2023 Form 5500 filing — Blue Cross Blue Shield Of Michigan Long Term Disability Program
Plain-English filing 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, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20241015110055NAL0048947184005) for Blue Cross Blue Shield Of Michigan Long Term Disability Program, reported by Blue Cross Blue Shield Of Michigan under EIN 38-2069753 and plan number 527. It reports 327 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
Form 5500 2 · 2023
Filing snapshot
Net assets (EOY)$7.9MReported net assets$7,923,738
Participants327
Provider compensation$241.9K3 Schedule C row(s)$241,883
Schedules filedSchedule H, Schedule CLoaded schedules
- EFAST2 acknowledgement
- 20241015110055NAL0048947184005
- Plan sponsor
- Blue Cross Blue Shield Of Michigan
- EIN
- 38-2069753
- Plan number
- 527
- Location
- Detroit, MI
- Received date
- not reported in the loaded dataset
Schedule H · 2023
Reported financial snapshot
Reported figures as filed, in whole dollars. Only fields the filing reports are shown.
Reported balance (end of year)$7.9M total assets
Net assets$7.9MLiabilities—
Full reported line items
- Total assets (EOY)
- $7,923,738
- Net assets (EOY)
- $7,923,738
- Total income / additions
- $947,416
- Benefits paid
- $3,163,363
- Administrative expenses
- $241,951
- Total expenses
- $3,405,314
- Net increase / (decrease)
- -$2,457,898
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Broadspire Services | PLAN ADMINISTRATOR | $194,463 | not reported in the loaded dataset |
| Gjc Cpa'S & Advisors | AUDITOR | $24,500 | not reported in the loaded dataset |
| The Northern Trust Company | CUSTODIAN | $22,920 | not reported in the loaded dataset |