Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
BLUE CARE NETWORK OF MICHIGAN |
382359234 | 9 | Yes | 964,172 | 0 | |
|
Total 1
|
964,172 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section A, Line 3b Qualified Under 501C(4)(5) Or (6) | DETERMINATION MADE BY ORGANIZATION THE BLUE CROSS BLUE SHIELD OF MICHIGAN FOUNDATION CONFIRMS THAT BLUE CARE NETWORK OF MICHIGAN HAS MET THE SUPPORT TEST BY REVIEWING THE ANNUAL 990 AND THE STATE OF MICHIGAN ANNUAL REPORT EACH YEAR. |
| Schedule A, Part IV, Section A, Line 3c Support To Org. Used Exclusively Sec. 170(c)(2)(B) Purposes | CONTROLS FOR 170(C)(2)(B) PURPOSES GRANTS MADE BY THE BLUE CROSS BLUE SHIELD OF MICHIGAN FOUNDATION DURING 2023 WERE AWARDED TO SUCH ORGANIZATIONS USED EXCLUSIVELY FOR SECTION 170 (C)(2)(B). EACH GRANT APPLICANT IS REQUIRED TO SUBMIT A PROOF OF INTERNAL REVENUE TAX EXEMPT STATUS AND THE GRANT COMMITTEE OF THE BOARD IS RESPONSIBLE FOR APPROVING EACH GRANT TO QUALIFYING ORGANIZATIONS. |
| Software ID: | 23017437 |
| Software Version: | 2023v5.1 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 1 (continued) | OUR WORK REQUIRES DEEP RELATIONSHIPS WITH GRANTEES TO UNDERSTAND AND ENCOURAGE THEIR WORK AND COORDINATE OUR INVESTMENTS IN INTERVENTIONS WITH ORGANIZATIONS THAT ALSO INVEST IN COMMUNITY HEALTH. IN 2023, THE BLUE CROSS BLUE SHIELD OF MICHIGAN FOUNDATION DEMONSTRATED THAT WE REMAIN READY TO HELP IMPROVE THE STATE OF HEALTH IN MICHIGAN BY FOCUSING ON STRENGTHENING POPULATION HEALTH IN COMMUNITIES. WE WORKED WITH OUR GRANTEES AND FUNDING PARTNERS TO FOCUS ON COMMUNITY-INSPIRED INITIATIVES AND PROGRAMS THAT GO BEYOND TREATING ILLNESS AND SUPPORT THE HEALTH OF MICHIGANDERS. AS WE WORK WITH ORGANIZATIONS THROUGHOUT MICHIGAN TO GALVANIZE POPULATION-FOCUSED HEALTH RESEARCH AND PROGRAMS, WE ARE FORTUNATE TO HAVE A MISSION AND VISION THAT ALLOW US TO ADDRESS ALL ASPECTS OF HEALTH CARE THROUGH RESEARCH AND A WIDE VARIETY OF INTERVENTIONS. THROUGH OUR FUNDING AND GRANT-MAKING PARTNERSHIPS, WE PROMOTE IMPROVED HEALTHCARE PROCESSES, FOSTER INNOVATIONS TO DRIVE HEALTHY COMMUNITIES, PROVIDE ACCESS TO HEALTH CARE, AND HELP ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. WORKING WITH OTHER FUNDERS IS VITAL BECAUSE IT FACILITATES INCREASED SUPPORT TO ORGANIZATIONS THAT ARE ANSWERING THE NEEDS OF THEIR COMMUNITIES. WE BEGAN 2023 BY COLLABORATING WITH THE SOCIAL MISSION TEAM AT BLUE CROSS BLUE SHIELD OF MICHIGAN, ADDRESSING MATERNAL HEALTH EQUITY TO REDUCE MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY. THROUGH OUR FUNDING PARTNERSHIP WITH SOCIAL MISSION, WE INVESTED IN SEVEN INNOVATIVE PROGRAMS IN FIVE MICHIGAN REGIONS TO ADDRESS THE BEHAVIORAL HEALTH CARE NEEDS OF EXPECTANT PARENTS, INCREASE COMMUNITY RESOURCE NAVIGATION FOR PREGNANT PEOPLE AND INCREASE ACCESS TO SERVICES AND SUPPORT FOR PREGNANT PEOPLE WITH SUBSTANCE USE DISORDER. IN A NINE-FUNDER COLLABORATIVE, WE ADDRESSED THE MENTAL HEALTH OF BLACK YOUTH AND ADULTS BY SUPPORTING SEVEN BLACK-LED COMMUNITY ORGANIZATIONS TO BETTER CONNECT THEM TO MENTAL HEALTH RESOURCES, CASE MANAGEMENT, REFERRALS TO PRIMARY CARE CLINICS AND OTHER INNOVATIVE SOLUTIONS. SENIORS REPRESENT A VULNERABLE AND GROWING PART OF OUR POPULATION, AND IN 2023 WE PARTICIPATED IN A FOUR-PARTNER WASHTENAW COUNTY FUNDING COLLABORATION SUPPORTING PROGRAMS TO CREATE COMMUNITY CONNECTIONS ENHANCING SENIORS' WELL-BEING. THE BCBSM FOUNDATION CONTINUES TO ADDRESS THE HEALTH OF CHILDREN. IN 2023, WE FOCUSED OUR EFFORTS ON CHILD ABUSE AWARENESS AND PREVENTION BY SUPPORTING FOUR ORGANIZATIONS THAT PROVIDE CRITICAL CHILD ABUSE SERVICES AND AWARENESS AND PREVENTION PROGRAMS IN MICHIGAN. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE ORGANIZATION IS FORMED AS A NON-PROFIT STOCK CORPORATION WHOLLY OWNED BY BLUE CARE NETWORK OF MICHIGAN (EIN 38-2359234), A HEALTH MAINTENANCE ORGANIZATION, WHICH IS ORGANIZED AND EXEMPT UNDER SECTION 501(C)(4). |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | ELECTION OF MEMBERS AND THEIR RIGHTS SHAREHOLDERS HAVE THE POWER TO ELECT THE BOARD OF DIRECTORS, PRESIDENT, VICE PRESIDENT, AND CHAIRPERSON. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | ELECTION OF MEMBERS AND THEIR RIGHTS SHAREHOLDERS HAVE THE POWER TO ELECT THE BOARD OF DIRECTORS, PRESIDENT, VICE PRESIDENT, AND CHAIRPERSON. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE ORGANIZATION'S PROCESS FOR FORM 990 IS THE RETURN IS PREPARED BY AN OUTSIDE FIRM, EY, AND REVIEWED BY THE MANAGEMENT TEAM OF THE FOUNDATION. THE MANAGEMENT TEAM REQUESTS SUPPORT FROM VARIOUS SOURCES AND PROVIDES TO EY AS NEEDED. THE CURRENT EXECUTIVE DIRECTOR AND CEO, AUDREY J. HARVEY, HAD THE OPPORTUNITY TO REVIEW THE RETURN BEFORE IT WAS FILED WITH THE INTERNAL REVENUE SERVICE. THE RETURN IS NOT PRESENTED TO THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE MEMBER WITH THE CONFLICT WILL ABSTAIN THEIR VOTE ON ISSUES RELATED TO THE CONFLICTING ORGANIZATION. MEMBERS RECEIVE ANNUALLY DISCLOSURE CONFLICT FORMS AND ARE REQUIRED TO REVIEW, UPDATE OR SUBMIT A NEW DISCLOSURE FORM. WHEN BOARD FORMS ARE SUBMITTED, THEY ARE THEN APPROVED BY THE BOARD CHAIR AND FINANCE COMMITTEE CHAIR. IF ANY CONFLICT IS TO BE RESOLVED THE BOARD CHAIR AND FINANCE COMMITTEE CHAIR WILL WORK WITH THE BOARD MEMBER TO RESOLVE THE CONFLICT. UPDATED FORMS WITH ALL CONFLICTS RESOLVED ARE PRESENTED ANNUALLY TO THE ENTIRE BOARD FOR APPROVAL. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE COMPENSATION RECOMMENDATIONS FOR BCBSM FOUNDATION'S OFFICERS OR KEY EMPLOYEES ARE REVIEWED AND APPROVED BY BLUE CROSS BLUE SHIELD OF MICHIGAN (BCBSM), PERSONNEL AND COMPENSATION SUBCOMMITTEE AND EXECUTIVE COMMITTEE. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS - DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE OFFICE OF THE FOUNDATION. CONFLICT OF INTEREST POLICY - DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE OFFICE OF THE FOUNDATION. AUDITED FINANCIALS ARE PUBLISHED IN THE ANNUAL REPORT WHICH IS AVAILABLE ON THE FOUNDATION'S WEBSITE AND AVAILABLE UPON REQUEST. |
| Additional information | RELATED ORGANIZATIONS - BLUE CROSS BLUE SHIELD OF MICHIGAN FOUNDATION HAS ASSIGNED EMPLOYEES FROM ITS ULTIMATE PARENT, BLUE CROSS BLUE SHIELD OF MICHIGAN, (BCBSM). THE EXPENSES ASSOCIATED WITH THESE INDIVIDUALS ARE REFLECTED ON FORM 990, PART IX, LINE 5 AND LINE 7. PAYMENTS WERE MADE TO BCBSM THROUGH AN INTERCOMPANY AGREEMENT. NO EMPLOYEES WERE REFLECTED ON PART V, LINE 2A SINCE THE ACTUAL W-2'S AND 941'S ARE REPORTED BY BCBSM. COMPENSATION PAID TO THE EXECUTIVE DIRECTOR AND CEO, OFFICERS AS WELL AS FORMER OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES, BY THE PARENT COMPANY AND REIMBURSED BY THE FOUNDATION, IS INCLUDED ON FORM 990, PART VII, SECTION A. COMPENSATION PAID TO OTHER BOARD MEMBERS THAT WAS NOT REIMBURSED BY THE FOUNDATION IS REFLECTED ON FORM 990, PART VII, SECTION A. THEIR COMPLETE COMPENSATION AS PAID BY THE PARENT IS REPORTED IN COLUMN E. COMPENSATION AMOUNTS REPORTED ON PART IX LINE 5 AND 7 INCLUDE PENSION PLAN CONTRIBUTIONS, OTHER EMPLOYEE BENEFITS, AND PAYROLL TAXES THAT WOULD OTHERWISE BE REPORTED ON LINES 8, 9, AND 10, RESPECTIVELY. CURRENT OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES THAT ARE EMPLOYED BY THE FILING ORGANIZATION OR BY A RELATED ORGANIZATION SPLIT THEIR TIME AS NEEDED BETWEEN THE FILING ENTITY AND RELATED ORGANIZATIONS. A PER WEEK ESTIMATE FOR THE FILING ORGANIZATION AND RELATED ORGANIZATIONS IS REFLECTED ON THE FILING ENTITY'S PART VII, COLUMN B, WITH THE COMPLETE REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION AND RELATED ORGANIZATIONS REFLECTED IN COLUMN D AND COLUMN E AS APPROPRIATE. |
| Software ID: | 23017437 |
| Software Version: | 2023v5.1 |