FEC Form 1 for HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)Form 1 for HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-458042

1. HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)

55 WATER STREET
NEW YORK, NY 10041
Email: hipfedpac@hipusa.com

2. Date: 04/01/2010

3. FEC Committee ID #: C00412247 This committee is a separate segregated fund. Its connected organization is a
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Committee ID# C00412247
HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)
55 WATER STREET
NEW YORK, New York 10041
Affiliated Relationship Code: Connected Organization

Custodian of Records:

David Abernethy
55 Water St.
4th Floor
New York, NY 10041
Title: Senior VP

Treasurer:

Arthur J. Byrd
55 Water St.
13th Floor
New York, New York 10041
Title: Vice President
Phone # (646) 447-6263

Designated Agent(s):

Jay A. Schoenfeld
55 Water St.
New York, New York 10041
Title: Assistant Treasurer
Phone # (646) 447-5950

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-458042

1. HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)

2. Date: 04/01/2010

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Jay A. Schoenfeld
Date Signed: 04/01/2010

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-458042

1. HEALTH INSURANCE PLAN OF GREATER NEW YORK FEDERAL PAC (HIPHEALTH PLAN FEDERAL PAC)

2. Date: 04/01/2010

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Jay A. Schoenfeld Date Signed: 04/01/2010

(End FEC FORM 1)

Signed: Jay A. Schoenfeld
Date Signed: 04/01/2010