BLUE CROSS & BLUE SHIELD ASSOCIATN NATIONAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- BLUE CROSS & BLUE SHIELD ASSOCIATN NATIONAL (EIN 51-0245316)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201613199349310621
- Schema version
- 2015v2.1
- 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 | 2016-11-14T16:37:23-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510245316 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE CROSS & BLUE SHIELD ASSOCIATN NATIONAL | BusinessNameLine1Txt |
| Business Name Line2 | LONG TERM DISABILITY TRUST | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TERRENCE J COONEY | InCareOfNm |
| Business Name Control | BLUE | 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 | 3128560200 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Bridget T Roche | PreparerPersonNm |
| PTIN | P00666837 | PTIN |
| Phone | 3128560200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | 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 | $7,460,299 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1960 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | The trust was created for the exclusive purpose of providing long term disability benefits to eligible employees under the blue cross & blue shield national ltd program. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,029,581 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,940,769 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,015,740 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,519,530 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $8,045,321 | PYTotalRevenueAmt |
| CY Total Revenue | $7,460,299 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $11,448,535 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $15,510,347 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,613 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,590 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,451,761 | PYOtherExpensesAmt |
| CY Other Expenses | $1,180,121 | CYOtherExpensesAmt |
| PY Total Expenses | $12,945,909 | PYTotalExpensesAmt |
| CY Total Expenses | $16,734,058 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,900,588 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$9,273,759 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $64,142,500 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,325,749 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,699,305 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $195,648 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $62,443,195 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $51,130,101 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The trust was created for the exclusive purpose of providing long term disability benefits to eligible employees under the blue cross and blue shield association national long term disability program. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | provided long term disability benefits to eligible employees under the blue cross and Blue shield association national long term disability program. Total benefits paid to (or for the benefit of) eligible employees during the 2015 plan year were $15,510,347. | 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 | false | 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 | Yes (true) | 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 | false | UnrelatedBusIncmOverLimitInd |
| 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 | 12 | 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 | PersonNm |
| Phone | 3122976000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | VP NEBA 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 | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Michael Gold | ||||||||
| Committee member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Andrew C Corbin | ||||||||
| Committee member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| John F Giblin | ||||||||
| Vice Chairman | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Mark P Stimpson | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Karen M Abraham | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Michael Mizeur | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Peter Andruszkiewicz | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Rick Schum | ||||||||
| Chairman | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Chuck Divita | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Don George | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Tim Huckle | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Robert J Kolodgy | ||||||||
| Committee Member | 0.1 | 0.0 | Yes (X) | $0 | $758,142 | $50,142 | ||
| The Northern Trust Company | ||||||||
| Trustee | 40.0 | 0.0 | $45,000 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $45,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $758,142 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $50,142 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Willis Towers Watson | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 71 S Wacker Dr | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Actuarial | ServicesDesc |
| Compensation | $212,421 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | $4,913,616 | $4,913,616 |
| EMPLOYEE CONTRIBUTIONS | 900099 | $27,153 | $27,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,940,769 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,519,530 | TotalRevenueColumnAmt |
