2025-10-28T10:00:31-05:00 2024-12-31 621142155 PUGH & COMPANY PC 315 N CEDAR BLUFF RD SUITE 200 KNOXVILLE TN 37923 990 2024-01-01 626290632 TRUST FBO EMPLOYEES OF HOME FEDERAL BANK OF TENNESSEE EMPL 8655416376 515 MARKET STREET KNOXVILLE TN 379022145 ANDREW HARPER EXEC. VP & TREASURER 8655416376 2025-10-22 1 1 KIMBERLY W YOUNG CPA P00745372 8657690660 2025-10-22 2024 2025-03-06 01:10:19Z ANDREW HARPER 515 MARKET STREET KNOXVILLE TN 379022145 3087287 0 X N/A X 1988 TN RECEIVE, INVEST, AND DISBURSE FUNDS FOR PAYMENT OF MEDICAL CARE COSTS. 1 0 0 0 42375 0 0 0 3321590 3044912 46012 42375 0 0 3367602 3087287 0 0 2664851 2524995 0 0 0 0 0 737628 728905 3402479 3253900 -34877 -166613 1030122 863509 0 0 1030122 863509 NONE 0 0 3253900 3044912 PAYMENT OF HEALTH CARE BENEFITS AND ASSOCIATED FEES TO AND FOR THE BENEFIT OF CURRENT AND FORMER EMPLOYEES OF HOME FEDERAL BANK OF TENNESSEE. 3253900 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 X THE ORGANIZATION 8655416384 515 MARKET STREET KNOXVILLE TN 379022145 X INVESTOR'S TRUST COMPANY TRUSTEE 10.00 X 0 0 0 0 0 0 0 0 0 0 BLUECROSS BLUESHIELD 801 PINE STREET CHATTANOOGA TN 37402 ADMINISTRATION 155587 1 EMPLOYER CONTRIBUTIONS 525100 1768000 1768000 EMPLOYEE CONTRIBUTIONS 525100 1276912 1276912 3044912 42375 42375 3087287 3044912 42375 0 2524995 REINSURANCE PREMIUMS 573318 ADMINISTRATION EXPENSES 155587 3253900 1030122 863509 1030122 863509 0 0 X 0 0 0 0 1030122 863509 1030122 863509 1030122 863509 -166613 0 X 0 1 X 1 0 0 FEDERATED GOVERNMENT OBLIGATIONS FUND #117 863509 C 863509 X 3087287 0 3087287 0 3087287 3251710 0 3251710 2190 2190 3253900 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY(OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: ACCRUAL TO CASH ADJ - REFUND/REBATES RECEIVABLES 2,190. FORM 990, PART VI STATEMENT REGARDING OVERALL GOVERNING BODY AND MANAGEMENT FUNCTIONS: THE TAXPAYER IS A VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION (THE "TRUST") WHOSE SOLE PURPOSE IS TO RECEIVE CONTRIBUTIONS AND MAKE DISBURSEMENTS PURSUANT TO THE HOME FEDERAL BANK OF TENNESSEE MEDICAL INSURANCE PLAN (THE "PLAN"). THE PLAN IS A WELFARE BENEFIT PLAN SUBJECT TO ERISA THAT PROVIDES MEDICAL BENEFITS TO THE EMPLOYEES OF HOME FEDERAL BANK OF TENNESSEE AND ITS SUBSIDIARIES ("EMPLOYER") AND IS FUNDED IN PART BY EMPLOYEE CONTRIBUTIONS AND IN PART FROM THE GENERAL ASSETS OF EMPLOYER WHOSE PAYMENTS ALSO FLOW THROUGH THE TRUST. BLUECROSS BLUESHIELD OF TENNESSEE ADMINISTERS THE PLAN. EMPLOYEE PREMIUMS ARE DEDUCTED FROM EMPLOYEE EARNINGS EACH PAYDAY AND A CHECK FOR TOTAL EMPLOYEE PREMIUMS IS THEN FORWARDED TO THE HOME FEDERAL BANK TRUST DEPARTMENT FROM HUMAN RESOURCES FOR CREDITING TO THE TRUST'S ACCOUNT. EMPLOYER'S CONTRIBUTION IS CALCULATED MONTHLY, BASED ON THE TARGET AMOUNT THAT IS DETERMINED ANNUALLY, AND FORWARDED TO THE TRUST DEPARTMENT, AS WELL. HOME FEDERAL BANK'S TRUST DEPARTMENT INVESTS THE FUNDS IN FEDERATED GOVERNMENT OBLIGATIONS. INVOICES ARE RECEIVED FROM BLUECROSS BLUESHIELD WEEKLY AND A REQUEST FOR A CHECK IS SUBMITTED TO THE TRUST DEPARTMENT BY EMPLOYER'S HUMAN RESOURCE DEPARTMENT FOR PAYMENT OF CLAIMS. THE TRUST DEPARTMENT PROVIDES MONTHLY STATEMENTS TO THE HUMAN RESOURCE DEPARTMENT, WHICH USES THOSE REPORTS TO PREPARE SUMMARY REPORTS FOR MANAGEMENT OF EMPLOYER. PART VI CONTAINS SEVERAL QUESTIONS THAT ARE EITHER INAPPLICABLE TO THE TRUST OR THAT ARE ANSWERED DIFFERENTLY FROM OTHER TYPES OF TAX-EXEMPT ORGANIZATIONS, SPECIFICALLY: NO. 3 - THE TRUSTEE HAS DELEGATED THE MANAGEMENT AND INVESTMENT OF ITS ASSETS TO THE TRUST DEPARTMENT OF THE BANK. NO. 8 - ALL ACTIONS TAKEN BY THE TRUST ARE WELL DOCUMENTED BY EMPLOYER'S PERSONNEL IN HUMAN RESOURCES AND THE TRUST DEPARTMENT (WHICH IS MONITORED BY A COMMITTEE OF THE BANK'S BOARD OF DIRECTORS) BUT THE TRUSTEE'S BOARD DOES NOT SEPARATELY MEET AND DOCUMENT ACTIONS WITH RESPECT TO THE TRUST. NO. 11 - THE TRUSTEE RELIES UPON REVIEW BY THE PERSONNEL IN THE BANK'S HUMAN RESOURCE DEPARTMENT. NO. 12 - THE TRUST DOES NOT HAVE A WRITTEN CONFLICT OF INTEREST POLICY. HOWEVER, EMPLOYER DOES REQUIRE ITS OFFICERS, DIRECTORS AND EMPLOYEES TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. NO. 14 - EMPLOYER HAS A VERY WELL ESTABLISHED DOCUMENT RETENTION AND DESTRUCTION POLICY. NO. 15 - THIS IS NOT APPLICABLE. THE TRUST DOES NOT HAVE EMPLOYEES AND DOES NOT COMPENSATE DIRECTLY OR INDIRECTLY ANY EMPLOYEES OF EMPLOYER. NO. 19 - THE PLAN AND THE EMPLOYER PROVIDE INFORMATION TO PLAN PARTICIPANTS AS REQUIRED BY ERISA AND THE DEPARTMENT OF LABOR. THE TRUST HAS NOT MADE GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AND THE TRUST DOES NOT MAINTAIN A CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION A, LINE 8A INCLUDED IN DISCUSSION ABOVE FORM 990, PART VI, SECTION A, LINE 8B INCLUDED IN DISCUSSION ABOVE FORM 990, PART VI, SECTION B, LINE 11B INCLUDED IN DISCUSSION ABOVE FORM 990, PART VI, SECTION C, LINE 19 SEE DISCUSSION ABOVE. HOME FEDERAL BANK OF TENNESSEE 515 MARKET STREET KNOXVILLE TN 37902 620239150 FINANCIAL SERVICES TN C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 HOME FEDERAL BANK OF TENNESSEE S 1768000 CASH