FEC Form 1 for The Regence Group BluePACForm 1 for The Regence Group BluePAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-281355

1. The Regence Group BluePAC

700 12th Street NW
Suite 700
Washington, DC 20005
Fax: 202-904-2361
Email: jadaugh@regence.com

2. Date: 03/19/2007

3. FEC Committee ID #: C00252684 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

The Regence Group
200 SW Market Street
PO Box 1271 M/S E12A
Portland, Oregon 972071271
Relationship: Connected Organization
Organization Type: Corporation W/O Capital Stock

Committee ID# C00194746
BluePAC-The Blue Cross and Blue Shield
1310 G Street NW
Washington, DC 20005
Relationship: Affiliated Cmte.

Committee ID# C00215202
Healthy Govt. Cmte.-The PAC of Blue Cr
PO Box 13466
Phoenix, Arizona 85002
Relationship: Affiliated Cmte.

Committee ID# C00340364
Blue Shield of California
50 Beale Street
San Francisco, California 94105
Relationship: Affiliated Cmte.

Committee ID# C00161141
Florida Health Political Action Commit
532 Riverside Avenue
Jacksonville, Florida 92202
Relationship: Affiliated Cmte.

Committee ID# C00321992
Hawaii Medical Svce. Assn. Employees'
818 Keeaumoku St.
Honolulu, Hawaii 96814
Relationship: Affiliated Cmte.

Committee ID# C00199711
Blue Cross and Blue Shield of Illinois
300 E. Randolph St.
Suite 1500
Chicago, Illinois 60601
Relationship: Affiliated Cmte.

Committee ID# C00342022
Wellmark Inc. PAC - Well PAC
636 Grand Avenue
Station 13
Des Moines, Iowa 50309
Relationship: Affiliated Cmte.

Committee ID# C00197202
Blue Cross and Blue Shield of Kansas E
1133 Topeka Blvd.
Topeka, Kansas 666290001
Relationship: Affiliated Cmte.

Committee ID# C00286922
CareFirst Associates Federal PAC
10455 Mill Run Circle
Owings Mills, Maryland 21117
Relationship: Affiliated Cmte.

Committee ID# C00199166
Federal CarePAC-The Blue Cross and Blu
401 Park Drive
Boston, Massachusetts 02215
Relationship: Affiliated Cmte.

Committee ID# C00084061
Blue Cross and Blue Shield of Michigan
602 West Ionia
Lansing, Michigan 48933
Relationship: Affiliated Cmte.

Committee ID# C00301358
Blue Cross and Blue Shield of Kansas C
2301 Main
Kansas City, Missouri 641082488
Relationship: Affiliated Cmte.

Committee ID# C00276311
Blue Cross and Blue Shield of Nebraska
7261 Mercy Road
Omaha, Nebraska 681800001
Relationship: Affiliated Cmte.

Committee ID# C00312223
Blue Cross and Blue Shield of North Ca
5901 Chapel Hill Road
Box 2291
Durham, North Carolina 27702
Relationship: Affiliated Cmte.

Committee ID# C00270967
BluePAC of Pennsylvania
P.O. Box 60710
Harrisburg, Pennsylvania 171060710
Relationship: Affiliated Cmte.

Committee ID# C00302844
Highmark Health PAC of Highmark Blue C
1800 Center Street
Camp Hill, Pennsylvania 17011
Relationship: Affiliated Cmte.

Committee ID# C00379537
Blue Cross Voice (Blue Cross of Northe
19 North Main Street
Wilkes Barre, Pennsylvania 18711
Relationship: Affiliated Cmte.

Committee ID# C00406850
Blue Cross and Blue Shield of South Ca
Interstate 20-Alpine Road
Columbia, South Carolina 29219
Relationship: Affiliated Cmte.

Committee ID# C00409227
Premera Blue Cross Political Action Co
7001 220th Street SW
MS355
Mountlake Terrace, Washington 98043
Relationship: Affiliated Cmte.

Custodian of Records:

Michael S Becker
200 SW Market Street
PO Box 1271 M/S E12A
Portland, OR 972071271
Title: Assistant Treasurer
Phone # (503) 226-8766

Treasurer:

Jason A Daughn
700 12th Street NW
Suite 700
Washington, DC 20005
Title: Treasurer
Phone # (202) 904-2360

Designated Agent(s):

Kerry Barnett
200 SW Market Street
PO Box 1271 M/S E15A
Portland, Oregon 972071271
Title: Assistant Treasurer
Phone # (503) 276-1814

Banks or Depositories

Wells Fargo Bank NA
PO Box 63020
San Francisco, California 94163

Signed: Jason A Daughn
Date Signed: 03/19/2007
Official Committee FAX: 202-904-2361

(End FEC FORM 1)

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