Enter a 3-digit numeric code when:
- reporting TPL information for the first time,
- changing TPL information, or
- reporting HIB and/or SMIB.
Do not code automobile-medical comprehensive insurance. If the client has automobile-medical comprehensive insurance and has no other health insurance, enter code 000 - no TPL coverage.
Choose the health insurance code that applies from the following list.
| 000 |
No Health Insurance Coverage |
| 888 |
More Than One Health Insurance Company |
| 999 |
Miscellaneous TPL Resource |
A B C D-E F G H I J-L M N-O P Q-S T-U W-Z
| 136 |
Academy Life Insurance Company |
| 001 |
Aetna Life Insurance Company |
| 142 |
Aid Association for Lutherans |
| 048 |
Allstate Life Insurance Company |
| 002 |
Amalgamated Life and Health Company |
| 153 |
Amalgamated Life Insurance Company |
| 154 |
American Centennial Life Insurance Company |
| 061 |
American Family Life Assurance Company |
| 475 |
American Federation of Government Employees |
| 042 |
American Fidelity Assurance Company |
| 103 |
American General Life and Accident - Nashville, TN |
| 114 |
American General Life and Accident - Houston, TX |
| 144 |
American Heritage Life Company |
| 105 |
American Income Life Insurance Company |
| 098 |
American Independence Life Insurance |
| 062 |
American Integrity Insurance Company |
| 161 |
American International Life Assurance Company of New York |
| 063 |
American Liberty Life Insurance Company |
| 064 |
American Life and Accident Insurance Company |
| 065 |
American Life Insurance Company |
| 066 |
American Mutual Life Insurance Company |
| 056 |
American National Insurance Company |
| 453 |
American Postal Workers Union |
| 053 |
American Republic Insurance Company |
| 137 |
American States Insurance Company |
| 067 |
American Union Life Insurance Company |
| 068 |
American United Life Insurance Company |
| 169 |
Association Life Insurance Company Inc. |
| 485 |
Atkinson Topeka & Santa Fe Employees Benefits Association |
| 430 |
Automotive Wholesalers of Illinois |
| 460 |
Bakery & Confectionery Workers Union |
| 003 |
Bankers Life and Casualty Company |
| 045 |
Bankers Multiple/World Insurance Company |
| 086 |
Banner Life Insurance Company |
| 069 |
Beneficial National Life Insurance Company |
| 070 |
Beneficial Standard Life Insurance Company |
| 611 |
Benefit Administration Systems - Homewood, Illinois |
| 044 |
Blue Cross Blue Shield - Out of State |
| 480 |
Blue Cross/Blue Shield - Federal |
| 462 |
Boilermaker's Union |
| 469 |
Bricklayer's Union |
| 604 |
Brookfield Harrington |
| 007 |
Business Men's Assurance Company |
| 159 |
California Western States Life Insurance Company |
| 008 |
Capitol Life Insurance Company |
| 448 |
Carpenters' Health & Welfare Trust Fund |
| 449 |
Caterpillar Tractor Company |
| 080 |
Central Life Assurance Company |
| 072 |
Central States Health & Life Company of America |
| 443 |
Central States Joint Board Health & Welfare Trust Fund |
| 452 |
Central States Southeast & Southwest Area H & W Fund |
| 009 |
CHAMPUS/CHAMPVA/TRICARE PRIME |
| 433 |
Chrysler Corporation |
| 179 |
Chubb Life |
| 073 |
Colonial Life and Accident Insurance Company |
| 178 |
Combined American Life Insurance Company |
| 047 |
Combined Insurance Company |
| 084 |
Combined Insurance Company of America |
| 076 |
Commonwealth Life and Accident Insurance Company |
| 151 |
Commonwealth Life Insurance Company |
| 180 |
Community Health Plan |
| 077 |
Confederation Life Insurance Company |
| 010 |
Connecticut General Life Insurance Company |
| 074 |
Conseco Direct/Colonial Penn |
| 011 |
Continental Assurance Company |
| 613 |
Coordinated Financial Services - Chicago, Illinois |
| 012 |
Country Life Insurance Company |
| 054 |
Crown Life Insurance Company |
| 156 |
Cuna Mutual Insurance Society |
| 600 |
DuKane Claim Company - Aurora, Illinois |
| 181 |
Educators Mutual Insurance |
| 458 |
Electrical Workers Union |
| 182 |
Employers Health/Humana |
| 050 |
Employers Life Insurance Company of Wausau |
| 013 |
Equitable Life Assurance |
| 078 |
Equity National Life Insurance Company |
| 171 |
Farmland Industries Inc. |
| 163 |
Federal Home Life Insurance Company |
| 079 |
Federal Life Insurance Company |
| 183 |
Federated Mutual Insurance |
| 081 |
Fidelity Life Association |
| 082 |
Fidelity National Life Insurance Company |
| 176 |
Fireman's Fund Life Insurance Company |
| 149 |
First All America Financial |
| 454 |
Food Handlers Union |
| 096 |
Ford Life Insurance Company |
| 431 |
Ford Motor Company |
| 130 |
Fortis Benefits Insurance Company |
| 120 |
Fortis Insurance Company (Time Insurance) |
| 468 |
Furniture Worker's Union |
| 608 |
Gallagher Benefit Administration |
| 014 |
General American Life Insurance Company |
| 437 |
General Electric Corporation |
| 432 |
General Motors Corporation |
| 461 |
Glazer's Union |
| 083 |
Globe Life and Accident Insurance Company |
| 085 |
Golden Rule Insurance Company |
| 459 |
Government Employees Hospital Association |
| 015 |
Great-West Life Assurance Company |
| 201 |
Group Health Northwest |
| 087 |
Guarantee Reserve Life Insurance Company |
| 088 |
Guarantee Trust Life Insurance Company |
| 089 |
Guardian Life Insurance Company |
| 155 |
Gulf Life Insurance Company |
| 016 |
Hartford Life/Mass Mutual |
| 184 |
Harvard Community Health Plan |
| 006 |
Health Care Service Corporation - BC/BS |
| 601 |
Health Claims Administration |
| 605 |
Health Insurance Administration |
| 196 |
Health Partners of Midwest |
| 187 |
Health Plus/John Alden |
| 051 |
Hill Country/Columbia University |
| 090 |
Holy Family Society of the USA |
| 017 |
Home Life Insurance Company |
| 018 |
Horace Mann Insurance Company |
| 075 |
Humana Health Plans HMO |
| 165 |
Ideal National Insurance Company |
| 043 |
ILL Hospital and Health Service |
| 019 |
ILL Mutual Life & Casualty Company |
| 434 |
Illinois Bell |
| 474 |
Illinois Central Hospital Association |
| 445 |
Indiana Laborers and HOD Carrier |
| 092 |
Industrial Life Insurance Company |
| 441 |
International Funds |
| 093 |
Inter-Ocean Insurance Company |
| 164 |
Iowa State Travelers Mutual Assurance Company |
| 471 |
Iron Worker's Union |
| 446 |
J. C. Penney Company Inc. |
| 049 |
J. C. Penney Life Insurance Company |
| 145 |
Jefferson Pilot Insurance Company |
| 447 |
John Deere - Heritage National Plan |
| 071 |
John Deere Life Insurance Company |
| 020 |
John Hancock Mutual/Unicare |
| 603 |
Jonn P. Pearl & Associates |
| 190 |
Kaiser Foundation Health Plan |
| 451 |
Laborers Welfare Fund |
| 021 |
Liberty Life Assurance Company |
| 095 |
Liberty National Life Insurance Company |
| 097 |
Life Investors Insurance Company of America |
| 094 |
Lincoln Liberty Life Insurance Company |
| 022 |
Lincoln National Life Insurance Company |
| 023 |
Loyal Protective Life Insurance Company |
| 473 |
Mail Handler's Benefit Plan |
| 609 |
Management Services Inc. |
| 467 |
Marine Worker's Union |
| 099 |
Marquette National Life Insurance Company |
| 444 |
Meatcutters and Butchers #100 |
| 146 |
Mennonite Mutual Aid Association |
| 025 |
Metrahealth/United HealthCare |
| 041 |
Mica (California Life Claims) |
| 152 |
Midland Mutual Life Insurance Company |
| 472 |
Millinery Worker's Union |
| 479 |
Missouri Pacific Employee |
| 100 |
Montgomery Ward Life Insurance Company |
| 026 |
Monumental Life Insurance Company |
| 058 |
Mutual Benefit Life Insurance Company |
| 602 |
Mutual Medical Plan Inc. - Peoria, Illinois |
| 028 |
Mutual of New York (MONY) |
| 140 |
Mutual Protective Insurance Company |
| 162 |
Mutual Security Life Insurance Company |
| 027 |
Mutual/United of Omaha Insurance Company |
| 455 |
National Association of Letter Carriers |
| 101 |
National Benefit Life Insurance Company |
| 102 |
National Ben Franklin Life Insurance Company |
| 104 |
National Liberty Life Insurance Company |
| 106 |
National States Insurance Company |
| 107 |
Nationwide Life Insurance Company |
