FEC Form 1 for BLUEPAC - Blue Cross Blue Shield Association PACForm 1 for BLUEPAC - Blue Cross Blue Shield Association PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-426625

1. BLUEPAC - Blue Cross Blue Shield Association PAC

1310 G Street NW
Washington, DC 20005
Email: alcox@comerica.com

2. Date: 07/23/2009

3. FEC Committee ID #: C00194746 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

Blue Cross Blue Shield Association
1310 G Street NW
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Florida Health Political Actio
532 Riverside Avenue
Jacksonville, Florida 92202
Affiliated Relationship Code: Affiliated Committee

Healthy Government Committee
PO Box 13466
Phoenix, Arizona 85002
Affiliated Relationship Code: Affiliated Committee

Hawaii Medical Service Associa
818 Keeaumoku
Honolulu, Hawaii 96814
Affiliated Relationship Code: Affiliated Committee

Regence BLUEPAC
2890 East Cottonwood Parkway
Dept #8
Salt Lake City, Utah 84121
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
233 North Michigan Avenue
Chicago, Illinois 60690
Affiliated Relationship Code: Affiliated Committee

Wellmark, Incorporated PAC, WE
636 Grand Avenue
Station 13
Des Moines, Iowa 50309
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
1133 Topeka Blvd
Topeka, Kansas 66629
Affiliated Relationship Code: Affiliated Committee

BLUEPAC, Capital, Independenc
2500 Elmerton Avenue
Harrisburg, Pennsylvania 17177
Affiliated Relationship Code: Affiliated Committee

Highmark Health PAC of
1800 Center Street
Camp Hill, Pennsylvania 17011
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
901 South Central Expressway
Richardson, Texas 75080
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
10455 Mill Run Circle
Owens Mills, Maryland 21117
Affiliated Relationship Code: Affiliated Committee

Federal CAREPAC-The BCBS of Ma
100 Summer Street
Boston, Massachusetts 02110
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
600 Lafayette East
Detroit, Michigan 48226
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
2301 Main
Kansas City, Missouri 64108
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
7261 Mercy Road
Omaha, Nebraska 68180
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of
5901 Chapel Hill Road
Box 2291
Durham, North Carolina 27702
Affiliated Relationship Code: Affiliated Committee

Blue Shield of California
50 Beale Street
San Fransisco, California 94105
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

COMERICA BANK
PAC SERVICES MC#2250
P.O. BOX 75000
DETROIT, MI 482752250
Title: RECORD KEEPER
Phone # (248) 371-7271

Treasurer:

Kathy Didawick
1310 G Street NW
Washington, DC 20005
Title: TREASURER
Phone # (202) 626-4804

Designated Agent(s):

Bill Breskin
1310 G Street NW
Washington, DC 20005
Title: Asst. Treas.
Phone # (202) 626-4795

Banks or Depositories

Comerica Bank
P.O. Box 75000
PAC Services MC 2250
Detroit, Michigan 482752250

Signed: Kathy Didawick
Date Signed: 07/23/2009

(End FEC FORM 1)

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