Capital Blue Cross Medical And Life Insurance Plan For Disabled Former Employees — Form 5500 plan (Capital Blue Cross)

Plain-English plan summary

According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, Capital Blue Cross Medical And Life Insurance Plan For Disabled Former Employees is a benefit plan reported by Capital Blue Cross under EIN 23-0455154 and plan number 511. The latest loaded filing year is 2023. The filing reports 27 participants and not reported in the loaded dataset in end-of-year plan assets, where available in the loaded dataset.

Key reported metrics

Plan sponsor
Capital Blue Cross
EIN
23-0455154
Plan number
511
Plan type
2
Location
Harrisburg, PA
Latest filing year
2023
Participants
27
End-of-year plan assets
not reported in the loaded dataset

Form 5500 filing history

Filings loaded for this plan
Filing yearParticipantsSchedulesFiling
202327C20241008083522NAL0028168400001

Reported financial statement

This plan is loaded, but Schedule H / I financial-statement detail is not present for it in the current loaded dataset.

Service provider compensation (Schedule C)

Reported service provider compensation
ProviderServiceDirect comp.Indirect comp.Year
Capital Advantage Assurance CompanyCONTRACT ADMINISTRATOR$7,558not reported in the loaded dataset2023

Related Form 5500 pages