| Plan Name | BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. |
| Employer identification number (EIN): | 860004538 |
| NAIC Classification: | 524140 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2024-01-01 | GREG WELLS, CHIEF PEOPLE OFFICER | |||
| 508 | 2023-01-01 | ||||
| 508 | 2023-01-01 | GREG WELLS, CHIEF PEOPLE OFFICER | |||
| 508 | 2022-01-01 | ||||
| 508 | 2022-01-01 | GREG WELLS, CHIEF PEOPLE OFFICER | |||
| 508 | 2021-01-01 | ||||
| 508 | 2021-01-01 | GREG WELLS, CHIEF HR OFFICER |
| 2023: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |