2023-11-15T19:39:50+00:00 2022-12-31 346565596 ERNST & YOUNG US LLP 200 CLARENDON STREET BOSTON MA 021165072 990 2022-01-01 382359234 Blue Care Network of Michigan BLUE 2487996363 600 E LAFAYETTE BLVD MC 1816 DETROIT MI 48226 DAVID JACKSON CORPORATE TAX ADVISOR 3132259628 2023-11-16 true WAYMOND HARRIS 999009999 Mike A Cincotta P01595811 6172662000 2023-11-15 2022 2023-04-26 12:10:37Z WAYMOND HARRIS 600 E LAFAYETTE BLVD MC 1816 DETROIT MI 48226 4285835542 false X WWW.BCBSM.COM X 1981 MI BLUE CARE NETWORK PROVIDES HEALTH CARE SERVICES TO SUBSCRIBERS THROUGH CONTRACTS IT HAS ENTERED INTO WITH VARIOUS PHYSICIAN GROUPS, HOSPITALS, AND OTHER HEALTH CARE PROVIDERS. 14 11 0 0 723418 587254 0 3923824150 4198253676 144847773 -44257010 422 0 4068672345 4153996666 0 3594681725 3639672391 236201539 271876450 0 0 320840638 330392275 4151723902 4241941116 -83051557 -87944450 2791773564 2627985022 1000393839 934519698 1791379725 1693465324 BLUE CARE NETWORK PROVIDES HEALTH CARE SERVICES TO SUBSCRIBERS THROUGH CONTRACTS IT HAS ENTERED INTO WITH VARIOUS PHYSICIAN GROUPS, HOSPITALS, AND OTHER HEALTH CARE PROVIDERS. false false 3775878010 4147448730 BCN'S PROGRAM SERVICE ACCOMPLISHMENTS SUPPORT PEOPLE HELPING PEOPLE TO PROMOTE HEALTH AND PEACE OF MIND THROUGH HIGH QUALITY CARE AND SERVICE, PARTNERING TO MANTAIN AND IMPROVE HEALTH. BCN 2022. HEALTH CARE SERVICES-MEMBER BASED AS WELL AS FEE-FOR-SERVICE, 663,057 MEMBERS AND 6,906,839 AMBULATORY ENCOUNTERS. 2022 COMMUNITY BENEFIT - BCN PARTIPATED IN NEARLY 36 SEPARATE ACTIVITIES, TOTALING OVER 243,000 THROUGH COMMUNITY OUTREACH AND CHARITABLE CONTRIBUTIONS TO BENEFIT THE GENERAL PUBLIC AND SUPPORT WELLNESS, INCLUDING CONNECTIONS WITH INDIVIDUALS AND SMALL BUSINESSES, SUPPORTING MULTIPLE HEALTH INITIATIVES. 2022 SOCIAL MISSION AND PUBLIC AFFAIRS - BCN IS COMMITTED TO IMPROVE THE HEALTH OF MICHIGAN RESIDENTS, WITH SPECIAL EMPHASIS ON THE HEALTH AND WELLNESS OF CHILDREN AND SENIORS, WHILE REDUCING THE COST OF HEALTH CARE PROACTIVE INITIATIVES INCLUDE NUTRITION AND HEALTHY LIFESTYLES, HEALTHY AGING AND MENTAL HEALTH PRINCIPLES INCLUDE EMPOWERING INDIVIDUALS AND COMMUNITIES TO TAKE ACTIVE ROLES IN CREATING A CULTURE OF HEALTH AND PROVIDING LEADERSHIP AS AN INFORMED CONVENER & EDUCATOR TO HELP RAISE AWARENESS AND UNDERSTANDING OF IMPORTANT HEALTH ISSUES AND EFFECTIVE APPROACHES. 27654800 50804946 PROGRAM EXPENSES RELATED TO SELF-FUNDED BUSINESS AS A RESULT OF A RECENT CHANGE IN THE MICHIGAN INSURANCE CODE. HEALTH MAINTENANCE ORGANIZATIONS ARE PERMITTED TO DIRECTLY CONTRACT WITH GROUPS TO ADMINISTER SELF-FUNDED GROUP HEALTH PLANS. EFFECTIVE JANUARY 1, 2018 BCN BEGAN PROVIDING ADMINISTERING SERVICE ONLY (ASO) PLANS THAT ARE SUBSTANTIALLY RELATED TO BCN'S EXEMPT PURPOSES. AS A 501(C)(4) ENTITY BCN IS PROVIDING THE SAME CLAIMS PROCESSING, ADMINISTRATIVE SERVICES AND PROVIDER NETWORK FOR ITS ASO CUSTOMERS AS IT DOES FOR THE UNDERWRITTEN CUSTOMERS. 3803532810 false false false false false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false true X 15457 0 true 0 true true false false false false false false false X 14 11 false false false false true true false true true false false false true true true true true true true false MI X DAVID JACKSON 3132259628 600 E LAFAYETTE BLVD MAILCODE 1816 DETROIT MI 48226 Kathryn Levine VP & Pres & CEO BCN 23.0 25.0 X X 0 1705920 -86561 Paul Mozak Director & Officer - EVP & CFO 2.0 48.0 X X 0 3663619 -401626 Bruce Wolf Director 1.0 1.0 X 69275 0 0 David Bing Director 1.0 0.0 X 34572 0 0 Gregory Sudderth Director 2.0 4.0 X 63130 225000 0 Julie Angott Director 1.0 0.0 X 71039 0 0 Kenneth Dallafior EVP President Hlth Plan Bus 1.0 44.0 X 0 6953951 -327591 Mary Ann Weaver Director 1.0 0.0 X 62072 0 0 Melvin Larsen Director 1.0 1.0 X 69000 0 255487 Paula Manderfield Director 1.0 0.0 X 70116 0 0 Richard Posthumus Director 1.0 0.0 X 62189 0 0 Robert Paul Kelch Director 1.0 1.0 X 62072 0 0 Sarah Doyle Director 1.0 1.0 X 62000 145000 0 Shauna Diggs Director 1.0 1.0 X 0 45000 0 Valeriah A Holmon Director 1.0 1.0 X 63042 0 0 William Black Director 1.0 1.0 X 108456 140000 0 Sheela Manyam Sr Dir Corp Perfrmnce & Admin 65.0 0.0 X 0 263830 -53079 Tiffany Otis-Albert Officer - SVP 0.0 60.0 X 0 1947453 -454233 Waymond Harris Officer - SVP & Treasurer 20.0 30.0 X 0 1804121 26285 Rajesh Vunnam Sr Director BCN IT 30.0 20.0 X 0 417649 -100547 Carl Siebers VP Claims Operations 0.0 0.0 X 0 653934 -130496 James Kallas Director 0.0 0.0 X 0 260056 1421 Kevin Klobucar EVP Health Care Value 0.0 0.0 X 0 571035 0 Lisa Hardy VP Bus Perf & Execution BCN 0.0 0.0 X 0 613802 -240957 Marc Keshishian MD VP HL & CLN AFS & BCN SVP CMO 0.0 0.0 X 0 296744 0 Mark Bartlett Former Director 0.0 0.0 X 0 9154283 -893180 Phillip Gillespie VP Bus & Program Dev &Reg Exec 0.0 0.0 X 0 500120 -126641 796963 29361517 -2531718 0 true true false REGENTS OF THE UNIVERSITY OF MICHIGAN 700 KMS PL ANN ARBOR MI 481081652 HEALTH CARE 529313788 HENRY FORD HEALTH SYSTEM PO BOX 670884 DETROIT MI 482020000 HEALTH CARE 139624836 SPECTRUM HEALTH HOSPITALS PO BOX 2127 Grand Rapids MI 495012127 HEALTH CARE 138511037 WILLIAM BEAUMONT HOSPITAL PO BOX 5042 TROY MI 480075042 HEALTH CARE 124240331 ST JOSEPH MERCY HOSPITAL PO BOX 776499 CHICAGO IL 606776499 HEALTH CARE 104284227 1875 0 PREPAID HEALTH CARE 524298 4151678080 4151678080 SELF-FUNDED REVENUE 524292 46561596 46561596 NON-SUBSCRIBER REVENUE 524298 14000 14000 0 0 0 0 4198253676 -45025781 -425053 -44600728 0 0 132607647 131838876 768771 0 768771 1148471 -379700 0 0 0 0 0 4153996666 4198253676 723418 -44980428 3639672391 3639672391 286221 286221 257938060 93082708 164855352 13652169 4937604 8714565 5942009 1823914 4118095 26959418 9749487 17209931 0 0 0 0 8589328 3106517 5482811 9759869 3529869 6230000 7653539 2768069 4885470 2367005 856079 1510926 57905788 20942886 36962902 2704790 896870 1807920 CLAIMS ADJUSTMENTS 51439846 19798557 31641289 AGENT/BROKER FEES 86801843 86801843 LICENSES & FEES 33270331 1754313 31516018 STATE & LOCAL TAXES 16238113 16238113 20760396 327325 20433071 0 4241941116 3803532810 438408306 0 162013502 75821671 284003795 277159000 0 0 0 0 0 0 0 0 2345756067 2275004151 200 200 0 0 0 2791773564 2627985022 437699623 409661230 110350875 107907176 0 0 50044625 50044625 402298716 366906667 1000393839 934519698 10000 10000 15703045 152249736 1775666680 1541205588 1791379725 1693465324 2791773564 2627985022 X -87944450 4756132 -14726083 X false true X true false IBNR LIABILITIES 366906667 DEFERRED TAXES 366906667 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote ON EXAMINATION OF ALL RELEVANT FACTS AND CIRCUMSTANCES FOR THE COMPANY'S TAX ISSUES, IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED DECEMBER 31, 2022. false true false false false false false false false Paul Mozak Director & Officer - EVP & CFO 0 741770 0 2710630 0 211219 0 -426334 0 24708 0 3261993 0 0 Kathryn Levine VP & Pres & CEO BCN 0 612174 0 922035 0 171711 0 -133943 0 47382 0 1619359 0 0 Kenneth Dallafior EVP President Hlth Plan Bus 0 992847 0 4080743 0 1880361 0 -410000 0 82409 0 6626360 0 0 William Black Director 108456 140000 0 0 0 0 0 0 0 0 108456 140000 0 0 Melvin Larsen Director 69000 0 0 0 0 0 255487 0 0 0 324487 0 0 0 Gregory Sudderth Director 63130 225000 0 0 0 0 0 0 0 0 63130 225000 0 0 Sarah Doyle Director 62000 145000 0 0 0 0 0 0 0 0 62000 145000 0 0 Waymond Harris Officer - SVP & Treasurer 0 550769 0 1125124 0 128228 0 2577 0 23708 0 1830406 0 0 Tiffany Otis-Albert Officer - SVP 0 619025 0 1170706 0 157722 0 -479978 0 25745 0 1493220 0 0 Sheela Manyam Sr Dir Corp Perfrmnce & Admin 0 192655 0 60789 0 10386 0 -86164 0 33085 0 210751 0 0 Rajesh Vunnam Sr Director BCN IT 0 304054 0 93258 0 20337 0 -112216 0 11669 0 317102 0 0 Mark Bartlett Former Director 0 38163 0 4080743 0 5035377 0 -937564 0 44384 0 8261103 0 0 Kevin Klobucar EVP Health Care Value 0 0 0 566798 0 4237 0 0 0 0 0 571035 0 0 Carl Siebers VP Claims Operations 0 296177 0 321385 0 36372 0 -159838 0 29342 0 523438 0 0 Phillip Gillespie VP Bus & Program Dev &Reg Exec 0 221063 0 243968 0 35089 0 -153486 0 26845 0 373479 0 0 Lisa Hardy VP Bus Perf & Execution BCN 0 282105 0 300300 0 31397 0 -278312 0 37355 0 372845 0 0 Marc Keshishian MD VP HL & CLN AFS & BCN SVP CMO 0 0 0 287659 0 9085 0 0 0 0 0 296744 0 0 James Kallas Director 0 0 0 188896 0 71160 0 970 0 451 0 261477 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE COMPENSATION STRATEGY IS DESIGNED TO ENSURE THAT AN APPROPRIATE BALANCE EXISTS BETWEEN INTERNAL EQUITY CONSIDERATIONS AND MARKET COMPENSATION FACTORS AND PRACTICES. MARKET DATA FROM THIRD PARTY EXECUTIVE COMPENSATION SURVEYS AND INDEPENDENT COMPENSATION CONSULTANTS ARE USED TO DETERMINE THE PRESIDENT/CEO'S COMPENSATION. THE COMPENSATION RECOMMENDATIONS ARE REVIEWED BY BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY (BCBSM), PERSONNEL AND COMPENSATION SUBCOMMITTEE AND EXECUTIVE COMMITTEE. THE ORGANIZATION'S PRESIDENT/CEO IS ALSO AN EXECUTIVE OF THE PARENT, BCBSM, AND AS SUCH, THE COMPENSATION IS SUBJECT TO REVIEW BY THE BCBSM EXECUTIVE COMMITTEE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE NONQUALIFIED PENSION PLAN PROVIDES RETIREMENT BENEFITS FOR A GROUP OF KEY EMPLOYEES UNDER NONQUALIFIED DEFINED PENSION PLANS. THE GENERAL PURPOSE OF THE PLAN IS TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO PARTICIPANTS WHO ARE SUBJECT TO THE CONTRIBUTION AND BENEFIT LIMITATION APPLICABLE TO TAX-QUALIFIED PLANS UNDER IRC. BENEFITS UNDER THE PLAN ARE FUNDED AND PAID OUT OF THE GENERAL ASSETS OF THE CORPORATION. THESE AMOUNTS ARE ACCRUED AND ELIGIBLE TO BE PAID OUT WITHIN 2022. MARK BARTLETT - ($68,602) PHILLIP GILLESPIE- ($368) CARL SIEBERS - $4,220 LISA HARDY - ($9,761) KENNETH DALLAFIOR - $234,616 KATHRYN LEVINE - $73,357 RAJESH VUNNAM - ($16,749) PAUL MOZAK $51,922 TIFFANY OTIS-ALBERT - ($56,437) WAYMOND HARRIS - $17,801 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 TAX DIRECTOR, MATTHEW ERIKSEN, 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 15a Process to establish compensation of top management official THE COMPENSATION STRATEGY IS DESIGNED TO ENSURE THAT AN APPROPRIATE BALANCE EXISTS BETWEEN INTERNAL EQUITY CONSIDERATIONS AND MARKET COMPENSATION FACTORS AND PRACTICES. MARKET DATA FROM THIRD PARTY EXECUTIVE COMPENSATION SURVEYS AND INDEPENDENT COMPENSATION CONSULTANTS ARE USED TO DETERMINE THE PRESIDENT/CEO'S COMPENSATION. THE COMPENSATION RECOMMENDATIONS ARE REVIEWED BY BLUE CROSS BLUE SHIELD OF MICHIGAN MUTUAL INSURANCE COMPANY (BCBSM), PERSONNEL AND COMPENSATION SUBCOMMITTEE AND EXECUTIVE COMMITTEE. THE ORGANIZATION'S PRESIDENT/CEO IS ALSO AN EXECUTIVE OF THE PARENT, BCBSM, AND AS SUCH, THE COMPENSATION IS SUBJECT TO REVIEW BY THE BCBSM EXECUTIVE COMMITTEE. 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 FINANCIALS - AUDITED STATUTORY - BASIS FINANCIAL STATEMENTS ARE AVAILABLE 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 - -14726083; Form 990, Part XII, Line 2b FORM 990 IS FILED BASED ON THE GAAP METHOD OF ACCOUNTING, ADJUSTED TO TAX. IN 2022, SEPARATE GAAP BASIS AUDITED FINANCIAL STATEMENTS WERE ISSUED BY INDEPENDENT AUDITORS. THE BCN AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE ANNUAL INDEPENDENT AUDIT. BCBS FOUNDATION OF MICHIGAN 600 LAFAYETTE BLVD EAST DETROIT MI 48226 382338506 GRANTS MI 501(c)(3) Type I BCN true BLUE CROSS BLUE SHIELD OF MICHIGAN 00 LAFAYETTE EAST DETROIT MI 48226 382069753 INSURANCE MI N/A C Corporation false ACCIDENT FUND INSURANCE CO-AMERICA 200 N GRAND RIVER LANSING MI 48901 383207001 INSURANCE MI N/A C Corporation false LIFESECURE INSURANCE COMPANY 10559 CITATION DR 300 BRIGHTON MI 48116 750956156 INSURANCE MI N/A C Corporation false BLUE CROSS COMPLETE OF MICHIGAN LLC 200 STEVENS DR PHILADELPHIA PA 19113 472582248 HMO MI N/A C Corporation false WOODWARD STRAITS INSURANCE COMPANY 600 EAST LAFAYETTE DETROIT MI 48226 472221114 INSURANCE MI N/A C Corporation false AMERIHEALTH CARITAS HEALTH PLAN 200 STEVENS DR PHILADELPHIA PA 19113 232859523 CARE MGT PA N/A C Corporation false COBX CO 1000 TOWN CENTER SOUTHFIELD MI 48075 813438452 CARE MGT MI N/A C Corporation false TESSELLATE LLC 600 E LAFAYETTE DETROIT MI 48226 453742721 SERVICE DE N/A C Corporation false false false true false false false false false false false true true true true true true true true true