FEC Form 1 for Medicaid Health Plans of America Political Action CommitteeForm 1 for Medicaid Health Plans of America Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-725796

1. Medicaid Health Plans of America Political Action Committee

1150 18th Street NW, Suite 1010
Washington, DC 20036

NOTE: Address is different than previously reported

Email: jmoser@mhpa.org

2. Date: 04/20/2011

3. FEC Committee ID #: C00475426 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Medicaid Health Plans of America
1150 18th Street NW, Suite 1010
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Joseph William Moser
1150 18th Street NW, Suite 1010
Washington, DC 20036
Title: Director of Federal
Phone # (202) 857-5724

Treasurer:

Thomas Lee Johnson
1150 18th Street, NW Suite 1010
Washington, DC 20036
Title: President & CEO
Phone # (202) 857-5725

Designated Agent(s):

Kearline Jones
901 Market Street, Suite 500
Philadelphia, Pennsylvania 19107
Title: VP of Government Rel
Phone # (215) 849-9606

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-725796

1. Medicaid Health Plans of America Political Action Committee

NOTE: Address is different than previously reported

2. Date: 04/20/2011

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Thomas Lee Johnson
Date Signed: 04/20/2011

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-725796

1. Medicaid Health Plans of America Political Action Committee

NOTE: Address is different than previously reported

2. Date: 04/20/2011

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Thomas Lee Johnson Date Signed: 04/20/2011

(End FEC FORM 1)

Signed: Thomas Lee Johnson
Date Signed: 04/20/2011