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Amended Form A Filing
State of Alaska > Commerce > Division of Insurance > Alaska Premera Proposed Conversion    > Amended Form A Filing
 


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Change Number 1 to Form A

Form A Statement Form A - Statement Regarding the Acquisition of Control of a Domestic Health Carrier and a Domestic Insurer
Form A Statement Form A - Statement Regarding the Acquisition of Control of a Domestic Health Carrier and a Domestic Insurer (Black Lined)
Exhibit A-1 No Change to Documents Filed on September 17, 2002
Exhibit A-2a Articles of Amendment of the Articles of Incorporation of Premera
Exhibit A-2b Articles of Amendment of the Articles of Incorporation of Premera (Black Lined)
Exhibit A-3a Premera Conversion Transaction
Exhibit A-3b Premera Conversion Transaction
Exhibit A-4a Plan of Conversion of Premera
Exhibit A-4b

Plan of Conversion of Premera (Black Lined)

Exhibit A-5a Disclaimer of Control
Exhibit A-5b Disclaimer of Control (Black Lined)
Exhibit A-6 No Change to Documents Filed on October 25, 2002
Annex 1 No Change to Documents Filed on September 17, 2002
Exhibit B-1a Articles of Incorporation of [New Premera Corp.]
Exhibit B-1b Articles of Incorporation of [New Premera Corp.] (Black Lined)
Exhibit B-2a Bylaws of [New Premera Corp.]
Exhibit B-2b

Bylaws of [New Premera Corp.] (Black Lined)

Exhibit B-3a Organizational Chart Post Conversion Transaction
Exhibit B-3b Organizational Chart Post Conversion Transaction
Exhibit C-1 Biographical Affidavit
Exhibit E-1a Articles of Incorporation of [Washington Foundation Shareholder]
Exhibit E-1b Articles of Incorporation of [Washington Foundation Shareholder] (Black Lined)
Exhibit E-2a Bylaws of [Washington Foundation Shareholder] (the "Corporation")
Exhibit E-2b Bylaws of [Washington Foundation Shareholder] (the "Corporation") (Black Lined)
Exhibit E-3a The Form of Articles of Incorporation of the Washington Charitable Organization has been Eliminated from the Form A Statement
Exhibit E-3b

Articles of Incorporation of [Alaska Health Foundation]

Exhibit E-3c Articles of Incorporation of [Alaska Health Foundation] (Black Lined)
Exhibit E-4a The Form of Bylaws of the Washington Charitable Organization has been Eliminated From the Form A Statement
Exhibit E-4b Bylaws of [Alaska Health Foundation] (the "Corporation")
Exhibit E-4c Bylaws of [Alaska Health Foundation] (the "Corporation") (Black Lined)
Exhibit E-5 This Document has been Eliminated From the Form A Statement
Exhibit E-6 This Document has been Eliminated From the Form A Statement
Exhibit E-7 No Change to Document Filed on September 17, 2002 and supplemented on October 25, 2002
Exhibit E-8a The Description of Destacking Transaction has been Eliminated From the Form A Statement
Exhibit E-8b Washington Economic Impact Assurances
Exhibit G-1a Description of the Amount of voting Securities of the Acquired Companies Which the Applicant and its Affiliates Beneficially Own
Exhibit G-1b Description of the Amount of voting Securities of the Acquired Companies Which the Applicant and its Affiliates Beneficially Own (Black Lined)
Exhibit G-2 No Change to Documents Filed on September 27, 2002
Exhibit G-3a Form of Transfer, Grant and Loan Agreement by and among Premera
Exhibit G-3b Form of Transfer, Grant and Loan Agreement by and among Premera (Black Lined)
Exhibit G-4a Form of Voting Trust and Divestiture Agreement by and among [New Premera Corp.] - Washington
Exhibit G-4b Form of Voting Trust and Divestiture Agreement by and among [New Premera Corp.] Washington (Black Lined)
Exhibit G-4c Form of Voting Trust and Divestiture Agreement by and among [New Premera Corp.] - Alaska
Exhibit G-4d Form of Voting Trust and Divestiture Agreement by and among [New Premera Corp.] Alaska (Black Lined)
Exhibit G-5a Form of Registration Rights Agreement by and among [New Premera]
Exhibit G-5b Form of Registration Rights Agreement by and among [New Premera] (Black Lined)
Exhibit G-6 This Document has been Eliminated From the Form A Statement
Exhibit G-7 No Change to Document Filed on September 17, 2002 and supplemented on October 25, 2002
Exhibit G-8a The Form of Indemnification Agreement has Been Eliminated From the Form A Statement
Exhibit G-8b Guaranty Agreement - Washington
Exhibit G-8c Guaranty Agreement - Alaska
Exhibit G-9a Form D Prior Notice of a Transaction
Exhibit G-9b Form D Prior Notice of a Transaction (Black Lined)
Exhibit G-10a Exhibit G-10 (February, 2004) Description of Stock Ownership Plans
Exhibit G-10b Exhibit G-10 (February, 2004) Description of Stock Ownership Plans (Black Lined)
Exhibit G-11a Premera Blue Cross/Premera of Alaska Transfer of Assets Agreement
Exhibit G-11b Premera Blue Cross/Premera of Alaska Transfer of Assets Agreement (Black Lined)
Exhibit G-12a Premera Blue Cross/New Premera Blue Cross Transfer of Assets Agreement
Exhibit G-12b Premera Blue Cross/New Premera Blue Cross Transfer of Assets Agreement (Black Lined)
Exhibit G-13a Premera/New Premera Transfer of Assets Agreement
Exhibit G-13b Premera/New Premera Transfer of Assets Agreement (Black Lined)
Exhibit G-14a Plans of Reorganization of Premera Blue Cross
Exhibit G-14b Plans of Reorganization of Premera Blue Cross (Black Lined)
Exhibit G-15a Plan of Distribution of Premera Blue Cross
Exhibit G-15b Plan of Distribution of Premera Blue Cross (Black Lined)
Exhibit G-16a Articles of Incorporation of [New Premera Blue Cross Corp.]
Exhibit G-16b Articles of Incorporation of [New Premera Blue Cross Corp.] (Black Lined)
Exhibit G-17a Bylaws of [New Premera Blue Cross Corp.]
Exhibit G-17b Bylaws of [New Premera Blue Cross Corp.] (Black Lined)
Exhibit G-18a Plan of Reorganization of Premera
Exhibit G-18b Plan of Reorganization of Premera (Black Lined)
Exhibit G-19a Plan Distribution of Premera
Exhibit G-19b Plan Distribution of Premera (Black Lined)
Exhibit G-20a Blue Cross License Agreement
Exhibit G-20b Blue Shield License Agreement
Exhibit G-20c Blue Cross Controlled Affiliate License Agreement
Exhibit G-20d Blue Shield Controlled Affiliate License Agreement
Exhibit G-21a License Agreement
Exhibit G-21b License Agreement (Black Lined)
Exhibit G-22 Form of Unallocated Shares Escrow Agent Agreement
Exhibit H-1 Consolidated Financial Statements- Premera
Exhibit H-2a Management Agreement
Exhibit H-2b

Management Agreement (Black Lined)

 

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