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<br />© 2012 Hitesman & Wold, P.A. City of Elk River <br />Flexible Benefits Plan <br />49 <br />EXHIBIT A. <br />INSURANCE CARRIER/THIRD PARTY PROVIDER INFORMATION <br />(as of January 1, 2013 ) <br /> <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 /> <br /> <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 /> <br /> <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 /> <br /> <br />Long Term Disability Benefits <br />Carrier Name: National Insurance Services of Wisconsin <br />Address: <br /> <br />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 /> <br /> <br />Short Term Disability Benefits <br />Carrier Name: Unicare Life & Health Insurance Company <br />Address: <br /> <br />PO Box 7654 <br />Chicago, IL 60680-4654 <br />Phone Number: 800-618-6435 <br />Policy or Group Number: 146133W001 <br />Policy Year: January – December <br /> <br />Page 142 of 254