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

BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE 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
508	2022-01-01
508	2021-01-01

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

Measure	Date	Value
2022: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	125
Total of all active and inactive participants	2022-01-01	125
Total participants	2022-01-01	125
2021: BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	109
Total of all active and inactive participants	2021-01-01	109
Total participants	2021-01-01	109

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

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• BLUE CROSS & BLUE SHIELD OF RHODE ISLAND RETIREMENT PLAN [EIN = 050158952]
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• BLUE CROSS BLUE SHIELD OF MICHIGAN HEALTH CARE [EIN = 382069753]
• BLUE CROSS OF NORTH EASTERN PENNSYLVANIA [EIN = 202572391]
• BLUE CROSS BLUE SHIELD OF WYOMING FLEXIBLE BENEFIT PLAN [EIN = 830231011]
• BLUE CROSS BLUE SHIELD OF MICHIGAN FOR ALMA COLLEGE [EIN = 381359083]
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• BLUE CROSS BLUE SHIELD OF RI [EIN = 050258809]
• BLUE CROSS BLUE SHIELD OF GEORGIA HEALTH PPO 1047626000 [EIN = 582067428]
• BLUE CROSS/BLUE SHIELD [EIN = 580707657]
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• BLUE CROSS BLUE SHIELD OF DELAWARE RETIREE MEDICAL PLAN [EIN = 510020405]
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• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA RETIREMENT SAVINGS PLAN [EIN = 560894904]
• BLUE CROSS OF NORTHEASTERN PENNSYLVANIA [EIN = 161486032]
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• BLUE CROSS AND BLUE SHIELD OF ALABAMA RETIREE MEDICAL PLAN [EIN = 630103830]
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• BLUE CROSS AND BLUE SHIELD OF ALABAMA 401(K) SALARY DEFERRAL PLAN & TRUST [EIN = 630103830]
• BLUE CROSS BLUE SHIELD OF MICHIGAN REPRESENTED EMPLOYEES SAVINGS PLAN [EIN = 382069753]
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• BLUE CROSS BLUE SHEILD [EIN = 464218169]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN [EIN = 561868823]
• BLUE CROSS BLUE SHEILD OF ALABAMA [EIN = 273410813]
• BLUE CROSS AND BLUE SHIELD OF NEBRASKA WRAP PLAN [EIN = 470095156]
• BLUE CROSS AND BLUE SHIELD OF ALABAMA VISION PLAN [EIN = 630103830]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 200232609]
• BLUE CROSS BLUE SHIELD OF TEXAS [EIN = 752469062]
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• BLUE CROSS BLUE SHIELD [EIN = 030369958]
• BLUE CROSS BLUE SHIELD [EIN = 273144760]
• BLUE CROSS & BLUE SHIELD OF MONTANA TAX-FAVORED SAVINGS PROGRAM [EIN = 810216685]
• BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA [EIN = 270229866]
• BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICAL PLAN [EIN = 300752433]
• BLUE CROSS BLUE SHIELD OF NORTH CAROLINA [EIN = 562151684]
• BLUE CROSS OF WESTERN PENNSYLVANIA MEDICARE SUPPLEMENT OVER 65 SPECIAL PORT ALLEGANY [EIN = 250729265]
• BLUE CROSS BLUE SHIELD DENTAL [EIN = 570678887]
• BLUE CROSS BLUE SHIELD OF ILLINOIS HMOS [EIN = 383984647]
• BLUE CROSS AND BLUE SHIELD OF NC [EIN = 560611127]
• BLUE CROSS VISION [EIN = 231365953]
• BLUE CROSS BLUE SHIELD MAJOR MEDICAL HEALTH [EIN = 050269232]
• BLUE CROSS AND BLUE SHIELD HOSPITAL AND MEDICAL INSURANCE PLAN [EIN = 380533740]
• BLUE CROSS BLUE SHIELD OF DELAWARE RETIREE LIFE INSURANCE PLAN [EIN = 510020405]
• BLUE CROSS BLUE SHIELD OF DELAWARE SEVERANCE PLAN [EIN = 510020405]
• BLUE CROSS BLUE SHIELD OF NORTH DAKOTA [EIN = 911853068]
• BLUE CROSS BLUE SHIELD OF NORTH CAROLINA [EIN = 561902865]
• BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC [EIN = 043000119]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 561950817]
• BLUE CROSS BLUE SHIELD HEALTH INS [EIN = 510333030]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 201137248]
• BLUE CROSS BLUE SHIELD OF NORTH CAROLINA [EIN = 561236854]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 201137248]
• BLUE CROSS BLUE SHIELD OF ILLINOIS GROUP HEALTH INSURANCE PLAN [EIN = 362754650]
• BLUE CROSS BLUE SHIELD NC [EIN = 141919474]
• BLUE CROSS BLUE SHIELD OF GREATER NY MEDICAL PLAN [EIN = 133957095]
• BLUE CROSS BLUE SHIELD OF MICHIGAN [EIN = 381362823]
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• BLUE CROSS OF NORTHWEST OHIO EMPLOYEES' RETIREMENT TRUST [EIN = 340648820]
• BLUE CROSS BLUE SHIELD DENTAL [EIN = 042103638]
• BLUE CROSS BLUE SHIELD GP HOSP AND MED SURG PL MAJOR MEDICAL COVERAGE [EIN = 610458355]
• BLUE CROSS BLUE SHIELD OF ILLINIOS HMOS [EIN = 363984647]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 561975885]
• BLUE CROSS & BLUE SHIELD OF ALABAMA ELECTIVE LIFE INSURANCE PLAN [EIN = 630103830]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 561625075]
• BLUE CROSS BLUE SHIELD OF RI [EIN = 160812661]
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• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 581622664]
• BLUE CROSS BLUE SHIELD OF MA GROUP HLTH INS EMPLS UNION BUTTERFIELD [EIN = 561628422]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 562161782]
• BLUE CROSS AND BLUE SHIELD PPO [EIN = 205832739]
• BLUE CROSS BLUE SHIELD COMPCARE [EIN = 391500683]
• BLUE CROSS BLUE SHIELD [EIN = 751299243]
• 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 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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