2012-11-15T08:06:51-06:00 2011-12-31 990 2011-01-01 382359234 BLUE CARE NETWORK OF MICHIGAN BLUE 2487996730 20500 CIVIC CENTER DR MC C455 SOUTHFIELD MI 48076 SUSAN A KLUGE 2487996730 2012-11-15 2012-11-15 2011 2016-02-24 21:20:13Z SUSAN A KLUGE CFO TREASURER 20500 CIVIC CENTER DR SOUTHFIELD MI 48076 4851256544 false X WWW.MIBCN.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. 18 16 0 38645489 1271153 0 2384648997 2647081152 26364737 25643482 10191497 14902206 2421205231 2687626840 0 2040595116 2226539279 107105368 116051229 0 0 161766184 176087166 2309466668 2518677674 111738563 168949166 1069174508 1309143675 519450879 597526529 549723629 711617146 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 2388623520 2667500527 HEALTH CARE SERVICES-MEMBER BASED AS WELL AS FEE-FOR-SERVICE; 569,229 MEMBERS AND 4,640,483 AMBULATORY ENCOUNTERS. 2388623520 false false false false false false false false false true 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 true false false false false false true true true false true 8293 0 true 0 true true false false false false false false false false false X 18 16 true false false false true true false true true false false false true true true true true true true false X LISA ZIEGLER FINANCE SUPERVISOR 2484553403 20500 CIVIC CENTER DR MC C455 SOUTHFIELD MI 48076 X MARK R BARTLETT CPA 1.00 X 0 1436686 443053 KEVIN JAMES KLOBUCAR CPA 40.00 X X 0 521806 311237 GREGORY A SUDDERTH 1.00 X X 11800 98947 73211 WILLIAM H BLACK 1.00 X X 36550 66239 0 SARAH DOYLE 1.00 X 9650 50989 0 MELVIN L LARSEN 1.00 X 24300 29374 67167 SHAUNA RYDER DIGGS MD 1.00 X 24300 25852 0 D BONTA HISCOE MD 1.00 X 28300 3197 0 DIANA L WATSON 1.00 X 25550 72 0 JAMES ROBERT DIETZ 1.00 X 25550 72 0 BARRY NEWCOMB 1.00 X 25550 72 0 JANET L HARDEN PHD 1.00 X 24300 72 0 TEOLA PEARL HUNTER 1.00 X 24300 72 0 VALERIAH ANN HOLMON RN 1.00 X 21800 72 0 ROBERT KELCH 1.00 X 20550 72 0 KENDRICK ADKINS 1.00 X 20550 72 0 CALVIN T RAPSON 1.00 X 11167 8320 0 JULIE A ANGOTT 1.00 X 14900 4447 14900 GERALD KARIEM 1.00 X 11617 48 0 DONALD G OETMAN 1.00 X 0 24 8933 MARC KESHISHIAN MD 40.00 X 618741 0 87405 SUSAN A KLUGE 40.00 X 476005 0 90707 JULIE C SWANTEK 40.00 X 99532 0 56348 JANET MACQUEEN 40.00 X 409304 0 73030 CARL SIEBERS 40.00 X 327340 0 89496 GAIL ROSS 40.00 X 319931 0 101379 CARLA CHAMBERS 40.00 X 319530 0 82479 ALISON POLLARD 40.00 X 316032 0 94169 SETH CRAWFORD 40.00 X 303407 0 56477 ELANA KOZIK 40.00 X 265936 0 105799 PHILLIP GILLESPIE 40.00 X 208212 0 71341 HASHIM YAR 40.00 X 283633 0 83681 ROBERT GOODMAN 40.00 X 282173 0 77888 DUANE DIFRANCO 40.00 X 259698 0 59553 BARB DERIAN 40.00 X 224368 0 95538 ROBERT KLIMEK 40.00 X 209031 0 63445 DANIEL LOEPP 0.00 X 0 3270176 947880 KEVIN L SEITZ 0.00 X 0 576250 5738 DAVID NELSON 0.00 X 0 543734 289404 SANDRA BOOZER 0.00 X 0 275765 0 JEANNE H CARLSONCPA 0.00 X 0 223678 1183 LAURIE WESTFALL 0.00 X 180864 0 11869 DOUGLAS WOLL MD 0.00 X 176419 0 0 JOAN MOREHEAD 0.00 X 112539 0 5798 CHARLES BURKETT 0.00 X 0 22825 0 5753429 7158933 3469108 113 true true false TRIZETTO GROUP INC TRIZETTO GROUP INC DEPT 2140 PO BOX 122140 DEPT 2140 PO BOX 122140 DALLAS TX 75312 SOFTWARE ADMIN 10250795 MEDASSURANT INC MEDASSURANT INC 4321 COLLINGTON RD STE 100 4321 COLLINGTON RD STE 100 BOWIE MD 20716 RISK ADJUSTMENT 7812531 ICONMA LLC ICONMA LLC 850 STEPHENSON HWY STE 612 850 STEPHENSON HWY STE 612 TROY MI 48083 TECHNOLOGY SERV 1997934 ACCENTURE LLP ACCENTURE LLP PO BOX 70629 PO BOX 70629 CHICAGO IL 60673 TECHNOLOGY SERV 1850120 IHT SERVICES LLC IHT SERVICES LLC 115 PERIMETER CENTER PLACE STE 700 115 PERIMETER CENTER PLACE STE 700 ATLANTA GA 30346 CLAIMS MGT SERV 1816667 45 PREPAID HEALTH CARE 524298 2608685945 2608685945 ADMINISTRATIVE&SUPPORT SERV 561000 38357989 38357989 NON-SUBSCRIBER REVENUE 524298 37218 37218 2647081152 20413813 287500 20126313 2168858373 1000 2163629704 5228669 1000 5229669 5229669 NET INCOME-STOP LOSS TRUST 900099 10948103 10948103 NET INCOME-MED MALPRAC TRUST 900099 3954103 3954103 14902206 2687626840 2628855038 38645489 20126313 2226539279 2226539279 5753429 3494189 2259240 75174444 45655156 29519288 6234308 2511797 3722511 23047783 13562797 9484986 5841265 3809531 2031734 25976 25976 548807 39705 509102 2821180 8649 2812531 7606442 1499978 6106464 13564905 9167167 4397738 5850248 3737071 2113177 731679 393170 338509 221561 179167 42394 132570 132570 10335097 2707480 7627617 128772 128772 PURCHASED SERVICES 60076103 10416130 49659973 AGENT/BROKER FEES 59818942 59818942 EQUIPMENT RENTAL AND MAIN 6159973 4750103 1409870 UNRELATED BUS INCOME TAX 449059 449059 7615852 333209 7282643 2518677674 2388623520 130054154 0 68545786 41876924 71722719 121416735 3783593 1154427 65753796 53057218 11096029 12696578 818438046 1041083203 9886784 11414257 85701551 79501551 1069174508 1309143675 244139076 257819386 42188974 45418349 50000000 233122829 244288794 519450879 597526529 X 10000 10000 15643045 15643045 534070584 695964101 549723629 711617146 1069174508 1309143675 X 168949166 -7055649 X X false true true X false false false false false false false false false false false 10254818 9925361 329457 16358287 16212995 145292 39140691 26918862 12221829 12696578 5326 INCURRED BENEFITS NOT YET REPORTED 244283468 244288794 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X ON EXAMINATION OF ALL RELEVANT FACTS AND CIRCUMSTANCES FOR THE COMPANY'S TAX ISSUES, IT WAS DETERMINED THAT THERE WERE NO UNCERTAIN POSITIONS FOR THE PERIOD ENDED DECEMBER 31, 2011. THE COMPANY BELIEVES THAT THE LIABILITY BALANCE FOR UNCERTAIN TAX POSITIONS WILL NOT SIGNIFICANTLY INCREASE OR DECREASE WITHIN THE NEXT TWELVE MONTHS. X true true X X X X true true false false false false false false false MARK R BARTLETT CPA 648900 689842 97944 392983 50070 1879739 KEVIN JAMES KLOBUCAR CPA 285175 189927 46704 274882 36355 833043 GREGORY A SUDDERTH 11800 98875 72 12500 60711 24300 159658 MARC KESHISHIAN MD 313850 260666 44225 54175 33230 706146 SUSAN A KLUGE 265147 178619 32239 58279 32428 566712 JULIE C SWANTEK 90891 8814 -173 38395 17953 155880 JANET MACQUEEN 225060 156696 27548 53494 19536 482334 CARL SIEBERS 184129 124136 19075 65841 23655 416836 GAIL ROSS 181634 119907 18390 85603 15776 421310 CARLA CHAMBERS 182404 119822 17304 66484 15995 402009 ALISON POLLARD 180850 121921 13261 64789 29380 410201 SETH CRAWFORD 187996 96865 18546 47747 8730 359884 ELANA KOZIK 148713 104224 12999 77137 28662 371735 PHILLIP GILLESPIE 162400 34340 11472 50351 20990 279553 HASHIM YAR 225876 47039 10718 57746 25935 367314 ROBERT GOODMAN 223181 46478 12514 66084 11804 360061 DUANE DIFRANCO 210953 43932 4813 36917 22636 319251 BARB DERIAN 171976 43537 8855 75919 19619 319906 ROBERT KLIMEK 131777 45675 31579 47081 16364 272476 DANIEL LOEPP 1387107 1585172 297897 849912 97968 4218056 KEVIN L SEITZ 7750 344361 224139 5738 581988 DAVID NELSON 288915 216095 38724 248614 40790 833138 SANDRA BOOZER 63585 212180 275765 JEANNE H CARLSONCPA 219691 3987 1183 224861 LAURIE WESTFALL 180864 10813 1056 192733 DOUGLAS WOLL MD 104020 72399 176419 JOAN MOREHEAD 112539 60 5738 118337 CHARLES BURKETT 22753 72 22825 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 MARK R. BARTLETT, CPA 0 330,246 0 KEVIN JAMES KLOBUCAR, CPA 0 121,292 0 MARC KESHISHIAN, MD 0 34,366 0 SUSAN A. KLUGE 0 20,542 0 JANET MACQUEEN 0 9,281 0 CARL SIEBERS 0 1,750 0 GAIL ROSS 0 837 0 CARLA CHAMBERS 0 1,128 0 ALISON POLLARD 0 747 0 SETH CRAWFORD 0 762 0 HASHIM YAR 0 2,865 0 ROBERT GOODMAN 0 3,680 0 DUANE DIFRANCO 0 666 0 ROBERT KLIMEK 0 50 0 DANIEL LOEPP 0 743,752 0 DAVID NELSON 0 137,959 0 SANDRA BOOZER 212,180 0 0 LAURIE WESTFALL 180,864 3,522 0 JOAN MOREHEAD 112,539 0 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III FORM 990, SCHEDULE J, LINE 6A AND 6B THE ORGANIZATION DOES NOT HAVE A COMPENSATION PROGRAM BASED ON A PERCENTAGE OF NET INCOME; HOWEVER, THERE IS A COMPENSATION PROGRAM THAT IS A CAPPED PERCENTAGE OF SALARY BASED UPON A MINIMUM AND MAXIMUM NET INCOME RANGE OF THE CONTROLLED ENTITIES. BLUE CROSS BLUE SHIELD OF MICHIGAN BUSRELATIONSHIP SEE SCH R PART V false BCN SERVICE COMPANY BUSRELATIONSHIP SEE SCH R PART V false RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 KEVIN JAMES KLOBUCAR, CPA SUSAN A. KLUGE CEO & PRES CFO & TREAS BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA JULIA C. SWANTEK CEO & PRES SECRETARY BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA MARC C. KESHISHIAN, MD CEO & PRES CMO BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA JULIE A. ANGOTT CEO & PRES DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA WILLIAM H. BLACK CEO & PRES DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA GREGORY A. SUDDERTH CEO & PRES DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA CALVIN T. RAPSON CEO & PRES DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA MARK R. BARTLETT CEO & PRES DIRECTOR BUSINESS RELATIONSHIP SUSAN A. KLUGE JULIA C. SWANTEK CFO & TREAS SECRETARY BUSINESS RELATIONSHIP SUSAN A. KLUGE MARC KESHISHIAN, MD CFO & TREAS CMO BUSINESS RELATIONSHIP SUSAN A. KLUGE JULIE A. ANGOTT CFO & TREAS DIRECTOR BUSINESS RELATIONSHIP JULIA C. SWANTEK MARC KESHISHIAN, MD SECRETARY CMO BUSINESS RELATIONSHIP JULIA C. SWANTEK JULIE A. ANGOTT SECRETARY DIRECTOR BUSINESS RELATIONSHIP MARC KESHISHIAN, MD JULIE A. ANGOTT CMO DIRECTOR BUSINESS RELATIONSHIP WILLIAM H. BLACK GREGORY A. SUDDERTH DIRECTOR DIRECTOR BUSINESS RELATIONSHIP WILLIAM H. BLACK CALVIN T. RAPSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP GREGORY A. SUDDERTH CALVIN T. RAPSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP GREGORY A. SUDDERTH MARK R. BARTLETT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA MELVIN LARSEN CEO & PRES DIRECTOR BUSINESS RELATIONSHIP MELVIN LARSEN MARK R. BARTLETT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MELVIN LARSEN CALVIN T. RAPSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MELVIN LARSEN WILLIAM H. BLACK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MELVIN LARSEN GREGORY A. SUDDERTH DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MARK R. BARTLETT CALVIN T. RAPSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MARK R. BARTLETT WILLIAM H. BLACK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KEVIN JAMES KLOBUCAR, CPA SARAH DOYLE CEO & PRES DIRECTOR BUSINESS RELATIONSHIP MELVIN LARSEN SARAH DOYLE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP WILLIAM H. BLACK SARAH DOYLE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP GREGORY A. SUDDERTH SARAH DOYLE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP MARK R. BARTLETT SARAH DOYLE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 100% STOCKHOLDER: BLUE CROSS BLUE SHIELD OF MICHIGAN ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A BLUE CROSS BLUE SHIELD OF MICHIGAN IS A 100% STOCKHOLDER AND HAS THE RIGHT TO APPOINT BOARD DIRECTORS. BCN'S MEMBERS ELECT THE REMAINING BOARD DIRECTORS. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B NO REVIEW WAS CONDUCTED BY THE GOVERNING BODY. THE CFO & TREASURER, SUSAN A. KLUGE, REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C 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. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A 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'S (BCBSM) PERSONNEL AND COMPENSATION SUBCOMMITTEE. THE ORGANIZATION'S PRESIDENT/CEO IS ALSO AN EXECUTIVE OF THE PARENT, BCBSM, AND AS SUCH, THE COMPENSATION MUST BE PRESENTED TO THE BCBSM EXECUTIVE COMMITTEE AND BCBSM BOARD OF DIRECTORS. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION RECOMMENDATIONS FOR BLUE CARE NETWORK'S OFFICERS ARE REVIEWED AND APPROVED BY THE BLUE CROSS BLUE SHIELD OF MICHIGAN (BCBSM) PERSONNEL AND COMPENSATION SUBCOMMITTEE AND BY THE BLUE CARE NETWORK'S BOARD OF DIRECTORS. COMPENSATION RECOMMENDATIONS FOR BLUE CARE NETWORK'S KEY EMPLOYEE EXECUTIVES ARE REVIEWED AND APPROVED BY THE BCBSM PERSONNEL AND COMPENSATION SUBCOMMITTEE AND REQUIRES ACTION FROM THE BLUE CARE NETWORK OF MICHIGAN BOARD OF DIRECTORS. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS - NO DOCUMENTS AVAILABLE TO THE PUBLIC. CONFLICT OF INTEREST POLICY - NO DOCUMENTS AVAILABLE TO THE PUBLIC. AUDITED FINANCIALS - AUDITED STATUTORY-BASIS FINANCIALS ARE AVAILABLE FROM THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS AND THE OFFICE OF FINANCIAL AND INSURANCE REGULATION. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII CURRENT OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES THAT ARE EMPLOYED BY THE FILING ORGANIZATION OR BY A RELATED ORGANIZATION TYPICALLY WORK 40+ HOURS PER WEEK, WITH TIME SPLIT AS NEEDED BETWEEN THE FILING ENTITY AND THE RELATED ORGANIZATION. A PER WEEK ESTIMATE FOR THE FILING ORGANIZATION IS REFLECTED ON THE FILING ENTITY'S PART VII, COLUMN B, WITH THE COMPLETE REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION AND RELATED ORGANIZATION REFLECTED IN COLUMN D AND COLUMN E AS APPROPRIATE. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE UNREALIZED GAINS ON INVESTMENTS OF 6,319,084, CONSOLIDATED SUBSIDIARIES BOOK NET INCOME OF 1,527,473, MALPRACTICE TRUST NET INCOME OF (3,954,103), AND STOP-LOSS TRUST NET INCOME OF (10,948,103). ADDITIONAL INFORMATION FORM 990, PART XII FORM 990 IS FILED BASED ON THE GAAP METHOD OF ACCOUNTING. NO SEPARATE GAAP BASIS AUDITED FINANCIAL STATEMENTS WERE ISSUED. HOWEVER, THE GAAP TRIAL BALANCE, WITH ADDITIONAL STATUTORY BASIS ADJUSTMENTS, WAS UTILIZED BY THE INDEPENDENT AUDITORS AS A BASIS FOR THE ISSUED AUDITED STATUTORY-BASIS FINANCIAL STATEMENTS. BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN 20500 CIVIC CENTER DRIVE 20500 CIVIC CENTER DRIVE SOUTHFIELD MI 48076 320026448 HMO MI 501C4 N/A false BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC 20500 CIVIC CENTER DRIVE 20500 CIVIC CENTER DRIVE SOUTHFIELD MI 48076 382536979 INSURANCE MI 501C4 N/A false BCBS FOUNDATION OF MICHIGAN BCBSM FOUNDATION OF MICHIGAN 600 LAFAYETTE BLVD EAST 600 LAFAYETTE BLVD EAST DETROIT MI 48226 382338506 INSURANCE MI 501C3 11A N/A false BCN SERVICE COMPANY BCN SERVICE COMPANY 20500 CIVIC CENTER DRIVE 20500 CIVIC CENTER DRIVE SOUTHFIELD MI 48076 383134881 TPA MI N/A BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN 600 LAFAYETTE EAST 600 LAFAYETTE EAST DETROIT MI 48226 382069753 INSURANCE MI N/A false false false false false false false false false true true true true true true true true true BCN SERVICE COMPANY BCN SERVICE COMPANY M 2219213 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY N 14872936 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY P 193844748 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY Q 4143155 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN M 488747 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN N 2036517 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN P 3713932 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC P 58805 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC K 118774 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN R 35495452 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN Q 130011446 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN J 1127639 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN O 936625377 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN P 13771308 INTERCOMPANY AGREEMENTS LIFESECURE INSURANCE COMPANY LIFESECURE INSURANCE COMPANY R 79106 INTERCOMPANY AGREEMENTS ACCIDENT FUND INS CO OF AMERICA ACCIDENT FUND INS CO OF AMERICA R 3035794 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY M 2219213 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY N 14872936 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY P 193844748 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY Q 4143155 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN M 488747 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN N 2036517 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN P 3713932 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC P 58805 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC K 118774 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN R 35495452 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN Q 130011446 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN J 1127639 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN O 936625377 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN P 13771308 INTERCOMPANY AGREEMENTS LIFESECURE INSURANCE COMPANY LIFESECURE INSURANCE COMPANY R 79106 INTERCOMPANY AGREEMENTS ACCIDENT FUND INS CO OF AMERICA ACCIDENT FUND INS CO OF AMERICA R 3035794 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY M 2219213 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY N 14872936 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY P 193844748 INTERCOMPANY AGREEMENTS BCN SERVICE COMPANY BCN SERVICE COMPANY Q 4143155 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN M 488747 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN N 2036517 INTERCOMPANY AGREEMENTS BLUE CROSS COMPLETE OF MICHIGAN BLUE CROSS COMPLETE OF MICHIGAN P 3713932 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC P 58805 INTERCOMPANY AGREEMENTS BLUE CARE OF MICHIGAN INC BLUE CARE OF MICHIGAN INC K 118774 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN R 35495452 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN Q 130011446 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN J 1127639 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN O 936625377 INTERCOMPANY AGREEMENTS BLUE CROSS BLUE SHIELD OF MICHIGAN BLUE CROSS BLUE SHIELD OF MICHIGAN P 13771308 INTERCOMPANY AGREEMENTS LIFESECURE INSURANCE COMPANY LIFESECURE INSURANCE COMPANY R 79106 INTERCOMPANY AGREEMENTS ACCIDENT FUND INS CO OF AMERICA ACCIDENT FUND INS CO OF AMERICA R 3035794 INTERCOMPANY AGREEMENTS ADDITIONAL INFORMATION SCHEDULE R FORM 990 PART I SUMMARY AND PART VIII LINE 12 BLUE CARE NETWORK OF MICHIGAN BCN IS A GRANTOR IN TWO GRANTOR TRUSTS BLUE CARE NETWORK MEDICAL MALPRACTICE SELFINSURANCE TRUST EIN XXX-XX-XXXX AND BLUE CARE NETWORK STOPLOSS CASUALTY SELFINSURANCE TRUST EIN XXX-XX-XXXX AS SUCH BCN IS REQUIRED TO INCLUDE AND REPORT THEIR ALLOCABLE SHARE OF ALL GRANTOR TRUST INCOME AND EXPENSES IN THEIR INDIVIDUAL TAX RETURN SUMMARIZED BELOW ARE THE INCOME AND EXPENSE ITEMS FROM THESE TWO TRUSTS THAT HAVE BEEN INCLUDED IN PART 1 SUMMARY AND PART VIII LINE 12 OF FORM 990 FOR BCN FOR 2011 MEDICAL STOP MALPRACTICE LOSS TRUST TRUST TOTAL DESCRIPTION INVESTMENT INCOME INTEREST INCOME 2668435 1343072 4011507 CAPITAL GAINSLOSSES SHORTTERM 130042 51854 181896 LONGTERM 822075 96435 918510 TOTAL INVESTMENT INCOME 3620552 1491361 5111913 OTHER INCOME PREMIUM RECEIVED 961 34876906 34877867 TOTAL INCOME 3621513 36368267 39989780 EXPENSES CLAIMS EXPENSE 430120 25327545 24897425 MANAGEMENT FEES 89649 86164 175813 GENERAL ADMINISTRATIVE 7881 6455 14336 TOTAL EXPENSES 332590 25420164 25087574 NET INCOMELOSS 3954103 10948103 14902206