Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| 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 CHECK 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 11 | INCLUDED IN DISCUSSION ABOVE |
| FORM 990, PART VI, SECTION C, LINE 19 | SEE DISCUSSION ABOVE. |
| FORM 990, PART XI, LINE 9: | CHANGE IN HEALTH CLAIMS PAYABLE 64,059. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT THAT AUDITED THE STATEMENTS WAS REVIEWED BY THE DIRECTOR OF HUMAN RESOURCES AND THE CFO/PLAN ADMINISTRATOR. THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
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