401k Plan data: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN plan

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 401k Plan overview

Plan Name	BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN
Plan identification number	510

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Other welfare benefit cover

401k Sponsoring company profile

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA has sponsored the creation of one or more 401k plans.

Company Name: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA

Employer identification number (EIN): 450173185

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2022-01-01
510 2021-01-01 CYNTHIA THORMODSON 2022-10-14
510 2020-01-01 DAVE BREUER 2021-10-14
510 2019-01-01 DAVE BREUER 2020-10-14
510 2018-01-01 DAVE BREUER 2019-10-15
510 2017-01-01
510 2016-01-01
510 2015-01-01
510 2014-01-01
510 2013-01-01
510 2012-01-01 DAVE BREUER
510 2011-01-01 DAVID BREUER
510 2010-01-01 DAVE BREUER
510 2009-01-01 DAVID BREUER
510 2009-01-01 KRISTEN KUTZER

Plan Statistics for BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN

401k plan membership statisitcs for BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN

Measure Date Value
2022: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 546
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 817
Number of retired or separated participants receiving benefits 2022-01-01 15
Number of other retired or separated participants entitled to future benefits 2022-01-01 9
Total of all active and inactive participants 2022-01-01 841
2021: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 652
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 546
Total of all active and inactive participants 2021-01-01 546
Total participants 2021-01-01 546
2020: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 505
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 652
Total of all active and inactive participants 2020-01-01 652
Total participants 2020-01-01 652
2019: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 463
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 505
Total of all active and inactive participants 2019-01-01 505
Total participants 2019-01-01 505
2018: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 569
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 463
Total of all active and inactive participants 2018-01-01 463
Total participants 2018-01-01 463
2017: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 482
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 569
Total of all active and inactive participants 2017-01-01 569
Total participants 2017-01-01 569
2016: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 433
Number of retired or separated participants receiving benefits 2016-01-01 482
Total of all active and inactive participants 2016-01-01 482
Total participants 2016-01-01 482
2015: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 447
Number of retired or separated participants receiving benefits 2015-01-01 433
Total of all active and inactive participants 2015-01-01 433
Total participants 2015-01-01 433
2014: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 333
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 447
Total of all active and inactive participants 2014-01-01 447
Total participants 2014-01-01 447
2013: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 338
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 333
Total of all active and inactive participants 2013-01-01 333
Total participants 2013-01-01 333
2012: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 339
Number of retired or separated participants receiving benefits 2012-01-01 338
Total of all active and inactive participants 2012-01-01 338
Total participants 2012-01-01 338
2011: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 336
Number of retired or separated participants receiving benefits 2011-01-01 339
Total of all active and inactive participants 2011-01-01 339
Total participants 2011-01-01 339
2010: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 321
Number of other retired or separated participants entitled to future benefits 2010-01-01 336
Total of all active and inactive participants 2010-01-01 336
Total participants 2010-01-01 336
2009: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 316
Number of retired or separated participants receiving benefits 2009-01-01 321
Total of all active and inactive participants 2009-01-01 321
Total participants 2009-01-01 321

Measure	Date	Value
2022: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	546
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	817
Number of retired or separated participants receiving benefits	2022-01-01	15
Number of other retired or separated participants entitled to future benefits	2022-01-01	9
Total of all active and inactive participants	2022-01-01	841
2021: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	652
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	546
Total of all active and inactive participants	2021-01-01	546
Total participants	2021-01-01	546
2020: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	505
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	652
Total of all active and inactive participants	2020-01-01	652
Total participants	2020-01-01	652
2019: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	463
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	505
Total of all active and inactive participants	2019-01-01	505
Total participants	2019-01-01	505
2018: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	569
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	463
Total of all active and inactive participants	2018-01-01	463
Total participants	2018-01-01	463
2017: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	482
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	569
Total of all active and inactive participants	2017-01-01	569
Total participants	2017-01-01	569
2016: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	433
Number of retired or separated participants receiving benefits	2016-01-01	482
Total of all active and inactive participants	2016-01-01	482
Total participants	2016-01-01	482
2015: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	447
Number of retired or separated participants receiving benefits	2015-01-01	433
Total of all active and inactive participants	2015-01-01	433
Total participants	2015-01-01	433
2014: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	333
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	447
Total of all active and inactive participants	2014-01-01	447
Total participants	2014-01-01	447
2013: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	338
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	333
Total of all active and inactive participants	2013-01-01	333
Total participants	2013-01-01	333
2012: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	339
Number of retired or separated participants receiving benefits	2012-01-01	338
Total of all active and inactive participants	2012-01-01	338
Total participants	2012-01-01	338
2011: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	336
Number of retired or separated participants receiving benefits	2011-01-01	339
Total of all active and inactive participants	2011-01-01	339
Total participants	2011-01-01	339
2010: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	321
Number of other retired or separated participants entitled to future benefits	2010-01-01	336
Total of all active and inactive participants	2010-01-01	336
Total participants	2010-01-01	336
2009: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	316
Number of retired or separated participants receiving benefits	2009-01-01	321
Total of all active and inactive participants	2009-01-01	321
Total participants	2009-01-01	321

Financial Data on BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN

Measure	Date	Value
2022 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-14,077,035
Total unrealized appreciation/depreciation of assets	2022-12-31	$-14,077,035
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$370,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$4,672,897
Total income from all sources (including contributions)	2022-12-31	$3,687,317
Total loss/gain on sale of assets	2022-12-31	$4,451,506
Total of all expenses incurred	2022-12-31	$28,189,474
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$29,891,670
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$9,763,797
Value of total assets at end of year	2022-12-31	$16,592,684
Value of total assets at beginning of year	2022-12-31	$45,397,738
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$-1,702,196
Total interest from all sources	2022-12-31	$629,970
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$109,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$26,095
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$9,615,842
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$1,226,564
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$1,148,387
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$196,784
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$370,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$4,672,897
Administrative expenses (other) incurred	2022-12-31	$-1,785,813
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-24,502,157
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$16,222,684
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$40,724,841
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,758,844
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$12,218,273
Interest earned on other investments	2022-12-31	$318,408
Income. Interest from US Government securities	2022-12-31	$120,833
Income. Interest from corporate debt instruments	2022-12-31	$161,004
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$3,593,056
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$633,189
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$633,189
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$29,725
Asset value of US Government securities at end of year	2022-12-31	$2,115,269
Asset value of US Government securities at beginning of year	2022-12-31	$13,606,074
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$2,809,708
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$147,955
Employer contributions (assets) at end of year	2022-12-31	$147,955
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$83,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$29,891,670
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$1,571,278
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$5,993,734
Contract administrator fees	2022-12-31	$83,617
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$3,031,331
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$12,749,684
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$20,408,973
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$15,957,467
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2022-12-31	450250958
2021 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2021-12-31	$-6,549,309
Total unrealized appreciation/depreciation of assets	2021-12-31	$-6,549,309
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$4,672,897
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$5,169,636
Total income from all sources (including contributions)	2021-12-31	$14,395,686
Total loss/gain on sale of assets	2021-12-31	$6,278,454
Total of all expenses incurred	2021-12-31	$29,157,882
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$27,911,516
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$9,075,227
Value of total assets at end of year	2021-12-31	$45,397,738
Value of total assets at beginning of year	2021-12-31	$60,656,673
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$1,246,366
Total interest from all sources	2021-12-31	$756,546
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$419,229
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$84,829
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$8,945,181
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$27,849,174
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$196,784
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$226,114
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$4,672,897
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$5,169,636
Administrative expenses (other) incurred	2021-12-31	$1,083,678
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-14,762,196
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$40,724,841
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$55,487,037
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$12,218,273
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$25,111,459
Interest earned on other investments	2021-12-31	$348,708
Income. Interest from US Government securities	2021-12-31	$133,060
Income. Interest from corporate debt instruments	2021-12-31	$274,620
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$633,189
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$227,882
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$227,882
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$158
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$62,342
Asset value of US Government securities at end of year	2021-12-31	$13,606,074
Asset value of US Government securities at beginning of year	2021-12-31	$15,318,623
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$4,415,539
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$130,046
Income. Dividends from common stock	2021-12-31	$334,400
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$5,993,734
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$6,310,980
Contract administrator fees	2021-12-31	$162,688
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$12,749,684
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$13,461,615
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Aggregate proceeds on sale of assets	2021-12-31	$53,362,583
Aggregate carrying amount (costs) on sale of assets	2021-12-31	$47,084,129
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2021-12-31	450250958
2020 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$-897,169
Total unrealized appreciation/depreciation of assets	2020-12-31	$-897,169
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$5,169,636
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$3,439,667
Total income from all sources (including contributions)	2020-12-31	$7,007,210
Total loss/gain on sale of assets	2020-12-31	$-45,319
Total of all expenses incurred	2020-12-31	$2,629,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$311,490
Value of total assets at end of year	2020-12-31	$60,656,673
Value of total assets at beginning of year	2020-12-31	$54,549,466
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,318,482
Total interest from all sources	2020-12-31	$965,637
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$246,425
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$80,036
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$226,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$220,735
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$5,169,636
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$3,439,667
Administrative expenses (other) incurred	2020-12-31	$2,159,017
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$4,377,238
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$55,487,037
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$51,109,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$25,111,459
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$21,836,148
