INDIANA. National Group Roster and Delta Dental Addresses

INDIANA

National Group Roster and Delta Dental Addresses

Delta Dental National Groups The national Delta Dental system provides seamless benefit administration for all groups, even those with employees/members in more than one state. Delta Dental Premier, Delta Dental PPO (Point-of-Service), Delta Dental PPO (Standard) and DeltaCare are available nationwide. Please note Delta Dental PPO (Point-ofService) will be referenced as POS on the following pages. Administration, enrollment, and claims are handled by the Delta Dental that contracts with the national group. The contracting Delta Dental is designated as the control plan for that group, and all claims, inquiries, eligibility requests, and other communications regarding that group’s enrollees must be directed to the control plan. Usually, the state in which a company’s corporate headquarters is located determines which Delta Dental is the control plan. In each state, local Delta Dental participation agreements include national groups. Participating dentists have the advantage of extending their patient base to enrollees of all national groups in their area. Delta Dental serves nearly one-quarter of Americans with dental insurance and provides dental coverage to more than 54 million people in more than 93,000 groups across the nation. This means that dentists and their staff may work with a number of different Delta Dental member companies. Administration of claims is similar and consistent throughout the Delta Dental system. The following information applies to all national groups:       

To identify the control plan, go to www.deltadental.com and access the National Portal to look up information on any Delta Dental enrollee. (Due to the sensitive nature of the information on this Web site, dentists are required to register and select a password.) Always mail claims and/or predeterminations to the Delta Dental listed as the control plan for that group. The control plan processes claims and issues payments to the participating dentist. Usually, the control plan follows the same processing policies as the local Delta Dental. Inquiries about claims should be addressed to the Delta Dental listed as the control plan for that group. If the patient is covered by a Delta Dental Premier plan, Delta Dental will base the allowed amount on Delta Dental’s maximum payable amount for the geographic region where treatment was rendered. If the patient is covered by a Delta Dental PPO plan, Delta Dental will base the allowed amount on the fee table for the geographic region where treatment was rendered. Regardless of program type, the amount payable depends on the enrollee’s benefits, including copayment percentages, limitations, exclusions, maximums, and deductibles. Enrollees of DeltaCare, our national dental HMO-type plan, are covered only for treatment provided by the dental office they selected when enrolling or by a DeltaCare specialist to whom they were referred by that office.

Following is a list of national groups that have employees located in Indiana as of April 1, 2013. All claims, inquiries, and confirmation of program type should be directed to their respective control plan. *Please note: Some groups may have two states listed under the control plan column. The first state is the control plan; the second state processes claims for that group. Please send claims to the address for the second state. XX Call the control plan to confirm the group number or program type for appropriate benefits.

IN National Group Roster-PRRL

1

04/2013

Group Name 1st Source Corporation 24 Hour Fitness USA, Inc. 5metacom A & P Tool, Inc. A B C Supply Co. Inc. A.B. Dick Company Adtran, Inc. A.E.C./Sterling, Inc. A.E.R.O. Special Education Cooperative AAA Allied Group, Inc. AAF – McQuay, Inc. AAI Corporation Aakron Rule AAMCO Transmissions, Inc. AARP Abatement Worker's National Health and Welfare Fund Abiomed ABM Industries Incorporated ABN-AMRO Absolute Storage Management, Inc. Acadia Healthcare Company, Inc. Accelerated Health Systems Accessory Associates, Inc. Accor Hospitality ACE Cash Express, Inc. ACH Food Companies, INC. Acrisure, LLC ACS State and Local Action Brace and Prosthetic, Inc. ActioNet, Inc. Active Day Inc. Acuity Healthcare, LP Acxiom Adams Communications Management Corp. Adams Keegan, Inc. Addison Wesley Longman Addus Healthcare Aditya Birla Minacs dba The Minacs Group USA Administrative Employer Services Adobe Systems Inc. Adrian Dominican Sisters ADTRAN Advance America Cash Advance Centers, Inc. Advance Auto Parts Advance Food Company Advance Municipal Equipment, Inc. Advanstar Communications Inc Adventist Health Systems IN National Group Roster-PRRL

Group Number 0000104 XX 0000292 0000236 XX 20068 1346 5895 2019 0000116 5484 7205 XX 5024 5461 0000207

Program Type Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental Premier Delta Dental PPO (XX) Delta Dental PPO (POS)

Control Plan Indiana/Michigan* California Indiana/Michigan* Ohio/Michigan* Wisconsin Illinois DDIC Illinois Illinois Ohio/Michigan* Minnesota Pennsylvania New York Pennsylvania Pennsylvania Michigan

007505 XX XX 0005129 0005603 XX 5473 XX XX 0004129 0005526 XX 0000068 600264 XX 15311 9180 XX

XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (XX) XX XX

Massachusetts New York Illinois Tennessee Tennessee Illinois Rhode Island DDIC DDIC Tennessee Michigan Texas Indiana/Michigan* Virginia Pennsylvania Texas Arkansas Minnesota

0001916 5355 XX 0000623

Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS)

Tennessee Massachusetts Illinois Michigan

0009684 2700 0000897 019562 6102

Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX

Michigan California Michigan Alabama South Carolina

61590000 XX 0000140 2778 1493

Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX)

Virginia Oklahoma Indiana/Michigan* California Florida

2

04/2013

Group Name Advest, Inc. ADVICS North America, Inc. Aegis Media Aegon USA, Inc. AEI Resources and Indiana/West Virginia Coal Aeropostale, Inc. Aesseal AetherSystems Affiliated Computer Services (ACS) AFFINA AFGE AFGE-Local #375 AFL Telecommunications, Inc., Aftermarket Technologies Ag-Chem AGCO Corporation AGFA Corporation Agilent Technologies AgReliant Genetics Agrigenetics Ahead Human Resources Ahresty Wilmington Corporation AIM Air Products and Chemicals, Inc. Air Force One, Inc. Air Medical Group Holdings Air Products and Chemicals, Inc. Air T, Inc. AirServ Corporation AirTran Airways AirWorx Aisin Chemical, LLC Aisin Holdings of America, Inc. AIT Worldwide Logistics AK Tube LLC Akima LLC AKZO Coatings, Inc. Alaska Airlines Albertson’s Inc. Albertson’s, Inc. Aleris Ohio Management, Inc. Alfe Heat Treating, Inc. Alkermes, Inc. Allegiance Health Allegro Microsystems Inc. Allen County Public Library Allergan, Inc Alliance Entertainment Alliant Energy Allied Mineral Products, Inc. Allied Telesyn, Inc. Allison Transmission IN National Group Roster-PRRL

Group Number XX 0000100 XX XX XX

Program Type XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier Delta Dental Premier

Control Plan New Jersey Indiana/Michigan* New York Iowa Kentucky

2393 0001448 XX 3780 2043 8432 XX XX 2026 50592 11-3763 9352 XX 0000112 0000081 XX 0222 8000 XX 0001073 XX XX 0433538 03887 XX 0000206 0000117 0005751 20192 0000145 0554931 5915 XX XX XX 0005089 0005774 007588 0007165 XX 0000440 5370 15329 XX 0000128 9106 0001030

XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental PPO Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (XX) XX XX Delta Dental PPO (Standard) XX XX XX Delta Dental PPO XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS) XX Delta Dental Premier XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (Standard) DeltaCare XX Delta Dental PPO (POS) XX Delta Dental PPO (POS)

New York Tennessee Pennsylvania Texas Illinois Illinois Illinois Missouri Illinois Minnesota Georgia New Jersey California Indiana/Michigan* Indiana/Michigan* Kentucky Ohio/Michigan* Massachusetts Pennsylvania Ohio/Michigan* DDIC Pennsylvania North Carolina/Michigan* Georgia DDIC Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Illinois Ohio/Michigan* North Carolina/Michigan* Kentucky Washington Idaho Minnesota Ohio/Michigan* Indiana/Michigan* Massachusetts Michigan Massachusetts Indiana/Michigan* California Florida Wisconsin Ohio/Michigan* Wisconsin Indiana/Michigan*

3

04/2013

Group Name Allmerica Alloy Merchandising Group, Inc. Alltel Corp. Albertson’s Inc. Alpha Natural Resources ALSAC Altarum Institute Altegrity, Inc. Alterra Healthcare Corp Altra Industrial Motion AM General LLC Amarr Garage Doors AMCOR Amcor Flexibles AMCOR RIGID PLASTICS USA, INC. AMCOR Sunclipse, North America/CNC Containers Amdocs, Inc. Amedistaff, LLC dba The Right Solutions AmerCable Corporation Ameren (Union Segments) Ameresco, Inc. America’s Car Mart, Inc. American Achievement Corporation American Automobile Association (AAA) American Axle & Manufacturing, Inc. American Biosystems, Inc. American Building Maintenance American Cancer Society American Casino and Entertainment Properties American Cast Iron Pipe Company American Commercial Lines American Eagle Outfitters American Express American Express Financial Corporation American Family Insurance American Farm Bureau American Financial Group American Hardware Insurance Group American Heart Associations American Home Patient American Management Group American Media Operations American Mitsuba Corporation American Nursing Care dba Consolidated Health Services American Nursing Services American Roller Company American Senior Benefit Association American Senior Communities IN National Group Roster-PRRL

Group Number 1159 2400 90870001 009610 XX 0004143 9961-0001 600253 90802 006272 0009665 1498 XX XX 0005474 XX XX 9452

Program Type XX XX Delta Dental Premier XX XX Delta Dental PPO (POS) XX Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (Standard) Delta Dental Premier XX XX Delta Dental PPO (POS) XX XX XX

Control Plan Massachusetts New York Arkansas Minnesota Virginia Tennessee Michigan Virginia Wisconsin Massachusetts Indiana/Michigan* Kansas Illinois Washington Michigan Washington Missouri Arkansas

9062 XX 001808 9433 XX 5198 0008370 & 0009706 50594 5919 016827 XX

Delta Dental Premier XX XX XX XX Delta Dental Premier Delta Dental PPO (POS)

Arkansas Missouri Massachusetts Arkansas Texas DDIC Michigan

Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (XX)

Minnesota California Alabama Nevada

01-1377 0001190 XX XX 5651 5080 20032 0001035 5938 44-4088 0004096 5154 10-3773 0005772 0005423

XX Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Alabama Indiana/Michigan* Pennsylvania Pennsylvania Minnesota Wisconsin Illinois Ohio/Michigan* Minnesota Texas Tennessee DDIC Florida Michigan Ohio/Michigan*

XX 53898 XX 0000078

Delta Dental PPO Delta Dental PPO (XX) XX Delta Dental PPO (POS)

Louisiana Wisconsin Illinois Indiana/Michigan*

4

04/2013

Group Name American Tower Corporation Americas Styrenics LLC America’s Car Mart America’s Car Mart, Inc. Americomm Direct Marketing, Inc. Amerinet Amerisure Mutual Insurance Company AMF Bowling Worldwide, Inc. Amica Mutual Insurance Company AMLI Residential Ampac Holdings, LLC AMPCO Amphenol Corp Amstar Mortgage Company Amsted Industries, Inc. Amsurg Corp. Amtrol Amway AmWINS Group, Inc. Amylin Pharmaceuticals, Inc. Analogic Corp. Andersen Corporation Android Industries Angio dynamics, Inc. Anheuser-Busch Annett Holdings, Inc. Aptalis Pharma Apertus Technologies, Inc. APEX Contractors API Group, Inc. Appleton papers Inc. Applied Graphics Technologies Applied Materials, Inc. Applied Power, Inc. APW Aquent Aramark Education Resources, Inc. Aramark Uniform & Career Apparel Aranon Corporation Arch Capital Services, Inc. Arch Coal, Inc. Archer Daniel Midland Architectural Iron Workers Architectural Iron Workers Local No. 63 Welfare Fund Architectural Testing, Inc. Argonne National Laboratory Ariens Company Arkema Armada/Hub One Logistics Armstrong Manufacturing Inc. Armstrong Relocation IN National Group Roster-PRRL

Group Number 003903 0001514 XX XX 6938 XX 0005201 8626 5813 20154 0000122 5757 4543 XX 20051 0001378 5494 0001072 0001021 XX XX XX 0009746 & 0009747 XX 6903 XX 0000013 5625 6333 XX XX 2572 XX 5448 5448 006127 6858 2835 103702 XX 5996 2103 XX 20078

Program Type XX Delta Dental PPO (POS) XX XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX XX PPO (Point-of-Service) XX Delta Dental PPO (POS) XX XX XX XX Delta Dental PPO (POS)

Control Plan Massachusetts Michigan Arkansas Arkansas Missouri Pennsylvania Michigan Virginia Rhode Island Illinois Ohio/Michigan* Pennsylvania New Jersey Texas Illinois Tennessee Rhode Island Michigan North Carolina/Michigan* California Massachusetts Minnesota Michigan

XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier XX XX XX XX XX Delta Dental Premier Delta Dental Premier XX XX Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental Premier XX XX

Pennsylvania Missouri Iowa Ohio/Michigan* Minnesota Virginia Minnesota Wisconsin California California Wisconsin Wisconsin Massachusetts Colorado Pennsylvania Florida New York Missouri Illinois Illinois Illinois

XX 20084 XX 9344 XX 0009268 0002895

XX XX XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Pennsylvania Illinois Wisconsin Pennsylvania Pennsylvania Michigan Tennessee

5

04/2013

Group Name Armstrong World Industries, Inc. Arthrosurface Arthur J Gallagher & Co Asahi Kasei Plastics North America, Inc. Ascension Health Ashland University Ashley Furniture Homestores Ashley Furniture Industries Aspen Technology, Inc. ASSA ABLOY INC Asset Plus Companies Associated Banc Associated Builders & Contractors Associated Pathologists II Associated Pathologists, Llc D/B/A Pathgroup Astaris, LLC ASU Group, The Asurion Athens Paper Company, Inc. ATI Atlanta Public Schools Atlantic Aviation/Airport Atlantic Container Line ATLAS COPCO NORTH AMERICA LLC Atlas Machine and Supply Atlas Oil Company Atos Origin Atria Communities, Inc. Atrium Centers LLC Attachmate Corporation ATTC Mfg. Augat Corporation Aurora Bank Fsb Aurora Flight Sciences, Corp Auspex Systems Austin Tri-Hawk Automotive, Inc. Authentic Fitness Corp. Auto Club Group, The Autocam Corporation AutoGate, Inc. Ave Maria Press, Inc. Averitt Express Avery Dennison Corporation Aviva USA Corporation Avid Technology AVL North America Avocent, Inc. AXA Equitable Axcess Financial Axletech International B E & K, Inc. Bacardi U.S.A., Inc. & Affiliates IN National Group Roster-PRRL

Group Number XX XX 20211 0000186 XX 0000014 XX 54099 003849 4644 XX 50401 XX 0005181 0002994

Program Type XX XX Delta Dental PPO Delta Dental PPO (POS) XX Delta Dental PPO (Standard) XX Delta Dental Premier XX XX Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan Pennsylvania Massachusetts Illinois Michigan Missouri Ohio/Michigan* Wisconsin Wisconsin Massachusetts New Jersey Texas Wisconsin Oregon Tennessee Tennessee

6950 0009297 0004106 0001435 9360 11-3769 XX 9154 9224 690660 0000328 XX 6682 0001003 0609 0000115 XX 9701, 9702 XX 2095 0000142 439 0009191 0001293 0000019 0000064 0004014 XX XX 006866 0000195 XX XX 0000002 0009757 1381 XX

Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX XX XX DeltaCare Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO XX XX Delta Dental PPO (Standard) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) DeltaCare Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX

Missouri Michigan Tennessee Tennessee Arkansas Georgia Texas New Jersey New Jersey Kentucky Michigan Texas Kentucky Ohio/Michigan* Washington Indiana/Michigan* Massachusetts Colorado Pennsylvania California Indiana/Michigan* California Michigan Michigan Ohio/Michigan* Indiana/Michigan* Tennessee California Iowa Massachusetts Michigan DDIC New York Ohio/Michigan* Michigan Alabama DDIC

6

04/2013

Group Name Bader Company Badger Meter Bake-N-Joy Foods Baker & Hostetler LLP Baker Book House Bally Technologies/Rainbow Casino Bally Total Fitness Bank Leumi Trust Company of New York Bank of the West Banta Corporation Bantam Doublesday Dell Baptist Healthcare System Bare Excentuals Barnhart Crane & Rigging Co. BARR LABORATORIES INC BarrierSafe Solutions International Barr-Nunn Transportation, Inc. Barry-Wehmiller Companies, Inc. Bartech Group, The Bartholomew Consolidated Schools Bartlett Incorporated Barton Marlow Company BASF Battelle Memorial Institute Baugo Community School Corporation Bay Bluffs Emmet County Medical Care Facility Bayer Corporation BBN Technologies BCBG Max Azaria Group, Inc. BCN Services BE Aerospace Beam Global Spirits & Wine, Inc. Bear Creek Corp Beaty Construction Company, Inc. Becton Dickinson & Co. Beechmont Press Beelman Truck Co. Behr America, Inc. Behr Process Corporation Bekaert Corp Belcan Corporation Bellisio Foods dba Michelina’s Bell's Brewery, Inc. Belo Corp Bemis Company, Inc. Benchmark Hospitality International Benson Eye Care Bensussen Deutsch & Associates, Inc. Benton Harbor Area Schools Berbee Information Networks Corp IN National Group Roster-PRRL

Group Number 0000049 50302 006572 0001047 0000235 29-9180 & 299182 20213 2238

Program Type Delta Dental PPO (Standard) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX

Control Plan Indiana/Michigan* Wisconsin Massachusetts Ohio/Michigan* Michigan Nevada

Delta Dental PPO XX

Illinois New York

XX 50198 1526 6680 XX 0005794 9226 20233 XX XX 0009808 0000127 005372 0009096 9317 0001033 0000168 0005895

XX Delta Dental Premier Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (Standard) XX Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) DeltaCare Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

California Wisconsin New York/Pennsylvania* Kentucky California Tennessee New Jersey Illinois Iowa Missouri Michigan Indiana/Michigan* Massachusetts Michigan New Jersey Ohio/Michigan* Indiana/Michigan* Michigan

9152 2652 XX 0009452 1502 XX XX 0010040 3780 XX 20053 0009676 2483 0009796 0009565 747207 0005865 XX XX XX 5146 9043 0006113 52005

Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (XX) XX XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX

Pennsylvania Massachusetts Connecticut Michigan Florida Illinois Oregon New Mexico New Jersey Kentucky Illinois Michigan California Ohio/Michigan* Ohio/Michigan* Minnesota Michigan Texas Minnesota DDIC Texas Washington Michigan Wisconsin

7

04/2013

Group Name Bernard C Harris Publishing Berrien Springs Public Schools Bertelsmann, Inc. Best Buy Company, Inc. Bethesda Lutheran Communities BI Incorporated Bidpal Inc. Big Rock Sports Biggs/Gilmore Communications, Inc. Bimbo Bakeries USA Bimbo Foods, Inc./f.k.a. Weston foods, Inc. Biogen Inc. Biomarin Pharmaceuticals bioMerieux Bio-Rad Laboratories Bio-Serv Corporation Biotage, LLC Biovail BJ’s Restaurants Black & Veatch Non-Union Black and Veatch Blanchard Valley Health System Blauer MFG Blooming Blount Bluegreen Corp BMG Entertainment (Bertiesmann, Inc) Bodine Electric Company Boeing Company, The Boilermakers Bon Ton, The Books A Million Booz Allen Hamilton Bose Corporation Bose McKinney & Evans LLP Bosselman Inc. Boston Financial Group, The Boston Scientific Corporation Boston Scientific Retiree Plan Bowers Envelope Company Bowling Green State University Brach’s Confections, Inc. Bradford Soap Works, Inc. Bradley Pharmaceuticals Brady Corporation Braintree Laboratories Brandywine Public Schools Brasfield & Gorrie Brd Trustees N IL Benefit Fund Brembo North America Brethren in Christ Church Brevard County BOCC IN National Group Roster-PRRL

