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["COVID-19 Nonparticipating Transmittal Form (Form e-316CV)\nForm e-316CV should only be submitted by primary insurance carriers, brokers, or agents",null,null,null,null,null,"Please Select Primary Carrier"]
["Health care providers volunteering without compensation as described in",null,null,"PA Bulletin Notice 2020-8",null,null,"ACADEMIC MEDICAL PROFESSIONALS RRG 362"]
["Primary Carrier","Please Select Primary Carrier",null,null,null,null,"ACCREDITED SURETY & CASUALTY CO INC 391"]
["Carrier Code",{"$f":"IF(B3=\"Please Select Primary Carrier\",\"\",RIGHT(B3,3))","v":""},null,null,null,null,"ACE USA (ACE American/INA/Pacific Emp) 023"]
["Date","Completion Date",null,null,null,null,"ADMIRAL INSURANCE COMPANY 113"]
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["Contact Person's Address",null,null,null,null,null,"AFFILIATED F.M. 002"]
["Contact Person's Telephone #",null,null,null,null,null,"AFFILIATES INSUR RECIPROCAL RRG 303"]
["Contact Person's Email",null,null,null,null,null,"AHERF 119"]
["For a listing of related numbers for Hospitals and Nursing Homes,",null,null,null,"click here.",null,"AIG SPECIALTY INSUR CO 276"]
["License Number","Name\nLast, First, M.I.","From Date","To Date","Carrier's Policy #","Related #","AIX SPECIALTY INSUR CO 327"]
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[null,null,null,null,null,null,"JEFFERSON INSUR CO OF NY 024"]
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[null,null,null,null,null,null,"LANTANA INSURANCE LTD 230"]
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[null,null,null,null,null,null,"MEDICAL MUTUAL LIAB INS SOC 030"]
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[null,null,null,null,null,null,"MEDICUS INSUR CO 317"]
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[null,null,null,null,null,null,"MEDPRO RRG 300"]
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[null,null,null,null,null,null,"MERCY HOSP-WILKES BARRE S45"]
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[null,null,null,null,null,null,"METROPOLITAN-SPRINGFIELD S20"]
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[null,null,null,null,null,null,"MIDWEST INS GROUP INC RRG 270"]
[null,null,null,null,null,null,"MILLENNIUM INS CO RRG 205"]
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[null,null,null,null,null,null,"MONTEFIORE HOSP S31"]
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[null,null,null,null,null,null,"NORCAL MUTUAL INSUR CO 067"]
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[null,null,null,null,null,null,"NORTHWESTERN NATIONAL 036"]
[null,null,null,null,null,null,"NOVUS INSURANCE CO RRG 257"]
[null,null,null,null,null,null,"NY UNDERWRITERS INSUR CO 116"]
[null,null,null,null,null,null,"OCEANUS INSURANCE CO RRG 277"]
[null,null,null,null,null,null,"OHIO HOSPITAL INSUR CO 149"]
[null,null,null,null,null,null,"OHIO VALLEY GEN HOSP S41"]
[null,null,null,null,null,null,"OLD REPUBLIC INSURANCE CO 112"]
[null,null,null,null,null,null,"ONEBEACON INSURANCE CO 267"]
[null,null,null,null,null,null,"OPHTHALMIC MUTUAL INS CO 138"]
[null,null,null,null,null,null,"OSTEOPATHIC MUTUAL INSUR 123"]
[null,null,null,null,null,null,"P.I.E. MUTUAL INSUR CO 143"]
[null,null,null,null,null,null,"PA PROF LIAB J U A 032"]
[null,null,null,null,null,null,"PACE RISK RETENTION GROUP 220"]
[null,null,null,null,null,null,"PACIFIC INSURANCE COMPANY 111"]
[null,null,null,null,null,null,"PACIFIC INSUR CO LIMITED 186"]
[null,null,null,null,null,null,"PALLADIUM RRG 338"]
[null,null,null,null,null,null,"PEACE CHURCH RRG, INC. 235"]
[null,null,null,null,null,null,"PEDIATRICIANS INS RRG 272"]
[null,null,null,null,null,null,"PELICAN INS A RECIP RRG 217"]
