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BLUE CROSS BLUE SHIELD ASSOC RETIRE BENEFIT TRUST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLUE CROSS BLUE SHIELD ASSOC RETIRE BENEFIT TRUST (EIN 36-4018700)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-07
IRS object ID
201343119349302034
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-11-07T17:03:20-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1330 N Wabash Suite 3200AddressLine1
CityCHICAGOCity
StateILState
ZIP Code60611ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN364018700EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Blue Cross Blue Shield Assoc RetireBusinessNameLine1
Business Name Line2Benefits TrustBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% NEBA EXECUTIVE DIRECTORInCareOfName
Name ControlBLUENameControl
Phone3124445670Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 North Michigan AvenueAddressLine1
Address Line2SuiteAddressLine2
CityChicagoCity
StateILState
ZIP Code60601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTerrence J CooneyName
TitleOfficerTitle
Phone3128219100Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRebekuh EleyName
Phone3128569100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTerrence J CooneyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1225 North Michigan AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code60601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4632765GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1994YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTHE TRUST WAS CREATED FOR THE EXCLUSIVE PURPOSE OF PROVIDING POST- RETIREMENT HEALTH CARE & LIFE INSURANCE BENEFITS TO ELIGIBLE retirees & THEIR DEPENDENTS UNDER BCBSA benefit programs.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4039482ProgramServiceRevenuePriorYear
Program Service Revenue CY1646256ProgramServiceRevenueCY
Investment Income Prior Year1854353InvestmentIncomePriorYear
Investment Income Current Year1639036InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5893835TotalRevenuePriorYear
Total Revenue Current Year3285292TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year1029774BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY1021368BenefitsPaidToMembersCY
Salaries Etc Prior Year27030SalariesEtcPriorYear
Salaries Etc Current Year45069SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7625OtherExpensePriorYear
Other Expenses Current Year15718OtherExpensesCurrentYear
Total Expenses Prior Year1064429TotalExpensesPriorYear
Total Expenses Current Year1082155TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4829406RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2203137RevenuesLessExpensesCY
Total Assets BOY42171710TotalAssetsBOY
Total Assets EOY48225862TotalAssetsEOY
Total Liabilities BOY1123575TotalLiabilitiesBOY
Total Liabilities EOY2376259TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY41048135NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY45849603NetAssetsOrFundBalancesEOY
Mission DescriptionTHE TRUST WAS CREATED FOR THE EXCLUSIVE PURPOSE OF PROVIDING POST-RETIREMENT HEALTH CARE AND LIFE INSURANCE BENEFITS TO ELIGIBLE RETIREES AND THEIR DEPENDENTS UNDER BLUE CROSS & BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAMS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
DescriptionPROVIDED POST-RETIREMENT HEALTH CARE AND LIFE INSURANCE BENEFITS TO ELIGIBLE RETIREES AND THEIR DEPENDENTS UNDER BLUE CROSS & BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAMS. TOTAL BENEFITS PAID TO (OR FOR THE BENEFIT OF) PARTICIPANTS AND THEIR DEPENDENTS DURING YEAR WERE $1,021,368Description
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonNEBA EXECUTIVE DIRECTORNamePerson
Telephone Number3122976000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1225 NORTH MICHIGAN AVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60601ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInstitutional TrusteeInstitutionalTrusteeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Karen M Abraham
committee member0.1X
Michael Mizeur
committee member0.1X
Robert P Hiam
committee member0.1X
Andrew C Corbin
Committee Member0.1X
Michael Frank
Vice-Chairman0.1X
Peter Andruszkiewicz
Committee Member0.1X
Scott P Serota
committee member0.1X
R Chris Doerr
committee member0.1X
Rick Schum
committee member0.1X
John F Giblin
committee member0.1X
Mark P Stimpson
committee member0.1X
Paul von Ebers
Chairman0.1X
THE NORTHERN TRUST
TRUSTEE40.0X4506900
FieldValueIRS element (for citing)
Total Reportable Comp From Org45069TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionEMPLOYER CONTRIB.Description
Total Revenue Column1646256TotalRevenueColumn
Related Or Exempt Function Income1646256RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1646256TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1126930TotalRevenueColumn
Exclusion$1,126,930ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1859579Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1347473Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities512106Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column512106TotalRevenueColumn
Exclusion$512,106ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3285292TotalRevenueColumn
Related Or Exempt Function Income1646256RelatedOrExemptFunctionIncome
Exclusion$1,639,036ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total1021368Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total45069Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4214Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total11504Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1082155Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY130364BOY
EOY1718629EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY41947527BOY
EOY46402291EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY93819BOY
EOY104942EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42171710BOY
EOY48225862EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY93801BOY
EOY1354891EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1029774BOY
EOY1021368EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1123575BOY
EOY2376259EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY41048135BOY
EOY45849603EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41048135BOY
EOY45849603EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42171710BOY
EOY48225862EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2203137ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2598331ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO SPONSOR PREMIUM REIMBURSEMENTDescription
Amount$1,021,368Amount
FieldValueIRS element (for citing)
Total Of Amounts1021368TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10 (FORMERLY FIN 48)Identifier
ExplanationAccounting principles generally accepted in the United States of America require trust management to evaluate tax positions taken by the Trust and recognize a tax liability (or asset) if the organization has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Trust Administrator has analyzed the tax positions taken by the Trust, and has concluded that as of December 31, 2012 and 2011, 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 Trust is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanation
part vi, section a, line 2certain 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.
part vi, section b, line 11BForm 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 consolidated audited financial statements of the blue cross and blue shield health and life program were presented to the Committee that serves as the governing body by the independent auditors.
part vi, section b, 12cBCBSA 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 hot-line 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 the Committee's 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.
part vi, SECTION b, line 15 a and bthe organization does not require compensation policies as it does not compensate any officers, management officials or key employees.
part vi, section c, line 19The governing documents and Form 990 are made available upon request to the Executive Director, National Employee Benefits Administration, Blue Cross and Blue Shield Association, 225 N. Michigan Avenue, Chicago, IL 60601.
part vii, section awith the exception of the institutional trustee, all listed are members of an independent committee that supervises the trust.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Blue Cross Blue Shield AssociationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1225 North Michigan AveAddressLine1
CityChicagoCity
StateILState
ZIP Code60601ZIPCode
FieldValueIRS element (for citing)
EIN135656874EIN
Primary ActivitiesContrib.ERPrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section501(C)(4)ExemptCodeSection
Public Charity StatusN/APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Sharing Of Paid EmployeestrueSharingOfPaidEmployees