Common Contracts

7 similar Medicare Supplement Plan contracts

EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • October 5th, 2022

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians’ 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 identification card.

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EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • January 14th, 2016 • California

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Phy- sicians’ Service dba Blue Shield of California ("Blue Shield"), a health care service plan, to the Sub- scriber whose name, group number, Subscriber identification number and Effective Date shall appear on his or her identification card.

EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • December 1st, 2014

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians’ 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 identification card.

MEDICARE SUPPLEMENT PLAN
Medicare Supplement Plan • December 1st, 2014

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians’ 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 identification card.

EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • December 1st, 2014

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians’ 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 identification card.

EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • December 1st, 2014

This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians’ 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 identification card.

EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENT
Medicare Supplement Plan • December 1st, 2014

This Evidence of Coverage and Health Service Agreement (‘Agreement”) is issued by California Physi- cians’ 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 Identi- fication Card.

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