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
Blue Cross and Blue Shield of Kansas
Foundation Inc
Number and street (or P.O. box number if mail is not delivered to street address)1133 SW Topeka Blvd
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Topeka, KS66629
A Employer identification number

20-3085640
B Telephone number (see instructions)

(785) 291-7263
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$14,231,193J 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      
4 Dividends and interest from securities... 380,295 380,295  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 198,732
b Gross sales price for all assets on line 6a 3,437,508
7 Capital gain net income (from Part IV, line 2)... 198,732
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
154,580    
12 Total. Add lines 1 through 11........ 733,607 579,027  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc.        
14 Other employee salaries and wages......        
15 Pension plans, employee benefits.......        
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment
List of Attached Documents:
// Content
1,200     1,200
c Other professional fees (attach schedule).... Click to see attachment
List of Attached Documents:
// Content
54,564 54,564    
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment
List of Attached Documents:
// Content
7,290      
19 Depreciation (attach schedule) and depletion...      
20 Occupancy..............        
21 Travel, conferences, and meetings.......        
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see list of attachments
List of Attached Documents:
// Content
154,620     40
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 217,674 54,564   1,240
25 Contributions, gifts, grants paid....... 944,152 767,041
26 Total expenses and disbursements. Add lines 24 and 25 1,161,826 54,564   768,281
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements -428,219
b Net investment income (if negative, enter -0-) 524,463
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............. 43,978 -142,744 -142,744
2 Savings and temporary cash investments......... 3,052,424 2,201,947 2,201,947
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).......      
c Investments—corporate bonds (attach schedule).......      
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).......... 10,415,602 Click to see attachment
List of Attached Documents:
// Content
11,201,154 		12,166,299
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
5,103 		Click to see attachment
List of Attached Documents:
// Content
5,691 		Click to see attachment
List of Attached Documents:
// Content
5,691
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 13,517,107 13,266,048 14,231,193
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................   177,111
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) Click to see attachment
List of Attached Documents:
// Content
783 		Click to see attachment
List of Attached Documents:
// Content
832
23 Total liabilities (add lines 17 through 22)......... 783 177,943
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........... 13,516,324 13,088,105
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    
29 Total net assets or fund balances (see instructions)..... 13,516,324 13,088,105
30 Total liabilities and net assets/fund balances (see instructions). 13,517,107 13,266,048
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
13,516,324
2
Enter amount from Part I, line 27a .....................
2
-428,219
3
Other increases not included in line 2 (itemize) right arrow
3
 
4
Add lines 1, 2, and 3 ..........................
4
13,088,105
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
13,088,105
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 8853.83 BAIRD AGGREGATE BOND FUND P 2017-04-25 2023-10-03
b 4070.04 DOUBLELINE TOTL RET BND P 2018-07-06 2023-10-03
c 1018.00 ISHARES CORE MSCI EAFE ETF P 2019-12-16 2023-09-14
d 100.00 ISHARES CORE MSCI EAFE ETF P 2020-03-12 2023-09-14
e 527.00 ISHARES CORE MSCI EAFE ETF P 2020-03-12 2023-11-21
3347.00 ISHARES CORE MSCI EMERGING P 2023-02-02 2023-09-14
2377.00 ISHARES CORE S&P SMALL CAP E P 2023-02-02 2023-05-04
588.00 ISHARES CORE U S AGGREGATE P 2019-01-02 2023-10-03
1475.00 ISHARES CORE U S AGGREGATE P 2019-02-01 2023-10-03
211.00 ISHARES CORE U S AGGREGATE P 2019-03-25 2023-10-03
6045.00 ISHARES GOLD TRUST P 2022-02-24 2023-06-27
3435.00 ISHARES GOLD TRUST P 2022-02-24 2023-10-03
1528.00 ISHARES GOLD TRUST P 2022-06-15 2023-10-03
5178.00 ISHARES GOLD TRUST P 2023-05-09 2023-10-03
4079.00 ISHARES GOLD TRUST P 2023-09-14 2023-10-03
1023.00 ISHARES INTL AGGREGATE BOND P 2019-10-02 2023-10-03
2341.00 ISHARES JP MORGAN USD EMERGI P 2023-02-02 2023-05-09
303.00 ISHARES S P MID CAP 400 VALU P 2020-03-25 2023-02-02
1855.00 ISHARES S&P 500 GROWTH ETF P 2018-12-24 2023-02-02
414.00 ISHARES S&P 500 GROWTH ETF P 2020-03-04 2023-02-02
3031.00 ISHARES S&P 500 GROWTH ETF P 2020-03-04 2023-06-27
938.00 ISHARES S&P 500 GROWTH ETF P 2020-03-04 2023-11-16
604.00 ISHARES S&P 500 GROWTH ETF P 2020-03-04 2023-11-21
1014.00 ISHARES S&P 500 VALUE ETF P 2019-12-16 2023-02-02
889.00 ISHARES S&P 500 VALUE ETF P 2020-02-04 2023-02-02
54.00 ISHARES S&P 500 VALUE ETF P 2020-03-12 2023-02-02
597.00 ISHARES S&P 500 VALUE ETF P 2020-03-12 2023-11-16
270.00 ISHARES S&P 500 VALUE ETF P 2020-03-12 2023-11-21
209.00 ISHARES S&P 500 VALUE ETF P 2020-03-12 2023-12-01
9011.76 METROPOLITAN WEST T R BOND P 2018-07-06 2023-10-03
1764.51 MFS INTERNATIONAL EQUITY I P 2023-03-10 2023-09-14
203.45 OAKMARK INTERNATIONAL P 2019-07-25 2023-03-10
6242.77 OAKMARK INTERNATIONAL P 2020-03-25 2023-03-10
1790.72 OAKMARK INTERNATIONAL P 2020-06-01 2023-03-10
4891.56 OAKMARK INTERNATIONAL P 2021-08-09 2023-03-10
3107.17 OAKMARK INTERNATIONAL P 2022-09-27 2023-03-10
0.02 OAKMARK INTERNATIONAL P 2022-09-27 2023-03-31
10450.16 PIMCO INTL BND USD HGD I3 P 2019-10-02 2023-10-03
4353.23 PIMCO TATAL RETURN FUND I3 P 2019-07-23 2023-10-03
(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 84,200   98,632 -14,432
b 33,700   42,451 -8,751
c 68,045   66,531 1,514
d 6,684   4,737 1,947
e 35,301   24,962 10,339
165,047   171,199 -6,152
214,594   254,933 -40,339
54,378   62,675 -8,297
136,407   157,788 -21,381
19,513   22,944 -3,431
219,462   218,523 939
118,612   124,173 -5,561
52,762   52,846 -84
178,799   199,795 -20,996
140,850   147,495 -6,645
49,492   56,920 -7,428
198,886   209,637 -10,751
35,058   16,503 18,555
116,863   65,718 51,145
26,081   19,930 6,151
208,933   145,909 63,024
67,484   45,154 22,330
43,834   29,076 14,758
161,381   130,938 30,443
141,487   114,572 26,915
8,594   5,222 3,372
96,636   57,730 38,906
44,050   26,109 17,941
34,863   20,210 14,653
76,600   93,812 -17,212
55,000   52,247 2,753
5,155   4,102 1,053
158,192   97,200 60,992
45,377   33,200 12,177
123,952   142,100 -18,148
78,736   60,000 18,736
       
97,500   117,878 -20,378
35,000   44,925 -9,925
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       -14,432
b       -8,751
c       1,514
d       1,947
e       10,339
      -6,152
      -40,339
      -8,297
      -21,381
      -3,431
      939
      -5,561
      -84
      -20,996
      -6,645
      -7,428
      -10,751
      18,555
      51,145
      6,151
      63,024
      22,330
      14,758
      30,443
      26,915
      3,372
      38,906
      17,941
      14,653
      -17,212
      2,753
      1,053
      60,992
      12,177
      -18,148
      18,736
       
      -20,378
      -9,925
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 2 198,732
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 -63,394
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 7,290
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 7,290
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 7,290
6 Credits/Payments:
a 2023 estimated tax payments and 2022 overpayment credited to 2023 6a 6,458
b Exempt foreign organizations—tax withheld at source...... 6b  
c Tax paid with application for extension of time to file (Form 8868)... 6c 832
d Backup withholding erroneously withheld .......... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 7,290
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment
List of Attached Documents:
// Content
8  
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......right arrow 9 0
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 arrow0 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
 
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. 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 arrow
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 arrowN/A
14
The books are in care ofright arrowJeff Bergman Telephone no.right arrow (785) 291-7263

Located atright arrow1133 SW Topeka BlvdTopekaKS ZIP+4right arrow666290001
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)
 
No
(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
1a(4)
 
No
(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)
 
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
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
 
 
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
Matthew D All President
0.10 		0    
1133 SW Topeka Blvd
Topeka,KS66629
Marlou Wegener COO
20.00 		0    
1133 SW Topeka Blvd
Topeka,KS66629
Jeff Bergman Treasurer
0.10 		0    
1133 SW Topeka Blvd
Topeka,KS66629
Carolyn Banning Director
0.02 		0    
1108 Champions View Drive
Dodge City,KS67801
Jena Lysen Director
0.06 		0    
301 N Main Suite 1700
Wichita,KS67202
Clay Britton Secretary
0.25 		0    
1133 SW Topeka Blvd
Topeka,KS66629
Garrett Love Director
0.06 		0    
1133 SW Topeka Blvd
Topeka,KS66629
2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a) Name and address of each employee paid more than $50,000 (b) Title, and average
hours per week
devoted to position 		(c) Compensation (d) Contributions to
employee benefit
plans and deferred
compensation 		(e) Expense account,
other allowances
NONE
Total number of other employees paid over $50,000...................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
NONE
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 KU Endowment 100,000
2 United Way of Kaw Valley 50,000
3 Kansas Dental Charitable Foundation 40,000
4 Girl Scouts of NE Kansas NW Missouri 35,000
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.........................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
11,476,542
b
Average of monthly cash balances.......................
1b
2,450,045
c
Fair market value of all other assets (see instructions)................
1c
5,691
d
Total (add lines 1a, b, and c).........................
1d
13,932,278
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation) .............
1e
0
2
Acquisition indebtedness applicable to line 1 assets..................
2
 
