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4.9. SR 12-16-2013
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4.9. SR 12-16-2013
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12/13/2013 9:23:37 AM
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12/13/2013 9:12:55 AM
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12/16/2013
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EXHIBIT A. <br /> INSURANCE CARRIER/THIRD PARTY PROVIDER INFORMATION <br /> (as oflanuary 1,2013) <br /> Group Medical Benefits <br /> Carrier Name: Medica <br /> Address: 401 Carlson Parkway <br /> Minnetonka, MN 55305 <br /> Phone Number: 952-945-8000 <br /> Policy or Group Number: 553904 <br /> Policy Year: January— December <br /> Group Dental Benefits <br /> Carrier Name: Principal Financial Group <br /> Address: 711 High Street <br /> Des Moines, IA 50392-0001 <br /> Phone Number: 800-843-1371 <br /> Policy or Group Number: 1015564 <br /> Policy Year: January— December <br /> Group Term Life <br /> Carrier Name: The Standard Insurance Company <br /> Address: PO Box 5676 <br /> Portland, OR 97228-5676 <br /> Phone Number: 800-628-8600 <br /> Policy or Group Number: 142052 <br /> Policy Year: January— December <br /> Long Term Disability Benefits <br /> Carrier Name: National Insurance Services of Wisconsin <br /> Address: 250 South Executive Drive, Suite 300 <br /> Brookfield, WI 63005-4273 <br /> Phone Number: 800-627-3660 <br /> Policy or Group Number: 018374 <br /> Policy Year: January— December <br /> Short Term Disability Benefits <br /> Carrier Name: Unicare Life & Health Insurance Company <br /> Address: PO Box 7654 <br /> Chicago, IL 60680-4654 <br /> Phone Number: 800-618-6435 <br /> Policy or Group Number: 146133WO01 <br /> Policy Year: January— December <br /> ©2012 Hitesman&Wold, P.A. 49 City of Elk River <br /> Flexible Benefits Plan <br />
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