Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
right arrowDo not enter social security numbers on this form as it may be made public.
right arrowGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
For calendar year 2023, or tax year beginning 01-01-2023 , and ending 12-31-2023
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 right arrow
G Check all that apply:

D 1. Foreign organizations, check here............. right arrow
2. Foreign organizations meeting the 85%
test, check here and attach computation ... right arrow
E right arrow
H Check type of organization:
F right arrow
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)right arrow$77,106,995J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check right arrow.............
3 Interest on savings and temporary cash investments 43,231 43,231  
4 Dividends and interest from securities... 3,326,137 3,326,137  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 272,396
b Gross sales price for all assets on line 6a 77,337,420
7 Capital gain net income (from Part IV, line 2)... 1,463,464
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
List of Attached Documents:
// Content
55,859 55,859  
12 Total. Add lines 1 through 11........ 3,697,623 4,888,691  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 394,829     394,829
14 Other employee salaries and wages...... 439,745     439,745
15 Pension plans, employee benefits....... 174,013     174,013
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule).... Click to see attachment
List of Attached Documents:
// Content
399,293     399,293
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
112,200      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings....... 29,184     29,184
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
541,609 301,849   246,298
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 2,090,873 301,849   1,683,362
25 Contributions, gifts, grants paid....... 4,791,453 4,803,505
26 Total expenses and disbursements. Add lines 24 and 25 6,882,326 301,849   6,486,867
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -3,184,703
b Net investment income (if negative, enter -0-) 4,586,842
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2023)
Form 990-PF (2023)
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............. 367,989 1,175,053 1,175,053
2 Savings and temporary cash investments.........      
3 Accounts receivable right arrow  
Less: allowance for doubtful accounts right arrow        
4 Pledges receivable right arrow  
Less: allowance for doubtful accounts right arrow        
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) right arrow  
Less: allowance for doubtful accounts right arrow        
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)....... 66,037,114 Click to see attachment
List of Attached Documents:
// Content
63,697,704 		63,697,704
c Investments—corporate bonds (attach schedule)....... 4,125,436 Click to see attachment
List of Attached Documents:
// Content
3,868,885 		3,868,885
11 Investments—land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 2,962,610 Click to see attachment
List of Attached Documents:
// Content
8,246,245 		8,246,245
14 Land, buildings, and equipment: basis right arrow  
Less: accumulated depreciation (attach schedule) right arrow        
15 Other assets (describe right arrow) Click to see attachment
List of Attached Documents:
// Content
172,922 		Click to see attachment
List of Attached Documents:
// Content
119,108 		Click to see attachment
List of Attached Documents:
// Content
119,108
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 73,666,071 77,106,995 77,106,995
Liabilities 17 Accounts payable and accrued expenses.......... 584,419 879,357
18 Grants payable................. 388,516 376,464
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 right arrow)    
23 Total liabilities (add lines 17 through 22)......... 972,935 1,255,821
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here right arrow
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 right arrow
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 72,693,136 75,851,174
29 Total net assets or fund balances (see instructions)..... 72,693,136 75,851,174
30 Total liabilities and net assets/fund balances (see instructions). 73,666,071 77,106,995
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
72,693,136
2
Enter amount from Part I, line 27a .....................
2
-3,184,703
3
Other increases not included in line 2 (itemize) right arrowClick to see attachment
List of Attached Documents:
// Content
3
6,342,741
4
Add lines 1, 2, and 3 ..........................
4
75,851,174
5
Decreases not included in line 2 (itemize) right arrow
5
 
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
75,851,174
Form 990-PF (2023)
Form 990-PF (2023)
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 Trade Securities      
b Bonds      
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 77,337,420   77,060,933 1,467,555
b     4,091 -4,091
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       1,467,555
b       -4,091
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 1,463,464
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
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 right arrow 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) 1 63,757
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  
3 Add lines 1 and 2........................... 3 63,757
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 63,757
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 24,967
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c 37,000
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: 61967 7 61,967
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.......right arrow 9 1,790
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...right arrow 10  
11 Enter the amount of line 10 to be: Credited to 2024 estimated taxright arrow   Refundedright arrow 11  
Form 990-PF (2023)
Form 990-PF (2023)
Page 4
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
 
 
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
 
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. right arrow$   (2) On foundation managers.right arrow$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.right arrow$  
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:
round bullet By language in the governing instrument, or
round bullet 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)
right arrowMN
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 2023 or the taxable year beginning in 2023? 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
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 addressright arrowwww.bluecrossmn.com/foundation
14
The books are in care ofright arrowCorporate Offices Telephone no.right arrow (651) 662-9668

Located atright arrow3400 Yankee DriveEaganMN ZIP+4right arrow551211627
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........right arrow
and enter the amount of tax-exempt interest received or accrued during the year ........right arrow
15
 
16 At any time during calendar year 2023, 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 right arrow
Form 990-PF (2023)
Form 990-PF (2023)
Page 5
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
Organizations relying on a current notice regarding disaster assistance check here ........right arrow
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 2023? .............
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 2023, did the foundation have any undistributed income (Part XII, lines 6d
and 6e) for tax year(s) beginning before 2023?....................
2a
 
No
If "Yes," list the years right arrow20, 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.
right arrow20, 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 2023 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 2023.) .....................
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 2023? ..
4b
 
No
Form 990-PF (2023)
Form 990-PF (2023)
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)
Yes
 
(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
 
No
c
Organizations relying on a current notice regarding disaster assistance check .........right arrow
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
Yes
 
If "Yes," attach the statement required by Regulations section 53.4945–5(d). Click to see attachment
List of Attached Documents:
// Content
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
MARK STEFFEN MD DIRECTOR
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
RACHEL HARDEMAN DIRECTOR
000.00 		500    
3400 YANKEE DRIVE
EAGAN,MN55121
BUKATA HAYES BOARD CHAIR
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
DANA ERICKSON DIRECTOR
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
PAUL SAND SECRETARY
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
ANN HOWES ASST SECRETARY
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
MAY VANG DIRECTOR
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
NASH SHAIKH DIRECTOR
000.00 		0    
3400 YANKEE DRIVE
EAGAN,MN55121
NANCY VYSKOCIL VICE CHAIR
000.00 		1,000    
3400 YANKEE DRIVE
EAGAN,MN55121
KRISTINE RHODES DIRECTOR
000.00 		500    
3400 YANKEE DRIVE
EAGAN,MN55121
CAROLYN LINK PRESIDENT
040.00 		390,829 74,672  
3400 YANKEE DRIVE
EAGAN,MN55121
EMILY PIPER DIRECTOR
000.00 		2,000    
3400 YANKEE DRIVE
EAGAN,MN55121
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 		183,620 68,912  
3400 YANKEE DRIVE
EAGAN,MN55121
ALLISON CORRADO SENIOR PROGRAM OFFIC
040.00 		163,312 57,891  
3400 YANKEE DRIVE
EAGAN,MN55121
JANET JABLONSKE OPERATIONS MANAGER
040.00 		105,095 42,087  
3400 YANKEE DRIVE
EAGAN,MN55121
MAJRA MUCIC GIBBONS SENIOR PROGRAM OFFIC
040.00 		138,520 68,556  
3400 YANKEE DRIVE
EAGAN,MN55121
Total number of other employees paid over $50,000...................right arrow  
Form 990-PF (2023)
Form 990-PF (2023)
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
PADILLA SPEER BEARDSLEY Consulting Service 65,000
1101 West River Parkway Ste 400
Minneapolis,MN55415
Arcadia Research and Evaluation LLC Consulting Service 448,381
364 Warwick St
St Paul,MN55105
Total number of others receiving over $50,000 for professional services.............right arrow  
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 The Foundation conducts programs in support of healthy communities. Areas of focus are equitable care and coverage, early childhood care and education, and community connections to reduce social isolation. Funds were used for program evaluation, grantee technical assistance, and garantee convening to support three focus areas. 448,381
2 Funds were used for planning and communications related to a community event focused on racial and health equity and communications to support grantees. 65,000
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 None  
2 None  
All other program-related investments. See instructions.
3  
Total. Add lines 1 through 3.........................right arrow  
Form 990-PF (2023)
Form 990-PF (2023)
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
74,426,693
b
Average of monthly cash balances.......................
1b
1,341,947
c
Fair market value of all other assets (see instructions)................
1c
0
d
Total (add lines 1a, b, and c).........................
1d
75,768,640
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
75,768,640
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
1,136,530
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
74,632,110
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
3,731,606
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
3,731,606
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
63,757
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
63,757
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
3,667,849
4
Recoveries of amounts treated as qualifying distributions................
4
 
5
Add lines 3 and 4............................
5
3,667,849
6
Deduction from distributable amount (see instructions).................
6
 
7
Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
7
3,667,849
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 Click to see attachment
List of Attached Documents:
// Content
..........
1a
6,486,867
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
6,486,867
Form 990-PF (2023)
Form 990-PF (2023)
Page 9
Part XII
Undistributed Income (see instructions)
(a)
Corpus 		(b)
Years prior to 2022 		(c)
2022 		(d)
2023
1 Distributable amount for 2023 from Part X, line 7 3,667,849
2 Undistributed income, if any, as of the end of 2022:
a Enter amount for 2022 only.......  
b Total for prior years:20 , 20, 20  
3 Excess distributions carryover, if any, to 2022:
a From 2018...... 1,335,370
b From 2019...... 2,524,418
c From 2020...... 4,310,236
d From 2021...... 2,831,258
e From 2022...... 2,796,781
f Total of lines 3a through e ........ 13,798,063
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 6,486,867
a Applied to 2022, 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 2023 distributable amount..... 3,667,849
e Remaining amount distributed out of corpus 2,819,018
5 Excess distributions carryover applied to 2023.    
(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 16,617,081
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 2022. Subtract line
4a from line 2a. Taxable amount—see
instructions ............. 		 
f Undistributed income for 2023. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2024 .......... 		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 2018 not
applied on line 5 or line 7 (see instructions) ... 		1,335,370
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		15,281,711
10 Analysis of line 9:
a Excess from 2019.... 2,524,418
b Excess from 2020.... 4,310,236
c Excess from 2021.... 2,831,258
d Excess from 2022.... 2,796,781
e Excess from 2023.... 2,819,018
Form 990-PF (2023)
Form 990-PF (2023)
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 2023, enter the date of the ruling ...... right arrow
 
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 IX for each
year listed .......... 		Tax year Prior 3 years (e) Total
(a) 2023 (b) 2022 (c) 2021 (d) 2020
         
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).)
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 right arrow
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 (2023)
Form 990-PF (2023)
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

African Community Senior Services

2722 Park Avenue
Minneapolis,MN55407 		  PC Access to Coverage, Assist with Public Program Renewals 40,000

African Community Services

1305 East 24th Street
Minneapolis,MN55404 		  PC ACS Access to Coverage 100,000

African Economic Development Solutions

1821 University avenue Suite S-145
St Paul,MN55104 		  PC African Minnesotan Early Childhood Provider Initiative 100,000

Alight

325 Quincy Street NE Ste A1
Minneapolis,MN55413 		  PC Welcome Home Afghans in MN 50,000

All Nations Rise

34248 250th Ave
Ogema,MN56569 		  PC First Children First Nations Child Care Collaborative 80,000

Amherst H Wilder Foundation

451 LEXINGTON PARKWAY NORTH
ST PAUL,MN55104 		  PC African American Babies Coalition and Projects Birth Equity and Justice 121,000

Apple Tree Dental

2442 Mounds View Blvd
Mounds View,MN55112 		  PC Launching a Family-Centered Dental Home Pilot 200,000

CARE Clinic

906 College Ave
Red Wing,MN55066 		  PC Expand Access to Equitable Dental Care and Coverage 80,000

Centro Tyrone Guzman

1915 Chicago Avenue
Minneapolis,MN55404 		  PC Manos Montessori Intergenerational Social Enterprise 80,000

Children's Defense Fund

555 Park Street Suite 410
St Paul,MN55103 		  PC Building Power and Raising Voices for MN Families 100,000

Children's Dental Services

636 Broadway St NE
Minneapolis,MN55413 		  PC Advancing Equitable Care Access to Underserved in Central and Northern Minnesota 80,000

Comunidades Latinas Unidas En Servicio

797 East 7th Street
St Paul,MN55106 		  PC CLUES Access to Coverage 2023 70,000

Frontstream

11480 Commerce Park Dr
Reston,VA20191 		  Expenditure Responsi 2023 MN FoodShare 19,623

Generations Healthcare Initiative

130 W Superior St Ste 700
Duluth,MN55802 		  PF Insure Duluth Coalition Partner, YMCA 50,000

Grantmakers in Health

1100 Connecticut Avenue NW Suite 12
Washington,DC20036 		  PC 2023 GIH funding partner renewal 6,150

Greater Minneapolis Community Connections

1100 East Lake Street
Minneapolis,MN55407 		  PC 2022 MN FoodShare March Campaign match 19,623

Greater Twin Cities United Way

404 South 8th Street
Minneapolis,MN55404 		  PC Start Early Funders Coalition 22,500

Green Card Voices

2611 1st Ave S
Minneapolis,MN55408 		  PC Bridging Gaps Through Storytelling 91,123

Hispanic Outreach Program of Goodhue County

PO Box 146
Red Wing,MN55066 		  PC Meet.Learn.Share 2.0 81,603

Hmong American Partners

1075 Arcade St
St Paul,MN55106 		  PC Health Insurance Enrollment Assistance for Low-Income Families and Individuals 50,000

Hmong American Partners (for Navigator Coalition)

1075 Arcade Street
StPaul,MN55106 		  PC Navigator Coalition 120,000

Intercultural Mutual Assistance Association

2500 Valleyhigh Drive NW
Rochester,MN55901 		  PC Match Program 50,000

Irreducible Grace

643 Virginia St
Saint Paul,MN55103 		  PC Elders in Arts 100,000

Lakes & Prairies Community Action Partnership

891 Belsly Blvd
Moorhead,MN56560 		  PC New American Child Care Program 100,000

Lao Assistance Center of Minnesota

1015 4th Avenue N
MINNEAPOLIS,MN55405 		  PC Nitan Building Bridges Across Generations 99,990

Liberty Chuch

3700 Broadway Avenue North
Minneapolis,MN55412 		  PC Strengthening intergenerational social connections 80,000

Mid-Minnesota Legal Assistance

110 6th Ave S Suite 200
St Cloud,MN56301 		  PC Healthcare Outreach and Enrollment 80,000

Minnesota Council on Foundation

800 Washington Ave N
Minneapolis,MN55401 		  PC 2024 Membership Contribution 9,000

Minnesota Seeds of Justice

2150 Castlewood Dr
Worthington,MN56187 		  PC Healthcare Access in SW Minnesota 70,000

MN Zej Zog

8940 29TH AVE N
NEW HOPE,MN55427 		  PC Finding Me Exploring Hmong Identity Through Culture, Language and History 25,000

Native American Community Clinic

1213 E Franklin Ave
Minneapolis,MN55404 		  PC NACC Increasing Access To Care Project 80,000

Northfield Healthy Community Initiative

1651 JEFFERSON PARKWAY HS 128
NORTHFIELD,MN55057 		  PC Increasing Early Childhood Access Quality in Rice County 95,000

Northland Foundation

202 West Superior Street
Duluth,MN55802 		  PC Quality Early Care and Education Improvement Initiative 150,000

Northpoint Health and Wellness

1256 Penn Ave N
MINNEAPOLIS,MN55411 		  PC Access to Coverage 100,000

Northside Achievement Zone

2123 West Broadway Ave Suite 100
Minneapolis,MN55411 		  PC NAZ Early Childhood Education Programs 100,000

Northwest Indian Community Development Center

1819 Bemidji Ave N
Bemidji,MN56601 		  PC Maskawizi Wayeshkad - Strong Beginnings 180,000

Northwest Minnesota Foundation

201 3rd St NW
Bemidji,MN56601 		  PC Step Up - Community of Belonging 100,000

Open Door Health Center

309 Holly Lane
Mankato,MN56001 		  PC Health Insurance Application and Enrollment Assistance 75,000

Partnership Academy (La Red Latina de Educacion Temprana )

6500 Nicollet Ave
Richfield,MN55423 		  PC La Red Latina de Educacion Temprana 100,000

Portico Healthnet

2925 Chicago Avenue South
Minneapolis,MN55114 		  PC MA and MNcare Outreach, Application, and Enrollment Assistance 105,000

Project Motherpath

16821 NE 6th Ave N
Miami,FL33162 		  PC Roots Community Birth Center Community Perinatal Transformation 100,000

Propel Nonprofits

One SE Main St
Minneapolis,MN55414 		  PC Saint Paul All Ready for Kindergarten 100,000

Queerspace Collective

PO Box 11455
Minneapolis,MN55411 		  PC QUEERSPACE collective LGBTQ Group Mentoring and Training 99,327

Rabata Inc

3533 LEXINGTON AVE N
ARDEN HILLS,MN55112 		  PC Rabata Community Development for Muslim Girls Women 75,000

Rainbow Health

701 S 4th Ave
Minneapolis,MN55415 		  PC Expanding Insurance Coverage for LGBTQ and HIV-positive Minnesotans 75,000

Regents of the U of M (SHADAC)

Sponsored Projects Administration
Minneapolis,MN55455 		  Public School Describing Minnesota Communities and Uninsured Phase 5 - data refresh and promo 72,039

Rise Incorporated

8406 Sunset Road NE
Spring Lake Park,MN55432 		  PC Intergenerational Connections for Better Health for Seniors and Disabled Adults 67,957

St David's Center (for MN Coalition for Family Home Visiting)

3395 Plymouth Road
Hopkins,MN55305 		  PC Improving Equity and Responsiveness in Family Home Visiting Systems 100,000

Tiwahe Foundation

570 N Asbury St
St Paul,MN55104 		  PC Addressing Root Causes of Native Health Disparities 75,000

United Community Action

200 4th Street SW PO Box 1359
Willmar,MN56201 		  PC Community Connectors 75,000

FrontStream

11480 Commerce Park Dr
Reston,VA20191 		  Expenditure Responsi 2021 Community Giving Campaign 57,695

FrontStream

11480 Commerce Park Dr
Reston,VA20191 		  Expenditure Responsi 2022 Community Giving Campaign 258,875

Voices for Racial Justice

2525 E Franklin Avenue Ste 301
Minneapolis,MN55406 		  PC Early Childhood Parent Fellowship 87,000

Way to Grow

201 Irving Ave N
Minneapolis,MN55405 		  PC Way to Grow Healthy Start 100,000

Wildflower Foundation

1330 LAGOON AVE 4TH FLOOR
MINNEAPOLIS,MN55408 		  PC Wildflower Equity Initiative 100,000

YWCA of Minneapolis

1130 Nicollet Mall
Minneapolis,MN55403 		  PC YWCA Holistic, High-Quality ECE Programming for Marginalized Communities 100,000
Total .................................right arrow 3a 4,803,505
bApproved for future payment

Alight
325 Quincy Street NE Ste A1
Minneapolis,MN55413 		  PC Welcome Home Afghans in MN 50,000

Centro Tyrone Guzman
1915 Chicago Avenue
Minneapolis,MN55404 		  PC Manos Montessori Intergenerational Social Enterprise 75,000

Green Card Voices
2611 1st Ave S
Minneapolis,MN55408 		  PC Bridging Gaps Through Storytelling 93,700