| Exclusion | $2,519,530 | 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 |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 | $7,460,299 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,940,769 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,519,530 | 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 | $15,510,347 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,590 | 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 | $98,544 | 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 | $18,563 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,605 | 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 | ADMINISTRATIVE FEES | Desc |
| Total | $636,409 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,734,058 | 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 | $1,523,153 | BOYAmt |
| EOY | $1,310,879 | 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 |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,708,496 | BOYAmt |
| EOY | $49,826,219 | 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 | $1,910,851 | BOYAmt |
| EOY | $188,651 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,142,500 | BOYAmt |
| EOY | $51,325,749 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,305 | BOYAmt |
| EOY | $195,648 | 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 | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,305 | BOYAmt |
| EOY | $195,648 | 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 | $62,443,195 | BOYAmt |
| EOY | $51,130,101 | 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 | $62,443,195 | BOYAmt |
| EOY | $51,130,101 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,142,500 | BOYAmt |
| EOY | $51,325,749 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$9,273,759 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,039,335 | NetUnrlzdGainsLossesInvstAmt |
| 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 |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,420,964 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,039,335 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$2,039,335 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,460,299 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,460,299 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,734,058 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $16,734,058 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $16,734,058 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | FIN 48 DISCLOSURE The Trust established under the Program to hold the Program assets is qualified pursuant to Section 501(c)(9) of the Internal Revenue Code (the Code) and, accordingly, the Trusts net investment income is exempt from income taxes, within certain limits. The Trust has received a favorable tax determination letter dated March 8, 1983 from the Internal Revenue Service (the IRS) indicating that the Program, as then designed, was in compliance with the requirements of Section 501(c)(9) of the Code. The Program administrator believes that the Trust, as amended, is designed and is currently being operated in compliance with the applicable requirements of the Code. Therefore, no provision for income taxes has been included in the Programs financial statements. Accounting principles generally accepted in the United States of America require Program management to evaluate tax positions taken by the Program and recognize a tax liability (or asset) if the Program has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Program administrator has analyzed the tax positions taken by the Program and has concluded that as of December 31, 2015, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Program is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 | $470,779 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $260,000 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $27,363 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $18,000 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $32,142 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $808,284 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BCBSA EMPLOYER OF 28C PERSONS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BUSINESS RELATIONSHIP | RelationshipDescriptionTxt |
| Transaction | $630,036 | TransactionAmt |
| Transaction | REIMBURSES FOR SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 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 the 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 review process | Form 990, part vi, section b, line 11B Form 990's content and sources 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. BCBSAs chief employee benefits counsel also provides the committee with an Annual Assessment of the organization's and the committees legal compliance, including compliance with ERISA. As employees of various blue plans, each committee member 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD ASSOCIATION | ||||||||||
| 225 NORTH MICHIGAN AVENUE | CHICAGO | IL | 60601 | 135656874 | Membership | IL | 501(C)(4) | N/A | NA | false |
| Blue Care of Michigan Inc | ||||||||||
| 20500 CIVIC Center Drive | Southfield | MI | 48076 | 382536979 | CONTRIB.ER | MI | 501(c)(4) | N/a | BCBS of Mich | false |
| BCN of Michigan Inc | ||||||||||
| 20500 CIVIC Center Drive | Southfield | MI | 48076 | 382359234 | CONTRIB.ER | MI | 501(c)(4) | N/a | BCBS of Mich | false |
| BC&BS of Michigan foundation | ||||||||||
| 600 E Lafayette Blvd | Detroit | MI | 48226 | 382338506 | CONTRIB.ER | MI | 501(c)(3) | 11-I | BCBS of Mich | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| NORIDIAN ADMIN SVCS | |||||||
| 901 40TH ST | S FARGO | ND | 58103 | 450173185 | CONTRIB.ER | ND | NORIDIAN MUTUAL |
| HEALTH INTELLIGENCE | |||||||
| 225 N MICHIGAN AVE | Chicago | IL | 60601 | 274269034 | CONTRIB.ER | DE | NA |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (34 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 |
|---|---|---|---|---|---|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF FLORIDA INC | |||||||||
| 4800 DEERWOOD CAMPUS PARKWAY | JACKSONVILLE | FL | 32246 | 592015694 | CONTRIB.ER | FL | NA | C CORP | false |
| BLUE CROSS OF IDAHO HEALTH SERVICE INC | |||||||||
| 3000 E PINE AVENUE | MERIDIAN | ID | 836425995 | 820344294 | CONTRIB.ER | ID | NA | C CORP | false |
| BLUE CROSS & BLUE SHIELD OF KANSAS INC | |||||||||
| 1133 TOPEKA BLVD | TOPEKA | KS | 66629 | 480952857 | CONTRIB.ER | KS | NA | C CORP | false |
| LOUISIANA HEALTH SRV & INDEMNITY CO INC | |||||||||
| 5525 REITZ AVENUE | BATON ROUGE | LA | 70809 | 237384555 | CONTRIB.ER | LA | NA | C CORP | false |
| BLUE CROSS AND BLUE SHIELD OF MICHIGAN | |||||||||
| 600 LAFAYETTE | EAST DETROIT | MI | 482262998 | 382069753 | CONTRIB.ER | MI | NA | C CORP | false |
| BLUE CROSS & BLUE SHIELD OF MISSISSIPPI | |||||||||
| 3545 LAKELAND DRIVE | EAST FLOWOOD | MS | 39232 | 640295748 | CONTRIB.ER | MS | NA | C CORP | false |
| BLUE CROSS & BLUE SHIELD OF KANSAS CITY | |||||||||
| 2301 MAIN STREET | KANSAS CITY | MO | 64108 | 431257251 | CONTRIB.ER | MO | NA | C CORP | false |
| EXCELLUS HEALTH PLAN INC | |||||||||
| 165 COURT STREET | ROCHESTER | NY | 14647 | 150329043 | CONTRIB.ER | NY | NA | C CORP | false |
| NORIDIAN MUTUAL INSURANCE COMPANY | |||||||||
| 4510 13TH AVENUE | SW FARGO | ND | 581210001 | 450173185 | INSURANCE | ND | NA | C CORP | false |
| CORELINK ADMINISTRATIVE SOLUTIONS LLC | |||||||||
| 4510 13TH AVE SW | FARGO | ND | 58121 | 263655982 | CONTRIB.ER | ND | NA | C CORP | false |
| BLUE CROSS & BLUE SHIELD OF RHODE ISLAND | |||||||||
| 500 EXCHANGE | STREET PROVIDENCE | RI | 02903 | 050158952 | CONTRIB.ER | RI | NA | C CORP | false |
| BLUE CROSS AND BLUE SHIELD OF VERMONT | |||||||||
| 445 INDUSTRIAL LANE | BERLIN | VT | 05602 | 030277307 | CONTRIB.ER | VT | NA | C CORP | false |
| BLUE CROSS AND BLUE SHIELD OF WYOMING | |||||||||
| 4000 HOUSE AVENUE | CHEYENNE | WY | 82001 | 830231011 | CONTRIB.ER | WY | NA | C CORP | false |
| TRIPLE-S MANAGEMENT CORP | |||||||||
| 660555678 | CONTRIB.ER | NA | C CORP | false | |||||
| BCS FINANCIAL CORPORATION | |||||||||
| 2 MID-AMERICA PLAZA SUITE 200 | OAKBROOK TERRACE | DE | 60181 | 364247278 | CONTRIB.ER | DE | NA | C CORP | false |
| ACCIDENT FUND INSURANCE CO OF AMERICA | |||||||||
| 232 S CAPITOL AVENUE | LANSING | MI | 489017990 | 383207001 | CONTRIB.ER | MI | NA | C CORP | false |
| UNITED WISCONSIN INSURANCE COMPANY | |||||||||
| 200 N GRAND AVE PO BOX 40790 | LANSING | MI | 48901 | 390941450 | CONTRIB.ER | WI | NA | C CORP | false |
| FIRST COAST SERVICE OPTIONS INC | |||||||||
| 532 RIVERSIDE AVENUE | JACKSONVILLE | FL | 32202 | 593514335 | CONTRIB.ER | FL | DIVERSIFIED SER | C CORP | false |
| INCEPTURE INC | |||||||||
| 5011 GATE PARKWAY | JACKSONVILLE | FL | 32256 | 593720231 | CONTRIB.ER | FL | BCBS OF FLORIDA | C CORP | false |
| NOVITAS SOLUTIONS INC | |||||||||
| 2020 TECHNOLOGY PARKWAY STE 101 | MECHANICSBURG | PA | 17050 | 205296137 | CONTRIB.ER | PA | DIVERSIFIED SER | C CORP | false |
| LIFESECURE INSURANCE COMPANY | |||||||||
| 10559 CITATION DRIVE | BRIGHTON | MI | 48116 | 750956156 | CONTRIB.ER | MI | BCBS OF MI | C CORP | false |
| BLUEBONNET LIFE INSURANCE COMPANY INC | |||||||||
| 3475 LAKELAND DRIVE EAST | FLOWOOD | MS | 39232 | 721008243 | CONTRIB.ER | MS | BCBS OF MS | C CORP | false |
| ADVANCED HEALTH SYSTEMS INC | |||||||||
| 3545 LAKELAND DRIVE | EAST FLOWOOD | MS | 39232 | 640703343 | CONTRIB.ER | MS | BCBS OF MS | C CORP | false |
| EXCELLUS INSURANCE AGENCY INC | |||||||||
| 165 COURT STREET | ROCHESTER | NY | 14647 | 161588653 | CONTRIB.ER | NY | EXCELLUS HEALTH | C CORP | false |
| UNIVERA HEALTHCARE | |||||||||
| 205 PARK CLUB LANE | BUFFALO | NY | 14221 | 150329043 | CONTRIB.ER | NY | EXCELLUS HEALTH | C CORP | false |
| MEDAMERICA INSURANCE COMPANY OF NEW YORK | |||||||||
| 165 COURT STREET | ROCHESTER | NY | 14647 | 161310986 | CONTRIB.ER | NY | EXCELLUS HEALTH | C CORP | false |
| HEALTH AND WELLNESS INSTITUTE LLC | |||||||||
| 291 PROMENADE ST | PROVIDENCE | RI | 02908 | 204336322 | CONTRIB.ER | RI | BCBS OF Ri | C CORP | false |
| TRIPLE-S PROPIEDAD INC | |||||||||
| 15010 FD ROOSEVELT AVE | GUAYNABO | PR | 00968 | 660437064 | CONTRIB.ER | PR | TRIPLE-S mgmt | C CORP | false |
| INTERACTIVE SYSTEMS INC | |||||||||
| 1441 FD ROOSEVELT AVE 00920 | CAPARRA RQ | PR | 00920 | 660482092 | CONTRIB.ER | PR | TRIPLE-S MGMT | C CORP | false |
| TRiple-S INSURANCE AGENCY | |||||||||
| 1510 FD ROOSEVELT AVENUE | GUAYNABO | PR | 00968 | 660286587 | CONTRIB.ER | PR | TRIPLE-S mgmt | C CORP | false |
| TRIPLE-S SALUD INC | |||||||||
| 1441 FD ROOSEVELT AVENUE | CAPARRA | PR | 00920 | 660555677 | CONTRIB.ER | PR | TRIPLE-S mgmt | C CORP | false |
| DIVERSIFIED SERVICE OPTIONS INC | |||||||||
| 532 RIVERSIDE AVENUE | T JACKSONVILLE | FL | 32202 | 593514333 | CONTRIB.ER | FL | NA | C CORP | false |
| COMP WEST INSURANCE COMPANY | |||||||||
| 200 N GRAND AVE PO BOX 40790 | LANSING | MI | 48901 | 201117107 | CONTRIB.ER | CA | NA | C CORP | false |
| THIRD COAST UNDERWRITERS | |||||||||
| 200 N GRAND AVE PO BOX 40790 | LANSING | MI | 48901 | 383207001 | CONTRIB.ER | MI | NA | 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 |