2024-10-09T14:29:47-05:00 2024-05-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS ROAD SUITE 1500 RALEIGH NC 27609 990 2023-06-01 562138565 NORTH CAROLINA BANKERS ASSOCIATION HEALTH BENEFIT TRUST NORT 9197817979 3601 HAWORTH DRIVE RALEIGH NC 27609 STEPHANIE TUCKER CFO 9197817979 2024-10-09 1 0 J CALVIN MARKS P01226973 9197196400 2023 2024-10-15 13:58:12Z STEPHANIE TUCKER 3601 HAWORTH DRIVE RALEIGH NC 27609 32254418 0 X N/A X 1999 NC SELF-FUNDED MULTIPLE EMPLOYER WELFARE ASSOCIATION BENEFIT PLAN 5 5 0 0 0 0 0 0 30603342 31959917 65362 229012 11750 65489 30680454 32254418 0 0 26100883 28410103 0 0 0 0 0 5662257 5291663 31763140 33701766 -1082686 -1447348 11956356 10310440 2047420 2354743 9908936 7955697 SELF-FUNDED MULTIPLE EMPLOYER WELFARE ASSOCIATION BENEFIT PLAN 0 0 THE NCBA HEALTH BENEFIT TRUST PROVIDED COVERAGE FOR AN AVERAGE OF 2,350 EMPLOYEES AND DEPENDENTS OF NCBA MEMBER INSTITUTIONS IN THE PAST PLAN YEAR. THE PLAN COLLECTED PREMIUMS AND PAID CLAIMS IN ACCORDANCE WITH THE TRUST AGREEMENT. 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 NC X SUZANNE BROOKS 9197817979 3601 HAWORTH DRIVE RALEIGH NC 27609 DAVID SAULS CHAIRMAN 1.00 X 0 0 0 MIKE AYOTTE TRUSTEE 1.00 X 0 0 0 DAVID KEUL TRUSTEE 1.00 X 0 0 0 DEBRA MEDLIN TRUSTEE 1.00 X 0 0 0 LARISSA PROCIUK TRUSTEE 1.00 X 0 0 0 STEPHANIE TUCKER CFO (TO DEC '23) 1.00 39.00 X 0 211899 24642 MARK HOLMES CFO (FROM JAN '24) 1.00 39.00 X 0 0 0 0 211899 24642 0 0 1 0 0 PARTICPANT CONTRIBUTIONS 525100 29623616 29623616 REBATE & OTHER INCOME 525100 2146948 2146948 COBRA PREMIUMS 525100 189353 189353 31959917 229012 229012 65489 65489 65489 32254418 31959917 0 294501 28410103 48755 77202 2727943 12622 REINSURANCE PREMIUMS 2201794 ENROLLMENT EXPENSES 117592 INCOME TAX 55091 PROVIDER FEES 34286 16378 33701766 10167858 7992540 1788498 2317900 11956356 10310440 5420 743 2042000 2354000 2047420 2354743 X 0 0 0 0 9908936 7955697 9908936 7955697 11956356 10310440 X -1447348 -186415 -319476 X 0 1 X 1 0 0 STOP LOSS RECEIVABLE 1690301 SECURITY DEPOSIT 475000 CAPTIVE COLLATERAL 78161 ACCRUED INTEREST 80541 INCOME TAX REFUND -6103 2317900 BENEFIT CLAIMS PAYABLE 2354000 2354000 X 27840187 0 27840187 4414231 4414231 32254418 29599535 312000 312000 29287535 4414231 4414231 33701766 PART X, LINE 2: MANAGEMENT ANALYZED TAX POSITIONS TAKEN BY THE TRUST, AND CONCLUDED THAT AS OF MAY 31, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUE RECORDED AS CONTRA-EXPENSE ON THE FINANCIAL STATEMENTS 2,212,437. EXPENSE RECORDED AS CONTRA-REVENUE ON THE FINANCIAL STATEMENTS 2,201,794. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS 312,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUE RECORDED AS CONTRA-EXPENSE ON THE FINANCIAL STATEMENTS 2,212,437. EXPENSE RECORDED AS CONTRA-REVENUE ON THE FINANCIAL STATEMENTS 2,201,794. 0 0 0 STEPHANIE TUCKER CFO (TO DEC '23) 0 189000 0 15120 0 7779 0 23226 0 1416 0 236541 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION WILL SUBMIT ITS FORM 990 TO THE FULL BOARD OF TRUSTEES FOR THEIR REVIEW PRIOR TO FILING. UPON THE REVIEW AND APPROVAL BY THE TRUSTEES, THE ORGANIZATION WILL FILE ITS FORM 990. FORM 990, PART VI, SECTION B, LINE 12C TRUSTEES ARE REQUIRED TO SIGN AND RETURN ACKNOWLEDGMENT FORMS ATTESTING THAT THEY WILL COMPLY WITH THE ORGANIZATION'S ETHICS POLICY AND PROVIDE NOTICE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. IN THE EVENT OF A CONFLICT THAT PERSON RECUSES THEMSELVES FROM ALL DISCUSSIONS AND VOTE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DID NOT COMPENSATE ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: NET CHANGE IN BENEFIT OBLIGATIONS -312,000. NONADMITTED PREPAID INSURANCE PREMIUM -7,476. NORTH CAROLINA BANKERS ASSOCIATION 3601 HAWORTH DRIVE RALEIGH NC 27609 560340440 TO OFFER EDUCATION AND SERVICES TO THE FINANCIAL INSTITUTIONS OF NC NC 501(C)(6) 0 ALLIANCE BANK & TRUST 292 W MAIN AVE GASTONIA NC 28052 841372965 0 AMERICAN BANK & TRUST 3302 US HIGHWAY 74 MONROE NC 28110 832832916 0 BELMONT FEDERAL SAVINGS 42 CATAWBA STREET BELMONT NC 280123349 560138905 0 BLACK MOUNTAIN SAVINGS BANK 200 EAST STATE STREET BLACK MOUNTAIN NC 28711 560142695 0 BLUEHARBOR BANK 106 CORPORATE PART DRIVE MOORESVILLE NC 28117 261665679 0 COASTAL BANK & TRUST 2414 N MARINE BLVD JACKSONVILLE NC 28546 263754431 0 DOGWOOD STATE BANK 5401 SIX FORKS ROAD RALEIGH NC 27804 350260214 0 F&M BANK 221 N MAIN STREET SALISBURY NC 28144 560220355 0 FIRST CAPITAL BANK 909 S MAIN STREET LAURINBURG NC 283524736 571084848 0 FIRST CAROLINA BANK 171 N WINSTEAD AVENUE ROCKY MOUNT NC 27804 200967347 0 FIRST FEDERAL BANK 200 E DIVINE STREET DUNN NC 28335 560680378 0 FIRST FEDERAL SAVINGS 320 EAST MAIN STREET LINCOLNTON NC 280923398 560499280 0 FIRST SAVINGS & LOAN 206 WEST CENTER STREET MEBANE NC 273022433 560319795 0 HERTFORD SAVINGS BANK SSB 121 NORTH CHURCH STREET HERTFORD NC 279441103 560259952 0 JACKSON SAVINGS BANK SSB 741 W MAIN ST SYLVA NC 287790757 560628727 0 KS BANK INC 1031 BRIGHTLEAF BLVD SMITHFIELD NC 27577 560688557 0 LUMBEE GUARANTY BANK 403 EAST 3RD STREET PEMBROKE NC 28372 560990387 0 M&F BANK 2634 DURHAM CHAPEL HILL BLVD DURHAM NC 27704 560319960 0 MORGANTON FEDERAL SAVINGS 205 NORTH KING STREET MORGANTON NC 285663438 560327830 0 NANTAHALA BANK & TRUST CO 120 SILER ROAD FRANKLIN NC 28734 043777694 0 NEW REPUBLIC SAVINGS BANK 420 BECKER DRIVE ROANOKE RAPIDS NC 27870 562105187 0 NORTH STATE BANK 6204 FALLS OF NEUSE ROAD RALEIGH NC 27609 562183599 0 OLD NORTH STATE TRUST LLC 125 S ELM STREET SUITE 100 GREENSBORO NC 27401 561861608 0 PARAGON BANK 3535 GLENWOOD AVENUE RALEIGH NC 27612 621748175 0 PROVIDENCE BANK 450 N WINSTEAD AVE ROCKY MOUNT NC 27804 204006556 0 RIVERSIDE SAVINGS BANK 325 BECKER DRIVE ROANOKE RAPIDS NC 278703206 560370020 0 ROXBORO SAVINGS BANK 313 SOUTH MAIN STREET ROXBORO NC 27573 560384190 0 SOUTHERN BANK 116 EAST MAIN STREET MOUNT OLIVE NC 28365 560132260 0 TARBORO SAVINGS BANK SSB 501 MAIN STREET TARBORO NC 278869364 560424070 0 TAYLORSVILLE SAVINGS BANK 107 MAIN AVE DR NE TAYLORSVILLE NC 28681 560425630 0 TRIAD BUSINESS BANK 1501 HIGHWOODS BLVD SUITE 103 GREENSBORO NC 27410 844479810 0 WAKE FOREST FEDERAL SAVINGS 10116 LIGON MILL ROAD WAKE FOREST NC 27587 560440967 0 WEST TOWN BANK & TRUST 3802 LAWNDALE DRIVE GREENSBORO NC 27455 361950478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0