FEC Form 1 for Coventry Health Care Inc.-First Health Group Corp. PACForm 1 for Coventry Health Care Inc.-First Health Group Corp. PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-266423

1. Coventry Health Care Inc.-First Health Group Corp. PAC

901 New York Avenue NW Third Floor
Washington, DC 20001

NOTE: Address is different than previously reported

Email: jruhlmann@cvty.com; mdschooley@cvty.com; hpwilliams@cvty.com

2. Date: 12/22/2006

3. FEC Committee ID #: C00217216 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

First Health
3200 Highland Avenue
Downers Grove, Illinois 60515
Relationship: Connected Organization
Organization Type: Corporation

Coventry Health Care Inc.
6705 Rockledge Dr.
Suite 900
Bethesda, Maryland 20817
Relationship: Connected Organization
Organization Type: Corporation

Custodian of Records:

Melissa Schooley
901 New York Avenue NW Third Floor
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 654-7411

Treasurer:

John Ruhlmann
6705 Rockledge Dr. Suite 900
Bethesda, Maryland 20817
Title: Treasurer
Phone # (301) 581-5867

Designated Agent(s):

Ken Robinson
6705 Rockledge Drive
Suite 900
Bethesda, Maryland 20817
Title: Asst. Treasurer
Phone # (301) 581-5655

Banks or Depositories

J.P. Morgan Chase Bank
300 South Riverside Plaza
Mailcode IL1-0196 Flr 18
Chicago, Illinois 60670

Signed: John Ruhlmann
Date Signed: 12/22/2006

FORM TEXT

(End FEC FORM 1)

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