Proposed Groups
Group W Nbr Insurer Name
E W000004 UNINSURED EMPLOYERS FUND
B W010003 TRAVELERS CASUALTY & SURETY CO
F W010250 ACADIA INSURANCE CO
B W010508 TRAVELERS CASUALTY & SURETY CO OF IL
B W010698 TRAVELERS CASUALTY CO OF CONNECTICUT
E W011001 ACE FIRE UNDERWRITERS INS CO
E W012009 ACE PROPERTY & CASUALTY INS CO
A W014005 GREAT AMERICAN ASSURANCE CO
E W015002 COUNTRYWIDE INSURANCE COMPANY
F W015754 AIU INSURANCE CO
F W016380 ALEA NORTH AMERICA INSURANCE CO
E W019004 ACE AMERICAN INS COMPANY
B W019509 ST PAUL PROTECTIVE INSURANCE CO
B W020002 ALLSTATE INSURANCE COMPANY
A W020507 GREAT AMERICAN ALLIANCE INS CO
B W020754 AMERICAN ALTERNATIVE INS CO
F W021000 AMERICAN AUTOMOBILE INSURANCE CO
E W022008 AMERICAN CASUALTY COMPANY OF READING PA
B W024004 AMERICAN EMPLOYERS INS CO
A W026009 AMERICAN AND FOREIGN INSURANCE CO
B W027007 AMERICAN GUARANTEE & LIABILITY INS CO
F W029003 AMERICAN HOME ASSURANCE CO
F W030001 AMERICAN INSURANCE CO
A W031009 AMERICAN MANUFACTURERS MUTUAL INS CO
A W032007 AMERICAN MOTORIST INSURANCE CO
A W033005 AMERICAN MUTUAL INSURANCE CO OF BOSTON
A W034003 AMERICAN MUTUAL LIABILITY INS CO
A W035000 GREAT AMERICAN INSURANCE CO OF NY
A W036008 VILLANOVA INSURANCE COMPANY
A W036578 AMERICAN STATES INSURANCE CO
B W036636 AMERICAN ZURICH INSURANCE CO
F W036669 AMGUARD INSURANCE CO
B W037006 ARGONAUT INSURANCE COMPANY
B W037253 ARGONAUT-MIDWEST INSURANCE CO
F W037501 AMERISURE INS CO
F W038004 ASSOCIATED INDEMNITY CORP
B W039002 ASSURANCE CO OF AMERICA
A W040000 ATLANTIC MUTUAL INSURANCE COMPANY
B W040257 ATLANTIC SPECIALTY INS CO
B W041503 AUTOMOBILE INS CO OF HARTFORD CONN
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
E W043251 BANKERS STANDARD INSURANCE COMPANY
F W045009 AIG PROPERTY CASUALTY CO
A W047500 CATLIN INDEMNITY COMPANY
E W049506 C I M INSURANCE CORPORATION
A W051007 CENTENNIAL INSURANCE COMPANY
A W052500 FIRST CENTRAL INSURANCE CO
B W054001 CHARTER OAK FIRE INS CO
E W054605 CHUBB INDEMNITY INS CO
E W054639 CHURCH MUTUAL INSURANCE COMPANY
E W054696 WESTCHESTER FIRE INS CO
B W054753 CINCINNATI INSURANCE COMPANY
E W056253 CITIZENS INSURANCE CO OF AMERICA
F W056386 CLARENDON NATIONAL INSURANCE CO
F W058002 COMMERCE AND INDUSTRY INS CO
A W058507 COMMERCIAL COMPENSATION INS CO
E W060008 LAMORAK INSURANCE COMPANY
E W060750 CONNECTICUT GENERAL FIRE & CASLTY INS CO
A W061006 CONNECTICUT INDEMNITY COMPANY
E W063002 CONTINENTAL CASUALTY COMPANY
E W064000 CONTINENTAL INSURANCE CO
A W066005 COVENANT INSURANCE CO
A W067250 CREDIT GENERAL INSURANCE CO
F W067508 CRUM & FORSTER INDEMNITY CO
A W068001 CUMIS INSURANCE SOCIETY INC
A W069009 SENTRY SELECT INSURANCE COMPANY
F W071005 SENECA INSURANCE COMPANY INC
E W071757 ELECTRIC INSURANCE CO
B W073001 EMPIRE INSURANCE COMPANY
E W074009 EMPLOYERS FIRE INSURANCE COMPANY
A W075006 EMPLOYERS MUTUAL CASUALTY CO
A W076004 EMPLOYERS INS OF WAUSAU A MUTUAL CO
F W076889 ERIE INSURANCE COMPANY
F W076947 ERIE INSURANCE CO OF NEW YORK
A W077002 EXCELSIOR INSURANCE CO
A W078000 SELECTIVE INSURANCE CO OF NEW YORK
F W078257 FAIRFIELD INSURANCE COMPANY
F W078505 FAIRMONT INSURANCE COMPANY
F W079008 FARM FAMILY CASUALTY INS CO
B W079503 FARMINGTON CASUALTY COMPANY
E W080006 FEDERAL INSURANCE COMPANY
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
E W083000 FIDELITY AND CASUALTY CO OF NEW YORK
B W084008 FIDELITY & DEPOSIT COMPANY OF MD
B W084503 FIDELITY AND GUARANTY INSURANCE COMPANY
F W085500 FIRE DISTRICTS OF NY MUTUAL INS CO
A W085757 FIRE & CASUALTY INS CO OF CONNECTICUT
F W086003 FIREMANS FUND INSURANCE CO
F W087258 FIREMENS INSURANCE CO OF WASHINGTON DC
A W087381 ARCH INSURANCE COMPANY
A W087449 FIRST LIBERTY INSURANCE CO
A W089007 FLORISTS MUTUAL INSURANCE CO
B W090757 HOMELAND INS COMPANY OF NY
E W091003 BEDIVERE INSURANCE COMPANY
B W091508 AUTOONE INSURANCE COMPANY
F W091755 GENERAL CASUALTY CO OF WISCONSIN
F W092001 ALLIANZ GLOBAL RISKS US INS CO
F W093884 GENESIS INSURANCE CO
A W096002 GLOBE INDEMNITY COMPANY
F W098008 GRANITE STATE INSURANCE CO
A W099006 GRAPHIC ARTS MUTUAL INS CO
A W100002 GREAT AMERICAN INS CO
F W100135 GREAT DIVIDE INSURANCE CO
E W100507 GREAT NORTHERN INSURANCE CO
A W100754 GREAT WEST CASUALTY COMPANY
E W101000 GREATER NEW YORK MUTUAL INS CO
B W102008 GULF INSURANCE CO
E W103006 HANOVER INSURANCE CO
B W104509 HARCO NATIONAL INSURANCE CO
F W105001 HARTFORD ACCIDENT & INDEMNITY CO
F W106009 HARTFORD CASUALTY INS CO
F W106504 HARTFORD FIRE INSURANCE CO
F W106751 HARTFORD INSURANCE CO OF THE MIDWEST
A W106884 HEREFORD INS CO
A W107007 HIGHLANDS INSURANCE CO
B W108005 HOLYOKE MUTUAL INS CO IN SALEM
A W109003 HOME INDEMNITY COMPANY
A W110001 HOME INSURANCE COMPANY
F W111504 HOUSTON GENERAL INS CO
F W112254 ILLINOIS NATIONAL INSURANCE CO
E W112502 INDEMNITY INSURANCE CO OF NORTH AMERICA
E W114003 FREMONT INDUSTRIAL INDEMNITY CO
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W114508 MARKEL INS CO
E W115000 INSURANCE COMPANY OF GREATER NY
E W116008 INSURANCE COMPANY OF NORTH AMERICA
F W117006 INS CO OF THE STATE OF PA
E W118004 INTERBORO MUTUAL INDEMNITY INS CO
A W118251 XL SPECIALTY INSURANCE COMPANY
A W118756 OLD REPUBLIC GENERAL INS CORP
B W119507 SPECIALTY SURPLUS INSURANCE CO
A W122824 LM INSURANCE CORPORATION
A W123251 LIBERTY INSURANCE CORP
A W123509 LIBERTY MUTUAL FIRE INS CO
A W124002 LIBERTY MUTUAL INSURANCE CO
A W130009 LUMBERMENS MUTUAL CASUALTY CO
A W130256 LUMBERMENS UNDERWRITING ALLIANCE
F W132500 MAIN STREET AMERICA ASSURANCE CO
A W133508 MANUFACTURERS ALLIANCE INS CO
B W134001 MARYLAND CASUALTY CO
E W134506 MASSACHUSETTS BAY INSURANCE CO
F W135008 MERCHANTS MUTUAL INSURANCE CO
A W136006 MICHIGAN MILLERS MUTUAL INS CO
F W137004 AMERISURE MUTUAL INSURANCE COMPANY
F W139638 MIDWEST EMPLOYERS CASUALTY CO
E W147003 NATIONAL FIRE INSURANCE CO OF HARTFORD
F W148001 NGM INSURANCE COMPANY
A W148506 LEGION INSURANCE COMPANY
A W148639 NATIONAL INTERSTATE INSURANCE CO
F W148753 NATIONAL LIABILITY AND FIRE INS CO
F W149009 NATIONAL SURETY CORPORATION
F W150007 NATL UNION FIRE INS CO OF PITT PA
F W152003 NATIONWIDE MUTUAL INSURANCE CO
A W153001 NETHERLANDS INSURANCE COMPANY
F W154009 NEW HAMPSHIRE INSURANCE CO
F W155006 AMERICAN EUROPEAN INSURANCE COMPANY
A W156004 NEW JERSEY MANFACTURERS INS CO
F W156509 HARLEYSVILLE INS CO OF NY
A W156756 LMI INSURANCE COMPANY
F W158000 HARTFORD UNDERWRITERS INS CO
A W159008 NEWARK INSURANCE COMPANY
F W160659 NORGUARD INSURANCE CO
A W160675 NORTH AMERICAN SPECIALTY INS CO
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W160816 DISCOVER PROPERTY & CASUALTY INS CO
F W161004 NORTH RIVER INS CO
B W162002 NORTHERN ASSURANCE CO OF AMERICA
B W163000 NORTHERN INSURANCE CO OF NY
A W164008 NORTHWESTERN NATIONAL INS CO
E W164255 NOVA CASUALTY COMPANY
A W165005 OHIO CASUALTY INSURANCE CO
A W166003 OLD REPUBLIC INSURANCE COMPANY
F W166250 ORISKA INSURANCE CO
B W166508 AUTOONE SELECT INSURANCE COMPANY
E W167001 PACIFIC EMPLOYERS INSURANCE CO
E W168009 PACIFIC INDEMNITY COMPANY
E W168256 PARAMOUNT INSURANCE COMPANY
A W168504 PATRIOT GENERAL INSURANCE CO
A W170005 PEERLESS INSURANCE COMPANY
B W172001 PENNSYLVANIA INSURANCE COMPANY
A W173009 PENNSYLVANIA MANUFACTURERS ASSN INS CO
A W173504 PENNSYLVANIA MFG INDEMNITY CO
B W175004 PENN NATIONAL MUTUAL CASUALTY INS CO
A W176507 PHICO INSURANCE COMPANY
B W177000 PHOENIX INSURANCE CO
A W178008 RELIANCE NATIONAL INDEMNITY COMPANY
B W179006 POTOMAC INSURANCE CO
B W179063 POTOMAC INSURANCE CO OF ILLINOIS
A W179196 PREFERRED PROFESSIONAL INS CO
F W179501 TIG INS CO OF NY
F W179758 PRINCETON INSURANCE COMPANY
B W181002 PROTECTIVE INSURANCE CO
F W182000 PROVIDENCE WASHINGTON INS COMPANY
A W183693 EVEREST NATIONAL INS COMPANY
E W184006 PUBLIC SERVICE INSURANCE CO
A W186258 REALM NATIONAL INSURANCE CO
A W187009 RELIANCE INSURANCE COMPANY
A W187504 RELIANCE INS COMPANY OF NEW YORK
A W187637 RELIANCE NATIONAL INSURANCE COMPANY
A W187751 REPUBLIC FRANKLIN INSURANCE CO
A W187884 REPWEST INSURANCE COMPANY
E W188502 ROCHDALE INS CO
A W190003 ROYAL INSURANCE COMPANY OF AMERICA
A W191001 ARROWOOD INDEMNITY COMPANY
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
A W193007 SAFEGUARD INSURANCE COMPANY
B W193502 SAFETY NATIONAL CASUALTY CORP
B W194005 ST PAUL FIRE & MARINE INS CO
B W195002 ST PAUL MERCURY INSURANCE CO
E W196000 SEABOARD FIRE & MARINE INS CO
A W197008 SECURITY INSURANCE CO OF HARTFORD
A W198253 SELECTIVE INS CO OF AMERICA
A W198329 SELECTIVE INSURANCE COMPANY OF SC
A W198386 SELECTIVE WAY INSURANCE CO
A W200000 SENTRY INSURANCE A MUTUAL CO
B W202006 STANDARD FIRE INS CO
A W202501 STAR INSURANCE COMPANY
F W203004 STATE FARM FIRE AND CASUALTY CO
C W204002 STATE INSURANCE FUND
D W204002 STATE INSURANCE FUND
B W204135 STATE NATIONAL INSURANCE COMPANY INC
E W204259 STRATHMORE INSURANCE CO
B W204507 MITSUI SUMITOMO INS CO OF AMERICA
B W206254 TOKIO MARINE AMERICA INS CO
E W206759 TECHNOLOGY INSURANCE CO INC
B W207500 TOKIO MARINE & NICHIDO FIRE INS CO LTD
F W207757 TOWER INSURANCE CO OF NY
F W208003 TIG INSURANCE COMPANY
E W209001 TRANSCONTINENTAL INSURANCE CO
E W211007 TRANSPORTATION INSURANCE COMPANY
B W212005 TRAVELERS INDEMNITY COMPANY
B W212252 TRAVELERS INDEMNITY CO OF AMERICA
B W212500 TRAVELERS INDEMNITY CO OF CONNECTICUT
B W212757 TRAVELERS PROPERTY CASUALTY CO OF AMER
B W213003 METLIFE INSURANCE COMPANY OF CT
A W214001 TRUCK INSURANCE EXCHANGE
F W215008 TWIN CITY FIRE INSURANCE CO
A W215503 ULLICO CASUALTY COMPANY
F W216501 UNIGARD INSURANCE CO
F W217004 UNIGARD JAMESTOWN MUTUAL INS CO
F W218002 SEATON INSURANCE CO
A W218507 UNITED COMMUNITY INSURANCE CO
A W219000 UNITED PACIFIC INSURANCE CO
A W219505 UNITED PACIFIC INS CO OF NY
B W220008 UNITED STATES FIDELITY & GUARANTY CO
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W221006 UNITED STATES FIRE INS CO 994
F W221253 UNITED STATES LIABILITY INS CO
B W221501 UNIVERSAL UNDERWRITERS INS CO
A W221758 UTICA NATIONAL ASSURANCE CO
A W222004 UTICA MUTUAL INSURANCE CO
A W222509 UTICA NATIONAL INS CO OF TEXAS
E W224000 VALLEY FORGE INSURANCE COMPANY
A W224505 VAN LINER INSURANCE COMPANY
E W225007 VIGILANT INSURANCE COMPANY
A W225254 VIRGINIA SURETY COMPANY INC
A W225445 WAUSAU BUSINESS INSURANCE COMPANY
A W225486 WAUSAU GENERAL INSURANCE CO
A W225502 WAUSAU UNDERWRITERS INSURANCE CO
A W227060 WESTPORT INSURANCE CORP
F W227102 MOUNTAIN VALLEY INDEMNITY COMPANY
F W227193 HARLEYSVILLE WORCESTER INS CO
A W227508 SOMPO JAPAN INS CO OF AMERICA
B W228001 ZURICH AMERICAN INSURANCE CO
A W303002 ADT COMPANY INC
A W303507 APA TRANSPORT CORPORATION
A W303754 ABEX CORPORATION
A W303879 ADIRONDACK STEEL CASTING CO INC
A W304133 AIRBORNE EXPRESS INC
A W305007 AMOCO OIL COMPANY
A W307250 ALBANY INTERNATIONAL CORPORATION
