BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 401k Plan overview

BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT Benefits

401k Sponsoring company profile

Company Name:	BLUE CROSS OF IDAHO HEALTH SERVICE, INC.
Employer identification number (EIN):	820344294
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
502	2022-01-01
502	2021-01-01
502	2019-01-01
502	2018-01-01
502	2017-01-01
502	2016-06-01

Plan Statistics for BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT

Measure	Date	Value
2022: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2022 401k membership
Total participants, beginning-of-year	2022-01-01	275
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	300
Total of all active and inactive participants	2022-01-01	300
Total participants	2022-01-01	300
2021: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2021 401k membership
Total participants, beginning-of-year	2021-01-01	268
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	292
Total of all active and inactive participants	2021-01-01	292
Total participants	2021-01-01	292
2019: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2019 401k membership
Total participants, beginning-of-year	2019-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	270
Total of all active and inactive participants	2019-01-01	270
Total participants	2019-01-01	270
2018: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2018 401k membership
Total participants, beginning-of-year	2018-01-01	235
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	247
Total of all active and inactive participants	2018-01-01	247
Total participants	2018-01-01	247
2017: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2017 401k membership
Total participants, beginning-of-year	2017-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	239
Total of all active and inactive participants	2017-01-01	239
Total participants	2017-01-01	239
2016: BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership
Total participants, beginning-of-year	2016-06-01	208
Total number of active participants reported on line 7a of the Form 5500	2016-06-01	213
Total of all active and inactive participants	2016-06-01	213
Total participants	2016-06-01	213

Form 5500 Responses for BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT

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• BLUE CROSS BLUE SHIELD GROUP INSURANCE [EIN = 160743037]
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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 BLUE SHIELD OF ALABAMA [EIN = 831077369]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]

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