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EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN
Plan identification number 503

EMPLOYEE HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. has sponsored the creation of one or more 401k plans.

Company Name:BLUE CROSS & BLUE SHIELD OF ARIZONA, INC.
Employer identification number (EIN):860004538
NAIC Classification:524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032024-01-01GREG WELLS, CHIEF PEOPLE OFFICER
5032023-01-01
5032023-01-01GREG WELLS, CHIEF PEOPLE OFFICER
5032022-01-01
5032022-01-01GREG WELLS, CHIEF PEOPLE OFFICER
5032021-01-01
5032021-01-01GREG WELLS, CHIEF HR OFFICER
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01GREG WELLS, CHIEF HR OFFICER
5032016-01-01GREG WELLS, VICE PRESIDENT
5032015-01-01GREG WELLS, VICE PRESIDENT
5032014-01-01GREG WELLS, VICE PRESIDENT
5032013-01-01GREG WELLS, VICE PRESIDENT
5032012-01-01GREG WELLS, VICE PRESIDENT
5032011-01-01GREG WELLS, VICE PRESIDENT
5032009-01-01GREG WELLS, VICE PRESIDENT
5032009-01-01GREG WELLS, VICE PRESIDENT

Plan Statistics for EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN

Measure Date Value
2023: EMPLOYEE HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-012,616
Total number of active participants reported on line 7a of the Form 55002023-01-012,735
Number of retired or separated participants receiving benefits2023-01-01186
Total of all active and inactive participants2023-01-012,921
Total participants2023-01-012,921
2022: EMPLOYEE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,000
Total number of active participants reported on line 7a of the Form 55002022-01-012,404
Number of retired or separated participants receiving benefits2022-01-01211
Total of all active and inactive participants2022-01-012,615
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-011
Total participants2022-01-012,616
2021: EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,019
Total number of active participants reported on line 7a of the Form 55002021-01-011,805
Number of retired or separated participants receiving benefits2021-01-01194
Total of all active and inactive participants2021-01-011,999
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-012,000
2020: EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,797
Total number of active participants reported on line 7a of the Form 55002020-01-011,802
Number of retired or separated participants receiving benefits2020-01-01190
Number of other retired or separated participants entitled to future benefits2020-01-0126
Total of all active and inactive participants2020-01-012,018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-012,019
2019: EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,894
Total number of active participants reported on line 7a of the Form 55002019-01-011,690
Number of retired or separated participants receiving benefits2019-01-01100
Number of other retired or separated participants entitled to future benefits2019-01-017
Total of all active and inactive participants2019-01-011,797
Total participants2019-01-011,797
2018: EMPLOYEE HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,797
Total number of active participants reported on line 7a of the Form 55002018-01-011,413
Number of retired or separated participants receiving benefits2018-01-01463
Number of other retired or separated participants entitled to future benefits2018-01-0112
Total of all active and inactive participants2018-01-011,888
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-016
Total participants2018-01-011,894
2017: EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,777
Total number of active participants reported on line 7a of the Form 55002017-01-011,346
Number of retired or separated participants receiving benefits2017-01-01448
Total of all active and inactive participants2017-01-011,794
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-013
Total participants2017-01-011,797
2016: EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,755
Total number of active participants reported on line 7a of the Form 55002016-01-011,335
Number of retired or separated participants receiving benefits2016-01-01436
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,771
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-016
Total participants2016-01-011,777
2015: EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,619
Total number of active participants reported on line 7a of the Form 55002015-01-011,343
Number of retired or separated participants receiving benefits2015-01-01407
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,750
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-015
Total participants2015-01-011,755
2014: EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,613
Total number of active participants reported on line 7a of the Form 55002014-01-011,248
Number of retired or separated participants receiving benefits2014-01-01366
Total of all active and inactive participants2014-01-011,614
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-015
Total participants2014-01-011,619
2013: EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,576
Total number of active participants reported on line 7a of the Form 55002013-01-011,266
Number of retired or separated participants receiving benefits2013-01-01342
Total of all active and inactive participants2013-01-011,608
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-015
Total participants2013-01-011,613
2012: EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,604
Total number of active participants reported on line 7a of the Form 55002012-01-011,282
Number of retired or separated participants receiving benefits2012-01-01291
Total of all active and inactive participants2012-01-011,573
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-013
Total participants2012-01-011,576
2011: EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,678
Total number of active participants reported on line 7a of the Form 55002011-01-011,324
Number of retired or separated participants receiving benefits2011-01-01278
Total of all active and inactive participants2011-01-011,602
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-012
Total participants2011-01-011,604
2009: EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,697
Total number of active participants reported on line 7a of the Form 55002009-01-011,458
Number of retired or separated participants receiving benefits2009-01-01225
Total of all active and inactive participants2009-01-011,683
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-017
Total participants2009-01-011,690

Form 5500 Responses for EMPLOYEE HEALTH PLAN

2023: EMPLOYEE HEALTH PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: EMPLOYEE HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPLOYEE HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPLOYEE HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: EMPLOYEE HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: EMPLOYEE HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number007626
Policy instance 2
Insurance contract or identification number007626
Number of Individuals Covered3125
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $167,619
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,820,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
Insurance contract or identification number50 / 52
Number of Individuals Covered2921
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,434,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number007626
Policy instance 3
Insurance contract or identification number007626
Number of Individuals Covered2673
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $67,598
Total amount of fees paid to insurance companyUSD $56,572
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,268,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberYZ4 038, 039
Policy instance 2
Insurance contract or identification numberYZ4 038, 039
Number of Individuals Covered3995
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
Insurance contract or identification number50 / 52
Number of Individuals Covered2616
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,249,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number007626
Policy instance 3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberYZ4 038, 039
Policy instance 2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberYZ4 038, 039
Policy instance 2
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number52712
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberYZ4 038, 039
Policy instance 2
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number52712
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number52712
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783 / 98545
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402674G
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402674G
Policy instance 4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number52712
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783 / 98545
Policy instance 2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402674G
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402674G
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152459
Policy instance 3
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152459
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number152459
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )
Policy contract number50 / 52
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9728783
Policy instance 2
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number675730-0GL
Policy instance 3

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