BLUE CROSS AND BLUE SHIELD PLANS NATIONAL RETIREE HEALTH BENEFITS: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- BLUE CROSS AND BLUE SHIELD PLANS NATIONAL RETIREE HEALTH BENEFITS (EIN 36-7008317)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201843199349305539
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T10:36:13-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 171 N CLARK ST SUITE 200 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 367008317 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE CROSS AND BLUE SHIELD PLANS | BusinessNameLine1Txt |
| Business Name Line2 | NATIONAL RETIREE HEALTH BENEFITS TRUST | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TERRENCE J COONEY VP NEBA | InCareOfNm |
| Business Name Control | BLU | BusinessNameControlTxt |
| Phone | 3124445670 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH MICHIGAN AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRENCE J COONEY | PersonNm |
| Person Title | VP, NEBA | PersonTitleTxt |
| Phone | 3124445670 | PhoneNum |
| Signature | 2018-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL ROMANO | PreparerPersonNm |
| PTIN | P00504182 | PTIN |
| Phone | 3128560200 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.220.64.52 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 36941220183195000003 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D3DD5683B4A4F9ED0F5FC750A01E0847A880CEB1 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A9899077D59173BDE12301F24C193D2CA4773CA1 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERRENCE J COONEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH MICHIGAN AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $68,330,500 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE PRIMARY PURPOSE OF THE TRUST IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE RETIREES OF THE BLUE CROSS & BLUE SHIELD COMPANIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $5,661,793 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $5,130,652 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $695,688 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $542,467 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,093,620 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,486,802 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,945,886 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $14,735,194 | PYTotalRevenueAmt |
| CY Total Revenue | $10,029,269 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $11,871,234 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $14,170,736 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $379,113 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $482,455 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $150,853 | PYOtherExpensesAmt |
| CY Other Expenses | $6,802,092 | CYOtherExpensesAmt |
| PY Total Expenses | $12,401,200 | PYTotalExpensesAmt |
| CY Total Expenses | $21,455,283 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,333,994 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$11,426,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $207,889,634 | TotalAssetsBOYAmt |
| Total Assets EOY | $219,337,939 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,139,795 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,719,137 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $195,749,839 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $200,618,802 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PRIMARY PURPOSE OF THE TRUST IS TO PROVIDE HEALTH BENEFITS TO ELIGIBLE RETIREES OF THE BLUE CROSS & BLUE SHIELD COMPANIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | PROVIDED HEALTH BENEFITS TO ELIGIBLE RETIREES OF BLUE CROSS & BLUE SHIELD. TOTAL HEALTH BENEFITS PAID DURING THE YEAR WAS $14,170,736. | Desc |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRENCE J COONEY VP NEBA | PersonNm |
| Phone | 3122976000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 N MICHIGAN AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Rick Schum | ||||||||
| Chairman | 0.1 | 10.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John F Giblin | ||||||||
| Vice Chairman | 0.1 | 0.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Andrew C Corbin | ||||||||
