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

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-871109

1. Coventry Health Care Inc - First Health Group PAC

6720-B Rockledge Dr., Suite 800
Bethesda, MD 20817
Email: mdeyles@cvty.com

2. Date: 05/07/2013

3. FEC Committee ID #: C00217216 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Coventry Health Care Inc.
6720-B Rockledge Dr., Suite 800
Bethesda, Maryland 20817
Affiliated Relationship Code: Connected Organization

First Health
3200 Highland Avenue
Downers Grove, Illinois 60515
Affiliated Relationship Code: Connected Organization

Aetna Inc. Political Action Committee
151 Farmington Ave.
Hartford, Connecticut 06156
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Matthew D Eyles
6720-B Rockledge Dr., Suite 800
Bethesda, MD 20817
Title: Custodian
Phone # (301) 581-5690

Treasurer:

John Ruhlmann
6720-B Rockledge Dr., Suite 800
Bethesda, Maryland 20817
Title: Treasurer
Phone # (301) 581-5867

Designated Agent(s):

Banks or Depositories

J.P. Morgan Chase Bank
300 S. Riverside Plza MC IL 1-
Chicago, Illinois 60670

Signed: John Ruhlmann
Date Signed: 05/16/2013

FORM TEXT

(End FEC FORM 1)

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