Evidence of Coverage and Health Service AgreementMedicare Supplement High Deductible Plan F • 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.