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HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameHOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN
Plan identification number 503

HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

HOME FEDERAL BANK has sponsored the creation of one or more 401k plans.

Company Name:HOME FEDERAL BANK
Employer identification number (EIN):620239150
NAIC Classification:522120
NAIC Description:Savings Institutions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01ANDREW HARPER2023-09-28
5032021-01-01ANDREW HARPER2022-10-10
5032020-01-01ANDREW HARPER2021-10-11
5032019-01-01ANDREW HARPER2020-10-13
5032018-01-01
5032017-01-01ANDREW HARPER
5032016-01-01ANDREW HARPER
5032015-01-01ANDREW HARPER
5032014-01-01ANDREW HARPER ANDREW HARPER2015-10-06
5032013-01-01ANDREW HARPER ANDREW HARPER2014-09-24
5032012-01-01ANDREW HARPER ANDREW HARPER2013-10-15
5032011-01-01GRACIE BISHOP
5032009-01-01GRACIE BISHOP GRACIE BISHOP2010-09-02

Plan Statistics for HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN

401k plan membership statisitcs for HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN

Measure Date Value
2022: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01296
Total number of active participants reported on line 7a of the Form 55002022-01-01285
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01288
2021: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01309
Total number of active participants reported on line 7a of the Form 55002021-01-01296
Number of retired or separated participants receiving benefits2021-01-016
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01302
2020: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01313
Total number of active participants reported on line 7a of the Form 55002020-01-01306
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01307
2019: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01316
Total number of active participants reported on line 7a of the Form 55002019-01-01310
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01312
2018: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01318
Total number of active participants reported on line 7a of the Form 55002018-01-01312
Number of retired or separated participants receiving benefits2018-01-014
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
2017: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01321
Total number of active participants reported on line 7a of the Form 55002017-01-01314
Number of retired or separated participants receiving benefits2017-01-014
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01318
2016: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01324
Total number of active participants reported on line 7a of the Form 55002016-01-01316
Number of retired or separated participants receiving benefits2016-01-015
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01321
2015: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01327
Total number of active participants reported on line 7a of the Form 55002015-01-01342
Number of retired or separated participants receiving benefits2015-01-014
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01346
2014: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01336
Total number of active participants reported on line 7a of the Form 55002014-01-01325
Number of retired or separated participants receiving benefits2014-01-012
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01327
2013: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01323
Total number of active participants reported on line 7a of the Form 55002013-01-01324
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01325
2012: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01322
Total number of active participants reported on line 7a of the Form 55002012-01-01322
Number of retired or separated participants receiving benefits2012-01-011
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01323
2011: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01331
Total number of active participants reported on line 7a of the Form 55002011-01-01331
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01333
2009: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01346
Total number of active participants reported on line 7a of the Form 55002009-01-01349
Number of retired or separated participants receiving benefits2009-01-014
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01353

Financial Data on HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN

Measure Date Value
2022 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$174,402
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$243,316
Total income from all sources (including contributions)2022-12-31$3,635,701
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$3,552,093
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,393,987
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$3,624,089
Value of total assets at end of year2022-12-31$1,145,529
Value of total assets at beginning of year2022-12-31$1,130,835
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$158,106
Total interest from all sources2022-12-31$11,612
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,369,089
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$80,531
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$89,967
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$83,608
Value of net assets at end of year (total assets less liabilities)2022-12-31$971,127
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$887,519
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,064,998
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$1,040,868
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$1,040,868
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$11,612
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$538,614
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$2,255,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,855,373
Contract administrator fees2022-12-31$158,106
Liabilities. Value of benefit claims payable at end of year2022-12-31$174,402
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$243,316
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2022-12-31621142155
2021 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$243,316
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$131,911
Total income from all sources (including contributions)2021-12-31$3,607,564
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$3,695,172
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,533,877
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,607,350
Value of total assets at end of year2021-12-31$1,130,835
Value of total assets at beginning of year2021-12-31$1,107,038
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$161,295
Total interest from all sources2021-12-31$214
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$10,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,402,350
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$89,967
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$67,844
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-87,608
Value of net assets at end of year (total assets less liabilities)2021-12-31$887,519
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$975,127
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$1,040,868
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$1,039,194
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$1,039,194
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$214
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$565,703
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$2,205,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$2,968,174
Contract administrator fees2021-12-31$161,295
Liabilities. Value of benefit claims payable at end of year2021-12-31$243,316
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$131,911
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2021-12-31621142155
2020 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$131,911
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$366,620
Total income from all sources (including contributions)2020-12-31$3,241,958
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$3,462,939
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,301,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,235,588
Value of total assets at end of year2020-12-31$1,107,038
Value of total assets at beginning of year2020-12-31$1,562,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$161,378
Total interest from all sources2020-12-31$6,370
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,476,588
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$67,844
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$125,741
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-220,981
Value of net assets at end of year (total assets less liabilities)2020-12-31$975,127
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,196,108
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$1,039,194
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$1,436,987
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$1,436,987
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$6,370
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$536,068
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,759,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$2,765,493
Contract administrator fees2020-12-31$161,378
Liabilities. Value of benefit claims payable at end of year2020-12-31$131,911
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$366,620
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31PUGH & COMPANY, PC
Accountancy firm EIN2020-12-31621142155
2019 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$366,620
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$366,620
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$234,067
Total income from all sources (including contributions)2019-12-31$4,032,786
Total income from all sources (including contributions)2019-12-31$4,032,786
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$3,788,867
Total of all expenses incurred2019-12-31$3,788,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$3,632,453
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$4,013,434
Value of total assets at end of year2019-12-31$1,562,728
Value of total assets at beginning of year2019-12-31$1,186,256
Value of total assets at beginning of year2019-12-31$1,186,256
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$156,414
Total interest from all sources2019-12-31$19,352
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$10,000,000
Value of fidelity bond cover2019-12-31$10,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,479,434
Contributions received from participants2019-12-31$1,479,434
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$248,816
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$125,741
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$146,776
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$146,776
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$243,919
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,196,108
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$952,189
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$952,189
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$1,436,987
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$1,436,987
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,039,480
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,039,480
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,039,480
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,039,480
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$19,352
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$19,352
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$417,385
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$417,385
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$2,534,000
Contributions received in cash from employer2019-12-31$2,534,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,966,252
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,966,252
Contract administrator fees2019-12-31$156,414
Liabilities. Value of benefit claims payable at end of year2019-12-31$366,620
Liabilities. Value of benefit claims payable at end of year2019-12-31$366,620
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$234,067
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$234,067
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31PUGH & COMPANY, P.C.
Accountancy firm name2019-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2019-12-31621142155
2018 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$234,067
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$217,039
Total income from all sources (including contributions)2018-12-31$3,416,289
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$3,086,908
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,926,477
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,405,559
Value of total assets at end of year2018-12-31$1,186,256
Value of total assets at beginning of year2018-12-31$839,847
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$160,431
Total interest from all sources2018-12-31$10,730
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$10,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,372,559
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$231,990
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$146,776
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$88,576
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$329,381
Value of net assets at end of year (total assets less liabilities)2018-12-31$952,189
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$622,808
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,039,480
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$751,271
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$751,271
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$10,730
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$398,954
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$2,033,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$2,295,533
Contract administrator fees2018-12-31$160,431
Liabilities. Value of benefit claims payable at end of year2018-12-31$234,067
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$217,039
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2018-12-31621142155
2017 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$217,039
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$777,616
Total income from all sources (including contributions)2017-12-31$3,715,068
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$3,564,649
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,397,525
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,710,345
Value of total assets at end of year2017-12-31$839,847
Value of total assets at beginning of year2017-12-31$1,250,005
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$167,124
Total interest from all sources2017-12-31$4,723
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$10,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$1,404,345
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$206,180
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$88,576
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$499,673
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$150,419
Value of net assets at end of year (total assets less liabilities)2017-12-31$622,808
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$472,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$751,271
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$750,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$750,332
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$4,723
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$390,549
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$2,306,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,800,796
Contract administrator fees2017-12-31$167,124
Liabilities. Value of benefit claims payable at end of year2017-12-31$217,039
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$777,616
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2017-12-31621142155
2016 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$777,616
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$250,490
Total income from all sources (including contributions)2016-12-31$3,569,326
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$3,779,114
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,615,733
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$3,567,643
Value of total assets at end of year2016-12-31$1,250,005
Value of total assets at beginning of year2016-12-31$932,667
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$163,381
Total interest from all sources2016-12-31$1,683
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$10,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$1,084,143
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$38,236
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$499,673
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-209,788
Value of net assets at end of year (total assets less liabilities)2016-12-31$472,389
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$682,177
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$750,332
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$932,667
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$932,667
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1,683
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$346,521
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$2,483,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,230,976
Contract administrator fees2016-12-31$163,381
Liabilities. Value of benefit claims payable at end of year2016-12-31$777,616
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$250,490
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2016-12-31621142155
2015 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$250,490
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$191,714
Total income from all sources (including contributions)2015-12-31$3,287,033
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$3,347,605
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,177,428
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$3,286,948
Value of total assets at end of year2015-12-31$932,667
Value of total assets at beginning of year2015-12-31$934,463
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$170,177
Total interest from all sources2015-12-31$85
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$10,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$1,086,448
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$23,358
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$275,688
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-60,572
Value of net assets at end of year (total assets less liabilities)2015-12-31$682,177
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$742,749
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$932,667
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$658,775
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$658,775
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$85
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$335,384
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$2,200,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,818,686
Contract administrator fees2015-12-31$170,177
Liabilities. Value of benefit claims payable at end of year2015-12-31$250,490
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$191,714
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31PUGH & COMPANY
Accountancy firm EIN2015-12-31621142155
2014 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$191,714
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$195,379
Total income from all sources (including contributions)2014-12-31$3,551,580
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$3,538,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,365,352
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$3,551,497
Value of total assets at end of year2014-12-31$934,463
Value of total assets at beginning of year2014-12-31$925,457
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$173,557
Total interest from all sources2014-12-31$83
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$1,128,479
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$320,018
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$22,261
Total non interest bearing cash at end of year2014-12-31$275,688
Total non interest bearing cash at beginning of year2014-12-31$248,382
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Income. Non cash contributions2014-12-31$0
Value of net income/loss2014-12-31$12,671
Value of net assets at end of year (total assets less liabilities)2014-12-31$742,749
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$730,078
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$658,775
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$677,075
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$677,075
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$83
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$320,809
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$2,103,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$3,022,282
Contract administrator fees2014-12-31$173,557
Liabilities. Value of benefit claims payable at end of year2014-12-31$191,714
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$195,379
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2014-12-31621142155
2013 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$195,379
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$259,438
Total income from all sources (including contributions)2013-12-31$3,401,828
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$3,345,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$3,179,186
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,401,740
Value of total assets at end of year2013-12-31$925,457
Value of total assets at beginning of year2013-12-31$933,003
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$166,129
Total interest from all sources2013-12-31$88
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$10,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,076,924
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$192,316
Total non interest bearing cash at end of year2013-12-31$248,382
Total non interest bearing cash at beginning of year2013-12-31$38,103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$56,513
Value of net assets at end of year (total assets less liabilities)2013-12-31$730,078
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$673,565
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$677,075
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$894,900
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$894,900
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$88
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$307,240
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$2,132,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,871,946
Contract administrator fees2013-12-31$166,129
Liabilities. Value of benefit claims payable at end of year2013-12-31$195,379
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$259,438
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2013-12-31621142155
2012 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$259,438
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$290,915
Total income from all sources (including contributions)2012-12-31$3,060,039
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$3,127,477
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$2,955,908
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$3,059,922
Value of total assets at end of year2012-12-31$933,003
Value of total assets at beginning of year2012-12-31$1,031,918
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$171,569
Total interest from all sources2012-12-31$117
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$10,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,050,644
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$296,192
Total non interest bearing cash at end of year2012-12-31$38,103
Total non interest bearing cash at beginning of year2012-12-31$18
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-67,438
Value of net assets at end of year (total assets less liabilities)2012-12-31$673,565
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$741,003
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$894,900
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$1,031,900
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$1,031,900
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$117
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$327,005
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,713,086
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$2,628,903
Contract administrator fees2012-12-31$171,569
Liabilities. Value of benefit claims payable at end of year2012-12-31$259,438
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$290,915
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2012-12-31621142155
2011 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$290,915
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$290,691
Total income from all sources (including contributions)2011-12-31$3,618,806
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$3,490,753
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$3,312,270
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,618,709
Value of total assets at end of year2011-12-31$1,031,918
Value of total assets at beginning of year2011-12-31$903,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$178,483
Total interest from all sources2011-12-31$97
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,077,171
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$226,038
Total non interest bearing cash at end of year2011-12-31$18
Total non interest bearing cash at beginning of year2011-12-31$16
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$128,053
Value of net assets at end of year (total assets less liabilities)2011-12-31$741,003
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$612,950
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$1,031,900
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$903,625
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$903,625
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$97
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$275,796
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$2,315,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$3,036,474
Contract administrator fees2011-12-31$178,483
Liabilities. Value of benefit claims payable at end of year2011-12-31$290,915
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$290,691
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2011-12-31621142155
2010 : HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$290,691
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$309,156
Total income from all sources (including contributions)2010-12-31$3,161,627
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$3,014,744
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,841,331
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,161,336
Value of total assets at end of year2010-12-31$903,641
Value of total assets at beginning of year2010-12-31$775,223
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$173,413
Total interest from all sources2010-12-31$291
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$909,969
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$43,175
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$42
Total non interest bearing cash at end of year2010-12-31$16
Total non interest bearing cash at beginning of year2010-12-31$6
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$146,883
Value of net assets at end of year (total assets less liabilities)2010-12-31$612,950
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$466,067
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$903,625
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$775,175
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$775,175
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$291
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$278,946
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,208,192
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,562,385
Contract administrator fees2010-12-31$173,413
Liabilities. Value of benefit claims payable at end of year2010-12-31$290,691
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$309,156
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31PUGH & COMPANY, P.C.
Accountancy firm EIN2010-12-31621142155

Form 5500 Responses for HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN

2022: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered621
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $31,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered657
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $33,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered679
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $54,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered684
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $392,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered692
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $401,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered428
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $412,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered342
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $354,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered325
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,675
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered324
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $307,240
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered323
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered333
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $275,796
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number91190
Policy instance 1
Insurance contract or identification number91190
Number of Individuals Covered343
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $278,946

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