f. Blue Cross Blue Shield proxy vote
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f. Blue Cross Blue Shield proxy vote
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<br />INSTRUCTIONS: <br /> <br />As a Voting Member, you can participate in the election process in one of five ways: <br /> <br />1. Attend the annual meeting in person on December 7, 2007. <br /> <br />2. Vote by mail using the ballot form below. If you complete the ballot form, please do not complete the proxy form. <br /> <br />3. Assign your proxy to the Proxy Committee using the proxy form on the reverse side of this form. By completing <br />the proxy form, you are authorizing the committee to cast your vote in a manner they would recommend. <br /> <br />4. Appoint another Voting Member of the corporation as your proxy, which requires a special proxy form. <br />Contact the Company at 1-800-342-4718 to request this form. Fargo residents should call 277-2227. <br /> <br />5. Vote online at www.BCBSND.com by midnight CST, December 3, 2007. Once you've arrived at the home page, <br />click on the online proxylballot section. This will bring you to a page requiring you to login with a User Key and <br />the first three (3) characters of your last name. The following is your User Key for this page. Please type it exactly <br />as it appears. <br /> <br />User Key: <br /> <br />7900349549 <br /> <br />After you login, you must choose whether you are submitting a ballot or a proxy. You cannot do both. Please <br />make sure that only the Voting Member completes this process. If you have questions regarding online voting, <br />please call the Company at 1-800-342-4718. <br /> <br />Proxy forms must be received by December 3, 2007, to be valid. Please complete and sign either the proxy or ballot <br />side of the form attached below. Forms received with both sides completed and signed are void, as we are unable to <br />determine which option you intended. <br /> <br />IMPORTANT NOTE: <br />Because the company offers several options for you to participate in this election - in person, by mail, <br />or online - it is important that you use only one of these methods to cast your vote. If you use <br />more than one method, your vote will be void. <br /> <br />SIGN ONLY ONE SIDE OF THIS CARD <br /> <br />Detach along perforation <br /> <br />Consumer Seat #1: Roger A. Kenner <br />Consumer Seat #2: Robert L. Lamp <br /> <br />D <br />D <br /> <br />Provider Seat #1: Gary P. Miller <br />Provider Seat #2: Robert E. Grossman, M.D. <br /> <br />D <br />D <br /> <br /> <br />Form MUST be received by December 3, 2007 <br /> <br />To cast your vote for the following candidates, please mark the box next to the name. <br />This year's incumbent candidates run unopposed. You may vote for all four. <br /> <br />Election of Directors: <br />INCUMBENT CANDIDATES: <br /> <br />User Key 7900349549 <br /> <br />ATTN: MIKE MONTPLAISIR <br />CASS COUNTY PERSONNEL <br />211 9TH ST S <br />FARGO ND 58103-1833 <br /> <br />Dated and signed this <br /> <br />day of <br /> <br />,2007 <br /> <br />Signature of Voting Member (SIGN ONLY ONE SIDE) <br /> <br />M5354OA_03. <br /> <br />7JSO <br /> <br />JM91J01~ND)ll <br />
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