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NEWSImportant Medicare Part B New Jersey News

Medigap Insurer ID Listing

Below is the most current listing of the Medigap Insurer IDs. Contact 1-888-555-4346 to have a Medigap Insurer ID added or to request an update to an address. Please use these codes when submitting a claim for a beneficiary who has a Medigap Supplemental Insurance Plan that is not on the Automatic Crossover List. The following information is required for Medigap claims:

Electronic Claims

Paper

Information

ANSI 4010A1

1500 Claim Form

Insurance Type Code

2320 SBR/05 Must be ‘MI’ when indicating the other payer is Medigap

N/A

Assignment Of Benefits

2320 OI/03 Value must be ‘Y’

Item 13

Policy Number

2330A NM1/09

Item 9A

Insurer ID

2330B NM1/09

Item 9D

Remember that only assigned Medigap claims from participating providers will be forwarded to secondary Medigap insurers.

Number Name Address City ST ZIP
MA001 AARP/UNITEDHEALTHCARE P.O. BOX 1011 MONTGOMERYVILL PA 18936
MA062 ADMINSTRATIVE BENEFIT PO BOX 3988 PORTLAND OR 92208
MA061 ADMINISTRATION ASSOCI 734 15TH ST NW STE 5 WASHINGTON DC 20055
MA063 AFSCME 3001 WALNUT ST. PHILADELPHIA PA 19104
MA057 AGIA, INC. 1155 EUGENIA PLACE CARPINTERIA CA 93013
MA043 AIDE ASSOC. FOR LUTHE 4321 BALLARD RD APPLETON WI 54919
MA026 AIG LIFE INS. ONE ALICO PLAZA WILMINGTON DE 19801
MA065 ALBERT H. WOHLERS & C 1440 N. NORTHWEST HW PARK RIDGE IL 60068
MA013 ALICARE PO BOX 1442 NEW YORK NY 10116
MA067 ALL AMERICAN LIFE INS 3600 ROUTE 66 NEPTUNE NJ 07754
MA049 ALLIANZ LIFE INS OF N 1750 HENNEPIN AVE MINNEAPOLIS MN 55403
MA015 ALLIANCE FAIRWAY CORP 4350 HADDONFIELD RD PENNSAUKEN NJ 08109
MA079 AMERICAN NATIONAL INS ONE MOODY PLAZA GALVESTON TX 77550
MA050 AMERICAN COMBINED INS P.O. BOX 1009 LANGHORNE PA 19047
MA037 AMERICAN LIFE ASSURAN P.O. BOX 130 PENSACOLA FL 32591
MA055 AMERICAN GENERAL LIFE P.O. BOX 10845 CLEARWATER FL 33757
MA010 AMERICAN TRAVELLERS L P.O. BOX 10319 DES MOINES IA 50306
MA052 AMERICARE/AMER REPUBL P.O. BOX 1 DES MOINES IA 50310
MA033 AMERICAN HARDWARE MUT P.O. BOX 435 MINNEAPOLIS MN 55440
MA027 AMERICAN STANDARD LIF P.O. BOX 3248 ENID OK 73702
MA009 AMERICAN LIFE INS P.O. BOX 1600 DALLAS TX 75221
MA028 AMERICAN EXCHANGE LIF P.O. BOX 1530 DALLAS TX 75221
MA036 AMERICAN INSURANCE CO P.O. BOX 2650 WACO TX 76702
MA051 AMERICAN INCOME LIFE P.O. BOX 2608 WACO TX 76797
MA035 AMERICAN INDUSTRIES L P.O. BOX 2952 HOUSTON TX 77252
MA017 AMERICA REPUBLIC INS PO BOX 10 DES MOINE IA 50301
MA077 AMERICAN MILITARY SOC PO BOX 96987 WASHINGTON DC 20090
MA081 AMERICAN PUBLIC LIFE PO BOX 925 JACKSON MS 39205
MA082 AMERICAN UNITED LIFE PO BOX 368 INDIANAPOLIS IN 46206
MA075 AMERICAN LIFE & CASUA PO BOX 9163 DES MOINES IA 50306
MA074 AMERICAN INVESTORS AS PO BOX 247 SALT LAKE CITY UT 84110
MA076 AMERICAN MANU. MUTUAL STAT. ACTU., B-2 LONG GROVE IL 60049
MA078 AMERICAN MOTORIST INS STAT. ACTU., B-2 LONG GROVE IL 60049
MA083 AMERICAN WESTERN LIFE 100 FOSTER CITY BLVD FOSTER CITY CA 94404
MA012 AMERICARE WM MCGINLEY 108 KINGS HWY E HADDONFIELD NJ 8033
MA071 AMERICAN BANKERS INS 11222 QUAIL ROOST DR MIAMI FL 33157
MA016 AMERICAN BENEFIT 119 S CENTRE ST CUMBERLAND MD 21502
MA070 AMERICAN ADMINISTRATI 1515 WOODFIELD ROAD SCHAUMBURG IL 60173
MA053 AMERICARE PROTECTION 2607 WALNUT HILL STE DALLAS TX 75220
MA024 AMERICAN LIFE AND ACC 2909 N. BUCKNER DALLAS TX 75221
MA084 AMERICARE 312 BLVD OF THE ALLI PITTSBURGH PA 15222
MA030 AMERICAN COMMUNITY MU 39201 SEVEN MILE RD. LIVONIA MI 48152
MA029 AMERICAN COMBINED LIF 4850 STREET RD. TREVOSE PA 19071
MA073 AMERICAN FAMILY MUTUA 6000 AMERICAN PKWY. MADISON WI 53783
MA007 AMERICAN INTEGRITY 777 MAIN ST SUITE 90 FORT WORTH TX 76102
MA210 ANTHEM INSURANCE COMP 220 VIRGINIA AVE INDIANAPOLIS IN 46204
MA086 ANTHEM LIFE INS. CO. 1750 CREEKSIDE OAKS SACRAMENTO CA 95833
MA085 ANTHEM LIFE INS. CO. 828 TAFT AVENUE ORANGE CA 92665
MA011 ARKANSAS BC & BS P.O. BOX 2181 LITTLE ROCK AR 72203
MA045 ASSOCIATED DOCTORS HE P.O. BOX 3013 LANHORNE PA 19047
MA046 ASSOCIATED INSURANCE P.O. BOX 957 INDIANAPOLIS IN 46206
MA058 ASSOCIATED MUTUAL HOS 2047 EAST 9 MILE RD WARREN MI 48091
MA089 ASSURED INVESTORS LIF 1005 W ORANGEBURG, S MODESTO CA 95350
MA022 ATLANTIC AMERICAN LIF 4370 PEACHTREE RD. N ATLANTA GA 30319
MA047 ATLANTIC & PACIFIC IN 9777 S. YOSEMITE ST. LITTLETON CO 80126
MA021 AUSA MASTERCARE INS. P.O. BOX 10421 DES MOINES IA 50306
MB002 BANKERS LIFE & CASUAL CONSECO CARMEL IN 46032
MB079 BANKERS UNITED LIFE A PO BOX 97 SCRANTON PA 18504
MB001 BANKERS FIDELITY 4370 PEACHTREE RD N ATLANTA GA 30319
MB041 BC & BS OF SOUTH CARO I-20 EAST AT ALPINE COLUMBIA SC 29219
MB046 BC & BS OF VERMONT ONE EAST ROAD BERLIN VT 5602
MB050 BC & BS OF WESTERN NE P O BOX 80 BUFFALO NY 14240
MB073 BC & BS OF VERMONT P.O. BOX 186 MONTPELIER VT 5601
MB077 BC & BS OF GEORGIA P.O. BOX 7368 COLUMBUS GA 31908
MB071 BC & BS OF OHIO P.O. BOX 943 TOLEDO OH 43656
MB013 BC & BS OF INDIANA P.O. BOX 7025 INDIANAPOLIS IN 46207
MB038 BC & BS OF OREGON P.O. BOX 1071 PORTLAND OR 97207
MB008 BC & BS OF CONNECTICU PO BOX 1019 NORTH HAVEN CT 6473
MB024 BC & BS OF MINNESOTA PO BOX 64560 ST PAUL MN 55164
MB043 BC & BS OF TEXAS PO BOX 655730 DALLAS TX 75265
MB020 BC & BS OF MASSACHUSE 100 SUMMER STREET BOSTON MA 2110
MC014 CALIFORNIA FARM BUREA P.O. BOX 15016-1016 SACRAMENTO CA 95851
MC044 CAPITAL SECURITY LIFE PO BOX 61 DURHAM NC 27702
MC038 CARE AMERICA LIFE INS 20520 NORDHOFF CHATSWORTH CA 91311
MC045 CATHOLIC ASSOC OF FOR 347 COMMONWEALTH AVE BOSTON MA 02115
MC040 CENTRAL SECURITY LIFE P.O. BOX 833879 RICHARDSON TX 75083
MC041 CENTRAL MASSACHUSETTS 100 FRONT ST. WORCESTER MA 01608
ML022 CENTRAL UNITED LIFE I 2727 ALLEN PARKWAY HOUSTON TX 77019
MC035 CERTIFIED LIFE INSURA 222 MERCHANDISE MART CHICAGO IL 60654
MC048 CHAMPION DENTAL SVCS. 940 W. PORT PLAZA ST ST LOUIS MO 63146
MC015 CHRISTIAN FIDELITY LI 2001 BATES DR. WAXAHACHIE TX 75165
MC020 CINCINNATI LIFE INS. P.O. BOX 145496 CINCINNATI OH 45250
MC050 CINCINNATI LIFE INS. PO BOX 140167 AUSTIN TX 78714
MC049 CINCINNATI EQUITABLE 5910 HARPER ROAD CLEVELAND OH 44139
MC025 CLALLAM COUNTY PHYSIC P.O. BOX 1307 PT. ANGELES WA 98362
MC055 COLUMBIA UNIVERSAL LI PO BOX 200225 AUSTIN TX 78720
MC003 COLUMBIA HEALTH SERVI 312 S.E. STONEMILL D VANCOUVER WA 98684
MC007 COMMONWEALTH MUTUAL P.O. BOX 33335 BALTIMORE MD 21218
MC016 COMMONWEALTH NATIONAL P.O. BOX 1560 CLEVELAND MS 38732
MC006 COMMONWEALTH LIFE 7720 RIVERS EDGE DR COLUMBUS OH 43235
MC051 COMMUNITY HEALTH PLAN 1202 TROY-SCHENECTAD LATHAM NY 12110
MC008 COMMUNITY MUTUAL 1351 WILLIAM HOWARD CINCINNATI OH 45206
MC024 COMPCARE HEALTH SERVI P.O. BOX 1581 MILWAUKEE WI 53201
MC052 COMPCARE HEALTH SVC. 401 WEST MICHIGAN ST MILWAUKEE WI 53201
MC043 CONESTOGA LIFE ASSURA P.O. BOX 7777 LANCASTER PA 17604
MC053 CONSOLIDATED BENEFITS PO BOX 3988 PORTLAND OR 97208
MC036 CONSUMERS UNITED INS. 1150 CONNECTICUT AVE WASHINGTON DC 20036
MC032 CONTINENTAL CASUALTY P.O. BOX 593925 ORLANDO FL 32859
MC026 CONTINENTAL LIFE INS. P.O. BOX 118 BRENTWOOD TN 37024
MC037 CONTINENTAL CASUALTY 3335 WALBASH-CNA PLA CHICAGO IL 60685
MC029 COSMOPOLITAN LIFE INS P.O. BOX 4171 WOODLAND HILLS CA 91364
MC023 COUNTRY LIFE INS. CO. P.O. BOX 2000 BLOOMINGTON IL 61702
MC054 CUNA MUTUAL PO BOX 2995 MADISON WI 53701
MD001 D S M M I S CO INS 122 C STREET N W WASHINGTON DC 20001
MD002 DALLAS GENERAL LIFE P.O. BOX 1080 DALLAS TX 75221
MD003 DELMARVA PO BOX 2410 EASTON MD 21601
MD005 DIRECT RESPONSE ADMIN 7815 TELEGRAPH ROAD BLOOMINGTON MN 55438
MD004 DONEGAL MUTUAL INS 1195 RIVER RD MARIETTA PA 17547
ME012 EBA 620 SE MADISON TOPEKA KS 66607
ME004 EDUCATORS MUTUAL INS. 852 E. ARROWHEAD LN. MURRAY UT 84107
ME014 EDUCATORS INSURANCE C 852 ARROWHEAD LANE MURRAY UT 84107
ME015 EHD ADMIN INSURANCE PO BOX 3080 LANCASTER PA 17603
ME005 ELECTRIC MUTUAL BENEF P.O. BOX 27008 SALT LAKE CITY UT 84127
ME016 ELM CO. AGWAY. 180 CLEMENS CIR. ELMIRA NY 14901
ME017 EMERALD LIFE CO. OF A PO BOX 16526 COLUMBUS OH 43216
ME019 EMPLOYERS HEALTH INS. 1100 EMPLOYERS BLVD. GREEN BAY WI 54344
ME006 EPIC LIFE INSURANCE 6525 GRAND TETON PLA MADISON WI 53705
ME010 EQUITABLE LIFE INS. AMERICAN GENERAL CTR NASHVILLE TN 37250
ME009 EQUITABLE LIFE ASSURA P.O. BOX 3000 LANCASTER SC 29721
ME011 EQUITY BENEFIT LIFE I 4808 N. 22ND ST. PHOENIX AZ 85016
ME020 EXECUTIVE FUND LIFE I 1001 WADE AVENUE RALEIGH NC 27605
MF009 FARM AND HOME LIFE IN 300 W OSBORN RD. PHOENIX AZ 85013
MF026 FARMERS AND TRADERS L 960 JAMES ST PO BOX SYRACUSE NY 13201
MF027 FARMLAND LIFE INS. CO 1963 BELL AVENUE DES MOINES IA 50315
MF011 FEDERATED INVESTORS L P.O. BOX 1009 LANGHORNE PA 19049
MF029 FEDERATED MUTUAL INS. 121 EAST PARK SQUARE QWATONNA MN 55060
MF010 FEDERAL LIFE INS. 3750 W. DEERFIELD RD RIVERWOODS IL 60015
MF031 FHP PO BOX 441170 AURORA CO 80044
MF015 FHP LIFE INS. CO. P.O. BOX 20840 FOUNTAIN VALLE CA 92708
MF021 FIDELITY SECURITY LIF 3130 BROADWAY KANSAS CITY MO 64111
MF014 FINANCIAL SECURITY LI 2525 E. ARIZ. BILTMO PHOENIX AZ 85016
MN019 FIRST PROVIDIAN LIFE& ONE MARINE MIDLAND P BINGHAMTON NY 13902
MF013 FIRST NATIONAL LIFE P.O. BOX 130 PENSACOLA FL 32591
MF016 FIRST CENTENNIAL LIFE P.O. BOX 149151 AUSTIN TX 78714
MF017 FIRST HEALTH OF ARIZO P.O. BOX 1763 SUN CITY AZ 85372
MF005 FIRST HEALTH P.O. BOX 22530 TUCSON AZ 85734
MF023 FIRST FARWEST P.O. BOX 8738 PORTLAND OR 97208
MF007 FIRST NATIONAL LIFE 7 CLAYTON ST. MONTGOMERY AL 36197
MF030 FIRST CONNECTICUT LIF 8 FAIRFIELD BLVD. WALLINGFORD CT 06492
MF004 FKA HAWAIIN MED SERV PO BOX 8 HONOLULU HI 96808
MF008 FLEET RESERVE ASSOC. 1776 WESTLAKES PKY DES MOINES IA 50398
MF022 FLIGHT-CARE P.O. BOX 10401 DES MOINES IA 50306
MF020 FOREMOST LIFE INS. P.O. BOX 2450 GRAND RAPIDS MI 49501
MF024 FOUNDATION HEALTH PO BOX 255700 SACRAMENTO CA 95865
MF003 FRA INSURANCE PLAN PO BOX 10340 DES MOINES IA 50306
MF002 FRA/MILLICARE HEALTH 2100 M STREET N.W. WASHINGTON DC 20063
MG019 GARDEN STATE LIFE INS GEICO PLAZA WASHINGTON DC 20076
MG021 GEORGIA LIFE & HEALTH P.O. BOX 79326 HOUSTON TX 77279
MG024 GEORGE WASH UNIV HEAL 1901 PENN AVE. NW WASHINGTON DC 20006
MG001 GERBER LIFE INS CO PO BOX 2088 GRAND RAPIDS MI 49501
MG007 GLOBE LIFE AND ACCIDE 2909 N BUCKNER BLVD DALLAS TX 75221
MG025 GLOBE LIFE INSURANCE 5050 BROADWAY CHICAGO IL 60640
MG008 GOLDEN RULE INS. GOLDEN RULE BLD. LAWRENCEVILLE IL 62439
MG018 GOLDEN STATE MUTUAL I P.O. BOX 2332, TERMI LOS ANGELES CA 90051
MG015 GOLDEN STATE MUTUAL 2001 S. BEACH ST. ST FT. WORTH TX 76103
MG005 GOLDEN RULE INS 7440 WOODLAND DR INDIANAPOLIS IN 46278
MG017 GRAYS HARBOR MEDICAL 421 W. STATE ST. ABERDEEN WA 98520
MG012 GREATER LACROSSE HEAL P.O. BOX 38 LA CROSSE WI 54602
MG010 GREAT MIDWEST LIFE IN P.O. BOX 181493 DALLAS TX 75218
MG027 GREATER ATLANTIC INS. PO BOX 8139 PHILADELPHIA PA 19101
MG009 GREAT AMERICAN RESERV 11815 N. PENNSYLVANI CARMEL IN 46032
MG011 GREAT REPUBLIC INS. 226 2ND AVE. WEST SEATTLE WA 98119
MG003 GREAT WEST LIFE 4700 N STATE ROAD FT LAUDERDALE FL 33319
MG028 GP. HEALTH OF SC. WIS ONE SOUTH PARK STREE MADISON WI 53715
MG029 GP. HEALTH SERVICE OF 1215 S. BOULDER TULSA OK 74119
MG030 GP. LIFE & HEALTH INS 901 S. CENTRAL EXPRE RICHARDSON TX 75080
MG004 GUARANTEE TRUST LIFE 1275 MILWAUKEE AVE GLENVIEW IL 60025
MG013 GUARANTEE RESERVE LIF 530 RIVER OAKS WEST CALUMET CITY IL 60409
MG031 GUARDIAN LIFE INS. CO 201 PARK AVE. SOUTH NEW YORK NY 10003
MG016 GULF LIFE INS. AMERICIAN GENERAL CT NASHVILLE TN 38250
MH011 HARBOR INSURANCE 4201 WILSHIRE BLVD. LOS ANGELES CA 90010
MH023 HARRIS METHODIST HEAL 611 RYAN PLAZA DR. ARLINGTON TX 76011
MH001 HARTFORD INSURANCE P.O. BOX 2818 HARTFORD CT 06104
MH021 HARTFORD INS. CO. 1776 W. LAKES PKWY. DES MOINES IA 50398
MH028 HARVARD COMM. HEALTH PO BOX 15027 BOSTON MA 02215
MH012 HARVARD COMM. HEALTH 27 MICA LN. WELLESLEY MA 02181
MH002 HAWAII MEDICAL SERVIC 818 KEEAUMOKU STREET HONOLULU HI 96814
MH013 HAWKEYE NATIONAL LIFE 2700 WESTOWN PKWY. WEST DES MOINE IA 50265
MH017 HEALTHGUARD SERVICES, P.O. BOX 10106 EUGENE OR 97440
MH016 HEALTHCARE INC. P.O. BOX 38 GREENACRES WA 99016
MH005 HEALTHPLUS PO BOX 509 GREENBELT MD 20768
MH030 HEALTHCARE MGMT. SVCS PO BOX 22681 LONG BEACH CA 90801
MH031 HEALTH INS. CORP. ALA PO BOX 5348 BELLINGHAM WA 98227
MH003 HEALTH CARE 2000 1407 YORK RD. STE 30 LUTHERVILLE MD 21093
MH032 HEALTHGUARD SVCS WASH 1752 IOWA STREET BELLINGHAM WA 98226
MH015 HEALTH CARE SERVICE C 233 N. MICHIGAN AVE. CHICAGO IL 60601
MH014 HEALTH & LIFE INS. 304 N. MAIN ST. ROCKFORD IL 61101
MH018 HERITAGE LIFE INS. 30851 W. AGOURA RD. AGOURA HILLS CA 91301
MH024 HILL COUNTRY LIFE INS P.O. BOX 200225 AUSTIN TX 78720
MH033 HMO MIDWEST PO BOX 64560 ST. PAUL MN 55164
MH034 HMO OF WISCONSIN INS. 840 CAROLINA STREET SAUK CITY WI 53583
MH019 HOLY FAMILY SOCIETY O 1 FAIRLAND DR. JOLIET IL 60434
MH025 HORACE MANN LIFE INS. P.O. BOX 20487 SPRINGFIELD IL 62708
MH020 HOSPITAL SERVICE ASSO 70 N. MAIN ST. WILKES BARRE PA 18711
MH010 HUMANA GOLD P.O. BOX 2180 LOUISVILLE KY 40201
MH035 HUMANA HEALTH INS. CO PO BOX 2180 LOUISVILLE KY 40201
MH036 HUMANA HEALTH INS CO PO BOX 2180 LOUISVILLE KY 40201
MH037 HUMANA HEALTH PLAN NE PO BOX 2180 LOUISVILLE KY 40201
MH038 HUMANA INSURANCE CO. PO BOX 2180 LOUISVILLE KY 40201
MH007 HUMANA HEALTH CARE PR 5401 W KENNEDY BLVD TAMPA FL 33609
MH027 HUMANA REGIONAL SERVI 8119 DATAPOINT SAN ANTONIO TX 78229
MI005 IASD HEALTH SERVICES 636 GRAND AVE. DES MOINES IA 50309
MI020 IDEAL LIFE INSURANCE PO BOX 9100 CLEARWATER FL 34618
MI006 INCOME SECURITY INS. 401 PARKWAY BLVD. BROOMALL PA 19008
MI008 INDUSTRIAL CASUALTY I 137 N. OAK PARK AVE. OAK PARK IL 60302
MI009 INDUSTRIAL LIFE INS. 3815 MONTROSE BLVD. HOUSTON TX 77006
MI011 INTEGRITY NATIONAL LI P.O. BOX 32350 LOUISVILLE KY 41232
MI013 INTERCONTINENTAL LIFE P.O. BOX 13564 PHILADELPHIA PA 19101
MI012 INTERCONTINENTAL LIFE P.O. BOX 149138 AUSTIN TX 78714
MI023 INTERNATIONAL LIFE IN PO BOX 97 SCRANTON PA 18504
MI014 INTERGROUP PREPAID HE 1010 N. FINANCE DR. TUSCON AZ 85710
MI010 INTERNATIONAL BENEFIT 4150 INTERNATIONAL P FT. WORTH TX 76109
MI001 INTERNATIONAL MONETAR 700 19TH ST NW ROOM WASHINGTON DC 20431
MI018 INTERSTATE SERVICE IN 7270 RIVERS EDGE DR. COLUMBUS OH 43235
MI015 INVESTORS CONSOLIDATE P.O. BOX 30 DURHAM NC 27702
MI004 INVESTORS HERITAGE LI 200 CAPITAL AVE. FRANKFORT KY 40602
MI016 INVESTORS DIVERSIFIED 3636 S. SHERWOOD FOR BATON ROUGE LA 70816
MI024 IRON WORKERS BENEFIT 6401 CASTOR AVENUE PHILADELPHIA PA 19149
MI017 ITT LIFE INSURANCE CO 505 N. HWY. 169 MINNEAPOLIS MN 55441
MJ002 JC PENNEY