From: Linda Turner
To: Treasurer@msptrooper.org
Date: Sep 19, 2025, 2:19 PM
Subject: Blue Cross Blue Shield of MA - Acct.# 8104040

Good morning,

I have attached the following 3 documents pertaining to the Blue Cross Blue Shield Account # 8104040 with the State Police Association of MA:

1. Blue Cross Blue Shield of Massachusetts Benefit Proposal for State Police Association of Massachusetts. This document lists Employee 001 (Theodore J. Stephanides - DOB 12/14/1989) Coverage Type Medical-EE and Coverage Type Dental-EE.

2. Blue Cross Blue Shield of Massachusetts letter of confirmation of coverage Account # 8104040.

Group # 006953928 HMO Blue

3. Blue Cross Blue Shield of Massachusetts Account Application Form for State Police Association of Massachusetts.

The State Police Association of MA is requesting to terminate this policy effective