2024-11-13T10:57:45-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2023-01-01 364018700 BLUE CROSS BLUE SHIELD ASSOCIATION RETIREE BENEFITS TRUST BLUE 3122976000 200 E RANDOLPH STREET CHICAGO IL 60601 JOHN BANTA VICE PRESIDENT 3122976000 2024-11-12 1 1 DAVID LOWENTHAL P00378651 3122071040 2024-11-12 2023 2024-10-15 13:58:12Z X JOHN BANTA 200 E RANDOLPH STREET CHICAGO IL 60601 34325776 0 X N/A X 1994 IL SEE SCHEDULE OTHE 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. 14 13 0 0 0 0 0 0 0 0 7122339 18463217 0 0 7122339 18463217 0 0 2519061 2701760 0 0 0 0 0 72646 80284 2591707 2782044 4530632 15681173 89188249 98381220 2692192 2950396 86496057 95430824 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. 0 0 PROVIDED POST-RETIREMENT HEALTH CARE AND LIFE INSURANCE BENEFITS TO ELIGIBLE RETIREES AND THEIR DEPENDENTS UNDER BLUE CROSS & BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAM. 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 14 13 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X JOHN BANTA 3122976000 200 E RANDOLPH STREET CHICAGO IL 60601 DIANE GORE COMMITTEE MEMBER - CHAIR 0.10 0.20 X X 0 0 0 JOHN F GIBLIN COMMITTEE MEMBER - VICE CHAIR 0.10 0.20 X X 0 0 0 MATTHEW ALL COMMITTEE MEMBER 0.10 0.20 X 0 0 0 JENNIFER ALLEN COMMITTEE MEMBER 0.10 0.20 X 0 0 0 HENRI COURNAND COMMITTEE MEMBER - THRU 03/23 0.10 0.20 X 0 0 0 ANDREAS ELLIS COMMITTEE MEMBER - THRU 09/23 0.10 0.20 X 0 0 0 MARK EL-TAWIL COMMITTEE MEMBER - THRU 09/23 0.10 0.20 X 0 0 0 CHRISTINA FISHER COMMITTEE MEMBER 0.10 40.00 X 0 915677 46045 LORI HAIR COMMITTEE MEMBER 0.10 0.20 X 0 0 0 CHRIS HAUSER COMMITTEE MEMBER 0.10 0.20 X 0 0 0 THURMAN JUSTICE COMMITTEE MEMBER - THRU 10/23 0.10 0.20 X 0 0 0 GINA MARTING COMMITTEE MEMBER 0.10 0.20 X 0 0 0 SUSAN PICKAR COMMITTEE MEMBER 0.10 0.20 X 0 0 0 MARGARET PINELLO-WHITE COMMITTEE MEMBER - STARTED 03/23 0.10 0.20 X 0 0 0 MICHAEL RAINS COMMITTEE MEMBER - STARTED 11/23 0.10 0.20 X 0 0 0 JAMES REED COMMITTEE MEMBER 0.10 0.20 X 0 0 0 ADAM SHORT COMMITTEE MEMBER 0.10 0.20 X 0 0 0 MICHAEL STUART COMMITTEE MEMBER 0.10 0.20 X 0 0 0 0 915677 46045 0 0 1 0 0 2582306 2582306 31743470 15862559 15880911 15880911 15880911 18463217 0 0 18463217 2701760 CUSTODIAN EXPENSES 80284 2782044 905583 954802 87733986 96800920 548680 625498 89188249 98381220 173131 248636 2519061 2701760 2692192 2950396 X 0 0 86496057 95430824 0 0 86496057 95430824 89188249 98381220 15681173 -6746407 0 X 0 1 X 1 0 0 COMMON COLLECTIVE TRUST 96800920 F 96800920 DUE TO SPONSOR (VEBA REIMBURSEMENT) 2701760 2701760 X PART X, LINE 2: U.S. GAAP REQUIRES THE RECOGNITION OF 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 IRS. MANAGEMENT OF THE PROGRAM HAS ANALYZED TAX POSITIONS TAKEN BY THE PROGRAM AND CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE WITHIN THE FINANCIAL STATEMENTS. THE PROGRAM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT OF THE PROGRAM BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2020. 0 0 0 CHRISTINA FISHER COMMITTEE MEMBER 0 569975 0 343100 0 2602 0 16500 0 29545 0 961722 0 0 FORM 990, PART VI, SECTION A, LINE 2 CERTAIN BOARD MEMBERS OF THE NATIONAL EMPLOYEE BENEFITS COMMITTEE (COMMITTEE) SERVE TOGETHER ON THE BOARD OF THE BLUE CROSS AND BLUE SHIELD ASSOCIATION (BCBSA) AND THE BLUE CROSS & BLUE SHIELD ASSOCIATION NATIONAL RETIREE BENEFITS TRUST. ALL MEMBERS OF THE COMMITTEE ARE EITHER EMPLOYEES OF THE BLUE CROSS AND BLUE SHIELD ASSOCIATIONS OR ONE OF THE MEMBER PLANS. FORM 990, PART VI, SECTION B, LINE 11B FORM 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. FORM 990, PART VI, SECTION B, LINE 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 ARE CHARGED WITH INVESTIGATING ANY ALLEGATIONS OF NON COMPLIANCE WITH THE CODE OF CONDUCT, INCLUDING ANY COMPLAINTS REPORTED THROUGH THE ANONYMOUS HOTLINE 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. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FORM 990 ARE MADE AVAILABLE TO PARTICIPANTS IN THE EMPLOYEE BENEFIT PROGRAMS FUNDED THROUGH VEBA UPON REQUEST TO THE VICE PRESIDENT, NATIONAL EMPLOYEE BENEFITS ADMINISTRATION, BLUE CROSS AND BLUE SHIELD ASSOCIATION, 200 E. RANDOLPH STREET, CHICAGO, IL 60601. BLUE CROSS BLUE SHIELD ASSOCIATION 200 E RANDOLPH STREET CHICAGO IL 60601 135656874 ADMINISTRATION IL 501(C)(4) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 SCHEDULE R, PART II, LINE 1: 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 AND THEIR DEPENDENTS UNDER BLUE CROSS AND BLUE SHIELD ASSOCIATION'S BENEFIT PROGRAMS.