BLUE CROSS & BLUE SHIELD ASSOCIATN NATIONAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BLUE CROSS & BLUE SHIELD ASSOCIATN NATIONAL (EIN 51-0245316)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-16
- IRS object ID
- 201203219349300530
- Schema version
- 2011v1.3
- 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) |
|---|---|---|
| Timestamp | 2012-11-16T10:31:17-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 N Wabash Suite 3200 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60611 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510245316 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue Cross & Blue Shield Associatn National | BusinessNameLine1 |
| Business Name Line2 | Long Term Disability Trust | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % EXECUTIVE DIRECTOR | InCareOfName |
| Name Control | BLUE | NameControl |
| Phone | 3124445670 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 North Michigan Avenue | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | david manuszak | Name |
| Title | OFFICER | Title |
| Date Signed | 2012-11-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rebekuh Eley | Name |
| Phone | 3128569100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID MANUSZAK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH MICHIGAN AVE | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 13047394 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1960 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5179385 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5558497 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2562684 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2177794 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7742069 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7736291 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 9625501 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 10012978 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 43211 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 43577 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1574305 | OtherExpensePriorYear |
| Other Expenses Current Year | 1469815 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11243017 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11526370 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3500948 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3790079 | RevenuesLessExpensesCY |
| Total Assets BOY | 68879325 | TotalAssetsBOY |
| Total Assets EOY | 65109364 | TotalAssetsEOY |
| Total Liabilities BOY | 298652 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 306351 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 68580673 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 64803013 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE TRUST WAS CREATED FOR THE EXCLUSIVE PURPOSE OF PROVIDING LONG TERM DISABILITY BENEFTIS TO ELIGIBLE EMPLOYEES UNDER THE BLUE CROSS AND BLUE SHIELD ASSOCIATION NATIONAL LONG TERM DISABILITY PROGRAM. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | 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 2011 PLAN YEAR WERE $10,012,978. | Description |
| Described In501 C3 | false | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | EXECUTIVE DIRECTOR | NamePerson |
| Telephone Number | 3122976000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH MICHIGAN AVE | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Institutional TrusteeInstitutionalTrustee | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Tim J Crilly | ||||||
| committee member | 0.1 | X | ||||
| Robert A Leichtle | ||||||
| committee member | 0.1 | X | ||||
| Robert P Hiam | ||||||
| COMMITTEE MEMBER | 0.1 | X | ||||
| Michael Frank | ||||||
| committee member | 0.1 | X | ||||
| PAUL VON EBERS | ||||||
| Vice-Chairman | 0.1 | X | ||||
| Scott P Serota | ||||||
| COMMITTEE MEMBER | 0.1 | X | ||||
| R Chris Doerr | ||||||
| COMMITTEE MEMBER | 0.1 | X | ||||
| David Southwell | ||||||
| Committee Member | 0.1 | X | ||||
| ANDREW C CORBIN | ||||||
| committee member | 0.1 | X | ||||
| JOHN F GIBLIN | ||||||
| COMMITTEE MEMBER | 0.1 | X | ||||
| MICHAEL REITZ | ||||||
| Chairman | 0.1 | X | ||||
| MARK P STIMPSON | ||||||
| COMMITTEE MEMBER | 0.1 | X | ||||
| THE NORTHERN TRUST COMPANY | ||||||
| TRUSTEE | 40.0 | X | 43577 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 43577 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | 5530398 | 5530398 |
| EMPLOYEE CONTRIBUTIONS | 900099 | 28099 | 28099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5558497 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1988897 | TotalRevenueColumn |
| Exclusion | $1,988,897 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5500000 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5311103 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 188897 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188897 | TotalRevenueColumn |
| Exclusion | $188,897 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7736291 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5558497 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,177,794 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10012978 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43577 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42177 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16168 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal |
|---|---|
| ADMINISTRATIVE FEES | 817421 |
| MEDICAL CONSULTANTS | 388633 |
| ACTURARIAL SERVICES | 205416 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11526370 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1067897 | BOY |
| EOY | 1628857 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67558297 | BOY |
| EOY | 63147115 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 253131 | BOY |
| EOY | 333392 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68879325 | BOY |
| EOY | 65109364 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298652 | BOY |
| EOY | 306351 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298652 | BOY |
| EOY | 306351 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68580673 | BOY |
| EOY | 64803013 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68580673 | BOY |
| EOY | 64803013 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68879325 | BOY |
| EOY | 65109364 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3790079 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 12419 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements | |
| Equipment | Equipment | |
| Other Land Buildings | OtherLandBuildings | |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Total Revenue | 7736291 | TotalRevenue |
| Total Expenses | 11526370 | TotalExpenses |
| Excess Or Deficit For Year | -3790079 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 12419 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 12419 | TotalAdjustments |
| Excess Or Deficit Per FS | -3777660 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7748710 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 12419 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 12419 | RevenueNotRptdF990 |
| Revenue Subtotal | 7736291 | RevenueSubtotal |
| Total Revenue Per Form990 | 7736291 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11526370 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 11526370 | ExpensesSubtotal |
| Total Expenses Per Form990 | 11526370 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 STATEMENT | Identifier |
| Explanation | 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, 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 Program is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Program administrator believes it is no longer subject to income tax examinations for years prior to 2008. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BCBSA EMPLOYER OF 28C PERSONS | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BUSINESS RELATIONSHIP | Relationship |
| Description Of Transaction | REIMBURSES FOR SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| part v, line 3b | the organization does not have any unrelated business income. | |
| PART VI, 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. | |
| part vi, line 11 | form 990's consent 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 were presented to the committee that serves as the governing body by the independent auditors. | |
| PART VI, SECTION B, 12C | 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 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, LINE 15A AND B | THE ORGANIZATION DOES NOT REQUIRE COMPENSATION POLICIES AS IT DOES NOT COMPENSATE ANY OFFICERS, MANAGEMENT OFFICIALS OR KEY EMPLOYEES. | |
| PART VI, LINE 19 | The 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 A | WITH THE EXCEPTION OF THE INSTITUTIONAL TRUSTEE, ALL LISTED ARE MEMBERS OF AN INDEPENDENT COMMITTEE THAT SUPERVISES THE TRUST. | |
| Part XI, Line 5 | Unrealized Gains - $12,419 | Changes in net assets or fund balances |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue Cross Blue Shield Association | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 North Michigan Ave | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135656874 | EIN |
| Primary Activities | Contrib.ER | PrimaryActivities |
| Legal Domicile State | IL | LegalDomicileState |
| Exempt Code Section | 501(c)(4) | ExemptCodeSection |
| Public Charity Status | N/A | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType |
|---|---|---|---|---|---|---|---|---|
| NORIDIAN ADMINISTRATIVE SERVICES LLC | ||||||||
| 901 40TH ST S | FARGO | ND | 58103 | 450173185 | CONTRIB.ER | ND | NORIDIAN MUTUAL | N/A |
| HEALTH INTELLIGENCE COMPANY LLC | ||||||||
| 225 N MICHIGAN AVENUE | CHICAGO | IL | 60601 | 274269034 | CONTRIB.ER | DE | NA | N/A |
| HEALTHCARE ADMINISTRATION ASSOCIATION OF | ||||||||
| 4510 13TH AVE SW | FARGO | ND | 58121 | 270515523 | CONTRIB.ER | ND | NA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (41 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Cross & Blue Shield of Florida Inc | ||||||||||||
| 4800 Deerwood Campus Parkway | Jacksonville | FL | 32246 | 592015694 | Contrib.ER | FL | NA | C Corp | ||||
| Blue Cross of Idaho Health Service Inc | ||||||||||||
| 3000 E Pine Avenue | Meridian | ID | 836425995 | 820344294 | Contrib.ER | ID | NA | C Corp | ||||
| Blue Cross & Blue Shield of Kansas Inc | ||||||||||||
| 1133 Topeka Blvd | Topeka | KS | 66629 | 480952857 | Contrib.ER | KS | NA | C Corp | ||||
| Louisiana Health Srv & Indemnity Co Inc | ||||||||||||
| 5525 Reitz Avenue | Baton Rouge | LA | 70809 | 237384555 | Contrib.ER | LA | NA | C Corp | ||||
| Blue Cross and Blue Shield of Michigan | ||||||||||||
| 600 Lafayette East | Detroit | MI | 482262998 | 382069753 | Contrib.ER | MI | na | c corp | ||||
| Blue Cross & Blue Shield of Mississippi | ||||||||||||
| 3545 Lakeland Drive East | FLOWOOD | MS | 39232 | 640295748 | Contrib.ER | MS | na | c corp | ||||
| Blue Cross & Blue Shield of Kansas City | ||||||||||||
| 2301 Main Street | Kansas City | MO | 64108 | 431257251 | Contrib.ER | MO | na | c corp | ||||
| Excellus Health Plan Inc | ||||||||||||
| 165 Court Street | Rochester | NY | 14647 | 150329043 | Contrib.ER | NY | na | c corp | ||||
| Blue Cross & Blue Shield of Montana Inc | ||||||||||||
| 560 North Park Avenue | Helena | MT | 59601 | 810216685 | Contrib.ER | MT | na | c corp | ||||
| Noridian Mutual Insurance Company | ||||||||||||
| 4510 13th Avenue SW | Fargo | ND | 581210001 | 450173185 | Contrib.ER | ND | na | c corp | ||||
| CoreLink Administrative Solutions LLC | ||||||||||||
| 4510 13th Ave SW | Fargo | ND | 58121 | 263655982 | Contrib.ER | ND | na | c corp | ||||
| Blue Cross & Blue Shield of Rhode Island | ||||||||||||
| 500 exchange street | Providence | RI | 02903 | 050158952 | Contrib.ER | RI | na | c corp | ||||
| Blue Cross and Blue Shield of Vermont | ||||||||||||
| 445 Industrial Lane | Berlin | VT | 05602 | 030277307 | Contrib.ER | VT | na | c corp | ||||
| Highmark West Virginia Inc | ||||||||||||
| 614 Market Street | Parkersburg | WV | 26101 | 550624615 | Contrib.ER | WV | na | c corp | ||||
| Blue Cross and Blue Shield of Wyoming | ||||||||||||
| 4000 House Avenue | Cheyenne | WY | 82001 | 830231011 | Contrib.ER | WY | na | c corp | ||||
