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Program Sponsorship Program Scope  Program Performance Measures  Incentive/Reward Characteristics Collaboration Characteristics Program Evaluation   PROGRAM SPONSORSHIP Formal name of the incentive and/or reward program initiative (if applicable) Program name Colorado & Nevada Primary Care PHQ Program sponsor(s) and parent organization of sponsor(s), if applicable Program sponsor(s) Anthem Blue Cross and Blue Shield Colorado, Anthem Blue Cross and Blue Shield Nevada Parent organization WellPoint Inc. Primary program contact information Name Jerry Low Title Project Manager Organization Anthem Blue Cross and Blue Shield Colorado & Nevada Email jerry.low@wellpoint.com Phone (818) 234-3798 Sponsoring organization type Health Plan(s) Single HMO, Multiple health plans Source of funding associated with program set-up costs Funding source Funded by program sponsor(s) Percent contributed by sponsor and grant organization % Sponsor 100 Program set-up costs 0 Source of funding associated with program operations costs Funding source Funded by program sponsor(s) Percent contributed by sponsor and by grant organization % Sponsor 100 Program operations cost 0 Start date & end date of the program Start Date 6/5/2004 End ongoing

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