SHORT TERM DISABILITY 401k Plan overview

SHORT TERM DISABILITY Benefits

401k Sponsoring company profile

Company Name:	BLUE CROSS AND BLUE SHIELD OF NEBRASKA
Employer identification number (EIN):	470095156
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
513	2016-01-01	CATHY FILIPIAK
513	2016-01-01
513	2015-01-01	BRAD SCHROEDER
513	2014-01-01	CATHY FILIPIAK
513	2013-01-01	CATHY FILIPIAK
513	2012-01-01	TOM WHALEN		LEWIS E TROWBRIDGE	2013-06-25
513	2011-01-01	TOMMY WHALEN
513	2009-01-01	TOMMY WHALEN		LEWIS TROWBRIDGE	2010-07-19

Plan Statistics for SHORT TERM DISABILITY

Measure	Date	Value
2016: SHORT TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,126
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
2015: SHORT TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,109
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,126
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	1,126
2014: SHORT TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,109
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,109
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	1,109
2013: SHORT TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,192
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,109
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	1,109
2012: SHORT TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,324
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,192
Number of retired or separated participants receiving benefits	2012-01-01	0
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	1,192
2011: SHORT TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,421
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,324
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,324
2009: SHORT TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,281
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,437
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,437

Form 5500 Responses for SHORT TERM DISABILITY

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