General Announcement

Transcription

1 Cement Masons Health and Welfare Trust Fund for Northern California 220 Campus Lane Fairfield, CA or General Announcement June 20, 2014 Dear Participants and Eligible Dependents: Preliminary Notice of PPO Network Cancellation Important Read Carefully Your Action Is Required. The Trust Fund Office has been notified by Anthem Blue Cross of a possible termination of the Dignity Health network, effective July 16, Anthem Blue Cross and Dignity Health continue in negotiations and will attempt to work towards mutually agreeable contracts. However, in the meantime, we must assume that there is a very good likelihood that the Dignity Health network will terminate on July 16, Plan Participants and their eligible Dependents should be on notice that as of July 16, 2014, certain Hospitals and other Providers of Service (Physicians, laboratories, etc.) within the Dignity Health network will not be available to you as a PPO. If the PPO contract is not renewed and you continue to use a Hospital or Provider of Service that is no longer a PPO, your claims will be reimbursed at the Non-PPO rate. This means you may have a higher than usual share of cost on your claims. You can find a list of the affected Hospitals, along with a list of alternative Hospitals in the Southern and Northern Regions of California, located at the Trust Funds website If you do not have access to the internet where you can visit the Trust Funds website, call the Trust Fund Office at Physicians, laboratories, and other providers under the Dignity Health are also affected. Unfortunately, we do not have a list of all affected non-hospital providers. You must, therefore, be cautious when you use a Provider of Service on or after July 16, Always confirm that your Hospital or non-hospital provider is part of the Anthem Blue Cross Advantage PPO network before you schedule an appointment. Sincerely, Board of Trustees Keep this General Announcement with your September 2007 Health and Welfare Plan booklet

2 Dignity Health - Alternate Hospital List May 2014 Dignity Health - Southern Regional Hospitals ARROYO GRANDE COMMUNITY HOSPITAL 345 S HALCYON RD ARROYO CA SAN LUIS OBISPO SIERRA VISTA REGIONAL MEDICAL CENTER 1010 MURRAY AVE SAN LUIS OBISPO CA SAN LUIS OBISPO TWIN CITIES COMMUNITY HOSPITAL INC 1100 LAS TABLAS RD TEMPLETON CA SAN LUIS OBISPO BAKERSFIELD MEMORIAL HOSPITAL TH ST BAKERSFIELD CA KERN GOOD SAMARITAN HOSPITAL 901 OLIVE DR BAKERSFIELD CA KERN KERN MEDICAL CENTER 1700 MOUNT VERNON AVE BAKERSFIELD CA KERN SAN JOAQUIN COMMUNITY HOSPITAL 2615 CHESTER