BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 401k Plan overview

BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN Benefits

401k Sponsoring company profile

Company Name:	BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.
Employer identification number (EIN):	860004538
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
505	2022-01-01
505	2021-01-01
505	2020-01-01
505	2019-01-01
505	2018-01-01
505	2017-01-01	GREG WELLS, CHIEF HR OFFICER
505	2016-01-01	GREG WELLS, VICE PRESIDENT
505	2015-01-01	GREG WELLS, VICE PRESIDENT
505	2014-01-01	GREG WELLS, VICE PRESIDENT
505	2013-01-01	GREG WELLS, VICE PRESIDENT
505	2012-01-01	GREG WELLS, VICE PRESIDENT
505	2011-01-01	GREG WELLS, VICE PRESIDENT
505	2010-01-01	GREG WELLS, VICE PRESIDENT
505	2009-01-01	GREG WELLS, VICE PRESIDENT

Plan Statistics for BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN

Measure	Date	Value
2022: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	2,567
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	2,814
Total of all active and inactive participants	2022-01-01	2,814
Total participants	2022-01-01	2,814
2021: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,986
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	2,567
Total of all active and inactive participants	2021-01-01	2,567
Total participants	2021-01-01	2,567
2020: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,843
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,986
Total of all active and inactive participants	2020-01-01	1,986
Total participants	2020-01-01	1,986
2019: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,468
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,843
Total of all active and inactive participants	2019-01-01	1,843
Total participants	2019-01-01	1,843
2018: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,362
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,468
Total of all active and inactive participants	2018-01-01	1,468
Total participants	2018-01-01	1,468
2017: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,457
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,428
Total of all active and inactive participants	2017-01-01	1,428
Total participants	2017-01-01	1,428
2016: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,458
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,457
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	1,457
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1,457
2015: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,438
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,458
Number of retired or separated participants receiving benefits	2015-01-01	0
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	1,458
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	1,458
2014: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,337
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,436
Number of retired or separated participants receiving benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	1,438
Total participants	2014-01-01	1,438
2013: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,341
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,337
Total of all active and inactive participants	2013-01-01	1,337
Total participants	2013-01-01	1,337
2012: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,385
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,341
Total of all active and inactive participants	2012-01-01	1,341
Total participants	2012-01-01	1,341
2011: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,480
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,383
Number of retired or separated participants receiving benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	1,385
Total participants	2011-01-01	1,385
2010: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,531
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,480
Total of all active and inactive participants	2010-01-01	1,480
Total participants	2010-01-01	1,480
2009: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,562
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,531
Total of all active and inactive participants	2009-01-01	1,531
Total participants	2009-01-01	1,531

Form 5500 Responses for BLUE CROSS BLUE SHIELD OF ARIZONA, INC. SEVERANCE PLAN

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• 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 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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