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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-899428

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1. Blue Cross Blue Shield of Alabama PAC

    2 North Jackson Street
    Suite 202
    Montgomery, AL 36104
    Email: slruhl@comerica.com

2. Date: 01/08/2014

3. FEC Committee ID #: C00457242 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Blue Cross Blue Shield of Alabama
2 North Jackson Street
Suite 202
Montgomery, Alabama 36104
Affiliated Relationship Code: Connected Organization

Florida Health Political Action Commit
PO Box 6936
Jacksonville, Florida 32202
Affiliated Relationship Code: Affiliated Committee

Hawaii Medical Service Assn Empl Comte
818 Keeaumoku
Honolulu, Hawaii 96814
Affiliated Relationship Code: Affiliated Committee

Regence BLUEPAC
330 9th Street SE
Washington, DC 20003
Affiliated Relationship Code: Affiliated Committee

Wellmark, Incorporated PAC, WELL PAC
636 Grand Avenue
Station 13
Des Moines, Iowa 50309
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of Kansas E
1133 Topeka Blvd
Topeka, Kansas 66629
Affiliated Relationship Code: Affiliated Committee

BLUEPAC, Capital Blue Cross
PO Box 60710 Elmerton Avenue
Harrisburg, Pennsylvania 17106
Affiliated Relationship Code: Affiliated Committee

Highmark Health PAC of Highmark Blue C
1800 Center Street
Camp HIll, Pennsylvania 17011
Affiliated Relationship Code: Affiliated Committee

BLUEPAC-Blue Cross Blue Shield Assn PA
1310 G Street NW
Washington, DC 20005
Affiliated Relationship Code: Affiliated Committee

Carefirst Associates Federal Political
10455 Mill Run Circle
Owens Mills, Maryland 21117
Affiliated Relationship Code: Affiliated Committee

Health Care Service Corporation Politi
330 East Randolph Street
Chicago, Illinois 60601
Affiliated Relationship Code: Affiliated Committee

Federal CAREPAC-The Blue Cross Blue Sh
401 Park Drive
Boston, Massachusetts 02115
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of MI PAC
602 West Ionia
Lansing, Michigan 48933
Affiliated Relationship Code: Affiliated Committee

Healthy Government Cmte, The Political
PO Box 13466
Phoenix, Arizona 85002
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of Kansas C
2301 Main
Kansas City, Missouri 64108
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of NE PAC
7261 Mercy Road
Omaha, Nebraska 68180
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of NC Emplo
5901 Chapel Hill Road
Box 2291
Durham, North Carolina 27702
Affiliated Relationship Code: Affiliated Committee

Blue Shield of California PAC
50 Beale Street
San Francisco, California 94105
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of AL PAC
2 North Jackson Street Suite 2
Montgomery, Alabama 36104
Affiliated Relationship Code: Affiliated Committee

Blue Cross Voice(Blue Cross of NE Penn
19 North Main Street
Wilkes Barre, Pennsylvania 18711
Affiliated Relationship Code: Affiliated Committee

IBC PAC Independence Blue Cross PAC
1901 Market Street
Philidelphia, Pennsylvania 19103
Affiliated Relationship Code: Affiliated Committee

Blue Cross and Blue Shield of SC Feder
Interstate 20 at Alpine Road
Columbia, South Carolina 29219
Affiliated Relationship Code: Affiliated Committee

Premera Blue Cross PAC
7001 220th Street SW
Mountlake Terrace, Washington 98043
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Comerica Bank PAC Services
MC #2250
PO Box 75000
Detroit, MI 482752250
Title: Book Keeper
Phone # (248) 371-7271

Treasurer:

Robin Stone
2 North Jackson Street
Suite 202
Montgomery, Alabama 36104
Title: Treasurer
Phone # (334) 262-4657

Designated Agent(s):

Banks or Depositories

Comerica Bank
PO Box 75000
PAC Services MC 2250
Detroit, Michigan 48275

Signed: Robin Stone
Date Signed: 01/08/2014

FORM TEXT

(End FEC FORM 1)

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