Form990-PF
Click to see list of attachments

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2020
Open to Public Inspection
For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020
Name of foundation
Blue Cross and Blue Shield of Kansas
Foundation Inc
Number and street (or P.O. box number if mail is not delivered to street address)1133 SW Topeka Blvd
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Topeka, KS66629
A Employer identification number

20-3085640
B Telephone number (see instructions)

(785) 291-8262
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$15,036,738J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 284,193 284,193  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 703,591
b Gross sales price for all assets on line 6a 7,307,616
7 Capital gain net income (from Part IV, line 2)... 703,591
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 134,280    
12 Total. Add lines 1 through 11........ 1,122,064 987,784  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 3,000     3,000
c Other professional fees (attach schedule).... Click to see attachment 53,479 53,479    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 12,987      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments 134,820     540
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 204,286 53,479   3,540
25 Contributions, gifts, grants paid....... 683,022 683,022
26 Total expenses and disbursements. Add lines 24 and 25 887,308 53,479   686,562
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 234,756
b Net investment income (if negative, enter -0-) 934,305
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2020)
Form 990-PF (2020)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 23,622 62,518 62,518
2 Savings and temporary cash investments......... 887,289 43,853 43,853
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 11,891,661 Click to see attachment12,940,243 14,927,060
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment5,145 Click to see attachment3,307 Click to see attachment3,307
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 12,807,717 13,049,921 15,036,738
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)   Click to see attachment7,448
23 Total liabilities (add lines 17 through 22).........   7,448
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 12,807,717  
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 12,807,717 13,042,473
30 Total liabilities and net assets/fund balances (see instructions). 12,807,717 13,049,921
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
12,807,717
2
Enter amount from Part I, line 27a .....................
2
234,756
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
13,042,473
5
Decreases not included in line 2 (itemize) bullet
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
13,042,473
Form 990-PF (2020)
Form 990-PF (2020)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 5139.47 BAIRD AGGREGATE BOND FUND P 2017-04-25 2020-03-12
b 5020.68 BAIRD AGGREGATE BOND FUND P 2017-04-25 2020-06-01
c 5480.23 DOUBLELINE TOTL RET BND P 2017-04-25 2020-06-01
d 2270.37 HRDNG LVNR INST EM MRKT INST P 2019-08-02 2020-02-24
e 2395.01 HRDNG LVNR INST EM MRKT INST P 2019-08-02 2020-05-11
1686.5 HRDNG LVNR INST EM MRKT INST P 2019-08-02 2020-07-06
122.24 OAKMARK INTERNATIONAL P 2019-07-25 2020-02-04
2914.67 OAKMARK INTERNATIONAL P 2019-07-25 2020-02-04
2845.09 OAKMARK INTERNATIONAL P 2019-07-25 2020-05-11
2021.16 OAKMARK INTERNATIONAL P 2019-07-25 2020-07-06
5116.62 OAKMARK INTERNATIONAL P 2019-07-25 2020-08-04
3982.37 HARTFORD INTL OPPORT I P 2017-09-20 2020-05-11
2132.99 HARTFORD INTL OPPORT I P 2017-09-20 2020-07-06
7543.54 HARTFORD INTL OPPORT I P 2017-09-20 2020-08-04
4339 ISHARES GOLD TRUST P 2020-01-06 2020-02-28
1986 ISHARES GOLD TRUST P 2020-01-06 2020-05-11
2754 ISHARES GOLD TRUST P 2020-01-06 2020-08-04
18983 ISHARES GOLD TRUST P 2020-01-06 2020-10-12
2855 ISHARES GOLD TRUST P 2020-06-01 2020-10-12
2084 ISHARES TIPS BOND ETF P 2020-01-06 2020-03-16
1930 ISHARES TIPS BOND ETF P 2020-08-04 2020-11-16
1428 ISHARES CORE U S AGGREGATE P 2017-04-25 2020-02-28
904 ISHARES CORE U S AGGREGATE P 2017-04-25 2020-03-12
514 ISHARES CORE U S AGGREGATE P 2017-04-25 2020-03-25
2050 ISHARES CORE U S AGGREGATE P 2017-04-25 2020-06-01
807 ISHARES CORE U S AGGREGATE P 2017-04-25 2020-08-04
1903 ISHARES S&P 500 GROWTH ETF P 2017-04-25 2020-05-11
3908.5 ISHARES S&P 500 GROWTH ETF P 2017-04-25 2020-11-16
3484 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-01-06
1200 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-03-04
1064 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-04-13
1661 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-05-11
391 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-07-06
2293 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-08-04
1664 ISHARES S&P 500 VALUE ETF P 2017-04-25 2020-11-16
937 ISHARES S&P 500 VALUE ETF P 2017-05-15 2020-11-16
226 ISHARES S&P MID CAP 400 GROW P 2017-04-25 2020-01-06
234 ISHARES S&P MID CAP 400 GROW P 2017-04-25 2020-05-11
133 ISHARES S&P MID CAP 400 GROW P 2017-04-25 2020-07-06
17 ISHARES S&P MID CAP 400 GROW P 2019-01-02 2020-07-06
625 ISHARES S P MID CAP 400 VALU P 2018-11-01 2020-01-06
292 ISHARES S P MID CAP 400 VALU P 2018-11-14 2020-01-06
449 ISHARES S P MID CAP 400 VALU P 2018-11-14 2020-05-11
153 ISHARES S P MID CAP 400 VALU P 2018-11-14 2020-07-06
100 ISHARES S P MID CAP 400 VALU P 2018-12-24 2020-07-06
139 ISHARES S P MID CAP 400 VALU P 2019-01-02 2020-07-06
123 ISHARES S P MID CAP 400 VALU P 2020-02-04 2020-07-06
14 ISHARES CORE S&P SMALL CAP E P 2017-04-25 2020-02-04
1831 ISHARES CORE S&P SMALL CAP E P 2018-01-11 2020-02-04
1062 ISHARES CORE S&P SMALL CAP E P 2019-09-10 2020-02-04
594 ISHARES CORE S&P SMALL CAP E P 2019-09-10 2020-05-11
90 ISHARES CORE S&P SMALL CAP E P 2019-09-10 2020-07-06
1477 ISHARES CORE S&P SMALL CAP E P 2019-12-16 2020-07-06
212 ISHARES CORE S&P SMALL CAP E P 2020-01-06 2020-07-06
1586 ISHARES CORE MSCI EAFE ETF P 2017-04-25 2020-02-04
225 ISHARES CORE MSCI EAFE ETF P 2017-04-25 2020-05-11
1354 ISHARES CORE MSCI EAFE ETF P 2017-05-15 2020-05-11
3042 ISHARES CORE MSCI EAFE ETF P 2017-05-15 2020-08-04
3241 ISHARES CORE MSCI EMERGING P 2020-01-06 2020-02-24
2211 ISHARES INTL AGGREGATE BOND P 2019-10-02 2020-01-06
1089 ISHARES INTL AGGREGATE BOND P 2019-10-02 2020-03-12
654 ISHARES INTL AGGREGATE BOND P 2019-10-02 2020-06-01
5457.81 METROPOLITAN WEST T R BOND P 2017-04-25 2020-03-12
5253.5 METROPOLITAN WEST T R BOND P 2017-04-25 2020-06-01
5779.46 PIMCO TOTAL RETURN FUND I3 P 2019-07-23 2020-03-12
5526.56 PIMCO TOTAL RETURN FUND I3 P 2019-07-23 2020-06-01
9590.31 PIMCO INTL BND USD HGD I3 P 2019-08-26 2020-01-06
5692.88 PIMCO INTL BND USD HGD I3 P 2019-08-26 2020-03-12
3647.39 PIMCO INTL BND USD HGD I3 P 2019-08-26 2020-06-01
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 60,800   57,254 3,546
b 60,700   55,930 4,770
c 58,200   58,529 -329
d 48,200   46,248 1,952
e 42,200   48,786 -6,586
34,000   34,354 -354
2,914   3,158 -244
69,486   76,648 -7,162
47,200   74,818 -27,618
40,100   53,151 -13,051
103,100   134,553 -31,453
54,200   68,178 -13,978
34,000   36,517 -2,517
125,600   129,145 -3,545
64,868   64,955 -87
32,162   29,730 2,432
52,701   41,227 11,474
348,141   284,176 63,965
52,359   47,407 4,952
236,477   244,662 -8,185
241,534   243,577 -2,043
165,746   155,523 10,223
99,155   98,454 701
58,940   55,980 2,960
240,604   223,265 17,339
96,481   87,890 8,591
367,937   254,906 113,031
957,457   523,542 433,915
452,040   364,636 87,404
143,944   125,592 18,352
109,720   111,359 -1,639
174,402   173,840 562
42,815   40,922 1,893
259,005   239,985 19,020
207,163   174,154 33,009
116,654   97,523 19,131
53,761   44,073 9,688
49,165   45,633 3,532
30,150   25,937 4,213
3,854   3,206 648
105,885   96,356 9,529
49,470   45,018 4,452
55,846   69,223 -13,377
20,378   23,588 -3,210
13,319   13,178 141
18,514   19,174 -660
16,382   20,618 -4,236
1,153   988 165
150,733   144,330 6,403
87,427   83,404 4,023
37,185   46,649 -9,464
6,146   7,068 -922
100,857   122,405 -21,548
14,476   17,759 -3,283
102,485   94,620 7,865
11,984   13,423 -1,439
72,119   82,672 -10,553
181,576   185,738 -4,162
162,046   173,879 -11,833
121,733   123,020 -1,287
59,926   60,592 -666
36,141   36,389 -248
60,800   57,853 2,947
60,100   55,687 4,413
60,800   59,644 1,156
59,300   57,034 2,266
103,000   108,562 -5,562
60,800   64,443 -3,643
39,100   41,288 -2,188
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       3,546
b       4,770
c       -329
d       1,952
e       -6,586
      -354
      -244
      -7,162
      -27,618
      -13,051
      -31,453
      -13,978
      -2,517
      -3,545
      -87
      2,432
      11,474
      63,965
      4,952
      -8,185
      -2,043
      10,223
      701
      2,960
      17,339
      8,591
      113,031
      433,915
      87,404
      18,352
      -1,639
      562
      1,893
      19,020
      33,009
      19,131
      9,688
      3,532
      4,213
      648
      9,529
      4,452
      -13,377
      -3,210
      141
      -660
      -4,236
      165
      6,403
      4,023
      -9,464
      -922
      -21,548
      -3,283
      7,865
      -1,439
      -10,553
      -4,162
      -11,833
      -1,287
      -666
      -248
      2,947
      4,413
      1,156
      2,266
      -5,562
      -3,643
      -2,188
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 703,591
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 -37,990
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1 Reserved
(a)
Reserved 		(b)
Reserved 		(c)
Reserved 		(d)
Reserved
2
Reserved...........................
2
3
Reserved...........................
3
4
Reserved...........................
4
5
Reserved...........................
5
6
Reserved...........................
6
7
Reserved...........................
7
8
Reserved,..........................
8
Form 990-PF (2020)
Form 990-PF (2020)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Reserved................................ 1 12,987
c All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2  
3 Add lines 1 and 2........................... 3 12,987
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4  
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 12,987
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 5,539
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c 7,448
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 12,987
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet   RefundedBullet 11  
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bullet
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletANN M SHELTON Telephone no.bullet (785) 291-8262

    Located atbullet1133 SW Topeka BlvdTopekaKS ZIP+4bullet666290001
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2020?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2020?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2020.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
    4b
     
    No
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    Matthew D All President
    0.10     		0    
    1133 SW Topeka Blvd
    Topeka,KS66629
    Marlou Wegener COO
    20.00     		0    
    1133 SW Topeka Blvd
    Topeka,KS66629
    Ann M Shelton Treasurer
    1.00     		0    
    1133 SW Topeka Blvd
    Topeka,KS66629
    Carolyn Banning Director
    0.10     		0    
    1108 Champions View Drive
    Dodge City,KS67801
    Jena Lysen Director
    0.10     		0    
    301 N Main Suite 1700
    Wichita,KS67202
    Scott H Raymond Secretary
    0.25     		0    
    1133 SW Topeka Blvd
    Topeka,KS66629
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet  
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 Childcare Aware of Kansas 50,000
    2 United Way of Greater Topeka 50,000
    3 Kansas Dental Charitable Foundation 30,000
    4 American Red Cross 25,000
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    13,036,208
    b
    Average of monthly cash balances.......................
    1b
    726,547
    c
    Fair market value of all other assets (see instructions)................
    1c
    3,307
    d
    Total (add lines 1a, b, and c).........................
    1d
    13,766,062
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    13,766,062
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    206,491
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    13,559,571
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    677,979
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    677,979
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    12,987
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    12,987
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    664,992
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    664,992
    6
    Deduction from distributable amount (see instructions).................
    6
     
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    664,992
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    686,562
    b
    Program-related investments—total from Part IX-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    686,562
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
     
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    686,562
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2019     		(c)
    2019     		(d)
    2020
    1 Distributable amount for 2020 from Part XI, line 7 664,992
    2 Undistributed income, if any, as of the end of 2020:
    a Enter amount for 2019 only.......  
    b Total for prior years:20, 20, 20  
    3 Excess distributions carryover, if any, to 2020:
    a From 2015...... 53,207
    b From 2016...... 25,705
    c From 2017...... 88,315
    d From 2018...... 76,397
    e From 2019...... 132,690
    fTotal of lines 3a through e........ 376,314
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 686,562
    a Applied to 2019, but not more than line 2a  
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		 
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2020 distributable amount..... 664,992
    e Remaining amount distributed out of corpus 21,570
    5 Excess distributions carryover applied to 2020.    
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 397,884
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		 
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		 
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		 
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		 
    f Undistributed income for 2020. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2021 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		 
    8 Excess distributions carryover from 2015 not
    applied on line 5 or line 7 (see instructions) ...     		53,207
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		344,677
    10 Analysis of line 9:
    a Excess from 2016.... 25,705
    b Excess from 2017.... 88,315
    c Excess from 2018.... 76,397
    d Excess from 2019.... 132,690
    e Excess from 2020.... 21,570
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2020 (b) 2019 (c) 2018 (d) 2017
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    BCBS of Kansas Foundation
    1133 SW Topeka Boulevard
    Topeka,KS66629
    (785) 291-7246
    marlou.wegener@bcbsks.com
    bThe form in which applications should be submitted and information and materials they should include:
    Grant Request Application and IRS 501( C) (3) determination letter
    cAny submission deadlines:
    October 31, 2020
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Must be a IRS Section 501(c)(3) organization and promote health imporment, community health access and/or health education, healthy behaviors, prevention initiatives or direct health services to the uninsured
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    BCBS of Kansas Foundation
    1133 SW Topeka Blvd
    Topeka,KS66629
    (785) 291-7246
    marlou.wegener@bcbsks.com
    bThe form in which applications should be submitted and information and materials they should include:
    Healthy Habits for Life Grant Application
    cAny submission deadlines:
    10/30/2020
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    $1,000 maximum
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    'KS Lions Sight Foundation
    2101 E 29th St
    Lawrence,KS66046     		None PF Funding of mobile screening unit expenses. This is the third year of a three-year commitment. 10,000
    Envision Foundation
    610 N Main St
    Wichita,KS67203     		None PF Help with funding Public Education Supplies about eye health, eye safety, and eye disease 5,000
    The Arc of Sedgwick County Inc
    2919 W Second St
    Wichita,KS67203     		None PF Help with funding the ARC's youth programs - YESS & Circle of Friends to youth with developmental disabilities 5,000
    Ronald McDonald House Charities of
    825 SW Buchanan St
    Topeka,KS66606     		None PF Funding will be used to help offset the costs of family stays with the Share-a-Night Room Sponsorship program. 5,000
    E Topeka Council on Aging
    432 SE Norwood
    Topeka,KS66607     		None PF Help support transportation needs to medical appointments for the elderly. 5,000
    Greater Wichita YMCA Camp Hyde
    402 N Market
    Wichita,KS67202     		None   Support of the Strong Community Healthy Lifestyles Program. 2,500
    Community Mercantile Eduation Found
    PO Box 35356
    Lawrence,KS66046     		None PF Support the Growing Food Growing Hope garden project. 3,000
    Caney Valley Agape Network Inc
    PO Box 153
    Caney,KS67333     		None PF Support the Food Box and Health Advisory Group 4,250
    Ronald McDonald House of Wichita
    551 N Hillside Suite 100
    Wichita,KS67214     		None PF Support the Adopt-A-Room program 5,000
    PRAIRIE VIEW INC
    1901 E 1st St
    Newton,KS67114     		None PF Community Mental Health Clinics 2,000
    VALEO BEHAVIORAL HEALTH CARE Foun
    330 SW Oakley Ave
    Topeka,KS66606     		None   Community Mental Health Clinics 2,000
    USD NO 383 - FRANK BERGMAN ELEMENTA
    3430 Lombard Dr
    Manhattan,KS66503     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD NO 416 - LOUISBURG BROADMOOR EL
    29020 Mission Belleview Rd
    Louisburg,KS66053     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    SAINT VINCENT CLINIC
    818 N 7th St
    Leavenworth,KS66048     		None PF Community Medical Health Clinics 2,000
    HEALTH MINISTRIES CLINIC
    720 Medical Center Dr
    Newton,KS67114     		None PF Community Medical Health Clinics 2,000
    HOXIE MEDICAL CLINIC
    826 18th St
    Hoxie,KS67740     		None PF Community Medical Health Clinics 2,000
    Kansas Dental Charitable Foundation
    5200 SW Huntoon
    Topeka,KS66604     		None PF Support the 2020 Kansas Mission of Mercy dental clinic in Dodge City 30,000
    ChildCare Aware
    PO Box 2294
    Salina,KS67402     		None PF Support children's behavioral health curriculum in 103 counties - COVID relief 50,000
    American Red Cross Wichita
    707 N Main
    Wichita,KS67203     		None PF Support immediate/extra needs due to COVID response 5,000
    HEARTS - Helping Emplower Ad
    4208 SE Oakwood St
    Topeka,KS66609     		None PF Support the pilot program of Peers Accomplishing Life Successfully (PALS) program 4,000
    Real Men Real Leaders
    PO Box 2037
    Garden City,KS67846     		None PF Support of the Stepping Up Program, teaching valuable life and leadership skills to 5th and 6th grade male students. 2,640
    Special Olympics KS
    5280 Foxridge Dr
    Mission,KS66202     		None PF Support of the Healthy Athletes programming in Sedgwick, Ellis, Shawnee, and Crawford counties. 5,000
    Spring River Mental Health Wellness
    PO Box 550
    Riverton,KS66770     		None PF Funding to assist with low income families with scholarships to attend the fitness center. 5,000
    Starfish Project
    134 S Clairborne Rd Suite B
    Olathe,KS66062     		None PF Support of health and wellness activities through Taekwondo for autistic students and disabled adults in Miami County. 5,000
    The Treehouse
    151 N Volutsia
    Wichita,KS67214     		None PF Support the Earn While You Learn project. 1,000
    United Methodist Open Door
    PO Box 27656
    Wichita,KS67201     		None PF Help with the basic needs of the Homeless Resource Center. 5,000
    Heartland Rural Counseling Services
    485 W 4th St
    Colby,KS67701     		None PF Support mental health services in Northwest Kansas for uninsured. 5,000
    American Diabetes Association
    608 W Douglas Suite 100
    Wichita,KS67203     		None PF Provide assistance to the Virtual ADA Imagine Camp and Virtual ADA Imagine Camp Discovery 5,000
    Big Lakes Developmental Center Inc
    1415 Hayes Drive
    Manhattan,KS66502     		None PF Provide medical supplies for individuals with intellectual and developmental disabilities 5,000
    Kansas Food Bank Warehouse
    1919 E Douglas
    Wichita,KS67211     		None PF Provide assistance for their Food 4 Kids program 5,000
    Numana Inc
    405 SW Boyer Rd
    El Dorado,KS67042     		None PF Provide assistance to their Virtual Meal Packing Program 5,000
    Project Laundry Inc
    9035 W Central Ave
    Wichita,KS67212     		None PF Provide laundry assisxtance to the low income. 2,500
    Wheels of HOPE Inc
    804 N Jefferson
    Junction City,KS66441     		None PF Provide assistance for their mobile food pantry 3,500
    Paxton's Blessing Box
    911 W 13th St North
    Wichita,KS67203     		None PF Support for the Paxton's Blessing Box program 2,500
    Valeo Behavioral Health Care
    330 SW Oakley
    Topeka,KS66606     		None PF Support Valeo's Prescription Assistance and Medication Voucher program 15,000
    The Arc of Central Plains
    600 Main Street
    Hays,KS67601     		None PF Support the ARC Park playground Sway Fun equipment for individuals with disabilities. 5,000
    First Call For Help of Ellis County
    607 E 13th Street
    Hays,KS67601     		None PF Support for the hygiene bags for Backpacks For Kids distributed in Ellis County 1,500
    ICARE Intergenerational Clearinghou
    701 W 10th St
    Junction City,KS66441     		None PF Support for the ICARE program encourgaing intergenerational activities in Geary County 1,000
    Positive Connections - Prevention
    2044 SW Fillmore St
    Topeka,KS66604     		None PF Support for the Positive Connections Prevention program and client testing 5,000
    KS Elks TrainCntr Handicapped
    1006 E Wateman
    Wichita,KS67211     		None PF Support for the KETCH Safety program and updating First-Aid kits 5,000
    Community Behavioral Health
    534 S Kansas Ave Suite 330
    Topeka,KS66603     		None PF Support the Behavioral Health Toolbox for Community Mental Health Centers in the service area 14,770
    Kansas CASA Association
    501 SE Jefferson Suite 2000
    Topeka,KS66607     		None PF Provide 23 Kansas local programs with licenses for the CASA Manager database for one year. 20,771
    Saint Francis Ministries
    110 W Ottis Ave
    Salina,KS67401     		None PF Support for their behavioral health telehelath system training and assist the Outpatient Behavioral Health Program 25,000
    American Baptist Estates
    1605 W May St
    Wichita,KS67213     		None PF Support for the Fun,Fitness, and Fellowship initiative 5,000
    Indy Saves
    3773 County Road
    Independence,KS67301     		None PF Support for the CPR education and training classes for Montgomery county 2,000
    Journey to Recovery
    112 W Pine Ave
    El Dorado,KS67042     		None PF Support for the Dual Diagnosis group with the purchase of books 1,200
    Sunrise Project
    1501 Learnard Avd Ste E
    Lawrence,KS66044     		None PF Support for the Dual Diagnosis group with the purchase of books 2,000
    SN Co Extension Master Gardeners
    1740 SW Western Avd
    Topeka,KS66604     		None GOV Support for the community gardens 3,000
    Tammy Walker Cancer Center
    511 S Santa Fe
    Salina,KS67401     		None PF Support for colorectal screening kits to the uninsured 748
    Wichita Women's Initiative Network
    510 E 3rd North
    Wichita,KS67202     		None PF Support for the Beyond Trauma program. 3,302
    Petterson Health Center
    485 N KS Hwy 2
    Anthony,KS67003     		None PF Support for the Harper County Health Fair in November 3,000
    American Red Cross Topeka
    1221 SW 17th St
    Topeka,KS66604     		None PF Support for disaster response efforts in our Plan's service area. 25,000
    United Way of Greater Topeka
    PO Box 4188
    Topeka,KS66604     		None PF Gift to accompany employee contributions 50,000
    United Way of the Plains
    245 N Water
    Wichita,KS67202     		None PF Gift to accompany employee contributions 10,000
    Salina Area United Way
    210 E Walnut St Suite 100
    Salina,KS67401     		None PF Gift to accompany employee contributions 5,000
    United Way of Reno County
    924 N Main St
    Hutchinson,KS67501     		None PF Gift to accompany employee contributions 5,000
    WSU Tech
    4004 N Webb Rd
    Wichita,KS67226     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Manhattan Area Tech College
    3136 Dickens Ave
    Manhattan,KS66503     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Northwest Kansas Tech College
    1209 Harrison
    Goodland,KS67335     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Washburn Institute of Technology
    5724 SW Huntoon
    Topeka,KS66604     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Salina Area Technical College
    2562 Centennial Rd
    Salina,KS67401     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    North Central Technical College
    3033 US Hwy 24
    Beloit,KS67420     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Allen Community College Endowment A
    1801 N Cottonwood
    Iola,KS66749     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Barton Community College Foundation
    245 NW 30th Rd
    Great Bend,KS67530     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Butler Community College Foundation
    901 S Haverhill
    El Dorado,KS67042     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Cloud Co Community College Foundati
    PO Box 1002
    Concordia,KS66901     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Coffeyville Community College Found
    400 W 11th St
    Coffeyville,KS67337     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Colby Community College Foundation
    1255 S Range
    Colby,KS67701     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Cowley Community College Foundation
    PO Box 1147
    Arkansas City,KS67005     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Dodge City Community College Founda
    2501 N 14th Ave
    Dodge City,KS67801     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Ft Scott Community College Endowmen
    2108 S Horton
    Fort Scott,KS66701     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Garden City Community College Endow
    801 Campus Dr
    Garden City,KS67846     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Highland Community College Foundati
    606 W Main
    Highland,KS66035     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Hutchinson Community College Endowm
    1300 N Plum
    Hutchinson,KS67501     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Independence Comm College Foundatio
    1057 W College Ave
    Independence,KS67301     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Labette Community College Foundatio
    200 S 14th St
    Parsons,KS67357     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Neosho Co Community College Endowme
    800 W 14th St
    Chanute,KS66720     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Pratt Community College Endowment
    348 NE State Rd 61
    Pratt,KS67124     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Seward Co Community College Foundai
    PO Box 1137
    Liberal,KS67901     		None GOV Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
    Baker University
    1500 SW 10th St
    Topeka,KS66604     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Benedictine College
    1020 N Second St
    Atchison,KS66002     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Bethel College
    300 E 27th St North
    Newton,KS67117     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Emporia State University
    1127 Chestnut
    Emporia,KS66801     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Fort Hays State University
    600 Park St
    Hays,KS67601     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Kansas Wesleyan University
    100 E Claflin Ave
    Salina,KS67401     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Pittsburg State University
    1701 S Broadway
    Pittsburg,KS66762     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Univ of KS School of Nursing Salina
    138 N Santa Fe Ave
    Salina,KS67401     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Washburn University
    1700 SW College Ave
    Topeka,KS66621     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Wichita State University
    1845 Fairmount
    Wichita,KS67260     		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
    Atchison Community Health Clinic
    PO Box 27
    Atchison,KS66002     		None PF Support for uninsured patients of the clinics. 2,000
    Community Health Center Cowley
    221 W 8th Ave
    Winfield,KS67156     		None PF Support for uninsured patients of the clinics. 2,000
    Community Health Center SW KS
    3011 N Michigan St
    Pittsburg,KS66762     		None PF Support for uninsured patients of the clinics. 2,000
    First Care Clinic
    105 W 13th
    Hays,KS67601     		None PF Support for uninsured patients of the clinics. 2,000
    Flint Hills Community Clinic
    401 Houston St Suite C
    Manhattan,KS66502     		None PF Support for uninsured patients of the clinics. 2,000
    Flinit Hills Community Health Cen
    420 W 15th Ave
    Emporia,KS66801     		None PF Support for uninsured patients of the clinics. 2,000
    Genesis Family Health
    712A St John
    Garden City,KS67846     		None PF Support for uninsured patients of the clinics. 2,000
    GraceMed Capitol Family Clinic
    1400 SW Huntoon Street
    Topeka,KS66604     		None PF Support for uninsured patients of the clinics. 2,000
    GraceMed Helen Galloway Fam Clinic
    1122 N Topeka
    Wichita,KS67214     		None PF Support for uninsured patients of the clinics. 2,000
    Greeley County Health Services
    504 E 6th St
    Sharon Springs,KS67758     		None GOV Support for uninsured patients of the clinics. 2,000
    Guadalupe Clinic
    940 S St Francis
    Wichita,KS67211     		None PF Support for uninsured patients of the clinics. 2,000
    Health Ministries Clinic Inc
    720 Medical Center Drive
    Newton,KS67114     		None PF Support for uninsured patients of the clinics. 2,000
    HealthCore Clinic Inc
    2707 E 21st St N
    Wichita,KS67214     		None PF Support for uninsured patients of the clinics. 2,000
    Heart of KS Fam Health Care
    1905 19th St
    Great Bend,KS67530     		None PF Support for uninsured patients of the clinics. 2,000
    Heartland Community Health Center
    346 Maine St Suite 150
    Lawrence,KS66044     		None PF Support for uninsured patients of the clinics. 2,000
    Hoxie Medical Clinic
    826 18th St
    Hoxie,KS67740     		None PF Support for uninsured patients of the clinics. 2,000
    Hunter Health
    2318 E Central
    Wichita,KS67214     		None PF Support for uninsured patients of the clinics. 2,000
    Konza Prairie Community Health
    361 Grant Ave
    Junction City,KS66441     		None PF Support for uninsured patients of the clinics. 2,000
    Marian Clinci Inc
    3164 SE 6th Ave
    Topeka,KS66607     		None PF Support for uninsured patients of the clinics. 2,000
    PrairieStar Health Center
    2700 E 30th Ave
    Hutchinson,KS67502     		None PF Support for uninsured patients of the clinics. 2,000
    Rawlins County Dental Clinic
    515 State St
    Atwood,KS67730     		None PF Support for uninsured patients of the clinics. 2,000
    Salina Family Healthcare Center
    651 E Prescott
    Salina,KS67401     		None PF Support for uninsured patients of the clinics. 2,000
    St Vincent Clinic
    818 N 7th St
    Leavenworth,KS66048     		None PF Support for uninsured patients of the clinics. 2,000
    Bert Nash Comm Mental Health Center
    200 Maine Suite A
    Lawrence,KS66044     		None PF Support for uninsured patients of the clinics. 2,000
    Central KS Mental Health Center
    809 Elmhurst
    Salina,KS67401     		None PF Support for uninsured patients of the clinics. 2,000
    Compass Behavioral Health
    531 Campus View/PO Box 477
    Garden City,KS67846     		None PF Support for uninsured patients of the clinics. 2,000
    Crosswinds Counseling and Wellness
    1000 Lincoln
    Emporia,KS66801     		None PF Support for uninsured patients of the clinics. 2,000
    Elizabeth Layton Center
    2537 Eisenhower Rd
    Ottawa,KS66067     		None PF Support for uninsured patients of the clinics. 2,000
    Family Service Guidance Center
    325 SW Frazier
    Topeka,KS66606     		None PF Support for uninsured patients of the clinics. 2,000
    Four County Mental Health Center
    3751 West Main/PO Box 688
    Independence,KS67301     		None PF Support for uninsured patients of the clinics. 2,000
    Horizons Mental Health Center
    1600 N Lorraine Suite 202
    Hutchinson,KS67501     		None PF Support for uninsured patients of the clinics. 2,000
    Iroquois Center for Human Developme
    610 E Grant Ave
    Greensburg,KS67054     		None PF Support for uninsured patients of the clinics. 2,000
    Kanza Mental Health Guidance
    909 S 2nd St/PO Box 319
    Hiawatha,KS66434     		None PF Support for uninsured patients of the clinics. 2,000
    Labette Center for Mental Health Se
    1730 Belmont
    Parsons,KS67357     		None PF Support for uninsured patients of the clinics. 2,000
    Pawnee Mental Health Services
    2001 Claflin Rd
    Manhattan,KS66502     		None PF Support for uninsured patients of the clinics. 2,000
    Prairie View Inc
    1901 E 1st St/PO Box 467
    Newton,KS67114     		None PF Support for uninsured patients of the clinics. 2,000
    S Central Mental Health Counseling
    520 E Augusta Ave
    Augusta,KS67010     		None PF Support for uninsured patients of the clinics. 2,000
    Southwest Guidance Center
    PO Box 2945
    Liberal,KS67905     		None PF Support for uninsured patients of the clinics. 2,000
    Spring River Mental Health
    6610 SE Quakervale Rd/PO Box 550
    Riverton,KS66770     		None PF Support for uninsured patients of the clinics. 2,000
    Summer Mental Health Center
    1601 W 16th St/PO Box 607
    Wellington,KS67152     		None PF Support for uninsured patients of the clinics. 2,000
    Center for Counseling Consultation
    5815 Broadway
    Great Bend,KS67530     		None PF Support for uninsured patients of the clinics. 2,000
    The Guidance Center Inc
    500 Limit Street
    Leavenworth,KS66048     		None PF Support for uninsured patients of the clinics. 2,000
    Valeo Behavioral Healthcare
    330 SW Oakley
    Topeka,KS66606     		None PF Support for uninsured patients of the clinics. 2,000
    USD212 Northern Vally High
    512 W Bryant
    Almena,KS67622     		None GOV Support for healthy lifestyle programs in K-12 schools. 600
    USD214 Ulysses School District
    111 S Baughman St
    Ulysses,KS67880     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD215 Lakin Grade School
    407 N Main St
    Lakin,KS67860     		None GOV Support for healthy lifestyle programs in K-12 schools. 989
    USD216 Deerfield Schools
    803 Beech
    Deerfield,KS67838     		None GOV Support for healthy lifestyle programs in K-12 schools. 996
    USD218 Elkhart Elementary School
    331 S Cosmos
    Elkhart,KS67950     		None GOV Support for healthy lifestyle programs in K-12 schools. 996
    USD218 Elkhart High School
    150 Wildcat Avenue
    Elkhart,KS67950     		None GOV Support for healthy lifestyle programs in K-12 schools. 996
    USD218 Elkhart Middle School
    149 Wildcat Avenue
    Elkhart,KS67950     		None GOV Support for healthy lifestyle programs in K-12 schools. 997
    USD234 Eugene Ware Elementary
    900 East 3rd St
    Fort Scott,KS66701     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD239 Minneapolis Grade School
    317 Argyle Street PO Box 48
    Minneapolis,KS67467     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD247 Southeast High School
    126 West 400 Hwy
    Cherokee,KS66724     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD252 Neosho Rapids Elementary
    240 N Commercial
    Neosho Rapids,KS66864     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD253 William Allen White
    220 W Listerscheid Street
    Olpe,KS66865     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD255 South Barber
    902 Exchange
    Emporia,KS66860     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD257 Iola High School
    512 Main Street
    Kiowa,KS67078     		None GOV Support for healthy lifestyle programs in K-12 schools. 935
    USD257 Iola Middle School
    300 E Jackson
    Iola,KS66749     		None GOV Support for healthy lifestyle programs in K-12 schools. 996
    USD257 Jefferson Elementary School
    300 South Jefferson Ave
    Iola,KS66749     		None GOV Support for healthy lifestyle programs in K-12 schools. 999
    USD257 McKinley Elementary School
    209 S Kentucky Street
    Iola,KS66749     		None GOV Support for healthy lifestyle programs in K-12 schools. 979
    USD259 Allen Elementary 1
    1881 S Elpyco
    Wichita,KS67212     		None GOV Support for healthy lifestyle programs in K-12 schools. 949
    USD267 Andale ElementaryHigh
    500 Rush Ave
    Andale,KS67001     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD274 Oakley School
    621 Center Ave Suite 103
    Oakley,KS67748     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD310 Langdon-Fairfield
    16115 S Langdon Road
    Langdon,KS67583     		None GOV Support for healthy lifestyle programs in K-12 schools. 995
    USD323 Rock Creek High School
    9355 Flush Road
    St George,KS66535     		None GOV Support for healthy lifestyle programs in K-12 schools. 907
    USD323 Rock Creek Middle School
    9357 Flush Road
    St George,KS66535     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD323 St George Elementary
    200 Blackjack Road
    St George,KS66535     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD323 Westmoreland Elementary
    205 S 4th Street
    Westmoreland,KS66549     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD329 Alma elementary
    215 East 9th Street
    Alma,KS66401     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD329 Maple Hill Elementary
    212 Pierce Street
    Maple Hills,KS66507     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD329 Wabaunsee Jr High
    112 Elm Street
    Paxico,KS66526     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD330 Mission Valley High School
    12913 Mission Valley Road
    Eskridge,KS66423     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD332 Cunningham-West Kingman
    104 W 4th
    Cunningham,KS67035     		None GOV Support for healthy lifestyle programs in K-12 schools. 989
    USD337 Royal Valley Elementary
    1st and Highland
    Hoyt,KS66440     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD337 Royal Valley High
    101 E 1st
    Hoyt,KS66440     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD337 Royal Valley Middle School
    204 S 4th
    Mayetta,KS66440     		None GOV Support for healthy lifestyle programs in K-12 schools. 986
    USD340 Jefferson West Elementary
    301 E Main PO Box 265
    Meriden,KS66512     		None GOV Support for healthy lifestyle programs in K-12 schools. 770
    USD340 Jefferson West High School
    619 Conray Street
    Meriden,KS66512     		None GOV Support for healthy lifestyle programs in K-12 schools. 902
    USD340 Jefferson West Middle School
    210 Miller Street
    Meriden,KS66512     		None GOV Support for healthy lifestyle programs in K-12 schools. 952
    USD342 McLouth High School
    217 Summit St
    McLouth,KS66054     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD 343 Perry-Lecompton Elementary
    626 Whitifield Street
    Lecompton,KS66050     		None GOV Support for healthy lifestyle programs in K-12 schools. 997
    USD345 Logan Elementary
    1124 NW Lyman Road
    Topeka,KS66608     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD345 North Fairview Elementary
    1941 NW 39th Street
    Topeka,KS66617     		None GOV Support for healthy lifestyle programs in K-12 schools. 525
    USD366 Yates Center Elementary
    802 S State Street
    Yates Center,KS66783     		None GOV Support for healthy lifestyle programs in K-12 schools. 417
    USD369 Burton Schools
    105 E Lincoln PO Box 369
    Burrton,KS67020     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD377 Atchison Co Community Elemen
    506 6th Street
    Effingham,KS66023     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD377 Atchinson Co Community Jr Hi
    908 Tiger Road
    Effingham,KS66023     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD377 Atchinson Co Community Sr Hi
    908 Tiger Road
    Effingham,KS66023     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD408 Marion Middle School
    125 S Lincoln
    Marion,KS66861     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD409 Atchison Middle School
    301 N 5th Street
    Atchinson,KS66002     		None GOV Support for healthy lifestyle programs in K-12 schools. 700
    USD409 Atchison High School
    1500 Riley
    Atchison,KS66002     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD409 Central School
    215 N 8th Street
    Atchison,KS66002     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD410 Hillsboro Elementary
    812 East A Street
    Hillsboro,KS67063     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD413 Royster Middle School
    400 West Main
    Chanute,KS66720     		None GOV Support for healthy lifestyle programs in K-12 schools. 982
    USD430 Everest Middle School
    221 S 7th Street
    Everest,KS66424     		None GOV Support for healthy lifestyle programs in K-12 schools. 999
    USD437 Tallgrass Student Learning C
    5740 SW 61st Street
    Topeka,KS66619     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD439 RL Wright Elementary
    400 W 4th
    Segdwick,KS67135     		None GOV Support for healthy lifestyle programs in K-12 schools. 990
    USD448 Inman Elementary
    207 N Maple
    Inman,KS67546     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD457 Kenneth Henderson Middle Sch
    2406 Fleming Street
    Garden City,KS67846     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD460 Hesston Elementary
    300 E Amos
    Hesston,KS67062     		None GOV Support for healthy lifestyle programs in K-12 schools. 840
    USD460 Hesston Middle School
    100 N Ridge Road
    Hesston,KS67062     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD461 Heller Elementary
    415 N 8th
    Neodesha,KS66757     		None GOV Support for healthy lifestyle programs in K-12 schools. 840
    USD461 Neodesha MiddleHigh School
    1001 N 8th St
    Neodesha,KS66757     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD461 North Lawn Elementary
    620 W Granby
    Neodesha,KS66757     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD464 Tonganoxie Elementary
    1180 South East Street
    Tonganoxie,KS66086     		None GOV Support for healthy lifestyle programs in K-12 schools. 792
    USD465 Community Day School
    1317 Wheat Road
    Winfield,KS67156     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD465 Irving Elementary
    311 Harter Street
    Winfield,KS67156     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD465 Winfield Middle School
    130 Viking Blvd
    Winfield,KS67156     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD467 Wichita County Elementary
    109 N Indian Road
    Leoti,KS67846     		None GOV Support for healthy lifestyle programs in K-12 schools. 983
    USD469 Lansing Elementary
    450 West Mary Street
    Lansing,KS66043     		None GOV Support for healthy lifestyle programs in K-12 schools. 999
    USD471 Dexter
    311 N Main Street
    Dexter,KS67038     		None GOV Support for healthy lifestyle programs in K-12 schools. 994
    USD483 SW Heights Jr High
    17222 Mustang Road
    Kismet,KS67859     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD489 Hays High School
    2300 E 13th Street
    Hays,KS67601     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD491 Eudora Middle School
    2635 Church Street
    Eudora,KS66026     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD499 Liberty Elementary
    702 E 7th Street
    Galena,KS66739     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD501 Jag Academy
    2600 SW 33rd Street
    Topeka,KS66611     		None GOV Support for healthy lifestyle programs in K-12 schools. 937
    USD501 Jardine Elementary
    2600 SW 33rd Street
    Topeka,KS66611     		None GOV Support for healthy lifestyle programs in K-12 schools. 999
    USD501 McCarter Elementary
    5512 SW 16th Street
    Topeka,KS66604     		None GOV Support for healthy lifestyle programs in K-12 schools. 993
    USD501 McEachron Elementary
    4433 SW 29th Terrance
    Topeka,KS66614     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    USD507 Satanta Grade School
    800 Wichita
    Satanta,KS67870     		None GOV Support for healthy lifestyle programs in K-12 schools. 900
    USD511 Attica Public School
    718 N Main Street
    Attica,KS67009     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    Parsons Middle School
    2719 Main
    Parsons,KS67357     		None GOV Support for healthy lifestyle programs in K-12 schools. 795
    East Central Kansas Academy
    212 S Pine
    Garnett,KS66032     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Project Alternative SEKESC
    403 Brunetti Drive
    McCune,KS66753     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Project Plus SEKESC
    6822 SE Ross St Bldg 605
    Topeka,KS66619     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Special Purpose School SEKESC
    2601 Gabriel Ave
    Parsons,KS67357     		None PF Support for healthy lifestyle programs in K-12 schools. 966
    Transitional Learning Center
    700 E 13th Ave
    Hutchinson,KS67502     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Darrel and Dee Rolph Literacy Acade
    2220 E 21st St N
    Wichita,KS67214     		None PF Support for healthy lifestyle programs in K-12 schools. 862
    Hayden Catholic High School
    401 SW Gage Blvd
    Topeka,KS66606     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Holy Name Catholic School Wichita
    700 Fuller
    Winfield,KS67156     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Magdalen Catholic School
    2221 N 127th St E
    Wichita,KS67226     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    St Mary's Grade School
    605 Monroe
    Ellis,KS67637     		None PF Support for healthy lifestyle programs in K-12 schools. 500
    St Peter Catholic School
    11010 SW Blvd
    Wichita,KS67215     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Trinity Lutheran Church School
    910 Mound
    Winfield,KS67156     		None PF Support for healthy lifestyle programs in K-12 schools. 1,000
    Trinity Lutheran School
    611 N 8Th
    Atchison,KS66002     		None PF Support for healthy lifestyle programs in K-12 schools. 978
    Xavier Catholic School
    541 Muncie Road
    Leavenworth,KS66048     		None PF Support for healthy lifestyle programs in K-12 schools. 920
    USD252 Olpe JrSr High School
    220 W Listerscheid Street
    Olpe,KS66865     		None GOV Support for healthy lifestyle programs in K-12 schools. 1,000
    Total .................................bullet 3a 683,022
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities....         284,193
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		        703,591
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aDonated Services     		    3 134,280  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   134,280 987,784
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    1,122,064
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    4 & 8 Investment Income provides funding to support healthcare activities in Kansas.
    11a Donated services comprise all required activities performed on behalf of the Foundation.
    Form 990-PF (2020)
    Form 990-PF (2020)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2020)
    Additional Data


    Software ID: 20011566
    Software Version: 2020v4.0


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2020 AccountingFeesSchedule
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Audit Services 3,000 0 0 3,000

    TY 2020 InvestmentsOtherSchedule2
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    BAIRD AGGREGATE BOND FUND FMV 502,251 537,405
    DOUBLELINE TOTL RET BND FMV 528,046 536,771
    HRDNG LVNR INST EM MRKT INST FMV 488,412 633,098
    OAKMARK INTERNATIONAL FMV 437,266 534,744
    HARTFORD INTL OPPORT I FMV 415,594 517,770
    ISHARES CORE U S AGGREGATE FMV 2,067,493 2,200,580
    ISHARES S&P 500 GROWTH ETF FMV 1,612,051 2,346,917
    ISHARES S&P 500 VALUE ETF FMV 2,095,154 2,353,008
    ISHARES S&P MID CAP 400 GROW FMV 245,619 322,173
    ISHARES S P MID CAP 400 VALU FMV 276,327 321,985
    ISHARES CORE S&P SMALL CAP E FMV 871,895 987,557
    ISHARES CORE MSCI EAFE ETF FMV 960,519 1,074,142
    ISHARES CORE MSCI EMERGING FMV 621,042 705,767
    ISHARES INTL AGGREGATE BOND FMV 371,726 376,270
    METROPOLITAN WEST T R BOND FMV 528,040 550,442
    PIMCO TOTAL RETURN FUND I3 FMV 540,502 550,501
    PIMCO INTL BND USD HGD I3 FMV 378,306 377,930

    TY 2020 OtherAssetsSchedule
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    Accrued Investment Interest 5,145 3,307  
    Tax Receivable/Open Investments     3,307


    TY 2020 OtherExpensesSchedule
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Administrative Purchased Services 134,280      
    Association Royalty Fee 500     500
    Not-for-Profit Filing Fee 40     40


    TY 2020 OtherIncomeSchedule2
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Donated Services 134,280    


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Fees 53,479 53,479 0 0


    TY 2020 TaxesSchedule
    Name:
    Blue Cross and Blue Shield of Kansas
     
    Foundation Inc
    EIN:
    20-3085640
    Software ID:
    20011566
    Software Version:
    2020v4.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Investment Income Excise Tax 12,987