[null,null,null,null,null,null,"PENN MANUFACTURERS ASSOC 038"]
[null,null,null,null,null,null,"PENN PHYS RECIP INSURERS 246"]
[null,null,null,null,null,null,"PENN STATE HEALTH S69"]
[null,null,null,null,null,null,"PENN-AMERICA INSURANCE CO 085"]
[null,null,null,null,null,null,"PENNSYLVANIA HOSPITAL S11"]
[null,null,null,null,null,null,"PHICO INSURANCE COMPANY 086"]
[null,null,null,null,null,null,"PHILADELPHIA ACADEMIC RRG LLC 368"]
[null,null,null,null,null,null,"PHILA INDEMNITY INSUR CO 165"]
[null,null,null,null,null,null,"PHILA PROTESTANT HOME S61"]
[null,null,null,null,null,null,"PHOEBE RECIPROCAL RRG 242"]
[null,null,null,null,null,null,"PHYSICIANS INSURANCE CO 093"]
[null,null,null,null,null,null,"PHYSICIANS SPEC LTD RRG 212"]
[null,null,null,null,null,null,"POCONO MEDICAL CTR S60"]
[null,null,null,null,null,null,"PODIATRY INSURANCE CO 124"]
[null,null,null,null,null,null,"POSITIVE MUTUAL RRG INC 201"]
[null,null,null,null,null,null,"POSITIVE PHYSICIANS INS CO 221"]
[null,null,null,null,null,null,"POSITIVE PHYSICIANS INS CO 239"]
[null,null,null,null,null,null,"POSITIVE PHYSICIANS INS CO 258"]
[null,null,null,null,null,null,"PREFERRED PHYSICIANS MEDICAL RRG INC 294"]
[null,null,null,null,null,null,"PREFERRED PROF INSUR CO 129"]
[null,null,null,null,null,null,"PRESBYTERIAN UNIV HOSP S16"]
[null,null,null,null,null,null,"PRIME INSURANCE COMPANY 296"]
[null,null,null,null,null,null,"PRINCETON EX & SL INS CO 266"]
[null,null,null,null,null,null,"PRINCETON INSURANCE CO 126"]
[null,null,null,null,null,null,"PROASSURANCE CASUALTY CO 162"]
[null,null,null,null,null,null,"PROASSURANCE INDEMNITY CO INC 349"]
[null,null,null,null,null,null,"PROASSURANCE SPEC INS CO 324"]
[null,null,null,null,null,null,"PROF MUT INSUR CO-RRG 125"]
[null,null,null,null,null,null,"PROF SOLUTIONS INSUR CO 213"]
[null,null,null,null,null,null,"PROFESSIONAL MED INSUR CO 133"]
[null,null,null,null,null,null,"PROFESSIONAL MUT INS RRG 057"]
[null,null,null,null,null,null,"PROFESSIONAL RRG INC 204"]
[null,null,null,null,null,null,"PROFESSIONALS ADVOCATE 152"]
[null,null,null,null,null,null,"PROFESSIONAL SECURITY INS CO 370"]
[null,null,null,null,null,null,"PROSELECT INSURANCE CO 271"]
[null,null,null,null,null,null,"PROSPECT MEDICAL HOLDINGS RRG INC 355"]
[null,null,null,null,null,null,"PRUDENTIAL P & C 091"]
[null,null,null,null,null,null,"PUBLIC SERVICE MUTUAL 083"]
[null,null,null,null,null,null,"PURITAN 066"]
[null,null,null,null,null,null,"QBE SPECIALTY INSUR CO 315"]
[null,null,null,null,null,null,"RANGER INSURANCE COMPANY 075"]
[null,null,null,null,null,null,"READING HOSP & MED CTR S12"]
[null,null,null,null,null,null,"RECIPROCAL ALLIANCE-RRG 158"]
[null,null,null,null,null,null,"RECIPROCAL OF AMERICA 181"]
[null,null,null,null,null,null,"RED MOUNTAIN CASUALTY INS 214"]
[null,null,null,null,null,null,"REDLAND INSURANCE COMPANY 193"]
[null,null,null,null,null,null,"RELIANCE INSURANCE CO 039"]
[null,null,null,null,null,null,"RELIANCE NATIONAL INS CO 146"]
[null,null,null,null,null,null,"RLI INSURANCE COMPANY 102"]
[null,null,null,null,null,null,"ROCKHILL INSUR CO 312"]
[null,null,null,null,null,null,"ROCKWOOD 054"]
[null,null,null,null,null,null,"ROYAL & SUNALLIANCE INSUR 188"]
[null,null,null,null,null,null,"ROYAL GLOBE INSURANCE GRP 041"]
[null,null,null,null,null,null,"ROYAL INDEMNITY INSURANCE 176"]
[null,null,null,null,null,null,"ROYAL SURP LINES INSUR CO 166"]
[null,null,null,null,null,null,"SAFECO P & C INSUR COS 042"]
[null,null,null,null,null,null,"SAFEGUARD INSURANCE CO 178"]
[null,null,null,null,null,null,"SCHUYLKILL CROSSING RECIP 228"]
[null,null,null,null,null,null,"SCOTTSDALE INSURANCE CO 110"]
[null,null,null,null,null,null,"SCRUBS MUTUAL ASSURANCE CO RRG 375"]
