Form990-PF
Click to see attachment
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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. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
BLUE CROSS & BLUE SHIELD OF
LOUISIANA FOUNDATION
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 98022
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BATON ROUGE, LA708989022
A Employer identification number

72-1232379
B Telephone number (see instructions)

(225) 295-3307
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$38,803,366J 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) 140,023
2 Check bullet.............
3 Interest on savings and temporary cash investments 61 61  
4 Dividends and interest from securities... 1,277,992 1,277,992  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 2,335,980
b Gross sales price for all assets on line 6a 14,960,589
7 Capital gain net income (from Part IV, line 2)... 2,216,188
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 51 0 51
12 Total. Add lines 1 through 11........ 3,754,107 3,494,241 51
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 149,229 0 0 149,229
14 Other employee salaries and wages...... 312,106 0 0 312,106
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 43,425 8,685 0 34,740
c Other professional fees (attach schedule).... Click to see attachment 190,599 133,193 0 57,406
17 Interest...............        
18 Taxes (attach schedule) (see instructions)...        
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 9,720 0 0 9,720
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 117,618 0 0 49,314
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 822,697 141,878 0 612,515
25 Contributions, gifts, grants paid....... 8,268,245 8,371,489
26 Total expenses and disbursements. Add lines 24 and 25 9,090,942 141,878 0 8,984,004
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -5,336,835
b Net investment income (if negative, enter -0-) 3,352,363
c Adjusted net income (if negative, enter -0-)... 51
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
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............. 918,081 831,235 831,235
2 Savings and temporary cash investments.........      
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.......... 4,500 4,500 4,500
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 43,902,955 Click to see attachment37,966,251 37,966,251
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)..........      
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet) Click to see attachment2,115 Click to see attachment1,380 Click to see attachment1,380
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 44,827,651 38,803,366 38,803,366
Liabilities 17 Accounts payable and accrued expenses.......... 175,148 547,793
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)...... 2,500,000  
22 Other liabilities (describe bullet) Click to see attachment28,995 Click to see attachment31,291
23 Total liabilities (add lines 17 through 22)......... 2,704,143 579,084
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........... 35,847,296 32,575,691
25 Net assets with donor restrictions............ 6,276,212 5,648,591
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)..... 42,123,508 38,224,282
30 Total liabilities and net assets/fund balances (see instructions). 44,827,651 38,803,366
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
42,123,508
2
Enter amount from Part I, line 27a .....................
2
-5,336,835
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
1,437,609
4
Add lines 1, 2, and 3 ..........................
4
38,224,282
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
38,224,282
Form 990-PF (2021)
Form 990-PF (2021)
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 TRADED SECURITIES P    
b
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 14,960,589   12,744,401 2,216,188
b
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       2,216,188
b
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 2,216,188
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 0
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
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 All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) 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 0
3 Add lines 1 and 2........................... 3 46,598
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 46,598
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 88,750
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 88,750
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
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 42,152
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet42,152 RefundedBullet 11 0
Part VI-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$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
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 XIV..................................
    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 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    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 (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-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 addressbulletWWW.BCBSLAFOUNDATION.ORG
    14
    The books are in care ofbulletADAM SHORT VP FINANCE CONTROLLER Telephone no.bullet (225) 295-3307

    Located atbullet5525 REITZ AVENUEBATON ROUGELA ZIP+4bullet70809
    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 2021, 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 VI-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? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
    Yes
     
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (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)? ......................
    1a(5)
     
    No
    (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.) ...............
    1a(6)
     
    No
    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
    c
    ........bullet
    d
    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 2021? .............
    1d
     
    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 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    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? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 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 2021.) .....................
    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 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-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))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    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
     
     
    c
    .........bullet
    d
    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? .................
    5d
     
     
    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? .............................
    6a
     
    No
    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?
    7a
     
    No
    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? .........................
    8
     
    No
    Part VII
    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
    C RICHARD ATKINS VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    PEGGY SCOTT VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    DAN BORNE CHAIRMAN
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    JEROME JERRY GREIG VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    KEVIN MCCOTTER SECRETARY & TREASURER
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    CARL LUIKART MD VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    VINDELL WASHINGTON MD VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    JUDY MILLER VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    MICHAEL BRUNO VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    MICHAEL TIPTON PRESIDENT
    28.00     		0 0 0
    PO BOX 98022
    BATON ROUGE,LA70898
    LOUISIANA HEALTH SERVICE INDEMNITY NA
    1.00     		149,229 0 3,451
    PO BOX 98022
    BATON ROUGE,LA70898
    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 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    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.............bullet0
    Part VIII-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  
    2  
    3  
    4  
    Part VIII-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.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    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
    42,582,811
    b
    Average of monthly cash balances.......................
    1b
    531,127
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    43,113,938
    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
    0
    3
    Subtract line 2 from line 1d.........................
    3
    43,113,938
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    646,709
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    42,467,229
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    2,123,361
    Part X
    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 IX, line 6..................
    1
    2,123,361
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    46,598
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    46,598
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    2,076,763
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    2,076,763
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    2,076,763
    Part XI
    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
     
    b
    Program-related investments—total from Part VIII-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 XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 2,076,763
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018...... 479,469
    d From 2019...... 1,387,934
    e From 2020...... 10,363,086
    f Total of lines 3a through e ........ 12,230,489
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 8,984,004
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 2,076,763
    e Remaining amount distributed out of corpus 6,907,241
    5 Excess distributions carryover applied to 2021. 0 0
    (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 19,137,730
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    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......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		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) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		19,137,730
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018.... 479,469
    c Excess from 2019.... 1,387,934
    d Excess from 2020.... 10,363,086
    e Excess from 2021.... 6,907,241
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-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 2021, 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) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    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 IX, 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 XIV
    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:
    MICHAEL TIPTON
    5525 REITZ AVENUE
    BATON ROUGE,LA70809
    (225) 297-2849
    WWW.BCBSLAFOUNDATION.ORG
    bThe form in which applications should be submitted and information and materials they should include:
    SEE STATEMENT 12
    cAny submission deadlines:
    SEE STATEMENT 12
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    SEE STATEMENT 12
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    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
    FRONT YARD BIKES
    413 STEELE BLVD
    BATON ROUGE,LA70806     		NONE PC BATON ROUGE YOUTH WORKFORCE AND EMPOWERMENT COALITION 25,000
    BAYOU DISTRICT FOUNDATION
    320 JULIA STREET
    NEW ORLEANS,LA701303604     		NONE PC SPROUTS OF MUSIC 45,000
    CENTER FOR THE INNOVATIVE TRAINING OF YOUTH INC (STEM NOLA)
    4910 DREXEL DR BOX 61
    NEW ORLEANS,LA701251126     		NONE PC BUILDING BRIDGES FROM HIGH SCHOOL TO STEM CAREERS 80,000
    SON OF A SAINT
    2803 ST PHILIP STREET
    NEW ORLEANS,LA70119     		NONE PC EXPANDING AND IMPROVING EFFECTIVE MENTORSHIP FOR NEW ORLEANS YOUNG MEN 100,000
    504HEALTHNET INC
    2701 AIRLINE DRIVE SUITE K 140
    METAIRIE,LA70001     		NONE PC IMPROVING HEALTH EQUITY IN NEW ORLEANS THROUGH COMMUNITY BASED CARE, OUTREACH, AND EDUCATION 27,778
    MAYOR'S HEALTHY CITY INITIATIVE
    222 SAINT LOUIS ST RM 301
    BATON ROUGE,LA70802     		NONE PC GEAUX GET HEALTHY 200,000
    SOUTHERN UNIVERSITY AT SHREVEPORT COMMUNITY DEVELOPMENT CORPORATION
    4646 HILRY HUCKABY AVE
    SHREVEPORT,LA71107     		NONE PC MILAM STREET KITCHEN INCUBATOR AND COMMUNITY KITCHEN (MS KICK) 50,000
    SOUTHERN UNIVERSITY AT SHREVEPORT COMMUNITY DEVELOPMENT CORPORATION
    4646 HILRY HUCKABY AVE
    SHREVEPORT,LA71107     		NONE PC MILAM STREET KITCHEN INCUBATOR AND COMMUNITY KITCHEN (MS KICK) 25,000
    WORKFORCE DEVELOPMENT BOARD SDA-83 INC (WDB-83)
    PO BOX 14269
    MONROE,LA71207     		NONE PC NELA NURSING ADJUNCT FACULTY PROJECT 50,000
    AHECS FOR A HEALTHY LOUISIANA INC
    1302 JW DAVIS DRIVE
    HAMMOND,LA70403     		NONE PC AHEC OF A SMILE 50,000
    LOYOLA UNIVERSITY NEW ORLEANS
    6363 ST CHARLES AVENUE CAMPUS BOX
    909
    NEW ORLEANS,LA701186143     		NONE PC INCREASING PRECEPTOR CAPACITY IN LOUISIANA 132,000
    LOYOLA UNIVERSITY NEW ORLEANS
    6363 ST CHARLES AVENUE CAMPUS BOX
    909
    NEW ORLEANS,LA701186143     		NONE PC INCREASING PRECEPTOR CAPACITY IN LOUISIANA 120,000
    CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
    1900 S ACADIAN THRUWAY
    BATON ROUGE,LA70808     		NONE PC HIPPY EXPANSION IN RURAL, SOUTHERN LOUISIANA POINTE COUPEE AND ST. HELENA PARISHES 93,000
    CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
    1900 S ACADIAN THRUWAY
    BATON ROUGE,LA70808     		NONE PC HIPPY EXPANSION IN RURAL, SOUTHERN LOUISIANA POINTE COUPEE AND ST. HELENA PARISHES 84,000
    CAL RIPKEN SR FOUNDATION INC
    1427 CLARKVIEW RD SUITE 100
    BALTIMORE,MD21209     		NONE PC TEAM OF DREAMS ADAPTIVE FIELD 38,333
    LSUA
    8100 HWY 71 SOUTH
    ALEXANDRIA,LA71302     		NONE PC BUILDING A PIPELINE TO INCREASE NURSING WORKFORCE IN CENTRAL LOUISIANA (CENLA) 145,000
    KINGSLEY HOUSE INC
    1600 CONSTANCE STREET
    NEW ORLEANS,LA70130     		NONE PC KINGSLEY HOUSE'S HEALTHCARE WORKFORCE DEVELOPMENT 100,000
    OCHSNER CLINIC FOUNDATION
    1514 JEFFERSON HIGHWAY BH 607
    NEW ORLEANS,LA701212429     		NONE PC EAT FIT LOUISIANA 34,500
    FLETCHER TECHNICAL COMMUNITY COLLEGE FOUNDATION INC
    1407 HWY 311
    SCHRIEVER,LA70395     		NONE PC THE BAYOU REGION NURSING FACULTY PROJECT 150,000
    LSU EUNICE FOUNDATION
    PO BOX 1551
    EUNICE,LA705351551     		NONE PC ASSOCIATE OF NURSING RN WEEKEND AND EVENING COHORT 93,750
    CITY OF THIBODAUX
    310 WEST 2ND STREET PO BOX 5418
    THIBODAUX,LA70302     		NONE PC MENARD PED BIKE TRAIL 250,000
    NEW ORLEANS CAREER CENTER
    1020 N PRIEUR ST
    NEW ORLEANS,LA70116     		NONE PC LICENSED PRACTICAL NURSE (LPN) APPRENTICESHIP PROGRAM 60,250
    THE GREATER NEW ORLEANS FOUNDATION
    919 ST CHARLES AVENUE
    NEW ORLEANS,LA70130     		NONE PC BABY'S FIRST YEARS 50,000
    POINTE AU CHIEN INDIAN TRIBE
    PO BOX 416
    MONTEGUT,LA70377     		NONE PC HURRICANE RELIEF - ZETA 5,000
    XAVIER UNIVERSITY OF LOUISIANA
    1 DREXEL ROAD
    NEW ORLEANS,LA70125     		NONE PC TRUST OUR ACTIONS TOGETHER PROJECT (TOAT PROJECT) 25,000
    CENTRAL LOUISIANA COALITION TO PREVENT HOMELESSNESS INC
    1515 JACKSON STREET
    ALEXANDRIA,LA713016934     		NONE PC CLHC HOUSING RESOURCE CENTER 50,000
    BATON ROUGE HEALTH DISTRICT
    6400 PERKINS ROAD
    BATON ROUGE,LA70808     		NONE PC COVID SAFE 50,000
    CADDO COUNCIL ON AGING
    1700 BUCKNER STREET SUITE 240
    SHREVEPORT,LA71101     		NONE PC MEALS ON WHEELS 50,000
    SOUTHERN UNIVERSITY ALUMNI FEDERATION HOME CHAPTER
    SU BOX 12321 500 JESSE STONE AVE
    BATON ROUGE,LA70813     		NONE PC SUPPORTING SOUTHERN UNIVERSITY NURSING STUDENTS 5,000
    FOOD BANK OF CENTRAL LOUISIANA
    3223 BALDWIN AVENUE
    ALEXANDRIA,LA713013506     		NONE PC MOBILE PANTRY PROGRAM 50,000
    AGENDA FOR CHILDREN
    8300 EARHART BLVD SUITE 201
    NEW ORLEANS,LA70118     		NONE PC STRENGTHENING THE CHILD CARE SECTOR DURING AND POST-COVID-19 25,000
    LOUISIANA HOSPITAL ASSOCIATION RESEARCH AND EDUCATION FOUNDATION
    LHA 9521 BROOKLINE AVE
    BATON ROUGE,LA70809     		NONE PC 2021 LOUISIANA HOSPITAL ASSOCIATION RESEARCH AND EDUCATION FOUNDATION (LHAREF) PHYSICIAN LEADERSHIP ACADEMY (PLA) 29,600
    ST BERNARD PROJECT INC
    2645 TOULOUSE STREET
    NEW ORLEANS,LA70119     		NONE PC SWLA PLUMBING AND HOME REPAIRS 25,000
    THE ARC CADDO-BOSSIER
    351 JORDAN STREET
    SHREVEPORT,LA711014846     		NONE PC BUILDING UNILIMITED OPPORTUNITIES DURING A TIME OF CRISIS 50,000
    LOUISIANA ASSOCIATION OF UNITED WAYS INC
    PO BOX 3416
    BATON ROUGE,LA708213416     		NONE PC RIDE UNITED VACCINATION ACCESS CAMPAIGN 50,000
    TEAM RUBICON
    214 MAIN ST 354
    EL SEGUNDO,CA90245     		NONE PC LOUISIANA REBUILD PROGRAM 50,000
    AUTISM SERVICES OF SOUTHWEST LOUISIANA
    3006 COMMON STREET
    LAKE CHARLES,LA70601     		NONE PC EMERGENCY GENERATORS FOR CLIENT HOMES 25,000
    CHRISTIAN SERVICE PROGRAM INSTITUTE
    2346 LEVY STREET
    SHREVEPORT,LA71103     		NONE PC CHRISTIAN SERVICE HOSPITALITY HOUSE 50,000
    CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
    1900 S ACADIAN THRUWAY
    BATON ROUGE,LA70808     		NONE PC MAY 2021 FLOOD DISASTER RECOVERY 50,000
    WILLIAM C SCHUMACHER FAMILY FOUNDATION
    1035 CAMELLIA BOULEVARD SUITE 100
    LAFAYETTE,LA705087256     		NONE PC ACADIANA RESPONDS - WILLIAM C. SCHUMACHER FAMILY FOUNDATION PARTNERSHIP PROJECT 50,000
    SOCIAL ENTREPRENEURS OF NEW ORLEANS INC
    4035 WASHINGTON AVE
    NEW ORLEANS,LA701252935     		NONE PC ECONOMIC RECOVERY COLLABORATIVE INITIATIVE 50,000
    BATON ROUGE COMMUNITY COLLEGE FOUNDATION
    201 COMMUNITY COLLEGE DRIVE
    BATON ROUGE,LA708064156     		NONE PC BRCC FOUNDATION COVID IMPACT SUPPORT FUND 50,000
    ST BERNARD PROJECT INC
    2645 TOULOUSE STREET
    NEW ORLEANS,LA70119     		NONE PC SBP - HURRICANE IDA RESPONSE AND RECOVERY 250,000
    AMERICAN RED CROSS OF LOUISIANA - MAIN
    4655 SHERWOOD COMMON BLVD
    BATON ROUGE,LA70816     		NONE PC RED CROSS - HURRICANE IDA RESPONSE AND RECOVERY 250,000
    COVENANT HOUSE NEW ORLEANS
    611 N RAMPART ST
    NEW ORLEANS,LA701123505     		NONE PC CARE FOR COVENANT HOUSE YOUTH IN THE AFTERMATH OF HURRICANE IDA. 50,000
    CAPITAL AREA UNITED WAY
    700 LAUREL STREET
    BATON ROUGE,LA708025634     		NONE PC HURRICANE IDA RELIEF & RECOVERY 50,000
    POLICY INSTITUTE FOR THE CHILDREN OF LOUISIANA INC
    PO BOX 13552 3400 S CARROLLTON
    AVENUE
    NEW ORLEANS,LA70085     		NONE PC HURRICANE IDA RECOVERY FUND FOR LOUISIANA CHILD CARE PROVIDERS 100,000
    THE LIFE OF A SINGLE MOM MINISTRIES
    12015 JUSTICE AVENUE
    BATON ROUGE,LA708165327     		NONE PC SINGLE MOM HURRICANE CRISIS RELIEF 50,000
    CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
    1900 S ACADIAN THRUWAY
    BATON ROUGE,LA70808     		NONE PC HURRICANE IDA RESPONSE 250,000
    BAYOU COMMUNITY FOUNDATION
    PO BOX 582
    HOUMA,LA70361     		NONE PC HURRICANE IDA RECOVERY FUND 250,000
    THE SALVATION ARMY
    1450 RIVERSIDE DRIVE
    JACKSON,MS39202     		NONE PC THE SALVATION ARMY ALM DIVISION HURRICANE IDA DISASTER RESPONSE 250,000
    ST JOHN UNITED WAY
    POB 2019
    RESERVE,LA70084     		NONE PC ST. JOHN THE BAPTIST PARISH HURRICANE IDA RELIEF 250,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC HURRICANE IDA RESPONSE 250,000
    NORTHSHORE COMMUNITY FOUNDATION
    807 N COLUMBIA STREET
    COVINGTON,LA704336119     		NONE PC HURRICANE IDA RESPONSE 250,000
    GREATER BATON ROUGE FOOD BANK
    10600 S CHOCTAW DR
    BATON ROUGE,LA708151826     		NONE PC HURRICANE IDA RESPONSE- EMERGENCY FOOD BOXES 50,000
    UNITED WAY OF ST CHARLES
    13145 HIGHWAY 90
    BOUTTE,LA70039     		NONE PC DISASTER ASSISTANCE 100,000
    SECOND HARVEST FOOD BANK OF GREATER NEW ORLEANS AND ACADIANA
    700 EDWARDS AVE
    NEW ORLEANS,LA70123     		NONE PC SECOND HARVESTS HURRICANE IDA DISASTER RESPONSE 100,000
    REBUILDING TOGETHER NEW ORLEANS
    2801 MARAIS ST
    NEW ORLEANS,LA701177243     		NONE PC REBUILDING TOGETHER NEW ORLEANS DISASTER RESPONSE & RECOVERY PROGRAM 50,000
    FLETCHER TECHNICAL COMMUNITY COLLEGE FOUNDATION INC
    1407 HWY 311
    SCHRIEVER,LA70395     		NONE PC FLETCHER FOUNDATION EMERGENCY FUNDS FOR HURRICANE IDA RELIEF 50,000
    YMCA OF GREATER NEW ORLEANS
    320 METAIRIE HAMMOND HIGHWAY SUITE
    321
    METAIRIE,LA700055100     		NONE PC YMCA OF GREATER NEW ORLEANS HURRICANE IDA EMERGENCY RESPONSE 50,000
    MAGNOLIA COMMUNITY SERVICES INC
    100 CENTRAL AVE
    JEFFERSON,LA701213402     		NONE PC HURRICANE IDA RELIEF FOR I/DD ADULTS 50,000
    SHREVEPORT-BOSSIER RESCUE MISSION
    901 MCNEIL ST
    SHREVEPORT,LA711013723     		NONE PC LIFE RECOVERY PROGRAM 50,000
    THREE O'CLOCK PROJECT
    804 MAIN STREET SUITE C-322
    BATON ROUGE,LA708025528     		NONE PC KIDS PANTRY PACK FOR IDA RELIEF 50,000
    CATHOLIC CHARITIES DIOCESE OF HOUMA-THIBODAUX
    PO BOX 505
    SCHRIEVER,LA70395     		NONE PC CATHOLIC CHARITIES HURRICANE IDA 250,000
    UNITED WAY FOR SOUTH LOUISIANA
    600 ACADEMY ST
    HOUMA,LA703605602     		NONE PC REBUILD UNITED WAY'S CENTRAL COMMAND BUILDING 75,000
    COMMUNITY FOUNDATION OF ACADIANA
    1035 CAMELLIA BLVD STE 100
    LAFAYETTE,LA705087256     		NONE PC ACADIAN COMPANIES EMPLOYEE DISASTER RELIEF FUND (HURRICANCE IDA) 50,000
    18TH WARD
    3329 BELL ST
    NEW ORLEANS,LA70119     		NONE PC DIRECT AID TO LOW-INCOME NEW ORLEANS FAMILIES FOR BASIC NEEDS POST-IDA 20,000
    TERREBONNE ECONOMIC DEVELOPMENT FOUNDATION
    PO BOX 3209
    HOUMA,LA703613209     		NONE PC BAYOU BUSINESS COMMUNITY HOUSING INITIATIVE 250,000
    FOUNDATION FOR TERREBONNE GENERAL MEDICAL CENTER
    8166 MAIN ST
    HOUMA,LA703603404     		NONE PC EMERGENCY RELIEF FOR TG EMPLOYEES 50,000
    UNITED HOUMA NATION INC
    400 MONARCH DRIVE
    HOUMA,LA70364     		NONE PC UNITED HOUMA NATION HURRICANE IDA RELIEF 50,000
    GRAMBLING UNIVERSITY FOUNDATION INC
    PO BOX 587
    GRAMBLING,LA71245     		NONE PC BAYOU CLASSIC VACCINE CAMPAIGN (GRAMBLING) 10,000
    CATHOLIC CHARITIES OF ACADIANA
    PO BOX 3177
    LAFAYETTE,LA70502     		NONE PC CATHOLIC CHARITIES OF ACADIANA DISASTER RESPONSE 250,000
    OPERATION RESTORATION
    1450 POYDRAS ST SUITE 2260
    NEW ORLEANS,LA70112     		NONE PC HURRICANE IDA RELIEF 25,000
    THE GREATER NEW ORLEANS FOUNDATION
    919 ST CHARLES AVENUE
    NEW ORLEANS,LA70130     		NONE PC HURRICANE IDA- DISASTER RESPONSE AND RESTORATION 100,000
    UNITED WAY OF SOUTHEAST LOUISIANA
    2515 CANAL STREET
    NEW ORLEANS,LA701196435     		NONE PC HURRICANE IDA RELIEF AND RECOVERY 50,000
    LOUISIANA NATIONAL GUARD FOUNDATION
    6400 SAINT CLAUDE AVE
    NEW ORLEANS,LA701171456     		NONE PC DISASTER RECOVERY 50,000
    OPTIONS INC
    19362 WEST SHELTON ROAD
    HAMMOND,LA704018251     		NONE PC NATURAL GAS WHOLE HOME GENERATOR FOR PEOPLE WITH DISABILITIES 25,000
    LITTLE LEAGUE BASEBALL INC ALSO KNOWN AS LAKE CHARLES SOFTBALL
    2428 QUINCE MICHEAL LN
    LAKE CHARLES,LA706058157     		NONE PC COMMUNITY CRISIS & DISASTER RESPONSE GRANT 50,000
    FULLER CENTER DISASTER REBUILDERS INC
    PO BOX 96
    HAMMOND,LA70404     		NONE PC REBUILD TANGI 50,000
    GIGIS PLAYHOUSE INC
    1023 RIDGEWOOD DRIVE STE 2
    METAIRIE,LA700016135     		NONE PC COVID/HURRICANE IDA IMPACT RELIEF 25,000
    SOUTHEASTERN LOUISIANA UNIVERSITY FOUNDATION
    SLU 10703
    HAMMOND,LA70402     		NONE PC ADDRESSING IMMEDIATE AND CRITICAL NEEDS AMONG SLU STUDENTS RELATED TO HURRICANE IDA 50,000
    LOUISIANA LIBRARY FOUNDATION
    PO BOX 131
    BATON ROUGE,LA70821     		NONE PC AA HONORARIUM-UNA PAUL 5,000
    CHRISTIAN COMMUNITY ACTION INC
    108 S BONNER
    RUSTON,LA71270     		NONE PC 2021 AA JUDGING HONORARIUM-PAM ALLEN 1,000
    ARTS COUNCIL OF GREATER BATON ROUGE
    427 LAUREL ST
    BATON ROUGE,LA708011810     		NONE PC 2021 AA JUDGING HONORARIUM 1,000
    VOLUNTEERS FOR YOUTH JUSTICE
    900 JORDAN STREET SUITE 102
    SHREVEPORT,LA711014310     		NONE PC 2021 AA JUDGING HONORARIUM 1,000
    JO JO'S HOPE ENTERPRISES INC
    955 MONTGOMERY STREET
    MANDEVILLE,LA70448     		NONE PC WINGS JUDGING HONORARIUM-PAULA LACOUR 1,000
    THE LIFE OF A SINGLE MOM MINISTRIES
    12015 JUSTICE AVENUE
    BATON ROUGE,LA708165327     		NONE PC 2021 BLUE ANGEL AWARD HONOREE-KELLIE DUHON 10,000
    BATON ROUGE YOUTH COALITION INC
    448 NORTH 11TH STREET
    BATON ROUGE,LA708024607     		NONE PC 2021 ANGEL AWARD HONOREE-LUCAS SPIELFOGEL 25,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC 2021 ANGEL AWARD-JAMES "BIG BROWN" JOSEPH 25,000
    CRD NO LIMITS FOUNDATION
    184 CYCLE PLANT ROAD
    BENTON,LA71006     		NONE PC 2021 ANGEL AWARD HONOREE-RYLIE DUOS 25,000
    BIG BUDDY PROGRAM
    1415 MAIN STREET
    BATON ROUGE,LA70802     		NONE PC SUPPORT FOR BIG BROWN-2021 ANGEL AWARD 500
    THE ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
    1555 POYDRAS SUITE 1000
    NEW ORLEANS,LA70112     		NONE PC 2021 ANGEL AWARD HONOREE-MIGUEL ALONSO 25,000
    JEWISH FEDERATION OF GREATER NEW ORLEANS
    3747 WEST ESPLANADE AVENUE
    METAIRIE,LA70002     		NONE PC 2021 ANGEL AWARD HONOREE-DR. MARC BEHAR 5,000
    COLLEGE BEYOND
    612 ANDREW HIGGINS BLVD 3RD FLOOR
    NEW ORLEANS,LA70130     		NONE PC 2021 ANGEL AWARD HONOREE-ERIN WHEELER 25,000
    THE GREATER NEW ORLEANS FOUNDATION
    919 ST CHARLES AVENUE
    NEW ORLEANS,LA70130     		NONE PC 2021 ANGEL AWARD HONOREE-DR. MARC BEHAR 5,000
    AVODAH THE JEWISH SERVICE CORPS INC
    125 MAIDEN LN RM 8B
    NEW YORK,NY100385041     		NONE PC 2021 ANGEL AWARD HONORARIUM-MARC BEHAR 5,000
    COVENANT HOUSE NEW ORLEANS
    611 N RAMPART ST
    NEW ORLEANS,LA701123505     		NONE PC 2021 ANGEL AWARD HONORARIUM-DR. MARC BEHAR 5,000
    THE ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
    1555 POYDRAS SUITE 1000
    NEW ORLEANS,LA70112     		NONE PC EXTERNAL EVALUATOR-504HEALTHNET 4,187
    B & B WELLNESS INC
    PO BOX 13002
    ALEXANDRIA,LA71315     		NONE PC EXTERNAL EVALUATORS FOR THE UNITED WAY OF CENTRAL LOUISIANA CIG 10,250
    HEALTHY NETWORKS DESIGN AND RESEARCH
    19 HACKBERRY CIRCLE
    SHEPHERDSTOWN,WV25443     		NONE PC EE-COORDINATED CARE FOR THE WHOLE CHILD-BUILDING A SUSTAINABLE BUSINESS MODEL 16,900
    UNIVERSITY OF LOUISIANA AT LAFAYETTE
    PO BOX 43551
    LAFAYETTE,LA70504     		NONE PC EE FOR NELA NURSES CIG GRANT 11,303
    UNIVERSITY OF LOUISIANA AT LAFAYETTE
    PO BOX 43551
    LAFAYETTE,LA70504     		NONE PC EE FOR NELA NURSES CIG GRANT 11,303
    UNIVERSITY OF NEW ORLEANS
    2000 LAKESHORE DR ADMIN BLD ROOM
    1005
    NEW ORLEANS,LA70148     		NONE PC EXTERNAL EVALUATOR FOR CITY OF RUSTON 17,196
    FATHERS ON A MISSION (FOAM)
    1120 GOVERNMENT ST
    BATON ROUGE,LA70802     		NONE PC LEVAR ROBINSON-2020 ANGEL AWARD 25,000
    100 BLACK MEN OF METRO BATON ROUGE
    2050 NORTH FOSTER DRIVE
    BATON ROUGE,LA708061009     		NONE PC RESPECT-4-LIFE PROGRAM 25,000
    LOUISIANA NURSES FOUNDATION
    543 SPANISH TOWN ROAD
    BATON ROUGE,LA70802     		NONE PC BETTER TOGETHER: PARTNERSHIPS FOR ADDRESSING DOMESTIC VIOLENCE IN A HEALTHCARE SETTING 25,000
    CENTER FOR RESILIENCE INC
    1035 CALHOUN ST
    NEW ORLEANS,LA701185913     		NONE PC PLAAY AT CFR COMMUNITY EXPANSION 21,800
    LOUISIANA TECH UNIVERSITY FOUNDATION INC
    PO BOX 3183
    RUSTON,LA71272     		NONE PC MOTIVATIONAL HEALTH IMPROVEMENT PROGRAM IN LAW ENFORCEMENT OFFICERS 25,000
    NATIONAL FOUNDATION OF DENTISTRY FOR THE HANDICAPPED
    1800 15TH ST STE 100
    DENVER,CO802027134     		NONE PC DONATED DENTAL SERVICES (DDS) 25,000
    COMMUNITY SUPPORT PROGRAMS INC
    2924 KNIGHT ST STE 326
    SHREVEPORT,LA711052413     		NONE PC SAFE AND HEALTHY BABIES 25,000
    EXCEPTIONAL LIVES
    77 HEATH STREET
    BROOKLINE,MA02445     		NONE PC PARENT PARTNERS PILOT PROGRAM: PEER SUPPORT FOR RURAL BIPOC FAMILIES OF CHILDREN WITH DISABILITIES 23,840
    LSU HEALTH SCIENCES FOUNDATION IN SHREVEPORT
    920 PIERREMONT SUITE 506
    SHREVEPORT,LA71106     		NONE PC THE CADDO PROMISE 25,000
    EDUCARE NEW ORLEANS
    3801 ST BERNARD AVENUE
    NEW ORLEANS,LA70122     		NONE PC PROVIDING MENTAL HEALTH SUPPORT TO NEW ORLEANS VULNERABLE CHILDREN AND FAMILIES 25,000
    LSU FOUNDATION
    3796 NICHOLSON DRIVE
    BATON ROUGE,LA708028633     		NONE PC P.J. MILLS KEYNOTE ADDRESS AT THE ANNUAL LOUISIANA PARKINSONS CONFERENCE AND RELATED EFFORTS 50,000
    ALZHEIMER'S SERVICES OF THE CAPITAL AREA
    3772 NORTH BLVD
    BATON ROUGE,LA708063822     		NONE PC P.J. MILLS RESOURCE LIBRARY AND RELATED EFFORTS 50,000
    CROSSROADS NOLA
    5290 CANAL BLVD
    NEW ORLEANS,LA70124     		NONE PC FAMILIES & COMMUNITIES: COLLABORATION FOR LOUISIANA CHILDREN 100,000
    LSU AGCENTER
    103 EFFERSON HALL CORNER OF
    HIGHLAND AND PARKER
    BATON ROUGE,LA70803     		NONE PC LIVE HEALTHY THIBODAUX: CONNECTING EVERYDAY DESTINATIONS 25,000
    HOUMA DOWNTOWN DEVELOPMENT CORPORATION
    317 GOODE ST
    HOUMA,LA70360     		NONE PC GOVERNMENT TOWER PARK 25,000
    CAPITAL AREA AUTISM NETWORK
    100 NORTH ST SUITE 900
    BATON ROUGE,LA70801     		NONE PC CAPITAL AREA AUTISM NETWORK DEVELOPMENT 25,000
    SHREVEPORT GREEN
    3625 SOUTHERN AVENUE
    SHREVEPORT,LA71104     		NONE PC EXPANDING THE MOBILE MARKET FLEET! 25,000
    CHILDREN'S COALITION FOR NORTHEAST LOUISIANA
    117 HALL STREET
    MONROE,LA71201     		NONE PC SIGNS OF SUICIDE PREVENTION TRAINING AND AWARENESS 65,000
    FAMILY & YOUTH COUNSELING AGENCY
    220 LOUIE ST
    LAKE CHARLES,LA706017250     		NONE PC ENHANCEMENT OF TRADITIONAL COUNSELING 85,000
    BATON ROUGE YOUTH COALITION INC
    448 NORTH 11TH STREET
    BATON ROUGE,LA708024607     		NONE PC HEALTH FELLOWS PROGRAM 50,000
    LSUA
    8100 HWY 71 SOUTH
    ALEXANDRIA,LA71302     		NONE PC SPECIAL PROGRAM FOR YOUNG PEOPLE WITH DEVELOPMENTAL DISABILITIES 42,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC MID CITY MEDICAL CORRIDOR (MCMC) PARTNERSHIP 100,000
    THE BRIDGE ALZHEIMERS & DEMENTIA RESOURCE CENTER
    PO BOX 4038
    SHREVEPORT,LA711340038     		NONE PC A COMPREHENSIVE SUPPORT SYSTEM FOR PERSONS AFFECTED BY ALZHEIMER'S & DEMENTIA AND THEIR CAREGIVERS 75,000
    PROPEL AMERICA
    3867 PLAZA TOWER DRIVE 1ST FLOOR
    BATON ROUGE,LA70816     		NONE PC PROPEL LOUISIANA EXPANSION PROJECT 100,000
    TOP BOX FOODS LOUISIANA
    300 NORTH BROAD ST STE 101
    NEW ORLEANS,LA70119     		NONE PC SECURING FOOD ACCESS IN SOUTHEAST LOUISIANA DURING COVID-19 AND BEYOND 100,000
    Total .................................bullet 3a 8,371,490
    bApproved for future payment
    BAYOU DISTRICT FOUNDATION
    320 JULIA STREET
    NEW ORLEANS,LA701303604     		NONE PC ANGELS OF CHANGE GRANT 30,000
    BAYOU DISTRICT FOUNDATION
    320 JULIA STREET
    NEW ORLEANS,LA701303604     		NONE PC ANGELS OF CHANGE GRANT 15,000
    CENTER FOR THE INNOVATIVE TRAINING OF YOUTH INC (STEM NOLA)
