2012-11-16T10:31:17-06:00 2011-12-31 BDO USA LLP 330 N Wabash Suite 3200 CHICAGO IL 60611 990 2011-01-01 510245316 Blue Cross & Blue Shield Associatn National Long Term Disability Trust % EXECUTIVE DIRECTOR BLUE 3124445670 225 North Michigan Avenue Chicago IL 60601 david manuszak 2012-11-07 true Rebekuh Eley 3128569100 2011 2016-02-24 21:20:13Z DAVID MANUSZAK 225 NORTH MICHIGAN AVE CHICAGO IL 60601 13047394 false X N/A X 1960 IL 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. 12 12 0 0 0 0 0 5179385 5558497 2562684 2177794 0 0 7742069 7736291 0 0 9625501 10012978 43211 43577 0 0 0 1574305 1469815 11243017 11526370 -3500948 -3790079 68879325 65109364 298652 306351 68580673 64803013 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. false false 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. false false false false false false false false false false false false false false true true false false false false false false false false false false false false false false false false false false true false false false false false true false false false true X 0 0 0 false false false false false false X 12 12 true false false false false false false true true false false false true true true true true false false false X EXECUTIVE DIRECTOR 3122976000 225 NORTH MICHIGAN AVE CHICAGO IL 60601 X Tim J Crilly 0.1 X Robert A Leichtle 0.1 X Robert P Hiam 0.1 X Michael Frank 0.1 X PAUL VON EBERS 0.1 X Scott P Serota 0.1 X R Chris Doerr 0.1 X David Southwell 0.1 X ANDREW C CORBIN 0.1 X JOHN F GIBLIN 0.1 X MICHAEL REITZ 0.1 X MARK P STIMPSON 0.1 X THE NORTHERN TRUST COMPANY 40.0 X 43577 0 0 43577 0 0 0 false false false 0 0 EMPLOYER CONTRIBUTIONS 900099 5530398 5530398 EMPLOYEE CONTRIBUTIONS 900099 28099 28099 5558497 1988897 1988897 0 0 5500000 5311103 188897 188897 188897 0 0 0 0 7736291 5558497 2177794 0 0 0 10012978 43577 0 0 0 0 0 0 0 42177 0 0 16168 0 0 0 0 0 0 0 0 0 0 0 0 0 ADMINISTRATIVE FEES 817421 MEDICAL CONSULTANTS 388633 ACTURARIAL SERVICES 205416 11526370 0 0 1067897 1628857 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67558297 63147115 0 0 0 0 0 0 253131 333392 68879325 65109364 298652 306351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298652 306351 X 68580673 64803013 0 0 0 0 68580673 64803013 68879325 65109364 X -3790079 12419 X false true true X false 0 0 7736291 11526370 -3790079 12419 12419 -3777660 7748710 12419 12419 7736291 7736291 11526370 11526370 11526370 FIN 48 STATEMENT 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. BCBSA EMPLOYER OF 28C PERSONS BUSINESS RELATIONSHIP REIMBURSES FOR SERVICES false 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 Changes in net assets or fund balances Unrealized Gains - $12,419 Blue Cross Blue Shield Association 225 North Michigan Ave Chicago IL 60601 135656874 Contrib.ER IL 501(c)(4) N/A NA false 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 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 15010 FD Roosevelt Ave Triple-S Guaynabo RQ 00968 660437064 Contrib.ER PR Triple-S Manage C Corp Intereactive Systems Inc 1441 FD Roosevelt Ave Triple-S Bl Caparra RQ 00920 660482092 Contrib.ER PR Triple-S Manag C Corp Signature Insurance Agency 1510 FD Roosevelt Avenure Triple GUAYNABO RQ 00968 660286587 Contrib.ER PR Triple-S Manag C Corp Triple-S Inc 1441 FD Roosevelt Avenue Caparra RQ 00920 660555677 Contrib.ER PR Triple-S Manag C Corp 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 true