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← BLUE CROSS AND BLUE SHIELD OF MICHIGAN FOUNDATION

Form 990 for tax year 2022

Filed by BLUE CROSS AND BLUE SHIELD OF MICHIGAN FOUNDATION.

Totals

Total revenue
$1,121,426
Total expenses
$2,952,454
Contributions and grants received
$173,315
Grants paid
$1,368,183
Program services expenses (Part IX)
$2,277,469
Management and general expenses
$674,985
Fundraising expenses
$0
Program service expenses (Part III)
$2,277,469

Program services were 77.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JAMES HAVEMAN

    TREASURER & DIRECTOR

    Total calculated
    $35,072
    From this org
    $35,072
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • LYNDA ROSSI

    PRESIDENT & EXEC VP

    Total calculated
    $3,171,987
    From this org
    $0
    From related orgs
    $3,977,956
    Other
    -$805,969
    Hours/week
    1 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $809,426 related
    Bonus
    $0 + $2,939,089 related
    Other
    $0 + $229,441 related
    Deferred
    $0 + -$832,814 related
    Nontaxable benefits
    $0 + $26,845 related
    Filer's total
    $0 + $3,171,987 related

  • SHAUNA RYDER DIGGS MD

    CHAIR & DIRECTOR

    Total calculated
    $45,000
    From this org
    $45,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • BRUCE WOLF

    DIRECTOR

    Total calculated
    $30,000
    From this org
    $30,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • FARIS AHMAD MD

    MEDICAL DIRECTOR

    Total calculated
    $399,680
    From this org
    $0
    From related orgs
    $363,903
    Other
    $35,777
    Hours/week
    1

    Schedule J breakdown matched by us

    Base
    $0 + $279,922 related
    Bonus
    $0 + $70,403 related
    Other
    $0 + $13,578 related
    Deferred
    $0 + $13,570 related
    Nontaxable benefits
    $0 + $22,207 related
    Filer's total
    $0 + $399,680 related

  • HAIFA FAKHOURI PHD

    DIRECTOR

    Total calculated
    $25,072
    From this org
    $25,072
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • JOEL FERGUSON

    DIRECTOR & VICE-CHAIR

    Total calculated
    $25,072
    From this org
    $25,072
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • PAUL HILLEGONS

    DIRECTOR

    Total calculated
    $25,072
    From this org
    $25,072
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • AUDREY HARVEY

    EXECUTIVE DIRECTOR & CEO

    Total calculated
    $778,641
    From this org
    $0
    From related orgs
    $763,180
    Other
    $15,461
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $0 + $320,665 related
    Bonus
    $0 + $396,791 related
    Other
    $0 + $45,724 related
    Deferred
    $0 + -$18,332 related
    Nontaxable benefits
    $0 + $33,793 related
    Filer's total
    $0 + $778,641 related

  • BENJAMIN GRIER

    TREASURER

    Total calculated
    $210,832
    From this org
    $0
    From related orgs
    $237,140
    Other
    -$26,308
    Hours/week
    5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $182,028 related
    Bonus
    $0 + $45,000 related
    Other
    $0 + $10,112 related
    Deferred
    $0 + -$48,815 related
    Nontaxable benefits
    $0 + $22,507 related
    Filer's total
    $0 + $210,832 related

  • THOMAS SIMMER

    SVP & CHIEF MEDICAL OFFICER

    Total calculated
    $492,249
    From this org
    $0
    From related orgs
    $492,249
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $484,964 related
    Other
    $0 + $7,285 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $492,249 related

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 — 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
COMPENSATION PROCESS FOR TOP OFFICIAL THE COMPENSATION STRATEGY IS DESIGNED TO ENSURE THAT AN APPROPRIATE BALANCE EXISTS BETWEEN INTERNAL EQUITY CONSIDERATIONS AND MARKET COMPENSATION FACTORS AND PRACTICES. MARKET DATA FROM THIRD PARTY EXECUTIVE COMPENSATION SURVEYS AND INDEPENDENT COMPENSATION CONSULTANTS ARE USED TO DETERMINE THE EXECUTIVE DIRECTOR AND CEO'S COMPENSATION. THE COMPENSATION RECOMMENDATIONS ARE REVIEWED BY BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY (BCBSM), PERSONNEL AND COMPENSATION SUBCOMMITTEE AND EXECUTIVE COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE NONQUALIFIED PENSION PLAN PROVIDES RETIREMENT BENEFITS FOR A GROUP OF KEY EMPLOYEES UNDER NONQUALIFIED DEFINED PENSION PLANS. THE GENERAL PURPOSE OF THE PLAN IS TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO PARTICIPANTS WHO ARE SUBJECT TO THE CONTRIBUTION AND BENEFIT LIMITATION APPLICABLE TO TAX-QUALIFIED PLANS UNDER IRC. BENEFITS UNDER THE PLAN ARE FUNDED AND PAID OUT OF THE GENERAL ASSETS OF THE CORPORATION. THESE AMOUNTS ARE ACCRUED AND ELIGIBLE TO BE PAID OUT WITHIN 2022. AUDREY HARVEY - NONQUALIFIED - 26,045 LYNDA ROSSI - NONQUALIFIED - (64,873) FARIS AHMAD, M.D. - NONQUALIFIED - 1,343

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
15 November 2023
IRS schema version
2022v5.0
Source object
202313199349316566

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