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TENNESSEE CAPTIVE INSURANCE ASSOCIATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
TENNESSEE CAPTIVE INSURANCE ASSOCIATION (EIN 45-2882002)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201823179349302852
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-13T10:42:01-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN721396621PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CARR RIGGS & INGRAM LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13011 ARMORY DRIVE SUITE 190AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN452882002EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TENNESSEE CAPTIVE INSURANCEBusinessNameLine1Txt
Business Name Line2ASSOCIATION INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlTENNBusinessNameControlTxt
Phone8886683188PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1533 CHURCH STREET NO 222AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37219ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBELINDA FORTMANPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4195315531PhoneNum
Signature2018-11-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANN M HAMZAPreparerPersonNm
PTINP10275296PTIN
Phone6156651811PhoneNum
Preparation2018-11-09PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address12.180.254.146IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-09IPDt
IP Tm10:22:59IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdFDBEDA3726D2251A942D7BBA229A5246B179863CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBELINDA FORTMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1533 CHURCH STREET NO 222AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37219ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$227,815GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressWWW.TNCAPTIVES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionTHE TENNESSEE CAPTIVE INSURANCE ASSOCIATION'S PRIMARY PURPOSE IS TO PROMOTE THE GROWTH OF THE CAPTIVE INSURANCE INDUSTRY IN THE STATE OF TENNESSEE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$201,775PYProgramServiceRevenueAmt
CY Program Service Revenue$227,815CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$201,775PYTotalRevenueAmt
CY Total Revenue$227,815CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$187,641PYOtherExpensesAmt
CY Other Expenses$212,392CYOtherExpensesAmt
PY Total Expenses$187,641PYTotalExpensesAmt
CY Total Expenses$212,392CYTotalExpensesAmt
PY Revenues Less Expenses$14,134PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$15,423CYRevenuesLessExpensesAmt
Total Assets BOY$92,841TotalAssetsBOYAmt
Total Assets EOY$94,810TotalAssetsEOYAmt
Total Liabilities BOY$28,418TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,964TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$64,423NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$79,846NetAssetsOrFundBalancesEOYAmt
MissionTHE TENNESSEE CAPTIVE INSURANCE ASSOCIATION'S PRIMARY PURPOSE IS TO PROMOTE THE GROWTH OF THE CAPTIVE INSURANCE INDUSTRY IN THE STATE OF TENNESSEE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescEDUCATIONAL EVENTS: THE ORGANIZATION'S PROFESSIONAL CONTRACTOR AND ELECTED LEADERSHIP PRODUCE EDUCATIONAL EVENTS DESIGNED TO INFORM ATTENDEES ON HOW TO ESTABLISH AND OPERATE INSURANCE COMPANIES IN THE STATE OF TENNESSEE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescPROMOTION: THE ORGANIZATION'S PROFESSIONAL CONTRACTOR AND ELECTED LEADERSHIP WILL PRODUCE AND DISTRIBUTE INFORMATION TO BUSINESS EXECUTIVES NATIONWIDE ENCOURAGING THEM TO CONSIDER ESTABLISHING CAPTIVE INSURANCE COMPANIES IN TENNESSEE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescLEGISLATIVE/REGULATORY ADVOCACY: THE ORGANIZATION'S PROFESSIONAL CONTRACTOR AND ELECTED LEADERSHIP SHALL ADVOCATE FOR THE BUSINESS INTEREST OF ITS MEMBERS BEFORE THE TENNESSEE STATE LEGISLATURE AND STATE REGULATORY AGENCIES.Desc
FieldValueIRS element (for citing)
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy TaxYes (1)SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIFER IVY CALMETTO MGTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8886683188PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14310 THERMAL DRAddressLine1Txt
CityMIDLANDCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28107ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KEVIN DOHERTY
CHAIRMAN/PRESIDENT/DIRECTO2.00Yes (X)Yes (X)$0$0$0
WM GARY GREENE
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
BILL BEELER
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
SHIRLEY FULLER COOPER
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
MARY FRANCIS MILLER
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
ANDREW CLAYTON
SECRETARY2.00Yes (X)Yes (X)$0$0$0
BELINDA FORTMAN
TREASURER2.00Yes (X)Yes (X)$0$0$0
SCOTT STONE
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
ANDY RHEA
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ANNUAL CONFERENCE900099$116,535$116,535
MEMBERSHIP DUES900099$68,200$68,200
NETWORKING EVENTS900099$43,080$43,080
FieldValueIRS element (for citing)
Total Program Service Revenue$227,815TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$227,815TotalRevenueColumnAmt
Related Or Exempt Func Income$227,815RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$105,407TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,200TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,237TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,621TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,815TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,328TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$63,517TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,994TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmt
NETWORKING EVENTS$13,071
GENERAL ADMINISTRATION$7,867
BOARD OF DIRECTORS$1,075
COMMITTEES$260

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$212,392TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$73,381BOYAmt
EOY$74,210EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$19,460BOYAmt
EOY$20,600EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$92,841BOYAmt
EOY$94,810EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$18,263BOYAmt
EOY$3,592EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,850BOYAmt
EOY$1,350EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,305BOYAmt
EOY$10,022EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,418BOYAmt
EOY$14,964EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$64,423BOYAmt
EOY$79,846EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,423BOYAmt
EOY$79,846EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,841BOYAmt
EOY$94,810EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$15,423ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (1)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS Audited0FSAuditedInd
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Substantially All Dues Nonded0SubstantiallyAllDuesNondedInd
Only In House LobbyingYes (1)OnlyInHouseLobbyingInd
Agree Carryover Prior Year0AgreeCarryoverPriorYearInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescMANAGEMENT FEE ACCRUALDesc
Amt$10,022Amt
FieldValueIRS element (for citing)
Total Liability$10,022TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION UTILIZES A MANAGEMENT COMPANY FOR ALL ACTIVITIES.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION WILL PROVIDE A COPY OF THE FORM 990 TO ITS BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST BELINDA FOREMAN 533 CHURCH STREET #222 NASHVILLE, TN 37219
FORM 990, PART XII, LINE 2C:THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE COMPILATION OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.