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CCA OF TENNESSEE LLC EMPLOYEEBENEFIT TRUST: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CCA OF TENNESSEE LLC EMPLOYEEBENEFIT TRUST (EIN 20-4970215)
Tax period
2010-04-01 to 2011-03-31
Filed
2011-11-07
IRS object ID
201133119349301413
Schema version
2010v3.4
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)
Timestamp2011-11-07T15:22:12-05:00Timestamp
Tax Period End Date2011-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Pope Shamsie & Dooley LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14201 W Parmer B-200AddressLine1
CityAustinCity
StateTXState
ZIP Code78727ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204970215EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CCA of Tennessee LLC Employee Benefit TrustBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCCAONameControl
Phone5126527574Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 BURTIN HILLS BLVDAddressLine1
Address Line2C/O TRISH BARNARDAddressLine2
CityNashvilleCity
StateTNState
ZIP Code37215ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCliff LangwithName
TitleVP for Comerica Bank, TrusteeTitle
Date Signed2011-11-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameRichard DooleyName
Phone5128361186Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCliff Langwith - Comerica BankNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line18850 Boedeker St 5th FloorAddressLine1
CityDallasCity
StateTXState
ZIP Code75225ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18204808GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation2005YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionVoluntary employees' beneficiary trust providing for the payment of life and medical benefits to current and elegible former cca employees and their dependents.ActivityOrMissionDescription
Nbr Voting Members Governing Body1NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17319482ProgramServiceRevenuePriorYear
Program Service Revenue CY18204348ProgramServiceRevenueCY
Investment Income Prior Year1625InvestmentIncomePriorYear
Investment Income Current Year460InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year17321107TotalRevenuePriorYear
Total Revenue Current Year18204808TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year17316669BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY18185808BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7391OtherExpensePriorYear
Other Expenses Current Year35000OtherExpensesCurrentYear
Total Expenses Prior Year17324060TotalExpensesPriorYear
Total Expenses Current Year18220808TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2953RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-16000RevenuesLessExpensesCY
Total Assets BOY1753944TotalAssetsBOY
Total Assets EOY1668182TotalAssetsEOY
Total Liabilities BOY-2259700TotalLiabilitiesBOY
Total Liabilities EOY-1188028TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4013644NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2856210NetAssetsOrFundBalancesEOY
Mission DescriptionCCA OF TENNESSEE LLC EMPLOYEE BENEFIT TRUST IS A VOLUNTARY EMPLOYEES' BENEFICIARY TRUST THAT PROVIDES FOR THE PAYMENT OF LIFE AND MEDICAL BENEFITS TO CURRENT AND ELIGIBLE FORMER CCA EMPLOYEES AND THEIR DEPENDENTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense18185808Expense
Revenue18204348Revenue
DescriptionProviding for the payment of life and medical benefits to current and eligible former CCA employees and their dependants.Description
Total Program Service Expense18185808TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members1NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDIANA PETAIANamePerson
Telephone Number5126527593TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16300 BRIDGEPOINT PKY BLDG 3AddressLine1
CityaustinCity
StateTXState
ZIP Code78730ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA

FieldValueIRS element (for citing)
Name PersonCOMERICA BANKNamePerson
TitleVP & Trust OfficerTitle
Institutional TrusteeXInstitutionalTrustee
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonBlue Cross Blue ShieldNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line185 North Danny Thomas BoulevardAddressLine1
CityMEMPHISCity
StateTXState
ZIP Code381032398ZIPCode
FieldValueIRS element (for citing)
Description Of Servicesclaims processingDescriptionOfServices
Compensation9021525Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionCONTRIBUTIONSDescription
Total Revenue Column18204348TotalRevenueColumn
Related Or Exempt Function Income18204348RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue18204348TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column460TotalRevenueColumn
Exclusion$460ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18204808TotalRevenueColumn
Related Or Exempt Function Income18204348RelatedOrExemptFunctionIncome
Exclusion$460ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total18185808Total
Program Services18185808ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
BANK CHARGES30003000
AUDIT EXPENSE3200032000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18220808Total
Program Services18185808ProgramServices
Management And General35000ManagementAndGeneral

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1753944BOY
EOY1668182EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1753944BOY
EOY1668182EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY-2259700BOY
EOY-1188028EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY-2259700BOY
EOY-1188028EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY9111850BOY
EOY7970416EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-5098206BOY
EOY-5114206EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4013644BOY
EOY2856210EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1753944BOY
EOY1668182EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-16000ReconcilationRevenueExpenses
Reconcilation Other Changes-1141434ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Total Revenue18204808TotalRevenue
Total Expenses18220808TotalExpenses
Excess Or Deficit For Year-16000ExcessOrDeficitForYear
Excess Or Deficit Per FS-16000ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt18204808TotRevenueEtcAuditedFinclStmt
Revenue Subtotal18204808RevenueSubtotal
Total Revenue Per Form99018204808TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18220808TotExpensesEtcAuditedFinclStmt
Expenses Subtotal18220808ExpensesSubtotal
Total Expenses Per Form99018220808TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part VI, Section B, Question 11APart VI, Section B, Question 11ATrustee reviews Form 990 prior to filing.
Part VI, Section B, Question 12cPart VI, Section B, Question 12cAnnual conflict of interest statement reviewed
Part VI, Section B, Question 19Part VI, Section B, Question 19Available Upon Request

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CCA of Tennessee LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110 Burton Hills BlvdAddressLine1
CityNashvilleCity
StateTNState
ZIP Code37215ZIPCode
FieldValueIRS element (for citing)
EIN621806755EIN
Primary ActivityCorrectionalPrimaryActivity
Legal Domicile StateTNLegalDomicileState
Type Of EntityLLCTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg