401k Plan data: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN plan

NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 401k Plan overview

Plan Name	NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN
Plan identification number	004

NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

BLUE CROSS BLUE SHIELD OF NORTH DAKOTA has sponsored the creation of one or more 401k plans.

Company Name: BLUE CROSS BLUE SHIELD OF NORTH DAKOTA

Employer identification number (EIN): 450173185

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2017-01-01
004 2016-01-01
004 2015-01-01
004 2014-01-01
004 2013-01-01
004 2012-01-01 DAVE BREUER
004 2011-01-01 DAVID BREUER
004 2009-01-01 KRISTEN KUTZER

Plan Statistics for NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN

401k plan membership statisitcs for NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN

Measure Date Value
2017: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 203
Total of all active and inactive participants 2017-01-01 0
Total participants 2017-01-01 0
2016: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 139
Number of other retired or separated participants entitled to future benefits 2016-01-01 64
Total of all active and inactive participants 2016-01-01 203
Total participants 2016-01-01 203
Number of participants with account balances 2016-01-01 203
2015: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 139
Total of all active and inactive participants 2015-01-01 139
Total participants 2015-01-01 139
Number of participants with account balances 2015-01-01 212
2014: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 195
Total of all active and inactive participants 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 212
2013: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 223
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 195
Total of all active and inactive participants 2013-01-01 195
Total participants 2013-01-01 195
2012: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 273
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 1
Total participants 2012-01-01 1
Number of participants with account balances 2012-01-01 254
2011: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 352
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 272
Number of retired or separated participants receiving benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 273
Total participants 2011-01-01 273
Number of participants with account balances 2011-01-01 296
2009: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 480
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 346
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 347
Total participants 2009-01-01 347
Number of participants with account balances 2009-01-01 305
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2017: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	203
Total of all active and inactive participants	2017-01-01	0
Total participants	2017-01-01	0
2016: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	139
Number of other retired or separated participants entitled to future benefits	2016-01-01	64
Total of all active and inactive participants	2016-01-01	203
Total participants	2016-01-01	203
Number of participants with account balances	2016-01-01	203
2015: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	139
Total of all active and inactive participants	2015-01-01	139
Total participants	2015-01-01	139
Number of participants with account balances	2015-01-01	212
2014: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	195
Total of all active and inactive participants	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	212
2013: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	223
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	195
Total of all active and inactive participants	2013-01-01	195
Total participants	2013-01-01	195
2012: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	273
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	1
Total participants	2012-01-01	1
Number of participants with account balances	2012-01-01	254
2011: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	352
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	272
Number of retired or separated participants receiving benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	273
Total participants	2011-01-01	273
Number of participants with account balances	2011-01-01	296
2009: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	480
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	346
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	347
Total participants	2009-01-01	347
Number of participants with account balances	2009-01-01	305
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN

Measure	Date	Value
2017 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2017 401k financial data
Total transfer of assets from this plan	2017-07-05	$4,137,399
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-07-05	$0
Total income from all sources (including contributions)	2017-07-05	$248,413
Total of all expenses incurred	2017-07-05	$31,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-07-05	$28,750
Value of total assets at end of year	2017-07-05	$0
Value of total assets at beginning of year	2017-07-05	$3,920,684
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-07-05	$2,948
Total dividends received (eg from common stock, registered investment company shares)	2017-07-05	$2,062
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-07-05	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-07-05	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-07-05	$2,062
Was this plan covered by a fidelity bond	2017-07-05	Yes
Value of fidelity bond cover	2017-07-05	$5,000,000
If this is an individual account plan, was there a blackout period	2017-07-05	Yes
Were there any nonexempt tranactions with any party-in-interest	2017-07-05	No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-07-05	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-07-05	No
Value of net income/loss	2017-07-05	$216,715
Value of net assets at end of year (total assets less liabilities)	2017-07-05	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-07-05	$3,920,684
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-07-05	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-07-05	No
Were any leases to which the plan was party in default or uncollectible	2017-07-05	No
Investment advisory and management fees	2017-07-05	$2,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-07-05	$268,636
Value of interest in common/collective trusts at end of year	2017-07-05	$0
Value of interest in common/collective trusts at beginning of year	2017-07-05	$3,652,048
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-07-05	$21,894
Net investment gain or loss from common/collective trusts	2017-07-05	$224,457
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-07-05	No
Was there a failure to transmit to the plan any participant contributions	2017-07-05	No
Has the plan failed to provide any benefit when due under the plan	2017-07-05	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-07-05	$28,750
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-07-05	Yes
Did the plan have assets held for investment	2017-07-05	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-07-05	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-07-05	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-07-05	Yes
Opinion of an independent qualified public accountant for this plan	2017-07-05	Disclaimer
Accountancy firm name	2017-07-05	EIDE BAILLEY
Accountancy firm EIN	2017-07-05	450250958
2016 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$259,780
Total of all expenses incurred	2016-12-31	$139,363
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$133,454
Value of total assets at end of year	2016-12-31	$3,920,684
Value of total assets at beginning of year	2016-12-31	$3,800,267
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,909
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$6,668
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$6,668
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$120,417
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,920,684
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,800,267
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$5,909
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$268,636
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$214,505
Value of interest in common/collective trusts at end of year	2016-12-31	$3,652,048
Value of interest in common/collective trusts at beginning of year	2016-12-31	$3,585,762
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$17,958
Net investment gain or loss from common/collective trusts	2016-12-31	$235,154
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$133,454
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2016-12-31	450250958
2015 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$-47,716
Total of all expenses incurred	2015-12-31	$306,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$300,204
Value of total assets at end of year	2015-12-31	$3,800,267
Value of total assets at beginning of year	2015-12-31	$4,154,278
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,091
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$8,878
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$8,878
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-354,011
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,800,267
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,154,278
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$214,505
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$223,056
Value of interest in common/collective trusts at end of year	2015-12-31	$3,585,762
Value of interest in common/collective trusts at beginning of year	2015-12-31	$3,931,222
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-6,283
Net investment gain or loss from common/collective trusts	2015-12-31	$-50,311
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$300,204
Contract administrator fees	2015-12-31	$6,091
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	EIDE BAILLY
Accountancy firm EIN	2015-12-31	450250958
2014 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$770,399
Total of all expenses incurred	2014-12-31	$265,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$259,982
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$468,006
Value of total assets at end of year	2014-12-31	$4,154,278
Value of total assets at beginning of year	2014-12-31	$3,649,711
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$5,850
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$7,914
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$7,914
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$504,567
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,154,278
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,649,711
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$223,056
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$155,446
Value of interest in common/collective trusts at end of year	2014-12-31	$3,931,222
Value of interest in common/collective trusts at beginning of year	2014-12-31	$3,494,265
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$7,019
Net investment gain or loss from common/collective trusts	2014-12-31	$287,460
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$468,006
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$259,982
Contract administrator fees	2014-12-31	$5,850
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2014-12-31	450250958
2013 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$1,070,477
Total of all expenses incurred	2013-12-31	$109,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$104,997
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$481,661
Value of total assets at end of year	2013-12-31	$3,649,711
Value of total assets at beginning of year	2013-12-31	$2,688,806
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$4,575
Total interest from all sources	2013-12-31	$150
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$3,313
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$3,313
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$960,905
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,649,711
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$2,688,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$4,575
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$155,446
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$55,195
Value of interest in common/collective trusts at end of year	2013-12-31	$3,494,265
Value of interest in common/collective trusts at beginning of year	2013-12-31	$2,633,611
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$150
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$22,816
Net investment gain or loss from common/collective trusts	2013-12-31	$562,537
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$481,661
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$104,997
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2013-12-31	450250958
2012 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$276,678
Total unrealized appreciation/depreciation of assets	2012-12-31	$276,678
Total transfer of assets from this plan	2012-12-31	$59,372
Total income from all sources (including contributions)	2012-12-31	$803,613
Total loss/gain on sale of assets	2012-12-31	$34,411
Total of all expenses incurred	2012-12-31	$276,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$272,883
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$490,828
Value of total assets at end of year	2012-12-31	$2,688,806
Value of total assets at beginning of year	2012-12-31	$2,221,067
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,619
Total interest from all sources	2012-12-31	$393
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$983
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$611
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Other income not declared elsewhere	2012-12-31	$133
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$527,111
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$2,688,806
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,221,067
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$3,619
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$55,195
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$28,695
Value of interest in common/collective trusts at end of year	2012-12-31	$2,633,611
Value of interest in common/collective trusts at beginning of year	2012-12-31	$2,173,198
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$393
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$187
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$490,828
Employer contributions (assets) at beginning of year	2012-12-31	$19,174
Income. Dividends from common stock	2012-12-31	$372
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$272,883
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$532,317
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$497,906
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2012-12-31	450250958
2011 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-58,669
Total unrealized appreciation/depreciation of assets	2011-12-31	$-58,669
Total income from all sources (including contributions)	2011-12-31	$556,854
Total of all expenses incurred	2011-12-31	$234,324
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$231,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$614,198
Value of total assets at end of year	2011-12-31	$2,221,067
Value of total assets at beginning of year	2011-12-31	$1,898,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$3,067
Total interest from all sources	2011-12-31	$375
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$423
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Other income not declared elsewhere	2011-12-31	$130
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$322,530
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,221,067
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,898,537
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$3,067
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$28,695
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$49,073
Value of interest in common/collective trusts at end of year	2011-12-31	$2,173,198
Value of interest in common/collective trusts at beginning of year	2011-12-31	$1,827,654
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$375
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$397
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$614,198
Employer contributions (assets) at end of year	2011-12-31	$19,174
Employer contributions (assets) at beginning of year	2011-12-31	$21,810
Income. Dividends from common stock	2011-12-31	$423
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$231,257
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	EIDE BAILLY LLP
Accountancy firm EIN	2011-12-31	450250958
2010 : NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$210,670
Total unrealized appreciation/depreciation of assets	2010-12-31	$210,670
Total income from all sources (including contributions)	2010-12-31	$800,899
Total of all expenses incurred	2010-12-31	$134,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$132,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$588,254
Value of total assets at end of year	2010-12-31	$1,898,537
Value of total assets at beginning of year	2010-12-31	$1,232,120
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,108
Total interest from all sources	2010-12-31	$370
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$330
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$666,417
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,898,537
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,232,120
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$2,108
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$49,073
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$29,656
Interest earned on other investments	2010-12-31	$123
Value of interest in common/collective trusts at end of year	2010-12-31	$1,827,654
Value of interest in common/collective trusts at beginning of year	2010-12-31	$1,181,469
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$247
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,275
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$588,254
Employer contributions (assets) at end of year	2010-12-31	$21,810
Employer contributions (assets) at beginning of year	2010-12-31	$20,995
Income. Dividends from common stock	2010-12-31	$330
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$132,374
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2010-12-31	450250958

Form 5500 Responses for NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN

2017: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: NORIDIAN MUTUAL INSURANCE COMPANY RETIREMENT INVESTMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	BLUE CROSS BLUE SHIELD OF NORTH DAKOTA
Employer identification number (EIN):	450173185
NAIC Classification:	524140