[null,null,null,null,null,null,"SHADYSIDE HOPSITAL S24"]
[null,null,null,null,null,null,"SIGMA RRG 290"]
[null,null,null,null,null,null,"SOUTH SIDE HOSPITAL S42"]
[null,null,null,null,null,null,"SOUTHWEST PHYSICIANS RRG 279"]
[null,null,null,null,null,null,"SPECIALTY NATIONAL INS CO 189"]
[null,null,null,null,null,null,"SPHERE INSURANCE COMPANY 072"]
[null,null,null,null,null,null,"SPIRIT MOUNTAIN INSURANCE CO RRG 301"]
[null,null,null,null,null,null,"ST BARNABAS HEALTH SYSTEM S58"]
[null,null,null,null,null,null,"ST LUKE'S HEALTH NET RRG 223"]
[null,null,null,null,null,null,"ST. CLAIR MEM HOSP S40"]
[null,null,null,null,null,null,"ST. PAUL COMPANIES 045"]
[null,null,null,null,null,null,"STAR INSURANCE COMPANY 134"]
[null,null,null,null,null,null,"STARSTONE SPEC INSUR 322"]
[null,null,null,null,null,null,"STATE AUTO MUTUAL 046"]
[null,null,null,null,null,null,"STC HEALTHCARE PARTNERS RRG 374"]
[null,null,null,null,null,null,"STEADFAST INSURANCE CO 196"]
[null,null,null,null,null,null,"STONINGTON INSURANCE CO 255"]
[null,null,null,null,null,null,"SUPERIOR INS CO RRG 273"]
[null,null,null,null,null,null,"TDC SPECIALTY INSUR CO 173"]
[null,null,null,null,null,null,"TEMPLE UNIV HOSP S13"]
[null,null,null,null,null,null,"THE DOCTORS COMPANY 121"]
[null,null,null,null,null,null,"THE MEDICAL PROTECTIVE CO 031"]
[null,null,null,null,null,null,"THOMAS JEFFERSON UNIV HOSP S14"]
[null,null,null,null,null,null,"THOMAS JEFFERSON UNIV S65"]
[null,null,null,null,null,null,"TIG INSURANCE COMPANY 180"]
[null,null,null,null,null,null,"TIG SPECIALTY INSUR CO 168"]
[null,null,null,null,null,null,"TITAN RRG 372"]
[null,null,null,null,null,null,"TOWER HEALTH RECIPROCAL RRG 365"]
[null,null,null,null,null,null,"TRANSCONTINENTAL INSUR CO 190"]
[null,null,null,null,null,null,"TRANSIT CASUALTY COMPANY 100"]
[null,null,null,null,null,null,"TRANSPORT INDEMNITY CO 104"]
[null,null,null,null,null,null,"TRAVELERS 047"]
[null,null,null,null,null,null,"TRI-CENTURY INSURANCE CO 144"]
[null,null,null,null,null,null,"TRUCK INSURANCE EXCHANGE 164"]
[null,null,null,null,null,null,"TUREGUM INSURANCE COMPANY 108"]
[null,null,null,null,null,null,"UNIONAMERICA INS CO LTD 153"]
[null,null,null,null,null,null,"UNITED CTR PA RECIP RRG 203"]
[null,null,null,null,null,null,"UNITED NATIONAL INSUR CO 148"]
[null,null,null,null,null,null,"UNITED SPECIALTY INS CO 363"]
[null,null,null,null,null,null,"UNITED STATES FIRE INS CO 320"]
[null,null,null,null,null,null,"UNITED STATES LIAB INS CO 049"]
[null,null,null,null,null,null,"URGENT CARE ASSURANCE CO RRG 366"]
[null,null,null,null,null,null,"US FIDELITY & GUARANTY CO 048"]
[null,null,null,null,null,null,"US STEEL CORP S15"]
[null,null,null,null,null,null,"US UNDERWRITERS INSUR CO 080"]
[null,null,null,null,null,null,"VALIANT INSURANCE COMPANY 285"]
[null,null,null,null,null,null,"VANTAGE RISK SPEC INS CO 390"]
[null,null,null,null,null,null,"WARREN RRG INC 233"]
[null,null,null,null,null,null,"WELLSPAN HEALTH SYS S55"]
[null,null,null,null,null,null,"WELLSPAN RECIPROCAL RRG 224"]
[null,null,null,null,null,null,"WESLEY ENHANCED LIVING S67"]
[null,null,null,null,null,null,"WESTERN CASUALTY & SURETY 076"]
[null,null,null,null,null,null,"WESTERN INDEMNITY INS CO 140"]
[null,null,null,null,null,null,"WESTERN WORLD 077"]
[null,null,null,null,null,null,"WYOMING VALLEY HCS S62"]
[null,null,null,null,null,null,"XL CATLIN INS CO UK LTD 383"]
[null,null,null,null,null,null,"YORK HOSPITAL S35"]
[null,null,null,null,null,null,"ZURICH AMER INS CO OF IL 901"]
[null,null,null,null,null,null,"ZURICH AMERICAN INSUR CO 900"]
[null,null,null,null,null,null,"ZURICH INSURANCE COMPANY 904"]
[null,null,null,null,null,null,"MCARE TEST CO 000"]