STRATEGY STUDIO / PUBLIC DATA EXPLORER

DAVIDSON HOTEL COMPANY HEALTH CARE TRUST: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
DAVIDSON HOTEL COMPANY HEALTH CARE TRUST (EIN 62-6176418)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201623209349302857
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T09:13:48-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN454084437PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Warren Averett LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1Six Concourse Parkway Suite 600AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30328ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN626176418EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVIDSON HOTEL COMPANY EMPLOYEE HEALTHBusinessNameLine1Txt
Business Name Line2CARE TRUSTBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlDAVIBusinessNameControlTxt
Phone6783490909PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Ravina Drive No 1600AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30346ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBARRY WABLERPersonNm
Person TitleCFOPersonTitleTxt
Phone6783490909PhoneNum
Signature2016-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan HillPreparerPersonNm
PTINP00846200PTIN
Phone7703961100PhoneNum
Preparation2016-11-14PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBARRY WABLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE RAVINA DRIVE NO 1600AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30346ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$21,273,970GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization TrustYes (X)TypeOfOrganizationTrustInd
Formation1983FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionVOLUNTARY EMPLOYEE BENEFIT ASSOCIATION - A PROGRAM TO PROVIDE COMPREHENSIVE HEALTH CAREActivityOrMissionDesc
Voting Members Governing Body0VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
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$23,064,946PYProgramServiceRevenueAmt
CY Program Service Revenue$21,273,970CYProgramServiceRevenueAmt
PY Investment Income$86,000PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$23,150,946PYTotalRevenueAmt
CY Total Revenue$21,273,970CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$20,129,095PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$18,352,778CYBenefitsPaidToMembersAmt
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$4,379,884PYOtherExpensesAmt
CY Other Expenses$4,745,751CYOtherExpensesAmt
PY Total Expenses$24,508,979PYTotalExpensesAmt
CY Total Expenses$23,098,529CYTotalExpensesAmt
PY Revenues Less Expenses-$1,358,033PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,824,559CYRevenuesLessExpensesAmt
Total Assets BOY$9,033,601TotalAssetsBOYAmt
Total Assets EOY$7,124,682TotalAssetsEOYAmt
Total Liabilities BOY$808,303TotalLiabilitiesBOYAmt
Total Liabilities EOY$723,943TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,225,298NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,400,739NetAssetsOrFundBalancesEOYAmt
MissionVOLUNTARY EMPLOYEE BENEFIT ASSOCIATION - A PROGRAM TO PROVIDE COMPREHENSIVE HEALTH CAREMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$23,098,529ExpenseAmt
Revenue$21,273,970RevenueAmt
DescVOLUNTARY EMPLOYEE BENEFIT ASSOCIATION - A PROGRAM TO PROVIDE COMPREHENSIVE HEALTH CAREDesc
Total Program Service Expenses$23,098,529TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
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 Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
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 EntityYes (1)RelatedEntityInd
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
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members0GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing Body0MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
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
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BARRY WABLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6783490909PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE RAVINA DRIVE NO 1600AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30346ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp

FieldValueIRS element (for citing)
PersonBarry WablerPersonNm
TitleTrusteeTitleTxt
Average Hours Per Week5.00AverageHoursPerWeekRt
Individual Trustee Or DirectorYes (X)IndividualTrusteeOrDirectorInd
Reportable Comp From Org$0ReportableCompFromOrgAmt
Reportable Comp From Rltd Org$0ReportableCompFromRltdOrgAmt
Other Compensation$0OtherCompensationAmt
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

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AETNA
PO Box 88863ChicagoIL60695ADMINISTRATIVE FEES$2,568,116
Unum Life Insurance of America
PO Box 406955AtlantaGA30384AdMINISTRATIVE FEES$303,505
MC & H LIFE AGENCY INC
8144 WALNUT HILL LANE 16th FloorDALLASTX75231CONSULTING FEES$295,999
Eligibility Tracking Calculations LLC
14607 San Pedro Avenue Suite 155San AntonioTX78232AdminISTRATIVE FEES$111,990
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescEMPLOYER/EMPLOYEE CONTRIBUTIONSDesc
Business525100BusinessCd
Total Revenue Column$21,273,970TotalRevenueColumnAmt
Related Or Exempt Func Income$21,273,970RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$21,273,970TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,273,970TotalRevenueColumnAmt
Related Or Exempt Func Income$21,273,970RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$18,352,778TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,286TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,252,382TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescPREMIUMS PAIDDesc
Total$2,470,083TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$23,098,529TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,997,103BOYAmt
EOY$6,517,853EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$36,498BOYAmt
EOY$606,829EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,033,601BOYAmt
EOY$7,124,682EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$808,303BOYAmt
EOY$723,943EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$808,303BOYAmt
EOY$723,943EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$8,225,298BOYAmt
EOY$6,400,739EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,225,298BOYAmt
EOY$6,400,739EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,033,601BOYAmt
EOY$7,124,682EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,824,559ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$21,273,970TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$21,273,970RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$21,273,970TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$23,098,529TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$23,098,529ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$23,098,529TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationGAAP requires plan management to evaluate tax positions taken by the Plan and recognize a tax liability if the Plan has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. The Plan is subject to routine audits by taxing jurisdictions, including the IRS. The Plan is not currently under IRS examination for any Plan years. The Trust has filed Form 990 and the Plan has filed Form 5500, which are the annual returns for the Trust and the health care benefit plan, respectively, for all years through December 31, 2014. Years December 31, 2012, and subsequent remain subject to audit by taxing authorities.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2THE ONE BOARD MEMBER ALSO SERVES AS AN OFFICER OF ANOTHER BUSINESS
Form 990, Part VI, Section A, line 8aDAVIDSON HOTEL COMPANY EMPLOYEE HEALTH CARE TRUST IS A TRUST, ALL MEETINGS ARE HELD AT CORPORATE LEVEL
Form 990, Part VI, Section A, line 8bDAVIDSON HOTEL COMPANY EMPLOYEE HEALTH CARE TRUST IS A TRUST, ALL MEETINGS ARE HELD AT CORPORATE LEVEL
Form 990, Part VI, Section B, line 11A COPY OF THE 990 DRAFT WAS PROVIDED TO THE TRUSTEE PRIOR TO FILING WITH THE IRS
Form 990, Part VI, Section C, line 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST
Form 990 Part IX, Line 11gAdministrative Fees= $1,433,263 Consulting Fees=$337,420 Miscellaneous Fees= $1,500 ACA Reinsurance Fee= $480,199

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DAVIDSON HOTEL CO LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE RAVINA DRIVE NO 1600AddressLine1Txt
CityatlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30346ZIPCd
FieldValueIRS element (for citing)
EIN475394301EIN
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd