Form990-PF

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
BCBSM Foundation Inc
 
Number and street (or P.O. box number if mail is not delivered to street address)PO Box 64560
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
St Paul, MN55164
A Employer identification number

36-3525653
B Telephone number (see instructions)

(866) 812-1593
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$77,434,821J 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) 10,000,000
2 Check bullet.............
3 Interest on savings and temporary cash investments 5,915 5,915  
4 Dividends and interest from securities... 1,574,692 1,574,692  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 Click to see attachment 402,206
b Gross sales price for all assets on line 6a 28,005,611
7 Capital gain net income (from Part IV, line 2)... 402,206
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 64,367 64,367  
12 Total. Add lines 1 through 11........ 12,047,180 2,047,180  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 293,075     293,075
14 Other employee salaries and wages...... 433,171     433,171
15 Pension plans, employee benefits....... 162,839     162,839
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment 448,661     448,661
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 70,600      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 3,542     3,542
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 484,281 485,797   -2,046
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 1,896,169 485,797   1,339,242
25 Contributions, gifts, grants paid....... 6,119,428 6,170,641
26 Total expenses and disbursements. Add lines 24 and 25 8,015,597 485,797   7,509,883
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 4,031,583
b Net investment income (if negative, enter -0-) 1,561,383
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............. 419,145 865,397 865,397
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet   4,680,684    
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)....... 64,230,728 Click to see attachment69,258,223 69,258,223
c Investments—corporate bonds (attach schedule).......   Click to see attachment4,211,377 4,211,377
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule)..........   Click to see attachment2,937,441 2,937,441
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment103,901 Click to see attachment162,383 Click to see attachment162,383
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 69,434,458 77,434,821 77,434,821
Liabilities 17 Accounts payable and accrued expenses.......... 236,756 787,570
18 Grants payable................. 1,232,964 1,132,501
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)    
23 Total liabilities (add lines 17 through 22)......... 1,469,720 1,920,071
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...........    
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 67,964,738 75,514,750
29 Total net assets or fund balances (see instructions)..... 67,964,738 75,514,750
30 Total liabilities and net assets/fund balances (see instructions). 69,434,458 77,434,821
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
67,964,738
2
Enter amount from Part I, line 27a .....................
2
4,031,583
3
Other increases not included in line 2 (itemize) bullet
3
 
4
Add lines 1, 2, and 3 ..........................
4
71,996,321
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
-3,518,429
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
75,514,750
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 Publicly Tradeed Securities      
b Capital Gain Distribution      
c
d
e
(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 27,532,748   27,603,405 -70,657
b 472,863     472,863
c
d
e
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       -70,657
b       472,863
c
d
e
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 2 402,206
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  
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 21,703
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 21,703
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 21,703
6 Credits/Payments:
a 2020 estimated tax payments and 2019 overpayment credited to 2020 6a 28,671
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c  
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. Part VI Line 7 - Tax Paid with the Original Return: 28671 7 28,671
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 6,968
11 Enter the amount of line 10 to be: Credited to 2021 estimated taxBullet6,968 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)
    bulletMN
    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
     
     
    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 addressbulletwww.bluecrossmn.com/foundation
    14
    The books are in care ofbulletCorporate Offices Telephone no.bullet (651) 662-9668

    Located atbullet3535 Blue Cross RoadEaganMN ZIP+4bullet551221154
    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
     
    No
    .........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). Click to see attachment
    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
    MARK STEFFEN MD BOARD CHAIR
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    RACHEL HARDEMAN DIRECTOR
    000.00     		500    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    BUKATA HAYES VICE CHAIR
    000.00     		2,000    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    MARIA REGAN GONZALEZ DIRECTOR
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    LAYLA NOURAEE SECRETARY
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    LAURA TONGUE ASST SECRETARY
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    JOHN ORNER TREASURER
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    NASH SHAIKH DIRECTOR
    000.00     		0    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    NANCY VYSKOCIL DIRECTOR
    000.00     		2,000    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    PAMELA MORET DIRECTOR
    000.00     		2,000    
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    CAROLYN LINK PRESIDENT
    040.00     		286,575 57,859  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    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
    CLAIRE CHANG SENIOR PROGRAM OFFIC
    040.00     		167,621 57,712  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    ALLISON CORRADO SENIOR PROGRAM OFFIC
    040.00     		126,580 46,691  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    JANET JABLONSKE OPERATIONS MANAGER
    040.00     		109,445 37,360  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    BILAL ALKATOUT SENIOR PROGRAM OFFIC
    040.00     		115,959 27,642  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    GILBERT ACHAY SENIOR PROGRAM OFFIC
    040.00     		137,793 30,831  
    3535 BLUE CROSS ROAD
    ST PAUL,MN55122
    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
    Amherst H Wilder Foundation Consulting Service 69,700
    451 Lexingtion Pkwy N
    St Paul,MN55104
    Arcadia Research and Evaluation LLC Consulting Service 277,366
    364 Warwick St
    St Paul,MN55105
    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 Funds were used for evaluation of a protfolio of grantees working on health equity projects funded by the Foundation. Grantee work in this focus area is amined at advancing community strategies that improve opportunities for people to reach their full health potential 69,700
    2 Funds supported evaluation for the Foundation's quality early education and care program that helps licensed faimly childcare providers improve the qual,ity of care provided to Minnesota children, giving them the best chance for a healthy future. 109,786
    3 The Foundation contracted for strategic advising around its charitable investments in early childhood education and development including planning and facilitating the Learn Together MN meetings and consultation and support on program planning. 14,875
    4 The Foundation engaged wiht a communications consultant to develop a plan for communicating the findings of grant funded research on Minnesotan's lacking health insurance to key audiences. Funds used for evaluation of a portfolio of grantee efforts to conduct outreach and enrollment of people into Medicaid and Minnesota Care. 72,077
    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 None  
    2 None  
    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
    64,554,494
    b
    Average of monthly cash balances.......................
    1b
    853,637
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    65,408,131
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
     
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
     
    3
    Subtract line 2 from line 1d.........................
    3
    65,408,131
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) Click to see attachment.............................
    4
    981,122
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    64,427,009
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    3,221,350
    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
    3,221,350
    2a
    Tax on investment income for 2020 from Part VI, line 5......
    2a
    21,703
    b
    Income tax for 2020. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    21,703
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    3,199,647
    4
    Recoveries of amounts treated as qualifying distributions................
    4
     