Interest earned on other investments	2020-12-31	$499,516
Income. Interest from US Government securities	2020-12-31	$188,030
Income. Interest from corporate debt instruments	2020-12-31	$278,069
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$227,882
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$456,353
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$456,353
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$22
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$311,490
Asset value of US Government securities at end of year	2020-12-31	$15,318,623
Asset value of US Government securities at beginning of year	2020-12-31	$16,439,917
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$6,737,636
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Income. Dividends from common stock	2020-12-31	$166,389
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$6,310,980
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$6,664,395
Contract administrator fees	2020-12-31	$159,465
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$13,461,615
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$8,931,918
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$26,301,112
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$26,346,431
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2020-12-31	450250958
2019 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$2,371,245
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$2,371,245
Total unrealized appreciation/depreciation of assets	2019-12-31	$2,371,245
Total unrealized appreciation/depreciation of assets	2019-12-31	$2,371,245
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$3,439,667
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$3,439,667
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,527,168
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,527,168
Total income from all sources (including contributions)	2019-12-31	$8,189,491
Total income from all sources (including contributions)	2019-12-31	$8,189,491
Total loss/gain on sale of assets	2019-12-31	$794,835
Total loss/gain on sale of assets	2019-12-31	$794,835
Total of all expenses incurred	2019-12-31	$2,685,184
Total of all expenses incurred	2019-12-31	$2,685,184
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$530,102
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$530,102
Value of total assets at end of year	2019-12-31	$54,549,466
Value of total assets at end of year	2019-12-31	$54,549,466
Value of total assets at beginning of year	2019-12-31	$48,132,660
Value of total assets at beginning of year	2019-12-31	$48,132,660
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,155,082
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,155,082
Total interest from all sources	2019-12-31	$995,301
Total interest from all sources	2019-12-31	$995,301
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$377,982
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$377,982
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$239,453
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$239,453
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$5,000,000
Value of fidelity bond cover	2019-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$220,735
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$621,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$621,685
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$3,439,667
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$2,527,168
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$2,527,168
Administrative expenses (other) incurred	2019-12-31	$2,005,191
Administrative expenses (other) incurred	2019-12-31	$2,005,191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$5,504,307
Value of net income/loss	2019-12-31	$5,504,307
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$51,109,799
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$51,109,799
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$45,605,492
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$45,605,492
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$21,836,148
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$21,836,148
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$18,076,937
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$18,076,937
Interest earned on other investments	2019-12-31	$482,542
Interest earned on other investments	2019-12-31	$482,542
Income. Interest from US Government securities	2019-12-31	$213,801
Income. Interest from US Government securities	2019-12-31	$213,801
Income. Interest from corporate debt instruments	2019-12-31	$291,983
Income. Interest from corporate debt instruments	2019-12-31	$291,983
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$456,353
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$456,353
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$204,405
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$204,405
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$204,405
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$204,405
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$6,975
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$6,975
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$530,102
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$530,102
Asset value of US Government securities at end of year	2019-12-31	$16,439,917
Asset value of US Government securities at end of year	2019-12-31	$16,439,917
Asset value of US Government securities at beginning of year	2019-12-31	$16,895,308
Asset value of US Government securities at beginning of year	2019-12-31	$16,895,308
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,650,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$3,650,128
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Income. Dividends from common stock	2019-12-31	$138,529
Income. Dividends from common stock	2019-12-31	$138,529
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$6,664,395
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$6,664,395
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$4,808,367
Contract administrator fees	2019-12-31	$149,891
Contract administrator fees	2019-12-31	$149,891
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$8,931,918
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$8,931,918
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$7,525,958
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$7,525,958
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$14,059,130
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$13,264,295
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$13,264,295
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Opinion of an independent qualified public accountant for this plan	2019-12-31	Unqualified
Accountancy firm name	2019-12-31	EIDE BAILLY, LLP
Accountancy firm name	2019-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2019-12-31	450250958
Accountancy firm EIN	2019-12-31	450250958
2018 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$-4,466,836
Total unrealized appreciation/depreciation of assets	2018-12-31	$-4,466,836
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$2,527,168
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$3,200,000
Total income from all sources (including contributions)	2018-12-31	$-1,031,863
Total loss/gain on sale of assets	2018-12-31	$98,201
Total of all expenses incurred	2018-12-31	$767,199
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$627,168
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$10,928
Value of total assets at end of year	2018-12-31	$48,132,660
Value of total assets at beginning of year	2018-12-31	$50,604,554
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$140,031
Total interest from all sources	2018-12-31	$956,260
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$324,041
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$176,588
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$621,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$240,338
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$2,527,168
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$3,200,000
Other income not declared elsewhere	2018-12-31	$902,868
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-1,799,062
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$45,605,492
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$47,404,554
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$18,076,937
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$15,815,557
Interest earned on other investments	2018-12-31	$458,842
Income. Interest from US Government securities	2018-12-31	$262,837
Income. Interest from corporate debt instruments	2018-12-31	$229,561
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$204,405
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$295,441
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$295,441
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$5,020
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$627,168
Asset value of US Government securities at end of year	2018-12-31	$16,895,308
Asset value of US Government securities at beginning of year	2018-12-31	$18,034,091
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$1,142,675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$10,928
Employer contributions (assets) at beginning of year	2018-12-31	$2,705,862
Income. Dividends from common stock	2018-12-31	$147,453
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$4,808,367
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$3,165,649
Contract administrator fees	2018-12-31	$140,031
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$7,525,958
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$10,347,616
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Aggregate proceeds on sale of assets	2018-12-31	$21,216,300
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$21,118,099
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Unqualified
Accountancy firm name	2018-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2018-12-31	450250958
2017 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$1,156,781
Total unrealized appreciation/depreciation of assets	2017-12-31	$1,156,781
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$3,200,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,960,000
Total income from all sources (including contributions)	2017-12-31	$8,262,991
Total loss/gain on sale of assets	2017-12-31	$999,365
Total of all expenses incurred	2017-12-31	$3,098,433
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$919,603
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,351,804
Value of total assets at end of year	2017-12-31	$50,604,554
Value of total assets at beginning of year	2017-12-31	$44,199,996
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,178,830
Total interest from all sources	2017-12-31	$739,575
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$416,532
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$161,768
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$240,338
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$302,316
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$3,200,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$1,960,000
Administrative expenses (other) incurred	2017-12-31	$2,042,019
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$5,164,558
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$47,404,554
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$42,239,996
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$15,815,557
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$11,289,925
Income. Interest from US Government securities	2017-12-31	$739,575
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$295,441
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$4,520,346
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$4,520,346
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$919,603
Asset value of US Government securities at end of year	2017-12-31	$18,034,091
Asset value of US Government securities at beginning of year	2017-12-31	$17,566,998
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,598,934
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$2,351,804
Employer contributions (assets) at end of year	2017-12-31	$2,705,862
Income. Dividends from common stock	2017-12-31	$254,764
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$3,165,649
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$1,815,278
Contract administrator fees	2017-12-31	$136,811
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$10,347,616
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$8,705,133
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Aggregate proceeds on sale of assets	2017-12-31	$24,554,294
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$23,554,929
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2017-12-31	450250958
2016 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$254,655
Total unrealized appreciation/depreciation of assets	2016-12-31	$254,655
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,960,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,900,000
Total income from all sources (including contributions)	2016-12-31	$2,289,538
Total loss/gain on sale of assets	2016-12-31	$1,010,881
Total of all expenses incurred	2016-12-31	$1,933,377
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,172,387
Value of total assets at end of year	2016-12-31	$44,199,996
Value of total assets at beginning of year	2016-12-31	$43,783,835
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$760,990
Total interest from all sources	2016-12-31	$593,686
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$430,316
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$186,340
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$302,316
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$481,641
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,960,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$1,900,000
Administrative expenses (other) incurred	2016-12-31	$632,300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$356,161
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$42,239,996
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$41,883,835
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$11,289,925
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$16,818,352
Income. Interest from corporate debt instruments	2016-12-31	$593,686
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$4,520,346
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$938,388
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$938,388
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$1,172,387
Asset value of US Government securities at end of year	2016-12-31	$17,566,998
Asset value of US Government securities at beginning of year	2016-12-31	$13,383,571
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Income. Dividends from common stock	2016-12-31	$243,976
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$1,815,278
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$2,152,311
Contract administrator fees	2016-12-31	$128,690
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$8,705,133
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$10,009,572
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$31,978,079
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$30,967,198
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2016-12-31	450250958
2015 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-2,052,485
Total unrealized appreciation/depreciation of assets	2015-12-31	$-2,052,485
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$1,900,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$2,700,000
Total income from all sources (including contributions)	2015-12-31	$-636,288
Total loss/gain on sale of assets	2015-12-31	$-69,857
Total of all expenses incurred	2015-12-31	$1,510,897
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,387,353
Value of total assets at end of year	2015-12-31	$43,783,835
Value of total assets at beginning of year	2015-12-31	$46,731,020
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$123,544
Total interest from all sources	2015-12-31	$419,360
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$630,239
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$193,039
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$481,641
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$825,628
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$1,900,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$2,700,000
Other income not declared elsewhere	2015-12-31	$436,455
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-2,147,185
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$41,883,835
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$44,031,020
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$16,818,352
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$21,432,442
Income. Interest from corporate debt instruments	2015-12-31	$419,360
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$938,388
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$118,488
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$118,488
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$1,387,353
Asset value of US Government securities at end of year	2015-12-31	$13,383,571
Asset value of US Government securities at beginning of year	2015-12-31	$9,761,436
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Income. Dividends from common stock	2015-12-31	$437,200
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$2,152,311
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$3,282,927
Contract administrator fees	2015-12-31	$123,544
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$10,009,572
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$11,310,099
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$29,727,392
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$29,797,249
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2015-12-31	450250958
2014 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$-603,178
Total unrealized appreciation/depreciation of assets	2014-12-31	$-603,178
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2,700,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$2,600,000
Total income from all sources (including contributions)	2014-12-31	$2,500,712
Total loss/gain on sale of assets	2014-12-31	$1,029,338
Total of all expenses incurred	2014-12-31	$2,417,904
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,570,997
Value of total assets at end of year	2014-12-31	$46,731,020
Value of total assets at beginning of year	2014-12-31	$46,548,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$846,907
Total interest from all sources	2014-12-31	$423,270
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$636,010
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$306,229
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$825,628
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$616,287
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$2,700,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$2,600,000
Administrative expenses (other) incurred	2014-12-31	$720,473
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$82,808
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$44,031,020
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$43,948,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$21,432,442
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$21,344,659
Income. Interest from corporate debt instruments	2014-12-31	$423,270
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$118,488
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$197,218
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$197,218
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$1,570,997
Asset value of US Government securities at end of year	2014-12-31	$9,761,436
Asset value of US Government securities at beginning of year	2014-12-31	$9,916,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$1,015,272
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Income. Dividends from common stock	2014-12-31	$329,781
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$3,282,927
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$3,323,250
Contract administrator fees	2014-12-31	$126,434
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$11,310,099
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$11,150,310
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$20,889,128
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$19,859,790
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2014-12-31	450250958
2013 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$1,025,976
Total unrealized appreciation/depreciation of assets	2013-12-31	$1,025,976
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$2,600,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$1,872,242
Total income from all sources (including contributions)	2013-12-31	$5,477,866
Total loss/gain on sale of assets	2013-12-31	$1,564,137
Total of all expenses incurred	2013-12-31	$3,152,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,345,614
Value of total assets at end of year	2013-12-31	$46,548,212
Value of total assets at beginning of year	2013-12-31	$43,495,010
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,806,808
Total interest from all sources	2013-12-31	$505,565
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$573,637
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$616,287
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$105,021
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$2,600,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$1,872,242
Administrative expenses (other) incurred	2013-12-31	$1,684,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,325,444
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$43,948,212
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$41,622,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$21,344,659
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$18,339,595
Interest earned on other investments	2013-12-31	$45,247
Income. Interest from corporate debt instruments	2013-12-31	$460,318
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$197,218
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$723,413
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$723,413
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$1,345,614
Asset value of US Government securities at end of year	2013-12-31	$9,916,488
Asset value of US Government securities at beginning of year	2013-12-31	$12,004,747
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,808,551
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Income. Dividends from common stock	2013-12-31	$573,637
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$3,323,250
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$3,856,445
Contract administrator fees	2013-12-31	$122,201
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$11,150,310
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$8,465,789
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$18,085,582
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$16,521,445
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2013-12-31	450250958
2012 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$1,901,834
Total unrealized appreciation/depreciation of assets	2012-12-31	$1,901,834
