Other Payor Summary List Other Payor Type of Plan Blue Cross Blue Shield Plans Individual and Group Health Plans Other Arrangements Arrangements pursuant to which Blue Shield subsidiaries, e.g., Blue Shield of Life & Health Insurance Company, may utilize the Blue Shield Life Network. Blue Shield of California Life & Health Insurance Individual Health Plans (Blue Shield Life Network) Company Risk Management Accounts (RMCs) Group health plans - Blue Shield of California provides one or more of the following services for a fixed administrative fee: administrative services (such as eligibility and claims processing), benefit determinations, generation of identification (ID) cards, check issuance, and reconciliation.

The group is at risk for the cost of health care.

Only large groups are eligible.

This list is updated periodically. Please contact Blue Shield of California directly if an updated list is needed.

A - MCSIG/San Mateo MCSIG/Santa Rita - Z 24 Hour Fitness USA, Inc. MCSIG / Santa Rita Union School District ACCO Management Company MCSIG / Soledad Comm Health Care District Activision Publishing, Inc. MCSIG / South Monterey County Join Union HSD Adept Fasteners Inc Mitchell International Inc AHMC Healthcare, Inc Monterey Peninsula Surgery Center LLC AirConditioning and Refrigeration Industry Joint National University Trust Funds Alhambra Unified School District Nikon Precision, Inc. Allen Lund Company, Inc North American Video Corporation Alliance HealthCare Services North Coast Schools Medical Insurance Group Amarillo College of Hairdressing dba Milan Institute Northern CA Sheet Metal Workers Local 162

Amerit Fleet Solutions Northern California Tile Industry Health Trust ARM, INC. (ARM, Physical IP, Inc.) Onni Group./Onni Properties Big Creek Lumber Orchard Machinery Corporation Box, Inc. organicgirl LLC Brighton Collectibles,LLC. Pacific Southwest Container, LLC Burrtec Waste Industries Inc Palantir Technologies Business Administration Support Services Paskenta Band of Nomlaki Indians Buttonwillow Warehouse Co Inc. Pechanga Band Of Luiseno Mission Indians C&D Technologies Petco Animal Supplies Inc California Olive Ranch, Inc. Pinterest Inc California's Valued Trust Pioneers Memorial Healthcare District Carlsbad Unified School District Pomona Valley Hospital Medical Center

Updated June 2021 A - MCSIG/San Mateo MCSIG/Santa Rita - Z Citrus Valley Health Partners, Inc. (Emanate Health) Powerschool Group LLC

City of Hanford Premium Packing, Inc City of Tulare Prime HealthCare Services Clovis Unified School District Printing Specialties & Paper Products Joint Benefits H&W Trust CMG Mortgage, Inc. DBA CMG Financial Professional Auto Transport, Inc. Cottage Health Pure Storage, Inc. County of Kings Radnet, Inc. County of Orange Raley's County of San Mateo Riverside Community College District Credit Karma Rolling Hills Casino CrossFit, Inc Sabor Farms LLC CSAC Excess Insurance Authority Saddleback Valley USD CSEBA/Alta Loma School District Sakura Fineteck USA Inc CSEBA/Bear Valley Unified School District Electrical Workers Health & Welfare CSEBA/Beaumont Unified School District San Francisco Symphony, Inc.

CSEBA/Brea Olinda Unified School District Saticoy Lemon CSEBA/Central School District Save Mart Supermarkets CSEBA/Centralia School District Saxco International LLC CSEBA/Chaffey Community College District Schools Apparel, Inc. CSEBA/Chartersafe - Clear Passage Education Self-Insured Schools of California CSEBA/Chartersafe - New Opportunities Sensient Technologies Corporation Organization CSEBA/Chartersafe - Paramount Collegiate Servicon Systems. Inc. CSEBA/Chartersafe - Pathways Sheet Metal Workers Intl Assoc Local Union 104 CSEBA/Chartersafe - River Springs Charter School Sheppard, Mullin Richter & Hampton LLP CSEBA/Chartersafe - Ross Valley Charter School Sierra Forest Products, Inc. CSEBA/Chartersafe - Sierra Sign Pictorial and Display Industry CSEBA/Chino Valley SISC/Alexander Valley CSEBA/Colton Jt. Unified School District SISC/Alpaugh USD CSEBA/Covina Valley Unified School District SISC/Alvord USD CSEBA/Cucamonga School District SISC/Antelope Valley CCD CSEBA/East San Gabriel Valley ROP SISC/Arcadia USD CSEBA/East Whittier City School District SISC/ASCIP La Canada USD CSEBA/Encinitas Union School District SISC/Azusa Unified School District CSEBA/ SISC/Bennett Valley Union Elementary CSEBA/Hemet Unified School District SISC/Cabrillo College CSEBA/Hesperia Unified School District - Classified SISC/Calistoga Joint Unified School District

CSEBA/Mountain View School District SISC/Ceiba Public Schools CSEBA/North Orange County ROP SISC/Central Region School CSEBA/Ontario-Montclair School District SISC/Ceres Unified School District CSEBA/Ramona Unified School District SISC/Chawanakee USD CSEBA/Rim of the World Unified School District SISC/Chowchilla Elementary CSEBA/San Bernardino Community College District SISC/Cinnabar Elementary

Updated June 2021 A - MCSIG/San Mateo MCSIG/Santa Rita - Z CSEBA/San Bernardino CSS SISC/Cloverdale Unified CSEBA/San Marino Unified School District SISC/College of the Desert CSEBA/Santee School District SISC/Dunham School District CSEBA/Savanna School District SISC/El Centro Elementary School District CSEBA/Summit Leadership Academy High Desert SISC/Empire Union Elementary CSEBA/ SISC/Evergreen School District CSEBA/Yucaipa Calimesa Joint USD (Classified) SISC/Firebaugh-Las Deltas Joint Unified School District

Delano Union School District SISC/Fort Ross Elementary Dexcom Inc. SISC/Fullerton Elementary School District Downey Unified School District SISC/Geyserville Unified EDCO Disposal Corp Inc SISC/Gratton Elementary Educational Media Foundation SISC/Gravenstein Union Elem EIA/Amador County SISC/Guerneville SD EIA/City of Huntington Beach SISC/Harmony Union Elementary EIA/City of Irvine SISC/Hart Ransom Union Elementary EIA/City of Redding SISC/Hickman Community Charter School District EIA/City of Walnut Creek SISC/Holtville Unified EIA/City of Yuba City SISC/Kashia Elementary EIA/Community Development Commission of Los SISC/Kentfield School District Angeles EIA/County of Imperial SISC/Kenwood Elementary EIA/County of Santa Barbara SISC/Keyes Union School District EIA/El Dorado County SISC/Liberty Elementary EIA/Mendocino Coast District Hospital SISC/Los Banos USD EIA/Santa Barbara Superior Courts SISC/Madera County Office of Education EIA/Small Group Program SISC/Marin Community College District EIA/South Coast Air Quality Management District SISC/Mark West Union Enloe Medical Center SISC/Mendocino USD Enphase Energy Inc SISC/Monte Rio Union Elem Ensign Services, Inc. SISC/Montgomery Elem EPIC (Edgewood Partners Insurance Center) SISC/Oak Grove Union Elem Excess Insurance Authority (EIA) SISC/Old Adobe Union Elem Farwest Corrosion Control SISC/Pajaro Valley Unified School District Fire Districts Association of California SISC/Palmdale Aerospace Academy Foster Farms SISC/Palmdale School District Fresno City Employees Health & Welfare Trust SISC/Pasadena Unified School District Fresno Truck Center SISC/Petaluma School District Gar Tootelian, Inc SISC/Piner-Olivet Union Elem Glidewell Laboratories SISC/Plumas Unified School District Bridge Highway & Transport Dist. SISC/Redwood Empire School Ins Grp Golden Valley Health Centers SISC/Rincon Valley Union Elem Grimmway Enterprise SISC/Rio School District Haight, Brown and Bonesteel, LLP SISC/Roberts Ferry Union Elementary Hanford Joint Union High School District SISC/Roseland Elem Hankey Investment Co. SISC/Salida Union Elementary Hunt & Sons, Inc. SISC/Santa Cruz City Schools Hutchison & Bloodgood SISC/Santa Maria Joint Union High School District

