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NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC. 401k Plan overview

Plan NameNON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.
Plan identification number 009

NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC. Benefits

401k Plan TypeDefined Benefit Pension
Plan Features/Benefits
  • Benefits are primarily pay related
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HEALTHCARE SERVICE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:HEALTHCARE SERVICE CORPORATION
Employer identification number (EIN):361236610
NAIC Classification:524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0092013-01-01TERRENCE COONEY GENE GEORGE2014-10-15

Plan Statistics for NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.

401k plan membership statisitcs for NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.

Measure Date Value
2013: NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-01719
Total number of active participants reported on line 7a of the Form 55002013-01-01250
Number of retired or separated participants receiving benefits2013-01-01317
Number of other retired or separated participants entitled to future benefits2013-01-0181
Total of all active and inactive participants2013-01-01648
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-0123
Total participants2013-01-01671
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010

Financial Data on NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.

Measure Date Value
2013 : NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC. 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$7,264,948
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$8,862,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$8,697,356
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$0
Value of total assets at end of year2013-12-31$69,824,871
Value of total assets at beginning of year2013-12-31$71,422,532
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$165,253
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$26,279
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-1,597,661
Value of net assets at end of year (total assets less liabilities)2013-12-31$69,824,871
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$71,422,532
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Investment advisory and management fees2013-12-31$123,863
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$69,824,871
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$57,457,273
Net gain/loss from 103.12 investment entities2013-12-31$7,264,948
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Employer contributions (assets) at beginning of year2013-12-31$13,965,259
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$8,697,356
Contract administrator fees2013-12-31$15,111
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BDO USA, LLP
Accountancy firm EIN2013-12-31135381590

Form 5500 Responses for NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC.

2013: NON-CONTRIBUTORY RETIREMENT PROGRAM FOR CERTAIN EMPLOYEES OF BLUE CROSS AND BLUE SHIELD OF MONTANA, INC. 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingYes
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes

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