3
Subtract line 2 from line 1d.........................
3
13,932,278
4
Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
instructions) .............................
4
208,984
5
Net value of noncharitable-use assets. Subtract line 4 from line 3. ............
5
13,723,294
6
Minimum investment return. Enter 5% (0.05) of line 5................
6
686,165
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
686,165
2a
Tax on investment income for 2022 from Part V, line 5.......
2a
7,290
b
Income tax for 2022. (This does not include the tax from Part V.) ...
2b
 
c
Add lines 2a and 2b............................
2c
7,290
3
Distributable amount before adjustments. Subtract line 2c from line 1............
3
678,875
4
Recoveries of amounts treated as qualifying distributions................
4
 
5
Add lines 3 and 4............................
5
678,875
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
678,875
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
768,281
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
768,281
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 7 678,875
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...... 76,397
b From 2019...... 132,690
c From 2020...... 21,570
d From 2021......  
e From 2022......  
f Total of lines 3a through e ........ 230,657
4Qualifying distributions for 2023 from Part
XI, line 4: right arrow$ 768,281
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)........ 		0
d Applied to 2023 distributable amount..... 678,875
e Remaining amount distributed out of corpus 89,406
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 5 320,063
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) ... 		76,397
9 Excess distributions carryover to 2024.
Subtract lines 7 and 8 from line 6a ...... 		243,666
10 Analysis of line 9:
a Excess from 2019.... 132,690
b Excess from 2020.... 21,570
c Excess from 2021....  
d Excess from 2022....  
e Excess from 2023.... 89,406
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).)
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 right arrow
aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
BCBS of Kansas Foundation
1133 SW Topeka Blvd
Topeka,KS66629
(785) 291-7246
marlou.wegener@bcbsks.com
bThe form in which applications should be submitted and information and materials they should include:
Grant Request Application and IRS 501(c)(3) determination letter
cAny submission deadlines:
November 15, 2023
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Must be an IRS Section 501(c)(3) organization and promote health improvement, community health access and/or health education, healthy behaviors, prevention initiatives or direct health services to the uninsured.
aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
BCBS of Kansas Foundation
1133 SW Topeka Blvd
Topeka,KS66629
(785) 291-7246
marlou.wegener@bcbsks.com
bThe form in which applications should be submitted and information and materials they should include:
Healthy Habits for Life Grant Application
cAny submission deadlines:
October 20, 2023
dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Must be a public or private K-12 school and promote healthy lifestyle choices. $2,000 maximum.
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
YMCA of Wichita


402 N Market St
Wichita,KS67202 		None PC Support for the Greater Wichita YMCA camp programs 5,000
Valeo Behavioral Health Care Inc


330 SW Oakley Ave
Topeka,KS66606 		None PC Support for uninsured patients of the clinics. 2,000
Kansas Dental Charitable Foundation


5200 SW Huntoon
Topeka,KS66604 		None PC Support for the Kansas Mission of Mercy dental clinics 40,000
American Red Cross


1221 SW 17th St
Topeka,KS66604 		None PC Support for Disaster Response Program 25,000
United Way of the Plains


245 N Water St
Wichita,KS67202 		None PC Gift to accompany employee contributions 10,000
Salina Area United Way


113 N 7th St Suite 201
Salina,KS67401 		None PC Gift to accompany employee contributions 5,000
United Way of Reno County


111 N Walnut St Suite B
Hutchinson,KS67501 		None PC Gift to accompany employee contributions 5,000
WSU Tech Foundation


4004 N Webb Rd
Wichita,KS67226 		None PF Support for technical college scholarships for students enrolled in health related degree tracks 2,000
Manhattan Area Tech College Foundat


3136 Dickens Ave
Manhattan,KS66503 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Northwest Kansas Tech College Endow


1209 Harrison
Goodland,KS67335 		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Washburn Institute of Technology


5724 SW Huntoon
Topeka,KS66604 		None PC Support for technical college scholarships for students enrolled in health related degree tracks 2,000
Salina Area Technical College Found


2562 Centennial Rd
Salina,KS67401 		None PF Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
North Central Kansas Endowment


3033 US Hwy 24
Beloit,KS67420 		None NC Support for technical college scholarships for students enrolled in health related degree tracks 2,000
Butler Community College Foundation


901 S Haverhill
El Dorado,KS67042 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Colby Community College Foundation


1255 S Range
Colby,KS67701 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Dodge City Community College Founda


2501 N 14th Ave
Dodge City,KS67801 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Fort Scott Community College Endowm


2108 S Horton
Fort Scott,KS66701 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Garden City Community College Endow


801 Campus Dr
Garden City,KS67846 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Highland Community College Foundati


606 W Main
Highland,KS66035 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Hutchinson Community College Endowm


1300 N Plum
Hutchinson,KS67501 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Independence Comm College Foundatio


1057 W College Ave
Independence,KS67301 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Neosho Co Community College Endowme


800 W 14th St
Chanute,KS66720 		None PC Support for community college scholarships for students enrolled in health related degree tracks 2,000
Pratt Community College Endowment


348 NE State Rd 61
Pratt,KS67124 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Baker University


1500 SW 10th St
Topeka,KS66604 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Benedictine College


1020 N Second St
Atchison,KS66002 		None PF Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Bethel College


300 E 27th St
North Newton,KS67117 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Emporia State University Foundation


1127 Chestnut
Emporia,KS66801 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Fort Hays State University Foundati


600 Park St Stroup Hall 129
Hays,KS67601 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Kansas Wesleyan University


100 E Claflin Ave Campus Box 39
Salina,KS67401 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Pittsburg State University Foundati


1701 S Broadway
Pittsburg,KS66762 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 5,000
Washburn University Foundation


1700 SW College Ave
Topeka,KS66621 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Atchison Community Health Clinic


PO Box 27
Atchison,KS66002 		None PC Support for uninsured patients of the clinics 2,000
Community Health Center Cowley


221 W 8th Ave
Winfield,KS67156 		None PC Support for uninsured patients of the clinics. 2,000
Community Health Center SE KS


3011 N Michigan St
Pittsburg,KS66762 		None PF Support for uninsured patients of the clinics 2,000
Flint Hills Community Clinic


401 Houston St Suite C
Manhattan,KS66502 		None PC Support for uninsured patients of the clinics. 2,000
GraceMed Helen Galloway Fam Clinic


1150 N Broadway Ave
Wichita,KS67214 		None PC Support for uninsured patients of the clinics. 2,000
Greeley County Health Services


506 3rd Street
Tribune,KS67879 		None PC Support for uninsured patients of the clinics. 2,000
Guadalupe Clinic Inc


940 S St Francis
Wichita,KS67211 		None PC Support for uninsured patients of the clinics. 2,000
Health Ministries Clinic Inc


720 Medical Center Drive
Newton,KS67114 		None PC Support for uninsured patients of the clinics. 2,000
Agape Health Clinic


314 S Main
Pratt,KS67124 		None PC Support for uninsured patients of the clinic 2,000
Heartland Community Health Center


1312 W 6th
Lawrence,KS66044 		None PF Support for uninsured patients of the clinics. 2,000
Konza Prairie Community Health


361 Grant Ave
Junction City,KS66441 		None PF Support for uninsured patients of the clinics. 2,000
PrairieStar Health Center


2700 E 30th Ave
Hutchinson,KS67502 		None PF Support for uninsured patients of the clinics. 2,000
Rawlins County Dental Clinic


515 State St
Atwood,KS67730 		None PF Support for uninsured patients of the clinics. 2,000
Salina Family Healthcare Center


651 E Prescott
Salina,KS67401 		None PF Support for uninsured patients of the clinics. 2,000
Bert Nash Comm Mental Health Center


200 Maine Suite A
Lawrence,KS66044 		None PF Support for uninsured patients of the clinics. 2,000
Central KS Mental Health Center


809 Elmhurst
Salina,KS67401 		None PF Support for uninsured patients of the clinics. 2,000
Compass Behavioral Health


531 Campus View
Garden City,KS67846 		None PF Support for uninsured patients of the clinics. 2,000
Crosswinds Counseling and Wellness


1000 Lincoln
Emporia,KS66801 		None PF Support for uninsured patients of the clinics. 2,000
Elizabeth Layton Center


PO Box 677
Ottawa,KS66067 		None PF Support for uninsured patients of the clinics. 2,000
Family Service Guidance Center


325 SW Frazier
Topeka,KS66606 		None PF Support for uninsured patients of the clinics. 2,000
Four County Mental Health Center


PO Box 688
Independence,KS67301 		None PF Support for uninsured patients of the clinics. 2,000
Horizons Mental Health Center


1600 N Lorraine Suite 202
Hutchinson,KS67501 		None PF Support for uninsured patients of the clinics. 2,000
Iroquois Center for Human Developme


610 E Grant Ave
Greensburg,KS67054 		None PF Support for uninsured patients of the clinics. 2,000
Kanza Mental Health Guidance


909 South 2nd
Hiawatha,KS66434 		None PF Support for uninsured patients of the clinics. 2,000
Pawnee Mental Health Services


2001 Claflin Rd
Manhattan,KS66502 		None PF Support for uninsured patients of the clinics. 2,000
Prairie View Inc


1901 E 1st St
Newton,KS67114 		None PF Support for uninsured patients of the clinics. 2,000
S Central Mental Health Counseling


520 E Augusta Ave
Parsons,KS67357 		None PF Support for uninsured patients of the clinics. 2,000
Southwest Guidance Center


333 W 15th St
Liberal,KS67901 		None PF Support for uninsured patients of the clinics. 2,000
Spring River Mental Health


6610 SE Quakervale Rd
Riverton,KS66770 		None PF Support for uninsured patients of the clinics. 2,000
The Center for Counseling Consultat


5815 Broadway
Great Bend,KS67530 		None PF Support for uninsured patients of the clinics. 2,000
The Guidance Center Inc


500 Limit Street
Leavenworth,KS66048 		None PF Support for uninsured patients of the clinics. 2,000
High Plains Mental Health Center


208 E 7th
Hays,KS67601 		None PF Support for uninsured patients of the clinics. 2,000
USD108 Washington Elementary School


114 North E Street
Washington,KS66968 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD206 Remington Elementary


200 E Ellis
Potwin,KS67123 		None PC Support for healthy lifestyle programs in K-12 schools. 1,969
USD215 Lakin Middle School


1201 W Kingman
Lakin,KS67860 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD218 Elkhart High School


150 Wildcat Avenue
Elkhart,KS67950 		None PC Support for healthy lifestyle programs in K-12 schools. 1,233
USD234 Fort Scott Middle School


1105 East 12th Street
Fort Scott,KS66701 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD247 Southeast Middle School


206 W Magnolia
Cherokee,KS66724 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD253 Emporia Middle School


2300 Graphic Arts Rd
Emporia,KS66801 		None PC Support for healthy lifestyle programs in K-12 schools. 986
USD257 Iola Senior High School


300 E Jackson
Iola,KS66749 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD266 Pray-Woodman Elementary


605 W Academy Ave
Maize,KS67101 		None PC Support for healthy lifestyle programs in K-12 schools. 1,850
USD268 Cheney High School


100 W 6th Ave
Cheney,KS67025 		None PC Support for healthy lifestyle programs in K-12 schools. 1,928
USD272 Lakeside Elementary


913 7th St
Cawker City,KS67430 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD329 Wabaunsee High School


912 Missouri Street
Alma,KS66401 		None PC Support for healthy lifestyle programs in K-12 schools. 1,800
USD286 Sedan Elementary


404 Sherman St
Sedan,KS67361 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD340 Jefferson West Middle School


210 N Miller Street
Meriden,KS66512 		None PC Support for healthy lifestyle programs in K-12 schools. 1,980
USD345 West Indianola Elementary Sc


4201 NW Brickyard Road
Topeka,KS66436 		None PC Support for healthy lifestyle programs in K-12 schools. 1,911
USD369 Burton Schools


105 E Lincoln PO Box 369
Burrton,KS67020 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD376 Sterling Grade School


218 S 5th Street
Sterling,KS67579 		None PC Support for healthy lifestyle programs in K-12 schools. 798
USD408 Marion High School


701 E Main St
Marion,KS66861 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD409 Central School


301 1/2 N 5th Street
Atchison,KS66002 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD410 Hillsboro MiddleHigh School


400 East Grand St
Hillsboro,KS67063 		None PC Support for healthy lifestyle programs in K-12 schools. 1,982
USD422 Kiowa County Elementary


730 S Main St
Greensburg,KS67054 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD437 Pauline Central Primary Scho


6625 SW Westview
Topeka,KS66619 		None PC Support for healthy lifestyle programs in K-12 schools. 1,269
USD454 Burlingame High School


100 Bloomquist Dr
Burlingame,KS66413 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD460 Hesston Elementary


300 E Amos
Hesston,KS67062 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD446 Independence Sr High


1301 N 10th
Independence,KS67301 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD461 Neodesha High School


1001 N 8th St
Neodesha,KS66757 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD464 Tonganoxie High School


404 E Hwy 24-40
Tonganoxie,KS66086 		None PC Support for healthy lifestyle programs in K-12 schools. 1,500
USD480 MacArthur Elementary School


1100 W 11th Street
Liberal,KS67901 		None PC Support for healthy lifestyle programs in K-12 schools. 1,990
USD497 Sunset Hill Elementary


901 Schwarz
Lawrence,KS66049 		None PC Support for healthy lifestyle programs in K-12 schools. 1,955
USD491 Eudora Middle School


2635 Church Street
Eudora,KS66025 		None PC Support for healthy lifestyle programs in K-12 schools. 1,950
USD499 Galena High School


702 E 7th Street
Galena,KS66739 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD501 Highland Park Central Elemen


2717 SE Illinois Ave
Topeka,KS66605 		None PC Support for healthy lifestyle programs in K-12 schools. 460
USD501 Lowman Hill


1101 SW Garfield Ave
Topeka,KS66604 		None PC Support for healthy lifestyle programs in K-12 schools. 1,533
USD501 Quincy VA Signature Elementa


1500 NE Quincy St
Topeka,KS66608 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD609 Special Purpose School SEKES


2601 Gabriel Ave
Parsons,KS67357 		None PC Support for healthy lifestyle programs in K-12 schools. 1,997
Diocese of Wichita Holy Name Cathol


406 Willow Street
Coffeyville,KS67337 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
St Peter Catholic School


11010 SW Blvd
Wichita,KS67215 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
St Catherine of Siena Catholic Scho


3660 N Ridge Road
Wichita,KS67205 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD211 Eisenhower Elementary


1100 Eisenhower Dr
Norton,KS67654 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD320 West Elementary


1911 6th Street
Wamego,KS66547 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD346 Jayhawk Linn Elementary


415 S 6th St
Mound City,KS66056 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Flint Hills Technical College


3301 W 18th
Emporia,KS66801 		None PF Support for technical college scholarships for students enrolled in health related degree tracks 2,000
Girls on the Run of the Flint Hills


1880 Kimball Ave Ste 8
Manhattan,KS66502 		None PC Support for Girls on the Run program. 5,000
Kansas Fairgrounds Foundation


2000 N Poplar
Hutchinson,KS67502 		None PF Support for AED devices for the Kansas State Fairgrounds 18,500
Caney Valley Agape Network Inc


PO Box 142
Caney,KS67333 		None PF Support for the Healthier Food Access and Well-Being Education program. 5,000
Extension Education Foundation


7001 W 21st St N
Wichita,KS67205 		None PC Support for supplies for the Hypertension and Awareness program. 2,000
Children First CEO Kansas Inc


PO Box 2385
Wichita,KS67201 		None PF Support for Garden to Kitchen program 4,675
Girl Scouts of NE Kansas NW Missour


10561 Barkley St Ste 101
Overland Park,KS66212 		None PF Support the Health Programming for Girl Scouts in 20 Kansas counties. 35,000
Holy Family Medical


114 S Hillside
Wichita,KS67211 		None PF Support for uninsured patients of the clinics. 2,000
Heart of Kansas Family Health Care


1905 19th Street
Great Bend,KS67530 		None PC 2022 Contribution to Heart of KS Family Health Care 2,000
Central Plains Health Care Partners


1102 S Hillside
Wichita,KS67211 		None PC Support for Project Access - Services to the Uninsured 20,000
Community Mental Health Center Craw


911 E Centennial
Pittsburg,KS66762 		None PC Support for uninsured patients of the clinic. 2,000
USD105 Rawlins County JrSr High Sch


100 N 8th Street
Atwood,KS67730 		None PC Support for healthy lifestyle programs in K-12 schools. 1,996
USD207 Eisenhower Elementary School


1 Eisenhower Circle
Fort Leavenworth,KS66027 		None PC Support for healthy lifestyle programs in K-12 schools. 850
USD259 Peterson Elementary School


6710 W Central
Wichita,KS67212 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD259 Wichita High School East


2301 E Douglas Ave
Wichita,KS67211 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD267 Andale Elementary


500 W Rush
Andale,KS67001 		None PC Support for healthy lifestyle programs in K-12 schools. 1,500
USD267 Garden Plain High School


720 N Sedgwick St
Garden Plain,KS67050 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD330 Mission Valley Jr Sr High


12913 Mission Valley Road
Eskridge,KS66423 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD341 Oskaloosa Elementary School


404 Park St
Oskaloosa,KS66066 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD383 Oliver Brown Elementary Scho


4787 Jackies Way
Manhattan,KS66502 		None PC Support for healthy lifestyle programs in K-12 schools. 1,989
USD385 Cottonwood


1747 N Andover Rd
Andover,KS67002 		None PC Support for healthy lifestyle programs in K-12 schools. 1,100
USD416 Louisburg Middle School


505 E Amity
Louisburg,KS66053 		None PC Support for healthy lifestyle programs in K-12 schools. 1,550
USD430 Horton High School


1120 First Ave East
Horton,KS66439 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD434 Overbrook Attendance Center


202 W 7th St
Overbrook,KS66524 		None PC Support for healthy lifestyle programs in K-12 schools. 1,963
USD439 Sedgwick JrSr High


400 W 4th
Sedgwick,KS67135 		None PC Support for healthy lifestyle programs in K-12 schools. 1,683
USD447 Cherryvale High School


700 S Carson St
Cherryvale,KS67335 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD457 Charles Stone Intermediate C


401 N Jennie Barker Rd
Garden City,KS67846 		None PC Support for healthy lifestyle programs in K-12 schools. 1,992
USD458 Gray Hawk Elementary School


16000 Garden Parkway
Basehor,KS66007 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD464 Tonganoxie Elementary School


1180 East St
Tonganoxie,KS66086 		None PC Support for healthy lifestyle programs in K-12 schools. 925
USD467 Wichita County Elementary Sc


109 N Indian Road
Leoti,KS67861 		None PC Support for healthy lifestyle programs in K-12 schools. 1,994
USD501 Randolph Elementary


1400 SW Randolph Ave
Topeka,KS66604 		None PC Support for healthy lifestyle programs in K-12 schools. 1,867
USD501 Ross Elementary


1400 SE 34th Street
Topeka,KS66605 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD501 Whitson Elementary


1725 SW Arnold Ave
Topeka,KS66614 		None PC Support for healthy lifestyle programs in K-12 schools. 1,197
USD501 WIlliams SFA Magnet Elementa


1301 SE Monroe St
Topeka,KS66612 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD504 Oswego JrSr High School


719 4th Street
Oswego,KS67356 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Darrel Dee Rolph Literacy Academy


14533 E Sharon Lane
Wichita,KS67230 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Magdalen Catholic School


2221 N 127th St E
Wichita,KS67226 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Most Pure of Heart of Mary School


1750 SW Stone Ave
Topeka,KS66604 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
TFI Family Services


PO Box 2224
Emporia,KS66801 		None PC Support for wellness for TRAIL Youth Project. 3,210
Big Lakes Developmental Center


1416 Hayes Drive
Manhattan,KS66502 		None PC Support of medical supplies for the Health Services department. 5,000
Leon Senior Center


PO Box 308
Leon,KS67074 		None PC Support for the Leon Senior Center pantry. 5,000
Big Lakes Developmental Center


1416 Hayes Drive
Manhattan,KS66502 		None PC Support for the Health Services department with medical supplies. 5,000
Episcopal Social Services


PO Box 670
Wichita,KS67201 		None PC Support for the Clubhouse Model of Psychiatric Rehabilitation for the Wichita & Hutchinson locations. 4,940
First Tee - Greater Wichita


PO Box 8313
Wichita,KS67208 		None PC Support for the 2023 First Tee program. 30,000
KU Endowment


PO Box 928
Lawrence,KS66044 		None PC Support for the Psychiatry Fellowship Program. 100,000
Wildwood Outdoor Education Center


7095 W 39th St
La Cygne,KS66040 		None PC Support for campers with social-emotional learning boxes. 4,060
Ronald McDonald House Charities Wic


551 N Hillside St Suite 100
Wichita,KS67214 		None PC Support for the Family Care program. 5,000
Special Olympics Kansas


5280 Fox Ridge Dr
Mission,KS66202 		None PC Support for the Healthy Athletes program. 5,000
Eudora Parks Recreation Foundation


1630 Elm St
Eudora,KS66025 		None PC Support for exercise equipment for the Eudora Community Center. 4,994
Independence Comm College Foundatio


1057 West College Ave
Independence,KS67301 		None PC Support for equipment for the EMS program 4,014
Rainbows United Inc


3223 N Oliver St
Wichita,KS67220 		None PC Support for hearing testing equipment. 3,850
Valley Hope Association


PO Box 510
Norton,KS67654 		None PC Support for the Continuing Care Fund. 5,000
United Way of Kaw Valley


1527 SW Fairlawn Rd
Topeka,KS66604 		None PC Gift to accompany employee contributions 50,000
KU School of Nursing - Salina


138 N Sante Fe Ave
Salina,KS67401 		None PC Support for four year university/college scholarships for students enrolled in health related degree tracks 5,000
Barton County Community College


245 NE 30th Road
Great Bend,KS67530 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
Cowley Community College


PO Box 1147
Arkansas City,KS67005 		None PC Support for technical college scholarships for students enrolled in health related degree tracks. 2,000
USD 101 Erie-Galesburg


410 West 3rd St
Erie,KS66733 		None PC Support for healthy lifestyle programs in K-12 schools. 1,956
USD 214 Hickok Elementary School


810 N Missouri
Ulysses,KS67880 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 234 Winfield Scott Elementary


316 W 10th St
Fort Scott,KS66701 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 246 Northeast


1001 E South St
Arma,KS66712 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 251 Northern Heights High Schoo


1208 HWY 56
Allen,KS66833 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 252 Olpe High School


220 W Listerscheid St
Olpe,KS66865 		None PC Support for healthy lifestyle programs in K-12 schools. 1,931
USD 260 Stone Creek Elementary


3012 N Triple Creek Road
Derby,KS67037 		None PC Support for healthy lifestyle programs in K-12 schools. 1,528
USD 261 Tri City Day School


1975 W Grand Ave
Haysville,KS67060 		None PC Support for healthy lifestyle programs in K-12 schools. 1,995
USD 283 Elk Valley Elementary


701 S Delaware
Longton,KS67352 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 283 Elk Valley MSHS


701 S Delaware
Longton,KS67352 		None PC Support for healthy lifestyle programs in K-12 schools. 746
USD 293 Quinter Schools


601 Gove Street
Quinter,KS67752 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 309 Nickerson Elementary


400 N Nickerson St
Nickerson,KS67501 		None PC Support for healthy lifestyle programs in K-12 schools. 1,262
USD 312 Haven High School


400 East 5th PO Box C
Haven,KS67543 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 313 Buhler Grade School


808 N Main
Buhler,KS67522 		None PC Support for healthy lifestyle programs in K-12 schools. 1,100
USD 343 Perry-Lecompton High School


404 Lecompton Road
Perry,KS66073 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 347 Kinsley-Offerle Elementary


325 S Elm Street
Offerle,KS67563 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 350 John-Hudson Elementary


505 N Braodway
St John,KS67576 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 353 Kennedy Elementary


501 N Woodman
Wellington,KS67152 		None PC Support for healthy lifestyle programs in K-12 schools. 1,800
USD 353 Lincoln Elementary


104 South F
Wellington,KS67152 		None PC Support for healthy lifestyle programs in K-12 schools. 1,800
USD 364 Marysville JrSr High School


1011 Walnut
Marysville,KS66508 		None PC Support for healthy lifestyle programs in K-12 schools. 1,935
USD 367 Trojan Elementary School


1901 Parker Ave
Osawatomie,KS66064 		None PC Support for healthy lifestyle programs in K-12 schools. 1,969
USD 380 Frankfort Schools


604 North Kansas Ave
Frankfort,KS66427 		None PC Support for healthy lifestyle programs in K-12 schools. 1,193
USD 386 Madison High School


1500 SW Blvd PO Box 39
Madison,KS66865 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 387 Altoona-Midway Elementary


833 River Street
Altoona,KS66710 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 390 Hamilton Schools


2596 W Road North
Hamilton,KS66853 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 413 Chanute High School


1501 W 35th St
Chanute,KS67301 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 415 Hiawatha High School


600 Red Hawk Drive
Hiawatha,KS66434 		None PC Support for healthy lifestyle programs in K-12 schools. 500
USD 417 Morris County


17 South Wood Street
Council Grove,KS66846 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 431 Hoisington Middle School


360 W 11th
Hoisington,KS67544 		None PC Support for healthy lifestyle programs in K-12 schools. 1,924
USD 435 Eisenhower Elementary Schoo


1101 N Vine
Abilene,KS67410 		None PC Support for healthy lifestyle programs in K-12 schools. 1,800
USD 440 Halstead-Bentley


521 W 6th
Halstead,KS67056 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 450 Shawnee Heights Middle Scho


4335 SW Shawnee Heights Rd
Tecumseh,KS67337 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 445 Community Elementary School


201 S Cline Street
Coffeyville,KS67337 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 469 Lansing Intermediate


509 Ida St
Lansing,KS66043 		None PC Support for healthy lifestyle programs in K-12 schools. 1,900
USD 489 O'Loughlin Elementary Schoo


1401 Hall St
Hays,KS67601 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
USD 493 Park Elementary School


724 Garfield Street
Columbus,KS66725 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Reno County Education Cooperative


2500 E 30th Ave
Hutchinson,KS67502 		None PC Support for healthy lifestyle programs in K-12 schools. 1,912
St Elizabeth Ann Seton Catholic Sch


645 N 119 St
Wichita,KS67235 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
The Independent School


8313 East Douglas Ave
Wichita,KS67207 		None PC Support for healthy lifestyle programs in K-12 schools. 2,000
Scott City Christian School


1104 Elizabeth St
Scott City,KS67871 		None PC Support for healthy lifestyle programs in K-12 schools. 1,850
Total .................................right arrow 3a 767,041
bApproved for future payment
KU Endowment

PO Box 928
Lawrence,KS66044 		None PC Support for the Psychiatry Fellowship Program. 177,111
Total ................................. right arrow 3b 177,111
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 ........... 		         
4 Dividends and interest from securities ....         380,295
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 ............ 		        198,732
9 Net income or (loss) from special events:          
10 Gross profit or (loss) from sales of inventory          
11 Other revenue:
aDonated Services 		        154,580
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e) ..     733,607
13Total. Add line 12, columns (b), (d), and (e)..................
13
733,607
(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.)
4 & 8 Investment Income provides funding to support healthcare activities in Kansas.
11a Donated services comprise all required activities performed on behalf of the Foundation.
Form 990-PF (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)
 
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.
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: 23017518
Software Version: 2023v5.1


Form 990PF - Special Condition Description:
Special Condition Description

TY 2023 AccountingFeesSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Audit Services 1,200 0 0 1,200

TY 2023 InvestmentsOtherSchedule2
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
BAIRD AGGREGATE BOND FUND FMV 425,806 387,161
DOUBLELINE TOTL RET BND FMV 494,770 432,264
OAKMARK INTERNATIONAL FMV    
HARTFORD INTL OPPORT I FMV 413,572 420,514
ISHARES CORE U S AGGREGATE FMV 1,850,051 1,703,229
ISHARES S&P 500 GROWTH ETF FMV 2,203,909 2,639,990
ISHARES S&P 500 VALUE ETF FMV 1,984,181 2,681,210
ISHARES S&P MID CAP 400 GROW FMV 248,589 312,681
ISHARES S P MID CAP 400 VALU FMV 246,361 329,576
ISHARES CORE MSCI EAFE ETF FMV 818,564 883,526
ISHARES INTL AGGREGATE BOND FMV 519,379 485,052
METROPOLITAN WEST T R BOND FMV 487,631 436,006
PIMCO TOTAL RETURN FUND I3 FMV 501,283 434,366
PIMCO INTL BND USD HGD I3 FMV 378,539 354,567
ISHARES GOLD TRUST ETF FMV    
MFS INTERNATIONAL EQUITY I FMV 363,153 403,748
ISHARES CORE MSCI EMERGING FMV 265,366 262,409

TY 2023 OtherAssetsSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
Open Sales - Investment 5,103 5,691 5,691


TY 2023 OtherExpensesSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Administrative Purchased Services 154,580      
Not-for-Profit Filing Fee 40     40


TY 2023 OtherIncomeSchedule2
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
Donated Services 154,580    


TY 2023 OtherLiabilitiesSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Description Beginning of Year - Book Value End of Year - Book Value
Federal Excise Tax Payable 783 832


TY 2023 OtherProfessionalFeesSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Investment Fees 54,564 54,564 0 0


TY 2023 TaxesSchedule
Name:
Blue Cross and Blue Shield of Kansas
 
Foundation Inc
EIN:
20-3085640
Software ID:
23017518
Software Version:
2023v5.1
Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
Investment Income Excise Tax 7,290