2025-09-15T17:04:26-05:00 2024-12-31 621199757 LBMC PC PO BOX 1869 BRENTWOOD TN 370241869 990 2024-01-01 822427358 FLORIDA BANKERS HEALTH CONSORTIUM INC FLOR 4073330088 1201 S ORLANDO AVE 450 WINTER PARK FL 32789 JESSICA MARTINEZ CONTROLLER 4073330088 2025-09-15 1 1 ABIGAIL CAMPBELL P01296738 6153774600 2025-09-11 2024 2025-03-06 01:10:19Z ADELLA SALINAS 300 PRIMERA BLVD 140 LAKE MARY FL 32746 26159940 0 X HTTPS://FLBANKHEALTH.COM/ X 2017 FL TO PROVIDE GROUP INSURANCE BENEFITS FOR THE EMPLOYEES OF ITS PARTICIPATING MEMBERS. 7 6 0 0 0 0 0 0 25932502 25774928 41078 6408 184388 378604 26157968 26159940 0 0 0 0 0 0 0 0 0 26643214 25873726 26643214 25873726 -485246 286214 2065429 1504871 216255 572300 1849174 932571 TO PROVIDE GROUP INSURANCE BENEFITS FOR THE EMPLOYEES OF ITS PARTICIPATING MEMBERS. 0 0 TO PROVIDE GROUP INSURANCE BENEFITS FOR THE EMPLOYEES OF ITS PARTICIPATING MEMBERS. 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 0 1 1 0 0 0 1 0 0 0 0 0 0 0 X JESSICA MARTINEZ 4073330088 1201 S ORLANDO AVE 450 WINTER PARK FL 32789 X SANDRA CREYAUFMILLER TRUSTEE 1.00 X 0 0 0 GREGORY L NELSON TRUSTEE 1.00 X 0 0 0 RAY D COLADO TRUSTEE 1.00 X 0 0 0 PAMELA P RICCO TRUSTEE 1.00 X 0 0 0 LLYOD DEVAUX TRUSTEE 1.00 X 0 0 0 PAMELA GASS TRUSTEE 1.00 X 0 0 0 ADELLA SALINAS CEO 40.00 X 0 0 0 JESSICA MARTINEZ CONTROLLER-PARTIAL YEAR 40.00 X 0 0 0 JULIUS WALKER CONTROLLER-PARTIAL YEAR 40.00 X 0 0 0 0 0 0 0 0 0 0 0 PREMIUMS EARNED 524298 25774928 25774928 25774928 6408 6408 OTHER INCOME 900099 378604 378604 378604 26159940 26153532 0 6408 23358 23095 5500 806 52329 PREMIUMS PAID 25768638 25873726 50 2050191 1454276 10159 44801 5079 5744 2065429 1504871 216255 572300 216255 572300 X 0 0 1243299 40482 605875 892089 1849174 932571 2065429 1504871 X 286214 -1202817 X 0 1 X 0 0 0 X 26159940 0 26159940 0 26159940 25873726 0 25873726 0 25873726 PART X, LINE 2: THE PLAN WAS ESTABLISHED AS A VOLUNTARY EMPLOYEE BENEFIT ASSOCIATION WITHIN THE MEANING OF SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE ("IRC") OF 1986. THE PLAN RECEIVED A DETERMINATION LETTER DATED SEPTEMBER 17, 2018, WHICH STATED THAT THE PLAN WAS IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEREFORE, THE TRUST IS EXEMPT FROM INCOME TAX, BUT IS REQUIRED TO FILE AN ANNUAL INFORMATION RETURN. THE PLAN IS ALSO REQUIRED TO FILE AN ANNUAL RETURN/REPORT WITH THE DEPARTMENT OF LABOR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERS CONSIST OF THE PARTICIPATING BANKS IN FLORIDA WHO HAVE CONSOLIDATED UNDER ONE ENTITY TO PROVIDE HEALTH BENEFITS TO THEIR EMPLOYEES AND ELIGIBLE DEPENDENTS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS SHALL HAVE THE RIGHT TO APPOINT OR ELECT TRUSTEES OR ALTERNATES TO VACANCIES AMONG THEIR RESPECTIVELY ELECTED TRUSTEES FOR ANY REASON. A TRUSTEE MUST BE AN EMPLOYEE OF A MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE CONTROLLER HAS BEEN DELEGATED THE AUTHORITY TO REVIEW AND FILE THE FORM 990 AND SUBSEQUENT TO THE FILING, IT IS DISTRIBUTED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES,FINANCIAL STATEMENTS AND FORM 990 ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: RETURN OF SELF-INSURED CAPITAL AND SURPLUS -1,202,817.