2025-01-27T12:52:25-06:00 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 SUZANNE BROOKS CFO, CONTROLLER 9197817979 2025-01-27 1 0 J CALVIN MARKS P01226973 9197196400 2023 2025-03-06 01:10:19Z X SUZANNE BROOKS 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 5 0 0 0 0 30603342 31959917 65362 229012 11750 65489 30680454 32254418 0 0 26100883 28410103 0 0 0 0 0 5662257 5251628 31763140 33661731 -1082686 -1407313 11956356 10350475 2047420 2354743 9908936 7995732 SELF-FUNDED MULTIPLE EMPLOYER WELFARE ASSOCIATION BENEFIT PLAN 0 0 THE NCBA HEALTH BENEFIT TRUST PROVIDED COVERAGE FOR AN AVERAGE OF 2,155 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 1 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 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NC X SUZANNE BROOKS 9197817979 3601 HAWORTH DRIVE RALEIGH NC 27609 DAVID SAULS CHAIRMAN 1.00 X 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 BLUE CROSS AND BLUE SHIELD OF NC 5901 CHAPEL HILL ROAD DURHAM NC 27707 ADMINISTRATIVE SERVICES 1289215 COMMUNITY BANK SERVICES 3601 HAWORTH DRIVE RALEIGH NC 27609 THIRD PARTY ADMINISTRATOR 1205424 SENTRY HEALTH 7410 NEW LA GRANGE RD STE 205 LOUISVILLE KY 40222 MONITORING SERVICES 136400 BUSINESSSOLVERCOM INC PO BOX 850411 MINNEAPOLIS MN 554850411 ADMINISTRATIVE SERVICES 106299 4 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 PROVIDER FEES 34286 INCOME TAX 15055 16379 33661731 10167858 7992540 1788498 2357935 11956356 10350475 5420 743 2042000 2354000 2047420 2354743 X 0 0 0 0 9908936 7995732 9908936 7995732 11956356 10350475 X -1407313 -193706 -312185 X 0 1 X 1 0 0 STOP LOSS RECEIVABLE 1690301 SECURITY DEPOSIT 475000 CAPTIVE COLLATERAL 78161 ACCRUED INTEREST 80541 INCOME TAX REFUND 33932 2357935 BENEFIT CLAIMS PAYABLE 2354000 2354000 X 27840187 0 27840187 4414231 4414231 32254418 29559500 312000 312000 29247500 4414231 4414231 33661731 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: PHARMACY REBATE 2,212,437. STOP LOSS PREMIUM 2,201,794. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET CHANGE IN BENEFIT OBLIGATIONS 312,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: PHARMACY REBATE 2,212,437. STOP LOSS PREMIUM 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. CHANGE IN NONADMITTED ASSETS -185. 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 AMERICAN BANK & TRUST BELMONT FEDERAL SAVINGS BLACK MOUNTAIN SAVINGS BANK BLUEHARBOR BANK COASTAL BANK & TRUST DOGWOOD STATE BANK F&M BANK FIRST CAPITAL BANK FIRST CAROLINA BANK FIRST FEDERAL BANK FIRST FEDERAL SAVINGS FIRST SAVINGS & LOAN HERTFORD SAVINGS BANK SSB INTEGRATED FINANCIAL HOLDINGS JACKSON SAVINGS BANK SSB KS BANK INC LUMBEE GUARANTY BANK M&F BANK MORGANTON FEDERAL SAVINGS NANTAHALA BANK & TRUST CO NEW REPUBLIC SAVINGS BANK NORTH STATE BANK OLD NORTH STATE TRUST LLC PARAGON BANK PROVIDENCE BANK RIVERSIDE SAVINGS BANK ROXBORO SAVINGS BANK SOUTHERN BANK TARBORO SAVINGS BANK SSB TAYLORSVILLE SAVINGS BANK TRIAD BUSINESS BANK WAKE FOREST FEDERAL SAVINGS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0