Common Contracts

3 similar Medicare Supplement Plan K contracts

Evidence of Coverage and Health Service Agreement
Medicare Supplement Plan K • 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 K • January 4th, 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 identi- fication card.

Evidence of Coverage and Health Service Agreement
Medicare Supplement Plan K • February 27th, 2014

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.