    4910 DREXEL DR BOX 61
    NEW ORLEANS,LA701251126     		NONE PC ANGELS OF CHANGE GRANT 15,000
    CENTER FOR THE INNOVATIVE TRAINING OF YOUTH INC (STEM NOLA)
    4910 DREXEL DR BOX 61
    NEW ORLEANS,LA701251126     		NONE PC ANGELS OF CHANGE GRANT 15,000
    SON OF A SAINT
    2803 ST PHILIP STREET
    NEW ORLEANS,LA70119     		NONE PC ANGELS OF CHANGE GRANT 75,000
    DAVID RAINES COMMUNITY HEALTH CENTERS
    3041 DR MARTIN LUTHER KING DR
    SHREVEPORT,LA711074705     		NONE PC ANGELS OF CHANGE GRANT 25,000
    UNITED WAY OF CENTRAL LOUISIANA INC
    1101 FOURTH STREET SUITE 202
    ALEXANDRIA,LA713018311     		NONE PC COLLECTIVE IMPACT GRANT 67,000
    MAYOR'S HEALTHY CITY INITIATIVE
    222 SAINT LOUIS ST RM 301
    BATON ROUGE,LA70802     		NONE PC COLLECTIVE IMPACT GRANT 120,000
    AHECS FOR A HEALTHY LOUISIANA INC
    1302 JW DAVIS DRIVE
    HAMMOND,LA70403     		NONE PC COLLECTIVE IMPACT GRANT 50,000
    UNIVERSITY OF LOUISIANA MONROE FOUNDATION
    700 UNIVERSITY AVENUE
    MONROE,LA712034352     		NONE PC COLLECTIVE IMPACT GRANT 32,226
    LOYOLA UNIVERSITY NEW ORLEANS
    6363 ST CHARLES AVENUE CAMPUS BOX
    909
    NEW ORLEANS,LA701186143     		NONE PC COLLECTIVE IMPACT GRANT 11,213
    CATHOLIC CHARITIES OF THE DIOCESE OF BATON ROUGE
    1900 S ACADIAN THRUWAY
    BATON ROUGE,LA70808     		NONE PC COLLECTIVE IMPACT GRANT 10,000
    MARY BIRD PERKINS CANCER CENTER
    4950 ESSEN LANE
    BATON ROUGE,LA70809     		NONE PC COLLECTIVE IMPACT GRANT 208,000
    MARY BIRD PERKINS CANCER CENTER
    4950 ESSEN LANE
    BATON ROUGE,LA70809     		NONE PC COLLECTIVE IMPACT GRANT 10,115
    CAL RIPKEN SR FOUNDATION INC
    1427 CLARKVIEW RD SUITE 100
    BALTIMORE,MD21209     		NONE PC COLLECTIVE IMPACT GRANT 38,333
    SOUTHERN UNIVERSITY AT SHREVEPORT COMMUNITY DEVELOPMENT CORPORATION
    4646 HILRY HUCKABY AVE
    SHREVEPORT,LA71107     		NONE PC COLLECTIVE IMPACT GRANT 25,000
    KINGSLEY HOUSE INC
    1600 CONSTANCE STREET
    NEW ORLEANS,LA70130     		NONE PC COLLECTIVE IMPACT GRANT 50,000
    KINGSLEY HOUSE INC
    1600 CONSTANCE STREET
    NEW ORLEANS,LA70130     		NONE PC COLLECTIVE IMPACT GRANT 50,000
    FLETCHER TECHNICAL COMMUNITY COLLEGE FOUNDATION INC
    1407 HWY 311
    SCHRIEVER,LA70395     		NONE PC COLLECTIVE IMPACT GRANT 80,000
    FLETCHER TECHNICAL COMMUNITY COLLEGE FOUNDATION INC
    1407 HWY 311
    SCHRIEVER,LA70395     		NONE PC COLLECTIVE IMPACT GRANT 70,000
    LSU EUNICE FOUNDATION
    PO BOX 1551
    EUNICE,LA705351551     		NONE PC COLLECTIVE IMPACT GRANT 93,750
    LSU EUNICE FOUNDATION
    PO BOX 1551
    EUNICE,LA705351551     		NONE PC COLLECTIVE IMPACT GRANT 93,750
    CITY OF THIBODAUX
    310 WEST 2ND STREET PO BOX 5418
    THIBODAUX,LA70302     		NONE PC COLLECTIVE IMPACT GRANT 25,000
    NEW ORLEANS CAREER CENTER
    1020 N PRIEUR ST
    NEW ORLEANS,LA70116     		NONE PC COLLECTIVE IMPACT GRANT 60,250
    NEW ORLEANS CAREER CENTER
    1020 N PRIEUR ST
    NEW ORLEANS,LA70116     		NONE PC COLLECTIVE IMPACT GRANT 60,250
    NEW ORLEANS CAREER CENTER
    1020 N PRIEUR ST
    NEW ORLEANS,LA70116     		NONE PC COLLECTIVE IMPACT GRANT 60,250
    PFLAG NEW ORLEANS CHAPTER INC
    PO BOX 15515
    NEW ORLEANS,LA701755515     		NONE PC FOUNDATION HONORARIUM 5,000
    HEALTHY NETWORKS DESIGN AND RESEARCH
    19 HACKBERRY CIRCLE
    SHEPHERDSTOWN,WV25443     		NONE PC IMPORTED 5,000
    UNIVERSITY OF LOUISIANA MONROE FOUNDATION
    700 UNIVERSITY AVENUE
    MONROE,LA712034352     		NONE PC IMPORTED 2,500
    UNIVERSITY OF NEW ORLEANS
    2000 LAKESHORE DR ADMIN BLD ROOM
    1005
    NEW ORLEANS,LA70148     		NONE PC IMPORTED 17,196
    LOUISIANA PUBLIC HEALTH INSTITUTE
    400 POYDRAS STREET SUITE 1250
    NEW ORLEANS,LA70130     		NONE PC IMPORTED 35,000
    LOUISIANA PUBLIC HEALTH INSTITUTE
    400 POYDRAS STREET SUITE 1250
    NEW ORLEANS,LA70130     		NONE PC IMPORTED 22,500
    LSUA
    8100 HWY 71 SOUTH
    ALEXANDRIA,LA71302     		NONE PC SPECIAL PROJECT GRANT 21,000
    LSUA
    8100 HWY 71 SOUTH
    ALEXANDRIA,LA71302     		NONE PC SPECIAL PROJECT GRANT 21,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC SPECIAL PROJECT GRANT 25,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC SPECIAL PROJECT GRANT 25,000
    BATON ROUGE AREA FOUNDATION
    100 NORTH ST SUITE 900
    BATON ROUGE,LA708025264     		NONE PC SPECIAL PROJECT GRANT 25,000
    Total .................................bullet 3b 1,594,333
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-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 61  
    4 Dividends and interest from securities ....          
    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 ............     		    18 2,335,980  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue:
    aMISCELLANEOUS INCOME     		    01 51  
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 3,614,084 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    3,614,084
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-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 XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    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 (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990)
    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
    2021
    Name of the organization
    BLUE CROSS & BLUE SHIELD OF
    LOUISIANA FOUNDATION
    Employer identification number

    72-1232379
    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) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    BLUE CROSS & BLUE SHIELD OF
    LOUISIANA FOUNDATION         		Employer identification number
    72-1232379
    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
    LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY DBA BCBS OF
     
    5525 REITZ AVENUE
     
    BATON ROUGE, LA70809

    		$ 140,023


    (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) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    BLUE CROSS & BLUE SHIELD OF
    LOUISIANA FOUNDATION         		Employer identification number

    72-1232379
    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
    1
    		 IN-KIND CONTRIBUTIONS OF SERVICE $ 140,023  
    (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) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    BLUE CROSS & BLUE SHIELD OF
    LOUISIANA FOUNDATION         		Employer identification number

    72-1232379
    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) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    AUDITING SERVICES 43,425 8,685 0 34,740

    TY 2021 GeneralExplanationAttachment
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Identifier Return Reference Explanation
    SEE STATEMENT 10 FORM 990-PF, PART VIII, LINE 1 THE AMOUNT ABOVE PAID IN 2021 BY THE FOUNDATION TO LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY, DBA BLUE CROSS BLUE SHIELD OF LOUISIANA (BCBS), IS IN ACCORDANCE WITH THE MANAGEMENT CONTRACT THE FOUNDATION HAS WITH BCBS FOR SERVICES BCBS EMPLOYEES PROVIDE TO THE FOUNDATION. ALL PAYMENTS ARE PROPORTIONATE TO THE DIRECT COMPENSATION OF BCBS EMPLOYEES 53.4941(D)-3; NO AMOUNTS ARE CHARGED TO THE FOUNDATION TO REIMBURSE BCBS FOR BCBS'S OVERHEAD. THE AMOUNT REPORTED IS FOR SERVICES PERFORMED DURING 2021.
    INFORMATION REGARDING CONTRIBUTION, GRANT, GIFT, LOAN, SCHOLARSHIP, ETC., FORM 990-PF, PART XV, LINE 2B-2D THE MISSION OF THE BLUE CROSS AND BLUE SHIELD OF LOUISIANA FOUNDATION IS TO PROMOTE THE WELLNESS AND WELL-BEING OF LOUISIANANS BY SUPPORTING PROJECTS AND PROGRAMS FOR HEALTH, EDUCATION OR COMMUNITY WELL-BEING RELATED CAUSES. POTENTIAL AREAS OF INTEREST FOR THE FOUNDATION'S GRANT MAKING PROGRAMS ARE LISTED BELOW.HEALTHY EATING -PROGRAMS THAT INCREASE ACCESS TO, KNOWLEDGE ABOUT AND USE OF HEALTHY FOOD AND HEALTHY EATINGPHYSICAL ACTIVITY -PROGRAMS THAT INCREASE ACCESS TO, KNOWLEDGE ABOUT AND ENGAGEMENT WITH DAILY NATURAL PHYSICAL ACTIVITY-INCENTIVE AND REWARD-BASED PROGRAMS (VIRTUOUS CYCLES)COMMUNITY HEALTH -COMMUNITY LEVEL COMMITMENTS TO TACKLING HEALTH AND QUALITY OF LIFE ISSUESEARLY CHILDHOOD INTERVENTION -EARLY CHILDHOOD INTERVENTIONS THAT HELP SET CHILDREN, PARTICULARLY LOW-INCOME AND HIGH-NEEDS CHILDREN, ON A GOOD PATH EDUCATIONALLY, SOCIALLY-EMOTIONALLY, HEALTH-WISE ETC.SCHOOL-BASED HEALTH -HAVING SCHOOLS OR EDUCATIONAL INSTITUTIONS MAKE IMPROVING HEALTH OUTCOMES A TOP PRIORITYFAMILY STABILITY -PROGRAMS THAT SUPPORT STRONGER FAMILIES AND FAMILY UNITS, PROVIDING PARTICULARLY FOR LOW-INCOME KIDS STABILITY AND SUPPORTTHE FOUNDATION CURRENTLY FUNDS PROGRAMS THROUGH THE FOLLOWING GRANT PROGRAMS:NEW HORIZONS GRANT PROGRAM:PURPOSE - GRANTS HELP PILOT INNOVATIVE, PROOF OF CONCEPT PROJECTS AIMED AT IMPROVING THE HEALTH AND WELLBEING OF LOUISIANANS AMOUNT - GENERALLY GRANTS UP TO $25,000 ARE MADE IN SUPPORT OF PROJECTS THAT TAKE LESS THAN ONE YEAR TO COMPLETEELIGIBILITY - ONLY LOUISIANA-BASED 501( C)(3) NONPROFIT ORGANIZATIONS MAY APPLYAPPLYING - LETTERS OF INTENT MUST BE SUBMITTED ONLINE AT BCBSLAFOUNDATION.ORG ON OR BEFORE THE BELOW DEADLINESLETTER ON INTENT DEADLINES - MARCH 1, JUNE 1, SEPTEMBER 1, DECEMBER 1SPECIAL PROJECTS GRANT PROGRAM:PURPOSE - GRANTS ARE INTENDED TO HELP EXPAND OR COMPLETE PROJECTS PREVIOUSLY FUNDED BY THE FOUNDATION AND/OR SCALE UP SUCCESSFUL PROJECTS AND INITIATIVES- FURTHER IMPROVING THE HEALTH AND WELLBEING OF LOUISIANIANSAMOUNT - GENERALLY GRANTS UP TO $100,000 ARE MADE IN SUPPORT OF PROJECTS THAT TAKE LESS THAN ONE YEAR TO COMPLETEELIGIBILITY - GRANTS ARE ONLY MADE TO LOUISIANA-BASED, 501( C)(3) NONPROFIT ORGANIZATIONS WITH WHOM THE FOUNDATION HAS A PAST GRANTING HISTORYAPPLYING - LETTERS OF INTENT MUST BE SUBMITTED ONLINE AT BCBSLAFOUNDATION.ORG ON OR BEFORE THE BELOW DEADLINESLETTER ON INTENT DEADLINES - MARCH 1, JUNE 1, SEPTEMBER 1, DECEMBER 1COLLECTIVE IMPACT GRANT PROGRAM:PURPOSE - COLLECTIVE IMPACT GRANTS ARE MADE TO COMMUNITY COALITIONS WORKING TOGETHER TO ADDRESS MAJOR PUBLIC HEALTH CONCERNSAMOUNT - GENERALLY GRANTS UP TO $250,000 TO $1 MILLION OVER AN AVERAGE OF THREE YEARSMATCHING -COLLECTIVE IMPACT GRANTS REQUIRE A MINIMUM ONE-TO-ONE MATCH (MAY COME FROM MULTIPLE SOURCES; UP TO ONE-HALF MAY BE IN-KIND)ELIGIBILITY -ONLY LOUISIANA-BASED, 501( C)(3) NONPROFIT ORGANIZATIONS MAY APPLYAPPLYING - LETTERS OF INTENT MUST BE SUBMITTED ONLINE AT BCBSLAFOUNDATION.ORG ON OR BEFORE THE BELOW DEADLINESLETTER ON INTENT DEADLINES - MARCH 1, JUNE 1, SEPTEMBER 1, DECEMBER 1DISASTER RELIEF GRANT PROGRAM:PURPOSE - INVESTMENTS TO MEET THE IMMEDIATE TO LONG-TERM NEEDS OF LOUISIANA COMMUNITIES IMPACTED BY NATURAL DISASTERS - SPECIFICALLY COVID-19, HURRICANE LAURA AND HURRICANE IDA PLUS OTHER NATURAL DISASTERS.AMOUNT - GRANTS OF UP TO $50,000 FOR THOSE DOING COVID RELIEF OR DISASTER RELIEF THROUGHOUT THE STATE; GRANTS UP TO $250,000 FOR THOSE DOING DISASTER RELIEF IN FEDERALLY DECLARED DISASTER AREAS.MATCHING -NO MATCH REQUIREDELIGIBILITY -ONLY LOUISIANA-BASED, 501( C)(3) NONPROFIT ORGANIZATIONS MAY APPLYAPPLYING - APPLICATION SUBMITTED ONLINE AT BCBSLAFOUNDATION.ORGDEADLINES - ROLLING & REVIEWED AS SUBMITTEDANGELS OF CHANGE GRANTS:PURPOSE - ANGELS OF CHANGE GRANTS ARE MADE TO COALITIONS OF PREVIOUS ANGEL HONOREES AND THEIR PARTNERS WORKING TOGETHER TO ADDRESS THE SYSTEMIC HEALTH & QUALITY OF LIFE ISSUES IMPACTING LOUISIANA'S CHILDREN.AMOUNT - TEN (10) GRANTS OF UP TO $250,000 EACH TO BE IMPLEMENTED OVER ONE TO THREE YEARS. MULTI-YEAR AWARDS WILL BE MADE IN YEARLY INCREMENTS WITH EACH YEAR INCREMENT CONTINGENT UPON SUCCESSFUL PERFORMANCE OF PREVIOUS BENCHMARKS OR GRANT COMPLETION.MATCHING - ANGELS OF CHANGE GRANTS DO-NOT REQUIRE A MATCH ALTHOUGH MATCHING COMMITMENTS WILL FACTOR FAVORABLY INTO CALCULATIONS OF PROJECT SUSTAINABILITYELIGIBILITY -LOUISIANA INDIVIDUALS WHO ARE DOING WORK THAT GOES ABOVE AND BEYOND IN SUPPORT OF LOUISIANA'S CHILDREN; GRANT DESIGNATIONS ARE MADE BY EACH OF THE SELECTED ANGELS - THE ORGANIZATIONS MUST BE LOUISIANA-BASED 501( C)(3) NONPROFIT ORGANIZATIONS.APPLYING - REQUESTS ARE MADE THROUGH A LETTER OF INTENT, SUBMITTED ONLINE AT BCBSLAFOUNDATION.ORG.LETTER ON INTENT DEADLINES - DECEMBER 1, MARCH 1, JUNE 1 AND SEPTEMBER 1 UNTIL FUNDS ARE EXHAUSTED; IF THE 1ST FALLS ON A WEEKEND OR HOLIDAY WE WILL ACCEPT LETTERS OF INTENT THROUGH THE DEADLINE, BUT WE WILL NOT BE IN THE OFFICE TO ANSWER QUESTIONS. IN THIS CASE, WE RECOMMEND SUBMITTING YOUR LETTER OF INTENT NO LATER THAN 4:00PM CST ON THE LAST WORK DAY PRECEDING THE DEADLINEADDITIONALLY, THE FOUNDATION CURRENTLY OPERATES ONE SIGNATURE PROGRAM, THE ANGEL AWARDS, WHICH HIGHLIGHTS AND SUPPORTS LOUISIANA LEADERS WHOSE WORK GOES ABOVE AND BEYOND TO MEET THE NEEDS OF LOUISIANA CHILDREN. THE FOUNDATION ANNUALLY HIGHLIGHTS THESE INDIVIDUALS AND MAKES GRANTS IN SUPPORT OF THEIR EFFORTS.

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Name of Stock End of Year Book Value End of Year Fair Market Value
    TAIWAN SEMICONDUCTOR MFG CO 221,611 221,611
    STERIS ORD 130,468 130,468
    SIKA 10 ADR REP ORD 156,598 156,598
    SHOPIFY INC CL A 150,136 150,136
    RESMED INC COM 180,513 180,513
    RBC EM MKTS EQ R6 2,568,115 2,568,115
    PRINCIPAL: DVS RL AS INST 1,902,786 1,902,786
    PIMCO: INCOME INST 3,758,299 3,758,299
    NESTLE S A SPONSORED ADR REPSTG 140,230 140,230
    METTLER-TOLEDO INTL INC COM 157,841 157,841
    METROPOLITAN WEST TOTAL RET ETF 3,121,879 3,121,879
    LVMH MOET HENNESSY LOUIS VUITTON 163,845 163,845
    LULULEMON ATHLETICA ORD 143,662 143,662
    LONZA GROUP ADR 152,722 152,722
    J HANCOCK DS VAL ITL R6 3,934,750 3,934,750
    ICON PLC LTD SHS 167,857 167,857
    GUGGENHEIM TOTAL RETURN BOND ETF 2,441,162 2,441,162
    FIDELITY EXTENDED MKT IX 3,603,566 3,603,566
    FIDELITY 500 INDEX FUND 9,903,180 9,903,180
    FERRARI ORD 157,363 157,363
    EXPERIAN PLC SPON ADR 207,842 207,842
    DSV AS ADR 208,350 208,350
    CSL LTD SPONSORED ADR 170,444 170,444
    CANADIAN PACIFIC RAILWAY LIMITED - W/I COM 176,900 176,900
    ATLAS COPCO AB SPON ADR NEW R 149,640 149,640
    ASML HLDG NV NY REGISTRY NEW 2012 253,969 253,969
    AON CL A ORD 105,196 105,196
    AMADEUS IT GROUP, S.A. 103,408 103,408
    ALCON ORD 148,104 148,104
    AIA GROUP LTD 163,435 163,435
    ADYEN UNSPON 50 ADR REP 1 ORD 114,887 114,887
    ACCENTURE PLC CL A COM 188,620 188,620
    WUXI BIOLOGICS CAYMAN ADR 87,595 87,595
    SHENZHOU INTL GROUP HLDGS ADR 84,614 84,614
    EPAM SYSTEMS ORD 145,722 145,722
    EVOLUTION ADR 89,493 89,493
    LASERTEC ADR 197,657 197,657
    ATLASSIAN CL A ORD 109,049 109,049
    LI NING COMPANY ADR 85,437 85,437
    PERNOD RICARD S A SPONSORED ADR 105,298 105,298
    NOVO NORDISK ADR REPSG 1 ORD 102,032 102,032
    DODGE & COX GLOBAL BOND 1,811,976 1,811,976

    TY 2021 OtherAssetsSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    DIVIDENDS RECEIVABLE 2,116 1,381 1,381
    INVESTMENT INCOME REC - S-T -1 -1 -1


    TY 2021 OtherExpensesSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ADVERTISING & PROMOTIONAL 18,000 0 0 18,000
    BOARD MEETING MEALS 301 0 0 301
    BUSINESS MEALS 271 0 0 271
    DUES - CIVIC AND PROMOTIONAL 2,336 0 0 2,336
    DUES - CORPORATE 20,290 0 0 20,290
    EQUIPMENT RENTALS & LEASES 4,700 0 0 4,700
    TELEPHONE - OTHER 680 0 0 680
    TRAVEL MEALS 220 0 0 220
    BANK SERVICE CHARGES 1,265 0 0 1,265
    PRINTING & OFFICE EXPENSES 605 0 0 605
    FEDERAL EXCISE TAX 68,304 0 0 0
    EMPLOYER TRAIN AND EDUCATION 600 0 0 600
    EMPLOYEE ONLY BUSINESS MEALS 46 0 0 46


    TY 2021 OtherIncomeSchedule2
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    MISCELLANEOUS INCOME 51   51


    TY 2021 OtherIncreasesSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Description Amount
    UNREALIZED GAIN/LOSS ON INVESTMENTS 1,437,609


    TY 2021 OtherLiabilitiesSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Description Beginning of Year - Book Value End of Year - Book Value
    REIMBURSEMENT UNDER MGMT AGREEMENT 28,995 31,291


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    BLUE CROSS & BLUE SHIELD OF
     
    LOUISIANA FOUNDATION
    EIN:
    72-1232379
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    OUTSOURCING AND TEMP SERVICES 57,406 0 0 57,406
    INVESTMENT EXPENSE - NON-CW 13,253 13,253 0 0
    INVESTMENT EXPENSE - EXTERNAL 119,940 119,940 0 0