    5
    Add lines 3 and 4............................
    5
    3,199,647
    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
    3,199,647
    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 Click to see attachment..........
    1a
    7,509,883
    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
    7,509,883
    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
    7,509,883
    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 3,199,647
    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...... 2,472,723
    b From 2016...... 1,948,179
    c From 2017...... 1,756,980
    d From 2018...... 1,335,370
    e From 2019...... 2,524,418
    fTotal of lines 3a through e........ 10,037,670
    4Qualifying distributions for 2020 from Part
    XII, line 4: bullet$ 7,509,883
    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)........     		 
    d Applied to 2020 distributable amount..... 3,199,647
    e Remaining amount distributed out of corpus 4,310,236
    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 14,347,906
    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) ...     		2,472,723
    9Excess distributions carryover to 2021.
    Subtract lines 7 and 8 from line 6a ......     		11,875,183
    10 Analysis of line 9:
    a Excess from 2016.... 1,948,179
    b Excess from 2017.... 1,756,980
    c Excess from 2018.... 1,335,370
    d Excess from 2019.... 2,524,418
    e Excess from 2020.... 4,310,236
    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).)
    None
    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.
    None
    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:
    Carolyn Link
    PO Box 64560
    St Paul,MN55164
    (866) 812-1593
    foundationbluecrossmnfoundation.org
    bThe form in which applications should be submitted and information and materials they should include:
    Please visit our website at www.bluecrossmn.com/foundation for instructions on how to apply.
    cAny submission deadlines:
    Inquiries are accepted throughout the year and applicants are given a proposal due date at the time
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    We typically do not provide funding for programs outside Minnesota.
    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
    Advocates For Human Rights
    330 Second Avenue South Suite 800
    Minneapolis,MN55401     		  PC Pro Bono Engagement for Immigrant Defense Project 87,500
    African American Babies Coalition (AABC)
    920 Selby Ave
    St Paul,MN55104     		  PC COVID-19 Relief for Expecting Mothers 20,000
    African Community Senior Services
    3040 4th Ave South 5C
    Minneapolis,MN55408     		  PC outreach application and enrollment assistance to low-income families and individuals 25,000
    African Community Services in Minnesota
    1305 East 24th Street
    Minneapolis,MN55404     		  PC African Community Services COVID-19 Response 25,000
    African Community Services in Minnesota
    1305 East 24th Street
    Minneapolis,MN55404     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Alliance for Metropolitan Stability
    2525 E Franklin Avenue Ste 200
    Minneapolis,MN55406     		  PC Capacity Builder 50,000
    Alliance of Early Childhood Professionals
    1308 East Franklin Avenue Suite 126
    Minneapolis,MN55404     		  PC Wicoie Nandagikendan 50,000
    American Indian Cancer Foundation
    3001 BROADWAY ST NE STE 185
    MINNEAPOLIS,MN554132657     		  PC Honoring Indigenous Cancer Survivors in MN - Providing Support to Indigenous Cancer Survivors AI/AN Cancer COVID-19 20,000
    Amherst H Wilder Foundation
    451 LEXINGTON PARKWAY NORTH
    ST PAUL,MN551044636     		  PC Minnesota Compass 20,000
    Appetite for Change
    1200 West Broadway Avenue 180
    Minneapolis,MN55411     		  PC Appetite for Change - COVID Response Funding Request 16,940
    Appetite for Change
    1200 West Broadway Avenue 180
    Minneapolis,MN55411     		  PC Community Cooks Meal Box Program 15,000
    CARE Clinic
    906 College Ave
    Red Wing,MN55066     		  PC Coordinated MNsure Enrollment Program to Decrease Barriers to Successful Health Insurance Enrollment 20,000
    Casa de Esperanza
    PO Box 40115
    Saint Paul,MN55104     		  PC Emergency Response 25,000
    Casa de Esperanza
    PO Box 40115
    Saint Paul,MN55104     		  PC Building Healthy Latin Families and Communities 100,000
    Casa de Esperanza
    PO Box 40115
    Saint Paul,MN55104     		  PC Ensuring Bright Futures for Latin Youth 10,000
    Centro de Trabajadores Unidos en Lucha
    3715 Chicago Ave S
    Minneapolis,MN55407     		  PC Worker-Led Reform of the Twin Cities Construction Industry 100,000
    Centro Tyrone Guzman
    1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Centro Community Support 25,000
    Centro Tyrone Guzman
    1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Wise Elders Microenterprise 40,968
    Centro Tyrone Guzman
    1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Community Support Services 10,000
    Children's Defense Fund-Minnesota
    555 Park Street Suite 410
    St Paul,MN55103     		  PC Building Power and Raising Voices for MN Families 100,000
    Close Gaps by 5
    3948 Market St PO Box 24885
    MINNEAPOLIS,MN55424     		  PC Close Gaps by 5 General Operating Support 20,000
    COALITION OF ASIAN AMERICAN LEADERS
    941 Lafond Ave Ste 205
    St Paul,MN55104     		  PC Anti-Asian Racism During COVID-19 100,000
    COALITION OF ASIAN AMERICAN LEADERS
    941 Lafond Ave Ste 205
    St Paul,MN55104     		  PC Paths Forward on Safe Communities 100,000
    Comunidades Latinas Unidas En Servicio
    797 East 7th Street
    St Paul,MN55106     		  PC CLUES Emergency Response for Latino Families 25,000
    Comunidades Latinas Unidas En Servicio
    797 East 7th Street
    St Paul,MN55106     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Comunidades Latinas Unidas En Servicio
    797 East 7th Street
    St Paul,MN55106     		  PC CLUES Covid Relief Reinforcement Food Security 10,000
    Council on American-Islamic Relations Minnesota
    2511 East Franklin Ave Suite 100
    Minneapolis,MN55406     		  PC CAIR-MN 2020 Funding Support for COVID-19 15,000
    Fond du Lac Tribal College
    1720 Big Lake Road
    Cloquet,MN55720     		  PC Healthy Start Strengthening Ojibwe Identity Ages 0-3 Years 99,803
    Friendship House
    310 NW 1st Ave
    Faribault,MN55021     		  PC Covid-19 Food Security for SPMI in Rice County 6,250
    FrontStream
    11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2018 Community Giving Campaign 62,648
    FrontStream
    11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2019 Community Giving Campaign 307,531
    Generations Health Care Initiatives
    130 W Superior St Ste 700
    Duluth,MN55802     		  PC Insure Duluth Coalition Partner, YMCA 50,000
    Grantmakers In Health
    1100 Connecticut Avenue NW Suite 12
    Washington,DC20036     		  PC 2020 GIH funding partner renewal 6,000
    Greater Minneapolis Community Connections
    1100 East Lake Street
    Minneapolis,MN55407     		  PC GMCC and Somali Minnesota Covid-19 Task Force Partnership Project 25,000
    Greater Minneapolis Community Connections
    1100 East Lake Street
    Minneapolis,MN55407     		  PC Minnesota FoodShare 2020 100,000
    Headwaters Foundation for Justice
    2801 21st Ave S Ste 132B
    Minneapolis,MN55407     		  PC Communities First Fund 100,000
    Hispanic Outreach Program of Goodhue County
    PO Box 146
    Red Wing,MN55066     		  PC Emergency Fund 6,750
    Hispanic Outreach Program of Goodhue County
    PO Box 146
    Red Wing,MN55066     		  PC Meet.Learn.Share 62,500
    Hmong American Partnership
    1075 Arcade St
    St Paul,MN55106     		  PC HAP411 25,000
    Hmong American Partnership
    1075 Arcade St
    St Paul,MN55106     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Hope Community Inc
    611 East Franklin Avenue
    Minneapolis,MN55082     		  PC Community Food Security in Phillips 5,000
    Hope Community Inc
    611 East Franklin Avenue
    Minneapolis,MN55082     		  PC Engaging Community and Building Assets for Healing, Safety, and Sanctuary 100,000
    Immigrant Development Center
    810 4th Ave S Ste 204
    Moorhead,MN56560     		  PC COVID-19 Responsive Grants 2020 18,000
    Immigrant Development Center
    810 4th Ave S Ste 204
    Moorhead,MN56560     		  PC COVID-19 Responsive Grants 2020 15,000
    Immigrant Law Center of Minnesota
    450 North Syndicate Street Suite 20
    St Paul,MN55104     		  PC ILCM General Operating Support 100,000
    Isuroon Project
    1600 East Lake Street Suite 1
    Minneapolis,MN55407     		  PC Somali Community Food Assistance 24,000
    JEWISH COMMUNITY ACTION
    2375 UNIVERSITY AVENUE WEST
    ST PAUL,MN551148755     		  PC Building a Shared Analysis to Combat Antisemitism and Strengthen Movements for Justice 90,000
    Justus Health
    2577 Territorial Road
    Saint Paul,MN55114     		  PC COVID-19 Response for HIV-Positive Minnesotans 25,000
    Justus Health
    2577 Territorial Road
    Saint Paul,MN55114     		  PC Expanding Insurance Coverage for LGBTQ and HIV-positive Minnesotans 50,000
    Justus Health
    2577 Territorial Road
    Saint Paul,MN55114     		  PC Benefits Housing for Former Encampment Residents 30,000
    Karen Organization of Minnesota
    2353 Rice St Suite 240
    Roseville,MN55113     		  PC COVID-19 Response for Refugees from Burma 25,000
    La RED Latina de Educacion Temprana
    6500 Nicollet Ave
    Richfield,MN55423     		  PC COVID-19 Response for Latinx Families and FFN Child Care Providers 25,000
    La RED Latina de Educacion Temprana
    6500 Nicollet Ave
    Richfield,MN55423     		  PC La Red Latina de Educacion Temprana 100,000
    La RED Latina de Educacion Temprana
    6500 Nicollet Ave
    Richfield,MN55423     		  PC COVID-19 Response for Latinx Families and FFN Child Care Providers 10,000
    Lakes & Prairies Community Action Partnership Inc
    715 11th Street N Suite 402
    Moorhead,MN56560     		  PC New American Child Care Project 100,000
    Leech Lake Band of Ojibwe
    190 Sailstar Drive NW
    Cass Lake,MN56633     		  GOV LLBO COVID-19 Response 25,000
    Liberty Community Church PCUSA
    3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Immediate Needs - North Minneapolis 20,000
    Liberty Community Church PCUSA
    3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Capacity-building for Thriving, Healthy, and Connected Communities through Youth Participatory Action Research YPAR 100,000
    Liberty Community Church PCUSA
    3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Libertys COVID-19 Recovery Project 25,000
    Lower Sioux Indian Community
    39527 Reservation Hwy 1 PO Box 308
    Morton,MN56270     		  GOV Lower Sioux Emergency Food Shelf 24,990
    Mid-Minnesota Legal Assistance
    111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Healthcare Outreach and Enrollment Project 100,000
    Mid-Minnesota Legal Assistance
    111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Navigator Coalition 100,000
    Minneapolis American Indian Center
    1530 East Franklin Avenue
    Minneapolis,MN55404     		  PC Emergency Food Relief 15,000
    Minnesota Council on Foundations
    800 Washington Ave N Suite 703
    Minneapolis,MN554011167     		  PC 2020 Membership Contribution 10,150
    Minnesota Public Radio
    480 Cedar Street
    St Paul,MN551012274     		  PC Minnesotas Diverse Communities Phase 1 Listening Sessions 20,000
    Native American Community Clinic
    1213 E Franklin Ave
    Minneapolis,MN55404     		  PC NACC response to COVID-19 20,000
    Native American Community Clinic
    1213 E Franklin Ave
    Minneapolis,MN55404     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 30,000
    Native American Community Clinic
    1213 E Franklin Ave
    Minneapolis,MN55404     		  PC NACC COVID Emergency Response 25,000
    Navigate
    1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC Resilience and Rapid Response 25,000
    Navigate
    1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC From resilience to power a safe community is an organized one 100,000
    Navigate
    1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC Minnesota Immigrant Families Fund 10,000
    NEXUS COMMUNITY PARTNERS
    2314 UNIVERSITY AVE W STE 18
    SAINT PAUL,MN55113     		  PC Community Engagement Capacity Building 100,000
    NORTHFIELD HEALTHY COMMUNITY INITIATIVE
    1651 JEFFERSON PARKWAY HS 128
    NORTHFIELD,MN550572760     		  PC Food for Families 18,000
    NORTHFIELD HEALTHY COMMUNITY INITIATIVE
    1651 JEFFERSON PARKWAY HS 128
    NORTHFIELD,MN550572760     		  PC Increasing Early Childhood Access in Rice County during COVID-19 60,000
    Northland Foundation
    202 West Superior Street Suite 610
    Duluth,MN55802     		  PC Northeastern Minnesota Emergency Child Care Grant Program 25,000
    Northland Foundation
    202 West Superior Street Suite 610
    Duluth,MN55802     		  PC Pathways to Quality Early Care and Education Expansion initiative 100,000
    NorthPoint Health & Wellness Inc
    1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Emergency Food Relief 15,000
    NorthPoint Health & Wellness Inc
    1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 75,000
    NorthPoint Health & Wellness Inc
    1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Meeting Basic Needs in North Minneapolis 25,000
    Northside Achievement Zone
    2123 West Broadway Ave Suite 100
    Minneapolis,MN55411     		  PC Healthy Start -NAZ general operating funding 100,000
    Northwest Indian Community Development Center
    1819 Bemidji Ave N
    Bemidji,MN56601     		  PC NWICDC COVID Community Response and Support 25,000
    Northwest Minnesota Foundation
    201 3rd St NW
    Bemidji,MN56601     		  PC Northwest Minnesota COVID-19 Disaster Response 25,000
    Northwest Minnesota Foundation
    201 3rd St NW
    Bemidji,MN56601     		  PC Step Up 2.0 100,000
    Open Door Health Center
    309 Holly Lane
    Mankato,MN56001     		  PC Outreach Application and Enrollment Assistance for Low-Income Families and Individuals 75,000
    OutFront Minnesota Community Services
    310 East 38th Street Suite 209
    Minneapolis,MN554091337     		  PC COVID Emergency Fund for LGBTQ Vulnerable Communities 25,000
    OutFront Minnesota Community Services
    310 East 38th Street Suite 209
    Minneapolis,MN554091337     		  PC Anti-Violence Program 50,000
    Portico Healthnet
    2610 University Avenue West Suite 5
    St Paul,MN551142007     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 100,000
    Project FINE
    202 W 3rd St
    Winona,MN55987     		  PC Project FINE COVID-19 Response 25,000
    Project FINE
    202 W 3rd St
    Winona,MN55987     		  PC Healthy Connections Advancing Equity and Addressing Social Determinants of Health 100,000
    Regents of the University of Minnesota
    Sponsored Projects Administration 2
    Minneapolis,MN55455     		  PC DESCRIBING MINNESOTAS UNINSURED AND THE COMMUNITIES IN WHICH THEY LIVE PHASE 3 - DATA REFRESH AND TARGETING NEW STAKEHOLDERS 107,146
    Region Nine Area Inc
    3 Civic Center Plaza Suite 310
    Mankato,MN56001     		  PC COVID-19 Responsive Grants 2020 - Supporting RELC Welcoming Communities Project Area Food Shelves 20,000
    Region Nine Area Inc
    3 Civic Center Plaza Suite 310
    Mankato,MN56001     		  PC Welcoming Communities Project 100,000
    Reviving the Islamic Sisterhood for Empowerment
    1007 West Broadway Ave
    Minneapolis,MN55411     		  PC Challenging Xenophobic hate 15,000
    Reviving the Islamic Sisterhood for Empowerment
    1007 West Broadway Ave
    Minneapolis,MN55411     		  PC Healthy, Safe, and Connected Communities for Muslim Women 75,000
    Saint Paul 3K
    15 West Kellogg Blvd Suite 310B
    Saint Paul,MN55102     		  PC Saint Paul 3K 100,000
    SEWA-AIFW
    3702 E Lake St
    Minneapolis,MN55406     		  PC SEWA emerging covid needs 25,000
    SEWA-AIFW
    3702 E Lake St
    Minneapolis,MN55406     		  PC Closing the Gap to Toward Healthy Connections 75,000
    SEWA-AIFW
    3702 E Lake St
    Minneapolis,MN55406     		  PC Responding to Emerging Needs during Covid-19 25,000
    SOMALI COMMUNITY RESETTLEMENT SERVICES
    201 S Lyndale Ave
    Faribault,MN55021     		  PC FFN Provider Training 70,000
    Southern Minnesota Regional Legal Services Inc
    Administrative Office 55 E 5th Stre
    St Paul,MN55101     		  PC Lawyers Advancing Wellness at Open Door 78,165
    Southwest Initiative Foundation
    15 3RD AVE NW
    Hutchinson,MN553501643     		  PC Community Solutions for SW MN Child Care 100,000
    ST PAUL YOUTH SERVICES INC
    2100 WILSON AVE
    SAINT PAUL,MN551194146     		  PC Providing Academic and Social Emotional Student Support During COVID-19 20,000
    ST PAUL YOUTH SERVICES INC
    2100 WILSON AVE
    SAINT PAUL,MN551194146     		  PC How Black Youth Advance Health Equity and Build Youth Power at St. Paul Youth Services 100,000
    St Stephen's Human Services Inc
    2309 Nicollet Avenue South
    Minneapolis,MN55404     		  PC Expanding Shelter and Street Outreach to Help Everyone Stay Home 15,000
    Steele County Transitional Housing
    560 Dunnell Drive 212
    Owatonna,MN55060     		  PC Eviction Prevention 15,000
    The Aliveness Project
    3808 Nicollet Avenue
    Minneapolis,MN55409     		  PC Meals and Food Shelf for Minnesotans Living With HIV 15,000
    The Saint Paul Foundation
    101 Fifth Street East Suite 2400
    Saint Paul,MN55101     		  PC MCF Minnesota Disaster Recovery Fund 100,000
    Think Small
    10 Yorkton Ct
    Saint Paul,MN551171065     		  PC Think Small COVID-19-Emergency Fund for Child Care 20,000
    Think Small
    10 Yorkton Ct
    Saint Paul,MN551171065     		  PC Think Small Blue Cross Blue Shield Foundation Healthy Start Grant Application 100,000
    United Community Action Partnership
    200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC UCAP COVID-19 Emergency Response Support 20,000
    United Community Action Partnership
    200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC Partners in Care - Mentoring and Beyond 100,000
    Voices for Racial Justice
    2525 E Franklin Avenue Ste 301
    Minneapolis,MN55406     		  PC Voices for Racial Justice COVID-19 Response 25,000
    Voices for Racial Justice
    2525 E Franklin Avenue Ste 301
    Minneapolis,MN55406     		  PC Capacity Builder 100,000
    Way to Grow
    201 Irving Ave N Suite 100
    Minneapolis,MN55405     		  PC Way to Grow Healthy Start 70,000
    WEST BANK CDC INC
    1808 RIVERSIDE AVE STE 201
    MINNEAPOLIS,MN554541121     		  PC Ileys Dariis / Neighborhood Light 33,300
    West Central Initiative
    PO Box 318
    Fergus Falls,MN565380318     		  PC Helping our Child Care Professionals after the Pandemic 50,000
    WEST SIDE CITIZENS ORGANIZATION
    209 Page Street West Suite 260
    Saint Paul,MN55107     		  PC Supporting Immigrant Renters and Small Businesses 25,000
    WILDFLOWER FOUNDATION
    1330 LAGOON AVE 4TH FLOOR
    MINNEAPOLIS,MN554082885     		  PC Wildflower Schools Cohort Expansion and COVID-19 Relief 70,000
    YWCA of Minneapolis
    1130 Nicollet Mall
    Minneapolis,MN55403     		  PC YWCA Holistic Programming to Create Access to High-Quality Early Childhood Education for Marginalized Communities W 60,000
    Total .................................bullet 3a 6,170,641
    bApproved for future payment
    United eWayFrontstream
    11480 Commerce Park Dr Stie 300
    Reston,VA201911575     		  PC 2020 Community Giving Campaign 494,716
    African Community Services in Minnesota
    1305 East 24th Street
    Minneapolis,MN55404     		  PC Outreach Application and Enrollment 15,000
    Centro di Trabajadores Unidos en Lucha
    3715 Chicago Avenue South
    Minneapolis,MN55407     		  PC Covid Adaptation and Response 25,000
    Leech Lake Band of Ojibwe
    190 Sailstar Drive NW
    Cass Lake,MN56633     		  GOV Covid 19 Emergency Food 25,000
    West Bank Community Development Center
    1808 Riverside Ave Ste 201
    Minneapolis,MN55454     		  PC Electronic Commections 10,000
    Lower Sioux Indian Community
    39527 Reservation Hwy 1
    Morton,MN56270     		  GOV Covid 19 Response 25,000
    United Community Action Partnership
    200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC Partners In Care 75,000
    Northwest Indian CDC
    1819 Bemidji Ave N
    Bemidji,MN56601     		  PC Outreach Application and Enrollment Assistance for low income 100,000
    Immigrant Law Center
    450 North Syndicate Street Ste 200
    St Paul,MN55104     		  PC General Operating Support 100,000
    FrontStream
    11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2019 Community Giving Campaign 62,785
    Mid-Minnesota Legal Assistance
    111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Healthcare Outreach and Enrollment Project 100,000
    Portico Healthnet
    2610 University Avenue West Suite 5
    St Paul,MN551142007     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 100,000
    Total .................................bullet 3b 1,132,501
    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 ...........     		    14 5,915  
    4 Dividends and interest from securities....     14 1,574,692  
    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.....     14 64,367  
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 402,206  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e)..   2,047,180  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    2,047,180
    (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.)
    N/a N/A
    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)
    Yes
     
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
    Yes
     
    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
    1b(6) 828,379 BCBSM Inc BCBSM, Inc. employees performed personal services for reporting organisation
    1c 1 BCBSM Inc Sharing of Facilties
    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: 20011406
    Software Version: 20.0.2.0
    Part VI Line 7 - Tax Paid with the Original Return: 28,671


    Form 990PF - Special Condition Description:
    Special Condition Description

    Form 990PF Part XV Line 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
    Advocates For Human Rights330 Second Avenue South Suite 800
    Minneapolis,MN55401     		  PC Pro Bono Engagement for Immigrant Defense Project 87,500
    African American Babies Coalition (AABC)920 Selby Ave
    St Paul,MN55104     		  PC COVID-19 Relief for Expecting Mothers 20,000
    African Community Senior Services3040 4th Ave South 5C
    Minneapolis,MN55408     		  PC outreach application and enrollment assistance to low-income families and individuals 25,000
    African Community Services in Minnesota1305 East 24th Street
    Minneapolis,MN55404     		  PC African Community Services COVID-19 Response 25,000
    African Community Services in Minnesota1305 East 24th Street
    Minneapolis,MN55404     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Alliance for Metropolitan Stability2525 E Franklin Avenue Ste 200
    Minneapolis,MN55406     		  PC Capacity Builder 50,000
    Alliance of Early Childhood Professionals1308 East Franklin Avenue Suite 126
    Minneapolis,MN55404     		  PC Wicoie Nandagikendan 50,000
    American Indian Cancer Foundation3001 BROADWAY ST NE STE 185
    MINNEAPOLIS,MN554132657     		  PC Honoring Indigenous Cancer Survivors in MN - Providing Support to Indigenous Cancer Survivors AI/AN Cancer COVID-19 20,000
    Amherst H Wilder Foundation451 LEXINGTON PARKWAY NORTH
    ST PAUL,MN551044636     		  PC Minnesota Compass 20,000
    Appetite for Change1200 West Broadway Avenue 180
    Minneapolis,MN55411     		  PC Appetite for Change - COVID Response Funding Request 16,940
    Appetite for Change1200 West Broadway Avenue 180
    Minneapolis,MN55411     		  PC Community Cooks Meal Box Program 15,000
    CARE Clinic906 College Ave
    Red Wing,MN55066     		  PC Coordinated MNsure Enrollment Program to Decrease Barriers to Successful Health Insurance Enrollment 20,000
    Casa de EsperanzaPO Box 40115
    Saint Paul,MN55104     		  PC Emergency Response 25,000
    Casa de EsperanzaPO Box 40115
    Saint Paul,MN55104     		  PC Building Healthy Latin Families and Communities 100,000
    Casa de EsperanzaPO Box 40115
    Saint Paul,MN55104     		  PC Ensuring Bright Futures for Latin Youth 10,000
    Centro de Trabajadores Unidos en Lucha3715 Chicago Ave S
    Minneapolis,MN55407     		  PC Worker-Led Reform of the Twin Cities Construction Industry 100,000
    Centro Tyrone Guzman1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Centro Community Support 25,000
    Centro Tyrone Guzman1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Wise Elders Microenterprise 40,968
    Centro Tyrone Guzman1915 Chicago Avenue
    Minneapolis,MN55404     		  PC Community Support Services 10,000
    Children's Defense Fund-Minnesota555 Park Street Suite 410
    St Paul,MN55103     		  PC Building Power and Raising Voices for MN Families 100,000
    Close Gaps by 53948 Market St PO Box 24885
    MINNEAPOLIS,MN55424     		  PC Close Gaps by 5 General Operating Support 20,000
    COALITION OF ASIAN AMERICAN LEADERS941 Lafond Ave Ste 205
    St Paul,MN55104     		  PC Anti-Asian Racism During COVID-19 100,000
    COALITION OF ASIAN AMERICAN LEADERS941 Lafond Ave Ste 205
    St Paul,MN55104     		  PC Paths Forward on Safe Communities 100,000
    Comunidades Latinas Unidas En Servicio797 East 7th Street
    St Paul,MN55106     		  PC CLUES Emergency Response for Latino Families 25,000
    Comunidades Latinas Unidas En Servicio797 East 7th Street
    St Paul,MN55106     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Comunidades Latinas Unidas En Servicio797 East 7th Street
    St Paul,MN55106     		  PC CLUES Covid Relief Reinforcement Food Security 10,000
    Council on American-Islamic Relations Minnesota2511 East Franklin Ave Suite 100
    Minneapolis,MN55406     		  PC CAIR-MN 2020 Funding Support for COVID-19 15,000
    Fond du Lac Tribal College1720 Big Lake Road
    Cloquet,MN55720     		  PC Healthy Start Strengthening Ojibwe Identity Ages 0-3 Years 99,803
    Friendship House310 NW 1st Ave
    Faribault,MN55021     		  PC Covid-19 Food Security for SPMI in Rice County 6,250
    FrontStream11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2018 Community Giving Campaign 62,648
    FrontStream11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2019 Community Giving Campaign 307,531
    Generations Health Care Initiatives130 W Superior St Ste 700
    Duluth,MN55802     		  PC Insure Duluth Coalition Partner, YMCA 50,000
    Grantmakers In Health1100 Connecticut Avenue NW Suite 12
    Washington,DC20036     		  PC 2020 GIH funding partner renewal 6,000
    Greater Minneapolis Community Connections1100 East Lake Street
    Minneapolis,MN55407     		  PC GMCC and Somali Minnesota Covid-19 Task Force Partnership Project 25,000
    Greater Minneapolis Community Connections1100 East Lake Street
    Minneapolis,MN55407     		  PC Minnesota FoodShare 2020 100,000
    Headwaters Foundation for Justice2801 21st Ave S Ste 132B
    Minneapolis,MN55407     		  PC Communities First Fund 100,000
    Hispanic Outreach Program of Goodhue CountyPO Box 146
    Red Wing,MN55066     		  PC Emergency Fund 6,750
    Hispanic Outreach Program of Goodhue CountyPO Box 146
    Red Wing,MN55066     		  PC Meet.Learn.Share 62,500
    Hmong American Partnership1075 Arcade St
    St Paul,MN55106     		  PC HAP411 25,000
    Hmong American Partnership1075 Arcade St
    St Paul,MN55106     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 50,000
    Hope Community Inc611 East Franklin Avenue
    Minneapolis,MN55082     		  PC Community Food Security in Phillips 5,000
    Hope Community Inc611 East Franklin Avenue
    Minneapolis,MN55082     		  PC Engaging Community and Building Assets for Healing, Safety, and Sanctuary 100,000
    Immigrant Development Center810 4th Ave S Ste 204
    Moorhead,MN56560     		  PC COVID-19 Responsive Grants 2020 18,000
    Immigrant Development Center810 4th Ave S Ste 204
    Moorhead,MN56560     		  PC COVID-19 Responsive Grants 2020 15,000
    Immigrant Law Center of Minnesota450 North Syndicate Street Suite 20
    St Paul,MN55104     		  PC ILCM General Operating Support 100,000
    Isuroon Project1600 East Lake Street Suite 1
    Minneapolis,MN55407     		  PC Somali Community Food Assistance 24,000
    JEWISH COMMUNITY ACTION2375 UNIVERSITY AVENUE WEST
    ST PAUL,MN551148755     		  PC Building a Shared Analysis to Combat Antisemitism and Strengthen Movements for Justice 90,000
    Justus Health2577 Territorial Road
    Saint Paul,MN55114     		  PC COVID-19 Response for HIV-Positive Minnesotans 25,000
    Justus Health2577 Territorial Road
    Saint Paul,MN55114     		  PC Expanding Insurance Coverage for LGBTQ and HIV-positive Minnesotans 50,000
    Justus Health2577 Territorial Road
    Saint Paul,MN55114     		  PC Benefits Housing for Former Encampment Residents 30,000
    Karen Organization of Minnesota2353 Rice St Suite 240
    Roseville,MN55113     		  PC COVID-19 Response for Refugees from Burma 25,000
    La RED Latina de Educacion Temprana6500 Nicollet Ave
    Richfield,MN55423     		  PC COVID-19 Response for Latinx Families and FFN Child Care Providers 25,000
    La RED Latina de Educacion Temprana6500 Nicollet Ave
    Richfield,MN55423     		  PC La Red Latina de Educacion Temprana 100,000
    La RED Latina de Educacion Temprana6500 Nicollet Ave
    Richfield,MN55423     		  PC COVID-19 Response for Latinx Families and FFN Child Care Providers 10,000
    Lakes & Prairies Community Action Partnership Inc715 11th Street N Suite 402
    Moorhead,MN56560     		  PC New American Child Care Project 100,000
    Leech Lake Band of Ojibwe190 Sailstar Drive NW
    Cass Lake,MN56633     		  GOV LLBO COVID-19 Response 25,000
    Liberty Community Church PCUSA3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Immediate Needs - North Minneapolis 20,000
    Liberty Community Church PCUSA3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Capacity-building for Thriving, Healthy, and Connected Communities through Youth Participatory Action Research YPAR 100,000
    Liberty Community Church PCUSA3700 Broadway Avenue North
    Minneapolis,MN55412     		  PC Libertys COVID-19 Recovery Project 25,000
    Lower Sioux Indian Community39527 Reservation Hwy 1 PO Box 308
    Morton,MN56270     		  GOV Lower Sioux Emergency Food Shelf 24,990
    Mid-Minnesota Legal Assistance111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Healthcare Outreach and Enrollment Project 100,000
    Mid-Minnesota Legal Assistance111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Navigator Coalition 100,000
    Minneapolis American Indian Center1530 East Franklin Avenue
    Minneapolis,MN55404     		  PC Emergency Food Relief 15,000
    Minnesota Council on Foundations800 Washington Ave N Suite 703
    Minneapolis,MN554011167     		  PC 2020 Membership Contribution 10,150
    Minnesota Public Radio480 Cedar Street
    St Paul,MN551012274     		  PC Minnesotas Diverse Communities Phase 1 Listening Sessions 20,000
    Native American Community Clinic1213 E Franklin Ave
    Minneapolis,MN55404     		  PC NACC response to COVID-19 20,000
    Native American Community Clinic1213 E Franklin Ave
    Minneapolis,MN55404     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 30,000
    Native American Community Clinic1213 E Franklin Ave
    Minneapolis,MN55404     		  PC NACC COVID Emergency Response 25,000
    Navigate1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC Resilience and Rapid Response 25,000
    Navigate1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC From resilience to power a safe community is an organized one 100,000
    Navigate1515 East Lake Street Suite 202
    Minneapolis,MN55407     		  PC Minnesota Immigrant Families Fund 10,000
    NEXUS COMMUNITY PARTNERS2314 UNIVERSITY AVE W STE 18
    SAINT PAUL,MN55113     		  PC Community Engagement Capacity Building 100,000
    NORTHFIELD HEALTHY COMMUNITY INITIATIVE1651 JEFFERSON PARKWAY HS 128
    NORTHFIELD,MN550572760     		  PC Food for Families 18,000
    NORTHFIELD HEALTHY COMMUNITY INITIATIVE1651 JEFFERSON PARKWAY HS 128
    NORTHFIELD,MN550572760     		  PC Increasing Early Childhood Access in Rice County during COVID-19 60,000
    Northland Foundation202 West Superior Street Suite 610
    Duluth,MN55802     		  PC Northeastern Minnesota Emergency Child Care Grant Program 25,000
    Northland Foundation202 West Superior Street Suite 610
    Duluth,MN55802     		  PC Pathways to Quality Early Care and Education Expansion initiative 100,000
    NorthPoint Health & Wellness Inc1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Emergency Food Relief 15,000
    NorthPoint Health & Wellness Inc1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 75,000
    NorthPoint Health & Wellness Inc1256 Penn Ave N Minneapolis
    MINNEAPOLIS,MN554113047     		  PC Meeting Basic Needs in North Minneapolis 25,000
    Northside Achievement Zone2123 West Broadway Ave Suite 100
    Minneapolis,MN55411     		  PC Healthy Start -NAZ general operating funding 100,000
    Northwest Indian Community Development Center1819 Bemidji Ave N
    Bemidji,MN56601     		  PC NWICDC COVID Community Response and Support 25,000
    Northwest Minnesota Foundation201 3rd St NW
    Bemidji,MN56601     		  PC Northwest Minnesota COVID-19 Disaster Response 25,000
    Northwest Minnesota Foundation201 3rd St NW
    Bemidji,MN56601     		  PC Step Up 2.0 100,000
    Open Door Health Center309 Holly Lane
    Mankato,MN56001     		  PC Outreach Application and Enrollment Assistance for Low-Income Families and Individuals 75,000
    OutFront Minnesota Community Services310 East 38th Street Suite 209
    Minneapolis,MN554091337     		  PC COVID Emergency Fund for LGBTQ Vulnerable Communities 25,000
    OutFront Minnesota Community Services310 East 38th Street Suite 209
    Minneapolis,MN554091337     		  PC Anti-Violence Program 50,000
    Portico Healthnet2610 University Avenue West Suite 5
    St Paul,MN551142007     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 100,000
    Project FINE202 W 3rd St
    Winona,MN55987     		  PC Project FINE COVID-19 Response 25,000
    Project FINE202 W 3rd St
    Winona,MN55987     		  PC Healthy Connections Advancing Equity and Addressing Social Determinants of Health 100,000
    Regents of the University of MinnesotaSponsored Projects Administration 2
    Minneapolis,MN55455     		  PC DESCRIBING MINNESOTAS UNINSURED AND THE COMMUNITIES IN WHICH THEY LIVE PHASE 3 - DATA REFRESH AND TARGETING NEW STAKEHOLDERS 107,146
    Region Nine Area Inc3 Civic Center Plaza Suite 310
    Mankato,MN56001     		  PC COVID-19 Responsive Grants 2020 - Supporting RELC Welcoming Communities Project Area Food Shelves 20,000
    Region Nine Area Inc3 Civic Center Plaza Suite 310
    Mankato,MN56001     		  PC Welcoming Communities Project 100,000
    Reviving the Islamic Sisterhood for Empowerment1007 West Broadway Ave
    Minneapolis,MN55411     		  PC Challenging Xenophobic hate 15,000
    Reviving the Islamic Sisterhood for Empowerment1007 West Broadway Ave
    Minneapolis,MN55411     		  PC Healthy, Safe, and Connected Communities for Muslim Women 75,000
    Saint Paul 3K15 West Kellogg Blvd Suite 310B
    Saint Paul,MN55102     		  PC Saint Paul 3K 100,000
    SEWA-AIFW3702 E Lake St
    Minneapolis,MN55406     		  PC SEWA emerging covid needs 25,000
    SEWA-AIFW3702 E Lake St
    Minneapolis,MN55406     		  PC Closing the Gap to Toward Healthy Connections 75,000
    SEWA-AIFW3702 E Lake St
    Minneapolis,MN55406     		  PC Responding to Emerging Needs during Covid-19 25,000
    SOMALI COMMUNITY RESETTLEMENT SERVICES201 S Lyndale Ave
    Faribault,MN55021     		  PC FFN Provider Training 70,000
    Southern Minnesota Regional Legal Services IncAdministrative Office 55 E 5th Stre
    St Paul,MN55101     		  PC Lawyers Advancing Wellness at Open Door 78,165
    Southwest Initiative Foundation15 3RD AVE NW
    Hutchinson,MN553501643     		  PC Community Solutions for SW MN Child Care 100,000
    ST PAUL YOUTH SERVICES INC2100 WILSON AVE
    SAINT PAUL,MN551194146     		  PC Providing Academic and Social Emotional Student Support During COVID-19 20,000
    ST PAUL YOUTH SERVICES INC2100 WILSON AVE
    SAINT PAUL,MN551194146     		  PC How Black Youth Advance Health Equity and Build Youth Power at St. Paul Youth Services 100,000
    St Stephen's Human Services Inc2309 Nicollet Avenue South
    Minneapolis,MN55404     		  PC Expanding Shelter and Street Outreach to Help Everyone Stay Home 15,000
    Steele County Transitional Housing560 Dunnell Drive 212
    Owatonna,MN55060     		  PC Eviction Prevention 15,000
    The Aliveness Project3808 Nicollet Avenue
    Minneapolis,MN55409     		  PC Meals and Food Shelf for Minnesotans Living With HIV 15,000
    The Saint Paul Foundation101 Fifth Street East Suite 2400
    Saint Paul,MN55101     		  PC MCF Minnesota Disaster Recovery Fund 100,000
    Think Small10 Yorkton Ct
    Saint Paul,MN551171065     		  PC Think Small COVID-19-Emergency Fund for Child Care 20,000
    Think Small10 Yorkton Ct
    Saint Paul,MN551171065     		  PC Think Small Blue Cross Blue Shield Foundation Healthy Start Grant Application 100,000
    United Community Action Partnership200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC UCAP COVID-19 Emergency Response Support 20,000
    United Community Action Partnership200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC Partners in Care - Mentoring and Beyond 100,000
    Voices for Racial Justice2525 E Franklin Avenue Ste 301
    Minneapolis,MN55406     		  PC Voices for Racial Justice COVID-19 Response 25,000
    Voices for Racial Justice2525 E Franklin Avenue Ste 301
    Minneapolis,MN55406     		  PC Capacity Builder 100,000
    Way to Grow201 Irving Ave N Suite 100
    Minneapolis,MN55405     		  PC Way to Grow Healthy Start 70,000
    WEST BANK CDC INC1808 RIVERSIDE AVE STE 201
    MINNEAPOLIS,MN554541121     		  PC Ileys Dariis / Neighborhood Light 33,300
    West Central InitiativePO Box 318
    Fergus Falls,MN565380318     		  PC Helping our Child Care Professionals after the Pandemic 50,000
    WEST SIDE CITIZENS ORGANIZATION209 Page Street West Suite 260
    Saint Paul,MN55107     		  PC Supporting Immigrant Renters and Small Businesses 25,000
    WILDFLOWER FOUNDATION1330 LAGOON AVE 4TH FLOOR
    MINNEAPOLIS,MN554082885     		  PC Wildflower Schools Cohort Expansion and COVID-19 Relief 70,000
    YWCA of Minneapolis1130 Nicollet Mall
    Minneapolis,MN55403     		  PC YWCA Holistic Programming to Create Access to High-Quality Early Childhood Education for Marginalized Communities W 60,000
    Total ...............................bullet 3a 6,170,641
    bApproved for future payment
    United eWayFrontstream11480 Commerce Park Dr Stie 300
    Reston,VA201911575     		  PC 2020 Community Giving Campaign 494,716
    African Community Services in Minnesota1305 East 24th Street
    Minneapolis,MN55404     		  PC Outreach Application and Enrollment 15,000
    Centro di Trabajadores Unidos en Lucha3715 Chicago Avenue South
    Minneapolis,MN55407     		  PC Covid Adaptation and Response 25,000
    Leech Lake Band of Ojibwe190 Sailstar Drive NW
    Cass Lake,MN56633     		  GOV Covid 19 Emergency Food 25,000
    West Bank Community Development Center1808 Riverside Ave Ste 201
    Minneapolis,MN55454     		  PC Electronic Commections 10,000
    Lower Sioux Indian Community39527 Reservation Hwy 1
    Morton,MN56270     		  GOV Covid 19 Response 25,000
    United Community Action Partnership200 4th Street SW PO Box 1359
    Willmar,MN56201     		  PC Partners In Care 75,000
    Northwest Indian CDC1819 Bemidji Ave N
    Bemidji,MN56601     		  PC Outreach Application and Enrollment Assistance for low income 100,000
    Immigrant Law Center450 North Syndicate Street Ste 200
    St Paul,MN55104     		  PC General Operating Support 100,000
    FrontStream11480 Commerce Park Dr Ste 300
    Reston,VA201911575     		  Expenditure Responsi 2019 Community Giving Campaign 62,785
    Mid-Minnesota Legal Assistance111 N Fifth Street Suite 100
    Minneapolis,MN55403     		  PC Healthcare Outreach and Enrollment Project 100,000
    Portico Healthnet2610 University Avenue West Suite 5
    St Paul,MN551142007     		  PC Outreach, Application and Enrollment Assistance for Low-Income Families and Individuals 100,000
    Total ................................bullet 3b 1,132,501
    Schedule B
    (Form 990, 990-EZ,
    or 990-PF)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2020
    Name of the organization
    BCBSM Foundation Inc
     
    Employer identification number

    36-3525653
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
    Name of organization
    BCBSM Foundation Inc
          		Employer identification number
    36-3525653
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    Available Upon Request
    PO Box 64560
     
    St Paul, MN55164

    		$ 10,000,000


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 3
    Name of organization
    BCBSM Foundation Inc
          		Employer identification number

    36-3525653
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Page 4
    Name of organization
    BCBSM Foundation Inc
          		Employer identification number

    36-3525653
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
    Additional Data


    Software ID: 20011406
    Software Version: 20.0.2.0

    TY 2020 AllOthProgRltdInvestmentsSch
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Category Amount
    None  

    TY 2020 InvestmentsCorpBondsSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Name of Bond End of Year Book Value End of Year Fair Market Value
      4,211,377 4,211,377

    TY 2020 InvestmentsCorpStockSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Name of Stock End of Year Book Value End of Year Fair Market Value
      69,258,223 69,258,223

    TY 2020 InvestmentsOtherSchedule2
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    Asset-backed securities   2,937,441 2,937,441

    TY 2020 OtherAssetsSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    See statement 1 attached 103,901 162,383 162,383


    TY 2020 OtherDecreasesSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Description Amount
    Unrealized depreciation on investments -3,518,429


    TY 2020 OtherExpensesSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Other 484,281 485,797   -2,046


    TY 2020 OtherIncomeSchedule2
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    Miscellaneous investment income 64,367 64,367  


    TY 2020 OtherProfessionalFeesSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Professional fees 448,661     448,661


    TY 2020 TaxesSchedule
    Name:
    BCBSM Foundation Inc
    EIN:
    36-3525653
    Software ID:
    20011406
    Software Version:
    20.0.2.0
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    Income tax 70,600