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Appendix L-Blue Cross and Blue Shield Plan Numbers

PLAN NUMBERS FOR UNITED STATES

BC BS STATE CITY PLAN NAME
00010 00510 Alabama Birmingham Blue Cross and Blue Shield of Alabama
00030 00530 Arizona Phoenix Blue Cross and Blue Shield of Arizona, Inc.
00020 00520 Arkansas Little Rock Arkansas Blue Cross and Blue Shield
00040 California Van Nuys Blue Cross of California
00542 California San Francisco Blue Shield of California
00050 00550 Colorado Denver Blue Cross and Blue Shield of Colorado
00060 00560 Connecticut North Haven Blue Cross and Blue Shield of Connecticut, Inc.
00070 00570 Delaware Wilmington Blue Cross and Blue Shield of Delaware, Inc.
00080 00580 District of Columbia Washington, DC Blue Cross and Blue Shield -
Columbia National Capital Area Shield of California
00090 00590 Florida Jacksonville Blue Cross and Blue Shield of Florida
00100 00600 Georgia Atlanta Blue Cross and Blue Shield of Georgia, Inc.
00471 00971 Hawaii Honolulu Hawaii Medical Service Association
00110 00610 Idaho Boise Blue Cross of Idaho Health Service, Inc.
00611 Idaho Lewiston Blue Shield of Idaho
00121 00621 Illinois Chicago Blue Cross and Blue Shield of Illinois
00130 00630 Indiana Indianapolis Anthem Blue Cross and Blue Shield of Indiana
00140 00640 Iowa Des Moines Wellmark Blue Cross and Blue Shield of Iowa
00150 00650 Kansas Topeka Blue Cross and Blue Shield of Kansas, Inc.
00160 00660 Kentucky Louisville Anthem Blue Cross and Blue Shield of Kentucky, Inc.
00170 00670 Louisiana Baton Rouge Blue Cross and Blue Shield of Louisiana
00180 00680 Maine Portland Blue Cross and Blue Shield of Maine
00190 00690 Maryland Owings Mills Blue Cross and Blue Shield of Maryland, Inc.
00200 00700 Massachusetts Boston Blue Cross and Blue Shield of Massachusetts, Inc.
00210 00710 Michigan Detroit Blue Cross and Blue Shield of Michigan
00220 00720 Minnesota St. Paul Blue Cross and Blue Shield of Minnesota
00230 00730 Mississippi Jackson Blue Cross and Blue Shield of Mississippi, Inc.
00240 00740 Missouri Kansas City Blue Cross and Blue Shield of Kansas City
00241 00741 Missouri St. Louis Alliance Blue Cross and Blue Shield of Missouri
00250 00751 Montana Helena Blue Cross and Blue Shield of Montana
00260 00760 Nebraska Omaha Blue Cross and Blue Shield of Nebraska
00265 00765 Nevada Reno Blue Cross and Blue Shield of Nevada
00270 00770 New Hampshire Manchester Blue Cross and Blue Shield of New Hampshire
00280 00780 New Jersey Newark Blue Cross and Blue Shield of New Jersey, Inc.
00790 New York New York Empire HealthChoice HMO, Inc.
00300 New York Albany Blue Cross of Northeastern New York
00800 New York Albany Blue Cross and Blue Shield of New Hampshire
00301 00801 New York Buffalo Blue Cross and Blue Shield of Western New York, Inc.
00302 New York Rochester Excellus Blue Cross and Blue Shield
00304 00804 New York Rochester The Fingerlakes Companies, Inc of New York
00305 00805 New York Syracuse Blue Cross and Blue Shield of Central New York, Inc.
00306 00806 New York Utica Blue Cross and Blue Shield of Utica-Watertown Inc.
00310 00810 North Carolina Durham Blue Cross and Blue Shield of North Carolina
00320 00820 North Dakota Fargo Blue Cross and Blue Shield of North Dakota
00332 00834 Ohio Cincinnati Anthem Blue Cross and Blue Shield of Ohio
00340 00840 Oklahoma Tulsa Blue Cross and Blue Shield of Oklahoma
00350 00851 Oregon Portland Blue Cross and Blue Shield of Oregon
00351 00850 Oregon Portland The Benchmark Group of Oregon
00865 Pennsylvania Camp Hill Pennsylvania Blue Shield
00361 Pennsylvania Harrisburg Capital Blue Cross
00362 Pennsylvania Philadelphia Independence Blue Cross
00363 Pennsylvania Pittsburgh Highmark Blue Cross and Blue Shield of Pennsylvania
00364 Pennsylvania Wilkes-Barre Blue Cross of Northeastern Pennsylvania
00370 00870 Rhode Island Providence Blue Cross and Blue Shield of Rhode Island
00380 00880 South Carolina Columbia Blue Cross and Blue Shield of South Carolina
00141 South Dakota Sioux City Wellmark Blue Cross and Blue Shield of South Dakota
00889 South Dakota Sioux Falls South Dakota Blue Shield
00390 00890 Tennessee Chattanooga Blue Cross and Blue Shield of Tennessee
00392 00892 Tennessee Memphis Blue Cross and Blue Shield of Memphis
00400 00900 Texas Dallas Blue Cross and Blue Shield of Texas, Inc.
00410 00910 Utah Salt Lake City Regence Blue Cross and Blue Shield of Utah
00415 00915 Vermont Montpelier Blue Cross and Blue Shield of Vermont
00423 00923 Virginia Richmond Trigon Blue Cross and Blue Shield of Virginia
00430 00934 Washington Seattle Blue Cross of Washington and Alaska;
Blue Shield in North Central Washington
00932 Washington Seattle Regence Washington Health of Washington
00938 Washington Bellingham Northwest Medical Bureau of Washington
00936 Washington Spokane Medical Service Corporation of Eastern Washington
00937 Washington Tacoma Regence Blue Shield of Washington
00443 00943 West Virginia Parkersberg Mountain State Blue Cross and Blue Shield, Inc.
00450 00950 Wisconsin Milwaukee Blue Cross and Blue Shield United of Wisconsin
00460 00960 Wyoming Cheyenne Blue Cross and Blue Shield of Wyoming
00470 Puerto Rico San Juan La Cruz Axul de Puerto Rico
00973 Puerto Rico San Juan Triple-s of Puerto Rico

PLAN NUMBERS FOR CANADIAN PROVINCES

BC BS STATE CITY PLAN NAME
00480 Alberta Edmonton Alberta Blue Cross Plan
00488 00988 British Columbia Vancouver Medical Services Association
00481 Manitoba Winnipeg Manitoba Blue Cross
00482 00982 New Brunswick Moncton Blue Cross of Atlantic Canada
00483 Ontario Toronto Ontario Blue Cross
00484 Quebec Montreal Quebec Blue Cross
00486 00986 Saskatchewan Regina Group Medical Services
00487 00987 Saskatchewan Saskatoon Saskatchewan Blue Cross

Revised 11/1998

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