Blue Cross Blue Shield Of North Dakota Funded Group Benefit Plan — Form 5500 plan (Blue Cross Blue Shield Of North Dakota)

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, Blue Cross Blue Shield Of North Dakota Funded Group Benefit Plan is a benefit plan reported by Blue Cross Blue Shield Of North Dakota under EIN 45-0173185 and plan number 510. The latest loaded filing year is 2023. The filing reports 841 participants and $15,649,210 in end-of-year plan assets, where available in the loaded dataset.

Key reported metrics

Plan sponsor
Blue Cross Blue Shield Of North Dakota
EIN
45-0173185
Plan number
510
Plan type
2
Location
Fargo, ND
Latest filing year
2023
Participants
841
End-of-year plan assets
$15,649,210

Form 5500 filing history

Filings loaded for this plan
Filing yearParticipantsSchedulesFiling
2023841H, C20241015111324NAL0047520640001

Reported financial statement (2023 · Schedule H)

Net assets

Total assets (EOY)
$15,649,210
Total liabilities (EOY)
$700,000
Net assets (EOY)
$14,949,210
Net assets (BOY)
$16,222,684

Income & contributions

Employer contributions
$149,308
Participant contributions
$10,044,167
Total contributions
$10,193,475
Total income / additions
$12,490,789

Expenses & distributions

Benefits paid
$13,336,056
Administrative expenses
$428,207
Total expenses
$13,764,263
Net increase / (decrease)
-$1,273,474

Service provider compensation (Schedule C)

Reported service provider compensation
ProviderServiceDirect comp.Indirect comp.Year
Prime TherapeuticsNONE$0$254,0202023
Bank Of The WestTRUSTEE$31,120$02023
Bell State BankTRUSTEE$13,040not reported in the loaded dataset2023

Related Form 5500 pages