ADP TOTALSOURCE INC HEALTH ANDWELFARE PLAN TRUST: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: ADP TOTALSOURCE INC HEALTH ANDWELFARE PLAN TRUST (EIN 20-7248306)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-09-26
IRS object ID: 201612709349300446
Schema version: 2015v2.1
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
Form 990
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-09-26T15:00:07-05:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE HORWATH LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	401 East Las Olas Blvd	AddressLine1Txt
Address Line2	Suite 1100	AddressLine2Txt
City	Fort Lauderdale	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	33301	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	207248306	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ADP TotalSource Inc H&W Trust	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ADPT	BusinessNameControlTxt
Phone	3056301000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10200 Sunset Drive	AddressLine1Txt
City	Miami	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	33173	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Cristian Orihuela	PersonNm
Person Title	Treasurer	PersonTitleTxt
Signature	2016-06-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BRITTNEY KOCAJ	PreparerPersonNm
PTIN	P01320603	PTIN
Phone	9542028600	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Cristian Orihuela	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10200 Sunset Drive	AddressLine1Txt
City	Miami	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	33173	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$27,920	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c	Yes (X)	Organization501cInd
Website Address	n/a	WebsiteAddressTxt
Type Of Organization Trust	Yes (X)	TypeOfOrganizationTrustInd
Formation	2007	FormationYr
Legal Domicile State	FL	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE FOR PAYMENT OF HEALTH BENEFIT EXPENSES FOR THE ADP TOTALSOURCE INC. HEALTH AND WELFARE PLAN.	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	5	TotalVolunteersCnt
Total Gross UBI	$262	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$2,365	PYProgramServiceRevenueAmt
CY Program Service Revenue	$27,658	CYProgramServiceRevenueAmt
PY Investment Income	$761	PYInvestmentIncomeAmt
CY Investment Income	$262	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$3,126	PYTotalRevenueAmt
CY Total Revenue	$27,920	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$13,511	PYOtherExpensesAmt
CY Other Expenses	$5,277	CYOtherExpensesAmt
PY Total Expenses	$13,511	PYTotalExpensesAmt
CY Total Expenses	$5,277	CYTotalExpensesAmt
PY Revenues Less Expenses	-$10,385	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$22,643	CYRevenuesLessExpensesAmt
Total Assets BOY	$8,800	TotalAssetsBOYAmt
Total Assets EOY	$31,443	TotalAssetsEOYAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$8,800	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$31,443	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE FOR PAYMENT OF HEALTH BENEFIT EXPENSES FOR THE ADP TOTALSOURCE, INC. HEALTH AND WELFARE PLAN.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Desc	THE EXCLUSIVE PURPOSE OF ADP TOTALSOURCE, INC. HEALTH AND WELFARE PLAN TRUST IS TO PROVIDE WELFARE BENEFITS TO THOSE PERSONS WHO QUALIFY AS PARTICIPANTS UNDER THE PLAN AND THEIR ELIGIBLE DEPENDENTS COVERED BY THE PLAN WHO ARE IN NEED OF WELFARE BENEFIT COVERAGE AFTER MEETING ANY APPLICABLE ELIGIBILITY REQUIREMENTS DESCRIBED IN THE PLAN.	Desc
Total Program Service Expenses	$0	TotalProgramServiceExpensesAmt
Described In Section501c3	false	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	false	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	false	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	false	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	false	ConflictOfInterestPolicyInd
Whistleblower Policy	false	WhistleblowerPolicyInd
Document Retention Policy	false	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Cristian Orihuela	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3056301000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10200 Sunset Drive	AddressLine1Txt
City	Miami	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	33173	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
SERGIO FERNANDEZ
TRUSTEE	1.0	Yes (X)	$0	$0	$0
MARK ACQUADRO
TRUSTEE	1.0	Yes (X)	$0	$0	$0
MARIA BLACK
TRUSTEE	1.0	Yes (X)	$0	$0	$0
ART BAUMMAN
TRUSTEE	1.0	Yes (X)	$0	$0	$0
CRISTIAN ORIHUELA
TRUSTEE	1.0	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Total Contributions	$0	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	INSURANCE REIMBURSEMENTS	Desc
Business	900099	BusinessCd
Total Revenue Column	$27,658	TotalRevenueColumnAmt
Related Or Exempt Func Income	$27,658	RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$27,658	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$262	TotalRevenueColumnAmt
Unrelated Business Revenue	$262	UnrelatedBusinessRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$27,920	TotalRevenueColumnAmt
Related Or Exempt Func Income	$27,658	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$262	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,925	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,352	TotalAmt

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,277	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$8,800	BOYAmt
EOY	$31,443	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$0	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$0	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,800	BOYAmt
EOY	$31,443	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Org Does Not Follow SFAS117	Yes (X)	OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$8,800	BOYAmt
EOY	$31,443	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,800	BOYAmt
EOY	$31,443	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,800	BOYAmt
EOY	$31,443	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$22,643	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 15a COMPENSATION OF TOP MANAGEMENT OFFICIAL	THE ORGANIZATION DOES NOT HAVE A TOP MANAGEMENT OFFICIAL THAT RECEIVES COMPENSATION. THEREFORE THIS QUESTION IS ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 15b COMPENSATION OF TOP MANAGEMENT OFFICIAL	THE ORGANIZATION DOES NOT HAVE ANY OTHER OFFICERS THAT RECEIVE COMPENSATION. THEREFORE THIS QUESTION IS ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body	THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THEREFORE, THE QUESTION IS ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE RETURN IS PREPARED BY A THIRD PARTY TAX RETURN PREPARER, THEN THE RETURN IS REVIEWED INTERNALLY BY THE LEGAL DEPARTMENT OF ADP TOTALSOURCE, INC. FOR ACCURACY. A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE GOVERNING BODY.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION DOES NOT HAVE A CONFLICT OF INTEREST POLICY.