Group Number XX 0000323 1517 50602 54111 & 54211 XX 0000044 0942594 0000399 XX XX

Program Type XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO XX Delta Dental PPO (Standard) XX Delta Dental PPO (POS) XX XX

Control Plan Virginia Michigan New York Minnesota Wisconsin Colorado Indiana/Michigan* North Carolina/Michigan* Michigan Illinois Pennsylvania

XX XX 0006967 5619 0000688 0000540 9193 XX XX 5586 0002073 XX 342 D833 103644 1517 20156 4400 XX 5244 XX 700093 1532 0000209 XX 2967 XX XX 0000110 0009811 5853 5320 9165 51898 8883 0006016 01-1385 XX 0005924 9019 10-6798

XX XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) XX XX XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier XX Delta Dental PPO XX Delta Dental PPO (POS) XX Delta Dental Premier XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (Standard) XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX XX

Massachusetts California North Carolina/Michigan* Colorado Michigan North Carolina/Michigan* New Jersey California Missouri Missouri Ohio/Michigan* Massachusetts Iowa Oregon Florida New York/Pennsylvania* Illinois Washington Kansas Pennsylvania DDIC Virginia Massachusetts Indiana/Michigan* Nebraska Massachusetts Massachusetts Massachusetts Indiana/Michigan* Ohio/Michigan* Illinois Rhode Island New Jersey Wisconsin Massachusetts Michigan Alabama Illinois Michigan Pennsylvania Florida

8

04/2013

Group Name Breyden Products, Inc. Bricklayers and Allied Workers Health and Welfare Fund Bridgestone/Firestone Bridgman Public Schools Briggs & Stratton Bristow Broadcast Music, Inc. Bronson Community Schools Bronson Healthcare Group, Inc. Brookdale – F & B Brookfield RPS, LLC Brookhaven Science Associates Brother International Corporation Brotherhood Health Plan Brownsburg Community School Corporation Broyhill Bruker Biospin Corporation Brunner & Lay, Inc. Brunswick Corporation BSH Appliances Corporation Buca Inc. Buckeye Check Cashing Buckeye Pipe Line Company Buckman Laboratories Buffalo Wild Wings Buffets, Inc. Bulgari USA Inc. Bunge North America Bunzl Distribution USA, Inc. Burlington Coat Factory Burrelle Butler Trucking Company Butler University Butterball LLC C & A Industries, Inc. C & H Distributors C.F. Sauer Company, The CMF & Z, Inc. CNH (Case New Holland) CNH Global C.I.S. Technologies, Incorporated C.M. Offray & Sons C.R. Bard Cabela’s Cabletron Systems Cabot Corporation CACI International, Inc. Cadillac Insurance/Advanced Benefit Solutions Caldwell Industries Calibre Systems, Inc IN National Group Roster-PRRL

Group Number 0000002 0005022

Program Type Delta Dental Premier Delta Dental PPO (POS)

Control Plan Indiana/Michigan* Indiana/Michigan*

0005712 0006234 XX 44-05654 0005138 0006433 0002006 20052 20162 XX 9009 XX 0001145

Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX DeltaCare Delta Dental Premier XX Delta Dental PPO (POS)

Tennessee Michigan Wisconsin Texas Tennessee Michigan Michigan Illinois Illinois New York New Jersey Pennsylvania Indiana/Michigan*

XX 007005 9399 20080 XX XX XX XX 0004092 XX 50561 XX 6958 5159 5507 XX 4456 0007070 0008120 XX 51002 700005 121 51401 XX XX 3981 3732-0001 XX 4786 9850 700085 0000296

XX XX XX XX Delta Dental PPO XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (Standard) Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO Delta Dental Premier Delta Dental Premier Delta Dental PPO Delta Dental PPO (POS)

Missouri Massachusetts Arkansas Illinois California Minnesota Ohio/Michigan* Pennsylvania Tennessee Minnesota Minnesota New York Missouri Missouri New Jersey New Jersey Pennsylvania Indiana/Michigan* North Carolina/Michigan* Nebraska Wisconsin Virginia Iowa Wisconsin Wisconsin Oklahoma New Jersey New Jersey Nebraska New Hampshire Massachusetts Virginia Michigan

XX XX

Delta Dental Premier Delta Dental Premier

Kentucky Virginia

9

04/2013

Group Name California Federal Bank California Field Ironworkers Welfare Plan Trust Callaway Golf/Callaway Golf Ball Operations, Inc. Camp Dresser & McKee Canam Steel Corporation Canberra Industries, Inc. Cannon Cochran Management Services, Inc. Cannondale Corp Capgemini Financial Strategic Services Capital Tire, Inc. Capitol Bancorp, Ltd. Caps Group, The (formerly Group 20136 and 329) Capstone Companies Captain D'S, L.L.C. Car Toys / Wireless Advocates Ancillary Carboloy Inc Cardiac Science Corporation Care Source Management Group Co. CareTech Solutions Careworks of Ohio, Ltd. Cargill Incorporated Cargill – Meat Solutions Carl Buddig Carlex Glass Carlisle Companies Carmel Clay Schools Carnegie Institution for Science Carpenter Co. Carpenter Technology Corporation Carplex, Inc. & American International Finance Inc. Carquest Carrier & Gable, Inc. Carterair International Corp. Carustar Industries Cascade Tissue Group Casey Family Program Casey’s General Stores, Inc. Cass County Road Commission Cass Information Systems Cassopolis Public Schools Casual Male Casual Male Retail Group, Inc. Caterpillar Logistics Services Cathay Industries Catholic Charities USA Catholic Healthcare Partners Catholic Relief Services CBC Companies, Inc. IN National Group Roster-PRRL

Group Number 7527 XX

Program Type Delta Dental Premier XX

Control Plan California California

XX

DeltaCare

California

5896 XX 5276 10842

Delta Dental Premier Delta Dental PPO Delta Dental Premier Delta Dental PPO

Massachusetts Pennsylvania New Jersey Illinois

4597 20135 0000228 0005198 XX

XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX

Connecticut Illinois Ohio/Michigan* Michigan Illinois

01-1368 0005484 XX 9442 XX 0005764 0000004 0009734 051043 XX 2013 0004123 PA8081 0000169 XX 6403 2168 0000141

XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) XX Delta Dental PPO (POS) DeltaCare XX Delta Dental Premier Delta Dental PPO (POS)

Alabama Tennessee Washington Michigan Wisconsin Ohio/Michigan* Michigan Ohio/Michigan* Minnesota Minnesota Illinois Tennessee Pennsylvania Indiana/Michigan* District of Columbia Virginia Pennsylvania Indiana/Michigan*

XX 0005571 5890 11-5951 XX XX XX 0004468 7713 0006152 XX 5323 XX 20152 XX 0009950 XX 0005777

XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO XX XX XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS) XX XX Delta Dental PPO XX XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS)

North Carolina/Michigan* Michigan Pennsylvania Georgia New York Washington Iowa Michigan Missouri Michigan Massachusetts Massachusetts Illinois Illinois Virginia Ohio/Michigan* Pennsylvania Ohio/Michigan*

10

04/2013

Group Name Cbeyond CBL & Associates Management, Inc. CBMC, Inc. CCA Global Partners CCC Group, Inc. CCI/Triad CCL Industries Corporation CCOERA CDC IXIS CDI Headstart Cecil County Public Schools Cedar Rapids, Inc. Celanese Americas Corporation Celtic Management Corporation Centene Management Center Grove Community School Corporation Centerline Capital Group Inc. & Related Companies Central Pennsylvania Teamsters Health & Welfare Fund Central Indiana Gastroenterology Group, P.C. Central Parking System Central State University Centria Centro Centurion Medical Products Century Bank & Trust Century Business Services Century Lending/Century Mortgage CenturyLink Cephalon, Inc. Cequel III Ceridian Corporation Cerro Wire & Cable Co. Certified Floorcovering Service, Inc. CFM Religion Publishing Group, LLC CGI Group, Inc. CH Robinson Worldwide Challenge Electric II, Ltd. Challenge Mfg. Company Challenger Lifts Charles River Laboratories Charles Schwab & Co., Inc. Charette LLC Checkpoint Systems, Inc. Checksmart Financial LLC Chef Solutions Inc. Chelsea Milling Company ChemTreat, Inc. Chemical Financial Corporation IN National Group Roster-PRRL

Group Number 11-3802 0002747 0005579 XX 44-3922 XX 006130 XX XX XX XX 90153 03258 05127 XX 0007024

Program Type XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX XX XX XX XX XX Delta Dental Premier Delta Dental PPO (XX) Delta Dental PPO (XX) XX Delta Dental PPO (POS)

Control Plan Georgia Tennessee Tennessee Missouri Texas Texas Massachusetts Colorado Massachusetts Colorado Pennsylvania Iowa Texas Louisiana Missouri Indiana/Michigan*

XX

XX

New York

XX

XX

Pennsylvania

0000040

Delta Dental PPO (POS)

Indiana/Michigan*

0007404 0000208 9199 XX 0000250 0003090 90604 690830 51204 XX XX 50575 11344 0000011 0000253 700095 & 600257 50598 0000269 0001331 6576-DU XX 5783 2564 5253 0000226 20060 0005111 6296 0001283

Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (XX) Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX)

Tennessee Ohio/Michigan* Pennsylvania Iowa Michigan Michigan Kansas Kentucky Kansas Pennsylvania Missouri Minnesota Florida Indiana/Michigan* Ohio/Michigan* Virginia

Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Minnesota Ohio/Michigan* Michigan Kentucky Massachusetts California Massachusetts New Jersey Ohio/Michigan* Illinois Michigan Virginia Michigan

11

04/2013

Group Name Chevy’s Taco Bell Chicago Regional Council of Carpenters Benefit Funds Chicago Tribune Publisher Chipotle ChoicePoint, Inc. Christian Broadcasting Network Christian Church (Disciples of Christ) Health Care Benefit Trust Christian Church Homes Christopher & Banks Corporation Chrysler

Church of the Nazarene Cincinnati Insurance Company, its Subsidiaries and Affiliates, The Ciproms, Inc. Circle City Security Systems, Inc. Cisco Companies, The Citadel Investment Group Citadel Plastics Holding Inc. Citigroup, Inc. Citizens Energy Group Citizens Health Corporation Citizens Republic Bancorp City Financial Corporation City of Anderson City of Angola City of Auburn Hills City of Austin (Retirees) City of Battle Creek City of Dearborn - Retirees City of Garland City of Hobbs City of Indianapolis City of Lansing City of Louisville City of Lowell City of Romulus City of Royal Oak Claire’s Stores, Inc. Clarcor Inc. Clark Memorial Hospital Clarke American Checks, Inc. and Affiliated Companies Clarks Companies Clarkson University Classified Ventures Clay Community Schools Clean Harbors Environmental Services Clear Channel Communications IN National Group Roster-PRRL

Group Number 5785 XX

Program Type Delta Dental Premier XX

Control Plan California Illinois

8102 XX 3665 XX 0009823

Delta Dental Premier XX Delta Dental PPO (XX) XX Delta Dental PPO (POS)

Illinois Colorado Georgia Virginia Indiana/Michigan*

DU 6647 051065 0005220, 0005223, 0005224 & 0008220 XX 0009696

Delta Dental Premier XX Delta Dental PPO (POS)

Kentucky Minnesota Michigan

XX Delta Dental PPO (POS)

Missouri Ohio/Michigan*

0000070 0000076 0000054 2146 20173 XX 0000079 0005316 0009535 0000170 0000088 0000036 0001778 44-4233 0003153 0009474 44-4094 0001516 0007040 & 0007060 0001820 6583-DU XX 0007605 0001401 5992 0004118 0005065 443769

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Illinois Illinois New York Indiana/Michigan* Indiana/Michigan* Michigan Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Michigan Texas Michigan Michigan Texas New Mexico Indiana/Michigan*

Delta Dental Premier Delta Dental PPO (Standard) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX)

Michigan Kentucky Massachusetts Michigan Michigan Illinois Tennessee Indiana/Michigan* Texas

2005 XX 2046 0005756 0339 XX

XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) XX XX

Massachusetts Pennsylvania Illinois Indiana/Michigan* Massachusetts DDIC

12

04/2013

Group Name Cleveland and Vicinity Carpenters Hospitalization Cloyes Gear ClubCorp, Inc. CNO Services, LLC Coach – USA Coalition of Public Safety Employees Health Trust Cobe Laboratories/Patient Services Cobe Laboratories/Patient Services Coca-Cola Company Cogent Healthcare Cognex Cognicase USA Coinmach Corporation Coinstar, Inc. Colbri, Parklane Associates Coldwater Machine Company, LLC Colfax Collins Industries Coloma Community Schools Columbia Sussex Columbus Board of Education Columbus Zoo and Aquarium Comort Line Comfortex, Inc. Command Electronics Commerce One, Inc. Commercial Steel Treating Corporation Commercial Vehicle Group, Inc. Committee for Steelworkers Rockwell Retirees Health Care Trust Common Payment Corporation Commonwealth of MA/NAGE – H&W Trust Commonwealth of Virginia Commonwealth of Virginia Retiree Health Benefits Program Communicare Health Services Communications Workers of America Community Health Network

Community Health Systems Compass Bancshares, Inc. Comprehensive Health Management Computer Sciences Corporation (CSC) Computershare Computrex Inc Conair Corporation Conair Group, The Confined Space Services dba National Labor Services IN National Group Roster-PRRL

Group Number 0009755

Program Type Delta Dental PPO (POS)

Control Plan Ohio/Michigan*

9500 44-4226 0005489 & 0009523 XX 0005055

Delta Dental Premier XX Delta Dental PPO (POS)

Arkansas Texas Indiana/Michigan*

XX Delta Dental PPO (POS)

DDIC Michigan

5371 5458 XX 3077 XX XX 0597461 XX XX 0000224 3727 XX 0006232 XX 0000215 0000142 0009894 XX 0005413 2171 0009182 0004016 XX

Delta Dental PPO (Standard) Delta Dental Premier XX XX XX XX XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX

Colorado Colorado DDIC Tennessee Massachusetts New Jersey North Carolina/Michigan* Washington Rhode Island Ohio/Michigan* Virginia Kansas Michigan Kentucky Ohio/Michigan* Ohio/Michigan* Ohio/Michigan* New York Michigan California Michigan Tennessee Pennsylvania

XX XX

XX XX

Florida Massachusetts

XX 020222222

XX Delta Dental PPO (XX)

Virginia Virginia

0005346 5905 0005868, 0005872 & 0009941 0004097 XX 05835 700080 20108 XX 9255 9194 0000053

Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Ohio/Michigan* Pennsylvania Indiana/Michigan*

Delta Dental PPO (POS) XX XX Delta Dental PPO XX Delta Dental Premier XX XX Delta Dental PPO (POS)

Tennessee DDIC Florida Virginia Illinois Kentucky New Jersey Pennsylvania Michigan

13

04/2013

Group Name CONGOLEUM CORPORATION Consolidated Transport Systems, Inc. Constantine Public Schools Construction Management Services Consumers/CMS Energy Contec Continental Emsco Co. Continental Resources, Inc. Convergent Group Cooper Cameron Corporation Coors Brewing Company Copart, Inc. Copolymer Retiree Trust Coral Graphic Services Corbus, LLC Core BTS Cornerstone Preparatory School, Inc. Cornerstone University Country Financial Country Insurance & Financial Services County Employee Benefits Consortium of Ohio, Inc. Covance, Inc. Covanta Energy Corporation Covenant Church, The Covenant Health-Fort Sanders Covenant Transport Coventry Health Care of Kansas, Inc. CP Commercial Specialists Cramer Krasselt Company Crane America Services, Inc. Crane Co. CRC Health Corp Credit Acceptance Corporation Credit Union Master Group Crescent Electric Supply Co. Critical Therapeutics Crosby Group, The Crothall Healthcare, Inc. Crown Equipment Corporation CRST International CSI Insurance Plan and Trust Fund CSN, LLC CTI Billing Solutions, Inc. Cubist Pharmaceuticals, Inc. Cumberland Consulting Group, L.L.C. Cummins Bridgeway, LLC Cummins Engine Cummins NPower LLC Cumulus Media CUNA Mutual Group Curative Health Services Curtis Wright IN National Group Roster-PRRL

Group Number 9233 0002072 0006435 9044 0009203 XX 3612 XX 6502 3744 5702 XX 19-6810 2292 0005207 XX 0005817 0003215 20054 20054 0009916

Program Type XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier XX XX XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO XX Delta Dental PPO (POS)

Control Plan New Jersey Michigan Michigan Arkansas Michigan Pennsylvania Texas Oklahoma Colorado Texas Colorado California Louisiana New York Ohio/Michigan* Wisconsin Tennessee Michigan Illinois Illinois Ohio/Michigan*

3851 XX XX 0007419 0001659 50097 3003 XX 0000023 4612 XX 0000191 0001905 XX 005393 5234 2515 0001050 335 0005439 0000091 0000429 009804 0001727 0009871 0005422 0005909 XX XX XX 9002

Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO XX XX Delta Dental PPO (XX)

New Jersey New Jersey Illinois Tennessee Tennessee Kansas Kansas Wisconsin Ohio/Michigan* New Jersey California Michigan Michigan Illinois Massachusetts Oklahoma Pennsylvania Ohio/Michigan* Iowa Michigan Indiana/Michigan* Indiana/Michigan* Massachusetts Tennessee Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Georgia Wisconsin Pennsylvania New Jersey

14

04/2013

Group Name Curtiss Wright Corp Custard Insurance Adjusters CVS Caremark Cyberonics, Inc. Cygnus Business Media Cyprus-RAG Cytyc Corporation D&M Holdings Dairy Farmers of America Dairy Farmers of America Damar Services, Inc. Daniels Associates, Inc. Daou Systems, Inc. Darling International Dart Container of Michigan, LLC Data Card Corporation Datascope Corporation DAOU Systems, Inc. Davco Technology Davis Industries – Multi-Plex Inc Dayton Power & Light

Dayton Progress Corp. Dayton Superior Corporation Dean Foods Defense Support Services, LLC Delaware North Companies, Inc. De Boer Inc De La Rue Systems DealerTrack.com Inc. Decrane Aerospace Defense Support Services, LLC Del Monte Foods Del Monte Fresh Produce Del Monte Fresh Produce Company Delaware North Companies, Inc. dELia*s, Inc. Delphi Community School Corporation Delta Air Lines, Inc. Delta Dental Plan of Michigan, Inc. Dematic Corp Denso International America, Inc. Denso Manufacturing Michigan Denso Sales California, Inc. DENTSPLY International DePauw University Derby Industries Deroyal Industries Detroit Diesel Corporation Devon Facility Management, LLC DFS Group & Sephora DHL Airways IN National Group Roster-PRRL

Group Number XX 11-3749 7000 XX 52503 5909 1495 9156 6910 6922 0007016 0000131 564 XX 0001168 5870 5784 564 0009143 9441 0001268, 0001556 & 0009436 0005930 0009818 3720 9174 1995 51710 53700 XX 51650 XX 5790 10-05576 6317 XX XX 0001130 XX 0009700 0000187 0004222 0004223 0004227 XX 0000210 DU 6651 0007400 0009086 0000021 2046 1605-201 15

Program Type XX XX Delta Dental PPO (POS) XX XX Delta Dental Premier XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX

Control Plan New Jersey Georgia Rhode Island Texas Wisconsin Pennsylvania Massachusetts New Jersey Missouri Missouri Indiana/Michigan* Indiana/Michigan* California Texas Michigan Minnesota New Jersey California Michigan Michigan Ohio/Michigan*

Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (XX) XX Delta Dental Premier XX DeltaCare XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX

Ohio/Michigan* Ohio/Michigan* Texas New Jersey New York Wisconsin Wisconsin New York Kansas New Jersey California Florida California Pennsylvania Pennsylvania Indiana/Michigan Minnesota Michigan Michigan Tennessee Tennessee Tennessee Pennsylvania Indiana/Michigan* Kentucky Tennessee Michigan Michigan California California 04/2013

Group Name DHR / Terra Firma 7/1/2011 Diamond Healthcare Dick Corporation Dietz & Watson, Inc. Digi-Lab Digital Media Group, Inc. Digital Technology International LLC Dillard’s, Inc. Direct HR Services Directors Guild of America Discount tire Dismas Disney Worldwide Services, Inc. Dispatch Printing Company, The Diversey Inc. Dixon Hughes Goodman LLP DJO, Inc. Dodson Group Doe Anderson Dollar Tree Stores Inc Domino’s Pizza LLC Donaldson Company, Inc. Donrey Media Group Dopaco, Inc. Dorma Group North America Double-Cola Co.-USA Double H Plastics Doubleday Direct (Bertlesmann, Inc.) DoveBid, Inc. Dover Corporation The Dow Chemical Company Dow Corning Corporation Dowagiac Union Schools Dr Pepper Snapple Group Dr. Pepper/7UP Bottling Group Driven Brands DRT Holdings, Inc. Drug Plastics & Glass Company DSC Logistics, Inc. DSI Renal DSI Transportation DSLT, Inc. DSM Engineering Plastics, Inc. (UNION) - Evansville DSM Services USA, Inc. Dspace, Inc. DSS Prodiesel Partners, LLC DST Systems, Inc. DTE Energy Co. DTE Energy Non-Regulated Affiliates Ducks Unlimited Dugan & Meyers Construction Company IN National Group Roster-PRRL

Group Number XX 64870000 8086 9369 1816 0000073 XX XX 0000683 480 XX 0005721 3000 0009003 XX 0001020 XX 6957 XX 600061 0009408 504 7000 9263 XX 0003249 XX 1522 2644 XX 0005432 & 0009014 0005452 0006167 XX 44-4120 0838010 0000110 9267 20018 0005643 6696 5051 0008119

Program Type XX Delta Dental Premier XX XX XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO XX XX Delta Dental PPO (Standard) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (POS) XX Delta Dental Premier XX XX Delta Dental PPO (POS)

Control Plan Colorado Virginia Pennsylvania Pennsylvania Massachusetts Ohio/Michigan* DDIC Arkansas Michigan California Illinois Tennessee California Ohio/Michigan* Wisconsin North Carolina/Michigan* California Missouri Kentucky California Michigan Minnesota Arkansas Pennsylvania Pennsylvania Tennessee Pennsylvania New York/Pennsylvania* California New York Michigan

Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX

Michigan Michigan DDIC Texas North Carolina/Michigan* Ohio/Michigan* Pennsylvania Illinois Tennessee Kentucky Massachusetts North Carolina/Michigan*

0008118 0003927 0005049 XX 0009810 0009686 0004063 0005940

XX Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

North Carolina/Michigan* Michigan Tennessee Missouri Michigan Michigan Tennessee Ohio/Michigan*

16

04/2013

Group Name Duncan Aviation, Inc. Dungarvin, Inc. Dunnhumby USA, LLC Duron Paints & Wallcoverings Dycom Dykema Gossett, P.L.L.C. Dynamic Metal Forming DynCorp Dynergy Dyno Nobel E & R Industrial Sales E H Construction EQ: The Environmental Quality Company Eagle Adjusting Services, Inc. Eagle Creek Nursery Eagle Network Power Earle M. Jorgensen Company Earth Networks, Inc. Earthgrains Company, The East Penn Manufacturing Co. East Wayne Head Start Eastern Michigan University Eateries, Incorporated Eaton Corporation Eau Claire Public Schools ebay Eby-Brown Company, L.P. Eddie Bauer (formerly The Spiegel Group) Edgen Corporation Edison Brothers Stores, Inc. Edison Schools, Inc. EDSI Inc. Edvantages Edward D. Jones Edwards and Kelcey Edwardsburg Public Schools EF Education, Inc. EFCO Corporation Division of Pella Corporation Effective Management Systems, Inc. EFunds Corporation Egghead Software, Inc. Egyptian Area Schools Employee Benefit Trust Einstein Noah Restaurant Group, Inc. Elan Home systems, LLC ELCA Board of Pensions Electa Holdings, U.S.A. Electrical Workers Insurance Fund Electro-Motive Diesel, Inc. Electronic Consulting Services IN National Group Roster-PRRL

Group Number XX 728113 0009772 7098 XX 0009510 2175 5398 XX XX 0000934 DU8043 009472

Program Type XX XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Control Plan Nebraska Minnesota Ohio/Michigan* Pennsylvania Florida Michigan Pennsylvania Virginia DDIC Utah Michigan Kentucky Michigan

0000082 0000007 20207 2235 XX 5505 5929 0000301 0001873 1780 0005085 0000488 1690 20029 XX

Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO XX XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX

Indiana/Michigan* Indiana/Michigan* Illinois California Pennsylvania Missouri Pennsylvania Indiana/Michigan* Michigan Oklahoma Ohio/Michigan* Michigan California Illinois Illinois

XX 5898 2399 2233 0000276 5752 9180 0006085 008489 XX

XX Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier

Louisiana Missouri New York California Ohio/Michigan* Missouri New Jersey Michigan Massachusetts Iowa

52698 4234 5064 20204

Delta Dental Premier XX Delta Dental Premier Delta Dental PPO

Wisconsin Arizona Washington Illinois

XX DU8050 50643 11-3803 5800 XX 600258

XX XX Delta Dental Premier XX Delta Dental PPO (POS) XX Delta Dental PPO

Colorado Kentucky Minnesota Georgia Michigan Illinois Virginia

17

04/2013

Group Name Electronic Evolutions Electronic Systems, USA Elekta Holdings Elf Atochem Eliassen Group, LLC Eli Lilly Federal Credit Union Elliott Aviation Elliott Company of Indianapolis, Inc. Ellis & Everard (U.S. Holdings), Inc. EMC Corporation EMD/Greenbriar Emergent BioSolutions Emeritus Senior Living Emerson Network Power Empire Food Brokers, Inc. Employer Group, The Empower HR En Pointe Technologies Encore Rehabilitation Services, LLC Endo Pharmaceuticals Inc. Endress + Hauser, Inc. Energizer Holding Company Energy Transfer Equity Energy Transfer Partners GP, L.P Enkei America, Inc. Ensign-Bickford EnerSys Engelhard Corporation Enhanced Wireless Ennis Paint Ensign-Bickford Enterasys Networks, Inc. Enterprise RentACar Entertainment Cruises Envestnet Asset Management Envirotronics, Inc. Enzymatic Therapy Inc. Epicor Software Corporation EPKO Industries, Inc. EQ: The Environmental Quality Company Equity Residential Erie Insurance Ernest Health, Inc. Ervin Industries ESA, Inc. ESCO Technologies, Inc. Eskenazi Medical Group ESL Spectrum Essilor of America Essroc Cement Estes Express Lines ETNA Supply Company IN National Group Roster-PRRL

Group Number 0000066 5179 15308 5711 XX 0000031 20224 0000243 XX 9563 20070 0000168 XX 20207 0005334 50802 10303 XX 0005334 XX 0000164 XX XX XX 0000149 4677 XX 5707 XX XX XX 4786 6927 20137 20184 0004414 XX XX XX 0009472

Program Type Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier Delta Dental Premier XX XX XX XX Delta Dental Premier XX Delta Dental PPO Delta Dental PPO (POS) XX XX Delta Dental PPO Delta Dental PPO (POS)

Control Plan Indiana/Michigan* Kentucky Georgia Pennsylvania Massachusetts Indiana/Michigan* Illinois Indiana/Michigan* Georgia Massachusetts Illinois Michigan Washington Illinois Tennessee Wisconsin Illinois California Michigan Pennsylvania Indiana/Michigan* Missouri Texas Oklahoma Indiana/Michigan* Connecticut Pennsylvania New Jersey Virginia DDIC New Jersey New Hampshire Missouri Illinois Illinois Michigan Wisconsin California Illinois Michigan

20056 XX 0008538 0009410 5678 6941 0007064 0000133 3772 8067 6435 0000283

XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX Delta Dental PPO (POS)

Illinois Pennsylvania New Mexico Michigan Massachusetts Missouri Indiana/Michigan* Indiana/Michigan* Texas Pennsylvania Virginia Michigan

18

04/2013

Group Name Eurofins Scientific, Inc. Evangelical Covenant Church Everbank & Affiliates – DDIC High Plan Everbank & Affiliates – DDIC Low Plan Evergreen Rehabilitation EWIE Companies Excel Storage Executive Council of the Protestant Episcopal Church for the Diocese of Michigan Express Personnel Services Extendicare Health Services Extra Space Storage Eye Surgeons of Indiana, P.C. EZ Loader Trailer F.C. Tucker Company, Inc. Fabri-Kal Corporation Faegre Baker Daniels, LLP Fairchild Semiconductor International, Inc. Fairfield Communities Faith Technologies Fall Creek Regional Waste District Family Christian Stores Fastenal Company and Subsidiaries Faurecia FedEx National LTL Fenkell Automotive Services, LTD. Fenner Dunlop Ferguson Enterprises, Inc. Ferrellgas Ferro Corporation FEV, Inc. Fidelity National Financial Field Museum, The Fifth Third Bank Filter Specialists, Inc. Findlay's Tall Timbers Distribution Center, Inc. Finova Group, Inc. FireKeepers Development Authority, dba FireKeepers Casino Fireman’s Fund Insurance Co. First Acceptance Corporation First Consulting Group, Inc. First Financial Bancorp First Horizon National Corporation First Savings Bank FirstEnergy Service Company FirstMerit Corporation Fisher Scientific International, Inc. Fives Corporation FKA Distributing Company IN National Group Roster-PRRL

Group Number XX 20066 37210002 3710001 DU8042 0005560 XX 0005781

Program Type XX XX XX XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Control Plan Iowa Illinois Florida Florida Kentucky Michigan Pennsylvania Michigan

XX 51309 45-3430 0000171 5170 0000189 0005524 0000457 6331

XX Delta Dental PPO (XX) XX Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier

Oklahoma Wisconsin Utah Indiana/Michigan* Washington Indiana/Michigan* Michigan Indiana/Michigan* Minnesota

XX 54306 0000174 0000641 063755 0005483 9381 0004665 06494 700090 5751 0005696 0005416 10-3745 8405 0009513 0000446 0000247

XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO DeltaCare Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

DDIC Wisconsin Indiana/Michigan* Michigan Minnesota Michigan Arkansas Michigan Georgia Virginia Missouri Ohio/Michigan* Michigan Florida Illinois Ohio/Michigan* Indiana/Michigan* Ohio/Michigan*

5733 0000182

Delta Dental Premier Delta Dental PPO (POS)

Arizona Michigan

5481 0003240 XX 0005551 0001881 0000151 0009673 0009814 1111 0000657 0000653

Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS)

California Tennessee California Ohio/Michigan* Tennessee Indiana/Michigan* Ohio/Michigan* Ohio/Michigan* New Hampshire Michigan Michigan

19

04/2013

Group Name Flad Affiliated Corp Flagstar Bancorp & Subsidiaries Flat Rock Metal Fleetguard, Inc Flexsteel Industries Inc Flint Energy Flintco Companies, Incorporated, The Florida Marlins, LP Florilli Corporation, The Flow International Flowserve Flynn Brothers Contracting, Inc. Foodbrands America, Inc. Footstar Foremost Farms USA Forest Resources Forever 21 Formica Corporation Forward Air Corporation Founders Group, Inc. FPO Solutions (formerly RSM McGladrey Financial) Fram Group, The Framatome ANP, Inc. Framatome Connectors Franciscan Alliance Frankenmuth Mutual Insurance Franklin American Mortgage Company Frankton-Lapel Community Schools FRC Holding Company Fred's Inc. Freedom Communications Inc. Freedom Graphic System Inc Freeport-McMoRan Copper & Gold, Inc. Fresh Market, The Freudenberg –NOK General Partnership Freudenberg Fru-Con Construction Fry, Inc. Fuji Photo Film USA, Inc. Fujitsu Synergy Group Full Perspective Services, Inc. Fund Evaluation Group Furniture Brands International FusionStorm Future Brands LLC G & G Pepper, L.L.C. G & J Pepsi-Cola Bottlers, Inc. GAF MATERIALS CORPORATION Galderma Laboratories Gale Industries, Inc. Galliano Marine Service IN National Group Roster-PRRL

Group Number 54700 0009025 0005217 75702 90501 XX XX 10-03766 XX 09341 44-4228 690790 6978 3991 XX 10402 XX 0005268 0001809 5607 XX

Program Type Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX XX XX Delta Dental Premier XX XX Delta Dental PPO Delta Dental Premier Delta Dental Premier XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX

Control Plan Wisconsin Michigan Michigan Iowa Iowa Oklahoma Oklahoma Florida Iowa Washington Texas Kentucky Oklahoma New Jersey Wisconsin Illinois California Ohio/Michigan* Tennessee Illinois Illinois

XX 700006 4541 0009975 0000461 0001606 0007080 20206 0004043 2335 55104 XX 0264144 1158

XX XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) XX XX XX XX XX

Illinois Virginia New Jersey Indiana/Michigan* Michigan Tennessee Indiana/Michigan* Illinois Tennessee California Wisconsin Arizona North Carolina/Michigan* New Hampshire

0008104 XX 0005927 5324 XX 0005590 0000185 XX 000323 20064 0000014 0009034 9222 XX 1418 LA 0291

XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO XX XX XX Delta Dental PPO (POS) Delta Dental PPO (Standard) XX XX Delta Dental PPO (POS) XX

North Carolina/Michigan* Missouri Michigan Pennsylvania California Indiana/Michigan* Ohio/Michigan* Missouri Massachusetts Illinois Indiana/Michigan* Ohio/Michigan* New Jersey DDIC Florida Louisiana

20

04/2013

Group Name Galien Township Schools Games Workshop Gannett Co Inc Gap, Inc., The Gateway Freight Garau Germano Hanley & Pennington, P.C. Gardens Alive! Gart Sports/Sports Mart Gary Housing Authority Gateway Hospitality Group, Inc. Gaylord Entertainment GCA Services Group, Inc. Gecom Corporation Geisinger Health System Genentech, Inc. Generac Power Systems General Casualty Insurance Co. General Dynamics Land Systems General Mills, Inc General Motors Corp General Nutrition, Inc. Genesco Genesee County Genesis Consolidated Genova Diagnostics, Inc. Gentex Corporation Genus Americas dba ABS Global, Inc. – PIC Genworth Financial, Inc. Genzyme Corporation GEO Group Geometric Results, Inc. Georgetown University Georgia Gulf Corporation Gerber's Poultry, Inc. Gershman Brown Crowley, Inc. Gerson Companies, The Gestamp North America Getty Images Ghafari Associates Glen Oaks Community College Gibson Guitar Corporation Gift of Hope Gilbane, Inc. GILT Groupe Glen Oak Lumber & Milling Inc GMAC Insurance Management Corporation GMAC Mortgage Corp. Godiva Chocolatier, Inc. Gobles Public Schools Golden Living IN National Group Roster-PRRL

Group Number 0000991 XX 700038 600 560 0000017

Program Type Delta Dental PPO (POS) Delta Dental PPO XX Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO (POS)

Control Plan Michigan Pennsylvania Virginia California California Indiana/Michigan*

0000041 0253 0000130 0000200 4051 0009242 0005261 XX 376 XX 52098 0008580 501 0008330 5343 0005221 0001888 XX 0000522 0001081 XX

Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier Delta Dental PPO Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (XX)

Ohio/Michigan* Colorado Indiana/Michigan* Ohio/Michigan* Tennessee Ohio/Michigan* Indiana/Michigan* Pennsylvania California Wisconsin Wisconsin Michigan Minnesota Michigan Pennsylvania Tennessee Michigan Massachusetts North Carolina/Michigan* Michigan Wisconsin

XX 001125 XX 5314 XX 11-6891 0002135 0000013 XX 0000642 XX 0000183 0006441 0004119 20008 XX XX XX 0447828

XX XX Delta Dental PPO Delta Dental Premier DeltaCare XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO XX XX

Virginia Massachusetts Florida California District of Columbia Georgia Ohio/Michigan* Indiana/Michigan* Kansas Michigan Washington Michigan Michigan Tennessee Illinois Rhode Island New York Wisconsin North Carolina/Michigan*

5923 XX 0006090 XX

Delta Dental Premier XX Delta Dental PPO (POS) XX

Pennsylvania New York Michigan Arkansas

21

04/2013

Group Name Goodman Networks Goodyear Dunlop Hourly Associates Goodyear Tire & Rubber Co. The Goodyear Tire & Rubber Company Gordon Flesch Co Inc. Gordon Flesh Company Inc Graco, Inc. Graebel Companies Graham Packaging Grand Victoria Casino Granite Industries, Inc. Graphic Communication National Health & Welfare Fund Graphic Packaging Corporation Great Lakes Assemblies, LLC Greatwide Logistic Services Greektown Casino Green Path, Inc. Green Tree Acceptance Greenfield Central Community School Corporation GreenTree Servicing Greenwood Community School Corporation Gresham, Smith And Partners Greyhound Lines, Inc. Greyhound Lines, Inc. ATU National Local 1700 Greyhound Retirees (ATU) Greyhound Retirees (salaried) Greystone & Co Griffin Industries Grifols Grolier Group 329 formerly known as Caps 57 Group Management Services Groupon GSI Commerce Gtech Holdings Corp Guardian Alarm Company Guardian Auto Glass, LLC Guardian Industries Corp. Guckenheimer Enterprises, Inc. GuideOne Services, L.L.C. Gund Inc. GVW Group, LLC Gyrus ACMI, Inc. H & R Block Tax Services, Inc. H. T. Hackney H.B. Zackary H P Hood Habasit America, Inc. IN National Group Roster-PRRL

Group Number XX 0009800 0005768 0005115 & 0005550 XX XX 50587 9675 XX 29-9155 0002122 1249

Program Type Delta Dental PPO Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX)

Control Plan Texas Ohio/Michigan* Ohio/Michigan* Ohio/Michigan*

XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO Delta Dental Premier XX Delta Dental PPO (POS) XX

Wisconsin Wisconsin Minnesota Colorado Pennsylvania Nevada Ohio/Michigan* District of Columbia

XX 0000232 44-4230 0007599 0005511 5950 0005684

Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Colorado Ohio/Michigan* Texas Michigan Michigan Minnesota Indiana/Michigan*

XX 0005748

XX Delta Dental PPO (POS)

Minnesota Indiana/Michigan*

0001655 XX 3850

Delta Dental PPO (POS) XX XX

Tennessee DDIC Texas

5070 5060 XX XX 0008108 5806 20092 0001084 20227 XX XX 0009628 0001117 0005799 XX XX 9023 0009742 000264 7702 0002715 5195 XX XX

Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier XX XX

California California Pennsylvania Kentucky North Carolina/Michigan* New Jersey Illinois Ohio/Michigan* Illinois Pennsylvania Rhode Island Michigan Ohio/Michigan* Michigan California Iowa New Jersey Indiana/Michigan* Massachusetts Missouri Tennessee DDIC Massachusetts DDIC

22

04/2013

Group Name Hackensack University Hospital Hafele America Hagemeyer North America, Inc. Hagemeyer, N.A. Hahn Systems, LLC Haley & Aldrich Halo BrandedSolutions Inc./Lee Wayne Hamilton Community Schools Hamilton Southeastern Schools Hanchett Paper Company Hancock Fabrics, Inc. Hancock Madison Shelby Educational Services Hancock Physician Network Hanover Foods Harland Clarke Harlem Furniture Harris N.A. Harris Steel, Inc. Harshaw Trane & Trane Parts Center Harte-Hanks, Inc. – DDIC Hartford Steam Boiler Inspection & Insurance Company Harvard University – Active Harvard University Retirees (open) Harvey Industries, LLC Hasbro, Inc Hastings Mutual Insurance Company Haven Behavioral Healthcare Haworth, Inc. Haynes International, Inc. Hay Group, The Hazen & Sawyer, PC HBM, Inc. HCR ManorCare HD Supply Hdg Mansur Investment Services Health Tech Healthcare Management Systems, Inc. HealthPrime Healthspring, Inc. HealthSouth Corporation Hearthside Food Solutions LLC Heartland Express Heartland Foods Corporation Heartland Sweeteners Hebrew Orthodox Congregation HECO, Inc. Heifer Project International Heil Trailer International, Co. Helmerich & Payne Henkels and McCoy Henniges Automotive Holdings, Inc. IN National Group Roster-PRRL

Group Number 9110 0291517 XX XX 0000097 000235 XX 0006106 0007099 2142 XX 0000062

Program Type XX XX XX XX Delta Dental PPO (Standard) XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS)

Control Plan New Jersey North Carolina/Michigan* Missouri Missouri Indiana/Michigan* Massachusetts Illinois Michigan Indiana/Michigan* Illinois Mississippi Indiana/Michigan*

0000022 XX 440154 20125 XX XX DU8079 XX 5666

Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX XX XX XX XX Delta Dental Premier

Indiana/Michigan* Pennsylvania Texas Illinois Illinois Massachusetts Kentucky Texas New Jersey

XX XX 0000971 3900 0000005 0003994 0009090 0009092 5907 XX 000560 0001040 XX 0005579 0001942 0001672 11-3730 0004117 1371 20214 XX 2088 0000056 0000095 0000261 9049 0004147 5730 9013 0005516

XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS)

Massachusetts Massachusetts Michigan Rhode Island Michigan Tennessee Michigan* Indiana/Michigan* Pennsylvania New York Massachusetts Ohio/Michigan* DDIC Indiana/Michigan* Tennessee Tennessee Georgia Tennessee Alabama Illinois Iowa Illinois Indiana/Michigan* Indiana/Michigan* Michigan Arkansas Tennessee Oklahoma Pennsylvania Michigan

23

04/2013

Group Name Henry County Memorial Hospital Henry M. Jackson Foundation for the Advancement of Military Medicine, The Herff Jones, Inc. Heritage Food Service Group, Inc. Herman Miller Inc Hermes Abrasives, Ltd. Hess Industries, Inc. Heublein, Inc. Hewlett Packard Company HIAP Hilb, Rogal and Hobbs Hilex Poly Co., LLC Hillman Group, The Hilti, Inc. Hilton Hotels Corporation Hinshaw & Culberton Hirsh Industries Hitachi Data Systems Corporation HLI Operating Company HNTB Hobby Lobby Hobsons Inc. Hoffman-LaRoche, Inc. Holcim (US) Inc Holder Construction Holiday Companies Holland & Knight LLP Hologic, Inc. Home Meridian International HomeDirect USA HON Industries Honigman Miller Schwartz and Cohn LLP Honeywell, Inc. Hope Network Horizon Group Properties, Inc. Hormel Foods Corporation Howard County, Maryland Howard Hughes Medical Institute HR Plus Hughes Supply, Inc. Hunter Douglas, Inc Huntington County Community School Corporation Employee Benefit Trust Huntington Ingalls Industries, Inc. Hurley Medical Center Husqvarna Outdoor Products, Inc. Hussey-Mayfield Memorial Public Library Huttig Building Products Hydraulic Technologies Hydrite Chemical Co IN National Group Roster-PRRL

Group Number 0005351 XX

Program Type Delta Dental PPO (POS) Delta Dental PPO (XX)

Control Plan Indiana/Michigan* Pennsylvania

0005978 0000349 0009525 8625 0005624 5675 XX 0000155 XX 6099-1000 0009588 XX XX 2072 XX XX 0009827 6905 5104 0000166 5860 0009834 XX 502 03847 001495 0882045 20186 5671 0007116

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier DeltaCare Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental Premier XX XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO XX XX DeltaCare Delta Dental Premier Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan* Michigan Virginia Michigan New Jersey California Indiana/Michigan* Virginia South Carolina Ohio/Michigan* Oklahoma California Illinois Iowa California Michigan Missouri Oklahoma Ohio/Michigan* New Jersey Michigan DDIC Minnesota Florida Massachusetts North Carolina/Michigan* Illinois Iowa Michigan

150 0003811 0000237 50582 XX XX 0001561 1629 9003 0000109

Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Minnesota Michigan Michigan Minnesota Pennsylvania Pennsylvania Ohio/Michigan* Florida New Jersey Indiana/Michigan*

XX 0001785 11-5874 0000214

XX Delta Dental PPO (POS) Delta Dental PPO Delta Dental PPO (POS)

Virginia Michigan Georgia Indiana/Michigan*

XX 90033 XX

XX Delta Dental Premier XX

Missouri Iowa Wisconsin

24

04/2013

Group Name Hydro Automotive Structures Hylant Group IAI International I.A.T.S.E. National Health & Welfare Fund I T & E Retiree Supplemental Benefit Trust I Village IAI International IATSE Iberdrola USA and Renewables IBEW IBEW-NECA ICAHN & Co., Inc. ICC Industries I-Deal Optics Holdings, Inc. IDEX Corporation IDEXX Laboratories, Inc. IDEXX Laboratories, Inc. idX IHS, Inc. IKA Systems Ilitch Holdings, Inc. Ilmor Engineering Inc. Imation Corporation IMO Industries IMS Indco, Inc. Independent Concrete Pipe Indiana 2 to 9 Lives - Plan B Indiana 2 to 9 Lives Plan A Indiana 2 to 9 Lives Plan E Indiana Area United Food Indiana Association for the Education of Young Children Indiana Black Expo, Inc. Indiana Continuing Legal Education Forum Indiana Credit Union League Indiana Hemophilia & Thrombosis Center, Inc. Indiana Laborers Welfare Fund Indiana Organ Procurement Organization, Inc. Indiana Rotomolding, Inc. Indiana State Teacher's Association (ISTA) Indiana State University Indiana Tool & Manufacturing Company Indiana University Health Indiana University Health Arnett Hospital Indiana Wesleyan University

IN National Group Roster-PRRL

Group Number 0005068 0000099 2264 XX

Program Type Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX

Control Plan Michigan Ohio/Michigan* New York Pennsylvania

0009100

Delta Dental PPO (POS)

Michigan

2162 XX 2430 XX 5904 3760 2125 XX 0000135 5873 1573 6686 XX XX XX 0001170 0005375 5384 3727 XX 0000147 0000055 0007776 0007775 0007779 0000700 0000004

XX XX XX Delta Dental PPO Delta Dental Premier XX XX Delta Dental PPO Delta Dental PPO (POS) Delta Dental Premier XX XX XX XX XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS)

New York Pennsylvania New York New York Pennsylvania Texas New York New York Michigan Illinois Maine Maine Missouri Colorado Massachusetts Michigan Michigan Minnesota New Jersey Pennsylvania Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan*

0000086 0000047

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan*

0000356 0005419

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan*

0005617 0007061

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan*

0000129 0001101

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan*

0007001 0005857 0007082 0005770

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan*

0005754

Delta Dental PPO (POS)

Indiana/Michigan*

25

04/2013

Group Name Indiana/Kentucky Carpenters Welfare Fund Indiana Western Express, Inc. Indianapolis Private Industry Council Indianapolis Public Schools Indians, Inc. Inductoheat Inficon, Inc. Infinisource, Inc. Infinite Computer Solutions Infinity Property and Casualty Corporation InFocus Corporation Informatics Corporation Of America Information Control Corporation InfraSource Inc. ING North American Insurance Corporation Ingram Entertainment, Inc/DBI Beverage, Inc. Ingram Industries, Inc. Ingram Micro Inland Intermodal Logistics Services, Llc Inland Real Estate Group, The Inland Western Retail Real Estate Insituform Technologies, Inc. INSL-X Products Corp. Institute for Behavioral Medicine, The Institute for Study Abroad Insulet Corporation INTAT Precision, Inc. INTEGRA LIFE SCIENCES CORPORATION Integrated Electric Services Integrated Manufacturing and Assembly, LLC (Brownstown Division) Integrated Service Company LLC Integration Partners Corp Integreo, Inc. Integrion Financial Network Integrys Energy Group Interactive Business Systems, Inc. Interface Intergen Intermec Corporation International Automotive Components Group of North America International Brotherhood of Electrical Workers International Consulting Technology, LLC International Dairy Queen International Specialty Products

IN National Group Roster-PRRL

Group Number 0005966

Program Type Delta Dental PPO (POS)

Control Plan Indiana/Michigan*

5404 0000005 0000096 0000308 0005968 2246 0009981 XX 01-1634

Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO XX

Missouri Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Michigan New York Michigan Pennsylvania Alabama

622 0005137 0005196 9033 XX

XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX

Oregon Tennessee Ohio/Michigan* Pennsylvania Georgia

0004038

Delta Dental PPO (XX)

Tennessee

0004084 XX 0003826 XX XX XX 2447 5193 0000107 XX 0000116 XX

Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX XX XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX

Tennessee California Tennessee Illinois Illinois Missouri New York Rhode Island Indiana/Michigan* Massachusetts Indiana/Michigan* New Jersey

44-4108 0005368

XX Delta Dental PPO (XX)

Texas/DDIC* Michigan

5136 XX 11-3740 8578 20109 XX XX XX XX 0005753 & 0005754 XX

XX XX XX Delta Dental Premier XX XX XX XX XX Delta Dental PPO (POS)

Oklahoma Massachusetts Georgia Virginia Illinois Illinois DDIC Massachusetts Washington Michigan

0001637

Delta Dental Premier

XX

XX 9220

XX XX

26

Pennsylvania Tennessee Minnesota New Jersey

04/2013

Group Name International Union of Operating Engineers International Union U A W Insurance Office Inter-Regional Financial Group, Inc. Interstate Brands Companies InterWire Products, Inc. Intown Lessee Services LLC Inverness Medical Innovations Invesmart, Inc. InvestLinc Group, LLC, The Investors Management Corporation Interactive Business Systems, Inc. Interface Intermec Corp International Brotherhood of Electrical Workers International Dairy Queen International Mission Board (US Missionaries) International Union of Operating Engineers Internos Corporation Inter-Regional Financial Group, Inc. Interstate Brands Companies Intown Lessee Services LLC Ionics Incorporated Iostudio Iowa Packing Co., The Iron Mountain Corporation Iron Worker’s Health Fund of Eastern Michigan Iron Workers Tri-State Welfare Fund ISC Group Nevada LLC & Companies, The ITT Corporation IUOE & Pipe Line Employers H & W Fund Ivey Mechanical Company Ivy Tech Community College of Indiana J L French J. Rettenmaier USA LP J. Baker J.B. Hunt Transport, Inc J.B. Hunt Transport, Inc J.B. Poindexter J.I.T. Services LLC J.M. Smucker Company, The J.W. Harris Co., Inc. dba The Harris Products Group JP Health Plans Jabil Circuit, Inc. Jack A. Russo Corp Jackson County Bank IN National Group Roster-PRRL

Group Number XX

Program Type XX

Control Plan Pennsylvania

0005974

Delta Dental PPO (POS)

Michigan

5693 44-03299 2117 XX 000252 9193 44-3940 0351697 2074 XX 5301 5904

Delta Dental Premier Delta Dental PPO (XX) XX XX XX XX XX XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier

Alabama Texas New York Georgia Massachusetts Pennsylvania Texas North Carolina/Michigan* Illinois Georgia Washington Pennsylvania

50617 700019

Delta Dental Premier XX

Minnesota Virginia

1244

XX

7291 5693 XX XX 5480 0005266 60009 004895 0009830

Delta Dental Premier Delta Dental Premier XX XX XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (Standard)

XX 19-3739

XX XX

District of Columbia Virginia Alabama DDIC DDIC Massachusetts Tennessee Iowa Massachusetts Michigan Illinois Louisiana

9452 1250

Delta Dental PPO (XX) XX

Colorado District of Columbia

XX 0007054 51805 0009854 5323 5380 5381 XX 01-01387 0001038 0005847

XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (Standard) Delta Dental Premier XX XX Delta Dental PPO (POS) XX

Mississippi Indiana/Michigan* Wisconsin Michigan Massachusetts Arkansas Arkansas DDIC Alabama Ohio/Michigan* Ohio/Michigan*

15304 1492 0009236 0000136

DeltaCare Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS)

Georgia Florida Michigan Indiana/Michigan*

27

04/2013

Group Name Jackson County R.E.M.C. Jackson National Life Jackson Products, Inc. Jacobs Engineering Group, Inc.

Group Number 0000195 0009224 6942 XX

Program Type Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX

Control Plan Indiana/Michigan* Michigan Missouri California

Jacuzzi Brands Corp James A. Rhodes State College Jason Incorporated Jay Packaging Jay School Corporation, The JD Edwards and Company Jefferson Hospital Association Jefferson Wells International 52704 Jeffrey Chain, LP Jet Aviation Holdings, Inc. JetBlue Airways JFW Industries, Inc. Jim Beam Brand Co. John O. Butler Company John Hancock John Hancock Financial network John Morrell & Co. Johnson & Wales University Johnson Controls Johnson Matthey, Inc. Johnson Materials, LLC Joint Commission, The Joint Commission on Accreditation Jones - Hamilton Company Jos. A. Bank Jostens JP Health Plans JSJ Corporation Juniper Networks Jupiter Communities, LLC/Jupiter Realty Corp. Justrite Manufacturing Corporation K O N E Inc. Kar Auction Services, Inc. Karmanos Cancer Institute Kawasaki Robotics (USA), Inc. KB Home KCS International Inc KeHe Distributors, LLC Kele, Inc. Keller Foundation Kellermeyer Company Kellwood Company Kelly Services Kelly Services-Salaried Employees Kenco Kendall Electric Kenney Machinery Kenny Industries

XX 0005399 XX 5607 0001157 6805 4502 XX 0003982 9082 XX 0000392 L20061 2149 XX XX 0009200 5815 3718 XX 0000084 XX 2033 0005794 XX 5653 XX 0005494 XX 20144

XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX Delta Dental Premier XX XX XX Delta Dental Premier XX XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental PPO (POS) XX XX

California Ohio/Michigan* Wisconsin Rhode Island Indiana/Michigan* Colorado Arkansas Wisconsin Tennessee New Jersey Pennsylvania Indiana/Michigan* Illinois Illinois Massachusetts Massachusetts Ohio/Michigan* Rhode Island Florida Pennsylvania Indiana/Michigan* Illinois Illinois Ohio/Michigan* Pennsylvania Minnesota DDIC Michigan DDIC Illinois

NY2360 XX 0005697 0007157 0005517 XX 54011 XX 0001136 XX 0005879 XX 0009146 0009419 0004101 0002760 0000094 2002

XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier

New York Illinois Indiana/Michigan* Michigan Michigan California Wisconsin Illinois Tennessee Pennsylvania Ohio/Michigan* Missouri Michigan Michigan Tennessee Michigan Indiana/Michigan* Illinois

IN National Group Roster-PRRL

28

04/2013

Group Name Kent State University Kentucky Bankers Association Kentucky Utilities Kenwal Steel Corporation Kerr McGee Corporation Keystone Automotive Keystone Helicopter Corporation KHS America, Inc. Kimball International, Inc. Kimberly-Clark Kinetic Concepts Kinetico Incorporated Kirkland & Ellis, LLP Kitchen Collection, LLC, The Kleen Air Research KLLM Transport Services Knight Transportation, Inc. Knoll, Inc. Knowledge Learning Corporation Koch Filters Koch Industries Koch Industries, Inc./Georgia Pacific LLC Kohl’s Corporation Kohner Properties Koll Company, The Koll International Komet of America Komatsu America Corporation Komet of America KONE Inc. Kos Pharmaceuticals Kreher Steel Krone Na Inc Kronos K2, Inc. Kum & Go KV Pharmaceutical Company KY State District Council of Carpenters Kyocera Kyphon Inc Kyzen Corporation Labinal, Inc. L & W Engineering Company LA Fitness International Laborers International Union of North America Laborers' Metropolitan Detroit Health Care Fund L'Acquis Consulting Enterprises L-AD-V Management, LLC dba Element National Manage Lafayette School Corporation IN National Group Roster-PRRL

Group Number 0001010 669 6581-DU 0005126 5107 XX 9072 0002977 0000154 XX XX 0009281 20089 0005656 XX XX 407 2317 XX XX XX XX

Program Type Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO (Standard) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX XX

Control Plan Ohio/Michigan* Kentucky Kentucky Michigan Oklahoma Pennsylvania Pennsylvania Tennessee Indiana/Michigan* DDIC DDIC Ohio/Michigan* Illinois Ohio/Michigan* DDIC Alabama Arizona Pennsylvania Oregon Kentucky Kansas Kansas

5879 6928 5957 5948 2075 20083 XX 2139 XX 20168 0003699 XX 2497 92225 XX 5054 2419 XX 0001671 2040 0009597 XX XX

Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier XX XX XX XX XX Delta Dental Premier XX XX Delta Dental Premier XX Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX XX

Wisconsin Missouri California California Illinois Illinois Illinois Illinois Florida Illinois Tennessee Massachusetts California Iowa Missouri Kentucky California California Tennessee Illinois Michigan California Pennsylvania

0001657

Delta Dental PPO (POS)

Michigan

0000048 0005903

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Michigan

0007088

Delta Dental PPO (POS)

Indiana/Michigan*

29

04/2013

Group Name LaFayette Township Fire Lake County Lake Ridge Schools Lakeshore Public Schools Lamar Construction Lamco Finishers, Inc. Lancaster Laboratories, Inc. Land America Property Inspection Services LANDesk Software Landis+Gyr Landmark Media Enterprises LLC and Dominion Enterprises Landscape Forms, Inc. Lang Company, The Lane Automotive, Inc. Lane Furniture Lanesville Community School Corporation Lansing Board of Water & Light Latheus Medical Imaging, Inc. Lanxess Lapham-Hickey Steel Lapham-Hickey Steel Corp. LaSalle Bank (Standard Federal) Lauth Group, Inc. Lawrence Township of Marion County Lawson Associates, Inc. La-Z-Boy Incorporated LeMans Corporation Leapnet, Inc. Lear Corporation Learning Care Group Lee Enterprises, Inc. Legacy Healthcare Services, Inc. Legal Seafood Legislative Retirement System LEGRAND NORTH AMERICA Lehigh Portland Cement Lender Processing Svcs Inc. Lenny's Franchisor, LLC Leona Group, L.L.C., The Lester Building Systems Letica Corporation Lexmark International, Inc. Lextron, Inc. LG Electronics USA, Inc. LHP Software Liberty Mutual Insurance Lifeline Systems Lifepoint Hospitals, Inc. LifeTime Fitness Lifetouch Inc. IN National Group Roster-PRRL

Group Number 0000135 XX 0000207 0006442 0001167 0000038 XX XX

Program Type Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) XX

Control Plan Indiana/Michigan* Illinois Indiana/Michigan* Michigan Michigan Indiana/Michigan* Pennsylvania DDIC

5985 50915 XX

XX Delta Dental PPO (XX) Delta Dental PPO (XX)

Utah Minnesota Virginia

0009144 DU8081 0004424 XX 0001132

Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier

Michigan Kentucky Michigan Missouri Indiana/Michigan*

0005100 XX XX 20133 XX 9698 0005815 0000146 0589 0009200 54201 2070 0009600 0001187 XX 0209572 XX 0002514 4260 5872 6180 0002688 0005394 XX 0005352 691710 9488 20178 0000156 4310 XX 0004075 XX 5065

Delta Dental PPO (POS) XX XX XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (Standard) XX XX XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO Delta Dental PPO Delta Dental PPO (Standard) XX XX Delta Dental PPO (POS) XX Delta Dental Premier

Michigan Massachusetts Pennsylvania Illinois Illinois Illinois Indiana/Michigan* Indiana/Michigan* Minnesota Michigan Wisconsin Illinois Michigan Michigan Iowa North Carolina/Michigan* Massachusetts Michigan Connecticut Pennsylvania California Tennessee Michigan Minnesota Michigan Kentucky Colorado Illinois Indiana/Michigan* Massachusetts Massachusetts Tennessee Minnesota Minnesota

30

04/2013

Group Name Lifeway Christian Resources Light Engineering, Inc. Lima Memorial Health System Lincoln Consolidated Schools Lincoln Technical Institute Lindsey Company, The Linear Technology Corporation Link Engineering Lion Apparel, Inc. Little League International Litton-Sperry Marine, Inc. Living Social LMC (SI Organization) Local 309 Electrical Health & Welfare Fund Local 707 National Production Workers Union Local 731, I.B. of T. Health & Welfare Fund Local Units Of Government State Of Indiana Lockheed Martin Corp. Lockhead Martin Operations Support Lodgian, Inc. Logan's Roadhouse Logica Logicalis Logistics Company, Inc., The Logistics Express, Inc. Lonza Group Los Alamos Technical Associates, Inc. Los Angeles Unified School District Loudon County & Public Schools Louisville & Jefferson County Louisville Bedding Louisville Transportation LPL Financial Services LSI Corporation Lubing Systems Lp Luckett Holdings, Inc. Lufthansa German Airlines Lund International Lund, Inc. Lutheran Brotherhood Agent Luxtec Corporation Lyons Companies, The Lyons HR Lyons Township High School District #204 M & T Bank M.C. Sports M.S. Management dba USA Checks Cashed M.S.U. Federal Credit Union IN National Group Roster-PRRL

Group Number 0007416 0000208 XX 0000786 3764 9439 2558 0005007 0000256 XX 6007 XX XX 20197

Program Type Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO Delta Dental Premier XX Delta Dental PPO Delta Dental PPO

Control Plan Tennessee Indiana/Michigan* Ohio/Michigan* Michigan New Jersey Arkansas California Michigan Ohio/Michigan* Pennsylvania Virginia Pennsylvania Pennsylvania Illinois

10468

XX

Illinois

20013, 20014, 20015 0009842

XX

Illinois

Delta Dental PPO (POS)

Indiana/Michigan*

3001 5457 11-6099 0005735 TX-0333 0005287 0000424 768 XX 0011739 922 61110000 5056 7264 7249 XX XX 0003842 0002726 5617 XX XX 0543 007127 690340 XX 20019

Delta Dental Premier Delta Dental Premier Delta Dental PPO Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (XX) Delta Dental Premier XX XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental Premier XX Delta Dental PPO XX XX

California California Georgia Tennessee Texas Michigan North Carolina/Michigan* Alabama New Jersey New Mexico California Virginia Kentucky Kentucky Kentucky California California Tennessee Tennessee New York/Pennsylvania* Minnesota DDIC Minnesota Massachusetts Kentucky DDIC Illinois

2160 0007618 9900

XX Delta Dental PPO (POS) XX

New York Michigan Illinois

0001773

Delta Dental PPO (POS)

Michigan

31

04/2013

Group Name M/I Homes, Inc. Maax Holding Macklanburg-Duncan Macomb County MAG IAS, LLC Magnum Corporation Mail Contractors MailSouth, Inc. Maintenance Management Company, Inc. Majestic Star Casino, LLC, The Mallinckrodt Manhattan Associates, Inc. Mann Properties Management, LLC MANN+HUMMEL USA, INC. MANP Manpower of Lansing, Michigan, Inc. ManTech International Corporation Manufacturers Marketing Marakon Associates Marathon Electric MARC Global Services Marel Holding LP and Affiliated Companies Marigold Foods Maritz Markel Corporation Market Strategies International MarketVision Research Marposs Corporation Marquette General Hospital Marshall & Ilsley Corp. Marten Transport Ltd Marubeni-Itochu Steel American, Inc. Marygrove College Mascari Sales & Marketing, LLC Mass State Carpenters H & W Fund Massachusetts Financial Services Massachusetts Institute of Technology MasTec, Inc. Masterbrand Cabinets, Inc. Mastercraft Boat Company Masters, Mates and Pilots Health & Benefit Plan Material Sciences Corporation Matrix Metals, LLC Mattel Inc Mattel, Inc. Mattingly Foods Maurice Sporting Goods Maurice Sporting Goods IN National Group Roster-PRRL

Group Number 0009737 50922 XX 0007346 0009301 0003831 9347 01-1391 0000045

Program Type Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS)

Control Plan Ohio/Michigan* Minnesota Oklahoma Michigan Michigan Michigan Arkansas Alabama Indiana/Michigan*

0001003 6929-6930 11-3749 0000148 0000625 9371, 9372, 9373, 9374 0009023 700007 0000072 XX XX 64020000 15322

Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX

Indiana/Michigan* Missouri Georgia Indiana/Michigan* Michigan Pennsylvania

Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO

Michigan Virginia Indiana/Michigan* New York Wisconsin Virginia Georgia

5993 XX 600051 0005823 0000056 0005861 0005428 50300 XX 2413 0001370 0000680 7525 9247 004577 XX 0005765 & 0005766 0004047 7117

Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX XX Delta Dental PPO (POS)

Minnesota Missouri Virginia Michigan Ohio/Michigan Michigan Michigan Wisconsin Wisconsin New York Michigan Michigan Massachusetts Massachusetts Massachusetts DDIC Indiana/Michigan*

Delta Dental PPO (POS) XX

Tennessee Pennsylvania

20023 XX 50504 2667 0001064 5312 XX

XX Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental Premier XX

Illinois Iowa Wisconsin California Ohio/Michigan* Illinois Illinois

32

04/2013

Group Name Maurices Maverick Specialized, LLC Maverick Transportation Maxim Integrated Products Maximus May Institute, Inc. Mayo Clinic Maytag Corporation McBride Distributing MBT Financial Corporation McCain Foods USA, Inc. McCoy Group, Inc., The McCullough-Hyde Memorial Hospital McDonald’s Licensees McDonnell Technical Services McFarland Cascade Holdings McGladrey Contract McGladrey & Pullen McGuire Woods LLP MCHCP (State & Public Entity) McLaren Medical Center-Bay Region McLaren Medical Center-Greater Lansing McMaster-Carr Supply Company McNaughton-McKay Electric Company MDwise, Inc. MedAssist, Inc. Mediacom Communications Corporation Medical Action Industries, Inc. Medical Specialties Distributors, Inc. Medical Staffing Network Mediq/PRN Medpartners/Mullikin, Inc. Medplus, Inc. (A Quest Diagnostics Company) MEDRAD, Inc. Medtronic, Inc Meggitt USA Meharry Medical College Meijer, Inc. Meijer, Inc. - Basic Meister Abrasives, USA Melling Tool Company Members United Corporate Federal Credit Union Memphis Conference Umc Memphis Light Gas & Water Menard Inc. Menasha Corporation Men’s Wearhouse Mentor Network/REM, The Mercantile Bancorp, Inc. Mercer Transportation IN National Group Roster-PRRL

Group Number NY 2370 XX 72231 870-0001 XX XX XX 90354 9489 0007587 20030 XX 0000134 20150 646 XX 20017 9996 86170000 XX 0002659 0003139

Program Type XX XX XX Delta Dental PPO (Standard) XX XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan New York Arkansas Arkansas California Virginia Massachusetts Minnesota Iowa Arkansas Michigan Illinois Iowa Ohio/Michigan* Illinois California Washington Illinois Iowa Virginia Missouri Michigan Michigan

XX 0005482 0007046 XX 2112 XX 006431 10-6909 3996 5187 0009736

XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS)

Illinois Michigan Indiana/Michigan* Kentucky New York Pennsylvania Massachusetts Florida New Jersey California Ohio/Michigan*

XX XX 2497 0005622 0005695 0005696 5715 0000943 20155

Delta Dental PPO (XX) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS) XX

Pennsylvania Minnesota California Tennessee Michigan Michigan Rhode Island Michigan Illinois

0001320 0001298 56006 50398 XX 1615 XX 6578-DU

Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental Premier XX XX XX Delta Dental Premier

Tennessee Tennessee Wisconsin Wisconsin California Massachusetts Illinois Kentucky

33

04/2013

Group Name Merit Resources Meritor Merkle Merrill Corporation Merz Inc. Mesa Industries, Inc. Metal Technologies Inc. Metaldyne, LLC Metavante Methodist Hospital, Inc., The Metra Metro International Trade Services LLC Metro Storage Metropolitan Govt Of Nashville & Davidson Co. Metropolitan Govt Of Nashville & Davidson County Metropolitan Nashville Public Schools Metropolitan School District of Warren Township MetroSouth Medical Center Metson Minerals Industries Inc. Metso USA MGI PHARMA, Inc. MH Equipment Corporation MHM Services Inc. Miami-Dade County Government Miami University Michael Best & Friedrich LLP Michael Foods Michigan 2 to 9 Lives Plan A Michigan Bankers Insurance Plan Michigan Catholic Conference Michigan Chamber of Commerce Michigan Conference of Teamsters Welfare Fund Michigan Education Association Michigan Health & Hospital Association Michigan Institute of Aviation and Technology Michigan Public School Employees Retirement System Michigan Retailers Services, Inc. Michigan Schools and Government Credit Union Michigan Schools and Government Credit Union Mid America Clinical Laboratories, LLC Mid State Oil Tools, Inc. MIDAS Mid-States Bolt and Screw Co. Midway Games Inc. Midwest Communications IN National Group Roster-PRRL

Group Number XX 0000835 & 0005001 XX 50523 XX 0005929 XX 0000952 51808 0000150 2148 0009658 20139 0001600

Program Type XX Delta Dental PPO (POS)

Control Plan Iowa Michigan

XX Delta Dental Premier XX Delta Dental PPO (Standard) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Pennsylvania Minnesota Wisconsin Ohio/Michigan* Wisconsin Michigan Wisconsin Indiana/Michigan* Illinois Michigan Illinois Tennessee

0008800

Delta Dental PPO (Standard)

Tennessee

0004113 0005265

Delta Dental PPO (POS) Delta Dental PPO (POS)

Tennessee Indiana/Michigan*

20143 XX 50303 51079 20158 XX 06756 0007188 50902 XX 0007775 0009035 0009253 0005515 0009275 & 0009276 0006346 0002064 0000416

XX XX XX XX XX XX Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Illinois Wisconsin Wisconsin Minnesota Illinois Virginia Florida Ohio/Michigan* Wisconsin Minnesota Michigan Michigan Michigan Michigan Michigan

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

Michigan Michigan Michigan

0003250

Delta Dental PPO (POS)

Michigan

0004279 0003976

Delta Dental PPO (POS) Delta Dental PPO (POS)

Michigan Michigan

0003100

Delta Dental PPO (POS)

Michigan

0007096 0005625 5749 0005780 20161 XX

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX XX

Indiana/Michigan* Michigan Illinois Michigan Illinois Wisconsin

34

04/2013

Group Name Midwest Energy Cooperative Midwest Express Airlines Midwest Form Constructors Midwest Grain Products Midwest Memorial Group, LLC Mid-West Metal Products Company Midwest Plastic Engineering, Inc. MILA, Inc. Millbrook Distribution Services, Inc. Millennium Pharmaceuticals, Inc. Millwrights Local 1102 Health & Welfare Fund Milwaukee Electric Tool Corporation Minerals Technologies, Inc. Minnesota Valley Engineering Minolta Minster Machine Company, The MinuteClinic Group of Employers, The MiraMed Global Services, Inc. Mirant Corporation Mission Essential Personnel, LLC Mitchel Group, The MiTek Industries, Inc. Mitel, Inc. Mitsubishi Caterpillar Forklift American Mobile Drill Moen Incorporated MOL Logistics Molina Healthcare Molnlycke Health Care US, LLC Monaco Coach Monet Group, The Moneygram International Monrovia Nursery Monroe Central School Corporation Monsanto Moody’s Corporation Morgan Stanley – Smith Barney Mortgage Contracting Services Mosaica Education, Inc. Moss, Inc. Mpower Communications Corporation MPB Corporation MPI Research, Inc. MS Consultants MSC Industrial MSD of Lawrence Township MSD of Pike Township MSD of Washington Township Mt. Vernon Community School Corporation MTS Systems Corporation Multi Packaging Solutions (MPS) IN National Group Roster-PRRL

Group Number 0000783 50601 0000213 91605 0005976 0005910 0004539 XX 000276 007571 0005797

Program Type Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental Premier XX XX XX Delta Dental PPO (Standard)

Control Plan Michigan Wisconsin Indiana/Michigan Kansas Michigan Indiana/Michigan* Michigan Washington Massachusetts Massachusetts Michigan

XX XX 5976 5687 0001049 6999 0009482 11-3699 0001031 0009088 XX 6203 5164 0000052 0005761 2298 XX 06509 XX XX XX 369 0001129 6952 XX XX 15264 0000433 20193 2235 3822 0005864 XX XX 0007007 0007027 0007003 0001136

Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (Standard) Delta Dental PPO (POS) XX DeltaCare Delta Dental PPO XX XX XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

Wisconsin New York Minnesota New Jersey Ohio/Michigan* Rhode Island Michigan Georgia Ohio/Michigan* Indiana/Michigan* Missouri Virginia DDIC Indiana/Michigan* Ohio/Michigan* New York California Georgia Oregon Rhode Island Minnesota California Indiana/Michigan* Missouri Pennsylvania New York Florida Michigan Illinois New York New Hampshire Michigan Ohio/Michigan* New York Indiana/Michigan* Indiana/Michigan* Indiana/Michigan* Indiana/Michigan*

5303 0005567

Delta Dental Premier Delta Dental PPO (POS)

Minnesota Michigan

35

04/2013

Group Name Multi-Color Corporation Multifoods Multiquip, Inc. Muncie Community Schools Muncie Power Products, Inc. Munson Medical Center Munters Corporation Murata Machinery USA Holdings, Inc. Murphy McGinnis Media, Inc. Murray Guard Inc. Muscular Dystrophy Association Musicland Group, The Mutual of American Inc. Myers Industries Incorporated Myers Plumbing MyFamily.com, Inc. MYR Group, Inc. Myriad Genetics Nabisco Foods Group NACA Logistics Group NACM Great Lakes Region NAMIC Group Insurance Trust Nash Finch Companies Nashville Dental, Inc. Natare Corporation National Assoc. for Female Executives National Automatic Sprinkler Industry (NASI) Welfare Fund National Benevolent Association National Cinemedia National Computer Systems National Dairy Holdings National Data Corp. National Electronics Warranty, LLC. Nationsal Entertainment Network, Inc. National Federation of Independent Business National FFA National Heritage Academies, Inc. a Michigan Corporation National I.A.M. Benefit Trust Fund National Medical Health Card National Railroad Passenger Corporation (Amtrak) National Security Technology National Vision, Inc. Nationwide Children’s Hospital, Inc. Navigant Consulting, Inc. Navigators Group, Inc. Navilyst Medical NAVTEQ North America LLC NBTY, Inc. NC - Individual Dental Plans IN National Group Roster-PRRL

Group Number 0000106 5629 2752 0001160 0000400 0001969 000257 0000541 5360 0003868 4375 5739 2222 0005933 0003946 3888 5549 XX 5462 XX 0000111 0000105 XX 0001568 0000042 5129 XX

Program Type Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX

Control Plan Ohio/Michigan* Minnesota California Indiana/Michigan* Indiana/Michigan* Michigan Massachusetts North Carolina/Michigan* Minnesota Tennessee Arizona Minnesota New York Ohio/Michigan* Tennessee Utah Illinois DDIC New Jersey California Indiana/Michigan* Indiana/Michigan* Minnesota Tennessee Indiana/Michigan* California Pennsylvania

5073 XX 50527 XX 5285 0004127 XX 0001429

Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Missouri Colorado Minnesota Texas DDIC Tennessee Colorado Tennessee

0000167 0001180

Delta Dental PPO (POS) Delta Dental PPO (POS)

Indiana/Michigan* Michigan

5103 XX 1210

Delta Dental PPO (XX) XX Delta Dental Premier

Illinois New York District of Columbia

29-9210 XX 0001024 XX XX XX 20157 XX 0005100

XX XX Delta Dental PPO (POS) Delta Dental Premier DeltaCare XX XX XX XX

Nevada DDIC Ohio/Michigan* Illinois New York Massachusetts Illinois New York North Carolina/Michigan*

36

04/2013

Group Name NCH Corporation-DDIC NDH – (UC Milk Goldenrod Local #14746) Nease Group, The Nebraska Book Company, Inc. NEC America, Inc. Neighbor Care Nen Life Science Products NetScout Systems, Inc. Network General Network General Corporation Neutral Tandem New Albany-Floyd County Schools New Balance Athletic Shoe, Inc. New Buffalo Area Schools New England Automobile Dealers Insurance Trust New England Carpenters, The New England College of Optometry New Holland, Inc. New Resource Corporation New World Systems Nexeo Solutions LLC Next Wave Systems, LLC NFO, Inc. Niagara LaSalle Corporation Nicor Niles Community Schools Nintendo Nishikawa Standard Company, LLC (NISCO) Nissan North America, Inc. Nitrex, Inc. NLB Corp. NMRHCA - Basic Plan NMRHCA - Comprehensive Plan Noblesville Schools Norcraft Companies Norfolk Southern Corporation Norgren, Inc. Norman Noble, Inc. Norsk-Hydro Americas Nortek, Inc. North American Mission Board North Central Illinois Laborers’ Welfare Fund North Central Indiana School Insurance Consortium North Harrison Community School Corporation North Metro Advisor Network North Newton School Corporation Northeast Business Trust Northeast Foods, Inc. IN National Group Roster-PRRL

Group Number XX 3588

Program Type XX XX

Control Plan Texas Texas

XX XX 44-3947 XX 8796 000268 XX 2651 20142 0005849 7543 0006216 000661

Delta Dental Premier XX XX XX Delta Dental Premier XX XX Delta Dental Premier XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX)

Kentucky DDIC Texas Pennsylvania Massachusetts Massachusetts California California Illinois Indiana/Michigan* Massachusetts Michigan Massachusetts

XX 004735 5716 55099 0000196 XX 0000200 90092 2242 20018 0000884 5930 0000023

XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Massachusetts Massachusetts Pennsylvania Wisconsin Michigan Kentucky Indiana/Michigan* Iowa New York Illinois Michigan Washington Indiana/Michigan*

0004015 XX 0009412 0011578 0011579 0001151 XX 64690000 XX 0000049 7124 5750 113632 20141

Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) XX XX Delta Dental Premier XX

Tennessee Nevada Michigan New Mexico New Mexico Indiana/Michigan* Minnesota Virginia Colorado Ohio/Michigan* Pennsylvania Rhode Island Georgia Illinois

0000021

Delta Dental PPO (POS)

Indiana/Michigan*

0001139

Delta Dental PPO (POS)

Indiana/Michigan*

0009662 0000173 006624 7123

Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX

Michigan Indiana/Michigan* Massachusetts Pennsylvania

37

04/2013

Group Name Northeast School Corporation Northgate Arinso Northrop Grumman Corp Northwest Airlines, Inc Northwest Corporation Northwestern Mutual Life Norton Healthcare Norwood Promotional Products, LLC Nova Biomedical Novacare Novametrix Medical Center Novartis Nutrition Corporation Novartis Seeds, Inc. Novus International, Inc. NPL Construction Company NSK Americas NTH Consultants, Ltd. NuFarm Americas, Inc. NuTone Nuveen Investments, LLC NVR Incorporated NxStage Medical, Inc. ORAU Oak Street Funding LLC Oakland County O'Charley's Oakland County Oconomowok Residential Office Max/Boise OFS Fitel, LLC Ohio Association of County Boards of MR/DD Health Care Plan and Trust Ohio Carpenters' Health Fund Ohio Decorative Products, Inc. Ohio Education Association Ohio National Financial Services Ohio State Highway Patrol Retirement System Ohio State University, The The Ohio State University Comprehensive Student Dental Plan Ohio Transmission & Pump Company Ohio Turnpike Commission OhioHealth Old Mother Hubbard, Inc. Oldham Chemicals Co., Inc O'Leary Paint Company and O'Leary Services, LLC Olin Group Olympic Steel Olympic Steel, Inc. OMG Americas Omni Guide, Inc. IN National Group Roster-PRRL

Group Number 0000179 11-5752 XX 50522 5710 XX XX 0005414 004773 4166 4159 50518 50517 XX 4432 0000169 0009279 20164 1740 20180 XX XX 0001188 0000039 0009936 0004102 5438 50197 20048 XX 0001015

Program Type Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (XX) XX XX Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (XX) XX XX Delta Dental PPO (POS)

Control Plan Indiana/Michigan* Georgia California Minnesota Minnesota Wisconsin Kentucky Indiana/Michigan* Massachusetts Pennsylvania Connecticut Minnesota Minnesota Missouri Arizona Michigan Michigan Illinois Massachusetts Illinois Virginia Massachusetts Tennessee Indiana/Michigan* Michigan Tennessee Michigan Wisconsin Illinois Georgia Ohio/Michigan*

0001055 0001060 0002060 0005782 0005403

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS)

Ohio/Michigan* Ohio/Michigan* Ohio/Michigan* Ohio/Michigan* Ohio/Michigan*

0001733 0001960

Delta Dental PPO/OSU Clinic Delta Dental PPO/OSU Clinic

Ohio/Michigan* Ohio/Michigan*

0005532 0000214 0009711 006507 0001366 0004341

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS)

Ohio/Michigan* Ohio/Michigan Ohio/Michigan* Massachusetts Tennessee Michigan

4540 3925 0000107 0000225 XX

Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX

New Jersey New Jersey Ohio/Michigan* Ohio/Michigan* Massachusetts

38

04/2013

Group Name Omnicare Clinical Research, Inc. Omnicell, Inc. Omnium Worldwide, Inc. ON SemiConductor Onan Corporation Oncure One Calls of America One Click Internet Ventures, LLC One Stop O’neal Steel Oneok, Inc. Ontario Systems, LLC Onyx North America Group OPEIU Local #55 Operating Engineers Local 324 Health Care Plan Opteum Optos, Inc. Opus Corporation Orchid Orthopedic Solutions, LLC O’Reilly Automotive, Inc. – CSK Auto Organogenesis, Inc. Orica USA, Inc. ORIX USA – Holdings Lokey Orleans Homebuilders, Inc. Orthopedic Systems, Inc. Orvis Company, The Oshkosh Truck Corporation Otis Spunkmeyer Ottawa County Otterbein University Our Lady Queen of the Clergy Our Savior Lutheran Church & School Outsource Group, LLC, The Overhead Door Company of Columbus, Inc. Overland Solutions Overnite Transportation Owens & Minor Owens Corning Sales, LLC Owens State Community College Owens-Illinois, Inc Oxford Financial Group, Ltd. Ozark Electronics Repair Ozburn Hessey Logistics, LLC Ozer Group, The P.A.M. Transport P.B. & S. Chemical P & M Services Dba Fibercore Ops Pacer International Inc Pacific Coast Feather Pacific Cycle LLC Packaging Personified, Inc. IN National Group Roster-PRRL

Group Number 16 XX XX 4242 5941 XX 0005024 0000211 0001602 XX XX 0000089 XX XX 0002324

Program Type Delta Dental Premier XX XX XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (Standard) Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS)

Control Plan Kentucky California Nebraska Arizona Minnesota Colorado Ohio/Michigan* Indiana/Michigan* Michigan Alabama Oklahoma Indiana/Michigan* Wisconsin Florida Michigan

9185 005027 51066 0005863 69073000 006037 XX XX 9328 848 7752 XX XX 0000607 0007359 3036 0003270 XX 0000223

XX XX XX Delta Dental PPO (POS) Delta Dental Premier XX XX XX XX Delta Dental PPO (XX) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental PPO (POS)

New Jersey Massachusetts Minnesota Michigan Missouri Massachusetts Colorado DDIC Pennsylvania California Vermont Wisconsin California Michigan Ohio/Michigan* Rhode Island Tennessee California Indiana/Michigan*

XX 6377 8627 0009401 0009667 0001167 0007032 9337 0001668 4424 9402 5741 0003977 2705 XX XX 20039

XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX XX

Kansas Virginia Virginia Ohio/Michigan* Ohio/Michigan* Ohio/Michigan* Indiana/Michigan* Arkansas Tennessee Massachusetts Arkansas Kentucky Tennessee California Washington Wisconsin Illinois

39

04/2013

Group Name Pactiv Paddington Corp., The Page One, LLC Paidos Health Care, Inc Painters District Council #30 Benefits Fund Palace Sports & Entertainment, LLC Paladin Brands Pamida Panattoni Construction Panduit Corporation Pantheos Group, The Panther Racing LLC Paradies Shops, The Paralyzed Veterans of America Parametric Technologies Paragon Properties Parexel International Park Place Entertainment Parker Hannifin Corporation, Hydraulic Systems Division Parksite Group, The Parkway School District Partners HealthCare System, Inc.-MGH Pason Systems USA Corp Paul Schultz Advertising Payless Shoe Source PayPros, Inc. Peabody Holding Co., Inc. PEEHIP Pella Corporation Pendum, LLC Penn Mutual Life Insurance Co. Pennoni Associates Pentagon Federal Credit Union Penn Harris Madison School Corporation Penske Automotive Group Pepsi Bottling Group PepsiAmericas Pepsico Pepsi-Cola Per Se Technologies PeraCare Perdue Farms Perfect 10 Perfetti Van Melle USA Performance Food Group Performance Mechanical Contracting, Inc. PerkinElmer Perkins & Will Permacel IN National Group Roster-PRRL

Group Number XX 5297 0005366 2089 20156

Program Type Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX

Control Plan Texas New Jersey Tennessee Illinois Illinois

0005851 XX XX XX 20067 20187 0009897 XX XX 0407 0001556 007990 29-9070 0005306

Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental PPO (Standard) Delta Dental PPO (POS)

Michigan Iowa Wisconsin California Illinois Illinois Indiana/Michigan* Massachusetts Pennsylvania Massachusetts Michigan Massachusetts Georgia Michigan

XX XX XX XX XX 1000 XX 5325 XX XX 9466 4482 XX 600255 0007093

XX XX XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX XX Delta Dental PPO (XX) Delta Dental Premier XX Delta Dental PPO (XX) Delta Dental PPO (POS)

Illinois Missouri Massachusetts Colorado Kentucky Kentucky DDIC Missouri DDIC Iowa Colorado Pennsylvania Pennsylvania Virginia Indiana/Michigan*

0001103 XX 5747 XX 5747 XX 9426 7064 9061 DU8006 700065 0000217

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental Premier XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (Standard)

Michigan Georgia Illinois Florida Illinois Georgia Colorado Pennsylvania Arkansas Kentucky Virginia Indiana/Michigan*

XX 20179 3997

XX Delta Dental PPO (XX) Delta Dental Premier

Massachusetts Illinois New Jersey

40

04/2013

Group Name Permatex Petersen Engineering, Inc. Peterson American Corporation PFPC Enterprises Inc. Pharmacia Phi Kappa Psi Fraternity PHICO Insurance Co. Philadelphia Glass Bending & Sea Gull Lighting Philip Services Corporation Philip Services Corporation-DDIC Phillips Edison & Company, LTD Philips Electronics North America Phillips Feed and Pet Supply Phillips Plastics Phillips Service Industries Physician Service Group Physicians Choice Laboratory Services, LLC Physicians Health Plan Pick N Pull Pillar Data Systems Pillar Technology Group, LLC Pillsbury Pinnacle Corporation dba Town and Country Homes Pinnacle Entertainment Inc. Pioneer Hi-Bred International, Inc. Pipefitters Local 636 Insurance Fund Pitney Bowes Pittston Company, The PKC Group Plan Unit 116 Midwest Riverboats Planned Parenthood Mid and South Michigan Plante & Moran, LLP Plastic Moldings Company, LLC Plexus Corporation Plumbers & Pipefitters Local 162 Insurance Fund Plumbers & Pipefitters Local 189 Health & Welfare Fund Plumbers’ Welfare Fund 130 U.A. Plus Group, The Ply Gem Industries, Inc. Ply Gem Industries Plymouth Community School Corporation Pokagon Gaming Authority Polaris Laboratories PolyOne Corporation Polypore International, Inc. Pomps Tire Service Inc. Popular Financial Holdings, Inc. IN National Group Roster-PRRL

Group Number 4089 0005396 0005283 0000182 3979 0000027 XX 3486

Program Type Delta Dental Premier Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier

Control Plan Connecticut Indiana/Michigan* Michigan Ohio/Michigan* New Jersey Indiana/Michigan* Pennsylvania New Jersey

XX XX 0000133 1681 XX 52804 0009168 0007551 0000548

XX XX Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX

New York Texas Ohio/Michigan* New York Pennsylvania Wisconsin Michigan Michigan North Carolina/Michigan*

0005175 XX XX 0000251 XX 2112

XX XX XX Delta Dental PPO (POS) XX Delta Dental Premier

Michigan California California Ohio/Michigan* Minnesota Illinois

XX 77773 0005030 5855 61310000 0000185 20093 0004145

XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS)

DDIC Iowa Michigan New Jersey Virginia Michigan Illinois Michigan

0009726 0009247 XX 0000170

Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Michigan Ohio/Michigan* Wisconsin Ohio/Michigan*

0009148

Delta Dental PPO (POS)

Ohio/Michigan*

20079 2130 0316974 XX 0001105

XX Delta Dental PPO (XX) XX XX Delta Dental PPO (POS)

Illinois Illinois North Carolina/Michigan* Missouri Indiana/Michigan*

0005556 0007078 0001189 0000518 55304 XX

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX

Michigan Indiana/Michigan* Ohio/Michigan* North Carolina/Michigan* Wisconsin New Jersey

41

04/2013

Group Name Porter Precision Products Co. Post Glover Resistors, Inc. Power Construction/Power Wellness PPS Holdings, Inc. Precision Rings, Inc. Precision Roll Grinder Preferred USA Voluntary (Enhanced) Preit Services, LLC Premcor Premdor US Holdings Premier Dental Products Premier Salons Premier Salons International Premier USA Voluntary Premier USA Voluntary (Enhanced) Pres Metro Pres Metro Member Option Presbyterian Church (USA) Prevent Blindness America Prince Telecom Priority Health Medicare Plan PriorityHealth Pri-Pak, Inc. Pro Mach Inc. ProAssurance ProMedica Health System Production Resource Group LLC Professional Dental Technologies, Inc. Professional Services Industries Professional Services Industries Prolift Industrial Propak Logistics, Inc. Protection One Protective Life Insurance PSC-CUNY Welfare Fund PSINet, Inc PSS/World Medical, Inc. Public Service Company of New Mexico Publicis Group International – MMS US Holdings, Inc. Publishers Printing Publishers Printing Company Pulitzer, Inc. Puma North America Purdue University Pure Air/Lott Enterprises Purity Cylinder - Airway Oxygen Pyrotek Qbe QEK Global Solutions QinetiQ IN National Group Roster-PRRL

Group Number 0009180 690310 20191 0001610 & 0001620 0009131 XX XX 2864 XX 1003695 5345 50591 5756 XX XX 0011493 0011494 6580-DU 20003 1240 0001179 0005791 0000083 0000011 XX 0009006 & 0009007 6250 9191 20102 XX XX 9359-subs 90401 XX XX 62320000 1417 0008517 XX XX XX XX 008694 9824 & 5186 25-05668 0004864 9262 XX 0009586 700039 42

Program Type Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO (XX)

Control Plan Ohio/Michigan* Kentucky Illinois Tennessee

Delta Dental PPO (POS) XX XX XX XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (Standard) Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Indiana/Michigan* Pennsylvania Massachusetts Pennsylvania Missouri Florida Pennsylvania Minnesota Minnesota Massachusetts Massachusetts New Mexico New Mexico Kentucky Illinois Delaware Michigan Michigan Indiana/Michigan* Ohio/Michigan* DDIC Ohio/Michigan*

DeltaCare XX XX XX Delta Dental PPO (XX) XX Delta Dental Premier XX XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (XX)

California Arkansas Illinois Illinois Kentucky Arkansas Kansas DDIC New York Virginia DDIC New Mexico New York

Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX

Kentucky Kentucky Missouri Massachusetts Indiana/Michigan* Mississippi Michigan Pennsylvania New York Michigan Virginia 04/2013

Group Name Qol Meds, LLC Quadion Corporation QuadraMed Affinity Corporation Quality Distribution, Inc. Quality Mill Supply Co., Inc. Quality Synthetic Rubber, Inc. QualxServ Quanex Building Products Corporation Quest Specialty Chemicals Quik Print Quincy Newspapers, Inc. Quincy Street, Inc. Quinton Instrument Company R&L Carriers Shared Services Inc. Welfare Benefit Plan R.L. Polk & Company R.A. Jones – DU1570 R.A.B. Holdings Rabobank RADAC Radio Systems Corp Radiopharmacy RailAmerica, Inc. Railtech Boutet, Inc. Railworks Corporation Rally Software Randstad L.L.D., Ransome & Randolph Raymond James Financial Raytheon Raytheon Aircraft Co & Raytheon Aircraft Services RCAB – Clergy RCM Technologies, Inc. Re Transportation ReAble Therapeutics, Inc. (formerly EMPI-Encore Medical Group) Reading Community Schools Real Times, Inc. Red Robin International Redcats USA, Inc. Refrigerated Holdings, Inc. Regal Cinemas, Inc. Regenstrief Institute, Inc. Regis Corporation Rehmann Reit Management LLC Reliance Steel & Aluminum Remedy Temp., Inc. Remington Hotel Renter’s Choice Republic Steel

IN National Group Roster-PRRL

Group Number XX XX 600224 10-3761 0000098 0001044 XX XX 0000706 5556 XX 0001047 9007 0001005

Program Type XX Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS)

Control Plan Pennsylvania Minnesota Virginia Florida Indiana/Michigan* Ohio/Michigan* New York Texas Michigan Pennsylvania Illinois Michigan Washington Ohio/Michigan*

0009538 XX XX XX 5200 0003008 0000050 106962 0005647 XX XX 8999 401-0119 XX XX 90105 & 90205

Delta Dental PPO (POS) Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX Delta Dental Premier XX XX DeltaCare XX

Michigan Kentucky New York New York Kentucky Tennessee Indiana/Michigan* Florida Ohio/Michigan* New York Colorado Massachusetts Pennsylvania DDIC Massachusetts Kansas

000554 3923 0005670 051063

Delta Dental PPO (XX) Delta Dental Premier Delta Dental PPO (POS) XX

Massachusetts New Jersey Tennessee Minnesota

0006476 20027 XX 0000080 06772 0004095 0000063 5901 0005689 000374 XX 685 441303 5779 0009693

Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS)

Michigan Illinois Colorado Indiana/Michigan* Georgia Tennessee Indiana/Michigan* Minnesota Michigan Massachusetts California California Texas DDIC Ohio/Michigan*

43

04/2013

Group Name Republic National Distribution Company Res Care Restaurants Unlimited Resurgent Capital Services, L.P. Reta Trust, The Retired Police of Washington Retirees of the Goodyear Tire & Rubber Co Health Care Trust, The Retirees of Veyance Technologies, Inc. Health Care Trust Revlon, Inc. Revolution LLC Rex Energy Reynolds & Reynolds Reynolds Metals Company RFC Corporation Rheem Manufacturing` Rhodes, Inc. Richfield Iron Works Ride Control, LLC dba Gabriel North America Rio Tinto America, Inc. RISO Rite Aid Ritz Carlton Hotels River Valley School District Riverain Medical Group Riverside Company/Savings Rx Plan Riverside Radiology and Interventional Associates, Inc. RMT, Inc. Robbins & Myers, Inc. Roche Diagnostics Rock of Ages Memorials Inc. RockTenn Rockwell International Rockwood Service Corporation ROCOR International Rocore Industries Roehl Transport Inc. Rogers Group Inc. Rolf C. Hagen Roll Global, LLC Rolls-Royce North America, Inc. Rosalind Franklin University of Medicine & Science Rosemount, Inc. Rossi American Hardwoods Roto-Rooter Services Company Roundy’s Rowe Furniture Company Roy Jorgensen Associates IN National Group Roster-PRRL

Group Number 11-9737 thru 11-9743 5246 XX 6098-1000 XX XX 0001011

Program Type XX

Control Plan Georgia

Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (XX) Delta Dental PPO (POS)

Kentucky Washington South Carolina California Washington Ohio/Michigan*

0001012

Delta Dental PPO (POS)

Ohio/Michigan*

1582 XX XX XX 5781 XX 11-6996 XX 0009004 0000133

Delta Dental PPO (XX) XX Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental Premier XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS)

New York District of Columbia Pennsylvania DDIC Virginia Minnesota Georgia Georgia Michigan Michigan

5401 1037 XX 36171819 0006088 0005890 XX 0000167

XX Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (Standard) XX Delta Dental PPO (POS)

Utah Massachusetts Pennsylvania Georgia Michigan Ohio/Michigan* New York Ohio/Michigan*

5576 0009103 3998 XX XX XX 4179 5580 XX XX 0006520 004613 XX 0009220 20055

Delta Dental Premier Delta Dental Premier Delta Dental Premier XX XX XX XX Delta Dental Premier XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX

Wisconsin Ohio/Michigan* New Jersey Vermont DDIC California New Jersey Oklahoma Wisconsin Wisconsin Tennessee Massachusetts California Indiana/Michigan* Illinois

50605 XX 0009564 51298 6229 XX

Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX

Minnesota New Jersey Ohio/Michigan Wisconsin Virginia Pennsylvania

44

04/2013

Group Name Royal Bank of Canada (formerly Dain Rauscher Corporation) Royal Caribbean Cruises Royco Hotels RSDC of Michigan, L.L.C. RTA/Metra Ruan Transportation Rudolph/Libbe & Companies, Inc. Ryan International Airlines Ryerson Tull S C Johnson & Son Inc S.M. Stoller Corporation, The S&S Industries, Inc. Sabre Industries Saco Industries, Inc. Sacramento Municipal Utilities District Sadler Brothers Trucking SAFECO Safety Kleen Safeworks SAF-HOLLAND USA, Inc. Safran USA, Inc. Safway Steel Products Saga Communications Saginaw Chippewa Indiana Tribe Saginaw Machine Systems Saint Francis Academy, The SAJ/Stephen LaFrance Pharmacy, Inc. SAKS, Inc. Saks, Incorporated SALLIE MAE, Inc Samsonite Corp. San Diego County Employees Retirement Association Sandia National Laboratories Sanjo Steel, Inc. Sara lee Sargent & Lundy LLC Sarnova HC, LLC dba Boundtree Medical and Tri-anim Health Services, Inc. Savage Companies Savvis Sazerac Company SBA Network Services, Inc. SBC Executive Committee SCA Americas Scan Optics Scarpino, Patterson, & Associates Schaeffler Group US Schawk, Inc. Schenectady International, Inc. Schering Berlin, Inc. (Berlex Labs) IN National Group Roster-PRRL

Group Number XX

Program Type XX

Control Plan Minnesota

XX 473156 0004547 2148 90332 0005653 90402 5390 50111 XX 0005051 XX 0000183 XX 0003375 9004 44-4390 XX 0009719 XX XX 0000211 0001188 0001511 701 5259 XX XX 600220 5375 2472

Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX XX Delta Dental PPO (XX) Delta Dental PPO (Standard) XX

Florida Nebraska Michigan Illinois Iowa Ohio/Michigan* Kansas Illinois Wisconsin Colorado Tennessee Pennsylvania Indiana/Michigan* California Tennessee Washington Texas Washington Michigan DDIC Wisconsin Michigan Michigan Michigan Kansas Arkansas DDIC New York Virginia Colorado California

0009550 0000026 XX 2108 0005804

Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (Standard)

New Mexico Indiana/Michigan* Illinois Illinois Ohio/Michigan*

45-6351 91711000 XX 101485 0001728 9400 4076 0001906 XX 20075 2232 5442

XX Delta Dental PPO (XX) XX Delta Dental PPO (XX) Delta Dental Premier XX Delta Dental Premier Delta Dental Premier XX XX XX Delta Dental Premier

Utah Missouri Kentucky Florida Tennessee Pennsylvania New Jersey Tennessee Missouri Illinois New York New Jersey

45

04/2013

Group Name Schneider National Inc School Specialty Inc. Schulte Corporation Schupan & Sons, Inc. Scientific Games Corp Scientific Image Center Management Scopelitis, Garvin, Light, Hanson, and Feary, P.C. Scott A. Jones Household Secura Insurance Securian Security Seed And Chemical, Inc. sedgwick SEIU – Health Care Access Trust Select Comfort Select Medical Co. Select Sires, Inc. Selective Capital Selective Insurance Selective Insurance Company Semiconductor Component Industries, LLC dba: ON Semiconductor Senior Operations, Inc. SeniorCare Sensata Technologies, Inc. Sepracor, Inc. Sequoia Consulting Group Serrot Corporation/National Seal Co. Service Link Setzer Corporation SGP Acquisition SGS Thompson Micro Electronics Shaw Material Handling Systems, Inc. Shaw Newspapers Shawmut National Corporation Sheet Metal Workers’ International Association Sheet Metal Workers’ Intl Local Union 104 Sheet Metal Workers Local 104 Sheet Metal Workers Local #20 Welfare & Benefit Plan Sheet Metal Workers Local 36 Sheet Metal Workers' Local 73 Welfare Fund Shelby County Government Sherrard & Roe, PLC Sherry Holdings, LLC Shrader Tire & Oil, Inc. Shimadzu Scientific Instruments, Inc. Shionogi USA Holding, Inc. Shipco Transport, Inc. Shire US Shoney’s IN National Group Roster-PRRL

Group Number 50201 XX 0005459 0005266 113766 0000010 0000090

Program Type Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan Wisconsin Wisconsin Ohio/Michigan* Michigan Georgia Michigan Indiana/Michigan*

0000061 5243 XX 0002721 0004133 XX XX XX 0000096 XX XX 3933 4242

Delta Dental PPO (Standard) Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) XX XX XX Delta Dental PPO (POS) XX XX Delta Dental Premier XX

Indiana/Michigan* Wisconsin Minnesota Tennessee Tennessee District of Columbia Minnesota Pennsylvania Ohio/Michigan* Texas New Jersey New Jersey Arizona

20097 684470 000537 XX 0000019 1638 XX 0007442 65001005 5592 0001569 20196 5558 1243

XX XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier XX

Illinois Kentucky Massachusetts Massachusetts Indiana/Michigan* California Pennsylvania Ohio/Michigan* South Carolina Texas Tennessee Illinois Rhode Island District of Columbia

XX

XX

California

XX 0001020

XX Delta Dental PPO (POS)

California Indiana/Michigan*

9176-0000 0009765

Delta Dental PPO (XX) Delta Dental PPO (POS)

Missouri Michigan

0005319 0005695 0009112 0001085 7100 XX 3841 7154 5483

Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental Premier XX Delta Dental PPO (Standard)

Tennessee Tennessee Indiana/Michigan* Ohio/Michigan* Pennsylvania DDIC New Jersey Pennsylvania Tennessee

46

04/2013

Group Name Shopko, Inc.-SV Pharmacies Showboat Marina Casino Partnership Shurguard Sidley Austin Brown & Wood, LLP Siemon Company Sierra pacific Mortgage Silberline Manufacturing Co, Inc. Silverbrook Manor, Inc. Silversmith, Inc. Simpson Housing, LLLP Sims Deltec, Inc. Sinclair Broadcast Group, Inc. Sinsinawa Dominicans SIRIUS Satellite Radio, Inc. SIRVA, Inc. Six Flags Inc. Skadden, Arps, Slate, Meagher & Flom LLC Skechers USA Skidmore College Skillsoft Corporation Skyline Corporation Skyway Airlines, Inc. Sleep Products, Inc. SLM Corporation “Sallie Mae” Sloan Valve Corporation Small Business Plan B Smarte Carte, Inc. SMS Holdings, Inc Smead Manufacturing Company, The Smiths Group North American, Inc. Smithway Motor Xpress, Inc. Snappy Car Rental, Inc. SNE Enterprises, Inc. Society of Manufacturing Engineers Solae Solidarity Federal Credit Union Solstice Neurosciences Solutia, Inc Sonic Industries Inc.& Sonic Restaurant Sonopress, Inc. (Bertelsmann, Inc) Sony/BMG Soo Line Railroad Soundbite Corporation Source Interlink Companies Sourcelink South Central Area Special Education Cooperative South Harrison Community School Corporation South Madison Community School Corporation

IN National Group Roster-PRRL

Group Number 91491 7023 9023 20082 4154 XX 2516 0000886 0005659 XX 5818 XX XX NY 2351 XX XX 2224

Program Type Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (Standard) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (XX) XX XX XX XX XX

Control Plan Wisconsin Indiana/Michigan* Wisconsin Illinois Connecticut California Pennsylvania Michigan Michigan Colorado Minnesota Pennsylvania Wisconsin New York Illinois New York New York

XX XX 1142 0005905 52806 0005839 XX 20198 XX 50570 0001767 5385 9156 XX 5581 5222 0000193 7700 0000362 XX 6954 5015 1524 XX 5918 001852 06090 XX 0000190

XX XX XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental PPO (Standard) Delta Dental Premier Delta Dental Premier XX Delta Dental Premier XX Delta Dental PPO (XX) XX Delta Dental PPO (POS)

California New York New Hampshire Indiana/Michigan* Wisconsin Indiana/Michigan* Virginia Illinois Massachusetts Minnesota Tennessee Minnesota Pennsylvania Iowa Oklahoma Wisconsin Michigan Missouri Indiana/Michigan* Pennsylvania Missouri Oklahoma New York/Pennsylvania* New York Minnesota Massachusetts Florida Illinois Indiana/Michigan*

0007026

Delta Dental PPO (POS)

Indiana/Michigan*

0007103

Delta Dental PPO (POS)

Indiana/Michigan*

47

04/2013

Group Name South Ripley Community School Corporation Southern Company Southern Michigan Bank & Trust Southern Sales Southern States Cooperative, Inc. Southern Union Company Southland Management Group Southport Presbyterian Church Southwest Airlines Southwest Gas Corp Southwest School Corporation Southwestern Ohio Educational Purchasing Council (EPC Schools) Spansion Spansion, Inc Spartan Motors, Inc. Special Olympics of Indiana, Inc. Specialty Brands Specialtycare, Inc. Spectrum Brands Inc. Spectrum Health Speidel-Hirsh Spencer Gifts LLC Spencer Industries, Inc. Spiegel Group, The SPL Integrated Solutions Sportech Springs Window Fashions Sprint Square D / Schneider Electric SRAM LLC SSOE, Inc. St. Joseph County ISD St. Francis Academy St. Louis Cardinals St. Tammany Federation of Teachers and Schools Health and Welfare St. Vincent Heart Center of Indiana Staff Management Staffmark Staffmark Holdings, Inc. Standard Aero Standard Motor Products Star Transportation, Inc. State Auto Insurance Company State Industrial Products State Line Pizza State of Delaware State of Illinois State of Indiana State of Iowa State of Ohio IN National Group Roster-PRRL

Group Number 0007102

Program Type Delta Dental PPO (POS)

Control Plan Indiana/Michigan*

3668 0001517 0005081 86120000 XX DU8069 0005881 44-4084 XX 0001110 0005630

Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS Delta Dental Premier XX XX Delta Dental PPO (Standard) XX XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Georgia Michigan Tennessee Virginia DDIC Kentucky Indiana/Michigan* Texas Nevada Indiana/Michigan* Ohio/Michigan*

XX XX 0000654 0000006 2376 0003507 XX 0004512 3711 9168 0000294 20004 7192 XX XX XX 20049 20225 0009111 0006463 701 1757 19-7016

XX DeltaCare Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) XX XX Delta Dental PPO (XX) XX XX XX Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO (XX)

California California Michigan Indiana/Michigan* California Tennessee Wisconsin Michigan Rhode Island New Jersey Indiana/Michigan* Illinois Pennsylvania Delaware Wisconsin Kansas Illinois Illinois Ohio/Michigan* Michigan Kansas Arizona Louisiana

0000153 XX 5095 0009141 XX XX 0004144 XX 0000125 0000242 XX XX 0009840 2330 9273

Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (Standard) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (XX)

Indiana/Michigan* Illinois Arkansas Ohio/Michigan* Arizona New York Tennessee Ohio/Michigan* Ohio/Michigan* Indiana/Michigan* Delaware Illinois Indiana/Michigan* Iowa Ohio/Michigan*

48

04/2013

Group Name State of Michigan State of Michigan-Retirees State of Missouri State of Montana State of NM General Services Dept Risk Management Division State of Ohio State of Rhode Island Employee Plan State of Tennessee State Police Officers Council State Teachers Retirement System of Ohio Steamfitters Local 3449 Medical and Benefit Plan Steel Technologies, Inc. Stefanini TechTeam Stephens Media Group Sterling Info Systems Sterling Jewelers Stevens Group STIHL, Inc Stiles Machinery, Inc. Stites & Harbison Stockyards Bank Stone & Webster Stonepath Group, Inc. Stout Risius Ross Inc Stratas Foods Stream International, Inc. Strick Corporation Strippert, Inc. Stryker Stuart Manufacturing, Inc. Sub Zero Freezer Co Inc. Suburban Health Organization Sud-Chemie, Inc Suffolk Public Schools Sumitomo Electric Group Summit Polymers, Inc. Sun Communities Operating Limited Partnership Sun Pharmaceutical Industries, Inc. Superior Essex Superior Insurance Group Supreme Corporation Surgical Nurses, LLC Sun HealthCare Group Inc. Sun Life Financial Sungard Data Systems, Inc. Sunnen Products Co. Sunoco, Inc. (Retirees) Sunspring American, Inc. IN National Group Roster-PRRL

Group Number 0008700 0008600 & 0008601 XX XX 0008523

Program Type Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan Michigan Michigan

XX XX Delta Dental PPO (XX)

Missouri DDIC New Mexico

0009273 8350 0001800 186 0009888

XX XX Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO (POS)

Ohio/Michigan* Rhode Island Tennessee Iowa Ohio/Michigan*

XX

XX

Pennsylvania

DU 6655 0009221 XX XX 0005236 0005943 XX 0001620 XX XX 5364-5101 9028 0009585 0004130 000633 9079 4580 0005480 0000212 XX 0000037 7181 600009 XX 0009469 0009987

Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX X Delta Dental PPO (POS) Delta Dental PPO (POS)

Kentucky Michigan Arkansas Pennsylvania Ohio/Michigan* Michigan Virginia Michigan Kentucky Kentucky Massachusetts Pennsylvania Michigan Tennessee Massachusetts Pennsylvania New York Michigan Indiana/Michigan* Wisconsin Indiana/Michigan Kentucky Virginia Kentucky Michigan Michigan

0000319 XX 9603 0005407 90990001 2485 1810 5595 5035 XX XX

Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (XX)

Michigan DDIC Indiana/Michigan* Indiana/Michigan* Arizona California Massachusetts Pennsylvania Missouri Pennsylvania Kentucky

49

04/2013

Group Name Sunstar f/n/a John O. Butler Company Sun-Times Media Productions, LLC Superior Essex Superior Group, Inc. Superior Services Incorporated Supervalu Sur La Table Susquehanna Bancshares Sutter Home Winery Svedala Industries SVS Vision Swank Audio Visual Swankmotion Pictures, Inc. Swat Pest Management Inc. Swedish Match North America, Inc. Swift & Company Swift & Company Sybex, Inc. Symbion Arc Management Services, Inc. Symmetry Medical Symphony Health Services syncreon America Inc. Syncreon North America Synergy, Inc. Syntegra Sypris Solutions Sypris Solutions, Inc. Syracuse University System Components, Inc. Systems Contracting TJ Maxx Taft, Stettinius & Hollister LLC Talaris (formerly De La Rue, Inc.) Talbots Talus Brokerage Services, LLC Tandem Health Care Target Corporation Tarkett Enterprises, Inc. Tate & Lyle Taylor Corporation TCA Management Services TD Auto Finance LLC TDK Corporation of America Teamhealth Team Staffing Inc Technical Aid Corporation TechSmith Corporation TechTarget, Inc. Tecumseh Power Company Ted Lansing Corporation Telcordia Telect, Inc. IN National Group Roster-PRRL

Group Number XX 20205 15269 2173 294 50529 XX XX XX 54598 0009622 XX XX 0000205 XX XX DU 6593 2093 0005333

Program Type XX Delta Dental PPO (XX) Delta Dental PPO (XX) Delta Dental Premier Delta Dental Premier Delta Dental Premier XX XX XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (Standard) XX XX Delta Dental PPO (Standard) XX Delta Dental PPO (POS)

Control Plan Illinois Illinois Georgia Pennsylvania Wisconsin Minnesota Washington Pennsylvania California Wisconsin Michigan Missouri Missouri Indiana/Michigan* Virginia Colorado Kentucky California Tennessee

9219 7176 0009259 0000259 20219 50632 XX 684440 XX 0003821 9455 7850 0000113 20145 007000 0000255 10-3762 XX 0000163 2113 XX 3604 0005670 2007 0004073 9256 XX 0000949 005483 XX 700018 3789 09335

Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental Premier XX XX XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX XX XX Delta Dental Premier XX

Indiana/Michigan* Pennsylvania Michigan Michigan Illinois Minnesota Kentucky Kentucky New York Michigan Arkansas Massachusetts Ohio/Michigan* Illinois Massachusetts Ohio/Michigan* Florida Minnesota Ohio/Michigan* Illinois Minnesota Texas Michigan* Illinois Tennessee New Jersey Massachusetts Michigan Massachusetts Wisconsin Virginia New Jersey Washington

50

04/2013

Group Name Teledyne Technologies, Inc. TeleTech Company, Inc Temple Inland Tennant Company Tenneco Automotive Tennis Corporation of America Tennsco Corp. Teradyne, Inc. Terracon, Inc. TestAmerica Laboratories, Inc. Thermadyne Thermo Fisher Scientific Inc. Thomas & Betts Corp Thomas Industries Inc. Thorton Oil Corp Three Rivers Hospital Thule Inc Thyssen Elevator Thyssenkrupp Materials NA, Inc. TIAA Cref TIC International, Corporation Tier Technologies Timberland Company, The Time Warner Telecom Tippecanoe School Corporation Tire Centers, LLC TLC Trucking TLD Logistics Services, Inc. T-Mobile USA, Inc. TMP Worldwide TN Coalition to End Domestic & Sexual Violence TN Community Development and Headstart TNT Logistics North America Toledo Cardiology Consultants, Inc. Toledo Firefighters Health Plan Tommy Bahama Tommy Bahama Tones Brothers, Inc. Toshiba American, Inc. TOTAL eMED Total Entertainment Restaurants Total Logistics Control (wholly owned subsidiary of SuperValu) Tom James Company Tones Brothers, Inc. Touchpoint Print Solutions Tower International Town of Lexington Town of Mooresville Town of Munster, Indiana IN National Group Roster-PRRL

Group Number 2343 DU 6592 XX XX 3671 20123 0004032 5936 6801 XX 7706 XX 0005525 XX 5719 0002235 4223 1116 0005190 XX 0000073 700041 1973 XX 0000114 XX XX 0005716 XX 2125 0005565

Program Type XX Delta Dental Premier XX Delta Dental PPO (XX) XX XX Delta Dental PPO (POS) XX XX XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental PPO (POS)

Control Plan California Kentucky DDIC Minnesota Illinois Illinois Tennessee Massachusetts Kansas Vermont Missouri New Hampshire Tennessee Wisconsin Kentucky Michigan Connecticut DDIC Michigan New York Indiana/Michigan* Virginia New Hampshire Colorado Indiana/Michigan* Missouri Minnesota Tennessee Washington New York Tennessee

0001178

Delta Dental PPO (POS)

Tennessee

1491 0000048 0001008 XX XX XX XX 7463 2601 50529

XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX XX XX XX Delta Dental Premier XX

Florida Ohio/Michigan* Ohio/Michigan* DDIC Washington Iowa California Tennessee Kansas Minnesota

0007479 & 0007522 XX 20190 0005525 XX 0007041 0000016

Delta Dental PPO (POS)

Tennessee

Delta Dental Premier Delta Dental PPO (XX) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Iowa Illinois Michigan Massachusetts Indiana/Michigan* Indiana/Michigan*

51

04/2013

Group Name Town of Norwood Towne Air Freight Toyoda Gosei North America Corporation Toyota Toyota Industrial Equipment TPSOS AMERICA INC Tracor Tractor Supply Company Trading Post Mobile Homes Trak Auto Corporation & Forest City Auto Parts Trans States Holding Transco Lines, Inc. TransMontaigne Product Services Inc. Transport Corporation of America TRC Companies Tredegar Corporation Tree of Life TreeHouse Foods, Inc. Trelleborg Corporation Tribal Members of the Pechanga Band of Luiseno Indians TRICARE Retiree Dental Program Tri-Creek Schools Trimac Transportation TriMark United Trimas Corporation Trimble Navigation Limited Trinchero Family Estates – Sutter Home Winery Trinity Health Trinity Health Corporation Tripp Lite Triton School Corporation Triumph Foods Stores Trott & Trott Troy Design and Manufacturing Company True North Management, LLC True Speed Enterprises, Inc. True Value Co. TRW, Inc. Tucker Ellis, LLP Tulane University Tulox Plastics Corporation Turner Industries Group, LLC Tway Co., Inc. The Tweeter Home Entertainment Group, Inc. Twin Disc Incorporated Twin Rivers Technol, LP Tyson Foods, Inc. IN National Group Roster-PRRL

Group Number 000601 0000085 0001174

Program Type Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan Massachusetts Indiana/Michigan* Michigan

M-00096 0000077 4646 XX 0004126 XX 7058

XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental Premier

Kentucky Indiana/Michigan* New Jersey Texas Tennessee Kentucky Pennsylvania

7725 9244 XX XX 000248 700020 XX 20081 0000020 & 0000030 XX

Delta Dental PPO (XX) XX XX XX XX XX XX XX Delta Dental PPO (POS)