| Triple-S Management Corp | ||||||||||||
| 1441 FD Roosevelt Avenue | Caparra | PR | 00920 | 660555678 | Contrib.ER | PR | na | c corp | ||||
| BCS Financial Corporation | ||||||||||||
| 2 Mid-America Plaza Suite 200 | Oakbrook Terrace | IL | 601814712 | 364247278 | Contrib.ER | DE | na | c corp | ||||
| Blue Cross and Blue Shield Association | ||||||||||||
| 225 North Michigan Avenue | Chicago | IL | 60601 | 135656874 | Contrib.ER | IL | na | c corp | ||||
| Accident Fund Insurance Comp of America | ||||||||||||
| 232 S Capitol Avenue | Lansing | MI | 489017990 | 383207001 | Contrib.ER | MI | na | c corp | ||||
| United Wisconsin Insurance Company | ||||||||||||
| 232 S Capitol Avenue | Lansing | MI | 48901 | 390941450 | Contrib.ER | WI | na | c corp | ||||
| First Coast Service Options Inc | ||||||||||||
| 532 Riverside Avenue | Jacksonville FL | FL | 32202 | 593514335 | Contrib.ER | FL | BCBS of Florida | C Corp | ||||
| Incepture Inc | ||||||||||||
| 5011 Gate Parkway | Jacksonville | FL | 32256 | 593720231 | Contrib.ER | FL | BCBS of Florida | C Corp | ||||
| Comp Options Insurance Co Inc | ||||||||||||
| 4800 Deerwood Campus Parkway | Jacksonville | FL | 322466498 | 593433503 | Contrib.ER | FL | BCBS of Florida | C Corp | ||||
| C2C Solutions Inc | ||||||||||||
| 532 Riverside Drvie 6 Tower | Jacksonville | FL | 32022 | 412235948 | Contrib.ER | FL | BCBS of Florida | C Corp | ||||
| Blue Care of Michigan Inc | ||||||||||||
| 20500 Civic Center Drive | Southfield | MI | 48076 | 382536979 | Contrib.ER | MI | BCBS of Michiga | 501(C)(4) | ||||
| Blue Cross and Blue Shield of Michigan | ||||||||||||
| 600 E Lafayette Blvd | Detroit | MI | 48226 | 382338506 | Contrib.ER | MI | BCBS of Michiga | 501(C)(3) | ||||
| BCN of Michigan Inc | ||||||||||||
| 20500 Civic Center Drive | Southfield | MI | 48076 | 382359234 | Contrib.ER | MI | BCBS of Michiga | 501(C)(4) | ||||
| Lifesecure Insurance Company | ||||||||||||
| 10559 Citation Drive | Brighton | MI | 48116 | 750956156 | contrib.er | MI | BCBS of Michiga | C Corp | ||||
| BlueBonnet Life Insurance Company Inc | ||||||||||||
| 3475 Lakeland Drive East | Flowood | MS | 39232 | 721008243 | Contrib.ER | MS | BCBS of Mississ | C Corp | ||||
| Advanced Health Systems Inc | ||||||||||||
| 3545 lakeland Drive East | flowood | MS | 39232 | 640703343 | contrib.er | MS | BCBS of Mississ | C Corp | ||||
| Excellus Insurance Agency Inc | ||||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161588653 | Contrib.ER | NY | Excellus Health | C Corp | ||||
| Univera Healthcare | ||||||||||||
| 205 Park Club Lane | Buffalo | NY | 14221 | 150329043 | Contrib.ER | NY | Excellus Health | C Corp | ||||
| MedAmerica Insurance Company of New York | ||||||||||||
| 165 Court Street | Rochester | NY | 14647 | 161310986 | Contrib.ER | NY | Excellus Health | C Corp | ||||
| Health and Wellness Institute LLC | ||||||||||||
| 291 Promenade St | Providence | RI | 02908 | 204336322 | Contrib.ER | RI | BCBS of Rhode I | C Corp | ||||
| Parker Benefits Inc | ||||||||||||
| 614 Market Street | Pakersburg | WV | 26101 | 550625743 | Contrib.ER | WV | Highmark West | C Corp | ||||
| Seguros Triple-S Inc | ||||||||||||
| 660437064 | Contrib.ER | PR | Triple-S Manage | C Corp | 15010 FD Roosevelt Ave Triple-S | Guaynabo | RQ | 00968 | ||||
| Intereactive Systems Inc | ||||||||||||
| 660482092 | Contrib.ER | PR | Triple-S Manag | C Corp | 1441 FD Roosevelt Ave Triple-S Bl | Caparra | RQ | 00920 | ||||
| Signature Insurance Agency | ||||||||||||
| 660286587 | Contrib.ER | PR | Triple-S Manag | C Corp | 1510 FD Roosevelt Avenure Triple | GUAYNABO | RQ | 00968 | ||||
| Triple-S Inc | ||||||||||||
| 660555677 | Contrib.ER | PR | Triple-S Manag | C Corp | 1441 FD Roosevelt Avenue | Caparra | RQ | 00920 | ||||
| Blue Cross and Blue Shield Foundation on | ||||||||||||
| 225 N Michigan Avenue | Chicago | IL | 60601 | 237164980 | Contrib.ER | IL | BCBS Associatio | C Corp | ||||
| Health E-Web Inc | ||||||||||||
| 2525 Colonial Dr STE A | Helena | MT | 59601 | 810525733 | Contrib.er | MT | BCBS of Montana | C Corp | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |