Independence Blue Cross, LLC

Form 5500

INDEPENDENCE BLUE CROSS, LLC

1901 Market Street, 26th Floor, Philadelphia, Pa 19103 (215) 241-3230 EIN:46-3867722 Plan Admin:Denise Hines-Mckeown

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2022	Plan NameINDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN Plan #002 Participants BOY/EOY5,422 / 5,872 Assets BOY/EOY$982,571,489 / $809,344,884	2022	INDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN - Plan #002	5,422 / 5,872	$982,571,489 / $809,344,884
2022	Plan NamePENSION PLAN OF INDEPENDENCE BLUE CROSS Plan #001 Participants BOY/EOY4,107 / 3,989 Assets BOY/EOY$874,360,100 / $702,461,258	2022	PENSION PLAN OF INDEPENDENCE BLUE CROSS - Plan #001	4,107 / 3,989	$874,360,100 / $702,461,258
2022	Plan NamePUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN Plan #503 Participants BOY/EOY170 / 0 Assets BOY/EOY$0 / $0	2022	PUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN - Plan #503	170 / 0	$0 / $0
2022	Plan NameINDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN Plan #501 Participants BOY/EOY4,152 / 0 Assets BOY/EOY$0 / $0	2022	INDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN - Plan #501	4,152 / 0	$0 / $0
2022	Plan NamePUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN Plan #502 Participants BOY/EOY154 / 0 Assets BOY/EOY$0 / $0	2022	PUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN - Plan #502	154 / 0	$0 / $0
2022	Plan NameINDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN Plan #510 Participants BOY/EOY1,815 / 0 Assets BOY/EOY$0 / $0	2022	INDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN - Plan #510	1,815 / 0	$0 / $0
2021	Plan NameINDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN Plan #002 Participants BOY/EOY5,563 / 5,550 Assets BOY/EOY$859,528,010 / $982,571,489	2021	INDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN - Plan #002	5,563 / 5,550	$859,528,010 / $982,571,489
2021	Plan NamePENSION PLAN OF INDEPENDENCE BLUE CROSS Plan #001 Participants BOY/EOY4,189 / 4,107 Assets BOY/EOY$796,661,614 / $874,360,100	2021	PENSION PLAN OF INDEPENDENCE BLUE CROSS - Plan #001	4,189 / 4,107	$796,661,614 / $874,360,100
2021	Plan NamePUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN Plan #503 Participants BOY/EOY170 / 0 Assets BOY/EOY$0 / $0	2021	PUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN - Plan #503	170 / 0	$0 / $0
2021	Plan NameINDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN Plan #501 Participants BOY/EOY4,118 / 0 Assets BOY/EOY$0 / $0	2021	INDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN - Plan #501	4,118 / 0	$0 / $0
2021	Plan NameINDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN Plan #510 Participants BOY/EOY1,264 / 0 Assets BOY/EOY$0 / $0	2021	INDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN - Plan #510	1,264 / 0	$0 / $0
2021	Plan NamePUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN Plan #502 Participants BOY/EOY155 / 0 Assets BOY/EOY$0 / $0	2021	PUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN - Plan #502	155 / 0	$0 / $0
2020	Plan NameINDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN Plan #002 Participants BOY/EOY5,687 / 5,563 Assets BOY/EOY$724,158,993 / $859,528,010	2020	INDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN - Plan #002	5,687 / 5,563	$724,158,993 / $859,528,010
2020	Plan NamePENSION PLAN OF INDEPENDENCE BLUE CROSS Plan #001 Participants BOY/EOY4,304 / 4,189 Assets BOY/EOY$765,833,488 / $796,661,614	2020	PENSION PLAN OF INDEPENDENCE BLUE CROSS - Plan #001	4,304 / 4,189	$765,833,488 / $796,661,614
2020	Plan NameINDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN Plan #510 Participants BOY/EOY1,254 / 0 Assets BOY/EOY$0 / $0	2020	INDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN - Plan #510	1,254 / 0	$0 / $0
2020	Plan NamePUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN Plan #503 Participants BOY/EOY170 / 0 Assets BOY/EOY$0 / $0	2020	PUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN - Plan #503	170 / 0	$0 / $0
2020	Plan NamePUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN Plan #502 Participants BOY/EOY156 / 0 Assets BOY/EOY$0 / $0	2020	PUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN - Plan #502	156 / 0	$0 / $0
2020	Plan NameINDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN Plan #501 Participants BOY/EOY4,182 / 0 Assets BOY/EOY$0 / $0	2020	INDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN - Plan #501	4,182 / 0	$0 / $0
2019	Plan NamePENSION PLAN OF INDEPENDENCE BLUE CROSS Plan #001 Participants BOY/EOY5,305 / 4,304 Assets BOY/EOY$719,760,675 / $765,833,488	2019	PENSION PLAN OF INDEPENDENCE BLUE CROSS - Plan #001	5,305 / 4,304	$719,760,675 / $765,833,488
2019	Plan NameINDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN Plan #002 Participants BOY/EOY5,594 / 5,687 Assets BOY/EOY$582,830,882 / $724,158,993	2019	INDEPENDENCE BLUE CROSS BLUE CHIP RETIREMENT SAVINGS PLAN - Plan #002	5,594 / 5,687	$582,830,882 / $724,158,993
2019	Plan NamePUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN Plan #502 Participants BOY/EOY156 / 0 Assets BOY/EOY$0 / $0	2019	PUERTO RICO HEALTH PLAN, INC. MEDICAL PLAN - Plan #502	156 / 0	$0 / $0
2019	Plan NameINDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN Plan #501 Participants BOY/EOY4,110 / 0 Assets BOY/EOY$0 / $0	2019	INDEPENDENCE BLUE CROSS WELFARE AND FLEXIBLE BENEFITS PLAN - Plan #501	4,110 / 0	$0 / $0
2019	Plan NameINDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN Plan #510 Participants BOY/EOY1,220 / 0 Assets BOY/EOY$0 / $0	2019	INDEPENDENCE BLUE CROSS RETIREE HEALTH AND WELFARE PLAN - Plan #510	1,220 / 0	$0 / $0
2019	Plan NamePUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN Plan #503 Participants BOY/EOY170 / 0 Assets BOY/EOY$0 / $0	2019	PUERTO RICO HEALTH PLAN, INC. GROUP LIFE INS PLAN - Plan #503	170 / 0	$0 / $0