AVE BAKERSFIELD CA KERN CALIFORNIA HOSPITAL MEDICAL CENTER 1401 S GRAND AVE CA AHMC GARFIELD HOSPITAL MEDICAL 525 N GARFIELD AVE MONTEREY PARK CA ALHAMBRA HOSPITAL MEDICAL CENTER 100 S RAYMOND AVE ALHAMBRA CA BEVERLY HOSPITAL 309 W BEVERLY BLVD MONTEBELLO CA CEDARS SINAI MEDICAL CENTER 8700 BEVERLY BLVD CA CENTINELA HOSPITAL MEDICAL CENTER 555 E HARDY ST INGLEWOOD CA CHILDRENS HOSPITAL 4650 W SUNSET BLVD CA CITRUS VALLEY MED CTRS-QUEEN OF THE VALLEY CAMPUS 1115 S SUNSET AVE WEST COVINA CA CITY OF HOPE NATIONAL MEDICAL CENTER 1500 DUARTE RD DUARTE CA COMMUNITY HOSPITAL LONG BEACH 1720 TERMINO AVE LONG BEACH CA DOCTORS HOSPITAL OF WEST COVINA 725 S ORANGE AVE WEST COVINA CA DOWNEY REGIONAL MEDICAL CENTER - HOSPITAL INC BROOKSHIRE AVE DOWNEY CA ENCINO HOSPITAL MEDICAL CENTER VENTURA BLVD ENCINO CA GLENDALE ADVENTIST MEDICAL CENTER 1509 WILSON TER GLENDALE CA GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD CA GREATER EL MONTE COMMUNITY HOSPITAL 1701 SANTA ANITA AVE SOUTH EL CA HOLLYWOOD COMMUNITY HOSPITAL AT BROTMAN 3828 DELMAS TER CULVER CITY CA HOLLYWOOD PRESBYTERIAN MEDICAL CENTER 1300 N VERMONT AVE CA HUNTINGTON MEMORIAL HOSPITAL 100 W CALIFORNIA BLVD PASADENA CA KENNETH NORRIS JR CANCER HOSPITAL 1441 EASTLAKE AVE CA LA PALMA INTERCOMMUNITY HOSPITAL LLC 7901 WALKER ST LA PALMA CA ORANGE LAKEWOOD REGIONAL MEDICAL CENTER 3700 SOUTH ST LAKEWOOD CA LONG BEACH MEMORIAL MEDICAL CENTER 2801 ATLANTIC AVE LONG BEACH CA LOS ALAMITOS MEDICAL CENTER 3751 KATELLA AVE LOS ALAMITOS CA ORANGE ORTHOPEDIC MEDICAL CENTER 2400 S FLOWER ST CA Page 1

3 MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA METHODIST HOSPITAL OF SOUTHERN CALIFORNIA 300 W HUNTINGTON DR ARCADIA CA MILLER CHILDRENS HOSPITAL 2801 ATLANTIC AVE LONG BEACH CA MIRACLE MILE MEDICAL CENTER 6000 SAN VICENTE BLVD CA MISSION COMMUNITY HOSPITAL-PANORAMA CAMPUS ROSCOE BLVD PANORAMA CITY CA MONTEREY PARK HOSPITAL 900 S ATLANTIC BLVD MONTEREY PARK CA OLYMPIA MEDICAL CENTER 5900 W OLYMPIC BLVD CA PACIFIC ALLIANCE MEDICAL CENTER 531 W COLLEGE ST CA PACIFIC HOSPITAL OF LONG BEACH 2776 PACIFIC AVE LONG BEACH CA PACIFICA HOSPITAL OF THE VALLEY 9449 SAN FERNANDO RD SUN VALLEY CA PRESBYTERIAN INTERCOMMUNITY HOSPITAL WASHINGTON BLVD WHITTIER CA PROMISE HOSP OF EAST -SUBURBAN CAMPUS COLORADO AVE PARAMOUNT CA PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE 4101 TORRANCE BLVD TORRANCE CA PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO 1300 W 7TH ST SAN PEDRO CA PROVIDENCE SAINT JOSEPH MEDICAL CENTER 501 S BUENA VISTA ST BURBANK CA PROVIDENCE TARZANA MEDICAL CENTER CLARK ST TARZANA CA RONALD REAGAN UCLA MEDICAL CENTER 757 WESTWOOD PLZ CA SAN GABRIEL VALLEY MEDICAL CENTER 438 W LAS TUNAS DR SAN GABRIEL CA SANTA MONICA UCLA MEDICAL CENTER TH ST SANTA MONICA CA SHERMAN OAKS HOSPITAL 4929 VAN NUYS BLVD SHERMAN OAKS CA ST FRANCIS MEDICAL CENTER 3630 E IMPERIAL HWY LYNWOOD CA ST JOHNS HOSPITAL AND HEALTH CENTER ND ST SANTA MONICA CA ST VINCENT MEDICAL CENTER 2131 W 3RD ST CA TEMPLE COMMUNITY HOSPITAL 235 N HOOVER ST CA TORRANCE MEMORIAL MEDICAL CENTER 3330 LOMITA BLVD TORRANCE CA TRI CITY REGIONAL MEDICAL CENTER PIONEER BLVD HAWAIIAN CA USC UNIVERSITY HOSPITAL 1500 SAN PABLO ST CA VALLEY PRESBYTERIAN HOSPITAL VANOWEN ST VAN NUYS CA VERDUGO HILLS HOSPITAL 1812 VERDUGO BLVD GLENDALE CA WEST ANAHEIM MEDICAL CENTER 3033 W ORANGE AVE ANAHEIM CA ORANGE WHITE MEMORIAL MEDICAL CENTER 1720 E CESAR E CHAVEZ CA WHITTIER HOSPITAL MEDICAL CENTER 9080 COLIMA RD WHITTIER CA COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DR SN BERNRDNO CA SAN BERNARDINO LOMA LINDA UNIVERSITY MEDICAL CENTER ANDERSON ST LOMA LINDA CA SAN BERNARDINO PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER 3865 JACKSON ST RIVERSIDE CA RIVERSIDE REDLANDS COMMUNITY HOSPITAL 350 TERRACINA BLVD REDLANDS CA SAN BERNARDINO RIVERSIDE COMMUNITY HOSPITAL 4445 MAGNOLIA AVE RIVERSIDE CA RIVERSIDE SAN ANTONIO COMMUNITY HOSPITAL 999 SAN BERNARDINO RD UPLAND CA SAN BERNARDINO FRENCH HOSPITAL MEDICAL CENTER 1911 JOHNSON AVE SAN LUIS CA SAN LUIS OBISPO SIERRA VISTA REGIONAL MEDICAL CENTER 1010 MURRAY AVE SAN LUIS OBISPO CA SAN LUIS OBISPO Page 2

4 TWIN CITIES COMMUNITY HOSPITAL INC 1100 LAS TABLAS RD TEMPLETON CA SAN LUIS OBISPO Terminating Hospital street addr city state zip code GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER 1420 S CENTRAL AVE GLENDALE CA AHMC GARFIELD HOSPITAL MEDICAL 525 N GARFIELD AVE MONTEREY PARK CA ALHAMBRA HOSPITAL MEDICAL CENTER 100 S RAYMOND AVE ALHAMBRA CA BEVERLY HOSPITAL 309 W BEVERLY BLVD MONTEBELLO CA CEDARS SINAI MEDICAL CENTER 8700 BEVERLY BLVD CA CENTINELA HOSPITAL MEDICAL CENTER 555 E HARDY ST INGLEWOOD CA CHILDRENS HOSPITAL 4650 W SUNSET BLVD CA CITY OF HOPE NATIONAL MEDICAL CENTER 1500 DUARTE RD DUARTE CA DOCTORS HOSPITAL OF WEST COVINA 725 S ORANGE AVE WEST COVINA CA DOWNEY REGIONAL MEDICAL CENTER - HOSPITAL INC BROOKSHIRE AVE DOWNEY CA ENCINO HOSPITAL MEDICAL CENTER VENTURA BLVD ENCINO CA GLENDALE ADVENTIST MEDICAL CENTER 1509 WILSON TER GLENDALE CA GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD CA GREATER EL MONTE COMMUNITY HOSPITAL 1701 SANTA ANITA AVE SOUTH EL CA HOLLYWOOD COMMUNITY HOSPITAL AT BROTMAN 3828 