FEC Form 1 for Guidewell Mutual Holding Corporation Political Action Committee (Guidewell PAC)Form 1 for Guidewell Mutual Holding Corporation Political Action Committee (Guidewell PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1782172

1. Guidewell Mutual Holding Corporation Political Action Committee (Guidewell PAC)

4800 Deerwood Campus Parkway
DC1-7
Jacksonville, FL 32246

NOTE: Address is different than previously reported

Email: craig.provenzano@bcbsfl.com;suzanne.horne@bcbsfl.com

2. Date: 05/10/2024

3. FEC Committee ID #: C00161141 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Guidewell Mutual Holding Corporation
4800 Deerwood Campus Parkway
DC1-8
Jacksonville, Florida 32246
Affiliated Relationship Code: Connected Organization

LOUISIANA HEALTH SERVICE & INDEMNITY C
5525 Reitz Avenue
Baton Rouge, Louisiana 40809
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS AND BLUE SHIELD OF NEBRASKA
7261 MERCY ROAD
PO BOX 3248
OMAHA, Nebraska 68180
Affiliated Relationship Code: Affiliated Committee

HORIZON HEALTHCARE SERVICES, INC.-HORI
3 PennPlz E
PP-11G
Newark, New Jersey 07105
Affiliated Relationship Code: Affiliated Committee

HIGHMARK PAC OF HIGHMARK INC.
1800 Center Street
Camp Hill, Pennsylvania 17089
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS AND BLUE SHIELD OF KANSAS C
2301 MAIN STREET
KANSAS CITY, Missouri 64108
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS AND BLUE SHIELD OF KANSAS,
1133 SW TOPEKA BLVD
CC:855 - B3
TOPEKA, Kansas 66629
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS BLUE SHIELD OF MICHIGAN PAC
232 S. CAPITOL
MC L10A
LANSING, Michigan 48933
Affiliated Relationship Code: Affiliated Committee

BLUE SHIELD OF CALIFORNIA
50 BEALE STREET17-C356
SAN FRANCISCO, California 94105
Affiliated Relationship Code: Affiliated Committee

CAPITAL BLUEPAC, THE POLITICAL ACTION
PO BOX 60710
HARRISBURG, Pennsylvania 17177
Affiliated Relationship Code: Affiliated Committee

Blue Cross Blue Shield of Alabama
2 North Jackson St.
Suite 202
Montgomery, Alabama 36104
Affiliated Relationship Code: Affiliated Committee

CAREFIRST BLUECROSS BLUESHIELD ASSOCIA
10455 MILL RUN CIRCLE
OWINGS MILL, Maryland 21117
Affiliated Relationship Code: Affiliated Committee

HEALTHY GOVERNMENT COMMITTEE-THE POLIT
P.O. BOX 13466
PHOENIX, Arizona 85002
Affiliated Relationship Code: Affiliated Committee

PREMERA BLUE CROSS POLITICAL ACTION CO
7001 220TH STREET SWMS 355
MOUNTLAKE TERRACE, Washington 98043
Affiliated Relationship Code: Affiliated Committee

WELLMARK, INC. PAC (WELLPAC)
1331 GRAND AVENUESTA. 5W570
DES MOINES, Iowa 50309
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS AND BLUE SHIELD OF NORTH CA
P.O. Box 2291
Durham, North Carolina 27702
Affiliated Relationship Code: Affiliated Committee

BLUEPAC - BLUE CROSS BLUE SHIELD ASSOC
1310 G STREET NW
WASHINGTON, DC 20005
Affiliated Relationship Code: Affiliated Committee

BLUECROSS BLUESHIELD OF TENNESSEE INC
1 Cameron Hill Circle
Chattanooga, Tennessee 37402
Affiliated Relationship Code: Affiliated Committee

BLUE CROSS BLUE SHIELD OF SOUTH CAROLI
INTERSTATE 20 AT ALPINE ROAD
COLUMBIA, South Carolina 29214
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Suzanne Horne
4800 Deerwood Campus Parkway
DC1-7
Jacksonville, FL 32246
Title: President
Phone # (904) 905-8720

Treasurer:

Craig Provenzano
4800 Deerwood Campus Parkway
DC1-5
Jacksonville, Florida 32246
Title: Treasurer
Phone # (904) 905-0440

Designated Agent(s):

Banks or Depositories

Bank of America
P.O. Box 25118
Tampa, Florida 336225118

Signed: Craig Provenzano
Date Signed: 05/10/2024

FORM TEXT-1

(End FEC FORM 1)

Generated Tue Nov 5 12:53:43 2024