Evidence of Coverage and Health Service AgreementMedicare Supplement Plan G • December 13th, 2021
Contract Type FiledDecember 13th, 2021This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physicians’ Service dba Blue Shield of California (“Blue Shield”), a health care service plan, to the Subscriber whose name, group number, Subscriber identification number, and Effective Date shall appear on his or her identi- fication card.
EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENTMedicare Supplement Plan G • August 27th, 2020
Contract Type FiledAugust 27th, 2020This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physicians’ Service dba Blue Shield of California ("Blue Shield"), a health care service plan, to the Subscriber whose name, group number, Subscriber identification number, and Effective Date shall appear on his or her identi- fication card.