DELMAS TER CULVER CITY CA HOLLYWOOD PRESBYTERIAN MEDICAL CENTER 1300 N VERMONT AVE CA HUNTINGTON MEMORIAL HOSPITAL 100 W CALIFORNIA BLVD PASADENA CA KENNETH NORRIS JR CANCER HOSPITAL 1441 EASTLAKE AVE CA ORTHOPAEDIC MEDICAL CENTER 2400 S FLOWER ST CA MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA METHODIST HOSPITAL OF SOUTHERN CALIFORNIA 300 W HUNTINGTON DR ARCADIA CA MIRACLE MILE MEDICAL CENTER 6000 SAN VICENTE BLVD CA MISSION COMMUNITY HOSPITAL-PANORAMA CAMPUS ROSCOE BLVD PANORAMA CITY CA MONTEREY PARK HOSPITAL 900 S ATLANTIC BLVD MONTEREY PARK CA OLYMPIA MEDICAL CENTER 5900 W OLYMPIC BLVD CA PACIFIC ALLIANCE MEDICAL CENTER 531 W COLLEGE ST CA PACIFICA HOSPITAL OF THE VALLEY 9449 SAN FERNANDO RD SUN VALLEY CA PROVIDENCE HOLY CROSS MEDICAL CENTER RINALDI ST MISSION HILLS CA PROVIDENCE SAINT JOSEPH MEDICAL CENTER 501 S BUENA VISTA ST BURBANK CA PROVIDENCE TARZANA MEDICAL CENTER CLARK ST TARZANA CA RONALD REAGAN UCLA MEDICAL CENTER 757 WESTWOOD PLZ CA SAN GABRIEL VALLEY MEDICAL CENTER 438 W LAS TUNAS DR SAN GABRIEL CA SANTA MONICA UCLA MEDICAL CENTER TH ST SANTA MONICA CA SHERMAN OAKS HOSPITAL 4929 VAN NUYS BLVD SHERMAN OAKS CA ST FRANCIS MEDICAL CENTER 3630 E IMPERIAL HWY LYNWOOD CA ST JOHNS HOSPITAL AND HEALTH CENTER ND ST SANTA MONICA CA ST VINCENT MEDICAL CENTER 2131 W 3RD ST CA TEMPLE COMMUNITY HOSPITAL 235 N HOOVER ST CA USC UNIVERSITY HOSPITAL 1500 SAN PABLO ST CA VALLEY PRESBYTERIAN HOSPITAL VANOWEN ST VAN NUYS CA VERDUGO HILLS HOSPITAL 1812 VERDUGO BLVD GLENDALE CA WHITE MEMORIAL MEDICAL CENTER 1720 E CESAR E CHAVEZ AVE CA Page 3

5 Terminating Hospital MARIAN MEDICAL CENTER Alternate Hospitals GOLETA VALLEY COTTAGE HOSPITAL LOMPOC HEALTHCARE DISTRICT SANTA BARBARA COTTAGE HOSPITAL SANTA YNEZ VALLEY COTTAGE HOSPITAL SIERRA VISTA REGIONAL MEDICAL CENTER street addr city state zip code 1400 E CHURCH ST SANTA MARIA CA SANTA BARBARA street addr city state zip code 351 S PATTERSON AV SANTA BARBARA CA SANTA BARBARA 508 E HICKORY AVE LOMPOC CA SANTA BARBARA PUEBLO AT BATH SANTA BARBARA CA SANTA BARBARA 2050 VIBORG RD SOVANG CA SANTA BARBARA 1010 MURRAY AVE SAN LUIS OBISPO CA SAN LUIS OBISPO MERCY HEALTHCARE BAKERSFIELD 2215 TRUXTUN AVE BAKERSFIELD CA KERN DELANO REGIONAL MEDICAL CENTER 1401 GARCES HWY DELANO CA KERN GOOD SAMARITAN HOSPITAL 901 OLIVE DR BAKERSFIELD CA KERN KERN MEDICAL CENTER 1700 MOUNT VERNON AVE BAKERSFIELD CA KERN SAN JOAQUIN COMMUNITY HOSPITAL 2615 CHESTER AVE BAKERSFIELD CA KERN NORTHRIDGE HOSPITAL MEDICAL CENTER ROSCOE BLVD NORTHRIDGE CA CEDARS SINAI MEDICAL CENTER 8700 BEVERLY BLVD CA CHILDRENS HOSPITAL 4650 W