BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 401k Plan overview

BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL 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
510	2022-01-01
510	2021-01-01
510	2020-01-01
510	2019-01-01
510	2018-01-01	CHERI D. GREEN		CHERI D. GREEN	2019-07-17
510	2017-01-01	CHERI GREEN		CHERI GREEN	2018-07-30
510	2016-01-01	CHERI GREEN		CHERI GREEN	2017-06-23
510	2015-01-01	CHERI GREEN		CHERI GREEN	2016-08-01
510	2014-01-01	CHERI GREEN		CHERI GREEN	2015-07-16
510	2013-01-01	ALISON TYLER		ALISON TYLER	2014-10-13
510	2012-01-01	JOHN H. PROCTOR		JOHN H. PROCTOR	2013-06-10
510	2011-01-01	AMY AYERS		AMY AYERS	2012-07-05
510	2010-01-01	AMY AYERS		AMY AYERS	2011-06-30
510	2009-01-01	AMY AYERS		AMY AYERS	2010-07-20

Plan Statistics for BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN

Measure	Date	Value
2022: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	877
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	474
Number of retired or separated participants receiving benefits	2022-01-01	339
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	813
2021: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	866
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	488
Number of retired or separated participants receiving benefits	2021-01-01	388
Total of all active and inactive participants	2021-01-01	876
2020: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	865
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	545
Number of retired or separated participants receiving benefits	2020-01-01	323
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	868
2019: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	879
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	557
Number of retired or separated participants receiving benefits	2019-01-01	307
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	864
2018: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	858
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	570
Number of retired or separated participants receiving benefits	2018-01-01	301
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	871
2017: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	783
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	519
Number of retired or separated participants receiving benefits	2017-01-01	291
Total of all active and inactive participants	2017-01-01	810
2016: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	817
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	544
Number of retired or separated participants receiving benefits	2016-01-01	269
Total of all active and inactive participants	2016-01-01	813
2015: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	779
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	540
Number of retired or separated participants receiving benefits	2015-01-01	261
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	801
2014: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	830
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	559
Number of retired or separated participants receiving benefits	2014-01-01	227
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	864
2013: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	638
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	572
Number of retired or separated participants receiving benefits	2013-01-01	23
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	673
2012: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	660
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	566
Number of retired or separated participants receiving benefits	2012-01-01	72
Number of other retired or separated participants entitled to future benefits	2012-01-01	74
Total of all active and inactive participants	2012-01-01	712
2011: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	808
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	599
Number of retired or separated participants receiving benefits	2011-01-01	209
Number of other retired or separated participants entitled to future benefits	2011-01-01	63
Total of all active and inactive participants	2011-01-01	871
2010: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	860
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	598
Number of retired or separated participants receiving benefits	2010-01-01	197
Number of other retired or separated participants entitled to future benefits	2010-01-01	108
Total of all active and inactive participants	2010-01-01	903
2009: BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,001
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	674
Number of retired or separated participants receiving benefits	2009-01-01	32
Number of other retired or separated participants entitled to future benefits	2009-01-01	216
Total of all active and inactive participants	2009-01-01	922
Total participants	2009-01-01	0

Form 5500 Responses for BLUE CROSS & BLUE SHIELD OF MISS, INC. GROUP DENTAL PLAN

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• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 133082788]
• BLUE CROSS BLUE SHIELD OF MISSISSIPPI [EIN = 620510412]
• BLUE CROSS/BLUE SHIELD OF MICHIGAN GAYLORD DIVISION PLAN [EIN = 340549970]
• BLUE CROSS BLUE SHIELD GROUP INSURANCE [EIN = 160743037]
• BLUE CROSS OF NORTHEASTERN PENNSYLVANIA [EIN = 231743282]
• 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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