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$1,872,242
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$665,000
Total income from all sources (including contributions)	2012-12-31	$4,633,949
Total loss/gain on sale of assets	2012-12-31	$1,551,265
Total of all expenses incurred	2012-12-31	$3,466,510
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,617,958
Value of total assets at end of year	2012-12-31	$43,495,010
Value of total assets at beginning of year	2012-12-31	$41,120,329
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,848,552
Total interest from all sources	2012-12-31	$613,703
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$567,147
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$105,021
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$727,733
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$1,872,242
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$665,000
Administrative expenses (other) incurred	2012-12-31	$1,732,218
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,167,439
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$41,622,768
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$40,455,329
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$116,334
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$18,339,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$16,083,675
Interest earned on other investments	2012-12-31	$28,247
Income. Interest from corporate debt instruments	2012-12-31	$585,456
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$723,413
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$281,935
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$281,935
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$1,617,958
Asset value of US Government securities at end of year	2012-12-31	$12,004,747
Asset value of US Government securities at beginning of year	2012-12-31	$11,608,587
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Income. Dividends from common stock	2012-12-31	$567,147
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$3,856,445
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$4,897,133
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$8,465,789
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$7,521,266
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$22,403,173
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$20,851,908
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2012-12-31	450250958
2011 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-1,318,332
Total unrealized appreciation/depreciation of assets	2011-12-31	$-1,318,332
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$665,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$1,404,521
Total income from all sources (including contributions)	2011-12-31	$148,857
Total loss/gain on sale of assets	2011-12-31	$281,555
Total of all expenses incurred	2011-12-31	$1,558,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,441,815
Value of total assets at end of year	2011-12-31	$41,120,329
Value of total assets at beginning of year	2011-12-31	$43,269,778
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$116,970
Total interest from all sources	2011-12-31	$835,600
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$306,259
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$727,733
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$208,747
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$665,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$1,404,521
Other income not declared elsewhere	2011-12-31	$43,775
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-1,409,928
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$40,455,329
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$41,865,257
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$116,970
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$16,083,675
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$18,859,929
Interest earned on other investments	2011-12-31	$134,216
Income. Interest from US Government securities	2011-12-31	$7,968
Income. Interest from corporate debt instruments	2011-12-31	$693,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$281,935
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$153,496
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$153,496
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$84
Asset value of US Government securities at end of year	2011-12-31	$11,608,587
Asset value of US Government securities at beginning of year	2011-12-31	$11,788,297
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Income. Dividends from common stock	2011-12-31	$306,259
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,441,815
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$4,897,133
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$4,591,224
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$7,521,266
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$7,668,085
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$17,410,707
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$17,129,152
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2011-12-31	450250958
2010 : BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$2,360,341
Total unrealized appreciation/depreciation of assets	2010-12-31	$2,360,341
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$1,404,521
Total income from all sources (including contributions)	2010-12-31	$4,705,958
Total loss/gain on sale of assets	2010-12-31	$472,161
Total of all expenses incurred	2010-12-31	$3,038,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,099,690
Value of total assets at end of year	2010-12-31	$43,269,778
Value of total assets at beginning of year	2010-12-31	$40,197,918
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,938,929
Total interest from all sources	2010-12-31	$774,195
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$1,099,261
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$113,313
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$208,747
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$158,689
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$1,404,521
Administrative expenses (other) incurred	2010-12-31	$1,827,673
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,667,339
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$41,865,257
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$40,197,918
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$111,256
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$18,859,929
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$17,541,203
Interest earned on other investments	2010-12-31	$70,612
Income. Interest from US Government securities	2010-12-31	$21,063
Income. Interest from corporate debt instruments	2010-12-31	$682,532
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$153,496
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$250,703
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$250,703
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$-12
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$1,099,690
Asset value of US Government securities at end of year	2010-12-31	$11,788,297
Asset value of US Government securities at beginning of year	2010-12-31	$11,647,600
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Income. Dividends from common stock	2010-12-31	$1,099,261
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$4,591,224
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$3,857,982
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$7,668,085
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$6,628,428
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Aggregate proceeds on sale of assets	2010-12-31	$33,025,712
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$32,553,551
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2010-12-31	450250958

Form 5500 Responses for BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN

2022: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA FUNDED GROUP BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0612

Policy instance

Insurance contract or identification number	0612
Number of Individuals Covered	3724
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $974,506
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,640,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	974506
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	5

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0611

Policy instance

Insurance contract or identification number	0611
Number of Individuals Covered	412
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $58,598
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $112,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	58598
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	5

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0610

Policy instance

Insurance contract or identification number	0610
Number of Individuals Covered	2289
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $485,650
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,441,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	485650
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	5

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0610

Policy instance

Insurance contract or identification number	0610
Number of Individuals Covered	1958
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $486,683
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,442,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	486683
Additional information about fees paid to insurance broker	ADMIN FEES

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0612

Policy instance

Insurance contract or identification number	0612
Number of Individuals Covered	3511
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $911,205
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $3,226,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	911205
Additional information about fees paid to insurance broker	ADMIN FEES

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0611

Policy instance

Insurance contract or identification number	0611
Number of Individuals Covered	399
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of fees paid to insurance company	USD $58,326
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $154,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	58326
Additional information about fees paid to insurance broker	ADMIN FEES

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

0611

Policy instance

Insurance contract or identification number	0611
Number of Individuals Covered	460
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of fees paid to insurance company	USD $54,452
Welfare Benefit Premiums Paid to Carrier	USD $239,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	54452
Additional information about fees paid to insurance broker	ADMIN FEES

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	464
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Welfare Benefit Premiums Paid to Carrier	USD $253,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	490
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Welfare Benefit Premiums Paid to Carrier	USD $306,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	481
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Welfare Benefit Premiums Paid to Carrier	USD $440,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	505
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Welfare Benefit Premiums Paid to Carrier	USD $399,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	473
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $381,396

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	143
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $407,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )

Policy contract number

19712

Policy instance

Insurance contract or identification number	19712
Number of Individuals Covered	173
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $288,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 )

Policy contract number

G 14802

Policy instance

Insurance contract or identification number	G 14802
Number of Individuals Covered	339
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 )

Policy contract number

G 14802

Policy instance

Insurance contract or identification number	G 14802
Number of Individuals Covered	336
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,766

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Company Name:	BLUE CROSS BLUE SHIELD OF NORTH DAKOTA
Employer identification number (EIN):	450173185
NAIC Classification:	524140

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510	2012-01-01	DAVE BREUER
510	2011-01-01	DAVID BREUER
510	2010-01-01	DAVE BREUER
510	2009-01-01	DAVID BREUER
510	2009-01-01	KRISTEN KUTZER