Annual Mid Year Supplemental (2013) for BLUE CROSS BLUE SHIELD OF TN PAC submitted on 07/09/2013
Beginning Balance
$12,615.53
Receipts
Monetary Contributions, Unitemized
$3,443.80
Monetary Contributions, Itemized
| Contributor | C/P | Date | Amount |
|---|---|---|---|
|
COOK
, SHEILA
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 REGIONAL SALES DIR. BCBST |
2/24/2012 | $500.00 | |
|
COULTER
, STEVEN
801 PINE ST. CHATTANOOGA , TN 37402 President BCBST |
2/28/2012 | $150.00 | |
|
DAVIS
, CLARENCE
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 MEDICAL DIRECTOR BCBST |
1/18/2012 | $200.00 | |
|
DEVINNEY
, BETTY
231 EMORY CHURCH RD. KINGSPORT , TN 37664 Retired Eastman Chemical |
1/25/2012 | $1,000.00 | |
|
GIBLIN
, JOHN
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 EXEC. VP AND CFO BLUECROSS BLUESHIELD |
2/28/2012 | $150.00 | |
|
GRACEY
, WILLIAM
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 PRESIDENT & COO BCBST |
2/28/2012 | $150.00 | |
|
GREGG
, VICKY
801 PINE ST CHATTANOOGA , TN 37402 President and CEO BlueCross BlueShield of TN |
2/28/2012 | $250.00 | |
|
HICKEY
, J.D.
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 SVP HEALTHCARE SERVICES BCBST |
2/22/2012 | $5,000.00 | |
|
PHILLIPS
, CLAY
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 SR. COUNSEL BCBST |
2/28/2012 | $140.00 | |
|
SMILTH
, BARBARA
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 MEDICAL DIRECTOR BCBST |
1/18/2012 | $200.00 | |
|
WINTON
, DAKASHA
1 CAMERON HILL CIR. CHATTANOOGA , TN 37402 COUNSEL BCBST |
2/28/2012 | $140.00 |
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
(other than adjustments, loans, and interest)
$21,181.80
Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$21,181.80
Disbursements
Expenditures, Unitemized
| Purpose | Amount |
|---|---|
| BANK FEES | $60.88 |
Expenditures, Itemized
$0.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
(other than adjustments)
$100.00
Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$100.00
Ending Balance
ENDING BALANCE
$33,697.33
Outstanding Loans
TOTAL OUTSTANDING LOAN BALANCE
$0.00
In-Kind Contributions
In-Kind Contributions are not included in the report ending balance.
Unitemized
$0.00
Itemized
$0.00
TOTAL IN-KIND CONTRIBUTIONS
$0.00
Obligations
Obligations are not included in the report ending balance.
Unitemized
$0.00
Itemized
$0.00
Obligations, Outstanding from Previous Reports
$0.00
TOTAL OBLIGATIONS OUTSTANDING
$0.00