| Return Reference | Explanation |
|---|---|
| Form 990, Part V, Line 15 | THE INDIVIDUALS WHO RECEIVE RENUMERATION ABOVE $1M ARE COVERED EMPLOYEES OF BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY (EIN 38-2069753). THEREFORE, THE RENUMERATION OF THE COVERED EMPLOYEES IS SUBJECT TO LIMITATION UNDER IRC SECTION 162(M)(6) AND NO AMOUNTS ARE SUBJECT TO EXCISE TAX UNDER IRC SECTION 4960. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | 100% STOCKHOLDER BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY, AS A 100% STOCKHOLDER, HAS THE RIGHT TO APPOINT BOARD DIRECTORS. BCN'S MEMBERS ELECT THE REMAINING BOARD DIRECTORS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | NO REVIEW WAS CONDUCTED BY THE GOVERNING BODY. THE Sr. Director of Corporate Tax, Rachel Allen, REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| Form 990, Part VI, Line 12c Conflict of interest policy | EACH BOARD MEMBER AND CORPORATE OFFICER ANNUALLY COMPLETES A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. THE QUESTIONNAIRES ARE REVIEWED TO IDENTIFY ANY POSSIBLE CONFLICTS AND DETERMINE HOW TO RESOLVE THEM. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE COMPENSATION RECOMMENDATIONS FOR BLUE CARE NETWORK'S OFFICERS ARE REVIEWED AND APPROVED BY BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY (BCBSM), PERSONNEL AND COMPENSATION SUBCOMMITTEE AND EXECUTIVE COMMITTEE. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS - NO DOCUMENTS AVAILABLE TO THE PUBLIC; CONFLICT OF INTEREST POLICY - NO DOCUMENTS AVAILABLE TO THE PUBLIC; AUDITED STATUTORY - BASIS FINANCIAL STATEMENTS - ARE AVAILABLE TO THE PUBLIC FROM THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS AND THE DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES. |
| Form 990, Part VII, Section A Part VII - Compensation | RELATED ORGANIZATIONS: BLUE CARE NETWORK OF MICHIGAN HAS ASSIGNED EMPLOYEES FROM ITS ULTIMATE PARENT, BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY, (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 BLUE CARE NETWORK, IS INCLUDED ON FORM 990, PART VII, SECTION A. CURRENT OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES THAT ARE ASSIGNED 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. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | GAAP to STAT adjustments - -27823258; Total - -27823258; |
| Form 990, Part XII, Line 2b | FORM 990 IS FILED BASED ON THE GAAP METHOD OF ACCOUNTING, ADJUSTED TO TAX. IN 2024, SEPARATE STAT BASIS AUDITED FINANCIAL STATEMENTS WERE ISSUED BY INDEPENDENT AUDITORS. THE BCN AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ANNUAL INDEPENDENT AUDIT. |
| Software ID: | 24020961 |
| Software Version: | 2024v5.1 |