BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 401k Plan overview

BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN Benefits

401k Sponsoring company profile

Company Name:	BLUE CROSS AND BLUE SHIELD OF MISSISSIPPI, A MUTUAL INSURANCE COMPANY
Employer identification number (EIN):	640295748
NAIC Classification:	524140

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2022-01-01
506	2021-01-01
506	2020-01-01
506	2019-01-01
506	2018-01-01	CHERI D, GREEN		CHERI D, GREEN	2019-07-17
506	2017-01-01	CHERI GREEN		CHERI GREEN	2018-07-30
506	2016-01-01	CHERI GREEN		CHERI GREEN	2017-06-23
506	2015-01-01	CHERI GREEN		CHERI GREEN	2016-08-01
506	2014-01-01	CHERI GREEN		CHERI GREEN	2015-07-16
506	2013-01-01	ALISON TYLER		ALISON TYLER	2014-10-13
506	2012-01-01	JOHN H. PROCTOR		JOHN H. PROCTOR	2013-06-10
506	2011-01-01	AMY AYERS		AMY AYERS	2012-07-05
506	2009-01-01	AMY AYERS		AMY AYERS	2010-07-20

Plan Statistics for BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN

Measure	Date	Value
2022: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	846
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	485
Number of retired or separated participants receiving benefits	2022-01-01	353
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	838
2021: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	894
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	500
Number of retired or separated participants receiving benefits	2021-01-01	343
Total of all active and inactive participants	2021-01-01	843
2020: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	896
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	555
Number of retired or separated participants receiving benefits	2020-01-01	340
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	895
2019: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	907
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	567
Number of retired or separated participants receiving benefits	2019-01-01	335
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	902
2018: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	915
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	579
Number of retired or separated participants receiving benefits	2018-01-01	338
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	917
2017: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	871
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	574
Number of retired or separated participants receiving benefits	2017-01-01	330
Total of all active and inactive participants	2017-01-01	904
2016: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	871
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	561
Number of retired or separated participants receiving benefits	2016-01-01	312
Total of all active and inactive participants	2016-01-01	873
2015: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	849
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	555
Number of retired or separated participants receiving benefits	2015-01-01	316
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	871
2014: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	874
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	583
Number of retired or separated participants receiving benefits	2014-01-01	305
Number of other retired or separated participants entitled to future benefits	2014-01-01	78
Total of all active and inactive participants	2014-01-01	966
2013: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	814
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	751
Number of retired or separated participants receiving benefits	2013-01-01	275
Number of other retired or separated participants entitled to future benefits	2013-01-01	78
Total of all active and inactive participants	2013-01-01	1,104
2012: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	810
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	588
Number of retired or separated participants receiving benefits	2012-01-01	218
Number of other retired or separated participants entitled to future benefits	2012-01-01	76
Total of all active and inactive participants	2012-01-01	882
2011: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	853
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	617
Number of retired or separated participants receiving benefits	2011-01-01	236
Number of other retired or separated participants entitled to future benefits	2011-01-01	64
Total of all active and inactive participants	2011-01-01	917
2009: BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,083
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	694
Number of retired or separated participants receiving benefits	2009-01-01	251
Number of other retired or separated participants entitled to future benefits	2009-01-01	225
Total of all active and inactive participants	2009-01-01	1,170
Total participants	2009-01-01	0

Form 5500 Responses for BLUE CROSS & BLUE SHIELD OF MS, INC. EMPLOYEE GROUP HEALTH PLAN

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• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 561038919]
• BLUE CROSS BLUE SHIELD ALABAMA [EIN = 630355713]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHEILD OF ALABAMA [EIN = 273410813]
• BLUE CROSS AND BLUE SHIELD OF ALABAMA [EIN = 630103830]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHEILD OF NORTH CAROLINA [EIN = 562384240]
• BLUE CROSS BLUE SHIELD ALABAMA DENTAL [EIN = 630355713]
• BLUE CROSS BLUE SHIELD PLAN [EIN = 451580204]
• BLUE CROSS BLUE SHIELD OF MICHIGAN EMPLOYEES' MASTER RETIREMENT TRUST [EIN = 301140600]
• BLUE CROSS BLUE SHIELD OF MINNESOTA [EIN = 416050237]
• BLUE CROSS ANIMAL HOSPITAL GROUP 401(K) PLAN [EIN = 870903171]
• BLUE CROSS & BLUE SHIELD OF RHODE ISLAND GROUP BUSINESS TRAVEL ACCIDENT PLAN [EIN = 050158952]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN [EIN = 860004538]
• BLUE CROSS BLUE SHIELD OF TEXAS MEDICAL INSURANCE PLAN [EIN = 842662763]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]
• BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA [EIN = 223851031]
• BLUE CROSS BLUE SHIELD OF ND SEVERANCE PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF NORTH DAKOTA HEALTHCARE REIMBURSEMENT PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF AZ [EIN = 882806512]
• BLUE CROSS PET CARE, INC 401K PLAN [EIN = 873520766]
• BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT [EIN = 820344294]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 831077369]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]

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