A W307508 AL-TECH SPECIALTY STEEL CORPORATION
A W311757 AIL SYSTEMS INC
A W314009 ALCOA INC
A W315501 AURUBIS BUFFALO INC
A W317507 AMERICAN CYANAMID COMPANY
A W319008 AMERICAN EXPRESS BANK LTD
A W321509 ROLL INTERNATIONAL CORPORATION
A W322507 AMERICAN SALES COMPANY
A W323000 TRANE INC
A W325005 AT&T CORP
A W328504 AMPCO-PITTSBURGH CORP
A W329882 ABF FREIGHT SYSTEMS INC (DEL)
A W331755 ARMOR KONE ELEVATOR INC
A W332001 ARMSTRONG WORLD INDUSTRIES INC
A W332506 ARNOT OGDEN MEDICAL CENTER
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
A W333132 ASCENSION HEALTH
A W333199 ASPIRE OF WESTERN NEW YORK
A W333256 ASSOCIATED BUILDERS & CONTRACTOR TRUST
A W334007 ASSOCIATED TRANSPORT INC
A W334759 AUTOZONE INC
A W335251 AUTOMOBILE DEALERS WC SELF-INS TRUST
A W335756 BJ'S WHOLESALE CLUB INC
A W336382 BALL CORPORATION
A W338503 ABA TRANSPORTATION HOLDING COMPANY INC
A W342752 BEER WHOLESALERS COMP TRUST OF NY
A W343008 BETHLEHEM STEEL CORPORATION
A W343503 BETHLEHEM STEEL CORP 1988
A W344253 BIG V SUPERMARKETS INC
A W347504 OFFICEMAX INCORPORATED
A W347751 BOMBARDIER INC
A W348007 BORDEN INC
A W351506 BRADLEES INC
A W354252 BROOKDALE HOSPITAL MED CTR
A W356943 BROWNING FERRIS INDUSTRIES OF NY INC
A W361638 BUSH INDUSTRIES INC
A W361687 BUSINESS COUNCIL WC MFG GP SI TRUST
A W361828 CALDOR CORP
A W364251 CAREER HORIZONS INC
A W364509 CAROLINA FREIGHT CARRIERS CORP
A W364517 CARGILL INC
A W364608 PLAINVIEW HOSPITAL
A W365134 CHAMPION INTERNATIONAL CORP
A W365258 CHAMPLAIN VALLEY PHYS HOSP MED CTR
A W365324 CHARMER INDUSTRIES INC
A W367007 CHICAGO PNEUMATIC TOOL COMPANY
A W367130 CHICAGO PNEUMATIC TOOL CO (1990)
A W367254 CHILDREN AND WOMEN'S HEALTH INC
A W368385 AT-A-GLANCE INC
A W368757 CARTHAGE SPECIALTY PAPERBOARD INC
A W370753 TRUSTEES OF COLUMBIA UNIVERSITY
A W371504 COMMUNITY RES INS SAVING PLAN SI TRUST
A W372007 COMSTOCK GREENWOOD INC
A W372254 CONAGRA FOODS INC
A W372387 CON AGRA MAPLE LEAF MILLING INC
A W372502 CONDEC CORPORATION
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W373005 CONSOLIDATED EDISON COMPANY OF NY INC
A W374003 CONSOL FREIGHTWAYS CORP OF DELAWARE
A W375265 CONTRACTORS SELF-INS TRUST FUND
A W375331 CONTRACTORS WORKERS COMP TRUST
A W375398 COOPER INDUSTRIES INC
A W375937 COOPER US INC (2005)
A W375943 COOP ASSOC OF FOOD ENT WC TRUST
A W376008 CORNELL UNIVERSITY
A W378004 CORNING INCORPORATED
A W378251 CORNING HOSPITAL
A W378442 COSTCO WHOLESALE CORP
A W378632 CRAWFORD FURNITURE MFG CORP
A W379002 CROUSE HINDS COMPANY
A W379259 CROUSE HEALTH HOSPITAL INC
A W379440 JAMES RIVER CORP OF NEVADA
A W379507 COLT INDUSTRIES OPERATING CORP
A W379697 CRUCIBLE MATERIALS CORP 1989
A W379887 CUMMINS INC
A W380257 BIRDS EYE FOODS INC
A W380323 CURTIS NIAGARA LLC
A W380380 CURTIS SCREW COMPANY INC
A W381255 DPWN HOLDINGS (USA) INC
A W382253 TARGET CORPORATION
A W384630 DELPHI CORPORATION
A W384754 DENNYS INC
A W384820 DEPAUL GROUP INC
A W388003 R E DIETZ COMPANY
A W389506 WHITE ROSE INC
A W389753 DOLGENCORP OF NY INC
A W390504 DRESSER INDUSTRIES INC
A W391007 E I DUPONT DENEMOURS AND CO
B W395008 EASTMAN KODAK COMPANY
A W397756 ELEC-CON TRUST
A W398002 ELECTRICAL EMPLOYERS SELF INS SFTY PLAN
B W398259 WASHINGTON MILLS ELECTRO MINERAL CORP
B W398325 ELDERWOOD SENIOR CARE SI TRUST
B W398531 EMERSON POWER TRANSMISSION CORP
B W398770 EMPIRE STATE AGRICULTURAL COMP TRUST
B W398788 EMPIRE STATE HOSPITALITY WC TRUST
B W399505 EMPIRE STATE TRANSPORTATION WC TRUST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W400006 ENDICOTT JOHNSON CORP
B W400501 TEAM TRANSPORTATION WORKERS COMP TRUST
B W410880 ESTRA SELF INSURANCE TRUST
B W412001 EXXON CORPORATION NJ
B W413075 FCA US LLC
B W413132 FHE SERVICES INC
B W413785 FEDERAL EXPRESS CORPORATION
B W413843 MACYS INC
B W413868 SHOP VAC CORPORATION
B W413876 FEUER LEATHER CORP
B W415509 MILLARD FILLMORE HOSPITALS (1991)
B W417323 FINGER LAKES REGIONAL HEALTH SYSTEM INC
B W417380 LIFETIME HEALTHCARE INC
B W417752 FIRST NATIONAL SUPERMARKETS (1989)
B W417885 FLEET BOSTON FINANCIAL CORPORATION
B W419006 FOOD FAIR INC
B W420509 MCKESSON CORPORATION
B W421002 FORD MOTOR COMPANY
B W421754 BON SECOURS HEALTH SYSTEM, INC
B W422380 FULTON BOILER WORKS INC
B W424006 GAF CORPORATION
B W424634 GANNETT CO INC
B W424758 GARLOCK SEALING TECHNOLOGIES INC
B W430003 GENERAL MILLS INC
B W431001 GENERAL MOTORS CORPORATION
B W433759 GENEVA REGIONAL HEALTH SYS INC
B W434005 GEORGIA PACIFIC CORPORATION
B W437008 GLEASON WORKS
B W437750 GOLUB CORPORATION
B W438501 GOULD PUMPS INC
B W439756 CPP - SYRACUSE INC
B W440507 GREAT ATLANTIC & PACIFIC TEA CO INC
B W440754 ROCHESTER GENERAL HEALTH SYSTEM
B W446256 CBS CORPORATION
B W446389 HNI CORPORATION
B W446447 H J WILSONS CO INC
B W448252 DELHAIZE AMERICA LLC
B W448633 HARDEN FURNITURE
B W449003 HARRIS STRUCTUAL STEEL CO
B W450134 HEALTH QUEST SYSTEMS INC
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W450753 HEALTHCARE UNDERWRITERS MUTUAL INS TRUST
B W450886 HEALTHCARE OF NY WC TRUST (HONY)
B W450944 HEALTHSTAR NETWORK INC
B W452007 HERCULES INCORPORATED
B W452502 HICKEY-FREEMAN CO INC
B W453252 HIGHLAND HOSPITAL OF ROCHESTER
B W453757 HOLLINGSWORTH AND VOSE CO
B W454888 HILLSIDE FAMILY OF AGENCIES
B W455000 HILTON WORLDWIDE INC
B W458509 SIX CONTINENTS HOTELS INC
B W461008 HONEYWELL INC
B W462576 HOSPITAL FOR JOINT DISEASE ORTH INST
