2025-09-01T06:09:34-05:00 2024-12-31 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS RD STE 1500 RALEIGH NC 27609 990 2024-01-01 562096193 NORTH CAROLINA MEDICAL SOCIETY EMPLOYEE BENEFIT TRUST NORT 9198787502 700 SPRING FOREST ROAD 400 RALEIGH NC 27609 KENNETH HOLT CHAIRMAN 9198787502 2025-08-28 1 0 J CALVIN MARKS P01226973 9197196400 2024 2025-03-06 01:10:19Z DR KENNETH A HOLT MD 700 SPRING FOREST ROAD 400 RALEIGH NC 27609 63968820 0 X WWW.NCMSPLAN.COM X 1998 NC THE TRUST IS A FUNDING MECHANISM FOR A MULTIPLE EMPLOYER WELFARE ARRANGEMENT. MEMBERS OF THE NORTH CAROLINA MEDICAL SOCIETY, THEIR EMPLOYEES, AND DEPEDENTS ARE ELIGIBLE TO ENROLL FOR THE HEALTH, DENTAL, AND LIFE BENEFITS OFFERED. 4 4 0 0 0 0 0 0 44479035 46380305 687399 1457476 0 0 45166434 47837781 113600 107600 42223384 45649234 8000 4500 0 0 0 6877933 6852463 49222917 52613797 -4056483 -4776016 29038709 24111332 4335285 5837527 24703424 18273805 X THE NORTH CAROLINA MEDICAL SOCIETY EMPLOYEE BENEFIT PLAN PROVIDES NORTH CAROLINA PHYSICIANS WITH A VALUE-ADDED PLAN THAT IS STRAIGHTFORWARD AND SPECIFICALLY CUSTOMIZED TO MEET THEIR PRACTICE AND EMPLOYEES' NEEDS. AS THE ONLY STATEWIDE HEALTH BENEFITS PLAN DESIGNED EXCLUSIVELY FOR NORTH CAROLINA PHYSICIANS, THE NCMS PLAN OFFERS CHOICES THAT ARE UNIQUE TO THE MARKET. 0 0 THE TRUST PROVIDES HEALTH, DENTAL, AND LIFE INSURANCE BENEFITS TO ELIGIBLE MEMBERS OF THE NORTH CAROLINA MEDICAL SOCIETY AND THEIR EMPLOYEES. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 X STEVEN SAWYER CO MEDICAL MUTUAL INSURANCE CO OF NC 9198787502 700 SPRING FOREST ROAD 400 RALEIGH NC 27609 KENNETH A HOLT MD CHAIR 2.00 X X 3000 0 0 SANDY COHEN MD TRUSTEE 1.00 X 500 0 0 WILLIAM INGRAM III MD TRUSTEE 1.00 X 500 0 0 MARY ANN CONTAGIANNIS MD TRUSTEE 1.00 X 500 0 0 4500 0 0 0 0 0 0 BLUE CROSS BLUE SHIELD OF NC PO BOX 580086 CHARLOTTE NC 28258 CLAIMS ADJUDICATION & ADMINISTRATION 2566830 SENTINEL BENEFIT CONSULTING 4700 SIX FORKS RD SUITE 200 RALEIGH NC 27609 SALES & MARKETING 1874458 MEDICAL MUTUAL INSURANCE CO OF NC 700 SPRING FOREST RD SUITE 400 RALEIGH NC 27609 MANAGEMENT & ADMINISTRATION 1460015 CRUM & FORSTERNORTH RIVER INSURANCE 5 CHRISTOPHER WAY 2ND FLOOR EATONTOWN NJ 07724 STOP LOSS COVERAGE 879100 NC MEDICAL SOCIETY PO BOX 27167 RALEIGH NC 27611 PLAN SPONSORSHIP & ADMINISTRATION 424248 6 MEMBER PREMIUM PAYMENTS 900099 46380305 46380305 46380305 636265 636265 16952250 16131039 821211 821211 821211 47837781 46380305 0 1457476 107600 45649234 4500 4454542 990 54594 25112 2236671 2502 14752 315 350 39465 PCORI FEE 23114 TAXES & LICENSES 56 52613797 4200929 8112531 951949 283476 23885831 15715325 29038709 24111332 404542 983426 474911 1067522 3455832 3786579 4335285 5837527 X 0 0 0 0 24703424 18273805 24703424 18273805 29038709 24111332 X -4776016 -633603 -1020000 X 0 1 X 1 0 0 DUE AND UNPAID CLAIMS 3678000 DUE TO RELATED PARTY 108579 3786579 X 47176564 -633603 -633603 47810167 27614 27614 47837781 52586183 0 52586183 27614 27614 52613797 PART X, LINE 2: MANAGEMENT ANALYZED TAX POSITIONS TAKEN BY THE TRUST, AND CONCLUDED THAT AS OF DECEMBER 31, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 0 RALEIGH MEDICAL GROUP 3700 BARRETT DR SUITE 300 RALEIGH NC 27609 561166754 N/A 50000 0 WELLNESS GRANT UROLOGY SPECIALISTS OF THE CAROLINAS 325 HAWTHORNE LN SUITE 300 CHARLOTTE NC 28204 522107759 N/A 17850 0 WELLNESS GRANT CHARLOTTE DERMATOLOGY 2630 E 7TH ST SUITE 200 CHARLOTTE NC 28204 561004551 N/A 11700 0 WELLNESS GRANT LOOKING GLASS EYE CENTER 188 MEDICAL PARK DR BREVARD NC 28712 020622351 N/A 8700 0 WELLNESS GRANT TRIANGLE DERMATOLOGY 3008 PICKETT RD DURHAM NC 27705 560960506 N/A 5400 0 WELLNESS GRANT NASH OB GYN ASSOCIATES 200 NASH MEDICAL ARTS MALL ROCKY MOUNT NC 27804 561032153 N/A 5250 0 WELLNESS GRANT 0 6 NORTH CAROLINA MEDICAL SOCIETY SPONSORING ORGANIZATION 428995 SERVICES RENDERED 0 FORM 990, PART VI, SECTION A, LINE 3 THE TRUST HIRED MEDICAL MUTUAL INSURANCE COMPANY OF NORTH CAROLINA TO MANAGE THE DAY-TO-DAY OPERATIONS PURSUANT TO A WRITTEN MANAGEMENT AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED AND APPROVED BY THE CHAIRMAN OF THE TRUST PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. THE STATEMENT IS REVIEWED FOR POTENTIAL AND POSSIBLE CONFLICTS OF INTEREST AND ANY SUCH FINDING IS FORWARDED TO THE CHAIRMAN AND SPONSOR. FORM 990, PART VI, SECTION C, LINE 19 THE TRUST'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE FILED WITH THE NORTH CAROLINA DEPARTMENT OF INSURANCE AND ARE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN NONADMITTED ASSETS -1,020,000. 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