| Committee member | 0.1 | 20.2 | Yes (X) | $0 | $0 | $0 | ||
| Chuck Divita | ||||||||
| Committee Member | 0.1 | 0.2 | Yes (X) | $0 | $0 | $0 | ||
| Don George | ||||||||
| Committee Member | 0.1 | 10.2 | Yes (X) | $0 | $0 | $0 | ||
| Karen M Abraham | ||||||||
| Committee Member | 0.1 | 0.2 | Yes (X) | $0 | $0 | $0 | ||
| Mark P Stimpson | ||||||||
| Committee Member | 0.1 | 0.2 | Yes (X) | $0 | $0 | $0 | ||
| Michael A Gold | ||||||||
| Committee member | 0.1 | 10.2 | Yes (X) | $0 | $0 | $0 | ||
| Michael Mizeur | ||||||||
| Committee Member | 0.1 | 0.2 | Yes (X) | $0 | $0 | $0 | ||
| Christopher Booth | ||||||||
| Committee Member | 0.1 | 10.2 | Yes (X) | $0 | $0 | $0 | ||
| Robert J Kolodgy | ||||||||
| Committee Member | 0.1 | 40.2 | Yes (X) | $0 | $968,451 | $55,014 | ||
| Tim Huckle | ||||||||
| Committee Member | 0.1 | 10.2 | Yes (X) | $0 | $0 | $0 | ||
| The Northern Trust | ||||||||
| Trustee | 40.0 | 0.0 | $482,455 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $482,455 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $968,451 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $55,014 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EMPLOYER CONTRIBUTION | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $542,467 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $542,467 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $542,467 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,053,599 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $3,228,590 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,825,099 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $60,734,434 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $58,301,231 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,433,203 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,433,203 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $2,433,203 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,029,269 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $542,467 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $5,661,793 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,825,099 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,170,736 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,455 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,350 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,975 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TAXES INCURRED | Desc |
| Total | $6,705,767 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,455,283 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,442,106 | BOYAmt |
| EOY | $217,847,781 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,447,528 | BOYAmt |
| EOY | $1,490,158 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,889,634 | BOYAmt |
| EOY | $219,337,939 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,139,795 | BOYAmt |
| EOY | $14,599,540 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,119,597 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,139,795 | BOYAmt |
| EOY | $18,719,137 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,749,839 | BOYAmt |
| EOY | $200,618,802 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,749,839 | BOYAmt |
| EOY | $200,618,802 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,889,634 | BOYAmt |
| EOY | $219,337,939 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$11,426,014 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $17,363,842 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,068,865 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME TAXES PAYABLE | Desc |
| Amt | $4,119,597 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,119,597 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,324,246 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $17,363,842 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$1,068,865 | OtherRevenueAmt |
| Revenue Not Reported | $16,294,977 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,029,269 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $10,029,269 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,455,283 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $21,455,283 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $21,455,283 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| schedule d, part X, line 2 | FIN 48 Disclosure INCOME TAXES INCURRED, WHICH ARE REPORTED WITHIN THE ACCOMPANYING FINANCIAL STATEMENTS, REPRESENT THE TRUST'S PROVISION FOR UNRELATED BUSINESS INCOME TAX, WHICH IS BASED ON THE DIVIDEND INCOME, REALIZED GAINS ON THE SALE OF INVESTMENTS, AND INTEREST INCOME ON CERTAIN INVESTMENTS OF THE TRUST THAT DO NOT GENERATE TAX-EXEMPT INTEREST. The trust evaluates unrelated business income tax including the impact of regulation code 419A. Income taxes payable or receivable is recognized within the statements of net assets available for retiree health benefits. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT INCLUDED ON FORM 990: RETURN OF CAPITAL - reclass $35,354 adjustment to basis of securities (Including Amortization) $(1,104,219) |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert J Kolodgy | PersonNm |
| Title | Committee Member | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $580,710 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $355,000 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $32,741 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $18,000 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $37,014 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $1,023,465 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SOCIAL CLUB DUES | FormAndLineReferenceDesc |
| Explanation | FORM 990, SCHEDULE J, PART I, LINE 1A TO FACILITATE BUSINESS MEETINGS WITH VISITING PLAN OFFICIALS AND OTHERS AND TO FOSTER SOCIAL INTERACTION SERVING THE INTERESTS OF THE ASSOCIATION AND TO FOSTER THEIR GOOD HEALTH, THE ASSOCIATION REIMBURSES A LUNCHEON CLUB MEMBERSHIP FOR OFFICERS. THE EXPENSES ARE REIMBURSED AND INCLUDED IN TAXABLE COMPENSATION, IF APPLICABLE, IN ACCORDANCE WITH THE ASSOCIATION'S POLICY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 CERTAIN MEMBERS OF THE NATIONAL EMPLOYEE BENEFITS COMMITTEE ("COMMITTEE") SERVE TOGETHER ON THE BOARD OF BLUE CROSS AND BLUE SHIELD ASSOCIATION. ALL MEMBERS OF THE COMMITTEE ARE EITHER EMPLOYEES OF THE BLUE CROSS AND BLUE SHIELD ASSOCIATION OR ONE OF THE MEMBER PLANS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990'S CONTENT AND SOURCE OF INFORMATION ARE REVIEWED BY SUBJECT MATTER EXPERTS INCLUDING, BUT NOT LIMITED TO, INTERNAL AND EXTERNAL TAX AND ACCOUNTING PROFESSIONALS AND INTERNAL LEGAL PERSONNEL, AND THE AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE COMMITTEE THAT SERVES AS THE GOVERNING BODY BY THE INDEPENDENT AUDITORS. |
| MONITORING & ENFORCEMENT POLICIES | FORM 990, PART VI, SECTION B, LINE 12C BLUE CROSS BLUE SHIELD ASSOCIATION (BCBSA) MAINTAINS A COMPREHENSIVE CODE OF CONDUCT AND COMPLIANCE PROGRAM APPLICABLE TO ALL EMPLOYEES AND OFFICERS, INCLUDING THOSE WHO EITHER SERVE ON THE COMMITTEE (THAT GOVERNS AND ACTS FOR THE ORGANIZATION) OR ACT ON BEHALF OF THAT COMMITTEE. IN ADDITION, ALL EMPLOYEES, OFFICERS, AND DIRECTORS (INCLUDING THOSE WHO SERVE ON THE COMMITTEE OR ACT ON ITS BEHALF) ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM. THE BCBSA CHIEF AUDITOR AND COMPLIANCE OFFICER IS CHARGED WITH INVESTIGATING ANY ALLEGATIONS OF NON-COMPLIANCE WITH THE CODE OF CONDUCT, INCLUDING ANY COMPLAINTS REPORTED THROUGH THE ANONYMOUS HOTLINE MAINTAINED THROUGH AN INDEPENDENT ORGANIZATION. THE RESULTS OF THE COMPLIANCE PROGRAM'S EFFECTIVENESS ARE REPORTED TO THE AUDIT COMMITTEE OF THE BCBSA BOARD OF DIRECTORS ON AN ANNUAL BASIS. FAILURE TO ADHERE TO THE CODE OF CONDUCT MAY RESULT IN DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. MOREOVER, COMMITTEE MEMBERS RECEIVE FIDUCIARY TRAINING FROM THE BCBSA CHIEF EMPLOYEE BENEFITS COUNSEL REGARDING THEIR FIDUCIARY DUTIES, INCLUDING THE ERISA FIDUCIARY CONFLICT OF INTEREST RULES. BCBSA'S CHIEF EMPLOYEE BENEFITS COUNSEL ALSO PROVIDES THE COMMITTEE WITH AN ANNUAL ASSESSMENT OF THE ORGANIZATION'S AND COMMITTEE'S LEGAL COMPLIANCE, INCLUDING COMPLIANCE WITH ERISA. AS EMPLOYEES OF VARIOUS BLUE PLANS, EACH COMMITTEE MEMBERS NOT EMPLOYED BY BCBSA IS SUBJECT TO ADDITIONAL CONFLICT OF INTEREST RESTRICTION UNDER POLICIES ADOPTED BY HIS OR HER EMPLOYER PLAN. |
| PROCESS FOR DETERMINING COMPENSATION | FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION DOES NOT REQUIRE COMPENSATION POLICIES AS IT DOES NOT COMPENSATE ANY OFFICERS, MANAGEMENT OFFICIALS, OR KEY EMPLOYEES. |
| HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC | FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FORM 990 ARE MADE AVAILABLE TO PARTICIPANTS IN THE EMPLOYEE BENEFIT PROGRAMS FUNDED THROUGH VEBA UPON REQUEST TO THE VICE PRESIDENT, NATIONAL EMPLOYEE BENEFITS ADMINISTRATION, BLUE CROSS AND BLUE SHIELD ASSOCIATION, 225 N. MICHIGAN AVENUE, CHICAGO, IL 60601. |
| other changes in net assets | form 990, part XI, line 9 RETURN OF CAPITAL - reclass $35,354 adjustment to basis of securities (including Amort.) $(1,104,219) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE CROSS BLUE SHIELD ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH MICHIGAN AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135656874 | EIN |
| Primary Activities | MEMBERSHIP | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(4) | ExemptCodeSectionTxt |
| Public Charity Status | N/A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ANTHEM INC | |||||||||
| 120 MONUMENT CIRCLE | INDIANAPOLIS | IN | 46204 | 352147515 | CONTRIB.ER | IN | NA | C Corp | false |
| BLUE CROSS & BLUE SHIELD OF NC | |||||||||
| 5901 CHAPEL HILL ROAD | DURHAM | NC | 27707 | 560894904 | CONTRIB.ER | NC | NA | C Corp | false |
| BLUE CROSS & BLUE SHIELD OF TENNESSEE | |||||||||
| 1 CAMERON HILL CIRCLE | CHATTANOOGA | TN | 37402 | 621624483 | CONTRIB.ER | TN | NA | C Corp | false |
| BLUE CROSS & BLUE SHIELD OF WYOMING | |||||||||
| 4000 HOUSE AVENUE | CHEYENNE | WY | 82001 | 830231011 | CONTRIB.ER | WY | NA | C Corp | false |
| COMMUNITY INSURANCE COMPANY | |||||||||
| 4361 IRWIN SIMPSON ROAD | MASON | OH | 45040 | 311440175 | CONTRIB.ER | OH | ANTHEM INC | C Corp | false |
| ANTHEM HOLDING CORP | |||||||||
| 120 MONUMENT CIRCLE | INDIANAPOLIS | IN | 46204 | 611459939 | CONTRIB.ER | IN | ANTHEM INC | C Corp | false |
| NATIONAL GOVERNMENT SERVICES INC | |||||||||
| 8115 KNUE ROAD | INDIANAPOLIS | IN | 46250 | 351840597 | CONTRIB.ER | IN | ANTHEM INC | C Corp | false |
| ATH HOLDING COMPANY LLC | |||||||||
| 120 MONUMENT CIRCLE | INDIANAPOLIS | IN | 46204 | 113713086 | CONTRIB.ER | IN | ANTHEM INC | C Corp | false |
| ANTHEM INSURANCE COMPANIES INC | |||||||||
| 120 MONUMENT CIRCLE | INDIANAPOLIS | IN | 46204 | 350781558 | CONTRIB.ER | IN | ANTHEM INC | C Corp | false |
| VOLUNTEER STATE HEALTH PLAN INC | |||||||||
| 1 CAMERON HILL CIRCLE | CHATTANOOGA | TN | 37402 | 621656610 | CONTRIB.ER | TN | BCBS OF TN | C Corp | false |
| SHARED HEALTH | |||||||||
| 401 M L KING BLVD | CHATTANOOGA | TN | 37402 | 203484545 | CONTRIB.ER | TN | BCBS OF TN | C Corp | false |
| RIVERBEND GOVT BENEFITS ADMINISTRATOR | |||||||||
| 1 CAMERON HILL CIRCLE | CHATTANOOGA | TN | 37402 | 202469347 | CONTRIB.ER | TN | BCBS OF TN | C Corp | false |
| RIVERTRUST SOLUTIONS INC | |||||||||
| 1 CAMERON HILL CIRCLE | CHATTANOOGA | TN | 37402 | 200528228 | CONTRIB.ER | TN | BCBS OF TN | C Corp | false |
| CAMBIA HEALTH SOLUTIONS INC | |||||||||
| 200 SW MARKET STREET SUITE 1500 | PORTLAND | OR | 97201 | 931179316 | CONTRIB.ER | OR | NA | C Corp | false |
| REGENCE BLUESHIELD OF IDAHO | |||||||||
| 1602 21ST AVENUE | LEWISTON | ID | 83501 | 820206874 | CONTRIB.ER | ID | CAMBIA HEALTH | C Corp | false |
| REGENCE BLUE CROSS BLUE SHIELD UTAH | |||||||||
| 2890 EAST COTTONWOOD PARKWAY | SALT LAKE CITY | UT | 84121 | 870200138 | CONTRIB.ER | UT | CAMBIA HEALTH | C Corp | false |
| REGENCE BLUE SHIELD | |||||||||
| 1800 NINTH AVENUE | SEATTLE | WA | 98101 | 910282080 | CONTRIB.ER | WA | CAMBIA HEALTH | C Corp | false |
| REGENCE BLUE CROSS & BLUE SHIELD OF OR | |||||||||
| 200 SW MARKET STREET SUITE 1500 | PORTLAND | OR | 97201 | 930238155 | CONTRIB.ER | OR | CAMBIA HEALTH | C Corp | false |
| BLUE CROSS AND BLUE SHIELD OF ARIZONA | |||||||||
| 2444 WEST LAS PALMARITAS DR | PHOENIX | AZ | 85021 | 860004538 | CONTRIB.ER | AZ | NA | C Corp | false |
| CSA GENERAL INSURANCE AGENCY INC | |||||||||
| 2480 WEST LAS PALMARITAS DR | PHOENIX | AZ | 85021 | 860489277 | CONTRIB.ER | AZ | BCBS ARIZONA | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |