BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 401k Plan overview

BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT Benefits

401k Sponsoring company profile

Company Name:	BLUE CROSS BLUE SHIELD MICHIGAN
Employer identification number (EIN):	382069753
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
523	2022-01-01
523	2021-01-01
523	2020-01-01
523	2019-01-01
523	2018-01-01
523	2017-01-01	DARRELL MIDDLETON		JAC AMERELL	2018-10-11
523	2016-01-01	DARRELL MIDDLETON		JAC AMERELL	2017-10-05
523	2015-01-01	DARRELL MIDDLETON		PAUL MOZAK	2016-10-12
523	2014-01-01	DARRELL MIDDLETON		PAUL MOZAK	2015-10-12
523	2013-01-01	DARRELL MIDDLETON		PAUL MOZAK	2014-10-06
523	2012-01-01	DARRELL MIDDLETON		AUDREY HARVEY	2013-10-04
523	2011-01-01	DARRELL MIDDLETON		AUDREY HARVEY	2012-10-04
523	2009-01-01	DARRELL E. MIDDLETON		AUDREY J. HARVEY	2010-10-14
523	2009-01-01	DARRELL E. MIDDLETON		AUDREY L. HARVEY	2010-10-12

Plan Statistics for BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT

Measure	Date	Value
2022: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,523
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,493
Total of all active and inactive participants	2022-01-01	1,493
2021: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,451
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,523
Total of all active and inactive participants	2021-01-01	1,523
2020: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,684
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,451
Total of all active and inactive participants	2020-01-01	1,451
2019: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,644
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,684
Total of all active and inactive participants	2019-01-01	1,684
2018: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,761
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,710
Total of all active and inactive participants	2018-01-01	1,710
2017: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,900
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,838
Total of all active and inactive participants	2017-01-01	1,838
2016: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,130
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2,054
Total of all active and inactive participants	2016-01-01	2,054
2015: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,800
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,862
Total of all active and inactive participants	2015-01-01	1,862
2014: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,650
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,685
Total of all active and inactive participants	2014-01-01	1,685
2013: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,419
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,425
Total of all active and inactive participants	2013-01-01	1,425
2012: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,419
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,419
Total of all active and inactive participants	2012-01-01	1,419
Total participants	2012-01-01	1,419
2011: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,350
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,367
Total of all active and inactive participants	2011-01-01	1,367
2009: BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE REIMBURSEMENT ACCOUNT 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,097
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,077
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,077

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• BLUE CROSS BLUE SHIELD OF ND SEVERANCE PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF NORTH DAKOTA HEALTHCARE REIMBURSEMENT PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF AZ [EIN = 882806512]
• BLUE CROSS PET CARE, INC 401K PLAN [EIN = 873520766]
• BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT [EIN = 820344294]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 831077369]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]

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