ALEA NORTH AMERICA INSURANCE COMPANY CT 06067 [email protected]

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

ALBANY INTERNATIONAL CORP NY 12201 [email protected]

Page 8: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10295 VAN WERT

VAN WERT OH 45891

Phone:

SBWC # Insurer Name Address Email

13275 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13244 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

21464 ATLANTA

ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

13293 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

21596 ALPHARETTA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

13245 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

ALLIED SYSTEMS LTD 2302 PARKLAKE DR,

BUILDING 15 SUITE 600

GA 30378 [email protected]

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

800-985-7078 Ext.

ALLIED PROPERTY AND CASUALTY INSURANCE

COMPANY

ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 [email protected]

ALLIED EASTERN

INDEMNITY COMPANY

26-0026993 P O BOX 83777 [email protected]

888-654-7100 Ext.

ALLIED EASTERN INDEMNITY COMPANY PA 17608 [email protected]

CENTRAL INSURANCE 34-4202560 800 SOUTH WASHINGTON [email protected]

800-736-7000 Ext. 2380

ALL AMERICA INSURANCE CO OH 45891 [email protected]

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

800-985-7078 Ext.

AMCO INSURANCE COMPANY ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

ALPHARETTA CITY OF GA 30009 [email protected]

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET [email protected]

800-628-0250 Ext.

ALLMERICA FINANCIAL BENEFIT INSURANCE

COMPANY

MA 01653 [email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

Page 9: Georgia State Board of Workers' Compensation Insurer and Claim

13122 PRINCETON

ATLANTA GA 30319

Phone:

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10006 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

10007 CHICAGO

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

IRVING TX 75039

Phone:

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 [email protected]

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY [email protected]

AMERICAN AUTOMOBILE INSURANCE

COMPANY

CA 94998 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

AMERICAN ALTERNATIVE INSURANCE

CORPORPATION

NJ 08543 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

312-822-2331 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

AMERICAN CASUALTY COMPANY OF READING

PENNSYLVANIA

333 S WABASH AVENUE,

28 SOUTH

IL 60604 [email protected]

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE [email protected]

GALLAGHER BASSET 36-3365500 222 W LAS COLINAS BLVD [email protected]

800-787-6750 Ext.

Page 10: Georgia State Board of Workers' Compensation Insurer and Claim

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13271 BLOOMINGTON

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

10262 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13255 MADISON

SCHOFIELD WI 55476

Phone:

SBWC # Insurer Name Address Email

10011 FAIRFIELD

CHARLOTTE NC 28277

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

866-246-0259 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

AMERICAN FIRE & CASUALTY COMPANY OH 45014 [email protected]

800-692-6326 Ext. 41237

AMERICAN FAMILY INSURANCE COMPANY WI 53783 [email protected]

AMERICAN FAMILY

INSURANCE COMPANY

CLAIMS

39-1835307 P O BOX 530 [email protected]

678-417-3654 Ext.

AMERICAN ECONOMY INS CO CO LICENSING T-18,

SAFECO PLAZA

WA 98185 [email protected]

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

866-291-0194 Ext.

AMERICAN COMPENSATION INSURANCE

COMPANY

MN 55437 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

Page 11: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10013 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

404-851-3207 Ext.

AMERICAN GUARANTEE

AND LIABILITY COMPANY

36-6071400 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

AMERICAN GUARANTEE & LIABILITY

INSURANCE COMPANY

IL 60196 [email protected]

AMERICAN GUARANTEE

AND LIABILITY COMPANY

36-6071400 1001 SUMMIT BLVD [email protected]

AMERICAN FIRE &

CASUALTY COMPANY

59-141790 13830 BALLANTYNE CORP

800-334-0197 Ext.

800-334-0078 Ext. 214

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

866-814-1740 Ext. 201

Page 12: Georgia State Board of Workers' Compensation Insurer and Claim

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10015 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

AMERICAN HOME ASSURANCE COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 [email protected]

404-851-3208 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

678-969-7337 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

ALTERNATIVE SERVICE

CONCEPTS LLC DBA ASC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

CLAIMETRICS 20-1604010 PO BOX 22478 [email protected]

866-291-0194 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

Page 13: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

EDI USE ONLY 01 72756 JUDY PIERCE

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

985-624-6739 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

770-352-2978 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

405-728-5544 Ext. 2326

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

241-922-0638 Ext.

SEDGWICK WALMART HD 71-0738006 EDI USE ONLY

479-621-2900 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

Page 14: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10016 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13021 DERIDDER

DERIDDER LA 70634

Phone:

LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

13296 BIRMINGHAM

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20459 WASHINGTON

RICHMOND VA 23285

Phone:

SBWC # Insurer Name Address Email

20496 CUMMING

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 [email protected]

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY [email protected]

AMERICAN INSURANCE COMPANY CA 94998 [email protected]

605 CRESCENT EXECUTIVE

COURT

800-541-0139 Ext.

770-339-9878 Ext.

AMERISAFE RISK SERVICES

INC

58-1181498 2301 HWY 190 WEST [email protected]

800-256-3462 Ext.

AMERISAFE RISK SERVICES

INC

72-1274075 555 OLD NORCROSS RD [email protected]

AMERICAN INTERSTATE INSURANCE COMPANY LA 70634 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

678-393-4584 Ext.

AMERICAN PROTEINS INC GA 30041 [email protected]

SEDGWICK CMS 36-2685608 1800 BAYBERRY COURT [email protected]

804-673-5400 Ext.

AMERICAN NATIONAL RED CROSS 2025 E. STREET NW, 3RD

FLOOR, NW3-144A

DC 20006 [email protected]

-- Ext.

AMERICAN MINING INSURANCE COMPANY INC AL 35266 [email protected]

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

Page 15: Georgia State Board of Workers' Compensation Insurer and Claim

13007 MOBILE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13124 DALLAS

ATLANTA GA 30348

Phone:

SBWC # Insurer Name Address Email

13223 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10254 SEATTLE

DULUTH GA 30097

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10244 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

12077 SCHAUMBURG

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

678-258-8000 Ext.

AMERICAN RESOURCES INS CO AL 36695 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

AMERICAN STATES INSURANCE COMPANY SAFECO PLAZA, 1001

4TH AVENUE

WA 98185 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

AMERICAN SAFETY CASUALTY INSURANCE 100 GALLERIA

PARKWAY SE, SUITE 700

GA 30339 [email protected]

800-283-2318 Ext.

AMERICAN RISK FUNDING 12222 MERIT DRIVE,

SUITE 1660

TX 75251

CNA CLAIMS PLUS - P O BOX 105497

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

AMERICAN STATES INSURANCE COMPANY OF

TEXAS

SAFECO PLAZA, 1001

4TH AVENUE

WA 98154 [email protected]

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

404-851-3207 Ext.

AMERICAN ZURICH

INSURANCE COMPANY

36-3141762 1001 SUMMIT BLVVD [email protected]

AMERICAN ZURICH INSURANCE COMPANY IL 60196 [email protected]

AMERICAN ZURICH

INSURANCE COMPANY

36-3141762 1900 SUMMIT TOWER [email protected]

Page 16: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33630

Phone:

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

UNIONTOWN OH 44685

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 [email protected]

800-258-1811 Ext.

404-851-3207 Ext.

CHESTERFIELD SERVICES 34-1709723 3520 FOREST LAKE DRIVE [email protected]

330-896-4311 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 [email protected]

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

770-352-2978 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-473-9009 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

800-354-6494 Ext. 201

Page 17: Georgia State Board of Workers' Compensation Insurer and Claim

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

WILMINGTON NC 28404

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

TAMPA FL 33602

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

JACKSONVILLE FL 32256

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

678-731-9091 Ext. 252

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD [email protected]

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE [email protected]

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

888-878-0005 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD [email protected]

888-784-3470 Ext.

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

Page 18: Georgia State Board of Workers' Compensation Insurer and Claim

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

FT SMITH AR 72919

Phone:

TAMPA FL 33610

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12022 FARMINGTON

HILLSDULUTH GA 30097

Phone:

DULUTH GA 30097

Phone:

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

678-338-4171 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-548-1373 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 FIANA WAY [email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

AMERISURE INSURANCE COMPANY MI 48331 [email protected]

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 10401 HIGHLAND MANOR

DRIVE

[email protected]

800-842-5612 Ext. 4611

800-230-9338 Ext.

AMERISURE MUTUAL 38-0829210 2160 SATELLITE BLVD [email protected]

770-813-3302 Ext.

AMERISURE INSURANCE

COMPANY

38-1869912 2160 SATELLITE BLVD [email protected]

Page 19: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

10106 FARMINGTON

HILLSDULUTH GA 30097

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13167 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

ALPHARARETTA GA 30009

Phone:

WILKES-BARRE PA 18703

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

13095 DALLAS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13210 FRANKENMUTH

FRANKENMUTH MI 48787

Phone:

FRANKENMUTH MI 48787

Phone:

SBWC # Insurer Name Address Email

13183 STAMFORD

SAVANNAH GA 31405

AMERISURE MUTUAL 38-0829210 2160 SATELLITE BLVD [email protected]

770-813-3302 Ext.

AMERISURE INSURANCE

COMPANY

38-1869912 2160 SATELLITE BLVD [email protected]

800-230-9338 Ext.

AMERISURE MUTUAL INSURANCE COMPANY MI 48331 [email protected]

800-673-2465 Ext. 8302

GUARD INSURANCE GROUP - P O Box 1368 [email protected]

678-581-0589 Ext.

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

[email protected]

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H [email protected]

800-673-2465 Ext. 8110

AMGUARD 23-2240321 P O Box 1368 [email protected]

800-673-2465 Ext. 8110

AMGUARD INSURANCE

COMPANY

23-2240321 294 SOUTH MAIN STREET [email protected]

AMGUARD INSURANCE COMPANY PA 18703 [email protected]

ANSUR AMERICA INSURANCE COMPANY MI 48787 [email protected]

ANSUR AMERICA

INSURANCE COMPANY

38-3467437 ONE MUTUAL AVENUE [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

AMTRUST INSURANCE COMPANY OF KANSAS

INC

TX 75265 [email protected]

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

ARCH INSURANCE COMPANY 300 1ST STAMFORD

PLACE, 5TH FLOOR

CT 06902 [email protected]

800-234-1133 Ext.

FRANKENMUTH MUTUAL

INSURANCE COMPANY

38-0555290 ONE MUTUAL AVE. [email protected]

800-234-1122 Ext.

Page 20: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21371 THOMASVILLE

MARIETTA GA 30006

Phone:

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 20104

800-580-6912 Ext.

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

866-246-0259 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE [email protected]

800-422-4436 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

770-901-3124 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 [email protected]

800-476-7601 Ext.

ARCHBOLD MEDICAL CENTER INC GA 31799 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

Page 21: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21644 DECATUR

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10081 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

10026 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

IRVING TX 75015

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12039 SAN ANTONIO

ALPHARETTA GA 30022

Phone:

IRVING TX 75015

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10147 CHARLOTTE

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD [email protected]

770-754-0424 Ext.

ARGONAUT GREAT CENTRAL 10101 REUNION PLACE,

SUTIE 500

TX 78216 [email protected]

866-246-0259 Ext.

ARCHER DANIELS MIDLAND COMPANY IL 62525 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

ARGONAUT INSURANCE

COMPANY

94-1390273 255 W WASHINGTON [email protected]

800-678-6766 Ext.

ARGONAUT INSURANCE 94-1390273 P O BOX 152007 [email protected]

800-678-6766 Ext.

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD [email protected]

770-754-0424 Ext.

ARGONAUT INSURANCE COMPANY 10101 REUNION PLACE,

SUITE 500

TX 78216 [email protected]

ARGONAUT GREAT

CENTRAL INSURANCE

37-0301640 3000 OLD ALABAMA ROAD [email protected]

770-754-0424 Ext.

ARGONAUT MIDWEST INS CO 10101 REUNION PLACE,

SUITE 500

TX 78216 [email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

ARGONAUT MIDWEST

INSURANCE COMPANY

36-2489372 275 W WASHINGTON [email protected]

800-678-6766 Ext.

ARGONAUT INSURANCE 94-1390273 P O BOX 152007 [email protected]

800-678-6766 Ext.

ARROWOOD INDEMNITY COMPANY NC 28273 [email protected]

Page 22: Georgia State Board of Workers' Compensation Insurer and Claim

CHARLOTTE NC 28273

Phone:

SBWC # Insurer Name Address Email

21476 WILLOW GROVE

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

10027 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

13115 BOCA RATON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13173 AUSTIN

ATLANTA GA 30319

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

10144 ATLANTA

ATLANTA GA 30339

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

ASPLUNDH TREE EXPERT CO 708 BLAIR MILL ROAD,

RISK MGMT 3RD FLOOR

PA 19090 [email protected]

800-523-6235 Ext. 3

ARROWOOD INDEMNITY

COMPANY

13-5358230 3600 ARCO CORPORATE

DRIVE

[email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

ASSOCIATED INDUSTRIES INSURANCE

COMPANY INC

FL 33481 [email protected]

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY [email protected]

678-393-4584 Ext.

ASSOCIATED INDEMNITY CORP CA 94998 [email protected]

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 [email protected]

573-474-6193 Ext.

ASSOCIATION CASUALTY 74-1958653 4370 PEACHTREE ROAD NE [email protected]

404-442-1174 Ext.

ASSOCIATION CASUALTY

INSURANCE CO

74-1958653 P O BOX 618 [email protected]

ASSOCIATION CASUALTY INSURANCE

COMPANY

3420 EXECUTIVE

CENTER DRIVE, #200

TX 78731 [email protected]

[email protected]

866-710-0908 Ext.

800-883-9305 Ext.

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY

ASSOCIATION INSURANCE COMPANY GA 30339 [email protected]

BUILDERS INSURANCE 58-2453325 P O BOX 723099 [email protected]

Page 23: Georgia State Board of Workers' Compensation Insurer and Claim

10252 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20505 FORT WORTH

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

10215 ST PAUL

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21534 ATHENS

ATHENS GA 30603

Phone:

SBWC # Insurer Name Address Email

21257 ATHENS

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

20314 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20485 ATLANTA

ASSURANCE COMPANY OF

AMERICA

13-6081895 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ASSURANCE COMPANY OF

AMERICA

13-6081895 1900 SUMMIT TOWER [email protected]

ASSURANCE COMPANY OF AMERICA IL 60196 [email protected]

COLLINS & COMPANY 62-0882150 555 RIVER STREET [email protected]

800-884-1535 Ext.

ATCO RUBBER PRODUCTS INC TX 76118 [email protected]

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

404-851-3207 Ext.

706-613-3101 Ext.

ATHENS CLARKE CTY GOVT GA 30603

ATHENS CLARKE CTY GOVT 58-1911146 P O BOX 1868

888-487-3492 Ext.

ATHENA ASSURANCE

COMPANY

41-1435765 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

ATHENA ASSURANCE CO MN 55102 [email protected]

ATHENA ASSURANCE

COMPANY

41-1435765 BLDG V STE 200 [email protected]

ATLANTA HOUSING AUTHORITY GA 30303 [email protected]

[email protected]

678-731-9091 Ext. 252

ATLANTA CITY OF 68 MITCHELL STREET

SW, SUITE 9100

GA 30303

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE

800-421-0710 Ext.

ATHENS REGIONAL MEDICAL CENTER GA 30606 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

Page 24: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

20313 ATLANTA

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

13154 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13232 MARIETTA

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21676 AUGUSTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10030 LANSING

DULUTH GA 30096

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12010 HARTFORD

TAMPA FL 33610

ATLANTIC SPECIALTY INS CO MA 02108 [email protected]

ATLANTA PUBLIC SCHOOLS - 130 TRINITY AVENUE [email protected]

404-802-2335 Ext.

ATLANTA PUBLIC SCHOOLS GA 30303

ATLANTA HOUSING

AUTHORITY

- 230 JOHN WESLEY DOBBS

AVE NE

404-817-7465 Ext.

AUGUSTA RICHMOND COUNTY BOARD

COMMISSIONERS

CITY/COUNTY

BUILDING, ROOM 217

GA 30911 [email protected]

800-277-7442 Ext. 1336

ATLANTIC STATES INSURANCE COMPANY 1195 RIVER ROAD, PO

BOX 302

PA 17547 [email protected]

SOUTHERN INSURANCE 54-0386765 3237 SATELLITE BLVD [email protected]

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

AUTO OWNERS INSURANCE

CO

38-0315280 P O BOX 100044 [email protected]

770-931-7766 Ext. 201

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

AUTO-OWNERS INSURANCE CO MI 48909 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

AUTOMOBILE INSURANCE COMPANY OF

HARTFORD CT

CT 06183 [email protected]

AUTOMOBILE INS CO OF

HARTFORD CT

06-0848755 10401 HIGHLAND MANOR

DRIVE

[email protected]

Page 25: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21545 COOKEVILLE

COOKEVILLE TN 38502

Phone:

SBWC # Insurer Name Address Email

21348 MILLEDGEVILLE

MILLEDGEVILLE GA 31059

Phone:

SBWC # Insurer Name Address Email

13074 OKLAHOMA CITY

ATLANTA GA 30319

Phone:

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

FRISCO TX 75034

Phone:

SBWC # Insurer Name Address Email

13299 ST PETERSBURG

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10269 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

800-906-4461 Ext.

931-525-5384 Ext.

AVERITT EXPRESS INC TN 38502 [email protected]

AVERITT EXPRESS INC 62-0755421 P O BOX 3166 [email protected]

888-329-6259 Ext.

AUTOMOBILE INSURANCE

COMPANY OF HARTFORD CT

06-0848755 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

[email protected]

866-424-2480 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

BANCINSURE INC OK 73126 [email protected]

912-453-8404 Ext.

BALDWIN CO BOARD OF COMMISSIONERS GA 31061 [email protected]

BALDWIN COUNTY RISK - P O BOX 1599 [email protected]

BANKERS INSURANCE COMPANY FL 33716 [email protected]

IMPERIAL CASUALTY

INDEMNITY COMPANY

47-0412734 P O BOX 2009 [email protected]

888-339-5736 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

BANKERS STANDARD FIRE AND MARINE

COMPANY

436 WALNUT STREET,

WB04

PA 19106 [email protected]

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE [email protected]

678-731-9091 Ext. 252

Page 26: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13071 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20529 DULUTH

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21760 DALTON

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

21209 DALLAS

NORCROSS GA 30010

Phone:

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30338

678-338-4171 Ext.

BANKERS STANDARD INSURANCE COMPANY 436 WALNUT STREET,

WB04G

PA 19106 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

BARTOW COUNTY BOE 3473 SATELLITE BLVD,

STE 310 NORTH

GA 30096

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

[email protected]

770-962-3627 Ext.

SEDGWICK CMS BELLSOUTH

DISABILITY

36-2685608 1200 ASHWOOD PARKWAY [email protected]

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

[email protected]

678-969-7337 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD [email protected]

BROADSPIRE INC 36-3917295 P O BOX 926240

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

BELLSOUTH TELECOMMUNICATIONS INC fka

BELLSOUTH CORPORATION

ONE AT&T PLAZA, 208 S

AKARD ROOM 2731

TX 75202 [email protected]

706-275-4451 Ext. 5406

BEAULIEU GROUP LLC GA 30722 [email protected]

BEAULIEU GROUP LLC 58-2272636 PO BOX 1248 [email protected]

Page 27: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13077 OVERLAND PARK

JOHNS CREEK GA 30097

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20537 DOUGLASVILLE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13290 NAPERVILLE

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13298 NAPERVILLE

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20608 MOUNT BERRY

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21186 MACON

MACON GA 31201

Phone:

SBWC # Insurer Name Address Email

21654 COLUMBUS

BENCHMARK INSURANCE CO 6405 METCALF AVENUE,

SUITE 400

KS 66202 [email protected]

770-353-4591 Ext.

678-258-8000 Ext.

BENTON-GEORGIA INC GA 30133 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

866-246-0259 Ext.

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

478-779-3527 Ext.

BIBB COUNTY BOARD OF EDUCATION GA 31208 [email protected]

BIBB COUNTY BD P ED & - P O BOX 6157 [email protected]

336-668-9050 Ext. 7539

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

BERRY COLLEGE INC GA 30149 [email protected]

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY [email protected]

800-366-1511 Ext. 7732

BERKLEY REGIONAL INSURANCE COMPANY 215 SHURMAN BLVD,

SUITE 200

IL 60563 [email protected]

800-366-1511 Ext. 7732

BERKLEY NATIONAL INSURANCE COMPANY 215 SHUMAN BLVD,

SUITE 200

IL 60563 [email protected]

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY [email protected]

BIG LOTS STORES INC FKA CONSOLIDATED

STORES CORP

OH 43228 [email protected]

Page 28: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

10032 ROCK ISLAND

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

10033 ROCK ISLAND

DULUTH GA 30096

Phone:

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21729 WESTBOROUGH

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

20541 FORT VALLEY

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21746 BOWDON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13179 LAKELAND

800-822-2905 Ext.

BITUMINOUS FIRE & MARINE

INS CO

36-6054328 3700 CRESTWOOD

PARKWAY

[email protected]

800-822-2905 Ext.

BITUMINOUS FIRE & MARINE INSURANCE CO IL 61201 [email protected]

BITUMINOUS CASUALTY 36-0810360 3700 CRESTWOOD

PARKWAY

[email protected]

800-822-2905 Ext.

BITUMINOUS CASUALTY CORP IL 61201 [email protected]

BITUMINOUS CASUALTY 36-0810360 3700 CRESTWOOD

PARKWAY

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

678-258-8000 Ext.

BREMEN BOWDON INVESTMENT COMPANY GA 30108 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

BLUE BIRD BODY COMPANY GA 31010 [email protected]

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

BJ'S WHOLESALE CLUB INC 25 RESEARCH DRIVE, P

O BOX 5230

MA 01581 [email protected]

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD [email protected]

BRIDGEFIELD CASUALTY INSURANCE

COMPANY

FL 38802 [email protected]

Page 29: Georgia State Board of Workers' Compensation Insurer and Claim

CHARLOTTE NC 28277

Phone:

GAINESVILLE GA 30501

Phone:

SBWC # Insurer Name Address Email

13286 BOSTON

GAINESVILLE GA 30501

Phone:

SBWC # Insurer Name Address Email

21888 WAUWATOSA

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

10031 FORT WAYNE

FORT WAYNE IN 46801

Phone:

SBWC # Insurer Name Address Email

21649 DALTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20394 BRUNSWICK

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

40008 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

BROTHERHOOD MUTUAL INSURANCE

COMPANY

IN 46801 [email protected]

[email protected]

866-434-2480 Ext.

BRIGGS AND STRATTON CORPORATION WI 53222

PARKER SERVICES 39-1956269 P O BOX 81029

800-971-2667 Ext.

BRIDGEFIELD EMPLOYERS INSURANCE

COMPANY

MA 02116 [email protected]

SUMMIT CONSULTING INC. 59-1683711 340 JESSE JEWELL

PARKWAY SE

[email protected]

800-334-0078 Ext.

SUMMIT CONSULTING INC. 59-1683711 340 JESSE JEWELL

PARKWAY SE

[email protected]

800-971-2667 Ext.

BRIDGEFIELD CASUALTY

INSURANCE COMPANY

59-3269531 1380 BALLANTYNE CORP

PLACE

[email protected]

BUILDERS INSURANCE 58-2453325 P O BOX 723099 [email protected]

800-883-9305 Ext.

BUILDERS INSURANCE A MUTUAL CAPTIVE 2410 PACES FERRY

ROAD, SUITE 300

GA 30339 [email protected]

912-355-8989 Ext.

BRUNSWICK CITY OF GA 31521 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

BROWN INDUSTRIES INC GA 30722 [email protected]

BROTHERHOOD MUTUAL

INSURANCE COMPANLY

35-0198580 P O BOX 2227 [email protected]

800-333-3735 Ext.

Page 30: Georgia State Board of Workers' Compensation Insurer and Claim

13261 RALEIGH

RALEIGH NC 27624

Phone:

SBWC # Insurer Name Address Email

21517 TIFTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21427 ATLANTA

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

13234 OMAHA

OMAHA NE 68103

Phone:

SBWC # Insurer Name Address Email

21762 WOODBINE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10036 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13099 GREENVILLE

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

21297 SAVANNAH

SAVANNAH GA 31401

Phone:

877-234-4424 Ext.

CALIFORNIA INSURANCE COMPANY NE 68103 [email protected]

CALIFORNIA INSURANCE

COMPANY

94-1627528 P O BOX 3804 [email protected]

770-752-0122 Ext.

CAGLES INC & SUBSIDIARY GA 30318 [email protected]

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400 [email protected]

678-258-8000 Ext.

BURLEN CORPORATION GA 31793 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

800-809-4861 Ext.

BUILDERS MUTUAL INSURANCE COMPANY NC 27606 [email protected]

AEGIS ADMINISTRATIVE

SERVICES INC

56-1749798 P O BOX 150006 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

CANDLER HOSPITAL INC GA 31405 [email protected]

678-447-0200 Ext. 302

CANAL INSURANCE CO. SC 29602

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

[email protected]

800-203-9600 Ext. 9706

ONEBEACON INSURANCE 23-1502700 P O BOX 9155

CAMDEN FIRE INSURANCE ASSOCIATION MA 02021 [email protected]

678-258-8000 Ext.

CAMDEN COUNTY BOARD OF COMMISSIONERS GA 31569 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

912-355-8929 Ext. 224

Page 31: Georgia State Board of Workers' Compensation Insurer and Claim

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13048 COLUMBIA

759507 MACON GA 31221

Phone:

SBWC # Insurer Name Address Email

13078 WOODBRIDGE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21775 CARTERSVILLE

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

21139 FAIRVIEW

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

12098 CHICAGO

MOBILE AL 36695

Phone:

MAITLAND FL 32751

Phone:

CHICAGO IL 60606

Phone:

SBWC # Insurer Name Address Email

20621 SMYRNA

COLUMBIA SC 29202

CASCADE CORPORATION OR 97024 [email protected]

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

CARTERSVILLE CITY OF GA 30120 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

336-668-9050 Ext. 7539

CAROLINA CASUALTY INS 12701 MARBLESTONE

DRIVE, SUITE 250

VA 22192 [email protected]

800-471-2103 Ext.

CAPITAL CITY INS SC 29221 [email protected]

SOUTHEASTERN CLAIMS

SERVICES INC

57-0851047 P O BOX 27180 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

866-450-8608 Ext.

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA [email protected]

888-782-4672 Ext.

CASTLEPOINT NATIONAL

INSURANCE COMPANY

23-2182777 1111 HILLCREST ROAD [email protected]

800-711-4405 Ext.

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

[email protected]

CASTLEPOINT NATIONAL INSURANCE

COMPANY FKA SUA INS CO

222 SOUTH RIVERSIDE

PLAZA, SUITE 1600

IL 60606 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

336-668-9050 Ext. 7539

CATHOLIC ARCHDIOCESE OF ATLANTA GA 30080 [email protected]

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

Page 32: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

21624 RINGOLD

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21368 LEBANON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21533 MACON

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

10040 VAN WERT

VAN WERT OH 45891

Phone:

SBWC # Insurer Name Address Email

10267 PHILADELPHIA

ROSWELL GA 30076

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21081 VALLEY FORGE

RICHMOND IN 47374

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

CBOCS INC F/K/A CRACKER BARREL COUNTRY

STORE

PO BOX 787, HARTMAN

DRIVE

TN 37088 [email protected]

[email protected]

800-845-2724 Ext. 43582

CATOOSA COUNTY BOARD OF EDUCATION GA 30736

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159

800-845-2724 Ext. 43582

COMPANION THIRD PARTY

ADMINISTRATORS LLC

CENTRAL MUTUAL INSURANCE COMPANY OH 45891 [email protected]

866-434-2480 Ext.

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 [email protected]

CENTRAL GA HEALTH SYSTEM fka MACON BIBB

HOSP AUTHORITY

777 HEMLOCK STREET,

MSC#135

GA 31201 [email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-685-7361 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

CENTURY INDEMNITY COMPANY PA 19106 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

CENTRAL INSURANCE 34-4202560 800 SOUTH WASHINGTON [email protected]

800-736-7000 Ext. 2380

CERTAINTEED CORPORATION PA 19482 [email protected]

ESIS INC. - 120 NORTH 9TH STREET [email protected]

800-541-0139 Ext.

Page 33: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10272 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10146 NEW YORK

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

Phone:

TAMPA FL 33610

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

765-983-6244 Ext.

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

678-969-7337 Ext.

CHARTIS CASUALTY COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

888-329-6259 Ext.

CHARTER OAK FIRE INS CO 06-0291290 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

CHARTER OAK FIRE INSURANCE COMPANY CT 06183 [email protected]

CHARTER OAK FIRE INS CO 06-0291290 BLDG V STE 200 [email protected]

CLAIMETRICS 20-1604010 PO BOX 22478 [email protected]

405-728-5544 Ext. 2326

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

800-448-9707 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

[email protected]

888-329-6259 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR [email protected]

770-934-3414 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

Page 34: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33602

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10193 NEW YORK

ALPHARETTA GA 30023

Phone:

TAMPA FL 33610

Phone:

ATLANTA GA 30338

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

20561 SAVANNAH

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21738 CARTERSVILLE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

20443 CANTON

800-426-5990 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD [email protected]

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

800-541-0139 Ext. 35832

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

[email protected]

888-329-6259 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

CHARTIS PROPERTY CASUALTY COMPANY 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

CHEMICAL PRODUCTS CORP GA 30120 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

CHATHAM COUNTY BOC P O BOX 9297, 12 E BAY GA 31412 [email protected]

CHEROKEE COUNTY BD OF ED GA 30114 [email protected]

336-668-9050 Ext. 7539

Page 35: Georgia State Board of Workers' Compensation Insurer and Claim

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21129 CANTON

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

13250 STERLING

HEIGHTSSTERLING

HEIGHTS

MI 48310

Phone:

SBWC # Insurer Name Address Email

20607 SAN RAMON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21504 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13075 WARREN

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

CHEROKEE COUNTY BOARD OF

COMMISSIONER

GA 30114 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

678-258-8000 Ext.

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CHEVRON USA INC PO BOX 6022, 6001

BOLLINGER CANYON

ROAD

CA 94583 [email protected]

800-201-0450 Ext. 3436

CHEROKEE INSURANCE COMPANY MI 48310 [email protected]

CHEROKEE INSURANCE CO 38-3464294 34200 MOUND ROAD [email protected]

336-668-9050 Ext. 7539

404-266-4855 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

[email protected]

866-424-2480 Ext.

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

CHUBB INDEMNITY INSURANCE COMPANY NJ 07061 [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

CHILDRENS HEALTHCARE OF ATL (EGLESTON/SCOTTISH

RITE), 1600 TULIE

CIRCLE NE

GA 30329 [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

Page 36: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13195 WARREN

ATLANTA GA 30326

Phone:

GLEN ALLEN VA 23058

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10297 MERRILL

MERRILL WI 54452

Phone:

SBWC # Insurer Name Address Email

13014 CINCINNATI

NORCROSS GA 30010

Phone:

SBWC # Insurer Name Address Email

13060 CINCINNATI

NORCROSS GA 30010

Phone:

SBWC # Insurer Name Address Email

10195 CINCINNATI

NORCROSS GA 30010

TAMPA FL 33610

CHUBB NATIONAL INSURANCE COMPANY NJ 07061 [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

[email protected]

866-424-2480 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

404-266-4855 Ext.

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 [email protected]

770-662-8753 Ext.

CINCINNATI CASUALTY CO 6200 S. GILMORE RD., P

O BOX 145496

OH 45250 [email protected]

800-554-2642 Ext. 2

CHURCH MUTUAL 39-0712210 3000 SCHUSTER LANE [email protected]

CHURCH MUTUAL INSURANCE COMPANY WI 54452 [email protected]

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 10401 HIGHLAND MANOR

DRIVE

[email protected]

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 [email protected]

CINCINNATI INS CO THE OH 45250 [email protected]

CINCINNATI INSURANCE

COMPANY

31-0542366 P O BOX 920338 [email protected]

770-662-8753 Ext.

CINCINNATI INDEMNITY COMPANY OH 45250 [email protected]

Page 37: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10043 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

12094 NEW YORK

ATLANTA GA 30366

FL 32716

Phone:

SBWC # Insurer Name Address Email

21159 JONESBORO

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21069 JONESBORO

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

20527 MORROW

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21487 ELKHART

MANDEVILLE LA 70471

TRAVELERS COMMERCIAL

CASUALTY COMPANY

10401 HIGHLAND MANOR

DRIVE

888-329-6259 Ext.

CLARENDON NATIONAL INS 466 LEXINGTON AVE,

19TH FLOOR

NY 10017 [email protected]

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET [email protected]

800-628-0250 Ext.

CITIZENS INSURANCE COMPANY OF AMERICA MA 01653 [email protected]

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

CLAYTON COUNTY PUBLIC SCHOOLS GA 30236 [email protected]

[email protected]

800-421-0710 Ext.

CLAYTON COUNTY BOARD OF COMMISSIONERS RISK MANAGEMENT, 112

SMITH STREET

GA 30236

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

800-315-6090 Ext.

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 [email protected]

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

[email protected]

COACHMEN RECREATIONAL VEHICLE IN 46515 [email protected]

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

888-888-8136 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

CLAYTON COUNTY WATER AUTHORITY GA 30260 [email protected]

Page 38: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

20345 CHARLOTTE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21066 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21038 MARIETTA

MARIETTA GA 30061

Phone:

SBWC # Insurer Name Address Email

20514 ATLANTA

ALPHARETTA GA 30005

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20347 COLLEGE PARK

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

13181 SCHAUMBURG

ATLANTA GA 30319

Phone:

985-624-6739 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

[email protected]

800-675-2771 Ext. 225

678-258-8000 Ext.

COBB COUNTY BD OF COMMISS GA 30061 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

800-450-0692 Ext.

COATS NORTH AMERICA FKA COATS & CLARK

INC

3430 TORINGDON WAY,

SUITE 301

NC 28277 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

COCA COLA COMPANY ONE COCA-COLA

PLAZA, MAIL STOP NAT

GA 30313 [email protected]

770-426-3357 Ext.

COBB COUNTY SCHOOL SYSTEM GA 30061 [email protected]

COBB COUNTY SCHOOLS

RISK M

58-6000214 P O BOX 1088 [email protected]

COLONIAL AMERICAN CASUALTY & SURETY

COMPANY

IL 60196 [email protected]

ASSURANCE COMPANY OF

AMERICA

13-6081895 3003 SUMMIT BLVD [email protected]

877-295-0011 Ext.

COLLEGE PARK CITY OF GA 30337 [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

404-851-3207 Ext.

Page 39: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21505 SAVANNAH

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13221 BOSTON

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21529 MOULTRIE

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

20323 MOULTRIE

MOULTRIE GA 31768

Phone:

SBWC # Insurer Name Address Email

20550 APPLING

LAWRENCEVILLE GA 30042

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

COLONIAL AMERICAN

CASUALTY AND SURETY

52-1096670 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

COLONIAL AMERICAN

CASUALTY AND SURETY

52-1096670 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

COLORADO CASUALTY INSURANCE COMPANY MA 02116 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

COLONIAL GROUP INC GA 31402 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

800-928-9096 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

COLQUITT CTY BD OF ED GA 31776 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

COLUMBIA COUNTY BD OF ED GA 30802

COLQUITT REGIONAL

MEDICAL CENTER

58-0607088 3131 SOUTH MAIN STREET [email protected]

229-890-3482 Ext.

COLQUITT REGIONAL MEDICAL CENTER GA 31768 [email protected]

Page 40: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13127 COLUMBIA

ATLANTA GA 30345

Phone:

SBWC # Insurer Name Address Email

10010 COLUMBIA

ATLANTA GA 30345

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

20958 COLUMBUS

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21094 COLUMBUS

COLUMBUS GA 31902

Phone:

SBWC # Insurer Name Address Email

10248 NEW YORK

POMPANO BEACH FL 33064

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

800-224-9524 Ext.

800-767-4080 Ext.

COLUMBIA NATIONAL INS 47-0685688 P O BOX 618 [email protected]

573-474-6193 Ext.

COLUMBIA NATIONAL INSURANCE COMPANY MO 65205 [email protected]

COLUMBIA INSURANCE

GROUP

43-0926456 2295 PARKLAKE DR [email protected]

800-767-4080 Ext.

COLUMBIA MUTUAL MO 65202 [email protected]

COLUMBIA INSURANCE

GROUP

43-0926456 2295 PARKLAKE DR [email protected]

706-649-3436 Ext.

COLUMBUS WATER WORKS GA 31902 [email protected]

COLUMBUS WATER WORKS 58-6001931 P O BOX 1600 [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

COLUMBUS REGIONAL HEALTHCARE SYSTEM

INC

GA 31901 [email protected]

800-685-7361 Ext.

CLAIMETRICS 20-1604010 PO BOX 22478 [email protected]

405-728-5544 Ext. 2326

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-448-9707 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

COMMERCE AND INDUSTRY INS 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

Page 41: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13165 COLUMBIA

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

13000 COLUMBIA

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

FRANKLIN TN 37067

Phone:

SBWC # Insurer Name Address Email

40016 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

21393 OMAHA

COLUMBIA SC 29210

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

800-845-2724 Ext.

COMPANION PROPERTY &

CASUALTY

57-0768836 P O BOX 100165 [email protected]

877-379-7389 Ext.

COMPANION COMMERCIAL INS SC 29202 [email protected]

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE [email protected]

800-233-2436 Ext. 1897

COMPTRUST AGC MUTUAL CAPTIVE

INSURANCE CO

1940 THE EXCHANGE,

SUITE 200

GA 30339 [email protected]

[email protected]

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

800-845-2724 Ext.

COMPANION PROPERTY &

CASUALTY

57-0768836 P O BOX 100165 [email protected]

877-379-7389 Ext.

COMPANION PROPERTY & CASUALTY SC 29202 [email protected]

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 [email protected]

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

CONAGRA FOODS INC AND SUBSIDIARIES NE 68102 [email protected]

Page 42: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

30006 TYRONE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

10051 CHICAGO

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

CONSTRUCTION SUPPLIERS 120 HANDLEY ROAD,

SUITE 610

GA 30290 [email protected]

241-922-0638 Ext.

800-426-9218 Ext. 12131

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

312-822-2331 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE [email protected]

CONTINENTAL CASUALTY CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 [email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

877-241-6121 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

[email protected]

Page 43: Georgia State Board of Workers' Compensation Insurer and Claim

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20523 NEW YORK

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

10052 CHICAGO

POMPANO BEACH FL 33064

Phone:

DULUTH GA 30096

Phone:

ALPHARETTA GA 30005

Phone:

CHICAGO IL 60604

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21016 FORT MILL

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

13225 URBANDALE

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

CONTINENTAL GRAIN F/K/A CONTIGROUP

COMPANIES INC

NY 10172 [email protected]

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

800-238-6214 Ext.

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

312-822-2331 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-283-2318 Ext. 3574

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

CONTINENTAL INSURANCE CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 [email protected]

UNION STANDARD 47-0547953 122 W CARPENTER

FREEWAY

[email protected]

CONTINENTAL WESTERN INS CO IA 50322 [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CONTINENTAL TIRE THE AMERICAS LLC FKA

CONTINENTAL TIRE NORTH

SC 29707 [email protected]

800-444-0049 Ext.

Page 44: Georgia State Board of Workers' Compensation Insurer and Claim

13295 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21694 ISSAQUAH

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20603 COVINGTON

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21755 NEWNAN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20552 NEWNAN

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21532 ATLANTA

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21360 STILLMORE

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13037 MORRISTOWN

LAKE MARY FL 32795

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-548-1373 Ext.

COSTCO WHOLESALE CORPORATION WA 98027 [email protected]

CORNHUSKER CASUALTY

COMPANY

- 1725 WINDWARD

CONCOURSE

[email protected]

877-212-3816 Ext. 253

CORNHUSKER CASUALTY COMPANY 3333 FARNAM STREET,

SUITE 300

NE 68131 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

COWETA COUNTY BOC GA 30263

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

COVINGTON CITY OF GA 30015 [email protected]

-- Ext.

[email protected]

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

CRAWFORD & COMPANY INC GA 30319 [email protected]

[email protected]

800-845-2724 Ext. 43582

COWETA COUNTY SCHOOL SYS BD OF ED GA 30264

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD [email protected]

CRUM & FORSTER INDEMNITY COMPANY NJ 07962 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

CRIDER INCORPORATED GA 30464 [email protected]

Page 45: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

21021 MARIETTA

MARIETTA GA 30061

Phone:

SBWC # Insurer Name Address Email

13109 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21370 ALMA

ALMA GA 31510

Phone:

SBWC # Insurer Name Address Email

13265 SIOUX FALLS

ATLANTA GA 30302

Phone:

SBWC # Insurer Name Address Email

13228 DALLAS

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

21355 DALTON

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21789 MASON

MASON MI 48854

Phone:

SBWC # Insurer Name Address Email

20610 MASON

UNITED STATES FIRE

INSURANCE COMPANY

800-423-3060 Ext. 6301

CYPRESS INSURANCE COMPANY 3333 FRNAM STREET,

SUITE 300

NE 68131 [email protected]

770-422-7520 Ext.

CW MATTHEWS CONTRACTING CO INC GA 30061 [email protected]

C W MATTHEWS

CONTRACTING CO.

58-0652729 P O DRAWER 970 [email protected]

DALLAS NATIONAL INSURANCE COMPANY 14160 DALLAS

PARKWAY, SUITE 500

TX 75254 [email protected]

404-300-1250 Ext.

DAKOTA TRUCK UNDERWRITERS SD 30319 [email protected]

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 [email protected]

800-673-9339 Ext.

D L LEE & SON INC GA 31510 [email protected]

D L LEE & SON INC - P O BOX 206 [email protected]

800-884-1535 Ext.

DALTON CITY OF GA 30720 [email protected]

COLLINS & COMPANY 62-0882150 555 RIVER STREET [email protected]

COLLINS & COMPANY 62-0882150 P O BOX 6429 [email protected]

706-277-1253 Ext.

DART CONTAINER CORPORATION OF GEORGIA MI 48854 [email protected]

800-545-3278 Ext. 2548

DART CONTAINER CORP OF CALIFORNIA MI 48854 [email protected]

DART CONTAINER CORP 38-2482823 500 HOGSBACK ROAD [email protected]

CYPRESS INSURANCE 95-6042929 1725 WINDWARD

CONCOURSE

[email protected]

877-212-3816 Ext. 230

Page 46: Georgia State Board of Workers' Compensation Insurer and Claim

MASON MI 48854

Phone:

SBWC # Insurer Name Address Email

20617 DECATUR

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20298 DECATUR

DECATUR GA 30030

Phone:

SBWC # Insurer Name Address Email

20722 STONE

MOUNTAINSTONE MOUNTAIN GA 30083

Phone:

SBWC # Insurer Name Address Email

20499 DECATUR

DECATUR GA 30030

Phone:

SBWC # Insurer Name Address Email

21410 DECATUR

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

21175 PORTLAND

SALISBURY NC 28145

Phone:

SBWC # Insurer Name Address Email

800-545-3278 Ext. 2548

DART CONTAINER CORPORATION OF GEORGIA

DART CONTAINER CORP 38-2482823 500 HOGSBACK ROAD [email protected]

404-371-4791 Ext.

DEKALB COUNTY BOARD OF COMMISSIONERS 1300 COMMERCE DRIVE,

4TH FLOOR

GA 30030 [email protected]

DEKALB COUNTY RISK

MANAGEMENT

58-6000814 1300 COMMERCE DRIVE [email protected]

770-677-3423 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

DECATUR CITY OF GA 30031 [email protected]

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD [email protected]

DEKALB REGIONAL HEALTHCARE SYSTEM INC

DBA DEKALB MEDICAL

GA 30033 [email protected]

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

404-371-3912 Ext. 3915

DEKALB FARMERS MARKET(YOUR) GA 30030 [email protected]

DEKALB FARMERS

MARKET(YOUR)

58-1332242 3000 E PONCE DE LEON [email protected]

678-676-0401 Ext.

DEKALB COUNTY BOARD OF EDUCATION GA 30083 [email protected]

DEKALB COUNTY BOARD OF

EDUCATION

58-6000227 1701 MOUNTAIN

INDUSTRIAL BLVD

704-633-8250 Ext.

DELHAIZE AMERICA LLC ME 04104 [email protected]

DELHAIZE RISK

MANAGEMENT

56-0660192 P O BOX 1330 [email protected]

800-524-0604 Ext.

Page 47: Georgia State Board of Workers' Compensation Insurer and Claim

20538 ATLANTA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

13177 ATLANTA

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13243 DES MOINES

DES MOINES IA 50391

Phone:

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

13281 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10198 ST PAUL

NORCROSS GA 30071

Phone:

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

ATLANTA GA 30319

DELTA AIR LINES HARTSFIELD-JACKSON

INT'L, P O BOX 20706

DEPT 858

GA 30320 [email protected]

800-985-7078 Ext.

DEPOSITORS INSURANCE

COMPANY

42-1207150 1100 LOCUST STREET [email protected]

800-532-1436 Ext. 3340

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

DEPOSITORS INSURANCE COMPANY IA 50391

GEORGIA CASUALTY &

SURETY

58-0537066 4370 PEACHTREE ROAD NE [email protected]

800-877-3579 Ext.

DELTA FIRE & CASUALTY INS GA 30319 [email protected]

DISCOVER PROPERTY & CASUALTY MN 55102 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

DIAMOND STATE INSURANCE COMPANY THREE BALA PLAZA

EAST, SUITE 300

PA 19004 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

[email protected]

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

800-580-6912 Ext.

678-447-0200 Ext. 302

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

[email protected] SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

ALTERNATIVE SERVICE

CONCEPTS LLC DBA ASC

43-1954328 3135 AVALON RIDGE [email protected]

Page 48: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

ROSWELL GA 30076

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

866-291-0194 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

877-295-0011 Ext.

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

DISCOVER PROPERTY &

CASUALTY INS CO

36-2999370 1000 WINWARD [email protected]

800-238-6214 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 1000 FIANA WAY [email protected]

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

-- Ext.

ESIS 95-2008390 500 COLONIAL CENTER

PARKWAY

[email protected]

678-795-4500 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 2420 LAKEMONT AVENUE

888-329-6259 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext.

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 10401 HIGHLAND MANOR

DRIVE

[email protected]

800-842-5612 Ext. 4611

DISCOVER PROPERTY &

CASUALTY INSURANCE

COMPANY

36-2999370 6640 CAROTHERS [email protected]

615-660-6258 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

Page 49: Georgia State Board of Workers' Compensation Insurer and Claim

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

866-654-4001 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

Page 50: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

LEXINGTON KY 40512

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

20854 DALTON

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

20302 GOODLETSVILLE

GOODLETTSVILLE TN 37070

Phone:

SBWC # Insurer Name Address Email

13287 MARIETTA

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

20405 ALBANY

SAVANNAH GA 31405

Phone:

800-541-0139 Ext. 35832

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-822-4469 Ext.

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

770-752-0122 Ext.

DIXIE GROUP & SUBSIDIARIES GA 30721 [email protected]

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400 [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

DOUGHERTY COUNTY BOC GA 31703

DONEGAL INSURANCE - 3097 SATELLITE BLVD [email protected]

800-277-7442 Ext.

DONEGAL MUTUAL INSURANCE COMPANY PA 17547 [email protected]

800-871-6670 Ext.

RISK ENTERPRISES

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

615-855-5110 Ext.

DOLLAR GENERAL CORPORATION TN 37070 [email protected]

DOLLAR GENERAL

CORPORATION

61-0502302 100 MISSION RIDGE DRIVE [email protected]

Page 51: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21367 ALBANY

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

20301 DOUGLAS

ALPHARETTA GA 30004

Phone:

SBWC # Insurer Name Address Email

20365 DOUGLASVILLE

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20553 DOUGLASVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21328 AUGUSTA

AUGUSTA GA 30903

Phone:

SBWC # Insurer Name Address Email

21609 DULUTH

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20366 WILMINGTON

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21538 SNELLVILLE

800-524-0604 Ext.

DOUGHERTY COUNTY SCHOOL SYSTEM GA 31701 [email protected]

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

706-849-6250 Ext.

DSM CHEMICALS NORTH AMERICA INC GA 30903 [email protected]

DSM CHEMICALS RISK

MANAGEMENT

58-0942142 P O BOX 2451 [email protected]

800-224-9524 Ext.

DOUGLAS COUNTY SCHOOLS GA 30134 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-233-2436 Ext. 1897

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

678-969-7337 Ext.

E I DUPONT NEMOURS & COMPANY 1007 MARKET STREET,

ROOM D-8065

DE 19898 [email protected]

678-258-8000 Ext.

DULUTH CITY OF GA 30096 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

DOUGLAS COUNTY BOC GA 30134

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE [email protected]

[email protected]

770-752-0122 Ext.

DOUGLAS CITY OF GA 31533

AMERICAN PROFESSIONAL

RISK

58-1872616 1255 MCFARLAND 400

E R SNELL CONTRACTOR INC GA 30078 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

Page 52: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21558 EAST POINT

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13276 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13249 LANCASTER

LANCASTER PA 17608

Phone:

SBWC # Insurer Name Address Email

13168 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

ALPHARETTA GA 30009

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

21552 ELBERTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13072 BEVERLY

888-654-7100 Ext.

EASTERN ADVANTAGE ASSURANCE COMPANY PA 17608 [email protected]

EASTERN ADVANTAGE

ASSURANCE COMPANY

65-1316719 P O BOX 83777 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

EAST POINT CITY OF GA 30344

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

ELBERTON CITY OF GA 30345

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

[email protected]

800-673-2465 Ext. 8302

800-673-2465 Ext. 8110

EASTGUARD INSURANCE

COMPANY

01-0125870 294 S MAIN STREET [email protected]

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H [email protected]

800-673-2465 Ext. 8110

EASTGUARD INSURANCE COMPANY PA 18703 [email protected]

AMGUARD 23-2240321 P O Box 1368 [email protected]

888-654-7100 Ext.

EASTERN ALLIANCE INSURANCE CO PA 17608 [email protected]

EASTERN ALLIANCE 23-2900463 P O BOX 83777 [email protected]

ELECTRIC INSURANCE COMPANY MA 01915 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

Page 53: Georgia State Board of Workers' Compensation Insurer and Claim

ALBANY NY 12212

Phone:

SBWC # Insurer Name Address Email

10017 DES MOINES

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

13152 DES MOINES

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

20379 ATLANTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13117 RENO

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10196 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

10189 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

10241 DES MOINES

EMORY UNIVERSITY 1364 CLIFTON RD NE,

ROOM HB53

GA 30322 [email protected]

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568 [email protected]

800-239-1407 Ext. 301

EMCASCO INSURANCE COMPANY IA 50306 [email protected]

[email protected]

800-239-1407 Ext. 301

EMC PROPERTY & CASUALTY COMPANY IA 50306

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568

800-434-8331 Ext.

[email protected]

SEDGWICK CMS 36-2685608 PO BOX 15065 [email protected]

704-759-2580 Ext.

EMPLOYERS INS CO OF

WAUSAU

39-0264050 3901 PREMIER NORTH DR [email protected]

813-264-6588 Ext.

EMPLOYERS INSURANCE CO OF WAUSAU MA 02116 [email protected]

EMPLOYERS INS CO OF

WAUSAU

39-0264050 P O BOX 49000 [email protected]

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

EMPLOYERS FIRE INS CO THE MA 02021 [email protected]

EMPLOYERS ASSURANCE

COMPANY

61-0477370 14120 BALLANTYNE

CORPORATE PL

[email protected]

800-992-1072 Ext.

EMPLOYERS ASSURANCE COMPANY NV 89521 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

EMPLOYERS MUTUAL CASUALTY CO IA 50306 [email protected]

Page 54: Georgia State Board of Workers' Compensation Insurer and Claim

BIRMINGHAM AL 35201

Phone:

SBWC # Insurer Name Address Email

13126 RENO

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13188 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13189 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13190 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13191 CHICAGO,

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21617

KNOXVILLE TN 37919

Phone:

SBWC # Insurer Name Address Email

21572 RICHMOND

TUCKER GA 30084

ENCOMPASS INDEPENDENT INS. CO. CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 [email protected]

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

ENCOMPASS HOME AND AUTO INS. CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 [email protected]

EMPLOYERS ASSURANCE

COMPANY

61-0477370 14120 BALLANTYNE

CORPORATE PL

[email protected]

800-992-1072 Ext.

EMPLOYERS PREFERRED INSURANCE

COMPANY

NV 89521 [email protected]

EMPLOYERS MUTUAL

CASUALTY COMPANY

42-0234980 P O BOX 1568 [email protected]

800-239-1407 Ext. 301

865-583-8342 Ext.

[email protected]

SEDGWICK CMS 36-2685608 1111 NORTHSHORE DRIVE [email protected]

EQUITY GROUP GA DIV fka CAGLE FOODS JV

LLC

300 BARR HARBOR

DRIVE, SUITE 600

WEST

CONSHOHOCKEN

PA 19428

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

ENCOMPASS PROPERTY & CASUALTY CNA CENTER-28TH

FLOOR, 333 SO WABASH

IL 60604 [email protected]

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

ENCOMPASS INS.CO. OF AMERICA CNA CENTER-28TH

FLOOR, 333 SO. WABASH

IL 60604 [email protected]

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

ESTES EXPRESS LINES VA 23260 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

Page 55: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21620 ROME

DALTON GA 30722

Phone:

SBWC # Insurer Name Address Email

13082 LIBERTY CORNER

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30009

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

TUCKER GA 30084

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

EVEREST NATIONAL INSURANCE CO 477 MARTINSVILLE RD.,

PO BOX 830

NJ 07938 [email protected]

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

706-277-1253 Ext.

EVANS GRADING CO. INC 3225 ALABAMA HWY,

P.O. BOX 2160

GA 30164 [email protected]

COLLINS & COMPANY 62-0882150 P O BOX 6429 [email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

[email protected]

800-675-2771 Ext. 225

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

678-942-2330 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

EVEREST NATIONAL

INSURANCE COMPANY

22-2660372 P O BOX 1620 [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

Page 56: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SARASOTA FL 34230

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13180 ALPHARETTA

LIBERTY CORNER NJ 07938

Phone:

BRENTWOOD TN 37027

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

12023 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13091 WARREN

ATLANTA GA 30326

Phone:

ATLANTA GA 30326

Phone:

EVEREST SECURITY INSURANCE 925 NORTH POINT

PARKWAY, SUITE 400

GA 30005 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-595-2255 Ext.

PBOA (PROFESSIONAL

BUSINESS OWNERS ASSN

65-0923856 P O BOX 49468 [email protected]

866-246-0259 Ext.

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

404-266-4855 Ext.

EXECUTIVE RISK INDEMNITY INC NJ 07061 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

EXCELSIOR INSURANCE CO NH 03431 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

800-675-2771 Ext. 225

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

EVEREST NATIONAL

INSURANCE

22-2660372 477 MARTINSVILLE ROAD [email protected]

800-438-4375 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

[email protected]

EXECUTIVE RISK 13-2912259 2 LIVE OAK CENTER SUITE

900

[email protected]

404-266-4127 Ext.

Page 57: Georgia State Board of Workers' Compensation Insurer and Claim

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13128 STAMFORD

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

10214 MANCHESTER

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

MANCHESTER NH 03101

Phone:

SBWC # Insurer Name Address Email

10230 MANCHESTER

ATLANTA GA 30348

Phone:

SBWC # Insurer Name Address Email

13009 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13142 DES MOINES

FAIRMONT PREMIER INSURANCE COMPANY 250 COMMERCIAL

STREET, SUITE 5000

NH 03101 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

FAIRFIELD INSURANCE COMPANY CT 06904 [email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

FARMINGTON CASUALTY

COMPANY

06-1067463 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

FARMINGTON CASUALTY

COMPANY

06-1067463 10401 HIGHLAND MANOR

DRIVE

[email protected]

FARMINGTON CASUALTY COMPANY CT 06183 [email protected]

CNA CLAIMS PLUS - P O BOX 105497

800-283-2318 Ext.

FAIRMONT SPECIALTY INSURANCE COMPANY 250 COMMERCIAL

STREET, SUITE 5000

NH 03101 [email protected]

TIG WORK COMP CLAIMS - 250 COMMERCIAL STREET [email protected]

888-805-9184 Ext.

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

FARMLAND MUTUAL INSURANCE COMPANY 1100 LOCUST STREET,

DEPT 0301

IA 50391 [email protected]

888-329-6259 Ext.

Page 58: Georgia State Board of Workers' Compensation Insurer and Claim

DES MOINES IA 50391

Phone:

SBWC # Insurer Name Address Email

21361 FAYETTEVILLE

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20516 FAYETTEVILLE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13153 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

21433 MEMPHIS

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

10062 WARREN

ATLANTA GA 30319

Phone:

ATLANTA GA 30326

Phone:

DULUTH GA 30097

Phone:

PARSIPPANY NJ 07054

Phone:

FCCI INSURANCE COMPANY FL 34240 [email protected]

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE [email protected]

404-266-5749 Ext.

FAYETTE COUNTY BOARD OF EDUCATION GA 30214 [email protected]

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE [email protected]

800-233-2436 Ext. 1897

FAYETTE COUNTY BOARD OF COMMISSIONERS GA 30214 [email protected]

NATIONWIDE AGRIBUSINESS 42-1015537 1100 LOCUST ST. [email protected]

800-532-1436 Ext. 4344

1100 LOCUST STREET,

DEPT 0301

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

FEDERAL INSURANCE COMPANY NJ 07061 [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

FEDERAL EXPRESS CORPORATION 3620 HACKS CROSS

ROAD, BLG B, 3RD

TN 38125 [email protected]

800-226-3243 Ext. 5729

FCCI SERVICES 59-1968027 P O BOX 58004 [email protected]

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY [email protected]

800-422-4436 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE [email protected]

404-266-4127 Ext.

FEDERAL INSURANCE

COMPANY

13-1963496 2 LIVE OAK CNTR #900 [email protected]

Page 59: Georgia State Board of Workers' Compensation Insurer and Claim

DULUTH GA 33622

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10064 OWATONNA

TAMPA FL 33634

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12059 LENEXA

ATLANTA GA 30302

Phone:

GAINESVILLE GA 30503

Phone:

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PKWY [email protected]

770-823-0997 Ext. 230

FEDERATED MUTUAL INS CO MN 55060 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

800-226-8002 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

404-992-3845 Ext.

[email protected]

404-300-1250 Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 41 [email protected]

CRAWFORD & COMPANY 58-0506554 P O BOX 5056

FEDERATED RURAL ELECTRIC INSURANCE

EXCHANGE

KS 66285

FEDERATED MUTUAL

INSURANCE COMPANY

- 20 PERIMETER SUMMIT

BLVD NE

800-241-4945 Ext.

FEDERATED MUTUAL

INSURANCE COMPANY

41-0417460 P O BOX 31716 [email protected]

800-237-8292 Ext. 8253

Page 60: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

13130 OWATONNA

TAMPA FL 33634

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20535 HARRISON

800-237-8292 Ext. 8253

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

FEDERATED SERVICE INSURANCE COMPANY MN 55060 [email protected]

FEDERATED MUTUAL

INSURANCE COMPANY

41-0417460 P O BOX 31716 [email protected]

615-493-5802 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

FEDEX FREIGHT EAST INC fka AMERICAN

FREIGHTWAYS

AR 72602

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

Page 61: Georgia State Board of Workers' Compensation Insurer and Claim

HARRISON AR 72602

Phone:

SBWC # Insurer Name Address Email

21705 PITTSBURGH

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13146 MAITLAND

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

13229 JACKSONVILLE

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

10299 ST PAUL

NORCROSS GA 30071

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

Phone:

TAMPA FL 33630

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

FEDEX GROUND PACKAGE SYSTEM INC WORKERS

COMPENSATION

SECTION, P O BOX

535859

PA 15253 [email protected]

FEDEX EAST 71-0562003 P O BOX 840 [email protected]

870-741-9000 Ext.

FEDEX FREIGHT EAST INC fka AMERICAN

FREIGHTWAYS

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

FIDELITY & GUARANTY INSURANCE CO MN 55102 [email protected]

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

FHM INSURANCE COMPANY FKA FLORIDA

HOSPITALITY MUTUAL INS CO

4601 TOUCHTON ROAD

EAST, SUITE 3150

BUILDING 300

FL 32246 [email protected]

800-346-4825 Ext.

FFVA MUTUAL CLAIMS 59-6828087 800 TRAFALGAR COURT [email protected]

FFVA MUTUAL FL 32794 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG [email protected]

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

678-969-7337 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 [email protected]

800-258-1811 Ext.

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-580-6912 Ext.

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

[email protected]

800-755-1441 Ext.

Page 62: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

FARMINGTON CT 06032

Phone:

ROSWELL GA 30076

Phone:

ROSWELL GA 30076

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

FRANKLIN TN 37067

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

TAMPA FL 33610

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

800-742-4248 Ext.

800-842-5612 Ext. 4611

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

43-1091525 1000 FIANA WAY [email protected]

678-795-4500 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

DISCOVER RE MANAGERS 06-1288492 5 BATTERSON PARK [email protected]

866-657-2827 Ext.

ESIS 95-2008390 500 COLONIAL CENTER

PARKWAY

[email protected]

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-295-0011 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 6640 CAROTHERS [email protected]

615-660-6258 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 2420 LAKEMONT AVENUE [email protected]

470-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 2420 LAKEMONT AVENUE [email protected]

407-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 10401 HIGHLAND MANOR

DRIVE

[email protected]

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 6640 CAROTHERS [email protected]

615-660-6258 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 11440 CARMEL COMMONS

BLVD

[email protected]

Page 63: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

CHARLOTTE NC 28226

Phone:

FT SMITH AR 72919

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

MAITLAND FL 32794

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

10401 HIGHLAND MANOR

DRIVE

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 1000 FIANA WAY [email protected]

800-842-5612 Ext. 4611

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3298

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

407-916-8580 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GATES MCDONALD 31-4187660 P O BOX 945150

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

Page 64: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

800-532-7706 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

888-888-8136 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

800-896-3079 Ext.

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

Page 65: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

10257 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10197 ST PAUL

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

FIDELITY AND DEPOSIT CO OF MARYLAND IL 60196 [email protected]

FIDELITY AND DEPOSIT

COMPANY OF MARYLAND

13-3046577 3003 SUMMIT BLVD [email protected]

800-444-9098 Ext. 214

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

[email protected]

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

800-580-6912 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

FIDELITY AND GUARANTY UNDERWRITERS

INSURANCE

MN 55102 [email protected]

404-851-3207 Ext.

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

FIDELITY AND DEPOSIT

COMPANY OF MARYLAND

13-3046577 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

877-295-0011 Ext.

[email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

Page 66: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

ALPHARETTA GA 30005

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

TAMPA FL 33610

Phone:

CHARLOTTE NC 28226

Phone:

FT SMITH AR 72919

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 1000 WINDWARD

CONCOURSE

[email protected]

877-241-6121 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

866-291-0194 Ext.

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 1000 FIANA WAY [email protected]

800-842-5612 Ext. 4611

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

INC

52-0616768 11440 CARMEL COMMONS

BLVD

[email protected]

FIDELITY & GUARANTY

INSURANCE UNDERWRITERS

52-0616768 6640 CAROTHERS [email protected]

615-660-6258 Ext.

407-388-2587 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3298

FIDELITY & GUARANTY

INSURANCE COMPANY

42-1091525 2420 LAKEMONT AVENUE [email protected]

800-238-6214 Ext.

FIDELITY & GUARANTY

INSURANCE COMPANY

43-1091525 1000 FIANA WAY [email protected]

800-842-5612 Ext. 4611

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

Page 67: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-843-8999 Ext.

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

888-888-8136 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

800-282-6218 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

800-896-3079 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

Page 68: Georgia State Board of Workers' Compensation Insurer and Claim

CHARLOTTE NC 28217

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

227968 CHARLOTTE NC 28262

Phone:

LEXINGTON KY 40512

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

21022 BALDWIN

BALDWIN GA 30511

Phone:

SBWC # Insurer Name Address Email

10067 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

12029 NOVATO

ATLANTA GA 30374

Phone:

SBWC # Insurer Name Address Email

13066 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 10735 DAVID TAYLOR [email protected]

800-822-4469 Ext.

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 [email protected]

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY [email protected]

FIREMAN'S FUND INS CO CA 94998 [email protected]

FIELDALE FARMS

CORPORATION

58-1119934 P O BOX 558 [email protected]

706-778-5100 Ext.

FIELDALE FARMS CORPORATION GA 30511 [email protected]

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

877-300-6187 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-541-0139 Ext. 35832

FIRST LIBERTY INSURANCE

CORPORATION

04-3058503 P O BOX 49000 [email protected]

800-532-7706 Ext.

FIRST LIBERTY INSURANCE

CORPORATION

04-3058503 P O BOX 31204 [email protected]

FIRST LIBERTY INSURANCE CORPORATION MA 02116 [email protected]

[email protected]

678-393-4550 Ext.

FIREMAN'S FUND INSURANCE CO OF GEORGIA CA 94998

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174

Page 69: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10292 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21196 DUBUQUE

DUBUQUE IA 52004

Phone:

SBWC # Insurer Name Address Email

20932 BIRMINGHAM

JACKSONVILLE FL 32207

Phone:

SBWC # Insurer Name Address Email

13174 EDWARDSVILLE

ATLANTA GA 30319

Phone:

LAWRENCEVILLE GA 30045

Phone:

ATLANTA GA 30319

Phone:

ORLANDO FL 32822

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

FIRST LIBERTY INSURANCE

CORPORATION

877-241-6121 Ext.

FLEXSTEEL INDUSTRIES INC IA 52004 [email protected]

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

FIRST NATIONAL INSURANCE COMPANY OF

AMERICA

SAFECO PLAZA, 1901

FOURTH AVENUE

WA 98154 [email protected]

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 [email protected]

800-282-6218 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 31204 [email protected]

800-282-6218 Ext.

-- Ext.

HORTICA - 5840A SOUTH SEMORAN

BLVD

[email protected]

CRAWFORD & COMPANY 58-0506554 160-3130 SUGARLOAF

PARKWAY

[email protected]

678-377-5654 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

FLORISTS INSURANCE COMPANY IL 62025 [email protected]

866-293-5353 Ext. 114

FLORIDA ROCK INDUSTRIES INC AL 35242 [email protected]

BROADSPIRE 36-3917295 1965 BEACHWAY ROAD [email protected]

Page 70: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10259 EDWARDSVILLE

ATLANTA GA 30319

Phone:

LAWRENCEVILLE GA 30045

Phone:

ATLANTA GA 30319

ORLANDO FL 32822

Phone:

SBWC # Insurer Name Address Email

21002 THOMASVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21598 ROME

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Address Email

20600 ROME

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21472 ROME

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20380 DEARBORN

DEARBORN MI 48121

Phone:

SBWC # Insurer Name Address Email

5840A SOUTH SEMORAN

BLVD

800-566-5458 Ext.

FLORISTS MUTUAL INSURANCE COMPANY IL 62025 [email protected]

800-421-9139 Ext. 859

FLOYD COUNTY BOARD OF COMMISSIONERS GA 30162 [email protected]

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 [email protected]

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

FLOWERS FOODS INC GA 31792 [email protected]

HORTICA - 5840A SOUTH SEMORAN

BLVD

[email protected]

800-566-5458 Ext.

678-377-5654 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 160-3130 SUGARLOAF

PARKWAY

[email protected]

313-206-4709 Ext.

FORD MOTOR COMPANY MI 48121 [email protected]

FORD MOTOR CLAIMS 38-0549190 P O BOX 607 [email protected]

678-258-8000 Ext.

FLOYD HEALTHCARE MANAGEMENT INC GA 30162 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

FLOYD COUNTY BOARD OF EDUCATION GA 30161 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

Page 71: Georgia State Board of Workers' Compensation Insurer and Claim

20393 FOREST PARK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21559 CUMMING

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

13259 CLEARWATER

TAMPA FL 33630

Phone:

SBWC # Insurer Name Address Email

13164 FRANKENMUTH

FRANKENMUTH MI 48787

Phone:

FRANKENMUTH MI 48787

Phone:

SBWC # Insurer Name Address Email

21756 FRANKLIN

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

21574 MANCHESTER

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

20599 ATLANTA

ATLANTA GA 30303

Phone:

800-224-9524 Ext.

FOREST PARK CITY OF GA 30051 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

ANSUR AMERICA

INSURANCE COMPANY

38-3467437 ONE MUTUAL AVENUE [email protected]

800-234-1133 Ext.

FRANKENMUTH MUTUAL

INSURANCE COMPANY

38-0555290 ONE MUTUAL AVE. [email protected]

FRANKENMUTH MUTUAL INS. MI 48787 [email protected]

800-258-1811 Ext.

FRANK WINSTON CRUM INSURANCE INC FL 33756 [email protected]

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 [email protected]

800-524-0604 Ext.

FORSYTH COUNTY BOARD OF EDUCATION GA 30040 [email protected]

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

FULTON COUNTY 58-6001729 141 PRYOR ST [email protected]

404-730-6749 Ext.

FULTON COUNTY 141 PRYOR STREET, 5070-

A

GA 30303 [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

FREUDENBERG-NOK GENERAL PARTNERSHIP 100 COMMERCIAL ST

1ST FL NORTH, FIRST

FLOOR NORTH

NH 03101 [email protected]

800-932-4464 Ext.

FRANKLIN ALUMINUM CO INC GA 30217 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-234-1122 Ext.

Page 72: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21172 COLLEGE PARK

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

30003 NORCROSS

NORCROSS GA 30071

Phone:

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

30004 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20388 THOMASVILLE

THOMASVILLE GA 31799

Phone:

SBWC # Insurer Name Address Email

30017 ATLANTA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

30008 ATLANTA

ATLANTA GA 30303

Phone:

SBWC # Insurer Name Address Email

30029 CONYERS

MACON GA 31210

866-646-8516 Ext. 245

GA AUTO DEALERS ASSOC SI GA 30339 [email protected]

GA AUTO DEALERS (GADA)

CLAIMS

58-1493566 2060 POWERS FERRY ROAD

SE

[email protected]

678-447-0200 Ext. 302

ACCG 58-1044477 3169 HOLCOMB BRIDGE

ROAD

[email protected]

678-225-4241 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

GA ASSOCIATION COUNTY COM ACCG-GSIWCF, 3169

HOLCOMB BRIDGE

ROAD STE 400

GA 30071

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

800-845-2724 Ext. 43582

FULTON COUNTY BOARD OF EDUCATION GA 30349 [email protected]

GA NURSING HOME GROUP C/O TIS OF GA, 2281

MORRISON ROAD SW

GA 30094 [email protected]

GA MUNICIPAL 58-1740980 201 PRYOR STREET SW [email protected]

888-488-4462 Ext. 124

GA MUNICIPAL ASSOCIATION GA 30303 [email protected]

[email protected]

800-233-2436 Ext. 1897

GA EDUCATION WC TRUST FUND 1940 THE EXCHANGE,

STE 200

GA 30339

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE

800-841-0001 Ext.

GA CRATE & BASKET COMPANY INC GA 31799 [email protected]

GA CRATE & BASKET CO 58-0255590 PO BOX 46 [email protected]

SANFORD COMPANY 02-0634255 4025 VINEVILLE AVE [email protected]

Page 73: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

30014 LAWRENCEVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

30033 CLEARWATER

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

30023 LAWRENCEVILLE

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21665 MCLEAN

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13264 ST LOUIS

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10213 BOSTON

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

10058 SUN PRAIRIE

ATLANTA GA 31145

GA SCHOOL BOARD ASSOC GA 30243

888-888-8136 Ext.

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD [email protected]

770-677-3423 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

GA OPERATORS SELF INSURED FUND C/O ARTHUR J

GALLAGHER, P O BOX

9000

FL 33758 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

GA OILMEN'S ASSSOCIATION GA 30043

800-281-9761 Ext.

800-762-5573 Ext.

GENERAL ACCIDENT INSURANCE CO MA 02108

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

770-813-0997 Ext. 230

GATEWAY INSURANCE COMPANY MO 63144 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-352-2978 Ext.

GANNETT COMPANY INC VA 22107 [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 [email protected]

GENERAL CASUALTY CO OF WISCONSIN WI 55359 [email protected]

Page 74: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10073 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10075 COLUMBIA

ATLANTA GA 30319

Phone:

COLUMBIA MO 65205

Phone:

SBWC # Insurer Name Address Email

30007 TUCKER

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

30011 MARIETTA

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

20788 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21453 LAGRANGE

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

800-877-3579 Ext.

GEORGIA CASUALTY &

SURETY

58-0537066 2102 WHITE GATE DR [email protected]

573-474-6193 Ext.

GEORGIA CASUALTY & SURETY MO 65205 [email protected]

GEORGIA CASUALTY &

SURETY

58-0537066 4370 PEACHTREE ROAD NE [email protected]

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

GENERAL INSURANCE COMPANY OF AMERICA 1001 FOURTH AVENUE,

SAFECO PLAZA

WA 98154 [email protected]

GENERAL CASUALTY

COMPANY OF WISCONSIN

770-493-1931 Ext.

GFF HOLDING CO GA 30240 [email protected]

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

770-963-7732 Ext.

GEORGIA STATE OF CAPITOL HILL STATION,

P O BOX 38198

GA 30334 [email protected]

800-476-7601 Ext.

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 [email protected]

GEORGIA HOSPITAL ASSOCIATION WC FUND GA 30067 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

GEORGIA EMC WORKERS COMP FUND GA 30085 [email protected]

BRENTWOOD SERVICES 62-1482047 1602 KNOX COURT [email protected]

800-524-0604 Ext.

Page 75: Georgia State Board of Workers' Compensation Insurer and Claim

21787 GROVETOWN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21516 BRUNSWICK

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

20554 BRUNSWICK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21386 BOGART

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21227 ATLANTA

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

10277 COLUMBUS

WARRENVILLE IL 60555

Phone:

COLUMBUS OH 43216

Phone:

SBWC # Insurer Name Address Email

10079 NEW YORK

NORCROSS GA 30071

Phone:

ALPHARETTA GA 30023

Phone:

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

GLYNN COUNTY BOARD OF EDUCATION GA 31520

678-447-0200 Ext. 302

GLYNN COUNTY BOARD OF COMMISSIONERS GA 31520 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

GIW INDUSTRIES INC GA 30813 [email protected]

800-935-5300 Ext. 254

GRANGE MUTUAL

CASUALTY COMPANY

31-4192970 P O BOX 182306 [email protected]

800-348-1741 Ext. 8407

GRANGE MUTUAL CASUALTY CO OH 43206 [email protected]

GRANGE MUTUAL 31-4192970 27755 DIEHL ROAD [email protected]

800-524-0604 Ext.

GRADY HOSPITAL FKA FULTON DEKALB HOSP

AUTHOR

80 JESSE HILL JR DR,

BOX 26208

GA 30303 [email protected]

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

678-258-8000 Ext.

GOLDEN PANTRY FOOD STORES INC GA 30622 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

678-447-0200 Ext. 302

GRANITE STATE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

Page 76: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

12006 NEW HARTFORD

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

12062 METAIRIE

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12007 CINCINNATI

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

12075 CINCINNATI

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

-- Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

GRAY INSURANCE COMPANY (THE) LA 70002 [email protected]

GRAPHIC ARTS MUTUAL

INSURANCE CO

13-5274760 1040 CROWN POINT

PARKWAY

[email protected]

800-477-1914 Ext.

GRAPHIC ARTS MUT INS CO NY 13413 [email protected]

770-225-3538 Ext. 360

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

GREAT AMERICAN 31-0501234 P O BOX 5432 [email protected]

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

GREAT AMERICAN ALLIANCE INS. 49 EAST FOURTH

STREET, 4400 SOUTH

OH 45202 [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

GREAT AMERICAN ASSURANCE COMP OH 45202 [email protected]

GREAT AMERICAN 31-0501234 P O BOX 5432 [email protected]

Page 77: Georgia State Board of Workers' Compensation Insurer and Claim

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

10080 CINCINNATI

MAITLAND FL 32751

Phone:

CINCINNATI OH 45202

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10080 CINCINNATI

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30099

SBWC # Insurer Name Address Email

10192 CINCINNATI

CINCINNATI OH 45202

Phone:

ALPHARETTA GA 30099

Phone:

SBWC # Insurer Name Address Email

13216 SCOTTSDALE

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

12072 WARREN

ATLANTA GA 30326

Phone:

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 [email protected]

770-225-3538 Ext. 360

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

GREAT AMERICAN INS CO 49 EAST FOURTH

STREET, SUITE 400

OH 45202 [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

770-901-3121 Ext.

GREAT AMERICAN 31-0501234 P O BOX 5432 [email protected]

877-589-6846 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

GREAT AMERICAN INS CO 49 EAST FOURTH

STREET, SUITE 400

OH 45202 [email protected]

GREAT NORTHERN INSURANCE COMPANY NJ 07061 [email protected]

800-449-2024 Ext. 8952

GREAT DIVIDE INSURANCE COMPANY AZ 85260 [email protected]

BERKLEY SPECIALTY

UNDERWRITING

45-0397186 122 WEST CARPENTER

FREEWAY #300

[email protected]

770-225-3538 Ext. 360

[email protected]

877-589-6846 Ext.

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 [email protected]

GREAT AMERICAN INS CO OF NY 49 EAST FOURTH OH 45202

GREAT AMERICAN 31-0501234 P O BOX 5432

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

STRATEGIC COMP SERVICES 72-1331800 P O BOX 1445 [email protected]

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

404-266-4855 Ext.

Page 78: Georgia State Board of Workers' Compensation Insurer and Claim

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10298 SOUTH SIOUX

CITYSOUTH SIOUX

CITY

NE 68776

Phone:

SBWC # Insurer Name Address Email

10082 NEW YORK

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

12078 EXTON

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

ATLANTA GA 30305

Phone:

BIRMINGHAM AL 35209

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

GREAT WEST CASUALTY

COPANY

47-6024508 P O BOX 277 [email protected]

800-228-8602 Ext. 7208

GREAT WEST CASUALTY COMPANY NE 68776 [email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

866-246-0259 Ext.

GREAT NORTHERN

INSURANCE

41-0729473 2 LIVE OAK CENTER SUITE

900

[email protected]

404-266-4127 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

404-504-6290 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

ECS CLAIM - 3525 PIEDMONT RD #300

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE [email protected]

800-862-4252 Ext.

GREENWICH INSURANCE COMPANY PA 19341 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-838-9853 Ext.

GREATER NEW YORK MUTUAL INS. CO NY 10016 [email protected]

INDEPENDENT ADJUSTERS

INC.

58-1075455 2130 TUCKER INDUSTRIAL

RD

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 1 METROPLEX DRIVE [email protected]

800-587-3773 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

Page 79: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30338

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

20555 GRIFFIN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

30020 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

12046 FT LAUDERDALE

LAKE MARY FL 32746

Phone:

FORT

LAUDERDALE

FL 33301

Phone:

SBWC # Insurer Name Address Email

21053 AUBURN HILLS

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

10246 WEST DES

STONE MOUNTAIN GA 30087

Phone:

SBWC # Insurer Name Address Email

21135 SAVANNAH

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

615-493-5802 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

654-703-8038 Ext.

GUARANTEE INSURANCE 22-2222789 1000 PRIMERA BLVD [email protected]

800-948-2651 Ext. 1306

GUARANTEE INSURANCE 22-2222789 401 EAST LAS OLAS BLVD [email protected]

GUARANTEE INSURANCE CO 401 EAST LAS OLAS

BLVD, SUITE 1540

FL 33301 [email protected]

[email protected]

800-421-0710 Ext.

GTMA/AYSA 50 HURT PLAZA, SUITE GA 30303

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE

[email protected]

678-258-8000 Ext.

GRIFFIN SPALDING BOARD OF EDUCATION GA 30223

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

GULFSTREAM AEROSPACE CORP DBA GENERAL

DYNAMICS

500 GULFSTREAM ROAD,

MAIL STATION B-06

GA 31407 [email protected]

[email protected]

800-659-1232 Ext. 6337

GUIDEONE MUTUAL INSURANCE COMPANY IA 50265

GUIDEONE MUTUAL

INSURANCE CO

42-0645088 2305 W PARK PLACE

800-685-7361 Ext.

GUARDIAN AUTOMOTIVE CORPORATION MI 48326 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

Page 80: Georgia State Board of Workers' Compensation Insurer and Claim

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21780 LAWRENCEVILLE

227948 LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

21076 LAWRENCEVILLE

995259 CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21418 LAWRENCEVILLE

228131 LAWRENCEVILLE GA 30046

Phone:

SBWC # Insurer Name Address Email

20466 GAINESVILLE

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21097 DALTON

928653 ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10086 WORCESTER

WORCESTER MA 01653

912-355-8929 Ext. 224

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

HALL COUNTY BOARD OF EDUCATION 711 GREEN STREET,

SUITE 100

GA 30501 [email protected]

GWINNETT HEALTH SYSTEM 58-2135755 100 MEDICAL CENTER [email protected]

678-312-4164 Ext.

GWINNETT HEALTH SYSTEM 100 MEDICAL CENTER

BLVD, SUITE 100

GA 30046 [email protected]

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 [email protected]

800-524-0604 Ext.

GWINNETT COUNTY PUBLIC SCHOOLS 53 GWINNETT DRIVE,

BUILDING A

GA 30045 [email protected]

770-822-7850 Ext.

GWINNETT COUNTY BOARD OF

COMMISSIONERS

GA 30045 [email protected]

GWINNETT COUNTY BD OF

COM

- 75 LANGLEY DRIVE

HANOVER INSURANCE CO MA 01653 [email protected]

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

HAMILTON HEALTH CARE SYSTEM INC GA 30722 [email protected]

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 [email protected]

770-962-3627 Ext.

Page 81: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

21031 HAPEVILLE

227674 ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13020 NEW YORK

ATLANTA GA 30366

Phone:

ATLANTA GA 30339

Phone:

FL 32716

Phone:

SBWC # Insurer Name Address Email

12051 ROLLING

MEADOW

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13057 HARLEYSVILLE

227475 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

13285 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

12018 HARLEYSVILLE

227475 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

13284 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

HAPEVILLE CITY OF GA 30354 [email protected]

SELF-INSURANCE

ADMINISTRATORS (SIA)

58-1870166 4370 PEACHTREE ROAD NE [email protected]

800-628-0250 Ext.

800-450-0692 Ext.

HARCO NATIONAL INSURANCE COMPANY IL 60008 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-315-6090 Ext.

800-883-9305 Ext.

NORTH AMERICAN RISK

SERVICES INC

13-3901415 P O BOX 166002 ALTAMONTE

SPRINGS

[email protected]

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 [email protected]

800-772-8427 Ext.

BUILDERS INSURANCE 58-2453325 P O BOX 723099 [email protected]

HARBOR SPECIALTY INS 7 TIMES SQUARE, 36 & 37

FLOOR

NY 10036 [email protected]

404-266-5749 Ext.

HARLEYSVILLE PREFERRED INSURANCE

COMPANY

PA 19438 [email protected]

HARLEYSVILLE GROUP - P O BOX 244 [email protected]

888-549-9876 Ext. 1217

HARLEYSVILLE MUTUAL INSURANCE PA 19438 [email protected]

HARLEYSVILLE ATLANTIC 23-0902325 P O BOX 244 [email protected]

888-549-9826 Ext. 5003

HARLEYSVILLE INSURANCE COMPANY PA 19438 [email protected]

HARLEYSVILLE GROUP - P O BOX 244 [email protected]

888-549-9876 Ext. 1217

HARLEYSVILLE ATLANTIC INSURANCE PA 19438 [email protected]

HARLEYSVILLE ATLANTIC 23-0902325 P O BOX 244 [email protected]

Page 82: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13283 HARLEYSVILLE

1004829 HARLEYSVILLE PA 19438

Phone:

SBWC # Insurer Name Address Email

20389 BETHLEHEM

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

10089 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

888-549-9826 Ext. 5003

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

HARTFORD ACCIDENT & INDEMNITY CT 06115 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

HARRISON POULTRY INC GA 30620 [email protected]

888-549-9826 Ext. 5003

HARLEYSVILLE WORCESTER INSURANCE

COMPANY

PA 19438 [email protected]

HARLEYSVILLE GROUP - P O BOX 244 [email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

Page 83: Georgia State Board of Workers' Compensation Insurer and Claim

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10044 HARTFORD

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

800-450-0692 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

HARTFORD CASUALTY INSURANCE COMPANY CT 06155 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

Page 84: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

831038 HARTFORD CT 06115

Phone:

ATLANTA GA 30328

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

[email protected]

800-304-5035 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

860-547-7936 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 HARTFORD PLAZA [email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-932-4464 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

Page 85: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12045 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

SUNRISE FL 33323

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

770-901-3124 Ext.

866-291-0194 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

HARTFORD FIRE INS CO CT 06115 [email protected]

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

985-624-6739 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

770-577-9657 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

Page 86: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30328

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32795

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

200 COLONIAL CENTER

PARKWAY

[email protected]

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

407-562-3632 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

[email protected]

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 958424 [email protected]

877-300-6187 Ext. 1012

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

Page 87: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12037 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

407-562-3632 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

800-541-0139 Ext.

605 CRESCENT EXECUTIVE

COURT

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

HARTFORD INSURANCE CO OF THE SOUTHEAST CT 06155 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

Page 88: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SYRACAUSE NY 13202

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

12092 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DUBUQUE IA 52004

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

407-562-3632 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

200 COLONIAL CENTER

PARKWAY

[email protected]

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 [email protected]

800-450-0692 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

HARTFORD INSURANCE COMPANY OF

MIDWEST

CT 06155 [email protected]

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

Page 89: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

SYRACRUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

800-422-4436 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE [email protected]

770-813-0997 Ext. 230

985-624-6739 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD INS CO MIDWEST 06-1008026 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD INC CO MIDWEST 06-1008026 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

Page 90: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10123 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

615-824-5095 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

[email protected]

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

877-241-6121 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

HARTFORD UNDERWRITERS INS CT 06155 [email protected]

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-675-2771 Ext. 225

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

[email protected]

Page 91: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

800-426-2885 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

Page 92: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

954444 TAMPA FL 33610

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

40012 LAWRENCEVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21779 N LIBERTY

TUCKER GA 30084

Phone:

SBWC # Insurer Name Email

20580 MCDONOUGH

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

21426 BRANSON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20533 SUWANEE

JOHNS CREEK GA 30097

615-824-5095 Ext.

407-562-3632 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

[email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

678-258-8000 Ext.

HERSCHEND FAMILY ENTERTAINMENT FKA

SILVER DOLLAR CITY

MO 65616 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

770-962-3627 Ext.

Address

HENRY COUNTY BOARD OF EDUCATION GA 30253 [email protected]

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 [email protected]

800-354-6494 Ext. 201

HEARTLAND EXPRESS INC IA 52317 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-421-0710 Ext.

HEALTHCARE MUTUAL CAPTIVE GA 30043 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

HILLCREST FOODS INC 50 SATELLITE BLVD,

SUITE G

GA 30024 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

Page 93: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

21612 MUSCATINE

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20565 AUSTIN

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20312 CUTHBERT

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21046 VALDOSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20362 WARNER ROBINS

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Address Email

20407 PERRY

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

HORMEL FOODS MN 55912 [email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

HNI CORPORATION/HON INDUSTRIES IA 52761 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

678-258-8000 Ext.

[email protected]

800-421-9139 Ext. 859

HOUSTON COUNTY BOARD OF

COMMISSIONERS

GA 31088

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

HOSPITAL AUTHORITY OF

VALDOSTA/LOWNDES

2501 N PATTERSON

STREET, P.O. BOX 1727

GA 31603 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

HOSPITAL AUTHORITY OF RANDOLPH COUNTY GA 39840 [email protected]

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

770-962-3627 Ext.

HOUSTON COUNTY BOARD OF EDUCATION GA 31069

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 [email protected]

Page 94: Georgia State Board of Workers' Compensation Insurer and Claim

21286 WARNER ROBINS

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21354 SANDERSVILLE

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21001 CHICAGO

MIRAMAR FL 33027

Phone:

SBWC # Insurer Name Address Email

21182 PINE MOUNTAIN

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

12071 PHILADELPHIA

NORCROSS GA 30010

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30005

Phone:

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

HOWARD SHEPPARD INC GA 31082 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

HOUSTON HOSPITALS INC dba HOSP AUTHOR

OF HOUSTON CO

GA 31099 [email protected]

[email protected]

678-969-7337 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

BROADSPIRE INC 36-3917295 P O BOX 926240

INDEMNITY INSURANCE COMPANY OF NORTH

AMERICA

PA 19105 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

IDA CASON CALLAWAY FOUNDATION GA 31822 [email protected]

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-473-9009 Ext.

HYATT HOTELS CORPORATION 71 SOUTH WACKER

DRIVE, 17TH FLOOR

IL 60606 [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

Page 95: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33612

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

TUCKER GA 30084

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33618

Phone:

TAMPA FL 33631

Phone:

ATLANTA GA 30328

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-934-3414 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2600 MCCORMICK DR #110 [email protected]

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

Page 96: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

986169 PARSIPPANY NJ 07054

Phone:

SBWC # Insurer Name Address Email

21344 ASHEVILLE

941165 ASHEVILLE NC 28816

Phone:

SBWC # Insurer Name Address Email

10093 PHILADELPHIA

ROSWELL GA 30076

Phone:

DULUTH GA 30097

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

770-901-3121 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

INSURANCE COMPANY OF NORTH AMERICA 436 WALNUT STREET,

WB04G

PA 19106 [email protected]

828-669-2941 Ext. 426

INGLES MARKETS INC NC 28816 [email protected]

INGLES MARKETS 56-0846267 P O BOX 6676 [email protected]

877-927-2255 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD [email protected]

Page 97: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10094 NEW YORK

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30023

Phone:

OKLAHOMA CITY OK 73123

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

Phone:

FT SMITH AR 72919

Phone:

ROSWELL GA 30076

GAB ROBINS NORTH

AMERICA INC

770-813-0997 Ext. 230

[email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

INSURANCE COMPANY OF STATE OF PA 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

770-934-3414 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 FIANA WAY [email protected]

800-842-5612 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR [email protected]

770-352-2978 Ext.

CLAIMETRICS 20-1604010 PO BOX 22478 [email protected]

405-728-5544 Ext. 2326

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

800-448-9707 Ext.

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

Page 98: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13089 SAN DIEGO

678-731-9091 Ext. 252

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

800-226-8002 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

800-685-7361 Ext.

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-541-0139 Ext. 35832

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

INSURANCE COMPANY OF THE WEST CA 92130 [email protected]

800-238-6214 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

Page 99: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33602

Phone:

SBWC # Insurer Name Address Email

20359 LAGRANGE

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

20642 MEMPHIS

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21514 RICEBORO

228221 RICEBORO GA 31323

Phone:

SBWC # Insurer Name Address Email

21321 DALTON

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21143 JESUP

227978 JESUP GA 31545

Phone:

SBWC # Insurer Name Address Email

21474 ATLANTA

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

20412 DENVER

INTERNATIONAL PAPER CO 6400 POPLAR AVENUE,

TOWER III, 4-110

TN 38197 [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

INTERFACE INC GA 30240 [email protected]

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD [email protected]

800-426-5990 Ext.

912-427-1313 Ext.

JESUP CITY OF GA 31545

JESUP CITY OF - P O BOX 427

800-884-1535 Ext.

J & J INDUSTRIES INC GA 30721 [email protected]

COLLINS & COMPANY 62-0882150 555 RIVER STREET [email protected]

912-884-3371 Ext. 238

INTERSTATE PAPER LLC GA 31323 [email protected]

INTERSTATE PAPER LLC 54-1876547 2366 INTERSTATE PAPER

ROAD

[email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

JOHNS MANVILLE CO 80202 [email protected]

800-845-2724 Ext. 43582

JOHN WIELAND HOMES AND NEIGHBORHOODS

INC.

GA 30337 [email protected]

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

Page 100: Georgia State Board of Workers' Compensation Insurer and Claim

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21719 WAYCROSS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20571 TIFTON

GRAYSON GA 30017

Phone:

SBWC # Insurer Name Address Email

20944 BATTLE CREEK

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

13155 GREENSBORO

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

21051 NEENAH

NEEAH WI 54957

Phone:

SBWC # Insurer Name Address Email

21461 JACKSON

JACKSON MS 39218

Phone:

SBWC # Insurer Name Address Email

21752 PHOENIX

BIRMINGHAM AL 35209

770-962-3627 Ext.

KELLEY MANUFACTURING COMPANY GA 31793 [email protected]

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 [email protected]

678-258-8000 Ext.

JONES COMPANY (THE) GA 31502 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

800-685-7361 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

-- Ext.

KIMBERLY-CLARK

CORPORATION

39-0394230 2300 WINCHESTER RD

KIMBERLY CLARK CORPORATION 2300 WINCHESTER

ROAD, PO BOX 2007

WI 54957 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

336-668-9050 Ext. 7539

KEY RISK INSURANCE CO 7900 MCCLOUD ROAD,

SUITE 300

NC 27409 [email protected]

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 [email protected]

866-434-2480 Ext.

KELLOGG CO AND SUBSIDIARIES fka KEEBLER MI 49017 [email protected]

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

KNIGHT TRANSPORTATION INC AZ 85043 [email protected]

601-933-4942 Ext.

KLLM TRANSPORT SERVICES LLC MS 39218 [email protected]

KLLM TRANSPORT SERVICES 64-0577750 135 RIVERVIEW DRIVE [email protected]

Page 101: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13267 WEST TRENTON

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21704 ATLANTA

DULUTH GA 30096

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21709 TACOMA

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21763 LAGRANGE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21340 VALDOSTA

763045 VALDOSTA GA 31603

Phone:

SBWC # Insurer Name Address Email

21550 LAWRENCEVILLE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20507 BIRMINGHAM

BIRMINGHAM AL 35238

Phone:

KROGER COMPANY (THE) GA 30345 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

KODIAK INSURANCE COMPANY NJ 08628 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

800-277-7500 Ext. 29106

LANGDALE INDUSTRIES 58-1688919 P O BOX 1088 [email protected]

229-333-2551 Ext.

LANGDALE COMPANY (THE) GA 31603 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

LAGRANGE CITY OF GA 30240 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

LABOR READY INC 1015 A STREET, P O BOX

2910

WA 98401 [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

LEGACY VULCAN

MATERIALS CO

63-0366371 P O BOX 385014 [email protected]

800-474-4082 Ext.

LEGACY VULCAN F/K/A VULCAN MATERIALS

COMPANY

AL 35242 [email protected]

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE [email protected]

404-266-5749 Ext.

LAWRENCEVILLE CITY OF GA 30046 [email protected]

Page 102: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

13182 BOSTON

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10097 BOSTON

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

10098 BOSTON

TAMPA FL 33618

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

LIBERTY INSURANCE CORPORATION MA 02116 [email protected]

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

LIBERTY MUTUAL FIRE INS CO MA 02116 [email protected]

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 [email protected]

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 [email protected]

800-282-6218 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 49000 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-532-7706 Ext.

LIBERTY MUTUAL INS CO MA 02117 [email protected]

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204 [email protected]

800-282-6218 Ext.

800-282-6218 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 49000 [email protected]

800-532-7706 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 [email protected]

800-532-7706 Ext.

LIBERTY MUTUAL FIRE

INSURANCE

04-1924000 P O BOX 31204 [email protected]

800-282-6218 Ext.

Page 103: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

SBWC # Insurer Name Address Email

13220 HOLIDAY

HOLIDAY FL 34691

Phone:

SBWC # Insurer Name Address Email

13059 BOSTON

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES

LM INSURANCE CO MA 02116 [email protected]

PACKARD CLAIMS

ADMINISTRATION INC.

03-0567602 2739 US HIGHWAY 19 [email protected]

727-682-1072 Ext. 5552

LION INSURANCE COMPANY 2739 US HIGHWAY 19

NORTH, SUITE 600

FL 34691 [email protected]

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204 [email protected]

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 49000 [email protected]

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 [email protected]

800-282-6218 Ext.

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 [email protected]

[email protected]

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 31204

LIBERTY MUTUAL GROUP 04-1543470 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-532-7706 Ext.

LIBERTY INSURANCE

CORPORATION

03-0316876 P O BOX 31204 [email protected]

866-246-0259 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

Page 104: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21547 JONESBORO

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21333 MOORESVILLE

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

12005 BOCA RATON

BOCA RATON FL 33431

Phone:

SBWC # Insurer Name Address Email

21530 OKLAHOMA CITY

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20430 MACON

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21389 MACON

ORLANDO FL 32861

Phone:

800-532-7706 Ext.

800-282-6218 Ext.

LM INSURANCE

CORPORATION

04-3058504 P O BOX 49000 [email protected]

LUMBERMENS UNDERWRITING ALLIANCE FL 33431 [email protected]

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-548-1373 Ext.

LOWES HOME CENTERS INC NC 28115 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

678-258-8000 Ext.

LOW TEMP INDUSTRIES GA 30237 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

800-444-9098 Ext. 214

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

MACON/BIBB WATER/SEWERAGE GA 31298

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

MACON CITY OF 700 POPLAR STREET,

3RD FLOOR

GA 31201 [email protected]

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

-- Ext.

M-D BUILDING PRODUCTS INC OK 73118 [email protected]

LUMBERMENS

UNDERWRITING ALLIANCE

CLAIMS

43-0799570 1905 NW CORPORATE [email protected]

800-327-0515 Ext. 227

Page 105: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21630 CINCINNATI

CINCINNATI OH 45202

Phone:

SBWC # Insurer Name Address Email

10140 ATLANTA

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13139 BLUE BELL

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21490 GAINESVILLE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21415 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20577 CHATTANOOGA

DALTON GA 30722

Phone:

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD [email protected]

770-677-3423 Ext.

MANUFACTURERS

ALLIANCE INSURANCE

23-2086596 500 NORTHPARK TOWN

CENTER

[email protected]

888-888-8136 Ext.

MANUFACTURERS ALLIANCE INSURANCE

COMPANY

PA 19422 [email protected]

678-447-0200 Ext. 302

MAG MUTUAL INSURANCE COMPANY 3525 PIEDMONT ROAD,

BLDG 8-600

GA 30305 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

866-908-2395 Ext.

MACYS INC F/K/A FEDERATED DEPARTMENT

STORES INC

OH 45202 [email protected]

MACY'S F/K/A FEDERATED

DEPART STORE CLAIMS

13-3324058 7 WEST SEVENTH STREET [email protected]

423-265-0541 Ext.

COLLINS & COMPANY 62-0882150 P O BOX 6429 [email protected]

706-277-1253 Ext.

COLLINS & COMPANY 62-0882150 555 RIVER ST [email protected]

MARKETPLACE HOLDINGS fka COLLIS FOODS

INC

701 CHEROKEE BLVD,

SUITE 100

TN 37405 [email protected]

[email protected]

678-258-8000 Ext.

MARIETTA CITY OF AND BOARD OF LIGHTS &

WATER

GA 30061

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

678-258-8000 Ext.

MAR-JAC POULTRY INC GA 30503 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

Page 106: Georgia State Board of Workers' Compensation Insurer and Claim

21610 BETHESDA

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

20809 ATLANTA

ATLANTA GA 30324

Phone:

SBWC # Insurer Name Address Email

10103 SCHAUMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10258 WORCESTER

WORCESTER MA 01653

Phone:

SBWC # Insurer Name Address Email

21878 CORAL GABLES

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

20487 COLUMBIA

GREENVILLE SC 29607

Phone:

SBWC # Insurer Name Email

21764 AUGUSTA

404-851-3207 Ext.

MARYLAND CASUALTY

COMPANY

52-0403120 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

MARYLAND CASUALTY COMPANY IL 60196 [email protected]

MARYLAND CASUALTY

COMPANY

52-0403120 3003 SUMMIT BLVD [email protected]

404-848-4521 Ext.

MARTA RISK MANAGEMENT,

2424 PIEDMONT ROAD

GA 30324 [email protected]

MARTA 58-0964286 RISK MANAGEMENT [email protected]

MARRIOTT CLAIMS SERVICE 52-2055918 320 INTERSTATE NORTH

PKWY

[email protected]

800-825-2467 Ext.

MARRIOTT INTERNATIONAL INC 10400 FERNWOOD ROD,

DEPT 51/924.36

MD 20817 [email protected]

MB KAHN CONSTRUCTION SC 29202 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

MASTEC NORTH AMERICA INC FL 33134 [email protected]

HANOVER INSURANCE

COMPANY

13-5129825 440 LINCOLN STREET [email protected]

800-628-0250 Ext.

MASSACHUSETTS BAY INS CO MA 01653 [email protected]

404-851-3208 Ext.

ZURICH SERVICES CORP 36-3839542 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 [email protected]

Address

MCG HEALTH INC 1120 15TH STREET, (CJ

2332)

GA 30912 [email protected]

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 [email protected]

800-421-9139 Ext. 859

Page 107: Georgia State Board of Workers' Compensation Insurer and Claim

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20606 TEMPLE

ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

21759 VIDALIA

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

21737 RICHMOND

COLUMBIA SC 29210

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13215 PORTLAND

MAITLAND FL 32751

Phone:

MANCHESTER NH 03104

Phone:

SBWC # Insurer Name Address Email

21446 SAVANNAH

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21675 MACON

888-741-2673 Ext.

CORE RISK MANAGEMENT

SERVICES

58-2314468 P O BOX 90 [email protected]

MEADOWS REGIONAL MEDICAL CENTER INC GA 30475 [email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

MCLANE COMPANY INC 4747 MCLANE

PARKWAY, PO BOX 6115

TX 76503 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

1120 15TH STREET, (CJ

2332)

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

MEMORIAL HEALTH INC GA 31403 [email protected]

866-291-0194 Ext.

MEMIC INDEMNITY 02-0515329 1750 ELM STREET [email protected]

800-660-1306 Ext. 612

MEMIC INDEMNITY COMPANY ME 04104 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

800-426-2885 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

MEADWESTVACO VA 23219 [email protected]

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

MERCER UNIVERSITY (THE CORPORATION OF) GA 31207 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

Page 108: Georgia State Board of Workers' Compensation Insurer and Claim

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

13148 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

21525 BIRMINGHAM

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10172 BLOOMFIELD

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13274 LANSING

ATLANTA GA 30319

Phone:

SARASOTA FL 34233

Phone:

LANSING MI 48917

Phone:

SBWC # Insurer Name Address Email

20502 NORCROSS

NORCROSS GA 30071

Phone:

800-777-7324 Ext.

MERIDIAN SECURITY

INSURANCE

35-1135866 P O BOX 7183 [email protected]

800-777-7324 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET [email protected]

800-906-4461 Ext.

MERIDIAN SECURITY INSURANCE CO IN 46208 [email protected]

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

888-741-2673 Ext.

CORE RISK MANAGEMENT

SERVICES

58-2314468 P O BOX 90 [email protected]

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

-- Ext.

MICHIGAN COMMERCIAL

INSURANCE MUTUAL

38-3497412 4161 CLARK ROAD [email protected]

MICHIGAN COMMERCIAL INSURANCE MUTUAL MI 48917 [email protected]

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

METLIFE INSURANCE OF CONNECTICUT FKA

TRAVELERS INSURANCE CO

CT 06002 [email protected]

770-677-3423 Ext.

METALPLATE GALVANIZING AL 35201 [email protected]

PMA INS GROUP 23-1642962 1100 ABERNATHY ROAD [email protected]

678-447-0200 Ext. 302

MICROMERITICS INSTRUMENT CORPORATION GA 30093 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

800-262-4743 Ext.

MICHIGAN COMMERCIAL

INSURANCE MUTUAL

38-3497412 1044 EASTBURY DRIVE [email protected]

800-262-4743 Ext.

Page 109: Georgia State Board of Workers' Compensation Insurer and Claim

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

10222 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13292 KANSAS CITY

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

10104 CHESTERFIELD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

TUCKER GA 30084

Phone:

AUBRUNDALE FL 33823

Phone:

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

13208 LOVELAND

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

MIDDLESEX INSURANCE COMPANY WI 54481 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 2501 MCGAVOCK PIKE [email protected]

800-322-1276 Ext. 382

800-282-2460 Ext.

HERITAGE CONSULTANTS 59-2305659 209 PALMETTO STREET [email protected]

800-354-6494 Ext. 201

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

MIDWEST EMPLOYERS CASUALTY 14755 NORTH OUTER

FORTY DR., SUITE 300

MO 63017 [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

MIDWEST BUILDERS CASUALTY MUTUAL

COMPANY

1100 WALNUT STREET,

SUITE 3010

MO 64106 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

MIDWESTERN INDEMNITY COMPANY OH 45140 [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

336-668-9050 Ext. 7539

Page 110: Georgia State Board of Workers' Compensation Insurer and Claim

21536 MILLEDGEVILLE

MILLEDGEVILLE GA 31059

Phone:

SBWC # Insurer Name Address Email

20410 JACKSONVILLE

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

13054 WARREN

ATLANTA GA 30305

Phone:

CINCINNATI OH 45202

Phone:

SBWC # Insurer Name Address Email

13233 WARREN

ATLANTA GA 30305

Phone:

SBWC # Insurer Name Address Email

20299 MONROE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13219 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

21020 MAULDIN

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21103 COLUMBUS

800-421-0710 Ext.

MILTON J WOOD COMPANY (MJW

CONSOLIDATED)

FL 32226 [email protected]

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

478-453-9496 Ext.

MILLEDGEVILLE CITY OF GA 31059 [email protected]

MILLEDGEVILLE CITY OF 58-1467285 P O BOX 1599 [email protected]

[email protected]

678-258-8000 Ext.

MONROE CITY OF GA 30655

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE

MITSUI SUMITO MARINE 13-3429270 14 PIEDMONT CNT #415 [email protected]

877-365-2299 Ext.

MITSUI SUMITOMO INSURANCE USA INC NJ 07059 [email protected]

MITSUI SUMITOMO MARINE

MANAGEMENT (USA) INC

22-3818012 312 ELM STREET

-- Ext.

877-365-2299 Ext.

MITSUI SUMITOMO INS. CO. OF AM NJ 07059 [email protected]

MITSUI SUMITO MARINE 13-3429270 14 PIEDMONT CNT #415 [email protected]

MUSCOGEE COUNTY SCHOOL DISTRICT GA 31904 [email protected]

800-845-2724 Ext. 43582

MOUNT VERNON MILLS SC 29662 [email protected]

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY [email protected]

800-226-3243 Ext. 5729

MONROE GUARANTY INSURANCE COMP FL 34240 [email protected]

FCCI SERVICES 59-1968027 P O BOX 58004 [email protected]

Page 111: Georgia State Board of Workers' Compensation Insurer and Claim

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21701 LAVONIA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

12081 CHANDLER

CHANDLER OK 74834

Phone:

SBWC # Insurer Name Address Email

10115 CHICAGO

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DUBUQUE IA 52004

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

12088 OMAHA

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13184 RICHFIELD

DALTON GA 30722

Phone:

CHATTANOOGA TN 37405

Phone:

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

312-822-2331 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

NATIONAL FIRE INS COMPANY OF HARTFORD 3333 S WABASH AVENUE,

28 SOUTH

IL 60604 [email protected]

[email protected]

800-332-2210 Ext.

NATIONAL AMERICAN INSURANCE COMPANY OK 74834

NATIONAL AMERICAN INS 47-0247300 1010 MANVEL AVENUE

888-888-8136 Ext.

NASH JOHNSON & SONS FARMS INC GA 30553 [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

423-265-0541 Ext.

COLLINS & COMPANY 62-0882150 P O BOX 6429 [email protected]

706-277-1253 Ext.

COLLINS & COMPANY 62-0882150 555 RIVER ST [email protected]

NATIONAL INTERSTATE INSURANCE COMPANY OH 44286 [email protected]

CYPRESS INSURANCE 95-6042929 1725 WINDWARD

CONCOURSE

[email protected]

877-212-3816 Ext. 230

NATIONAL INDEMNITY COMPANY NE 68131 [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

Page 112: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 31139

Phone:

SBWC # Insurer Name Address Email

13047 OMAHA

MONTGOMERY AL 36123

Phone:

SBWC # Insurer Name Address Email

10117 NOVATO

ATLANTA GA 30374

Phone:

ALPHARETTA GA 30022

Phone:

SBWC # Insurer Name Address Email

13061 SARASOTA

SARASOTA FL 34232

Phone:

SARASOTA FL 34240

Phone:

SBWC # Insurer Name Address Email

10118 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ALPHARETTA GA 30023

Phone:

ROSWELL GA 30076

COLLINS AND COMPANY 62-0882150 P O BOX 723783 [email protected]

770-434-9222 Ext.

NATIONAL TRUST INSURANCE COMPANY FL 34240 [email protected]

FCCI SERVICES 59-1968027 P O BOX 58004 [email protected]

678-393-4584 Ext.

FIREMAN'S FUND CLAIMS

CENTER

58-1373156 P O BOX 740174 [email protected]

678-393-4550 Ext.

FIREMAN'S FUND

INSURANCE CO

94-1610280 11475 GREAT OAKS WAY [email protected]

NATIONAL SURETY CORPORATION CA 94998 [email protected]

ASSOCIATED INSURANCE

ADMINISTRATORS

63-1103582 P O BOX 230848 [email protected]

800-388-6268 Ext.

NATIONAL LIABILITY & FIRE INSURANCE

COMPANY

NE 68131 [email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

678-447-0200 Ext. 302

NATIONAL UNION FIRE INSURANCE COMPANY

OF PITTSBURGH PA

175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

800-226-3243 Ext. 5729

FCCI SERVICES INC 59-1968027 6300 UNIVERSITY [email protected]

800-226-3243 Ext. 5729

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

Page 113: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

MANDEVILLE LA 70471

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13143 DES MOINES

DES MOINES IA 50391

Phone:

SBWC # Insurer Name Address Email

12021 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

10119 COLUMBUS

GAINESVILLE FL 32614

Phone:

SBWC # Insurer Name Address Email

13015 COLUMBUS

GAINESVILLE FL 32614

Phone:

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

800-985-7078 Ext.

NATIONWIDE MUTUAL INS CO ONE NATIONWIDE

PLAZA, 3-13-401

OH 43215 [email protected]

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

800-985-7078 Ext.

NATIONWIDE MUTUAL FIRE INS CO OH 43215 [email protected]

NATIONWIDE AGRIBUSINESS 42-1015537 1100 LOCUST ST. [email protected]

800-532-1436 Ext. 4344

NATIONWIDE AGRIBUSINESS 1100 LOCUST ST., DEPT

3030

IA 50391 [email protected]

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

800-985-7078 Ext.

NATIONWIDE PROPERTY AND CASUALTY

INSURANCE CO

OH 43215 [email protected]

NATIONWIDE INSURANCE 31-4177100 P O BOX 147061 [email protected]

Page 114: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

13045 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10122 NEW YORK

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

SBWC # Insurer Name Address Email

10122 NEW YORK

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

ALPHARETTA GA 30023

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33612

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

NEW HAMPSHIRE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

NETHERLANDS INS CO NH 03431 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

[email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

800-277-7500 Ext. 20104

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

NEW HAMPSHIRE INSURANCE CO 175 WATER STREET,

18TH FLOOR

NY 10038 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

770-352-2978 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR [email protected]

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

CHARTIS CLAIMS 13-2925174 P O BOX 1821 [email protected]

800-448-9707 Ext.

Page 115: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

FT SMITH AR 72919

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

CLEARWATER FL 33758

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

877-241-6121 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 FIANA WAY [email protected]

800-842-5612 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

770-934-3414 Ext.

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-473-9009 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-532-7706 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

800-226-8002 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

Page 116: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

LEXINGTON KY 40512

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13294 NEW YORK

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20601 COVINGTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

12040 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-282-6218 Ext.

NEWTON COUNTY BOARD OF EDUCATION GA 30015 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

NEW YORK MARINE & GENERAL INSURANCE

COMPANY

919 3RD AVENUE, 10TH

FLOOR

NY 10022 [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-541-0139 Ext. 35832

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

98-0032627 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

98-0032627 10401 HIGHLAND MANOR

DRIVE

[email protected]

NIPPONKOA INS CO LTD (US BRANCH) CT 06183

XCALIBRE RISK SERVICES 26-4197853 4370 PEACHTREE ROAD NE [email protected]

404-266-5749 Ext.

Page 117: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13101 WASHINGTON

WASHINGTON DC 20004

Phone:

SBWC # Insurer Name Address Email

21643 AMHERST

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21679 SEATTLE

SANTA ANA CA 92799

Phone:

SBWC # Insurer Name Address Email

13169 WILKES-BARRE

WILKES-BARRE PA 18703

Phone:

WILKES-BARRE PA 18703

Phone:

TOWSON MD 21204

Phone:

SBWC # Insurer Name Address Email

20591 CLAXTON

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13001 MANCHESTER

ATLANTA GA 30319

Phone:

FT MILL SC 29716

NORDSON CORPORATION OH 44001 [email protected]

NLC Mutual Insurance Company 52-1479893 1301 PENNSYLVANIA AVE [email protected]

202-626-3162 Ext.

NLC MUTUAL INSURANCE COMPANY 1301 PENNSYLVANIA

AVENUE NW, #550

DC 20004 [email protected]

888-329-6259 Ext.

NIPPONKOA INSURANCE

COMPANY LIMITED (U S

BRANCH)

800-673-2465 Ext. 8110

GUARD INSURANCE GROUP 23-2240322 P O BOX A - H [email protected]

800-673-2465 Ext. 8110

NORGUARD INSURANCE COMPANY PA 18703 [email protected]

AMGUARD 23-2240321 P O Box 1368 [email protected]

877-275-7475 Ext.

NORDSTROM INC WA 98111 [email protected]

NORDSTROM 91-0515058 P O BOX 25799 [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

NORTH AMERICAN SPECIALTY INSURANCE NH 03101 [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

NORMAN W. FRIES INC dba CLAXTON POULTRY GA 30417 [email protected]

800-673-2465 Ext. 8302

GUARD INSURANCE GROUP 23-2240322 102 WEST PENNSYLVANIA

AVE

[email protected]

Page 118: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10125 MORRISTOWN

LAKE MARY FL 32795

Phone:

SBWC # Insurer Name Address Email

12026 NORTHBROOK

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

21388 GAINESVILLE

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

10126 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

10209 SCHAMBURG

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

SCHAUMBERG IL 60666

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21259 ATLANTA

GALLAGHER BASSETT

SERVICES INC

866-814-1740 Ext. 201

NORTHERN ASSURANCE COMPANY OF

AMERICA

MA 02081 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

NORTHEAST GEORGIA HEALTH SYSTEM INC GA 30501 [email protected]

[email protected]

800-238-6214 Ext.

NORTHBROOK INDEMNITY INSURANCE CO IL 60062

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

800-423-3060 Ext. 6301

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD [email protected]

NORTH RIVER INSURANCE COMPANY NJ 07962 [email protected]

NORTHSIDE HEALTH SERVICES INC GA 30342 [email protected]

404-851-3208 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ZURICH NORTH AMERICA 36-3839542 P.O. BOX 2769 [email protected]

404-851-3601 Ext.

NORTHERN INSURANCE

COMPANY OF NEW YORK

13-5283360 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

NORTHERN INSURANCE COMPANY OF NEW

YORK

IL 60196 [email protected]

NORTHERN INSURANCE

COMPANY OF NEW YORK

13-5283360 3003 SUMMIT BLVD [email protected]

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

Page 119: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13288 BUFFALO

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

PARSIPPANY NJ 07054

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

10212 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12093 WESTFIELD

CENTERDULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13147 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21062 THOMASVILLE

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

OHIO CASUALTY INS CO OH 45014 [email protected]

YORK CLAIMS SERVICE INC 13-1963636 1117 PERIMETER CENTER

WEST

[email protected]

678-225-2284 Ext.

888-888-8136 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD [email protected]

877-927-2255 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

NOVA CASUALTY COMPANY 726 EXCHANGE STREET,

STE 1020

NY 14210 [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

877-295-0011 Ext.

OLD DOMINION FREIGHT LINE INC NC 27360 [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

800-334-0078 Ext. 214

OHIO SECURITY INSURANCE CO OH 45014 [email protected]

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD [email protected]

800-685-4604 Ext. 222

OHIO FARMERS INSURANCE CO OH 44251 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

Page 120: Georgia State Board of Workers' Compensation Insurer and Claim

13032 JACKSONVILLE

SYRACUSE NY 13212

Phone:

SBWC # Insurer Name Address Email

12058 GREENSBURG

ATLANTA GA 30319

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

10129 GREENSBURG

ALPHARETTA GA 30005

Phone:

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30356

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-450-0692 Ext.

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-473-9009 Ext.

OLD REPUBLIC GENERAL INSURANCE

CORPORATION

PA 15601 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

315-434-1450 Ext.

OLD DOMINION INSURANCE

COMPANY

59-2070420 P O BOX 4828 [email protected]

OLD DOMINION INS CO 4601 TOUCHTON ROAD

EAST, SUITE 3400

FL 32245 [email protected]

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

419-847-6323 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

[email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

800-247-2656 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

OLD REPUBLIC INSURANCE COMPANY PA 15601 [email protected]

BERKLEY RISK

ADMINISTRATORS

22-2235730 3655 NORTH POINT

PARKWAY

[email protected]

678-942-7300 Ext.

CUSTARD INSURANCE

ADJUSTERS

- P O BOX 888385 [email protected]

CORVEL 42-1704550 2905 PREMIER PARKWAY [email protected]

Page 121: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

BIRMINGHAM AL 35266

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

770-551-2070 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

800-541-0139 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

241-922-0638 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

Page 122: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13028 CHICAGO

TUCKER GA 30084

Phone:

CHICAGO IL 60601

Phone:

SBWC # Insurer Name Address Email

13197 CANTON

DULUTH GA 30096

Phone:

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13199 CANTON

DULUTH GA 30096

Phone:

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

13131 CANTON

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13196 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

21468 TOLEDO

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

OLD REPUBLIC UNION

INSURANCE

36-3765116 307 N MICHIGAN AVE

800-621-0365 Ext.

OLD REPUBLIC UNION INS IL 60601 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

912-355-8989 Ext.

ONEBEACON MIDWEST INS CO FKA

COMMERICAL UNION MIDWEST INS

MA 02021

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

[email protected]

800-203-9600 Ext. 9706

800-762-5573 Ext.

ONEBEACON INSURANCE 23-1502700 P O BOX 9155

ONEBEACON INSURANCE CO. MA 02021 [email protected]

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

MONTGOMERY INSURANCE - 3555 KOGER BLVD.

800-762-5573 Ext.

ONEBEACON AMERICAN INS CO MA 02021 [email protected]

800-354-6494 Ext. 201

OWENS CORNING ONE OWENS CORNING

PARKWAY, 2G

OH 43659 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

ONEBEACON MIDWEST INS. CO. MA 02021 [email protected]

800-762-5573 Ext.

Page 123: Georgia State Board of Workers' Compensation Insurer and Claim

20814 PERRYSBURG

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13004 LANSING

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21717 ALBANY

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10130 PHILADELPHIA

LITTLE ROCK AZ 72231

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

10132 WARREN

ATLANTA GA 30326

Phone:

TUCKER GA 30084

Phone:

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

OWENS ILLINOIS INC ONE O-I PLAZA, ONE

MICHAEL OWENS WAY

OH 43551 [email protected]

800-685-7361 Ext.

ALTERNATIVE SERVICE

CONCEPTS LLC

43-1954328 P O BOX 15550 [email protected]

800-669-0437 Ext. 108

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

PACIFIC EMPLOYERS INSURANCE COMPANY 436 WALNUT STREET,

WB04G

PA 19106 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

OXFORD CONSTRUCTION COMPANY GA 31707 [email protected]

AUTO OWNERS INSURANCE

CO

38-0315280 P O BOX 100044 [email protected]

770-931-7766 Ext. 201

OWNERS INSURANCE COMPANY MI 48917 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

404-266-4855 Ext.

PACIFIC INDEMNITY COMPANY NJ 07061 [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

615-824-5095 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

Page 124: Georgia State Board of Workers' Compensation Insurer and Claim

DULUTH GA 30097

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30326

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20457 CLEVELAND

SAVANNAH GA 31405

Phone: 912-355-8989 Ext.

SBWC # Insurer Name Email

10247 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

21553 TOCCOA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21327 DOUGLAS

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10029 WARRENVILLE

CHARLOTTE NC 28277

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

PATRIOT GENERAL INSURANCE COMPANY WI 54481 [email protected]

Address

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

PARKER HANNIFIN CORP OH 44124 [email protected]

770-901-3121 Ext.

PACIFIC INDEMNITY

INSURANCE

95-1078160 2 LIVE OAK CENTER SUITE

900

[email protected]

404-266-4127 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

866-246-0259 Ext.

PACIFIC INDEMNITY 95-1078160 3445 PEACHTREE RD [email protected]

404-266-4127 Ext.

PEERLESS INDEMNITY INSURANCE COMPANY 27201 BELLA VISTA

PARKWAY, SUITE 130

IL 60555 [email protected]

912-355-8929 Ext. 224

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

PCC AIRFOILS INC GA 31535 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

PATTERSON PUMP COMPANY GA 30577 [email protected]

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

[email protected] INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130

Page 125: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10134 KEENE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10291 WILKES BARRE

ATLANTA GA 31139

Phone:

SBWC # Insurer Name Address Email

13280 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13198 CANTON

CANTON MA 02021

Phone:

SBWC # Insurer Name Address Email

12074 PHILADELPHIA

ATLANTA GA 30350

Phone:

SBWC # Insurer Name Address Email

12009 BLUE BELL

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13138 BLUE BELL

PENN STAR INSURANCE THREE BALA PLAZA

EAST, SUITE 300

PA 19004 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

770-434-9222 Ext.

PENN MILLERS INSURANCE PA 18773 [email protected]

COLLINS AND COMPANY 62-0882150 P O BOX 723783 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

PEERLESS INSURANCE CO NH 03431 [email protected]

800-334-0078 Ext. 214

MONTGOMERY INSURANCE

CLAIM CENTER

888-888-8136 Ext.

PENNSYLVANIA MANUFACTURERS ASSN INS CO PA 19422 [email protected]

PENNSYLVANIA

MANUFACTURERS

INDEMNITY

23-1642962 1100 ABERNATHY ROAD [email protected]

800-621-1313 Ext.

PENNSYLVANIA LUMBERMENS MUTUAL

INSURANCE CO

ONE COMMERCE

SQUARE, 2005 MARKET

ST, STE 1200

PA 19103 [email protected]

TENCO SERVICES 62-0449213 8735 DUNWOODY PL [email protected]

ONEBEACON INSURANCE 23-1502700 P O BOX 9155 [email protected]

800-203-9600 Ext. 9706

PENNSYLVANIA GENERAL INS CO MA 02028 [email protected]

800-347-4494 Ext.

PENNSYLVANIA MANUFACTURERS INDEMNITY

CO

PA 19422 [email protected]

Page 126: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10136 HARRISBURG

ATLANTA GA 30319

Phone:

GREENSBORO NC 27405

Phone:

SBWC # Insurer Name Address Email

10285 HOUSTON

FAIRFAX VA 22037

Phone:

SBWC # Insurer Name Address Email

13257 ALGONA

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

21292 ALBANY

OWING MILLS MD 21117

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

SBWC # Insurer Name Address Email

10138 HARTFORD

DULUTH GA 30097

888-975-2667 Ext.

EXXON MOBIL RISK

MANAGEMENT INC.

76-0006056 3225 GALLOWS ROAD [email protected]

PETROLEUM CASUALTY COMPANY TX 77253 [email protected]

PENNSYLVANIA NATIONAL

MUTUAL CASUALTY

23-0961349 1703 E WENDOUR AVENUE

800-877-7366 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

PENNSYLVANIA NAT MUT CAS PA 17105 [email protected]

888-888-8136 Ext.

PENNSYLVANIA

MANUFACTURERS

INDEMNITY

23-1642962 1100 ABERNATHY ROAD [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

866-654-4001 Ext.

MATRIX ABSENCE 77-0493584 11221 N 28TH DRIVE [email protected]

800-866-2301 Ext.

PHOEBE PUTNEY HEALTH SYSTEM INC GA 31707 [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

PHARMACISTS MUTUAL INSURANCE CO 808 HIGHWAY 18 WEST,

PO BOX 370

IA 50511 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

PHOENIX INSURANCE COMPANY CT 06183 [email protected]

Page 127: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

CHARLOTTE NC 28226

Phone:

SBWC # Insurer Name Address Email

21237 ATLANTA

ATLANTA GA 30309

Phone:

SBWC # Insurer Name Address Email

21622 CHARLESTON

CHARLOTTE NC 28226

Phone:

SBWC # Insurer Name Address Email

21728 KNOXVILLE

KNOXVILLE TN 37939

Phone:

SBWC # Insurer Name Address Email

20454 ALLISON PARK

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13251 NEW YORK

ATLANTA GA 30366

Phone:

SBWC # Insurer Name Address Email

13141 OMAHA

PIEDMONT MEDICAL 58-1503902 1968 PEACHTREE RD NW [email protected]

404-605-3614 Ext.

PIEDMONT HEALTHCARE GA 30309 [email protected]

PHOENIX INSURANCE

COMPANY

06-0303275 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3298

800-238-6214 Ext.

PHOENIX INSURANCE

COMPANY

06-0303275 BUILDING V SUITE 200 [email protected]

888-487-3492 Ext.

866-246-0259 Ext.

PHOENIX INSURANCE

COMPANY

06-0303275 1000 WINDWARD

CONCOURSE

[email protected]

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

PPG INDUSTRIES INC 4325 ROSANNA DRIVE,

BLDG C

PA 15101 [email protected]

PILOT CORPORATION 34-1953155 P O BOX 10146 [email protected]

800-562-6210 Ext.

PILOT TRAVEL CENTERS LLC TN 37939 [email protected]

CONSTITUTION STATE

SERVICES LLC

06-1501229 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3353

PIGGLY WIGGLY CAROLINA COMPANY INC 176 CROGHAN SPUR

ROAD, STE 301

SC 29407 [email protected]

PREFERRED PROFESSIONAL INS CO 11605 MIRACLE HILLS

DRIVE, SUITE 200

NE 68154 [email protected]

800-772-8427 Ext.

PRAETORIAN INSURANCE CO NY 10005 [email protected]

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 [email protected]

Page 128: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

MANDEVILLE LA 70471

Phone:

BRENTWOOD TN 37027

Phone:

SBWC # Insurer Name Address Email

13226 MURFREESBORO

POMPANO BEACH FL 33064

Phone:

SBWC # Insurer Name Address Email

21712 AUSTELL

ATLANTA GA 30366

Phone:

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21567 ATLANTA

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13084 BIRMINGHAM

227414 ATLANTA GA 30350

Phone:

SBWC # Insurer Name Address Email

21449 CINCINNATI

CINCINNATI OH 45224

PREMIER GROUP INSURANCE COMPANY TN 37130 [email protected]

F A RICHARD (FARA) 72-0837383 7000 EXECUTIVE CENTER

DRIVE

[email protected]

800-675-2771 Ext. 225

-- Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

11605 MIRACLE HILLS

DRIVE, SUITE 200

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

PRINTPACK INC GA 30339 [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

404-266-5749 Ext.

ADJUSTMENT SERVICES INC. 58-1623664 P O BOX 81306 [email protected]

800-772-8427 Ext.

SELF-INSURANCE

ADMINISTRATORS (SIA)

58-1870166 4370 PEACHTREE ROAD NE [email protected]

PRESBYTERIAN HOMES OF GEORGIA INC GA 30106 [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

PROCTER & GAMBLE CO 5299 SPRING GROVE

AVENUE, BOX 209

OH 45217 [email protected]

800-621-1313 Ext.

PROASSURANCE INDEMNITY COMPANY INC SUITE 500, 100

BROOKWOOD PLACE

AL 35209 [email protected]

TENCO SERVICES 62-0449213 8735 DUNWOODY PL [email protected]

Page 129: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13094 HARTFORD

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

13094 HARTFORD

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

PROPERTY & CASUALTY INSURANCE COMPANY

OF HARTFORD

CT 06155

800-235-1134 Ext. 5

615-824-5095 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

[email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

[email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

PROPERTY & CASUALTY INSURANCE COMPANY

OF HARTFORD

CT 06155

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW

Page 130: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10266 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46207

Phone:

SBWC # Insurer Name Address Email

12054 ST. LOUIS

227399 FRAZER PA 19355

Phone:

SBWC # Insurer Name Address Email

10142 NEW YORK

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10042 DENVER

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21706 TULSA

228406 TULSA OK 74101

Phone:

SBWC # Insurer Name Address Email

20350 ATLANTA

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21772 JACKSONVILLE

ROSWELL GA 30076

800-644-5501 Ext. 6573

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

800-906-4461 Ext.

PROTECTIVE INSURANCE 35-6021485 PO BOX 7099 GEORGIACLAIMNOTIFICATIONS@PROTECTIVEINSURANC

E.COM

PROTECTIVE INSURANCE CO IN 46204 GEORGIACLAIMNOTIFICATIONS@PROTECTIVEINSURA

NCE.COM

407-562-3632 Ext.

QUIKTRIP CORPORATION 73-0675375 P O BOX 3475 [email protected]

918-615-7754 Ext.

QUIKTRIP CORPORATION OK 74101 [email protected]

[email protected]

770-813-0997 Ext. 230

QUANTA INDEMNITY COMPANY FKA NATIONAL

FARMERS UNION STANDARD

1125 17TH STREET,

SUITE 600

CO 80202

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

800-580-6912 Ext.

PUBLIC SERVICE MUTUAL INSURANCE CO NY 10016 [email protected]

-- Ext.

PROVIDIAN AUTO & HOME MO 63146

PROVIDIAN AUTO & HOME - 20 MOORES ROAD

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

RAYONIER INC 1301 RIVERPLACE BLVD,

SUITE 2300

FL 32207 [email protected]

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

RACETRAC PETROLEUM INC 3225 CUMBERLAND

BLVD, SUITE 100

GA 30339 [email protected]

Page 131: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10055 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

21771 BIRMINGHAM

BIRMINGHAM AL 35209

Phone:

SBWC # Insurer Name Address Email

13031 NEW HARTFORD

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20920 AUGUSTA

AUGUSTA GA 30901

Phone:

SBWC # Insurer Name Address Email

21671 RIVERDALE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13269 MINNEAPOLIS

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13227 CLEVELAND

REGIONS FINANCIAL CORPORATION 1900 5TH AVENUE

NORTH, ALBH10901B

AL 35203 [email protected]

[email protected]

770-493-1931 Ext.

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409

REGENT INSURANCE CO WI 53596 [email protected]

M

800-685-7361 Ext.

RIVERDALE CITY OF GA 30274 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

706-826-1010 Ext.

RICHMOND COUNTY BD OF ED 864 BROAD ST, 2ND

FLOOR #208

GA 30901 [email protected]

RICHMOND COUNTY BD OF 58-6000310 864 BROAD ST [email protected]

770-510-4100 Ext.

REPUBLIC FRANKLIN INSURANCE COMPANY NY 13413 [email protected]

REPUBLIC-FRANKLIN

INSURANCE COMPANY

31-4290270 1040 CROWN POINT

PARKWAY

[email protected]

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

ROCHDALE INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE 200

OH 44131 [email protected]

800-366-1511 Ext. 7732

RIVERPORT INSURANCE COMPANY 222 SOUTH NINTH

STREET, SUITE 1300

MN 55402 [email protected]

KEY RISK MANAGEMENT

SERVICES LLC

56-1800954 3655 NORTH POINT PKWY [email protected]

678-258-8000 Ext.

Page 132: Georgia State Board of Workers' Compensation Insurer and Claim

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

20602 CONYERS

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

20862 ATLANTA

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21441 LAFAYETTE

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

21773 ROSEBURG

MAITLAND FL 32751

Phone:

SBWC # Insurer Name Address Email

20520 ROSWELL

ATLANTA GA 30328

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

ROLLINS INC GA 30324 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-845-2724 Ext. 43582

ROCKDALE COUNTY BOARD OF EDUCATION GA 30012 [email protected]

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

800-304-5035 Ext.

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

866-710-0908 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

[email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

ROSWELL CITY OF GA 30075

866-291-0194 Ext.

ROSEBURG FOREST PRODUCTS COMPANY OR 97470 [email protected]

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

800-884-1535 Ext.

ROPER CORPORATION GA 30728 [email protected]

COLLINS & COMPANY 62-0882150 555 RIVER STREET [email protected]

Page 133: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10226 CHARLOTTE

CHARLOTTE NC 28219

Phone:

SBWC # Insurer Name Address Email

21656 ATLANTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

21500 MARYVILLE

TUCKER GA 30084

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20945 ALPHARETTA

227900 ALPHARETTA GA 30023

Phone:

SBWC # Insurer Name Address Email

10274 SEATTLE

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13092 HOFFMAN

ESTATES

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13187 ST LOUIS

NORCROSS GA 30010

Phone:

ROYAL & SUNALLIANCE INS.

CO

- P O BOX 19809

866-227-1500 Ext.

ROYAL & SUNALLIANCE INSURANCE CO NC 28219

PMA MANAGEMENT

CORPORATION

888-888-8136 Ext.

800-695-0359 Ext.

RYDER SYSTEM INC GA 30023 [email protected]

RYDER SYSTEM INC 59-2305021 P O BOX 2370 [email protected]

770-901-3124 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

RUBY TUESDAY INC TN 37801 [email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

770-901-3124 Ext.

RTM LLC 1155 PERIMETER

CENTER WEST, SUITE

GA 30338 [email protected]

678-969-7337 Ext.

SAFETY FIRST INSURANCE MO 63146 [email protected]

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

SAFECO INSURANCE OF ILLINOIS 2800 HIGGINS ROAD,

SUITE 1000

IL 60169 [email protected]

SAFECO 91-0742148 2055 SUGARLOAF CIRCLE [email protected]

678-417-3654 Ext.

SAFECO INSURANCE COMPANY OF AMERICA SAFECO PLAZA, 1001

FOURTH AVENUE

WA 98154 [email protected]

Page 134: Georgia State Board of Workers' Compensation Insurer and Claim

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

TUCKER GA 30084

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

762600 ST LOUIS MO 63146

Phone:

ATLANTA GA 30338

LAKE MARY FL 32746

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

419-847-6323 Ext.

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

866-654-4001 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

800-548-1373 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

888-878-0005 Ext.

SAFETY NATIONAL

CASUALTY CORPORATION

43-0727872 2043 WOODLAND [email protected]

888-995-5300 Ext. 29506

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

Page 135: Georgia State Board of Workers' Compensation Insurer and Claim

13121 ST LOUIS

ATLANTA GA 30319

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

ROSWELL GA 30076

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ST LOUIS MO 63146

Phone:

ATLANTA GA 30338

Phone:

LAKE MARY FL 32746

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21885 HOUMA

800-235-1134 Ext. 5

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

419-847-6323 Ext.

SAFETY NATIONAL CASUALTY CORPORATION MO 63146 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

888-995-5300 Ext. 29506

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

SAFETY NATIONAL

CASUALTY CORPORATION

43-0727872 2043 WOODLAND [email protected]

866-246-0259 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

800-866-2301 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

SAIA MOTOR FREIGHT LINE LLC LA 70363 [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE [email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

Page 136: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21296 WAYCROSS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20468 SAVANNAH

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20884 SAVANNAH

COLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

13253 SEATTLE

SEATTLE WA 98101

Phone:

SBWC # Insurer Name Address Email

13096 DALLAS

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10240 HARTFORD

ALPHARETTA GA 30052

Phone:

TAMPA FL 33610

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

SATILLA HEALTH SERVICES HUMAN RESOURCES, 410

DARLING AVE

GA 31501 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

SEABRIGHT INSURANCE

CLAIMS

43-1436329 1501 4TH AVENUE [email protected]

813-315-8449 Ext.

SEABRIGHT INSURANCE COMPANY 1501 4TH AVENUE, SUITE

2600

WA 98101 [email protected]

800-845-2724 Ext.

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

800-845-2724 Ext. 43582

SAVANNAH-CHATHAM COUNTY BOARD OF

EDUCATION

GA 31401 [email protected]

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 [email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

SAVANNAH CITY OF GA 31402 [email protected]

800-238-6214 Ext.

SELECT INSURANCE 75-6013697 10401 HIGHLAND MANOR

DRIVE

[email protected]

SELECT INSURANCE CO CT 06183 [email protected]

SELECT INSURANCE 75-6013697 1000 WINDWARD

CONCOURSE

[email protected]

678-258-8000 Ext.

SECURITY NATIONAL INSURANCE TX 75265 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

Page 137: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13069 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12097 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13042 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13097 BRANCHVILLE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

12032 NEW YORK

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

13218 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY [email protected]

800-688-9656 Ext. 1772

SELECTIVE INSURANCE CO OF AMERICA NJ 07890 [email protected]

888-329-6259 Ext.

SENECA INSURANCE COMPANY INC 160 WATER STREET,

16TH FLOOR

NY 10038 [email protected]

800-688-9656 Ext. 1772

[email protected] INSURANCE

COMPANY

22-1272390 3426 TORINGDON WAY

SELECTIVE WAY INSURANCE NJ 07890 [email protected]

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY [email protected]

800-688-9656 Ext. 1772

SELECTIVE INSURANCE COMPANY OF SOUTH

CAROLINA

NJ 07890 [email protected]

SELECTIVE INSURANCE

COMPANY OF AMERICA

22-1272390 3426 TORINGDON WAY [email protected]

800-688-9656 Ext. 1772

SELECTIVE INSURANCE CO OF THE SOUTHEAST NJ 07890 [email protected]

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

SENTINEL INSURANCE COMPANY LTD CT 06155 [email protected]

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

Page 138: Georgia State Board of Workers' Compensation Insurer and Claim

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

866-246-0259 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

407-562-3640 Ext.

SENTINEL INS CO 06-1552103 200 COLONIAL CENTER

PKWY

[email protected]

404-562-3640 Ext.

SENTINEL INS CO 06-1552103 300 SOUTH STATE ST [email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

407-562-3632 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

Page 139: Georgia State Board of Workers' Compensation Insurer and Claim

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13247 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

10087 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

10255 STEVENS POINT

RICHMOND VA 23260

Phone:

STEVENS POINT WI 54481

Phone:

SBWC # Insurer Name Address Email

13268 MONTEREY

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SENTRY INSURANCE COMPANY WI 54481 [email protected]

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

SENTRY CASUALTY COMPANY WI 54481 [email protected]

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

800-450-0692 Ext.

SEQUOIA INSURANCE COMPANY CA 93940 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-338-2487 Ext. 4616

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

SENTRY SELECT INSURANCE COMPANY WI 54481 [email protected]

SENTRY SELECT INSURANCE

COMPANY

39-0333950 P O BOX 8032 [email protected]

800-739-3344 Ext. 9063

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

Page 140: Georgia State Board of Workers' Compensation Insurer and Claim

21084 DALTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

21645 ATLANTA

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

21744 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21266 CLEVELAND

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

13256 DERIDDER

DERIDDER LA 70634

Phone:

LAWRENCEVILLE GA 30045

Phone:

SBWC # Insurer Name Address Email

21758 SILOAM SPRINGS

ROGERS AR 72756

Phone:

SBWC # Insurer Name Address Email

21786 WILMINGTON

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

SHERWIN-WILLIAMS CO THE OH 44115 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

770-963-7732 Ext.

SHEPHERD CONSTRUCTION COMPANY INC P O BOX 8088, STATION F GA 31106 [email protected]

GA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 [email protected]

800-476-7601 Ext.

SHEPHERD CENTER INC GA 30309 [email protected]

866-246-0259 Ext.

SHAW INDUSTRIES INC GA 30722 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

SIMPSON LUMBER COMPANY LLC NC 28412 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

479-636-0198 Ext.

SIMMONS FOODS INC AR 72761 [email protected]

S.B. HOWARD & CO. - P O BOX 1627 [email protected]

800-256-3462 Ext.

AMERISAFE RISK SERVICES

INC

72-1274075 555 OLD NORCROSS RD [email protected]

770-339-9878 Ext.

SILVER OAK CASUALTY INC LA 70634 [email protected]

AMERISAFE RISK SERVICES

INC

58-1181498 2301 HWY 190 WEST [email protected]

866-246-0259 Ext.

Page 141: Georgia State Board of Workers' Compensation Insurer and Claim

20596 AUGUSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21539 LANDSALE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13200 NEW YORK,

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

20478 CAYCE

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21497 BRUNSWICK

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

20428 COLUMBIA

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20858 ATLANTA

ATLANTA GA 30308

Phone:

SBWC # Insurer Name Address Email

10243 SUN PRAIRIE,

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

SOMPO JAPAN INS OF AMERICA TWO WORLD

FINANCIAL CTR, 225

LIBERTY STREET 43RD

FL

NY 10281 [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

SKF USA INC PA 19446 [email protected]

678-258-8000 Ext.

SIZEMORE INC GA 30904 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

SOUTHERN COMPANY 30 IVAN ALLEN JR BLVD

NW, BIN SC 1404

GA 30308 [email protected]

866-246-0259 Ext.

SOUTHEASTERN FREIGHT LINE SC 29202 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

678-258-8000 Ext.

SOUTHEAST GEORGIA HEALTH SYS. GA 31520 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

800-845-2724 Ext. 43582

SOUTH CAROLINA ELECTRIC & GAS 220 OPERATION WAY,

MAIL CODE C105

SC 29033 [email protected]

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

SOUTHERN FIRE & CAS CO WI 53596 [email protected]

M

SOUTHERN COMPANY

SERVICES

58-0690070 241 RALPH MCGILL BLVD [email protected]

404-506-2881 Ext.

Page 142: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

12053 SUN PRAIRIE

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

10224 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

13272 DALLAS

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13230 DULUTH

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

21042 UNION CITY

NORCROSS GA 30071

Phone:

SBWC # Insurer Name Address Email

13063 COLUMBIACOLUMBIA SC 29202

Phone:

COLUMBIA SC 29202

Phone:

770-493-1931 Ext.

SOUTHERN GUARANTY INS. CO. WI 53596 [email protected]

M

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 [email protected]

800-450-0692 Ext.

SOUTHERN GUARANTY INS CO OF GA WI 53596 [email protected]

M

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 [email protected]

770-493-1931 Ext.

SOUTHERN MUTUAL CHURCH SC 29290 [email protected]

678-447-0200 Ext. 302

SOUTHERN MILLS INC GA 30291 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

800-277-7442 Ext. 1336

SOUTHERN INSURANCE

COMPANY OF VIRGINIA

54-0386765 3237 SATELLITE BLVD [email protected]

SOUTHERN INSURANCE COMPANY OF VIRGINIA 3097 SATELLITE BLVD,

SUITE 250

GA 30096 [email protected]

770-813-0997 Ext. 230

SOUTHERN INSURANCE COMPANY TX 75240 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

800-845-2724 Ext. 43582

COMPANION COMMERCIAL

INS

58-2292212 P O BOX 100165 [email protected]

800-845-2724 Ext.

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

Page 143: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

13277 ATHENS

ATHENS GA 30604

Phone:

SBWC # Insurer Name Address Email

12099 SUN PRAIRIE

ATLANTA GA 31145

Phone:

SBWC # Insurer Name Address Email

21117 RIVERDALE

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

13185 RICHMOND

VALDOSTA GA 31603

Phone:

RICHMOND VA 23230

Phone:

SBWC # Insurer Name Address Email

10236 MACON

MACON GA 31202

Phone:

SBWC # Insurer Name Address Email

20870 CARROLLTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13260 HARTFORD

DUBUQUE IA 52004

Phone:

TUCKER GA 30084

678-258-8000 Ext.

SOUTHERN REGIONAL HEALTH SYSTEM INC GA 32074 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

770-493-1931 Ext.

SOUTHERN PILOT INSURANCE COMPANY WI 53596 [email protected]

M

GENERAL CASUALTY

COMPANY OF WISCONSIN

39-0301590 P O BOX 450409 [email protected]

800-226-1919 Ext. 211

SOUTHERN MUTUAL INSURANCE COMPANY GA 30606 [email protected]

SOUTHERN MUTUAL

INSURANCE

58-0439230 P O BOX 7009 [email protected]

SPARTA INSURANCE COMPANY (THE) CITY PLACE II, 185

ASYLUM STREET

CT 06103 [email protected]

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

SOUTHWIRE CO GA 30119 [email protected]

SOUTHERN TRUST INS CO 58-1025758 P O BOX 250 [email protected]

800-476-5566 Ext.

SOUTHERN TRUST INSURANCE COMPANY GA 31202 [email protected]

[email protected]

877-243-6677 Ext. 1421

229-242-0523 Ext.

SOUTHERN STATES INS

EXCHANGE

54-6048396 6606 WEST BROAD STREET

SOUTHERN STATES INSURANCE EXCHANGE VA 23260 [email protected]

CRAWFORD & COMPANY 58-0506554 P O BOX 2172 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

Page 144: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

20338 COLUMBUS

BRENTWOOD TN 37024

Phone:

CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21391 SAVANNAH

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10287 ST PAUL

ROSWELL GA 30076

Phone:

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10149 ST PAUL

TUCKER GA 30084

Phone:

ST JOSEPHS HOSPITAL INC (SAVANNAH) GA 31405 [email protected]

800-524-0604 Ext.

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

800-524-0604 Ext.

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 [email protected]

ST FRANCIS HOSPITAL INC GA 31908 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 10401 HIGHLAND MANOR

ROAD

[email protected]

888-329-6259 Ext.

888-329-6259 Ext.

ST PAUL FIRE & CASUALTY

INSURANCE COMPANY

41-1419276 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

ST PAUL FIRE & CASUALTY

INSURANCE COMPANY

41-1419276 10401 HIGHLAND MANOR

DRIVE

[email protected]

ST PAUL FIRE & CASUALTY INSURANCE

COMPANY

MN 55102 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

ST PAUL FIRE & MARINE INSURANCE COMPANY MN 55102 [email protected]

Page 145: Georgia State Board of Workers' Compensation Insurer and Claim

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12055 ST PAUL

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10200 ST PAUL

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10150 ST PAUL

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13206 ST. PAUL

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

800-238-6214 Ext.

ST PAUL GUARDIAN INS CO 41-0963301 2420 LAKEMONT AVE [email protected]

407-388-2587 Ext.

ST PAUL GUARDIAN INSURANCE COMPANY MN 55102 [email protected]

ST PAUL GUARDIAN INS CO 41-0963301 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 10401 HIGHLAND MANOR

ROAD

[email protected]

888-329-6259 Ext.

ST PAUL FIRE & MARINE

INSURANCE COMPANY

41-0406690 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

ST PAUL MERCURY

INSURANCE COMPANY

41-0881659 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

ST PAUL MERCURY

INSURANCE COMPANY

41-0881659 1000 WINDWARD

CONCOURSE

[email protected]

ST PAUL MERCURY INSURANCE COMPANY 385 WASHINGTON ST,

MC 502L

MN 55102 [email protected]

888-329-6259 Ext.

ST PAUL MEDICAL

LIABILITY INSURANCE

41-1435766 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

ST PAUL MEDICAL

LIABILITY INSURANCE

41-1435766 10401 HIGHLAND MANOR

DRIVE

[email protected]

ST PAUL MEDICAL LIABILITY INSURANCE

COMPANY

MN 55102 [email protected]

ST PAUL GUARDIAN INS CO 41-0963301 10401 HIGHLAND MANOR [email protected]

888-329-6259 Ext.

800-238-6214 Ext.

ST PAUL PROTECTIVE

INSURANCE COMPANY

36-2542404 10401 HIGHLAND MANOR

DRIVE

[email protected]

ST PAUL PROTECTIVE INSURANCE COMPANY MN 55102 [email protected]

ST PAUL PROTECTIVE

INSURANCE COMPANY

36-2542404 1000 WINDWARD

CONCOURSE

[email protected]

Page 146: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10216 HARTFORD

ALHPARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13053 SOUTHFIELD

SARASOTA FL 34232

Phone:

SBWC # Insurer Name Address Email

13252 WOODBRIDGE

GREENSBORO NC 27419

Phone:

SBWC # Insurer Name Address Email

10159 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

10163 INDIANAPOLIS

GLEN ALLEN VA 23058

Phone:

INDIANAPOLIS IN 46206

Phone:

SBWC # Insurer Name Address Email

10164 BLOOMINGTON

DULUTH GA 30098

MEADOWBROOK INC 38-1798156 P O BOX 50608 [email protected]

800-741-7244 Ext.

STAR INSURANCE COMPANY MI 48034 [email protected]

800-238-6214 Ext.

STANDARD FIRE INSURANCE

COMPANY

06-6033509 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

STANDARD FIRE INSURANCE COMPANY CT 06183 [email protected]

STANDARD FIRE INSURANCE

COMPANY

06-6033509 1000 WINDWARD

CONCOURSE

[email protected]

ST PAUL PROTECTIVE

INSURANCE COMPANY

10401 HIGHLAND MANOR

DRIVE

888-329-6259 Ext.

STATE AUTOMOBILE MUTUAL INS IN 46206 [email protected]

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

800-777-7324 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET [email protected]

800-906-4461 Ext.

STATE AUTO PROPERTY & CASUALTY INS. CO IN 46208 [email protected]

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

KEY RISK MANAGEMENT

SERVICES

56-1800954 P O BOX 49129 [email protected]

336-668-9050 Ext. 7539

STARNET INSURANCE COMPANY 12701 MARBLESTONE

DRIVE, SUITE 250

VT 22192 [email protected]

STATE FARM FIRE & CAS CO IL 61710 HOME.ACCT-STAR-

[email protected]

STATE FARM FIRE & CAS CO 37-0533080 11350 JOHNS CREEK

PARKWAY

[email protected]

800-906-4461 Ext.

STATE AUTOMOBILE 31-4316080 2955 N MERIDIAN STREET [email protected]

800-777-7324 Ext.

Page 147: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

13291 BEDFORD

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13238 BALTIMORE

BIRMINGHAM AL 35266

Phone:

SBWC # Insurer Name Address Email

21473 LOUISVILLE

LOUISVILLE KY 40210

Phone:

SBWC # Insurer Name Address Email

13282 ST PETERSBURG

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

ORLANDO FL 32861

Phone:

SBWC # Insurer Name Address Email

13297 CHARLOTTE

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13186 TREASURE

ISLANDATLANTA GA 30302

Phone:

STONEBRIDGE CASUALTY INSURANCE

COMPANY

MD 21044 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

770-813-0997 Ext. 230

STATE NATIONAL INSURANCE COMPANY INC TX 76021 [email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

800-816-2449 Ext.

866-434-2480 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

CORVEL CORPORATION 95-3382819 4820 LAKE BROOK DRIVE

#150

[email protected]

-- Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 [email protected]

SUNZ INSURANCE COMPANY 100 2ND AVENUE

NORTH, STE 300

FL 33701 [email protected]

502-634-7390 Ext.

SUD-CHEMIE INC KY 40210 [email protected]

SUD-CHEMIE INC 61-0536101 1600 W HILL STREET [email protected]

800-762-3486 Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 [email protected]

404-300-1250 Ext.

T H E INSURANCE COMPANY FL 33706 [email protected]

866-710-0908 Ext.

SYNERGY INSURANCE COMPANY 3440 TORINGDON WAY,

STE 300

NC 28277 [email protected]

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

Page 148: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21568 CARROLLTON

CHARLOTTE NC 28247

Phone:

SBWC # Insurer Name Address Email

21535 MINNEAPOLIS

LAKE MARY FL 32746

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13224 CLEVELAND

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21585 COLUMBIA

GREENVILLE SC 29607

Phone:

TARGET CORPORATION 1000 NICOLLET MALL,

TPN 1300

MN 55403 [email protected]

800-524-0604 Ext.

TANNER HEALTH SERVICES GA 30117 [email protected]

BRENTWOOD SERVICES

ADMINISTRATORS INC

62-1482047 P O BOX 471127 [email protected]

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-235-1134 Ext. 5

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

TECHNOLOGY INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE #200

OH 44131 [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 255 PRIMERA BLVD [email protected]

800-548-1373 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 [email protected]

800-421-9139 Ext. 859

TERMINIX SERVICE INC SC 29210 [email protected]

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

866-710-0908 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

[email protected]

800-304-5035 Ext.

Page 149: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21387 MINNEAPOLIS

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

21463 AUGUSTA

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

20492 THOMASVILLE

THOMASVILLE GA 31799

Phone:

SBWC # Insurer Name Address Email

10167 MANCHESTER

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

SBWC # Insurer Name Address Email

21429 MARIETTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

21557 VALDOSTA

SAVANNAH GA 31401

Phone:

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

13289 NEW YORK

THERMAL CERAMICS INC GA 30903 [email protected]

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

TEXTRON INC C/O AON, 8300 NORMAN

CENTER DRIVE, SUITE

MN 55437 [email protected]

TIP TOP POULTRY INC GA 30065 [email protected]

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

TIG INSURANCE COMPANY 250 COMMERICAL

STREET, SUITE 5000

NH 03101 [email protected]

912-228-7673 Ext.

THOMASVILLE CITY OF GA 31799

THOMASVILLE CITY OF - P O BOX 1540

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

TNUS INSURANCE COMPANY NY 10169 [email protected]

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5105 PAULSEN ST [email protected]

912-355-8929 Ext. 224

TM POLYFILM INC GA 31601 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

Page 150: Georgia State Board of Workers' Compensation Insurer and Claim

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

12003 NEW YORK

TUCKER GA 30084

Phone:

HARTFORD CT 06115

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

12003 NEW YORK

LAKE MARY FL 32746

Phone:

HARTFORD CT 06103

Phone:

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

13159 MANCHESTER

MANCHESTER NH 03101

Phone:

SBWC # Insurer Name Address Email

13239 NEW YORK

TUCKER GA 30084

Phone:

MAITLAND FL 32751

Phone:

TOKIO MARINE & NICHIDO FIRE INSURANCE

COMPANY

NY 10169 [email protected]

770-481-3227 Ext.

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE [email protected]

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 225 ASYLUM STREET [email protected]

TOKIO MARINE & NICHIDO FIRE INSURANCE

COMPANY

NY 10169 [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 HARTFORD PLAZA [email protected]

860-547-7936 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

866-450-8608 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

[email protected]

TOWER INSURANCE CO OF NEW YORK 120 BROADWAY, 31ST

FLOOR

NY 10271 [email protected]

800-805-9184 Ext.

TORUS NATIONAL INSURANCE COMPANY FKA

TIG INDEMNITY COMPANY

250 COMMERCIAL

STREET, SUITE 5000

NH 03101 [email protected]

TIG WORK COMP CLAIMS - 250 COMMERCIAL STREET [email protected]

800-551-0271 Ext.

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE [email protected]

770-481-3227 Ext.

Page 151: Georgia State Board of Workers' Compensation Insurer and Claim

CHICAGO IL 60606

Phone:

MOBILE AL 36695

Phone:

PARSIPPANY NJ 07054

Phone:

TALLAHASSEE FL 32302

Phone:

SBWC # Insurer Name Address Email

13273 NEW YORK

MAITLAND FL 32751

Phone:

CHICAGO IL 60606

Phone:

ATLANTA GA 30339

Phone:

MAITLAND FL 32794

Phone:

FT LAUDERDALE FL 33309

Phone:

MOBILE AL 36695

Phone:

SBWC # Insurer Name Address Email

12091 NEW YORK

TUCKER GA 30084

Phone:

ATLANTA GA 30346

Phone:

SBWC # Insurer Name Address Email

13237 WESTMONT

WESTMONT IL 60559

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA [email protected]

888-782-4672 Ext.

888-782-4672 Ext.

TOWER NATIONAL

INSURANCE COMPANY

23-2182777 2780 BERT ADAM RD [email protected]

212-655-7330 Ext.

SUA INSURANCE CLAIMS 23-2182777 101 SOUTHHALL LANE,

SUITE 365

[email protected]

866-450-8608 Ext.

SUA INSURANCE CO 23-2182777 2222 S RIVERSIDE PLAZA [email protected]

TOWER NATIONAL INSURANCE COMPANY 120 BROADWAY, 31ST

FLOOR

NY 10271 [email protected]

866-456-5630 Ext.

YORK CLAIMS SERVICE INC 13-1963636 P O BOX 10609 [email protected]

877-927-2255 Ext.

TOWER INSURANCE

COMPANY OF NEW YORK

13-3548249 1111 HILLCREST ROAD [email protected]

800-711-4405 Ext.

YORK CLAIMS SERVICE INC 13-1963636 99 CHERRY HILL ROAD [email protected]

TRANSGUARD 36-3529298 700 OAKMONT LANE [email protected]

TRANSGUARD INSURANCE COMPANY OF

AMERICA INC

IL 60559 [email protected]

TOKIO MARINE

MANAGEMENT

13-2871816 ONE RAVINIA DRIVE [email protected]

770-481-3227 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

TRANS PACIFIC INS CO NY 10169 [email protected]

800-711-4405 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 1111 HILLCREST ROAD [email protected]

877-490-0049 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 101 SOUTHHALL LANE [email protected]

877-490-0049 Ext.

TOWER NATIONAL

INSURANCE COMPANY

04-2811570 500 W CYPRESS CREEK [email protected]

Page 152: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

10170 DALLAS

DALLAS TX 75219

Phone:

SBWC # Insurer Name Address Email

10171 CHICAGO

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

CHICAGO IL 60604

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10001 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

12016 HARTFORD

ALPHARETTA GA 30005

Phone:

800-474-2526 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

800-283-2318 Ext. 3574

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

312-822-2331 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

TRANSPORTATION INSURANCE COMPANY 333 S WASBASH AVENUE,

28 SOUTH

IL 60604 [email protected]

214-526-3876 Ext.

TRANSPORT INSURANCE CO TX 75219

TRANSPORT INSURANCE CO - 4100 HARRY HINES BLVD

800-238-6214 Ext.

TRAVELERS CASUALTY & SURETY OF AMERICA CT 06183 [email protected]

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS CASUALTY & SURETY COMPANY CT 06183 [email protected]

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 1000 WINDWARD

CONCOURSE

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

Page 153: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13207 HARTFORD,

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13064 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

12017 HARTFORD

TUCKER GA 30084

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

TRAVELERS CASUALTY &

SURETY COMPANY OF

AMERICA

06-0907370 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

800-238-6214 Ext.

TRAVELERS CASUALTY CO

OF CT

06-1286266 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS CASUALTY

COMPANY OF CONNECTICUT

06-1286266 1000 WINDWARD

CONCOURSE

[email protected]

TRAVELERS CASUALTY COMPANY OF

CONNECTICUT

CT 06183 [email protected]

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

888-329-6259 Ext.

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS CASUALTY COMPANY OF

AMERICA

CT 06183 [email protected]

TRAVELERS CASUALTY &

SURETY COMPANY

06-6033504 10401 HIGHLAND MANOR

DRIVE

[email protected]

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

800-354-6494 Ext. 201

TRAVELERS CASUALTY

INSURANCE COMPANY OF

AMERICA

06-0876835 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS CASUALTY INS CO OF AMERICA CT 06183 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

Page 154: Georgia State Board of Workers' Compensation Insurer and Claim

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13158 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

13065 HARTFORD

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10218 HARTFORD

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

TAMPA FL 33610

Phone:

FT SMITH AR 72919

Phone:

CHARLOTTE NC 28226

Phone:

888-329-6259 Ext.

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS COMMERCIAL CASUALTY CO FKA

TRAVELERS INDEMNITY CO

CT 06183 [email protected]

TRAVELERS COMMERCIAL

CASUALTY COMPANY

95-3634110 10401 HIGHLAND MANOR

DRIVE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 2420 LAKEMONT AVENUE [email protected]

407-388-2587 Ext.

TRAVELERS INDEMNITY COMPANY CT 06183 [email protected]

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

888-329-6259 Ext.

TRAVELERS COMMERCIAL

INS CO

06-1286268 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS COMMERCIAL

INS CO

06-1286268 10401 HIGHLAND MANOR

DRIVE

[email protected]

TRAVELERS COMMERCIAL INSURANCE

COMPANY

CT 06183 [email protected]

TRAVELERS COMMERCIAL

INS CO

06-1286268 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

800-842-5612 Ext. 4611

TRAVELERS INDEMNITY

COPMANY

06-0566050 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3298

TRAVELERS INDEMNITY

COMPANY

06-0566050 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 FIANA WAY [email protected]

Page 155: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

10162 HARTFORD

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

10060 HARTFORD

TAMPA FL 33610

Phone:

ALPHARETTA GA 30005

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13039 HARTFORD

ALPHARETTA GA 30005

Phone:

FRANKLIN TN 37067

Phone:

-- Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 6640 CAROTHERS [email protected]

615-660-6258 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 1000 WINDWARD

CONCOURSE

[email protected]

800-759-6194 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 2420 LAKEMONT AVENUE [email protected]

TRAVELERS INDEMNITY COMPANY OF

AMERICA

CT 06183 [email protected]

TRAVELERS PROPERTY CASUALTY COMPANY

OF AMERICA

CT 06183 [email protected]

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 10401 HIGHLAND MANOR

DR #200

[email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY CO

OF CT

06-0336212 1000 WINDWARD

CONCOURSE

[email protected]

TRAVELERS INDEMNITY COMPANY OF

CONNECTICUT

CT 06183 [email protected]

888-329-6259 Ext.

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 11440 CARMEL COMMONS

BLVD

[email protected]

800-759-6194 Ext. 3298

TRAVELERS INDEMNITY

COMPANY OF AMERICA

58-6020487 10401 HIGHLAND MANOR

DRIVE

[email protected]

800-238-6214 Ext.

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 6640 CAROTHERS [email protected]

800-342-4062 Ext.

Page 156: Georgia State Board of Workers' Compensation Insurer and Claim

TAMPA FL 33610

Phone:

ORLANDO FL 32814

Phone:

SBWC # Insurer Name Address Email

21599 ATLANTA

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

10237 DALLAS

DALLAS TX 75265

Phone:

SBWC # Insurer Name Address Email

21595 LAGRANGE

CHATTANOOGA TN 37405

Phone:

SBWC # Insurer Name Address Email

10174 LOS ANGELES

ALBANY GA 31708

Phone:

ATLANTA GA 30319

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

13157 HARTFORD

ATLANTA GA 30319

Phone:

ROSWELL GA 30076

888-291-8298 Ext. 8667

TRINITY UNIVERSAL INS CO TX 75265 [email protected]

TRINITY UNIVERSAL

INSURANCE COMPANY OF

KANSAS INC

75-1413993 P O BOX 650665 [email protected]

866-246-0259 Ext.

TRC STAFFING SERVICES INC GA 30346 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

407-388-2587 Ext.

TRAVELERS PROPERTY

CASUALTY COMPANY OF

AMERICA

36-2719165 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

TRAVELERS PROPERTY

CAUSLATY COMPANY OF

AMERICA

36-2719165 2420 LAKEMONT AVENUE [email protected]

TRUMBULL INSURANCE COMPANY ONE HARTFORD

INSURANCE, HARTFORD

PLAZA

CT 06115 [email protected]

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

[email protected]

-- Ext.

CRAWFORD & COMPANY 58-0506554 P O BOX 71465

229-436-3376 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD

TRUCK INSURANCE EXCHANGE CA 90010 [email protected]

[email protected]

800-884-1535 Ext.

TROUP COUNTY BOARD OF ED GA 30241

COLLINS & COMPANY 62-0882150 555 RIVER STREET

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

Page 157: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DULUTH GA 30097

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACAUSE NY 13202

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

800-685-7361 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-932-4464 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

800-822-4469 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

Page 158: Georgia State Board of Workers' Compensation Insurer and Claim

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

13213 COLUMBUS

WARRENVILLE IL 60555

Phone:

COLUMBUS OH 43216

Phone:

SBWC # Insurer Name Address Email

10175 HARTFORD

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

MAITLAND FL 32751

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

TUCKER GA 30084

Phone:

SUNRISE FL 33323

Phone:

800-348-1741 Ext. 8407

GRANGE MUTUAL 31-4192970 27755 DIEHL ROAD [email protected]

800-935-5300 Ext. 254

GRANGE MUTUAL

CASUALTY COMPANY

31-4192970 P O BOX 182306 [email protected]

TRUSTGARD INSURANCE COMPANY OH 43218 [email protected]

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 [email protected]

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

877-241-6121 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

800-277-7500 Ext. 20104

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

TWIN CITY FIRE INSURANCE COMPANY CT 06115 [email protected]

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-354-6494 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

Page 159: Georgia State Board of Workers' Compensation Insurer and Claim

DULUTH GA 30097

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

FRANKLIN TN 37067

Phone:

SYRACAUSE NY 13202

Phone:

DULUTH GA 30096

Phone:

COLUMBIA SC 29210

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

HARTFORD ACCIDENT &

INDEMNITY CO

06-0383030 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD CASUALTY INS 06-0294398 200 COLONIAL CENTER

PARKWAY

[email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

800-426-2885 Ext.

PROPERTY & CASUALTY INS

CO OF HARTFORD

06-1276326 300 SOUTH STATE STREET [email protected]

407-562-3632 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

407-562-3632 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

[email protected]

800-304-5035 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD INS CO OF THE 06-1013048 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

HARTFORD FIRE INS CO 06-0383750 300 SOUTH STATE STREET [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

Page 160: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

LAKE MARY FL 32746

Phone:

SYRACUSE NY 13202

SBWC # Insurer Name Address Email

21101 SPRINGDALE

OXFORD AL 36203

Phone:

SBWC # Insurer Name Address Email

13166 HOUSTON

ATLANTA GA 30302

Phone:

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

13102 WASHINGTON

ATLANTA GA 30302

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30097

Phone:

SBWC # Insurer Name Address Email

13217 IRVING

IRVING TX 75039

Phone:

SBWC # Insurer Name Address Email

20756 CHICAGO

SUNRISE FL 33323

800-541-0139 Ext.

TWIN CITY FIRE INS CO 06-0732738 200 COLONIAL CENTER

PARKWAY

[email protected]

407-562-3632 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

ULLICO CASUALTY COMPANY DC 20006 [email protected]

800-354-6494 Ext. 201

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 [email protected]

404-300-1250 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

U.S. SPECIALTY INSURANCE COMPANY TX 77040 [email protected]

TYSON FOODS INC 71-0225165 1520 MCPHERSON STREET [email protected]

256-831-4381 Ext.

TYSON FOODS INCORPORATED AR 72762 [email protected]

TWIN CITY FIRE INS CO 06-0732738 300 SOUTH STATE STREET [email protected]

UNITED AIRLINES INC IL 60666 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-444-0049 Ext.

UNION STANDARD 47-0547953 122 W CARPENTER

FREEWAY

[email protected]

UNION INSURANCE COMPANY TX 75015

866-246-0259 Ext.

CRAWFORD & COMPANY 58-0506554 1001 SUMMIT BLVD [email protected]

-- Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

CRAWFORD & COMPANY 58-0506554 P O BOX 5056 [email protected]

404-300-1250 Ext.

Page 161: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

SBWC # Insurer Name Address Email

40015 MARIETTA

MARIETTA GA 30067

Phone:

SBWC # Insurer Name Address Email

13278 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13279 BALA CYNWYD

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

10177 ST PAUL

NORCROSS GA 30071

Phone:

SAVANNAH GA 31405

Phone:

LAKE MARY FL 32746

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

POMPANO BEACH FL 33064

Phone:

MAITLAND FL 32751

800-889-6764 Ext. 201

UNITED STATES FIDELITY & GUARANTY

COMPANY

MN 55102 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

UNITED NATONAL CASUALTY INSURANCE

COMPANY

THREE BALA PLAZA

EAST, SUITE 300

PA 19004 [email protected]

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-347-4494 Ext.

UNITED NATIONAL SPECIALTY INSURANCE THE THREE BALA PLAZA

EAST, SUITE 300

PA 19004 [email protected]

UNITED BUSINESS

INSURANCE COMPANY

02-0608690 350 FRANKLIN ROAD [email protected]

678-766-8242 Ext. 204

UNITED BUSINESS INSURANCE COMPANY A

MUTUAL CAPTIVE

350 FRANKNLIN ROAD,

STE 330

GA 30067 [email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 20104

AVIZENT 31-4359765 701 INTERNATIONAL

PARKWAY

[email protected]

800-755-1441 Ext.

AS&G CLAIMS

ADMINISTRATION INC

76-0516648 125 PARK OF COMMERCE

DRIVE #B

[email protected]

800-580-6912 Ext.

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

Page 162: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

DUBUQUE IA 52004

Phone:

ROSWELL GA 30076

Phone:

DULUTH GA 30097

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

TAMPA FL 33631

Phone:

TAMPA FL 33631

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-288-9843 Ext. 201

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

COTTINGHAM & BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

877-241-6121 Ext.

CANNON COCHRAN

MANAGEMENT SERVICES

866-291-0194 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

[email protected]

813-264-6588 Ext.

LIBERTY MUTUAL INS CO 04-1543470 P O BOX 31204

800-532-7706 Ext.

HELMSMAN MANAGEMENT

SERVICES LLC

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 31204 [email protected]

800-282-6218 Ext.

HELMSMAN MANAGEMENT

SERVICES

04-2791584 P O BOX 49000 [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

800-896-3079 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

Page 163: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

CHARLOTTE NC 28217

Phone:

MEMPHIS TN 38120

Phone:

RICHMOND VA 23260

Phone:

ATLANTA GA 30328

Phone:

LEXINGTON KY 40512

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

800-347-4494 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

800-866-2301 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

866-654-4001 Ext.

770-901-3121 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 14151 [email protected]

800-541-0139 Ext. 35832

SENTRY INSURANCE A

MUTUAL COMPANY

39-0333950 P O BOX 26263 [email protected]

800-338-2487 Ext. 4616

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-932-4464 Ext.

RISK ENTERPRISES

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-871-6670 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 ONE LAKEVIEW [email protected]

615-493-5802 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

Page 164: Georgia State Board of Workers' Compensation Insurer and Claim

ORLANDO FL 32861

Phone:

ALPHARETTA GA 30005

Phone:

ORLANDO FL 32814

Phone:

FT SMITH AR 72919

Phone:

FRANKLIN TN 37067

Phone:

CHARLOTTE NC 28226

Phone:

TAMPA FL 33610

Phone:

SBWC # Insurer Name Address Email

13263 NEW BERLIN

NEW BERLINE WI 53151

Phone:

SBWC # Insurer Name Address Email

10179 ORLANDO

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

21241 AUGUSTA

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

10178 MORRISTOWN

ROSWELL GA 30076

Phone:

407-388-2587 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 1000 FIANA WAY [email protected]

800-842-5612 Ext. 4611

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 2420 LAKEMONT AVENUE [email protected]

800-238-6214 Ext.

UNITED SELF INSURED

SERVICES

20-4580645 P O BOX 616648 [email protected]

800-444-9098 Ext. 214

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 1000 WINDWARD

CONCOURSE

[email protected]

UNIVERSITY HEALTH INC GA 30901 [email protected]

UNIVERSAL UNDERWRITERS - 600 GALLERIA PKY. [email protected]

800-433-8842 Ext.

UNIVERSAL UNDERWRITERS INSURANCE

COMPANY

1900 SUMMIT TOWER

BOULEVARD, SUITE 600

FL 32810 [email protected]

UNITED WISCONSIN

INSURANCE COMPANLY

39-0941450 15200 WEST SMALL ROAD [email protected]

800-258-2667 Ext. 7704

UNITED WISCONSIN INSURANCE COMPANY WI 53151 [email protected]

800-759-6194 Ext. 3298

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 10401 HIGHLAND MANOR

DRIVE

[email protected]

888-329-6259 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 6640 CAROTHERS [email protected]

800-342-4064 Ext.

UNITED STATES FIDELITY &

GUARANTY COMPANY

52-0515280 11440 CARMEL COMMONS

BLVD

[email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-685-7361 Ext.

US FIRE INSURANCE COMPANY NJ 07962 [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

Page 165: Georgia State Board of Workers' Compensation Insurer and Claim

LAKE MARY FL 32795

Phone:

SBWC # Insurer Name Address Email

21688 OVERLAND PARK

NASHVILLE TN 37229

Phone:

SBWC # Insurer Name Address Email

13134 ST PAUL

ALPHARETTA GA 30005

Phone:

SBWC # Insurer Name Address Email

10180 UTICA

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13132 NEW HARTFORD

ATLANTA GA 30338

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

20503 VALDOSTA

JOHNS CREEK GA 30097

Phone:

SBWC # Insurer Name Address Email

10181 CHICAGO

ATLANTA GA 30319

Phone:

DULUTH GA 30096

Phone:

USF&G FAMILY INSURANCE CO MN 55102

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

USF HOLLAND INC FKA YRC WORLDWIDE 10990 ROE AVENUE, MS

A305

KS 66211 [email protected]

UNITED STATES FIRE

INSURANCE COMPANY

13-5459190 1064 GREENWOOD BLVD [email protected]

800-423-3060 Ext. 6301

VALDOSTA CITY OF GA 31601

UTICA NATIONAL

ASSURANCE CO

16-1486064 1040 CROWNE POINTE [email protected]

770-510-4100 Ext.

UTICA MUTUAL INSURANCE

CO

15-0476880 1040 CROWN POINTE

PARKWAY, STE 450

[email protected]

800-477-1914 Ext.

UTICA NATIONAL ASSURANCE CO NY 13413 [email protected]

800-477-1914 Ext.

UTICA MUTUAL INSURANCE

CO

15-0476880 1040 CROWN POINTE

PARKWAY, STE 450

[email protected]

UTICA MUTUAL INSURANCE CO NY 13504 [email protected]

TRAVELERS INDEMNITY

COMPANY

06-0566050 1000 WINDWARD

CONCOURSE

[email protected]

800-238-6214 Ext.

800-283-2318 Ext. 3574

[email protected]

800-450-0692 Ext.

CNA CLAIMS PLUS 16-1633560 2435 COMMERCE AVENUE [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

VALLEY FORGE INSURANCE CO 333 S WABASH AVENUE,

28 SOUTH

IL 60604 [email protected]

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

Page 166: Georgia State Board of Workers' Compensation Insurer and Claim

CHICAGO IL 60604

Phone:

SBWC # Insurer Name Address Email

13025 FENTON

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21725 HENDERSON

GREENVILLE SC 29607

Phone:

GREENVILLE SC 29606

Phone:

SBWC # Insurer Name Address Email

10235 WARREN

ATLANTA GA 30326

Phone:

TUCKER GA 30084

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30326

Phone:

SBWC # Insurer Name Address Email

13222 ATLANTA

ATLANTA GA 30339

Phone:

CHARLOTTE NC 28277

Phone:

800-421-0710 Ext.

VANLINER INSURANCE CO MO 63026 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

CONTINENTAL CASUALTY

COMPANY

36-2114545 333 SOUTH WABASH [email protected]

312-822-2331 Ext.

866-246-0259 Ext.

SPECIALTY RISK SERVICES 20-0730592 P O BOX 60000 [email protected]

770-901-3121 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

CHUBB SERVICES

CORPORATION

22-3096895 3445 PEACHTREE ROAD NE [email protected]

404-266-4855 Ext.

VIGILANT INSURANCE COMPANY NJ 07061 [email protected]

800-421-9139 Ext. 859

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 6528 [email protected]

864-240-5851 Ext.

VARIETY WHOLESALERS INC NC 27536 [email protected]

HEWITT COLEMAN

ASSOCIATES

57-0297041 P O BOX 8500 [email protected]

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

866-710-0908 Ext.

BUILDERS INSURANCE 58-2453325 P O BOX 723099 [email protected]

800-883-9305 Ext.

VININGS INSURANCE COMPANY 2410 PACES FERRY

ROAD, SUITE 300

GA 30339 [email protected]

VIGILANT INSURANCE

COMPANY

13-1963495 2 LIVE OAK CENTER #900 [email protected]

404-266-4127 Ext.

Page 167: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

12063 GLENVIEW

TUCKER GA 30084

Phone:

SBWC # Insurer Name Address Email

20481 ATLANTA

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

21119 NORCROSS

BRENTWOOD TN 37024

Phone:

SBWC # Insurer Name Address Email

21629 GREER

GREER SC 29651

Phone:

SBWC # Insurer Name Address Email

21876 BENTONVILLE

DULUTH GA 30096

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

21661 LAFAYETTE

COLUMBIA SC 29202

Phone:

SBWC # Insurer Name Address Email

21735 MONROE

GRAYSON GA 30017

Phone:

VISITING NURSE HEALTH SYSTEM INC 5775 GLENRIDGE DRIVE,

E200

GA 30328 [email protected]

800-354-6494 Ext. 201

VIRGINIA SURETY CO INC IL 60025 [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

WAL MART ASSOCIATES INC 702 SW 8TH STREET, MS

0695

AR 72716

WAGGONERS TRUCKING 81-0290880 1131 HWY. 101 SOUTH [email protected]

800-462-0602 Ext.

WAGGONERS TRUCKING THE SC 29651 [email protected]

BRENTWOOD SERVICES 62-1482047 P O BOX 1125 [email protected]

800-524-0604 Ext.

WAFFLE HOUSE INC GA 30091 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

800-421-0710 Ext.

CORE ADMINISTRATIVE

SERVICES

58-2314468 P O BOX 969 [email protected]

770-962-3627 Ext.

WALTON COUNTY BOARD OF EDUCATION GA 30655

COMPANION THIRD PARTY

ADMINISTRATORS LLC

56-2151867 P O BOX 100159 [email protected]

800-845-2724 Ext. 43582

WALKER COUNTY BOARD OF EDUCATION GA 30728

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

800-625-6588 Ext.

Page 168: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

20349 DUBLIN

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

21357 WARNER ROBINS

SAVANNAH GA 31405

Phone:

SBWC # Insurer Name Address Email

21788 ALBANY

ATLANTA GA 30339

Phone:

SBWC # Insurer Name Address Email

10095 BOSTON

TAMPA FL 33618

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

13116 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

Phone:

SBWC # Insurer Name Address Email

12036 BOSTON

CHARLOTTE NC 28277

Phone:

TAMPA FL 33618

WARNER ROBINS CITY OF GA 31099

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

800-224-9524 Ext.

WAREHOUSE HOME FURNISHINGS

DISTRIBUTORS INC

GA 31040 [email protected]

WAUSAU GENERAL INSURANCE COMPANY MA 02116 [email protected]

WAUSAU BUSINESS

INSURANCE COMPANY

36-3522250 P O BOX 49000 [email protected]

800-282-6218 Ext.

WAUSAU BUSINESS

INSURANCE COMPANY

36-3522250 3901 PREMIER NORTH [email protected]

800-282-6218 Ext.

WAUSAU BUSINESS INSURANCE COMPANY MA 02116 [email protected]

800-233-2436 Ext. 1897

WATER GAS & LIGHT COMMISSION OF ALBANY GA 31702 [email protected]

AFFINITY SERVICE GROUP 58-2438483 1940 THE EXCHANGE [email protected]

912-355-8989 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

WAUSAU UNDERWRITERS

INS GO

39-1341459 3901 PREMIER NORTH DR [email protected]

WAUSAU UNDERWRITERS

INS CO

39-1341459 P O BOX 49000 [email protected]

704-759-2580 Ext.

WAUSAU UNDERWRITER INSURANCE COMPANY MA 02116 [email protected]

813-264-6588 Ext.

[email protected]

704-759-2580 Ext.

WAUSAU GENERAL

INSURANCE COMPANY

36-2753986 3901 PREMIER NORTH DR [email protected]

WAUSAU GEN INS CO 36-2753986 P O BOX 49000

Page 169: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

20451 WAYCROSS

GLEN ALLEN VA 23058

Phone:

CHARLESTON SC 29416

Phone:

SBWC # Insurer Name Address Email

21767 NEW YORK

ROSWELL GA 30076

Phone:

SBWC # Insurer Name Address Email

21626 MARIETTA

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

20548

ATLANTA GA 30328

Phone:

SBWC # Insurer Name Address Email

13242 CLEVELAND

JOHNS CREEK GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

MANDEVILLE LA 70471

Phone:

FRANKLIN TN 37067

Phone:

WAYCROSS CITY OF GA 31502 [email protected]

CORVEL CORP 95-3382819 4820 LAKE BROOK DRIVE [email protected]

800-943-1113 Ext. 454

WAUSAU UNDERWRITERS

INS GO

813-264-6588 Ext.

WAUSAU UNDERWRITERS

INSURANCE

39-1341459 P O BOX 49000 [email protected]

WENDYS INTERNATIONAL INC 1155 PERIMETER

CENTER WEST, 6TH

GA 30328 [email protected]

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

WELLSTAR HEALTH SYSTEM 140 LACY STREET, SUITE GA 30060 [email protected]

800-685-7361 Ext.

WAYNE FARMS LLC NY 10172 [email protected]

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

800-906-4461 Ext.

CORVEL ENTERPRISES 42-1704550 P O BOX 81029 [email protected]

866-434-2480 Ext.

800-304-5035 Ext.

JOHNSTON & ASSOCIATES 62-1426686 1885 GENERAL GEORGE

PATTON DRIVE

[email protected]

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

AMTRUST NORTH AMERICA 34-1965476 11330 LAKEFIELD DRIVE [email protected]

678-258-8000 Ext.

WESCO INSURANCE COMPANY 5800 LOMBARDO

CENTER, STE 200

OH 44131 [email protected]

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

678-338-4171 Ext.

Page 170: Georgia State Board of Workers' Compensation Insurer and Claim

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

10275 FAIRFIELD

CHARLOTTE NC 28277

Phone:

SBWC # Insurer Name Address Email

21511 LAGRANGE

MARIETTA GA 30006

Phone:

SBWC # Insurer Name Address Email

12084 WESTFIELD

CENTERDULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13044 WESTFIELD

CENTER

DULUTH GA 30096

Phone:

SBWC # Insurer Name Address Email

13204 OVERLAND PARK

NASHVILLE TN 37229

Phone:

FT MILL SC 29716

Phone:

SBWC # Insurer Name Address Email

20726 FEDERAL WAY

NASHVILLE TN 37214

Phone:

SYNERGY COVERAGE

SOLUTIONS

04-3718801 3440 TORINGDON WAY [email protected]

866-710-0908 Ext.

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD [email protected]

800-685-4604 Ext. 222

WESTFIELD NATIONAL INSURANCE COMPANY OH 44251 [email protected]

WESTFIELD INSURANCE

GROUP

34-6516838 3505 KROGER BLVD [email protected]

800-685-4604 Ext. 222

WESTFIELD INSURANCE COMPANY OH 44251 [email protected]

ALLIED CLAIMS

ADMINISTRATION INC

58-1962415 P O BOX 674869 [email protected]

800-476-7601 Ext.

WEST GEORGIA MEDICAL CENTER INC FKA

LAGRANGE-TROUP CTY HOSP

GA 30240 [email protected]

800-334-0078 Ext. 214

WEST AMERICAN INSURANCE COMPANY OH 45014 [email protected]

MONTGOMERY INSURANCE

CLAIM CENTER

52-0424870 P O BOX 49130 [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

WEYERHAEUSER COMPANY P O BOX 9777, CH 3K33 WA 98063 [email protected]

866-814-1740 Ext. 201

[email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

WESTPORT INSURANCE CORP KS 66202

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109

Page 171: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

21353 DALTON

LAWRENCEVILLE GA 30042

Phone:

SBWC # Insurer Name Address Email

13120 SOUTHFIELD

SARASOTA FL 34232

Phone:

SBWC # Insurer Name Address Email

20889 JACKSONVILLE

JACKSONVILLE FL 32256

Phone:

MEMPHIS TN 38120

Phone:

SBWC # Insurer Name Address Email

13236 WILMINGTON

ATLANTA GA 30319

Phone:

SBWC # Insurer Name Address Email

13270 EXTON

NORCROSS GA 30071

Phone:

TAMPA FL 33630

Phone:

NORCROSS GA 30010

Phone:

ATLANTA GA 30319

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

TUCKER GA 30084

800-224-9524 Ext.

UNDERWRITERS SAFETY &

CLAIMS

61-0489172 5415 SUGARLOAF [email protected]

WHITFIELD CO BOARD OF ED GA 30720

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

WORK FIRST CASUALTY COMPANY 3411 SILVERSIDE RD,

BARNARD BLDG STE 101

DE 19810 [email protected]

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

WINN-DIXIE STORES INC FL 32254 [email protected]

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD [email protected]

MEADOWBROOK INC 38-1798156 P O BOX 50608 [email protected]

800-741-7244 Ext.

WILLIAMSBURG NATIONAL INSURANCE

COMPANY

MN 48034 [email protected]

770-813-0997 Ext. 230

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

800-473-9009 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD [email protected]

800-450-0692 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

BROADSPIRE INC 36-3917295 P O BOX 926240 [email protected]

678-969-7337 Ext.

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 [email protected]

800-258-1811 Ext.

678-447-0200 Ext. 302

XL INSURANCE AMERICA INC PA 19341 [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

Page 172: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

ATLANTA GA 30338

Phone:

SBWC # Insurer Name Address Email

13081 EXTON

NORCROSS GA 30071

Phone:

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30339

Phone:

POMPANO BEACH FL 33064

Phone:

TAMPA FL 33619

Phone:

DULUTH GA 30097

Phone:

BIRMINGHAM AL 35209

Phone:

PARSIPPANY NJ 07054

Phone:

TUCKER GA 30084

800-277-7500 Ext. 29106

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

ALTERNATIVE SERVICE

CONCEPTS DBA ASC LLC

43-1954328 3135 AVALON RIDGE [email protected]

678-447-0200 Ext. 302

XL SPECIALTY INSURANCE COMPANY PA 19341 [email protected]

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

800-422-4436 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

GAB ROBINS NORTH

AMERICA INC

13-2747054 9 CAMPUS DRIVE [email protected]

800-587-3773 Ext.

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 1 METROPLEX DRIVE [email protected]

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 9950 PRINCESS PALM

AVENUE

[email protected]

800-303-4437 Ext.

800-862-4252 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

[email protected]

800-450-0692 Ext.

CAMBRIDGE INTEGRATED 23-2731565 1775 THE EXCHANGE [email protected]

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

Page 173: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33622

Phone:

ORLANDO FL 32878

Phone:

DULUTH GA 30097

Phone:

DULUTH GA 30096

Phone:

ATLANTA GA 30338

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SBWC # Insurer Name Address Email

21601 MACON

LAWRENCEVILLE GA 30043

Phone:

SBWC # Insurer Name Address Email

13056 E PROVIDENCE

E. PROVIDENCE RI 02914

Phone:

SBWC # Insurer Name Address Email

10143 WOODLAND

HILLSCHARLOTTE NC 28202

Phone:

SBWC # Insurer Name Address Email

800-354-6494 Ext. 201

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

SPECIALTY RISK SERVICES 20-0730592 ONE LAKE VIEW [email protected]

615-824-5095 Ext.

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 3700 CRESTWOOD

PARKWAY

[email protected]

678-628-1318 Ext.

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

ZENITH INSURANCE

COMPANY

95-1651549 900 W TRADE STREET [email protected]

800-200-2667 Ext.

ZENITH INSURANCE CO CA 91367 [email protected]

800-556-3825 Ext.

YORK INSURANCE COMPANY RI 02901 [email protected]

PROVIDENCE WASHINGTON - 88 BOYD AVENUE [email protected]

800-421-0710 Ext.

YKK CORPORATION OF AMERICA GA 31217 [email protected]

GEORGIA ADMINISTRATIVE

SERVICES

58-2196973 1775 SPECTRUM DRIVE [email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

800-541-0139 Ext.

Page 174: Georgia State Board of Workers' Compensation Insurer and Claim

10187 SCHAUMBURG

TAMPA FL 33630

Phone:

ATLANTA GA 30319

Phone:

LOUISVILLE KY 40222

Phone:

TOWSON MD 21286

Phone:

POMPANO BEACH FL 33064

Phone:

CINCINNATI OH 45224

Phone:

MAITLAND FL 32751

Phone:

UNIONTOWN OH 44685

Phone:

ALPHARETTA GA 30005

Phone:

DUBUQUE IA 52004

Phone:

WHITESBURG GA 30185

Phone:

ROSWELL GA 30076

Phone:

MANDEVILLE LA 70471

Phone:

DULUTH GA 30097

Phone:

MIRAMAR FL 33027

Phone:

NASHVILLE TN 37229

Phone:

TUCKER GA 30084

800-235-1134 Ext. 5

CANNON COCHRAN

MANAGEMENT SERVICES

37-1057804 2600 LAKE LUCIEN DR [email protected]

866-291-0194 Ext.

CAMBRIDGE INTEGRATED

SERVICES

23-2731565 1100 PARK CENTRAL BLVD

SOUTH

[email protected]

877-295-0011 Ext.

CAMBRIDGE INTEGRATED

SERVICES GROUP INC

23-2731565 6300 CENTER HILL ROAD [email protected]

800-742-4248 Ext.

CAMBRIDGE INTEGRATED

SERVICE GROUP INC

23-2731565 809 GLEN EAGLES COURT [email protected]

419-847-6323 Ext.

[email protected]

800-450-0692 Ext.

BROADSPIRE SERVICES INC. 36-3917295 9502 WILLIAMSBURG [email protected]

800-258-1811 Ext.

BROADSPIRE SERVICES 36-3917295 1001 SUMMIT BOULEVARD

ZURICH AMERICAN INSURANCE COMPANY IL 60196 [email protected]

BROADSPIRE CLAIMS 36-3917295 CALL BOX 30539 [email protected]

770-813-0997 Ext. 230

GAB ROBINS NORTH

AMERICA INC

13-2747054 3039 PREMIERE PARKWAY [email protected]

800-685-7361 Ext.

F A RICHARD (FARA) 72-0837383 1625 WEST CAUSEWAY

APPROACH

[email protected]

985-624-6739 Ext.

CREATIVE RISK SOLUTIONS 20-0989430 P O BOX 9207 [email protected]

770-577-9657 Ext.

ESIS INC 95-2008390 500 COLONIAL PARKWAY [email protected]

877-241-6121 Ext.

COTTINGHAM AND BUTLER

CLAIM SERVICES

20-5233506 P O BOX 28 [email protected]

330-896-4311 Ext.

CONSTITUTION STATE

SERVICES

06-1501229 1000 WINDWARD

CONCOURSE

[email protected]

770-352-2978 Ext.

CHESTERFIELD SERVICES 34-1709723 3520 FOREST LAKE DRIVE [email protected]

GALLAGHER BASSETT

SERVICES INC

36-3365500 100 CRESCENT CENTRE

PARKWAY

[email protected]

800-473-9009 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 292109 [email protected]

800-288-9843 Ext. 201

GALLAGHER BASSETT

SERVICES

36-3365500 P O BOX 279310 [email protected]

Page 175: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

TAMPA FL 33622

Phone:

BIRMINGHAM AL 35266

Phone:

ORLANDO FL 32878

Phone:

SUNRISE FL 33323

Phone:

DULUTH GA 30097

Phone:

FT MILL SC 29716

Phone:

CLEARWATER FL 33758

Phone:

LAKE MARY FL 32746

Phone:

WILMINGTON NC 28404

Phone:

OWING MILLS MD 21117

Phone:

PLANT CITY FL 33563

Phone:

PHOENIX AZ 85029

Phone:

SAN JOSE CA 95109

Phone:

TAMPA FL 33602

Phone:

ATLANTA GA 30328

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 785071 [email protected]

800-843-8999 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1301 INTERNATIONAL

PARKWAY

[email protected]

866-428-0283 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 601 VESTAVIA PARKWAY [email protected]

800-762-3486 Ext.

GALLAGHER BASSETT

SERVICES INC

100 CRESCENT CENTRE

PARKWAY

800-354-6494 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 21227 [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1479 [email protected]

866-654-4001 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 3448 [email protected]

407-562-3632 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 10156 [email protected]

800-896-3079 Ext.

HARTFORD UNDERWRITERS

INS CO

06-1222527 200 COLONIAL CENTER

PARKWAY

[email protected]

800-226-8002 Ext.

GALLAGHER BASSETT

SERVICES INC

36-3365500 1096 ASSEMBLY DRIVE [email protected]

866-814-1740 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 P O BOX 4840 [email protected]

800-889-6764 Ext. 201

GALLAGHER BASSETT

SERVICES INC

36-3365500 2915 PREMIERE PARKWAY [email protected]

866-246-0259 Ext.

800-426-5990 Ext.

NOVAPRO RISK SOLUTIONS 36-4550659 SIX CONCOURSE [email protected]

MATRIX ABSENCE

MANAGEMENT

77-0493584 P O BOX 1468 [email protected]

888-878-0005 Ext.

NOVAPRO RISK 36-4550659 101 E KENNEDY BLVD [email protected]

888-878-0005 Ext.

MATRIX ABSENCE

MANAGEMENT

77-0493584 11221 N 28TH DRIVE [email protected]

800-866-2301 Ext.

Page 176: Georgia State Board of Workers' Compensation Insurer and Claim

Phone:

ATLANTA GA 30328

Phone:

ATLANTA GA 30328

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30338

Phone:

JACKSONVILLE FL 32256

Phone:

COLUMBIA SC 29210

Phone:

CHARLOTTE NC 28217

Phone:

LEWISVILLE TX 75067

Phone:

MEMPHIS TN 38120

Phone:

NASHVILLE TN 37214

Phone:

ATLANTA GA 30328

Phone:

LAKE MARY FL 32746

Phone:

SAVANNAH GA 31405

Phone:

ORLANDO FL 32810

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone:

ATLANTA GA 30319

Phone:

800-871-6670 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 565 MARRIOTT DRIVE [email protected]

800-347-4494 Ext.

PMA MANAGEMENT

CORPORATION

23-2652239 1100 ABERNATHY ROAD [email protected]

888-888-8136 Ext.

RISK ENTERPRISE

MANAGEMENT LIMITED

13-3832689 1140 HAMMOND DR [email protected]

678-731-9091 Ext. 252

404-851-3207 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]

404-851-3207 Ext.

ONE LAKE VIEW [email protected]

615-824-5095 Ext.

SPECIALTY RISK SERVICES 20-0730592 50 GLENLAKE PARKWAY [email protected]

ZURICH NA ATL CLAIMS 36-4233459 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 3003 SUMMIT BLVD [email protected]

ZURICH AMERICAN

INSURANCE OF ILLINOIS

36-2781080 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

UNDERWRITERS SAFETY &

CLAIMS INC

61-0489172 5105 PAULSEN STREET [email protected]

912-355-8989 Ext.

800-541-0139 Ext.

SPECIALTY RISK SERVICES 20-0730592 605 CRESCENT EXECUTIVE

COURT

[email protected]

678-338-4171 Ext.

SPECIALTY RISK SERVICES 20-0730592

972-906-8599 Ext.

SEDGWICK CMS 36-2685608 1100 RIDGEWAY LOOP [email protected]

241-922-0638 Ext.

SEDGWICK CMS 36-2685608 5260 PARKWAY PLAZA

BLVD

[email protected]

800-822-4469 Ext.

SEDGWICK CMS 36-2685608 750 STATE HWY 121 [email protected]

888-784-3470 Ext.

SEDGWICK CMS 36-2685608 2000 CENTER POINT DRIVE [email protected]

800-426-9218 Ext. 12131

SEDGWICK CMS 36-2685608 1117 PERIMETER CENTER

WEST

[email protected]

800-932-4464 Ext.

SEDGWICK CMS 36-2685608 8649 BAYPINE ROAD [email protected]

Page 177: Georgia State Board of Workers' Compensation Insurer and Claim

SBWC # Insurer Name Address Email

13017 SCHAUMBURG

BIRMINGHAM AL 35209

Phone:

ATLANTA GA 30319

Phone:

ORLANDO FL 32810

Phone:

ORLANDO FL 32810

Phone:

ATLANTA GA 30319

Phone: 404-851-3207 Ext.

ZURICH AMERICAN

INSURANCE OF ILLINOIS

36-2781080 1900 SUMMIT TOWER [email protected]

404-851-3207 Ext.

ZURICH NA ATL CLAIMS 36-4233459 1900 SUMMIT TOWER [email protected]

ZURICH AMERICAN

INSURANCE COMPANY OF

ILLINOIS

36-2781080 3003 SUMMIT BLVD [email protected]

404-851-3207 Ext.

AVIZENT fka FRANK GATES

SERVICE CO

31-4359765 #1 INDEPENDENCE PLAZA [email protected]

800-277-7500 Ext. 29106

ZURICH AMERICAN INSURANCE COMPANY OF

IL

IL 60196 [email protected]

404-851-3207 Ext.

ZURICH SERVICES

CORPORATION

36-3839542 1001 SUMMIT BLVD [email protected]