| 057 |
New England Mutual Life Insurance Company |
| 029 |
New York Life Insurance Company |
| 122 |
North America Benefit Network |
| 139 |
North American Company for Life & Health Insurance |
| 150 |
North American Insurance Company |
| 030 |
Northwestern Mutual Life Insurance Company |
| 109 |
Old American Insurance Company |
| 168 |
Old Republic Life Insurance Company |
| 167 |
Old Southern Life Insurance Company |
| 456 |
Operating Engineer Health & Welfare Fund |
| 194 |
PACC HMO |
| 177 |
Pacific Heritage Assurance Company |
| 032 |
Pacific Mutual Life Insurance Company |
| 450 |
Painters & Decorators Fund |
| 110 |
Pan-American Insurance Company |
| 111 |
Paul Revere Life Insurance Company |
| 614 |
Paul Weisman & Associates - St. Louis, Missouri |
| 200 |
PCA Solutions |
| 112 |
Pekin Insurance Company |
| 113 |
Penn Mutual Life Insurance Company |
| 033 |
Pennsylvania Life Insurance Company |
| 046 |
Peoples Benefit Life Insurance Company |
| 195 |
Philadelphia American Life |
| 158 |
Philadelphia Life Insurance Company |
| 197 |
Phoenix Home Life |
| 034 |
Physician's Mutual Life Insurance Company |
| 198 |
Pilgrim Insurance Company |
| 060 |
Pioneer Life Insurance Company |
| 463 |
Pipefitter's Union |
| 465 |
Plasterer's Union |
| 466 |
Plumber's Union |
| 478 |
Postmaster's Benefit Plan |
| 004 |
Principal/American HMO |
| 147 |
Protective Life Insurance Company |
| 035 |
Provident Life & Casualty Insurance Company |
| 157 |
Provident Mutual Insurance Company of Philadelphia |
| 036 |
Prudential Insurance Company |
| 188 |
Qual Medical Insurance |
| 175 |
Reliable Life Insurance Company |
| 059 |
Reliable Life/Rockford Life |
| 108 |
Reliastar/Northwestern National Life |
| 115 |
Reserve Life Insurance Company |
| 477 |
Rural Carrier Benefit Plan |
| 055 |
Safeco Life Insurance Company |
| 607 |
Scott Wetzel Services Inc. - Chicago, Illinois |
| 148 |
Security Benefit Life Insurance Company |
| 037 |
Sentry Life Insurance Company |
| 471 |
Service Employees & Maintenance Worker's Union |
| 464 |
Sheet Metal Worker's Union |
| 116 |
Southland Life Insurance Company |
| 439 |
St Clair County Health Plan |
| 117 |
Standard Life & Accident Insurance Company |
| 118 |
Standard Life Insurance Company - Austin, Texas |
| 119 |
Standard of America Life Insurance Company |
| 052 |
State Farm Health Insurance Company |
| 482 |
State of Illinois - Health Insurance |
| 160 |
Supreme Life Insurance Company |
| 615 |
Syncor Administrative Services - Northbrook, Illinois |
| 457 |
Teamster's Health & Welfare Fund |
| 191 |
Transport Life Insurance Company |
| 038 |
Travelers Insurance Company |
| 005 |
Trustmark Insurance Company |
| 192 |
Tufts Associated Health |
| 186 |
Unicare |
| 141 |
Union Banker's Insurance Company |
| 121 |
Union Casualty Company |
| 123 |
Union Fidelity Life Insurance Company |
| 039 |
Union Labor Life Insurance Company |
| 173 |
Union Mutual Life Insurance Company |
| 124 |
United American Insurance Company |
| 125 |
United Benefit Life Insurance Company |
| 442 |
United Food and Comm. Workers |
| 128 |
United Founders Life Insurance Company |
| 189 |
United Healthcare |
| 127 |
United Insurance Company of America |
| 436 |
United Mine Workers - The Funds |
| 438 |
United Parcel Services |
| 174 |
United States Life Insurance Company |
| 166 |
United Teacher Associates Insurance |
| 193 |
U S Healthcare |
| 129 |
Wabash Life Insurance Company |
| 476 |
Wabash Memorial Hospital Association |
| 138 |
Wabash/Conseco |
| 040 |
Washington National Insurance Company |
| 172 |
Western Catholic Union |
| 435 |
Western Electric Company |
| 131 |
Western Southern Life Insurance Company |
| 091 |
Wisconsin National Life Insurance Company |
| 132 |
Woodmen Accident and Life Company |
| 133 |
World Insurance Company |
| 440 |
ZEBA - Flex Plus |
| 610 |
Zenith Administrators Inc. |
| 134 |
Zenith Life Insurance Company |
| 135 |
Zurich American Insurance Company |