SUNSET BLVD CA ENCINO HOSPITAL MEDICAL CENTER VENTURA BLVD ENCINO CA GLENDALE ADVENTIST MEDICAL CENTER 1509 WILSON TER GLENDALE CA HENRY MAYO NEWHALL MEMORIAL HOSPITAL MCBEAN PKWY VALENCIA CA HOLLYWOOD COMMUNITY HOSPITAL AT BROTMAN 3828 DELMAS TER CULVER CITY CA HOLLYWOOD PRESBYTERIAN MEDICAL CENTER 1300 N VERMONT AVE CA MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA MIRACLE MILE MEDICAL CENTER 6000 SAN VICENTE BLVD CA MISSION COMMUNITY HOSPITAL-PANORAMA CAMPUS ROSCOE BLVD PANORAMA CITY CA OLYMPIA MEDICAL CENTER 5900 W OLYMPIC BLVD CA PACIFICA HOSPITAL OF THE VALLEY 9449 SAN FERNANDO RD SUN VALLEY CA PROVIDENCE HOLY CROSS MEDICAL CENTER RINALDI ST MISSION HILLS CA PROVIDENCE SAINT JOSEPH MEDICAL CENTER 501 S BUENA VISTA ST BURBANK CA PROVIDENCE TARZANA MEDICAL CENTER CLARK ST TARZANA CA RONALD REAGAN UCLA MEDICAL CENTER 757 WESTWOOD PLZ CA SANTA MONICA UCLA MEDICAL CENTER TH ST SANTA MONICA CA SHERMAN OAKS HOSPITAL 4929 VAN NUYS BLVD SHERMAN OAKS CA SIMI VALLEY HOSPITAL 2975 SYCAMORE DR SIMI VALLEY CA VENTURA ST JOHNS HOSPITAL AND HEALTH CENTER ND ST SANTA MONICA CA ST VINCENT MEDICAL CENTER 2131 W 3RD ST CA TEMPLE COMMUNITY HOSPITAL 235 N HOOVER ST CA VALLEY PRESBYTERIAN HOSPITAL VANOWEN ST VAN NUYS CA WEST HILLS HOSPITAL & MEDICAL CENTER 7300 MEDICAL CENTER DR WEST HILLS CA Page 4

6 ST BERNARDINE MEDICAL CENTER 2101 N WATERMAN AVE SN BERNRDNO CA SAN BERNARDINO LOMA LINDA UNIVERSITY MEDICAL CENTER ANDERSON ST LOMA LINDA CA SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL HOSPITAL ROAD LK ARROWHEAD CA SAN BERNARDINO PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER 3865 JACKSON ST RIVERSIDE CA RIVERSIDE REDLANDS COMMUNITY HOSPITAL 350 TERRACINA BLVD REDLANDS CA SAN BERNARDINO RIVERSIDE COMMUNITY HOSPITAL 4445 MAGNOLIA AVE RIVERSIDE CA RIVERSIDE SAN ANTONIO COMMUNITY HOSPITAL 999 SAN BERNARDINO RD UPLAND CA SAN BERNARDINO SAN GORGONIO MEMORIAL HOSPITAL 600 N HIGHLAND SPRINGS BANNING CA RIVERSIDE ST JOHNS PLEASANT VALLEY HOSPITAL 2309 ANTONIO AVE CAMARILLO CA VENTURA COMMUNITY MEMORIAL HOSPITAL SAN BUENAVENTURA 147 N BRENT ST VENTURA CA VENTURA LOS ROBLES REGIONAL MEDICAL CENTER 215 W JANSS RD THOUSAND OAKS CA VENTURA OJAI VALLEY COMMUNITY HOSPITAL 1306 MARICOPA HWY OJAI CA VENTURA SANTA PAULA HOSPITAL 825 N TENTH ST SANTA PAULA CA VENTURA SIMI VALLEY HOSPITAL 2975 SYCAMORE DR SIMI VALLEY CA VENTURA VENTURA COUNTY MEDICAL CENTER 3291 LOMA VISTA RD VENTURA CA VENTURA ST JOHNS REGIONAL MEDICAL CENTER 1600 N ROSE AVE OXNARD CA VENTURA COMMUNITY MEMORIAL HOSPITAL SAN BUENAVENTURA 147 N BRENT ST VENTURA CA VENTURA LOS ROBLES REGIONAL MEDICAL CENTER 215 W JANSS RD THOUSAND OAKS CA VENTURA OJAI VALLEY COMMUNITY HOSPITAL 1306 MARICOPA HWY OJAI CA VENTURA SANTA PAULA HOSPITAL 825 N TENTH ST SANTA PAULA CA VENTURA VENTURA COUNTY MEDICAL CENTER 3291 LOMA VISTA RD VENTURA CA VENTURA ST MARY MEDICAL CENTER - LONG BEACH 1050 LINDEN AVE LONG BEACH CA ANAHEIM GENERAL HOSPITAL 3350 W BALL RD ANAHEIM CA ORANGE CHILDRENS HOSPITAL OF ORANGE COUNTY 455 S MAIN ST ORANGE CA ORANGE COASTAL COMMUNITIES HOSPITAL 2701 S BRISTOL ST SANTA ANA CA ORANGE COMMUNITY HOSPITAL LONG BEACH 1720 TERMINO AVE LONG BEACH CA DOWNEY REGIONAL MEDICAL CENTER - HOSPITAL INC BROOKSHIRE AVE DOWNEY CA FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER EUCLID ST FOUNTAIN CA ORANGE GARDEN GROVE HOSPITAL AND MEDICAL CENTER GARDEN GROVE GARDEN GROVE CA ORANGE HUNTINGTON BEACH HOSPITAL BEACH BLVD HUNTINGTN BCH CA ORANGE LA PALMA INTERCOMMUNITY HOSPITAL LLC 7901 WALKER ST LA PALMA CA ORANGE LAKEWOOD REGIONAL MEDICAL CENTER 3700 SOUTH ST LAKEWOOD CA LONG BEACH MEMORIAL MEDICAL CENTER 2801 ATLANTIC AVE LONG BEACH CA LOS ALAMITOS MEDICAL CENTER 3751 KATELLA AVE LOS ALAMITOS CA ORANGE MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY CA Page 5

7 MILLER CHILDRENS HOSPITAL 2801 ATLANTIC AVE LONG BEACH CA ORANGE COAST MEMORIAL MEDICAL CENTER 9920 TALBERT AVE FOUNTAIN CA ORANGE PACIFIC HOSPITAL OF LONG BEACH 2776 PACIFIC AVE LONG BEACH CA PROMISE HOSP OF EAST SUBURBAN CAMPUS COLORADO AVE PARAMOUNT CA PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO 1300 W 7TH ST SAN PEDRO CA PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE 4101 TORRANCE BLVD TORRANCE CA ST FRANCIS MEDICAL CENTER 3630 E IMPERIAL HWY LYNWOOD CA ST JOSEPH HOSPITAL - ORANGE 1100 W STEWART DR ORANGE CA ORANGE TORRANCE MEMORIAL MEDICAL CENTER 3330 LOMITA BLVD TORRANCE CA TRI CITY REGIONAL MEDICAL CENTER PIONEER BLVD HAWAIIAN CA UC IRVINE MEDICAL CENTER 101 CITY DRIVE S ORANGE CA ORANGE WEST ANAHEIM MEDICAL CENTER 3033 W ORANGE AVE ANAHEIM CA ORANGE WHITE MEMORIAL MEDICAL CENTER 1720 E CESAR E CHAVEZ AVE CA Dignity Health - Northern Regional Hospitals DOMINICAN SANTA CRUZ HOSPITAL 1555 SOQUEL DR SANTA CRUZ CA SANTA CRUZ GOOD SAMARITAN HOSPITAL 2425 SAMARITAN DR SAN JOSE CA SANTA CLARA OCONNOR HOSPITAL 2105 FOREST AVE SAN JOSE CA SANTA CLARA SANTA CLARA VALLEY HEALTH & HOSPITAL SYSTEM 751 S BASCOM AVE SAN JOSE CA SANTA CLARA WATSONVILLE COMMUNITY HOSPITAL 75 NEILSON ST WATSONVILLE CA SANTA CRUZ MARK TWAIN ST JOSEPHS HOSPITAL 768 MOUNTAIN RANCH RD SAN ANDREAS CA CALAVERAS SUTTER AMADOR HOSPITAL 200 MISSION BLVD JACKSON CA AMADOR SONORA REGIONAL MEDICAL CENTER 1 S FOREST RD SONORA CA TUOLUMNE MERCY GENERAL HOSPITAL 4001 J ST SACRAMENTO CA SACRAMENTO UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD SACRAMENTO CA SACRAMENTO MERCY HOSPITAL OF FOLSOM 1650 CREEKSIDE DR FOLSOM CA SACRAMENTO MARSHALL MEDICAL CENTER 1100 MARSHALL WAY PLACERVILLE CA EL DORADO UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD SACRAMENTO CA SACRAMENTO MERCY MEDICAL CENTER MT SHASTA 914 PINE ST MOUNT SHASTA CA SISKIYOU FAIRCHILD MEDICAL CENTER 444 BRUCE ST YREKA CA SISKIYOU SHASTA REGIONAL MEDICAL CENTER 1100 BUTTE ST REDDING CA SHASTA Page 6

8 MERCY MEDICAL CENTER REDDING 2175 ROSALINE AVE REDDING CA SHASTA NORTHERN CALIFORNIA REHABILITATION HOSPITAL 2801 EUREKA WAY REDDING CA SHASTA PATIENTS HOSPITAL OF REDDING 2900 EUREKA WAY REDDING CA SHASTA TRINITY HOSPITAL 60 EASTER AVE WEAVERVILLE CA TRINITY SHASTA REGIONAL MEDICAL CENTER 1100 BUTTE ST REDDING CA SHASTA MERCY MEDICAL CENTER MERCED 301 E 13TH ST MERCED CA MERCED EMANUEL MEDICAL CENTER 825 DELBON AVE TURLOCK CA STANISLAUS MADERA COMMUNITY HOSPITAL 1250 E ALMOND AVE MADERA CA MADERA MERCY SAN JUAN HOSPITAL 6501 COYLE AVE CARMICHAEL CA SACRAMENTO UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD SACRAMENTO CA SACRAMENTO METHODIST HOSPITAL OF SACRAMENTO 7500 HOSPITAL DR SACRAMENTO CA SACRAMENTO UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD SACRAMENTO CA SACRAMENTO SEQUOIA HEALTH SERVICES 170 DE LAS REDWOOD CITY CA EL CAMINO HOSPITAL 2500 GRANT RD MOUNTAIN VIEW CA SANTA CLARA LUCILE SALTER PACKARD CHILDRENS HOSPITAL OF STANFORD 725 WELCH RD PALO ALTO CA SANTA CLARA MENLO PARK SURGICAL HOSPITAL 570 WILLOW RD MENLO PARK CA MILLS HOSPITAL 100 S DR CA PENINSULA HOSPITAL & MEDICAL CENTER 1783 EL CAMINO REAL BURLINGAME CA COUNTY GEN HOSP 222 W 39TH AVE CA ST ROSE HOSPITAL CALAROGA AVE HAYWARD CA STANFORD UNIVERSITY HOSPITAL 300 PASTEUR DR PALO ALTO CA SANTA CLARA Terminating Hospital street addr city state zip SIERRA NEVADA MEMORIAL HOSPITAL 155 GLASSON WAY GRASS VALLEY CA Alternate Hospitals street addr city state zip code RIDEOUT MEMORIAL HOSPITAL 726 4TH ST MARYSVILLE CA Terminating Hospital street addr city state zip code ST ELIZABETH COMMUNITY HOSPITAL 2550 SISTER MARY RED BLUFF CA ENLOE MEDICAL CENTER INC 1531 ESPLANADE CHICO CA GLENN MEDICAL CENTER 1133 W SYCAMORE ST WILLOWS CA Page 7 NEVADA YUBA TEHAMA BUTTE GLENN

