Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
BLUE CROSS BLUE SHIELD ASSOCIATION
 
Employer identification number

13-5656874
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019
Page 2

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1SCOTT P SEROTA
PRESIDENT AND CEO
(i)

(ii)
1,356,035
-------------
 
4,216,681
-------------
 
2,465,250
-------------
 
3,182,058
-------------
 
31,727
-------------
 
11,251,751
-------------
 
2,279,242
-------------
 
2JENNIFER VACHON
EVP ADMIN SRVS CHIEF OF STAFF
(i)

(ii)
473,680
-------------
 
334,600
-------------
 
314,767
-------------
 
148,879
-------------
 
43,877
-------------
 
1,315,803
-------------
 
75,326
-------------
 
3ROBERT J KOLODGY JR
EVP & CFO
(i)

(ii)
631,155
-------------
 
396,900
-------------
 
9,501
-------------
 
14,000
-------------
 
44,951
-------------
 
1,096,507
-------------
 
 
-------------
 
4KARI J HEDGES
SVP COMMERCIAL MARKETS
(i)

(ii)
368,416
-------------
 
210,000
-------------
 
160,754
-------------
 
122,723
-------------
 
45,034
-------------
 
906,927
-------------
 
5,160
-------------
 
5JUSTINE HANDELMAN
SVP POLICY & REPRESENTATION
(i)

(ii)
422,753
-------------
 
213,200
-------------
 
154,199
-------------
 
84,476
-------------
 
27,237
-------------
 
901,865
-------------
 
59,244
-------------
 
6MAUREEN E SULLIVAN
SVP CHIEF STRATEGY INNOVATION
(i)

(ii)
433,798
-------------
 
208,000
-------------
 
143,430
-------------
 
33,140
-------------
 
32,127
-------------
 
850,495
-------------
 
15,823
-------------
 
7WILLIAM A BRESKIN
SVP GOVERNMENT PROGRAMS
(i)

(ii)
325,835
-------------
 
160,000
-------------
 
238,953
-------------
 
93,158
-------------
 
27,573
-------------
 
845,519
-------------
 
11,283
-------------
 
8JOHN BANTA
ED VENTURE FUNDS
(i)

(ii)
272,777
-------------
 
294,569
-------------
 
4,479
-------------
 
217,475
-------------
 
38,723
-------------
 
828,023
-------------
 
169,569
-------------
 
9KATHY DIDAWICK
VP CONGRESSIONAL COMMUNICATION
(i)

(ii)
400,033
-------------
 
107,200
-------------
 
133,636
-------------
 
123,363
-------------
 
39,036
-------------
 
803,268
-------------
 
26,207
-------------
 
10WILLIAM S NEHS
SVP GEN COUNSEL & CORP SEC
(i)

(ii)
481,626
-------------
 
221,200
-------------
 
2,851
-------------
 
14,000
-------------
 
48,229
-------------
 
767,906
-------------
 
 
-------------
 
11TERRY COONEY
VP INVESTMENT & NEBA
(i)

(ii)
272,832
-------------
 
107,000
-------------
 
236,711
-------------
 
102,061
-------------
 
47,211
-------------
 
765,815
-------------
 
23,103
-------------
 
12PETAR NAUMOVSKI
VP CHIEF INFO SECURITY OFFICER
(i)

(ii)
483,598
-------------
 
225,000
-------------
 
1,993
-------------
 
14,000
-------------
 
39,510
-------------
 
764,101
-------------
 
 
-------------
 
13TRENT T HAYWOOD
SVP CHIEF MEDICAL OFFICER
(i)

(ii)
497,175
-------------
 
211,600
-------------
 
361
-------------
 
14,000
-------------
 
31,543
-------------
 
754,679
-------------
 
 
-------------
 
14KRIS O HALTMEYER
VP LEGISLATIVE & REG POLICY
(i)

(ii)
312,441
-------------
 
137,000
-------------
 
132,030
-------------
 
84,133
-------------
 
36,417
-------------
 
702,021
-------------
 
31,121
-------------
 
15JOHN CERISANO
VP FEDERAL RELATIONS
(i)

(ii)
278,600
-------------
 
124,000
-------------
 
120,579
-------------
 
76,787
-------------
 
46,300
-------------
 
646,266
-------------
 
31,396
-------------
 
16MIKE JOYCE
VP CHIEF AUDITOR & COMPLIANCE
(i)

(ii)
270,387
-------------
 
100,000
-------------
 
71,337
-------------
 
85,076
-------------
 
31,111
-------------
 
557,911
-------------
 
6,996
-------------
 
17DENISE SCHOFIELD
ED CLINICAL OPERATIONS
(i)

(ii)
289,718
-------------
 
85,400
-------------
 
33,296
-------------
 
79,166
-------------
 
1,000
-------------
 
488,580
-------------
 
 
-------------
 
18BRAD LUBRANT
VP FINANCE
(i)

(ii)
225,948
-------------
 
76,000
-------------
 
18,271
-------------
 
132,157
-------------
 
34,833
-------------
 
487,209
-------------
 
14,064
-------------
 
19MARK TALLUTO
VP STRATEGY & ANALYTICS
(i)

(ii)
312,732
-------------
 
126,900
-------------
 
3,458
-------------
 
9,781
-------------
 
33,580
-------------
 
486,451
-------------
 
 
-------------
 
20REED MELTON
VP CLINICAL OPERATIONS
(i)

(ii)
239,325
-------------
 
77,500
-------------
 
11,775
-------------
 
148,661
-------------
 
8,708
-------------
 
485,969
-------------
 
 
-------------
 
21JULIE KOEWLER
VP BRAND STRATEGY
(i)

(ii)
314,421
-------------
 
115,900
-------------
 
1,795
-------------
 
14,000
-------------
 
39,812
-------------
 
485,928
-------------
 
 
-------------
 
22JEFFREY BERTA
ED EIT BUSINESS PARTNER
(i)

(ii)
267,002
-------------
 
74,000
-------------
 
50,881
-------------
 
77,747
-------------
 
28,919
-------------
 
498,549
-------------
 
 
-------------
 
23MELISSA ROTUNNO
VP DEPUTY GEN COUNSEL BRAND
(i)

(ii)
234,153
-------------
 
88,000
-------------
 
33,840
-------------
 
89,198
-------------
 
32,681
-------------
 
477,872
-------------
 
19,688
-------------
 
24PAUL GERRARD
VP STRATEGIC COMMUNICATIONS
(i)

(ii)
292,773
-------------
 
115,200
-------------
 
3,820
-------------
 
12,060
-------------
 
53,731
-------------
 
477,584
-------------
 
 
-------------
 
25JENNIFER ATKINS
VP NETWORK SOLUTIONS
(i)

(ii)
275,656
-------------
 
119,000
-------------
 
2,229
-------------
 
14,000
-------------
 
43,927
-------------
 
454,812
-------------
 
 
-------------
 
26RICH CULLEN
VP INTER-PLAN SOLUTIONS
(i)

(ii)
229,694
-------------
 
70,000
-------------
 
30,423
-------------
 
75,615
-------------
 
41,447
-------------
 
447,179
-------------
 
 
-------------
 
27DOUGHTON LAWRENCE
ED ENTERPRISE PROGRAM
(i)

(ii)
233,342
-------------
 
59,000
-------------
 
57,471
-------------
 
77,731
-------------
 
11,485
-------------
 
439,029
-------------
 
 
-------------
 
28NAOMI ARONSON
ED CLINICAL EVAL & INNOVATION
(i)

(ii)
232,513
-------------
 
57,900
-------------
 
98,727
-------------
 
14,660
-------------
 
29,719
-------------
 
433,519
-------------
 
 
-------------
 
29DAVID YODER
VP MEMBER CARE BENEFITS
(i)

(ii)
285,613
-------------
 
90,000
-------------
 
3,071
-------------
 
13,683
-------------
 
36,248
-------------
 
428,615
-------------
 
 
-------------
 
30NISHA K LULLA
VP OFFICE OF THE PRESIDENT
(i)

(ii)
252,288
-------------
 
91,200
-------------
 
280
-------------
 
10,697
-------------
 
38,885
-------------
 
393,350
-------------
 
 
-------------
 
31VINCENT NELSON
VP MEDICAL AFFAIRS
(i)

(ii)
304,766
-------------
 
 
-------------
 
30,651
-------------
 
14,000
-------------
 
38,857
-------------
 
388,274
-------------
 
 
-------------
 
32NGAN MACDONALD
VP ENTERPRISE DATA SOLUTIONS
(i)

(ii)
235,141
-------------
 
78,000
-------------
 
2,292
-------------
 
12,301
-------------
 
48,339
-------------
 
376,073
-------------
 
 
-------------
 
33PATRICK POPE
VP DEPUTY GENERAL COUNSEL
(i)

(ii)
191,572
-------------
 
107,000
-------------
 
1,026
-------------
 
10,777
-------------
 
41,877
-------------
 
352,252
-------------
 
 
-------------
 
34KELLY WILLIAMS
VP HUMAN RESOURCES
(i)

(ii)
238,927
-------------
 
72,000
-------------
 
513
-------------
 
10,601
-------------
 
12,435
-------------
 
334,476
-------------
 
 
-------------
 
35KIM D HOLLAND
VP STATE AFFAIRS
(i)

(ii)
167,993
-------------
 
95,600
-------------
 
670
-------------
 
11,994
-------------
 
17,810
-------------
 
294,067
-------------
 
 
-------------
 
36BLAKE WILKERSON
VP STRATEGIC PARTNERSHIPS
(i)

(ii)
196,442
-------------
 
41,000
-------------
 
17,980
-------------
 
7,410
-------------
 
13,635
-------------
 
276,467
-------------
 
 
-------------
 
37LACHLAN TIDMARSH
SVP & CIO
(i)

(ii)
185,315
-------------
 
 
-------------
 
452
-------------
 
433
-------------
 
7,239
-------------
 
193,439
-------------
 
 
-------------
 
38JODY VOSS
VP DEVELOPMENT INNOVATION
(i)

(ii)
24,500
-------------
 
 
-------------
 
89,496
-------------
 
 
-------------
 
 
-------------
 
113,996
-------------
 
89,496
-------------
 
39WILLIAM O'LOUGHLIN
VP CHIEF INFORMATION OFFICER
(i)

(ii)
 
-------------
 
 
-------------
 
106,568
-------------
 
 
-------------
 
 
-------------
 
106,568
-------------
 
106,568
-------------
 
Schedule J (Form 990) 2019
Page 3

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
FORM 990, SCHEDULE J, PART I, LINE 1A AS AN ORGANIZATION SERVING A SYSTEM OF LOCALLY BASED INDEPENDENT PLANS OFFERING HEALTH INSURANCE IN ALL 50 STATES, DC AND PUERTO RICO, THE ASSOCIATION'S OFFICERS ARE EXPECTED TO MAINTAIN AN UNUSUALLY DEMANDING TRAVEL SCHEDULE. A COMMITTEE OF THE ASSOCIATION'S BOARD COMPRISED OF INDEPENDENT PLAN EXECUTIVES HAS ESTABLISHED CEO TRAVEL POLICIES DESIGNED TO ASSURE THE ORGANIZATION IS ABLE TO MEET THE CEO'S TRAVEL COMMITMENTS, INCLUDING TRAVEL TO UNDERSERVED REGIONAL DESTINATIONS. THESE POLICIES INCLUDE THE USE OF CHARTER AIRCRAFT AND FIRST CLASS TRAVEL ON SCHEDULED COMMERCIAL FLIGHTS UNDER CERTAIN LIMITED CIRCUMSTANCES. THE ASSOCIATION HAS DESIGNED A COMPREHENSIVE FINANCIAL AND SERVICE-RELOCATION PROGRAM TO ASSIST RELOCATING EMPLOYEES AND NEW HIRES WITH THE RELOCATION PROCESS. THE ASSOCIATION MAY PROVIDE A TAX GROSS UP ON ALL OR PART OF A RELOCATING EMPLOYEE'S TAXABLE RELOCATION EXPENSES IN ORDER TO ASSIST THE RELOCATING EMPLOYEE OR NEW HIRE FOR NEGATIVE TAX CONSEQUENCES DUE TO TAXATION OF RELOCATION EXPENSE REIMBURSEMENTS. THE EXPENSES ARE REIMBURSED AND INCLUDED IN TAXABLE COMPENSATION, IF APPLICABLE, IN ACCORDANCE WITH THE ASSOCIATION'S POLICY. TO FACILITATE BUSINESS MEETINGS WITH VISITING PLAN OFFICIALS AND OTHERS, AND TO FOSTER SOCIAL INTERACTION SERVING THE INTERESTS OF THE ASSOCIATION AND TO FOSTER THEIR GOOD HEALTH, THE ASSOCIATION REIMBURSES A LUNCHEON CLUB MEMBERSHIP FOR OFFICERS. THE EXPENSES ARE REIMBURSED AND INCLUDED IN TAXABLE COMPENSATION, IF APPLICABLE, IN ACCORDANCE WITH THE ASSOCIATION'S POLICY.
FORM 990, SCHEDULE J, PART I, LINE 3 THE COMPENSATION OF THE CEO AND THE CONTINUED RETENTION OF HIS SERVICES ARE APPROVED EACH YEAR BY A COMMITTEE OF THE ASSOCIATIONS BOARD COMPRISED OF INDEPENDENT PLAN EXECUTIVES. THAT COMMITTEE ACTS AFTER DELIBERATIONS BASED UPON ADVICE FROM A QUALIFIED INDEPENDENT COMPENSATION CONSULTING FIRM. THE CONSULTANT'S ADVICE AND THOSE DELIBERATIONS INCLUDE A REVIEW OF THE RESULTS OF THE INDEPENDENT CONSULTANT'S RESEARCH REGARDING COMPENSATION PAID BY OTHER ORGANIZATIONS FOR OFFICERS SERVING IN CAPACITIES COMPARABLE TO THAT OF THE ASSOCIATIONS CEO. EACH YEAR THIS COMMITTEES DECISIONS ARE REPORTED TO THE FULL BOARD DURING A REGULARLY SCHEDULED MEETING. THE BOARD DELIBERATES ON BOTH MATTERS. EXTENSION OF THE PERIOD OF THE CEOS SERVICE REQUIRES ACTION BY THE FULL BOARD. THE COMPENSATION DETERMINATIONS OF THE COMMITTEE STAND APPROVED UNLESS THE BOARD EXERCISES ITS INHERENT PREROGATIVE TO MODIFY THE COMMITTEE'S COMPENSATION DECISIONS. THE SAME COMMITTEE OF INDEPENDENT PLAN EXECUTIVES ANNUALLY RECEIVES THE CEOS RECOMMENDATIONS REGARDING THE COMPENSATION TO BE PAID TO THE OFFICERS. AS WITH THE CEOS COMPENSATION, THE DELIBERATIONS OF THIS COMMITTEE AND ITS DECISIONS TO APPROVE OR MODIFY THE CEO'S COMPENSATION ARE BASED UPON THE RESULTS OF AN INDEPENDENT CONSULTANT'S MARKET RESEARCH REGARDING COMPARABLE OFFICER PAY AND THE INDEPENDENT CONSULTANT'S ADVICE.
FORM 990, SCHEDULE J, PART I, LINE 4 QUESTION 4A - ONE OFFICER RECEIVED SEVERANCE PAY DURING 2019: TRENT HAYWOOD $147,077 QUESTION 4B - AS REQUIRED BY THE INSTRUCTIONS TO FORM 990, SCHEDULE J, PART II, A HYPOTHETICAL SERP ACCRUAL OF ADDITIONAL VESTED BENEFITS WAS CALCULATED FOR EACH REPORTABLE PERSON WHO WAS ELIGIBLE TO PARTICIPATE IN THAT PROGRAM. THE ACCRUAL AMOUNTS WERE DETERMINED USING THE ASSOCIATION'S BEST ESTIMATE OF THE ACTUARIAL VALUE OF THE ADDITIONAL VESTED BENEFITS. ADDITIONAL VESTED BENEFITS UNDER THE SERP ARE TAXED AND INCLUDED IN FORM W-2 BASED ON INCOME TAX REGULATIONS, WHICH DIFFER FROM THE INSTRUCTIONS TO SCHEDULE J. BECAUSE THE INSTRUCTIONS TO SCHEDULE J SPECIFY THAT AMOUNTS REPORTED IN COLUMNS B(I) THROUGH B(III), I.E., AMOUNTS REPORTED ON FORM W-2, SHOULD NOT BE REPORTED AGAIN IN COLUMN C OR D, THE AMOUNT OF IMPUTED SERP INCOME REPORTED IN FORM W-2 AND COLUMN B(III) WAS SUBTRACTED IN EACH CASE FROM THE HYPOTHETICAL SERP ACCRUAL OF ADDITIONAL VESTED BENEFITS. THE BALANCE OF THE HYPOTHETICAL ACCRUAL WAS INCLUDED IN COLUMN C FOR THE APPLICABLE REPORTABLE PERSONS AS FOLLOWS: SCOTT P SEROTA - 444,988 WILLIAM A BRESKIN - 0 JOHN CERISANO - 7,970 TERRY COONEY - 0 RICH CULLEN - 12,822 KATHY RIPLEY DIDAWICK - 51,174 KRIS O HALTMEYER - 15,549 JUSTINE HANDELMAN - 30,390 KARI J HEDGES - 62,806 MIKE JOYCE - 9,486 BRAD LUBRANT - 19,543 MELISSA ROTUNNO - 9,926 MELTON REED - 34,725 MAUREEN SULLIVAN - 0 JENNIFER VACHON - 85,976 DENISE SCHOFIELD - 5,958 DOUGHTON LAWRENCE - 5,651 JEFFREY BERTA - 6,812 The combined total of imputed SERP included in column C: 803,776.
FORM 990, SCHEDULE J, PART I, LINE 7 The Association maintains an Association wide annual performance bonus program that assures a portion of employees annual compensation is contingent upon the attainment of pre-approved organizational performance goals, as weighted by the performance measurement process that evaluates each individual employees' efforts. Officers, like all employees, are eligible to participate in this program. The performance goals and the budget for this bonus program are approved each year by the Associations Board based upon recommendations from a Board committee consisting of independent Plan executives. Moreover, the performance assessment judgments and the approval of actual payouts require approval by that committee. The CEO and an Executive Director participate in separate Long Term Incentive Bonus programs. As with the regular performance bonus programs, payouts under these Long Term Incentive Programs reflect the extent to which pre-established performance goals are reached. However, unlike the annual performance bonus program, the Long Term Incentive programs operate on a multi-year cycle to assure that the CEO and an Executive Director have incentives that look beyond the immediate year. Under the CEO's program, the performance measurements and the assessment of the achievement of those goals and the resulting payout amounts are all approved by the same Board committee described above and reported to the full Board. The committee's deliberations regarding the establishment of the program, the selection of the performance factors and assessment of performance all include consultation and recommendation from a qualified independent compensation consultant based upon a market study of comparable programs for comparable executives. Under the Executive Director's program, the performance measurement is based on the performance of specified investments.
Schedule J (Form 990) 2019

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