Hispanic Outreach Program of Goodhue County
PO Box 146
Red Wing,MN55066 		  PC Meet.Learn.Share 2.0 70,629

Intercultural Mutual Assistance Association
2500 Valleyhigh Drive NW
Rochester,MN55901 		  PC Match Program 50,000

Irreducible Grace
643 Virginia St
Saint Paul,MN55103 		  PC Elders in Arts 100,000

Lao Assistance Center of Minnesota
1015 4th Avenue N
MINNEAPOLIS,MN55405 		  PC Nitan Building Bridges Across Generations 100,000

Liberty Chuch
3700 Broadway Avenue North
Minneapolis,MN55412 		  PC Strengthening intergenerational social connections 75,000

Northland Foundation
202 West Superior Street
Duluth,MN55802 		  PC Quality Early Care and Education Improvement Initiative 50,000

Queerspace Collective
PO Box 11455
Minneapolis,MN55411 		  PC QUEERSPACE collective LGBTQ Group Mentoring and Training 99,327

Rabata Inc
3533 LEXINGTON AVE N
ARDEN HILLS,MN55112 		  PC Rabata Community Development for Muslim Girls Women 75,000

Rise Incorporated
8406 Sunset Road NE
Spring Lake Park,MN55432 		  PC Intergenerational Connections for Better Health for Seniors and Disabled Adults 90,000

Tiwahe Foundation
570 N Asbury St
St Paul,MN55104 		  PC Addressing Root Causes of Native Health Disparities 75,000

FrontStream
11480 Commerce Park Dr
Reston,VA20191 		  Expenditure Responsi 2023 Community Giving Campaign 319,854
Total ................................. right arrow 3b 1,323,510
Form 990-PF (2023)
Form 990-PF (2023)
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 43,231  
4 Dividends and interest from securities ....     14 3,326,137  
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 55,859  
8 Gain or (loss) from sales of assets other than
inventory ............ 		    18    
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) ..   3,425,227  
13Total. Add line 12, columns (b), (d), and (e)..................
13
3,425,227
(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.)
N/a N/A
Form 990-PF (2023)
Form 990-PF (2023)
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)
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) 944,831 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.
right arrow right arrow
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 Check if self-
employed right arrow		 PTIN
Firm's name SmallBullet
 Firm's EIN SmallBullet
Firm's address SmallBullet


 Phone no.
Form 990-PF (2023)
Additional Data


Software ID: 23017659
Software Version: 23.1.0.0
Part VI Line 7 - Tax Paid with the Original Return: 61,967


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
2023
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) (2023)
Schedule B (Form 990) (2023) 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

$ 0


(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) (2023)
Schedule B (Form 990) (2023)
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) (2023)
Schedule B (Form 990) (2023)
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) (2023)
Additional Data


Software ID: 23017659
Software Version: 23.1.0.0

TY 2023 AllOthProgRltdInvestmentsSch
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Category Amount
None  

TY 2023 InvestmentsCorpBondsSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Name of Bond End of Year Book Value End of Year Fair Market Value
  3,868,885 3,868,885

TY 2023 InvestmentsCorpStockSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Name of Stock End of Year Book Value End of Year Fair Market Value
  63,697,704 63,697,704

TY 2023 InvestmentsOtherSchedule2
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
Asset-backed securities   8,246,245 8,246,245

TY 2023 OtherAssetsSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
See statement 1 attached 172,922 119,108 119,108


TY 2023 OtherExpensesSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Other 541,609 301,849   246,298


TY 2023 OtherIncomeSchedule2
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
Miscellaneous investment income 55,859 55,859  


TY 2023 OtherIncreasesSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Description Amount
Unrealized Gain/Loss on Investments 6,342,741


TY 2023 OtherProfessionalFeesSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Professional fees 104,250     104,250
Unrestricted Grantee Support 295,043     295,043


TY 2023 TaxesSchedule
Name:
BCBSM Foundation Inc
EIN:
36-3525653
Software ID:
23017659
Software Version:
23.1.0.0
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Income tax 112,200