9 NORTHERN CALIFORNIA REHABILITATION HOSPITAL 2801 EUREKA WAY REDDING CA PATIENTS HOSPITAL OF REDDING 2900 EUREKA WAY REDDING CA SHASTA REGIONAL MEDICAL CENTER 1100 BUTTE ST REDDING CA SHASTA SHASTA SHASTA Terminating Hospital street addr city state zip ST FRANCIS MEMORIAL HOSPITAL 900 HYDE ST CA HOSPITAL 2070 CLINTON AVE CA ALTA BATES SUMMIT MC-ALTA BATES/HERRICK CAMPUS 2450 ASHBY AVE BERKELEY CA ALTA BATES SUMMIT MC-SUMMIT CAMPUS 350 HAWTHORNE AVE OAKLAND CA CALIFORNIA PACIFIC MEDICAL CENTER - DAVIES CAMPUS CASTRO AND DUBOCE CA CALIFORNIA PACIFIC MEDICAL CENTER-CALIFORNIA CAMPUS 3700 CALIFORNIA ST CA CALIFORNIA PACIFIC MEDICAL CENTER-PACIFIC CAMPUS CLAY AT BUCHANAN CA CALIFORNIA PACIFIC MEDICAL CENTER-ST LUKES CAMPUS 3555 CESAR CHAVEZ CA CHILDRENS HOSPITAL OAKLAND ND ST OAKLAND CA CHINESE HOSPITAL 845 JACKSON ST CA DOCTORS MEDICAL CENTER-SAN PABLO/PINOLE 2000 VALE RD SAN PABLO CA MARIN GENERAL HOSPITAL 250 BON AIR RD GREENBRAE CA MILLS HOSPITAL 100 S DR CA PENINSULA HOSPITAL & MEDICAL CENTER 1783 EL CAMINO REAL BURLINGAME CA SAN LEANDRO HOSPITAL CAMPUS E 14TH ST SAN LEANDRO CA SETON MEDICAL CENTER 1900 SULLIVAN AVE DALY CITY CA UCSF BENIOFF CHILDREN S HOSPITAL 505 PARNASSUS AVE CA UCSF MEDICAL CENTER 505 PARNASSUS AVE CA Terminating Hospital street addr city state zip ST JOSEPHS MEDICAL CENTER OF STOCKTON 1800 N CALIFORNIA ST STOCKTON CA code DAMERON HOSPITAL 525 W ACACIA ST STOCKTON CA DOCTORS HOSPITAL OF MANTECA INC 1205 E NORTH ST MANTECA CA LODI MEMORIAL HOSPITAL 975 S FAIRMONT AVE LODI CA Terminating Hospital street addr city state zip code ST MARYS MEDICAL CENTER 450 STANYAN ST CA HOSPITAL 2070 CLINTON AVE CA ALTA BATES SUMMIT MC-ALTA BATES/HERRICK CAMPUS 2450 ASHBY AVE BERKELEY CA ALTA BATES SUMMIT MC-SUMMIT CAMPUS 350 HAWTHORNE AVE OAKLAND CA CALIFORNIA PACIFIC MEDICAL CENTER - DAVIES CAMPUS CASTRO AND DUBOCE CA CALIFORNIA PACIFIC MEDICAL CENTER-CALIFORNIA CAMPUS 3700 CALIFORNIA ST CA CALIFORNIA PACIFIC MEDICAL CENTER-PACIFIC CAMPUS CLAY AT BUCHANAN CA CALIFORNIA PACIFIC MEDICAL CENTER-ST LUKES CAMPUS 3555 CESAR CHAVEZ CA CHILDRENS HOSPITAL OAKLAND ND ST OAKLAND CA CHINESE HOSPITAL 845 JACKSON ST CA DOCTORS MEDICAL CENTER-SAN PABLO/PINOLE 2000 VALE RD SAN PABLO CA MARIN GENERAL HOSPITAL 250 BON AIR RD GREENBRAE CA Page 8 CONTRA COSTA MARIN SAN JOAQUIN SAN JOAQUIN SAN JOAQUIN SAN JOAQUIN CONTRA COSTA MARIN

10 MILLS HOSPITAL 100 S DR CA PENINSULA HOSPITAL & MEDICAL CENTER 1783 EL CAMINO REAL BURLINGAME CA SETON MEDICAL CENTER 1900 SULLIVAN AVE DALY CITY CA UCSF BENIOFF CHILDREN S HOSPITAL 505 PARNASSUS AVE CA UCSF MEDICAL CENTER 505 PARNASSUS AVE CA Terminating Hospital street addr city state zip code WOODLAND MEMORIAL HOSPITAL 1325 COTTONWOOD ST WOODLAND CA UC DAVIS MEDICAL CENTER 2315 STOCKTON BLVD SACRAMENTO CA YOLO SACRAMENTO Page 9