Evidence of Coverage and Health Service AgreementCoverage and Health Service Agreement • October 19th, 2023
This 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 identification card.
Evidence of Coverage and Health Service AgreementCoverage and Health Service Agreement • August 30th, 2022
This 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 identification card.
Evidence of Coverage and Health Service AgreementCoverage and Health Service Agreement • August 30th, 2022
This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians' Service d/b/a Blue Shield of California ("Blue Shield"), a not for profit health care service Plan, to the Subscriber whose identification cards are issued with this Agreement. In consideration of statements made in the application and timely payment of Dues, Blue Shield of California agrees to provide the benefits of this Agreement.
Evidence of Coverage and Health Service AgreementCoverage and Health Service Agreement • September 20th, 2021
This Evidence of Coverage and Health Service Agreement (“Agreement”) is issued by California Physi- cians' Service d/b/a Blue Shield of California ("Blue Shield"), a not for profit health care service Plan, to the Subscriber whose identification cards are issued with this Agreement. In consideration of statements made in the application and timely payment of Dues, Blue Shield of California agrees to provide the benefits of this Agreement.
NOTICE TO BUYER OR NEW SUBSCRIBERCoverage and Health Service Agreement • December 1st, 2014
Please read this Agreement carefully. If you have any questions, contact the Blue Shield of California office nearest you. If you are not satisfied with the Service Agreement, you may surrender it by delivering or mailing it with the Identification (ID) Cards, within 30 days from the date it is received by you, to BLUE SHIELD OF CALIFORNIA, 50 BEALE STREET, SAN FRANCISCO, CALIFORNIA94105, or 100 N. SEPULVEDA BLVD., EL SEGUNDO, CALIFORNIA 90245, OR TO
EVIDENCE OF COVERAGE AND HEALTH SERVICE AGREEMENTCoverage and Health Service Agreement • October 4th, 2010
This AGREEMENT is issued by California Physicians' Service d/b/a Blue Shield of California ("Blue Shield"), a not for profit health care service Plan, to the Subscriber whose identification cards are issued with this Agreement. In consideration of state- ments made in the application and timely payment of Dues, Blue Shield of California agrees to provide the benefits of this Agree- ment.
Evidence of Coverage and Health Service AgreementCoverage and Health Service Agreement • October 19th, 2023
This 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 identification card.