Missouri Arkansas Colorado Minnesota Massachusetts Virginia Florida Illinois Michigan

XX 0007098 XX 000613 0009839 XX XX

XX Delta Dental PPO (POS) Delta Dental Premier DeltaCare Delta Dental PPO (POS) XX XX

Pennsylvania Indiana/Michigan* Kentucky Massachusetts Michigan California California

0009558 0009557 2156 0001149 XX 0000011 0009423

Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) Delta Dental PPO (XX) 0000011 Delta Dental PPO (POS)

Michigan Michigan Illinois Indiana/Michigan* Missouri Michigan Michigan

0000199 0000075 20065 XX 0000003 XX 0000046 XX 0000450 XX

Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) XX

Ohio/Michigan* Indiana/Michigan* Illinois Virginia Ohio/Michigan* Louisiana Indiana/Michigan* Louisiana Indiana/Michigan* Massachusetts

XX

91708 009880 9429

XX XX XX 52

California

Wisconsin Massachusetts Arkansas 04/2013

Group Name U A Local 190 Health Care Plan U.S. Bank U.S. Epperson Underwriting Company U.S. Industries, Inc. U.S. Medical Management, Inc. U.S. Military Retirees (AKA Tricare) U.S. Tsubaki UAW Group Health & Welfare Plan UAW Legal Services Plan UAW Retiree Medical Benefits Trust UFCW of Southwestern Ohio UFCW Unions and Employers Health and Welfare Plan of Central Ohio U-Haul International, Inc. UMWA Funds Unified Brands Unified Financial Services Union Benefits Trust Union Hospital Unique Fabricating, Inc. Unit Corporation UNITE! ACTWU Staff Unite HERE Staff Health Benefits United Business Media United Components, Inc. United Conveyor Corporation United Dairy Farmers United Defense, L.P. United Drug United Farm Family Life Insurance Company United Fire Group, The United Insurance Co. – Home SVCS United Laboratories, Inc. United Natural Foods, Inc. United Road Services, Inc. United Surgical Partners International United Technologies (division of Rocketdyne) United University Professions Benefit Trust Fund United Way Agencies of Allen County Univar USA Universal Health Services, Inc. (UHS) Universal Music Group University Bank University Health System University High School of Indiana, Inc. University Medical Center University of Illinois/Grad Assistants University of Indianapolis University of Louisville IN National Group Roster-PRRL

Group Number 0009053 XX XX XX 0009773 4600 20091 0009773 0009058 0001166 0005763 0001059

Program Type Delta Dental PPO (POS) XX Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS)

Control Plan Michigan Missouri Florida New Jersey Michigan California Illinois Michigan Michigan Michigan Ohio/Michigan* Ohio/Michigan*

XX XX 25-6811 6944 0001009 7024 0005303 5141 5349 20215 2124 20047 20166 0009735 6222 XX 0000035, 0007012 & 0007031 XX 5717 5513 XX 0009778 XX 4219

Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental PPO XX XX XX Delta Dental PPO (POS) Delta Dental Premier XX Delta Dental PPO (POS)

Arizona District of Columbia Mississippi Kentucky Ohio/Michigan* Maryland Michigan Oklahoma New York/Pennsylvania* Illinois New York Illinois Illinois Ohio/Michigan* Virginia Pennsylvania Indiana/Michigan*

XX Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (POS) XX XX

Iowa California Illinois Rhode Island Michigan Texas Connecticut

5829

Delta Dental Premier

Pennsylvania

0000325 XX XX XX 0001439 11-3776 0000204 DU7905 XX 0007067 XX

Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX Delta Dental PPO (POS) Delta Dental PPO (XX)

Indiana/Michigan* Washington Pennsylvania California Michigan Georgia Indiana/Michigan* Kentucky Illinois Indiana/Michigan* Kentucky

53

04/2013

Group Name University of Michigan, The University of Missouri, The University of New Mexico University of Notre Dame Du Lac University of Oklahoma, The University of Texas* University of Texas claims should be sent to: DDIC PO Box 152140 Irving, TX 75015-2140 800-89-DELTA University of Toledo, The Urban Retail Properties Urology Healthcare Group US Industries, Inc. US Xpress USA Trucks USAA USIS USN Communication UTi Integrated Logistics UTi Worldwide V3 Companies, Ltd. VAE Nortrak North America, Inc. Vaisala 4/1/2011 Valassis Communications, Inc. Valco Cincinnati Valero Energy Corporation Valley Record Distributors Valmont Industries, Inc. Valparaiso Community Schools Valspar Corporation, The Van Buren County Consortium Van Hoof Companies Vanguard Car Rental USA, Inc. Vecellio Group Vectren Corporation Ventra Plastics Veolia Transportation Veolia Water North America Veolia Water Solutions & Technologies Ventura Plastics Veritas Software Vermont American Corp Vernon Company Vertellus VERTIS Veyance Technologies, Inc. Viamedia Inc. VICORP Restaurants, Inc. Village of Downers Grove IN National Group Roster-PRRL

Group Number 0005970 XX 0008532 0005541 & 0009541 XX 5968

0005686 20106 0005465 XX 0007496 XX 3791 XX 2052 6101 XX 20188 XX XX 0001184 0009458 44-4091 402 50652 0000139 5766 0006486 52811 / 52911 5140 XX 0009280 XX 20098 20151 20160 6984 583 6584-DU 74913 0000024 XX 0005627 & 0005628 XX 50007 XX 54

Program Type Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental PPO (POS)

Control Plan Michigan Missouri New Mexico Indiana/Michigan*

XX Delta Dental Premier

Oklahoma Texas/DDIC*

Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX XX XX Delta Dental PPO (XX) XX Delta Dental PPO (XX) DeltaCare XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) XX XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX XX Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) XX Delta Dental PPO (POS)

Ohio/Michigan* Illinois Tennessee New Jersey Tennessee Arkansas Texas Pennsylvania Illinois South Carolina California Illinois DDIC Colorado Michigan Ohio/Michigan* Texas California Nebraska Indiana/Michigan* Minnesota Michigan Wisconsin Oklahoma DDIC Indiana/Michigan* Kentucky Illinois Illinois Illinois Kentucky California Kentucky Iowa Indiana/Michigan* Pennsylvania Ohio/Michigan*

XX XX XX

Kentucky Colorado Illinois 04/2013

Group Name Village of Lansing Virginia College, LLC Vishay Intertechnology, Inc. Viskase Companies, Inc. Vista Higher Learning Visual Aids Electronics Vital Signs, Inc. Vitran Express VMS VMware, Inc. Voicestream Wireless Voith Industrial Services, Inc. Voith Paper Inc Volume Service America, Inc. d/b/a Centerplate Von Maur Vorys, Sater, Seymour and Pease LLP Votorantim Cimentos North America dba VCNA W.W. Norton and Company WABTEC Corp. Wacker Chemical Corporation Wag Enterprises, Inc. Walbridge Walgreen, Co. Walgreen, Co. Walgreens – Options Care, Inc. Wal-Mart Stores, Inc. Wasserstrom Holding, Inc. Waste Management Wastren Advantage, Inc. WatchGuard Technologies Waterford Wedgwood USA, Inc. Waters Corporation Watlow Watsontown Trucking Company, Inc. Wausau Homes, Inc. Wayne State University WE Energies Weas Engineering, Inc. Weather Channel Company, The Weather Shield Mfg Inc Webster University Weiler Welding Company, Inc. Weiss & Neuman Weiss Communications, Inc. Welch’s Wellbridge Company, The WellCare – Comprehensive Health Management, Inc. Wellington Management Company, LLP Wells’ Dairy, Inc. Wells Fargo & Company Norwest IN National Group Roster-PRRL

Group Number 2051 05763 XX NY2371 XX XX 5605 0009293 2403 XX XX 0005509 XX XX

Program Type Delta Dental Premier Delta Dental PPO (XX) XX XX XX XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) XX

Control Plan Illinois Alabama Pennsylvania New York Massachusetts Pennsylvania New Jersey Indiana/Michigan* New York California Washington Ohio/Michigan* Wisconsin Missouri

XX 0009852 0005911

XX Delta Dental PPO (POS) Delta Dental PPO (POS)

Iowa Ohio/Michigan* Michigan

XX XX 0000102 0001359 0009272 5772 XX XX 8000 0009533 XX 0005365 XX 5778 7857 XX 8093 52898 0007544 XX 0007072 XX XX 6918-1000 0007313 6926 0005118 1753 6487 XX

XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX Delta Dental PPO (POS) XX Delta Dental Premier XX XX XX Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (XX) Delta Dental PPO (POS) Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental PPO (Standard) Delta Dental Premier Delta Dental PPO (POS) XX XX XX

Pennsylvania Delaware Michigan Michigan Michigan Illinois Illinois Illinois Arkansas Ohio/Michigan* DDIC Tennessee Washington New Jersey Massachusetts Missouri Pennsylvania Wisconsin Michigan Wisconsin Indiana/Michigan* Georgia Wisconsin Missouri Ohio/Michigan* Missouri Indiana/Michigan* Massachusetts Colorado DDIC

1096 XX 5710

XX XX Delta Dental Premier

Massachusetts Iowa Minnesota

55

04/2013

Group Name Wells Fargo Financial Wells Fargo/Wachovia (added to Wells Fargo contract) Wells Lamont Wessin & Gorman, Inc. West Lafayette School Corporation West Michigan Conference - UMC West Side Unlimited Corp West Washington School Corporation WestCare Foundation, Inc. Western and Central MA Plans Westminster Village North, Inc. Westmont Hospitality, Inc. Weston Foods, Inc. WestPoint Home Westrock Capital Partners, LLC Westview Hospital Weyerhaeuser Weyerhaeuser Company Wheaton Franciscan Services Whirlpool Corporation White River Township Fire Department Wil Tel Wilbert, Inc. Wild Oats Markets, Inc. Willbros USA, Inc. Willis-Knighton Health Systems Willis North America William Carter Center, The Williamson Medical Center WilmerHale Wilson Sporting Goods Windmoeller & Hoelscher Corp. Windstream, Inc. Winfield Industries Wintz Companies Wire Industries Wireless Vision LLC Wirthlin Worldwide Wirtgen America, Inc. Wisconsin Laborers Health Fund Witco Corp. WMS Gaming WMX Technology, Inc. Wolcott Squared Wolverine World Wide, Inc. Women in Community Service Word Systems, Inc. WorkflowOne, LLC Worklink World Travel Service, Inc Wright Medical Technology Wright State University IN National Group Roster-PRRL

Group Number 50649 5710, 51054

Program Type Delta Dental Premier Delta Dental PPO (XX)

Control Plan Minnesota Minnesota

740 5982 0001158 0001220 XX 0001125 29-15259 009504 0000020 3941 XX XX 9516 0007033 XX XX XX 0009179 0000201 XX 0371231 6066 XX 19-5893 XX XX 0008406 006165 20121 1759 XX 375 5824 9282 0001309 63440000 0003144 54601 5298 20116 5649 0002997 0005844 8587000 0000132 0005101 2014 0002234 0004088 0007344

Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO (XX) XX Delta Dental PPO (POS) XX XX XX XX Delta Dental PPO (POS) XX Delta Dental PPO (XX) XX Delta Dental PPO (POS) Delta Dental PPO (POS) XX XX Delta Dental Premier XX Delta Dental PPO (XX) XX Delta Dental Premier Delta Dental PPO (POS) XX XX Delta Dental Premier XX Delta Dental Premier Delta Dental PPO (Standard) XX Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (Standard) Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS)

Illinois Minnesota Indiana/Michigan* Michigan Iowa Indiana/Michigan* Nevada Massachusetts Indiana/Michigan* Texas Pennsylvania New York Arkansas Indiana/Michigan* Washington Washington Wisconsin Michigan Indiana/Michigan* Oklahoma North Carolina/Michigan* Colorado Oklahoma Louisiana New York Georgia Tennessee Massachusetts Illinois Rhode Island Arkansas California Minnesota Arkansas Michigan Virginia Tennessee Wisconsin New Jersey Illinois Illinois Tennessee Michigan Virginia Indiana/Michigan* Ohio/Michigan* Illinois Tennessee Tennessee Tennessee

56

04/2013

Group Name Writer’s Guild Xanitos XO Communications Xspedius Communications Xtek, Inc. Xtend Healthcare Xtra Corporation Yale Enforcement Services YALE UNIVERSITY Yankee Candle Company Yellow Roadways Yeshiva University York International Corp. Young Life, The Youth Villages Ypsilanti Township Yusen Logistics (Americas) Inc. Yushin America Zah Group Zale Corporation Zale Corporation – DeltaCare USA Zappos.com Zappos.com Zebra Technologies Zhongding USA, Inc. Zimmer Melia & Associates Zomax Zones, Inc. Zuken USA Inc. Zumiez Zurich Scudder Investments, Inc. 

Group Number XX XX NY2336 XX 0007321 0003070 6961 XX 4630 8907 XX XX 5863 5735 0004140 0001792 0004104 3033-0001 XX XX XX 299130 XX XX 0000270 0002704 50590 09331 003948 XX 1993

Program Type Delta Dental PPO (XX) XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX Delta Dental Premier XX XX Delta Dental Premier Delta Dental Premier Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier Delta Dental Premier XX Delta Dental PPO (XX) DeltaCare XX XX XX Delta Dental PPO (POS) Delta Dental PPO (POS) Delta Dental Premier XX XX XX XX

Control Plan California Pennsylvania New York Missouri Ohio/Michigan* Tennessee Missouri Illinois New Jersey Massachusetts Kansas Pennsylvania Pennsylvania Colorado Tennessee Michigan Tennessee Rhode Island Illinois Texas Texas Nevada DDIC Illinois Ohio/Michigan* Tennessee Minnesota Washington Massachusetts Washington New York

Please Note: Some groups may have two states listed under the Control Plan column. The first state is the Control Plan; the second state processes claims for that group. Please send those claims to the address listed for the second state.

XX Call the Control Plan to confirm the appropriate group number or program type.

IN National Group Roster-PRRL

57

04/2013

Following is an alphabetical list of addresses and telephone numbers for the members of the national Delta Dental system. (Note: two or more independent Delta Dental plans may use one processing center.) ALABAMA

ILLINOIS

MONTANA

RHODE ISLAND

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental of Illinois P.O. Box 5402 Lisle, IL 60532 (800) 323-1743

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental of Rhode Island P.O. Box 1517 Providence, RI 02901-1517 (800) 843-3582

ALASKA

INDIANA

NEBRASKA

SOUTH CAROLINA

ODS Health Plan 610 SW 2nd Avenue, Suite 900 Portland, OR 97204 (888) 374-8906

Delta Dental of Michigan P.O. Box 9085 Farmington Hills, MI 48333-9085 (800) 524-0149

Delta Dental of Minnesota P.O. Box 59238 Minneapolis, MN 55459-0238 (800) 448-3815

Delta Dental of Missouri P.O. Box 8690 St. Louis, MO 63126 (800) 335-8266

ARIZONA

IOWA

NEVADA

SOUTH DAKOTA

Delta Dental of Arizona P.O. Box 43026 Phoenix, AZ 85080-3026 (800) 352-6132

Delta Dental of Iowa P.O. Box 9000 Johnston, IA 50131-9000 (800) 544-0718

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental of South Dakota P.O. Box 1157 Pierre, SD 57501 (800) 627-3961

ARKANSAS

KANSAS

NEW HAMPSHIRE

TENNESSEE

Delta Dental of Arkansas P.O. Box 15965 N. Little Rock, AR 72231 (800) 462-5410

Delta Dental of Kansas P.O. Box 789769 Wichita, Kansas 67278-9769 (800) 234-3375

Northeast Delta Dental P.O. Box 2002 Concord, NH 03302-2002 (800) 832-5700

Delta Dental of Tennessee 240 Venture Circle Nashville, TN 37228 (800) 223-3104

CALIFORNIA

KENTUCKY

NEW JERSEY

TEXAS

Delta Dental of California P.O. Box 997330 Sacramento, CA 95899-7330 (888) 335-8227

Delta Dental of Kentucky P.O. Box 242810 Louisville, KY 40224-2810 (800) 955-2030

Delta Dental of New Jersey P.O. Box 222 Parsippany, NJ 07054 (800) 346-5377

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

COLORADO

LOUISIANA

NEW MEXICO

UTAH

Delta Dental of Colorado P.O. Box 173803 Denver, CO 80217 (800) 233-0860

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

CONNECTICUT

MAINE

Delta Dental of New Mexico 2500 Louisianna Blvd., N.E. Suite 300 Albuquerque, NM 87110 (800) 999-0963

Delta Dental of New Jersey P.O. Box 222 Parsippany, NJ 07054 (800) 346-5377

Northeast Delta Dental P.O. Box 2002 Concord, NH 03302-2002 (800) 832-5700

NEW YORK

Northeast Delta Dental P.O. Box 2002 Concord, NH 03302-2002 (800) 832-5700

DELAWARE

MARYLAND

Delta Dental of Pennsylvania One Delta Drive Mechanicsburg, PA 17055 (800) 932-0783

Delta Dental of Pennsylvania One Delta Drive Mechanicsburg, PA 17055 (800) 932-0783

DISTRICT OF COLUMBIA

MASSACHUSETTS

Delta Dental of Pennsylvania One Delta Drive Mechanicsburg, PA 17055 (800) 932-0783

Delta Dental of Massachusetts P.O. Box 9695 Boston, MA 02114 (800) 872-0500

FLORIDA

MICHIGAN

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental of Michigan P.O. Box 9085 Farmington Hills, MI 48333-9085 (800) 524-0149

GEORGIA

MINNESOTA

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

Delta Dental of Minnesota P.O. Box 59238 Minneapolis, MN 55459-0238 (800) 448-3815

HAWAII

MISSISSIPPI

Hawaii Dental Service 700 Bishop Street Seventh Floor Honolulu HI 96813-4196 (800) 232-2533

Delta Dental Insurance Company P.O. Box 1809 Alpharetta, GA 30023-1809 (800) 521-2651

IDAHO

Delta Dental of Missouri P.O. Box 8690 St. Louis, MO 63126 (800) 392-1167

Delta Dental of Idaho P.O. Box 2870 Boise, ID 83701 (800) 356-7586

MISSOURI

Delta Dental of Pennsylvania One Delta Drive Mechanicsburg, PA 17055 (800) 932-0783 NORTH CAROLINA

Delta Dental of Michigan P.O. Box 9085 Farmington Hills, MI 48333-9085 (800) 662-8856 OHIO

Delta Dental of Michigan P.O. Box 9085 Farmington Hills, MI 48333-9085 (800) 524-0149 OKLAHOMA

Delta Dental of Oklahoma P.O. Box 548809 Oklahoma City, OK 73154-8809 (800) 990-7337 OREGON

ODS Health Plan 610 SW 2nd Avenue Portland, OR 97204 (800) 452-1058 PENNSYLVANIA

Delta Dental of Pennsylvania One Delta Drive Mechanicsburg, PA 17055 (800) 932-0783

VERMONT

VIRGINIA

Delta Dental of Virginia 4818 Starkey Rd. SW Roanoke, VA 24014 (800) 237-6060 WASHINGTON

Washington Dental Service P.O. Box 75983 Seattle, WA 98175 (800) 238-3107 WISCONSIN

Delta Dental of Wisconsin P.O. Box 828 Stevens Point, WI 54481 (800) 236-3712 WYOMING

Delta Dental of Wyoming P.O. Box 29 Cheyenne, WY 82003-0029 (800) 735-3379 TRICARE RETIREE DENTAL PROGRAM

Delta Federal Services P.O. Box 537007 Sacramento, CA 95853-7007 (888) 838-8737

Delta Dental...the nation’s leader in dental benefits

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