Civic Intelligence

Bcbsm Non-Bargaining Unit Internal Health Benefit Trust

990 • Fiscal year 2019 • EIN 84-6871980

Nov 26, 2019 to Dec 31, 2019 • Filed on Nov 13, 2020

600 Lafayette East Mail Code 1801Detroit, MI 48226-2998

(313) 983-1633

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

17th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2019 filings • 501(c)9 • $100M-$250M nonprofits • Source year 2019

Liabilities / Revenue

17th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2019 filings • 501(c)9 • $100M-$250M nonprofits • Source year 2019

Net Margin

100th percentile

100%

Higher net margin than 100% of similar nonprofits.

2019 filings • 501(c)9 • $100M-$250M nonprofits • Source year 2019

Top Officer Pay

32nd percentile

$0

Higher top officer pay than 32% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2019 filings • 501(c)9 • $100M-$250M nonprofits • Source year 2019

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2019

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2019

Assets

$106,875,515

No earlier filing loaded for comparison.

Net Assets

$106,875,515

No earlier filing loaded for comparison.

Liabilities

$0

No earlier filing loaded for comparison.

Revenue

$106,875,515

No earlier filing loaded for comparison.

Expenses

$0

No earlier filing loaded for comparison.

Net Income

$106,875,515

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$150M$100M$50M$0Assets 2019: $106,875,515Liabilities 2019: $0Net Assets 2019: $106,875,5152019Assets 2020: $99,343,018Liabilities 2020: $1,715,542Net Assets 2020: $97,627,4762020Assets 2021: $91,208,135Liabilities 2021: $51,402Net Assets 2021: $91,156,7332021Assets 2022: $64,495,910Liabilities 2022: $38,228Net Assets 2022: $64,457,6822022Assets 2023: $53,944,248Liabilities 2023: $24,046Net Assets 2023: $53,920,2022023Assets 2024: $30,158,950Liabilities 2024: $12,579Net Assets 2024: $30,146,3712024

Highlighted filing

2019

Assets$106,875,515
Liabilities$0
Net Assets$106,875,515

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$150M$100M$50M$0-$50MRevenue 2019: $106,875,515Expenses 2019: $0Net Income 2019: $106,875,5152019Revenue 2020: $709,750Expenses 2020: $10,234,850Net Income 2020: -$9,525,1002020Revenue 2021: $2,924,541Expenses 2021: $14,107,937Net Income 2021: -$11,183,3962021Revenue 2022: $638,478Expenses 2022: $15,441,126Net Income 2022: -$14,802,6482022Revenue 2023: $829,636Expenses 2023: $17,545,642Net Income 2023: -$16,716,0062023Revenue 2024: $3,105,939Expenses 2024: $27,860,357Net Income 2024: -$24,754,4182024

Highlighted filing

2019

Revenue$106,875,515
Expenses$0
Net Income$106,875,515
Jump To
Filing Snapshot
Filing Period
Nov 26, 2019 to Dec 31, 2019
Signed
Nov 13, 2020
Return Version
2019v5.1
Gross Receipts
$106,875,515
Mission and Program Overview

Mission

The trust was created for the exclusive purpose of providing health benefits to eligible employees of blue cross blue shield of michigan.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cap Stk Tr Prin Current Funds$0$106,875,515▲ $106,875,515
Investments in Publicly Traded Securities-$106,800,000-
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Rtn Earn Endowment Incm Other Fnds$0$0→ $0
Total Assets$0$106,875,515▲ $106,875,515
Other Assets Total$0$75,515▲ $75,515
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$0$106,875,515▲ $106,875,515
Total Liabilities and Net Assets / Fund Balance$0$106,875,515▲ $106,875,515
Compensation and Service Providers

Board Members and Trustees

NameTitle
-Trustee
Cathy GoheenAdministrative Committee Member
Laurie ParmelyAdministrative Committee Member
Mark BartlettAdministrative Committee Member
Paul MozakAdministrative Committee Member
Waymond HarrisAdministrative Committee Member
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$106,800,000
Investment Income
$75,515
Other Revenue
$0
Change in Net Assets
$106,875,515
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$0
Other Expenses$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

Form 990 is reviewed and approved by a member of the senior management of blue cross blue shield of michigan, the primary contributing employer, before being filed.

Form 990, Part VI, Section B, Line 12C

All members of the trust's administrative committee are employees of blue cross blue shield of michigan and are required to certify their review of conflict of interest policies annually.

Form 990, Part VI, Section C, Line 19

The governing documents and conflict of interest policy, as well as the financial statements of the related plan, are available upon request.

Form 990, Part VII Contact Addresses for Officers, Directors, Etc

The northern trust company - 50 south la salle street, m-27, chicago, il 60603-1008.

Filing and Contact Details

Filer

Filer Name
Bcbsm Non-bargaining Unit Internal
EIN
84-6871980
Phone
3139831633
Address
600 LAFAYETTE EAST MAIL CODE 1801, DETROIT, MI 48226-2998

Signing Officer

Name
Matthew E Gray
Title
Northern Trust, as Trustee
Phone
3139831633
Signed
2020-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Benjamin Grier
Formed
2019
Legal Domicile
Mi
Voting Board Members
5
Independent Board Members
5
Employees
0
Volunteers
0

Preparer

Firm
George Johnson & Company
Address
1200 BUHL BUILDING 535 GRISWOLD, DETROIT, MI 48226-3689
Preparer
Michael R Nicholas
Phone
3139652655
Supplemental Narrative

Additional Explanations

FORM 990, PAGE 1, ITEM C - LEGAL NAME OF ORGANIZATION:

The legal name of the organization is the "blue cross blue shield of michigan non-bargaining unit internal health benefit trust".

Raw XML Appendix347 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/ActivityOrMissionDesc0THE TRUST WAS CREATED FOR THE EXCLUSIVE PURPOSE OF PROVIDING HEALTH BENEFITS TO ELIGIBLE EMPLOYEES OF BLUE CROSS BLUE SHIELD OF MICHIGAN.
IRS990/AnnualDisclosureCoveredPrsnInd01
IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt0THE NORTHERN TRUST COMPANY
IRS990/BooksInCareOfDetail/PhoneNum03126308934
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt050 SOUTH LA SALLE STREET M-27
IRS990/BooksInCareOfDetail/USAddress/CityNm0CHICAGO
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IRS990/Form990PartVIISectionAGrp/PersonNm1CATHY GOHEEN
IRS990/Form990PartVIISectionAGrp/PersonNm2WAYMOND HARRIS
IRS990/Form990PartVIISectionAGrp/PersonNm3PAUL MOZAK
IRS990/Form990PartVIISectionAGrp/PersonNm4LAURIE PARMELY
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
IRS990/Form990PartVIISectionAGrp/TitleTxt0ADMINISTRATIVE COMMITTEE MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt1ADMINISTRATIVE COMMITTEE MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt2ADMINISTRATIVE COMMITTEE MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt3ADMINISTRATIVE COMMITTEE MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt4ADMINISTRATIVE COMMITTEE MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt5TRUSTEE
IRS990/Form990ProvidedToGvrnBodyInd01
IRS990/Form990TFiledInd01
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IRS990/FSAuditedInd00
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IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt05
IRS990/GrantsToIndividualsInd00
IRS990/GrantsToOrganizationsInd00
IRS990/GrantToRelatedPersonInd00
IRS990/GrossReceiptsAmt0106875515
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd00
IRS990/IndependentAuditFinclStmtInd00
IRS990/IndependentVotingMemberCnt05
IRS990/IndivRcvdGreaterThan100KCnt00
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InitialReturnInd0X
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt075515
IRS990/InvestmentIncomeGrp/UnrelatedBusinessRevenueAmt075515
IRS990/InvestmentInJointVentureInd00
IRS990/InvestmentsPubTradedSecGrp/EOYAmt0106800000
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LegalDomicileStateCd0MI
IRS990/LoanOutstandingInd00
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembersOrStockholdersInd00
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd01
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IRS990/MoreThan5000KToIndividualsInd00
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IRS990/NetAssetsOrFundBalancesEOYAmt0106875515
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IRS990/NondeductibleContributionsInd00
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IRS990/OperateHospitalInd00
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IRS990/PoliticalCampaignActyInd00
IRS990/PrincipalOfficerNm0BENJAMIN GRIER
IRS990/ProfessionalFundraisingInd00
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IRS990/ProgramServiceRevenueGrp/Desc0EMPLOYER CONTRIBUTIONS
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt0106800000
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IRS990/ReconcilationRevenueExpnssAmt0106875515
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IRS990/ReportLandBuildingEquipmentInd00
IRS990/ReportOtherAssetsInd00
IRS990/ReportOtherLiabilitiesInd00
IRS990/ReportProgramRelatedInvstInd00
IRS990/RtnEarnEndowmentIncmOthFndsGrp/BOYAmt00
IRS990/RtnEarnEndowmentIncmOthFndsGrp/EOYAmt00
IRS990/ScheduleBRequiredInd00
IRS990/ScheduleJRequiredInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FORM 990 IS REVIEWED AND APPROVED BY A MEMBER OF THE SENIOR MANAGEMENT OF BLUE CROSS BLUE SHIELD OF MICHIGAN, THE PRIMARY CONTRIBUTING EMPLOYER, BEFORE BEING FILED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1ALL MEMBERS OF THE TRUST'S ADMINISTRATIVE COMMITTEE ARE EMPLOYEES OF BLUE CROSS BLUE SHIELD OF MICHIGAN AND ARE REQUIRED TO CERTIFY THEIR REVIEW OF CONFLICT OF INTEREST POLICIES ANNUALLY.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY, AS WELL AS THE FINANCIAL STATEMENTS OF THE RELATED PLAN, ARE AVAILABLE UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE NORTHERN TRUST COMPANY - 50 SOUTH LA SALLE STREET, M-27, CHICAGO, IL 60603-1008.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE LEGAL NAME OF THE ORGANIZATION IS THE "BLUE CROSS BLUE SHIELD OF MICHIGAN NON-BARGAINING UNIT INTERNAL HEALTH BENEFIT TRUST".
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PAGE 1, ITEM C - LEGAL NAME OF ORGANIZATION:
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IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd1AZ
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IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt0BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt1LIFESECURE HOLDINGS CORPORATION
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IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd1N/A
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0BLUE CARE NETWORK OF MICHIGAN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt1BLUE CROSS BLUE SHIELD OF MICHIGAN FOUNDATION
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt2BLUE CROSS BLUE SHIELD OF MICHIGAN LONG TERM DISABILITY TRUST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt3BCBSM BARGAINING UNIT INTERNAL HEALTH BENEFIT TRUST
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IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt1CONTRIBUTING EMPLOYER
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt2FUND LONG-TERM DISABILITY BENEFITS
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt3FUND HEALTH BENEFITS
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IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt1600 LAFAYETTE EAST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt2600 LAFAYETTE EAST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt3600 LAFAYETTE EAST
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IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0MI
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IRS990ScheduleR/SharingOfFacilitiesInd01
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToExcsTaxNetInvstIncInd00
IRS990/SubjectToProxyTaxInd00
IRS990/SubjToTaxRmnrtnExPrchtPymtInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsEOYAmt0106875515
IRS990/TotalAssetsGrp/BOYAmt00
IRS990/TotalAssetsGrp/EOYAmt0106875515
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/TotalAmt00
IRS990/TotalGrossUBIAmt075515
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt0106875515
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceRevenueAmt0106800000
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt00
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt0106800000
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0106875515
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt075515
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt00
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt0106875515
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TypeOfOrganizationTrustInd0X
IRS990/UnrelatedBusIncmOverLimitInd01
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0600 LAFAYETTE EAST MAIL CODE 1801
IRS990/USAddress/CityNm0DETROIT
IRS990/USAddress/StateAbbreviationCd0MI
IRS990/USAddress/ZIPCd0482262998
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt05
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd01
ReturnHeader/BuildTS02022-01-07 14:23:13Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0MATTHEW E GRAY
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0NORTHERN TRUST, AS TRUSTEE
ReturnHeader/BusinessOfficerGrp/PhoneNum03139831633
ReturnHeader/BusinessOfficerGrp/SignatureDt02020-11-13
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0BCBSM NON-BARGAINING UNIT INTERNAL
ReturnHeader/Filer/BusinessName/BusinessNameLine2Txt0HEALTH BENEFIT TRUST
ReturnHeader/Filer/BusinessNameControlTxt0BCBS
ReturnHeader/Filer/EIN0846871980
ReturnHeader/Filer/PhoneNum03139831633
ReturnHeader/Filer/USAddress/AddressLine1Txt0600 LAFAYETTE EAST MAIL CODE 1801
ReturnHeader/Filer/USAddress/CityNm0DETROIT
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MI
ReturnHeader/Filer/USAddress/ZIPCd0482262998
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId02A9B21FBBB57783960DCEB571D07D3FD8F6ACE3A
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0F9159E65D14CDF74BC6ADD3B9DC0DE67E55A2CD6
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt064.88.174.3
ReturnHeader/FilingSecurityInformation/IPDt02020-11-13
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0ES
ReturnHeader/FilingSecurityInformation/IPTm009:47:00
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0382029668
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0GEORGE JOHNSON & COMPANY
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01200 BUHL BUILDING 535 GRISWOLD
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0DETROIT
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MI
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd0482263689
ReturnHeader/PreparerPersonGrp/PhoneNum03139652655
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0MICHAEL R NICHOLAS
ReturnHeader/ReturnTs02020-11-13T08:59:48-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02019-11-26
ReturnHeader/TaxPeriodEndDt02019-12-31
ReturnHeader/TaxYr02019

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