Updated June 2021 A - MCSIG/San Mateo MCSIG/Santa Rita - Z Illumina, Inc SISC/Santa Rosa Junior College ILWU-PMA Welfare Plan SISC/Sebastopol Ind Charter Indian Health Council, Inc. SISC/Shiloh Elementary Interface Rehab, Inc. SISC/Shoreline Unified Iron Mechanical, Inc. SISC/Sierra Joint Community College District Irvine Unified School District SISC/Sierra Unified Irwin International, Inc. SISC/Sonoma County Office of Ed Jazz Pharmaceuticals, Inc SISC/South Orange County CCD JBR Inc. DBA Gourmet Coffee SISC/Stanislaus Union Elementary Johasee Rebar, LP dba LMS Reinforcing Steel SISC/Tamalpais Union HSD Group Juniper Networks, Inc SISC/Tree of Life Charter La Tapatia Tortilleria, Inc. SISC/Twin Hills Union SD Linear Technology Corporation SISC/Two Rock Union Elementary Lyons Magnus, LLC SISC/Waugh Elem Madsen,Kneppers and Associates SISC/West Hills CCD Manco Abbott, Inc. SISC/West Side Union School District Marin Healthcare District SISC/West Sonoma County HSD MCSIG / Alum Rock Union Elementary School SISC/Westminster School District District MCSIG / Bayshore Elementary School District SISC/Westside Union Elem MCSIG / Belmont-Redwood Shores School District SISC/Wilmar Union Elem

MCSIG / Big Sur Charter School SISC/Yosemite Community College District MCSIG / Big Sur Unified School District SISC/Yosemite USD MCSIG / Bradley Union School District SoCal Pipe Trades MCSIG / Cabrillo Unified School District Southern California Edison Company (Edison International) MCSIG / Carmel Unified School District Southwest Traders MCSIG / Castro Valley Unified School District SpaceX (Space Exploration Technologies) MCSIG / City of Seaside Stanford University MCSIG / El Dorado County Office of Education Steadfast Management Company, Inc (STAR REIT Services LLC) MCSIG / Gonzales Unified School District Sukut Construction Inc MCSIG / Graves School District Sutter Homes (Trinchero Family Estates) MCSIG / Hartnell College The Heffernan Group MCSIG / International School of Monterey The Hignell Companies MCSIG / Jefferson Elementary School District The Lagunitas Brewing Company MCSIG / Jefferson Union High School District The Sun Valley Group MCSIG / King City Union School District The Wonderful Company MCSIG / La Honda-Pescadero Unified School Tom's Truck Center District MCSIG / Lagunitas School District Topcon Positioning Systems Inc. dba Topcon America Corp MCSIG / Learning 4 Life Charter School District Tri Cal MCSIG / MCSIG Cobra Tutor Perini Corporation MCSIG / Mission Union School District UA 447 Local Pipe Trades & Welfare Trust Fund MCSIG / Monterey Bay Charter School District Uber Technologies Inc.

Updated June 2021 A - MCSIG/San Mateo MCSIG/Santa Rita - Z MCSIG / Monterey COE / Headstart UFCW & Employers Benefit Trust MCSIG / Monterey County Office of Education UFCW Comprehensive Benefit Trust MCSIG / Monterey Educational Risk Mgmt UFCW Northern California and Drug Employers Health MCSIG / Monterey Peninsula Unified School District United Agricultrual Benefit Trust MCSIG / Municipalities Colleges Schools Insurance Valley Children's Hospital Group MCSIG / Oak Grove School District Valley Pacific Petroleum Services MCSIG / Ohlone College Victor Community Support Services Inc MCSIG / Pacific Grove Unified School District Washington Hospital MCSIG / Portola Valley School District Wellfleet Insurance Company (UC Berkeley Student Health Insurance Plan) MCSIG / Salinas City Elementary School District Western Dental Services Inc MCSIG / Salinas Union High School District Whittier Union High School District MCSIG / San Antonio Union School District Yelp MCSIG / San Lucas Union School District Yocha Dehe Wintun Nation (Cache Creek Casino) MCSIG / San Luis Obispo Community College ZenDesk Inc. District MCSIG / San Mateo County Schools Insurance Group

Updated June 2021