2023 Form 5500 filing — Blue Cross Blue Shield Of North Dakota Funded Group Benefit Plan
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 20241015111324NAL0047520640001) for Blue Cross Blue Shield Of North Dakota Funded Group Benefit Plan, reported by Blue Cross Blue Shield Of North Dakota under EIN 45-0173185 and plan number 510. It reports 841 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20241015111324NAL0047520640001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Blue Cross Blue Shield Of North Dakota
- EIN
- 45-0173185
- Plan number
- 510
- Location
- Fargo, ND
- Participants
- 841
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $15,649,210
- Total liabilities (EOY)
- $700,000
- Net assets (EOY)
- $14,949,210
- Employer contributions
- $149,308
- Participant contributions
- $10,044,167
- Total income / additions
- $12,490,789
- Benefits paid
- $13,336,056
- Administrative expenses
- $428,207
- Total expenses
- $13,764,263
- Net increase / (decrease)
- -$1,273,474
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Prime Therapeutics | NONE | $0 | $254,020 |
| Bank Of The West | TRUSTEE | $31,120 | $0 |
| Bell State Bank | TRUSTEE | $13,040 | not reported in the loaded dataset |