2016-03-08T13:31:09-06:00 2015-07-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2014-08-01 467521485 ND Banks Benefit Trust NDBA 7012235303 122 East Main Ave Ste 201 Bismarck ND 58501 Angi Day Benefits Coordinator 7012235303 2016-02-26 1 LISA CHAFFEE CPA P00193453 7012398500 2016-02-26 2014 2016-08-17 19:52:53Z X Angi Day 122 East Main Ave Ste 201 Bismarck ND 58501 11181380 0 X N/A X Trust 2014 ND To provide and maintain those benefits which the Benefit Plan Trustees, in its sole discretion, determines form time-to-time shall be provided and as are specified in the Plan Document and for payment, in accordance with ERISA, of reasonable expenses incurred in the administration of the Plan. 9 9 0 9 1023 23 0 11180357 1023 0 11181380 0 6927094 0 0 0 2142110 9069204 2112176 2421328 309152 2112176 None 0 0 As of July 31, 2015, the ND Banks Benefit Trust covered approximately 3,047 persons for Health Insurance. In addition approximately 1,403 persons were covered for Dental Insurance and approximately 950 persons covered for Vision Insurance at end of year. There were a total of 57 participating banks in the Trust. 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 1 0 0 1 0 0 0 1 1 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 X Angi Day 7012235303 122 E Main Ave Ste 201 Bismarck ND 58501 X Todd Heilman Chairman 0.10 40.00 X X 0 0 0 Pam Binder Vice Chairman 0.10 40.00 X X 0 0 0 Sarah Getzlaff Treasurer 0.10 40.00 X X 0 0 0 Ilene Baker Trustee 0.10 40.00 X 0 0 0 Rick Beall Jr Trustee 0.10 40.00 X 0 0 0 Nancy Peterson Trustee 0.10 40.00 X 0 0 0 Bonnie Dahl Trustee 0.10 40.00 X 0 0 0 Rick Clayburgh Trustee 0.10 40.00 X 0 0 0 John Brown Trustee (thru Dec.) 0.10 40.00 X 0 0 0 Barry Haugen Trustee (from Jan) 0.10 40.00 X 0 0 0 0 0 0 0 0 0 0 Blue Cross Blue Shield of North Dakota 4510 13th Ave S Fargo ND 58121 Administrative fees 246883 1 Member Contributions 900001 11180357 11180357 11180357 1023 1023 11181380 11180357 1023 0 6927094 792480 18685 600 1639 766 1557 14079 Stop Loss Fees 1183190 Affordable Care Act 65138 Trustee Expense 629 63347 9069204 2381721 39607 0 2421328 62181 246971 0 309152 X 0 0 0 0 0 2112176 0 2112176 0 2421328 2112176 0 X 0 1 X 0 0 0 X 11181380 0 11181380 0 11181380 9069204 0 9069204 0 9069204 Part X, Line 2: The Trust established under the Plan to hold the Plan's assets received an exemption letter from the Internal Revenue Service dated October 30, 2014, stating that the Trust is qualified pursuant to Section 501(c)(9) of the Internal Revenue Code. In addition, the Plan and the Trust are required to operate in conformity with the IRC to maintain the tax-exempt status of the Trust. The Plan Administrator believes that the Plan is being operated in compliance with the applicable requirements of the IRC and, therefore, believes that the related Trust is tax-exempt. Accounting principles generally accepted in the United States of America require trust management to evaluate tax positions taken by the trust and recognize a tax liability (or asset) if the trust has taken an uncertain tax position that more likely than not would not be sustained upon examination of the Internal Revenue Service. The trust is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The trust administrator believes it is subject to income tax examinations since inception. Form 990, Part VI, Section A, line 8b There are no committees that are able to act on behalf of the board. Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the board at a board meeting prior to being filed. Form 990, Part VI, Section C, line 19 The organization does not make its governing documents and financial statements available to the public. North Dakota Bankers Association PO Box 1438 Bismarck ND 585021438 450172930 Provide education to its members and promote the banking industry ND 501(c)(6) N/A 0 Independent Community Banks of North Dakota PO Box 6128 Bismarck ND 585066128 450338033 To provide information, seminars, and education for member banks ND 501(c)(6) N/A 0 FIRST STATE BANK OF ND FIRST UNITED BANK RAMSEY NATIONAL BANK UNITED COMMUNITY BANK OF ND DAKOTA WESTERN BANK GARRISON STATE BANK HUNTER HOLDING COMPANY CORNERSTONE BANK NORTHLAND FINANCIAL CITIZENS STATE BANK OF MIDWEST SECURITY FIRST BANK OF ND LAKESIDE STATE BANK UNITED VALLEY BANK PEOPLES STATE BANK - WESTHOPE FIRST NATIONAL BANK - MILNOR KODABANK CITIZENS STATE BANK MCKENZIE COUNTY BANK MCINTOSH COUNTY BANK STRASBURG STATE BANK PEOPLES STATE BANK - VELVA FIRST STATE BANK OF CANDO STATE BANK OF BOTTINEAU UNION STATE BANK FIRST NATIONAL BANK - BOTTINEAU UNION STATE BANK COMMERCIAL BANK OF MOTT HEARTLAND STATE BANK UNION BANK SARGENT COUNTY BANK SECURITY STATE BANK FIRST STATE BANK EMPLOYEES - HARVEY LIBERTY STATE BANK MERCHANTS BANK FIRST STATE BANK - BEACH LINCOLN STATE BANK CITIZENS STATE BANK STOCK GROWERS BANK GRANT COUNTY STATE BANK FARMERS SECURITY BANK BANK OF GLEN ULLIN KINDRED STATE BANK STATE BANK OF LAKOTA BANK OF HAZELTON INDEPENDENT COMMUNITY BANK HARWOOD STATE BANK BANK OF TURTLE LAKE BANK OF HAMILTON SECURITY FIRST BANK OF ND FARMERS & MERCHANTS BANK - FARGO THE BANK OF TIOGA FIRST SECURITY BANK WEST ND BANKERS ASSOCIATION QUALITY BANK PEOPLES STATE BANK - FAIRMOUNT STATE BANK OF BOTTINEAU INS AGENCY FARMERS STATE BANK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1