Common Contracts

4 similar Medicare Supplement Plan C contracts

Evidence of Coverage and Health Service Agreement
Medicare Supplement Plan C • 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 AGREEMENT
Medicare Supplement Plan C • December 13th, 2021

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 C • December 3rd, 2019

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 C • January 15th, 2016

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.