FEC Form 1 for HIGHMARK HEALTH PAC OF HIGHMARK INC.Form 1 for HIGHMARK HEALTH PAC OF HIGHMARK INC.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-726642

1. HIGHMARK HEALTH PAC OF HIGHMARK INC.

1800 Center Street
Camp Hill, PA 17089
Email: betsy.taylor@highmark.com

NOTE: Email address is different than previously reported

2. Date: 04/27/2011

3. FEC Committee ID #: C00302844 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Highmark Inc.
1800 Center Street
Camp Hill, Pennsylvania 17089
Affiliated Relationship Code: Connected Organization

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

Custodian of Records:

Betsy H Taylor
1800 Center Street
Camp Hill, PA 17011
Title: Govt Affairs Atty
Phone # (717) 302-3984

Treasurer:

Kenneth B Gebhard
1800 Center Street
Camp Hill, Pennsylvania 17089
Title: VP Cost Mgmt&Ana
Phone # (717) 302-2544

Designated Agent(s):

Kelly S Lieblein
1800 Center Street
Camp Hill, Pennsylvania 17011
Title: VP Sales&Client Mgmt
Phone # (717) 302-2013

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-726642

1. HIGHMARK HEALTH PAC OF HIGHMARK INC.

NOTE: Email address is different than previously reported

2. Date: 04/27/2011

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Kenneth B Gebhard
Date Signed: 04/27/2011

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-726642

1. HIGHMARK HEALTH PAC OF HIGHMARK INC.

NOTE: Email address is different than previously reported

2. Date: 04/27/2011

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Kenneth B Gebhard Date Signed: 04/27/2011

(End FEC FORM 1)

Signed: Kenneth B Gebhard
Date Signed: 04/27/2011