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Nonprofiteer
← BLUE CROSS BLUE SHIELD ASSOC RETIRE BENEFIT TRUST

Form 990 for tax year 2022

Filed by BLUE CROSS BLUE SHIELD ASSOC RETIRE BENEFIT TRUST.

Totals

Total revenue
$7,122,339
Total expenses
$2,591,707
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$7,122,339
Other revenue
$0
Total assets, end of year
$89,188,249
Total liabilities, end of year
$2,692,192
Net assets or fund balances, end of year
$86,496,057
Program services expenses (Part IX)
not reported
Management and general expenses
not reported
Fundraising expenses
not reported
Program service expenses (Part III)
not reported

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $1,955,896 · excluded $1,955,896

  • 7a · Gross sales of assets other than inventory

    securities $9,916,753

  • 7b · Less cost or other basis and sales expenses

    securities $4,750,310

  • 7c · Gain or loss

    securities $5,166,443

  • 7d · Net gain or loss

    total $5,166,443 · excluded $5,166,443

Functional expenses

Part IX, the statement of functional expenses.

  • 4 · Benefits paid to or for members

    total $2,519,061

  • 24a · Other expenses: CUSTODIAN EXPENSES

    total $72,646

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $165,446 · end of year $905,583

  • 12 · Investments: other securities

    beginning of year $107,978,679 · end of year $87,733,986

  • 15 · Other assets

    beginning of year $168,661 · end of year $548,680

  • 17 · Accounts payable and accrued expenses

    beginning of year $168,661 · end of year $173,131

  • 25 · Other liabilities

    beginning of year $2,296,151 · end of year $2,519,061

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $105,847,974 · end of year $86,496,057

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

THE 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 AND BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAMS.

Activities or mission (Part I)

THE TRUST WAS CREATED FOR THE EXCLUSIVE PURPOSE OF PROVIDING POST-RETIREMENT HEALTH CARE AND LIFE INSURANCE TO ELIGIBLE RETIREES AND THEIR DEPENDENTS UNDER BCBSA BENEFIT PROGRAMS.

  • PROVIDED POST-RETIREMENT HEALTH CARE AND LIFE INSURANCE BENEFITS TO ELIGIBLE RETIREES AND THEIR DEPENDENTS UNDER BLUE CROSS & BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAM.

As filed on the 2022 return.

Listed in Part VII

  • Christina Fisher

    COMMITTEE MEMBER

    Total calculated
    $696,339
    From this org
    $0
    From related orgs
    $653,004
    Other
    $43,335
    Hours/week
    0.1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $549,796 related
    Bonus
    $0 + $100,000 related
    Other
    $0 + $3,208 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $28,085 related
    Filer's total
    $0 + $696,339 related

  • Diane Gore

    COMMITTEE MEMBER - CHAIR

    Total calculated
    $0
    Hours/week
    0.1

  • John F Giblin

    COMMITTEE MEMBER - VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.1

  • Matthew All

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Jennifer Allen

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Henri Cournand

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Andreas Ellis

    COMMITTEE MEMBER - 03/22

    Total calculated
    $0
    Hours/week
    0.1

  • Mark El-Tawil

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Lori Hair

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Chris Hauser

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Thurman Justice

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Susan Lindquist

    COMMITTEE MEMBER - THRU 03/22

    Total calculated
    $0
    Hours/week
    0.1

  • Gina Marting

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Susan Pickar

    COMMITTEE MEMBER - 06/22

    Total calculated
    $0
    Hours/week
    0.1

  • James Reed

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Dawn Schneiderman

    COMMITTEE MEMBER - THRU 11/22

    Total calculated
    $0
    Hours/week
    0.1

  • Adam Short

    COMMITTEE MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • Michael Stuart

    COMMITTEE MEMBER - 06/22

    Total calculated
    $0
    Hours/week
    0.1

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
7 November 2023
IRS schema version
2022v5.0
Source object
202303139349305065

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