B W466759 SAMARITAN MEDICAL CENTER
B W468508 HUDSON HEALTH CARE WORKERS COMP GROUP
B W470504 J B HUNT TRANSPORT INC
B W472880 INDEPENDENT GROCERS WC SELF INS TRUST
B W473003 INGERSOLL RAND COMPANY
B W473508 INTERNATIONAL BUSINESS MACHINE CORP
B W475503 INTERNATIONAL IMAGING MATERIALS
B W476006 INTERNATIONAL PAPER COMPANY
B W480503 DYNO NOBEL INC
B W487508 ST JOSEPHS HOSPITAL HEALTH CNTR
B W488639 KENNECOTT CORP
B W488829 KEY CORP
B W488860 KEYSPAN CORPORATION
B W489009 KIMBERLY CLARK CORPORATION
B W489256 KING KULLEN GROCERY CO INC
B W491500 KRASDALE FOODS INC
B W492003 K MART CORPORATION
B W492508 L & JG STICKLEY
B W492755 LANDIS PLASTIC INC
B W498257 LENOX HILL HOSPITAL
B W499040 LIBBEY GLASS INC
B W499073 L BRANDS SERVICE COMPANY LLC
B W499750 LIPE ROLLWAY CORP
B W509004 LOBLAW INC
B W511505 LONG ISLAND LIGHTING CO (1995)
B W512503 LONG TERM CARE RISK MGMT GROUP
B W515506 LOWE'S HOME CENTERS LLC
B W516132 LUCENT TECHNOLOGIES INC
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
B W517387 MAGNA POWERTRAIN USA, INC
B W517569 KEYSPAN CORPORATION
B W517601 MARMON INDUSTRIAL CORPORATION
B W517627 MARRIOTT INTERNATIONAL INC
B W519383 JOHN T MATHER MEM HOSPITAL OF PORT JEFF
B W519508 MATLACK INC
B W519698 MAY DEPARTMENT STORES CO
B W519722 T MARZETTI COMPANY
B W520506 MCGRATH SERVICES CORP
B W520571 MCGUIRE GROUP TRUST
B W520696 MCWANE INC
B W520720 PREFERRED MANUFACTURERS INS TRUST FD
B W520746 MEMORIAL SLOAN KETTERING CANCER CTR
B W520829 METROPOLITAN MUSEUM OF ART
B W520852 MERRILL LYNCH & CO INC & SUB
B W521256 METRO NY COLLEGE AND UNIV WC GROUP
B W521504 SPECIAL TRADES CONTR & CONST TRUST
B W522759 MOBIL CORPORATION
B W524003 MOBIL OIL CORPORATION
B W537005 N L INDUSTRIES INC
B W537500 NYSARC INC CHAUTAUQUA CHAPTER (1994)
B W537633 NYSARC INC CHAUTAUQUA CHAPTER (2008)
B W537757 NYAHSA SERVICES INC SI TRUST
B W537823 NY TRANSPORTATION WORKERS COMP TRUST
B W537880 NYU HOSPITALS CENTER
B W538003 NABISCO INC
B W539001 NASSAU METALS CORPORATION
B W541254 NATIONAL FUEL GAS COMPANY
B W548002 NEPTUNE WORLD WIDE MOVING
B W548507 NEW YORK MCDONALDS OPER WC TRUST
B W549257 NEW ERA CAP CO INC
B W549638 NEW PROCESS GEAR INC (2004)
B W549943 NEW YORK BUS OPERATORS COMP TRUST
B W550503 NEW YORK OPERATORS SELF INS TRUST
B W551006 NEW YORK LUMBERMENS INS TRUST FUND
B W552509 NEW YORK NEWS INC
B W552632 NEW YORK STATE MOTOR ASSOC COMP TRUST
B W552756 NEW YORK STATE HEALTH PROVIDERS WC TRUST
B W552889 BUILDING EXTERIOR SERVICES TRUST OF NY
B W553002 VERIZON NEW YORK INC
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W554000 NEW YORK UNIVERSITY
F W554299 NEW YORK CHOICE SELF-INS TRUST
F W554828 NEW YORK PETROLEUM ASSOC COMP TRUST
F W555064 NIAGARA BUSINESS TRUST
F W555122 NIAGARA FALLS MEMORIAL MEDICAL CENTER
F W555502 TOPS MARKETS INC
F W556500 NATIONAL GRID USA
F W557417 NORDSTROM INC
F W557789 PHILIPS ELECTRONICS NORTH AMERICA CORP
F W557862 SAINT-GOBAIN ABRASIVES INC
F W558092 PROCTER & GAMBLE PHARMACEUTICALS
F W558381 NYSARC WORKERS COMPENSATION TRUST
F W558555 OHI WORKERS COMPENSATION TRUST
F W558605 O-AT-KA MILK COOPERATIVE INC
F W558696 OCCIDENTAL CHEMICAL CORP
F W558720 OLDCASTLE INC
F W559009 OLIN CORPORATION
F W559256 OUR LADY OF VICTORY HOMES OF CHARITY INC
F W559504 ONEIDA LTD
F W560502 ORANGE & ROCKLAND UTILITIES INC
F W560759 OSWEGO HOSPITAL
F W561500 OUR LADY OF LOURDES MEMORIAL HOSPITAL
F W561633 OUR LADY OF VICTORY HOSP OF LACKAWANNA
F W561757 OWENS ILLINOIS INC 1987
F W562250 OWENS CORNING
F W562508 OWENS ILLINOIS INC
F W565253 VISITING NURSE SERVICE OF NEW YORK
F W565386 UNITY HEALTH SYSTEM
F W565501 PARKER HANNIFIN CORPORATION
F W565691 PATHMARK STORES INC
F W566004 PENN DIXIE INDUSTRIES INC
F W568078 PEOPLE INC
F W569255 PFALTZGRAFF CO
F W570253 PITTWAY CORPORATION
F W572622 PRESBYTERIAN HOSPITAL IN THE CITY OF NY
F W572887 PRESTON TRUCKING CO INC 1990
F W572945 PRICE COMPANY
F W573000 PROCTER AND GAMBLE MANUFACTURING CO
F W574255 QUALEX INC
F W576003 RAILWAY EXPRESS AGENCY INC
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W576250 RALSTON PURINA COMPANY
F W576755 RAYMOND CORP
F W577506 USF RED STAR INC
F W579007 LTV STEEL COMPANY INC
F W580005 REST INN SAFETY PLAN INC
F W580500 RETAILER OF NEW YORK WC TRUST
F W581003 REVERE COPPER & BRASS INC
F W586002 ROADWAY EXPRESS INC
F W586259 FEDEX GROUND PACKAGE SYSTEM INC
F W587505 ROCHESTER INSTITUTE OF TECHNOLOGY
F W588008 FRONTIER CORPORATION
F W589501 UNIVERSITY OF ROCHESTER (1979)
F W591002 ROCKEFELLER UNIVERSITY
F W591127 ROMAN CATHOLIC DIOCESE OF ALBANY
F W591192 ROMAN CATHOLIC DIOCESE OF BUFFALO
F W591259 ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK
F W591374 ROMAN CATHOLIC ARCHDIOCESE OF OGDENSBURG
F W591382 ROMAN CATHOLIC DIOCESE OF BROOKLYN
F W591408 ROMAN CATHOLIC DIOCESE OF ROCHESTER
F W591432 ROMAN CATHOLIC DIOCESE OF ROCKVILLE CTR
F W591507 ROMAN CATHOLIC DIOCESE OF SYRACUSE
F W592133 ROSINA FOOD PRODUCTS INC
F W592257 ROSWELL PARK CANCER INSTITUTE CORP
F W595755 RYDER SYSTEMS INC
F W596258 P I E NATIONWIDE INC
F W596845 ST BARNABAS COMMUNITY ENTERPRISES INC
F W596878 SKF USA INC
F W596944 ST JOSEPHS HOSPITAL
F W597009 SJM HOLDING CORPORATION
F W597256 ST LUKES MEMORIAL HOSPITAL CTR
F W597538 ST LUKES-ROOSEVELT HOSP CTR
F W597561 ST MARYS HOSPITAL AT AMSTERDAM
F W597629 ROCHESTER ST MARYS HOSP OF SIST CHARITY
F W597751 ST MARYS HOSPITAL OF TROY
F W600258 SAMARITAN-KEEP NURSING HOME INC
F W600381 NORTHEAST HEALTH WORKERS COMP PLAN
F W600720 SAXON INDUSTRIES INC
F W600944 SCOTT PAPER COMPANY
F W601009 SEALRIGHT CO INC
F W604003 SEARS ROEBUCK & COMPANY
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W607501 LEHMAN BROTHERS INC
F W608004 SHELL OIL COMPANY
F W610505 SHOPWELL INC
F W615009 SINGER COMPANY
F W616502 SISTERS OF CHARITY HOSPITAL OF BUFFALO
F W616635 SISTERS OF ST FRANCIS HEALTHCARE GROUP
F W616882 SNYDER TANK CORP
F W617500 SOCIETY OF THE NEW YORK HOSPITAL
F W617757 SONOCO PRODUCTS CO
F W626758 STANDARD PRODUCTS CO
F W627756 STARBUCKS CORPORATION
F W628002 STAR SUPERMARKETS INC
F W629133 STATEN ISLAND UNIVERSITY HOSPITAL
F W629257 CARBORUNDUM COMPANY (1989)
F W629505 STOP AND SHOP COMPANIES INC
F W630503 STEWARTS SHOPS CORP
F W630750 STEWARTS MARKETING CORP
F W633507 STROEHMANN BAKERIES INC
F W633754 SUGAR CREEK CORP
F W634000 SUPERMARKETS GENERAL HOLDINGS CORP
F W638225 SWIFT TRANSPORTATION CO LLC
F W639504 SYRACUSE UNIVERSITY
F W640387 USF HOLLAND INC
F W645501 TIMES MIRROR COMPANY
F W646509 CAYUGA MEDICAL CENTER AT ITHACA
F W648000 TRANSAMERICAN FREIGHT LINES INC
F W650006 TRICO PRODUCTS CORPORATION
F W651046 US MANAGEMENT WC INC
F W651160 UNIFRAX CORP (1997)
F W653000 UNITED AIRLINES
F W655500 NEW YORK UNITED HOSPITAL MEDICAL CENTER
F W659007 UNITED STATES STEEL CORP
F W662035 HUMAN SERVICES SELF INSURANCE TRUST FUND
F W662068 UPSTATE NIAGARA COOPERATIVE INC
F W662092 NY COLLEGE AND UNIVERSITY RISK MGMT GRP
F W662126 VERMONT AMERICAN CORPORATION
F W662191 WNY HOSPITAL RISK MGMT GROUP
F W665509 WEGMANS FOOD MARKET INC
F W667257 WEIS MARKETS INC
F W669006 AT AND T TECHNOLOGIES INC
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W676001 WESTINGHOUSE ELECTRIC CORP
F W677009 MEADWESTVACO CORPORATION
F W677504 WEYERHAEUSER COMPANY
F W678254 WHITE CASTLE SYSTEMS INC
F W678759 M WILE & COMPANY INC
F W687503 XEROX CORPORATION
F W688006 YELLOW TRANSPORTATION INC
F W800502 ADIRONDACK CENTRAL SCHOOL
F W800759 ALBANY CITY SCHOOL DISTRICT
F W801005 CITY OF ALBANY NEW YORK
F W801500 COUNTY OF ALBANY
F W801633 ALBION CENTRAL SCHOOL DIST
F W801690 ALDEN CENTRAL SCHOOL DIST
F W802003 ALLEGANY COUNTY MUTUAL SELF INS PLAN
F W802045 AMHERST CENTRAL SCHOOL DIST
F W802102 ANDOVER CENTRAL SCHOOL DISTRICT
F W802169 TOWN OF AMHERST
F W802193 AMITYVILLE UNION FREE SCHOOL DIST
F W802250 ARDSLEY UNION FREE SCHOOL DIST
F W802326 ARKPORT CENTRAL SCHOOL DISTRICT
F W802342 ARLINGTON CENTRAL SCHOOL DIST
F W802359 AUSABLE VALLEY CENTRAL SCHOOL
F W802375 AUBURN ENLARGED CITY SCHOOL DIST
F W802383 AVERILL PARK CENTRAL SCHOOL DIST
F W802441 AVOCA CENTRAL SCHOOL DIST
F W802508 TOWN OF BABYLON
F W802631 BALDWINSVILLE SCHOOL DIST
F W802698 BABYLON UNION FREE SCHOOL DIST
F W802755 BALDWIN UNION FREE SCHOOL DIST
F W802797 BATH CENTRAL SCHOOL
F W802813 BAYPORT-BLUE POINT UNION FREE SCHL DIST
F W802839 BAY SHORE UNION FREE SCHOOL DIST
F W803076 BEACON CITY SCHOOL DISTRICT
F W803134 BEEKMANTOWN CENTRAL SCHOOL DIST
F W803258 BEDFORD CENTRAL SCHOOL DISTRICT
F W803506 BELLMORE MERRICK CENTRAL HIGH SCH DIST
F W803886 BETHLEHEM CENTRAL SCHOOL DIST
F W803944 BETHPAGE UNION FREE SCHOOL DIST
F W804256 CITY OF BINGHAMTON (1995)
F W804504 COMMUNITY COLLEGES OF CUNY
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W805253 BOCES - SUFFOLK COUNTY 3RD SUPV DISTRICT
F W805261 BOCES CAPITAL REGION
F W805295 BOLIVAR-RICHBURG CENTRAL SCHOOL DISTRICT
F W805311 BAINBRIDGE GUILFORD CENTRAL SCHOOL DIST
F W805329 BRASHER FALLS CENTRAL SCHOOL DISTRICT
F W805378 BRENTWOOD UNION FREE SCHOOL DIST
F W805386 BREWSTER CENTRAL SCHOOL DISTRICT
F W805501 TOWN OF BROOKHAVEN
F W805758 BROOKHAVEN COMSEWOGUE UFSD
F W805881 BROOME DELAWARE-TIOGA BOCES
F W806004 BROOME COUNTY SELF INSURANCE PLAN
F W806509 BRUNSWICK CENTRAL SCHOOL DIST
F W806756 BRUSHTON-MOIRA CENTRAL SCHOOL DIST
F W807002 CITY OF BUFFALO
F W807507 BUFFALO SEWER AUTHORITY
F W807663 CNY CENTRO INC
F W808000 CITY OF BUFFALO BD OF EDUCATION
F W808075 BURNT HILLS-BALLSTON LAKE CSD
F W808240 CANTON CENTRAL SCHOOL DIST
F W808257 CARTHAGE CENTRAL SCHOOL DISTRICT
F W808380 CAPITAL DISTRICT TRANS AUTHORITY
F W808505 CARMEL CENTRAL SCHOOL DISTRICT
F W808638 CATTARAUGUS-LITTLE VALLEY CSD
F W808752 CATTARAUGUS COUNTY SELF INS PLAN
F W808885 CATTARAUGUS/ALLEGANY/ERIE/WYOMING BOCES
F W809388 CAZENOVIA CENTRAL SCHOOL DIST
F W809792 CENTRAL ISLIP UNION FREE SCHOOL DIST
F W809842 CENTRAL SQUARE CENTRAL SCHOOLS
F W809883 CHAPPAQUE CENTRAL SCHOOL DIST
F W809941 CHARLOTTE VALLEY CENTRAL SCHOOL
F W810006 CHAUTAUQUA COUNTY SELF INSURANCE PLAN
F W810501 CHURCHVILLE-CHILI CENTRAL SCHOOL DIST
F W811004 COUNTY OF CHEMUNG
F W811251 CHEEKTOWAGA-SLOAN UFSD
F W811509 TOWN OF CHEEKTOWAGA
F W812002 CHENANGO COUNTY SELF INSURANCE PLAN
F W812168 TOWN OF CHILI
F W812192 CHITTENANGO CENTRAL SCHOOL DISTRICT
F W812325 TOWN OF CLARKSTOWN
F W812507 CLARKSTOWN CENTRAL SCHOOL DIST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W812630 CLIFTON FINE CENTRAL SCHOOL DIST
F W812820 COUNTY OF CLINTON
F W814008 CITY OF COHOES
F W814255 COHOES CITY SCHOOL DIST
F W814388 TOWN OF COLONIE
F W815005 COLUMBIA COUNTY MUTUAL SELF INS
F W815252 COMMACK UNION FREE SCHOOL DIST
F W815500 CONNETQUOT CENTRAL SCHOOL DIST OF ISLIP
F W815799 COPIAGUE UNION FREE SCHOOL DIST
F W815856 CORNING-PAINTED POST AREA SCHOOL DIST
F W816003 CORTLAND COUNTY SELF INSURANCE PLAN
F W816045 CORTLAND CITY SCHOOL DIST
F W816078 TOWN OF CORTLANDT
F W816136 COXSACKIE ATHENS CENTRAL SCHOOL DIST
F W816383 CUBA-RUSHFORD CENTRAL SCHOOL DIST
F W816474 DANSVILLE CENTRAL SCHOOL DIST
F W816508 DEER PARK UNION FREE SCHOOL DIST
F W817001 DELAWARE COUNTY SELF INSURANCE FUND
F W817035 SULLIVAN WEST CENTRAL SCHOOL DISTRICT
F W817043 DELHI CENTRAL SCHOOL
F W817050 DEPEW UNION FREE SCHOOL DIST
F W817076 DE RUYTER CENTRAL SCHOOL
F W817118 DOBBS FERRY UNION FREE SCHOOL DISTRICT
F W817134 DUTCHESS COUNTY SELF INSURANCE PLAN
F W817324 DUTCHESS COUNTY BOCES
F W817357 EAST GREENBUSH CENTRAL SCHOOLS
F W817399 TOWN OF EAST HAMPTON
F W817506 EAST ISLIP SCHOOL DISTRICT
F W817571 EAST ROCKAWAY UNION FREE SCHOOL DISTRICT
F W817639 EAST MEADOW UNION FREE SCHOOL DIST
F W817662 EAST SYRACUSE MINOA SCHOOL DIST
F W817688 EAST WILLISTON UNION FREE SCHOOL DIST
F W817696 EAST ROCHESTER UNION FREE SCHOOL DIST
F W817704 EASTCHESTER UNION FREE SCHOOL DIST
F W817712 TOWN OF EASTCHESTER
F W817720 EASTPORT UNION FREE SCHOOL DIST
F W817738 EDWARDS-KNOX CENTRAL SCHOOL DIST
F W817753 ELMIRA CITY SCHOOL DISTRICT
F W817761 EASTPORT/SOUTH MANOR CSD
F W817779 ELDRED CENTRAL SCHOOL DIST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W817944 ELWOOD UNION FREE SCHOOL DIST
F W817977 ERIE #2 AREA SCHOOLS SF WC CONSORTIUM
F W818009 COUNTY OF ERIE
F W818256 ERIE COUNTY MEDICAL CENTER CORP
F W818504 BOCES-FIRST SUP DIST OF ERIE COUNTY
F W819007 ESSEX COUNTY SELF INSURANCE PLAN
F W819130 FABIUS-POMPEY CENTRAL SCHOOL DISTRICT
F W819254 FAIRPORT CENTRAL SCHOOL DISTRICT
F W819502 FARMINGDALE UNION FREE SCHOOL DISTRICT
F W819635 FAYETTEVILLE-MANLIUS CENTRAL SCHOOL DIST
F W819858 FLORAL PARK-BELLEROSE SCHOOL DIS
F W819882 FORT ANN CENTRAL SCHOOL DIST
F W819965 FRANKLIN-ESSEX-HAMILTON BOCES
F W820005 FRANKLIN COUNTY SELF INSURANCE PLAN
F W820252 FRANKLINVILLE CENTRAL SCHOOL DISTRICT
F W820443 FREEPORT UNION FREE SCHOOL DIST
F W820500 VILLAGE OF FREEPORT
F W820633 FRIENDSHIP CENTRAL SCHOOL DIST
F W820690 FRONTIER CENTRAL SCHOOL DISTRICT
F W820716 INCORPORATED VILLAGE OF GARDEN CITY
F W820724 FULMONT WORKERS COMPENSATION PLAN
F W820757 GARDEN CITY UNION FREE SCHOOL DISTRICT
F W821003 COUNTY OF FULTON SELF INS PLAN
F W821631 TOWN OF GATES
F W821755 GATES CHILI CENTRAL SCHOOL DIST
F W822506 GENERAL BROWN CENTRAL SCHOOL DISTRICT
F W823009 GENESEE COUNTY SELF INSURANCE PLAN
F W823090 CITY OF GLEN COVE
F W823108 GLEN COVE CITY SCHOOL DIST
F W823124 GLENS FALLS CITY SCHOOL DIST
F W823132 GREAT NECK UNION FREE SCHOOL DIST
F W823199 TOWN OF GREECE
F W823256 GREECE CENTRAL SCHOOL DISTRICT
F W823322 GREENBURGH CENTRAL SCHOOL DIST #7
F W823389 COUNTY OF GREENE
F W823504 TOWN OF GREENBURGH
F W823579 GOUVERNEUR CENTRAL SCHOOL DIST
F W823611 GREENWOOD LAKE UNION FREE SCHOOL DIST
F W823637 HALDANE CENTRAL SCHOOL DISTRICT
F W823751 HALF HOLLOW HILLS CENTRAL SCHOOL DIST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W823769 TOWN OF HAMBURG
F W823777 HAMMONDSPORT CENTRAL SCHOOL DIST
F W823785 HAMPTON BAYS UNION FREE SCHOOL DIST
F W823793 HAUPPAUGE UNION FREE SCHOOL DIST
F W823835 HARBORFIELDS CENTRAL SCHOOL DIST
F W824007 TOWN OF HEMPSTEAD
F W824049 TOWN/VILLAGE OF HARRISON
F W824072 HARRISON CENTRAL SCHOOL DIST
F W824130 HARRISVILLE CENTRAL SCHOOL DIST
F W824254 HENDRICK HUDSON SCHOOL DISTRICT
F W824387 HEMPSTEAD UNION FREE SCHOOL DIST
F W824502 INCORPORATED VILLAGE OF HEMPSTEAD
F W824635 HERKIMER COUNTY
F W825004 HERKIMER COUNTY SELF INSURANCE PLAN
F W826093 HERRICK UNION FREE SCHOOL DIST
F W826101 HEWLETT WOODMERE UFSD
F W826127 HIGHLAND FALLS-FORT MONTGOMERY CSD
F W826135 HICKSVILLE UNION FREE SCHOOL DISTRICT
F W826168 HOOSIC VALLEY CENTRAL SCHOOL
F W826176 HILTON CENTRAL SCHOOL DISTRICT
F W826192 TOWN OF HUNTINGTON
F W826218 HORNELL CITY SCHOOL DIST
F W826234 HUDSON FALLS CENTRAL SCHOOL DIST
F W826259 HUNTINGTON UNION FREE SCHOOL DISTRICT
F W826267 HORSEHEADS CENTRAL SCHOOL DISTRICT
F W826291 HYDE PARK CENTRAL SCHOOL DIST
F W826325 INDIAN RIVER CENTRAL SCHOOL DIST
F W826382 TOWN OF IRONDEQUOIT
F W826507 TOWN OF ISLIP
F W826754 ISLIP UNION FREE SCHOOL DIST
F W826887 ITHACA SCHOOL DIST
F W829139 JAMESVILLE-DEWITT CENTRAL SCHOOL DIST
F W829501 JAMESTOWN CITY SCHOOL DISTRICT
F W830004 JEFFERSON COUNTY
F W830079 JEFFERSON LEWIS BOCES
F W830111 JORDAN-ELBRIDGE CENTRAL SCHOOL DIST
F W830137 KATONAH LEWISBORO SCHOOLS
F W830178 KESHEQUA CENTRAL SCHOOL DIST
F W830194 KINDERHOOK CENTRAL SCHOOL DIST
F W830228 KINGS PARK CENTRAL SCHOOL DIST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W830319 CITY OF LACKAWANA
F W830368 LAKE PLACID CENTRAL SCHOOL DIST
F W830376 LAKE GEORGE SCHOOL DIST
F W830384 LAKELAND CSD OF SHRUB OAK
F W830442 LAWRENCE UNION FREE SCHOOL DIST
F W830475 LETCHWORTH CENTRAL SCHOOL DIST
F W830509 LEVITTOWN UNION FREE SCHOOL DISTRICT
F W831002 LEWIS COUNTY SELF INSURANCE FUND
F W831259 LINDENHURST UNION FREE SCHOOL DISTRICT
F W831473 LIVERPOOL CENTRAL SCHOOL DISTRICT (1994)
F W832000 LIVINGSTON COUNTY SELF INS PLAN
F W832257 LIVINGSTON-STEUBEN-WYOMING BOCES
F W832380 LIVONIA CENTRAL SCHOOL DISTRICT
F W832448 LOCKPORT CITY SCHOOL DISTRICT
F W832471 CITY OF LOCKPORT
F W833008 CITY OF LONG BEACH
F W833073 LONG BEACH CITY SCHOOL DIST
F W833131 LYME CENTRAL SCHOOL DIST
F W833503 LYNBROOK UNION FREE SCHOOL DISTRICT
F W833883 MADISON-ONEIDA-HERKIMER WC CONSORTIUM
F W834501 MAHOPAC CENTRAL SCHOOL DISTRICT
F W834576 MAINE-ENDWELL CENTRAL SCHOOL DISTRICT
F W834634 MALVERNE UNION FREE SCHOOL DISTRICT
F W834758 MAMARONECK UNION FREE SCHOOL DISTRICT
F W834881 MANHASSET UNION FREE SCHOOL DISTRICT
F W835003 MANHATTAN & BRONX SURF TRANS OPER AUTH
F W835078 MARATHON CENTRAL SCHOOL DIST
F W835136 MASSAPEQUA UNION FREE SCHOOL DIST
F W835342 MECHANICVILLE PUBLIC SCHOOL DIST
F W835359 MEDINA CENTRAL SCHOOL DIST
F W835383 METROPOLITAN SUBURBAN BUS AUTHORITY
F W835441 MEXICO CENTRAL SCHOOL DISTRICT
F W835508 MIDDLE COUNTRY CENTRAL SCHOOL DISTRICT
F W835755 LONGWOOD CENTRAL SCHOOL DIST
F W835888 ENLARGED CITY SCHOOL DIST OF MIDDLETOWN
F W836001 CITY OF MIDDLETOWN
F W836829 MILLER PLACE UNION FREE SCHOOL DISTRICT
F W836886 MINERVA CENTRAL SCHOOL DIST
F W836910 MINISINK VALLEY CENTRAL SCHOOL DISTRICT
F W837009 COUNTY OF MONROE
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
F W837256 MONROE COUNTY WATER AUTHORITY
F W837504 BOCES - MONROE COUNTY - FIRST SUP DIST
F W837751 MONROE - ORLEANS BOCES
F W837942 MONROE-WOODBURY CENTRAL SCHOOL DISTRICT
F W837975 MONTICELLO CENTRAL SCHOOL DIST
F W838007 MONTOGOMERY COUNTY MUTUAL SELF INS PLAN
F W839005 CITY OF MOUNT VERNON
F W839252 MOUNT VERNON CSD
F W840003 COUNTY OF NASSAU
F W840078 NASSAU HEALTH CARE CORP
F W840326 NEW HARTFORD CENTRAL SCHOOL DIST
F W840383 NEWARK VALLEY CENTRAL SCHOOL DIST
F W840508 CITY OF NEWBURGH
F W841001 CITY OF NEW ROCHELLE
F W841258 NEWBURGH ENLARGED CITY SCHOOL DIST
F W841381 NEWCOMB CENTRAL SCHOOL
F W841506 NEW ROCHELLE CITY SCHOOL DISTRICT
E W842009 BOARD OF EDUCATION CNY
E W843007 BOARD OF HIGHER EDUCATION CNY
E W843254 NEW YORK CITY HOUSING AUTHORITY
E W843502 HEALTH & HOSPITALS CORPORATION CNY
E W844005 NYC TRANSIT BOARD OF TRANSPORTATION
E W846000 DEPARTMENT OF HEALTH CNY
E W846505 POLICE FIRE SANITATION & CORRECTIONS CNY
E W847008 CNY OTHER THAN ED HED WATER HHC & HEALTH
F W847750 POWER AUTHORITY OF THE STATE OF NEW YORK
E W848006 NEW YORK CITY TRANSIT AUTHORITY
F W848139 NEW YORK MUNICIPAL WORKERS COMP ALLIANCE
F W848758 TOWN OF NIAGARA
F W849004 CITY OF NIAGARA FALLS
F W850002 NIAGARA FALLS BOARD OF EDUCATION
E W851000 NIAGARA COUNTY MUTUAL SELF INS PLAN
E W851075 NIAGARA FRONTIER TRANS AUTHORITY
E W851083 NIAGARA WHEATFIELD CENTRAL SCHOOL DIST
E W851091 TOWN OF NISKAYUNA
E W851109 NISKAYUNA CENTRAL SCHOOL DIST
E W851133 NORTH BABYLON UNION FREE SCHOOL DIST
E W851190 NORTH COLONIE CENTRAL SCHOOL DISTRICT
E W851224 TOWN OF NORTH HEMPSTEAD
E W851257 NORTHPORT-EAST NORTHPORT UFSD
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
E W851380 NORTH SALEM CENTRAL SCHOOL DIST
E W851505 NORTH SHORE CENTRAL SCHOOL DIST
E W851752 CITY OF NORTH TONAWANDA
E W851885 NORTH SYRACUSE CENTRAL SCHOOL DISTRICT
E W852008 NORTH TONAWANDA BOARD OF EDUCATION
E W852503 NYACK UNION FREE SCHOOL DISTRICT
E W852578 OCEANSIDE UNION FREE SCHOOL DIST
E W852636 ODESSA-MONTOUR CENTRAL SCHOOL
E W852883 OLEAN CITY SCHOOL DIST
E W852941 ONEIDA COUNTY BOCES
E W854004 ONEIDA COUNTY SELF INSURANCE FD
E W855001 COUNTY OF ONONDAGA
E W855506 ONONDAGA CORTLAND MADISON BOCES
E W856009 ONTARIO COUNTY MUTUAL SELF INS PLAN
E W857007 COUNTY OF ORANGE
E W857387 TOWN OF ORANGETOWN
E W857502 SOUTH ORANGETOWN CENTRAL SCHOOL DIST
E W857635 TOWN OF ORCHARD PARK
E W857882 ORLEANS-NIAGARA BOCES
E W858005 ORLEANS COUNTY SELF INS PLAN
E W858500 OSSINING UNION FREE SCHOOL DIST
E W858757 VILLAGE OF OSSINING
E W858880 OSWEGO COUNTY BOCES
E W859003 OSWEGO COUNTY SELF INSURANCE PLAN
E W860001 OTSEGO COUNTY SELF INSURANCE PLAN
E W860258 OTESGO-NORTHERN CATSKILLS BOCES
E W860506 TOWN OF OYSTER BAY
E W860548 PARISHVILLE-HOPKINTON CENTRAL SCHL DIST
E W860571 CITY SCHOOL DISTRICT OF PEEKSKILL
E W860597 PAWLING CENTRAL SCHOOL DIST
E W860605 PATCHOGUE MEDFORD SCHOOL DISTRICT
E W860613 CITY OF PEEKSKILL
E W860662 PELHAM UNION FREE SCHOOL DIST
E W860688 PHOENIX CENTRAL SCHOOL DISTRICT
E W860696 PENFIELD CENTRAL SCHOOL DIST
E W860712 PERU CENTRAL SCHOOL DIST
E W860720 PITTSFORD CENTRAL SCHOOL DIST
E W860738 PINE PLAINS CENTRAL SCHOOL DIST
E W860746 PLAINEDGE UNION FREE SCHOOL DIST
E W860795 PINE BUSH CENTRAL SCHOOL DIST
\\SDF Reimbursement Form wFormulas.xlsx\Proposed Groups
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Proposed Groups
Group W Nbr Insurer Name
E W860829 PLAINVIEW-OLD BETHPAGE CSD (1987)
E W860845 PLATTSBURGH CITY SCHOOL DIST
E W860852 BOCES CLINTON ESSEX WARREN & WASHINGTON
E W861009 PORT AUTHORITY OF NEW YORK & NEW JERSEY
E W861041 PORT BYRON CENTRAL SCHOOL DIST
E W861074 CITY OF PORT JERVIS CITY SCHOOL DIST
E W861132 PORT WASHINGTON UNION FREE SCHOOL DIST
E W861140 VILLAGE OF PORT CHESTER
E W861165 POTSDAM CENTRAL SCHOOL DIST
E W861199 CITY OF POUGHKEEPSIE
E W861207 POUGHKEEPSIE CITY SCHOOL DIST
E W861215 PRATTSBURG CENTRAL SCHOOL DIST
E W861223 PUBLIC EMPLOYERS RISK MANAGEMENT ASSN
E W861256 COUNTY OF PUTNAM
E W861447 BOCES PUTNAM WESTCHESTER COUNTIES
E W861454 QUEENSBURY SCHOOL DIST
E W861470 RAMAPO CENTRAL SCHOOL DISTRICT
E W861488 TOWN OF RAMAPO
E W861496 EAST RAMAPO CENTRAL SCHOOL DIST
E W861504 RENSSELAER COUNTY SELF INSURANCE PLAN
E W861629 REMSENBURG SPEONK UNION FREE SCHL DIST
E W861694 BOCES RENSSELAER-COLUMBIA-GREENE
E W861702 RHINEBECK CENTRAL SCHOOL DIST
E W861728 RIVERHEAD CENTRAL SCHOOL DIST
E W861744 TOWN OF RIVERHEAD
E W861751 CITY OF ROCHESTER
E W862007 ROCHESTER CITY SCHOOL DISTRICT
E W862130 ROCHESTER-GENESEE REGIONAL TRANS AUTH
E W862254 NORTH ROCKLAND CENTRAL SCHOOL DIST
E W862759 ROCKLAND COUNTY SELF INSURANCE PLAN
E W862767 CITY OF ROME
E W862775 ROCKY POINT UNION FREE SCHOOL DIST
E W862783 ROOSEVELT UNION FREE SCHOOL DIST
E W862825 ROCKLAND COUNTY BOCES
E W862858 ROCKVILLE CENTRE UNION FREE SCHOOL DIST
E W862866 ROME CITY SCHOOL DIST
E W862874 INC VILLAGE OF ROCKVILLE CENTRE
E W862882 SACHEM CENTRAL SCHOOL DISTRICT
E W862916 RYE CITY SCHOOL DIST
E W863005 ST LAWRENCE COUNTY SELF INS PLAN
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Proposed Groups
Group W Nbr Insurer Name
E W863757 SALAMANCA CITY SCHOOL DISTRICT
E W863856 SALMON RIVER CENTRAL SCHOOL DIST
E W863880 SARANAC CENTRAL SCHOOL DIST
E W864003 SARATOGA COUNTY SELF INS PLAN
E W864250 SARATOGA SPRINGS CITY SCHOOLS
E W864326 SAUQUOIT VALLEY CENTRAL SCHOOL
E W864441 SAYVILLE UNION FREE SCHOOL DIST
E W864508 SHENENDEHOWA CENTRAL SCHOOL DIST
E W864631 SCARSDALE UNION FREE SCHOOL DIST
E W864755 SCHENECTADY CITY SCHOOL DISTRICT
E W865000 CITY OF SCHENECTADY
E W865505 SCHENECTADY COUNTY
E W865638 SCHENEVUS CENTRAL SCHOOL
E W865919 SCHUYLER-CHEMUNG-TIOGA BOCES
E W865927 BOCES SCHU-STEU-CHEM-TIOG-ALLE
E W865943 SCIO CENTRAL SCHOOL DIST
E W866008 SENECA COUNTY SELF INSURANCE PLAN
E W866503 SEWANHAKA CENTRAL HIGH SCHOOL DISTRICT
E W866693 SHOREHAM WADING RIVER CSD
E W866750 SMITHTOWN CENTRAL SCHOOL DIST
E W866883 TOWN OF SMITHTOWN
E W866917 SOUTHOLD UNION FREE SCHOOL DIST
E W866933 SOLVAY UNION FREE SCHOOL DIST
E W866966 SOUTH COUNTY CENTRAL SCHOOL DIST
E W866974 SOUTH HUNTINGTON UNION FREE SCHOOL DIST
E W866982 SPENCERPORT CENTRAL SCHOOL DIST
E W866990 STATEN ISLAND RAPID TRANSIT OPER AUTH
E W867006 STEUBEN COUNTY SELF INSURANCE PLAN
E W867022 SOUTH GLENS FALLS CENTRAL SCHOOL DIST
E W867048 STILLWATER CENTRAL SCHOOL DIST
E W867063 SOUTH COLONIE SCHOOL DIST
E W867139 BOCES SOUTHERN WESTCHESTER
E W867162 SPACKENKILL UNION FREE SCHOOL DIST
E W867329 STEUBEN-ALLEGANY BOCES
E W867378 VILLAGE OF SUFFERN
E W867386 BOCES FIRST SUPERVISORY DIST SUFFOLK CTY
E W867501 COUNTY OF SUFFOLK
E W868004 SULLIVAN COUNTY SELF INSURANCE PLAN
E W868137 SULLIVAN COUNTY BOCES
E W868251 SWEET HOME SCHOOL DISTRICT
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Proposed Groups
Group W Nbr Insurer Name
E W868509 SYOSSET CENTRAL SCHOOL DISTRICT
E W869002 CITY OF SYRACUSE
E W869135 SYRACUSE CITY SCHOOL DISTRICT
E W869192 TACONIC HILLS CENTRAL SCHOOL DISTRICT
E W869259 TARRYTOWN UNION FREE SCHOOL DIST
E W870000 TIOGA COUNTY MUTUAL SELF INS PLAN
E W870505 THREE VILLAGE CENTRAL SCHOOL DIST
E W870752 TOMPKINS COUNTY
E W871636 CITY OF TONAWANDA
E W871750 TOWN OF TONAWANDA
E W872006 KENMORE-TOWN OF TONAWANDA UFSD
E W872253 TRI-VALLEY CENTRAL SCHOOL DIST
E W872501 TRIBOROUGH BRIDGE & TUNNEL AUTH (1990)
E W873004 CITY OF TROY
E W873251 CITY SCHOOL DISTRICT OF TROY
E W873442 TULLY CENTRAL SCHOOL DIST
E W873509 ULSTER COUNTY SELF INSURANCE PLAN
E W873632 ULSTER COUNTY BOCES
E W873889 UNATEGO CENTRAL SCHOOL DIST
E W874002 TOWN OF UNION
E W874077 UNIONDALE UNION FREE SCHOOL DIST
E W874135 UTICA CITY SCHOOL DISTRICT
E W874192 VALLEY CENTRAL SCHOOL DIST
E W874226 INCORPORATED VILLAGE OF VALLEY STREAM
E W874259 VALLEY STREAM CENTRAL HIGH SCHOOL DIST
E W874507 WANTAGH UNION FREE SCHOOL DIST
E W874630 WAPPINGERS CENTRAL SCHOOL DIST
E W874754 WARREN COUNTY SELF INSURANCE PLAN
E W874911 WARWICK VALLEY CENTRAL SCHOOL DIST
E W874945 WASHINGTONVILLE CENTRAL SCHOOL DIST
E W875009 WASHINGTON COUNTY SELF INS PLAN
E W875504 BOCES WASH-WARREN-HAMILTON-ESX CTYS
E W876007 CITY OF WATERTOWN
E W876502 WATERTOWN CITY SCHOOL DIST
E W877005 CITY OF WATERVLIET
E W877252 WATERVILLE CENTRAL SCHOOL DIST
E W877351 WATKINS GLEN CENTRAL SCHOOL DIST
E W878003 WAYNE COUNTY SELF INSURANCE PLAN
E W878078 WAYNE FINGER LAKES BOCES
E W878110 WEBSTER CENTRAL SCHOOL DIST
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Proposed Groups
Group W Nbr Insurer Name
E W878128 WEBUTUCK CENTRAL SCHOOL DIST
E W878136 WEST BABYLON UNION FREE SCHOOL DIST
E W878185 WEST GENESEE CENTRAL SCHOOL DIST
E W878193 WEST IRONDEQUOIT CENTRAL SCHOOL DIST
E W878250 WEST ISLIP UNION FREE SCHOOL DISTRICT
E W878383 TOWN OF WEST SENECA
E W878508 WEST SENECA CENTRAL SCHOOL DIST
E W878631 WESTBURY UNION FREE SCHOOL DIST
E W878755 COUNTY OF WESTCHESTER
E W878797 WESTCHESTER COUNTY HEALTH CARE CORP
E W878854 WESTHILL CENTRAL SCHOOL DISTRICT
E W878912 WHEATLAND CHILI CENTRAL SCHOOL DIST
E W878920 WILLIAMSVILLE CENTRAL SCHOOL DIST
E W878938 WHITESBORO CENTRAL SCHOOL
E W878946 CITY OF WHITE PLAINS
E W878961 WINDSOR CENTRAL SCHOOL DIST
E W878979 WHITE PLAINS CITY SCHOOL DIST
E W879001 WYOMING COUNTY WORKERS COMP
E W879076 WHITEHALL CENTRAL SCHOOL DIST
E W879258 WYANDANCH UNION FREE SCHOOL DIST
E W879753 WHITNEY POINT CENTRAL SCH DIST
E W880009 YATES COUNTY MUTUAL SELF INS PLAN
E W881007 CITY OF YONKERS
E W883250 TOWN OF YORKTOWN
E W887756 YORK CENTRAL SCHOOL DIST
E W890008 YORKTOWN CENTRAL SCHOOL DISTRICT
E W990004 UNINSURED EMPLOYERS FUND (TPA)
D W995005 THE AGGREGATE TRUST FUND
E W997001 FUND FOR REOPENED CASES
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