North Carolina Department of Insurance Financial …

1 North Carolina Department of Insurance Mike Causey, Commissioner Licensed Self-Insured Workers Compensation Individual Financial Analysis and Receivership Division 1203 Mail Service Center Raleigh, NC 27699-1203 (919) 807-6140 Fax: (919) 807-6635 As of: 9 / 2 2 / 2 0 1 7 AAA Cooper Transportation 1751 Kinsey Rd Dothan AL 36303 ABF Freight System, Inc. P. O. Box 10048 Fort Smith, AR 72917 Adventist Health System Sunbelt Healthcare Corporation 900 Hope Way Altamonte Springs, FL 32714 Alex Lee, Inc. P. O. Box 800 Hickory NC, 28603 Altec Industries, Inc. 210 Inverness Center Drive Birmingham, AL 35242 Asplundh Tree Expert Co. 708 Blair Mill Road Willow Grove, PA 19090 Averitt Express, Inc. P. O. Box 3166 Cookeville, TN 38501 BJ's Warehouse Club, Inc. 25 Research Dr. Box 5230 Westborough, MA 01581-5230 Baxter International, Inc. One Baxter Parkway Deerfield, IL 60015 Blue Cross Blue Shield of North Carolina P.

2 O. Box 2291 Durham, NC 27702 Boddie-Noell Enterprises, Inc. P. O. Box 1908 Rocky Mount, NC 27802 Butterball, LLC One Butterball Lane Garner, NC 27529 CVS Health Corporation One CVS Drive Woonsocket, RI 2895 CaroMont Health, Inc. Box 1747 Gastonia, NC 28053 Case Foods, Inc. P. O. Box 729 Troutman, NC 28166 Coats American, Inc. 3430 Toringdon Way, Suite 301 Charlotte, NC 28277 Columbia Forest Products, Inc. 7420 Thorndike Road Greensboro, NC 27409 Consolidated Diesel Company, Inc. 8300 Norman Center Drive, Suite 1000 Minneapolis, MN 55437 Costco Wholesale Corporation 999 Lake Drive Issaquah, WA 98027 Cracker Barrel Old Country Store, Inc. 305 Hartmann Drive Lebanon, TN 37088 Cumberland County Hospital System Inc. P. O. Box 2000 Fayetteville, NC 28302 D. H. Griffin Wrecking Company, Inc. P O Box 7657 Greensboro, NC 27407 Dart Container Corporation of Georgia 500 Hogsback Road Mason, MI 48854 Davey Tree Expert Company 1500 N Mantua St Kent, OH 44240 Delhaize America LLC P.

3 O. Box 1330 Salisbury, NC 28145 Depaul Adult Care Communities, Inc. 1931 Buffalo Road Rochester, NY 14624 Dolgencorp, LLC. P. O. Box 1728 Goodlettsville, TN 37070 Duke Energy Corporation P. O. Box 1244 Charlotte, NC 28201 Duke University P. O. Box 90448 Durham, NC 27708 E. I. Du Pont De Nemours & Company 1007 Market St. D-8065 Wilmington, DE 19898 ESA Management, LLC 11525 N. Community House Rd., Suite 100 Charlotte, NC 28277 Engineered Controls International, LLC P. O. Box 247 Elon, NC 27244 Estes Express Lines, Inc. P. O. Box 25612 Richmond, VA 23260 FedEx Freight, Inc. 2200 Forward Drive Harrison, AR 72601 FedEx Ground Package System, Inc. P. O. Box 535859 Pittsburgh, PA 15253 Federal Express Corporation 3620 Hacks Cross Road, Building B, 3rd Floor Memphis, TN 38125 First Citizens BancShares, Inc. P. O. Box 27131 Raleigh, NC 27611 FirstHealth of the Carolinas, Inc.

4 P. O. Box 3000 Pinehurst, NC 28374 Flowers Foods, Inc. 1919 Flowers Circle Thomasville, GA 31757 General Motors LLC P. O. Box 69 Southfield, MI 48034-0069 Halifax Regional Medical Center, Inc. and Affiliates 250 Smith Church Road Box 1089 Roanoke Rapids, NC 27870 High Point Regional Health Care System P. O. Box HP-5 High Point, NC 27261 Hillcrest Foods, Inc. 50 Satellite Blvd. Ste. G Suwanee, GA 30024 Home Depot A., Inc. and Affiliates 2455 Paces Ferry Road NW Building C, 20th Floor Atlanta, GA 30339 Hyster-Yale Group, Inc. 5200 Martin Luther King, Jr Hwy Greenville, NC 27834 Ingles Markets, Inc. P. O. Box 6676 Asheville, NC 28816 Kimberly-Clark Corporation PO Box 349 Neenah, WI 54957 Knight Transportation, Inc. 5601 W. Buckeye Rd. Phoenix, AZ 85043 Kroger Co. and Subsidiaries, The 3631 Peters Creek Road Roanoke, VA 24019 LA-Z-Boy Incorporated One La-Z-Boy Drive Monroe, MI 48162 Louisiana-Pacific Corporation 805 SW Broadway Portland, OR 97205 Lowe's Companies, Inc.

5 P. O. Box 1000 Mooresville, NC 28115 M. B. Kahn Construction Company, Inc. P. O. Box 1179 Columbia, SC 29202 Macy's Retail Holdings, Inc. 7 West Seventh Street Cincinnati, OH 45202 Marriott International, Inc. 10400 Fernwood Rd. Dept 52 Bethesda, MD 20817-0000 MasTec Incorporated 800 Douglas Road Coral Gables, FL 33134 Masco Corporation 17450 Masco Way Livonia, MI 48152 Maxwell Family Holding Company System P. O. Box 10009 Goldsboro, NC 27532 Meritor, Inc. 444 Hebron Rd Heath, OH 43056 Mission Health, Inc. 509 Biltmore Avenue Asheville, NC 28801 Moses H. Cone Memorial Hospital 1200 North Elm Street Greensboro, NC 27401 Mount Vernon Mills Chemicals, LLC 503 South Main Street Mauldin, SC 29662 Nash Johnson & Sons Farms, Inc. 441 Sunset Blvd West Columbia, SC 29036 Nordstrom, Inc. P. O. Box 21865 Seattle, WA 98111 Novant Health, Inc. P. O. Box 25686 Winston-Salem, NC 27114 Old Dominion Freight Lines, Inc.

6 500 Old Dominion Way Thomasville, NC 27360 PB Enterprises of Claremont, Inc. 339 Claremont, NC 28610 PCC Airfoils, LLC 25201 Chagrin Blvd. Beachwood, OH 44122 PPG Industries, Inc. One PPG Place - 9 Pittsburgh, PA 15272 PSNC Energy 220 Operation Way - C122 Cayce, SC 29033 Parkdale Mills, Inc. P. O. Box 1787 Gastonia, NC 28053 Parker Hannifin Corporation 6035 Parkland Boulevard Cleveland, OH 44124 Piedmont Natural Gas Company P. O. Box 33068 Charlotte, NC 28233 Precor Incorporated 20031 142nd Ave NE Woodinville, WA 98072 Procter & Gamble Company 6300 Center HIll Ave, Box 112 Cincinnati, OH 45224 Progress Energy, Inc. P. O. Box 1551 Raleigh, NC 27602 QuikTrip Corporation Box 3475 Tulsa, OK 74101 Research Triangle Institute P. O. Box 12194 Research Triangle Park, NC 27709 Reynolds American, Inc. 401 North Main Street Winston-Salem, NC 27102 Roberts Company Acquisitions, LLC (The ) 133 Forlines Road Winterville, NC 28590-0000 STM Industries, Inc P.

7 O. Box 2228 Hickory NC 28603 Saia Inc. P. O. Box A Station 1 Houma, LA 70363 Sherwin Williams Company 101 Prospect Avenue, NW Cleveland, OH 44115 Southeastern Freight Lines, Inc. P. O. Box 1691 Columbia, SC 29202 St. Joseph of the Pines, Inc. 20555 Victor Parkway Livonia, MI 48152 Terminix Service, Inc. P. O. Box 2627 Columbia, SC 29202 Textron, Inc. 8300 Norman Center Dr, Ste. 400 Minneapolis, MN 55437 Tyson Foods, Inc. P. O. Box 2020 Springdale, AR 72765 VF Corporation P. O. Box 21488 Greensboro, NC 27420 Variety Wholesalers, Inc. P. O. Box 947 Henderson, NC 27536 Virginia Electric & Power Company P. O. Box 26666 Richmond, VA 23261 Vulcan Materials Company P. O. Box 385014 Birmingham, AL 35238 Waffle House, Inc. P. O. Box 6450 Norcross, GA 30091 Wake Forest University Baptist Medical Center Medical Center Blvd. Winston-Salem, NC 27103 Wake Forest University P. O.

8 Box 7201 Winston-Salem, NC 27109 WakeMed P. O. Box 14465 Raleigh, NC 27620 Wegmans Food Markets 1500 Brooks Ave Rochester, NY 14624 Wendy's International, LLC One Dave Thomas Blvd Dublin, OH 43017-2093 Western and Southern Life Insurance Company (The) 400 Broadway Cincinnati, OH 45202 Weyerhaeuser Company P. O. Box 9777 MS:EC2-2B2 Federal Way, WA 98063 YRC, Inc. 10990 Roe Avenue Overland Park, KS 66211 Count: 101